Item - Gifford Health Care
201
Item # Description CPT Price 500100 ANESTHESIA $150.00 501630 ANESTH SURGERY OF SHOULDER 1630 $0.00 503003 ANTEPARTUM CARE ONLY 4‐6 VIS 59425 $1,760.00 503004 ANTEPARTUM CARE ONLY 7 OR MO 59426 $3,535.00 503005 PREBIRTH VISIT NO CHG 90021 90021 $0.00 503006 OCCUPATIONAL PHYSICAL EXAM DOT CRASH CDL 99499 $100.00 503007 HEP A VACCINE ADULT IM 90632 $342.00 503008 CL‐ STATE HEPATITIS A VAC PEDI ADOL 90633 $0.01 503009 CL‐ STATE HIB 90648 $0.01 503010 TYPHOID VACCINE VI CAPSULAR 90691 $124.00 503011 CL‐ MMR LIVE 90707 $188.00 503012 CL‐ STATE DTaP DAPTACEL INFANRIX 90700 $0.01 503013 CL‐ DT ABSORBED FOR USE IN INDIVID LT 7Y 90702 $0.00 503014 CL‐ STATE MMR LIVE 90707 $0.01 503015 CL‐ POLIOVIRUS VACCINE INACTIVATED 90713 $117.00 503016 CL‐ VARICELLA VIRUS VACCINE LIVE 90716 $349.00 503018 CL‐ YELLOW FEVER IMMUNIZATION TRAVEL 90717 $239.00 503020 CL‐ STATE POLIOVIRUS VACCINE INACTIVATED 90713 $0.01 503021 CL‐ STATE VARICELLA VACCINE LIVE 90716 $0.01 503025 DRUG SCREEN COLLECTION ONLY 99199 $41.00 503026 PRENATAL CARE 99212 99212 $0.00 503027 CL‐ ACETAMINOPHEN LIQ 160MG 5ML $0.00 503028 CL‐ IBUPROFEN LIQ 100MG 5ML $0.00 503029 CL‐ IBUPROFEN TAB 200 MG $0.00 503030 CL‐ DIPHENHYDRAMINE LIQ 12 5MG 5ML $0.00 503031 SURGICAL EQUIPMENT SUPPLIES A4550 $47.00 503033 ROUTINE VENIPUNCTURE OR FINGER 36415 $20.00 503038 FLEXIBLE SIGMOIDOSCOPY SCREENING G0104 $284.00 503039 COLONOSCOPY SCREENING HIGH RISK G0105 $351.00 503040 HEMOCCULT SCREENING 82270 $45.00 503041 COLONOSCOPY SCREENING LOW/NO RI 45378 $347.00 503042 TRIMMING DYSTROPHIC NAILS G0127 $27.00 503043 CL‐ CEFTRIAXONE 250 MG VIAL J0696 $70.00 503046 CL‐ DEPO MEDROL 40 MG 1 ML VIAL J1030 $47.00 503047 CL‐ DEPO MEDROL 80 MG 1 ML J1040 $101.00 503048 CL‐ MEDROXYPROGESTERONE FOR CONTRA 1MG J1050 $175.00 503049 CL‐ DEPO TESTOSTERONE 100MG J1070 $48.00 503050 CL‐ DEPO TESTOSTERONE 200MG J1080 $96.00 503052 CL‐ LOVENOX 10MG J1650 $25.00 503053 CL‐ KETOROLAC 15 MG VIAL J1885 $75.00 503054 CL‐ LUPRON DEPOT 3 75 MG J1950 $2,784.00 503055 CL‐ MEPERIDINE DEMEROL 50MG 1ML J2175 $23.00 503056 CL‐ MORPHINE 10MG ML 1ML VIAL J2270 $4.00 503057 CL‐ PHENERGAN 50 MG INJECTION J2550 $28.00 503058 CL‐ PHENERGAN UP TO 50 MG INJECTION J2550 $0.00 503059 CL‐ ACETAMINOPHEN TAB 325 MG $0.00
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Transcript of Item - Gifford Health Care
Item # Description CPT Price
500100 ANESTHESIA $150.00
501630 ANESTH SURGERY OF SHOULDER 1630 $0.00
503003 ANTEPARTUM CARE ONLY 4‐6 VIS 59425 $1,760.00
503004 ANTEPARTUM CARE ONLY 7 OR MO 59426 $3,535.00
503005 PREBIRTH VISIT NO CHG 90021 90021 $0.00
503006 OCCUPATIONAL PHYSICAL EXAM DOT CRASH CDL 99499 $100.00
503007 HEP A VACCINE ADULT IM 90632 $342.00
503008 CL‐ STATE HEPATITIS A VAC PEDI ADOL 90633 $0.01
503009 CL‐ STATE HIB 90648 $0.01
503010 TYPHOID VACCINE VI CAPSULAR 90691 $124.00
503011 CL‐ MMR LIVE 90707 $188.00
503012 CL‐ STATE DTaP DAPTACEL INFANRIX 90700 $0.01
503013 CL‐ DT ABSORBED FOR USE IN INDIVID LT 7Y 90702 $0.00
503014 CL‐ STATE MMR LIVE 90707 $0.01
503015 CL‐ POLIOVIRUS VACCINE INACTIVATED 90713 $117.00
503016 CL‐ VARICELLA VIRUS VACCINE LIVE 90716 $349.00
503018 CL‐ YELLOW FEVER IMMUNIZATION TRAVEL 90717 $239.00
503020 CL‐ STATE POLIOVIRUS VACCINE INACTIVATED 90713 $0.01
503021 CL‐ STATE VARICELLA VACCINE LIVE 90716 $0.01
503025 DRUG SCREEN COLLECTION ONLY 99199 $41.00
503026 PRENATAL CARE 99212 99212 $0.00
503027 CL‐ ACETAMINOPHEN LIQ 160MG 5ML $0.00
503028 CL‐ IBUPROFEN LIQ 100MG 5ML $0.00
503029 CL‐ IBUPROFEN TAB 200 MG $0.00
503030 CL‐ DIPHENHYDRAMINE LIQ 12 5MG 5ML $0.00
503031 SURGICAL EQUIPMENT SUPPLIES A4550 $47.00
503033 ROUTINE VENIPUNCTURE OR FINGER 36415 $20.00
503038 FLEXIBLE SIGMOIDOSCOPY SCREENING G0104 $284.00
503039 COLONOSCOPY SCREENING HIGH RISK G0105 $351.00
503040 HEMOCCULT SCREENING 82270 $45.00
503041 COLONOSCOPY SCREENING LOW/NO RI 45378 $347.00
503042 TRIMMING DYSTROPHIC NAILS G0127 $27.00
503043 CL‐ CEFTRIAXONE 250 MG VIAL J0696 $70.00
503046 CL‐ DEPO MEDROL 40 MG 1 ML VIAL J1030 $47.00
503047 CL‐ DEPO MEDROL 80 MG 1 ML J1040 $101.00
503048 CL‐ MEDROXYPROGESTERONE FOR CONTRA 1MG J1050 $175.00
503049 CL‐ DEPO TESTOSTERONE 100MG J1070 $48.00
503050 CL‐ DEPO TESTOSTERONE 200MG J1080 $96.00
503052 CL‐ LOVENOX 10MG J1650 $25.00
503053 CL‐ KETOROLAC 15 MG VIAL J1885 $75.00
503054 CL‐ LUPRON DEPOT 3 75 MG J1950 $2,784.00
503055 CL‐ MEPERIDINE DEMEROL 50MG 1ML J2175 $23.00
503056 CL‐ MORPHINE 10MG ML 1ML VIAL J2270 $4.00
503057 CL‐ PHENERGAN 50 MG INJECTION J2550 $28.00
503058 CL‐ PHENERGAN UP TO 50 MG INJECTION J2550 $0.00
503059 CL‐ ACETAMINOPHEN TAB 325 MG $0.00
503060 CL‐ ACETAMINOPHEN TAB 500 MG $0.00
503061 CL‐ RHOGAM ONE DOSE PACKAGE J2790 $366.00
503062 CL‐ SUMATRIPTAN SUCCINATE 6 MG VIAL J3030 $421.00
503063 CL‐ TRIESENCE 10MG J3300 $31.00
503064 CL‐ HYDROXYZINE INJECTION J3410 $22.00
503066 CL‐ VITAMIN B‐12 1000 MCG J3420 $19.00
503068 RINGERS LACTATE INFUSION 1000 CC J7120 $3.00
503069 CL‐ IUD PARAGARD J7300 $1,261.00
503071 CL‐ SUPPLY PROVIDED BY PATIENT JAAAA $0.00
503075 GMC‐ORTHOTICS FUNCTIONAL LONG EACH L3010 $154.00
503076 GMC‐ORTHOTICS FUNCTIONAL MET EACH L3020 $277.00
503077 GMC‐ARCH BINDERS W O MET PAD EACH L3040 $35.00
503078 GMC ‐ ARCH BINDERS W MET PA EACH L3050 $53.00
503085 TISSUE EXAM KOH SLIDE FOR FUNGI Q0112 $39.00
503086 CL‐ EPOETIN ALFA PROCRIT NON‐ESRD 1000U J0885 $25.00
503090 PATIENT CARE PLAN G9001 G9001 $100.00
503091 CL‐ STATE PNEUMOCOCCAL CONJ VAC 7 VAL 90669 $0.01
503092 CL‐ STATE HEPATITIS B PED/ADOL ENGERIX 90744 $0.01
503093 NURSE VISIT ONLY W DOCUMENTATION 99211 99211 $42.00
503094 AEROCHAMBER A4627 $100.00
503096 CERVICAL COLLAR‐LOW CONTOUR L0120 $49.00
503099 CAST SHOE‐ZIMMER L3260 $125.00
503101 URINE PREGNANCY TEST BY VISUAL 81025 $28.00
503104 NEW PT PREV GYN ONLY 18‐39 YR 9938552 99385 $318.00
503105 NEW PT PREV GYN ONLY 40‐64 YR 99386 99386 $330.00
503106 NEW PT PREV GYN ONLY 65 AND UP 99387 99387 $260.00
503107 EST PT PREV GYN ONLY 18‐39 YR 99395 99395 $306.00
503108 EST PT PREV GYN ONLY 40‐64 YR 99396 99396 $369.00
503109 EST PT PREV GYN ONLY 65 YR AND UP 99397 99397 $177.00
503112 IMMUN ADMIN INFLUENZA 90471 90471 $38.00
503113 IMMUN ADMIN PNEUMOCOCCAL MEDICARE 90471 90471 $43.00
503114 IMMUN ADMIN HEP B MEDICARE 90471 90471 $55.00
503122 CL‐ CEFTRIAXONE 250 MG VIAL J0696 $54.00
503124 POST PARTUM CARE 59430 $0.00
503125 URINALYSIS WITHOUT MICROSCOPY 81002 $0.00
503126 AUDIOGRAM/PE NO CHG 92552 92552 $0.00
503131 IEP EVALUATION H2000 $77.00
503135 WRIST HAND FINGER SPLINT L3807 L3807 $121.00
503139 REMOVAL OF HEMORRHOID CLOT 46320 $440.00
503140 EXC MALIGNANT LESION 3 1 TO 4 0 CM 11604 $962.00
503148 CL‐ STATE PEDIARIX 90723 $0.01
503153 CL‐ DEXAMETHASONE SOD PHOS 1MG INJ J1100 $7.00
503157 DESTRUCTION OF SKIN LESIONS 17280 $309.00
503160 WOUND CLOSURE UTILIZING TISSUE ADHESIVE G0168 $86.00
503162 CL‐ STATE FLU VACCINE 90658 $0.01
503169 CL‐ BOTULINUM TOXIN A PER UNIT J0585 $61.00
503170 CL‐ LUPRON 7 5 MG J9217 $1,229.00
503171 CL‐ ZOLADEX 3 6 MG J9202 $2,380.00
503172 PROSTATIC MICROWAVE THERMOTHERAPY 53850 $3,367.00
503174 INSERT NON INDWELLING BLADDER CATHETER 51701 $150.00
503175 DILATE URETHRA STRICTURE 53600 $292.00
503176 DILATION OF URETHRA 53660 $231.00
503178 CHANGE GASTROSTOMY TUBE 43760 $269.00
503179 INCISION AND REMOVAL FOREIGN BODY COMP 10121 $579.00
503181 MULT ALRGY INJ ‐ COMMERCIAL INS 95117 95117 $62.00
503184 BIOPSY OF CERVIX WITH SCOPE 57455 $582.00
503185 EXC MALIGNANT LESION 2 1 TO 3 0 CM 11623 $629.00
503189 EXC MALIGNANT LESION 0 6 TO 1 0 CM 11641 $579.00
503191 INSERT TEMP INDWELLING CATHETER SIMPLE 51702 $161.00
503192 INSERT BLADDER CATHETER 51701 51701 $151.00
503194 EXC MALIGNANT LESION GREATER THAN 4 0 CM 11626 $855.00
503195 DESTROY CONDYLOMATA FEMALE 56501 56501 $409.00
503196 EXC BENIGN LESION 2 1 TO 3 0 CM 11423 $835.00
503197 BIOPSY SKIN LESION 11100 $302.00
503198 EXC BENIGN LESION 1 1 TO 2 0 CM 11402 $667.00
503199 EXC BENIGN LESION UP TO 0 5 CM 11440 $598.00
503200 SHAVE SKIN LESION GREATER 2CM F E EL N L 11313 $390.00
503201 INJ 1 OR 2 TRIGGER 20552 $234.00
503202 OBTAINING SCREEN PAP SMEAR Q0091 $76.00
503203 OBSERVATION EST PATIENT LEVEL 3 99213 $110.00
503204 NERVE BLOCK PERIPHERAL NERVE 64450 $257.00
503205 SHAVE SKIN LESION 1 1 TO 2 CM F E EL N L 11312 $336.00
503206 CYSTOURETHROSCOPY 52000 $719.00
503208 CL‐ IUD MIRENA J7302 $1,023.00
503209 SMOKE/TOBACCO COUNSELING 3‐10 MINUTES G0375 $41.00
503210 SMOKE/TOBACCO COUNSELING >10 MINUTES G0376 $82.00
503211 VASECTOMY UNILATERAL OR BILATERAL 55250 $1,470.00
503213 REMOVAL OF NAIL BED 11750 $517.00
503215 I D ABSCESS SIMPLE 10060 $447.00
503216 SPIROMETRY WO BRONCHODILATOR 94010 94010 $80.00
503217 SPIROMETRY PRE PST BRONCHODILATION 94060 94060 $137.00
503219 COMPLEX CYSTOMETROGRAM 51726 $469.00
503220 ANAL URINARY MUSCLE STUDY 51784 $423.00
503221 URINE VOIDING PRESSURE STUDY 51795 $273.00
503222 INTERABDOMINAL PRESSURE STUDY 51797 $228.00
503223 EXC BENIGN LESION 0 6 TO 1 0 CM 11401 $666.00
503224 CYSTOSCOPY AND TREATMENT 52310 $935.00
503225 REM IMPACTED CERUMEN/IRRIGATE EAR 69210 69210 $171.00
503226 INITIAL PREVENTATIVE EXAM MEDICARE G0402 $250.00
503229 CL‐ NEULASTA 6 MG INJ J2505 $7,484.00
503230 EXC MALIGNANT LESION UP TO 0 5 CM 11600 $503.00
503232 INITIAL FOOT EXAM PT LOPS G0245 $145.00
503233 FOLLOW UP EVAL OF FOOT LOPS G0246 $76.00
503234 ROUTINE FOOTCARE PATIENT W LOPS G0247 $108.00
503236 CL‐ STATE TDaP (BOOSTRIX) 90715 $0.01
503237 CONIZATION OF CERVIX 57522 $1,105.00
503238 CL‐ STATE MENACTRA VACCINE 90734 $0.01
503239 REMOVE FOREIGN BODY EAR 69200 69200 $275.00
503244 TREATMENT OF TOE FRACTURE 28510 $233.00
503246 TREATMENT OF ANKLE FRACTURE 29405 $293.00
503248 CL‐ STATE ROTAVIRUS VACCINE 2 DOSE 90681 $0.01
503250 EXC BENIGN LESION 1 1 TO 2 0 CM 11442 $511.00
503252 CL‐ HPV 4 VACCINE GARDASIL 4 90649 $489.00
503253 CL‐ ZOSTER VACCINE ZOSTAVAX 90736 $437.00
503256 OBSERVATION EST PATIENT LEVEL 4 99214 99214 $205.00
503257 OBSERVATION EST PATIENT LEVEL 5 99215 99215 $348.00
503258 OBSERVATION EST PATIENT LEVEL 2 99212 $101.00
503260 ARTHROCENTESIS ASPIR OR INJ INTJNT 20605 $197.00
503261 ARTHROCENTESIS ASPIR OR INJ MJRJNT 20610 $228.00
503262 CLOSED TX DISTAL RADIAL FX EPIPHYSEAL 25600 $795.00
503264 DARBOPOETIN 1MCG INJ NON‐ESRD J0881 $6.00
503266 EUFLEXXA INJ PER DOSE J7323 $363.00
503267 CYSTOSCOPY AND TREATMENT 52281 $502.00
503268 CL‐ BETHAMETHASONE CELESTONE J0702 $255.00
503270 INSERT PESSARY DEVICE 57160 $224.00
503271 APPLY SHORT LEG CAST 29405 $295.00
503274 INCISION AND REMOVAL FOREIGN BODY SIMPLE 10120 $434.00
503275 DILATION OF CERVICAL CANAL 57800 $156.00
503276 INSERT TEMP INDWELLING CATHETER COMPLEX 51703 $374.00
503277 CL‐ BCG INTRAVESICAL VAC J9031 $462.00
503282 ANOSCOPY DIAG W/WO COLLECTION HOSPITAL 46600 $223.00
503287 DIABETIC MANAGEMENT TRAINING PER INDIVID G0108 $94.00
503288 DIABETIC MANAGEMENT TRAINING GROUP G0109 $54.00
503289 DESTRUCTION OF HEMORRHOIDS 46083 $659.00
503290 URETHRA PRESSURE PROFILE 51772 $759.00
503291 ELECTROUROFLOWMETRY FIRST 51741 $48.00
503299 TREATMENT OF HEEL FRACTURE 28400 $511.00
503302 CL‐ STATE PNEUMOVAX 23 90732 $0.01
503306 CYSTOSCOPY W BIOPSY 52204 $751.00
503308 SHAVE SKIN LESION 1 1 TO 2 CM S N H F G 11307 $311.00
503309 DESTRUCTION PENIS LESION S 54055 $233.00
503310 NERVE BLOCK INJ PARACERVICAL 64435 $315.00
503311 N BLOCK INJ PUDENDAL 64430 $268.00
503314 CL‐ ONDANSETRON(ZOFRAN)VIAL 4MG/2ML VIAL J2405 $5.00
503315 INJECTION SINGLE ORIGIN INSERTION 20551 20551 $187.00
503316 CL‐ GENTAMICIN UP TO 80 MG J1580 $23.00
503317 INSERTION NONBIODEGRADABLE DRUG DEVICE 11981 $353.00
503320 CL‐ HEPATITIS A B COMBO NO CHARGE 90636 $0.00
503324 ULTRASOUND PREGNANT UTERUS LIMITED 76815 $274.00
503325 TRANSVAGINAL US OBSTETRIC 76817 $229.00
503330 CL‐ STATE DTAP HIB IP VACCINE 90698 $0.01
503332 APPLICATION RIGID TOTAL CONTACT LEG CAST 29445 $338.00
503333 CLOSED TX RADIUS ULNA FX W MANIPULATION 25605 $1,238.00
503335 CLOSED TX METACARPAL FX SINGLE W MANIP 26605 $762.00
503337 INJECTION TREATMENT OF NERVE PLANTAR DIG 64455 $167.00
503338 BLADDER INSTILLATION OF ANTICARCINOGENIC 51720 $403.00
503339 CHEMO ADMIN SQ IM HORMONAL ANTI NEOPLAST 96402 $91.00
503343 PLATELET RICH PLASMA INJECTION FIRST $1,158.00
503344 PLATELET RICH PLASMA INJECTION EA ADDL $781.00
503345 INJ 3 OR MORE TRIGGER 20553 $227.00
503347 TENDON SHEATH INCISION 26055 $1,425.00
503351 REMOVAL SWEAT GLAND LESION 11450 $772.00
503356 CL‐ STATE HEPATITIS A VAC ADULT 90632 $0.01
503358 IRRIGATION OF BLADDER 51700 $143.00
503359 US GUIDANCE NDL PLACEMENT SPRV INTRP 76942 $196.00
503360 ARTHROCENTESIS ASPIR OR INJ SMJNT 20600 $57.00
503361 INJECT SINGLE TENDON SHEATH OR LIGAMENT 20550 $189.00
503362 US GUIDANCE NDL PLACEMENT SPRV INTR NC 76942 $106.00
503363 GMC ORTHOTICS REPAIR $50.00
503365 DESTROY CONDOLYMATA MALE 54050 54050 $426.00
503366 INJ INTRALESIONAL UP TO AND INCL 7 LESIO 11900 $116.00
503367 TREAT METATARSAL FRACTURE 28470 $472.00
503371 HEMORRHOIDECTOMY BY SIMPLE LIGATURE 46221 $685.00
503376 EXCISION OF PENIS LESION 54060 $352.00
503377 CRYOSURGERY PENIS LESION S 54056 $252.00
503378 NERVE BLOCK INJ OCCIPITAL 64405 $259.00
503379 BLOOD COUNT HEMOGLOBIN FINGERSTICK 85018 $7.00
503380 STATE SUP PED VACC ADMIN 90471 90471 $21.00
503381 STATE SUP PED VACC ADMIN EA ADDL 90472 90472 $21.00
503384 CL‐ STATE NASAL FLU VACCINE 90660 $0.01
503386 REMOVAL OF FOREIGN BODY SIMPLE 20520 $415.00
503388 PUNCTURE ASPIRATION OF HYDROCLE WWO INJ 55000 $441.00
503391 I D PERIRECTAL/ISCHIORECTAL ABSCESS 46040 $1,166.00
503394 TX WRIST BONE FX 25622 $593.00
503398 TENOTOMY PERCUTANEOUS TOE SINGLE TENDON 28010 $441.00
503399 REMOVE TENDON SHEATH LESION 26160 $1,273.00
503400 INCISION TENDON SHEATH 25000 $515.00
503402 CYSTOMETROGRAM W URINE VOIDING PRESSURE 51728 $552.00
503405 CL‐ COSYNTROPIN 0 25MG ACTH J0834 $229.00
503409 REMOVAL OF IMPLANT SUPERFICIAL 20670 $805.00
503410 REMOVAL NONBIODEGRADABLE DRUG DEVICE 11982 $443.00
503411 APPLY LONG ARM CAST 29065 $259.00
503412 APPLY SHORT ARM CAST 29075 $247.00
503414 APPLY SHORT ARM SPLINT 29125 $188.00
503416 APPLY SHORT LEG CAST WALKER 29425 $233.00
503417 APPLY LONG LEG CAST 29345 $308.00
503418 APPLY LONG ARM SPLINT 29105 $220.00
503419 APPLY SHORT LEG SPLINT 29515 $209.00
503420 CL‐ IMPLANON 68 MG J7307 $2,290.00
503421 CONTROL OF NOSEBLEED 30901 $221.00
503422 EXC BENIGN LESION UP TO 0 5 CM 11400 $347.00
503425 CL‐ PROCHLORPERAZINE COMPAZINE 10MG VIAL J0780 $20.00
503426 CL‐ INTERFERON ALFA‐2B RECOMBINANT 1 MIL J9214 $45.00
503427 CLOSED TX OF PHALANGEAL SHAFT FX 26720 $478.00
503428 CYSTOSCOPY AND TREATMENT 52224 $1,234.00
503430 NEGATIVE PRESSURE WOUND THERAPY LT 50CM 97605 $107.00
503431 TX BIG TOE FX 28490 $348.00
503433 APPLY LONG LEG CAST WALKER 29355 $300.00
503434 APPLY LONG LEG CAST CYLINDER 29365 $274.00
503435 CL‐ ORTHOVISC PER DOSE J7324 $586.00
503437 ANKLE FOOT ORTHOSIS RIGID PREFABRICATED L2116 $443.00
503439 SHAVE SKIN LESION GREATER 2 CM S N H F G 11308 $317.00
503443 CLOSED TX OF DISTAL FIBULAR FX WO MANIP 27786 $960.00
503447 REMOVE DEVITAL TISSUE PER SESSION 20SQCM 97597 $131.00
503448 REMOVE DEVITAL TISSUE PER SESSION ADDL20 97598 $65.00
503449 MEDICARE ANNUAL WELLNESS INITIAL PPPS G0438 $356.00
503450 MEDICARE ANNUAL WELLNESS SUBSEQ PPPS G0439 $237.00
503452 APPLY MULTILAYER VENOUS WOUND COMPRESS 29581 $99.00
503453 GMC‐ORTHOTICS FUNCTIONAL MET DEPOSIT L3020 $105.00
503454 GMC‐ORTHOTICS FUNCTIONAL MET PAIR L3020 $0.00
503455 N BLOCK INJ SUPRASCAPULAR 64418 $321.00
503459 EXAM OF VULVA W SCOPE 56820 $236.00
503460 EXAM BIOPSY OF VULVA W SCOPE 56821 $296.00
503462 SPECIAL REPORTS OR FORMS 99080 $159.00
503466 TX OF TOE FX 28515 $366.00
503467 IMMUNIZATION ADMIN NASAL OR ORAL 90473 $40.00
503476 I D PILONIDAL CYST COMPLICATED 10081 $623.00
503479 INCISION OF TOE TENDON 28232 $483.00
503480 TREAT METATARSAL FRACTURE 28475 $552.00
503481 THER INJECTION CARP TUNNEL 20526 20526 $178.00
503482 DIMETHYL SULFOXIDE 50 50ML J1212 $211.00
503483 CLOSED TX PHALANGEAL SHAFT FX EACH 26725 $778.00
503485 TREATMENT OF ANKLE FRACTURE 27788 $820.00
503486 EXC BACK LES SC 3 CM 21931 $851.00
503487 INFLUENZA ASSAY W OPTIC EACH 87804 $43.00
503488 CL‐ HEPARIN SODIUM PER 1000U PER ML 1ML J1644 $1.00
503489 CL‐ SODIUM BICARBONATE 8 4 SYRD 50 ML J3490 $17.00
503490 CL‐ LIDOCAINE 2 20 ML MDV J3490 $9.00
503492 CL‐ STATE ZOSTER VACCINE 90736 $0.01
503493 CL‐ STATE HEPATITIS B VACCINE ADULT 90746 $0.01
503497 CL‐ NEXPLANON 68MG J7307 $2,333.00
503501 EXC HIP PELVIS LES SC 3C 27047 $1,029.00
503503 WOUND PREP F N HF G 15004 $781.00
503504 SKIN SUB GRAFT FACE NK HF G 15275 $311.00
503505 CLOSED TX GRT HUMERAL TUBER FX WO MANIP 23620 $678.00
503506 CL‐ MEDROXYPROGESTERONE ACETATE 1MG INJ J1050 $3.00
503507 IMPLANT NEUROSTIMULATOR SACRAL NERVE 64561 $1,802.00
503508 RELEASE OF FOOT TENDON 28225 $823.00
503510 IMPLANT NEUROSTIM SACRAL NERVE ADDTL 64561 $1,802.00
503511 ANOSCOPY WITH BIOPSY SINGLE OR MULTIPLE 46606 $467.00
503512 LYSIS OR EXC PENILE POSTCIRC ADHESI 54162 $548.00
503513 DILATION URETHRAL STRICTURE MALE INITIAL 53620 $251.00
503515 REMOVE INSERT DRUG IMPLANT 11983 $464.00
503516 REM CENTRAL VENOUS ACCESS DEVICE 36590 $807.00
503518 CL‐ ADRENALIN EPINEPHRINE 0 1MG J0171 $53.00
503519 EXC BREAST LESION ONE OR MORE 19120 $1,260.00
503520 CL‐ DENOSUMAB PER MG J0897 $32.00
503523 CL‐ TRIPTORELIN TRELSTAR 3 75MG J3315 $444.00
503525 CL‐ DUONEB J7620 $2.00
503526 CL‐ RACEPINEPHRINE HYDRCHL 11.25 MG .5ML $2.00
503527 CL‐ STATE KINRIX DTaP IPV 4 6 YEARS 90696 $0.01
503528 CL‐ STATE PREVNAR 13 90670 $0.01
503529 CL‐ EPIPEN JR 0.15 MG AUTOINJECTOR $0.00
503530 CL‐ EPIPEN ADULT 0.3 MG AUTOINJECTOR $0.00
503531 INSERT TEMP BLADDER CATH 51702 $156.00
503532 CYSTOMETROGRAM W/VP 51728 $700.00
503533 CYSTOMETROGRAM W VP UP 51729 $777.00
503534 EXC OF ANAL LESIONS 46922 $596.00
503535 EXC BACK LES SC 3 CM 21930 $1,042.00
503536 REMOVE FOREIGN BODY COMP SUBCUTAN TISSUE 10121 $608.00
503537 EXC MALIGNANT LESION 2 1 TO 3 0 CM 11603 $591.00
503538 MEASURE BLOOD OXYGEN LEVEL 94760 94760 $6.00
503539 REMOVE FOREIGN BODY EYE 65205 65205 $129.00
503540 REMOVE FOREIGN BODY NOSE 30300 30300 $527.00
503541 HYDRATION IV INFUSION INITIAL 96360 96360 $126.00
503542 HYDRATION IV INFUSION ADD‐ON 96361 96361 $32.00
503543 THERAPEUTIC PROPHYLACTIC OR DX INJ 96372 $58.00
503544 CL‐ SKYLA 13 5 MG J7301 $2,125.00
503545 EXAM OF VAGINA W SCOPE 57420 $260.00
503546 EXAM/BIOPSY OF VAGINA W/SCOPE 57421 $349.00
503547 TREAT FINGER DISCLOCATION 26770 $611.00
503548 SUTURE REMOVAL OTHER PROVIDER 99211 99211 $56.00
503549 CL‐ DOXYCYCLINE 100 MG VIAL $39.00
503550 CL‐ MONOVISC J7327 $1,998.00
503551 CL‐ MEPIVACAINE 1 5 J0670 $7.00
503552 NEURAL PROLOTHERAPY $244.00
503553 CL‐ FIRMAGON 1MG INJ J9155 $9.00
503554 CL‐ TRAUMEEL 1 AMPULE 2 2ML J3490 $17.00
503555 NEG PRES WND THRPY PER SESS LT 50CM G0456 $425.00
503556 NEG PRES WND THRPY PER SESS GT 50CM G0457 $583.00
503557 DISP WND SUCTION DRSG AND ACCESS A9272 $91.00
503558 CL‐ MITOMYCIN INJECTION 5MG J9280 $141.00
503559 ESTABLISHED PATIENT LEVEL 3 99213 99213 $405.00
503560 NEEDLE BIOPSY LYMPH NODES SUPERFICIAL 38505 $273.00
503561 CL‐ DEXAMETHASONE 0 25 MG ORAL J8540 $1.00
503562 CYSTOSCOPY AND TREATMENT 52234 $520.00
503563 CL‐ DEPO TESTOSTERONE PER MG J1071 $0.00
503564 CYSTOMETROGRAM WITH VOIDING PRESSURE 51728 $673.00
503565 CYSTOMETROGRAM WITH VP AND UP 51729 $727.00
503567 DRAIN INJ SMALL JOINT BURSA W US CLINIC 20604 $160.00
503568 DRAIN INJ INTMED JOINT BURSA W US CLINIC 20606 $183.00
503569 DRAIN INJ MAJOR JOINT BURSA W US CLINIC 20611 $204.00
503570 MM DIGITAL SCREENING BILAT ALL VIEWS 77067 $82.00
503571 MM 2D DIGITAL DIAGNOSTIC BILAT ALL VIEWS G0204 $103.00
503572 MM 2D DIGITAL DIAGNOSTIC UNI ALL VIEWS G0206 $82.00
503573 EPAT TREATMENTS 1 TO 3 $131.00
503574 EPAT TREATMENTS 4 AND 5 $105.00
503575 CL‐ ALBUTEROL 25MG 3 ML NEB J7613 $2.00
503576 RAD DRAIN INJ JOINT BURSA W O US 20610 $140.00
503577 CL‐ PENICILLIN G BENZATHINE 600000 UNIT J0561 $111.00
503578 CYSTOSCOPY AND TREATMENT 52214 $1,343.00
503579 CL‐ EPOETIN ALFA PROCRIT ESRD 1000U J0886 $24.00
503580 MARSUPIALIZATION BARTHOLINS GLAND CYST 56440 $387.00
503581 APPLY SHORT LEG SPLINT 29515 $179.00
503582 VULVECTOMY SIMPLE PARTIAL 56620 $1,098.00
503583 PARTIAL HYMENECTOMY REV OF HYMENAL RING 56700 $396.00
503584 CIRCUMCISION SURGICAL EXC OTH GTR 28DAYS 54161 $420.00
503585 SLITTING OF PREPUCE 54001 $375.00
503586 CMPLX RPR F C C M N AX G H F 13131 $777.00
503587 CHANGE OF BLADDER TUBE 51705 $176.00
503588 TREAT WRIST BONE FRACTURE 25650 $647.00
503589 TREAT FRACTURE OF ULNA 25530 $532.00
503590 APPLY HAND WRIST CAST 29085 $199.00
503591 CL‐ DEPO‐SUBQ PROVERA 104MG PF SYRINGE J1050 $185.00
503592 CL‐ STATE TD VACCINE AGE 7+ 90714 $0.01
503593 MR ABDOMEN WWO CONTRAST C8902 $124.00
503594 EXCISION OF NAIL FOLD TOE 11765 $343.00
503595 CARPAL TUNNEL SURGERY 64721 $880.00
503596 CL‐ STATE TDaP ADACEL 90715 $0.01
503597 LDCT FOR LUNG CA SCREEN G0297 $58.00
503598 EXC TR EXT B9 MARG 3 1 4 CM 11404 $530.00
503599 BONE BIOPSY TROCAR NEEDLE 20220 $345.00
503600 TREAT METACARPAL FRACTURE 26600 $603.00
503601 TREAT FINGER FRACTURE EACH 26750 $377.00
503602 TX CLAVICLE FX 23500 $447.00
503603 INJECT SACROILIAC JOINT 27096 $370.00
503604 CL‐ STATE TETANUS DIPTHERIA TOXOID TD 05 90714 $0.01
503605 GI TRACT CAPSULE ENDOSCOPY 0355T $390.00
503606 DEEP MUSCLE BIOPSY 20205 $558.00
503607 DESTRUCT B9 LESION 1 14 17110 $216.00
503608 CL‐ METOCLOPRAMIDE HCL INJECT UP TO 10MG J2765 $5.00
503609 REMOVAL OF SKIN TAGS W 15 11200 $183.00
503610 EXC TR EXT B9 PLUS MARG GREATER 4 CM 11406 $602.00
503611 EXC TR EXT B9 PLUS MARG 2 1 TO 3 CM 11403 $444.00
503612 DEBRIDE INFECTED SKIN 11000 $106.00
503613 INCISION OF ANAL ABSCESS 46050 $473.00
503614 EXC H F NK SP B9 MARG 1 1 2 11422 $338.00
503615 BIOPSY REMOVAL LYMPH NODES 38500 $642.00
503616 EXC FACE MM B9 PLUS MARG 0 6 1 CM 11441 $350.00
503617 BIOPSY OF CERVIX 57500 $257.00
503618 CL‐ AMNIO OR BIODMATRIC INJ PER CC Q4139 $3,319.00
503619 INCISION OF FOOT TENDON 28234 $815.00
503620 AFO RIGID PLASTIC ANKLE CUSTOM FABRICATE L1970 $939.00
503621 CL‐ HYDROXYPROGESTERONE 250 MG/ML J1725 $276.00
503622 EXC TR EXT MAL PLUS MARG 1 1 2 CM 11602 $483.00
503623 EXC F E E N L MAL PLUS MRG 1 1 2 11642 $528.00
503624 DIAGNOSTIC LARYNGOSCOPY 31575 $222.00
503625 I AND D OF VULVA PERINEUM 56405 $255.00
503626 REVISION OF PENIS 54300 $1,258.00
503627 ORAL HEALTH RISK ASSESSMENT LESS 3 YRS D0145 $42.00
503628 BRIEF EMOTIONAL BEHAV ASSMT 96127 $12.00
503629 ALCOHOL SUBS INTERV 15 TO 30 MN 99408 $68.00
503630 ALCOHOL SUBS INTERV GREATER THAN 30 MIN 99409 $137.00
503631 LOWER EXTREMITY STUDY 93926 $46.00
503632 CONSULT BEFORE SCREENING COLONOSCOPY S0285 $250.00
503633 DRESS DEBRID P THICK BURN S 16020 $160.00
503634 ASP INJ INTERMEDIATE JNT 20605 20605 $170.00
503635 CL‐ INSULIN NOVOLOG 100unit/ML J1815 $1.00
503636 CL‐ STATE MENINGOCOCCAL B BEXSERO 90620 $0.01
503637 DESTRUCT PREMALG LESION 17000 $135.00
503638 DESTRUCT PREMALG LES 2 14 17003 $12.00
503639 GENITAL SURGERY PROCEDURE 55899 $701.00
503640 CL‐ AZITHROMYCIN TAB 250MG $3.00
503641 CL‐ ADALIMUMAB 20MG J0135 $0.00
503642 REMOVAL TUNNELED CV CATH 36589 $303.00
503643 CL‐ PREDNISONE 20MG TAB $0.00
503644 SIMPLE REPAIR 7.6 CM TO 12.5 CM 12004 $245.00
503645 REMOVAL OF FINGER LESION 26210 $815.00
503646 REPAIR SIMPLE 2 6 TO 7 5 CM 12002 $209.00
503647 TRIM SKIN LESIONS 2 TO 4 11056 $109.00
503648 REMOVE INTRAUTERINE DEVICE 58301 $166.00
503649 CYSTOURETHROSCOPY REM URETERAL CALCULUS 52320 $460.00
503650 TRIM SKIN LESION 11055 $89.00
503651 CYSTOSCOPY REMOVAL OF CLOTS 52001 $692.00
503652 OCCULT BLOOD FECES 82270 $0.00
503653 CL‐ ROPIVACAINE 0.5% 30ML J2795 $21.00
503654 TREAT FINGER FRACTURE EACH 26740 $428.00
503655 ECHO EXAM ABDOMEN 76705 $55.00
503656 TTE LIMITED 93308 $48.00
503657 CL‐ NUCALA 100MG NC J2182 $0.00
503658 TREATMENT OF TOE FRACTURE 28510 $229.00
503659 TREAT HUMERUS FRACTURE 23600 $606.00
503660 FNA WO IMAGING 10021 $215.00
503661 CHIROPRACTIC MANJ 5 REGIONS 98942 98942 $116.00
503662 VASCULAR SURGERY PROCEDURE 37799 $836.00
503663 US EXAM PELVIC LIMITED 76857 $98.00
503664 ECHO EXAM OF ABDOMEN 76705 $55.00
503665 OB US LIMITED FETUS 76815 $57.00
503666 TREATMENT OF ANKLE FRACTURE 27808 $670.00
503667 CL‐ TRIAMCINOLONE ACETONIDE 10MG INJ J3301 $31.00
503668 CL‐ STATE SHINGRIX 90750 $0.01
503669 COMPREHENSIVE HEARING TEST 92557 $69.00
503670 STAB PHLEB VEINS XTR 10 20 37765 $1,188.00
503671 COMPREHENSIVE HEARING TEST 92557 $72.00
503672 CL‐ HZV VACC RECOMBINANT IM NJX SHINGRIX 90750 $260.00
503673 CL‐ EXPAREL 20 ML VIAL C9290 $580.00
503674 CLTX MEDICAL ANKLE FX 27760 $620.00
503675 CLTX POST ANKLE FX 27767 $521.00
503676 IR BIOPSY OF NECK CHEST 21550 $488.00
503677 NEW PT OFFICE OUTPATIENT LEVEL 5 99205 $359.00
503678 CL‐ MAKENA 10MG J1726 $52.00
503679 TREAT HIP SOCKET FRACTURE 27222 $1,772.00
503680 CLTX THIGH FX 27267 $792.00
503681 SKIN SUB GRAFT F N HF G ADDL 15276 $64.00
503682 FETAL BIOPHYS PROFILE W NST INTERP 76816 $99.00
503683 ADJUST BONE FIXATION DEVICE 20693 $815.00
503684 TREAT HUMERUS FRACTURE 24500 $691.00
503685 CL‐ HYDROXYPROGESTERONE CAPROATE J1726 $47.00
503686 SKIN TISSUE PROCEDURE 17999 $511.00
503687 CL‐ FLU VAX PRES FREE 6 MO AND UP QUAD 90686 $32.00
503688 FRENULOTOMY OF PENIS 54164 $361.00
503689 DRAINAGE OF BREAST LESION 19000 $210.00
503690 DRAINAGE OF SKIN ABSCESS 10061 $380.00
503691 BIOPSY OF UTERUS LINING 58100 $197.00
503692 BX OF CERVIX W SCOPE LEEP 57460 $559.00
503693 DRAINAGE OF GLAND ABSCESS 56420 $271.00
503694 FETAL BIOPHYS PROFIL W O NST 76819 $191.00
503695 INJ FLIGRASTIM 300 MCG J1442 $699.00
503696 BIOPSY OF VULVA PERINEUM 56605 $160.00
503697 ENDOCERVICAL CURETTAGE 57505 $203.00
503698 US EXAM ABDOM COMPLETE 76700 $71.00
503699 FINE NEEDLE ASP W IMAGING 10022 $271.00
503700 BIOPSY OF UTERUS LINING 58100 $188.00
503701 CL‐ FLIGRASTIM G‐CSF PER MCG J1442 $3.00
503702 BIOPSY OF THYROID 60100 $250.00
503703 TANGENTIAL BX SKIN SINGLE LESION 11102 $194.00
503704 TANGENTIAL BX SKIN LESION EA ADDITIONAL 11103 $108.00
503705 PUNCH BX SKIN LESION SINGLE 11104 $254.00
503706 PUNCH BX SKIN LESION EACH ADDITIONAL 11105 $121.00
503707 INCISIONAL BX SKIN LESION SINGLE 11106 $301.00
503708 INCISIONAL BX SKIN LESION EACH ADDITIONA 11107 $139.00
503709 RPLC GTUBE WO IMAGING W REVISION 43763 $623.00
503710 DEVELOPMENTAL TEST ADMIN 1ST HR 96112 $251.00
503711 DEVELOPMENTAL TEST ADMIN ADDTL 30 MIN 96113 $112.00
503712 CHANGE OF WINDPIPE AIRWAY 31502 $65.00
503713 EXC BENIGN LESION UP TO 0 5 CM 11420 $222.00
503714 CL‐ STATE HEP B 3 DOSE PED/ADOL RECOMB 90744 $0.01
503715 GASTROSTOMY TUBE PLCMT 43762 $400.00
503716 INS PICC 5YR+ WO IMAGE 36569 $212.00
503717 BX DONE W COLPOSCOPY ADDON 58110 $101.00
503718 TX FIBULA FX 27780 $542.00
503719 CL‐ STATE ROTAVIRUS 3 DOSE VAC 90680 $0.00
503720 PALIPERIDIONE PALMITATE INJ 117MG PER 75 J2426 $3,157.00
503721 OB US LESS THAN 14 WKS SNGL FETUS ‐ ER 76801 $277.00
503722 DIPHENHYDRAMINE HCL INJ J1200 $3.00
503723 ENDOCERVICAL CURETTAGE W SCOPE 57456 $310.00
503724 LDCT LUNG CANCER SCR READ G0297 $100.00
503725 DIPHENHYDRAMINE CAPSULE 25MG J3490 $1.00
503726 RPR SUPERFICIAL WOUNDS 12011 $219.00
503727 CL‐ METOCLOPRAMIDE 10 MG TABLET J3490 $1.00
503728 EPINEPHRINE 1‐1000 INJ 1MG/1ML J0171 $56.00
503729 CL‐ CEFAZOLIN INJECTION 500MG J0690 $5.00
503730 EPIFIX PER SQ CM Q4186 $287.00
503731 INCISION OF ANAL ABSCESS 46050 $376.00
503732 US EXTREMITY STUDY 93971 $217.00
503733 US EXAM ABDO BACK WALL COMP 76770 $202.00
503734 DRAINAGE OF PILONIDAL CYST 10080 $329.00
503735 COLOGUARD REPORT $0.00
503736 DEBRIDE SUBQ TISSUE 20 SQ CM OR LESS 11042 $228.00
503737 REPAIR SIMPLE 2.5 CM OR LESS 12001 $183.00
503738 TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDO 28011 $600.00
503739 US LIMITED 76882 $102.00
503740 US OB FOLLOW UP PER FETUS 76816 $258.00
503741 PESSARY NON RUBBER ANY TYPE A4562 $119.00
503742 N BLOCK INJ FEM SINGLE 64447 $217.00
503743 US URINE CAPACITY MEASURE $23.00
503744 US URINE CAPACITY MEASURE 51798 $24.00
503745 INJ FORAMEN EPIDURAL LS $406.00
503746 CL‐ BCG LIVE INTRAVESICAL 1 MG J9030 $5.00
503747 INJ FORAMEN EPIDURAL L S 64483 $406.00
503748 INS PICC LINE WO IMAGING 36569 $168.00
503749 US EXAM CHEST 76604 $201.00
503750 VASCULAR LAB BILATERAL EXTREMITY STUDY 93970 $444.00
503751 US EXAM PELVIC LIMITED 76857 $87.00
503752 CL‐ RABIES IMMUNE GLOBULIN 1 ML 90375 $1,466.00
503753 HANDLING CONVEYANCE SPECIMEN 99000 $23.00
503754 SOTRADECOL 1% 2 ML VL SODIUM TETRADECYL J3490 $305.00
503755 CL‐ OB US LESS 14 WKS SNGL FETUS 76801 $230.00
503757 CL‐ STATE HPV VAC GARDASIL 9 90651 $0.01
503758 CL‐ PREDNISOLONE 15MG 5ML ORAL SOLN $2.00
503759 STRAPPING ELBOW OR WRIST 29260 $64.00
503760 EXC OF LOCAL LESION OF EPIDIDYMIS 54830 $796.00
503761 CL‐ IUD MIRENA J7298 $1,178.00
503762 PROGRAM INTAKE ASSESSMENT IEP T1023 $68.00
503765 CL‐ DEPO MEDROL 20 MG 1 ML VIAL J1020 $42.00
503766 CL‐ EPOETIN ALFA 100 UNITS ESRD Q4081 $2.00
503767 CL‐ DIHYDROERGOTAMINE INJ (DHE) J1110 $205.00
503769 REMOVE IMPACTED EAR WAX UNI 69209 $27.00
503999 CLINIC BASED PRO CHARGE TEMPLATE $0.00
506001 CHIRO NEW PATIENT OFFICE VISIT L1 99201 99201 $95.00
506002 CHIRO NEW PATIENT OFFICE VISIT L2 99202 99202 $155.00
506003 CHIRO NEW PATIENT OFFICE VISIT L3 99203 99203 $266.00
506004 CHIRO NEW PATIENT OFFICE VISIT L4 99204 99204 $352.00
506005 CHIRO NEW PATIENT OFFICE VISIT L5 99205 99205 $320.00
506006 CHIRO EST PATIENT OFFICE VISIT L1 99211 99211 $42.00
506007 CHIRO EST PATIENT OFFICE VISIT L2 99212 99212 $98.00
506008 CHIRO EST PATIENT OFFICE VISIT L3 99213 99213 $182.00
506009 CHIRO EST PATIENT OFFICE VISIT L4 99214 99214 $236.00
506010 CHIRO EST PATIENT OFFICE VISIT L5 99215 99215 $222.00
506011 CHIRO OFFICE CONSULT L1 99241 99241 $129.00
506012 CHIRO OFFICE CONSULT L2 99242 99242 $125.00
506013 CHIRO OFFICE CONSULT L3 99243 99243 $126.00
506014 CHIRO OFFICE CONSULT L4 99244 99244 $145.00
506015 CHIRO OFFICE CONSULT L5 99245 99245 $164.00
506051 CHIRO HOT COLD PACK 97010 $30.00
506052 CHIRO ELECTRICAL STIMULATION 97014 $53.00
506053 CHIRO ELECTRICAL STIMULATION EA 15 MIN 97032 $54.00
506054 CHIRO ULTRASOUND EA 15 MIN 97035 $42.00
506055 CHIRO THERAPEUTIC EXERCISE EA 15 MIN 97110 $152.00
506056 CHIRO NEUROMUSCULAR REEDUCATION 15 MIN 97112 $120.00
506057 CHIRO MANUAL THERAPY TECHNIQUE EA 15 MIN 97140 $116.00
506058 CHIRO THERAPEUTIC ACTIVITIES EA 15 MIN 97530 $116.00
506059 CHIRO SELF CARE HOME TRAINING EA 15 MIN 97535 $101.00
506060 CHIRO CMT SPINAL 1 OR 2 REGIONS 98940 $103.00
506061 CHIRO CMT SPINAL 3 OR 4 REGIONS 98941 $156.00
506062 CHIRO CMT EXTRASPINAL 1 OR MORE REGIONS 98943 $197.00
506063 CHIRO STRAPPING OF CHEST 29200 $119.00
506064 CHIRO CASTING STRAPPING PROCEDURE 29799 $119.00
506065 CHIRO EST PATIENT OFFICE VISIT LEVEL 4 99214 $198.00
506101 CHIRO CERVICAL PILLOW E0190 $38.00
506102 CHIRO CERVICAL COLLAR L0120 $26.00
506103 CHIRO LUMBAR SUPPORT L0625 $65.00
506104 CHIRO LUMBOSACRAL BRACE L0628 $71.00
506105 CHIRO HIP STRAPPING 29520 $64.00
506999 CHIROPRACTOR PRO CHARGE TEMPLATE $0.00
510005 FINE NEEDLE ASP W IMG GUIDANCE 10005 $258.00
510021 FINE NEEDLE ASPIRATION W O IMAGING 10021 $253.00
510022 FNA W IMAGE 10022 $332.00
510040 ACNE SURGERY 10040 $227.00
510060 INCISION DRAINAGE OF ABSCESS 10060 $376.00
510061 I D ABSCESS COMPLICATED MULTIPLE 10061 $723.00
510080 I D PILONIDAL CYST SIMPLE 10080 $403.00
510081 DRAINAGE OF PILONIDAL CYST 10081 $656.00
510120 INCISION REMOVAL FOREIGN BODY 10120 10120 $420.00
510121 REMOVE FOREIGN BODY 10121 $691.00
510140 I D OF HEMATOMA 10140 $507.00
510160 PUNCTURE ASPIRATION ABSCESS OR HEMATOMA 10160 $406.00
510180 I D COMPLEX POST OP WOUND 10180 $464.00
511000 DEBRIDE INFECTED SKIN 11000 $120.00
511004 DEBRIDGE GENITALIA & PERINEUM 11004 $1,173.00
511005 DEBRIDE ABDOM WALL 11005 $1,502.00
511010 DEBRIDE SKIN AT FRACTURE SITE 11010 $1,175.00
511012 DEB SKIN BONE AT FX SITE 11012 $1,572.00
511042 DEBRIDE SKIN SUBCUTANEOUS UP TO 20 SQCM 11042 $249.00
511043 DEBRIDE TISSUE MUSCLE 20 SQ CM OR LESS 11043 $583.00
511044 DEBRIDE TISSUE MUSCLE BONE 11044 $1,290.00
511045 DEB SUBQ TISSUE ADD‐ON 11045 $84.00
511046 DEBRIDEMENT MUSCLE FASCIA EA ADDTL 20 SQ 11046 $152.00
511055 PARING OR CUTTING BENIGN LESION SINGLE 11055 $71.00
511056 PARING OR CUTTING BENIGN LESION 2‐4 11056 $84.00
511057 PARING OR CUTTING BENIGN LESION OVER 4 11057 $105.00
511100 BIOPSY SKIN LESION SUBCUT 11100 $299.00
511101 BX EACH ADD L SKIN LESION 11101 11101 $160.00
511104 PUNCH BX SKIN SNGL LESION 11104 $222.00
511105 PUNCH BX SKIN EA ADDL 11105 $109.00
511200 REMOVAL OF SKIN TAGS UP TO 15 11200 $298.00
511201 REMOVAL OF SKIN TAGS EACH ADDITIONAL 10 11201 $106.00
511300 SHAVE SKIN LESION UP TO 0 5 CM T A L 11300 $193.00
511301 SHAVE SKIN LESION 0 6 TO 1 0 CM T A L 11301 $323.00
511302 SHAVE SKIN LESION 1 1 TO 2 0 CM T A L 11302 $375.00
511303 SHAVE SKIN LESION GREATER 2 0 CM T A L 11303 $213.00
511305 SHAVE SKIN LESION UP TO 0 5 CM S N H F G 11305 $221.00
511306 SHAVE SKIN LESION 0 6 TO 1 CM S N H F G 11306 $272.00
511310 SHAVE SKIN LESION UP TO 5 CM F E EL N L 11310 $232.00
511311 SHAVE SKIN LESION 0 6 TO 1 CM F E EL N L 11311 $263.00
511312 SHAVE SKIN LESION 1 1 2 0 CM 11312 $277.00
511400 LESION DIAM UP TO 0 5 CM EXC 11400 $273.00
511401 EXC TR EXT B9 MARG 0.6 1 CM 11401 $302.00
511402 EXC BENIGN LESION 1 1 TO 2 0 CM 11402 $523.00
511403 EXC BENIGN LESION 2 1 TO 3 0 CM 11403 $862.00
511404 EXC BENIGN LESION 3 1 TO 4 0 CM 11404 $738.00
511406 EXC BENIGN LESION GREATER THAN 4 CM 11406 $1,212.00
511420 EXC BENIGN LESION UP TO 0 5 CM 11420 $377.00
511421 EXC BENIGN LESION 0 6 TO 1 0 CM 11421 $608.00
511422 EXC BENIGN LESION 1 1 TO 2 0 CM 11422 $783.00
511423 EXC LESION SCALP ETC 2‐3 CM 11423 $802.00
511424 EXC BENIGN LESION 3 1 TO 4 0 CM 11424 $525.00
511426 EXC BENIGN LESION GREATER THAN 4 0 CM 11426 $696.00
511441 EXC BENIGN LESION 0 6 TO 1 0 CM 11441 $590.00
511442 LESION DIAM 1 0 CM TO 2 0 CM E 11442 $663.00
511443 EXC BENIGN LESION 2 1 TO 3 0 CM 11443 $811.00
511444 EXC BENIGN LESION 3 1 TO 4 0 CM 11444 $563.00
511462 EXC SKIN SUBC TISSUE FOR HIDRADENITIS 11462 $840.00
511470 REMOVAL SWEAT GLAND LESION 11470 $916.00
511601 EXC MALIGNANT LESION 0 6 CM TO 1 0 CM 11601 $566.00
511602 EXC MALIGNANT LESION 1 1 CM TO 2 0 CM 11602 $763.00
511603 EXC LESION TRUNK ETC 2‐3 CM 11603 $941.00
511604 EXC TR EXT MLG MARG 3 TO 4 CM 11604 $526.00
511606 EXC MALIGNANT LESION GREATER 4 0 CM 11606 $1,210.00
511620 EXC MALIGNANT LESION UP TO 0 5 CM 11620 $575.00
511621 EXC MALIGNANT LESION 0 6 TO 1 0 CM 11621 $502.00
511622 EXC MALIGNANT LESION 1 1 TO 2 0 CM 11622 $747.00
511623 EXC S N H F G MAL MRG 2 1 3 11623 $581.00
511624 EXC MALIGNANT LESION 3 1 TO 4 0 CM 11624 $1,127.00
511640 EXC MALIGNANT LESION UP TO 0 5 CM 11640 $596.00
511641 LESION 0 5 CM TO 1 0 CM DIAM 11641 $876.00
511642 EXC MALIGNANT LESION 1 1 TO 2 0 CM 11642 $873.00
511643 EXC MALIGNANT LESION 2 1 TO 3 0 CM 11643 $698.00
511644 EXC MALIGNANT LESION 3 1 TO 4 0 CM 11644 $828.00
511646 EXC MALIGNANT LESION GREATER THAN 4 0 CM 11646 $1,028.00
511719 TRIMMING OF NONDYSTROPHIC NAILS 11719 $27.00
511720 DEBRIDEMENT OF NAIL ANY METHOD 11720 $74.00
511721 DEBRIDEMENT OF NAIL ANY METHOD 6 PLUS 11721 $103.00
511730 EXCISION NAIL PLATE SINGLE 11730 $267.00
511732 EXCISION EACH ADDITIONAL NAIL PLATE 11732 $107.00
511740 EVACUATE SUBUNGUAL HEMATOMA 11740 $149.00
511750 REMOVAL OF NAIL BED 11750 $469.00
511752 REMOVE NAIL BED TIP 11752 $660.00
511755 BIOPSY NAIL UNIT 11755 $273.00
511760 REPAIR OF NAIL BED 11760 $324.00
511765 WEDGE EXCISION SKIN NAIL FOLD 11765 $323.00
511770 EXC OF A PILONIDAL CYST OR SINUS SIMPLE 11770 $658.00
511771 REMOVE PILONIDAL CYST EXTENSIVE 11771 $1,210.00
511928 REMOVE DRUG IMPLANT DEVICE 11982 $329.00
511976 REMOVE CONTRACEPTIVE CAPSULE 11976 $317.00
511981 INSERTION NONBIODEGRADABLE DRUG DELIVE 11981 $318.00
511982 REMOVE DRUG IMPLANT DEVICE 11982 $313.00
512001 SUTURE SIMPLE LACERATION A 12001 $200.00
512002 SUTURE SIMPLE LACERATION 12002 $262.00
512004 SUTURE SIMPLE LACERATION 12004 $328.00
512005 SIMPLE REPAIR SUPERFICIAL WOUNDS 12005 $336.00
512006 REPAIR WOUNDS S N A GEN TRK 20 1‐30 0 CM 12006 $420.00
512011 SUTURE SIMPLE LACERATION 12011 $247.00
512013 SUTURE SIMPLE LACERATION 12013 $259.00
512014 SUTURE SIMPLE LACERATION 12014 $436.00
512015 REPAIR WOUNDS FE E EN L M 7 6‐12 5 CM 12015 $347.00
512016 REPAIR WOUNDS FE E EN L M 12 6‐20 0 CM 12016 $445.00
512020 CLOSURE OF SPLIT WOUND 12020 $742.00
512021 CLOSURE OF SPLIT WOUND 12021 $351.00
512031 LAYER CLOSURE WOUNDS SCALP 12031 $656.00
512032 INTERMEDIATE REPAIR WND SCALP E 12032 $981.00
512034 LAYER CLOSURE WOUNDS SCALP ETC 12034 $943.00
512035 INTMD RPR S A T EXT 12 6‐20 12035 $771.00
512037 INTMD RPR S TR EXT GREATER THAN 30 CM 12037 $928.00
512041 LAYER CLOSURE WND NECK ETC TO 2 12041 $583.00
512042 LAYER CLOSURE WOUND NECK ETC 12042 $861.00
512044 REPAIR INTMD WND NECK HAND FEET OR EXT G 12044 $762.00
512045 REPAIR INTMD WND NHFG 12045 $770.00
512051 LAYER CLOSURE WOUNDS FACE ETC 12051 $781.00
512052 LAYER CLOSURE WOUNDS FACE ETC 12052 $991.00
512053 INTERMED REPAIR FACE MM 12053 $759.00
512054 INTMD RPR FACE MM 7 6 12 5 CM 12054 $666.00
513120 CMPLX RPR S A L 1 1 2 5 13120 $649.00
513121 COMPLEX REPAIR S A L 13121 $904.00
513122 CMPLX RPR S A L ADD 5 CM OR LESS 13122 $271.00
513131 CMPLX RPR F C C M N AX G H F 13131 $679.00
513132 COMPLEX REPAIR F C C M N AX G H F 13132 $1,127.00
513160 LATE CLOSURE OF WOUND 13160 $1,903.00
514000 TIS TRNFR TRUNK 10 SQ CM 14000 $1,090.00
514040 ADJ TISSUE TRANS OR REARRANGEMENT 14040 $1,959.00
514041 TISSUE TRANSFER OR REARRANGE 10 TO 30CM 14041 $1,922.00
514350 FILLETED FINGER TOE FLAP 14350 $1,427.00
515002 SURG WOUND PREP TRK ARM LEG 1ST 100 SQCM 15002 $654.00
515003 WOUND PREP ADDL 100 CM 15003 $130.00
515004 SURG PREP OR CREATION OF RECIP SITE 15004 $908.00
515100 SKIN SPLIT GRAFT TRUNK ARM LEG 15100 $1,731.00
515101 SKIN SPLT GRFT T A L ADD ON 15101 $361.00
515120 SKN SPLT A GRAFT FAC NCK HF G 15120 $1,576.00
515240 SKIN FULL GRFT FACE GENIT HF 15240 $1,978.00
515271 SKIN SUB GRAFT TRUNK ARMS LEGS 1ST 25 SQ 15271 $307.00
515272 SKIN SUB GRAFT T A L ADD ON 15272 $56.00
515275 SKIN SUB GRAFT FACE SCALP EYELIDS MOUTH 15275 $384.00
515734 MUSCLE SKIN GRAFT TRUNK 15734 $2,744.00
515783 DERMABRASION SUPERFICIAL ANY SITE 15783 $1,031.00
515839 EXCISE EXCESS SKIN AND TISSUE 15839 $2,067.00
515850 REMOVE SUTURES SAME SURGEON 15850 $0.00
515851 REMOVE SUTURES UNDER ANESTH OTR SURGEON 15851 $184.00
515852 DRESSING CHANGE NOT FOR BURN 15852 $98.00
516000 INITIAL TREATMENT OF BURN S 16000 $139.00
516020 DRESS AND OR DEBRIDE PARTIAL THICK BURNS 16020 $230.00
516025 DRESS DEBRID P THICK BURN M 16025 $272.00
517000 DEST BEN PREM FIRST LESION 17000 $228.00
517003 DEST BEN PREM LESION 2‐14 17003 $25.00
517004 DEST BEN PREM LESION 15 OR MORE 17004 $616.00
517110 DESTRUCTION OF WARTS CRYO 17110 $268.00
517111 DESTRUCTION WARTS MORE THAN 15 17111 17111 $323.00
517250 CHEMICAL CAUTERIZATION GRANULATION TISSU 17250 $167.00
517280 DESTRUCTION OF SKIN LESIONS 17280 $321.00
517281 DESTRUCTION OF SKIN LESIONS FACE 17281 $390.00
519000 ASPIRATION OF BREAST CYST 19000 $237.00
519020 INCISION OF BREAST LESION 19020 $1,389.00
519081 BX BREAST 1ST LESION STEREOTACTIC 19081 $766.00
519083 BX BREAST 1ST LESION US IMAGING 19083 $722.00
519100 BIOPSY BREAST PERCUTANEOUS WO IMAGING 19100 $357.00
519120 EXC CYST FIBROADENOMA OR OTH MAL BEN TUM 19120 $1,881.00
519125 EXC BREAST LESION ID BY PRE OP MARKER 19125 $1,872.00
519281 PERQ DEVICE BREAST 1ST IMAGE 19281 $462.00
519300 REMOVAL OF BREAST TISSUE 19300 $1,110.00
519301 MASTECTOMY PARTIAL 19301 $1,159.00
519302 MASTECTOMY PARTIAL W AXILLARY LYMPHADENE 19302 $2,113.00
519303 MASTECTOMY SIMPLE COMPLETE 19303 $2,223.00
519307 MASTECTOMY MOD RAD 19307 $2,461.00
519316 SUSPENSION OF BREAST 19316 $1,496.00
520103 EXPLORE WOUND EXTREMITY 20103 $1,279.00
520205 DEEP MUSCLE BIOPSY 20205 $674.00
520206 NEEDLE BIOPSY MUSCLE 20206 $464.00
520220 BONE BIOPSY TROCAR NEEDLE 20220 $314.00
520240 BIOPSY BONE OPEN SUPERFICIAL 20240 $441.00
520245 BONE BIOPSY EXCISIONAL 20245 $1,581.00
520501 INJECT SINUS TRACT FOR X RAY 20501 $222.00
520520 REMOVAL OF FOREIGN BODY 20520 $396.00
520525 REMOVAL OF FOREIGN BODY DEEP COMPLICATED 20525 $1,016.00
520526 THER INJECTION CARP TUNNEL 20526 $190.00
520551 INJ SINGLE TENDON ORIGIN/INSERTION $120.00
520552 INJ TRIGGER POINT 1 2 MUSCL 20552 $112.00
520600 ASP INJ SMALL JOINT 20600 $217.00
520604 US DRAIN INJ SMALL JOINT BURSA 20604 $154.00
520605 XR ASP INJ INTERMEDIATE JOINT 20605 $170.00
520606 US DRAIN INJ INTMED JOINT BURSA 20606 $170.00
520610 ASP INJ MAJOR JOINT 20610 $208.00
520611 US DRAIN INJ MAJOR JOINT BURSA 20611 $195.00
520612 ASPIRATE INJ GANGLION CYST 20612 $209.00
520670 REMOVAL OF SUPPORT IMPLANT 20670 $667.00
520680 REMOVAL OF SUPPORT IMPLANT 20680 $1,166.00
520690 APPLY BONE FIXATION DEVICE 20690 $1,148.00
520692 APPLY BONE FIXATION DEVICE 20692 $2,167.00
520694 REMOVE BONE FIXATION DEVICE 20694 $824.00
520900 REMOVAL OF BONE FOR GRAFT 20900 $857.00
520931 SP BONE ALGRFT STRUCT ADD ON 20931 $253.00
520983 ABLATE BONE TUMOR PERQ CRYO W GUIDANCE 20983 $1,614.00
521012 EXC FACE LES SBQ 2 CM 21012 $690.00
521501 DRAIN NECK CHEST LESION 21501 $929.00
521550 BIOPSY NECK OR CHEST 21550 $513.00
521552 EXC NECK LES SC 3 CM 21552 $975.00
521931 EXC BACK LES SC 3 CM 21931 $860.00
522551 NECK SPINE FUSE REMOV BEL C2 22551 $3,857.00
522552 ADDL NECK SPINE FUSION 22552 $900.00
522845 INSERT SPINE FIXATION DEVICE 22845 $1,649.00
522853 INSJ BIOMECHANICAL DEVICE 22853 $564.00
522903 EXC ABD LES SC 3 CM 22903 $845.00
522999 ABDOMEN SURGERY PRCEDURE 22999 $1,447.00
523000 REMOVAL OF CALCUIM DEPOSITS 23000 $1,080.00
523073 EXC SHOULDER TUM DEEP 5 CM 23073 $1,405.00
523120 PARTIAL REMOVAL COLLAR BONE 23120 $1,296.00
523130 ACROMIOPLASTY ACROMIONECTOMY PARTIAL WWO 23130 $1,693.00
523330 REMOVE SHOULDER FOREIGN BODY 23330 $510.00
523350 INJECTION FOR SHOULDER X‐RAY 23350 $234.00
523405 TENOTOMY SHOULDER AREA SINGLE TENDON 23405 $1,715.00
523410 REPAIR ROTATOR CUFF ACUTE 23410 $1,748.00
523412 REPAIR ROTATOR CUFF CHRONIC 23412 $3,457.00
523420 RECONSTRUCTION COMPLETE SHOULDER CUFF AV 23420 $3,493.00
523430 TENODESIS LONG TENDON BICEPS 23430 $2,693.00
523472 RECONSTRUCT SHOULDER JOINT 23472 $2,524.00
523480 REVISION OF COLLAR BONE 23480 $1,496.00
523515 OPEN TREATMENT CLAVICULAR FX WWO FIXATI 23515 $1,955.00
523550 TREAT CLAVICLE DISLOCATION 23550 $1,028.00
523552 TREAT CLAVICLE DISCLOCATION 23552 $1,147.00
523575 TREAT SHOULDER BLADE FX 23575 $892.00
523605 TREAT HUMERUS FRACTURE 23605 $1,064.00
523615 TREAT HUMERUS FRACTURE 23615 $1,862.00
523630 TREAT HUMERUS FRACTURE 23630 $1,647.00
523650 CLOSED TRMT OF SHOULDER DISLOCATION 23650 $1,320.00
523655 CLOSED TX SHLDR DISLOC W MANIP REQ ANES 23655 $867.00
523675 TREAT DISLOCATION FRACTURE 23675 $1,156.00
523680 TREAT DISLOCATION FRACTURE 23680 $1,889.00
523700 MANIPULATION W ANES SHOULDER JOINT W FIX 23700 $580.00
523929 SHOULDER SURGERY PROCEDURE 23929 $897.00
523931 DRAINAGE OF ARM BURSA 23931 $534.00
524000 EXPLORATORY ELBOW SURGERY 24000 $968.00
524071 EXC ARM ELBOW LES SC 3 CM 24071 $784.00
524075 EXC ARM OR ELBOW LES SC LESS THAN 3 CM 24075 $1,032.00
524101 EXPLORE TREAT ELBOW JOINT 24101 $963.00
524105 REMOVAL OF ELBOW BURSA 24105 $747.00
524147 PARTIAL REMOVAL OF ELBOW 24147 $1,204.00
524341 REPAIR ARM TENDON MUSCLE 24341 $1,512.00
524342 REPAIR OF RUPTURED TENDON 24342 $1,650.00
524357 REPAIR ELBOW PERC 24357 $876.00
524358 TENOTOMY ELBOW LAT OR MED DEBRIDEMENT 24358 $1,367.00
524359 TENOTOMY ELBOW LAT OR MED EPICONDYLITIS 24359 $1,399.00
524430 REPAIR OF HUMERUS 24430 $1,945.00
524505 TREAT HUMERUS FRACTURE 24505 $964.00
524515 TREAT HUMERUS FRACTURE 24515 $1,754.00
524516 TX HUMERAL SHAFT FX W INSERT IMPLANT 24516 $1,827.00
524535 TREAT HUMERUS FRACTURE 24535 $1,194.00
524579 TX HUMERUS FX 24579 $1,758.00
524600 CLOSED TREATMENT ELBOW DISLOCATION 24600 $1,379.00
524605 TREAT ELBOW DISLOCATION 24605 $906.00
524640 CLOSED TREAT OF RADIAL HEAD SUBLUXATION 24640 $381.00
524655 TREAT RADIUS FRACTURE 24655 $924.00
524665 TREAT RADIUS FRACTURE 24665 $1,328.00
524666 TREAT RADIUS FRACTURE 24666 $1,416.00
524685 TREAT ULNAR FRACTURE 24685 $1,325.00
525000 INCISION EXTENSOR TENDON SHEATH WRIST 25000 $1,083.00
525028 DRAINAGE OF FOREARM LESION 25028 $1,116.00
525071 EXC FOREARM LESION SC 3 CM 25071 $933.00
525101 EXPLORE TREAT WRIST JOINT 25101 $858.00
525111 EXC GANGLION WRIST PRIM DORSAL OR VOLAR 25111 $1,085.00
525115 REMOVE WRIST OR FOREARM LESION 25115 $1,595.00
525246 INJECTION FOR WRIST X‐RAY 25246 $383.00
525248 REMOVE FOREARM FOREIGN BODY 25248 $753.00
525295 RELEASE WRIST FOREARM TENDON 25295 $1,153.00
525400 REPAIR RADIUS OR ULNA 25400 $1,685.00
525505 TX FX OF RADIUS 25505 $967.00
525545 TREAT FRACTURE OF ULNA 25545 $1,532.00
525565 TREAT FRACTURE RADIUS AND ULNA 25565 $951.00
525575 TREAT FRACTURE RADIUS ULNA 25575 $1,644.00
525600 TREAT FRACTURE RADIUS ULNA 25600 $673.00
525605 TREAT FX DISTAL RADIAL W MANIPULATION 25605 $1,634.00
525606 TREAT FX DISTAL RADIAL 25606 $1,410.00
525607 TREAT FX RAD EXTRA ARTICULAR 25607 $2,013.00
525608 TREAT FX RAD INTRA‐ARTICULAR 25608 $2,108.00
525609 OPEN TX DISTAL RADIAL INTRAARTICULAR FX 25609 $2,167.00
525645 TREAT WRIST BONE FRACTURE 25645 $1,254.00
525651 PIN ULNAR STYLOID FRACTURE 25651 $1,029.00
525652 TREAT FRACTURE ULNAR STYLOID 25652 $1,274.00
526010 DRAINAGE OF FINGER ABSCESS 26010 $579.00
526011 DRAINAGE OF FINGER ABSCESS 26011 $819.00
526055 INCISE FINGER TENDON SHEATH 26055 $1,420.00
526070 EXPLORE/TREAT HAND JOINT 26070 $662.00
526080 EXPLORE TREAT FINGER JOINT 26080 $790.00
526105 BIOPSY FINGER JOINT LINING 26105 $718.00
526110 BIOPSY FINGER JOINT LINING 26110 $684.00
526113 EXC HAND TUM DEEP 1 5 CM 26113 $1,063.00
526115 EXC HAND LES SC < 1 5 CM 26115 $1,038.00
526121 RELEASE PALM CONTRACTURE 26121 $1,154.00
526123 FASCIECTOMY PARTIAL PALMAR WITH RELEASE 26123 $1,731.00
526125 RELEASE PALM CONTRACTURE 26125 $576.00
526160 EXC LESION OF TENDON SHEATH OR 26160 $1,508.00
526210 REMOVAL OF FINGER LESION 26210 $815.00
526340 MANIPULATE FINGER W ANESTHESIA 26340 $763.00
526370 REPAIR FINGER HAND TENDON 26370 $1,456.00
526410 REPAIR HAND TENDON 26410 $1,176.00
526418 REPAIR EXTENSOR TENDON FINGER PRIMARY OR 26418 $1,730.00
526433 REPAIR FINGER TENDON 26433 $1,117.00
526460 INCISE HAND FINGER TENDON 26460 $863.00
526502 HAND TENDON RECONTRUCTION 26502 $1,429.00
526525 RELEASE FINGER CONTRACTURE 26525 $1,355.00
526540 REPAIR HAND JOINT 26540 $1,368.00
526541 REPAIR HAND JOINT WITH GRAFT 26541 $1,624.00
526546 REPAIR NONUNION HAND 26546 $2,014.00
526567 CORRECT FINGER DEFORMITY 26567 $1,505.00
526605 TREAT METACARPAL FRACTURE 26605 $887.00
526608 PERCUTANEOUS SKELETAL FIX OF METACARPAL 26608 $1,180.00
526615 OPEN TX METACARPAL FX SINGLE EACH BONE 26615 $1,272.00
526670 TREAT HAND DISLOCATION 26670 $749.00
526675 TREAT HAND DISLOCATION 26675 $798.00
526685 TREAT HAND DISLOCATION 26685 $1,114.00
526715 TREAT KNUCKLE DISLOCATION 26715 $1,216.00
526725 CLOSED TREATMENT PHAL SHAFT 26725 $1,143.00
526727 TX FINGER FX EACH 26727 $1,118.00
526735 TREAT FINGER FRACTURE EACH 26735 $1,318.00
526742 TREAT FINGER FRACTURE EACH 26742 $815.00
526746 TREAT FINGER FRACTURE EACH 26746 $1,360.00
526755 TREAT FINGER FRACTURE EACH 26755 $1,164.00
526756 PIN FINGER FRACTURE EACH 26756 $879.00
526765 TREAT FINGER FRACTURE EACH 26765 $1,062.00
526770 CLOSED TREATMETN IP JOINT DISLOCATION 26770 $1,433.00
526775 TX FINGER DISLOCATION 26775 $849.00
526785 TREAT FINGER DISLOCATION 26785 $1,208.00
526951 AMPUTATION OF FINGER THUMB 26951 $1,723.00
526952 AMPUTATION OF FINGER THUMB 26952 $1,236.00
527033 EXPLORATION OF HIP JOINT 27033 $2,046.00
527043 EXC HIP PELVIS LES SC 3 CM 27043 $992.00
527045 EXC HIP PELV TUM DEEP 5 CM 27045 $1,371.00
527060 EXCISION ISCHIAL BURSA 27060 $990.00
527093 INJECTION FOR HIP X‐RAY 27093 $443.00
527096 INJECT SACROILIAC JOINT 27096 $320.00
527100 TRANSFER OF ABDOMINAL MUSCLE 27100 $1,756.00
527122 ACETABULOPLASTY RESECTION FEMORAL HEAD 27122 $2,753.00
527130 ARTHROPLASTY TOTAL HIP W WO AUT 27130 $5,455.00
527222 TREAT HIP SOCKET FRACTURE 27222 $2,135.00
527235 TREAT THIGH FRACTURE 27235 $1,765.00
527236 OPEN TREATMENT FEMORAL FX PROXIMAL END 27236 $2,688.00
527244 TREAT THIGH FRACTURE 27244 $2,264.00
527245 OPEN TREATMENT THIGH FX INTER PER SUBTRO 27245 $3,537.00
527252 TREAT HIP DISLOCATION 27252 $1,461.00
527269 OPEN TREATMENT THIGH FRACTURE 27269 $2,618.00
527301 I D DEEP ABSCESS BURSA OR HEMATOMA THIGH 27301 $1,314.00
527306 INCISION OF THIGH TENDON 27306 $733.00
527310 EXPLORATION OF KNEE JOINT 27310 $1,537.00
527328 EXC TUMOR THIGH KNEE AREA SUBFAS LT5CM 27328 $1,160.00
527334 REMOVE KNEE JOINT LINING 27334 $1,320.00
527340 EXCISION OF PREPATELLAR BURSA 27340 $780.00
527345 REMOVAL OF KNEE CYST 27345 $1,012.00
527347 REMOVE KNEE CYST 27347 $1,021.00
527350 PATELLECTOMY OR HEMIPATELLECTOMY 27350 $1,257.00
527372 REMOVAL OF FOREIGN BODY 27372 $1,239.00
527380 REPAIR OF KNEECAP TENDON 27380 $1,253.00
527385 REPAIR OF THIGH MUSCLE 27385 $1,063.00
527405 REPAIR OF KNEE LIGAMENT 27405 $1,370.00
527422 REVISION OF UNSTABLE KNEECAP 27422 $1,580.00
527446 REVISION OF KNEE JOINT 27446 $2,947.00
527447 ARTHROPLASTY KNEE CONDYLE AND P 27447 $6,107.00
527486 REVISION TOTAL KNEE ARTHROPLASTY W WO AL 27486 $4,416.00
527488 REMOVAL OF KNEE PROSTHESIS 27488 $2,443.00
527506 TX OF THIGH FX 27506 $2,725.00
527514 TX THIGH FX 27514 $1,674.00
527524 TREAT KNEECAP FRACTURE 27524 $1,582.00
527532 TREAT KNEE FRACTURE 27532 $1,131.00
527535 TREAT KNEE FRACTURE 27535 $1,905.00
527536 TREAT KNEE FRACTURE 27536 $2,421.00
527552 TREAT KNEE DISLOCATION 27552 $1,317.00
527560 TREAT KNEECAP DISLOCATION 27560 $767.00
527566 TREAT KNEECAP DISLOCATION 27566 $1,874.00
527570 FIXATION OF KNEE JOINT 27570 $510.00
527599 UNLISTED PROCEDURE FEMUR OR KNEE 27599 $510.00
527600 DECOMPRESSION OF LOWER LEG 27600 $838.00
527603 DRAIN LOWER LEG LESION 27603 $978.00
527605 TENOTOMY PERCUTANEOUS ACHILLES TENDON 27605 $797.00
527606 TENOTOMY PERCUTANEOUS ACHILLES TENDON 27606 $761.00
527612 EXPLORATION OF ANKLE JOINT 27612 $1,151.00
527618 EXC LEG ANKLE TUM LESS THAN 3 CM 27618 $879.00
527626 REMOVE ANKLE JOINT LINING 27626 $1,175.00
527630 EXC LESION TENDON SHEATH OR CAPSULE 27606 $1,453.00
527632 EXC LEG ANKLE LES SC 3 CM 27632 $802.00
527635 REMOVE LOWER LEG BONE LESION 27635 $1,140.00
527638 REMOVE GRAFT LEG BONE LESION 27638 $1,703.00
527640 PARTIAL REMOVAL OF TIBIA 27640 $1,619.00
527648 INJECTION FOR ANKLE X‐RAY 27648 $384.00
527650 REPAIR PRIMARY OPEN PERCUTANEOUS RUPTURE 27650 $2,956.00
527652 REPAIR GRAFT ACHILLES TENDON 27652 $1,469.00
527654 REPAIR OF ACHILLES TENDON 27654 $1,661.00
527658 REPAIR OF LEG TENDON EACH 27658 $763.00
527659 REPAIR FLEXOR TENDON LEG SECONDARY EACH 27659 $1,366.00
527664 REPAIR EXTENSOR TENDON LEG PRIMARY EACH 27664 $1,054.00
527665 REPAIR OF LEG TENDON EACH 27665 $835.00
527675 REPAIR PERONEAL TENDON WO FIBULAR OSTEOT 27675 $1,623.00
527676 REPAIR LOWER LEG TENDONS 27676 $1,524.00
527680 RELEASE OF LOWER LEG TENDON 27680 $830.00
527685 REVISION LOWER LEG TENDON 27685 $1,635.00
527687 REV CALF TENDON GASTROCNEMIUS RECISION 27687 $1,370.00
527690 REVISE LOWER LEG TENDON 27690 $1,347.00
527691 REVISE LOWER LEG TENDON DEEP 27691 $1,968.00
527692 REVISE ADDITIONAL LEG TENDON 27692 $203.00
527695 REPAIR OF ANKLE LIGAMENT 27695 $2,165.00
527696 REPAIR PRIMARY DISRUPTED LIGAMENT ANKLE 27696 $1,504.00
527698 REPAIR OF ANKLE LIGAMENT 27698 $1,644.00
527705 INCISION OF TIBIA 27705 $1,601.00
527752 CLOSED TX TIBIAL SHAFT FX W MANIP WWO TR 27752 $1,132.00
527759 TREATMENT OF TIBIA FRACTURE 27759 $1,927.00
527766 OPTX MEDIAL ANKLE FX 27766 $1,305.00
527784 TREATMENT OF FIBULA FRACTURE 27784 $1,389.00
527788 TX OF ANKLE FX 27788 $889.00
527792 OPEN TX OF DISTAL FIBULAR FX INC INT FIX 27792 $2,155.00
527810 TREATMENT OF ANKLE FRACTURE 27810 $903.00
527814 OPEN TX OF BIMALLEOLAR ANKLE FX 27814 $1,876.00
527818 TREATMENT OF ANKLE FRACTURE 27818 $2,163.00
527822 OPEN TX OF TRIMALLEOLAR ANKLE FX INC INT 27822 $2,247.00
527823 OPEN TX TRIMALLEOLAR ANKLE FX INC INT FI 27823 $1,985.00
527827 TX LOWER LEG FX 27827 $2,126.00
527828 TREAT LOWER LEG FRACTURE 27828 $3,058.00
527829 TREAT LOWER LEG JOINT 27829 $1,680.00
527842 CLOSED TX ANKLE DISLOC REQ ANES WWO FIX 27842 $1,058.00
527860 FIXATION OF ANKLE JOIN 27860 $353.00
527870 ARTHRODESIS ANKLE OPEN 27870 $2,849.00
527880 AMPUTATION OF LOWER LEG 27880 $1,939.00
527882 AMPUTATION OF LOWER LEG 27882 $1,275.00
527884 AMPUTATION FOLLOW‐UP SURGERY 27884 $1,218.00
527886 AMPUTATION FOLLOW‐UP SURGERY 27886 $1,393.00
527899 LEG ANKLE SURGERY PROCEDURE 27899 $1,368.00
528005 TX FOOT BONE LESION 28005 $1,013.00
528008 FASCIOTOMY FOOT AND OR TOE 28008 $1,121.00
528020 EXPLORATION OF FOOT JOINT 28020 $1,020.00
528022 EXPLORATION OF FOOT JOINT 28022 $1,115.00
528035 DECOMPRESSION OF TIBIA NERVE 28035 $1,706.00
528039 EXC FOOT TOE TUM SC 1 5 CM 28039 $1,051.00
528041 EXC FOOT TOE TUM DEP 1 5 CM 28041 $896.00
528043 EXC TUMOR FOOT SUBCUTANEOUS 28043 $1,020.00
528052 BIOPSY OF FOOT JOINT LINING 28052 $946.00
528054 BIOSPY OF TOE JOINT LINING 28054 $713.00
528055 NEURECTOMY FOOT 28055 $778.00
528060 PARTIAL REMOVAL FOOT FASCIA 28060 $1,173.00
528080 EXCISION OF INTERDIGITAL MORTO 28080 $1,700.00
528086 EXCISE FOOT TENDON SHEATH 28086 $1,134.00
528090 EXC LESION TENDON SHEATH OR C 28090 $2,081.00
528092 REMOVAL OF TOE LESIONS 28092 $1,860.00
528100 REMOVAL OF ANKLE/HEEL LESION 28100 $1,195.00
528104 REMOVAL OF FOOT LESION 28104 $1,049.00
528107 REMOVE GRAFT FOOT LESION 28107 $1,030.00
528108 REMOVAL OF TOE LESIONS 28108 $1,004.00
528110 PART REMOVAL OF METATARSAL 28110 $1,104.00
528111 PART REMOVAL OF METATARSAL 28111 $883.00
528112 PART REMOVAL OF METATARSAL 28112 $1,154.00
528113 PART REMOVAL OF METATARSAL 28113 $1,478.00
528114 REMOVAL OF METATARSAL HEADS 28114 $2,227.00
528116 OSTECTOMY EXCISION TARSAL COALITION 28116 $2,098.00
528118 OSTECTOMY CALCANEUS 28118 $1,904.00
528119 REMOVAL OF HEEL SPUR 28119 $1,379.00
528120 PART REMOVAL OF ANKLE HEEL 28120 $2,280.00
528122 PARTIAL EXC BONE TARSAL OR META 28122 $1,758.00
528124 PARTIAL EXCISION BONE 28124 $1,546.00
528126 PARTIAL REMOVAL OF TOE 28126 $1,205.00
528160 PARTIAL REMOVAL OF TOE 28160 $837.00
528190 REMOVAL OF FOOT FOREIGN BOD 28190 $702.00
528192 REMOVAL OF FOOT FOREIGN BODY 28192 $936.00
528200 REPAIR TENDON FLEXOR FOOT PRIMARY SECOND 28200 $1,236.00
528202 REPAIR GRAFT OF FOOT TENDON 28202 $1,419.00
528208 REPAIR TENDON EXTENSOR FOOT PRIM OR SEC 28208 $1,197.00
528210 REPAIR GRAFT FOOT TENDON 28210 $1,528.00
528225 RELEASE OF FOOT TENDON 28225 $991.00
528230 INCISION OF FOOT TENDONS 28230 $1,508.00
528232 INCISION OF TOE TENDON 28232 $768.00
528234 INCISION OF FOOT TENDON 28234 $1,108.00
528238 REVISION OF FOOT TENDON 28238 $2,233.00
528270 RELEASE OF FOOT CONTRACTURE 28270 $1,543.00
528285 CORRECTION HAMMERTOE 28285 $1,747.00
528288 OSTECTOMY PARTIAL EXOSTECTOMY 28288 $1,519.00
528289 HALLUS RIGIDUS CORRECTION W/CHE 28289 $2,113.00
528291 CORRJ HALUX RIGDUS W IMPLT 28291 $1,750.00
528292 CORRECTION HALLUX VALGUS WWO SESAMOIDECT 28292 $2,238.00
528293 CORRECTION OF BUNION 28293 $2,841.00
528295 CORRECTION HALLUX VALGUS 28295 $2,149.00
528296 RADICAL EXOSTECTOMY WITH METAT 28296 $2,372.00
528297 CORRECTION HALLUX VALGUS W OR WO SESAMOI 28297 $2,983.00
528298 HALLUX VALGUS BUNION W OR WO 28298 $2,286.00
528299 LAPIDUS TYPE BY DOUBLE OSTEOT 28299 $3,241.00
528300 OSTEOTOMY CALCANEUS W/WO INTERNAL FIXAT 28300 $2,137.00
528304 INCISION OF MIDFOOT BONES 28304 $1,710.00
528306 INCISION OF METATARSAL 28306 $1,160.00
528308 OSTEOTOMY METATARSAL OTHER THAN FIRST TO 28308 $1,745.00
528312 REVISION OF TOE 28312 $1,012.00
528313 REPAIR DEFORMITY OF TOE 28313 $1,549.00
528315 REMOVAL OF SESAMOID BONE 28315 $1,499.00
528322 REPAIR NONUNION MALUNION METATARSAL WWO 28322 $2,250.00
528415 TREAT HEEL FRACTURE 28415 $2,349.00
528435 TREATMENT OF ANKLE FRACTURE 28435 $627.00
528450 TREAT MIDFOOT FRACTURE EACH 28450 $463.00
528465 OPEN TX TARSAL BONE FX INC INT FIX EACH 28465 $1,322.00
528476 TREAT METATARSAL FRACTURE 28476 $689.00
528485 OPEN TREATMENT METATARSAL FX 28485 $2,781.00
528495 TREAT BIG TOE FRACTURE 28495 $366.00
528496 TREAT BIG TOE FRACTURE 28496 $873.00
528505 OPEN TX GREAT TOE FX INC INTERNAL FIX 28505 $1,393.00
528515 TX TOE FX W MANIPULATION 28515 $400.00
528525 TREAT TOE FRACTURE 28525 $1,292.00
528531 TREAT SESAMOID BONE FRACTURE 28531 $686.00
528615 REPAIR FOOT DISLOCATION 28615 $1,434.00
528630 TREAT TOE DISLOCATION 28630 $337.00
528645 REPAIR TOE DISLOCATION 28645 $1,363.00
528660 TREAT TOE DISLOCATION 28660 $251.00
528665 TX TOE DISLOCATION 28665 $349.00
528666 TX TOE DISLOCATION 28666 $384.00
528705 FUSION OF FOOT BONES 28705 $2,178.00
528715 ARTHRODESIS TRIPLE 28715 $2,031.00
528725 FUSION OF FOOT BONES 28725 $1,915.00
528730 FUSION OF FOOT BONES 28730 $1,643.00
528735 FUSION OF FOOT BONES 28735 $1,601.00
528737 REVISION OF FOOT BONES 28737 $1,360.00
528740 ARTHRODESIS GREAT TOE METATARSOPHALANGEA 28740 $1,662.00
528750 ARTHRODESIS GREAT TOE METATARSOPHALENGEA 28750 $2,510.00
528755 FUSION OF BIG TOE JOINT 28755 $1,054.00
528805 AMPUTATION THRU METATARSAL 28805 $1,800.00
528810 AMPUTATION TOE METATARSAL 28810 $1,286.00
528820 AMPUTATION TOE METATARSO‐PHALA 28820 $1,249.00
528825 PARTIAL AMPUTATION OF TOE 28825 $1,079.00
528899 FOOT TOES SURGERY PROCEDURE 28899 $417.00
529075 SHORT ARM CAST ELBOW TO FINGERS 29075 $308.00
529085 APPLY HAND/WRIST GAUNTLET CAST 29085 $259.00
529086 APPLY FINGER CAST 29086 $167.00
529105 ARM SPLINT LONG 29105 $218.00
529125 ARM SPLINT SHORT 29125 $181.00
529126 APPLY FOREARM SPLINT 29126 $201.00
529130 APPLY FINGER SPLINT 29130 $131.00
529200 STRAPPING OF CHEST 29200 $119.00
529240 STRAPPING OF SHOULDER 29240 $87.00
529280 STRAPPING HAND FINGER 29280 $93.00
529345 APPLICATION OF LONG LEG CAST 29345 $278.00
529358 APPLY LONG LEG CAST BRACE 29358 $357.00
529435 APPLY SHORT LEG CAST PTB 29435 $257.00
529445 APPLY RIGID LEG CAST 29445 $232.00
529450 APPLY CLUB FOOT CAST TOTAL CONTACT 29450 $305.00
529505 APPLY LONG LEG SPLINT 29505 $214.00
529515 SHORT LEG SPLINT 29515 $226.00
529520 STRAPPING OF HIP 29520 $108.00
529530 STRAPPING OF KNEE 29530 $109.00
529540 ANKLE FOOT STRAPPING 29540 $83.00
529550 STRAPPING TOES 29550 $53.00
529580 STRAPPING UNNA BOOT 29580 $189.00
529700 REMOVAL REVISION OF CAST 29700 $147.00
529806 SHOULDER ARTHROSCOPY SURGERY 29806 $2,050.00
529807 ARTHOSCOPY SHOULDER SURGICAL REPAIR SLAP 29807 $4,205.00
529819 SHOULDER ARTHROSCOPY SURGERY 29819 $1,372.00
529820 ARTHO SHLDR SURGICAL SYNOVECTOMY PARTIAL 29820 $1,140.00
529822 ARTHOSCOPY SHOULDER SURGICAL DEBRIDEMENT 29822 $2,304.00
529823 ARTHOSCOPY SHOULDER SURGICAL DEBRIDEMENT 29823 $2,337.00
529824 ARTHOSCOPY SHOULDER SURGICAL DISTAL CLAV 29824 $3,034.00
529825 ARTHROSCOPY SHOULDER SURGICAL W LYSIS 29825 $2,483.00
529826 ARTHOSCOPY SHOULDER SURGICAL DECOMPRESSI 29826 $788.00
529827 ARTHOSCOPY SHOULDER SURGICAL W ROTATOR C 29827 $3,736.00
529828 ARTHROSCOPY SHLDR SURGICAL BICEPS TENODE 29828 $2,599.00
529834 ELBOW ARTHROSCOPY SURGERY 29834 $901.00
529838 ELBOW ARTHROSCOPY SURGERY 29838 $1,250.00
529846 WRIST ARTHROSCOPY SURGERY 29846 $1,070.00
529848 ENDOSCOPY WRIST SURGICAL W RELEASE TRANS 29848 $1,607.00
529866 AUTGRFT IMPLNT KNEE W SCOPE 29866 $2,317.00
529870 KNEE ARTHROSCOPY DX 29870 $1,200.00
529873 KNEE ARTHROSCOPY SURGERY 29873 $1,163.00
529874 KNEE ARTHROSCOPY REMOVAL OF LOOSE BODY 29874 $1,379.00
529875 ARTHROSCOPY KNEE SURGICAL SYNOVECTOMY LI 29875 $1,565.00
529876 ARTHROSCOPY KNEE SURG SYNOVECTOMY MAJOR 29876 $1,403.00
529877 ARTHOSCOPY KNEE SURGICAL DEBRIDEMENT SHA 29877 $2,313.00
529879 KNEE ARTHROSCOPY SURGERY 29879 $1,628.00
529880 ARTHOSCOPY KNEE SURGERY 29880 $2,144.00
529881 ARTHOSCOPY KNEE SURGICAL W MENISCECTOMY 29881 $2,482.00
529882 ARTHROSCOPY KNEE SURGICAL W MENISCUS REP 29882 $1,650.00
529884 ARTHROSCOPY KNEE SURGICAL W LYSIS OF ADH 29884 $1,783.00
529886 KNEE ARTHROSCOPY SURGERY 29886 $1,294.00
529888 ARTHROSCOPICALLY AIDED ACL REPAIR AUGMEN 29888 $4,819.00
529891 ANKLE ARTHROSCOPY 29891 $2,657.00
529893 SCOPE PLANTAR FASCIOTOMY 29893 $2,010.00
529895 ANKLE ARTHROSCOPY SURGERY 29895 $1,052.00
529897 ANKLE ARTHROSCOPY SURGERY 29897 $1,085.00
529898 ANKLE ARTHROSCOPY SURGERY 29898 $1,459.00
529999 ARTHROSCOPY OF JOINT 29999 $1,922.00
530300 REMOVAL FOREIGN BODY INTRANASAL 30300 $500.00
530901 CONTROL NASAL HEMORRHAGE ANTER 30901 $254.00
530903 CONTROL NASAL HEMORRHAGE ANTERIOR COMPLE 30903 $352.00
530905 CONTROL NASAL MEORRHAGE POSTERIOR W POST 30905 $557.00
530906 REPEAT CONTROL OF NOSEBLEED 30906 $602.00
531500 ENDOTRACHEAL INTUBATION 31500 $636.00
531505 DIAGNOSTIC LAYNGOSCOPY 31505 $152.00
531575 DIAGNOSTIC LARYNGOSCOPY 31575 $222.00
532405 PERCUT BX LUNG MEDIASTINUM 32405 $1,070.00
532550 INSERT PLEURAL CATHETER 32550 $939.00
532551 TUBE THORACOSTOMY INCLUDES WATER SEAL 32551 $524.00
532554 ASPIRATE PLEURA W O IMAGING 32554 $411.00
532555 ASPIRATE PLEURA W IMAGING 32555 $512.00
534248 EGD GUIDE WIRE INSERTION 43248 $851.00
535206 REPAIR BLOOD VESSEL LESION 35206 $1,652.00
535800 EXPLORE NECK VESSELS 35800 $1,259.00
535840 EXPLORE ABDOMINAL VESSELS 35840 $2,073.00
536000 PLACE NEEDLE IN VEIN 36000 $56.00
536410 NON ROUTINE BL DRAW 3 YRS 36410 $34.00
536415 ROUTINE VENIPUNCTURE OR FINGER 36415 $19.00
536416 CAPILLARY BLOOD DRAW 36416 $20.00
536510 INSERTION OF CATHETER VEIN 36510 $247.00
536556 INSERT NONTUNNEL CV CATH GT 5 YEARS OLD 36556 $386.00
536557 INSERT TUNNEL CV CATH 36557 $2,090.00
536558 INSERT TUNNEL CV CATH 36558 $1,492.00
536561 INSERTION CENTRAL VENOUS 5 YRS AND OLDER 36561 $1,526.00
536568 INSERT PICC CATH 36568 $486.00
536569 INSERT PICC CATH 36569 $333.00
536573 INSJ PICC RS&I 5YR+ 36573 $387.00
536589 REMOVAL TUNNELED CV CATH 36589 $337.00
536590 REMOVAL TUNNELED CV CATH 36590 $568.00
536597 REPOSITION VENOUS CATHETER 36597 $285.00
536660 INSERTION CATHETER ARTERY 36660 $148.00
536680 PLACE NEEDLE FOR INTRAOSSEOUS INFUSION 36680 $154.00
537609 BIOPSY UNILAT TEMPORAL ARTERY 37609 $689.00
537785 LIGATE DIVIDE EXCISE VARICOSE VEIN 37785 $756.00
537799 VASCULAR SURGERY PROCEDURE 37799 $1,029.00
538220 BONE MARROW ASPIRATION 38220 $322.00
538222 DX BONE MARROW BX AND ASPIR 38222 $319.00
538500 BX OR EXC OF LYMPH NODES 38500 $1,226.00
538505 NEEDLE BIOPSY LYMPH NODES 38505 $301.00
538510 BIOPSY REMOVAL LYMPH NODES 38510 $1,276.00
538525 BX OR EXC OF LYMPH NODES OPEN 38525 $1,404.00
538570 LAPAROSCOPY LYMPH NODE BIOP 38570 $977.00
538571 LAPAROSCOPY LYMPHADENECTOMY 38571 $3,594.00
538792 INJ PROCEDURE FOR ID OF SENTINEL NODE 38792 $213.00
540800 DRAINAGE OF MOUTH LESION 40800 $560.00
541010 INCISION OF TONGUE FOLD 41010 $451.00
541800 DRAINAGE OF GUM LESION 41800 $418.00
542000 DRAINAGE MOUTH ROOF LESION 42000 $317.00
543201 ESOPHAGOSCOPY W SUBMUCOSAL INJ 43201 $411.00
543202 ESOPHAGOSCOPY FLEX BIOPSY 43202 $576.00
543215 ESOPHAGOSCOPY FLEX REMOVE FB 43215 $649.00
543235 UPPER GI ENDOSCOPY DIAG W WO C 43235 $566.00
543236 UPPER GI W SUBMUC INJ 43236 $640.00
543237 ENDOSCOPIC US EXAM ESOPH 43237 $389.00
543239 UPPER GI ENDOSCOPY W BX SING 43239 $640.00
543245 EGD DILATE STRICTURE 43245 $1,338.00
543246 EGD PLACE GASTROSTOMY TUBE 43246 $477.00
543247 UPPER GI ENDOSCOPY W REMOVAL 43247 $816.00
543248 EGD GUIDE WIRE INSERTION 43248 $851.00
543249 ESOPHAGUS ENDOSCOPY DILATION 43249 $515.00
543251 UPPER GI ENDOSCOPY WITH REMOVAL OF TUMOR 43251 $722.00
543255 EGD CONTROL BLEEDING ANY 43255 $927.00
543270 EGD LESION ABLATION 43270 $1,634.00
543450 DILATION OF ESOPHAGUS BY UNGUI 43450 $349.00
543752 NASAL OROGASTRIC W STENT 43752 $216.00
543753 TX GASTRO INTUB W ASP 43753 $40.00
543760 CHANGE GASTROSTOMY TUBE 43760 $258.00
543840 REPAIR OF STOMACH LESION 43840 $2,441.00
544005 FREEING OF BOWEL ADHESION 44005 $2,648.00
544120 REMOVAL OF SMALL INTESTINE 44120 $2,580.00
544125 REMOVAL OF SMALL INTESTINE 44125 $2,495.00
544139 MOBILIZATION OF COLON 44139 $452.00
544140 COLECTOMY PARTIAL WITH ANASTOMOSIS 44140 $6,059.00
544141 PARTIAL REMOVAL OF COLON 44141 $3,697.00
544144 PARTIAL REMOVAL OF COLON 44144 $3,741.00
544150 REMOVAL OF COLON 44150 $3,778.00
544160 REMOVAL OF COLON 44160 $2,269.00
544180 LAP ENTEROLYSIS 44180 $1,855.00
544187 LAP ILEO JEJUNO STOMY 44187 $2,253.00
544204 LAPARO PARTIAL COLECTOMY 44310 $3,113.00
544310 ILEOSTOMY JEJUNOSTOMY 44310 $2,184.00
544320 COLOSTOMY 44320 $2,510.00
544388 COLONOSCOPY THRU STOMA SPX 44388 $686.00
544389 COLONOSCOPY WITH BIOPSY 44389 $843.00
544394 COLONOSCOPY W SNARE 44394 $749.00
544602 SUTURE SMALL INTESTINE 44602 $2,852.00
544603 SUTURE SMALL INTESTINE 44603 $3,741.00
544604 SUTURE LARGE INTESTINE 44604 $2,136.00
544620 REPAIR BOWEL OPENING 44620 $1,842.00
544625 REPAIR BOWEL OPENING 44625 $2,161.00
544626 REPAIR BOWEL OPENING 44626 $2,882.00
544650 REPAIR BOWEL FISTULA 44650 $3,025.00
544660 REPAIR BOWEL BLADDER FISTULA 44660 $2,570.00
544850 REPAIR OF MESENTERY 44850 $1,440.00
544950 APPENDECTOMY 44950 $2,549.00
544955 APPENDECTOMY ADD‐ON 44955 $183.00
544960 APPENDECTOMY FOR RUPTURED APPENDIX 44960 $2,875.00
544970 LAPAROSCOPY SURG APPENDECTOMY 44970 $2,694.00
545100 BIOPSY OF RECTUM 45100 $666.00
545300 PROCTOSIGMOIDOSCOPY DX 45300 $222.00
545321 PROCTOSIGMOIDOSCOPY VOLVUL 45321 $186.00
545330 SIGMOIDOSCOPY FLEX DIAGNOSTIC 45330 $259.00
545331 SIGMOIDOSCOPY FLEX W BX SING 45331 $330.00
545335 SIGMOIDOSCOPY FLEX W DIRECT SUBMUCOSAL I 45335 $526.00
545338 SIGMOIDOSCOPY FLEX W REM OF TUM 45338 $973.00
545350 SGMDSC W BAND LIGATION 45350 $984.00
545378 COLONOSCOPY FLEX PROX‐SPLENIC F 45378 $416.00
545379 COLONOSCOPY W FB REMOVAL 45379 $755.00
545380 COLONOSCOPY FLEX PROX‐SPLENIC 45380 $926.00
545381 COLONOSCOPY SUBMUCOSA INJECTIONS ANY SUB 45381 $926.00
545382 COLONOSCOPY W CONTROL BLEED 45382 $1,196.00
545383 COLONOSCPY FLEX PROX SPLENIX 45383 $1,764.00
545384 COLONOSCOPY FLEX PROX‐SPLENIC 45384 $1,048.00
545385 COLONOSCOPY FLEX PROX‐SPLENIC 45385 $1,174.00
545388 COLONOSCOPY WITH ABLATION 45388 $1,430.00
545390 COLONOSCOPY W RESECTION 45390 $658.00
545393 COLONOSCOPY WITH DECOMPRESSION 45393 $794.00
545398 COLONOSCOPY W BAND LIGATION 45398 $685.00
545560 REPAIT OF RECTOCELE 45560 $1,201.00
545910 DILATION OF RECTAL NARROWING 45910 $358.00
545990 SURG DX EXAM ANORECTAL 45990 $218.00
546040 INCISION OF RECTAL ABSCESS 46040 $1,090.00
546050 I D PERIANAL ABSCESS 46050 $333.00
546083 INCISION THROMBOSED HEMORRHOID 46083 $537.00
546220 EXCISION OF EXTERNAL HEMORRHOID 46220 $421.00
546221 LIGATION OF HEMORRHOID S 46221 $581.00
546230 REMOVAL OF ANAL TAGS 46230 $637.00
546250 REMOVE EXT HEM GROUPS 2 46250 $944.00
546255 REMOVE INT EXT HEM 1 GROUP 46255 $1,072.00
546260 INT AND EXT HEMORRHOIDECTOMY COMPLETE 46260 $1,213.00
546270 REMOVE ANAL FIST SUBQ 46270 $943.00
546275 REMOVE ANAL FIST INTER 46275 $1,226.00
546288 REPAIR ANAL FISTULA 46288 $1,175.00
546320 REMOVAL OF HEMORRHOID CLOT 46320 $374.00
546600 ANOSCOPY DIAG W WO COLLECTION CLINIC 46600 $205.00
546610 ANOSCOPY REMOVE LESION 46610 $508.00
546615 ANOSCOPY 46615 $293.00
546910 DESTRUCTION ANAL LESION S 46910 $500.00
546930 DESTROY INTERNAL HEMORRHOIDS 46930 $421.00
546945 REMOVE BY LIGAT INT HEM GRP 46945 $665.00
546946 REMOVE BY LIGAT INT HEM GRP 46946 $835.00
546999 ANUS SURGERY PROCEDURE 46999 $674.00
547000 NEEDLE BIOPSY OF LIVER 47000 $863.00
547001 NEEDLE BIOPSY LIVER ADDON W MJR PROCEDUR 47001 $217.00
547490 INCISION OF GALLBLADDER 47490 $655.00
547562 LAPAROSCOPY SURG CHOLECYSTECTOM 47562 $2,947.00
547563 LAPAROSCOPY SURG CHOLECYSTECTO 47563 $3,934.00
547600 CHOLECYSTECTOMY 47600 $2,874.00
549000 EXPLORATION OF ABDOMEN 49000 $1,550.00
549020 DRAINAGE ABDOM ABSCESS OPEN 49020 $3,204.00
549060 DRAIN OPEN RETROPERI ABSCESS 49060 $2,212.00
549082 ABDOMINAL PARACENTESIS WO IMAGING GUID 49082 $336.00
549083 ABD PARACENTESIS W IMAGING 49083 $495.00
549084 PERITONEAL LAVAGE 49084 $218.00
549180 XR BIOPSY ABDOMINAL MASS 49180 $336.00
549320 LAPAROSCOPY ABDOMEN PERITONEUM 49320 $1,468.00
549321 LAPAROSCOPY BIOPSY 49321 $876.00
549322 LAPAROSCOPY ASPIRATION 49322 $747.00
549329 LAPARO PROC ABDM PERI OMENT 49329 $2,502.00
549453 REREPAIR VENTRL HERN REDUCE 49565 $1,677.00
549465 FLUORO EXAM OF G COLON TUBE 49465 $386.00
549505 REPAIR INIT INGUINAL HERNIA AGE 49505 $2,655.00
549507 REP ING HERN INIT BLOCK 5 YR AND OLDER 49507 $1,952.00
549520 REPAIR RECURRENT INGUINAL HERNIA 49520 $2,837.00
549521 RE‐REPAIR INGUINAL HERNIA BLOCKED 49521 $1,484.00
549525 REPAIR ING HERNIA SLIDING 49525 $1,348.00
549550 REPAIR FEM HERNIA INIT REDUCE 49550 $1,214.00
549553 RPR FEM HERNIA INIT BLOCKED 49553 $1,268.00
549560 REPAIR INITIAL INC OR VENT HERNIA REDUC 49560 $1,612.00
549561 RPR VENTRAL HERN INIT BLOCK 49561 $1,961.00
549565 REREPAIR VENTRL HERN REDUCE 49565 $1,597.00
549566 REREPAIR VENTRL HERN BLOCK 49566 $1,685.00
549568 IMPLANT OF MESH OR OTHER PROSTH 49568 $1,190.00
549570 REPAIR EPIGASTRIC HERNIA 49570 $730.00
549585 REPAIR UMBILICAL HERNIA AGE 5 AND OLDER 49585 $1,999.00
549587 REPAIR UMBILICAL HERNIA AGE 5 OR OLDER 49587 $2,287.00
549650 LAP ING HERNIA REPAIR INIT 49650 $946.00
549651 LAP ING HERNIA REPAIR RECUR 49651 $1,071.00
549652 LAP VENT ABD HERNIA REPAIR 49652 $1,663.00
549653 LAP VENT ABD HERN PROC COMP 49653 $1,872.00
549654 LAP INC HERNIA REPAIR 49654 $2,045.00
549655 LAP INC HERNIA REPAIR COMP 49655 $2,179.00
549656 LAP INC HERNIA REPAIR RECUR 49656 $1,673.00
549659 LAPARO PROC HERNIA REPAIR 49659 $1,704.00
549900 REPAIR OF ABDOMINAL WALL 49900 $1,427.00
549905 OMENTAL FLAP INTRA ABDOM 49905 $634.00
549999 ABDOMEN SURGERY UNLISTED 49999 $1,262.00
550080 REMOVAL OF KIDNEY STONE 50080 $1,769.00
550130 PYELOTOMY W REMOVAL OF CALCULUS 50590 $2,207.00
550200 RENAL BIOPSY PERQ 50200 $590.00
550205 RENAL BIOPSY OPEN 50205 $1,362.00
550384 REMOVE INDWELLING URETER STENT PERCUTAN 50384 $1,310.00
550387 XR FLUORO STENT PLACEMENT W C ARM 50387 $1,122.00
550390 DRAINAGE OF KIDNEY LESION 50390 $230.00
550431 NJX PX NFROSGRM AND URTRGRM 50431 $321.00
550541 LAPAROSCOPY ABLATION OF RENAL CYSTS 50541 $2,651.00
550542 LAPARO ABLATE RENAL MASS 50542 $2,372.00
550543 LAPAROSCOPY PARTIAL NEPHRECTOMY 50543 $4,576.00
550544 LAPAROSCOPY PYELOPLASTY 50544 $2,768.00
550545 LAPARO RADICAL NEPHRECTOMY 50545 $2,725.00
550546 LAPAROSCOPIC NEPHRECTOMY 50546 $2,350.00
550548 LAPARO REMOVE W URETER 50548 $2,365.00
550549 LAPAROSCOPE PROC RENAL 50549 $3,159.00
550590 FRAGMENTING OF KIDNEY STONE 50590 $2,197.00
550593 PERC CRYO ABLATE RENAL TUM 50593 $2,849.00
550715 RELEASE OF URETER 50715 $2,213.00
550953 ENDOSCOPY OF URETER 50953 $777.00
551040 INCISE AND DRAIN BLADDER 51040 $539.00
551050 REMOVAL OF BLADDER STONE 51050 $1,050.00
551065 REMOVE URETER CALCULUS 51065 $1,236.00
551102 ASPIRATION OF BLADDER W INSERTION OF SUP 51102 $796.00
551525 REMOVAL OF BLADDER LESION 51525 $1,668.00
551610 INJ PROC RETROGRADE URETHROCYSTOGRAPHY 51610 $228.00
551700 IRRIGATION OF BLADDER 51700 $138.00
551702 INSERTION TEMP INDWELLING CATH 51702 $116.00
551703 INSERT BLADDER CATH COMPLEX 51703 $273.00
551705 CHANGE OF BLADDER TUBE 51705 $171.00
551710 CHANGE OF BLADDER TUBE 51710 $285.00
551715 ENDOSCOPIC INJECTION IMPLANT 51715 $712.00
551720 BLADDER INSTALLATION OF ANTICARCINOGENIC 51720 $201.00
551798 US URINE CAPACITY MEASURE 51798 $53.00
551990 LAPARO URETHRAL SUSPENSION STRESS INCONT 51990 $1,999.00
551992 LAPARO SLING OPERATION 51992 $3,047.00
552000 CYSTOURETHROSCOPY 52000 $370.00
552001 CYSTOSCOPY REMOVAL OF CLOTS 52001 $791.00
552005 CYSTOURETHROSCOPY 52005 $608.00
552007 CYSTOSCOPY AND BIOPSY 52007 $760.00
552204 CYSTOURETHROSCOPY WITH BIOPSY 52204 $647.00
552214 CYSTOSCOPY AND TREATMENT 52214 $805.00
552224 CYSTOSCOPY TX FULGURATION MINOR 52224 $1,100.00
552234 CYSTOSCOPY TX FULGURATION 52234 $722.00
552235 CYSTOSCOPY AND TREATMENT 52235 $905.00
552240 CYSTOURETHROSCOPY W FULGURATION OR RESEC 52240 $1,323.00
552250 CYSTOSCOPY AND RADIOTRACER 52250 $512.00
552260 CYSTOSCOPY AND TREATMENT 52260 $645.00
552265 CYSTOSCOPY TX DILATION BLADDER 52265 $740.00
552270 CYSTOSCOPY AND REVISE URETHRA 52270 $719.00
552276 CYSTOSCOPY AND TREATMENT 52276 $533.00
552281 CYSTOSCOPY AND TREATMENT 52281 $657.00
552287 CYSTOSCOPY CHEMODENERVATION 52287 $679.00
552305 CYSTOSCOPY AND TREATMENT $544.00
552310 CYTOSCOPY TX REM FB SIMPLE 52310 $835.00
552315 CYSTOURETHROSCOPY W REM FGN BODY COMPLIC 52315 $1,096.00
552317 REMOVE BLADDER STONE 52317 $1,559.00
552318 REMOVE BLADDER STONE 52318 $1,014.00
552320 CYSTOSCOPY AND TX REM URETERAL CALCULUS 52320 $1,032.00
552325 CYSTOSCOPY STONE REMOVAL 52325 $656.00
552332 CYSTOSCOPY TX INSERT INDWELLING STENT 52332 $713.00
552341 CYSTO W URETER STRICTURE TX 52341 $579.00
552344 CYSTOURETHROSCOPY URETEROSCOPY TX STRIC 52344 $813.00
552345 CYSTO URETERO W TX UP STRICTURE 52345 $825.00
552351 CYSTOURETERO OR PYELOSCOPE 52351 $1,353.00
552352 CYSTOURETHOSCOPY 52352 $1,644.00
552353 CYSTOURETERO WITH LITHOTRIPSY 52353 $1,628.00
552354 CYSTOURETERO W/BIOPSY 52354 $799.00
552356 CYSTO URETERO W/LITHOTRIPSY 52356 $939.00
552400 CYSTOURETERO W/CONGEN REPR 52400 $977.00
552450 INCISION OF PROSTATE 52450 $914.00
552500 TRANSURETHRAL RESECTION BLADDER NECK 52500 $1,416.00
552601 PROSTATECTOMY TURP 52601 $1,742.00
552630 REMOVE PROSTATE REGROWTH 52630 $1,308.00
553230 REMOVAL OF URETHRA LESION 53230 $1,237.00
553265 TREATMENT OF URETHRA LESION 53265 $422.00
553275 EXCISION OR FULGURATION URETHRAL PROLAPS 53275 $537.00
553450 REVISION OF URETHRA 53450 $1,301.00
553460 REVISION OF URETHRA 53460 $935.00
553502 REPAIR OF URETHRA INJURY 53502 $991.00
553600 DILATE URETHRA STRICTURE 53600 $211.00
553605 DILATE URETHRA STRICTURE 53605 $137.00
553620 DILATE URETHRA STRICTURE 53620 $245.00
553665 DILATION OF URETHRA 53665 $87.00
553899 UROLOGY SURGERY PROCEDURE 53899 $240.00
554001 SLITTING OF PREPUCE DORSAL OR LATERAL 54001 $449.00
554050 DESTROY CONDYLOMATA MALE 54050 54050 $301.00
554150 CIRCUMCISION USING CLAMP OR DEVICE 54150 54150 $446.00
554160 CIRCUMCISION 28DAYS OTH SURG PROC 54160 54160 $794.00
554161 CIRCUMCISION 28DAYS OTH SURG PROC 54161 54161 $686.00
554162 LYSIS PENILE POST CIRCUMCISION LESION 54162 $548.00
554300 REVISION OF PENIS 54300 $1,650.00
554530 REMOVAL OF TESTIS 54530 $1,078.00
554600 REDUCE TESTIS TORSION 54600 $1,487.00
554640 SUSPENSION OF TESTIS 54640 $1,023.00
554700 DRAINAGE OF SCROTUM 54700 $459.00
554830 REMOVE EPIDIDYMIS LESION 54830 $696.00
554840 REMOVE EPIDIDYMIS LESION 54840 $759.00
554860 REMOVAL OF EPIDIDYMIS 54860 $1,558.00
554861 REMOVAL OF EPIDIYMIS 54861 $1,158.00
555000 PUNC ASPIRATION HYDROCELE TUNICA VAGINAL 55000 $322.00
555040 EXCISION OF HYDROCELE UNILATERAL 55040 $1,344.00
555060 REPAIR OF TUNICA VAGINALIS HYDROCELE 50590 $876.00
555100 DRAINAGE OF SCROTUM ABSCESS 55100 $460.00
555110 EXPLORE SCROTUM 55110 $754.00
555150 REMOVAL OF SCROTUM 55150 $1,054.00
555250 VASECTOMY BILATERAL 55250 $1,050.00
555400 REPAIR OF SPERM DUCT 55400 $1,065.00
555500 REMOVAL OF HYDROCELE 55500 $879.00
555520 REMOVAL OF SPERM CORD LESION 55520 $1,395.00
555550 LAPARO LIGATE SPERMATIC VEIN 55550 $917.00
555700 BIOPSY OF PROSTATE 55700 $560.00
555821 PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1 OR 2 55821 $2,198.00
555873 CRYOABLATE PROSTATE 55873 $3,504.00
555874 TPRNL PLMT BIODEGRDABL MATRL 55874 $758.00
556405 I D VULVA ABSCESS 56405 $494.00
556420 I D BARTHOLINS GLAND ABSCESS 56420 $422.00
556440 SURGERY FOR VULVA LESION 56440 $379.00
556501 DESTROY VULVA LESIONS 56501 $292.00
556605 BIOPSY OF VULVA OR PERINEUM 56605 $270.00
556606 BIOPSY OF VULVA OR PERINEUM ADD ON 56606 $157.00
556620 PARTIAL REMOVAL OF VULVA 56620 $1,196.00
557022 I D VAGINAL HEMATOMA PP 57022 $389.00
557061 DESTROY VAG LESIONS SIMPLE 57061 $219.00
557100 BIOPSY OF VAGINA SIMPLE 57100 $527.00
557105 BIOPSY OF VAGINA EXTENSIVE 57105 $288.00
557107 VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL 57107 $3,752.00
557120 COLPOCLEISIS 57120 $1,104.00
557135 EXCISION VAGINAL CYST OR TUMOR 57135 $1,266.00
557160 INSERT PESSARY 57160 $111.00
557170 DIAPHRAGM OR CERVICAL CAP FITTING 57170 $320.00
557200 REPAIR OF VAGINA 57200 $583.00
557240 REPAIR BLADDER AND VAGINA 57240 $1,402.00
557250 REPAIR RECTUM VAGINA 57250 $1,634.00
557260 REPAIR OF VAGINA 57260 $1,677.00
557265 EXTENSIVE REPAIR OF VAGINA 57265 $1,469.00
557267 INSERT MESH PELVIS FLR ADDON 57267 $525.00
557282 COLPOPEXY EXTRAPERITONEAL 57282 $877.00
557285 REPAIR PARAVAG DEFECT VAG 57285 $1,297.00
557287 REVISE REMOVE SLING REPAIR 57287 $1,736.00
557288 SLING OPERATION FOR STRESS INCONTINENCE 57288 $3,202.00
557295 REVISE VAG GRAFT VIA VAGINA 57295 $866.00
557410 PELVIC EXAMINATION 57410 $228.00
557415 REMOVE VAGINAL FOREIGN BODY 57415 $292.00
557452 COLPOSCOPY SCREENING 57452 $375.00
557454 COLPOSCOPY W BIOPSY CERVIX AND ECC 57454 $692.00
557456 ENDOCERV CURETTAGE W SCOPE 57456 $340.00
557460 COLPOSCOPY VAGINOSCOPY W LO 57460 $724.00
557461 CONZ OF CERVIX W SCOPE LEEP 57461 $609.00
557500 BIOPSY OF THE CERVIX 57500 $453.00
557505 ENDOCERVICAL CURETTAGE 57505 $393.00
557510 CAUTERIZATION OF CERVIX 57510 $306.00
557511 CAUTERIZATION OF CERVIX CRYOS 57511 $794.00
557520 CONIZATION OF CERVIX 57520 $764.00
557522 CONIZATION OF CERVIX 57522 $600.00
557720 REVISION OF CERVIX 57720 $593.00
558100 ENDOMETRIAL AND OR ENDOCERVICAL SAMPLING 58100 $429.00
558110 BX DONE W COLPOSCOPY ADDON 58110 $97.00
558120 DILATION AND CURETTAGE DIAG 58120 $1,378.00
558145 MYOMECTOMY VAG METHOD 58145 $1,054.00
558146 MYOMECTOMY ABDOM COMPLEX 558146 58146 $2,485.00
558150 TOTAL ABDOMINAL HYSTERECTOMY WWO TUBE RE 58150 $4,560.00
558180 SUPERACERVICAL ABDOMINAL HYSTERE 58180 $1,717.00
558260 VAGINAL HYSTERECTOMY 58260 $1,583.00
558262 VAGINAL HYSTERECTOMY INCL T O 58262 $3,734.00
558263 VAGINAL HYSTERECTOMY W TUBAL W REPAIR 58263 $2,221.00
558267 VAG HYST W URINARY REPAIR 58267 $1,837.00
558270 VAGINAL HYSTERECTOMY W/ENTEROCELE REPAIR 58270 $2,043.00
558290 VAGINAL HYSTERECTOMY UTERUS GT 250G 58270 $2,424.00
558300 INSERTION OF IUD 58300 58300 $300.00
558301 REMOVAL IUD 58301 58301 $404.00
558340 HYSTERSAPINGOGRAPHY OR HYSTERO 58340 $261.00
558350 REOPEN FALLOPIAN TUBE 58350 $215.00
558353 ENDOMETR ABLATE THERMAL 58353 $995.00
558550 LAPARO ASST VAG HYSTERECTOMY 58550 $3,117.00
558552 LAPARO SURGICAL VAG HYST 250 G OR LESS 58552 $2,986.00
558554 LAPARO VAG HYST W T O COMPL 58554 $2,776.00
558558 HYSTEROSCOPY SURG W SAMPLING OF 58558 $1,047.00
558561 HYSTEROSCOPY REMOVE MYOMA 58561 $1,199.00
558562 HYSTEROSCOPY REMOVAL OF IMPACTED FB 58562 $1,002.00
558563 HYSTEROSCOPY ABLATION 58563 $1,115.00
558570 TLH UTERUS 250 G OR LESS 58570 $1,463.00
558571 LAPARO HYSTERECTOMY UTERUS 250 G TUBAL 58571 $2,848.00
558573 TLH W T O UTERUS OVER 250 G 58573 $2,848.00
558600 LIGATION OF FALLOPIAN TUBE 58600 $1,432.00
558605 TRANSECTION OF FALLOPIAN TUBE 58605 $1,397.00
558611 LIGATION TRANSECTION FALLOPIAN 58611 $343.00
558660 LAPARSCOPY LYSIS 58660 $3,764.00
558661 LAPAROSCOPY REMOVE ADENEXAL STRUCTURES 58661 $2,953.00
558662 LAPAROSCOPY EXCISE LESIONS 58662 $2,925.00
558670 LAPAROSCOPY TUBAL CAUTERY 58670 $735.00
558671 LAPAROSCOPY SURG W OCCLUSION OF 58671 $2,196.00
558679 LAPARO PROC OVIDUCT OVARY 58679 $1,406.00
558700 SALPINGECTOMY COMPLETE BILATERAL 58700 $3,032.00
558720 SALPINGO OOPHORECTOMY COMPLETE 58720 $3,393.00
558999 GENITAL SURGERY PROCEDURE 58999 $0.00
559150 TREAT ECTOPIC PREGNANCY 59150 $1,698.00
559151 TREAT ECTOPIC PREGNANCY 59151 $1,574.00
559160 D C AFTER DELIVERY 59160 $663.00
559200 INSERT CERVICAL DILATOR 59200 $137.00
559300 EPISIOTOMY OR VAGINAL REPAIR B 59300 $654.00
559400 ROUTINE OBSTETRIC CARE INCL ANT 59400 $11,424.00
559409 VAGINAL DELIVERY ONLY W WO EPI 59409 $3,581.00
559410 OBSTETRICAL CARE VAGINAL BIRTH AND POSTP 59410 $5,577.00
559412 EXT CEPHALIC VERSION W WO TOCOLYIS 59412 $457.00
559414 DELIVER PLACENTA 59414 $402.00
559425 ANTEPARTUM CARE ONLY 4‐6 VISITS 59425 $1,950.00
559426 ANTEPARTUM CARE ONLY 7 OR MORE 59426 $3,069.00
559430 POST PARTUM CARE 59430 $685.00
559510 CESAREAN DELIVERY 59510 $5,275.00
559514 CAESAREAN DELIVERY ONLY 59514 $4,024.00
559515 CESAREAN DELIVERY ONLY 59515 $2,698.00
559525 REMOVE UTERUS AFTER CESAREAN 59525 $869.00
559610 OBSTETRIC ANTEPARTUM CARE VAG D 59610 $7,862.00
559612 VBAC DELIVERY ONLY 59612 $3,075.00
559614 VBAC CARE AFTER DELIVERY 59614 $2,376.00
559618 ATTEMPTED VBAC DELIVERY 559618 59618 $4,346.00
559620 ATTEMPTED VBAC DELIVERY ONLY 59620 $3,612.00
559812 TREATMENT OF INCOMPLETE ABORTION 59812 $1,702.00
559820 TREATMENT OF MISSED ABORTION 59820 $1,623.00
559821 TREATMENT OF MISCARRIAGE 59821 $805.00
559841 ABORTION 59841 $855.00
559870 EVACUATE MOLE OF UTERUS 59870 $880.00
559899 MATERNITY CARE PROCEDURE 59899 $835.00
560100 BIOPSY OF THYROID 60100 $268.00
560220 PARTIAL REMOVAL OF THYROID 60220 $1,361.00
560300 ASPIRATION AND OR INJECTION THYROID CYST 60300 $216.00
562270 SPINAL PUNCT LUMBAR DIAG 62270 62270 $352.00
562272 DRAIN CEREBRO SPINAL FLUID 62272 $395.00
562273 INJECT EPIDURAL PATCH 62273 $670.00
562311 INJ SINGLE OF DIAGNOSTIC OR THE 62311 $569.00
562321 NJX INTERLAMINAR CRV THRC 62321 $488.00
562322 NJX INTERLAMINAR LMBR SAC 62322 $290.00
562323 NJX INTERLAMINAR LMBR SAC 62323 $453.00
563030 LAMINOTOMY HEMILAMINECTOMY W DECOMP 63030 $2,162.00
563035 SPINAL DISK SURGERY ADD ON 63035 $366.00
563042 LAMINOTOMY SINGLE LUMBAR 63042 $2,249.00
563046 REMOVE SPINE LAMINA 1 THRC 63046 $2,461.00
563047 REMOVE SPINE LAMINA 1 LMBR 63047 $2,154.00
563048 REMOVE SPINAL LAMINA ADD ON 63048 $379.00
563267 EXCISE INTRSPINL LESION LMBR 63267 $2,617.00
564400 NERVE BLOCK ANESTHETIC TRIGEMINAL NERVE 64400 $259.00
564402 NERVE BLOCK INJECTION FACIAL 64402 $274.00
564405 NERVE BLOCK INJ GREATER OCCIPITAL NERVE 64405 $252.00
564413 N BLOCK INJ CERVICAL PLEXUS 64413 $253.00
564415 NERVE BLOCK ANESTHETIC BRACHIAL PLEXUS 64415 $297.00
564417 N BLOCK INJ AXILLARY 64417 $271.00
564418 N BLOCK INJ SUPRASCAPULAR 64418 $315.00
564425 N BLOCK INJ ILIO‐ING HYPOGI 64425 $281.00
564445 INJ ANESTHETIC AGENT SCIATIC NERVE SINGL 64445 $331.00
564447 INJ ANESTHETIC AGENT FEMORAL NERVE SNGLE 64447 $272.00
564450 NERVE BLOCK PERIPHERAL NERVE 64450 $205.00
564455 N BLOCK INJ PLANTAR DIGIT 64455 $88.00
564483 INJ FORAMEN EPIDURAL L S 64483 $517.00
564484 INJ FORAMEN EPIDURAL ADD‐ON 64484 $206.00
564486 TAP BLOCK BY INJECTION 64486 $306.00
564488 TAP BLOCK BI INJECTION 64488 $329.00
564493 INJ PARAVERT FACET JNT L S 1ST LEVEL 64493 $435.00
564494 INJ PARAVERT FACET JNT L S 2ND LEVEL 64494 $195.00
564581 IMPLANT NEUROELECTRODES 64581 $1,161.00
564595 REVISE RMV PN GASTR STIMUL 64595 $606.00
564704 REVISE HAND FOOT NERVE 64704 $1,759.00
564708 REVISE ARM LEF NERVE 64708 $966.00
564718 REVISE ULNAR NERVE AT ELBOW 64718 $1,177.00
564721 NEUROPLASTY MEDIAN AT CARPAL TU 64721 $2,159.00
564726 DECOMPRESSION PLANTAR DIGITAL NERVE 64726 $1,177.00
564727 INTERNAL NERVE REVISION 64727 $375.00
564782 REMOVE LIMB NERVE LESION 64782 $880.00
564795 BIOPSY OF NERVE 64795 $372.00
564831 REPAIR OF DIGIT NERVE 64831 $1,520.00
564999 NERVOUS SYSTEM SURGERY 64999 $461.00
565205 REMOVE FOREIGN BODY FROM EYE 65205 $156.00
565220 REMOVE FOREIGN BODY EYE 65220 65220 $293.00
565222 REMOVE EMBEDDED FOREIGN BODY EYE 65222 65222 $239.00
567700 DRAINAGE OF EYELID ABSCESS 67700 $627.00
567800 REMOVE EYELID LESION 67800 $247.00
567938 REMOVE EYELID FOREIGN BODY 67938 $546.00
569000 DRAIN EXTERNAL EAR LESION 69000 $403.00
569200 REMOVE FOREIGN BODY EAR 69200 69200 $207.00
569205 CLEAR OUTER EAR CANAL 69205 $208.00
569209 REMOVE IMPACTED EAR WAX UNI 69209 $25.00
569210 REMOVE IMPACTED CERUMEN 69210 $149.00
569990 MICROSURGERY ADD ON 69990 $413.00
570030 XR EYE FOR FOREIGN BODY 70030 $24.00
570110 XR EXAM JAW 4 VIEWS 70110 $30.00
570140 X RAY EXAM OF FACIAL BONES 70140 $61.00
570150 XR EXAM FACIAL BONES 70150 $30.00
570160 XR EXAM NASAL BONES 70160 $22.00
570170 XR OF TEAR DUCT 70170 $37.00
570200 XR EXAM ORBITS COMPLETE MIN 4 VIEWS 70200 $40.00
570210 XR EXAM SINUSES LESS THAN 3V 70210 $21.00
570220 XR EXAM SINUSES 3V OR MORE 70220 $29.00
570250 XR EXAM SKULL 70250 $27.00
570260 XRAY EXAM OF SKULL 70260 $33.00
570336 XR MAGNETIC IMAGE JAW JOINT 70336 $158.00
570360 XR EXAM NECK 70360 $23.00
570450 CT HEAD BRAIN W O DYE 70450 $102.00
570460 CT HEAD BRAIN W DYE 70460 $134.00
570470 CT HEAD BRAIN WWO DYE 70470 $157.00
570480 CT ORBIT EAR FOSA W O DYE 70480 $145.00
570481 CT ORBIT EAR FOSA W DYE 70481 $162.00
570486 CT MAXILLOFACIAL W O DYE 70486 $105.00
570487 CT MAXILLOFACIAL W DYE 70487 $153.00
570488 CT MAXILLOFACIAL WWO DYE 70488 $151.00
570490 CT SOFT TISSUE NECK W O DYE 70490 $153.00
570491 CT SOFT TISSUE NECK W DYE 70491 $173.00
570492 CT SOFT TISSUE NECK WWO DYE 70492 $170.00
570496 CT ANGIOGRAPHY HEAD 70496 $214.00
570498 CT ANGIOGRAPHY NECK 70498 $213.00
570540 MRI ORBIT FACE NECK W O DYE 70540 $166.00
570543 MR ORBIT FACE NECK WWO DYE 70543 $240.00
570544 MR ANGIOGRAPHY HEAD W O DYE 70544 $144.00
570545 MR ANGIO HEAD W DYE READ ONLY 70545 $106.00
570546 MRA HEAD WWO DYE 70546 70546 $168.00
570547 MR ANGIOGRAPHY NECK W O DYE 70547 $133.00
570548 MR ANGIOGRAPHY NECK W DYE 70548 $141.00
570549 MR ANGIOGRAPHY NECK WWO DYE 70549 $218.00
570551 MR BRAIN STEM W O DYE 70551 $179.00
570552 MR BRAIN STEM W DYE 70552 $255.00
570553 MR BRAIN STEM WWO DYE 70553 $279.00
571010 XR CHEST 1V FRONTAL 71010 $22.00
571020 XR CHEST 2V FRONTAL AND LATERAL 71020 $25.00
571021 CHEST X RAY FRNT LAT LORDOTC 71021 $27.00
571023 XR AND FLUORO CHEST 71023 $46.00
571030 XR CHEST COMPLETE 4 VIEW 71030 $32.00
571035 XR CHEST SPECIAL VIEWS 71035 $22.00
571045 XR CHEST 1V 71045 71045 $22.00
571046 XRAY EXAM CHEST 2 VIEWS 71046 $26.00
571047 X RAY EXAM CHEST 3 VIEWS 71047 $28.00
571048 XRAY EXAM CHEST 4 PLUS VIEWS 71048 $32.00
571100 XR EXAM RIBS UNILATERAL 2V 71100 $26.00
571101 XR EXAM RIBS CHEST UNILATERAL 3V 71101 $32.00
571110 XR EXAM RIBS BILATERAL 3V 71110 $30.00
571111 XR EXAM RIBS CHEST 4V 71111 $43.00
571120 XR EXAM BREASTBONE 2V 71120 $26.00
571130 XR STRENOCLAVIC JOINT 3V 71130 $32.00
571250 CT THORAX W O DYE 71250 $120.00
571260 CT THORAX W DYE 71260 $150.00
571270 CT THORAX W O AND W DYE 71270 $152.00
571275 CT ANGIOGRAPHY CHEST 71275 $220.00
571550 MR CHEST W O DYE 71550 $162.00
571552 MRI CHEST WO AND WDYE 71552 $232.00
571555 MR ANGIOGRAPHY CHEST WWO DYE 71555 $212.00
572010 XR EXAM SPINE ANTEROPOSTERIOR AND LATERA 72010 $54.00
572020 XR EXAM SPINE 1V 72020 $22.00
572040 XR EXAM NECK SPINE 2V OR 3V 72040 $29.00
572050 XR EXAM NECK SPINE 4V OR 5V 72050 $40.00
572052 XR EXAM NECK SPINE 6V 72052 $48.00
572069 XR EXAM TRUNK SPINE STAND 72069 $26.00
572070 XR EXAM THORACIC SPINE 2V 72070 $29.00
572074 XR EXAM THORACIC SPINE 4V 72074 $30.00
572080 XR EXAM TRUNK SPINE 2V 72080 $28.00
572082 XR SCOLIOSIS 2 V 72082 $34.00
572090 XR EXAM SCOLIOSIS ERECT 72090 $37.00
572100 XR EXAM LUMBOSACRAL SPINE 2V OR 3V 72100 $28.00
572110 XR EXAM LUMBOSACRAL SPINE 4V 72110 $40.00
572114 XR EXAM LUMBOSACRAL SPINE BENDING 72114 $47.00
572125 CT NECK SPINE WO DYE 72125 $128.00
572126 CT NECK SPINE W DYE 72126 $125.00
572127 CT NECK SPINE WO AND WDYE 72127 $130.00
572128 CT CHEST SPINE WO DYE 72128 $124.00
572129 CT CHEST SPINE W DYE 72129 $142.00
572130 CT CHEST SPINE WWO DYE 72130 $151.00
572131 CT LUMBAR SPINE WO DYE 72131 $117.00
572132 CT LUMBAR SPINE W DYE 72132 $144.00
572141 MR NECK SPINE WO DYE 72141 $184.00
572142 MRI NECK SPINE W DYE 72142 $159.00
572146 MR CHEST SPINE WO DYE 72146 $185.00
572148 MR LUMBAR SPINE WO DYE 72148 $186.00
572149 MR LUMBAR SPINE W DYE 72149 $202.00
572156 MR NECK SPINE WWO DYE 72156 $281.00
572157 MR CHEST SPINE WWO DYE 72157 $278.00
572158 MR LUMBAR SPINE WWO DYE 72158 $283.00
572170 XR EXAM PELVIS 1V OR 2V 72170 $23.00
572190 XR EXAM PELVIS 3V 72190 $28.00
572192 CT PELVIS WO DYE 72192 $130.00
572193 CT PELVIS W DYE 72193 $136.00
572194 CT PELVIS W O W DYE 72194 $327.00
572195 MR PELVIS WO DYE 72195 $181.00
572197 MR PELVIS WWO DYE 72197 $272.00
572200 XR EXAM SI JOINTS 2V 72200 $23.00
572202 XR EXAM SI JOINTS 3V 72202 $25.00
572220 XR EXAM SACRUM TAILBONE 72220 $23.00
573000 XR EXAM COLLAR BONE 73000 $22.00
573010 XR EXAM SHOULDER BLADE 73010 $27.00
573020 XR EXAM SHOULDER 1V 73020 $21.00
573030 XR EXAM SHOULDER 2V 73030 $24.00
573050 XR EXAM SHOULDERS 73050 $25.00
573060 XR EXAM HUMERUS 73060 $23.00
573070 XR EXAM ELBOW 2V 73070 $23.00
573080 XR EXAM ELBOW 3V 73080 $23.00
573090 XR EXAM FOREARM 73090 $22.00
573092 XR EXAM ARM INFANT 73092 $20.00
573100 XR EXAM WRIST 2V 73100 $22.00
573110 XR EXAM WRIST 3V 73110 $23.00
573115 XR CONTRAST WRIST 73115 $67.00
573120 XR EXAM HAND 2V 73120 $22.00
573130 XR EXAM HAND 3V 73130 $22.00
573140 XR EXAM FINGER S 73140 $18.00
573200 CT UPPER EXTREMITY WO DYE 73200 $122.00
573201 CT UPPER EXTREMITY W DYE 73201 $130.00
573202 CT UPPER EXT WWO CONTRAST 73202 $108.00
573206 CT ANGIO UPR EXTRM W WO DYE 73206 $159.00
573218 MR UPPER EXTREMITY WO DYE 73218 $172.00
573220 MR UPPER EXTREMITY WWO DYE 73220 $275.00
573221 MR JOINT UPPER EXTREMITY WO DYE 73221 $170.00
573222 MR JOINT UPPER EXTREMITY W DYE 73222 $215.00
573223 MR JOINT UPPER EXTREMITY WWO DYE 73223 $264.00
573500 XR EXAM HIP 1V 73500 $22.00
573501 XR PELVIS 1V HIP 73501 $21.00
573502 XR PELVIS 2V HIP 73502 $24.00
573510 XR EXAM HIP 2V 73510 $26.00
573520 XR EXAM HIPS 73520 $32.00
573521 X RAY EXAM HIPS BI 2 VIEWS 73521 $23.00
573522 X RAY EXAM HIPS BI 3 4 VIEWS 73522 $33.00
573523 XR HIP BILAT COMPLETE AND PELVIS 73523 $31.00
573525 XR ARTHROGRAPHY OF HIP 73525 $32.00
573540 XR EXAM PELVIS AND HIPS 73540 $32.00
573550 XR EXAM THIGH 73550 $22.00
573552 XR FEMUR 73552 $20.00
573560 XR EXAM KNEE 1V OR 2V 73560 $24.00
573562 XR EXAM KNEE 3V 73562 $24.00
573564 XR EXAM KNEE 4V 73564 $29.00
573565 XR EXAM KNEES 73565 $25.00
573590 XR EXAM LOWER LEG 73590 $22.00
573592 XR EXAM LEG INFANT 73592 $20.00
573600 XR EXAM ANKLE 2V 73600 $23.00
573610 XR EXAM ANKLE 3V 73610 $24.00
573615 XR CONTRAST ANKLE 73615 $68.00
573620 XR EXAM FOOT 2V 73620 $22.00
573630 XR EXAM FOOT 3V 73630 $23.00
573650 XR EXAM HEEL 73650 $22.00
573660 XR EXAM TOE S 73660 $17.00
573700 CT LOWER EXTREMITY WO DYE 73700 $122.00
573701 CT LOWER EXTREMITY W DYE 73701 $136.00
573702 CT LOWER EXTREMITY WWO DYE 73702 $141.00
573706 CT ANGIOGRAPHY LOWER EXTREMITY WWO DYE 73706 $211.00
573718 MR LOWER EXTREMITY WO DYE 73718 $176.00
573719 MR LOWER EXTREMITY W DYE 73719 $182.00
573720 MR LOWER EXTREMITY WWO DYE 73720 $264.00
573721 MR JOINT LOWER EXTREMITY WO DYE 73721 $174.00
573722 MR JOINT LOWER EXTREMITY W DYE 73722 $192.00
573723 MR JOINT LOWER EXTREMITY WWO DYE 73723 $271.00
574000 XR EXAM ABDOMEN ANTEROPOSTERIOR 1V 74000 $22.00
574010 X RAY EXAM OF ABDOMEN 74010 $24.00
574018 XRAY EXAM ABDOMEN 1 VIEW 74018 $23.00
574019 XRAY EXAM ABDOMEN 2 VIEWS 74019 $25.00
574020 XR EXAM ABDOMEN COMPLETE 74020 $32.00
574021 XRAY EXAM ABDOMEN 3 PLUS VIEWS 74021 $32.00
574022 XR EXAM ABDOMEN SERIES 74022 $39.00
574150 CT ABDOMEN WO DYE 74150 $168.00
574160 CT ABDOMEN W DYE 74160 $156.00
574170 CT ABDOMEN WWO DYE 74170 $166.00
574174 CT ANGIOGRAPHY ABDOMEN AND PELVIS WWO DY 74174 $267.00
574175 CT ANGIOGRAPHY ABDOMEN WWO DYE 74175 $224.00
574176 CT ABDOMEN AND PELVIS WO DYE 74176 $211.00
574177 CT ABDOMEN AND PELVIS W DYE 74177 $225.00
574178 CT ABDOMEN AND PELVIS 1 REGIONS 74178 $246.00
574181 MR ABDOMEN WO DYE 74181 $183.00
574183 MR ABDOMEN WWO DYE 74183 $265.00
574185 MR ANGIO ABDOMEN WWO CONTRAST 74185 $183.00
574220 XR CONTRAST ESOPHAGUS 74220 $56.00
574230 XR CIN VID THROAT ESOPHAGUS 74230 $63.00
574246 XR CONTRAST UPPER GI TRACT 74246 $85.00
574249 XR CONTRAST UPPER GI TRACT 74249 $107.00
574250 XR EXAM SMALL BOWEL 74250 $56.00
574270 XR CONTRAST EXAM COLON 74270 $82.00
574280 XR CONTRAST EXAM COLON 74280 $117.00
574300 XR BILE DUCTS PANCREAS 74300 $43.00
574400 CONTRAST X RAY URINARY TRACT 74400 $47.00
574420 XR CONTRAST URINARY TRACT 74420 $41.00
574430 XR CONTRAST BLADDER 74430 $38.00
574455 XR URETHRA BLADDER 74455 $39.00
574475 XR CONTROL CATH INSERT 74475 $62.00
574740 XR FEMALE GENITAL TRACT 74740 $56.00
575635 CT ANGIOGRAPHY ABDOMINAL ARTERIES 75635 $303.00
575820 XR VEIN ARM LEG 75820 $82.00
575989 XR ABCESS DRAINAGE 75989 $138.00
576000 FLUORO EXAMINATION 76000 $22.00
576001 FLUORO EXAMINATION EXTENSIVE 76001 $89.00
576080 XR EXAM FISTULA 76080 $62.00
576098 XR EXAM BREAST SPECIMEN 76098 $19.00
576376 CT 3D RECON 76376 $20.00
576377 RENDER W INTRP POSTPROCES 76377 $85.00
576536 XR EXAM HEAD AND NECK 76536 $70.00
576604 US EXAM CHEST 76604 $61.00
576641 US BREAST COMPLETE 76641 $87.00
576642 US BREAST LIMITED 76642 $86.00
576700 US EXAM ABDOMINAL COMPLETE 76700 $104.00
576705 ECHO EXAM OF ABDOMEN 76705 $74.00
576770 US EXAM ABDO BACK WALL COMPLETE 76770 $88.00
576775 US EXAM ABDO BACK WALL LIMITED 76775 $68.00
576801 US OB 14 WKS SINGLE FETUS 76801 $135.00
576802 US OB 14 WKS ADDL FETUS 76802 $101.00
576805 US OB 14 WKS SINGLE FETUS 76805 $134.00
576810 US OB 14 WKS ADDL FETUS 76810 $118.00
576812 US DETAILED ADDL FETUS 76812 $217.00
576815 US OB LIMITED FETUS S 76815 $84.00
576816 US OB FOLLOW UP PER FETUS 76816 $112.00
576817 US OB TRANSVAGINAL 76817 $98.00
576818 FETAL BIO PHYS PROFILE W NST 76818 $129.00
576819 FETAL BIO PHYS PROFILE W O NST 76819 $118.00
576826 ECHO EXAM OF FETAL HEART 76826 $188.00
576830 US NON‐OB TRANSVAGINAL 76830 $92.00
576831 ECHO EXAM UTERUS 76831 $87.00
576856 US EXAM PELVIC COMPLETE 76856 $87.00
576857 US EXAM PELVIC LIMITED 76857 $61.00
576870 US EXAM SCROTUM 76870 $82.00
576872 US TRANSRECTAL 76872 $79.00
576881 US EXTREMITY NON‐VASCULAR COMPLETE 76881 $76.00
576882 US EXTREMITY NON‐VASCULAR LIMITED 76882 $63.00
576885 US EXAM INFANT HIPS DYNAMIC 76885 $95.00
576937 US GUIDE VASCULAR ACCESS 76937 $35.00
576942 ECHO GUIDE FOR BIOPSY 76942 $82.00
576998 US GUIDE INTRAOP 76998 $114.00
577001 FLUORO GUIDE FOR VEIN DEVICE 77001 $45.00
577002 XR NEEDLE LOCALIZATION 77002 $68.00
577003 FLUORO GUIDE SPINE INJECTION 77003 $71.00
577012 CT SCAN NEEDLE BIOPSY 77012 $129.00
577051 MM COMPUTER DIAGNOSTIC ADD‐ON 77051 $6.00
577052 MM COMPUTER SCREENING ADD‐ON 77052 $6.00
577061 MM 3D MAMMO DX UNI ADDON 77061 77061 $64.00
577062 MM 3D MAMMO DX BILAT ADDON 77062 77062 $63.00
577063 MM 3D MAMMO SCREEN BILAT ADDON 77063 77063 $64.00
577065 MM MAMMO DIAG UNI W CAD 77065 $82.00
577066 DX MAMMO INCL CAD BI 77066 $100.00
577067 SCR MAMMO BI INCL CAD 77067 $78.00
577072 XR FOR BONE AGE 77072 $23.00
577073 XR FOR BONE LENGTH STUDIES 77073 $34.00
577075 XR BONE SURVEY COMPLETE 77075 $61.00
577076 X RAY BONE SURVEY INFANT 77076 $64.00
577080 BD DXA AXIAL 77080 $25.00
577081 BD DXA PERIPHERAL 77081 $25.00
578102 NM BONE MARROW IMAGING LTD 78102 $63.00
578195 NM LYMPH SYSTEM IMAGING 78195 $138.00
578226 NM HEPATOBILIARY SYSTEM IMAGING 78226 $93.00
578227 NM HEPATOBILIARY SYSTEM IMAGING W DRUG 78227 $113.00
578264 NM GASTRIC EMPTYING STUDY 78264 $87.00
578278 NM ACUTE GI BLOOD LOSS IMAGING 78278 $109.00
578300 NM BONE IMAGING LIMITED AREA 78300 $74.00
578306 NM BONE IMAGING WHOLE BODY 78306 $99.00
578315 NM BONE IMAGING 3 PHASE 78315 $127.00
578320 NM BONE IMAGING 3 D 78320 $118.00
578451 NM HEART MUSCLE IMAGE SPECT SINGLE 78451 $190.00
578452 NM HEART MUSCLE IMAGE SPECT MULTIPLE 78452 $192.00
578582 NM LUNG VENTILATION PERFUSION IMAGING 78582 $200.00
578607 BRAIN IMAGING 3D 78607 $105.00
578707 K FLOW FUNCT IMAGE W O DRUG 78707 $95.00
578708 NM KIDNEY FLOW FUNCTION IMAGING W DRUG 78708 $159.00
578805 NM ABSCESS IMAGING LIMITED AREA 78805 $88.00
578806 NM ABSCESS IMAGING WHOLE BODY 78806 $95.00
579999 RADIOLOGY PROFESSIONAL TEMPLATE $0.00
580305 CL‐ MAT DRUG URINE 10 80305 $30.00
581001 URINALYSIS AUTOMATED W MICROSCOPY 81001 $45.00
581002 URINALYSIS MANUAL WO MICROSCOPY 81002 $35.00
581003 POC URINALYSIS AUTOMATED WO MICROSCOPY 81003 $16.00
581015 URINALYSIS MICROSCOPY ONLY 81015 $79.00
582075 POC BREATH ETHANOL 82075 $33.00
582270 BLOOD OCCULT BY PEROXIDASE ACTIVITY 82270 $44.00
582948 POC GLUCOSE BLOOD REAGENT STRIP 82948 $37.00
583036 POC HEMOGLOBIN A1C TESTING 83036 $88.00
583986 PH BODY FLUID EXCEPT BLOOD 83986 $28.00
585013 BLOOD COUNT SPUN MICROHEMATORCRI 85013 $19.00
586580 SKIN TEST TUBERCULOSIS INTRADERMAL 86580 $29.00
587210 SMEAR PRIMARY SOURCE W INTERP WET MOUNT 87210 $40.00
587400 INFLUENZA A OR B TESTING 87400 $47.00
587807 RSV ASSAY WITH OPTIC OBSERVATION 87807 $62.00
587880 RAPID STREP 87880 $68.00
589321 SEMEN ANAL SPERM DETECTION 89321 $116.00
589999 CLINIC BASED LAB ITEM 87400 $0.00
590021 NO CHARGE VISIT PROC ONLY 90021 90021 $0.00
590028 LIMITED EXAM ‐ NO CHARGE OFF VISIT 90028 90028 $0.00
590375 CL‐ RABIES IMMUNE GLOBULIN 2 ML VIAL 90375 $1,207.00
590471 IMMUNIZATION ADMIN FIRST VACCINE 90471 $49.00
590472 IMMUNIZATION ADMIN EA ADDL VACCINE 90472 $46.00
590630 CL‐ FLU VAX INTRADERMAL 18 64 YEARS 90630 $30.00
590632 CL‐ HEPATITIS A VACCINE ADULT DOSAGE 90632 $458.00
590633 CL‐ HEPATITIS A VACCINE PEDI‐ADOLESCENT 90633 $170.00
590636 CL‐ HEPATITIS A B COMBO ADULT DOSAGE 90636 $520.00
590649 CL‐ STATE HPV VAC GARDASIL 4 90649 $0.01
590651 CL‐ GARDASIL 9 90651 $359.00
590654 CL‐ FLU VAC INTRADERMAL PRES FREE 18‐64Y 90654 $30.00
590655 CL‐ FLU VAC PRES FREE 6‐35 MOS 90655 $0.00
590656 CL‐ FLU VAC TRIVALENT PRES FREE PFS 90656 $24.00
590658 CL‐ INFLUENZA VIRUS VACCINE SPLIT VIRUS 90658 $18.00
590660 **CL‐ FLUMIST NASAL FLU VAC *DO NOT USE* 90660 $0.00
590662 CL‐ FLU VAX HIGH DOSE PF FOR 65Y & OLDER 90662 $57.00
590670 CL‐ PREVNAR 13 NON‐STATE 0.5ML 90670 $322.00
590672 CL‐ STATE FLUMIST QUADRIVALENT 90672 $0.01
590674 CL‐ FLU VAX QUAD FOR 64 YO AND UNDER 90674 $31.00
590675 CL‐ RABIES VACCINE INTRAMUSCULAR USE 90675 $670.00
590685 CL‐ STATE FLU VAC PRES FREE 6‐35 MO QUAD 90685 $0.01
590686 CL‐ STATE FLU VAC PRES FREE 3YR UP QUAD 90686 $0.01
590687 CL‐ STATE FLU VAC 6‐35 MOS QUAD 90687 $0.01
590688 CL‐ STATE FLU VAC 3Y AND OVER QUAD 90688 $0.01
590691 CL‐ TYPHOID INJECTABLE VACCINE 90691 $161.00
590702 CL‐ DT ABSORBED FOR USE IN INDIVID LT 7Y 90702 $43.00
590703 CL‐ TETANUS TOXOID ABSORBED 90703 $24.00
590710 CL‐ STATE MMRV VACCINE 90710 $0.01
590714 CL‐ TETANUS DIPHTHERIA TOXOIDS TD 90714 $64.00
590715 CL‐ TDAP VACCINE 90715 $81.00
590717 CL‐ YELLOW FEVER VACCINE LIVE 90717 $245.00
590732 CL‐ PNEUMOVAX 23 90732 $73.00
590734 CL‐ MENACTRA VACCINE 90734 $415.00
590738 CL‐ INACTD JAPANESE ENCEPHALITIS VAX 90738 $510.00
590739 CL‐ HEP B VACC 2 DOSE ADULT IM 90739 $193.00
590746 CL‐ HEPATITIS B ADULT ENGERIX 20 MCG 90746 $131.00
590791 PSYCHIATRIC DIAGNOSTIC EVALUATION 90791 $402.00
590792 PSYCHIATRIC DIAGNOSTIC EVAL W MED SRVCES 90792 $337.00
590832 PSYCHOTHERAPY PT FAM 30 MIN 90832 $184.00
590833 PSYCHOTHERAPY PT FAM W E M 30 MIN 90833 $152.00
590834 PSYCHOTHERAPY PT FAM 45 MIN 90834 $233.00
590836 PSY TX PT AND FAM W E M 45 MIN 90836 $195.00
590837 PSYCHOTHERAPY PT FAM 60 MIN 90837 $235.00
590839 PSYCHOTHERAPY CRISIS FIRST 60 MINUTES 90839 $279.00
590840 PSYCHOTHERAPY CRISIS ADDTL 30 MINUTES 90840 $133.00
590846 FAMILY PSYCHOTHERAPY WO PT 90846 $232.00
590847 FAMILY PSYCHOTHERAPY W PT 90847 $243.00
591035 G ESOPH REFLX TST W ELECTROD 91035 $939.00
591110 GI TRACT CAPSL ENDOSCOPY INTERP REPORT 91110 $482.00
592542 POSITIONAL NYSTAGMUS TEST 92542 $51.00
592548 POSTUROGRAPHY 92548 $223.00
592552 PURE TONE AUDIOMETRY THRESHOLD 92552 92552 $79.00
592558 EVOKED AUDITORY TEST QUAL 92558 $16.00
592567 TYMPANOMETRY IMPEDANCE TESTING 92567 92567 $57.00
592587 EVOKED OTOACOUSTIC EMISSIONS LTD 92587 92587 $101.00
592950 HEART LUNG RESUSCITATION CPR 92950 $611.00
592960 CARDIOVERSION ELECTRIC EXT 92960 $355.00
593005 ELECTROCARDIOGRAM TRACING OFFSITE ONLY 93005 $39.00
593010 ELECTROCARDIOGRAM INTERPRETATION REPORT 93010 $39.00
593018 STRESS TEST INTERPRETATION AND REPORT 93018 $68.00
593042 RHYTHM ECG 3 LEADS INTERPRETATION ONLY 93042 $148.00
593227 ECG MONITORING FOR 24 HOURS PHY REVIEW 93227 $121.00
593272 ECG REVIEW PHYSICIAN REVIEW AND INTERPRE 93272 $116.00
593880 VASCULAR LAB EXTRACRANIAL BILAT STUDY 93880 $92.00
593922 UPR L XTREMITY ART 2 LEVELS 93922 $25.00
593923 UPR LXTR ART STDY 3 LVLS 93923 $45.00
593924 LWR XTR VASC STDY BILAT 93924 $49.00
593925 LOWER EXTREMITY STUDY READ 93925 $74.00
593926 LOWER EXTREMITY STUDY 93926 $59.00
593931 UPPER EXTREMITY STUDY 93931 $49.00
593970 VASCULAR LAB BILATERAL EXTREMITY STUDY 93970 $83.00
593971 VASCULAR LAB UNILATERAL EXTREMITY STUDY 93971 $54.00
594010 SPIROMETRY INCL GRAPHIC RECORD TOTAL 94010 $25.00
594060 BRONCHODILATION RESPONSIVENESS SPIROMETR 94060 $37.00
594070 BRONCHOSPASM PROVOCATION EVALUATION 94070 $80.00
594618 PULMONARY STRESS TESTING 94618 $48.00
594620 PULMONARY STRESS TESTING SIMPLE 94620 $86.00
594640 NEBULIZER TREATMENTS 94640 94640 $84.00
594726 PFT PLETHYSMOGRAPH 94726 $31.00
594727 PFT PLETHYSMOGRAPH 94727 $26.00
594729 PFT CO2 MEMBRANE DIFFUSE CAPACITY 94729 $22.00
595115 ALLERGY INJECTION FIRST 95115 95115 $43.00
595117 ALLERGY INJECTIONS ADDITIONAL 95117 95117 $58.00
595806 SLEEP STUDY UNATT AND RESP EFFORT 95806 $95.00
595812 EEG 41 60 MINUTES 95812 $107.00
595816 EEG SLEEP DEPRIVED 95816 $410.00
595819 EEG INCLUDING RECORDING AWAKE 95819 $510.00
595857 CHOLINESTERASE CHALLENGE 95857 $118.00
595860 MUSCLE TEST ONE LIMB 95860 $259.00
595861 MUSCLE TEST TWO LIMBS 95861 $359.00
595863 MUSCLE TEST THREE LIMBS 95863 $437.00
595864 MUSCLE TEST FOUR LIMBS 95864 $504.00
595869 MUSCLE TEST THOR PARASPINAL 95869 $161.00
595870 MUSCLE TEST NON PARASPINAL 95870 $189.00
595885 MUSCLE TEST DONE W NERVE TEST LIMITED 95885 $112.00
595886 MUSCLE TEST DONE W NERVE TEST COMPLETE 95886 $238.00
595905 MOTOR SENSORY NERVE CONDUCTION EACH LIMB 95905 $138.00
595907 NERVE CONDUCTION 1 TO 2 STUDIES 95907 $132.00
595908 NERVE CONDUCTION 3 TO 4 STUDIES 95908 $294.00
595909 NERVE CONDUCTION STUDIES 5‐6 STUDIES 95909 $374.00
595910 NERVE CONDUCTION STUDIES 7 TO 8 STUDIES 95910 $474.00
595911 NERVE CONDUCTION STUDIES 9 TO 10 STUDIES 95911 $576.00
595912 NERVE CONDUCTION 11 TO 12 STUDIES 95912 $694.00
595913 NERVE CONDUCTION STUDIES 13 OR MORE 95913 $744.00
595992 CANALITH REPOSITIONING PROC 95992 $88.00
596001 COMPRE COMPUTER BASED MOTION ANALYSIS 96001 $231.00
596110 DEVELOPMENTAL TEST LIMITED 96110 96110 $26.00
596111 DEVELOPMENTAL TEST EXTENDED 96111 96111 $513.00
596150 HEALTH AND BEHAVIOR ASSESSMENT 15 MIN 96150 $43.00
596151 HEALTH AND BEHAVIOR REASSESSMENT 15 MIN 96151 $42.00
596152 HEALTH AND BEHAVIOR INTERVENTION 15 MIN 96152 $39.00
596372 THERAPEUTIC PROPHYLACTIC OR DX INJ 96372 $66.00
596405 CHEMO INTRALESIONAL UP TO 7 96405 $135.00
597597 REMOVE DEVITAL TISSUE LT EQ 20 SQ CM 97597 $110.00
597598 RMVL DEVITAL TIS ADDL 20CM 97598 $50.00
597602 WOUND S CARE NON‐SELECTIVE 97602 $175.00
597605 NEGATIVE PRESSURE WOUND THERAPY LT 50 CM 97605 $87.00
597607 NEG PRES WND THRPY PER SESS LT 50CM 97607 $422.00
597608 NEG PRES WND THRPY PER SESS GT 50CM 97608 $584.00
597802 MNT INDIVIDUAL INITIAL 15 MIN 97802 $70.00
597803 MNT INDIVIDUAL REASSES 15 MIN 97803 $60.00
598925 OSTEO MANIP 1‐2 REGIONS 98925 98925 $158.00
598926 OSTEO MANIP 3‐4 REGIONS 98926 98926 $234.00
598927 OSTEO MANIP 5‐6 REGIONS 98927 98927 $158.00
598928 OSTEO MANIP 7‐8 REGIONS 98928 98928 $162.00
598929 OSTEO MANIP 9‐10 REGIONS 98929 98929 $194.00
599024 POSTOPERATIVE FOLLOW UP VISIT 99024 99024 $0.00
599144 MODERATE SEDATION SERVICES 99144 $138.00
599145 MODERATE SEDATION PHYS QHP EA 15 MIN 99145 $72.00
599152 MOD SED SAME PHYS QHP 5 GREATER YRS 99152 $56.00
599153 MOD SED SAME PHYS QHP EA 99153 $21.00
599156 MOD SED OTH PHYS QHP GREATER THAN 5 YEAR 99156 $139.00
599157 MOD SED OTHER PHYS QHP EA 99157 $110.00
599173 SCREENING TEST OF VISUAL ACUITY 99173 99173 $11.00
599188 CL‐ APPLY TOPICAL FLUORIDE VARNISH 99188 $28.00
599201 NEW PATIENT LEVEL 1 99201 99201 $144.00
599202 NEW PATIENT LEVEL 2 99202 99202 $244.00
599203 NEW PATIENT LEVEL 3 99203 99203 $332.00
599204 NEW PATIENT LEVEL 4 99204 99204 $438.00
599205 NEW PATIENT LEVEL 5 99205 99205 $557.00
599211 ESTABLISHED PATIENT LEVEL 1 99211 99211 $57.00
599212 ESTABLISHED PATIENT LEVEL 2 99212 99212 $124.00
599213 ESTABLISHED PATIENT LEVEL 3 99213 99213 $173.00
599214 ESTABLISHED PATIENT LEVEL 4 99214 99214 $218.00
599215 ESTABLISHED PATIENT LEVEL 5 99215 99215 $339.00
599217 OBSERVATION CARE DISCHARGE DAY 99217 $330.00
599218 INIT OBSERV CARE PER DAY FOR 99218 $291.00
599219 INIT OBSERV CARE PER DAY FOR E 99219 $412.00
599220 INIT OBSERV CARE PER DAY FOR 99220 $558.00
599221 INIT HOSP CARE PER DAY FOR E M 99221 $221.00
599222 INPATIENT HOSPITAL CARE LEVEL 2 99222 $349.00
599223 INPATIENT HOSPITAL CARE LEVEL 3 99223 $464.00
599224 SUBSEQ OBSERVATION CARE 99224 $87.00
599225 SUBSEQUENT OBSERVATION CARE 99225 $150.00
599231 SUBSEQ HOSPITAL CARE LEVEL 1 99231 $125.00
599232 SUBSEQ HOSPITAL CARE LEVEL 2 99232 $169.00
599233 INPATIENT HOSPITAL CARE LEVEL 99233 $265.00
599234 OBSERVATION HOSPITAL CARE LEVEL 99234 $598.00
599235 OBSERVATION HOSPITAL CARE LEVEL 99235 $926.00
599236 OBSERVATION HOSPITAL CARE LEVEL 99236 $1,177.00
599238 HOSPITAL DISCHARGE MGMNT 30 MIN 99238 $278.00
599239 HOSPITAL DISCHARGE DAY MNGMNT M 99239 $418.00
599241 CLINIC OUT PT CONSULT LEVEL 1 99241 99241 $244.00
599242 CLINIC OUT PT CONSULT LEVEL 2 99242 99242 $482.00
599243 CLINIC OUT PT CONSULT LEVEL 3 99243 99243 $548.00
599244 CLINIC OUT PT CONSULT LEVEL 4 99244 99244 $695.00
599245 CLINIC OUT PT CONSULT LEVEL 5 99245 99245 $977.00
599251 INPATIENT CONSULTATION LEVEL 1 99251 99251 $210.00
599252 INPATIENT CONSULTATION LEVEL 2 99252 99252 $268.00
599253 INPATIENT CONSULTATION LEVEL 3 99253 99253 $270.00
599254 INPATIENT CONSULTATION LEVEL 4 99254 99254 $426.00
599255 INPATIENT CONSULTATION LEVEL 5 99255 99255 $597.00
599281 EMERGENCY DEPT VISIT LEVEL 1 99281 $94.00
599282 EMERGENCY DEPT VISIT LEVEL 2 99282 $158.00
599283 EMERGENCY DEPT VISIT LEVEL 3 99283 $243.00
599284 EMERGENCY DEPT VISIT LEVEL 4 99284 $422.00
599285 EMERGENCY DEPT VISIT LEVEL 5 99285 $733.00
599291 CRITICAL CARE E M OF CRITICALLY 99291 $997.00
599292 CRITICAL CARE EACH ADDL 30 MI 99292 $500.00
599304 INIT NURSING FAC CARE PER DAY L1 99304 99304 $125.00
599305 INIT NURSING FAC CARE PER DAY L2 99305 99305 $189.00
599306 INIT NURSING FAC CARE PER DAY L3 99306 99306 $314.00
599307 SUBSEQ NURSING FAC CARE L1 99307 99307 $97.00
599308 SUBSEQ NURSING FAC CARE L2 99308 99308 $132.00
599309 SUBSEQ NURSING FAC CARE L3 99309 99309 $171.00
599310 SUBSEQ NURSING FAC CARE L4 99310 99310 $258.00
599315 NURSING FACILITY DISC DAY LT 30MIN 99315 $269.00
599316 NURSING FACILITY DISC DAY GT 30MIN 99316 $315.00
599318 NURSING FACILITY ANNUAL ASSESSMENT 99318 $211.00
599324 DOMICIL R‐HOMEVISIT NEW PATIENT L1 99324 99324 $128.00
599325 DOMICIL R‐HOMEVISIT NEW PATIENT L2 99325 99325 $181.00
599326 DOMICIL R‐HOMEVISIT NEW PATIENT L3 99326 99326 $342.00
599327 DOMICIL R‐HOMEVISIT NEW PATIENT L4 99327 99327 $413.00
599328 DOMICIL R‐HOMEVISIT NEW PATIENT L5 99328 99328 $479.00
599334 DOMICIL R‐HOMEVISIT EST PATIENT L1 99334 99334 $132.00
599335 DOMICIL R‐HOMEVISIT EST PATIENT 21 99335 99335 $203.00
599336 DOMICIL R‐HOMEVISIT EST PATIENT L3 99336 99336 $283.00
599337 DOMICIL R‐HOMEVISIT EST PATIENT L4 99337 99337 $428.00
599341 HOME VISIT ‐ NEW PATIENT LEVEL 1 99341 99341 $122.00
599342 HOME VISIT ‐ NEW PATIENT LEVEL 2 99342 99342 $224.00
599343 HOME VISIT ‐ NEW PATIENT LEVEL 3 99343 99343 $333.00
599344 HOME VISIT ‐ NEW PATIENT LEVEL 4 99344 99344 $419.00
599345 HOME VISIT ‐ NEW PATIENT LEVEL 5 99345 99345 $488.00
599347 HOME VISIT ‐ ESTAB PATIENT LEVEL 1 99347 99347 $79.00
599348 HOME VISIT ‐ ESTAB PATIENT LEVEL 2 99348 99348 $168.00
599349 HOME VISIT ‐ ESTAB PATIENT LEVEL 3 99349 99349 $259.00
599350 HOME VISIT ‐ ESTAB PATIENT LEVEL 4 99350 99350 $437.00
599354 PROLONG SERVICE OFFICE 99354 $202.00
599355 PROLONG SERVICE OFFICE 99355 $196.00
599356 PROLONG SERVICE INPATIENT 99356 $330.00
599357 PROLONGED SERVICE INPATIENT ADDL 30 MIN 99357 $293.00
599360 PHYSICIAN STANDBY SERVICES 99360 $0.00
599381 NEW PT PREV MED UNDER 1 99381 99381 $250.00
599382 NEW PT PREV MED 1‐4 YR 99382 99382 $280.00
599383 NEW PT PREV MED 5‐11 YR 99383 99383 $267.00
599384 NEW PT PREV MED 12‐17 YR 99384 99384 $358.00
599385 NEW PT PREV MED 18‐39 YR 99385 99385 $365.00
599386 NEW PT PREV MED 40‐64 YR 99386 99386 $444.00
599387 NEW PT PREV MED 65 YR AND UP 99387 99387 $438.00
599391 EST PT PREV MED UNDER 1 YR 99391 99391 $221.00
599392 EST PT PREV MED 1‐4 YR 99392 99392 $233.00
599393 EST PT PREV MED 5‐11 YR 99393 99393 $276.00
599394 EST PT PREV MED 12‐17 YR 99394 99394 $313.00
599395 EST PT PREV MED 18‐39 YR 99395 99395 $335.00
599396 EST PT PREV MED 40‐64 YR 99396 99396 $362.00
599397 EST PT PREV MED 65 YR AND UP 99397 99397 $385.00
599406 BEHAV CHNG SMOKING 3 TO 10 MIN 99406 $32.00
599407 BEHAV CHNG SMOKING GREATER THAN 10 MIN 99407 $56.00
599435 NEWBORN DISCHARGE DAY HOSP 99435 $174.00
599441 PHONE EVAL MGMT 5‐10 MIN 99441 $0.00
599442 PHONE EVAL MGMT 11‐20 MIN 99442 $0.00
599443 PHONE EVAL MGMT 21‐30 MIN 99443 $0.00
599455 WORK RELATED OR MEDICAL DISABILITY 99455 99455 $418.00
599460 INIT NEWBORN EVAL AND MGMT PER DAY 99460 $199.00
599462 SUBQT NEWBORN EVAL AND MGMT PER DAY 99462 $108.00
599463 SAME DAY NB DISCHARGE 99463 $255.00
599464 ATTENDANCE AT DELIVERY 99464 $256.00
599465 NB RESUSCITATION 99465 $317.00
599468 NEONATE CRIT CARE INITIAL 99468 $1,981.00
599477 INIT DAY HOSP NEONATE CARE 99477 $677.00
599495 TRANS CARE MGMT 14 DAY DISCH 99495 $317.00
599496 TRANS CARE MGMT 7 DAY DISCH 99496 $448.00
599499 UNLISTED E AND M SERVICE 99499 $107.00
2500012 BLOOD TRSF UNDER 2 HOURS 36430 $831.83
2500013 BLOOD TRSF 2‐4 HOURS 36430 $1,131.67
2500014 BLOOD TRSF 4‐6 HOURS 36430 $1,198.30
2500015 BLOOD TRSF OVER 6 HOURS 36430 $1,485.25
2500016 CARDIOVERSION 92960 $789.72
2500017 EXTERNAL PACER 92953 $105.15
2500019 MED/SURG‐MED OBSVO 99220 $161.21
2500020 SUBCUTANEOUS IM NON FLOOR PATIENTS ONLY 96372 $293.40
2500021 INFUSION THER HYDRATION 1ST HOUR 96360 $514.79
2500022 INFUSION THER HYDRATION EA ADDTL HOUR 96361 $282.65
2500023 INFUSION THERAPY OR PROPHYLAXIS 1ST HR 96365 $753.37
2500024 INFUSION THERAPY OR PROPHYLAXIS EA ADDTL 96366 $282.65
2500025 INFUSION THERAPY SEQ SUBSTANCE 1ST HOUR 96367 $319.75
2500026 INFUSION THERAPY CONCURRENT INFUSION 96368 $311.67
2500028 IV PUSH INITIAL 96374 $502.96
2500029 IV PUSH EA ADDITIONAL SEQ SUBSTANCE 96375 $283.72
2500030 IV PUSH EACH ADDITIONAL SEQUENTIAL 96376 $321.34
2500031 IV SUBQ INFUSION FOR PROPHYLAXIS 1ST HR 96369 $300.44
3300003 HRLY‐OBSVO RM NRSY $112.66
3300004 ADMIN STATE SUPPLIED PEDIATRIC VACCINE 90471 $23.64
3300005 CAR SEAT BED TESTING FIRST 60 MIN 94780 $149.38
3300006 CAR SEAT BED TESTING EACH ADDTL 30 MIN 94781 $161.21
3400010 BLOOD TRSF UNDER 2 HOURS 36430 $789.72
3400011 BLOOD TRSF 2‐4 HOURS 36430 $1,125.57
3400012 BLOOD TRSF 4‐6 HOURS 36430 $1,179.22
3400013 BLOOD TRSF OVER 6 HOURS 36430 $1,508.63
3400014 SUBCUTANEOUS IM NON FLOOR PATIENTS ONLY 96372 $292.93
3600001 HOME BASED WAIVER ADULT SVC 15 MIN $4.49
3600002 MODERATE GROUP ADULT SVC 15 MIN $4.49
3600003 DAY HEALT ADULT SVC 15 MIN $4.49
3600004 PRIVATE ADULT SVC HOURLY $13.89
3700001 IV PUSH INITIAL 96374 $502.16
3700044 OPTHOMOLOGY PROCEDURE PER MINUTE $153.68
3700045 MINOR ROOM PROCEDURE PER MINUTE $78.45
3700046 OPERATING ROOM PROCEDURE PER MINUTE $157.98
3700047 ENDOSCOPY ROOM PROCEDURE PER MINUTE $89.19
3700048 GI TRACT CAPSULE ENDOSCOPY 91110 $3,294.08
3700049 C SECTION PER MINUTE $82.75
3800013 RECOVERY PACU PER MINUTE $75.23
3900001 FETAL CONTRACT STESS TEST 59020 $849.02
3900002 NON STRESS TEST 59025 $537.35
3900003 FETAL MONITORING 59050 $854.39
3900004 LABOR CHECK 0‐2 HRS 99211 $428.81
3900005 LABOR CHECK 2‐4 HRS 99211 $435.26
3900006 LABOR CHECK 4 HRS 99211 $440.63
3900010 LABOR 24 HRS $0.00
3900011 VAGINAL BIRTH $4,478.31
3900012 SURG PRO IN L&D 0‐15 MIN $234.99
3900013 SURG PRO IN L&D 15‐30 MIN $469.97
3900014 SURG PRO IN L&D 30 MIN+ $939.94
3900015 NEONAT MONITOR 1ST HR $1,521.79
3900016 NEONAT MONITOR PER HR EACH ADDITIONAL $233.21
3900017 VAGINAL DELIVERY IN THE OR $6,440.10
3900024 OBSTETRICS OBSERVATION 99220 $161.21
3900025 BILIRUBIN TOTAL TRANSCUTANEOUS 88720 $35.92
3900026 INFUSION THER HYDRATION 1ST HOUR 96360 $514.79
3900027 INFUSION THER HYDRATION EA ADDTL HOUR 96361 $282.65
3900028 INFUSION THERAPY OR PROPHYLAXIS 1ST HOUR 96365 $753.37
3900029 INFUSION THERAPY OR PROPHYLAXIS EA ADDTL 96366 $282.65
3900030 INFUSION THERAPY SEQ SUBSTANCE 1ST HOUR 96367 $319.75
3900031 INFUSION THERAPY CONCURRENT INFUSION 96368 $311.17
3900032 SUBCUTANEOUS IM NON FLOOR PATIENTS ONLY 96372 $293.40
3900033 CHILD BIRTHING INDIVIDUAL CLASS $19.34
3900034 CHILD BIRTHING CLASSES $79.40
3900035 IV PUSH INITIAL 96374 $502.96
3900036 IV PUSH EA ADDITIONAL SEQ SUBSTANCE 96375 $283.72
3900037 IV PUSH EACH ADDITIONAL SEQUENTIAL 96376 $321.34
3900038 EXTERNAL CEPHALIC VERSION WWO TOCOLYSIS 59412 $8,382.73
3900039 BLOOD TRANSFUSION UNDER 2 HOURS 36430 $789.72
3900040 BLOOD TRANSFUSION 2‐ 4 HOURS 36430 $1,125.57
3900041 BLOOD TRANSFUSION 4‐ 6 HOURS 36430 $1,181.11
3900042 BLOOD TRANSFUSION OVER 6 HOURS 36430 $1,508.63
3900043 ADMIN VACCINE 90471 $121.25
3900044 AMNIOCENTESIS DIAGNOSTIC 59000 $997.88
3900045 DAILY MNGMT EPIDURAL CONT DRUG ADMIN 1996 $1,074.71
3900046 CHILD BIRTHING PRIVATE CLASS PER SESSION $166.31
4000001 BRIEF VISIT ESTABLISHED PATIENT 99212 $119.10
4000002 LIMITED VISIT ESTABLISHED PATIENT 99213 $169.53
4000003 INTERMEDIATE VISIT ESTABLISHED 99214 $231.77
4000004 COMPREHENSIVE VISIT ESTABLISHED PATIENT 99215 $291.85
4000037 ANESTESTIST LOCAL $510.74
4000038 ANESTHESIA SERVICES PER MINUTE $13.97
4100003 XR INJ SINUS TRACT 20501 20501 $526.81
4100004 XR INJ SHOULDER ARTHRO 23350 23350 $3,146.86
4100005 XR INJ ELBOW ARTHROG 24220 24220 $486.54
4100006 XR INJ WRIST ARTHROG 25246 25246 $1,402.58
4100007 XR INJ PROC HIP ARTHR 27093 27093 $2,092.69
4100009 XR INJ ANKLE ARTHRO 27648 27648 $1,158.76
4100012 XR BIOPSY PLEURA 32400 32400 $394.83
4100013 XR BIOPSY LUNG MEDIAS 32405 32405 $5,911.20
4100019 XR INJ URETEROGRAPHY 50684 50684 $1,320.93
4100020 XR INJ PROCE LOOPOGRAM 50690 50690 $1,320.93
4100021 XR INJ PROC CYSTO VCUG 51600 51600 $1,424.95
4100022 XR INTRO CATH HYSTERO 58340 58340 $2,399.63
4100023 XR ORBIT FOREIGN BODY 70030 70030 $408.91
4100024 XR MANDIBLE JAW 70110 70110 $581.43
4100025 XR MASTOID 70130 70130 $795.25
4100026 XR FACIAL BONES LT 3VIEWS 70140 70140 $408.25
4100027 XR FACIAL BONES GT 3 VIEWS 70150 70150 $904.07
4100028 XR NASAL BONES 70160 70160 $408.91
4100029 XR OPTIC FOARMINA 70190 70190 $669.98
4100030 XR ORBITS 4V 70200 70200 $1,056.42
4100031 XR SINUS 3 OR MORE VIEWS 70220 70220 $906.30
4100032 XR SELLA TURCICA 70240 70240 $413.84
4100033 XR SKULL 70250 70250 $594.86
4100034 XR SKULL 5V 70260 70260 $916.05
4100035 XR TMJS 70330 70330 $413.84
4100036 MR TMJS 70336 70336 $2,569.92
4100037 XR SOFT TISSUE NECK 70360 70360 $408.91
4100038 XR SALIVARY GLAND 70380 70380 $413.84
4100039 XR SIALOGRAM 70390 70390 $702.41
4100040 CT HEAD WO CONTRAST 70450 70450 $1,622.81
4100041 *CT HEAD W CONTRAST 70460 70460 $1,928.03
4100042 *CT HEAD WWO CONTRAST 70470 70470 $2,328.90
4100043 CT EAR WO CONTRAST 70480 70480 $1,744.27
4100044 *CT EAR W CONTRAST 70481 70481 $1,481.99
4100045 *CT EAR WWO CONTRAST 70482 70482 $2,565.81
4100046 CT SINUS WO CONTRAST 70486 70486 $1,776.49
4100047 *CT SINUS FACIAL W CONTRAST 70487 70487 $2,228.95
4100048 CT SINUS FACIAL WWO CONTRAST 70488 70488 $2,488.63
4100049 CT NECK WO CONTRAST 70490 70490 $1,752.11
4100050 *CT NECK W CONTRAST 70491 70491 $2,140.82
4100051 MR ORBITS WO CONTRAST 70540 70540 $2,794.07
4100052 *MR ORBITS WWO CONTRAST 70543 70543 $3,220.80
4100053 MRA HEAD WO CONTRAST 70544 70544 $2,978.02
4100054 *MRA HEAD W CONTRAST 70545 70545 $3,022.08
4100055 *MRA HEAD WWO CONTRAST 70546 70546 $2,960.89
4100056 MRA NECK WO CONTRAST 70547 70547 $2,569.92
4100057 *MRA NECK W CONTRAST 70548 70548 $2,777.20
4100058 *MRA NECK WWO CONTRAST 70549 70549 $3,205.12
4100059 MR BRAIN WO CONTRAST 70551 70551 $2,999.51
4100060 *MR BRAIN W CONTRAST 70552 70552 $3,258.52
4100061 *MR BRAIN WWO CONTRAST 70553 70553 $4,224.68
4100066 XR RIB UNI 71100 71100 $408.91
4100067 XR RIB UNI CHEST 71101 71101 $554.54
4100068 XR RIB BIL 71110 71110 $600.47
4100069 XR RIB BIL CHEST 71111 71111 $854.77
4100070 XR STERNUM 71120 71120 $406.66
4100071 XR STERNOCLAVICULAR JTS 71130 71130 $408.91
4100072 CT CHEST WO CONTRAST 71250 71250 $1,774.35
4100073 *CT CHEST W CONTRAST 71260 71260 $2,254.74
4100074 *CT CHEST WWO CONTRAST 71270 71270 $4,372.44
4100075 MR CHEST WO CONTRAST 71550 71550 $2,558.71
4100077 *MR CHEST WWO CONTRAST 71552 71552 $3,835.29
4100078 XR SPINE 1V ANY LEVEL 72020 72020 $340.56
4100079 XR CSPINE 2V 72040 72040 $554.54
4100080 XR CERVICAL INC FLEX 72052 72052 $554.54
4100082 XR TSPINE 2V 72070 72070 $554.54
4100084 XR LSSPINE 2V 72100 72100 $588.94
4100085 XR LSSPINE 4V 72110 72110 $554.54
4100086 XR LSSPINE BENDING 72114 72114 $554.54
4100087 CT CSPINE WO CONTRAST 72125 72125 $1,953.82
4100088 *CT CSPINE W CONTRAST 72126 72126 $2,216.80
4100089 *CT CSPINE WWO CONTRAST 72127 72127 $2,465.14
4100090 CT TSPINE WO CONTRAST 72128 72128 $1,752.11
4100091 *CT TSPINE W CONTRAST 72129 72129 $1,567.00
4100092 *CT TSPINE WWO CONTRAST 72130 72130 $1,753.78
4100093 CT LSSPINE WO CONTRAST 72131 72131 $1,902.24
4100094 *CT LSSPINE W CONTRAST 72132 72132 $2,250.06
4100095 *CT LSSPINE WWO CONTRAST 72133 72133 $3,057.94
4100096 MR CSPINE WO CONTRAST 72141 72141 $3,070.44
4100097 *MR CSPINE W CONTRAST 72142 72142 $3,884.00
4100098 MR TSPINE WO CONTRAST 72146 72146 $3,098.39
4100099 *MR TSPINE W CONTRAST 72147 72147 $3,389.01
4100100 MR LSPINE WO CONTRAST 72148 72148 $3,114.51
4100101 *MR LSPINE W CONTRAST 72149 72149 $3,424.99
4100102 *MR CSPINE WWO CONTRAST 72156 72156 $4,198.89
4100103 *MR TSPINE WWO CONTRAST 72157 72157 $4,054.88
4100104 *MR LSPINE WWO CONTRAST 72158 72158 $4,213.94
4100105 *MRA SPINE WWO CONTRAST 72159 72159 $2,371.19
4100106 XR PELVIS 1 OR 2V 72170 72170 $554.54
4100108 CT PELV WO CONTRAST 72192 72192 $1,823.78
4100109 CT PELV W CONTRAST 72193 72193 $2,178.44
4100110 *CT PELV WWO CONTRAST 72194 72194 $2,365.95
4100111 MR PELV WO CONTRAST 72195 72195 $2,869.47
4100112 *MR PELV W CONTRAST 72196 72196 $2,364.48
4100113 *MR PELV WWO CONTRAST 72197 72197 $4,014.04
4100114 *MRA PELV WWO CONTRAST 72198 72198 $2,957.17
4100115 XR SACRO ILIAC JOINTS 2 VIEWS 72200 72200 $408.91
4100116 XR SACRUM COCCYX 72220 72220 $408.91
4100118 *XR CLAVICLE 73000 73000 $408.91
4100119 XR SCAPULA 73010 73010 $362.97
4100120 XR SHOULDR 1V 73020 73020 $408.91
4100121 XR SHOULDER 2 OR 3V 73030 73030 $478.25
4100122 XR SHOULDER ARTHRO 73040 73040 $1,394.75
4100123 XR AC JOINTS BIL 73050 73050 $553.65
4100124 XR HUMERUS 73060 73060 $408.91
4100125 XR ELBOW 2V 73070 73070 $408.91
4100126 XR ELBOW 3V 73080 73080 $408.91
4100127 XR ELBOW ARTHROGRAM 73085 73085 $1,292.97
4100128 XR RADIUS ULNA 73090 73090 $408.91
4100129 XR INF ARM 73092 73092 $553.65
4100130 XR WRIST 3V OR MORE 73110 73110 $497.59
4100131 XR WRIST ARTHROGRAM 73115 73115 $1,342.18
4100132 XR HAND UNILATERAL 2V 73120 73120 $403.02
4100133 XR HAND UNILATERAL 3V 73130 73130 $492.22
4100134 XR FINGER 73140 73140 $408.91
4100135 *CT UP EXT WO CONTRAST 73200 73200 $1,752.11
4100136 *CT UP EXT W CONTRAST 73201 73201 $1,487.73
4100137 *CT UP EXT WWO CONTRAST 73202 73202 $2,368.26
4100138 MR UP EXT WO CONTRAST 73218 73218 $2,569.92
4100139 *MR UP EXT W CONTRAST 73219 73219 $2,364.48
4100140 *MR UP EXT WWO CONTRAST 73220 73220 $2,819.74
4100141 MR UP JT WO CONTRAST 73221 73221 $2,895.27
4100142 *MR UP JT W CONRAST 73222 73222 $3,459.49
4100143 *MR UP JT WWO CONTRAST 73223 73223 $3,256.65
4100144 *MRA UP EXT WWO CONTRAST 73225 73225 $1,698.99
4100149 XR KNEE 2V 73560 73560 $443.85
4100151 XR KNEE 3V 73562 73562 $533.06
4100152 XR KNEE 4V 73564 73564 $756.19
4100153 XR KNEE BIL STAND 73565 73565 $408.91
4100154 XR KNEE ARTHROGRAPHY 73580 73580 $1,573.71
4100156 XR TIB FIB 2V 73590 73590 $395.46
4100157 XR INF LEG 73592 73592 $568.19
4100158 XR ANKLE 3V 73610 73610 $495.44
4100159 XR ANKLE ARTHROGRAM 73615 73615 $2,592.65
4100160 XR FT 2V WGT BR 73620 73620 $419.14
4100161 XR FOOT 3V 73630 73630 $457.83
4100162 *XR CALCANEOUS 73650 73650 $408.91
4100163 XR TOE 73660 73660 $408.91
4100164 *CT LOW EXT WO CONTRAST 73700 73700 $1,753.24
4100165 *CT LOW EXT W CONTRAST 73701 73701 $1,606.48
4100166 *CT LOW EXT WWO CONTRAST 73702 73702 $2,386.85
4100167 MR LOW EXT WO CONTRAST 73718 73718 $2,569.92
4100168 *MR LOW EXT W CONTRAST 73719 73719 $2,131.89
4100169 *MR LOW EXT WWO CONTRAST 73720 73720 $3,248.80
4100170 MR LOW JT WO CONTRAST 73721 73721 $2,924.28
4100171 *MR LOW JT W CONTRAST 73722 73722 $2,859.97
4100172 *MR LOW JT WWO CONTRAST 73723 73723 $3,201.75
4100176 XR ACUTE ABD SER 74022 74022 $554.54
4100177 CT ABD WO CONTRAST 74150 74150 $1,837.75
4100178 *CT ABD W CONTRAST 74160 74160 $2,240.77
4100179 *CT ABD WWO CONTRAST 74170 74170 $2,584.68
4100180 MR ABDOMEN WO CONTRAST 74181 74181 $2,569.92
4100181 *MR ABDOMEN W CONTRAST 74182 74182 $2,732.46
4100182 *MR ABDOMEN WWO CONTRAST 74183 74183 $2,819.74
4100183 XR BA SWALLOW 74220 74220 $593.74
4100184 XR BA SWALL MOD 74230 74230 $593.74
4100185 XR UGI W KUB 74247 74247 $853.40
4100186 XR UGI W SMALL BOWEL FOLLOW THRU 74249 74249 $1,202.37
4100187 XR SMALL BOWEL 74250 74250 $592.80
4100188 XR BARIUM ENEMA 74270 74270 $880.25
4100189 XR BA ENEMA W AIR 74280 74280 $880.25
4100190 XR ORAL CHOLECYSTOGRAM 74290 74290 $1,473.05
4100191 XR OR CHOLANGIOGRAM 74300 74300 $4,133.93
4100194 XR INTRO LONG TUBE 74340 74340 $847.81
4100195 XR IVP 74400 74400 $1,559.18
4100196 XR UROGRAPHY DRIP 74410 74410 $1,791.81
4100197 XR NEPHROTOMOGRAM 74415 74415 $1,492.06
4100198 XR OR KIDNEY RETRO 74420 74420 $1,545.75
4100200 XR CYSTOGRAM 74430 74430 $1,625.16
4100201 XR CYSTO VOIDING 74455 74455 $1,308.63
4100202 *XR HYSTEROSALPINGOGRAM 74740 74740 $2,194.62
4100203 XR ANGIO EXT UNI 75710 75710 $652.08
4100204 XR VENOGRAPHY UNI 75820 75820 $1,120.72
4100206 XR GUIDANCE PERC DRAIN 75989 75989 $810.90
4100213 XR FISTULAGRAM 76080 76080 $1,365.67
4100219 MM SURG SPECIMEN 76098 76098 $1,967.20
4100220 XR TOMO 1 PLANE 76100 76100 $1,292.97
4100223 MR SPECTROSCOPY 76390 76390 $2,371.19
4100225 US INF HEAD 76506 76506 $530.17
4100226 *US SOFT TISSUE HEAD NECK 76536 76536 $897.34
4100227 US CHEST 76604 76604 $877.18
4100229 US ABD COMP 76700 76700 $1,005.93
4100230 US ABD SINGLE ORGAN QUADRANT 76705 76705 $721.13
4100231 US KIDNEY BLADDER 76770 76770 $787.56
4100232 US SPINAL CANAL 76800 76800 $672.21
4100233 US PREG GT 14 WKS 76805 76805 $757.67
4100234 US PREG GT 14 WKS ADDTL FET 76810 76810 $1,531.21
4100235 US PREG OB LIMITED 76815 76815 $787.56
4100236 US BPP NON STRESS 76818 76818 $898.15
4100237 US PREG BIOPHY 76819 76819 $1,141.97
4100238 US PELV TRANSVAG 76830 $837.20
4100239 US PELV HYSTERO 76831 76831 $795.25
4100240 US PELV TRANSABD 76856 76856 $749.07
4100241 US SCROTUM 76870 76870 $897.34
4100242 US PROSTATE 76872 76872 $787.56
4100244 US INF HIPS BIL 76885 76885 $535.50
4100246 US GUIDE NEEDLE PL 76942 76942 $1,938.08
4100247 US GUIDANCE AMNIO 76946 76946 $653.19
4100253 XR DUPLICATING OF XRAY $107.37
4100254 XR DUPLICATE SF $59.28
4100259 XR GUIDEWIRE 035 C1769 C1769 $99.54
4100260 *MRA ABDOMEN WWO CONTRAST 74185 74185 $3,139.60
4100263 *MRA CHEST WWO CONTRAST 71555 71555 $2,342.12
4100264 *MRA LOW EXT WWO CONTRAST 73725 73725 $2,892.41
4100284 US EXT VEINS UNI 93971 93971 $787.56
4100285 US EXT VEINS BIL 93970 93970 $1,106.83
4100286 XR CSPINE 4V 72050 72050 $554.54
4100290 XR UPPER GI 74246 74246 $881.66
4100291 US AORTA KIDNEY 76775 76775 $787.56
4100292 US PELV LIM F UP 76857 76857 $1,064.26
4100295 *US PREG LT 14 WKS 76801 76801 $827.53
4100296 US PREG LT 14 WKS ADDTL FET 76802 76802 $624.12
4100297 US PREG TRANS VAGINAL 76817 76817 $736.18
4100304 US CAROTID BIL 93880 93880 $1,249.11
4100309 XR NEPHROSTOGRAM 74425 74425 $1,462.98
4100311 XR URETHRAGRAM 74450 74450 $1,440.61
4100314 *CTA HEAD CIR WIL WWO CONTRAST 70496 70496 $1,861.90
4100315 *CTA NECK CAROTID WWO CONTRAST 70498 70498 $1,869.75
4100319 *CTA CHEST AORTA WWO CONTRAST 71275 71275 $1,863.02
4100320 CTA PELV WWO CONTRAST 72191 72191 $2,415.93
4100321 CTA ARM WWO CONTRAST 73206 73206 $2,373.87
4100322 CTA LEG ART VEIN WWO CONTRAST 73706 73706 $1,836.13
4100323 CTA ABD WWO CONTRAST 74175 74175 $1,914.55
4100325 CTA AORTA RUN OFF WWO CONTRAST 75635 75635 $1,836.13
4100326 CT PERCUT DRAINAGE W CATH 75989 75989 $2,324.22
4100330 CT 3D RECON 76376 76376 $694.57
4100331 CT POST PROC IND STATION 76377 76377 $773.00
4100332 CT RECON OR LIMIT LOC F UP STUDY 76380 76380 $406.01
4100336 CTA CEREB PERFUS 0042T 0042T $290.80
4100345 XR ANKLE 2V 73600 73600 $418.06
4100346 XR WRIST 2V 73100 73100 $414.84
4100347 CT FACIAL WO CONTRAST 70486 70486 $1,776.49
4100349 CONT SINOGRAFIN PER ML Q9963 $419.14
4100350 XR FLUORO C ARM 76000 76000 $947.75
4100351 XR FLUORO NEEDLE PLAC CARM 77002 77002 $6,005.81
4100352 XR INF BONE AGE 77072 77072 $1,020.06
4100353 XR LEG LENGTH 77073 77073 $554.54
4100354 XR BONY SURVEY INFANT 77076 77076 $381.41
4100355 BD SCREEN WRIST HEEL 77081 77081 $413.84
4100356 MM DUCTAL GALACTOGRAM 77053 77053 $850.05
4100362 CT GUIDE NEEDLE PL 77012 77012 $3,910.89
4100363 MR BONE MARROW 77084 77084 $2,600.48
4100364 US GUIDE INTRAOP 76998 76998 $554.77
4100367 XR BONE SURVEY LIMITED 77074 77074 $677.80
4100368 XR BONE SURVEY 77075 77075 $930.95
4100372 XR FLUORO CVAD PLACEMENT 77001 77001 $3,180.46
4100373 CT BONE MIN DENSITY STUDY 77078 77078 $413.84
4100374 CT CONTRAST SUBTRACTION 77011 77011 $2,035.65
4100376 BD BONE DENSITY COMP 77080 DEXA 77080 $638.38
4100377 XR EPIDUROGRAPHY 72275 72275 $1,134.14
4100378 XR FLUORO SPINE INJ 77003 77003 $980.91
4100379 XR THORACOLUMBAR 2 VIEW 72080 72080 $408.91
4100380 CONT LOCM ISOVUE 300 100 ML VIAL Q9967 $261.03
4100381 CONTRAST PROHANCE PER 17 ML SYR MRI A9576 $1,060.90
4100382 XR CORPORA CAVERNOSOGRAPHY 74445 74445 $1,379.09
4100383 CONTRAST MULTIHANCE PER 20 ML SYR MRI A9577 $517.86
4100384 CONTRAST PROHANCE PER 20 ML VIAL MRI A9576 $1,191.19
4100385 CONTRAST PROHANCE PER 5 ML VIAL MRI A9576 $401.06
4100386 US PREG UTERUS FOLLOWUP PER FETUS 76816 76816 $662.02
4100390 CONT LOCM ISOVUE 300 50 ML VIAL Q9967 $217.34
4100391 XR ARTHROCENTESIS MAJOR JOINT 20610 20610 $1,233.42
4100392 XR PELVIS COMPLETE 3 VIEWS + 72190 72190 $554.54
4100393 CONT GADOXETATE DISODIUM INJ A9581 $247.58
4100394 US ARTERIAL LOWER EXT BILAT 93925 93925 $890.62
4100395 US ARTERIAL LOWER EXT UNILT 93926 93926 $559.02
4100396 US ARTERIAL UPPER EXT BILAT 93930 93930 $889.20
4100397 US ARTERIAL UPPER EXT UNILAT 93931 93931 $875.78
4100398 US SOFT TISSUE EXTERMITY COMPLETE 76881 76881 $1,531.42
4100399 US SOFT TISSUE EXTREMITY LIMITED 76882 76882 $794.27
4100400 CT ABD PELVIS WO CONTRAST 74176 74176 $2,808.22
4100401 *CT ABD PELVIS W CONTRAST 74177 74177 $3,483.13
4100402 *CT ABD PELVIS WWO CONTRAST 74178 74178 $4,137.63
4100403 CONT INJ RADIOLOGIC EVAL OF CVAD 36598 36598 $1,219.15
4100404 *CT NECK WWO CONTRAST 70491 70492 $3,967.27
4100405 *XR INSERT PICC CATH AGE 5 OR OLDR 36569 36569 $6,371.02
4100406 US GUIDANCE VASCULAR ACCESS 76937 76937 $1,493.33
4100407 *XR PERQ SACRAL AUGMT UNILAT INJ 0200T 0200T $8,038.56
4100408 *XR PERQ SACRAL AUGMT BILAT INJ 0201T 0201T $10,866.10
4100410 *XR BIOPSY BONE TROCAR NEEDLE DEEP 20225 20225 $9,934.40
4100418 XR INJ PARAVERTEBRAL F JNT 1 LEVEL 64493 $3,451.65
4100419 XR BIOPSY OF LYMPH NODE NEEDLE SUPERFIC 38505 $6,148.32
4100420 XR INSERT NONTUNNEL CV CATH AGE 5 OR GTR 36556 $4,124.98
4100421 XR ARTHROCENTESIS INTERMED JNT 20605 20605 $1,233.42
4100422 XR SINUS LT 3 VIEWS 70210 70210 $406.66
4100423 XR SACRO ILIAC JNTS 3 OR MORE VIEW 72202 72202 $554.54
4100424 CT INJ FORAMEN EPIDURAL CERVICAL OR THOR 64479 $2,628.44
4100425 CT INJ FORAMEN EPIDURAL CERV OR THOR ADD 64480 $1,358.97
4100426 CT INJ FORAMEN EPIDURAL LUMBAR OR SACRAL 64483 $4,369.93
4100427 CT INJ FORAMEN EPIDURAL LUMBAR OR SAC AD 64484 $1,504.37
4100428 XR INJ PARAVERT F JNT CERVICAL OR THOR 1 64490 $2,628.44
4100429 XR INJ PARAVERT F JNT CERVICAL OR THOR 2 64491 $932.82
4100430 XR INJ PARAVERT F JNT CERVICAL OR THOR 3 64492 $932.82
4100431 XR INJ PARAVERTEBRAL F JNT 2 LEVEL 64494 $879.13
4100432 XR INJ PARAVERTEBRAL F JNT 3 LEVEL 64495 $932.82
4100433 XR ARTHROCENTESIS MAJOR JNT BURSA 20610 20610 $1,231.45
4100434 XR INJ ANESTHETIC AGENT LUMBAR OR THORAC 64520 $2,658.64
4100435 XR BIOPSY OF LIVER NEEDLE PERCUTANEOUS 47000 $8,961.32
4100436 US FETAL BIOPHYSIC PROFILE WO NST 76819 76819 $1,221.11
4100439 XR BIOPSY BONE TROCAR NEEDLE 20220 20220 $4,133.93
4100450 *IR BIOPSY ABD RETROPERITONEAL MASS PERC 49180 $5,911.20
4100451 *IR REPLACE GASTR CECOSTOMY TUBE 49450 49450 $2,206.78
4100452 *IR INJ NEUROLYTIC SUBSTANCE EPIDURAL LU 62282 $4,585.80
4100453 *XR HIP ARTHROGRAPHY 73525 73525 $1,974.13
4100454 CTA ABD PELVIS WWO CONTRAST 74174 74174 $2,489.25
4100455 XR ABDOMINAL PARACENTESIS W IMAGES 49083 49083 $3,805.09
4100456 XR ARTHROCENTESIS SMALL JNT 20600 20600 $1,184.14
4100462 IR THORACENTESIS W IMAGING 32555 32555 $2,380.59
4100463 *IR DRAIN SPINAL CORD CYST 62268 62268 $2,126.24
4100465 *IR BIOPSY OF THYROID 60100 $3,409.00
4100466 *IR CATH FLUID PERI RETRO 49406 49406 $4,329.66
4100467 *IR CATH FLUID TRNS VGNL 49407 49407 $2,854.37
4100468 *IR BX BREAST 1ST LESION US 19083 19083 $6,172.72
4100469 MM NEEDLE PLACEMENT 1ST LESION 19281 19281 $863.73
4100470 *IR BX BREAST ADDITIONAL LESION US 19084 19084 $1,153.15
4100471 *IR BX BREAST 1ST LESION STEREOTAC 19081 19081 $6,098.79
4100472 *IR BX BREAST ADDL LESION STEREOTA 19082 19082 $2,640.75
4100473 *IR DRAINAGE OF BREAST LESION 19000 19000 $2,364.48
4100474 XR DEEP MUSCLE BIOPSY 20205 20205 $8,275.68
4100475 *IR DRAIN OF BREAST LESION ADD ON 19001 19001 $929.46
4100476 *IR DRAIN OF KIDNEY LESION 50390 50390 $5,911.20
4100478 XR TSPINE 4V MIN 72074 72074 $768.51
4100479 *IR SPINAL FLUID TAP DIAGNOSTIC 62270 62270 $1,448.44
4100480 XR FLUORO EXAM OF G/COLON TUBE 49465 $946.24
4100482 US BREAST UNILATERAL LIMITED 76642 76642 $637.30
4100484 XR EXAM OF TEAR DUCT 70170 70170 $1,295.21
4100486 XR SCOLIOSIS 2V 72082 72082 $796.36
4100488 *XR PELVIS 1V HIP 73501 73501 $364.09
4100490 *XR PELVIS 2V HIP 73502 73502 $451.47
4100491 XR HIP BILAT COMPLETE PELVIS 73523 73523 $390.98
4100492 *XR FEMUR 73552 73552 $563.50
4100493 XR FLUORO STENT PLACEMENT W C ARM 50387 50387 $1,554.70
4100494 XR BILAT HIPS PELVIS 3 4V 73522 73522 $410.02
4100496 XR EXAM HIP BI 2 VIEWS 73521 73521 $387.00
4100497 XR EXAM HIP BI 3 4 VIEWS 73522 73522 $396.58
4100498 *CT LOW DOSE FOR LUNG CA SCREEN G0297 $1,213.35
4100499 *IR REPLACE PICC CATH 36584 $341.14
4100500 MM MAMMO DIAG UNI W CAD 77065 77065 $499.74
4100501 MM MAMMO DIAG BIL W CAD 77066 77066 $603.99
4100502 MM MAMMO SCREEN BIL W CAD 77067 77067 $554.55
4100503 *MM 3D MAMMO SCREEN BIL ADDON 77063 77063 $110.91
4100504 *MM 3D MAMMO DX BIL ADDON 77062 77062 $110.91
4100505 *MM 3D MAMMO DX UNI ADDON 77061 77061 $110.91
4100506 XR FLUORO INJ INTERLAMINAR LMBRSAC 62323 62323 $980.91
4100507 INTERVENTIONAL RADIOLOGY PER MINUTE $80.66
4100508 BILATERAL ARTERIES SINGLE LEVEL 93922 $488.78
4100509 US ABI BILATERAL MULTILEVEL 93923 93923 $697.94
4100510 BILATERAL ARTERIES AT REST AND AFTER TRE 93924 $761.68
4100511 XR CHEST 1V 71045 71045 $298.00
4100512 XR CHEST 2V 71046 71046 $421.22
4100513 XR CHEST SPECIAL W DECUB 2V 71046 71046 $221.82
4100514 XR CHEST W APICAL 3V 71047 71047 $221.82
4100515 XR CHEST W OBL 4V 71048 71048 $365.74
4100516 XR CHEST COMPLETE 4V 71048 71048 $365.74
4100517 XR ABD 1V KUB 74018 74018 $221.82
4100518 XR ABD KUB AND UPRIGHT 2V 74019 74019 $366.33
4100519 XR ABD DECUB 3V 74021 74021 $366.33
4100524 *IR BIOPSY OF NECK OR CHEST 21550 $1,747.08
4100525 FINE NEEDLE ASPIRATION W US GUID 10005 $831.24
4100526 *IR ASPIRATION AND OR INJECTION THYROID 60300 $829.92
4100527 15ML DOTAREM GADOTERATE MEGLUMI A9575 $91.35
4100528 20ML DOTAREM GADOTERATE MEGLUMI A9575 $118.22
4100529 XR CHEST 3V INSP EXPT LAT 71047 71047 $212.79
4300011 NM LYMPHATICS AND LYMPH NODES IMAG 78195 78195 $2,543.44
4300026 NM GASTRIC EMPTYING STUDY 78264 78264 $1,926.88
4300027 NM ACUTE GI BLOOD LOSS 78278 78278 $1,656.89
4300030 NM BONE &/OR JOINT LIM AREA 78300 78300 $2,232.04
4300032 NM BONE OR JOINT WHOLE BODY 78306 78306 $2,118.25
4300033 NM BONE OR JOINT 3 PHASE STUDY 78315 78315 $1,926.88
4300034 NM BONE OR JOINT TOMO SPECT 78320 78320 $2,876.28
4300053 NM CRD BLD POOL IMG GATED S 78496 78496 $988.74
4300054 NM PULM PERF PARTICULATE 78580 78580 $1,370.15
4300077 NM RENAL W VASCULAR FLOW 78707 78707 $2,353.30
4300078 NM KID FUNC W/PHARMACOLOCIC INTV 78708 78708 $2,492.62
4300090 NM RADIOPHARM LOCAL TUMOR SPECT 78803 78803 $2,848.78
4300091 NM ABCESS LOCALIZATION LTD 78805 78805 $3,965.79
4300092 NM WBC LOC WHOLE BODY 78806 78806 $3,965.79
4300094 NM RADIONUCLIDE THERAPY I‐131 79005 $1,457.94
4300095 NM P‐32 THERAPUTIC NUCLIDE 79005 $848.93
4300096 NM RADIOPH THER THY SUPP 79005 $1,457.94
4300097 NM RADIOPH ABLAT GLAND FOR T 79005 $1,457.94
4300098 NM RADIOPH THER METASTASES 79005 $1,457.94
4300099 NM 99M SESTAMIBI PER DOSE A9500 $687.13
4300100 NM 99M MEDRONATE UP TO 30 MCI A9503 $323.09
4300101 NM 99M ALBUMIN AGGR PER MCI A4641 $196.85
4300102 NM 99M MEBROFENIN PER VIAL A4641 $262.84
4300104 NM INJEC DIPYRID 10MG J1245 $106.26
4300107 NM 99M TETROFOSMIN PER DOSE A9502 $1,258.30
4300108 NM 99M MERTIATIDE PER DOSE MAG3 A9562 $1,272.72
4300109 NM 99M MEBROFENIN PER DOSE A9537 $229.65
4300110 NM 99M PYROPHOSPHATE PER DOSE A9538 $975.32
4300111 NM 99M PENTETATE PER DOSE DTPA A9539 $144.87
4300112 NM 99M MAA PER DOSE A9540 $235.96
4300113 NM 99M SULFUR COLLOID PER DOSE A9541 $1,646.24
4300115 NM TC99M THALLIUM TL201 PER MCI A9505 $213.63
4300116 NM INDIUM IN‐111 PER 0.5 MCI A9547 $4,095.90
4300118 NM GALLIUM GA‐67 CITRATE 6 MILLICURIE A9556 $653.19
4300119 NM LOCALIZATION OF TUMOR WHOLE BDY 78804 78804 $6,179.64
4300120 NM MYOCARDIAL PERFUSION IMAGING MULTIPLE 78452 $7,599.96
4300121 NM MYOCARDIAL PERFUSION IMAGING SINGLE 78451 $5,973.32
4300122 NM TC 99M LABELED RBC PER 30 MCI A9560 $688.97
4300123 NM HEPATOBILIARY SYSTEM IMAGING 78226 78226 $1,904.47
4300124 NM HEPATOBILIARY SYSTEM W DRUG 78227 78227 $2,520.62
4300125 NM PULMONARY VENTILATION PERFUSION 78582 78582 $1,437.32
4300126 NM LIVER IMAGING SPECT W VASC FLOW 78206 78206 $1,315.34
4300127 NM BONE MARROW IMAGE LMTD AREA 78102 78102 $1,188.95
4300128 NM BONE MARROW IMAGE MULTPLE 78103 78103 $1,262.77
4300129 NM BONE MARROW IMAGE BODY 78104 78104 $1,262.77
4300130 NM TC99M TECHNETIUM AUTO WBC PER DOSE A9569 $5,717.74
4300131 *NM BRAIN IMAGING TOMOGRAPHIC 78607 $4,035.23
4300132 *NM IODINE I‐123 IOFLUPANE PER STUDY A9584 $5,601.39
4400001 BONE MARROW ASPIRATION 38220 $3,673.11
4400002 BONE MARROW BIOPSY 38221 $3,673.11
4400004 CYCLOBENZAPRINE(FLEXERIL) 80299 $191.26
4400007 BASIC METABOLIC PANEL 80048 $116.51
4400008 COMPREHENSIVE METABOL 80053 $125.74
4400009 *PRENATAL PANEL 80055 $487.32
4400011 LIPID PROFILE 80061 $109.62
4400013 ELECTROLYTE PROFILE 80051 $81.68
4400014 FETAL FIBRONECTIN 82731 $890.62
4400016 TRANSGLUTAMINASE TISSUE IGA 83516 $159.08
4400017 VITAMIN K 84597 $189.33
4400018 *R ANCA TITER (ANTI NEUTROPHIL CYTO AB) 86256 $82.77
4400019 RENAL PROFILE 80069 $114.99
4400021 HEPATIC PROFILE 80076 $113.15
4400024 BB RBC ANTIGENS OTHER 86905 $339.45
4400034 PHLEB PROCESS FEE $147.64
4400035 AMIKACIN 80150 $148.76
4400043 CARBAMAZEPINE 80156 $201.65
4400046 CYCLOSPORINE 80158 $326.60
4400048 DIGOXIN 80162 $183.72
4400049 VALPROIC ACID 80164 $187.09
4400051 ETHOSUXIMIDE 80168 $225.93
4400052 GENTAMICIN RANDOM 80170 $226.29
4400053 HALOPERIDOL 80173 $145.40
4400055 LIDOCAINE QUANTITATIVE 80176 $144.29
4400056 LITHIUM 80178 $91.87
4400058 PHENOBARBITAL 80184 $171.41
4400059 PHENYTOIN 80185 $183.72
4400061 *PRIMIDONE 80188 $229.65
4400062 *NAPA OF P&N LEVEL 80192 $102.90
4400063 PROCAINAMIDE 80192 $248.30
4400064 QUINIDINE 80194 $204.68
4400066 FK‐506 (TACROLIMUS) 80197 $104.18
4400068 THEOPHYLLINE 80198 $184.85
4400069 TOBRAMYCIN 80200 $200.21
4400070 TOPIRAMATE 80201 $164.68
4400071 VANCOMYCIN PEAK 80202 $172.25
4400073 FLUOXETINE (PROZAC) 80299 $191.26
4400074 GABAPENTIN 80299 $208.38
4400079 FLECAINIDE 80299 $224.06
4400083 PAROXETINE 80299 $191.26
4400091 **TOCAINIDE (TOCAINAMIDE) 80299 $135.34
4400111 URINE W/MICRO 81000 $52.66
4400114 URINE DIP STICK ONLY 81002 $39.21
4400119 CLINITEST URINE/ REDUCING SUB 81005 $22.37
4400120 URINE MICROSCOPIC ONLY 81015 $42.57
4400121 PREGNANCY SCREEN URINE 81025 $63.41
4400124 ACETONE SERUM 82009 $62.73
4400127 ACTH‐ADRENOCORT HORM 82024 $534.37
4400129 ALBUMIN 82040 $68.34
4400130 *MICROALBUMIN URINE 82043 $80.53
4400133 ALCOHOL SCREEN BREATH (DOT) 82075 $92.84
4400134 ALDOLASE 82085 $134.44
4400136 ALDOSTERONE SERUM 82088 $563.50
4400137 ALPHA‐1‐ANTITRYPSIN TOTAL 82103 $185.97
4400138 *ALPHA‐1‐ANTITRYPSIN PHENO 82104 $200.21
4400142 AFP(TUMOR MARKER) 82105 $231.90
4400147 *AMINO ACID SCREEN BLOOD 82128 $154.35
4400156 AMINO ACID PLASMA 82139 $137.58
4400157 AMMONIA PLASMA 82140 $201.65
4400160 AMYLASE 82150 $89.62
4400164 ANDROSTENEDIONE 82157 $404.42
4400166 ANGIOTENSIN CONVERTING ENZYME 82164 $201.65
4400170 ARSENIC BLOOD 82175 $312.56
4400177 BETA‐2‐MICROBLOBULIN URINE 82232 $246.46
4400179 BILIRUBIN TOTAL 82247 $69.46
4400180 BILIRUBIN DIRECT 82248 $69.46
4400184 CADMIUM BLOOD 82300 $331.60
4400185 **VITAMIN D 1 25 DIHYDROXY 82306 $203.87
4400186 VITAMIN D 25 HYDROXY (D3) 82306 $204.19
4400190 CALCIUM SERUM 82310 $54.81
4400191 *CALCIUM/CREATININE RATIO 82310 $54.72
4400194 IONIZED CALCIUM 82330 $189.33
4400195 CALCIUM URINE 24 HR 82340 $82.90
4400196 *STONE ANALYSIS QUALITATIVE 82355 $142.04
4400198 STONE ANALYSIS 82365 $178.12
4400200 CO2 SERUM 82374 $73.82
4400202 CARBOXYHEMOGLOBIN 82375 $170.28
4400205 CEA‐CARCINOEMBRYONIC AG 82378 $183.78
4400206 CARNITINE SERUM 82379 $233.02
4400207 *CARNITIN 82379 $236.00
4400209 CAROTENE SERUM 82380 $127.50
4400212 CATECHOLAMINES FRAC UR 82384 $349.53
4400213 CERULOPLASMIN SERUM 82390 $149.00
4400217 CHLORIDE 82435 $52.66
4400218 CHLORIDE URINE RANDOM 82436 $69.46
4400221 CHOLESTEROL 82465 $53.74
4400239 CITRATE URINE 24 82507 $384.25
4400243 COPPER SERUM 82525 $171.41
4400246 CORTISOL BLOOD 82533 $225.17
4400251 CK‐CREATINE PHOSPHOKINASE 82550 $88.13
4400255 CREATININE 82565 $49.44
4400256 CREATININE URINE 24 HR 82570 $71.69
4400258 CREATININE CLEARANCE 82575 $85.14
4400260 CRYOGLOBULIN 82595 $50.41
4400262 VITAMIN B12 82607 $122.52
4400265 *DHEA UNCONJUGATED 82626 $83.89
4400266 DHEA 82626 $159.94
4400267 DHEA‐S 82627 $249.33
4400279 ERYTHROPOIETIN 82668 $259.91
4400280 ESTRADIOL SERUM 82670 $386.50
4400281 *ES‐ESTRADIOL 82670 $438.45
4400286 ESTRIOL SERUM 82677 $356.24
4400289 ESTRONE 82679 $345.05
4400293 FERRITIN 82728 $138.64
4400294 FOLATE SERUM 82746 $132.19
4400298 *IGG SERUM 82784 $128.84
4400299 *IGA SERUM 82784 $128.84
4400300 IGM SERUM 82784 $128.84
4400303 IGE 82785 $137.56
4400306 PH VENOUS 82800 $40.33
4400309 O2 TENSION ARTERIAL 82803 $38.03
4400310 O2 SATURATION ARTERIAL 82803 $43.62
4400314 GLUCOSE BODY FLUID 82945 $54.90
4400316 GLUCOSE SERUM 82947 $42.99
4400320 GLUCOSE 50GM 82950 $66.09
4400321 *GLUCOSE TT 3HR 82951 $118.55
4400322 *GLUCOSE TT 5HR 82951 $133.10
4400323 LACTOSE TOLERANCE TEST 82951 $165.81
4400326 *GLUCOSE TT EACH ADD SPEC 82952 $55.92
4400330 GGT (GLUTAMYL TRANSFERASE) 82977 $76.30
4400334 FSH 83001 $256.54
4400336 LH 83002 $256.54
4400340 HAPTOGLOBINS SERUM 83010 $173.64
4400346 *HEAVY METAL SCREEN URINE 83018 $303.11
4400347 HEMOGLOBIN ELECTROPH 83020 $178.12
4400348 HEMOGLOBIN A2 83021 $265.08
4400349 HEMOGLOBIN A1C 83036 $111.77
4400357 HOMOVANILLIC ACID 24 HR 83150 $265.08
4400359 HIAA 5 SCREEN URINE 83497 $180.08
4400360 HIAA 5 QUANT UR 83497 $178.12
4400361 HYDROXYPROGESTERONE 17 83498 $375.29
4400364 *GLIADIN AB 83516 $162.18
4400372 *TISSUE TRANSGLUTAM AB 83520 $171.13
4400378 *GMI AUTOANTIBODY 83520 $181.20
4400380 IGF BINDING PROTEIN‐3 83520 $193.81
4400383 *MAG DUAL AGNAUTO AB 83520 $193.50
4400391 INSULIN 83525 $127.89
4400392 IRON 83540 $82.75
4400394 IRON BINDING CAPACITY 83550 $93.50
4400397 *L‐LACTATE 83605 $120.80
4400400 LDH (LACTATE DEHYDROGENASE) 83615 $74.15
4400404 LEAD BLOOD 83655 $168.04
4400406 LIPASE 83690 $88.13
4400408 HDL (HIGH DENSITY LIPOPROTEIN) 83718 $113.15
4400411 MAGNESIUM 83735 $93.50
4400413 MANGANESE 83785 $231.90
4400415 *MERCURY URINE 83825 $225.17
4400416 MERCURY BLOOD 83825 $247.58
4400417 METANEPHRINES FRACTIONATED 24HR 83835 $118.74
4400423 MYOGLOBIN SERUM 83874 $165.81
4400456 NUCLEOTIDASE 5 83915 $155.47
4400461 OSMOLALITY SERUM 83930 $91.87
4400463 OSMOLALITY URINE 83935 $94.10
4400468 *PARATHYROID HORMONE PTH‐IRMA 83970 $296.15
4400470 PTH INTACT 83970 $296.62
4400471 PH BODY FLUID 83986 $49.22
4400475 PKU NEWBORN SCREENING 84030 $76.18
4400477 ACID PHOS PROSTATIC 84066 $105.14
4400478 ALKALINE PHOS 84075 $69.86
4400480 PHOSPHORUS SERUM 84100 $66.09
4400488 POTASSIUM 84132 $63.86
4400490 PREALBUMIN SERUM 84134 $113.15
4400491 PREGNENOLONE 84140 $188.20
4400493 PROGESTERONE 84144 $289.03
4400494 PROLACTIN 84146 $62.33
4400496 PSA SCREENING 84153 $148.31
4400497 *FREE PSA 84154 $153.23
4400498 *PSA FREE 84154 $254.30
4400499 PROTEIN BODY FLUIDS 84157 $50.41
4400500 PROTEIN TOTAL 84155 $53.74
4400503 *PROTEIN ELECTROPHORESIS CSF 84165 $97.64
4400504 *PROTEIN ELEC UR 24 HR 84165 $97.80
4400505 *PROTEIN ELEC SERUM 84165 $97.80
4400506 *PROTEIN ELECTROPHORESIS URINE RANDOM 84165 $97.64
4400513 *FREE PROTOPORPHYRINS 84202 $143.17
4400517 PYRUVIC ACID 84210 $161.07
4400523 RENIN ACTIVITY PLASMA 84244 $304.71
4400526 SELENIUM 84255 $418.99
4400532 SODIUM 84295 $51.59
4400533 SODIUM URINE RANDOM 84300 $67.21
4400534 INSULIN LIKE GROWTH FACTOR 84305 $147.88
4400535 *ES‐IGF‐1 84305 $345.61
4400538 *R PROTOPORPHYRINS FRACTIONATED 84202 $154.35
4400539 PORPHYRINS TOTAL RBC 84311 $108.49
4400540 *TAY SACHS 84311 $98.43
4400543 *TESTOSTERONE FREE 84402 $250.41
4400545 TESTOSTERONE SERUM 84403 $183.78
4400549 VITAMIN B1 84425 $293.51
4400551 *THYROGLOBULIN TUMOR MARKER ONLY 84432 $221.82
4400552 T4 TOTAL 84436 $85.98
4400554 T4 FREE 84439 $109.62
4400558 TSH (THYROID STIMULATING HORMONE) 84443 $164.43
4400560 THYROID STIM IMMUNOGLOB 84445 $357.37
4400561 VITAMIN E 84446 $196.05
4400562 AST 84450 $66.63
4400563 ALT 84460 $67.71
4400564 TRANSFERRIN 84466 $177.00
4400565 TRIGLYCERIDES 84478 $64.48
4400566 T3 UPTAKE 84479 $93.35
4400567 T3 TOTAL 84480 $164.43
4400568 T3 FREE 84481 $161.21
4400570 T3 REVERSE 84482 $218.46
4400571 TROPONIN I 84484 $140.03
4400575 BUN (BLOOD UREA NITROGEN) 84520 $56.96
4400578 URIC ACID SERUM 84550 $65.56
4400579 URIC ACID 24 HOUR URINE 84560 $66.09
4400580 *VMA 24 HR URINE (VANILLYMANDELIC ACID) 84585 $100.83
4400584 VITAMIN A 84590 $160.20
4400588 ZINC SERUM 84630 $157.96
4400589 C‐PEPTIDE 84681 $287.91
4400591 HCG‐QUANT NOT SCREEN 84702 $208.38
4400592 *HCG TRIPLE SCREEN 84702 $124.16
4400594 PREGNANCY SCREEN SERUM 84703 $99.95
4400603 DIFFERENTIAL SMEAR 85007 $39.14
4400605 HEMATOCRIT SPUN 85013 $27.96
4400607 HEMATOCRIT 85014 $32.49
4400617 CBC HEMOGRAM COMPLETE 85025 $81.68
4400619 *HEMOGRAM 85027 $66.53
4400620 RETICULOCYTE COUNT 85044 $59.38
4400622 WHITE CELL COUNT BLOOD 85048 $39.14
4400628 *FACTOR V LEIDEN 85220 $174.48
4400630 FACTOR VIII 85240 $247.58
4400632 VON WILLEBRAND ANTIGEN 85246 $317.04
4400640 ANTI‐THROMBIN III 85300 $163.56
4400641 PROTEIN C FUNCTIONAL 85303 $191.26
4400644 PROTEIN S 85306 $211.39
4400645 PROTEIN C RES ACTIVATED 85307 $211.39
4400651 *D DIMER SEMIQUANTATIVE 85378 $99.54
4400653 D DIMER QUANTITATIVE 85379 $141.15
4400655 FIBRINOGEN 85384 $117.63
4400672 PLATELET COUNT 85049 $61.61
4400674 *LUPUS ANTICOAGULANT 85597 $106.26
4400675 PT INR 85610 $51.59
4400677 *DILUTE RUSSELL VIPER VENOM TIME 85613 $132.19
4400679 ESR‐SEDIMENTATION RATE 85651 $60.18
4400680 SICKLE CELL SCREEN 85660 $76.18
4400681 THROMBIN TIME 85670 $50.33
4400683 PTT 85730 $82.90
4400687 LATEX ALLERGY 86003 $65.45
4400689 RAST EACH ALLERGEN 86003 $65.56
4400695 ANA 86038 $147.24
4400697 *R ANA TITER (ANTINUCLEAR ANTIBODY) 86039 $154.60
4400698 ANTI STREPTOLYSIN O 86060 $100.83
4400699 *ANTISTREPTOLYSIN O SCREEN 86063 $57.04
4400700 C‐REACTIVE PROTEIN CRP 86140 $72.01
4400702 C‐REACTIVE PROTEIN HS CRP 86141 $121.44
4400703 BETA 2 GLYCOPROTEIN AB IGA 86146 $233.02
4400704 *CARIOLIPIN AB IGG&IGM (PHOSPHOLIPID AB) 86147 $323.24
4400706 *COLD AGGLUTININS SERUM 37% 86156 $93.95
4400708 COMPLEMENT C3 86160 $165.81
4400712 COMPLEMENT TOTAL 86162 $281.19
4400714 DNA AB (DOUBLE STRANDED) 86225 $190.45
4400716 JO 1 AB 86235 $247.58
4400717 *RO AB (SSA) 86235 $247.58
4400718 *LA AB (SSB) 86235 $247.58
4400719 *EXTRACTABLE NUCLEAR ANTIGEN AB 86235 $127.50
4400720 *SMITH AB‐SM‐NOT SMOOTH MUSCLE TEST 86235 $247.58
4400723 SCL 70 AB 86235 $247.58
4400725 *SJORGRENS AB (SSA & SSB) 86235 $250.54
4400727 ANCA 86255 $166.92
4400730 *DNA ANTIBODY DS (NATIVE) 86255 $167.77
4400732 SMOOTH MUSCLE AB 86255 $191.57
4400735 *ANDOMYSIAL AB 86256 $181.20
4400739 *R MITOCHONDRIAL AB TITER 86256 $183.43
4400740 *R SMOOTH MUSCLE AB TITER 86256 $185.67
4400741 *ANNA‐2 86256 $166.92
4400742 *ANNA‐1 86256 $166.92
4400743 PCA‐1(PURKINEJE CELL CYTO AB TYPE 1) 86256 $166.92
4400745 STRIATIONAL MUSCLE AB 86256 $166.66
4400746 CA 15‐3 86300 $287.91
4400747 CA 27.29 BREAST CARCINOMA 86300 $287.91
4400748 CA 19‐9 86301 $287.91
4400749 CA 125 86304 $287.91
4400750 MONO TEST 86308 $71.69
4400754 *IMMUNOFIXATION 24 HR URINE (BENCE JONES 86325 $148.76
4400760 *IMMUNOFIXATION SERUM (INC SPEP) 86334 $309.19
4400762 INSULIN AB QUANT 86337 $295.28
4400763 INTRINSIC FACTOR AB 86340 $208.38
4400764 GAD65 AB 86341 $273.35
4400768 THYROPEROXIDASE AB (TPO) 86376 $201.65
4400769 RABIES AB 86382 $234.14
4400771 CRYPTOCOCCAL ANTIGEN CSF 86403 $140.93
4400772 RHEUMATOID FACTOR 86431 $78.42
4400774 VDRL CSF 86592 $59.38
4400776 RPR SERUM 86592 $59.38
4400782 *PNEUMOCOCCAL ANTIBODIES 86609 $180.08
4400788 **R LYME DISEASE AB CONFIRM WEST BLOT 86617 $128.97
4400790 LYME DISEASE SCREEN AB 86618 $132.19
4400815 *EPSTEIN BARR VIRUS AB IGG & IGM 86665 $274.03
4400827 *R HERPES SIMPL AB IgM CONFIRM 86694 $225.17
4400835 HIV 1/2 AB 86703 $142.94
4400836 HEPATITIS B CORE AB 86704 $166.92
4400838 HEPATITIS B SURF AB 86706 $114.99
4400841 HEPATITIS A AB SCREEN 86708 $171.41
4400842 HEPATITIS A AB IGM 86709 $155.71
4400847 MUMPS AB IGM 86735 $180.37
4400848 MUMPS AB IGG 86735 $180.37
4400849 *MYCOPLASMA AB IGG & IGM 86738 $104.02
4400850 *MYCOPLASMA LGM 86738 $184.55
4400851 *PARVOVIRUS B19 IGG & IGM 86747 $191.26
4400857 RUBELLA AB 86762 $199.41
4400858 RUBEOLA MEASLES AB SCREEN 86765 $178.12
4400861 TOXOPLASMA SCREEN 86777 $199.41
4400862 TOXOPLASMA AB IGM 86778 $199.41
4400863 *TOXOPLASMA IGM 86778 $201.33
4400867 VARICELLA ZOSTER IGG 86787 $145.09
4400872 THYROGLOBULIN AB 86800 $139.71
4400873 HEPATITIS C AB 86803 $124.67
4400885 BB ABO TYPING 86900 $74.15
4400888 *CONC FOR INFECTIOUS AGENTS 87015 $91.87
4400889 CULTURE BLOOD 87040 $142.27
4400892 PERTUSSIS CULTURE AND SLIDE 87070 $137.34
4400895 CULTURE SPUTUM 87070 $137.56
4400897 CULTURE BODY FLUID 87070 $137.56
4400899 CULTURE CSF 87070 $137.56
4400904 CULTURE EAR 87070 $137.56
4400905 CULTURE EYE 87070 $137.56
4400906 CULTURE GENITAL 87070 $137.56
4400907 CULTURE SKIN 87070 $137.56
4400908 CULTURE WOUND ABSCESS 87070 $137.56
4400913 ANAEROBIC ID 87076 $112.03
4400914 ID OTHER 87077 $96.72
4400915 CULTURE GC 87081 $71.89
4400916 CULTURE GROUP B STREP 87081 $72.01
4400921 CULTURE THROAT QA 87081 $72.01
4400922 CULTURE URINE 87086 $77.38
4400924 ID URINE 87088 $70.93
4400927 CULTURE FUNGUS MISC SOURCE 87102 $116.51
4400933 CHLAMYDIA CULTURE 87110 $356.80
4400934 *MYCOBACTERIA CULTURE 87116 $137.58
4400944 TICK ARTHROPOD ID 87168 $59.38
4400946 PIN WORM SCOTCH TAPE PREP 87172 $59.28
4400948 *OVA & PARASITES STOOL 87177 $153.68
4400949 ANTIBIOTIC SUSCEPT ETEST 87181 $16.78
4400950 ANTIBIOTIC SUSCEPT‐KB 87184 $97.31
4400954 ANTIBIOTIC SUSCEPTIBILITY‐‐VITEK 87186 $137.56
4400961 GRAM STAIN FOR BACTERIA 87205 $67.71
4400962 FECAL LEUCOCYTES 87205 $67.71
4400964 *AFB OR FLUORSCENT SMEAR 87206 $75.06
4400968 MALARIA SMEAR 87207 $82.90
4400971 *TICK ID 87168 $49.22
4400973 WET PREP/KOH PREP 87210 $64.98
4400977 VIRAL CELL CULTURE 87252 $360.73
4400988 *INFLUENZA B IFA 87275 $157.71
4400989 *INFLUENZA A IFA 87276 $157.71
4400992 *PARAINFLUENZA IFA 87279 $157.71
4400993 *RSV DFA STAIN 87280 $167.77
4400999 *C DIFF TOXIN ASSAY 87324 $157.71
4401003 H PYLORI STOOL ANTIGEN 87338 $199.41
4401004 HEPATITIS B SURF AG 87340 $143.40
4401007 HEPATITIS BE ANTIGEN 87350 $158.82
4401010 RSV 87420 $165.81
4401014 *INFLUENZA ELISA 87449 $140.93
4401016 CHLAMYDIA PROBE 87491 $169.80
4401017 CHLAMYDIA PROBE URINE 87491 $169.80
4401026 **HCV QL RNA RT‐PCR 87521 $391.47
4401038 GONORRHEA PROBE 87591 $190.22
4401039 GONORRHEA PROBE URINE 87591 $190.22
4401055 CYTOLOGY FLUIDS/WASHINGS/BRUSHINGS 88104 $165.81
4401061 CYTOLOGY‐PAP TP 88142 $134.34
4401068 CYTOLOGY SMEAR NON GYN 88160 $118.55
4401074 CYTOLOGY‐FNA SCREEN 88173 $490.68
4401083 *TISSUE CULTURE SKIN 88233 $759.45
4401094 CHROMOS ANALY SKIN BIOPSY 88262 $1,808.59
4401110 GROSS EXAMINATION ONLY 88300 $191.57
4401111 GROSS EXAM+MICRO LEVEL II 88302 $213.97
4401112 GROSS EXAM+MICRO LEVEL III 88304 $247.58
4401114 GROSS EXAM+MICRO LEVEL IV 88305 $490.68
4401117 GROSS EXAM+MICRO LEVEL V 88307 $578.06
4401118 GROSS EXAM+MICRO LEVEL VI 88309 $560.14
4401119 DECALCIFICATION TISSUE 88311 $125.47
4401120 SPECIAL STAIN I 88312 $185.97
4401121 SPECIAL STAIN II 88313 $192.68
4401135 TC FROZEN SECTION, SINGLE 88331 $287.45
4401137 TC IMMUNOHISTOCHEM EACH ANTIBODY 88342 $411.14
4401146 *TC IN SITU HYBRIDIZATION 88365 $251.66
4401150 CSF CELL COUNT 89050 $64.98
4401151 BODY FLUID CELL COUNT 89050 $64.98
4401153 CSF DIFFERENTIAL COUNT 89051 $90.59
4401154 BODY FLUID DIFFERENTIAL 89051 $71.58
4401155 BODY FLUID CRYSTALS 89060 $98.58
4401170 SPECIMEN HANDLING FOR ESOTERIC TESTING 99001 $79.54
4401187 VENIPUNCTURE 36415 $33.61
4401191 CYTO GYN/AUTO/MAN RESCREEN 88148 $71.58
4401192 CYTOLOGY GYN MANUAL SCREEN 88150 $135.34
4401193 BREATH ALCOHOL SCREEN 82075 $79.41
4401194 *DOT URINE COLLECT $71.58
4401200 *INHIBIN A 86336 $215.86
4401201 *ARSENIC URINE 82175 $262.14
4401202 *CADMIUM URINE 82300 $320.40
4401203 *LEAD URINE 83655 $168.04
4401204 *GLIADIN AB IgG 83516 $159.08
4401205 *GLIADIN AB IgA 83516 $159.08
4401218 ANTI RNP (U1 RNP) 86235 $247.58
4401219 *BARTONELLA HENSELAE IgG 86611 $141.15
4401220 *BARTONELLA HENSELAE IgM 86611 $141.15
4401221 *BARTONELLA QUINTANA IgG 86611 $141.15
4401222 *BARTONELLA QUINTANA IgM 86611 $141.15
4401223 *STREP PNEUMO IgG SEROTYPE 1 86609 $117.44
4401224 *STREP PNEUMO IgG SEROTYPE 3 86609 $117.44
4401225 *STREP PNEUMO IgG SEROTYPE 14 86609 $117.44
4401226 *STREP PNEUMO IgG SEROTYPE 19 86609 $117.44
4401227 *STREP PNEUMO IgG SEROTYPE 23 86609 $117.44
4401228 *STREP PNEUMO IgG SEROTYPE 51 86609 $117.44
4401229 *LYME DISEASE IgG 86617 $213.97
4401230 *LYME DISEASE IgM 86617 $213.97
4401231 *EB VIRAL CAPSID ANTIGEN IgG 86665 $250.94
4401232 *EB VIRAL CAPSID ANTIGEN IgM 86665 $250.94
4401233 *EPSTEIN BARR NUCLEAR ANTIGEN 86664 $211.73
4401234 *HERPES SIMPLEX TYPE 1 IgM 86695 $120.18
4401235 *HERPES SIMPLEX TYPE 2 IgM 86696 $158.80
4401236 *HERPES SIMPLEX TYPE 1 IgG 86695 $120.37
4401237 *HERPES SIMPLEX TYPE 2 IgG 86696 $159.06
4401238 *HERPES SIMPLEX AB 1 2 IgM 86694 $199.41
4401239 *MYCOPLASMA AB IgG 86738 $182.60
4401240 *MYCOPLASMA AB IgM 86738 $182.60
4401241 *PARVOVIRUS IgM 86747 $208.38
4401242 *PARVOVIRUS IgG 86747 $208.38
4401243 *AFB CULTURE 87116 $149.00
4401244 *CONCENTRATION FOR INFECTIOUS AGENTS 87015 $91.87
4401245 *CARDIOLIPIN AB IgG 86147 $230.77
4401246 *CARDIOLIPIN AB IgM 86147 $230.77
4401247 *HEMOGLOBIN 85018 $32.49
4401248 *HEMATOCRIT 85014 $32.49
4401249 GLUCOSE TT FIRST 3 SPECIMENS 82951 $178.12
4401250 GLUCOSE TT EACH ADDNL SPEC 82952 $53.78
4401251 *CBC HEMOGRAM COMPLETE (NO CHARGE) 85025 $81.55
4401252 *BB ABO TYPING (NO CHARGE) 86900 $74.04
4401253 *BB RH TYPE (NO CHARGE) 86901 $63.31
4401255 *BB ANTIBODY SCREEN (NO CHARGE) 86850 $128.76
4401259 *IMMUNOELECTROPHORESIS OTHER FLUID 86325 $309.19
4401260 *THYROPEROXIDASE ANTIBODY 86376 $201.65
4401265 GLUCOSE CSF 82945 $54.90
4401266 GENTAMYCIN PEAK 80170 $215.09
4401267 GENTAMYCIN TROUGH 80170 $199.41
4401268 *CADMIUM URINE 82300 $352.89
4401269 PSA DIAGNOSTIC 84153 $148.31
4401270 METHEMOGLOBIN 83050 $102.90
4401271 CORTISOL FREE 24 HR URINE 82530 $230.77
4401273 SEX HORMONE BINDING GLOBULIN 84270 $300.23
4401274 POTASSIUM URINE RANDOM 84133 $56.01
4401275 POTASSIUM URINE 24 HOUR 84133 $59.38
4401276 ARSENIC URINE 24 HR 82175 $252.78
4401277 LEPTOSPIRA AB IGM S 86720 $122.11
4401278 *ALBUMIN CSF 82042 $87.38
4401279 *IGG CSF 82784 $128.84
4401285 *DNA PROBE EACH 88271 $295.75
4401286 *MOLECULAR GENE 10‐30 CELL 88273 $449.63
4401289 CREATININE URINE RANDOM 82570 $71.69
4401290 TC FROZEN SECTION ADD 88332 $124.16
4401291 CALCIUM URINE RANDOM 82340 $82.90
4401292 *WEST NILE AB IGG 86318 $176.72
4401293 *WEST NILE AB IGM 86318 $176.72
4401294 *ANALYZE 100 TO 300 CELLS 88275 $573.58
4401296 GLOMERULAR BASEMENT MEMBRANE AB 83520 $177.84
4401300 OXALATE 24 HR URINE 83945 $178.12
4401301 PHOSPHORUS URINE 24 Hr 84105 $71.58
4401302 MAGNESIUM URINE 24 Hr 83735 $93.50
4401303 SULFATE URINE 24 Hr 84392 $67.10
4401304 *COXSACKIE A‐2 86658 $139.81
4401305 *COXSACKIE A‐4 86658 $139.81
4401306 *COXSACKIE A‐7 86658 $139.81
4401307 *COXSACKIE A‐9 86658 $139.81
4401308 *COXSACKIE A‐10 86658 $139.81
4401309 *COXSACKIE A‐16 86658 $139.81
4401310 *COXSACKIE B‐1 86658 $144.29
4401311 *COXSACKIE B‐2 86658 $144.29
4401312 *COXSACKIE B‐3 86658 $144.29
4401313 *COXSACKIE B‐4 86658 $144.29
4401314 *COXSACKIE B‐5 86658 $144.29
4401315 *COXSACKIE B‐6 86658 $144.29
4401316 CHROMIUM SERUM 82495 $268.87
4401319 WORM IDENTIFICATION 87169 $59.38
4401321 *ROCKY MOUNTAIN SPOTTED FEVER AB IGG 86757 $259.91
4401322 SEROTONIN 84260 $251.66
4401323 *CKMB 82553 $160.20
4401326 BABESIA AB IGG 86753 $171.41
4401327 FECAL FAT 82710 $233.02
4401328 *EHRLICHIOSIS HUMAN GRAM A PHAGO 86666 $141.15
4401329 *EHRLICHIOSIS HUMAN GRAM CHAF 86666 $141.15
4401332 *CHLAMYDIA PNEUMONIAE IGG 86631 $190.14
4401333 *CHLAMYDIA PSITTACI IGG 86631 $190.14
4401334 *CHLAMYDIA TRACHOMATIS IGG 86631 $190.14
4401335 *CHLAMYDIA PNEUMONIAE IGM 86631 $195.74
4401336 *CHLAMYDIA PSITTACI IGM 86631 $195.74
4401337 *CHLAMYDIA TRACHOMATIS IGM 86631 $195.74
4401338 *LIPID PANEL 80061 $109.62
4401344 PTT 50/50 85732 $89.48
4401347 GROWTH HORMONE 83003 $230.40
4401348 THYROID BINDING GLOBULIN 84442 $205.01
4401350 FACTOR X 85260 $291.93
4401351 HEPARIN ASSAY LOW MOLECULAR WEIGHT 85520 $168.04
4401353 EBV PCR EPSTEIN BARR CSF 87798 $484.31
4401354 TOXOPLASMA GONDII PCR CSF 87798 $326.60
4401355 NEURON SPECIFIC ENDOLASE CSF 83520 $181.20
4401356 OSTEOCALCIN 83937 $357.92
4401357 *TCELLS TOTAL COUNT 86359 $163.56
4401358 *ABSOLUTE CD4 CD8 COUNT 86360 $196.05
4401362 IGA 82784 $128.84
4401363 GASTRIN 82941 $339.45
4401364 BETA2 MICROGLBN SERUM 82232 $262.14
4401366 *TISSUE CULTURE CHROMO 88230 $507.79
4401367 *CHROMOSOME ANALYSIS CT15 88262 $1,693.38
4401374 REDUCING SUBSTANCES FECES 84376 $76.18
4401375 *VIRUS INNOCULATE 87252 $356.80
4401376 *VIRUS IDENT 87254 $127.50
4401377 *HCV QN BDNA PROC 87522 $432.86
4401378 HEPATITIS C QN RT PCR VIRAL LOAD 87522 $592.63
4401379 CATECHOLAMINE FRAC PLASMA 82384 $367.98
4401382 PROTEIN C CHROMOGENIC 85302 $165.54
4401391 ROTA VIRUS AG FECES 87425 $186.79
4401392 LEAD HAIR 83655 $170.00
4401393 ARSENIC HAIR 82175 $259.49
4401394 MERCURY HAIR 83825 $261.72
4401395 CADMIUM HAIR 83018 $200.21
4401396 PLATELET FUNCTION ANALYSIS 85576 $318.76
4401399 *GLUCOSE CAPILLARY 82948 $33.61
4401400 RAPID STREP TEST INFECTIOUS AGENT DETECT 87880 $92.43
4401403 ESTROGEN RECEPTOR TUMOR HISTOCHEMISTRY 88360 $356.24
4401404 PROGESTERONE RECEPTOR TUMOR HISTOCHEMIST 88360 $354.01
4401405 GLUC 6 PHOSPHATE DEHYDR RBC 82955 $134.44
4401407 *R HIV REFLEX 86689 $301.99
4401408 SODIUM URINE 24 HOUR 84300 $67.21
4401410 BILE ACID TOTAL 82239 $236.38
4401411 SIROLIMUS BLOOD 80195 $116.51
4401412 *PHENYLALANINE PLASMA 84030 $53.78
4401413 *TYROSINE PLASMA 84510 $120.99
4401414 OLIGOCLONAL BANDING 83916 $306.96
4401416 FATTY ACID VERY LONG CHAIN SERUM 82726 $253.18
4401418 *HANTA VIRUS IGG 86790 $132.19
4401419 *HANTA VIRUS IGM 86790 $117.63
4401420 S CEREVISIAE AB IGA 83520 $206.92
4401422 *NSA INFLAMMATORY BOWEL DISEASE 86255 $163.56
4401427 HIV VIRAL LOAD RNA PCR QN 87536 $694.57
4401430 FRUCTOSAMINE SERUM 82985 $208.38
4401432 *IMMUNOFIXATION ELEC 86335 $405.54
4401433 *PROTEIN TOTAL URINE EXCEPT BY REFRACTOM 84156 $56.96
4401434 *PROT ELECTROPHORETIC FRACTIONATION 84166 $246.46
4401436 PHOSPHORUS URINE RANDOM 84105 $71.58
4401439 CENTROMERE ANTIBODY SERUM 83516 $158.82
4401446 FELBAMATE SERUM 80299 $148.76
4401448 ANTI DNASE B 86215 $183.72
4401450 LYSOZYME MURAMIDASE P 85549 $363.51
4401452 IGG TOTAL 82784 $128.84
4401453 *IGG SUBCLASSES 82787 $43.69
4401454 TUMOR ANALYSIS 88358 $1,307.52
4401455 DNA DROPS $38.03
4401456 *PORPHOBILINOGEN 84110 $91.87
4401457 *URINE PORPHYRINS 84120 $176.72
4401458 HISTOPLASMA AB S 86698 $172.52
4401463 AFP ONLY OBS 82105 $231.53
4401464 VISCOSITY SERUM 85810 $161.07
4401465 *Q FEVER Ab, IgG,S 86638 $167.77
4401466 *Q FEVER Ab, IgM,S 86638 $167.77
4401467 *ASPERGILLUS 86671 $104.02
4401468 *FUNGUS NOT ELSEWHERE 86671 $104.18
4401470 SMITH AB IgG SM 86235 $247.58
4401472 *ALKALINE PHOSPHATE ISO 84080 $204.68
4401473 NTX SERUM 82523 $243.96
4401474 *B PERTUSSIS AB IGG S 86615 $165.81
4401475 *B PERTUSSIS AB IGM S 86615 $165.54
4401476 CYTOMEGALOVIRUS AB IGG 86644 $199.41
4401477 *CYTOMEGALOVIRUS AB IGM 86645 $233.02
4401478 *DENGUE FEVER VIRUS AB IgG 86790 $177.84
4401479 *DENGUE FEVER VIRUS AB IgM 86790 $177.84
4401480 HTLV I II AB S 86687 $116.51
4401483 *VARICELLA ZOSTER IgM 86787 $145.09
4401484 PTH RELATED PEPTIDE 82397 $194.93
4401488 LACTIC ACID 83605 $147.88
4401489 LIVER KIDNEY MICROSOM AB 86376 $203.89
4401491 NT PRO BNP P 83880 $469.40
4401492 LYME DISEASE CSF BORRELIA BURGDORFERI 86618 $132.19
4401493 CULTURE CSF ‐ AFB CULTURE ONLY 87116 $148.76
4401494 *R LA CONFIRMATION ‐RUSSELL VIPER VENOM 85613 $131.98
4401496 *FLOW CYTOMETRY EACH ADD‐ON 88185 $124.35
4401497 21 HYDROXYLASE AB S 83519 $216.99
4401499 BETA 2 TRANSFERRIN BF 86335 $429.50
4401500 CALCITONIN 82308 $370.81
4401501 VITAMIN B6 84207 $388.73
4401502 *IMMUNOASSY ASSAY 83519 $190.14
4401504 VASOACTIVE INTEST POLYPEP 84586 $487.66
4401505 DIRECT LDL 83721 $108.55
4401506 METANEPHRINES FRACT FREE PLASMA 83835 $234.14
4401507 BETA 2 GLYCOPROTEIN AB IGG 86146 $207.25
4401508 BETA 2 GLYCOPROTEIN AB IGM 86146 $209.49
4401509 INTERLEUKIN 2 RECEPTOR ELISA 83520 $172.25
4401510 *UROTHELIAL CANCER FISH EACH 88368 $154.35
4401511 HEPATITIS B CORE AB IGM 86705 $97.47
4401512 INTERLEUKIN 6 83520 $193.81
4401518 INTERFERON NEUTRALIZING AB 86382 $258.37
4401519 *SPECIAL STAINS INTERFERON NEUTRALING AB 88313 $237.12
4401520 HEPATITIS DELTA TOTAL AB 86692 $211.39
4401521 *SPECIAL STAINS LIPID LADEN MACROPHAGES 88313 $237.12
4401522 *CYTOPATH CELL EHANCE TECH 88112 $92.98
4401524 CORTISOL SALIVA 82533 $225.17
4401525 DEOXYCORTICOSTEROIDS 82634 $343.38
4401526 TUMOR NECROSIS FACTOR ALPHA HIGHLY SENSI 83520 $193.50
4401527 *LYMPHOCYTE SUBSET 86361 $135.34
4401528 C TELOPEPTIDE BETA CROSSLAPS 82523 $243.96
4401529 NOROVIRUS NORWALK VIRUS 87449 $194.62
4401530 ENTERIC ADENOVIRUS 87301 $186.79
4401531 TOUCH PREP 88333 $1,309.61
4401532 CRYPTOCOCCAL ANTIGEN SERUM 86403 $136.45
4401533 INTERLEUKIN 1A 83519 $189.03
4401534 INTERLEUKIN 1B 83519 $189.03
4401536 URIC ACID RANDOM URINE 84560 $65.99
4401537 *TISSUE HOMOGENIZATION CULTURE 87176 $53.69
4401538 VANCOMYCIN TROUGH 80202 $187.09
4401539 VASOPRESSIN 84588 $456.34
4401541 *LIPOPROTEIN BLOOD HIGH RESOLUTION FRACT 83701 $364.62
4401542 CYANIDE BLOOD 82600 $209.16
4401543 ACETYLCHOLINE RECEPT BINDING AB 83519 $206.13
4401544 *ACHR GANGLIONIC NEURONAL AB 83519 $206.13
4401545 *AMPHIPHYSIN 86256 $166.92
4401546 *ANNA‐3 86256 $166.92
4401547 *CRMP‐5‐IGG 86256 $166.92
4401548 *N‐TYPE CA CHANNEL AB 83519 $206.13
4401549 *PQ‐TYPE CA CHANNEL AB 83519 $206.13
4401550 *PCA‐2 86256 $166.92
4401551 *PCA‐TR 86256 $166.92
4401552 *STRIATIONAL ABS 83520 $193.81
4401554 *IMMUNOFIXATION 86664 $211.73
4401555 ALDOSTERONE URINE 24HR 82088 $437.33
4401556 FNA RAPID PRELIMINARY 88172 $165.54
4401557 SPECIFIC GRAVITY URINE 81002 $24.60
4401558 RETICULIN AB IGG IGA 86255 $119.68
4401560 CHROMAGRANIN A 86316 $287.45
4401561 HISTONE AUTOANTIBODIES 83516 $197.97
4401563 PROTEIN URINE RANDOM 84156 $56.96
4401564 PROTEIN URINE 24 HR 84156 $56.96
4401565 PROTEIN CSF 84157 $50.41
4401566 CSF ANGIOTENSIN CONVERTING ENZYME 82164 $201.33
4401567 METHOTREXATE LEVEL 83520 $143.17
4401568 *ROCKY MOUNTAIN SPOTTED FEVER AB IGM 86757 $373.05
4401572 *MICROALBUMIN URINE 82043 $79.54
4401573 *CREATININE URINE RANDOM 82570 $71.69
4401574 GLUCAGON P 82943 $208.04
4401575 PLASMINOGEN ACTIVATOR INHIBITOR AG 83520 $181.20
4401576 MYOGLOBIN URINE 83874 $205.80
4401577 PLATELET ANTIBODY SERUM 86022 $253.89
4401578 CMV QUANT PCR PLASMA 87497 $592.63
4401579 *R HEPATITIS B SURF AG CONFIRM 87341 $107.37
4401588 NOROVIRUS STOOL PCR 87798 $326.60
4401592 *R PHENCYCLIDINE CONFIRMATION URINE 83992 $172.25
4401593 PHENYTOIN FREE 80186 $190.45
4401595 HISTAMINE 24 HOUR URINE 83088 $350.09
4401596 *FLOW CYTOMETRY TC 1 MARKER 88184 $777.48
4401599 ORGANIC ACIDS SCREEN URINE 83919 $224.81
4401600 *FLOW CYTOMETRY TC 1 MARKER SEP DIST 88184 $816.49
4401602 WARFARIN PLASMA 80299 $161.07
4401603 *TRANSGLUTAMINASE TISSUE IGG 83516 $159.08
4401606 TRYPTASE SERUM 83520 $161.07
4401607 EBV PCR BLOOD 87799 $592.63
4401608 *KAPPA FREE LIGHT CHAIN 83883 $188.20
4401609 *LAMBDA FREE LIGHT CHAIN 83883 $188.20
4401610 BK VIRUS DNA QUANTITATIVE 87799 $274.03
4401613 MYCOPLASMA PNEUMONIAE CULTURE 87109 $171.13
4401614 SOMATOSTATIN 84307 $255.02
4401617 VARICELLA ZOSTER PCR 87798 $485.08
4401621 BABESIA MICROTI PCR 87798 $414.50
4401622 ASPERGILLUS IGG AB 86606 $208.04
4401624 PLASMINOGEN ACTIVITY 85420 $92.84
4401625 VITAMIN B2 84252 $244.95
4401626 HHV 6 PCR PLASMA 87532 $284.10
4401627 *EHRLICHIA ANAPLASMA PCR 87798 $485.08
4401628 ANTIBIOTIC SUSCEPT REF LAB 87186 $137.56
4401629 ID OTHER ORGANISM REF LAB 87077 $96.72
4401630 ID OTHER ANAEROBE REF LAB 87077 $96.57
4401632 HIT HEPARIN PF4 AB 86022 $253.89
4401633 *APOLIPOPROTEIN A1 82172 $178.95
4401634 *APOLIPOPROTEIN B 82172 $156.59
4401636 FENTANYL AND METABOLITE SCREEN URINE 80299 $208.38
4401638 *ANTI‐GLIAL NUCLEAR AB TYPE 1 86256 $166.92
4401639 *NEURONAL (V‐G) K CHANNEL AB 83519 $206.13
4401640 HIV 1 PROVIRAL DNA QUALIT DET PCR, BLOOD 87535 $231.53
4401641 PARVOVIRUS PCR 87798 $485.08
4401643 CARBOHYDRATE DEFICIENT TRANSFERRIN 82373 $183.43
4401644 CLOSTRIDIUM DIFFICLE PCR 87493 $485.08
4401645 S PNEUMONIAE AG UR 87450 $111.85
4401646 *CAPILLARY BLOOD DRAW 36416 $26.89
4401647 *PHOSPHATIDYLSERINE IGA 86148 $143.17
4401648 PHOSPHATIDYLSERINE AB IGG 86148 $221.47
4401649 *PHOSPHATIDYLSERINE IGM 86148 $143.17
4401651 CMV PCR CSF URINE 87496 $484.31
4401652 *MUCOPOLYSACCHARIDES QUANT 83864 $164.41
4401657 CULTURE PERIANAL 87070 $137.56
4401660 ANTI HU 86255 $152.12
4401661 HEPATITIS BE AB 86707 $159.94
4401662 HEPATITIS B DNA PCR VIRAL LOAD 87517 $592.63
4401664 LYME DISEASE PCR SYNOVIAL 87476 $485.08
4401665 *C DIFF ANTIGEN 87449 $140.93
4401666 ACH RECEPTOR MODULATING AB 83519 $147.88
4401667 PSEUDOCHOLINESTERASE 82480 $99.70
4401668 AMINO ACID URINE RANDOM 82139 $137.58
4401671 *COCCIDIOMYCOSIS CF IGG 86635 $158.82
4401672 *COCCIDIOMYCOSIS ID IGG 86635 $158.82
4401673 *COCCIDIOMYCOSIS ID IGM 86635 $158.82
4401675 *R TETRAHYDROCANNABINOL URINE CONFIRM 80299 $208.38
4401677 YEAST ID 87106 $122.11
4401679 *BRUCELLA AB IGG 86622 $123.23
4401680 *BRUCELLA AB IGM 86622 $123.23
4401682 UREA NITROGEN URINE RANDOM 84540 $35.85
4401684 ADENOVIRUS 1 2 3 PCR 87798 $297.52
4401685 ENTEROVIRUS PCR CSF 87498 $247.58
4401686 INFLUENZA A B PCR 87502 $569.31
4401687 PARAINFLUENZAE 1 2 3 PCR 87798 $234.88
4401688 RSV PCR 87503 $87.24
4401689 METAPNEUMOVIRUS PCR 87798 $263.97
4401690 *R HIV CONFIRM IFA 86689 $174.48
4401691 MYELOPEROXIDASE AB 83516 $87.24
4401692 PROTEINASE 3 AB 83516 $87.24
4401693 FRANCISELLA TULARENSIS AB 86000 $58.25
4401694 *R HIV 2 AB 86702 $130.86
4401701 *RBC ENZYMES 82657 $223.70
4401702 *GLUTATIONE 82978 $176.72
4401704 *B CELLS TOTAL COUNT 86355 $172.52
4401705 *NK CELLS TOTAL COUNT 86357 $172.52
4401707 UROVYSION DETECTION OF BLADDER CANCER 88120 $1,419.39
4401709 *ASSAY OF MAGNESIUM 83735 $93.35
4401710 *ASSAY OF PHOSPHORUS 84100 $41.39
4401714 SUDAN III STAIN 82705 $210.27
4401716 QUANTIFERON TB GOLD 86480 $269.75
4401717 PERTUSSIS PCR 87798 $325.48
4401718 *MONONUCLEAR CELL ANTIGEN QUANTITATIVE 86356 $148.76
4401720 ENTAMOEBA HISTOLYTICA AG STOOL 87337 $183.43
4401721 ENTAMOEBA HISTOLYTICA AB 86753 $119.68
4401723 *VON WILLEBRAND FACTOR ACTIVITY 85397 $346.16
4401724 PNEUMOCYSTIS JIROVECI PCR 87798 $256.13
4401725 TZANK SMEAR 88108 $96.19
4401726 URINE CYTOLOGY 88108 $187.09
4401727 VONWILLEBRAND FACTOR MULTIMER 85247 $199.09
4401728 *CALIFORNIA VIRUS IGG 86651 $125.27
4401729 *CALIFORNIA VIRUS IGM 86651 $125.27
4401730 *EASTERN EQUINE AB IGG 86652 $125.27
4401731 *EASTERN EQUINE AB IGM 86652 $125.27
4401732 *ST LOUIS ENCEPHALITIS IGG 86653 $125.27
4401733 *ST LOUIS ENCEPHALITIS IGM 86653 $125.27
4401734 *WESTERN EQUINE AB IGG 86654 $125.27
4401735 *WESTERN EQUINE AB IGM 86654 $125.27
4401736 BRUCELLA TOTAL AB CONFIRM 86622 $118.55
4401737 DEXAMETHASONE 82542 $269.99
4401738 *TISSUE CULTURE 88230 $506.68
4401739 *CYTOGENIC REPORT 88291 $510.84
4401740 *CYTOGENIC STUDY UNLISTED 88299 $102.90
4401741 BLASTOMYCES AB 86612 $153.23
4401742 *TISSUE CULTURE INTERFERON B‐1 87253 $232.65
4401743 *CRYPTOSPORIDIUM 87272 $133.32
4401744 *GIARDIA 87269 $133.32
4401745 *NMR LIPOPROFILE 83704 $320.40
4401746 HCG TUMOR MARKER 84702 $208.38
4401748 ISLET ANTIGEN 2 ANTIBODY 86341 $272.92
4401749 *DESMOGLEIN 1 83516 $156.59
4401750 *DESMOGLEIN 3 83516 $156.59
4401751 MOLD ID 87107 $83.89
4401754 *BORRELIA BURGDORFI IGG 86618 $131.98
4401755 *BORRELIA BURGDORFI IGM 86618 $131.98
4401760 HEPATITIS C GENOTYPE 87902 $664.32
4401762 LAB *TEST* 82948 $112.96
4401763 *BABESIA IGG 86753 $97.31
4401764 *BABESIA IGM 86753 $97.31
4401765 COMPLEMENT 2 86160 $170.00
4401766 *PSEUDOCHOLINESTERASE TOTAL 82480 $68.23
4401767 *PSEUDOCHOLINESTERASE DIBUCAINE INHIBITI 82638 $91.72
4401768 *LDH ENZYMES 83615 $74.04
4401769 *ASSAY OF LDH ENZYMES 83625 $128.63
4401772 *QUANTIFICATION OF DRUG 80299 $135.34
4401775 CLINICAL PATHOLOGY CONSULTATION COMPRE 80502 $340.02
4401776 ASCORBIC ACID 82180 $136.45
4401777 *WEST NILE VIRUS AB IGM CSF 86788 $104.02
4401778 *WEST NILE VIRUS ANTIBODY 86789 $110.91
4401779 *BLOOD CLOT FACTOR VII TEST 85230 $127.50
4401780 *FACTOR INHIBITOR TEST 85335 $91.72
4401781 MALARIA PCR 87798 $278.95
4401782 MYELIN ASSOCIATED GLYCOPROTEIN 84181 $235.25
4401783 CYSTINURIA 24 HR 82136 $137.58
4401784 MIB 1 88360 $1,114.68
4401786 MTHFR MUTATION 81291 $206.92
4401787 MEN 2 KNOWN MUTATION 81403 $592.80
4401788 PROTHROMBIN GENE MUTATION 20210A 81240 $163.30
4401789 HEMOCHROM HFE GENE ANALYSIS 81256 $263.26
4401790 MEN TYPE 2 SCREEN 81405 $427.27
4401791 CYSTIC FIBROSIS 81220 $697.94
4401792 CGTR GENE KNOWN MUTATION 81221 $638.66
4401793 FRAGILE X 81243 $350.09
4401795 Y CHROMOSOME MICRODELETIONS MOLECULAR 81403 $582.73
4401796 APOLIPOPROTEIN E GENOTYPE 81401 $325.48
4401797 FACTOR 5 LEIDEN 81241 $410.02
4401800 *ASSAY OF URINE CREATININE 82570 $33.61
4401801 *MICROALBUMIN QUANTITATIVE 82043 $35.85
4401802 PSA ULTRASENSITIVE 84153 $148.31
4401803 ALUMINUM SERUM 82108 $181.20
4401804 VITAMIN D1 25 82652 $306.96
4401805 MICROALBUMIN 24 HOUR URINE 82043 $79.54
4401807 VON HIPPEL‐LINDAU DELETION 81403 $724.78
4401809 MTHFR 2 MUTATIONS 81291 $318.76
4401810 UREA NITROGEN URINE 24 HOUR 84580 $62.73
4401811 METHYLPHENIDATE URINE 82542 $269.99
4401814 PARIETAL CELL AB 83516 $159.08
4401815 HIV‐1 GENOTYPIC DRUG RESISTANCE MUTATION 87901 $587.03
4401816 PORPHYRINS PLASMA 84311 $90.59
4401817 ANTIMULLERIAN HORMONE 83520 $179.24
4401818 EPSTEIN BARR VIRUS IGG EA 86663 $181.49
4401820 JC POLYOMA VIRUS PCR 87799 $591.68
4401823 PROINSULIN PLASMA 84206 $154.60
4401824 *PHENOTYPE DNA HIV W CULTURE 87903 $3,758.11
4401825 *PHENOTYPE DNA HIV W CLT ADD 87904 $201.33
4401826 TZANK SMEAR 87207 $40.27
4401827 ANAPLASMA PHAGOCYTOPHILUM IGG 86666 $78.42
4401829 *WEST NILE VIRUS AB IGM 86788 $109.79
4401831 CYTOPATH SMEAR OTHER SOURCE 88161 $182.31
4401833 *BORRELIA SPECIES MIAMOTOI PCR 87798 $286.79
4401834 COPPER URINE 24 HR 82525 $82.90
4401835 *EHRLICHIA CHAFFEENSIS IGG 86666 $71.58
4401836 *EHRLICHIA CHAFFEENSIS IGM 86666 $71.58
4401837 LIPOPROTEIN A 83695 $110.91
4401838 HOMOCYSTEINE PLASMA 83090 $136.67
4401839 METHYLMALONIC ACID 83921 $124.35
4401840 ARIPIPRAZOLE PLASMA ABILIFY 82542 $114.08
4401841 *MYOTONIC DYSTROPHY EVAL LEVEL 2 81401 $947.36
4401842 *MYOTONIC DYSTROPHY EVAL UNLISTED PROC 81479 $947.36
4401843 *RSV AB IGG 86756 $83.89
4401844 *RSV AB IGM 86756 $83.89
4401845 MYCOBACTERIUM TUBERCULOSIS 87556 $271.79
4401846 CEA PERITONEAL FLUID 82378 $183.48
4401847 AFP PERITONEAL FLUID 83520 $189.03
4401848 URINE DIP STICK ONLY AUTOMATED 81003 $39.70
4401849 HUMAN ANTIMOUSE ANTIBODY 83520 $384.76
4401850 AMINOLEVULNIC ACID UR 82135 $127.71
4401851 THYROTROPIN RECEPTOR ANTIBODY 83520 $95.22
4401853 HYPERBILIRUBINEMIA GENE SEQ UGT1A1 81350 $1,162.10
4401854 CLOZAPINE 80159 $116.51
4401856 ANTIMULLERIAN HORMONE 83520 $193.81
4401857 KEPPRA 80177 $97.47
4401858 PM‐SCL AB 86235 $147.64
4401859 SIGNAL RECOGNITION PARTICLE (SRP) 83516 $138.69
4401860 BILE ACID TOTAL AND FRACT 83789 $269.99
4401861 ACYLCARNITIN 82017 $69.35
4401863 C1 ESTERASE INHIBITOR AG 83883 $77.18
4401864 MYCOPHENOLIC ACID 80180 $116.32
4401865 *TUMOR NECROSIS FACTOR ‐ ALPHA 83520 $82.77
4401866 *INTERLEUKIN 2 83520 $82.77
4401867 *INTERLEUKIN 2 RECEPTOR CD 25 SOLUBLE 83520 $82.77
4401868 *INTERLEUKIN 12 83520 $82.77
4401869 *INTERFERON GAMMA 83520 $82.77
4401870 *INTERLEUKIN 4 83520 $82.77
4401871 *INTERLEUKIN 5 83520 $82.77
4401872 *INTERLEUKIN 10 83520 $82.77
4401873 *INTERLEUKIN 13 83520 $82.77
4401874 *INTERLEUKIN 1 BETA 83520 $82.77
4401875 *INTERLEUKIN 6 83520 $82.77
4401876 *INTERLEUKIN 8 83520 $82.77
4401888 PANCREATIC ELASTASE STOOL 82656 $159.08
4401889 COMPLEMENT C4 FUNCTIONAL 86161 $79.54
4401891 *SHIGA TOXIN 1 87899 $81.65
4401892 *SHIGA TOXIN 2 87899 $81.65
4401893 *CHROMOSOMAL MICROARRAY 81229 $2,009.92
4401894 SPERM CHECK 89310 $118.74
4401895 *SEMEN ANALYSIS 89320 $80.66
4401896 ANGIOTENSIN II PLASMA 82163 $418.32
4401897 STREPTOZYME SCREEN W/REFLEX 86403 $86.12
4401898 *R HIV REFLEX HVCOP 87389 $172.52
4401899 MuSK ANTIBODY 83519 $206.13
4401900 *SEROTYPE 1 (1) 86317 $93.95
4401901 *SEROTYPE 2 (2) 86317 $93.95
4401902 *SEROTYPE 3 (3) 86317 $93.95
4401903 *SEROTYPE 4 (4) 86317 $93.95
4401904 *SEROTYPE 5 (5) 86317 $93.95
4401905 *SEROTYPE 8 (8) 86317 $93.95
4401906 *SEROTYPE 9N (9) 86317 $93.95
4401907 *SEROTYPE 12F (12) 86317 $93.95
4401908 *SEROTYPE 14 (14) 86317 $93.95
4401909 *SEROTYPE 17F (17) 86317 $93.95
4401910 *SEROTYPE 19F (19) 86317 $93.95
4401911 *SEROTYPE 20 (20) 86317 $93.95
4401912 *SEROTYPE 22F (22) 86317 $93.95
4401913 *SEROTYPE 23F (23) 86317 $93.95
4401914 *SEROTYPE 6B (26) 86317 $97.31
4401915 *SEROTYPE 10A (34) 86317 $97.31
4401916 *SEROTYPE 11A (43) 86317 $97.31
4401917 *SEROTYPE 7F (51) 86317 $97.31
4401918 *SEROTYPE 15B (54) 86317 $97.31
4401919 *SEROTYPE 18C (56) 86317 $97.31
4401920 *SEROTYPE 19A (57) 86317 $97.31
4401921 *SEROTYPE 9V (68) 86317 $97.31
4401923 CADMIUM BLOOD OCCUPATIONAL MONITORING 82300 $174.76
4401929 *N‐METHYLHISTAMINE 24 HR URINE 83789 $144.29
4401933 *11 BETA‐PROSTAGLANDIN F2 ALPHA,24 URINE 84150 $209.16
4401934 COMPLEMENT C4 SERUM 86160 $87.38
4401935 LEGIONELLA ANTIGEN, URINE 87899 $98.58
4401936 LISTERIA ANTIBODY, CF SERUM 86609 $130.86
4401937 ZONISAMIDE, SERUM 80203 $86.26
4401950 *TPP1 AND PPT1 WBC 82657 $354.56
4401951 *SODIUM F 84302 $31.37
4401952 *POTASSIUM F 84999 $31.37
4401953 *CHLORIDE F 82438 $31.37
4401954 *MAGNESIUM F 83735 $93.50
4401955 *OSMOTIC GAP F 84999 $31.32
4401956 *PHOSPHORUS F 84100 $30.24
4401957 *OSMOLALITY F 84999 $31.37
4401958 BETA HYDROXYBUTYRATE 82010 $51.53
4401959 OXYCODONE QUANTITATIVE URINE 82542 $140.93
4401961 VITAMIN B3 (NIACIN) 84591 $108.66
4401962 VITAMIN B7 (BIOTIN) 84591 $139.81
4401963 IMMUNOGLOBULIN D (IgD) 82784 $81.65
4401964 CRYPTOCOCCUS ANTIGEN SCREEN 87899 $73.82
4401965 TRICHINELLA ANTIBODY SERUM 86784 $90.59
4401966 OLANZAPINE (ZYPREXA) 82542 $116.32
4401967 STRONGYLOIDES AB IgG 86682 $86.12
4401968 SYPHILLIS AB (TP‐PA) 86780 $85.00
4401976 FECAL LACTOFERRIN 83630 $145.63
4401977 GAA EXON 18 DELETION 81403 $515.63
4401978 GAA VARIANT ‐32‐13T>G 81403 $515.63
4401979 CHLAMYDOPHILA PNEUMONIAE, PCR 87486 $319.89
4401981 *UREAPLASMA UREALYTICUM PCR 87798 $190.14
4401982 *UREAPLASMA PARVUM PCR 87798 $190.14
4401986 *COXIELLA BURNETII PCR 87798 $484.31
4401988 SYPHILLIS AB IgG 86780 $85.14
4401989 OCCULT BLOOD FECES 82272 $45.86
4401990 OXCARBAZEPINE METABOLITE (MHC) 80183 $82.90
4401991 *R METHADONE CONFIRM UR 80358 $41.45
4401993 *R BENZODIAZEPINE CONFIRM URINE 80346 $51.53
4401994 *R COCAINE CONFIRMATION URINE 80353 $52.65
4401995 *R FENTANYL AND METABOLITE 80354 $108.49
4401996 BUPRENORPHINE QUANT AND METABOLITE 80348 $115.39
4401997 *R BARBITURATE CONFIRMATION URINE 80345 $51.45
4402000 CLONAZEPAM SERUM 80346 $48.17
4402001 AMITRIPTYLINE NORTRIPTYLINE 80335 $25.73
4402002 *HPV TYPING 87624 $223.54
4402003 *16 18 HPV TYPING 87625 $168.04
4402004 *OPIATES ONE OR MORE 80361 $24.64
4402005 *DRUG SCREENING OXYCODONE 80365 $24.64
4402009 *AMPHETAMINE SCREEN 80324 $25.77
4402010 *METHYLENEDIOXY AMPHETAMINES 80359 $25.77
4402011 IMMUNOHISTOCHEMISTRY EACH ADDL STAIN 88341 $54.90
4402012 HIV AG/AB 87806 $155.71
4402013 BERYLLIUM BLOOD 83018 $140.93
4402014 NICKEL RANDOM URINE 83885 $157.71
4402016 *ASSAY OF NICOTINE 80323 $147.88
4402020 CALPROTECTIN 83993 $271.11
4402021 *TPMT GENOTYPING 81401 $530.17
4402025 *AMPAR‐Ab CSF 86255 $166.66
4402026 *GABAR‐Ab CSF 86255 $166.66
4402027 *NMDAR‐Ab CSF 86255 $166.66
4402028 *LYMPHOCYTIC CHORIOMENINGITIS IgM CSF 86727 $67.10
4402029 *LYMPHOCYTIC CHORIOMENINGITIS IgG CSF 86727 $67.10
4402030 STRONTIUM 83018 $140.93
4402031 BARIUM 83018 $140.93
4402033 ALLERGEN SPECIFIC IGG EACH TEST 86001 $31.32
4402035 *CELIAC HLA DQ A 81376 $825.65
4402036 *CELIAC HLA DQ B 81376 $887.26
4402037 *DIPHTERIA TETANUS AB PANEL 86317 $97.31
4402038 SERTRALINE ZOLOFT 80332 $98.43
4402039 PROCALCITONIN PLASMA 84145 $193.81
4402040 STOOL FIT 82274 $79.54
4402041 NTX TELOPEPTIDE URINE 82523 $243.96
4402042 QUAD MARKER 81511 $187.09
4402043 PRADER WILLI ANGELMAN SYNDROME BLOOD 81331 $378.05
4402044 FUNGITELL SERUM 87449 $156.59
4402045 ANTIDEPRESSANTS CLASS 3‐5 80333 $178.12
4402046 *TRICYCLIC AND CYCLICALS 6 MORE 80337 $178.12
4402047 SKELETAL MUSCLE RELAXANT 1 2 80369 $178.12
4402048 LIPOPROTEIN ASSOCIATED PHOSPHOLIPASE A2 83698 $199.09
4402049 *BCR ABL 1 GENE MAJOR BP 81206 $952.24
4402050 *BCR ABL1 GENE MINOR BP 81207 $880.25
4402051 *BCR ABL1 GENE OTHER BP 81208 $977.56
4402052 ALBUMIN BODY FLUID 82042 $30.24
4402053 CREATININE BODY FLUID 82570 $31.37
4402054 AMYLASE BODY FLUID 82150 $32.49
4402055 LDH BODY FLUID 83615 $74.15
4402056 CHOLESTEROL BODY FLUID 84311 $42.50
4402057 IGH SOMATIC MUTATION B‐CLL 81263 $1,781.75
4402058 *FLOW CYTOMETRY INTERPRETATION 2 TO 8 MA 88187 $78.30
4402059 PROMETHEUS THIOPURINE METABOLITES 82542 $269.99
4402060 CYCLIC CITPEPTIDE AB S 86200 $84.02
4402061 ENDOMYSIAL AB 86255 $77.30
4402062 HEPATITIS E IGG 86790 $57.04
4402063 CK ISOENZYMES 82552 $79.54
4402064 *R ALC BIOMARKER CONFIRM 80321 $48.17
4402065 DRUG ABUSE URINE 13 80306 $90.74
4402066 MATERNAL URINE SCREEN 80306 $96.35
4402067 TRICHLOROETHYLENE 82441 $176.72
4402068 PCA3 81313 $817.61
4402069 TRICHOMONAS VAGINALIS NUCLEIC ACID 87661 $178.12
4402072 ALPHA 2 MACROGLOBULIN SERUM 83883 $69.35
4402073 VENOUS BLOOD GAS 82803 $116.51
4402074 HISTAMINE PLASMA 83088 $173.64
4402075 *TETANUS IGG AB 86317 $88.50
4402077 MARFAN AND RELATED GENETIC PANEL 81410 $3,383.42
4402078 VHL TUMOR SUPPRESSOR FULL GENE 81404 $325.48
4402079 SHIGA TOXIN PCR 87798 $164.41
4402080 WEST NILE PCR CSF 87798 $165.81
4402081 HEPATITIS E IGM 86790 $55.92
4402082 STOOL PCR 87507 $1,342.10
4402083 *FREE BETA HCG 84704 $108.49
4402084 STREP PNEUMO AG UR 87899 $74.94
4402085 BACTERIAL VAGINOSIS GRAM STAIN 87205 $67.71
4402086 *ECHOVIRUS 4 AB 86658 $63.76
4402087 *ECHOVIRUS 7 AB 86658 $63.76
4402088 *ECHOVIRUS 9 AB 86658 $63.76
4402089 *ECHOVIRUS 11 AB 86658 $63.76
4402090 *ECHOVIRUS 30 AB 86658 $63.76
4402091 *HIV 1 86701 $54.81
4402092 *R SILICIA CLOTTING TIME 85732 $56.01
4402094 RIBOSOM P AB IGG S 83516 $78.30
4402095 CU INDEX 86352 $658.78
4402096 HERPES SIMPLEX PCR CSF 87529 $156.84
4402097 HERPESVIRUS 6 A B PCR 87533 $755.07
4402098 *AGNA 1 86255 $97.31
4402099 *AMPHIPHYSIN 86255 $97.31
4402100 *ANNA 1 86255 $97.31
4402101 *ANNA 2 86255 $97.31
4402102 *ANNA 3 86255 $97.31
4402103 *CRMP 5 IGG 86255 $97.31
4402104 *PCA 1 86255 $100.67
4402105 *PCA 2 86255 $97.31
4402106 *PCA TR 86255 $97.31
4402107 CHLAMYDIA PNEUMONIAE IGM 86632 $72.71
4402108 CHLAMYDIA TRACHOMATIS IGM 86632 $72.71
4402109 CHLAMYDIA PSITTACI IGM 86632 $72.71
4402111 DESIPRAMINE 80335 $38.03
4402112 URIC ACID BODY FLUID 84560 $53.69
4402113 JAK2 V617F MUTATION 81270 $508.91
4402114 *BABESIA SPECIES PCR 87798 $154.60
4402115 CLINICAL PATHOLOGY CONSULTATION 80500 $201.33
4402116 TRAMADOL URINE 80373 $49.30
4402117 HLA B27 86812 $153.48
4402118 IPECAC FWD MEDTOX 80323 $143.17
4402119 ADENOVIRUS ANTIBODY 86603 $99.54
4402120 STREP PNEUMO AG CSF 87899 $65.99
4402121 CORD BLOOD GAS 82805 $163.30
4402122 NORTRIPTYLINE SERUM 80335 $24.64
4402123 DRUG OF ABUSE MECONIUM 80307 $326.00
4402125 *BP 180 83516 $63.76
4402126 *BP 230 83516 $63.76
4402127 *LYMPH PROLIF MITOGENS 86353 $250.54
4402128 *ADDITIONAL FLOW STIMULANT 86353 $250.54
4402129 *CRP 86140 $71.89
4402130 *ICAM 82397 $61.51
4402131 *VCAM 82397 $61.51
4402132 *SAA 82397 $61.51
4402133 *ASCA IGA ELISA 83520 $74.94
4402134 *ASCA IGG ELISA 83520 $74.94
4402135 *ANTI OMPC IGA ELISA 83520 $74.94
4402136 *ANTI CBIR1 IGG ELISA 83520 $74.94
4402137 *ANTI A4 FLA2 IGG ELISA 83520 $74.94
4402138 *ANTI FLAX IGG ELISA 83520 $74.94
4402139 *IBD SPECIFIC PANCA AUTOANTIBODY ELISA 83520 $74.94
4402140 *VEGF 83520 $74.94
4402141 *IBD SPECIFIC PANCA IFA PERINUCLEAR PATT 88346 $244.95
4402142 *IBD SPECIFIC PANCA IFA DNASE SENSITIVIT 88350 $186.79
4402143 *ATG16L1 SNP 81479 $549.18
4402144 *ECM1 SNP 81479 $549.18
4402145 *NKX2 3 SNP 81479 $549.18
4402146 *STAT3 SNP 81479 $549.18
4402147 ALCOHOL BIOMARKERS SCREEN REFLEX 80307 $336.08
4402148 *R ALCOHOL BIOMARKERS QUANT 80321 $45.86
4402149 ALCOHOL BLOOD 80307 $336.08
4402150 ACETAMINOPHEN 80307 $337.20
4402151 SALICYLATES 80307 $357.37
4402152 UDS PRESCRIPTION OTC 80307 $336.66
4402153 HAEMOPHILUS FLU B IGG 86684 $60.40
4402154 INFLUENZA A AND B 87804 $67.21
4402155 MITOCHONDRIAL IGG AB 83516 $69.46
4402156 RECOMBX HU AB 84999 $532.40
4402157 *RUBELLA IGG 86762 $82.90
4402158 INFLIXIMAB QUANT WITH AB REFLEX 80299 $208.38
4402159 TRICHOMONAS UVM 87808 $65.99
4402160 6 MONOACETYLMORPHINE CONFIRM 80356 $45.86
4402161 *CANDIDA ALBICANS IGG 86628 $127.50
4402162 *CANDIDA ALBICANS IGM 86628 $127.50
4402163 *CANDIDA ALBICANS IGA 86628 $127.50
4402165 *CBL 81479 $548.06
4402166 *HRAS 81404 $128.63
4402167 *NRAS 81311 $1,253.82
4402168 *KRAS 81405 $55.92
4402169 *SHOC2 81405 $55.92
4402170 *BRAF 81406 $305.35
4402171 *MAP2K1 81406 $305.35
4402172 *MAP2K2 81406 $305.35
4402173 *PTPN11 81406 $305.35
4402174 *RAF1 81406 $305.35
4402175 *SOS1 81406 $305.35
4402176 *HISTO BLASTO RESULT 87798 $483.19
4402177 *HISTO BLASTO RESULT 87798 $483.19
4402178 CHICKUNGUNYA RNA PCR 87798 $399.30
4402180 *DENGUE NS1 AG 86790 $104.02
4402181 MANNOSE BINDING LECTIN 83520 $193.50
4402182 VYVANSE LISDEXAMFETAMINE 80324 $213.63
4402183 HCV AB CONFIRMATION 86804 $221.82
4402184 *TESTOSTERONE BIOAVAILABLE 84410 $314.79
4402185 BCR ABL 1 TKI MUTATION 81170 $1,351.13
4402186 CULTURE FUNGAL 87101 $45.93
4402187 ADAMTS13 ACTIVITY INHIBITOR 85397 $164.41
4402188 GMAPS1 82016 $79.41
4402189 GMAPS2 82128 $79.41
4402190 GMAPS3 82180 $57.04
4402191 GMAPS4 82239 $99.54
4402192 GMAPS5 82247 $29.08
4402193 GMAPS6 82379 $61.51
4402194 GMAPS7 82383 $144.29
4402195 GMAPS8 82465 $53.65
4402196 GMAPS9 82507 $106.26
4402197 GMAPS10 82528 $129.75
4402198 GMAPS11 82533 $93.95
4402199 GMAPS12 82540 $26.85
4402200 GMAPS13 82542 $104.02
4402201 GMAPS14 82565 $49.36
4402202 GMAPS15 82570 $30.19
4402203 GMAPS16 82725 $76.05
4402204 GMAPS17 82726 $104.02
4402205 GMAPS18 82746 $131.98
4402206 GMAPS19 82760 $64.87
4402207 GMAPS20 82947 $42.92
4402208 GMAPS21 82978 $81.65
4402209 GMAPS22 83150 $111.85
4402210 GMAPS23 83605 $61.51
4402211 GMAPS24 83789 $104.02
4402212 GMAPS25 83919 $95.07
4402213 GMAPS26 83945 $73.82
4402214 GMAPS27 84035 $21.26
4402215 GMAPS28 84207 $162.18
4402216 GMAPS29 84210 $62.63
4402217 GMAPS30 84252 $116.32
4402218 GMAPS31 84260 $178.95
4402219 GMAPS32 84377 $31.32
4402220 GMAPS33 84425 $121.91
4402221 GMAPS34 84446 $81.65
4402222 GMAPS35 84510 $60.40
4402223 GMAPS36 84525 $12.31
4402224 GMAPS37 84550 $65.45
4402225 GMAPS38 84560 $25.73
4402226 GMAPS39 84590 $67.10
4402227 *IMMUNOASSAY QUANT NOS NONAB1 83520 $476.47
4402228 *IMMUNOASSAY QUANT NOS NONAB2 83520 $476.47
4402229 *IMMUNOASSAY QUANT NOS NONAB3 83520 $476.47
4402230 PROSTATE HEALTH INDEX 84153 $148.31
4402231 *R FREE PSA 84154 $27.96
4402232 *R P2PSA 86316 $124.16
4402233 ETHYLENE GLYCOL 80320 $82.77
4402234 VOLATILE SUBSTANCE SCREEN 80320 $12.31
4402235 BR BACT PCR SEQ 87801 $401.53
4402236 TRAZODONE 80338 $82.90
4402237 COMPLEMENT C4A 86160 $165.54
4402238 CHLORIDE 24HR URINE 82436 $41.45
4402239 PS PT AB IGG 86148 $181.20
4402240 TROPHERYMA WHIPPLEI PCR 87798 $148.76
4402241 *SEMEN MORPHOLOGY 89331 $115.39
4402242 *ID OTHER AER MML 87077 $96.57
4402243 *BURGDORFERI PCR 87476 $149.00
4402244 *MAYONII PCR 87798 $149.00
4402245 *GARINII AFZELII 87798 $149.00
4402246 TISSUE DRUG SCREEN 80307 $312.06
4402247 *CANDIDA ALBICANS NAA 87481 $162.18
4402248 *CANDIDA GLABRATA NAA 87481 $162.18
4402249 *ATOPOBIUM VAGINAE 87798 $184.55
4402250 *BVAB 2 87798 $184.55
4402251 *MEGASPHAERA 1 87798 $184.55
4402252 *TRICHOMONAS NAA 87661 $162.18
4402253 *IDENT BY MALDI TOF 87077 $96.57
4402254 *AEROBE IDENT BY SEQUENCING 87153 $578.26
4402255 *R THC MECONIUM CONFIRM 80349 $110.91
4402256 *R COCAINE CONFIRMATION MECONIUM 80353 $110.73
4402257 *AMPHETAMINES MECONIUM 80324 $57.04
4402258 *METHYLENEDIOXYAMPHETAMINES 80359 $57.04
4402259 *MECONIUM SCRN OXYCODONE 80365 $57.04
4402260 *OPIATES MECONIUM 80361 $57.04
4402261 COENZYME Q 10 82542 $157.71
4402262 *POLIOVIRUS 1 AB 86382 $234.14
4402263 *POLIOVIRUS 3 AB 86382 $234.14
4402264 *BORDETELLA PERTUSSIS 87798 $146.75
4402265 *BORDETELLA PARAPERTUSSIS 87798 $146.75
4402266 ADALIMUMAB AB REFLEX 80299 $208.38
4402267 R ADALIMUMAB AB 83520 $210.27
4402268 RHD GENE ANALYSIS 81403 $518.97
4402269 TARGETED OPIOID SCREEN URINE 80364 $47.05
4402270 LAMOTRIGINE LAMICTAL 80175 $76.18
4402271 *IGA 1 82787 $110.91
4402272 *IGA 2 82787 $110.91
4402273 INFLUENZA A B PCR 87631 $440.27
4402275 CORTISOL STIM BASELINE 82533 $87.24
4402276 CORTISOL STIM 30 MINUTE 82533 $87.24
4402277 CORTISOL STIM 60 MINUTE 82533 $87.24
4402278 CLOMIPRAMINE 80335 $57.04
4402279 QUETIAPINE SEROQUEL 80342 $87.24
4402280 LG1CC 86255 $78.30
4402281 CS2CC 86255 $78.30
4402282 HEMOQUANT FECES 84126 $136.67
4402283 BATH SALTS MDPV 80307 $312.56
4402284 SHOX DNA 81479 $580.50
4402285 *BABESIA DUNCANI 87798 $144.52
4402286 *BABESIA DIVERGENS 87798 $144.52
4402287 *BABESIA MIYAMOTOI 87798 $144.52
4402288 *COCAINE AND METABOLITE WB 80307 $312.06
4402289 *COCAINE REFLEX WB 80353 $41.39
4402290 CYSTATIN C W EGFR 82610 $71.58
4402291 IODINE SERUM 83789 $97.31
4402292 VGCC 83519 $526.81
4402293 PRENATAL ZIKA IGM 86794 $182.60
4402294 S CEREVISIAE IGG 86671 $86.26
4402295 ZIKA PCR SERUM 87662 $267.74
4402296 ZIKA PCR URINE 87662 $267.74
4402297 BLOOD BONE MARROW CULTURE 88237 $215.09
4402298 *HSV 1 PCR 87529 $140.03
4402299 *HSV 2 PCR 87529 $140.03
4402301 NMO AQP4 FACS 86255 $464.27
4402302 MOG FACS 86255 $464.27
4402303 NALOXONE URINE 80307 $312.56
4402304 BARTONELLA PCR 87801 $280.07
4402305 *TRICHROME STAIN 87209 $96.35
4402306 COBALT SERUM 83018 $117.63
4402307 D LACTATE URINE 83605 $333.16
4402308 CITALOPRAM CELEXA 80299 $73.94
4402309 METHADONE SERUM 80358 $280.07
4402311 *EHRLICHIA CHAFFENNSIS 87798 $140.03
4402312 *EHRLICHIA EWINGII 87798 $140.03
4402313 *EHRLICHIA MURIS 87798 $140.03
4402314 RESPIRATORY VIRAL PANEL EXP 87632 $618.39
4402315 *ASSAY OF APOLIPOPROTEIN 82172 $82.90
4402316 *ASSAY OF NEPHELOMETRY NOT SPEC 83883 $61.61
4402317 *ASSAY OF HAPTOGLOBIN QUANT 83010 $67.21
4402318 *ALANINE AMINO ALT SGPT 84460 $67.71
4402319 *ASSAY OF GGT 82977 $76.30
4402320 *BILIRUBIN TOTAL 82247 $26.89
4402321 *CD19 88184 $777.48
4402322 *CD20 88185 $124.35
4402323 *SMNI GENE DOS DELETE ALYS 81329 $537.73
4402324 *TISSUE CULTURE SKIN BIOPSY 88233 $611.81
4402325 *CELL CRYOPRESERVE STORAGE 88240 $50.33
4402326 RITALIN METHYLPHENIDATE SERUM 80360 $140.03
4402328 BLOOD CULTURE PCR 27* 87150 $3,960.30
4402329 PROTOPORPHRYNS OCCUPATIONAL 82542 $155.83
4402330 EOSINOPHILS URINE 85999 $85.98
4402331 CULTURE FUNGAL BLOOD 87103 $77.38
4402332 ENTEROVIRUS PCR BLOOD 87498 $247.19
4402333 *GANGLIOSIDE ANTIBODIES 83516 $59.11
4402334 DIHYDROTESTOSTERONE SERUM 82642 $122.52
4402335 LEGIONELLA AB 86713 $64.48
4402337 PROSTAGLANDIN D2 URINE 84150 $398.08
4402338 BK VIRUS URINE 87798 $146.16
4402339 THC CONFIRMATION BLOOD 80349 $430.96
4402340 FLOW CYTOMETRY READ 9 TO 15 MARKERS 88188 $134.34
4402341 C1 ESTERASE INHIBITOR FA 83520 $64.48
4402342 HERPES SIMPLEX IGM 86694 $60.09
4402343 COPEPTIN PROAVP 84588 $141.86
4402344 ADULTERANTS SURVEY URINE 81005 $13.97
4402345 TPMT RBC 82657 $333.70
4500001 BLOOD TRANSFUSION UNDER 2 HOURS 36430 $1,147.03
4500002 BLOOD TRANSFUSION 2‐4 HOURS 36430 $1,969.94
4500003 BLOOD TRANSFUSION 4‐6 HOURS 36430 $1,086.94
4500004 BLOOD TRANSFUSION OVER 6 HOURS 36430 $1,545.11
4500005 SUBCUTANEOUS/M 96372 $293.40
4500006 IV PUSH NON CHEMO INITIAL SUBSTANCE 96374 $502.96
4500007 OUTPATIENT VISIT INITIAL 99201 $160.95
4500008 OUTPATIENT VISIT LEVEL 1 99211 $252.15
4500009 NON‐COVERED VENIPUNCTURE 36415 $19.31
4500015 CHEMO ADMIN IV PUSH UP TO 15 MIN 96409 $359.45
4500026 OUTPATIENT VISIT LEVEL 2 99212 $312.74
4500027 INFUSION THERAPY HYDRATION 1ST HOUR 96360 $540.58
4500028 INFUSION THERAPY HYDRATION EA ADDTL HOUR 96361 $282.65
4500029 INFUSION THERAPY OR PROPHYLAXIS 1ST HOUR 96365 $753.37
4500030 INFUSION THERAPY OR PROPHYLAXIS EA ADDTL 96366 $282.65
4500031 INFUSION THERAPY SEQ SUB UP TO 1 HOUR 96367 $320.26
4500032 INFUSION THERAPY CONCURRENT INFUSION 96368 $311.17
4500033 CHEMO IV INFUSION 1ST HOUR INT SUB 96413 $1,823.82
4500034 CHEMO IV INFUSION EA ADDTL HOUR 96415 $323.49
4500035 CHEMO IV INF PROLONGED 8+HOURS REQ PUMP 96416 $1,460.34
4500036 CHEMO IV SEQUENTIAL SUBSTANCE 1ST HOUR 96417 $297.69
4500037 CHEMO INTRA ARTERIAL INFUSION 1ST HOUR 96422 $1,181.94
4500038 CHEMO INTRA ARTERIAL INF EA ADDTL HOUR 96423 $239.17
4500039 CHEMO ARTERIAL PROLONGED 8+HOURS REQ PUM 96425 $1,496.82
4500040 IV PUSH NON CHEMO EA ADDTL SEQ SUBSTANCE 96375 $283.72
4500041 MEDIPORT FLUSH 96523 $293.40
4500042 CHEMO ADMIN IV PUSH EA ADDTL SEQ SUB 96411 $158.80
4500043 CHEMO ADMIN SQ OR IM NON HORMONAL ANTI N 96401 $281.57
4500044 CHEMO ADMIN SQ OR IM HORMONAL ANTI NEOPL 96402 $325.12
4500045 CHEMO INTRA ARTERIAL PUSH TECHNIQUE 96420 $532.20
4500046 REFILLING AND MAINTENANCE OF PORTABLE PU 96521 $1,181.94
4500048 COLLECT BLOOD SPECIMEN COMPLETELY IMPLAN 36591 $561.00
4500049 THERAPEUTIC PHLEBOTOMY 99195 $317.04
4500050 IV PUSH EACH ADDITIONAL SEQUENTIAL 96376 $321.34
4500051 ONCOLOGY ROOM PROCEDURE PER MINUTE $95.50
4500053 OUTPATIENT VISIT LEVEL 3 99213 $445.29
4500054 OUTPATIENT VISIT LEVEL 4 99214 $478.55
4500055 DECLOT VASCULAR DEVICE 36593 $605.06
4600007 KLEIHAUER‐BETKE 85460 $59.28
4600008 FETAL CELL DETECTION ROSETTE 85461 $54.90
4600019 BB ANTIBODY SCREEN 86850 $128.97
4600022 ANTIBODY ID 86870 $458.19
4600027 BB DIRECT ANTIGLOBULIN TEST 86880 $44.82
4600029 TITER‐ANTIBODY 86886 $362.39
4600034 BB RH TYPE 86901 $63.41
4600045 BB CROSSMATCH IMMEDIATE SPIN 86920 $216.21
4600047 BB CROSSMATCH AHG 86922 $196.05
4600056 ANTIBODY INDENTIFICATION‐ENZYME 86971 $400.42
4600063 ANTIBODY ABSORPTION 86978 $766.16
4600066 THERAPEUTIC PHELEBOTOMY 99195 $487.66
4600072 BB ABO TYPING 86900 $74.15
4600073 BB RBC ANTIGEN TEST EACH ANTIGEN 86902 $42.50
4600074 BB ANTIBODY ID EACH 86885 $40.33
4700023 BB TR AUTOLOGOUS PACKED RBC 86890 $494.37
4700031 BB RHO(D)IMMUME GLOBULIN IM 90384 $308.08
4700035 BB FRESH FROZEN PLASMA $369.69
4700036 BB CRYOPRECIPTATE P9012 $295.28
4700037 BB RBC LEUKODEPLETED P9016 $944.39
4700038 BB PLATELET CONC RANDOM P9019 $539.11
4700041 BB PLATELET PHERESIS SINGLE DONOR P9034 $2,385.07
4700042 BB TR PSLD RBC IRRADIATED P9040 $1,148.68
4700044 BB 25% ALBUMIN‐50ML P9047 $395.94
4700045 BB PLATELET PHERESIS LR CMV IRRIADIATED P9053 $3,774.89
4700046 BB RBC IRRADIATED EACH UNIT P9038 $1,356.72
4700047 BB WHOLE BLOOD FOR TRANSFUSION EACH UNIT P9010 $984.27
4700048 BB AUTOLOGOUS BLOOD OP SALVAGE 86891 $304.23
4900001 ABG PUNCTURE 36600 $215.09
4900004 CARDIAC STRESS TEST 93017 $1,351.05
4900005 PFT SIMPLE SPRIROMETRY 94010 $678.88
4900006 PFT AP BRONCHODILATORS 94060 $1,072.11
4900007 PFT METHACHOLINE CHALLENGE 94070 $1,373.46
4900009 INCENT SPIRO OR PEAKFLOW 94150 $380.90
4900014 HHN IPPB MDI SUBSEQUENT TX 1 94640 $243.10
4900015 MED INHALER RX 94640 $61.51
4900019 CPAP OR BIPAP PER PROTOCOL 94660 $417.87
4900020 HHN INITIAL TREATMENT 94640 $255.43
4900021 AEROSOL INITIAL TX 94640 $171.13
4900022 SPUTUM INDUCTION 94664 $206.13
4900023 AEROSOL TENT THERAPY 94664 $120.80
4900024 SMALL VOLUME NEB RESP TX 94664 $120.80
4900026 CPT PD OR COUGH ASSIST INITIAL TX 94667 $227.42
4900027 CPT PD OR COUGH ASSIST SUBSEQUENT TX 94668 $118.74
4900029 PULSE OX READING EACH 94760 $40.33
4900030 PULSE OX HOME O2 EVAL 94761 $160.20
4900031 CONTINUOUS OXIMETRY 94762 $511.97
4900032 CO2 DETERMINATION 94770 $309.82
4900035 NASOTRACHEAL SUCTION 31720 $298.00
4900036 OXYGEN PER DAY 94799 $225.17
4900037 O2 BASE $795.39
4900050 HHN IPPB MDI SUBSEQUENT TX 2 94640 $229.65
4900051 HHN IPPB MDI SUBSEQUENT TX 3 94640 $244.22
4900052 HHN IPPB MDI SUBSEQUENT TX 4 94640 $236.38
4900055 VENTILATOR INITIAL DAY 94002 $1,090.03
4900056 VENTILATOR SUBSEQUENT DAY 94003 $684.49
4900057 MDI EVALUATION AND TEACHING 94664 $198.28
4900061 CONT INHALATION TX W AEROSOL MED 1ST HR 94644 $356.24
4900062 CONT INHALATION TX W AEROSOL MED EA ADD 94645 $237.12
4900067 CP PULMONARY REHAB INC EXER 31 TO 60 MIN G0424 $328.24
4900068 *BLOOD GAS ANALYSIS 82803 $153.48
4900069 CP PULMONARY REHAB MAINTENANCE MONTHLY $28.01
4900070 PFT PLETHYSMOGRAPH 94726 94726 $384.25
4900071 PFT GAS DILUTION WASHOUT 94727 94727 $313.17
4900072 PFT DIFFUSING CAPACITY 94729 94729 $384.25
4900073 NEWBORN HEARING SCREENING OAE 92558 $187.09
4900075 VENOUS PUNCTURE 36415 $16.78
4900076 PFT EXERCISE 6 MINUTE WALK TEST 94618 $352.89
4900077 TYPE 3 HOME SLEEP STUDY 95806 $453.53
5000002 PT MMT EXREMITY TRUNK 95831 $99.79
5000003 PT MMT HAND 95832 $182.41
5000004 PT ROM TEST EXTREMITY TRUNK 95851 $125.54
5000005 PT ROM TEST HAND 95852 $97.64
5000008 PT HOT COLD PACK TREAT 97010 $35.41
5000009 PT TRACTION MECHANICAL 97012 $121.44
5000010 PT ELECTICAL STIMULATION UNATTENDED 97014 $90.28
5000011 PT PARAFIN BATH 97018 $84.77
5000012 PT WHIRLPOOL 97022 $120.18
5000013 PT ELECTRICAL STIMULATION MANUAL 15 MIN 97032 $109.62
5000014 PT IONTOPHORESIS EA 15 MIN 97033 $104.25
5000015 PT CONTRAST BATHS EACH 15 MIN 97034 $113.74
5000016 PT ULTRASOUND EA 15 MIN 97035 $102.10
5000017 PT THERAPEUTIC EXERCISES 15 MIN 97110 $134.34
5000019 PT NEUROMUSCULAR REEDUCATION EA 15 MIN 97112 $126.82
5000020 PT AQUATIC THERAPY W EXERCISES EA 15 MIN 97113 $145.09
5000021 PT GAIT TRAINING EA 15 MIN 97116 $124.67
5000026 PT MASSAGE EA 15 MIN 97124 $133.05
5000029 PT MANUAL THERAPY TECHNIQUES EA 15 MIN 97140 $193.45
5000030 PT TRACTION MANUAL EA 15 MIN 97140 $181.34
5000031 PT MYOFASCIAL RELEASE EA 15 MIN 97140 $201.72
5000032 PT JOINT MOBILIZATION EA 15 MIN 97140 $201.72
5000033 PT GROUP THERAPY PROCEDURES 97150 $119.10
5000034 PT ORTHOTICS FITTING AND TRAINING EA 15M 97760 $150.46
5000035 PT PROSTHETIC TRAINING EA 15 MIN 97761 $184.55
5000036 PT THERAPEUTIC ACTVITIES EA 15 MIN 97530 $171.95
5000038 PT SENSORY INTEGRATIVE TECHNIQUE EA 15MI 97533 $229.62
5000040 PT SELF CARE TRAINING EA 15 MIN 97535 $243.96
5000042 PT COMMUNITY WORK REINTERGRATION EA 15MI 97537 $207.09
5000043 PT WHEELCHAIR MANAGEMENT EA 15 MIN 97542 $190.99
5000044 PT WOUND CARE SELECTIVE LESS THAN 20SQCM 97597 $247.86
5000046 PT PHYS PFM TEST W WRITTEN REPORT EA 15M 97750 $159.88
5000059 PT SERVICE PER HOUR $107.30
5000080 PT GMC NEW EMPLOYEE SCREENING $79.53
5000081 PT GMC EMPLOYEE ERGONOMIC EVALUATION $97.64
5000082 PT COMPUTERIZED DYNAMIC POSTUROGRAPHY 92548 $1,305.83
5000085 PT DEVELOPMENTAL TESTING LIMITED 96110 $432.42
5000087 *PT INDEPENDANT MEDICAL EXAM $134.12
5000088 PT CANALITH REPOSITIONING PROC PER DAY 95992 $241.81
5000089 PT EVAL LOW COMPLEXITY 97161 $325.64
5000090 PT EVAL MODERATE COMPLEXITY 97162 $340.68
5000091 PT EVAL HIGH COMPLEXITY 97163 $355.73
5000092 PT RE EVALUATION 97164 $234.29
5100004 OT OCC THERAPIST/HR. $379.84
5100005 OT MMT EXTREMITY TRUNK 95831 $198.50
5100006 OT MMT HAND 95832 $184.55
5100007 OT ROM TEST EXTREM TRNK 95851 $66.53
5100008 OT ROM TEST HAND 95852 $98.72
5100009 OT THERAPEUTIC EXERCISES 15' 97110 $122.52
5100010 OT MASSAGE 15 MIN 97124 $133.05
5100011 OT MYOFASCIAL RELEASE 97140 $204.94
5100012 OT JOINT MOBILIZATION 97140 $204.94
5100013 OT ORTOOTCS FTTNG/TRAIN 97760 $150.46
5100014 OT PRSTHTC TRAINING 15' 97761 $223.18
5100015 OT THERAPY ACTIVITS 15' 97530 $141.86
5100016 OT SELFCARE HOMEMGMT 15 MIN 97535 $232.84
5100017 OT COMM WORK INTGRT 15' 97537 $210.31
5100018 OT WHEELCHAIR MGMT 15' 97542 $212.45
5100020 OT PHYSICAL PERFORM TEST W WRITTEN REPOR 97750 $159.88
5100021 OT PARAFFIN BATH 97018 $84.90
5100022 OT ELECT STIM MANUAL 97032 $109.45
5100024 OT NEUROMUSCULAR RE ED 97112 $126.82
5100025 OT ORTHOTIC TRAINING 97760 $150.22
5100026 OT THERAPEUTIC ACTIVITIES 97530 $141.86
5100027 OT PROSTHETIC TRAINING 97530 $141.63
5100028 OT SELF CARE TRAINING 97535 $225.69
5100029 OT COMM WORK REINTEG 97537 $210.31
5100030 OT WOUND CARE SELECTIVE LESS THAN 20SQCM 97597 $247.86
5100032 OT FCE (EACH 15 MIN) 97750 $159.88
5100034 OT ELECT STIM (UNATTENDED) 97014 $90.28
5100035 OT WHIRLPOOL 97022 $120.37
5100036 OT IONTOPHORESIS 97033 $104.25
5100037 OT CONTRAST BATH OT 97034 $98.87
5100038 OT ULTRASOUND 97035 $102.10
5100039 OT MANUAL THERAPY 97140 $181.63
5100040 OT GROUP THERAPY PROCED 97150 $119.10
5100043 OT FCE (FLAT FEE) 97750 $159.88
5100044 OT EMPLOYEE ERGO $1,718.93
5100046 OT GMC EMPLOYEE ERGONOMIC EVALS $151.53
5100047 OT GMC NEW EMPLOYEE SCREENING $68.78
5100049 OT DEVELOPMENTAL TESTING LIMITED 96110 $438.85
5100051 OT EVALUATION SWALLOW ORAL FUNCTION 92610 $444.22
5100052 OT EVAL LOW COMPLEXITY 97165 $319.19
5100053 OT EVAL MODERATE COMPLEXITY 97166 $336.38
5100054 OT EVAL HIGH COMPLEXITY 97167 $353.58
5100055 OT RE EVALUATION 97168 $241.81
5100056 OT COGNITIVE FUNCTION 97127 $206.34
5100057 OT COGNITIVE SKILLS DEV G0515 $182.70
5200002 ST TREAT SPEECH LANGUAGE 92507 $497.59
5200003 ST EVALUATION SWALLOW ORAL FUNCTION 92610 $409.46
5200004 ST TREAT SWALLOW DISFUNC 92526 $443.85
5200005 ST LARYNGEAL FUNCTION STUDIES 92520 $648.09
5200006 ST EVAL SPEECH GEN AUG DEV 1HR 92607 $721.05
5200007 ST EVAL SPEECH GEN AUG DEV ADD 92608 $155.58
5200008 ST TEACH SPEECH GEN DEVICE 92609 $412.03
5200010 ST MODIFIED BARIUM SWALLOW EVALUATION 92611 $360.03
5200019 ST ASSESSMENT APHASIA 96105 $446.36
5200020 ST DEVELOP TEST LIMITED 96110 $700.66
5200022 ST THERAPIST HOURLY $96.57
5200023 ST EDUCATION EA 15 MIN ‐ NC $16.12
5200024 ST EVAL OF SPEECH FLUENCY 92521 92521 $510.74
5200025 ST EVAL SPEECH PRODUCTION 92522 92522 $591.22
5200026 ST EVAL SOUND LANG COMPREHENSION 92523 92523 $815.70
5200027 ST VOICE AND RESONANCE 92524 92524 $567.45
5200028 ST COGNITIVE PERFRMNC TEST PER HR 96125 96125 $673.84
5200029 ST EVAL FOR NONSPEECH DEVICE RX 1ST HR 92605 $464.61
5300002 FLUOROSCOPY UP TO 1 HR PHYSICIAN TIME 76000 $882.00
5300003 AUDITORY EVOKED POTENTIAL 92585 $1,134.15
5300004 CARDIOPULMONARY RESUSCITATION 92950 $639.50
5300005 EXTERNAL PACER 92953 $113.74
5300006 CARDIOVERSION 92960 $761.82
5300007 EKG LONG LEAD 93005 $280.05
5300008 *EKG REGULAR 93005 $280.50
5300012 DOPPLER 93320 $462.46
5300013 MAP 93325 $696.41
5300014 CARTOID DUP SCAN 93880 $1,449.61
5300015 CARTOID DUP SCAN LMT 93882 $710.43
5300016 BILAT ARTERIES SINGLE LEVEL 93922 $483.92
5300017 BILATERAL ARTERIES MULTIPLE LEVELS 93923 $700.66
5300023 VEIN STDY DUP LIMIT 93971 $710.43
5300027 EEG‐SLEEP DEPRIVED 95816 $1,439.95
5300028 EEG‐REGULAR 95816 $1,490.39
5300029 EEG‐PORTABLE 95819 $1,318.71
5300031 EVENT MONITOR HOOKUP 93270 $199.90
5300033 24 HR BP RECORDING 93786 $376.62
5300037 ECHO TRANSESOPHAGEAL 93312 $2,441.06
5300038 STRESS ECHO TRANSTHORACIC 93350 $2,507.30
5300039 SHORT LATENCY SOMATOSENSORY PERIPH NERVE 95925 $1,306.90
5300040 SHORT LATENCY SOMATOSENSORY LOWER EXTREM 95926 $1,306.90
5300041 VISUAL EVOKED POTENTIAL 95930 $858.44
5300051 BILATERAL ARTERIES AT REST & AFTER TREAD 93924 $754.31
5300052 ECHOCARDIOGRAM COMPLETE (ORDER) 93306 $2,364.36
5300053 *ECHO TRANSTHORACIC LIMITED 93308 $1,229.47
5300054 *ECHO DOPPLER LIMITED 93321 $735.10
5300055 CARDIAC REHAB W MONITORING 31‐60 MIN 93798 $591.09
5300056 CARDIAC REHAB WO MONITORING 31‐60 MIN 93797 $537.35
5300057 CARDIAC REHAB PHASE 3 $26.87
5300058 HOLTER MONITOR HOOKUP 93225 $562.07
5300059 HOLTER ANALYSIS 93226 $561.00
5300060 RHYTHM ECG TRACING 93041 $70.82
5300064 EEG 41 TO 60 MIN 95812 95812 $1,570.86
5300065 EEG AWAKE AND DROWSY 95816 95816 $1,383.15
5300066 EEG AWAKE AND ASLEEP 95819 95819 $1,491.70
5500075 COLLAR EXT BABY NONK $76.18
5500076 CLIP ENDO MULTI DISP $689.93
5500081 SUTURE‐GUT PL 3‐0 $23.61
5500082 CATH ALL PURPOSE 18F $22.53
5500084 SHOE SURG FEMALE SM $75.11
5500085 AIRWAY ORAL 80MM GRN $4.29
5500086 AIRWAY ORAL 90MM YEL $4.29
5500088 CATH‐URETH OPEN 6FR $63.31
5500089 CATH‐URETH OPEN 5FR $71.89
5500090 SUTURE‐GUT CHR 4‐0 $25.75
5500092 WIRE GUIDE .038 145C $112.66
5500095 STENT DBL J DUAL 6FR $1,076.21
5500097 PENCIL‐SUCT/COAG 6" $98.72
5500098 CLIP LIGATING M/L $38.63
5500100 STAPLER‐LINEAR 60MM $658.82
5500101 ZEROFORM 1X8 $23.61
5500102 SPONGE/BRUSH HIB $18.24
5500104 SUTURE PDS II 4‐0 $55.80
5500105 TUBE FEEDING 8F W/STY $142.71
5500106 TUBING‐SUCTION 12' $21.46
5500107 BARRIER SKIN 4 W/FL" $46.14
5500108 GUIDE WIRE 0.038 $76.18
5500109 CATHETER10FR3CCFOLEY $67.60
5500110 STR‐VCRL VIL BR 2‐0 $18.24
5500111 SUTURE‐VICR 3‐0 $20.39
5500114 CIRCUIT ANES INF BN $86.91
5500115 SUTURE PDS II 5‐0 $55.80
5500116 CATH.FOGARTY 5FR $495.72
5500117 IV CATH‐EZ 16X24 $87.99
5500119 COLLAR EXT ADLT TALL $72.96
5500120 BLADE MICRO 18.5X17 $386.28
5500121 AIRWAY ORAL 100MM RD $4.29
5500122 AQUAPAK HUMIDIFIER $5.36
5500126 RT MASK‐FACE AEROSOL $0.18
5500127 BAG‐BILE $94.42
5500129 TUBING‐AEROSOL 100' $18.24
5500254 CATHETER URETH 8FR $110.52
5500256 TRAY THORACEN W CATH $192.07
5500257 AQUAPLAST 3X1/16 SPL $46.14
5500258 AQUAPLAST 3X3/32 SPL $46.14
5500259 CATH 3 WAY 22FR 30CC $83.69
5500260 SPLINT WRIST RT MED $8.58
5500261 CANISTER SUCTION 2L $19.31
5500263 SUPPORT BACK TAPERED $166.31
5500264 TRAY IRRIG TURY $80.47
5500265 POUCH STOMA DRAINABL $20.39
5500266 SPLINT WRIST L MED $48.28
5500267 SPLINT WRIST RT LARG $10.73
5500268 SPLINT WRIST LFT LRG $48.28
5500269 TRAY LUMBAR PUN PEDI $100.86
5500270 TRAY LUMBAR PUNCT AD $174.90
5500272 IV BUTTERFLY 21X3/4 $20.39
5500273 TUBE FEEDING 5FR 15 $18.24
5500274 BOOT CAST MED CL TOE $56.87
5500275 TUBE FEEDING 8FR 15 $20.39
5500276 IV BUTTERFLY 23X3/4 $20.39
5500277 TUBE FEEDING 8FR 42 $20.39
5500278 TUBE CANTOR 16 FR DP $393.79
5500279 COLLAR LOW CONTOUR L $38.63
5500281 TUBE LEVIN STOM 12 FR $20.39
5500284 TUBE LEVIN STOM 14FR $20.39
5500285 CATHETER URETH 5FR $518.26
5500287 TUBE LEVIN STOM 16FR $20.39
5500290 TUBE LEVIN STOM 18FR $20.39
5500291 TUBE TRACHEAL 6.0 $30.04
5500292 TUBE TRACHEAL 6.5 $22.53
5500293 IMMOBILIZER KNEE 20" $208.16
5500294 URINE METER $3.22
5500295 TUBE TRACHEAL 7.0 $31.12
5500296 BANDAGE CONFORM 6" $19.31
5500299 COLLAR LOW CONTOUR M $3.22
5500300 TUBE TRACHEAL 8.0 $31.12
5500302 NAIL HIP 4 IN $512.89
5500303 TUBE TRACHEAL 8.5 $31.12
5500304 TUBE TRACHEAL 9.0 $48.28
5500306 SUTURE SKIN STAPLER $185.63
5500309 TUBE LAVACUATOR 28FR $108.37
5500310 TRACHEAL TUBE 5.0 MM $21.46
5500311 DRAIN T DEAVER 14 $95.50
5500312 IRRIGATOR CONE/TUBE $75.11
5500313 CATH‐FOLEY24F30CC $101.93
5500316 STENT‐DBL J URETERAL $950.67
5500317 URINARY DRNBG 2000ML $26.82
5500318 INST‐SUCT YANKAUR $18.24
5500320 CURETTE ENDOM SUCTN $34.34
5500321 SUTURE‐PROLENE 4.0P3 $51.50
5500322 POUCH‐STOMA 1 1/4 $20.39
5500323 POUCH STOMA 1 1/2 $20.39
5500324 POUCH‐STOMA DR 1 3/4 $20.39
5500325 BLADE‐MICRO $339.07
5500327 BLADE‐MICRO CRESC $781.14
5500329 SUTURE NUROLON C‐541D $99.79
5500330 SUTURE‐PROLENE 2‐0 $24.68
5500335 SUTURE‐PROL BL MONO3 $32.19
5500336 SUTURE‐ETHLON BLK10 $215.67
5500342 SUTURE VICRYL O $18.24
5500343 POUCH CUT/FIT DRAIN $28.97
5500344 POUCH‐POST OR OSTOMY $20.39
5500345 SUTURE‐VICRYL VIL2‐0 $99.79
5500347 DRESSING‐TRANS SM/ME $19.31
5500354 URIN MET W/TRAY 16FR $135.20
5500355 BOOT UNNAS GELO4X360 $40.77
5500356 TUBE‐FEED 8FR/STYLET $119.10
5500358 SUTURE‐PROLENE 3‐0 $24.68
5500359 NEEDLE‐SPINAL 22GX5" $48.28
5500360 SUTURE‐VICR COAT 2‐0 $18.24
5500361 KNEE CRYO CUFF ONLY $441.00
5500364 ELECTRODE COAGULATING $510.74
5500365 CATH‐4LUM 7.5FR $811.18
5500366 KIT‐TRANSPAC $118.03
5500367 BANDAGE‐CONFORM 1" $19.31
5500368 SOL‐THERMOSET INJ $112.66
5500369 TUB‐ART PRESS M/M48 $20.39
5500371 BANDAGE‐TRIANGULAR $12.88
5500372 BELT‐RIB FEMALE $41.85
5500373 BELT‐RIB MALE $41.85
5500374 CATHETER‐IVSURFLO20G $20.39
5500375 DRESSING ADAPTIC 3X3 $19.31
5500376 STAPLER CVD ILS 33MM $974.28
5500377 CATH‐TROCAR 20FR16 $113.74
5500378 DRESSING‐VAS GAUZE $18.24
5500382 SCREW‐HOP 3 1/4 $360.53
5500383 SHIELD‐EYE BLACK $20.39
5500384 IOBAN 2PT ISOL SYS $195.28
5500388 DRESSING‐ADAPTIC 3X8 $18.24
5500397 SCREW‐HIP 3" $281.12
5500402 BOOT‐CAST X‐LARGE $59.01
5500403 SCREW‐BONE 1 1/2 $62.23
5500404 SCREW‐BONE 1 3/4 $112.66
5500405 SCREW‐BONE 1 3/8 $41.85
5500406 SCREW‐BONE 1 5/8 $112.66
5500407 SCREW‐BONE 2 $41.85
5500408 SCREW‐HIP 3 1/2 $398.08
5500409 SCREW‐HIP 3 3/4 $360.53
5500410 SCREW‐HIP 4 $378.77
5500411 SCREW‐HIP 4 1/2 $515.04
5500412 SCREW‐HIP 4 1/4 $398.08
5500413 SCREW‐HIP 4 3/4 $515.04
5500414 NEEDLE‐BIOPSY 14GA $262.88
5500415 BOOT‐CAST SM CL TOE $59.01
5500416 CAUTERY‐DISPOSABLE $62.23
5500417 CATH‐FOGARTY VENOUS $437.78
5500418 CATH‐TROCAR 32FR 16 $139.49
5500419 CATH‐FOLEY20FR5CC $104.08
5500420 CATH‐FOLEY24FR5CC $77.26
5500421 CATH‐FOLEY22F30CC $101.93
5500423 CATH‐TAUT CHOLANGIOG $185.63
5500424 CATH‐PEZZER 26FR $66.53
5500425 CATH‐PEZZER 30FR $66.53
5500426 DRAIN DEAVER T 16FR $57.94
5500427 DRAIN‐DEAVER T‐18FR $81.55
5500428 CATHETER‐UMBLIC ART $120.18
5500429 CATHETER‐UMBILI ART $93.35
5500430 ELECTRODE‐PT RET REM $33.26
5500435 IV HEPARIN SOD 500ML $37.55
5500436 SCALEL‐DIPOSBL #15 $18.24
5500440 SCAPEL‐DISPOSBL #11 $19.31
5500442 XEROFLO 5X9 $19.31
5500443 SUTURE‐VICRYL 3‐0 SH $22.53
5500444 SUTURE‐VICRYL O CT $18.24
5500445 SUTURE‐VICRYL4‐0 PC‐5 $39.70
5500447 ORTHOSIS ANT BAR LNG $66.53
5500451 MESH‐PROLENE 2X12" $758.61
5500452 SUTURE‐ETHILON BLK 3 $31.12
5500453 SUTURE‐ETHILON 40 P3 $31.12
5500454 BLADE4 SLIT KNIFE 2.5 $183.48
5500455 BANDAGE COBAN 2X5YDS $20.39
5500456 NEEDLE VAREES ENDO $216.74
5500457 SUTURE‐SILK BLK 5‐0 $43.99
5500458 SUTURE‐SILK BLK BR 4 $41.85
5500459 SUTURE‐PROLENE 5‐0 $51.50
5500460 SUTURE 60 P1 PROLENE $39.70
5500462 PIN ABSORBABLE TAPER $797.23
5500463 SOD‐CHLOR IRRIGATION $20.39
5500464 SIMPULSE IRRIG SYS $390.57
5500466 SUTURE‐PROLN BL MONO $53.65
5500467 AIRWAY ORAL 50MM BLU $8.58
5500468 MASK‐TRACHEOSTOMY $2.15
5500469 CAP‐INTRMIT INFUSION $20.39
5500470 SET‐FEEDING GRAVITY $43.99
5500471 TUBE‐TRACHEAL 7.5 $31.12
5500472 CATH‐TROCAR 10FR 9 $139.49
5500473 CATH‐TROCAR 12FR 9 $127.69
5500474 CATH‐TROCAR 16FR 10 $148.07
5500475 CATH‐TROCAR 24FR 16 $139.49
5500476 CATH‐TROCAR 28FR 16 $130.90
5500477 GAUZEIODOFORM5%1/4IN $31.12
5500478 SIGMOIDOSCOPE $24.68
5500479 NEEDLE‐SPINAL22G 3.5 $23.61
5500481 SCREW‐BONE 3 1/2 $112.66
5500482 ADAPTER‐CATH URETERA $19.31
5500483 PAD‐PUMP 18X26 $3.22
5500484 TUB‐TRACHEAL 3.0MM $20.39
5500485 CATHETER‐6 EYED 24FR $113.74
5500486 CATHETER‐6 EYED 26FR $116.96
5500487 KIT‐EYE POST OP CUST $145.93
5500488 SUTURE‐ALLERGAN $114.81
5500492 BRACE‐KNEE HINGED SM $340.14
5500493 CATH FOGARTY 6FR $454.95
5500496 TRAY‐CATH 16FR $77.26
5500497 TUBE‐TRACHEAL 4.0 $18.24
5500498 TRAYURETHRALCATH15FR $18.24
5500499 TRAY‐UROLOGIST HEYMA $1,150.25
5500500 TRAY IRRIG/PISTON $17.17
5500502 TRAY‐CATH 18FR $78.33
5500504 DRAIN‐ MALECOT 22FR $110.52
5500505 DRAIN‐MALCOT 24FR $110.52
5500506 DRAIN‐MALECOT 26FR $110.52
5500507 DRAIN‐MALECOT 28FR $110.52
5500508 BLADE‐SAW SAGGIT $335.85
5500510 CATHETER‐FOLEY 12FR $37.55
5500511 CATHETER‐FOLEY 14FR $38.63
5500512 CATHETER‐FOLEY 16FR $51.50
5500513 CATHETER‐FOLEY 18FR $47.21
5500514 CATHETERFOLEY20FR5CC $34.34
5500515 CATHETER‐FOLEY 30FR $43.99
5500516 CATHETER FOX POST NA $281.12
5500520 CAP‐MALE NON VENTED $2.15
5500524 ELECTRODE‐FEDTL SCALP $48.28
5500529 CATHETER‐NELATION 12F $22.53
5500533 KIT‐BIPOLAR PAC.CATH $721.05
5500534 KIT LAVAGE TUMEVAC $126.61
5500536 SUPPORT‐BACK 13" $216.74
5500537 SCREW‐BONE 1 1/4 $53.65
5500538 FOLEY CATHETER 22 FR $42.92
5500539 TUBE‐SALEM SUMP 18FR $18.24
5500540 LIGACLIP LC‐300 M‐L $53.65
5500541 SUTURE‐SK STAPL TW35 $216.74
5500546 STENT‐DBL‐J $950.67
5500547 STENT‐DOUBLE J URETH $950.67
5500548 PADS‐ANAL VAGINAL $16.09
5500549 SUPPORT ELASTTIC KNEE $123.39
5500559 BANDAGE‐WEBRIL 4" $20.39
5500562 BANDAGE WEBRIL 2" $20.39
5500563 BANDAGE WEBRIL 3" $24.68
5500564 BANDAGE WEBRIL 6" $20.39
5500565 PLATE‐BONE 4H/71MM $683.50
5500566 PLATE‐BONE 5H/87MM $683.50
5500567 PLATE‐BONE 6H/103MM $683.50
5500568 PLATE‐BONE 7H/119MM $683.50
5500569 PLATE‐BONE 8H/135MM $683.50
5500570 PLATE‐BONE 9H/151MM $683.50
5500571 PLATE‐BONE 10H 167MM $683.50
5500572 PLATE‐BONE 12H 199MM $683.50
5500573 PLATE‐BONE 6H 103MM $683.50
5500574 PLATE‐BONE 7H 119MM $683.50
5500575 PLATE‐BONE 8H 135MM $683.50
5500576 PLATE‐BONE 14H 231MM $683.50
5500577 PLATE‐BONE L‐BUTTRES $794.01
5500578 PLATE‐1/3 TUBULAR 3H $143.78
5500579 PLATE 1/3 TUBULAR 4H $298.29
5500580 PLATE 1/3 TUBLAR 5H $272.54
5500581 PLATE‐1/3 TUBLAR 6H $289.71
5500582 PLATE‐1/3 TUBLAR 7H $310.09
5500583 PLATE 1/3 TUBLAR $289.71
5500584 PLATE‐DYN COMP 5HOLE $523.62
5500585 PLATE‐DYN COMP 3.5MM $493.58
5500586 PLATE‐DYN COMP 3.5MM $502.16
5500587 STRIP‐REINFORCING $93.35
5500589 SCREW‐CORTEX 2.7X8 $77.26
5500590 SCREW‐CORTEX 2.7X6 $77.26
5500591 SCREW‐CORTEX 2.7X16 $77.26
5500592 SCREW CANC 3.5X12MM $77.26
5500593 SCREW CANC 3.5X14MM $79.40
5500594 SCREW‐CANC 3.5X16MM $79.40
5500595 SCREW ‐CANC 3.5MMX18MM $70.82
5500596 SCREW‐CANC 3.5MX20MM $79.40
5500597 SCREW‐CANC 3.5X24MM $97.64
5500598 SCREW CANC‐4.0/18MM $79.40
5500601 SCREW CANC‐4.0X40MM $97.64
5500602 SCREW CANC 4.0MMX50MM $81.55
5500603 SCREW‐CORTEX 4.5MX32 $62.23
5500604 SCREW‐CORTEX 4.5X34MM $79.40
5500605 SCREW‐CORTEX 4.5MX36 $62.23
5500606 CORTEX SCREW $46.14
5500607 SCREW‐CORTEX 4.50MX52 $55.80
5500608 SCREW‐CORTEX 4.5X64MM $86.91
5500616 PENCIL‐SKIN MARKING $20.39
5500617 SKIN BARRIER 1 3/4 $31.12
5500618 SKIN BARRIER 2 1/4 $34.34
5500619 DRAINABLE BAG 1 3/4 $20.39
5500620 DRAINABLE BAG 2 1/4 $16.09
5500621 KIT‐TRACH CLEANING $18.24
5500626 ELECTRODE CUTTING BL $298.29
5500628 BRUSH‐INTRAMEDULLARY $128.76
5500629 NEEDLE SP /TECH 20GA $46.14
5500630 NEEDLE SP/TECH 22GA $46.14
5500631 ELECTRODE‐CUTTING YE $510.74
5500632 FILTER MOUTHPCE PFT $64.38
5500633 LENS MORGAN/THERAP $173.82
5500634 SUTURE CHROMIC 4‐0 $53.65
5500635 HEMOVAC‐SNYDER KIT $170.61
5500636 HEMOVAC DRAIN‐FL/TRO $197.43
5500637 STR‐ETHLN BL MON 4‐0 $31.12
5500638 STR‐ETHLN BL MON 5‐0 $31.12
5500639 SUTURE‐SILK BLK BL 3 $41.85
5500640 SUTUR 4‐0 VICRYL CT1 $20.39
5500641 SUTURE‐VICRL 5‐0 PS2 $48.28
5500642 SUTURE 3‐0 VCRYL CT1 $22.53
5500643 PLEUREVAC $371.26
5500644 ASPIRATOR MECONIUM $46.14
5500645 CATH‐RED RUB 16 FR $20.39
5500646 SUTURE‐VICR VIL 6‐0 $116.96
5500648 DUODERM 8X8 $137.34
5500650 SUTURE‐VICR 8‐0 COAT $154.51
5500653 CATH ALL PURPOSE 14F $18.24
5500654 BLADE‐15 OPTHAL TIP $51.50
5500655 KNIFE‐SLIT 3.2 MM $152.36
5500657 SUTURE‐PROLN 2‐0 LR $91.20
5500658 WATER‐STER SUCTION $17.17
5500659 TUBE‐BILATERAL SHEA $114.81
5500660 ELECTRODE‐PACING $502.16
5500661 COUNTER NEEDLE MAGNE $19.31
5500662 SUTURE ENDDROP O GUT $123.39
5500663 TROCAR‐ENDO REDUCER $70.82
5500665 SUSPENSORY‐SMALL $41.85
5500666 SUTURE RET BOLSTER $24.68
5500667 CATHETER HYSTEROSALP $195.28
5500668 SUSPENSORY‐MEDIUM $41.85
5500669 BANDAGE COBAN 1X5 YDS $22.53
5500670 SUTURE‐GUT O CT‐1 $20.39
5500677 OCUBLADE $137.34
5500678 DRESSING‐COMFEEL 4X4 $34.34
5500681 VACURETTE STRAIGHT 8 $42.92
5500689 TUBE GOOD T BIOLIT R $481.77
5500691 DRAIN‐EYE 80CC $31.12
5500693 SUTURE PROL BL MONO4 $24.68
5500694 TRAY‐GASTROSTOMY RSL $625.55
5500695 BANDAGE COBAN 4X5YDS $2.15
5500696 CATH‐CHOLANGIS 4FR $216.74
5500697 SUTURE PROL O CT $24.68
5500699 SUTURE‐GUT PL 5‐0 $46.14
5500701 BLADE OPHTH CRESENT $160.95
5500702 OSTOMY‐SKIN BARR 2" $33.26
5500703 OSTOMY‐CONV INS 13/8 $20.39
5500704 VENODYNE SLEEVE 14" $210.31
5500705 VEDODYNE SLEEVE 16" $192.07
5500706 VENODYNE SLEEVE 12" $210.31
5500707 SUTURES‐ETHIBOND $94.42
5500708 SUTURES‐ETHIFLEX $79.40
5500709 SUTUERS‐VICRYL J574G $46.14
5500710 KIT‐EYE CARE SS $53.65
5500711 SUTURE SILK $53.65
5500712 SUTURE‐VICRYL O 54" $20.39
5500713 PLASTER SPLINT ARM $43.99
5500714 PLASTER SPLINT ANKLE $113.74
5500715 PLASTER SPLINT LEG $120.18
5500716 PLASTER CAST S ARM $59.01
5500717 PLASTER CAST L ARM $91.20
5500718 PLASTER CAST S LEG $38.63
5500719 PLASTER CAST L LEG $74.04
5500720 FIBERGLASS CAST S AR $178.12
5500721 FIBERGLASS CAST L AR $213.53
5500722 FIBERGLASS CAST S LE $31.12
5500723 FIBERGLASS CAST L LE $110.52
5500724 UNIVERSAL PLUG $1,198.53
5500725 KIT‐JACKSON PRATT $298.29
5500726 STYLET‐INTUB 14FR $40.77
5500728 SUTURE PDS II 6‐0 $72.96
5500729 CATHLON‐24GA X 3/4" $16.09
5500730 WIRE‐GUIDE C M CATH $45.07
5500731 METER‐PEAK FLOW/DISP $214.60
5500734 VACURETT DISPA TOP $31.12
5500735 VACURETT‐STAIT 12MM $46.14
5500736 VACURETT‐CURVED 12MM $46.14
5500739 SENSOR‐OXI NEONATAL $189.92
5500740 TRANSDUCER ADULT $210.31
5500741 TRANSDUCER‐INFANT O2 $199.58
5500742 SLING‐MED ARM HEMIPL $87.99
5500743 KIT‐CATH C VENOUS/S $195.28
5500744 KIT‐CATH C VENOUS/M $378.77
5500745 KIT‐CATH RADIAL ART $332.63
5500746 KIT‐INTRODUCER/SHEATH $304.73
5500748 PUMP SET FLEX III $22.53
5500749 VACURETTE‐CURVED, 8MM $46.14
5500750 VACURETTE‐STRAIGHT 9MM $46.14
5500752 VACURETTE‐CURVED 10M $53.65
5500753 SET CATH IRRIG/CLAMP $68.67
5500754 RESERVOIR 100 CC H S $135.20
5500755 TRANSDUCER‐AD D‐25 $139.49
5500756 STAPLER‐INT PLC‐50 $906.68
5500757 STAPLER CARTRIDGE $491.43
5500761 CEMENT ‐ 1/2 DOSE $460.31
5500762 CEMENT‐SIMPLEX P $589.07
5500763 MIX KIT I $846.59
5500764 SCREW‐CANE 6.5MM 70M $121.25
5500765 SCREW‐CANCELLOUS $112.66
5500766 SCREW‐CANC 6.5X55MM $152.36
5500767 SCREW‐CANE 6.5MMX65M $121.25
5500768 SCREW‐CANC 6.5X70 MM $137.34
5500769 SCREW‐CANE 6.5MMX80M $121.25
5500770 SCREW MALLEOLAR $145.93
5500771 SCREW MALLEOLAR 45MM $145.93
5500772 SCREW‐MALLEOLAR $145.93
5500774 NAIL‐LOTTES INTR 14" $694.23
5500775 EXCHANGER HEAT/MOIST $23.61
5500776 TUBE BLAKEMORE 23FR $791.87
5500778 SCREW‐FEMORAL BONE $427.05
5500779 SCREW‐FEMORAL DIAGN $723.20
5500780 SCREW‐FEMORAL TRANSV $694.23
5500781 SCREW‐FEMORAL TRANSV $420.61
5500782 PIN‐STEINMAN 5/65" $64.38
5500783 PIN‐STEINMAN 3/32 $86.91
5500784 PIN‐STEINMAN 7/64 $68.67
5500785 PIN‐STEINMAN 1/8X9 $91.20
5500786 PIN‐STEINMAN 3/32" $81.55
5500787 DOME‐PATELLAR MET BK $1,216.77
5500788 PIN‐CALIBRATED GUIDE $39.70
5500789 GUIDE PIN ASSEMBLY $875.56
5500790 PIN‐GUIDE THREAD TIP $72.96
5500791 PLATE‐HIP COMP 6SLOT $1,171.71
5500792 PIN‐REAMER GUIDE DRL $408.81
5500793 PIN‐REAMER GUIDE BAL $408.81
5500796 PLATE‐HIP COMP 8SLOT $1,059.04
5500798 PLATE‐HIP COMP 15SLO $1,123.42
5500800 MESHER‐TEMPLATE 11/2 $145.93
5500801 PLATE‐HIP CMP 6S150D $1,171.71
5500802 PLATE‐HIP CMP 8S145D $1,059.04
5500803 PLATE‐HIP CMP 8S150D $1,059.04
5500804 SCREW‐FEMORAL DIAGON $427.05
5500805 SCREW‐FEM DIAG 70MM $446.36
5500806 DRAIN H S FLAT $121.25
5500807 CANNULA‐PEDI OXYGEN $20.39
5500808 SCREW COMPR 28.5MM $937.79
5500809 SCREW COMPR 19MM $937.79
5500810 STRIPPER‐VEIN $163.09
5500811 PLATE HIP COMP 4SLOT $1,044.02
5500812 PLATE HIP CMP 6S135D $1,061.19
5500813 PLATE HIP CMP 8S135D $1,280.08
5500814 PLATE HIP CMP 10S135 $1,282.23
5500815 PLATE HIP CMP 12S135 $1,358.41
5500816 PLATE HIP CMP 5S135D $1,108.40
5500817 SCREW FEM TRAN 50MM $427.05
5500818 SCREW FEM TRANS 55MM $427.05
5500819 SCREW FEM TRANS 70MM $427.05
5500820 PLATE SUPRACONDYLAR $1,195.31
5500821 PIN HOFFMAN SMALL HF $418.47
5500822 SCREW‐KEYLOK LAG $933.50
5500823 SCREW‐COMPR 90MM $924.92
5500824 SCREW‐KEY LOK LAG $856.25
5500825 SCREW‐KEYLOK $933.50
5500826 SCREW COMPR 85MM $796.16
5500827 SCREW‐KEYLOKLAG4 $820.84
5500828 SCREW‐KEYLOKLAG 41/4 $866.98
5500829 SCREW‐KEYLOKLAG 41/2 $850.88
5500830 SCREW COMP 75MM $1,116.98
5500831 SCREW‐KEY LOCK LAG $933.50
5500832 NAIL FEMORAL LEFT $958.18
5500833 NAIL LOCK LEFT 40MM $948.52
5500834 NAIL LOCKING LEFT $948.52
5500835 SCREW‐SUPER LAG $825.13
5500836 NAIL HIP 80MM ZICKII $816.55
5500837 TUBE‐ENDOTRACH 7.5MM $25.75
5500838 STAPLE‐FIX W/SPIKES $366.96
5500839 STAPLE‐FIX SH/SPIKES $660.96
5500840 STAPLE FIX‐SH/SPIKES $335.85
5500841 PIN‐FLEXIBLE 340MM $333.70
5500842 STAPLE‐OSTEOTOMY FIX $458.17
5500843 STAPLE OSTECTOMY FIX $856.25
5500844 ROD‐ZICKEL II RIGHT $1,563.35
5500845 MIX KIT II $401.30
5500846 WIRE‐KIRSCHNER.045X4 $78.33
5500847 WIRE‐KIRSCHNER.028 $253.23
5500848 WIRE‐KIRSCHNER.035X4 $34.34
5500849 WIRE‐KIRSHNER.045X4 $52.58
5500850 WIRE‐KIRCHNER 0624X4 $48.28
5500852 PIN‐STEINMAN $154.51
5500853 PIN‐STNMN THRD 5/64" $114.81
5500854 SCREW‐COMPSNG 28.5MM $183.48
5500855 SCREW‐CORTEX 202 SER $76.18
5500856 SCREW‐CORTX 4.5X32MM $78.33
5500857 SCREW‐CANC 3.5X12MM $84.77
5500858 SCREW‐CANC 4.OX45MM $92.28
5500859 SCREW‐CANCEL 216 SER $140.56
5500860 SCREW‐CANCEL 217 SER $179.19
5500861 SCREW‐MALLEO 60MM $209.23
5500862 WASHER‐COMPR 219 SER $71.89
5500863 WIRE‐KIRSCHNER 9" $27.90
5500864 WIRE‐KIRSCHNR 4" $71.89
5500865 WIRE‐KRSCHNR 045X4 $52.58
5500866 DRESSING‐TRANSPAR M $27.90
5500867 TRAY‐LUMBAR PEDI $71.89
5500869 TRAY‐LUMBAR ADULT $111.59
5500872 DRESSING‐TRANSPAR L $257.52
5500873 SPLINT‐ACROMIO $232.84
5500874 PLATE‐ONE/THIRD TUBE $212.45
5500875 THOCAR ENDO BLUNT $828.35
5500876 PLUG SYS‐SEIDEL INTR $726.42
5500877 SCREW‐CANNULATE 80MM $711.39
5500878 SCREW‐CANNULATE 85MM $711.39
5500879 SCREW‐CANNULATE 90MM $711.39
5500880 SCREW‐CANNULATE 95MM $711.39
5500881 SCREW‐CANNULATE 100M $711.39
5500882 SCREW‐CANNULATE 105M $711.39
5500883 SCREW‐CANNULATE 110M $711.39
5500884 TUBE‐ENDOTRACH 5.5M $25.75
5500891 SET FILTER IVEX 2 $21.46
5500892 BAG‐LEG, URINARY 19OZ $18.24
5500893 CANNULA‐INFANT OXYG $17.17
5500895 DRESSING‐UNIFLEX IV $21.46
5500896 DRESSING‐UNIFLEX WND $25.75
5500898 BLADE OPTH CRES ANG $142.71
5500900 CATHETER‐SUCTION 5/6 $21.46
5500901 TRAY‐SPINAL 22 ANES $82.62
5500902 TRAY‐SPINAL 25G ANES $158.80
5500903 TUBE‐TRACHEAL 4.5MM $22.53
5500905 TUBE‐TRACHEAL 2.0MM $25.75
5500906 STYLET‐INTUBAT 6FR $32.19
5500907 CIRCUIT‐ANES BREATH $38.63
5500912 BANDAGE‐WEBRIL 6" $25.75
5500914 SPIROMETER‐VOLUME $83.69
5500915 TRAY‐LUMBAR PNC ADUL $90.13
5500917 SUTURE VICRYL 5‐O $50.43
5500918 TRAY‐EPIDURAL ANESTH $162.02
5500920 CIRCUIT‐ANES ARTEC $50.43
5500922 HEMOVAC‐SNYDER OTUBE $310.09
5500923 HEMOVAC SNYDER 1/4" $291.85
5500924 HEMOVAC‐SNYDER LARGE $223.18
5500925 CRT ANS ADLT W FLTR $26.82
5500934 CATH KIT‐SUCTION 14F $18.24
5500936 VACURETTE‐FLEX 7MM $34.34
5500937 VACURETTE‐CURVED 9MM $54.72
5500938 VACURETTE‐STRAIGHT 10M $48.28
5500948 DRESSING‐TRANSPAR S $21.46
5500949 TRACH TUBE PEDI O $381.99
5500950 TRACH TUBE PEDI 1 $381.99
5500951 TRACH TUBE‐2PT $271.47
5500952 TRACH TUBE‐3PT $271.47
5500953 TRACH TUBE‐4PT $271.47
5500954 TRACH TUBE‐4 FEN $531.13
5500955 TRACH TUBE‐6 FEN $488.21
5500956 TRACH TUBE‐8 FEN $531.13
5500957 TRACH TUBE‐10 FEN $531.13
5500958 T‐UPDRAFT NEBULIZR $12.88
5500959 CATH‐20 GA EPIDURAL $490.36
5500960 BLADE‐HAIR CLIPPER $35.41
5500961 TUBE‐ENDOTRACH 7MM $19.31
5500962 TUBE‐ENDOTRACH 8MM $27.90
5500963 TUBE‐ENDOTRACH 8.5MM $33.26
5500966 KIT‐DUO TRACH $52.58
5500967 BAND‐FALOPE RING $122.32
5500968 SEAL‐8MM SLIMLINE $21.46
5500969 CASSETTE I/A 008 $589.07
5500970 CASSETTE EPSILON 45 $1,104.11
5500972 SUTURE‐ALCON 1921‐01 $221.04
5500973 SUTURE‐ALCON 2012‐01 $200.65
5500974 SUTURE‐ALCON 2020‐01 $200.65
5500975 CAUTERY‐SURETEMP EYE $78.33
5500976 LENS GLIDE STERILE $32.19
5500978 CATHETER8FR3CCFOLEY $89.06
5500979 LENS‐I/O MT‐4 16X $949.60
5500980 LENS‐I/O MT‐4 20X $949.60
5500981 LENS‐I/O MT‐4 21.5X $949.60
5500982 LENS‐I/O MT‐4 22X $949.60
5500983 LENS‐I/O SI6BLRU 17X $949.60
5500984 LINS‐I/O S16BLRU 18X $949.60
5500985 LENS‐I/O S16BLRU 19X $949.60
5500986 LENS‐I/O S16BLRU 20X $949.60
5500987 LENS‐I/O S16BLRU 21X $949.60
5500988 LENS‐I/O S16BLRU 22X $949.60
5500989 LENS‐I/O S16BLRU 23X $949.60
5500990 LENS‐I/O S16BLRU 24X $949.60
5500991 LENS‐I/O JF1LRU 17.5 $949.60
5500992 LENS‐I/O JF1LRU 18.5 $949.60
5500993 LENS‐I/O JF1LRU 19.5 $949.60
5500994 LENS‐I/O JF1LRU 20.5 $949.60
5500995 LENS‐I/O JF1LRU 21.5 $949.60
5500996 LENS‐I/O JF1LRU 22.5 $949.60
5500997 LENS‐I/O JFILRU 23.5 $949.60
5500998 CATH‐THERM 4L‐7 FR $476.41
5501001 LENS‐I/O JFILRU 18X $949.60
5501002 LENS‐I/O JFILRU 19X $949.60
5501003 LENS‐I/O JFILRU 20X $949.60
5501004 LENS‐I/O JFILRU 21X $949.60
5501005 LENS‐I/O JFILRU 22X $949.60
5501006 LENS‐I/O JFILRU 23X $949.60
5501007 LENS‐I/O JFILRU 24X $949.60
5501010 ANESTHESIA KIT‐LTA $37.55
5501011 LENS INTRAOC POSTER $925.99
5501012 LENS INTRAOC ANTER $949.60
5501013 LENS‐CD92 POSTERIER $949.60
5501014 FIBERGLASS CAST‐BODY $582.63
5501015 JONES ANKLE SPLINT $47.21
5501016 CENTALIZER DISTAL $273.61
5501017 PLUG INTRAMED $662.04
5501019 DRAIN‐PENROSE $22.53
5501020 SUTURE CHROMIC $27.90
5501021 SUTURE‐PLAIN $24.68
5501022 SURGICAL WIRE $72.96
5501025 STERI STRIPS $22.53
5501029 SOLUTION‐IRRIG 250CC $21.46
5501034 CATH‐COUDE 16FR 5CC $91.20
5501035 AQUAPAK 760ML W/ADAP $31.12
5501036 SOLUTION‐IRRIG NACL $22.53
5501037 SOLUTION‐IRRIG STERI $19.31
5501039 ELECTRODE‐BLADE 6" $30.04
5501041 KIT‐ABG 2.5ML/PREGA $20.39
5501044 PASTE‐KARAYA REG $80.47
5501045 PASTE‐KARAYA PREM $104.08
5501046 CATH‐ALL PURPOSE 12F $19.31
5501047 CATH ALL PURPOSE 10F $18.24
5501051 TUBE‐TRACHEAL 5.5 MM $21.46
5501052 SET‐PNEUMOTHORAX $761.82
5501053 SOL‐IRRIG WATER BAG $24.68
5501056 CATH‐COUDE 18FR 5CC $100.86
5501057 CATH‐COUDE 20FR 5CC $142.71
5501058 TRAY‐IRRIG CYSTO $47.21
5501059 CATH‐COUDE 22FR 5CC $142.71
5501060 CATH‐SILASTIC 16FR 5 $80.47
5501061 CATH‐SILASTIC 18FR 5 $96.57
5501062 CATH‐SILASTIC 20FR 5 $80.47
5501063 CONCHA PAK COLUMNS $128.76
5501064 CONCHA PAK WATER $30.04
5501065 TUBE‐SALEM SUMP 16FR $17.17
5501066 TUBE‐SALEM SUMP 12FR $19.31
5501067 SCREW COMPR 110MM $971.06
5501068 SCREW COMPR 115MM $979.64
5501069 SCREW SELF TAP .34MM $479.63
5501070 SCREW SELF TAP .38MM $120.18
5501071 SCREW SELF TAPG 40MM $120.18
5501072 INST‐BIOPSY MONOPTY $295.07
5501074 BAG‐URINARY DRG 4000 $55.80
5501082 SUTURE 4‐OVICRYL P3 $50.43
5501083 SUTURE 6‐0 VICRYL P3 $55.80
5501084 SUTURE 5‐0 VICRYL P3 $50.43
5501085 DRESSING ADAPTIC 3X16 $21.46
5501086 LOCATOR‐NERVE VERIS3 $321.90
5501087 DRESSING KALTOSTAT $46.14
5501088 CATHETER SUCTION 6FR $22.53
5501089 NEEDLE 25 X 1 1/2 $60.18
5501090 PUNCH BIOPSY 5MM DIS $23.61
5501091 PUNCH BIOPSY 3MM DIS $23.61
5501092 PUNCH BIOPSY 8MM DIS $23.61
5501095 NEEDLE INFUS 22X3/4 $53.65
5501096 UROJET 10ML LID 2% $80.47
5501097 CATH‐NASOSTAT SLIMLN $275.76
5501098 KIT‐NORPLANT $1,442.10
5501099 TRAY‐PIC 18G 20CM $570.83
5501100 CATH‐PORT A SINGL LUM $1,532.23
5501101 IMPLANT‐BREAST 240CC $1,991.47
5501102 TRAY PEG PONSKY POLL $116.96
5501103 SUTURE‐ETHIBOND X BR $136.27
5501104 TROCAR‐ENDO 5X100MM $589.07
5501105 BAG‐DRAINABLE 2.75F" $15.02
5501106 BARRIER‐SKIN 2.75F" $27.90
5501107 GRAFT‐VASC 5MMX10CM $822.98
5501112 SET‐CATH SUPRA XCHG $372.33
5501113 WIREGUIDE SUPRA XCHG $68.67
5501114 SET‐CATH SUPRA PERC $301.51
5501115 CATH‐NEPHROST 22FR $197.43
5501116 CATH‐NEPROST 14FR $321.90
5501118 SUTURE‐PDS II 4‐0 $57.94
5501119 SUTURE‐VICRYL 2‐0 $23.61
5501122 ORTHOPLAST 18X24X1/8 $439.93
5501123 WIRE‐KIRSCHNER .062X4 $52.58
5501124 SUTUR 4‐0 VICRYL PC5 $38.63
5501125 SUTUR 5‐0 VICRYL PS2 $48.28
5501127 IV‐SOD CHBR 3%500ML $74.04
5501128 SUTURE‐O PROLENE $27.90
5501129 TROCAR‐REDUCER 5MM $50.43
5501130 SUTURE‐ETHIL BLK 4‐0 $21.46
5501131 SUTURE‐ETHIL BLK 5‐0 $18.24
5501132 SUTURE‐ETHIL BLK6‐0 $21.46
5501134 ARM BAND $77.26
5501137 SUTURE‐VICRYL 3‐0 $25.75
5501138 CATHETER‐PACING BIPO $977.50
5501139 FILTER INSUFFLATION $64.38
5501140 DUODERM 4X4 ULTRATHN $30.04
5501141 SUTURE‐VICRYL3‐0 PC5 $52.58
5501143 KIT‐CENTRAL LINE $46.14
5501145 ENCHANCER‐AEROSOL CL $9.66
5501146 CATHETER PACING BIPO $977.50
5501147 SUTURE‐VCRL VIL BR60 $152.36
5501148 SUTUR‐PRLN BL MONO70 $57.94
5501149 SUTURE‐PRLN BL 10‐0 $204.94
5501150 SET‐LACRIMAL INTUBAT $699.59
5501156 NEEDLE‐IL ASPIR 16G $100.86
5501157 NEEDLE‐BIOP ASP 13G $144.85
5501158 SUTUR‐PROLENE 3‐0 SH $27.90
5501159 SUTUR‐PROLENE 4‐0 SH $27.90
5501165 TRACH‐TUBE FEN 6 $559.03
5501166 TRACH‐TUBE FEN 8 $559.03
5501167 SUTURE‐ETHICON 4‐0 $319.75
5501168 SUTURE‐GUT PLAN 6‐0 $38.63
5501169 SUTURE‐ETHICON 5‐0 $38.63
5501170 SUTURE‐MONOCRYL 4‐0 $50.43
5501171 SUTURE‐PROLENE 10‐0 $144.85
5501172 SUTURE‐ETHILON 6‐0 $46.14
5501173 COLLECTOR‐PEDI DBL B $20.39
5501174 SUTUR‐VICRYL 3‐0 $122.32
5501178 ELECTRODE DISP 50X50 $23.61
5501179 SCREW‐SELF TAPG 42MM $108.37
5501181 POUCH‐STOMA DRAIN $23.61
5501182 SUTURE‐ETHLN BLK 6‐0 $32.19
5501184 SCREW‐LAG 120MM $961.40
5501185 SCREW‐LAG 125MM $60.09
5501186 SCREW‐ASNS 6.5MMX100 $1,096.60
5501187 SCREW‐ASNIS 6.5X95MM $1,027.93
5501188 SCREW‐ASNIS 6.5MMX90 $800.45
5501189 SUTURE‐SILK BLK $21.46
5501192 BLADE‐ARTH 5MM SCLOP $623.41
5501193 NEEDLE‐SPIN 22G 1.5" $27.90
5501195 STERIS‐STERILANT 20 $52.58
5501196 CATH PORTA 9FR SINGL $1,186.73
5501197 SUTURE‐GUT 6‐0 PLAIN $108.37
5501198 RETRACTOR BALLOON $570.83
5501200 STOCKINET‐IMPRV12X48 $64.38
5501201 STYLET‐INTUB 5.0‐7.5 $30.04
5501202 PLATE‐TIBIAL R SIDE $1,055.82
5501203 SUTURE‐VICRYL O $131.98
5501204 WIRE GUIDE.038 145C $68.67
5501205 STYLET‐INTUB 14FR $43.99
5501206 DRESSING‐KALTO 10X20 $104.08
5501207 STYLET‐INTUB 6FR $47.21
5501209 BARRIER FLANG 2 3/4" $50.43
5501210 CLAMP‐POUCH DRAINABL $23.61
5501218 TUBE TRACH DIR 5.0 $72.96
5501219 TUBE TRACH DIR 5.5 $71.89
5501220 TUBE TRACH DIR 6.0 $74.04
5501221 TUBE TRACH DIR 6.5 $79.40
5501222 TUBE TRACH DIR 7.0 $71.89
5501223 TUBE TRACH DIR 7.5 $71.89
5501224 TUBE TRACH DIR 8.0 $71.89
5501225 TUBE TRACH DIR 8.5 $74.04
5501226 SUTURE‐SILK 3‐0 8STD $56.87
5501230 SUCTION‐POOLE $15.02
5501240 SCREW‐ASNIS 6.5X70MM $963.55
5501241 SCREW‐ASNIS 6.5X75MM $800.45
5501245 CATH‐TRANSTRACH ADUL $377.69
5501246 CATH‐TRANSTRACH CHIL $377.69
5501251 TUBE‐VENT COLLAR BTN $74.04
5501252 PEN‐MARK FINE PT/OR $23.61
5501253 PIN‐GUIDE 3.2X230MM $183.48
5501254 CORD‐BIPOLAR DISP $77.26
5501255 PACKING NASAL 8CM $67.60
5501257 ASNIS‐GUIDE SCREWS $466.75
5501258 EXTFIX‐BALL JOINT $1,093.38
5501259 EXTFIX‐PINS $48.28
5501260 EXTFIX‐ROD CONNECTOR $806.89
5501261 HIP‐COMPRESS SIDE PLATE $1,081.58
5501262 HIP PIN‐COMPRESSION SCREW $82.62
5501263 HIP PIN‐LAG SCREW $554.74
5501264 HIP‐SUPRA CONDYLAR PLATE $1,553.69
5501265 HIP‐ACE BN CEMNT FLL DOSE $288.63
5501266 HIP‐ACETAB BIPOLAR CUP $2,917.46
5501267 G & K NAILS $2,092.33
5501268 G & K SCREWS D&T $361.60
5501269 HIP‐ACETABULAR SHELL $4,043.03
5501270 HIP‐APICAL PLUG $314.39
5501271 HIP‐DEFINITION DIST CENT $341.21
5501272 HIP‐RELIANCE HIP STERR $4,375.66
5501273 HIP‐DISTAL CENTRALIZER $314.39
5501274 HIP‐FEMORAL HEAD $1,664.21
5501275 HIP‐DEFINITION HIP STERR $8,576.42
5501276 HIP‐TALON SHELL INSERT $2,203.93
5501277 HIP‐UNIVERS BONE PLUG KIT $490.36
5501278 KNEE‐FEMORAL COMPONANT $7,412.23
5501279 KNEE‐FEMORAL STABILIZER $6,816.72
5501280 KNEE‐STABILIZER INSERT $3,128.84
5501281 KNEE‐PATELLA $2,473.25
5501283 KNEE‐TIBIAL OCMPONANT $7,008.78
5501284 KNEE‐TRAY/INSERT $3,069.83
5501285 MISC‐PROSTH & IMPLANTABLE $1,329.89
5501286 CATH‐FOLEY 18F 30CC $41.85
5501288 LAP‐SUCT IRRIG SYS $430.27
5501289 CATJ‐FOLEY 20FR 30CC $48.28
5501293 SCREW‐ASNIS 6.5X85MM $800.45
5501297 OMNIPAQUE 300 50ML $192.07
5501300 SUTURE‐VICRL 8.0 12" $202.80
5501302 SET‐TUBING HYDROVALV $501.09
5501306 SUTURE‐CHROMIC 4‐0 $27.90
5501307 FILTER‐INSUFF 1 MICR $51.50
5501310 CLIP‐LIGATING MED $85.84
5501312 PROBE 7 F DISP LITHO $816.55
5501317 SUTURE‐SILK 6‐0 $124.47
5501318 SUTURE‐VICRYL 10‐0 $237.13
5501320 WARMER‐FLUID BAIRHUG $96.57
5501325 SUTURE‐VICRYL 4‐0 $25.75
5501326 SUTURE VICRYL 4‐0 $21.46
5501327 DRESSING‐GAUZE 1X8" $21.46
5501328 SUTURE‐VICRYL ENDLO $168.46
5501329 STENT DBL J 6.0X26CM $1,005.39
5501330 KIT EXCH 7.0X26CM $1,005.39
5501331 KNIFE‐CRESC BEV UP60 $271.47
5501332 SUTURE 4‐0 VICRYL $23.61
5501333 DRAINBAG‐URINE 4L $49.36
5501334 VORTEX‐PORT 9.6FR $1,321.93
5501335 BLADE ARTHRO 4.0MM $654.52
5501336 BARRIER SKIN W FLANG $38.63
5501337 SUTRUE‐GUT CHROM 4‐0 $24.68
5501342 SOLN IRRIG NACL 250M $17.17
5501343 PLATE BASE TIBIAL $3,714.70
5501346 BLADE MENISCUS 3.5MM $604.09
5501347 NEEDLE WHTCR 4 11/16 $76.18
5501349 AEROCHAMBER W/MD MSK $0.95
5501350 CAUTERY DISP LNG TIP $98.72
5501351 KIT CATHETER FEMALE $31.12
5501352 SET FLUID WARMER $89.06
5501353 BARRIER SKIN 1" $27.90
5501364 BELT RIB X‐LGE $54.72
5501369 BIPAP HEADSTRAP DISP $5.36
5501370 BIPAP CIRCUITS SGLPT $28.97
5501372 BIPAP MASK NASL MDSM $28.97
5501374 BIPAP MASK NASL SM $120.18
5501375 BAG DRAINABLE W/FLNG $18.24
5501376 POUCH DRAINABLE $19.31
5501377 SCREW ASNIS 6.5X80MM $989.30
5501378 AMINOSYN W/ELECTRO $60.09
5501379 CATH‐UMB 5FR W/LOCK $118.03
5501380 SUTURE ALCNYL10‐0 $237.13
5501381 STPLR PROX ACCESS 55 $1,074.06
5501382 SUTURE VICRYL 5‐0 $38.63
5501383 BANDAGE COVAN 5X5YD" $18.24
5501387 CUTTING LOOP ANGLED $436.71
5501388 LOOP ELECTRODE $488.21
5501389 CATHETER BALOON DIL $804.74
5501390 BASKET STONE RETRVL $908.82
5501391 FILTER FEMORAL SST $2,915.32
5501392 FILTER JUGULAR SST $3,171.76
5501393 PUNCH BIOPSY 2MM DIS $55.80
5501394 PUNCH BIOPSY 3MM DIS $55.80
5501395 PUNCH BIOPSY 4MM DIS $55.80
5501396 PUNCH‐BIOPSY $55.80
5501399 BARRIER‐SKIN 2.75 W FL $32.19
5501400 POUCH‐DRNABLE 70MM $32.19
5501401 KIT‐VAS VIEW DIAG $464.61
5501403 KIT‐STENT URAPASS $738.22
5501406 STUTURE OPHTHAL 10.0 $149.15
5501408 KIT LAPAROSCOPIC ACC $423.83
5501409 ARCH BINDER‐MED $80.47
5501413 CAUDERY CORDLESS VAS $98.72
5501415 SPONGE‐TONSIL MED $18.24
5501416 BAG PRESS INFUSON DP $106.23
5501419 TUBE ENDOTRACH 5.0MM $27.90
5501422 LEETZ‐SMOKE FILT SET $124.47
5501426 CTH FLY 18FR 30CC 3W $122.32
5501427 PENCIL HND ELECT SRG $48.28
5501428 PROBE ELECTRO HYD 3F $816.55
5501429 PROBE ELEC HYD 1.6FR $816.55
5501430 SCREW SELF TAP 40MM $110.52
5501431 CATH FOLEY 2 WAY $116.96
5501432 NDLE ASP IL 16X1.875 $100.86
5501433 MASK PEDI $17.17
5501434 SET‐DELIVERY OB VAC $245.72
5501435 NDL‐INJ 7.0 220 23 $287.56
5501436 PNCL CAUT TFLN CTD $153.44
5501437 WIRE GUIDE 025 145CM $126.61
5501438 PLATEBONE9HOLE4.5MM $822.98
5501439 DRILL‐BIT 3.2X145MM $299.36
5501443 TIP VCRTTS F TIP 7MM $250.01
5501444 IMMOBILIZE SHOULD MD $71.89
5501445 IMMOBILIZE SHOULD LG $71.89
5501446 IMMOBILIZE SHOULD XL $71.89
5501447 STENT STRETCH VL FLX $883.07
5501448 GUIDEWIRE 3 CM FLEX $120.18
5501449 GUIDEWIRE 8 CM FLEX $1,005.39
5501452 KNIFE STERILE $756.46
5501454 BLADE MINISCUS 4.0MM $561.17
5501455 DILATOR 18MMX8CM 54F $716.76
5501456 DILATOR 16MMX8CM 48F $750.02
5501457 DILATOR 18MM X 5.5CM $750.02
5501458 DILATOR 16MM X 5.5CM $750.02
5501464 ARTHREX ARTHRO PUMP TUBING $192.07
5501465 ARTHREX 10MM MENISCAL DARTS $329.41
5501466 ARTHREX 12 MM MENISCAL DARTS $329.41
5501467 ARTHREX 14MM MENISCAL DARTS $329.41
5501468 ARTHREX PROBE MEASURING DART $156.66
5501469 ARTHRO WAND 3MM 45 $708.17
5501470 ARTHRO WAND SABER 30 $466.75
5501471 ARTHRO WAND VAC 90 $551.52
5501472 ARTHRO WAND COVAC 50 $551.52
5501473 ACUSNARE 7FR 250MX 5.5 CM $115.88
5501474 SYNTHESIS 1/3 TUBULAR PLATE $263.96
5501475 STAPLE 60MM PROX $409.88
5501476 DUOVISC $639.50
5501477 H2O IRRIGATION $9.66
5501478 DERMABOND SKIN ADHESIVE $226.40
5501479 OXISENSOR ADULT $148.07
5501480 ACUSNARE 7 FR PLOYPECTOMY $142.71
5501481 BAG SPECIMEN RETRIEVAL $571.90
5501482 POUCH DRAINABLE 2 1/2 INCH $25.75
5501483 HOLDER FOLEY CATHETER $27.90
5501484 TRAY‐ABSORBABLE PIN $1,027.93
5501485 SUTURE PDS 11 60 TP1 $30.04
5501486 STAPLER‐ROTICULAR $902.39
5501487 TUBE‐FEEDING EXT SET $76.18
5501488 SCREW‐LG CARTICAL SELFTAP $116.96
5501489 SCREW‐OMEGA CHS 85 MM LG $800.45
5501490 SCREW COMPRESSION 32.5 LG $195.28
5501491 SEDEPLATE‐STD BARRELL $1,055.82
5501492 SUTURE‐2.0 CHRONIC UR 6 $18.24
5501493 TUBE‐ENDOTRACHEAL 5.5M $17.17
5501494 MICRO SNARE $76.18
5501495 SUTURE ETHIBOND 2‐0 $192.07
5501496 GRAFT 16‐08MM X 40CM $2,530.11
5501497 GRAFT 18‐09MM X 40CM $2,530.11
5501498 SUTURE GORTEX $575.12
5501499 VASCULAR PATCH GORTEX $356.23
5501513 CATHETER CHOLANG TAUT $21.46
5501516 ARTHREX 3.5 CORKSCREWS C1713 $570.83
5501523 FOOT LONGITUDINAL ARCH SUPPORT L3010 $414.17
5501525 FOOT LONGITUD/METATARSAL SUP L3020 $689.93
5501536 SHOE LIFTS TAPERED TO ONE‐HA L3332 $60.09
5501543 WHFO NO JOINT PREFABRICATED L3807 $229.62
5501545 WRIST COCK‐UP NON‐MOLDED L3908 $202.80
5501546 FLEX GLOVE W/ELASTIC FINGER L3912 $138.42
5501548 HFO NO JOINT PREFABRICATED L3923 $229.62
5501557 MISC‐GENERAL $586.58
5501559 REGULAR LENS V2632 $586.93
5501560 TORK LENS V2787 $733.93
5501561 CRYSTALENS $1,643.82
5501562 SECONDARY LENS $684.57
5501563 CLEAR LENS $733.93
5501564 DRESS 2X2 AG AQUA EXTRA $20.39
5501565 DRESS AG ROPE AQUACEL $35.47
5501566 BOOT MULTI XTR MED/LRG $247.86
5501567 BOOT LINER MULTI M/LRG STANDARD $96.57
5501568 MASK BAT ADULT STERILE $23.61
5502000 ACAPELLA DH GRN $150.46
5502002 ANCHOR 6.5 HEALIX BR $585.85
5502003 ANCHOR 3.0 MICRO $563.32
5502004 ANCHOR 2.0 MINI $655.60
5502005 ADHESIVE .75ML DERMABOND $60.18
5502007 ANCHOR BIO PUSHLCK 3.5 $472.12
5502010 AIRWY ORL BK 60MM $2.15
5502011 AIRWY ORL BL 50MM $2.15
5502012 AIRWY ORL GR 80MM $2.15
5502013 AIRWY ORL RD 100MM $2.15
5502014 AIRWY ORL WT 70MM $2.15
5502015 AIRWY ORL YW 90MM $2.15
5502016 AIRWY NASOPHARY 26 $5.37
5502017 AIRWY NASOPHARY 28 $5.37
5502018 AIRWY NASOPHARY 30 $6.45
5502019 AIRWY NASOPHARY 32 $6.44
5502020 ANCHOR CORKSCREW 5 $338.53
5502021 AIRWY MASK LMA SUP 3 $45.14
5502022 AIRWY MASK LMA SUP 4 $45.14
5502023 AIRWY MASK LMA SUP 5 $45.14
5502025 BAG LEG URINARY 500ML $10.75
5502026 BAG SPEC RETRIEVAL $165.51
5502027 BAG URINE 2000ML $9.67
5502028 BAG URINE 4000ML $15.05
5502029 BAG INFUSER 1000 $25.79
5502035 ANCHOR 2.9 PEEK PUSHLCK $482.85
5502046 BANDGE COBAN 3X5 LF COLOR $4.30
5502048 BAND FALOPE RING $280.05
5502049 BANDGE COBAN 4X5 LF COLOR $6.45
5502050 BANDGE CONFORM 1 $1.07
5502051 BANDGE CONFORM 2 $0.63
5502052 BANDGE CONFORM 3 $0.80
5502053 BANDGE CONFORM 4 $1.01
5502054 BANDGE CONFORM 6 $2.15
5502055 BANDGE ELAST 2 $1.07
5502056 BANDGE ELAST 3 $1.07
5502057 BANDGE ELAST 4 $2.15
5502058 BANDGE ELAST 6 $3.22
5502060 BANDGE 4 LAYER PROF $39.70
5502061 BANDGE ESMARK 4X9 $6.45
5502062 BANDGE STER WEBRIL 2 $3.22
5502063 BANDGE STER WEBRIL 4 $4.30
5502065 BLADE 3.0 ABRASION BUR $190.99
5502070 BASKT ST 3F URET $345.50
5502072 STONEBRE PROBE 2MM DIA 400MM $395.93
5502073 EXTRACT STONE BASKET 1.0 $416.99
5502074 STIMUBLAST CB PUTTY 5CC $925.32
5502075 STIMUBLAST PUTTY 2.5CC $520.16
5502076 STIMUBLAST PUTTY 5CC $901.31
5502077 CATH SILICONE 16F 2Y 5CC COUDE $59.01
5502078 BELT RIB FEM $13.95
5502079 BELT RIB MALE $13.95
5502080 BELT REG SI $63.31
5502084 BINDER ABD 10 $20.42
5502085 BINDER ABD 15 $83.83
5502110 BLADE 5.5 RESECTOR $139.49
5502111 BLADE 3.5 RESECTOR $139.71
5502112 BLADE 4.0 BARREL BUR 12 FLUTE $139.71
5502113 BLADE 4.5 ANG AGRS PLUS $139.49
5502114 BLADE STANDARD $4.29
5502115 BLADE PEAK PLASMA 3.0 W EXT $459.24
5502117 BLADE 4.0 RESECTOR $166.58
5502118 BLADE BEAVER MINI 64 $13.97
5502119 BLADE HOOK ENDO $422.36
5502120 BLADE HOOK ANGLED $370.18
5502121 BLADE CURVED SCISSOR TIP $110.70
5502122 BLADE STR SCISSOR TIP DISP $105.32
5502123 BLADE SAG SYS 6 NARROW $185.92
5502125 BLADE 2.5 FULL RADIUS $139.71
5502126 BLADE SAG 6 $185.92
5502127 BLADE RECIP SHORT $174.90
5502128 BLADE RECIP MINI SHORT $174.90
5502129 BLADE RECIP LONG SHORT $179.19
5502130 BLADE RECIP LO TAPER SHORT $174.90
5502131 BLADE RECIP SH TAPER SHORT $179.19
5502139 BLADE CAUT PEN 1 $13.97
5502140 BLADE DERMATOME $104.25
5502141 BLADE ENDOTRAC $681.37
5502143 BLADE 3.5 AGRS PLUS $139.71
5502144 BLADE MIC 11.5X5.5 $93.50
5502145 BLADE MIC 18.5X7.0 $93.50
5502146 BLADE MIC 31X9 $93.50
5502147 BLADE MIC 29.5X7 $93.50
5502148 BLADE NARR 18X5.5 $93.50
5502149 BLADE NARR 25 5X5 $95.50
5502152 BLADE SAW 25MM $93.50
5502163 BLANKT BAR MULTI $19.34
5502165 BLANKT BAR UPPR BOD $25.79
5502166 BLADE BEAVER MINI 180 $19.31
5502171 BRUSH CYTOLOGY 1.8X160 2MM $48.36
5502173 BLADE 3.5 TOMCAT $139.49
5502175 BOOT CAST L CLSDTOE $42.92
5502176 BOOT CAST M CLSDTOE $42.92
5502177 BOOT CAST S CLSDTOE $42.92
5502178 BOOT CAST XL CLSDTOE $40.77
5502179 BOOT UNNAS GELCAST $19.31
5502182 BLADE AGGRES PLUS 4.0MM $139.71
5502183 BUR BARREL LONG 6MM $274.69
5502193 BUR ROUND POLISH 4MM $133.05
5502194 BUR ROUND 4MM $124.67
5502195 BUR SIDE CUT CARB 1.2 $41.85
5502196 BUR SIDE CUT CARB 1.6 $37.55
5502198 BUR CARB OVAL 4MM $79.53
5502199 BUR MICRO EGG 4MM $140.79
5502200 BUR SLAP 4.0MM $139.71
5502201 CANN UNIVER 5.5X70 WITHOUT FEN $40.84
5502204 CANN TWIST 8.5X75 $139.71
5502205 CANN TWIST 7X75 $139.71
5502209 CANN 19GA $72.96
5502210 CANN 27GA $68.67
5502211 CANN 30GA $72.96
5502220 CANISTER VAC W/GEL $101.02
5502222 CAST PLASTER FAST 3 $0.54
5502223 CAST PLASTER FAST 4 $0.59
5502224 CARRIER MESH DERMTME $77.38
5502225 CANN 26G ANG MCINTYRE A/C $103.01
5502226 CANN NAS CO2 PEDI SAMP $37.55
5502227 CANN NAS CO2 ALT SAMP $37.55
5502228 CAST PLASTER 5 $6.44
5502229 CAST PLASTER 2 $3.22
5502230 CAST PLASTER 3 $3.22
5502231 CAST PLASTER 4 $5.37
5502232 CAST TAPE WHITE 2X4YD $7.51
5502233 CAST TAPE WHITE 3X4YD $9.66
5502234 CAST TAPE WHITE 4X4YD $11.80
5502235 CAST FIBER PRE CUT 3X35 $40.84
5502236 CAST FIBER PRE CUT 4X30 $39.76
5502237 CANN NAS CO2 PEDI W/O2 $9.67
5502238 CANN NAS CO2 ALT W/O2 $16.12
5502239 CANN DRI LOCK 5.0 $98.72
5502240 CANN INNER DISP 6 SHILEY $10.73
5502241 CANN INNER DISP 8 SHILEY $10.73
5502242 CANN L PRES CUFF DISP 6 $133.05
5502243 CAST PLASTER FAST 5 $1.07
5502244 CAST PADDING 6X4 $13.97
5502245 CAST PADDING 4X4 $6.45
5502246 CABLE SLEEVE 2.0 BEADED $534.35
5502247 CAST TAPE WHITE 1X2YD $7.51
5502248 CANN SONOPLEX STIM 22GX80 $54.81
5502249 CANN CLEAR TRAC 10MM $83.69
5502250 CANN SONOPLEX STIM 22GX50 $54.81
5502372 CATH SUC 8F $5.37
5502373 KIT INTRO SHEATH PERCUT 9FR $150.22
5502374 CATH URET 18F 6 EYES $38.63
5502375 CATH URET 20F 6 EYES $38.63
5502376 CATH 22F FOLEY 6 EYES $38.63
5502377 CATH OPEN TIP URET 4 FR $39.70
5502378 CATH URET D3.5 L82 KOALA $81.68
5502380 CATH URET 5F OPEN END $52.66
5502382 CATH SUCT GRAD PEDI 6FR $1.07
5502384 CATH 14F FOLEY 5CC 2WY ROUND $11.82
5502385 CATH 16F FOLEY 5CC 2WY ROUND $11.82
5502386 CATH 18F FOLEY 5CC 2WY ROUND $11.82
5502387 CATH FOL 8F 3CC 2WY ROUND $11.82
5502388 CATH HEMA COUDE 24F 30CC 3WY $64.38
5502389 CATH CHOLANGIO $90.13
5502391 CATH COUDE TIP URET 18F LTX $13.95
5502392 CATH FOL TIEMANN 14F 5CC 2WY $40.77
5502394 CATH 18F COUDE 5CC 2WY $72.01
5502395 CATH 20F COUDE $99.95
5502398 DILATR BAL 12 $369.70
5502399 CATH EXTERNAL TEXAS $4.30
5502401 CATH FOL SIL 12F 5CC 2WY $11.80
5502405 CATH FOL 18F 30CC 2WY ROUND $21.46
5502407 CATH FOL 18F 5CC 2WY OPEN $18.27
5502408 CATH 20F FOLEY ROUND $11.82
5502409 CATH 20F FOLEY 5CC 2WY OPEN $60.18
5502411 CATH FOL 22F 5CC 2WY ROUND $16.12
5502412 CATH 22F FOLEY 30CC 2WY ROUND $11.82
5502413 CATH FOL 24F 30CC 2WY ROUND $21.46
5502414 CATH FOL SIL 24F 5CC 3WY $38.69
5502416 CATH 14F FOLEY 5CC 2WY OPEN $21.49
5502417 CATH FOL IRR 18F 3WY $47.21
5502418 CATH FOL SIL 22F 30CC 3WY $37.55
5502419 CATH 24F FOLEY 30CC 3WY ROUND $47.29
5502421 CATH FOL SIL 24F 30CC 2WY $13.95
5502424 CATH GUIDE FEM $167.39
5502425 CATH HICK S LUM 9.6F $351.94
5502426 CATH INJ 7F GOLD PR $306.29
5502427 CATH IV 14G ORG $7.52
5502428 CATH IV 16G GRY $6.45
5502429 CATH IV 18G GRN $6.45
5502430 CATH IV 20G PNK $6.45
5502431 CATH IV 22G BLU $6.45
5502432 CATH IV 24G YLW $6.45
5502433 CATH KIT FEM 8F $5.37
5502434 CATH KIT SUC 14F $3.22
5502435 CATH TRIPLE LUMEN $272.98
5502438 KIT PICC DOUBLE LUMEN 5FR $268.68
5502442 CATH FOL 20F 30CC 2WY ROUND $16.09
5502446 CATH SUC 10F $2.15
5502447 CATH SUC 14F $2.15
5502448 CATH SUC 18F $2.15
5502449 CATH TRAY 16F LATEX FREE $20.42
5502450 CATH TRAY 18F LATEX FREE $32.24
5502451 CATH TRAY URET 14F LATEX FREE $5.37
5502454 CATH URET 3F $26.82
5502458 CATH URET WHISTP 5F $156.66
5502459 DEVICE ABLATION ENDMET $1,262.78
5502460 CATH VESSEL UMBIL 3.5FR $39.70
5502461 CATH VESSEL UMBIL 5F $39.76
5502464 CATH W/LUMAN SINGLE SENSOR $144.85
5502465 CATH W/OUT LUMAN SINGLE SENSOR $142.71
5502466 CATH 14F SELF $2.15
5502467 CAUT CORD BIPOL DISP $6.45
5502468 CAUTRY DISP $25.79
5502469 CAUTRY DISP VAS $32.19
5502470 CAUTRY PENC SUC 10F $37.55
5502471 CAUTRY PENC TEFLN CTD $20.39
5502473 CATH FOL SIL 22F 5CC 3WY $66.53
5502474 CATH FOL 24F 5CC 3WY LTX $177.04
5502475 CATH POST PARTUM BALL BAKRI $401.94
5502476 CEMENT BONE FULL DS $186.70
5502477 CEMENT BONE ANTIBIOTIC $353.58
5502478 CAPS TEN CTS TYPE 6D 9.61 $418.47
5502479 CAPS TEN CTS TYPE 6E 10.16 $418.47
5502480 BANDGE ESMARK 6X9 $8.60
5502481 CHAMBR AERSOL ENHANC AEROCHAMBER $23.64
5502484 CATH STR 36F THORACIC $22.53
5502485 CATH RT ANG 36F THORACIC $33.26
5502486 CIRCUIT ANES ADULT LF $12.90
5502487 CIRCUIT ANES INFANT $26.87
5502488 CIRCUIT BAIN BREATHING $57.94
5502489 CUTIMED SILTEC SORBACT 6X6 $52.58
5502490 VENTRALIGHT ST W/ECHO PS 11CM $653.45
5502491 VENTRALIGHT ST W/ECHO PS 10X15CM $598.73
5502492 VENTRALIGHT ST W/ECHO PS 15CM $930.70
5502494 VENTRALIGHT ST W/ECHO PS 15X20 CM $1,129.86
5502495 PIN DISTRACTION 14MM $311.67
5502496 SUTURE PDS II 5‐0 Z303H $8.58
5502498 CLIP APPLIER 12 LG $240.73
5502499 CLIP ENDO MULTI M $38.69
5502501 CLIP ENDO 10 M/L $235.36
5502503 CLIP DEV RES 235 2.8 $353.58
5502505 CLIP TITANIUN MED $28.97
5502511 COLLECT SET DISP $24.72
5502512 COLLR CER BABY $38.63
5502513 COLLR CER EXT PEDI $25.75
5502514 COLLR CER LOW CONT L $11.82
5502515 COLLR CER LOW CONT M $11.82
5502516 COLLR CER LOW CONT S $12.88
5502517 COLLR CER LOW CONT XL $17.17
5502518 COLLAR CER STIFF NK $21.49
5502524 CONN Y PATRL PUMP $19.31
5502531 CUFF DISP 18X3 STER $152.36
5502532 CUFF DISP 24X4 STER $161.21
5502538 SCREW 6.5 CANC 16 THR 45MM $78.33
5502543 CURETT VAC CVD 8MM $15.05
5502544 CURETT VAC F TIP 6MM $15.02
5502545 CURETT SUC ENDOMETRL $30.04
5502546 CURETT VAC CVD 10MM $38.69
5502548 CURETT VAC CVD 9MM $16.09
5502549 SYS COLLECTION 3/8 SAFETOUCH $27.94
5502550 CURETT VAC F TIP 8MM $16.12
5502551 CURETT VAC STR 8MM $15.02
5502552 CURETT VAC STR 9MM $16.09
5502555 DETECTOR C02 $33.32
5502556 DEBRIDER MICRO TOPAZ $640.53
5502557 DETECTOR PEDI CO2 $33.32
5502558 DEVICE PROTACK 5MM $530.06
5502560 DEVICE AUTOMIZIAT $39.76
5502562 DEVICE LAP DISC HAND MED ACCESS $571.90
5502563 DEVICE W/POSITIVE DISP $4.30
5502565 DILATR BAL 18 $369.70
5502566 DILATR BAL 10 $428.81
5502567 DILATR 5F BALLN ST $297.22
5502568 DILATR REN AMPLTZ ST $403.44
5502569 DILATR TAPERD 6F 12F $306.88
5502570 DILATR URET 7F BALN $297.22
5502571 DILATR BAL 15 $369.70
5502572 DEVICE ENDOSTAT FIBEROPTIC $491.14
5502573 DILATR URET SET 8TO24FR $453.53
5502574 DEVICE GRASPING TALON $384.75
5502575 DISECTR ENDOPEANUT $51.59
5502576 DISTRCT AKL FOOT STRAP $117.14
5502577 12MM ACCESS PORT 150MM LENGTH $289.71
5502578 MEPILEX TRANS AG 8X20 $251.08
5502580 DRAIN CHEST PLEURVAC $146.16
5502590 DRAIN 7FR ROUND W/TROCR $118.22
5502591 CATHETER MALECOT 18F $118.03
5502593 CATHETER MALECOT 12F $113.74
5502594 CATHETER MALECOT 14F $113.74
5502595 CATHETER MALECOT 16F $113.74
5502596 CATHETER MALECOT 20F $259.66
5502602 DRESSG DUODERM 6X6 $18.24
5502603 DRESSG VAC LG KIT WHT $41.91
5502604 DRESSG SENSA MED BLK TRAC $122.52
5502605 DRESSG ALLVYN ADH 3X3 $7.51
5502606 DRESSG HEEL $30.09
5502607 DRESSG ALLVYN SACRUM 6X6 $26.82
5502608 DRESSG ALLVYN ADH 5X5 $19.31
5502609 DRESSG ADAPT 3X3 $2.15
5502610 DRESSG ADAPT 3X8 $2.15
5502611 DRESSG ALLVYN 4X4 $9.67
5502612 DRESSG COMFEEL 4X4 $13.95
5502613 DRESSG TEGADERM 3X3 $0.86
5502614 DRESSG TEGADERM 4X4 $2.15
5502615 DRESSG TEGADERM 6X8 $5.37
5502616 DRESSG TEGADERM 8X12 $7.52
5502617 DRESSG VASL GAU 3X9 $1.07
5502618 DRESSG XERFM 5X9 $5.37
5502619 DRESSG COVRSITE 4 $2.15
5502620 DRESSG ALGISITE 4X4 $12.88
5502621 DRESSG XERFM 1X8 $1.07
5502623 DRESSG VASL GAU 1/2"X72 $4.29
5502628 DRILL BIT 4.5MM CANN QC 170 $572.98
5502629 DRILL BIT 3.5 QC 110 $282.65
5502630 DRILL BIT 2.5 GOLD QC 110 $218.17
5502631 DRILL BIT 2.7 CANN QC160 $490.36
5502632 DRILL BIT 3.2MM CANN QC 170 $480.70
5502633 DRILL BIT 1.5MM QC 110 $267.17
5502634 DRILL BIT 5.0 CANN QC $483.62
5502635 DRILL BIT 7.3 CANN QC $568.69
5502636 DRILL BIT 2.0MM CANN 150MM $527.68
5502637 INK SPOT ENDO 5ML $113.92
5502639 DRILL BIT 2.0 MM $229.99
5502646 * DRILL BONE 3.2 HM $90.13
5502649 DRILL SIDE CUT 2.1 $149.15
5502650 DRILL WIRE PASS 1.1MM $146.16
5502651 DRILL WIRE PASS 1.5MM $145.93
5502654 DUOVISC $270.39
5502656 ELECTRD SPIRAL FETAL $12.90
5502657 ELECTRD SHAFT RT ANGLE 5MM $207.42
5502659 ELECTRD COAG 27F $275.76
5502663 ELECTRD PREMI MONITR $3.22
5502666 ELEC BUTTON $557.96
5502667 CORD ACTIVE SYS DISP $56.96
5502668 ENEMA BAG SET $5.37
5502669 ENEMA MINERAL OIL $8.60
5502670 ENEMA PEDI $7.52
5502671 ENEMA SOD PHOS $7.52
5502673 ELECTRIC PEN HAND DISP $90.13
5502674 ELEC FT LOAD SUPERSECT $659.89
5502675 ELEC FT LOAD SUPERLOOP $533.06
5502681 BACTERI HUM AQUA FH $7.51
5502690 FELT ORTH 36X21X1/4 $47.21
5502691 KNIFE MVR 20G $98.72
5502693 HOOD INFANT LARGE $42.99
5502694 HEAD 28MM C‐TAPER +7.5 $584.64
5502695 HEAD 28MM C‐TAPER +2.5 $576.20
5502696 HEAD 28MM C‐TAPER +10 $583.71
5502697 HEAD 28MM C‐TAPER +5 $603.02
5502698 HEAD 28MM C‐TAPER +0 $695.30
5502699 HEAD 28MM C‐TAPER ‐3 $675.98
5502701 FILTR INSUFFLATION $21.49
5502705 FILTR BUFFALO VAC HOSE 7/8X10 $37.61
5502708 FOLLR CATH URET 10F $168.46
5502709 FOLLR CATH URET 12F $168.46
5502710 FOLLR CATH URET 14F $110.52
5502711 FOLLR CATH URET 16F $106.23
5502712 FOLLR CATH URET 18F $106.23
5502713 FOLLR CATH URET 20F $110.52
5502714 FOLLR CATH URET 22F $174.90
5502715 FOLLR CATH URET 24F $174.90
5502718 IRRIG BSS 500ML $23.61
5502719 IV D5 NS .45% 500ml $6.45
5502720 IV D5 NS .2% 500ml $8.60
5502721 FORCP BX HOT $88.13
5502722 FORCP BX L CLD 240CM $60.18
5502723 FORCP BX RAD 3GP PED $157.98
5502724 FORCP GRASP 2.5FX115CM $322.41
5502726 FORCP BX RAD JUMBO $99.95
5502727 FORCP RAD JAW 4 $50.51
5502728 INSTR HARMONIC FOCUS $522.31
5502729 GASTROSTOMY 20F $326.71
5502730 GRASPER RATCHET HANDLE 5MM $174.10
5502731 INSTR HARMONIC ACE $483.62
5502734 GAUZE PACKG IODOFORM 1 $8.60
5502735 GAUZE PACKG IODOFORM 1/2 $6.45
5502736 GAUZE PACKG IODOFORM 1/4" 5% $6.45
5502737 GAUZE PACKG PLAIN 1/2 $16.12
5502738 GAUZE PACKG PLAIN 1/4 $6.45
5502739 INSTR IMPACT LIGASURE $969.98
5502740 INSTR VESS SEAL LIGASURE $555.81
5502744 IV GASTROGRAFIN Q9963 $36.48
5502749 HEMOSTAT GELFOAM S 100 $72.01
5502751 HANDLE PISTOL GRIP $329.94
5502752 HEMOSTAT GELFOAM 2X2 $45.07
5502753 HEMOSTAT 4X8 SURGICEL $192.37
5502754 HEALON 5 $167.65
5502755 HEMOSTAT GELFOAM 12 7MM $17.20
5502756 HEALON GV .85 $206.34
5502757 IMMOB KNEE FOAM 14 $92.28
5502758 IMMOB KNEE FOAM 18 $34.34
5502759 IMMOB KNEE FOAM 19 $41.91
5502760 IMMOB KNEE FOAM 24 $60.09
5502763 KIT OSTEO BEAD RESORB 25CC $1,351.97
5502764 KIT SURG SET UP KWIK $59.01
5502766 INSTRUMENT BIOPSY 18GX20CM $107.47
5502767 INJECT OSTOCURE CRG 3CC $921.70
5502769 IRRIG WOUND INTERPULSE $104.25
5502770 IRRIG GLYCINE 3000ML $33.32
5502771 IRRIG NACL 1500ML $12.90
5502772 IRRIG NACL 2000ML $19.34
5502773 IRRIG NACL 500ML $8.60
5502775 IRRIG WATER 1500ML $12.90
5502776 IRRIG WATER 500ML $7.52
5502777 KIT IV TRANS MONITOR 60 $50.51
5502778 KIT TRACH ST W/REMOVE BASIN $11.82
5502779 KIT PARTS MICRO TIP $104.08
5502780 KIT ORAL CARE Q‐2HR $111.59
5502781 IV D10 INJ 500ml $7.52
5502782 IV D10 INJ 1000ml $8.60
5502783 IV D5 INJ 1000ml $7.52
5502784 IV D5 INJ 250ml $6.45
5502785 IV D5 INJ 500ml $6.45
5502786 IV LR 3000ML $29.02
5502787 IV LR D5 INJ 1000ml $7.52
5502788 IV LR D5 INJ 500ml $7.52
5502789 IV LR INJ 1000ML $7.52
5502790 IV LR INJ 500ml $7.52
5502791 IV NACL .45% 1000ml $6.45
5502792 IV NACL .9% 1000ml $6.45
5502793 IV NACL .9% 250ml $6.45
5502794 IV NACL .9% 500ml $6.45
5502795 IV D5 NS .45% 1000ml $6.45
5502796 IV D5 NS .9% 1000ml $6.45
5502797 IV D5 NS .2% 1000ml $7.51
5502801 KIT ACL DISPOSABLES $389.50
5502803 KIT BONE PREP $279.42
5502804 KIT MIX EVAC III $146.16
5502805 KIT CEMNT MIX ADVAN $288.02
5502808 KIT LTA ANESTH $22.53
5502810 KIT LAVAGE GAS 34FR/36"L $63.31
5502812 KIT SUPRAPUBIC CATH $186.70
5502813 KIT WRIST STERILE $3,387.43
5502815 KNIFE DISP COLD $289.10
5502816 KNIFE SIDEPORT $46.14
5502819 KNIFE TRIANGL SET $180.26
5502823 LENS IOL STD 4204/2003/2010 $177.04
5502824 LENS IOL TORIC 4203/AQ5010 $402.37
5502825 LENS IOL STD SN60WF/MA60 $367.55
5502826 LENS CRYS AT50AO/AT52SE $1,008.61
5502827 LEG STRAP CATH $7.52
5502828 LENS VERISYSE $150.22
5502829 KIT SHLDER STAB $163.36
5502830 MORGAN LENS $186.70
5502831 LABEL MOIST PROOF W/PEN $6.45
5502832 LOOP VESSEL BLUE $9.67
5502833 LENS GLIDE 5MM X 35MM $4.29
5502834 LENS IOL TORIC SN60T/MTA/SN6AT $557.77
5502835 KNIFE CRESCENT ANG BEV $57.94
5502836 KNEE CUTTING BLOCK OTIS $1,689.96
5502837 MASK AEROCHMBR MED $46.21
5502838 MASK AEROCHMBR SM $46.21
5502840 MASK BILIRUBIN $16.12
5502846 SEE ITEM 58002378 $5.37
5502847 MASK MULTI VENT PEDI $5.36
5502848 LENS ACRYSOF TORIC SV25TO $1,008.61
5502849 MESH SOFT 2.4X5.4 KEYHOLE $217.09
5502850 MESH PLUG S LIGHT PERFIX $362.18
5502851 MESH 3X6 MONOF KNITTED POLY $149.15
5502852 MESH SOFT LG 2.4X5.4 $217.09
5502853 MESH SOFT FLAT 6X6 $198.82
5502854 MESH PLUG M LIGHT PERFIX $364.33
5502855 MESH PLUG L LIGHT PERFIX $368.63
5502856 MENISCAL REPAIR SYS 0 $443.15
5502857 MENISCAL REPAIR SYS 12 $443.15
5502858 METER PEAK FLOW LOW $37.61
5502859 PEAK FLOW METER MULTI RANGE $24.72
5502860 MENISCAL REPAIR SYS 27 $443.15
5502861 MARKER 14GSS BREAST BIOPSY $225.33
5502862 MARKER 14GT BREAST BIOPSY $225.69
5502864 NEBULIZER HOPE $43.99
5502865 NEBULIZER T UPDRFT $2.15
5502866 KIT SYS NON REBREATH ADJ O2 E0560 $37.55
5502867 LENS CRYS HD500 $1,098.74
5502868 LENS BL MI60 $321.90
5502869 VENTRALEX ST SM CIRCLE $524.46
5502870 VENTRALEX ST MED CIRCLE $550.25
5502871 VENTRALEX ST LG CIRCLE $675.98
5502872 VENTRALIGHT ST 8X10 ELLIPTICAL $1,502.19
5502874 NEEDLE MAYO HALF CIRC 6D $13.95
5502875 NEEDLE MAYO HALF CIRC 5D $13.97
5502876 NEEDLE MAYO HALF CIRC 4D $13.95
5502877 NEEDLE ACHIEVE BIOPSY 14GX11CM $202.05
5502879 NEEDLE 22X3 1/8 15 B $51.50
5502880 NEEDLE 22X2 30 B $46.14
5502881 NEEDLE 25X1 3/8 15 B $47.21
5502882 NEEDLE INTRAOSSE PEDI $366.96
5502883 NEEDLE INTRAOSSE 25MM ADULT $367.55
5502884 OPTIFIX ABSORBALE FIXATION SYSTEM $666.32
5502887 NEEDLE HEMOVAC 1/8 $32.19
5502891 NEEDLE SPINAL 18G $4.30
5502892 NEEDLE SPINAL 20G 3 1/2 $4.29
5502893 NDL SPINAL 22G $4.30
5502894 NEEDLE SPINAL QUINCKE 22GX5 $11.82
5502895 NDL SPINAL 25G 3 1/2" $4.30
5502897 NEEDLE VARIJECT $109.62
5502898 NEEDLE WHTACRE 27G 3.50 $18.24
5502899 NEEDLE WHTACRE 25G $20.42
5502900 NEEDLE WHTACRE 27G $26.82
5502901 NEEDLE EXPRESS III $353.01
5502905 OINT DERMAGRAN $27.94
5502907 NEEDLE SPINAL 21G 18DEG $35.41
5502909 OCCUCOAT VISCOELASTIC 6X1 $172.75
5502910 KIT BICEPTOR 7X15 $458.17
5502911 KIT BICEPTOR 8X15 $458.17
5502912 KIT BICEPTOR 9X15 $458.17
5502913 KIT TRACHTRANSCRICO 4F $369.11
5502914 KIT PNEUMOTHRAX $333.16
5502915 LENS BL L122UV $402.37
5502916 KIT BICEPTOR 7X25 $458.17
5502917 KIT BICEPTOR 8X25 $458.17
5502918 KIT BICEPTOR 9X25 $458.17
5502919 NEEDLE AUTO BIO 18G X 20 $248.93
5502920 PACK CATARACT GMC $442.78
5502921 PACKING NASAL RHINO 5.5 $134.34
5502922 PACKING NASAL RHINO 7.5 $142.94
5502923 PACK ARTHR KNEE $83.83
5502924 PACK ARTHR SHLDR $83.83
5502925 PACK CUST C SECT $213.87
5502928 PACK LAP PELVISCOPY III $76.30
5502929 PACK LAPCHOLE $59.11
5502930 PACK LITHO V $40.84
5502931 PACK ORTHO II UP EXT $45.14
5502932 PACK ORTHOARTS L EXT $107.47
5502934 PACK UBAR III $62.33
5502935 PACK CYSTO IV $18.27
5502938 PAD ATTACH SPIRAL ELEC $3.22
5502939 PAD NEEDLE COUNTER $3.22
5502940 PAD T PUMP 18X26 $17.20
5502941 PAD STABILIZATION $63.31
5502943 PAD SCRATCH STERILE $4.29
5502945 MESH PLUG XL LIGHT PERFIX $329.41
5502946 MESH SOFT 1.8X4 KEYHOLE $184.55
5502951 PEN SKIN MARK FN PT $1.07
5502952 HOOD INFANT MEDIUM $37.55
5502953 HOOD INFANT SMALL $37.55
5502956 PERFRATOR AMNIOTIC $2.15
5502983 PIN STEIN .125 X 9 $54.72
5502984 PIN STEIN .188 X 9 $27.94
5502985 PIN STEIN .094 X 9 $49.36
5502986 PIN STEIN .156 X 9 $94.42
5502987 PIN STEIN .078 X 9 $77.26
5502988 PIN STEIN .141 X 9 $27.94
5502989 PIN STEIN .109 X 9 $49.36
5502990 PIN STEIN 1/8 X 9 THRD $45.07
5502991 PIN STEIN 3/16 X 9 THRD $202.80
5502992 PIN STEIN 3/32 X 9 THRD $45.07
5502993 PIN STEIN 5/32 X 9 THRD $90.13
5502994 PIN STEIN 5/64 X 9 THRD $45.07
5502995 PIN STEIN 7/64 X 9 THRD $45.07
5502996 PIN STEIN 9/64 X 9 THRD $101.93
5503001 PAD HEEL W H 2 5 16 FELT L3485 $71.89
5503002 PAD HEEL W H 2.5 5 16 FELT L3485 $71.89
5503003 PAD HEEL W H 3 5 16 FELT L3485 $100.86
5503023 PLATE 3.5 RECON 5 HOLE $506.45
5503024 PLATE SM T RT ANGLE 4/6 HOLE $347.65
5503025 PLATE LP MET WEDGE 7MM RT $895.95
5503026 PLATE LP MET WEDGE 7MM LT $584.78
5503027 PLATE LP MET WEDGE 6MM RT $895.95
5503028 PLATE LP MET WEDGE 6MM LT $895.95
5503029 PLATE LP MET WEDGE 5.5MM RT $584.78
5503030 PLATE LP MET WEDGE 5.5MM LT C1713 $895.95
5503037 PLATE LP MET WEDGE 3MM LT $475.34
5503038 PLATE LP MET WEDGE 3MM RT $475.34
5503039 PLATE LP MET WEDGE 3.5MM LT $475.34
5503040 PLATE LP MET WEDGE 3.5MM RT $503.23
5503041 PLATE LP MET WEDGE 4MM LT $503.23
5503042 PLATE LP MET WEDGE 4MM RT $475.34
5503043 PLATE LP MET WEDGE 4.5MM LT $584.78
5503044 PLATE LP MET WEDGE 4.5MM RT $584.78
5503045 PLATE LP MET WEDGE 5MM LT $503.23
5503046 PLATE LP MET WEDGE 5MM RT $503.23
5503047 PLATE 1/3 TUBULAR 6 HOLE $192.07
5503048 PLATE 1/3 TUBULAR 10 HOLE $162.02
5503049 PLATE 1/3 TUBULAR 12 HOLE $147.00
5503050 PLATE 1/3 TUBULAR 3 HOLE $199.58
5503051 PLATE 1/3 TUBULAR 4 HOLE $229.62
5503052 PLATE 1/3 TUBULAR 5 HOLE $243.57
5503053 PLATE 1/3 TUBULAR 8 HOLE $198.50
5503054 PLATE 3.5 LC‐DCP 5 HOLE $337.99
5503055 PLATE 3.5 LC‐DCP 6 HOLE $343.36
5503056 PLATE 3.5 LC‐DCP 7 HOLE $391.64
5503057 PLATE 3.5 LC‐DCP 8 HOLE $394.86
5503058 PLATE 3.5 RECON 6 HOLE $285.42
5503059 PLATE 4.5 BROAD DCP 12 HOLE $335.85
5503060 PLATE 4.5 BROAD DCP 14 HOLE $335.85
5503061 PLATE 4.5 BROAD DCP 6 HOLE $335.85
5503062 PLATE 4.5 BROAD DCP 7 HOLE $335.85
5503063 PLATE 4.5 BROAD DCP 8 HOLE $335.85
5503064 PLATE 4.5 BROAD DCP 10 HOLE $335.85
5503065 PLATE 4.5 NARROW DCP 10 HOLE $314.39
5503066 PLATE 4.5 NARROW DCP 12 HOLE $314.39
5503067 PLATE 4.5 NARROW DCP 4 HOLE $253.23
5503068 PLATE 4.5 NARROW DCP 5 HOLE $253.23
5503069 PLATE 4.5 NARROW DCP 6 HOLE $409.88
5503070 PLATE 4.5 NARROW DCP 7 HOLE $286.49
5503071 PLATE 4.5 NARROW DCP 8 HOLE $286.49
5503072 PLATE 4.5 NARROW DCP 9 HOLE $286.49
5503073 PLATE SM T RT ANGLE 3/3 HOLE $212.45
5503074 PLATE SM T OBLIQUE 3/3 HOLE $305.80
5503075 PLATE SM T OBLIQUE 3/4 HOLE $325.12
5503076 PLATE SM T RT ANGLE 3/5 HOLE $244.64
5503077 PLATE SM T OBLIQUE 3/5 HOLE $335.85
5503078 PLATE L‐BUTTRESS LT 4 HOLE $401.30
5503079 PLATE L‐BUTTRESS RT 4 HOLE $401.30
5503080 PLATE T BUTTRESS 4 HOLE $334.77
5503081 PLATE CALCANEAL 60MM $457.09
5503082 PLATE CALCANEAL Y $466.75
5503083 PLATE CLOVER LEAF 4 HOLE $371.26
5503084 PLATE 1/3 TUBULAR 7 HOLE $206.01
5503085 PLATE SEMI‐TUBULAR 4 HOLE $134.12
5503086 PLATE SEMI‐TUBULAR 5 HOLE $139.49
5503087 PLATE SEMI‐TUBULAR 6 HOLE $159.88
5503088 PLATE SEMI‐TUBULAR 7 HOLE $257.52
5503101 PLATE SPOON 5 HOLE $339.07
5503105 PLATE T 4 HOLES $378.77
5503106 PLATE T 6 HOLE $351.94
5503107 PLATE T 8 HOLE $370.18
5503108 PLATE LATERAL TIB BUTTRESS LT 5HOLE $500.01
5503109 PLATE LATERAL TIB BUTTRESS LT 7 HOLE $474.26
5503110 PLATE LATERAL TIB BUTTRESS LT 9HOLE $507.53
5503111 PLATE LATERAL TIB BUTTRESS RT 5 HOLE $500.01
5503112 PLATE LATERAL TIB BUTTRESS RT 7 HOLE $474.26
5503113 PLATE LATERAL TIB BUTTRESS RT 9 HOLE $507.53
5503114 PLATE TITAN LAT TIB HEAD BUT RT 13HOLE $603.02
5503115 TUB SALEM SUMP SILICONE 16F $401.30
5503118 CEMENT RESTRICTOR 24D $341.21
5503119 CEMENT RESTRICTOR 18.5D $325.12
5503124 PORT POWER 8F $415.91
5503125 PORT POWER DUAL 9.5F $462.46
5503176 PROBE 21G INF CANN VITRECT $337.99
5503179 PROBE DART MRASURE $169.53
5503183 HEAD 26MM C‐TAPER +10 $561.17
5503184 PROS HD TPR 26X16 $436.71
5503185 OMNI HFX #10 132 $578.34
5503186 HEAD 26MM C‐TAPER +5 $502.16
5503187 PROS HD UH1 41 OSTEO $948.52
5503188 PROS HD UH1 42 OSTEO $1,036.51
5503189 PROS HD UH1 43 OSTEO $948.52
5503190 PROS HD UH1 44 OSTEO $1,198.53
5503191 PROS HD UH1 45 OSTEO $948.52
5503192 PROS HD UH1 46 OSTEO $736.07
5503193 PROS HD UH1 47 OSTEO $811.18
5503194 PROS HD UH1 48 OSTEO $1,130.93
5503195 PROS HD UH1 49 OSTEO $788.65
5503196 PROS HD UH1 50 OSTEO $1,679.23
5503197 PROS HD UH1 51 OSTEO $811.18
5503198 PROS HD UH1 52 OSTEO $1,198.53
5503199 PROS HD UH1 53 OSTEO $919.55
5503200 PROS HD UH1 54 OSTEO $1,679.23
5503201 PROS HD UH1 55 OSTEO $1,679.23
5503202 PROS HD UH1 56 OSTEO $1,679.23
5503203 PROS HD UH1 58 OSTEO $1,679.23
5503204 PROS HD UH1 61 OSTEO $1,036.51
5503205 OMNI HFX 11 132 $1,404.55
5503206 HEAD 26MM C‐TAPER +0 $583.71
5503207 UNI 11MM DIS CEM SP $351.94
5503208 UNI 8MM DIS CEM SP $296.15
5503209 UNI 9MM DIS CEM SP $362.67
5503210 UNI 10MM DIS CEM SP $375.55
5503211 UNI 12MM DIS CEM SP $296.15
5503212 UNI 13MM DIS CEM SP $351.94
5503213 UNI 14MM DIS CEM SP $209.23
5503214 UNI 15MM DIS CEM SP $154.51
5503215 UNI 16MM DIS CEM SP $375.55
5503216 OMNI HFX 5 132 $1,404.55
5503217 OMNI HFX 6 132 $1,814.43
5503218 OMNI HFX 7 132 $1,391.67
5503219 OMNI HFX 8 132 $1,814.43
5503220 OMNI HFX 9 132 $1,351.97
5503225 REMOVER TICKED OFF $18.27
5503226 RETRACT PRO WOUND SM 2.5X6 INC $167.39
5503227 RETRACT PRO WOUND MED 5X9 INC $167.65
5503228 RETRACT C SECTION 9X14 LG $235.36
5503229 RELD SELECTABLE 75 $223.54
5503230 RASP LG TEAR CROSS CUT $275.13
5503231 RASP SM TEAR CROSS CUT $275.13
5503232 RASP LG COTTLE $332.63
5503234 ROD GUIDE W SMOOTH TIP 3.0 $425.98
5503235 ROD REAMING 3.0MM 950MM $347.13
5503237 RING DILATR IRIS MALYUGIN 7.00MM $357.88
5503239 RING CAPS EYEJET TYPE 14AR $427.05
5503240 RING CAPS EYEJET TYPE 14CR $427.05
5503243 RELD STAPL TR45W $274.05
5503244 RELD STAPL VAS TR352 $304.73
5503245 RELD STAPL OTR 35B $298.29
5503250 RESUSCIT AMBU ADULT $47.29
5503251 RESUSCIT AMBU INFANT $42.99
5503252 RESUSCIT DISP NEONATE $45.07
5503253 RESUSCIT AMBU PEDI $58.03
5503254 RESUSCIT MASK ADULT $23.61
5503256 DEVICE TWISTER PLUS $274.05
5503257 CERVICAL RIPENING BALLOON W/STYLET $163.36
5503259 RETRV PED FORGN BODY $295.55
5503262 RESERVOIR CONSTAVAC $304.73
5503263 RETRV SUTURE $103.01
5503264 SCALPEL DISP 11 $2.15
5503265 SCALPEL DISP 15 $2.15
5503266 DILATOR URET 6F 18F 60CM $328.86
5503267 SYS W TRACT FORCE INDI KIWI $107.47
5503268 SYS PROCUP KIWI $94.42
5503269 SYS GELPORT LAPAROSCOP 120MM $648.09
5503304 NEEDLE MAYO HALF CIRC 2D $17.17
5503381 SCREW LP CORTICAL 2.3X10MM $209.23
5503382 SCR AR CORT 2.3X11 $177.04
5503383 SCREW LP CORTICAL 2.3X12MM $209.23
5503384 SCREW LP CORTICAL 2.3X13MM $177.04
5503385 SCREW LP CORTICAL 2.3X14MM $209.23
5503386 SCREW CORTICAL 2.3X15MM $177.04
5503387 SCREW LP CORTICAL 2.3X16MM $209.23
5503388 SCREW LP CORTICAL 2.3X17MM $177.04
5503389 SCR AR CORT 2.3X18 $209.23
5503390 SCREW LP CORTICAL 2.3X19MM $209.23
5503391 SCREW LP CORTICAL 2.3X20MM $209.23
5503392 SCREW LP CORTICAL 2.3X21MM $209.23
5503393 SCREW LP CORTICAL 2.3X22MM $209.23
5503394 SCREW LP CORTICAL 2.3X23MM $209.23
5503395 SCREW LP CORTICAL 2.3X24MM $177.04
5503396 SCREW LP CORTICAL 2.3X25MM $177.04
5503397 SCREW LP CORTICAL 2.3X26MM $177.04
5503398 SCREW LP CORTICAL 2.3X27MM $177.04
5503399 SCR AR CORT 2.3X28 $177.04
5503400 SCREW LP CORTICAL 2.3X29MM $177.04
5503401 SCREW LP CORTICAL 2.3X30MM $177.04
5503402 SCREW 4.0 ASNIS CANN 70MM $302.58
5503403 SCREW 4.0 ASNIS CANN 65MM $314.39
5503404 SCREW 4.0 ASNIS CANN 60MM $302.58
5503405 SCREW 4.0 ASNIS CANN 55MM $379.84
5503406 SCREW 4.0 ASNIS CANN 50MM $391.19
5503407 SCREW 4.0 ASNIS CANN 48MM $302.58
5503408 SCREW 4.0 ASNIS CANN 46MM $360.53
5503409 SCREW 4.0 ASNIS CANN 44MM $379.84
5503410 SCREW 4.0 ASNIS CANN 42MM $314.39
5503411 SCREW 4.0 ASNIS CANN 40MM $302.58
5503412 SCREW 4.0 ASNIS CANN 18MM $302.58
5503413 SCREW 4.0 ASNIS CANN 16MM $302.58
5503414 SCREW 4.0 ASNIS CANN 14MM $302.58
5503422 SCREW 2.7 CORT 10MM $63.31
5503423 SCREW 2.7 CORT 12MM $41.85
5503424 SCREW 2.7 CORT 14MM $41.85
5503425 SCREW 2.7 CORT 16MM $61.16
5503426 SCREW 2.7 CORT 18MM $41.85
5503427 SCREW 2.7 CORT 20MM $41.85
5503428 SCREW 2.7 CORT 22MM $41.85
5503429 SCREW 2.7 CORT 24MM $41.85
5503430 SCREW 2.7 CORT 6MM $41.85
5503431 SCREW 2.7 CORT 8MM $63.31
5503432 SCREW 3.5 CORTEX SELF‐TAP 34MM $74.15
5503433 SCREW 3.5 CORTEX SELF‐TAP 36MM $74.15
5503434 SCREW 3.5 CORTEX SELF‐TAP 38MM $74.15
5503435 SCREW 3.5 CORTEX SELF‐TAP 40MM $91.20
5503437 SCREW 3.5 CORTEX SELF‐TAP 50MM $74.15
5503438 SCREW 3.5 CORTEX SELF‐TAP 16MM $74.04
5503439 SCREW 3.5 CORTEX SELF‐TAP 18MM $74.04
5503440 SCREW 3.5 SHAFT 16MM $92.28
5503441 SCREW 3.5 SHAFT 18MM $81.55
5503443 SCREW 4.0 CANC FULL THR 10MM $39.70
5503444 SCREW 4.0 CANC FULL THR 12MM $60.09
5503445 SCR 4.0 CANC FULL THR 14MM $86.91
5503446 SCREW 4.0 CANC FULL THR 16MM $86.91
5503447 SCR 4.0 CANC FULL THR 18MM $86.91
5503448 SCREW 4.0 CANC FULL THR 20MM $70.82
5503449 SCREW 4.0 CANC FULL THR 22MM $74.04
5503450 SCREW 4.0 CANC FULL THR 24MM $54.72
5503451 SCREW 4.0 CANC FULL THR 26MM $39.70
5503452 SCREW 4.0 CANC FULL THR 28MM $34.34
5503454 SCREW 4.0 CANC FULL THR 40MM $24.68
5503455 SCREW 4.0 CANC PART THR 10MM $39.70
5503456 SCREW 4.0 CANC PART THR 12MM $39.70
5503457 SCREW 4.0 CANC PART THR 14MM $39.70
5503458 SCREW 4.0 CANC PART THR 16MM $39.70
5503459 SCREW 4.0 CANC PART THR 18MM $39.70
5503460 SCREW 4.0 CANC PART THR 20MM $39.70
5503461 SCREW 4.0 CANC PART THR 22MM $39.70
5503462 SCREW 4.0 CANC PART THR 24MM $39.70
5503463 SCREW 4.0 CANC PART THR 26MM $74.04
5503464 SCREW 4.0 CANC PART THR 28MM $39.70
5503465 SCREW 4.0 CANC PART THR 30MM $74.04
5503466 SCREW 4.0 CANC PART THR 35MM $74.04
5503467 SCREW 4.0 CANC PART THR 40MM $74.04
5503468 SCREW 4.0 CANC PART THR 50MM $74.04
5503470 SCREW 4.0 ASNIS CANN 20MM $302.58
5503471 SCREW 4.0 ASNIS CANN 22MM $302.58
5503472 SCREW 4.0 ASNIS CANN 24MM $302.58
5503473 SCREW 4.0 ASNIS CANN 26MM $302.58
5503474 SCREW 4.0 ASNIS CANN 28MM $303.07
5503475 SCREW 4.0 ASNIS CANN 30MM $416.99
5503476 SCREW 4.0 ASNIS CANN 32MM $302.58
5503477 SCREW 4.0 ASNIS CANN 34MM $302.58
5503478 SCREW 4.0 ASNIS CANN 36MM $416.99
5503479 SCREW 4.0 ASNIS CANN 38MM $302.58
5503480 SCREW 4.5 CANC PART THR 45MM $74.04
5503481 SCREW 4.5 CORTEX 38MM $273.61
5503482 SCREW 4.5 CORTEX 14MM $40.77
5503483 SCREW 4.5 CORTEX 16MM $40.77
5503484 SCREW 4.5 CORTEX 18MM $40.77
5503485 SCREW 4.5 CORTEX 20MM $37.55
5503486 SCREW 4.5 CORTEX 22MM $40.77
5503487 SCREW 4.5 CORTEX 24MM $40.77
5503488 SCREW 4.5 CORTEX 26MM $40.77
5503489 SCREW 4.5 CORTEX 28MM $40.77
5503490 SCREW 4.5 CORTEX 30MM $40.77
5503491 SCREW 4.5 CORTEX 32MM $40.77
5503492 SCREW 4.5 CORTEX 34MM $40.77
5503493 SCREW 4.5 CORTEX 36MM $40.77
5503494 SCREW 4.5 CORTEX 40MM $40.77
5503495 SCREW 4.5 CORTEX 42MM $40.77
5503496 SCREW 4.5 CORTEX 44MM $40.77
5503497 SCREW 4.5 CORTEX 46MM $38.63
5503498 SCREW 4.5 CORTEX 48MM $40.77
5503499 SCREW 4.5 CORTEX 50MM C1713 $40.77
5503500 SCREW 4.5 CORTEX 52MM $40.77
5503501 SCREW 4.5 CORTEX 54MM $40.77
5503502 SCREW 4.5 CORTEX 56MM $40.77
5503503 SCREW 4.5 CORTEX 58MM $40.77
5503504 SCREW 4.5 CORTEX 60MM $52.58
5503505 SCREW 4.5 CORTEX 64MM $40.77
5503506 SCREW 4.5 CORTEX 70MM $40.77
5503521 SCR 4.5 CORT ST 54MM $75.11
5503522 SCREW 4.5 MALLEOLAR 25MM $74.04
5503523 SCREW 4.5 MALLEOLAR 30MM $74.04
5503524 SCREW 4.5 MALLEOLAR 35MM $74.04
5503525 SCREW 4.5 MALLEOLAR 40MM $74.04
5503526 SCREW 4.5 MALLEOLAR 45MM $108.37
5503527 SCREW 4.5 MALLEOLAR 50MM $74.04
5503528 SCREW 4.5 MALLEOLAR 55MM $74.04
5503529 SCREW 4.5 MALLEOLAR 60MM $74.04
5503530 SCREW 4.5 MALLEOLAR 65MM $74.04
5503531 SCREW 4.5 MALLEOLAR 70MM $84.77
5503532 SCREW 3.0 CANN SHORT 8MM $383.06
5503533 SCREW 3.0 CANN SHORT 9MM $383.06
5503534 SCREW 3.0 CANN SHORT 10MM $383.06
5503535 SCREW 3.0 CANN SHORT 11MM $383.06
5503536 SCREW 3.0 CANN SHORT 12MM C1713 $409.88
5503537 SCREW 3.0 CANN SHORT 13MM $383.06
5503538 SCREW 3.0 CANN SHORT 14MM $409.88
5503539 SCREW 3.0 CANN SHORT 15MM $383.06
5503540 SCREW 3.0 CANN SHORT 16MM C1713 $409.88
5503541 SCREW 3.0 CANN SHORT 17MM $383.06
5503542 SCREW 3.0 CANN SHORT 18MM C1713 $409.88
5503543 SCREW 3.0 CANN SHORT 19MM $383.06
5503544 SCREW 6.5 ASNIS CANN 100MM $356.23
5503545 SCREW 6.5 ASNIS CANN 105MM $421.69
5503546 SCREW 6.5 ASNIS CANN 110MM $378.77
5503547 SCREW 6.5 ASNIS CANN 115MM $459.24
5503548 SCREW 6.5 ASNIS CANN 50MM $450.66
5503549 SCREW 6.5 ASNIS CANN 55MM $459.24
5503550 SCREW 6.5 ASNIS CANN 60MM $332.63
5503551 SCREW 6.5 ASNIS CANN 65MM $332.63
5503552 SCREW 6.5 ASNIS CANN 70MM $327.26
5503553 SCREW 6.5 ASNIS CANN 75MM $325.12
5503554 SCREW 6.5 ASNIS CANN 80MM $442.07
5503555 SCREW 6.5 ASNIS CANN 85MM $459.24
5503556 SCREW 6.5 ASNIS CANN 90MM $459.24
5503557 SCREW 6.5 ASNIS CANN 95MM $421.69
5503558 SCREW 6.5 CANC 16 THR 100MM $86.91
5503559 SCREW 6.5 CANC 16 THR 105MM $86.91
5503560 SCREW 6.5 CANC 16 THR 110MM $86.91
5503561 SCREW 6.5 CANC 16 THR 30MM $78.33
5503562 SCREW 6.5 CANC 16THR 35MM $78.33
5503563 SCR 6.5 CAN 216 40MM $140.56
5503564 SCREW 6.5 CANC 16 THR 50MM $78.33
5503565 SCR 6.5 CAN 216 55MM $78.33
5503566 SCREW 6.5 CANC 16 THR 60MM $78.33
5503567 SCREW 6.5 CANC 16 THR 65MM $78.33
5503568 SCREW 6.5 CANC 16 THR 70MM $78.33
5503569 SCREW 6.5 CANC 16 THR 75MM $78.33
5503570 SCREW 6.5 CANC 16 THR 80MM $78.33
5503571 SCREW 6.5 CANC 16 THR 85MM $86.91
5503572 SCREW 6.5 CANC 16 THR 90MM $91.20
5503573 SCREW 6.5 CANC 16 THR 95MM $86.91
5503574 SCREW 6.5 CANC 32 THR 100MM $86.91
5503575 SCREW 6.5 CANC 32 THR 110MM $86.91
5503576 SCREW 6.5 CANC 32 THR 45MM $78.33
5503577 SCREW 6.5 CANC 32 THR 50MM $78.33
5503578 SCREW 6.5 CANC 32 THR 55MM $78.33
5503579 SCREW 6.5 CANC 32 THR 60MM $78.33
5503580 SCREW 6.5 CANC 32 THR 65MM $78.33
5503581 SCREW 6.5 CANC 32 THR 70MM $57.94
5503582 SCREW 6.5 CANC 32 THR 75MM $78.33
5503583 SCREW 6.5 CANC 32 THR 85MM $86.91
5503584 SCREW 6.5 CANC 32 THR 90MM $86.91
5503585 SCREW 6.5 CANC 32 THR 95MM $86.91
5503586 SCREW 6.5 CANC 32 THR 80MM $78.33
5503587 SCREW 6.5 CANC FULL THR 25MM $78.33
5503588 SCREW 6.5 CANC FULL THR 30MM $78.33
5503589 SCREW 6.5 CANC FULL THR 35MM $78.33
5503590 SCREW 6.5 CANC FULL THR 40MM $78.33
5503592 SCR CORK 3.5 SYSTEM $418.47
5503608 SCREW 6.5 ASNIS CANN 40MM $332.63
5503609 SCREW 6.5 ASNIS CANN 45MM $459.24
5503610 SCREW 6.5 ASNIS CANN 120MM $332.63
5503613 SENSR OXI NEONATE $26.87
5503617 SCREW 3.0 CANN SHORT 20MM $333.70
5503618 SCREW 3.0 CANN SHORT 21MM $383.06
5503619 SCREW 3.0 CANN SHORT 22MM $383.06
5503620 SCREW 3.0 CANN SHORT 23MM $383.06
5503621 SCREW 3.0 CANN SHORT 24MM $333.70
5503622 SCREW 3.0 CANN SHORT 25MM $387.35
5503623 SCREW 3.0 CANN SHORT 26MM $345.50
5503624 SCREW 3.0 CANN SHORT 27MM $374.47
5503625 SCREW 3.0 CANN SHORT 28MM $356.23
5503626 SCREW 3.0 CANN SHORT 29MM $409.88
5503627 SCREW 3.0 CANN SHORT 30MM $409.88
5503628 SCREW 3.0 CANN SHORT 32MM $387.35
5503629 SCREW 3.0 CANN SHORT 34MM $374.47
5503630 SCREW 3.0 CANN SHORT 36MM $374.47
5503631 SCREW 3.0 CANN SHORT 38MM $387.35
5503632 SCREW 3.0 CANN SHORT 40MM $387.35
5503633 SET DRESSG $52.66
5503635 SET ANES MICRBORE $9.67
5503638 SET INFUS NEEDL 19G 1 $25.79
5503639 SET INFUS NEEDL 20G 1 $25.79
5503640 SET INFUS NEEDL 20G .75 $25.79
5503642 SET PUMP FEEDING $9.66
5503644 SET CATH NEPH $257.52
5503646 SCREW 3.0 CANN LONG 40MM $366.96
5503647 SET INFUS NEEDL 20G 1.5 $25.79
5503650 PEDI LAPAROTOMY DRAPE II $15.05
5503651 1/2 X 1/2 NEURO SPONGE $21.49
5503653 ANOSCOPE DISP 19MMX10CM $8.60
5503654 SLING M CRADLE $8.60
5503658 SLEEVE SCD L $119.29
5503659 SLEEVE SCD M $85.84
5503660 SLEEVE SCD CALF $100.86
5503665 SLING L CRADLE $8.60
5503666 SLING L SHLDR ADULT $18.27
5503667 SLING XL CRADLE A4565 $8.60
5503668 SLING M SHLDR ADUL $18.27
5503669 SLING S CRADLE $8.60
5503670 SLING S SHLDR ADUL $18.27
5503671 SLING XL SHDLR ADUL $18.24
5503672 SLING ULTRA S $180.26
5503673 SLING ULTRA M $164.43
5503674 SLING ULTRA L $164.43
5503676 SNARE 13MM ROTATABLE $67.71
5503677 SNARE 20MM ROTATABLE $67.71
5503679 SNARE PED PROFILE $73.08
5503680 SUT VIC 4‐0 CTD J422H $7.51
5503681 CUTIMED SILTEC SORBACT 3X3 $29.02
5503684 SOL AQUAPK 760ML $9.67
5503685 SOL AQUAPK HUM 340 ML $4.30
5503689 BALLOON DISSECTION $514.79
5503691 SPLINT FINGER LARGE $5.37
5503692 SPIROMETER VOLDYNE $7.52
5503696 STENT 5F 22 32CM $172.75
5503697 SPLIN CLAV L $25.75
5503698 SPLIN CLAV MED $19.31
5503699 SPLIN CLAV XS $22.53
5503700 SPLIN CLAV XL $30.04
5503702 SPLIN FING 4 PRG L $3.22
5503703 SPLIN FING 4 PRG M $3.22
5503704 SPLIN FING 4 PRG S $3.22
5503705 SPLINT FINGER MEDIUM $5.37
5503706 SPLINT FINGER SMALL $5.37
5503707 SPLIN LT FORARM WRST $19.34
5503711 SPLIN RT FORARM WRST $19.34
5503715 SPLIN FING STRIP 1/2X18 $3.22
5503716 SPLIN FING STRIP 3/4X18 $3.22
5503717 SPLIN FING STRIP 3X16 $25.75
5503718 SPLIN FING STRIP 1X18 $3.22
5503719 SPONG 4X4 RAYTEC $2.15
5503720 SPONG LAP 18X18 $5.37
5503721 SPONG PEANUT KITNR $3.22
5503722 SPONG RL KERLIX 4 $2.15
5503724 SPONG WECK SPEAR EYE $10.75
5503725 SCREW 3.0 CANN LONG 14MM $356.23
5503726 SCREW 3.0 CANN LONG 15MM $383.06
5503727 SCREW 3.0 CANN LONG 16MM $356.23
5503728 SPRAY DERMAGRAM $17.20
5503729 SCREW 3.0 CANN LONG 17MM $398.72
5503730 SCREW 3.0 CANN LONG 18MM $336.92
5503731 SCREW 3.0 CANN LONG 19MM $336.92
5503732 SCREW 3.0 CANN LONG 20MM $383.06
5503733 SCREW 3.0 CANN LONG 21MM $398.72
5503734 SCREW 3.0 CANN LONG 22MM $366.96
5503735 SCREW 3.0 CANN LONG 23MM $398.72
5503736 SCREW 3.0 CANN LONG 24MM $398.72
5503737 SCREW 3.0 CANN LONG 25MM $398.72
5503738 SCREW 3.0 CANN LONG 26MM $398.72
5503739 SCREW 3.0 CANN LONG 27MM $398.72
5503740 SCREW 3.0 CANN LONG 28MM $378.77
5503741 SCREW 3.0 CANN LONG 29MM $345.50
5503742 SCREW 3.0 CANN LONG 30MM $374.47
5503743 SCREW 3.0 CANN LONG 32MM $387.35
5503744 SCREW 3.0 CANN LONG 34MM $383.06
5503745 SCREW 3.0 CANN LONG 36MM $387.35
5503746 SCREW 3.0 CANN LONG 38MM $383.06
5503756 STAPL FIX XS 6.4MM $311.17
5503757 STAPLR 45 ENDO ARTIC $404.09
5503758 STAPLR ACCESS CS40G $444.22
5503759 STAPLR ARTIC ATW35 $351.94
5503760 STAPLR CVD ILS 25MM $429.20
5503761 STAPLR CVD ILS 29MM $326.71
5503762 STAPLR CVD ILS 33MM $384.13
5503765 STAPLR LINEAR 90MM $272.98
5503767 STAPLR SKIN 35W $33.32
5503772 * STENT URET 7F $407.74
5503773 STENT LUBRIFLX 6X26 $375.55
5503774 STENT LUBRIFLX 6X28 $375.55
5503775 STENT MULTIFLX 6X24 $375.55
5503776 STENT MULTIFLX 6X26 $375.55
5503777 STENT PERCUFLX 6F 26CM $356.23
5503778 STONEBRE CO2 CARTRIDGE $53.65
5503779 STENT URET 6F $407.74
5503780 STETHOSCP SONATEMP 12 $8.60
5503782 STETHOSCP SONATEMP 18 $5.37
5503783 CATH URET OPEN END 6F 70CM $38.63
5503785 STOCKNETTE IMPERV $11.82
5503786 STOCKNG KNEE ELAST L $9.67
5503787 STOCKNG KNEE ELAST M $9.67
5503788 STOCKNG KNEE ELAST S $8.60
5503789 STOCKNG KNEE ELAST XL $8.60
5503792 STENT 6F 22 32CM $185.92
5503793 STENT 7F 22 32CM $185.92
5503794 STYLET CATH 4F $98.72
5503796 * STYLET COUNCIL 6F $109.45
5503797 STYLET INTUBATE 14F $7.52
5503798 STYLET INTUBATE 6F $7.52
5503799 STOCKNG THIGH ELAST S $18.24
5503800 STOCKNG THIGH ELAST M $18.27
5503801 STOCKNG THIGH ELAST L $16.12
5503803 SUCT JACKSON PRATT $64.48
5503805 SUCT YANKAUER $1.07
5503806 SYRG GLASS LOR 7ML $31.12
5503807 STOCKNG THIGH ELAST XL $23.61
5503808 STOCKNG THIGH ELAST XXL $35.41
5503809 STAPLR RELOAD ENDO ETS45 $277.28
5503810 STAPLR LIN CUT NLTC75 $174.10
5503811 STYLET INTUBATE 7.5 10 $13.97
5503812 STOCKNETTE IMPERV MED $10.75
5503813 STAPLR ENDOSCOPIC ARTIC 35 $457.09
5503814 SUT VICRYL 2.0 J417H $5.36
5503815 SUT VICRYL 0 CT‐2 $274.69
5503816 SLING JOSLIN $25.75
5503932 SUT VIC 4.0 VCP504G P‐2 UND $25.79
5503933 SUT MONO 0 Y946H CT1 $6.44
5503934 SUT FORCE FIBER 5 38 STD W NEEDLE $103.01
5503935 SUT BOOTIES STD YW $10.73
5503936 SUT MONO 3.0 Y350H $6.44
5503938 SUT PLN GUT 6.0 1916G PC1 $15.02
5503940 SUT PRO 8.0 M8753 BV175‐8 $162.02
5503941 SUT PDS2 4.0 Z494G PS3 $15.02
5503943 SUT ULTRABRAID 2 COBRAID $61.16
5503946 SUT PRO 2.0 8623H $8.58
5503947 SUT RETRIEVER HEWSON $341.76
5503950 SUT VIC 0 J418H UND SH27 $5.36
5503953 SUT ACCU PASS CRESCENT $289.71
5503955 SUT FIBERWIRE 2 T5 $82.75
5503956 SUT VIC 0 JB840 $40.77
5503958 SUT VIC 1 J650G TP 1 $47.21
5503960 SUT SUPRAMID 5.0 MPR50 $12.88
5503961 SUT SUPRAMID 4.0 PR40 $12.88
5503962 SUT SUPRAMID 3.0 PR30 $11.80
5503964 SUT TFCC MENDER SYSTEM $296.15
5503967 SUT ORTHOCORD 2 MO7 $175.18
5503971 SUT ETHBD 1.0 X425H CT1 $19.31
5503972 SUT ETHBD 2.0 X519H OS4 $7.52
5503973 SUT VIC 3.0 J936H PS1 $15.05
5503974 SUT VIC 2.0 J917H V34 $8.60
5503975 SUT VIC 0 J260H CT1 $5.37
5503977 SUT PRO 1.0 8824G TP1 $12.90
5503978 SUT PDS2 3.0 Z442H FS1 $11.80
5503980 SUT ETHLN 3.0 1669H PS2 $10.75
5503981 SUT ETHLN 3.0 1673H FSLX $6.44
5503984 SUT VIC 4.0 VR496 RAPIDE PS2 $60.09
5503987 SUT PDS2 4.0 Z441H FS1 $11.82
5503988 SUT PDS2 4.0 Z496G PS2 $17.17
5503989 SUT VIC 0 J603H $6.45
5503990 SUT VIC 1.0 J695H OS4 $8.60
5503993 SUT FORCE FIBER 2 NO NEEDLE 021 $64.38
5503994 SUT MERS 5.0 746G $38.69
5503995 SUT PRO 5.0 8686G $15.05
5503996 SUT SILK 4.0 SA83H $6.45
5503997 SUT VIC 2.0 J785G $36.54
5504000 SUT PDS2 2.0 Z195T CP $9.66
5504001 SUT PLN 0 L104G $10.75
5504004 SUT VIC 3.0 J393 $7.52
5504005 SUT BOLSTER RET $37.55
5504006 SUT CHR GUT 0 CT‐1 924H $9.67
5504007 SUT CHR 0 812H $6.44
5504008 SUT CHR 0 884H $6.44
5504009 SUT CHR 0 L114G $10.75
5504016 SUT CHR 3.0 892H $9.67
5504017 SUT CHR 3.0 G122H $9.67
5504018 SUT CHR 3.0 L112G $6.45
5504021 SUT CHR 4.0 G121H $9.67
5504022 SUT ETHBD 0 CX27D $37.61
5504023 SUT ETHBD 0 X412H $5.37
5504028 SUT ETHBD 3.0 X936H $37.55
5504029 SUT ETHLN 2.0 593H $10.75
5504030 SUT ETHLN 3.0 1663G $11.82
5504032 SUT ETHLN 4.0 699G $10.75
5504033 SUT ETHLN 5.0 661G $5.37
5504034 SUT ETHLN 5.0 698H $9.67
5504035 SUT ETHLN 6.0 697G $10.75
5504036 SUT FORCE FIBER 2 W NEEDLE 020 $98.72
5504043 SUT MERS 4.0 1778G S4 $34.34
5504047 SUT NYL 10.0 $121.25
5504049 SUT ETHLN 4.0 1667G $10.75
5504050 SUT NYL 9.0 $103.17
5504055 SUT PDS2 0 Z991G TP1 $17.20
5504057 SUT PDS2 2.0 Z317H SH $7.52
5504058 SUT PDS2 2.0 Z339H $7.51
5504060 SUT CHR 3.0 810H $9.67
5504061 SUT PLN 4.0 1644G $13.95
5504062 SUT PLN 5.0 1626G $12.88
5504064 SUT PLN GUT 5.0 1915 $21.49
5504067 SUT PRO 0 8412H CT2 $8.60
5504068 SUT PRO 0 8434H CT $8.60
5504074 SUT PRO 2.0 8523H SH $17.20
5504076 SUT PRO 3.0 8665G $9.67
5504077 SUT PRO 3.0 8832H $9.66
5504079 SUT PRO 4.0 8682G $16.12
5504080 SUT PRO 4.0 8699G P3 $16.12
5504082 SUT PRO 5.0 8698G P3 $16.09
5504083 SUT PRO 6.0 8697G $17.20
5504087 SUT SILK 2.0 K833H $4.30
5504088 SUT SILK 2.0 SA65H $6.45
5504089 * SUT SILK 2.0 SA85H $6.44
5504090 SUT SILK 3.0 C0135 $16.12
5504091 SUT SILK 3.0 K832H $4.30
5504092 SUT SILK 3.0 SA84H $6.45
5504093 SUT SILK 4.0 735G $12.88
5504094 SUT SILK 4.0 SA63H $6.44
5504101 SUT STEEL 4.0 603G $6.44
5504102 SUT PDS 0 Z358T $8.58
5504104 SUT VIC 0 J207G $6.45
5504105 SUT VIC 0 J334H $5.37
5504106 SUT VIC 0 J358H $5.37
5504107 SUT VIC 0 J752D $36.54
5504108 SUT VIC 1.0 J359H $5.37
5504111 SUT VIC 2.0 J206G $7.52
5504112 SUT VIC 2.0 J306H $5.36
5504113 SUT VIC 2.0 J333H $5.37
5504114 SUT VIC 2.0 J345H $5.37
5504115 SUT VIC 0 J270H CT2 $5.37
5504116 SUT VIC 3.0 J205G $7.52
5504117 SUT VIC 3.0 J316H $5.37
5504118 SUT VIC 0 J329H CT3 $5.36
5504119 SUT VIC 3.0 J338H $5.37
5504120 SUT VIC 3.0 J774D $36.48
5504121 SUT VIC 3.0 J824G $13.97
5504122 SUT VIC 0 EJ10G $121.44
5504123 SUT VIC 3.0 VR416 $6.44
5504125 SUT VIC 4.0 J315H $5.37
5504126 SUT VIC 4.0 J337H $5.36
5504127 SUT VIC 4.0 J434H $6.45
5504128 SUT VIC 4.0 J494G $13.97
5504129 SUT VIC 4.0 J522H $6.45
5504130 SUT VIC 4.0 J823H $13.97
5504131 SUT VIC 4.0 VR494 RAPIDE $18.24
5504132 SUT VIC 5.0 J493G $15.02
5504133 SUT VIC 5.0 J495G $12.90
5504134 SUT VIC 6.0 J492G $13.95
5504135 SUT VIC 6.0 J570G $40.84
5504136 SUT VIC 8.0 J974G $52.66
5504137 SUT VIC 2.0 J602H $6.45
5504139 SUT ACCU PASS LT $289.71
5504140 SUT ACCU PASS RT $289.71
5504141 SUT ACCU PASS 70DEG $289.71
5504142 SUT FIBERWIRE 2.0 BL T13 $82.75
5504143 ANCHOR 5.5 HEALIX BR $585.85
5504146 SUT MONO 4.0 Y426H PS2 $17.20
5504147 SUT VIC 1.0 VCP359H PLUS CT36 $6.44
5504148 SUT VIC 0 J727D $37.61
5504149 SUT MONO 4.0 Y494G P3 $17.20
5504150 SUT VIC 4.0 J496G $12.90
5504152 SUT ETHBD 0 CX21D $34.34
5504153 SUT ETHBD 2.0 X411H $5.37
5504154 SUT VIC 3.0 J332H $5.37
5504155 SUT ETHLN 5.0 1666G $10.75
5504156 SYRG CEMENT $120.18
5504157 SYRG CONT TOP 10CC $2.15
5504158 SYRG ENDO GUN $109.62
5504159 SYRG TOOMY 70CC $13.95
5504160 SYRG TREATMENT COLLAGEN $427.05
5504161 ORTHOVISC J7324 $397.01
5504162 SUT SILK 4.0 K831H $4.29
5504163 SYSTEM URETH INJECT $84.77
5504165 TAMPON NASAL $39.70
5504167 TISSUE MEND 5X6CM $3,363.83
5504168 TIP MINI FLARE 45 0.9 $229.62
5504173 TIP FILFORM 42.5CM 4F SPIRL $108.37
5504174 TIP FILFORM 42.5CMF STR $109.45
5504180 TRACH 6.0MM UNCUF $4.29
5504181 TRACH 5.5MM $9.66
5504182 TRACH 5.0MM $10.73
5504183 TRAP DIGIT SMALL $70.82
5504184 TRACH 2.5MM UNCUF $5.37
5504185 TRACH 3.5MM UNCUF $0.39
5504186 TRACH 4.0MM UNCUF $4.29
5504187 TRACH 4.5MM UNCUF $4.29
5504188 TRACH 5.0MM UNCUF $5.36
5504189 TRACH 5.5MM UNCUF $5.36
5504190 TRACH 6.0MM $6.45
5504191 TRACH 6.5MM $5.37
5504192 TRACH 7.0MM $6.45
5504193 TRACH 7.5MM $6.45
5504194 TRACH 8.0MM $5.37
5504195 TRACH 8.5MM $6.44
5504196 TRACH 9.0MM $9.66
5504197 TRACH 3.0MM UNCUF $4.30
5504198 TRAP FING STER L $93.35
5504199 TRAP FING STER M $93.35
5504200 TRAP SUCT POLY ENDO $15.05
5504201 TRAY ABSORB PIN $357.31
5504202 TRAY EPIDURAL ANES $67.60
5504203 TRAY IRRIG ASEPTO $3.22
5504204 TRAY IRRIG CYSTO $16.12
5504205 TRAY IRRIG PISTON $4.30
5504206 TRAY IRRIG TURY $25.79
5504207 TRAY LUMBR PUNC ADL $39.76
5504208 TRAY LUMBR PUNC PED $30.09
5504209 TRAY NERVE BLOCK W CLORAPREP $64.38
5504210 TRAY THORACET/PARACENT $92.43
5504211 TRAY UROLOG HEYMAN $377.69
5504212 TRAY SPINAL W/BUPI 25 $79.53
5504213 TRAY SUTURE $18.27
5504214 TRAY PREP LG DISP $12.90
5504215 TRAY PREP MED DISP $15.05
5504216 TRAY PREP VAG DISP $18.27
5504217 TAPE UMBILICAL COTTON $4.30
5504219 DIAPHRAM OMNIFLEX 75 $189.92
5504220 FISCHER CONE BIOPSY EXCISOR MED $85.84
5504221 FISCHER CONE BIOPSY EXCISOR LG SHALLOW $85.84
5504226 TROCR 12MM BLUNT TIP SRYG $361.60
5504227 TROCR BLADLESS 5MM 150MM $145.09
5504228 TROCR BLADLESS 12MM 150MM $92.28
5504229 TROCR BLADLESS 8MM $145.93
5504230 TROCR BLADLESS 12MM 100MM $113.92
5504231 TROCR 10MM $120.18
5504232 TROCR BLADLESS 5MM $113.92
5504233 TROCR BT TIP 12MM $63.41
5504234 TROCR CATH 10F $72.96
5504235 TROCR CATH 12F $57.94
5504236 TROCR CATH 16F $69.74
5504237 TROCR CATH 20F $74.04
5504238 TROCR CATH 28F $74.04
5504239 TROCR CATH 32F $74.15
5504240 TROCR CATH 24F $74.15
5504241 TROCR SLEEVE 5MM $44.06
5504243 TUB FEED DOBBHOFF 8F 43 B4081 $37.55
5504244 TUB FEED DOBBHOFF 12F 43 B4081 $30.04
5504245 TUB TRACH NEONAT 3 0 $118.03
5504247 TUB 4 LUMN 18 BLAKEMORE $413.10
5504248 TUB FEEDING 5F $2.15
5504249 TUB FEEDING 8F $38.63
5504250 TUB FEEDING 8F S $2.15
5504251 TUB JEJUN PEG 24 $210.31
5504252 TUBE SET FLOSTEADY ARTHO PUMP $164.43
5504253 TUB NG SALEM SUMP 18F $16.12
5504254 TUB VENT COLLAR $35.41
5504255 TUB NG SALEM SUMP 10F $21.49
5504256 TUB NG SALEM SUMP 12F $16.09
5504257 TUB NG SALEM SUMP 14F $21.49
5504258 TUB NG SALEM SUMP 16F $16.12
5504259 URINE METER $22.57
5504260 TUB TRACH 4 L PRES CUF $182.41
5504261 TUB TRACH 6 L PRES CUF $143.78
5504262 TUB TRACH 8 L PRES CUF $184.55
5504263 TUB TRACH 10 L PRES CUF $174.90
5504264 VALVE LOPEZ FEEDG $6.44
5504265 UNDERPAD KCI DRI FLO LG $40.77
5504267 TUBE MEDULLARY $357.31
5504269 VISCRA RETAINER FISH $80.60
5504271 VISCOADHERENT $172.75
5504273 WAND 3.5MM CONTOUR $339.07
5504274 WAND ARTHR 3MM $330.48
5504275 WAND 3.5MM HOOK $339.07
5504276 90‐S CRUISE WAND $339.61
5504277 * SERFAS ENERGY 2.5MM MICRO $359.45
5504281 WASHER 7.0MM $103.01
5504282 WASHER 13.0MM $72.96
5504283 WASHER THR FOR 3.0MM SCR $333.70
5504284 WASHER 6.5MM FOR 3.0MM SCR C1713 $126.61
5504285 WASHER 10.0MM FOR 4.5 SET $93.35
5504286 BALL JURGAN 0.065‐5/64 $22.57
5504287 WATER STER SUC 4OZ $7.52
5504288 WAX BONE 2.5 GRAMS $16.12
5504289 BALL JURGAN 3/32 $22.57
5504290 BALL JURGAN 0.54‐.062 $26.87
5504291 BALL JURGAN 0.045 $26.87
5504292 WIRE K 028MM 4 $87.05
5504293 WIRE K 035MM 4 $84.90
5504294 WIRE K 035 X 9 $107.30
5504295 WIRE K 035 X 9 THRD $90.13
5504296 WIRE K 045 X 9 $105.15
5504297 WIRE K 045 X 9 THRD $45.07
5504298 WIRE K 045MM 4 C1769 $87.05
5504299 WIRE K 062MM 4 $87.05
5504300 WIRE K 062 X 9 $120.37
5504301 WIRE K 062 X 9 THRD $105.15
5504302 WIREGUIDE 2.8 NON THR $292.93
5504303 WIREGLIDE .018 $42.92
5504304 WIREGLIDE AG 035X150 $131.98
5504305 STONEBRE PROBE 1MM DIA 605MM $395.93
5504306 WIREGLIDE ST 038X150 $180.26
5504307 WIREGUIDE BENTS .035 $52.58
5504308 WIREGUIDE AMPLTZ STF $103.01
5504309 WIREGUIDE CM CATH $19.31
5504310 WIREGUIDE ANG .035 $111.77
5504311 WIREGUIDE STR TIP .035 $169.80
5504312 WRAP ICE KNEE $83.83
5504313 WRAP ICE SHLDER $112.84
5504314 WRAP ICE AKL $111.77
5504315 WRAP COBAN 1 LF NON STRL $2.15
5504316 WRAP COBAN 4 LF STRL $8.60
5504317 WIREGUIDE 4.0 THR ASNIS $272.98
5504318 WIREGUIDE 1.1 THR 150 C1769 $104.08
5504319 WIREGUIDE 1.1 NON THR 150 C1769 $98.87
5504320 WIREGUIDE NITINOL $24.68
5504321 WIREGUIDE 2.8MM THR $160.13
5504322 WIREGUIDE 1.25 THD 150 $121.25
5504323 WIREGUIDE 1.25 NON THD 150 $97.80
5504324 WIREGUIDE 3.2MM 400MM $289.10
5504325 WIRE K 054MM 4 $12.90
5504326 WIREGUIDE 1.6MM GOLD $144.85
5504327 WRAP COBAN 2 LF NON STRL $3.22
5504328 WRAP COBAN 3 LF STRL $6.45
5504329 ACCESS BALLOON PORT 12MM X 70MM $241.81
5504399 LENS IOL STD SN6AD1 $1,067.19
5504400 WRAP COBAN 2 LAYER COMPRESS SYS $40.84
5504403 DRESSG TEGA ALGINATE 4X5 $37.55
5504404 DRESSG TEGA ALGINATE 2X2 $18.24
5504405 DRESSG TEGA ALGINATE 1X12 $31.12
5504408 DRESSG TEGA WOUND FILL 15GM $12.88
5504409 DRESSG TEGA ABSORB 3X3.75 $8.58
5504411 DRESSG TEGA AG MESH 2X2 $12.88
5504412 DRESSG TEGA FOAM 4X4.5 $18.24
5504414 DRESSG SILVEASORB PERF 4.25X4.25 $37.55
5504416 DRESSG BURN ACTICOAT 0.75X12 $33.26
5504417 DRESSG HYDROCOLLIOD 3.5X5.5 $11.80
5504418 DRESSG AQUACEL AG SURG 3.5X10 $107.47
5504419 DRESSG TEGA PAD 3.5X8 $6.44
5504420 DRESSG TEGA ALGI ROPE 12IN $16.09
5504421 WRAP COBAN 6 LF NON STRL $8.58
5504422 MESH VICRYL KNITTED 12X12 $809.04
5504423 RETRACT CAPSULE MST $295.07
5504424 KIT 2.9 PUSHLCK DISP $375.55
5504425 MARK BIO SITE SUPERFICIAL $241.42
5504426 MARK BIO SITE STANDARD $195.60
5504427 DEVICE BIO STEREO STD $420.21
5504428 DEVICE BIO STEREO PETITE $417.39
5504429 KIT BIOPSY BREAST $73.08
5504430 SYS DRAPE MULTICARE $72.96
5504431 NEEDLE BONE BIO COAXIAL 13GX10CM $282.20
5504432 NEEDLE CATH YEUH CENTISIS $63.31
5504433 CATH DRAIN 8F MULTI $252.15
5504434 KIT FLOSEAL HEMO MATRIX 10ML $413.76
5504435 CATH DRAIN 10F MULTI $252.15
5504436 CATH DRAIN 12F MULTI $252.15
5504437 CATH FIXATION DEVICE $35.41
5504438 DILATOR STD 6F 15CM $40.77
5504439 DILATOR COONS TAPER 6F 20CM $74.04
5504440 DILATOR STD 8F 15CM $40.77
5504441 DILATOR STD 10F 15CM $40.77
5504442 FILTER TISSUE ATEC $12.90
5504443 GUN BIOPSY 18GX15CM QC $168.46
5504444 GUN BIOPSY 20X15 20T $181.34
5504445 NEEDLE GUIDE 9G EVIVA $32.24
5504446 NEEDLE PERCUT ENTRY THIN 18GX7CM $20.39
5504447 NEEDLE BIO ASP CHIBA 21G $46.14
5504448 NEEDLE BIO ASP CHIBA 22G $51.50
5504449 SET NEFF PERCUT ACCESS $286.49
5504450 WIREGUIDE BENT .035X145CM $62.23
5504451 WIREGUIDE ULTRA STIFF .038X80CM $61.16
5504452 WIREGUIDE CURVED .035X80CM $54.72
5504453 NEEDLE WHITACRE 22G 3 1/2 $18.27
5504454 NEEDLE BIO CORE 16GX15CM $125.54
5504455 SET IRRIG FLUID WARM $148.07
5504456 CATH DEVICE STABIL PICC $16.12
5504457 SET JEJUN FEED $281.12
5504458 KIT INFUS 0.9MM ULTRA INTREPID $145.93
5504459 KNIFE SLIT BEV 2.2 $115.88
5504460 KNIFE SLIT S BEV 2.4 $165.51
5504461 SPLIN FING ALUMAFOAM 3/4X9 $4.29
5504462 CLIP FILSHIE $302.58
5504463 MARK BIO SITE PETITE $241.42
5504464 SYRG ADAPT REPLACEMENT $94.42
5504465 NEEDLE ENDOSCOPIC $112.84
5504466 IMPLANT MACROPLASTIQUE $614.73
5504467 PUNCH BIOPSY 2MM $4.30
5504468 PUNCH BIOPSY 3MM $4.29
5504469 PUNCH BIOPSY 4MM $4.29
5504470 PUNCH BIOPSY 6MM $7.52
5504471 PUNCH BIOPSY 8MM $4.29
5504472 PUNCH BIOPSY 5MM $4.30
5504473 ARROW EPIDURAL KIT $93.50
5504474 SET MICROPUNCTURE $131.11
5504475 DERMABOND PRINEO $222.11
5504480 FORCP CUT HALO 5MM $700.66
5504481 KIT AIRWY ADT PEDI ADAPT $30.09
5504482 KIT AIRWY PEDI INF ADAPT $38.63
5504483 CANN CO2 ADULT GE $52.66
5504484 CANN CO2 PEDIATRIC GE $42.92
5504486 KIT DRAINAGE PLEURX 500ML $221.04
5504487 GUN BIOPSY 20GX9CM QC 10MM $168.46
5504488 CLIP APPLIER LIGAMAX 5MM $342.83
5504489 SYS IMPLANT TRANSTEND HEALIX $638.43
5504490 KIT NEEDLE BONE 13G $193.14
5504491 TIP INTOR NEEDLE 5 13G $168.46
5504492 NEEDLE GHIATAS BIO 20G 7CM MAMMO $79.40
5504493 SYS ENDO CAPSULE $475.34
5504495 WIRE K BLUNT 062MM 4 $26.82
5504496 TENDON ACHILLES $3,329.49
5504497 TENDON PATELLAR 10 10MM $4,055.91
5504498 TENDON PATELLAR 9 10MM $4,055.91
5504499 CLIP MED LG HEMOLOK $103.17
5504500 CLIP LG HEMOLOK $104.25
5504501 COIL ENDORECTAL 1.5T C1770 $295.07
5504502 PROBE FIAPC 7FR 2.3MM $341.21
5504503 PROBE FIAPC CIRCUM OD 6.9 FR 2.3MM $350.36
5504504 NEEDLE INSULATED 22G X 4 3/4 $48.28
5504505 TUB TRACH REINFORCED PK 7.0 M TIP $70.82
5504506 TUB TRACH REINFORCED 8.0 M TIP $70.82
5504507 NEEDLE EPIDURAL 2OGX3 1/2 E2035T $25.75
5504508 NEEDLE PNEUMO 150MM INSUF $56.96
5504509 LOCK TITE SECURE ET TUB $16.09
5504510 CATH HYSTERO BALLON SHOLKOFF $183.48
5504511 SET MICROPUNCHTURE INTRO $119.10
5504512 SET MICROPUNCHTURE INTRO $173.82
5504513 SET MICROPUNCHTURE INTRO $99.79
5504514 NEEDLE BIO CORE 20GX15CM 10 $125.54
5504515 NEEDLE BIO CORE 20GX15CM 20 $125.54
5504516 SET NEEDLE BIOPSY 20X15 10T $168.46
5504517 DRESSG SILVERCEL 2X2 ANTMI $10.73
5504518 CATH DRAIN 8.5 MUELLER $236.06
5504519 CUTTER LOOP STRAIGHT $169.53
5504520 CUTTER LOOP RT ANGLE $169.80
5504521 ROLLER BALL $267.60
5504522 KIT 30 SPLIN FING STAX START $311.17
5504523 SPLIN FING ALUMAFOAM 1/2X9 $4.29
5504525 BANDGE COBAN 1X5 LF COLOR $2.15
5504526 BANDGE COBAN 2X5 LF COLOR $3.22
5504527 FILTER APC MEMBRANE $36.48
5504528 BIOCARTILAGE $1,104.11
5504529 DILATOR URETHRAL MEATAL $105.15
5504530 DRESSING IODOSORB 40G $118.03
5504531 GEL HYPERGEL WOUND .17OZ $6.44
5504532 AIRWY MASK LMA SUP 2.5 $39.70
5504533 SUT ETHLN 2.0 BLK MONO FS 18 $5.36
5504534 NEEDLE CORE BIOPSY SET $168.46
5504535 DRILL BICORTICAL POST $244.64
5504536 DRILL CANCELLOUS 25MM $263.96
5504537 DRILL BICORTICAL BIOPOST $330.48
5504538 ROPE MEDIHONEY 3/4 X 12 $29.02
5504539 TIGHTROPE KNOTLESS TITANIUM $1,684.60
5504540 TIGHTROPE KNOTLESS SS $1,687.29
5504541 STAPLE LIGAMENT SPIKE 6X20 $254.30
5504542 STAPLE LIGAMENT SPIKELESS 6X20 $254.30
5504543 STAPLE LIGAMENT SPIKE 8X20 $254.30
5504544 STAPLE LIGAMENT SPIKE 11X20 $254.30
5504545 STAPLE LIGAMENT SPIKE 16X20 $254.30
5504546 DRILL BIT 2.3MM SM FRAG $241.42
5504547 BIMANUAL ULTRAFLOW $85.84
5504548 BLADE MCGRATH SIZE 3 $60.18
5504549 BLADE MCGRATH SIZE 4 $60.18
5504550 AIRWAY ADAPTER PEDI ADULT $25.75
5504551 VENTRIO ST HERNIA PATCH 13.8CM X 17.8CM $1,213.35
5504552 VENTRIO ST HERNIA PATCH 19.6CM X 24.6CM $1,695.33
5504553 VENTRIO ST HERNIA PATCH 27.4CM X 34.9CM $2,542.99
5504554 CUTIMED SORB HYDRO ACTIVE B $204.94
5504555 SORBION SACHET S 4X8 $283.27
5504556 DRESSG OPTILOCK 4X4 $68.78
5504557 CUTIMED SORBACT RIBBON .8X19.7 $29.02
5504558 SYRINGE PORTEX L.O.R $15.05
5504601 KIT DRESSING BLACK HEEL $175.97
5504998 CAST PADDING 4X4 NON STERILE $2.15
5504999 CAST PADDING 6X4 NON STERILE $3.22
5505000 CAST TAPE LT BLUE 2X4YD $9.66
5505001 CAST TAPE PURPLE 2X4YD $7.51
5505002 CAST TAPE YELLOW 2X4YD $7.51
5505003 CAST TAPE BLUE 2X4YD $7.51
5505004 CAST TAPE RED 2X4YD $7.51
5505005 CAST TAPE BR ORNG 2X4YD $9.66
5505006 CAST TAPE GREEN 2X4YD $7.51
5505007 CAST TAPE BR PINK 2X4YD $7.51
5505008 CAST TAPE BLACK 2X4YD $7.51
5505020 CAST TAPE LT BLUE 3X4YD $9.66
5505021 CAST TAPE PURPLE 3X4YD $9.66
5505022 CAST TAPE YELLOW 3X4YD $9.66
5505023 CAST TAPE BLUE 3X4YD $9.66
5505024 CAST TAPE RED 3X4YD $9.66
5505025 CAST TAPE BR ORNG 3X4YD $9.66
5505026 CAST TAPE GREEN 3X4YD $9.66
5505027 CAST TAPE BR PINK 3X4YD $9.66
5505028 CAST TAPE BLACK 3X4YD $9.66
5505029 GRASPER MINILAP CLUTCH $402.37
5505030 CAST TAPE LT BLUE 4X4YD $16.09
5505031 CAST TAPE PURPLE 4X4YD $11.80
5505032 CAST TAPE YELLOW 4X4YD $11.80
5505033 CAST TAPE BLUE 4X4YD $11.80
5505034 CAST TAPE RED 4X4YD $11.80
5505035 CAST TAPE BR ORNG 4X4YD $16.09
5505036 CAST TAPE GREEN 4X4YD $11.80
5505037 CAST TAPE BR PINK 4X4YD $16.09
5505038 CAST TAPE BLACK 4X4YD $11.80
5505040 CAST TAPE WHITE 5X4YD $15.02
5505041 CAST TAPE BLUE 5X4YD $15.02
5505042 CAST TAPE RED 5X4YD $20.39
5505043 CAST TAPE GREEN 5X4YD $20.39
5505044 CAST TAPE LT BLUE 5X4YD $20.39
5505045 SUT VIC 2‐0 J269H $5.37
5505046 SUT VIC 3‐0 J956H $5.36
5505047 SUT VIC 3‐0 J232H $5.37
5505048 SUT VIC 2‐0 J957H $5.37
5505050 TENSOPLAST 2" $19.31
5505051 TENSOPLAST 3" $31.12
5505052 GLOBO PED HEEL ORTHOSIS SM $257.52
5505053 GLOBO PED HEEL ORTHOSIS MD $257.52
5505054 GLOBO PED HEEL ORTHOSIS LG $257.52
5505055 NEPTUNE E‐SEP SMOKE EVAC PENCIL $185.92
5505056 MEROCEL NASAL PACKING $37.61
5505057 SYS IMPLANT PROXIMAL BICEPS $760.75
5505058 SUT FIBERLOOP $161.21
5505059 SUT FIBERSTICK 2‐0 $142.94
5505060 CATH TRACH IN‐LINE SUCTION 14FR $41.85
5505061 SHOULDER SPEEDBRIDGE $1,963.49
5505062 SONO TAP CANNULA 22GX80MM $51.59
5505063 REAMER 4 MM $418.47
5505064 REAMER 4.5 MM $419.14
5505065 REAMER 5 MM $419.14
5505066 REAMER 5.5 MM $419.14
5505067 REAMER 6 MM $418.47
5505068 REAMER 6.5 MM $418.47
5505069 REAMER 7 MM $418.47
5505070 REAMER 7.5 MM $418.47
5505071 REAMER 8 MM $418.47
5505072 TUB GASTRO 12F LOW VOL $108.37
5505073 KIT TENODESIS DISPOSABLE $419.14
5505074 SCREW TENODESIS 3X8MM $478.55
5505075 SCREW TENODESIS 4X10MM $462.46
5505076 SCREW TENODESIS 4.75X15MM $463.20
5505077 SCREW TENODESIS 5.5X15MM $463.20
5505078 SCREW TENODESIS 6.25X15MM $462.46
5505079 SCREW TENODESIS 7X10MM $462.46
5505080 TORPEDO SHAVER 4.0MMX13CM $271.47
5505081 REELX STT 4.5MM ANCHOR $462.46
5505082 SUT 5.5MM BIOSTEON INTRALINE 2 W/O NEEDL $576.20
5505083 AIRWY MASK LMA CLASSIC 3 $25.79
5505084 AIRWY MASK LMA CLASSIC 4 $25.79
5505085 AIRWY MASK LMA CLASSIC 5 $28.97
5505086 BLADE AGRS SHVER CUTTER 2.5MM $139.71
5505087 THUMB ORTHOSIS XS LEFT $47.21
5505088 THUMB ORTHOSIS XS RIGHT $47.21
5505089 DEVICE TISSUE REMOVAL MYOSURE $1,055.36
5505090 SEAL ROD LENS SCOPE $35.47
5505091 DRILL 7MM ENDOSCOPIC XL $433.49
5505092 IRRIG STRYKERFLOW II W/TIP DISP $185.92
5505093 DEVICE XL TISSUE REMOVAL MYOSURE $1,088.68
5505094 CATH SET FANELLI CHOLANGIOGRAPHY 5FR $217.82
5505095 SET OLSEN ENDO CHOLANGIOGRAPHY 4 FR $242.50
5505096 MESH SOFT 12X12 $354.09
5505097 DRESSG OPTIFOAM 4X4 ADH $11.80
5505450 KIT SYSTEM MIX AND DEL 3CC $405.59
5505451 FUNNEL $105.15
5505452 SEALENT EVICEL FIBRIN 2ML $427.05
5505453 DRESS AQUACEL EXTRA HYDROFIBER 4X5 $13.95
5505454 DRESS MEPILEX FOAM LITE 4X4 $28.97
5505455 BLADE BEAVER MINI 62 $7.51
5505456 CATH KIT INF 5FR $5.37
5505457 SUT CHR GUT 3‐0 882H $9.66
5505458 DRESS BIATAIN 5X5 ADH FOAM $12.88
5505459 DRESS BIATAIN 4X4 ADH FOAM $11.80
5505500 SHOE DARCO M LG $36.54
5505501 SHOE DARCO M M $37.61
5505502 SHOE DARCO M SM $36.54
5505503 SHOE DARCO M XLG $36.54
5505504 NEEDLE WHTACRE 25GX 3 1/2 $17.20
5505508 SHOE DARCO W LG $36.54
5505509 SHOE DARCO W M $36.54
5505510 SHOE DARCO W SM L3260 $37.61
5505511 DRESSG ALLVYN 2X2 $10.73
5505512 SHOE BT CLOSE TOE LG DARCO $48.36
5505513 SHOE BT CLOSE TOE MED DARCO $48.36
5505514 SHOE BT CLOSE TOE SM DARCO $50.43
5505515 KNEE CPM OPTIFLEX $94.42
5505516 RESTRAINT WRIST $16.12
5505517 BOOT UBC W CALAMINE 4 $36.54
5505518 DRESSG COLLAGEN 4X4 W ALGINATE $33.26
5505519 DRESSG PROMOGRAN MATRIX 4.34SQ IN $32.19
5505520 DRESSG FIBRACOL 2X2 PLUS $11.80
5505521 IRRIG WATER 1000ML $8.60
5505522 MIRENA IUD $404.52
5505523 PARAGARD J7300 $910.97
5505524 KNEE CPM OPTIMA $94.42
5505525 GAUZE SACKS W O RING $6.45
5505526 CEMENT AUTOPLEX MIXING SYSTEM $901.31
5505527 ANCHOR ICONIX 1.4 $469.97
5505528 ANCHOR ICONIX 2.3 $469.97
5505529 DRILL ICONIX 2.3 $335.85
5505530 DRILL ICONIX 1.4 $375.55
5505531 WASHER SPIKED 14MM $268.25
5505532 WASHER SPIKED 18MM $268.25
5505533 WASHER SUTURE 14MM $268.25
5505534 WASHER SUTURE 18MM $268.25
5505535 POST BI‐CORTICAL 35MM $268.25
5505536 POST BI‐CORTICAL 37.5MM $268.25
5505537 POST BI‐CORTICAL 40MM $268.25
5505538 POST BI‐CORTICAL 42.5MM $268.25
5505539 POST BI‐CORTICAL 45MM $268.25
5505540 POST BI‐CORTICAL 47.5MM $268.25
5505541 POST BI‐CORTICAL 50MM $268.25
5505542 STAPLE RELOAD PROXIMATE 90MM $318.68
5505543 KIT BONE BIOPSY 13G 5" $193.14
5505544 SET FEED GRAVITY 1000ML $9.66
5505545 DRILL BIT 1.7MM $254.30
5505546 CATH 22F FOLEY $32.19
5505547 TRAY CIRCUMCISION $21.46
5505548 SCREW 2.7 LP LOCKING 10MM $309.02
5505549 SCREW 2.7 LP LOCKING 12MM $309.52
5505550 SCREW 2.7 LP LOCKING 14MM $309.52
5505551 SCREW 2.7 LP LOCKING 16MM $309.52
5505552 SCREW 2.7 LP LOCKING 18MM $309.52
5505553 SCREW 2.7 LP LOCKING 20MM $309.52
5505554 SCREW 2.7 LP LOCKING 22MM $309.02
5505555 SCREW 2.7 LP LOCKING 24MM $309.02
5505556 SCREW 2.7 LP LOCKING 26MM $128.76
5505557 SCREW 3.5 LP LOCKING 10MM $309.02
5505558 SCREW 3.5 LP LOCKING 12MM $309.02
5505559 SCREW 3.5 LP LOCKING 14MM $309.02
5505560 SCREW 3.5 LP LOCKING 16MM $309.52
5505561 SCREW 3.5 LP LOCKING 18MM $309.02
5505562 SCREW 3.5 LP LOCKING 20MM $309.02
5505563 SCREW 3.0 CANC FULL THR 10MM $131.98
5505564 SCREW 3.0 CANC FULL THR 12MM $131.98
5505565 SCREW 3.0 CANC FULL THR 14MM $131.98
5505566 SCREW 3.0 CANC FULL THR 16MM $131.98
5505567 SCREW 3.0 CANC FULL THR 18MM $132.19
5505568 SCREW 3.0 CANC FULL THR 20MM $131.98
5505569 SCREW 3.0 CANC FULL THR 22MM $131.98
5505570 SCREW 3.0 CANC FULL THR 24MM $42.92
5505571 SCREW 3.0 CANC FULL THR 26MM $131.98
5505572 SCREW 3.0 CANC FULL THR 28MM $109.45
5505573 SCREW 3.0 CANC FULL THR 30MM $132.19
5505574 SCREW 3.5 LP TM CORTEX 10MM $131.98
5505575 SCREW 3.5 LP TM CORTEX 12MM $132.19
5505576 SCREW 3.5 LP TM CORTEX 14MM $132.19
5505577 SCREW 3.5 LP TM CORTEX 16MM $132.19
5505578 SCREW 3.5 LP TM CORTEX 18MM $131.98
5505579 SCREW 3.5 LP TM CORTEX 20MM $132.19
5505580 SCREW 3.5 LP TM CORTEX 22MM $132.19
5505581 SCREW 3.5 LP TM CORTEX 24MM $131.98
5505582 SCREW 3.5 LP TM CORTEX 26MM $131.98
5505583 SCREW 3.5 LP TM CORTEX 28MM $131.98
5505584 SCREW 3.5 LP TM CORTEX 30MM $132.19
5505585 SCREW 3.5 LP TM CORTEX 32MM $131.98
5505586 SCREW 3.5 LP TM CORTEX 35MM $132.19
5505587 SCREW 3.5 LP TM CORTEX 40MM $42.92
5505588 SCREW 3.5 LP TM CORTEX 45MM $42.92
5505589 SCREW 3.5 LP TM CORTEX 50MM $131.98
5505590 SCREW 3.5 LP TM CORTEX 55MM $131.98
5505591 SCREW 3.5 LP TM CORTEX 60MM $42.92
5505592 SCREW 4.0 LP CANC 10MM $131.98
5505593 SCREW 4.0 LP CANC 12MM $131.98
5505594 SCREW 4.0 LP CANC 14MM $131.98
5505595 SCREW 4.0 LP CANC 16MM $131.98
5505596 SCREW 4.0 LP CANC 18MM $131.98
5505597 SCREW 4.0 LP CANC 20MM $131.98
5505598 SCREW 4.0 LP CANC 22MM $131.98
5505599 SCREW 4.0 LP CANC 24MM $131.98
5505600 SCREW 4.0 LP CANN SHT THR 30MM $184.55
5505601 SCREW 4.0 LP CANN SHT THR 35MM $354.09
5505602 SCREW 4.0 LP CANN SHT THR 40MM $354.65
5505603 SCREW 4.0 LP CANN SHT THR 45MM $184.55
5505604 SCREW 4.0 LP CANN SHT THR 50MM $184.55
5505605 SCREW 4.0 LP CANN SHT THR 55MM $184.55
5505606 SCREW 4.0 LP CANN SHT THR 60MM $184.55
5505607 SCREW 4.0 LP CANN LONG THR 30MM $354.09
5505608 SCREW 4.0 LP CANN LONG THR 35MM $184.55
5505609 SCREW 4.0 LP CANN LONG THR 40MM $354.09
5505610 SCREW 4.0 LP CANN LONG THR 45MM $184.55
5505611 SCREW 4.0 LP CANN LONG THR 50MM $354.09
5505612 SCREW 4.0 LP CANN LONG THR 55MM $184.55
5505613 SCREW 4.0 LP CANN LONG THR 60MM $354.09
5505614 WASHER 7.0MM ARTHREX $120.18
5505615 PLATE LOCKING DIST FIB RT 4 HOLE $621.18
5505616 PLATE LOCKING DIST FIB RT 5 HOLE $732.85
5505617 PLATE LOCKING DIST FIB RT 6 HOLE $817.85
5505618 PLATE LOCKING DIST FIB RT 8 HOLE $895.95
5505619 PLATE LOCKING DIST FIB LFT 4 HOLE $620.19
5505620 PLATE LOCKING DIST FIB LFT 5 HOLE $732.85
5505621 PLATE LOCKING DIST FIB LFT 6 HOLE $816.55
5505622 PLATE LOCKING DIST FIB LFT 8 HOLE $895.95
5505623 PLATE LOCKING STRAIGHT 4 HOLE $531.13
5505624 PLATE LOCKING STRAIGHT 6 HOLE $561.17
5505625 PLATE LOCKING STRAIGHT 7 HOLE $414.17
5505626 PLATE LOCKING STRAIGHT 8 HOLE $434.56
5505627 PLATE LOCKING STRAIGHT 10 HOLE $469.97
5505628 PLATE LOCKING STRAIGHT 12 HOLE $457.09
5505629 PLATE LOCKING MEDIAL HOOK 3 HOLE $929.21
5505630 PLATE LOCKING MEDIAL HOOK 5 HOLE $477.48
5505631 PLATE LOCKING MEDIAL HOOK 7 HOLE $521.47
5505632 PLATE LOCKING THIRD TUBULAR 4 HOLE $362.67
5505633 PLATE LOCKING THIRD TUBULAR 5 HOLE $378.77
5505634 PLATE LOCKING THIRD TUBULAR 6 HOLE $386.28
5505635 PLATE LOCKING THIRD TUBULAR 7 HOLE $410.96
5505636 PLATE LOCKING THIRD TUBULAR 8 HOLE $348.72
5505637 PLATE LOCKING THIRD TUBULAR 10 HOLE $369.11
5505638 PLATE LOCKING THIRD TUBULAR 12 HOLE $394.86
5505639 PLATE LOCKING LATERAL HOOK 3 HOLE $788.65
5505640 PLATE LOCKING LATERAL HOOK 5 HOLE $460.31
5505641 PLATE LOCKING LATERAL HOOK 7 HOLE $460.31
5505642 SYS IMPLNT ACHILLES 4.75X19.1MM $2,251.52
5505643 ANCHOR SWIVELOCK $472.12
5505644 DRESS AQUACEL FOAM 4X4 $7.51
5505645 INTRDUCER ADULT BOUGIE $27.94
5505646 SUT MONO 2‐0 Y945H $6.44
5505647 BLADE LONG RECIP SHORT $174.90
5505648 DRESSG SENSA SM BLK TRAC $96.72
5505649 CATH 18FR FOLEY $17.17
5505650 CATH SET H/S $108.37
5505651 DRESSG SACRM MEPLX BORD 7X7 $26.87
5505652 NEEDLE 18X5 WEISS FIXED WING $38.69
5505653 K WIRE 1.6MM TROCAR POINT $40.77
5505654 PLATE 3.5 RECON 7 HOLE $538.64
5505655 DRESSG PRISM MATRIX 4.75 SQ" $36.48
5505656 SHEET ADH MEDIHONEY 2.8X2.8 $20.39
5505657 SHEET ADH MEDIHONEY 4.5X4.5 $42.92
5505658 SHEET NON‐ ADH MEDIHONEY 4.3X4.3 $37.55
5505659 DRESSING XTRASORB 2X2 $9.66
5505660 DRESSING XTRASORB 4X4.75 $13.95
5505661 DRESSING ALLDRESS 4X4 $4.30
5505662 DRESSING ALLDRESS 6X6 $7.51
5505663 SHOE BT CLOSE TOE XLG DARCO $42.92
5505664 SHOE WALKWELL M XLG $37.55
5505665 SHOE WALKWELL W SM $37.55
5505666 SHOE PO CLASSIC M XXL $25.75
5505667 NEEDLE SURG 1/2" CIRC 8DG $6.44
5505668 DRESSG RESTORE 4X5 FLEX $30.04
5505669 DRESSG FOAM SM WHT W/DRP $144.85
5505671 DRESSG SIMPLACE MED $144.01
5505672 DRESSG SIMPLACE MED $179.19
5505673 SNAP STRAP MED $41.85
5505674 SNAP CARTRIDGE 125MMHG $309.02
5505675 SNAP DRESS KIT FOAM 15X15 CM $162.02
5505676 DERSSG SENSA TRAC SILVER MED KCI $175.97
5505677 BOOT UBZ COFLEX 2 LAYER $36.48
5505679 EXCELLAGEN ADVANTAGE $675.98
5505680 BOOT MULTI X‐CEL LRG $324.04
5505681 DRILL BIT GRAD LM 2.5 $274.05
5505682 DRILL BIT 3.5MM $254.71
5505683 DRILL BIT 2.5MM $274.05
5505684 DRILL BIT CANN 2.6MM $376.15
5505685 DRILL BIT GRAD 2MM $306.29
5505686 BB‐TAK $161.21
5505687 DRILL BIT 3.0MM $309.52
5505688 HEMOSTAT GELFOAM DENTAL SZ 4 $119.29
5505689 CATH AINTREE INTUBATION $184.55
5505690 INTRDUCER FROVA INTUBATING $312.24
5505691 GUIDEWIRE 1.35MM TROCAR TIP $75.23
5505692 GUIDEWIRE 1.35MM TROCAR TIP TH $75.11
5505693 GUIDEWIRE 1.6 MM TROCAR TIP $56.87
5505694 GUIDEWIRE 2.0 MM TROCAR TIP $37.55
5505695 TECA ELITE 1" RED CON NEEDLE $38.63
5505696 BOOT LARGE $247.86
5505697 BOOT XLARGE $259.66
5505698 CAST SYSTEM 3" 5 SYS $305.80
5505699 CAST SYSTEM 4" $316.53
5505700 CAST SYS 4" W/BOOT $1,214.63
5505701 POUCH SENSURA W/EASICLOSE 3/4X3" $9.66
5505702 BAG OSTOMY SENSURA 5/8X1 3/4 $18.24
5505703 DRESSG MEPILEX 4X8 ADH FOAM $21.46
5505704 DRESSG MEPILEX SAFTAC 8X8 $37.61
5505705 NEEDLE INTRAOSSE 45MM ADULT $367.55
5505706 KIT BMA BONE MARROW ASPIRATION $99.79
5505707 SUT ETHLN 4.0 BLK MONO FS 18 662H $5.36
5505708 BLADE BEAVER MINI 61 $7.51
5505710 DRESSG MELGISORB PLUS 4X4 $24.68
5505711 DRESSG MELGISORB AG 4X4 $23.61
5505712 DRESSG MEPITEL 2X3 $13.97
5505714 DRESS GENTLE BORDER FOAM 3.5X3.5 $20.39
5505715 DERSSG SENSA TRAC SILVER LRG KCI $210.31
5505716 STAPLER REFLEX ONE $33.32
5505717 PESSARY DONUT 3" A4562 $186.70
5505718 PESSARY DONUT 2‐3/4" A4562 $186.70
5505719 PESSARY DONUT 2‐1/2" A4562 $186.70
5505720 PESSARY RING W/SUPPORT 3" A4562 $199.58
5505721 PESSARY RING W/SUPPORT 2‐1/2" A4562 $199.58
5505722 PESSARY RING W/SUPPORT 2‐1/4" A4562 $199.90
5505723 SKYLA 13.5MG $530.06
5505724 PESSARY RING W/SUPPORT 2‐3/4" A4562 $199.58
5505725 DRESSG MEPILEX AG POST OP BOARDER 4X8 $76.18
5505726 BAG OSTOMY CONVEX $18.24
5505727 BLADE MCGRATH SIZE 2 $37.55
5505728 KUMAR CATHETER $126.61
5505729 SENSOR INF O2 18" ADH MASIMO $54.72
5505730 CURETT VAC CVD 11MM $16.09
5505731 CURETT VAC STR 11MM $16.12
5505732 DRESSG FOAM LRG WHT W/DRP $167.39
5505734 SUT TI CRON 3.7 $31.12
5505735 TUB GASTRO 20F ADULT $80.47
5505736 SHOE PRESSURE RELIEF SMALL $259.66
5505737 SHOE PRESSURE RELIEF MED $300.44
5505738 SHOE PRESSURE RELIEF LRG $259.66
5505739 SHOE PRESSURE RELIEF XLRG $259.66
5505740 COLLECT BLADDER EVAC $102.10
5505741 SUT VLOC WOUND CLOSER180 0/0 GR 9 GS‐21 $74.15
5505742 NEEDLE TEMNO BIOPSY 18GX15CM $129.83
5505743 SUT MONO 3.0 MCP523H $31.17
5505744 SUT VIC 1.0 J977 $6.45
5505745 SUT GORE CV2 2N08B $90.13
5505746 SUT MONO 4.0 Y415H $6.44
5505747 DRESSG RESTORE 2X2 FLEX $12.88
5505748 DRESSG HYDROFERA BL 4X4 FOAM $35.41
5505749 DRESSG FOAM ADH 5X5 $21.46
5505750 DRESSG AQUACEL FOAM NON‐ADH 6X8 $21.46
5505751 URI‐DRAIN TUBING AND CONNECTOR $6.44
5505752 TRAY FOLEY 16F DOVER SILICONE $65.45
5505753 CATH FOLEY 5CC 14FR SILICON $54.72
5505754 CATH FOLEY 2WAY 14FR 10CC SILICON $54.72
5505755 CATH FOLEY 2WAY 12FR 5CC BALLOON $134.12
5505756 CATH FOLEY 2WAY 14FR 5CC BALLOON $134.12
5505757 NEEDLE TUOHY 18G 6" $26.82
5505758 ENDO STITCH 10MM $290.17
5505759 V‐LOC RELOAD 2‐0 10MM $240.73
5505760 SYS CLOSURE CARTER THOMASON $58.03
5505761 GUIDE PILOT 15MM CARTER THOMASON $110.70
5505762 ENDOPATH SPATULA 5MMX34CM $246.11
5505763 NEEDLE INJ WILLIAMS CYSTOSCOPIC $103.17
5505764 IV NACL .9% 50ml $5.37
5505765 V‐CARE RETRACTOR SMALL $241.81
5505766 V‐CARE RETRACTOR MEDIUM $241.81
5505767 V‐CARE RETRACTOR LARGE $300.92
5505768 STOMA WAFER NATURA 6X6 W/FLANGE $6.44
5505769 OSTOMY SUR‐FIT NATURA POUCH 14 $2.15
5505770 CAPIO OPEN ACCESS SUT CAP DEVICE $612.58
5505771 CAPIO SUT MONOFILAMENT $131.11
5505772 CAPIO SUT POLYESTER $130.90
5505773 CUFF DISP 15X2.5 STER $134.12
5505774 NOVA STITCH PLUS $589.07
5505775 SUT CUTTER CETERIX $268.25
5505776 SUT 2‐0 CETERIX $160.95
5505777 SET BONOPTY PENETRATION $295.07
5505778 SET BONOPTY BIOPSY $268.25
5505779 NEBULIZER SYS ISO FILTERED $15.02
5505780 PREVENA INCISION MGMT SYS $531.13
5505781 PREVENA DRESS PEEL & PLACE $379.84
5505783 PLATE 3.5 RECON 8 HOLE $560.10
5505784 PLATE 3.5 RECON 9 HOLE $574.05
5505785 PLATE 3.5 RECON 10 HOLE $579.42
5505786 PLATE CALCANEAL 70MM $688.86
5505787 PLATE CLOVERLEAF 3 HOLE $439.93
5505788 PLATE CLOVERLEAF 7 HOLE $610.53
5505789 PLATE CLOVERLEAF 8 HOLE $656.67
5505790 PLATE 3.5 LC‐DCP 9 HOLE $415.25
5505791 PLATE 3.5 LC‐DCP 10 HOLE $421.69
5505792 CATH FOL 22F 5CC 2WY OPEN $19.31
5505793 12MM ACCESS PORT 120MM LENGTH $287.56
5505794 5MM ACCESS PORT 120MM LENGTH $268.68
5505795 TRI LUMEN FILTERED TUBE SET $253.63
5505796 CATH 16FR FOL SILVER IMPREG $31.12
5505797 SUT ETHBD 5.0 MB47 $53.65
5505798 CATH 22FR FOL SILVER IMPREG $31.17
5505799 TVT SLING $961.40
5505801 ARTHREX COOLCUT 45 ABLATOR SM JOINT $309.52
5505802 BAG OSTOMY SENSURA 3/8X3 $13.97
5505803 SPONG 4X4 STERILE $2.15
5505804 STOMA RING MOLDABLE 2.0MM $12.88
5505805 BARRIER SKIN SHEET 6X6 $20.39
5505806 KNIFE SLIT BEV 2.4 $165.24
5505807 OSTOMY POWDER 1 OZ $7.51
5505808 OSTOMY STRIP PASTE COLOPLAST $3.22
5505809 BARRIER STRIP ELASTIC COLOPLAST $4.29
5505810 JAW OPEN EXT THUNDERBEAT $643.75
5505811 THUNDERBEAT 5MM 35CM $472.87
5505812 SNAP DRESS KIT BRIDGE 14X11 $173.82
5505813 SNAP CARTRIDGE 150CC $397.01
5505814 SNAP STRAP MEDIUM LONG $92.28
5505815 TOP CLOSURE 4MM PINK $303.66
5505816 THUMB ORTHOSIS SMALL LEFT $47.21
5505817 THUMB ORTHOSIS SMALL RIGHT $47.21
5505818 THUMB ORTHOSIS MED LEFT $47.21
5505819 THUMB ORTHOSIS MED RIGHT $47.21
5505820 THUMB ORTHOSIS LRG LEFT $47.21
5505821 THUMB ORTHOSIS LRG RIGHT $47.21
5505822 ANGIOCATH NEEDLE 14GX3.25 $46.21
5505823 DILATOR COLONIC CRE 6‐8MM $370.18
5505824 DILATOR COLONIC CRE 8‐10MM $370.18
5505825 DILATOR COLONIC CRE 10‐12MM $370.18
5505826 DILATOR COLONIC CRE 12‐15MM $370.18
5505827 DILATOR COLONIC CRE 15‐18MM $370.77
5505828 SUT MAXBRAID 3‐0 BLUE $96.72
5505829 TUBING PLUMSF FILTER $28.97
5505830 CYSTOGRAFIN 300ML $63.31
5506000 SYS W SM PEG ASSIST DARCO $78.33
5506001 SYS W MED PEG ASSIST DARCO $78.33
5506002 SYS W LG PEG ASSIST DARCO $66.53
5506003 SYS M SM PEG ASSIST DARCO $66.53
5506004 SYS M MED PEG ASSIST DARCO $66.53
5506005 SYS M LG PEG ASSIST DARCO $66.53
5506006 SYS M XLG PEG ASSIST DARCO $66.53
5506008 ADH DERMABOND PROPEN $83.69
5506009 BAG PRESS IRRIG TUB SET W SPIKE $128.76
5506010 DRESSG MEPILEX BORD 3X3 AG $25.79
5506011 DRESSG ALGINATE 4X4 SOFT SILVER $30.04
5506012 DRESSG ALGINATE 4X4 STERILE $16.09
5506013 DRESSG BARRIER W SILVER 4X4 $41.85
5506014 DRESSG CLR PLU STR 4X4 COMFEEL $11.80
5506015 DRESSG FLEX 3 ACTICOAT 4X8 $39.70
5506016 DRESSG BIATAIN NON ADH 4X4 $15.05
5506017 DRESSG FOAM NON ADH STR 6X6 $21.46
5506018 DRESSG MEPILEX HEEL ADH $40.77
5506019 DRESSG MESALT RIB IMPREG WOUND 3/4X39 $7.51
5506020 DRESSG MEPILEX BORD 3X3 $8.60
5506021 DRESSG MEPILEX BORD 4X4 AG $41.91
5506022 DRESSG MEPILEX BORD 6X6 AG $78.45
5506024 DRESSG AQUACEL 3.5X14 SURG AG $121.44
5506025 DRESSG MEPILEX FOAM 4X4 AG $31.12
5506050 SYS COBAN 2 LAYER LIT COMPRESS GN $39.76
5506051 SYS ENDO GASTROC RELEASE INTEGRA $1,914.06
5506053 OSTOMY BARRIER WITH FLANGE 2 3/4 $4.30
5506054 POUCH OSTOMY 2 3/4 $7.52
5506055 PEN EYE MARK FN TIP W RULER $4.30
5506057 TRACH CUFFED 4.0MM $10.73
5506058 TRACH 4.5MM $9.66
5506059 CATH COUD 14F TAPERED TIP $7.51
5506060 CATH SELF 16F COUD OLIVE TIP $7.52
5506061 CATH 16F SELF $2.15
5506062 CATH 18F SELF COUDE $5.36
5506063 CATH 14F SELF COUDE LONG STR TIP $2.15
5506100 HAMMERLOCK $1,233.94
5506101 DRILL DIAMETER $443.15
5506102 CANN CHAM ANTERIOR RYCROFT $18.27
5506103 SYS TISSUE REMOVAL $861.61
5506104 TUB MEDIHONEY W APPLICATOR $18.27
5506105 DRESSING XTRASORB 4 X 5 $8.60
5506106 DRESSING ALGICELL AG 2 X2 $7.52
5506200 TUB GASTRO 14F LOW VOL $108.37
5506201 TUB GASTRO 16F LOW VOL $80.47
5506202 TUB GASTRO 18F ADULT $107.30
5506203 DRESSG MEPILEX 4X8 $20.39
5506204 TEGADERM ABS 5 7/8 X 6 $182.41
5506205 DRESSING BRIDGE $525.77
5506206 CHAMPION SLING SHOT 45 DEG LEFT $421.69
5506207 CHAMPION SLING SHOT 70 DEG UP $421.69
5506208 CHAMPION SLING SHOT 45 DEG RIGHT $421.69
5506209 RP 360 DEG FLEXIBLE NEEDLE $327.26
5506210 GEL PRONTOSAN 30ML $53.74
5506211 PICO DRESSING 6X8 $360.03
5506212 PICO DRESSING 6X6 $435.26
5506213 WALLACH LOOP ELECTRODE 10MMX8MM SQUARE $43.99
5506214 CUTIMED SILTEC SORBACT 5X5 $45.14
5506215 PRONTOSAN WOUND IRRIGATION $262.88
5506216 VERALINK CASSETTE $176.25
5506217 VERAFLO DUO TUBE SET $204.94
5506218 VERAFLO MEDIUM DRESSING KIT $314.89
5506219 DRESSG TEGA ABSORB 7.9"X8" $40.84
5506220 SUT ETHLN L886T O $9.66
5506221 SUT VICRYL 0 J418H $275.13
5506222 AIRWY MASK LMA CLASSIC 2.5 $25.79
5506223 AIRWY MASK LMA CLASSIC 2 $25.79
5506224 MEPILEX BORDER LITE 4X4.5 CM $6.44
5506225 VIVIDTRAC ADULT DISPOSABLE $241.42
5506226 CURETT VAC STR 7MM $16.09
5506227 OPTIFLOW CANNULA LARGE E0560 $78.45
5506228 OPTIFLOW ADULT CANNULA MED E0560 $75.11
5506229 OPTIFLOW CANNULA SMALL E0560 $78.45
5506230 MICRO FX OCD UNIVERSAL DRILL $403.02
5506231 LEUKOMED SORBACT 4X10 $78.33
5506232 LEUKOMED SORBACT 4X12 $94.42
5506233 CUTIMED EPIONA 2X2 $37.55
5506234 SUT 3‐0 30" VICRYL TIE $122.52
5506235 SUT 3‐0 18" VICRYL TIE $27.90
5506236 SCALPEL DISP 10 $2.15
5506237 SUT 3‐0 18" SILK TIE $5.36
5506238 SUT 3‐0 30" SILK TIE $8.58
5506239 CONCHA COLUMN $34.34
5506240 SUT QUILL MONODERM 2‐0 $73.08
5506241 SUT VIC 1.0 JB977 $7.51
5506242 FIBER TAPE 2MM $282.65
5506243 ARTHTO WAND SABER 30 $355.73
5506244 AIRVO 2 CIRCUIT $185.63
5506245 XLG WEDGE L3260 $83.83
5506246 DARCO TOE ALIGNMENT SPLINT L3260 $37.55
5506247 SHOE ORTHO WEDGE SM L3260 $62.23
5506248 SHOE ORTHO WEDGE MD L3260 $63.41
5506249 SHOE ORTHO WEDGE LG L3260 $63.41
5506250 UNIVERSAL SET W/CHLORAPREP $548.30
5506251 DRILL 4.5 SYN $177.04
5506252 DRILL 4.5 SYN $346.58
5506253 DRILL 3.2 SYN $214.60
5506254 PLATE 4.5 BROAD DCP 9 HOLE $335.85
5506255 ENDOCELL $18.24
5506256 PRONTOSAN IRRIGATION 40ML $26.82
5506257 MONOVISC $953.89
5506258 SYMPHONY BMI KIT STERILE $103.17
5506259 MINILAP MINIGRIP INSTUMENT $434.56
5506260 ILEX SKIN PROTECTANT 57 GR TUBE $53.65
5506261 DRESS AQUACEL AG EXT 4X5 $30.09
5506262 NEONATAL RESUSCITATION CIRCUIT $25.79
5506263 NEOPIP MASK SIZE 0 $19.34
5506264 NEOPIP MASK SIZE 1 $19.34
5506265 2‐0 FIBER LOOP, KEITH NEEDLE $160.95
5506266 PESSARY DONUT 2‐1/4" A4562 $186.70
5506267 NEEDLE WHTACRE 22G 5" $23.64
5506268 DISPOSABLE KIT FOR 3X8MM BIO TENODESIS $475.34
5506269 SUT 2‐0 DIGITEX $108.37
5506270 DIGITEX SUTURE DELIVERY DEVICE $410.54
5506271 ALTIS SLING $1,655.05
5506272 EPIDURAL KIT $52.66
5506273 RESTORELLE MESH POSTERIOR $1,242.52
5506274 RESTORELLE MESH ANTERIOR $1,244.51
5506275 SUT 3‐0 VICRYL UNDYED J416H $5.37
5506276 LONE STAR RETRACTOR $332.09
5506277 NOSE BLEED TRAY $33.32
5506278 ICONIX ANCHOR 1.4 W/FIBER FORCE #2 $531.98
5506279 CELERO BREAST BX $465.68
5506280 SUT STRATIFIX 1 CTX $93.50
5506281 SUT MONOCRYL 3‐0 Y427H $17.20
5506282 SUT 3 VICRYL J808T $8.60
5506283 SUT 2‐0 VICRYL J259H $5.37
5506284 SUT 1 VICRYL J959H $5.37
5506285 DRESSG AQUACEL 3.5X4 AG $71.89
5506286 STIMULAN 10CC $1,684.60
5506287 STIMULAN 5CC $1,291.80
5506288 4.0MM ANGLED TOMCAT $147.24
5506289 BOOT LINER LARGE $170.61
5506290 TRAUMA POST PAD $194.21
5506291 FRACTURE TABLE HIP DRAPE $216.74
5506292 AQUAMARTYS 6.0 BIPOLAR SEALER $522.31
5506293 URO POUCH FLAT $13.95
5506294 GYNECORE TVT EXACT $1,503.52
5506295 NON‐ABS MONOFILAMENT $131.11
5506296 MONODEK ABS SUTURE $131.11
5506297 SUT 2‐0 ABS POLYDIOXANONE W/NEEDLE $108.55
5506298 SUT 2‐0 NON‐ABS POLYPROPYLENE W/NEEDLE $101.93
5506299 TDOC 7FR DUAL SENSOR CATHETER $200.65
5506300 PUMP TUBING INFUSION LINE $59.01
5506301 NEOTRODE II $11.80
5506302 INTERNAL BRACE KIT $1,211.41
5506303 FAST FIX 360 CURVED $554.74
5506304 FAST FIX 360 STRAIGHT $554.74
5506305 FAST FIX 360 REVERSED CURVE $554.74
5506306 FAST FIX 360 CANNULA $340.14
5506307 TRACH CUFFED 5.5MM $9.66
5506308 WORD CATHETER $81.55
5506309 SYSTEM 6 BLADE $185.92
5506310 RECIPROCATING SAW BLADE $92.43
5506311 VICRYL 1 CT NEEDLE, UNDYED $6.44
5506312 TUBE FEEDING 6.5FR $2.15
5506313 FLANGE TIP YANKAUER $1.07
5506314 50 DEGREE WAND $351.43
5506315 ORTHOMAX BEACH CHAIR SHOULDER DRAPE $74.15
5506316 IV D5 NS .9% 500ml $22.57
5506317 SCORPION NEEDLES $365.40
5506318 SMARTSET GMV BONE CEMENT GENTANICIN 40G $353.58
5506319 SMARTSET MV BONE CEMENT 40G $187.00
5506320 SMARTSET HV BONE CEMENT 40G $187.00
5506321 COUNTER SINK $368.63
5506322 VENAFLOW BARIATRIC CALF CUFF $113.74
5506323 VENAFLOW THIGH CUFF $110.70
5506324 VENAFLOW CALF CUFF $41.91
5506325 PICO MULTISITE 15cm x 20 cm $359.45
5506326 3.0 CANNULATED COUNTERSINK $476.10
5506327 4.0MM CANNULATED COUNTERSINK $321.90
5506328 3.5/4.0MM COUNTERSINK $322.41
5506329 FLUFF 6" x 6.75" STERILE $3.22
5506330 PROTOSAN WOUND CLEANSER 350ML $49.36
5506331 COTTON STOCKINETTE 4" $6.45
5506332 PEDIATRIC POSTOP SHOE DARCO $42.92
5506333 SUPER NO2VA ADULT MED SATELLITE SET $150.46
5506334 SUT CHROMIC 5‐0 1636G PS‐3 $15.02
5506335 HYDROFERA BLUE FOAM 4X4 DRESSING $26.82
5506336 ENDOBLADE, PLANTAR FASCIA RELEASE SYS $1,010.23
5506337 SPINAL NEEDLE 25Gx5" QUINCKE $15.02
5506338 GLIDESCOPE GVL 4 STAT $59.11
5506339 GLIDESCOPE GVL 3 STAT $59.11
5506340 AIRWY NASOPHARY 22 $5.36
5506341 CATH SUC 12FR $2.15
5506342 IRRIG NACL 3000ML $24.72
5506343 PASSPORT CANNULA $120.37
5506344 PROGRIP MESH 16X12CM $623.41
5506345 PROGRIP MESH 15X10CM $483.62
5506346 TRACH 2.0mm UNCUFFED $4.29
5506347 ULTRA PRO HERNIA SYSTEM MESH MEDIUM $484.69
5506348 ULTRA PRO HERNIA SYSTEM MESH LARGE $483.92
5506349 EPIFIX 2x3CM Q4186 $1,290.73
5506350 EPIFIX 18MM DISK Q4186 $675.98
5506351 EPIFIX 4X4CM Q4186 $3,267.12
5506352 SPACEMAKER OVAL DISSECTION BALLOON $709.31
5506353 Kii ADVANCED FIXATION SLEEVE 5X75MM $65.56
5506354 CLEARIFY VISUALIZATION SYSTEM $136.49
5506355 2" COBAN LF STERILE $5.37
5506356 AB THERA $419.54
5506357 MEDENVISION GRIPPER BOX $337.46
5506358 STIMUBLAST 1CC $322.41
5506359 ISTENT INJECT L8699 $2,426.69
5506360 HEALON GV .55 $120.37
5506361 BONE BIOPSY $371.85
5506362 ATERIAL CATH KIT 20G $44.06
5506363 CATHETER PLEURX PLEURAL $902.76
5506364 MILOOP LENS FRAGMENTATION DEVICE $322.41
5506365 2 PIECE POUCH $7.51
5506366 2 PIECE OSTOMY $17.17
5506367 AMBU KING LTS‐D SIZE 4 $98.72
5506368 X‐RAY DETECTABLE OR TOWEL $4.30
5506369 MEPILEX POST OP 4" x 6" $17.20
5506370 ADHESIVE .36ML DERMABOND $34.34
5506371 PESSARY ONLY RING W/ SUPPORT 2 1/4 A4562 $199.58
5506372 PESSARY ONLY RING W/ SUPPORT 2 1/2 A4562 $199.58
5506373 PESSARY ONLY RING W/ SUPPORT 3 A4562 $199.58
5506374 PESSARY ONLY RING W/ SUPPORT 3 1/4 A4562 $199.58
5506375 EPICORD 2X3 CM Q4186 $1,408.94
5506376 FLEXOR URETERAL ACCESS SHEATH $366.48
5506377 GUARDUS OVERTUBE $419.14
5506378 ENDO PROCEDURE KIT $46.21
5506379 WALLACH LOOP ELECTRODE 20MM $55.80
5506380 WALLACH LOOP ELECTRODE 10MM $55.80
5506381 WALLACH BALL ELECTRODE 5MM $39.70
5506382 GE WATER TRAP $45.07
5506383 5.5MM SWIVEL LOCK $472.12
5506384 BLACK STENT 7F 24CM $292.93
5506385 BLACK STENT 7F 22CM $293.40
5506386 TEGADERM SACRAL $36.54
5506387 PEDI OXY MASK $16.09
5506388 EPICORD 15 SQ CM Q4186 $3,515.12
5506389 BLADE, SAW, SAG 18.5X83.5MMX1.24 $72.96
5506390 CPAP INTERFACE KIT $56.87
5506391 MEDIUM OVAL MESH 4.3" X 5.5" $957.11
5506392 SMALL OVAL MESH 3.1" X 4.7" $648.09
5506393 PESSARY ONLY RING W/ SUPPORT 4 A4562 $199.58
5506394 AIRWY NASOPHARY 12 $5.36
5506395 TRACH 3.5MM $5.36
5506396 GAS SAMPLING LINE ET TUBE $5.36
5506397 STRAIGHT T‐ADAPTER $6.44
5506398 SCOPE WARMER DISPOSABLE SEAL $21.46
5506399 DIAPHRAM OMNIFLEX 70 $189.92
5507200 SCREW 6.5 CANN 16THR 30MM $406.66
5507201 SCREW 6.5 CANN 16THR 35MM $406.66
5507202 SCREW 6.5 CANN 16THR 40MM $421.69
5507203 SCREW 6.5 CANN 16THR 45MM $421.69
5507204 SCREW 6.5 CANN 16THR 50MM $406.66
5507205 SCR 6.5 CAN 16 THD 55 $421.69
5507206 SCREW 6.5 CANN 16THR 60MM $406.66
5507207 SCREW 6.5 CANN 16THR 65MM $406.66
5507208 SCREW 6.5 CANN 16THR 70MM $422.36
5507209 SCREW 6.5 CANN 16THR 75MM $390.12
5507210 SCREW 6.5 CANN 16THR 80MM $390.12
5507211 SCREW 6.5 CANN 16THR 85MM $478.55
5507212 SCREW 6.5 CANN 16THR 90MM $421.69
5507213 SCREW 6.5 CANN 16THR 95MM $421.69
5507214 SCREW 6.5 CANN 16THR 100MM $406.66
5507215 SCREW 6.5 CANN 16THR 105MM $406.66
5507216 SCREW 6.5 CANN 16THR 110MM $406.66
5507217 SCREW 6.5 CANN 16THR 115MM $406.66
5507218 SCREW 6.5 CANN 16THR 120MM $406.66
5507219 SCREW 6.5 CANN 16THR 125MM $406.66
5507220 SCREW 6.5 CANN 16THR 130MM $406.66
5507221 SCREW 6.5 CANN 16THR 135MM $406.66
5507222 SCREW 6.5 CANN 16THR 140MM $410.96
5507223 SCREW 6.5 CANN 16THR 145MM $406.66
5507224 SCREW 6.5 CANN 16THR 150MM $406.66
5507225 SCREW 6.5 CANN 32THR 45MM $406.66
5507226 SCREW 6.5 CANN 32THR 50 $406.66
5507227 SCREW 6.5 CANN 32THR 55MM $406.66
5507228 SCREW 6.5 CANN 32THR 60MM $421.69
5507229 SCREW 6.5 CANN 32THR 65MM $406.66
5507230 SCREW 6.5 CANN 32THR 70MM $406.66
5507231 SCREW 6.5 CANN 32THR 75MM $464.61
5507232 SCREW 6.5 CANN 32THR 80MM $421.69
5507233 SCREW 6.5 CANN 32THR 85MM $410.96
5507234 SCREW 6.5 CANN 32THR 90MM $450.66
5507235 SCREW 6.5 CANN 32THR 95MM $421.69
5507236 SCREW 6.5 CANN 32THR 100MM $406.66
5507237 SCREW 6.5 CANN 32THR 105MM $406.66
5507238 SCREW 6.5 CANN 32THR 110MM $406.66
5507239 SCREW 6.5 CANN 32THR 115MM $406.66
5507240 SCREW 6.5 CANN 32THR 120MM $406.66
5507241 SCREW 6.5 CANN 32THR 125MM $406.66
5507242 SCREW 6.5 CANN 32THR 130MM $406.66
5507243 SCREW 6.5 CANN 32THR 135MM $421.69
5507244 SCREW 6.5 CANN 32THR 140MM $406.66
5507245 SCREW 6.5 CANN 32THR 145MM $406.66
5507246 SCREW 6.5 CANN 32THR 150MM $406.66
5507247 SCREW 7.3 CANN 16THR 30MM $406.66
5507248 SCREW 7.3 CANN 16THR 35MM $406.66
5507249 SCREW 7.3 CANN 16THR 40MM $406.66
5507250 SCREW 7.3 CANN 16THR 45MM $406.66
5507251 SCREW 7.3 CANN 16THR 50MM $406.66
5507252 SCREW 7.3 CANN 16THR 55MM $406.66
5507253 SCREW 7.3 CANN 16THR 60MM $406.66
5507254 SCREW 7.3 CANN 16THR 65MM $406.66
5507255 SCREW 7.3 CANN 16THR 70MM $406.66
5507256 SCREW 7.3 CANN 16THR 75MM $462.46
5507257 SCREW 7.3 CANN 16THR 80MM $406.66
5507258 SCREW 7.3 CANN 6THR 90MM $387.97
5507259 SCREW 7.3 CANN 16THR 95MM $387.97
5507260 SCREW 7.3 CANN 16THR 100MM $448.51
5507261 SCREW 7.3 CANN 16 THR 105MM $387.97
5507262 SCREW 7.3 CANN 16THR 110MM $387.97
5507263 SCREW 7.3 CANN 16THR 115MM $406.66
5507264 SCREW 7.3 CANN 16THRD 120MM $406.66
5507265 SCREW 7.3 CANN 16THR 125MM $406.66
5507266 SCREW 7.3 CANN 16THR 130MM $406.66
5507267 SCREW 7.3 CANN 16THR 135MM $406.66
5507268 SCREW 7.3 CANN 16THR 140MM $406.66
5507269 SCREW 7.3 CANN 16THR 145MM $406.66
5507270 SCREW 7.3 CANN 16THR 150MM $406.66
5507271 SCREW 7.3 CANN 32THR 45MM $406.66
5507272 SCREW 7.3 CANN 32THR 50MM $406.66
5507273 SCREW 7.3 CANN 32THR 55MM $406.66
5507274 SCREW 7.3 CANN 32THR 60MM $406.66
5507275 SCREW 7.3 CANN 32THR 65MM $406.66
5507276 SCREW 7.3 CANN 32THR 70MM $406.66
5507277 SCREW 7.3 CANN 32THR 75MM $406.66
5507278 SCR 7.3 CAN 32 THD 80 $448.51
5507279 SCREW 7.3 CANN 32THR 85MM $406.66
5507280 SCREW 7.3 CANN 32THR 90MM $406.66
5507281 SCREW 7.3 CANN 32THR 95MM $406.66
5507282 SCREW 7.3 CANN 32THR 100MM $448.51
5507283 SCREW 7.3 CANN 32THR 105MM $406.66
5507284 SCREW 7.3 CANN 32THR 110MM $406.66
5507285 SCREW 7.3 CANN 32THR 115MM $406.66
5507286 SCREW 7.3 CANN 32THR 120MM $406.66
5507287 SCREW 7.3 CANN 32TH 125MM $406.66
5507288 SCREW 7.3 CANN 32THR 130MM $406.66
5507289 SCREW 7.3 CANN 32THR 135MM $406.66
5507290 SCREW 7.3 CANN 32THR 140MM $406.66
5507291 SCREW 7.3 CANN 32THR 145MM $406.66
5507292 SCREW 7.3 CANN 32THR 150MM $406.66
5507293 SCREW 4.5 CANN PART THD 20MM $416.32
5507294 SCREW 4.5 CANN PART THD 22MM $416.32
5507295 SCREW 4.5 CANN PART THD 24MM $328.34
5507296 SCREW 4.5 CANN PART THD 26MM $416.32
5507297 SCREW 4.5 CANN PART THD 28MM $416.32
5507298 SCREW 4.5 CANN PART THD 30MM $416.32
5507299 SCREW 4.5 CANN PART THD 32MM $402.37
5507300 SCREW 4.5 CANN PART THD 34MM $416.32
5507301 SCREW 4.5 CANN PART THD 36MM $402.37
5507302 SCREW 4.5 CANN PART THD 38MM $402.37
5507303 SCREW 4.5 CANN PART THD 40MM $328.34
5507304 SCREW 4.5 CANN PART THD 42MM $328.34
5507305 SCREW 4.5 CANN PART THD 44MM $328.34
5507306 SCREW 4.5 CANN PART THD 46MM $416.32
5507307 SCREW 4.5 CANN PART THD 48MM $384.13
5507308 SCREW 4.5 CANN PART THD 50MM $359.45
5507309 SCREW 4.5 CANN PART THD 52MM $416.32
5507310 SCREW 4.5 CANN PART THD 54MM $416.32
5507311 SCREW 4.5 CANN PART THD 56MM $416.32
5507312 SCREW 4.5 CANN PART THD 60MM $384.13
5507313 SCREW 4.5 CANN PART THD 64MM $328.34
5507314 SCREW 4.5 CANN PART THD 68MM $416.32
5507315 SCREW 4.5 CANN PART THD 72MM $416.32
5507316 SCREW 3.5 CANN PART THD 10MM $393.79
5507317 SCREW 3.5 CANN PART THD 12MM $337.99
5507318 SCREW 3.5 CANN PART THD 14MM $393.79
5507319 SCREW 3.5 CANN PART THD 16MM $393.79
5507320 SCREW 3.5 CANN PART THD 18MM $393.79
5507321 SCREW 3.5 CANN PART THD 20MM $393.79
5507322 SCREW 3.5 CANN PART THD 22MM $393.79
5507323 SCREW 3.5 CANN PART THD 24MM $393.79
5507324 SCREW 3.5 CANN PART THD 26MM $359.45
5507325 SCREW 3.5 CANN PART THD 28MM $393.79
5507326 SCREW 3.5 CANN PART THD 30MM $346.58
5507327 SCREW 3.5 CANN PART THD 32MM $378.77
5507328 SCREW 3.5 CANN PART THD 34MM $348.72
5507329 SCREW 3.5 CANN PART THD 36MM $348.72
5507330 SCREW 3.5 CANN PART THD 38MM $348.72
5507331 SCREW 3.5 CANN PART THD 40MM $359.45
5507332 SCREW 3.5 CANN PART THD 42MM $393.79
5507333 SCREW 3.5 CANN PART THD 44MM $409.88
5507334 SCREW 3.5 CANN PART THD 46MM $393.79
5507335 SCREW 3.5 CANN PART THD 48MM $348.72
5507336 SCREW 3.5 CANN PART THD 50MM $348.72
5507337 SCREW 7.3 CANN 16THR 85MM $406.66
5507338 SCREW 5.0 LOCKING 26MM $378.77
5507339 SCREW 5.0 LOCKING 28MM $378.77
5507340 SCREW 5.0 LOCKING 30MM $344.43
5507341 SCREW 5.0 LOCKING 32MM $336.92
5507342 SCREW 5.0 LOCKING 34MM $378.77
5507343 SCREW 5.0 LOCKING 36MM $361.10
5507344 SCREW 5.0 LOCKING 38MM $361.10
5507345 SCREW 5.0 LOCKING 40MM $361.10
5507346 SCREW 5.0 LOCKING 42MM $417.39
5507347 SCREW 5.0 LOCKING 44MM $378.77
5507348 SCREW 5.0 LOCKING 46MM $331.55
5507349 SCREW 5.0 LOCKING 48MM $321.90
5507350 SCREW 5.0 LOCKING 50MM $331.55
5507351 SCREW 5.0 LOCKING 52MM $378.77
5507352 SCREW 5.0 LOCKING 54MM $378.77
5507353 SCREW 5.0 LOCKING 56MM $417.39
5507354 SCREW 5.0 LOCKING 58MM $378.77
5507355 SCREW 5.0 LOCKING 60MM $378.77
5507356 SCREW 5.0 LOCKING 64MM $321.90
5507357 SCREW 5.0 LOCKING 68MM $378.77
5507358 SCREW 5.0 LOCKING 72MM $378.77
5507359 SCREW 5.0 LOCKING 76MM $378.77
5507360 SCREW 5.0 LOCKING 80MM $378.77
5507361 SCREW 5.0 LOCKING 85MM $378.77
5507362 SCREW 5.0 LOCKING 90MM $378.77
5507363 SCREW 5.0 LOCKING 95MM $378.77
5507364 SCREW 5.0 LOCKING 100MM $378.77
5507365 SCREW 2.7 CORTEX SELF‐TAP 10MM $89.06
5507366 SCREW 2.7 CORTEX SELF‐TAP 12MM $89.06
5507367 SCREW 2.7 CORTEX SELF‐TAP 14MM $89.06
5507368 SCREW 2.7 CORTEX SELF‐TAP 16MM $114.81
5507369 SCREW 2.7 CORTEX SELF‐TAP 18MM $89.06
5507370 SCREW 2.7 CORTEX SELF‐TAP 20MM $89.06
5507371 SCREW 2.7 CORTEX SELF‐TAP 22MM $89.06
5507372 SCREW 2.7 CORTEX SELF‐TAP 24MM $114.99
5507373 SCREW 2.7 CORTEX SELF‐TAP 26MM $114.99
5507374 SCREW 2.7 CORTEX SELF‐TAP 28MM $114.99
5507375 SCREW 2.7 CORTEX SELF‐TAP 30MM $89.06
5507376 SCREW 2.7 CORTEX SELF‐TAP 32MM $89.06
5507377 SCREW 2.7 CORTEX SELF‐TAP 34MM $89.06
5507378 SCREW 2.7 CORTEX SELF‐TAP 36MM $89.06
5507379 SCREW 2.7 CORTEX SELF‐TAP 38MM $89.06
5507380 SCREW 2.7 CORTEX SELF‐TAP 40MM $89.06
5507381 SCREW 2.7 CORTEX SELF‐TAP 45MM $89.06
5507382 SCREW 2.7 CORTEX SELF‐TAP 50MM $89.06
5507383 SCREW 2.7 CORTEX SELF‐TAP 55MM $89.06
5507384 SCREW 3.5 SHAFT 20MM $92.28
5507385 SCREW 3.5 SHAFT 22MM $81.55
5507386 SCREW 3.5 SHAFT 24MM $81.55
5507387 SCREW 3.5 SHAFT 26MM $81.55
5507388 SCREW 3.5 SHAFT 28MM $81.55
5507389 SCREW 3.5 SHAFT 30MM $81.55
5507390 SCREW 3.5 SHAFT 32MM $81.55
5507391 SCREW 3.5 SHAFT 34MM $81.55
5507392 SCREW 3.5 SHAFT 36MM $81.55
5507393 SCREW 3.5 SHAFT 38MM $81.55
5507394 SCREW 3.5 CORTEX SELF‐TAP 10MM $84.77
5507395 SCREW 3.5 CORTEX SELF‐TAP 12MM $74.04
5507396 SCREW 3.5 CORTEX SELF‐TAP 14MM $74.04
5507397 SCREW 3.5 CORTEX SELF‐TAP 20MM $91.20
5507398 SCREW 3.5 CORTEX SELF‐TAP 22MM $91.20
5507399 SCREW 3.5 CORTEX SELF‐TAP 24MM $91.20
5507400 SCREW 3.5 CORTEX SELF‐TAP 26MM $91.20
5507401 SCREW 3.5 CORTEX SELF‐TAP 28MM $74.15
5507402 SCREW 3.5 CORTEX SELF‐TAP 30MM $89.20
5507403 SCREW 3.5 CORTEX SELF‐TAP 32MM $74.15
5507404 SCREW 3.5 CORTEX SELF‐TAP 45MM $91.20
5507407 SCREW 4.0 CANC FULL THR 45MM $83.69
5507408 SCREW 4.0 CANC FULL THR 50MM $86.91
5507409 SCREW 4.0 CANC FULL THR 55MM $83.69
5507410 SCREW 4.0 CANC FULL THR 60MM $70.82
5507411 SCREW 3.5 LOCKING SELF TAP 10MM $324.04
5507412 SCREW 3.5 LOCIN SELF TAP 12MM $324.04
5507413 SCREW 3.5 LOCKING SELF TAP 14MM $313.31
5507414 SCREW 3.5 LOCKING SELF TAP 16MM $373.40
5507415 SCREW 3.5 LOCKING SELF TAP 18MM $324.04
5507416 SCREW 3.5 LOCKING SELF TAP 20MM $364.82
5507417 SCREW 3.5 LOCKING SELF TAP 22MM $313.31
5507418 SCREW 3.5 LOCKING SELF TAP 24MM $324.04
5507419 SCREW 3.5 LOCKING SELFT TAP 26MM $324.04
5507420 SCREW 3.5 LOCKING SELF TAP 28MM $313.82
5507421 SCREW 3.5 LOCKING SELF TAP 30MM $313.82
5507422 SCREW 3.5 LOCKING SELF TAP 32MM $313.82
5507423 SCREW 3.5 LOCKING SELF TAP 34MM $313.82
5507424 SCREW 3.5 LOCKING SELF TAP 36MM $313.82
5507425 SCREW 3.5 LOCKONG SELF TAP 38MM $385.20
5507426 SCREW 3.5 LOCKING SELF TAP 40MM $313.82
5507427 SCREW 3.5 LOCKING SELF TAP 45MM $313.82
5507428 SCREW 3.5 LOCKING SELF TAP 50MM $313.82
5507429 SCREW 3.5 LOCKING SELF TAP 55MM $377.69
5507430 SCREW 3.5 LOCING SELF TAP 60MM $385.20
5507431 SCREW 4.5 CORTEX SELF‐TAP 14MM $92.28
5507432 SCREW 4.5 CORTEX SELF‐TAP 16MM $72.96
5507433 SCREW 4.5 CORTEX SELF‐TAP 18MM $72.96
5507434 SCREW 4.5 CORTEX SELF‐TAP 20MM $72.96
5507435 SCREW 4.5 CORTEX SELF‐TAP 22MM $92.28
5507436 SCREW 4.5 CORTEX SELF‐TAP 24MM $72.96
5507437 SCREW 4.5 CORTEX SELF‐TAP 26MM $92.28
5507438 SCREW 4.5 CORTEX SELF‐TAP 28MM $92.28
5507439 SCREW 4.5 CORTEX SELF‐TAP 30MM $72.96
5507440 SCREW 4.5 CORTEX SELF‐TAP 32MM $72.96
5507441 SCREW 4.5 CORTEX SELF‐TAP 34MM $72.96
5507442 SCREW 4.5 CORTEX SELF‐TAP 36MM $72.96
5507443 SCREW 4.5 CORTEX SELF‐TAP 38MM $72.96
5507444 SCREW 4.5 CORTEX SELF‐TAP 40MM $72.96
5507445 SCREW 4.5 CORTEX SELF‐TAP 42MM $86.91
5507446 SCREW 4.5 CORTEX SELF‐TAP 44MM $72.96
5507447 SCREW 4.5 CORTEX SEL‐TAP 46MM $72.96
5507448 SCREW 4.5 CORTEX SELF‐TAP 48MM $86.91
5507449 SCREW 4.5 CORTEX SELF‐TAP 50MM $72.96
5507450 SCREW 4.5 CORTEX SELF‐TAP 52MM $72.96
5507451 SCREW 4.5 CORTEX SELF‐TAP 54MM $72.96
5507452 SCREW 4.5 CORTEX SELF‐TAP 56MM $72.96
5507453 SCREW 4.5 CORTEX SELF‐TAP 58MM $72.96
5507454 SCREW 4.5 CORTEX SELF‐TAP 60MM $72.96
5507455 SCREW 4.5 CORTEX SELF‐TAP 62MM $72.96
5507456 SCREW 4.5 CORTEX SELF‐TAP 64MM $72.96
5507457 SCREW 4.5 CORTEX SELF‐TAP 66 $72.96
5507458 SCREW 4.5 CORTEX SELF‐TAP 68MM $72.96
5507459 SCREW 4.5 CORTEX SELF‐TAP 70MM $72.96
5507460 SCREW 4.0 CANC FULL THR 30MM $86.91
5507461 SCREW 4.0 CANC FULL THRD 35MM $70.82
5507462 SCREW 3.5 CORTEX SELF‐TAP 55MM $89.06
5507463 SCREW 3.5 CORTEX SELF‐TAP 60MM $91.20
5507464 3.5 CANN COUNTERSINK $430.27
5507500 K‐WIRE TROCAR POINT 1.25MM $41.85
5507501 K‐WIRE TROCAR POINT THR 1.6MM $58.03
5507502 K‐WIRE TROCAR POINT 2.0MM $41.91
5507550 PLATE 3.5MM LCP 5 HOLES $472.12
5507551 PLATE 3.5MM LCP 6 HOLES $417.39
5507552 PLATE 3.5MM LCP 8 HOLES $460.31
5507553 PLATE 3.5MM LCP 9 HOLES $477.48
5507554 PLATE 3.5MM LCP 10 HOLES $407.74
5507555 PLATE 3.5MM LCP 12 HOLES $533.28
5507556 PLATE 3.5MM LCP 14 HOLES $682.42
5507557 PLATE 3.5MM LCP RECON 5 HOLE $571.90
5507558 PLATE 3.5MM LCP RECON 6 HOLE $631.99
5507559 PLATE 3.5MM LCP RECON 7 HOLE $656.67
5507560 PLATE 3.5MM LCP RECON 8 HOLE $685.64
5507561 PLATE 3.5MM LCP RECON 10 HOLE $716.76
5507562 PLATE 3.5MM LCP RECON 12 HOLE $778.99
5507563 PLATE 3.5MM LCP T RT 3 HOLE $418.47
5507564 PLATE 3.5MM LCP T RT 5 HOLE $477.48
5507565 PLATE 3.5MM LCP T RT 7 HOLE $586.93
5507566 PLATE 3.5MM LCP T RT 4 HOLE $490.36
5507567 PLATE 3.5MM LCP T RT 6 HOLE $491.43
5507568 PLATE 3.5MM LCP T RT 3 HOLE $475.34
5507569 PLATE 3.5MM LCP T RT 4 HOLE $494.65
5507570 PLATE 3.5MM LCP T RT 5 HOLE $518.26
5507571 PLATE 3.5MM LCP T RT 7 HOLE $495.72
5507572 PLATE 3.5MM LCP T LT 3 HOLE $475.34
5507573 PLATE 3.5MM LCP T LT 4 HOLE $497.87
5507574 PLATE 3.5MM LCP T LT 5 HOLE $518.26
5507575 PLATE 3.5MM LCP T LT 7 HOLE $495.72
5507576 PLATE LCP 1/3 TUBULAR 5 HOLE $405.59
5507577 PLATE LCP 1/3 TUBULAR 6 HOLE $405.59
5507578 PLATE LCP 1/3 TUBULAR 7 HOLE $366.96
5507579 PLATE LCP 1/3 TUBULAR 8 HOLE $385.20
5507580 PLATE LCP 1/3TUBULAR 10 HOLE $326.19
5507581 PLATE LCP 1/3 TUBULAR 12 HOLE $401.30
5507582 PLATE 3.5MM PROX HUM 3 HOLE $1,967.87
5507583 PLATE 3.5MM PROX HUM 5 HOLE $1,656.13
5508000 NAIL FIX TI CANN TROCH 10MM 125DEG 170MM $1,305.83
5508001 NAIL FIX TI CANN TR 10MM 130DEG 170MM $1,423.99
5508002 NAIL FIX TI CANN TR 10MM 135DEG 170MM $1,477.51
5508003 NAIL FIX TI CANN TR 11MM 125DEG 170MM $1,745.76
5508004 NAIL FIX TI CANN TR 11MM 130DEG 170MM $1,423.99
5508005 NAIL FIX TI CANN TR 11MM 135DEG 170MM $1,477.51
5508006 NAIL FIX TI CANN TR 12MM 125DEG 170MM $1,477.51
5508007 NAIL FIX TI CANN TR 12MM 130DEG 170MM $1,423.99
5508008 NAIL FIX TI CANN TR 12MM 135DEG 170MM $1,799.41
5508009 NAIL FIX TI CANN TR 11MM 130DEG 300MM RT $1,944.26
5508010 NAIL FIX TI CANN TR 11MM 130DEG 300MM LT $1,944.26
5508011 NAIL FIX TI CANN TR 11MM 130DEG 320MM RT $1,944.26
5508012 NAIL FIX TI CANN TR 11MM 130DEG 320MM LT $2,182.47
5508013 NAIL FIX TI CANN TR 11MM 130DEG 340MM RT $1,944.26
5508014 NAIL FIX TI CANN TR 11MM 130DEG 340MM LT $1,944.26
5508015 NAIL FIX TI CANN TR 11MM 130DEG 360MM RT $2,165.30
5508016 NAIL FIX TI CANN TR 11MM 130DEG 360MM LT $2,258.65
5508017 NAIL FIX TI CANN TR 11MM 130DEG 380MM RT $2,165.30
5508018 NAIL FIX TI CANN TR 11MM 130DEG 400MM RT $2,297.28
5508019 NAIL FIX TI CANN TR 11MM 130DEG 400MM LT $2,230.75
5508020 NAIL FIX TI CANN TR 11MM 130DEG 420MM RT $1,944.26
5508021 NAIL FIX TI CANN TR 11MM 130DEG 420MM LT $2,258.65
5508022 NAIL FIX TI CANN TR 11MM 130DEG 440MM RT $1,944.26
5508023 NAIL FIX TI CANN TR 11MM 130DEG 440MM LT $1,944.26
5508024 TROCHANTERIC END CAP 0MM $379.84
5508025 TROCHANTERIC END CAP 5MM $328.34
5508026 TROCHANTERIC END CAP 10MM $328.34
5508027 NAIL FIX TI CANN TR 11MM 130DEG 380MM LS $2,230.75
5508200 BLADE 11MM TI HELICAL 85MM $727.49
5508201 BLADE 11MM TI HELICAL 90MM $629.78
5508202 BLADE 11MM TI HELICAL 105MM $629.78
5508203 BLADE 11MM TI HELICAL 110MM $771.48
5508204 BLADE 11MM TI HELICAL 115MM $654.52
5508205 BLADE 11MM TI HELICAL 120MM $759.68
5508206 BLADE 11MM TI HELICAL 80MM $771.48
5508207 BLADE 11MM TI HELICAL 95MM $733.93
5508208 BLADE 11MM TI HELICAL 100MM $629.78
5508209 KIT IV START A4649 $12.90
5508210 AIRWY NASOPHARY 34 $8.58
5508212 ELECTRD VAPOR TRODE VAPORIZATION $330.48
5508213 STYLET SLICK ENDOTRACH 10F $10.73
5508220 KIT 6MM COR DISP $1,282.23
5508222 KIT 10MM COR DISP $998.96
5508300 MEDICAL GAS HELIUM PER TANK $386.28
5508301 MEDICAL GAS ARGON PER TANK $348.72
5508400 KNIFE ELECTRD 26F $267.60
5508401 BAND TYPE 240 SERIES 200 $49.36
5508402 CANN THREADED 8.0X90MM GN $109.62
5508403 NEEDLE GUIDE INFINITI $33.26
5508404 NEEDLE GUIDE W COVER INFINITI $59.01
5508405 BLADE 5.0 HIP RESECTOR $153.44
5508406 CATH 14F SELF FEMALE W/TIP $2.15
5508407 IV STER WTR INJ 1000ML $9.66
5508408 AIRWY NASOPHARY 14 $15.02
5508409 AIRWY NASOPHARY 18 $16.12
5508410 AIRWY NASOPHARY 20 $6.44
5508411 AIRWY NASOPHARY 24 $15.02
5508413 NEEDLE GUIDE ENDOCAVITY $51.59
5508414 HANDPIECE 12G 2.7MM X 12CM 2MM $362.67
5508415 MARK SECUR BIOSPY CELERO $225.33
5508416 CELERO INTRODUCER‐12 $52.58
5508418 CONCHA WTR & COLUMN $37.61
5508419 URTERINE EXPLORA MODEL I $35.41
5508420 SOLUTION FOR INHALATION $8.60
5508500 NEBULIZER CUP JET PLUS $31.12
5508501 TUBE DISP FEN TRACH SZ 4 $134.12
5508502 TUBE TRACH CUFFLESS 6 $104.08
5508503 TUBE TRACH CANN SZ 8 DISP $134.12
5508504 FASTEN ANCHOR ENDOTRACH TUBE ORAL $39.76
5508505 BLADE SURG CLIPPER ASSEMBLY $8.60
5508506 DRESSG VAC SM SIMPLACE $121.25
5508507 COHESIVE SM 2INCH 48MM EAKIN SEAL $6.44
5508508 PROBE 23G INF CANN VITRECT $344.43
5508509 TUBE TRACH CUFFLESS 8 $131.98
5508510 TUBE TRACH CUFFLESS 4 $104.08
5508511 DRESSG VAC LG FOAM BK $159.06
5508512 DRESSG DUODERM 4X4 $7.52
5508513 DRESSG FOAM NON ADH 4X4 $15.02
5508514 DRESSG FOAM ADH 5X5 $19.31
5508515 DRESSG ACRYLIC 5.9X6 ABS CLR $41.91
5508516 DRESSG ACRYLIC ABS CLR $38.63
5508517 DRESSG ALLIDEX TRACH 4X4 $39.70
5508518 NEXPLANON $1,004.85
5508519 BONE CEMENT W MIXER $375.55
5508520 BONE FILLER DEVICE DIRECT SZ 2 $309.02
5508521 BONE FILLER DEVICE SZ 2 $295.07
5508522 DRILL EXPRESS $1,222.14
5508523 CEMENT GUN BONE FILLER SISE 2 $584.78
5508524 BONE BIOPSY DEVICE TAPER SZ 2 $348.72
5508525 CEMENT CARTRIDGES CDS $268.25
5508526 BONE CEMENT XPEDE W MIX $431.34
5508527 DRILL EXPRESS OID TROCARS $472.12
5508528 DRESSG FOAM LG WHITE $51.50
5508529 CONNECT Y TRAC $6.45
5508530 DRESSG GRANUFOAM BRIDGE $163.09
5508531 CATH SELF 12F FEMALE STR TIP 6 $2.15
5508532 CATH SELF 14F FEM STR TIP CONN $2.15
5508533 APPL FLOSEAL ENDOSCOPIC $208.49
5508534 WIREGUIDE 3.2 THR ASNIS $139.49
5508535 DRILL BIT 3.2MM THR ASNIS $357.31
5508536 DRILL BIT 6.5MM CANN 6.5 ASNIS $528.98
5508537 WASHER FOR 6.5 ASNIS $143.78
5508538 DRILL BIT 2.7MM CAN 4.0 ASNIS $449.23
5508539 DRILL BIT 4.0MM CAN 4.0 ASNIS $461.39
5508540 DRILL BIT 1.4MM 4.0 ASNIS $329.41
5508541 WASHER 4.0 ASNIS $121.25
5508542 DRILL BIT 4.0MM CAL $405.17
5508543 DRILL BIT 2.7 QC 100 $217.82
5508544 DRILL BIT 4.0 SYN TFN $361.60
5508545 DRILL BIT 2.0 QC 125 $243.96
5508546 DRILL BIT 2.7 QC 125 $289.71
5508547 DRILL BIT 2.8 QC 165 $270.83
5508549 SUT MONO 3.0 Y416H $6.45
5508550 ISTENT LEFT L8699 $2,313.85
5508551 CAST SYS 3" W/2 REG BOOT $276.83
5508552 CAST SYS 4" W/2 REG BOOT $290.78
5508553 CONFORM BIOG ANTIMICRO $5.36
5508554 GAUZE LG BIOG ANTIMICRO $6.44
5508555 SPONG BIOG ANTIMICRO $45.07
5508556 TRAY EPIDURAL BRAUN $87.05
5508557 DRESSG MEPILEX BORD 4X4 $11.82
5508558 DRESSG MEPILEX BORD 6X6 $20.42
5508559 DRESSG MEPILEX BORD 6X8 $24.68
5508560 AUTO ENDO 5 ML $283.72
5508561 SYS WECK SH PORT SITE CLOSURE $282.20
5508562 BAG COLLECTION FECAL MGMT $16.09
5508563 KIT FECAL MNGT SYS FLEXISE $290.17
5508564 ANOSCOPE DISP 18X90 $7.51
5508565 ANOSPEC DISP W LIGHT SOURCE $20.42
5508566 BOOT REGULAR $208.16
5508567 KIT MAGELLAN COMPLETE ONE SOURCE $435.63
5508568 SUT CHR GUT 2‐0 UND 36" 923H $10.75
5508569 PESSARY RING W/SUPPORT 1‐3/4" A4562 $186.70
5508570 TUB SMOKE EVAC W/SPEC TUB $50.43
5508571 FILTER ASSEMBLY SMOKE EVAC $156.66
5508572 FILLER CANCELLOUS CRUSHED 5.0CC $286.49
5508573 FILLER CANCELLOUS CRUSHED 15CC $416.32
5508574 DIAPHRAM OMNIFLEX 65 $186.70
5508575 PESSARY DONUT 2" A4562 $186.70
5508576 PESSARY RING W/SUPPORT 3‐1/4" A4562 $199.58
5508577 CAPSULE BRAVO $395.93
5508578 NEEDLE HEMOVAC 1/4 $33.26
5508579 SUC E‐SEP NEPTUNE SLEEVE 165MM $15.05
5508580 PESSARY GELLHORN FLEX 1 1/2" A4562 $186.70
5508581 PESSARY GELLHORN FLEX 1 3/4" A4562 $186.70
5508582 PESSARY GELLHORN FLEX 2" A4562 $186.70
5508583 PESSARY GELLHORN FLEX 2 1/2" A4562 $193.14
5508584 PESSARY GELLHORN FLEX 2 1/4" A4562 $193.14
5508585 PESSARY GELLHORN FLEX 2 3/4" A4562 $193.14
5508586 PESSARY GELLHORN FLEX 3" A4562 $186.70
5508587 SYS IMPLANT DISTAL BICIP REPAIR $958.18
5508588 SUT VICRYL 2‐0 D7585 $285.87
5508589 POST BI‐CORTICAL 4.5X25MM $268.25
5508590 POST BI‐CORTICAL 4.5X27.5MM $268.25
5508591 POST BI‐CORTICAL 4.5X30MM $268.25
5508592 POST BI‐CORTICAL 4.5X32.5MM $268.25
5508593 TRAP DIGIT LARGE $92.43
5508594 DRESS OPTILOCK 6.5X10 $19.34
5508595 GUN BIOPSY 18GX9CM QC 10MM $168.46
5508596 GUN BIOPSY 18GX9CM QC 20MM $168.46
5508597 GUN BIOPSY 20GX9CM QC 20MM $168.46
5508598 HANDSET DISP VERSAJET II EXACT 45/8MM $596.46
5508599 STAPLER FLEX 60MM $463.53
5508600 RELOAD 60MM BLUE $340.14
5508601 RELOAD 60MM GREEN $326.19
5508602 TECA ELITE 1.5" GREEN CON NEEDLE $39.70
5508603 MESH 3D MAX MED LEFT $379.37
5508604 MESH 3D MAX LRG LEFT $321.90
5508605 MESH 3D MAX MED RIGHT $379.37
5508606 MESH 3D MAX LRG RIGHT $321.90
5508607 STAPLR 12MM HERNIA MULTI ENDO $511.82
5508608 STAPLER RELOAD $333.70
5508609 AIRWY MASK LMA CLASSIC 1 $28.97
5508610 EXTRACT STONE BASKET 2.0 $465.35
5508611 TROCAR 5.5MM LOCKING $272.54
5508612 SCALPEL DISP #20 $3.22
5508613 SUT 0 PDSII Z334H $8.60
5508614 CUTTER LINEAR RELOAD VASCULAR $358.38
5508615 SUT 0 PDSII Z352H $8.60
5508616 SUT VIC 2‐0 J726D $36.54
5508617 SUT VIC 3‐0 J864D $37.61
5508618 LOOP OSTOMY ROD 90MM $11.80
5508620 SUT SILK 0 624H $4.30
5508621 DRAPE MICROSCOPE $113.74
5508622 TUBING SMOKE EVACUATION $49.44
5508623 DRESSING OPTILOCK 6.5X10 $19.34
5508624 DRILL PRECISION NEURO 3MMX3.8MM $269.75
5508625 BUR BARREL DIAMOND EXTRA COARSE $270.83
5508626 BUR DIAMOND ROUND ELITE $269.75
5508627 MIS PRECISION NEURO 3.0MM $350.36
5508628 DURAMATRIX 1X3 SUTURABLE $419.14
5508629 SUT 4‐0 NUROLON C584D $39.70
5508630 DRESS MEPITEL ONE 7.5X10CM $18.27
5508631 DRESS MEPITEL ONE 5X7.5CM $13.97
5508632 CARTRIDGE 2.0 NOVA STITCH $535.42
5508633 SUT 5‐0 PRO HS‐7 9702H $60.09
5508634 SUT 5‐0 PDS PDP495G $18.27
5508635 ANGIOCATH 12GX3 $47.29
5508636 BLADE INSULATED ELECTRODE 2.75" $18.27
5508637 DURASEAL EXACT SPINE SEALANT $1,345.53
5508638 STAPLER ECS 25A $373.40
5508639 STAPLER ECS 29A $368.04
5508640 PILLOW GENTLE TOUCH RIGHT INTUB SLOT $23.64
5508641 BLADE INSULATED ELECTRODE 4" $26.87
5522222 VENTRALIGHT ST W/ECHO PS 10X15CM $598.73
5599991 MEDSURG STERILE SUPPLY TEMPLATE 44 $248.93
5600001 RABIES IMMUNE GLOBULIN 300 mg/2 ml ‐ NF 90376 $1,199.38
5600004 ISOSULFAN BLUE 10MG/ML 5ML VIAL (NF) $700.66
5600201 IV SOD CHL 45% 500ML $30.04
5600553 CHONDROITIN SOD HYALU SYR $787.58
5600611 GASTROGRAFIN SOLN $740.36
5600830 LIDOCAINE 4% SOL: 5ML AMP (NF) $40.77
5600854 MEPERIDINE TUBEX $10.73
5601260 HEPARIN 1000UL VIAL $18.24
5601265 HEPARIN SODIUM VIAL 1000 UNITS $11.80
5601412 XYLOCAINE MPF 4% TOP $72.96
5601529 ETOMIDATE 2 MG/ML VIAL (ANESTHESIA) $48.36
5601581 VERSED INJ PER MG J2250 $68.67
5601600 LIDOCAINE 2% JELLY 5ML $18.27
5601758 LIDOCAINE2UROJEDT10CC $74.04
5601878 MANUAL CHARGE SELF ADMIN $37.55
5601879 CHARCOAL POWDER 30 GRAMS $88.13
5601880 CHLORPHENIRAMINE MALEATE TAB : 4 MG $0.04
5601881 DIPHENHYDRAMINE LIQUID 4 OZ BOTTLE $4.29
5601882 DIPHENHYDRAMINE (BENADRYL) CAP 25 MG $1.07
5601883 CYPROHEPADINE TAB : 4 MG (NF) $1.07
5601884 DIPHENHYDRAMINE HCL VIAL 50 MG/1ML J1200 $3.22
5601885 FEXOFENADINE HCL (ALLEGRA) CAP : 60 MG $3.22
5601886 LORATADINE (CLARITIN) TAB 10 MG $2.15
5601887 PROMETHAZINE (PHENERGAN) INJ 25 MG/1ML J2550 $6.45
5601888 PROMETHAZINE HCL(PHENERGAN) SUPP:12.5 MG $10.73
5601889 PROMETHAZINE (PHENERGAN) SUPP 25 MG NF $1.07
5601890 PROMETHAZINE (PHENERGAN) TAB 25 MG ‐ NF $2.15
5601891 GENTAMICIN 80 MG/NS *100 ML* PREMIX $17.20
5601892 GENTAMICIN SULFATE VIAL : 40 MG/ML 2ML $7.52
5601893 TOBRAMYCIN VIAL 40 MG/ML 2ML (NF) $7.51
5601894 GENTAMICIN 20 MG/2ML VIAL ‐ NEONATAL USE $4.30
5601895 GENTAMICIN SULFATE VIAL : 40 MG $39.70
5601896 NEOMYCIN SULFATE TAB 500 MG (NF) $3.22
5601897 AMPHOTERICIN B VIAL : 50 MG/10ML $25.75
5601898 FLUCONAZOLE (DIFLUCAN) TAB 100 MG $4.30
5601899 FLUCONAZOLE 200 MG/100 ML IVPB (NF) $298.29
5601900 NYSTATIN POWDER $62.33
5601901 NYSTATIN SUSP 100,000U/ML 60ML (NF) $18.24
5601902 CEFACLOR CAP : 250 MG $0.64
5601903 CEFACLOR SUSP : 250 MG $34.34
5601904 CEFADROXIL MONO(DURICEF) CAP : 500 MG $5.36
5601905 CEFPODOXIME (VANTIN) TAB : 100 MG $11.80
5601906 CEFPODOXIME (VANTIN) TAB : 200 MG $16.09
5601907 CEFAZOLIN VIAL 500 MG (NF) $4.30
5601908 CEFAZOLIN 1 GRAM VIAL J0690 $4.30
5601909 CEFTAZIDIME VIAL 1 GM J0713 $12.90
5601910 CEFTRIAXONE VIAL 250 MG $6.45
5601911 CEFTRIAXONE VIAL 500 MG $11.82
5601912 CEFTRIAXONE VIAL 1000 MG $4.30
5601913 CEFTRIAXONE ADD‐VANTAGE VIAL : 1GM (NF) $48.28
5601914 CEFTRIAXONE VIAL 2 GRAMS $11.82
5601915 CEFUROXIME (CEFTIN) TAB : 250 MG (NF) $0.94
5601916 CEFUROXIME AXETIL (CEFTIN) TAB : 500 MG $23.61
5601917 CEFUROXIME VIAL 750 MG $13.95
5601918 CEPHALEXIN CAP : 250 MG $0.34
5601919 CEPHALEXIN (KEFLEX) CAP 250 MG $0.39
5601920 CEPHALEXIN (KEFLEX) CAP : 500 MG $0.47
5601921 CEPHALEXIN (KEFLEX) SUSP:125MG/5ML 100ML $46.14
5601922 AZTREONAM VIAL 2 GRAM ‐ OB USE ONLY $267.60
5601923 CEFOTETAN DISODIUM (CEFOTAN) VIAL : 2 GM $75.11
5601924 CEFOTETAN DISODIUM (CEFOTAN) VIAL : 1 GM $31.12
5601925 IMIPENEM‐CILASTATIN(PRIMAXIN) 500MG (NF) J0743 $135.20
5601926 CHLORAMPHENICOL NA SUCC VIAL : 1 GM $18.24
5601927 AZITHROMYCIN (ZITHROMAX) TAB 250 MG $6.45
5601928 AZITHROMYCIN (ZITHROMAX)VIAL : 500 MG $18.27
5601929 CLARITHROMYCIN TAB : 250 MG $11.80
5601930 CLARITHROMYCIN TAB 500 MG ‐NF $17.20
5601931 ERYTHROMYCIN BASE TABE : 250 MG $0.21
5601932 ERYTHROMYCIN TAB : 333 MG (NF) $1.07
5601933 ERYTHROMYCIN ETHYLSUCC SUSP : 200MG/5ML $31.12
5601934 ERYTHROMYCIN 500 MG VIAL $240.35
5601935 ERYTHROMYCIN 1 GRAM VIAL $11.80
5601936 ERYTHROMYCIN‐SULFISOXAZOLE SUSP : $25.75
5601937 AMOX/CLAVULATE LIQU : 4000 MG $121.25
5601938 AMOXICILLIN CAP 250 MG $0.30
5601939 AMOXICILLIN TRIHYD(AMOXIL) CAP : 500 MG $0.21
5601940 AMOXICILLIN SUSP:125MG/5ML 150ML $5.37
5601941 AMOXICILLIN SUSP 250MG/5ML 80ML $7.51
5601942 AMOXICILLIN TAB CHEWABLE: 250 MG (NF) $0.52
5601943 AMOXICILLIN‐POTAS CLAVULANATE TAB : 500 $12.88
5601944 AMOX/CLAV (AUGM) TAB:250MG (NF) $8.58
5601945 AMOX‐CLAVULANT (AUGMENTIN) TAB: 500MG $16.09
5601946 AMOXICILLIN‐CLAV(AUGUMENTIN)CHEW :250 MG $8.58
5601947 AMPICILLIN/SULBACTAM VIAL 1.5 GRAM J0295 $27.94
5601948 AMPICILLIN VIAL FOR DOSES 250 MG OR LESS $5.37
5601949 AMPICILLIN VIAL FOR DOSES 501 MG‐1 GRAM $12.90
5601950 AMPICILLIN VIAL FOR DOSES OVER 1 GRAM $29.02
5601951 AMPICILLIN SODIUM ADD‐VANTAGE VIAL : 1 G $5.36
5601952 AMPICILLIN SODIUM‐SULBACTAM NA VIAL : 3 $50.43
5601953 AMPICILLIN CAP 250 MG $0.26
5601954 AMPICILLIN TRIHYDRATE CAP : 500 MG $0.34
5601955 AMPICILLIN VIAL FOR DOSES 251‐500 MG $6.45
5601956 DICLOXACILLIN CAP 250 MG ‐ NF $0.73
5601957 NAFCILLIN VIAL 1 GRAM (NF) $42.92
5601958 NAFCILLIN VIAL 2 GRAMS $121.44
5601959 NAFCILLIN SODIUM ADD‐VANTAGE VIAL : 1 GM $9.66
5601960 OXACILLIN SODIUM VIAL : 1 GM $4.29
5601961 OXACILLIN SODIUM VIAL : 2 GM $8.58
5601962 PENICILLIN G BENZATHINE 1,200,000 UNITS $469.97
5601963 PENICILLIN G POTASSIUM VIAL : 5 MU $11.80
5601964 PENICILLIN G POTASSIUM VIAL : 1000000 U $4.29
5601965 PENICILLIN IV‐VARIABLE DOSE RX TO SUPPLY $130.04
5601966 PENICILLIN G PROCAINE SYR 600,000 U (NF) $25.75
5601967 PENICILLIN V POT SUSP : 125MG/5ML 100ML $4.29
5601968 PENICILLIN V POT SUSP : 250MG/5ML 100ML $7.51
5601969 PENICILLIN V POTASSIUM TAB 250 MG $0.30
5601971 PENICILLIN V POTASSIUM TAB : 500 MG $0.17
5601972 CARBENICLLIN (GEOCILLIN) 382 MG (NF) $7.51
5601973 TICARCILLIN‐K CLAV 3.1 GM (NF) $42.92
5601974 DOXYCYCLINE TAB 100 MG $0.39
5601975 TETRACYCLINE CAP 250 MG (NF) $0.09
5601976 BACITRACIN VIAL 50,000 UNITS $45.14
5601977 CLINDAMYCIN CAP 150 MG $0.30
5601978 CLINDAMYCIN PHOS VIAL : 150MG/ML 4ML $13.97
5601979 CLINDAMYCIN PHOS VIAL : 150MG/ML 6ML $15.05
5601980 VANCOMYCIN HCL VIAL 1 GM J3370 $16.12
5601981 VANCOMYCIN HCL VIAL : 500 MG J3370 $9.67
5601982 ACYCLOVIR (ZOVIRAX) 200 MG CAP $1.07
5601983 ACYCLOVIR VIAL 500 MG $11.82
5601984 HYDROXYCHLOROQUINE TAB 200 MG $11.82
5601985 QUININE SULFATE CAP : 325 MG $0.21
5601986 CIPROFLOXACIN HCL (CIPRO) TAB 250 MG $0.39
5601987 CIPROFLOXACIN HCL (CIPRO) TAB 500 MG $1.07
5601988 CIPROFLOXA 200 MG/100 ML NS‐rx to supply $8.60
5601989 CIPROFLOXACIN 400MG‐D5W PB 200ML $81.55
5601990 SULFASALAZINE TAB 500 MG ‐ NF $0.90
5601991 NITROFURANTOIN MACRO CAP 50 MG (NF) $1.07
5601992 NITROFURANTOIN CAP (MACROBID): 100MG $3.22
5601993 METRONIDAZOLE (FLAGYL) TAB 250 MG (NF) $0.21
5601994 METRONIDAZOLE (FLAGYL) 500MG PB 100ML $8.60
5601995 SULFAME‐TRIMETH SUSP 200‐40MG/5ML (ML) $0.73
5601996 SULFAMETHOX‐TRIMETHOPRIM VIAL 400/80/5ml $18.24
5601998 DAPSONE TAB 100 MG $1.07
5601999 SULFAMETHOXA‐TRIMETH DS(BACTRIM) TAB : $1.07
5602001 BLEOMYCIN SULFATE (CHEMO)VIAL : 30 U J9040 $170.61
5602003 CARBOPLATIN VIAL (CHEMO): 150 MG J9045 $816.55
5602004 CARBOPLATIN VIAL (CHEMO): 450 MG J9045 $1,633.09
5602005 CEFTRIAXONE 1.5GM 100ML BAG J0696 $13.95
5602006 CHLORAMBUCIL TAB (CHEMO): 2 MG $4.29
5602007 CISPLATIN VIAL (CHEMO): 1 MG J9060 $1,041.87
5602008 CYCLOPHOSPHAMIDE (CYTOXAN)NF TAB : 50 MG J8530 $13.95
5602013 DOXORUBICIN HCL VIAL : 10 MG $196.36
5602014 DOXORUBICIN HCL VIAL : 2 MG $368.04
5602015 DOXORUBICIN HCL VIAL : 2 MG $1,443.17
5602019 FLUTAMIDE (EULEXIN) CAP : 125 MG $7.51
5602023 MEGESTROL ACETATE SUSP : 40 MG/ML 240ML $78.45
5602024 MEGESTROL ACETATE TAB : 40 MG $4.29
5602025 MERCAPTOPURINE TAB : 50 MG (NF) $8.58
5602028 METHOTREXATE SODIUM VIAL : 25 MG J9260 $71.89
5602032 TAMOXIFEN CITRATE TAB 10 MG (NF) $6.44
5602037 BETHANECHOL CHLORIDE TAB : 10 MG $1.07
5602038 BETHANECHOL CHLORIDE TAB : 25 MG $13.95
5602039 NEOSTIGMINE (1:2000) ‐ DO NOT USE! $137.34
5602040 PHYSOSTIGMINE SALICYLATE AMP: 1MG/ML 2ML $141.86
5602041 PYRIDOSTIGMINE BROMIDE AMP : 5MG/ML 2ML $20.39
5602042 BENZTROPINE (COGENTIN) TAB 0.5 MG $0.17
5602043 PERGOLIDE MESYLATE TAB : 0.05 MG (NF) $4.29
5602044 ATROPINE VIAL : 0.4 MG/ML 1ML (NF) $1.07
5602046 DICYCLOMINE HCL (BENTYL) CAP : 10 MG $0.34
5602047 GLYCOPYRROLATE VIAL 0.2 MG/ML 2 ML $59.11
5602048 HYOSCYAMINE SULFATE AMP : 0.5MG/ML 1ML $32.19
5602049 HYOSCYAMINE (LEVSIN) TBSL 0.125 MG‐NF $0.17
5602050 IPRATROPIUM (ATROVENT) INHALER (NF) $257.52
5602051 IPRATROPIUM NEB : 0.5MG/2.5ML $0.52
5602052 ALBUTEROL INHALER (VENTOLIN) $169.80
5602053 ALBUTEROL(VENTOLIN)NEB : 2.5MG/3ML UD $1.03
5602054 ALBUTEROL 5MG/ML 20ML FOR CONT NEB $207.42
5602055 ALBUTER‐IPRATR (COMBIVENT)‐VENT USE ‐ NF $701.74
5602056 DOBUTamine : 250 MG/ML 20 ML VIAL $9.67
5602057 DOPamine HCL VIAL : 80MG/ML 5ML $1.07
5602058 DOPamine 200MG‐D5W PBAG 250ML $40.84
5602059 EPHEDrine INJ 50 MG/ML 1ML $48.36
5602060 RACEMIC EPINEPHRINE 2.25% SOLUTION $7.52
5602062 EPINEPHRINE SYRD : 0.15 MG $134.12
5602063 EPINEPHRINE SYRD : 1 MG $7.51
5602065 EPINEPHRINE 1‐1000 SYRD : 1MG $4.29
5602066 EPInephrine 1:10000 ABBO :0.1MG/ML 10ML $23.64
5602067 ISOPROTERENOL HCL AMP 0.2 MG/ML 5ML (NF) $16.09
5602068 PHENYLEPHRINE 10MG/ML 1ML VIAL J2370 $48.36
5602069 PSEUDOEPHEDRINE HCL(SUDAFED) TAB : 30 MG $0.09
5602070 TERBUTALINE SULFATE : 1MG/ML 1ML J3105 $11.82
5602071 TERBUTALINE SULFATE TAB 2.5 MG ‐ NF $1.07
5602072 DIHYDROERGOTAMINE (DHE) AMP : 1MG/ML 1ML $325.12
5602073 ATRACURIUM BESYLATE VIAL : 10MG/ML 10ML $15.02
5602074 BACLOFEN TAB 10 MG $1.07
5602075 CYCLOBENZAPRINE (FLEXERIL) TAB 10 MG $0.30
5602076 DANTROLENE CAP 100 MG $5.36
5602077 DANTROLENE SODIUM VIAL 20 MG $204.94
5602078 METHOCARBAMOL 750 MG TAB (NF) $0.77
5602079 MIVACURIUM CHLORIDE VIAL : 2MG/ML 10ML $60.09
5602080 ROCURONIUM 10 MG/ML 10 ML VIAL $131.98
5602082 RALOXIFENE (EVISTA) TAB : 60 MG (NF) $25.75
5602083 SUCCINYLCHOLINE VIAL 20 MG/ML 10ML J0330 $89.20
5602084 NICOTINE 14 MG/24 HR PATCH $8.60
5602085 NICOTINE 21 MG/24HR PATCH $6.45
5602086 NICOTINE 7 MG/24HR PATCH $8.60
5602087 FERROUS GLUCONATE TAB 325 MG $0.21
5602088 FERROUS SULFATE ELIX 220MG/5ML 473ML(NF) $11.80
5602089 FERROUS SULFATE TAB 325 MG $0.13
5602090 FERROUS SULFATE TAB : 160 MG $0.77
5602092 ENOXAPARIN (LOVENOX) 30 MG SYRINGE J1650 $24.72
5602093 ENOXAPARIN SODIUM (LOVENOX) SYRD : 60 MG J1650 $139.49
5602094 ENOXAPARIN SODIUM (LOVENOX) SYRD: 100 MG J1650 $231.77
5602095 HEPARIN 20 UNITS/2 ML PF (BABY FLUSH) $2.15
5602096 HEPARIN SOD PORCINE VIAL : 10U/ML 30ML $1.07
5602097 HEPARIN 10,000U/ML 1 ML (NF) $3.22
5602098 HEPARIN 1,000 UNITS/ML 1ML $1.07
5602099 HEPARIN 100 UNITS/ML 5ML (NF) $1.07
5602100 HEPARIN 100 UNITS/ML 10 ML (FLUSH) $1.07
5602101 HEPARIN 5,000 UNITS/ML 1ML J1644 $7.52
5602102 WARFARIN SODIUM (COUMADIN) TAB 2 MG $0.13
5602103 WARFARIN SODIUM (COUMADIN) TAB 5 MG $0.17
5602104 WARFARIN SODIUM (COUMADIN) TAB 2.5 MG $0.17
5602105 PROTAMINE SULFATE VIAL 10MG/ML 25ML $90.13
5602106 AMINOCAPROIC(AMICAR) VL :250MG/ML (NF) $2.15
5602107 GELATIN SPONGE,ABSORBABLE PWD : $179.19
5602108 THROMBIN VIAL : 10000 U $42.92
5602110 PENTOXIFYLLINE TBSA : 400 MG $1.07
5602111 ALTEPLASE (TPA) VIAL : 100 MG J2997 $17,948.72
5602112 RETEPLASE KIT 10 U ‐ NF J2993 $3,919.64
5602113 STREPTOKINASE VIAL : 1.5 MU J2995 $1,081.58
5602114 AMIODARONE HCL (CORDARONE) TAB 200 MG $0.99
5602115 AMIODARONE VIAL 150 MG/3ML $9.67
5602116 AMLODIPINE (NORVASC) TAB 5 MG $0.30
5602117 AMLODIPINE BESYLATE (NORVASC)TAB : 10 MG $7.51
5602118 ATENOLOL (TENORMIN) TAB 50 MG $0.21
5602119 BRETYLIUM TOSYLATE VIAL : 50MG/ML 10ML $41.85
5602120 CAPTOPRIL (CAPOTEN) TAB : 25 MG (NF) $0.21
5602121 CAPTOPRIL (CAPOTEN) TAB : 12.5 MG $0.21
5602122 DIGOXIN (LANOXIN) AMP 0.5 MG/2ML $24.72
5602123 DIGOXIN (LANOXIN) TAB 0.125 MG $1.07
5602124 DIGOXIN (LANOXIN) TAB : 0.25 MG (NF) $0.90
5602125 DIGOXIN PEDIATRIC ELIX 0.05MG/ML (NF) $16.09
5602126 DILTIAZEM ER (CARDIZEM) CAP 180 MG $3.22
5602127 DILTIAZEM ER (CARDIZEM) CAP 120 MG $0.90
5602128 DILTIAZEM HCL (CARDIZEM) CPSA : 240 MG $6.44
5602129 DILTIAZEM IR (CARDIZEM) TAB 30 MG $0.30
5602130 DILTIAZEM INJ (CARDIZEM) : 5MG/ML 10ML $20.42
5602131 DILTIAZEM SYRD : 5MG/ML 5ML (NF) $93.35
5602132 ENALAPRIL (VASOTEC) TAB 5 MG $0.34
5602133 ENALAPRIL (VASOTEC) TAB : 2.5 MG (NF) $1.07
5602135 ESMOLOL HCL VIAL 10MG/ML 10ML $30.09
5602136 LIDOCAINE 2% ABBOJECT : 100MG/ML 5ML $6.45
5602137 LIDOCAINE 2% SYRD : 5ML $5.36
5602138 LISINOPRIL (PRINIVIL) TAB 5 MG $0.26
5602139 LISINOPRIL TAB : 10 MG $2.15
5602140 LISINOPRIL (PRINIVIL) TAB 10 MG $0.86
5602141 LISINOPRIL (PRINIVIL) TAB 20 MG $0.43
5602142 METOPROLOL SUCCINATE *ER* TABS 50 MG $4.30
5602143 METOPROLOL (LOPRESSOR) VIAL 5 MG/5 ML $5.37
5602144 METOPROLOL (LOPRESSOR) TAB : 100 MG $0.39
5602145 METOPROLOL TARTRATE *IR* TAB 50 MG $0.43
5602146 NADOLOL TAB : 40 MG (NF) $1.07
5602147 NIFEDIPINE CAP 10 MG $3.22
5602148 NIFEDIPINE (ADALAT) TBSA 30 MG $1.07
5602149 PROCAINAMIDE HCL TBSA : 500 MG (NF) $0.39
5602150 PROCAINAMIDE VIAL 500MG/ML 2ML (NF) $2.15
5602151 PROPRANOLOL (INDERAL) AMP: 1MG/ML (NF) $16.09
5602152 PROPRANOLOL (INDERAL) LA 60 MG (NF) $4.29
5602153 PROPRANOLOL HCL (INDERAL) TAB 40 MG $0.17
5602154 PROPRANOLOL HCL (INDERAL) TAB : 10 MG $0.13
5602155 QUINIDINE GLUCONATE TBSA : 324 MG (NF) $1.07
5602156 QUINIDINE SULFATE TAB : 200 MG (NF) $0.64
5602157 SOTALOL HCL (BETAPACE)TAB 80 MG $1.07
5602158 VERAPAMIL HCL TAB : 80 MG $0.17
5602159 VERAPAMIL IR : 120 MG (NF) $2.15
5602160 VERAPAMIL ER 120 MG $2.15
5602161 VERAPAMIL ER : 180 MG (NF) $1.07
5602162 VERAPAMIL SR TBSA : 240 MG $1.03
5602163 VERAPAMIL VIAL 2.5MG/ML 2ML ‐ NF $52.58
5602164 ATORVASTATIN CALCIUM TAB : 10 MG $7.51
5602165 GEMFIBROZIL (LOPID) TAB 600 MG $0.43
5602166 LOVASTATIN TAB : 20 MG $7.51
5602167 LUBRIDERM LOTION LOTN 473 ML (NF) $8.58
5602168 SIMVASTATIN (ZOCOR) TAB 10 MG $1.07
5602169 SIMVASTATIN (ZOCOR) TAB : 40 MG $11.80
5602170 BENAZEPRIL HCL (LOTENSIN) TAB : 20 MG $5.36
5602171 CLONIDINE HCL (CATAPRESS) PATC : 0.1 MG $96.57
5602172 CLONIDINE HCL (CATAPRESS) PATC : 0.2 MG $60.09
5602173 CLONIDINE HCL (CATAPRESS) PATC : 0.3 MG $299.36
5602174 cloniDINE (CATAPRESS) TAB 0.1 MG $0.13
5602175 DOXAZOSIN MESYLATE (CARDURA) TAB : 1 MG $3.22
5602176 hydrALAZINE TAB 25 MG $0.86
5602177 hydrALAZINE VIAL 20MG/ML 1ML J0360 $16.12
5602178 LABETALOL SYRD : 5 MG (NF) $60.09
5602179 LABETALOL VIAL 5 MG/ML 20ML $7.52
5602180 LABETALOL TAB 200 MG $1.07
5602181 LOSARTAN POTASSIUM (COZAAR) TAB 50 MG $2.15
5602182 METHYLDOPA (ALDOMET) TAB : 250 MG $0.21
5602183 NITROPRUSSIDE VIAL 25MG/ML 2ML $1,302.61
5602184 RESERPINE TAB : 0.1 MG $1.07
5602185 TERAZOSIN (HYTRIN) HCL CAP 1 MG $0.77
5602186 TAMSULOSIN (FLOMAX) CAP 0.4 MG $2.15
5602187 TERAZOSIN (HYTRIN) HCL CAP : 5 MG $1.07
5602188 ISOSORBIDE DINITRATE TAB 10 MG (NF) $0.13
5602189 ISOSORBIDE DINITRATE TAB 20 MG $2.15
5602190 ISOSORBIDE MONO (IMDUR) TAB 60 MG $6.45
5602191 NITROGLYCERIN TBSL : 0.3 MG (NF) $28.97
5602192 NITROGLYCERIN TBSL (1/150): 0.4 MG $8.60
5602193 NITROGLYCERIN VIAL : 5MG/ML 10ML $2.15
5602194 NITROGLYCERIN 0.1 MG/HR PATCH $2.15
5602195 NITROGLYCERIN 0.2 MG/HR PATCH (NF) $3.22
5602196 NITROGLYCERIN 0.4 MG/HR PATCH (NF) $3.22
5602197 NITROGLYCERIN 0.6MG/HR PATCH (NF) $2.15
5602198 NITROGLYCERIN 2% OINT : 1GM $0.99
5602199 NITROGLYCERIN 2% OINT 1 GRAM TUBE $8.60
5602200 ISOFLURANE (ANES) (FORANE) : 10ML $8.60
5602201 PROPOFOL (DIPRIVAN) VIAL 10MG/ML 20ML $9.67
5602202 PROPOFOL (DIPRIVAN) VIAL 10MG/ML 50ML $23.64
5602203 THIOPENTAL SODIUM SYRD : 500 MG $62.23
5602204 ASPIRIN SUPP 300 MG $5.37
5602206 ASPIRIN TAB 325 MG $0.04
5602207 ASPIRIN 81 MG CHEWABLE TABLET $0.09
5602208 ASPIRIN(ENTERIC COATED)TAB 325 MG $0.09
5602209 CLOPIDOGREL (PLAVIX) TAB 75 MG $26.87
5602211 ASPIRIN(ENTERIC COATED)TAB 81 MG $0.04
5602212 ASPIRIN‐CAFFEINE‐BUTALBITAL CAP (NF) $2.15
5602213 CELECOXIB 200 MG CAP $2.15
5602214 ROFECOXIB (VIOXX) TAB : 12.5 MG $8.58
5602215 ROFECOXIB (VIOXX) TAB : 25 MG $0.77
5602216 CHOL‐MG‐SAL(TRILISATE)(NF) TAB :500 MG $0.60
5602218 IBUPROFEN (MOTRIN) TAB 800 MG $0.43
5602219 IBUPROFEN (MOTRIN) TAB 600 MG $0.17
5602220 IBUPROFEN (MOTRIN) TAB 400 MG $0.13
5602222 INDOMETHACIN (INDOCIN) CAP 25 MG $0.64
5602223 INDOMETHACIN (INDOCIN) SUPP : 50 MG $6.44
5602224 INDOMETHACIN VIAL:1MG/ML 1ML (NF) $109.45
5602225 KETOROLAC (FOR IM USE ONLY) 60MG/2ML J1885 $3.22
5602226 KETOROLAC (TORADOL) VIAL 30MG/ML 1ML J1885 $9.67
5602227 NABUMETONE TAB : 500 MG $4.29
5602228 NAPROXEN TAB : 375 MG $0.52
5602229 NAPROXEN 250MG: $0.43
5602230 SALSALATE TAB : 500 MG (NF) $0.17
5602231 ALFENTANIL HCL AMP : 2.5MG/5ML $42.92
5602232 CODEINE‐APAP ELIX : 120ML $6.44
5602234 CODEINE‐APAP #3 (TYL#3)TAB : $1.07
5602235 CODEINE SULFATE TAB : 30 MG $1.07
5602236 CODEINE‐ASA‐CAFFEIN‐BUTALB #3CAP: 30MG $4.29
5602237 FENTANYL 100 MCG/2 ML AMPULE ‐ ANES ONLY $3.22
5602238 FENTANYL 250 MCG/5 ML VIAL $4.30
5602239 FENTANYL (DURAGESIC) 25 MCG/HR PATC $20.42
5602240 FENTANYL (DURAGESIC) 50MCG/HR PATC : $49.36
5602241 hydroCODONE‐APAP 5/500 (VICODIN) TAB‐NF $0.26
5602242 hydroMORPHONE VIAL 2 MG/ML 1 ML J1170 $7.52
5602243 HYDROMORPHONE AMP : 50 MG $38.63
5602244 hydroMORPHONE DRIP IVSL : 10MG/100ML BAG $23.61
5602245 hydroMORPHONE TAB 2 MG $0.56
5602246 MEPERIDINE HCL 30ML PCA : 10MG/ML (NF) $26.82
5602247 MEPERIDINE INJECTION 50MG/ML 1ML $13.97
5602248 MEPERIDINE HCL VIAL : 75 MG $2.15
5602249 MEPERIDINE HCL VIAL : 100 MG $0.17
5602250 MEPERIDINE HCL VIAL : 25 MG $2.15
5602251 MEPERIDINE HCL TAB : 50 MG $3.22
5602252 MORPHINE/ASTRAMORPH 2MG AMP‐anes only $26.82
5602253 MORPHINE SULFATE AMP : 10MG/ML 1ML $32.19
5602254 MORPHINE SULFATE ELIXIR 10MG/5ML J2270 $4.30
5602255 TINCTURE OF OPIUM (NF) $2.15
5602256 TIZANIDINE HCL TAB 4 MG $0.99
5602257 MORPHINE DRIP VIAL 25MG/ML 10 ML $40.84
5602259 MORPHINE SULFATE VIAL 10MG/1ML 1ML $2.15
5602260 MORPHINE SULFATE (MSIR) TAB 15 MG $3.22
5602261 MORPHINE SULFATE (MS CONTIN) : 30 MG $0.82
5602262 MORPHINE SULFATE (MS CONTIN):60MG $2.15
5602263 MORPHINE SULFATE (MS CONTIN) 15 MG $2.15
5602264 MORPHINE PCA 30 MG/30 ML J2270 $38.69
5602265 oxyCONTIN 10 MG TAB (EXTENDED RELEASE) $13.97
5602266 OXYCONTIN 20 MG TAB (EXT REL) ‐ NF $17.20
5602267 oxyCODONE‐APAP 5‐325 TAB (PERCOCET) $1.07
5602268 OXYCODONE‐ACETAMINOPHEN 5MG/325MG LIQU : $1.07
5602269 oxyCODONE 5 MG TAB (IMMEDIATE RELEASE) $2.15
5602270 PROPOXYPHENE (DARVON) CAP 65 MG (NF) $0.34
5602271 PROPOXYPHENE‐‐APAP (DARVOCET) TAB : (NF) $1.07
5602272 SUFENTANIL CITRATE AMP:100MCG/2ML (NF) $18.24
5602273 traMADOL HCL TAB 50 MG $3.22
5602274 BUTORPHANOL (STADOL) *** 2 MG/1 ML *** J0595 $17.20
5602275 NALBUPHINE HCL AMP : 10MG/ML 1ML $1.07
5602276 ACETAMINOPHEN 160MG/5ML 240ML BOTTLE $4.30
5602277 ACETAMINOPHEN (TYLENOL) SUPP 120 MG $0.47
5602278 ACETAMINOPHEN (TYLENOL) SUPP 650 MG $2.15
5602279 ACETAMINOPHEN (TYLENOL) SUPP 325 MG $0.73
5602280 ACETAMINOPHEN (TYLENOL) TAB 325 MG $0.43
5602281 ACETAMINOPHEN (TYLENOL EX) TAB 500 MG $0.86
5602282 ACETAMINOPHEN (TYLENOL)CHEW TAB : 80 MG $4.29
5602283 ACETAMINOPHEN INFANT DROP 80MG/0.8ML(NF) $8.58
5602284 ACETAMINOPH‐CAFF‐BUTAL(FIORICET)TAB ‐ NF $12.88
5602285 NALOXONE 0.4 MG/1 ML VIAL J2310 $25.79
5602286 PRIMIDONE TAB : 50 MG (NF) $0.77
5602287 CLONAZEPAM (KLONIPIN) TAB : 1 MG $0.77
5602288 clonAZEPAM (KLONIPIN) TAB 0.5 MG $0.77
5602289 PHENYTOIN(DILANTIN) SUSP:125MG/5ML 237ML $64.38
5602290 PHENYTOIN CHEW TAB : 50 MG (NF) $1.07
5602291 PHENYTOIN (DILANTIN) VIAL 250 MG/5 ML $5.36
5602292 PHENYTOIN (DILANTIN) CAP : 100 MG $1.03
5602293 LAMOTRIGINE (LAMICTAL) TAB 25 MG ‐NF $6.45
5602294 CARBAMAZEPINE TAB 200 MG $2.15
5602295 CARBAMAZEPINE XR (TEGRETOL) TAB : 100 MG $0.86
5602296 CARBAMAZEPINE CHEWABLE TAB 100 MG (NF) $0.86
5602298 DIVALPROEX SOD (DEPAKOTE) TAB : 500 MG $6.44
5602299 DIVALPROEX (DEPAKOTE) TAB 250 MG $6.45
5602301 GABAPENTIN (NEURONTIN) CAP 100 MG $2.15
5602302 GABAPENTIN (NEURONTIN) CAP 300 MG $1.07
5602303 GABAPENTIN (NEURONTIN) CAP : 400 MG $7.51
5602304 MAGNESIUM SUL 4%(40mg/ml) 1L‐OB use only $31.17
5602305 MAGNESIUM SUL 50% VIAL : 1GM/2ML 2ML $6.45
5602306 MAGNESIUM SUL 50% VIAL : 40.6MEQ/10ML $1.07
5602307 VALPROATE SOD SYR 250MG/5ML (NF) $41.85
5602308 AMITRIPTYLINE HCL (ELAVIL) TAB 50 MG‐NF $1.07
5602309 AMITRIPTYLINE HCL (ELAVIL) TAB 10 MG $0.13
5602310 BUPROPION HCL *IR* TAB 75 MG $0.86
5602311 BUPROPION SR (WELLBUTRIN) 150 MG $4.30
5602312 BUPROPION SR (WELLBUTRIN) 100 MG (NF) $5.36
5602313 DOXEPIN HCL (SINEQUAN) CAP 25 MG (NF) $0.26
5602314 DOXEPIN HCL (SINEQUAN) CAP : 50 MG $0.13
5602315 FLUOXETINE HCL (PROZAC) CAP 10 MG $0.43
5602316 PACLITAXEL (TAXOL) 30 MG (CHEMO) J9267 $35.41
5602317 FLUOXETINE HCL (PROZAC) TAB : 20 MG (NF) $2.15
5602318 CITALOPRAM HBR (CELEXA) TAB 20 MG $0.56
5602319 IMIPRAMINE (TOFRANIL) HCL TAB : 25 MG $1.07
5602320 IMIPRAMINE (TOFRANIL) TAB 10 MG (NF) $0.30
5602321 MIRTAZAPINE (REMERON) TAB : 15 MG $7.51
5602322 MIRTAZAPINE (REMERON) TAB 15MG $7.52
5602323 NORTRIPTYLINE HCL CAP : 25 MG (NF) $0.17
5602325 PAROXETINE (PAXIL) TAB 20 MG $0.95
5602326 PAROXETINE (PAXIL) TAB 30 MG (NF) $7.51
5602328 SERTRALINE HCL (ZOLOFT) TAB : 100 MG $8.58
5602329 SERTRALINE HCL (ZOLOFT) TAB 50 MG $0.39
5602330 traZODONE HCL TAB 50 MG $0.43
5602331 TRAZADONE (DESYREL) TAB : 100 MG $0.43
5602333 VENLAFAXINE IR : 25 MG TAB (NF) $4.29
5602334 VENLAFAXINE IR 37.5 MG TAB $2.15
5602335 CHLORPROMAZINE AMP :25MG/ML 2ML (NF) $13.95
5602336 CHLORPROMAZINE (THORAZINE) 25 MG TAB‐NF $1.07
5602337 HALOPERIDOL (HALDOL) TAB : 0.5 MG $0.26
5602338 HALOPERIDOL (HALDOL) TAB 1 MG $0.39
5602339 HALOPERIDOL (HALDOL) VIAL 5MG/ML 1ML $10.75
5602340 OLANZAPINE (ZYPREXA) TAB : 10 MG $31.12
5602341 OLANZAPINE (ZYPREXA) TAB 2.5 MG $0.60
5602342 OLANZAPINE (ZYPREXA) TAB : 2.5 MG $17.17
5602343 QUETIAPINE FUMARATE TAB 100 MG $18.27
5602344 QUETIAPINE FUMARATE TAB 25 MG $1.03
5602345 RISPERIDONE 1 MG TABLET $2.15
5602346 RISPERIDONE TAB : 3 MG (NF) $22.53
5602347 THIORIDAZINE HCL TAB 50 MG (NF) $0.73
5602348 THIORIDAZINE HCL TAB : 25 MG $0.13
5602349 AMMONIA INHALATION $1.07
5602350 METHYLPHENIDATE HCL (RITALIN)TAB : 10 MG $0.99
5602351 METHYLPHENIDATE (RITALIN) TAB 5 MG $1.07
5602352 METHYLPHENIDATE (RITALIN) TAB 20 MG (NF) $3.22
5602353 PHENOBARBITAL ELIX : 20MG/5ML 480ML $20.39
5602354 PHENOBARBITAL TAB : 30 MG (NF) $0.09
5602355 PHENOBARBITAL SODIUM VIAL : 65MG/ML 1ML J2560 $72.01
5602356 SCOPOLAMINE PATCH 1.5MG $79.53
5602357 ALPRAZOLAM (XANAX) TAB 0.5 MG $0.21
5602358 CHLORDIAZEPOXIDE HCL AMP : 100 MG $68.67
5602359 CHLORDIAZEPOXIDE HCL (LIBRIUM)CAP: 25 MG $0.17
5602360 DIAZEPAM (VALIUM) TAB 5 MG $0.13
5602361 DIAZEPAM GEL 5 MG (NF) $377.69
5602362 DIAZEPAM (VALIUM) INJ 5MG/ML 2ML J3360 $96.57
5602363 FLURAZEPAM HCL (DALMANE) CAP : 15 MG $0.26
5602364 LORAZEPAM (ATIVAN) VIAL 2MG/ML 1ML $17.20
5602365 LORAZEPAM DRIP : 1 MG/ML FINAL CONC $47.21
5602369 LORAZEPAM (ATIVAN) TAB 0.5 MG $0.21
5602370 ZOLPIDEM (AMBIEN) TAB 5 MG $0.26
5602371 MIDAZOLAM ORAL SYRUP 5 MG/2.5 ML $11.82
5602372 MIDAZOLAM 5MG/1ML VIAL‐ AMBULANCE USE $4.30
5602373 MIDAZOLAM 2 MG/2 ML VIAL J2250 $2.15
5602374 OXAZEPAM (SERAX) : 10 MG (NF) $0.86
5602375 OXAZEPAM (SERAX) : 15 MG (NF) $2.15
5602376 TEMAZEPAM CAP 15 MG (NF) $1.07
5602378 TRIAZOLAM (HALCION) TAB 0.25 MG (NF) $18.24
5602379 BUSPIRONE HCL (BUSPAR) TAB : 5 MG $3.22
5602380 BUSPIRONE HCL (BUSPAR) TAB (NF): 15 MG $6.44
5602381 CHLORAL HYDRATE SYRP : 500MG/5ML $0.04
5602382 DROPERIDOL VIAL: 5 MG/2 ML $12.88
5602383 hydroXYZINE (VISTARIL) HCL TAB 25 MG $0.13
5602384 hydrOXYZINE HCL(VISTARIL):50MG/1ML (NF) $13.95
5602385 LITHIUM CARBONATE CAP : 300 MG (NF) $0.13
5602386 AMANTADINE CAP 100 MG $6.44
5602387 CARBIDOPA‐LEVO (SINEMET) 25‐100 IR TAB $1.07
5602388 CARBI‐LEVO (SINEMET) 25‐250 IR TAB (NF) $2.15
5602389 CARBI‐LEVO (SINEMET) 50‐200 ER $1.07
5602390 PRAMIPEXOLE TAB 1 MG $7.52
5602391 FLUMAZENIL VIAL 0.1MG/ML $12.90
5602392 FLUMAZENIL VIAL : 0.1MG/ML 10ML $261.81
5602393 SUMATRIPTAN (IMITREX) VIAL 6MG J3030 $25.79
5602394 CHLORHEXIDINE (PERIDEX) LIQU : 480ML $17.17
5602395 FLUORESCEIN STRIP (FLUOR‐I‐STRIP) $2.15
5602397 INDIGO CARMINE SOD 0.8% AMP : 5ML (NF) $31.12
5602398 EDROPHONIUM CHLORIDE AMP : 10 MG/ML 1ML $15.02
5602399 TUBERCULIN PURIF PROT DERIV VIAL : 5 U $33.26
5602400 SODIUM BICARBONATE 4.2% INFANT SYR: 10ML $36.48
5602401 SODIUM BICARBONATE 4% VIAL : 2.4 MEQ/5ML $29.02
5602402 SODIUM BICARBONATE 8.4% SYRINGE 50ML $38.69
5602403 SODIUM CITRATE‐CITRIC ACID SOLN :30ML $5.37
5602404 LACTULOSE SYRUP 10GM/15ML 480ML $12.88
5602405 LACTULOSE SYRP UD 20 GM/30ML $3.22
5602406 CALCIUM ACETATE (PHOSLO) TAB 667 MG $3.22
5602407 CALCIUM CARBONATE (OS‐CAL) TAB : 1.25 GM $0.17
5602408 CALCIUM CHLORIDE 10% SYR : 1GM/10ML $32.24
5602409 CALCIUM GLUC 1GM/10ML VIAL FOR IVP $35.47
5602410 ELECTROLYTE SOLN (PEDIALYTE) 1 LITER $9.67
5602411 HETASTARCH‐NA CHLOR 0.9% PBAG : $185.63
5602412 MAGNESIUM GLUCONATE TAB : 500 MG $0.09
5602413 POTASSIUM CHLORIDE (K‐DUR) TB : 10 MEQ $1.07
5602414 POTASSIUM CHL (K‐DUR) TAB 20 MEQ $3.22
5602415 POTASSIUM CHL VIAL 40MEQ/20ML(NO IVPUSH) $13.97
5602416 POTASSIUM CHL 10% ELIX 20MEQ/15ML $26.87
5602417 POTASSIUM PHOSPHATE VIAL 3MMOL/ML 5ML $35.47
5602418 SODIUM CHLORIDE TAB : 1 GM (NF) $0.43
5602419 SODIUM CHLOR VIAL (23.4%) 4 MEQ/ML 30ML $23.64
5602420 NS VIAL 10ML $3.22
5602421 TRACE METALS VIAL $10.73
5602422 SELENIUM VIAL : 40 MCG/ML 10ML (NF) $2.15
5602423 ZINC SULFATE VIAL : 1 MG/ML 10ML $1.07
5602424 CHROMIUM VIAL : 4 MCG/ML 1ML $2.15
5602425 TRASTUZUMAB VIAL 440MG (CHEMO) J9355 $8,977.72
5602426 ZINC LOZG : 23 MG $0.17
5602427 ZINC SULFATE CAP 220 MG $0.09
5602428 SODIUM POLYSTY SULFONATE SUSP :15GM/60ML $30.09
5602429 DEXTROSE 25% (INFANT) : 10ML $32.24
5602430 D50% ABBOJECT : 50ML $33.32
5602431 GLUCOSE POLYMERS PWD : $11.80
5602434 LACTOSE‐FREE FOOD LIQU : $1.07
5602435 LACTOSE‐FREE FOOD LIQU : $2.15
5602437 LACTOSE‐FREE FOOD‐FIBER LIQU : $2.15
5602439 BUMETANIDE (BUMEX) TAB : 1 MG $0.86
5602440 BUMETANIDE 1 MG/4 ML VIAL $9.67
5602441 CHLOROTHIAZIDE (DIURIL)(NF) VIAL :500 MG $35.41
5602442 CHLORTHALIDONE TAB 25 MG $0.43
5602443 ETHACRYNATE SODIUM VIAL : 50 MG (NF) $76.18
5602444 ETHACRYNIC ACID TAB : 25 MG $1.03
5602445 FUROSEMIDE(LASIX)SOLN (NF):10 MG/ML 60ML $12.88
5602447 FUROSEMIDE (LASIX) TAB 20 MG $0.18
5602448 FUROSEMIDE (LASIX) TAB 40 MG $0.26
5602449 FUROSEMIDE FOR IVP DOSES 1‐20 MG $8.60
5602450 FUROSEMIDE FOR IVP DOSES 21‐40 MG $15.05
5602451 FUROSEMIDE FOR IVP DOSES 41‐80 MG $16.12
5602452 HYDROCHLOROTHIAZIDE (HCTZ) TAB 25 MG $0.13
5602453 HYDROCHLOROTHIAZIDE (HCTZ) TAB : 50 MG $0.13
5602454 MANNITOL 25% VIAL : 12.5 GM $7.52
5602455 METOLAZONE (ZAROXOYLN) TAB 2.5 MG $6.45
5602456 TRIAMTERENE‐HCTZ 37.5MG‐25MG $0.64
5602458 SPIRONOLACTONE (ALDACTONE) TAB 25 MG $0.95
5602459 DEXTRAN 70‐DEXTROSE 10%‐WATER SOLI : $96.57
5602460 NS IRRIGATION BOTTLE 1.5 L $18.27
5602461 HYALURONIDASE VIAL : 150 U $80.47
5602462 BENZONATATE (TESSALON PERLE) CAP: 100 MG $0.95
5602463 CODEINE‐PROMETHAZINE SYRP : $0.04
5602464 GUAIFENESIN & DEXTROMETHORPHAN 120ML $3.22
5602465 GUAIFENESIN PLAIN 200 MG/10 ML UD CUP $1.07
5602466 GUAIFENESIN PLAIN SYRP : 100MG/5ML 120ML $2.15
5602467 acetylCYSTEINE INHALA(MUCOMYST) 20% ‐ NF $41.85
5602468 BACITRACIN OPHTHALMIC OINTMENT $207.09
5602469 ERYTHROMYCIN OPHTH OINT 3.5GM $61.26
5602470 ERYTHROMYCIN OPHTH OINT 1 GM $17.20
5602471 GENTAMICIN OPTH DROP (NF) $4.29
5602472 GENTAMICIN SULFATE OPH OINT 3.5GM ‐NF $41.85
5602473 NEOMY‐POLY‐HC(CORTISPORIN)OTIC 10ML $212.45
5602474 TOBRAMYCIN SULFATE DROP : 5ML (NF) $4.29
5602475 TOBRAMYCIN 0.3% OPTH OINT 3.5 GM (NF) $185.63
5602476 TOBRAMYCIN‐DEXAMET 0.3%‐0.1% DROP $141.86
5602477 SULFACETAMIDE SODIUM 10% DROP 5 ML $305.80
5602478 SULFACETAMIDE 10% OPHT OINT 3.5 GM (NF) $4.29
5602479 CARBAMIDE PEROXIDE 10% SOLN : 15ML $16.09
5602480 CIPROFLOXACIN 0.3% OPTH DROP:5ML $48.36
5602481 BECLOMETHAS(BECONASE) 0.042% SPRA : 25GM $136.27
5602482 FLUOROMETHOLONE DROP : 5ML (NF) $12.88
5602483 FLUTICASONE (FLONASE) NASAL SPRAY : 16GM $23.64
5602484 PREDNISOLONE ACETATE 1% OPTH DROP $151.53
5602485 ACETAZOLAMIDE (DIAMOX) TAB : 250 MG $0.47
5602486 ACETAZOLAMIDE (DIAMOX) VIAL 500 MG J1120 $51.59
5602487 SOFT LENS ADJUNCTIVE SOLUTIONS : 360ML $16.09
5602488 SOFT LENS ENZYMATIC CLEANSER EACH : $16.09
5602489 ANTIPYRINE‐BENZOCAINE OTIC DROP : 15ML $55.80
5602490 BENZOCAINE 20% SPRY BOT : 60ML $20.42
5602491 CETYLPYRIDINIUM (CEPACOL) LOZG : 2 MG $1.07
5602492 COCAINE HCL 4% SOLN : 4ML $80.47
5602493 LIDOCAINE VISCOUS 2% SOLN : 100ML $5.36
5602494 LIDOCAINE TOPICAL 4% SOLN 50 ML $126.82
5602495 TETRACAINE HCL 0.5% OPHTH DROP ‐ NF $134.12
5602496 CARBACHOL OPHTH (MIOSTAT)0.01% : 1.5ML $54.81
5602497 CARBACHOL 3% OPHTH DROP(ISOPTO) : 15ML $69.74
5602498 PILOCARPINE HCL 2% DROP : 15ML $7.51
5602499 PHENYLEPHRINE‐CYCLOPENTOLATE : 2ML (NF) $66.53
5602500 TROPICAMIDE 1% OPHTH DROP : 1 DROP $9.66
5602501 HYDROGEN PEROXIDE 3% SOLN : 480ML $3.22
5602502 PHENYLEPHRINE 2.5% OPTH ‐ DON'T USE! $358.38
5602503 PHENYLEPHRINE 2.5% OPHTH DROP $113.92
5602504 BRIMONIDINE 0.2% DROP : 15ML (NF) $851.96
5602505 CARBAMIDE PEROXIDE 6.5% OTIC DROP : 15ML $26.82
5602506 FLURBIPROFEN 0.03% OPHTH DROP : 2.5ML $16.09
5602507 LANOL‐MINERA‐PETRO OINT OPT(1GM TUBE) NF $3.22
5602508 EYE LUBRICANT (OPTH OINT) 3.5 GM $8.60
5602509 POLYVINYL ALCOHOL 1.4% OPHTH DROP : 15ML $5.37
5602510 SOD‐POT‐CAL‐MAG,EYE STREAM SOL : 30ML $81.68
5602511 BSS OPTHALMIC SOLN: 500ML $22.53
5602512 SODIUM CHLORIDE SPRY : 45ML $4.30
5602513 BSS OPTHALMIC SOLN : 15ML $10.75
5602514 EYE WASH OPTH SOLUTION: 118ML $26.82
5602515 TIMOLOL MALEATE 0.5% OPTH SOL 5ML $20.42
5602516 TRIETHANOLAMINE POLY OLEATE DROP : 6ML $71.89
5602517 ACTIVATED CHARCOAL W/ SORBITAL 120ML $88.13
5602518 CALCIUM CARBONATE (TUMS) TABC 500 MG $0.17
5602519 MAG HYDROX‐AL HYDROX‐SIMETH SUSP : 360ML $6.44
5602520 MILK OF MAGNESIUM:80MEQ/30ML $1.07
5602521 MAGNESIUM OXIDE (MAG‐OX) TAB 400 MG $0.69
5602522 BISMUTH SUBSALICYL SUSP : 262MG/15ML $6.44
5602523 DIPHENOXYLATE‐ATROP (LOMOTIL) TAB : (NF) $1.07
5602524 LOPERAMIDE (IMODIUM) CAPSULE 2 MG $2.15
5602525 LOPERAMIDE LIQUID 1 MG/5ML 120ML (NF) $9.66
5602526 SIMETHICONE DROP 40 MG/0.6ML 30ML $8.58
5602527 SIMETHICONE CHEW TAB 80 MG $0.13
5602528 BISACODYL (DULCOLAX) SUPP 10 MG $0.21
5602529 BISACODYL (DULCOLAX) TAB 5 MG $0.09
5602530 FIBERCON 625 MG UD TABLET (NF) $0.43
5602531 CASTOR OIL $4.29
5602532 DOCUSATE CALCIUM (SURFAK) CAP (NF) $0.17
5602533 DOCUSATE SODIUM (COLACE) 100 MG $0.34
5602534 DOCUSATE (COLACE) 10MG/1ML 480ML (NF) $9.66
5602535 DONEPEZIL (ARICEPT) TAB 5 MG $4.29
5602536 ELECTROLYTE SOLN (GOLYTELY) : 4 LITER $26.87
5602537 GLYCERIN ADULT SUPPOSITORY $0.56
5602538 MAGNESIUM CHLORIDE TBSA : 64 MG (NF) $0.52
5602539 MAGNESIUM CITRATE SOLN 300ML $6.45
5602540 MAGNESIUM HYDR/ALUM SUSP : 80 MEQ/30ML $7.51
5602541 MINERAL OIL (TOPICAL, STERILE) 25 ML $17.20
5602542 MINERAL OIL OIL : 480ML $8.58
5602543 MINERAL OIL OIL : 30ML $0.86
5602544 PSYLLIUM‐SODIUM BICARBONATE PACK : 1PACK $0.60
5602545 SENNA TAB 8.6 MG $0.13
5602546 SORBITOL SOLUTION 70% SOLN : 480ML (NF) $16.09
5602547 IPECAC SYRP : 30ML $8.58
5602548 MECLIZINE HCL TAB 12.5 MG (NF) $0.13
5602549 MECLIZINE HCL TAB 25 MG $0.17
5602551 PROCHLORPERAZINE VIAL 10 MG/2 ML J0780 $48.36
5602552 PROCHLORPERAZINE SUPP 5 MG (NF) $8.58
5602553 PROCHLORPERAZINE (COMPAZINE) SUPP 25 MG $25.79
5602554 PROCHLORPERAZINE (COMPAZINE) TAB 5 MG $1.07
5602555 TRIMETHOBENZAMIDE HCL SUPP : 200 MG $1.07
5602556 FAMOTIDINE (PEPCID) VIAL 10 MG/ML 2ML $5.37
5602557 MESALAMINE (ASACOL) TAB 400 MG (NF) $11.80
5602558 METOCLOPRAMIDE (REGLAN) TAB 10 MG $0.34
5602559 METOCLOPRAMIDE (REGLAN) VIAL 10MG/2ML J2765 $4.30
5602560 MISOPROSTOL (CYTOTEC) TAB 100 MCG $2.15
5602561 NIZATIDINE CAP : 150 MG $0.43
5602562 OMEPRAZOLE CAP 20 MG $0.99
5602563 LANSOPRAZOLE (PREVACID)CPDR : 15 MG $1.07
5602564 LANSOPRAZOLE (PREVACID) CPDR : 30 MG $1.07
5602565 SUCRALFATE SUSP:1GM/10ML 480ML (NF) $137.34
5602566 SUCRALFATE TAB : 1 GM $1.07
5602567 SUCRALFATE TAB : 1 GM $1.07
5602568 BECLOMETHASONE DIPROPIONATE ARED: 16.8GM $145.93
5602569 BETAMETH PHOS‐BETAMETH VIAL: 6MG/ML 5ML J0702 $144.01
5602570 DEXAMETHASONE TAB : 0.5 MG (NF) $0.13
5602571 DEXAMETHASONE (DECADRON) TAB 4 MG $1.07
5602572 DEXAMETHASONE SOD PHOS VIAL 4MG/ML 1ML J1100 $4.30
5602573 DEXAMETHASONE SOD PHOS VIAL 4MG/ML 5ML $3.22
5602574 FLUDROCORTISONE TAB 0.1 MG $2.15
5602575 MIDODRINE TAB 2.5 MG (NF) $4.29
5602576 FLUTICASONE (FLOVENT) ARED : 44 MCG $187.77
5602577 FLUTICASONE (FLOVENT) INH 110MCG‐NF $546.15
5602578 HYDROCORTISONE TAB 10 MG $2.15
5602579 HYDROCORTISONE SOD SUCCI VIAL 100MG J1720 $53.74
5602580 hydroCORTISONE SOD SUCCI VIAL 250MG‐NF J1720 $20.39
5602581 METHYLPREDNISOLONE (DEPO) VIAL 40 MG J2920 $27.90
5602582 METHYLPREDNI SOD SUCC(SOLU‐MEDROL) 500MG $30.04
5602583 METHYLPREDNI SOD SUC(SOLU‐MEDROL) 1000MG J2930 $47.29
5602584 METHYLPRED (SOLU‐MEDROL) 40MG $19.34
5602585 METHYLPRED (SOLU‐MEDROL) 125 MG J2930 $30.09
5602586 PREDNISOLONE SOLN:5MG/5ML 120ML $3.22
5602587 PREDNISONE TAB : 5 MG (NF) $0.09
5602588 PREDNISONE TAB 20 MG $0.30
5602589 PREDNISONE TAB 10 MG $0.09
5602590 TRIAMCINOLONE ACETONIDE ARED (NF) $267.17
5602591 TRIAMCINOLONE ACET VIAL 40 MG/ML 1 ML J3301 $36.54
5602592 TRIAMCINOLONE DIAC 25MG/ML 25ML (NF) $69.74
5602594 ESTRADIOL (ESTRACE) TAB : 1 MG (NF) $0.77
5602595 ESTRADIOL (ESTRACE) TAB : 0.5 MG $0.39
5602596 ESTRADIOL (DEPO) VIAL 5MG/ML 5ML (NF) $74.04
5602597 ESTROGENS,CONJUG (PREMARIN) TAB : 0.9 MG $2.15
5602598 ESTROGENS,CONJ (PREMARIN) 0.625MG (NF) $2.15
5602600 ESTROGENS,CONJ (PREMARIN) 0.3 MG (NF) $4.29
5602601 ESTROGENS,CONJ (PREMARIN) VIAL 25 MG(NF) $666.33
5602602 INSULIN NPH 70/30 VIAL : 100U/ML $184.55
5602603 INSULIN (ULTRALENTE): 100U/ML $57.94
5602604 INSULIN (NOVOLOG) VIAL :100U/ML PER UNIT $0.17
5602605 INSULIN NPH VIAL : 100U/ML $57.94
5602606 INSULIN LANTUS VIAL : 100U/ML $218.89
5602607 INSULIN REG HUMAN VIAL : 100U/ML $64.38
5602608 INSULIN (LENTE) : 100 U/ML $66.53
5602609 GLIPIZIDE (GLUCOTROL) TAB 5 MG $0.26
5602611 GLYBURIDE (MICRONASE) TAB : 2.5 MG $0.52
5602612 GLYBURIDE (MICRONASE) TAB : 5 MG ‐ NF $0.69
5602613 GLIMEPIRIDE (AMARYL) TAB : 4 MG $4.29
5602614 ROSIGLITAZONE MALEATE TAB : 4 MG $11.80
5602617 GLUCAGON VIAL : 1 MG J1610 $424.51
5602618 METFORMIN (GLUCOPHAGE) TAB 500 MG $1.07
5602619 CALCITONIN‐SALMON VIAL 200U/ML 2ML (NF) J0630 $43.99
5602620 DESMOPRESSIN NASAL SPRAY 0.1MG/ML (NF) $195.28
5602621 DESMOPRESSIN (DDAVP) 4 MCG/ML 10 ML (NF) J2597 $1,331.58
5602622 VASOPRESSIN VIAL 20 UNITS $470.72
5602623 MEDROXYPROGESTERONE ACET TAB : 10 MG $0.30
5602624 MEDROXYPROGESTERONE TAB 10 MG $0.60
5602625 MEDROXYPROG (DEPO‐PROVERA) 150MG/ML $336.38
5602626 levoTHYROXINE (SYNTHROID) TAB 100 MCG $5.37
5602627 LEVOTHYROXINE (SYNTHROID) TAB: 125MCG $0.17
5602628 LEVOTHYROXINE (SYNTHROID) TAB:0.075MG $0.04
5602629 LEVOTHYROXINE TAB (NF) 150 MCG $0.43
5602630 levoTHYROXINE (SYNTHROID) TAB 25 MCG $0.39
5602634 levoTHYROXINE (SYNTHROID) VIAL 100 MCG $428.81
5602635 THYROID TAB : 60 MG (NF) $0.09
5602636 METHIMAZOLE (TAPAZOLE) TAB : 5 MG $1.07
5602637 PROPYLTHIOURACIL (PTU) TAB : 50 MG (NF) $0.13
5602638 BUPIVacaine MPF 0.25% VIAL : 10ML $21.49
5602639 BUPIVacaine MPF 0.25% VIAL : 30ML $5.37
5602640 BUPIVACAINE 0.25%‐EPI 1:200000 VIAL 30ML $33.32
5602641 BUPIVacaine plain 0.5% VIAL : 10ML $7.51
5602642 BUPIVacaine MPF 0.5% VIAL : 30ML $33.32
5602643 LIDOCAINE 1% 10 ML MDV $4.30
5602644 LIDOCAINE MPF 0.5% VIAL : 50ML $30.09
5602645 LIDOCAINE 1% VIAL : 2ML $3.22
5602646 LIDOCAINE MPF 1% VIAL 30ML ‐ DO NOT USE $7.51
5602647 LIDOCAINE MPF 1% STERILE‐PAK:10ML $13.95
5602648 LIDOCAINE 2% 20 ML MDV $5.37
5602649 ETHYL ANESTHESIA TOP SPRAY (NF) $48.28
5602650 LIDOCAINE 2% VIAL : 5ML $12.90
5602651 LIDOCAINE 4% AMP : 5ML $9.66
5602652 LIDOCAINE 1.5%‐EPI 1:200000 VIAL : 30ML $31.17
5602653 LIDOCAINE 1%‐EPI 1:100000 VIAL 10ML (NF) $11.82
5602654 LIDOCAINE 1%‐EPI 1:100000 VIAL 20ML $17.20
5602655 MEPIVACAINE HCL 1.5% VIAL : 30ML $18.24
5602656 PROCAINE HCL 10% AMP : 2ML (NF) $25.75
5602657 CARBOPROST (HEMABATE) AMP:250MCG/ML 1ML $1,044.62
5602658 METHYLERGONOVINE MALEATE AMP : 0.2 MG/ML $67.71
5602659 METHYLERGONOVINE MALEATE TAB 0.2 MG (NF) $233.91
5602660 oxyTOCIN VIAL : 10 U J2590 $5.37
5602662 TETANUS DIPH TOXOID ADULT SYRD : 0.5ML 90714 $106.40
5602663 HEPATITIS A VIRUS VACCINE SYRD : 1440 U $328.34
5602664 HEPATITIS B (ENGERIX‐B) 10MCG/0.5ML‐PEDI J3490 $92.28
5602665 MEASLES,MUMPS&RUBELLA VACCINE VIAL 90707 $285.87
5602666 PNEUMOCOCCAL VACC 23‐VALENT VIAL :0.5ML 90732 $309.02
5602667 INFLUENZA VACCINE FOR 64 YO AND YOUNGER 90658 $45.14
5602668 RABIES VACCINE,HUMAN DIPLOID SYRD : 0.25 $331.55
5602669 RABIES VACCINE,HUMAN DIPLOID VIAL : 2.5 90675 $1,009.15
5602670 RUBELLA VACCINE VIAL : $66.53
5602671 TYPHOID VI VACCINE 25 MCG/0.5ML (NF) $300.44
5602672 BACITRACIN TOPICAL UD PACK $0.43
5602673 BACITRACIN ZINC OINT 15 GRAM TUBE $9.67
5602674 MUPIROCIN (BACTROBAN) 2% OINT : 22GM $25.79
5602675 NEOMYCIN‐BACITRA‐POLYMYXIN PACK : $0.17
5602676 CLOTRIMAZOLE 1% (LOTRIMIN)CREM : 15GM $8.60
5602677 CLOTRIMAZOLE‐BETAMETHASONE CREM : 15GM $8.60
5602678 KETOCONAZOLE 2% CREM : 15GM $78.45
5602679 KETOCONAZOLE 2% SHAM : 120ML (NF) $82.62
5602680 MICONAZOLE NITRATE 2% CREAM : 45GM $19.34
5602681 NYSTATIN CREAM 15 GM $35.47
5602682 LINDANE 1% SHAM : 480ML (NF) $10.73
5602683 BAG BALM OINT (NF) $15.02
5602684 POVIDONE‐IODINE 10% SOLN : 4 OZ $17.17
5602685 POVIDONE‐IODINE 7.5% SCRUB : 4 OZ $17.17
5602686 SILVER SULFADIAZINE 1% CREME 25GM $20.42
5602687 SILVER SULFADIAZINE 1% CREME : 400GM $62.23
5602688 BETAMETHASONE VALERATE 0.1% CREM : 15GM $6.44
5602689 FLUOCINONIDE 0.05% CREM : 15GM $5.36
5602690 hydroCORTISONE ACETATE SUPP 25 MG $37.61
5602691 HYDROCORTISONE VALERATE 0.2% CREM : 15GM $41.85
5602692 hydroCORTISONE 1% CREM : 30GM $5.37
5602693 TRIAMCINOLONE ACETONIDE 0.1% CREM : 80GM $6.44
5602694 TRIAMCINOLONE ACETONIDE 0.1% CREM: 15GM $2.15
5602695 LIDOCAINE‐PRILOCAINE 2.5%/2.5% 5 gram $25.79
5602696 PHENAZOPYRIDINE (PYRIDIUM) TAB 100 MG $3.22
5602697 PHENAZOPYRIDINE HCL TAB : 100 MG $0.43
5602698 CALAMINE LOTION: 120ML $3.22
5602699 METHYL SALIC‐MENT OINT (BEN‐GAY): 57GM $8.60
5602700 EUCERIN (GENERIC) CREAM 4 OZ $16.12
5602701 ZINC OXIDE PAST : 30GM (NF) $3.22
5602702 CAPSAICIN (ZOSTRIX)CREAM (NF) $68.67
5602703 ISOPROPYL ALCOHOL 70% SOLN : 480ML $4.29
5602704 HEMORRHOIDAL OINT : 30GM $25.79
5602705 ZINC OXIDE OINT 60GM $3.22
5602706 oxyBUTYNIN CHLORIDE (DITROPAN)TAB 5 MG $1.07
5602707 AMINOPHYLLINE VIAL 500 MG/20 ML $25.79
5602708 THEOPHYLLINE ANHYDROUS SOLN : 80 MG/15ML $0.52
5602709 NF‐THEOPHYLLINE TAB : 200 MG $2.15
5602710 THEOPHYLLINE ANHYDROUS TAB : 300 MG $0.30
5602711 VITAMIN A CAP : 10000 U $0.09
5602712 CYANOCOBALAMIN (VIT B12)TAB 500 MCG $0.09
5602713 CYANOCOBALAMIN (VIT B12) VIAL1000 MCG/ML $15.05
5602714 FOLIC ACID TAB 1 MG $0.86
5602716 FOLIC ACID VIAL : 5 MG $16.09
5602717 FOLIC ACID‐VITAMIN B COMP W‐C CAP : 1 MG $0.64
5602718 PYRIDOXINE VIAL 100 MG/ML 1ML ‐ NF $32.19
5602719 THIAMINE HCL TAB : 100 MG $0.13
5602720 THIAMINE HCL VIAL 100 MG/ML 2ML J3411 $39.76
5602721 ASCORBIC ACID TAB (VITAMIN C) 500 MG $0.17
5602723 CALCITRIOL CAP 0.25 MCG $2.15
5602724 VITAMIN D 50,000 IU ‐ FOR WEEKLY USE $0.90
5602725 VITAMIN E CAP : 400 U (NF) $0.17
5602726 PHYTONADIONE (NEWBORN) 1 MG/0.5 ML $69.86
5602727 PHYTONADIONE (ADULT) 10 MG/ML PO/IM/SC J3430 $180.55
5602728 MULTIVITAMINS INFUSION VIAL : 10ML $26.87
5602729 PRENATAL VITS W‐CA,FE,FA(1MG) TAB : $0.26
5602730 MULTIVITAMINS W‐IRON TAB (NF) $0.09
5602731 MULTIVITAMINS LIQUID : 120ML $12.88
5602732 ALENDRONATE SODIUM (FOSAMAX) TAB : 5 MG $6.44
5602733 ALLOPURINOL TAB 100 MG $0.13
5602734 ALLOPURINOL TAB 300 MG ‐ NF $0.13
5602735 BROMOCRIPTINE MESYLATE TAB 2.5 MG (NF) $5.36
5602738 COLCHICINE (COLCRYS) TAB 0.6 MG $26.87
5602739 PROBENECID TAB : 500 MG $1.07
5602740 DINOPROSTONE SUPP 10 MG $1,203.67
5602741 DINOPROSTONE SUPP 20 MG (NF) $381.99
5602742 LEUCOVORIN CALCIUM VIAL : 50 MG (CHEMO) J0640 $11.80
5602743 METHYLENE BLUE 1% VIAL 1 ML Q9968 $65.45
5602744 OCTREOTIDE 100 MCG/ML 1ML INJECTION J2353 $17.20
5602745 SODIUM FLUORIDE DROP : 0.5 MG/ML 50ML $15.02
5602746 SODIUM FLUORIDE TABC : 1 MG $0.04
5602747 SODIUM FLUORIDE TABC : 0.5 MG $0.04
5602748 HEALON GV : 14 MG $393.79
5602750 GLYCERIN LIQUID : 120ML (NF) $5.36
5602751 PEPPERMINT OIL SPIR : 30ML $6.44
5602752 PETROLATUM WHITE JEL 390 GM (NF) $5.36
5602753 WATER FOR INJECTION STERILE VIAL : 10ML $3.22
5602754 GLYCOPYRROLATE VIAL : 0.2 MG/ML 1ML $2.15
5602755 ALUMINUM ‐CALCIUM(DOMEBORO)PACK $2.15
5602756 NYSTATIN OINT 30 GM (NF) $7.51
5602757 BACITRACIN ZINC OINT 120 GRAM TUBE $11.80
5602760 BECAPLERMIN (NF) GEL : 15GM $1,201.75
5602761 COD‐ZINC OXIDE (DIAPER RASH)OINT : 120GM $5.36
5602762 NEOMYCIN‐BACITRA‐POLYMYXIN OINT 30GM $5.37
5602763 LIDOCAINE HCL 1% VIAL : 30ML $22.53
5602764 PHENYLEPHRINE 0.5% NASAL SPRY :15ML $16.12
5602765 MULTIVITAMINS TAB $0.21
5602767 TETANUS IMMUNE GLOBULIN SYRD : 250 U J1670 $1,295.10
5602768 LIDOCAINE 2% JELLY 20ML $32.24
5602769 GUAIFENESIN & CODEINE SYRUP 120ML $23.61
5602770 PHOSPHORUS (K‐PHOS) TAB 250 MG $1.07
5602771 FENTANYL (DURAGESIC) 75 MCG/HR PATC $55.80
5602772 GUAIFENESIN & CODEINE SYRUP 5 ML UD CUP $2.15
5602773 METHYLENE BLUE 1% VIAL : 10ML $15.02
5602774 LINDANE 1% SHAM : 60ML (NF) $10.73
5602775 CODEINE‐APAP ELIX UD: 5 ML $2.15
5602776 HEPATITIS A VIRUS VACCINE SYRD : 720 U $114.81
5602777 ACETYLCHOLINE (MIOCHOL‐E) DROP : 2ML $110.52
5602779 ALENDRONATE (FOSAMAX) TAB 10 MG (NF) $6.44
5602780 ALENDRONATE LA (FOSAMAX) TAB 70 MG $3.22
5602781 HEPATITIS A (VAQTA) ADULT SYRD : 50 U $177.04
5602782 BETAXOLOL 0.25% OPHTH DROP : 10ML (NF) $180.26
5602783 PHENYLEPHRINE‐CYCLOPENTOLATE : 5ML (NF) $42.92
5602784 CYCLOPENTOLATE HCL 1% OPHTH DROP $22.57
5602785 KETAMINE VIAL 500 MG/10 ML $15.05
5602786 SEVOFLURANE (ANES) (ULTANE) : 20ML $64.48
5602787 NYSTATIN TAB 100,000 UNITS (NF) $6.44
5602788 GLYCOPYRROLATE VIAL : 0.2 MG/ML 5ML $68.67
5602790 SODIUM PHOSPHATE SOLN : 90ML $5.36
5602791 SODIUM PHOSPHATE SOLN 45ML (FLEETS)‐NF $6.44
5602792 ELECTROLYTES (CERALYTE) PACK 10 GM (NF) $3.22
5602793 ALBUTEROL ORAL SUSP :2 MG/5ML (NF) $0.43
5602794 NALTREXONE HCL TAB 50 MG $7.52
5602795 MULTIVITAMIN W/ MINERALS CAP : $0.04
5602796 LEVOCARNITINE VIAL 500 MG (NF) $70.82
5602797 SELENIUM 200 MCG TABLET (NF) $0.09
5602798 CALCITONIN‐SALMON(MIACALCIN)SPRAY: 2200U $62.33
5602799 BICALTUTAMIDE (CASODEX) (NF) TAB 50 MG $45.07
5602800 GOSERELIN ACETATE VIAL : 3.6 MG (NF) J9202 $563.32
5602801 VANCO 1.5MG EYE SYRINGE $122.32
5602802 VANCO 0.5MG EYE SYRINGE $122.32
5602803 hydroCORTISONE EYE SYRINGE $122.32
5602804 IV PUMP/DAILY CHG $2.15
5602805 PCA PUMP/DAILY CHG $2.15
5602806 FEEDING PUMP/DAILY CHG $2.15
5602808 CALCIUM WITH VIT D (OSCAL‐D)TAB 1 TAB $1.07
5602809 CALCIUM CITRATE‐VIT D TAB (NF) $36.48
5602810 FIBERCON TAB:625MG BULK (NF) $37.55
5602813 MULTIVITAMINS TAB BOTTLE (NF) $5.36
5602814 HEPARIN 25,000 UNITS/500ML $25.79
5602815 LIDOCAINE 2GM‐D5W IVSL : 500ML $11.80
5602816 D5%‐1/2NS‐KCL 10MEQ :1000ML $6.44
5602817 D5‐1/2NS‐20MEQ KCL/1000ML $10.75
5602818 D5%‐1/4NS‐KCL 20MEQ : 1000ML $5.36
5602819 D5‐LR BAG 500ML‐FOR PEDI‐RX TO SUPPLY $7.52
5602820 D5‐LR BAG 1000ML $4.29
5602821 RINGERS SOLUTION IVSL : 1000ML $4.29
5602822 LR 500 ML $7.51
5602823 LR 1000 ML $4.30
5602824 NS VIAL 50 ML $8.60
5602825 NS ADD‐VANTAGE IVSL : 100ML $7.51
5602826 1/2 NS : 500ML $4.30
5602827 SODIUM CHLORIDE(1/2NS) : 1/2NS 1000ML $4.30
5602828 NS 250 ML $6.45
5602829 NS 500 ML $7.52
5602830 NS 1000 ML $4.30
5602831 NS 50 ML BAG $6.45
5602832 NS 100 ML BAG $6.45
5602833 AMINO ACIDS 8.5% IVSL : 500ML $36.48
5602834 AMINO ACIDS 8.5%‐ELECTROL IVSL : 500ML $20.39
5602835 D5‐1/2 NS (0.45%) 1000 ML $4.29
5602836 D5‐1/4 NS (0.225%) 1000 ML $4.29
5602837 D10% IVSL : 500ML $7.52
5602838 DEXTROSE 30% IVSL : 500ML $24.68
5602839 D10% IVSL : 1000ML $4.29
5602840 DEXTROSE 20% IVSL : 500ML $13.95
5602841 DEXTROSE 40% 500ML (NF) $12.88
5602842 D5 BAG 250ML VISIV BAG $10.75
5602843 D5% GLASS 250ML $20.39
5602844 D5 BAG 500ML $11.82
5602845 D5% GLASS 500ML $11.80
5602846 DEXTROSE 5% 1000ML BAG $4.30
5602847 D5% BAG : 100ML $3.22
5602848 D5 BAG 50 ML $4.30
5602849 D5 ADD‐VANTAGE IVSL : 50ML $5.36
5602850 D5 ADD‐VANTAGE IVSL : 100ML $4.29
5602851 D5‐NS 1000 ML $4.30
5602852 DEXTROSE 50% 500 ML (NF) $19.31
5602853 DEXTROSE 70% : 500ML (NF) $25.75
5602854 FAT EMULSIONS 10% IVSL : 500ML ‐ NF $40.77
5602855 WATER FOR INJECTION,STERILE 1000 ML (NF) $20.39
5602856 TPN USING AMINO ACID 15% 2000ML (NF) $155.58
5602857 OCTREOTIDE ACETATE DEPOT KIT 1 MG (NF) J2353 $261.81
5602861 EPTIFIBATIDE(INTEGRILIN)INFUS 75MG/100ML J1327 $465.68
5602862 EPTIFIBATIDE(INTEGRILIN)BOLUS 20MG/10ML J1327 $401.30
5602864 INFLIXIMAB (REMICADE) 100 MG VIAL J1745 $1,910.83
5602865 LEUPROLIDE ACETATE KIT : 3.75 MG (NF) J1950 $2,230.75
5602866 ONDANSETRON(ZOFRAN)VIAL 4MG/2ML VIAL J2405 $2.15
5602867 PAMIDRONATE VIAL : 30 MG J2430 $75.11
5602869 MELPHALAN TAB : 2 MG J8600 $6.44
5602870 METHOTREXATE TAB : 2.5 MG (CHEMO) (NF) J8610 $2.15
5602873 DOXORUBICIN VIAL : 50MG/25ML (CHEMO) J9000 $174.90
5602877 BLEOMYCIN SULFATE (CHEMO)VIAL : 15 U J9040 $96.57
5602880 CARBOPLATIN VIAL (CHEMO): 50 MG J9045 $25.79
5602882 CARMUSTINE VIAL (CHEMO): 100 MG J9050 $378.77
5602893 CYTARABINE VIAL : 100 MG (CHEMO) J9100 $30.04
5602896 FLUDARABINE VIAL : 50 MG (CHEMO) J9185 $572.98
5602897 FLUOROURACIL VIAL : 500MG 10ML (CHEMO) J9190 $17.17
5602899 GEMCITABINE HCL VIAL : 200 MG(CHEMO) J9201 $33.32
5602902 IRINOTECAN HCL VIAL : 20 MG J9206 $402.37
5602903 INTERFERON ALFA‐2B,RECOMB. VIAL : 100000 J9214 $38.63
5602904 LEUPROLIDE ACETATE KIT : 7.5 MG (NF) J9217 $1,007.54
5602907 METHOTREXATE SODIUM VIAL : 50MG (CHEMO) J9260 $17.20
5602911 MITOMYCIN VIAL : 5 MG (NF) J9280 $284.34
5602914 MITOXANTRONE VIAL : 20 MG (CHEMO) J9293 $1,879.88
5602919 VINBLASTINE VIAL : 10MG (CHEMO) J9360 $45.07
5602925 VINORELBINE VIAL : 50 MG/ML 5ML (CHEMO) J9390 $185.63
5602926 ERYTHROPOEITIN 10000 UNITS J0885 $348.72
5602927 GLATIRAMER (COPAXONE)VIAL : 20 MG(NF) J1595 $145.93
5602928 DEPO‐TESTADIOL 50MG‐2MG 10ML INJ(NF) $518.26
5602930 ROPINIROLE 1 MG TAB $2.15
5602931 SPECIAL ORAL PHARMACEUTICAL $23.61
5602932 SPECIAL PHARMACEUTICAL $94.42
5602933 LEUKINE 250 MCG/VIAL (NF) J2820 $361.60
5602934 FAMOTIDINE (PEPCID) TAB 20MG $0.21
5602935 AZITHROMYCIN 200 MG/5 ML ORAL SUSP $63.41
5603000 ACYCLOVIR 500MG/D5W 100ML $2.15
5603001 AMPICILLIN 250MG/NS 50ML $2.15
5603002 AMPICILLIN 500MG/ NS 50ML $2.15
5603003 hydrOXYZINE (VISTARIL) LIQuid (NF) $25.75
5603005 AMPICLIIN/SULBACTAM 3GM/NS 100 ML $2.15
5603006 AMPICILLIN/SULBACTAM 1.5GM/ NS 50ML $2.15
5603007 AZTREONAM 1GM/ NS 50ML $2.15
5603008 AZITHROMYCIN 500MG/ NS 250ML $2.15
5603009 CEFAZOLIN 1GM/ D5W 50ML $2.15
5603010 CEFAZOLIN 500MG/ D5W 50ML $2.15
5603011 CEFOTETAN 1 GM/ D5W 50ML $2.15
5603012 CEFOTETAN 2GM/ D5W 100ML $2.15
5603013 CEFTAZIDIME 1 GM/NS 50 ML ‐ RX TO SUPPLY $2.15
5603014 CEFTAZIDIME 2GM / D5W 100ML $2.15
5603015 CEFTRIAXONE 250MG / D5W 50ML $2.15
5603016 CEFTRIAXONE 500MG / D5W 50ML $2.15
5603017 CEFTRIAXONE 1GM / D5W 50ML $2.15
5603018 CEFTRIAXONE 2GM / D5W 100ML $2.15
5603019 CEFUROXIME 750MG / D5W 50 ML $2.15
5603020 CLINDAMYCIN 300MG / D5W 50ML $2.15
5603021 CLINDAMYCIN 600MG/D5W 50ML $2.15
5603022 CLINDAMYCIN 900MG/D5W 100ML $2.15
5603023 CIPROFLOXACIN 200MG/100ML PREMIXED $2.15
5603024 CIPROFLOXACIN 400MG/200ML (2X200MG) NF $2.15
5603025 FLUCONAZOLE 200MG/100ML PREMIXED $32.19
5603026 ERYTHROMYCIN 500MG/NS 100ML $2.15
5603027 ERYTHROMYCIN 1GM/NS 250ML $2.15
5603028 GENTAMYCIN 80MG/100ML PREMIXED $5.36
5603029 IMIPENEM/CISLASTATIN/500MG/NS 100ML $2.15
5603030 METRONIDAZOLE 500MG/100ML PREMIXED $2.15
5603031 NAFACILLIN 1GM/D5W 50ML $2.15
5603032 NAFACILLIN 2GM/D5W 100ML $2.15
5603033 NITROGLYCERIN 50MG/D5W 500ML $2.15
5603034 VANCOMYCIN 500MG/D5W 100ML $2.15
5603036 VANCOMYCIN 1GM/D5W 250ML $2.15
5603304 AMPICILLIN 1GM/ NS 50ML $2.15
5603305 MAGNESIUM HYDR/ALUM SUSP: 80MEQ/30ML $7.52
5603306 IBUPROFEN (MOTRIN) TAB 200 MG $2.15
5603307 ALBUTEROL INHALER STARTER PACK $93.50
5603308 ALBUTEROL SOLN STARTER PACK 60 ML (NF) $3.22
5603309 AMOXICILLIN SUSP(125MG/5ML) 150ML BTL SP $8.58
5603310 AMOXICILLIN SUSP(250MG/5ML) 100ML BTL SP $7.52
5603311 AMOXICILLIN CHEW TABS 250MG SP (NF) $2.15
5603312 AMOXICILLIN CAPSULES 250MG STARTER PACK $2.15
5603313 AUGMENTIN CHEWABLE TABS 250MG STARTER PA $69.74
5603314 ANTIPYR‐BENZO OTIC DROPS STARTER PACK $38.63
5603315 CEPHALEXIN (125MG/5ML) OS STARTER PACK $46.21
5603316 CEPHALEXIN CAPSULES 250MG STARTER PACK $2.15
5603317 CIPROFLOXACIN OPTH SOLN STARTER PACK $21.46
5603318 CIPROFLOXACIN TABLETS 250MG STARTER PACK $2.15
5603319 CIPROFLOXACIN TABLETS 500MG STARTER PACK $2.15
5603320 PROCHLORPERAZINE(COMPAZINE) 25MG SUPP SP $24.68
5603321 CORTISPORIN OTIC SUSP 10ML STARTER PACK $212.79
5603322 DARVOCET N‐100 STARTER PACK $4.29
5603323 DOXYCYCLINE 100MG STARTER PACK $2.15
5603324 ERYTHROMYCIN TABLETS 333MG SP (NF) $7.51
5603325 LIDOCAINE MPF 1% VIAL : 5 ML $7.52
5603326 TIOTROPIUM (SPIRIVA) 18 MCG INHALER‐NF $202.05
5603327 TOLTERODINE (DETROL) LA 4 MG CAP (NF) $11.80
5603328 DESFLURANE (ANES) (SUPRANE) : 240ML $480.40
5603329 REMIFENTANIL 2MG VIAL $86.91
5603330 DIBUCAINE OINTMENT 1% $25.75
5603331 IRINOTECAN 100 MG/5 ML (CHEMO) J9206 $57.94
5603332 IRINOTECAN 40MG/2ML VIAL (CHEMO) J9206 $789.72
5603333 PAMIDRONATE 90MG VIAL J2430 $324.04
5603334 METRONIDZOLE (FLAGYL) TAB 500MG SP $1.07
5603335 NITROGLYCERIN SUBLINGUAL TAB STARTER PAC $6.44
5603336 PENICILLIN SUSP (250MG/5ML)100ML SP $7.52
5603337 PENICILLIN TAB 250 MG STARTER PACK $2.15
5603338 PHENAZOPYRIDINE (PYRIDUIM) TAB 100MG SP $2.15
5603339 PREDNISOLONE SOLN (3MG/ML) 20ML START PK $10.75
5603340 PREDNISONE TAB 5 MG STARTER PACK (NF) $3.22
5603341 PREDNISONE TAB 20MG STARTER PACK $1.07
5603342 PROMETHAZINE (PHENERGAN) TAB 25MG SP‐NF $7.51
5603343 GUAIFENESIN & CODEINE ELIX 60ML STARTER $11.82
5603344 SILVADENE CREAM 25 GRAM STARTER PACK $20.42
5603345 SULFACETAMIDE OPTH SOLN 5ML STARTER PAC $305.80
5603346 SULFACETAMIDE OPTH OINT STARTER PK (NF) $4.29
5603347 BACTRIM (GENERIC)SUSP 60 ML STARTER PAC $44.06
5603348 BACTRIM DS (GENERIC) TAB STARTER PACK $2.15
5603349 ACETAMINOPHEN W COD (TYLENOL#3) TAB SP $2.15
5603350 hydroCODONE W APAP 5/500 (VICODIN) SP‐NF $2.15
5603351 ERYTHROMYCIN (E.E.S) SUSP SP (NF) $6.44
5603352 ERYTHROMYCIN OPTH OINTMENT STARTER PACK $62.33
5603353 FAMOTIDINE TAB 20MG STARTER PACK $1.07
5603354 CYCLOBENZAPRINE (FLEXERIL) TAB 10MG STAR $1.07
5603355 GENTAMYCIN OPTH OINTMENT STARTER PACK $50.43
5603356 IBUPROFEN TAB 800MG STARTER PACK $1.07
5603357 INDOMETHACIN (INDOCIN) CAP 25MG SP $2.15
5603358 LORAZEPAM TAB 0.5MG STARTER PACK $2.15
5603359 MECLIZINE TAB 25MG STARTER PACK $1.07
5603360 SODIUM PHOSPHATE 45MMOL/15ML VIAL $79.40
5603361 PENICILLIN G 5 MILLION UNIT/100 ML NS $23.64
5603362 PROCHLORPERAZINE 5MG TAB STARTER PACK $2.15
5603363 THIAMINE 100 MG TAB $0.09
5603364 PIPERACILLIN‐TAZOBA (ZOSYN) 3.375GM VIAL J2543 $55.88
5603366 MORPHINE ORAL *CONC* 20 MG/ML BOTTLE $18.24
5603367 LORAZEPAM ORAL CONC (2 mg/ml) SOLN $42.99
5603368 HEPARIN 500 UNITS/5 ML SYR (ONCOLOGY) J1642 $2.15
5603371 AMOX/CLAV (AUGM) 875MG STARTER PACK $46.21
5603372 DIPHENHYDRAMINE LIQUID 12.5 MG/5 ML $0.13
5603373 IBUPROFEN LIQUID 100 MG/5 ML UD CUP $2.15
5603374 ACETAMINOPHEN CHEW TABS 80 MG (NF) $0.09
5603375 ADVAIR INHALER 115/21 (CHARGES PER PUFF) $10.73
5603376 ADVAIR INHALER 230/21 (CHARGES PER PUFF) $15.02
5603377 ALBUTEROL INHALER (CHARGES PER PUFF) $1.03
5603378 FLUTICASONE 110 MCG (PER PUFF) ‐ NF $6.44
5603379 LIDOCAINE MPF 2% WITH EPI 10ML $34.34
5603380 ASCORBIC ACID 500 MG/ML 50 ML VIAL ‐ NF $29.02
5603381 ERTAPENEM 1 GRAM VIAL J1335 $358.95
5603382 COMBIVENT INHALER $7.51
5603383 CEFDINIR 300 MG CAPSULE $3.22
5603384 CIPROFLOXACIN 400 MG/200 ML BAG J0744 $30.09
5603388 ACETAMINOPHEN LIQ 160MG/5ML UD CUP $3.22
5603389 DIPYRIDAMOLE 5MG/ML 10ML VIAL J1245 $16.09
5603390 D10% & AMINO ACID 4.25% IN 1000ML BAG $75.11
5603391 D20% & AMINO ACID 4.25%/1000ML BAG (nf) $65.45
5603392 LIPIDS 20% (250 MG BAG) $55.88
5603393 MIRALAX 17 GRAM DOSE $7.52
5603394 IBUTILIDE 1 MG/10 ML VIAL (NF) J1742 $272.54
5603395 HEPARIN 1000 UNITS/ML 10 ML (ER USE) J1642 $15.02
5603396 EVACUATED CONTAINER 1 LITER $27.90
5603397 BANANA BAG (HOSPITALIST SERVICE RECIPE) $2.15
5603399 IMMUNE GLOBULIN (HUMAN) VIAL : 1 GM J1572 $322.41
5603400 ALBUTEROL 2.5MG/0.5 ML NEB (NOT FOR HP) J7613 $1.07
5603402 ABHR CREAM $18.24
5603403 ESTROGEN VAGINAL CREAM $872.66
5603404 ONDANSETRON ODT 4 MG STARTER PACK $32.24
5603408 BONIVA 3MG/3ML J1740 $773.79
5603409 PENICILLIN 2.5 MILLION UNITS/NS 50 ML $2.15
5603410 CELLUVISC 0.4 ML UD GEL (NF) $1.07
5603411 NORETHINDRONE 5 MG ‐ NF $8.58
5603412 LEVALBUTEROL (XOPENEX) 0.63MG NEBS (NF) J7614 $25.75
5603413 CHLORDIAZEPOXIDE 25 MG CAPS $0.21
5603415 FENTANYL 100 MCG/2 ML VIAL J3010 $6.45
5603416 INFLUENZA VACCINE PRESERVATIVE FREE 90656 $45.07
5603418 BUPRENORP/NALOX 2MG/0.5MG TAB (Suboxone) $22.53
5603419 ARGININE 10% 300 ML INJECTABLE SOLUTION $45.07
5603420 SUCROSE ORAL SOLUTION 24% 15ML UD CUP $2.15
5603421 PREDNISOLONE ORAL SOLN 15MG/5ML (PER ML) $0.09
5603422 ASTRINGYN 8 GRAM UD VIAL $45.07
5603423 VITAMIN D 400 IU TABLET (NF) $0.09
5603424 MIDAZOLAM 10 MG/10 ML (RX USE ONLY) J2250 $6.45
5603425 FENTANYL 2500 MCG/50 ML (RX USE ONLY) J3010 $23.61
5603426 MEROPENEM 1 GRAM/NS 50 ML J2185 $42.99
5603427 HYDROMORPHONE 40 MG/20 ML (RX USE ONLY) J1170 $38.69
5603428 B&O SUPPOSITORIES 30‐16.2 MG $89.20
5603429 ROCURONIUM 10 MG/ML 5 ML VIAL $19.34
5603430 NICOTINE 2 MG LOZENGES ‐ NF $1.07
5603431 LIDOCAINE MPF 1% EPI 1:200000 10 ML $11.82
5603432 GUAIFENESIN & DEXTROMETH 10 ML UD $1.07
5603433 FULVESTRANT 250 MG J9395 $1,943.07
5603434 levETIRACEtam 500 MG TABLETS $0.95
5603435 CLINDAMYCIN 600 MG/D5W 50 ML (PREMIX) $54.81
5603436 PIPERACILLIN‐TAZOBAC (ZOSYN) 2.25GM VIAL J2543 $15.05
5603437 ROPIVACAINE 0.5% 30 ML SDV J2795 $32.24
5603438 AZITHROMYCIN 200 MG/5 ML Starter Pack $63.41
5603439 MORPHINE 2 MG/ML INJECTION J2270 $9.67
5603440 BALM BARR CREME 6 OZ $17.17
5603441 BEVACIZUMAB 400 MG VIAL (CHEMO) J9035 $6,090.30
5603442 CEFTRIAXONE 1 GRAM/50 ML DUPLEX BAG J0696 $33.32
5603443 AMOX/CLAV (AUGM) PO SUSP 200MG/5ML 50ML $46.14
5603444 AMOX/CLAV (AUGM) SP 200 MG/5 ML 50 ML $46.14
5603445 TRIAMCINOLONE CREAM STARTER PACK $6.44
5603446 RIFAMPIN 300 MG CAPSULES $4.30
5603447 CEFAZOLIN 1 GRAM/50 ML DUPLEX BAG $17.20
5603448 TRIESENCE 40MG/ML J3300 $442.07
5603449 KETAMINE 200MG/20ML (NF) $53.65
5603450 LIDOCAINE 4% TOPICAL ANESTHETIC CREAM $26.87
5603451 CLINDAMYCIN 150 MG CAPS STARTER PACK $11.82
5603453 CHLORASEPTIC THROAT SPRAY $4.29
5603454 AGGRENOX 25 MG/200 MG (NF) $25.75
5603455 LEXISCAN 5ML J2785 $679.22
5603456 BENDAMUSTINE 100MG VIAL (CHEMO) J9033 $4,309.13
5603457 METHOCARBAMOL 500 MG TAB $0.64
5603458 AMPICILLIN/SULBACTAM VIAL 3 GRAM J0295 $35.47
5603459 BUDESONIDE 0.5 MG/2 ML NEBULE J7627 $13.97
5603460 ALBUTEROL 3MG & IPRATROPIUM 0.5MG NEB $1.07
5603461 ALBUTEROL 2.5MG/3 ML NEB J7613 $1.07
5603462 THROMBIN 5000 UNIT KIT $206.34
5603463 ACIDOPHILUS CAPS/TABS $0.30
5603464 CHLOROPROCAINE 3% 20ML VIAL J2400 $89.20
5603465 POTASSIUM 10 MEQ/100 ML NS (KCL RUNNER) $13.97
5603466 COSYNTROPIN VIAL (CORTROSYN): 0.25 MG J0834 $380.91
5603467 DOCETAXEL VIAL 20 MG (CHEMO) J9171 $104.25
5603468 ATROPINE SYR 0.1 MG/ML 10ML J0461 $35.47
5603469 SYNVISC 16 MG INJECTION J7325 $800.45
5603470 CATHFLO 2 MG J2997 $468.57
5603471 TOPIRAMATE 50 MG TAB $0.34
5603472 TENECTEPLASE 50 MG KIT J3101 $12,287.90
5603473 LINEZOLID 600 MG TAB $18.27
5603474 oxyCONTIN 80 MG TAB (EXT REL) ‐ NF $49.36
5603475 CEFDINIR 250 MG/5 ML ORAL SUSP ‐ NF $57.94
5603476 LIDOCAINE PATCH 5% $16.12
5603478 PROPOFOL (DIPRIVAN) VIAL 10MG/ML 100ML J3490 $42.99
5603479 OXYTOCIN 30 UNITS/LR 500ML J2590 $30.09
5603481 SIMVASTATIN (ZOCOR) TAB 40 MG $0.52
5603482 METHOHEXITAL (BREVITAL) 500MG VIAL J3490 $164.17
5603483 OLANZAPINE 10MG VIAL FOR IM ADMIN $170.88
5603484 CLINIMIX E 5/15 2000ML $255.37
5603485 GUAIFENESIN 600MG TABLET $4.30
5603486 DARBOPOETIN 60 MCG PFS J0881 $773.79
5603487 KINEVAC (SINCLIDE) 5 MCG J2805 $313.82
5603488 HALOPERIDOL (HALDOL) MDV: 50 MG/10 ML J1630 $36.48
5603489 FLUMIST NASAL FLU VACCINE 90660 $80.47
5603490 MORPHINE SULFATE (MS CONTIN) 60 MG (NF) $3.22
5603491 D5‐1/2NS (0.45%) W/ 10 MEQ KCL/500 ML $8.58
5603492 D5W 0.2%NS 500 ML $11.80
5603493 levoFLOXACIN 500 MG TAB $1.07
5603494 levoFLOXACIN 500 MG/100 ML BAG J1956 $58.03
5603495 levoFLOXACIN 250 MG/50 ML J1956 $8.60
5603496 LEVOCARNITINE 1 GRAM/5 ML VIAL J1955 $28.97
5603497 ACETAZOLAMIDE 250 MG TABLET (NF) $1.07
5603498 D5‐1/2NS W/ 10 mEq KCL/500 ML‐RX TO SUPP $10.73
5603499 D5‐1/2 NS (0.45%) 500 ML $10.73
5603500 MIDAZOLAM 50MG/10ML VIAL (RX USE ONLY) $30.09
5603501 CHOLESTYRAMINE POWDER 4 gram PACKS $6.45
5603502 EPInephrine SYRD : 0.3 MG J0171 $134.12
5603503 EPInephrine 1‐1000 INJ 1MG/1ML J0171 $60.18
5603504 EPInephrine 0.3 MG AUTOINJECTOR J0171 $425.98
5603505 CISPLATIN VIAL (CHEMO): 50MG J9060 $36.54
5603507 CYCLOPHOSPHAMIDE(CYTOXAN)1000 MG (CHEMO) J9070 $1,564.42
5603508 CYTARABINE VIAL : 1 GM (CHEMO) J9100 $59.01
5603509 DACARBAZINE (CHEMO) 200 MG VIAL J9130 $30.04
5603510 TOPOTECAN HCL VIAL : 4 MG (CHEMO) J9351 $1,578.37
5603511 VINCRISTINE VIAL : 2 MG/2 ML (CHEMO) J9370 $24.68
5603512 METRONIDAZOLE (FLAGYL) TAB 500 MG $2.15
5603513 NORepinephrine DRIP $73.08
5603514 MEMANTINE 5 MG TAB $18.27
5603515 PHENTOLAMINE 5MG VIAL J2760 $363.74
5603516 PREGABALIN 50 MG CAPSULE $32.24
5603517 HEPARIN 100 UNITS/ML 5ML SYRINGE J1642 $5.37
5603518 HYPERTONIC 3% SALINE FOR NEBULIZATION $4.29
5603519 VENLAFAXINE XR 75 MG CAPSULE $1.07
5603520 METOPROLOL TARTRATE *IR* TAB 25 MG $0.21
5603522 DORIPENEM 250 MG VIAL ‐ NF J1267 $64.38
5603523 BACITRACIN OPHT OINT STARTER PACK $207.09
5603524 CARBIDOPA 25 MG TABLET (NF) $10.73
5603525 LIDOCAINE VISCOUS FLAVORED 2% SOLN:20 ML $11.80
5603526 PRAMIPEXOLE 0.125 MG TABS $0.62
5603527 levoFLOXACIN 750 MG/150 ML BAG J1956 $16.12
5603528 Daptomycin ‐ Rx To Supply J0878 $588.94
5603529 AMINOCAPROIC ACID VIAL 5 GM/20 ML J3490 $22.57
5603530 PALONOSETRON 250 MCG/5 ML VIAL J2469 $254.71
5603531 DORIPENEM 500 MG VIAL ‐ NF J1267 $116.96
5603532 LORAZEPAM 20MG/10ML VIAL (RX USE ONLY)NF $24.68
5603533 HYDROMORPHONE AMPULE 2 MG/ML 1ML J1170 $4.30
5603534 ATROPINE VIAL/SYRINGE 1 MG/1 ML $34.39
5603535 TETRACAINE INJECTION 1% 2ML AMPS $143.78
5603536 BUPIVacaine MPF0.25% W EPI 1:200000 30ML J3490 $12.90
5603537 CLADRIBINE 10 MG VIAL (CHEMO) J9065 $668.47
5603538 INFLUENZA INTRADERMAL 90654 $68.67
5603539 ABATACEPT 250 MG VIAL J0129 $2,222.50
5603540 ALFENTANIL 1000MCG/2ML AMP $11.80
5603541 clonAZEPAM (KLONIPIN) TAB 0.25 MG $2.15
5603542 ORPHENADRINE 60 MG VIAL (NF) J2360 $19.31
5603543 FENTANYL 250 MCG/5 ML AMP ‐ ANES ONLY $2.15
5603544 ACYCLOVIR (ZOVIRAX) 800 MG TAB (NF) J8499 $5.36
5603545 PYRIDOXINE (VIT B6) 25 MG TABLET ‐ NF $0.05
5603546 DOXYLAMINE 25 MG TABLET ‐ NF $1.07
5603547 ATROPINE DROPS 1% OS ‐ COMFORT CARE $149.38
5603548 BORTEZOMIB 3.5 MG VIAL J9041 $3,364.90
5603549 ONDANSETRON ODT (DISINTEGRATING TAB)4MG Q0162 $0.60
5603550 ETOPOSIDE VIAL 100MG 5ML (CHEMO) J9181 $25.79
5603551 DOXYLAMINE 25 MG TAB ‐ DON'T USE $0.30
5603552 VITAMIN B6 TAB ‐ DON'T USE $0.04
5603553 ESTRADIOL PATCH 0.05MG/DAY $32.19
5603554 NS 250 MG IVPB PVC & DEHP FREE $7.52
5603555 NORETHINDR/ETHINYL ESTRADIO 1/35 TAB‐NF $75.11
5603556 MITOMYCIN 20 MG VIAL (CHEMO) J9280 $1,245.59
5603558 ERIBULIN (HALAVEN) 1MG/2ML (CHEMO) J9179 $2,023.66
5603559 DENOSUMAB (XGEVA) 70 MG/ML 1.7 ML VIAL J0897 $4,674.99
5603560 MISOPROSTOL 1000MCG 10 TAB PACK (OB USE) $17.20
5603561 CEFTAZIDIME VIAL 2 GM J0713 $46.21
5603562 CEFAZOLIN 2 GRAM/50 ML DUPLEX BAG J0690 $34.39
5603563 acetylCYSTEINE INJ (ACETADOTE) 200 MG $249.33
5603564 NITROGLYCERIN 25 MG/250 ML D5W $31.17
5603565 SUMATRIPTAN 50 MG TAB $3.22
5603566 LIDOCAINE MPF 1% EPI 1:200000 30 ML $29.02
5603567 VENLAFAXINE XR : 37.5 MG CAP (NF) $0.94
5603568 TIGECYCLINE 50 MG VIAL J3243 $306.88
5603569 IDARUBICIN 5 MG/5 ML VIAL (CHEMO) J9211 $165.24
5603570 MICAFUNGIN 100 MG VIAL J2248 $332.63
5603571 FOSAPREPITANT (EMEND) 150MG J1453 $1,000.55
5603572 hydroCODONE‐APAP 5/325 (VICODIN) TAB $0.64
5603573 hydroCODONE W APAP 5/325 (VICODIN) SP $11.82
5603574 CEFEPIME 2GM/100ML NS J0692 $23.64
5603575 NYSTATIN 500,000 UNITS/5 ML UD CUP $3.22
5603576 NS 10ML VIAL TO USE FOR DRUG DILUTION $3.22
5603577 NICOTINE INHALER 10 MG/CARTRIDGE $214.94
5603578 LIDOCAINE MPF 2% EPI 1:200,000 20 ML $20.42
5603579 ROPIVACAINE 0.2% 20 ML SDV J2795 $32.24
5603580 ROPIVACAINE 0.2% **200 ML** SDV J2795 $159.88
5603581 NICOTINE 2 MG GUM $1.07
5603582 ROPIVacaine PLAIN Epidu 250ML‐Pharmedium $275.76
5603583 ROPIVacaine/FENT Epidu 250ml‐Pharmedium $366.96
5603585 NEOSTIGMINE 1 MG/1 ML 10 ML VIAL(1:1000) $23.64
5603586 BUPRENORPHINE 8 MG TAB (Subutex) $9.67
5603587 BUMETANIDE 2.5 MG/10 ML VIAL $7.51
5603588 TALC FOR PLEURODESIS $394.86
5603589 MISOPROSTOL 1000 MCG SUPPOSITORY $141.63
5603590 LATANOPROST 0.005% EYE DROP 2.5 ML $26.87
5603592 hydrOXYZINE HCL *100 MG/2 ML* (NF) $13.95
5603593 MANNITOL 20% BAG (100 GRAMS/500 ML) $67.71
5603594 DOCUSATE 100 MG/10 ML UD CUP $2.15
5603595 MOISTURIZING MOUTH SPRAY $23.64
5603596 BUPRENORP/NALOX 2MG/0.5MG FILM ‐Suboxone $18.27
5603598 PIPERACILLIN‐TAZOBAC (ZOSYN) 4.5 GM VIAL J2543 $31.17
5603599 CASPOFUNGIN 50 MG (NF) J0637 $1,047.24
5603600 AMOX/CLAV (AUGM) 600MG/42.9MG/5ML PO SUS $75.23
5603601 AMOX/CLAV (AUGM) 600MG/42.9MG/5ML *SP* $75.23
5603602 LIDOCAINE 5% OINTMENT ‐ NF $226.40
5603603 KETAMINE 50 MG/1 ML PREFILLED SYRINGE $20.39
5603605 LEVALBUTEROL (XOPENEX)1.25 MG NEBS (NF) J7614 $24.68
5603606 ROPIV 0.125%/FENT Epidu 100ml‐Pharmedium $189.92
5603607 PROPARACAINE 0.5% OPTH SOLN 15 ML $91.35
5603608 VITAMIN D 1000 IU TABLET $0.15
5603609 TRANEXAMIC ACID 1000MG/10ML VIAL $103.17
5603610 BUPIVACAINE ***LIPOSOMAL*** 20 ML VIAL C9290 $1,045.69
5603611 FILGRASTIM VIAL 300MCG/ML 1ML J1442 $961.86
5603612 ZOLEDRONIC ACID (ZOMETA) 4 MG INFUSION J3489 $68.78
5603615 ZOLEDRONIC ACID (RECLAST) 5 MG INFUSION J3489 $300.92
5603616 PERTUZUMAB (PERJETA) 420 MG VIAL J9306 $11,043.71
5603617 CHLORPROMAZINE (THORAZINE) 50 MG TAB NF J3230 $0.43
5603619 PROBIOTIC ‐ SACCHAROMYCES (FLORASTOR) $3.22
5603620 TRAMADOL 50 MG STARTER PACK $3.22
5603621 ACETAMINOPHEN *IV* 1000 MG/100 ML J0131 $174.10
5603622 LIDOCAINE 5% & DEXTROSE 7.5% 2 ML AMP‐NF $25.75
5603623 FILGRASTIM SYR 480 MCG/0.8 ML (NF) J1442 $1,082.23
5603624 CEFTRIAXONE 2 GRAMS/50 ML DUPLEX BAG J0696 $54.81
5603625 DARBOPOETIN 25 MCG PFS J0881 $322.97
5603626 IPILIMUMAB (YERVOY ‐ CHEMO) 200 MG VIAL J9228 $54,663.56
5603627 VALACYCLOVIR 500 MG TABLET $3.22
5603628 ENTACAPONE 200 MG TAB $18.24
5603629 CARBI‐LEVO (SINEMET) 10‐100 IR TAB $0.43
5603630 LIDOCAINE OPTH GEL 3.5% 1ML $80.47
5603631 TRIMETHOPRIM/POLYMIXIN B OPTH SOLN SP‐NF $21.46
5603632 PHENYTOIN SODIUM 100MG/2 ML‐RX TO SUPPLY J1165 $3.22
5603633 TRIAMCINOLONE‐EUCERIN 1:1 CREAM $30.09
5603634 DULOXETINE 30 MG CAPSULE $4.30
5603636 amiKACIN (aminoglycoside abx)‐RX TO SUPP J0278 $19.31
5603637 CLINIMIX E 4.25/10 2000ML $233.21
5603638 MAGNESIUM SULF 2 GRAM/50 ML PREMIX BAG $55.88
5603639 COLISTIMETHATE 150MG BOLUS‐RX TO SUPPLY J0770 $34.34
5603640 DULERA INHALER 100/5 (CHARGES PER PUFF) J3490 $10.73
5603641 DULERA INHALER 200/5 (CHARGES PER PUFF) J3490 $10.73
5603642 TRIAMCINOLONE ACET 0.1% OINTMENT $11.82
5603643 MOMETASONE (ASMANEX) INH (PER PUFF) $5.36
5603644 PACLITAXEL (TAXOL) 300 MG (CHEMO) J9267 $219.96
5603645 DARBOPOETIN 40 MCG PFS J0881 $907.75
5603646 DOCUSATE LIQUID FOR EAR CLEANING $12.90
5603647 OBINUTUZUMAB 1000 MG/40 ML VIAL (CHEMO) J9301 $11,378.00
5603648 DABIGATRAN 75 MG CAP ‐ NF $20.42
5603649 MELATONIN TAB 3MG $0.17
5603651 MELOXICAM 7.5MG TABLET $4.30
5603652 ADENOSINE VIAL 6 MG/2 ML (6MG X1 DOSE) J0153 $18.27
5603654 CETUXIMAB 200 MG VIAL (CHEMO) J9055 $2,121.30
5603655 TOBRAMYCIN 1.2G PWD (OR BEAD USE ONLY) $279.42
5603656 MICONAZOLE VAGINAL SUPPS 100 MG $2.15
5603657 AMPHOTERICIN B 50MG VIAL (NF) J0285 $93.35
5603658 CEFTAZIDIME 1 GM DUPLEX BAG J0713 $39.76
5603659 ATORVASTATIN 40 MG TAB $1.07
5603660 NEOSTIGMINE 5 MG/10 ML (1:2000) J2710 $333.70
5603661 FERRIC CARBOXYMALTOSE 750MG/15ML J1439 $1,544.04
5603662 PREDNISOLONE EYE DROP STARTER PACK $189.92
5603663 FLUCONAZOLE 400 MG/200 ML IVPB (NF) $15.02
5603664 VANCOMYCIN HCL VIAL : 1 GM (RX USE ONLY) J3370 $16.12
5603665 AMPICILLIN/SULB 1.5 GM VIAL ‐RX USE ONLY J0295 $15.05
5603667 ARANESP 150 MCG PFS J0881 $1,198.30
5603668 DONEPEZIL (ARICEPT) TAB 10 MG $4.30
5603669 VANCOMYCIN ORAL SUSP FOR C‐DIFF 150 ML $410.54
5603670 PIP‐TAZO 2.25G VIAL‐(RX USE ONLY) $15.02
5603671 GANCICLOVIR 500 MG VIAL ‐ NF J1570 $290.78
5603672 PROPOFOL (DIPRIVAN) VIAL 10MG/ML 10ML $4.30
5603673 EPInephrine 0.3 mg autoinjector *SP* J0171 $426.66
5603674 NITROFURANTOIN (MACROBID) 100MG SP $8.60
5603675 CALCIUM GLUC 1GM/10ML VIAL FOR PO ADMIN $35.41
5603676 RIVAROXABAN (XARELTO) 10 MG TAB $46.21
5603677 CELECOXIB (CELEBREX) 100 MG CAP ‐ NF $4.29
5603678 GENTAMICIN 80 MG/NS *50 ML* PREMIX $6.44
5603679 GRANISETRON 1MG/ML J1626 $12.88
5603680 GENTAMICIN 120 MG/NS 100 ML OB KIT $11.82
5603681 EPINEPHRINE 30 MG/30 ML MDV $568.52
5603682 BUTORPHANOL (STADOL) *** 4 MG/2 ML *** J0595 $24.68
5603683 KCENTRA (4 FACTOR PCC) 1000 U C9132 $3,670.13
5603684 KCENTRA (4 FACTOR PCC) 500 U C9132 $1,792.97
5603685 IDARUCIZUMAB (PRAXBIND) 2500 MG/VIAL‐NF J3490 $2,886.35
5603687 APIXABAN (ELIQUIS) 5 MG TAB‐NF‐Don't use $19.31
5603688 ALBUMIN 25% 50 ML VIAL $178.40
5603689 MAGNESIUM SULF 4 GM/100 ML PREMIX BAG $19.34
5603690 MORPHINE DRIP VIAL 50MG/ML 10 ML $42.92
5603691 SUCCINYLCHOLINE SYRINGE 140 MG/7 ML J0330 $66.53
5603692 NEOSTIGMINE 1 MG/1 ML 5 ML SYR (1:1000) $91.20
5603693 INFLUENZA VACCINE *HIGH DOSE* 65YO+ ONLY 90662 $160.13
5603694 TBO‐FILGRASTIM 480 MCG J1447 $817.62
5603695 PNEUMONIA VACCINE (PREVNAR 13) 90670 $538.43
5603696 PHENYLEPHRINE 40MCG/ML 5 ML SYR (ANES) J2370 $17.17
5603697 PHENYLEPHRINE 5 MG/50 ML SYR **ANES** J2370 $51.59
5603698 D5‐1/2NS‐40MEQ KCL/1000ML $11.82
5603699 DARATUMUMAB 100MG/5ML VIAL J9145 $1,556.91
5603700 MORPHINE 30MG PCA FOR NON PCA USE J2270 $29.02
5603701 LAMOTRIGINE ORAL TABLET 100MG $0.42
5603702 TRIAM‐EUCERIN‐CAMPHOR 1:1:1 (NF) $45.07
5603703 PANTOPRAZOLE (PROTONIX) 40 MG IVP J3490 $16.12
5603704 NALOXONE 4MG NASAL SPRAY $248.93
5603705 NS *20*ML VIAL TO USE FOR DRUG DILUTION $4.29
5603706 SIMPONI ARIA 50MG/4ML J1602 $3,533.64
5603707 MORPHINE SULFATE 15 MG STARTER PACK $25.79
5603708 GENTAMICIN 100 MG/NS 100 ML PREMIX‐NF $7.51
5603709 TRASTUZUMAB VIAL 150MG SDV (CHEMO) J9355 $3,349.87
5603710 APIXABAN (ELIQUIS) *2.5* MG TAB $22.57
5603711 NS FOR IRRIGATION 2L ‐ NOT FOR IV USE $19.34
5603712 HYDROMORPHONE 10 MG/ML **RX USE ONLY** J1170 $22.57
5603713 TRIAZOLAM (HALCION) TAB 0.125 MG $5.37
5603714 BUPIVACAINE 0.25%‐EPI 1:200000 VIAL 10ML $33.26
5603715 DEXAMETHASONE SOD PHOS VIAL 10MG/ML 1ML J1100 $3.22
5603716 SODIUM BICARBONATE 650 MG TABLET $0.30
5603717 HYPERTONIC 3% SALINE 500 ML PREMADE $7.52
5603718 CLOZAPINE 100 MG TAB S0136 $11.80
5603719 SUCCINYLCHOLINE SYRINGE 100 MG/5 ML J0330 $66.53
5603721 CLONIDINE 1000 MCG/10 ML INJECTION $46.21
5603722 D5‐NS‐40MEQ KCL/1L‐RX TO SUPPLY $10.75
5603723 METHYLENE BLUE 0.5% 10 ML AMP (50MG) Q9968 $482.85
5603724 CALCIUM GLUC 1GM/10ML VIAL $35.47
5603725 DOPamine 400MG‐D5W 250ML *PEDIATRIC* $40.77
5603726 D5 BAG 250 ML $15.05
5603728 KETAMINE VIAL 500MG/10ML‐CHARGED PER MG $0.02
5603729 BUPIVAC 0.75%‐DEXT 8.25% 2ML AMP*SPINAL* $7.52
5603730 LIDOCAINE 1% 5 ML AMP FOR SPINALS $3.22
5603731 PEMBROLIZUMAB (KEYTRUDA) 100MG/4ML‐CHEMO J9271 $9,993.72
5603732 DIAZEPAM (DIASTAT) 10 MG RECTAL GEL $333.70
5603734 BUPIV0.0625%/FENT Epidu 250ml‐Pharmedium $366.96
5603735 ACETAMINOPHEN *IV*650MG/65ML‐Rx to suppy J0131 $151.53
5603736 KETAMINE ** 50 MG/5ML ** (10MG/ML) SYR $19.34
5603737 NIVOLUMAB (OPDIVO) 240 MG/24 ML VIAL J9299 $13,729.41
5603738 METOCLOPRAMIDE (REGLAN) **SYR** 10MG/2ML J2765 $4.30
5603739 SODIUM BICARBONATE 8.4% **VIAL** 50ML $34.39
5603740 HEPARIN 50,000 UNITS/10 ML J1644 $21.49
5603741 LEVETIRACETAM (KEPPRA) 500MG/5ML VIAL $18.27
5603742 NICARDIPINE 25 MG/1 ML VIAL $63.41
5603743 MORPHINE ORAL *CONC* 10 MG/0.5ML PO SYR $7.52
5603744 MORPHINE PCA **HIGH DOSE** 150 MG/30 ML J2270 $35.47
5603745 EPInephrine 1MG/1ML AMP for ANAPHYLAXIS J0171 $39.76
5603746 PHENYLEPHRINE 40MCG/ML 10 ML SYR (ANES) J2370 $17.20
5603747 CAFFEINE CITRATE 60 MG/3 ML VIAL $23.64
5603748 ROPIV 0.2%/FENT Epidu 100ml‐Pharmedium $190.22
5603749 DENOSUMAB (PROLIA) 60 MG/ML SYRINGE J0897 $2,484.73
5603750 KETAMINE 500 MG/5 ML **AMBULANCE ONLY** $33.32
5603751 MITOMYCIN 40 MG VIAL (CHEMO) J9280 $1,228.39
5603752 METHADONE 10MG/ML ORAL CONCENTRATE‐NF $1.07
5603753 CEFDINIR 300 MG STARTER PACK $4.29
5603754 MONSEL'S SOLUTION 8 ML JAR $76.18
5603755 IPILIMUMAB (YERVOY ‐ CHEMO) 50 MG VIAL J9228 $15,418.86
5603756 NIVOLUMAB (OPDIVO) 100 MG/10 ML VIAL J9299 $5,635.78
5603757 CYCLOPHOSPHAMIDE(CYTOXAN) 500 MG (CHEMO) J9070 $616.88
5603758 MEROPENEM 1 GRAM/50 ML DUPLEX BAG J2185 $60.18
5603759 MIRENA IUD J7298 $1,953.82
5603760 BRIMONIDINE 0.2% 5 ML OPTH SOLN $10.75
5603761 SKYLA IUD J7301 $1,627.11
5603762 PEP HIV STARTER PACK ‐ ER USE ONLY $293.40
5603763 RITUXIMAB VIAL 100 MG 10ML (CHEMO) J9312 $2,019.38
5603764 VEDOLIZUMAB 300 MG IN NS 250 ML J3380 $13,499.43
5603765 FISH OIL 1000 MG GELCAP $0.16
5603766 PRESERVISION AREDS 2 CAPSULE $1.07
5603767 OMIDRIA 1‐0.3% 4 ML OCULAR INJ C9447 $1,499.22
5603768 AMOXICILLIN SUSP 400MG/5ML 100ML $7.52
5603769 AMOXICILLIN SUSP 400MG/5ML 100ML *SP* $7.52
5603770 LUGOL'S SOLUTION 0.8 ML FOR NUCLEAR $7.52
5603791 BENZOCAINE 20% 0.5 ML UD SPRAY $47.21
5603792 ALVIMOPAN (ENTEREG) 12 MG CAPSULES $531.98
5603793 CLINIMIX E 4.25/5 2000ML $174.90
5603794 SUGAMMADEX 100 MG/ML 5 ML VIAL J3490 $549.18
5603795 WARFARIN SODIUM (COUMADIN) TAB 1 MG $0.13
5603796 RISPERIDONE 0.25 MG TABLET‐NF $0.13
5603797 RABIES IMMUNE GLOBULIN 300 mg/1 ml 90376 $1,481.80
5603798 IRON DEXTRAN COMPLEX (INFED) 100 MG VIAL J1750 $111.77
5603799 BUPRENORP/NALOX 8MG/2MG FILM ‐Suboxone $13.95
5603800 BUPRENORP/NALOX 8MG/2MG FILM RAM PACK $45.07
5603802 ARTIFICIAL TEAR EYE LUBRICANT UD DROPPER $1.07
5603803 VANCOMYCIN 1.5 GM/300 ML‐NOT FOR PREGN $77.38
5603804 ALP1‐PROTEINASE INHIB 1000MG/20ML VIAL J0256 $1,483.10
5603805 OCREVUS OCRELIZUMAB 300 MG/10 ML VIAL J2350 $34,872.23
5603806 INFLIXIMAB‐DYYB (INFLECTRA) 100 MG VIAL Q5103 $1,418.50
5606004 AMPICILLIN 2GM/ NS 100ML $2.15
5606007 ACYCLOVIR IV (WEIGHT BASED)‐RX TO SUPPLY $2.15
5606008 AMPICILLIN 250MG/NS 50ML‐RX TO SUPPLY $2.15
5606009 AMPICILLIN 500MG/NS 50ML $2.15
5606010 AMPICILLIN 1 GM/NS 50 ML $2.15
5606011 AMPICILLIN 2 GM/NS 100 ML $2.15
5606012 AMPICILLIN/SULBACTAM 1.5GM/NS50ML $2.15
5606013 AMPICILLIN/SULBACTAM 3GM/NS100ML $2.15
5606014 AZTREONAM 2GM/NS 100ML ‐ OB USE ONLY $2.15
5606015 AZITHROMYCIN 500 MG/250 ML $2.15
5606016 CEFAZOLIN 500 MG/50 ML‐RX TO SUPPLY $2.15
5606017 CEFAZOLIN 1 GM/NS 50 ML $2.15
5606018 CEFOTETAN 1GM/D5W50ML $2.15
5606019 CEFOTETAN 2GM/D5W100ML $2.15
5606020 CEFTAZIDIME (FORTAZ) 1GM/D5W50ML $2.15
5606021 CEFTAZIDIME 2 GM/NS 100 ML $25.75
5606022 CEFTRIAXONE 250 MG/NS 50 ML $2.15
5606023 CEFTRIAXONE 500 MG/NS 50 ML $2.15
5606024 CEFTRIAXONE 1 GM/NS 50 ML J0696 $2.15
5606025 CEFTRIAXONE 2 GRAMS/NS 100 ML‐DON'T USE J0696 $8.58
5606026 CEFUROXIME (KEFUROX) : 750 MG/NS 50 ML J0697 $2.15
5606027 CLINDAMYCIN 300 MG/NS 50 ML‐RX TO SUPPLY $2.15
5606028 CLINDAMYCIN 600 MG/NS 50 ML $2.15
5606029 CLINDAMYCIN 900 MG/NS 100ML‐rx to supply $2.15
5606030 CIPROFLOXACIN 200MG/100ML PRE MIXED $2.15
5606031 CIPROFLOXACIN 400MG/200ML PRE MIXED $2.15
5606032 FLUCONAZOLE 200MG/100ML PRE MIXED $2.15
5606033 ERYTHROMYCIN IV ‐ rx to supply $2.15
5606034 ERYTHROMYCIN 1 GM/NS 250 ML $2.15
5606035 GENTAMYCIN 80MG/100ML0ML $2.15
5606036 IMIPENEM‐CILASTATIN 500MG/NS100ML (NF) $2.15
5606037 METRONIDAZOLE 500MG/100ML ‐ DON'T USE $2.15
5606038 NAFCILLIN 1 GRAM/NS 50 ML *RX TO SUPPLY* $2.15
5606039 NAFCILLIN 2 GRAM/NS 100 ML $2.15
5606040 NITROGLYCERIN 50 MG/D5W 500 ML (NF) $15.02
5606041 TOBRAMYCIN/DOSE VARIES/NS100ML $2.15
5606042 VANCOMYCIN 500 MG/NS 100 ML $2.15
5606043 VANCOMYCIN 1 GRAM/250 ML $2.15
5606044 EPIRUBICIN 50MG/25ML INJ (CHEMO) J9178 $1,285.44
5606045 BUPIVacaine MPF 0.5% VIAL : 10ML $7.52
5606046 LIDOCAINE MPF 1% 30ML VIAL $7.52
5606047 POTASSIUM ACETATE 40MEQ/20ML $2.15
5606048 METRONIDAZOLE TOP GEL 0.75% 45GM $266.10
5606049 CARBIDOPA‐LEVODOPA(SINEMET):25/250MG/TAB $2.15
5606050 FLUVOXAMINE(LUVOX) NF: 100MG/TAB $7.51
5606051 COPPER: 0.4MG/ML 10ML VIAL (NF) $2.15
5606052 ESTRADIOL(CLIMARA): 0.05MG ‐ DON'T USE $18.24
5606053 ERYTHROPOEITIN 40000 UNITS J0885 $1,154.54
5606054 ENOXAPARIN (LOVENOX) 40MG SYRINGE $25.79
5606055 ENOXAPARIN (LOVENOX) 60MG SYRINGE $36.54
5606056 ENOXAPARIN (LOVENOX) 100 MG SYRINGE $44.06
5606057 PERIPHERAL STANDARD FORMULAS(PPN‐MVI): $2.15
5606058 PERIPHERAL STANDARD FORMULAS(PPN‐PLAIN): $2.15
5606059 1/2 NS :100ML $4.29
5606060 1/4 NS: 1000ML $3.22
5606061 METHYLPREDNISOLONE (DEPO) VIAL 80 MG J1040 $49.44
5606062 NALBUPHINE (NUBAIN) 10MG/ML 1ML VIAL $3.22
5606063 PHARMACY CLINIC LEVEL 1 99211 $154.51
5606064 PHARMACY CLINIC LEVEL 2 99212 $187.77
5606065 PHARMACY CLINIC LEVEL 3 99213 $222.11
5606066 NAPROXEN 250MG TAB $1.07
5606067 MOXIFLOXACIN IV:400 MG/250 ML BAG J2280 $144.85
5606068 MOXIFLOXACIN ORAL: 400MG/TAB $45.07
5606069 SUCRALFATE (CARAFATE) TAB 1 GRAM $1.07
5606070 ERYTHROPOEITIN 4000 UNITS J0885 $254.30
5606071 IRON SUCROSE (VENOFER) 100MG VIAL J1756 $127.89
5606072 IBUPROFEN 100MG/5ML 120ML‐DON'T PROFILE $9.66
5606073 PEGFILGRASTIM (NEULASTA) 6MG INJ J2505 $10,224.79
5606074 METHADONE 10MG TAB $1.07
5606075 CEFOXITIN 1 GRAM VIAL (NF) J0694 $17.17
5606076 CEFOXITIN 2 GM/NS 100 ML (NF) $51.50
5606077 LEVOTHYROXINE TAB (NF) 112 MCG $2.15
5606078 DARBOPOETIN 300 MCG PFS J0881 $2,233.97
5606079 BOTULINUM A TOXIN 100 UNIT J0585 $1,291.80
5606080 DARBOPOETIN 200 MCG PFS J0881 $1,727.06
5606082 VECURONIUM 10MG/10ML VIAL ‐ NF $40.77
5606083 TRIAMCINOLONE ACET VIAL 40 MG/ML 5 ML J3301 $188.85
5606084 MEROPENEM 500 MG/NS 50 ML J2185 $12.90
5606085 PHENYLEPHRINE 10% OPTH DROP: 5ML $13.95
5606086 CARVEDILOL 6.25 MG TAB $0.43
5606087 DOXYCYCLINE 100MG VIAL $76.30
5606088 NABUMETONE 500MG TAB $2.15
5606089 ACETAZOLAMIDE SEQUELS 500MG CAP (NF) $19.31
5606090 THALIDOMIDE 200 MG CAPSULE (NF) $317.61
5606091 LINEZOLID 600MG/300ML (NF) J2020 $418.47
5606092 FINASTERIDE 5MG TABLET $2.15
5606093 DEXTROAMPHETAMINE 10MG TAB (NF) $2.15
5606095 LANSOPRAZOLE IV 30MG NS 50ML $21.46
5606096 VALPROATE ACID 500MG VIAL (NF) $18.24
5606097 VITRASE OVINE 200 UN/ML $100.86
5606098 DIGIBIND 38MG VIAL (NF) J1162 $1,085.87
5606099 INSULIN(LENTE) 100UNIT/ML (OR 1U/0.01ML) $0.09
5606100 INSULIN *RAPID ACTING* 100 UNIT/ML $0.26
5606101 INSULIN(ULTRALEN)100UNIT/ML(OR1UNIT/0.01 $0.09
5606102 INSULIN(LANTUS)100UNIT/ML OR 1UNIT/0.01M J1817 $0.99
5606103 INSULIN 70/30 100 UNIT/ML OR 1 UN/0.01ML $0.04
5606104 INSULIN(NPH)100 UNIT/ML OR 1UNIT/0.01ML $0.17
5606105 INSULIN (REG)100UNIT/ML OR 1UNIT/0.01ML $0.13
5606106 SODIUM ACETATE 40 MEQ/20 ML VIAL $2.15
5606107 LIDOCAINE 1% 20 ML MDV $6.45
5606110 ESOMEPRAZOLE 20 MG CAPSULE (NF) $22.53
5606111 ESOMEPRAZOLE 40 MG CAPSULE (NF) $15.02
5606112 METHACHOLINE CHALLENGE NEB 100MG J7674 $334.23
5606113 GI COCKTAIL (BEN/MYL/LIDO 1:1:1) 15ML UD $17.20
5606114 PEMETREXED 500 MG INJECTION (CHEMO) J9305 $6,249.10
5606115 LEVONORGESTREL 0.75MG/TAB ‐ ER USE ONLY $54.81
5606116 ESOMEPRAZOLE 40MG IV (NF) $16.09
5606117 PACLITAXEL PROTEIN BOUND 100 MG (CHEMO) J9264 $2,194.27
5606118 DARBOPOETIN 100 MCG PFS J0881 $1,290.73
5606119 ENZYMATIC DEBRIDMENT OINTMENT $712.53
5606120 MULTIVITAMIN CHEWABLE (NF) $0.09
5606121 LIDOCAINE VISCOUS 2% SOLN : 15 ML $3.22
5606122 DIAZEPAM (DIASTAT) 2.5 MG RECTAL GEL $390.12
5606123 ELECTROLYTES FOR TPN/PPN 20 ML VIAL (NF) $25.75
5606124 PERTUSSIS, DIPTHERIA, TETANUS VACCINE 90715 $156.91
5606125 NS 50 ML MINI‐BAG +PLUS+ $11.82
5606126 NS 100 ML MINI‐BAG +PLUS+ $12.90
5606127 LET TOPICAL GEL: 3ML SYRINGE $73.08
5606128 SMOOTH MOVE STIMULANT TEA $0.86
5606129 LEVOTHYROXINE TAB (NF) 88 MCG $2.15
5606130 OSELTAMIVIR (TAMIFLU) 75 MG CAPSULE $41.91
5606131 CEFUROXIME EYE SYRINGE $120.18
5606132 ADVAIR 100/50 INHALER $324.04
5606133 ADVAIR 250/50 INHALER $333.70
5606134 PANTOPRAZOLE (PROTONIX) 40 MG TABLET $0.99
5606135 CIPROFLOXACIN 200MG/20ML VIAL $49.36
5606136 PANTOPRAZOLE 20 MG TABLET (NF) $15.02
5606137 AMOX/CLAV (AUGM) 875MG TAB $7.52
5606138 CISATRACURIUM (NF) 10MG/5ML $41.85
5606139 PANTOPRAZOLE IVPB (PROTONIX) 40 MG VIAL J3490 $21.49
5606140 OXALIPLATIN 100 MG VIAL (CHEMO) J9263 $333.70
5606141 LIDOCAINE MPF 2% VIAL 5 ML $7.52
5606142 BUPIVacaine MPF 0.5% W EPI 1:200000 30ML $11.82
5606143 FENTANYL (DURAGESIC) 12 MCG/HR PATCH $65.56
5606144 ELOXATIN 50MG (CHEMO) J9263 $1,914.22
5606145 LEUCOVORIN 350MG VIAL (CHEMO) J0640 $77.26
5606147 PHENYLEPHRINE 0.1 MG/ML OPTHALMIC SYR $37.55
5606148 MONOVISC J3490 $2,010.79
5606149 OSELTAMIVIR (TAMIFLU) 30 MG CAPSULE $53.74
5606150 TESTOSTERONE VIAL 200 MG/1 ML (NF) J1071 $51.50
5606152 MORPHINE (DURAMORPH) 10MG AMP‐anes only J2274 $67.71
5606153 TOCILIZUMAB (ACTEMRA) 400 MG VIAL J3262 $3,735.08
5606154 MOXIFLOXACIN (VIGAMOX) EYE DROP $462.13
5606155 KETOROLAC (ACULAR) EYE DROP $19.31
5680033 MONTELUKAST ORAL TABLET 10 MG $22.57
5680099 NF‐CLARITHROMYCIN ORAL TABLET 500MG $5.36
5680206 NF‐BUMETANIDE TAB 1MG $3.22
5680223 NF‐DRONABINOL LIQ CAP 2.5MG $20.39
5680476 HYDROXYUREA CAP 500MG $1.07
5680729 NF‐XARELTO ORAL TABLET 10MG $31.12
5680774 DICYCLOMINE HCL TABLET 20MG $0.19
5680954 NF‐ENTACAPONE ORAL TABLET 200MG $9.66
5681139 NF‐BRIMONIDINE TARTRATE 0.2% OPHTHALMIC $40.77
5681144 NF‐PERMETHRIN CRM 5% $15.02
5681376 NF‐FISH OIL CAPSULE 1000MG $0.16
5681384 NF‐Doxepin HCl Capsule 25MG $0.13
5681385 NF‐Oxaprozin Oral Tablet 600MG $0.29
5681386 NF‐Doxepin HCl Capsule 50MG $0.17
5681395 NF‐PYRIDOXINE HCL TABLET 100MG $9.66
5681396 NF‐Clotrimazole Solution 1% $5.36
5681397 NF‐Floxin Otic Solution 0.3% $3.22
5681398 NF‐Ear Wax Removal Otic Solution 6.5% $0.04
5681400 NF‐Flovent HFA Inh/Neb Aer Pwd 0.044MG/1 $50.43
5681605 NF‐MYCOPHENOLATE MOFETIL 500MG ORAL TABL $4.29
5681671 NF‐XARELTO 20MG ORAL TABLET $21.46
5681727 NF‐DEMECLOCYCLINE HCL ORAL TABLET 300MG $49.36
5681793 NF‐DORZOLAMIDE HCL‐TIMOLOL 22.3MG‐6.8MG/ $60.09
5681849 NF‐COSOPT PF 2%‐0.5% OPHTHALMIC SOLUTION $6.44
5682004 NF‐chlorproMAZINE HCl Tablet 25MG $16.09
5682242 NF‐Tacrolimus Oral Capsule 1MG $10.73
5682397 NF‐Tacrolimus Oral Capsule 0.5MG $2.15
5682415 NF‐Mestinon Tablet 60MG $51.50
5682508 NF‐Dronabinol Liquid Filled Capsule 5MG $41.85
5682534 NF‐Ranexa Extended‐Release Tablet 500MG $32.19
5682546 NF‐Hydrocortisone Rectal Enema 100MG/60M $3.22
5690001 FENTANYL FOR INFUSION $1.87
5690002 SALINE FLUSH 10 ML $1.87
5690004 REMOVE NITROglycerin PATCH $1.87
5690006 AMBIEN 5 MG ** PT'S OWN MED ** $1.87
5690007 AMINOPHYLINE 500MG/500ML DRIP $1.87
5690008 CEFAZOLIN 2 GM/NS 50 ML $1.87
5690009 CIPROFLOXACIN 400MG‐D5W PB 200ML $1.87
5690010 CLINDAMYCIN 450 MG/NS 50 ML‐rx to supply $1.87
5690011 FUROSEMIDE DRIP 100MG/100ML‐RX TO SUPPLY $1.87
5690012 GENTAMICIN : 250 MG/NS 100 ML $1.87
5690013 GENTAMICIN : 300 MG/NS 100 ML $1.87
5690014 GENTAMICIN : 350 MG/NS 100 ML $1.87
5690015 GENTAMICIN : 400 MG/NS 100 ML $1.87
5690016 INSULIN (REG) DRIP 100 UNITS/NS 100 ML $1.87
5690017 MAGNESIUM SULF 1GM/NS50ML ‐ RX TO SUPPLY $1.87
5690018 MAGNESIUM SULF 2GM/NS50ML ‐ RX TO SUPPLY $1.87
5690019 MAGNESIUM SULF 3GM/NS100ML ‐RX TO SUPPLY $1.87
5690020 MAGNESIUM SULF 4GM/NS100ML‐RX TO SUPPLY $1.87
5690022 PAMIDRONATE 60MG/D5W 250ML J2430 $1.87
5690023 PAMIDRONATE 90MG/D5W 500ML J2430 $1.87
5690024 PHENYTOIN 500 MG/NS 100 ML‐ RX TO SUPPLY $1.87
5690025 PHENYTOIN 750 MG/NS 100 ML‐ RX TO SUPPLY $1.87
5690026 PHENYTOIN 1000 MG/NS 100 ML‐RX TO SUPPLY $1.87
5690027 COMBIVENT NEB $185.48
5690033 VANCOMYCIN ORAL FOR C DIFF $6.66
5690086 REMOVE LIDODERM PATCH $1.87
5690087 REMOVE FENTANYL PATCH $2.00
5690092 PIP‐TAZO (ZOSYN) 4.5GM TRADITIONAL INFU J2543 $66.37
5690094 LR 1000 ML W/ MULTIVITAMIN $1.87
5690107 HYDROMORPHONE PCA 40 MG/20 ML J1170 $27.51
5690108 HYDROMORPHONE PCA 80 MG/40 ML J1170 $27.51
5690109 HYDROMORPHONE PCA 200 MG/100 ML J1170 $34.88
5690127 ACETAMINOPHEN *IV* 650MG/65ML‐DON'T USE J0131 $185.09
5690146 GENTAMICIN 80MG/NS100 ML ‐ RX TO SUPPLY $8.04
5690151 TRANEXAMIC ACID 1000 MG *IV* $134.54
5690152 TRANEXAMIC ACID 3000 MG *IA* $134.54
5690172 FILGRASTIM (ZARXIO) 300MCG/0.5ML Q5101 $874.66
5690195 ROPIV 0.2%/FENT Epidu 100ml ‐ GMC MADE $221.35
5690197 PIP‐TAZO (ZOSYN) 4.5GM EXTENDED INFU J2543 $66.27
5690198 PIP‐TAZO (ZOSYN) 3.375GM TRADITIONAL INF J2543 $66.27
5690199 PIP‐TAZO (ZOSYN) 2.25GM TRADITIONAL INFU J2543 $66.27
5800001 BLOOD TRANSFUSION <2 HRS 36430 $800.45
5800002 BLOOD TRANSFUSION 2‐4 HRS 36430 $956.04
5800003 BLOOD TRANSFUSION 4‐6 HRS 36430 $1,203.90
5800004 BLOOD TRANSFUSION OVER 6 HRS 36430 $1,450.68
5800059 LITHOTRIPSY 50590 $18,481.17
6100022 BLOOD TRANSFUSION ‐2 HOURS 36430 $797.43
6100023 BLOOD TRANSFUSION 2‐4 HOURS 36430 $1,090.16
6100024 BLOOD TRANSFUSION 4‐6 HOURS 36430 $1,179.22
6100025 BLOOD TRANSFUSION +6 HOURS 36430 $1,508.63
6100035 URINE DIP STICK 81002 $12.88
6100041 NURSE ONLY 99201 $150.22
6100052 E D LEVEL 1 99281 $272.98
6100053 E D LEVEL 2 99282 $396.57
6100054 E D LEVEL 3 99283 $654.50
6100055 E D LEVEL 4 99284 $995.18
6100056 E D LEVEL 5 99285 $1,439.04
6100057 CRITICAL CARE FIRST HR 99291 $3,291.84
6100058 CRITICAL CARE EA ADDITIONAL 30 MIN 99292 $715.63
6100066 VENIPUNCTURE‐THA‐ 36415 $19.31
6100074 SUBCUTANEOUS 96372 $293.40
6100075 IV PUSH INITIAL 96374 $502.96
6100079 URINE DIP PREGNANCY 81025 $53.74
6100080 STRAIGHT CATHERIZATION OF BLADDER 51701 $198.82
6100081 INSERT TEMP INDWELLING BLADDER CATHETER 51702 $171.95
6100083 MEDIPORT FLUSH 96523 $297.22
6100084 IMMUNIZATION ADMIN 1 SINGLE OR COMBINATI 90471 $161.21
6100085 INFUSION THER HYDRATION 1ST HOUR 96360 $514.79
6100086 INFUSION THER HYDRATION EA ADDTL HOUR 96361 $282.65
6100087 INFUSION THERAPY OR PROPHYLAXIS 1ST HR 96365 $753.37
6100088 INFUSION THERAPY OR PROPHYLAXIS EA ADDTL 96366 $282.65
6100089 INFUSION THERAPY SEQ SUBSTANCE 1ST HOUR 96367 $320.26
6100090 INFUSION THERAPY CONCURRENT INFUSION 96368 $311.67
6100091 IV PUSH EA ADDITIONAL SEQ SUBSTANCE 96375 $283.72
6100092 COLLECT BLOOD SPECIMEN COMPLETELY IMPLAN 36591 $261.15
6100093 IV PUSH EACH ADDITIONAL SEQUENTIAL 96376 $321.34
6100094 INDEPENDANT BLOOD ALCOHOL DRAW KIT STATE $133.05
6100095 RAPID STREP 87880 $91.35
6100096 STOOL FIT FECAL BLOOD 82274 $85.98
6100097 MOD SED SAME PHY <5 YRS OLD INITAL 15MIN 99151 $134.12
6100098 MOD SED SAME PHY 5+ YRS OLD INITAL 15MIN 99152 $79.76
6100099 MOD SED SAME PHY EA ADDTL 15MIN 99153 $53.65
6100100 URINE DIP AUTOMATIC 81003 $12.88
6500001 ANTICOAG CLINIC LEVEL 1 99211 $92.43
6500002 ANTICOAG CLINIC LEVEL 2 99212 $124.67
6500003 ANTICOAG CLINIC LEVEL 3 99213 $188.07
6500004 *ANTICOAG CLINIC POC INR 85610 $51.59
7800004 DIAB CLINIC INDIV 30 MIN COMMER SELFPAY G0108 $145.93
7800007 DIAB CLINIC GROUP 30 MIN COMMER SELFPAY G0109 $72.96
7900001 OCC MED HEARING SCREEN‐15 MIN $27.90
7900003 INFLUENZA A/B ‐OB $27.90
7900004 RESPIRATORY QUESTIONNAIRE‐OH $54.72
7900005 HEPATITIS B VACCINE‐OH $136.27
7900006 OCCUPATIONAL NURSE EDUCATION/HR $95.50
7900007 AUDIOMETER TEST‐OHT $35.41
7900008 AUDIOMETER TEST‐OHO $54.72
7900009 FUNCTION CAPACITY EVALUATION $1,913.14
7900010 PFT VC‐OH $76.18
7900011 HEPATITIS B VACCINE MUNICIPAL‐OH $123.39
7900012 TETANUS MUNICIPAL‐OH $74.04
7900013 HEP B SERIES GROUP ADMIN 1ST IN SERIES $82.62
7900014 HEP B SERIES INDIV ADMIN 1ST IN SERIES $99.79
9000011 MNT INITIAL 15 MINUTES 97802 $152.61
9000012 MNT REASSES 15 MINUTES 97803 $176.25
