March 28, 2012
January 2012 1st QTR ASC Drug File
| HCPCS Code | Status Indicator | Amount |
|---|---|---|
| A9584 | A | $1,905.88 |
| C9121 | A | $19.35 |
| C9248 | A | $2.65 |
| C9250 | A | $136.58 |
| C9254 | A | $0.15 |
| C9257 | A | $1.50 |
| C9275 | A | $623.28 |
| C9279 | A | $1.39 |
| C9285 | A | $13.22 |
| C9286 | A | $3.80 |
| C9287 | A | $95.40 |
| C9358 | A | $11.00 |
| C9360 | A | $11.33 |
| C9363 | A | $19.91 |
| C9366 | A | $144.81 |
| C9367 | A | $4.35 |
| C9399 | C | $0.00 |
| J0129 | A | $20.99 |
| J0130 | A | $545.49 |
| J0131 | A | $0.11 |
| J0132 | A | $2.80 |
| J0135 | A | $424.92 |
| J0152 | A | $97.93 |
| J0180 | A | $138.53 |
| J0205 | A | $41.24 |
| J0207 | A | $312.57 |
| J0210 | A | $41.60 |
| J0215 | A | $38.78 |
| J0220 | A | $155.85 |
| J0221 | A | $148.31 |
| J0256 | A | $3.74 |
| J0257 | A | $3.85 |
| J0287 | A | $8.02 |
| J0288 | A | $12.48 |
| J0289 | A | $14.90 |
| J0300 | A | $23.95 |
| J0348 | A | $1.87 |
| J0364 | A | $5.50 |
| J0475 | A | $185.16 |
| J0476 | A | $76.21 |
| J0480 | A | $2,178.28 |
| J0490 | A | $38.42 |
| J0583 | A | $2.72 |
| J0585 | A | $5.38 |
| J0586 | A | $7.19 |
| J0587 | A | $10.72 |
| J0588 | A | $5.53 |
| J0594 | A | $18.72 |
| J0597 | A | $30.23 |
| J0598 | A | $43.37 |
| J0600 | A | $186.92 |
| J0637 | A | $13.08 |
| J0638 | A | $89.02 |
| J0641 | A | $1.68 |
| J0712 | A | $0.74 |
| J0718 | A | $4.13 |
| J0740 | A | $740.27 |
| J0775 | A | $37.51 |
| J0795 | A | $5.50 |
| J0800 | A | $2,643.55 |
| J0833 | A | $80.96 |
| J0840 | A | $2,111.36 |
| J0850 | A | $947.86 |
| J0878 | A | $0.50 |
| J0881 | A | $3.15 |
| J0885 | A | $9.44 |
| J0894 | A | $32.56 |
| J0897 | A | $14.43 |
| J1162 | A | $667.76 |
| J1190 | A | $181.60 |
| J1205 | A | $274.51 |
| J1212 | A | $84.65 |
| J1290 | A | $288.91 |
| J1300 | A | $190.44 |
| J1324 | A | $0.51 |
| J1327 | A | $22.40 |
| J1410 | A | $112.47 |
| J1430 | A | $294.28 |
| J1438 | A | $215.44 |
| J1440 | A | $252.63 |
| J1441 | A | $400.43 |
| J1451 | A | $7.61 |
| J1453 | A | $1.69 |
| J1455 | A | $13.06 |
| J1458 | A | $341.15 |
| J1459 | A | $34.40 |
| J1460 | A | $21.06 |
| J1557 | A | $37.29 |
| J1559 | A | $7.15 |
| J1560 | A | $210.65 |
| J1561 | A | $36.91 |
| J1562 | A | $7.33 |
| J1566 | A | $30.24 |
| J1568 | A | $55.80 |
| J1569 | A | $37.21 |
| J1570 | A | $66.04 |
| J1571 | A | $48.86 |
| J1572 | A | $35.08 |
| J1573 | A | $48.86 |
| J1595 | A | $111.08 |
| J1610 | A | $104.46 |
| J1620 | A | $93.03 |
| J1640 | A | $10.43 |
| J1642 | A | $0.16 |
| J1644 | A | $0.26 |
| J1670 | A | $234.89 |
| J1680 | A | $71.57 |
| J1725 | A | $2.25 |
| J1740 | A | $148.40 |
| J1742 | A | $179.32 |
| J1743 | A | $446.44 |
| J1745 | A | $61.50 |
| J1750 | A | $11.83 |
| J1756 | A | $0.31 |
| J1786 | A | $41.20 |
| J1830 | A | $210.52 |
| J1835 | A | $372.55 |
| J1930 | A | $32.46 |
| J1931 | A | $26.33 |
| J1945 | A | $389.32 |
| J1950 | A | $625.28 |
| J2020 | A | $35.36 |
| J2170 | A | $0.76 |
| J2248 | A | $0.97 |
| J2278 | A | $6.48 |
| J2315 | A | $2.76 |
| J2323 | A | $10.85 |
| J2325 | A | $48.70 |
| J2353 | A | $119.29 |
| J2355 | A | $239.71 |
| J2357 | A | $21.52 |
| J2358 | A | $2.70 |
| J2425 | A | $11.47 |
| J2426 | A | $6.68 |
| J2469 | A | $18.12 |
| J2503 | A | $1,009.65 |
| J2504 | A | $254.80 |
| J2505 | A | $2,702.11 |
| J2507 | A | $302.13 |
| J2513 | A | $13.23 |
| J2562 | A | $280.63 |
| J2700 | A | $2.79 |
| J2724 | A | $12.90 |
| J2725 | A | $27.03 |
| J2730 | A | $88.49 |
| J2760 | A | $53.55 |
| J2770 | A | $171.48 |
| J2778 | A | $394.25 |
| J2783 | A | $193.76 |
| J2785 | A | $51.74 |
| J2788 | A | $24.52 |
| J2790 | A | $80.64 |
| J2791 | A | $5.09 |
| J2792 | A | $15.41 |
| J2793 | A | $23.64 |
| J2794 | A | $5.18 |
| J2796 | A | $45.92 |
| J2820 | A | $24.30 |
| J2850 | A | $26.98 |
| J2941 | A | $61.34 |
| J2993 | A | $2,258.47 |
| J2995 | A | $33.43 |
| J2997 | A | $44.82 |
| J3030 | A | $73.78 |
| J3095 | A | $2.04 |
| J3101 | A | $62.97 |
| J3240 | A | $1,032.54 |
| J3243 | A | $1.30 |
| J3246 | A | $10.12 |
| J3262 | A | $3.47 |
| J3285 | A | $60.08 |
| J3300 | A | $3.43 |
| J3310 | A | $19.54 |
| J3315 | A | $174.72 |
| J3350 | A | $72.00 |
| J3355 | A | $57.58 |
| J3357 | A | $124.63 |
| J3365 | A | $449.09 |
| J3385 | A | $349.23 |
| J3396 | A | $9.86 |
| J3465 | A | $6.39 |
| J3487 | A | $222.55 |
| J3488 | A | $218.44 |
| J7180 | A | $6.41 |
| J7183 | A | $0.88 |
| J7185 | A | $1.04 |
| J7186 | A | $0.91 |
| J7187 | A | $0.87 |
| J7189 | A | $1.53 |
| J7190 | A | $0.88 |
| J7191 | A | $9.12 |
| J7192 | A | $1.10 |
| J7193 | A | $0.90 |
| J7194 | A | $0.87 |
| J7195 | A | $1.17 |
| J7196 | A | $101.40 |
| J7197 | A | $2.70 |
| J7198 | A | $1.61 |
| J7308 | A | $148.54 |
| J7309 | A | $73.75 |
| J7310 | A | $16,640.00 |
| J7311 | A | $18,980.00 |
| J7312 | A | $192.25 |
| J7321 | A | $88.84 |
| J7323 | A | $151.17 |
| J7324 | A | $162.26 |
| J7325 | A | $12.04 |
| J7326 | A | $1,014.00 |
| J7335 | A | $25.55 |
| J7501 | A | $117.03 |
| J7504 | A | $604.59 |
| J7505 | A | $1,111.58 |
| J7511 | A | $433.33 |
| J7513 | A | $516.41 |
| J7525 | A | $136.96 |
| J8501 | A | $6.05 |
| J8510 | A | $3.82 |
| J8520 | A | $7.69 |
| J8521 | A | $25.36 |
| J8560 | A | $39.94 |
| J8561 | A | $5.68 |
| J8562 | A | $79.27 |
| J8700 | A | $9.56 |
| J8705 | A | $77.96 |
| J9001 | A | $532.79 |
| J9010 | A | $577.97 |
| J9015 | A | $1,034.45 |
| J9017 | A | $40.07 |
| J9020 | A | $62.08 |
| J9025 | A | $5.16 |
| J9027 | A | $119.88 |
| J9031 | A | $113.29 |
| J9033 | A | $18.46 |
| J9035 | A | $59.93 |
| J9041 | A | $41.65 |
| J9043 | A | $135.20 |
| J9050 | A | $172.48 |
| J9055 | A | $49.51 |
| J9065 | A | $22.96 |
| J9070 | A | $14.63 |
| J9098 | A | $503.48 |
| J9120 | A | $566.49 |
| J9150 | A | $14.07 |
| J9151 | A | $56.58 |
| J9155 | A | $2.75 |
| J9160 | A | $1,615.12 |
| J9171 | A | $13.69 |
| J9178 | A | $1.70 |
| J9179 | A | $90.05 |
| J9185 | A | $93.44 |
| J9200 | A | $60.84 |
| J9201 | A | $50.22 |
| J9202 | A | $173.35 |
| J9206 | A | $4.58 |
| J9207 | A | $63.47 |
| J9208 | A | $31.43 |
| J9211 | A | $114.31 |
| J9214 | A | $17.42 |
| J9215 | A | $13.08 |
| J9216 | A | $26.63 |
| J9217 | A | $210.98 |
| J9218 | A | $4.77 |
| J9219 | A | $4,728.88 |
| J9225 | A | $3,128.60 |
| J9226 | A | $15,402.12 |
| J9228 | A | $125.05 |
| J9230 | A | $154.88 |
| J9245 | A | $1,290.39 |
| J9261 | A | $113.96 |
| J9263 | A | $10.07 |
| J9264 | A | $9.45 |
| J9266 | A | $2,675.40 |
| J9268 | A | $1,068.41 |
| J9280 | A | $17.50 |
| J9293 | A | $38.82 |
| J9300 | A | $2,690.84 |
| J9302 | A | $45.42 |
| J9303 | A | $85.53 |
| J9305 | A | $54.02 |
| J9307 | A | $165.63 |
| J9310 | A | $615.09 |
| J9315 | A | $225.98 |
| J9320 | A | $264.12 |
| J9328 | A | $4.73 |
| J9330 | A | $51.34 |
| J9340 | A | $127.92 |
| J9351 | A | $7.72 |
| J9355 | A | $71.08 |
| J9357 | A | $972.66 |
| J9390 | A | $11.37 |
| J9395 | A | $84.62 |
| J9600 | A | $18,961.14 |
| P9041 | A | $21.22 |
| P9045 | A | $62.01 |
| P9046 | A | $26.87 |
| P9047 | A | $68.04 |
| Q0138 | A | $0.64 |
| Q0515 | A | $1.77 |
| Q2017 | A | $316.31 |
| Q2043 | A | $32,860.00 |
| Q3025 | A | $245.28 |
| Q4101 | A | $35.88 |
| Q4102 | A | $7.24 |
| Q4103 | A | $7.24 |
| Q4104 | A | $16.60 |
| Q4105 | A | $11.71 |
| Q4106 | A | $40.50 |
| Q4107 | A | $97.65 |
| Q4108 | A | $22.58 |
| Q4110 | A | $30.23 |
| Q4111 | A | $6.93 |
| Q4112 | A | $174.26 |
| Q4113 | A | $174.26 |
| Q4114 | A | $1,090.61 |
| Q4115 | A | $9.61 |
| Q4116 | A | $31.57 |
| Q4118 | A | $2.92 |
| Q4119 | A | $4.85 |
| Q4121 | A | $20.98 |
| Q4122 | A | $32.42 |
| Q4124 | A | $10.39 |
| 90371 | A | $114.60 |
| 90375 | A | $184.38 |
| 90376 | A | $176.30 |
| 90378 | A | $928.18 |
| 90396 | A | $94.01 |
| 90585 | A | $110.69 |
| 90675 | A | $196.84 |
| 90676 | A | $146.53 |
| 90681 | A | $106.60 |
| 90733 | A | $110.75 |
| 90734 | A | $92.08 |
| 90735 | A | $100.15 |
| 90740 | C | $0.00 |
| 90743 | C | $0.00 |
| 90744 | C | $0.00 |
| 90746 | C | $0.00 |
| 90747 | C | $0.00 |
All CPT codes begin with a numeric character and all HCPCS codes begin with an alpha character.
All Current Procedural Terminology (CPT) codes and descriptors are copyrighted 2011 by the American Medical Association.

