Charge# Description Price0011106 ROOM CARE SEMI-PRIV-MB LD 4,399.000011155 ROOM CARE SEMI PRIV-OVERFLOW 61701 4,399.000011205 ROOM CARE SEMI PRIV-CCU CCU 4,399.000011254 ROOM CARE SEMI PRIV-OPC2 OPC2 4,399.000011452 ROOM CARE SEMI PRIV-SCN 4,399.000011502 ROOM CARE SEMI-PRIV-MB OBS 4,399.000011551 ROOM CARE SEMI PRIV-1E 1E 4,399.000012104 ROOM CARE SEMI PRIV-2N 2N 4,399.000012203 ROOM CARE SEMI PRIV-OVERFLOW 61500 4,399.000012302 ROOM CARE SEMI PRIV-2E 2E 4,399.000012500 ROOM CARE SEMI PRIV-2W 2W 4,399.000012609 ROOM CARE SEMI PRIV-3N 3N 4,399.000012708 ROOM CARE SEMI-PRIV-3S 3S 4,399.000012807 ROOM CARE SEMI PRIV-2N 2N 4,399.000012906 ROOM CARE SEMI PRIV-2S 2S 4,399.000013102 ROOM CARE SEMI PRIV-3N 3N 4,399.000013201 ROOM CARE SEMI PRIV-3S 3S 4,399.000013300 ROOM CARE SEMI PRIV-3S 3S 4,399.000013318 ROOM CARE SEMI PRIV-3S DEPT 61501 4,399.000013409 ROOM CARE SEMI PRIV-3N 3N 4,399.000014159 ROOM CARE SEMI PRIV-4N 4N 4,399.000014209 ROOM CARE SEMI PRIV-4S 4S 4,399.000021154 ROOM CARE TELEMETRY-OVERFLOW 61701 6,903.000021204 ROOM CARE TELEMETRY-CCU CCU 6,903.000021253 ROOM CARE TELEMETRY-OPC2 OPC2 6,903.000021451 ROOM CARE TELEMETRY-SCN SCN 6,903.000021550 ROOM CARE TELEMETRY-1E 1E 6,903.000022103 ROOM CARE TELEMETRY-2N 2N 6,903.000022202 ROOM CARE TELEMETRY-OVERFLOW 61500 6,903.000022301 ROOM CARE TELEMETRY-2E 2E 6,903.000022509 ROOM CARE TELEMETRY-2W 2W 6,903.000022608 ROOM CARE TELEMTRY-3N 3N 6,903.000022707 ROOM CARE TELEMETRY-3S 3S 6,903.000022806 ROOM CARE TELEMETRY-2N 2N 6,903.000022905 ROOM CARE TELEMETRY-2S 2S 6,903.000023101 ROOM CARE TELEMETRY-3N 3N 6,903.000023200 ROOM CARE TELEMETRY-3S 3S 6,903.000023309 ROOM CARE TELEMETRY-3S 3S 6,903.000023317 ROOM CARE TELEMETRY-3S DEPT 61501 6,903.000023408 ROOM CARE TELEMETRY-3N 3N 6,903.000024158 ROOM CARE TELEMETRY-4N 4N 6,903.000024208 ROOM CARE TELEMETRY-4S 4S 6,903.000031203 ROOM CARE ICU-CCU CCU 10,799.000031252 ROOM CARE ICU-OPC2 OPC2 10,799.000031401 ROOM CARE NURSERY-NSY NSY 2,076.000031559 ROOM CARE ICU-1E 1E 10,799.00

0032201 ROOM CARE ICU-1W 1W 10,799.000032300 ROOM CARE ICU - 2E 2E 10,799.000032508 ROOM CARE ICU-2W 2W 10,799.000032904 ROOM CARE ICU-2SO 2SO 10,799.000041103 ROOM CARE SEMI PRIV-LDRP LD 4,399.000041152 ROOM CARE ADMIN DAY-LOW SNF 61701 1,858.000041202 ROOM CARE ADMIN DAY-ICU LOW SNF ICU 1,858.000041251 RM CARE ADMIN DAY-OPC2 LOW SNF OPC2 1,858.000041509 ROOM CARE SEMI PRIV LDRP-MB OBS 4,399.000041558 ROOM CARE ADMIN DAY-1E LOW SNF 1E 1,858.000042101 ROOM CARE ADMIN DAY-2NO LOW SNF 2NO 1,858.000042200 ROOM CARE ADMIN DAY-LOW SNF 61500 1,858.000042309 ROOM CARE ADMIN DAY-2E LOW SNF 2E 1,858.000042507 ROOM CARE ADMIN DAY-2W LOW SNF 2W 1,858.000042804 ROOM CARE ADMIN DAY-2N LOW SNF 2N 1,858.000042903 ROOM CARE ADMIN DAY-2S LOW SNF 2S 1,858.000044156 ROOM CARE ADMIN DAY-4NO LOW SNF 4NO 1,858.000044206 ROOM CARE ADMIN DAY-4SO LOW SNF 4SO 1,858.000051151 ROOM CARE ADMIN HIGH SUB ACT 61701 2,000.000051201 ROOM CARE ADMIN HIGH SUB ACUTE ICU 2,000.000051250 ROOM CARE ADMIN HIGH SUB ACUTE OPC2 2,000.000051508 ROOM CARE ADMIN HIGH SUB ACUTE OBS 2,000.000051557 ROOM CARE ADMIN HIGH SUB ACUTE 1E 2,000.000052100 ROOM CARE ADMIN HIGH SUB ACUTE 2NO 2,000.000052209 ROOM CARE ADMIN HIGH SUB ACUT 61500 2,000.000052308 ROOM CARE ADMIN HIGH SUB ACUTE 2E 2,000.000052506 ROOM CARE ADMIN HIGH SUB ACUTE 2W 2,000.000052803 ROOM CARE ADMIN HIGH SUB ACUTE 2NO 2,000.000052902 ROOM CARE ADMIN HIGH SUB ACUTE 2S 2,000.000054155 ROOM CARE ADMIN HIGH SUB ACUTE 4NO 2,000.000054205 ROOM CARE ADMIN HIGH SUB ACUTE 4SO 2,000.000061200 ROOM CARE PCU-CCU CCU 6,903.000061259 ROOM CARE PCU-OPC2 OPC2 6,903.000062109 ROOM CARE PCU - 2N 2N 6,903.000062208 ROOM CARE PCU-OVERFLOW 61500 6,903.000062307 ROOM CARE PCU-2E 2E 6,903.000062505 ROOM CARE PCU-2W 2W 6,903.000062802 ROOM CARE PCU-2N 2N 6,903.000062901 ROOM CARE PCU-2S 2S 6,903.000100016 SUTURE VALVE 3,175.000100024 SUTURE CABG W/AV/MV 3,614.000100032 SUTURE CABG 1,591.000100040 STERNAL ZIPFIX WITH NEEDLE 293.000100057 ENDOSCOPY BLUNT CHERRY 132.000100065 ENDO PEANUT BLUNT DISSECTOR 63.000100073 ENDO MINI RETRACT 225.000100602 CORNEAL PROCESSING-TISSUE ANGIOGDYE 8,067.00

0100651 MINOR SURG-C 1/4 HR 659.000101557 melatonin 3 mg tablet 1.900102962 MAJOR SURG-A 1 HR 9,973.000102970 MAJOR SURG-A 1/4 HR 1,879.000103721 MAJOR SUTURE SET 605.000103739 MINOR SUTURE SET 328.000104059 MAJOR SUTURE A SET 1,241.000104729 CABG OR SERVICES 25,780.000104760 MAJOR B WITH HIGH TECH 15,247.000104778 MAJOR A WITH HIGH TECH 23,205.000104786 COSMETIC 1/4 HOUR SSS 110.000104794 COSMETIC A SSS 990.000104802 UTERINE MANIPULATOR COOPER 2,155.000104836 MINOR SURG-C 1 HR 7,332.000104919 MICRO VENTRICULAR BOLT PRESSUR 4,430.000104927 GRAFT CV PATCH 965.000104935 KIT CEMENT HIP 864.000104943 VALVE POLARIS 11,713.000104950 PASSER SHEATH 65MM 371.000104968 CASPAR DISP PIN ALL SIZES 426.000104976 VALVE SHUNT PROGRAMMABLE 15,137.000104984 BURR MIDAS REX 613.000104992 NEURO PERFORATOR (ACUCUT) 935.000105007 PIN GUIDE LG 383.000105015 MAYFIELD PINS 376.000105023 ETHICON SECURE STRAP 2,560.000105031 CAROTID SHUNT ALL SIZES 1,902.000105049 CSF DRAINAGE EDS3 517.000105056 VENTRICULAR DRAINAGE SYSTEM 652.000105064 BONE ACF 6.14.11 SOFAMOR 3,456.000105072 BN CEMENT KYPHON 1,206.000105080 BN CEMENT TOBRA 1,859.000105098 BN PUTTY 5CC 2,280.000105106 BN PUTTY 1CC 579.000105114 RAINEY GUN 612.000105122 WHITNEY KNIFE 96.000105130 SPLINT S/LEG ADLT 296.000105148 SPLINT L/ARM ADLT 356.000105155 BURR 660.000105163 DRILL BIT 401.000105171 KIT VERTEBROPLASTY 2,684.000105189 GIRTIE MAX SPINAL NEEDLE 76.000105197 FEM CANAL IRRIG/PLUG/RING 315.000105205 FACE FM HEAD REST PILLOW 88.000105213 MONITOR LINE 16.000105221 JACKSON/ANDREWS TABLE KIT 1,610.000105239 ZERO TIP 782.00

0105247 FRAZIER TIP DISPOSABLE 20.000105254 ABDUCTOR PILLOW 247.000105262 FACE SHIELD 130.000105270 FIBER WIRE 143.000105288 FEMORAL BRUSH 171.000105296 FEMORAL CANAL TIP 289.000105304 FEMORAL CANAL IRRIG HIGH FLOW 368.000105312 KIT CEMENT - STRYKER KNEE 494.000105338 ORTHO HOOD 316.000105346 CATH URETERAL ADAPTER 99.000105353 PIN AND DRILL SET 1,030.000105361 CO2 FILTER TUBING 83.000105379 TUBING SMOKE EVAC 378.000105387 FOLEY HOLDER 23.000105403 IMAGER II GAUGE 236.000105411 SHEATH APPL 2,149.000105429 STONE CATCHER 1,445.000105437 CATH QUINTON 451.000105445 BAG DECANTER 7.000105460 STONE EXTRACTOR HELICAL BOS SC 875.000105478 TRUCUT BIOP NEEDLE 70.000105486 URO DRA BAG 41.000105494 SHEATH ACCESS - ALL 683.000105502 CAUTERY DISP CORD 99.000105510 ELECTRODE KNIFE LOOP. BALL 589.000105528 LONE STAR STAYS 209.000105536 LONE STAR RETRACTOR 224.000105544 HEYMAN DILATOR 50.000105551 URETERAL CONN. ADAPTER 15.000105569 TUBING CYSTO 126.000105577 J-PRATT RESERVOIR 573.000105650 CO2 FILTER TUBING HUMID 470.000105676 ENDO PATH TRISTAR 2,477.000105684 TUBING TUR 193.000105692 DB URETHRAL 400.000105700 H-U MANIP 464.000105718 FALOPE RX2 1,189.000105726 KENDALL HOSE 275.000105734 TAUT-CHOL 369.000105742 SKIN MARKER 61.000105759 HYPOTHERMIA PAD 361.000105767 CATH URETERAL 67.000105783 SCLERAL BLADE 372.000105791 RIGID NEEDLE 153.000105809 SMART THERMAL TIP 117.000105817 IVAC TUBING 37.000105825 ADDITIVE SET 98.00

0105833 SECONDARY SET 105.000105841 IV T/NO I SITE 73.000105858 INTRA CATH 70.000105866 CATH TRIPLE LUMEN 481.000105874 EXT T 36.000105882 MICRO PTSX1 379.000105890 ANAEROBIC CULT TB 120.000105908 OP SITE 63.000105916 COVADERM 31.000105924 EYE SHIELD 28.000105932 ULTRASOUND BIOPSY PROBE 14GA 763.000105940 TED HOSE/KNEE 159.000105957 PACK-VAG 92.000105965 PACK IODO 1-2 101.000105973 PACK IODO 1/4-1/2 117.000105981 SPLINT L/LEG ADLT 412.000105999 SURGICEL 2X14 289.000106005 SHLDR IMMOB 394.000106013 WIRE-KIRSCHNR 121.000106021 CEM MIX BOWL 204.000106039 CEM BOX X1 459.000106047 WATER PIK W/TUBNG 718.000106062 BLADE ENDO 2,782.000106088 TPS RASP 499.000106096 CONNECTION TUBE DISP 47.000106104 TPS SAWBLADE 244.000106112 QUILL SUTURE 118.000106120 ARM SLING 130.000106138 POST OP K D/L/A 722.000106153 BRAD POINT TIP GUIDE PIN 499.000106161 BLD WARMING BAG 300.000106179 MANIFOLD NEPTUNE 108.000106187 NOVASURE ABLATER 3,920.000106195 VERSA STEP INSULFLATOR NEEDLE 236.000106203 ORTHO CORD 152.000106211 TPS BURR 392.000106229 WIRE K (ALL SIZE) 126.000106237 PACKING PLAIN 86.000106245 AUTO SUTURE GIA 1,686.000106252 SKIN STAPLER 112.000106260 ELECTRO GPX3 72.000106278 CANNISTER INITIAL 21.000106286 CATH/URET DISP 286.000106294 CATH/URET ILLU 432.000106302 CATH/URET STEN 1,178.000106310 PLEUREVAC 1,146.000106328 TUR LOOPS 613.00

0106336 CATH DISTAL ATRIAL/PERITIONEAL 668.000106344 DRILL 2.0 & 2.5 403.000106351 DRILL BIT SS PLF 1,626.000106369 ON Q PAIN PUMP 1,547.000106377 ENDO TRACH TUBE EMG 916.000106385 NERVE STIMULATOR 349.000106393 FILLAFORM & FOLLOWER 443.000106401 SLEEVE 754.000106419 BLADES ORTHO 518.000106427 WIRE-KIRSCH-THR 199.000106435 URO DR THPSN 168.000106443 O2 CATHETER 36.000106450 GELFOAM SP#100 340.000106468 SURGICEL 2X3 252.000106476 GZ XEROFORM 38.000106492 KLING 51.000106500 RL KERLIX 4.5 57.000106534 CLIPS-RAINY EA 8.000106542 SURG PAD 8X10 19.000106559 J-PRATT TUB 573.000106567 02 CANNULA 51.000106575 BAKER JEJU T 988.000106583 CLIPS WECK X1 127.000106591 CAUTERY PENCIL 20.000106609 CATH MAHUKAR 520.000106617 TEMP-A-STRIP 19.000106625 NASAL AIRWAY 159.000106633 VACUR TIP/T 261.000106641 CATH VENTRICULAR 668.000106666 ANCHOR PORT KIT 1,113.000106674 RUMI KOH-EFFICIENT (ALL SIZES) 286.000106682 CARTER-THOMPSON PORT CLS SYSTM 386.000106690 THUNDERBEAT 5MM 35CM 1,590.000106708 PLASMA J-HOOK W/CORD 33CM 954.000106724 TRACH T SIL 834.000106732 TRACH T SHIL 511.000106740 SOD CHL IRR 282.000106757 SPECIMEN TRAP NAKAS QUICK 39.000106765 TSK ACE CUT BIOPSY DEVICE 134.000106773 INSTRUMENT POUCH 3 COMPARTMENT 16.000106781 APPLIED OPTIVE VIEW PORT 791.000106807 ENDO SHEARS 321.000106823 STEALTH NAVIGATOR 11,575.000106831 SHAVER / HAIR CLIPPER 58.000106849 RVAC SUCT KIT 45.000106856 SUP ADULT 172.000106864 WATER 2000CC 158.00

0106880 KIT HIP PREP 572.000106898 DRILL INTERTAN LAG SCREW 2,400.000106906 GRAFT VASCULAR GORETEX 2,119.000106914 V-LOCK WOUND CLOSURE 94.000106922 APPLIED PORT 5MM 67.000106930 GUIDEWIRE ARCHER SUPER STIFF 607.000106948 MICRO - INTRODUCER KIT 111.000106955 BONE CEMENT WITH GENTAMICIN 840.000106963 RUMI TIP (ALL COLORS) 140.000106971 BLADE PATELLAR REAMER 496.000106989 DEFOG HEATED ENDO LENS PROTECT 127.000107011 APPLICATOR TIP 248.000107037 COVIDIEM LIGASURE SMALL 1,907.000107045 COVIDIEN LIGASURE MED 2,060.000107052 COVIDIEN LIGASURE LARGE 2,687.000107060 SMOKE FILTER W/THUMBWHEEL CLMP 70.000107078 SALEM SUMP TUBE 122.000107086 SEALANT DURASEAL 1,908.000107102 CATH SUCT 74.000107110 FIBRIJET RATIO APP/ASSEMB KIT 73.000107128 COVIDIEN LIGASURE MYOSURE XL 4,667.000107130 BLADE KAHOOK 1,488.000107136 FIBRIJET APP TIP DUAL 20X2 65.000107144 FIBRIJET APP TIP DUAL 20X18 69.000107169 DRILL SHAFT 535.000107177 C/ROBINSON 96.000107185 CATH/FOLY/3WAY 267.000107193 ANGEL BLOOD ACCESS KIT 229.000107201 SAWBLADE 439.000107219 ANGEL WH BLOOD SEP PROCESS KIT 916.000107243 PLASMAX 5,864.000107250 ZOLL PADS 234.000107268 BIO GLUE 2,950.000107284 COBAN 15.000107292 CRANIAL ACCESS KIT 1,380.000107300 ANCHOR PORT ARC 5LU 223.000107318 CATH/FOLEY/SIL 145.000107342 YANKAUR SUCTION TUBE 79.000107359 ISOCOOL FORCEPS TIPS 1,526.000107367 ETHIBOND SUTURES ALL SIZES 633.000107383 RELOADS CONTOUR 761.000107417 FIBRIJET APP W/DUAL SPRAY 122.000107433 LUKI TUBE 37.000107441 FEEDING T 38.000107458 C/F/A 264.000107466 F CATH TRAY 349.000107474 URINARY DB 192.00

0107482 PRINT ARTHROS 22.000107490 PIN BUTTERFLY 395.000107508 HEMOVAC ALL SIZES 1,040.000107516 MEDTRONIC NEUROSTIMULATOR 55,687.000107524 DRILL 7.0MM 926.000107532 COAPTITE INJECTABLE IMPLANT 1,082.000107540 THORACOPORT ALL 84.000107557 CEEA ALL SIZES 1,665.000107565 TA PREMIUM 30 55 90 ALL 277.000107573 MULTI FIRE ENDO HERNIA 4.0 & 4 222.000107581 MULTI FIRE VERSA TAC 383.000107599 ENDO STITCH SUTURE 331.000107607 ROTICULATOR ENDO GIA LOADS 610.000107615 ENDO GIA & GIA LOADS ALL 1,335.000107623 ENDO GIA & GIA UNIVER INSTR. 1,741.000107631 GLUTERALDYHDE CAPPS 321.000107649 SPRING GRIP 27.000107656 PROTACK 999.000107664 VERSA STEP ALL 650.000107672 INLET CLOSURE DEVICE 75.000107680 LAPARATY XC200 721.000107698 CVP INF SU 631.000107706 BIOPATCH 48.000107714 SURGIFOAM 472.000107722 CATH FOG 614.000107730 PROFIX BONE SPIKES 290.000107748 ENDO CLIP ALL SIZES 598.000107755 SUTURE ASSIST DEVICE 1,691.000107763 BASKET 907.000107771 CONROY DYE 599.000107789 MEGADYNE BOULE SPATULA HOOK 254.000107797 SPLINT S/ARM 215.000107805 TOOMEY SYRINGE 7.000107813 BERKLEY SUCTION CANISTER 34.000107821 CATH P/D 1,673.000107839 GI CONNECTING TUBE/SUCTION 117.000107854 BLADELESS TROCAR 579.000107862 ENDO CATCH 345.000107870 STAPLER CUTTER CONTOUR 1,519.000107888 VCS STAPLER ALL 1,599.000107896 PROXIMATE SKIN STAPLES 155.000107920 CLPS HEMO REG ALL SIZES 134.000107938 CLIPS HEM LOC ENDO 538.000107946 RANFAO SUTURE PASSER 118.000107961 BERKLEY SUCTION TIP 61.000107979 5% DW 045% NAC 143.000107987 COMBO SWAN W/VIP 902.00

0107995 STAPLER INCISIVE SURGICAL 183.000108001 DRILL 2.8 178.000108019 DRILL 2.9 413.000108027 DRILL 4.8 X 3.2 585.000108043 PIN GUIDE 3.2 572.000108050 ART L SU 982.000108068 EVICEL 2ML 817.000108084 GORTEX SUTURE 96.000108100 L/RG 250/5C/1M 105.000108118 SC INJ SOL 106.000108126 GLYC 2000 CC 224.000108142 SENSOR ANGLE TIP DUAL FLEX 417.000108159 DRILL 3.2 308.000108167 EMBOLIZATION PROTECTION DEVICE 4,952.000108175 WIRE ZEBRA 308.000108183 5% DW 250-500 108.000108191 DAVOL IRRIGATOR 710.000108209 EXTRA SUCTION 349.000108217 FEMORAL ARTRY LINE KIT 104.000108225 RECTAL PROBE 149.000108233 OCTOBASE-MEDRC 236.000108241 FLOSEAL 693.000108258 DERMABOND 134.000108266 KIMBERLY CLARK ELECTRODES 102.000108274 FILTER 75.000108282 EVICEL 5ML 1,879.000108308 POUCH IRRIGATION V 32.000108324 SEALANT FIBR 381.000108332 DURAGEN 3X3 DP1033 3,305.000108340 CAPIO SUTURE CAPTR DVC INSTR 1,635.000108357 CAPIO SUTURE 120.000108365 CATHETER/CHEST 210.000108373 DERMATOME HD 296.000108381 OMNIPAQUE 300/50ML 14.000108399 DURAGUARD 791.000108407 FIBRILLAR 355.000108423 UROMAX ULTRA 954.000108431 A-LINE EXT TUBING 19.000108456 KELLER FUNNEL 413.000108464 SCREW PEDICLE ACF SPISOL/USSPI 1,473.000108472 CATH COUDE/FOLEY 57.000108480 ESSURE 6,344.000108506 CONT IRR SET 154.000108514 INTRODUCER NEEDLE 595.000108522 INTERMED BRUSH 220.000108530 NIPPLE/PORT SEALS 98.000108548 BALLOON CATHETER 1,698.00

0108555 ROD BALL TIP GUIDE 702.000108563 BN CHIP 15CC 763.000108571 PIN GUIDE SM 266.000108589 PRO BONE SPIKE SHORT 290.000108597 ACE BANDAGE 33.000108605 ROTICULATOR PADDLE GRASP STITC 594.000108621 OR STENT NON-CORONARY TEMPORARY 580.000108623 OXYGEN MASK/ADULT 66.000108639 OR CATH TRANSLUMINAL BALLOON 789.000108647 OR CATH DUAL LUMEN 482.000108654 PINS GUIDE 14 X 3.2 547.000108662 OR WIRE GUIDE/GLIDE/SENSOR 198.000108670 OR CATH PALIND SAPPHIRE 7,288.000108688 SLING BLADDER 4,489.000108696 BLD DERM BRN 323.000108738 THERA DIAG BK 1,042.000108753 5% D/0 NACL 126.000108761 VITREC/TUB KT/BSS 828.000108779 CORNEAL PROCESSING 11,038.000108787 TREPHINE 756.000108795 PHACO-SITE 2,699.000108811 BREAST IMPLANTS INAMED 2,620.000108829 RADIESSE VOICE IMPLANT 965.000108837 SUTURE RETRIEVER 179.000108845 VERSAPORT 5/12 MM 745.000108860 DISECT FORCEPS LYONS 5MM,33CM 859.000108878 VESSEL MARKER 42.000108886 GRAFT BIF 3,813.000108894 5% D/W 100ML 37.000108910 ISOLYTE 191.000108928 URIMETER 317.000108936 HYPOTHERM PROBE 268.000108944 SCALP VEIN 38.000108951 HEART SUPPORT HOLDER 317.000108969 PACING CABLE (SCREW TYPE) 281.000108973 WOUND DRESSING PROCELLERA 61.250108985 CHROMOTUBATION CATHTHER HSG 65.000108986 TISSEEL SEALANT 4ML 680.460108993 SEAL SET 30.000108995 TISSEEL SEALANT 10ML 1,669.890109002 SPRAYER 30 1,135.540109017 FLUID SAFE CANISTER 30.000109018 SPRAYER 40 763.850109025 FLUID SAFE TUBING 285.000109029 PREVENA KCI WOUND VAC 1,717.500109033 BERKLEY SUCTION TUBING DISP 47.000109058 4.0 LONG PILOT DRILL 1,180.00

0109082 BEACH CHAIR KIT-TRIMANO 262.500109090 ENDO BLUE KIT 60.000109108 ELECTRODE BUTTON-OLYMPUS 1,372.000109116 STERILE TURNIQUET ALL SIZES 92.000109124 ECHELON LOAD 2,654.000109132 ECHELON STAPLER 3,244.000109140 PREVENA PLUS CANISTER 91.000109157 AQUACELL DRESSING ALL 133.000109165 BARD UROLOGYIST TRAY 840.000109172 AORTIC BALLOON CATHETER 3,395.000109173 KII BALLOON BLUNT TIP SYSTEM 84.000109181 BN CANCELLOUS CHIPS 30CC 1,830.000109199 SEPRAFILM 1,020.000109207 MINICAP EXTENDED LIFE PD 230.000109215 MINICAP W/POVIDONE IODINE 21.000109223 BROCHOSCOPE DISP SLIM 3.8OD 955.000109231 BROCHOSCOPE DISP REG 5.0OD 955.000109249 BROCHOSCOPE DISP LRG 5.8OD 1,099.000109256 ACTICOAT FLEX 7 49.770109264 AMSCO FOOT TRACTION BOOT 521.160109272 HALO OBTARYX SLING 4,900.000109280 ATRICLIP FLEX ALL SIZES 5,550.000109306 CATH SUPRAPUBIC ONE STEP ALL 266.000109322 BONE MARROW ASPIRATION NEEDLE 675.000109330 QUICKSET KIT 10,474.000109348 RETRACTOR ALEXIS FLEXIBLE 156.000109355 BN CEMENT 1/2 DOSE 222.000109363 PIRANHA FORCEPS 953.000109371 RADICAL JAW FORCEPS 953.000109389 IRRIGATION TUBESET MISONIX 150.000109397 BONE SCALPEL/SHAVER MISONIX 1,215.000109405 PROXICOR CMCV-003-402 4,736.000109413 HALO CERVICAL 9,579.000109421 MRI COMPATIBLE SYSTEM 3,393.000109439 BLADE PLASMA AQUAMANTIS 1,755.000109447 HAND IMMOBILIZER ALUMINUM 114.000109454 MALYUGIN RING 240.000109462 ECHELON STAPLER 45 2,450.000109470 ECHELON LOAD 45 1,259.000109496 PURSESTRING AUTOSUTURE ALL 199.000109504 HARMONIC FOCUS 1,548.000109512 CAROTID SHUNT PRUITT F3 2,796.000109520 SMOKE EVACUATOR PUREVIEW 73.000109538 ATRICLIP FLEX V ALL 6,475.000109546 TALC BLOWER NOVATECH 126.000109553 SHUKLA EXTRACTION 753.000109561 NEEDLE TOUGHY ALL SIZES 487.00

0109579 NEEDLE SPINAL ALL SIZES 220.000109595 COR-KNOT KIT 2,172.000109637 SHUNT CAROTID PRUITT 2,637.000109645 GLIDEWIRE ADVANTAGE 1,380.000109652 PERIPHERAL NERVEBLOCK 3,340.000109660 BALLOON SINUS STRYKER 5,925.000300244 ANES LOCAL/MAC ANESTH 547.000300426 ACTIVATED CLOTTING TIME (ACT) 648.000300780 IABP BALLOON CATHETER 4,692.000300806 ANESTHESIA UP TO 3 HOURS 3,514.000300814 GEN ANES OVER 3 HOURS 8,968.000300822 ESOPH STETH 156.000300830 SPINAL ANESTHESIA TRAY 158.000300848 DUO TRACH KIT 190.000608638 CLIPS WECK X 1 127.000608646 TSEAL 2ML 1,250.000608661 GUIDE PINS 133.000608687 BLADE 294.000608695 ACL KIT 929.000608703 SCORPION NEEDLE 579.000608745 VISION BLUE DYE 209.000608794 LEEP BALL/LOOP 244.000608802 FISHER CONE BIOPSY 159.000608810 BSS 15ML 9.000608836 IV STARTER KIT 27.000608844 INTRA CATH 58.000608851 HEPARIN LOCK 36.000608877 ADDITIVE SET 82.000608885 IVAC TUBING 37.000608893 MICRODRIP 102.000608901 BLOOD COMP INF SET 108.000608919 GRAFT EYE 2.0 AMNIOTIC 2,486.000608927 EXTENSION TUB 102.000608950 SET EXT W/ T 51.000608968 TUBING DRIPRIVAN 79.000608984 LENS IOL POSTERIOR 2,475.000609008 LENS IOL POSTERIOR NEW TECHNOLOGY 4,475.000609024 CONN TUBE DISP 47.000609115 VERSAPORT 7/8MM 612.000609149 PACU INITAL HOUR 4,500.000609150 OPSC INITIAL HOUR 1,202.000609156 PACU ADD'L 15 MINUTES 699.000609157 OPSC ADD'L 15 MINUTES 267.000609180 FIBER STICK 290.000609206 MYOSURE 4,118.000609222 SUSP KIT SHOULDER 505.000609230 SUTURE LASSO 890.00

0609263 HAMONIC SCALPEL 796.000609305 SPL-SHRT LEG ADLT 296.000609313 LATERAL TRACTION KT DISP 419.000609339 BOVIE CONCEPT 877.000609347 BLADE SAW 244.000609354 CANNULA SHOULD 251.000609362 CUTTER ARTHROS 809.000609388 TUBING ART PMP 562.000609404 PAIN BUSTER INFUSION PUMP 763.000609420 OSI POSITIONER KIT 244.000609438 NASAL INSERT 182.000609446 SPLINT NASAL 254.000609453 SUCTION CAUTERY 123.000609461 TUBE X EAR X 1 226.000609479 KERRWAX MOLD 32.000609495 SUPPORTER-ADLT 172.000609511 CATHETER-SUCTION 51.000609529 ATRHROCARE WAND 807.000609537 SALEM SUMP TUBE 122.000609552 CATH/ROBINSON 96.000609560 SCREW CANNULATED ANY SIZE 1,099.000609578 SHAVE PREP KIT 58.000609636 MANNITOL 20% 369.000609644 SOD CHL 0.9% 129.000609651 LACTATED RINGER-ALL 126.000609677 5% D/W 045% 1M 143.000609693 FLO SEAL SEALANT 693.000609701 5% D/W 1000 CC 141.000609719 DEBRIDERS DIEGO (ALL SZ) 665.000609735 IRIS RETRACTOR 448.000609743 EPIDURAL TRAY ARROW 99.000609750 NEEDLE TOUHY 99.000609768 NEEDLE CHIBA 89.000609776 SIENTRA BREAST IMPLNT (ALL SZ) 3,506.000609784 GYRUS IRR TUBING 101.000609792 EAR DRESSING KIT 117.000609818 CUTTING BLOCK 381.000609826 KERLIX 65.000609834 KLING 51.000609842 XEROFORM GAUZE 43.000609859 BAIR HUGGER 200.000609891 EYE PATCH X 1 22.000609909 ADAPTIC 3 X 3 36.000609925 GELFOAM #100 387.000609933 CORNEAL SHIELD 217.000609941 EYE PACK 1,038.000609974 SCLERA KN BL 211.00

0609990 FILT UN SWINNE 118.000610014 OP-SITE SMALL 22.000610022 VEIN STRIP DIS 373.000610063 SEQUENTIALS 264.000610071 FALOPE RNGS X2 1,189.000610089 HUMI-UTER MANI 464.000610139 TUR TUBING 193.000610154 MICROCATH CANLPLSTY 3,797.000610170 SURGIPAD 8 X 10 22.000610196 CAUTERY 312.000610212 INTRODUCER NEEDLE 448.000610220 CORK SCREW ANCHOR 1,091.000610238 PACK IOD 1-2 90.000610253 COVADERM 31.000610261 ADAPTIC 3 X 8 45.000610287 FOLEY CATH KIT 264.000610303 WIRE K (ALL SIZE) 61.000610311 SURGINEEDLE 94.000610329 BREAST IMPLANTS ALLERGAN 5,751.000610337 SPL-LNG ARM CHILD 293.000610352 FIBER CHAIN 178.000610360 ACE BANDAGE 33.000610378 ELECTR-GEL PAD 63.000610386 POLARUS ROD 8 X 200MM 3,853.000610394 SHAVER BLADE OLYMPUS ALL SIZES 2,176.000610403 NEOTRACT UROLIFT PER IMPLANT 2,975.000610410 CALIBRATED REAMER 668.000610428 CANNULA OXYGEN 51.000610444 MULTIDEBRIDER TUBESET 688.000690016 LENS IOL ANTERIOR CHAMBER 2,798.000696450 CEMENT MIXING SYSTEM 622.000696468 CEMENT FEMORAL BONE PREP KIT 990.000700039 AMNIOCENTESIS 974.000700047 LD CERCLAGE 12,453.000700062 LD FETAL MONITORING 674.000700096 LD MINOR SURGERY 4,000.000700120 LD OR MAJOR SURG 10,638.000700153 FETAL CONTRACTION STRESS TEST 538.000700161 NON-STRESS TEST 500.000700336 PHOTOTHERAPY-DLY 73.000700344 TEMPA-A-STRIP 19.000700351 CATHETER SUCTION 51.000700369 YANK SUCTION TUBE 79.000700377 SKIN MARKER 61.000700385 CANNISTER INITIAL 929.000700393 LDRP LACTATED RINGERS 126.000700401 SKIN STAPLES 262.00

0700419 CAUTERY PAD 136.000700427 ADAPTIC 3X8 45.000700435 OXYGEN CANNULA 51.000700443 OXYGEN MASK 66.000700450 ELECTRODE GEL PAD 158.000700468 CULTERETTE II 22.000700476 EPIDURAL PUMP TUBING 114.000700484 ANESTHESIA BAG-INFANT 144.000700492 STERIWATER 2000CC 156.000700500 VACUUM EXTRACTOR 244.000700526 OR ONE HR 45 MIN 9,308.000700534 LDRP SOD CHL IRRI(ALL SIZES) 282.000700542 NORMAL SALINE 105.000700559 EPIDURAL PUMP DAILY 485.000705004 LDRP DELIVERY-NSVD 1,492.000705020 OB LABOR FEE C-SECTION 5,322.000705038 LD OB RECOVERY ROOM 2,108.000705046 OB OBS IV PUSH INITIAL 479.000705053 OB OBS INFUSION HYDR ADDL HR 218.000705061 OB OBS SUBQ/1M INJECTION 306.000705079 OB OBS CATH INSERTION 357.000705087 OB OBS IV INFUSION HYDR 31-60M INTL 759.000705095 OB OBS IV PUSH ADDL NEW DRUG 545.000705103 OB BLOOD PATCH 901.000705111 OB OBS HRS ADMIT D/C SAME DAY 3,333.000705129 I&D OF VULVA/PERINEUM 670.000705152 OB OBS IV INFS HYD 31-60M INT MOD59 1,510.000705160 OB OBS INFSN HYD ADDL HR >31M MOD59 137.000705178 OB OBS THERAPEUTIC INF INTL MOD 59 1,510.000705186 OB OBS THRP INF ADDL HR >31M MOD59 137.000705194 OB OBS THRP INF SEQ 16-60M MOD 59 137.000705202 OB OBS SUBQ/1M INJECTION MOD59 306.000705210 OB OBS IV PUSH INITIAL MOD 59 981.000705228 OB OBS IV PUSH ADDL NEW DRUG MOD 59 1,018.000705236 OB OBS IV PUSH ADDL SAME DRUG MOD59 162.000705244 OBS BIOPHYSICAL WITHOUT NST 677.000705251 CERVICAL RIPENING BALLOON 51.000751271 BLOOD TRANSFUSION-OB 3,050.000751289 STAPLER INCISIVE SURGICAL 183.000800326 THORACIC RIB BELT 502.000800342 BINDER ABDOMINAL UNIV 19.000800821 CANNULA OXYGEN 51.000802041 FOAM C COLLAR-BO 502.000802447 CRUTCHES COMPLETE 40.000802454 PHILADELPHIA CERVICAL COLLAR 502.000805382 DRESSING GAUZE 4X4 6/TRAY 10.000807206 TRAY SPINAL ADULT 25.00

0807214 TRAY SPINAL PEDS 25.000809103 STOPCOCKS (3-WAY) 25.000812065 TRAY THORACENTISE 25.000815050 BLOOD PUMP SET 25.000816553 TUBE EXTENSION K-50 52.000816884 HEMOSTAT SURGICAL 454.000816934 KIT CENTRAL VEIN 25.000821637 HO ABDUCTION POST 4,052.000822072 REMOVER STAPLE 25.000830190 NEEDLE LOCALIZATION PERCUGUIDE 523.000831115 DILATORS 675.000833178 LONG LEG SPLINT PLASTER 481.000834374 SET PRIMARY IV NONVENTED 1857 25.000835819 PAD INTELLI FLO KNEE 127.000836361 WIRE FRAME COLLAR 652.000837120 OXYGEN MASK/ADULT 66.000839134 PLST FEM FX BRAC 6,164.000839480 LSO FULL CORSET 709.000843599 CONTINUOUS FLOW CAUTERY CORD DAC 25.000847012 MRI COMPAT HALO 3,723.000849455 MOTION KNEE JOINT 713.000850032 SPINAL ORTHOSIS 884.000852996 ANKLE JTS FOR AFO 502.000853085 PL AFO W/ANKS JTS 1,843.000854588 KOPANE BREAST LESION NEEDLE/WIRE 324.000854612 DRESSING MEPILEX 4X4 FOAM 74.000855031 HANDPIECE VACUUM ASSTEXCISION 2,990.000855122 INTRODUCER LOCALIZATION SET 1,666.000855387 CORE BIOPSY SYSTEM MAGNUM 226.000855395 BIOPSY SITE IDENTIFIER 640.000855890 DRESSING MEPILEX LITE 62.000856880 FAB HIP ABD BRACE 1,824.000857375 INTRODUCER 150.000857466 BREAST TISSUE MARKER 309.000857557 MAMMOTOME PROBE 2,000.000858431 TLSO SAGITTAL-CORONAL CONTROL 2,886.000858522 BIOPSY DEVICE ROTATIONAL/VACUUM 2,254.000860890 CATH 2 WAY 30CC 68.000860908 CATHETER 10 FR MAHURKAR 1,453.000860916 PILLOW ABDUCT 403.000860924 CATHETER COUDE 16FR 186.000860932 TRAY FOLEY 18FR 207.000860940 CATHETER COUDE 18FR 186.000860957 ENEMA KIT 21.000860965 CATHETER 11.5 FR MAHURKAR 1,583.000860973 CATH ROBNEL 46.000860981 WOUND VAC THERAPY DRESSING LRG 252.00

0860999 CATH-FOLEY 8-11 117.000861005 FLEET ENEMA 16.000861013 URETHAL KIT PEDS 61.000861021 CATHETER 12 FR MAHURKAR 1,809.000861039 TRAY FOLEY 16FR 195.000861047 TUBE FEEDING ENT 143.000861054 IABP MONITORING/DAY 890.000861062 IRR NACL .9 250CC 27.000861070 BELT RIB ALL SZS 86.000861088 PLEURAVAC 517.000861096 WOUND VAC THRPY CANISTER W/GEL 216.000861104 ORTHO APPLIANCE 1,304.000861112 LSO SAGITTAL CNTRL RGD A&P PAN 4,241.000861120 TLSO A-P W/APRON FRONT 1,329.000861138 DRESSING-PLASTER BANDAGE 27.000861146 PELVIC BAND AND BELT 502.000861153 CHEST TU/TROCAR 254.000861161 FEM LENGTH SOCK 1,357.000861179 TRACH SUCT KIT 113.000861187 KNEE BRACE (KO) 2,461.000861195 FLEXI SEAL 3,483.000861203 POST-OP SHOE 99.000861211 CAST BOOT S-L 98.000861229 KNEE IMMOBZ 20 502.000861237 KNEE IMMOBZ 24 502.000861245 KNEE IMMOBZ 16 502.000861252 SUPPORT LUMBAR 176.000861260 TRACTION SPLINT 181.000861278 AFO SOLID ANKLE 2,178.000861286 C-COLLAR L/N 47.000861294 PRE-TIBAL SHELL 502.000861302 INTUBATION TRAY NEWBORN 273.000861310 SHOE INSERT-PLSTC 502.000861328 ADJ KNEE JNT 2 EA 502.000861336 PNEUM WLK. SPLINT 1,079.000861344 C-COLLAR SEMI-RIG 642.000861351 CORSET FOR B BRACE 540.000861369 FLEX EXT FOR HIP ABDUCT BRACE 1,260.000861377 ABOVE KNEE SOFT INTERFACE 502.000861385 FEM FX CAST (KAFO) 3,909.000861393 CHEST TU PLAIN 205.000861401 TRANSDUCER NEONAT 188.000861419 PLST AFO PRE-FAB 938.000861427 EPID ANES TRAY 485.000861435 TRAY UMB CATH 853.000861443 BLADDER FOLEY TRAY 16FR 555.000861450 CATH UMBILICAL 249.00

0861468 CATH UMBILICAL 243.000861476 DRESSING FOAM 69.000861484 NU-GAUZE PACKING 66.000861492 VASE GAUZE 1/2X72 20.000861500 BIOPATCH 123.000861518 BOOT SUSPENSION 511.000861526 C-COLLAR 52.000861534 TRAY INCISION & DRAINAGE 398.000861542 WOUND VAC THERAPY DRESSING MED 193.000861559 CLAMP CHEST TUBE 27.000861567 KIT ORAL SUCTION 2 HR 563.000861575 KIT ORAL SUCTION 4 HR 373.000861583 PERIOCARD TRAY 2,504.000861591 BONE MARROW TRAY 419.000861609 CRASH CART 2,271.000861617 BURN PACK STERILE 41.000861625 HUBER NEEDLE 143.000861633 TRAY PER-Q-CATH 554.000861641 TRANSDUCER TUBING 51.000861658 INTRAOSSEOUS 261.000861666 SWAN GANZ CATHETER 1,146.000861674 UROLOGY CART 318.000861682 TRANSDUCER A LINE 272.000861690 SURGINET 13-24 27.000861708 BASIC BIOP TRAY 180.000861716 A-LINE KIT 266.000861724 HEMODIALYSIS TRAY 1,332.000861732 FEMOSTOP 1,436.000861740 POST-OP SHOE 98.000861757 IV-MANNITOL 293.000861765 GENTRAN 40/ 96.000861773 IV SOL HEPARIN 50.000861781 WEBRIL-ALL SIZES 20.000861799 SURGICAL BINDR 154.000861807 XEROFORM 1X8 18.000861815 ARMSLING 502.000861823 SUTURE RMV SET 33.000861831 AMBU BAG 201.000861849 SKIN STAPL RMV 99.000861856 IMMOBILIZER KN 502.000861864 SURGICAL BINDER 141.000861872 CANNULA NASAL 41.000870014 D BAZA CREAM 89.000870022 D CATH 2 WAY 5CC 59.000870030 D CATH 3 WAY 30CC 153.000870048 D CATH 3 WAY 5CC 213.000870055 D CATHETER LEG STRAP 65.00

0870071 D CLAV STRAP 122.000870089 COMFEEL 54.000870097 D DISP TRACH CANNULA 52.000870105 D DISP TRACH TUBE 669.000870113 D DOUBLE SUBCATH 1,248.000870139 D GASTRC LAVAGE 313.000870147 D GEL DRESSING WOUND 99.000870154 D INTUBATION TRAY 273.000870170 D L/ARM SPLINT ADLT 306.000870196 D NU-GAUZE/IODOFORM 1/4 - 1/2 46.000870204 D NU-GAUZE PLAIN 1/2 55.000870212 D DRESSING OP SITE WND 52.000870220 D DRESSING OP SITE SMALL 15.000870238 D PAD ELECTRODE ADT 313.000870246 D PERCUTANEOUS INTRO 577.000870253 D PLASTER SPLINT 238.000870261 D POST-OP SHOE 98.000870279 D S/ARM SPLINT 251.000870287 D S/LEG SPLINT ADLT 300.000870295 D SALEM SUMP TUBE 63.000870303 D SHT ARM SPLINT 66.000870311 D SPLINT FINGER 86.000870329 D STERI STRIP 1/8 X 3 24.000870337 D STIFNECK COLLAR 98.000870360 D SURGI GEL 4X8 250.000870394 D TRACH SUCT KIT 113.000870402 D TRAY 16FR FOLEY-FBC 161.000870410 D TRAY DISP LAC 216.000870428 D TUBE FEEDING 34.000870451 D VASE GAUZE 3X18 31.000870469 D XEROFORM GZ 43.000870477 D PLASTER SPLINT 2' 389.000870485 D PLASTER SPLINT 3' 66.000870493 IV-5% DW 9% SOD 124.000870501 5% D/W 45% SOD 500 69.000870519 IV BUTTERFLY CATH 25.000870527 5% DW 45%SOD 500 133.000870535 5% DW 500 CC 88.000870543 IV SOD CHL 77.000870550 IV SOL-10% DW 83.000870568 IV-SOL 5% DW 50CC 33.000870576 IV SOD CHL 77.000870584 IV-SOD CHL SOL 107.000870592 5% DW 250CC 93.000870600 5% DW 250CC 93.000870618 10%D/W IN 1000CC 77.000870626 5% D/W IN-100 CC 130.00

0870634 5% D/W IN 1000 CC 141.000870642 10 MEQ POT CHL D5 0.45% 127.000870659 IV-5% DW L R 92.000870667 IV-5% DW 9% SOD 124.000870675 IV-SOD CHL SOL 107.000870683 LAC RG PLAIN 1M 109.000870691 20 MEQ POT CHL D5 0.45% 127.000870709 IV 5% DW 45% SOD 1000CC 124.000870717 IV-SOD CHL SOL 107.000870725 SOD CLR INJ 1C 71.000870733 9% SOD 250CC 88.000870741 POST-OP SHOE 99.000870758 CATH ROBINSON 96.000870766 SUCTION CATH 244.000870774 ELASTOPLAST - 4 74.000870782 STOMAHESIVE POWDR 88.000870790 TUBING IRRIGATION FOR GU MEDS 30.000870808 FOLEY BAG EXT 120.000870824 AIRWAY NASAL 44.000870832 BAG-INSTANT COLD PACK 9.000870840 POST-OP SHOE 98.000870857 DRAINAGE POUCH 619.000870865 POST-OP SHOE 98.000870873 STOMAHESIVE PASTE 149.000870881 TUBING IRRIGATION STRAIGHT 50.000870899 DRESSING CALCIUM ALGINATE 58.000870907 SUBCLAV CATH 1,465.000870915 LYOFOAM 69.000870923 SUR-FIT UROSTOMY 25.000870931 SUBCLAVIAN CATH 400.000870949 SUCTION CATH TRAC 250.000870956 SUR-FIT FLANGES 25.000870964 CATH IUP 515.000870972 ACTIVE LIFE OSTOMY 21.000870980 ULCER DRESSING 33.000870998 SUR-FIT POUCH 39.000871004 SHOULDER IMMOB 138.000871012 LOPEZ VALVE 39.000871020 STERI STRIP/CLOSURE STRP 1/2X4 28.000871038 TELFA 54.000871046 INTERNAL ELECTROD 515.000871053 FEEDING TUBING/PUMP 122.000871061 ELASTIC BANDAGE 67.000871079 IV-SOD CHL SOL 24.000871087 IV CATH 35.000871095 AFO PRE-TIB SHELL 502.000871103 LS ORTHOSIS 681.00

0871111 BDY JACT W/INFACE 5,645.000871129 KNEE BRACE-FITTED 3,906.000871137 PLS TIBIA FX CAST 3,760.000871145 K-T BACK BRACE 1,679.000871152 HIP JNT ADJ FLEXION 502.000871160 HO ABDUCTION 669.000871178 BODY SOCK 502.000871186 KAFO CUSTOM-PLASTIC 5,117.000871194 DORSAL LS SUPPORT 703.000871202 BREAST BIOPSY TRAY 1,510.000871210 NS 0.45% 1L 4.000891325 TRAY TRIPLE LUMEN PICC 304.000892174 CELOX HEMOSTATIC PAD 80.000892406 IMPLANT BREAST TISSUE EXPANDER 5,757.500895292 SKAFFOLD 5CC 8,750.000895300 CEMENT MIXING SYSTEM(SKAFFOLD 5CC) 531.000895771 MIRENA IUD 4,250.000901074 glycerin suppository - PEDIATRIC 1.200901124 NON Formulary - Regular (see below) 0.010902783 diphenhydrAMINE (BENADRYL) capsule 1.400902809 diphenhydrAMINE (BENADRYL) oral li 29.750902882 diphenhydrAMINE (BENADRYL) injectio 14.250902965 cyproheptadine (PERIACTIN) 4 mg tab 11.850903096 rifabutin (MYCOBUTIN) capsule - 150 194.150903179 zinc sulfate 220 mg capsule 0.400903443 nitrofurantoin monohydrate/macrocry 39.250903534 hydroxychloroquine (PLAQUENIL) 200 45.400903930 flucytosine (ANCOBON) capsule - 250 416.250903948 flucytosine (ANCOBON) capsule - 500 497.550903955 isoniazid 100 mg tablet 1.650903963 isoniazid 300 mg tablet 5.650903989 ethambutol (MYAMBUTOL) 400 mg table 8.000904003 ketoconazole (NIZORAL) tablet - 200 42.100904060 amantadine (SYMMETREL) 100 mg capsu 22.750904094 sulfaSALAzine (AZULFIDINE) tablet - 13.350904276 sulfamethoxazole-trimethoprim (BACT 12.850904342 clotrimazole 1% (GYNE-LOTRIMIN) vag 89.950904508 metroNIDAZOLE (FLAGYL) tablet - 500 8.100904516 acyclovir (ZOVIRAX) 500 mg injecti 250.450904532 phenazopyridine (PYRIDIUM) tablet - 30.000904540 phenazopyridine (PYRIDIUM) tablet - 32.400904680 aztreonam (AZACTAM) 2 gram injectio 772.600904821 erythromycin lactobionate injection 1,084.150904870 clindamycin (CLEOCIN) capsule - 15 8.150904896 clindamycin (CLEOCIN) injection - 1 46.800904938 amoxicillin (AMOXIL) 250 mg capsule 2.800905232 polymyxin B injection - 500,000 uni 149.85

0905240 dicloxacillin (DYNAPEN) capsule - 2 15.300905257 penicillin V potassium (PEN VK) tab 8.150905331 penicillin G potassium 5,000,000 un 168.650905356 penicillin G potassium 20,000,000 u 25.550905364 rifampin (RIFADIN) capsule - 300 mg 15.150905372 metroNIDAZOLE (FLAGYL) tablet - 250 5.300905513 ampicillin 500 mg injection 48.950905521 ampicillin 1 gram injection 95.950905539 ampicillin 2 gram injection 176.750905737 nafcillin injection - 1 gm 146.550905745 nafcillin injection - 2 gm 313.900905877 cefOXitin (MEFOXIN) injection - 1 g 85.050905885 cefOXitin (MEFOXIN) injection - 2 g 249.750905893 cephalexin (KEFLEX) capsule - 250 m 9.700905901 cephalexin (KEFLEX) capsule - 500 m 15.300905950 cefaclor (CECLOR) capsule - 250 mg 22.100906008 ceFAZolin (ANCEF) injection - 1 gm 71.750906032 amphotericin B conventional (FUNGIZ 506.200906156 gentamicin PF 10 mg/mL IV Syringe 49.500906164 gentamicin injection - 40 mg/mL ( 2 14.800906222 tobramycin injection - 40 mg/mL (2 31.450906305 amikacin 250 mg/mL (2 mL) injection 163.250906388 neomycin tablet - 500 mg 15.150906438 penicillin G benzathine (BICILLIN L 1,461.250906453 vancomycin injection - 1 gm 82.900906487 erythromycin base (ERYC) delayed re 67.000906495 amoxicillin-clavulanate (AUGMENTIN) 42.050906560 cefTRIAXone (ROCEPHIN) injection - 40.000906578 tobramycin injection - 1.2 gm 1,110.000906594 cefTRIAXone (ROCEPHIN) injection - 79.950906644 cefTAZidime (FORTAZ) injection - 1 59.950906719 cefTAZidime (FORTAZ) injection - 2 146.550906750 clotrimazole (LOTRIMIN) 1% cream - 220.950906784 imipenem-cilastatin (PRIMAXIN) 500 364.750906792 pyrazinamide tablet - 500 mg 70.100906917 tetracycline capsule - 250 mg 87.450906974 aztreonam (AZACTAM) 1 gram injectio 438.900907154 bacitracin injection - 50,000 units 147.750907204 doxycycline (VIBRAMYCIN) injection 292.300907212 doxycycline (VIBRAMYCIN) capsule - 18.350907220 doxycycline (VIBRAMYCIN) capsule - 25.050907261 clindamycin (CLEOCIN-T) 1% lotion - 1,332.000907287 bacitracin zinc ointment - 500 unit 2.600907329 ciprofloxacin (CIPRO) 250 mg tablet 2.750907345 ampicillin-sulbactam (UNASYN) 3 gr 162.100907352 ampicillin-sulbactam (UNASYN) 1.5 85.900907378 metroNIDAZOLE (FLAGYL) IVPB - 500 m 104.60

0907444 cefotaxime (CLAFORAN) injection - 1 29.350907469 demeclocycline (DECLOMYCIN) 150 mg 118.050907899 cefuroxime (ZINACEF) injection - 1. 59.950907923 clarithromycin (BIAXIN) 250 mg tabl 66.800907956 azithromycin (ZITHROMAX) 250 mg tab 86.450908079 cycloSPORINE non-modified (SandIMMU 6,101.650908095 PARoxetine (PAXIL) tablet - 20 mg 31.000908103 rifampin (RIFADIN) injection - 600 2,378.400908202 ganciclovir (CYTOVENE) 500 mg Injec 1,078.950908210 fluconazole (DIFLUCAN) 200 mg table 151.100908228 fluconazole (DIFLUCAN) 100 mg table 97.750908236 fluconazole (DIFLUCAN) IVPB - 400 m 186.500908244 fluconazole (DIFLUCAN) IVPB - 200 m 53.300908293 itraconazole (SPORANOX) capsule - 1 103.000908327 dinoprostone (CERVIDIL) VAGINAL ins 4,487.550908996 vancomycin 5 mg/mL IV Syringe 49.500913277 azaTHIOprine (IMURAN) 50 mg tablet 26.050913350 cyclophosphamide (CYTOXAN) capsule 171.850913624 hydroxyurea (HYDREA) capsule - 500 9.800913657 tamoxifen (NOLVADEX) tablet - 10 mg 21.050913673 megestrol (MEGACE) 40 mg tablet 11.650913863 methotrexate injection - 25 mg/mL 44.750914242 leucovorin 5 mg tablet 31.100915272 azithromycin (ZITHROMAX) 500 mg inj 46.300915322 bupivacaine 0.5% injection - 10 mL 24.650915330 fentaNYL 50 mcg/mL ( 2 mL) injectio 13.350916429 succinylcholine (ANECTINE) injectio 266.200916502 trihexyphenidyl (ARTANE) tablet - 2 4.100916619 atropine 0.1 mg/mL ( 5 mL) injectio 110.600916627 norepinephrine (LEVOPHED) 1 mg/mL ( 242.250916676 dicyclomine (BENTYL) capsule - 10 m 2.950916759 phenylephrine (NEO-SYNEPHRINE) 10 m 47.650916767 PHYSOstigmine 1 mg/mL Injection (2 449.700916890 sucralfate (CARAFATE) tablet - 1 gm 4.250916924 benztropine (COGENTIN) injection - 652.150916932 benztropine (COGENTIN) 0.5 mg table 13.350916965 prazosin (MINIPRESS) capsule - 1 mg 19.850917146 methocarbamol (ROBAXIN) tablet - 50 5.650917153 methocarbamol (ROBAXIN) tablet - 75 4.150917211 methocarbamol (ROBAXIN) injection - 791.250917245 glycopyrrolate (ROBINUL) injection 180.400917252 cyclobenzaprine (FLEXERIL) 10 mg ta 12.800917260 baclofen (LIORESAL) 10 mg tablet 5.600917286 glycopyrrolate (ROBINUL) 1 mg table 14.600917419 neostigmine (BLOXIVERZ) injection - 244.600917427 scopolamine (TRANSDERM-SCOP) patch 224.250917492 ePHEDrine injection - 50 mg/mL (1 m 205.15

0917500 EPINEPHrine 1 mg/mL (1 mL) injectio 199.250917625 isoproterenol (ISUPREL) 0.2 mg/mL ( 23,844.200917641 terbutaline (BRETHINE) injection - 239.650917666 terbutaline (BRETHINE) tablet - 2.5 60.450917757 pseudoephedrine (SUDAFED) tablet - 0.400917807 carisoprodol (SOMA) 350 mg tablet 6.650917856 bethanechol (URECHOLINE) 10 mg tabl 22.250917864 bethanechol (URECHOLINE) 25 mg tabl 29.650917906 dicyclomine (BENTYL) injection - 10 541.150917930 pancuronium (PAVULON) injection - 1 59.500918003 atropine 1 mg/mL ( 1 mL) injection 76.350918029 famotidine (PEPCID) tablet - 20 mg 1.150918052 ketamine 50 mg/mL (10 mL) Injectio 58.300918144 sodium bicarbonate 8.4% injection - 147.350918177 nicotine (HABITROL) patch - 14 mg/2 23.800918185 nicotine (HABITROL) patch - 21 mg/2 23.800918193 nicotine (HABITROL) patch - 7 mg/2 23.800918201 misoprostol (CYTOTEC) tablet - 100 9.150918227 DOPamine 40 mg/mL (5 mL) injection 24.650918268 EPINEPHrine 1 mg/mL (30 mL) injecti 3,337.700918292 misoprostol (CYTOTEC) tablet - 200 15.900918300 cisatracurium (NIMBEX) 10 mg/mL (20 3,956.050918318 cisatracurium (NIMBEX) 2 mg/mL (10 325.900920702 albumin human 25% 50 mL injection 1,193.850920710 albumin human 25% 100 mL injection 1,541.800920728 albumin human 5% 250 mL injection 768.700920736 albumin human 5% 500 mL injection 1,287.600920819 hepatitis B immune globulin (NABI-H 8,929.300920835 hepatitis B (ENGERIX-B) 10 mcg/0.5 305.400921502 aminocaproic acid (AMICAR) 250 mg/m 67.950921585 ferrous sulfate enteric coated tabl 0.750921619 ferrous gluconate (FERGON) tablet - 0.700921783 protamine injection - 10 mg/mL (25 299.150921809 heparin injection - 1,000 units/mL 18.200921817 heparin injection - 5,000 units/mL 44.900921940 warfarin (COUMADIN) 2 mg tablet 23.850921973 warfarin (COUMADIN) 5 mg tablet 25.650922005 warfarin (COUMADIN) 2.5 mg tablet 24.600922062 protamine injection - 10 mg/mL ( 5 100.600922104 Surgifoam (GELFOAM) Size 50 371.200922112 Surgifoam (GELFOAM) Size 100 555.000922260 heparin injection - 1,000 units/mL 96.800922385 warfarin (COUMADIN) 1 mg tablet 22.850922419 heparin (HEPARINIZED SALINE) infusi 53.850923797 digoxin (LANOXIN PEDIATRIC) injecti 725.250923995 lidocaine 1% (XYLOCAINE) 50 mg/5 m 56.100924001 lidocaine 1% (XYLOCAINE) 20 mL Inje 18.95

0924076 lidocaine 2 gm/500 mL D5W infusion 74.350924084 lidocaine 2% (XYLOCAINE) 100 mg/5m 53.300924217 digoxin (LANOXIN) injection - 250 m 83.050924225 captopril (CAPOTEN) 25 mg tablet 15.300924241 digoxin (LANOXIN) 125 mcg (0.125 m 28.450924290 metoprolol tartrate (LOPRESSOR) 50 7.050924316 metoprolol tartrate (LOPRESSOR) 100 10.150924498 propranolol (INDERAL) 10 mg tablet 4.550924506 propranolol (INDERAL) 20 mg tablet 5.700924589 NIFEdipine (PROCARDIA) capsule - 10 14.300924787 phentolamine (REGITINE) 5 mg 5,938.300924829 verapamil (ISOPTIN) injection - 2.5 387.450924845 verapamil (CALAN) 80 mg tablet 6.350924878 hydrALAZINE (APRESOLINE) injection 174.300924886 hydrALAZINE (APRESOLINE) 10 mg tabl 5.950924894 hydrALAZINE (APRESOLINE) 25 mg tabl 6.950924902 hydrALAZINE (APRESOLINE) 50 mg tabl 1.800924910 atenolol (TENORMIN) 50 mg tablet 9.950924969 minoxidil (LONITEN) tablet - 2.5 mg 8.700924977 methyldopa (ALDOMET) tablet - 250 m 4.150925057 cloNIDine (CATAPRES) 0.1 mg tablet 2.900925065 cloNIDine (CATAPRES) 0.2 mg tablet 5.050925149 DOBUTamine 12.5 mg/mL (20 mL) injec 73.300925180 dipyridamole (PERSANTINE) 25 mg tab 11.800925321 cholestyramine (PREVALITE) oral pac 37.400925354 quiNINE capsule - 324 mg 81.350925412 isosorbide dinitrate (ISORDIL) 10 m 8.150925446 isosorbide dinitrate (ISORDIL) 20 m 9.500925487 nitroglycerin (NITRO-DUR) patch - 0 20.650925511 enalaprilat (VASOTEC) injection - 1 58.600925552 nitroglycerin (NITRO-DUR) patch - 0 18.550925685 nitroglycerin (NITROSTAT) sublingua 4.850925693 nitroglycerin 5 mg/mL (10 mL) injec 138.550925719 nitroglycerin (NITRO-TIME) extended 9.900925735 nitroglycerin (NITRO-DUR) patch - 0 20.850925743 nitroglycerin (NITRO-TIME) extended 8.900925792 diltiazem (CARDIZEM) 30 mg tablet 11.100925800 diltiazem (CARDIZEM) 60 mg tablet 17.400925826 disopyramide (NORPACE CR) extended 42.650925891 labetalol (TRANDATE) 200 mg tablet 5.350925917 pentoxifylline (TRENTAL) extended r 16.650925982 captopril (CAPOTEN) 12.5 mg tablet 14.100926006 cloNIDine (CATAPRES) 0.3 mg tablet 2.450926022 metoprolol tartrate (LOPRESSOR) inj 14.000926055 cloNIDine (CATAPRES TTS-1) patch - 368.100926063 cloNIDine (CATAPRES TTS-2) patch - 619.000926071 cloNIDine (CATAPRES TTS-3) patch - 858.70

0926089 nitroglycerin (NITRO-DUR) patch - 0 35.050926105 mexiletine (MEXITIL) capsule - 150 28.150926147 amiodarone (PACERONE) 200 mg tablet 37.000926170 labetalol (TRANDATE) 100 mg tablet 5.700926360 terazosin (HYTRIN) capsule - 5 mg 17.850926386 nitroglycerin 50 mg/250 mL D5W infu 275.400926428 amLODIPine (NORVASC) 5 mg tablet 19.200926451 milrinone (PRIMACOR) 1 mg/mL (20 mL 122.350926642 doxazosin (CARDURA) tablet - 2 mg 12.250926659 verapamil (CALAN SR) 180 mg extende 16.000926683 NIFEdipine (PROCARDIA XL/ADALAT CC) 29.650926709 terazosin (HYTRIN) capsule - 1 mg 17.850926733 niMODipine (NIMOTOP) capsule - 30 m 204.400926766 nitroglycerin (NITROLINGUAL) SPRAY 2,491.650926774 labetalol (TRANDATE) 5 mg/mL (20 mL 31.100926782 NIFEdipine (PROCARDIA XL/ADALAT CC) 436.900926790 NIFEdipine (PROCARDIA XL/ADALAT CC) 25.700926808 diltiazem (CARDIZEM) 90 mg tablet 23.800926840 adenosine (ADENOCARD) 3 mg/mL ( 2 m 82.600926857 esmolol (BREVIBLOC) 10 mg/mL (10 mL 97.150926873 lisinopril (ZESTRIL) 20 mg tablet 11.800926881 lisinopril (ZESTRIL) 10 mg tablet 11.050926899 lisinopril (ZESTRIL) 5 mg tablet 5.350926964 digoxin immune fab (DIGIFAB) inject 38,974.350927020 divalproex (DEPAKOTE) 500 mg delay 15.800927038 divalproex (DEPAKOTE) 250 mg delay 11.950927053 zolpidem (AMBIEN) 10 mg tablet 51.600927186 FLUoxetine (PROzac) capsule - 10 mg 26.900927194 risperiDONE (RISPERDAL) tablet - 1 50.450927210 verapamil (CALAN SR) 120 mg extende 11.950927236 atorvastatin (LIPITOR) 10 mg tablet 7.050927244 atorvastatin (LIPITOR) 20 mg tablet 5.850927335 sotalol (BETAPACE) 80 mg tablet 28.450927343 atenolol (TENORMIN) 25 mg tablet 9.100927368 isosorbide mononitrate (IMDUR) 60 m 22.500927376 diltiazem (CARDIZEM) 5 mg/mL ( 5 mL 41.450927392 amLODIPine (NORVASC) 10 mg tablet 26.500927400 losartan (COZAAR) 25 mg tablet 18.600927459 losartan (COZAAR) 50 mg tablet 7.000930677 morphine injection - 4 mg/mL (1 m 13.200930859 morphine (ROXANOL) 20 mg/mL Oral Sy 16.500930958 butalbital-aspirin-caffeine-codeine 30.450930966 clonazePAM (KlonoPIN) 0.5 mg tablet 8.350930974 clonazePAM (KlonoPIN) 1 mg tablet 9.500930990 aspirin (ECOTRIN) 325 mg enteric co 0.200931006 nortriptyline (PAMELOR) capsule - 2 9.800931097 ibuprofen (MOTRIN) 600 mg tablet 6.10

0931220 ibuprofen (MOTRIN) 400 mg tablet 0.850931402 naloxone (NARCAN) injection - 0.4 m 263.300931493 indomethacin (INDOCIN) capsule - 25 4.500931568 acetaminophen (TYLENOL) 325 mg tabl 0.010931675 acetaminophen-codeine (TYLENOL NO. 5.850931709 acetaminophen (TYLENOL) 160 mg/5 mL 0.010931741 acetaminophen (TYLENOL) 500 mg tabl 0.010931782 acetaminophen (TYLENOL) 650 mg/20.3 0.010931816 butorphanol (STADOL) injection - 2 71.050931873 meperidine (DEMEROL) injection - 5 62.350931956 methadone (DOLOPHINE) tablet - 10 m 3.400931998 fentaNYL 50 mcg/mL (20 mL) injectio 113.250932046 HYDROmorphone (DILAUDID) 2 mg table 4.150932053 HYDROmorphone (DILAUDID) 1 mg/mL (1 27.750932095 oxyCODONE-acetaminophen (PERCOCET 15.200932178 aspirin 325 mg tablet 0.650932186 aspirin 81 mg chewable tablet 0.700932244 carBAMazepine (TEGRETOL) 200 mg tab 17.750932608 aspirin 300 mg suppository 16.200932624 morphine (ASTRAMORPH) injection - 1 72.600932707 carBAMazepine (TEGRETOL) 100 mg che 7.700932715 nortriptyline (PAMELOR) capsule - 1 6.300932822 midazolam (VERSED) injection - 1 mg 5.400932921 LORazepam (ATIVAN) 0.5 mg tablet 7.150932947 butalbital-acetaminophen-caffeine ( 18.750932954 ibuprofen (MOTRIN) 800 mg tablet 4.700932996 busPIRone (BUSPAR) 5 mg tablet 8.600933085 fentaNYL 50 mcg/mL ( 5 mL) injectio 21.550933184 PHENobarbital 10 mg/mL IV Syringe 49.500933200 morphine injection - 10 mg/mL (1 m 13.500933267 amitriptyline (ELAVIL) 10 mg tablet 3.350933275 amitriptyline (ELAVIL) 25 mg tablet 7.100933283 amitriptyline (ELAVIL) 50 mg tablet 12.900933432 SUMAtriptan (IMITREX) injection - 6 319.700933481 doxepin (SINEQUAN) capsule - 10 mg 4.600933499 doxepin (SINEQUAN) capsule - 25 mg 9.150933531 naloxone (NARCAN) injection - 1 mg/ 417.600933549 diazepam (VALIUM) injection - 5 mg/ 209.800933580 sertraline (ZOLOFT) tablet - 50 mg 53.550933762 fentaNYL (DURAGESIC) patch - 100 mc 873.700933820 fentaNYL (DURAGESIC) patch - 50 mc 430.950933838 fentaNYL (DURAGESIC) patch - 25 mc 236.000933853 midazolam (VERSED) 5 mg/mL (10 mL) 91.950933895 fentaNYL (DURAGESIC) patch - 75 mc 658.250933911 morphine PCA infusion - 1 mg/mL (3 159.850933937 propofol (DIPRIVAN) injection - 10 79.950933945 ibuprofen (ADVIL) 200 mg tablet 0.80

0934034 phenytoin (DILANTIN) 100 mg/4 mL Or 17.350934117 diclofenac sodium (VOLTAREN) 75 mg 8.950934208 imipramine (TOFRANIL) 10 mg tablet 4.800934216 imipramine (TOFRANIL) 25 mg tablet 8.000934232 lithium capsule - 300 mg 2.350934257 lithium 60 mg/mL Oral Syringe 2.100934307 PHENobarbital 30 mg tablet 4.700934398 PHENobarbital injection - 65 mg/mL 319.500934554 temazepam (RESTORIL) 15 mg capsule 9.050934877 traZODone (DESYREL) 50 mg tablet 11.950934919 hydrOXYzine (ATARAX) injection - 5 296.400934943 hydrOXYzine hydrochloride (ATARAX) 7.050934992 LORazepam (ATIVAN) 1 mg tablet 1.900935049 LORazepam (ATIVAN) injection - 2 mg 10.000935098 haloperidol (HALDOL) 0.5 mg tablet 3.650935122 haloperidol (HALDOL) 5 mg tablet 10.850935155 haloperidol lactate (HALDOL) inject 16.000935247 chlorproMAZINE (THORAZINE) injectio 384.800935270 chlorproMAZINE (THORAZINE) 25 mg t 82.600935528 diazepam (VALIUM) 5 mg tablet 2.250935536 diazepam (VALIUM) 10 mg tablet 3.700935726 prochlorperazine (COMPAZINE) tablet 6.600935734 prochlorperazine (COMPAZINE) tablet 9.950935775 prochlorperazine (COMPAZINE) inject 246.450935783 promethazine (PHENERGAN) 25 mg/mL I 20.000935817 promethazine (PHENERGAN) tablet - 2 6.700935825 promethazine (PHENERGAN) suppositor 196.550935924 thioridazine (MELLARIL) 25 mg table 5.350935965 trifluoperazine (STELAZINE) tablet 9.750935981 trifluoperazine (STELAZINE) tablet 18.600936153 ALPRAZolam (XANAX) 0.25 mg tablet 6.850936161 ALPRAZolam (XANAX) 0.5 mg tablet 8.250936203 phenytoin (DILANTIN) injection - 50 42.650936211 phenytoin (DILANTIN) injection - 50 22.000936237 phenytoin (DILANTIN) extended relea 7.150936294 phenytoin (DILANTIN INFATAB) chewab 5.850936302 primidone (MYSOLINE) tablet - 50 m 10.600936310 primidone (MYSOLINE) tablet - 250 m 11.100936336 valproic acid (DEPAKENE) capsule - 9.350936344 valproic acid (DEPAKENE) oral liqui 24.000936377 methylphenidate (RITALIN) tablet - 8.150936401 carbidopa-levodopa (SINEMET) 10 mg 8.600936419 carbidopa-levodopa (SINEMET) 25 mg 17.950936492 oxyCODONE (OxyCONTIN) 20 mg Tablet 71.350936500 oxyCODONE (OxyCONTIN) 10 mg Tablet 38.300936526 divalproex (DEPAKOTE) 125 mg delay 9.950936534 haloperidol decanoate injection - 5 344.90

0936542 gabapentin (NEURONTIN) capsule - 30 15.300936567 propafenone (RYTHMOL) tablet - 150 18.200936591 gabapentin (NEURONTIN) capsule - 10 6.500936609 fosphenytoin 50 mg PE/mL Injection 299.700936617 fosphenytoin 50 mg PE/mL Injection 444.100936658 valproic acid (DEPACON) injection - 89.250936682 OLANZapine (ZyPREXA) tablet - 5 mg 146.700936716 PARoxetine (PAXIL) tablet - 10 mg 31.250942771 indigo carmine 8 mg/mL (5 mL) injec 95.950942789 methylene blue 1% injection - (10 m 2,235.100942847 candida skin test antigen injection 1,838.200942896 tuberculin purified protein derivat 64.200943126 traMADol (ULTRAM) tablet - 50 mg 9.350943944 potassium acetate injection - 2 mEq 6.450943977 sodium chloride 23.4% injection - 4 10.700943985 sodium acetate injection - 2 mEq/mL 39.100944009 magnesium sulfate injection - 4 mEq 16.000944439 potassium bicarbonate (K-LYTE) effe 4.350944454 sodium chloride tablet - 1 gm 0.900944504 calcitriol (ROCALTROL) capsule - 0. 14.250944520 calcium GLUCONATE 500 mg tablet 1.850944710 sodium bicarbonate 650 mg tablet 0.150944728 sodium bicarbonate 8.4% injection - 133.200944744 sodium bicarbonate 8.4% injection - 116.550944777 sodium polystyrene sulfonate (KAYEX 175.500944793 potassium iodide (SSKI) solution - 253.100944884 metolazone (ZAROXOLYN) tablet - 2.5 25.200944892 metolazone (ZAROXOLYN) tablet - 5 m 26.200944967 fat emulsion (INTRALIPID) 20% infus 460.650945097 lactulose oral liquid - 10 gm/15 mL 385.750945105 bumetanide (BUMEX) 1 mg tablet 23.700945113 bumetanide (BUMEX) injection - 0.25 30.350945212 spironolactone (ALDACTONE) tablet 9.800945220 desmopressin (DDAVP) injection - 4 506.200945238 furosemide (LASIX) injection - 10 m 45.100945279 furosemide (LASIX) tablet - 20 mg 5.750945287 furosemide (LASIX) tablet - 40 mg 1.900945311 potassium chloride (K-DUR) extended 6.300945329 bumetanide (BUMEX) injection - 0.25 44.100945337 potassium phosphate-sodium phosphat 5.800945360 dextrose 25% injection - 10 mL syri 80.950945386 sodium bicarbonate 4.2% injection - 144.000945402 indapamide (LOZOL) 2.5 mg tablet 17.200945428 citric acid-sodium citrate (BICITRA 33.050945493 aMILoride (MIDAMOR) 5 mg tablet 3.000945527 furosemide (LASIX) injection - 10 m 29.100945535 furosemide (LASIX) injection - 10 m 42.60

0945634 hydrochlorothiazide (HYDRODIURIL) 2 0.950945691 triamterene (DYRENIUM) capsule - 50 127.650945709 ethacrynic acid (EDECRIN) 25 mg tab 268.550945725 hydrochlorothiazide-triamterene (DY 4.250945840 mannitol 25% (OSMITROL) injection - 64.750945956 spironolactone (ALDACTONE) tablet 4.800945972 probenecid (BENEMID) tablet - 500 m 10.950948927 hemin (PANHEMATIN) 7 mg/mL IV Syrin 125,169.550948976 torsemide (DEMADEX) 20 mg tablet 9.250948992 torsemide (DEMADEX) 5 mg tablet 7.050949016 isosulfan blue 10 mg/mL (5 mL) Inje 13,458.200949693 acetylcysteine 20% (MUCOMYST) 30 mL 170.850949842 benzonatate (TESSALON) perles - 10 4.200949867 guaiFENesin (ROBITUSSIN) SUGAR FREE 7.150949941 promethazine (PHENERGAN) oral liqui 3.450950402 levOCARNitine 200 mg/mL (5 mL) Inje 426.250951392 acetaZOLAMIDE (DIAMOX) 250 mg table 32.050951418 acetaZOLAMIDE (DIAMOX) 500 mg injec 585.550951541 fluorometholone 0.1% (FML) ophthal 823.000951608 phenylephrine 0.25% (NEO-SYNEPHRINE 43.300951749 ARTIFICIAL TEARS ophthalmic solutio 79.950951764 sodium hyaluronate (HEALON) ophthal 1,778.800951897 tobramycin 0.3% (TOBREX) ophthalmic 153.850951996 neomycin-polymyxin B-gramicidin (NE 687.100952002 bacitracin-neomycin-polymyxin B (NE 632.150952051 bacitracin-polymyxin B (AK-POLY-BAC 285.300952077 tobramycin 0.3% (TOBREX) ophthalmic 2,334.150952101 trifluridine (VIROPTIC) 1% Ophthalm 2,474.650952143 timolol maleate 0.5% (TIMOPTIC) oph 72.850952150 timolol maleate 0.25% (TIMOPTIC) op 166.500952176 atropine 1% 3.5 gram ophthalmic oin 221.100952184 atropine 1% 5 mL ophthalmic solutio 283.050952218 cyclopentolate 0.2%-phenylephrine 1 370.750952226 cyclopentolate (CYCLOGYL) 1% Ophtha 181.300952291 pilocarpine 1% (ISOPTO CARPINE) oph 1,029.350952309 phenylephrine 10% (NEO-SYNEPHRINE) 555.000952416 phenylephrine 2.5% (AK-DILATE) 2 m 451.000952457 neomycin-polymyxin B-dexamethasone 488.400952499 ophthalmic irrigation (EYE WASH) so 36.700952523 bacitracin-neomycin-polymyxin B-hyd 722.100952531 neomycin-polymyxin B-hydrocortisone 639.400952614 Balanced Salt Solution (BSS) Ophth 104.900952655 carbamide peroxide 6.5% (DEBROX) ot 50.950952697 pilocarpine 2% (ISOPTO CARPINE) oph 167.850952721 acetylcholine 1% (MIOCHOL-E) 20 mg 1,096.150952820 phenol 1.4% (CHLORASEPTIC) mouth/th 53.200952846 dexamethasone 0.1% (DECADRON) ophth 717.95

0952986 prednisoLONE acetate 1% (PRED FORTE 586.100953000 ipratropium (ATROVENT) MDI - 17 mcg 5,479.750953083 sulfacetamide sodium 10% (BLEPH-10) 677.200953109 proparacaine 0.5% (OPHTHETIC) ophth 486.850953158 sodium chloride 0.65% (SALINE) nasa 43.500953182 carbachol 0.01% (MIOSTAT) intraocul 448.650953307 flurbiprofen 0.03% (OCUFEN) ophthal 96.850953414 albuterol (PROVENTIL) 0.4 mg/mL Ora 16.500953463 fluorescein (BIO-GLO) ophthalmic st 2.050953471 polymyxin B-trimethoprim (POLYTRIM) 149.200953521 albuterol (VOSPIRE or VOLMAX) 4 mg 19.850953588 albuterol 0.083% 2.5 mg/3 mL inhala 15.550953604 sodium chondroitin-hyaluronate opht 1,628.400953828 guaiFENesin (MUCINEX) 600 mg extend 11.900953893 latanoprost 0.005% (XALATAN) ophtha 1,054.500953927 fluticasone (FLONASE) nasal spray - 944.850956375 bismuth subsalicylate (PEPTO-BISMOL 24.350956417 bisacodyl (DULCOLAX) 5 mg enteric c 0.450956433 bisacodyl (DULCOLAX) suppository - 11.650956458 docusate sodium (COLACE) 100 mg cap 0.500956482 charcoal, activated (ACTIDOSE with 185.150956524 senna (SENOKOT) tablet - 8.6 mg 0.300956714 docusate sodium (COLACE) 250 mg cap 0.750956821 diphenoxylate-atropine (LOMOTIL) 2. 12.950956904 mineral oil - 30 mL cup 9.000956920 loperamide (IMODIUM) capsule - 2 mg 9.750956938 aspirin 600 mg suppository 16.750956961 glycerin suppository - ADULT 8.700957035 simethicone (MYLANTA GAS) chewable 0.300957068 simethicone (MYLICON INFANT) drops 24.650957159 aluminum hydroxide-magnesium hydrox 47.750957506 magnesium citrate (CITROMA) oral li 16.650957563 meclizine (ANTIVERT) 12.5 mg tablet 0.300957589 meclizine (ANTIVERT) 25 mg tablet 9.550957696 metoclopramide (REGLAN) tablet - 10 8.000957704 metoclopramide (REGLAN) injection - 14.800957902 polyethylene glycol 3350 with elect 799.200958074 ursodiol (ACTIGALL) 300 mg capsule 81.600958181 ranitidine (ZANTAC) injection - 25 41.550958215 ondansetron (ZOFRAN) injection - 2 104.600958231 calcium acetate (PHOSLO) capsule - 11.400958256 mesalamine (ROWASA) enema - 4 gm/60 269.750958397 aluminum hydroxide (AMPHOJEL) 64 mg 4.000958447 charcoal,activated 25 gm/120 mL bot 185.150958454 cherry syrup oral liquid - 5 mL 1.700958496 mesalamine (PENTASA) extended relea 28.650958637 ondansetron (ZOFRAN) injection - 2 12.70

0958652 metoclopramide (REGLAN) oral liquid 7.250958686 famotidine (PEPCID) injection - 10 11.900958710 dorzolamide 2% (TRUSOPT) ophthalmic 741.500961342 deferoxamine (DESFERAL) injection - 104.200961615 betamethasone sodium phosphate-beta 532.800961623 calcitonin (MIACALCIN) injection - 36,004.850961698 glyBURIDE (DIABETA) 2.5 mg tablet 5.100961722 dexamethasone (DECADRON) injection 29.350961839 dexamethasone (DECADRON) 4 mg table 13.100961896 methylPREDNISolone (Solu-MEDROL) in 80.550961904 methylPREDNISolone (Solu-MEDROL) in 64.650961912 methylPREDNISolone (Solu-MEDROL) in 150.050961920 methylPREDNISolone (Solu-MEDROL) in 558.000961953 methylPREDNISolone acetate (DEPO-ME 217.350961995 hydrocortisone (Solu-CORTEF) inject 195.700962043 vasopressin (VASOSTRICT) 20 units/m 80.500962100 predniSONE tablet - 1 mg 3.100962118 predniSONE tablet - 2.5 mg 2.050962126 predniSONE tablet - 5 mg 2.300962134 predniSONE tablet - 10 mg 2.900962159 predniSONE tablet - 20 mg 3.200962175 predniSONE tablet - 50 mg 4.700962324 estradiol (ESTRACE) 1 mg tablet 7.550962365 methylPREDNISolone (MEDROL) tablet 18.350962431 triamcinolone acetonide (KENALOG 10 147.100962464 triamcinolone acetonide (KENALOG 40 113.250962555 medroxyPROGESTERone (PROVERA) 10 mg 5.500962563 liothyronine (CYTOMEL) 5 mcg tablet 9.450962589 methimazole (TAPAZOLE) tablet - 10 8.550962597 propylthiouracil (PTU) tablet - 50 37.300962662 glipiZIDE (GLUCOTROL) 5 mg tablet 4.500962746 glucagon injection - 1 mg 2,153.400962753 conjugated estrogens (PREMARIN) inj 2,928.300962779 conjugated estrogens (PREMARIN) 0.6 52.850962811 conjugated estrogens (PREMARIN) 0.3 52.850962928 calcium carbonate (OS CAL) 500 mg 1.200962936 cosyntropin (CORTROSYN) injection - 1,174.400962944 calcium chloride injection - 100 mg 90.400962944 calcium chloride injection - 100 mg 128.550962951 calcium GLUCONATE injection - 100 m 71.950963009 fludrocortisone (FLORINEF) 0.1 mg t 8.850963033 levothyroxine (SYNTHROID) 100 mcg ( 8.050963041 levothyroxine (SYNTHROID) 150 mcg ( 9.750963082 levothyroxine (SYNTHROID) 50 mcg (0 14.700963124 thyroid, desiccated tablet - 60 mg 8.100963215 liothyronine (CYTOMEL) 25 mcg table 11.550963280 levothyroxine (SYNTHROID) 125 mcg ( 15.45

0965517 glipiZIDE (GLUCOTROL XL) 5 mg exten 4.550965533 metFORMIN (GLUCOPHAGE) tablet - 850 0.800965541 metFORMIN (GLUCOPHAGE) tablet - 500 0.900965558 medroxyPROGESTERone (DEPO-PROVERA) 458.100965566 levothyroxine (SYNTHROID) 75 mcg (0 7.850965624 insulin aspart (NovoLOG) 100 units/ 66.100965632 levothyroxine (SYNTHROID) 88 mcg (0 6.750965640 levothyroxine (SYNTHROID) 25 mcg (0 4.900965657 levothyroxine (SYNTHROID) 112 mcg ( 7.850966101 lidocaine 1% preservative-free 5 mL 45.000966127 lidocaine topical 4% (XYLOCAINE) to 717.650966184 lidocaine-EPINEPHrine 2%-1:100,000 50.650966192 lidocaine 2% (XYLOCAINE MPF) injec 80.400966226 lidocaine-EPINEPHrine 1%-1:100,000 28.200966242 lidocaine 1% preservative-free 30 m 33.300966317 lidocaine 1% (XYLOCAINE) 50 mL Inje 30.800966341 bupivacaine 0.5% injection - 30 mL 83.950966473 lidocaine 2% (XYLOCAINE) injection 23.100966499 bupivacaine 0.75% spinal injection 59.800966507 bupivacaine 0.25% injection - 30 m 35.650966507 bupivacaine 0.25% injection - 30 m 45.650966515 bupivacaine 0.25% injection - 10 m 21.450966531 lidocaine-EPINEPHrine 1.5%-1:200,00 152.850966549 lidocaine-EPINEPHrine 2%-1:200,000 170.750966556 bupivacaine 0.75% injection - 10 m 26.650966572 miconazole (MONISTAT) vaginal suppo 10.400967612 methylergonovine (METHERGINE) table 746.250967620 methylergonovine (METHERGINE) injec 95.250967646 oxytocin (PITOCIN) injection - 10 u 49.950967695 carboprost (HEMABATE) injection - 2 3,013.600968347 tetanus immune globulin (HyperTET S 5,532.700968354 crotalidae polyvalent immune FAB ov 30,129.850968362 latrodectus mactans (antivenin blac 369.100968487 pneumococcal polysaccharide (PPV or 1,155.000968503 tetanus-diphtheria toxoids (Td) (DE 785.450968511 measles-mumps-rubella (MMR-II) inje 831.450969428 miconazole (MONISTAT) 2% vaginal cr 95.450969667 triamcinolone (KENALOG) 0.1% cream 61.850970046 methyl salicylate-menthol (MUSCLE R 25.100970053 povidone iodine 10% (BETADINE) oint 70.950970129 gentamicin 0.1% cream - 15 gm 364.650970343 dibucaine 1% (NUPERCAINAL) ointment 66.550970350 silver sulfADIAZINE 1% (SILVADENE) 706.000970368 silver sulfADIAZINE 1% (SILVADENE) 167.650970384 lidocaine topical 5% (XYLOCAINE) oi 2,981.000970509 glycerin-witch hazel 10%-50% topica 0.700970517 benzocaine 20%-menthol 0.5% (DERMOP 55.30

0970541 acetaminophen (TYLENOL) 120 mg supp 0.010970558 acetaminophen (TYLENOL) 325 mg supp 0.010970566 acetaminophen (TYLENOL) 650 mg supp 0.010970624 prochlorperazine (COMPRO) supposito 148.750970707 hydrocortisone suppository - 25 mg 42.350970780 bacitracin zinc ointment (30 gram) 79.600970806 hydrocortisone 0.5% cream (30 gram) 36.000970814 conjugated estrogens (PREMARIN) vag 3,841.500970822 hydrocortisone 1% cream - 30 gm 44.300970830 hydrocortisone 1% ointment - 30 gm 44.300970855 nystatin-triamcinolone (MYCOLOG-II) 1,242.600970863 nystatin topical powder - 15 gm 304.850970871 EPINEPHrine 1 mg/mL topical solutio 2,530.800971010 hydrocortisone (COLOCORT) 100 mg/60 117.900971259 gentamicin 0.1% ointment - 15 gm 364.650971325 nystatin cream - 15 gm 194.850971333 nystatin ointment - 15 gm 155.400971416 white petrolatum ointment 29.750971473 hydrogen peroxide 3% topical soluti 15.750971556 silver nitrate topical stick 7.950971648 sodium hypochlorite 0.25% (DAKIN'S 127.900971671 nitroglycerin 2% (NITRO-BID) ointme 27.850971697 collagenase (SANTYL) ointment - 30 2,727.950971937 vitamin A and D ointment - 60 gm 13.700972596 ketoconazole 2% (NIZORAL) shampoo - 309.050972620 dapsone 100 mg tablet 33.600975912 aminophylline 25 mg/mL (10 mL) inje 125.700975953 papaverine injection - 30 mg/mL (2 156.200976167 oxybutynin (DITROPAN) tablet - 5 m 7.350976225 pyridoxine (Vitamin B6) 25 mg table 0.350977975 cyanocobalamin (VITAMIN B-12) injec 97.050978049 multivitamin adult (INFUVITE) injec 134.750978056 folic acid tablet - 1 mg 3.700978171 pyridoxine (Vitamin B6) tablet - 50 0.350978239 thiamine (VITAMIN B1) tablet - 100 0.600978270 thiamine (VITAMIN B1) injection - 1 118.450978346 ascorbic acid (VITAMIN C) 250 mg ta 0.350978353 ascorbic acid (VITAMIN C) 500 mg ta 0.400978437 vitamin E 180 mg (400 units) capsul 0.600978494 multivitamin with Iron (POLY VI SOL 94.950978528 phytonadione (Vitamin K) (AQUAMEPHY 569.700978569 phytonadione (Vitamin K) (AQUAMEPHY 239.800978734 multivitamin, prenatal tablet with 0.700978858 pyridoxine (Vitamin B6) injection - 155.750978908 ergocalciferol (VITAMIN D) 1,250 mc 21.900978916 multivitamin with minerals (THERAGR 0.400980490 bromocriptine (PARLODEL) 2.5 mg tab 45.95

0980508 allopurinol (ZYLOPRIM) 100 mg table 5.400980516 allopurinol (ZYLOPRIM) 300 mg table 8.450980532 colchicine (COLCRYS) 0.6 mg tablet 79.800980771 pamidronate (AREDIA) injection - 3 359.650980789 Talc Irrigation 1,864.800980821 flumazenil (ROMAZICON) injection - 90.300981407 neomycin-polymyxin B-dexamethasone 220.450982140 cocaine 4% topical solution - 4 mL 2,937.100982256 atropine 0.1 mg/mL (10 mL) injectio 138.800982306 EPINEPHrine 0.1 mg/mL (10 mL) injec 66.600982314 atropine 0.4 mg/mL ( 1 mL) injectio 48.600982389 ketorolac (TORADOL) 30 mg/mL (1 mL) 23.350982413 dextrose 50% injection - 50 mL syri 86.600983460 finasteride (PROSCAR) tablet - 5 mg 14.500983577 glimepiride (AMARYL) 1 mg tablet 4.500983593 glimepiride (AMARYL) 4 mg tablet 13.650983601 donepezil (ARICEPT) tablet - 5 mg 8.650983619 amoxicillin-clavulanate (AUGMENTIN) 56.100983684 bicalutamide (CASODEX) 50 mg tablet 205.800983726 carvedilol (COREG) 6.25 mg tablet 21.650983791 venlafaxine (EFFEXOR XR) 75 mg Caps 51.800983825 tamsulosin (FLOMAX) capsule - 0.4 m 5.300983916 levoFLOXacin (LEVAQUIN) 500 mg tabl 186.750983932 enoxaparin (LOVENOX) injection - 4 53.450983999 methotrexate tablet - 2.5 mg 69.250984013 cycloSPORINE modified (NEORAL) caps 61.050984021 cycloSPORINE modified (NEORAL) caps 23.350984435 acarbose (PRECOSE) 50 mg tablet 10.750984450 midodrine (PROAMATINE) 5 mg tablet 11.550984468 promethazine-codeine (PHENERGAN WIT 5.400984484 mirtazapine (REMERON) 15 mg tablet 30.200984492 mesalamine (CANASA) suppository - 1 206.350984518 diltiazem (TIAZAC) extended releas 5.700984526 topiramate (TOPAMAX) 25 mg tablet 23.350984534 flecainide (TAMBOCOR) 50 mg tablet 28.450984542 metoprolol (TOPROL XL) 50 mg extend 12.350984559 magnesium oxide 400 mg tablet 1.650984617 rocuronium (ZEMURON) 10 mg/mL Injec 336.500984625 rocuronium (ZEMURON) 10 mg/mL Injec 136.900984690 amiodarone (CORDARONE) 50 mg/mL ( 3 27.750984708 aspirin (ECOTRIN) 81 mg enteric co 0.650984724 isosorbide mononitrate (IMDUR) 30 m 18.450984757 repaglinide (PRANDIN) tablet - 0.5 36.900984864 cephalexin (KEFLEX) 25 mg/mL Oral S 16.500985242 gabapentin (NEURONTIN) capsule - 40 13.600985291 nevirapine (VIRAMUNE) tablet - 200 156.450985309 cetirizine (ZyrTEC) 10 mg tablet 27.70

0985317 terbinafine (LamISIL) 250 mg tablet 144.600985325 morphine (MS CONTIN) extended rele 20.800985390 lamoTRIgine (LaMICtal) 100 mg table 2.600985416 pramipexole (MIRAPEX) tablet - 0.25 3.450985432 lactulose oral liquid - 20 gm/30 mL 33.000985598 hepatitis B immune globulin (HYPERH 1,178.200985606 buPROPion (WELLBUTRIN SR) 150 mg ex 8.500985655 diltiazem (TIAZAC) extended releas 14.450985671 venlafaxine (EFFEXOR XR) 37.5 mg Ca 46.250986059 acyclovir (ZOVIRAX) 400 mg tablet 21.950986109 mycophenolate mofetil (CELLCEPT) ca 8.350986125 nadolol (CORGARD) 20 mg tablet 40.750986133 dantrolene (DANTRIUM) injection - 2 70,842.450986182 glycerin 80 % NEONATAL enema 0.2 mL 0.150986208 hyoscyamine (LEVSIN) 0.125 mg table 6.350986257 levoFLOXacin (LEVAQUIN) 250 mg tabl 183.100986364 tacrolimus (PROGRAF) 1 mg capsule 49.550986372 mercaptopurine (6-MP) 50 mg tablet 45.400986414 octreotide (SandoSTATIN) injection 905.800986422 carbidopa-levodopa (SINEMET) 25 mg 14.100986448 diltiazem (TIAZAC) extended releas 25.550986471 valACYclovir (VALTREX) 500 mg table 80.200986927 amLODIPine (NORVASC) 2.5 mg tablet 17.700987024 ammonium lactate 12% (AMLACTIN or L 423.150987032 SUMAtriptan (IMITREX) tablet - 25 300.300987040 raloxifene (EVISTA) tablet - 60 mg 49.400987222 citalopram (CeleXA) 20 mg tablet 29.900987263 carvedilol (COREG) 12.5 mg tablet 21.650987313 tolterodine (DETROL) 2 mg tablet 37.750987719 ethiodized oil (LIPIODOL) 48% Injec 13,357.750987735 ethyl chloride topical spray 344.100987768 hydrocortisone 2.5% cream (30 gram) 122.250987842 metroNIDAZOLE 0.75% (FLAGYL) vagina 1,696.200987941 repaglinide (PRANDIN) tablet - 1 mg 7.500988014 montelukast (SINGULAIR) tablet - 10 62.750988030 methimazole (TAPAZOLE) tablet - 5 6.700988048 diltiazem (TIAZAC) extended releas 16.650988170 piperacillin-tazobactam (ZOSYN) inj 79.100988550 brinzolamide 1% (AZOPT) ophthalmic 4,343.350988576 alteplase (ACTIVASE) 1 mg/mL (100 m 117,220.800988592 aminocaproic acid (AMICAR) 500 mg t 271.200988600 anastrozole (ARIMIDEX) 1 mg tablet 133.200988725 alteplase (CATH-FLO) 2 mg injection 2,038.750988758 sodium hyaluronate (DUOVISC) ophtha 2,515.300988766 leucovorin 25 mg tablet 142.650988782 celecoxib (CeleBREX) capsule - 100 51.150988816 onabotulinumtoxinA (BOTOX) 100 unit 7,712.30

0988840 topiramate (TOPAMAX) 100 mg tablet 77.300988972 lidocaine topical 5% (LIDODERM) pat 103.900989376 buPROPion (WELLBUTRIN) 75 mg table 8.850989384 buPROPion (WELLBUTRIN) 100 mg tabl 11.800989426 enoxaparin (LOVENOX) injection - 6 80.200989434 enoxaparin (LOVENOX) injection - 8 211.800989442 enoxaparin (LOVENOX) injection - 10 133.750989459 oseltamivir (TAMIFLU) capsule - 75 171.600989517 tiZANidine (ZANAFLEX) 4 mg tablet 19.600989533 venlafaxine (EFFEXOR) 37.5 mg table 22.200989608 indocyanine green (IC GREEN) 25 mg 1,176.500989624 pioglitazone (ACTOS) tablet - 15 mg 77.800989657 mupirocin 2% (BACTROBAN) ointment - 949.000989723 eptifibatide (INTEGRILIN) infusion 7,246.750989731 propofol (DIPRIVAN) injection - 10 189.850989830 perphenazine (TRILAFON) tablet - 2 19.400990192 tenecteplase (TNKase) injection - 5 65,718.450990200 zolpidem (AMBIEN) 5 mg tablet 51.300990218 clopidogrel (PLAVIX) 75 mg tablet 4.600990234 HYDROcodone-acetaminophen (NORCO) 13.450990259 oxyCODONE (OXY IR) 5 mg tablet 6.900990309 linezolid (ZYVOX) IVPB - 600 mg/D5W 253.100990481 etomidate (AMIDATE) injection - 2 m 130.650990499 pantoprazole (PROTONIX) injection - 68.000990572 vitamin B complex with vitamin C (T 0.500990598 budesonide (PULMICORT) inhalation s 104.500990614 FLUoxetine (PROzac) capsule - 20 mg 27.600991026 tobramycin-dexamethasone (TOBRADEX) 724.950991042 caffeine citrate 20 mg/mL IV Syring 319.700991059 cefTRIAXone (ROCEPHIN) injection - 12.150991109 pravastatin (PRAVACHOL) tablet - 20 7.500991117 ofloxacin (FLOXIN) 0.3% OTIC Soluti 1,746.500991216 levalbuterol (XOPENEX) inhalation s 22.250991224 levalbuterol (XOPENEX) inhalation s 22.250991299 pamidronate (AREDIA) injection - 9 1,246.200991331 entacapone (COMTAN) 200 mg tablet 45.300991349 vitamin E 450 mg (1,000 units) caps 3.650991372 dorzolamide 2%-timolol 0.5% (COSOPT 1,354.200991406 voriconazole (VFEND) 200 mg Injecti 1,693.650991455 divalproex (DEPAKOTE ER) 500 mg ext 45.250991463 divalproex (DEPAKOTE ER) 250 mg ext 6,812.650991844 racepinephrine 2.25% inhalation sol 11.100991869 morphine injection - 2 mg/mL (1 m 38.250991877 ciprofloxacin 0.3% (CILOXAN) ophtha 139.900991943 ziprasidone (GEODON) 20 mg capsule 99.500991976 OLANZapine (ZyPREXA Zydis) oral dis 777.000991984 cyanocobalamin (VITAMIN B-12) 100 m 3.40

0991992 AQUAPHOR ORIGINAL FORMULA 396 gram 124.350992024 OLANZapine (ZyPREXA) tablet - 2.5 124.300992123 midazolam (VERSED) 10 mg/5 mL Syrup 81.450992156 budesonide (PULMICORT) inhalation s 123.050992172 naproxen (NAPROSYN) 250 mg tablet 8.600992206 sodium chloride (AYR SALINE NASAL G 34.200992214 acetaminophen (TYLENOL) 80 mg supp 0.010992222 cadexomer iodine 0.9% (IODOFLEX GEL 195.200992248 propofol (DIPRIVAN) injection - 10 285.300992339 fondaparinux (ARIXTRA) 2.5 mg/0.5 m 303.350992388 clindamycin (CLEOCIN) IVPB - 900 mg 173.750992396 perflutren lipid microspheres (DEFI 721.200992412 hepatitis A (HAVRIX) 1440 units/mL 924.900992453 celecoxib (CeleBREX) capsule - 200 83.700992487 acetylcysteine 20% (ACETADOTE) 30 m 2,504.200992503 levoFLOXacin (LEVAQUIN) IVPB - 250 53.300992511 meloxicam (MOBIC) 7.5 mg tablet 35.200992552 fentaNYL (DURAGESIC) patch 12 mcg/ 225.400992560 HYDROmorphone (DILAUDID) 6 mg/30 mL 93.150992586 cyanocobalamin (VITAMIN B-12) 1,000 2.400992594 salmeterol (SEREVENT) DISKUS - 50 m 2,536.800992628 lidocaine topical 2% (XYLOCAINE) je 86.600992719 megestrol (MEGACE) oral liquid - 40 50.300992743 sorbitol 70% Cup 30 mL 20.650992768 ibuprofen (MOTRIN) oral liquid - 10 10.450992784 tigecycline (TYGACIL) injection - 5 1,587.300992842 DOBUTamine 500 mg/250 mL D5W infusi 464.800992859 lidocaine (LMX) 4% cream (5 gram) 73.300992867 barium sulfate 2.1% (READI-CAT 2) o 100.550992909 DOPamine 400 mg/250 mL D5W infusion 121.800992958 aspirin-dipyridamole (AGGRENOX) 25 92.750992982 levETIRAcetam (KEPPRA) 100 mg/mL (5 73.300993022 metoprolol tartrate (LOPRESSOR) 25 2.700993030 fluticasone-salmeterol 100 mcg-50 m 1,717.200993048 levOCARNitine (CARNITOR) 100 mg/mL 16.500993063 heparin 10 units/mL Flush Injection 8.000993097 fluticasone-salmeterol 250 mcg-50 m 1,715.650993139 DOPamine 32 mg in Dextrose 5% 20 mL 137.300993154 fluticasone-salmeterol 500 mcg-50 m 2,797.200993162 benzocaine 20% (HURRICAINE) topical 416.150993261 sodium hyaluronate (HEALON 5) ophth 1,632.150993311 desmopressin (DDAVP) nasal spray - 2,733.400993329 lidocaine 0.5% (XYLOCAINE) 50 mL In 73.850993345 esmolol (BREVIBLOC) 2,500 mg/250 mL 6,229.500993360 bivalirudin (ANGIOMAX) 250 mg injec 12,623.700993378 zonisamide (ZONEGRAN) 100 mg capsul 10.050993394 diphenhydrAMINE 2% (BENADRYL) cream 44.30

0993402 caffeine with sodium benzoate 500 m 255.150993436 calcitonin (MIACALCIN) nasal spray 1,315.800993444 lidocaine-EPINEPHrine 0.5%-1:200,00 81.600993469 erythromycin 0.5% ophthalmic ointme 137.800993485 memantine (NAMENDA) 5 mg tablet 10.600993501 bupivacaine 0.5% injection - 50 mL 149.200993519 enoxaparin (LOVENOX) injection - 3 284.850993527 ondansetron (ZOFRAN ODT) orally dis 247.450993543 iron sucrose (VENOFER) 20 mg/mL (5 666.000993576 metoprolol (TOPROL XL) 25 mg extend 11.950993584 escitalopram (LEXAPRO) 10 mg tablet 58.200993634 oxybutynin (DITROPAN XL) extended r 38.600993659 tiotropium (SPIRIVA) capsule for in 209.850993717 levoFLOXacin (LEVAQUIN) IVPB - 750 83.150993725 piperacillin-tazobactam (ZOSYN) inj 90.600993774 levoFLOXacin (LEVAQUIN) 750 mg tabl 392.850993790 ezetimibe (ZETIA) 10 mg tablet 125.400993808 lidocaine 0.5% (XYLOCAINE MPF) 50 m 167.650993816 albuterol 0.042% 1.25 mg/3 mL inhal 18.450993824 sterile water for injection - 100 m 3.500993857 pregabalin (LYRICA) capsule - 25 mg 70.000993881 sodium chloride 3% Inhalation (15 m 9.950993899 hyaluronidase (AMPHADASE/HYLENEX) i 743.300993907 lamoTRIgine (LaMICtal) 25 mg tablet 2.300993915 pregabalin (LYRICA) capsule - 50 mg 93.550993931 albuterol 0.5% 2.5 mg/0.5 mL inhala 10.000993949 calcium carbonate (TUMS) 500 mg (2 0.750993972 pregabalin (LYRICA) capsule - 75 mg 10.250993998 clindamycin (CLEOCIN) IVPB - 600 mg 142.300994525 octreotide (SandoSTATIN) injection 132.450994541 vancomycin IVPB - 1 gm/D5W 200 mL 306.900994558 nystatin oral liquid - 500,000 unit 11.250994681 piperacillin-tazobactam (ZOSYN) IVP 203.250994707 labetalol (TRANDATE) 5 mg/mL (4 mL) 98.550994723 sodium chloride 0.9% (SALINE FLUSH) 40.550994749 piperacillin-tazobactam (ZOSYN) IVP 304.950994764 magnesium hydroxide (MOM) oral liqu 9.250994772 valsartan (DIOVAN) 160 mg tablet 23.150994798 thrombin topical 5,000 units KIT 975.150994806 piperacillin-tazobactam (ZOSYN) IVP 386.400994814 furosemide (LASIX) 10 mg/mL Oral S 16.500994855 ropivacaine (NAROPIN) 0.5% injecti 84.250994863 misoprostol (CYTOTEC) tablet - 25 6.900994871 haloperidol (HALDOL) 2 mg/mL Oral S 16.500994954 zidovudine (RETROVIR) 300 mg tablet 27.500995027 adenosine (ADENOSCAN) 3 mg/mL (20 m 879.150995035 arformoterol (BROVANA) 15 mcg/2 mL 167.85

0995084 ferric subsulfate (MONSELS SOLUTION 164.750995100 cetirizine (ZyrTEC) 1 mg/mL Oral S 16.500995134 niacin (NIASPAN) extended release t 28,948.800995142 carvedilol (COREG) 3.125 mg tablet 23.700995167 azithromycin (ZITHROMAX) 40 mg/mL 16.500995183 albuterol (PROAIR or VENTOLIN HFA) 293.750995209 heparin infusion - 25,000 units/D5W 135.900995282 caffeine citrate 20 mg/mL Oral Syri 155.400995324 lidocaine topical 2% (XYLOCAINE) vi 12.000995357 risperiDONE (RISPERDAL) 1 mg/mL Ora 56.400995373 clindamycin (CLEOCIN) 2% vaginal cr 999.600995399 dextrose 40% (GLUTOSE 15) oral gel 109.500995415 amoxicillin-clavulanate (AUGMENTIN) 16.500995423 sucralfate (CARAFATE) oral liquid - 87.400995449 phenylephrine (NEO-SYNEPHRINE) 10 m 294.000995472 cephalexin (KEFLEX) 50 mg/mL Oral S 16.500995480 voriconazole (VFEND) 200 mg tablet 48.900995498 temazepam (RESTORIL) 7.5 mg capsule 92.700995514 levoFLOXacin (LEVAQUIN) IVPB - 500 27.750995555 carbidopa-levodopa (SINEMET CR) 25 10.350995597 ferrous sulfate drops 15 mg/mL Oral 16.500995605 permethrin (RID or NIX) 1% lotion ( 111.900995670 sodium thiosulfate injection - 250 1,078.950995704 atovaquone (MEPRON) 750 mg/5 mL ora 372.700995761 calcium gluBIONate 23 mg/mL Oral Sy 16.500995803 estradiol (ESTRACE) 0.01% vaginal c 3,770.250995829 rOPINIRole (REQUIP) tablet - 2 mg 27.850995845 azithromycin (ZITHROMAX) 600 mg tab 206.800995902 QUEtiapine (SEROquel) tablet - 100 6.300995969 QUEtiapine (SEROquel) tablet - 25 41.250995985 triamcinolone (KENALOG) 0.025% crea 49.500996025 atorvastatin (LIPITOR) 40 mg tablet 9.550996124 digoxin (LANOXIN) 50 mcg/mL Oral S 27.550996132 clopidogrel (PLAVIX) 300 mg tablet 213.850996140 cefuroxime (CEFTIN) 250 mg tablet 48.850996165 ferrous sulfate oral liquid - 300 m 6.350996223 digoxin (LANOXIN) 125 mcg/ 2.5 mL E 68.800996249 erythromycin ethylsuccinate (EES) 4 44.100996264 carvedilol (COREG) 25 mg tablet 23.350996272 coagulation factor VIIA recombinant 53,280.000996280 docusate sodium (COLACE) oral liqui 7.800996355 coagulation factor VIIA recombinant 26,640.000996397 niCARdipine (CARDENE) 2.5 mg/mL (10 268.300996447 tranexamic acid 100 mg/mL (10 mL) I 666.000996470 ipratropium 0.02% (ATROVENT) inhala 14.700996488 Surgicel 2 x 14 gauze 940.350996504 Surgicel 2 x 3 gauze 651.65

0996553 FLOSEAL Hemostatic Matrix 10 mL 4,707.400996587 OLANZapine (ZYPREXA) 5 mg/mL Inject 944.200996603 levETIRAcetam (KEPPRA) 500 mg table 2.800996629 immune globulin (PRIVIGEN) 10% 10 g 18,115.200996637 fibrin sealant (TISSEEL DUPLOJECT) 2,031.100996694 DAPTOmycin (CUBICIN) injection - 50 2,397.600996728 rOPINIRole (REQUIP) tablet - 0.25 m 6.550996744 ARIPiprazole (ABILIFY) 10 mg tablet 353.800996793 atazanavir (REYATAZ) 300 mg capsule 592.900996801 abacavir (ZIAGEN) 300 mg tablet 111.500996843 sodium chloride 0.9% solution for i 1.800996868 linezolid (ZYVOX) 600 mg tablet 2,038.650996900 tobramycin 10 mg/mL IV Syringe 49.500996926 lopinavir-ritonavir (KALETRA) 200-5 77.900997056 permethrin 5% (ELIMITE) cream - 60 1,345.350997148 EPINEPHrine PF 1 mg/mL (1 mL) injec 194.250997163 meropenem (MERREM) injection - 500 79.950997197 nafcillin 40 mg/mL IV Syringe 49.500997254 ceFAZolin (ANCEF) 330 mg/mL IM Syri 49.500997262 morphine preservative free 1 mg in 111.000997270 isoniazid 10 mg/mL Oral Syringe 16.500997312 inFLIXimab (REMICADE) 100 mg inject 13,605.500997411 sildenafil (REVATIO) tablet - 20 mg 244.750997429 epoetin alfa PF 2,000 units/mL IV S 425.150997544 influenza PF vaccine (FLUARIX) - 0. 167.300997627 regadenoson (LEXISCAN) injection - 3,333.350997791 argatroban (ACOVA) 100 mg/mL (2.5 m 6,660.000997841 digoxin (LANOXIN) 10 mcg/mL IV Syri 145.900997882 NICU Admission TPN D5W 250 mL bag 669.700998005 OXcarbazepine (TRILEPTAL) tablet - 29.350998013 adenosine (ADENOSCAN) 3 mg/mL (30 m 2,610.750998120 ceFAZolin (ANCEF) 20 mg/mL IV Syri 49.500998153 morphine preservative free 10 mg in 106.600998229 cefotaxime (CLAFORAN) 50 mg/mL IV 49.500998260 alprostadil (PGE-1) 500 mcg/D5W 50 65,490.000998286 fat emulsion (INTRALIPID) 20% IV Sy 49.500998302 penicillin G potassium 100,000 unit 49.500998336 fentaNYL 200 mcg in Dextrose 5% 20 543.900998351 phenytoin (DILANTIN) 10 mg/mL IV Sy 49.500998419 aminophylline 5 mg/mL IV Syringe 49.500998476 cefTRIAXone (ROCEPHIN) 40 mg/mL IV 164.300998526 cefuroxime (ZINACEF) 30 mg/mL IV Sy 49.500998641 metoclopramide (REGLAN) 1 mg/mL Ora 16.500998690 metoclopramide (REGLAN) 1 mg/mL IV 49.500998724 dexamethasone (DECADRON) 0.1 mg/mL 16.500998815 ampicillin-sulbactam (UNASYN) 30 mg 49.500998872 digoxin (LANOXIN) 100 mcg/mL IV Syr 1,458.55

0998997 midazolam (VERSED) 2 mg in Dextrose 49.500999045 midazolam (VERSED) 2 mg/mL Oral Syr 16.500999078 risperiDONE (RISPERDAL) tablet - 0. 43.250999094 clotrimazole (MYCELEX) oral lozenge 38.150999300 hydrocortisone 0.5% ointment - 30 g 44.000999318 sulfamethoxazole-trimethoprim (BACT 16.500999326 sodium bicarbonate 150 mEq in 1000 142.000999334 lansoprazole (PREVACID) 3 mg/mL Or 16.500999458 Ibutilide (CORVERT) injection - 0.1 6,024.200999508 imatinib (GLEEVEC) 100 mg tablet 3,554.700999607 iodine 5%-potassium iodide 10% (LUG 234.450999623 SUMAtriptan (IMITREX) tablet - 100 279.100999672 tacrolimus (PROGRAF) injection - 5 2,197.950999680 ceFAZolin (ANCEF) IVPB - 1 gm/D5W 5 59.700999706 ivermectin (STROMECTOL) 3 mg tablet 55.200999730 cefepime (MAXIPIME) injection - 1 g 225.750999755 lamiVUDine (EPIVIR) 150 mg tablet 79.400999813 pyridostigmine (MESTINON) tablet - 14.200999821 triamcinolone (KENALOG) 0.5% cream 125.900999870 valGANciclovir (VALCYTE) 450 mg tab 735.150999888 cilostazol (PLETAL) 50 mg tablet 24.800999904 lidocaine 2% (XYLOCAINE MPF) injec 45.200999979 varicella (VARIVAX) injection - 0.5 1,432.600999987 clobetasol 0.05% (TEMOVATE) 15 gm c 1,423.451000041 sodium chloride 0.9% 1000 mL LVP 128.851000058 lactated ringers LVP - 1000 mL 128.851000066 dextrose 5%-NaCl 0.45% LVP - 1000 m 128.851000082 dextrose 10% IVPB - 250 mL 128.851000165 sodium chloride 0.9% irrigation - 1 44.401000181 sodium chloride 0.45% 1000 mL LVP 128.851000199 sodium chloride 0.9% 500 mL IVPB 128.851000207 sodium chloride 0.9% 250 mL IVPB 128.851000231 dextrose 5% 1000 mL LVP 128.851000348 sterile water for irrigation - 1000 128.851000363 dextrose 5% 500 mL IVPB 128.851000371 dextrose 5% 250 mL IVPB 128.851000579 TPN - Neonatal 669.701000603 potassium chloride injection - 2 mE 43.201000611 potassium chloride injection - 2 mE 26.651000751 sterile water for injection - 10 mL 1.051000801 sodium chloride 0.9% injection - 10 10.351000934 sodium chloride 0.9% 100 mL IVPB 128.851001007 sterile water for irrigation - 1000 20.801001064 folic acid injection - 5 mg/mL (10 485.651001080 dextrose 5%-lactated ringers LVP - 128.851001114 potassium PHOSPHATE injection - 3 m 139.901001148 dextrose 5% 50 mL IVPB 128.85

1001189 dextrose 5%-NaCl 0.9% LVP - 1000 mL 128.851001197 dextrose 5% 100 mL IVPB 128.851001239 sodium chloride 0.9% 50 mL IVPB 128.851001999 TPN - Adult 1,053.801002203 sodium chloride 0.9% irrigation - 3 99.901003300 sodium chloride 3% (HYPERTONIC SALI 128.851003326 electrolyte (PLASMA-LYTE A / NORMOS 128.851003409 dextrose 10% LVP - 1000 mL 128.851003417 dextrose 5%-NaCl 0.45% IVPB - 500 m 128.851003425 dextrose 5%-NaCl 0.9% IVPB - 500 mL 128.851003441 NICU Admission TPN D10W 250 mL bag 669.701003508 sodium chloride 0.45%-KCl 20 mEq LV 128.851003540 dextrose 5%-NaCl 0.45%-KCl 30 mEq/L 128.851003557 dextrose 5%-NaCl 0.45%-KCl 40 mEq/L 128.851003565 dextrose 12.5% 250 mL 128.851003581 dextrose 5%-NaCl 0.9%-KCl 40 mEq/L 108.701003607 dextrose 5%-KCl 20 mEq/L LVP - 1000 128.851003615 methylnaltrexone (RELISTOR) 12 mg/0 1,332.001003623 cholecalciferol (Vitamin D3) 25 mcg 0.551003656 dextrose 5%-lactated ringers-KCl 20 128.851003664 levETIRAcetam (KEPPRA) oral liquid 415.001003698 dextrose 5%-NaCl 0.9%-KCl 20 mEq/L 128.851003706 potassium chloride IVPB - 20 mEq/SW 35.451003730 oxytocin (PITOCIN) LVP - 20 units/l 88.801003748 sodium chloride 0.9%-KCl 20 mEq LVP 128.851003755 sodium chloride 0.9%-KCl 40 mEq LVP 128.851003763 tacrolimus (PROGRAF) capsule - 0.5 40.201003771 dexamethasone (INTENSOL) 1 mg/mL CO 16.501003789 magnesium sulfate IVPB - 4 gm/SW 1 105.901003797 dextrose 5%-0.45% NaCl - KCl 20 mEq 128.851003839 magnesium sulfate infusion - 20 gm/ 82.051003862 polyethylene glycol 3350 (MIRALAX) 12.801003870 fondaparinux (ARIXTRA) 10 mg/0.8 mL 779.251003912 dexmedetomidine (PRECEDEX) 100 mcg/ 254.301003961 dexamethasone (DECADRON) 1 mg table 4.701004001 dextrose 5%-0.45% NaCl - KCl 10 mEq 128.851004019 fondaparinux (ARIXTRA) 7.5 mg/0.6 m 1,427.601004027 cholecalciferol (Vitamin D3) 10 mcg 2.551004068 heparin PF (HEPARIN FLUSH) injectio 7.851004084 DULoxetine (CYMBALTA) capsule - 60 65.801004191 fluconazole (DIFLUCAN) IVPB - 100 m 122.701004290 immune globulin (PRIVIGEN) 10% 5 gr 8,658.001004373 insulin detemir (LEVEMIR) 100 units 66.101004423 prasugrel (EFFIENT) tablet - 10 mg 183.251004480 ACD Solution A 1,000 mL 128.851004498 emtricitabine-tenofovir (TRUVADA) t 609.101004514 dronedarone (MULTAQ) tablet - 400 m 114.70

1004522 pancrelipase (CREON 12,000) capsule 34.751004530 mannitol 20% (OSMITROL) infusion - 395.001004548 raltegravir (ISENTRESS) tablet - 40 285.851004720 DULoxetine (CYMBALTA) capsule - 20 19.401004753 fomepizole (ANTIZOL) 1.5 gram/1.5 19,980.001004779 DULoxetine (CYMBALTA) capsule - 30 87.201004787 cefepime (MAXIPIME) injection - 2 g 448.001004803 potassium acid phosphate (K-PHOS OR 5.351004837 fondaparinux (ARIXTRA) 5 mg/0.4 mL 1,507.401004845 hydroxocobalamin (CYANOKIT) 5 gram 9,166.401004860 aztreonam (AZACTAM) 1 gram/D5W 50 m 443.451004878 buPROPion (WELLBUTRIN XL) 150 mg/24 57.951004886 nystatin-triamcinolone (MYCOLOG-II) 1,243.801004902 acetaminophen (OFIRMEV) 1 gram/100 161.451004936 desmopressin (DDAVP) 0.1 mg tablet 58.701004944 mycophenolic acid (MYFORTIC) delaye 50.751004993 omega-3 acid ethyl esters (LOVAZA) 22.951005024 colistimethate (COLISTIN) 150 mg In 372.851005032 buPROPion (WELLBUTRIN SR) 100 mg ex 18.751005180 ranolazine (RANEXA) extended releas 71.301005198 vancomycin IVPB - 750 mg/D5W 150 m 321.801005222 morphine (ASTRAMORPH) injection - 0 78.851005230 rifaximin (XIFAXAN) tablet - 550 mg 373.251005271 pneumococcal 13-valent (PREVNAR 13) 2,820.401005370 tolvaptan (SAMSCA) 15 mg tablet 6,929.101005388 diclofenac sodium (VOLTAREN) 50 mg 16.351005537 aztreonam (AZACTAM) 2 gram/D5W 50 m 887.451005552 amiodarone (NEXTERONE) 150 mg/D5W 1 462.101005578 oseltamivir (TAMIFLU) 6 mg/mL Oral 26.801005669 isoflurane (FORANE) anesthesia inha 166.501005719 sevoflurane (ULTANE) 4.201005727 fidaxomicin (DIFICID) tablet - 200 2,324.101005735 levothyroxine (SYNTHROID) 100 mcg I 998.151005883 sennosides-docusate (SENNA PLUS) 50 1.901005966 magnesium sulfate IVPB - 2 gm/SW 5 213.651006014 lidocaine 1% (XYLOCAINE) 10 mL Inje 28.201006063 lacosamide (VIMPAT) 50 mg tablet 107.351006162 lacosamide (VIMPAT) 200 mg/20 mL In 1,088.501006345 povidone iodine (BETADINE) 10% Topi 20.851006402 colistimethate (COLY-MYCIN M) injec 373.001006428 bupivacaine liposome (EXPAREL) 1.3% 3,496.301006451 iohexol (OMNIPAQUE) 180 mg/mL (20 m 694.651006469 palonosetron (ALOXI) 0.25 mg/5 mL I 966.951006477 fosaprepitant (EMEND IV) 150 mg Inj 865.801006501 iohexol (OMNIPAQUE) 240 mg/mL (10 m 675.901006527 micafungin (MYCAMINE) injection - 1 2,490.851006543 sodium chloride 0.9% irrigation - 22.20

1006550 iohexol (OMNIPAQUE) 240 mg/mL (20 m 714.401006568 rivaroxaban (XARELTO) tablet - 10 m 148.001006576 rivaroxaban (XARELTO) tablet - 15 m 148.001006600 iohexol (OMNIPAQUE) 350 mg/mL (50 m 672.351006626 linagliptin (TRADJENTA) 5 mg tablet 158.601006659 iohexol (OMNIPAQUE) 350 mg/mL (100 1,340.901006667 chlorhexidine gluconate 0.12% (PERI 14.701006691 ticagrelor (BRILINTA) 90 mg tablet 89.951006709 iohexol (OMNIPAQUE) 350 mg/mL (150 1,851.501006725 triamcinolone (KENALOG) 0.1% ointme 61.951006741 docusate sodium (VACUANT MINI ENEMA 5.001006808 iodixanol (VISIPAQUE) 320 mg/mL 50 763.701006857 iodixanol (VISIPAQUE) 320 mg/mL 150 1,986.351006899 nitroglycerin 100 mcg/mL (10 mL) in 49.501006949 milrinone (PRIMACOR) 20 mg/100 mL D 202.501006956 gadobenate dimeglumine (MULTIHANCE) 774.701007004 gadobenate dimeglumine (MULTIHANCE) 1,133.701007103 tretinoin 10 mg capsule 336.601007129 acetylcysteine (MUCOMYST) 100 mg/mL 16.501007137 tocilizumab (ACTEMRA) 400 mg Inject 30,713.301007178 sevelamer carbonate (RENVELA) 800 m 67.701007210 leuprolide (LUPRON DEPOT) 22.5 mg D 49,856.651007251 ceftaroline fosamil (TEFLARO) injec 2,687.001007269 barium sulfate (E-Z PAQUE) 96% 176 43.001007319 barium sulfate (E-Z HD) 98% 135 mL 74.951007335 sodium chloride 0.9% irrigation - 44.401007368 barium sulfate (E-Z PASTE) 60% 454 564.301007376 PHENobarbital tablet - 32.4 mg 5.101007418 barium sulfate (E-Z DISK) 700 mg ta 30.851007467 citric acid-simethicone-sodium bica 31.451007541 gadobenate dimeglumine (MULTIHANCE) 394.951007574 piperacillin-tazobactam (ZOSYN) inj 76.351007582 epoprostenol (FLOLAN) 1.5 mg Inject 821.701007616 benzocaine (HURRICAINE ONE) 20% Ora 129.901007624 iodixanol (VISIPAQUE) 320 mg/mL 100 1,526.251007632 iohexol (OMNIPAQUE) 300 mg/mL (50 m 615.501007640 EUCERIN cream - 120 gm 46.651007665 sevelamer carbonate (RENVELA) 800 m 126.001007681 iohexol (OMNIPAQUE) 300 mg/mL (100 1,208.801007764 rivaroxaban (XARELTO) tablet - 20 m 208.701007806 heparin 25 units D5W 50 mL bag 111.001007814 heparin 25 units NaCl 0.45% 50 mL b 111.001007897 sterile water for injection LVP - 1 128.851007954 apixaban (ELIQUIS) 5 mg tablet 110.801007962 factor IX complex human (PROFILNINE 8,991.001007996 tetanus/diphtheria/acellular pertus 509.301008069 DOPamine 40 mg/mL Injection (10 mL) 27.45

1008077 mesalamine (DELZICOL) delayed relea 51.701008085 HYDROcodone-acetaminophen (NORCO) 7.701008119 calamine 8% lotion - 6 oz 27.651008135 HYDROcodone-acetaminophen (NORCO) 9.851008143 prothrombin complex human (KCENTRA) 15,373.501008150 apixaban (ELIQUIS) 2.5 mg tablet 110.801008168 desmopressin (DDAVP) injection - 4 6,235.551008259 dexmedetomidine (PRECEDEX) 200 mcg/ 739.951008333 benzocaine-menthol (CEPACOL) lozeng 1.851008358 hydrocortisone (Solu-CORTEF) inject 211.251008382 lidocaine-prilocaine (EMLA) 2.5%-2. 110.101008465 sulfamethoxazole-trimethoprim (BACT 167.101008515 ascorbic acid (VITAMIN C) 500 mg/mL 204.251008580 bupivacaine 0.75% preservative-free 87.251008598 oseltamivir (TAMIFLU) capsule - 30 157.401008622 atropine 0.4 mg/mL (20 mL) injectio 467.551008747 hetastarch 6% (HESPAN) infusion - 3 167.101008796 dextrose 20% 250 mL 128.851008820 bupivacaine 0.25%-EPINEPHrine 1:200 70.751008960 amiodarone (CORDARONE) 50 mg/mL ( 9 58.401008986 fibrin sealant (TISSEEL FROZEN SYRI 3,423.701009000 ceftaroline fosamil (TEFLARO) injec 2,687.001009018 sodium chloride 0.45% 500 mL IVPB 128.851009067 tenofovir (VIREAD) tablet - 300 mg 405.301009075 rasburicase (ELITEK) 1.5 mg Injecti 11,379.151009083 ceFAZolin (ANCEF) injection - 10 gm 113.251009166 diazoxide (PROGLYCEM) 50 mg/mL Oral 137.501009190 dornase alfa (PULMOZYME) 2.5 mg inh 1,457.851009216 bupivacaine 0.5%-EPINEPHrine 1:200, 28.001009240 cinacalcet (SENSIPAR) 30 mg tablet 340.301009406 ARISTA AH hemostat kit 3 gram 2,333.251009489 ARIPiprazole (ABILIFY) 5 mg tablet 356.451009513 vitamin E (AQUASOL E) 22.5 mg/mL (5 9.101009539 ceFAZolin (ANCEF) IVPB - 2 gm/D5W 5 97.251009562 betaxolol (BETOPTIC) 0.5% Ophthalmi 735.601009604 vancomycin injection - 5 gm 665.901009638 sorbitol 3% Urologic Irrigation 3,0 266.401009729 romiPLOStim (NPLATE) 250 mcg inject 21,184.151009836 vancomycin 500 mg RETENTION ENEMA 66.601009844 HYDROcodone-acetaminophen (HYCET) o 60.901009943 oxyCODONE-acetaminophen (PERCOCET 1 39.451009992 amphotericin B liposomal (AMBISOME) 2,178.401010008 dextrose 5% 30 mL Flush 49.501010057 TPN - CLINIMIX (Amino Acids 4.25% w 421.801010065 TPN - CLINIMIX (Amino Acids 5% with 477.301010073 levETIRAcetam (KEPPRA) IVPB - 500 364.451010081 levETIRAcetam (KEPPRA) IVPB - 1,000 286.40

1010115 dolutegravir (TIVICAY) 50 mg tablet 811.001010131 phenylephrine-mineral oil (PREPARAT 55.401010172 TPN - CLINIMIX E (Amino Acids 5% wi 477.301010180 TPN - CLINIMIX (Amino Acids 5% with 477.301010248 cefTAZidime-avibactam (AVYCAZ) inje 3,986.051010255 TPN - CLINIMIX E (Amino Acids 5% wi 521.701010263 nitroglycerin 25 mg in D5W 250 mL 233.101010305 TPN - CLINIMIX E (Amino Acids 4.25% 444.001010396 heparin 25 units NA ACETATE 0.45% 5 114.001010412 meropenem (MERREM) injection - 1 gm 266.401010453 influenza PF vaccine HIGH DOSE (FLU 712.751010578 tirofiban (AGGRASTAT) 12.5 mg/250 m 6,895.901010669 isavuconazonium (CRESEMBA) 186 mg c 1,067.151010701 acetylcysteine (MUCOMYST) 200 mg/mL 16.501010743 idaruCIZUMAB (PRAXBIND) 2.5 gram In 28,499.901010834 lamiVUDine (EPIVIR) 10 mg/mL Oral S 5.551010917 theophylline (THEO-24) 100 mg/24 ho 20.051010941 abacavir-lamivudine-zidovudine (TRI 321.651010958 acetylcysteine 20% (MUCOMYST) 4 mL 166.151010966 acyclovir (ZOVIRAX) 1000 mg injecti 333.001010974 acyclovir 5% (ZOVIRAX) 15 gram oint 4,017.151010982 albendazole (ALBENZA) 200 mg tablet 1,358.501011006 albuterol-ipratropium (DUONEB) 2.5 24.551011030 ampicillin 250 mg injection 46.501011048 AQUAPHOR ORIGINAL FORMULA 10 gram o 20.551011055 atorvastatin (LIPITOR) 80 mg tablet 21.601011063 azithromycin (ZITHROMAX) 500 mg tab 76.301011071 bacitracin zinc ointment - 500 unit 39.451011089 bacitracin-neomycin-polymyxin B (NE 2.601011097 bacitracin-polymyxin B (POLYSPORIN 2.801011139 bupivacaine 0.25%-EPINEPHrine 1:200 107.901011147 calcitriol (ROCALTROL) injection - 83.001011154 calcium carbonate-vitamin D 600 mg- 2.001011162 cardioplegia, blood - INDUCTION 4:1 1,821.751011170 cardioplegia, blood - MAINTENANCE 4 1,821.751011188 cardioplegia, del Nido formula - 10 643.801011196 cefotaxime (CLAFORAN) injection - 20.001011204 chlorhexidine gluconate 4% (HIBICLE 77.501011220 cisatracurium (NIMBEX) 2 mg/mL ( 5 186.501011238 clindamycin (CLEOCIN) IVPB - 300 mg 109.251011246 cloZAPine (CLOZARIL) 50 mg tablet 18.351011253 danazol 100 mg capsule 100.701011279 dexamethasone (DECADRON) injection 26.001011287 diatrizoate meglumine (CYSTOGRAFIN) 735.951011311 dibucaine 1% (NUPERCAINAL) rectal o 79.951011329 diltiazem (CARDIZEM) 5 mg/mL (25 mL 77.151011337 diphenhydramine-lidocaine 2% viscou 4.55

1011345 donepezil (ARICEPT) tablet - 10 mg 8.651011352 doripenem (DORIBAX) injection - 250 255.301011360 doripenem (DORIBAX) injection - 500 556.001011378 efavirenz (SUSTIVA) capsule - 200 m 124.801011386 efavirenz-emtricitabine-tenofovir ( 983.601011394 emtricitabine (EMTRIVA) 10 mg/mL Or 1,679.451011402 enalaprilat (VASOTEC) injection - 1 104.601011410 enoxaparin (LOVENOX) injection - 12 317.701011428 eptifibatide (INTEGRILIN injection 2,081.701011444 ergoloid mesylates 1 mg tablet 90.001011451 fenofibrate tablet - 54 mg 8.801011469 fenofibrate tablet - 160 mg 32.001011477 ferric gluconate (FERRLECIT) inject 423.601011493 fibrin sealant (TISSEEL) topical - 8,399.401011501 fluocinonide 0.05% (LIDEX) topical 1,286.751011519 fosamprenavir (LEXIVA) 50 mg/mL Or 2,047.951011527 gentamicin IVPB - 80 mg/NS 50 mL 44.401011535 gentamicin IVPB - 100 mg/NS 100 mL 46.551011543 gentamicin IVPB - 120 mg/NS 100 mL 45.301011550 glycopyrrolate (ROBINUL) injection 306.401011568 guaiFENesin-codeine (CHERATUSSIN AC 7.851011576 heparin injection - 1,000 units/mL 3.201011584 hydrocortisone (CORTEF) 5 mg tablet 3.801011600 hypromellose 0.3% (GENTEAL TEARS) o 93.951011618 iohexol (OMNIPAQUE) 240 mg/mL (50 m 520.601011626 iohexol (OMNIPAQUE) 350 mg/mL (75 m 1,003.201011634 ketoconazole 2% (NIZORAL) cream - 1 343.001011642 lactobacillus acidophilus capsule - 1.201011659 lanthanum carbonate (FOSRENOL) 1000 124.501011667 levETIRAcetam (KEPPRA) 250 mg table 6.651011675 levobunolol 0.5% (BETAGAN) ophthalm 268.401011683 lidocaine 1% (XYLOCAINE MPF) 10 mL 68.851011691 lidocaine-EPINEPHrine 1%-1:200,000 137.201011709 lidocaine 2% (XYLOCAINE) injection 82.701011717 lidocaine 3.5% (AKTEN) ophthalmic g 324.151011725 lidocaine (LARYNG-O-JET) 4% 4 mL 266.401011733 lidocaine 5%-dextrose 7.5% injectio 91.951011741 pancrelipase (CREON 36,000) capsule 104.701011758 lisinopril (ZESTRIL) 2.5 mg tablet 7.601011766 LORazepam (ATIVAN) injection - 2 mg 90.351011774 magnesium sulfate IVPB - 1 gm/D5W 1.101011790 meperidine (DEMEROL) injection - 2 60.501011816 methotrexate injection - 25 mg/mL ( 120.351011824 methylnaltrexone (RELISTOR) injecti 1,332.001011832 metoclopramide (REGLAN) tablet - 5 3.701011857 mineral oil (FLEET MINERAL OIL) adu 23.651011865 modafinil (PROVIGIL) 100 mg tablet 293.10

1011873 morphine injection - 8 mg/mL (1 m 14.951011881 mupirocin 2% (BACTROBAN) nasal oint 197.751011899 naphazoline-pheniramine (NAPHCON-A) 36.951011907 naproxen (NAPROSYN) 375 mg tablet 11.001011949 oxymetazoline 0.05% (AFRIN) Nasal S 65.951011964 pantoprazole (PROTONIX GRANULES) gr 121.751011972 pantoprazole (PROTONIX) delayed rel 5.151011980 penicillin G potassium IVPB - 2 mil 117.151011998 potassium chloride (K-DUR) extended 7.551012004 propofol (DIPRIVAN) injection - 10 40.001012012 piperonyl butoxide-pyrethrins (RID 67.601012038 sincalide (KINEVAC) injection - 5 m 1,111.201012053 sodium hypochlorite 0.5% (DAKIN'S F 126.051012061 sodium nitrite injection - 30 mg/mL 1,078.951012079 sodium PHOSPHATE Injection - 3 mmol 142.951012087 sulindac (CLINORIL) tablet - 200 mg 13.351012111 triamcinolone (KENALOG) 0.1% topic 470.901012129 vancomycin 100 mg/mL Oral Syringe 8.051012137 vancomycin IVPB - 500 mg/D5W 100 m 87.951012160 vitamin B complex capsule 0.551012186 multivitamin tablet 0.351012194 vitamin B complex-vitamin C-folic a 1.601012202 ritonavir (NORVIR) tablet - 100 mg 102.801012251 zinc oxide-menthol (CALMOSEPTINE) o 55.501012277 zinc oxide 20% ointment - 60 gm 53.301012319 hydrOXYzine hydrochloride (ATARAX) 4.401012327 potassium phosphate-sodium phosphat 5.651012350 sulfacetamide 10%-prednisoLONE 0.25 208.151012368 psyllium (METAMUCIL) packet - 12 gm 3.801012434 cefTAZidime (FORTAZ) 40 mg/mL IV Sy 66.551012442 dexamethasone (DECADRON) 0.1 mg/mL 69.851012624 morphine preservative free 5 mg in 106.601012657 hepatitis B (ENGERIX-B) injection - 688.201012673 filgrastim-sndz (ZARXIO) injection 3,671.801012681 filgrastim-sndz (ZARXIO) injection 7,309.051012715 multivitamin with Iron (POLY VI SOL 69.201012756 polidocanol (ASCLERA) 1% Injection 366.301012764 sterile water for irrigation - 2000 128.851012780 glycopyrrolate (ROBINUL) injection 399.601012806 droxidopa (NORTHERA) 100 mg capsule 289.301012830 multivitamin pediatric (POLY VI SOL 16.501012848 potassium bicarbonate (EFFER-K) eff 5.351012855 potassium bicarbonate (EFFER-K) eff 5.351012863 loxapine (LOXITANE) capsule - 25 mg 21.351012871 sugammadex (BRIDION) 100 mg/mL Inje 1,464.351012921 succinylcholine (ANECTINE) injectio 138.751012939 ePHEDrine injection - 10 mg/mL (5 m 185.95

1012970 tetracaine 0.5% (PONTOCAINE) ophtha 1,634.951012996 ketorolac 0.5% (ACULAR) ophthalmic 1,171.051013077 tropicamide 1% (MYDRIACYL) ophthalm 118.251013085 methylene blue (PROVAYBLUE) 0.5% In 3,169.801013275 ferric carboxymaltose (INJECTAFER) 16,104.901013317 procainamide 100 mg/mL Injection (1 1,132.201013374 acetylcysteine 10% (MUCOMYST) 4 mL 110.651013481 doxycycline INTRAPLEURAL 321.801013549 paliperidone (INVEGA SUSTENNA) 234 0.011013564 JW ALTEPLASE 50 MG INJECTION 56,903.301013572 JW ALTEPLASE 100 MG INJECTION 113,806.651013606 paliperidone (INVEGA SUSTENNA) 156 0.011013762 sacubitril-valsartan (ENTRESTO) 24 113.051013770 sacubitril-valsartan (ENTRESTO) 49 113.051013846 fentaNYL 10 mcg/mL IV Syringe (1 m 49.501013853 morphine PF 0.5 mg/mL (ASTRAMORPH P 27.951014000 norepinephrine (LEVOPHED) 8 mg/250 205.351014109 dextrose 50% injection - 50 mL Vial 36.101014133 povidone iodine (BETADINE) 5% Ophth 171.201014208 dexamethasone (DECADRON) injection 69.801014430 carboxymethylcellulose 1% (CELLUVI 4.301014448 prednisoLONE sodium phosphate 3 mg/ 17.351014612 iothalamate (CYSTO CONRAY) 17.2% 2 335.801014687 ketamine 1 mg/mL IV Syringe 49.501014836 minocycline (MINOCIN) 100 mg Capsul 37.751014869 methadone 10 mg/mL Oral Syringe 16.501014885 tranexamic acid 1000 mg/100 mL IVPB 279.751014943 Investigational Drug - IVPB 0.011015213 remdesivir 100 mg Injection 6,349.201015528 caplacizumab-yhdp (CABLIVI) 11 mg I 97,236.001015602 gadobutrol (GADAVIST) 1 mmol/mL (10 1,105.601015603 ioversol (OPTIRAY) 350 mg/mL 150 mL 709.301015604 ioversol (OPTIRAY) 350 mg/mL 50 mL 253.101015627 epoetin alfa epbx (RETACRIT) inject 2,938.401015908 calcium GLUCONATE 20 mg/mL IV Syri 133.451016021 JW TENECTEPLASE 50 MG INJECTION 86,562.801016195 anastrozole 0.1 mg/mL Oral Syringe 23.001016690 mitoMYcin ophthalmic (MITOSOL) KIT 3,984.901016708 insulin regular (HumuLIN R) 100 uni 66.101016716 sterile water for irrigation - 250 38.851016724 sterile water for irrigation - 500 38.851016732 sterile water for irrigation - 1500 83.251016751 potassium chloride IVPB - 10 mEq/SW 45.551016757 chlordiazePOXIDE (LIBRIUM) capsule 6.901016765 chlordiazePOXIDE (LIBRIUM) capsule 7.451016781 bacitracin-neomycin-polymyxin B (NE 4.001016799 bismuth subgallate powder 822.55

1016807 desflurane (SUPRANE) 2,133.901016815 lactated ringers LVP - 250 mL 128.851016849 selegiline (ELDEPRYL) capsule - 5 m 25.601016856 sodium chloride 0.9% (15 mL) UD inh 5.351016880 sodium chloride 0.9% irrigation - 1 83.251016906 tincture benzoin spray 120 mL 99.901016955 glycine 1.5% irrigation - 3000 mL 166.501016963 benazepril (LOTENSIN) 5 mg tablet 11.701017128 indomethacin (INDOCIN) 5 mg/mL Oral 124.901017151 niCARdipine (CARDENE) capsule - 20 24.751017169 niCARdipine (CARDENE) capsule - 30 35.451017334 mineral oil, light (MURI-LUBE) - 10 185.451017615 lurasidone (LATUDA) 120 mg tablet 671.501017623 dimethyl fumarate (TECFIDERA) 240 m 846.401017771 lacosamide (VIMPAT) 200 mg tablet 177.751017797 TPN - CLINIMIX E (Amino Acids 2.75% 510.601017813 TPN - CLINIMIX E (Amino Acids 5% wi 477.301017821 TPN - CLINIMIX (Amino Acids 4.25% w 532.801017839 TPN - CLINIMIX (Amino Acids 4.25% w 477.301017896 chlorthalidone (HYGROTON) 25 mg tab 13.401017904 cetirizine (ZyrTEC) 5 mg tablet 27.701017961 mycophenolate mofetil (CELLCEPT) 50 965.701017979 fibrin sealant (TISSEEL DUPLOJECT) 3,411.701017987 phytonadione (VITAMIN K) 1 mg/mL Or 64.301017995 povidone iodine (BETADINE) 10% topi 2.601018001 fluticasone-salmeterol 55 mcg-14 m 1,323.701018019 lidocaine topical 2% (URO-JET) 20 m 102.851018027 emtricitabine-rilpivirine-tenofovir 1,190.301018035 bisoprolol (ZEBETA) 5 mg tablet 15.601018043 TPN - CLINIMIX (Amino Acids 4.25% w 555.001018050 butalbital-aspirin-caffeine (FIORIN 18.901018068 calfactant (INFASURF) suspension 35 5,050.551018084 RHo (D) immune globulin (RHOGAM) 15 1,411.951018100 cloBAZam 10 mg tablet 217.551018118 fluticasone furoate 100 mcg (ARNUIT 1,078.801018126 saliva substitute (BIOTENE MOISTURI 58.501018134 pimavanserin (NUPLAZID) 17 mg table 432.901018142 minocycline (MINOCIN) 100 mg Tablet 66.851018167 epoetin alfa epbx (RETACRIT) inject 293.851018175 epoetin alfa epbx (RETACRIT) inject 440.801018183 epoetin alfa epbx (RETACRIT) inject 587.701018191 epoetin alfa epbx (RETACRIT) inject 1,469.201018266 TPN - CLINIMIX (Amino Acids 5% with 510.601018274 midazolam (VERSED) injection - 1 mg 10.801018282 calcitonin (MIACALCIN) - 200 units/ 36,071.451018290 nitroglycerin 200 mcg/mL (10 mL) in 85.501018308 ribavirin (REBETOL) 200 mg capsule 110.30

1018316 fluticasone furoate 200 mcg (ARNUIT 1,444.451018324 potassium chloride (KLOR-CON) 20 mE 119.251018332 electrolyte replacement (PEDIALYTE) 13.351018340 promethazine-dextromethorphan (PHEN 5.151018357 carBAMazepine (TEGRETOL) 100 mg/5 m 40.301018365 esomeprazole (NexIUM) 40 mg injecti 666.001018373 sodium chloride bacteriostatic 0.9% 12.001018381 HYDROmorphone (DILAUDID) 4 mg/mL (1 34.101018407 triamcinolone (KENALOG) 0.5% ointme 112.101018415 immune globulin (PRIVIGEN) 10% 20 g 36,230.401018423 morphine 4 mg/mL (1 mL) preservativ 25.051018431 amikacin 250 mg/mL (2 mL) preservat 103.251018449 bupivacaine liposome (EXPAREL) 1.3% 2,332.351018456 eslicarbazepine (APTIOM) 800 mg tab 429.851018464 HYDROmorphone (DILAUDID) 10 mg/50 m 155.251018472 tobramycin 300 mg/7.5 mL Inhalation 121.551018498 cefOXitin (MEFOXIN) 1 gm/D5W 50 mL 168.901018522 balsam Peru-castor oil (VENELEX) Oi 330.351018530 influenza PF vaccine (FLUCELVAX) - 328.701018548 isavuconazonium (CRESEMBA) 372 mg I 3,635.951018563 sodium chondroitin-hyaluronate opht 2,515.301018571 atovaquone-proguanil (MALARONE) 250 79.351018589 meningococcal group B (BEXSERO) vac 2,385.951018597 collagen topical (AVITENE ULTRAFOAM 294.751018605 collagen topical (AVITENE ULTRAFOAM 1,030.451018613 ARISTA AH hemostat kit 1 gram 1,165.501018621 eculizumab (SOLIRIS) 300 mg injecti 86,886.401018639 sodium hyaluronate (HEALON) ophthal 1,318.151018647 baloxavir marboxil (XOFLUXA) 40 mg 999.001018654 remifentanil (ULTIVA) 2 mg Injectio 3,265.601018662 barium sulfate (E-Z PAQUE) 60% 355 73.351018670 sodium zirconium cyclosilicate (LOK 299.551018688 sodium zirconium cyclosilicate (LOK 299.551018696 silodosin (RAPAFLO) capsule - 4 mg 88.551018720 prothrombin complex human (KCENTRA) 33,300.001018738 cefdinir (OMNICEF) capsule - 300 mg 56.801018746 bupivacaine 0.125%-fentanyl 2 mcg/m 274.751018753 methadone 1 mg/mL Oral Syringe 16.501018761 PROGEL Pleural Air Leak Sealant 4 m 10,578.301018779 sodium hyaluronate (PROVISC) ophtha 2,368.901018787 sodium hyaluronate (HEALON DUET PRO 2,719.501018795 ciprofloxacin 0.2% otic solution - 91.751018829 riTUXimab-abbs (TRUXIMA) 100 mg Inj 11,262.751018837 riTUXimab-abbs (TRUXIMA) 500 mg Inj 56,313.651018845 ambrisentan 5 mg Tablet 4,094.901018852 fluPHENAZine (PROLIXIN) 2.5 mg tabl 75.501018878 bacteriostatic water for injection 0.60

1018886 levOCARNitine 330 mg tablet 14.251018902 lidocaine 2% (XYLOCAINE) injection 40.001018910 sodium bicarbonate 4.2% injection - 101.651018936 immune globulin (FLEBOGAMMA) 10% 10 11,867.051018944 chlorhexidine gluconate 4% (HIBICLE 93.401018969 midazolam (VERSED) injection - 1 mg 15.251018977 sodium chloride 0.9% injection - 50 33.851018985 buprenorphine (SUBUTEX) 8 mg sublin 46.651018993 buprenorphine (SUBUTEX) 2 mg sublin 27.201019017 baricitinib (OLUMIANT) 2 mg tablet 1,005.701019025 sodium chloride-sodium hyaluronate 61.301019041 HYDROmorphone (DILAUDID) 0.5 mg/0.5 44.001019058 brimonidine 0.2% (ALPHAGAN) ophthal 194.251019066 insulin NPH-insulin regular (HumuLI 66.101019074 febuxostat (ULORIC) 80 mg tablet 146.551019082 tranexamic acid 650 mg tablet 57.901019090 Surgicel FIBRILLAR 4 x 4 2,190.451019132 guaiFENesin-dextromethorphan (ROBIT 14.701019157 fluticasone-salmeterol 113 mcg-14 m 1,323.701019165 fluticasone-salmeterol 232 mcg-14 m 1,323.701019181 sodium polystyrene sulfonate (KAYEX 1,940.201019199 multivitamin, adult oral liquid - 3 16.501019207 amoxicillin (AMOXIL) 25 mg/mL Oral 16.501019215 calcium gluconate IVPB - 1 gm/NS 50 312.851019223 colchicine (COLCRYS) capsule - 0.6 90.601019249 sevelamer carbonate (RENVELA) 2.4 g 126.001019264 calcium gluconate IVPB - 2 gm/NS 10 526.151019272 mitoMYcin injection - 40 mg 15,713.651019298 lidocaine 2 gm/250 mL D5W infusion 105.701019306 dutasteride (AVODART) 0.5 mg capsul 67.201019413 lidocaine 1% preservative-free 2 mL 34.151019421 fluPHENAZine (PROLIXIN) 10 mg table 128.801019439 empagliflozin (JARDIANCE) 10 mg tab 232.001019462 hydroxyurea (HYDREA) 100 mg/mL Oral 16.501019876 insulin NPH (HumuLIN N) 100 units/m 66.101100130 NARCAN 4MG/10ML INJ 5.001100478 ATROVENT INH 157.001100486 INDERAL 1MGAMP 7.001100726 XYLOC OINT35GM 11.001100734 CYCLOMYDRIL 2ML OPHTHALMIC SOLUTION 3.001100759 LASIX SOLN 9.001100775 OCEAN NAS SOLN 2.001100783 SSD CRM 50GM 5.001100825 PROZAC 20MG CAP 3.001100882 FORTAZ 1GM INJ 15.001100890 HYDROCOR 1%CRM 2.001100908 TRACRIUM 5ML 6.00

1100916 CORTIS OTICSUS 7.001100981 FORTAZ 1GM INJ 16.001100999 ZOVIR500MG INJ 6.001101039 TETRACAIN OPHT 2.001101047 HYDROCOR2.5%CRM 8.001101070 MOTRIN 800MG TAB 6.001101088 IMDUR 30MG TAB 14.001101096 TNKASE 50 MG INJ 1,260.001101104 DDAVP 0.01% NASAL 647.001101112 ZITHROMAX IV 500 MG 25.001101120 ADENOSCAN 90MG IV 315.001101138 ADENOSCAN 60MG IV 210.001101146 CIPRO HC OTIC SUSP 1,311.001101153 CARDIZEM 125MGIV 20.001101161 ZOVIR 400MG TAB 2.001101179 REMERON 15MG 27.001101195 CELEBREX 100MG CAP 15.001101203 IMITREX 25MG TAB 18.001101229 LEVAQUIN IV 250MG 123.001101237 INSULIN LANTUS INJ 100U 109.001101245 TOPAMAX 25 MG TAB 21.001101252 VASOTEC 2.5MG INJ 79.001101260 FLOMAX 0.4MG CAP 2.001101278 DECADRON 2MG TAB 7.001101286 MUCOMYST 10% 19.001101294 CELLCEPT 250 MG 30.001101310 NEURONTIN 400MG CAP 2.001101344 PROZAC 10MG CAP 2.001101369 CILOXAN OPHTH. SOLN. 20.001101377 ZOVIRAX 800MG CAP 3.001101393 VANCOMYCIN 1GM INJ 16.001101427 FENTANYL 0.1 MG 2.001101435 PAXIL 20MG TAB 2.001101443 ZYPREXA 5MG TAB 12.001101468 ZYVOX 600MG TAB 872.001101476 ZEMURON 10MG/ML INJ 13.001101500 LOVENOX 30MG INJ 15.001101518 DIOVAN 160MG TAB 38.001101526 ZAROXOLYN 2.5MGTAB 2.001101534 AMARYL 4MG TAB 10.001101542 CELEBREX 200MG CAP 27.001101559 NIX 1% SHAMPOO 102.001101567 ZYVOX 600MG INJ 97.001101575 PRANDIN 1MG 13.001101591 MAGNESIUM SULF 2GM/50ML D5W 2.001101609 MAGNESIUM SULFATE 50GM/D5W 500ML 4.001101617 VORICONAZOLE 200 MG 31.00

1101625 RANEXA 500MG 3.001101633 ATORVASTATIN CALCIUM 40 3.001101658 AZITHROMYCIN 500 7.001101666 DIPHENHYDRAMINE HCL 2.001101690 SIMVASTATIN 80MG 3.001101708 REQUIP 0.25MG 17.001101724 RISPERIDONE 0.25 3.001101732 LIDODERM 5% PATCH 101.001101740 PROCRIT 2000 UNITS 31.001101765 MESALAMINE 1000MG SUPP 23.001101773 NORVASC 2.5MG 7.001101781 LYRICA 25 MG TAB 23.001101799 REQUIP (ROPINIROLE) 4MG TAB 37.001101807 KEPPRA 500MG/5ML INJ 328.001101815 NIACIN 250 MG 6.001101823 LYRICA 75MG TAB 26.001101856 ZONISAMIDE 100MG 2.001101864 VITAMIN D 400 IU 6.001101872 AMARYL 2MG PO 10.001101880 GLUCOTROL 5MG XL 10.001101898 VIT E 1000 UNITS 7.001101906 KEPPRA 500MG 27.001101914 OCTREOTIDE 0.05MG 9.001101922 MAGNESIUM OXIDE 400 MG 7.001101930 BACTROBAN 2% 8.001101948 PRECOSE 50 MG 12.001101955 TOPAMAZ 100 MG TAB 46.001101971 MAGSULFATE4GM/D5W100MLBAG 2.001101989 OXCARBAZEPINE 300MG 2.001101997 IBUPROFEN 100 4.001102003 LAMICTAL 25MG TAB 36.001102011 PRANDIN 2MG TAB 15.001102029 REMINYL 4MG CAP 33.001102037 MIRALAX 17 GM PWD 31.001102045 ZOCOR 40 MG/1 TAB 39.001102052 PROGRAF 1MG/CAP 45.001102060 COREG 12.5MG 2.001102078 VFEND 200MG 92.001102086 FLEBOGAMMA 5% 609.001102094 COREG 12.5MG 2.001102102 MARCAINE-MPF 0.25% 3.001102128 BICILL-CR1.2MU 13.001102177 PREP H OINT 3.001102193 MORPHIN10MGINJ 2.001102201 AMP 1GM INJ 7.001102219 AMP 2GM IVPB 10.001102227 ATIVAN 2MG INJ 11.00

1102268 BICIL-LA 1.2MU 48.001102284 COMPAZ10INJ 5.001102300 PROCTOCORT 1% 7.001102318 PRED-FORTE 5ML 3.001102326 ADENOCARD 6MG IV 23.001102342 DEMEROL 1MG INJ 2.001102359 COCAINE 4%4ML 18.001102367 DIFLUCAN PO 100MG 7.001102383 NS 3% IV 500ML 6.001102391 PYRIDOX100MG 3.001102425 D5W 250ML BAG 2.001102433 D5W 500ML BAG 2.001102441 D5W 1L BAG 2.001102458 D5W 50ML BAG 2.001102466 D5W 100ML BAG 2.001102482 DEXTROSE 25GM/250ML(D10W/250ML) 3.001102490 D10W 1L BAG 3.001102516 MANNITOL 25% 50ML 5.001102532 NS .9% 1L 2.001102540 NS .9% 50ML 2.001102557 NS 0.45% 500ML 2.001102565 BACITRACIN 50,000 UNITS POW F/INJ 13.001102599 DEPOMED40MGINJ 5.001102607 DEPOMED80MGINJ 12.001102615 KAOPECTATE SUS 3.001102631 BLEPHAMIDE 5ML 8.001102649 MANNITOL 20%250 28.001102672 CARDIZEM 25MG INJ 4.001102680 BETOPTIC 0.25% 33.001102698 CARDURA 1MG 12.001102714 TEGRETOL SUSP. 4.001102722 CARDIZEM CD 300MG 2.001102730 SANDIMMUNE 25MG 2.001102748 RIFADIN INJ. 65.001102755 ROWASA SUPP 3.001102763 BIAXIN 500MG TAB 4.001102771 ROCEPHIN 250MG 14.001102805 AREDIA 30MG/10ML 181.001102813 SENSORCAINE-MPF 0.75% 2.001102839 PROCARDIA XL 90MG 2.001102854 DIPRIVAN 10MG INJ 13.001102862 NORVASC 5MG TAB 18.001102896 PCA-M.S. 30 MG 7.001102904 KEPPRA ORAL SOLUTION 100MG/ML 12.001102920 TOBRAMYCIN PWD 40.001102938 MARCAINE-MPF 0.5% 5.001102946 COLACE LIQ 3.00

1102961 METH BLUE 10ML 2.001102987 NIMOTOP 30MGCAP 8.001102995 CANDIDA 1:100 5.001103001 FLURBIPROFEN 0.03% EYE SOLU 54.001103019 TORADOL 30MG INJ 4.001103027 TORADOL 60MG INJ 11.001103043 ATROP .05MG/ML 4.001103068 DIGIBIND INJ. 765.001103092 ELIMITE 5% CRM 16.001103126 NEUPOGEN 300MCG 2,694.001103134 NEUPOGEN 480MCG 4,268.001103142 ZOFRAN 4 MG INJ 19.001103167 OCTREOTIDE 0.1MG 20.001103175 OCTREOTIDE .5MG 87.001103183 DIFLUCAN INJ 200MG 61.001103431 ACIDOPHILUS TAB 6.001103738 HEPARIN SODIUM 2000UN/1000ML 88.551103746 DITROPAN XL 5MG TAB 1.911103753 DITROPAN XL 10MG TAB 1.961103761 DEXTROSE 5% / AVIVA BAG 108.001103779 XOPENEX 1.25MG/3ML INH 2.961103860 ELIQUIS 5MG TAB 9.001103878 EMTRIVA 10MG/ML 170ML 36.001103886 ARAVA 10MG TAB 65.331103894 PAPAVERINE 30MG/ML 2ML 35.281103902 ROCEPHIN 1 GM/50ML 925.001103910 PHOSPHA 250 NEUTRAL 2.001103928 REQUIP (ROPIRINOLE) 2MG TAB 35.001103936 PRADAXA 150 MG CAP 40.001103944 PRADAXA 75 MG CAP 40.001103951 SANTYL 30 GM OINTMENT 852.001104108 FIRST MOUTHWASH BLM 39.881104256 ZOLOFT 50 MG 2.001104264 OLANZAPINE 2.5MG TABLET 3.001104272 AZITHROMYCIN 200MG/5ML SUSP 47.001104280 ZOCOR 10 MG TAB 2.001104298 ZOCOR 20MG TAB 2.001104348 COZAAR 50MG TAB 2.001104355 CORDARONE INJ. 86.001104389 MELOXICAM 7.5MG TABLET 2.001104397 ZITHROMAX 250 MG 7.001104413 NIMBEX INJ 2MG/ML 21.001104421 LAMICTAL 100MG 3.001104439 MIDAZOLAM(VERSED)2MG/2ML SOL F/INJ 5.001104454 ATIVAN DRIP 2.001104488 EPIVIR 150MG 4.001104496 XALATAN 0.005% 64.00

1104504 MEPRON 750MG SUSP. 15.001104512 XARELTO 20MG TAB 79.001104520 IODOSORB 40GM GEL 768.001104538 BUMEX 1MG TAB 9.001104546 KEPPRA 250MG TAB 11.001104553 ANTIZOL 1.5 GM/1.5ML INJ 16,110.001104561 PAXIL 10MG TAB 13.001104579 NITROGLYCERIN 2%OINT 60 GM 182.001104587 FENOFIBRATE 54MG TAB 12.001104595 FENOFIBRATE 160MG TAB 18.001104603 ARIPIPRAZOLE 5MG TAB 196.001104611 ARIPIPRAZOLE 10MG TAB 196.001104629 XARELTO 10 MG TAB 79.001104637 VITAMIN D 1 000 UNIT TABLET 6.001104645 XARELTO 15 MG TAB 79.001104652 MELOXICAM 15MG TABLET 2.001104660 MERREM I GM IV 273.001104678 CYTOTEC 25MCG PO 11.001104686 ERYTHROMYCIN 0.55 OPTHALMIC 108.001104694 LEVEMIR 100UNITS/10 ML VIAL 296.001104736 STROMECTOL 3MG PO 58.001104751 TRANEXAMIC ACID 1000MG/10ML VL 642.001104769 NEORAL 100MG 5.001104777 AQUA MEPHYTON 1MG/0.5ML 85.001105030 TRANS-SCOP 3.001105055 DIFLUCAN 400MG IV 131.001105071 OCUFLOX 0.3% OPH 32.001105097 COREG 3.125MG 2.001105105 VERSED LIQ 2MG 3.001105121 LEVAQUIN 500MG INJ 22.001105139 CEFOXITIN 1GM INJ 10.001105147 LEVAQUIN 250MG TAB 109.001105154 LEVAQUIN 500MG TAB 162.001105162 MERREM 500MGIV 23.001105204 ACTIVASE 5MG 1,126.001105212 TRUSOPT SML 24.001105220 NO 0.45% 1L 2.001105238 CALCUIM GLUCONATE 5MEG/10ML 32.001105246 ROCEPHIN 500MG IV 201.001105253 KCL PREMIXED 20 MEQ 85.001105261 KCL PREMIXED 10MEQ 85.001105279 IRRIGATION 22.001105329 VANCOMYCIN HCL/D5W 7.001105337 INVANZ (ERTAPENEM) 1GM 744.001105345 STARLIX 120MG TAB 18.001105352 PHENERGAN VC 5 ML 12.001105360 AGGRENOX CAP 31.00

1105378 CEFEPIME(MAXIPIME)2GM POWDER F/INJ 409.001105394 ESOMEPRAZOLE MAG TRIHYDRATE 40.001105402 TIGECYCLINE 50 45.001105410 ZIPRASIDONE HCL 20 81.001105428 PEN G POT/DEXTROSE-WATER 2MU 2.001105436 VISCOUS LIDOCAINE 2% 100ML 2.001105444 TAMIFLU 9.001105451 CLINDAMYCIN PHOSPHATE/D5W 10.001105469 CANCIDAS 50 MG INJ 410.001105477 EZETIMIBE/SIMVASTATIN 2.001105485 EZETIMIBE/SIMVASTATIN 2.001105493 PITOCIN 30 UNIT/D5LR 1 LITER 6.001105501 PITOCIN 30 UNIT/LR 1 LITER 5.001105519 TROPHAMINE 10% 231.001105527 NORMAL SALINE 10ML PFS 40.001105535 CAFCIT 20MG/ML-3ML VIAL 471.001105543 INSULIN(NOVOLOG 70/30)1000U/10ML 17.001105550 METOCLOPRAMIDE 5MG TAB 9.001105568 BETADINE 10% OINTMENT 60.001105584 ESMOLOL HCL 2500MG/SOD CL IV 96.001105592 DEXTROSE 15% 500ML 63.001105618 SULAR 20 MG 18.001105642 INTEGRELIN 20MG IV 103.001105659 WINRHO 1000MCG 655.001105667 RECOMBIVAX TF PED 10.001105675 REOPRO 10MG/5ML INJ 546.001105683 ALPHAGAN 5ML 17.001105691 ACTOS 15MG 4.001105709 PROTONIX IV 40MG 276.001105717 AMBIEN 10MG 3.001105725 DEXTROSE 14% 500ML 63.001105733 NEUTRA PHOS PKTS 8.001105741 ARICEPT 10MG TAB 4.001105758 ZANAFLEX 4MG TAB 20.001105766 FERRLECIT 62.5MG/5ML SOLUTION F/INJ 28.001105774 EFFEXOR 75MG TAB 20.001105782 AYR NASAL GEL 2.001105790 ADVAIR 100/50 3,887.001105808 EVISTA 60MG 2.001105816 HUMALOG 75/25 INJ 100U 655.001105824 SUDAFED 120MG ER 9.001105832 ZETIA 10MG TAB 3.001105840 SUFENTA 5ML INJ 200.001105857 WINRHO 300 MCG 198.001105873 COLISTIMETHATE 150MG/VIAL 307.001105881 MORPHINE SULFATE 4MG/1ML SOL F/INJ 2.001105980 COMBIVENT INH 173.00

1106004 MVI 10ML 5.001106145 KALETRA 200MG TAB 72.001106152 CELEXA 10MG TAB 19.001106160 DORIBAX 250MG VIAL 358.001106178 PAVULON 1MG/ML 10ML VIAL 67.001106186 MMR II VACCINE 0.5 ML INJ 606.001106194 STARLIX (NATEGLINIDE) 60MG TAB 24.001106202 SURVANTA 25MG/ML 4ML VL IT 2,964.001106210 JANUVIA 100MG TAB 80.001106228 DULOXETINE 30MG CAP 63.001106236 VALPORIC ACID 250MG/5ML SOLN 11.001106244 ALBUTEROL 0.5% 20ML INH 267.001106251 LOVENOX 80MG 42.001106269 CLINDAMYCIN 300MG/50ML 399.001106277 TALC POWDER 5 GM 88.001106285 GI COCKTAIL 110ML 92.001106293 AVAPRO 300MG TAB 19.001106301 DILAUDID 1MG/ML CARPUJECT 61.001106319 GLYCOPHOS VIAL 249.001106327 LOVAZA 1 GM CAPSULE 24.001106343 HEPARIN SODIUM 1000UNITS/500ML 160.001106350 CEFAZOLIN 2 GM - D5W BAG 350.001106392 ROWASA ENEMA 16.001106426 TYLEN/COD ELIX 6.001106467 PNEUMOVAX VIAL 53.001106491 DILAN 100MG IV 2.001106525 MTE CONC 1ML 2.001106533 BETADINE SPRAY 5.001106541 HYDROCOR250INJ 3.001106558 NIPRIDE VIAL 18.001106566 NEOSTIGMINE 10MG/10ML INJ 6.001106608 SODPOLY-SULFON 5.001106624 AFRIN NAS SOLN 3.001106640 ANCEF500MGVIAL 5.001106657 COMPZINE SYRUP 13.001106673 METHOTREX 50MG INJ 4.001106699 ETHYL CHLORIDE 13.001106707 INDIGO CARMINE 7.001106723 XYLOC MPF 1% 7.001106731 STER H2O 100ML 2.001106756 DILAUDID-2 TAB 3.001106764 ISOPTIN IV 3.001106780 DECLOMYCIN 150 4.001106806 MINOCIN 100CAP 2.001106814 THORAZINE 50MG AMP 2ML 2.001106848 TB PPD 5U 120.001106863 DESITIN OINT 2.00

1106871 PAPAVER INJ 30MG/ML 2ML 3.001106889 ONCOVIN 2MG IV 58.001106897 TOBRA80MG VIAL 2.001106905 AMINO 250 VIAL 4.001106921 HYDROCOR100INJ 2.001106947 MARCAINE SPINAL 3.001106954 LET SOLUTION 2.001106970 DEMEROL/PHENERGAN 61.001106988 DILAN100MG/4ML 2.001106996 LOCOID .1% CRM 6.001107010 DOPAMINE/D5W 400MG 7.001107028 XYLOC/EPI 1% 7.001107044 TOBRADEX OPH OINT 20.001107051 CIPRO 400MG IV 26.001107077 PERIDEX RINSE 12.001107085 PHENOBARBITAL 130MG INJ 4.001107093 CARDIZEM CD 240MG 2.001107119 PRAVACHOL 10MG 3.001107135 TRIAMCINOLONE LOTION 21.001107176 MYCOBUTIN 150MG 3.001107184 MUCOMYST 20% SOLN. 6.001107192 MYCAMINE 100MG INJ 2,249.001107200 LIDO-MPF 1% 5ML 9.001107218 D5/.9NS 1L 2.001107267 OPHTHAIN OPSOL 5.001107283 PRONESTYL 100MG/ML 10ML VL 12.001107317 D2.5NS.45 1L 2.001107325 D5LR 1L 2.001107333 ISOPROTERENOL INJ 1MG/5ML 3.001107341 D5/.2NS 1L 2.001107358 PHENERGAN 12.5 SUPP 3.001107366 LR 1L BAG 2.001107374 NS .9% 500ML 2.001107382 CLEOCIN PEDSOL 12.001107408 LEVOTH0.2MGINJ 8.001107416 RYNATAN PEDSUS 16.001107424 DEMEROL50MGINJ 2.001107432 DEMEROL 100MGINJ 2.001107440 DILAUDID4MGINJ 2.001107473 THORAZ 25MGAMP 2.001107523 AMOX PO 250/150ML 3.001107531 THERAGRAN SOLN 5.001107549 AMP 250MG100ML 2.001107564 KENALOG-40 INJ 40MG 8.001107572 KENALOG-10 INJ 10MG 4.001107580 FUNGIZONE VIAL 50MG 33.001107598 AZACTAM 2GM 29.00

1107622 CHLORAS SPRAY 4.001107630 AZOPT 1% OPH 1,245.001107655 COMPAZ25MGSUPP 3.001107671 PEPTO-BISMOL 2.001107689 MONISTAT-7 CRM 8.001107697 MICONAZOLE CRM 10.001107705 SPECTAZOLE85GM 13.001107713 DILAN-125 SUSP 10.001107721 ADRENALIN INJ 2.001107739 NITROSTAT.4MG 2.001107747 AZACTAM 1GM 19.001107770 TYLENOL SOLN 160MG/5ML 7.001107846 LACTULOSE 30ML 2.001107853 MYCELEX10MGLOZ 2.001107911 AQUAMEPH1MGAMP 2.001107929 VIT-K 10MG AMP 5.001107937 PRIMAXIN250INJ 12.001107945 PRIMAXIN500INJ 26.001107960 TIMOPT.25% OPH 3.001107978 TIMOPT .5% OPTH 5.001107986 TIMOPTIC.5%10M 5.001107994 VASOTEC 1.25MG INJ 3.001108000 ZAROXOLYN 5TAB 2.001108042 ROBINUL INJ1ML 5.001108067 BUMEX 1MG INJ 3.001108133 VALIUM 10MG SYR 3.001108141 CELEST SOLUSPN 6MG/ML 5.001108166 LOTRIMIN 15GM 4.001108190 VERSED 5MGINJ 11.001108240 UNASYN 1.5GM INJ 7.001108257 NITROLINGUAL 29.001108281 VALIUM10MG AMP 3.001108299 ROBINUL INJ20M 5.001108315 PEN 5000000 U 3.001108323 ANCEF 2GM IVPB 13.001108398 DONNATAL ELIX 4OZ 2.001108406 REGLAN10MG INJ 3.001108497 FLAGYL 500MGIV 3.001108513 VALISON.1% CRM 2.001108539 PROVENTIL INH 4.001108547 LOTRIMIN 1%CRM 3.001108711 HEPAR5000U/ML 5.001108729 REGLAN 10MG/2ML AMP 9.001108737 LITHIUM SOLN 12.001108752 MAGIC MOUTHWASH 90 ML 64.001108778 NOVOSEVEN 5000 MCG VIAL 68,072.001108786 DEBROX OTIC 15 3.00

1108794 NITROGLYCERIN IV 50MG 16.001109008 LIDEX-E.05%CRM 7.001109016 LIDEX.05% CRM 8.001109024 LIDEX.05% OINT 13.001109073 HESPAN 500ML 19.001109123 ERYTHR 500MGIV 6.001109149 NOVOSEVN 1200MCG PER VIAL 14,817.001109164 SUBLIMAZE 250MCG 5.001109198 AMICAR 5GM IV 14.001109206 SUBLIMAZE 500MCG 6.001109214 MGSO410GM VIAL 144.001109222 FENTANYL 1MG 17.001109230 ARIST-A .1%CRM 7.001109255 ARIST-A .5%CRM 3.001109271 METHOTREX2.5MG 2.001109321 VIBRA 100MG IV 12.001109396 MYDRIACYL 1% 15ML 11.001109404 BETOPTIC.5%OPH 15.001109412 MAXITROL 3.5GM 3.001109420 TETRACAINE 2ML 4.001109438 TOBREX OP SOLN 3.001109446 PRED-FORTE10ML 5.001109453 BETAGAN.5% OPH 11.001109479 LASIX 100MG IV 2.001109487 LIDO LARYNGJET 4.001109503 OXYTOCIN IOU 2.001109560 NIZORAL 2% CRM 12.001109602 DAPTOMYCIN 500MG 1,936.001109628 MYCOSTATIN PWD 18.001109636 MONISTAT-3 VAG 10.001109644 GARAMY OPH UNG 2.001109651 PREMARIN IV 25MG 1,247.001109693 PEPCID 20MG IV 13.001109719 RANITIDINE 50 MG VL 2.001109727 ANGIOMAX 250MG 7,389.001109735 VALACYCLOVIR HCL 500MG TABLET 15.001109743 POLYTRIM 10ML 8.001109776 MYLICON DROPS 2.001109784 MINERAL OIL LT 3.001109842 HUMULIN R U-500 3,617.001109859 METHYLPRED SOD SUCC 125MG 3.001109875 INSTANT GLUCOSE 3.001109883 ELDEPRYL 5MG 2.001109891 VASOPRESSIN 20UNITS/ML INJ 5.001109917 METHYLPRED SOD SUCC 1GM 17.001109925 DEPO-PROVERA INJ 150MG/ML 317.001109933 CORTROSYN .25MG 68.00

1109958 CASPOFUNGIN ACETATE 70MG INJ 198.001109974 BROVANA 15MCG/2ML INH 97.001109982 DOBUTREX250INJ 31.001109990 DEPAKOTE ER 250 MG TAB 24.001110006 SPIRIVA W/HANDIHALER 18MCG/CAP 293.001110022 PHENERGAN EXP 5ML 9.001110030 NPLATE 250MCG SQ 5,944.001110048 SUMATRIPTAH SUCCINATE 208.001110089 AMOX TR/POTASSIUM CLAVULANATE 4.001110121 ACTOS 30MG 5.001110139 LOVENOX 100MG 49.001110147 NAFCIL 1GM INJ 7.001110154 ZOSYN 3.375GM IV 15.001110162 WELLBUTRIN SR 100MG RELEASE TAB 2.001110188 ARIMIDEX 1MG 7.001110196 PARLODEL2.5TAB 2.001110204 ZOSYN 4.5GM INJ 19.001110220 OPTIMYD OP SOL 13.001110246 XOPENEX 0.63MG 6.001110253 DEPACON 500MG INJ 10.001110279 LOVENOX 40MG 20.001110287 H-BIG 0.5ML INJ 783.001110295 SLOW RELEASE IRON 6.001110303 PROTAM250MGINJ 9.001110352 HEP 25000U BAG 3.001110360 HEPARIN 100U/ML 5ML PFS 42.001110378 DIAMOX500 INJ 15.001110394 LIDO 50MG SYR 2.001110402 NICOTINE 14MG PATCH 5.001110410 NICOTINE 7MG PATCH 5.001110428 NICOTINE 21MG PATCH 5.001110451 BRETHINE AMP 1MG 23.001110469 CYCLOMYDRIL 5ML 5.001110501 LEVOPHED AMP 4MG 10.001110519 LAMASIL 250MG TAB 107.001110550 TRANDATE VIAL 16.001110568 DEPAKOTE 500MG 2.001110576 XYLOCAINE 1% 30ML VIAL 4.001110592 APRES 20MG AMP 4.001110626 LOPRESSOR AMP 3.001110659 PLAVIX 300 MG TAB (CLOPIDOGEL) 196.001110667 SEROQUEL 25MG TAB 2.001110683 ROCEPHIN 1GM INJ 43.001110691 VANCO 500MG PO 5.001110709 ANCEF1GM IVPB 8.001110717 TEFLARO 400MG IV 616.001110725 NAFCIL 2GM INJ 13.00

1110741 AMP 1GM IVPB 3.001110758 CLINDAMYCIN 900MG/6ML 77.001110766 CLINDAMYCIN PHOSPHATE 36.001110774 LEXAPRO 10 MG TAB 2.001110790 ACYCLOVIR 34.001110808 FLUDARABINE 50MG 272.001110840 UNASYN 1.5GM INJ 7.001110857 MEGESTROL ACETATE 6.001110865 LANOX .5MG AMP 2.001110873 SURVANTA IT 478.001110881 COGENT 2MG AMP 7.001110899 TIGAN200MG AMP 2.001110907 FLOVENT 110MCG 1,548.001110915 CARBOPROST(HEMABATE)250UG/1ML F/INJ 574.001110923 EUCERIN CREAM 6.001110949 METHOTREX 25MG INJ 24.001110964 SEROMYCIN 250MG CAP 3.001110972 NAMENDA 5 MG TAB 3.001110980 ABELCET 100MG/20ML 193.001110998 CERVIDIL 10MG SUPP 189.001111004 SPORANOX 100MG CAP 107.001111038 CLAFORAN 500MG INJ 5.001111046 UNASYN 3GM INJ 13.001111053 CELEXA 20MG TAB 2.001111061 DEPAKENE SOLN 3.001111079 LUMIGAN OPTH SOLN 1,229.001111095 D25% 500ML 7.001111103 VASOCON OP SOL 6.001111129 MVI-12 4.001111160 NORCO TAB 8.001111178 KETOROLAC TROMETH OPH SOL 3.001111202 DEPAKOTE ER 500MG 2.001111210 PERCOCET 10-325MG TAB 14.001111228 OXYCONTIN 40MG PO 3.001111269 PROM VC/COD 2.001111277 PHENERG50MGSUP 3.001111285 PHEN 50MG INJ 2.001111301 METHERGINE 0.2MG AMP 3.001111319 ATROP .5MG SYR 2.001111327 GENT 80MG INJ 3.001111335 GARAMY OPH SOL 2.001111343 SULFACETAMIDE 10% OPTH SOL 5ML 373.001111376 CORTIS OPH UNG 5.001111384 NEOSYN2.5% OPH 4.001111392 CYCLOGYL1% 5ML 5.001111418 TIMOLOL MALEATE/DORZOLAM HCL 9.001111426 NEBCIN 1.2GM BULK 184.00

1111434 NEOSP OPH SOLN 2.001111442 NEO-SYNEPH INJ 10MG 2.001111475 DEMADEZ 10MG PO 10.001111483 ALTEPLASE INJ 2MG 1,166.001111491 CYCLOGYL1% 2ML 3.001111533 ASA 81MG CHEWTAB 6.001111541 AFRIN PED NAS 3.001111558 DILAUDID 2MG INJ 2.001111574 DEMEROL 75MG INJ 2.001111616 MORPHINE15MGINJ 2.001111624 EFFEXOR 37.5MG TAB 23.001111640 NARCAN 1MG/ML 5.001111673 FENTANYL/BUPIVAC HCL/NS/PF 16.001111707 HALDOL 5MG AMP 7.001111749 PROPOFOL 10MG/ML 100ML 692.001111756 DURAGESIC 50 MCG 19.001111772 DURAGESIC 100MCG 31.001111780 ADRIAYMIN 50MG 37.001111806 ZIAGEN 300MG 76.001111814 DURAMORPH 10MG 5.001111822 FONDAPARINUX 2.5MG/0.5ML SYR 176.001111848 OSMITROL 20% 611.001111855 PRAVACHOL 20MG TAB 3.001111863 SINGULAIR 10MG TAB 3.001111871 IPRATROPIUM/ALBUTEROL .5MG 40.001111897 VENTOLIN INH REFILL 17 15.001111905 XYLOC 1% 50ML 3.001111921 FLOVENT 220MCGINH 82.001111939 TEMOVATE .05% CRM 24.001111947 NITROGLYCERIN/D5W 4.001111970 TIMENTIN3.1INJ 13.001111988 NORCO 10MG/325MG TAB 9.001111996 BOTULINUM TOXIN TYPE A 100 6,771.001112002 NUBAIN 10MG 2.001112010 RENVELA 800MG TAB 32.001112028 DESMOPRESSIN 4MCG 24.001112044 CETACAINE SPRAY 38.001112051 LEVOFLOXACIN 750MG/D5%-WATER 18.001112077 ROPIVACAINE HCL 0.5% 5MG/ML 13.001112085 CLINDAMYCIN 600MG/4ML 67.001112093 CLEOCIN300 INJ 4.001112101 MIACALCIN NAS 42.001112119 PLAVIX 75MG 6.001112127 ACTIGALL 300MG 2.001112135 CASCARA 5ML 6.001112143 MAR.5/EPI 1:2 7.001112150 QUINAPRIL HCL 16.00

1112184 TRAVATAN OPTH 2.5ML 159.001112192 NILSTAT SUSP 2.001112200 NIASPAN 500 MG 28.001112218 PHENERG25MGSUP 3.001112226 AUGMENTIN 500 3.001112242 ACTOS 45MG 91.001112259 IMOGAM RABIES 41.001112267 LIDOCAINE 2GM/500ML PREMIX BAG 220.001112275 D5/.45NS 1L 2.001112283 HEPARIN FLUSH 1U/ML SYR 41.001112291 DIP TET ADULT 0.5 ML 261.001112309 SODIUM CHLORIDE 10% INH 15ML 46.001112317 HYDROCOR 1%UNG 2.001112325 BACTRIM 400MG INJ 3.001112341 LOTRISONE CRM 21.001112366 METRONIDAZOLE 64.001112382 CLAFORAN 1GM INJ 11.001112408 NS .9% 100ML 2.001112416 BETADIN 10% SOLN 8.001112424 VANCO500MG INJ 8.001112440 MUCOMYST 20% SOLN. 9.001112465 AMIKIN INJ 500MG 23.001112473 AMPIC 250MGINJ 4.001112481 SSKI SOLN 6.001112499 LEVETIRACETAM-NACL 1 000MG/100 462.001112515 MEFOXIN 2GM INJECTION 119.001112523 INTRALIPID 20% 250ML 7.001112556 UNASYN 3GM INJ 13.001112564 DEFINITY CONTRAST PER ML 394.001112580 D20W 500ML BOT 3.001112598 JANUVIA 50MG TAB 7.001112606 BIMATOPROST 78.001112705 EFFEXOR XR 37.5MG 28.001112713 DORIBAX(DORIPENEM)500MG/VIAL 297.001112721 TUCKS REC SWAB 2.001112739 ADVAIR 250/50MCG DISK #60 2,964.001112770 XYL 2%/EPI 1:1 2.001112788 GARAMY .1% UNG 6.001112804 POLYMYX INJ 500MU 3.001112853 WATER IRRIGATION IL 190.001112861 IBUTILIDE INJ 1MG 174.001112879 VIREAD 300 MG TAB 162.001112887 SEPTRA SUSP 9.001112903 RELISTOR 12MG/0.6ML INJ 493.001112937 KALETRA CAPSULE 34.001112945 CARPINE2% 15ML 3.001112952 ADRENLIN TOPICAL 5.00

1113000 BENADRYL ELIX 4.001113034 FLUORESCITE 10% 13.001113042 REGITIN5MG INJ 64.001113075 LAMISIL 1% CREAM 12GM 99.001113117 FLOVENT 44MCG 1,157.001113125 DURAGESIC 25MCG 16.001113141 SEREVENT INHAL. 52.001113166 HEPARIN 100 UNITS/ML VIAL 45.001113174 NORCURON VIAL 15.001113182 MVI PEDIATRIC 9.001113190 OCTREOTIDE ACET 200MCG/ML 5ML VL 143.001113208 PROTAM 50MGINJ 2.001113216 NEOSYN.25% 3.001113224 TET TOX PLAIN 0.5ML 278.001113232 XIFAXAN 200MG PO 130.001113257 LIDOCAINE HCL 3.5% PF 18.001113265 XYL 1%/EPI 1:1 2.001113273 PRASUGREL(EFFIENT)5MG TAB 68.001113299 ROBIT SOL120ML 3.001113315 DURAGESIC 75MCG 277.001113323 NARCAN.4MG INJ 5.001113331 HURRICAINE SPRAY 13.001113349 XYLO 2%/EPI .0005% MPF 138.001113356 PLETAL 50 MG TAB 14.001113364 BENTYL20MG AMP 17.001113398 PROVIGIL 100MG 5.001113406 MEVACOR 20MG 2.001113414 TEFLARO 600MG IV 616.001113422 AVC CREAM 124.001113448 PHENOBARB INJ 3.001113455 GENTAMICIN 80MG IN SOD CHLOR 3.001113463 PROGRAF 0.5 MG CAP 22.001113471 OXYCONTIN 20MG TAB 2.001113489 DULOXETINE 20 MG CAP 57.001113497 PREMARIN VAG 1,419.001113513 NEOSYN10% OPH 5.001113521 CHARCOAL SUSP. 13.001113547 ADVAIR 500/50 131.001113562 PRASUGREL(EFFIENT)10MG TAB 68.001113570 DULOXETINE 60MG CAP 63.001113588 XYLOCAINE MPF 1% STERILE PAK 65.001113596 HYLENEX 150 UNITS / ML 535.001113638 MORPHINE8MGINJ 2.001113646 ROMAZICON 0.5 MG/VIAL 40.001113653 INTEGRELIN 75MG/100ML VL 324.001113661 CLINDAMYCIN PHOSPHATE/D5W 15.001113687 WELLBUTRIN SR 150 MG 23.00

1113703 BENADRYL 25MG/10ML 10.001113745 INSUL-HUM-NPH INJ 100U 14.001113752 BUPIVACAINE PF 0.5% 10ML SOL F/INJ 3.001113760 GLUCAGON INJ 1MG VL 86.001113778 CIPRO 250MG 3.001113786 ROBAXIN 1000MG/10ML VIAL 7.001113794 MUPRIOCIN 2% 21.001113810 PROCARDIA XL 60MG 1,271.001113828 ARICEPT 5MG TAB 4.001113851 BREVIBLOC 100MG 12.001113885 CIPRO 500MG 3.001113893 GOLYTELY 4L 5.001113943 XOPENEX 1.25 MG 6.001113968 ETOMIDAE 2MG/ML 10ML VIAL 14.001113976 INTROPIN 400MG 2.001113984 STADOL 2 MG INJ 100.001113992 SOLUMED 500MG IV 9.001114016 XYLOC-MPF 2% 6.001114024 DETROL 2MG TAB 2.001114032 ADVAIR 250/50 89.001114040 OXYTOCIN IOU 5.001114057 LOVENOX/ENOXAPARIN 120MG/0.8ML 803.001114073 XYLOC 2% 20ML 55.001114081 XYLOC 2% JELLY 9.001114099 MARCAINE .5% 7.001114123 DURAMORPH 5MG 8.001114131 PHEN 25MG INJ 2.001114198 METHYLPRED SOD SUCC 40MG 2.001114222 THROMB-TOP 5MU 65.001114230 ROCEPHIN 2GMINJ 85.001114255 ANCEF 1GM VIAL 8.001114263 INSUL-HUM-REG INJ 100U 14.001114271 NOVULIN 70/30 INJ 100U 14.001114305 COLCHIC.6MGTAB 61.001114313 NS .9% 250ML 2.001114321 NS .9% 100ML 2.001114354 DEMEROL25MGINJ 2.001114370 EPINEPHRINE SYRN 1MG 3.001114396 DEXTROSE 50% 3.001114412 INTEGRELIN 200MG/100ML VL 10,010.001114420 PROTONIX 40MG 30.001114438 SEROQUEL 100MG PO 65.001114446 MORPHINE 2MG INJ 2.001114453 PROAMATINE 5MG 2.001114461 NOVOLOG ASP INJ 100U 44.001114479 COMTAN 200MG TAB 20.001114487 TOPROL XL 50MG 14.00

1114495 EFFEXOR XR 75MG 3.001114503 ZOSYN 2.25GM INJ 10.001114529 ATORVASTATIN CALCIUM 80 3.001114537 DOBUTAMINE HCL 500/D5W 8.001114545 ATORVASTATIN CALCIUM 20 4.001114552 LEVALBUTEROL TARTRATE 45 536.001114560 ATORVASTATIN 10MG TAB 34.001114578 PITOCIN 20 UNIT/D5LR 1 LITER 6.001114586 FLONASE NASAL SPRAY 135.001114594 LEVAQUIN 500MG PMX PB 190.001114602 ZOFRAN 4MG TAB 12.001114628 CEFEPIME 1GM IV 194.001114636 MULTAQ 400MG TAB 46.001114644 ZOLPIDEM 5 MG TAB 35.001114651 NORCO 5MG/325MG TAB 8.001114669 LEVOTHYROXINE 0.1MG/5ML INJ 643.001114677 SODIUM CHLORIDE 0.9% 3ML INH 41.001114685 CALMOSEPTINE 113GM OINT 79.001114693 LEXISCAN 0.4MG/5ML 2,381.001114701 NICARDIPINE 25MG/250D5W 287.001114727 LOVENOX 60MG 31.001114743 LEVOTHR3MG INJ 58.001114750 FLUORESCEIN 40.001114768 DAKINS 13.001114776 WATER FOR INJECTION 139.001114792 VIRA-A OPH UNG 8.001114818 GANCICLOVIR 500MG IV 30.001114826 MILRINONE LACTATE 20/D5W 17.001114834 ADVAIR 100/50MCG DISK #60 2,393.001114842 GRANULEX SOLN 9.001114925 HEALON GV OPTH 14MG/ML 0.85ML SYR 435.801115716 AZITHROMYCIN 600MG TAB 28.651300441 RESP CPAP PER DAY 3,653.001300466 RESP IPPB INITIAL 306.001300540 RESP AEROSOL TREATMENT INITIAL 306.001300581 RESP SPUTUM COLLECTION INITIAL 306.001300771 RESP INHALER TREATMENT INITIAL 306.001300839 BRONCHIAL HYGIENE SUB SAME DAY 326.001300961 RESP BRONCHIAL HYGIENE INITIAL 524.001301019 SUPER DIMENSION BRONCHOSCOPY 6,891.001301076 MECH CHEST WALL OSCILLATION INITIAL 1,074.001301100 MECH CHEST WALL OSCILLATION SUBS 1,074.001301134 HHN TREATMENT SUBSEQUENT 306.001301142 MDI SUSP CHAMBER 51.001301159 PULSE OXIMETRY OVERNIGHT 696.001301167 PULSE OXIMETRY/TITRATING O2 180.001301175 INFANT RECOVRY RT 441.00

1301183 CONT NEB INITIAL HOUR 644.001301191 IPPB TREATMENT SUBSEQUENT 306.001301225 RESP BRONCHIAL ALVEOLAR LAVAGE 4,591.001301258 INTER PERCUSS VENTILATION INITIAL 524.001301274 RESP INTER PERCUSS VENT SUBSEQUENT 326.001301308 RESP PEAK FLOW IP ONLY DX 441.001301324 NEONATAL RESUSCITATION 1,751.001301332 HHN IPPB INLINE SUPPLY CHNG 46.001301340 VENT SUPPLY 109.001301357 CONT NEB TX EA ADDL HOUR 359.001301365 PULSE OXIMETRY MULTIPLE 719.001301373 VENTILATOR NEONATE INITIAL DAY 6,592.001301381 RESP BIPAP PER DAY 3,653.001301449 RESP VENT - 2 TOWER SUBSEQUENT 4,764.001301456 RESP VENT 2-TOWER DAY ONE 6,592.001301464 RESP VENTILATOR SUBSEQUENT 4,764.001301472 RESP VENTILATOR INITIAL DAY 6,592.001301498 RESP ADULT OSCILLATOR DAY ONE 6,592.001301506 RESP ADULT OSCILLATOR SUBSQUENT 4,764.001301514 CPR 1,751.001301522 O2 INITIAL 48.001301530 OXIMETRY/OP WALK ASSESSMENT 719.001301548 PUL MVV 243.001301555 IP BLOOD GAS 621.001301563 AEROSOL TREATMENT SUBSEQUENT 306.001301571 ABG CAPILLARY 18.001301589 O2 PER HOUR 88.001301597 PH CORD BLOOD 360.001301605 OP CODE BLUE W/ PULM RESUSCITATION 441.001301654 AEROSOL TX INIT 251.001301662 VENTILATOR NEONATE SUBSEQ DAY 4,764.001301670 OP/ER BLOOD GAS 621.001301688 RESP PDN ASSESSMENT SUBSQNT 450.001301696 RESP PDN ASSESSMENT INITIAL 450.001301761 BLOOD GAS ANALYSIS 999.001301779 STANDARD RESP CCM 242.001301787 STANDARD RESP CCM ADD-ON 133.001301795 COMPLEX RESP CCM 431.001301803 COMPLEX RESP CCM ADD-ON 154.001350297 BLOOD GASES & ELECTROLYTES 1,478.001350305 BLOOD GASES VENOUS 1,478.001350313 PULSE OXIMETRY ONE-TIME ONLY 180.001350321 LAB BODY FLUID-PH 203.001350370 IONIZED CALCIUM 268.001350388 PULMONARY STRESS TEST 6 MINUTE WALK 1,101.001350396 AIRWAY RESISTANCE BY OSCLMT 580.001350404 ARTERIAL PUNCTURE 658.00

1350412 CAPNOGRAPHY 829.011370030 BRONCHOSCOPY FIBEROPTIC 4,174.001370824 ULTRASONIC BRONCHOSCOPY 693.001380427 NITRIC OXIDE ADMINISTRATION PER HR 828.001390087 HYPERBARIC THERAPY INIT. 3,612.001390095 HYPERBARIC THERAPY BASIC 3,612.001390434 RESP FREE FLOW INITIAL TX/DAY 306.001390475 HYPERBARIC TRANSCUT STUDY-IP 1,589.001390574 HYPERBARIC M/CARE EA 30 MIN 434.001390582 HYPERBARIC M/CAL SUBQ 15 MIN 221.001390590 HYPERBARIC M/CAL 1ST 15 MIN 221.001390608 RESP OXIMETRY TREND OVERNIGHT STUDY 696.001390616 SMOKING CESSATION OP SYMPTOMS >10M 199.001390624 TRACH CARE OP ONLY 441.001390632 CCU-BROCHOSCOPE DISP LRG 5.8OD 1,099.001390640 CCU-BROCHOSCOPE DISP REG 5.0 OD 955.001390657 CCU-BRONCHOSCOPE DISP SLIM 3.8 OD 955.001400076 PUL FUNC RESID 745.001400084 LAB PF-VITAL CAP 331.001400092 LAB PF-SCREENING 653.001400100 LAB PF-BEFORE 653.001400118 PUL COMP PFT 1,368.001400126 LAB N2 WASHOUT 745.001400134 LAB THORACIC GAS VOL 518.001400159 DIFFUSING STUDY 638.001400167 LAB PF C02 INFRARED 1,227.001400225 LAB PF BEDSIDE SCRN 869.001400258 LAB AIRWY RESISTANCE 518.001500081 SP PULMONARY 4,982.001500156 SP ARCH AORTA DSA 8,891.001500370 ABD ANGIO TRANSLUMBAR 6,239.001500412 SP RENAL UNILATERAL 13,574.001500438 SP ADRENAL BILAT 4,854.001500479 SP RENAL BILAT 13,574.001500552 SP AORTA ILIAC FEMORAL ANGIO 6,239.001500610 SP EXTREMITY ANGIOGRAM UNILATERAL 8,891.001500636 XR ANGIO IN SURG. 1,677.001500644 XR SUP.VENA CAVA 6,136.001500743 SP VENACAVA DSA INFERIOR 5,689.001500776 SP RENAL REN ONLY 4,275.001500834 XR VENOGRAM UNILAT EXTREM 2,121.001500842 XR VENOGRAM BILATERAL EXT 2,929.001500883 XR FLUOROSCOPY LESS THAN 1 HR 789.001501063 SP ABSCESS DRAIN CATH PLACMNT 6,236.001501147 SP PTA TIBIOPER ARTERY & BRANCHS 20,384.001501170 SP PTA ILIAC ARTERY 20,384.001501188 SP PTA FEMORAL-POPLITEAL ARTERY 20,384.00

1501196 SP ANGIOPLASTY INITIAL ARTERY 28,125.001501444 SP INFUSION THROMBOLYSIS 4,057.001501477 SP PERC PLCMNT IVC FILTER 6,894.001501568 SP CHANGE BIL DRAIN CATH 2,844.001501584 SP PERC DILAT BILIARY W/STENT 7,370.001501931 XR EYE F.B.W/LOCAL 1,010.001501949 XR MANDIBLE LIMIT 504.001501956 XR MANDIBLE COMPLETE 1,127.001501972 XR MASTOID MIN 3 VWS PER SIDE 1,701.001501980 XR INT AUDITRY CAN 485.001502004 XR FACIAL BONE ITD 986.001502012 XR FACIAL BONES 1,226.001502038 XR FACIAL W/NASAL 1,226.001502046 XR NASAL BONES 776.001502061 XR OPTIC FORAMINA 842.001502079 XR SINUSES LIMITED 724.001502087 XR SINUSES COMPLETE 1,174.001502095 XR SELLA TURCICA 702.001502103 XR SKULL LIMIT 808.001502111 XR SKULL 1,420.001502145 XR TEETH COMPLETE 884.001502152 XR TMJ JOINTS 1,114.001502160 XR NECK (TISSUES) 617.001502178 XR MAXILLA 1,226.001502186 XR LARYNGOGRAPHY 1,677.001502202 XR SIALOGRAM 945.001502277 XR IVPW/TOMOGRAPH 2,301.001502301 XR CHEST 1 VIEW 571.001502319 XR CHEST 2 VIEW 914.001502327 XR CHEST W APICAL LORDOTI 823.001502335 XR CHEST 4 V 764.001502343 XR CHEST W/FLUORO 558.001502400 XR RIBS BILATERAL 854.001502418 XR STERNUM 767.001502426 XR STERNOCLAVICLAR 649.001502459 XR SPINE ANY LEVEL 1 VIEW 666.001502467 XR SPINE CERV 3 OR 4 VIEWS 1,294.001502483 XR SPINE CERV W/OB 1,241.001502491 XR SPIN CERV W/BND 1,241.001502509 XR T-SPINE 3 VIEWS 867.001502525 XR SPINE THORCOLUM 2V 705.001502558 3R SPINE LUMBAR 2 OR 3 VIEWS 1,102.001502566 XR SPINE LUMBISAC COMP W/OBLIQUE 1,458.001502574 XR SPINE LS COMP W/BENDING VIEW 1,710.001502590 XR PELVIS 1V 781.001502608 XR PELVIS 2 VIEW 781.001502624 XR SACRO-ILIAC MIN 3 VIEWS 688.00

1502632 XR SACRUM&COCCYX 833.001502640 XR MYELOGRAM CERV 2,760.001502657 XR MYELOGRAM COMP 2,760.001502665 XR MYELOGRM LUMBAR 2,760.001502681 XR DISCOGRAM LUMBAR 3,429.001502707 CLAVICLE BILATERAL 615.001502731 SHOULDER BILATERAL 730.001502749 XR ARTHROGRAM SHOULDER LT 1,539.001502756 XR AC JOINTS BI. 772.001502798 ELBOW BILATERAL 678.001502806 XR ELBOW ARTHROGRAM 1,260.001502848 XR WRIST ARTHROGRAM 1,061.001502863 HAND BILATERAL 679.001502871 XR FINGERS RIGHT 446.001502921 XR HIP,BILATERAL 2V 595.001502939 XR HIP ARTHROGRAM 1,416.001502947 HIP DURING SURG ADD VIEWS 1,829.001502962 XR PELVIS INFANT 2V 1,008.001503010 XR KNEE ARTHROGRM 1,395.001503036 XR LOWER EXTREMITY INFANT LT 343.001503069 ANKLE BILATERAL 657.001503077 XR ANKLE ARTHROGRAM LT 1,370.001503093 FOOT BILATERAL 701.001503119 XR TOES RIGHT 625.001503143 XR ABD 1 VIEW 586.001503150 XR ABDOMEN 2V 866.001503168 ABD FOR FETAL POSITION 2V 1,075.001503184 XR ESOPHAGUS 1,239.001503200 XR UPPER GI TRACT W/KUB 1,984.001503218 XR UGI SINGLE CONTRAST 1,984.001503226 XR UPPER GI&BOWEL 2,909.001503234 XR UGI W/KUB HD BARIUM 1,677.001503259 XR SMALL BOWEL 1,614.001503267 XR HYPTNC DUODENGM 1,921.001503275 EN COLON BARIUM 1,691.001503283 XR BARIUM ENMA/AIR 2,103.001503309 XR CHOLECYSTO (GB) 1,077.001503325 XR CHOLANG SURG 1,391.001503333 XR CHOLANG SURG ADDED SET 187.001503341 XR CHOLANG-T-TUBE 1,200.001503358 XR CHOLANG POSTOPERATIVE 2,935.001503366 XR CHOLANG IV TOM 1,200.001503374 SP PERCUT TRANSHEP CHOLANGIOGRM 1,200.001503382 SP CHOLANGIOGRAM PERCUT 1,200.001503408 XR BILIARY STONE REMOV POST OP 1,358.001503416 XR BILIARY ENDOSCOPIC CATHETER 2,227.001503424 XR PANCREATIC ENDOSCOPIC CATH 2,280.00

1503432 XR GI TUBE PLACEMENT 1,022.001503440 XR NASAL GASTROINTEST INAL 1,361.001503465 XR ESOPHEAGEAL DILATION 7,370.001503473 XR ERCP-BILIARY & PANCREATIC 3,208.001503499 XR IVP (UROGRAPHY) 2,301.001503523 XR ANTEGRADE PYELOGRAM 1,214.001503531 XR RETRO PYLOGRAM 1,791.001503549 SP PERC ANTEGRADE PYELOGRAM 1,214.001503556 SP URETER STENT PLACEMENT 3,042.001503564 XR CYSTOGRAM 880.001503598 XR RETRO URETH 1,130.001503606 XR URETHROCYSTOGRAPHY VI 1,501.001503614 XR VOIDING CYSTOURETHROGRAM 1,501.001503630 XR RENAL CYST STUDY 2,846.201503655 SP NEPHROSTOMY DILATIONAL 7,295.001503663 XR PELVIMETRY 1,543.001503689 ABD FOR FETAL POSITION 1V 586.001503697 XR HYSTEROSALPINGRAM 1,041.001503747 SP AORTOGRAPHY THORACIC BY SERI 8,891.001503770 SP CERVICOCEREBRL (ARCH) 13,502.001503812 SP CAROTID EXTERNAL UNILATERAL 16,014.001503820 SP EMBOLIZATION TRANSCATH THER 9,130.001503838 SP CAROTID/CERE COMMON UNILAT 25,922.001503911 SP VERTEBRAL NON SELECTIVE UNIL 14,642.001503937 SP SPINAL ANGIO SELECTIVE 7,434.001503960 SP EXTREMITY ANGIO BILATERAL 6,360.001503986 SP VISCERAL SUPRASEL ANGIO 6,239.001503994 SP ADRENAL UNILAT SELECT ANGIO 9,992.001504000 SP PELVIC SELECT ANGIO 8,891.001504018 SP PULMONARY UNILAT SELECT ANG 4,982.001504026 SP PULMONARY BIL SELECT ANGIO 8,891.001504034 SP INTERNAL MAMMARY ANGIO 4,982.001504042 ANGIO ANY ADDED VESSEL 4,982.001504059 SP AV DIALYSIS SHUNT ANGIOGRAM 4,000.001504109 SP LYMPHANGIO PELV/ABD UNI 3,944.001504133 SP VENOGRAPHY CAVAL SUPERIOR S 6,136.001504166 SP VENOGRAPHY ADRENAL BI SELEC 11,710.001504174 SP VENOGRAPHY SINUS/JUGULAR CA 8,921.001504182 SP VENOGRAPHY ORBITAL 7,434.001504190 SP PERCUT TRANSHEP PORT W/HEMO 7,362.001504208 SP PERCUT TRANSHEP PORT W/O 7,362.001504216 SP INFUSION EMBOLIZATION 4,057.001504232 SP PERCUT PLACMT IVC FILTER 20,123.001504281 SP ANGIOPLASTY,EA ADD'L-ADD ON CODE 7,030.001504299 SP VENOPLASTY EACH ADD'L VEIN-ADD 7,030.001504315 SP VENOPLASTY INITIAL VEIN 28,125.001504455 XR FB INFANT 1 FILM 241.00

1504463 XR BONE AGE 278.001504471 XR BONE LENGTH 1,391.001504489 XR BONE SURVEY COMPLETE 2,831.001504497 XR BONE SURVEY LIMITED 1,557.001504505 XR INFANT SURVEY 2,061.001504513 XR JOINT SURVEY 1 VIEW 615.001504521 XR FISTULA-SINUS 1,436.001504596 BC DUCTOGRAM 1,058.001504604 SPECIMEN RADIOGRAPH 606.001504638 BC MAMMOGRAM MOTHERS DAY 489.001504661 XR FLUORO GUIDE FOR NEEDLE PCMT 789.001504687 XR ESOPHAGUS W/VID 1,405.001504810 US THYROID NECK 1,668.001504828 US THORACENTESIS 3,599.001504836 US CHEST 1,220.001504869 US PLEURAL EFFUSION 1,220.001504877 US GUIDE CYST 3,782.001504885 US ABDOMEN COMPLETE 2,011.001504893 US ABDOMEN RLQ(APPENDIX) 1,507.001504901 US LIVER 1,507.001504919 US GALLBLADDER 1,507.001504927 US KIDNEY 1,508.001504935 US PANCREAS 1,507.001504943 US SPLEEN 1,507.001504950 US AORTA DUPLEX SCAN 2,547.001504968 US RETROPERITONEAL COMP 1,677.001504976 US URINARY BLADDER 1,508.001504992 US OB AFTER 1ST TRIMESTER 2,089.001505007 US OB REPEAT 1,491.001505015 US BIOPYSICAL PROFILE 677.001505023 US PLACENTAL LOCAL 825.001505031 US PELVIC ENDOVAGINAL 1,432.001505049 US IUD LOCALIZTION 1,673.001505056 US PELVIC NON-OB 1,673.001505064 US OB POSITION 825.001505072 US ECHOGRAPHY TRANSRECTAL-PROSTATE 1,692.001505080 US AMNIOCENTESIS 2,367.001505098 US NEONATE HEAD 379.001505106 US PELVIC NON-OB LIMITED 1,056.001505114 US TESTICULAR WITHOUT DUPLEX DOPPLE 1,640.001505122 US SHOULDER 2,448.001505130 US EXTREMITY COMPLETE 2,448.001505163 US AMNIOTIC FLUID INDEX 825.001505197 US GUIDANCE 76942 3,782.001505205 US THERAPY PLN ECHO FOLLOW-UP 3,260.001505213 US ECHOGRAPHY INTRAOPERATIVE 1,790.001505221 US ECHOGRAPHY TRANSRECTAL 1,692.00

1505429 XR HYPAQUE ENEMA 1,691.001505445 SP NEPH TUBE PLACEMENT/EXT DRN 3,910.001505510 XR CINERADIOGRAPHY 1,424.001505536 BC MAMMARY DUCT MULITPLE DUCTS 1,147.001505544 US OB LIMITED 825.001505577 US BILIARY 2,011.001505585 XR HIP INFANT 2V 1,008.001505650 BC US GUIDED BREAST FNA 3,782.001505668 US DOPPLER ABD RENAL OR PELVIS 2,596.001505676 BC US BREAST CYST ASPIRATION 3,782.001505742 US LIMITED QUADRANT 1,507.001505759 US GUIDANCE DRAINAGE 3,782.001505767 XR SPINE CERV 2 OR 3 VIEWS 714.001505775 US GROIN 2,058.001505791 XR MYELOGRAM THORACIC 2,760.001505809 XR BE FOR REDUCTION OF INTUSS 2,081.001505874 US PYLORIC STENOSIS 1,507.001505965 XR LOOQOGRAM 1,214.001505981 ENTEROCLYSIS TRAY 1,431.001505999 BC-US GUIDED SKIN MARKING LOC 1,274.001506005 BC INTERVENTIAL RADIOLOGY 2 2,616.001506013 BC MOTHERS DAY MAMMO W/TOMO 489.001506021 BC SCREENING MAMMO W/TOMO 489.001506039 BC SCREENING MAMMO IMP W/TOMO 489.001506187 US SPINAL CANAL & CONTENTS 1,277.001506583 US RETROPERITONEAL LIMITED 1,508.001506591 BC DIAG MAMMO BILAT W/TOMO 935.001506609 BC DIAG MAMMO RIGHT W/TOMO 364.001506617 BC DIAG MAMMO LEFT W/TOMO 364.001506641 BC INTERVENTIONAL RADIOLOGY 4 4,542.001506666 XR PEDIATRIC CHEST SINGLE VIEW 571.001506674 XR PEDIATRIC ABDOMEN 586.001506682 XR BONE SURVEY-CHD(1>COMPLETE 2,831.001506690 SP REMOVAL VENOUS PORT CATH 789.001506708 SP TRANSCATHETER BIOPSY 4,855.001506716 SP EMBOLIZATION OR INFUSION THY F/U 2,243.001506724 SP FLUOROGUIDE-PLACE INJ PORT 789.001506732 SP FLUORO-GUIDE VENOUS CATH CHK 882.001506740 SP NERVE BLOCK CERV OR THORACIC 4,157.001506757 SP FACET INJ CERV OR THORACIC 4,492.001506765 SP ADDITIONAL FACET/NERVE INJECT 1,635.001506773 SP EPIDURAL/CAUDAL INJECTION 2,454.001506781 SP EPIDURAL BLOOD PATCH 2,974.001506799 SP TRIGGER POINT INJECTION 1,401.001506807 SP INSERTION EPIDURAL CATHETER 2,479.001506815 SP INTERCOSTAL NERVE MULTIPLE 2,466.001506849 SP PARAVERTEBRAL FACET MULTIPLE 2,479.00

1506856 SP PARAVERTEBRAL FACET SINGLE 2,479.001506864 SP REMOVE DRAINAGE CATHETER 615.001506872 SP NEPHRO CATH CHANGE 2,844.001506914 SP DISCOGRAM CERVICAL 4,822.001506922 SP SACROILIAC INJECTION 4,157.001506948 SP LUMBAR PUNCT/DIAG.W/FLURO INJ 1,704.001506955 SP MICRO CATHETER 2,476.001506963 SP PICC LINE PLACEMENT-FLUOROGD 789.001506971 SP STELLATE GANGLION INJECTION 2,479.001506989 SP CHEST TUBE INJERTION 2,256.001506997 SP CERVICAL EPIDURAL INJECTION 2,479.001507003 SP PERC TRANSHEPATIC BIL DRAINAGE 4,003.001507011 SP PERC BILIARY INT/EXT DRIANGE 3,287.001507029 SP CHANGE GASTROSTOMY TUBE 3,976.001507037 SP PERC PLACEMENT GASTROSTOMY TB 3,686.001507045 BIOPSY WITH FLUORO 789.001507052 SP BALLOON CUTTING 4,000.001507060 SP BALLOON OCCLUSION 1,508.001507078 SP PICC LN PLCMT PED-FLUOROGUID 789.001507086 SP CENTRAL LINE PLACEMENT 4,403.001507110 INTERVENTIONAL RADIOLOGY 1 3,000.001507128 INTERVENTIONAL RADIOLOGY 2 3,250.001507136 INTERVENTIONAL RADIOLOGY 3 4,550.001507144 SP MICRO CATHETER/WIRE SET 3,528.001507151 SP TRANDUCER KIT 79.001507169 SP SUTURE 16.001507177 SP TIPPS 5,561.001507185 US GUIDANCE FLUID ASPIRATION 3,782.001507193 SP CHORO PREP 25.001507219 US OB TRANSVAGINAL 1,044.001507227 US GUIDANCE FOR VASCULAR ACCESS 768.001507235 US PARACENTESIS 4,134.001507250 BC US NEEDLE LOCALIZATION 3,782.001507268 US ABDOMEN RUQ 1,507.001507284 US EYE (OPHTHALMIC) 1,901.001507292 US SOFT TISSUES OF HEAD&NECK 1,668.001507300 US GUIDED COMPRESSION REPAIR 1,901.001507318 SP CHANGE OF TUBE OR CATH W/CNT 2,844.001507326 SP FLUOROGUIDE REPOST CENT LINE 4,585.001507367 SP PELVIS ANGIOGRAM/SELECTIVE 8,891.001507383 SP RENAL VENOUS UNILAT 4,738.001507391 SP RENAL VENOUS BILAT 5,628.001507516 BC SPECIAL VIEWS RIGHT W/TOMO 364.001507524 BC SPECIAL VIEWS LEFT W/TOMO 364.001507532 US OB-1ST TRIMESTER 1,438.001507540 US OB-1ST TRIMESTER EA ADD GEST 593.001507557 US OB TRANSVAGINAL 1,044.00

1507565 US OB AFTER 1ST TRIM EA ADD GES 1,149.001507573 US BREAST-RADIOLOGY AFTER HOURS 1,274.001507581 BC SPECIAL VIEWS BILAT W/TOMO 935.001507607 SP EPIDURAL INJECTION-CERVICAL 1,704.001507615 SP EPIDURAL INJECTION -LUMBAR 1,704.001507623 SP EPIDURAL INJECTION -THORACIC 1,704.001507631 SP ADRENAL BILAT ANGIO 4,854.001507664 SP CATHETER STRIPPING 630.001507698 SP HEPATIC VENOGRAM W/O HEMODYNAMIC 4,982.001507706 SP ABCESS THERAPY INTRACATH 4,057.001507714 SP ULTRASOUND ACCESS GUIDANCE 1,394.001507730 INTERVENTIONAL RADIOLOGY 4 5,850.001507748 SP TRANSCERVICAL CATH OF FALL TB 1,935.001507755 XR INCISIONAL BIOPSY NON IMAGING 3,379.001507763 SP VERTEBROPLASTY LUMBAR 14,144.001507771 SP VERTEBROPLASTY THORACIC/CERVICAL 14,002.001507797 SP VERTEBROPLASTY ADD LEVEL 5,162.001507805 INTERVENTIONAL RADIOLOGY 5 7,150.001507813 INTERVENTIONAL RADIOLOGY 6 8,450.001507821 INTERVENTIONAL RADIOLOGY 7 9,750.001507839 INTERVENTIONAL RADIOLOGY 8 13,650.001507847 SP PAIN MANAGEMENT CONSULT 719.001507854 SP PAIN MGMT CONSULT W/ADD TEST 719.001507862 SP E&M LEVEL 5 91MIN & OVER 174.001507870 XR SM BOWEL ENTEROCYYSIS STUDY 3,572.001507896 BC DIAG MAMMO BILAT IMP W/TOMO 935.001507904 BC DIAG MAMMO RIGHT IMP W/TOMO 364.001507912 BC DIAG MAMMO LEFT IMP W/TOMO 364.001507938 BC MOTHERS DAY MAMMO W/IMPLANTS 489.001507946 BC MOTHERS DAY MAMMO IMP W/TOMO 489.001507953 XR ANKLE MIN 3 VIEWS RIGHT 657.001507961 XR ANKLE MIN 3 VIEWS LEFT 657.001507979 XR ANKLE 2 VIEWS RIGHT 551.001507987 XR ANKLE 2 VIEWS LEFT 551.001507995 XR CLAVICLE RIGHT 615.001508001 XR CLAVICLE LEFT 615.001508019 XR ELBOW COMPLETE RIGHT 678.001508027 XR ELBOW COMPLETE LEFT 678.001508035 XR ELBOW LIMITED RIGHT 602.001508043 XR ELBOW LIMITED LEFT 602.001508050 XR EYE FOR FOREIGN BODY RIGHT 1,010.001508068 XR EYE FOR FOREIGN BODY LEFT 1,010.001508191 XR FOOT MIN 3 VIEWS RIGHT 701.001508209 XR FOOT MIN 3 VIEWS LEFT 701.001508217 XR FOOT LIMITED 2 VIEWS RIGHT 607.001508225 XR FOOT LIMITED 2 VIEWS LEFT 607.001508233 XR FOREARM RIGHT 608.00

1508241 XR FOREARM LEFT 608.001508258 XR HAND 3-4 VIEWS RIGHT 679.001508266 XR HAND 3-4 VIEWS LEFT 679.001508274 XR HAND 2 VIEWS RIGHT 491.001508282 XR HAND 2 VIEWS LEFT 491.001508290 XR HEEL RIGHT 566.001508308 XR HEEL LEFT 566.001508316 XR HIP IN SURGERY RIGHT 503.001508324 XR HIP IN SURGERY LEFT 503.001508332 XR HIP UNILATERAL 1 VIEW RIGHT 543.001508340 XR HIP UNILATERAL 1 VIEW LEFT 543.001508357 XR HIP UNILATERAL 2V RIGHT 1,008.001508365 XR HIP UNILATERAL 2V LEFT 1,008.001508373 XR HUMERUS 2 JOINTS RIGHT 688.001508381 XR HUMERUS 2 JOINTS LEFT 688.001508399 XR KNEE RT 1-2 VIEWS 596.001508407 XR KNEE LT 1-2 VIEWS 596.001508415 XR KNEE 4 VIEWS RIGHT 891.001508423 XR KNEE 4 VIEWS LEFT 891.001508431 XR ORBITS BILATERAL 1,100.001508449 XR ORBITS ONE EYE 1,100.001508456 XR RIBS UNILATERAL RIGHT 746.001508464 XR RIBS UNILATERAL LEFT 746.001508472 XR SCAPUAL RIGHT 669.001508480 XR SCAPULA LEFT 669.001508498 XR SHOULDER 1V RIGHT 566.001508506 XR SHOULDER 1V LEFT 566.001508514 XR SHOULDER COMPLETE RIGHT 730.001508522 XR SHOULDER COMPLETE LEFT 730.001508530 XR TIBIA/FIBULA RIGHT 699.001508548 XR TIBIA/FIBULA LEFT 699.001508654 XR WRIST AP&LAT RIGHT 616.001508662 XR WRIST AP&LAT LEFT 616.001508670 XR WRIST COMPLETE RIGHT 748.001508688 XR WRIST COMPLETE LEFT 748.001508696 XR CHEST SPCIAL VIEWS(DECUB) 706.001508704 XR KNEES BOTH STANDING AP 635.001508712 XR SPINE LS BENDING VIEWS ONLY 1,360.001508720 XR SPINE ENTIRE SURVEY AP&LAT 1,095.001508738 XR FEMUR AP&LAT RIGHT 776.001508746 XR FEMUR AP&LAT LEFT 776.001508753 XR KNEE 3 VIEWS-RIGHT 783.001508761 XR KNEE 3 VIEWS-LEFT 783.001508795 BC-INTERVENTIONAL DRAIN W/CATH 908.001508803 XR CHEST 2V W OBLIQUE 706.001508811 XR ABD SERIES AND PA CHEST 1,087.001508829 XR VASOGRAPHY 1,692.00

1508837 XR UPPER EXTREMITY INFANT LT 378.001508845 XR ANKLE ARTHROGRAM RT 1,330.001508852 SP E&M LEVEL 1 LESS THAN 15 MIN 719.001508860 SP E&M LEVEL 2 16-30 MIN 84.001508878 XR ARTHROGRAM SHOULDER RT 1,539.001508894 SP E&M LEVEL 3 31-60 MIN 100.001508902 SP NERVE BLOCK LUMB OR SACRAL 5,040.001508910 SP PERCUT TNL CATH PLCMT-FL GDE 789.001508928 SP NERVE BLOCK LUMORSAC ADD LVL 2,656.001508936 SP FLUROGUIDE FOR SPINE INJECT 1,704.001508944 XR ERCP-BILIARY DUCTAL SYSTEM 2,227.001508951 XR ERCP-PANCREATIC DUCTAL SYSTEM 2,280.001508969 US PARATHYROID 1,668.001508977 ZILVER DRUG ELUTING STENT 140MM 12,975.001508993 SP FACET INJ LUMBAR/SACRAL ADDL 1,635.001509009 SP ANGIO SEAL DEVICE 1,757.001509017 SP NERVE BLOCK CERORTHO ADD LVL 2,213.001509025 SP FACET INJ LUMBAR/SACRAL 4,492.001509041 ZILVER DRUG ELUTING STENT 40-60MM 7,475.001509058 SP DIALYSIS CATH INSERTION-FLOR 789.001509066 SP HEPATIC VENOGRAM W HEMODYNAMIC 4,982.001509074 SP FLUORO GUIDE FOR CNT VENOUS 789.001509082 XR FLUORO FOR CENTRAL VENOUS CATH 789.001509090 BALLOON EXPANDABLE STENT 8,670.001509108 SP AUX ANGIOJET CATH 4,651.001509116 SP XVG ANGIOJET CATH 15,447.001509124 CATH VAXCEL DIALYSIS 28CM 5,210.001509132 DIALYSIS CATH 1,750.001509140 CATH VAXCEL DIALYSIS 19CM 2,715.001509157 STENT BILIARY LG PALMAZ BALL EXP 10,086.001509165 INTRO COOK CHECK-FLO LARGE VALVE 820.001509173 AMPLATZ RENA DILATOR SET 1,833.001509181 WALLSTENT BILIARY TRANSHEPATIC 8,741.001509199 STENT PALMAZ BILIARY BALL EXPAND 8,404.001509223 WALLGRAFT STENT TRACHEO 50MM 18,825.001509231 WALLGRAFT STENT TRACHEO 30MM 18,825.001509249 WALLGRAFT STENT TRACHEO 20MM 18,825.001509256 WALLGRAFT STENT TRACHEO 70MM 18,825.001509264 STENT URETERAL PERCUFLEX 1,076.001509272 WALLSTENT ENTERAL DELIVERY 90MM 10,421.001509280 WALLSTENT RP BILIARY DELIVERY 80M 9,412.001509298 WALLSTENT RP BILIARY DELIVERY SYS 9,412.001509306 STENT SMART BILIARY SYSTEM 80MM 7,733.001509314 STENT SMART BILIARY SYSTEM 60MM 7,733.001509322 STENT SMART BILIARY SYSTEM 40MM 7,733.001509330 STENT SMART BILIARY SYSTEM 20MM 7,733.001509348 STENT MED PALMAZ BILIARY/DELIVER 10,421.00

1509355 STENT CORINTHIAN 1Q & DELIVERY SY 8,067.001509363 STENT PALMAZ CORINTHIAN 1Q 7,398.001509371 CATH FLEXIMA BILIARY DRAIN W/PIG 865.001509389 THROMBO ARROW TERROTOLA 5,391.001509397 CATH VISTA BRITE TIP GUIDE 5FR 1,124.001509405 CATH VISTA BRITE TIP GUIDE 6FR 1,124.001509413 CATH VISTA BRITE TIP GUIDE 7FR 1,124.001509421 CATH VISTA BRITE TIP GUIDE 8FR 1,124.001509462 BALLOON CATH OPTA 5 PTA 2,267.001509470 BALLOON CATH POWERFLEX EXTREME 2,267.001509488 BALLOON CATH OPTA LP PTA 2,267.001509496 BALLOON CATH CENTURION OPTIPLAST 2,156.001509504 BALLOON CATH TALON 5,175.001509520 HYDROLYSER THROMBECTOMY CATH 7FR 6,902.001509538 HYDROLYSER THROMBECTOMY CATH 6FR 6,902.001509546 OASIS THROMBECTOMY CATH 6,450.001509553 WALLSTENT BILIARY TRANSHEPATIC 1K 10,086.001509561 WALLSTENT TIPS SYSTEM 60MM 10,086.001509579 WALLSTENT TIPS SYSTEM 40MM 10,086.001509587 WALLSTENT TIPS SYSTEM 20MM 10,086.001509595 WALLSTENT PERMALUME COVER&UNISTEP 12,775.001509603 STENT CORDIS SMART NITINOL 11,766.001509611 STENT CORINTHIAN BILIARY PALMAZ 8,908.001509629 WALLSTENT TRACHEOBRONCH COVERED 11,685.001509637 WALLSTENT TRACHEOBRONCHIAL/PERMU 10,546.001509645 PORTACATH 5,045.001509652 R-PORT PREMIER IMPLANTABLE DEVICE 5,045.001509660 BALLOON CATH ULTRATHIN DIAMOND 2,915.001509678 BALLOON CATH BLUE MAX 20 2,915.001509686 BALLOON CATH MARSHAL 2,915.001509694 BALLOON CATH RADIAL EXPANSION 2,479.001509702 PERCLOSE VAS DEVICE 1,681.001509710 VASOSEAL ES CLOSURE DEVICE 2,069.001509728 SP ANGIO SEAL INSERTION 4,615.001509736 SP ANGIOJET PUMP KIT 9,267.001509744 SP KYPHOPLASTY LUMBAR 41,704.001509751 SP INSERT DUODEN OR JEJUN TUBE 3,686.001509769 SP REPLACE GASTRO OR J-TUBE 3,976.001509785 SP CHOLANG THRU EXISTING CATH 2,935.001509801 VISAPAQUE 320MG/ML IODINE PER ML 2.001509819 OMNIPAQUE 300MG/ML I0DINE PER ML 2.001509827 ZILVER DRUG ELUTING STENT 80-100MM 6,285.001509835 SP ATHERECTOMY PERIPHERAL 18,559.001509850 SP KYPHOPLASTY SUPPLY KIT 41,323.001509868 SP KYPHOPLASTY ADD'L LEVEL 8,681.001509884 SP THROMBC CT ART NON SHUNT SNDY 4,566.001509892 SP THROMBECT VENOUS NON SHUNT P 11,150.00

1509900 SP THROMABECT VENOUS NON SHUNT A 11,150.001509918 SP FLUOROSCOPIC PROCEDURE INTV 1,024.001509934 SP ATHERECTOMY PERIPH EA ADDL 16,380.001509942 SP ATHERECTOMY RENAL 18,559.001509959 SP ATHERECTOMY VISCERAL 18,559.001509967 SP US GUIDANCE FOR VICERAL ACC 3,782.001509975 SP VENOGRAPHY SUP SAGITTAL SIN 8,921.001509991 SP MECH REMOVAL THRU DEVICE 984.001510007 SP AORTIC STENT ENDOVAS REPAIR-IP 4,359.001510015 SP AORTIC STENT EXTENSION 1 PER IP 2,180.001510023 SP THROMBECT ART NON SHUNT PRMY 11,150.001510031 SP THROMBECT ART NON SHUNT AD U 4,566.001510049 INTERVENTIONAL RADIOLOGY 9 19,500.001510072 SP NEPHROSTOGRAM THRU EXST CATH 1,214.001510080 SP DILAT OF NEPHRO TRACT-ENDOUR 7,295.001510098 SP GI(NG G-TUBE J-TUBE) CHECK 945.001510106 XR TOES LEFT 625.001510114 XR FINGERS LEFT 446.001510148 SP RF ABLATION LUMBAR 5,870.001510155 SP BILATERAL URETER STENT PLACEMENT 6,970.001510163 SP RF ABLATION THORACIC 3,400.001510171 SP PRESSURE WIRE 3,475.001510189 SP KYPHOPLASTY THORACIC/CERVICAL 41,323.001510197 LOW OSMOLAR CONTRAST 300-399MG/ML 2.001510205 SP UTERINE FIBROID EMBOLIZATION 56,855.001510221 SP INTRAPERITONEAL CATH PL PLEUREX 14,015.001510239 XR DISCOGRAM THORACIC 4,822.001510247 SP OFFICE CONSULTATION 719.001510254 SP ENDOVASC ILIAC STENT GRAFT 10,272.001510262 SP RFA VENOUS 5,868.001510270 SP RFA VENOUS ADD'L LEVEL 1,677.001510288 SP INJECTION THERAPY OF VEIN - 1 299.001510296 SP INJECTION THERAPY OF VEINS 299.001510304 STENT COVERED 5-9 W/DELIVERY SYS 19,475.001510312 STENT COVERED 10-14 W/DELIVERY SYS 14,611.001510320 DIAMONDBACK ATHERETOMY CATH 20,275.001510338 WIRE VIPER 1,165.001510346 CLOSER FAST RFA CATHETHER 4,049.001510353 PERFORATOR RFA CATH 1,957.001510361 HUBER POWERLOC NEEDLE 20 GX.75 36.001510387 PICC LINE INSERTION - OP 4,000.001510395 TRAY TRIPLE LUMEN PICC 304.001510403 TRAY DUAL LUMEN PICC 247.001510411 RFA ELECTRODES 17,746.001510429 LC BEADS CHEMO 11,819.001510452 SP CHEMOTHERAPY ADM ARTERIAL 653.001510478 SP SHUNT 2ND ACCESS 398.00

1510486 SP DECLOT OF VAS ACCESS DEVICE 1,214.001510494 SP IVUS CATHETER 4,875.001510502 US FOLLICLES LIMITED 1,056.001510551 US SONOHYSTEROGRAPHY (SIS) 2,448.001510569 US GUIDE MONITOR TISSUE ABLTN 769.001510577 INTERVENTIONAL RADIOLOGY US GDN 2,158.001510593 US FAST SCAN FOR TRAUMA 1,507.001510627 IVUS CORONARY OR GRAFT 4,389.001510643 US INTRAVASCULAR (NON-CORONARY) 961.001510650 IVUS ADD'L VSL 324.001510668 XR EXTREMITY ANGIO UNILAT-MOD 59 8,891.001510676 XR EXTREMITY ANGIOGRAM UNILATERAL 8,891.001510684 SP US COVER 33.001510692 SP IO BAN 51.001510700 SP BACK STOP 41.001510718 SP G TUBE 1,373.001510726 SP AVA MAX VERT NEEDLE 2,726.001510734 SP TRIPLE LUMEN 132.001510759 CATH YUEN CENTESIS 418.001510775 SP SHUNTOGRAM 595.001510783 SP SUBCUTANEOUS SPINE INJECTION 550.001510791 SP SCLEROTHERAPY FLUID COLLECTION 2,911.001510809 SP RFA GANGLION 1,324.001510817 SP REMOVAL OF ABSCESS DRAIN CATH 719.001510825 CYSTOGRAFIN 141MG IOD 300ML PER ML 2.001510833 SINOGRAFIN 380MG IOD/10ML PER ML 5.001510841 SP REMOVAL OF URETERAL STENT 10,144.001510858 SP DILAT OF BIL DUCT ST W/WO STENT 7,370.001510866 PTA ILIAC ARTERY ADD LEVEL 20,384.001510874 PTA ADD'L TIBIOPERONEAL 20,384.001510882 INTRAVACULAR STENT ILIAC UNILATERAL 24,475.001510890 INTRAVASCULAR STENT ILIAC EA ADD'L 24,475.001510908 INTRVSCLR STNT FMRL/POP W/WO PLASTY 24,475.001510916 INTRVSCLR STNT FMRL/POP&ARTHRCTMY 24,475.001510924 INTRVSCLR STENT TBOPRNL W/WO PLASTY 24,475.001510932 INTRAVASCULAR STENT TBOPRNL EA ADD 24,475.001510940 LOW OSMOLAR CONTRAST 300-399MG/ML 2.001510957 LOW OSMOLAR CONTRAST 100-199MG/ML 2.001510965 LOW OSMOLAR CONTRAST 200-299MG/ML 2.001510973 GASTROVIEW 367MG/ML PER ML 2.001510981 CYSTOGRAFIN 300MG/ML PER ML 2.001510999 XR SPINE SCOLIOSIS SUP & ERECT 1,095.001511005 XR ESOPHAGUS PHRYNX / OR CERVCL 1,486.001511013 XR PEDIATRIC CHEST CROSS TABLE 571.001511039 XR FLOURO FOR SPINE INJECTION 1,704.001511047 XR LUMBAR PUNCTURE AT BEDSIDE 2,435.001511054 XR RIBS UNILAT RT W CHEST PA 1,396.00

1511062 XR RIBS UNILAT LT W CHEST PA 1,396.001511070 INTVSCLR STN TBOPRNL&ATHRCTMY EA AD 24,475.001511088 ATHERECTOMY ILIAC EACH VESSEL 16,380.001511096 ATHRECTOMY TIB/PERONEAL W/WO PLASTY 18,559.001511104 ATHRCTMY ADD'L TIB/PRNL W/WO PLSTY 16,380.001511112 ATHERECTOMY ABDOMINAL AORTA 18,559.001511120 ATHERECTOMY BRACHIOCEPHALIC 18,559.001511138 INTRVSCLR STNT TBOPRNL&ARTHERECTOMY 24,475.001511146 SP SCLEROTHERAPY CYST 14,203.001511153 XR ABD 3 VIEWS 1,075.001511161 CATH PIONEER 13,975.001511179 COIL VASCULAR PLUG 5,039.001511187 BC-SCRNING MAMMO DIGITAL BILAT 489.001511195 BC-SCREENING IMPLANT DIGITAL BI-LAT 489.001511203 BC-DIAG MAMMOGRAM DIGITAL BI-LAT 935.001511211 BC-DIAG IMPLANT DIGITAL BILAT 935.001511229 BC-UNLIATERAL RIGHT DIGITAL 624.001511237 BC-UNILATERAL LEFT DIGITAL 624.001511245 BC-SPECIAL VIEWS LT DIGITAL 624.001511252 BC-SPECIAL VIEWS RT DIGITAL 624.001511302 BC DIAG MAMMO IMPLANT - LEFT 624.001511310 BC DIAG MAMMO IMPLANT-RIGHT 624.001511328 INTERVENTIONAL LOCALIZATION 1 5,856.001511336 INT LOCALIZATION 1 ADD'L SITE 5,856.001511344 INTERVENTIONAL LOCALIZATION 2 6,197.001511351 INT LOCALIZATION 2 ADD'L SITE 4,463.001511377 BC - BILATERAL SPEC VIEWS - DIGITAL 935.001511393 INTERVENTIONAL BIOPSY 1 8,273.001511401 INT BIOPSY 1 ADD'L SITE 8,273.001511419 US AAA SCREENING 1,508.001511427 BC SURGICAL SPECIMEN ULTRASOUND 606.001511435 BC INTERVENTIONAL RADIOLOGY 5 7,088.001511443 BC GUIDANCE TISSUE MARKER PLACEMENT 3,782.001511468 BC MRI CAD BREAST 81.001511476 BC GUIDANCE FOR LYMPHNODE BX 3,782.001511484 XR FLURO FOR PORTACATH NON RAD 789.001511492 XR CHEST 1V LATERAL 706.001511500 US EXTREMETY LIMITED 2,058.001511518 SP GJ TUBE INSERTION 5,072.001511526 XR ERCP BILIARY DUCTAL SYSTEM-OR 2,227.001511534 XR ERCP PANCREATIC DUCTAL SYS-OR 2,280.001511542 XR ERCP BILIARY&PANCREATIC-OR 3,208.001511559 XR ABDOMEN 1-VIEW SITZ MARKER 586.001511567 XR UGI TRACT W/O KUB 559.001511575 US LEFT THOROCENTESIS 2,475.001511583 XR GI(NG,G-TUBE,J-TUBE) CHECK 869.001511591 XR REMOVE ESOPHAGUS OBST W FLUORO 300.00

1511609 XR RIB SERIRES BILAT W CHEST PA 522.001511617 US TRANSPLANTED KIDNEY W DOPPLER 773.001511625 SP TUNNLD PERITONEAL CATH FOR DRNG 15,072.001511633 SP REMOVAL OF NEPH TUBE W FLUORO 3,617.001511641 SP RENAL UNILATERAL 2ND ORDER 13,574.001511658 SP RENAL BILATERAL 2ND ORDER 13,574.001511682 USHER CROSSER SUPPORT 2,187.001511690 EKKOS CATHETER 14,475.001511708 SP IVC FILTER REMOVAL 13,814.001511716 SP IVC FILTER REPOSITION 13,814.001511724 SP RFA LUMBAR/SACRAL EA ADDL JNT 3,400.001511732 SP RFA CERVICAL/THORACIC EA ADDL 1,189.001511757 PARACENTESIS W/O GUIDANCE 2,507.001511765 SP NASO OR ORO GASTRIC TUBE PL 574.001511773 SP INSERTION OF INDWELLING TN CATH 14,012.001511781 SP PERCUT CHOLECYSTOSTOMY 13,274.001511799 SP PERCUT CYSTOSTOMY 7,442.001511807 SP EMBOLIZATION OF ABSCESS/FISTULA 2,418.001511815 SP REMOVE&REPLACE IN/EX URT STENT 7,397.001511823 SP PERITONEOGRAM 1,759.001511831 SP INSTALL VIA CHEST/CATH PLEURODES 2,228.001511849 SP SECONDARY THROMBECTOMY 11,150.001511856 EMP CHEST IV 571.001511864 SP TIPS REVISION 52,665.001511872 SP PERINEOGRAM 1,059.001511880 SP BIL ENDOSCOP W BIOPSY SNG OR MLT 13,286.001511898 SP ABLATION RENAL TUMOR UNILAT 29,265.001511906 SP PLEURAL DRAINAGE W/INDWLLNG CATH 2,475.001511914 SP THROMBOLYSIS ARTERIAL INFUSION 4,782.001511922 SP THROMBOLYSIS VENOUS INFUSION 4,782.001511930 SP THROMBOLYSIS CONTINUED TREATMENT 10,669.001511948 SP THROMBOLYSIS CESSATION OF TRTMNT 10,669.001511955 SP CAROTID CEREBRAL INTERNAL UNILAT 22,082.001511963 SP VERTEBRAL SELECTIVE UNILATERAL 22,082.001511971 SP INTRACRANIAL BR OF CAROT OR VERT 1,070.001511989 SP DECLOG JEJUNOSTOMY OR OTHER TUBE 2,675.001511997 SP EXTREMITY ANGIO UNI W INTERVNTN 8,891.001512003 SP INTRO OF CATH TO URTER EPL RENAL 11,610.001512011 SP SELECTIVE ADDED VESSEL 4,982.001512029 SP VENOGRAM BILATERAL EXT 2,929.001512045 SP EXTREMITY ANGIO BILATERAL WI 6,360.001512052 FLOURO GUIDE FOR NEEDLE PLACEMENT 1,704.001512060 FLUORO GUIDE FOR NDLE PL NON SPINE 789.001512078 SP RECONSTRUCTION IMAGES SAME WS 1,061.001512086 SP RECONSTRUCTION IMAGES SP WK 759.001512102 SP VISERAL SUPRASEL ANGIO ADDTL 6,239.001512128 US INFANT HIPS DYNAMIC 393.00

1512136 US INFANT HIPS LIMITED STATIC 393.001512144 SP STENT PLCMNT INTRAV PERCUT ARTRL 51,828.001512151 SP ADDTNL STENT PLCMNT INTRAV PERCU 25,065.001512169 SP STENT PLCMNT INTRAV PRCT-VENOUS 51,828.001512177 SP ADDTNL STENT PLCMNT -VENOUS 25,065.001512185 SP EMBOLIZATION NON NEURO 56,855.001512193 US GUIDANCE FOR VASCULAR ACCESS 1,394.001512201 SP IMAGE GUIDE FL CL DRN BY CATH 7,025.001512227 SP POWER GLIDE INSERTION 5,092.001512235 SP PSEUDOANEURYSM TRT DRT PNCT 1,096.001512243 SP IVAS EACH ADD'L LEVEL 324.001512250 BC-INTERVENTIONAL LOC 3 5,856.001512268 BC-INTERVENTIONAL LOC 3 ADD'L SITE 5,856.001512276 BC-BREAST TOMO SCREENING 230.001512284 BC-BREAST TOMO DIAGNOSTIC UNILAT 230.001512292 BC-BREAST TOMO DIAGNOSTIC BILAT 230.001512300 BC-BREAST U/S COMPLETE RIGHT 1,274.001512318 BC-BREAST U/S COMPLETE LEFT 1,274.001512326 BC-BREAST U/S LIMITED RIGHT 1,274.001512334 BC-BREAST U/S LIMITED LEFT 1,274.001512342 BC-BREAST U/S LIMITED-BILAT 2,548.001512359 BC-BREAST U/S COMPLETE-BILAT 2,548.001512367 EMBOL PARTICLES(MICROSPHERES) 1,197.001512433 NEEDLE HOLDER SHORT STOP 64.001512466 CATHETER QUICK CROSS 4FR 5,550.001512656 GUIDEWIRE ANGLED ADVANTAGE 975.001512672 TR BAND REGULAR TERUMO 225.001512722 BALLOON HYPERFORM 7,120.001512755 BALLOON ECHELON 3,230.001512771 CATHETER MARKSMAN STENT 4,725.001512847 NAVIEN DSC 5,120.001512854 BALLOON HYPERGLIDE 5,815.001512862 CATHETER ORION 4,480.001512888 CATHETER CELLO BALLOON GUIDE 4,785.001512896 DX SLIM DELIVERY CATHETER 4,650.001512904 NEURON MAX DELIVERY CATHETER 1,975.001512912 NEURON DELIVERY CATHETER 2,975.001512920 REPERFUSION CATHETER 6,900.001512946 VELOCITY DELIVERY MICROCATHETER 4,650.001512979 BARE AXIOM COIL 5,500.001512987 AXIUM 3D COIL 7,000.001512995 BARE AXIUM 3D COIL 5,500.001513001 BARE AXIUM PRIME 3D COIL 5,500.001513027 CONCERTO HELIX COIL 2,975.001513043 COIL 400 COMPLEX EXTRA SOFT 12,500.001513050 COIL 400 CURVE EXTRA SOFT 10,500.001513068 J COIL 12,500.00

1513076 COIL 400 SOFT 12,500.001513084 COIL 400 STANDARD 12,500.001513092 AXIUM HELIX COIL 6,000.001513118 BARE AXIUM HELIX COIL 5,000.001513142 CATHETER POWERGLIDE FULL 422.501513159 GATEWAY PTA BALLOON 5,366.001513183 TARGET DETACHABLE COIL ULTRA 9,096.001513191 TARGET DETACHABLE COIL HELICAL 5,760.001513258 SYNCHRO GUIDEWIRE 2,424.001513282 BALLOON GUIDE CATHETER 4,375.001513290 TREVO PRO VUE SYSTEM 36,475.001513308 SOLITAIRE FR DEVICE 31,685.001513332 BAG-A-JET 330.001513423 CONNECTING TUBE HPCT8.880PFM 471.001513506 WIRE GLIDE 895.001513514 WIRE REG 0.35 482.001513522 EMBOL COIL .018 1,483.001513589 ROTATING HEMOSTATIC VALVE 958.001513621 GI KIT 3,191.001513753 STERILE DRAPE COVER 156.001513761 TRAY ARTERIOGRAM 993.001513811 SHEATH REG 658.001513829 SHEATH LONG 549.001513837 IV CATHETER QUICK 22X1 57.001513886 SYRINGE DISP 200MI MED-RAD 273.001513894 MONARCH SYRINGE IN2001 2,021.001513910 DEVICE TORQUE OTD-100 243.001513928 CATHETER PICS 501 MPIS 1,331.001513936 LIVER BX SET 3,011.001513944 INTRODUCER MPIS-501-NT 786.001514058 EMBOL COIL .035 1,026.001514231 TUNNELED DIALYSIS CATHETER 1,569.001514249 WIRE FILTER SPIDER 6,500.001514256 BALLOON REGULAR 4,038.001514265 STENT SELF EXPANDING 13,269.001514272 WIRE COIL PUSHER 16 175CM 2,156.001514280 IVC FILTER PERMAMENT 7,900.001514298 IVC FILTER REMOVABLE 7,900.001514306 ACUSTICK INTRODUCER SYSTEM 1,526.001514314 INFUSION WIRE 11,985.001514322 BILIARY CATH 1,755.001514330 INFUSION CATH 1,630.001514348 NEPHROSTOMY SYSTEM 8F 1,526.001514355 NEPH URETER INT STENT 2,516.001514363 GUIDEWIRE TRANSEND .014 2,479.001514371 GUIDEWIRE V-18 150CM 1,513.001514405 US POST THYROIDETOMY HEAD/NECK 2,278.00

1514413 SHEATH GUIDING SHUTTLE SELECT 648.001514421 CATHETER MARATHON FLOW DIR 13,585.001514439 TRANSEND GUIDEWIRE SOFT/PLATINUM 2,111.001514447 GUIDEWIRE MIRAGE 2,100.001514454 GUIDEWIRE AVIGO 1,935.001514462 SNARES 3,755.001514470 INTRODUCER MPSIS-NT 786.001514488 BALLOON SM3 OR LESS 4,881.001514496 SHEATH CONTRALATERAL 525.001514504 CATH GLIDE/SLIP 1,027.001514512 CATH REG NON GLIDE 551.001514520 ARC STROKE SUPPORT CATHETER 11,000.001514538 SP BONE TUMOR ABLATION 22,000.001514553 XR SHUNT SERIES 580.001514579 XR PELVIS AND HIPS 2V 590.001514587 XR FEMURE RIGHT 1V 590.001514629 XR PEDIATRIC CHEST 2V 914.001514926 SP CONV NEPHROSTOMY TO NEPHROURETER 2,622.001514934 SP ENDOLUMIN BX URETER RENAL PELVIS 7,532.001514942 URTERAL EMBOLIZATION OR OCCLUSION 7,532.001514959 SP REMOVE BILLIARY TUBE W/FLUORO 2,235.001514967 SP PLACE ACCESS THRU BILIARY TREE 16,690.001514975 SP REMOVAL CALCULUS FROM BILE OR GB 4,175.001515048 SP SHUNT WITH PERIPHERAL PTA 28,125.001515055 SP SHUNT WITH STENT INSERTION 56,850.001515063 SP SHUNT WITH THROMBECTOMY 28,125.001515071 XR FEMUR LEFT 1V 590.001515089 SP COILING CAROTID CEREBRL INT UNIL 22,082.001515112 NC - XR CR IMAGES 0.011515121 SP SHUNT W/THOMBECT & PERIPH PTA 56,850.001515139 SP SHUNT W/THROMB & PERIPH STENT 86,175.001515147 SP PTA OF CENTRAL DIALYSIS SECTION 7,030.001515154 SP STENT PLD IN CENT DIALY SEGMENT 7,030.001515162 SP DIALYSIS CIRCUIT EMBOLIZATION 7,030.001515204 MOD SEDAT-INITIAL 15MIN,< 5 YR OLD 130.001515212 MOD SEDAT-INITIAL 15MIN,> 5 YR OLD 70.001515220 MOD SEDAT-EA ADD'D 15MIN 65.001515238 MOD SEDAT OTHER PHY-INIT 15MIN <5YR 500.001515246 MOD SEDAT OTHER PHY-INIT 15MIN >5YR 410.001515253 MOD SEDAT OTHER PHY-EA ADD'D 15MIN 310.001515261 SP REM AND REP EXT ACC NEPH CATH 9,588.001515279 COIL TARGET ULTRA 360 10,750.001515287 COIL AXIUM BARE PRIME 8,975.001515295 PIPELINE EMBO DEVICE 71,500.001515311 LIFESTREAM BALLOON COVERED STENT 12,250.001515345 NAV 6 EMBO FILTER 8,475.001515352 NEURO GLUE EMBOLIC 19,635.00

1515360 KIT ONYX EMBOLIC 12,500.001515394 NEURO ENTERPRISE Z STENT 30,666.001515402 NEURO CODMAN COIL 9,998.001515410 STRYKER TREVO STROKE PACK 49,825.001515444 CATD INDIGO CATHETER 13,950.001515451 LANTERN MICROCATHETER 3,250.001515469 CATD SEPATATOR 8,400.001515501 VERTEBROPLASTY CEMENT 2,232.001515519 SP CHANGE URETERAL STENT THRU ILEAL 4,603.001515535 DRUG COATED BALLOON PTA CATHETER 7,000.001515543 BARRICADE COIL 2,085.001515550 ENDOCARE AMICA MICROWAVE PROBE 11,000.001515568 PULSE RIDER DEVICE 62,500.001515600 TURBO ELITE LASER CATHETER 11,200.001515634 XR ELBOW LT 2V(POST REDUCTION) 207.001515642 XR ELBOW RT 2V(POST REDUCTION) 207.001515659 XR ELBOW LT 2V(SURGERY ONLY) 207.001515667 XR ELBOW RT 2V(SURGERY ONLY) 207.001515675 AXIUM DETACHABLE COIL 7,000.001515683 XR HAND LT 2V(POST REDUCTION) 378.001515691 XR HAND RT 2V(POST REDUCTION) 378.001515709 XR HAND LT 2V(SURGERY ONLY) 378.001515717 XR HAND RT 2V(SURGERY ONLY) 378.001515733 XR SHOULDER LT 2V(POST REDUCTION) 207.001515741 XR SHOULDER RT 2V(POST REDUCTION) 207.001515758 XR SHOULDER LT 1V(SURGERY ONLY) 207.001515766 XR SHOULDER RT 1V(SURGERY ONLY) 207.001515782 XR WRIST LT 2V(POST REDUCTION) 207.001515790 XR WRIST RT 2V(POST REDUCTION) 207.001515808 XR WRIST LT 2V(SURGERY ONLY) 207.001515816 XR WRIST RT 2V(SURGERY ONLY) 207.001515832 VALIENT CAPTIVIA STENT GRAFT 53,617.001515840 EDURANT BIFURCATED GRAFT 33,166.001515857 EDURANT CONTRA LIMB GRAFT 16,542.001515865 EDURANT ILIAC EXTENSION GRAFT 16,542.001515881 EDURANT AORTIC EXTENSION GRAFT 24,855.001515899 APTUS ENDO ANCHOR 1,488.001515907 TALENT OCCLUDER 9,013.001515915 SENTRANT INTRO SHEATH 788.001515931 US SCLEROTHERAPHY FLUID COLLECTION 1,890.001515949 SP ANGIO W/LASER ARTHERECTOMY 49,505.001515956 SP ANGIO,LASER ATHER & STENT PLACEM 75,455.001515964 SP TIBIAL/PERO ANGIO W/LASER ATHERE 75,455.001515980 SP TIBIAL/PERO ANGIO LASER ATH/STEN 75,455.001515992 POWER LASER CATHETER 12,932.001515998 POD OCCLUSION DEVICE 8,950.001516004 POD PACKING COIL 8,950.00

1516012 NEUROFORM ATLAS STENT 36,250.001516020 XR ANKLE LT 2V(SURGERY ONLY) 360.001516038 XR ANKLE RT 2V(SURGERY ONLY) 360.001516046 XR ANKLE LT 2V(POST REDUCTION) 360.001516053 XR ANKLE RT 2V(POST REDUCTION) 360.001516087 XR FOOT LT 2V(SURGERY ONLY) 360.001516095 XR FOOT RT 2V(SURGERY ONLY) 360.001516103 XR FOOT LT 2V(POST REDUCTION) 607.001516111 XR FOOT RT 2V(POST REDUCTION) 360.001516129 XR KNEE LT 2V(SURGERY ONLY) 360.001516137 XR KNEE RT 2V(SURGERY ONLY) 360.001516145 XR KNEE LT 2V(POST REDUCTION) 360.001516152 XR KNEE RT 2V(POST REDUCTION) 360.001516160 XR TIBIA-FIBULA LT(SURGERY) 699.001516178 XR TIBIA-FIBULA RT(SURGERY) 360.001516186 XR TIBIA-FIBULA LT(POST REDUCTION) 360.001516194 XR TIBIA-FIBULA RT(POST REDUCTION) 360.001516228 XR KNEE LT 2V WEIGHT BEARING ONLY 360.001516236 XR KNEE RT 2V WEIGHT BEARING ONLY 360.001516244 PROTEGE CAROTID STENT 10,875.001516251 SPIDER EMBOLIC PROTECTION DEVICE 7,975.001516269 OPTIMA COIL 7,975.001516277 LUTONIX DRUG BALLOON .018 7,250.001516285 JET-7 REPERFUSION CATHETER 14,175.001516293 REVASCULARIZATION DEVICE 3D 26,950.001516301 REACT CATHETER 9,750.001516319 REACT CATHETER - 71 9,750.001516327 SNIPER OCCLUSION MICROCATHETER 6,000.001516335 PWR MIDLINE PROVENA 3FR SINGL LUMEN 715.001516343 PWR MIDLINE PROVENA 4FR SNGL LUMEN 666.001516350 COVERA COVERED STENT 13,250.001516368 VENOVO STENT 8,500.001516376 EMBOTRAP STOKE RETRIEVER 32,000.001516384 JET D ASPIRATION CATHETER 14,175.001516392 PRESSURE SENSING SHEATH 8FRX25CM 4,250.001516400 JET D REPERFUSION CATHETER 13,975.001516418 SWIFT NINJA MICRO CATHETER 8,000.001516434 XR UGI AND SMALL BOWEL FOLLOW THROU 2,909.001516442 SP PROSTATE ARTERY EMBOLIZATION 56,855.001516459 SP SELECTIVE ADDED VESSEL-XU 4,982.001516467 SP CHEMICAL ABLATION-SINGLE VEIN 5,868.001516483 VENASEAL CLOSURE SYSTEM CATHETER 9,195.001516491 CLOT TRIEVER CATHETER 40,000.001516509 CLOT TREIVER SHEATH 10,000.001516525 FLOW TRIEVER CATHETER 0.051520063 BC US AXILLA UNILATERAL 462.001520071 BC US AXILLA BILATERAL 924.00

1530013 NONIN EXT ART NO EX 1,589.001530021 U/S GUIDED NEEDLE PLACEMENT 3,782.001530039 U/S GUIDED CATH INSERTION 1,394.001530054 DPLX CAROTID LTD 1,279.001530062 PSEUDO ANEURSYM INJECTION 653.001530070 UPPER VENOUS UNILATERAL 2,725.001530088 UPPER VENOUS BILATERAL 2,725.001530096 LOWER VENOUS UNILATERAL 2,725.001530104 LOWER VENOUS BILATERAL 2,725.001530112 ART/VEIN MAPPING DIALYSIS ACCESS 2,725.001550003 ICG 495.001550011 CHEST X-RAY POST PICC PLCMNT 571.001550029 CHEST PORTABLE 571.001550037 CHEST FLOURO 789.001550052 XR SPINE THORACIC 2 VIEWS 744.001550060 XR PELVIS COMPLETE 777.001550078 SPINAL DISC ASPIRATION 1,683.001550086 XR HIP BILAT AP 4 VIEW 1,236.001550094 CALCIS/HEEL LT 566.001550102 NEONAT(P)ABD/CHEST 1,087.001550110 PEDIATRIC 2VW CHEST 771.001550128 ESOPH BY VID 1,405.001550136 GI W/SM BWL 2,009.001550144 COLON-BE 1,691.001550151 CHANGE PERC CATH 2,844.001550169 HYPERTENSIVE IVP 1,358.001550177 PERICUT/NEPHROS 3,042.001550185 FLUID COLLECT DRAIN;IMAGE GUID 2,507.001550193 ABD/AOR SER 6,239.001550201 ABD W/RUN-OFF 6,239.001550219 RENAL ANGIO UNI 11,043.001550227 ABD/AOR/SEL 6,239.001550235 EXTREMITY ANGIO BIL 6,360.001550243 ARTERIOVENOUS SHUNT 4,209.001550250 ARTERIOVENOUS FISTULA 4,209.001550268 CATH/OCC/VCSS 9,130.001550276 PLASTY VENOUS VES 9,300.001550284 CESSATION OF THERAPY W/CATH RM 1,736.001550292 VENO/INF/VC 5,689.001550300 LYMPH COM 3,238.001550326 ULTRA SOUND GUIDANCE 1,394.001550334 ERCP C-ARM PORTABLE USE 789.001550342 BRONCH C-ARM PORTABLE USE 789.001550359 CATH TRANSLUMINAL ANGIO NON-LASER 550.001550367 CATH DRAINAGE 959.001550375 NEPH PTC CATH DRAINAGE 563.001550383 BIO-THOR SUP 373.00

1550391 FILTER DEVICE VENA CAVA 4,035.001550417 SUPPLIES ADD 54.001550425 SUPPLY INJEC 27.001550433 SUPPLIES TRAY 134.001550441 LOW OSMOLAR CONTRAST 300/100ML/ML 2.001550458 LOW OSMOLAR CONTRAST 300/50ML/ML 2.001550466 LOW OSMOLAR CONTRAST 300/150ML/ML 2.001550474 LOW OSMOLAR CONTRAST 370/50ML/ML 2.001550482 LOW OSMOLAR CONTRAST M-300/15ML/ML 5.001550490 STENT INTRO ARTERIAL 6,892.001550508 STENT INTRO ARTERIAL ADD 5,418.001550516 STENT INTRO VENOUS 5,418.001550524 TRANS CATH THERAPY NON THROMBO 4,556.001550532 CATHETER THROMBECTOMY 2,664.001550540 THROMBO SUP 2 4,794.001550557 THROMBO SUP ADD 2,398.001550565 CATH PICC 3,167.001550573 TRANS CATH FB RETRIEVAL 5,331.001550581 THROMBOLYTIC THERAPY SUBSEQNT 2,243.001550599 MIDLINE CATHETER KIT 282.001550607 GUIDEWIRE DIAGNOSTIC 852.001550615 CLOSURE DEVICE 2,048.001550623 SHEATH NON-GUIDE/NON-EP/NON-LASER 630.001555085 DIGITAL D CAD 228.001555093 DIGITAL S CAD 228.001555101 MAMMO DUCTOGRAM S 1,058.001555119 INJECT FOR DUCTOGRAM 629.001555135 MAMMO IMPLANTS 935.001555143 MAMMO DIAGNOSTIC 935.001555176 BREAST NEEDLE LOCALIZATION 1,894.001555184 BREAST INCIS BIO 8,236.001555192 MAMMOTONE SUPPLY 899.001555200 BREAST STEREOTACTIC BIOPSY 2,234.001555218 BREAST MARKER 370.001555226 BREAST STEREOTACTIC BIOPSY ADD 1,754.001555234 CLIP/WIRE PLACE W/ MAMMO 196.001555242 CLIP/WIRE PLACE W/ STEREO 185.001555259 C A D SCREENING 228.001555267 C A D DIAGNOSTIC 228.001555275 DIGITAL BREAST TOMO UNILATERAL 230.001555283 DIGITAL BREAST TOMO BILATERAL 230.001555291 SCREENING DIGITAL BREAST TOMO BIL 230.001560002 UNLISTED PRO 648.001560010 BREAST MARKER 308.001560028 LIVER BIOPSY 1,725.001560036 BIOPHYSICAL PROFILE W/STRESS 1,000.001560044 OB US FETAL DETAIL 1,745.00

1560051 CERV LENGTH 648.001560069 BREAST ULTRASOUND COMPLETE 1,274.001560085 ABD RETRO BIOPSY 1,725.001560101 BPP NON STRESS ADDITIONAL 677.001560119 MAMMTOME SUP 899.001560127 VENO/SUP/VC 6,136.001560135 PERCUTANEOUS CHOLECYSTOSTOMY 1,709.001560143 CHOLECYSTOSTOMY W/ FLUORO 6,236.001560150 CHANGE NEPHROS TUBE 4,219.001560168 INTRO CATH VENA CAVA 2,417.001560176 PICC REPLACEMENT 4,523.001560184 AAA STENTING PROCEDURE 9,246.001560192 VAC ASST BIOP WO CLIP 7,136.001560200 ABDOMEN AAA STENT PLACEMENT 4,732.001560218 PELVIS AAA STENT PLACEMENT 5,331.001560226 BONE BIOPSY PUNC 3,055.001560234 INTERV SUP ADDITIONAL 134.001560242 GASTROJEJUNOSTOMY TUBE STD 1,235.001590488 BC US GUIDED CORE BX 3,782.001595271 INTERVENTIONAL BIOPSY 2 8,714.001595289 INT BIOPSY 2 ADD'L SITE 6,980.001595297 BC INTERVENTIAL RADIOLOGY 1 1,911.001595305 BC INTERVENTIAL RADIOLOGY 3 4,463.001595313 MAM SURGICAL SPECIMEN EXAM 606.001595321 BC US VACUUM ASSISTED BX 3,782.001595347 BC GUIDANCE FLUID ASPIRATION 3,782.001595354 SP CAROTID CEREBRAL ANGIO UNILAT 8,169.001595461 PERITONEAL CATH KIT 2,729.001595479 BREAST ULTRASOUND LIMITED 1,274.001595489 MIDLINE INSERTION - OP 4,000.001595495 XR SPINE SCOLIOSIS 1 VIEW 282.001595503 US DOPPLER STUDY LMTD ART&VEN FLOW 2,000.001600097 PACEMAKER INSERT SGL CH 18,000.001600154 PTCA SINGLE VESSEL - 92920 12,579.001600717 LOW OSMOLAR CONTRAST 300-399MG 2.001600725 IMAG SUPERVISION INJECT CATH ANGIO 569.001600733 IMAG SUPERVISION CORONARY ANGIO 569.001600766 EP DEFIB THRESHOLD EVAL LEAD/GEN 3,805.001600774 ANGIO RENAL UNILAT SEL S&I 13,574.001600782 ANGIO RENAL BILAT SEL S&I 13,574.001600816 PTA RENAL OR VISCERAL 28,125.001600832 CATH STENT PLACE NON-COR 1 EA ADDL 23,480.001600865 RIGHT HEART CATH ONLY 19,244.001600873 SELECTIVE CORONARY ONLY 23,862.001600881 SELECTIVE CORONARY W/GRAFTS 32,757.001600899 SELECTIVE CORONARY W/RT HEART CATH 47,725.001600907 SLCTV CRNRY W/GRFTS & RT HRT CATH 45,661.00

1600915 SELECTIVE CORONARY W/LT HEART CATH 28,452.001600923 SELECTIVE CRNRY W/GRFTS&LT HRT CATH 37,345.001600931 SELECTIVE CORONARY W/RT&LT HRT CATH 52,314.001600949 SLCT CRNRY W/RT&LT HRT CTH W/GRFTS 49,361.001600956 LT HEART CATH W/TRASSEPTAL PUNCTUR 17,823.001600964 AORTIC ROOT W/93460 & 93461 569.001600972 MICROPUNCTURE SET 204.001600980 PERIVAC KIT 892.001600998 INTRACORONARY STENT PLCMNT NODES 44,634.001601004 AORTOGRAPHY INJECTION 3,496.001601012 ARTERIAL CONDUIT INJECTION 3,417.001601020 BIOPSY FORCEPS 1,627.001601038 BIOPSY SHEATHS 299.001601046 CARDIAC OUTPUT SEPARATE PROCEDURE 1,428.001601053 STENT PLACEMENT ADDL VSL 8,425.001601061 CV TRAY CHARGES 1,590.001601079 DIAGNOSTIC HEART CATHETERS 120.001601087 SHEATH 151.001601103 GRAFTS INJECTION 3,757.001601111 GUIDE WIRE 487.001601129 IABP INSERTION 835.001601145 INTRACRNRY STNT PLCMNT DES 44,634.001601160 LT HEART CATHETERIZATION W/LV 12,526.001601194 LV ANGIOGRAPHY 3,132.001601251 PERMANENT PACEMAKER REMOVAL 3,259.001601269 PERMANENT PACER INSERT ATRIAL 4,022.001601277 PACER INSERT DUAL CH 21,704.001601285 PERMANENT PACER INSERT VENTRICULR 4,022.001601301 PTCA ADDITIONAL VESSEL 14,609.001601327 PTCA BALLOON GUIDE WIRE 704.001601335 PTCA GUIDING CATHETER 666.001601343 PTCA INDEFLATORS 666.001601350 PTCA KITS 304.001601368 PULMONARY ANGIO 4,067.001601376 RIGHT HEART CATHETERIZATION 6,564.001601384 RT & LT HEART CATHETERIZATION 15,498.001601426 SELECTIVE CORONARY ANGIOGRAPHY 3,883.001601434 SWAN GANZ INSERTION 1,170.001601442 TEMP PACEMAKER INSERT 7,068.001601459 TEMP PACEMAKER WIRE 997.001601541 PHARM AGENT ADMIN NITRIC OXIDE 954.001601574 STENT CORONARY MAGIC WALL LONG 12,354.001601590 STENT CORONARY MAGIC WALL SHORT 8,361.001601616 CORONARY STENT PL EA ADD NODES 8,425.001601640 CANCELLED CATH LAB PROCEDURE 1,911.001602747 SWAN GANZ CATHETER 359.001602754 INTRAVAS STENT ILIAC UNILATERAL 24,475.00

1602762 INSERT BIVENT PACER GEN ONLY 23,373.001602770 INSERT SC PACER GEN ONLY 40,220.001602796 TEE WITH CONTRAST 5,942.001602986 ANGIO-SEAL CLOSURE DEVICE 1,757.001603000 PERCUTANEOUS CORONARY THROMBECTOMY 3,816.001603026 CORONARY THROMBECTOMY CATHETER 1,557.001603042 LEAD PACER T-VEIN VDD SNGL PASS 267.001603208 FFR HEART FLOW RESERVE MEASURE 1,447.001603216 EXTERNAL ELECTRICAL CARDIOVERSION 3,447.001603232 COR ATHER W PTCA SINGLE VESSEL 44,634.001603240 COR ATHER W PTCA ADD VESSELS 44,634.001603257 PERC ATHER W STENT DES - 92933 60,400.001603265 PERC ATHER W STENT NO DES 60,400.001603273 ATHERECTOMY W/STENT ADD'L VESSEL 22,091.001603281 PERC ATHER W STENT DES ADD VES 22,091.001603299 REVASC COR GRAFT W DES - 92937 44,634.001603307 REVASC COR GRAFT W NO DES 44,634.001603315 REVAS COR ADD GRAFT W DES - 92938 22,091.001603323 REVAS COR ADD GRAFT W NO DES 22,091.001603349 REVAS STEMI W DES - 92941 44,634.001603356 REVAS STEMI W NO DES 44,634.001603364 REVAS CTO W DES 44,634.001603372 REVAS CTO W NO DES 44,634.001603380 REVAS CTO W DES ADD VES 22,091.001603398 REVAS CTO W NO DES ADD VES 22,091.001603406 DRUG ADM & HEMODYN MEASUREMENT 954.001603414 L&CORS W OR W/O LV GRAM 15,224.001603422 L & CORS W/LV GRAM & GRAFTS 15,224.001603430 RHC & CORS NO LV GRAM 15,224.001603448 CORS W/GRAFTS NO LV GRAM 15,224.001603455 COR ANGIO W/O CONCMT LHRTCAT 15,224.001603463 RT LT HRT CTH W/LV GRM NO CORS 12,686.001603471 1000 ML NACL BAG FLUSH 56.001603489 INTRAVASC FR MSMT INIT VESSEL 5,322.001603497 RADI GUIDEWIRE 1,886.001603505 ICD GEN ONLY W/EXIST MULTI LDS 81,390.001603539 US GUIDANCE VASCULAR ACCESS 1,394.001603554 SWAN GANZ FOR MONITORING 3,056.001603562 RIGHT HEART CATH 14,901.001603588 500ML NACL BAG 45.001603596 EX INFLATE DEV 439.001603638 IMPELLA INSERTION 47,027.001603646 R/L & CORS W/LV GRAM 15,224.001603661 R/L & CORS W/LV GRAM & GRAFTS 15,224.001603687 PROGRAM EVENT RCDR/ENCOUNTER 123.001603703 EX 063 WIRE 309.001603711 EX SWAN GANZ 930.00

1603729 500 ML HEPARIN SALINE BAG 29.001603745 DIAG CATHETER GUIDING 852.001603778 CLOSURE DEVICE VAS 180.001603786 TR BAND 206.001603794 SHEATH RADIAL 191.001603802 EX IONIC CONTRAST 2.541603810 CATH TRANSLUMINAL BALLOON 2,556.001603828 GUIDEWIRE DIAGNOSTIC 431.001603836 CATH BALLOON CUTTING TRANSLUM 2,519.001603844 CARDIOVERSION 3,447.001603851 GUIDEWIRE PTCA/INTERVENTIONAL 1,458.001603869 LARGE BORE HEMO VALVE 154.001603877 DE STENT PROCEDURE 44,634.001603885 AORTOGRAPHY INJ (SUPRAVALVULAR) 2,663.001603893 SHEATH PEEL-AWAY 707.001603901 CATH RADIAL DIAGN OR GUIDE 334.001603919 BACK STOP 80.001603927 ADDITL VESSEL FFRM 934.001603935 D-STAT 817.001603943 IOBAN 57.001603950 IV CATHETER 41.001603968 GROUNDING/CAUTERY PAD 18.001603976 DELIVERY SYSTEM 668.001603992 MICROPUNCTURE KIT 137.001604008 A-LINE INITIAL 134.001604016 THROMBOLYSIS - IC 623.001604024 HOLD DEVICE 361.001604032 R2 PADS 29.001604040 SKIN STAPLER 766.001604057 STENT COATED/COVERED W/DELIVER 4,478.001604065 STENT NON COATED W/DELIVERY 8,404.001604073 OCCLUSION BALLOON CATHETER 3,273.001604081 YANKAUER SUCTION 79.001604099 CAUTERY PENCIL 20.001604107 02 MASK 65.001604115 1000 ML NACL POUR BOTTLE 56.001604123 ACT TESTING 252.001604131 IV TUBING 69.001604149 GUIDEWIRE FILTER 4,140.001604156 CV TRAY CHARGE 200.001604164 O2 CANNULA 50.001604172 OPSITE 63.001604180 CATHETER TRANSLUMINAL ROTATION 2,815.001604198 EX BURR 6,135.001604206 IVUS CATHETER 2,957.001604313 LEADLESS PACEMAKER INSERT/REPLACE 89,795.001604339 IMPELLA REMOVAL 47,027.00

1604347 IMPELLA REPOSITIONING 47,027.001610609 PERCLOSE VASCULAR CLOSURE DEVICE 1,648.001612936 AORTOGRAPHY ABDOMINAL W/ILIOFEM 6,239.001612944 GUIDELINER CATHETER 2,304.001612969 VENOGRAM UNILAT EXTREMITY 4,738.001612977 VENOGRAM BILATERAL EXTREMITY 2,929.001612993 ABDOMINAL AORTOGRAM 6,239.001613009 ABDOM AORTOGRAM W/RUN OF W/CC 6,239.001613017 ANGIOGRAPHY EXTREM UNILATERAL 8,891.001613025 ANGIOGRAPHY EXTREM BIALTERAL 6,360.001613066 VENOGRAPHY SINUS OR JUGLAR 8,921.001613140 ANGIO RAD S&I EA ADDL VESSEL 4,982.001613157 THORACIC AORTOGRAM 8,891.001613264 VISCERAL ANGIO S&I 6,239.001613306 ANGIO PULMONARY SELECT UNILATERAL 4,982.001613314 ANGIO PULMONARY SELECT BILATERAL 8,891.001613322 ANGIO PULMONARY NON-SELECTIVE 4,982.001613371 RENAL SELECTIVE UNILATERAL 4,738.001613397 STENT ARTERY RENAL 12,681.001613504 STENT ARTERY ADD'L (RENAL) 12,681.001613512 VISIPAQUE 300-399MG/ML 33.001613546 EP RIGHT VENTRICULAR RECORDING 19,012.001613553 EP MAP TACHYCARDIA ADD-ON 19,012.001613561 EP INTRA-ATRIAL PACING 19,012.001613579 EP INTRAVENTRICULAR PACING 19,012.001613587 EP ELECTROPHYS MAP 3D ADD-ON 19,012.001613595 EP ESOPHAGEAL RECORDING 19,012.001613603 EP ESOPHAGEAL RECORDING W/PACING 19,012.001613629 EP COMPREHENSIVE EP W/O INDUCTN 19,811.001613637 EP COMPREHENSIVE EP W INDUCTION 19,811.001613645 EP LA RECORDING & PACING FRM COR 19,811.001613652 EP LV RECORDING AND PACING 19,811.001613660 EP STIMULATION POST IV DRUG INF 19,012.001613678 EP F/U TESTING (NIPS) 19,811.001613686 EP EVAL PREV PLACED ICD (NIPS) 7,089.001613694 EP ABLATION AV NODE 27,446.001613702 COMP EPS W/ SVT ABLATION 67,794.001613710 COMP EPS W/ VT ABLATION & 3D MAP 67,794.001613728 TILT TABLE EVALUATION 2,971.001613736 TRANSEPTAL HEART CATH 21,419.001613744 EP EVAL OF ICD LEADS AT INT INJ 636.001613751 OP EVAL OF ICD LEADS AT INT INSERT 3,805.001613769 EP BUNDLE OF HIS RECORDING 19,012.001613777 EP INTRA-ATRIAL RECORDING 19,012.001613785 EP INTRACARDIAC ECG (ICE) 23,136.001613793 AFIB ABLATION (W) TRANSEPTAL 67,794.001613801 INTERVENTIONAL CARDIOLOGY 1 1,911.00

1613835 INTERVENTIONAL CARDIOLOGY 4 10,144.001613843 INTERVENTIONAL CARDIOLOGY 5 14,201.001613850 INSERT NEW SC PACER RA SYSTEM 26,825.001613868 INSERT NEW RV SC PACER SYSTEM 26,825.001613876 INSERT NEW DC PACER SYSTEM 26,825.001613918 REPLACE DC PACER GEN 23,904.001613926 UPGRADE PACER SC TO DC 22,623.001613934 REPOSITION ELECTRODE PACER/AICD 8,959.001613942 INSERT SINGLE ELECTRODE ANY DEV 25,984.001613959 INSERT TWO ELECTRODES ANY DEV 25,984.001613967 REPAIR SINGLE ELECTRODE ANY DEV 8,959.001613975 REPAIR TWO ELECTRODES ANY DEV 8,959.001613983 REVISE/RELOCATE POCKET - PACER 5,206.001613991 REVISE/RELOCATE POCKET - ICD 2,471.001614007 INSERT LV LEAD TO EXISTING DEVICE 18,031.001614015 INSERT LV LEAD TO NEW IMPLANT 18,031.001614031 REMOVE PACER GENERATOR 4,174.001614049 REMOVE LEAD FROM SC PACEMAKER 26,825.001614056 REMOVE LEAD FROM DC PACEMAKER 26,825.001614064 INSERT SC ICD GEN ONLY 26,712.001614072 REMOVE LEAD(S) ICD 3,673.001614080 INSERT NEW SC-DC ICD SYSTEM 24,876.001614098 REMOVE ICD GEN. ONLY SC OR DC 4,174.001614106 IMPLANT CARDIAC RECORDER 11,520.001614114 REMOVE CARDIAC RECORDER 1,536.001614122 REPLACE BIVENT ICD GENERATOR 53,500.001614130 REPLACE SC ICD GENERATOR ONLY 53,500.001614148 REPLACE DC ICD GENERATOR 53,500.001614155 INSERT DC ICD GEN ONLY 53,500.001614163 INSERT BIVENT ICD GEN ONLY 53,500.001614171 REMOVAL PACEMAKER W/REPLMT DUAL LD 47,027.001614189 REPLACE BIVENT PACER GEN 47,027.001614197 INSERT DC PACER GEN ONLY 17,697.001614205 REPLACE SC PACER GEN ONLY 23,904.001614213 FLUTTER ALBATION WITH AFIB ABL 535.001614221 ABLATION OF SECONDARY ARRHYTHMI 535.001614452 DEFLECTABLE D-TYPE CATH DECA EP 3,256.001614460 3EFLECTABLE D-TYPE CATH QUAD EP 2,258.001614478 QUAD CATH FIXED EP 799.001614486 1EFLEXION SPIRAL DUO-DECA EP 8,477.001614494 LIVEWIRE DUO-DECA LG CURVE EP 5,486.001614502 OPTIMA LASSO EP 8,477.001614510 QUAD SUPREME FIXED EP 1,695.001614528 DEFLECTABLE DECA EP 3,491.001614536 ARRAY CATHETER EP 25,614.001614544 NAV X SURFACE ELECTRODE KIT 8,112.001614551 LBL ABLATION EP 7,973.00

1614569 SAFIRE ABLATION EP 6,584.001614577 DECAPOLAR FIXED LSL W LUMEN EP 3,592.001614585 COOLPATH ABLATION EP 13,022.001614593 TRANSSEPTAL NEEDLE EP 2,049.001614601 AGILIS NXT INTRODUCER EP 8,531.001614619 TRANSSEPTAL SHEATH INTRODUCER EP 1,538.001614627 ABL LIVEWIRE TC LG 7FR 4MM TIP 5,078.001614635 BW HEX D CRV 6FR 222 4,236.001614643 BW HEX FIX 6FR 222 1,793.001614668 INTRO SEPT 8FR 1,592.001614676 INTRO SAFL 8FR 60CM 1,437.001614684 TRIO INTRO 12FR 320.001614692 INTRO RAMP 8FR 60CM 1,397.001614700 DECA LIVEWIRE MED 3,445.001614718 DECA LIVEWIRE XL 3,445.001614726 DECA CSL 6FR 282 2,866.001614734 DECA CSL 7 FR 120CM 2,902.001614742 ABL COOLPATH BR MD 11,838.001614759 ABL COOLPATH BR XL 11,838.001614767 ABL COOLPATH BD LG 11,838.001614775 DUPLEX SCAN EXTREMITY VEINS LMT 1,430.001614783 ATTAIN VENO BALLOON 908.001614791 WHISPER EDS WIRE 1,087.001614809 WHOLEY WIRE 175CM 761.001614817 WRENCH KIT PACER 350.001614825 WORLEY GUIDE CSG 1,260.001614833 COPILOT 381.001614841 SAFE SHEATH 567.001614858 ATTAIN SELECT 1,476.001614874 CATH VENTURE 5,045.001614882 CATH TORNUS 963.001614890 CATH TWIN PASS 2,329.001614908 BENT TIP RETREVAL CATH 582.001614916 MICROSNARE 4,346.001614924 PACER INTEGRATION IN PERSON 305.001614932 PACER EVAL 276.001614940 PACEMAKER PROGRAMMING SINGLE CH 438.001614957 PACEMAKER PROGRAMMING DUAL CHAMB 580.001615079 COMPLETE ECHOCARDIOGRAM 3,740.001615145 HOLTER MONITOR SCANNING 1,486.001615152 HOLTER MONITOR HOOKUP 1,479.001615194 CW NUC ISOTOPE PHARMACOLOGICAL 2,035.001615202 STRESS TEST 2,006.001615269 IVUS CATHETER 4,875.001615277 PRESSURE WIRE 3,718.001615285 US INTRAVASCULAR CORONARY VESSEL 642.001615293 US INTRAVASCULAR EA ADD'L VESSEL 250.00

1615335 VENOUS ABLATION CLOSURE SURGERY 11,556.001615343 BW DECA F-CURVE UNIDIR 858.001615350 CARTO REF PATCH 2,060.001615368 BW ABL THERMO F-CURVE UNIDIR 13,720.001615376 BW LASSO D-CURVE ECO 4,410.001615384 COOLFLOW TUBING 440.001615392 INTRO CATH AORTA 3,657.001615400 CATH PLACEMENT 1ST ORDER VESSEL 6,106.001615418 CATH PLACE 2ND ORDER VESSEL 4,607.001615426 CATH PLACE 3RD ORDER VESSEL 4,607.001615434 CATH PLACEMENT ADD'L VESSEL 3,797.001615442 ANGIO RENAL UNILAT 4,606.001615459 ANGIO RENAL BILAT 4,766.001615467 PTA VENOUS 8,437.001615475 PTA ILIAC UNILATERAL 7,155.001615483 PTA ILIAC ADD'L VESSEL 2,471.001615491 PTA FEMORAL POPLITEAL 6,678.001615509 PTA TIBIAL/PERONEAL 15,125.001615517 PTA TIBIAL/PERONEAL ADD'L VESSEL 2,471.001615525 PTA AORTIC 7,981.001615533 PTA BRACHIOCEPHALIC 11,448.001615541 STENT ILIAC ARTERY UNILATERAL 39,505.001615558 STENT ILIAC ARTERY ADD'L VESSEL 2,471.001615566 STENT FEM/POP UNILATERAL 39,505.001615574 STENT TIBIAL/PERONEAL UNILATERAL 60,918.001615582 STENT TIB/PERONEAL ADD'L VESSEL 2,471.001615590 ATH STENT FEM/POP 60,918.001615608 ATH STENT TIB/PERONEAL 60,918.001615616 ATH STENT TIB/PERONEAL ADD'L VESSEL 2,471.001615624 ATH RENAL S&I 5,009.001615632 ATH VISCERAL S&I 5,009.001615640 ATH AROTIC 15,419.001615657 ATH ILIAC 7,513.001615665 ATHRECTOMY FEMORAL POPLIT 11,130.001615673 ATH TIBIOPERONEAL 10,685.001615681 REVASCULARIZATION EACH ADD'L VESSEL 2,471.001615699 CARDIOVERSION - INTERNAL 3,447.001615715 INFUSION CATHETER 2,800.001615723 INTRA AORTIC BALLOON 3,395.001615731 INTRA NEEDLE/INTRACATH AORTA 320.001615749 PERICARDIOCENTESIS-INITIAL 1,715.001615756 BI-V PACEMAKER INSERTION(INC RA/RV) 23,373.001615764 LEAD REPOSITION RA OR RV 4,091.001615772 LEAD INSERT/ONE PCR OR ICD 11,165.001615780 LEAD INSERT/TWO PCR OR ICD 12,188.001615798 PACEMAKER POCKET RELOCATE 2,471.001615806 LEAD REPOSITION LV 4,091.00

1615814 LEAD REMOVAL(ONE) 3,673.001615822 LEAD REMOVAL(TWO) 4,885.001615830 REMOVE/REPLACE ICD GEN(DUAL) 23,904.001615848 INTRO NEEDLE/INTRACATH ARTERY 2,965.001615855 ATHERECTOMY 44,636.001615863 ATHERECTOMY ADDL VSL 44,636.001615871 ATHERECTOMY W/STENT ADD'L VSL 22,091.001615889 REVASC CTO ADDL VSL 22,091.001615897 THROMBOLYSIS-INTRAVENOUS 623.001615905 PERICARDIOCENTESIS-SUBSEQUENT 1,715.001615913 IVUS NON-CORONARY 4,389.001615921 IVUS NON-CORONARY ADDL VSL 324.001615939 ABDOM AORTOGRAM W/RUN OFF INDEPENT 6,239.001615947 INTRA CORONARY BM STENT PLACEMENT 44,634.001615954 INTRA CORONARY BM STENT PLAC EA ADD 8,425.001615962 SP VENOPLASTY INITIAL VEIN 28,125.001615970 CATH DRUG COATED BALLOON 5,215.001615988 CATH ATHERECTOMY 12,110.001615996 EPICARDIAL LEAD 3,325.001616002 PERC DRUG ELUTING CORONARY STENT 48,140.001616010 AQUACEL DRESSING 99.851616028 PICO WOUND DRESSING ANY SIZE 681.001616036 FLEX STRIP 648.001616044 CANNISTER ANY SIZE 366.001616051 ALLY ADAPTER DRAPE 375.001616069 TRACH KIT ALL SIZES 900.001616168 CW-DOBUTAMINE CARDIOLITE STRESS TES 2,035.001616176 ELECTIVE CARDIOVERSION EXTERNAL 2,557.001616192 RICORS W/GRAFTS 15,224.001616200 ANTIBACTERIAL ENVELOPE 4,007.001616475 SP CHEMICAL ABLATION-MULTIPLE VEIN 5,868.001700558 DNY FOLLOW-UP COMPLEX 999.001701242 DNY FOLLOW-UP INTERMEDIATE 719.001701259 DNY FOLLOW-UP COMPREHENSIVE 897.001701317 DNY FOLLOW-UP SIMPLE 511.001701598 DNY CONSULTATION 2 1,034.001702000 DNY CONSULTATION 1 1,426.001800010 CT HEAD W/C 15 SL 4,770.001800051 CT SPINE LUMB 3LVL W/O 3,871.001800069 CT SPINE THOR 3LVL W/O 3,947.001800077 CT SPINE CERV 3LVL W/O 3,760.001800085 CT CHEST WITH IV CONTRAST 4,930.001800093 CT ORBITS W/O CONTRAST MEDIA 3,417.001800119 CT ORBITS WITH CONTRAST 3,797.001800135 CT TEMPORAL BONELIC W/O 3,417.001800143 CT GUIDE FOR NEEDLE PLACEMENT 4,643.001800168 CT RT LOWER EXTREMITY W/O CONTRAST 5,514.00

1800226 CT HEAD NO CONTRAST 15SL 4,575.001800234 CT HEAD W/WO CONT 4,979.001800259 CT TEMPORAL BONE NO IV CONTRAST 3,417.001800267 MRI TEMPOROMANDIBULAR JOINT 5,818.001800291 CT SELLA/PITUITRY W/O 3,417.001800317 CT SINUSES W/O 3,601.001800325 CT FACIAL BONES W/O 3,601.001800341 MRI ORBIT W/O CONTRAST 4,452.001800366 MRI NECK W/O CONTRAST 4,452.001800374 MRI HEAD W/O CONT 7,784.001800382 MRI HEAD W/CONTRAST 8,268.001800408 MRI CHEST W/O CONTRAST 4,644.001800416 CT COR SAG OBC AND OR RECONSTR 1,061.001800432 MRI LUMBAR SPINE W/O CONTRAST 7,738.001800440 MRI CERVICAL SPINE W/O CONT 7,875.001800457 MRI CERVICAL SPINE W/CONTRAST 9,572.001800465 MRI THORACIC SPINE W/O CONTRAS 6,131.001800481 MRI LUMBAR SPINE W/CONTRAST 9,572.001800515 CT RT UPPER EXT W/O CONTRAST 5,290.001800523 CT RT UPPER EXT W/W/O CONTRAST 5,290.001800531 CT RT UPPER EXT W/CONTRAST 5,290.001800549 MRI RT UPPER EXT NO JOINT WO&W 9,668.001800564 CT RT LOW EXT W/CONTRAST 5,514.001800572 CT RT LOW EXT W&W/O CONTRAST 5,514.001800606 MRI ABDOMEN W/O CONTRAST 5,806.001800622 CT PELVIS 30 SL W/CONTRAST 4,070.001800630 CT NECK NO CONTRAST 3,556.001800655 CT NECK WITH IV CONTRAST 3,816.001800663 CT GUIDE CYST ASPIRATION 4,643.001800705 CT ABDOMEN NO IV CONTRAST 4,463.001800713 CT ABDOMEN W/O & W IV CONTRAST 5,108.001800804 CT ABD WITH IV CONTRAST 4,695.001800812 CT PELVIS W/O 3,943.001800820 CT CHEST NO IV CONTRAST 4,698.001800838 CT NEEDLE LOCALIZATION 4,643.001800853 CT PERCUT ABCESS DRAIN WITH CATH 6,236.001800861 CT FACIAL BONES W/CONTRAST 3,879.001800879 CT FACIAL BONES W&WO CONTRAST 5,593.001800895 CT VERTEBROPLASTY UNDER CT 1,906.001800903 CT CHEST W/O & W CONTRAST 4,965.001800929 CT SPINE LUMB W/CONTRAST 4,304.001800937 CT SPINE LUMB W/O & W CONTRAST 6,437.001800978 CT ANGIO HEAD W/WO IV CNTRST VIZ 4,831.001800986 CT LUNG SCREENING-LDCT 4,000.001800994 CT ANGIOGRAPHY NECK W/O & W CONT 4,728.001801000 CT ANGIOGRAPHY CHEST W/O & W CONT 5,024.001801018 CT ANGIOGRAPHY LWR EXT W/O& W CONT 4,591.00

1801026 CT ANGIOGRAPHY HEAD W/O & W CONT 4,831.001801034 CT ANGIOGRAPHY ABD W/O & W CONT 4,732.001801042 ABDOMINAL ILIO-FEMORAL ANGIO 5,882.001801059 CT ANGIOGRAPHY PELVIS W/O & W CONT 5,331.001801067 CT ANGIO LEFT UPR EXT W/O & W CONT 4,407.001801075 CT PELVIS W/O & W CONTRAST 4,349.001801083 CT NECK W & W/O CONTRAST 4,170.001801091 CT ORBIT W & W/O CONTRAST 5,593.001801109 CT SPINE CERV W/CONTRAST 4,556.001801117 CT SPINE CERV W&W/O CONTRAST 6,437.001801125 CT SPINE THORACIC W/CONTRAST 4,304.001801133 CT SPINE THORACIC W/O & W CONTRAST 6,437.001801141 CT SINUS W/CONTRAST 3,879.001801158 CT LOWER EXTREMITY W/O CONTRAST 5,514.001801166 CT LOWER EXT W&WO CONTRAST 5,514.001801174 CT LOWER EXT W/CONTRAST 5,514.001801182 CT GUIDANCE FOR TISSUE ABLATION 783.001801257 CT LT UPPER EXT W/O&W CONTRAST 5,290.001801265 CT LT UPPER EXT W/O CONTRAST 5,290.001801273 CT UPPER EXT W/CONTRAST 5,290.001801315 CT RECONSTRUCT ON SEP WORKSTATN 759.001801323 CT H W/O CON 4,575.001801331 CT TEMPORAL BONE WITH IV CONTRAST 3,797.001801349 CT SINUS W/WO 5,593.001801356 CT TEMPOROMANDIBULAR JOINT W*WO 5,593.001801364 CT TEMPOROMANDIBULAR JOINT W CNT 3,879.001801372 CT CHEST W/O CON HIGH RES 4,698.001801398 CT SACROILIAC JOINT NO CONT 3,943.001801406 CT THORACOLUMBAR SPINE NO CONT 3,871.001801430 LOW OSMOLAR CONT 300-399MG P/ML 2.001801448 LOW OSMOLAR CONTRAST 300-399MG P/ML 2.001801455 GASTROVIEW 367 MG/ML PER ML 2.001801463 CT LEFT SHOULDER NO IV CONT 5,290.001801471 CT LEFT SHOULDER WO/W IV CONT 5,290.001801489 CT LEFT SHOULDER WITH IV CONT 5,290.001801497 CT RIGHT SHOULDER NO IV CONT 5,290.001801505 CT RIGHT SHOULDER WO/W IV CONT 5,290.001801513 CT RIGHT SHOULDER WITH IV CONT 5,290.001801521 CT LEFT HIP NO IV CONT 5,514.001801539 CT LEFT HIP WO/W IV CONT 5,514.001801547 CT LEFT HIP WITH IV CONT 5,514.001801554 3T LEFT ANKLE NO IV CONT 5,514.001801562 CT LEFT ANKLE WO/W IV CONT 5,514.001801588 CT LEFT KNEE NO IV CONT 5,514.001801596 CT LEFT KNEE WO/W IV CONT 5,514.001801604 CT LEFT KNEE WITH IV CONT 5,514.001801612 CT LEFT FOOT NO IV CONT 5,514.00

1801620 CT LEFT FOOT WO/W IV CONT 5,514.001801638 CT LEFT FOOT WITH IV CONT 4,771.001801646 CT RIGHT HIP NO IV CONT 5,514.001801653 CT RIGHT HIP WO/W IV CONT 5,514.001801661 CT RIGHT HIP WITH IV CONT 5,514.001801679 CT RIGHT KNEE NO IV CONT 5,514.001801687 CT RIGHT KNEE WO/W IV CONT 5,514.001801695 CT RIGHT KNEE WITH IV CONT 5,514.001801703 CT RIGHT ANKLE NO IV CONT 5,514.001801711 CT RIGHT ANKLE WO/W IV CONT 5,514.001801737 CT RIGHT FOOT NO IV CONT 5,514.001801794 CT RIGHT FOOT WO/W IV CONT 5,514.001801802 CT RIGHT FOOT WITH IV CONT 4,771.001801810 CTLOW EXT (BOTH)WITH IV CONTRAST 5,514.001801836 CT TEMPORAL BONE W/WO IV CONTRAST 5,593.001801851 CT HEART WITH IV CONT (CHD) 6,564.001801869 CT ANGIO HRT W/WO IV CON (CRN ART) 6,564.001801893 CT HEART NO IV CONTRAST (COR CA) 6,564.001801901 CT HEART WITH IV CONTRAST (PULUN) 6,564.001801935 CT CEREBRAL PERFUSION WITH CONTRAST 5,697.001801943 CT ABD/PELVIS W/WO CONT (UROGRAM) 9,246.001801950 CT ABDOMEN/PELVIS WC (ENTEROGRAPHY) 8,406.001801984 CTA ABD-PELVIS W/WO IV CONTRAST 9,246.001801992 CT SACROILIAC INJECTION 4,157.001802008 CT ANGIO RIGHT UPR EXT W/O & W CONT 4,407.001802016 CT GUIDE FOR RENAL TISSUE ABLATION 783.001802024 CT THORACOLUMBAR SPINE W CONTRAST 4,304.001802057 CT ANGIO CHEST W/WO IV CNTRST AORTA 5,024.001802065 CT LEFT UPPER EXT ARTHROGRAM W/C 5,290.001802073 CT RIGHT LOWER EXT ARTHROGRAM W/C 5,514.001802081 CT LEFT LOWER EXT ARTHROGRAM W/C 5,514.001802123 CT RIGHT THORACENTESIS 2,787.001802131 CT LEFT THORACENTESIS 2,787.001802149 CT RIGHT UPPER EXT ARTHROGRAM W/C 5,290.001802156 CT CHEST NO IV CONT(INIT LDCT(NCCN) 4,000.001802164 CT CHEST NO IV CONT(SUBSEQ LDCT NCC 4,000.001802172 CT CHEST NO IV CONT(NOD F/U LDCT NC 4,000.001802180 CT VENOGRAM ABD/PELVIS W/IV CONT 9,246.001802198 CT VENOGRAM LOWER EXT W/IV CONTRAST 4,591.001802354 MRA CHEST WO/W CONTRAST 9,668.001802362 MRA ABDOMEN WO/W CONTRAST 9,572.001802370 MRA PELVIS W/WO CONTRAST 9,668.001802388 MRA RT UPPER EXT W/WO CONTRAS 9,668.001802404 MRA HEAD W/O CONTRAST 7,657.001802412 MRA HEAD W/CONTRAST 7,950.001802420 MRA HEAD W/WO CONTRAST 9,572.001802438 MRA NECK W/O CONTRAST 9,572.00

1802453 MRA NECK W/WO CONTRAST 9,572.001802479 MRA RT LOWER EXT W/CONTRAST 9,668.001802487 MRA ABDOMEN W/CONTRAST 9,572.001802495 MRA ABDOMEN W/O CONTRAST 9,572.001802503 MRI HEAD W&W/O CONTRAST 8,656.001802511 MRI LUMBAR SPINE WO/W CONTRAST 8,357.001802529 MRI THORACIC SPINE WO/W CONTRAST 8,285.001802537 MRI PELVIS WO/W CONTRAST 8,565.001802545 MRI CERVICAL SPINE WO/W CONTRAST 8,687.001802578 MRI ABD WO/W CONTRAST 8,178.001802586 MRI PELVIS W/O CONTRAST 5,465.001802594 MRI CHEST WO/W CONTRAST 9,668.001802602 MRI RT SHOULDER W/O CONTRAST 9,668.001802628 MRI RT SHOULDER W/O&W CONTRAST 9,668.001802636 MRI FACE W/O CONTRAST 4,452.001802651 MRI FACE W/O & W 8,151.001802669 MRI NECK W/O & W 8,151.001802693 MRI ORBIT W/O & W 8,151.001802735 MRI RT UPPER EXT ANY JNT W/O&W 9,668.001802792 BC MRI RT BRST UNILAT W/O &W CNTRT 9,572.001802800 BC MRI BREAST BILAT WO&W CONTRAST 6,995.001802826 MRI PROSTATE NO IV CONTRAST 5,465.001802834 MRI PROSTATE W/W/O IV CONTRAST 8,565.001802842 MRI LT SHOULDER W/O CONTRAST 9,668.001802867 MRI LT SHOULDER W/O & W CONTRAST 9,668.001802875 MRI CARD F/MORPHOLOGY & FNCTN W/WO 3,111.001802933 BC MRI BREAST BILATERAL WO/C 9,572.001802941 BC MRI LT BREAST UNILAT WO CONTRAST 9,572.001802958 BC MRI RT BREAST UNILAT WO CNTRST 9,572.001802974 BC MRI LT BREAST UNILAT WO&W CNTRST 9,572.001802982 MRA PELVIS W/O CONTRAST 9,668.001802990 MRA PELVIS W/WO IV CONTRAST 9,668.001803006 MRA CHEST W/O CONTRAST 9,668.001803014 MRA CHEST W/CONTRAST 9,668.001803055 MRA LT UPPER EXT W/WO CONTRAST 9,668.001803162 MRI LT UPPER EXT NO JOIMT W/O&W 9,668.001803188 GADOLINIUM PER ML 30.001803279 MRV ABDOMEN W/WO IV CONSTRAST 9,572.001803287 MRV PELVIS W/WO IV CONTRAST 9,668.001803295 MRI & MRCP ABDOMEN NO IV CONTRAST 5,806.001803303 MRV HEAD W/O CONTRAST 7,657.001803311 MRI RECONSTRUCTION IMAGES SAME WS 1,061.001803329 MRV HEAD WITH IV CONTRAST 7,950.001803337 MRV HEAD WO&W IV CONTRAST 9,572.001803345 MRI SPECTROSCOPY 9,572.001803410 MRI RECONSTRUCTION IMAGES SP WS 759.001803444 MRI LEFT ANKLE WO/W IV CONTRAST 9,668.00

1803469 MRI LEFT KNEE NO IV CONTRAST 9,668.001803477 NRI LEFT ANKLE NO IV CONTRAST 9,668.001803493 MRI LEFT HIP NO IV CONTRAST 9,668.001803501 MRI LEFT HIP W/WO IV CONTRAST 9,668.001803527 MRI LEFT FOOT NO IV CONTRAST 9,668.001803535 MRI LEFT FOOT WO/W IV CONTRAST 9,668.001803550 MRI LEFT THIGH NO IV CONTRAST 9,668.001803568 MRI LEFT THIGH WO/W IV CONTRAST 9,668.001803584 MRI LEFT CALF NO IV CONTRAST 9,668.001803592 MRI LEFT CALF WO/W IV CONTRAST 9,668.001803618 MRI LEFT ELBOW NO IV CONTRAST 9,668.001803626 MRI LEFT ELBOW WO/W CONTRAST 9,668.001803642 MRI LEFT WRIST NO IV CONTRAST 9,668.001803659 MRI LEFT WRIST WO/W IV CONTRAST 9,668.001803667 MRI LEFT WRIST WITH IV CONTRAST 9,668.001803675 MRI LEFT HAND NO IV CONTRAST 9,668.001803683 MRI LEFT HAND WO/W IV CONTRAST 9,668.001803709 MRI LEFT HUMERUS NO IV CONTRAST 9,668.001803717 MRI LEFT HUMERUS WO/W IV CONTRAST 9,668.001803733 MRI LEFT FOREARM NO IV CONTRAST 9,668.001803741 MRI LEFT FOREARM WO/W IV CONTRAST 9,668.001803766 MRI RIGHT ANKLE NO IV CONTRAST 9,668.001803774 MRI RIGHT ANKLE WO/W IV CONTRAST 9,668.001803790 MRI RIGHT KNEE NO IV CONTRAST 9,668.001803808 MRI RIGHT KNEE WO/W IV CONTRAST 9,668.001803818 MRI LEFT KNEE WO/W CONTRAST 9,668.001803824 MRI RIGHT HIP NO IV CONTRAST 9,668.001803832 MRI RIGHT HIP WO/W IV CONTRAST 9,668.001803857 MRI RIGHT FOOT NO IV CONTRAST 9,668.001803865 MRI RIGHT FOOT WO/W IV CONTRAST 9,668.001803881 MRI RIGHT THIGH NO IV CONTRAST 9,668.001803899 MRI RIGHT THIGH WO/W IV CONTRAST 9,668.001803915 MRI RIGHT CALF NO IV CONTRAST 9,668.001803923 MRI RIGHT CALF WO/W IV CONTRAST 9,668.001803949 MRI RIGHT ELBOW NO IV CONTRAST 9,668.001803956 MRI RIGHT ELBOW WO/W IV CONTRAST 9,668.001803972 MRI RIGHT WRIST NO IV CONTRAST 9,668.001803980 MRI RIGHT WRIST WO/W IV CONTRAST 9,668.001804004 MRI RIGHT HAND NO IV CONTRAST 9,668.001804012 MRI RIGHT HAND WO/W IV CONTRAST 9,668.001804038 MRI RIGHT HUMERUS NO IV CONTRAST 9,668.001804046 MRI RIGHT HUMERUS WO/W IV CONTRAST 9,668.001804061 MRI RIGHT FOREARM NO IV CONTRAST 9,668.001804079 MRI RIGHT FOREARM WO/W IV CONTRAST 9,668.001804095 MRA LOWER EXTREMITY BILAT W/WO 9,668.001804103 MRI INTERVENTIONAL RADIOLOGY 1 1,623.001804111 BC MRI INTERVENTIONAL RADIOLOGY 2 1,834.00

1804129 MRI PITUITARY WO/W IV CONTRAST 8,656.001804137 MRI PITUITARY NO IV CONTRAST 7,784.001804145 MRI IAC WO/W IV CONTRAST 8,656.001804152 MRI IAC NO IV CONTRAST 7,784.001804228 CT BONE LENGTH 892.001804269 MRI SINUS NO IV CONTRAST 4,452.001804277 MRI SINUS WO/W IV CONTRAST 8,151.001804285 MRI LOWER EXT NO JOINT W/O&W CONT 9,668.001804293 MRI LOWER EXT NO JOINT NO CONTR 9,668.001804301 MRI & MRCP ABDOMEN W/WO IV CONTRAST 8,178.001804335 CT ABD & PELVIS NO IV CONTRAST 8,268.001804343 CT ABD & PELVIS WITH IV CONTRAST 8,406.001804350 CT ABD&PELVIS W/WO IV CONTRAST 9,246.001804376 MRV RT UPPER EXTRMTY W/WO IV CONTRS 6,995.001804384 MRV LT UPPER EXTRMTY W/WO IV CONTR 6,995.001804426 MRI TMJ WITH CONTRAST PER PROTOCOL 5,818.001804434 MRV BILAT LOWER EXTREMITY W/WO 9,668.001804459 MRI AND MRCP SS ABDOMEN NO IV CON 6,995.001804491 MRI HEAD AND IAC W/WO IV CONT 8,656.001804509 MRI HEAD AND IAC NO IV CONTRAST 7,784.001804517 MRI RIGHT ELBOW ARTHROGRAM W/C 9,668.001804525 MRI LEFT ELBOW ARTHROGRAM W/CON 9,668.001804533 MRI RIGHT SHOULDER ANTHROGRAM W/C 9,668.001804541 MRI LEFT SHOULDER ARTHROGRAM W/C 9,668.001804558 MRI RIGHT HIP ARTHROGRAM W/CONT 9,668.001804566 MRI LEFT HIP ARTHROGRAM W/CON 9,668.001804574 MRI RIGHT KNEE ARTHROGRAM W/C 9,668.001804582 MRI LEFT KNEE ARTHROGRAM W/CONT 9,668.001804590 MRI RIGHT ANKLE ARHTROGRAM W/C 9,668.001804608 MRI LEFT ANKLE ARTHROGRAM W/C 9,668.001804616 MRI CARDIAC FOR MORPHOLOGY&FUN W/WO 9,572.001804624 MRI RIGHT WRIST ARTHROGRAM W/CON 9,668.001804632 MRI LEFT WRIST ARTHROGRAM W/CON 9,668.001804640 MRI HEAD & PITUITARY W/WO IV CNTRST 8,656.001804657 MRI HEAD & PITUITARY NO IV CNTRST 7,784.001804665 MRI HEAD & CSF FLOW NO IV CONT 7,784.001804673 MRI HEAD & CSF FLOW W/WO IV CON 8,656.001804681 MRI CSF FLOW STUDY NO IV CONT 7,784.001804707 MRI BREAST CORE BIOPSY 6,353.001804715 MRI BREAST CORE BIOPSY EA ADD'L 3,457.001804723 MRI NEEDLE LOCALIZATION 4,729.001804731 MRI NEEDLE LOCALIZATION EA ADD'L 1,834.001804749 MRI SACRUM NO IV CONTRAST 6,995.001804756 MRI SACRUM W/WO IV CONTRAST 6,995.001804764 MRI CLAVICLE NO IV CONTRAST-RT 6,995.001804772 MRI CLAVICLE W/WO IV CONTRAST-RT 6,995.001804780 MRI CSF FLOW STUDY W/WO IV CONT 8,656.00

1804798 MRI CLAVICLE NO IV CONTRAST-LT 6,995.001804814 CT CHEST NO IV CONTRAST (LDCT) 4,000.001804822 CT IMAGE GUIDE FL CL DRN BY CATH 7,025.001804863 MRI THORACIC WITH CONTRAST 6,995.001804897 MRI CLAVICLE W/WO CONTRAST-LT 6,995.001804939 MRV NECK W/WO IV CONTRAST 6,995.001805001 CTA HEART W/WO IV CONTRAST - TAVR 6,564.001805019 CTA HEART W/WO IV CONTRAST - TAVR 6,564.001860006 LOWER EXT NONJOINT W&W/O CON 8,052.001860014 MRA UP EXT W CON 9,668.001860016 MRI LOW EXT ANY JOINT W/WO CONTR 9,668.001860030 GADOLINIUM 10ML/ML 19.001860048 BRAIN W/O & W CONTRAST 8,656.001860055 LW EX NO JNT 9,668.001860063 UPPER EXTREM JOINT WO/W CONTRAST 9,668.001860071 LOW EXT JOINT W/O 9,668.001860089 UPPER EXT JOINT WO/W CONTRAST 9,668.001860097 UPPER EXT W/WO 9,668.001860113 MRI UP EXT NO JNT 9,668.001860121 MRA NECK W/CONTRAST 7,789.001860139 ENDO REC COIL 431.001860147 POWER INJECTOR SUPPLY 94.001860154 GADOLINIUM 5ML/ML 19.001860162 LOWER EXT W/WO 8,052.001860170 ORBIT FACE NECK W/GADOLINIUM 4,770.001860188 MRI ORBIT FACE NECK W/O CONTRAST 4,452.001860196 BREAST W/O & W CONTRAST UNILAT 3,606.001860204 BRAIN NO CONTRAST 7,784.001860212 MRI CHEST W/CONTRAST 9,668.001860220 MRI ORBIT/FACE/NECK W&W/O CONT 8,151.001860238 UPPER EXT JOINT W/CONTRAST 9,668.001860246 MRI UNLISTED PROCEDURE 885.001860253 UP EXT JOINT W/O CONT 9,668.001860261 GADOLINIUM 15ML/ML 19.001865005 CONTRAST 300-399 130 ML 2.001865013 SUPPLY INJECTOR 76.001865021 CONTRAST 300-399 150 ML 2.001865039 CONTRAST 300-399 100ML/ML 2.001865047 CONTRAST 300-399 50 PER ML 2.001865054 CT ABD/PELV W&W/O CONTRAST 9,246.001865062 CT ABD PELVIS W/ORAL CONTRAST 8,268.001865070 ABDOMEN W/ORAL CONTRAST 4,463.001865088 CT ABD W/WO PELV W/CONTRAST 9,246.001865096 PELVIS W/ORAL CONTRAST 3,943.001865104 BONE MINERAL IND 1,002.001865112 BONE MINERAL SUP 505.001865120 FACIAL/SINUS LIM 2,134.00

1865138 CONTRAST 300-399 75 PER ML 2.001865146 CT CONTRAST 300/50ML/ML 2.001865153 CT PELVIS LIMITED 2,134.001900059 NM THYROID UPTAKE MULT W/O IMAGING 693.001900091 NM THYROID IMAGING W MULT UPTAKE 1,542.001900141 NM THYROID CA MET IMAGE WB 3,070.001900240 NM WHITE BLOOD CELL LOCAL WHLE 3,067.001900257 NM SENTINEL NODE INJECTN W/IMAGING 2,766.001900281 NM LIVER W/VASC FLOW 2,047.001900299 NM LIVER IMAGING (SPECT) 3,545.001900307 NM LIVER-SPLEEN SCAN 2,583.001900315 NM LIVER &SPLEEN W/VASC FLOW 2,451.001900349 NM HEPATOBIL IMAGE 2,784.001900422 NM GASTRIC EMPTYING STUDY 2,663.001900463 NM MECKELS 2,366.001900471 NM PERITONEAL-VENOUS SHUNT 2,213.001900497 NM BONE-LIMITED 2,059.001900505 NM BONE-MULTIPLE 1,931.001900521 NM BONE SCAN WHOLE BODY 3,776.001900539 NM BONE 3 PHASE 3,992.001900547 NM BONE SPECT 4,739.001900695 NM MYOCARD PERF SPECT SINGLE 2,463.001900703 NM MYOCARD PERF SPECT MULTIPLE 4,999.001900745 NM MUGA REST CARD BLOOD SINGLE 2,469.001900828 NM PULM VENT/PERF PARTICULATE 2,047.001900869 NM PULM VENT IMAG GASEOUS SGL 1,965.001900927 NM BRAIN W/VASC FLOW 4+VIEWS 1,533.001900935 NM BRAIN IMAGING TOMO GRAPHIC 3,972.001900950 NM CEREBRAL VASCULAR FLOW ONLY 2,569.001900968 NM CISTERNOGRAM 2,714.001900984 NM CSF SHUNT FLOW 2,865.001900992 NM CSF-LEAK-FLOW (30) 2,458.001901032 NM RENOGRAM W/FLOW&FUNC W/O RX 2,702.001901123 NM URETERAL CYSTOGRAM 1,826.001901131 NM TESTICULAR IMAG W/VASC FLOW 2,569.001901206 NM MUGA REST ONLY 2,469.001901222 NM MUGA REST-STRESS 1,602.001901289 NM GALLIUM IMAGING WB 2ORMORE D 5,665.001901297 WHOLE BODY SINGLE DAY IMAGING SPECT 5,470.001901305 NM INDIUM LEUKOYT WB 3,067.001901354 WHOLE BODY SINGLE DAY IMAGING 5,470.001901362 NM RADIOPHARM THERAPY ORAL ADM 3,509.001901404 NM THYROID CA THP ORAL ADMIN 3,509.001901552 NM GI BLOOD LOSS 2,272.001901578 NM HEPATOBIL IMAGE W/RADIOPPHA 1,908.001901610 NM LIVER IMAGING STATIC ONLY 2,633.001901636 NM TC99M MEDRONATE UP TO 30 MCI 356.00

1901644 NM TC99M SESTAMIBI PER DOSE 1,285.001901651 NM TC99M SULFUR COLLOID PER DOSE 437.001901677 NM TC99M MAA STUDY DS TO 10MCI 395.001901685 NM XENON 133 PER 10 MCI 164.001901693 NM GA 67 PER MCI 335.001901701 NM I123 PER 100 UCI CAPSULE 484.001901719 NM TL 201 PER MCI 128.001901768 NM I-131 SOD IOD CAP PER MCI TX 230.001901776 NM IN 111 OXYQUIN DX PER 0.5 MCI 3,185.001901784 NM TC99M MERTIATIDE DS TO 15MCI 746.001901800 NM TC99M EXAMETAZ DS TO 25 MCI 3,222.001901859 NM IN 111 PENTETATE PER 0.5MCI 1,198.001901883 NM TC99M DISOFENIN DS TO 15MCI 4,000.001901891 NM TC99M LABEL RBC DS TO 30 MCI 674.001901933 NM TC99M MEBROFENIN UP TO 15 MCI 474.001901941 NM INDIUM WBC LTD AREA 1,623.001901958 PULM/PERF/VENT AEROSAL 2,645.001901966 NM KIDNEY SCAN W/FLOW 2,585.001901974 LYMPHOSCINTOGRAPH 2,766.001901982 RED CELL MASS/SIN 1,034.001901990 MUGA SCAN 1,608.001902014 NM RENOGRAM W/RX INTERV SINGLE 3,498.001902022 NM BRAIN SCAN LTD W/FLOW 1,533.001902048 NM GALLIUM SCAN WB SGL DAY 3,532.001902055 MYOCAR-STR & R 2,584.001902063 MYO PERFUSION W/EJECTION 2,584.001902071 NM WALLMOTION MYO PERF SGL STUDY 1,383.001902501 NM GALLIUM SCAN LTD AREA 887.001902543 NM BONE DENSITY DEXA AXIAL SKEL 1,449.001902550 NM MYOCARD PERF SPECT MULT STUDIES 4,999.001902568 NM MYOCARD PERF SPECT SINGLE STUDY 2,463.001902576 NM BONE MARROW WHOLE BODY 2,850.001902592 NM ISO OCTREOSCAN STUDY DOSE 7,337.001902634 NM SM 153 IEXIDRONAMM UPTO 150MCI 13,993.001902642 NM TC99M SULF COLLOID TO 25 MCI 437.001902725 NM TC99M BICISATE TO 25 MCI 3,212.001902733 NM SOD IODIDE CAP P/UCI TX 230.001902741 NM IN111 PENTETREOTIDE UP TO 6 MCI 14,377.001902808 NM I131 MIBG IOBEN-SUFATE 0.5MCI 8,764.001902832 NM TC99M TETROFOSMIN PER DOSE 783.001902923 NM PHYSICIAN CONSULTATION 719.001902931 NM PHYSICIAN F/U W/TESTS/PROC 719.001903053 NM PARATHYROID IMAGING 1,978.001903178 NM WHOLE BODY SCAN 2OR MORE DAYS 5,665.001903186 NM LIVER IMG SPECT W/VASC FLOW 4,071.001903202 NM MYOCARD REST ONLY VIAB SPECT 2,463.001903244 NM PULMONARY QUANTITATIVE PERFUSION 2,040.00

1903269 NM TC 99M DTPA TO 25MCI 616.001903301 NM DEXA VERTEBRAL FX ASSESSMENT 1,664.001903392 NM FDG F-18 UP TO 45 MCI 1,342.001903400 NM TC99M PERTECHNETATE PER MCI 3.001903442 NM 18F NAF PER STUDY DOSE 1,259.001903673 NM PULM QUANT VENT/PERF 1,430.001903675 NM PULM QUANT PERF 1,078.001903681 NM PULMONARY VENT & PERFUSION 2,645.001903707 NM SENTINEL NODE INJECTION 1,070.001903715 NM I123 MIBG 16,050.001903723 NM PARATHYROID IMAGING W SPECT 1,929.001903731 NM I 125 SEED MARKER EA 1,000.001903749 RENAL SCAN W/ & W/O PHARM 1,437.001903780 NM GASTROINTESTINAL PROCEDURE 1,469.001903897 NM SENTINEL NODE LEFT INJ W IMAGING 3,363.001903905 NM SENTINAL RT INJ W IMAGING 3,363.001903913 NM SENTINAL NODE LT INJ W/O IMAGING 1,070.001903921 NM SENTINEL NODE RT INJ W/O IMAGING 1,070.001903939 NM RADIOPHARMACY THERAPY,INTR-ART 1,470.001903947 NM BASIC DOSIMETRY 631.851903954 NM SPEC MED RAD PHYSICS CONSULT 980.251903962 NM RENOGRAM W/WO PHARM INTERVENTION 2,702.001903970 TECHNECTIUM TC-99M PYROPHOSPHATE 370.001903988 NM I131 SOD IODIDE CAP(S) DIAG/MCI 135.001903996 NM TC99M DTPCA TO 25MCI 85.001904085 TC99M CERETEC PER DOSE 4,922.001904093 TC-99M TILMANOCEPT UP TO 0.5 MCI 1,300.001950005 PET CT FDG SB TO MID THIGH INT 11,163.001950013 PET CT FDG WHOLE BODY INITIAL 11,163.001950021 PET MYOCARDIAL METABOLIC EVAL 6,627.001950039 PET MYOCARDIAL SNG REST OR STRESS 6,627.001950047 PET MYOCARDIAL MLT REST OR STRESS 6,627.001950054 PET BRAIN IMAGING METABOLIC EVAL 6,627.001950062 PET CT FDG SB TO MID THIGH SUBS 11,163.001950070 PET CT FDG WHOLE BODY SUBS 11,163.001950088 PET CT FDG SB-MID THIGH SQ NOPR 11,163.001950096 PET CT FDG WHOLE BODY SUBQ NOPR 11,163.001950104 NM INDIUM-111 WBC 4,918.001950112 NM TC99M PENTETATE AREOSOL UP TO 75 721.001950120 NM PULMONARY PERF PARTICULATE ONLY 2,047.002000008 BLOOD FILTER 245.002000016 BLD PUMP Y TYPE 121.002000024 JACKSON PRATT TUB 573.002000032 JACKSN PRAT RV 573.002000040 PLEURAVAC 1,146.002000057 CARDIOPLEGIA 235.002000065 HYPOTHERM PAD 361.00

2000073 BLAKE DRAIN Y ADAPTER 54.002000081 CVP SET-UP 535.002000099 ARTERIAL LINE 982.002000107 LACTATED RINGERS 126.002000115 SOD CHLORIDE 199.002000123 BLAKE DRAIN 201.002000131 PLASMALYTE 16.002000149 HEART PACK 2,230.002000156 CATHETER SUCTION 51.002000164 SALEM SUMP PUMP 122.002000172 YANKAUR SUCTION 79.002000180 VESSEL CANNULA 66.002000198 TEMP FOLEY /URI 211.002000206 BLD WARMIMG BAG 300.002000214 SOD CHLORIDE 199.002000222 IAB PUMP W/CATH 11,826.002000230 ARISTA 1,103.002000248 CATHETER CHEST 210.002000255 STAT LOCK 95.002000263 FINGER PROBE 107.002000271 SAW BLADE 163.002000289 CARDIO PL CANN 243.002000297 PACER CABLE 94.002000305 OFF BYPASS 954.002000313 SKIN MARKER 61.002000321 CARDIO BYPASS 15,183.002000339 OR CARDIO VASC 1ST HOUR 8,348.002000347 OR CARDIO VASC EA ADD'L 15 MIN 1,584.002000354 SLUSH 116.002000362 PACER WIRES 123.002000370 AORTIC PUNCH 364.002000388 HEMOCC W/TUBING 1,584.002000396 BARD FELT 626.002000404 FOLEY TRAY W/ URI 394.002000412 FRED OIL 247.002000420 LONG BOVIE TIP 109.002000438 SURGIFOAM 472.002000453 HEMOPRO EVH KIT 3,560.002000461 DERMABOND 134.002000479 ARROW INSERT KIT 186.002000487 COUDE (ALL SIZES) 57.002000495 ENDOSCOPIC MAQUET 3,342.002000503 FILTER 75.002000511 KIMBERLY CLARK ELECTRODES 102.002000529 MISTER BLOWER 191.002000537 SCORPION 60.002000545 CULTURE TUBE 105.00

2000552 DERMABOND PRINEO 1,290.002000560 MULTI CLIP ALLPIER (SMALL) 635.002000578 ELECT GEL PADS 158.002000586 SKIN STAPLES 766.002000594 CAUTERY PENCIL 18.002000602 CLIPS LIGATURE 19.002000610 GELFOAM #100 387.002000628 FLOSEAL 693.002000636 OP SITE 63.002000644 CATH SWAN GANZ 824.002000651 MULTI CLIP APPLIER (MEDIUM) 748.002000669 INTRACATH 70.002000677 IV TUBING 68.002000685 SECONDARY SET 105.002000693 TUBING IMED 42.002000701 EXTENSION TUBING 122.002000719 CEREBRAL OXIMETER 532.002000727 BIOPATCH 48.002000743 SURGICEL 2X14 289.002000750 RETRACTOR OFF PUMP #29400 1,520.002000768 FLOW THRU SHUNT 164.002000776 SUTURE GUIDE RACK 109.002000784 CATHETER ROBINSON 85.002000792 CONNECT TUBE DIS 42.002000800 ACE BANDAGE 33.002000818 CAPNOLINE PLUS O2 41.402000826 BREATHING CIRCUIT 56.402000834 LARGNGEAL MASK AIRWAY 22.352101152 RETRIEVAL BASKET 1,107.002101160 ENDO-LOOP 287.002101178 TISSUE MARKER STAIN 102.002101186 TISSUE CLIP 338.002101194 ERPC CATHETER 443.002101202 GASTROSTOMY TUBE 511.002101210 SPEEDBAND 1,773.002101228 RADIAL JAW FORCEP 270.002101236 OCCLUSION BALLOON 899.002101244 SCLERO NEEDLE 273.002101251 GI CYTOLOGY BRUSH 249.002101269 BILLARY BRUSH 648.002101277 APC PROBE 1,104.002101285 SNARE 210.002101293 CRE GUIDE BALOON DLTN CATHRTR 1,373.002101301 PEG TRAY 868.002101319 CAUTERY PAD 136.002101327 CYTOLOGY BRUSH PULM 224.002101335 LUKI TUBE 70.00

2101343 GLIDE WIRE 780.002101350 ELECT-COAG PROBE 2,071.002101368 TISSUE MARKER CLIP 287.002101376 BIOPSY MEDIA 145.002101384 BILIARY DIL BALN 400.002101392 PAPILLOTOME 1,666.002101426 MICRO BRUSH PULMONARY 220.002101434 STENT-PLASTIC-BILLARY 650.002101475 GI INJECTION BICAP PROBE 1,754.002101483 GI BICAP PROBE 1,628.002101491 GI BICAP PROCEDURE 1,628.002101509 GI LAB REGULAR 1ST HOUR 7,829.002101517 GI LAB MINOR 3,913.002101525 GI LAB REGULAR WITH HIGH TECH 13,411.002101533 GI LAB EACH ADD'L 30 MINUTES 3,913.002101558 COLON DILATATION 2,250.002101566 WALL STENT ENTERAL 5,827.002101574 COLON-STENT-METAL 2,870.002101608 GI APC PROBE 868.002101616 GI LAB EACH ADD'L 15 MINUTES 1,957.002101624 CAPNOLINE PLUS O2 41.402101657 GI OUTPT FACILITY FEE-LEVEL2 84.002101707 GI LAB EACH ADD'L 15 MINUTES 1,957.002101715 PLUM TRANSBRONCHIAL STENT 8,265.002101731 N001344 LARGE FORCEPS 2,208.002101749 D10002 JUMBO FORCEPS 4,442.002101756 DREAMTOME CATH 501132 1,410.002200004 OMT 1-2 BODY REGIONS 32.002200012 OMT 3-4 BODY REGIONS 46.002200020 OMT 5-6 BODY REGIONS 60.002200038 OMT 7-8 BODY REGIONS 73.002200046 OMT 9-10 BODY REGIONS 87.002200053 OMT CONSULT LEVEL 1 89.002200061 OMT CONSULT LEVEL 2 123.002200079 OMT CONSULT 3 </= 4 MONTHS 100.002200087 OMT CONSULT LEVEL 4 198.002200095 OMT CONSULT LEVEL 5 230.002200103 E&M LEVEL 1 ESTABLISHED 65.002200111 E&M LEVEL 2 ESTABLISHED 84.002200129 E&M LEVEL 3 EST.< / = 4 MONTHS 100.002200137 E&M LEVEL 4 ESTABLISHED 131.002200145 E&M LEVEL 5 ESTABLISHED 174.002200152 E&M LEVEL 3 NEW 131.002200160 E&M LEVEL 4 NEW 199.002200178 E&M LEVEL 5 NEW 246.002200186 EXERCISE PRESCRIPTION 106.002200194 NUTRITIONAL COUNSELING 30.00

2200202 OMM TREATMENT 27.002200210 PREV MED COUNSEL INDIV: 15 MIN 27.002200228 PREV MED COUNSEL INDIV: 30 MIN 48.002200236 THER EXER >1 AREAS EA 15 MIN 184.002300051 CYTOLOGY - SMEARS 154.002300127 SPECIAL STAIN-TRICHROME 120.002300267 BONE MARROW IRON STAIN 120.002300317 SPECIAL STAIN-ELASTIC 120.002300341 SPECIAL STAIN - ALCIAN BLUE 120.002300457 SPECIAL STAIN-DIFF QUICK 144.002300564 CYTOSPIN PREP 439.002300622 ASP BX-SMEARS 273.002300630 ASP BX-CELL BLOCK 520.002300721 RETICULUM /GMS 144.002300739 DECAL,BONE 75.002300796 SPECIAL STAIN-GMS 144.002300846 IRON STAIN 120.002300861 GRAM STAIN-TISSUE 144.002300887 SPECIAL STAIN-PAS 120.002300895 MUCIKERATIN STAIN 120.002300903 ACID FAST STAIN - TISSUE 144.002300937 FROZEN SECTION 835.002300945 FRZN SXN, ADD'L 244.002301356 GROSS & MICROSCOPIC LEVLE 1 277.002301364 GROSS & MICROSCOPIC LEVEL 2 308.002301372 GROSS & MICROSCOPIC LEVEL 3 421.002301380 GROSS & MICROSCOPIC LEVEL 4 520.002301398 GROSS & MICROSCOPIC LEVEL 5 700.002301406 GROSS & MICROSCOPIC LEVEL 6 728.002301422 BONE MARROW ASPIRATION ONLY 4,132.902301455 CYTOPATHOLOGY FOR SPEC ADEQUACY 209.002301471 BONE MARROW SM,INTERP 2,040.002301521 SPECIAL STAIN,CONGO RED 120.002301547 SPECIAL STAIN,PAS/DIASTASE 120.002301570 BONE MARROW ASPIRATE 1,612.002301604 T PREP EXAM DURING SURGERY 60.002301612 T PREP EXAM DURING SURGERY EA ADDL 60.002301620 PATH CONSULT,REFERRED BLOCK 140.002400000 VENIPUNCTURE 14.002400059 CAPILLARY BLOOD COLLECTION 18.002501500 XR HYPAQUE UGI SM BOWEL 2,909.002501542 XR HYPAQUE SM BOWEL FOLLOW THR 1,614.003000015 UREA NITROGEN URINE RANDOM 134.003000049 SALICYLATE 292.003000056 RHEUMATOID FACTOR QUANT 32.003000064 PROTEIN 24 HR URINE 145.003000072 PROTEIN TOTAL 65.00

3000080 PROTEIN CSF 129.003000122 ALBUMIN FLUID 122.003000130 IGM 178.003000148 BENZODIAZEPINES, URINE 26.003000189 DILANTIN, FREE 238.003000205 WET MOUNT 131.003000213 URIC ACID, 24 HR URINE 117.003000221 GLUCOSE CSF 91.003000239 GLUCOSE QT 128.003000247 GLUCOMETER GLUCOSE 98.003000254 GLUCOSE 2 HR PP 194.003000262 ANA 15.003000320 MAGNESIUM, 24 HR URINE 229.003000338 SODIUM 24 HR URINE 69.003000353 PREGNANCY URINE (HCG QUAL) 164.003000361 PREGNANCY BLOOD QT 247.003000387 POTASSIUM 24 HR URINE 84.003000478 KLEIHAUER-BETHE STAIN 397.003000528 CRYOPRECIPITATE X 1 96.003000585 FFP X1 131.003001013 CULTURE, WOUND 607.003001021 CULTURE SPUTUM/BRONCH WASH AERO 133.003001047 CULTURE, CATHETER TIPS 607.003001054 CULTURE ANAEROBIC NOT BLOOD 410.003001062 CREATININE RANDOM URINE 95.003001070 CORTISOL P.M. 210.003001088 CORTISOL A.M.-W 7.003001104 CHLORIDE URINE RANDOM 84.003001120 ELUTION 250.003001153 SENSITIVITY MIC 142.003001203 CRYPTOSPORIDIUM SMEAR 258.003001237 T4 (THYROXINE) 206.003001252 WET-MOUNT INDIA INK 131.003001294 ACETAMINOPHEN 361.003001310 PROPOXYPHENE, URINE 26.003001328 PROTEIN, AMNIOTIC FLUID 116.003001336 AMMONIA 157.003001351 BARBITURATES, URINE 26.003001369 BASIC METABOLIC PANEL 691.003001385 CULTURE G.C.SCREEN 189.003001393 CULTURE BLOOD AEROBIC 191.003001401 FLUID CELL COUNT W/DIFF 166.003001443 OPIATES, URINE 26.003001450 PHENCYCLIDINE, URINE 26.003001468 PROSTATIC SPECIFIC ANTIGEN (PSA) 129.003001484 ACID-FAST CULTURE 299.003001500 CBC 125.00

3001534 METHAQUALINE, URINE 26.003001542 PRIMIDONE 259.003004991 ALCOHOL (ETHYL) 376.003008257 SODIUM URINE RANDOM 69.003008281 COMPLEMENT C3 7.003008299 AMYLASE FLUID 252.003008323 POTASSIUM URINE RANDOM 84.003008349 AMYLASE URINE RANDOM 252.003008356 URINE FOR EOSINOPHILS 60.003008372 CULTURE, JOINT REPLACEMENT 607.003008448 GLUCOSE FLUID 91.003008463 LDH FLUID 78.003009347 D-DIMER 247.003009404 TRANSFERRIN-W 13.683009495 SPECIFIC GRAVITY 31.003009594 RESPIRATORY SYNCITIAL VIRUS EI 349.003009958 ASO TITER 209.003010709 OCCULT BLOOD NON-COLORECT NEOPLASM 47.003011400 DRUG SCREEN, URINE 150.003011715 CULTURE, CSF 607.003011723 CULTURE, JOINT FLUID 607.003011731 CULTURE MRSA SCREEN 189.003011749 SPLIT BLOOD PRODUCTS 86.003011756 AUTO WHOLE BLOOD UNIT 540.003011871 HEPATITIS C VIRUS ANTIBODY-W 10.003011889 CARDIAC RISK PANEL 440.003011939 PREALBUMIN 242.003011988 PLATELETS X 1, REDUCED VOLUME 104.003012002 BACTERIAL ANTIGENS PANEL 509.003012051 CREATINE KINASE TOT/CKMB (REFLEX) 93.003012069 CKMB QUANTITATIVE 116.003012119 ELECTROLYTE PANEL 413.003012135 VALPROIC ACID TOTAL 406.003012143 LIVER PROFILE 585.003012218 CATH/TAP URINALYSIS 66.003012275 ACETONE SEMI-QNT SERUM 144.003012333 ALBUMIN PLASMA 49.003012408 AMIKACIN (AMIKIN)-W 22.643012465 AMPHETAMINES, URINE 26.003012473 AMYLASE 252.003012523 PHENOBARBITAL 159.003012614 CALCIUM 75.003012648 CALCIUM 24 HR URINE 140.003012671 CARBAMZEPINE (TEGRETOL)TOTAL 147.003012689 CARBON DIOXIDE (CO2) 173.003012788 CHLORIDE, BLOOD 173.003012838 CHOLESTEROL 88.00

3012895 COCAINE, URINE 26.003012952 CPK 238.003012986 CREATININE BLOOD 138.003013000 CREAT.CLEARANCE 225.003013018 CRYOGLOBULINS 277.003013042 VITAMIN B12 107.003013091 DIGOXIN TOTAL 145.003013265 FAT,QUALITATIVE 75.003013281 FIBRINOGEN ACTIVITY 120.003013299 FOLATE (SERUM) 104.003013307 FOLATE, RBC 56.003013414 GLUC TOLERANCE PRENATAL 209.003013463 GGTP 295.003013489 BETA HCG QUANT 552.003013547 HAPTOGLOBIN-W 10.003013570 FETAL HEMOGLOBIN (APT) 47.003013588 HEMOGLOBIN A1C 209.003013729 IRON (TOTAL ONLY) 66.003013810 LACTIC ACID (LACTATE) 376.003013828 LDH 78.003013869 LIDOCAINE 243.003013877 LIPASE 192.003013919 LITHIUM, LAB-W 10.073013935 MAGNESIUM 82.003014032 OSMOLALITY BLOOD 151.003014040 OSMOLALITY URINE 317.003014123 DILANTIN (PHENYTOIN)TOTAL 393.003014164 ALK. PHOSPHATASE 64.003014172 PHOSPHORUS 81.003014180 PHOSPHORUS,24 HR URINE 170.003014214 POTASSIUM PLASMA 65.003014305 FLUID PROTEIN 129.003014420 SODIUM PLASMA 53.003014537 CANNABINOIDS, URINE 26.003014545 THEOPHYLLINE 144.003014628 TSH 314.003014644 SGOT (AST) 211.003014651 SGPT (ALT) 222.003014669 TRIGLYCERIDES 87.003014677 T3,TOTAL-W 5.003014701 BUN (UREA NITROGEN) 139.003014719 URIC ACID BLOOD 88.003014735 VANCOMYCIN 314.003014800 GENTAMICIN 330.003014818 TOBRAMYCIN 459.003014891 EOSINOPHILE COUNT 76.003014909 HEMATOCRIT 87.00

3014933 CBC WITH DIFF 320.003014966 RETICULOCYTE COUNT AUTOMATED 59.003015229 PLATELET COUNT 75.003015237 PROTHROMBIN TIME 66.003015260 SEDIMENTATION RATE NON-AUTO 59.003015278 SICKLE CELL PREPARATION 76.003015294 PTT PLASMA/WB 66.003015385 CRP QUANTITATIVE (HS) 145.003015468 ANTIBODY SCREEN 184.003015492 ANTIBODY IDENTIFICATION 531.003015518 DIRECT,COOMBS 186.003015526 ANTIBODY TITER 531.003015575 COMPATIBILITY TESTING, AHG 194.003015666 ANTIGEN TYPING-DIRECT 207.003015765 CEA-W 7.003015773 FERRITIN 242.003016045 ANA, QUANTITATIVE 277.003016284 RUBELLA AB SCREEN-W 247.003016300 COLD AGGLUTININS 217.003016318 HEP B SURFACE ANTIGEN-W 6.183016342 HEP SURFACE AB-W 9.003016391 HEP A VIRUS IGM-W 11.003016409 HETEROPHILE SCREEN 201.003016466 IMMUNOGLOBULIN PANEL-Q.I.G. 437.003016490 CRYPTOCCOCCUS ANTIGEN 220.003016581 GLUCOSE URINE GTT 66.003016789 ACID FAST SMEAR CONCENTRATE 83.003016805 CULTURE STOOL AEROBIC S&S 171.003016821 CULTURE,EYE/EAR/NOSE/THROAT 607.003016839 CULTURE,BODY FLUIDS 607.003016870 STREP GROUP A SCREEN 239.003016888 CULTURE URINE 322.003016920 CULTURE FUNGUS 38.003016946 ACID FAST CULTURE BLOOD 176.003017035 CLOSTRIDIUM DIFFICILE TOXIN 324.003017043 OVA & PARASITES 432.003017092 GRAM STAIN 133.003017100 ACID FAST SMEAR, DIRECT 258.003017126 MALARIA SMEAR 156.003017597 NEWBORN ADDITIONAL UNIT 217.003017639 SPERM EXAM - PRESENCE/ABSENCE 144.003017647 ABO TYPING 166.003017654 RH TYPING 144.003017662 RBC COUNT 120.003017670 WBC COUNT 120.003017688 IRON BINDING CAPACITY,DIRECT 120.003017696 GTT SPECIMENS FIRST THREE 288.00

3017704 GTT SPECIMENS, FOURTH SPECIMEN 125.003017712 GTT SPECIMENS, FIFTH SPECIMEN 125.003017720 IGG, QUANTITATIVE 228.003017738 IGA, QUANTITATIVE 178.003017779 COMPREHENSIVE METABOLIC PANEL 977.003017860 GROUP B STREP SCREEN 239.003017902 CARDIAC TROPONIN I QT 355.003017910 MYOGLOBIN, SERUM 203.003017928 CULTURE, VRE SCREEN 239.003017936 RPR SEROLOGY QL 114.003017969 HELICOBACTER PYLORI SCREEN 239.003017985 RAPID GROUP B STREP SCREEN 334.003018009 PRENATAL PANEL 1,339.003018017 HIV 1/2 ANTIBODY-EIA 150.003018140 COMPLEMENT, C4 323.003018157 FREE T4 (FT4) 184.003018165 FREE T3 (FT3)-W 50.883018173 CAFFEINE 299.003018181 BILIRUBIN TOTAL 153.003018199 BILIRUBIN DIRECT 69.003018207 OCCULT BLOOD, URINE 60.003018223 CORTISOL TOTAL-W 7.003018231 FETAL FIBRONECTIN ASSAY-W 210.003018264 ACUTE HEPATITIS PANEL 1,358.003018272 GTT SPECIMENS, SIXTH SPECIMEN 125.003018298 COMPATIBILITY TEST, EACH UNIT 672.003018314 RENAL FUNCTION PANEL 648.003018322 HDL CHOLESTEROL 100.003018330 LDL CHOLESTEROL 104.003018363 MICROALBUMIN-W 20.723018371 PROTEIN URINE RANDOM 145.003018389 CALCIUM URINE RANDOM 75.003018405 METHADONE, URINE 26.003018488 BNP B NATRIURETIC PEPTIDE 373.003018496 LEGIONELLA ANTIGEN,URINE 210.003018504 STREP PNEUMONIAE AG,URINE 210.003018512 E.D.URINE HCG 164.003018520 RUBEOLA AB SCREEN-W 33.293018538 VARICELLA ZOSTER AB SCREEN 247.003018553 BILIRUBIN, NURSERY/NICU 116.003018561 PLATELET FUNCTION TEST 333.003018579 HEPATITIS B CORE AB,IGM-W 12.003018587 FLUID CHOLESTEROL 169.003018595 FLUID TRIGLYCERIDES 87.003018603 INFLUENZA A&B TEST 294.003018611 CULTURE, VAP,QUANTITATIVE 607.003018629 ALPHA FETO PROTEIN-W 10.00

3018637 CA 15-5-W 14.003018645 CA 125-W 10.003018652 CA 19-9-W 13.003018678 CULTURE GENITAL OB/GYN AEROBIC 133.003018686 E COLI 0157 H7 SCREEN 205.003018710 LACTATE ABG 242.003018769 PPD SKIN TEST 62.003018777 PTH INTACT-W 25.003018884 RAPID MRSA SCREEN 479.003018900 FLUID CELL COUNT, NO DIFF 203.003018918 URIC ACID,FLUID 144.003018926 URINE PH 66.003018934 FLUID SPECIFIC GRAVITY 33.003018942 SKIN TEST FOR CANDIDA 62.003018959 CDIFF TOXIN DNA BY PCR 128.003018967 CLOSTRIDIUM DIFFICILE AG, EIA 321.003018975 URINE DRUG SCREEN 135.003018983 PROCALCITONIN 413.003018991 VITAMIN D,25-HYDROXY-W 81.893019007 VALPROIC ACID,NON PROTEIN BOUND 269.003019015 POOLED BLOOD PRODUCT PROC CHG 118.003019023 BETAHYDROXYBUTYRATE QT 144.003019031 NICU DRUG RESISTANT ORG SCREEN 239.003019056 OCCULT BLOOD-ON SINGLE COLLECTION 121.003019064 HEMOGLOBIN 36.003019072 SHIGA TOXIN TEST 192.003019080 SHIGA TOXIN 1 DETECTION 98.003019098 SHIGA TOXIN 2 DETECTION 98.003019106 PROSTATIC SPECIFIC ANTIGEN(PSA)SCRN 286.003019114 OCCULT BLD,STL,1-3 BY IMMUNOASSAY 60.003019122 HEP B SURFACE AG CONFIRM 500.003019130 URINE DRUG SCREEN-EMPHEALTH 135.003019148 T-4 FREE DLAB 4.003019155 HEP C AB-DLAB 10.003019163 HEP B SURF AG W/REFLEX TO CONF-DLAB 6.183019171 HEP B SURF CONFIRM-DLAB 33.863019189 HEP A IGM AB-DLAB 11.003019197 HEP B CORE IGM AB-DLAB 12.003019205 HEP B SURF AB QL-DLAB 9.003019213 CEA-DLAB 7.003019221 VIT D 250H LC/MS/MS-DLAB 81.893019239 PTH,INTACT & CALCIUM-DLAB 25.003019247 T-3, FREE D-LAB 50.883019254 T-3, TOTAL-DLAB 5.003019262 CORISTOL, TOTAL-DLAB 7.003019270 HAPTOGLOBIN-DLAB 10.003019288 MICROALBUMIN RAND UR-DLAB 20.72

3019296 RUBELLA IMMUNE-DLAB 5.003019304 TRANSFERRIN-DLAB 13.683019312 LITHIUM-DLAB 10.073019320 FETAL FIBRONECTIN-DLAB 210.003019338 AFP,TUMOR-DLAB 10.003019346 CA125-DLAB 10.003019353 CA 15-3-DLAB 14.003019361 CA 19-9-DLAB 13.003019379 AMIKACIN-DLAB 22.643019387 ACUTE HEPATITIS PANEL-DLAB 39.183019395 HIV 1/2 ANTIBODY, SCREENING 240.003019403 VARICELLA ZOSTER,IMMUNE,IGG,AB-W 63.253019411 MUMPS IGG-DLAB 53.203019429 RUBEOLA IGG-DLAB 33.293019437 ANA W/RFX-DLAB 8.783019445 ANA RFX-DLAB 14.003019452 MUMPS IGG AB-W 53.203019460 URINALYSIS WITH MICROSCOPY 255.003019478 URINALYSIS WITHOUT MICROSCOPY 213.003019486 CCP ANTIBODIES-W 277.003019502 SYPHILIS AB 128.003019510 CPEPTIDE 210.003019528 RPR TITER 128.003019536 ANA ANTIBODY,EIA SCRN-W 240.003019544 DS DNA ANTIBODY,EIA-W 180.003019551 SSA ANTIBODY-W 180.003019569 SSB ANTIBODY-W 180.003019577 SM ANTIBODY-W 180.003019585 SM/RNP ANTIBODY-W 180.003019593 JO1 ANTIBODY-W 180.003019601 SC170 ANTIBODY-W 180.003019619 CENTROMERE ANTIBODIES(ANA) 180.003019627 HIV1 AB, HIV2 AB, P24AG SCREEN 280.003019635 POCT INR 257.003019650 AMIKACIN PEAK 335.003019668 AMIKACIN TROUGH 335.003019676 CHLAMYDIA TRACHOMATIS AMPLIF RNA-W 200.003019684 NEISSERIA GONORRHOEAE AMPLIF RNA-W 200.003019734 EVALUATION OF SPERM ABSENCE/PRESENC 156.003019742 CANDIDA AURIS SCREEN 239.003019759 PATHOLOGIST PERIPHERAL BLD SMR RVW 64.333019767 PATHOLOGIST BODY FLUID SMEAR REVIEW 160.693019775 INFLUENZA A/B VIRUS BY PCR 450.003019783 SARS-COV-2 RNA, QUALITATIVE RT PCR 250.003019791 SARS-COV-2 IGG ANTIBODY QUALITATIVE 150.003019809 SARS-COV-2 IGM ANTIBODY QUALITATIVE 75.003019817 VERIFYNOW - ASPIRIN 175.00

3019825 VERIFYNOW - PRU 175.003019833 SARS-COV-2 TOTAL ANTIBODY QUALITATV 75.003019841 RP2 MULTI RESP PCR PNL-12-25 TARGTS 416.003019858 RP2 MULTI RESP PCR PANEL-C.PNEUMO 35.003019866 RP2 MULTI RESP PCR PANEL-M.PNEUMO 35.003019874 RP2 MULTI RESP PCR PANEL-SARS-COV-2 51.003019882 SARS-COV2-ANTIGEN BY FIA 91.003020195 SARS-COV-2 RT PCR-ABBOTT IDKNOW 250.003020203 WESTPAC SPECIAL HNDLNG FEE-WEST PAC 50.003020211 LYRA SARSCOV2 PCR HI THRU INST ADD 25.003020229 LYRA SARS-COV-2 PCR HI THRUPUT INST 475.003020237 SALV DRCT COV2 PCR HI THRU INST ADD 25.003020245 SALIVA DIRCT COV2 PCR HI THRU INST 475.003020252 RSV DNA/RNA AMPLIFIED PROBE 140.843020260 LYRA SARS-COV-2 PCR-TRAVELER 125.003020278 TIMED URINE COLLECTION VOL MEASRMNT 7.893020286 CALCIUM, IONIZED 250.003060977 LP RIBOSOMAL P ANTIBODY 15.003060985 LP DNA (DS) ANTIBODY 15.003060993 LP SCL-70 ANTIBODY 15.003061009 LP THYROID PEROXIDASE ANTIBODY 15.003061017 LP RHEUMATOID FACTOR 15.003061025 BLOOD SMEAR EXAM - PHHD 61.003061033 FIBRIN PROD SEMI-QUANT 112.003061041 EOSINOPH SMEAR 51.003061058 WRIGHT STAIN 133.003061066 CRYSTALS IDENT 64.003061074 PROTHROMBIN TIME 66.003061082 PROTHROMB TIME PLASMA SUBSTN 66.003061090 PROTHROM TIME PLASMA SUBSTN 66.003061108 PTT PLASMA/WB 66.003061116 PTT PLASMA SUBSTITUTION 66.003061124 PTT PLASMA SUBSTITUTION 66.003061132 ORGANISM ID AEROBIC 127.003061140 ORGANISM ID URINE 76.003061157 ORGANISM ID ANAEROBIC 191.003061165 SENSITIVITY DISK METHOD 89.003061173 ADDL ANTIBIO SUSCEPTABILITY STUDY 19.003061181 CLOTEST 173.003061199 CULT FUNGUS CSF 144.003061207 CULTURE FUNGUS OTHER 144.003061215 CULTURE BLOOD AEROBIC 191.003061223 AFB CONCENTRATION 84.003061231 C DIFFICILE TOXIN AG A/B 77.003061249 RSV BY EIA 67.003061256 STREP TYPING IMMUNOLOGIC METH 101.003061264 STREP PNEUMO AG EIA MULTI-STEP 49.00

3061272 INFLUENZA A AG 90.003061280 INFLUENZA B AG 46.003061298 HIV-1 ANTIBODY 196.003061306 DISCHARGE MRSA SCREEN 189.003061314 T3 UPTAKE 242.003061322 VANCOMYCIN TR 314.003061330 VANCOMYCIN PK 314.003061348 TOBRAMYCIN 459.003061355 GENTAMYCIN 330.003061363 GLUCOSE 2HR PP 118.003061371 GLUCOSE URINE GTT 66.003061389 CREAT UR TIMED 95.003061397 URN VOL MEASURE 28.003061405 COMP METABOLIC 977.003061413 CSF CELL COUNT W/DIFF 166.003061421 GLUCOSE WB REAGENT STRIP 128.003061439 D-DIMER(DRMC)QT 45.003061447 ALBUMIN BODY FLD 49.003061454 CHOLESTEROL BF 88.003061462 RPR QUANTITAT 41.003061470 URINALYSIS 176.003061488 ADENOVIRUS 48.003061496 MUMPS-W 53.203061504 RUBEOLA-W 33.293061520 GTT EA ADD OVER 87.003061538 GTT EA ADD OVER 87.003061546 GTT EA ADD OVER 87.003061553 GTT EA ADD OVER 87.003061561 GTT EA ADD OVER 87.003061579 GLUCOSE URINE GTT 66.003061587 GLUCOSE URINE GTT 66.003061595 GLUCOSE URINE GTT 66.003061603 GLUCOSE URINE GTT 66.003061611 GLUCOSE URINE GTT 66.003061629 GLUCOSE URINE GTT 66.003061637 GLUCOSE URINE GTT 66.003061645 HETEROPHILE TITER 10.443061652 TISSUE GROSS 72.003900008 WHOLE BLOOD, ONE UNIT 1,240.003900016 RED BLOOD CELLS,ONE UNIT 1,311.003900024 CRYOPRECIPITATE,ONE UNIT 413.003900040 FRESH FROZEN PLASMA,ONE UNIT 413.003900123 SPECIAL SCREEN,PER ANTIGEN 184.003900156 RH IG PRODUCT 475.003900255 PLATELETPHERESIS UNIT 2,583.003900263 THERAPEUTIC PHLEBOTOMY 439.003900321 AUTOLOGOUS ADMINISTRATIVE PROC 186.00

3900412 RH IMM GLOB ADMIN 531.003900578 ARC AUTO RBC UNIT 1,311.003900925 BLOOD TRANSFUSION/HIM 3,050.003900941 CRYOPRECIPITATE POOLED X5 ARC UNIT 70.003900974 ANTIGEN SCREEN 2 58.003900982 LEUKO-DEPLETED PC 210.003900990 PLATELET ANTIBODY PER TEST,HLA-ARC 700.003901006 PLATELET ANTIGEN TYPING-ARC 400.003901014 FRESH FROZEN PLASMA,ONE UNIT 413.003901022 CRYOPRECIP ARC 70.003901030 FRESH FROZEN PLAZMA 24HR 413.003901048 PLT PHER ARC 460.003901055 PLTPH WBC REDUCED 460.003901063 RBC PED6 CMV ARC 1,311.003901071 PRETREAT/ENZYMES 133.003901089 ANTIGEN SCREEN 3 58.003901097 STAT SAMPLE TRANS 100.003901105 ANTIGEN SCREEN 4 58.003901113 ANTIGEN SCREEN 3 58.003901121 ANTIGEN SCREEN 2 58.003901139 ANTIGEN SCREEN 1 58.003901147 DIFF ADSORPTION 62.003901154 PRETREAT/CHEMICAL 133.003901162 SAMPLE TRANSPORT 35.003901170 ANTIBODY ID 361.003901188 WB DIRECTED ARC 577.003901204 RED BLOOD CELLS,ONE UNIT 1,311.003901212 ARC AUTO RBC UNIT 1,311.003901220 ELUTION 65.003901246 ANTIBODY SCREEN 221.003901253 ANTIGEN TYPE ARC 55.003901261 ABO TYPE 19.003901279 RH TYPE 96.003901287 RH PHENOTYPE 124.003901295 RBC PHENOTYPE 95.003901303 DAT 176.003901311 ANTIGEN TYPING 266.253901337 ANTIGEN TYPING PI 45.003901352 CELL WASH PIH 98.003901378 STAT HANDLING PIH 32.003901386 DONORS SCRN ABO RH 25.003901410 HLA TYPING ARC 275.003901428 PLATELET AB SCREEN 206.003901436 SICKLE CELL TEST 29.003901444 TRANS REACT ARC 425.003901451 WASH CELLS ARC 525.003901477 RBC FREEZING 250.00

3901493 SPECIAL SCRN ARC 75.003901501 RETIC SEPARATION 89.003901519 DILUTION OF SERUM 141.003901527 INHIBITION/SERUM 143.003901535 TITRATION 65.003901543 THAW/PREP RBC 969.003901550 HEMOLYSIN/AGGLUT 89.003901568 INCUBATE SERUM 131.003901576 MONOCYT MONOLAYER 630.003901584 DAT INVESTIGATION 289.003901592 ABO DESCREPANCY 189.003901600 SCREEN BLD UNIT 477.003901634 PRODUCT HANDLING / PREP 65.003901642 ANTIGEN SCREEN 5 58.003901659 ANTIGEN SCREEN 6 58.003901667 ANTIGEN SCREEN 7 58.003901675 SPECIAL RECUITEMENT PLATELET DONOT 68.003901683 SPECIAL RECUITMENT RBC DONER 68.003901691 ANTIGEN SCREEN 4 58.003901709 ANTIGEN SCREEN 5 58.003901725 SKELETAL MUSCLE BX ANALYSIS PTH-LBM 564.753901733 MUSCLE BX SPECIAL STAINS PTH-LBM 97.753901741 SKELETAL MUSCLE BX PTH - LBM 173.984900106 SEROTONIN BLOOD -NI 92.344900189 ANTI PARIETAL AB-MAYO 24.694900197 ANTI CARDIOLIPIN AB -MAYO 12.654900221 IGG SUBCLASS-NI 104.004900239 CMV, IGG + IGM AB -MAYO 9.084900254 LIPIDS, TOTAL,FECAL, -MAYO 30.004900262 DHEA S-MAYO 14.554900296 ESTRADIOL, 17 BETA-MAYO 13.224900320 G6PDH -MAYO 17.074900346 FTA ABS -MAYO 18.944900379 ARSENIC, BLOOD-NI 33.104900411 ESTROGEN TOTAL BLOOD-NI 40.554900437 PORPHYRINS 24 HR QUANT -MAYO 37.864900445 CELL BOUND PLATELET AB-MAYO 75.004900478 COCCI AB, CF -MAYO 9.474900486 CMV CULTURE-MAYO 66.894900536 ARSENIC, URINE-NI 51.004900593 FREE T4-MAYO 16.064900619 ALDOSTERONE SERUM -MAYO 15.314900627 GASTRIN -MAYO 17.964900635 CATECHOLAMINES, URINE-MAYO 30.004900668 ANTI MITOCHONDRIAL AB -MAYO 10.824900684 MICROALBUMIN -MAYO 16.134900783 MARIJUANA(THC)QUANTITATIVE-NI 43.69

4900791 METHAQUALONE (QUAALUDE)-NI 49.004900817 PCP (QUALITATIVE),GCMS CONF-NI 49.004900833 B PERTUSSIS CULTURE-NI 46.004900874 SJOGRENS SSA,SSB AB-NI 36.114900924 HIV WESTERN BLOT-MAYO 19.754900999 COXACKIE B ANTIBODIES -NI 55.304901021 EPSTEIN BARR PANEL-MAYO 13.614901088 ANTI SMOOTH MUSCLE AB-MAYO 12.904901104 SENDOUT PROCESSING CHARGE 23.004901112 LEAD, BLOOD -MAYO 9.564901161 CALCULUS ANALYSIS-ARAWAK 41.004901187 RISTOCETIN COFACTOR-QUEST 69.004901203 TOXOPLASMA AB, IGM-MAYO 19.484901211 T3 REVERSE - MAYO 31.224901229 CA 15 3-MAYO 16.204901302 PROINSULIN -NI 78.034901336 INSULIN LEVEL-MAYO 9.994901344 ANTI PLATELET AB-MAYO 50.004901351 C1 ESTERASE INHIBITOR -MAYO 22.604901369 R CHROMOSOME STUDY,TISSUE-MAYO 625.004901385 PROTEIN C-MAYO 77.504901393 PROTEIN S ANTIGEN-MAYO 22.754901419 CHLAMYDIA AB PANEL, IFA TWAR -MRL 198.904901468 HISTOPLASMA AB,CSF-MAYO 44.724901526 R HYPERSEN PNEUMONITIS PNL-MAYO 40.364901534 ASPERGILLUS AB, CF -MAYO 33.104901542 PREGNENOLONE -NI 77.354901559 AMIODARONE -MAYO 21.904901625 ALLERGEN, INDIVIDUAL-MAYO 9.744901708 B.BURGDORF.(LYMES) AB CSF-MRL 67.504901765 CHROMOGRANIN A -NI 87.554901856 R PARVOVIRUS B19, ANTIBODY-MAYO 11.234901930 IGF I (SOMATOMEDIN C)-NI 60.864901997 CERULOPLASMIN-MAYO 9.504902045 TOXIC SHOCK SYNROME PNL-MRL 200.704902060 A1 ANTITRYPSIN +PHENOTP-MAYO 23.224902110 ALLERGY PANEL FOOD PRO 1-NI 92.004902268 CARNITINE LEVEL-MAYO 30.674902326 R RUBEOLA IGG & IGM AB -MAYO 12.504902342 COCCI AB, CSF-MAYO 55.304902375 RUBELLA AB IGM-NI 38.594902409 THYROID STIMULATING IG-MAYO 50.034902425 CORTISOL, URINARY FREE-MAYO 22.004902466 DRUG SCREEN, BLOOD-MAYO 124.004902508 HEPATITIS A AB TOTAL-NI 62.404902516 HEPATITIS B CORE AB IGM-MAYO 15.004902532 ETHOSUXIMIDE-MAYO 38.74

4902680 IRON, QUANT, TISSUE-MAYO 62.874902706 ETHYLENE GLYCOL-MAYO 71.454902755 GMI ANTIBODY PANEL-MAYO 30.004902847 COMPLEMENT CH50 -MAYO 13.894902862 TREPONEMA PALLIDUM DFA -NI 18.084902870 JO 1 ANTIBODY-NI 30.804902995 HIV2 EIA SCREEN/WB REFLEX-NI 24.304903019 VITAMIN D, 1,25 DIHYDROXY-MAYO 16.674903043 ALPHA 1 ANTITRYPSIN QNT-MAYO 20.004903084 HERPES VIRUS 6, HUMAN-MRL 162.004903092 R HEMOGLOBIN ELECTROPHORESIS-MAYO 35.584903142 ACTH -MAYO 15.064903183 ALUMINUM-MAYO 21.004903191 DELTA AMINOLEVOLINIC ACID-NI 41.004903217 ANDROSTENEDIONE-MAYO 32.664903225 ANGIOTENSIN CONV ENZ -MAYO 10.004903258 CALCITONIN-NI 49.204903308 CATECHOLAMINES, SERUM - QUEST 47.554903324 CHLORAMPHENICOL-MAYO 65.414903340 LIBRIUM(CHLORDIAZEPOXIDE)-NI 26.244903357 TORCH PANEL IGM 86645-MAYO 18.004903365 ACETYLCHOLINE RECEPTOR AB-MAYO 52.384903381 COPPER, SERUM -MAYO 15.004903407 C PEPTIDE-MAYO 16.544903423 CYANIDE -MAYO 89.004903456 DIAZEPAM NORDIAZEPAM-MAYO 58.604903563 ESTRIOL, SERUM-NI 8.504903597 IGD-MAYO 38.754903605 IGE -MAYO 10.644903639 FSH, BLOOD -MAYO 9.734903654 GROWTH HORMONE-MAYO 15.854903696 17-OH CORTICOSTEROIDS-NI 44.004903704 5 HIAA (SEROTONIN METAB) -MAYO 20.004903720 IMIPRAMINE -MAYO 20.354903787 METANEPHRINES,24 HR URINE -MAYO 22.504903803 R METHEMALBUMIN-MAYO 101.004903837 5 NUCLEOTIDASE-MAYO 233.384903845 OXALATE, URINE -MAYO 21.014903860 PORPHOBILINOGREN 24HR UR-MAYO 30.314903894 PROGESTERONE, SERUM -MAYO 10.124903902 17 OH PROGESTERONE-MAYO 22.844903944 RENIN (PLASMA) -MAYO 12.074903977 THYROGLOBULIN TUMOR MARKER-MAYO 10.964903993 VMA, URINE -MAYO 22.344904017 ZINC-MAYO 12.224904033 ANTI THROMBIN III-MAYO 17.004904058 VISCOSITY, SERUM -MAYO 25.00

4904066 TRICHINELLA AB-MAYO 47.294904082 INTRINSIC FACTOR AB-NI 26.254904090 INSULIN AB-NI 58.504904108 ANCA CYTOPLASMIC NEUT AP,SER-MAYO 20.964904116 ANTI STRIATED MUSCLE AB -MAYO 23.004904140 ADENOVIRUS AB-MAYO 90.434904157 R EPSTEIN BARR VIRUS PANEL -MAYO 7.004904199 POLIO AB -NI 67.904904215 R Q FEVER AB -MAYO 30.004904223 TOXOPLASMA AB IGG-MAYO 19.984904231 ECHOVIRUS AB-NI 123.304904249 R V ZOSTER AB,IGG/IGM -MAYO 12.504904256 ANTI CENTROMERE AB-MAYO 10.734904280 GLOMERULAR BASMNT.MEMB.AB-MAYO 10.884904298 BETA-2 MICROGLOBULIN -MAYO 26.004904330 R CHLAMYDIA GROUP AB -MAYO 12.774904355 ERYTHROPOETIN-NI 24.034904397 HISTONE AUTOANTIBODIES-QUEST 49.054904413 BETA GLUCURONIDASE -NI 64.004904496 HISTOPLASMA AB,SERUM-MAYO 31.324904546 HLA B 27-MAYO 38.734904561 ANTI THYROGLOBULIN AB-NI 14.884904595 MYCOPLASMA CULTURE -MAYO 79.934904603 LEGIONELLA CULTURE-MAYO 13.014904694 LEGIONELLA AB(COMPLETE) -MAYO 23.414904801 SENS & MOTOR NEUROPATHY PNL-MRL 928.804904868 ANTI GLIADIN ANTIBODIES,IGG,IGA-NI 79.274904926 STOOL FOR ALPHA1 ANTITRYPSIN-SKB 20.004904975 TESTOSTERONE,TOTAL-MAYO 12.244905014 R COAG FACTOR II-MAYO 60.004905105 LYMES AB,EARLY,NONREFLEXED-NI 59.004905113 PLASMA HEMOGLOBIN-MAYO 39.744905147 AFB ID CONVENTIONAL-MRL 79.004905170 TYPHUS FEVER ANTIBODY-MAYO 49.704905238 LYME DISEASE AB,REFLEXED-NI 23.604905246 GIARDIA LAMBLIA ANTIGEN-MAYO 20.994905253 HELICOBACTER PYLORI AB-MAYO 14.514905295 LYME'S DISEASE AB, W BLOT-MAYO 30.004905303 BRUCELLA AB-MAYO 34.844905436 METHANOL URINE -QUEST 23.334905444 COAG FACTOR VIII - MAYO 49.304905493 PROSTATIC ACID PHOS BY RIA-MAYO 21.804905519 VITAMIN D 25 HYDROXY-MAYO 8.004905535 METHOTREXATE-MAYO 50.564905550 HEPATITIS BE AG & AB-MAYO 30.944905584 OSTEOCALCIN-NI 44.074905634 HEPATITIS BE AB-MAYO 15.95

4905667 CALCIUM IONIZED -MAYO 15.804905725 R RICKETTSIAL DISEASE PANEL-QUEST 34.054905741 BORRELIA BURGDORFERI DNA,PCR-MAYO 86.284905782 VITAMIN A-MAYO 14.054905865 LUPUS(PHOSPHOLIPID)AB REFLX-MAYO 36.504905873 R ALK PHOS ISOENZYMES-MAYO 13.004905964 FK506 (TACROLIMUS)-MAYO 24.064905972 ISLET CELL AB (IA-2)-MAYO 27.374906061 SEX HORMONE BINDING GLOBULIN-NI 37.504906194 THYROPEROXIDASE (TPO)AB-MAYO 9.884906335 BETA GLUCURONIDASE,CSF-MAYO 55.294906343 PSEUDOCHOLINESTERASE-MAYO 29.044906426 DEOXYCORTICOSTERONE-MAYO 36.674906467 BENZODIAZEPINES URINE-MAYO 76.604906509 POC CHROMOSOMAL ANALYSIS CHG2-MAYO 160.004906566 ALDOLASE -MAYO 9.004906582 R T & B CELL ANALYSIS-MAYO 18.174906608 MYCOPL PNEUM IGM & TOTAL-MAYO 21.874906624 ANTI ENA-MAYO 3.004906632 VIRAL CULTURE-MAYO 30.664906723 ALDOSTERONE URINE-MAYO 55.004906731 CANDIDA ANTIBODY -NI 97.854906749 VDRL, CSF -MAYO 7.504906814 CLONAZEPAM -MAYO 28.914906822 AFB PRIMARY DRUG SUSCEPT PNL-MRL 141.304906855 LEPTOSPIRA ANTIBODY -MAYO 50.004906871 PENTOBARBITAL-NI 50.584906889 THYROID PEROXIDASE AB(TPO AB)-NI 38.504906954 PROLACTIN-MAYO 10.134907028 ALLERGY PNL, ADULT-NI 262.004907135 COAG FACTOR IX-MAYO 60.004907150 MYOGLOBIN, SERUM-NI 45.504907234 MYOGLOBIN, URINE-NI 35.004907366 LEGIONELLA SPECIES BY PCR-MAYO 75.004907457 LUTEINIZING HORMONE-MAYO 9.844907499 NEISSERIA GONORRHOEAE PROBE-NI 27.324907515 HEPATITIS B VIRUS, DNA QNT-NI 107.614907564 COUMADIN LEVEL-NI 78.004907689 AEROBIC MIC CUSTOM 3 DRUGS -MRL 163.804907762 MAG ANTIBODY -MRL 225.904907861 MYELOPEROXIDASE AB-MAYO 31.704907887 ALPHA GALACTOSIDASE-MAYO 119.584907952 CK ISOENZYMES-MAYO 30.194907986 CA 27.29-MAYO 15.504907994 HEPARIN THROMBOCYTOPENIA-MAYO 35.034908026 LAMOTRIGINE-MAYO 15.004908034 GABAPENTIN-MAYO 21.70

4908067 HOMOCYSTEINE, TOTAL PLASMA-MAYO 16.854908075 HEPARIN ASSAY-MAYO 55.004908083 STREP PNEUMONIA SEROTYPING-MRL 157.004908091 CELIAC DISEASE FULL PNL FOCUS A-MRL 84.294908125 AEROBIC MIC/MBC 3 DRUGS-MRL 216.004908232 CRYPTOCOCCUS AG-MAYO 31.914908240 HOMOCYSTEINE,URINE-MAYO 68.474908265 3246OSOME ANAL,BLD,HEMAT-MAYO 576.844908273 AMINO ACID QN ION EXC, UR -MAYO 100.004908349 HCV QUANT, CHIRON RNA-MAYO 119.874908364 ALLERGEN,INDIVIDUAL-NI 18.444908430 R PSA FREE & TOTAL -MAYO 10.004908489 ANTI DNA,DOUBLESTRANDED-MAYO 11.894908497 INFLUENZA VIRUS DIR AG DETECT-NI 36.314908547 TISSUE PROCESSING-MAYO 43.864908562 LAMBERT EATON AUTOANTIBODY-MAYO 13.674908570 HISTOPLASMA ANTIGEN,URINE-MAYO 79.564908620 PI LINKED ANTIGEN,PNH-MAYO 99.884908679 INTERFERON, ALPHA-MAYO 60.004908711 R COAG FACTOR VII-MAYO 25.004908729 CITRATE,24 HR URINE-MAYO 35.094908737 ACETYLCHOLINE RECP MOD AB-MAYO 79.564908745 RUBELLA AB,IGG-MAYO 21.024908786 SOMATOMEDIN C,PLASMA-MAYO 28.694908828 CAFFEINE,SERUM-MAYO 21.074908836 ANTIFUNGAL SUSCEPT PANEL-MRL 369.904908851 AUTOANTIBODIES SSA-MAYO 19.494908869 AUTOANTIBODIES SSB-MAYO 19.494908877 AUTOANTIBODIES SM-MAYO 20.094908885 AUTOANTIBODIES SCL 70-MAYO 18.264908893 AUTOANTIBODIES U1 RNP-MAYO 20.094908927 MAGNESIU RBC & PLASMA-NI 20.754908950 CHROMIUM-MAYO 25.384908984 METANEPHRINE,24HR URINE-QUEST 99.534909024 IGG,IGM,IGA-MAYO 25.644909057 D/L AMPHETAMINE-NI 47.594909099 ELECTRON MICROSCOPY-MAYO 501.694909123 HCV BY RIBA-MAYO 106.344909131 DRUG SCREEN, SERUM-NI 72.144909180 R TESTOSTERONE, TOTAL & FREE-MAYO 14.334909263 AMITRIPTYLINE-MAYO 24.524909271 HERPES SIMPLEX PCR,CSF-MAYO 45.004909305 FRUCTOSAMINE-NI 17.094909321 COAG,VON WILLEBRAND DIS.-MAYO 372.424909339 VITAMIN C, ASCORBIC ACID-MAYO 10.084909396 AEROBIC MIC, CUSTOM, 2 DRUGS-MRL 150.304909404 AEROBIC MIC, CUST,4 DRUGS-MRL 233.10

4909461 SPECIAL STAINS GROUP 11-CS 72.004909511 PATHOLOGY CONSULTATION-MAYO 190.194909552 ACTIVATED PROTEIN C RESIST-MAYO 40.004909586 ESTRONE, SERUM-MAYO 28.874909602 APOLIPOPROTEIN A 1,B-MAYO 21.584909628 R BARTONELLA AB PANEL-MAYO 10.004909636 VITAMIN B1-NI 56.304909644 VITAMIN E-MAYO 9.934909651 R HEAVY METALS,WHOLE BLOOD-MAYO 11.824909669 IGF BP3-MAYO 13.214909677 R TRYPANOSOMA CRUZI ABS-MAYO 47.624909701 TOPIRAMATE (TOPAMAX)-MAYO 31.344909743 GLUCAGON,PLASMA-MAYO 43.964909768 DOXEPIN-MAYO 20.744909792 ARYLSULFATASE A, LEUK.-MAYO 90.634909842 MERCURY-MAYO 24.244909867 E HISTOLYTICA (AMEBIC)AB-MAYO 35.404909883 PORPHYRINS,FECES-MAYO 166.544909917 ANTI SPERM AB-NI 54.504909925 METHYLMALONIC ACID, SERUM-MAYO 20.244909933 HEMOGLOBIN S SCREEN-MAYO 43.394909941 AFB ID,DNA PROBE-MRL 80.104909958 AFB MAI MIC SENSITIVITIES-MRL 186.304909966 AFB PRIMARY SENSITIVITIES-MRL 112.504909974 AFB RAPID GROWER SENSI-MRL 115.204909990 AFB MTB COMPLEX DNA,PCR-MRL 233.814910006 VOLATILE SCREEN, BLOOD-MAYO 41.034910022 TRYPTASE-MAYO 44.904910048 ANAEROBIC BACTERIAL ID-MRL 90.904910055 ANAEROBE SUSCEPT MIC-MRL 95.404910063 ANTINUCLEAR ANTIBODIES-MAYO 8.904910097 AEROBIC BACTERIAL ID-MRL 78.304910147 MYCOBACTERIA,PCR,MISC-NI 95.404910170 R COAG FACTOR V-MAYO 60.004910188 R COAG FACTOR X-MAYO 60.004910212 MANGANESE-MAYO 289.004910220 HEPATITIS B SURFACE AB QNT-NI 38.504910261 IGF 1 SOMATOMEDIN C-MAYO 19.944910303 CYSTICERCUS IGG AB-MAYO 74.604910311 CYSTICERCUS AB CSF -MAYO 78.004910360 MICROSPORIDIA SPORE DETECT-MRL 94.504910394 FUNGAL SUSCEPTIBILITY MIC-1-MRL 130.004910410 VITAMIN B2,RIBOFLAVIN-MAYO 23.194910444 VITAMIN B6-MAYO 143.514910469 PEROXISOMAL PANEL(VLCFA(-MAYO 57.044910527 METHYLMALONIC ACID,URINE-MAYO 25.004910535 INHIBIN-NI 73.50

4910584 CARNITINE LEVEL, URINE-MAYO 62.464910659 CMV DNA,PCR-MRL 149.354910691 AEROBIC MIC,CUSTOM, 1 DRUG-MRL 74.704910766 MYASTHENIA GRAVIS PNL ADULT-MAYO 40.004910790 LIPOPROTEIN A-MAYO 37.144910832 LEUKOCYTE ALKALINE PHOS-MAYO 86.604910865 FACTOR VIII ACTIVITY-UCI 57.004910873 FACTOR VIII INHIBITOR-UCI 110.004910899 FACTOR VIII INHIBITOR PANEL-MAYO 373.464910915 HCV DNA GENOTYPING-MAYO 136.594910980 FLECANIDE-MAYO 66.714911046 HCV RNA DECT/QUANT,S-MAYO 88.504911079 GQ1B IGG ANTIBODY-MRL 148.504911087 ASCA, ANCA AB-PROM 415.004911095 SPECIAL STAINS, GROUP II-CS 39.104911129 SKELETAL MUSCLE BX ANALYSIS-LBM 564.754911145 FATTY ACID PROFILE-MAYO 91.624911228 ALDOSTERONE,SERUM-NI 81.504911236 RENIN ACTIVITY,PLASMA-NI 49.004911293 R FERRITIN-MAYO 53.554911319 BCR/ABL RN QT-MAYO 90.004911327 HEXAGONAL PHOSPHOLIPID PTT-NI 42.044911335 DRVVT CONFIRMATION-NI 42.044911350 ORGANIC ACIDS QNT,URINE-NI 569.344911400 BETA 2 GLYCOPROTEIN 1 AB-MAYO 50.004911442 FUNGAL SUSCEPT CUST MIC 2-MRL 167.114911459 M AVIUM-INTRAC MIC PANEL-MRL 140.404911467 STREP PNEUMO ANTIGEN,LA-MRL 74.704911475 NEURON SPECIFIC ENOLASE,CSF-MAYO 42.434911483 JC VIRUS DNA-MAYO 74.684911525 COCAINE QNT,CONFIRM-NI 43.574911533 METHADONE CONFIRMATION-NI 49.004911541 PROPOXYPHENE CONFIRMATION-NI 49.004911574 BENZODIAZEPINES,URINE QT-NI 52.434911756 BARBITURATES,U,QL,CONF-NI 44.404911764 AMPHETAMINES,UR,QNT-NI 124.064911798 OPIATES,U,QL,CONF-NI 44.704911871 IN SITU HYBRIDIZATION-MAYO 50.004911897 CYTOGENETICS REPORT-MAYO 50.004911947 MTHF REDUCTASE-QUEST 153.504911962 BILE ACIDS-NI 150.004911988 VON WILLEBRANDS MULTIMER 33.004912028 MEM VIRAL AB EVAL CSF-MRL 278.254912044 COBALT-NI 101.154912051 CADMIUM-MAYO 37.504912077 RISTOCETIN COFACTOR-MAYO 40.004912085 VON WILLEBRAND FACTOR AG-MAYO 30.00

4912200 CRP-HIGH SENSITIVITY-MAYO 23.254912218 ANGIOTENSIN CONV ENZ,CSF-MAYO 76.504912226 CMV BY PCR,URINE-MAYO 65.784912259 E COLI 0157 H7 SEROTYPING-MRL 60.304912317 FUNGAL SUSCEPT CUST MIC,3-MRL 320.404912358 VARICELLA ZOSTER AB-MAYO 16.804912366 R PROTEIN ELECTROPHORESIS-MAYO 14.214912374 HEMOGLOBIN A1C-MAYO 9.414912408 LEUK/LYMPHOMA CONSULT-MAYO 48.954912416 LEUK/LYPHM FLOW/C-MAYO 37.154912432 LEUKEMIA PHENOTYPE ACUTE-MAYO 128.804912465 HYPERCOAG PANEL-MAYO 789.424912473 SYPHILIS,IGG-MAYO 18.944912499 H PYLORI AG,FECE-QUEST 102.304912507 SELENIUM-MAYO 12.104912549 BORON - NI 71.004912564 R ECHOVIRUS AB PANEL-MRL 25.384912580 PTH RELATED PEPTIDE-MAYO 10.734912606 PROT.ELECTROPH,URINE-MAYO 33.944912614 MYCOPLASMA PNEUMO,CULTURE-MRL 99.004912648 LEVETIRACETAM(KEPPRA)-MAYO 12.914912655 CMV QUANT BY PCR,PLASMA-MAYO 354.204912689 HEPARIN PF4 AB-MAYO 42.484912713 B BURGDORFER DNA,PCR-MRL 268.204912739 14-3-3 PROTEIN-MAYO 106.084912754 FOLATE,RBC-MAYO 52.504912762 FUNGAL IDENTIFICATION-MRL 91.804912788 LYMPHOCYTE CHROMOSOMES A-GCTR 245.004912796 LYMPHOCYTE CHROMOSOMES B-GCTR 166.004912804 LYMPHOCYTE CHROMOSOMES C-GCTR 37.004912812 LYMPHOCYTE CHROMOSOMES D-GCTR 28.004912838 CMV PCR, SERUM-MAYO 62.004912846 TRILEPTAL (OXYCARB)-MAYO 21.234912887 HLA CLASS II TYPING-MAYO 132.174912911 MYCOBACTERIA PCR,CSF-NI 144.414912937 FTA-ABS IGG AND TPI-MAYO 72.854912945 IMMUNE COMPLEX PNL-MRL 277.204912952 HSV 1/2 DNA,PCR-MRL 292.504912960 E COLI SHIGA LIKE TOX-MRL 118.804912978 HSV 1/2 TYPING,IGG-MRL 186.304912986 BARTONELLA AB PNL-MRL 206.104913018 IBD P_ANCA_IFA PERINUCLR-PROM 41.004913026 83520 PROMETHEUS-PROM 63.754913109 VWD VON WILLEBRAND PANEL-MAYO 70.004913166 DIHYDROHDMN MYRISTATE ACETATE-MAYO 111.634913190 BABESIA MICROTI IGG-MAYO 40.354913216 COXIELLA BURNETII AB-MRL 129.60

4913240 FEBRILE AGGLUTININS-QUEST 29.294913257 IGF II-NI 98.604913265 IBD SG1 DIAGNOSTIC-PROM 35.004913273 IBD P_ANCA_DNASE-PROM 135.004913299 CAMPYLOBACTER J AB-NI 58.434913323 MOTOR NEUROPATHY PANEL-MRL 236.854913349 FUNGUS ANTIBODY PANEL,SERUM-NI 312.304913364 SENSORY NEUROPATHY PNL-MRL 471.604913422 ECHNIOCOCCUS IGG AB-MRL 153.004913430 ECHOVIRUS AB PANEL-MRL 123.304913471 HANTA VIRUS AB(IGG,IGM)-MAYO 86.864913489 MYCOPLASMA DNA,PCR-QUEST 161.504913505 EPSTEIN BARR(EBV)DNA,PCR-MRL 268.204913521 BETA 2 MICROGLOBULIN,CSF-MRL 94.504913547 ANTI NEURONAL AB SERUM CSF-MRL 159.304913570 B 2 MICROBLOGULIN,SERUM-MAYO 10.614913596 THYROTROP RECEPT AB-MAYO 26.004913638 PARAINFLUENZA VIRUS AG-DFA-QUEST 75.004913653 ASPERGILLUS AB-MRL 41.004913661 BLASTOMYCES AB-MRL 25.334913679 COCCIDIOIDES AB-MRL 40.804913687 CRYPTOCOCCUS AB-QUEST 84.274913695 HISTOPLASMA AB-MRL 40.804913703 CRYPTOCOCCUS AB, EIA-MRL 24.004913729 VIRAL CULTURE COMPREHENS-MRL 232.204913778 AFB,M.AV/INTRACELL MIC X7-MRL 352.804913786 CHROMOSOMES SPECIAL BANDING-GCTR 15.004913794 MYCOPHENOLIC ACID-MAYO 28.354913828 IMMUNOHISTOCHEMISTRY-USLABS 58.004913877 HEMOSIDERIN,URINE-MAYO 36.674913885 CYLIC CITRULLINATED PEPTD-MAYO 13.804913893 COMPLEMENT C1Q-MAYO 40.474913901 RAJI CELL IMMUN COMPLEX-MAYO 61.014913919 N-TELOPEPTIDE,SERUM-MAYO 70.004913943 METHYL ALCOHOL-MAYO 70.094913950 GAMMAHYDROXY BUTYRATE-MAYO 98.504914057 ANTI SS DNA-QUEST 130.254914073 CUTANEOUS IMMUNOFLUORSNCE-MAYO 64.464914081 COAG FACTOR XIII-MAYO 64.604914107 PLASMINOGEN ACTIVITY-MAYO 59.374914115 ALPHA 2 ANTIPLASMIN-MAYO 71.654914123 FRANCISELLA ANTIBODY-MAYO 125.004914172 AMNIOTIC L/S RATIO-UCI 50.004914180 AMNIOTIC FLUID P/G-UCI 46.004914198 AMNIOTIC FLM-UCI 39.004914214 FACTOR II ASSAY-UCI 65.004914222 FACTOR IX ASSAY-UCI 52.00

4914248 FACTOR VII ASSAY-UCI 88.004914255 FACTOR VIII ASSAY-UCI 52.004914271 FACTOR XI ASSAY-UCI 88.004914289 FACTOR XII ASSAY-UCI 88.004914297 FACTOR XIII QUALITATIVE-UCI 30.004914305 BARBITURATES CONFIRM-UCI 18.004914313 BENZODIAZEPINES CONFIRM-UCI 63.954914321 COCAINE METABOLITE CONFIRM-UCI 18.004914339 PROPOXYPHENE CONFIRM-UCI 18.004914347 OPIATES CONFIRM-UCI 63.954914354 THC CONFIRM-UCI 63.954914362 PHENCYCLIDINE CONFIRM-UCI 18.004914388 METHOTREXATE-UCI 17.004914396 POTASSIUM,FECES-MAYO 36.144914404 SODIUM,FECES-MAYO 36.174914412 CRYPOPORIDIUM,ISOSPORA DFA-MRL 126.904914438 TISSUE CULTURE-MAYO 280.494914446 DNA PROBE-MAYO 312.224914453 IN SITU HYBRIDIZATION-MAYO 312.224914461 INTERPRETATION,REPORT-MAYO 312.224914479 ELECTROLYTES,FECES-MAYO 16.204914495 HSV & VZV DNA,PCR,DERMAL-MAYO 115.814914511 ZONISAMIDE-MAYO 54.304914537 RUBEOLA AB SCREEN,IGG-MAYO 13.454914545 AMPHETAMINE CONFIRMATION-UCI 63.954914552 METHADONE CONFIRMATION-UCI 18.004914560 HIV P24 ANTIGEN-MAYO 247.784914586 CMV RAPID PCR,URINE-MAYO 66.894914594 GUADIN,IGA ANTIBODIES-MAYO 29.744914602 ENDOMYSIAL IGA AB-MAYO 20.004914628 LEAD WITH DEMOGRAPHICS-MAYO 8.004914636 PROCAINAMIDE PLUS NAPA-MAYO 26.914914651 AMIKACIN-UCI 18.004914669 COXSACKIE&ENTERO CSF PCR-MAYO 65.594914677 EPSTEIN BARR PCR-MAYO 50.004914693 COXSACKIE A ANTIBODY-MAYO 94.004914719 STRONGYLOIDES IGG AB-MAYO 40.254914727 COAG FACTOR XI-MAYO 60.004914735 COAG FACTOR XII-MAYO 60.004914750 DNASE ANTIBODIES-NI 34.004914776 HEPATITIS E IGG,IGM AB-NI 88.504914784 RENAL BX LIGHT MICROSCOPY-CS 52.154914792 RENAL BX ELECTRON MICROS-CS 631.134914800 RENAL BX IMMUNOFLUORESCENCE-CS 248.004914818 ROTAVIRUS ANTIGEN-NI 49.504914826 IMMUNOFIXATION SERUM-MAYO 15.764914834 AMINO ACID QN ION EXC,P-MAYO 100.00

4914842 COLORADO TICK FEVER AB-MAYO 78.404914859 DNA PROBE,MOLECULAR CYTOGEN-GCTR 122.004914891 IMMUNOHISTOCHEM STAIN-LABC 40.004914909 IMAGE ANALYSIS-ADPL 55.004914941 FTA IGM AB-MAYO 50.314915047 STREPTOCOCCAL ANTIBODIES-MAYO 21.984915062 HYPOGLYCEMIC SCREEN-MAYO 90.004915070 HTLV I/II AB-MAYO 20.034915088 ENTEROVIRUS DETECT,PCR-MRL 250.294915096 HERPES VIRUS 6 DNA,PCR-MRL 268.204915104 V ZOSTER DNA,PCR-MRL 268.204915153 ENTEROVIRUS AB PANEL 2-MAYO 247.854915161 WEST NILE VIRUS RNA,PCR-MAYO 268.204915187 MYCOPLASMA AB CF CSF-MRL 72.904915195 IMMUNE COMPLEX DETECTION 1-NI 118.504915203 HEPATITIS E IGM AB-NI 76.064915229 VITAMIN K1-NI 105.004915237 ANTI SM/RNP AB-NI 26.004915260 KAPPA/LAMBDA LT CHAINS-MAYO 14.954915286 COPPER,URINE-MAYO 12.664915302 PROTEINASE 3 AB(PR3)-MAYO 37.904915328 PAP CYTOLOGY-ADPL 22.004915351 MONOCLONAL PROTEIN STUDY-MAYO 16.004915401 DRUG SCREEN, COMPREHENSIVE-UCI 104.004915435 WEST NILE VIRUS AB,S IGG-MRL 32.474915443 WEST NILE VIRUS AB,CSF IGM-MRL 35.024915468 COMP C1 ESTERASE INHIB-MAYO 43.984915526 CHROMATIN AB-NI 44.504915567 RIBOSOMAL P ANTIBODY-NI 53.004915609 HEPATITIS BE AG-MAYO 17.044915617 CSF IGG INDEX-MAYO 9.644915625 MYELIN BASIC PROTEIN-MAYO 60.754915633 OLIGOCLONAL BANDS-MAYO 23.004915641 PLASMA METANEPHRINES-MAYO 13.614915658 HSV AB SCRN,IGM,E1A CHG1-MAYO 7.614915724 HEAVY METALS, URINE-MAYO 11.794915732 ACYLCANRITINES,QNT-MAYO 53.034915740 ACYLGLYCINES,QNT-MAYO 141.844915955 HSV AB,IGM,S BY IFA(CONFIRM)-MAYO 15.994915963 PROTEIN C ACTIVITY-MAYO 25.094915971 FLOW CYTOMETRY,FIRST MARKER-MAYO 24.544915989 FLOW CYTOMETRY,ADDED MARKERS-MAYO 21.464916037 CHLAMYDIA,GC RAPID PCR-MAYO 17.354916045 TORCH PANEL,IGG-MAYO 91.614916102 NB SCREEN COLLECTION-LB 7.004916136 TOXOPLASMA DNA,PCR-MRL 268.204916144 SALMONELLA TYPHI AB-NI 46.50

4916151 CYLCOSPORINE-UCI 45.004916169 PYRUVIC ACID-MAYO 62.964916177 H PYLORI IGG,IGM,IGA AB-MAYO 62.304916185 INFLUENZA A/B, PCR-MAYO 72.054916201 ARGININE VASOPRESSIN-MAYO 51.044916227 HIV DETECTION PANEL CSF-MRL 280.804916235 GAD65 ANTIBODY-MAYO 22.754916276 PATH VIS,MORPH ANALYSIS-USLABS 112.504916284 HIV 1 GENOTYPING-MAYO 543.784916334 RETICULIN AB-MAYO 18.074916375 TISSUE CULTURE-MAYO 423.244916383 CHROMOSOME ANALYS E KARYOTYPES-MAYO 423.244916391 CHROMOSOMES INTERP/RPT-MAYO 41.484916417 MUSCLE BX SPECIAL STAINS-LBM 97.754916508 COCCI ID IGG & IGM-UCDAVIS 36.004916516 COCCIDIOIDES CF-UCDAVIS 44.004916672 INFLUENZA A IGG,IGM AB-MAYO 16.024916680 INFLUENZA B IGG,IGM AB-MAYO 14.344916698 B PERTUSSIS RAPID PCR-MAYO 35.004916706 SIROLIMUS B-MAYO 21.184916755 SACCHAROMYCES CER IGG AB-MAYO 70.394916797 IN SITU HYBRD 10:30 CELLS-GCTR 122.004916805 CYTOGENETICS INTERPRET-GCTR 40.004916821 NICOTINE & METABOLITE,U -MAYO 26.044916839 17 HYDROXY PREGNENOLONE-MAYO 69.594916953 TISSUE TRANSGLUTAMASE IGG AB-MAYO 15.004916995 DENGUE FEVER IGG,IGM AB-MAYO 102.754917019 MULTIPLE SCLEROSIS PANEL-MAYO 104.014917076 PRO PREDICT METABOLITES-PROM 270.004917134 RBC FRAGILITY-MAYO 85.004917159 ENTEROVIRUS RAPID PCR-MAYO 69.534917183 PROTEIN S ACTIVITY-MAYO 33.244917191 MENIGITIS,ASEPTIC,CSF-MRL 733.504917209 RIBOSOME P AB,IGG-MAYO 41.554917225 VASOACT INT POLYPETIDE-MAYO 50.004917241 DRUG SCREEN ON MECONIUM-MAYO 30.934917258 CYSTATIN C-MAYO 41.464917290 ADENOVIRUS DFA-MRL 95.404917308 MORPHOMETRIC ANALYSIS,EA AB-USLABS 73.004917316 ADENOSINE DEAMINASE,FL-MAYO 120.004917324 BK VIRUS DNA,PCR-MAYO 55.994917332 CHLAMYDIA/GC DNA PROBE-MAYO 39.004917340 THYROGLOBULIN ANTIBODY-MAYO 19.254917357 HIV 1 AB IFA ASSAY-MAYO 19.754917365 HIV AB TYPE 2 EIA-MAYO 59.364917373 INTERLUKIN 5-MAYO 54.804917399 MS PROFILE-MAYO 10.00

4917415 TESTOSTERONE-ESTRX 41.004917464 T3 UPTAKE-MAYO 12.894917472 HEPATITIS A AB,IGG,IGG-MAYO 15.904917522 MUMPS AB,IGG,IGM-MAYO 25.004917563 LYMES DISEASE AB,RFLX WB-NI 23.604917589 SERTRALINE (ZOLOFT)-MAYO 70.844917621 HER 2/NEU QUANTITATIVE-MAYO 156.814917647 TISSUE TRANSGLUTAMINASE IGA AB-MAYO 15.004917688 TOXOPLASMA DNA,PCR,CSF-MAYO 89.514917696 ALPHA GLOBIN GENE ANALYSIS-MAYO 319.864917753 LATEX ALLERGEN,IGE-MAYO 4.504917829 PATH CONSULT,REPORT-MAYO 190.194917845 PNEUMOCOCCAL IGG AB-MAYO 11.124917852 NEUROMYELITIS OPTICAL AB-MAYO 169.704917860 CORTISOL LEVEL-ESTRX 37.004917902 MUMPS AB,IGG/IGA,IFA-MRL 133.204917936 NB METABOLIC SCREENING PANEL-LB 176.254917951 HIV P24 (ICD) ANTIGEN-MRL 198.004918025 A1 ANTITRYPSIN GENOTYPE-MAYO 239.984918041 BILE ACIDS,TOTAL-MAYO 40.284918082 CRMP 5IGG WESTERN BLOT-MAYO 120.304918090 HEMOCHROMATOSIS HFE GENE-MAYO 70.004918116 HEP B VIRAL DNA,QUANT-MAYO 142.004918124 NIACIN-MAYO 85.004918132 PARANEOPLASTIC EVAL-MAYO 26.754918140 ANTI-PHOSPHATIDYLINOSSITOL AB-MAYO 134.004918173 LUPUS PNL 83516-NI 36.004918207 COPPER RBC(WHOLE BLOOD)-NI 37.504918215 MYCOPLASMA DNA,PCR-MAYO 186.014918223 LUPUS PNL 83520-NI 36.004918231 ANA IFA SCREEN W/REFLEX TITER-NI 36.504918249 LUPUS PNL 86160-NI 36.004918256 LUPUS PNL 86235-NI 36.004918264 LUPUS PNL 86255-NI 36.004918330 CHOLESTEROL, VAP-MAYO 27.504918348 LP-PLA2-PAYO 150.004918355 HIV1 PROVIRAL DNA BY PCR-MAYO 50.004918363 ALLERGEN,INDIVIDUAL,ICG-NI 18.504918439 LACTOFERRIN DETECTION,FECAL-MAYO 91.224918454 THIOPURINE METHYLTRANSFERATE-MAYO 73.024918488 VARICELLA ZOSTER,RAPID PCR-MAYO 60.004918496 PARAINFLUENZA DFA-MRL 145.004918504 APOLIPOPROTEIN B-MAYO 17.004918538 HEP B DNA PCR, QNT,SERUM-MAYO 85.004918611 JC VIRUS DNA BY PCR-MAYO 75.004918629 FLOW CYTOMETRY AT-NGLABS 91.004918637 FLOW CYTOMET,ADDL MARKERS-NGLABS 15.00

4918645 FLOW INTERP 2-8 MARKERS-MAYO 76.004918652 FLOW INTERP 9-15 MARKERS-MAYO 121.004918660 FLOW INTERP 16+ MARKERS-NGLABS 145.704918678 TISSUE CULT AT-NGLABS 120.004918686 CYTOGENETICS AT-NGLABS 160.004918694 ADDED KARYOTYPES AT-NGLABS 35.004918702 ADDED CELL CT AT-NGLABS 33.004918710 TISSUE CULT NO GROWTH-NGLABS 90.004918728 CONSULT-NGLABS 188.004918736 IHC STAINS TC AT-NGLABS 35.004918744 INITIAL KARYOTYPES AT-NGLABS 70.004918777 LYME DISEASE ABS (IGG,IGM)-MAYO 100.004918785 T3 UPTAKE-MAYO 11.004918793 ORGANIC ACID SCREEN URINE-MAYO 52.544918819 ANCA VASCULITIDES-MAYO 9.474918835 ACETYLCHOLINE RCPT MOD AB-MAYO 107.004918850 VALPORIC ACID, FREE & TOTAL-MAYO 54.284918868 ACTIN ANTIBODY IGG 34.204918876 ADENOVIRUS DNA QNT PCR-MAYO 65.004918918 PNEUMOCCAL ANTIBODY TITER-MAYO 123.784918934 COXSACKIE B AB PANEL,CSF-MRL 134.104918942 ECHOVIRUS AB,CSF-MRL 132.304918975 CALIF ENCEPHALITIS AB,IFA,CSF-MRL 81.004918983 EAST EQUINE ENCHPHLTS AB,IFA,CS-MRL 144.004918991 ST LS ENCEPHALITIS AB,IFA,CSF-MRL 159.304919007 WEST EQUINE ENCHEPH IGG/IGM,CSF-MRL 172.804919023 FLOW CYTOMETRY ADDL MARKERS A-MAYO 24.004919049 FLOW CYTOMETRY ADDL MARKERS C-MAYO 14.374919056 FLUORES NONINFECTIOUS AGENT AB-MAYO 95.404919064 IMMUNOASSAY QNT NOT SPECIFIED-MAYO 112.954919072 PLASMINOGEN ACT INHIB AG-MAYO 150.854919114 PORPHYRIN PROFILE PLASMA-MAYO 32.304919122 SOLUBLE TRANSFERRIN RECPT-MAYO 29.004919130 HEPARIN LOW MOLECULAR WT-UCI 60.004919148 PROTEIN S AG,TOTAL-MAYO 22.064919155 TOXOCARA CANIS AB-MRL 137.204919163 HIV1 RNA QUANT RT PCR-NI 291.004919171 BETA-2 TRANSFERRIN,FLD-MAYO 81.974919189 TUMOR NECROSIS FACTOR-MAYO 155.384919213 FISH PROBE-NGLABS 191.004919221 ENTEROCOCCUS RNA RT PCR,QL-MRL 250.294919239 HSV 1/2 DNA,RT PCR-MRL 292.504919346 ADAM TS13 ACT INHIBIT-MAYO 132.604919353 CORTISOL,SALIVA-MAYO 53.474919361 PROTNHEMADSORPTION/HEMAGLUTIN-MAYO 42.334919379 VIRAL SMEAR,SHELL VIAL-MAYO 46.904919395 VWFACTOR COLLAGEN BIND-MAYO 110.00

4919411 VORICONAZOLE-MAYO 64.054919429 DIPHTHERIA IGG AB-MAYO 30.384919437 TETANUS IGG AB-MAYO 31.384919445 SEROTONIN,24HR URINE-MAYO 30.004919452 TOTAL T4-MAYO 54.604919460 ALPHA FETOPROTEIN L3% - MAYO 90.004919510 ANTITHROMBIN AG,PLASMA-MAYO 33.674919544 CALPROTECTIN,STOOL-MAYO 100.004919569 MUSK AB-MAYO 550.004919577 ANA, FLUID-MAYO 85.004919585 ERYTHROPOIETIN-MAYO 12.004919619 QUANTIFERON TB GOLD-NI 240.004919627 GONADOTROPIN RELEASING HORMONE-MAYO 250.004919643 TPMT,QNT HPLC-PROM 110.004919650 TPMT,ENZYME ACTIVITY-PROM 110.004919668 T.PALLIDUM DNA,PCR-MRL 268.204919676 FUNGITELL ASSAY1,3 B D GLUCANS-MAYO 143.004919684 PROCOLLAGEN TYPE 1-MAYO 200.414919700 INTERLUKIN 6-MAYO 130.004919783 IBD SGI PANEL CHG01-MAYO 203.004919791 IBD SGI PANEL EIA-MAYO 50.004919809 ANTITHROMBIN ACTIVITY-MAYO 21.224919817 LEGIONELLA PCR-MAYO 91.004919825 ASPERGILLUS AG GALACTOMANNAN-MAYO 50.004919833 COENZ Q10 REDUCED & TOT-MAYO 136.684919874 HSV CULTURE RAPID METHOD-NI 33.504919882 IMMUNE CELL FUNCTION-NI 275.004919890 CIC PANEL IMMUNE COMPLEX-MAYO 120.004919908 CIC PANEL CHG2-MAYO 31.094919916 ASCEPT MENINIGITIS PHL CHG1-MRL 38.604919924 ASCEPT MENINIGITIS PNL CHG2-MRL 38.614919932 ASCEPT MENINIGITIS PNL CHG3-MRL 38.614919940 ASCEPT MENINIGITIS PNL CHG4-MRL 38.614919957 ASCEPT MENINIGITIS PNL CHG5-MRL 38.634919965 DILANTIN FREE & TOTAL-MAYO CHG 1 12.654919973 MENINGOENCAPHALITIS CFS CHG1-MRL 23.174919981 MENINGOENCEPHALITIS CFS CHG2-MRL 22.544919999 MENINGOENCEPHALITIS CFS CHG3-MRL 23.534920005 MENINGOENCEPHALITIS CFS CHG4-MRL 23.534920013 MENINGOENCEPHALITIS CSF CHG5-MRL 23.534920021 MENINGOENCEPHALITIS CSF CHG6-MRL 23.544920039 MENINGOENCEPHALITIS CSF CHG7-MRL 23.544920047 MENINGOENCEPHALITIS CSF CHG8-MRL 23.544920054 MENINGOENCAPHALITIS CFS CHG9-MRL 23.544920070 R LAMBERT EATON AUTOANTIBODY-MAYO 13.664920088 MYASTHENIA GRAVIS ADULT-MAYO 41.924920096 ARSENIC,URINE-MAYO 35.63

4920112 CMV IGG/IGM CHARGES-MAYO 9.084920120 TOXOPLASMA A GONDII PCR,CSF-MAYO 104.404920138 DOXEPIN/NORDOXEPIN-MAYO 20.744920153 RNP IGG AB 81357-MAYO 18.264920161 FCL CHLORIDE,FECES-MAYO 35.904920179 CELIAC DISEASE ANTIBODY,FOCUS B-MRL 84.294920187 TIAGABINE 82524-MAYO 54.024920195 HYPERSENSITIVE PNEUMO IGG-MAYO 13.454920203 HIV 2 AB IBL-MAYO 101.694920211 MS PROFILE CHARGE1-MAYO 10.004920229 MS PROFILE CHARGES2-MAYO 15.004920237 MS PROFILE CHARGE3-MAYO 15.004920245 SENSORY AND MOTOR NEUROP 01-MAYO 50.104920252 SENSORY AND MOTOR NEUROP 02-MAYO 50.094920260 SEROTONIN RELEASE, UF HEPARIN-MAYO 295.004920278 SEROTONIN RLS, LLMW HEPARIN-MAYO 295.004920302 IMMUNOHISTO AB-CLARIENT 57.584920310 IMMUNOHIST TUMOR-CLARIENT 92.754920435 5 CELLS, 1 KAROTYPE-NGLABS 209.004920443 THIAMINE,VITAMIN B1-MAYO 32.004920450 MYCOPLASM PNEUM CULT-QUEST 45.234920468 ROTAVIRUS AG,FECES-MAYO 45.794920476 PROINSULIN,PLASMA-MAYO 30.004920484 INTRINSIC FAC BLK AB-MAYO 21.214920492 BK VIRUS DNA PCR,U -MAYO 35.804920500 SEROTONIN,S-MAYO 47.384920518 ENTEROVIRUS,PCR-MAYO 65.594920526 WARFARIN,SERUM-MAYO 38.004920534 EBVIRUS,DNA,QNT,PCR-MAYO 84.684920542 BARTONELLA,PCR,BLD-MAYO 144.084920559 ERYTHROPOIETIN,S-MAYO 14.624920567 HSV,RAPID,PCR-MAYO 46.104920575 INSULIN AB,S-MAYO 43.074920591 FUNGAL AB PANEL 86606-MRL 41.004920609 FUNGAL AB PANEL 86612-MRL 40.804920617 FUNGAL AB PANEL 86628-MRL 40.804920625 FUNGAL AB PANEL 86635-MRL 40.804920633 FUNGAL AB PANEL 86698-MRL 40.804920641 COAG CONSULT PROTIME-MAYO 40.004920658 COAG CONSULT PTT-MAYO 40.004920666 COAG CONSULT DRVV-MAYO 40.004920674 COAG CONSULT THROMBIN TIME-MAYO 40.004920682 COAG CONSULT FIBRINOGEN-MAYO 40.004920690 COAG CONSULT D DIMER-MAYO 40.004920708 COAG CONSULT PROT C ACTIVITY-MAYO 40.004920716 COAG CONSULT PROT S AG,FREE-MAYO 40.004920724 COAG CONSULT AT III ACTIVITY-MAYO 40.00

4920781 COAG CONSULT ACTPROT RESIST V-MAYO 40.004920799 CMV PCR, FLUIDS-MAYO 60.004920807 PYRIDINIUM COLL XLINK, UR-MAYO 122.354920815 HIV 1 QUANTITATIVE PCR-MAYO 85.004920823 T SPOT TB TEST-OXFORD 52.004920831 PAP SMEAR LIQUID PREP-ADPL 24.504920849 JO 1 ANTIBODIES, IGG-MAYO 18.264920856 COAG FACTOR II ACTIVITY-MAYO 64.624920864 COAG FCTR VIII ACTVTY ASSY, PL-MAYO 50.004920906 SPINAL FLUID INDEX CHG-MAYO 6.134920922 ZONIZAMIDE-MAYO 51.364920948 SEX HORMONE BINDING GLOBULIN-MAYO 20.004920955 COXSACKIE A AB PANEL, SERUM-QUEST 8.504920963 COXSACKIE A AB PANEL,SERUM-QUEST 8.504920971 COXSACKIE B AB PANEL,SERUM-QUEST 10.674920989 COXSACKIE B AB PANEL,SERUM-QUEST 10.674920997 ADRENAL ANTBDY(21 HYDROXYLS AB-MAYO 55.004921003 DRUG SCR PRESCRIPT OTC,PLASMA-MAYO 61.354921011 POLIOVIRUS AB,NEUTRALIZATION-NI 74.124921029 TORCH PROFILE IGG CMV-MAYO 11.004921037 TORCH PROFILE IGG HSV1-MAYO 9.264921045 TORCH PROFILE IGG HSV2-MAYO 11.004921052 TORCH PROFILE IGG RUBELLA-MAYO 11.004921060 TORCH PROFILE IGG TOXO-MAYO 11.004921078 HIV GENOTYPE DRUG RESISTANCE-MAYO 400.004921086 HCV FIBROSURE CHG1-MAYO 322.814921094 HCV FIBROSURE CHG2-MAYO 40.004921102 HCV FIBROSURE CHG3-MAYO 40.004921110 HCV FIBROSURE CHG4-MAYO 40.004921128 HCV FIBROSURE CHG5-MAYO 40.004921136 HCV FIBROSURE CHG6-MAYO 40.004921144 BCR/ABL FISH STUDY 88271-MAYO 87.034921151 BCR/ABL FISH STUDY 88275-MAYO 88.004921169 BONE ALKALINE PHOSPH,S-MAYO 14.904921177 PROPHYRINS, 24 HR QUANT-MAYO 8.614921185 AMINOLEVULONIC ACID, UR-MAYO 70.244921193 HISTAMINE-MAYO 130.004921201 TOXOPLASMA IGG IGM ANTIBODY-MAYO 15.364921219 PREGNENOLONE,SERUM-MAYO 65.834921227 CHLAMYDIA GROUP AB-MAYO 12.784921235 EBV AB PROFILE-MAYO 5.004921243 PARANEOPLASTIC AUTO1-MAYO 34.004921250 PARANEOPLASTIC AUTO2-MAYO 34.004921268 MYCOPLASMA PCR-MAYO 150.004921276 HSV TYPE 1 AB,IGG CHG2-MAYO 7.004921284 HSV TYPE 2 AB,IGG CHG3-MAYO 7.004921292 WEST NILE VIRUS BY PCR,CSF-MAYO 60.00

4921300 NEURON SPECIFIC ENOLASE, SERUM-MAYO 25.004921318 HANTAVIRUS ANTIBODY-MAYO 59.124921326 BILE ACIDS, TOTAL, SERUM-MAYO 40.004921334 VAP CHOLESTEROL CHG1-MAYO 27.504921342 BETA HYDROXYBUTYRATE DEHYROGEN-MAYO 32.284921359 PARANEOPLASTIC AB EVAL-MAYO 35.004921367 FCLL CHRONIC LYMPH LEUKEMIA-MAYO 34.594921375 FCLL CLL FISH PANEL 1-MAYO 34.594921383 HEAVY METALS SCREEN,B CHG1-MAYO 15.674921391 HEAVY METALS SCREEN,B CHG2-MAYO 15.664921409 HEAVY METALS SCREEN,B CHG3-MAYO 15.664921417 POC CHROMOSOMAL ANALYSIS CHG1-MAYO 160.004921425 ACID FAST BACTERIA (MTB) PCR-MAYO 145.004921433 HSVP 1/2 PCR 87529-MAYO 45.004921441 ARBOVIRUS ANTIBODY PANEL, SERUM-MRL 78.084921458 ARBOVIRUS ANTIBODY PANEL,1-MRL 78.084921466 ARBOVIRUS ANTIBODY PANEL 2-MRL 78.084921474 ARBOVIRUS ANTIBODY PANEL,3-MRL 78.084921482 STREPTOZYME-MAYO 62.004921490 WEST NILE VIRUSAB,S IGM-MRL 32.474921508 WEST NILE VIRUS AB CSF IGG-MRL 35.024921524 ENDOMYCELIAL AB IGG A-MAYO 38.594921532 ARBOVIRUS AB PANEL,CSF CHG1-MRL 78.084921540 ARBOVIRUS AB PANEL,CSF CHG2-MRL 78.084921557 ARBOVIRUS AB PANEL,CSF CHG3-MRL 78.084921565 ARBOVIRUS AB PANEL,CSF CHG4-MRL 78.084921573 WESTERN EQUINE ENCEP,CSF-QUEST 84.154921581 HGB ELECTROPHORESIS-MAYO 17.794921599 HEPATITIS B VIRUS QT-MAYO 142.044921623 HEAVY METALS SCREEN,01-MAYO 11.794921631 HEAVY METALS SCREEN,02-MAYO 11.794921644 N GONORRHOEA,RNA-MAYO 17.354921649 HEAVY METALS SCREEN,3-MAYO 11.794921656 LEAD URINE-MAYO 30.894921664 NEISERRIA GC PCR CHARGE-MAYO 17.354921672 LACTOFERIN DETECTION STOOL-MAYO 100.004921680 ANCA VASCULIT 83876-MAYO 9.484921698 MEXILETINE-MAYO 86.474921706 RIBISOME P AB IGG-MAYO 10.734921714 INTRINSIC FACTOR BLOCKING AB,S-MAYO 22.484921722 IBD SGI 88350-MAYO 196.004921730 FREE LIGHT CHAIN,URINE-MAYO 29.174921763 CHROMATIN ANTIBODIES ELISA-MAYO 92.754921771 CHROMOGRANIN A,SERUM-MAYO 20.004921797 IMIPRAMINE-MAYO 19.004921805 IGG SUBCLASS PANEL-MAYO 8.204921813 IGG SUBCLASS PANEL 2-MAYO 10.14

4921854 FEBRILE AB PANEL CHARGE1-QUEST 29.294921862 FEBRILE AB PANEL CHARGE2-QUEST 29.294921912 SEROTONIN, SERUM-MAYO 30.004921920 ELECTROLYTES,FECAL 82438-MAYO 16.204921938 ELECTROLYTES,FECAL 83735-MAYO 16.204921946 ELECTROLYTES,FECAL 84302-MAYO 16.204921953 EHRLICHIA AB IGG/IGM-MRL 91.354921961 HIV2 AB 86702-MAYO 59.364921979 ALPHA 1 ANTITRYPSIN,FECES-MAYO 33.054921987 SS A, SS B IGG ANTIBODIES-MAYO 15.004921995 TORCH PANEL IGM 86694-MAYO 18.004922001 ASP FUMIGATUS IGG AB-MAYO 30.304922019 ARSENIC BLOOD-MAYO 203.704922027 TORCH PANEL IGM 86778-MAYO 19.004922035 MONOCLONAL PROTEIN STUDY 84155-MAYO 18.994922043 MONOCLONAL PROTEIN STUDY 84165-MAYO 15.764922050 CHROMOSOME ANALYSIS 88230-MAYO 65.004922068 CHROMOSOME ANALYSIS 88262-MAYO 55.004922076 CHROMOSOME ANALYSIS 88291-MAYO 55.004922084 MONOCLONAL PRTN URINE 84156-MAYO 17.004922092 MONOCLONAL PROTEIN URINE 84166-MAYO 17.004922100 CALCITONIN,SERUM-MAYO 20.004922118 EPSTEIN BARR VIRUS,PCR-MAYO 33.204922126 TACROLIMUS LEVEL -UCI 40.004922134 H1N1 VIRAL DNA BY PCR-MRL 268.204922142 H1N1 VIRAL DNA,PCR,CHG2-MRL 97.504922175 BK VIRUS PCR-MAYO 55.994922183 COBALT,SERUM-MAYO 61.284922191 CHLORDIAZEPOXIDE (LIBRIUM)-MAYO 68.464922209 CHROMOSOME STUDY TISSUE-MAYO 326.314922217 EAST EQUINE ENCEPH VRS AB,CSF-MAYO 69.304922241 HEPATITIS BE AG CHARGE-MAYO 18.064922266 VIRAL CULTURE NONRESPIRATORY-MAYO 44.454922274 THIAMIN VITB1-MAYO 9.934922282 VON WILLEBRAND CHG1-MAYO 70.004922290 VON WILLEBRAND CHG2-MAYO 60.004922308 THYROGLOBULIN TUMOR MKR CHG1-MAYO 10.674922316 TESTOSTERONE FREE/TOTAL-MAYO 14.204922324 T AND B CELL QT CHG1-MAYO 14.534922332 T AND B CELL QT CHG2-MAYO 18.164922340 T AND B CELL QT CHG3-MAYO 18.164922357 T AND B CELL QT CHG4-MAYO 18.164922365 ST.LOUIS ENCEPH VIRUS AB,S-MRL 59.044922373 ST.LOUIS ENCEPH VIRUS AB,CSF-MRL 77.404922381 SPINAL FLUID INDEX CHG2-MAYO 11.534922399 PSA FREE/TOTAL CHG1-MAYO 10.004922449 PROTEIN ELECTROPHORESIS S CHG-MAYO 12.63

4922456 PENTOBARBITAL SERUM-MAYO 50.584922464 PARIETAL CELL ANTIBODY-MAYO 26.184922472 MUMPS IGG/M AB CSF-MRL 68.404922480 MENINGOENCEPHALITIS PANEL S-MRL 70.384922498 MENINGOENCEPHALITIS PNL S CHG1-MRL 70.384922506 MENINGOENCEPHALITIS PNL S CHG2-MRL 70.384922514 MENINGOENCEPHALITIS PNL S CHG3-MRL 35.194922522 MENINGOENCEPHALITIS PNL S CHG4-MRL 35.194922530 MENINGOENCEPHALITIS PNL S CHG5-MRL 35.194922548 MENINGOENCEPHALITIS PNL S CHG6-MRL 35.194922555 MEM PNL SERUM CHG7-MRL 35.194922563 MENINGOENCEPHALITIS PNL S CHG8-MRL 35.194922597 PORPHYRINS PROFILE CHARGE-MAYO 71.054922605 ALDOSTERONE CORTISOL RATIO-NI 47.494922613 ALDOSTERONE CORTISOL RATIO CHG2-NI 47.494922621 KIDNEY STONE ANALYSIS-MAYO 11.794922639 IN SITU COMP ASSISTED-CLARIENT 230.534922647 IN SITU MANUAL ASSISTED-CLARIENT 200.924922654 HEMOGLOBIN AIC-UCI 18.004922662 STRONGYLOIDES AB,IGG 35.004922670 PLASMINOGEN INHIB ACTIVITY 1-MAYO 150.004922688 MTB QUANTIFERON GOLDTEST-MAYO 85.004922696 VITAMIN K1 LEVEL-MAYO 76.004922787 URINE SUPERSAT,SODIUM-MAYO 9.864922795 URINE SUPERSAT,POTASSIUM-MAYO 8.724922803 URINE SUPERSAT,CALCIUM-MAYO 12.224922811 URINE SUPERSAT,MAGNESIUM-MAYO 13.584922829 URINE SUPERSAT,CHLORIDE-MAYO 10.184922837 URINE SUPERSAT PHOS-MAYO 10.484922845 URINE SUPERSAT SULFATE-MAYO 9.624922852 URINE SUPERSAT CITRATE-MAYO 50.964922860 URINE SUPERSAT OXALATE-MAYO 26.094922878 URINE SUPERSAT PH-MAYO 7.264922886 URINE SUPERSAT URIC ACID-MAYO 9.624922894 URINE SUPERSAT CREATININE-MAYO 10.404922902 URINE SUPERSAT OSMOLALITY-MAYO 13.204922936 DIHYDROTESTERON-MAYO 45.234922944 LYME DISEASE PCR,BLOOD-MAYO 86.284922969 LYME DISEASE AB,EIA,SERUM-MAYO 20.104922977 LYME DISEASE AB,EIA,CSF-MAYO 35.004922985 LYME DISEASE AB WB,CSF-MAYO 31.594923009 THROMBOPHILIA,FIBRINOLYSIN-MAYO 11.374923017 THROMBOPHILIA,SOLUBLE FIBRIN-MAYO 40.004923025 MYOGLOBIN,URINE-MAYO 19.644923033 HEMOGLOBIN A2 AND F-MAYO 70.904923041 RNA POYMERASAE III AB,IGG-MAYO 44.114923058 HISTOPLASMA AG,SERUM-MAYO 119.00

4923066 BETA CROSSLAPS (B-CTX)-MAYO 60.004923074 ENDOMYSIAL AB, IGG-MAYO 97.004923082 SM ANTIBIOTICS,IGG - MAYO 18.264923090 CYSTICERSOSIS,IGG AB S-MAYO 70.004923108 BK VIRUS PCR,QUAN,PLASMA-MAYO 83.684923116 JC POLYOMA DNA,QN PCR,PLASMA-MAYO 311.344923124 C ALBICANS AB IGG,IGA,IGM-MAYO 97.854923140 TESTOSTERONE BIOAVAILALBE-MAYO 57.694923181 PROTHROMBIN FRAGMENT 1+2-MAYO 169.004923215 LEPTIN-MAYO 113.004923256 STREP PNEUMO IGG AB-MAYO 63.714923264 SPECIMEN TRANSPORT-UCI 23.004923272 SPECIMEN TRANSPORT-CS 70.004923280 PERIODIC FEVER PANEL CHG1-GENEDX 275.004923298 PERIODIC FEVER PANEL CH2-GENEDX 275.004923306 PERIODIC FEVER PANEL CHG3-GENEDX 1,650.004923363 ANTIMULLERIAN HORMONE-MAYO 60.754923371 AMPHETAMINE CONFIRMATION-MAYO 50.004923421 PARANEOPLASTIC AB EVAL,CSF-MAYO 55.004923439 PARANEOPLASTIC AB CHG1,CSF-MAYO 60.004923447 INFLUENZA A/B & RSV,PCR,NP SWAP-MAY 76.724923454 RSV PCR DETECTION-MAYO 110.024923462 CERVICAL VAGINAL CYTOLOGY-PATHINC 30.004923470 HPV NAAT FRM CRVCL CYTOLOGY-PATHINC 39.004923488 CHLAMYDIA BY PCR-PATHINC 39.004923496 GONORRHEA BY PCR-PATHINC 39.004923629 MONOCLONAL PROTEIN STDY RAND U-MAYO 25.004923637 MONOCLONAL PRTN STDY,RAND U1-MAYO 25.004923645 GANGLIOSIDE ANTIBODY PNL - MAYO 30.004923678 MAG ANTIBODY-MAYO 140.004923686 MAG-SGPG AB-MAYO 105.004923694 MAG-IGM AB TITER-MAYO 115.004923702 HU ANTIBODY-MAYO 185.004923710 HU AB WESTERN BLOT-MAYO 105.004923728 HU AB TITER-MAYO 182.504923736 HIV1 SUSCEPTABILITY ANALYSIS-MAYO 120.004923744 HIV1 RT BASED DRUG ANALYSIS-MAYO 125.004923751 HIV1 DRUG RESISTANCE 1-10-MAYO 553.004923769 HIV1 DRUG RESIST EA ADDED DRUG-MAYO 55.004923835 THC CONFIRMATION,MECONIUM-MAYO 96.014923843 AMPHETAMINE/METHAMPH,MECONIUM-MAYO 46.014923850 VAGINITIS PCR SCREEN CHG1-PATH INC 25.004923868 VAGINITIS PCR SCREEN CHG2-PATH INC 25.004923876 VAGINITIS PCR SCREEN CHG3-PATH INC 25.004923884 FETAL LUNG MATURITY-LBC-UCI 39.004923892 N TERMINAL PRO-BNP-MAYO 71.774923942 CGH MORPHOMETRIC - GCTR 200.00

4923959 CGH INTERP - GCTR 200.004924007 MITOCHONDRIA INTERP-GCTR 60.004924015 COCAINE CONF ON MECONIUM-MAYO 96.014924023 FLOW CYTOMETRY 16+MARKERS-MAYO 141.304924031 PCP CONFIRMATION,MECONIUM-MAYO 146.484924049 CARBOHYDRATE DEF TRANSFERIN-MAYO 45.734924098 ESCITALOPRAM (LEXPRO)-MAYO 52.954924106 NEUTROPHIL SPECIFIC ANTIBODIES-MAYO 71.104924114 SACCHAROMYCES(IBD) ANTIBODIES-MAYO 70.004924122 ACANTHAMOEBA CULTURE-MRL 162.004924130 CHROMOSOME ANALYSIS CULTURE-MAYO 100.004924148 CHROMOSOME ANALYSIS CVS-MAYO 450.624924155 CHROMOSOME ANALYSIS IN SITU-MAYO 67.914924163 CHROMOSOME ADDL KARYOTYPES-MAYO 26.004924171 CHROMOSOME INTERP-MAYO 30.004924189 CHROMOSOME CYTOGENETICS-MAYO 100.004924221 HLA B5701 NA PROBE AMP-MAYO 517.734924247 RBC ENZYME EVAL CHG1-MAYO 71.694924254 RBC ENZYME EVAL CHG2-MAYO 69.804924262 RBC ENZYME EVAL CHG3 - MAYO 76.324924270 RBC ENZYME EVAL CHG4 - MAYO 133.514924288 RBC ENZYME EVAL CHG5 - MAYO 197.804924296 FLOW CYT BONE MARROW 1ST M-GEMINI 86.694924304 FLOW CYT BONE MARROW SUBS M-GEMINI 64.004924320 FLOW CYT LYMPH NODE SUBS M -GEMINI 34.004924338 FLOW CYT 1ST MARKER - GEMINI 55.144924346 FLOW CYT ADDED MARKERS-GEMINI 33.314924353 IHC STAIN TC-GEMINI 40.004924361 ACGH WHOLE GENOME CONSIT-MAYO 1,535.104924411 COXSACKIE B ANTINODY PANEL-QUEST 22.334924429 COXSACKIE B ANTIBODY_PANEL-QUEST 12.664924437 COXSACKIE A ANTIBODY PANEL-MAYO 18.144924445 COXSACKIE A ANTIBODY_PANE-MAYO 18.134924452 TCD4 T CELL COUNT - MAYO 21.604924460 TCD4 CD4/CD8 COUNT - MAYO 23.054924478 PSA ULTRASENSATIVE - MAYO 123.404924486 FIBRINOGEN ANTIGEN-NI 35.504924494 HE-4 OVARIAN TUMOR MARKER-MAYO 145.004924502 NMO EVALUATION W REFLEX-MAYO 169.704924510 C DIFFICILE CULTURE-MAYO 81.484924528 HEMOPHILUS MIC PANEL-MRL 80.104924536 OXCARBAZEPINE METABOLITE-MAYO 21.314924544 #N/A 10.004924551 FREE THYROXINE INDEX CHG2-MAYO 25.694924569 NOVOVIRUS ANTIGEN EIA-MAYO 123.004924577 LIPOPROTEIN A-SERUM-MAYO 15.394924585 HUMAN HERPES VIRUS 6 PCR-MAYO 116.50

4924593 HUMAN HERPES VIRUS 8 IGG-MAYO 156.444924601 GRANULOCYTE AB,SERUM-MAYO 72.894924619 UPG DECARBOXYLASE-MAYO 189.804924627 FACTOR VII INHIBITOR SCREEN-MAYO 54.454924635 FACTOR VII ASSAY-MAYO 88.854924668 FCTR V LEIDEN GENE MUTTN F5DNA-MAYO 50.004924676 CYTOCHORME P450 2C19,2C19S-MAYO 733.844924684 BCR/ABL P210,QNT,BCRAB-MAYO 350.064924692 CHRONIC GRAN DISEASE MUT PNL-GENEDX 2,860.004924700 CHRONIC GRAN DZ MUT PNLB-GENEDX 2,035.004924718 CYSTIC FBRSS GENE CAR PNL,CFPB-MAYO 121.314924726 FRGL X CHROMOSOME MUT PNL,FXPB-MAYO 290.994924734 HLA-B 5701 GENOTYPE,ABACAVIR,BLD-MA 597.004924742 HEREDITARY HFE GENE ANL,HHEMO-MAYO 150.004924759 JAK2 V617F MUT DETECT, JAK2B-MAYO 200.004924767 KIT ASP816VAL MUT ANL Q ,KITAS-MAYO 438.904924775 MITOCHONRIAL DNA ANALYSIS-GCTR 600.004924791 PROTHROMBIN G20210A MUTTN,PTNP-MAYO 48.634924809 SMA GENE CARRIER PNL,SMAGEN-MAYO 623.504924817 TPMT GENETC ANALYS PCR ,FPRTG-MAYO 380.504924825 HLA CLS 1 MOL TYP DISEASE,DISI-MAYO 29.374924833 RESPIRATORY ALLERGY PNL 10655X1-N1 9.604924841 RESPIRATORY ALLERGY PNL 10655X2-NI 7.204924858 RESPIRATORY ALLERGY PNL 10655X3-NI 48.004924866 FOOD ALLERGY PROFILE (10715X)A-NI 10.804924874 FOOD ALLERGY PROFILE (10715X)B-NI 9.604924882 NMDA RECEPTOR AB SERUM-MAYO 445.324924890 NMDA RECEPTOR AB,CSF-MAYO 450.004924908 LMP CHOLESTEROL-MAYO 10.004924916 LMP TRIGLYCERIDES-MAYO 10.004924924 LMP APOLIPOPROTIEN B-MAYO 15.004924932 LMP HDL CHOLESTEROL-MAYO 10.004924940 LMP LP (A) CHOLESTEROL-MAYO 25.074924957 CREATINE DISORDERS 01-MAYO 20.004924965 CREATINE DISORDERS 02-MAYO 20.004924973 CREATINE DISORDERS 03-MAYO 71.664924981 CHLAMYDIA TRACHOMATIS CULTURE-MAYO 89.384924999 C1 ESTERASE INHIBITOR,FUNCT-MAYO 43.984925004 MI-2 AB-MAYO 80.004925012 SRP ANTIBODIES-MAYO 80.004925020 FLUOXETINE,SERUM-MAYO 56.894925038 VITAMIN B12 BINDING UNSATUREATE-NI 39.504925046 CHROMOSOMES ADDL HIGH RES STDY-GCTR 27.004925053 URINE PROTEIN ELECTROPHORESIS-MAYO 30.004925061 URINE IMMUNOFXTN EL PHORESIS-MAYO 131.504925079 SEROTNN REL.ASSAY,UNFRCT-HEPRN-MAYO 367.004925087 TPMT GENOTYPE-MAYO 390.00

4925095 D-LACTATE,PLASMA-MAYO 56.584925103 INSULIN-LIKE GROWTH FACT PROT3-MAYO 22.004925111 EGFR GENE MUTATION ANALYSS-CLARIENT 1,291.644925129 KRAS GENE-CLARIENT 327.164925137 LEVETIRACETAM (KEPRA) LEVEL-UCI 60.404925145 SYPHILIS IGG AB W REFLEX-MAYO 12.754925152 HEAVY METAL SCREEN CHG4 - MAYO 15.664925160 R RICKETTSIAL DISEASE PNL CHG2-QUES 34.054925178 CELIAC DISEASE IGA-MAYO 12.004925186 CELIAC DISEASE HLA-DQ-MAYO 80.624925194 GLIADIN DEAMINATED IGA AB-MAYO 23.134925202 GLIADIN DEAMINATED IGG AB-MAYO 10.004925210 SYPHILIS AB BY TP-PA,S-MAYO 37.514925228 IN SITU HYBRIDIZATION-PATH INC 130.004925236 THROMBIN CLOTTING TIME-NI 37.184925244 PMLR RAR QUANT,PCR-MAYO 437.124925251 IBD SGI DIAGNOSTIC CHG4-PROM 41.004925269 IBD SGI DIAGNOSTIC CHG2-PROM 41.004925277 IBD SGI DIAGNOSTIC CHG3-PROM 41.004925319 BONE MARROW CHROMSM ANALYSS CHG1-GI 180.004925327 BONE MARROW CHRMSME ANALSS CHG2-GI 250.004925335 BONE MARROW CHRMSME ANALYSS CHG3-GI 20.004925343 6MAMU,6-MAM,U-MAYO 153.504925350 ACYCLOVIR-MAYO 146.004925368 REDUCING SUBSTANCES,STOOL-MAYO 20.004925376 COLLAGEN TYPE I C-TELOPEPTIDE-NI 69.504925384 ALPHA-GLOBIN COMMON MUT ANAL-CHG1 Q 299.004925434 COLOVANTAGE - QUEST-NI 355.004925442 ALDOSTERONE/PLSM RENIN RATION-NI 70.754925459 ALDOSTERONE/PLSM RENIN RATIO 1-NI 70.754925467 LEGIONELLA ANTIGEN DFA-FOCUS 86.404925475 DNA ANALYSIS FOR METHYLTN STDY-GCTR 500.004925483 DNA ANALYSIS CGH MICROARRAY-GCTR 1,100.004925491 HISTAMINE RLS(CHRONIC URTICARIA)-NI 150.004925509 DHEA (DEHYDROEPIANDROSTERONE)-NI 89.004925517 HEPATITIS B VRS DNA QNT RLTM APT-NI 110.004925525 HEPATITIS B VRS DNA QNT RLTM PCR-NI 259.444925533 TREPONEMA PALLIDUM AB IFA(CSF)-NI 43.504925541 OROTIC ACID,URINE MAYO 61.894925558 HTLV I,II DNA,RT,PCR-MAYO 249.674925566 CHILDHD ALLRGY PRFL 10659X CHG1-NI 40.804925574 PANCREATIC ELAST IN STOOL-MAYO 91.654925582 HEPATITIS BC AB IGG & M-MAYO 16.604925590 FRUCTOSAMINE,SERUM-MAYO 18.004925608 FLT3(ITD)&D835 VARNT DET CHG1-MAYO 162.504925616 FLT3(ITD)&D835 VARIANT DET CH2-MAYO 162.504925624 CEBRA MUTATION ANALYSIS-MAYO 413.00

4925632 KIT ASP816VAL MUTTN ANALYSIS,V-MAYO 380.244925640 NUCLEOPHOSMIN MUTATN ANALYSIS-MAYO 556.704925657 GANGLIOSIDE GQ1B AB(IGG)-MAYO 136.704925665 NICOTINE & METABOLITES, S - MAYO 53.474925673 DHEA-MAYO 21.904925681 HEPARIN,LOW MOLEC WT ANTI-XA-UCI 60.004925699 CORTISOL, TOTAL, LC/MS/MS-NI 97.784925707 HE4, OVARIAN CA MONITORING-MAYO 41.934925715 SSDNA (SNGL STRANDED DNA) IGG AB-NI 65.124925723 NEUROMYLTS OPTICA IGG ATOANTBDY-NI 295.004925731 HIV1 GENOSURE PRIME-M-BIOSCIENCE 300.004925749 HIV1 GENOSURE PRIME2-M-BIOSCIENCE 290.004925756 HIV1 GENOSURE PRIME3-M-BIOSCIENCE 300.004925764 HIV1 PHENSNS INTEGRACE-M-BIOSCIENCE 725.004925772 HIV1 PHNSNS ADDL DRGS-M-BIOSCIENCE 95.504925780 CA 19-9 CARBOHYDRATE AG-MAYO 18.214925798 NOROVIRUS RNA,RT PCR-MAYO 95.004925806 HSV TYPES 1&2 DNA,RT PCR-MRL 141.354925814 VON WILLEBRAND FACTOR ACTIVITY-MAYO 75.004925830 TSH ANTIBODY-NI 106.204925848 LACOSAMIDE (VIMPAT)-MAYO 96.004925855 CHROMIUM,SERUM-MAYO 26.924925863 HEMOSIDERIN-URINE-MAYO 34.594925871 RASPBERRY IGG-MAYO 39.804925889 SOYBEAN IGG-MAYO 39.804925897 PECAN FOOD IGG-MAYO 39.804925905 BETA-2 TRANSFERRIN BF-MAYO 88.644925913 MICROSPORIDIA STAIN CHRG1-MAYO 24.544925921 MICROSPORIDIA STAIN CHRG2-MAYO 24.544925939 CO-SEN NEURO PROFILE CHRG1-MAYO 1,256.924925947 CO-SEN NEURO PROFILE CHRG2-MAYO 1,256.924925954 DRVVT 1:1 MIX-NI 22.504925962 QUANTIFERON-TB GOLD-NI 258.304925970 ANTIMCRBRL SSCP,HMPHLS,MICPNL-FOCUS 80.104925988 MEFV GENE ANALYSIS FMF-MAYO 675.004926002 RBC FOLATE-NI 56.204926010 HEPATITIS A IGG ANTIBODY-MAYO 16.874926028 DPD GENE MUTATION-MAYO 287.504926044 INFLXMB&ANTI-INFLXMB AB CHRG1-MAYO 212.504926051 INFLXMB&ANTI-INFLXMB AB CHRG2-MAYO 212.504926069 MUCOPLYSCCHRDS (MPS)QN,U-MAYO 58.354926077 HELICOBACTER PYLORI AB,19M,S-MAYO 675.004926085 DES-GAMMA-CARBOXY PROTHRMBN,S-MAYO 150.004926093 H.PYLORI C UREA BREATH.T-MAYO 64.244926101 CEA,PERITONEAL FLUID-MAYO 186.904926119 INFLUENZA A&B,PCR-UCI 185.004926127 RESP VIRUS PCR PANEL III-FOCUS 1,386.90

4926135 CELIAC HLA DQ TYPING ALPHA-MAYO 101.504926143 CELIAC HLA DQ TYPING BETA-MAYO 101.504926168 IGE QUANTITATIVE-MAYO 10.644926176 ALLERGEN SPECIFIC IGE-MAYO 4.504926184 HSV AND VZV,PCR CHRG1-MAYO 45.004926192 HSV AND VZV,PCR CHRG2-MAYO 45.004926200 INTERLEUKIN 1-ALPHA-MAYO 260.004926218 INTERLEUKIN 1-BETA-MAYO 260.004926226 IL-6,SERUM-MAYO 164.604926234 MYOSITIS ANTIBODY PANEL-MAYO 310.004926242 HSV1/2(IGG),TYPE-SPEC AB CHG1-NI 43.004926259 HSV1/2(IGG) TYPE SPCFC AB CHG2-NI 43.004926267 BORDTLLA P/PARAPER DNA,QL RT PCR-NI 170.004926275 ETHANOL,U-MAYO 53.704926283 ANA, HEP-2 SUBSTATE-MAYO 18.124926291 ANA REFLEX TO TITER-MAYO 24.964926325 HUNTINGTON DISEASE ANALYSIS-MAYO 250.004926358 CLOBAZAM (ONFI) - MAYO 71.604926408 DRUG SCREEN BLOOD CHG 1 - MAYO 83.964926432 HIV-1/2-2 AG AND AB SCREEN,S-MAYO 25.004926440 HIV-1/2-2 AB DIFF,S CHRG 1-MAYO 20.004926457 HIV-1/2-2 AB DIFF,S CHRG2-MAYO 27.124926465 HIV-1 AB CONFIRM BY WB,S-MAYO 19.754926473 HIV-2 AB CONFIRMATION,S-MAYO 57.804926481 ANT SUS,GRAM-POS RDS,MIC PNL-FOCUS 82.804926499 HSV CX W/RFLX TO TYPING-FOCUS 60.304926507 HSV 1 AND 2 AG,DFA CHRG 1-FOCUS 40.504926515 HSV 1 AND 2 AG DFA CHRG2-FOCUS 40.504926523 CHLAMYDIA TRACHOMATIS AG,DFA-FOCUS 81.004926531 MYCOPLASMA IGG IGM AB-MAYO 17.334926549 MYOSITIS AB 2 PANEL CHRG 1 - MAYO 162.504926556 MYOSITIS AB 2 PANEL CHRG 2 - MAYO 162.504926564 INFLXMB & ANTI-INFLIX AB CHRG1-MAYO 212.504926572 INFLXMB & ANTI-INFLIX AB CHRG2-MAYO 212.504926580 RAJI CELL IMMUNE COMPLEX ASSAY-MAYO 295.604926705 UGT1A1 GENE SEQ IRINOTECAN-MAYO 953.804926713 TRICHOMONAS VAGINALIS PCR-PATHINC 38.304926721 CEA PLEURAL FLUID-MAYO 186.904926739 FACTOR X CHROMOGENIC ACT ASSY-MAYO 193.854926747 VON WILLEBRAND PROF CHGI-MAYO 30.004926754 VON WILLEBRAND PROF CHG2-MAYO 30.004926762 VON WILLEBRAND PROF CHG3-MAYO 30.004926770 BETHESDA UNITS RX-MAYO 145.604926788 COAG FACTOR VII INHIB SC RX -MAYO 296.604926796 RISTOCETIN CO-FACTOR-PL RX-MAYO 33.004926804 SPECIAL COAGULATION INTERP RX-MAYO 36.004926812 CTRACH/N GNONORR AMPLIFIED RNA-MAYO 43.83

4926820 BILE ACIDS FRACTNTD AND TOT-MAYO 84.864926838 HSV(NEONATES) CULTURE-MAYO 301.004926846 DRUGS SCREEN BLD 10 WB-MAYO 123.004926853 HSV TYPES 1&2 AB IGG-CHG1-MAYO 8.874926861 HSV TYPES 1&2 AB IGG CHG2-MAYO 9.004926879 FACTOR V(LEIDEN) MUT W/RX HR2-QUEST 192.184926887 FACTOR V REFLEX TO HR2CHG-QUEST 230.004926895 YEAST SUSCEPTIBILITY COMP PNL-FOCUS 497.234926903 SPECIAL STAIN, GRP2-ADPL-PATHINC 40.004926911 HPV LOW RISK DNA ISH-MAYO 565.104926929 AUTOIMM HEP DX CHG1-QUEST 61.004926937 AUTOIMM HEP DX CHG2-QUEST 61.004926945 AUTOIMM HEP DX CHG3-QUEST 61.004926952 AUTOIMM HEP DX CHG4-QUEST 61.004926960 IMAGE ANALYSIS(ASPERIO) PATHINC 177.334926978 OSTEOCALCIN-MAYO 62.954926986 THERMOACTIN VULGARIS IGG-MAYO 59.234926994 MICROPOLYSPORA FAENI-IGG-MAYO 44.254927000 URIC ACID-MAYO 25.654927034 CARBOHYDRATE, URINE - MAYO 49.454927042 THYROXINE BIND GLOBULIN-MAYO 30.684927059 CORTISONE SERUM - NI 132.304927067 ALLERGEN SPECIFIC IGG(8)-MAYO 17.924927075 HISTOPLASMA AG URINE-MAYO 92.804927091 BUPROPION (WELLBUTRIN)-MAYO 89.684927109 FLOWCYTOMETRY/TC 1 MARKER-CLARIENT 62.004927117 FLOWCYTOMETRY/TC,ADD-ON-CLARIENT 12.004927158 LIVER/KIDNEY MICROSOM AB - MAYO 22.874927216 ESTRIOL,UNCONJUGATED-MAYO 18.944927224 PANCREATIC POLYPEPTIDE-MAYO 93.644927232 FIBROGEN ANTIGEN-MAYO 95.004927240 C1 EST INHIB FUNCTIONAL-MAYO 12.254927257 BETA-GLOBIN COMPLETE - NI 349.004927281 RA DGNSTC PNL W/14-3-3 ETA CHG1-NI 108.004927299 RA DGNSTC PNL W/14-3-3 ETA CHG2-NI 85.754927307 RA DGNSTC PNL W/14-3-3 ETA CHG 3-NI 85.754927315 ZINC, RBC-MAYO 81.844927323 BRAF MUT ANAL PCR-CLARIENT 78.124927331 BRAF MUT FDA MELANOMA-CLARIENT 78.124927349 ALK REAMNT,FISH-CLARIENT 401.844927356 MSI BY PCR - CLARIENT 275.524927364 HEV IGM AB SCRN-MAYO 81.654927372 CYSTINURIA PRF,QN,24HRS-MAYO 107.344927380 KAPPA/LAMDA LT CHN,UR CHG2-MAYO 47.754927398 KAPPA/LAMDA LT CHN,UR CHG3-MAYO 47.754927406 KAPPA/LAMDA LT CHN,UR CHG1-MAYO 47.754927414 HCV RNA NS3 GENOTYPE-NI 700.00

4927448 CALPROTECTIN,STOOL-NI 140.004927463 PAN ANCA PLUS W/REFLEX CHG 1-NI 131.954927471 PAN ANCA PLUS W/REFLEX CHG 2-NI 131.954927489 PAN ANCA PLUS W/REFLEX CHG3-NI 131.954927497 LACTOFERRIN,QUAL,STOOL-NI 185.004927505 PAN ANCA PLUS W/REFLEX CHG4-NI 13.124927620 RPR-MAYO 30.004927638 DILANTIN FREE & TOTAL-MAYO CHG 2 12.664927646 DNA ANNALY CGH MICROARRAY 180K-GENE 1,100.004927653 NRAS MUTATION ANALYSIS-CLARIENT 542.404927661 CHROMOSOMES,CONGENITAL-MAYO 191.324927679 ACH RECEPT(MUSCLE)BINDING AB-MAYO 19.004927687 CASR GENE,FULL GENE ANALYSIS-MAYO 1,300.004927695 NOTCH3 DNA SEQUENCING-MAYO 2,525.004927703 WEST NILE VIRUS PCR(PLASMA)-MAYO 35.804927711 FREE THYROXINE INDEX(FTI)CHG 2-MAYO 10.294927729 AEROBIC BACTERIAL ID(7925)-FOCUS 78.304927737 AEROBIC MIC ROUTINE(7429)-FOCUS 51.004927745 AFB SUSCEPTIBILITY MTB(7235)-FOCUS 112.504927752 AFB SLOW GROW MIC SUSCEPT(92522)-MR 140.404927760 AFB RAPID GROW MIC SUSCEPT(7913)-MR 109.804927778 ANAEROBIC MIC PANEL(7921)-FOCUS 214.204927786 FUNGAL ID,MOLD(8028)-FOCUS 85.244927802 VANILLYLMANDELIC ACD-MAYO 22.344927810 YERSINIA AB IG(A,G,M)-MAYO 224.644927828 QUINIDINE-MAYO 41.524927836 PNEUMOCYSTS JIROVEC-QUEST 84.004927844 PARAINFLU(TYPES1,2,3)-MAYO 77.504927851 HLA CLAS I MOL TYPE-MAYO 29.374927869 IMMUNOGLOBULIN D-MAYO 41.074927885 PHENYLALAMIME&TYRSN CHG1-MAYO 53.554927893 PHENYLALANNE&TYRSN CHG2-MAYO 47.794927901 INHIBIN A,B CHG1-MAYO 40.004927919 INHIBIN A,B CHG2-MAYO 40.004927927 FAT STAIN(CHYLURIA CHG1-MAYO 20.684927935 FAT STAIN(CHYLURIA) CHG2-MAYO 20.684927943 FAT STAIN(CHYLURIA)CHG3-MAYO 20.684927950 BRAZIL NUT,IGE-MAYO 4.504927968 MAGNESIUM,RBC-MAYO 47.804927976 PREGABALIN(LYRICA)-MAYO 70.004927984 FATTY ACID PROFILE COMP(C8-26)-MAYO 125.074927992 OVA & PARASITIC EXAM-MAYO 27.764928008 BACTERIAL VAGINOSIS-LABC 75.004928016 BACTERIAL VAGINOSIS PNL CHRG 1-LABC 24.154928024 BACTERIAL VAGINOSIS PNL CHRG 2-LABC 24.154928032 BACTERIAL VAGINOSIS PNL CHRG 3-LABC 55.104928040 BACTERIAL VAGINOSIS PNL CHRG 4-LABC 55.10

4928057 TACROLIMUS-MAYO 25.004928065 ER/PR ESTRGN/PRGSTRNE RCPTR IMAGE-C 185.624928081 ZIKA VIRUS REAL-TIME RT-PCR,URINE-M 220.004928099 SUSCEPTIBILITY YEAST PANEL-MAYO 150.004928107 SULFAMETHOXAZOLE-MAYO 50.894928115 NMO/AQP4 FACS TITER-MAYO 150.004928123 JC PLYMA VRS DNA,QL,RT PCR PLSM-NI 161.504928131 DCP-QUEST 137.504928149 VON WILLEBRAND DIS TYPE-QUEST 220.004928156 NEOENCEPH PARANEO W/REFLEX-QUEST 3,780.004928164 IMMUNOFIXATION SERUM-MAYO 55.004928172 IMMUNOGLOBULIN G-MAYO 12.004928180 IMMUNOGLOBULIN M-MAYO 12.004928198 IMMUNOGLOBULIN A-MAYO 12.004928206 HSV CSF-MAYO 45.004928214 MP STUDY,IFE-MAYO 57.804928222 MP STUDY,PEL-MAYO 29.824928313 PROFESSIONAL CONSULT-CLARIENT 310.004928339 IHC QUAL EA SPEC,INIT AB T-CL 57.584928370 IHC IN SITU HYBRID TC-CLARIENT 98.234928396 ANTIBODY SCREEN, EA MEDIA-ARC 45.004928404 ABID/EACH PANEL & MEDIA-ARC 34.004928412 DAT,EACH ANTISERA-ARC 25.004928420 ABO TYPE-ARC 25.004928438 RBC AG,OTHER THAN ABO OR D,EACH-ARC 40.004928446 RH PENOTYPING,COMP-ARC 60.004928453 PRE-RX RBCS W/CHEMI/DRUGS-ARC 50.004928461 PRE-TREATMENT W/ENZYMES-ARC 20.004928479 ELUTION-ARC 80.004928487 1RBC AG NEG/UNIT-ARC 80.004928495 ANTI-CMV TEST-ARC 50.004928503 SHP-UNSCHEDULED(STAT FEE)-ARC 40.004928511 UNIT W/4 EMPTY BAG-EMP4(EDS BAG)ARC 80.004928537 OFF HOUR CONSULT/HR-ARC 158.004928545 SAMPLE TRANSPORTATION-ARC 35.004928560 SODIUM,FECES-QUEST 27.004928578 POTASSIUM,FECES,QUEST 26.004928586 LEVEL IV BIOPSY,NERVE OR MUSCLE-UCI 300.004928636 BLOOD TYPING FOR RH(D)-ARC 20.004928644 DIFFERENTIAL RBC ABSORBTION-ARC 39.004928651 AMIKACIN PEAK-UCI 18.004928669 AMIKACIN TROUGH-UCI 18.004928677 PRIMIDONE-MAYO 25.004928685 PHENOBARBITAL-MAYO 25.004928693 PLT AG NEG/OTHER COMP HLA-ARC 400.004928701 PT SERA AG SCREEN/UNIT-ARC 60.004928719 THAWING RARE REAGENT CELLS-ARC 40.00

4928727 DILUTION OF SERUM,PER ALIQUOT-ARC 30.004928735 INDIRECT TITER,PER ANTIBODY-ARC 80.004928743 SPECIAL ANTIGLOBULIN TEST-ARC 1,000.004928750 RENAL BX IHC STAIN-CS 251.344928768 RENAL BX SPCL STAIN-CS 37.104928776 HLA ANTIBODY ID,CLASS 1,IGG-ARC 800.004928784 HLA MOLECULAR AB TYPING-ARC 900.004928792 PLT ASSOC IGG,IGM TESTING DIR-ARC 242.004928800 GENITAL HSV1,2 BY PCR-QUEST 358.754928818 N-ACETYLPROCAINAMIDE-MAYO 26.914928826 FLOW INTERPRETATION(2-8)-CL 55.824928834 FLOW INTERPRETATION(9-15)-CL 68.594928842 FLOW INTERPRETATION(16+MARKERS)-CL 75.004928859 FISH AUTO-TECH-CL 355.044928867 BLADDER CANCER FISH GLOBAL-CL 800.004928875 KRAS GENE ANALYSIS-CL 303.004928883 KRAS GENE ANALYSIS_-CL 130.004928891 CEBPA MUTATION ANALYSIS-CL 358.004928909 IDH1,IDH2 MUTATIONS ANALYSIS-CL 265.004928917 MICROSATELLITE INSTABILITY ANAL-CL 536.004928925 NPM1 MUTATION ANAL-LIQUID BX-CL 300.004928933 IHC QUALITATIVE;ADDN'L STAIN-CL 57.584928941 IHC QUANTITATIVE TECH-CL 65.644928958 INSULIN-LIKE GRWTH FACTOR-BIND PRO3 18.214928966 CORTISOL,SERUM,LC-MS/MS-MAYO 53.274928974 CORTISOL,FREE,SERUM-MAYO 76.004928982 PANCREATIC ESTERASE,STOOL 224.004928990 IGF-1 LC/MS 29.914929006 PLATELET GLYCOPROTEIN FLOW 1 MARKER 172.854929014 PLATELET GLYCOPROTEIN FLOW ADDON 63.874929022 PLATELET BLYCOPROTEIN FLOW READ 2-8 97.464929048 CHROMOSOME CONGENTIAL CLTRE 01-MAYO 243.174929055 CTYO/MOLECULAR REPORT-MAYO 63.094929063 ADD'L SPECIALIZED BANDING-MAYO 10.004929071 LD ISOENZYMES-MAYO 7.204929089 PHOSPHLIPHASE A2 REC ANTIBODY SCRE 213.354929097 PHOSPHOLIPASE A2 REC ANIBODY TITER 185.004929113 RANDOM URINE FRACTIONATED CATECHOL 75.504929121 TREE NUT ALLERGY PANEL 94.004929139 CARDIO IQ APOLIPOPROTEIN B 28.504929147 CARDIO IQ LIPOPROTEIN FRACTIONATION 50.004929154 CARDIO IQ OMEGA-3,6 FATTY ACID 50.004929162 HCV RNA GENOTYPE 3 NSSA DRUG RESIST 563.714929170 JC POLYOMA VIRUS DNA 301.344929188 SCHISTOSOMA IGG ANTIBODY 66.204929196 T3 FREE,QUEST 50.004929204 T3 TOTAL,QUEST 50.00

4929212 AEROBIC MIC CUSTOM,1 DRUG MRL 74.704929220 METHYLENEDIOXY AMPHETAMINE CONFIRM 43.974929238 CHC 4Q12 GENE DELETION-MAYO 82.934929246 CHIC GENE DELETION REPORT-MAYO 128.314929253 FATTY ACID PROFILE,ESSENTIAL-MAYO 82.934929261 HEP E VIRUS IGM AB-MAYO 94.104929279 HEP E VIRUS IGM AB CONFIRM-MAYO 143.704929287 LD ISOENZYMES INTERP-MAYO 15.254929295 PHOSPHOLIPASE A2 RECEP.IFA-MAYO 185.004929303 FIBROTEST-HAPTOCLOBIN-MAYO 70.754929311 FIBROTEST-APO-A1-MAYO 78.344929329 FIBROTEST-BILIRUBIN-MAYO 12.474929337 FIBROTEST-GGTP-MAYO 12.474929345 FIBROTEST-ALT-MAYO 12.474929352 IGG4-MAYO 125.404929360 SOLUBLE LIVER AG AUTOAB-MAYO 77.974929378 24 HR MICROALBUMIN NO CREAT-MAYO 5.904929386 TOPHERYMA WHIPPLEI PCR-MAYO 119.064929394 IGA TOTAL-MAYO 124.114929402 IGA SUBCLASS 1-MAYO 106.994929410 IGA SUBCLASS 2-MAYO 107.004929428 E HISTOLYTICA AG-MAYO 106.264929436 PROLACTIN,TOTAL-MAYO 30.204929444 PROLACTIN,UNPRECIPITATED-MAYO 30.204929451 ESTROGEN FRACTIONATION-MAYO 25.014929469 ADDED TESTING,VIRAL ID-MAYO 55.204929477 AFB NUCLEIC ACID SEQUENCE-MAYO 442.804929485 MIC,EACH MULTIMICROBIAL-MAYO 157.504929519 NEURONAL(V-G)K+CHANNEL AB,S-MAYO 120.924929527 ACH RECEPTOR(MUSCLE)BINDING AB-MAYO 120.924929535 N-TYPE CALCIUM CHANNEL AB-MAYO 120.924929543 P/Q-TYPE CALCIUM CHANNEL AB-MAYO 120.924929550 GAD65 ANTIBODY ASSAY-MAYO 177.114929568 PURKINUE CEL CYTOPLAMC AP TYPE TR-M 107.864929576 CRMP-5-IGG,S-MAYO 107.874929584 ANTI-NEURONAL AB,TYPE 3-MAYO 107.874929592 PURKINUE CEL CYTOPLASMC AP TYPE 2-M 107.874929600 ACHR GANGLIONIC NEURONAL AB,S-MAYO 120.924929618 ANTI-NEURONAL NUCLEAR AB,TYPE 1-MAY 107.874929626 ANTI-NEURONAL NUCLEAR AB,TYPE 2-MAY 107.874929634 AMPHYIPHYSIN AB,S-MAYO 107.874929642 ANTI-GLIAL NUCLEAR AB,TYPE 1-MAYO 107.874929659 NMDA-R AB CBA,SERUM-MAYO 107.864929667 AMPA-R AB CBA,SERUM-MAYO 107.874929675 GABA-B-R AB CBA,SERUM-MAYO 107.874929683 LGI1-IGG CBA,S-MAYO 107.874929691 CASPR2-IGG CBA,S-MAYO 107.87

4929717 THYROID RFLX,FT3-NI 69.504929725 THYROID RFLX,FT4-NI 41.004929733 THYROID RFLX,TSH-NI 38.004929741 FIBROBLAST CULT FOR GENE CHG1-MAYO 250.004929758 FIBROBLAST CULT FOR GENE CHG2-MAYO 42.274929766 MATERNAL CELL CONT,B-MAYO 426.664929774 AMNIOTIC FLUID CUL/GENE CHG1-MAYO 690.274929782 AMNIOTIC FLUID CUL/GENE CHG2-MAYO 60.034929790 OVAPARASITES NONSTOOL CONCTRICHRM-M 99.604929808 14.3.3 ETA PROTEIN-QUEST 127.924929816 ALKALINE PHOSPHATASE,TOTAL-MAYO 29.304929824 ISOPROPANOL-MAYO 46.174929832 TRANSFERRIN-MAYO 16.234929840 BRCA1/BRCA2 FULL GENE ANALYSIS-MAYO 1,795.204929857 PRADER-WILLI/ANGELMAN SYNDROM-MAYO 328.394929865 ALLERGY-ICE-QUEST 10.004929873 MYOGLOBIN SERUM-MAYO 71.554929881 ANA LUPUS PANEL-QUEST 407.584929899 NTX-TELOPEPTIDE,CREAT URINE CHG1-MA 16.134929907 NTX-TELOPEPTIDE,URINE CHG2-MAYO 13.134929915 ALPHA-1-ANTITRYPSIN,SERUM CHG1-MAYO 17.504929923 ALPHA-1-ANTITRYPSIN,PHENO CHG2-MAYO 17.504929931 MYELOPEROXIDASE AB,MPO-MAYO 6.244929949 ANCA PANEL FOR VASCULITIS(PR3,MPO)M 18.954929956 DIPHTHERIA TOXOID IGG AB,S-MAYO 35.794929964 B.PERTUSSIS AB,IGG,S-MAYO 80.004929972 CREATININE BODY FLUID-MAYO 28.374929980 ANGIOTENSIN CONVERTING ENZY,CSF-MAY 64.704929998 LYSOZUME,SERUM-MAYO 76.604930004 C.TRACH,MISC,RNA-MAYO 50.174930012 CAMPLYLOBACTER JEJUNI ANTIBODY-MAYO 99.834930020 PANCREASTATIN-MAYO 165.004930038 HEPATITIS A TOTAL ANTIBODY-MAYO 10.574930046 RHEUMATOID ARTHRITIS PANEL3 CHG1-QU 25.254930053 RHEUMATOID ARTHRTIS PANEL3 CHG2-QUE 25.254930061 RHEUMATOID ARTHRTIS PANEL3 CHG3-QUE 25.254930079 FSH,PEDIATRICS-QUEST 93.634930087 LH,PEDIATRICS-QUEST 93.644930095 CYP2C19 GENOTYPE,B-MAYO 801.404930129 BCR/ABL1 CYTOGENETICS DNA PROBE-MAY 84.114930137 BCR/ABL1 CYTOMOLECULRE REPORT-MAYO 46.894930145 ANTI-DNASE B TITER,S-MAYO 22.064930152 SRY YP11.3 CYTOGENETICS DNA PROBE-M 161.964930160 SRY YP11.3 CYTOGENETICS REPORT-MAYO 90.294930178 CHLAMYDIA RNA,RECTAL-QUEST 60.004930186 LIVER FIBROSIS TEST PANEL-MAYO 250.004930194 MOTOR & SENSORY NEUROPATHY PANEL-MA 2,500.00

4930202 HLA-B 5801 GENOTYPE ALLOPURINOL-MAY 218.104930210 BILIRUBIN,BODY FLUID-MAYO 117.504930228 RHEUMATOID FACTOR,BODY FLUID-QUEST 22.504930236 CORTISOL,FREE-QUEST 62.504930244 ACID FAST BACILLI ID-JEWISH HEALTH 304.504930251 M.ABSCESSUS DIFFERNTIATION-JEW HEAL 108.774930269 MIC 20 DRUG COMBO-JEWISH HEALTH 389.624930277 PDL-1 BY ICHC-IO 340.004930285 ROS1 BY FISH-IO 550.004930293 FREE FATTY ACIDS,TOTAL SERUM-MAYO 42.524930301 PNH,PL-LINKED AG1 MARKER-MAYO 31.764930319 PNH,PL-LINKED AG ADD-ON-MAYO 68.124930327 TRICHOPHYTON RUBRUM IGE-QUEST 10.004930335 ROCKY MOUNTAIN SPOTTED FEVER IGG-MA 22.784930343 ROCKY MOUNTAIN SPOTTED FEVER IGM-MA 22.794930350 CYTOGENETICS ADD KARYOTYPES-NG 45.004930368 CYTOGENETICS ADD CULTURE-NG 90.004930376 IHC,ADDNL STAIN PROC-NEOGENOMICS 93.164930384 IHC BY ISH-NEOGENOMICS 147.924930392 TSH RECEPTOR ANTIBODY-MAYO 13.784930400 BETA CAROTENE-MAYO 122.754930418 HLA SELECT XMATCHED PLATELETS-ARC 1,000.004930426 RED CELLS LUERED AUTOLOGOUS-ARC 345.004930434 MUTATION ANALY BIDIRECT SEQ-NEOGEN 200.004930442 T.VAGINALIS RNA,QUAL TMA,MALES-QUES 75.344930459 COLLOIDAL IRON STAIN-LABCROP 20.004930467 SMMHC STAIN,FIRST ANTIBODY-LABCROP 40.004930475 SMMHC STAIN,EACH ADDNL AB-LABCORP 40.004930483 AMPHETAMINES CONFIRMATION,URINE-MAY 23.914930491 MDA CONFIRMATION,URINE-MAYO 23.914930509 BCR/ABL,P190,QUANT MONITOR-MAYO 350.064930517 COLLAGEN CROSSLNKD N-TELOPEP,URI-QU 58.504930525 HEREDTRY HEMOCHROM DNA MUT ANALY-QU 196.504930533 ANA MULTIPLEX W/REFLEX-QUEST 14.474930541 LIVER KIDNEY MICROSOMAL ANTBDY-MAYO 24.284930566 THYROID FUNCTION CASCADE - MAYO 10.044930574 BETA GLOBIN GENE SEQNC BLOOD-MAYO 600.004930582 CYP2D6 GEMOTYPE CASCADE-MAYO 561.904930590 MVISTA COCCIDIOIDES ANTIGN URN-MAYO 119.004930608 HLA TYPING FOR CELIAC DISEASE-QUEST 220.634930616 ALAKALINE PHOSPHATASE BN SPC-QUEST 61.004930624 MORPHANA TUMOR IMMUNO-LABCORP 388.004930632 IHC MULTIPLEX X1 TECHNICAL-LABOCRP 114.004930640 APHERESIS PLTS IRRAD LEUKORED-ARC 502.004930657 CUTANEOUS IMMFLUOR STAIN-MAYO 49.764930665 IHC-EACH ADDITIONAL STAIN-LABC 40.004930673 HERPES SMPLX VRS PCR (NON-BLD)-MAYO 46.10

4930681 MDS PANEL - INTEGRATED 80.004930699 MDS PANEL 88275 - INTEGRATED 80.004930707 STRATIFY JCV ANTIBODY W REFLEX-QUES 1,511.084930715 GONAD RELEASING HORMONE-MAYO 260.004930723 BCL-2 TRANSLOCATION T(14:18)-NG 315.004930731 BRAF MUTATION ANALYSIS-NEOGENOMICS 200.004930749 UNLISTED MOLECULAR PATHOLOGY - MAYO 110.004930756 MOPATH PROCEDURE LEVEL 2 - MAYO 110.004930764 MOPATH PROCEDURE LEVEL 5 - MAYO 110.004930772 MOPATH PROCEDURE LEVEL 6 - MAYO 110.004930780 MOPATH PROCEDURE LEVEL 7 - MAYO 110.004930798 MOPATH PROCEDURE LEVEL 8 - MAYO 110.004930806 MOPATH PROCEDURE LEVEL 9 - MAYO 110.004930814 THROMBIN TIME-MAYO 41.404930822 RHEUMATOID FACTOR,BODY FLUID-MAYO 79.004930830 CARDIO IQ LIPOPROTEIN(A)-MAYO 25.004930848 HEPATITIS C VIRL RNA GENO LIPA-QUES 193.004930855 AEROBIC BACTERIA SUSPECTIBILITY-QUE 133.674930863 AFB SEQUENCING 1-QUEST 442.804930871 POLIOVIRUS(TYPES 1,3)AB NEUT-MAYO 180.524930889 ALPHA-SUB OF PIT GLYCO-MAYO 35.004930897 IN SITU HYBRIDIZATION-1ST-LABCORP 125.004930905 IN SITU HYBRIDIZATION-EA ADDNL-LABC 125.004930913 3 RBC AG NEG UNIT-ARC 220.004930921 MAC PROBE-FOCUS 221.404930939 MAC MIC SUSCEPTIBILITY-FOCUS 161.504930947 RESPIRATORY VIRAL PANEL-MAYO 521.804930954 PNEUMOCYSTIS JEROVECII,DFA-MAYO 121.404930962 GANGLIOSIDE GM1,GM2,GD1A,GD1B,GQ1BM 310.404930970 AVOCADO,IGE-MAYO 5.334930988 INHIBIN A-QUEST 83.384930996 INHIBIN B-QUEST 135.004931002 KIT(C-KIT)MUTATION ANALY-NEOGENOMIC 304.004931010 FLT3(INCL D385)MUTATION ANALY-NEO 300.004931028 STAT3 MUTATION ANALY-NEO 490.004931036 TP53 MUTATION ANALY BI-DIRECT-NEO 900.004931044 NEOTYPE AML PROGNOSTIC PROFILE-NEO 1,630.004931051 ALCOHOL,METHYL-QUEST 68.254931069 BRUCELLA TOTAL AB,AGGLUT(CONF)-MAYO 20.454931077 14.3.3 ETA PROTEIN-MAYO 159.804931085 FECAL LEUKOCYTES-MAYO 45.764931093 UGT1A1 FULL GENE SEQUENCING-MAYO 1,000.004931101 MALDI-TOF ID-QUEST 221.404931119 PNEUMOCYSTIS JIROVECII,DFA-QUEST 42.004931127 ABL T3151 MUTATION IN CML-QUEST 500.004931135 PD-L1-NEOGENOMICS 150.004931143 MUMPS IGM ANTIBODY-MAYO 161.50

4931150 HSV IGM AB BY EIA-MAYO 7.644931168 DNA ANALY SKELTAL DYSPLSIA-GEN CNTR 495.004931176 C3A LEVEL - MAYO 126.864931184 C4A LEVEL - MAYO 126.864931192 PANCREATIC AMYLASE, SERUM - MAYO 42.764931200 FETOMTNL BLD,FLW CYTO-MAYO 538.804931218 COMPLEMENT COMP C3,BODY FLUIDS-NI 23.684931226 COMPLEMENT COMP C4,BODY BLUIDS-NI 23.684931234 OPIATE MECONIUM CONF CHG1-MAYO 59.894931242 OPIATE MECONIUM CONF CHG2-MAYO 49.954931259 BRAF MUTATION SNAPSHOT-INTEGRATED 325.004931267 CRYPTOCOCCUS AG TITER,LFA,CSF-MAYO 19.364931275 QUETIAPINE(SEROQUEL),S-MAYO 76.164931309 MDM2 GENE AMP FISH-INTEGRATED 540.004931317 MICRODISSECTION GLOBAL-INTEGRATED 55.004931325 ESTROGEN RECEPT IMAGE ANALY-INTEGRA 97.004931333 PROGEST RECEPT IMAGE ANALY-INTEGRAT 97.004931341 K167 IMAGE ANALYSIS-INTEGRATED 97.004931358 HER2 IMAGE ANALYSIS-INTEGRATED 97.004931366 PI-LINKED AG 1ST MARKRS-MAYO 15.004931374 PLINKED AG ADDL MARKRS-MAYO 10.004931382 TESTOSTERONE, FREE - MAYO 9.444931390 TESTOSTERONE,FREE-MAYO 9.564931408 TESTOSTERONE,FREE---MAYO 10.344931416 TESTOSTERONE,BIOAVAILALE-MAYO 20.554931424 CYTOGENITICS DNA PROBE,IMRGF-MAYO 192.364931432 CYTO/MOLECULAR REPORT,IMRGF-MAYO 121.874931440 EVEROLIMUS,BLOOD-MAYO 41.424931457 APOLIPOPROTEIN E GENO-MAYO 318.244931473 F-ACTIN AB,IGG,SERUM-MAYO 51.594931481 CHIKUNGUNYA IGM AB,SERUM-MAYO 90.004931499 CHIKUNGUNYA IGG AB,SERUM-MAYO 90.004931507 ZIKA VIRUS MAC-ELISA,IGM SERUM-MAYO 90.004931515 CASHEW NUT,IGE-MAYO 4.504931523 MOG FACS,SERUM-MAYO 525.004931531 CHICKEN IGG-MAYO 49.804931549 LETTUCE IGG-MAYO 49.804931556 SHRIMP IGG-MAYO 49.804931564 TRANSFORMING GROWTH FACTOR BETA-MAY 195.004931572 UGT1A1 GENE POLYMORPHISM-QUEST 210.004931580 QUANTITAT THYROGLOBUL W/O AB-QUEST 15.864931598 PAIN MGMT,ALCOHOL METAB QUANT-QUEST 85.004931606 IGF BINDIN PROTEIN-3,QUEST 80.514931614 STONE ANALYSIS-QUEST 47.364931622 CLL PROGNOSTIC PANEL COMPRENS-QUEST 2,120.014931630 BK VIRUS DNA QUANT PCR-QUEST 234.404931648 TOTAL GLUTATHIONE-QUEST 76.00

4931655 COTTONWOOD(T13)IGE-QUEST 10.074931663 DOG DANDER(E5)IGE-QUEST 10.074931671 ACACIA(T19)IGE-QUEST 10.074931689 WHITE ASH(T15)IGE-QUEST 10.074931697 CAT DANDER(E1)IGE-QUEST 18.444931705 MITOCHONDRIAL ANTIBODY TITIER-QUEST 19.724931713 MITOCHONDRIAL ANTIBODY TITIER-QUEST 18.204931721 HEPATITIS B SURFACE AB,QUANT-QUEST 43.164931739 LYMPHOCYTE SUBSET PANEL 5-QUEST 44.964931747 SURESWAB BACTERIAL VAGINOSIS-QUEST 650.004931754 LP-PLA2 ACTIVITY-QUEST 50.004931762 TPMT ACTIVITY PROFILE,RBC-MAYO 135.004931770 DHR FLOW FMLP ENZYME ACT-MAYO 66.944931788 DHR FLOW FMLP FLOWCYTOM/MARKER-MAYO 205.164931796 T CELL RECEPTOR GENE-PRB REARRAN-MA 257.754931804 T CELL RECEPTOR GENE-TRG REARRANG-M 248.594931812 ELASTASE-MAYO 260.004931820 PARVO VIRUS B19,PCR-MAYO 119.874931838 FLT3 MUTATION-INTEG 1,642.504931846 CEBPA MUTATION-INTEG 390.004931853 NPM1 MUTATION-INTEG 374.004931861 IGG SUBCLASS PANEL-QUEST 104.004931879 ALPHA-GLOBULIN MUTATION ANALY-QUEST 299.004931887 XSENSE,FRAGILE X SCREEN-QUEST 269.004931895 XSENSE,FRAGILE X REFLEX-QUEST 75.004931903 AUSTRAILAN PARROT DROPPINS IGE-QUES 10.004931911 HERPESVIRUS 8 IGG ANTIBODY-QUEST 45.604931929 HUMAN METAPNEU(HMPV)RNA-MAYO 335.004931937 EGFR MUTATN COBASV2 CG1 INTEGRATED 500.004931945 EFGR MUTATN ANALY COBASV2 CG2-INTGD 500.004931952 ALK GENE MUTATION CHG1 - INTEGRATED 400.004931960 ALK GEEN MUTATION CHG2 - INTEGRATED 200.004931978 MONOCLONAL GMMPTHY MNTR CHG1-MAYO 3.624931986 MONOCLONAL GMMPTHY MNTR CHG2-MAYO 10.594931994 5-FLUCYSTONE, SERUM-MAYO 73.284932000 IODINE SERUM/PLASMA-QUEST 72.964932018 MPN,CALR GENE MUT,EXON9-MAYO 689.804932026 T4 FREE,DIRECT DIALYSIS-QUEST 21.804932034 ENCEPHALPTHY-AUTOIMMN EVAL CSF-MAYO 850.004932042 MPL EXON 10 MUT DETECT-MAYO 291.724932059 OXYCODONE-FREE(UNCONJUGATED)-MAYO 120.004932067 OXYCODONE W/METABOLIC CONF URN-MAYO 43.044932075 MPSEX CHG1-IMMUNOFIXATION,S-MAYO 50.974932083 MPSEX CHG2-TOTAL PROTEIN,S-MAYO 8.364932091 MPSEX CHG3-PROTN ELECTRPHRSS,S-MAYO 24.494932109 MPSEX CHG4-KAPPA/LAMBDA FREELT-MAYO 62.044932117 GHRELIN, TOTAL-QUEST 275.00

4932125 MUSCLE BIOPSY CHARGE 1 - LGB 625.004932133 MUSCLE BIOPSY CAHRGE 2 - LGB 625.004932141 MUSCLE BIOPSY CHARGE 3 - LGB 625.004932158 MUSCLE BIOPSY CHARGE 4 - LGB 625.004932166 CHROMOSOMAL MICROARRAY,POV-MAYO 1,300.004932174 CHROMOSOMES,HEMATOLOGIC,BLD,CHG1 159.114932182 CHROMOSOMES,HEMATOLOGIC,BLD,CHG2 37.174932190 NOTCHB DNA SEQ MOPATH PRCDR L7-MAYO 2,525.004932208 CRYPTOSPORIDIUM ANTIGEN,FECES-MAYO 49.954932216 CYCLOSPORA SPECIAL STAIN-MAYO 22.164932224 CYCLOSPORA STAIN CONCENTRATION-MAYO 24.694932232 HERPES SIMPLX VIRUS PCR, BLOOD-MAYO 59.844932240 FLU A&B W/SUBTYPE,RT-PCR CHG1-QUEST 379.954932257 FLU A&B W/SUBTYPE,RT-PCR CHG2-QUEST 379.954932265 SACCHAROMYCES CER AB,IGG-MAYO 74.634932273 COCCIDNS IMMTS ID, DNA PROBE-QUEST 75.004932281 DRUG ABUSE PNL 9,W/CONFIM SRM-QUEST 143.004932299 ANTIPHSPHLPD SYNDRM DX PNL C1-QUEST 80.864932307 ANTIPHSPHLPD SYNDRM DX PNL C2-QUEST 80.864932315 ANTIPHSPHLPD SYNDRM DX PNL C3-QUEST 80.864932323 ANTIPHSPHLPD SYNDRM DX PNL C4-QUEST 80.864932331 BIRD FANCIER PRECIPITIN PNL I-MAYO 132.504932349 DRD3 GENOTYPE-MAYO 600.004932356 PROLACTIN,PITUITARY MACROADNMA-MAYO 51.164932364 COCCIDIOIDES DNA PROBE-QUEST 167.184932372 MYOSITIS ANTBDY PNL CHG 84182-QUEST 519.224932380 MYOSITIS ANTBDY PNL CHG 86235-QUEST 432.694932398 ANTI-HMGCR ANTIBODY IGG-QUEST 190.004932406 ADAMS TS13 ANTIBODY-LABCORP 287.754932414 MYCOPLASMA HOMINIS PCR-MAYO 115.254932422 HBS ANTIBODY,S-MAYO 14.084932430 ASPERIGILLUS PRECIP,ID,S-MAYO 108.454932448 MEASLES(RUBEOLA)AB,IGM,S-MAYO 24.044932455 INHIBIN B,S-MAYO 61.304932463 C3 NEPHRITIC FACTOR(C3NEF)-QUEST 72.064932471 HLA-B51 DETERMINATION-QUEST 80.004932489 ASPERGILLUS FUMIGATUS(M3)IGE-QUEST 10.074932497 ACETYLCHOLINE RCPTR BNDNG AB-QUEST 100.004932505 MOG ANTIBDY W REFLEX TO TITER-QUEST 528.004932513 NEUTROPHIL ANTIBODY,FLOW CYT-QUEST 142.044932521 FONDAPARINUX SODIUM(XA INHIB)-QUEST 152.004932539 MICROSPORIDIA EXAM-QUEST 60.304932547 STONE RISK DIAGNOSTIC PROFILE-QUEST 100.004932554 LIPASE,BODY FLUID-MAYO 10.134932562 COLLAGEN TYPE II ANTIBODIES-QUEST 78.604932570 BACTERIAL MENNINGITIS AG PNL-QUEST 98.504932588 SUSCEPTIBILITY,MIC,AEROBIC XI-QUEST 89.25

4932596 TPMT GENOTYPE-QUEST 420.004932604 PHOSPHOLIPASE A2 RECPT AB,SRM-QUEST 227.054932612 PHOSPHOLIPASE A2 RCPT AB(IFA)-QUEST 227.054932620 TPMT ACTIVITY-QUEST 285.034932638 MUSCLE BX-HISTO SPCL STN HSPST2-UCI 95.004932646 MUSCLE BX-HISTO SPCL STN HSPST3-UCI 206.344932653 STONE ANALYSIS PROCESSING CHRG-MAYO 10.004932661 LIVER FIBROSIS TST ACTTST PNL-QUEST 288.754932679 OXALATE,SERUM-QUEST 107.004932687 MYOMAKER IMMUNOASSAY NONANTBDY-MAYO 151.584932695 MYOMAKER ANTIGEN ANTIBODY-MAYO 183.424932703 HMG-COA ELISA,SERUM-MAYO 200.004932711 ASPERGILLUS FUMIGATUS,IGE-MAYO 4.504932729 BUPRENORPHINE SCREEN WREFLEX,U-MAYO 116.404932737 BUPRENORPHINE METABOLITES,U-MAYO 98.244932745 EGFR MUTATION ANALYSIS NSCLS-INTGRD 575.004932752 BRAF MUTATN DETCT MELNOMA CG1-INTGR 225.004932760 BRAF MUTATN DETCT MELNOMA CG2-INTGR 225.004932778 FLOW MARKER,FIRST - INTEGRATED 35.004932786 FLOW MARKER, ADDITIONAL- INTEGRATED 13.004932794 INTERPRETATION (2-8 MARKERS)-INTRGR 57.004932802 INTERPRETATION (9-15 MARKERS)-INTGR 70.004932810 INTERPRETATION (16+ MARKERS)-INTGRR 60.004932828 CKAPPA FLOW TECH - INTEGRATED 13.004932836 CLAMBDA FLOW TECH - INTEGRATED 13.004932844 HER2 GASTRIC(MD) - INTEGRATED 320.004932851 DSDNA AB BY CRITHIDIA IFA,IGG-MAYO 138.504932869 IODINE,SERUM - MAYO 45.744932877 NMDA RECPTR NR1-SUBUNT AUTOAB-QUEST 500.004932885 LIVER CYTOSOL(LC-1)AUTOAB - QUEST 138.004932893 H PYLORIA UREA BREATH TEST - QUEST 160.004932901 B PERTUSSIS TOXIN AB-IGG,IGA-QUEST 175.004932919 SURESWAB HSV 1-2 MRNA-QUEST 200.004932927 LYMPHOCYTE SUBSET PANEL 3- QUEST 134.884932935 HEPATITIS C VIRAN RNA,QUALTTV-QUEST 149.004932943 JC POLYOMA VRS DNA QL PCR CSF-QUEST 311.344932950 SNP MICROARRAY(REVL)PRODCNDP-LACORP 1,400.004932968 POMPE DISEASE, BS-MAYO 225.004932976 FENTANYL W/METAB CONF, U - MAYO 96.464932984 NK/NKT SUBST PNL NK CELL TCNT-MAYO 177.504932992 NK/NKT SUBSET MONONUC CELL AG-MAYO 377.904933008 NK/NKT SUBST PNL TCELL TCOUNT-MAYO 177.504933032 ANTIMICRO SUSECPT,AERO CUST MIC3-NI 201.264933040 FACTOR X ACTIVITY CHROMOGENIC-QUEST 145.004933057 ENTEROVIRUS CULTURE-QUEST 62.004933065 CORTISOL FREE URINE-MAYO 21.084933073 CORTISOL COL CHROMOTOGRPHY URN-MAYO 27.34

4933099 PARANEOPLASTIC PEMPHIGS,IGG AB-MAYO 330.904933107 IL-2 RECEPTOR(SOUBLE) BY MAFD-MAYO 130.004933115 TRICHOMONAS VAGINALIS AMP RNA-MAYO 61.304933123 RESPIRATORY PATHOLGN PNLS PCR-MAYO 500.004933131 METANEPHRINES,FRCTNTD,RNDM URN-MAYO 22.504933149 MLTPL MYELOMA MMRD BY FLW MRK1-MAYO 353.724933156 MLTPL MYELOMA MMRD BY FLW ADMK-MAYO 130.724933164 MLTPL MYELOMA MMRD BYFLW INTRP-MAYO 336.934933172 HER2 BREAST (MO) - INTEGRATED 794.004933180 MG/LES EVALUATION-MAYO 375.004933198 HCV ANTBDY W REFLEX TO HCV PCR-MAYO 28.314933206 MICROSPORIDIA PCR - MAYO 60.004933214 ETHYL GLUCURONIDE SCREEN,URINE-MAYO 116.404933222 CENTROMERE B ANTIBODY - QUEST 36.004933230 TRAMADOL AND METABOLIE,URINE-MAYO 40.004933248 ECHINOCOCCUS AB IGG,SERUM-MAYO 30.004933255 COCCIDIODES COMP FIX IMMUNODIF-MAYO 54.904933263 CHROMOSOMES,HEMA BMARROW,CULT-MAYO 141.864933271 CHROMOSOMES, HEMA BMRRW MOLRPT-MAYO 33.144933289 CHROMO HEMA BMRRW METAPHAS1-19-MAYO 175.004933297 CHROMO HEMA BMRRW METAPHS20-25-MAYO 175.004933313 CHROMO HEMA BMRRW AGNOR/CBLSTN-MAYO 11.604933321 TISSUE TRANSGLUTAMINASE IGG AB-MAYO 15.004933339 SARS-COV-2-RNA,QUALITTV RTPCR-QUEST 100.004933347 SARS-COV-2 BY RT-PCR - WESTPAC 70.004933354 SARS-COV-2 IGG ANTIBODY-MAYO 43.004933362 ANTISTREP-O TITER,S(ASO)-MAYO 19.504933370 SARS-COV-2 BY RT-PCR-PANGEA 80.004933388 SARS-COV2 BY RT-PCR-NEXTGEN 70.004933420 BRCA1/2 MUTA DD ANALYSIS-NEO 295.004933438 CEBPA MUTATION ANALYSIS-NEO 322.004933446 CALR MUTATION ANALYSIS-NEO 280.004933453 IGVH MUTATION ANALYSIS-NEO 417.004933461 JAK2 V617F MUTA ANALYSIS-NEO 250.004933479 KIT (C-KIT) MUTA ANALYSIS-NEO 274.004933487 MYD88 MUTATION ANALYSIS-NEO 290.004933495 NPM1 MUTATION ANALYSIS-NEO 270.004933503 T-CELL RECEPT BETA RRNGMNT-NEO 500.004933511 T-CELL RECEP GAMMA RRNGMNT-NEO 256.004933529 MPL MUTATION ANALYSIS-NEO 221.004933537 JAK2 EXON MUTA ANALYSIS-NEO 316.004933545 STAT3 MUTATION ANALYSIS-NEO 442.004933552 TP53 MUTATION ANALYSIS-NEO 810.004933560 NEOTYPE MDS/CML PROF-NEO 2,400.004933578 NEOTYPE MYELOID PROF-NEO 2,600.004933586 IDH1/IDH2 MUTA ANALYSIS-NEO 265.004933594 FLT3 MUTATION ANALYSIS-NEO 300.00

4933602 BCR-ABL1 STD P210,P190-NEO 388.004933610 B-CELL GENE RRNGMNT-NEO 492.004933628 MPN EXTENDED RFLX PNL-NEO 1,067.004933636 NEOTYPE CLL P PROFILE-NEO 420.004933644 STD LEUK/LYMPH FLO/CYT-NEO 168.004933651 CLL MRD FLOW CYTOMETRY-NEO 25.004933669 PNH FLOW CYTOMETRY-NEO 25.004933677 BCR/ABL1 FISH 88374-NEO 200.004933685 CCND1 IGH FISH 88374-NEO 200.004933693 PML RARA FISH 88374-NEO 200.004933701 AML FAVORABLE RISK 88374-NEO 200.004933719 CLL FISH PANEL 88374-NEO 200.004933727 EOSIOPHILIA FISH 88374-NEO 200.004933735 LG SML CELL LYMPH 88374-NEO 200.004933743 AML NONFVRABLE RISK 88374-NEO 400.004933750 MDS EXTENDED FISH PNL 88374-NEO 400.004933768 NEOTYPE CLL P PROFILE 88374-NEO 400.004933776 STD LEUK/LYMPH FLO/C 88185-NEO 35.004933784 CLL MRD FLOW CYTOMETRY 88185-NEO 28.004933792 PNH FLOW CYTOMETRY 88185-NEO 28.004933800 BCR/ABL1 FISH 88377-NEO 180.004933818 CCND1 IGH FISH 88377-NEO 180.004933826 PML RARA FISH 88377-NEO 180.004933834 AML FAVORABLE RISK 88377-NEO 180.004933842 CLL FISH PANEL 88377-NEO 180.004933859 EOSINOPHILA FISH 88377-NEO 180.004933867 LG SML CELL LYMPH 88377-NEO 180.004933875 AML NONFVRABLE RISK 88377-NEO 360.004933883 MDS EXTENDED FISH PNL 88377-NEO 360.004933891 CHLAMYDIA TRACHOMATS AMPLFD RNA-WPL 23.384933909 NEISSERIA GONRRHOEAE AMPLFD RNA-WPL 23.384933917 IBUPROFEN-QUEST 15.004933925 LIPOPROTEIN FRACTIONATN ULTRA-QUEST 113.004933933 CHLAMYDIA TRACHOMATIS RNA TMA-QUEST 60.004933941 NEISSERIA GONRRHOEAE RNA TIMA-QUEST 60.004933958 C TRACHOMATIS RNA ALT TARGET-QUEST 60.004933966 N GONNORRHOEAE RNA ALT TARGET-QUEST 60.004933990 CENOBAMATE (XCOPRI) PLASMA-LABCORP 135.004934006 H PYLORI C UREA BREATH TEST-MAYO 64.244934014 CLL FISH CHARGES 88291 - MAYO 51.774934022 ALZHMR DISEASE EVALUATION,CSF-MAYO 1,200.004934030 ISONIAZID (INH)-MAYO 77.694934048 BETA-GLOBIN COMPLETE-QUEST 349.004934055 NMR LIPROPTEIN PROFILE,2-MAYO 55.804934063 INFLUENZA A ANTIBODY-QUEST 26.454934071 NMS1 - SRP IFA SCREEN-MAYO 170.374934089 NMS1-HMG-COA REDUCTASE ANTIBDY-MAYO 199.63

4934097 FENTANYL SCREEN,U-MAYO 135.704934105 HONEY BEE IGG AB-MAYO 57.504934113 HB VARIANT,A2 AND F QUANT-MAYO 154.634934121 HPLC HB VARIANT-MAYO 216.984934139 FERRITIN-MAYO 163.764934147 ENCEPHALOPATHY GAS65 AB-MAYO 88.674934154 ENCEPHALOPATHY EVAL IFA AB-MAYO 45.334934162 HMG-COA REDUCTASE ANTIBODY-MAYO 222.904934170 ANTI-CN-1A NT5C1A IBM-MAYO 165.004934188 HIV12 AG/AB 4TH GENERATION-QUEST 60.004934196 HIV 12 AG/AB REFLEX-QUEST 82.294934204 PNH W/FLAER (HIGH SENSTVTY)-QUEST 350.004934212 VON WILLEBRAN COMP PANEL-QUEST 450.124934220 HEMOGLOBINOPATHY EVAL-QUEST 30.004934238 FISH CML/ALL BCR/ABL TRNS9,22-QUEST 299.004934246 SEX HORMONONE BINDNG GLOBULIN-QUEST 37.504934253 BILE ACIDS,PREGNANCY-QUEST 120.614934261 ADRENAL AB SCREEN - QUEST 27.144934279 ANA SCREEN IFA WITH REFLEX-QUEST 309.484934287 H.PYLORIPCRW/CLARITHROMYCIN-MAYO 75.794934295 SMOOTH MUSCLE ANTIBODY TITER-MAYO 15.004934303 PAP SMEAR SUREPATH AND PHV-LABCORP 69.004934311 HPV GENOTYPES 6 AND 18 -LABCORP 23.004934329 MALARIA SMEAR-QUEST 41.504934337 HSV 1/2 IGM ANTIBODY SCREEN-QUEST 40.334934345 HSV 1 IGM TITER-QUEST 42.934934352 HSV 2 IGM TITER-QUEST 42.934934360 PROTEIN S PANEL-QUEST 463.044934378 SARS-COV2-IGG AB SPIKE SEMI QNT-QST 65.004934386 MENINGITIS ENCEPHALITS PNL PCR-MAYO 501.404934394 VDRL SERUM-QUEST 19.174934402 RHEUMATD ARTHRTS IDENTRA PNL2-QUEST 226.774934410 PROLACTIN TOTAL MONOMERIC-QUEST 105.004934428 DIRECT ANTIGLOBUIN TEST-QUEST 12.904934436 DAT ANTI CD AND IGG REFLEX-QUEST 29.404934444 BP 180 AND 230 SERUM-MAYO 131.214934451 PSA POST-PROSTATECTOMY-QUEST 19.504950002 CRYOGLOBULIN 26.004950010 CATECHOL FRACT,24HR URINE-QUEST 30.004950028 PREALBUMIN 10.004950036 URIC ACID URINE 8.004950044 PHOSPHORUS URINE 11.004950051 SEROTONIN UR 17.004950069 HEP B SURF AG IND 6.004950077 HEP C AB IND 10.004950085 HOMOCYSTEINE 30.004950093 ANTISTREP O 11.00

4950101 LEAD 27.004950119 ARSENIC 27.004950127 MERCURY 27.004950135 AMPHETAMINES 4.004950143 ANALGESICS 4.004950150 HGB A2 29.004950168 ANTICOVALSANTS 4.004950176 ANTIDEPRESSANTS 4.004950184 ANTIHISTAMINES 4.004950192 COCAINE/METABOLITES 4.004950200 NARCOTICS 4.004950218 SEDATIVES/HYPNOTICS 4.004950226 TRANQUILIZERS 4.004950234 VOLATILES 4.004950242 HGB FETAL 16.004950259 HCV RNA BY PCR-QUEST 90.004950267 VMA 22.004950275 OLIGOCLONAL BANDS 30.004950283 MYELIN BASIC PROTEIN 31.004950291 ALBUMIN 11.004950309 GAMMAGLOBULIN X 1 11.004950317 GAMMAGLOBULIN X 2 11.004950325 NEPHELOMETRY 11.004950333 INHIBIN A 144.004950341 INHIBIN B 135.004950358 ALDOLASE 8.404950366 AMPHETAMINES 6.004950374 ANALGESICS 6.004950382 ANTICONVULSANTS 6.004950390 ANTIDEPRESSANTS 6.004950408 ANTIHISTAMINES 6.004950416 COCAINE & METABOLITES 6.004950424 NARCOTICS 6.004950432 SEDATIVES/HYPNOTICS 6.004950440 TRANQUILIZERS 6.004950457 VOLATILES 6.004950465 HGB ELECTROPHOR 20.004950473 EXTRACTION NUCLEIC ACID(PRT) 48.004950515 EOSINOPH COUNT 28.004950523 BENCE-JONES PROT 25.004950531 TACROLIMUS (FK506) 127.004950549 IGF BINDING PROTEIN-1 57.004950556 CK ISOENZYME 25.004950564 LUPUS EXPANDED PANEL 1 47.404950572 PROLACTIN 18.004950580 CEA BY RIA 7.004950598 LUPUS EXPANDED PANEL 2 47.40

4950606 LITHIUM 10.004950622 HCG QUANT 20.004950648 ALPHA FETO PROT 10.004950655 LUPUS EXPANDED PANEL 3 47.404950663 LUPUS EXPANDED PANEL 4 47.404950671 CHLAMYDIA TRACHOMATIS DNA 60.004950689 LACTIC ACID 15.004950697 LUPUS EXPANDED PANEL 5 47.404950705 LUPUS EXPANDED PANEL 6 47.404950713 LUPUS EXPANDED PANEL 7 47.404950721 LUPUS EXPANDED PANEL 8 47.404950739 T3 TOTAL 5.004950747 QUINIDINE 18.004950754 AMIKACIN RANDOM 27.004950762 HLA-B27 31.004950770 ANA 9.004950788 C-REACTIVE PROT 9.004950796 RHEUMATOID FACTOR 7.004950804 URIC ACID 5.004950812 HLA B27 25.004950820 HSV 1 BY PCR 123.004950838 HSV 2 BY PCR 123.004950846 MARIJUANA METABOLITES 32.004950853 ELECTROPHORESIS URINE 9.004950861 PROTEIN TOTAL URINE 9.004950879 CREATININE URINE 9.004950911 EXTRACTION OF NUCLEIC ACID 40.004950929 PH BODY FLUID 40.004950937 TECHOIC ACID AB 28.004950945 TEICHOIC ACID AB TITER 28.004950952 PROT ELEC SER 10.804950960 PROT ELEC CSF 17.004950978 AMPHETAMINES 6.004950986 ANALGESICS 6.004950994 ANTICONVULSANTS 6.004951000 ANTIDEPRESSANTS 6.004951018 ANTIHISTAMINES 6.004951026 COCAINE & METABOLITES 6.004951034 NARCOTICS 6.004951042 SEDATIVES/HYPNOTICS 6.004951059 TRANQUILIZERS 6.004951067 VOLATILES 6.004951083 FOLLICLE STIM HOR 20.004951091 MICROSOMAL AB HA 24.004951109 PROGESTERONE-QUEST 26.664951117 PTH-INTACT 18.004951125 C 4 13.00

4951133 HEPATITIS CAB 10.004951141 LEAD BLOOD 10.004951158 ALDOSTERONE SERUM 33.004951166 ALK P'TASE FRACT 22.004951174 CATACHOLAMIN FRAC 16.004951182 ALKALINE PHOSPHATASE ISOENZYME 22.004951190 HEPATITIS A B & C PANEL 41.004951208 HEPATITIS A (IGM) 11.004951216 HEP B SURF AG 6.004951224 HEP B CORE AB 13.004951232 VITAMIN B12 19.004951240 LIDOCAINE 18.004951257 HAPTOGLOBIN 10.004951265 ACID PHOS PROSTATIC 14.004951273 BETA-2-MICROGLOB-QUEST 25.754951281 MHA-TP 16.004951299 G6PD 21.004951307 C3 COMPLEMENT 14.004951315 FTA 11.004951323 CALCIUM 7.004951331 CATACHOLAMIN TOTL 16.004951349 AMIODARONE 46.004951356 AMITRIPTYLINE 45.004951364 ANTI ENA SM 40.004951372 ANTI ENA RNP 40.004951380 ALPHA ANTITRYPSIN 15.004951398 CARBON MONOXIDE-QUEST 34.404951406 DHEA-S 36.004951414 FETAL FIBRONECTIN 210.004951422 ESTRADIOL 33.004951430 GROWTH HORMONE 21.004951448 CALCIUM IONIZED 16.124951455 PARIETAL CELL AB 55.004951463 SJOGRENS AB SS-A 45.004951471 SJOGRENS AB SS-B 45.004951489 METHOTREXATE 110.004951497 VIP 51.004951505 CA 27-29 28.004951513 PORPHYRINS QUANT 35.004951521 FACTOR VII 120.004951539 FACTOR VIII 137.004951547 FACTOR IX 137.004951554 FACTOR X 137.004951562 PROTEIN C 55.004951570 PROTEIN S 55.004951588 ANTI-THROMBIN 111 140.004951596 HCV GENOTYPE-QUEST 256.00

4951604 OVA AND PARASITES 22.004951620 CHLORIDE UR RANDOM 66.004951638 ANTIGLIADIN AB IGA 52.004951646 ANTIGLIADIN AB IGG 52.004951653 CCP AB IGG 90.004951661 C-PEPTIDE 20.004951679 CARDIO CRP-QUANTITATIVE-QUEST 25.004951687 SEROTONIN RELEASE ASSAY 260.004951695 HEP-INDUCED THROMBOCYTOPENIAAB 124.004951703 B2 - GLYCO PROTEIN IGG 48.004951711 B2 - GLYCO PROTEIN IGA 48.004951729 B2 - GLYCO PROTEIN IGM 48.004951737 T3 FREE 51.004951745 FREE T4 4.004951752 MICROALBUMIN 21.004951760 MICROALBUMIN 21.004951778 COXSACKIE B 98.004951786 CARDIOLIPIN ANTIBODIES 63.004951794 RSV BY DFA 68.004951802 ASPERGILLUS ID 44.004951810 BLASTOMYCOS CF 49.004951828 COXS VIR CF 98.004951836 ECHINOCOCC AGG 122.004951844 CHLAMYDIA GR 91.004951851 CHLAMYDIA CULT 40.004951869 HERPES CULTURE 58.004951877 WESTERN BLOT 74.004951885 SCHLICTER TST 72.004951893 ANTI-NEUT IFA 79.004951901 ROTAVIRUS ANTIGEN 64.004951919 PSITTACOSIS CF 125.004951927 VIRAL CULTURE 43.004951935 Y ENTEROCOLITICA 45.004951943 Y PSEUDOTUBERCULO 45.004951950 OUCHTERLONY 13.004951968 ASPERGILLUS ELAV 13.004951976 ASPERGILLUS NIGER 13.004951984 ASPERGILLUS 13.004951992 ACTINOMYCETE #1 13.004952008 ACTINOMYCETE #2 13.004952016 SPINAL FLUID VDRL 36.004952024 ACTINOMYCETE #3 13.004952032 LUPUS ANTICOAG 71.004952040 CULTURE C. DIFF. 58.004952057 CRYPTOSP. STAIN 61.004952065 FAT STAIN STOOL 54.004952073 AEROBIC SENSI 59.00

4952081 CHLAMYDIA SM 63.004952099 HIV (SEND OUT) 24.004952107 ACTINOMYCETE #4 13.004952115 AFB SENSITIVITY 22.004952123 AFB STAIN URINE - FOCUS 23.524952131 SHIGELLA TYPING A 15.004952149 SHIGELLA TYPING B 15.004952156 SHIGELLA TYPING C 15.004952164 SHIGELLA TYPING D 15.004952172 CULT FUNGUS BLOOD 61.004952180 ACTINOMYCETE #5 13.004952198 AFB SENSITIVITY 22.004952206 AFB SENSITIVITY 22.004952214 AFB SENSITIVITY 22.004952222 AFB SENSITIVITY 22.004952230 ANTI-CENTROMERE 16.004952248 ANTI-NUCLEAR AB 16.004952255 ANTI-RNP AB 16.004952271 ANTI-SM AB 16.004952289 ANTI-SS-A AB 16.004952297 ANTI-SS-B AB 16.004952305 C3 16.004952313 C4 16.004952321 INFLUENZA A 33.004952339 INFLUENZA B 33.004952347 ECHO VIRUS TYPE 4 19.004952354 ECHO VIRUS TYPE 7 19.004952362 ECHO VIRUS TYPE 9 19.004952370 ECHO VIRUS TYPE 11 19.004952388 ECHO VIRUS TYPE 30 19.004952396 HERPES 1 IGG 38.004952404 HERPES 1 IGM 38.004952412 HERPES 2 IGG 38.004952420 HERPES 2 IGM 38.004952438 CARDIOLIPN AB IGG 47.004952446 CARDIOLIPN AB IGM 47.004952453 AMEBIASIS ELISA 59.004952461 AMEBIASIS ID 59.004952479 COCCIDIO, CF SERUM - FOCUS 53.904952487 COCCIDIO ID SERUM A - FOCUS 24.854952495 COCCIDIO ID SERUM B - FOCUS 24.854952503 CYTOMEGALOVIRUS ANTIBODY(IGG)FOCUS 49.704952511 CYTOMEGALOVIRUS ANTIBODY(IGM)FOCUS 49.704952529 HISTOPLASMOSIS ID 44.004952537 HISTOPLASMOSIS CF 44.004952545 LEGIONELL PNEUMO 29.004952552 LEGIONELL SPECIES 29.00

4952560 CHLAM PNEUMO IGG 15.004952578 CHLAM PNEUMO IGA 15.004952586 CHLAM PNEUMO IGM 15.004952594 CHLAM TRACH IGG 15.004952602 CHLAM TRACH IGA 15.004952610 CHLAM TRACH IGM 15.004952628 CHLAM PSITT IGG 15.004952636 CHLAM PSITT IGA 15.004952644 CHLAM PSITT IGM 15.004952651 EB VIRUS VCA IGG 31.004952669 ANTIBODY EB VIRUS,VIRAL CAPSID 42.914952677 ANTIBODY EB VIRUS NUCLEAR ANTIGEN 42.914952685 ANTIBODY EB VIRUS,EARLY ANTIGEN 42.914952693 LEGIONELLA AG/DFA 31.004952701 VERICELLA ZOS IGG 32.004952719 VARICELLA ZOS IGM 32.004952727 CANDIDA PRECIP AG 50.004952735 INFLUENZA A DFA 37.004952743 INFLUENZA B DFA 37.004952750 TOXOPLASMA IGG 54.004952768 TOXOPLASMA IGM 54.004952776 AFB STAIN,PEROTONEAL FLUID-FOCUS 23.524952784 AFB CULT BLD 31.004952792 H PYLORI IGG 52.004952800 H PYLORI IGA 52.004952818 CYSTICERCOSIS AB IGG - QUEST 65.304952826 CYSTICERCOSIS AB 86.004952834 HISTONE AB 68.004952842 RUBEOLA AB IGG-PIHW 33.294952859 RUBEOLA AB IGM 21.004952867 P CARINII DFA/STN 77.004952875 TULAREMIA AB 70.004952883 AGBM ANTIBODY 49.004952891 BRUCELLA ABOR IGG 47.004952909 BRUCELLA ABOR IGM 47.004952917 WEIL-FELIX TEST 47.004952925 WIDAL AGGLUTININS 47.004952933 AFB CULTURE ID 57.004952941 ANA 11.004952958 C4 11.004952966 CENTROMERE AB 11.004952974 DSDNA AB 11.004952982 MITOCHONDRIAL AB 11.004952990 MYOCARDIAL AB 11.004953006 PARIETAL CELL AB 11.004953014 RETICULIN AB 11.004953022 RIBOSOMAL P AB 11.00

4953030 RNP AB IGG 11.004953048 SM AB IGG 11.004953055 SCL-70 IGG 11.004953063 SMOOTH MUSCLE AB 11.004953071 SS-A AB IGG 11.004953089 SS-B AB IGG 11.004953097 STRIATIONAL MUSCLE AB 11.004953105 TPO AB 11.004953113 T CELLS (CD3) 29.004953121 B CELLS (CD19) 29.004953139 T HELPER CELLS 29.004953147 T SUPPRESSOR CELLS 29.004953154 BACT AG H FLU 59.004953162 BACT AG A/Y & CW135 59.004953170 BACT AG B/E COLI 59.004953188 BACT AG NEISSERIA 59.004953196 BACT AG S PNEUMO 59.004953204 PLATELET ANTIBODIES A - FOCUS 49.504953212 PLATELET ANTIBODIES B - FOCUS 49.494953220 PLT ASSOC AB IGG 50.004953238 PLT ASSOC AB IGM 52.004953246 PLATELET ANTIBODIES C - FOCUS 49.494953253 PLT ASSOC AB IGA 52.004953261 BRUCELLA IGG 38.004953279 BRUCELLA IGM 38.004953287 W NILE VIRUS IGG 66.004953295 W NILE VIRUS IGM 31.004953303 W NILE VIRUS IGG 71.004953311 W NILE VIRUS IGM 34.004953329 PHOSPHOLIPID AB IGG 76.004953337 PHOSPHOLIPID AB IGM 76.004953345 PHOSPHOLIPID AB IGA 76.004953352 MUMPS IGG AB-W 53.204953360 CHROMOSOME ANALYSIS 88237 175.004953378 CHROMOSOME ANALYSIS 88239 175.004953386 CHROMOSOME ANALYSIS 88262 175.004953394 KLEIHAUER-BETKE 69.004953402 NEWBORN GENETIC SCREEN MCAL - LB 112.004953436 STONE ANALYSIS 29.004953444 FLOW CYTOMETRY ADD'L ANTIBODY - PI 21.004953451 FLOW CYTOMETRY ADD'L ANTIBODY-PI 21.004953469 FLOW CYTOMETRY ADD'L ANTIBODY - PI 21.004953477 FLOW CYTOMETRY ADD'L ANTIBODY - PI 21.004953485 FLOW CYTOMETRY ADD'L ANTIBODY - PI 21.004953493 FLOW CYTOMETRY ADD'L ANTIBODY-PI 21.004953501 FLOW CYTOMETRY ADD'L ANTIBODY-PI 21.004953519 FLOW CYTOMETRY ADD'L ANTIBODY-PI 21.00

4953527 FLOW CYTOMETRY ADD'L ANTIBODY-PI 21.004953535 FLOW CYTOMETRY ADD'L ANTIBODY-PI 21.004953543 CYCLOSPORINE 31.004953550 MITOCHOND AB 20.004953568 HGB PLASMA 46.004953576 CORTISOL FREE 81.004953584 HISTOPLASMA AG URINE 103.004953592 METHYLMALONIC ACID 155.004953600 ANA TITER 18.004953618 ANTI-DNA 14.004953626 TRANSFERRIN 14.004953634 COMPLEMENT TOT 24.004953642 VIT D 1 25 DIHYDROXY 70.004953659 AMIKACIN TROUGH 27.004953667 AMIKACIN PEAK 27.004953675 CHLAMYDIA TRACHOMATIS DNA SDA 60.004953683 ACTH 47.044953691 CAROTENE 15.004953709 HEP B SURF AB QUANT 8.004953717 VITA D 25-HYDROXY 82.004953725 INFLUENZA A PCR 98.004953733 INFLUENZA 2009 H1N1 98.004953741 CHLAMYDIA TRACHOMATIS RNA TMA 60.004953758 CHLAMYDIA/GC RNA,TMA 120.004953766 CERULOPLAS 14.004953774 GASTRIN 21.004953782 INSULIN 14.004953790 SMOOTH MUSCLE 24.004953808 SMOOTH MUSCLE AB TITER 24.004953816 MYOGLOBIN URINE 20.004953824 MYOGLOBIN 27.004953832 IMMUNOGLO A IGA 11.004953840 ANGI COVER ENZ 13.004953857 IMMUNOGLO D 21.004953865 IMMUNOGLO E 13.004953873 IMMUNOELECT UR 39.004953881 IMMUNOGLO G 11.004953899 IMMUNOGLO M 11.004953907 IMMUNOELEC SERUM 39.004953915 IMMUNOGLOBULIN G 11.004953923 IMMUNOGLOBULIN A 11.004953931 LUTENNIZ HORMONE 15.004953949 LAB FAT FECAL QUALITATIVE 22.004953956 IMMUNOGLOBULIN M 11.004953964 TESTOSTERONE - QUEST 16.504953972 CA-19-9 13.004953980 CA-125-W 10.00

4953998 ZINC SERUM-QUEST 15.764954004 THYROGLOBULIN PANEL 18.004954012 TYHROGLOBULIN AB 18.004954020 HGB URINE 27.004954038 CA 15-3 14.004954046 D-DIMER - QUEST 35.004954061 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954079 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954087 FLOW CYTOMETRY ADD'L ANTIBODY-PI 21.004954095 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954103 FLOW CYTOMETRY BLOOD 43.004954111 FLOW CYTOMETRY BONE MARROW 43.004954129 FLOW CYTOMETRY TISSUE 43.004954137 INFUENZA A&B QUAL PCR-FOCUS 208.604954145 MASS SPECTROMETRY 16.004954152 GALACTOSE-1-PHOS 16.004954160 TSH 16.004954178 HEMOGLOBINOPATHY 15.624954186 IMMUNOREACTIVE TRYPSINOGEN 16.004954194 BIOTINIDASE 16.004954202 HYDROXYPROGESTERONE 16.004954210 HANDLING FEE 18.004954228 RIBOSOMAL P ANITBODY 14.004954236 ANA SCREEN IFA 14.004954244 COMPLEMENT C3C AND C4C 7.004954251 DNA (DS) ANTIBODY 14.004954269 SCL-70 ANTIBODY 14.004954277 THYROID PEROXIDASE ANTIBODY 14.004954285 RHEUMATOID FACTOR 14.004954293 ALPHA FETO PROTEIN-W 10.004954301 AMIKACIN PEAK-W 22.644954319 AMIKACIN TROUGH-W 22.644954327 AMIKACIN RANDOM-W 22.644954335 CA 15-5-W 14.004954343 CA 19-9-W 13.004954350 CA 125-W 10.004954368 CEA-W 7.004954376 CORTISOL TOTAL-W 7.004954384 FETAL FIBRONECTIN ASSAY-W 210.004954392 HAPTOGLOBIN-W 10.004954400 HEP A VIRUS IGM-W 11.004954418 HEPATITIS B CORE AB,IGM-W 12.004954426 HEP SURFACE AB-W 9.004954434 HEP B SURFACE ANTIGEN-W 6.184954442 HEPATITIS C ANTIBODY-W 10.004954459 LITHIUM, LAB-W 10.074954467 MICROALBUMIN-W 20.72

4954475 PTH INTACT-W 25.004954483 RUBELLA AB SCREEN-W 5.004954491 FREE T3 (FT3)-W 50.884954509 T3,TOTAL-W 5.004954517 FREE T4 (FT4) 184.004954525 TRANSFERRIN-W 13.684954533 VITAMIN D,25-HYDROXY-W 81.894954541 HEPATITIS A B & C PANEL 39.184954558 VARICELLA-W 63.254954566 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954574 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954582 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954590 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954608 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954616 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954624 FLOW CYTOMETRY ADD'L ANTIBODY 21.004954640 BM ADD'L ANTIBODY W/EXPLOSION 21.004954657 FLOW CYTO ADD'L COMPONENT 2 93.004954673 LEVEL II SURG PTH 470.004954681 LEVEL III SUR PTH 650.004954699 LEVEL IV SURG PTH 823.004954707 LEVEL V SURG PTH 901.004954715 LEVEL VI SURG PTH 1,047.004954723 FROZ/CONS 375.004954731 FROZ EA ADD - PHHD 263.004954749 SP STAIN SIM 165.004954756 SP STAIN COM 90.004954764 FNA/ CONS - PHHD 650.004954772 CYTOLOGY SMEAR 302.004954780 C BLK CYTO - PHHD 823.004954798 BN MAR-ASP INT - PHHD 112.004954806 BN MAR-INTERPRETATN - PHHD 823.004954814 FNA ST CONSULT - PHHD 244.004954822 CELL WASH INTERPT - PHHD 901.004954830 CELL BLK ADD'L - PHHD 823.004954848 CONCENTRATE/BLK - PHHD 901.004954855 DECALCIFICATION - PHHD 23.004954863 ORX-IMAG CONSUL 375.004954871 FNA ST ADD CONSUL - PHHD 244.004954889 LVL 4 GRS + MICRO 901.004954897 DIR IMMFLOUR AB 47.004954905 SPECIAL STAIN GRP II 90.004954913 PLASMA THAW & HANDL 61.004954921 ABO TYPING 24.004954939 PHENOTYPE 33.004954947 ANTIGEN TYPING 266.254954954 DIRECT COOMBS 14.00

4954962 RH TYPING 27.004954970 RH TYPE UNIT SCRN 27.004954988 DIRECT COOMBS 14.004954996 RHO DU TEST 24.004955001 DAT IGG 14.004955019 DAT C3(NON IGG) 14.004955027 FETAL SCREEN 30.004955035 SPEC XM PROCEDURE 127.004955043 ANTIBODY ID 43.004955050 POOLING BLD PROD 49.004955068 ANTIBODY SCRN PT 33.004955076 UNIT SCRN ABO TYPE 52.004955084 SPECIAL AB PANEL 43.004955092 CROSSMATCH 437.924955100 SPLITTING OF UNIT 31.004955118 ABSORPTION BLOOD 77.004955126 ANA-W 8.784955142 ACUTE HEPATITIS PANEL 39.184955159 HEP B SURFACE AG CONFIRM-W 33.864960001 AFB SMEAR-FOCUS 23.524960019 PROCALCITONIN - QUEST 200.004960027 CRYTOCOCCAL ANTIGEN - FOCUS 35.104960035 JAK 2 MUTATION-QUANTITATIVE-QUEST 449.004960043 NOROVIRUS, STOOL - FOCUS 62.784960050 QUANTIFERON TB GOLD-QUEST 60.004960068 MTB,PCR CFS-FOCUS 141.644960076 ANTIPYRINE - FOCUS 170.004960084 TSI-THYROID STIMLTNG IMMGLBN-QUEST 307.074960092 ANCA VASCULITIDES A - QUEST 100.004960118 RSV,PCR - FOCUS 208.604960126 ANCA VASCULITIDES B - QUEST 100.004960134 ANTIPYRINE - QUEST 170.004960142 BCR/ABL,PCR - QUEST 220.004960159 GIARDIA, STOOL - FOCUS 77.004960167 AFB STAIN, ASCITIC FLUID-FOCUS 23.524960175 BILE ACDS,FRCTN TTL PREGNANCY-QUEST 120.614960183 RHMTD ARTHRITIS PANEL A CCP-QUEST 48.444960191 RHMTD ARTHRTS PNL B FCTR QNT-QUEST 48.444960209 FECAL GLOBIN-QUEST 60.004960217 FREE LGHT KAPPA LAMBDA CHN A-QUEST 25.004960225 FREE LGHT KAPPA LAMBDA CHN B-QUEST 25.004960233 21 HYDROXYLASE ANTIBODY-QUEST 107.004960241 CYSTIC FIBROSIS CARRIER SCRN-QUEST 180.694990008 ER, PR BY IA - GLOBAL A - LABCORP 150.004990016 ER, PR BY IA - GLOBAL B - LABCORP 150.004990024 BCR/ABL QUANTIATIVE PCR A -LABCORP 486.004990032 BCR/ABL QUANTIATIVE PCR B-LABCORP 486.00

4990040 EGFR MUTATION, NSCLC - LABCORP 992.254990057 EGFR MUTATION, TUMOR ANALYSIS A-LC 450.004990065 EGFR MUTATION, TUMOR ANALYSIS B -LC 450.004990073 KRAS MUTATION - LABCORP 587.884990081 ALK BY FISH - LUNG A - LABCORP 216.674990099 ALK BY FISH - LUNG B - LABCORP 216.674990107 ALK BY FISH - LUNG C - LABCORP 216.674990115 HER 2 BY FISH - BREAST/GASTRIC A-LC 106.674990123 HER 2 BY FISH - BREAST/GASTRIC B-LC 106.674990131 HER 2 BY FISH - BREAST/GASTRIC C-LC 106.674995007 TC PRIMARY IHC STAIN - PATH INC 40.004995015 TC ADDITIONAL IHC STAINS - PATH INC 40.004995023 CONSULTATION WITHOUT IHC STAINS -PI 125.004995031 CONSULTATN WITH IHC STAINS-PATH INC 225.004995049 H. PYLORI STOOL - QUEST 102.304995064 ENTAMOEBA HISTOLYTICA,STOOL-FOCUS 63.004995072 ENTAMEOBA HISTOLYTICA ANTIGEN-QUEST 44.004995080 ENTAMOEBA HISTILYTICA,STOOL-FOCUS 63.004995098 ENTAMOEBA HISTOLYTICA ANTIGEN-FOCUS 63.004995106 H. PYLORI STOOL-FOCUS 90.304995114 H. PYLORI SERUM-FOCUS 90.304995122 KEPPRA(LEVITERACETAM)SERUM-QUEST 65.254995130 COCCIDIO ID,SERUM-FOCUS 49.704995148 COCCIDIO ID,SERUM-FOCUS 53.904995155 COCCIDIODES ANTIBODY-QUEST 46.444995163 COXIELLA BURNETTI(Q-FEVER)-FOCUS 163.174995171 ECHINOCOCCUS AB(IGG)W/RFLX TO WB 128.634995189 STRONGYLOIDES ANTIBODY,IGG-QUEST 56.754995197 BRUCELLA IGG,IGM-FOCUS 40.804995205 HISTAMINE RELEASE 100.004995213 ALLERGEN SPECIFIC,IGE-QUEST 10.374995221 TRYPTASE-QUEST 69.974995239 ANTI-MULLERIAN HORMONE(AMH)-QUEST 102.004995247 PLATELET ANTIBODY,DIRECT-FOCUS 135.984995254 BETA PROSTAGLANDIN F2-QUEST 197.104995262 VIT B6-QUEST 147.004995270 TREPONNEMA PALLIDUM(TPPA)-QUEST 69.304995288 INFLUENZA A&B PCR W/O REFLEX-QUEST 284.004995296 BARTONELLA PCR,BLOOD-FOCUS 208.604995304 BARTONELLA,SERUM-FOCUS 150.004995312 CMV,PCR SERUM-FOCUS 208.604995320 CMV,URINE-FOCUS 208.604995338 CMV,BLOOD-FOCUS 208.604995346 PROTHROMBIN GENE MUTATION-QUEST 158.564995353 ACETYLCHOLINE RECPTORS ANTIBODY-QUE 48.964995379 ACETYLCHOLINE RECEPTOR ANTI BY BLOC 135.784995387 ACETYLCHOLINE MODULATING ANTIBODY-Q 141.00

4995411 WEST NILE,PCR,CSF-FOCUS 65.634995429 AFB CULTURE W/STAIN-FOCUS(87015) 44.104995437 AFB CULTURE-FOCUS 44.104995445 AFB CULTURE W/STAIN-FOCUS(87206) 44.104995452 AFB STAIN,THORACENTESIS-FOCUS 23.524995460 AFB STAIN,SPUTUM-FOCUS 23.524995478 AFB STAIN,LUNG WASH-FOCUS 23.524995486 AFB STAIN,BRUSHING-FOCUS 23.524995494 CYSTINE,URINE-QUEST 25.734995502 FECAL FAT,QUALITATIVE-FOCUS 32.204995510 FAT STOOL,QUALITATIVE-FOCUS 22.114995528 FOLATE,RBC-QUEST 33.004995536 HYPOGLYCEMIC PANEL-QUEST 90.004995544 ACTIVATED PROTEIN C-RESISTANCE-QUES 94.784995551 C1 ESTERASE INHIBITOR PROTEIN-QUEST 24.204995569 M PNEUMO CF-FOCUS 101.434995577 MARIJUANA THC-QUEST 65.234995585 COCCAINE-QUEST 65.234995593 BENZODIAZEPINE LEVEL-QUEST 71.004995601 CAFFEINE LEVEL-QUEST 46.154995619 SPECIFIC GRAVITY,BODY FLUID 22.254995627 BCR/ABL,PCR(P)-QUEST 752.004995635 FACTOR XIII-QUEST 299.004995643 DIHYDROPYRIMIDINE DEHYD GENE-QUEST 350.004995650 THIOPURINE S-METHYLTRANSERASE-QUEST 420.004995668 ACHONDROPLASIA MUTATION ANALY-QUEST 273.004995676 24HR URINE ACETATE-QUEST 136.004995684 ACETONE,BLOOD-QUEST 55.394995692 BETA-HYDROXYBUTYRATE-QUEST 58.004995700 URINE AMPHETHAMINE CONFIRM-QUEST 96.454995718 VIT B2-QUEST 102.154995726 CYANIDE,BLOOD-QUEST 68.804995734 CITRATE 167.324995742 ANDROSTENEDIONE-QUEST 53.764995759 FREE TESTOSTERONE-QUEST 50.004995767 TESTOSTERONE,FREE & TOTAL-QUEST 50.004995775 PROCALCITONIN LEVEL-FOCUS 200.004995783 NEUROMYELITIS OPTICA-NMO-QUEST 585.004995791 KAPPA/LAMBDA LIGHT CHAIN FREE W/REF 135.514995809 OSMOLALITY,SERUM-QUEST 13.304995817 24HR URINE OXALATE 19.214995825 PSA,FREE-QUEST 15.204995833 PSA,TOTAL-QUEST 15.204995841 PROCALCITONIN-QUEST 15.204995858 ERYTHROCYTE PROTOPHORPHYRIN-QUEST 33.434995866 SELENIUM-QUEST 59.524995874 SOMATOMEDIN(IGF-1)-QUEST 57.21

4995882 STOMATOSTATIN-QUEST 142.614995890 SULFATE,URINE-QUEST 82.434995908 VIT E-QUEST 18.964995916 VIT B3-QUEST 154.804995924 FACTOR IX-LBM 140.754995932 CLOTTING FACTOR XI-QUEST 136.824995940 CLOTTING FACTOR XIII-QUEST 146.004995957 CLOTTING FACTOR I-QUEST 136.824995965 CLOTTING FACTOR XII-QUEST 136.824995973 VISCOSITY,SERUM-QUEST 26.794995981 PLATELET INDIRECT IGG,IGM,IGA-FOCUS 126.424995999 PLATELET AB-QUEST 106.534996005 CCND1/IGH FISH,BLOOD-LC 550.004996013 SMITH ANTIBODY-QUEST 52.004996021 SCL-70-QUEST 55.004996039 ALPHA FETOPROTEIN,PLEURAL FLUID-QUE 62.784996047 GLUTAMIC ACID DECARBOXYLASE AB-QUES 150.004996054 LYMPHOCYTE SUBSET B CELLS-FOCUS 38.164996062 LYMPHOCYTE SUBSET T CELLS-FOCUS 38.164996070 LYMPHOCYTE SUBSET T CELL W/RATIO-FO 38.184996088 CRYPTOCOCCAL ANTIGEN-QUEST 27.844996096 LYME DISEASE-QUEST 30.934996104 Q FEVER-FOCUS 155.404996112 COCCIODIO,CF SERUM-FOCUS 53.904996120 EBV-TITER(CAPSID ANTIGEN)-FOCUS 52.504996138 HTLV-1&2 ANTIBODY-QUEST 88.524996146 ECHINOCOCCUS-FOCUS 113.834996153 HEPATITIS A ANTIBODY,TOTAL-IGG-QUES 18.094996161 BORDETELLA PERTUSSIS-FOCUS 66.504996179 AFB SMEAR-PARASITES FOCUS 22.404996187 PNEUMOCYSTIS,DFA-FOCUS 38.504996195 CULTURE FUNGUS,BLOOD-QUEST 61.094996203 MYCOPLASMA PNEUMONIAE CULTURE-FOCUS 79.104996211 CULTURE,VIRUS,BODY FLDS,TISSU-FOCUS 132.304996229 RSV,DFA-FOCUS 70.704996237 ASPERGILLUS ANTIGEN,SERUM-FOCUS 217.004996245 ASPERGILLUS ANTIGEN,SERUM-QUEST 105.004996252 CRYPTOSPORIDIUM AG,STOOL-FOCUS 63.954996260 HIV(CONFIRMATION)-FOCUS 28.054996278 CYTOMEGALOVIRUS,PCR-QUEST 306.004996286 CMV,DNA QUANT,PCR-FOCUS 224.304996294 17-HYDROXYPROGESTERONE-QUEST 44.654996302 ENTEROVIRUS PCR-CSF-FOCUS 227.504996310 HEPATITIS B VIRUS DNA,QUAN PCR-QUES 216.204996328 HEPATITIS B VIRUS DNA QUANT-QUEST 259.444996336 HEPATITIS B VIR DNA QUAN PCR-QUEST 135.004996344 RSV,PCR-QUEST 219.03

4996351 HIV,GENOTYPE-QUEST 220.004996369 HIV GENOTYPE(P)-QUEST 220.004996377 HIV GENOTYPE(P)-QUEST 134.504996385 HIV GENOTYPE(P)-QUEST 134.504996401 HEMOSIDERIN STAIN,URINE-QUEST 12.094996419 JAK 2 MUTATION,QUALITATIVE-QUEST 350.004996427 ADAMTS 13 ACTIVITY-QUEST 440.004996435 VARICELLA-ZOSTER ANTIBODY IGG-FOCUS 55.864996443 TISSUE TRANSGLUTAMINASE AB-QUEST 79.564996450 ADP PLATELET-LBM 54.504996468 SJROGRENS-QUEST 39.884996484 PARTICLE AGGLUTINATION-QUEST 46.844996492 BORDETELLA PERTUSSIS-QUEST 32.504996500 BORDETELLA PERTUSSIS,SERUM-FOCUS 32.504996518 KAPPA/LAMBDA LIGHT CHAIN FREE,URINE 120.004996526 KAPPA/LAMBDA LIGHT CHAIN FREE,SERUM 120.004996534 ASCA-ANTI SACCHROMYCES CEREVIAE AB 100.004996542 HSV,HERPES 1/2CSF-QUEST 162.504996559 LEGIONELLA SEROLOGY-FOCUS 29.004996567 PARVO VIRUS-QUEST 16.154996575 ANTIBODY,RICKETTSIA 44.674996583 SALMONELLA ANTIBODY-FOCUS 15.684996591 DENGUE FEVER-FOCUS 78.654996609 TISSUE TRANSGLUTAMINASE AB IGA-QUES 91.124996617 MYCOBACTERIUM INTRACELLULARE DNA 197.404996625 BORDETELLA PERTUSSIS PCR-FOCUS 104.304996633 LEGIONELLA,URINE-FOCUS 67.204996641 MDS BY FISH(P)-LAB CORP 88271 80.004996658 MDS BY FISH(P)-LAB CORP 88275 80.004996815 QUANTIERON TB GOLD-FOCUS 60.004996856 ANTIBODY BRUCELLA-FOCUS 72.484996906 JAK 2,BONE MARROW-LC 225.004996922 BENZODIAZEPINE-QUEST 26.714996930 MALARIA BLOOD-QUEST 56.794996963 MUSK ANTIBODY TEST-QUEST 1,065.004996971 IMMUNO FIXATION ELECTROPHORESIS 361.424997011 CALCIUM URINE QUANTITATIVE-NI 9.924997219 POTASSIUM,URINE-QUEST 9.924997235 ANTIBODY CYTOMEGALOVIRUS-QUEST 11.404997243 ANTIBODY CYTOMEGALOVIRUS IGM-QUEST 11.404997268 CONCENTRATION FOR INFECT AGENT-NI 32.004997359 APOLPOPROTEIN-NI 35.814997367 BILIRUBIN-NI 35.814997375 GLUTAMATE DEHYDROGENASE-NI 35.814997383 TRANSFERASE,ALANINE ANINO-NI 35.814997409 UNLISTED PROC PANEL-QUEST 352.014997425 NOROVIRUS,STOOL-QUEST 98.00

4997433 PYRUVATE KINASE-QUEST 127.654997441 BICARBONATE URINE-QUEST 39.004997458 BULLOUS PEMPHIGOID BP180 AB-QUEST 42.004997466 GABAPENTIN NEURONTIN-QUEST 84.854997474 YEAST SUSCEPTIBILITY COMP PANEL-MR 339.384997482 LAMICTAL (LAMOTRIGINE)-QUEST 19.474997490 HERPES SIMPLEX VIRAL CULT-QUEST 57.504997508 VON WILLEBRAND ANTIGEN-QUEST 136.824997516 PLASMINOGEN-QUEST 242.314997524 COLD AGGLUTININ-QUEST 8.804997532 OSMOLALITY FECES-QUEST 56.654997540 GLUCAGON-QUEST 33.434997557 VON WILLEBRAND MULTIMETRIC-QUEST 173.374997565 RISTOCETIN COFACTOR-QUEST 136.824997573 GAD ANTIBODY-QUEST 150.004997581 ISLET ANTIBODY-QUEST 84.004997599 SCABIES-QUEST 29.754997607 DELTA AMINOLEVULINIC ACID URINE-QUE 80.544997615 BENZODIAZEPINE W/CONFIRMATION-QUEST 124.004997623 OPIATES SCREEN W/CONFIRMATION-QUEST 65.234997631 INSULIN AUTOANTIBODY-QUEST 142.004997649 PORPHOBILINOGEN QUANT URINE-QUEST 34.454997656 COLLAGEN TELOPEPTIDE-NTX URINE-QUES 114.004997664 OXCARBAZEPINE-TRILEPTAL-QUEST 71.004997672 LISTERIA ANTIBODY-QUEST 47.104997680 SHIGA TOXIN EIA-FOCUS 54.404997698 PARTICLE AGGLUTINATION-QUEST 74.594997706 HEREDITARY HEMOCHROMATOSIS-QUEST 180.694997714 HLA-B27 ANTIGEN-QUEST 25.464997722 JO-1 ANTIBODY-QUEST 55.004997730 MI-2 AUTOANTIBODIES-QUEST 98.004997748 SRP ANTIBODIES-QUEST 83.004997755 STRATIFY JCV ANTIBODY W/REFLUX-QUES 1,363.004997763 CYTOMEGALOVIRUS IGG/IGM CSF-FOCUS 99.404997771 LISTERIA ANTIBODY SERUM-FOCUS 82.604997789 ENTAMOEBA HISTOLYTICA SERUM 120.404997797 EPINEPHRINE-QUEST 145.004997805 NOREPINEPHRINE-QUEST 145.004997813 APOLIPOPROTEINE B-QUEST 10.644997821 IMMUNOFIXATION URINE 38.595100938 VER VISUAL EVOKE RESPONSE 1,087.005101720 SER IN UPPER LIMBS 1,511.005101738 SER IN THE TRUNK OR HEAD 1,260.005101746 SER IN LOWER LIMBS 1,511.005105044 ABER AUDITORY LEVEL 977.005105051 EMG-1 641.005105069 EMG-2 1,220.00

5105085 EMG-3 841.005105093 EMG-4 1,631.005105184 EMG CRANIAL NERVE MUSC UNILAT RT 1,430.005105192 EMG CRANIAL NERVE MUSCLES BILAT 1,430.005105200 EMG CRANIAL NERVE MUSC UNILAT LT 1,430.005105234 EMG NON EXT W/NERVE CONDUCTION 331.005105242 SER IN UPPER AND LOWER LIMBS 1,511.005105259 EMG LIMITED W/NERVE CONDUCTION 432.005105267 EMG COMPLETE W/NERVE CONDUCTION 679.005105309 NERVE CONDUCTION STUDIES 5-6 954.455105317 NERVE CONDUCTION STUDIES 7-8 1,364.005105333 NERVE CONDUCTION STUDIES 3-4 1,393.005105341 INTRA OP NEURO MONITOR EA 15 MIN 268.005300272 UP EXTREM ARTERIAL DUPLEX COMP 2,389.005300280 LOWER EXT VENOUS DUPLEX COMP 2,389.005300447 UP EXTREM ARTERIAL DUPLEX LTD 1,413.005300702 UPPER EXT ARTERIAL DOPPLER LMTD 1,052.005300710 LOWER EXT ARTERIAL DOPPLER LMTD 1,052.005300728 LWR EXT ART DOPPLER W/TREADMILL 1,061.005300736 UPPER EXT VENOUS DOPPLER RIGHT 1,413.005300744 UPPER EXT VENOUS DOPPLER LEFT 1,413.005301080 LOWER EXT VENOUS DOPPLER RIGHT 1,413.005301098 LOWER EXT VENOUS DOPPLER LEFT 1,413.005301106 PERFLUTREN/DEFINITY PER ML 385.005301114 PARTIAL ECHOCARDIOGRAM 1,812.005301122 U/S GUIDED PERICARDIAL CENTISI 1,715.005301130 INTRAOP T E E 3,782.005301148 STRESS ECHOCARDIOGRAM 5,676.005301155 STAT COMPLETE ECHOCARDIOGRAM 3,740.005301163 STAT PARTIAL ECHOCARDIOGRAM 1,812.005301171 ECHOCARDIOGRAM W/CONTRAST 3,740.005301569 UP EXTREM VENOUS DUPLEX COMP 2,389.005301577 UPPER EXTREM ARTERIAL DOPPLER COMP 1,589.005304969 EKG/ECG TELEMETRY 276.005306774 HOLTER MONITOR RECORDING 1,479.005306790 LOWER EXT ART DOPPLER 1,589.005306808 ECHOCARDIOGRAPHY F/U 768.005306816 EP EVAL PACING-DEFIB POST IMPLANT 7,089.005306824 DOPPLER ECHOCARDIOGRAM F/U 931.005306832 ECHOCARDIOGRAM CONGEN ABN COMPL 1,769.005306840 ECHOCARDIOGRAM CONGENITAL ABN F/U 931.005306857 DUPLEX SCAN HEMODIALYSIS ACCESS 1,624.005308085 TRANSCRANIAL ULTRASOUND 1,291.005309646 ECG - OUTPATIENT 588.005309679 SECTOR ECHOCARD W/ CONTRAST 3,740.005310230 ECHOCARDIOGRAM/EX TEST 3,740.005310248 TRANSESOPHAGEAL ECHOCARDIOGRAM 5,316.00

5310263 EVENT RECORDING-HOOK UP 968.005310305 HOLTER MONITOR SCANNING & REPORT 1,486.005310321 LOW EXTREM ARTERIAL DUPLEX COMP 2,389.005310339 LOWER EXT ART LIMIT DUPL 1,413.005310347 NUC ISOTOPE STRESS TEST 2,006.005310370 TRANSTELEPHONIC PM CHECK 276.005310396 PENILE PETHYSMOGRAPHY 736.005310404 PHARM STRESS TEST 2,006.005310412 SECTOR ECHOCARDIOGRAM 3,740.005310420 STRESS TEST TRACING ONLY 2,006.005310438 NUC ISOTOPE PHARMACOLOGICAL 2,006.005310446 STRESS TEST W/ECHO 2,006.005310453 STRESS TEST 2,006.005310487 ARTERIAL DOPPLER EXAM 1,589.005310628 CAROTID ULTRASOUND(DUPLX) 2,470.005310636 DOPPLER COLOR FLOW MAPPING 1,070.005310644 COLOR FLOW DOPPLER ECHOCARDIOGRAM 1,070.005310651 DOPPLER ECHOCARDIOGRAPHY 1,380.005310677 ECG RHYTHM STRIP 242.005310693 ECG ROUTINE 588.005310719 ECG STAT 588.005310743 UPPER EXTREM VENOUS DUPLEX UNI 1,430.005310750 LOWER EXTREM VENOUS DUPLEX UNI 1,430.005310768 STAT CAROTID DUPLEX 2,470.005310776 STAT VENOUS DUPLEX - BILATERAL 1,945.005310784 STAT VENOUS DUPLEX - UNILATERAL 1,430.005310792 STAT LE ARTERIAL DUPLEX - BILAT 2,272.005310800 STAT LE ARTERIAL DUPLEX - UNI 1,359.005310818 EKG - REPEAT 588.005370069 ECG PEDIATRIC 15 LEAD 588.005390141 AICD OR BIIV INTERROGATION 269.005390158 AICD PROGRAMMING SINGLE LEAD 420.005390166 AICD PROGRAMMING DUAL LEAD 424.005390174 AICD OR BIV PROGRAMMING MULT LEAD 501.005390182 PACEMAKER/AICD REMOTE DATA ACQ 223.005390190 UPPER EXTREMITY DOPPLER WITH 1,945.005390216 DUPLEX SCAN EXT VEINS LIMITED 1,413.005390224 LOWER VENOUS UNILATERAL 1,413.005390232 UPPER VENOUS UNILATERAL 1,413.005390240 U/S GUIDED CATH INSERTION 1,394.005390257 ART/VEIN MAPPING DIALYSIS ACCESS 1,069.005390265 DUPLEX CAROTID LIMITED 1,279.005390273 PSEUDO ANEURSYM INJECTION 653.005390299 DUPLEX SCAN EXTREMITY VEINS LEFT 1,413.005390307 DUPLEX SCAN EXTREMITY VEINS RIGHT 1,413.005390315 UPPER EXTREMITY ARTERIAL DUPLEX LT 1,413.005390323 UPPER EXTREMITY ARTERIAL DUPLEX RT 1,413.00

5390331 CAROTID DUPLEX LEFT 1,279.005390349 CAROTID DUPLEX RIGHT 1,279.005390356 LOWER EXTREMITY ARTERIAL DUPLEX LT 1,359.005390364 LOWER EXTREMITY ARTERIAL DUPLEX RT 1,359.005390372 UPPER VENOUS DUPLEX LEFT - 93971 1,413.005390380 UPPER VENOUS DUPLEX RIGHT - 93971 1,413.005390398 ART/VEIN MAPPING DIALYSIS-UNILATERL 514.005390414 LINQ2020 PLUS 271.005390422 INTRVNT ECHO TRANSESOPHGL GUIDANCE 3,500.005501259 EEG RECORDING IN COMA OR SLEEP 1,328.005501275 EEG EXTENDED MONITORING 41-60MIN 1,253.005502018 EEG AWAKE/SLEEP 1,798.005502026 EEG CEREBRAL SILENCE 879.005502034 EEG ROUTINE 1,798.005502042 STAT EEG AWAKE & DROWSY 1,798.005502059 EEG NON-INTRACRANIAL SURG MONITOR 3,262.005502109 DIGITAL ANALYSIS OF EEG 678.005502133 STAT EEG - COMA 1,328.005502141 STAT EEG - BRAIN DEATH 879.005502158 STAT EEG-EXTENDED 41-60 MIN 1,253.005700562 REVISE POCKET PACEMAKER 4,194.005700570 PERI-PROCED EVAL&PROGRAM DEFIB 279.005700588 PERI-PROCED EVAL&PROGRAM PACER 223.005900006 PT AQUATIC THERAPY 15 MIN 229.005900220 PT ULTRASOUND 15 MIN 107.005900246 PT TRACTION - MECHANICAL 83.005900329 PT ELECT-STIM UNATTENDED 129.005900444 PT THERAPEUTIC EXERCISE 15 MIN 162.005900477 PT GAIT TRAINING 15 MIN 148.005901327 PT WHIRLPOOL 292.005901392 PT ADL TRAINING 15 MIN 225.005901632 PT IONTOPHORESIS 15 MIN 225.005901657 PT MANUAL THERAPY 15 MIN 228.005901681 M/CAL PT EVALUATION-INITIAL 30 MIN 647.005901699 M/CAL PT EVALUATION ADD'L 15 MIN 121.005901707 M/CAL PT TREATMENT ADD'L 15 MIN 214.005901715 M/CAL PT TREATMENT INITIAL 30 MIN 324.005901780 PT DEBRIDEMENT NON-SELECTIVE 30 MIN 370.005901814 PT DEBRIDEMENT SELECT <=20CM-60 MIN 411.005901822 PT DEBRIDEMENT SELECT<OR=20CM-45MIN 411.005901830 PT DEBRIDEMENT SELECTIVE<=20CM-30MN 411.005901848 M/CAL PT AQUATIC THERAPY ADD'L 15MN 229.005901855 M/CAL PT AQUATIC THERAPY INIT 30MIN 458.005901863 GP PT BASIC EVAL 449.005901871 PT EVALUATION 90 MIN 449.005901889 GP PT BASIC EVAL 45 MIN 449.005901897 GP PT EVALUATION 60 MIN 449.00

5901905 PT DEBRIDEMENT NON-SELECTIVE 45MIN 370.005901913 PT DEBRIDEMENT NON-SELECTIVE 60MIN 370.005901954 PT CANALITH REPOSITIONING 106.005901988 PT DEBRIDEMENT SELECT >20CM 30 MIN 411.005901996 PT DEBRIDEMENT SELECT >20CM 45 MIN 411.005902028 M/CAL SNGL MOD IONTPHRSIS INITL 30M 87.005902036 M/CAL SNGL MOD TRCTION INIT 30MIN 83.005902044 M/CAL SNGL MOD ULTRASND INITL 30 MN 120.005902051 M/CAL SNGL MOD WHRLPOOL INITL 30 MN 247.005902069 M/CAL SNGL MOD 1 AREA EA ADD'L 15MN 162.005902077 M/CAL SNGL PROC 1 AREA INITL 30 MIN 324.005902085 M/CAL SNGL MOD MASSAGE INTL 30 MIN 53.005902093 M/CAL SNGL PROC 1 AREA ADD 15 MIN 162.005902143 PT EVALUATION-120 MIN 449.005902150 PT THERAPEUTIC ACTIVITIES-15MIN 270.005902200 GP MASSAGE 15 MIN 53.005902218 GP ORTHOTICS TRAININIG PER 15M 180.005902226 GP PROSTHETIC TRAINING 15 MIN 76.005902234 GP NEUROMUSCULAR RE-ED 15 MIN 88.005902242 PT PED DEV TESTING INITIAL 1 HR 449.005902259 PT PED DEV TEST EACH ADDTL 30 MIN 225.005902267 GA-PT PED DEV TEST EA ADD 30 MIN 225.005902275 GY-PT PED DEV TEST EA ADD 30 MIN 225.005902283 KX-PT PED DEV TEST EA ADD 30 MIN 225.005902291 PT TRACTION-MECHANICAL-CQ 107.005902309 PT ELECT-STIM UNATTENDED-CQ 107.005902317 PT VASOPNEUMATIC DEVICE-CQ 107.005902325 PT ELECT-STIM ATTENDED-CQ 225.005902333 PT IONTOPHORESIS-CQ 225.005902341 PT ULTRASOUND-CQ 107.005902358 PT THERAPEUTIC EXERCISE-CQ 225.005902366 PT GAIT TRAINING-CQ 225.005902374 PT MANUAL THERAPY -CQ 225.005902382 PT THERAPEUTIC ACTIVITIES 15 MIN-CQ 225.005902390 PT ADL TRAINING - CQ 225.005902408 PT CANALITH REPOSITIONING-CQ 449.005905013 PT RE-EVALUATION 225.005907191 GY-PT DEBRIDEMENT SELECT<=20CM-60M 411.005907209 GY-PT DEBRIDEMENT SELECT<=20CM45MIN 411.005907217 GY-PT DEBRIDEMENT SELECT<=20CM30MIN 411.005908009 KX-PT AQUATIC THERAPY 15 MIN 229.005908017 KX-PT ULTRASOUND 15 MIN 107.005908025 KX-PT TRACTION MECHANICAL 122.005908033 KX-PT ELECT-STIM UNATTENDED 107.005908058 KX-PT THERAPEUTIC EXERCISE 15 MIN 162.005908066 KX-PT GAIT TRAINING 15 MIN 148.005908082 KX-PT WHIRLPOOL 292.00

5908090 KX-PT ADL TRAINING 15 MIN 225.005908108 KX-PT IONTOPHORESIS 15 MIN 225.005908116 KX-PT MANUAL THERAPY 15 MIN 228.005908132 KX-PT DEBRIDEMENT NON-SLCTV 30 MIN 370.005908140 KX-PT DEBRIDEMENT NON-SLCTV 45 MIN 370.005908157 KX-PT DEBRIDEMENT NON-SLCTV 60 MIN 370.005908199 KX-PT DEBRIDEMENT <=20CM 60 MIN 411.005908207 KX-PT DEBRIDEMENT SELECT <=20CM 45M 411.005908215 KX-PT DEBRIDEMENT SELECT<=20CM 30M 411.005908223 KX-PT THERAPEUTIC ACTIVITIES-15MIN 270.005908231 KX-PT DEBRIDEMENT SELECT >=20CM 60M 411.005908249 KX-PT CANALITH REPOSITIONING 106.005908298 KX-PT EVALUATION 45 MIN 449.005908306 KX-PT EVALUATION 60 MIN 449.005908322 KX-PT RE-EVALUATION 420.005908330 KX-PY AFL TRAINING-CQ 225.005908348 KX-PT CANALITH REPOSITIONING-CQ 449.005908355 KX-PT ELECT-STIM ATTENDED-CQ 225.005908363 KX-PT ELECT-STIM UNATTENDED-CQ 107.005908371 KX-PT GAIT TRAINING-CQ 225.005908389 KX-PT IONTOPHORESIS-CQ 225.005908397 KX-PT MANUAL THERAPY-CQ 225.005908405 KX-PT THERAPEUTIC ACTIVITIES 15M-CQ 225.005908413 KX-PT THERAPEUTIC EXERCISE-CQ 225.005908421 KX-PT TRACTION MECHANICAL-CQ 107.005908439 KX-PT ULTRASOUND-CQ 107.005909007 GA-PT AQUATIC THERAPY 15 MIN 229.005909015 GA-PT ULTRASOUND 15 MIN 107.005909023 GA-PT TRACTION - MECHANICAL 122.005909031 GA-PT ELECT-STIM UNATTENDED 107.005909056 GA-PT THERAPEUTIC EXERCISE 15 MIN 162.005909064 GA-PT GAIT TRAINING 15 MIN 148.005909080 GA-PT WHIRLPOOL 292.005909098 GA-PT ADL TRAINING 15 MIN 225.005909106 GA-PT IONTOPHORESIS 15 MIN 225.005909114 GA-PT MANUAL THERAPY 15 MIN 228.005909130 GA-PT DEBRIDEMENT NON-SELECTIVE 30M 370.005909148 GA-PT DEBRIDEMENT NON-SELECT 45 MIN 370.005909155 GA-PT DEBRIDEMENT NON-SELECTIVE 60M 370.005909197 GA-PT DEBRIDEMENT SELECT<=20CM 60M 411.005909205 GA-PT DEBRIDEMENT SELECT<=20CM 45M 411.005909213 GA-PT DEBRIDEMENT SELECT<=20CM-30M 411.005909221 GA-PT THERAPEUTIC ACTIVITIES-15M 270.005909239 GA-PT DEBRIDEMENT SELECT>=20CM 411.005909247 GA-PT CANALITH REPOSITIONING 106.005909296 GA-PT EVALUATION 45 MIN 776.005909304 GA-PT EVALUATION 60 MIN 776.00

5909320 GA-PT RE-EVALUATION 420.005909338 GA-PT ADL TRAINING-CQ 225.005909346 GA-PT CANALITH REPOSITIONING-CQ 449.005909353 GA-PT ELECT-STIM ATTENDED-CQ 225.005909361 GA-PT ELECT-STIM UNATTENDED-CQ 107.005909379 GA-PT GAIT TRAINING-CQ 225.005909387 GA-PT IONTOPHORESIS-CQ 225.005909395 GA-PT MANUAL THERAPY-CQ 225.005909403 GA-PT THERAPEUTIC ACTIVITIES 15M-CQ 225.005909411 GA-PT THERAPEUTIC EXERCISE-CQ 225.005909429 GA-PT TRACTION-MECHANICAL-CQ 107.005909437 GA-PT ULTRASOUND-CQ 107.005920004 KX NEUROMUSCULAR RE-ED 15 MIN 93.005920012 KX MASSAGE 15 MIN 53.005920020 KX GROUP THERAPY 519.005920038 KX PROSTHETIC TRAINING 15 MIN 370.005920046 KX ORTHOTICS TRAINING PER 15 MIN 180.005920053 GA GROUP THERAPY 519.005920061 GA MASSAGE 15 MIN 53.005920079 GA NEUROMUSCULAR RE-ED 15 MIN 93.005920087 GA ORTHOTICS TRAINING PER 15 MIN 180.005920095 GA PROSTHETIC TRAINING 15 MIN 76.005993001 CK-PT EVAL MOBILITY:WLK&MVE AROUND 0.015996186 PT EVAL LOW COMPLEXITY 409.005996194 PT EVAL OBS LOW COMPLEXITY 409.005996202 KX PT EVAL LOW COMPLEXITY 409.005996210 PT EVAL MOD COMPLEXITY 449.005996228 PT EVAL OBS MOD COMPLEXITY 449.005996236 KX PT EVAL MOD COMPLEXITY 449.005996244 PT EVAL HIGH COMPLEXITY 489.005996251 PT EVAL OBS HIGH COMPLEXITY 489.005996269 KX PT EVAL HIGH COMPLEXITY 489.005996277 PT REEVAL 225.005996285 PT REEVAL OBS 225.005996293 KX PT REEVAL 225.006100051 GO THERAPEUTIC EXERCISE 15 MIN 195.006100168 GO SPLINT CHECKOUT 15 MIN 93.006101190 GO THERAPEUTIC ACTIVITIES-15MIN 270.006101216 GO SPLINT FITTING/TRAINING-15 MIN 180.006101224 GO ADL/SELF MGMT TRAINING 15 MIN 155.006101364 GO OT EVALUATION 60 MIN 449.006101380 GO OT EVALUATION 45 MIN 449.006101398 GO OT EVALUATION 75 MIN 449.006101505 OT EVALUATION-120 MIN 449.006101513 GO COGNITIVE TRAINING-15 MIN 73.006101547 OT COGNITIVE TRAINING INTL 15 MIN 129.006101554 OT COGNITIVE TRAINING EA ADD 15MIN 125.00

6101968 OT RE-EVALUATION 30 MIN 225.006101984 OT IONTOPHORESIS 15MIN - CO 225.006101992 OT MANUAL THERAPY-15MIN-CO 225.006102008 OT PARAFFIN BATH - CO 107.006102016 OT SPLINT CHECKOUT 15MIN - CO 225.006102024 OT SPLINT FITTING/TRAINING 15MIN-CO 225.006102032 OT THERAPEUTIC ACTIVITIES-15M-CO 225.006102040 OT THERAPEUTIC EXERCISE 15M-CO 225.006102057 OT ULTRASOUND 15 MIN-CO 107.006102065 OT VASOPNEUMATIC DEVICE - CO 107.006102073 OT ELECTRICAL STIM ATTENDED-CO 225.006102081 OT ELECTRICAL STIM UNATTENDED-CO 107.006102099 OT CONTRAST BATH - CO 107.006102107 OT FLUIDOTHERAPY - CO 107.006102115 OT ADL/SLF MGMT TRAINING 15MIN - CO 225.006102123 OT COGNITIVE TRAINING INTL 15MIN-CO 129.006102131 OT COGNITIVE TRN EA ADD 15MIN-CO 125.006105001 KX-OT THERAPEUTIC EXERCISE 15 MIN 225.006105019 KX-OT SPLINT CHECKOUT 15MIN 225.006105027 KX-WHIRLPOOL 107.006105035 KX-OT THERAPEUTIC ACTIVITIES 15MIN 270.006105043 KX-OT SPLINT FITTING/TRAINING 15MIN 225.006105050 KX-OT ADL/SELF MGMT TRAINING 15 MIN 225.006105076 KX-OT VASOPNEUMATIC DEVICE 107.006105084 KX-OT PARAFFIN BATH 107.006105092 KX-OT ELECTRICAL STIM UNATTENDED 107.006105118 KX-OT ULTRASOUND 15 MIN 107.006105126 KX-OT IONTOPHORESIS 15 MIN 225.006105134 KX-OT MANUAL THERAPY 15 MIN 228.006105142 KX-OT CONTRAST BATH 15 MIN 107.006105159 KX-OT EVALUATION 45 MIN 445.006105167 KX-OT EVALUATION 60 MIN 890.006105225 KX-OT RE-EVALUATION 30 MINS 449.006105233 KX-DBRMNT NON-SELECTIVE 30 MIN 370.006105241 KX-DBRMNT SEL EA ADD 20SQCM 30 MIN 411.006105258 KX-OT FLUIDOTHERAPY-CO 107.006105266 KX-OT ADL/SELF MGMT TRAINING 15M-CO 225.006105274 KX-OT COGNITIVE TRAINING 15M-CO 225.006105282 KX-OT CONTRAST BATH-CO 107.006105290 KX-OT ELECTRICAL STIM ATTENDED-CO 225.006105308 KX-OT ELECTRICAL STIM UNATTNDED-CO 107.006105316 KX-OT IONTOPHORESIS 15 MIN-CO 225.006105324 KX-OT MANUAL THERAPY 15 MIN-CO 225.006105332 KX-OT PARAFFIN BATH-CO 107.006105340 KX-OT SPLINT CHECKOUT 15 MIN-CO 225.006105357 KX-OT SPLINT FIT/TRAINING 15M-COM 225.006105365 KX-OT THERAPEUTIC ACTIVITIES 15M-CO 225.00

6105373 KX-OT THERAPEUTIC EXERCISE 15MIN-CO 225.006105381 KX-OT ULTRASOUND 15 MIN-CO 107.006105399 KX-OT VASOPNEUMATIC DEVICE-CO 107.006106009 GY-OT THERAPEUTIC EXERCISE-15 MIN 225.006106017 GY-OT SPLINT CHECKOUT 15 MIN 225.006106025 GY-OT FLUIDOTHERAPY 107.006106033 GY-OT THERAPEUTIC ACTVITIES 15 MIN 270.006106041 GY-OT SPLINT FITTING/TRAINING 15MIN 225.006106058 GY-OT ADL/SELF MGMT TRAINING 15 MIN 225.006106074 GY-OT VASOPNEUMATIC DEVICE 107.006106082 GY-OT PARAFFIN BATH 107.006106090 GY-OT ELECTRICAL STIM UNATTENDED 107.006106124 GY-OT IONTOPHORESIS 15 MIN 225.006106132 GY-OT MANUAL THERAPY 15 MIN 228.006106157 GY-OT EVALUATION 45 MIN 445.006106165 GY-OT EVALUATION 60 MIN 890.006106223 GY-OT RE-EVALUATION 30 MIN 449.006107007 GA-OT THERAPEUTIC EXERCISE 15 MIN 225.006107015 GA-OT SPLINT CHECKOUT 15 MIN 225.006107023 GA-OT WHIRLPOOL 107.006107031 GA-OT THERAPEUTIC ACTIVITY-15 MIN 270.006107049 GA-OT SPLINT FITTING/TRAINING 15MIN 225.006107056 GA-OT ADL/SELF MGMT TRAINING 15 M 225.006107072 GA-OT VASOPNEUMATIC DEVICE 107.006107080 GA-OT PARAFFIN BATH 107.006107098 GA-OT ELECTRICAL STIM UNATTENDED 107.006107114 GA-OT ULTRASOUND 15 MIN 107.006107122 GA-OT IONTOPHORESIS 15 MIN 225.006107130 GA-OT MANUAL THERAPY 15 MIN 228.006107148 GA-OT CONTRAST BATH 15 MIN 107.006107155 GA-OT EVALUATION 45 MIN 445.006107163 GA-OT EVALUATION 60 MIN 890.006107221 GA-OT RE-EVALUATION 449.006107239 GA DBRMNT NON-SELECTIVE 30 MIN 370.006107247 GA DBRMNT NON-SELECTIVE 45 MIN 370.006107254 GA-OT ADL/SELF MGMT TRAINING 15M-CO 225.006107262 GA-OT COGNITIVE TRAINING 15M-CO 225.006107270 GA-OT CONTRAST BATH - CO 107.006107288 GA-OT ELECTRICAL STIM ATTENDED-CO 225.006107296 GA-OT ELECTRICAL STIM UNATTENDED-CO 107.006107304 GA-OT FLUIDTHERAPY-CO 107.006107312 GA-OT IONTOPHORESIS 15 MIN-CO 225.006107320 GA-OT MANUAL THERAPY 15MIN-CO 225.006107338 GA-OT PARAFFIN BATH - CO 107.006107346 GA-OT SPLINT CHECKOUT 15MIN-CO 225.006107353 GA-OT SPLINT FITTING/TRN 15M-CO 225.006107361 GA-OT THEREAPEUTIC ACTIVITY 15M-C 225.00

6107379 GA-OT THERAPEUTIC EXERCISE 15M-CO 225.006107387 GA-OT ULTRASOUND 15 MIN-CO 107.006107395 GA-OT VASOPNEUMATIC DEVICE-CO 107.006120000 KX-EXTREMITY TESTING (BTE)15MIN 445.006120018 KX-GROUP THERAPY (2 OR MORE) 58.006120026 KX MASSAGE 15 MIN 53.006120034 KX NEUROMUSC RE-ED 15 MIN 93.006120042 KX PROSTHETIC TRAINING 15 MIN 120.006120059 GA EXTREMITY TESTING (BTE) 15 MIN 445.006120067 GA GROUP THERAPY (2 OR MORE) 58.006120075 GA MASSAGE 15 MIN 53.006120083 GA NEUROMUSC RE-ED 15 MIN 93.006170005 GO ULTRASOUND 15 MIN 120.006170013 GY DBRMNT NON-SELECTIVE 30 MIN 370.006170021 GY DBRMNT NON-SELECTIVE 45 MIN 370.006170039 GY DBRMNT NON-SELECTIVE 60 MIN 370.006170047 GY DBRMNT SEL EA ADD 20SQCM 30 411.006170054 GY DBRMNT SEL EA ADD 20SQCM 45 411.006170070 GO EXTREMITY TESTING(BTE) 15MN 445.006170096 GO ORTHOTICS TRAINING 15 MIN 180.006170104 GO THERAPEUTIC EXER 15 MIN 195.006170112 MCAL OT TREATMENT INITIAL 30 MIN 141.006170120 GA PROSTHETIC TRAINING 15 MIN 120.006170138 GO MASSAGE 15 MIN 53.006170146 PHYS MED TX-JOINT MOBILIZATION 217.006170153 MCAL OT TREATMENT ADD 15 MIN 129.006170161 GO SELF CARE/HOME MGMT ADL 15M 155.006170179 GO PARAFFIN BATH 81.006170187 MCAL OT EVAL INITIAL 30 MIN 456.006170195 GO THERPAEUTIC ACTIVITES 15MIN 270.006170203 GO MANUAL THERAPY PER 15 MIN 324.006170211 GO NEUROMUSCULAR RE-ED 15 MIN 112.006170237 CHECK OUT OPRTHO/PROSTH 15 MIN 93.006170245 ELECT CURR (IONOTOPHOR) 15 MIN 212.006170260 M/CAL OT THRPY EVAL EA ADD 15 MIN 228.006170278 PHYS MED MODALITY ELEC-STIM UNATND 129.006170286 PHYS MED TX-MASSAGE 30 MIN 53.006170294 PHYS MED TX-NEUROMUSC RE-ED 30MIN 93.006170302 GO OT CONTRAST BATH 15 MIN 58.006170310 GO DBRDMNT NON-SELECTIVE 30 MIN 370.006170328 GO DBRDMNT SEL 1ST 20SQCM 30 MIN 411.006170336 GO DBRMNT SEL EA ADD 20SQCM 30 MIN 411.006170344 GO DBRMNT SEL EA ADD 20SQCM 45 MIN 411.006170351 GO DBRMNT SEL EA ADD 20SQCM 60 MIN 411.006170369 GO ELECT STIM UNATTENDED 129.006170377 GO GROUP THERAPY ( 2 OR MORE) 519.006170385 GO OCCUPATIONAL THRPY RE-EVAL 273.00

6170401 GO PROSTHETIC TRAINING 15 MIN 76.006170419 GO VASOPNEUMATIC DEVICE 70.006170427 GO WHIRLPOOL 292.006196182 OT EVAL LOW COMPLEXITY 409.006196190 OT EVAL OBS LOW COMPLEXITY 409.006196208 KX OT EVAL LOW COMPLEXITY 409.006196216 OT EVAL MOD COMPLEXITY 449.006196224 OT EVAL OBS MOD COMPLEXITY 449.006196232 KX OT EVAL MOD COMPLEXITY 449.006196240 OT EVAL HIGH COMPLEXITY 489.006196257 OT EVAL OBS HIGH COMPLEXITY 489.006196265 KX OT EVAL HIGH COMPLEXITY 489.006196273 OT REEVAL 225.006196281 OT REEVAL OBS 225.006196299 KX OT REEVAL 225.006300016 ED DEPT LEVEL 1 99281 525.006300024 ED DEPT LEVEL 2 99282 1,084.006300032 ED DEPT LEVEL 4 99284 3,493.006300073 ED DEPT LEVEL 5 99285 4,685.006300156 ED DEPT LEVEL 1 99281 525.006300172 SUTURE GENERAL/EA 59.006300198 ED DEPT LEVEL 3 99283 2,169.006300347 EMERGNCY DEPT MEDICAL TRIAGE A 321.006301162 LEVEL 1 PROCEDURE-ER 424.006301170 LEVEL 2 PROCEDURE-ER 855.006301188 LEVEL 3 PROCEDURE-ER 1,774.006301196 LEVEL 4 PROCEDURE-ER 7,379.006301204 ED MINOR W/PROCEDURE-TEST-25 321.006301212 ED REGULAR W/PROCEDURE TEST-25 1,084.006301220 ED INTERMEDIATE W/PROCEDURE-25 2,169.006301238 ED ADVANCED CARE W/PROCEDURE 4,685.006301246 ED MAJOR W/PROCEDURE-TEST-25 3,493.006301253 ED CRITICAL CARE W/PROCEDURE-25 7,064.006301402 PHH-D ED BLOOD ADMIN (PER DAY) 1,829.006301410 PHH-D ED CARDIOVRSN ELECTRIC EXT 3,447.006301428 PHH-D ED RYTHM ECG TRACING 242.006301436 PHH-D STOCKINET BIAS X 4 114.006301444 PHH-D STOCKINET BIAS X 5 114.006301451 PHH-D STOCKINETTE TUBE 47.006301469 PHH-D STOCKINET BIAS X2 52.006301477 PHH-D STOCKINETTE TUB X 2 47.006301485 PHH-D STOCKINETTE TUB X3 70.006301493 PHH-D STOCKINETTE TUB X 4 70.006301501 PHH-D STOCKINET BIAS X 3 52.006301519 ER VISIT LEVEL III SAME DAY-9928327 2,169.006301527 ER VISIT LEVEL IV SAME DAY-9928427 3,493.006301543 UA DIPSTICK OR TABLET REAGENT 99.00

6301550 ED DEBRIDEMENT <=20CM 411.006302053 ED MAJOR W/PROC >12 HRS 3,493.006302061 ED ADVANCED W/PROC >12 HRS 7,048.006302079 ED CRITICAL CARE-25 >12 HRS 11,431.006302517 URINALYSIS W/O MICROSCOPY 30.006303002 ED DEPT LEVEL 1 99281 525.006303010 ED DEPT LEVEL 2 99282 1,084.006303028 FT ED REG W/PROC TEST-25 1,084.006303036 FT EMERG DEPT INTERMEDIATE 2,169.006303044 FT ED INTERMED W/PROC-25 2,169.006303051 ED DEPT LEVEL 4 99284 3,493.006303069 FT ED MAJ W/PROC TEST-25 3,493.006309140 EMERGENCY DEPT CRITICAL CARE 7,064.006309223 ED LAC REPAIR 2.6-7.5CM-12002 1,233.006309231 ED IMMUNIZATION ADMIN-90471 93.006309264 ED LAC REPAIR FACE-<2.5 12011 1,233.006309272 ED LAC REPAIR <2.5-12001 1,233.006309280 ED APPLY ST F/ARM SPLINT 29125 594.006309298 ED CASTING/STRAPPING UNLIS29799 496.006309306 ED APPLY DYN F/ARM SPLINT-29126 496.006309314 ED APPLY SHORT LEG SPLINT 29515 1,190.006309322 ED LAC REP-LYR-FACE 2.6-5 12052 1,233.006309330 ED LAC REPAIR FACE 2.6-5 12013 1,233.006309348 ED LAC REP-LYR-<2.5-FACE-12051 1,233.006309355 ED APPLY FINGER SPLINT-DYN29131 491.006309363 ED APPLY LONG ARM SPLINT 29105 594.006309371 ED REMOVE NAIL PLATE-11730 1,233.006309389 ED SHOULDER TX CLSD-W/ANES23655 5,940.006309397 ED NOSEBLEED CONTROL-30901 615.006309405 ED SPINAL TAP-62270 1,233.006309413 ED BURN TX NO ANEST SMALL-16020 1,190.006309421 ED DRAIN ABCESS SPL-10060 1,233.006309439 ED DRAIN ABCESS-COMP-MULTI-10061 1,233.006309447 ED APPLY FINGER SPLINT-STA29130 594.006309454 ED INSERT CATHETER-51702 424.006309488 ED LAC REP-DERMABOND-TRK ACMETC 906.006309496 ED LAC REP-DERMABOND-FACE 906.006309520 THUMB SPICA SPLINT 594.006309991 ED IV INFUSN 16-60M 96365 759.006310007 ED IV INFUSION EA ADDL HR 212.006310015 ED IV INF SEQUENTIAL 16-60M 96367 137.006310023 ED INFUSION CONCURRENT 96368 137.006310031 ED IV INF HYDRATION ADD HR 96361 218.006310049 ED INJECTION IV PUSH 96374 479.006310056 ED INJ ADDL PUSH NEW DRUG 96375 545.006310064 ED IV INF HYDRATION 31-60M 96360 759.006310072 ED INJECTION NOT IV PUSH 96372 306.00

6310080 ED INSERT BLADDER CATHETER-51701 357.006310098 ED IV INFUSN 16-60M 9636559 1,510.006310106 ED IV INFUS EA ADDL 59 137.006310114 ED IV INF SEQ 16-60M 96367-59 137.006310122 ED INFUSION CONCURRENT 96368-59 137.006310148 ED IV INF HYDRATION 31-60 96360-59 1,510.006310155 ED IV INF HYDRATION ADD HR 96361-59 137.006310163 ED INJ NOT IV PUSH 96372-59 531.006310171 ED INJECTION IV PUSH 96374-59 980.006310189 ED INJ ADDL PUSH NEW DRUG 96375-59 1,018.006310197 ED IMMUN ADMIN EA ADDL VAC-90472 93.006310205 ED CARDIOPUL RESUSICITATION-92950 1,751.006310221 ED VENIPUNCTURE 14.006310239 ED CRITICAL CARE 1ST HOUR-25 7,064.006310247 ED CRITICAL CARE EA ADD'L 30 MIN 1,744.006310254 ED INSERT PICC CAT 6,032.006310262 ED LAC REP-INT < 2.5 - 12041 706.006310270 ED LAC REP - 2.6-7.5 - 12042 706.006310288 ED CATHETER INSERT 51702-59 424.006310296 ED APPLY LONG LEG SPLINT -29505 682.006310304 ED LAC REP - INT <2.5 - 12031 694.006310312 ED LAC REP-INT 2.6-7.5 12032 706.006310320 ED ET INSERTION 31500 1,275.006310338 ED CENTRAL LINE INSERTION 36556 3,465.006310387 BAMLANIVIMAB INFUSION & MONITORING 1,084.006310395 CASIRIVIMAB & IMDEVIMAB INFS & MNTR 1,084.006331185 OBS INITIAL MOD SEVERITY 300.006331623 HEPATITIS B VACCINE-WC 393.006331631 DIPTHERIA/TETANUS VACCINE-WC 132.006332514 WRIST SPLINT 502.006390819 ED SUB INF TXPROP IN 16-90M96369-59 1,018.006390827 ED SUB INF TXPROP EA ADD HR-9637059 225.006390843 ED SUB INF TXPPROP ADD PUMP 9637159 455.006390850 ED TX PROPH/DX INJ EA ADDL 96376-59 162.006390900 ED SUBC INFSN TX/PROP INTL 16-60M 241.006390918 ED SUBC INFSN TX/PROP EA ADDL HR 225.006390926 ED SUBC INFSN TX/PROP ADDL PUMP 455.006390942 ED TX PROPH OR DX INJ EA ADD SEQ 262.006500508 INITIAL INFANT IP HEARING SCREEN 350.006500516 INFANT HEARING OP RESCREENING 977.006500524 INITIAL INFANT OP HEARING SCREENING 977.006500532 INFANT HEARING RESCREENING-OP 977.006500565 CIRCUMCISION 306.006500573 INTUB TRAY INFANT 524.006500581 PORTAWARMER 143.006500599 PAMPSWADDLER 89.006500607 VISUAL ASSESSMENT 320.00

6500615 LINE PLCEMENT/UMBILICAL VENOUS 306.006500623 LINE PLACEMENT/UMBIL ARTERY 306.006500631 NEOBAR 46.006500649 HUMAN MILK FORT 73.006500656 BILICOMBI JACK 85.006500664 GEL PILLOW 57.006500672 NIP SHIELD 25.006500680 BREAST MILK BOTTLES 9.006500698 PNEUMOGRAM 805.006601470 LD ULTRASOUND 825.006601561 BIOPHYSICAL PROFILE W/NS TEST 1,000.006601579 ULTRASOUND LIMITED OB 825.006601611 OB OBS IV PUSH ADDL SAME DRUG 262.006601637 OB OBS THERAPEUTIC INF INITIAL 759.006601645 OB OBS THERAPEUTIC INF ADDL HR 212.006601710 LDRP OR FIRST HOUR 5,322.006601728 L&D MAJOR SURGERY 1 HR 15 MIN 6,672.006601744 LD DELIVERY OF PLACENTA ONLY 1,283.006601777 LDRP OR EACH ADD'L 15 MIN 1,330.006904007 ENTEROSTOMAL THERAPY 350.006906002 MONITORED EA ADD'L-OBS UNIT 300.006906010 MONITORED HOUR ONE-OBS UNIT 300.006906028 NONMONITORED EA ADD'L-OBS UNIT 300.006906036 NONMONITORED HR ONE-OBS UNIT 300.006907001 OBSERVATION PER HOUR-ED 300.006907002 OBSERVATION PER HOUR-OBS 300.006907015 ED BED OCCUPANCY 1,291.006966477 VERAJET HAND PIECE-ALL 1,735.006966485 SIGNAFUSE 6,000.007000235 peritoneal dialysis solution with 1 212.607000243 peritoneal dialysis solution with 1 265.757000250 peritoneal dialysis solution with 1 1,165.507000268 peritoneal dialysis solution with 2 212.607000276 peritoneal dialysis solution with 2 212.607000284 peritoneal dialysis solution with 2 1,165.507000292 peritoneal dialysis solution with 4 212.607000300 peritoneal dialysis solution with 4 277.507000318 Dialysate - BiBag Bicarbonate Powde 206.307000326 Dialysate - Calcium Chloride 0.5 mE 7.257000334 Dialysate - CENTRISOL Bicarbonate 74.957000342 Dialysate - Naturalyte - 1.0 K 0 Ca 148.757000359 Dialysate - Naturalyte - 1.0 K 2.5 148.757000367 Dialysate - Naturalyte - 2.0 K 2.5 148.757000375 Dialysate - Naturalyte - 3.0 K 2.5 148.757000383 Dialysate - Potassium Chloride 0.5 6.307300064 SPEECH/LANG IND.TX 15 MIN 225.007300155 SPEECH TX COGNITIVE TX 15 MIN 225.00

7300163 SPEECH LANG SWALLOW TREATMNT 15 MIN 225.007300171 SPEECH LANG SWALLOW EVAL 449.007300197 ST VIDEOFLUOROSCOPIC SWALLOW 60 MIN 596.007300254 SPEECH/LANG IND TX 30MIN 499.007300262 SPEECH/LANG IND TX 45MIN 449.007300270 SPEECH/LANG IND TX 60MIN 449.007300288 ST DYSPHAGIA EVAL 45 MIN 449.007300296 ST DYSPHAGIA EVAL 60 MIN 449.007300304 SPEECH/LANG SWALLOW TREAT 30MIN 420.007300312 SPEECH/LANG SWALLOW TREAT 45MIN 449.007300320 SPEECH/LANG SWALLOW TREAT 60MIN 449.007300338 ST VIDEO FLUOROSCOPIC SWALLOW 75MIN 449.007300346 ST VIDEOFLUOROSCOPIC SWALLOW 90MIN 449.007300387 M/CAL SPEECH EVALUATION 449.007300395 M/CAL SPEECH/LANG THERAPY 60MIN 449.007300403 ST DYSPHAGIA EVAL 75 MIN 449.007300411 ST DYSPHAGIA EVAL 90 MIN 449.007300429 M/CAL SPEECH/LANG THERAPY 30 MIN 449.007300437 SPCH FLUENCY EVAL 75 MIN 450.007300445 SPCH FLUENCY EVAL 90 MIN 450.007300460 SPCH SOUND PROD EVAL 75 MIN 450.007300478 SPCH SOUND PROD EVAL 90 MIN 450.007301005 LANG COMP/EXP EVAL 75 MIN 450.007301013 LANG COMP/EXP EVAL 90 MIN 450.007301047 VOICE/RESNNC ANALYS EVAL 90 MIN 450.007301062 SPCH FLUENCY EVAL 30 MIN 450.007301070 SPCH FLUENCY EVAL 45 MIN 450.007301088 SPCH FLUENCY EVAL 60 MIN 450.007301104 SPCH SOUND PROD EVAL 45 MIN 450.007301112 SPCH SOUND PROD EVAL 60 MIN 450.007301120 LANG COMP/EXP EVAL 30 MIN 450.007301138 LANG COMP/EXP EVAL 45 MIN 450.007301146 LANG COMP/EXP EVAL 60 MIN 450.007301161 VOICE/RESONANCE ANALYS EVAL 45 MIN 450.007301179 VOICE/RESONANCE ANALYS EVAL 60 MIN 450.007301195 GN ASSESSMENT OF APHASIA 60 MIN 560.007301203 GN DEV TESTING EXTENDED 60MIN 740.007301211 GN SP GENERATING DEV ADD 30MIN 286.007301229 GN SP GENERATING DEV EVAL 60 M 1,272.007301237 GN STND COGNTVE PERF TEST 60MIN 475.007301245 GN THER EX NON SPCH GEN DEVICE 462.007301252 GN THER EX SP GENERATE DEVICE 657.007301260 GN VOICE PROSTHESIS EVAL/FITING 493.007301278 M/CAL LANGUAGE EVALUATION 493.007301286 M/CAL SPEECH LANG GRP EA PT 45MIN 173.007301294 SPEECH TX COGNITIVE TR INTL 15 MIN 129.007301302 SPEECH TX COGNITV TX EA ADD 15 MIN 125.00

7302003 KX-SPEECH/LANG IND TX 15 MIN 225.007302011 KX-SPEECH TX COGNITIVE TX 15 MIN 225.007302029 KX-SPEECH LANG SWALLOW TRTMNT 15MIN 225.007302037 KX-SPEECH/LANG IND TX 30 MIN 449.007302045 KX-SPEECH/LANG IND TX 45 MIN 449.007302052 KX-SPEECH/LANG IND TX 60 MIN 449.007302060 KX-SPEECH/LANG SWALLOW TREAT 30 MIN 449.007302078 KX-SPEECH/LANG SWALLOW TREAT 45 MIN 449.007302086 KX-SPEECH/LANG SWALLOW TREAT 60 MIN 449.007302094 KX-ST DYSPHAGIA EVAL 60 MIN 449.007302102 KX-ST DYSPHAGIA EVAL 75 MIN 449.007302110 KX-ST DYSPHAGIA EVAL 90MIN 449.007302128 KX-ST DYSPHAGIA EVAL 30 MIN 449.007302185 KX-ST VIDEO FLUOROSCPC SWLLW 75 MIN 449.007302193 KX-ST VIDEO FLUORSCPC SWLLW 60 MIN 449.007302201 KX-ST VIDEO FLOURSCPC SWLLW 90 MIN 449.007302219 KX-ST DYSPHAGIA EVAL 45 MIN 449.007302227 KX-ST SPCH FLUENCY EVAL 75 MIN 450.007302235 KX-ST SPCH FLUENCY EVAL 90 MIN 450.007302243 KX-ST SPCH FLUENCY EVAL 120 MIN 450.007302250 KX-ST SPCH SOUND PROD EVAL 75 MIN 450.007302268 KX-ST SPCH SOUND PROD EVAL 90 MIN 450.007302276 KX-ST SPCH SOUND PROD EVAL 120 MIN 450.007302284 KX-ST LANG COMP/EXP EVAL 75 MIN 450.007302292 KX-ST LANG COMP/EXP EVAL 90 MIN 450.007302300 KX-ST LANG COMP/EXP EVAL 120 MIN 450.007302318 KX-ST VCE/RSNC ANLYS EVAL 75 MIN 450.007302326 KX-ST VCE/RSNC ANLYS EVAL 90 MIN 450.007302334 KX-ST VCE/RSNC ANLYS EVAL 120 MIN 450.007302342 KX ASSESSMENT OF APHASIA 60 MIN 560.007302359 KX DEV TESTING EXTENDED 60MIN 740.007302367 KX GROUP SPEECH THERAPY 173.007302375 KX SP GENERATING DEV ADD 30 MIN 286.007302383 KX SP GENERATING DEV EVAL 60 MIN 1,272.007302391 KX STND COGNTV PERF TEST 60 MIN 475.007302409 KX THER EX SP GENERATING DEVICE 657.007302417 KX VOICE PROSTHESIS EVAL/FITING 493.007302425 KX-SPEECH TX COGNITIVE TR INTL 15MN 129.007302433 KX-SPEECH TX COGNITV TR EA ADD 15M 125.007303001 GY-SPEECH/LANG IN TX 15 MIN 225.007303019 GY-SPEECH TX COGNITIVE TX 15 MIN 225.007303027 GY-SPEECH LANG SWALLOW TRTMNT 15 MI 225.007303035 GY-SPEECH/LANG IND TX 30 MIN 449.007303043 GY-SPEECH/LANG IND TX 45 MIN 449.007303050 GY-SPEECH/LANG IND TX 60 MIN 449.007303068 GY-SPEECH/LANG SWALLOW TREAT 30 MIN 449.007303076 GY-SPEECH/LANG SWALLOW TREAT 45 MIN 449.00

7303084 GY-SPEECH/LANG SWALLOW TREAT 60 MIN 449.007303092 GY-ST DYSPHAGIA EVAL 45 MIN 449.007303100 GY-ST DYSPHAGIA EVAL 60 MIN 449.007303118 GY-ST DYSPHAGIA EVAL 75 MIN 449.007303126 GY-ST DYSPHAGIA EVAL 90 MIN 449.007303134 GY-ST DYSPHAGIA EVAL 30 MIN 449.007303191 GY-ST VIDEO FLUOROSCPC SWALLOW 75 M 449.007303209 GY-ST VIDEO FLUOROSCPC SWALLOW 60 M 449.007303217 GY-ST VIDEO FLUOROSCPC SWALLOW 90 M 449.007303225 GY-ST SPCH FLUENCY EVAL 75 MIN 450.007303233 GY-ST SPCH FLUENCY EVAL 90 MIN 450.007303241 GY-ST SPCH FLUENCY EVAL 120 MIN 450.007303258 GY-ST SPCH SOUND PROD EVAL 75 MIN 450.007303266 GY-ST SPCH SOUND PROD EVAL 90 MIN 450.007303274 GY-ST SPCH SOUND PROD EVAL 120 MIN 450.007303282 GY-ST LANG COMP/EXP EVAL 75 MIN 450.007303290 GY-ST LANG COMP/EXP EVAL 90 MIN 450.007303308 GY-ST LANG COMP/EXP EVAL 120 MIN 450.007303316 GY-ST VCE/RSNC ANLYS EVAL 75 MIN 450.007303324 GY-ST VCE/RSNC ANLYS EVAL 90 MIN 450.007303332 GY-ST VCE/RSNC ANLYS EVAL 120 MIN 450.007304009 GA-SPEECH/LANG IND.TX 15 MIN 225.007304017 GA-SPEECH TX COGNITIVE TX 15 MIN 225.007304025 GA-SPEECH LANG SWALLOW TREATMNT 15M 225.007304033 GA-SPEECH/LANG IND TX 30MIN 449.007304041 GA-SPEECH/LANG IND TX 45 MIN 449.007304058 GA-SPEECH/LANG IND TX 60MIN 449.007304066 GA-SPEECH/LANG SWALLOW TREAT 30 MIN 449.007304074 GA-SPEECH/LANG SWALLOW TREAT 45MIN 449.007304082 GA-SPEECH/LANG SWALLOW TREAT 60MIN 449.007304090 GA-ST DYSPHAGIA EVAL 45 MIN 449.007304108 GA-ST DYSPHAGIA EVAL 60 MIN 449.007304116 GA-ST DYSPHAGIA EVAL 75 MIN 449.007304124 GA-ST DYSPHAGIA EVAL 90 MIN 449.007304132 GA-ST DYSPHAGIA EVAL 30 MIN 449.007304215 GA-MOTION FLOUROSCPY/SWALLOW 449.007304249 GA-EVAL SPEECH FLUENCY 450.007304272 GA-EVAL SPEECH SOUND PRODUCTION 450.007304306 GA-EVAL SP LANG COMP/EXPRESSION 450.007304330 GA-ST VCE/RSNC ANLYS EVAL 120 MIN 450.007304348 GA ASSESSMENT OF APHASIA 60 MIN 560.007304355 GA DEV TESTING EXTENDED 60MIN 740.007304363 GA GROUP SPEECH THERAPY 173.007304371 GA SP GENERATING DEV ADD 30 MIN 286.007304389 GA SP GENERATING DEV EVAL 60 MIN 1,272.007304397 GA STND COGNTVE PERF TEST 60 MIN 475.007304405 GA SWALLOWING THERAPY 350.00

7304413 GA THER EX SP GENERATING DEVICE 657.007304421 GA VOICE PROSTHESIS EVAL/FITING 493.007900640 APHERESIS,THERAPEUTIC,PLASMA 7,820.008300121 OUTPATIENT OBS HR ONE - 2W 300.008300170 OUTPATIENT OBS HR ONE 300.008300212 OUTPATIENT OBS EA ADD'L HR-LD 300.008300279 OUTPATIENT OBS EA ADD'L HR-2W 300.008300428 DIRECT ADMIT OBS-2W 4,399.008300451 DIRECT ADMIT OBS 6,903.008300477 DIRECT ADMIT OBS 4,399.008300521 DIRECT ADMIT OBS-2W(25) 4,399.008300522 DIRECT ADMIT OBS(25) 4,399.008300642 IV PUSH SINGLE OR INIT DRUG - 2S 479.008300683 IRRIGATE IMPL VASC ACCESS DV - 2S 396.008300691 CHEMO ADMIN INTRATHECAL - 2S 1,858.008300717 IV INFUS HYDRATE INIT HR - 2S 759.008300808 OBS INSERT PICC CAT 6,032.008300816 OBS SUB INFSN/TX/PRP INTL 16-60M 241.008300824 OBS SUBC INFS TX/PROP 16-60M 1,018.008300832 OBS SUBC INFSN TX/PROP EA ADD HR 225.008300840 OBS SUBC INFS TX/PROP ADDL PUMP 455.008300873 OBSERVATION PROCEDURE 839.008300881 OBS SUBC INFSN TX/PROP EA ADD HR 225.008300899 OBS SUBC INFSN/TX/PROP ADDL PUMP 455.008300907 OBSERVATION DEBRIDEMENT 2,594.008300931 ADMIN INFLUENZA VIRUS VAC 93.008301038 IMMUNIZATION ADMIN 93.008301046 ADMINISTRATION HEPATITIS B VAC 93.008301053 ADMIN PNEUMOCCAL VACCINE 93.008301061 ADMIN INFLUENZA VIRUS VACCINE 93.008301103 OP IV INFUSION 16-60M 96365 759.008301111 OP IV INFUSION 16-60M 96365-59 1,510.008301129 OP IV INFUSION EA ADD'L HR 212.008301137 OP IV INFUSION EA ADDL MOD 59 137.008301145 OP INF SEQUENTIAL 16-60M 96367 137.008301152 OP IV INF SEQ 16-60M 96367-59 137.008301160 OP INFUSION CONCURRENT 96368 137.008301178 OP INFUSION CONCURRENT 96368-59 137.008301186 OP IV INF HYDRATION ADD HR 96361 218.008301194 OP IV HYDRATION ADD HR 96361-59 137.008301202 OP INJECTION IV PUSH 96374 479.008301210 OP INJECTION IV PUSH 96374-59 980.008301228 OP INJ ADDL PUSH NEW DRUG 96375 545.008301236 OP INJ ADDL PUSH NEW DRUG 96375-59 1,018.008301244 OP IV INF HYDRATION 31-60M 96360 759.008301251 OP IV INF HYDRATION 31-60M 96360-59 1,510.008301269 OP INJECTION NOT IV PUSH 96372 306.00

8301277 OP INJ NOT IV PUSH 96372-59 531.008301285 OP IMMUN ADMIN FIRST VAC 90471 93.008301293 OP IMMUN ADMIN EACH ADDL VAC 90472 93.008301301 OP ADMIN INFLUENZA VACCINE 93.008301319 OP ADMIN PNEUMOCCAL VACCINE 93.008301327 OP ADMIN HEPATITIS B VACCINE 93.008301350 OP IV PUSH ADDL SAME DRUG 96376 262.008301368 OP IV PUSH ADDL SAME DRUG 96376-59 162.008301376 ADMIN PNEUMOCCAL VACCINE-CCC 93.008301384 ADMIN INFLUENZA VIRUS VACCINE-CCC 93.008301392 IMMUNIZATION ADMIN-CCC 93.008301400 ADMIN HEPATITIS B VACCINE-CCC 93.008301491 ADMIN PNEUMOCCAL VACCINE - P2 93.008301509 ADMIN INFLUENZA VIRUS VACCINE-P2 93.008301517 IMMUNIZATION ADMIN-P2 93.008301525 ADMIN HEPATITIS B VACCINE-P2 93.008301582 ADMIN PNEUMOCCAL VACCINE-NSY 93.008301590 ADMIN INFLUENZA VIRUS VACCINE-NSY 93.008301608 IMMUNIZATION ADMIN-NSY 93.008301616 ADMIN HEPATITIS B VACCINE-NSY 93.008301632 IMMUNIZATION EA ADD'L-90472-CCC 96.008301665 IMMUNIZATION EA ADD'L-90472-P2 93.008301707 I&O STRAIGHT CATH FOR RETAINED URIN 357.008301715 I&O STRGHT CATH RTND URINE MOD 59 357.008301723 FOLEY INSERTION SIMPLE 424.008301731 FOLEY INSERTION SIMPLE MOD 59 424.008301764 OP DECLOTTING BY THROMBOLYTIC AGENT 1,050.008301772 IV INFUSION THERAPY 1ST HR 759.008301773 OPSC IV INFUSION THERAPY 1ST HR 759.008301780 IV INFUSION EACH ADD'L HOUR 212.008301781 OPSC IV INFUSION EACH ADD'L HR 212.008301798 BLOOD ADMINISTRATION (PER DAY) 1,829.008301799 OPSC BLOOD ADMINISTRATION(PER DAY) 1,829.008301806 SURGERY MINI 1,500.008301822 PROCEDURE-SIMPLE 424.008301830 PROCEDURE-COMPLEX 1,774.008301848 RHYTHM ECG TRACING 242.008301855 RN ULTRASOUND GUIDE IV ACCESS 1,394.008301863 ACCUCHECK 19.008301871 DIRECT ADMIT OBS - 2E 6,903.008301889 OUTPATIENT OBS EA ADDL HR 2E MOD25 300.008301897 OUTPATIENT OBS HR ONE - 3N 300.008301905 DIRECT ADMIT OBS - 3N 6,903.008301913 OUTPATIENT OBS EA ADDL HR 3N MOD25 300.008301921 OUTPATIENT OBS HR ONE - 3S 300.008301939 DIRECT ADMIT OBS - 3S 6,903.008301947 OUTPATIENT OBS EA ADDL HR 3S MOD25 300.00

8301954 OUTPATIENT OBS HR ONE - 4N 300.008301962 DIRECT ADMIT OBS = 4N 6,903.008301970 OUTPATIENT OBS EA ADDL HR 4N MOD25 300.008301988 OUTPATIENT OBS HR ONE - 4S 300.008301996 DIRECT ADMIT OBS - 4S 6,903.008302002 OUTPATIENT OBS EA ADDL HR 4S MOD25 300.008302010 OUTPATIENT OBS HR ONE - LD 300.008302028 DIRECT ADMIT OBS - LD 4,399.008302036 OUTPATIENT OBS EA ADDL HR LD MOD25 300.008302044 OUTPATIENT OBS HR ONE - MB 300.008302051 DIRECT ADMIT OBS - MB 4,399.008302069 OUTPATIENT OBS EA ADDL HR MB MOD25 300.008302077 OUTPATIENT OBS HR ONE - OBS 300.008302085 DIRECT ADMIT OBS-DEF OBS 6,903.008302093 OUTPATIENT OBS EA ADDL HR MOD25 300.008302101 OUTPATIENT OBS HR ONE - 2N 300.008302119 DIRECT ADMIT OBS - 2N 6,903.008302127 UNCODEABLE OUTPATIENT OBS HR ONE 1,541.008302135 UNCODEABLE OUTPT OBS EA ADD'L HR 169.008302143 UNCODEABLE OUTPATIENT OBS HR ONE-P2 1,541.008302150 UNCODEABLE OUTPT OBS EA ADD'L HR-P2 169.008302168 OUTPATIENT OBS EA ADDL HR 2N MOD25 300.008302176 OUTPATIENT OBS HR ONE - 2S 300.008302184 DIRECT ADMIT OBS 2S 6,903.008302192 OUTPATIENT OBS EA ADDL HR 2S MOD25 300.008302200 OUTPATIENT OBS HR ONE - 2E 300.008303018 THERAPEUTIC PHLEBOTOMY 439.008304008 PHH-D OUTPT OBS HR ONE - DOU 300.008305575 OBS SUB INFSN/TXPROP INTL 16-60M-2S 241.008305583 OBS SUBC INFSN/TXPROP INL 16-60M-2S 1,018.008305591 OBS SUB INFSN/TXPROP EA ADD'L HR-2S 225.008305609 OBS SUBC INFSN TX/PROP ADDL PUMP-2S 455.008306003 ADMIN SARSCOV2 30MCG/0.3ML 1ST 60.008306011 ADMIN SARSCOV2 30MCG/0.3ML 2ND 99.008306029 ADM SARSCOV2 100MCG/0.5ML 1ST 60.008306037 ADM SARSCOV2 100MCG/0.5ML 2ND 99.008306045 ADMIN SARSCOV2 AD26 0.5ML SNGL DOSE 141.008306052 ADMIN SARSCOV2 30MCG/0.3ML 3RD 99.008306060 ADM SARSCOV2 100MCG/0.5ML 3RD 142.008306078 ADMIN SARSCOV2 30MCG/0.3ML BOOSTER 99.008350480 OBS SUBC INFSN TX/PROP EA ADD HR-2S 225.008350498 OBS SUBC INFSN TX/PROP ADD PUMP-2S 455.008350514 IMMUNIZATION EA ADD'L - 90472 - 2S 93.008350522 ADMIN PNEUMOCCAL VACCNE-OBS 93.008350530 ADMIN INFLUENZA VIRUS VACCINE-OBS 93.008350548 IMMUNIZATION ADMIN - OBS 93.008350555 ADMIN HEPATITIS B VACCINE-OBS 93.00

8350563 OP BLOOD TRANSFUSION - 36430 1,829.008350571 OP BLOOD TRANSFUSION - 3643059 1,829.008450942 REHAB SPEECH COGNTV TR INTL 15 MIN 129.008450959 REHAB SPEECH COGNTV TR EA ADD15 MIN 125.008604134 VIDEOFLUOROSCOPIC SWALLOW 90 MIN 449.009613183 NC - INTER PERCUSS VENT INITIAL 524.009613191 NC - RESP INTER PERCUSS VENT SUSQ 326.009618042 NC - SP E&M LEVEL5 91 MIN & OVER 174.009630062 NC-DEVICE RECALL CHARGE SURGERY 0.01