Select Plan(s)
  • Aetna: Commercial
  • Aetna: Medicare Advantage
  • Aetna: Workers Compensation
  • AlaMed: Workers Compensation
  • Alabama Department of Labor: Workers Compensation
  • American PPO: Commercial
  • America's Choice Provider Network: Commercial
  • America's Choice Provider Network: Workers Compensation
  • America's Choice Provider Network: Medicare Advantage
  • BCBSAL: Commercial
  • Cigna: Commercial
  • CoreChoice: Commercial
  • GuideStar: Commercial
  • Healthchoice: Commercial
  • HealthLink: Commercial
  • HealthSpring: Medicare Advantage
  • Humana: Medicare Advantage
  • LifeSync: Commercial
  • MultiPlan: Commercial
  • NovaNet
  • Senior Select Partners: ISNP
  • Senior Select Partners: DSNP
  • United Healthcare: Commercial
  • United Healthcare: Medicare Advantage
  • Viva Health: Commercial
  • Viva Health: Medicare Advantage
  • Zelis: Commercial
  • Zelis: Workers' Compensation
  • De-identified Minimum Negotiated Charge
  • De-identified Maximum Negotiated Charge
Shoppable Service Primary Service and Ancillary Services Revenue Code Procedure Code Cash Price Service Location Site Type Aetna: Commercial Aetna: Medicare Advantage Aetna: Workers Compensation AlaMed: Workers Compensation Alabama Department of Labor: Workers Compensation American PPO: Commercial America's Choice Provider Network: Commercial America's Choice Provider Network: Workers Compensation America's Choice Provider Network: Medicare Advantage BCBSAL: Commercial Cigna: Commercial CoreChoice: Commercial GuideStar: Commercial Healthchoice: Commercial HealthLink: Commercial HealthSpring: Medicare Advantage Humana: Medicare Advantage LifeSync: Commercial MultiPlan: Commercial NovaNet Senior Select Partners: ISNP Senior Select Partners: DSNP United Healthcare: Commercial United Healthcare: Medicare Advantage Viva Health: Commercial Viva Health: Medicare Advantage Zelis: Commercial Zelis: Workers' Compensation De-identified Minimum Negotiated Charge De-identified Maximum Negotiated Charge
Uterine and adnexa procedures for non-malignancy without comorbid conditions (CC) or major comorbid conditions or complications (MCC) MS-DRG 743 Northwest Medical Center IP 1300.00 6081.02 2286.00 2194.56 2286.00 0.00 0.00 0.00 6081.02 2444.00 6019.69 Not Applicable 0.00 1300.00 0.00 6081.02 6081.02 Not Applicable 1100.00 0.00 6081.02 6081.02 2374.00 6081.02 1800.00 6081.02 1875.00 2171.70 0.00 6081.02
Room & Board/Semi-Private 120 1458.10 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1770.55 1458.10 1666.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1353.95 Included in Primary Procedure 1458.10 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1458.10 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1353.95 1770.55
Pharmacy 250 756.70 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 918.85 756.70 864.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 702.65 Included in Primary Procedure 756.70 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 756.70 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 702.65 918.85
IV Solutions 258 152.60 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 185.30 152.60 174.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 141.70 Included in Primary Procedure 152.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 152.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 141.70 185.30
Med-Sur Supplies 270 1438.15 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1746.33 1438.15 1643.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1335.43 Included in Primary Procedure 1438.15 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1438.15 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1335.43 1746.33
Sterile Supply 272 1433.95 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1741.23 1433.95 1638.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1331.53 Included in Primary Procedure 1433.95 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1433.95 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1331.53 1741.23
Lab/Chemistry 301 134.40 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 163.20 134.40 153.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 124.80 Included in Primary Procedure 134.40 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 134.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 124.80 163.20
Lab/Immunology 302 166.25 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 201.88 166.25 190.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 154.38 Included in Primary Procedure 166.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 166.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 154.38 201.88
Lab/Hemotology 305 98.70 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 119.85 98.70 112.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 91.65 Included in Primary Procedure 98.70 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 98.70 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 91.65 119.85
Lab/Urology 307 38.50 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 46.75 38.50 44.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 35.75 Included in Primary Procedure 38.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 38.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 35.75 46.75
Lab/Other 309 92.04 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 111.76 92.04 105.18 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 85.46 Included in Primary Procedure 92.04 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 92.04 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 85.46 111.76
OR Services 360 4431.00 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 5380.50 4431.00 5064.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 4114.50 Included in Primary Procedure 4431.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 4431.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 4114.50 5380.50
Anesthesia 370 990.50 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1202.75 990.50 1132.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 919.75 Included in Primary Procedure 990.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 990.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 919.75 1202.75
Drug/Detail Code 636 880.25 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1068.88 880.25 1006.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 817.38 Included in Primary Procedure 880.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 880.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 817.38 1068.88
Recovery Room 710 365.05 Northwest Medical Center IP Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 443.28 365.05 417.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 338.98 Included in Primary Procedure 365.05 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 365.05 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 338.98 443.28
Removal of Breast Growth Primary Procedure 360 19120 1914.85 Northwest Medical Center OP 1778.08 2582.93 2188.40 1860.14 2188.40 2325.18 1914.85 2188.40 2582.93 645.24 6000.00 Not Applicable 1942.21 1778.08 1914.85 2582.93 2582.93 Not Applicable 1911.00 1914.85 2582.93 2582.93 2270.00 2582.93 1887.50 2582.93 1641.30 1504.53 645.24 6000.00
Associated Procedure 360 38525 1914.85 Northwest Medical Center OP 1778.08 Included in Primary Procedure 2188.40 1860.14 2188.40 2325.18 1914.85 2188.40 Included in Primary Procedure 1305.90 Included in Primary Procedure Not Applicable 1942.21 1778.08 1914.85 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1914.85 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1887.50 Included in Primary Procedure 1641.30 1504.53 1305.90 2325.18
Associated Procedure 360 38900 1914.85 Northwest Medical Center OP 1778.08 Included in Primary Procedure 2188.40 1860.14 2188.40 2325.18 1914.85 2188.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1942.21 1778.08 1914.85 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1914.85 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1887.50 Included in Primary Procedure 1641.30 1504.53 1504.53 2325.18
Nuclear Medicine 341 78195 1314.95 Northwest Medical Center OP 1221.03 Included in Primary Procedure 1502.80 1277.38 1502.80 1596.73 1314.95 1502.80 Included in Primary Procedure 945.74 Included in Primary Procedure Not Applicable 1333.74 1221.03 1314.95 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1314.95 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1296.17 Included in Primary Procedure 1127.10 1033.18 945.74 1596.73
Nuclear Medicine 343 A9520 1855.70 Northwest Medical Center OP 1723.15 Included in Primary Procedure 2120.80 1802.68 2120.80 2253.35 1855.70 2120.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1882.21 1723.15 1855.70 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1855.70 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1829.19 Included in Primary Procedure 1590.60 1458.05 1458.05 2253.35
Laboratory 301 80053 278.25 Northwest Medical Center OP 258.38 Included in Primary Procedure 318.00 270.30 318.00 337.88 278.25 318.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 282.23 258.38 278.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 278.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 274.28 Included in Primary Procedure 238.50 218.63 218.63 337.88
Laboratory 305 85025 53.20 Northwest Medical Center OP 49.40 Included in Primary Procedure 60.80 51.68 60.80 64.60 53.20 60.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 53.96 49.40 53.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 53.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 52.44 Included in Primary Procedure 45.60 41.80 41.80 64.60
Pharmacy 250 588.35 Northwest Medical Center OP 546.33 Included in Primary Procedure 672.40 571.54 672.40 714.43 588.35 672.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 596.76 546.33 588.35 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 588.35 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 579.95 Included in Primary Procedure 504.30 462.28 462.28 714.43
IV Solutions 258 76.30 Northwest Medical Center OP 70.85 Included in Primary Procedure 87.20 74.12 87.20 92.65 76.30 87.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 77.39 70.85 76.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 76.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 75.21 Included in Primary Procedure 65.40 59.95 59.95 92.65
Drugs/Detail Code 636 Q9968 1750.00 Northwest Medical Center OP 1250.00 Included in Primary Procedure 2000.00 1700.00 2000.00 2125.00 1750.00 2000.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1775.00 1250.00 1750.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1750.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1725.00 Included in Primary Procedure 1500.00 1375.00 1250.00 2125.00
Drugs/Detail Code 636 J2710 213.50 Northwest Medical Center OP 152.50 Included in Primary Procedure 244.00 207.40 244.00 259.25 213.50 244.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 216.55 152.50 213.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 213.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 210.45 Included in Primary Procedure 183.00 167.75 152.50 259.25
Drugs/Detail Code 636 J2704 98.00 Northwest Medical Center OP 70.00 Included in Primary Procedure 112.00 95.20 112.00 119.00 98.00 112.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 99.40 70.00 98.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 98.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 96.60 Included in Primary Procedure 84.00 77.00 70.00 119.00
Drugs/Detail Code 636 J3010 60.20 Northwest Medical Center OP 43.00 Included in Primary Procedure 68.80 58.48 68.80 73.10 60.20 68.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 61.06 43.00 60.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 60.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 59.34 Included in Primary Procedure 51.60 47.30 43.00 73.10
Drugs/Detail Code 636 J2405 40.60 Northwest Medical Center OP 29.00 Included in Primary Procedure 46.40 39.44 46.40 49.30 40.60 46.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 41.18 29.00 40.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 40.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 40.02 Included in Primary Procedure 34.80 31.90 29.00 49.30
Drugs/Detail Code 636 J2250 20.30 Northwest Medical Center OP 14.50 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 20.59 14.50 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 14.50 24.65
Anesthesia 370 1491.70 Northwest Medical Center OP 1385.15 Included in Primary Procedure 1704.80 1449.08 1704.80 1811.35 1491.70 1704.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1513.01 1385.15 1491.70 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1491.70 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1470.39 Included in Primary Procedure 1278.60 1172.05 1172.05 1811.35
Supply 270 266.70 Northwest Medical Center OP 247.65 Included in Primary Procedure 304.80 259.08 304.80 323.85 266.70 304.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 270.51 247.65 266.70 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 266.70 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 262.89 Included in Primary Procedure 228.60 209.55 209.55 323.85
Sterile Supply 272 186.20 Northwest Medical Center OP 172.90 Included in Primary Procedure 212.80 180.88 212.80 226.10 186.20 212.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 188.86 172.90 186.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 186.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 183.54 Included in Primary Procedure 159.60 146.30 146.30 226.10
Recovery Room 710 1743.00 Northwest Medical Center OP 1618.50 Included in Primary Procedure 1992.00 1693.20 1992.00 2116.50 1743.00 1992.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1767.90 1618.50 1743.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1743.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1718.10 Included in Primary Procedure 1494.00 1369.50 1369.50 2116.50
Endoscopic Removal of Single Knee Cartilage Primary Procedure 360 29881 2130.80 Northwest Medical Center OP 1978.60 2333.90 2435.20 2069.92 2435.20 2587.40 2130.80 2435.20 2333.90 2304.33 1826.40 Not Applicable 2161.24 1978.60 2130.80 2333.90 2333.90 Not Applicable 1911.00 2130.80 2333.90 2333.90 3106.00 2333.90 2100.36 2333.90 1826.40 1674.20 1674.20 3106.00
Respiratory Services 410 94664 310.45 Northwest Medical Center OP 288.28 Included in Primary Procedure 354.80 301.58 354.80 376.98 310.45 354.80 Included in Primary Procedure Included in Primary Procedure 266.10 Not Applicable 314.89 288.28 310.45 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 310.45 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 306.02 Included in Primary Procedure 266.10 243.93 243.93 376.98
Respiratory Services 410 94640 93.80 Northwest Medical Center OP 87.10 Included in Primary Procedure 107.20 91.12 107.20 113.90 93.80 107.20 Included in Primary Procedure 262.36 80.40 Not Applicable 95.14 87.10 93.80 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 93.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 92.46 Included in Primary Procedure 80.40 73.70 73.70 262.36
Pharmacy 250 225.75 Northwest Medical Center OP 209.63 Included in Primary Procedure 258.00 219.30 258.00 274.13 225.75 258.00 Included in Primary Procedure Included in Primary Procedure 193.50 Not Applicable 228.98 209.63 225.75 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 225.75 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 222.53 Included in Primary Procedure 193.50 177.38 177.38 274.13
Pharmacy 250 42.35 Northwest Medical Center OP 39.33 Included in Primary Procedure 48.40 41.14 48.40 51.43 42.35 48.40 Included in Primary Procedure Included in Primary Procedure 36.30 Not Applicable 42.96 39.33 42.35 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 42.35 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 41.75 Included in Primary Procedure 36.30 33.28 33.28 51.43
Pharmacy 250 10.15 Northwest Medical Center OP 9.43 Included in Primary Procedure 11.60 9.86 11.60 12.33 10.15 11.60 Included in Primary Procedure Included in Primary Procedure 8.70 Not Applicable 10.30 9.43 10.15 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 10.15 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 10.01 Included in Primary Procedure 8.70 7.98 7.98 12.33
Pharmacy 250 5.60 Northwest Medical Center OP 5.20 Included in Primary Procedure 6.40 5.44 6.40 6.80 5.60 6.40 Included in Primary Procedure Included in Primary Procedure 4.80 Not Applicable 5.68 5.20 5.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 5.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 5.52 Included in Primary Procedure 4.80 4.40 4.40 6.80
Pharmacy 250 5.60 Northwest Medical Center OP 5.20 Included in Primary Procedure 6.40 5.44 6.40 6.80 5.60 6.40 Included in Primary Procedure Included in Primary Procedure 4.80 Not Applicable 5.68 5.20 5.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 5.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 5.52 Included in Primary Procedure 4.80 4.40 4.40 6.80
IV Solutions 258 76.30 Northwest Medical Center OP 70.85 Included in Primary Procedure 87.20 74.12 87.20 92.65 76.30 87.20 Included in Primary Procedure Included in Primary Procedure 65.40 Not Applicable 77.39 70.85 76.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 76.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 75.21 Included in Primary Procedure 65.40 59.95 59.95 92.65
Drugs/Detail Code 636 J0690 140.00 Northwest Medical Center OP 100.00 Included in Primary Procedure 160.00 136.00 160.00 170.00 140.00 160.00 Included in Primary Procedure Included in Primary Procedure 120.00 Not Applicable 142.00 100.00 140.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 140.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 138.00 Included in Primary Procedure 120.00 110.00 100.00 170.00
Drugs/Detail Code 636 J0171 105.00 Northwest Medical Center OP 75.00 Included in Primary Procedure 120.00 102.00 120.00 127.50 105.00 120.00 Included in Primary Procedure Included in Primary Procedure 90.00 Not Applicable 106.50 75.00 105.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 105.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 103.50 Included in Primary Procedure 90.00 82.50 75.00 127.50
Drugs/Detail Code 636 J2704 98.00 Northwest Medical Center OP 70.00 Included in Primary Procedure 112.00 95.20 112.00 119.00 98.00 112.00 Included in Primary Procedure Included in Primary Procedure 84.00 Not Applicable 99.40 70.00 98.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 98.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 96.60 Included in Primary Procedure 84.00 77.00 70.00 119.00
Drugs/Detail Code 636 J2405 40.60 Northwest Medical Center OP 29.00 Included in Primary Procedure 46.40 39.44 46.40 49.30 40.60 46.40 Included in Primary Procedure Included in Primary Procedure 34.80 Not Applicable 41.18 29.00 40.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 40.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 40.02 Included in Primary Procedure 34.80 31.90 29.00 49.30
Drugs/Detail Code 636 J3010 30.10 Northwest Medical Center OP 21.50 Included in Primary Procedure 34.40 29.24 34.40 36.55 30.10 34.40 Included in Primary Procedure Included in Primary Procedure 25.80 Not Applicable 30.53 21.50 30.10 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 30.10 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 29.67 Included in Primary Procedure 25.80 23.65 21.50 36.55
Drugs/Detail Code 636 J3301 26.60 Northwest Medical Center OP 19.00 Included in Primary Procedure 30.40 25.84 30.40 32.30 26.60 30.40 Included in Primary Procedure Included in Primary Procedure 22.80 Not Applicable 26.98 19.00 26.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 26.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 26.22 Included in Primary Procedure 22.80 20.90 19.00 32.30
Drugs/Detail Code 636 J2250 20.30 Northwest Medical Center OP 14.50 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure 17.40 Not Applicable 20.59 14.50 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 14.50 24.65
Anesthesia 370 739.90 Northwest Medical Center OP 687.05 Included in Primary Procedure 845.60 718.76 845.60 898.45 739.90 845.60 Included in Primary Procedure Included in Primary Procedure 634.20 Not Applicable 750.47 687.05 739.90 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 739.90 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 729.33 Included in Primary Procedure 634.20 581.35 581.35 898.45
Supply 270 522.90 Northwest Medical Center OP 485.55 Included in Primary Procedure 597.60 507.96 597.60 634.95 522.90 597.60 Included in Primary Procedure Included in Primary Procedure 448.20 Not Applicable 530.37 485.55 522.90 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 522.90 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 515.43 Included in Primary Procedure 448.20 410.85 410.85 634.95
Sterile Supply 272 150.50 Northwest Medical Center OP 139.75 Included in Primary Procedure 172.00 146.20 172.00 182.75 150.50 172.00 Included in Primary Procedure Included in Primary Procedure 129.00 Not Applicable 152.65 139.75 150.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 150.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 148.35 Included in Primary Procedure 129.00 118.25 118.25 182.75
Recovery Room 710 1556.80 Northwest Medical Center OP 1445.60 Included in Primary Procedure 1779.20 1512.32 1779.20 1890.40 1556.80 1779.20 Included in Primary Procedure Included in Primary Procedure 1334.40 Not Applicable 1579.04 1445.60 1556.80 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1556.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1534.56 Included in Primary Procedure 1334.40 1223.20 1223.20 1890.40
Endoscopic diagnostic examination of esophagus, stomach, and/or upper small bowel Primary Procedure 360 43235 1821.05 Northwest Medical Center OP 1690.98 670.06 2081.20 1769.02 2081.20 2211.28 1821.05 2081.20 670.06 939.85 1560.90 Not Applicable 1847.07 1690.98 1821.05 670.06 670.06 Not Applicable 1911.00 1821.05 670.06 670.06 1537.00 670.06 1795.04 670.06 1560.90 1430.83 670.06 2211.28
Laboratory 301 84132 33.60 Northwest Medical Center OP 31.20 Included in Primary Procedure 38.40 32.64 38.40 40.80 33.60 38.40 Included in Primary Procedure Included in Primary Procedure 28.80 Not Applicable 34.08 31.20 33.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 33.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 33.12 Included in Primary Procedure 28.80 26.40 26.40 40.80
Pharmacy 250 27.30 Northwest Medical Center OP 25.35 Included in Primary Procedure 31.20 26.52 31.20 33.15 27.30 31.20 Included in Primary Procedure Included in Primary Procedure 23.40 Not Applicable 27.69 25.35 27.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 27.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 26.91 Included in Primary Procedure 23.40 21.45 21.45 33.15
IV Solutions 258 76.30 Northwest Medical Center OP 70.85 Included in Primary Procedure 87.20 74.12 87.20 92.65 76.30 87.20 Included in Primary Procedure Included in Primary Procedure 65.40 Not Applicable 77.39 70.85 76.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 76.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 75.21 Included in Primary Procedure 65.40 59.95 59.95 92.65
Drugs/Detail Code 636 J2704 98.00 Northwest Medical Center OP 70.00 Included in Primary Procedure 112.00 95.20 112.00 119.00 98.00 112.00 Included in Primary Procedure Included in Primary Procedure 84.00 Not Applicable 99.40 70.00 98.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 98.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 96.60 Included in Primary Procedure 84.00 77.00 70.00 119.00
Drugs/Detail Code 636 J2250 20.30 Northwest Medical Center OP 14.50 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure 17.40 Not Applicable 20.59 14.50 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 14.50 24.65
Anesthesia 370 489.30 Northwest Medical Center OP 454.35 Included in Primary Procedure 559.20 475.32 559.20 594.15 489.30 559.20 Included in Primary Procedure Included in Primary Procedure 419.40 Not Applicable 496.29 454.35 489.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 489.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 482.31 Included in Primary Procedure 419.40 384.45 384.45 594.15
Supply 270 59.50 Northwest Medical Center OP 55.25 Included in Primary Procedure 68.00 57.80 68.00 72.25 59.50 68.00 Included in Primary Procedure Included in Primary Procedure 51.00 Not Applicable 60.35 55.25 59.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 59.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 58.65 Included in Primary Procedure 51.00 46.75 46.75 72.25
Non-sterile Supply 271 3.50 Northwest Medical Center OP 3.25 Included in Primary Procedure 4.00 3.40 4.00 4.25 3.50 4.00 Included in Primary Procedure Included in Primary Procedure 3.00 Not Applicable 3.55 3.25 3.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 3.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 3.45 Included in Primary Procedure 3.00 2.75 2.75 4.25
Recovery Room 710 1377.95 Northwest Medical Center OP 1279.53 Included in Primary Procedure 1574.80 1338.58 1574.80 1673.23 1377.95 1574.80 Included in Primary Procedure Included in Primary Procedure 1181.10 Not Applicable 1397.64 1279.53 1377.95 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1377.95 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1358.27 Included in Primary Procedure 1181.10 1082.68 1082.68 1673.23
Endoscopic biopsy of the esophagus, stomach, and/or upper small bowel Primary Procedure 360 43239 1821.05 Northwest Medical Center OP 1690.98 670.06 2081.20 1769.02 2081.20 2211.28 1821.05 2081.20 670.06 939.85 1560.90 Not Applicable 1847.07 1690.98 1821.05 670.06 670.06 Not Applicable 1911.00 1821.05 670.06 670.06 2270.00 670.06 1795.04 670.06 1560.90 1430.83 670.06 2270.00
Laboratory 300 36415 20.65 Northwest Medical Center OP 19.18 Included in Primary Procedure 23.60 20.06 23.60 25.08 20.65 23.60 Included in Primary Procedure Included in Primary Procedure 17.70 Not Applicable 20.95 19.18 20.65 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.65 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.36 Included in Primary Procedure 17.70 16.23 16.23 25.08
Laboratory 301 80053 278.25 Northwest Medical Center OP 258.38 Included in Primary Procedure 318.00 270.30 318.00 337.88 278.25 318.00 Included in Primary Procedure Included in Primary Procedure 238.50 Not Applicable 282.23 258.38 278.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 278.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 274.28 Included in Primary Procedure 238.50 218.63 218.63 337.88
Laboratory 305 85025 53.20 Northwest Medical Center OP 49.40 Included in Primary Procedure 60.80 51.68 60.80 64.60 53.20 60.80 Included in Primary Procedure Included in Primary Procedure 45.60 Not Applicable 53.96 49.40 53.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 53.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 52.44 Included in Primary Procedure 45.60 41.80 41.80 64.60
Laboratory 307 81025 38.50 Northwest Medical Center OP 35.75 Included in Primary Procedure 44.00 37.40 44.00 46.75 38.50 44.00 Included in Primary Procedure Included in Primary Procedure 33.00 Not Applicable 39.05 35.75 38.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 38.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 37.95 Included in Primary Procedure 33.00 30.25 30.25 46.75
Drugs/Detail Code 636 J2407 98.00 Northwest Medical Center OP 70.00 20.43 112.00 95.20 112.00 119.00 98.00 112.00 20.43 2641.54 84.00 Not Applicable 99.40 70.00 98.00 20.43 20.43 Not Applicable Included in Primary Procedure 98.00 20.43 20.43 Included in Primary Procedure 20.43 96.60 20.43 84.00 77.00 20.43 2641.54
IV Solutions 258 76.30 Northwest Medical Center OP 70.85 Included in Primary Procedure 87.20 74.12 87.20 92.65 76.30 87.20 Included in Primary Procedure Included in Primary Procedure 65.40 Not Applicable 77.39 70.85 76.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 76.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 75.21 Included in Primary Procedure 65.40 59.95 59.95 92.65
Anesthesia 370 364.00 Northwest Medical Center OP 338.00 Included in Primary Procedure 416.00 353.60 416.00 442.00 364.00 416.00 Included in Primary Procedure Included in Primary Procedure 312.00 Not Applicable 369.20 338.00 364.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 364.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 358.80 Included in Primary Procedure 312.00 286.00 286.00 442.00
Supply 270 74.90 Northwest Medical Center OP 69.55 Included in Primary Procedure 85.60 72.76 85.60 90.95 74.90 85.60 Included in Primary Procedure Included in Primary Procedure 64.20 Not Applicable 75.97 69.55 74.90 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 74.90 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 73.83 Included in Primary Procedure 64.20 58.85 58.85 90.95
Non-sterile Supply 271 3.50 Northwest Medical Center OP 3.25 Included in Primary Procedure 4.00 3.40 4.00 4.25 3.50 4.00 Included in Primary Procedure Included in Primary Procedure 3.00 Not Applicable 3.55 3.25 3.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 3.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 3.45 Included in Primary Procedure 3.00 2.75 2.75 4.25
Sterile Supply 272 138.25 Northwest Medical Center OP 128.38 Included in Primary Procedure 158.00 134.30 158.00 167.88 138.25 158.00 Included in Primary Procedure Included in Primary Procedure 118.50 Not Applicable 140.23 128.38 138.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 138.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 136.28 Included in Primary Procedure 118.50 108.63 108.63 167.88
Recovery Room 710 819.35 Northwest Medical Center OP 760.83 Included in Primary Procedure 936.40 795.94 936.40 994.93 819.35 936.40 Included in Primary Procedure Included in Primary Procedure 702.30 Not Applicable 831.06 760.83 819.35 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 819.35 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 807.65 Included in Primary Procedure 702.30 643.78 643.78 994.93
Endoscopic diagnostic examination of large bowel Primary Procedure 360 45378 1821.05 Northwest Medical Center OP 1690.98 651.27 2081.20 1769.02 2081.20 2211.28 1821.05 2081.20 651.27 785.13 1560.90 Not Applicable 1847.07 1690.98 1821.05 651.27 651.27 Not Applicable 1911.00 1821.05 651.27 651.27 1537.00 651.27 1795.04 651.27 1560.90 1430.83 651.27 2211.28
IV Solutions 258 76.30 Northwest Medical Center OP 70.85 Included in Primary Procedure 87.20 74.12 87.20 92.65 76.30 87.20 Included in Primary Procedure Included in Primary Procedure 65.40 Not Applicable 77.39 70.85 76.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 76.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 75.21 Included in Primary Procedure 65.40 59.95 59.95 92.65
Drugs/Detail Code 636 J2704 196.00 Northwest Medical Center OP 140.00 Included in Primary Procedure 224.00 190.40 224.00 238.00 196.00 224.00 Included in Primary Procedure Included in Primary Procedure 168.00 Not Applicable 198.80 140.00 196.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 196.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 193.20 Included in Primary Procedure 168.00 154.00 140.00 238.00
Drugs/Detail Code 636 J2250 20.30 Northwest Medical Center OP 14.50 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure 17.40 Not Applicable 20.59 14.50 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 14.50 24.65
Anesthesia 370 489.30 Northwest Medical Center OP 454.35 Included in Primary Procedure 559.20 475.32 559.20 594.15 489.30 559.20 Included in Primary Procedure Included in Primary Procedure 419.40 Not Applicable 496.29 454.35 489.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 489.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 482.31 Included in Primary Procedure 419.40 384.45 384.45 594.15
Supply 270 78.05 Northwest Medical Center OP 72.48 Included in Primary Procedure 89.20 75.82 89.20 94.78 78.05 89.20 Included in Primary Procedure Included in Primary Procedure 66.90 Not Applicable 79.17 72.48 78.05 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 78.05 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 76.94 Included in Primary Procedure 66.90 61.33 61.33 94.78
Non-sterile Supply 271 10.50 Northwest Medical Center OP 9.75 Included in Primary Procedure 12.00 10.20 12.00 12.75 10.50 12.00 Included in Primary Procedure Included in Primary Procedure 9.00 Not Applicable 10.65 9.75 10.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 10.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 10.35 Included in Primary Procedure 9.00 8.25 8.25 12.75
Recovery Room 710 1377.95 Northwest Medical Center OP 1279.53 Included in Primary Procedure 1574.80 1338.58 1574.80 1673.23 1377.95 1574.80 Included in Primary Procedure Included in Primary Procedure 1181.10 Not Applicable 1397.64 1279.53 1377.95 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1377.95 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1358.27 Included in Primary Procedure 1181.10 1082.68 1082.68 1673.23
Endoscopic biopsy of Large Bowel Primary Procedure 360 45380 1821.05 Northwest Medical Center OP 1690.98 856.18 2081.20 1769.02 2081.20 2211.28 1821.05 2081.20 856.18 785.13 1560.90 Not Applicable 1847.07 1690.98 1821.05 856.18 856.18 Not Applicable 1911.00 1821.05 856.18 856.18 1537.00 856.18 1795.04 856.18 1560.90 1430.83 785.13 2211.28
Drugs/Detail Code 636 J2704 294.00 Northwest Medical Center OP 210.00 Included in Primary Procedure 336.00 285.60 336.00 357.00 294.00 336.00 Included in Primary Procedure Included in Primary Procedure 252.00 Not Applicable 298.20 210.00 294.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 294.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 289.80 Included in Primary Procedure 252.00 231.00 210.00 357.00
Drugs/Detail Code 636 J2250 20.30 Northwest Medical Center OP 14.50 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure 17.40 Not Applicable 20.59 14.50 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 14.50 24.65
Anesthesia 370 489.30 Northwest Medical Center OP 454.35 Included in Primary Procedure 559.20 475.32 559.20 594.15 489.30 559.20 Included in Primary Procedure Included in Primary Procedure 419.40 Not Applicable 496.29 454.35 489.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 489.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 482.31 Included in Primary Procedure 419.40 384.45 384.45 594.15
Supply 270 93.45 Northwest Medical Center OP 86.78 Included in Primary Procedure 106.80 90.78 106.80 113.48 93.45 106.80 Included in Primary Procedure Included in Primary Procedure 80.10 Not Applicable 94.79 86.78 93.45 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 93.45 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 92.12 Included in Primary Procedure 80.10 73.43 73.43 113.48
Non-sterile Supply 271 10.50 Northwest Medical Center OP 9.75 Included in Primary Procedure 12.00 10.20 12.00 12.75 10.50 12.00 Included in Primary Procedure Included in Primary Procedure 9.00 Not Applicable 10.65 9.75 10.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 10.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 10.35 Included in Primary Procedure 9.00 8.25 8.25 12.75
Sterile Supply 272 138.25 Northwest Medical Center OP 128.38 Included in Primary Procedure 158.00 134.30 158.00 167.88 138.25 158.00 Included in Primary Procedure Included in Primary Procedure 118.50 Not Applicable 140.23 128.38 138.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 138.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 136.28 Included in Primary Procedure 118.50 108.63 108.63 167.88
Recovery Room 710 819.35 Northwest Medical Center OP 760.83 Included in Primary Procedure 936.40 795.94 936.40 994.93 819.35 936.40 Included in Primary Procedure Included in Primary Procedure 702.30 Not Applicable 831.06 760.83 819.35 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 819.35 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 807.65 Included in Primary Procedure 702.30 643.78 643.78 994.93
Endoscopic removal of polyps or growths of large bowel Primary Procedure 360 45385 1821.05 Northwest Medical Center OP 1690.98 856.18 2081.20 1769.02 2081.20 2211.28 1821.05 2081.20 856.18 967.07 1560.90 Not Applicable 1847.07 1690.98 1821.05 856.18 856.18 Not Applicable 1911.00 1821.05 856.18 856.18 1537.00 856.18 1795.04 856.18 1560.90 1430.83 856.18 2211.28
IV Solutions 258 76.30 Northwest Medical Center OP 70.85 Included in Primary Procedure 87.20 74.12 87.20 92.65 76.30 87.20 Included in Primary Procedure Included in Primary Procedure 65.40 Not Applicable 77.39 70.85 76.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 76.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 75.21 Included in Primary Procedure 65.40 59.95 59.95 92.65
Drugs/Detail Code 636 J2704 294.00 Northwest Medical Center OP 210.00 Included in Primary Procedure 336.00 285.60 336.00 357.00 294.00 336.00 Included in Primary Procedure Included in Primary Procedure 252.00 Not Applicable 298.20 210.00 294.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 294.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 289.80 Included in Primary Procedure 252.00 231.00 210.00 357.00
Drugs/Detail Code 636 J3010 30.10 Northwest Medical Center OP 21.50 Included in Primary Procedure 34.40 29.24 34.40 36.55 30.10 34.40 Included in Primary Procedure Included in Primary Procedure 25.80 Not Applicable 30.53 21.50 30.10 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 30.10 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 29.67 Included in Primary Procedure 25.80 23.65 21.50 36.55
Drugs/Detail Code 636 J2250 20.30 Northwest Medical Center OP 14.50 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure 17.40 Not Applicable 20.59 14.50 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 14.50 24.65
Anesthesia 370 865.20 Northwest Medical Center OP 803.40 Included in Primary Procedure 988.80 840.48 988.80 1050.60 865.20 988.80 Included in Primary Procedure Included in Primary Procedure 741.60 Not Applicable 877.56 803.40 865.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 865.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 852.84 Included in Primary Procedure 741.60 679.80 679.80 1050.60
Supply 270 167.30 Northwest Medical Center OP 155.35 Included in Primary Procedure 191.20 162.52 191.20 203.15 167.30 191.20 Included in Primary Procedure Included in Primary Procedure 143.40 Not Applicable 169.69 155.35 167.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 167.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 164.91 Included in Primary Procedure 143.40 131.45 131.45 203.15
Non-sterile Supply 271 10.50 Northwest Medical Center OP 9.75 Included in Primary Procedure 12.00 10.20 12.00 12.75 10.50 12.00 Included in Primary Procedure Included in Primary Procedure 9.00 Not Applicable 10.65 9.75 10.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 10.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 10.35 Included in Primary Procedure 9.00 8.25 8.25 12.75
Sterile Supply 272 138.25 Northwest Medical Center OP 128.38 Included in Primary Procedure 158.00 134.30 158.00 167.88 138.25 158.00 Included in Primary Procedure Included in Primary Procedure 118.50 Not Applicable 140.23 128.38 138.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 138.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 136.28 Included in Primary Procedure 118.50 108.63 108.63 167.88
Recovery Room 710 1191.75 Northwest Medical Center OP 1106.63 Included in Primary Procedure 1362.00 1157.70 1362.00 1447.13 1191.75 1362.00 Included in Primary Procedure Included in Primary Procedure 1021.50 Not Applicable 1208.78 1106.63 1191.75 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1191.75 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1174.73 Included in Primary Procedure 1021.50 936.38 936.38 1447.13
Endoscopic Removal of Gallbladder Primary Procedure 360 47562 4195.80 Northwest Medical Center OP 3896.10 4121.12 4795.20 4075.92 4795.20 5094.90 4195.80 4795.20 4121.12 4225.41 6000.00 Not Applicable 4255.74 3896.10 4195.80 4121.12 4121.12 Not Applicable 1911.00 4195.80 4121.12 4121.12 5085.00 4121.12 4135.86 4121.12 3596.40 3296.70 1911.00 6000.00
Laboratory 300 36415 27.65 Northwest Medical Center OP 25.68 Included in Primary Procedure 31.60 26.86 31.60 33.58 27.65 31.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 28.05 25.68 27.65 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 27.65 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 27.26 Included in Primary Procedure 23.70 21.73 21.73 33.58
Laboratory 301 80053 278.25 Northwest Medical Center OP 258.38 Included in Primary Procedure 318.00 270.30 318.00 337.88 278.25 318.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 282.23 258.38 278.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 278.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 274.28 Included in Primary Procedure 238.50 218.63 218.63 337.88
Laboratory 305 85025 53.20 Northwest Medical Center OP 49.40 Included in Primary Procedure 60.80 51.68 60.80 64.60 53.20 60.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 53.96 49.40 53.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 53.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 52.44 Included in Primary Procedure 45.60 41.80 41.80 64.60
Pharmacy 250 577.15 Northwest Medical Center OP 535.93 Included in Primary Procedure 659.60 560.66 659.60 700.83 577.15 659.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 585.40 535.93 577.15 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 577.15 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 568.91 Included in Primary Procedure 494.70 453.48 453.48 700.83
IV Solutions 258 152.60 Northwest Medical Center OP 141.70 Included in Primary Procedure 174.40 148.24 174.40 185.30 152.60 174.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 154.78 141.70 152.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 152.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 150.42 Included in Primary Procedure 130.80 119.90 119.90 185.30
Pharmacy 363 J2710 213.50 Northwest Medical Center OP 198.25 Included in Primary Procedure 244.00 207.40 244.00 259.25 213.50 244.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 216.55 198.25 213.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 213.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 210.45 Included in Primary Procedure 183.00 167.75 167.75 259.25
Pharmacy 363 J0690 140.00 Northwest Medical Center OP 130.00 Included in Primary Procedure 160.00 136.00 160.00 170.00 140.00 160.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 142.00 130.00 140.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 140.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 138.00 Included in Primary Procedure 120.00 110.00 110.00 170.00
Pharmacy 363 J2704 98.00 Northwest Medical Center OP 91.00 Included in Primary Procedure 112.00 95.20 112.00 119.00 98.00 112.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 99.40 91.00 98.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 98.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 96.60 Included in Primary Procedure 84.00 77.00 77.00 119.00
Pharmacy 363 J1100 63.00 Northwest Medical Center OP 58.50 Included in Primary Procedure 72.00 61.20 72.00 76.50 63.00 72.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 63.90 58.50 63.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 63.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 62.10 Included in Primary Procedure 54.00 49.50 49.50 76.50
Pharmacy 363 J2405 40.60 Northwest Medical Center OP 37.70 Included in Primary Procedure 46.40 39.44 46.40 49.30 40.60 46.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 41.18 37.70 40.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 40.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 40.02 Included in Primary Procedure 34.80 31.90 31.90 49.30
Pharmacy 363 J3475 29.40 Northwest Medical Center OP 27.30 Included in Primary Procedure 33.60 28.56 33.60 35.70 29.40 33.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 29.82 27.30 29.40 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 29.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 28.98 Included in Primary Procedure 25.20 23.10 23.10 35.70
Pharmacy 363 J2250 20.30 Northwest Medical Center OP 18.85 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 20.59 18.85 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 15.95 24.65
Pharmacy 363 J3490 4.20 Northwest Medical Center OP 3.90 Included in Primary Procedure 4.80 4.08 4.80 5.10 4.20 4.80 Included in Primary Procedure 0.00 Included in Primary Procedure Not Applicable 4.26 3.90 4.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 4.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 4.14 Included in Primary Procedure 3.60 3.30 0.00 5.10
Anesthesia 370 1115.80 Northwest Medical Center OP 1036.10 Included in Primary Procedure 1275.20 1083.92 1275.20 1354.90 1115.80 1275.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1131.74 1036.10 1115.80 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1115.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1099.86 Included in Primary Procedure 956.40 876.70 876.70 1354.90
Supply 270 2262.40 Northwest Medical Center OP 2100.80 Included in Primary Procedure 2585.60 2197.76 2585.60 2747.20 2262.40 2585.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 2294.72 2100.80 2262.40 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 2262.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 2230.08 Included in Primary Procedure 1939.20 1777.60 1777.60 2747.20
Sterile Supply 272 2005.15 Northwest Medical Center OP 1861.93 Included in Primary Procedure 2291.60 1947.86 2291.60 2434.83 2005.15 2291.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 2033.80 1861.93 2005.15 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 2005.15 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1976.51 Included in Primary Procedure 1718.70 1575.48 1575.48 2434.83
Recovery Room 710 2146.90 Northwest Medical Center OP 1993.55 Included in Primary Procedure 2453.60 2085.56 2453.60 2606.95 2146.90 2453.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 2177.57 1993.55 2146.90 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 2146.90 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 2116.23 Included in Primary Procedure 1840.20 1686.85 1686.85 2606.95
Repair of groin hernia patient age 5 years or older Primary Procedure 360 49505 6260.80 Northwest Medical Center OP 5813.60 2650.96 7155.20 6081.92 7155.20 7602.40 6260.80 7155.20 2650.96 2664.65 6000.00 Not Applicable 6350.24 5813.60 6260.80 2650.96 2650.96 Not Applicable 1911.00 6260.80 2650.96 2650.96 3106.00 2650.96 6171.36 2650.96 5366.40 4919.20 1911.00 7602.40
Supply/Impant 278 C1781 695.80 Northwest Medical Center OP 497.00 Included in Primary Procedure 795.20 298.20 273.35 844.90 695.80 273.35 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 705.74 497.00 695.80 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 695.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 685.86 Included in Primary Procedure 596.40 546.70 273.35 844.90
Pharmacy 250 127.05 Northwest Medical Center OP 117.98 Included in Primary Procedure 145.20 123.42 145.20 154.28 127.05 145.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 128.87 117.98 127.05 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 127.05 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 125.24 Included in Primary Procedure 108.90 99.83 99.83 154.28
Pharmacy 250 54.25 Northwest Medical Center OP 50.38 Included in Primary Procedure 62.00 52.70 62.00 65.88 54.25 62.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 55.03 50.38 54.25 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 54.25 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 53.48 Included in Primary Procedure 46.50 42.63 42.63 65.88
Pharmacy 250 42.35 Northwest Medical Center OP 39.33 Included in Primary Procedure 48.40 41.14 48.40 51.43 42.35 48.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 42.96 39.33 42.35 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 42.35 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 41.75 Included in Primary Procedure 36.30 33.28 33.28 51.43
Pharmacy 250 38.50 Northwest Medical Center OP 35.75 Included in Primary Procedure 44.00 37.40 44.00 46.75 38.50 44.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 39.05 35.75 38.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 38.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 37.95 Included in Primary Procedure 33.00 30.25 30.25 46.75
Pharmacy 250 16.80 Northwest Medical Center OP 15.60 Included in Primary Procedure 19.20 16.32 19.20 20.40 16.80 19.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 17.04 15.60 16.80 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 16.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 16.56 Included in Primary Procedure 14.40 13.20 13.20 20.40
Pharmacy 250 5.60 Northwest Medical Center OP 5.20 Included in Primary Procedure 6.40 5.44 6.40 6.80 5.60 6.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 5.68 5.20 5.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 5.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 5.52 Included in Primary Procedure 4.80 4.40 4.40 6.80
Pharmacy 250 5.60 Northwest Medical Center OP 5.20 Included in Primary Procedure 6.40 5.44 6.40 6.80 5.60 6.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 5.68 5.20 5.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 5.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 5.52 Included in Primary Procedure 4.80 4.40 4.40 6.80
IV Solutions 258 76.30 Northwest Medical Center OP 70.85 Included in Primary Procedure 87.20 74.12 87.20 92.65 76.30 87.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 77.39 70.85 76.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 76.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 75.21 Included in Primary Procedure 65.40 59.95 59.95 92.65
Drugs/Detail Code 636 J0690 140.00 Northwest Medical Center OP 100.00 Included in Primary Procedure 160.00 136.00 160.00 170.00 140.00 160.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 142.00 100.00 140.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 140.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 138.00 Included in Primary Procedure 120.00 110.00 100.00 170.00
Drugs/Detail Code 636 J2704 98.00 Northwest Medical Center OP 70.00 Included in Primary Procedure 112.00 95.20 112.00 119.00 98.00 112.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 99.40 70.00 98.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 98.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 96.60 Included in Primary Procedure 84.00 77.00 70.00 119.00
Pharmacy 363 J3010 60.20 Northwest Medical Center OP 55.90 Included in Primary Procedure 68.80 58.48 68.80 73.10 60.20 68.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 61.06 55.90 60.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 60.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 59.34 Included in Primary Procedure 51.60 47.30 47.30 73.10
Pharmacy 363 J1100 56.00 Northwest Medical Center OP 52.00 Included in Primary Procedure 64.00 54.40 64.00 68.00 56.00 64.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 56.80 52.00 56.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 56.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 55.20 Included in Primary Procedure 48.00 44.00 44.00 68.00
Pharmacy 363 J2405 40.60 Northwest Medical Center OP 37.70 Included in Primary Procedure 46.40 39.44 46.40 49.30 40.60 46.40 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 41.18 37.70 40.60 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 40.60 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 40.02 Included in Primary Procedure 34.80 31.90 31.90 49.30
Pharmacy 363 J2250 20.30 Northwest Medical Center OP 18.85 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 20.59 18.85 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 15.95 24.65
Anesthesia 370 1617.00 Northwest Medical Center OP 1501.50 Included in Primary Procedure 1848.00 1570.80 1848.00 1963.50 1617.00 1848.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 1640.10 1501.50 1617.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1617.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 1593.90 Included in Primary Procedure 1386.00 1270.50 1270.50 1963.50
Supply 270 374.50 Northwest Medical Center OP 347.75 Included in Primary Procedure 428.00 363.80 428.00 454.75 374.50 428.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 379.85 347.75 374.50 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 374.50 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 369.15 Included in Primary Procedure 321.00 294.25 294.25 454.75
Sterile Supply 272 452.20 Northwest Medical Center OP 419.90 Included in Primary Procedure 516.80 439.28 516.80 549.10 452.20 516.80 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 458.66 419.90 452.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 452.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 445.74 Included in Primary Procedure 387.60 355.30 355.30 549.10
Recovery Room 710 2038.05 Northwest Medical Center OP 1892.48 Included in Primary Procedure 2329.20 1979.82 2329.20 2474.78 2038.05 2329.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Not Applicable 2067.17 1892.48 2038.05 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 2038.05 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 2008.94 Included in Primary Procedure 1746.90 1601.33 1601.33 2474.78
Removal of recurring cataract in lens capsule using laser Primary Procedure 360 66821 1614.55 Northwest Medical Center OP 1499.23 432.20 1845.20 1568.42 1845.20 1960.53 1614.55 1845.20 432.20 604.85 1383.90 Not Applicable 1637.62 1499.23 1614.55 432.20 432.20 Not Applicable 1911.00 1614.55 432.20 432.20 2270.00 432.20 1591.49 432.20 1383.90 1268.58 432.20 2270.00
Drugs/Detail Code 636 J2704 98.00 Northwest Medical Center OP 70.00 Included in Primary Procedure 112.00 95.20 112.00 119.00 98.00 112.00 Included in Primary Procedure Included in Primary Procedure 84.00 Not Applicable 99.40 70.00 98.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 98.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 96.60 Included in Primary Procedure 84.00 77.00 70.00 119.00
Drugs/Detail Code 636 J2250 20.30 Northwest Medical Center OP 14.50 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure 17.40 Not Applicable 20.59 14.50 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 14.50 24.65
Anesthesia 370 364.00 Northwest Medical Center OP 338.00 Included in Primary Procedure 416.00 353.60 416.00 442.00 364.00 416.00 Included in Primary Procedure Included in Primary Procedure 312.00 Not Applicable 369.20 338.00 364.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 364.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 358.80 Included in Primary Procedure 312.00 286.00 286.00 442.00
Supply 270 4.20 Northwest Medical Center OP 3.90 Included in Primary Procedure 4.80 4.08 4.80 5.10 4.20 4.80 Included in Primary Procedure Included in Primary Procedure 3.60 Not Applicable 4.26 3.90 4.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 4.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 4.14 Included in Primary Procedure 3.60 3.30 3.30 5.10
Recovery Room 710 1005.55 Northwest Medical Center OP 933.73 Included in Primary Procedure 1149.20 976.82 1149.20 1221.03 1005.55 1149.20 Included in Primary Procedure Included in Primary Procedure 861.90 Not Applicable 1019.92 933.73 1005.55 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1005.55 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 991.19 Included in Primary Procedure 861.90 790.08 790.08 1221.03
Removal of cataract with insertion of lens Primary Procedure 360 66984 1614.55 Northwest Medical Center OP 1499.23 1723.80 1845.20 1568.42 1845.20 1960.53 1614.55 1845.20 1723.80 1787.02 1383.90 Not Applicable 1637.62 1499.23 1614.55 1723.80 1723.80 Not Applicable 1911.00 1614.55 1723.80 1723.80 2270.00 1723.80 1591.49 1723.80 1383.90 1268.58 1268.58 2270.00
Pharmacy 250 578.20 Northwest Medical Center OP 536.90 Included in Primary Procedure 660.80 561.68 660.80 702.10 578.20 660.80 Included in Primary Procedure Included in Primary Procedure 495.60 Not Applicable 586.46 536.90 578.20 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 578.20 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 569.94 Included in Primary Procedure 495.60 454.30 454.30 702.10
Drugs/Detail Code 636 J3010 30.10 Northwest Medical Center OP 21.50 Included in Primary Procedure 34.40 29.24 34.40 36.55 30.10 34.40 Included in Primary Procedure Included in Primary Procedure 25.80 Not Applicable 30.53 21.50 30.10 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 30.10 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 29.67 Included in Primary Procedure 25.80 23.65 21.50 36.55
Drugs/Detail Code 636 J2250 20.30 Northwest Medical Center OP 14.50 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure 17.40 Not Applicable 20.59 14.50 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 14.50 24.65
Drugs/Detail Code 636 A9270 29.05 Northwest Medical Center OP 20.75 Included in Primary Procedure 33.20 28.22 33.20 35.28 29.05 33.20 Included in Primary Procedure Included in Primary Procedure 24.90 Not Applicable 29.47 20.75 29.05 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 29.05 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 28.64 Included in Primary Procedure 24.90 22.83 20.75 35.28
Pharmacy Self Administered 637 A9270 19.95 Northwest Medical Center OP 18.53 Included in Primary Procedure 22.80 19.38 22.80 24.23 19.95 22.80 Included in Primary Procedure Included in Primary Procedure 17.10 Not Applicable 20.24 18.53 19.95 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 19.95 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 19.67 Included in Primary Procedure 17.10 15.68 15.68 24.23
Supply 270 27.65 Northwest Medical Center OP 25.68 Included in Primary Procedure 31.60 26.86 31.60 33.58 27.65 31.60 Included in Primary Procedure Included in Primary Procedure 23.70 Not Applicable 28.05 25.68 27.65 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 27.65 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 27.26 Included in Primary Procedure 23.70 21.73 21.73 33.58
Sterile Supply 272 20.30 Northwest Medical Center OP 18.85 Included in Primary Procedure 23.20 19.72 23.20 24.65 20.30 23.20 Included in Primary Procedure Included in Primary Procedure 17.40 Not Applicable 20.59 18.85 20.30 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 20.30 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 20.01 Included in Primary Procedure 17.40 15.95 15.95 24.65
Supply - Intraocular Lens 276 C1780 556.26 Northwest Medical Center OP 516.53 Included in Primary Procedure 635.73 238.40 218.53 675.46 556.26 218.53 Included in Primary Procedure Included in Primary Procedure 476.80 Not Applicable 564.21 516.53 556.26 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 556.26 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 548.32 Included in Primary Procedure 476.80 437.06 218.53 675.46
Anesthesia 370 364.00 Northwest Medical Center OP 338.00 Included in Primary Procedure 416.00 353.60 416.00 442.00 364.00 416.00 Included in Primary Procedure Included in Primary Procedure 312.00 Not Applicable 369.20 338.00 364.00 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 364.00 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 358.80 Included in Primary Procedure 312.00 286.00 286.00 442.00
Recovery Room 710 1005.55 Northwest Medical Center OP 933.73 Included in Primary Procedure 1149.20 976.82 1149.20 1221.03 1005.55 1149.20 Included in Primary Procedure Included in Primary Procedure 861.90 Not Applicable 1019.92 933.73 1005.55 Included in Primary Procedure Included in Primary Procedure Not Applicable Included in Primary Procedure 1005.55 Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure Included in Primary Procedure 991.19 Included in Primary Procedure 861.90 790.08 790.08 1221.03
Sleep Study Primary Procedure 920 95810 3638.95 Northwest Medical Center OP 3379.03 774.95 4158.80 3534.98 4158.80 4418.73 3638.95 4158.80 774.95 841.22 3119.10 Not Applicable 3690.94 3379.03 3638.95 774.95 774.95 Not Applicable 3638.95 3638.95 774.95 774.95 3638.95 774.95 3586.97 774.95 3119.10 2859.18 774.95 4418.73
Physical therapy, therapeutic exercise Primary Procedure 420 97110 85.40 Northwest Medical Center OP 79.30 29.58 97.60 82.96 97.60 103.70 85.40 97.60 29.58 225.15 73.20 Not Applicable 86.62 79.30 85.40 29.58 29.58 Not Applicable 85.40 85.40 29.58 29.58 85.40 29.58 84.18 29.58 73.20 67.10 29.58 225.15
Psychotherapy, 30 min 90832 152.60 Northwest Medical Center OP 141.70 111.99 174.40 148.24 174.40 185.30 152.60 174.40 111.99 164.59 130.80 Not Applicable 154.78 141.70 152.60 111.99 111.99 Not Applicable 152.60 152.60 111.99 111.99 Not Applicable 111.99 150.42 111.99 130.80 119.90 111.99 185.30
Psychotherapy, 45 min 90834 227.15 Northwest Medical Center OP 210.93 111.99 259.60 220.66 259.60 275.83 227.15 259.60 111.99 169.74 194.70 Not Applicable 230.40 210.93 227.15 111.99 111.99 Not Applicable 227.15 227.15 111.99 111.99 Not Applicable 111.99 223.91 111.99 194.70 178.48 111.99 275.83
Family psychotherapy, not including patient, 50 min 90846 173.60 Northwest Medical Center OP 161.20 111.99 198.40 168.64 198.40 210.80 173.60 198.40 111.99 181.75 148.80 Not Applicable 176.08 161.20 173.60 111.99 111.99 Not Applicable 173.60 173.60 111.99 111.99 Not Applicable 111.99 171.12 111.99 148.80 136.40 111.99 210.80
Family psychotherapy, including patient, 50 min 90847 205.80 Northwest Medical Center OP 191.10 111.99 235.20 199.92 235.20 249.90 205.80 235.20 111.99 181.75 176.40 Not Applicable 208.74 191.10 205.80 111.99 111.99 Not Applicable 205.80 205.80 111.99 111.99 Not Applicable 111.99 202.86 111.99 176.40 161.70 111.99 249.90
Group psychotherapy 90853 173.60 Northwest Medical Center OP 161.20 66.96 198.40 168.64 198.40 210.80 173.60 198.40 66.96 247.84 148.80 Not Applicable 176.08 161.20 173.60 66.96 66.96 Not Applicable 173.60 173.60 66.96 66.96 Not Applicable 66.96 171.12 66.96 148.80 136.40 66.96 247.84
Basic metabolic panel 80048 134.40 Northwest Medical Center OP 124.80 8.46 153.60 130.56 153.60 163.20 134.40 153.60 8.46 10.73 115.20 Not Applicable 136.32 124.80 134.40 8.46 8.46 Not Applicable 134.40 134.40 8.46 8.46 10.78 8.46 132.48 8.46 115.20 105.60 8.46 163.20
Blood test, comprehensive group of blood chemicals 80053 278.25 Northwest Medical Center OP 258.38 10.56 318.00 270.30 318.00 337.88 278.25 318.00 10.56 10.73 238.50 Not Applicable 282.23 258.38 278.25 10.56 10.56 Not Applicable 278.25 278.25 10.56 10.56 13.47 10.56 274.28 10.56 238.50 218.63 10.56 337.88
Obstetric blood test panel 80055 834.40 Northwest Medical Center OP 774.80 47.81 953.60 810.56 953.60 1013.20 834.40 953.60 47.81 10.73 715.20 Not Applicable 846.32 774.80 834.40 47.81 47.81 Not Applicable 834.40 834.40 47.81 47.81 51.77 47.81 822.48 47.81 715.20 655.60 10.73 1013.20
Blood test, lipids (cholesterol and triglycerides) 80061 187.95 Northwest Medical Center OP 174.53 13.39 214.80 182.58 214.80 228.23 187.95 214.80 13.39 10.73 161.10 Not Applicable 190.64 174.53 187.95 13.39 13.39 Not Applicable 187.95 187.95 13.39 13.39 17.07 13.39 185.27 13.39 161.10 147.68 10.73 228.23
Kidney function panel test 80069 191.45 Northwest Medical Center OP 177.78 8.68 218.80 185.98 218.80 232.48 191.45 218.80 8.68 10.73 164.10 Not Applicable 194.19 177.78 191.45 8.68 8.68 Not Applicable 191.45 191.45 8.68 8.68 11.07 8.68 188.72 8.68 164.10 150.43 8.68 232.48
Liver function blood test panel 80076 99.40 Northwest Medical Center OP 92.30 8.17 113.60 96.56 113.60 120.70 99.40 113.60 8.17 10.73 85.20 Not Applicable 100.82 92.30 99.40 8.17 8.17 Not Applicable 99.40 99.40 8.17 8.17 10.41 8.17 97.98 8.17 85.20 78.10 8.17 120.70
Manual urinalysis test with examination using microscope 81001 27.30 Northwest Medical Center OP 25.35 3.17 31.20 26.52 31.20 33.15 27.30 31.20 3.17 3.49 23.40 Not Applicable 27.69 25.35 27.30 3.17 3.17 Not Applicable 27.30 27.30 3.17 3.17 4.03 3.17 26.91 3.17 23.40 21.45 3.17 33.15
Automated urinalysis test 81003 19.95 Northwest Medical Center OP 18.53 2.25 22.80 19.38 22.80 24.23 19.95 22.80 2.25 3.49 17.10 Not Applicable 20.24 18.53 19.95 2.25 2.25 Not Applicable 19.95 19.95 2.25 2.25 2.86 2.25 19.67 2.25 17.10 15.68 2.25 24.23
PSA (prostate specific antigen) 84153 219.10 Northwest Medical Center OP 203.45 18.39 250.40 212.84 250.40 266.05 219.10 250.40 18.39 11.59 187.80 Not Applicable 222.23 203.45 219.10 18.39 18.39 Not Applicable 219.10 219.10 18.39 18.39 23.45 18.39 215.97 18.39 187.80 172.15 11.59 266.05
Blood test, thyroid stimulating hormone (TSH) 84443 109.55 Northwest Medical Center OP 101.73 16.80 125.20 106.42 125.20 133.03 109.55 125.20 16.80 16.00 93.90 Not Applicable 111.12 101.73 109.55 16.80 16.80 Not Applicable 109.55 109.55 16.80 16.80 21.42 16.80 107.99 16.80 93.90 86.08 16.00 133.03
Complete blood cell count, with differential white blood cells, automated 85025 53.20 Northwest Medical Center OP 49.40 7.77 60.80 51.68 60.80 64.60 53.20 60.80 7.77 6.93 45.60 Not Applicable 53.96 49.40 53.20 7.77 7.77 Not Applicable 53.20 53.20 7.77 7.77 9.92 7.77 52.44 7.77 45.60 41.80 6.93 64.60
Complete blood count, automated 85027 17.67 Northwest Medical Center OP 16.41 6.47 20.19 17.16 20.19 21.45 17.67 20.19 6.47 6.93 15.14 Not Applicable 17.92 16.41 17.67 6.47 6.47 Not Applicable 17.67 17.67 6.47 6.47 8.25 6.47 17.42 6.47 15.14 13.88 6.47 21.45
Blood test, clotting time 85610 33.60 Northwest Medical Center OP 31.20 4.29 38.40 32.64 38.40 40.80 33.60 38.40 4.29 4.41 28.80 Not Applicable 34.08 31.20 33.60 4.29 4.29 Not Applicable 33.60 33.60 4.29 4.29 5.00 4.29 33.12 4.29 28.80 26.40 4.29 40.80
Coagulation assessment blood test 85730 59.50 Northwest Medical Center OP 55.25 6.01 68.00 57.80 68.00 72.25 59.50 68.00 6.01 4.41 51.00 Not Applicable 60.35 55.25 59.50 6.01 6.01 Not Applicable 59.50 59.50 6.01 6.01 7.65 6.01 58.65 6.01 51.00 46.75 4.41 72.25
CT scan, head or brain, without contrast 70450 862.75 Northwest Medical Center OP 801.13 95.56 986.00 300.00 986.00 1047.63 862.75 986.00 95.56 332.86 739.50 986.00 875.08 801.13 862.75 95.56 95.56 Not Applicable 862.75 862.75 95.56 95.56 943.00 95.56 850.43 95.56 739.50 677.88 95.56 1047.63
MRI scan of brain before and after contrast 70553 1902.95 Northwest Medical Center OP 1767.03 325.56 2174.80 750.00 2174.80 2310.73 1902.95 2174.80 325.56 472.99 1631.10 2174.80 1930.14 1767.03 1902.95 325.56 325.56 Not Applicable 1902.95 1902.95 325.56 325.56 1141.00 325.56 1875.77 325.56 1631.10 1495.18 325.56 2310.73
X-Ray, lower back, minimum four views 72110 433.65 Northwest Medical Center OP 402.68 95.56 495.60 421.26 495.60 526.58 433.65 495.60 95.56 61.05 371.70 495.60 439.85 402.68 433.65 95.56 95.56 Not Applicable 433.65 433.65 95.56 95.56 433.65 95.56 427.46 95.56 371.70 340.73 61.05 526.58
MRI scan of lower spinal canal 72148 3077.55 Northwest Medical Center OP 2857.73 198.69 3517.20 600.00 3517.20 3737.03 3077.55 3517.20 198.69 271.01 2637.90 3517.20 3121.52 2857.73 3077.55 198.69 198.69 Not Applicable 3077.55 3077.55 198.69 198.69 1141.00 198.69 3033.59 198.69 2637.90 2418.08 198.69 3737.03
CT scan, pelvis, with contrast 72193 1146.60 Northwest Medical Center OP 1064.70 155.36 1310.40 400.00 1310.40 1392.30 1146.60 1310.40 155.36 332.86 982.80 1310.40 1162.98 1064.70 1146.60 155.36 155.36 Not Applicable 1146.60 1146.60 155.36 155.36 943.00 155.36 1130.22 155.36 982.80 900.90 155.36 1392.30
MRI scan of leg joint 73721 2466.45 Northwest Medical Center OP 2290.28 198.69 2818.80 600.00 2818.80 2994.98 2466.45 2818.80 198.69 271.01 2114.10 2818.80 2501.69 2290.28 2466.45 198.69 198.69 Not Applicable 2466.45 2466.45 198.69 198.69 1141.00 198.69 2431.22 198.69 2114.10 1937.93 198.69 2994.98
CT scan of abdomen and pelvis with contrast 74177 2044.70 Northwest Medical Center OP 1898.65 325.56 2336.80 400.00 2336.80 2482.85 2044.70 2336.80 325.56 332.86 1752.60 2336.80 2073.91 1898.65 2044.70 325.56 325.56 Not Applicable 2044.70 2044.70 325.56 325.56 943.00 325.56 2015.49 325.56 1752.60 1606.55 325.56 2482.85
Ultrasound of abdomen 76700 379.75 Northwest Medical Center OP 352.63 95.56 434.00 368.90 434.00 461.13 379.75 434.00 95.56 223.32 325.50 434.00 385.18 352.63 379.75 95.56 95.56 Not Applicable 379.75 379.75 95.56 95.56 379.75 95.56 374.33 95.56 325.50 298.38 95.56 461.13
Ultrasound pelvis through vagina 76830 493.15 Northwest Medical Center OP 457.93 95.56 563.60 479.06 563.60 598.83 493.15 563.60 95.56 171.89 422.70 563.60 500.20 457.93 493.15 95.56 95.56 Not Applicable 493.15 493.15 95.56 95.56 493.15 95.56 486.11 95.56 422.70 387.48 95.56 598.83
Mammography of one breast 77065 288.05 Northwest Medical Center OP 267.48 83.99 329.20 279.82 329.20 349.78 288.05 329.20 83.99 72.52 246.90 329.20 292.17 267.48 288.05 83.99 83.99 Not Applicable 288.05 288.05 83.99 83.99 340.90 83.99 283.94 83.99 246.90 226.33 72.52 349.78
Mammography of both breasts 77066 325.50 Northwest Medical Center OP 302.25 107.09 372.00 316.20 372.00 395.25 325.50 372.00 107.09 72.52 279.00 372.00 330.15 302.25 325.50 107.09 107.09 Not Applicable 325.50 325.50 107.09 107.09 325.50 107.09 320.85 107.09 279.00 255.75 72.52 395.25
Mammography, screening, bilateral 77067 35.00 Northwest Medical Center OP 32.50 88.81 40.00 34.00 40.00 42.50 35.00 40.00 88.81 72.52 30.00 40.00 35.50 32.50 35.00 88.81 88.81 Not Applicable 35.00 35.00 88.81 88.81 235.20 88.81 34.50 88.81 30.00 27.50 27.50 235.20
Prealbumin 84134 6.65 Northwest Medical Center OP 6.18 14.59 7.60 6.46 7.60 8.08 6.65 7.60 14.59 11.59 5.70 Not Applicable 6.75 6.18 6.65 14.59 14.59 Not Applicable 6.65 6.65 14.59 14.59 18.59 14.59 6.56 14.59 5.70 5.23 5.23 18.59
Sulfate Urine 84392 15.05 Northwest Medical Center OP 13.98 5.49 17.20 14.62 17.20 18.28 15.05 17.20 5.49 3.49 12.90 Not Applicable 15.27 13.98 15.05 5.49 5.49 Not Applicable 15.05 15.05 5.49 5.49 6.06 5.49 14.84 5.49 12.90 11.83 3.49 18.28
Volume Measurement U 81050 18.90 Northwest Medical Center OP 17.55 3.64 21.60 18.36 21.60 22.95 18.90 21.60 3.64 3.49 16.20 Not Applicable 19.17 17.55 18.90 3.64 3.64 Not Applicable 18.90 18.90 3.64 3.64 3.83 3.64 18.63 3.64 16.20 14.85 3.49 22.95
Ra Qn 86431 18.90 Northwest Medical Center OP 17.55 5.67 21.60 18.36 21.60 22.95 18.90 21.60 5.67 11.46 16.20 Not Applicable 19.17 17.55 18.90 5.67 5.67 Not Applicable 18.90 18.90 5.67 5.67 7.24 5.67 18.63 5.67 16.20 14.85 5.67 22.95
Routine Venipuncture 36415 20.65 Northwest Medical Center OP 19.18 3.00 23.60 20.06 23.60 25.08 20.65 23.60 3.00 2.64 17.70 Not Applicable 20.95 19.18 20.65 3.00 3.00 Not Applicable 20.65 20.65 3.00 3.00 2.70 3.00 20.36 3.00 17.70 16.23 2.64 25.08
Coll Capillary Blood 36416 20.65 Northwest Medical Center OP 19.18 0.00 23.60 20.06 23.60 25.08 20.65 23.60 0.00 0.00 17.70 Not Applicable 20.95 19.18 20.65 0.00 0.00 Not Applicable 20.65 20.65 0.00 0.00 2.58 0.00 20.36 0.00 17.70 16.23 0.00 25.08
Bone Decalcification 88311 20.65 Northwest Medical Center OP 19.18 0.00 23.60 20.06 23.60 25.08 20.65 23.60 0.00 17.65 17.70 Not Applicable 20.95 19.18 20.65 0.00 0.00 Not Applicable 20.65 20.65 0.00 0.00 10.04 0.00 20.36 0.00 17.70 16.23 0.00 25.08
Allergen Disk, Spong 86005 21.70 Northwest Medical Center OP 20.15 7.97 24.80 21.08 24.80 26.35 21.70 24.80 7.97 11.46 18.60 Not Applicable 22.01 20.15 21.70 7.97 7.97 Not Applicable 21.70 21.70 7.97 7.97 10.16 7.97 21.39 7.97 18.60 17.05 7.97 26.35
Hematocrit 85014 22.75 Northwest Medical Center OP 21.13 2.37 26.00 22.10 26.00 27.63 22.75 26.00 2.37 6.93 19.50 Not Applicable 23.08 21.13 22.75 2.37 2.37 Not Applicable 22.75 22.75 2.37 2.37 3.02 2.37 22.43 2.37 19.50 17.88 2.37 27.63
Rbc Count Bld Auto 85041 22.75 Northwest Medical Center OP 21.13 3.02 26.00 22.10 26.00 27.63 22.75 26.00 3.02 6.93 19.50 Not Applicable 23.08 21.13 22.75 3.02 3.02 Not Applicable 22.75 22.75 3.02 3.02 3.84 3.02 22.43 3.02 19.50 17.88 3.02 27.63
Hemoglobin 85018 22.75 Northwest Medical Center OP 21.13 2.37 26.00 22.10 26.00 27.63 22.75 26.00 2.37 6.93 19.50 Not Applicable 23.08 21.13 22.75 2.37 2.37 Not Applicable 22.75 22.75 2.37 2.37 3.02 2.37 22.43 2.37 19.50 17.88 2.37 27.63
Rh Type 86901 22.75 Northwest Medical Center OP 21.13 28.50 26.00 22.10 26.00 27.63 22.75 26.00 28.50 3.80 19.50 Not Applicable 23.08 21.13 22.75 28.50 28.50 Not Applicable 22.75 22.75 28.50 28.50 3.81 28.50 22.43 28.50 19.50 17.88 3.80 28.50
Ct Calcium Scoring 75571 23.02 Northwest Medical Center OP 21.37 68.04 26.30 22.36 26.30 27.95 23.02 26.30 68.04 128.55 19.73 26.30 23.34 21.37 23.02 68.04 68.04 Not Applicable 23.02 23.02 68.04 68.04 943.00 68.04 22.69 68.04 19.73 18.08 18.08 943.00
Cadmium 82300 24.15 Northwest Medical Center OP 22.43 23.64 27.60 23.46 27.60 29.33 24.15 27.60 23.64 13.73 20.70 Not Applicable 24.50 22.43 24.15 23.64 23.64 Not Applicable 24.15 24.15 23.64 23.64 29.50 23.64 23.81 23.64 20.70 18.98 13.73 29.50
Total Protein Serum 84155 26.25 Northwest Medical Center OP 24.38 3.67 30.00 25.50 30.00 31.88 26.25 30.00 3.67 5.15 22.50 Not Applicable 26.63 24.38 26.25 3.67 3.67 Not Applicable 26.25 26.25 3.67 3.67 4.67 3.67 25.88 3.67 22.50 20.63 3.67 31.88
Ua W Micro Auto 81001 27.30 Northwest Medical Center OP 25.35 3.17 31.20 26.52 31.20 33.15 27.30 31.20 3.17 3.49 23.40 Not Applicable 27.69 25.35 27.30 3.17 3.17 Not Applicable 27.30 27.30 3.17 3.17 4.03 3.17 26.91 3.17 23.40 21.45 3.17 33.15
Wbc Diff Only 85007 29.05 Northwest Medical Center OP 26.98 3.80 33.20 28.22 33.20 35.28 29.05 33.20 3.80 6.93 24.90 Not Applicable 29.47 26.98 29.05 3.80 3.80 Not Applicable 29.05 29.05 3.80 3.80 4.38 3.80 28.64 3.80 24.90 22.83 3.80 35.28
Pulse Oximetry Multi 94761 29.05 Northwest Medical Center OP 26.98 0.00 33.20 28.22 33.20 35.28 29.05 33.20 0.00 0.00 24.90 Not Applicable 29.47 26.98 29.05 0.00 0.00 Not Applicable 29.05 29.05 0.00 0.00 29.05 0.00 28.64 0.00 24.90 22.83 0.00 35.28
Wbc Count Bld Auto 85004 29.40 Northwest Medical Center OP 27.30 6.47 33.60 28.56 33.60 35.70 29.40 33.60 6.47 6.93 25.20 Not Applicable 29.82 27.30 29.40 6.47 6.47 Not Applicable 29.40 29.40 6.47 6.47 8.25 6.47 28.98 6.47 25.20 23.10 6.47 35.70
Antibody Aspergillus 86606 30.10 Northwest Medical Center OP 27.95 15.05 34.40 29.24 34.40 36.55 30.10 34.40 15.05 11.46 25.80 Not Applicable 30.53 27.95 30.10 15.05 15.05 Not Applicable 30.10 30.10 15.05 15.05 19.20 15.05 29.67 15.05 25.80 23.65 11.46 36.55
Hep B Core Ab Igm Ql 86705 30.10 Northwest Medical Center OP 27.95 11.77 34.40 29.24 34.40 36.55 30.10 34.40 11.77 11.46 25.80 Not Applicable 30.53 27.95 30.10 11.77 11.77 Not Applicable 30.10 30.10 11.77 11.77 15.00 11.77 29.67 11.77 25.80 23.65 11.46 36.55
Antibody Histoplasma 86698 30.10 Northwest Medical Center OP 27.95 13.79 34.40 29.24 34.40 36.55 30.10 34.40 13.79 11.46 25.80 Not Applicable 30.53 27.95 30.10 13.79 13.79 Not Applicable 30.10 30.10 13.79 13.79 15.94 13.79 29.67 13.79 25.80 23.65 11.46 36.55
Varic Zoster Igm 86787 30.80 Northwest Medical Center OP 28.60 12.88 35.20 29.92 35.20 37.40 30.80 35.20 12.88 11.46 26.40 Not Applicable 31.24 28.60 30.80 12.88 12.88 Not Applicable 30.80 30.80 12.88 12.88 16.43 12.88 30.36 12.88 26.40 24.20 11.46 37.40
Specimen Collection 99001 32.55 Northwest Medical Center OP 13.00 0.00 37.20 31.62 37.20 39.53 32.55 37.20 0.00 0.00 27.90 Not Applicable 33.02 30.23 32.55 0.00 0.00 Not Applicable 32.55 32.55 0.00 0.00 7.05 0.00 32.09 0.00 27.90 25.58 0.00 39.53
Fentanyl 80354 33.60 Northwest Medical Center OP 31.20 0.00 38.40 32.64 38.40 40.80 33.60 38.40 0.00 11.59 28.80 Not Applicable 34.08 31.20 33.60 0.00 0.00 Not Applicable 33.60 33.60 0.00 0.00 21.99 0.00 33.12 0.00 28.80 26.40 0.00 40.80
Triglycerides 84478 33.60 Northwest Medical Center OP 31.20 5.74 38.40 32.64 38.40 40.80 33.60 38.40 5.74 5.15 28.80 Not Applicable 34.08 31.20 33.60 5.74 5.74 Not Applicable 33.60 33.60 5.74 5.74 7.34 5.74 33.12 5.74 28.80 26.40 5.15 40.80
Phosphorus Bld 84100 33.60 Northwest Medical Center OP 31.20 4.74 38.40 32.64 38.40 40.80 33.60 38.40 4.74 5.15 28.80 Not Applicable 34.08 31.20 33.60 4.74 4.74 Not Applicable 33.60 33.60 4.74 4.74 6.05 4.74 33.12 4.74 28.80 26.40 4.74 40.80
Sed Rate Auto 85652 33.60 Northwest Medical Center OP 31.20 2.70 38.40 32.64 38.40 40.80 33.60 38.40 2.70 6.93 28.80 Not Applicable 34.08 31.20 33.60 2.70 2.70 Not Applicable 33.60 33.60 2.70 2.70 3.45 2.70 33.12 2.70 28.80 26.40 2.70 40.80
Syphilis Test Quant 86593 33.60 Northwest Medical Center OP 31.20 4.40 38.40 32.64 38.40 40.80 33.60 38.40 4.40 11.46 28.80 Not Applicable 34.08 31.20 33.60 4.40 4.40 Not Applicable 33.60 33.60 4.40 4.40 5.61 4.40 33.12 4.40 28.80 26.40 4.40 40.80
Manual Cell Count 85032 33.60 Northwest Medical Center OP 31.20 4.31 38.40 32.64 38.40 40.80 33.60 38.40 4.31 6.93 28.80 Not Applicable 34.08 31.20 33.60 4.31 4.31 Not Applicable 33.60 33.60 4.31 4.31 5.48 4.31 33.12 4.31 28.80 26.40 4.31 40.80
Uric Acid Blood 84550 33.60 Northwest Medical Center OP 31.20 4.52 38.40 32.64 38.40 40.80 33.60 38.40 4.52 5.15 28.80 Not Applicable 34.08 31.20 33.60 4.52 4.52 Not Applicable 33.60 33.60 4.52 4.52 5.76 4.52 33.12 4.52 28.80 26.40 4.52 40.80
Potassium Bld 84132 33.60 Northwest Medical Center OP 31.20 4.76 38.40 32.64 38.40 40.80 33.60 38.40 4.76 5.15 28.80 Not Applicable 34.08 31.20 33.60 4.76 4.76 Not Applicable 33.60 33.60 4.76 4.76 5.86 4.76 33.12 4.76 28.80 26.40 4.76 40.80
Platelet Auto 85049 33.60 Northwest Medical Center OP 31.20 4.48 38.40 32.64 38.40 40.80 33.60 38.40 4.48 6.93 28.80 Not Applicable 34.08 31.20 33.60 4.48 4.48 Not Applicable 33.60 33.60 4.48 4.48 5.70 4.48 33.12 4.48 28.80 26.40 4.48 40.80
Sodium Bld 84295 33.60 Northwest Medical Center OP 31.20 4.81 38.40 32.64 38.40 40.80 33.60 38.40 4.81 5.15 28.80 Not Applicable 34.08 31.20 33.60 4.81 4.81 Not Applicable 33.60 33.60 4.81 4.81 6.14 4.81 33.12 4.81 28.80 26.40 4.81 40.80
Retic Count Manual 85044 34.30 Northwest Medical Center OP 31.85 4.31 39.20 33.32 39.20 41.65 34.30 39.20 4.31 6.93 29.40 Not Applicable 34.79 31.85 34.30 4.31 4.31 Not Applicable 34.30 34.30 4.31 4.31 5.48 4.31 33.81 4.31 29.40 26.95 4.31 41.65
Retic Count Auto 85045 34.30 Northwest Medical Center OP 31.85 3.99 39.20 33.32 39.20 41.65 34.30 39.20 3.99 6.93 29.40 Not Applicable 34.79 31.85 34.30 3.99 3.99 Not Applicable 34.30 34.30 3.99 3.99 5.10 3.99 33.81 3.99 29.40 26.95 3.99 41.65
Path Consult Fs 1 Sp 88331 34.30 Northwest Medical Center OP 31.85 122.35 39.20 33.32 39.20 41.65 34.30 39.20 122.35 52.17 29.40 Not Applicable 34.79 31.85 34.30 122.35 122.35 Not Applicable 34.30 34.30 122.35 122.35 33.13 122.35 33.81 122.35 29.40 26.95 26.95 122.35
Ldh (Ld) 83615 35.70 Northwest Medical Center OP 33.15 6.04 40.80 34.68 40.80 43.35 35.70 40.80 6.04 5.15 30.60 Not Applicable 36.21 33.15 35.70 6.04 6.04 Not Applicable 35.70 35.70 6.04 6.04 7.70 6.04 35.19 6.04 30.60 28.05 5.15 43.35
Crude Allergen Extra 86003 35.70 Northwest Medical Center OP 33.15 5.22 40.80 34.68 40.80 43.35 35.70 40.80 5.22 11.46 30.60 Not Applicable 36.21 33.15 35.70 5.22 5.22 Not Applicable 35.70 35.70 5.22 5.22 6.65 5.22 35.19 5.22 30.60 28.05 5.22 43.35
Influenza Vaccine Hi 90660 35.70 Northwest Medical Center OP 33.15 0.00 40.80 34.68 40.80 43.35 35.70 40.80 0.00 25.07 30.60 Not Applicable 36.21 33.15 35.70 0.00 0.00 Not Applicable 35.70 35.70 0.00 0.00 28.05 0.00 35.19 0.00 30.60 28.05 0.00 43.35
Mnt Reasses 15 Min 97803 35.70 Northwest Medical Center OP 33.15 27.66 40.80 34.68 40.80 43.35 35.70 40.80 27.66 211.24 30.60 Not Applicable 36.21 33.15 35.70 27.66 27.66 Not Applicable 35.70 35.70 27.66 27.66 35.70 27.66 35.19 27.66 30.60 28.05 27.66 211.24
Mnt Init Ea 15 Min 97802 35.70 Northwest Medical Center OP 33.15 32.79 40.80 34.68 40.80 43.35 35.70 40.80 32.79 211.24 30.60 Not Applicable 36.21 33.15 35.70 32.79 32.79 Not Applicable 35.70 35.70 32.79 32.79 35.70 32.79 35.19 32.79 30.60 28.05 28.05 211.24
Port Film 77417 36.68 Northwest Medical Center OP 34.06 0.00 41.92 35.63 41.92 44.54 36.68 41.92 0.00 61.05 31.44 41.92 37.20 34.06 36.68 0.00 0.00 Not Applicable 36.68 36.68 0.00 0.00 36.68 0.00 36.16 0.00 31.44 28.82 0.00 61.05
Inj Shoulder Arthgrm 23350 36.93 Northwest Medical Center OP 34.29 0.00 42.21 35.88 42.21 44.85 36.93 42.21 0.00 0.00 31.66 Not Applicable 37.46 34.29 36.93 0.00 0.00 Not Applicable 36.93 36.93 0.00 0.00 36.93 0.00 36.40 0.00 31.66 29.02 0.00 44.85
Iron 83540 37.45 Northwest Medical Center OP 34.78 6.47 42.80 36.38 42.80 45.48 37.45 42.80 6.47 5.15 32.10 Not Applicable 37.99 34.78 37.45 6.47 6.47 Not Applicable 37.45 37.45 6.47 6.47 8.26 6.47 36.92 6.47 32.10 29.43 5.15 45.48
Cryoglobulin 82595 37.45 Northwest Medical Center OP 34.78 6.47 42.80 36.38 42.80 45.48 37.45 42.80 6.47 5.15 32.10 Not Applicable 37.99 34.78 37.45 6.47 6.47 Not Applicable 37.45 37.45 6.47 6.47 8.25 6.47 36.92 6.47 32.10 29.43 5.15 45.48
Hb E Ab Qual 86707 37.45 Northwest Medical Center OP 34.78 11.57 42.80 36.38 42.80 45.48 37.45 42.80 11.57 11.46 32.10 Not Applicable 37.99 34.78 37.45 11.57 11.57 Not Applicable 37.45 37.45 11.57 11.57 14.74 11.57 36.92 11.57 32.10 29.43 11.46 45.48
Preg Urine Qual 81025 38.50 Northwest Medical Center OP 35.75 8.61 44.00 37.40 44.00 46.75 38.50 44.00 8.61 3.49 33.00 Not Applicable 39.05 35.75 38.50 8.61 8.61 Not Applicable 38.50 38.50 8.61 8.61 8.06 8.61 37.95 8.61 33.00 30.25 3.49 46.75
Albumin Other Source 82042 38.50 Northwest Medical Center OP 35.75 7.78 44.00 37.40 44.00 46.75 38.50 44.00 7.78 5.15 33.00 Not Applicable 39.05 35.75 38.50 7.78 7.78 Not Applicable 38.50 38.50 7.78 7.78 6.60 7.78 37.95 7.78 33.00 30.25 5.15 46.75
Chloride Csf 82438 38.50 Northwest Medical Center OP 35.75 5.00 44.00 37.40 44.00 46.75 38.50 44.00 5.00 5.15 33.00 Not Applicable 39.05 35.75 38.50 5.00 5.00 Not Applicable 38.50 38.50 5.00 5.00 6.24 5.00 37.95 5.00 33.00 30.25 5.00 46.75
Chloride Urine 82436 38.50 Northwest Medical Center OP 35.75 5.75 44.00 37.40 44.00 46.75 38.50 44.00 5.75 5.15 33.00 Not Applicable 39.05 35.75 38.50 5.75 5.75 Not Applicable 38.50 38.50 5.75 5.75 6.41 5.75 37.95 5.75 33.00 30.25 5.15 46.75
Albumin Serum 82040 38.50 Northwest Medical Center OP 35.75 4.95 44.00 37.40 44.00 46.75 38.50 44.00 4.95 5.15 33.00 Not Applicable 39.05 35.75 38.50 4.95 4.95 Not Applicable 38.50 38.50 4.95 4.95 6.31 4.95 37.95 4.95 33.00 30.25 4.95 46.75
Pinworm Exam 87172 40.60 Northwest Medical Center OP 37.70 4.27 46.40 39.44 46.40 49.30 40.60 46.40 4.27 9.13 34.80 Not Applicable 41.18 37.70 40.60 4.27 4.27 Not Applicable 40.60 40.60 4.27 4.27 5.45 4.27 40.02 4.27 34.80 31.90 4.27 49.30
Carbon Dioxide Bld 82374 43.05 Northwest Medical Center OP 39.98 4.88 49.20 41.82 49.20 52.28 43.05 49.20 4.88 5.15 36.90 Not Applicable 43.67 39.98 43.05 4.88 4.88 Not Applicable 43.05 43.05 4.88 4.88 6.24 4.88 42.44 4.88 36.90 33.83 4.88 52.28
Chloride Blood 82435 43.05 Northwest Medical Center OP 39.98 4.60 49.20 41.82 49.20 52.28 43.05 49.20 4.60 5.15 36.90 Not Applicable 43.67 39.98 43.05 4.60 4.60 Not Applicable 43.05 43.05 4.60 4.60 5.86 4.60 42.44 4.60 36.90 33.83 4.60 52.28
Calcium Total 82310 44.10 Northwest Medical Center OP 40.95 5.16 50.40 42.84 50.40 53.55 44.10 50.40 5.16 5.15 37.80 Not Applicable 44.73 40.95 44.10 5.16 5.16 Not Applicable 44.10 44.10 5.16 5.16 6.57 5.16 43.47 5.16 37.80 34.65 5.15 53.55
Pth Related Peptide 82397 44.10 Northwest Medical Center OP 40.95 14.12 50.40 42.84 50.40 53.55 44.10 50.40 14.12 11.59 37.80 Not Applicable 44.73 40.95 44.10 14.12 14.12 Not Applicable 44.10 44.10 14.12 14.12 18.01 14.12 43.47 14.12 37.80 34.65 11.59 53.55
Surg Path Level 2 88302 44.10 Northwest Medical Center OP 40.95 19.60 50.40 42.84 50.40 53.55 44.10 50.40 19.60 17.65 37.80 Not Applicable 44.73 40.95 44.10 19.60 19.60 Not Applicable 44.10 44.10 19.60 19.60 15.37 19.60 43.47 19.60 37.80 34.65 15.37 53.55
Surg Path Level 1 88300 44.80 Northwest Medical Center OP 41.60 19.60 51.20 43.52 51.20 54.40 44.80 51.20 19.60 17.65 38.40 Not Applicable 45.44 41.60 44.80 19.60 19.60 Not Applicable 44.80 44.80 19.60 19.60 10.04 19.60 44.16 19.60 38.40 35.20 10.04 54.40
Hiv 1 And Hiv 2 86703 44.80 Northwest Medical Center OP 41.60 13.71 51.20 43.52 51.20 54.40 44.80 51.20 13.71 11.46 38.40 Not Applicable 45.44 41.60 44.80 13.71 13.71 Not Applicable 44.80 44.80 13.71 13.71 17.49 13.71 44.16 13.71 38.40 35.20 11.46 54.40
Ffp/Cryoprec Thawing 86927 45.50 Northwest Medical Center OP 42.25 122.35 52.00 44.20 52.00 55.25 45.50 52.00 122.35 28.75 39.00 Not Applicable 46.15 42.25 45.50 122.35 122.35 Not Applicable 45.50 45.50 122.35 122.35 13.44 122.35 44.85 122.35 39.00 35.75 13.44 122.35
Smoking Cess 3-10Min 99406 45.54 Northwest Medical Center OP 42.28 23.29 52.04 44.23 52.04 55.29 45.54 52.04 23.29 37.82 39.03 Not Applicable 46.19 42.28 45.54 23.29 23.29 Not Applicable 45.54 45.54 23.29 23.29 45.54 23.29 44.88 23.29 39.03 35.78 23.29 55.29
Chlamydia Ag Ift 87270 45.72 Northwest Medical Center OP 42.46 11.98 52.26 44.42 52.26 55.52 45.72 52.26 11.98 9.13 39.19 Not Applicable 46.38 42.46 45.72 11.98 11.98 Not Applicable 45.72 45.72 11.98 11.98 15.29 11.98 45.07 11.98 39.19 35.93 9.13 55.52
Ua Micro Only 81015 46.90 Northwest Medical Center OP 43.55 3.05 53.60 45.56 53.60 56.95 46.90 53.60 3.05 3.49 40.20 Not Applicable 47.57 43.55 46.90 3.05 3.05 Not Applicable 46.90 46.90 3.05 3.05 3.88 3.05 46.23 3.05 40.20 36.85 3.05 56.95
Cryofibrinogen 82585 46.90 Northwest Medical Center OP 43.55 14.14 53.60 45.56 53.60 56.95 46.90 53.60 14.14 11.59 40.20 Not Applicable 47.57 43.55 46.90 14.14 14.14 Not Applicable 46.90 46.90 14.14 14.14 10.94 14.14 46.23 14.14 40.20 36.85 10.94 56.95
Creatine Kinase (Ck) 82550 46.90 Northwest Medical Center OP 43.55 6.51 53.60 45.56 53.60 56.95 46.90 53.60 6.51 5.15 40.20 Not Applicable 47.57 43.55 46.90 6.51 6.51 Not Applicable 46.90 46.90 6.51 6.51 8.31 6.51 46.23 6.51 40.20 36.85 5.15 56.95
Potassium Urine 84133 46.90 Northwest Medical Center OP 43.55 4.73 53.60 45.56 53.60 56.95 46.90 53.60 4.73 5.15 40.20 Not Applicable 47.57 43.55 46.90 4.73 4.73 Not Applicable 46.90 46.90 4.73 4.73 5.48 4.73 46.23 4.73 40.20 36.85 4.73 56.95
Wbc Automated 85048 48.30 Northwest Medical Center OP 44.85 2.54 55.20 46.92 55.20 58.65 48.30 55.20 2.54 6.93 41.40 Not Applicable 48.99 44.85 48.30 2.54 2.54 Not Applicable 48.30 48.30 2.54 2.54 3.24 2.54 47.61 2.54 41.40 37.95 2.54 58.65
Magnesium 83735 48.30 Northwest Medical Center OP 44.85 6.70 55.20 46.92 55.20 58.65 48.30 55.20 6.70 5.15 41.40 Not Applicable 48.99 44.85 48.30 6.70 6.70 Not Applicable 48.30 48.30 6.70 6.70 8.54 6.70 47.61 6.70 41.40 37.95 5.15 58.65
Carbon Monoxide Qn 82375 48.30 Northwest Medical Center OP 44.85 12.32 55.20 46.92 55.20 58.65 48.30 55.20 12.32 11.59 41.40 Not Applicable 48.99 44.85 48.30 12.32 12.32 Not Applicable 48.30 48.30 12.32 12.32 15.71 12.32 47.61 12.32 41.40 37.95 11.59 58.65
Cytospin & Interp 88108 48.65 Northwest Medical Center OP 45.18 28.50 55.60 47.26 55.60 59.08 48.65 55.60 28.50 17.65 41.70 Not Applicable 49.35 45.18 48.65 28.50 28.50 Not Applicable 48.65 48.65 28.50 28.50 15.37 28.50 47.96 28.50 41.70 38.23 15.37 59.08
Hcg Qual 84703 49.00 Northwest Medical Center OP 45.50 7.52 56.00 47.60 56.00 59.50 49.00 56.00 7.52 5.15 42.00 Not Applicable 49.70 45.50 49.00 7.52 7.52 Not Applicable 49.00 49.00 7.52 7.52 9.58 7.52 48.30 7.52 42.00 38.50 5.15 59.50
Coll Sara Cov2 Any S G2023 49.00 Northwest Medical Center OP 45.50 0.00 56.00 47.60 56.00 59.50 49.00 56.00 0.00 2.64 42.00 Not Applicable 49.70 45.50 49.00 0.00 0.00 Not Applicable 49.00 49.00 0.00 0.00 21.11 0.00 48.30 0.00 42.00 38.50 0.00 59.50
Nm Hdl/Load Rad Src 77790 49.14 Northwest Medical Center OP 45.63 0.00 56.16 47.74 56.16 59.67 49.14 56.16 0.00 0.00 42.12 56.16 49.84 45.63 49.14 0.00 0.00 Not Applicable 49.14 49.14 0.00 0.00 49.14 0.00 48.44 0.00 42.12 38.61 0.00 59.67
Glucose Bld Meter 82962 50.75 Northwest Medical Center OP 47.13 3.28 58.00 49.30 58.00 61.63 50.75 58.00 3.28 5.15 43.50 Not Applicable 51.48 47.13 50.75 3.28 3.28 Not Applicable 50.75 50.75 3.28 3.28 2.99 3.28 50.03 3.28 43.50 39.88 2.99 61.63
Direct Measure Ldl 83721 51.10 Northwest Medical Center OP 47.45 10.50 58.40 49.64 58.40 62.05 51.10 58.40 10.50 11.59 43.80 Not Applicable 51.83 47.45 51.10 10.50 10.50 Not Applicable 51.10 51.10 10.50 10.50 12.16 10.50 50.37 10.50 43.80 40.15 10.50 62.05
Cholesterol Bld 82465 51.10 Northwest Medical Center OP 47.45 4.35 58.40 49.64 58.40 62.05 51.10 58.40 4.35 5.15 43.80 Not Applicable 51.83 47.45 51.10 4.35 4.35 Not Applicable 51.10 51.10 4.35 4.35 5.54 4.35 50.37 4.35 43.80 40.15 4.35 62.05
Sedative Hypnotics 80368 51.58 Northwest Medical Center OP 47.89 0.00 58.94 50.10 58.94 62.63 51.58 58.94 0.00 5.15 44.21 Not Applicable 52.31 47.89 51.58 0.00 0.00 Not Applicable 51.58 51.58 0.00 0.00 21.02 0.00 50.84 0.00 44.21 40.52 0.00 62.63
Fecal Fat Qual 82705 52.15 Northwest Medical Center OP 48.43 5.10 59.60 50.66 59.60 63.33 52.15 59.60 5.10 5.15 44.70 Not Applicable 52.90 48.43 52.15 5.10 5.10 Not Applicable 52.15 52.15 5.10 5.10 6.49 5.10 51.41 5.10 44.70 40.98 5.10 63.33
Alt (Sgpt) 84460 52.85 Northwest Medical Center OP 49.08 5.30 60.40 51.34 60.40 64.18 52.85 60.40 5.30 5.15 45.30 Not Applicable 53.61 49.08 52.85 5.30 5.30 Not Applicable 52.85 52.85 5.30 5.30 6.75 5.30 52.10 5.30 45.30 41.53 5.15 64.18
Ccp Ab 86200 52.85 Northwest Medical Center OP 49.08 12.95 60.40 51.34 60.40 64.18 52.85 60.40 12.95 11.46 45.30 Not Applicable 53.61 49.08 52.85 12.95 12.95 Not Applicable 52.85 52.85 12.95 12.95 16.51 12.95 52.10 12.95 45.30 41.53 11.46 64.18
Newborn Screen (Pku) 84030 53.20 Northwest Medical Center OP 49.40 5.50 60.80 51.68 60.80 64.60 53.20 60.80 5.50 5.15 45.60 Not Applicable 53.96 49.40 53.20 5.50 5.50 Not Applicable 53.20 53.20 5.50 5.50 7.01 5.50 52.44 5.50 45.60 41.80 5.15 64.60
Coll Sara-Cov Snf Hh G2024 53.20 Northwest Medical Center OP 49.40 0.00 60.80 51.68 60.80 64.60 53.20 60.80 0.00 2.64 45.60 Not Applicable 53.96 49.40 53.20 0.00 0.00 Not Applicable 53.20 53.20 0.00 0.00 22.91 0.00 52.44 0.00 45.60 41.80 0.00 64.60
Total Protein Urine 84156 54.25 Northwest Medical Center OP 50.38 3.67 62.00 52.70 62.00 65.88 54.25 62.00 3.67 5.15 46.50 Not Applicable 55.03 50.38 54.25 3.67 3.67 Not Applicable 54.25 54.25 3.67 3.67 4.67 3.67 53.48 3.67 46.50 42.63 3.67 65.88
Ast (Sgot) 84450 54.25 Northwest Medical Center OP 50.38 5.18 62.00 52.70 62.00 65.88 54.25 62.00 5.18 5.15 46.50 Not Applicable 55.03 50.38 54.25 5.18 5.18 Not Applicable 54.25 54.25 5.18 5.18 6.60 5.18 53.48 5.18 46.50 42.63 5.15 65.88
Assay Glucose Blood 82947 54.25 Northwest Medical Center OP 50.38 3.93 62.00 52.70 62.00 65.88 54.25 62.00 3.93 5.15 46.50 Not Applicable 55.03 50.38 54.25 3.93 3.93 Not Applicable 54.25 54.25 3.93 3.93 5.00 3.93 53.48 3.93 46.50 42.63 3.93 65.88
Cold Agglutinin Qual 86156 54.25 Northwest Medical Center OP 50.38 8.07 62.00 52.70 62.00 65.88 54.25 62.00 8.07 11.46 46.50 Not Applicable 55.03 50.38 54.25 8.07 8.07 Not Applicable 54.25 54.25 8.07 8.07 8.54 8.07 53.48 8.07 46.50 42.63 8.07 65.88
Hep B Core Ab Total 86704 54.25 Northwest Medical Center OP 50.38 12.05 62.00 52.70 62.00 65.88 54.25 62.00 12.05 11.46 46.50 Not Applicable 55.03 50.38 54.25 12.05 12.05 Not Applicable 54.25 54.25 12.05 12.05 15.36 12.05 53.48 12.05 46.50 42.63 11.46 65.88
Factor 2 Assay 85210 54.95 Northwest Medical Center OP 51.03 12.98 62.80 53.38 62.80 66.73 54.95 62.80 12.98 4.41 47.10 Not Applicable 55.74 51.03 54.95 12.98 12.98 Not Applicable 54.95 54.95 12.98 12.98 16.55 12.98 54.17 12.98 47.10 43.18 4.41 66.73
Ph Body Fluid 83986 55.65 Northwest Medical Center OP 51.68 3.58 63.60 54.06 63.60 67.58 55.65 63.60 3.58 5.15 47.70 Not Applicable 56.45 51.68 55.65 3.58 3.58 Not Applicable 55.65 55.65 3.58 3.58 4.56 3.58 54.86 3.58 47.70 43.73 3.58 67.58
Lipase 83690 55.65 Northwest Medical Center OP 51.68 6.89 63.60 54.06 63.60 67.58 55.65 63.60 6.89 5.15 47.70 Not Applicable 56.45 51.68 55.65 6.89 6.89 Not Applicable 55.65 55.65 6.89 6.89 8.78 6.89 54.86 6.89 47.70 43.73 5.15 67.58
Lithium 80178 56.35 Northwest Medical Center OP 52.33 6.61 64.40 54.74 64.40 68.43 56.35 64.40 6.61 12.87 48.30 Not Applicable 57.16 52.33 56.35 6.61 6.61 Not Applicable 56.35 56.35 6.61 6.61 8.42 6.61 55.55 6.61 48.30 44.28 6.61 68.43
Creatinine Blood 82565 56.35 Northwest Medical Center OP 52.33 5.12 64.40 54.74 64.40 68.43 56.35 64.40 5.12 5.15 48.30 Not Applicable 57.16 52.33 56.35 5.12 5.12 Not Applicable 56.35 56.35 5.12 5.12 6.53 5.12 55.55 5.12 48.30 44.28 5.12 68.43
Bun 84520 56.35 Northwest Medical Center OP 52.33 3.95 64.40 54.74 64.40 68.43 56.35 64.40 3.95 5.15 48.30 Not Applicable 57.16 52.33 56.35 3.95 3.95 Not Applicable 56.35 56.35 3.95 3.95 5.03 3.95 55.55 3.95 48.30 44.28 3.95 68.43
Aso Titer 86060 56.35 Northwest Medical Center OP 52.33 7.30 64.40 54.74 64.40 68.43 56.35 64.40 7.30 11.46 48.30 Not Applicable 57.16 52.33 56.35 7.30 7.30 Not Applicable 56.35 56.35 7.30 7.30 9.31 7.30 55.55 7.30 48.30 44.28 7.30 68.43
Phosphatase Alkaline 84075 56.35 Northwest Medical Center OP 52.33 5.18 64.40 54.74 64.40 68.43 56.35 64.40 5.18 5.15 48.30 Not Applicable 57.16 52.33 56.35 5.18 5.18 Not Applicable 56.35 56.35 5.18 5.18 6.60 5.18 55.55 5.18 48.30 44.28 5.15 68.43
Aso Qual Screen 86063 56.35 Northwest Medical Center OP 52.33 5.77 64.40 54.74 64.40 68.43 56.35 64.40 5.77 11.46 48.30 Not Applicable 57.16 52.33 56.35 5.77 5.77 Not Applicable 56.35 56.35 5.77 5.77 7.36 5.77 55.55 5.77 48.30 44.28 5.77 68.43
Surg Path Level 3 88304 57.40 Northwest Medical Center OP 53.30 42.18 65.60 55.76 65.60 69.70 57.40 65.60 42.18 37.94 49.20 Not Applicable 58.22 53.30 57.40 42.18 42.18 Not Applicable 57.40 57.40 42.18 42.18 33.13 42.18 56.58 42.18 49.20 45.10 33.13 69.70
Crp High Sensitivity 86141 57.75 Northwest Medical Center OP 53.63 12.95 66.00 56.10 66.00 70.13 57.75 66.00 12.95 11.46 49.50 Not Applicable 58.58 53.63 57.75 12.95 12.95 Not Applicable 57.75 57.75 12.95 12.95 16.51 12.95 56.93 12.95 49.50 45.38 11.46 70.13
Ebv Ebna Antibody 86664 58.35 Northwest Medical Center OP 54.18 15.29 66.69 56.68 66.69 70.86 58.35 66.69 15.29 11.46 50.02 Not Applicable 59.19 54.18 58.35 15.29 15.29 Not Applicable 58.35 58.35 15.29 15.29 19.50 15.29 57.52 15.29 50.02 45.85 11.46 70.86
C1Q Binding Imm Comp 86332 58.45 Northwest Medical Center OP 54.28 24.37 66.80 56.78 66.80 70.98 58.45 66.80 24.37 32.80 50.10 Not Applicable 59.29 54.28 58.45 24.37 24.37 Not Applicable 58.45 58.45 24.37 24.37 31.07 24.37 57.62 24.37 50.10 45.93 24.37 70.98
Blood Typing Ptserum 86904 58.45 Northwest Medical Center OP 54.28 28.50 66.80 56.78 66.80 70.98 58.45 66.80 28.50 3.80 50.10 Not Applicable 59.29 54.28 58.45 28.50 28.50 Not Applicable 58.45 58.45 28.50 28.50 12.12 28.50 57.62 28.50 50.10 45.93 3.80 70.98
Barbiturates 80345 59.50 Northwest Medical Center OP 55.25 0.00 68.00 57.80 68.00 72.25 59.50 68.00 0.00 11.59 51.00 Not Applicable 60.35 55.25 59.50 0.00 0.00 Not Applicable 59.50 59.50 0.00 0.00 14.02 0.00 58.65 0.00 51.00 46.75 0.00 72.25
Thrombin Time Plasma 85670 59.50 Northwest Medical Center OP 55.25 5.77 68.00 57.80 68.00 72.25 59.50 68.00 5.77 4.41 51.00 Not Applicable 60.35 55.25 59.50 5.77 5.77 Not Applicable 59.50 59.50 5.77 5.77 7.36 5.77 58.65 5.77 51.00 46.75 4.41 72.25
A-1-Antitrypsin Tot 82103 59.50 Northwest Medical Center OP 55.25 13.44 68.00 57.80 68.00 72.25 59.50 68.00 13.44 11.59 51.00 Not Applicable 60.35 55.25 59.50 13.44 13.44 Not Applicable 59.50 59.50 13.44 13.44 17.13 13.44 58.65 13.44 51.00 46.75 11.59 72.25
Syphilis Test Qual 86592 59.50 Northwest Medical Center OP 55.25 4.27 68.00 57.80 68.00 72.25 59.50 68.00 4.27 11.46 51.00 Not Applicable 60.35 55.25 59.50 4.27 4.27 Not Applicable 59.50 59.50 4.27 4.27 5.45 4.27 58.65 4.27 51.00 46.75 4.27 72.25
Fibrinogen Activity 85384 60.55 Northwest Medical Center OP 56.23 9.72 69.20 58.82 69.20 73.53 60.55 69.20 9.72 4.41 51.90 Not Applicable 61.42 56.23 60.55 9.72 9.72 Not Applicable 60.55 60.55 9.72 9.72 10.83 9.72 59.69 9.72 51.90 47.58 4.41 73.53
Gc Amp Probe 87591 60.55 Northwest Medical Center OP 56.23 35.09 69.20 58.82 69.20 73.53 60.55 69.20 35.09 35.74 51.90 Not Applicable 61.42 56.23 60.55 35.09 35.09 Not Applicable 60.55 60.55 35.09 35.09 44.74 35.09 59.69 35.09 51.90 47.58 35.09 73.53
Phosphorus Urine 84105 60.90 Northwest Medical Center OP 56.55 5.78 69.60 59.16 69.60 73.95 60.90 69.60 5.78 5.15 52.20 Not Applicable 61.77 56.55 60.90 5.78 5.78 Not Applicable 60.90 60.90 5.78 5.78 6.60 5.78 60.03 5.78 52.20 47.85 5.15 73.95
Uric Acid Body Fld 84560 60.90 Northwest Medical Center OP 56.55 5.08 69.60 59.16 69.60 73.95 60.90 69.60 5.08 5.15 52.20 Not Applicable 61.77 56.55 60.90 5.08 5.08 Not Applicable 60.90 60.90 5.08 5.08 6.06 5.08 60.03 5.08 52.20 47.85 5.08 73.95
Auto Blood Collectio 86890 60.90 Northwest Medical Center OP 56.55 122.35 69.60 59.16 69.60 73.95 60.90 69.60 122.35 28.75 52.20 Not Applicable 61.77 56.55 60.90 122.35 122.35 Not Applicable 60.90 60.90 122.35 122.35 42.36 122.35 60.03 122.35 52.20 47.85 28.75 122.35
Crystals Body Fl 89060 60.90 Northwest Medical Center OP 56.55 7.33 69.60 59.16 69.60 73.95 60.90 69.60 7.33 17.65 52.20 Not Applicable 61.77 56.55 60.90 7.33 7.33 Not Applicable 60.90 60.90 7.33 7.33 9.12 7.33 60.03 7.33 52.20 47.85 7.33 73.95
Smear Fungus 87205 61.25 Northwest Medical Center OP 56.88 4.27 70.00 59.50 70.00 74.38 61.25 70.00 4.27 9.13 52.50 Not Applicable 62.13 56.88 61.25 4.27 4.27 Not Applicable 61.25 61.25 4.27 4.27 5.45 4.27 60.38 4.27 52.50 48.13 4.27 74.38
C-Reactive Protein 86140 61.95 Northwest Medical Center OP 57.53 5.18 70.80 60.18 70.80 75.23 61.95 70.80 5.18 11.46 53.10 Not Applicable 62.84 57.53 61.95 5.18 5.18 Not Applicable 61.95 61.95 5.18 5.18 6.60 5.18 61.07 5.18 53.10 48.68 5.18 75.23
Glucose Post Dose 82950 61.95 Northwest Medical Center OP 57.53 4.75 70.80 60.18 70.80 75.23 61.95 70.80 4.75 5.15 53.10 Not Applicable 62.84 57.53 61.95 4.75 4.75 Not Applicable 61.95 61.95 4.75 4.75 6.06 4.75 61.07 4.75 53.10 48.68 4.75 75.23
Bile Acids Total 82239 62.65 Northwest Medical Center OP 58.18 17.12 71.60 60.86 71.60 76.08 62.65 71.60 17.12 11.59 53.70 Not Applicable 63.55 58.18 62.65 17.12 17.12 Not Applicable 62.65 62.65 17.12 17.12 21.83 17.12 61.76 17.12 53.70 49.23 11.59 76.08
11-Dehydrotxb2 84431 63.25 Northwest Medical Center OP 58.73 35.11 72.29 61.44 72.29 76.81 63.25 72.29 35.11 11.59 54.22 Not Applicable 64.16 58.73 63.25 35.11 35.11 Not Applicable 63.25 63.25 35.11 35.11 21.42 35.11 62.35 35.11 54.22 49.70 11.59 76.81
Selenium 84255 63.28 Northwest Medical Center OP 58.76 25.53 72.32 61.47 72.32 76.84 63.28 72.32 25.53 11.59 54.24 Not Applicable 64.18 58.76 63.28 25.53 25.53 Not Applicable 63.28 63.28 25.53 25.53 32.54 25.53 62.38 25.53 54.24 49.72 11.59 76.84
Influenza A Virus Ab 86710 63.70 Northwest Medical Center OP 59.15 13.55 72.80 61.88 72.80 77.35 63.70 72.80 13.55 11.46 54.60 Not Applicable 64.61 59.15 63.70 13.55 13.55 Not Applicable 63.70 63.70 13.55 13.55 17.28 13.55 62.79 13.55 54.60 50.05 11.46 77.35
Path Stain Group 2 88313 63.70 Northwest Medical Center OP 59.15 28.50 72.80 61.88 72.80 77.35 63.70 72.80 28.50 17.65 54.60 Not Applicable 64.61 59.15 63.70 28.50 28.50 Not Applicable 63.70 63.70 28.50 28.50 15.37 28.50 62.79 28.50 54.60 50.05 15.37 77.35
Covid Antigen Ia 87426 64.40 Northwest Medical Center OP 59.80 0.00 73.60 62.56 73.60 78.20 64.40 73.60 0.00 9.13 55.20 Not Applicable 65.32 59.80 64.40 0.00 0.00 Not Applicable 64.40 64.40 0.00 0.00 64.40 0.00 63.48 0.00 55.20 50.60 0.00 78.20
Occult Bld Stl 1-3 S 82272 65.10 Northwest Medical Center OP 60.45 4.23 74.40 63.24 74.40 79.05 65.10 74.40 4.23 5.15 55.80 Not Applicable 66.03 60.45 65.10 4.23 4.23 Not Applicable 65.10 65.10 4.23 4.23 4.15 4.23 64.17 4.23 55.80 51.15 4.15 79.05
Ferritin 82728 65.10 Northwest Medical Center OP 60.45 13.63 74.40 63.24 74.40 79.05 65.10 74.40 13.63 11.59 55.80 Not Applicable 66.03 60.45 65.10 13.63 13.63 Not Applicable 65.10 65.10 13.63 13.63 17.37 13.63 64.17 13.63 55.80 51.15 11.59 79.05
Antibody Actinomyces 86602 65.10 Northwest Medical Center OP 60.45 10.18 74.40 63.24 74.40 79.05 65.10 74.40 10.18 11.46 55.80 Not Applicable 66.03 60.45 65.10 10.18 10.18 Not Applicable 65.10 65.10 10.18 10.18 12.98 10.18 64.17 10.18 55.80 51.15 10.18 79.05
Creatinine Clearance 82575 65.10 Northwest Medical Center OP 60.45 9.46 74.40 63.24 74.40 79.05 65.10 74.40 9.46 11.59 55.80 Not Applicable 66.03 60.45 65.10 9.46 9.46 Not Applicable 65.10 65.10 9.46 9.46 12.05 9.46 64.17 9.46 55.80 51.15 9.46 79.05
Thyroxine Total 84436 65.10 Northwest Medical Center OP 60.45 6.87 74.40 63.24 74.40 79.05 65.10 74.40 6.87 16.00 55.80 Not Applicable 66.03 60.45 65.10 6.87 6.87 Not Applicable 65.10 65.10 6.87 6.87 8.76 6.87 64.17 6.87 55.80 51.15 6.87 79.05
Osmolality Blood 83930 65.10 Northwest Medical Center OP 60.45 6.61 74.40 63.24 74.40 79.05 65.10 74.40 6.61 5.15 55.80 Not Applicable 66.03 60.45 65.10 6.61 6.61 Not Applicable 65.10 65.10 6.61 6.61 8.42 6.61 64.17 6.61 55.80 51.15 5.15 79.05
Occult Bld Gastric 82271 65.10 Northwest Medical Center OP 60.45 5.32 74.40 63.24 74.40 79.05 65.10 74.40 5.32 5.15 55.80 Not Applicable 66.03 60.45 65.10 5.32 5.32 Not Applicable 65.10 65.10 5.32 5.32 4.15 5.32 64.17 5.32 55.80 51.15 4.15 79.05
Vitamin B12 82607 65.10 Northwest Medical Center OP 60.45 15.08 74.40 63.24 74.40 79.05 65.10 74.40 15.08 16.00 55.80 Not Applicable 66.03 60.45 65.10 15.08 15.08 Not Applicable 65.10 65.10 15.08 15.08 19.22 15.08 64.17 15.08 55.80 51.15 15.08 79.05
Folic Acid Serum 82746 65.10 Northwest Medical Center OP 60.45 14.70 74.40 63.24 74.40 79.05 65.10 74.40 14.70 11.59 55.80 Not Applicable 66.03 60.45 65.10 14.70 14.70 Not Applicable 65.10 65.10 14.70 14.70 18.74 14.70 64.17 14.70 55.80 51.15 11.59 79.05
Nasal Smear Eos 89190 65.10 Northwest Medical Center OP 60.45 5.79 74.40 63.24 74.40 79.05 65.10 74.40 5.79 17.65 55.80 Not Applicable 66.03 60.45 65.10 5.79 5.79 Not Applicable 65.10 65.10 5.79 5.79 6.06 5.79 64.17 5.79 55.80 51.15 5.79 79.05
Papdx Tcsc Norsc Not 88150 65.10 Northwest Medical Center OP 60.45 15.12 74.40 63.24 74.40 79.05 65.10 74.40 15.12 19.31 55.80 Not Applicable 66.03 60.45 65.10 15.12 15.12 Not Applicable 65.10 65.10 15.12 15.12 13.47 15.12 64.17 15.12 55.80 51.15 13.47 79.05
O&P Smear Conc Id 87177 65.80 Northwest Medical Center OP 61.10 8.90 75.20 63.92 75.20 79.90 65.80 75.20 8.90 9.13 56.40 Not Applicable 66.74 61.10 65.80 8.90 8.90 Not Applicable 65.80 65.80 8.90 8.90 11.34 8.90 64.86 8.90 56.40 51.70 8.90 79.90
Chlamydia T Dir Prob 87490 65.80 Northwest Medical Center OP 61.10 22.75 75.20 63.92 75.20 79.90 65.80 75.20 22.75 9.13 56.40 Not Applicable 66.74 61.10 65.80 22.75 22.75 Not Applicable 65.80 65.80 22.75 22.75 25.56 22.75 64.86 22.75 56.40 51.70 9.13 79.90
Cult Mycoplasma 87109 65.80 Northwest Medical Center OP 61.10 15.39 75.20 63.92 75.20 79.90 65.80 75.20 15.39 9.13 56.40 Not Applicable 66.74 61.10 65.80 15.39 15.39 Not Applicable 65.80 65.80 15.39 15.39 19.61 15.39 64.86 15.39 56.40 51.70 9.13 79.90
Hemoglobin A1C 83036 66.85 Northwest Medical Center OP 62.08 9.71 76.40 64.94 76.40 81.18 66.85 76.40 9.71 11.59 57.30 Not Applicable 67.81 62.08 66.85 9.71 9.71 Not Applicable 66.85 66.85 9.71 9.71 12.38 9.71 65.90 9.71 57.30 52.53 9.71 81.18
Aldolase 82085 66.85 Northwest Medical Center OP 62.08 9.71 76.40 64.94 76.40 81.18 66.85 76.40 9.71 11.59 57.30 Not Applicable 67.81 62.08 66.85 9.71 9.71 Not Applicable 66.85 66.85 9.71 9.71 12.38 9.71 65.90 9.71 57.30 52.53 9.71 81.18
Cmv Igg Qual 86644 66.85 Northwest Medical Center OP 62.08 14.39 76.40 64.94 76.40 81.18 66.85 76.40 14.39 11.46 57.30 Not Applicable 67.81 62.08 66.85 14.39 14.39 Not Applicable 66.85 66.85 14.39 14.39 18.35 14.39 65.90 14.39 57.30 52.53 11.46 81.18
Cyto Enhance & Inter 88112 66.85 Northwest Medical Center OP 62.08 42.18 76.40 64.94 76.40 81.18 66.85 76.40 42.18 37.94 57.30 Not Applicable 67.81 62.08 66.85 42.18 42.18 Not Applicable 66.85 66.85 42.18 42.18 33.13 42.18 65.90 42.18 57.30 52.53 33.13 81.18
Path Stain Group 1 88312 66.85 Northwest Medical Center OP 62.08 42.18 76.40 64.94 76.40 81.18 66.85 76.40 42.18 37.94 57.30 Not Applicable 67.81 62.08 66.85 42.18 42.18 Not Applicable 66.85 66.85 42.18 42.18 15.37 42.18 65.90 42.18 57.30 52.53 15.37 81.18
Glucose Body Fld Qn 82945 68.25 Northwest Medical Center OP 63.38 3.93 78.00 66.30 78.00 82.88 68.25 78.00 3.93 5.15 58.50 Not Applicable 69.23 63.38 68.25 3.93 3.93 Not Applicable 68.25 68.25 3.93 3.93 5.00 3.93 67.28 3.93 58.50 53.63 3.93 82.88
Wbc Wo Manual Diff 85008 68.25 Northwest Medical Center OP 63.38 3.43 78.00 66.30 78.00 82.88 68.25 78.00 3.43 6.93 58.50 Not Applicable 69.23 63.38 68.25 3.43 3.43 Not Applicable 68.25 68.25 3.43 3.43 4.38 3.43 67.28 3.43 58.50 53.63 3.43 82.88
Surg Path Level 4 88305 68.25 Northwest Medical Center OP 63.38 42.18 78.00 66.30 78.00 82.88 68.25 78.00 42.18 37.94 58.50 Not Applicable 69.23 63.38 68.25 42.18 42.18 Not Applicable 68.25 68.25 42.18 42.18 33.13 42.18 67.28 42.18 58.50 53.63 33.13 82.88
Calculus Analysis 82360 68.95 Northwest Medical Center OP 64.03 12.87 78.80 66.98 78.80 83.73 68.95 78.80 12.87 11.59 59.10 Not Applicable 69.94 64.03 68.95 12.87 12.87 Not Applicable 68.95 68.95 12.87 12.87 16.41 12.87 67.97 12.87 59.10 54.18 11.59 83.73
Ebv Vca Antibody 86665 69.22 Northwest Medical Center OP 64.27 18.14 79.10 67.24 79.10 84.05 69.22 79.10 18.14 11.46 59.33 Not Applicable 70.20 64.27 69.22 18.14 18.14 Not Applicable 69.22 69.22 18.14 18.14 23.12 18.14 68.23 18.14 59.33 54.38 11.46 84.05
Abo Type 86900 69.29 Northwest Medical Center OP 64.34 92.96 79.18 67.31 79.18 84.13 69.29 79.18 92.96 14.59 59.39 Not Applicable 70.28 64.34 69.29 92.96 92.96 Not Applicable 69.29 69.29 92.96 92.96 3.81 92.96 68.30 92.96 59.39 54.44 3.81 92.96
Complement C1 Inhib 86161 69.30 Northwest Medical Center OP 64.35 12.00 79.20 67.32 79.20 84.15 69.30 79.20 12.00 11.46 59.40 Not Applicable 70.29 64.35 69.30 12.00 12.00 Not Applicable 69.30 69.30 12.00 12.00 15.31 12.00 68.31 12.00 59.40 54.45 11.46 84.15
Ana Quant Titer 86039 70.00 Northwest Medical Center OP 65.00 11.16 80.00 68.00 80.00 85.00 70.00 80.00 11.16 11.46 60.00 Not Applicable 71.00 65.00 70.00 11.16 11.16 Not Applicable 70.00 70.00 11.16 11.16 14.23 11.16 69.00 11.16 60.00 55.00 11.16 85.00
Ua W O Micro Auto 81003 70.35 Northwest Medical Center OP 65.33 2.25 80.40 68.34 80.40 85.43 70.35 80.40 2.25 3.49 60.30 Not Applicable 71.36 65.33 70.35 2.25 2.25 Not Applicable 70.35 70.35 2.25 2.25 2.86 2.25 69.35 2.25 60.30 55.28 2.25 85.43
Sensitivity Mic 87186 70.35 Northwest Medical Center OP 65.33 8.65 80.40 68.34 80.40 85.43 70.35 80.40 8.65 9.13 60.30 Not Applicable 71.36 65.33 70.35 8.65 8.65 Not Applicable 70.35 70.35 8.65 8.65 11.03 8.65 69.35 8.65 60.30 55.28 8.65 85.43
Sputum Collection 89220 70.35 Northwest Medical Center OP 65.33 122.35 80.40 68.34 80.40 85.43 70.35 80.40 122.35 35.74 60.30 Not Applicable 71.36 65.33 70.35 122.35 122.35 Not Applicable 70.35 70.35 122.35 122.35 15.37 122.35 69.35 122.35 60.30 55.28 15.37 122.35
Mitochond Ab Titer 86256 71.05 Northwest Medical Center OP 65.98 12.05 81.20 69.02 81.20 86.28 71.05 81.20 12.05 11.46 60.90 Not Applicable 72.07 65.98 71.05 12.05 12.05 Not Applicable 71.05 71.05 12.05 12.05 15.36 12.05 70.04 12.05 60.90 55.83 11.46 86.28
Calretinin Perox Ab 88342 71.05 Northwest Medical Center OP 65.98 122.35 81.20 69.02 81.20 86.28 71.05 81.20 122.35 37.94 60.90 Not Applicable 72.07 65.98 71.05 122.35 122.35 Not Applicable 71.05 71.05 122.35 122.35 33.13 122.35 70.04 122.35 60.90 55.83 33.13 122.35
Antibody Rubella 86762 71.05 Northwest Medical Center OP 65.98 14.39 81.20 69.02 81.20 86.28 71.05 81.20 14.39 11.46 60.90 Not Applicable 72.07 65.98 71.05 14.39 14.39 Not Applicable 71.05 71.05 14.39 14.39 18.35 14.39 70.04 14.39 60.90 55.83 11.46 86.28
Amylase 82150 71.75 Northwest Medical Center OP 66.63 6.48 82.00 69.70 82.00 87.13 71.75 82.00 6.48 5.15 61.50 Not Applicable 72.78 66.63 71.75 6.48 6.48 Not Applicable 71.75 71.75 6.48 6.48 8.26 6.48 70.73 6.48 61.50 56.38 5.15 87.13
Chlamydia T Amp Prob 87491 71.75 Northwest Medical Center OP 66.63 35.09 82.00 69.70 82.00 87.13 71.75 82.00 35.09 35.74 61.50 Not Applicable 72.78 66.63 71.75 35.09 35.09 Not Applicable 71.75 71.75 35.09 35.09 44.74 35.09 70.73 35.09 61.50 56.38 35.09 87.13
Tet\Diphtoxoid Pf J 90714 71.75 Northwest Medical Center OP 66.63 0.00 82.00 69.70 82.00 87.13 71.75 82.00 0.00 25.07 61.50 Not Applicable 72.78 66.63 71.75 0.00 0.00 Not Applicable 71.75 71.75 0.00 0.00 56.38 0.00 70.73 0.00 61.50 56.38 0.00 87.13
Osmolality Urine 83935 72.80 Northwest Medical Center OP 67.60 6.82 83.20 70.72 83.20 88.40 72.80 83.20 6.82 5.15 62.40 Not Applicable 73.84 67.60 72.80 6.82 6.82 Not Applicable 72.80 72.80 6.82 6.82 8.69 6.82 71.76 6.82 62.40 57.20 5.15 88.40
D-Dimer Semi 85378 72.80 Northwest Medical Center OP 67.60 9.72 83.20 70.72 83.20 88.40 72.80 83.20 9.72 4.41 62.40 Not Applicable 73.84 67.60 72.80 9.72 9.72 Not Applicable 72.80 72.80 9.72 9.72 9.09 9.72 71.76 9.72 62.40 57.20 4.41 88.40
Ceruloplasmin 82390 72.80 Northwest Medical Center OP 67.60 10.74 83.20 70.72 83.20 88.40 72.80 83.20 10.74 11.59 62.40 Not Applicable 73.84 67.60 72.80 10.74 10.74 Not Applicable 72.80 72.80 10.74 10.74 13.69 10.74 71.76 10.74 62.40 57.20 10.74 88.40
Islet Cell Antibody 86341 72.80 Northwest Medical Center OP 67.60 23.57 83.20 70.72 83.20 88.40 72.80 83.20 23.57 11.46 62.40 Not Applicable 73.84 67.60 72.80 23.57 23.57 Not Applicable 72.80 72.80 23.57 23.57 25.22 23.57 71.76 23.57 62.40 57.20 11.46 88.40
Immunofix Electro Cs 86335 72.80 Northwest Medical Center OP 67.60 29.35 83.20 70.72 83.20 88.40 72.80 83.20 29.35 32.80 62.40 Not Applicable 73.84 67.60 72.80 29.35 29.35 Not Applicable 72.80 72.80 29.35 29.35 37.41 29.35 71.76 29.35 62.40 57.20 29.35 88.40
Cult Colony Count Ur 87086 72.80 Northwest Medical Center OP 67.60 8.07 83.20 70.72 83.20 88.40 72.80 83.20 8.07 9.13 62.40 Not Applicable 73.84 67.60 72.80 8.07 8.07 Not Applicable 72.80 72.80 8.07 8.07 10.29 8.07 71.76 8.07 62.40 57.20 8.07 88.40
Sed Rate Westergren 85651 73.15 Northwest Medical Center OP 67.93 4.27 83.60 71.06 83.60 88.83 73.15 83.60 4.27 6.93 62.70 Not Applicable 74.20 67.93 73.15 4.27 4.27 Not Applicable 73.15 73.15 4.27 4.27 4.52 4.27 72.11 4.27 62.70 57.48 4.27 88.83
Smear India Ink 87210 73.15 Northwest Medical Center OP 67.93 5.82 83.60 71.06 83.60 88.83 73.15 83.60 5.82 9.13 62.70 Not Applicable 74.20 67.93 73.15 5.82 5.82 Not Applicable 73.15 73.15 5.82 5.82 5.45 5.82 72.11 5.82 62.70 57.48 5.45 88.83
Iron Binding (Tibc) 83550 73.50 Northwest Medical Center OP 68.25 8.74 84.00 71.40 84.00 89.25 73.50 84.00 8.74 11.59 63.00 Not Applicable 74.55 68.25 73.50 8.74 8.74 Not Applicable 73.50 73.50 8.74 8.74 11.14 8.74 72.45 8.74 63.00 57.75 8.74 89.25
Antibody Adenovirus 86603 73.50 Northwest Medical Center OP 68.25 12.87 84.00 71.40 84.00 89.25 73.50 84.00 12.87 11.46 63.00 Not Applicable 74.55 68.25 73.50 12.87 12.87 Not Applicable 73.50 73.50 12.87 12.87 16.41 12.87 72.45 12.87 63.00 57.75 11.46 89.25
Cold Agglutinin Quan 86157 73.85 Northwest Medical Center OP 68.58 8.06 84.40 71.74 84.40 89.68 73.85 84.40 8.06 11.46 63.30 Not Applicable 74.91 68.58 73.85 8.06 8.06 Not Applicable 73.85 73.85 8.06 8.06 10.29 8.06 72.80 8.06 63.30 58.03 8.06 89.68
Inj Hip Anthrogram 27093 73.86 Northwest Medical Center OP 68.59 0.00 84.42 71.75 84.42 89.69 73.86 84.42 0.00 274.62 63.31 Not Applicable 74.92 68.59 73.86 0.00 0.00 Not Applicable 73.86 73.86 0.00 0.00 73.86 0.00 72.81 0.00 63.31 58.04 0.00 274.62
Alkaloids Nos 80323 74.55 Northwest Medical Center OP 69.23 0.00 85.20 72.42 85.20 90.53 74.55 85.20 0.00 11.59 63.90 Not Applicable 75.62 69.23 74.55 0.00 0.00 Not Applicable 74.55 74.55 0.00 0.00 36.77 0.00 73.49 0.00 63.90 58.58 0.00 90.53
Antibody Mycoplasma 86738 74.90 Northwest Medical Center OP 69.55 13.24 85.60 72.76 85.60 90.95 74.90 85.60 13.24 11.46 64.20 Not Applicable 75.97 69.55 74.90 13.24 13.24 Not Applicable 74.90 74.90 13.24 13.24 16.88 13.24 73.83 13.24 64.20 58.85 11.46 90.95
Cult W Presumptive I 87088 74.90 Northwest Medical Center OP 69.55 8.09 85.60 72.76 85.60 90.95 74.90 85.60 8.09 9.13 64.20 Not Applicable 75.97 69.55 74.90 8.09 8.09 Not Applicable 74.90 74.90 8.09 8.09 10.32 8.09 73.83 8.09 64.20 58.85 8.09 90.95
Irradiation Bld Ea 86945 75.57 Northwest Medical Center OP 70.17 28.50 86.37 73.41 86.37 91.77 75.57 86.37 28.50 28.75 64.78 Not Applicable 76.65 70.17 75.57 28.50 28.50 Not Applicable 75.57 75.57 28.50 28.50 13.44 28.50 74.49 28.50 64.78 59.38 13.44 91.77
Spec 3D Recnstr Wo P 76376 76.02 Northwest Medical Center OP 70.59 0.00 86.88 73.85 86.88 92.31 76.02 86.88 0.00 0.00 65.16 86.88 77.11 70.59 76.02 0.00 0.00 Not Applicable 76.02 76.02 0.00 0.00 76.02 0.00 74.93 0.00 65.16 59.73 0.00 92.31
Procalcitonin 84145 76.22 Northwest Medical Center OP 70.77 27.22 87.10 74.04 87.10 92.55 76.22 87.10 27.22 16.00 65.33 Not Applicable 77.30 70.77 76.22 27.22 27.22 Not Applicable 76.22 76.22 27.22 27.22 34.14 27.22 75.13 27.22 65.33 59.88 16.00 92.55
Calprotectin Fecal 83993 77.00 Northwest Medical Center OP 71.50 19.63 88.00 74.80 88.00 93.50 77.00 88.00 19.63 11.59 66.00 Not Applicable 78.10 71.50 77.00 19.63 19.63 Not Applicable 77.00 77.00 19.63 19.63 25.02 19.63 75.90 19.63 66.00 60.50 11.59 93.50
Vitamin B2 Whole Bld 84252 77.20 Northwest Medical Center OP 71.68 20.24 88.22 74.99 88.22 93.74 77.20 88.22 20.24 11.59 66.17 Not Applicable 78.30 71.68 77.20 20.24 20.24 Not Applicable 77.20 77.20 20.24 20.24 25.79 20.24 76.09 20.24 66.17 60.65 11.59 93.74
Occult Bld Stool 1-3 82270 77.35 Northwest Medical Center OP 71.83 4.38 88.40 75.14 88.40 93.93 77.35 88.40 4.38 5.15 66.30 Not Applicable 78.46 71.83 77.35 4.38 4.38 Not Applicable 77.35 77.35 4.38 4.38 4.15 4.38 76.25 4.38 66.30 60.78 4.15 93.93
Ck Cpk Isoenzymes 82552 77.35 Northwest Medical Center OP 71.83 13.39 88.40 75.14 88.40 93.93 77.35 88.40 13.39 11.59 66.30 Not Applicable 78.46 71.83 77.35 13.39 13.39 Not Applicable 77.35 77.35 13.39 13.39 17.08 13.39 76.25 13.39 66.30 60.78 11.59 93.93
Hepatitis A Ab Igm 86709 77.35 Northwest Medical Center OP 71.83 11.26 88.40 75.14 88.40 93.93 77.35 88.40 11.26 11.46 66.30 Not Applicable 78.46 71.83 77.35 11.26 11.26 Not Applicable 77.35 77.35 11.26 11.26 14.36 11.26 76.25 11.26 66.30 60.78 11.26 93.93
Declot Vad 36593 77.62 Northwest Medical Center OP 72.07 263.96 88.70 75.40 88.70 94.25 77.62 88.70 263.96 369.09 66.53 Not Applicable 78.72 72.07 77.62 263.96 263.96 Not Applicable 77.62 77.62 263.96 263.96 Not Applicable 263.96 76.51 263.96 66.53 60.98 60.98 369.09
Fdp Quant 85370 77.70 Northwest Medical Center OP 72.15 12.43 88.80 75.48 88.80 94.35 77.70 88.80 12.43 4.41 66.60 Not Applicable 78.81 72.15 77.70 12.43 12.43 Not Applicable 77.70 77.70 12.43 12.43 14.47 12.43 76.59 12.43 66.60 61.05 4.41 94.35
Acid Phosphatase Pro 84066 77.70 Northwest Medical Center OP 72.15 9.66 88.80 75.48 88.80 94.35 77.70 88.80 9.66 11.59 66.60 Not Applicable 78.81 72.15 77.70 9.66 9.66 Not Applicable 77.70 77.70 9.66 9.66 12.31 9.66 76.59 9.66 66.60 61.05 9.66 94.35
Ab Sc-170 86235 77.70 Northwest Medical Center OP 72.15 17.93 88.80 75.48 88.80 94.35 77.70 88.80 17.93 11.46 66.60 Not Applicable 78.81 72.15 77.70 17.93 17.93 Not Applicable 77.70 77.70 17.93 17.93 22.86 17.93 76.59 17.93 66.60 61.05 11.46 94.35
Hep B S Ag Eia 87340 77.70 Northwest Medical Center OP 72.15 10.33 88.80 75.48 88.80 94.35 77.70 88.80 10.33 9.13 66.60 Not Applicable 78.81 72.15 77.70 10.33 10.33 Not Applicable 77.70 77.70 10.33 10.33 13.17 10.33 76.59 10.33 66.60 61.05 9.13 94.35
Benzodiazepines 1-12 80346 78.40 Northwest Medical Center OP 72.80 0.00 89.60 76.16 89.60 95.20 78.40 89.60 0.00 11.59 67.20 Not Applicable 79.52 72.80 78.40 0.00 0.00 Not Applicable 78.40 78.40 0.00 0.00 24.25 0.00 77.28 0.00 67.20 61.60 0.00 95.20
Koh Prep Tissue 87220 78.75 Northwest Medical Center OP 73.13 4.27 90.00 76.50 90.00 95.63 78.75 90.00 4.27 9.13 67.50 Not Applicable 79.88 73.13 78.75 4.27 4.27 Not Applicable 78.75 78.75 4.27 4.27 5.45 4.27 77.63 4.27 67.50 61.88 4.27 95.63
Calcium Ur Qn 82340 79.80 Northwest Medical Center OP 74.10 6.03 91.20 77.52 91.20 96.90 79.80 91.20 6.03 5.15 68.40 Not Applicable 80.94 74.10 79.80 6.03 6.03 Not Applicable 79.80 79.80 6.03 6.03 7.69 6.03 78.66 6.03 68.40 62.70 5.15 96.90
Glycated Protein 82985 79.80 Northwest Medical Center OP 74.10 16.76 91.20 77.52 91.20 96.90 79.80 91.20 16.76 11.59 68.40 Not Applicable 80.94 74.10 79.80 16.76 16.76 Not Applicable 79.80 79.80 16.76 16.76 19.22 16.76 78.66 16.76 68.40 62.70 11.59 96.90
Fecal Wbc Count 89055 80.15 Northwest Medical Center OP 74.43 4.27 91.60 77.86 91.60 97.33 80.15 91.60 4.27 6.93 68.70 Not Applicable 81.30 74.43 80.15 4.27 4.27 Not Applicable 80.15 80.15 4.27 4.27 5.45 4.27 79.01 4.27 68.70 62.98 4.27 97.33
Dna Single Stranded 86226 80.50 Northwest Medical Center OP 74.75 12.11 92.00 78.20 92.00 97.75 80.50 92.00 12.11 11.46 69.00 Not Applicable 81.65 74.75 80.50 12.11 12.11 Not Applicable 80.50 80.50 12.11 12.11 15.44 12.11 79.35 12.11 69.00 63.25 11.46 97.75
Protein Electro Seru 84165 80.85 Northwest Medical Center OP 75.08 10.74 92.40 78.54 92.40 98.18 80.85 92.40 10.74 11.59 69.30 Not Applicable 82.01 75.08 80.85 10.74 10.74 Not Applicable 80.85 80.85 10.74 10.74 13.69 10.74 79.70 10.74 69.30 63.53 10.74 98.18
Immunofix Electro 86334 80.85 Northwest Medical Center OP 75.08 22.34 92.40 78.54 92.40 98.18 80.85 92.40 22.34 11.46 69.30 Not Applicable 82.01 75.08 80.85 22.34 22.34 Not Applicable 80.85 80.85 22.34 22.34 28.48 22.34 79.70 22.34 69.30 63.53 11.46 98.18
Hep A Ab Total 86708 80.85 Northwest Medical Center OP 75.08 12.39 92.40 78.54 92.40 98.18 80.85 92.40 12.39 11.46 69.30 Not Applicable 82.01 75.08 80.85 12.39 12.39 Not Applicable 80.85 80.85 12.39 12.39 15.80 12.39 79.70 12.39 69.30 63.53 11.46 98.18
Fdp Semiquant 85362 81.20 Northwest Medical Center OP 75.40 6.89 92.80 78.88 92.80 98.60 81.20 92.80 6.89 4.41 69.60 Not Applicable 82.36 75.40 81.20 6.89 6.89 Not Applicable 81.20 81.20 6.89 6.89 8.78 6.89 80.04 6.89 69.60 63.80 4.41 98.60
Aerobic Org Id 87077 81.20 Northwest Medical Center OP 75.40 8.08 92.80 78.88 92.80 98.60 81.20 92.80 8.08 9.13 69.60 Not Applicable 82.36 75.40 81.20 8.08 8.08 Not Applicable 81.20 81.20 8.08 8.08 10.31 8.08 80.04 8.08 69.60 63.80 8.08 98.60
Clonazepam Quant 80305 82.25 Northwest Medical Center OP 76.38 12.60 94.00 79.90 94.00 99.88 82.25 94.00 12.60 11.59 70.50 Not Applicable 83.43 76.38 82.25 12.60 12.60 Not Applicable 82.25 82.25 12.60 12.60 13.46 12.60 81.08 12.60 70.50 64.63 11.59 99.88
Clsd Trt Tibial Shft 27750 82.68 Northwest Medical Center OP 76.78 183.85 94.50 80.32 94.50 100.40 82.68 94.50 183.85 685.82 70.87 Not Applicable 83.87 76.78 82.68 183.85 183.85 Not Applicable 82.68 82.68 183.85 183.85 Not Applicable 183.85 81.50 183.85 70.87 64.97 64.97 685.82
Ana Qual Screen 86038 84.00 Northwest Medical Center OP 78.00 12.09 96.00 81.60 96.00 102.00 84.00 96.00 12.09 11.46 72.00 Not Applicable 85.20 78.00 84.00 12.09 12.09 Not Applicable 84.00 84.00 12.09 12.09 15.41 12.09 82.80 12.09 72.00 66.00 11.46 102.00
Covid 2 Nucleic Acid 87635 84.00 Northwest Medical Center OP 51.31 51.31 96.00 81.60 96.00 102.00 84.00 96.00 51.31 35.74 72.00 Not Applicable 85.20 78.00 84.00 51.31 51.31 Not Applicable 84.00 84.00 51.31 51.31 46.20 51.31 82.80 51.31 72.00 66.00 35.74 102.00
Sp Grav Body Fluid 84315 84.70 Northwest Medical Center OP 78.65 3.28 96.80 82.28 96.80 102.85 84.70 96.80 3.28 5.15 72.60 Not Applicable 85.91 78.65 84.70 3.28 3.28 Not Applicable 84.70 84.70 3.28 3.28 3.20 3.28 83.49 3.28 72.60 66.55 3.20 102.85
Bleeding Time Test 85002 84.70 Northwest Medical Center OP 78.65 4.82 96.80 82.28 96.80 102.85 84.70 96.80 4.82 4.41 72.60 Not Applicable 85.91 78.65 84.70 4.82 4.82 Not Applicable 84.70 84.70 4.82 4.82 5.74 4.82 83.49 4.82 72.60 66.55 4.41 102.85
Rapid Influenza 87804 85.18 Northwest Medical Center OP 79.09 16.55 97.34 82.74 97.34 103.43 85.18 97.34 16.55 9.13 73.01 Not Applicable 86.39 79.09 85.18 16.55 16.55 Not Applicable 85.18 85.18 16.55 16.55 15.29 16.55 83.96 16.55 73.01 66.92 9.13 103.43
Evac Subungual Hemat 11740 86.02 Northwest Medical Center OP 79.87 92.96 98.30 83.56 98.30 104.45 86.02 98.30 92.96 92.26 73.73 Not Applicable 87.24 79.87 86.02 92.96 92.96 Not Applicable 86.02 86.02 92.96 92.96 Not Applicable 92.96 84.79 92.96 73.73 67.58 67.58 104.45
Fecal Reducing Subst 84376 86.80 Northwest Medical Center OP 80.60 5.50 99.20 84.32 99.20 105.40 86.80 99.20 5.50 5.15 74.40 Not Applicable 88.04 80.60 86.80 5.50 5.50 Not Applicable 86.80 86.80 5.50 5.50 7.01 5.50 85.56 5.50 74.40 68.20 5.15 105.40
Total Protein Body F 84157 86.80 Northwest Medical Center OP 80.60 4.00 99.20 84.32 99.20 105.40 86.80 99.20 4.00 5.15 74.40 Not Applicable 88.04 80.60 86.80 4.00 4.00 Not Applicable 86.80 86.80 4.00 4.00 4.67 4.00 85.56 4.00 74.40 68.20 4.00 105.40
Cell Count Body Fld 89050 86.80 Northwest Medical Center OP 80.60 4.72 99.20 84.32 99.20 105.40 86.80 99.20 4.72 17.65 74.40 Not Applicable 88.04 80.60 86.80 4.72 4.72 Not Applicable 86.80 86.80 4.72 4.72 6.03 4.72 85.56 4.72 74.40 68.20 4.72 105.40
Finger Splint Dynami 29131 87.84 Northwest Medical Center OP 81.56 46.90 100.38 85.33 100.38 106.66 87.84 100.38 46.90 77.36 75.29 Not Applicable 89.09 81.56 87.84 46.90 46.90 Not Applicable 87.84 87.84 46.90 46.90 Not Applicable 46.90 86.58 46.90 75.29 69.01 46.90 106.66
Ra Factor Qual 86430 87.85 Northwest Medical Center OP 81.58 6.14 100.40 85.34 100.40 106.68 87.85 100.40 6.14 11.46 75.30 Not Applicable 89.11 81.58 87.85 6.14 6.14 Not Applicable 87.85 87.85 6.14 6.14 7.24 6.14 86.60 6.14 75.30 69.03 6.14 106.68
Thyroglob Ab Qual 86800 88.55 Northwest Medical Center OP 82.23 15.91 101.20 86.02 101.20 107.53 88.55 101.20 15.91 16.00 75.90 Not Applicable 89.82 82.23 88.55 15.91 15.91 Not Applicable 88.55 88.55 15.91 15.91 20.28 15.91 87.29 15.91 75.90 69.58 15.91 107.53
Knee 1 2 Views 73560 88.90 Northwest Medical Center OP 82.55 68.04 101.60 86.36 101.60 107.95 88.90 101.60 68.04 61.05 76.20 101.60 90.17 82.55 88.90 68.04 68.04 Not Applicable 88.90 88.90 68.04 68.04 88.90 68.04 87.63 68.04 76.20 69.85 61.05 107.95
Foot 2 Views 73620 88.90 Northwest Medical Center OP 82.55 68.04 101.60 86.36 101.60 107.95 88.90 101.60 68.04 61.05 76.20 101.60 90.17 82.55 88.90 68.04 68.04 Not Applicable 88.90 88.90 68.04 68.04 88.90 68.04 87.63 68.04 76.20 69.85 61.05 107.95
Cast Rem Bival/Sh 29700 89.29 Northwest Medical Center OP 82.91 195.94 102.05 86.74 102.05 108.43 89.29 102.05 195.94 232.39 76.54 Not Applicable 90.57 82.91 89.29 195.94 195.94 Not Applicable 89.29 89.29 195.94 195.94 Not Applicable 195.94 88.02 195.94 76.54 70.16 70.16 232.39
Transferrin 84466 89.60 Northwest Medical Center OP 83.20 12.76 102.40 87.04 102.40 108.80 89.60 102.40 12.76 11.59 76.80 Not Applicable 90.88 83.20 89.60 12.76 12.76 Not Applicable 89.60 89.60 12.76 12.76 16.28 12.76 88.32 12.76 76.80 70.40 11.59 108.80
Acute Hepatitis Pane 80074 90.65 Northwest Medical Center OP 84.18 47.63 103.60 88.06 103.60 110.08 90.65 103.60 47.63 10.73 77.70 Not Applicable 91.95 84.18 90.65 47.63 47.63 Not Applicable 90.65 90.65 47.63 47.63 60.72 47.63 89.36 47.63 77.70 71.23 10.73 110.08
Hepatitis Be Ag Eia 87350 90.65 Northwest Medical Center OP 84.18 11.53 103.60 88.06 103.60 110.08 90.65 103.60 11.53 9.13 77.70 Not Applicable 91.95 84.18 90.65 11.53 11.53 Not Applicable 90.65 90.65 11.53 11.53 14.69 11.53 89.36 11.53 77.70 71.23 9.13 110.08
Trichinomonas By Naa 87661 90.99 Northwest Medical Center OP 84.49 35.09 103.99 88.39 103.99 110.49 90.99 103.99 35.09 35.74 77.99 Not Applicable 92.29 84.49 90.99 35.09 35.09 Not Applicable 90.99 90.99 35.09 35.09 43.08 35.09 89.69 35.09 77.99 71.49 35.09 110.49
Haloperidol 80173 91.35 Northwest Medical Center OP 84.83 15.78 104.40 88.74 104.40 110.93 91.35 104.40 15.78 12.87 78.30 Not Applicable 92.66 84.83 91.35 15.78 15.78 Not Applicable 91.35 91.35 15.78 15.78 18.56 15.78 90.05 15.78 78.30 71.78 12.87 110.93
Carotene 82380 91.35 Northwest Medical Center OP 84.83 9.22 104.40 88.74 104.40 110.93 91.35 104.40 9.22 11.59 78.30 Not Applicable 92.66 84.83 91.35 9.22 9.22 Not Applicable 91.35 91.35 9.22 9.22 11.75 9.22 90.05 9.22 78.30 71.78 9.22 110.93
Hydroxyprog 17D 83498 92.40 Northwest Medical Center OP 85.80 27.17 105.60 89.76 105.60 112.20 92.40 105.60 27.17 16.00 79.20 Not Applicable 93.72 85.80 92.40 27.17 27.17 Not Applicable 92.40 92.40 27.17 27.17 34.63 27.17 91.08 27.17 79.20 72.60 16.00 112.20
Digoxin Free 80163 93.45 Northwest Medical Center OP 86.78 13.28 106.80 90.78 106.80 113.48 93.45 106.80 13.28 12.87 80.10 Not Applicable 94.79 86.78 93.45 13.28 13.28 Not Applicable 93.45 93.45 13.28 13.28 16.26 13.28 92.12 13.28 80.10 73.43 12.87 113.48
Cyclosporine 80158 94.50 Northwest Medical Center OP 87.75 18.05 108.00 91.80 108.00 114.75 94.50 108.00 18.05 12.87 81.00 Not Applicable 95.85 87.75 94.50 18.05 18.05 Not Applicable 94.50 94.50 18.05 18.05 23.01 18.05 93.15 18.05 81.00 74.25 12.87 114.75
Cell Ct & Diff Csf 89051 94.50 Northwest Medical Center OP 87.75 5.60 108.00 91.80 108.00 114.75 94.50 108.00 5.60 17.65 81.00 Not Applicable 95.85 87.75 94.50 5.60 5.60 Not Applicable 94.50 94.50 5.60 5.60 7.02 5.60 93.15 5.60 81.00 74.25 5.60 114.75
Bilirubin Direct 82248 95.20 Northwest Medical Center OP 88.40 5.02 108.80 92.48 108.80 115.60 95.20 108.80 5.02 5.15 81.60 Not Applicable 96.56 88.40 95.20 5.02 5.02 Not Applicable 95.20 95.20 5.02 5.02 6.39 5.02 93.84 5.02 81.60 74.80 5.02 115.60
B2 Glycoprotein Anti 86146 95.82 Northwest Medical Center OP 88.97 25.45 109.50 93.08 109.50 116.35 95.82 109.50 25.45 11.59 82.13 Not Applicable 97.18 88.97 95.82 25.45 25.45 Not Applicable 95.82 95.82 25.45 25.45 32.44 25.45 94.45 25.45 82.13 75.28 11.59 116.35
Russell Viper Dilute 85613 95.90 Northwest Medical Center OP 89.05 9.58 109.60 93.16 109.60 116.45 95.90 109.60 9.58 4.41 82.20 Not Applicable 97.27 89.05 95.90 9.58 9.58 Not Applicable 95.90 95.90 9.58 9.58 12.20 9.58 94.53 9.58 82.20 75.35 4.41 116.45
Inj Small Jt W/O Us 20600 96.21 Northwest Medical Center OP 89.34 223.18 109.95 93.46 109.95 116.82 96.21 109.95 223.18 348.92 82.46 Not Applicable 97.58 89.34 96.21 223.18 223.18 Not Applicable 96.21 96.21 223.18 223.18 Not Applicable 223.18 94.83 223.18 82.46 75.59 75.59 348.92
Immun Nasal/Oral 1St 90473 96.24 Northwest Medical Center OP 89.36 51.56 109.98 93.49 109.98 116.86 96.24 109.98 51.56 44.81 82.49 Not Applicable 97.61 89.36 96.24 51.56 51.56 Not Applicable 96.24 96.24 51.56 51.56 96.24 51.56 94.86 51.56 82.49 75.61 44.81 116.86
Hepatitis B Vaccin 90476 96.24 Northwest Medical Center OP 89.36 0.00 109.98 93.49 109.98 116.86 96.24 109.98 0.00 25.07 82.49 Not Applicable 97.61 89.36 96.24 0.00 0.00 Not Applicable 96.24 96.24 0.00 0.00 75.61 0.00 94.86 0.00 82.49 75.61 0.00 116.86
Chemo Admin Intra Ar 96423 96.24 Northwest Medical Center OP 89.36 32.49 109.98 93.49 109.98 116.86 96.24 109.98 32.49 551.33 82.49 Not Applicable 97.61 89.36 96.24 32.49 32.49 Not Applicable 96.24 96.24 32.49 32.49 75.61 32.49 94.86 32.49 82.49 75.61 32.49 551.33
Chemo Admin Intrales 96405 96.24 Northwest Medical Center OP 89.36 51.56 109.98 93.49 109.98 116.86 96.24 109.98 51.56 355.23 82.49 Not Applicable 97.61 89.36 96.24 51.56 51.56 Not Applicable 96.24 96.24 51.56 51.56 75.61 51.56 94.86 51.56 82.49 75.61 51.56 355.23
Pneumococcal Vaccina G0009 96.24 Northwest Medical Center OP 89.36 32.49 109.98 93.49 109.98 116.86 96.24 109.98 32.49 44.81 82.49 Not Applicable 97.61 89.36 96.24 32.49 32.49 Not Applicable 96.24 96.24 32.49 32.49 31.85 32.49 94.86 32.49 82.49 75.61 31.85 116.86
Hepatitis B Vacc 90746 96.24 Northwest Medical Center OP 89.36 0.00 109.98 93.49 109.98 116.86 96.24 109.98 0.00 25.07 82.49 Not Applicable 97.61 89.36 96.24 0.00 0.00 Not Applicable 96.24 96.24 0.00 0.00 75.61 0.00 94.86 0.00 82.49 75.61 0.00 116.86
Influenza Vaccinatio G0008 96.24 Northwest Medical Center OP 89.36 32.49 109.98 93.49 109.98 116.86 96.24 109.98 32.49 44.81 82.49 Not Applicable 97.61 89.36 96.24 32.49 32.49 Not Applicable 96.24 96.24 32.49 32.49 31.85 32.49 94.86 32.49 82.49 75.61 31.85 116.86
Cult Fungus 87102 96.25 Northwest Medical Center OP 89.38 8.41 110.00 93.50 110.00 116.88 96.25 110.00 8.41 9.13 82.50 Not Applicable 97.63 89.38 96.25 8.41 8.41 Not Applicable 96.25 96.25 8.41 8.41 10.71 8.41 94.88 8.41 82.50 75.63 8.41 116.88
Chest Physio Subsq 94668 96.25 Northwest Medical Center OP 89.38 92.96 110.00 93.50 110.00 116.88 96.25 110.00 92.96 262.36 82.50 Not Applicable 97.63 89.38 96.25 92.96 92.96 Not Applicable 96.25 96.25 92.96 92.96 96.25 92.96 94.88 92.96 82.50 75.63 75.63 262.36
Cult Fungus Skin 87101 96.25 Northwest Medical Center OP 89.38 7.71 110.00 93.50 110.00 116.88 96.25 110.00 7.71 9.13 82.50 Not Applicable 97.63 89.38 96.25 7.71 7.71 Not Applicable 96.25 96.25 7.71 7.71 9.84 7.71 94.88 7.71 82.50 75.63 7.71 116.88
Culture Fungus Blood 87103 96.25 Northwest Medical Center OP 89.38 20.46 110.00 93.50 110.00 116.88 96.25 110.00 20.46 9.13 82.50 Not Applicable 97.63 89.38 96.25 20.46 20.46 Not Applicable 96.25 96.25 20.46 20.46 11.49 20.46 94.88 20.46 82.50 75.63 9.13 116.88
Est Pt Visit Level 1 99211 97.30 Northwest Medical Center OP 90.35 0.00 111.20 94.52 111.20 118.15 97.30 111.20 0.00 0.00 83.40 Not Applicable 98.69 90.35 97.30 0.00 0.00 Not Applicable 97.30 97.30 0.00 0.00 97.30 0.00 95.91 0.00 83.40 76.45 0.00 118.15
Vitamin E 84446 97.65 Northwest Medical Center OP 90.68 14.18 111.60 94.86 111.60 118.58 97.65 111.60 14.18 11.59 83.70 Not Applicable 99.05 90.68 97.65 14.18 14.18 Not Applicable 97.65 97.65 14.18 14.18 18.07 14.18 96.26 14.18 83.70 76.73 11.59 118.58
Digoxin Total 80162 98.00 Northwest Medical Center OP 91.00 13.28 112.00 95.20 112.00 119.00 98.00 112.00 13.28 12.87 84.00 Not Applicable 99.40 91.00 98.00 13.28 13.28 Not Applicable 98.00 98.00 13.28 13.28 16.92 13.28 96.60 13.28 84.00 77.00 12.87 119.00
Antigen Dna Native 86225 98.00 Northwest Medical Center OP 91.00 13.74 112.00 95.20 112.00 119.00 98.00 112.00 13.74 11.46 84.00 Not Applicable 99.40 91.00 98.00 13.74 13.74 Not Applicable 98.00 98.00 13.74 13.74 17.51 13.74 96.60 13.74 84.00 77.00 11.46 119.00
Volatiles 84600 98.00 Northwest Medical Center OP 91.00 17.11 112.00 95.20 112.00 119.00 98.00 112.00 17.11 11.59 84.00 Not Applicable 99.40 91.00 98.00 17.11 17.11 Not Applicable 98.00 98.00 17.11 17.11 20.49 17.11 96.60 17.11 84.00 77.00 11.59 119.00
Hb S Ab Qual 86706 98.00 Northwest Medical Center OP 91.00 10.74 112.00 95.20 112.00 119.00 98.00 112.00 10.74 11.46 84.00 Not Applicable 99.40 91.00 98.00 10.74 10.74 Not Applicable 98.00 98.00 10.74 10.74 13.69 10.74 96.60 10.74 84.00 77.00 10.74 119.00
Hepatitis Delta Ab Q 86692 98.00 Northwest Medical Center OP 91.00 17.16 112.00 95.20 112.00 119.00 98.00 112.00 17.16 11.46 84.00 Not Applicable 99.40 91.00 98.00 17.16 17.16 Not Applicable 98.00 98.00 17.16 17.16 21.88 17.16 96.60 17.16 84.00 77.00 11.46 119.00
Strep A Ag Eia 87430 98.35 Northwest Medical Center OP 91.33 16.81 112.40 95.54 112.40 119.43 98.35 112.40 16.81 9.13 84.30 Not Applicable 99.76 91.33 98.35 16.81 16.81 Not Applicable 98.35 98.35 16.81 16.81 15.29 16.81 96.95 16.81 84.30 77.28 9.13 119.43
Breast Surgical Spec 76098 99.40 Northwest Medical Center OP 92.30 410.59 113.60 96.56 113.60 120.70 99.40 113.60 410.59 127.87 85.20 113.60 100.82 92.30 99.40 410.59 410.59 Not Applicable 99.40 99.40 410.59 410.59 99.40 410.59 97.98 410.59 85.20 78.10 78.10 410.59
Intrinsic Fact Ab 86340 99.40 Northwest Medical Center OP 92.30 15.08 113.60 96.56 113.60 120.70 99.40 113.60 15.08 16.00 85.20 Not Applicable 100.82 92.30 99.40 15.08 15.08 Not Applicable 99.40 99.40 15.08 15.08 19.22 15.08 97.98 15.08 85.20 78.10 15.08 120.70
Chest Physio Initial 94667 99.40 Northwest Medical Center OP 92.30 92.96 113.60 96.56 113.60 120.70 99.40 113.60 92.96 262.36 85.20 Not Applicable 100.82 92.30 99.40 92.96 92.96 Not Applicable 99.40 99.40 92.96 92.96 99.40 92.96 97.98 92.96 85.20 78.10 78.10 262.36
Inf Agent Concentrat 87015 100.45 Northwest Medical Center OP 93.28 6.68 114.80 97.58 114.80 121.98 100.45 114.80 6.68 9.13 86.10 Not Applicable 101.89 93.28 100.45 6.68 6.68 Not Applicable 100.45 100.45 6.68 6.68 8.51 6.68 99.02 6.68 86.10 78.93 6.68 121.98
Inj Interm JT W/O US 20605 100.60 Northwest Medical Center OP 93.42 223.18 114.98 97.73 114.98 122.16 100.60 114.98 223.18 348.92 86.23 Not Applicable 102.04 93.42 100.60 223.18 223.18 Not Applicable 100.60 100.60 223.18 223.18 Not Applicable 223.18 99.17 223.18 86.23 79.05 79.05 348.92
Complement TOT 86162 101.15 Northwest Medical Center OP 93.93 20.32 115.60 98.26 115.60 122.83 101.15 115.60 20.32 11.46 86.70 Not Applicable 102.60 93.93 101.15 20.32 20.32 Not Applicable 101.15 101.15 20.32 20.32 25.90 20.32 99.71 20.32 86.70 79.48 11.46 122.83
Fingers Min 2 Vws 73140 101.85 Northwest Medical Center OP 94.58 79.81 116.40 98.94 116.40 123.68 101.85 116.40 79.81 9.13 87.30 Not Applicable 103.31 94.58 101.85 79.81 79.81 Not Applicable 101.85 101.85 79.81 79.81 Not Applicable 79.81 100.40 79.81 87.30 80.03 9.13 123.68
Path Cons Extended R 88325 101.85 Northwest Medical Center OP 94.58 49.47 116.40 98.94 116.40 123.68 101.85 116.40 49.47 348.92 87.30 Not Applicable 103.31 94.58 101.85 49.47 49.47 Not Applicable 101.85 101.85 49.47 49.47 896.00 49.47 100.40 49.47 87.30 80.03 49.47 896.00
Alk Phos Isoenzymes 84080 101.50 Northwest Medical Center OP 94.25 14.78 116.00 98.60 116.00 123.25 101.50 116.00 14.78 11.59 87.00 Not Applicable 102.95 94.25 101.50 14.78 14.78 Not Applicable 101.50 101.50 14.78 14.78 Not Applicable 14.78 100.05 14.78 87.00 79.75 11.59 123.25
Shaving of shoulder bone using an endoscope Primary Procedure 29826 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Removal of tonsils and adenoid glands patient younger than age 12 Primary Procedure 42820 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Ultrasound examination of lower large bowel using an endoscope Primary Procedure 45391 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Biopsy of prostate gland Primary Procedure 55700 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Surgical removal of prostate and surrounding lymph nodes using an endoscope Primary Procedure 55866 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Routine obstetric care for vaginal delivery, including pre-and post- delivery care Primary Procedure 59400 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Routine obstetric care for cesarean delivery, including pre-and post-delivery care Primary Procedure 59510 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Routine obstetric care for vaginal delivery after prior cesarean delivery including pre-and post-delivery care Primary Procedure 59610 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Injection of substance into spinal canal of lower back or sacrum using imaging guidance Primary Procedure 62322-62323 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Injections of anesthetic and/or steroid drug into lower or sacral spine nerve root using imaging guidance Primary Procedure 64483 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Electrocardiogram, routine, with interpretation and report Primary Procedure 93000 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Insertion of catheter into left heart for diagnosis Primary Procedure 93452 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Psychotherapy, 60 min Primary Procedure 90837 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Patient office consultation, typically 40 min Primary Procedure 99243 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Patient office consultation, typically 60 min Primary Procedure 99244 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Initial new patient preventive medicine evaluation (18-39 years) Primary Procedure 99385 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Initial new patient preventive medicine evaluation (40-64 years) Primary Procedure 99386 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Abdominal ultrasound of pregnant uterus (greater or equal to 14 weeks 0 days) single or first fetus Primary Procedure 76805 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
New patient office or other outpatient visit, typically 30 min 99203 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
New patient office of other outpatient visit, typically 45 min 99204 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
New patient office of other outpatient visit, typically 60 min 99205 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Cardiac valve and other major cardiothoracic procedures with cardiac catheterization with major complications or comorbidities 216 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Spinal fusion except cervical without major comorbid conditions or complications (MCC) 460 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Major joint replacement or reattachment of lower extremity without major comorbid conditions or complications (MCC). 470 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Cervical spinal fusion without comorbid conditions (CC) or major comorbid conditions or complications (MCC). 473 Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided Service not provided
Notes and Disclaimers

The following pricing may not reflect the total amount due on a claim, nor does it reflect your financial responsibility as a patient. Pricing and services below reflect a typical encounter; however, your physician may render a different variation of services to provide you the best level of care. Payors often price claims with a 'lesser of' methodology; therefore, services may be priced less than the rates below.

The inclusion of pricing below does not indicate that a service is covered under your benefit plan. Likewise, the exclusion of a service below or pricing at $0 does not indicate that a service is not covered by your health plan, not offered by our facility, nor that the service may come at no cost to you.

"Included in primary procedure" indicates that, typically, the specified service is not separately priced; rather, it is considered packaged with the primary procedure pricing. However, any variation in services provided – including whether individual services below are provided along with other services, rather than independently – can cause variation in pricing, due to payor policies.

Workers' Compensation rates reflected below are based on claims filed in Alabama. Rates may vary depending on the state in which the injury claim is filed.

Contracted reimbursement rates are subject to change at any time.

Please contact Felicia Atkinson by phone at 205-487-7710 with any questions.

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