HOSPITAL_EIN CMS_PROVIDER_NUMBER HOSPITAL_NAME PATIENT_TYPE SERVICE_TYPE PROC_CODE MS_DRG EST_TOTAL_CHARGE MINIMUM_PAYMENT AVERAGE_PAYMENT MAXIMUM_PAYMENT PRIMARY_SERVICE_CHARGE PRICE_TRANS_REQ_SERVICE SERVICE_DESCRIPTION PDF_REPORT_SORT 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 282 14594 3072 6481 10041 "Acute Myocardial Infarction (AMI), heart attack - Low Acuity" 1 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 281 16165 7912 8787 8967 "Acute Myocardial Infarction (AMI), heart attack - Mid Acuity" 2 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 280 22690 10892 14165 22137 "Acute Myocardial Infarction (AMI), heart attack - High Acuity" 3 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 310 14972 4221 5842 12394 Cardiac arrhythmia (irregular heartbeat) & conduction disorders - Low Acuity 4 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 309 17416 2348 7410 13000 Cardiac arrhythmia (irregular heartbeat) & conduction disorders - Mid Acuity 5 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 308 17728 7294 11333 16064 Cardiac arrhythmia (irregular heartbeat) & conduction disorders - High Acuity 6 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 313 17193 3620 6114 11712 "Chest pain, sharp pain to dull ache crushing or burning feeling - Low Acuity" 7 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 293 15833 4559 6421 6921 "Heart Failure (HF) & shock, heart is not pumping blood well - Low Acuity" 8 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 292 17216 7659 8423 9341 "Heart Failure (HF) & shock, heart is not pumping blood well - Mid Acuity" 9 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 291 19748 8867 11977 14444 "Heart Failure (HF) & shock, heart is not pumping blood well - High Acuity" 10 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 305 20537 5008 7052 12479 "Hypertension, high blood pressure - Low Acuity" 11 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 304 20492 5347 9816 10710 "Hypertension, high blood pressure - High Acuity" 12 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 301 11589 5163 6326 8046 "Peripheral Vascular Disorders, circulation outside heart and brain - Low Acuity" 13 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 300 17698 6682 9037 10435 "Peripheral Vascular Disorders, circulation outside heart and brain - Mid Acuity" 14 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 299 20098 2146 11565 15122 "Peripheral Vascular Disorders, circulation outside heart and brain - High Acuity" 15 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 312 19953 4895 8191 17666 Syncope (fainting) & collapse - Low Acuity 16 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 316 23294 5734 6615 7496 Other circulatory system diagnoses - Low Acuity 17 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 315 22396 9352 9441 9589 Other circulatory system diagnoses - Mid Acuity 18 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 314 23360 10758 16667 19621 Other circulatory system diagnoses - High Acuity 19 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 392 15474 4950 7163 12085 "Esophagitis, gastrointestinal & other digestive disorders - Low Acuity" 20 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 391 23630 7259 12500 23630 "Esophagitis, gastrointestinal & other digestive disorders - High Acuity" 21 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 378 17799 5642 8646 9523 Gastrointestinal (GI) hemorrhage - Mid Acuity 22 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 377 16327 7860 11324 14283 Gastrointestinal (GI) hemorrhage - High Acuity 23 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 390 15082 3275 5790 10980 Gastrointestinal (GI) obstruction - Low Acuity 24 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 389 15543 5280 7634 7950 Gastrointestinal (GI) obstruction - Mid Acuity 25 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 388 20218 11436 14197 20218 Gastrointestinal (GI) obstruction - High Acuity 26 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 373 15809 5312 7965 12360 Major gastrointestinal disorders & peritoneal infections - Low Acuity 27 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 372 28089 7344 9542 10042 Major gastrointestinal disorders & peritoneal infections - Mid Acuity 28 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 371 38338 11371 13484 15598 Major gastrointestinal disorders & peritoneal infections - High Acuity 29 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 395 14848 5032 7057 11383 Other digestive system diagnoses - Low Acuity 30 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 394 16284 5313 8649 13944 Other digestive system diagnoses - Mid Acuity 31 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 393 16009 8852 13749 15746 Other digestive system diagnoses - High Acuity 32 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 639 12946 5649 6065 7603 Diabetes (diseases that affect how your body uses blood sugar) - Low Acuity 33 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 638 18649 6316 8021 8988 Diabetes (diseases that affect how your body uses blood sugar) - Mid Acuity 34 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 637 19545 6929 11319 13750 Diabetes (diseases that affect how your body uses blood sugar) - High Acuity 35 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 641 15987 4357 7324 11250 "Disorders of nutrition, metabolism, fluids, electrolytes - Low Acuity" 36 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 640 17914 8108 11041 12660 "Disorders of nutrition, metabolism, fluids, electrolytes - High Acuity" 37 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 690 17556 3232 7391 12669 Kidney & Urinary Tract Infections (UTI) - Low Acuity 38 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 689 21977 6401 9987 12256 Kidney & Urinary Tract Infections (UTI) - High Acuity 39 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 684 10251 5141 5653 6559 Kidney (Renal) Failure - Low Acuity 40 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 683 16154 5544 8218 15104 Kidney (Renal) Failure - Mid Acuity 41 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 682 24094 8890 13406 15494 Kidney (Renal) Failure - High Acuity 42 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 699 15713 7672 9023 11384 Other kidney & urinary tract diagnoses - Mid Acuity 43 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 698 21806 8939 12605 14550 Other kidney & urinary tract diagnoses - High Acuity 44 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 433 16000 6741 8750 10791 Cirrhosis & alcoholic hepatitis - Mid Acuity 45 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 432 17914 8552 11672 17914 Cirrhosis & alcoholic hepatitis - High Acuity 46 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 443 14897 4931 6291 6745 "Disorders of liver except malignancy, cirrhosis, alcoholic hepatitis - Low Acuity" 47 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 442 16067 7348 8829 9528 "Disorders of liver except malignancy, cirrhosis, alcoholic hepatitis - Mid Acuity" 48 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 441 16672 10447 12943 16672 "Disorders of liver except malignancy, cirrhosis, alcoholic hepatitis - High Acuity" 49 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 440 12920 5299 6120 7378 Disorders of pancreas except malignancy - Low Acuity 50 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 439 19173 6360 9199 15090 Disorders of pancreas except malignancy - Mid Acuity 51 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 438 26731 6380 9944 15774 Disorders of pancreas except malignancy - High Acuity 52 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 536 15721 5306 6869 7433 Fractures of hip & pelvis - Low Acuity 53 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 552 21296 5515 8438 12175 Medical back problems - Low Acuity 54 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 551 30615 14922 15676 17526 Medical back problems - High Acuity 55 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 563 13769 2205 7126 8683 "Fracture, sprain, dislolcation except femur, hip, pelvis, thigh - Low Acuity" 56 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 562 16832 8039 9880 10493 "Fracture, sprain, dislolcation except femur, hip, pelvis, thigh - High Acuity" 57 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 066 19949 3702 7055 13874 Intracranial hemorrhage or cerebral infarction - Low Acuity 58 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 065 23546 6702 9530 18204 Intracranial hemorrhage or cerebral infarction - Mid Acuity 59 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 064 30358 9506 15238 18536 Intracranial hemorrhage or cerebral infarction - High Acuity 60 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 069 19362 4729 7090 9381 Transient ischemia w/o thrombolytic - Low Acuity 61 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 074 18664 8167 9830 17521 Cranial & peripheral nerve disorders - Low Acuity 62 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 084 13014 7653 8621 9589 "Traumatic stupor & coma, coma >1 hour - Low Acuity" 63 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 083 28490 8716 10566 13235 "Traumatic stupor & coma, coma >1 hour - Mid Acuity" 64 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 082 29583 16564 18805 21557 "Traumatic stupor & coma, coma >1 hour - High Acuity" 65 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 093 20361 6239 7381 7951 Other disorders of nervous system - Low Acuity 66 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 092 18957 8653 9086 11982 Other disorders of nervous system - Mid Acuity 67 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 091 23195 15535 Other disorders of nervous system - High Acuity 68 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 101 15848 3052 7602 10879 Seizures - Low Acuity 69 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 100 17939 9726 13054 17567 Seizures - High Acuity 70 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 103 18228 5253 7973 12323 Headaches - Low Acuity 71 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 102 24240 11249 Headaches - High Acuity 72 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 203 7317 2291 4860 7317 Bronchitis & asthma - Low Acuity 73 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 202 14952 6505 8785 14952 Bronchitis & asthma - High Acuity 74 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 192 16041 6658 6817 7135 Chronic obstructive pulmonary disease (COPD) - Low Acuity 75 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 191 16850 4929 8344 12475 Chronic obstructive pulmonary disease (COPD) - Mid Acuity 76 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 190 27501 6190 11475 27501 Chronic obstructive pulmonary disease (COPD) - High Acuity 77 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 185 13910 4242 7021 9798 Major chest trauma - Low Acuity 78 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 184 14520 9811 9976 10066 Major chest trauma - Mid Acuity 79 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 183 33647 9585 16839 27768 Major chest trauma - High Acuity 80 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 176 14791 2943 8674 13146 "Pulmonary Embolism (PE), blood clot in artery of lung - Low Acuity" 81 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 175 35750 10206 14535 35750 "Pulmonary Embolism (PE), blood clot in artery of lung - High Acuity" 82 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 179 14710 8158 10028 14710 Respiratory infections & inflammations - Low Acuity 83 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 178 18412 7318 11939 17310 Respiratory infections & inflammations - Mid Acuity 84 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 177 27701 7434 16955 27701 Respiratory infections & inflammations - High Acuity 85 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 195 13509 4367 5716 6874 Simple pneumonia (PN) & pleurisy - Low Acuity 86 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 194 17730 5650 8047 11573 Simple pneumonia (PN) & pleurisy - Mid Acuity 87 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 193 22416 4189 11591 17351 Simple pneumonia (PN) & pleurisy - High Acuity 88 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 153 7952 2606 5177 7136 Otitis media & upper respiratory tract infection (URI) - Low Acuity 89 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 812 15573 5170 8545 8884 Red blood cell disorders - Low Acuity 90 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 811 19289 8117 10279 12662 Red blood cell disorders - High Acuity 91 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 776 10353 3159 4964 5824 Postpartum & post abortion diagnoses w/o surgical procedure - Low Acuity 92 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 833 6992 3083 4559 6992 Other antepartum diagnoses w/o surgical procedure - Low Acuity 93 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 832 8588 3261 5606 6764 Other antepartum diagnoses w/o surgical procedure - Mid Acuity 94 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 864 15521 4177 7301 9528 Fever and inflammatory conditions - Low Acuity 95 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 866 12504 5934 6380 8167 Viral illness - Low Acuity 96 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 872 19017 3433 8924 14130 Sepsis w/o mechanical vent for more than 96 hours - Low Acuity 97 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 871 29494 11931 16232 29494 Sepsis w/o mechanical vent for more than 96 hours - High Acuity 98 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 897 19620 6154 8045 16587 Alcohol/drug abuse or dependence w/o rehabilitation therapy - Low Acuity 99 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 896 27797 7805 11451 16788 Alcohol/drug abuse or dependence w/o rehabilitation therapy - High Acuity 100 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 918 16222 5244 6244 8243 Poisoning & toxic effects of drugs - Low Acuity 101 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 917 19869 6645 11370 16627 Poisoning & toxic effects of drugs - High Acuity 102 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 948 13789 7222 8123 13789 Other signs & symptoms not specified elsewhere - Low Acuity 103 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT MEDICAL 947 23625 6494 13064 20646 Other signs & symptoms not specified elsewhere - High Acuity 104 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 027034Z 247 46424 16623 17260 19849 "Dilation of Coronary Artery, One Artery with Drug-eluting Intraluminal Device, Percutaneous Approach " 1 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 027034Z 246 52128 23723 29146 47301 "Dilation of Coronary Artery, One Artery with Drug-eluting Intraluminal Device, Percutaneous Approach " 2 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 027035Z 247 48921 14552 19359 38587 "Dilation of Coronary Artery, One Artery with Two Drug-eluting Intraluminal Devices, Percutaneous Approach " 3 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0BH17EZ 208 32887 13226 18744 24262 "Insertion of Endotracheal Airway into Trachea, Via Natural or Artificial Opening " 4 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0D164ZA 621 20601 7114 10569 20038 "Bypass Stomach to Jejunum, Percutaneous Endoscopic Approach " 5 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DB64Z3 621 19692 9377 10918 19023 "Excision of Stomach, Percutaneous Endoscopic Approach, Vertical " 6 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DB68ZX 392 19562 1285 6738 11668 "Excision of Stomach, Via Natural or Artificial Opening Endoscopic, Diagnostic " 7 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DB68ZX 378 23992 8935 9697 10651 "Excision of Stomach, Via Natural or Artificial Opening Endoscopic, Diagnostic " 8 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DJ08ZZ 378 26071 7038 9116 11045 "Inspection of Upper Intestinal Tract, Via Natural or Artificial Opening Endoscopic " 9 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DJ08ZZ 377 23817 10426 15876 18204 "Inspection of Upper Intestinal Tract, Via Natural or Artificial Opening Endoscopic " 10 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DJD8ZZ 378 25627 9641 "Inspection of Lower Intestinal Tract, Via Natural or Artificial Opening Endoscopic " 11 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DTJ4ZZ 343 17361 4414 10211 13752 "Resection of Appendix, Percutaneous Endoscopic Approach " 12 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DTJ4ZZ 342 24505 8415 "Resection of Appendix, Percutaneous Endoscopic Approach " 13 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0DTJ4ZZ 340 21046 7178 9540 11526 "Resection of Appendix, Percutaneous Endoscopic Approach " 14 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0FT44ZZ 419 26103 7813 10434 14974 "Resection of Gallbladder, Percutaneous Endoscopic Approach " 15 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0FT44ZZ 418 28767 5279 13162 26728 "Resection of Gallbladder, Percutaneous Endoscopic Approach " 16 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0FT44ZZ 417 39257 11073 16102 21573 "Resection of Gallbladder, Percutaneous Endoscopic Approach " 17 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0JH606Z 243 56992 16826 21106 23465 "Insertion of Pacemaker, Dual Chamber into Chest Subcutaneous Tissue and Fascia, Open Approach " 18 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0JH606Z 242 68601 19415 30806 33432 "Insertion of Pacemaker, Dual Chamber into Chest Subcutaneous Tissue and Fascia, Open Approach " 19 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0PS43ZZ 478 43397 20890 21325 21433 "Reposition Thoracic Vertebra, Percutaneous Approach " 20 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0QS604Z 481 33314 17640 18847 19838 "Reposition Right Upper Femur with Internal Fixation Device, Open Approach " 21 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0QS606Z 481 34780 12040 20905 22135 "Reposition Right Upper Femur with Intramedullary Internal Fixation Device, Open Approach " 22 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0QS704Z 481 36324 19917 19971 20242 "Reposition Left Upper Femur with Internal Fixation Device, Open Approach " 23 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0QS734Z 481 24315 14947 "Reposition Left Upper Femur with Internal Fixation Device, Percutaneous Approach " 24 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0QSG04Z 494 25425 11727 14943 18160 "Reposition Right Tibia with Internal Fixation Device, Open Approach " 25 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0QSH04Z 494 27805 15687 16046 16669 "Reposition Left Tibia with Internal Fixation Device, Open Approach " 26 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0RG10A0 473 30896 17373 Y "Fusion of Cervical Vertebral Joint with Interbody Fusion Device, Anterior Approach, Anterior Column, Open Approach " 27 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0RG20A0 473 46526 7872 16200 22975 Y "Fusion of 2 or more Cervical Vertebral Joints with Interbody Fusion Device, Anterior Approach, Anterior Column, Open Approach " 28 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0RRJ00Z 483 42633 20407 21152 21220 "Replacement of Right Shoulder Joint with Reverse Ball and Socket Synthetic Substitute, Open Approach " 29 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0RRK00Z 483 42614 19614 21866 27431 "Replacement of Left Shoulder Joint with Reverse Ball and Socket Synthetic Substitute, Open Approach " 30 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0RRK0JZ 483 36148 20009 24202 28395 "Replacement of Left Shoulder Joint with Synthetic Substitute, Open Approach " 31 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SG0071 460 62430 33478 39110 48646 Y "Fusion of Lumbar Vertebral Joint with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Open Approach " 32 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SG00A0 460 75597 26129 38387 48632 Y "Fusion of Lumbar Vertebral Joint with Interbody Fusion Device, Anterior Approach, Anterior Column, Open Approach " 33 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SG00AJ 460 77256 21368 37434 60146 Y "Fusion of Lumbar Vertebral Joint with Interbody Fusion Device, Posterior Approach, Anterior Column, Open Approach " 34 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SG1071 460 64524 30942 33723 35099 Y "Fusion of 2 or more Lumbar Vertebral Joints with Autologous Tissue Substitute, Posterior Approach, Posterior Column, Open Approach " 35 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SG30AJ 460 85226 27136 34889 45460 Y "Fusion of Lumbosacral Joint with Interbody Fusion Device, Posterior Approach, Anterior Column, Open Approach " 36 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SR904A 460 27539 7063 16371 21731 Y "Replacement of Right Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach " 37 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SRB04A 470 29192 16040 20210 21164 Y "Replacement of Left Hip Joint with Ceramic on Polyethylene Synthetic Substitute, Uncemented, Open Approach " 38 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SRC0J9 470 28468 15934 18891 20918 Y "Replacement of Right Knee Joint with Synthetic Substitute, Cemented, Open Approach " 39 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SRC0JA 470 28412 7213 17588 16765 Y "Replacement of Right Knee Joint with Synthetic Substitute, Uncemented, Open Approach " 40 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SRD0J9 470 28470 7218 16338 26361 Y "Replacement of Left Knee Joint with Synthetic Substitute, Cemented, Open Approach " 41 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0SRD0JA 470 28188 14386 17083 26346 Y "Replacement of Left Knee Joint with Synthetic Substitute, Uncemented, Open Approach " 42 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0T768DZ 661 20668 3641 5661 10216 "Dilation of Right Ureter with Intraluminal Device, Via Natural or Artificial Opening Endoscopic " 43 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0T768DZ 660 20931 7358 12205 18917 "Dilation of Right Ureter with Intraluminal Device, Via Natural or Artificial Opening Endoscopic " 44 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0T778DZ 661 19135 5639 8525 12295 "Dilation of Left Ureter with Intraluminal Device, Via Natural or Artificial Opening Endoscopic " 45 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0T778DZ 660 21086 5853 9507 13635 "Dilation of Left Ureter with Intraluminal Device, Via Natural or Artificial Opening Endoscopic " 46 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0W3P8ZZ 378 29295 9458 12910 9937 "Control Bleeding in Gastrointestinal Tract, Via Natural or Artificial Opening Endoscopic " 47 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0W9G3ZZ 433 16069 6666 9496 11831 "Drainage of Peritoneal Cavity, Percutaneous Approach " 48 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 0W9G3ZZ 432 19406 9088 15368 15827 "Drainage of Peritoneal Cavity, Percutaneous Approach " 49 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 30233N1 378 22558 9020 9433 10391 "Transfusion of Nonautologous Red Blood Cells into Peripheral Vein, Percutaneous Approach " 50 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 3E0R33Z 552 22430 8735 9292 9969 "Introduction of Anti-inflammatory into Spinal Canal, Percutaneous Approach " 51 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 4A023N7 287 25788 8746 10459 16800 "Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach " 52 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 4A023N7 286 34916 7386 18613 20996 "Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach " 53 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 4A023N7 282 22714 1924 5889 14767 "Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach " 54 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 4A023N7 281 24417 6575 8608 11686 "Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach " 55 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 4A023N7 280 36053 6493 13279 17185 "Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach " 56 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 4A023N7 247 50674 17546 18252 18606 "Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach " 57 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 4A023N7 246 45057 30873 "Measurement of Cardiac Sampling and Pressure, Left Heart, Percutaneous Approach " 58 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 4A023N8 286 42947 17491 "Measurement of Cardiac Sampling and Pressure, Bilateral, Percutaneous Approach " 59 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A09357 291 21532 9211 11978 12895 "Assistance with Respiratory Ventilation, Less than 24 Consecutive Hours, Continuous Positive Airway Pressure " 60 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A09357 190 23298 7619 11505 21344 "Assistance with Respiratory Ventilation, Less than 24 Consecutive Hours, Continuous Positive Airway Pressure " 61 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1935Z 917 16838 4787 7910 9484 "Respiratory Ventilation, Less than 24 Consecutive Hours " 62 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1935Z 208 23908 20743 "Respiratory Ventilation, Less than 24 Consecutive Hours " 63 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1945Z 208 60649 11302 32096 54252 "Respiratory Ventilation, 24-96 Consecutive Hours " 64 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1955Z 207 91901 57172 59201 63260 "Respiratory Ventilation, Greater than 96 Consecutive Hours " 65 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1D70Z 640 19800 4495 10113 12132 "Performance of Urinary Filtration, Intermittent, Less than 6 Hours Per Day " 66 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1D70Z 291 23282 6754 12754 15580 "Performance of Urinary Filtration, Intermittent, Less than 6 Hours Per Day " 67 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1D70Z 280 15194 13442 "Performance of Urinary Filtration, Intermittent, Less than 6 Hours Per Day " 68 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1D70Z 193 27094 7639 10655 12167 "Performance of Urinary Filtration, Intermittent, Less than 6 Hours Per Day " 69 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A1D70Z 177 26163 11210 17046 20022 "Performance of Urinary Filtration, Intermittent, Less than 6 Hours Per Day " 70 042103586 220010 LAWRENCE GENERAL HOSPITAL INPATIENT PROCEDURE 5A2204Z 309 16542 7768 "Restoration of Cardiac Rhythm, Single " 71 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 19120 7807 1407 2435 5918 Y "Removal of 1 or more breast growth, open procedure" 1 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 19125 8890 1634 4144 8640 Excision (removal) of breast lesion 2 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 19301 12239 1868 5595 7911 "Partial mastectomy, removal of breast" 3 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 42820 6992 2260 3612 6884 Y Removal of tonsils and adenoid glands patient younger than age 12 4 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 42826 6819 2211 2623 4283 Removal Of tonsils 5 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 42830 6565 2260 2702 3874 Removal Of adenoids 6 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 43235 2513 948 1255 1717 Y "Endoscopic exam of esophagus, stomach, upper small bowel" 7 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 43239 3842 1009 1351 1976 Y "Endoscopic biopsy of the esophagus, stomach, upper small bowel" 8 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 45378 3212 1180 1466 1765 Y Endoscopic exam of large bowel 9 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 45380 3972 1381 1602 2745 Y Endoscopic biopsy of large bowel 10 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 45384 3541 1177 1389 1729 Colonoscopy with lesion removal 11 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 45385 4562 1431 1888 2792 Y Endoscopic removal of polyps or growths of large bowel 12 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 47562 9488 4166 5176 7165 Y Endoscopic removal of gallbladder 13 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 47563 10706 2868 6222 8224 Laparoscopy cholecystectomy with cholangiography 14 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 49324 10624 4098 5346 6585 Laparoscopy insert tunnel Intraperitoneal (IP) catheter 15 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 49505 8215 2694 3395 4827 Y Repair of groin hernia patient age 5 years or older 16 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 49585 8106 1422 3320 3886 Repair umbilical hernia reducible patient age 5 years or older 17 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 49587 9325 2644 3675 5307 Repair umbilical hernia block patient age 5 years or older 18 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 49650 12199 4251 5702 9506 Laparoscopy inguinal hernia repair inititial 19 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 20680 6118 1863 2670 3184 Removal of support implant 20 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 21931 6399 1633 2024 2744 Excision back lesion subcutaneous 3+ centimeters 21 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 22551 28383 7917 11520 23240 Neck spine fusion & removal below C2 22 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 25111 5993 1589 1921 2914 Remove wrist tendon lesion 23 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 25609 12991 2883 6700 11576 Treat fracture radial 3+ fragments 24 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 26055 4591 1607 1994 3617 Incise finger tendon sheath 25 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 26615 7716 2983 3461 5328 Treat metacarpal fracture 26 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 28296 12535 1862 4773 8162 Correction of hallux valgus (foot deformity) 27 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 29827 16267 4241 7780 14488 Arthroscopic rotator cuff repair 28 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 29848 5074 1577 2491 3053 Wrist endoscopy/surgery 29 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 29881 6562 2348 3343 5206 Y Removal of one knee cartilage using an endoscope 30 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 29888 15836 3037 7057 13287 Knee arthroscopy/surgery 31 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 63047 13818 2737 6630 11032 Remove spine lamina 1 lumbar 32 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 64718 7139 1560 2588 5280 Revise ulnar nerve at elbow 33 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 64721 4767 874 2051 3520 Carpal tunnel surgery 34 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 36821 6729 2794 3119 3724 Arteriovenous (AV) fusion direct any site 35 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 36832 7929 4327 4799 5748 Arteriovenous (AV) fistula revision open 36 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 30520 10162 2953 3725 6677 Repair Of nasal septum 37 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 52204 7852 989 2165 2877 Cystoscopy with biopsy(s) 38 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 52332 7633 1125 3610 6477 Cystoscopy and treatment 39 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 52356 9151 3299 5309 8530 Cystoscopy with ureteroscopy and lithotripsy 40 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 57288 10836 3333 3383 3434 Repair bladder defect 41 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 57522 6234 1539 2429 5575 Conization of cervix 42 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 58558 7941 1412 3173 5847 Hysteroscopy biopsy 43 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 58563 9551 2597 4280 8294 Hysteroscopy ablation 44 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 58661 8801 2988 4533 8664 Laparoscopy remove adnexa (connective tissue) 45 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 58670 7442 1640 4536 5821 Laparoscopy tubal cautery 46 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT PROCEDURE 59820 5626 1590 2474 4634 Care of miscarriage 47 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 80048 74 8 13 33 56 Y Blood Test: Basic Metabolic Panel 1 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 80053 141 13 23 123 86 Y Blood Test: Comp Metabolic Panel 2 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 80061 135 9 24 58 80 Y Blood Test: Lipid Panel 3 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 80069 69 8 10 14 51 Y Blood Test: Renal Function Panel 4 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 80076 86 4 15 54 64 Y Blood Test: Hepatic Function Panel 5 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 81001 30 3 4 8 28 Y Urology Test: Urinalysis Automated with Micro 6 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 82105 65 15 25 50 65 Blood Test: Alpha Fetoprotein Serum 7 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 82247 47 5 6 33 33 Blood Test: Bilirubin Total 8 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 82947 41 2 7 11 27 Blood Test: Glucose Quant Blood 9 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 83036 81 9 15 64 64 Blood Test: Glycosylated A1C 10 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 84144 156 19 39 41 131 Blood Test: Progesterone 11 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 84153 119 7 20 48 98 Y Blood Test: Prostate-Specific Antigen (PSA) 12 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 84443 176 14 29 115 109 Y Blood Test: Thyroid-Stimulating Hormone (TSH) 13 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 84702 150 4 22 125 125 Blood Test: Human Chorionic Gonadotropin (HCG) Quant 14 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 85018 49 2 2 5 35 Blood Test: Hemoglobin 15 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 85025 85 4 14 56 56 Y Blood Test: Complete Blood Count (CBC) automated diff 16 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 85027 46 5 9 32 32 Y Blood Test: Complete Blood Count (CBC) automated 17 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 85610 54 4 5 19 40 Y Blood Test: Blood Clotting Time 18 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 85730 72 8 10 25 50 Y Blood Test: Partial Thromboplastin Time 19 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 86480 311 48 72 224 260 Immunology Test: Tuberculosis Test 20 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 86592 54 4 4 10 40 Immunology Test: Syphilis Test Qual 21 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB 87536 624 88 104 224 437 Bacteria & Microbiology: HIV-1 Quant 22 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP LAB U0003 290 91 137 259 162 Bacteria & Microbiology: SARS COV (High Throughput) 23 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 70030 218 27 86 190 217 X-Ray: Orbits (Eye) for Foreign Body 24 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 70450 1456 96 165 628 1387 Y CT Scan/Head: Head w/o Contrast 25 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 70491 1790 144 252 575 1640 CT Scan: Neck w/Contrast 26 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 71046 409 38 100 393 368 X-Ray/Chest: Chest Posteroanterior/Lateral 27 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 71250 1647 52 148 693 1592 CT Scan/Body: Chest w/o Contrast 28 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 71260 2229 144 282 2028 1963 CT Scan/Body: Chest with Contrast 29 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 72110 763 89 154 613 629 Y X-Ray: Lumbar Spine 4+ Views 30 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 72131 1476 52 174 581 1315 CT Scan/Body: CT L Spine w/o Contrast 31 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 72193 2099 144 238 458 1959 Y CT Scan: Pelvis with Contrast 32 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 73030 331 62 99 288 288 X-Ray: Shoulder Left (Right) 2+ Views 33 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 73140 197 34 93 142 194 X-Ray: Hand Left (Right) Thumb 34 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 73501 277 33 102 245 241 X-Ray: Hip Left (Right) Unilateral; 1 View; Pelvis 35 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 73562 286 42 100 280 251 X-Ray: Knee Left (Right) 3 Views 36 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 73700 1672 26 113 956 1625 CT Scan/Body: Ext Lower Left (Right) w/o Contrast 37 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 74018 238 43 86 224 225 X-Ray: Abdomen Anteroposterior 38 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 74176 3408 105 324 2601 3293 CT Scan: Abdomen & Pelvis w/o Contrast 39 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 74177 4216 144 472 2392 3635 Y CT Scan: Abdomen & Pelvis with Contrast 40 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 74178 3941 150 469 2916 3748 CT Scan: Abdomen & Pelvis w/ & w/o Contrast 41 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 74220 440 54 176 413 439 X-Ray: Esoph/Barium Swallow 42 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 74240 627 128 235 501 580 X-Ray: Upper GI Single Contrast 43 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76536 669 100 157 644 644 Ultrasound: Thyroid 44 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76642 369 71 142 333 367 Ultrasound: Breast Unilateral Limited 45 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76700 1329 118 220 850 1229 Y Ultrasound: Abdomen Complete 46 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76705 657 89 157 548 634 Ultrasound: Abdomen Limited 47 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76770 766 113 192 725 725 Ultrasound: Retroperitoneal Complete 48 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76775 953 70 156 820 911 Ultrasound: Renal 49 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76801 436 118 171 430 426 Ultrasound: Pregnant Uterus < 14Wks 50 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76805 796 113 164 607 788 Y Ultrasound: Pregnant Complete >/= 14 Wks 51 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76811 949 66 226 678 898 Ultrasound: Detailed Single Fetus 52 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76815 642 98 166 615 615 Ultrasound: Preg Lim 1/More Fetuses 53 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76816 249 98 161 246 246 Ultrasound: Pregnant Uterus Follow Up 54 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76818 1721 132 199 410 1486 Ultrasound: Biophysical Profile with NST 55 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76830 731 97 179 430 621 Y Ultrasound: Transvaginal 56 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76857 287 54 142 278 285 Ultrasound: Limited Pelvis 57 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76870 736 122 172 706 706 Ultrasound: Testicular 58 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 76882 289 31 136 244 285 Ultrasound: Ext Non-Vasc Limited Rt 59 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 77065 746 97 216 484 419 Y Mammography: Diagnostic Mammo Digital Unilateral 60 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 77066 1062 125 215 922 631 Y Mammography: Diagnostic Mammo Digital Bilateral 61 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 77067 781 116 194 655 623 Y Mammography: Screening Mammo Digital Bilateral 62 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP RAD 77080 458 63 142 353 452 X-Ray: Bone Density; Axial 63 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 36902 13880 5616 5919 7648 10675 Dialysis: Fistulagram with Peripheral Segment Angioplasty 64 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 49083 1222 487 948 1006 1080 Procedure: Abdominal Fluid Sampling Diagnostic/Theraputic 65 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 64483 1825 966 1269 1502 1525 Y Procedure: Transforaminal Epidural Injection 66 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 93005 215 19 55 167 170 EKG/ECG: Electrocardiogram 67 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 93017 944 120 289 926 860 Stress Test: Exercise Tolerance Test 68 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 93225 498 87 120 251 498 Holter Monitor: External Electrocardiogram 69 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 93306 2392 224 514 1866 2299 Cardiology: Transthoracic Echo Complete with Doppler 70 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 93880 1032 131 272 534 966 Peripheral Vascular Lab: Duplex Carotid 71 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 93970 1068 227 290 756 972 Peripheral Vascular Lab: Duplex Venous Leg Bilat 72 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 93971 654 126 158 479 616 Peripheral Vascular Lab: Duplex Venous Leg Left (Right) 73 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 95806 980 81 407 560 980 Sleep Study: Unattended Sleep Study 74 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 95810 3126 224 1151 2958 3106 Y Sleep Study: Attended Sleep Study 75 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 95811 2930 224 1173 1920 2930 Sleep Study: Attended Cont. Pos. Airway Pressure (CPAP) 76 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 95816 999 230 359 637 984 Electroencephalogram: EEG Awake & Drowsy 77 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 96365 671 238 359 394 471 Intravenous (IV) Therapy: Infusion Therapy First-Hour 78 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER 97803 100 89 45 89 100 Education/Training: Individual Reassess 15-Minutes 79 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER J1561 15367 3033 4040 7828 13970 Drug/Detail Code: Immune Globulin 20Gm 80 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER J1569 16565 1596 3396 8003 15455 Drug/Detail Code: Gammagard 20G Vial 81 042103586 220010 LAWRENCE GENERAL HOSPITAL OUTPATIENT OP OTHER J1745 15913 1464 3709 6585 14707 Drug/Detail Code: Remicade 100Mg Vial 82