Charge description Average charge/unit

Average self-pay charge/unit (30% discount)

CVU FLOOR CARE PER DAY 1,949.00$ 1,364.30$ ICU FLOOR CARE PER DAY 1,949.00$ 1,364.30$ MEDICAL/ONCOLOGY FLR CARE PER DAY 1,949.00$ 1,364.30$ MEDICAL/ONCOLOGY PER DAY 1,949.00$ 1,364.30$ PEDIATRICS PER DAY 1,949.00$ 1,364.30$ SIERRA SGY - PVT ROOM PER DAY 1,138.00$ 796.60$ SURGICAL FLOOR CARE PER DAY 1,949.00$ 1,364.30$ SURGICAL PER DAY 1,949.00$ 1,364.30$ W&C NON OB PER DAY 1,949.00$ 1,364.30$ W&C OBS FLOOR CARE PED PER DAY 1,949.00$ 1,364.30$ W&C OBSTETRICS PER DAY 2,016.80$ 1,411.76$ MEDICAL/ONCOLOGY SEMI PVT PER DAY 1,949.00$ 1,364.30$ GEM 3,279.00$ 2,295.30$ PSYCHIATRIC 3,279.00$ 2,295.30$ CD DETOX 3,017.00$ 2,111.90$ CD REHAB 1,624.00$ 1,136.80$ GEN WELL BABY PED FLR CARE PER DAY 1,179.00$ 825.30$ NURSERY GENERAL WELL BABY PER DAY 1,179.00$ 825.30$ NURSERY NEWBORN LEVEL 1 PER DAY 1,395.00$ 976.50$ PED NEWBORN LEVEL 1 PER DAY 1,395.00$ 976.50$ NURSERY NEWBORN LEVEL II PER DAY 1,593.00$ 1,115.10$ PED NEWBORN LEVEL II PER DAY 1,593.00$ 1,115.10$ NURSERY NEWBORN LEVEL III PER DAY 1,793.00$ 1,255.10$ ICU SURGICAL UNIT PER DAY 4,018.00$ 2,812.60$ ICU MEDICAL UNIT PER DAY 4,018.00$ 2,812.60$ CV TELE PER DAY 2,497.00$ 1,747.90$ ICU TELE PER DAY 2,497.00$ 1,747.90$ MEDICAL/ONCOLOGY TELE PER DAY 2,497.00$ 1,747.90$ SUR TELEMETRY PER DAY 2,497.00$ 1,747.90$ TELEMETRY PER DAY 2,497.00$ 1,747.90$ CARDIOVASCULAR ICU PER DAY 4,018.00$ 2,812.60$ CVICU LEVEL PER DAY 5,469.00$ 3,828.30$ CVICU STEPDOWN PER DAY 4,018.00$ 2,812.60$ TRANSITIONAL CARE UNIT PER DAY 3,258.00$ 2,280.60$ 0 BAR FEM08040 ENDOVASC STENT 8X40 553.32$ 387.32$ 0 BOS H96540XXXX WALLSTENT XXX90X75 1,081.75$ 757.23$ 0 SKE SPLS-20140-TS SMOOTH PEG 673.60$ 471.52$ 0 SMI 25-2800 Q-FIX ANCHOR 551.18$ 385.83$ 0 SMI 42824020S TMT FUSION PLT,LONG 618.30$ 432.81$ 0 SMI 72465209 PLATE FIBULA 2.7/3.5 773.69$ 541.58$ 0 SYN 209.XXX 7.3 CANN SCREW FT 9.80$ 6.86$ 0.9% NACL 25 ML IVPB 91.99$ 64.39$ 1 ART AR-8725-XX SCREW HEADLESS 2.74$ 1.92$

1 BAR FEL10100 ENDOVAS STENT 10X100 1,900.60$ 1,330.42$ 1 BOS H965403310 WALLSTENT 16X40X75 2,261.40$ 1,582.98$ 1 SJM PM3222 LV GENERATOR 575.80$ 403.06$ 1 SKE TPLS-231XX-TS THR PG LCK 2.3 386.23$ 270.36$ 2 4WEB MOBIC-ADR CERVICAL DISC 68.18$ 47.73$ 2 ACU 7007-0107X LAT FIB PLATE 46.26$ 32.38$ 2 BOS H965404110 WALLSTENT 18X40X75 23.21$ 16.25$ 2 CAT 4FR MERIT BERN IMPRESS 46535 0.95$ 0.67$ 250 ML ALTERNATE POST OP EPIDURAL 694.70$ 486.29$ 250 ML STANDARD OB EPIDURAL 529.16$ 370.41$ 250 ML STANDARD POST OP EPIDURAL 529.80$ 370.86$ 3 BAR SM0002-USA ARISTA 1.95$ 1.37$ 3 BIO 185211 REV OFFSET ADAP EXPLAN 129.47$ 90.63$ 3 DEP SPI COMP CERVICAL SCREW 967.50$ 677.25$ 3 MED 97745 CONTROLLER 2.25$ 1.58$ 3 NUV SPI COMP RELINE MAS SHANK 46.57$ 32.60$ 3 SJM CAP PAIN TRIAL LEAD(S)/CABLE 2,371.30$ 1,659.91$ 3 ZAV SPI COMP CERV PLATE 1&2 LEVEL 46.47$ 32.53$ 4 ABB 1550300-38 STENT XIENCE SIERR 68.70$ 48.09$ 4 ART AR-3651TT FIBERTAK DR 100.20$ 70.14$ 4 BIO 185264 REV FEM W/SCR EXPLANT 82.98$ 58.08$ 4 MED 97725 WIRELESS EXT NEUROSTIM 22.21$ 15.55$ 4 NUV SPI COMP RELINE MAS TULIPHEAD 65.60$ 45.92$ 5 ACU 70-0338 DORSAL LUNATE PLATE 280.24$ 196.17$ 5 ACU 7008-0105 1/3 SEMI-TUB PL 5HL 151.10$ 105.77$ 5 ART AR-3602 FIBERTAK ANCHOR 622.46$ 435.72$ 5 BAR FEL07040 FLUENCY PLUS STENT 59.70$ 41.79$ 5 BIO 185344 REV PST AUG W/BLT EXPL 25.08$ 17.56$ 6 ACU 7008-0107 1/3 SEMI-TUB PL 7HL 810.10$ 567.07$ 6 BIO 148316 REV SPLINED V2 STEM 225.13$ 157.59$ 6 SYN 02.001.306 4.5 LCP CRVD CON P 441.50$ 309.05$ 7 ABI 005062 IMPELLA 5.0 PUMP 603.20$ 422.24$ 7 NUV 16016545 RELINE MAS SCREW CAN 24.80$ 17.36$ 7 ZAV SPI COMP CERV PLT 3&4 LEVEL 2.20$ 1.54$ 8 BIO 11-300919 REV WASTED DIST STM 61.62$ 43.14$ 8 BIO 8163-35-0XX 3.5 MULTI DIR SCR 1,239.00$ 867.30$ 8 GLO SPI COMP STAND ALONE LUMBAR 107.29$ 75.10$ 9 CAT 86700 VOLCANO VISIONS PV.018 154.70$ 108.29$ 9 SKE GMN-RTS-3HL VOLAR PLATE 69.18$ 48.43$ ACETAMINOPHEN 1000MG/100ML SDV 377.63$ 264.34$ ACETYLCHOLINE CL 1% 2.00$ 1.40$ ACETYLCYSTEINE 20% 30ML AMIH 282.83$ 197.98$ ACETYLCYSTEINE 20MG/ML 4ML SDV 177.39$ 124.17$ ACTIVATED CHARCOAL W/SORB 25GM 125.90$ 88.13$ ACU 70-0288 CLAVICLE PLATE 147.82$ 103.48$ ACU AT2-S24-S STAND ACUTRAK 2 SCR 57.96$ 40.57$ ACU COL-3240 3.5 LOCKING SCREW 4.10$ 2.87$

ACULAR 0.5% DROPS 333.90$ 233.73$ ACYCLOVIR 1000MG/20ML SDV 309.60$ 216.72$ ACYCLOVIR 200 MG/5 ML SUSP 6.64$ 4.65$ AEROSOL TALC 54.42$ 38.10$ ALBUMIN 5% 500 ML IVPB 1,012.85$ 709.00$ ALBUTEROL CFC FREOO (ANESTHESIA O 449.23$ 314.46$ ALBUTEROL/IPRATROPIUM 100-20MCG A 2,073.55$ 1,451.48$ ALISKIREN HEMIFUMARATE 150MG TAB 52.18$ 36.53$ ALPRAZOLAM 0.5MG ODT 117.42$ 82.20$ ALUMINUM HYDROXIDE GEL 320MG/5ML 0.16$ 0.11$ AMINOCARPROIC ACID 250MG/20ML 84.29$ 59.00$ AMOXICILLIN 125 MG/5 ML 1ML 0.41$ 0.29$ AMOXICILLIN 250 MG/5 ML 1 ML 0.48$ 0.34$ AMPICILLIN 1GM/NS 50ML 83.00$ 58.10$ AMPICILLIN 2MG/NS 50ML 109.30$ 76.51$ AMPICILLIN/SULBACTAM 3GM/NS100ML 116.20$ 81.34$ ANGIOTENSIN II 2.5MG/ML SDV 8,538.00$ 5,976.60$ APAP-HYDROCODONE 325/5MG ER STPAK 37.10$ 25.97$ APIXABAN 2.5MG TAB 54.83$ 38.38$ APIXABAN 5MG TAB 54.83$ 38.38$ ARFORMOTEROL 15MCG/2ML INHALATION 214.28$ 150.00$ ARGATROBAN 50MG/50ML SDPF 1,335.70$ 934.99$ ARIPIPRAZOLE 2MG TABLET 182.52$ 127.76$ ART AR-1588RT ACL TIGHTROPE RT 113.60$ 79.52$ ART AR-1928SF-2 CORKSCREW SUT 41.70$ 29.19$ ART AR-4500 MENISCAL CINCH 6.84$ 4.79$ ART AR-8835-14 NONLCK SCREW 208.40$ 145.88$ ART AR-8943BR-08 LOCK DIST FIB PL 485.00$ 339.50$ ART AR-8943T-04 1/3 TUB PLT LOCK 173.53$ 121.47$ ARTIFICIAL TEARS=AKWA 15 ML 20.90$ 14.63$ ASENAPINE 2.5MG SL TABLET 157.60$ 110.32$ ASENAPINE 5MG SL TAB 143.71$ 100.59$ ATAZANAVIR 150MG CAPSULE 191.25$ 133.88$ ATL 1106-01-6545 MODULAR SCREW 36.40$ 25.48$ ATOMOXETINE 60MG CAPSULE 87.80$ 61.46$ ATORVASTATIN 10MG TABLET 3.00$ 2.10$ ATORVASTATIN 20MG TABLET 3.40$ 2.38$ ATOVAQUONE 750MG/5ML SUSP 34.51$ 24.16$ ATROPINE 0.5MG/5ML SYRINGE #DIV/0! #DIV/0!AZACTAM (AZTERONAM) 1 GM VIAL 467.41$ 327.19$ AZITHROMYCIN 200MG/5ML PER ML 8.54$ 5.98$ AZTREONAM 2 GRAM PWVL 451.60$ 316.12$ BACITRACIN 50000U/ML 1 ML VIAL 149.33$ 104.53$ BACITRACIN TOPICAL OINT UD 1.51$ 1.06$ BACITRACIN TOPICAL OINTMENT 120.30$ 84.21$ BACITRACIN/NEO/POLYMIX OINT UD 2.48$ 1.74$ BACTRIM DS ER START PACK #2 3.10$ 2.17$

BALANCED SALT SOLU (BSS) 15ML 91.58$ 64.11$ BANANA BAG ER ONLY 50ML 279.60$ 195.72$ BENZOCAINE 20% ORAL GEL 19.50$ 13.65$ BENZOYL PEROXIDE 5% GEL 48.40$ 33.88$ BILIARY CATH. (IMAGE) 101.38$ 70.96$ BIMATOPROST 0.01% 2.5ML DROPS 864.50$ 605.15$ BISMUTH SUBSAL 262MG/15ML PER ML 0.13$ 0.09$ BISOPROLOL 5 MG TAB 10.64$ 7.45$ BREVIBLOC 10MG/ML 10 ML VIAL 91.00$ 63.70$ BREXPIPRAZOLE 0.25MG TABLET 211.84$ 148.29$ BREXPIPRAZOLE 1MG TABLET 247.90$ 173.53$ BRIMONIDINE 0.2% 5ML OS 211.35$ 147.95$ BUDESONIDE 0.5MG/2ML INHAL SUSP 124.90$ 87.43$ BUDESONIDE 1MG/2ML SUSP FOR INHAL 247.40$ 173.18$ BUMETANIDE 0.25MG/ML 10ML 40.56$ 28.39$ BUMETANIDE 0.25MG/ML 4 ML 57.03$ 39.92$ BUPIVACAINE 0.25% 30ML SDPF 53.13$ 37.19$ BUPIVACAINE 0.5% 10ML SDPF 57.60$ 40.32$ BUPIVACAINE 0.5% 30ML SDPF 57.34$ 40.14$ BUPIVACAINE 0.75% 10ML MPF 50.27$ 35.19$ BUPIVACAINE 0.75% MPF 2ML AMP 62.62$ 43.83$ BUPRENORPHINE 2MG SL TAB 241.19$ 168.83$ BUPRENORPHINE 8MG SL TAB 147.90$ 103.53$ BUPRENORPHINE/NALOXONE 2-0.5MG FI 39.81$ 27.86$ BUPRENORPHINE/NALOXONE 4-1MG FILM 70.36$ 49.25$ CABOT SOFT WAND BALLOON RETRACTOR 2.70$ 1.89$ CADEXOMER=IODOSORB 40G GEL 554.20$ 387.94$ CALCIUM CARBONATE 500MG TAB CHEW 1.23$ 0.86$ CALCIUM CHLORIDE 10% 10ML VIAL 273.53$ 191.47$ CARBAMAZEPINE 20MG/ML SUSP 1ML 1.30$ 0.91$ CARBOPROST 250MCG/ML 1,436.90$ 1,005.83$ CARDIZEM INJ 25MG (5MG/ML) 64.93$ 45.45$ CARDIZEM INJ 50MG (5MG/ML) 71.08$ 49.76$ CARIPRAZINE 1.5MG CAPSULE 199.08$ 139.36$ CARMEX LIP BAUM 12.80$ 8.96$ CAUTERY TIP, EXT. NEEDLE ELECTROD 207.70$ 145.39$ CEFAZOLIN 100MG/50ML PREMIX 57.89$ 40.52$ CEFAZOLIN 2GM/D5 50ML PREMIX 102.15$ 71.50$ CEFAZOLIN 2GM/NS 50ML 94.80$ 66.36$ CEFOTAN (CEFOTETAN) 1 GM VIAL 286.20$ 200.34$ CEFOTETAN 1 GM PREMIX 185.13$ 129.59$ CEFOTETAN 2 GM PWDI 556.70$ 389.69$ CEFOXITIN 1GM/D5 50ML PREMIX 146.71$ 102.70$ CEFOXITIN 2GM/D5 50ML PREMIX 262.65$ 183.85$ CEFTAROLINE 600MG PWDI 941.60$ 659.12$ CEFTAZIDIME 1000MG/D5 50ML PREMIX 135.57$ 94.90$ CEFTAZIDIME 2 GM SDV 164.90$ 115.43$

CEFTRIAXONE 1GM/DEXTROSE 50ML 148.10$ 103.67$ CERTIRIZINE 1MG/ML SYRUP 5ML 14.60$ 10.22$ CETAPHIL CREAM 453 GM 149.00$ 104.30$ CETAPHIL SKIN CLEANSER 8 OZ 79.50$ 55.65$ CHLORHEXIDINE ORAL SOL 15ML UDC 14.30$ 10.01$ CHLOROPROCAINE 3% 20ML MPF 326.50$ 228.55$ CHOLECALCIFEROL 1000 I.U. (D3) 1.80$ 1.26$ CHOLECALCIFEROL 400 UNIT CAP 2.90$ 2.03$ CLEOCIN PHOSPHATE 150MG/ML 6ML 165.98$ 116.19$ CLINDAMYCIN 1% TOPICAL SOLUTION 515.10$ 360.57$ CLINDAMYCIN 300MG INJ 81.80$ 57.26$ CLINDAMYCIN 300MG/D5 50ML PREMIX 93.98$ 65.79$ CLINDAMYCIN 900MG/D5 50ML PREMIX 183.54$ 128.47$ CLINDAMYCIN GEL 1% 30 ML 5.21$ 3.65$ CLINDAYMYCIN 600MG/D5 50ML PREMIX 152.19$ 106.53$ CLINIMIX 5/25 1000ML 415.80$ 291.06$ CLIPS HULKA 211.96$ 148.37$ CLOBETASOL 0.05% 30 GM CREAM 1,286.90$ 900.83$ CLOTRIMAZOLE 1% CREAM 61.70$ 43.19$ COCAINE HCL TOP SOLU 4% 4 ML 3,449.06$ 2,414.34$ COSOPT OPHTH SOL 10 ML 331.69$ 232.19$ COTTONOID 774.22$ 541.95$ COVER MAYO STAND 396.65$ 277.66$ CRY BG3515-5-US BIOGLUE 7.60$ 5.32$ CUC PH PHENEGRAN 12.5MG SUPP 129.60$ 90.72$ CYCLOGYL OPHT DROPS 1% 2 ML 86.45$ 60.52$ D5/.45% NS W/10MEQ KCL/1000ML 41.70$ 29.19$ D5/0.45%NS+20MEQ KCL 1000ML 41.58$ 29.10$ D5-0.225% NS + 20 MEQ KCL 1000ML 105.00$ 73.50$ D5-0.45%NS + 40 MEQ KCL 1000 ML 41.70$ 29.19$ D5LR + 20 MEQ KCL 1000 ML 52.20$ 36.54$ D5NS + 20 MEQ KCL 1000 ML 41.70$ 29.19$ D5NS + 40 MEQ KCL 1000 ML 52.20$ 36.54$ D5W (DEHP FREE) 250 ML IVPB 54.60$ 38.22$ DABIGATRAN 150 MG CAPSULE 52.48$ 36.74$ DABIGATRAN 75 MG CAPSULE 53.30$ 37.31$ DAKINS 0.125% (1/4 STRENGTH) 0.30$ 0.21$ DAKINS 0.25% (1/2 STRENGTH) 0.29$ 0.20$ DAKINS 0.5% (FULL STRENGTH) 0.29$ 0.20$ DEHYDRATED ALCOHOL 5CC AMP 618.36$ 432.86$ DEPACON (VALPROATE) IV 500 MG 47.03$ 32.92$ DESVENLAFAXINE ER 50 MG TAB 44.01$ 30.81$ DEX/TOBRAMYCIN 0.3-0.1% OPHT DROP 292.05$ 204.44$ DEXAMET/NEO/POLY B OPH OINT 223.20$ 156.24$ DEXAMETHASONE 0.5MG/5ML PER ML 0.48$ 0.34$ DEXAMETHASONE 10MG/ML 1ML VIAL 49.52$ 34.66$ DEXAMETHASONE 4MG/ML 1 ML VIAL 48.82$ 34.17$

DEXAMETHASONE PF 10MG/ML SDPF 99.38$ 69.57$ DEXMEDETOMIDINE 200MCG/2ML 690.05$ 483.04$ DEXTROMETHORPHAN 6MG/ML PER ML 0.77$ 0.54$ DEXTROSE 4 GM CHEW TAB - 10 PACK 16.28$ 11.39$ DEXTROSE 50% 50 ML SYRINGE 170.01$ 119.00$ DIATRIZOATE MEG/DIAT SOD 50ML 157.25$ 110.08$ DICLOXACILLIN 500MG CAPSULE 10.80$ 7.56$ DIGOXIN 50MCG/ML SOLN PER ML 6.78$ 4.75$ DILTIAZEM 125MG/25ML SDV 150.10$ 105.07$ DILTIAZEM 125MG/D5W 100ML DRIP 228.50$ 159.95$ DILTIAZEM 125MG-NS 100ML PREMIX 228.47$ 159.93$ DIPHENHYDRAMINE 12.5MG/5ML PER ML 11.28$ 7.90$ DIPHENHYDRAMINE GEL 1% 44.30$ 31.01$ DIPHENHYDRAMINE/ZINC 2-0.1% CR 23.10$ 16.17$ DIPRIVAN 10MG/ML 20ML AMP 62.92$ 44.05$ DIPTHERIA/TETANUS/PERTUSS PEDI 327.20$ 229.04$ DIPYRIDAMOLE-ASA 200MG-25MG CAP 68.78$ 48.14$ DIVALPROEX ER 250 MG TAB 12.34$ 8.64$ DIVALPROEX ER 500 MG TAB 22.12$ 15.48$ DOCUSATE 100 MG/10 ML SOLN UD 6.20$ 4.34$ DOXYCYCLINE 100 MG VIAL 345.17$ 241.62$ DOXYCYCLINE SUSP 25MG/5ML 2.67$ 1.87$ DRONEDARONE (MULTAQ) 400MG TABLET 78.53$ 54.97$ DULOXETINE 20 MG CAP 13.39$ 9.37$ DULOXETINE 30 MG CAP 13.56$ 9.49$ DUTASTERIDE=AVODART 0.5 MG TAB 5.60$ 3.92$ EDECRIN SODIUM 50 MG VIAL 0.82$ 0.57$ EDOXABAN 30MG TABLET 88.80$ 62.16$ ELECTROLYTE-R 1000ML 53.66$ 37.56$ EMOLLIENT TOPICAL AQUAPHOR 396GM #DIV/0! #DIV/0!EMPTY IV BAG 500ML 52.60$ 36.82$ ENDO CLIP II #176657 42.10$ 29.47$ EPHEDRINE 50 MG/10 ML SYRINGE 465.89$ 326.12$ EPHEDRINE SULFATE 50MG/ML AMP 351.11$ 245.78$ EPID FENTANYL 5MCG/BUP 0.62 250ML 238.10$ 166.67$ EPINEPHRINE 100 MCG/10 ML SYRINGE 491.77$ 344.24$ EPINEPHRINE 1MG/10ML INTRACARDIAC 179.60$ 125.72$ EPINEPHRINE 2MG/D5 250ML PREMIX 435.28$ 304.69$ EPLERENONE=INSPRA 25 MG TAB 27.51$ 19.26$ ERTAPENEM 1GM/NS 50ML 702.90$ 492.03$ ERYTHROMYCIN 1 GM OPHTH OINT 106.18$ 74.33$ ESMOLOL 2500MG/NS 250ML 3,004.96$ 2,103.47$ ESTRACE VAG CREAM 0.01% 42.5GM 1,654.50$ 1,158.15$ ETH EVICEL 2ML 41.70$ 29.19$ ETHIODIZED OIL 480MG/ML 10ML 5,856.10$ 4,099.27$ ETOMIDATE 20 MG/10 ML SDV 119.62$ 83.74$ EYE-STREAM OPHT IRRIG SOL 30ML 142.80$ 99.96$

FAMOTIDINE 20MG/2ML SDV 41.61$ 29.13$ FENIFIBRATE 160MG CAPLET 45.60$ 31.92$ FENOFIBRATE 54MG TABLET 6.90$ 4.83$ FENTANYL 12MCG/HR TDP 1,631.76$ 1,142.23$ FENTANYL 1500MCG/30ML PCA 249.98$ 174.98$ FERROUS GLUCONATE 324MG TABLET 1.30$ 0.91$ FERROUS SULFATE 220MG/5ML PER ML 0.21$ 0.15$ FIDAXOMICIN 200MG TABLET 925.10$ 647.57$ FLUCONAZOLE 40MG/ML SUSP PER ML 10.99$ 7.70$ FLUCONAZOLE/NS 100MG/50ML 126.60$ 88.62$ FLUMAZENIL 1MG/10ML SDV 445.32$ 311.72$ FLUORESCEIN 10% INJ 5ML 244.60$ 171.22$ FLUOR-I-STRIP OPTH 2.52$ 1.76$ FLUOXETINE 20MG/5ML PER ML 0.88$ 0.62$ FORANE 15 MIN 17.93$ 12.55$ FORANE 1HR 63.64$ 44.54$ FORANE INHALATION PER ML 1.84$ 1.29$ FOSFOMYCIN 3GM PACKET 368.30$ 257.81$ GABAPENTIN 250MG/5ML PER ML 2.24$ 1.57$ GELATIN SPONGE ABSORBABLE SZ 100 315.79$ 221.05$ GELFILM OPHT 25 X 50 MM 1,198.90$ 839.23$ GELFOAM 50 437.25$ 306.07$ GELFOAM TOPICAL SPONGE 12/7 MM 128.62$ 90.03$ GENTACIDIN OPHT GTT 3MG/ML 5ML 205.80$ 144.06$ GENTACIDIN OPHT OINT 3MG/GM 195.60$ 136.92$ GENTAMICIN 100MG/NS 50ML PREMIX 49.60$ 34.72$ GENTAMICIN 80MG/NS 50ML PREMIX 48.49$ 33.95$ GLYCERIN LIQUID PER ML 0.36$ 0.25$ GLYCINE IRRIGATION 3000 CC 94.77$ 66.34$ GOLYTELY PREP 4000 ML 157.40$ 110.18$ GRA F4008 IMPRA FLEX 455.65$ 318.95$ GRA F8006SC IMPRA CARBOFLO FLEX 60.27$ 42.19$ GRA F8008S FLEX GRAFT 9.40$ 6.58$ GUAIFENESIN 100 MG/5 ML SYRUP 1.50$ 1.05$ GUAIFENESIN 100MG/5ML UDC 5.18$ 3.62$ GUAIFENESIN DM 5ML UDC 5.47$ 3.83$ HAEMOP B TET TOX=ACTIB 378.40$ 264.88$ HALOPERIDOL 2 MG/ML SOLN 1.90$ 1.33$ HAN 1312-11-120 MULTI-DIR PEG 145.60$ 101.92$ HEPARIN 1000 UN/ML 30 ML MDV 109.48$ 76.64$ HEPARIN 30UNITS/3ML SYRINGE 418.32$ 292.82$ HEPARIN PF 100UNITS/1ML 47.70$ 33.39$ HUMALOG 75/25 300UN/3ML PEN 520.90$ 364.63$ HUMULIN 70/30 300UN/3ML PEN 466.90$ 326.83$ HUMULIN N 300 UN/3ML PEN 697.60$ 488.32$ HUMULOG 300UN/3ML PEN 520.87$ 364.61$ HUMULOG 50/50 300UN/3ML PEN 520.90$ 364.63$

HURRICAINE SPRAY 20% 60 ML 252.33$ 176.63$ HYDROCODONE/APAP 5-325 TAB 36.06$ 25.24$ HYDROCODONE/APAP 7.5/325MG/15ML U 236.16$ 165.31$ HYDROCORTISONE 2.5% OINTMENT 65.15$ 45.61$ HYDROGEN PEROXIDE 3% 4.92$ 3.45$ HYDROXYZINE 50MG/ML 1ML SDV 330.80$ 231.56$ IBUPROFEN 100 MG PER 5 ML 8.18$ 5.72$ ILOPERIDONE 4MG TAB 114.47$ 80.13$ INDIA INK STERILE 466.90$ 326.83$ INDIGO CARMINE 0.8% 5 ML AMP 1,064.50$ 745.15$ INDOCYANINE GREEN 25MG W/DILUENT 559.37$ 391.56$ INFLUENZA VACCINE 2017-2018 ADULT 238.87$ 167.21$ INFLUENZA VACCINE 2018-2019 ADULT 233.90$ 163.73$ INFLUENZA VACCINE 2018-2019 PEDI 263.00$ 184.10$ INSULIN ASPART (NOVOLOG) 3ML PEN 639.35$ 447.54$ INSULIN R HUMAN 100 UN/ML 3 ML 465.00$ 325.50$ IODINE-POTASSIUM IODINE 14ML SOLN 318.30$ 222.81$ IOPAMIDOL-250 50ML SSH 550.60$ 385.42$ IOPAMIDOL-370 50ML SSH 338.70$ 237.09$ IPRATROPIUM BR 0.5MG/2.5ML 3.80$ 2.66$ ISOPTO ATROPINE OPHT DROPS 1% 328.50$ 229.95$ KETAMINE 100MG/ML 5ML 121.33$ 84.93$ KETAMINE 200MG/20ML 229.10$ 160.37$ KNEE PATELLA 5550-G-339 132.96$ 93.08$ K-PHOS ORIGINAL 500MG TABLET 4.00$ 2.80$ LABETALOL 20MG/4ML SDV 109.10$ 76.37$ LACRI-LUBE OPHT OINTMENT 3.5GM 21.88$ 15.32$ LACTINEX 1 GM PACKET 17.80$ 12.46$ LACTULOSE SOLUTION 30 ML 9.89$ 6.92$ LANTUS INSULIN 300UN/3ML PEN 479.24$ 335.47$ LEI 50-20412 BONE SCREW 28.50$ 19.95$ LEI 50-20505 2.0 LOCKING SCREW 64.47$ 45.13$ LET GEL 3ML TOPICAL SYRINGE 236.57$ 165.60$ LEVETIRACETAM 500MG INJECTION 211.73$ 148.21$ LEVETIRACETAM SUSP 100MG/ML PER M 1.36$ 0.95$ LEVONORGESTREL 1.5MG TABLET 255.70$ 178.99$ LEVOTHYROXINE 100MCG PWDI 687.18$ 481.03$ LIDOCAINE .4% IN D5W 500 CC 105.00$ 73.50$ LIDOCAINE 1% 10MG/ML 5ML ESI 77.79$ 54.45$ LIDOCAINE 1% MPF 30ML STERILE 164.93$ 115.45$ LIDOCAINE JELLY TOPICAL 2% 11ML 85.70$ 59.99$ LIDOCAINE TOP OINT 5% 35.44 GM 1,505.20$ 1,053.64$ LIDOCAINE VISCOUS 2% PER ML 0.26$ 0.18$ LIDOCAINE VISCOUS 2% UDC 14.72$ 10.31$ LIDOCAINE W/EPI 1% 10ML VIAL 114.23$ 79.96$ LIDOCAINE W/EPI 1% 30ML 166.53$ 116.57$ LIDOCAINE W/EPI 1.5% 10ML MPF 142.70$ 99.89$

LIF TGEL01 GEL DBM OPTIUM 1CC 105.90$ 74.13$ LIF TGEL05 GEL DBM OPTIUM 5CC 71.81$ 50.27$ LIF TGEL10 GEL DBM OPTIUM 10CC 119.56$ 83.69$ LIF TPUT01 PUTTY DBM OPTIUM 1CC 79.90$ 55.93$ LIF TPUT05 PUTTY DBM OPTIUM 5CC 62.31$ 43.62$ LIF TPUT10 PUTTY DBM OPTIUM 10CC 84.70$ 59.29$ LITHIUM CARB 300 MG TAB 2.23$ 1.56$ LITHIUM CIT 8 MEQ/5 ML SYRUP 11.40$ 7.98$ LOPERAMIDE 1 MG/5 ML SOLN 15.63$ 10.94$ LORAZEPAM SOL 2 MG PER ML 98.45$ 68.91$ LOXAPINE 25MG CAPS 10.30$ 7.21$ LR IRRIG 3000 ML 117.03$ 81.92$ LURASIDONE 40MG TAB 246.37$ 172.46$ MAG SULF 2 GM IN 50 ML IVPB 202.82$ 141.97$ MAGNESIUM GLUC 1000MG/5ML PER ML 0.50$ 0.35$ MAGNESIUM SULFATE 4% 500 ML 83.72$ 58.60$ MANNITOL 20% 250ML PREMIX 800.68$ 560.47$ MANNITOL/SORBITOL IRRIG 3000ML 256.30$ 179.41$ MAXITROL OPHT DROPS 5 ML 210.60$ 147.42$ MECLIZINE 6.20$ 4.34$ MECLIZINE 6.20$ 4.34$ MEGESTROL 400MG/10ML UDC 32.17$ 22.52$ MELATONIN 5MG TABLET 1.15$ 0.80$ MEMANTINE 28 MG ER CAPSULE 102.60$ 71.82$ MENINGOCOCCAL CONJUGATE VACCINE 691.80$ 484.26$ MEROPENEM=MERREM 500 MG SDV 218.20$ 152.74$ MESALAMINE DR 400MG CAPSULE 28.18$ 19.73$ MESH MARLIX 3X6 335.94$ 235.16$ METHENAMINE MANDELATE 0.5GM TAB 7.02$ 4.91$ METHYL SALICYLATE CREAM 19.20$ 13.44$ METHYLENE BLUE 1% 10 ML AMPULE 1,162.40$ 813.68$ METHYLFOLATE 7.5MG CAP 19.20$ 13.44$ METOCLOPRAMIDE 10MG/10ML UD CUP 17.00$ 11.90$ METOPROLOL 5MG/5ML SDV 51.82$ 36.27$ METOPROLOL=TOPROL XL 100 MG TAB 11.16$ 7.81$ METRONIDAZOLE=FLAGYL 500 MG IV 50.37$ 35.26$ MIDAZOLAM 125MG/D5W 125ML DRIP 340.40$ 238.28$ MIDAZOLAM DRIP 100MG/100ML NS 383.93$ 268.75$ MINERAL OIL PER ML 0.14$ 0.10$ MINERAL OIL STERILE 10 ML SDV 141.46$ 99.02$ MINI-DRIVER 108.68$ 76.08$ MISOPROSTOL 25MCG VAGINAL TABLET 9.90$ 6.93$ M-M-R VACCINE SDV 435.20$ 304.64$ MOMETASONE 0.1% CREAM 45 GRAM 491.10$ 343.77$ MONOCRYL 4-0 Y426H 122.80$ 85.96$ MONOCRYL 5-0 Y493G 140.24$ 98.17$ MONTELUKAST=SINGULAIR 4 MG CHEW 8.80$ 6.16$

MORPHINE 0.4MG/ML SOLUTION (NRSY) 0.03$ 0.02$ MULTITRACE CONC 1ML VIAL 192.89$ 135.03$ MULTIVIT W/IRON 1 ML SOLN 2.30$ 1.61$ MULTIVITAMIN 10ML SDV 165.90$ 116.13$ MULTIVITAMIN ORAL SOL PER 1ML 0.31$ 0.22$ MUPIROCIN 2% CREAM 119.70$ 83.79$ MUPIROCIN 2% TOPICAL OINTMENT 427.08$ 298.96$ MYCOPHENOLATE MOFE 200MG/ML SOLN 37.43$ 26.20$ NAFCIL (NAFCILLIN NA) 1 GRAM 172.70$ 120.89$ NAFCIL (NAFCILLIN NA) 2 GRAMS 304.10$ 212.87$ NALBUPHINE 10MG/0.5ML SYRINGE 129.10$ 90.37$ NALBUPHINE 20MG/1ML INJ 97.06$ 67.94$ NEOSPORIN GU IRRIGANT 1 ML AMP 176.90$ 123.83$ NEOSPORIN TOPICAL OINTMENT 29.30$ 20.51$ NEUT 4% 5 ML VIAL 108.28$ 75.79$ NICARDIPINE=CARDENE 25MG AMP 284.05$ 198.84$ NITROFURANTION 25MG/5ML PER ML 18.18$ 12.72$ NITROGLYCERIN 25 MG/250 D5W IVPB 219.14$ 153.40$ NITROGLYCERIN 5MG/ML SDV 210.00$ 147.00$ NITROLINGUAL AEROSOL .4MG/DOSE 1,081.00$ 756.70$ NITROPRUSSIDE 50MG VIAL 4,721.08$ 3,304.75$ NITROSTAT 0.4MG 25.00$ 17.50$ NORCURON 10MG/5ML VIAL 105.66$ 73.97$ NOREPINEPHRINE 4MG/250ML 0.9% NS 498.43$ 348.90$ NOREPINEPHRINE 4MG/4ML SDV 260.70$ 182.49$ NOREPINEPHRINE 4MG/D5 250M PMIX 506.70$ 354.69$ NS (DEHP FREE) 250 ML IVPB 54.57$ 38.20$ NS IRRIG POUR BTL 500ML 19.16$ 13.42$ NS IRRIGATION 250ML 12.87$ 9.01$ NS/KETOROLAC/EPI/CLONID/ROPIV ADM 1,559.30$ 1,091.51$ NUV 5010020 FORMAGRAFT GRANULES 100.37$ 70.26$ NUV 8061100 19.09$ 13.36$ NYLON 11-0 AA-0130 129.31$ 90.52$ NYSTATIN CREAM 30 GM 305.60$ 213.92$ OCUFLOX 0.3% O/S 5ML 222.00$ 155.40$ OPIUM W/BELLADONNA (B&O) SUPP 2,532.70$ 1,772.89$ OSELTAMIVIR 6MG/ML 1 ML SUSP 14.53$ 10.17$ OXYCODONE 5MG/5ML SOLUTION 41.64$ 29.15$ OXYCODONE/APAP 10/325 MG TABLET 181.13$ 126.79$ OXYCODONE=OXYCONTIN 15 MG TAB 471.97$ 330.38$ PAINEASE TOPICAL SPRAY 30ML 134.30$ 94.01$ PALIPERIDONE 3MG ER TAB 150.87$ 105.61$ PALOMOSETRON 0.05MG/ML 5ML SDV 2,601.60$ 1,821.12$ PANCRELIPASE DR 5000 UNITS 11.95$ 8.37$ PANTOPRAZOLE=PROTONIX 40MG SUSP 96.48$ 67.54$ PARICALCITOL=ZEMPLAR 1 MCG TAB 76.70$ 53.69$ PDS 0 Z340H 8.19$ 5.73$

PENTAMIDINE=NEBUPENT 300 MG INH 1,075.80$ 753.06$ PETROLATUM 30GM OINTMENT 24.50$ 17.15$ PETROLATUM, WHITE 5 GM TOPICAL 12.10$ 8.47$ PH CYANOCOBALAMIN 1000 MCG/ML 46.20$ 32.34$ PH DEXAMETHASONE 10MG INJ 50.20$ 35.14$ PH DEXAMETHASONE 10MG INJ 50.20$ 35.14$ PH DEXAMETHASONE 4MG INJ 48.20$ 33.74$ PH DIPHENHYDRAMIN 50MG/ML INJ 69.30$ 48.51$ PH DIPHENHYDRAMINE 50MG/MLINJ 69.30$ 48.51$ PH FAMOTIDINE (PEPCID) IV 38.83$ 27.18$ PHARMACY FAMOTIDINE 20MG TABLET 1.80$ 1.26$ PHENYLEPHRINE 1000MCG/10ML SYR 151.20$ 105.84$ PHENYLEPHRINE 30MG/NS 500ML PREMI 327.54$ 229.28$ PHENYTION 125MG/5ML PER ML 4.49$ 3.14$ PIPERONYL BUTOXIDE/PYRETHRINS SHA 29.70$ 20.79$ PIPH LIDOCAINE 10MG 56.30$ 39.41$ PIPH MARCAINE 50.60$ 35.42$ PITRESSIN 20U/ML 1 ML AMPULE 712.79$ 498.95$ PLATE,Y 1,732.80$ 1,212.96$ PLEGISOL 1000 ML 418.73$ 293.11$ PNEUMOCOCCAL 13 VACCINE 0.5ML 1,030.46$ 721.32$ POLYSORB 5-0 SL-636 191.73$ 134.21$ POT ACETATE 20 MEQ/50 ML NS 63.20$ 44.24$ POT PEN G 2.5 MU/50 ML NS IVPB 81.07$ 56.75$ POT PHOS 30 MMOL/250 ML NS IVPB 253.40$ 177.38$ POT PHOSPHATES 20 MEQ/50 ML NS 112.68$ 78.88$ POTASSIUM ACETATE 2MEQ/ML 20ML 148.21$ 103.74$ POTASSIUM CHL 20MEQ/15ML PER ML 2.97$ 2.08$ POTASSIUM CHLORIDE 2 MEQ/ML 1 ML 2.65$ 1.85$ POTASSIUM PHOSPHATE 3MM/ML 264.89$ 185.43$ PRAMIPXOLE=MIRAPEX 1 MG TAB 2.51$ 1.76$ PRASUGREL 10MG TAB 95.66$ 66.96$ PREDNISOLONE 1% OPHTH SUSP 541.45$ 379.02$ PREDNISOLONE 15MG/5ML PER ML 0.67$ 0.47$ PREGABALIN=LYRICA 50 MG CAP 55.85$ 39.10$ PREMARIN VAG CREAM 0.625MG/GM 1,880.58$ 1,316.40$ PROMETHAZINE VC PER ML 2.56$ 1.79$ PROPAFENONE SR=RYTHMOL SR 225 MG 46.80$ 32.76$ PROPAFENONE=RYTHMOL 225 MG TAB 9.90$ 6.93$ PROPARACAINE HCL 0.5% 2 ML GTT 462.80$ 323.96$ PROPOFOL 10 MG/ML 100 ML IVPB 568.08$ 397.66$ PROPOFOL 500MG/50ML SDV 128.20$ 89.74$ PROPRANOLOL 20MG/5ML PER ML 0.95$ 0.66$ PROTAMINE 10MG/ML 25 ML SDV 296.13$ 207.29$ PSEUDOEPHEDRINE 30MG/5ML PER ML 0.24$ 0.17$ RISPERDAL CONSTA KT 50MG 5,007.72$ 3,505.40$ SCREW 3.5MMX34MM LKN EVOS #DIV/0! #DIV/0!

SMI 71653432 TRIGEN FEMORAL NAIL 1.30$ 0.91$ SMI 71655135 TRIGEN TIBIAL NAIL 47.86$ 33.50$ SOFSILK O-S-306 267.60$ 187.32$ STR 509-02-721 REV SHELL 14.32$ 10.02$ STR 53-27612E LOCKING SCREW 61.50$ 43.05$ STR 6481-2-140 REV TIB SLEEVE 543.62$ 380.54$ STR 6481-3-210 REV TIBIAL INSERT 129.95$ 90.96$ STR 6495-2-105 REV BUSHING 113.80$ 79.66$ STR 6495-6-100 REV EXT PIECE 42.00$ 29.40$ SUM 04.632.000 TITANIUM CAP 9.60$ 6.72$ SURGI-CLIP II [13.0]-LARGE 23.30$ 16.31$ SURGIGUT 1-0 CG-813 0.48$ 0.33$ SURGIGUT 2-0 G-3 133.50$ 93.45$ SURGIPRO 0 CP-454 2,031.00$ 1,421.70$ SYN 02.123.021 LCP HUMEROUS PLATE 0.82$ 0.57$ SYN 02.124.201 PROX TIBIA PLATE 25.15$ 17.61$ SYN 02.210.118 VA LOCK SCREW 130.75$ 91.53$ SYN 02.211.255 VA-LCP PLATE 125.51$ 87.86$ SYN 04.636.040 CURVED ROD 342.56$ 239.79$ SYN 207.750 4.0 CANN SCREW 28.26$ 19.78$ SYN 208.431 CANNULATED SCREW 99.43$ 69.60$ SYN 282.641 LCP DHHS SIDEPLATE 85.10$ 59.57$ SYN 294.950 FIXATION PIN 36.40$ 25.48$ SYN 390.005 LG COMBO CLAMP 49.16$ 34.41$ SYN 390.008 LG ADJUST CLAMP 46.66$ 32.66$ SYN 394.87 11.0 CARBON ROD 11.90$ 8.33$ SYN 458.936 36MM LOCKING SCREW 1.44$ 1.01$ TRAY,CANNULATED SCREW 6.5-8.0MM 109.06$ 76.34$ TRAY,COMMAND SYS,STARTER SET 56.92$ 39.85$ TRAY,DR FRY LAMI 20.99$ 14.69$ TRAY,OSTEONICS ACETABULAR REAMERS 108.37$ 75.86$ TRAY,PELVISCOPY 116.75$ 81.72$ TRAY,STANDARD PLATES 109.23$ 76.46$ TRAY,SYNTHES COMPACT AIR DRIVE II 244.44$ 171.11$ WIRE MONO DS24 1,213.80$ 849.66$ MEDICAL IMAGING CONTRAST 10.00$ 7.00$ MEDICAL IMAGING CONTRAST 156.78$ 109.74$ PHARMACY NUCLEAR MEDICINE 2,766.00$ 1,936.20$ 0 BIO 150352 REV RESURF FEM COMP 76.09$ 53.27$ 0.45% SODIUM CHLORIDE 1000ML 48.81$ 34.17$ 0.45% SODIUM CHLORIDE 50 ML 68.10$ 47.67$ 0.45% SODIUM CHLORIDE 500ML 50.20$ 35.14$ 0.9% N S 50 CC 42.15$ 29.51$ 0.9% N S 500 CC 56.35$ 39.45$ 0.9% NS + 20 MEQ/L KCL 1000 ML 30.78$ 21.55$ 0.9% SODIUM CHLORIDE 1000 ML 61.78$ 43.25$ 0.9% SODIUM CHLORIDE 100ML 43.13$ 30.19$

5% DEXTROSE 0.225% NS 1000 CC 48.96$ 34.28$ 5% DEXTROSE 0.45% NS 1000 CC 47.26$ 33.08$ 5% DEXTROSE 0.45% NS 500 CC 53.97$ 37.78$ AMINOSYN II 10% 500 ML IV SOL. 233.73$ 163.61$ CA GLUCONATE 1 GM/100 ML NS 175.69$ 122.98$ D5/LR 500 ML 50.20$ 35.14$ DEX 5% 0.9% NS 1000 CC 48.40$ 33.88$ DEX 5% LR 1000 CC 46.92$ 32.85$ DEXTROSE 10% 1000 CC 46.11$ 32.28$ DEXTROSE 10% 500 CC 45.26$ 31.68$ DEXTROSE 20% 500 ML 161.80$ 113.26$ DEXTROSE 5% 0.225NS 500 CC 58.08$ 40.65$ DEXTROSE 5% 100 CC 42.12$ 29.48$ DEXTROSE 5% 1000 CC 49.73$ 34.81$ DEXTROSE 5% 250 CC 53.49$ 37.44$ DEXTROSE 5% 50 CC 40.50$ 28.35$ DEXTROSE 5% 500 CC 57.58$ 40.31$ DEXTROSE 50% 1000 ML 122.70$ 85.89$ DEXTROSE 50% 500 ML 166.70$ 116.69$ DEXTROSE 70% 500 ML 54.40$ 38.08$ FAT EMULSION III 20% 500 ML 646.66$ 452.67$ HESPAN I.V. 6% 500 ML BAG 240.30$ 168.21$ LACTATED RINGERS 1000 CC 44.82$ 31.37$ LACTATED RINGERS 1000ML 42.90$ 30.03$ LACTATED RINGERS 500 CC 45.58$ 31.91$ MANNITOL 20% 500 CC 315.45$ 220.82$ NS 0.9% 250 ML 54.39$ 38.07$ PHARMACY STERILE SALINE SOLUTION 2.10$ 1.47$ STR 54-25376 VOLAR LOCK PLATE 64.69$ 45.28$ ADSORBONAC 5% OPTH SOL 15ML 98.00$ 68.60$ SYN 04.632.645 MATRIX SCREW 108.34$ 75.84$ IV INFUSION CONCURRENT 43.00$ 30.10$ IV INFUSION EA ADDL HOUR 67.00$ 46.90$ IV INFUSION SEQUENTIAL 111.00$ 77.70$ THERAPEUTIC PROPHYLACTIC INJ 111.00$ 77.70$ 70211231 ZIM 7871-01-10 VERSYS BUILD/BLK 128.00$ 89.60$ MEDICAL IMG SUPPLIES GUIDEWIRE 18.00$ 12.60$ ZIM R8018-28-02 FEM HEAD TAPER 148.00$ 103.60$ AEROSOL/HUMD CONT. WITH OXYGEN 526.00$ 368.20$ HIGH FLOW CONT OXYGEN DAILY 662.00$ 463.40$ OXYGEN 552.00$ 386.40$ OXYGEN DAILY 552.00$ 386.40$ CATHETER OCCLUSION 892.00$ 624.40$ CATHETER THROMBECTOMY/EMBOLECTOMY 1,607.00$ 1,124.90$ CATHETER,BALLOON DILATATION,EGD/C 975.00$ 682.50$ CATHETER,BALLOON DILATATION,ERCP 1,276.00$ 893.20$ COMPRESSION STOCKING 45.00$ 31.50$

DRAINAGE/DIAGNOSTIC CATHETER 85.00$ 59.50$ EMPTY 3-IN-1 MIXING CONT 73.20$ 51.24$ EMPTY FLEXIABLE CONTAINER 250ML 50.20$ 35.14$ EVACUATED CONTAINER 1000ML 129.80$ 90.86$ HEMODIALYSIS CATHETER 1,350.00$ 945.00$ HEMODIALYSIS CATHETER SHORT TERM 1,350.00$ 945.00$ MEDICAL IMAGING SUPPLIES CATH SET 934.00$ 653.80$ MEDICAL IMAGING SUPPLIES CATHETER 876.00$ 613.20$ MEDICAL IMAGING SUPPLIES CATHETER 2,344.00$ 1,640.80$ MEDICAL IMAGING SUPPLIES NEEDLE 112.00$ 78.40$ MEDICAL IMG SUP CRYOABLATION KIT 4,950.00$ 3,465.00$ MEDICAL IMG SUPPLIES CLOSURE DEV 1,085.00$ 759.50$ MEDICAL IMG SUPPLIES INTRODUCER 131.00$ 91.70$ PACEMAKER INTRODUCER 328.00$ 229.60$ PEG TUBE 362.00$ 253.40$ DUAL CHAMBER PACEMAKER 15,809.00$ 11,066.30$ MEDICAL IMG SUP PACEMAKER LEAD 3,159.00$ 2,211.30$ SINGLE CHAMBER PACEMAKER 14,136.00$ 9,895.20$ 0 ART AR-8952MC-SL MED COLNM PLT SM 838.00$ 586.60$ 0 BIO TOT HIP W/REV HEAD & CUP 341.00$ 238.70$ 0 NEV ACCK5300 N300 LEAD ANCHOR 7,086.00$ 4,960.20$ 0 TOR DWF364B RETEN REVSD INSERT 24,346.40$ 17,042.48$ 1 ACU 7008-0106 1/3 TUB PLATE 838.00$ 586.60$ 1 BIO 150366 REV BOWED IM STEM W/SC 3,015.00$ 2,110.50$ 1 BIO 912031 JUGGERKNOT ANCH SINGLE 1,173.00$ 821.10$ 1 CAT BOS 109676-001 ANGIOJET 3,015.00$ 2,110.50$ 1 COO MWCER-35-14-8 RETRACTA COIL 743.00$ 520.10$ 1 SJM 1743XXXX OCTRODE 3,015.00$ 2,110.50$ 2 BAL G50340 COOK ADVANCE BALLOON 3,015.00$ 2,110.50$ 2 COO MWCE-35-8/4 TORNADO COIL 216.00$ 151.20$ 2 SYN 02.102.001 UNI LCK STAB PLATE 590.00$ 413.00$ 3 BIO 11-301020 REV BWD STS DIS STM 362.00$ 253.40$ 3 SYN 02.112.08X LCP SUP CLAV PLATE 331.00$ 231.70$ 3 SYN MOD HAND 2.4 TIT T-PLATE 36.00$ 25.20$ 3M ILA CART 3,459.00$ 2,421.30$ 3M PI-55 3,459.00$ 2,421.30$ 3M PI-55 CART 3,459.00$ 2,421.30$ 4 ACU 70-0372 LONG STAND PLATE 126.00$ 88.20$ 4 BIO CM-9145SP QUATTRO ANCHOR 1,173.00$ 821.10$ 4 SJM MN12050 LEAD ACCESSORY KIT 118.00$ 82.60$ 4WEB CAP SPI COMP TPLIF/TLIF CAGE 8,550.00$ 5,985.00$ 4WEB MOBIC-ADR CERVICAL DISC 15,600.00$ 10,920.00$ 4WEB SPI COMP CERVICAL CAGE 2,848.00$ 1,993.60$ 4WEB SPI COMP CERVICAL CAGE 3,100.00$ 2,170.00$ 5 BOS H965404120 WALLSTENT 180.00$ 126.00$ 5 MED 97755 RECHARGER 419.00$ 293.30$ 5 SYN 204.675 3.5 PEL CORT ST SCREW 335.00$ 234.50$

5 ZIM 5001-53 REV BIPOLAR CUP 1,173.00$ 821.10$ 6 HER 5036964 PALACOS R+G 586.00$ 410.20$ 6 MED SPI COMP DOMINO CONNECTOR 239.00$ 167.30$ 7 MED 6972660 SOFAMOR DANEK CERV DC 838.00$ 586.60$ 7 SMI 718081XX 6.5 CANC SCREW 514.00$ 359.80$ 7 SMI 72412712 SCREW LOCKING 2.7 331.00$ 231.70$ 7 SURGERY 599.00$ 419.30$ 70210193 SURGIGUT 1-0 CG-813 590.00$ 413.00$ 70210241 WIRE MONO DS24 79.00$ 55.30$ 70210300 CABOT SOFT WAND BALLOON RETRACTOR 128.00$ 89.60$ 70210499 PDS 0 Z340H 1,001.00$ 700.70$ 70210897 SYN 394.993 PROTECTIVE CAP 165.00$ 115.50$ 70210916 POLYSORB 2-0 CL-843 138.00$ 96.60$ 70210937 STRYKER 2000 BATTERY DRILL 285.00$ 199.50$ 70211096 TRAY,ANTERIOR CERVICAL,SHADOWLINE 1,289.00$ 902.30$ 70211226 ETH EVICEL 5ML 301.00$ 210.70$ 70211356 STR 52-81204 1.2MM SCREWS 152.00$ 106.40$ 70211364 DEP 87-3549 POLY-DIAL LINER 233.00$ 163.10$ 70211415 SYN 04.613.666 VECTRA SCREW 172.00$ 120.40$ 70211417 SYN 498.142 TI-ROD 176.00$ 123.20$ 70211487 MIC KWIRES 28,35,45,54 & 62 8.00$ 5.60$ 70211493 SYN 202.822 CORTEX SCREW 2.7 135.00$ 94.50$ 70211496 HOW 6704-0-410 CABLE AND SLEEVE 737.00$ 515.90$ 70211519 MES 1000606-00 PROLITE MESH 155.00$ 108.50$ 70211546 TRA TRACH TUBE SHILEY DFEN 108.00$ 75.60$ 70211563 SYN 219.91 WASHER 110.00$ 77.00$ 70211598 SYN 212.818 2.4MM LOCKING SCREW 449.00$ 314.30$ 70211599 SYN 202.874 2.7MM CORTEX SCREW 158.00$ 110.60$ 70211635 ART AR-1934BCFT SUTURE ANCHOR 1,022.00$ 715.40$ 70211662 SYN 214.836 CORTEX SCREW 4.5MM 88.00$ 61.60$ 70211753 STR 6704-0-510 CABLE & SLEEVE 737.00$ 515.90$ 70211911 SMI 71655135 TRIGEN TIBIAL NAIL 6,775.00$ 4,742.50$ 70211929 ACU 70-0288 CLAVICLE PLATE 3,162.00$ 2,213.40$ 702120042 FLO 13827 PROMETRA PROGRM PUMP 23,400.00$ 16,380.00$ 702120043 FLO 11823 INTRATHECAL CATHETER 1,508.00$ 1,055.60$ 702120044 FLO 12860 PAT THERAPY CONTROLLER 1,843.00$ 1,290.10$ 702120045 BIO 11-163688 REV STND NECK HI CA 1,675.00$ 1,172.50$ 702120047 ZIM 00-6624-065-35 REV ACE CUP SC 442.00$ 309.40$ 702120048 GLO SPI COMP LAMINOPLASTY SCREW 369.00$ 258.30$ 702120053 MED 97745 CONTROLLER 1,939.60$ 1,357.72$ 702120054 MED 97725 WIRELESS EXT NEUROSTIM 502.50$ 351.75$ 702120057 NEV LEAD1058-50B BLUE PERC LEAD 1,675.00$ 1,172.50$ 702120060 NEV ACCK5300 N300 LEAD ANCHOR 596.00$ 417.20$ 702120063 RTI SPI COMP SET SCREW 335.00$ 234.50$ 8 ATR 85420 ICAST STENT 335.00$ 234.50$ 8 COV SYM9 SYMBOTEX 436.00$ 305.20$ 8 SMI 72403510 SCREW CORTEX 3.5 838.00$ 586.60$

9 ART AR-9060-XXPT JONES SCREW 6.0 838.00$ 586.60$ 9 MED PAIN CAP PROGRAMMER/HANDSET 1,256.00$ 879.20$ ABB 1012530-100 ABSOLUTE PRO STEN 419.00$ 293.30$ ABB 1012534-40 ABSOLUTE PRO STENT 543.00$ 380.10$ ABB 1012629-19 OMNILINK ELITE 3,099.00$ 2,169.30$ ABB 1012629-29 OMNILINK ELITE 374.00$ 261.80$ ABB 1012630-39 OMNILINK ELITE 422.00$ 295.40$ ABB 1012631-19 OMNILINK ELITE 842.00$ 589.40$ ABB 1012631-59 OMNILINK ELITE 899.75$ 629.83$ ABB 1012633-29 OMNILINK ELITE 3,255.00$ 2,278.50$ ABB 1125325-23 STENT XIENCE ALPIN 3,798.00$ 2,658.60$ ABB 1550300-38 STENT XIENCE SIERR 3,798.00$ 2,658.60$ ABB 22438-19 EMBOSHIELD 4,573.00$ 3,201.10$ ABB 82090-01 XACT CAROTID STENT 2,027.00$ 1,418.90$ ABB 82090-01 XACT CAROTID STENT 6,030.00$ 4,221.00$ ABB S-50-040-120-P6 SUPERA 4,650.00$ 3,255.00$ ABB S-55-100-120-P6 SUPERA STENT 4,805.00$ 3,363.50$ ABI 005062 IMPELLA 5.0 PUMP 65,000.00$ 45,500.00$ ACC MX6721 MYNX CLOSURE ART GRIP 771.00$ 539.70$ ACCU CAUTERY 493.00$ 345.10$ ACL/PCL SWIVELOCK FIXATION 733.00$ 513.10$ ACL/PCL SWIVELOCK FIXATION 2,874.00$ 2,011.80$ ACM 2200 LOCKING PLUG 9,597.00$ 6,717.90$ ACM 6545 SCREW 54.00$ 37.80$ ACM 6545 SCREW 12,123.00$ 8,486.10$ ACT ACTIFUSE ABX 1.5 1,374.00$ 961.80$ ACU 3004-230XX HEXALOBE MULTISCRW 338.00$ 236.60$ ACU 3006-40036 CANN SCREW LG THRD 419.00$ 293.30$ ACU 3006-40036 CANN SCREW LG THRD 492.00$ 344.40$ ACU 3013-35016 3.5 HEX VA SCREW 476.00$ 333.20$ ACU 70-0305 PLATE 5 HOLE 530.00$ 371.00$ ACU 70-0305 PLATE 5 HOLE 3,100.00$ 2,170.00$ ACU 70-0307 OLECRANON PLATE 7HRT 3,515.00$ 2,460.50$ ACU 70-0338 DORSAL LUNATE PLATE 2,506.00$ 1,754.20$ ACU 70-0357 ACU LOC 2 VDR PLATE 2,841.00$ 1,988.70$ ACU 70-0360 WIDE DIST RAD PLATE 2,841.00$ 1,988.70$ ACU 70-0364 NEUTRAL EXT PLATE 2,312.00$ 1,618.40$ ACU 70-0369 VDR STAND LONG PLATE 2,841.00$ 1,988.70$ ACU 70-0372 LONG STAND PLATE 2,841.00$ 1,988.70$ ACU 7005-08006 COMPRESSION PLATE 1,136.00$ 795.20$ ACU 7007-0105L LAT FIB PLATE 2,828.67$ 1,980.07$ ACU 7007-0107X LAT FIB PLATE 2,935.00$ 2,054.50$ ACU 7008-0107 1/3 SEMI-TUB PL 7HL 348.00$ 243.60$ ACU 7008-01XX SM FRAG 1/3 PLATE 362.00$ 253.40$ ACU AT2-MXX-S MINI ACUTRAK BN SCR 1,447.00$ 1,012.90$ ACU AT2-S24-S STAND ACUTRAK 2 SCR 1,591.00$ 1,113.70$ ACU COL-3240 3.5 LOCKING SCREW 1,673.00$ 1,171.10$

ACU CO-N2312 CORT SCRW NON-TOGGLE 338.00$ 236.60$ ACU CO-T2322 LCK SCREW 2.3MM 1,014.08$ 709.86$ ACU PL ELOX OLECRENON PLATE 14,604.00$ 10,222.80$ ACU PL-DR50L ACULOC PLATE 1,012.00$ 708.40$ ACU TR-H240R-S HEAD RIGHT 24.0MM 8,117.00$ 5,681.90$ ACU TR-S0902-S STEM 9MM X 2MM 5,375.00$ 3,762.50$ ACUMED 18MMLOCKHEXSCREW 30-0329 399.00$ 279.30$ ACUMED 2.7X12 NON LOC HEX 30-0345 281.00$ 196.70$ ACUMED 2.7X16 NON LOC HEX 30-0347 281.00$ 196.70$ ACUMED 2.7X20 LOC HEX 30-0330 405.00$ 283.50$ ACUMED 2.7X20 NON LOC 30-0349 281.00$ 196.70$ ACUMED 20MMHEXSCRWNONLOCK 30-0261 300.00$ 210.00$ ACUMED 3.5X10MM NON LOC 30-0256 300.30$ 210.21$ ACUMED 3.5X14MM NONLOCK 30-0258 302.00$ 211.40$ ACUMED 4.0X36 CAN SCR 3006-40036 985.00$ 689.50$ ACUMED 4HOLE LEFT FIB 7007-0204L 2,834.00$ 1,983.80$ ACUMED 8HOLE CLAV PLATE 70-0287 3,162.00$ 2,213.40$ ACUMED LOCHEXSCREW2.7X16 30-0328 350.00$ 245.00$ ACUMED LOCK HEXSCREW 14MM 30-0235 399.00$ 279.30$ ACUMED NONLOCHEXSC3.0X14 30-0304 262.00$ 183.40$ ACUMED NONLOCHEXSC3.0X16 30-0305 262.00$ 183.40$ ACUMED NONLOCHEXSC3.7X18 30-0348 262.00$ 183.40$ ACUMED NONLOCKHEXSCRW12MM 30-0257 300.00$ 210.00$ ACUMED OLCRANON PLATE 3H 70-0303 2,853.00$ 1,997.10$ ADAPTER X-MAS TREE 1,665.00$ 1,165.50$ AEROSOL TALC 3,372.00$ 2,360.40$ AGEE WRIST JACK 2,953.00$ 2,067.10$ ALL SPI COMP CROSSLINK 2,931.00$ 2,051.70$ ALL SPI COMP PED 2 OR 3 PART SCRW 2,931.00$ 2,051.70$ ALL SPI COMP ROD LESS THAN 300MM 670.00$ 469.00$ ALLODERM 6X16CM THICK 7,109.00$ 4,976.30$ ALLODERM MD PERF MD THCK BILAT 257.00$ 179.90$ ALLODERM MD PERF MD THCK BILAT 18,844.00$ 13,190.80$ ALLODERM MD PERF MD THICK 257.00$ 179.90$ ALLODERM MD PERF MD THICK 10,065.00$ 7,045.50$ AMS 72403867 SCROTAL RETRACT 268.00$ 187.60$ AMS 72403867 SCROTAL RETRACT 19,510.00$ 13,657.00$ ANCHOR BIO SWIVEL 5.5 464.00$ 324.80$ ANCHOR BIO SWIVEL 5.5 1,586.00$ 1,110.20$ ANCHOR BIOCOMPOSITE 2.9 1,331.00$ 931.70$ ANCHOR CORKSCRW 2.2X4 1,154.00$ 807.80$ ANCHOR CORKSCRW MINI 2-0 1,154.00$ 807.80$ ANCHOR JUGGERKNOT 2.9MM 980.00$ 686.00$ ANCHOR SUTURETAK 3.0 DBL 1,398.00$ 978.60$ ANCHOR TOGGLELOC 2.9MM 2,144.00$ 1,500.80$ ARG 352506070E VENA CAVA FILTER 1,173.00$ 821.10$ ARG 352506070E VENA CAVA FILTER 2,593.00$ 1,815.10$

ART 1351LB BIO TRANSFIX PLLA 3,511.00$ 2,457.70$ ART 3.0 BIOCOMP TAK AR1934BCFT 983.00$ 688.10$ ART ACL TIGHTROPE AR-1588RT 832.00$ 582.40$ ART AR 9100 09 STEM 4,718.00$ 3,302.60$ ART AR-1319FT MINI SUT ANCHOR 955.00$ 668.50$ ART AR1365 25 POST BI-CORTICAL 506.00$ 354.20$ ART AR1403TB FULL THREAD SCREW 50.00$ 35.00$ ART AR-1588AU-CP AUTOGRAFT PACK 3,256.00$ 2,279.20$ ART AR-1593 SWIVELOCK ACL/PCL 2,010.00$ 1,407.00$ ART AR-1655PS-10 TENODESIS SCREW 299.00$ 209.30$ ART AR-1655PS-10 TENODESIS SCREW 1,367.00$ 956.90$ ART AR-1677BC-CP CMC LIGAMENT SYS 126.00$ 88.20$ ART AR-1688-CP INTERNAL BRACE IMP 4,762.00$ 3,333.40$ ART AR-1920SNF SUT ANCR CRKSCREW 704.00$ 492.80$ ART AR-1927BCT-475 CORKSCREW DBL 1,189.00$ 832.30$ ART AR-1928SF-2 CORKSCREW SUT 771.00$ 539.70$ ART AR-1928SNF-2 ANCHOR CORKSCREW 854.00$ 597.80$ ART AR-1934BCFT SUTURE ANCHOR 884.00$ 618.80$ ART AR-1938BC ANCHOR 1,424.00$ 996.80$ ART AR-2323BCC BIOCOMP ANCHOR 1,340.00$ 938.00$ ART AR2323BCC BIOCOMPSWIVEL 1,150.00$ 805.00$ ART AR-2324BCC COMP SWIVELOCK 1,340.00$ 938.00$ ART AR-2324BCC COMP SWIVELOCK 2,848.00$ 1,993.60$ ART AR-2325BCC SWIVELOCK 3.5 1,772.00$ 1,240.40$ ART AR-2600SBS-4 SPEEDBRIDGE SWLK 7,085.00$ 4,959.50$ ART AR-3602 FIBERTAK ANCHOR 1,189.00$ 832.30$ ART AR-4500 MENISCAL CINCH 955.00$ 668.50$ ART AR-4550 IMPLANT MEN REPAIR 570.00$ 399.00$ ART AR-4550 IMPLANT MEN REPAIR 4,408.00$ 3,085.60$ ART AR-8005-20 COMPRESSION STAPLE 1,424.00$ 996.80$ ART AR-8665-18XX COMP SC HEADLESS 1,926.00$ 1,348.20$ ART AR-8725-XX SCREW HEADLESS 988.00$ 691.60$ ART AR-8835L-14 3.5MM LOCK SCREW 463.67$ 324.57$ ART AR-8926SS SYN TIGHTROPE 1,131.72$ 792.20$ ART AR-8926SS SYN TIGHTROPE 2,948.00$ 2,063.60$ ART AR-8935-32 CORTICAL SCREW 118.00$ 82.60$ ART AR-8943BR-08 LOCK DIST FIB PL 2,953.00$ 2,067.10$ ART AR-8943T-04 1/3 TUB PLT LOCK 8,418.00$ 5,892.60$ ART AR-8943T-08 LOCK 1/3 TUBE PLT 804.00$ 562.80$ ART AR-8952MC-SL MED COLNM PLT SM 4,635.00$ 3,244.50$ ART AR-8956R-0X LG META HOOK PLAT 3,953.00$ 2,767.10$ ART AR-8958 01S PLATE 2 HOLE SS 3,767.00$ 2,636.90$ ART AR-8990 FIBERTAK DX ANCHOR 1,730.50$ 1,211.35$ ART AR-9060-XXPT JONES SCREW 6.0 2,663.00$ 1,864.10$ ART AR9146 17 HUMERAL HEAD 265.00$ 185.50$ ART AR9146 17 HUMERAL HEAD 372.00$ 260.40$ ART AR9153 23 HUMERAL HEAD 20,732.00$ 14,512.40$

ART BIOCOMP SCREW AR1380C 743.00$ 520.10$ ART BIOCOMP SUT TAK AR1934BCF2 968.00$ 677.60$ ART-1322BCNF SUTURE ANCHOR 1,558.00$ 1,090.60$ ARTHREX 3X14.5 SUT ANC AR1934BCT 1,139.00$ 797.30$ ARTHREX 3X14.5 SUT ANCHAR1934BCF 1,022.00$ 715.40$ ARTHREX 3X14.5 SUTANCAR1934BCFT2 1,470.00$ 1,029.00$ ARTHREX 9X28MM ROUND AR-5028C-09 776.00$ 543.20$ ARTHREX DIST BI REPAIR AR-2260BC 2,848.00$ 1,993.60$ ARTHREX DRILPINACLTIGHT AR1595TC 413.00$ 289.10$ ARTHREX SUTURE ANCHOR AR1928SF-2 759.00$ 531.30$ ASC MCP 100 30 FINGER JOINT DEVIC 265.00$ 185.50$ ASC MCP 100 30 FINGER JOINT DEVIC 12,123.00$ 8,486.10$ ATL 1106-01-6545 MODULAR SCREW 14,917.00$ 10,441.90$ ATR 85405 ICAST 7,909.00$ 5,536.30$ ATR 85406 ICAST STENT 7,316.14$ 5,121.30$ ATR 85407 ICAST 4,183.00$ 2,928.10$ ATR 85407 ICAST 7,849.00$ 5,494.30$ ATR 85408 ICAST STENT 7,339.00$ 5,137.30$ ATR 85409 ICAST STENT 7,909.00$ 5,536.30$ ATR 85417 ICAST STENT 7,832.00$ 5,482.40$ ATR 85418 ICAST 7,316.00$ 5,121.20$ ATR 85419 ICAST STENT 2,848.00$ 1,993.60$ ATR 85419 ICAST STENT 7,339.00$ 5,137.30$ ATR 85420 ICAST STENT 7,276.00$ 5,093.20$ ATR 85451 ICAST STENT 191.00$ 133.70$ ATR 85451 ICAST STENT 7,168.00$ 5,017.60$ ATR 85453 ICAST 355.00$ 248.50$ ATR 85453 ICAST 7,151.00$ 5,005.70$ AUTOSTITCH 838.00$ 586.60$ AUTOSTITCH 5,105.00$ 3,573.50$ BAL 10081XX-XX VIATRAC 14 PLUS 670.00$ 469.00$ BAL 1013469-XXX ABBOTT ARMADA 687.00$ 480.90$ BAL 39171 MSTNG SZ XX-100/200-135 720.00$ 504.00$ BAL 39171 MUSTANG SIZE XX-100-135 660.00$ 462.00$ BAL 39171 MUSTANG SIZE XX-100-135 720.00$ 504.00$ BAL 39171 MUSTANG SIZE XX-XX-135 603.00$ 422.10$ BAL 39171 MUSTANG SIZE XX-XX-75 603.00$ 422.10$ BAL A20XX-040 ABBOTT ARMADA 787.00$ 550.90$ BAL A20XX-040 ABBOTT ARMADA 1,173.00$ 821.10$ BAL A20XX-120-200 ABBOTT ARMADA 921.00$ 644.70$ BAL ADM INPACT XX120X130 4,588.00$ 3,211.60$ BAL B1070-150 OR 200 ARMADA 536.00$ 375.20$ BAL B10XX-0X0 ARMADA SZ 35X-XX-80 1,675.00$ 1,172.50$ BAL B2040-150 ARMADA 536.00$ 375.20$ BAL B2050-150/200/250 ARMADA 536.00$ 375.20$ BAL B2060-150/200/250 ARMADA 536.00$ 375.20$ BAL B2060-150/200/250 ARMADA 596.00$ 417.20$

BAL G50340 COOK ADVANCE BALLOON 1,005.00$ 703.50$ BAL X/X/90 CUTTING BALLOON 2,596.00$ 1,817.20$ BAL XMMXXMMX135CM CHARGER 1,376.59$ 963.62$ BAR 0010301 VENTRALEX HERN PATCH 1,404.00$ 982.80$ BAR 0010302 VENTRALEX PATCH 1,611.50$ 1,128.05$ BAR 0010303 VENTRALEX HERNIA PTCH 2,157.00$ 1,509.90$ BAR 0010303 VENTRALEX HERNIA PTCH 2,848.00$ 1,993.60$ BAR 0042510 BAKER J-TUBE 1,183.00$ 828.10$ BAR 10P9004 CV PATCH IMPRA EPTFE 673.00$ 471.10$ BAR 1608062 POWERPORT 1,199.00$ 839.30$ BAR 1708001 POWER PORT 871.00$ 609.70$ BAR 1806051 POWER PORT 871.00$ 609.70$ BAR FEL07040 FLUENCY PLUS STENT 5,985.00$ 4,189.50$ BAR FEL10100 ENDOVAS STENT 10X100 6,555.00$ 4,588.50$ BAR FEM08040 ENDOVASC STENT 8X40 5,985.00$ 4,189.50$ BAR SM0007-USA ARISTA 4,306.00$ 3,014.20$ BASEPLATE STD 25MM 559.00$ 391.30$ BASEPLATE STD 25MM 8,318.00$ 5,822.60$ BASEPLATE TIBIAL SZ 5 RIGHT 9,901.61$ 6,931.13$ BASKET, 4-WIRE 5,104.00$ 3,572.80$ BEARING ART SURF. LT 10MM 5,115.00$ 3,580.50$ BEARING ART SURF. LT 10MM 6,621.00$ 4,634.70$ BEARING FIX CRUC RETAIN LT 11MM 7,334.00$ 5,133.80$ BEARING FIXD CRUC RETAIN LT 12MM 7,334.00$ 5,133.80$ BEARING FIXD CRUCIATE RETN LT 12M 7,334.00$ 5,133.80$ BEARING FIXD CURC RETAIN RT SZ 10 7,334.00$ 5,133.80$ BEARING FIXED CRUCIATE RETAIN 10M 7,334.00$ 5,133.80$ BEARING FIXED RIGHT 10MM 7,334.00$ 5,133.80$ BEARING FIXED RT SZ 13 379.00$ 265.30$ BEARING FIXED RT SZ 13 7,334.00$ 5,133.80$ BEARING TIBIAL PERSONA LT 10MM 7,334.00$ 5,133.80$ BEARING TIBIAL PERSONA RT 10MM 7,334.00$ 5,133.80$ BEARING TIBIAL PERSONA RT 12MM 7,334.00$ 5,133.80$ BILIARY CATH. (IMAGE) 2,953.00$ 2,067.10$ BIO 010000817 REV ACE LINER 5,556.80$ 3,889.76$ BIO 010000983 REV G7 ACE LINER 9,587.00$ 6,710.90$ BIO 01000099X REV ACE SCREW 603.75$ 422.63$ BIO 110005307 JUGGERKNOT ANCHOR 1,206.00$ 844.20$ BIO 110005315 JUGGERKNOT ANCH RIG 1,207.20$ 845.04$ BIO 110010266 REV ACE SHELL 838.00$ 586.60$ BIO 110010266 REV ACE SHELL 10,102.40$ 7,071.68$ BIO 110024464 REV ACE LINER 5,417.00$ 3,791.90$ BIO 11-107021 REV CONSTR MOD HEAD 4,705.50$ 3,293.85$ BIO 11-150842 PATELLA BUTTON 7,943.00$ 5,560.10$ BIO 11-150912 FEMORAL 1,172.00$ 820.40$ BIO 11-165218 REV ACE CUP 4,055.00$ 2,838.50$ BIO 11-300816 REV STS DISTAL STEM 9,750.00$ 6,825.00$

BIO 11-300919 REV WASTED DIST STM 7,091.00$ 4,963.70$ BIO 11-301020 REV BWD STS DIS STM 11,474.00$ 8,031.80$ BIO 11-301302 REV STAND CONE 17,260.00$ 12,082.00$ BIO 11-302102 REV TROCHANTRC BOLT 3,243.00$ 2,270.10$ BIO 11-302128 REV TROCH BOLT 270.00$ 189.00$ BIO 11-363665 REV MOD HEAD COMP 3,298.00$ 2,308.60$ BIO 141224 REV FIXED I-BEAM TIB P 682.00$ 477.40$ BIO 141224 REV FIXED I-BEAM TIB P 5,985.00$ 4,189.50$ BIO 141482 REV OFFSET TIB W/LBP 1,173.00$ 821.10$ BIO 141482 REV OFFSET TIB W/LBP 6,725.00$ 4,707.50$ BIO 141489 REV OFFSET TIB ADAPTOR 2,616.00$ 1,831.20$ BIO 141652 REV SPLINED STEM W/SCR 4,416.00$ 3,091.20$ BIO 141656 REV SPLINED STEM W/SCR 4,604.50$ 3,223.15$ BIO 148316 REV SPLINED V2 STEM 5,098.00$ 3,568.60$ BIO 150352 REV RESURF FEM COMP 18,604.00$ 13,022.80$ BIO 150357 REV OSS SEG ELLIPT FEM 22,573.00$ 15,801.10$ BIO 150366 REV BOWED IM STEM W/SC 5,422.00$ 3,795.40$ BIO 150410 REV OSS TIB POLY BEAR 3,393.00$ 2,375.10$ BIO 150457 PROX FEMORAL 20,732.00$ 14,512.40$ BIO 150476 REV OSS POLY TIB BUSHG 90.00$ 63.00$ BIO 150476 REV OSS POLY TIB BUSHG 977.00$ 683.90$ BIO 150477 REV OSS POLY FEM BUSHG 1,363.00$ 954.10$ BIO 150480 REVISIION OSS AXLE 90.00$ 63.00$ BIO 150480 REVISIION OSS AXLE 1,474.00$ 1,031.80$ BIO 150493 REV OSS REINFORCD YOKE 1,843.00$ 1,290.10$ BIO 150493 REV OSS REINFORCD YOKE 3,171.00$ 2,219.70$ BIO 163665 REV MOD HEAD 2,966.00$ 2,076.20$ BIO 179025 CONSTRAINED FEMUR 3,020.00$ 2,114.00$ BIO 179322 LIPPED BEARING 13,843.00$ 9,690.10$ BIO 183130 REV PS OPEN BOX FEM 11,647.00$ 8,152.90$ BIO 183740 REV TIB BEAR INSERT 295.00$ 206.50$ BIO 183740 REV TIB BEAR INSERT 4,655.00$ 3,258.50$ BIO 183740 REV WASTED TIB BEARING 3,385.00$ 2,369.50$ BIO 183746 REV PS+TIB BEARING DCM 4,655.00$ 3,258.50$ BIO 183864 REV CONSTR PS TIB BEAR 449.00$ 314.30$ BIO 183864 REV CONSTR PS TIB BEAR 6,489.50$ 4,542.65$ BIO 183866 REV DCM TIB BEARING 5,736.67$ 4,015.67$ BIO 183868 REV CONSTR DCM TIB BRG 6,207.00$ 4,344.90$ BIO 1841XX REV POST FEM AUG W/BLT 2,848.00$ 1,993.60$ BIO 1841XX REV POST FEM AUG W/BLT 3,461.00$ 2,422.70$ BIO 184704 REV STANDARD PATELLA 2,366.25$ 1,656.38$ BIO 185202 REV TIB W/LCK BAR-SCRW 7,464.40$ 5,225.08$ BIO 185211 REV OFFSET ADAP EXPLAN 1,943.00$ 1,360.10$ BIO 185211 REV OFFSET ADAP W/SCRW 2,672.00$ 1,870.40$ BIO 185235 REV TIB AUG W/BOLTS 3,222.00$ 2,255.40$ BIO 185262 REV FEM W/SCREW 373.00$ 261.10$ BIO 185262 REV FEM W/SCREW 17,499.63$ 12,249.74$

BIO 185264 REV FEM W/SCR EXPLANT 13,794.00$ 9,655.80$ BIO 185264 VANGUARD KNEE FEM SCRW 3,537.00$ 2,475.90$ BIO 185344 REV PST AUG W/BLT EXPL 2,720.00$ 1,904.00$ BIO 1853XX REV POST AUG W/BOLT 3,539.75$ 2,477.83$ BIO 185XXX REV DIST FEM AUG W/BOL 320.00$ 224.00$ BIO 185XXX REV DIST FEM AUG W/BOL 3,671.00$ 2,569.70$ BIO 192114 REV LAT FEM STEM 13,841.00$ 9,688.70$ BIO 193014 REV STAND FEM STEM 14,686.00$ 10,280.20$ BIO 35.23.014 NORMED 2.3 SCREW 811.00$ 567.70$ BIO 432165 STAGE 1 FEM MOLD SPACR 8,436.00$ 5,905.20$ BIO 433175 STAGE 1 TIB MOLD SPACR 4,387.00$ 3,070.90$ BIO 650-1057 REV OPT CERAMIC HEAD 6,512.08$ 4,558.46$ BIO 650-1064 REV TAPER ADAPTER 680.76$ 476.54$ BIO 6570-0-036 WASTED FEM HEAD 3,554.00$ 2,487.80$ BIO 8161-35-032 LOCK SCRW 3.5 307.00$ 214.90$ BIO 8240-76-002 LAPIDUS PLATE 2,776.00$ 1,943.20$ BIO 907 325 BONE MULCH SCREW 3,129.00$ 2,190.30$ BIO 912029 JUGGERKNOT ANCHOR 2.9 119.00$ 83.30$ BIO 912029 JUGGERKNOT ANCHOR 2.9 946.00$ 662.20$ BIO 912031 JUGGERKNOT ANCH SINGLE 800.00$ 560.00$ BIO CAP HEMI ARTHROPLASTY 7,125.00$ 4,987.50$ BIO CAP TOT HIP ACE LINER HI WALL 1,005.00$ 703.50$ BIO CAP TOT HIP W/ONE REV HEAD 4,635.00$ 3,244.50$ BIO CAP TOT HIP W/ONE REV HEAD 12,825.00$ 8,977.50$ BIO CAP TOT HIP W/REV CUP 11,115.00$ 7,780.50$ BIO CAP TOT KNEE WASTED TIB BEAR 3,385.00$ 2,369.50$ BIO CAP TOTAL HIPS 13,000.00$ 9,100.00$ BIO CAP UNI KNEE 7,125.00$ 4,987.50$ BIO CAP VITAMIN E POLY UPCHARGE 1,005.00$ 703.50$ BIO CAPITATED TOTAL KNEES 12,113.00$ 8,479.10$ BIO CM-9145SP QUATTRO ANCHOR 1,129.00$ 790.30$ BIO CP113124 REV METAL FEM W/SCRW 20,120.00$ 14,084.00$ BIO EP-105914 REV WASTED LINER 432.00$ 302.40$ BIO REV ACE SHELL 9,922.00$ 6,945.40$ BIO REV CERMAMIC HEAD 5,721.00$ 4,004.70$ BIO REV MODULAR HEAD 9,194.00$ 6,435.80$ BIO REV SHELL 9,922.00$ 6,945.40$ BIO REV TOT HIP COMP MOD HEAD 4,501.00$ 3,150.70$ BIO REV TOT KNEE NO PATELLA 7,695.00$ 5,386.50$ BIO REVISION CUP ONLY 11,115.00$ 7,780.50$ BIO TKA W REV TIB BEAR INSERT 295.00$ 206.50$ BIO TKA W REV TIB BEAR INSERT 8,693.00$ 6,085.10$ BIO TOT HIP REV HEAD,SHELL,LINER 7,125.00$ 4,987.50$ BIO TOT HIP W/REV HEAD & CUP 9,690.00$ 6,783.00$ BIO VIT E POLY LINER UPCHARGE 1,005.00$ 703.50$ BIO WASTED SHELL 4,365.00$ 3,055.50$ BIO XL-105995 REV ACE LINER 347.00$ 242.90$

BIO XL-105995 REV ACE LINER 4,535.00$ 3,174.50$ BIO XL-200150 REV BEARING 3,100.00$ 2,170.00$ BIOMET 4.5 LINK ANCHOR CM-9155 1,106.00$ 774.20$ BIOMET 5X10MM BOLT SCR CM-9505 1,156.00$ 809.20$ BIOMET JUG KNOT ANC 1.5MM 912031 1,256.00$ 879.20$ BIOMET TOGGLELOC 2.9MM 2,144.00$ 1,500.80$ BIOPTY BX INST. 155.00$ 108.50$ BIOPTY BX INST. 1,408.00$ 985.60$ BLA 55 2050 ROD 326.00$ 228.20$ BLA 55 2050 ROD 1,938.00$ 1,356.60$ BLA 55 2114 ROD 140MM 9,597.00$ 6,717.90$ BLA 55 5365 CROSS CONNECTOR 2,703.00$ 1,892.10$ BLA 60 6240 CERVICAL PLATE 265.00$ 185.50$ BLA 60 6240 CERVICAL PLATE 3,227.00$ 2,258.90$ BLA 65 3314 14MM SCREW 24,015.00$ 16,810.50$ BLOOD PUMP SET 6,062.00$ 4,243.40$ BONE HARVESTER 3,486.00$ 2,440.20$ BONECHIPS #68 1/OZ 590.00$ 413.00$ BOS 38046-70375 ILI/BILI STENT 2,764.00$ 1,934.80$ BOS 7065 WALLFLEX BILIARY 5,115.00$ 3,580.50$ BOS 8208 G-TUBE REPLACEMENT 20FR 97.00$ 67.90$ BOS H965403310 WALLSTENT 16X40X75 2,816.00$ 1,971.20$ BOS H965403320 WALLSTENT 2,814.00$ 1,969.80$ BOS H965404110 WALLSTENT 18X40X75 3,130.00$ 2,191.00$ BOS H965404120 WALLSTENT 3,129.00$ 2,190.30$ BOS H96540XXXX WALLSTENT XXX90X75 4,422.00$ 3,095.40$ BOS M00202019575P0 HEMASHIELD 266.00$ 186.20$ BOS M00202175428P0 HEMASHEILD PLT 1,410.00$ 987.00$ BOS M00536920 STENT PANCREATIC 270.00$ 189.00$ BOS SC-5500-2 PROGRAMMER KIT 4,483.00$ 3,138.10$ BOSCCI SPECTRA WR SC-1160 46,280.00$ 32,396.00$ BOSSCI REMOTE CONT SC-5562-1 3,015.00$ 2,110.50$ BRACHYTHERAPY NONSTRANDED YTTRIUM 43,463.00$ 30,424.10$ BREAST EXPANDER 550CC 2 4,404.00$ 3,082.80$ BUTTON PEC REPAIR 1,015.00$ 710.50$ CARDIAC EVENT RECORDER 408.00$ 285.60$ CARDIOVERTER-DEFIB GENERATOR 56,074.00$ 39,251.80$ CASCI CLEAR-TRAC CANNULA 1,722.00$ 1,205.40$ CASCI LASER, INST,SPEC,SUCT,EVAC 3,556.00$ 2,489.20$ CAT 056116 RED ROBINSON 14.00$ 9.80$ CAT 056116 RED ROBINSON 44,720.00$ 31,304.00$ CAT 100819X-XX ABB VIATRAC 14 PLS 670.00$ 469.00$ CAT 10632301 OMNI FLUSH 419.00$ 293.30$ CAT 31-478 BOSTON SCI TORCON 94.00$ 65.80$ CAT 31-XXX SELECT BERN IMAGER 32.00$ 22.40$ CAT 31-XXX SELECT BERN IMAGER 469.00$ 328.30$ CAT 392XX-XX RUBICON SUPPORT 68.00$ 47.60$

CAT 392XX-XX RUBICON SUPPORT 452.00$ 316.40$ CAT 41060-01 EV3 INFUSION CATH 160.92$ 112.65$ CAT 4FR MERIT BERN IMPRESS 46535 40.00$ 28.00$ CAT 500-55XXX CATHETER MACH4 EKOS 307.58$ 215.31$ CAT 500-55XXX CATHETER MACH4 EKOS 9,106.00$ 6,374.20$ CAT 518-083/093 SPECTRANETICS 187.00$ 130.90$ CAT 7718-CO 4F BERN I PERFORMA 40.00$ 28.00$ CAT 86700 VOLCANO VISIONS PV.018 2,328.00$ 1,629.60$ CAT 8887660184 COV RED RUBBER 3.60$ 2.52$ CAT 8888145057 PALINDROME SILVER 2,332.00$ 1,632.40$ CAT 88901 VOLCANO VISION PV 0.035 3,317.00$ 2,321.90$ CAT BARD PORT CATHETER 6,679.00$ 4,675.30$ CAT BOS 109676-001 ANGIOJET 4,356.00$ 3,049.20$ CAT CG41X TERUMO GLIDECATH 198.00$ 138.60$ CAT G1379X COOK VANSCHIE 3-5 299.00$ 209.30$ CAT G23733 CATHETER BALLOON CODA 1,484.00$ 1,038.80$ CAT G2699X NESTER 1,173.00$ 821.10$ CAT NC35XXX TERUMO NAVICROSS 115.00$ 80.50$ CAT NC35XXX TERUMO NAVICROSS 764.00$ 534.80$ CATH SAVI 6-MINI 347.00$ 242.90$ CATH SAVI 6-MINI 9,253.00$ 6,477.10$ CATHETER GUIDING 365.00$ 255.50$ CATHETER,COUDE 2W 5CC 20FR 297.00$ 207.90$ CATHETER,COUNCIL 2W 5CC 22FR 3,522.00$ 2,465.40$ CATHETER,ROBINSON 14FR 449.00$ 314.30$ CATHETER,ROBINSON 14FR 2,303.00$ 1,612.10$ CATHETER,ROBINSON 20FR 2,290.00$ 1,603.00$ CAUTERY TIP, EXT. NEEDLE ELECTROD 5,221.00$ 3,654.70$ CAUTERY TIP,NEEDLE #0067 697.50$ 488.25$ CAUTERY TIP,NEEDLE #0067 3,746.00$ 2,622.20$ CHIPS BONE 15CC (PCAN15) 497.00$ 347.90$ CHIPS BONE 15CC (PCAN15) 559.00$ 391.30$ CHIPS BONE 30CC (PCAN30) 995.00$ 696.50$ CHRONOS 100X25X3 4,898.00$ 3,428.60$ CHRONOS 47X18X3MM 3,829.00$ 2,680.30$ CIRCON ROLLER 3,459.00$ 2,421.30$ CLIPS HULKA 3,372.00$ 2,360.40$ COMPONENT PATELLA 38MM OVAL 7,810.00$ 5,467.00$ COMPONENT TROCHLEAR MED/RT 12,219.00$ 8,553.30$ CON ESS305 9,597.00$ 6,717.90$ CONCEPT BURR 2,862.00$ 2,003.40$ CONCEPT ELECTRODE 920.00$ 644.00$ COO AX1-2-28-113 GRAFT 16,936.00$ 11,855.20$ COO G18070 STENT PERCUFLEX UR DIV 324.00$ 226.80$ COO G21541 BILIARY STENT 419.00$ 293.30$ COO G21545 BILIARY STENT 330.00$ 231.00$ COO G21545 STENT BILIARY 335.00$ 234.50$

COO MWCE-35-20-8 NESTER COIL 693.00$ 485.10$ COO MWCE-35-8/4 TORNADO COIL 533.00$ 373.10$ COO MWCER-35-14-8 RETRACTA COIL 2,583.00$ 1,808.10$ COO TFFB-26-96-ZT GRAFT MAIN BODY 21,351.00$ 14,945.70$ COO TFFB-36-95-ZT MAIN BODY 21,351.00$ 14,945.70$ COO TFFB-XX-XX-ZT ALL MAIN BODY 21,411.62$ 14,988.13$ COO ZFEN-D-12-28-76-C LEGS 10,568.00$ 7,397.60$ COO ZFEN-P-2-36-137-R MAIN BODY 3,086.67$ 2,160.67$ COO ZFEN-P-2-36-137-R MAIN BODY 28,600.00$ 20,020.00$ COO ZSLE-13-74ZT LEG GRAFT 8,539.00$ 5,977.30$ COO ZSLE-16-74-ZT ILIAC LEG EXTEN 8,539.00$ 5,977.30$ COO ZSLE-20-56-ZT GRAFT 8,539.00$ 5,977.30$ COO ZSLE-XX-XX-ZT ALL EXTENSIONS 419.00$ 293.30$ COO ZSLE-XX-XX-ZT ALL EXTENSIONS 8,539.00$ 5,977.30$ COO ZTA-P-42-121-W THORACIC STENT 737.00$ 515.90$ COO ZTA-P-42-121-W THORACIC STENT 40,300.00$ 28,210.00$ COO ZTA-PT-XX-XX-XXX-W PROX THOR 41,509.00$ 29,056.30$ COTTONOID 2,953.00$ 2,067.10$ COV LGP1510 PROGRIP MESH 1,233.00$ 863.10$ COV LPG1510AL SELF-FIXATING MESH 1,444.00$ 1,010.80$ COV LPG1612 PROGRIP MESH 1,380.00$ 966.00$ COV SYM9 SYMBOTEX 901.00$ 630.70$ COV TEM1515G PROGRIP 1,327.00$ 928.90$ COVER MAYO STAND 4,443.00$ 3,110.10$ COVERED STENT W/DELIVERY 184.00$ 128.80$ CROSSOVER SPINE 1894-01-407 2,931.00$ 2,051.70$ CRY BG3502-5-US BIOGLUE 1,940.00$ 1,358.00$ CRY BG3515-5-US BIOGLUE 2,707.00$ 1,894.90$ DCI 06100019 FROZEN TENDON 3,305.00$ 2,313.50$ DCI 06300701 CANCELLS CUBES 30CC 161.00$ 112.70$ DCI 06300701 CANCELLS CUBES 30CC 2,023.00$ 1,416.10$ DCI 07804203-TIBIALIS TENDON ANT 2,992.50$ 2,094.75$ DCI 09600019 PERONEOUS TENDON FRZ 2,846.00$ 1,992.20$ DCI BONE CHIPS CANCELLOUS 30CC 185.00$ 129.50$ DCI BONE CHIPS CANCELLOUS 30CC 6,310.00$ 4,417.00$ DCI CANCELLOUS 1-4MM90CC LYOSTER 3,504.00$ 2,452.80$ DCI CANCELLOUS CUBES 15CC 1,233.00$ 863.10$ DCI PERONEUS TEND FRZN 030743862 2,420.00$ 1,694.00$ DEMNATOME PADGETT 1,035.00$ 724.50$ DEMNATOME PADGETT 1,555.33$ 1,088.73$ DEP 04.613.516 VECTRA SCREW 754.00$ 527.80$ DEP 1012-01-088 HIP STEM 372.00$ 260.40$ DEP 1218-36-660 REV ACE LINER 12,675.00$ 8,872.50$ DEP 1307-60-038 ECC GLENOSPHERE 1,292.00$ 904.40$ DEP 1365-12-500 REV FEMORAL HEAD 838.00$ 586.60$ DEP 1365-12-500 REV FEMORAL HEAD 2,124.00$ 1,486.80$ DEP 1365-21-000 REV FEM HEAD 2,555.00$ 1,788.50$

DEP 1797 02 000 SET SCREW 503.00$ 352.10$ DEP 1797-32-650 EXPEDIUM SCREW 330.00$ 231.00$ DEP 1797-32-650 EXPEDIUM SCREW 3,100.00$ 2,170.00$ DEP 1836-12-030 2 LEVEL PLATE 1,253.00$ 877.10$ DEP 1861-12-025 EXP. SCREW 6,669.00$ 4,668.30$ DEP 1868-02-032 SKYLINE PLATE 3,937.00$ 2,755.90$ DEP 1868-52-014 VAST SCREWS 14MM 754.00$ 527.80$ DEP 1873 01 106 BENGEL IMPLANT 81.25$ 56.88$ DEP 1873 01 106 BENGEL IMPLANT 3,875.00$ 2,712.50$ DEP 1881-02-640 EXP MONO SCREW 2,005.00$ 1,403.50$ DEP 1883 18 314 FA SCREW 3.5 3,100.00$ 2,170.00$ DEP 1883 42 200 POLY SCREW 503.00$ 352.10$ DEP 1883-41-021 CROSSLINK 2,178.00$ 1,524.60$ DEP 1883-41-100 OUTER SCREW 503.00$ 352.10$ DEP 1883-41-200 INNER SCREW 4,184.00$ 2,928.80$ DEP 1894-01-303 A3 SFX 2,178.00$ 1,524.60$ DEP 1894-01-405 SFX A5 561.00$ 392.70$ DEP 1894-01-405 SFX A5 2,178.00$ 1,524.60$ DEP 1894-01-406 SFX A6 2,178.00$ 1,524.60$ DEP 1894-07-232 EXP. CROSSLINK 9,960.00$ 6,972.00$ DEP 2761 01 015 CONDUIT TCP 15CC 13,843.00$ 9,690.10$ DEP 401.136.99 TITANIUM SCREW 503.00$ 352.10$ DEP 443.182 TIT LAMINOPLSTY PLT 2,831.00$ 1,981.70$ DEP 52-1504 S-ROM SCREW 593.00$ 415.10$ DEP 52-2028 REV FEMORAL HEAD 1,766.00$ 1,236.20$ DEP 52-2028 REV FEMORAL HEAD 3,162.00$ 2,213.40$ DEP 87-3557 REV LINER 7,343.00$ 5,140.10$ DEP FEM HEAD 522028 297.00$ 207.90$ DEP K-WIRE 28,35,45,54,62 455.00$ 318.50$ DEP SPI CONST ANT CERV P,S.COR L1 3,191.00$ 2,233.70$ DEP SPINE COMP CAGE CERVICAL 3,100.00$ 2,170.00$ DILAMEG INSERT 669.00$ 468.30$ DRESSING NUGAUZE PLAIN 1,133.00$ 793.10$ DUR 206320 INTEGRA DURASEAL 3ML 2,700.00$ 1,890.00$ DUR 206520 DURASEAL 3,345.00$ 2,341.50$ EDW 3000 PERICARDIAL VALVE 17,387.18$ 12,171.03$ EDW 4450 ANNULOPLASTY RING 7,258.46$ 5,080.92$ EDW 4900 MC3 ANNULOPLASTY SYS 8,108.00$ 5,675.60$ EDW 6900P PERICARDIAL HEART VALVE 15,447.71$ 10,813.40$ EDW DP1X6 DURAVESS BOVINE PATCH 553.00$ 387.10$ ELASTOPLAST 3 2,012.00$ 1,408.40$ ELECTRODE MITEK SIDE EFFECT 432.00$ 302.40$ ELECTRODE,VAPOR 297.00$ 207.90$ ENDO CLIP II #176657 2,953.00$ 2,067.10$ ENDO CLIP M00522610 65.00$ 45.50$ ENDO GAUGE 3,013.00$ 2,109.10$ ENSTRUM EDITH 8,418.00$ 5,892.60$

ENT COMPLEX 1ST 30 MIN 556.00$ 389.20$ ENT MAJOR 1ST 30 MIN 3,155.00$ 2,208.50$ ENT MINOR 1ST 30 MIN 3,976.00$ 2,783.20$ EP-200154 DUAL MOBILITY BEARING 5,985.00$ 4,189.50$ ETH EVICEL 2ML 995.00$ 696.50$ ETH STRAP25 FIXATION DEVICE 1,977.00$ 1,383.90$ EV3 SERB65-14-60-80 PROTEGE GPS 2,630.00$ 1,841.00$ EVERSHEARS II SCISSORS 3843 1,637.00$ 1,145.90$ EXA SPK0222 LARGE KNEE SPACER 8,987.00$ 6,290.90$ EXPANDER 475CC HI PROFILE 5,814.00$ 4,069.80$ EXPANDER BREAST 605CC INSPIRA 4,030.00$ 2,821.00$ EXPANDER BREAST 605CC INSPIRA 44,720.00$ 31,304.00$ EXPANDER MOD HT EXT PRO 600CC 733.00$ 513.10$ EXPANDER MOD HT EXT PRO 600CC 3,860.00$ 2,702.00$ EXPANDER TISSUE 250CC (133MV-11-T 4,805.00$ 3,363.50$ EXPANDER TISSUE 500CC 4,805.00$ 3,363.50$ EXPANDER TISSUE 850CC W-TAB 4,805.00$ 3,363.50$ EXPANDR BRST TISS TALL HT 350CC 4,578.00$ 3,204.60$ EXTRA NURSE 297.00$ 207.90$ FEMORAL SZ 6 RT OXINIUM 13,897.00$ 9,727.90$ FEMR CRUCIATE RETAINING NRW LT S8 24,233.00$ 16,963.10$ FEMUR CEMENTED NRW LT SZ 5 24,233.00$ 16,963.10$ FEMUR CEMENTED NRW LT SZ 9 4,650.00$ 3,255.00$ FEMUR CEMENTED NRW RT SZ 5 24,233.00$ 16,963.10$ FEMUR CEMENTED ST RT SZ 8 24,233.00$ 16,963.10$ FEMUR CEMENTED STD LEFT SZ 5 299.00$ 209.30$ FEMUR CEMENTED STD LEFT SZ 5 19,958.00$ 13,970.60$ FEMUR CEMENTED STD LT SZ 10 24,233.00$ 16,963.10$ FEMUR CEMENTED STD LT SZ 9 2,253.00$ 1,577.10$ FEMUR CEMENTED STD LT SZ 9 24,233.00$ 16,963.10$ FEMUR CEMENTED STD RT SZ 10 24,233.00$ 16,963.10$ FEMUR CEMENTED STD RT SZ 9 24,233.00$ 16,963.10$ FEMUR CRUCIATE RETAIN NRW RT SZ 6 24,233.00$ 16,963.10$ FEMUR CRUCIATE RETAIN NRW RT SZ 7 24,233.00$ 16,963.10$ FEMUR CRUCIATE RETAIN NRW RT SZ 8 24,233.00$ 16,963.10$ FEMUR CRUCIATE RETAIN STD LT SZ 6 24,233.00$ 16,963.10$ FEMUR CRUCIATE RETAIN STD LT SZ 8 22,033.00$ 15,423.10$ FEMUR CRUCIATE RETAIN STD RT SZ 6 24,233.00$ 16,963.10$ FEMUR NARROW LEFT SZ 6 24,233.00$ 16,963.10$ FEMUR NARROW RT SZ 9 CEMENTED 163.00$ 114.10$ FEMUR NARROW RT SZ 9 CEMENTED 19,957.60$ 13,970.32$ FEMUR NRW RT SZ 4 21,109.00$ 14,776.30$ FEMUR PERSONA NRW LT SZ 7 24,233.00$ 16,963.10$ FEMUR PERSONA STD RT SZ 7 24,233.00$ 16,963.10$ FEMUR STD LEFT SZ 7 24,233.00$ 16,963.10$ FEMUR STD LT SZ 11 24,233.00$ 16,963.10$ FEMUR STD RT SZ 11 24,233.00$ 16,963.10$

FEMUR STD SZ 5 RT CEMENTED 19,958.00$ 13,970.60$ FINGER JOINT IMPLANT 866.00$ 606.20$ FLEXHD SINGLE 6 X 16CM PERF 7,382.92$ 5,168.04$ FLEXHD SINGLE 6 X 16CM PERF THICK 737.00$ 515.90$ FLEXHD SINGLE 6 X 16CM PERF THICK 7,382.92$ 5,168.04$ FLOWONIX INTRA CATH 11823 1,508.00$ 1,055.60$ FLOWONIX PT CONTROLLER B18D0161 1,843.00$ 1,290.10$ FLOWONIX PUMP 10BC4A27X 23,400.00$ 16,380.00$ FRACTURE TABLE 2,149.00$ 1,504.30$ GAS SAMPLING TUBE 8,417.00$ 5,891.90$ GENERAL MAJOR SURGERY OR TIME 3,522.00$ 2,465.40$ GLENOID KEELED S35 6,021.00$ 4,214.70$ GLENOID PEGGED SZ 50 6,689.00$ 4,682.30$ GLENOSPHERE STD 36MM 559.00$ 391.30$ GLENOSPHERE STD 36MM 9,359.00$ 6,551.30$ GLENOSPHERE STD 39MM 9,359.00$ 6,551.30$ GLO COMP CROSS LINK 642.00$ 449.40$ GLO COMP CROSS LINK 2,931.00$ 2,051.70$ GLO COMP PEDICLE & 3 PART SCREWS 180.00$ 126.00$ GLO COMP PEDICLE & 3 PART SCREWS 2,931.00$ 2,051.70$ GLO COMP ROD LESS THAN 300MM 670.00$ 469.00$ GLO COMP WASTE/XPLANT PED SCREW 2,198.00$ 1,538.60$ GLO SPI COMP ANT LUMBAR PLATE 838.00$ 586.60$ GLO SPI COMP ANT LUMBAR PLATE 8,550.00$ 5,985.00$ GLO SPI COMP LAMINOPLASTY PLT PST 3,116.00$ 2,181.20$ GLO SPI COMP LUMBAR SCREW 830.00$ 581.00$ GLO SPI COMP STAND ALONE LUMBAR 16,640.00$ 11,648.00$ GLO SPI COMP WASTED SELF-TAP SCRW 297.00$ 207.90$ GLOVES, SURGEON 7 14.00$ 9.80$ GOWN, TOGA LARGE W/ZIPPER 3,811.00$ 2,667.70$ GRA 10002 5050 001 VASC ACCESS 306.00$ 214.20$ GRA 175434P VASULAR GRAFT 1,455.00$ 1,018.50$ GRA DF8006SC BYPASS GRAFT 451.00$ 315.70$ GRA DF8006SC BYPASS GRAFT 8,919.50$ 6,243.65$ GRA DF8008SC 5,214.00$ 3,649.80$ GRA F4006C IMPRA CARBOFLO GRAFT 1,763.00$ 1,234.10$ GRA F4008 IMPRA FLEX 1,528.00$ 1,069.60$ GRA F7008C PTFE VASC 70X8 2,526.00$ 1,768.20$ GRA F7010 IMPRA EPTFE REG WALL 2,446.00$ 1,712.20$ GRA F8006C PTFE VASCULAR GRAFT 3,045.00$ 2,131.50$ GRA F8006SC IMPRA CARBOFLO FLEX 3,212.00$ 2,248.40$ GRA F8008S FLEX GRAFT 2,801.00$ 1,960.70$ GRA GORE H470045A PROPATEN 3,819.00$ 2,673.30$ GRA HGK0008-40 8MM STRAIGHT 1,243.00$ 870.10$ GRA ID1101 DURAGEN 959.00$ 671.30$ GRA ID1101 DURAGEN 1,286.00$ 900.20$ GRA ID1301 DURAGEN DURAL GRAFT 2,080.00$ 1,456.00$

GRA IGK0010-20 STRAIGHT 10X20 894.00$ 625.80$ GRA IGK1608 BIFURCATION 674.00$ 471.80$ GRA IGK1608 BIFURCATION 1,799.00$ 1,259.30$ GRA IGK1809 BIFUR 18X9 1,837.00$ 1,285.90$ GRAFT GORE PROPATEN 4X7 3,819.00$ 2,673.30$ GUIDEWIRE-ENDO 634.00$ 443.80$ GYN/GU COMPLEX 1ST 30 MIN 4,341.00$ 3,038.70$ HAL 0100-18 MIC GJ-TUBE 144.00$ 100.80$ HALL OSCILLATOR 2,107.00$ 1,474.90$ HAN 1312-11-120 MULTI-DIR PEG 352.00$ 246.40$ HAN DISTAL VOLAR PLATE 2,814.00$ 1,969.80$ HAN FP18 2.5 FULL TREAD PEG 324.00$ 226.80$ HAN SP20 CANCELLOUS SCREW 2.5 241.00$ 168.70$ HAN TP20 THREADED PEG 2.5 338.00$ 236.60$ HAND INN CORT SCREW 14MM CS14000 336.00$ 235.20$ HAND INN CORT SCREW 3.5 CS12000 339.00$ 237.30$ HAND INN CORT SCREW CS16000 336.00$ 235.20$ HAND INN DVRANS-R PLATE 2,857.00$ 1,999.90$ HAND INN PEG 2.0X18MM P18000 334.00$ 233.80$ HAND INN PEG 2.0X20MM P20000 334.00$ 233.80$ HAND INN PEG SMOOTH 2.0 P16000 339.00$ 237.30$ HAND INN PLATE DVRASL 2,857.00$ 1,999.90$ HAND INN PLATE DVRAS-R 2,857.00$ 1,999.90$ HAND INN THREADPEG 2.5X18TP18000 336.00$ 235.20$ HAND INN THREADPEG 2.5X20TP20000 336.00$ 235.20$ HAND INN THREADPEG 2.5X22TP22000 336.00$ 235.20$ HAND INN THRPEG2.5X24 MM TP24000 336.00$ 235.20$ HAND INN TP16000PARTTHREDX16MM 336.00$ 235.20$ HEAD FEMORAL 28MM V40 3,344.03$ 2,340.82$ HEAD FEMORAL 36MM 3,406.00$ 2,384.20$ HEAD HUMERAL 18MM 93.00$ 65.10$ HEAD HUMERAL 18MM 9,092.00$ 6,364.40$ HEAD HUMERAL 43X16X1.5 9,092.00$ 6,364.40$ HEAD HUMERAL 50MM DIA 8,736.00$ 6,115.20$ HEAD HUMERAL SZ 52MM 9,117.00$ 6,381.90$ HER 5036964 PALACOS R+G 697.00$ 487.90$ HIP CUP 54MM E 10,962.00$ 7,673.40$ HIP CUP TRIDENT502-11-60G 2,930.00$ 2,051.00$ HIP HEAD 06-3675 590.00$ 413.00$ HIP HEAD 06-3675 3,937.00$ 2,755.90$ HIP HEAD 32MM -4MM 2,180.00$ 1,526.00$ HIP HEAD 32MM PLUS 2,180.00$ 1,526.00$ HIP HEAD 32MM PLUS-5 891.00$ 623.70$ HIP HEAD 32MM PLUS-5 2,801.00$ 1,960.70$ HIP HEAD 32MMX-4MM 3,576.00$ 2,503.20$ HIP HEAD 36MMX-436 LENTH 4,130.00$ 2,891.00$ HIP HEAD 36X+0 193.50$ 135.45$

HIP HEAD 36X+0 4,724.00$ 3,306.80$ HIP HEAD 36X+10 C TAPER 744.00$ 520.80$ HIP HEAD 36X+10 C TAPER 4,418.00$ 3,092.60$ HIP HEAD 6570-0-136 4,130.00$ 2,891.00$ HIP HEAD 6570-0-232 3,811.00$ 2,667.70$ HIP HEAD 6570-0-536 4,337.00$ 3,035.90$ HIP LINER 36MM SZD 3,305.00$ 2,313.50$ HIP LINER TRID 623-10-36G 2,584.00$ 1,808.80$ HIP STEM OMNIFIT SZ8 9,526.00$ 6,668.20$ HOW 0580 1 351 FEM STEM 24,015.00$ 16,810.50$ HOW 06 3200 C TAPER HEAD 265.00$ 185.50$ HOW 06 3200 C TAPER HEAD 372.00$ 260.40$ HOW 3003 0822S GAMMA SET SCREW * 265.00$ 185.50$ HOW 3060 0095S GAMMA LAG SCREW * 265.00$ 185.50$ HOW 3060 0095S GAMMA LAG SCREW * 3,833.00$ 2,683.10$ HOW 340636 CORTICAL SCREW 326.00$ 228.20$ HOW 340636 CORTICAL SCREW 372.00$ 260.40$ HOW 48694014 REFLEX 4.0 SCREW 810.00$ 567.00$ HOW 52-23622 2.3 LCK SCREW 1,012.00$ 708.40$ HOW 5260 4 000 PLUG 506.00$ 354.20$ HOW 5531-G-309 TIBIAL INSERT 5,756.00$ 4,029.20$ HOW 602695 TITANIUM SCREW 19,510.00$ 13,657.00$ HOW 602930 6.5 SCREW 1,670.00$ 1,169.00$ HOW 6052 0730A HIP STEM 15,305.00$ 10,713.50$ HOW 6076 0625 HIP STEM 6,690.00$ 4,683.00$ HOW 6183 2 008 CERVICAL BONE 372.00$ 260.40$ HOW 621 10 36G INSERT * 265.00$ 185.50$ HOW 621 10 36G INSERT * 10,443.00$ 7,310.10$ HOW 623-10-28D TRI POLY INSERT 493.00$ 345.10$ HOW 625 0T 28D ALUMINA INSERT 326.00$ 228.20$ HOW 625 0T 28D ALUMINA INSERT 3,599.00$ 2,519.30$ HOW 653002 ALLOCRAFT DBM 2,684.00$ 1,878.80$ HOW 6565 0 232 ALUMINA FEM HEAD 24,015.00$ 16,810.50$ HOW 6704-0-410 CABLE AND SLEEVE 232.00$ 162.40$ HOW 690-10-28H INSERT 12,123.00$ 8,486.10$ HOW 72 5 0710 SCORPIO INSERT #7 119.00$ 83.30$ HOW 72 5 0710 SCORPIO INSERT #7 3,946.00$ 2,762.20$ HOW EXETER HEAD-OBSOLETE 185.00$ 129.50$ HOW EXETER HEAD-OBSOLETE 3,533.00$ 2,473.10$ HOW HEADLESS PIN-OBSOLETE 566.00$ 396.20$ HOW HINGE FEM COMP-OBSOLETE 566.00$ 396.20$ HOW LOCKING SCREW 375065 14.00$ 9.80$ HOW STANDARD AXLE-OBSOLETE 566.00$ 396.20$ HOW STANDARD BUMPER-OBSOLETE 566.00$ 396.20$ HOW STEINMAN PIN-OBSOLETE 306.00$ 214.20$ HOW STEINMAN PIN-OBSOLETE 4,069.00$ 2,848.30$ HOW TIBIAL INSERT-OBSOLETE 566.00$ 396.20$

HOW TIBIAL NAIL 35182270 OBSOLETE 14.00$ 9.80$ HYSTEROSCOPE 1,039.00$ 727.30$ IMPLANT BREAST 485CC INSPIRA 4,030.00$ 2,821.00$ IMPLANT BREAST 560CC SFT TOUCH 4,030.00$ 2,821.00$ IMPLANT BREAST 650CC INSPIRA 744.00$ 520.80$ IMPLANT BREAST 650CC INSPIRA 3,166.00$ 2,216.20$ IMPLANT BREAST 695CC SOFTTOUCH 154.00$ 107.80$ IMPLANT BREAST 695CC SOFTTOUCH 4,030.00$ 2,821.00$ IMPLANT BREAST INSPIRA 415CC 3,166.00$ 2,216.20$ IMPLANT BREAST INSPIRA 445CC 154.00$ 107.80$ IMPLANT BREAST INSPIRA 445CC 3,166.00$ 2,216.20$ IMPLANT BREAST INSPIRA 485CC 1,015.00$ 710.50$ IMPLANT BREAST INSPIRA 485CC 3,166.00$ 2,216.20$ IMPLANT BREAST INSPIRA 560CC 83.00$ 58.10$ IMPLANT BREAST INSPIRA 560CC 3,166.00$ 2,216.20$ IMPLANT BREAST INSPIRA 600CC 3,166.00$ 2,216.20$ IMPLANT BREAST INSPIRA 61850CC 3,166.00$ 2,216.20$ IMPLANT BREAST MEM GEL 595C 2,760.00$ 1,932.00$ IMPLANT HAT-TRICK 2.7MM X 15 4,604.00$ 3,222.80$ IMPLANT NATRELLE INSPIRA 520CC 4,030.00$ 2,821.00$ IMPLANT NATRELLE INSPIRA 650CC 4,030.00$ 2,821.00$ INA 10-550 BREAST IMPLANT 810.00$ 567.00$ INSERT ARTIC LEGION SZ 7-8 12MM 4,718.00$ 3,302.60$ INSERT ARTIC SZ 5-6 11MM 4,633.00$ 3,243.10$ INSERT ARTIC SZ 5-6 18MM 4,633.00$ 3,243.10$ INSERT ARTIC SZ 5-6 18MM 5,115.00$ 3,580.50$ INSERT HIGH FLEXION SZ 5-6 12MM 4,718.00$ 3,302.60$ INSERT LEGION SZ 7-8 10MM 4,718.00$ 3,302.60$ INSERT REVERSED 36MM 3,511.00$ 2,457.70$ INSERT RVRS 39MM 3,447.00$ 2,412.90$ INSERT VIVACET-E RT 10MM SZ 8-9 744.00$ 520.80$ INSERT VIVACET-E RT 10MM SZ 8-9 4,650.00$ 3,255.00$ INSERT VIVACIT-E (42-5221-003-10) 4,650.00$ 3,255.00$ INSERT VIVACIT-E LT 10MM SZ 10-11 4,650.00$ 3,255.00$ INSERT VIVACIT-E LT 10MM SZ 4-5 4,650.00$ 3,255.00$ INSERT VIVACIT-E LT 10MM SZ 8-11 151.00$ 105.70$ INSERT VIVACIT-E LT 10MM SZ 8-11 4,650.00$ 3,255.00$ INSERT VIVACIT-E LT 10MM SZ 8-9 4,650.00$ 3,255.00$ INSERT VIVACIT-E LT POLY 10MM 4,650.00$ 3,255.00$ INSERT VIVACIT-E RT 10MM SZ 4-5 4,650.00$ 3,255.00$ INSERT VIVACIT-E RT 10MM SZ 6-7 4,650.00$ 3,255.00$ INSERT VIVACIT-E RT 10MM SZ 8-11 4,650.00$ 3,255.00$ INSERT VIVACIT-E RT 11MM SZ 6-7 4,650.00$ 3,255.00$ INSERT VIVACIT-RT 11MM SZ 8-9 4,650.00$ 3,255.00$ INSRT LEGN HIGH FLEX SZ 3-4 12MM 4,718.00$ 3,302.60$ INT 02-2110-050 PUTTY ORTHOBLAST 612.64$ 428.85$ INT 02-2110-100 PUTTY ORTHOBLAST 3,391.00$ 2,373.70$

JOH 3013SP SURGICEL POWDER 3GM 506.00$ 354.20$ JOINTRESTOR DBM PUTTY 1CC 660.00$ 462.00$ KIT INVISIKNOT SYNDEMOSIS REPAIR 551.00$ 385.70$ KIT INVISIKNOT SYNDEMOSIS REPAIR 2,948.00$ 2,063.60$ KNEE FEMORAL COM7142-0006 8,418.00$ 5,892.60$ KNEE FEMORAL COM7142-0008 7,767.00$ 5,436.90$ KNEE FEMORAL COM7142-0010 7,767.00$ 5,436.90$ KNEE FEMORAL COM7142-0012 7,767.00$ 5,436.90$ KNEE FEMORAL COM7142-0014 8,418.00$ 5,892.60$ KNEE FEMORAL LT SZ6 7,247.00$ 5,072.90$ KNEE FEMORAL OX 7142-0134 10,305.00$ 7,213.50$ KNEE FEMORAL OX 7142-0136 10,340.00$ 7,238.00$ KNEE INSERT 11MM 2 138.00$ 96.60$ KNEE INSERT 11MM 2 5,028.00$ 3,519.60$ KNEE INSERT 11MM 3 347.00$ 242.90$ KNEE INSERT 11MM 3 4,882.00$ 3,417.40$ KNEE INSERT 13MM 4,882.00$ 3,417.40$ KNEE INSERT 13MM 5-6 2 5,028.00$ 3,519.60$ KNEE INSERT COMP7142-0766 3,472.00$ 2,430.40$ KNEE INSERT COMP7142-0768 3,533.00$ 2,473.10$ KNEE INSERT COMP7142-0778 3,533.00$ 2,473.10$ KNEE INSERT COMP7142-0780 3,533.00$ 2,473.10$ KNEE INSERT COMP7142-0782 3,533.00$ 2,473.10$ KNEE PATELLA 5550-G-339 2,846.00$ 1,992.20$ KNEE PATELLA COM7142-0576 2,469.00$ 1,728.30$ KNEE PATELLA COM7142-0578 2,469.00$ 1,728.30$ KNEE TIBIAL COMP7142-0186 5,104.00$ 3,572.80$ KNEE TIBIAL SZ6 144.00$ 100.80$ KNEE TIBIAL SZ6 5,652.00$ 3,956.40$ K-WIRE 1.6MM X 61MM 88.00$ 61.60$ KYP CX01A KYPHX BONE CEMENT 72.00$ 50.40$ KYP CX01A KYPHX BONE CEMENT 500.00$ 350.00$ LASER 3,459.00$ 2,421.30$ LASER CATHETER 6,706.00$ 4,694.20$ LDR MOBI-C CERV DISC PROSTHESIS 15,600.00$ 10,920.00$ LEI 50-23410 2.3MM BONE SCREW 294.00$ 205.80$ LEI 55-10504 MINI PLATE 4 HOLE 2,848.00$ 1,993.60$ LEI CMF MOD PLATE 01-08203 10,304.00$ 7,212.80$ LEI CMF MOD SCREW 52-82006 10,340.00$ 7,238.00$ LEI PLATE 54-05105 10,340.00$ 7,238.00$ LEI T-PLATE LONG 54-06241 212.00$ 148.40$ LEI T-PLATE LONG 54-06241 13,837.00$ 9,685.90$ LIF 13125255 AORTIC VALVE 422.00$ 295.40$ LIF 13125255 AORTIC VALVE 26,250.00$ 18,375.00$ LIF 1520616 ALLODERM 6 X 16 CM 7,367.00$ 5,156.90$ LIF CRYO VEIN 71CM - 80CM 22,157.00$ 15,509.90$ LIF CV61-70 CRYO VEIN 61-70CM 20,927.00$ 14,648.90$

LIF PCAN15 14 CANCELLOUS CHIPS 520.57$ 364.40$ LIF PCAN30 14 CANC CHIPS 30CC 995.00$ 696.50$ LIF TGEL01 GEL DBM OPTIUM 1CC 556.00$ 389.20$ LIF TGEL05 GEL DBM OPTIUM 5CC 2,218.00$ 1,552.60$ LIF TGEL10 GEL DBM OPTIUM 10CC 3,034.86$ 2,124.40$ LIF TPUT05 PUTTY DBM OPTIUM 5CC 1,742.00$ 1,219.40$ LIF TPUT10 PUTTY DBM OPTIUM 10CC 2,700.00$ 1,890.00$ LIF VG1C-T57P CERV LORDOTIC 2,484.00$ 1,738.80$ LINVATEC MED SUTURE PASSER 3,372.00$ 2,360.40$ LOR L-PLATE 01-7036 10,340.00$ 7,238.00$ MAJOR-OPERATING TIME 1ST 60 MIN 432.00$ 302.40$ MARKER BIOZORB 3CM X 3CM X 1CM 3,100.00$ 2,170.00$ MASK ANESTHESIA SOFT 7,767.00$ 5,436.90$ MEADOX DBL VAS GRAFT 16X8X8 5,097.00$ 3,567.90$ MED 0112770 BARD MESH PLUG LG 331.00$ 231.70$ MED 0112770 BARD MESH PLUG LG 536.00$ 375.20$ MED 3998CWS SPECIFY LOAD 87.00$ 60.90$ MED 4968-60 LEAD 2,429.00$ 1,700.30$ MED 6972660 SOFAMOR DANEK CERV DC 15,600.00$ 10,920.00$ MED 7600709 MASTERGRAFT PTY 9CC 557.00$ 389.90$ MED 8780 CATHETER 2,851.00$ 1,995.70$ MED 8781 CATHETER 2,409.08$ 1,686.35$ MED 8784 INTRATHECAL CATHETER 1,898.33$ 1,328.83$ MED 8835 PERSONAL THERAPY MGR 2,191.46$ 1,534.02$ MED 97714 BATTERY 41,652.00$ 29,156.40$ MED 97755 RECHARGER 2,806.00$ 1,964.20$ MED 977A160 LEAD KIT 232.00$ 162.40$ MED 977A160 LEAD KIT 5,843.00$ 4,090.10$ MED 977A260 LEAD KIT 180.00$ 126.00$ MED 977A260 LEAD KIT 6,045.00$ 4,231.50$ MED 98716250 6.5 SCREW 4,483.00$ 3,138.10$ MED CAP COMP PED 3 PART SCREW 2,931.00$ 2,051.70$ MED CAP COMP ROD LESS THAN 300MM 670.00$ 469.00$ MED CAP COMP ROD LESS THAN 300MM 2,848.00$ 1,993.60$ MED CAP COMP SET SCREW 2,858.00$ 2,000.60$ MED CF-5260 PERI DIALYSIS CATH 213.50$ 149.45$ MED CF-5260 PERI DIALYSIS CATH 583.00$ 408.10$ MED CX01B KYPHON XPEDE BONE CEMNT 714.00$ 499.80$ MED PAIN CAP PROGRAMMER/HANDSET 2,680.00$ 1,876.00$ MED PAIN PUMP KIT 28,500.00$ 19,950.00$ MED SPI COMP CERV PLATE 3&4 LEVEL 3,100.00$ 2,170.00$ MED SPI COMP CV PLT 1-2 LEVEL 2,341.00$ 1,638.70$ MED SPI COMP DOMINO CONNECTOR 2,931.00$ 2,051.70$ MED SPI TRANSLATIONAL PLATE 3,410.00$ 2,387.00$ MED W1DR01 AZURE XT PACEMAKER 14,053.00$ 9,837.10$ MEDICAL IMAGING SUPPLIES 728.00$ 509.60$ MEDICAL IMAGING SUPPLIES PORT 2,140.00$ 1,498.00$

MEDICAL IMAGING SUPPLIES STENT 3,622.00$ 2,535.40$ MEDICAL IMG SUP URETERAL STENT 850.00$ 595.00$ MEDICAL IMG SUP VENT GENERATOR 24,323.00$ 17,026.10$ MEDICAL IMG SUP VENTRICULAR LEAD 8,577.00$ 6,003.90$ MEDICAL IMG SUPPLIES CATHETER 4,538.00$ 3,176.60$ MEDICAL IMG SUPPLIES GENERATOR 51,975.00$ 36,382.50$ MEDICAL IMG SUPPLIES GENERATOR 52,114.00$ 36,479.80$ MEDICAL IMG SUPPLIES ICD LEAD 9,818.00$ 6,872.60$ MEDICAL IMG SUPPLIES LEAD COIL 13,200.00$ 9,240.00$ MEDTRON 977D260 2,200.00$ 1,540.00$ MEDTRONIC 977D260 1,675.00$ 1,172.50$ MENISECTOMY BOVIE TIP 244.00$ 170.80$ MENISECTOMY BOVIE TIP 432.00$ 302.40$ MENISECTOMY ELECTRODE 3,459.00$ 2,421.30$ MER CC-2300 TITANIUM CATH CONNCTR 523.00$ 366.10$ MER CF-5260 PERI DIAL CATHETER 583.00$ 408.10$ MES 0112750 BARD MESH PLUG 516.00$ 361.20$ MES 0112760 BARD MEDIUM PLUG 359.56$ 251.69$ MES 0115312/0115322 XLG 3D MAX 119.00$ 83.30$ MES 0115312/0115322 XLG 3D MAX 683.00$ 478.10$ MES 0134680 BARD COMPOSIX MESH 829.00$ 580.30$ MES 0134680 BARD COMPOSIX MESH 2,837.00$ 1,985.90$ MES 1202025 PHASIX ST MESH 27,950.00$ 19,565.00$ MES 1DLMC02 DUAL MESH 506.00$ 354.20$ MES 1DLMCP06 GORE DUALMESH PLUS 2,855.00$ 1,998.50$ MES 1DLMCPO4 DUAL MESH 265.00$ 185.50$ MES 1DLMCPO4 DUAL MESH 9,597.00$ 6,717.90$ MES SMPL01 COVIDIEN HERNIA PLUG 744.00$ 520.80$ MES SMPM02 COVIDIEN 304.00$ 212.80$ MES SPMM66 SURGIPRO 6X6 958.00$ 670.60$ MES SPMM66 SURGIPRO 6X6 1,065.00$ 745.50$ MES SYM15 SYMBOTX 15CM 1,577.25$ 1,104.08$ MES SYM2015 SYMBOTEX MESH 1,894.40$ 1,326.08$ MES SYM2520 SYMBOTEX COVIDIEN 3,012.00$ 2,108.40$ MES SYM3020 SYMBOTEX 1,069.00$ 748.30$ MES SYM3020 SYMBOTEX 4,309.00$ 3,016.30$ MES SYMBOTEX SYM1510 1,290.00$ 903.00$ MES VWMM VICRYL MESH 6X6 ETHICON 184.00$ 128.80$ MES VWMM VICRYL MESH 6X6 ETHICON 1,437.00$ 1,005.90$ MESH 3D LT 3X5 590.00$ 413.00$ MESH 3D LT 3X5 699.00$ 489.30$ MESH 3D LT 4X6 590.00$ 413.00$ MESH 3D RT 4X6 590.00$ 413.00$ MESH COMPOSIX 7X9 3,512.00$ 2,458.40$ MESH MARLIX 3X6 3,691.00$ 2,583.70$ MESH MARLX PERFIX PLUG LG 1,302.00$ 911.40$ MESH PERFIX LIGHT PLUG MED 44.00$ 30.80$

MESH PERFIX LIGHT PLUG MED 704.00$ 492.80$ MESH VENTRALEX ST SZ MED 1,662.00$ 1,163.40$ MESH VENTRALEX ST SZ SM 1,394.00$ 975.80$ META-NAIL TRIGEN 11.5 X 30CM 8,963.00$ 6,274.10$ MINI-DRIVER 1,031.00$ 721.70$ MINOR-OR ADDTL PER MIN 3,257.00$ 2,279.90$ MONOCRYL 4-0 Y426H 978.00$ 684.60$ MONOCRYL 5-0 Y493G 2,953.00$ 2,067.10$ MTF 471816 FLEX DERMIS 9,092.00$ 6,364.40$ MYCROMESH 5.0X10 688.00$ 481.60$ NEURO COMPLEXPLUS SURGERY OR TIME 556.00$ 389.20$ NEV 44525 IPG KIT 51,402.00$ 35,981.40$ NEV CHGR1000 CHARGER 4,600.00$ 3,220.00$ NEV CHGR1000 CHARGER KIT 4,600.00$ 3,220.00$ NEV NIPG1500 IPG IMPLANT KIT 51,402.00$ 35,981.40$ NEV PTRC 1000 PT REMOTE KIT 3,311.00$ 2,317.70$ NEV PTRC1000 PATIENT REMOTE 3,311.00$ 2,317.70$ NEVRO TR LEAD KT TLEAD1058-50B 2,597.00$ 1,817.90$ NUV 16016545 RELINE MAS SCREW CAN 3,100.00$ 2,170.00$ NUV 5010020 FORMAGRAFT GRANULES 2,764.00$ 1,934.80$ NUV 5010125 GRAFT BLOCK 3,255.00$ 2,278.50$ NUV 5010205 FORMAGRAFT 1,390.00$ 973.00$ NUV 5565225 FACET SCREW 432.00$ 302.40$ NUV 7236200 20MM ROD 6,670.00$ 4,669.00$ NUV 7237250 25MM ROD 12,123.00$ 8,486.10$ NUV 8061100 5,735.00$ 4,014.50$ NUV CAP COMP CERV PLATE LEVEL 3&4 3,100.00$ 2,170.00$ NUV CAP COMPONENT CERVICAL CAGE 3,100.00$ 2,170.00$ NUV CAP TLIF LEVEL 1 8,550.00$ 5,985.00$ NUV COMP CAGE STAND ALONE CERVICA 135.00$ 94.50$ NUV COMP CAGE STAND ALONE CERVICA 7,125.00$ 4,987.50$ NUV COMP CROSSLINK 616.00$ 431.20$ NUV COMP CROSSLINK 2,931.00$ 2,051.70$ NUV COMP ROD LESS THAN 300MM 670.00$ 469.00$ NUV COMP ROD LESS THAN 300MM 838.00$ 586.60$ NUV COMP WASTED SCREW 628.00$ 439.60$ NUV SP COMP PEDICLE & 3 PART SCRW 2,931.00$ 2,051.70$ NUV SP COMP ROD W/1 OR 2 BALLS 189.00$ 132.30$ NUV SPI COMP CAGE EXPANDABLE LUMB 12,825.00$ 8,977.50$ NUV SPI COMP RELINE MAS SHANK 1,926.00$ 1,348.20$ NUV SPI COMP RELINE MAS TULIPHEAD 1,424.00$ 996.80$ NUV SPI COMP STAND ALONE LUM CAGE 16,640.00$ 11,648.00$ NYLON 11-0 AA-0130 2,953.00$ 2,067.10$ ORIGIN BALLOON DILATOR 2,953.00$ 2,067.10$ ORT CSS-011-70-070L SCREW 372.00$ 260.40$ ORTHO MAJOR SURGERY OR TIME 2,342.00$ 1,639.40$ OSTEOLOCK ALETABULAR INSERT 2,930.00$ 2,051.00$

OSTEOLOCK ALTETABNLAR CUP 2,931.00$ 2,051.70$ OSTEOLOCK CANCELLOUS SCREW 4,443.00$ 3,110.10$ PAIN MAJOR ADDITIONAL MIN 101.69$ 71.18$ PAIN MINOR 1ST 30 MIN 1,357.00$ 949.90$ PAR UQI00012 COFLEX 14,222.00$ 9,955.40$ PAT 019575P HEMASHIELD PATCH 326.00$ 228.20$ PAT 175430P HEMASHIELD PLATINUM 1,454.00$ 1,017.80$ PATELLA 3.5MM OVAL GENESIS II 6,435.00$ 4,504.50$ PATELLA 32MM 7.5MM THICK 10,606.00$ 7,424.20$ PATELLA 32MM OVAL GENESIS II 8,094.00$ 5,665.80$ PATELLA 35MM 7.5MM THICK 3,038.00$ 2,126.60$ PATELLA 38MM X 9.5MM 7,334.00$ 5,133.80$ PATELLA CEMENTED 32MM DIAMETER 4,464.00$ 3,124.80$ PATELLA CEMENTED 35MM DIAMETER 4,464.00$ 3,124.80$ PATELLA COMPONENT SZ 41MM 6,280.00$ 4,396.00$ PATELLA PERSONA 26MM X 7.5MM 4,464.00$ 3,124.80$ PATELLA PERSONA 29MM X 8MM 4,464.00$ 3,124.80$ PERI STRIP 2 1,675.00$ 1,172.50$ PERI STRIP 2 3,372.00$ 2,360.40$ PHY M63020 SET SCREW (HEXALOBE) 14.00$ 9.80$ PLAS COMPLEX 1ST 30 MIN 3,522.00$ 2,465.40$ PLAS MINOR 1ST 30 MIN 3,257.00$ 2,279.90$ PLATE 1.7MM MIDFACE 3-H 944.00$ 660.80$ PLATE 1/3 TUBULAR 5H 62MM 971.00$ 679.70$ PLATE 1/3RD TUBULAR 7-HOLE 348.00$ 243.60$ PLATE 1/3RD TUBULAR 7-HOLE 733.00$ 513.10$ PLATE 1/3RD TUBULAR 8 HOLE 533.00$ 373.10$ PLATE 12-HOLES 241.421 527.00$ 368.90$ PLATE 2.0 STRENGTH 6 HOLE 2,891.00$ 2,023.70$ PLATE 2.0MM T EVOS 156.00$ 109.20$ PLATE 2.0MM T EVOS 2,797.00$ 1,957.90$ PLATE 2.0MM FLEX 6H 2,891.00$ 2,023.70$ PLATE 2.0MM X 7H STR LINE 3,612.00$ 2,528.40$ PLATE 2.4MM Y TINE PLATE 5H 1,015.00$ 710.50$ PLATE 2.4MM Y TINE PLATE 5H 4,290.00$ 3,003.00$ PLATE 2.4MM T-PLATE 4,725.00$ 3,307.50$ PLATE 2.7/3.5 LAT DIST FIBULA 5H 216.00$ 151.20$ PLATE 2.7/3.5 LAT DIST FIBULA 5H 4,046.00$ 2,832.20$ PLATE 3.5MM 1/3 X 8H LKG 153.00$ 107.10$ PLATE 3.5MM 1/3 X 8H LKG 1,698.00$ 1,188.60$ PLATE 3.5MM X 80MM CLAVICLE 3,410.00$ 2,387.00$ PLATE 5H RIGHT LAT FIBULA 2,094.00$ 1,465.80$ PLATE 5H RIGHT LAT FIBULA 4,914.00$ 3,439.80$ PLATE 5HOLE LEFT 77MM 5,143.00$ 3,600.10$ PLATE 6H 2.4MM STRENGTH 2,981.00$ 2,086.70$ PLATE 7HOLE 103MM 5,564.00$ 3,894.80$ PLATE AEGIS 23MM 10,576.00$ 7,403.20$

PLATE COMP 5TH MET HOOK 5H 3,819.00$ 2,673.30$ PLATE DVRANS-R RIGHT 176.00$ 123.20$ PLATE DVRANS-R RIGHT 3,257.00$ 2,279.90$ PLATE FLEX 6H 2.4MM 513.00$ 359.10$ PLATE FLEX 6H 2.4MM 3,480.00$ 2,436.00$ PLATE L 12MM BAR 6 H 8,785.00$ 6,149.50$ PLATE LAPIDUS ALPS 2,776.00$ 1,943.20$ PLATE LAPIDUS AR-8941 3,023.00$ 2,116.10$ PLATE LG INLINE FUSION 2,278.00$ 1,594.60$ PLATE MIDFOOT FUSION SMALL 2,546.00$ 1,782.20$ PLATE ORBITAL 10H 874.00$ 611.80$ PLATE POSTEROLATERAL 6H LEFT 2,931.00$ 2,051.70$ PLATE RT 55-06761 993.00$ 695.10$ PLATE RT MEDIAL DIST HUMERAL 7H 4,404.00$ 3,082.80$ PLATE RT MEDIAL LAT HUMERAL 7H 4,464.00$ 3,124.80$ PLATE STD LEFT 3 HOLE DISTAL RAD 2,667.00$ 1,866.90$ PLATE STR PROX HUM 5H 114MM 6,983.00$ 4,888.10$ PLATE STR PROX HUMERUS 3H-9SMM 892.00$ 624.40$ PLATE STR PROX HUMERUS 3H-9SMM 6,769.00$ 4,738.30$ PLATE Y PLATE 2.0MM 3H 744.00$ 520.80$ PLATE,Y 297.00$ 207.90$ POLYSORB 4-0 GL-181 432.00$ 302.40$ POLYSORB 4-0 SL-691 432.00$ 302.40$ POLYSORB 5-0 SL-636 432.00$ 302.40$ PORT IMPLANTABLE BARDPORT 1,073.00$ 751.10$ POST 3.5 X 35 THREADED 3,156.00$ 2,209.20$ POST 6.5 X 40 THREADED 1,015.00$ 710.50$ POST BI-CORTICAL 6.5MM X 50MM 1,005.00$ 703.50$ PROBE/NEEDLE CRYOABLATION 8,000.00$ 5,600.00$ ROD PRELORDOSED 50MM 1,012.00$ 708.40$ ROD PRELORDOSED 75MM 1,012.00$ 708.40$ ROD TENDON 5MM 4,697.00$ 3,287.90$ RTI SPI COMP PED & 2-3 PART SCREW 2,931.00$ 2,051.70$ RTI SPI COMP ROD LESS THAN 300MM 670.00$ 469.00$ SCREW 1.5 X 12 CORT 1,307.00$ 914.90$ SCREW 2.0 X 8MM MINI FRAG 178.00$ 124.60$ SCREW 2.0MM X 10MM 7240-2010 573.00$ 401.10$ SCREW 2.0MM X 10MM LKG EVOS 380.00$ 266.00$ SCREW 2.0MM X 10MM SELF TAP 167.00$ 116.90$ SCREW 2.0MM X 11 CORT LKG 1,015.00$ 710.50$ SCREW 2.0MM X 12MM LCKNG 166.00$ 116.20$ SCREW 2.0MM X 12MM SELF TAP 167.00$ 116.90$ SCREW 2.0MM X 13MM LCKNG 513.00$ 359.10$ SCREW 2.0MM X 14MM SELF TAP 167.00$ 116.90$ SCREW 2.0MM X 14MM SPIN 870.00$ 609.00$ SCREW 2.0MM X 15MM LOCKG S&N 5,115.00$ 3,580.50$ SCREW 2.3MM X 12MM CORT 1,133.00$ 793.10$

SCREW 2.3MM X 12MM CORT 5,115.00$ 3,580.50$ SCREW 2.4 X 10 LKG S&N 513.00$ 359.10$ SCREW 2.4 X 11 LKG S&N 513.00$ 359.10$ SCREW 2.4 X 12 LKG S&N 513.00$ 359.10$ SCREW 2.4 X 13 CORTICAL S&N 207.00$ 144.90$ SCREW 2.4 X 13 CORTICAL S&N 559.00$ 391.30$ SCREW 2.4 X 15 CORTICAL S&N 203.00$ 142.10$ SCREW 2.4 X 16 VAL 527.00$ 368.90$ SCREW 2.4 X 17 LKG S&N 203.00$ 142.10$ SCREW 2.4 X 18 CORTICAL S&N 207.00$ 144.90$ SCREW 2.4 X 20 LKG 527.00$ 368.90$ SCREW 2.4 X 24 LKG 527.00$ 368.90$ SCREW 2.4MM X 12MM LKG 619.00$ 433.30$ SCREW 2.4MM X 13MM LKNG S&N 519.00$ 363.30$ SCREW 2.4MM X 14MM LKG 619.00$ 433.30$ SCREW 2.4MM X 15MM CORT S&N 180.00$ 126.00$ SCREW 2.4MM X 15MM LKNG S&N 101.00$ 70.70$ SCREW 2.4MM X 15MM LKNG S&N 519.00$ 363.30$ SCREW 2.4MM X 16MM LKNG S&N 519.00$ 363.30$ SCREW 2.4MM X 16MM LKNG S&N 1,015.00$ 710.50$ SCREW 2.4MM X 18MM CORTICAL 164.00$ 114.80$ SCREW 2.4MM X 18MM CORTICAL 573.00$ 401.10$ SCREW 2.4MM X 20MM CORT S&N 257.00$ 179.90$ SCREW 2.4MM X 22MM LOW PROFILE LK 527.00$ 368.90$ SCREW 2.4MMX 16 LOCKING 470.00$ 329.00$ SCREW 2.4X 12 CORTICAL S&N 203.00$ 142.10$ SCREW 2.4X13 LCKING S&N 195.00$ 136.50$ SCREW 2.4X13 LCKING S&N 613.00$ 429.10$ SCREW 2.4X16 LCKING S&N 195.00$ 136.50$ SCREW 2.4X16 LCKING S&N 613.00$ 429.10$ SCREW 2.7 X 12 VARIABLE LKG 623.00$ 436.10$ SCREW 2.7 X 13MM LOCK 620.00$ 434.00$ SCREW 2.7 X 16 LKG 623.00$ 436.10$ SCREW 2.7 X 16MM LOCK 620.00$ 434.00$ SCREW 2.7 X 17MM LOCK 620.00$ 434.00$ SCREW 2.7 X 38 CORTICAL S&N 175.00$ 122.50$ SCREW 2.7 X 38 CORTICAL S&N 207.00$ 144.90$ SCREW 2.7MM X 10MM LKNG 551.00$ 385.70$ SCREW 2.7MM X 10MM LKNG 580.00$ 406.00$ SCREW 2.7MM X 14MM CORTL 379.00$ 265.30$ SCREW 2.7MM X 16MM CORTL 744.00$ 520.80$ SCREW 2.7MM X 16MM LKG EVOS 481.00$ 336.70$ SCREW 2.7MM X 55MM LKG EVOS 481.00$ 336.70$ SCREW 2.7MM X 60MM LKG EVOS 481.00$ 336.70$ SCREW 202.734 2.7 CANNULT 935.00$ 654.50$ SCREW 204.818 3.5 SELFTAP 364.00$ 254.80$ SCREW 3.5 X 16 CORTICAL 265.00$ 185.50$

SCREW 3.5 X 18MM LOCKING 154.00$ 107.80$ SCREW 3.5 X 35MM SELF TAPPING 503.00$ 352.10$ SCREW 3.5 X 8 NONLOCK HEXALOBE 154.00$ 107.80$ SCREW 3.5MM X 12 LKG EVOS 154.00$ 107.80$ SCREW 3.5MM X 12MM CORTICAL 744.00$ 520.80$ SCREW 3.5MM X 13MM CORTICAL EVOS 637.00$ 445.90$ SCREW 3.5MM X 14MM CORT EVOS 744.00$ 520.80$ SCREW 3.5MM X 14MM LKG 744.00$ 520.80$ SCREW 3.5MM X 15MM LKG 2,848.00$ 1,993.60$ SCREW 3.5MM X 20MM LKG EVOS 559.00$ 391.30$ SCREW 3.5MM X 20MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MM X 24MM CENTRAL LKG 308.00$ 215.60$ SCREW 3.5MM X 26MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MM X 28MM LKG EVOS 559.00$ 391.30$ SCREW 3.5MM X 28MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MM X 30MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MM X 36MM LKG EVOS 147.00$ 102.90$ SCREW 3.5MM X 38MM LKG EVOS 147.00$ 102.90$ SCREW 3.5MM X 40MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MM X 40MM NON-LKG 1,015.00$ 710.50$ SCREW 3.5MM X 44MM CENTRAL LKG 308.00$ 215.60$ SCREW 3.5MMX14MM CENTRAL LKG 307.00$ 214.90$ SCREW 3.5MMX14MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MMX16MM CENTRAL LKG 307.00$ 214.90$ SCREW 3.5MMX16MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MMX18MM CENTRAL LKG 307.00$ 214.90$ SCREW 3.5MMX18MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MMX20MM CENTRAL LKG 307.00$ 214.90$ SCREW 3.5MMX22MM CENTRAL LKG 307.00$ 214.90$ SCREW 3.5MMX22MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MMX24MM LKN EVOS 299.00$ 209.30$ SCREW 3.5MMX24MM LOW PROFILE 161.00$ 112.70$ SCREW 3.5MMX26MM CORT EVOS 744.00$ 520.80$ SCREW 3.5MMX26MM LKN EVOS 281.00$ 196.70$ SCREW 3.5MMX32MM LKN EVOS 281.00$ 196.70$ SCREW 3.5X14 SELF TAP CORT 299.00$ 209.30$ SCREW 3.5X40 7114-9540 210.00$ 147.00$ SCREW 4.0 X 26MM SPINAL 733.00$ 513.10$ SCREW 4.0 X 26MM SPINAL 3,100.00$ 2,170.00$ SCREW 4.0 X 40 NON-LOCK 200.00$ 140.00$ SCREW 4.0MM X 26MM PRTL THREAD 486.00$ 340.20$ SCREW 4.0MM X 30MM CANN 2.5 HEX 710.00$ 497.00$ SCREW 4.0MM X 38MM CANN 2.5 HEX 710.00$ 497.00$ SCREW 4.5MM X 18MM SELF TAPPING 744.00$ 520.80$ SCREW 4.75 X 20 FIXED LKG 842.00$ 589.40$ SCREW 4.75MM X 15 LCKG 335.00$ 234.50$ SCREW 5.0MM X 26 CENTRAL 154.00$ 107.80$

SCREW 5.5 X 50MM JONES 2,663.00$ 1,864.10$ SCREW 5MM X 14MM CENTRAL 1,015.00$ 710.50$ SCREW 6.5MM X 25MM LO-PRO HEX 354.00$ 247.80$ SCREW 6.5MM X 30MM CENTRAL 1,015.00$ 710.50$ SCREW 6.5MM X 30MM LO-PRO HEX 354.00$ 247.80$ SCREW 6.5MM X 40MM 84.00$ 58.80$ SCREW 6.5MM X 40MM 697.00$ 487.90$ SCREW 7MM X 23MM INTER BIOSTEON 54.00$ 37.80$ SCREW 8MM X 23MM INTERF BIOSTEON 744.00$ 520.80$ SCREW CENTRAL SZ 6.5 X 45 697.00$ 487.90$ SCREW CORTEX 7114-9538 147.00$ 102.90$ SCREW CORTEX 7114-9538 241.00$ 168.70$ SCREW CORTICAL 3.4 X 18 330.00$ 231.00$ SCREW DELTA 8X28MM 326.00$ 228.20$ SCREW DELTA 8X28MM 956.00$ 669.20$ SCREW DELTA 9X28MM 956.00$ 669.20$ SCREW DELTA CANN 10X35 971.00$ 679.70$ SCREW DELTA CANN 12X35 971.00$ 679.70$ SCREW DELTA CANN 9X35 971.00$ 679.70$ SCREW EVOS 2.4 X 16 CORTICAL 156.00$ 109.20$ SCREW EVOS 2.7 X 32 CORITCAL 156.00$ 109.20$ SCREW FIXED LOCKING 4.75 X 30MM 766.00$ 536.20$ SCREW KLG 2.5MM X 17MM 519.00$ 363.30$ SCREW KLG 2.5MM X 18MM 519.00$ 363.30$ SCREW LKG 2.5MM X 10MM 519.00$ 363.30$ SCREW LKG 2.5MM X 14MM 519.00$ 363.30$ SCREW LKG 2.5MM X 16MM 519.00$ 363.30$ SCREW MMF 2.0X8MM 648.00$ 453.60$ SCREW NON LKG 4.75 X 20MM 647.00$ 452.90$ SCREW NONLCK 3.5X22MM 314.00$ 219.80$ SCREW NON-LOCK 2.5MM X 17MM 402.00$ 281.40$ SCREW PEEK 5.5X10MM 1,224.00$ 856.80$ SCREW PERFORM CENTRAL 35MM 892.00$ 624.40$ SCREW SELF TAP 1.2X3MM 349.00$ 244.30$ SCREW SELF TAP 1.2X4MM 335.00$ 234.50$ SCREW SELF TAP 1.2X4MM 349.00$ 244.30$ SCREW SPINE 1797-12-655 3,372.00$ 2,360.40$ SCREW T15 2.7MM X 12MM LKG 609.00$ 426.30$ SCREW T15 2.7MM X 14MM LKG 609.00$ 426.30$ SCREW T15 2.7MM X 18MM LKG 137.00$ 95.90$ SCREW T15 2.7MM X 18MM LKG 609.00$ 426.30$ SCREW T15 2.7MM X 26MM LKG 137.00$ 95.90$ SCREW T15 2.7MM X 26MM LKG 609.00$ 426.30$ SCREW T15 2.7MM X 28MM LKG 137.00$ 95.90$ SCREW T15 2.7MM X 28MM LKG 609.00$ 426.30$ SCREW T15 2.7MM X 48MM LKG 609.00$ 426.30$ SCREW T20 3.5MM X 10MM LKG 622.00$ 435.40$

SCREW T20 3.5MM X 22MM LKG 137.00$ 95.90$ SCREW T20 3.5MM X 22MM LKG 622.00$ 435.40$ SCREW T20 3.5MM X 36MM LKG 137.00$ 95.90$ SCREW T20 3.5MM X 36MM LKG 622.00$ 435.40$ SCREW T20 3.5MM X16MM LKG 622.00$ 435.40$ SCREW TRIGEN 5.0 X 30 984.00$ 688.80$ SCREW TRIGEN 5.0 X 30 1,015.00$ 710.50$ SCREW TRIGEN 5.0 X 35 984.00$ 688.80$ SCREW TRIGEN 5.0 X 37.5 1,015.00$ 710.50$ SCREW TRIGEN 5.0 X 37.5 1,347.00$ 942.90$ SCREW VAST 12MM 754.00$ 527.80$ SCRWE 2.4 X 18 LKG 527.00$ 368.90$ SEQURA BASKET 3FR 3,459.00$ 2,421.30$ SET CYSTO IRR 326.00$ 228.20$ SET PCA MINI BORE 326.00$ 228.20$ SET PCA MINI BORE 11,808.00$ 8,265.60$ SHELL TRIDENT 58MM ALPHA 7,869.00$ 5,508.30$ SHELL TRIDENT II ACETAB SZ 52 7,869.00$ 5,508.30$ SHELL TRIDENT II ACETAB SZ 54 7,869.00$ 5,508.30$ SHELL TRIDENT II ACETAB SZ 56 7,869.00$ 5,508.30$ SHELL TRUDENT 50MM ALPHA 7,869.00$ 5,508.30$ SHLDR BEARING 64MM 5,569.00$ 3,898.30$ SHLDR GLENOSPHERE 36MM 418.00$ 292.60$ SHLDR GLENOSPHERE 36MM 5,092.00$ 3,564.40$ SHLDR REV HUMERAL 44MM 182.34$ 127.64$ SHLDR REV HUMERAL 44MM 6,241.00$ 4,368.70$ SHLDR RVS TRAY 44MM 6,241.00$ 4,368.70$ SHLDR STEM 14X83 18,134.00$ 12,693.80$ SHLDR STEM 15X83 14,645.00$ 10,251.50$ SHLDR STEM HUMERAL SZ 5A 10,944.00$ 7,660.80$ SHOULDER BASEPLATE 6,815.00$ 4,770.50$ SHOULDER GLENOID113641026 1,382.00$ 967.40$ SHOULDER GLENOID113641026 4,446.00$ 3,112.20$ SJM 23AECJ 502 MECH HEART VALVE 9,548.00$ 6,683.60$ SJM 27AECJ-502 AORTIC VALVE 9,548.00$ 6,683.60$ SJM 29MECJ-502 MEC MITRAL VALVE 9,548.00$ 6,683.60$ SJM 3664 PROCLAIM DRG 44,460.00$ 31,122.00$ SJM 610131 ANGIO-SEAL CLOS DEVICE 680.00$ 476.00$ SJM 7883 PATIENT CONTROLLER 4,340.00$ 3,038.00$ SJM 9-AVP2-010 VASCULAR PLUG 3,082.00$ 2,157.40$ SJM 9-AVP2-012 AMP VASC PLUG 2,867.00$ 2,006.90$ SJM CAP PAIN TRIAL LEAD(S)/CABLE 5,865.00$ 4,105.50$ SJM MN10450-50A SLIMTIP LEAD 4,495.00$ 3,146.50$ SJM MN11350 CONNECTOR CABLE 1,199.00$ 839.30$ SJM MN11350 DRG CONNECTOR CABLE 1,340.00$ 938.00$ SJM PAIN DRG TRIAL LEAD 5,865.00$ 4,105.50$ SJM PM3222 LV GENERATOR 15,210.00$ 10,647.00$

SKE GMN-RTS-3HL VOLAR PLATE 2,626.00$ 1,838.20$ SKE PANL-351XX-TS CORT SCR NON-LK 308.00$ 215.60$ SKE SPLS-20140-TS SMOOTH PEG 308.00$ 215.60$ SKE TPLS-231XX-TS THR PG LCK 2.3 308.00$ 215.60$ SKIN STAPLER CONCORDE 1,977.00$ 1,383.90$ SLATER SLEEVE 7,767.00$ 5,436.90$ SMI 12 8692 BONE STAPLES 265.00$ 185.50$ SMI 12 8692 BONE STAPLES 12,123.00$ 8,486.10$ SMI 121130 4 SLOT AMBI PLATE 1,012.00$ 708.40$ SMI 121680 6.5 WASHER 1,281.00$ 896.70$ SMI 121848 CANN SCREW 4.0 843.00$ 590.10$ SMI 222835 4.0 CANN SCREW 335.00$ 234.50$ SMI 222835 4.0 CANN SCREW 804.00$ 562.80$ SMI 25-2800 Q-FIX ANCHOR 1,374.00$ 961.80$ SMI 42824020S TMT FUSION PLT,LONG 4,440.00$ 3,108.00$ SMI 71062007 PINCAP=OBSOLETE ITEM 5,067.00$ 3,546.90$ SMI 71062200 BAR 97.00$ 67.90$ SMI 71062200 BAR 1,038.00$ 726.60$ SMI 71064001 FREEDOM CLAMP 108.00$ 75.60$ SMI 71064001 FREEDOM CLAMP 2,840.00$ 1,988.00$ SMI 71065358 TIN PINS 5X35 138.00$ 96.60$ SMI 71065503 CALCANEOUS PIN 1,302.00$ 911.40$ SMI 71067376 MULTIPLE PIN CLAMP 2,347.00$ 1,642.90$ SMI 71067382 FREEDOM POST 2,840.00$ 1,988.00$ SMI 71127095 7.0 CANN SCREW. 1,028.00$ 719.60$ SMI 71127190 7.0 CANN SCREW 16MM 1,028.00$ 719.60$ SMI 71128100 CANN SCREW 32MM THRD 1,028.00$ 719.60$ SMI 71173322 FIXATION PIN 344.00$ 240.80$ SMI 71210002 TROCAR PIN 297.00$ 207.90$ SMI 71302808 WASTED/EXPL FEM HEAD 15,911.00$ 11,137.70$ SMI 71322047 TANDEM SHELL/LINER 14.00$ 9.80$ SMI 71322047 TANDEM SHELL/LINER 335.00$ 234.50$ SMI 71332540 6.5 SPHERICAL SCREW 527.00$ 368.90$ SMI 71333384 ACE LINER 14,604.00$ 10,222.80$ SMI 71338687 REV ACE LINER 5,894.00$ 4,125.80$ SMI 71340007 CABLE WITH CLAMP 1,451.00$ 1,015.70$ SMI 71343600 FEM HEAD 265.00$ 185.50$ SMI 71343600 FEM HEAD 372.00$ 260.40$ SMI 71420528 REV CONTR ART INSERT 7,963.00$ 5,574.10$ SMI 71420570 REV PATELLA BICONVEX 3,206.00$ 2,244.20$ SMI 71420574 PATELLA 297.00$ 207.90$ SMI 71420630 REV GENESIS LNG STEM 3,672.00$ 2,570.40$ SMI 71420782 REV DISHED ART INSRT 4,943.00$ 3,460.10$ SMI 71420816 9MM PS INSERT 4,680.00$ 3,276.00$ SMI 71420960 REV CONSTR ART INSRT 1,256.73$ 879.71$ SMI 71420960 REV CONSTR ART INSRT 7,963.00$ 5,574.10$ SMI 71421032 REV OVAL PATELLAR 432.00$ 302.40$

SMI 71421032 REV OVAL PATELLAR 3,342.00$ 2,339.40$ SMI 71421147 REV HEMI STPD TIB WG 5,780.00$ 4,046.00$ SMI 71421175 REV CONTR FEM COMP 22,851.00$ 15,995.70$ SMI 71421205 REV OXI FEM COMP 12,310.00$ 8,617.00$ SMI 71421672 REV SCREW-ON FEM WDG 6,688.00$ 4,681.60$ SMI 71421741 REV FEMORAL L-WEDGE 6,814.50$ 4,770.15$ SMI 71424008 REV TIB BASEPLATE 10,016.00$ 7,011.20$ SMI 71424027 REV PRESSFIT STEM 5,047.00$ 3,532.90$ SMI 71424047 REV PRESSFIT STEM 5,183.00$ 3,628.10$ SMI 71424225 COUPLER 5,175.00$ 3,622.50$ SMI 71453174 REV ART INSERT 6,725.00$ 4,707.50$ SMI 71635244 FAN ROSE NAIL 7,818.00$ 5,472.60$ SMI 71642305 INT HEX RECON SCREW 1,385.00$ 969.50$ SMI 71645030 L-P SCREW 5X30MM 804.00$ 562.80$ SMI 71646553 INTERTAN NAIL 11.5MM 1,187.75$ 831.43$ SMI 71646553 INTERTAN NAIL 11.5MM 7,236.00$ 5,065.20$ SMI 71648238 TRIGEN NAIL 7,989.00$ 5,592.30$ SMI 71653432 TRIGEN FEMORAL NAIL 6,948.00$ 4,863.60$ SMI 71653440 FEMORAL NAIL 6,948.00$ 4,863.60$ SMI 71675201 TRIGEN INTER NAIL 5,726.00$ 4,008.20$ SMI 71677090 LAG/COMPRES SCREW 2,966.00$ 2,076.20$ SMI 71677090 LAG/COMPRES SCREW 5,084.00$ 3,558.80$ SMI 71701227 CAP STANDARD TKA 12,113.00$ 8,479.10$ SMI 71800656 CORTEX 4.5 MM 105.00$ 73.50$ SMI 71801113 MED DIST TIB PLT 6,193.00$ 4,335.10$ SMI 718080XX 5.7 CANNULATED SCREW 1,086.00$ 760.20$ SMI 71820013S LAT DIST FEM PLATE 5,879.00$ 4,115.30$ SMI 71820110S 4.5 LAT FEMUR PLATE 5,467.00$ 3,826.90$ SMI 71820606 DIST TIB PLATE 39,567.00$ 27,696.90$ SMI 71821313 PROX HUMERUS PLATE 5,976.00$ 4,183.20$ SMI 71822705 ELBOW PLATE 1,012.00$ 708.40$ SMI 71827030 4.5 SLFTAP LOCK SCRW 326.00$ 228.20$ SMI 71827030 4.5 SLFTAP LOCK SCRW 610.00$ 427.00$ SMI 71829006 3.5 LCK TUB PLATE 1,012.00$ 708.40$ SMI 71829708 PLATE 5,556.00$ 3,889.20$ SMI 72201785 BIOSURE SCREW 3,511.00$ 2,457.70$ SMI 72204834 INVISIKNOT ANKLE 3,119.00$ 2,183.30$ SMI 724035XX 3.5 CORTEX SCREW 336.00$ 235.20$ SMI 72412712 SCREW LOCKING 2.7 620.00$ 434.00$ SMI 724135XX 3.5 LOCKING SCREW 336.00$ 235.20$ SMI 72424014 OSTEOPENIC SCREW 4.0 459.00$ 321.30$ SMI 7242710 4.7 CANC OSTEO SCREW 402.00$ 281.40$ SMI 72440406 2.7 COMPRESSION PLAT 1,253.00$ 877.10$ SMI 72440510 1/3 TUBULAR PLT 10HL 566.00$ 396.20$ SMI 72454506 PART ART DIS POST TB 4,015.00$ 2,810.50$ SMI 72465209 PLATE FIBULA 2.7/3.5 4,542.00$ 3,179.40$ SMI 72823218 CANCELLOUS SCREW 4.0 348.00$ 243.60$

SMI 72823418 4.0 LOCKING 299.00$ 209.30$ SMI 72823418 4.0 LOCKING 950.00$ 665.00$ SMI 72824022S SMALL X-PLATE 429.00$ 300.30$ SMI 72824022S SMALL X-PLATE 4,325.00$ 3,027.50$ SMI 73803010 NON-LOCK SCREW 2.7MM 116.00$ 81.20$ SMI 73804026 PERI-LOC CORTEX SCRW 1,256.00$ 879.20$ SMI 73824018 3.5 CORTEX SELF TAP 570.00$ 399.00$ SMI CERAMIC OXI UPCHARGE KNEE 759.00$ 531.30$ SMI CERAMIC OXI UPCHARGE KNEE 1,005.00$ 703.50$ SOF 7510200 SML INFUSE BONE GRAFT 5,751.50$ 4,026.05$ SOF 7510400 INFUSE BONE GRAFT 14,244.00$ 9,970.80$ SOF 7546545 6.5 MULTI AXIAL SCREW 24,015.00$ 16,810.50$ SOF WASHER X1B9090117 176.00$ 123.20$ SOFLEX RIGTAIL STENT 5,097.00$ 3,567.90$ SOFSILK 1-0 S-187 2,518.00$ 1,762.60$ SOFSILK O-S-306 2,953.00$ 2,067.10$ SPINE BULLET 9MM 16,123.00$ 11,286.10$ SPINE COUGAR 1871-10-212 14,924.00$ 10,446.80$ SPINE COUGAR 1871-10-214 184.00$ 128.80$ SPINE COUGAR 1871-10-214 15,449.00$ 10,814.30$ SPINE PLATE 1868-01-018 3,950.00$ 2,765.00$ SPINE PLATE 51MM 599.00$ 419.30$ SPINE PLATE 51MM 4,711.00$ 3,297.70$ SPINE PLATE AEGIS 21MM 132.00$ 92.40$ SPINE PLATE AEGIS 21MM 11,105.00$ 7,773.50$ SPINE PLATE AEGIS 25MM 10,576.00$ 7,403.20$ SPINE SCREW 4.35X35 2 193.00$ 135.10$ SPINE SCREW 4.35X35 2 3,309.00$ 2,316.30$ SPINE SCREW 5.0X45 590.00$ 413.00$ SPINE SCREW 5.0X45 3,309.00$ 2,316.30$ SPINE SCREW 5.2X28 1,626.00$ 1,138.20$ SPINE SCREW 6.0 1797-12-0 184.00$ 128.80$ SPINE SCREW 6.0 1797-12-0 3,474.00$ 2,431.80$ ST JUDE OCTRODE PERM LEADS 5,084.00$ 3,558.80$ ST JUDE PROCLAIM 5 ELITE 44,720.00$ 31,304.00$ ST JUDE PROCLAIM 7 ELITE 44,720.00$ 31,304.00$ ST JUDE SJM OCTRODE TRIAL LEAD 1,526.11$ 1,068.28$ STE 039600 COOK URETERAL STENT 1,939.00$ 1,357.30$ STE 85404 ICAST STENT 7,339.00$ 5,137.30$ STE 85416 ICAST COVERED STENT 6,373.00$ 4,461.10$ STE G23376 COOK UNIVERSAL SOFT 121.00$ 84.70$ STE PERCUFLEX PLUS URETERAL STENT 3,876.00$ 2,713.20$ STEM HUMERAL MINI SZ 11MM X 83MM 14,934.00$ 10,453.80$ STEM HUMERAL STD PTC 2C 20,486.00$ 14,340.20$ STEM HUMERAL STD PTC SZ 2B 488.00$ 341.60$ STEM HUMERAL STD PTC SZ 2B 16,871.00$ 11,809.70$ STEM HUMERAL STD SZ 6B 12,123.00$ 8,486.10$

STEM HUMERAL SZ 4A 127.5DEG 11,616.00$ 8,131.20$ STENT UNIVERSA 7FR X 20CM 178.00$ 124.60$ STENT UNIVERSA FIRM 6FR X 18CM 1,743.00$ 1,220.10$ STENT,BILIARY DRAINAGE CATHETER 317.44$ 222.21$ STR 1236-2-848 REVIS INSERT MDM 4,532.00$ 3,172.40$ STR 1826-1136S SCN LONG NAIL RETR 335.00$ 234.50$ STR 1826-1136S SCN LONG NAIL RETR 6,247.00$ 4,372.90$ STR 1826-1232S SUPRACONDYLAR NAIL 6,124.00$ 4,286.80$ STR 1896-5060S LOCK SCREW FT 621.09$ 434.76$ STR 2082-0072L REV ACE SHELL 3,817.00$ 2,671.90$ STR 234-102-060 PROCINCH RT 419.00$ 293.30$ STR 3704-0-510 CABLE & SLEEVE SET 1,049.00$ 734.30$ STR 3910-500-322 2.3MM ANCHOR 1,190.67$ 833.47$ STR 3910-600-062 4.5 ANCHOR 1,002.00$ 701.40$ STR 3910-600-062 4.5 ANCHOR 1,121.50$ 785.05$ STR 40-20903 DIST LAT FIB PLATE 138.00$ 96.60$ STR 40-20903 DIST LAT FIB PLATE 2,658.00$ 1,860.60$ STR 509-02-58F REV SHELL 8,538.00$ 5,976.60$ STR 509-02-60F REV SHELL/CUP 8,541.08$ 5,978.76$ STR 509-02-721 REV SHELL 5,008.00$ 3,505.60$ STR 5096-5415 REV ACE WEDGE AUG 2,201.00$ 1,540.70$ STR 53-27612E LOCKING SCREW 1,318.09$ 922.66$ STR 54-25376 VOLAR LOCK PLATE 377.00$ 263.90$ STR 5549-A-130 TIB SYM CONE AUG 162.00$ 113.40$ STR 5549-A-130 TIB SYM CONE AUG 2,017.00$ 1,411.90$ STR 5551-G-381 WASTED PATELLA 842.00$ 589.40$ STR 604640 4.0 PART THR SCREW 453.00$ 317.10$ STR 604640 4.0 PART THR SCREW 603.00$ 422.10$ STR 6097-0630 CEM HIP STEM WASTED 5,889.00$ 4,122.30$ STR 623-00-36D TRIDENT X3 INSERT 3,637.00$ 2,545.90$ STR 626-00-42E REVIS LINER MDM 5,753.00$ 4,027.10$ STR 626-00-54I MDM LINER 2,885.00$ 2,019.50$ STR 6260-9-128 REV LFIT FEM HEAD 2,355.00$ 1,648.50$ STR 6481-2-140 REV TIB SLEEVE 432.00$ 302.40$ STR 6481-3-210 REV TIBIAL INSERT 432.00$ 302.40$ STR 6495-1-101 REV PROX FEM COMP 3,257.00$ 2,279.90$ STR 6495-2-105 REV BUSHING 432.00$ 302.40$ STR 6495-6-100 REV EXT PIECE 432.00$ 302.40$ STR 6570-0-128 REV FEMORAL HEAD 4,745.00$ 3,321.50$ STR 6573XX 3.5 LOCKING SCREW 453.00$ 317.10$ STR 6574XX 3.5 NON-LOCKING SCREW 453.00$ 317.10$ STR 661170 LOCKING 5.0 SCREW 523.00$ 366.10$ STR 6704-0-510 CABLE & SLEEVE 288.00$ 201.60$ STR 6704-3-092 REV PLATE W/CABLES 4,452.00$ 3,116.40$ STR 6720-0435 WASTED ANG HIP STEM 2,496.00$ 1,747.20$ STR 6720-0435 WASTED ANG HIP STEM 9,402.00$ 6,581.40$ STR 6721-0230 REV HIP STEM 12,551.00$ 8,785.70$

STR 7770230 CANCELLOUS1-4MM 30CC 14.00$ 9.80$ STR 7770230 CANCELLOUS1-4MM 30CC 759.00$ 531.30$ STR CAP HEMI ARTHRO DEMAND 2,528.80$ 1,770.16$ STR CAP HEMI ARTHRO DEMAND 7,125.00$ 4,987.50$ STR CAP HIP REV CUP 11,115.00$ 7,780.50$ STR CAP THA 350.00$ 245.00$ STR CAP THA 13,000.00$ 9,100.00$ STR CAP TOT HIP WASTED HEX SCREW 274.00$ 191.80$ STR CAP TOTAL HIP X3 INSERT 1,005.00$ 703.50$ STR CAP UP CHARGE MDM X 3 1,985.63$ 1,389.94$ STR CAT02969 PIVOT ANCHOR 741.00$ 518.70$ STR CAT02969 PIVOT ANCHOR 1,407.00$ 984.90$ STR SPI COMP ANT CERVICAL CAGE 3,100.00$ 2,170.00$ STR SPI COMP PED 2 OR 3 PART SCRW 2,931.00$ 2,051.70$ STR SPI COMP ROD LESS THAN 300MM 670.00$ 469.00$ STR SPI COMP TPLIF/TLIF CAGE 8,550.00$ 5,985.00$ STR SPI COMP WASTED CERV SCREW 628.00$ 439.60$ STRUT CORTICAL >=180MM 2,033.00$ 1,423.10$ STRYKER 2000 BATTERY DRILL 220.00$ 154.00$ SUL BAK CAGES 30001724 185.00$ 129.50$ SUL BAK CAGES 30001724 2,811.00$ 1,967.70$ SUM 04.632.000 TITANIUM CAP 503.00$ 352.10$ SUR SURGIFLO 395.00$ 276.50$ SURGERY 599.00$ 419.30$ SURGERY 1,005.00$ 703.50$ SURGICEL 4X8 5,105.00$ 3,573.50$ SURGI-CLIP II [13.0]-LARGE 2,855.00$ 1,998.50$ SURGIFLO NO THROMBIN 395.00$ 276.50$ SURGIFLO NO THROMBIN 570.00$ 399.00$ SURGIGUT 2-0 G-3 756.00$ 529.20$ SURGIPRO 0 CP-454 15,855.00$ 11,098.50$ SURGITEK SURLOK HELICAL BASKETS 3 5,104.00$ 3,572.80$ SURGITER WMINA GUIDEWIRE 5,105.00$ 3,573.50$ SURGIWAND 3,307.00$ 2,314.90$ SYN 02.001.306 4.5 LCP CRVD CON P 5,701.00$ 3,990.70$ SYN 02.001.322 4.5 LCP CVD CON PL 5,959.00$ 4,171.30$ SYN 02.001.324 LCP 4.5 CVD COND P 6,084.00$ 4,258.80$ SYN 02.001.326 4.5 LCP CRVD CON P 5,701.00$ 3,990.70$ SYN 02.102.001 UNI LCK STAB PLATE 2,528.00$ 1,769.60$ SYN 02.104.010 LCP EX-ART DIS H P 3,015.00$ 2,110.50$ SYN 02.104.010 LCP EX-ART DIS H P 5,584.00$ 3,908.80$ SYN 02.111.521 2.4MM VA-LCP PLATE 3,415.00$ 2,390.50$ SYN 02.111.620 VA-LCP PLATE 3,415.00$ 2,390.50$ SYN 02.111.621 LOC DIST RAD PL LT 3,415.00$ 2,390.50$ SYN 02.112.027 SUPERIOR PLATE 3,213.00$ 2,249.10$ SYN 02.112.08X LCP SUP CLAV PLATE 3,213.00$ 2,249.10$ SYN 02.112.138 PLATE 4 HOLE RT 2,349.00$ 1,644.30$

SYN 02.112.515 PLATE 6 HOLE 135.00$ 94.50$ SYN 02.112.515 PLATE 6 HOLE 4,979.00$ 3,485.30$ SYN 02.118.520 2.7MM SCR SELF-TAP 3,015.00$ 2,110.50$ SYN 02.123.021 LCP HUMEROUS PLATE 5,416.00$ 3,791.20$ SYN 02.124.201 PROX TIBIA PLATE 5,048.00$ 3,533.60$ SYN 02.124.209 LCP LOW BEND PRTPL 5,168.00$ 3,617.60$ SYN 02.205.070 CANN-LCK SCREW 153.00$ 107.10$ SYN 02.205.070 CANN-LCK SCREW 777.00$ 543.90$ SYN 02.205.275 CONICAL SCREW 784.00$ 548.80$ SYN 02.207.100 7.3 LCK CANN SCR 197.00$ 137.90$ SYN 02.207.100 7.3 LCK CANN SCR 1,120.00$ 784.00$ SYN 02.210.118 VA LOCK SCREW 521.00$ 364.70$ SYN 02.211.255 VA-LCP PLATE 6,771.00$ 4,739.70$ SYN 02.221.510 5.0 LOCKING SCREW 815.00$ 570.50$ SYN 02.221.510 5.0 LOCKING SCREW 1,173.00$ 821.10$ SYN 04.004.346S CANN TIBIAL NAIL 2,834.00$ 1,983.80$ SYN 04.004.346S CANN TIBIAL NAIL 5,171.00$ 3,619.70$ SYN 04.004.546S TI CANN TIB NAIL 5,171.00$ 3,619.70$ SYN 04.005.424 LOCK SCREW 1,568.00$ 1,097.60$ SYN 04.037.0XXS 10/130 TFNA NAIL 5,938.00$ 4,156.60$ SYN 04.037.112S TFNA NAIL 11MM 2,848.00$ 1,993.60$ SYN 04.037.112S TFNA NAIL 11MM 5,938.00$ 4,156.60$ SYN 04.037.242S 12X170MM TIB NAIL 265.00$ 185.50$ SYN 04.037.242S 12X170MM TIB NAIL 5,938.00$ 4,156.60$ SYN 04.037.258S TFNA 12MM 7,651.00$ 5,355.70$ SYN 04.038.095S TFNA SCREW 2,922.00$ 2,045.40$ SYN 04.038.105 TFNA SCREW 2,692.00$ 1,884.40$ SYN 04.038.110S TFNA SCREW 278.69$ 195.08$ SYN 04.038.110S TFNA SCREW 2,922.00$ 2,045.40$ SYN 04.038.295S TRNA HELICAL BLD 3,066.00$ 2,146.20$ SYN 04.613.140 PLATE 1,012.00$ 708.40$ SYN 04.613.140 PLATE 2,144.00$ 1,500.80$ SYN 04.613.245 VECTRA PLATE 65.00$ 45.50$ SYN 04.613.245 VECTRA PLATE 4,126.00$ 2,888.20$ SYN 04.620.000 CAP 810.00$ 567.00$ SYN 04.632.001 TIT POLYAXIAL HEAD 1,340.00$ 938.00$ SYN 04.632.645 MATRIX SCREW 2,555.00$ 1,788.50$ SYN 04.639.XXX MATRIX SCREW 2,010.00$ 1,407.00$ SYN 07.801.101.99S CHRONOS STRIP 3,009.00$ 2,106.30$ SYN 07.801.200.99S CHRONOS STRIPS 2,235.00$ 1,564.50$ SYN 08.804.139 TPLIF PEEK 668.00$ 467.60$ SYN 08.804.139 TPLIF PEEK 6,669.00$ 4,668.30$ SYN 207 650 4.0 CANNULATED SCREW 754.00$ 527.80$ SYN 207.750 4.0 CANN SCREW 754.00$ 527.80$ SYN 208.410 6.5MM CANN SCREW 996.00$ 697.20$ SYN 208.431 CANNULATED SCREW 996.00$ 697.20$ SYN 208.8XX 7.3-16MM SCREW 990.15$ 693.11$

SYN 209.XXX 7.3 CANN SCREW FT 990.00$ 693.00$ SYN 212 125 3.5 LOCK SCREW 481.00$ 336.70$ SYN 212.327 3.5 CONICAL SCREW 527.00$ 368.90$ SYN 212.327 3.5 CONICAL SCREW 2,848.00$ 1,993.60$ SYN 212.425 3.5 CONICAL SCREW 527.00$ 368.90$ SYN 214.836 CORTEX SCREW 4.5MM 353.00$ 247.10$ SYN 219.953S SPHERICAL WASHER LG 766.00$ 536.20$ SYN 222 561 5.0 CANN CONE SCREW 10,614.00$ 7,429.80$ SYN 222.661 LCP 4.5 CONDYLAR PLT 5,781.00$ 4,046.70$ SYN 223.561 6 HOLE DC PLATE 1,198.00$ 838.60$ SYN 223.581 3.5MM LCP PLATE 8 HL 1,310.00$ 917.00$ SYN 239.904 MED DIST TIB PLATE 5,394.00$ 3,775.80$ SYN 239.954 PROXIMAL TIBIA PLAT 5,032.00$ 3,522.40$ SYN 241.351 LCP PLATE 647.75$ 453.43$ SYN 241.36 6 HOLE TUBULAR PLATE 8.00$ 5.60$ SYN 241.36 6 HOLE TUBULAR PLATE 1,482.00$ 1,037.40$ SYN 241.401 PLATE 10 HOLE 697.00$ 487.90$ SYN 241.401 PLATE 10 HOLE 2,848.00$ 1,993.60$ SYN 242 510 WRIST PLATE 506.00$ 354.20$ SYN 282.235 HELIX BLADE 1,320.29$ 924.20$ SYN 282.631 DHHS SIDEPLATE 2,228.00$ 1,559.60$ SYN 282.641 LCP DHHS SIDEPLATE 2,228.00$ 1,559.60$ SYN 282.677S LCP SHORT BARREL 2,415.00$ 1,690.50$ SYN 292.12 K WIRE 239.00$ 167.30$ SYN 292.12 K WIRE 340.00$ 238.00$ SYN 294.950 FIXATION PIN 556.00$ 389.20$ SYN 294.950 FIXATION PIN 17,374.00$ 12,161.80$ SYN 390.002 LG EX-FIX MULTI PIN 3,115.00$ 2,180.50$ SYN 390.003 CLAMP 1,745.00$ 1,221.50$ SYN 390.004 LR EX-FIX MULTI PIN 2,916.00$ 2,041.20$ SYN 390.005 LG COMBO CLAMP 1,126.00$ 788.20$ SYN 390.005 LG COMBO CLAMP 2,723.00$ 1,906.10$ SYN 390.008 LG ADJUST CLAMP 2,257.00$ 1,579.90$ SYN 394.82 ROD 933.00$ 653.10$ SYN 394.84 CARBON ROD 719.00$ 503.30$ SYN 394.87 11.0 CARBON ROD 1,100.00$ 770.00$ SYN 405 514 T1 AXON CANC SCREW 5,556.00$ 3,889.20$ SYN 405 514 T1 AXON CANC SCREW 20,732.00$ 14,512.40$ SYN 443 61 96 2.0 CONDY PLATE 1,012.00$ 708.40$ SYN 446.612 TIT Y-PLATE 1.5MM 872.00$ 610.40$ SYN 458.936 36MM LOCKING SCREW 691.00$ 483.70$ SYN 475.920 ELASTIC NAIL 305.11$ 213.58$ SYN 475.920 ELASTIC NAIL 1,611.00$ 1,127.70$ SYN 498 351 PEDICLE HOOK 4,906.00$ 3,434.20$ SYN 498 745 7.0 SCREW 100.00$ 70.00$ SYN 498.139 ROD 810.00$ 567.00$ SYN 498.57 LOCKING CAP 662.00$ 463.40$

SYN 498.57 LOCKING CAP 3,037.00$ 2,125.90$ SYN MOD HAND 2.4 TIT T-PLATE 1,019.00$ 713.30$ SYN SPI COMP ANT CERV L3 PL,SC,CO 94.00$ 65.80$ SYN SPI COMP ANT CERV L3 PL,SC,CO 14,521.00$ 10,164.70$ SYS MOD HIP 155MM X 17MM 8,903.00$ 6,232.10$ SYS MOD HIP 21MM X +0 V40 11,012.00$ 7,708.40$ SYSTEM CONFIDENCE SPINAL CEMENT 3,552.00$ 2,486.40$ TENDON PERONEUS (LIFELINK) 180.00$ 126.00$ TENDON POSTERIOR TIBIALIS 1650 180.00$ 126.00$ TIBIA 5DEG STEMMED LEFT SZ H 6,621.00$ 4,634.70$ TIBIA 5DEG STEMMED LT SZ C 10,522.00$ 7,365.40$ TIBIA 5DEG STEMMED RT SZ F 10,522.00$ 7,365.40$ TIBIA 5DEG STEMMED RT SZ G 10,522.00$ 7,365.40$ TIBIA CEMENTD 5DEG STEMMED RT SZC 10,522.00$ 7,365.40$ TIBIA CEMENTED 5DEG LT SZ G 10,522.00$ 7,365.40$ TIBIA CEMENTED 5DEG STEMMED SZ E 10,522.00$ 7,365.40$ TIBIA PERSONA 5DEG STEM LT SZ E 10,522.00$ 7,365.40$ TIBIA PERSONA 5DEG STEM RT SZ D 9,422.00$ 6,595.40$ TIBIA STEMMED 5DEG LEFT SZ F 10,522.00$ 7,365.40$ TIBIA STEMMED 5DEG LT SZ D 10,522.00$ 7,365.40$ TIGHTROPE ACL MPFL 5,230.00$ 3,661.00$ TIGHTROPE ACL RIGHT 1,169.00$ 818.30$ TIGHTROPE BTB 1,469.00$ 1,028.30$ TIGHTROPE XP 154.00$ 107.80$ TIT SPI COMP CERVICAL CAGE 3,100.00$ 2,170.00$ TOR CAP COMP REVERSE SHOULDER 18,500.00$ 12,950.00$ TOR DWF522 ASCEND FLEX ECC REVSD 6,530.00$ 4,571.00$ TRA SHILEY DCT 369.00$ 258.30$ TRA TRACH TUBE 110MM 326.00$ 228.20$ TRA TRACH TUBE 110MM 4,718.00$ 3,302.60$ TRACE PACK 3,372.00$ 2,360.40$ TRAY,CANNULATED SCREW 6.5-8.0MM 3,372.00$ 2,360.40$ TRAY,COMMAND SYS,STARTER SET 715.00$ 500.50$ TRAY,DEPUY 4.5MM DISTAL SCREWS 1,278.00$ 894.60$ TRAY,DEPUY 4.5MM DISTAL SCREWS 1,508.00$ 1,055.60$ TRAY,DR FRY LAMI 297.00$ 207.90$ TRAY,INNOVATION HAND 928.00$ 649.60$ TRAY,LEIBINGER/CMF 2,624.00$ 1,836.80$ TRAY,OSTEONICS ACETABULAR REAMERS 1,557.00$ 1,089.90$ TRAY,PELVISCOPY 3,663.00$ 2,564.10$ TRAY,RECON PLATES & BENDERS 1,682.00$ 1,177.40$ TRAY,STANDARD PLATES 862.00$ 603.40$ TRAY,SYNTHES COMPACT AIR DRIVE II 1,100.00$ 770.00$ TRAY,WINQUIST UNIV EXTRACTION #2 905.00$ 633.50$ TROCAR, THORACIC FLEXIPATH 2,297.00$ 1,607.90$ TROCHLEAR LRG RT OXINIUM 12,219.00$ 8,553.30$ TROCHLEAR LRG RT OXL PFJ 12,219.00$ 8,553.30$

TUBE 1.27MM FLUOPLASTIC/TITAN. 210.00$ 147.00$ TUBE EAR SIL COLLAR 185.00$ 129.50$ TUBE EAR SILICONE 1.14 PAPARELLA 551.00$ 385.70$ ULR CS2250-1446-6 SMALL VBR 96.00$ 67.20$ UNIVENT ETT 7.5 5,105.00$ 3,573.50$ UNIVENT ETT 8.0 5,105.00$ 3,573.50$ URETEROSCOPE 2,350.00$ 1,645.00$ URETHROTOME 618.40$ 432.88$ URETHROTOME 8,111.00$ 5,677.70$ VAL 31-15520 APOLLO KNOTLESS ANCH 1,005.00$ 703.50$ VASCULAR CLOSURE DEVICE 1,416.00$ 991.20$ VENA CAVA FILTER 6,915.00$ 4,840.50$ VIVACIT-E FEMUR LT 100MM SZ 8-11 4,650.00$ 3,255.00$ VIVACIT-E FEMUR RT 10MM SZ 6-7 4,650.00$ 3,255.00$ VIVACIT-E LEFT 13MM HT SZ 6-7 4,650.00$ 3,255.00$ VIVACIT-E RT 10MM HT SZ 6-7 4,650.00$ 3,255.00$ WALLSTENT,ESOPHAGEAL 5,714.00$ 3,999.80$ WRI 2496KTXL EVOLVE RADIAL HEAD 5,588.00$ 3,911.60$ WRI 495 H426 RADIAL HEAD 265.00$ 185.50$ WRI 495 H426 RADIAL HEAD 623.00$ 436.10$ X SCAN 5,097.00$ 3,567.90$ ZAV SPI COMP CERV PLT 3&4 LEVEL 3,100.00$ 2,170.00$ ZIM 00 1113 140 01 PALACOS R 903.74$ 632.62$ ZIM 00-4894-050-15 REV ACE AUG 6,928.00$ 4,849.60$ ZIM 00-4894-300-00 REV ACE SYSTEM 3,057.00$ 2,139.90$ ZIM 00-5972-066-29 REV PATELLA 374.00$ 261.80$ ZIM 00-7000-062-20 ACE REV SHELL 9,374.00$ 6,561.80$ ZIM 00-7864-015-00 REV STEM 13,935.00$ 9,754.50$ ZIM 2232-02-04 REV CABLES 1,328.00$ 929.60$ ZIM 2232-04-18 CABLE READY 1,161.00$ 812.70$ ZIM 2232-04-18 REV CABLE W/CRIMP 1,155.65$ 808.95$ ZIM 2252 01 05 NAIL END CAP 1,198.00$ 838.60$ ZIM 32 6732 90 01 LINER 265.00$ 185.50$ ZIM 32 6732 90 01 LINER 12,123.00$ 8,486.10$ ZIM 32-8105-27-01 TOT ELB PN/BUSH 3,410.00$ 2,387.00$ ZIM 42-5221-008-10 REV ART SURFAC 5,712.00$ 3,998.40$ ZIM 5001-53 REV BIPOLAR CUP 2,287.00$ 1,600.90$ ZIM 5880-03 REV TIBIAL COMP 312.00$ 218.40$ ZIM 5880-03 REV TIBIAL COMP 2,037.00$ 1,425.90$ ZIM 5880-40-17 REV ART SURFACE 312.00$ 218.40$ ZIM 6202-54-20 REV SHELL 359.00$ 251.30$ ZIM 6202-54-20 REV SHELL 7,461.00$ 5,222.70$ ZIM 62506535 REV SELF TAP SCREW 257.00$ 179.90$ ZIM 62506535 REV SELF TAP SCREW 424.00$ 296.80$ ZIM 90 5970 50 10 ART SURFACE 20,732.00$ 14,512.40$ ZIM 9981 150 32 FEM STEM 12,232.00$ 8,562.40$ ZIM CAP ALL TOTAL KNEES 12,113.00$ 8,479.10$

ZIM PROX CENTRALIZER 78581257 185.00$ 129.50$ ZIM PROX CENTRALIZER 78581257 3,522.00$ 2,465.40$ ZIM REV 5001-23-28 LINER 1,408.00$ 985.60$ ZIM TOT HIP W/REV STEM + CUP 359.00$ 251.30$ ZIM TOT HIP W/REV STEM + CUP 4,340.00$ 3,038.00$ ZIM VITAMIN E POLY 1,005.00$ 703.50$ ZIMMER 4.5 QUATTRO ANC CM-9145SP 1,307.00$ 914.90$ ZZ BR I-125 READI-LOADED 53.00$ 37.10$ ZZ BR I-125 SEEDS STRANDED 67.00$ 46.90$ BLOOD BANK DIVIDED PROD TRANS 718.00$ 502.60$ ETHANOL (ALCOHOL)BREATH 115.00$ 80.50$ INFLUENZA DNA/AMP PROBE 817.00$ 571.90$ LAB TEST A1C CONFIRMATION 92.00$ 64.40$ LAB TEST ANGIOTENSIN CSF 140.00$ 98.00$ LAB TEST ANTINUCLEAR AB 107.00$ 74.90$ LAB TEST ASSAY NONENDOCRINE RECEP 316.00$ 221.20$ LAB TEST B SUBSET 362.00$ 253.40$ LAB TEST COLD AGGLTN SCREEN 64.00$ 44.80$ LAB TEST COLD AGGLTN TEST, INDIR 747.00$ 522.90$ LAB TEST DRUG SCR QUANT ZONISAMDE 127.00$ 88.90$ LAB TEST F2 GENE 147.73$ 103.41$ LAB TEST F5 GENE 159.70$ 111.79$ LAB TEST FOLATE ACID RBC 166.00$ 116.20$ LAB TEST GENERAL HEALTH PANEL 112.00$ 78.40$ LAB TEST H PYLORI BREATH 642.00$ 449.40$ LAB TEST HFE GENE 375.00$ 262.50$ LAB TEST IRRADIATION OF BLOOD 221.00$ 154.70$ LAB TEST LEPTIN 199.00$ 139.30$ LAB TEST MOLECULAR RBC PHENO 551.00$ 385.70$ LAB TEST NEUROLOGICAL SYNDROME AB 190.00$ 133.00$ LAB TEST NEURON SPECIFIC CSF 200.00$ 140.00$ LAB TEST PARANEOPLASTIC AB 116.00$ 81.20$ LAB TEST PHENYLALANINE BLOOD 48.00$ 33.60$ LAB TEST PYRUVATE CSF 104.00$ 72.80$ LAB TEST RSV 674.00$ 471.80$ LAB TEST SHIGA LIKE TOXIN 104.00$ 72.80$ LAB TEST SIROLIMUS 132.00$ 92.40$ LAB TEST STREP B DNA AMP PROBE 337.00$ 235.90$ LAB TEST THAWING BLOOD PRODUCT 1,518.00$ 1,062.60$ LAB TEST VENIPUNCTURE 21.00$ 14.70$ LAB TEST VENIPUNCTURE 21.00$ 14.70$ LAB TEST VOLTAGE GATED POTASSIUM 130.00$ 91.00$ LAB TEST WEST NILE QUAL BLD 337.00$ 235.90$ STREP A AMPLIF NA PROBE 337.00$ 235.90$ CLOZARIL (CLOZAPINE) 80154 124.00$ 86.80$ LAB TEST ACETONE ASSAY 78.00$ 54.60$ LAB TEST ACTH 371.00$ 259.70$

LAB TEST ALANINE AMINO 50.00$ 35.00$ LAB TEST ALBUMIN BODY FLUID 47.49$ 33.24$ LAB TEST ALBUMIN SERUM 47.00$ 32.90$ LAB TEST ALDOLASE 93.00$ 65.10$ LAB TEST ALDOSTERONE 391.00$ 273.70$ LAB TEST ALKALINE PHOSPHATASE 49.00$ 34.30$ LAB TEST ALKALINE PHOSPHATASE ISO 142.00$ 99.40$ LAB TEST ALLERGY SPECIFIC IGG 72.00$ 50.40$ LAB TEST ALPHA 1 ANTITRYPSIN 163.00$ 114.10$ LAB TEST ALPHA 1 ANTITRYPSIN PHNO 154.00$ 107.80$ LAB TEST ALPHA FETOPROTEIN L3 532.00$ 372.40$ LAB TEST ALPHA FETOPROTEIN SERUM 161.00$ 112.70$ LAB TEST ALUMINUM SERUM 245.00$ 171.50$ LAB TEST AMINOLEVULINIC ACID 158.00$ 110.60$ LAB TEST AMMONIA 139.00$ 97.30$ LAB TEST AMNIOTIC FLUID PROTEIN 354.00$ 247.80$ LAB TEST AMYLASE 62.00$ 43.40$ LAB TEST ANABOLIC STEROID 366.00$ 256.20$ LAB TEST ANALGESICS NON-OPIOID 769.34$ 538.54$ LAB TEST ANDROSTENEDIONE 281.00$ 196.70$ LAB TEST APOLIPOPROTEIN EACH 149.00$ 104.30$ LAB TEST ARSENIC 182.00$ 127.40$ LAB TEST ARTERIAL BLOOD GAS 184.00$ 128.80$ LAB TEST ASPARTATE AMINO 49.00$ 34.30$ LAB TEST ASSAY OF VOLATILES 154.00$ 107.80$ LAB TEST BASIC METABOLIC PANEL 81.00$ 56.70$ LAB TEST BETA 2 MICROGLOBULIN 155.00$ 108.50$ LAB TEST BILE ACID TOTAL 234.00$ 163.80$ LAB TEST CADMIUM 222.00$ 155.40$ LAB TEST CALCITONIN SERUM 257.00$ 179.90$ LAB TEST CALCIUM IONIZED 130.00$ 91.00$ LAB TEST CALCIUM URINE 24 HOUR 57.00$ 39.90$ LAB TEST CALPROTECTIN FECAL 268.00$ 187.60$ LAB TEST CARBAMAZEPINE 139.00$ 97.30$ LAB TEST CARBOXYHEMOGLOBIN 117.00$ 81.90$ LAB TEST CARNITINE (TOTAL & FREE) 162.00$ 113.40$ LAB TEST CATECHOLAMINES PLASMA 242.00$ 169.40$ LAB TEST CEA 181.00$ 126.70$ LAB TEST CERULOPLASMIN 103.00$ 72.10$ LAB TEST CHLORIDE OTHER SOURCE 47.00$ 32.90$ LAB TEST CHLORIDE URINE 48.00$ 33.60$ LAB TEST CHOLINESTERASE RBC 74.00$ 51.80$ LAB TEST CHROMIUM 279.00$ 195.30$ LAB TEST CITRATE 267.00$ 186.90$ LAB TEST COLLAGEN CROSS LINKS 179.00$ 125.30$ LAB TEST COLUMN CHROMOTOGRAPHY 173.00$ 121.10$ LAB TEST COMP METABOLIC PANEL 101.00$ 70.70$

LAB TEST COMPLEMENT AG 115.00$ 80.50$ LAB TEST COPPER 119.00$ 83.30$ LAB TEST CORTICOSTERONE 216.00$ 151.20$ LAB TEST CORTISOL FREE 160.00$ 112.00$ LAB TEST CORTISOL TOTAL 157.00$ 109.90$ LAB TEST C-PEPTIDE 200.00$ 140.00$ LAB TEST CPK ISOENZYMES 189.00$ 132.30$ LAB TEST CPK TOTAL 62.00$ 43.40$ LAB TEST CREATININE CLEARANCE 90.00$ 63.00$ LAB TEST CREATININE OTHER SOURCE 49.00$ 34.30$ LAB TEST CREATININE SERUM 49.00$ 34.30$ LAB TEST CRYOGLOBULIN 75.93$ 53.15$ LAB TEST CYCLOSPORINE BLOOD 173.00$ 121.10$ LAB TEST CYSTIC FIBROSIS SCREEN 789.00$ 552.30$ LAB TEST CYTOGEN MICROARRAY SNP 600.00$ 420.00$ LAB TEST DESIPRAMINE QUANT 115.00$ 80.50$ LAB TEST DHEA 243.00$ 170.10$ LAB TEST DHEA SULFATE 214.00$ 149.80$ LAB TEST DIGOXIN 126.00$ 88.20$ LAB TEST DILANTIN/PHENYTOIN 126.00$ 88.20$ LAB TEST DIRECT BILIRUBIN 48.00$ 33.60$ LAB TEST DOXEPIN QUANT 123.50$ 86.45$ LAB TEST DRUG SCREEN 143.00$ 100.10$ LAB TEST ELECTROLYTE PANEL 67.00$ 46.90$ LAB TEST ERYTHROPOIETIN 180.00$ 126.00$ LAB TEST ESTRADIOL 268.00$ 187.60$ LAB TEST ESTRIOL 232.00$ 162.40$ LAB TEST FAT/LIPIDS FECES 49.00$ 34.30$ LAB TEST FERRITIN 130.00$ 91.00$ LAB TEST FETAL FIBRONECTIN 354.00$ 247.80$ LAB TEST FMR1 GENE DETECTION 600.00$ 420.00$ LAB TEST FOLATE ACID 140.00$ 98.00$ LAB TEST FSH 177.00$ 123.90$ LAB TEST G6PD SCREEN 58.00$ 40.60$ LAB TEST GAMMA 69.00$ 48.30$ LAB TEST GASTRIN 250.00$ 175.00$ LAB TEST GENTAMICIN 156.00$ 109.20$ LAB TEST GLUCOSE 37.00$ 25.90$ LAB TEST GLUCOSE 3.20$ 2.24$ LAB TEST GLUCOSE 45.00$ 31.50$ LAB TEST GLUCOSE ADDITIONAL 37.00$ 25.90$ LAB TEST GLUCOSE FLUID 37.00$ 25.90$ LAB TEST GLUCOSE TOLERANCE TEST 99.00$ 69.30$ LAB TEST GLYCATED PROTEIN 145.00$ 101.50$ LAB TEST HAPTOGLOBIN 121.00$ 84.70$ LAB TEST HCG QUAL 72.00$ 50.40$ LAB TEST HCG QUANT 134.00$ 93.80$

LAB TEST HEAVY METAL 302.00$ 211.40$ LAB TEST HEMOGLOBIN 173.00$ 121.10$ LAB TEST HEPATITIS ACUTE PANEL 454.66$ 318.27$ LAB TEST HEPATITIS C AB 137.00$ 95.90$ LAB TEST HISTAMINE 284.00$ 198.80$ LAB TEST HOMOCYSTEINE 161.00$ 112.70$ LAB TEST HOMOVANILLIC ACID 264.00$ 184.80$ LAB TEST HUMAN GROWTH HORMONE 160.00$ 112.00$ LAB TEST HYDROXYINDOLACETIC ACID 124.00$ 86.80$ LAB TEST HYDROXYPROGESTERONE 261.00$ 182.70$ LAB TEST IGA/IGD/IGG/IGM SERUM 64.00$ 44.80$ LAB TEST IGE SERUM 158.00$ 110.60$ LAB TEST IGG 77.00$ 53.90$ LAB TEST IMMUNOASSAY QUANTITATIVE 124.00$ 86.80$ LAB TEST IRON 54.00$ 37.80$ LAB TEST IRON BINDING CAPACITY 67.00$ 46.90$ LAB TEST LACTATE DEHYDROGENASE 57.00$ 39.90$ LAB TEST LACTIC ACID 102.00$ 71.40$ LAB TEST LEAD 116.00$ 81.20$ LAB TEST LEVETIRACETAM 127.00$ 88.90$ LAB TEST LIPASE 66.00$ 46.20$ LAB TEST LIPID PROFILE 128.00$ 89.60$ LAB TEST LIPOPROTEIN (A) 124.00$ 86.80$ LAB TEST LIPOPROTEIN BLD HR FRACT 238.00$ 166.60$ LAB TEST LIPOPROTEIN BY NMR 303.00$ 212.10$ LAB TEST LIPOPROTEIN HDL 78.00$ 54.60$ LAB TEST LIPOPROTEIN LDL 91.00$ 63.70$ LAB TEST LITHIUM 63.00$ 44.10$ LAB TEST LIVER PROFILE 78.00$ 54.60$ LAB TEST LUTEINIZING HORMONE 176.00$ 123.20$ LAB TEST MAGNESIUM 64.00$ 44.80$ LAB TEST MANGANESE 88.57$ 62.00$ LAB TEST MASS SPECTROMETRY 173.00$ 121.10$ LAB TEST MB FRACTION 110.00$ 77.00$ LAB TEST MERCURY 156.00$ 109.20$ LAB TEST METANEPHRINES 163.00$ 114.10$ LAB TEST METHEMOGLOBIN 70.00$ 49.00$ LAB TEST MICROALBUMIN URINE 55.00$ 38.50$ LAB TEST MTHFR GENE ANALYSIS 235.00$ 164.50$ LAB TEST MYELIN BASIC PROTEIN CSF 165.00$ 115.50$ LAB TEST MYOGLOBIN 124.00$ 86.80$ LAB TEST NATRIURETIC PEPTIDE 323.00$ 226.10$ LAB TEST NEPHELOMETRY EA ANALYTE 131.00$ 91.70$ LAB TEST NICOTINE/COTININE 158.00$ 110.60$ LAB TEST NUCLEOTIDASE 107.00$ 74.90$ LAB TEST OCCULT BLOOD OTHR SOURCE 31.00$ 21.70$ LAB TEST OCCULT BLOOD SAMPLE 153.00$ 107.10$

LAB TEST OCCULT BLOOD SCREEN 31.00$ 21.70$ LAB TEST OCCULT BLOOD SCREEN 31.00$ 21.70$ LAB TEST OLIGOCLONAL BANDS 193.00$ 135.10$ LAB TEST ONCOPROTEIN 526.00$ 368.20$ LAB TEST ORGANIC ACID 158.00$ 110.60$ LAB TEST ORGANIC ACID SINGLE QUAN 158.00$ 110.60$ LAB TEST OSMOLALITY 63.00$ 44.10$ LAB TEST OSMOLALLITY URINE 65.00$ 45.50$ LAB TEST OXALIC ACID RANDOM URINE 124.00$ 86.80$ LAB TEST PANCREATIC ELASTASE 157.00$ 109.90$ LAB TEST PARATHORMONE 393.00$ 275.10$ LAB TEST PH BODY FLUID 34.00$ 23.80$ LAB TEST PHENOBARBITAL 109.00$ 76.30$ LAB TEST PHOSPHORUS 45.00$ 31.50$ LAB TEST PHOSPHORUS URINE 49.00$ 34.30$ LAB TEST PLASMA HEMOGLOBIN 70.00$ 49.00$ LAB TEST PORPHOBILINOGEN URINE 81.00$ 56.70$ LAB TEST PORPHYRINS URINE 141.00$ 98.70$ LAB TEST POTASSIUM 44.00$ 30.80$ LAB TEST POTASSIUM URINE 41.00$ 28.70$ LAB TEST PREALBUMIN 139.00$ 97.30$ LAB TEST PREGNENOLONE 197.00$ 137.90$ LAB TEST PRIMIDONE 159.00$ 111.30$ LAB TEST PROGESTERONE 200.00$ 140.00$ LAB TEST PROLACTIN 186.00$ 130.20$ LAB TEST PROTEIN BODY FLUID 35.00$ 24.50$ LAB TEST PROTEIN ELECTRO FRACTION 103.00$ 72.10$ LAB TEST PROTEIN OTHER FLUIDS 171.00$ 119.70$ LAB TEST PROTEIN TOTAL 35.00$ 24.50$ LAB TEST PROTEIN TOTAL 46.00$ 32.20$ LAB TEST PROTEIN TOTAL URINE 35.00$ 24.50$ LAB TEST PSA FREE 175.00$ 122.50$ LAB TEST PSA SCREENING 175.00$ 122.50$ LAB TEST PSA TOTAL 175.00$ 122.50$ LAB TEST QUANTITATIVE ASSAY DRUG 132.00$ 92.40$ LAB TEST RENAL PANEL 83.00$ 58.10$ LAB TEST RENIN 211.00$ 147.70$ LAB TEST SELENIUM 243.00$ 170.10$ LAB TEST SEROTONIN 436.00$ 305.20$ LAB TEST SEX HORMONE BINDING 306.00$ 214.20$ LAB TEST SODIUM BODY FLUID 46.00$ 32.20$ LAB TEST SODIUM SERUM 46.00$ 32.20$ LAB TEST SODIUM URINE 46.00$ 32.20$ LAB TEST SOMATOMEDIN 204.00$ 142.80$ LAB TEST SPECTROPHOTOMETRY 67.00$ 46.90$ LAB TEST STONE QUANT ANALYSIS 123.00$ 86.10$ LAB TEST T3 FREE 177.02$ 123.92$

LAB TEST T3 HORMONE 151.99$ 106.39$ LAB TEST T3 REVERSE 151.00$ 105.70$ LAB TEST T3 UPTAKE 62.00$ 43.40$ LAB TEST TACROLIMUS 132.00$ 92.40$ LAB TEST TESTOSTERONE FREE 245.00$ 171.50$ LAB TEST TESTOSTERONE TOTAL 246.00$ 172.20$ LAB TEST THEOPHYLLINE 135.00$ 94.50$ LAB TEST THYROGLOBULIN 170.94$ 119.66$ LAB TEST THYROXINE BINDING 142.00$ 99.40$ LAB TEST THYROXINE FREE 86.00$ 60.20$ LAB TEST THYROXINE TOTAL 66.00$ 46.20$ LAB TEST TOBRAMYCIN 154.00$ 107.80$ LAB TEST TOCOPHEROL ALPHA VIT E 136.00$ 95.20$ LAB TEST TOPIRAMATE 169.00$ 118.30$ LAB TEST TOTAL BILIRUBIN 48.00$ 33.60$ LAB TEST TOTAL CALCIUM 49.00$ 34.30$ LAB TEST TOTAL CHOLESTEROL 41.00$ 28.70$ LAB TEST TOTAL ESTROGEN 208.00$ 145.60$ LAB TEST TOTAL INSULIN 110.00$ 77.00$ LAB TEST TRANSFERRIN 122.00$ 85.40$ LAB TEST TRIGLYCERIDES 55.00$ 38.50$ LAB TEST TROPONIN 94.00$ 65.80$ LAB TEST TSH 160.00$ 112.00$ LAB TEST TSI 488.00$ 341.60$ LAB TEST UNLISTED CHEMISTRY TEST 37.50$ 26.25$ LAB TEST UREA NITROGEN 38.00$ 26.60$ LAB TEST URIC ACID OTHER SOURCE 45.00$ 31.50$ LAB TEST URIC ACID SERUM 43.00$ 30.10$ LAB TEST VALPROIC ACID SERUM 129.00$ 90.30$ LAB TEST VANCOMYCIN 129.00$ 90.30$ LAB TEST VARICELLA ZOSTER AB 124.00$ 86.80$ LAB TEST VIP 486.00$ 340.20$ LAB TEST VITAMIN A 125.50$ 87.85$ LAB TEST VITAMIN B1 224.19$ 156.93$ LAB TEST VITAMIN B12 LEVEL 144.00$ 100.80$ LAB TEST VITAMIN B2 287.00$ 200.90$ LAB TEST VITAMIN B6 270.00$ 189.00$ LAB TEST VITAMIN D,1,25 DIHYDROXY 370.00$ 259.00$ LAB TEST VITAMIN D25 279.00$ 195.30$ LAB TEST VITAMIN NOT SPECIFIED 111.00$ 77.70$ LAB TEST VMA URINE 211.00$ 147.70$ LAB TEST ZINC 133.70$ 93.59$ PROINSULIN 84206 181.70$ 127.19$ SCREEN METABOLIC 52.00$ 36.40$ LAB TEST ADENOVIRUS AB 124.00$ 86.80$ LAB TEST ALLERGY SPECIFIC IGE 72.00$ 50.40$ LAB TEST ANTI DEOXYRIBONUCLEASE 127.00$ 88.90$

LAB TEST ANTI DNA DS 132.00$ 92.40$ LAB TEST ANTI DNA SS 116.00$ 81.20$ LAB TEST ANTI PHOSPHATIDYLSERINE 154.00$ 107.80$ LAB TEST ANTIBODY ID 1,331.00$ 931.70$ LAB TEST ANTIBODY ID LEUKOCYTE AB 109.00$ 76.30$ LAB TEST ANTINUCLEAR ANTIBODIES 127.32$ 89.12$ LAB TEST ASO TITER 70.00$ 49.00$ LAB TEST ASPERGILLUS AB 205.00$ 143.50$ LAB TEST B-2 GLYCOPROTEIN AB EACH 170.00$ 119.00$ LAB TEST BLOOD TYPING ABO 551.00$ 385.70$ LAB TEST BLOOD TYPING AG DONOR 551.00$ 385.70$ LAB TEST BLOOD TYPING RBC AG 551.00$ 385.70$ LAB TEST BLOOD TYPING RH 551.00$ 385.70$ LAB TEST BORDETELLA AB 127.00$ 88.90$ LAB TEST CA 125 198.00$ 138.60$ LAB TEST CA 15-3 200.00$ 140.00$ LAB TEST CA 19-9 200.00$ 140.00$ LAB TEST CARDIOLIPIN AB EACH 244.00$ 170.80$ LAB TEST CCP ANTIBODY 124.00$ 86.80$ LAB TEST COCCIDIOIDES AB 110.00$ 77.00$ LAB TEST COLD AGGLUTININ TITER 77.00$ 53.90$ LAB TEST COMPLEMENT FUNCTION ACT 165.00$ 115.50$ LAB TEST COMPLEMENT TOTAL 195.00$ 136.50$ LAB TEST COOMBS TITER 1,331.00$ 931.70$ LAB TEST C-REACTIVE PROTEIN 49.00$ 34.30$ LAB TEST CROSSMATCH ANTIGLOBULIN 907.00$ 634.90$ LAB TEST CROSSMATCH IMMED SPIN 907.00$ 634.90$ LAB TEST CYTOMEGALOVIRUS AB 138.00$ 96.60$ LAB TEST CYTOMEGALOVIRUS AB 162.00$ 113.40$ LAB TEST DIPHTHERIA AB 209.00$ 146.30$ LAB TEST DIRECT COOMBS 907.00$ 634.90$ LAB TEST ELECTRONIC CROSSMATCH 907.00$ 634.90$ LAB TEST ENA ANY METHOD 171.00$ 119.70$ LAB TEST ENTEROVIRUS AB 125.00$ 87.50$ LAB TEST EPSTEIN BARR VIRUS AB 126.00$ 88.20$ LAB TEST EPSTEIN BARR VIRUS AB 147.00$ 102.90$ LAB TEST FUNGUS AB 118.00$ 82.60$ LAB TEST GIARDIA AB 141.00$ 98.70$ LAB TEST HELICOBACTER PYLORI 165.41$ 115.78$ LAB TEST HELMINTH AB 125.00$ 87.50$ LAB TEST HEPATITIS A AB 119.00$ 83.30$ LAB TEST HEPATITIS A AB IGM 108.00$ 75.60$ LAB TEST HEPATITIS B CORE AB 116.00$ 81.20$ LAB TEST HEPATITIS B CORE AB IGM 113.00$ 79.10$ LAB TEST HEPATITIS B SURFACE AB 103.00$ 72.10$ LAB TEST HEPATITIS B SURFACE AG 98.33$ 68.83$ LAB TEST HEPATITIS BE AB 111.00$ 77.70$

LAB TEST HEPATITIS DELTA AB 165.00$ 115.50$ LAB TEST HERPES SIMPLEX I 127.00$ 88.90$ LAB TEST HERPES SIMPLEX II 186.00$ 130.20$ LAB TEST HETEROPHILE ANTIBODY 49.00$ 34.30$ LAB TEST HISTOPLASMA AB 120.00$ 84.00$ LAB TEST HIV 1+2 SCREEN 229.00$ 160.30$ LAB TEST HIV CONFIRMATION 204.39$ 143.08$ LAB TEST HLA TYPE SGL ANGTIGEN 218.71$ 153.10$ LAB TEST HLA TYPING MULTI ANTIGEN 464.00$ 324.80$ LAB TEST IA INFECTIOUS AGENT AB 30.00$ 21.00$ LAB TEST IMMUNE COMPLEX ASSAY 234.00$ 163.80$ LAB TEST IMMUNODIFFUSION AB/AG 115.00$ 80.50$ LAB TEST IMMUNOFIXATION ELECTRO 215.00$ 150.50$ LAB TEST IMMUNOFIXATION OTHR FLDS 403.00$ 282.10$ LAB TEST INHIBIN A 124.00$ 86.80$ LAB TEST INSULIN AB 206.00$ 144.20$ LAB TEST INTRINSIC FACTOR AB 145.00$ 101.50$ LAB TEST LYMES DISEASE AB 164.00$ 114.80$ LAB TEST MICROSOMAL AB EACH 140.00$ 98.00$ LAB TEST MUMPS ANTIBODY 125.00$ 87.50$ LAB TEST MYCOPLASMA AB 187.00$ 130.90$ LAB TEST NOCARDIA AB 127.00$ 88.90$ LAB TEST PARTICLE AGGLUTINATION 98.00$ 68.60$ LAB TEST PARVOVIRUS AB 144.00$ 100.80$ LAB TEST PLATELET AB 176.00$ 123.20$ LAB TEST PROTOZOA AB 119.00$ 83.30$ LAB TEST QUANTIFERON CONFIRMATION 595.00$ 416.50$ LAB TEST RBC AB SCREEN 551.00$ 385.70$ LAB TEST RHEUMATOID FACTOR 54.00$ 37.80$ LAB TEST RHEUMATOID FACTOR 54.00$ 37.80$ LAB TEST RUBELLA AB 137.00$ 95.90$ LAB TEST RUBEOLA AB 124.00$ 86.80$ LAB TEST SYPHILIS 41.00$ 28.70$ LAB TEST T-CELL TOTAL 362.00$ 253.40$ LAB TEST T-CELLS CD4 & CD8 451.00$ 315.70$ LAB TEST TETANUS AB 203.00$ 142.10$ LAB TEST THYROGLOBULIN AB 169.25$ 118.48$ LAB TEST TOXOPLASMA AB 138.00$ 96.60$ LAB TEST TOXOPLASMA IGM 138.00$ 96.60$ LAB TEST TREPONEMA PALLIDUM 126.00$ 88.20$ LAB TEST UNLISTED TRANSFUSION 21.00$ 14.70$ LAB TEST VIRAL CAPSID AB 174.00$ 121.80$ LAB TEST VIRUS AB OTHER 124.00$ 86.80$ LAB TEST WEST NILE IGG BLOOD 198.00$ 138.60$ LAB TEST WEST NILE IGM BLOOD 232.00$ 162.40$ PL-7 AUTOANTIBODY 157.00$ 109.90$ SKIN TEST TB 212.00$ 148.40$

LAB TEST ACTIVTED PROTEIN C RESIS 147.00$ 102.90$ LAB TEST ANTITHROMBIN III 114.00$ 79.80$ LAB TEST ANTITHROMBIN III 104.00$ 72.80$ LAB TEST AUTO PLATELET COUNT 43.00$ 30.10$ LAB TEST BLOOD SMEAR W/DIFF 33.00$ 23.10$ LAB TEST CBC W/DIFF 74.00$ 51.80$ LAB TEST CLOTTING FACTOR II 125.00$ 87.50$ LAB TEST CLOTTING FACTOR IX 194.50$ 136.15$ LAB TEST CLOTTING FACTOR V 169.00$ 118.30$ LAB TEST CLOTTING FACTOR VII 172.00$ 120.40$ LAB TEST CLOTTING FACTOR VIII 152.00$ 106.40$ LAB TEST CLOTTING FACTOR VIII 220.00$ 154.00$ LAB TEST CLOTTING INHIB PROTEIN C 133.00$ 93.10$ LAB TEST CLOTTING INHIB PROTEIN S 111.00$ 77.70$ LAB TEST CLOTTING PROTEIN S FREE 147.00$ 102.90$ LAB TEST D-DIMER 97.00$ 67.90$ LAB TEST FETAL HGB SCREENING 63.00$ 44.10$ LAB TEST FIBRINOGEN 81.00$ 56.70$ LAB TEST HEMATOCRIT 23.00$ 16.10$ LAB TEST HEMOGLOBIN 23.00$ 16.10$ LAB TEST HEMOGRAM 62.00$ 43.40$ LAB TEST HEPARIN ASSAY 185.00$ 129.50$ LAB TEST KLEIHAUER-BETKE STAIN 74.00$ 51.80$ LAB TEST MURAMIDASE 180.00$ 126.00$ LAB TEST PLATELET FUNCTION ASSAY 205.00$ 143.50$ LAB TEST PROTEIN CLOTTING INHIB 115.00$ 80.50$ LAB TEST PROTIME 37.00$ 25.90$ LAB TEST PTT PLASMA OR WHOLE BLD 57.00$ 39.90$ LAB TEST RETIC COUNT 38.00$ 26.60$ LAB TEST RISTOCETIN CO FACTOR 220.00$ 154.00$ LAB TEST RUSSELL VIPER VENOM 92.00$ 64.40$ LAB TEST SED RATE WESTERGREN 34.00$ 23.80$ LAB TEST VISCOSITY 160.00$ 112.00$ LAB TEST VON WILLEB FACTOR AG 230.67$ 161.47$ LAB TEST AEROBIC ADDL ID 77.00$ 53.90$ LAB TEST AEROBIC STOOL CULTURE 90.00$ 63.00$ LAB TEST AFB SMEAR 56.45$ 39.51$ LAB TEST AG DETECT 165.00$ 115.50$ LAB TEST AGEN NOS ASSAY W/OPTIC 114.00$ 79.80$ LAB TEST ANAEROBIC ADDL ID 77.00$ 53.90$ LAB TEST ANAEROBIC CULTURE 90.00$ 63.00$ LAB TEST BACTERIA CULTURE STOOL 90.00$ 63.00$ LAB TEST BACTERIAL BLOOD CULTURE 98.00$ 68.60$ LAB TEST BACTERIAL CULTURE 82.85$ 58.00$ LAB TEST BACTERIAL CULTURE 82.00$ 57.40$ LAB TEST BARTONELLA DNA 479.00$ 335.30$ LAB TEST C DIFFICILE AMPLIFIED 334.00$ 233.80$

LAB TEST CANDIDA DNA 191.00$ 133.70$ LAB TEST CHLAMYDIA RNA PROBE 334.00$ 233.80$ LAB TEST CMV RAPID CULTURE 188.00$ 131.60$ LAB TEST CONCENTRATION INF AGENT 64.00$ 44.80$ LAB TEST CRYPTOSPORIDIUM AG 115.00$ 80.50$ LAB TEST CULTURE PATH SCREEN 63.00$ 44.10$ LAB TEST CYTOMEGALOVIRUS 411.00$ 287.70$ LAB TEST FUNGUS CULTURE BLOOD 87.00$ 60.90$ LAB TEST FUNGUS CULTURE ONLY 87.98$ 61.59$ LAB TEST GARDNERELLA DNA 191.00$ 133.70$ LAB TEST GRAM STAIN 41.00$ 28.70$ LAB TEST H PYLORI AG STOOL 115.00$ 80.50$ LAB TEST HEPATITIS B QUANT 411.00$ 287.70$ LAB TEST HEPATITIS BE AG 111.00$ 77.70$ LAB TEST HEPATITIS C PROBE 337.00$ 235.90$ LAB TEST HEPATITIS C RNA 411.00$ 287.70$ LAB TEST HEPATITISC GENOTYPE 739.00$ 517.30$ LAB TEST HERPRES DNA QUANT 607.00$ 424.90$ LAB TEST HISTOPLASMA AG 165.00$ 115.50$ LAB TEST HIV-1 RNA QUANT 817.00$ 571.90$ LAB TEST LEGIONELLA DFA 115.00$ 80.50$ LAB TEST MALARIA SMEAR 57.00$ 39.90$ LAB TEST MICROBE SUSCEPTIBLE 82.00$ 57.40$ LAB TEST MYCOBACTERIA CULTURE 112.89$ 79.02$ LAB TEST MYCOPLASMA AMPLIFIED 479.00$ 335.30$ LAB TEST NEISSERIA AMPLIFIED 334.00$ 233.80$ LAB TEST NUCLEIC ACID NOS AGENT 411.00$ 287.70$ LAB TEST OVA+PARASITES SMEAR 85.00$ 59.50$ LAB TEST ROTAVIRUS AG 139.92$ 97.94$ LAB TEST TRICHOMONAS DNA 191.00$ 133.70$ LAB TEST URINE BACTERIA CULTURE 77.00$ 53.90$ LAB TEST VIRAL CULTURE 250.00$ 175.00$ LAB TEST WET MOUNT SMEAR 41.00$ 28.70$ LAB TEST URINALYSIS 21.00$ 14.70$ LAB TEST URINE PREGNANCY 60.00$ 42.00$ LAB TEST VOLUME MEASUREMENT 29.00$ 20.30$ LAB TEST CELL COUNT BODY FLUID 52.00$ 36.40$ LAB TEST CRYSTAL ID 68.00$ 47.60$ LAB TEST EOSINOPHIL SMEAR 45.00$ 31.50$ LAB TEST FECAL LEUKOCYTES 41.00$ 28.70$ LAB TEST SEMEN ANALYSIS 115.00$ 80.50$ LAB TEST SEMEN MOTILITY & COUNT 82.00$ 57.40$ BLOOD BANK PLASMA TRANS, PATH RED 508.00$ 355.60$ FISH MANUAL 744.00$ 520.80$ LAB TEST BONE MARROW INTERP 2,133.00$ 1,493.10$ LAB TEST BRAF GENE 1,252.00$ 876.40$ LAB TEST CALR GENE COM VARIANTS 1,168.00$ 817.60$

LAB TEST CHROMOSOME ANALYSIS 1,684.00$ 1,178.80$ LAB TEST CHROMOSOME ANALYSIS 1,187.00$ 830.90$ LAB TEST CHROMOSOME ANALYSIS ADDL 239.00$ 167.30$ LAB TEST CHROMOSOME ANALYSIS ADDL 181.00$ 126.70$ LAB TEST COMPREHENSIVE CONSULT 393.00$ 275.10$ LAB TEST CYTO CONSULT DURING SURG 2,133.00$ 1,493.10$ LAB TEST CYTO/MCG INTERPRETATION 228.00$ 159.60$ LAB TEST CYTOPATH CELL ENHANCE 393.00$ 275.10$ LAB TEST CYTOPATH FL NON GYN SMR 212.00$ 148.40$ LAB TEST CYTOPATH SMEAR OTHER SRC 212.00$ 148.40$ LAB TEST EGFR GENE ANALYSIS 2,304.00$ 1,612.80$ LAB TEST ELECTRON MICROSCOPY 2,133.00$ 1,493.10$ LAB TEST ENZYME HISTOCHEMISTRY 2,133.00$ 1,493.10$ LAB TEST FLOW CYTOMETRY ADDL MRKR 421.00$ 294.70$ LAB TEST FLOW CYTOMETRY INTERP 806.00$ 564.20$ LAB TEST FROZEN SECTION ADDL BLCK 100.00$ 70.00$ LAB TEST IGH GENE REARRANGEMENT 1,886.00$ 1,320.20$ LAB TEST IMMUNOFLUORESCENCE AB 1,331.00$ 931.70$ LAB TEST IMMUNOFLUORESCENCE AB 2,037.00$ 1,425.90$ LAB TEST IMMUNOHISTO AB 1ST STAIN 1,331.00$ 931.70$ LAB TEST IMMUNOHISTO AB SLIDE 1,331.00$ 931.70$ LAB TEST INSITU HYBRID AUTO 1,331.00$ 931.70$ LAB TEST INSITU HYBRID MANUAL 1,331.00$ 931.70$ LAB TEST INSITU HYBRIDIZATION 259.00$ 181.30$ LAB TEST INSITU HYBRIDIZATION 504.36$ 353.05$ LAB TEST JAK2 GENE 873.00$ 611.10$ LAB TEST KRAS GENE 1,379.00$ 965.30$ LAB TEST MCG DNA PROBE 205.00$ 143.50$ LAB TEST MCG SITU HYBRID 383.00$ 268.10$ LAB TEST MICRODISSECTION LASER 560.00$ 392.00$ LAB TEST MOPATH PROCEDURE LEVEL 2 529.00$ 370.30$ LAB TEST MORPHOMETRIC ANALYSIS 1,331.00$ 931.70$ LAB TEST OUTSIDE SLIDE CONSULT 212.00$ 148.40$ LAB TEST PATH CONSULT DURING SURG 212.00$ 148.40$ LAB TEST PERIPHERAL BLOOD SMEAR 179.00$ 125.30$ LAB TEST SURG PATH LEVEL IV 393.00$ 275.10$ LAB TEST TARGETED GENOMIC SEQ 4,571.00$ 3,199.70$ LAB TEST TARGETED GENOMIC SEQ ANL 4,571.00$ 3,199.70$ LAB TEST TISSUE CULTURE 1,203.00$ 842.10$ LAB TEST TUMOR IMMUNOHISTOCHEM 1,331.00$ 931.70$ LAB TEST TUMOR IMMUNOHISTOCHEM 1,331.00$ 931.70$ LAB TEST UNLISTED MOLECULAR PATH 280.60$ 196.42$ NRAS GENE VARIANTS EXON 2&3 2,085.00$ 1,459.50$ LAB TEST CYTOPATH FL NON GYN FIL 212.00$ 148.40$ LAB TEST CYTOPATH FNA INTERP 393.00$ 275.10$ LAB TEST FLOW CYTOMETRY 1,318.00$ 922.60$ LAB TEST DECALCIFICATION 60.00$ 42.00$

LAB TEST FROZEN SECTION SGL SPEC 1,331.00$ 931.70$ LAB TEST IMMUNOHISTO AB SLIDE 337.00$ 235.90$ LAB TEST REFERRED CONSULT W/SLIDE 1,331.00$ 931.70$ LAB TEST SPECIAL STAINS GROUP I 393.00$ 275.10$ LAB TEST SPECIAL STAINS GROUP II 393.00$ 275.10$ LAB TEST SURG PATH LEVEL I 212.00$ 148.40$ LAB TEST SURG PATH LEVEL II 212.00$ 148.40$ LAB TEST SURG PATH LEVEL III 393.00$ 275.10$ LAB TEST SURG PATH LEVEL V 1,331.00$ 931.70$ LAB TEST SURG PATH LEVEL VI 2,133.00$ 1,493.10$ BALLOON DILATE URETERAL STRICTURE 375.00$ 262.50$ BARIUM ENEMA 469.00$ 328.30$ BARIUM ENEMA W/AIR 469.00$ 328.30$ BONE AGE XRAY 295.00$ 206.50$ BONE LENGTH STUDY 295.00$ 206.50$ CHANGE DRAIN TUBE 280.25$ 196.18$ CHOLANGIOGRAM 1ST SET 58.00$ 40.60$ DEXA BONE DENSITY 295.00$ 206.50$ DEXA BONE DENSITY 1+ SITES 184.00$ 128.80$ DRAIN/INJECTION OF JOINT/BURSA 875.00$ 612.50$ ENDOSCOPIC CATH GALLBLADDER DUCTS 170.00$ 119.00$ ENDOSCOPIC CATH GALLBLADDER/PANCR 235.20$ 164.64$ ESOPHAGRAM 316.00$ 221.20$ EXCHANGE DRAINAGE CATHETER 5,339.00$ 3,737.30$ FISTULAGRAM OF SINUS TRACT 1,196.57$ 837.60$ FLOUROGUIDE FOR NEEDLE PLACEMENT 203.00$ 142.10$ FLOUROGUIDE FOR SPINE INJECTION 174.00$ 121.80$ FLOUROGUIDE VEIN DEVICE 162.00$ 113.40$ FLOUROSCOPE EXAMINATION <1 HR 496.00$ 347.20$ FLUOROGUIDE FOR NEEDLE PLACEMENT 270.67$ 189.47$ FLUOROGUIDE FOR SPINE INJECTION 260.50$ 182.35$ HEPATIC VENOGRAM W/HEMO EVAL 7,953.00$ 5,567.10$ IMAGING BLADDER 1,167.33$ 817.13$ IMAGING BLADDER & URINARY TRACT 824.00$ 576.80$ IMAGING KIDNEY & URINARY TRACT 824.00$ 576.80$ IMAGING KIDNEYS 824.00$ 576.80$ IMAGING OVARIES & FALLOPIAN TUBE 1,047.00$ 732.90$ IMAGING URINARY TRACT 824.00$ 576.80$ INJECTION HYPOGASTRIC PLEXUS 2,783.00$ 1,948.10$ KIDNEY VENOGRAM UNILATERAL 7,953.00$ 5,567.10$ MECHANICAL REMOVAL OF PERICATH 718.50$ 502.95$ MRA ABDOMEN W/WO CONTRAST 986.00$ 690.20$ MYELOGRAM 2 OR MORE REGIONS 2,544.00$ 1,780.80$ NM HEART STUDY 3,543.00$ 2,480.10$ PLACEMENT OF SOFT TISSUE DEVICE 1,493.00$ 1,045.10$ REMOVAL INTRALUMINAL OBSTRUCTION 207.25$ 145.08$ SELECTIVE SPINAL ANGIOGRAM 16,539.00$ 11,577.30$

SHUNTOGRAM 295.00$ 206.50$ SINUS/JUGULAR VENOGRAM 5,141.00$ 3,598.70$ SURGICAL SPECIMEN 1,047.00$ 732.90$ THERAPEUTIC BARIUM ENEMA 469.00$ 328.30$ TRANSCATHETER THERAPY 344.00$ 240.80$ TRIGGER POINT INJECTION 875.00$ 612.50$ TUBE PLACEMENT W/IMAGING 250.71$ 175.50$ US BREAST BIOPSY ADDL LESION 184.00$ 128.80$ VENOGRAM 7,953.00$ 5,567.10$ VENOGRAM 2,570.00$ 1,799.00$ VENOGRAM BILATERAL 3,368.00$ 2,357.60$ VENOGRAM UNILATERAL 2,570.00$ 1,799.00$ VESSEL MAP HEMODIALYSIS ACCESS 1,060.20$ 742.14$ VIDEO SWALLOWING STUDY 338.57$ 237.00$ XRAY ABDOMEN 1 VIEW 193.00$ 135.10$ XRAY ABDOMEN 2 VIEWS 369.00$ 258.30$ XRAY ABDOMEN 3 OR MORE VIEWS 646.50$ 452.55$ XRAY ABDOMEN SERIES W/1 VW CHEST 295.00$ 206.50$ XRAY AC JOINTS 295.00$ 206.50$ XRAY BONE SURVEY COMPLETE 496.00$ 347.20$ XRAY BONE SURVEY LIMITED 295.00$ 206.50$ XRAY CHEST >4 VIEWS 369.00$ 258.30$ XRAY CHEST 1 VIEW 193.00$ 135.10$ XRAY CHEST 2 VIEW 193.00$ 135.10$ XRAY CHEST 3 VIEWS 193.00$ 135.10$ XRAY ENTIRE SPINE 4-5 VIEWS 596.00$ 417.20$ XRAY ENTIRE SPINE MIN 6 VIEWS 596.00$ 417.20$ XRAY EYE FOR FOREIGN BODY 184.00$ 128.80$ XRAY INFANT BONE SURVEY 295.00$ 206.50$ XRAY JOINT SURVEY SGL VW >2 JNTS 295.00$ 206.50$ XRAY LOWER SPINE 2-3 VIEWS 295.00$ 206.50$ XRAY LOWER SPINE MIN 4 VIEWS 295.00$ 206.50$ XRAY LOWER SPINE MIN 6 VIEWS 295.00$ 206.50$ XRAY NECK >6 VIEWS 295.00$ 206.50$ XRAY NECK 2-3 VIEWS 295.00$ 206.50$ XRAY NECK MIN 4 VIEWS 295.00$ 206.50$ XRAY NECK SOFT TISSUE 184.00$ 128.80$ XRAY NOSE TO RECTUM SGL VIEW 184.00$ 128.80$ XRAY OF ANKLE 2 VIEWS 295.00$ 206.50$ XRAY OF ANKLE MIN 3 VIEWS 295.00$ 206.50$ XRAY OF ARM ON INFANT MIN 2 VIEWS 295.00$ 206.50$ XRAY OF BIL KNEES STANDING 184.00$ 128.80$ XRAY OF CLAVICLE 184.00$ 128.80$ XRAY OF ELBOW 2 VIEWS 184.00$ 128.80$ XRAY OF ELBOW MIN 3 VIEWS 184.00$ 128.80$ XRAY OF ENTIRE SPINE 189.00$ 132.30$ XRAY OF ENTIRE SPINE 2-3 VIEWS 313.00$ 219.10$

XRAY OF EYE SOCKET MIN 4 VIEWS 295.00$ 206.50$ XRAY OF FACIAL BONES <3 VIEWS 184.00$ 128.80$ XRAY OF FACIAL BONES >3 VIEWS 295.00$ 206.50$ XRAY OF FEMUR 1 VIEW 189.00$ 132.30$ XRAY OF FEMUR MIN 2 VIEWS 189.00$ 132.30$ XRAY OF FINGERS MIN 2 VIEWS 184.00$ 128.80$ XRAY OF FOOT 2 VIEWS 184.00$ 128.80$ XRAY OF FOOT MIN 3 VIEWS 184.00$ 128.80$ XRAY OF FOREARM 2 VIEWS 186.45$ 130.52$ XRAY OF FOREARM MIN 2 VIEWS 184.00$ 128.80$ XRAY OF HAND 2 VIEWS 295.00$ 206.50$ XRAY OF HAND MIN 3 VIEWS 184.00$ 128.80$ XRAY OF HEEL MIN 2 VIEWS 184.00$ 128.80$ XRAY OF HIP 1 VIEW 189.00$ 132.30$ XRAY OF HIP 2-3 VIEWS 189.00$ 132.30$ XRAY OF HIP MIN 4 VIEWS 626.00$ 438.20$ XRAY OF HIPS BIL MIN 5 VIEWS 596.00$ 417.20$ XRAY OF HIPS BILATERAL 2 VIEWS 313.00$ 219.10$ XRAY OF HIPS BILATERAL 3-4 VIEWS 313.00$ 219.10$ XRAY OF HUMERUS MIN 2 VIEWS 184.00$ 128.80$ XRAY OF JAW <4 VIEWS 184.00$ 128.80$ XRAY OF JAW >4 VIEWS 295.00$ 206.50$ XRAY OF JOINT SURVEY BILATERAL 590.00$ 413.00$ XRAY OF KNEE >4 VIEWS 295.00$ 206.50$ XRAY OF KNEE 1 OR 2 VIEWS 184.00$ 128.80$ XRAY OF KNEE 3 VIEWS 295.00$ 206.50$ XRAY OF LEG ON AN INFANT 2 VIEWS 295.00$ 206.50$ XRAY OF LEG ON AN INFANT 2 VIEWS 295.00$ 206.50$ XRAY OF LOWER LEG 2 VIEWS 184.00$ 128.80$ XRAY OF LOWER LEG 2 VIEWS BIL 369.00$ 258.30$ XRAY OF LOWER SPINE DISK 5,009.00$ 3,506.30$ XRAY OF NASAL BONES MIN 3 VIEWS 184.00$ 128.80$ XRAY OF RIBS 2 VIEWS 184.00$ 128.80$ XRAY OF RIBS 3 VIEWS 295.00$ 206.50$ XRAY OF RIBS/CHEST 295.00$ 206.50$ XRAY OF RIBS/CHEST MIN 3 VIEWS 295.00$ 206.50$ XRAY OF SCAPULA 184.00$ 128.80$ XRAY OF SHOULDER 1 VIEW 184.00$ 128.80$ XRAY OF SHOULDER 2 VIEWS 295.00$ 206.50$ XRAY OF SHOULDER MIN 2 VIEWS BIL 590.00$ 413.00$ XRAY OF SINUSES <3 VIEWS 184.00$ 128.80$ XRAY OF SINUSES MIN 3 VIEWS 295.00$ 206.50$ XRAY OF SKULL <4 VIEWS 295.00$ 206.50$ XRAY OF SKULL >4 VIEWS 295.00$ 206.50$ XRAY OF SMALL BOWEL SERIES 316.00$ 221.20$ XRAY OF STERNUM MIN 2 VIEWS 184.00$ 128.80$ XRAY OF TAILBONE MIN 2 VIEWS 184.00$ 128.80$

XRAY OF THE UPPER GI 469.00$ 328.30$ XRAY OF THE UPPER GI W/KUB 469.00$ 328.30$ XRAY OF TOES MIN 2 VIEWS 184.00$ 128.80$ XRAY OF TOES MIN 2 VIEWS 200.82$ 140.57$ XRAY OF UPPER GI & SMALL INTEST 469.00$ 328.30$ XRAY OF UPPER GI TRACT W/CONTRAST 469.00$ 328.30$ XRAY OF UPPER GI TRACT W/KUB 469.00$ 328.30$ XRAY OF WRIST 2 VIEWS 195.38$ 136.77$ XRAY OF WRIST 2 VIEWS 184.00$ 128.80$ XRAY OF WRIST 2 VIEWS BILATERAL 369.00$ 258.30$ XRAY OF WRIST MIN 3 VIEWS 184.00$ 128.80$ XRAY OF WRIST MIN 3 VIEWS 189.44$ 132.61$ XRAY OF WRIST MIN 3 VIEWS BIL 369.00$ 258.30$ XRAY PELVIS 1-2 VIEWS 295.00$ 206.50$ XRAY PELVIS MIN 3 VIEWS 413.00$ 289.10$ XRAY SACROILIAC JOINTS <3 VIEWS 184.00$ 128.80$ XRAY SACROILIAC JOINTS >3 VIEWS 295.00$ 206.50$ XRAY SPINE 1 VIEW 184.00$ 128.80$ XRAY THORACIC SPINE 2 VIEWS 295.00$ 206.50$ XRAY THORACIC SPINE 3 VIEWS 295.00$ 206.50$ XRAY THORACIC SPINE MIN 4 VIEWS 295.00$ 206.50$ XRAY THORACOLUMBAR MIN 2 VIEWS 184.00$ 128.80$ XRAY TMJ JOINT BILATERAL 184.00$ 128.80$ XRAY TMJ JOINT UNILATERAL 184.00$ 128.80$ XRAY UPPER GI W/AIR & BARIUM 469.00$ 328.30$ XRAY WRIST MIN 3 VIEWS 184.00$ 128.80$ 70215799 EXTREMITY ANGIO-UNILATERAL 10,912.26$ 7,638.58$ 70215800 BILATERAL EXTREMITIES ANGIOGRAM 10,604.00$ 7,422.80$ ABDOMINAL AORTOGRAM 9,278.50$ 6,494.95$ ANGIOGRAM ADDITIONAL VESSEL 268.78$ 188.15$ BILATERAL EXTREMETIES ANGIOGRAM 8,284.38$ 5,799.06$ PELVIC SELECTIVE ANGIOGRAM 7,953.00$ 5,567.10$ PULMONARY ANGIOGRAM 15,906.00$ 11,134.20$ PULMONARY ANGIOGRAM 15,906.00$ 11,134.20$ TRANSCATHETER ANGIO FOLLOW UP 2,570.00$ 1,799.00$ UNILATERAL EXTREMITY ANGIOGRAM 10,225.29$ 7,157.70$ VISCERAL ANGIOGRAM 20,674.00$ 14,471.80$ MRA CHEST W/WO CONTRAST 969.00$ 678.30$ CHEMO INIT IV PUSH 719.00$ 503.30$ CHEMO INJECTION IV PUSH EA ADDL 222.00$ 155.40$ CHEMOTHERAPY SC/IM 448.00$ 313.60$ LUMBAR PUNCTURE 1,181.00$ 826.70$ SQ/IM CHEMO/HORMONAL 222.00$ 155.40$ CHEMO INFUSION > 8 HRS 1,181.00$ 826.70$ CHEMO IV INFUSION 1 HOUR 1,181.00$ 826.70$ CHEMO IV INFUSION EA ADDL HOUR 222.00$ 155.40$ IV INF DIFF CHEMO 222.00$ 155.40$

NM GASTRIC EMPTYING W/BOWEL 2,067.00$ 1,446.90$ NM 3 PHASE BONE SCAN 1,616.00$ 1,131.20$ NM BONE/JOINT SCAN LMTD AREA 1,125.82$ 788.07$ NM BONE/JOINT WHOLE BODY SCAN 1,098.28$ 768.79$ NM CARDIAC MUGA SCAN 1,160.00$ 812.00$ NM GASTRIC EMPTYING STUDY 1,105.04$ 773.52$ NM GI BLEED STUDY 1,835.81$ 1,285.07$ NM GI HIDA SCN BILE LEAK 1,947.12$ 1,362.98$ NM GI HIDA W/CCK 1,506.01$ 1,054.20$ NM GI MECKELS DIVERT EXAM 2,031.00$ 1,421.70$ NM HEART STUDY 7,086.00$ 4,960.20$ NM KIDNEY FUNC IMG W/DRUG 1,353.64$ 947.55$ NM LIVER & SPLEEN SCAN 1,159.00$ 811.30$ NM LIVER IMAGING 1,159.00$ 811.30$ NM LOC OF ABSCESS WHOLE BODY 4,391.00$ 3,073.70$ NM LUNG PERFUSION IMAGING 1,471.50$ 1,030.05$ NM LUNG QUATITAIVE STUDY 1,368.00$ 957.60$ NM LYMPH & LYMPH GLANDS 1,148.00$ 803.60$ NM PARATHYROID 894.25$ 625.98$ NM RADIOGRAPH TUMOR LOC 3D 2,195.00$ 1,536.50$ NM THYROID IMAGING 876.00$ 613.20$ NM THYROID METS WHOLE BODY 1,172.00$ 820.40$ NM TUMOR IMG WHOLE BODY 2 DAY 3,692.00$ 2,584.40$ NM VENTILATION/PERFUSION IMG 1,910.48$ 1,337.34$ NM ORAL RADIOPHARMACEUTICAL 860.00$ 602.00$ AEROSOL INJECTION 375.00$ 262.50$ PHARMACY NUCLEAR MEDICINE 905.50$ 633.85$ PHARMACY NUCLEAR MEDICINE 1,000.00$ 700.00$ PHARMACY NUCLEAR MEDICINE 89.00$ 62.30$ PHARMACY NUCLEAR MEDICINE 149.00$ 104.30$ PHARMACY NUCLEAR MEDICINE 6.23$ 4.36$ PHARMACY NUCLEAR MEDICINE 177.00$ 123.90$ PHARMACY NUCLEAR MEDICINE 77.80$ 54.46$ PHARMACY NUCLEAR MEDICINE 70.00$ 49.00$ PHARMACY NUCLEAR MEDICINE 76.00$ 53.20$ PHARMACY NUCLEAR MEDICINE 164.00$ 114.80$ PHARMACY NUCLEAR MEDICINE 191.00$ 133.70$ PHARMACY NUCLEAR MEDICINE 318.00$ 222.60$ PHARMACY NUCLEAR MEDICINE 438.00$ 306.60$ PHARMACY NUCLEAR MEDICINE 379.00$ 265.30$ CT ABDOMINAL ARTERIES ANGIOGRAM 876.00$ 613.20$ CT ANGIOGRAM ABDOMEN W/WO CONTRAS 876.00$ 613.20$ CT ANGIOGRAPH LOWER EXT W/WO CONT 876.00$ 613.20$ CT ANGIOGRAPHY OF HEAD W/WO CON 876.00$ 613.20$ CT ANGIOGRAPHY OF NECK W/WO CON 876.00$ 613.20$ CT CHEST W/CONTRAST 748.00$ 523.60$ CT CHEST WO/CONTRAST 373.00$ 261.10$

CT CORONARY CALCIUM SCORING 106.00$ 74.20$ CT GUIDE FOR TISSUE ABLATION 711.00$ 497.70$ CT LIMITED STUDY 184.00$ 128.80$ CT NEEDLE BIOPSY 211.00$ 147.70$ DIAGNOSTIC COLONOSCOPY 373.00$ 261.10$ IMAGE RECONSTRUCTION 77.00$ 53.90$ IMAGE RECONSTRUCTON 41.00$ 28.70$ CT HEAD W/CONTRAST 748.00$ 523.60$ CT HEAD W/WO CONTRAST 838.00$ 586.60$ CT HEAD WO/CONTRAST 373.00$ 261.10$ CT ORBITS & INNER EAR W/CONTRAST 748.00$ 523.60$ CT ORBITS & INNER EAR W/WO CON 838.00$ 586.60$ CT ORBITS & INNER EAR WO/CONTRAST 373.00$ 261.10$ CT SINSUES WO/CONTRAST 373.00$ 261.10$ CT SINUSES W/CONTRAST 748.00$ 523.60$ CT SINUSES W/WO CONTRAST 838.00$ 586.60$ CT SOFT TISSUE NECK W/CONTRAST 748.00$ 523.60$ CT SOFT TISSUE NECK W/WO CONTRAST 838.00$ 586.60$ CT SOFT TISSUE NECK WO/CONTRAST 373.00$ 261.10$ CT ABDOMEN & PELVIS W/CONTRAST 1,167.00$ 816.90$ CT ABDOMEN & PELVIS W/WO CONTRAST 1,167.00$ 816.90$ CT ABDOMEN & PELVIS WO/CONTRAST 736.00$ 515.20$ CT ABDOMEN W/CONTRAST 748.00$ 523.60$ CT ABDOMEN W/WO CONTRAST 838.00$ 586.60$ CT ABDOMEN WO/CONTRAST 373.00$ 261.10$ CT ANGIO OF UPPER EXTREMITY 876.00$ 613.20$ CT ANGIOGRAM ABD/PEL W/WO CONTRAS 1,167.00$ 816.90$ CT ANGIOGRAPH OF PELVIS W/WO CONT 876.00$ 613.20$ CT ANGIOGRAPHY OF CHEST W/WO CON 876.00$ 613.20$ CT CERVICAL SPINE W/CONTRAST 748.00$ 523.60$ CT CERVICAL SPINE W/WO CONTRAST 838.00$ 586.60$ CT CERVICAL SPINE WO/ CONTRAST 373.00$ 261.10$ CT CHEST W/WO CONTRAST 838.00$ 586.60$ CT LOWER EXTERMITY W/CONTRAST 748.00$ 523.60$ CT LOWER EXTREMITY W/CONTRAST 1,106.22$ 774.35$ CT LOWER EXTREMITY W/WO CONTRAST 1,676.00$ 1,173.20$ CT LOWER EXTREMITY W/WO CONTRAST 838.00$ 586.60$ CT LOWER EXTREMITY WO/CONTRAST 425.22$ 297.65$ CT LOWER EXTREMITY WO/CONTRAST 373.00$ 261.10$ CT LUMBAR SPINE W/CONTRAST 748.00$ 523.60$ CT LUMBAR SPINE W/WO CONTRAST 838.00$ 586.60$ CT LUMBAR SPINE WO/CONTRAST 373.00$ 261.10$ CT PELVIS W/CONTRAST 748.00$ 523.60$ CT PELVIS W/WO CONTRAST 838.00$ 586.60$ CT PELVIS WO/CONTRAST 373.00$ 261.10$ CT THORACIC SPINE W/CONTRAST 748.00$ 523.60$ CT THORACIC SPINE W/WO CONTRAST 838.00$ 586.60$

CT THORACIC SPINE WO/CONTRAST 373.00$ 261.10$ CT UPPER EXTREMITY W/CONTRAST 914.44$ 640.11$ CT UPPER EXTREMITY W/CONTRAST 748.00$ 523.60$ CT UPPER EXTREMITY WO/CONTRAST 373.00$ 261.10$ 702120001 OR LEVEL 1-1ST 30 MIN 3,870.00$ 2,709.00$ 702120002 OR LEVEL 1-ADDL MIN 38.70$ 27.09$ 702120003 OR LEVEL 2-1ST 30 MIN 4,644.00$ 3,250.80$ 702120004 OR LEVEL 2-ADDL MIN 46.44$ 32.51$ 702120005 OR LEVEL 3-1ST 30 MIN 5,573.00$ 3,901.10$ 702120006 OR LEVEL 3-ADDL MIN 55.73$ 39.01$ 702120007 OR LEVEL 4-1ST 30 MIN 6,688.00$ 4,681.60$ 702120008 OR LEVEL 4-ADDL MIN 66.88$ 46.82$ 702120009 OR LEVEL 5-1ST 30 MIN 8,026.00$ 5,618.20$ 702120010 OR LEVEL 5-ADDL MIN 80.26$ 56.18$ 702120011 OR LEVEL 6-1ST 30 MIN 9,634.35$ 6,744.04$ 702120012 OR LEVEL 6-ADDL MIN 96.31$ 67.42$ 70214486 OR CONTACT 1ST 30 MINUTES 34.09$ 23.86$ 752124002 OR LEVEL 1-1ST 30 MIN 3,870.00$ 2,709.00$ 752124003 OR LEVEL 1-ADDL MIN 38.70$ 27.09$ 752124004 OR LEVEL 2-1ST 30 MIN 4,644.00$ 3,250.80$ 752124005 OR LEVEL 2-ADDL MIN 46.44$ 32.51$ 752124006 OR LEVEL 3-1ST 30 MIN 5,573.00$ 3,901.10$ 752124007 OR LEVEL 3-ADDL MIN 55.73$ 39.01$ 752124008 OR LEVEL 4-1ST 30 MIN 6,688.00$ 4,681.60$ 752124009 OR LEVEL 4-ADDL MIN 66.88$ 46.82$ 752124010 OR LEVEL 5-1ST 30 MIN 8,026.00$ 5,618.20$ 752124011 OR LEEVL 5- ADDL MIN 80.26$ 56.18$ 752124012 OR LEVEL 6-1ST 30 MIN 9,631.00$ 6,741.70$ 752124013 OR LEVEL 6-ADDL MIN 96.31$ 67.42$ CESAREAN SECTION 15,738.00$ 11,016.60$ OR LEVEL 1-1ST 30 MIN 3,870.00$ 2,709.00$ OR LEVEL 1-ADDL MIN 38.70$ 27.09$ OR LEVEL 2-1ST 30 MIN 4,644.00$ 3,250.80$ OR LEVEL 2-ADDL MIN 46.44$ 32.51$ OR LEVEL 3-1ST 30 MIN 5,573.00$ 3,901.10$ OR LEVEL 3-ADDL MIN 55.73$ 39.01$ OR LEVEL 4-1ST 30 MIN 6,688.00$ 4,681.60$ OR LEVEL 4-ADDL MIN 66.88$ 46.82$ OR LEVEL 5-1ST 30 MIN 8,026.00$ 5,618.20$ OR LEVEL 5-ADDL MIN 80.26$ 56.18$ OR LEVEL 6-1ST 30 MIN 9,631.00$ 6,741.70$ OR LEVEL 6-ADDL MIN 96.31$ 67.42$ POST PARTUM TUBAL LIGATION 2,032.00$ 1,422.40$ 70415495 BLOCK SCIATIC NERVE SINGLE 2,783.00$ 1,948.10$ 70418400 BLOCK EPI LUMBAR SINGLE 2,783.00$ 1,948.10$ 70418402 BLOCK BRACHIO PLEXUS CONTINUOUS 2,783.00$ 1,948.10$ 70418403 BLOCK FEMORAL/FASCIAL CONTINUOUS 6,088.00$ 4,261.60$

ABDOMINAL PARACENTESIS W/IMAGE 2,027.00$ 1,418.90$ ABDOMINAL/RETROPERITONEAL BIOPSY 4,360.00$ 3,052.00$ ADDL CYST ASPIRATION OF BREAST 91.00$ 63.70$ ANGIOPLASSTY ADDITIONAL VEIN 19,738.00$ 13,816.60$ ANGIOPLASTY 26,569.00$ 18,598.30$ ANGIOPLASTY ARTERY UNILATERAL 19,738.00$ 13,816.60$ ANGIOPLASTY VEIN INITIAL 8,582.00$ 6,007.40$ ASPIRATE/INJ KIDNEY CYST/PELVIS 4,360.00$ 3,052.00$ ASPIRATION OF ABSCESS 671.00$ 469.70$ BILATERAL KIDNEY ANGIOGRAM 10,604.00$ 7,422.80$ BLADDER DRAIN W/CATHETER INSERT 5,698.00$ 3,988.60$ BLOCK AXILLARY SINGLE 1,544.00$ 1,080.80$ BLOCK BRACHIO PLEXUS SINGLE 1,544.00$ 1,080.80$ BLOCK LUMBAR PLEXUS/TAP SINGLE 263.00$ 184.10$ BLOCK TRIGEMINAL NERVE SINGLE 875.00$ 612.50$ BONE MARROW BIOPSY 3,423.00$ 2,396.10$ BONE MARROW BIOPSY 3,423.00$ 2,396.10$ BREAST BIOPSY 1ST LESION 4,360.00$ 3,052.00$ BREAST BIOPSY ADDITIONAL LESION 351.00$ 245.70$ BREAST WIRE PLACEMENT 546.00$ 382.20$ BREAST WIRE PLCMNT ADDL LESION 216.00$ 151.20$ BRONCH REMOVAL FOREIGN BODY 4,370.00$ 3,059.00$ BRONCHIAL ALVEOLAR LAVAGE 4,370.00$ 3,059.00$ BRONCHOSCOPY BRUSHING/PROTECT 4,370.00$ 3,059.00$ BRONCHOSCOPY DIAGNOSTIC 4,370.00$ 3,059.00$ CARDIAC LEAD REMOVAL 9,721.00$ 6,804.70$ CARDIAC LEAD REPOSITION 6,527.00$ 4,568.90$ CATH PLACEMENT PULMONARY ARTERY 639.00$ 447.30$ CATHETER FLUID DRAIN 3,586.00$ 2,510.20$ CATHETER PLACEMENT 1ST ORDER 667.00$ 466.90$ CATHETER PLACEMENT 2ND ORDER 737.00$ 515.90$ CATHETER PLACEMENT ARTERY 491.00$ 343.70$ CATHETER PLACEMENT ARTERY 1,069.00$ 748.30$ CATHETER PLACEMENT ARTERY 1,140.00$ 798.00$ CATHETER PLACEMENT ARTERY 1,348.00$ 943.60$ CATHETER PLACEMENT ARTERY 209.00$ 146.30$ CATHETER PLACEMENT CAROTID 10,604.00$ 7,422.80$ CATHETER PLACEMENT THORACIC 998.00$ 698.60$ CATHETER REMOVAL W/PORT 3,493.00$ 2,445.10$ CATHETER REMOVAL WO/PORT 2,021.00$ 1,414.70$ CERVICAL MYELOGRAM 2,544.00$ 1,780.80$ CHEST TUBE INSERT W/IMAGE 2,027.00$ 1,418.90$ CHEST TUBE INSERTION 9,477.00$ 6,633.90$ CHEST TUBE REMOVAL 2,027.00$ 1,418.90$ CLOT REMOVAL 13,340.00$ 9,338.00$ CLOT REMOVAL 13,340.00$ 9,338.00$ CLOT REMOVAL 9,262.00$ 6,483.40$

CLOT REMOVAL 18,800.00$ 13,160.00$ CLOT REMOVAL W/STENT 39,875.00$ 27,912.50$ CLOT REMOVAL W/STENT 914.00$ 639.80$ CONTRAST INJECTION W/FLUORO 808.00$ 565.60$ CT SACROPLASTY 10,777.00$ 7,543.90$ CT SACROPLASTY 10,777.00$ 7,543.90$ CYST ABSCESS CONTRAST INJECTION 161.00$ 112.70$ CYST ASPIRATION OF BREAST 2,018.00$ 1,412.60$ CYSTO W/DIL OF URETHRAL STRICT 5,082.00$ 3,557.40$ DECLOT VASCULAR DEVICE 808.00$ 565.60$ DEEP BONE BIOPSY 5,556.00$ 3,889.20$ DESTRUCTION NEURO PUDENAL NERVE 4,181.00$ 2,926.70$ DIAGNOSTIC BONE MARROW BIOPSY 5,590.00$ 3,913.00$ DIAGNOSTIC SINUS TRACT INJECTION 160.00$ 112.00$ DILATION OF GALLBLADDER DUCTS 1,200.00$ 840.00$ DRAIN BLADDER BY TOCAR/CATH 469.00$ 328.30$ DRAIN/INJECTION OF JOINT/BURSA 875.00$ 612.50$ DRAIN/INJECTION OF JOINT/BURSA 875.00$ 612.50$ DRAIN/INJECTION OF JOINT/BURSA 875.00$ 612.50$ DUODENOSTOMY/JEJUNOSTOMY TUBE 3,380.00$ 2,366.00$ ENDOBRONCHIAL BIOPSY 4,370.00$ 3,059.00$ ENDOLUMINAL BIOPSY BILIARY TREE 12,792.00$ 8,954.40$ ENDOVENOUS RADIO FREQ 1ST VEIN 8,994.00$ 6,295.80$ ENDOVENOUS RADIO FREQ ADD ON 572.00$ 400.40$ EXCHANGE GALLBLADDER DRAIN 6,763.00$ 4,734.10$ FEMORAL NERVE BLOCK 1,544.00$ 1,080.80$ FEMORAL NERVE BLOCK 1,544.00$ 1,080.80$ FISTULOGRAM 5,597.00$ 3,917.90$ FISTULOGRAM W/ANGIO & THROMB 19,738.00$ 13,816.60$ FISTULOGRAM W/ANGIOPLASTY 19,738.00$ 13,816.60$ FISTULOGRAM W/STENT PLACEMENT 39,894.00$ 27,925.80$ FISTULOGRAM W/THROMBECTOMY 19,738.00$ 13,816.60$ FLUID COLLECT BY CATH IMAGE 4,360.00$ 3,052.00$ FLUORO EXAM OF G/COLON TUBE 625.00$ 437.50$ GALLBLADDER DRAIN PLACEMENT 6,763.00$ 4,734.10$ GALLBLADDER DRAIN REMOVAL 1,500.00$ 1,050.00$ GALLBLADDER STONE REMOVAL 3,000.00$ 2,100.00$ GASTROSTOMY TUBE PLCMNT W/FLUORO 4,410.00$ 3,087.00$ HIP ARTHROGRAM W/OUT ANESTHESIA 295.00$ 206.50$ HIP ARTHROGRAM W/OUT ANESTHESIA 295.00$ 206.50$ IMAGING OF LIVER/GALLBLADDER 6,763.00$ 4,734.10$ INCISION & DRAINAGE OF THIGH/KNEE 6,775.00$ 4,742.50$ INCISION & DRAINAGE OF WOUND 8,794.00$ 6,155.80$ INCISION OF LINGUAL FRENUM 4,250.00$ 2,975.00$ INJ FOR LUMBAR DISCOGRAPHY 724.00$ 506.80$ INJ FORAMEN EPI LUMBAR/SACRAL 2,783.00$ 1,948.10$ INJ FORAMEN EPIDURAL ADD ON 217.00$ 151.90$

INJ PARAVRTBL CERV/THORACIC LV2 253.00$ 177.10$ INJ PARAVRTBL CERV/THORACIC LV3 256.00$ 179.20$ INJ PARAVRTBL CERVICAL/THORACIC 2,783.00$ 1,948.10$ INJ PARAVRTBL LUMBAR/SACRAL LV1 2,783.00$ 1,948.10$ INJ PARAVRTBL LUMBAR/SACRAL LV1 5,566.00$ 3,896.20$ INJ PARAVRTBL LUMBAR/SACRAL LV1 2,783.00$ 1,948.10$ INJ PARAVRTBL LUMBAR/SACRAL LV2 218.00$ 152.60$ INJ PARAVRTBL LUMBAR/SACRAL LV2 218.00$ 152.60$ INJ PARAVRTBL LUMBAR/SACRAL LV3 221.00$ 154.70$ INJ PERIPHERAL NERVE/BRANCH 1,544.00$ 1,080.80$ INJ TO EVALUATE PERITONEAL SHUNT 190.00$ 133.00$ INJECTION ANESTHESIA VAGUS NRV 1,015.00$ 710.50$ INJECTION CELIAC PLEXUS 2,783.00$ 1,948.10$ INJECTION FOR CHOLANGIOGRAM 11,446.00$ 8,012.20$ INJECTION FOR CYSTOGRAM 187.00$ 130.90$ INJECTION FOR MYELOGRAM 364.00$ 254.80$ INJECTION ILEAL CONDUIT 298.00$ 208.60$ INJECTION IMAGING OVARIES 243.00$ 170.10$ INJECTION IVC FILTER 9,262.00$ 6,483.40$ INJECTION OF SCLEROSANT 1,289.00$ 902.30$ INJECTION SPIDER VEINS 605.00$ 423.50$ INJECTION SPINE 2,783.00$ 1,948.10$ INJECTION SPINE 2,783.00$ 1,948.10$ INJECTION SUPRASCAPULAR NERVE 2,253.00$ 1,577.10$ INSERT ATRIAL/VENTRICULAR LEAD 39,318.00$ 27,522.60$ INSERT ELECTRODE 27,108.00$ 18,975.60$ INSERT PACEMAKER 1,965.00$ 1,375.50$ INSERT VENTRICULAR LEAD 39,318.00$ 27,522.60$ INSERT/REPLACE DEFIB W/LEADS 99,000.00$ 69,300.00$ INSERTION OF INTRAPERITONEAL CATH 9,477.00$ 6,633.90$ INSERTION OF TEMPORARY PACEMAKER 27,108.00$ 18,975.60$ INTERDISCAL ASPIRATION 2,018.00$ 1,412.60$ INTRAVASCULAR ULTRASOUND 305.00$ 213.50$ INTRAVASCULAR ULTRASOUND 228.00$ 159.60$ INTRO LIVER STENT 6,763.00$ 4,734.10$ INTRO LIVER STENT 6,763.00$ 4,734.10$ INTRODUCTION OF AORTA CATHETER 650.00$ 455.00$ INTRODUCTION OF CATHETER 518.00$ 362.60$ KIDNEY ANGIOGRAM 2ND ORDER 10,604.00$ 7,422.80$ KIDNEY BIOPSY 4,360.00$ 3,052.00$ KIDNEY CATHETER PLACEMENT 4,679.00$ 3,275.30$ KIDNEY CATHETER PLACEMENT 4,679.00$ 3,275.30$ KIDNEY CATHETER PLACEMENT 1,629.00$ 1,140.30$ KIDNEY IMAGING 1,629.00$ 1,140.30$ KIDNEY TUBE CHANGE 1,629.00$ 1,140.30$ KIDNEY TUBE CHANGE 1,629.00$ 1,140.30$ KYPHOPLASTY LUMBAR 26,186.00$ 18,330.20$

KYPHOPLASTY THORACIC 26,186.00$ 18,330.20$ LIVER PERCUTANEUS BIOPSY 4,360.00$ 3,052.00$ LIVER RADIOFREQUENCY ABLATION 16,964.00$ 11,874.80$ LUMBAR EPIDURAL 2,075.00$ 1,452.50$ LUMBAR MYELOGRAM 2,544.00$ 1,780.80$ LUMBAR/SACRAL FACET ADDL INJ 252.00$ 176.40$ LUMBAR/SACRAL FACET INJECTION 6,088.00$ 4,261.60$ LUMBAR/SACRAL INJ W/CATHETER 2,614.00$ 1,829.80$ LUNG RADIO FREQ ABLATION 16,964.00$ 11,874.80$ LUNG/MEDIASTINUM BIOPSY 4,360.00$ 3,052.00$ LYMPH NODE BIOPSY 4,360.00$ 3,052.00$ LYMPH NODE BIOPSY 4,360.00$ 3,052.00$ MECHANICAL REMVL OF INTRALUMINAL 3,493.00$ 2,445.10$ MECHANICAL REMVL OF OBST MATERIAL 9,262.00$ 6,483.40$ MRI BREAST BIOPSY 1ST LESION 4,360.00$ 3,052.00$ MRI BREAST BIOPSY ADDL LESION 396.00$ 277.20$ MUSCLE BIOPSY 4,360.00$ 3,052.00$ NERVE ABLATION 2,783.00$ 1,948.10$ NERVE BLOCK ILIOING 1,544.00$ 1,080.80$ NON TUNNEL CATH >5 YEARS 3,493.00$ 2,445.10$ NONSELECTIVE CATH PLACEMENT 60.00$ 42.00$ OCCIPITAL NERVE BLOCK 1,544.00$ 1,080.80$ OCCIPITAL NERVE BLOCK 1,544.00$ 1,080.80$ PACEMAKER REMOVAL 27,108.00$ 18,975.60$ PANCREAS BIOPSY 4,360.00$ 3,052.00$ PERCUTANEOUS CHOLECYSTOSTOMY 7,594.00$ 5,315.80$ PERICARDIOCENTESIS W/TUBE PLCMNT 5,960.00$ 4,172.00$ PERIOCARDIOCENTESIS 2,027.00$ 1,418.90$ PERQ VERTEBRAL AUGMENTATION 959.00$ 671.30$ PI JNT/BURSA INTERMED UN/BIL20605 875.00$ 612.50$ PI JNT/BURSA MAJOR UNI/BIL 20610 875.00$ 612.50$ PI JNT/BURSA SML UNI/BIL 20600 875.00$ 612.50$ PI TRIGGER PNT INJ 3> MUSC 20553 875.00$ 612.50$ PI US DRAIN/INJ OF JOINT/BURSA 875.00$ 612.50$ PI US DRAIN/INJ OF SM JNT BURSA 875.00$ 612.50$ PI US DRAIN/INJECTION JOINT/BURSA 875.00$ 612.50$ PICC LINE WO/PORT PUMP >5 YEARS 3,493.00$ 2,445.10$ PLACE DEVICE MARKER NON-PRO 3,295.79$ 2,307.05$ PLACEMENT OF STENT INTO BILE DUCT 13,691.00$ 9,583.70$ PROSTATE NEEDLE BIOPSY 6,056.00$ 4,239.20$ RELOCATION POCKET PACEMAKER 5,829.00$ 4,080.30$ RELOCATION SKIN POCKET FOR DEFIB 5,829.00$ 4,080.30$ REMOVAL DUAL PACEMAKER LEADS 9,721.00$ 6,804.70$ REMOVAL IVC FILTER 9,262.00$ 6,483.40$ REMOVAL OF KIDNEY TUBE W/FLUORO 2,273.00$ 1,591.10$ REMOVAL PULSE GENERATOR 9,721.00$ 6,804.70$ REMOVE TUBE OBSTRUCTION 1,500.00$ 1,050.00$

REMOVE/REPLACE URETERAL STENT 8,635.00$ 6,044.50$ REPLACE CATHETER ONLY W/PORT PUMP 9,262.00$ 6,483.40$ REPLACE GASTRIC TUBE 2,021.00$ 1,414.70$ REPLACE GASTRIC TUBE 2,021.00$ 1,414.70$ REPLACE GATRIC TUBE 2,021.00$ 1,414.70$ REPLACE NON TUNNELED CV CATH 3,493.00$ 2,445.10$ REPLACE TUNNELED CV CATH 9,262.00$ 6,483.40$ REPLACE TUNNELED DEVICE W/PORT 9,262.00$ 6,483.40$ REPOSITION SUBSQ LEAD 9,721.00$ 6,804.70$ RETROGRADE INJECTION URETHRA 272.00$ 190.40$ SACROILIAC JNT INJ W/ANESTHESIA 2,783.00$ 1,948.10$ SACROILIAC JOINT INJECTION 353.00$ 247.10$ SACROILIAC JOINT INJECTION 353.00$ 247.10$ SALIVARY GLAND BIOPSY 2,018.00$ 1,412.60$ SCLEROTHERAPY FLUID COLLECTION 2,926.00$ 2,048.20$ SHOULDER ARTHROGRAM 215.00$ 150.50$ SHOULDER ARTHROGRAM INJECTION 215.00$ 150.50$ SINGLE INJECTION SHEATH/LIGAMENT 875.00$ 612.50$ SINGLE INJECTION SHEATH/LIGAMENT 875.00$ 612.50$ SINGLE TENDON INJECTION 875.00$ 612.50$ SINGLE TENDON INJECTION 875.00$ 612.50$ SOFT TISSUE OR UPPER ARM BIOPSY 5,556.00$ 3,889.20$ SPINAL INJECTION CERV/THORACIC 2,075.00$ 1,452.50$ STENT PLACEMENT 31,628.00$ 22,139.60$ STENT PLACEMENT INTO BILE DUCT 12,792.00$ 8,954.40$ STENT REMOVAL 18,800.00$ 13,160.00$ SUPERFICIAL BONE BIOPSY 3,423.00$ 2,396.10$ THORACENTESIS 2,027.00$ 1,418.90$ THORACIC MYELOGRAM 2,544.00$ 1,780.80$ THROMBOLYTIC ART/VENOUS THERAPY 9,262.00$ 6,483.40$ THROMBOLYTIC ARTERIAL THERAPY 3,493.00$ 2,445.10$ THROMBOLYTIC VENOUS THERAPY 3,493.00$ 2,445.10$ TRANSBRONCHIAL NEEDLE BIOPSY 9,345.00$ 6,541.50$ TRANSCATHETER/EMBOLIZATION 39,875.00$ 27,912.50$ TRANSPERI NEEDLE PLACEMENT 8,635.00$ 6,044.50$ TUNNELED CATH >5 YEARS 9,262.00$ 6,483.40$ TUNNELED CATH W/PORT >5 YEARS 9,262.00$ 6,483.40$ UNILATERAL KIDNEY ANGIOGRAM 10,604.00$ 7,422.80$ UNLISTED PROCEDURE OF NERVOUS SYS 1,015.00$ 710.50$ UNLSTD URINARY SYST PROCEDURE 952.00$ 666.40$ URETERAL STENT PLACEMENT 6,969.00$ 4,878.30$ URETERAL STENT PLACEMENT 6,969.00$ 4,878.30$ URETERAL STENT PLACEMENT 6,969.00$ 4,878.30$ US BREAST BIOPSY 1ST LESION 4,360.00$ 3,052.00$ US BREAST BIOPSY 1ST LESION 546.00$ 382.20$ US BREAST BIOPSY ADDL LESION 331.00$ 231.70$ US DRAIN/INJECTION JOINT/BURSA 875.00$ 612.50$

US DRAIN/INJECTION OF JOINT/BURSA 875.00$ 612.50$ US DRAIN/INJECTION OF JOINT/BURSA 875.00$ 612.50$ VENOGRAM 204.00$ 142.80$ VERTEBROPLASTY CERVICAL/THORACIC 10,777.00$ 7,543.90$ VERTEBROPLASTY LUMBOSACRAL 10,777.00$ 7,543.90$ WRIST ARTHROGRAM 317.00$ 221.90$ 754124014 ANES GENERAL LEVEL 1-1ST 30 MIN 1,225.00$ 857.50$ 754124015 ANES GENERAL LEVEL 1-ADDL MIN 12.25$ 8.58$ 754124016 ANES GENERAL LEVEL 2-1ST 30 MIN 1,470.00$ 1,029.00$ 754124017 ANES GENERAL LEVEL 2-ADDL MIN 14.70$ 10.29$ ANES GENERAL LEVEL 1-1ST 30 MIN 1,225.00$ 857.50$ ANES GENERAL LEVEL 1-1ST 30 MIN 1,225.00$ 857.50$ ANES GENERAL LEVEL 1-ADDL MIN 12.25$ 8.58$ ANES GENERAL LEVEL 1-ADDL MIN 12.25$ 8.58$ ANES GENERAL LEVEL 2-1ST 30 MIN 1,471.83$ 1,030.28$ ANES GENERAL LEVEL 2-ADDL MIN 14.70$ 10.29$ CONSCIOUS SEDATION 539.00$ 377.30$ LD SPI/EPI ANES 1ST 30 MIN 2,053.00$ 1,437.10$ LD SPI/EPI ANES ADDITIONAL MIN 8.03$ 5.62$ MEDICAL IMAGING CON SED ADDL 15MN 46.00$ 32.20$ MEDICAL IMAGING CON SEDATION 51.00$ 35.70$ MODERATE SED <5 YR 1ST 15 MINUTES 637.00$ 445.90$ MODERATE SED <5 YRS 1ST 15 MIN-2P 380.00$ 266.00$ MODERATE SED >5YR 1ST 15 MINUTES 637.00$ 445.90$ MODERATE SED >5YRS 1ST 15 MIN-2P 310.00$ 217.00$ MODERATE SED EA ADD 15 MINUTES 637.00$ 445.90$ MODERATE SED EA ADDL 15 MIN-2P 235.00$ 164.50$ BLOOD BANK CRYOPRECIPITATE 242.00$ 169.40$ BLOOD BANK PLATELETS 826.00$ 578.20$ BLOOD BANK PLATELETS PHERESIS LR 2,390.00$ 1,673.00$ BLOOD BANK PLATELETS PHERESIS LR 2,529.00$ 1,770.30$ BLOOD BANK RBC LR 767.00$ 536.90$ BLOOD BANK RBC LR IRRADIATED 906.00$ 634.20$ BLOOD BANK RED BLOOD CELLS 1,021.00$ 714.70$ BLOOD TRANSFUSION 1,231.00$ 861.70$ BLOOD TRANSFUSION 1,231.00$ 861.70$ DIAGNOSTIC BREAST TOMOSYNTHESIS 53.44$ 37.41$ DIAGNOSTIC MAMMOGRAM BILATERAL 396.00$ 277.20$ DIAGNOSTIC MAMMOGRAM UNILATERAL 314.00$ 219.80$ <14 WEEKS ADDL FETUS ULTRASOUND 72.00$ 50.40$ <14 WEEKS SGL FETUS ULTRASOUND 419.00$ 293.30$ >14 WEEKS ADDL FETUS ULTRASOUND 140.00$ 98.00$ >14 WEEKS SGL FETUS ULTRASOUND 419.00$ 293.30$ COMPLETE PELVIC ULTRASOUND 419.00$ 293.30$ COMPRESSION REPAIR ANEUR/FISTULA 1,024.00$ 716.80$ EXAM OF HEAD 651.78$ 456.24$ FOLLOW UP/REPEAT OB ULTRASOUND 285.00$ 199.50$

GUIDED NEEDLE PLACEMENT 86.00$ 60.20$ INFANT HIP W/WO MANIP ULTRASOUND 285.00$ 199.50$ INFANT HIPS W/MANIP ULTRASOUND 285.00$ 199.50$ KIDNEY LIMITED ULTRASOUND 419.00$ 293.30$ KIDNEY ULTRASOUND 419.00$ 293.30$ LIMITED 1+ FETUS(S) ULTRASOUND 419.00$ 293.30$ LIMITED ABDOMINAL ULTRASOUND 419.00$ 293.30$ LIMITED PELVIC ULTRASOUND 285.00$ 199.50$ OB BIOPHYSICAL PROFILE US 441.99$ 309.40$ PROSTATE VOLUME STUDY ULTRASOUND 589.00$ 412.30$ SCROTUM ULTRASOUND 419.00$ 293.30$ SPINE ULTRASOUND 285.00$ 199.50$ TRANSVAGINAL OB ULTRASOUND 419.00$ 293.30$ TRANSVAGINAL ULTRASOUND 419.00$ 293.30$ UC INTRAOPERATIVE 201.00$ 140.70$ US AAA SCREENING 519.00$ 363.30$ US ABDOMINAL COMPLETE 419.00$ 293.30$ US BREAST COMPLETE 285.00$ 199.50$ US BREAST LIMITED 285.00$ 199.50$ US EXTREMITY NON VASCULAR LIMITED 285.00$ 199.50$ US GUIDANCE FOR INTERSTITIAL APP 74.00$ 51.80$ US KIDNEY TRANSPLANT 419.00$ 293.30$ US OF BREAST COMPLETE 285.00$ 199.50$ US OF BREAST LIMITED 285.00$ 199.50$ US OF CHEST 419.00$ 293.30$ US OF HEAD AND NECK 419.00$ 293.30$ VASCULAR ACCESS GUIDE 55.00$ 38.50$ SCREENING BREAST TOMOSYNTHESIS 53.44$ 37.41$ SCREENING MAMMOGRAM 331.00$ 231.70$ PET BRAIN METABOLIC EVAL 3,995.00$ 2,796.50$ PET W/CT FULL BODY SCAN 3,995.00$ 2,796.50$ PET W/CT SKULL TO THIGH 3,995.00$ 2,796.50$ ARTERIAL PUNCTURE 546.00$ 382.20$ CHEST WALL MANIPULATION 682.00$ 477.40$ CHEST WALL MANIPULATION SUBSQNT 217.00$ 151.90$ CONT INHALATION TRTMT ADDL HOUR 59.00$ 41.30$ CONTINUOUS INHALATION TRTMT 1STHR 546.00$ 382.20$ CPAP INITIATION AND MANAGEMENT 682.00$ 477.40$ NASAL TRACHEAL SUCTIONING 682.00$ 477.40$ VENT SUBSEQUENT DAY 1,550.00$ 1,085.00$ VENTILATION ASSIST INITIAL DAY 1,550.00$ 1,085.00$ APPLICATION OF SHORT ARM SPLINT 546.00$ 382.20$ CANALITH REPOSITIONING 153.00$ 107.10$ ELECTRIC CURRENT THERAPY 15 MIN 136.00$ 95.20$ GAIT TRAINING 118.00$ 82.60$ MASSAGE THERAPY 15 MIN 110.00$ 77.00$ MECHANICAL TRACTION THERAPY 66.00$ 46.20$

ORTHOTIC/PROSTHETIC MGMNT 15 MIN 201.00$ 140.70$ ORTHOTICS (SUPPLY-NO EVAL) 191.00$ 133.70$ PHYSICAL PERFORMANCE TEST 15 MIN 137.00$ 95.90$ SELECTIVE WOUND DEBRIDE <20CM 605.00$ 423.50$ THERAPY NO SHOW CHARGE 25.00$ 17.50$ ULTRASOUND THERAPY 15 MIN 53.00$ 37.10$ WHEELCHAIR MNGMNT TRAINING 15MIN 126.00$ 88.20$ PT EVAL LOW COMPLEXITY 332.00$ 232.40$ PT EVAL MODERATE COMPLEXITY 332.00$ 232.40$ PT EVALUATION 332.00$ 232.40$ PT RE-EVALUATION EST PLAN OF CARE 226.00$ 158.20$ APPLICATION OF FINGER SPLINT 217.00$ 151.90$ APPLICATION OF SHORT ARM SPLINT 546.00$ 382.20$ COGNITIVE TRAINING 110.00$ 77.00$ MANUAL THERAPY 15 MIN 123.00$ 86.10$ NEUROMUSCULAR REEDUCATION 15 MIN 138.00$ 96.60$ NON WOUND ELECTRICAL STIMULATION 57.00$ 39.90$ ORTHOTIC MGMNT/TRAINING 15 MIN 158.00$ 110.60$ PARAFFIN BATH THERAPY 46.00$ 32.20$ PROSTHETIC TRAINING 1ST ENCOUNTER 15 MIN 137.00$ 95.90$ THERAPEUTIC ACTIVITIES 15 MIN 144.00$ 100.80$ THERAPEUTIC EXERCISES EA 15 MIN 134.00$ 93.80$ OT EVAL LOW COMPLEXITY 320.00$ 224.00$ OT EVAL MODERATE COMPLEXITY 320.00$ 224.00$ OT EVALUATION HIGH COMPLEXITY 320.00$ 224.00$ OT RE-EVALUATION EST PLAN OF CARE 213.00$ 149.10$ BEHAVIOR QUAL VOICE ANALYSIS 371.00$ 259.70$ COGNITIVE PERFORMANCE 484.00$ 338.80$ COGNITIVE SKILLS DEVELOPMENT 110.00$ 77.00$ COGNITIVE SKILLS DEVELOPMENT 110.00$ 77.00$ ENDOSCOPY SWALLOW (FEES) VID 281.00$ 196.70$ EVALUATE SWALLOW FUNCTION 299.00$ 209.30$ EVALUATION FOR SPEECH DEVICE 1 HR 513.00$ 359.10$ EVALUATION SPEECH FLUENCY 445.00$ 311.50$ EVALUATION SPEECH PRODUCTION 380.00$ 266.00$ MOTION FLUORO EVAL OF SWALLOWING 357.00$ 249.90$ SELF CARE MGMNT TRAINING ADDL 15 MIN 144.00$ 100.80$ SPEECH SOUND COMPRENSION 775.00$ 542.50$ SPEECH/HEARING THERAPY 326.00$ 228.20$ TREATMENT OF SWALLOWING DYS 355.00$ 248.50$ UNLISTED PT/REHAB SERVICE 133.00$ 93.10$ DEBRIDE TIS/MUSCLE/BONE <20CM 3,423.00$ 2,396.10$ IV PUSH ADDL SAME DRUG 169.00$ 118.30$ ABDOMINAL PARACENTESIS WO/IMAGE 2,027.00$ 1,418.90$ AIRWAY INHALATION TREATMENT 682.00$ 477.40$ ANOSCOPY W/ REMOVAL OF FOREIGN BODY 3,427.00$ 2,398.90$ APPLICATION OF ARM SPLINT 530.00$ 371.00$

APPLICATION OF FINGER SPLINT 217.00$ 151.90$ APPLICATION OF LONG LEG CAST 925.00$ 647.50$ APPLICATION OF LONG LEG SPLINT 530.00$ 371.00$ APPLICATION OF SHORT ARM CAST 925.00$ 647.50$ APPLICATION OF SHORT ARM SPLINT 546.00$ 382.20$ APPLICATION OF SHORT LEG CAST 925.00$ 647.50$ APPLICATION OF SHORT LEG SPLINT 530.00$ 371.00$ APPLY SHORT ARM SPLINT DYNAMIC 378.00$ 264.60$ ARTERIAL CATH SAMPLE 212.00$ 148.40$ ASPIRATION GANGLION CYST 875.00$ 612.50$ AVULSION OF NAIL PLATE EA ADDL 84.00$ 58.80$ BLADDER IRRIGATION 885.00$ 619.50$ BLOOD TRANSFUSION 1,231.00$ 861.70$ BURN TREATMNT 1ST DEGREE 408.00$ 285.60$ CARDIOPULMONARY RESUSCITATION 986.00$ 690.20$ CAUTERY OF CERVIX 7,646.00$ 5,352.20$ CHANGE OF CYSTOSTOMY TUBE 885.00$ 619.50$ CHEST TUBE INSERTION 2,027.00$ 1,418.90$ CLOSED TREATMENT OF FRACTURE GREAT TOE 891.00$ 623.70$ CLOSED TREATMENT OF HUMERAL FX 891.00$ 623.70$ CLOSED TREATMENT OF SHLDER DISLOC 886.00$ 620.20$ CLOSED TREATMENT OF TALUS 5,598.00$ 3,918.60$ CLOSED TREATMENT RADIAL SHAFT 2,954.00$ 2,067.80$ CLOSURE OF LACERATION <2.5CM 1,505.00$ 1,053.50$ CLSD TREATMENT MANDIBULAR FX 1,907.00$ 1,334.90$ CLSD TRTMNT FRACTURE OF CARPOMETACARPAL DISL 983.64$ 688.55$ CLSD TRTMNT OF ANKLE DISLOCATION 886.00$ 620.20$ CLSD TRTMNT OF BIMALLEOLAR ANKLE FRACTURE 2,954.00$ 2,067.80$ CLSD TRTMNT OF DISTAL FIBULAR FRACTURE 886.00$ 620.20$ CLSD TRTMNT OF DISTAL PHALANGEAL FRACTURE 886.00$ 620.20$ CLSD TRTMNT OF HIP DISLOCATION 886.00$ 620.20$ CLSD TRTMNT OF HUMERAL FRACTURE 886.00$ 620.20$ CLSD TRTMNT OF MEDIAL MALLEOLUS FRACTURE 5,435.00$ 3,804.50$ CLSD TRTMNT OF METACARPAL FRACTURE 886.00$ 620.20$ CLSD TRTMNT OF METACARPAL FRACTURE 886.00$ 620.20$ CLSD TRTMNT OF MONTEGGIA FRACTURE 16,304.00$ 11,412.80$ CLSD TRTMNT OF NASAL BONE FRACTURE 537.00$ 375.90$ CLSD TRTMNT OF PATELLAR DISLOCATION 700.00$ 490.00$ CLSD TRTMNT OF PHALANGEAL SHAFT FRACTURE 886.00$ 620.20$ CLSD TRTMNT OF POST HIP ARTHROPLASTY 886.00$ 620.20$ CLSD TRTMNT OF PROXIMAL FIBULA/SHAFT FRACTURE 2,954.00$ 2,067.80$ CLSD TRTMNT OF RADIAL/ULNAR SHAFT FRACTURE 886.00$ 620.20$ CLSD TRTMNT OF SHOULDER DISLOCATION W/MANIP 2,954.00$ 2,067.80$ CLSD TRTMNT OF SHOULDER DISL/ W/ANES 4,541.00$ 3,178.70$ CLSD TRTMNT OF TARSAL BONE DISLOCATION 700.00$ 490.00$ CLSD TRTMNT OF TEMPOROMANDIBULAR DISL 537.00$ 375.90$ CLSD TRTMNT OF TIBIAL FRACTURE 5,435.00$ 3,804.50$

CLSD TRTMNT OF TIBIAL SHAFT W/MANIPULATION 5,435.00$ 3,804.50$ CLSD TRTMNT OF TRIMALLEOLAR ANKLE FRACTURE 2,954.00$ 2,067.80$ COMPLEX REPAIR EYELIDS, NOSE, EARS, LIPS 1.1CM-2.5CM 1,781.00$ 1,246.70$ COMPLEX REPAIR FOREHEAD, CHEEK, CHIN 2.6-7.5CM 1,781.00$ 1,246.70$ COMPLEX REPAIR FOREHEAD, CHEEK, CHIN ETC 911.00$ 637.70$ COMPLEX SCALP, ARM, LEG REPAIR 1,781.00$ 1,246.70$ COMPLEX SCALP, ARM, LEG REPAIR ADDL 5CM 358.00$ 250.60$ CONTROL NASAL HEMORRHAGE 537.00$ 375.90$ CONTROL NASAL HEMORRHAGE 537.00$ 375.90$ CONTROL NASAL HEMORRHAGE COMPLEX 537.00$ 375.90$ CONTROL OF NASAL HEMORRHAGE 546.00$ 382.20$ CONTROL OROPHARYNGEAL HEMORRHAGE 537.00$ 375.90$ CRITICAL CARE ADDL 30 MIN 458.00$ 320.60$ CRITICAL CARE VISIT 2,721.00$ 1,904.70$ CV LEVEL 1 EST 130.00$ 91.00$ CV LEVEL 1 NEW PT 130.00$ 91.00$ CV LEVEL 2 EST 144.00$ 100.80$ CV LEVEL 2 NEW PT 144.00$ 100.80$ CV LEVEL 3 EST 234.00$ 163.80$ CV LEVEL 3 NEW PT 234.00$ 163.80$ CV LEVEL 4 824.00$ 576.80$ CV LEVEL 5 1,261.00$ 882.70$ CV LEVEL 6 CRITICAL CARE 2,721.00$ 1,904.70$ CYSTOURETHROSCOPY 2,273.00$ 1,591.10$ DECLOT VASCULAR DEVICE 808.00$ 565.60$ DENTOALVEOLAR STRUCTURE 537.00$ 375.90$ DIAGNOSTIC ANOSCOPY 546.00$ 382.20$ DIAGNOSTIC SPINAL PUNCTURE 1,544.00$ 1,080.80$ DILATION OF URETHRAL STRICTURE 885.00$ 619.50$ DILATION URETHERAL STRICTURE 2,249.00$ 1,574.30$ DRAIN/INJECTION OF JOINT/BURSA 875.00$ 612.50$ DRAINAGE OF ABSCESS, CYST, HEMATOMA 671.00$ 469.70$ DRAINAGE OF ABSCESS, CYST, HEMATOMA 671.00$ 469.70$ DRAINAGE OF DENTAL ABSCESS 671.00$ 469.70$ DRAINAGE OF DENTAL ABSCESS 671.00$ 469.70$ DRAINAGE OF EXTERNAL AUDITORY CANAL ABSC 671.00$ 469.70$ DRAINAGE OF EXTERNAL EAR ABSC/HEMATOMA 671.00$ 469.70$ DRAINAGE OF FINGER ABSCESS 671.00$ 469.70$ DRAINAGE OF FINGER ABSCESS COMPLICATED 3,586.00$ 2,510.20$ DRAINAGE OF SCROTAL WALL ABSCESS 3,586.00$ 2,510.20$ DRESS/DEBRID PART THICK BURN LRG 1,173.00$ 821.10$ DRESS/DEBRID PART THICK BURN MED 605.00$ 423.50$ EMERGENCY DEPT VISIT 467.00$ 326.90$ EMERGENCY DEPT VISIT 822.00$ 575.40$ EMERGENCY DEPT VISIT 1,382.00$ 967.40$ EMERGENCY DEPT VISIT LEVEL 2,041.00$ 1,428.70$ EMERGENCY DEPT VISIT LEVEL 1 251.00$ 175.70$

EMERGENT INTUBATION 537.00$ 375.90$ EVACUATION OF SUBUNGUAL HEMATOMA 217.00$ 151.90$ EXCISION OF BENIGN LESION <.5 CM 1,568.00$ 1,097.60$ EXPLORATION OF WOUND 3,586.00$ 2,510.20$ FEMORAL NERVE BLOCK 1,544.00$ 1,080.80$ FLEX DIAGNOSTIC LARYNGOSCOPY 624.00$ 436.80$ FORESKIN MANIPULATION 884.00$ 618.80$ GASTRIC LAVAGE 546.00$ 382.20$ IM/SQ INJECTION 111.00$ 77.70$ IMMUNIZATION EA ADDTL VACCINE 27.00$ 18.90$ INCISION & DRAIN OF CYST SIMPLE 671.00$ 469.70$ INCISION & DRAIN PERIANAL ABSCESS 1,833.00$ 1,283.10$ INCISION OF HEMORRHOID 885.00$ 619.50$ INCISION/DRAINAGE ABSCESS 1,505.00$ 1,053.50$ INCISION/DRAINAGE OF ABSCESS COMPLICATED/MULTI 671.00$ 469.70$ INCISION/DRAINAGE OF ABSCESS MOUTH/SUBMANDIBULAR 9,119.00$ 6,383.30$ INCISION/DRAINAGE OF BARTHOLIN GLAND ABSC 542.00$ 379.40$ INCISION/DRAINAGE OF HEMATOMA/FLUID 3,586.00$ 2,510.20$ INCISION/DRAINAGE OF PILONIDAL CYST 3,586.00$ 2,510.20$ INCISION/DRAINAGE OF VULVA/PERINEAL 937.00$ 655.90$ INCISION/REMOVAL OF FOREIGN BODY 1,173.00$ 821.10$ INJ EPIDURAL BLOOD CLOT PATCH 2,783.00$ 1,948.10$ INJ OF ANES INTO SPHENO GANGLION 1,015.00$ 710.50$ INJ PERIPHERAL NERVE/BRANCH 1,544.00$ 1,080.80$ INJ PERIPHERAL NERVE/BRANCH 2,780.16$ 1,946.11$ INJ TRIGEMINAL NERVE APICAL BL 875.00$ 612.50$ INJ/BLOCK C/T WO GUIDANCE 2,075.00$ 1,452.50$ INJECTION CERVICAL PLEXUS 1,544.00$ 1,080.80$ INJECTION/ANESTHETIC AGENT FACIAL NERVE 546.00$ 382.20$ INSERT FEED TUBE VIA TRACH/ESO 599.00$ 419.30$ INSERTION OF BLADDER CATHETER 546.00$ 382.20$ INSERTION OF FOLEY CATH 546.00$ 382.20$ INSERTION OF FOLEY CATH 546.00$ 382.20$ INSERTION OF TEMPORARY BLADDER CATH 469.00$ 328.30$ INTERMEDIATE WND REP 7.6-12.5CM 911.00$ 637.70$ INTERMEDIATE WND REPAIR <2.5CM 911.00$ 637.70$ INTERMEDIATE WND REPAIR 2.5-5.0CM 911.00$ 637.70$ INTERMEDIATE WND REPAIR 7.6-12.5CM 911.00$ 637.70$ INTERMEDIATE WND REPAIR NECK/HANDS/FEET 911.00$ 637.70$ INTERMEDIATE WND REPAIR SCALP, AXILLAE 12.6-20.0CM 1,781.00$ 1,246.70$ INTERMEDIATE WOUND REPAIR <2.5CM 911.00$ 637.70$ IRRIGATION CORPA CAVERN 885.00$ 619.50$ IRRIGATION REMOVAL OF CERUMEN 223.00$ 156.10$ KNEE STRAPPING 217.00$ 151.90$ LACERATION LIP/VERMILLION FT >1/2 HGT 2,856.00$ 1,999.20$ LACERATION LIP/VERMILLION FT 1/2 HGT 2,678.00$ 1,874.60$ LACERATION REPAIR <2.5 CM 537.00$ 375.90$

LIP REPAIR VERMILION ONLY 2,678.00$ 1,874.60$ NASO/OROGASTRIC TUBE PLACEMENT 625.00$ 437.50$ NEEDLE PLACEMENT FOR INTRAOSSEOUS INFUSION 546.00$ 382.20$ NON TUNNEL CATH <5 YEARS 3,493.00$ 2,445.10$ NON TUNNEL CATH >5 YEARS 3,493.00$ 2,445.10$ OCCIPITAL NERVE BLOCK 1,544.00$ 1,080.80$ OPEN CHEST HEART MASSAGE 2,496.00$ 1,747.20$ PERIRECTAL ABSCESS DRAIN 6,027.00$ 4,218.90$ PICC LINE WO/PORT PUMP >5 YEARS 3,493.00$ 2,445.10$ PROCEDURE OF THE SMALL INTESTINE 9,467.00$ 6,626.90$ PROCEDURE PHARYNX 537.00$ 375.90$ RADIAL HEAD SUBLAXATION 886.00$ 620.20$ REDUCTION OF RECTUM 2,944.00$ 2,060.80$ REMOVAL CAST ARM/LEG 925.00$ 647.50$ REMOVAL IUD 937.00$ 655.90$ REMOVAL OF EMBEDDED FB MOUTH 546.00$ 382.20$ REMOVAL OF EMBEDDED FB EYELID 1,236.00$ 865.20$ REMOVAL OF EYE W/SLIT LAMP 418.00$ 292.60$ REMOVAL OF EYE/CONJUNCTIVA 418.00$ 292.60$ REMOVAL OF FB FROM EYES/LENS 7,259.00$ 5,081.30$ REMOVAL OF FOREIGN BODY PHARYNX 546.00$ 382.20$ REMOVAL OF FOREIGN BODY; AUDITORY CANAL 546.00$ 382.20$ REMOVAL OF FOREIGN BODY; NOSE 546.00$ 382.20$ REMOVAL OF IMPACTED EAR WAX 217.00$ 151.90$ REMOVAL OF NAIL BED 1,568.00$ 1,097.60$ REMOVAL OF SKIN TAGS <=15 LESIONS 408.00$ 285.60$ REMOVE FB CORNEA 418.00$ 292.60$ REMOVE FB CORNEA 418.00$ 292.60$ REPAIR EXTENSOR TENDON/FINGER 5,087.00$ 3,560.90$ REPAIR MOUTH LACERATION >2.5CM 2,678.00$ 1,874.60$ REPAIR NAIL BED 911.00$ 637.70$ REPLACE GASTROSTOMY TUBE 808.00$ 565.60$ SHOULDER IMMOBILIZER 217.00$ 151.90$ SIMPLE REPAIR OF SUPERFICIAL FC WOUND 7.6-12.5CM 605.00$ 423.50$ SIMPLE REPAIR OF SUPERFICIAL WOUND 20.1-30.0CM 911.00$ 637.70$ SINGLE INJECTION SHEATH/LIGAMENT 875.00$ 612.50$ STRAPPING HAND/FINGER 217.00$ 151.90$ STRAPPING TOES 217.00$ 151.90$ SUPERFICIAL WND REPAIR 12.6-20.0CM 605.00$ 423.50$ SUPERFICIAL WND REPAIR 2.6-7.5CM 408.00$ 285.60$ SUPERFICIAL WND REPAIR 7.6-12.5CM 408.00$ 285.60$ SUPERFICIAL WOUND REPAIR <2.5 CM 408.00$ 285.60$ SUPERFICIAL WOUND REPAIR <2.5CM 408.00$ 285.60$ SUPERFICIAL WOUND REPAIR 2.5-5 CM 408.00$ 285.60$ THERAPEUTIC SPINAL PUNCTURE 1,544.00$ 1,080.80$ THORACENTESIS WO/IMAGE 2,027.00$ 1,418.90$ THROMBOLYSIS CEREBRAL BY IV 1,112.04$ 778.43$

TRACHEOSTOMY CRICOTHYROID 1,907.00$ 1,334.90$ TREATMENT HUMERUS FRACTURE 886.00$ 620.20$ TREATMENT JOINT DISLOCATION 886.00$ 620.20$ TREATMENT OF CLOSED ELBOW DISLOCATION 886.00$ 620.20$ TREATMENT OF DISTAL RADIAL FRACTURE 2,954.00$ 2,067.80$ TREATMENT OF JOINT DISLOCATION 700.00$ 490.00$ TREATMENT OF METACARP DISLOC 886.00$ 620.20$ TREATMENT OF SUPERFICIAL WOUND DEHISCENCE 911.00$ 637.70$ TRIGGER POINT INJECTION >3 875.00$ 612.50$ UNLISTED OPHTHALMOLOGY 216.00$ 151.20$ UNLISTED PROCEDURE RECTUM/PROCTOSCOPE 1,833.00$ 1,283.10$ WEDGE EXCISION OF SKIN/NAIL FOLD 605.00$ 423.50$ CAPNOGRAPY DAILY 981.00$ 686.70$ CARDIOPULMONARY EXERCISE TESTING 981.00$ 686.70$ CONTINUOUS PULSE OX 467.00$ 326.90$ CONTINUOUS PULSE OX 934.00$ 653.80$ DIFFUSE CAPACITY 384.00$ 268.80$ OXYGEN HOOD 13.00$ 9.10$ PULM FUNCTION TST PLETHYSMOGRAPHY 668.00$ 467.60$ PULSE OXIMETRY 21.00$ 14.70$ RESPIRATORY FLOW VOLUME LOOP 668.00$ 467.60$ SPIROMETERY W/DILATION 981.00$ 686.70$ EVOKED AUDITORY TEST LIMITED 592.00$ 414.40$ CARDIAC TILT TEST 1,366.00$ 956.20$ CARDIOVERSION 1,949.00$ 1,364.30$ CI CTO DES PCI ADDL 13,096.00$ 9,167.20$ DOPPLER W/COLOR FLOW 96.00$ 67.20$ ECHO TEE FOR MONITORING 2,462.00$ 1,723.40$ ECHOCARDIOGRAM LIMITED 785.00$ 549.50$ ECHOCARDIOGRAM W/DOPPLER 1,751.00$ 1,225.70$ ECHOCARDIOGRAM WO/DOPPLER 1,751.00$ 1,225.70$ HEART ANGIOPLASTY 18,800.00$ 13,160.00$ HEART ANGIOPLASTY 6,787.00$ 4,750.90$ HEART ARTHRECTOMY W/STENT 39,875.00$ 27,912.50$ HEART DEFIBULATOR TESTING 2,572.00$ 1,800.40$ HEART STENT 39,875.00$ 27,912.50$ HEART STENT 10,308.00$ 7,215.60$ HEART STENT 39,875.00$ 27,912.50$ HEART STENT 39,875.00$ 27,912.50$ MYOCARDIAL STRAIN IMAGING 116.00$ 81.20$ MYOCARDIAL STRAIN IMAGING 116.00$ 81.20$ PERIPHERAL ARTERIAL DISEASE REHAB 223.00$ 156.10$ SPECTRAL ECHO DOPPLER COMPLETE 153.00$ 107.10$ SPECTRAL ECHO DOPPLER LIMITED 86.00$ 60.20$ STRESS ECHO 1,751.00$ 1,225.70$ TRANSCATHETER PLACEMENT 39,875.00$ 27,912.50$ TRANSCATHETER PLACEMENT 13,096.00$ 9,167.20$

TRANSESOPHAGEAL ECHO 2,462.00$ 1,723.40$ TRANSLUMINAL ATHERECTOMY 61,488.00$ 43,041.60$ TRANSLUMINAL REVASCULARIZATION 39,875.00$ 27,912.50$ TRANSLUMINAL REVASCULARIZATION 61,488.00$ 43,041.60$ TRANSLUMINAL REVASCULARIZATION 61,488.00$ 43,041.60$ CARDIAC ANGIOGRAM 220.00$ 154.00$ CARDIAC CATHETERIZATION TEST 10,670.00$ 7,469.00$ CARDIAC CATHETERIZATION TEST 10,670.00$ 7,469.00$ CARDIAC CATHETERIZATION TEST 10,670.00$ 7,469.00$ CARDIAC CATHETERIZATION TEST 10,670.00$ 7,469.00$ CLOT REMOVAL 18,800.00$ 13,160.00$ CLOT REMOVAL 39,875.00$ 27,912.50$ CLOT REMOVAL 39,875.00$ 27,912.50$ CLOT REMOVAL 61,488.00$ 43,041.60$ CLOT REMOVAL 39,875.00$ 27,912.50$ CLOT REMOVAL 863.00$ 604.10$ CLOT REMOVAL 39,875.00$ 27,912.50$ CLOT REMOVAL 39,875.00$ 27,912.50$ CLOT REMOVAL 640.00$ 448.00$ CORONOARY ANGIOGRAM W/GRAFTS 10,670.00$ 7,469.00$ CORONOARY ARTERY ANGIOGRAM 10,670.00$ 7,469.00$ EMBOLIZATION FOR BLEED 39,875.00$ 27,912.50$ EMBOLIZATION FOR TUMOR 39,875.00$ 27,912.50$ EMBOLIZE AV MALFORMATION 39,875.00$ 27,912.50$ EMBOLIZE AV MALFORMATION 39,875.00$ 27,912.50$ HEART ANGIOGRAM 327.00$ 228.90$ INSERT INTRA AORTIC BALLOON PUMP 1,092.00$ 764.40$ INSERT PACEMAKER ATRIAL 39,318.00$ 27,522.60$ INSERT PULSE GENERATOR MULTI LEAD 67,953.00$ 47,567.10$ INTRAVASCULAR DOPPLER INTL VES 409.00$ 286.30$ PHARMACOLOGIC STUDY W/CATH 409.00$ 286.30$ REMOVE HEART CLOT 409.00$ 286.30$ REMOVE PACEMAKER LEAD 9,721.00$ 6,804.70$ REMOVE/REPLACE PACEMAKER 27,108.00$ 18,975.60$ REMOVE/REPLACE PACEMAKER 39,318.00$ 27,522.60$ REMOVE/REPLACE PACEMAKER 67,953.00$ 47,567.10$ REMV/REPLCE GENERATOR DUAL LEAD 94,911.00$ 66,437.70$ REMV/REPLCE GENERATOR MULTI LEAD 99,000.00$ 69,300.00$ REMV/REPLCE GENERATOR SINGLE LEAD 94,911.00$ 66,437.70$ RIGHT HEART CATHETER 10,670.00$ 7,469.00$ RIGHT HRT CORONOARY ARTERY ANGIO 10,670.00$ 7,469.00$ SWANZ GANZ CATHETER INSERT 6,527.00$ 4,568.90$ HEART STRESS TEST 986.00$ 690.20$ ECHO 2,031.00$ 1,421.70$ ECHO 2,031.00$ 1,421.70$ ECHO 2,852.00$ 1,996.40$ ECHO 2,852.00$ 1,996.40$

ECHO 2,852.00$ 1,996.40$ ECHO 2,852.00$ 1,996.40$ ECHOCARDIOGRAM COMPLETE 2,462.00$ 1,723.40$ ECHOCARDIOGRAM COMPLETE 2,462.00$ 1,723.40$ REPAIR OF LACERATION/ APPL OF TISSUE GLUE 7,967.00$ 5,576.90$ DECLOT VASCULAR DEVICE 808.00$ 565.60$ MOM PRENATAL 4-7 VISITS 1,506.00$ 1,054.20$ NEW OFFICE VISIT LEVEL 1 130.00$ 91.00$ NEW OUTPATIENT VISIT COMPLEX 630.00$ 441.00$ NEW OUTPATIENT VISIT EXTENDED 412.00$ 288.40$ OFFICE VISIT EST PT LEVEL 1 130.00$ 91.00$ OP CONSULT LEVEL 5 436.00$ 305.20$ OUTPATIENT VISIT EST EXTENDED 412.00$ 288.40$ OUTPATIENT VISIT EST LIMITED 144.00$ 100.80$ PREGNANCY TEST 28.00$ 19.60$ SPORTS PHYSICAL 79.00$ 55.30$ TB TEST 1 STEP 36.00$ 25.20$ TREATMENT OF BLADDER LESION 884.00$ 618.80$ WALMART OUTPATIENT VISIT 108.00$ 75.60$ WALMART NEW OFFICE VISIT LEVEL 1 108.00$ 75.60$ WALMART OFFICE VISIT EST PT LEVEL 1 108.00$ 75.60$ ANALYZE IMPLANTED PUMP 1,025.00$ 717.50$ ANALYZE SPINE INFUSION PUMP 1,025.00$ 717.50$ HOSPITAL OUTPATIENT CLINIC 199.00$ 139.30$ INFUSION PMP W/MD REPRG & FILL 1,025.00$ 717.50$ OFC VISIT LEVEL 1 EST 130.00$ 91.00$ OFC VISIT LEVEL 1 NEW PT 130.00$ 91.00$ OFC VISIT LEVEL 2 EST PT 144.00$ 100.80$ OFC VISIT LEVEL 2 NEW PT 144.00$ 100.80$ OFC VISIT LEVEL 3 EST PT 234.00$ 163.80$ OFC VISIT LEVEL 3 NEW PT 234.00$ 163.80$ OFC VISIT LEVEL 4 EST PT 412.00$ 288.40$ OFC VISIT LEVEL 4 NEW PT 412.00$ 288.40$ OFC VISIT LEVEL 5 EST PT 630.00$ 441.00$ OFC VISIT LEVEL 5 NEW PT 630.00$ 441.00$ PUMP REFILL/REPROGRAM 1,025.00$ 717.50$ CLOSURE OF LACERATION <2.5CM 752.00$ 526.40$ DIAGNOSTIC INJECTION NEW DRUG 67.00$ 46.90$ DIAGNOSTIC INJECTION SIMPLE PUSH 224.00$ 156.80$ DMV PHYSICAL 143.00$ 100.10$ EMP PHYSICAL 55.00$ 38.50$ HYDRATION IV INFUSION 31-60 MIN 224.00$ 156.80$ HYDRATION IV INFUSION ADD ON 67.00$ 46.90$ IMMUNIZATION VACCINE 111.00$ 77.70$ INFUSION THERAPY =<1 HR 359.00$ 251.30$ INJ PERIPHERAL NERVE/BRANCH 772.00$ 540.40$ INTERMEDIATE WND REPAIR 2.5-7.5CM 455.00$ 318.50$

PRE-EMPLOYMENT/ADULT PHYSICAL 79.00$ 55.30$ REMOVAL OF IMPACTED EAR WAX 108.00$ 75.60$ SHOULDER IMMOBILIZER 108.00$ 75.60$ SUPERFICIAL WND REPAIR 5.0-7.5 CM 204.00$ 142.80$ TB TEST 2 STEP 50.00$ 35.00$ URGENT CARE LEVEL 4 VISIT 412.00$ 288.40$ URGENT CARE AIRWAY INHALATION TREATMENT 341.00$ 238.70$ URGENT CARE APPLICATION OF ARM SPLINT 265.00$ 185.50$ URGENT CARE APPLICATION OF FINGER SPLINT 108.00$ 75.60$ URGENT CARE APPLICATION OF LONG LEG SPLINT 265.00$ 185.50$ URGENT CARE APPLICATION OF SHORT ARM SPLINT 273.00$ 191.10$ URGENT CARE APPLICATION OF SHORT LEG SPLINT 265.00$ 185.50$ URGENT CARE ASPIRATION OF ABSCESS 335.00$ 234.50$ URGENT CARE AVULSION OF NAIL PLATE 303.00$ 212.10$ URGENT CARE CLOSED TREATMENT OF SHLDER DISLOC 446.00$ 312.20$ URGENT CARE CONTROL OF NASAL HEMORRHAGE 273.00$ 191.10$ URGENT CARE DRAIN/INJECTION OF JOINT/BURSA 437.00$ 305.90$ URGENT CARE DRAIN/INJECTION OF JOINT/BURSA 437.00$ 305.90$ URGENT CARE DRAINAGE OF FINGER ABSCESS 335.00$ 234.50$ URGENT CARE DRESSINGS/DEBRID OF P/THICK BURNS 303.00$ 212.10$ URGENT CARE EVACUATION OF SUBUNGUAL HEMATOMA 108.00$ 75.60$ URGENT CARE INCISE & REMOVE FOREIGN BODY 586.00$ 410.20$ URGENT CARE INCISION & DRAIN OF CYST SIMPLE 335.00$ 234.50$ URGENT CARE INCISION & DRAIN PERIANAL ABSCESS 916.00$ 641.20$ URGENT CARE INCISION & DRAINAGE OF ABSCESS 335.00$ 234.50$ URGENT CARE INCISION AND DRAINAGE OF FLUID 1,793.00$ 1,255.10$ URGENT CARE INCISION OF HEMORRHOID 443.00$ 310.10$ URGENT CARE INTERMEDIATE WND REP 7.6-12.5CM 455.00$ 318.50$ URGENT CARE INTERMEDIATE WND REPAIR 2.5-5.0CM 455.00$ 318.50$ URGENT CARE INTERMEDIATE WND REPAIR 2.6-7.5CM 455.00$ 318.50$ URGENT CARE INTERMEDIATE WND REPAIR NECK/HANDS/FEET 455.00$ 318.50$ URGENT CARE INTERMEDIATE WOUND REPAIR <2.5CM 455.00$ 318.50$ URGENT CARE LEVEL 5 VISIT 1,261.00$ 882.70$ URGENT CARE NEW OUTPATIENT VISIT INTERMEDIATE 234.00$ 163.80$ URGENT CARE NEW OUTPATIENT VISIT LIMITED 144.00$ 100.80$ URGENT CARE OUTPATIENT VISIT EST INTERMEDIATE 234.00$ 163.80$ URGENT CARE RADIAL HEAD SUBLUXATION 443.00$ 310.10$ URGENT CARE REMOVAL OF EYE W/SLIT LAMP 209.00$ 146.30$ URGENT CARE REMOVAL OF EYE/CONJUNCTIVA 209.00$ 146.30$ URGENT CARE REMOVAL OF FOREIGN BODY; AUDITORY CANAL 273.00$ 191.10$ URGENT CARE REMOVAL OF FOREIGN BODY; NOSE 273.00$ 191.10$ URGENT CARE REMOVAL OF NAIL BED 784.00$ 548.80$ URGENT CARE REMOVAL OF SKIN TAGS <=15 LESIONS 204.00$ 142.80$ URGENT CARE SUPERFICIAL WND REPAIR 12.6-20CM 303.00$ 212.10$ URGENT CARE SUPERFICIAL WND REPAIR 2.6-7.5CM 204.00$ 142.80$ URGENT CARE SUPERFICIAL WND REPAIR 7.6-12.5CM 204.00$ 142.80$ URGENT CARE SUPERFICIAL WOUND REPAIR <2.5 CM 204.00$ 142.80$

URGENT CARE SUPERFICIAL WOUND REPAIR <2.5CM 204.00$ 142.80$ URGENT CARE SUPERFICIAL WOUND REPAIR 2.5-5 CM 204.00$ 142.80$ URGENT CARE TREATMENT OF JOINT DISLOCATION 350.00$ 245.00$ URGENT CARE TREATMENT OF METACARP DISLOC 443.00$ 310.10$ MRA ABDOMINAL W/WO CONTRAST 1,501.00$ 1,050.70$ MRA CHEST W/CONTRAST 1,657.75$ 1,160.43$ MRA HEAD W/CONTRAST 1,326.00$ 928.20$ MRA HEAD WO/CONTRAST 890.00$ 623.00$ MRA LOWER EXTREMITY W/WO CONTRAST 1,501.00$ 1,050.70$ MRA LOWER EXTREMITY WO/CONTRAST 890.00$ 623.00$ MRA NECK W/CONTRAST 1,326.00$ 928.20$ MRA NECK W/WO CONTRAST 1,501.00$ 1,050.70$ MRA NECK WO/CONTRAST 890.00$ 623.00$ MRA PELVIS W/WO CONTRAST 1,501.00$ 1,050.70$ MRA UPPER EXTREMITY W/WO CONTRAST 1,002.00$ 701.40$ MRI ABDOMEN W/WO CONTRAST 1,501.00$ 1,050.70$ MRI ABDOMEN WO/CONTRAST 890.00$ 623.00$ MRI BRAIN W/CONTRAST 1,326.00$ 928.20$ MRI BREAST BILATERAL W/WO CON 1,501.00$ 1,050.70$ MRI BREAST BILATERAL WO/CONTRAST 890.00$ 623.00$ MRI CERVICAL SPINE W/WO CONTRAST 1,501.00$ 1,050.70$ MRI CHEST W/WO CONTRAST 1,501.00$ 1,050.70$ MRI CHEST WO/CONTRAST 890.00$ 623.00$ MRI COMPUTER AIDED DETECTION 198.00$ 138.60$ MRI GUIDANCE FOR NEEDLE PLACEMENT 1,060.00$ 742.00$ MRI LOWER EXTREMITY W/WO CONTRAST 1,501.00$ 1,050.70$ MRI LOWER EXTRM NON JNT WO/CON 890.00$ 623.00$ MRI LOWER JOINT EXTREMITY W/CON 1,326.00$ 928.20$ MRI LOWER JOINT EXTRM W/WO CON 1,501.00$ 1,050.70$ MRI LOWER JOINT EXTRM WO/CON 890.00$ 623.00$ MRI LOWER JOINT EXTRM WO/CON 1,026.77$ 718.74$ MRI LUMBAR SPINE W/CONTRAST 1,326.00$ 928.20$ MRI LUMBAR SPINE W/WO CONTRAST 1,501.00$ 1,050.70$ MRI LWR EXTRM NON JNT W/WO CON 1,501.00$ 1,050.70$ MRI LWR EXTRM NON JNT W/WO CON 2,401.00$ 1,680.70$ MRI ORBIT/FACE/NECK W/CONTRAST 1,326.00$ 928.20$ MRI ORBIT/FACE/NECK W/WO CONTRAST 1,501.00$ 1,050.70$ MRI ORBIT/FACE/NECK WO/CONTRAST 890.00$ 623.00$ MRI PELVIS LIMITED WO/CONTRAST 1,223.38$ 856.36$ MRI PELVIS W/WO CONTRAST 1,501.00$ 1,050.70$ MRI PELVIS WO/CONTRAST 890.00$ 623.00$ MRI THORACIC SPINE W/CONTRAST 1,326.00$ 928.20$ MRI THORACIC SPINE W/WO CONTRAST 1,501.00$ 1,050.70$ MRI THORACIC SPINE WO/CONTRAST 890.00$ 623.00$ MRI TMJ W/WO CONTRAST 890.00$ 623.00$ MRI UPPER JNT EXTREMITY W/CON 1,326.00$ 928.20$ MRI UPPER JNT EXTREMITY W/WO CON 1,501.00$ 1,050.70$

MRI UPPER JNT EXTREMITY WO/CON 890.00$ 623.00$ MRI UPPER NON JNT EXTRM W/WO CON 1,501.00$ 1,050.70$ MRI UPPER NON JNT EXTRM WO/CON 890.00$ 623.00$ MRI BRAIN W/WO CONTRAST 1,501.00$ 1,050.70$ MRI BRAIN WO/CONTRAST 890.00$ 623.00$ MRI CERVICAL SPINE W/CONTRAST 1,326.00$ 928.20$ MRI CERVICAL SPINE WO/CONTRAST 890.00$ 623.00$ MRI LUMBAR SPINE WO/CONTRAST 890.00$ 623.00$ 25% BUPIVACAINE 30ML SINGLE DOSE 54.90$ 38.43$ ABATACEPT 250MG PWVL 5,902.44$ 4,131.71$ ABCIXIMAB (REOPRO) 2MG/ML 5ML 8,381.68$ 5,867.17$ ABRAXANE=PACLITAXEL SUSP 100 MG 7,842.34$ 5,489.64$ ACETAZOLAMIDE 500MG PWDI 605.30$ 423.71$ ACETYLCYSTEINE 200 MG/ML 30 ML 1,195.26$ 836.68$ ACTIVASE (TPA) 100MG VIAL 49,602.94$ 34,722.05$ ACTIVASE 50MG VIAL 24,800.43$ 17,360.30$ ACYCLOVIR (ZOVIRAX) 500MG VIAL 181.10$ 126.77$ ADENOSINE 3MG/ML 2ML SDPF 160.42$ 112.29$ ADENOSINE 90 MG/30 ML SDV 2,086.01$ 1,460.21$ ADO-TRASTUZUMAB 100MG PWDI 15,898.76$ 11,129.13$ ADO-TRASTUZUMAB 160MG PWDI #DIV/0! #DIV/0!ADRENALIN CHLORIDE 1MG/ML 30ML 407.80$ 285.46$ AHF RECOMBINANT +/- 1650 I.U. 11,836.37$ 8,285.46$ ALBUTEIN (ALBUMIN) 25% 100 ML 822.20$ 575.54$ ALBUTEIN (ALBUMIN) 25% 50ML 608.52$ 425.96$ AMANTADINE 50MG/5ML PER ML 0.40$ 0.28$ AMINOPHYLLINE 250 MG/10 ML SDV 157.80$ 110.46$ AMIODARONE 50MG/ML 3ML SDV 47.31$ 33.11$ AMIODARONE 900 MG/18 ML SDV 195.50$ 136.85$ AMPHOTERICIN B 50MG PWDI 527.60$ 369.32$ AMPICILLIN 1 GR PWDI 94.20$ 65.94$ AMPICILLIN 125MG PWDI 90.60$ 63.42$ AMPICILLIN 250MG PWDI 56.82$ 39.77$ AMPICILLIN 2GM PWDI 126.48$ 88.54$ AMPICILLIN 500MG PWDI. 71.74$ 50.22$ AMPICILLIN/SULBACTAM 1.5GM PWDI 68.53$ 47.97$ APLIGRAPH PER SQ CM 152.00$ 106.40$ AREDIA 30 MG VIAL 185.30$ 129.71$ ARGATROBAN 250MG/2.5ML SDV 7,480.60$ 5,236.42$ ATEZOLIZUMAB 60MG/ML 20ML PF 51,712.00$ 36,198.40$ ATRACURIUM 10MG/ML 10ML 186.84$ 130.79$ ATROPINE 0.4MG/ML 1 ML VIAL 126.14$ 88.30$ ATROPINE 1MG/10ML SYRINGE 85.12$ 59.58$ ATROPINE 1MG/ML 1 ML VIAL 178.83$ 125.18$ AZACITIDINE=VIDAZA 100 MG SDV 1,894.25$ 1,325.97$ AZATHIOPRINE 50MG TAB 5.19$ 3.63$ AZITHROMYCIN 500MG PWDI 114.68$ 80.27$

BELATACEPT 250MG PWVL 11,744.40$ 8,221.08$ BENDAMUSTINE 25MG/1ML MDPF VIAL 14,725.53$ 10,307.87$ BENZTROPINE 1MG/ML 2ML SDV 326.90$ 228.83$ BETAMETHASONE 6MG/ML SUSP 347.00$ 242.90$ BETAMETHASONE 6MG/ML SUSP 365.48$ 255.84$ BEVACIZUMAB=AVASTIN 25MG/ML 4ML 4,258.89$ 2,981.22$ BEVACIZUMAB=AVASTIN 400 MG SDV 17,646.50$ 12,352.55$ BICILLIN LA 1.2 MMU/2 ML SDV 782.79$ 547.95$ BIVALIRUDIN=ANGIOMAX 250 MG SDV 3,009.70$ 2,106.79$ BLENOXANE (BLEOMYCIN)15U VL 783.30$ 548.31$ BLEOMYCIN 30 UN SDV 450.30$ 315.21$ BORTEZOMID=VELCADE 3.5 MG SDV 9,516.80$ 6,661.76$ BOTOX 100 UNITS VIAL 3,640.99$ 2,548.69$ BOTOX 200 UNIT VIAL 6,598.90$ 4,619.23$ BRENTUXIMAB VEDOTIN 50 MG SDV 36,145.68$ 25,301.97$ BRETHINE 1MG/ML 1 ML AMPULE 281.10$ 196.77$ BUPIVACAINE HCI .5% 30ML 57.40$ 40.18$ BUTORPHANOL 2MG/ML SDV 82.10$ 57.47$ CABAZITAXEL 60MG/1.5ML SDV 52,076.90$ 36,453.83$ CALCIMAR 200IU/ML 2 ML VIAL 15,528.50$ 10,869.95$ CALCIUM CHLORIDE 10% 10ML SYRI 103.83$ 72.68$ CALCIUM GLUCONATE 10% 10ML VL 122.40$ 85.68$ CAMPTOSAR 20MG/ML VIAL 211.93$ 148.35$ CARBOPLATIN 450MG/45ML SOLUTION 589.78$ 412.84$ CARFILZOMIB 60MG PWVL 9,048.43$ 6,333.90$ CATHFLO=ALTEPLASE 2 MG SDV 838.11$ 586.68$ CEFAZOLIN (KEFZOL=ANCEF) 1GRAM 41.65$ 29.15$ CEFEPIME=MAXIPIME 2 GM SDV 170.50$ 119.35$ CEFOTAXIME 1GM PWDI 62.03$ 43.42$ CEFOXITIN 2 GM SDV 207.90$ 145.53$ CEFTAZIDIME 2GM/D5W 50ML PREMIX 190.85$ 133.59$ CEFTRIAXONE (ROCEPHIN) 1GRAM 58.20$ 40.74$ CEFTRIAXONE 2 GRAM PWDI 79.67$ 55.77$ CEFTRIAXONE 2GM/DEXTROSE 50ML 233.01$ 163.11$ CEFTRIAXONE SODIUM 1 GRAM 233.00$ 163.10$ CEFTRIAXONE SODIUM 1 GRAM 233.00$ 163.10$ CEFUROXIME 1.5 GM PWDI 95.10$ 66.57$ CELLCEPT 250 MG CAPSULE 7.05$ 4.93$ CERTOLIZUMAB 400MG (200MGX2)KIT 20,893.30$ 14,625.31$ CETUXIMAB 2MG/ML 50ML SDPF 3,445.29$ 2,411.70$ CETUXIMAB=ERBITUX 200MG/100ML SDV 6,861.06$ 4,802.74$ CHLORPROMAZINE 50MG/2ML AMPULE 417.00$ 291.90$ CIDOFOVIR 75MG/ML 5ML SDV 4,732.30$ 3,312.61$ CIPROFLOXACIN 400MG/D5 200ML 60.41$ 42.28$ CISPLATIN 100MG/ML SOLUTION 5.86$ 4.10$ CLAFORAN (CEFOTAXIME) 2GM VIAL 102.90$ 72.03$ CLINDAMYCIN 150MG/ML 4 ML SDV 120.46$ 84.32$

CODEINE PHOSPHATE 30MG 45.84$ 32.09$ CORTROSYN .25MG 1CC INJ. 637.40$ 446.18$ CORVERT=IBUTILIDE 0.1MG/ML INJ 1,897.80$ 1,328.46$ CYANOCOBALAMIN (B-12) 100 MCG 2.80$ 1.96$ CYANOCOBALAMIN 1000MCG/ML VIAL 129.00$ 90.30$ CYCLOPHOSPHAMIDE 1000 MG SDV 4,503.31$ 3,152.32$ CYCLOPHOSPHAMIDE 500MG SDV 2,256.60$ 1,579.62$ CYCLOSPORINE 100MG CAP SANDIMMUNE 80.62$ 56.44$ CYTARABINE 2OOOMG/20ML SDV 225.48$ 157.84$ CYTOSAR-U CYTARABINE 100 MG 148.24$ 103.77$ D.H.E.45 1MG/ML 1 ML AMPULE 815.13$ 570.59$ DACARBAZINE 200MG PWDI 226.38$ 158.46$ DALBAVANCIN 500MG PF PWDI 8,715.52$ 6,100.86$ DAPTOMYCIN 500MG VIAL 2,712.70$ 1,898.89$ DARATUMUMAB 100MG/5ML SDPF 2,785.05$ 1,949.54$ DARATUMUMAB 400MG/20ML SDPF 11,124.33$ 7,787.03$ DARBEPOETIN ALPHA 300 MCG/ML SDV 13,770.48$ 9,639.34$ DDAVP 4MCG/ML 1 ML AMPULE 436.09$ 305.27$ DELTASONE (PREDNISONE) 5MG TAB 2.36$ 1.65$ DELTASONE (PREDNISONE)10MG TAB 2.68$ 1.87$ DEMEROL 50MG AMP 179.82$ 125.88$ DENOSUMAB 120MG/1.7ML SDV 13,775.66$ 9,642.96$ DENOSUMAB 60MG/ML SYRINGE 6,706.43$ 4,694.50$ DEPO-MEDROL 40MG/ML 1 ML VIAL 139.33$ 97.53$ DEPO-MEDROL 80MG/ML VIAL 224.67$ 157.27$ DERMAGRAFT PER SQ CM 165.00$ 115.50$ DEXAMETHASONE 4 MG/ML 5 ML SDV 100.41$ 70.29$ DEXAMETHASONE INTENSOL 1MG/ML 7.16$ 5.01$ DEXAMETHASONE PF 10MG/ML INJ 102.20$ 71.54$ DEXRAZOXANE 500MG PWD VIAL 2,873.80$ 2,011.66$ DEXTROSE 5% DEHP FREE 500ML 58.90$ 41.23$ DIAZEPAM=VALIUM 5MG/ML 2 ML VL 197.90$ 138.53$ DICYCLOMINE=BENTYL 20MG/2ML VL 448.72$ 314.10$ DIGOXIN 0.25MG/ML 2 ML AMPULE 105.50$ 73.85$ DIGOXIN IMMUNE FAB 40MG PWVL 22,485.42$ 15,739.79$ DILANTIN 250MG/5ML VIAL 44.70$ 31.29$ DIPHENHYDRAMINE 50 MG VIAL 44.38$ 31.06$ DIPHENHYDRAMINE=BENADRYL 50 MGTAB 1.69$ 1.19$ DIPHTHERIA/TETANUS VACCINE >7 YRS 15.00$ 10.50$ DOBUTAMINE 250MG IN D5W 128.70$ 90.09$ DOBUTREX 250MG VL 20CC 93.70$ 65.59$ DOCETAXEL 80MG/8ML SOLUTION 6,657.09$ 4,659.97$ DOPAMINE 400 MG D5W 250 176.05$ 123.24$ DOXORUBICIN 10MG/5ML SDPF 190.37$ 133.26$ DOXORUBICIN 50MG/25ML SDPF 309.72$ 216.80$ DOXORUBICIN LIPO 2MG/ML 10ML SDV 5,835.30$ 4,084.71$ DURACLON=CLONIDINE 100MCG/ML 10ML 362.10$ 253.47$

DURAMORPH 5MG/10ML AMPULE 280.58$ 196.41$ DURVALUMAB 120MG/2.4ML SDPF 5,181.90$ 3,627.33$ DURVALUMAB 500MG/10ML SDPF 19,089.66$ 13,362.76$ ECULIZUMAB 300MG/30ML INJ 36,395.35$ 25,476.74$ ELOXATIN=OXALIPLATIN 50MG SDV 551.97$ 386.38$ ENOXAPARIN 100MG/ML SYRINGE 600.89$ 420.62$ ENOXAPARIN 150MG/ML SYRINGE 445.30$ 311.71$ ENOXAPARIN 30MG/0.3ML SYRINGE 168.17$ 117.72$ ENOXAPARIN 40MG/0.4ML SYRINGE 212.08$ 148.46$ ENOXAPARIN 60MG/0.6ML SYRINGE 308.92$ 216.24$ ENOXAPARIN 80MG/0.8ML SYRINGE 450.11$ 315.08$ EPIFIX PER 1 SQCM 795.00$ 556.50$ EPIFIX PER 1 SQCM 795.00$ 556.50$ EPINEPHRINE 0.1MG/ML 10ML SYRI 82.89$ 58.02$ EPINEPHRINE 1MG/ML 1 ML AMPULE 210.67$ 147.47$ EPOETIN 10,000 UNITS/ML 1,386.66$ 970.66$ EPOETIN=PROCRIT 20000 UN SDV 2,888.01$ 2,021.61$ EPOGEN 2000U/ML 445.30$ 311.71$ EPOGEN 4000U/ML VIAL 409.10$ 286.37$ ERIBULIN 1MG/2ML SDV 6,213.86$ 4,349.70$ ERYTHROCIN-LA 500 MG VIAL 418.36$ 292.85$ ETOPOSIDE 100MG/5ML 223.80$ 156.66$ FENTANYL CITRATE 0.1MG/2ML 51.16$ 35.81$ FENTANYL CITRATE 0.25MG/ML 59.42$ 41.60$ FERRIC CARBOXYMALTOSE 50MG/ML 15M 6,107.45$ 4,275.22$ FERRLECIT 62.5MG AMPULE 215.30$ 150.71$ FLEBOGAMMA IVIG 10 GM SDV 4,558.35$ 3,190.84$ FLEBOGAMMA IVIG 2.5 GM SDV 1,143.03$ 800.12$ FLEBOGAMMA IVIG 5 GM SDV 2,423.50$ 1,696.45$ FLUCONAZOLE 200MG/NS 100ML 95.42$ 66.79$ FLUCONAZOLE 400MG/NS 200ML 140.04$ 98.03$ FLUDARABINE 50MG/2ML SDPF 3,656.90$ 2,559.83$ FLUOROURACIL 1000 MG SDV 429.87$ 300.91$ FLUOROURACIL 500MG 10ML VIAL 153.90$ 107.73$ FLUOROURACIL 50MG/ML MDV 8.15$ 5.70$ FOLVITE 5MG/ML VIAL (PER ML) 44.50$ 31.15$ FOSAPREPITANT 150 MG PWD SDV 2,030.30$ 1,421.21$ FULVESTRANT=FASLODEX 50MG/ML 5ML 3,428.48$ 2,399.94$ FUROSEMIDE 100MG VIAL 76.21$ 53.34$ FUROSEMIDE 10MG/ML ORAL LIQUID 1.50$ 1.05$ FUROSEMIDE 20MG/2ML SDV 61.59$ 43.11$ FUROSEMIDE=LASIX 40MG/4ML VIAL 53.87$ 37.71$ GAMMAGARD 10% (IVIG) 5GM/10ML 2,965.12$ 2,075.58$ GAMMAGARD IVIG 10% 1 GM/10 ML 605.40$ 423.78$ GAMMAGARD IVIG 10% 10 GM/100 ML 5,753.93$ 4,027.75$ GAMMAGARD IVIG 20 GM/200 ML 11,792.42$ 8,254.70$ GAMUNEX C 10GM/100ML SDV 3,027.58$ 2,119.31$

GAMUNEX C 20GM/200ML SDV 13,047.16$ 9,133.01$ GAMUNEX C 40GM/400ML SDV 26,070.30$ 18,249.21$ GAMUNEX C 5GM/50ML SDV 3,083.46$ 2,158.42$ GANCICLOVIR SODIUM 500MG 641.10$ 448.77$ GEMCITABINE 1000MG PWDI 261.50$ 183.05$ GEMCITABINE 1000MG/26.3ML 301.54$ 211.08$ GEMCITABINE 200MG/5.26ML 232.11$ 162.48$ GEMTUZUMAB 4.5 PWVL 44,717.15$ 31,302.01$ GENTAMICIN 20MG/2ML VIAL 479.49$ 335.64$ GENTAMICIN SULFATE 80 MG 62.67$ 43.87$ GLUCAGON 1 MG VIAL 1,086.55$ 760.58$ GOLIMUMAB 50MG/4ML INJ 4,865.79$ 3,406.05$ GRAFIX PRIME PER 1 SQ CM 428.00$ 299.60$ HALDOL DECANOATE 100 MG/ML AMP 376.00$ 263.20$ HALOPERIDOL 5MG/ML SDV 47.19$ 33.03$ HEPARIN 1000U/ML 1 ML VIAL 64.46$ 45.12$ HEPARIN 1000UNITS/NS 500ML PREMIX 42.66$ 29.86$ HEPARIN 500 UN/5 ML SYRINGE 32.86$ 23.00$ HEPARIN 5000U/ML 1 ML VIAL 90.11$ 63.08$ HEPARIN IN 0.45%NS 50U/ML 500 78.43$ 54.90$ HEPARIN IN D5W 50UNITS/ML 500ML 120.80$ 84.56$ HYALOMATRIX PER 1 SQ CM 212.00$ 148.40$ HYALURONIDASE 150U/ML SDV 349.40$ 244.58$ HYCAMTIN 4 MG VIAL 1,386.70$ 970.69$ HYDRALAZINE (APRESOLINE) 20 MG 192.68$ 134.87$ HYDROCORTISONE 1% LOTION 89.60$ 62.72$ HYDROCORTISONE 100MG PWDI 152.51$ 106.75$ HYDROMORPHONE 2MG VIAL 43.74$ 30.62$ HYDROMORPHONE 4MG TAB 21.09$ 14.76$ HYDROMORPHONE HCL 2MG 18.74$ 13.12$ HYDROXYZINE HCL 10 MG TABLET 4.19$ 2.93$ HYDROXYZINE PAMOATE 25 MG CAP 1.75$ 1.23$ HYLAN G-F 20 8MG/ML 2 ML 2,135.50$ 1,494.85$ HYPER-TET 250U SYRINGE 2,291.20$ 1,603.84$ IBANDRONATE=BONIVA 3 MG SYRINGE 1,762.40$ 1,233.68$ IDARUBICIN 1 MG/ML 5 ML SDV 459.10$ 321.37$ IDARUBICIN=IDAMYCIN 10MG VIAL 903.10$ 632.17$ IFEX=IFOSAMIDE 3 MG VIAL 592.29$ 414.60$ INSULIN ASPART/ASPART PROT 70/30 645.66$ 451.96$ INTROPIN=DOPAMINE 200MG/5ML VL 37.28$ 26.09$ INVANZ=ERTAPENAM 1GM SDV 751.05$ 525.74$ IPILIMUMAB 200MG/40ML SDPF 155,861.65$ 109,103.16$ IPILIMUMAB 50MG/10ML 39,091.00$ 27,363.70$ IRINOTECAN 40 MG SDV 383.70$ 268.59$ IRON DEXTRAN 100MG/2ML SDV 177.42$ 124.19$ KCL 20 MEQ IN 50 ML PIGGYBACK 71.72$ 50.20$ KCL 40 MEQ IN 100ML IVPIGGYBA 66.49$ 46.54$

KEFUROX (CEFUROXIME) 750 MG 94.20$ 65.94$ KETOROLAC 60MG 2ML VIAL 98.90$ 69.23$ KETOROLAC 60MG/2ML SDV 118.85$ 83.20$ KETOROLAC=TORADOL 30MG VIAL 101.66$ 71.16$ LAB TEST RHO D IMMUNE GLOBULIN 218.00$ 152.60$ LANREOTIDE 120MG/0.5ML SYRINGE 41,134.90$ 28,794.43$ LEUCOVORIN 200 MG SDV 176.43$ 123.50$ LEUCOVORIN CALCIUM 100MG 271.80$ 190.26$ LEUCOVORIN CALCIUM 350MG 248.15$ 173.71$ LEUPROLIDE 45MG/6 MONTH INJ 39,739.50$ 27,817.65$ LEVAQUIN IV 250MG/50ML D5W 91.36$ 63.95$ LEVAQUIN IV 500MG/100ML D5W 169.50$ 118.65$ LEVOFLOXACIN 750 MG/150 ML IVPB 138.46$ 96.92$ LIDOCAINE 1% PF 2ML 61.25$ 42.87$ LIDOCAINE HCL 2% 5ML VIAL 62.71$ 43.90$ LORAZEPAM 2MG/ML SDV 42.55$ 29.79$ LUPRON DEPOT (3 MO) 22.5MG INJ 19,885.58$ 13,919.91$ LUPRON DEPOT 4 MONTH (30MG) 26,503.70$ 18,552.59$ MAG SULFATE 40MG/ML 100ML 105.81$ 74.07$ MAGNESIUM SULFATE 1 GM 8 MEQ IVPB 105.12$ 73.58$ MAGNESIUM SULFATE 1 GM/2 ML SDV 42.17$ 29.52$ MAGNESIUM SULFATE 4MEQ/ML 11.29$ 7.90$ MANNITOL 25% 12.5 GM/50 ML 40.45$ 28.31$ MARINOL=DRONABINOL 2.5 MG CAP 490.10$ 343.07$ MAXIPIME=CEFIPIME 1 GM VIAL 111.75$ 78.22$ MEDICAL IMAGING CONTRAST 0.50$ 0.35$ MEDICAL IMAGING CONTRAST LOCM 8.00$ 5.60$ MEDICAL IMAGING CONTRAST LOCM 1.80$ 1.26$ MEDICAL IMAGING CONTRAST LOCM 0.50$ 0.35$ MEDICAL IMG CONTRAST CYSTOGRAFIN 125.60$ 87.92$ MEDICAL IMG CONTRAST HOCM 1.00$ 0.70$ MEFOXIN (CEFOXITIN) 1 GRAM 115.57$ 80.90$ MEPERIDINE (DEMEROL) PCA 30 ML 125.90$ 88.13$ MEROPENEM 1GM/NS 50ML PREMIX 265.35$ 185.74$ MERREM=MEROPENEM 1 GM VIAL 404.31$ 283.02$ MESNEX=MESNA 100MG/ML 10ML 137.25$ 96.08$ METHERGINE 0.2MG/ML 1 ML AMP 362.70$ 253.89$ METHOTREXATE 1 GM SDV 411.40$ 287.98$ METHOTREXATE 100 MG SDV 138.50$ 96.95$ METHOTREXATE 2.5 MG TABLET 24.43$ 17.10$ METHOTREXATE 50 MG SDV 87.91$ 61.54$ METHYLENE BLUE 0.5% 50MG/10ML 1,182.30$ 827.61$ METHYLNALTREXONE 12 MG/0.6 ML SDV 651.10$ 455.77$ METOCLOPRAMIDE 10MG/2ML SDV 47.86$ 33.50$ MICAFUNGIN 100MG PWVL 2,390.09$ 1,673.06$ MIDAZOLAM 5MG/ML 1ML SDV 48.38$ 33.87$ MITOMYCIN 20MG PWDI 3,032.25$ 2,122.58$

MITOMYCIN 40MG PWDI 8,330.77$ 5,831.54$ MONONINE +/- 1160 IU 7,772.10$ 5,440.47$ MORPHINE 10MG/ML SDV 46.17$ 32.32$ MORPHINE PCA **5MG/ML** 146.60$ 102.62$ MORPHINE SULFATE 2MG/ML SYR 46.43$ 32.50$ MORPHINE SULFATE PCA 30 ML 124.50$ 87.15$ NALOXONE 0.4MG/ML SDPF 292.34$ 204.64$ NALOXONE 2 MG/2 ML SYR 416.91$ 291.84$ NEORAL=CYCLOSPORIN 25 MG CAP 16.30$ 11.41$ NEOSTIGMINE 1-1000 10 ML SDV 642.50$ 449.75$ NEOX CORD 1K, 1CM 486.00$ 340.20$ NEOX CORD 1K, 1CM 486.00$ 340.20$ NEUPOGEN 300MCG/ML 1ML VIAL 1,996.70$ 1,397.69$ NEUPOGEN 480MCG/1.6ML SDV 3,159.80$ 2,211.86$ NIVOLUMAB 10MG/ML 10ML 14,119.15$ 9,883.41$ NIVOLUMAB 10MG/ML 4ML 5,651.12$ 3,955.78$ NIVOLUMAB 240MG/24ML SDPF 33,812.98$ 23,669.08$ OBINUTUZUMAB 1GRAM/40ML SDPF 29,464.55$ 20,625.19$ OCTREOTIDE 100 MCG/ML AMP 172.50$ 120.75$ OLARATUMAB 190MG/19ML SDPF 4,956.53$ 3,469.57$ OLARATUMAB 500MG/50ML SDPF 13,040.28$ 9,128.19$ ONDANSETRON 4MG ODT 20.14$ 14.10$ ONDANSETRON 4MG ODT START PACK #4 22.90$ 16.03$ ONDANSETRON ODT 8MG 19.15$ 13.41$ ORPHENADRINE 60MG/2ML SDV 249.80$ 174.86$ OXACILLIN 2 GM SDV 320.91$ 224.64$ OXALIPLATIN 100 MG SDV 1,027.84$ 719.49$ OXYTOCIN 20 UN IN 1000 ML NS 126.02$ 88.21$ PACLITAXEL 300MG/50ML SOLUTION 542.82$ 379.97$ PANITUMUMAB 20MG/ML 20ML 25,909.10$ 18,136.37$ PANITUMUMAB 20MG/ML 5ML 6,480.51$ 4,536.36$ PANTOPRAZOLE 40MG PWDI 98.75$ 69.12$ PAPAVERINE 30MG/ML 2 ML AMPULE 492.87$ 345.01$ PCA HYDROMORPHONE 30MG/3ML 259.71$ 181.79$ PEGASPARGASE 3750IU/5ML SDPF 73,442.50$ 51,409.75$ PEGFILGRASTIM (ONPRO) 6MG/0.6ML 38,847.14$ 27,192.99$ PEGFILGRASTIM=NEULASTA 6MG/0.6ML 38,776.32$ 27,143.42$ PEMBROLIZUMAB 100MG/4ML SDPF 24,682.25$ 17,277.57$ PEMETREXED=ALIMTA 100 MG SDV 3,484.12$ 2,438.88$ PEMETREXED=ALIMTA 500 MG SDV 17,291.15$ 12,103.80$ PENICILLIN G BEZATHINE IM 1.2M 778.00$ 544.60$ PENICILLIN G POTASSIUM 20 MMU 320.10$ 224.07$ PENICILLIN G POTASSIUM 5 MMU 184.20$ 128.94$ PENTOSTATIN 10MG PWDI 12,040.40$ 8,428.28$ PERPHENAZINE=TRILAFON 2 MG TAB 13.00$ 9.10$ PERPHENAZINE=TRILAFON 4 MG TAB 14.80$ 10.36$ PERTUZUMAB 420MG/14ML SDPF 26,413.39$ 18,489.37$

PHARMACY ADRENALIN/EPINEPHRINE 69.00$ 48.30$ PHARMACY AZITHROMYCIN 17.51$ 12.26$ PHARMACY BENADRYL INJECTION 22.20$ 15.54$ PHARMACY BENADRYL INJECTION 22.20$ 15.54$ PHARMACY BETAMETHASONE ACETATE 59.80$ 41.86$ PHARMACY CEFAZOLIN SODIUM INJ 1.60$ 1.12$ PHARMACY DEMEROL INJECTION 1.70$ 1.19$ PHARMACY DEPOMEDROL 6.20$ 4.34$ PHARMACY DEPOMEDROL 12.20$ 8.54$ PHARMACY DEXAMETH INJECTION 17.64$ 12.35$ PHARMACY DEXAMETH INJECTION 18.00$ 12.60$ PHARMACY DEXAMETH INJECTION 18.00$ 12.60$ PHARMACY DEXAMETH INJECTION 18.00$ 12.60$ PHARMACY DEXAMETH SODIUM PHOS 1.10$ 0.77$ PHARMACY DEXTROSE NORMAL SALINE 2.50$ 1.75$ PHARMACY FENTANYL CITRATE 0.70$ 0.49$ PHARMACY HYDROXYZINE PAMOATE 25MG 2.20$ 1.54$ PHARMACY IMITREX INJECTION 226.00$ 158.20$ PHARMACY KENALOG INJECTION 30.00$ 21.00$ PHARMACY KENALOG INJECTION 30.00$ 21.00$ PHARMACY KENALOG INJECTION 19.60$ 13.72$ PHARMACY MEDROL INJECTION 38.00$ 26.60$ PHARMACY MEDROL INJECTION 38.00$ 26.60$ PHARMACY MIDAZOLAM INJECTION 1.60$ 1.12$ PHARMACY NUCLEAR MEDICINE 77.80$ 54.46$ PHARMACY NUCLEAR MEDICINE 172.00$ 120.40$ PHARMACY PERFLUTEN 217.00$ 151.90$ PHARMACY PERFLUTEN L 217.00$ 151.90$ PHARMACY PHENERGAN INJECTION 20.00$ 14.00$ PHARMACY PHENERGAN INJECTION 20.00$ 14.00$ PHARMACY PREDNISOLONE 8.00$ 5.60$ PHARMACY PREDNISOLONE 13.00$ 9.10$ PHARMACY ROCEPHIN INJECTION 80.00$ 56.00$ PHARMACY ROCEPHIN INJECTION 244.00$ 170.80$ PHARMACY ROCEPHIN INJECTION 244.00$ 170.80$ PHARMACY STERILE SALINE SOLUTION 2.10$ 1.47$ PHARMACY TORADOL INJECTION 54.00$ 37.80$ PHARMACY TORADOL INJECTION 54.00$ 37.80$ PHARMACY TORADOL INJECTION 56.00$ 39.20$ PHARMACY TORADOL INJECTION 56.00$ 39.20$ PHARMACY TORADOL INJECTION 1.30$ 0.91$ PHARMACY ZOFRAN INJECTION 59.00$ 41.30$ PHARMACY ZOFRAN INJECTION 59.00$ 41.30$ PHENOBARBITAL 130MG/1ML VIAL 425.35$ 297.75$ PHENYLEPHRINE 10MG/ML 1ML VIAL 104.19$ 72.93$ PIPH KENALOG 40MG/ML 141.20$ 98.84$ PITOCIN (OXYTOCIN) 10U/1ML VL 34.23$ 23.96$

PLATE POSTEROLATERAL 6H LEFT 440.70$ 308.49$ PREDNISOLONE 5 MG/5 ML SOLN 430.60$ 301.42$ PREDNISONE 10MG TABLETS 2.70$ 1.89$ PREDNISONE 10MG TABLETS 2.70$ 1.89$ PREDNISONE 1MG TABLET 2.45$ 1.71$ PREDNISONE 20MG TAB 2.22$ 1.55$ PREDNISONE 50MG 3.85$ 2.69$ PRIMACOR 1MG/ML INJ 20ML VIAL 927.50$ 649.25$ PROCAINAMIDE 100MG/ML 10ML VL 486.30$ 340.41$ PROCAINAMIDE 500MG/ML 2ML VIAL 431.70$ 302.19$ PROCHLORPERAZINE 10MG/2ML VIAL 279.35$ 195.55$ PROCHLORPERAZINE=COMPAZINE 5MG 3.81$ 2.67$ PROCRIT=EPOTIN 40,000 UN/ML 5,650.06$ 3,955.04$ PROGRAF 1MG CAPSULE 15.24$ 10.67$ PROMETHAZINE 25MG/ML 1 ML AMP 50.59$ 35.41$ PROMETHAZINE 50MG/ML 1 ML AMP 69.20$ 48.44$ PROTAMINE SULFATE 10MG/ML 5 ML 135.37$ 94.76$ PURAPLY PER SQ CM 144.00$ 100.80$ PYRIDOXINE 100MG/ML SDV 244.90$ 171.43$ QUELICIN 20MG/ML 10ML VIAL 309.79$ 216.85$ RABIES VACCINE IM/SC 260.00$ 182.00$ RAMUCIRUMAB 100MG/10ML SDPF 5,975.07$ 4,182.55$ RAMUCIRUMAB 500MG/50ML SDPF 30,102.43$ 21,071.70$ REMICADE=INFLIXIMAB 100 MG VIAL 6,627.88$ 4,639.52$ RISPERIDONE CONSTA 37.5MG KIT 3,889.90$ 2,722.93$ RITUXAN 100MG/10ML VIAL 5,100.51$ 3,570.36$ RITUXAN 500MG/50ML VIAL 25,476.79$ 17,833.75$ RITUXIMAB/HYALURONIDASE 1400MG 34,509.00$ 24,156.30$ RITUXIMAB/HYALURONIDASE 1600MG 39,434.10$ 27,603.87$ ROBAXIN 100MG/ML 10ML VIAL 395.60$ 276.92$ ROCEPHIN (CEFTRIAXONE) 1 GRAM 83.44$ 58.41$ ROCEPHIN (CEFTRIAXONE) 250 MG 52.29$ 36.61$ ROMIDEPSIN 10MG PWDI 19,232.37$ 13,462.66$ ROPIVACAINE 0.2% (2MG/ML)SOLN 507.60$ 355.32$ SANDIMMUNE 25 MG CAPSULE 26.94$ 18.86$ SANDOSTATIN 0.05MG/ML 1ML AMP 98.43$ 68.90$ SANDOSTATIN LAR 30 MG SYRINGE 31,521.70$ 22,065.19$ SCREW T20 3.5MM X 20MM CORTICAL 866.30$ 606.41$ SCREW T20 3.5MM X 24MM CORITCAL 4,516.11$ 3,161.28$ SODIUM TETRADECYL 3% 2ML 423.70$ 296.59$ SODIUM THIOSULFATE 25% 50CC 609.60$ 426.72$ SOLU-CORTEF 500 MG VIAL 447.50$ 313.25$ SOLU-MEDROL 1000 MG VIAL 482.33$ 337.63$ SOLU-MEDROL 125 MG VIAL 96.71$ 67.70$ SOLU-MEDROL 40 MG 72.17$ 50.52$ SOLU-MEDROL 500 MG VIAL 278.57$ 195.00$ STRUT CORTICAL >=180MM 72.50$ 50.75$

SUMATRIPTAN 6MG/0.5ML SDV 371.86$ 260.30$ SYS MOD HIP 21MM X +0 V40 2,038.95$ 1,427.26$ TACROLIMUS 0.5MG CAP 12.04$ 8.42$ TAZIDIME (CEFTAZIDIME) 1 GRAM 89.36$ 62.56$ TDAP VACCINE >7 YRS OLD 61.00$ 42.70$ TEDIZOLID PHOSPHATE 200MG PWDI 1.30$ 0.91$ TEMSIROLIMUS 25 MG SDV 9,243.95$ 6,470.77$ TESTOSTERONE CYP 200MG/ML SDV 317.90$ 222.53$ TESTOSTERONE ENANTHATE 200MG/ML 572.58$ 400.81$ THIAMINE 100MG/2ML 154.70$ 108.29$ THYROTROPIN ALPHA 1.1 MG SDV 6,563.20$ 4,594.24$ TIGECYCLINE=TYGACIL 50 MG SDV 1,006.67$ 704.67$ TOBRAMYCIN 80MG/2ML 36.57$ 25.60$ TOCILIZUMAB 200MG/10ML SDPF 5,892.17$ 4,124.52$ TRASTUZUMAB 150MG PWDI 7,779.71$ 5,445.80$ TRIAMCINOLONE ACET 40 MG VIAL 143.02$ 100.11$ UNASYN 3 GRAM VIAL 103.43$ 72.40$ USTEKINUMAB 130MG/26ML SDPF 9,535.46$ 6,674.82$ USTEKINUMAB 45MG/0.5ML SYRINGE 58,389.50$ 40,872.65$ USTEKINUMAB 90MG/ML SYRINGE 116,746.00$ 81,722.20$ VANCOCIN 1 GRAM VIAL 237.57$ 166.30$ VANCOMYCIN 1000MG/200ML NS PREMIX 286.50$ 200.55$ VANCOMYCIN 500 MG SDV 126.47$ 88.53$ VASOTEC IV 1.25MG/ML 2 ML VIAL 74.60$ 52.22$ VEDOLIZUMAB 300MG PF PWVL 67,186.75$ 47,030.72$ VENOFER 100 MG/5 ML SDV 317.71$ 222.39$ VERSED 1MG/ML 2 ML VIAL 38.91$ 27.24$ VERSED 1MG/ML 5 ML VIAL 36.38$ 25.47$ VINBLASTINE 10MG/10ML 299.70$ 209.79$ VINCRISTINE 2 MG SDV 284.10$ 198.87$ VITAMIN K 10MG/ML 1 ML AMPULE 499.98$ 349.98$ VITAMIN K 2MG/ML 0.5 ML AMPULE 288.24$ 201.77$ VORICONAZOLE=VFEND 200 MG SDV 778.84$ 545.19$ WINRHO SDF 5000 UN SDV 7,775.64$ 5,442.95$ XYLOCAINE MPF 1% 5ML 77.70$ 54.39$ ZOFRAN 4MG 2ML VIAL 37.18$ 26.02$ ZOFRAN TABLET 8 MG 8.80$ 6.16$ ZOLEDRONIC ACID 4MG/100ML 3,123.20$ 2,186.24$ ZOLEDRONIC ACID=RECLAST 5MG/100ML 3,883.68$ 2,718.58$ ZOMETA 4MG INJ 5,009.10$ 3,506.37$ ZOSYN 3.375GM INJ 185.38$ 129.77$ ZOSYN 4.5GM INJ 234.00$ 163.80$ ZYVOX 600 MG / 300 ML IVPB 604.30$ 423.01$ ZZ GIR SALINE INFUSION 1000ML 2.40$ 1.68$ ZZ MCT HOCM >=400 MG/ML IOD Q9964 0.67$ 0.47$ 0.45% NS 1000ML 89.40$ 62.58$ 0.9% NS 100ML 1.50$ 1.05$

0.9% NS 500ML 116.70$ 81.69$ 0.9% SODIUM CHLORIDE 50ML 2B1301 0.96$ 0.67$ ABILIFY=ARIPIPRAZOLE 15 MG TAB 208.16$ 145.71$ ACAMPROSATE CALCIUM 333MG DR TAB 8.84$ 6.19$ ACARBOSE 50MG TAB 5.30$ 3.71$ ACCUPRIL 5MG TABLET 1.98$ 1.38$ ACETAMINOPHEN 120MG SUPP 4.10$ 2.87$ ACETAMINOPHEN 150MG/5ML PER ML 0.18$ 0.12$ ACETAMINOPHEN 160 MG/5 ML UD 10.79$ 7.55$ ACETAMINOPHEN 325MG SUPP 6.25$ 4.38$ ACETAMINOPHEN 325MG TAB 0.89$ 0.62$ ACETAMINOPHEN 500MG TAB 0.83$ 0.58$ ACETAMINOPHEN 650MG SUPP 4.69$ 3.28$ ACETAMINOPHEN/CODEINE 120/12MG/5M 119.87$ 83.91$ ACETAMINOPHEN/CODEINE 300/30MG TA 16.86$ 11.80$ ACETAZOLAMIDE 250MG TAB 20.78$ 14.54$ ACTIGALL 300MG CAP 9.52$ 6.67$ ACTOS 15MG TAB 39.86$ 27.90$ ACTOS=PIOGLITAZONE 45 MG TAB 7.00$ 4.90$ ACYCLOVIR 200MG CAP 1.85$ 1.29$ ACYCLOVIR 5% TOPICAL OINTMENT 742.60$ 519.82$ ACYCLOVIR 800MG TAB 4.01$ 2.81$ ADALAT (PROCARDIA) 10MG CAP 6.96$ 4.87$ ADALAT CC (PROCARDIA XL) 30MG 10.89$ 7.62$ ADALAT CC (PROCARDIA XL) 60MG 16.10$ 11.27$ ADDERALL 20MG TABLET 97.00$ 67.90$ AEROCHAMBER SET UP 28.80$ 20.16$ ALBUTEROL 0.83MG/ML 3ML 3.06$ 2.14$ ALBUTEROL 2.5 MG/0.5 ML INH 6.39$ 4.47$ ALBUTEROL HFA 6.7 GM 257.29$ 180.10$ ALBUTEROL SULFATE 4 MG TAB UD 37.80$ 26.46$ ALDACTONE 50 MG TABLET 5.19$ 3.63$ ALENDRONATE 10MG TAB 3.21$ 2.25$ ALENDRONATE 70MG TAB 5.60$ 3.92$ ALFUZOSIN 10 MG ERT 5.30$ 3.71$ ALKA-SELTZER GOLD TABLET 1.77$ 1.24$ ALLEGRA=FEXFENADINE TABLET 6.19$ 4.33$ ALLOPURINOL 100MG TAB 3.82$ 2.68$ ALLOPURINOL 300MG TAB 5.74$ 4.02$ ALPHAGAN P 0.15% 5ML OPTH SOL 690.40$ 483.28$ ALPRAZOLAM 1MG TAB 10.27$ 7.19$ ALTACE (RAMIPRIL) 1.25 MG TAB 12.00$ 8.40$ ALTACE (RAMIPRIL) 2.5MG 2.40$ 1.68$ ALTACE 5MG TABLET 2.56$ 1.79$ AMANTADINE 100MG 16.70$ 11.69$ AMARYL=GLIMEPIRIDE 2 MG TAB 4.05$ 2.83$ AMERICAINE 20% AEROSOL 60 ML 52.80$ 36.96$

AMILORIDE 5MG TAB 6.98$ 4.89$ AMITRIPTYLINE 10MG TAB 2.10$ 1.47$ AMITRIPTYLINE 25MG TAB 3.10$ 2.17$ AMITRIPTYLINE 50MG TAB 6.84$ 4.79$ AMMONIA INHALANTS 7.60$ 5.32$ AMMONIUM LACTATE 12% LOTION 129.00$ 90.30$ AMOXICILLIN 500MG CAP 2.27$ 1.59$ AMOXIL/CLAVUL 200-28.5MG/5ML 2.44$ 1.71$ AMOXIL/CLAVUL 250-62.5MG /5ML 10.87$ 7.61$ AMOXIL/CLAVUL 400-57MG /5ML 1.06$ 0.74$ AMOXIL/CLAVUL 600-42.9MG /5ML 1.91$ 1.33$ AMPICILLIN 500MG CAP 5.10$ 3.57$ ANALPRAM HC 2.5% 30 GM CREAM 1,052.40$ 736.68$ ANTABUSE 250 MG TABLET 25.27$ 17.69$ ARAVA=LEFLUNOMIDE 20 MG TAB 34.92$ 24.44$ ARICEPT=DONEPEZIL 10 MG TAB 2.19$ 1.54$ ARIMIDEX=ANASTROZOLE 1 MG TAB 2.30$ 1.61$ ARIPIPRAZOLE 10MG TAB 33.47$ 23.43$ ARMOUR THYROID 60 MG TABLET 6.16$ 4.31$ ASCORBIC ACID 500 MG TABLET 1.06$ 0.75$ ASPIRIN (ENTERIC COATED) 325MG 1.20$ 0.84$ ASPIRIN 300 MG SUPPOSITORY 12.48$ 8.73$ ASPIRIN 325 MG TABLET 1.50$ 1.05$ ASPIRIN 600 MG SUPPOSITORY 13.00$ 9.10$ ASPIRIN CHEWABLE 81MG TAB 1.14$ 0.80$ ASPIRIN E.C. 81 MG/TABLET 1.48$ 1.04$ ATENOLOL 25MG TAB 1.51$ 1.06$ ATENOLOL 50MG TAB 1.72$ 1.20$ ATORVASTATIN 40MG 3.62$ 2.53$ ATROPINE/DIPHENOXYLATE 0.025/2.5M 55.27$ 38.69$ ATROVENT .03% NASAL SPRAY 390.90$ 273.63$ ATROVENT .06% NASAL SPRAY 492.63$ 344.84$ AUGMENTIN 500 MG TABLET 12.60$ 8.82$ AUGMENTIN 875MG TAB 10.60$ 7.42$ AVAPRO=IRBESARTAN 150MG TAB 3.81$ 2.66$ AVITENE=COLLAGEN 1 GM TOPICAL 1,046.40$ 732.48$ AZELASTINE 137MCH/INH SPRAY 301.20$ 210.84$ AZITHROMYCIN 100MG/5ML PER ML 16.55$ 11.59$ AZITHROMYCIN 250MG TAB 21.68$ 15.17$ BACITRACIN/POLYMIX B 1GM OINT 3.75$ 2.63$ BACITRACIN/POLYMIX B OPHTH OINT 291.40$ 203.98$ BACITRACIN/POLYMYXIN OINT 15GM 93.41$ 65.39$ BACLOFEN 10MG TAB 4.00$ 2.80$ BALSALAZIDE=COLAZAL 750 MG CAP 6.23$ 4.36$ BENADRYL 25 MG CAPSULE 1.29$ 0.90$ BENADRYL CREAM 1% 15 GM 30.90$ 21.63$ BENADRYL ELIXIR 12.5MG/5ML UD 13.47$ 9.43$

BENAZEPRIL 10MG TAB 5.88$ 4.12$ BENTYL (DICYCLOMINE) 20 MG TAB 1.89$ 1.32$ BENZONATATE 100MG CAP 3.26$ 2.28$ BENZTROPINE (COGENTIN) 1MG TAB 1.90$ 1.33$ BETADINE 236ML PERI-WASH 33.00$ 23.10$ BETAMETH/CLOTRIM 0.05/1% TOP CR 325.80$ 228.06$ BETAMETHASONE CR 0.05% 45GM 176.90$ 123.83$ BETAPACE (SOTALOL) 80 MG TAB 2.95$ 2.06$ BETHANECHOL CHLORIDE 10 MG TAB 6.00$ 4.20$ BICALUTAMIDE 50MG TAB 4.79$ 3.35$ BISAC-EVAC=BISACODYL 10MG SUPP 2.00$ 1.40$ BISACODYL (DULCOLAX) 5 MG TAB 0.91$ 0.64$ BRINZOLAMIDE 1% OPHTH SUSP 1,567.22$ 1,097.06$ BROMOCRIPTINE 2.5MG TAB 26.53$ 18.57$ BSS 15ML 9.41$ 6.59$ BUDESONIDE 0.25MG/2ML INHAL 106.10$ 74.27$ BUDESONIDE 3 MG ERC 65.83$ 46.08$ BUMEX (BUMETANIDE) 0.5 MG TAB 7.87$ 5.51$ BUMEX (BUMETANIDE) 1 MG TABLET 6.68$ 4.68$ BUPROPION 150MG ER TAB 6.06$ 4.24$ BUPROPION 75MG TABLET 6.98$ 4.89$ BUPROPION SA=WELLBUTRIN SR 100 MG 6.70$ 4.69$ BUSPAR (BUSPIRONE) 5 MG TAB 1.72$ 1.20$ BUSPIRONE 10MG TAB 1.84$ 1.29$ CA CITRATE/VITD=CITRACAL+D TAB 1.75$ 1.22$ CABIDOPA/LEVODOPA 10-100MG TAB 4.34$ 3.04$ CALAMINE 8% TOPICAL LOTION 20.30$ 14.21$ CALAN SR (VERAPAMIL) 120 MG 8.86$ 6.21$ CALAN SR (VERAPAMIL) 180MG TAB 4.85$ 3.40$ CALAN SR (VERAPAMIL) 240MG TAB 5.50$ 3.85$ CALCITONIN 200 INTL UNITS SPRAY 431.60$ 302.12$ CALCITROL 0.25MCG CAP 9.67$ 6.77$ CALCIUM CARBONATE 600MG TAB 1.18$ 0.83$ CALCIUM/VIT D500MG/200INTL U TAB 3.92$ 2.75$ CAPOTEN (CAPTOPRIL) 12.5MG TAB 127.60$ 89.32$ CAPOTEN (CAPTOPRIL) 25 MG TAB 13.18$ 9.23$ CAPSAICIN 0.025% CREAM 85.30$ 59.71$ CARAFATE (SUCRALFATE) 1 GM TAB 3.39$ 2.37$ CARBAMAZEPINE 200MG 8.56$ 5.99$ CARBAMIDE PEROXIDE 6.5% OTIC 13.60$ 9.52$ CARBIDOPA/LEVODOPA 25-100MG ER 3.38$ 2.36$ CARBIDOPA/LEVODOPA 50-200MG ERT 7.53$ 5.27$ CARDENE 20 MG CAPSULE 15.80$ 11.06$ CARDIZEM (DILTIAZEM) 30 MG TAB 2.16$ 1.51$ CARDIZEM (DILTIAZEM) 60 MG TAB 3.07$ 2.15$ CARDIZEM CD 120 MG CAPSULE 3.76$ 2.63$ CARDIZEM CD 180 MG CAPSULE 3.83$ 2.68$

CARDIZEM CD 240 MG CAPSULE 6.29$ 4.41$ CARDIZEM CD 300 MG CAPSULE 13.50$ 9.45$ CARDIZEM SR 120 MG CAPSULE 30.49$ 21.34$ CARDIZEM SR 60 MG CAPSULE 20.46$ 14.32$ CARDURA (DOXAZOSIN) 1 MG TAB 8.80$ 6.16$ CARDURA (DOXAZOSIN) 2MG TABLET 7.40$ 5.18$ CARISOPRODOL (SOMA) 350 MG TAB 2.19$ 1.53$ CARNITOR 330 MG TAB 8.17$ 5.72$ CARVEDILOL 12.5MG TAB 1.47$ 1.03$ CARVEDILOL 3.125MG TAB 1.67$ 1.17$ CASTOR OIL PER ML 0.56$ 0.39$ CEFDINIR 25MG/ML PER ML 5.11$ 3.57$ CEFDINIR 300MG CAP 23.00$ 16.10$ CEFIXIME 100MG/5ML PER ML 22.67$ 15.87$ CEFUROXIME 250 MG TAB 16.20$ 11.34$ CELEBREX=CELECOXIB 100 MG TAB 11.90$ 8.33$ CELECOXIB 200MG CAPSULE 19.02$ 13.32$ CEPHALEXIN (KEFLEX) 500 MG CAP 2.71$ 1.90$ CEPHALEXIN 250MG CAP 2.43$ 1.70$ CEPHALEXIN 250MG/5ML PER ML 1.74$ 1.22$ CEPHALEXIN 250MG/5ML SUSP PER ML 2.21$ 1.55$ CHLORDIAZEPOXIDE HCL 25MG CAP 30.13$ 21.09$ CHLORDIAZEPOXIDE HCL 5 MG CAP 24.90$ 17.43$ CHLORPROMAZINE HCL 25MG TABLET 55.38$ 38.77$ CHLORPROMAZINE HCL 50 MG TAB 79.63$ 55.74$ CHOLESTYRAMINE 4 GM PKT 17.10$ 11.97$ CIPRO HC OTIC SOL 0.3% 10 ML 1,705.40$ 1,193.78$ CIPROFLOXACIN 500MG TAB 2.59$ 1.81$ CITALOPRAM 20MG TAB 1.46$ 1.02$ CITRATE OF MAGNESIA 300 ML 8.40$ 5.88$ CLARITHROMYCIN 500MG TAB 8.87$ 6.21$ CLARITIN (LORATADINE) 10MG TAB 5.30$ 3.71$ CLARITIN D 24 HOUR TABLET 7.50$ 5.25$ CLEOCIN ER 6 PACK 150MG 25.20$ 17.64$ CLIDINIUM/LIBRIUM=LIBRAX CAP 19.60$ 13.72$ CLIMARA 0.05 MG/DAY TD PATCH 219.70$ 153.79$ CLINDAMYCIN 150MG CAP 4.49$ 3.14$ CLINDAMYCIN 300 MG CAP 8.19$ 5.73$ CLINDAMYCIN 75MG/5ML PER ML 4.15$ 2.91$ CLOBETASOL(TEMOVATE)0.05% OINT 2,605.80$ 1,824.06$ CLONAZEPAM 1MG TAB 1.32$ 0.92$ CLONIDINE 0.1MG TAB 1.44$ 1.01$ CLONIDINE 0.1MG/24HRS PATCH 346.23$ 242.36$ CLONIDINE 0.2MG PATCH 596.20$ 417.34$ CLONIDINE 0.3MG/24HR PATCH 356.90$ 249.83$ CLONIDINE=CATAPRESS 0.2 MG TAB 1.58$ 1.11$ CLOPIDOGREL 75MG TAB 2.61$ 1.83$

CLORAZEPATE (TRANXENE) 7.5 MG 12.00$ 8.40$ CLORHEXIDINE 4% TOPICAL SOAP 51.00$ 35.70$ CLOTRIMAZOLE 1% SOLUTION 456.60$ 319.62$ CLOTRIMAZOLE 1% VAGINAL CREAM 62.00$ 43.40$ CLOTRIMAZOLE 10MG LOZENGE 10.80$ 7.56$ CLOZAPINE 100MG TAB 20.31$ 14.22$ COLACE 50MG CAP 3.10$ 2.17$ COLCHICINE 0.6 MG TABLET 78.31$ 54.81$ COMPAZINE 25 MG SUPP 130.40$ 91.28$ CONJUGATED ESTROGEN 0.3MG TAB 37.01$ 25.91$ CONJUGATED ESTROGEN 0.625MG TAB 35.23$ 24.66$ CONSTANT-T=THEO DUR 200 MG TAB 5.80$ 4.06$ CORDARONE 200 MG TABLET 3.43$ 2.40$ CORGARD (NADOLOL) 20MG TABLET 24.20$ 16.94$ CORGARD (NADOLOL) 40 MG TABLET 28.10$ 19.67$ CORTEF=HYDROCORTISONE 10MG TAB 3.27$ 2.29$ CORTENEMA 100 MG 60 ML 95.40$ 66.78$ CORTISPORIN OTIC SUSP 10 ML 483.50$ 338.45$ COUMADIN (WARFARIN) 1 MG TAB 16.41$ 11.49$ COUMADIN (WARFARIN) 2 MG TAB 17.30$ 12.11$ COUMADIN (WARFARIN) 2.5 MG TAB 18.32$ 12.83$ COUMADIN (WARFARIN) 5 MG TAB 18.76$ 13.13$ COUMADIN (WARFARIN) 7.5 MG TAB 24.95$ 17.47$ CYANOCOBALAMIN 1000 MCG TAB 2.86$ 2.00$ CYANOCOBALAMIN 500 MCG TAB 2.90$ 2.03$ CYCLOBENZAPRINE 10 MG TABLET 3.49$ 2.45$ CYPROHEPTADINE HCL 4 MG TABLET 3.20$ 2.24$ CYTOMEL=LIOTHYRONINE 5 MCG TAB 6.47$ 4.53$ CYTOTEC 100MCG TABLET 6.79$ 4.75$ CYTOTEC 200 MCG TABLET 13.97$ 9.78$ CYTOTEC 50MCG TABLET 13.62$ 9.53$ DAPSONE 25MG TABLET 19.90$ 13.93$ DDAVP NASAL SPRAY 0.01% 5 ML 1,249.90$ 874.93$ DECLOMYCIN 150 MG TABLET 55.10$ 38.57$ DEMADEX (TORSEMIDE) 20MG TAB 2.70$ 1.89$ DEMEROL 50 MG TABLET 83.20$ 58.24$ DEPAKENE 250 MG CAPSULE 4.55$ 3.19$ DEPAKOTE (DIVALPROEX) 125MG UD 1.02$ 0.71$ DEPAKOTE 250 MG EC TABLET 2.46$ 1.72$ DEPAKOTE 500 MG TABLET 3.71$ 2.60$ DESIPRAMINE=NORPRAMIN 25MG TAB 8.53$ 5.97$ DETROL=TOLTERODINE 2MG TAB 24.81$ 17.36$ DEXAMETHASONE 0.5 MG TABLET 1.77$ 1.24$ DEXAMETHASONE 4MG TABLET 6.57$ 4.60$ DEXTROSE 5% 50CC 5.76$ 4.04$ DIABETA (MICRONASE) 5 MG TAB 3.88$ 2.72$ DIAZEPAM (VALIUM) 2 MG TABLET 10.38$ 7.27$

DIAZEPAM 10MG TAB 12.72$ 8.91$ DIAZEPAM 1MG/ML ORAL SOLN 5ML 367.00$ 256.90$ DIAZEPAM 5MG TAB 11.73$ 8.21$ DIFLUCAN=FLUCONAZOLE 100MG TAB 12.68$ 8.88$ DIGOXIN 0.125MG TAB 18.89$ 13.22$ DILANTIN 100 MG CAPSULE 9.57$ 6.70$ DILANTIN 50 MG INFATAB 11.31$ 7.92$ DILTIAZEM=CARDIZEM 90 MG TAB 3.90$ 2.73$ DIPYRIDAMOLE (PERSANTINE) 25MG 2.46$ 1.72$ DIVALPROEX SPRINKLE 125MG CAP 5.34$ 3.74$ DOCUSATE CA (SURFAK) 240MG CAP 1.50$ 1.05$ DOCUSATE SODIUM (COLACE) 100MG 1.39$ 0.97$ DOCUSATE SODIUM (COLACE) 250MG 2.60$ 1.82$ DOCUSATE-SENNA 50-8.6MG 1.40$ 0.98$ DOFETILIDE=TIKOSYN 0.25 MG CAP 58.40$ 40.88$ DOFETILIDE=TIKOSYN 0.5 MG CAP 68.90$ 48.23$ DONEPEZIL 5MG TABLET 2.35$ 1.64$ DONNATAL 16.2 MG TABLET 82.80$ 57.96$ DOXEPIN (SINEQUAN) 10 MG CAP 4.28$ 2.99$ DOXEPIN (SINEQUAN) 25 MG CAP 4.89$ 3.42$ DOXEPIN (SINEQUAN) 50 MG CAP 6.67$ 4.67$ DOXYCYCLINE HYCLATE 100MG TAB 8.42$ 5.89$ DURAGESIC PATCH 50UGM/H 1,187.80$ 831.46$ DYRENIUM=TRIAMTERENE 50 MG CAP 87.29$ 61.10$ EES 200MG/5ML PER ML 30.05$ 21.04$ EFFEXOR 100 MG TABLET 4.16$ 2.91$ EFFEXOR 37.5MG TAB 5.38$ 3.76$ EFFEXOR X.R. 37.5 MG CAP 4.33$ 3.03$ ELIMITE 5% CREAM 60 GM 854.90$ 598.43$ EMLA CREAM 2.5% 5 GM 95.59$ 66.91$ ENTACAPONE 200MG TAB 37.19$ 26.03$ ERYTHROCIN STEARATE 250 MG TAB 86.60$ 60.62$ ERYTHROMYCIN BASE 250 MG TAB 83.63$ 58.54$ ERYTHROMYCIN OPHT OINT 3.5 GM 200.70$ 140.49$ ESCITALOPRAM 10MG TAB 2.27$ 1.59$ ESGIC (FIORICET) TABLET 11.07$ 7.75$ ESTRACE (ESTRADIOL) 1 MG TAB 3.30$ 2.31$ ESTRADIOL 0.1MG/DAY PATCH 245.41$ 171.79$ ESTRATEST H.S. TABLET 300.60$ 210.42$ ESTROPIPATE 1.5MG TAB 5.80$ 4.06$ EUCERIN TOPICAL LOTION 240 ML 38.40$ 26.88$ EVISTA=RALOXIFENE 60 MG TAB 32.76$ 22.93$ EVOXAC=CEVIMELINE 30 MG CAP 21.30$ 14.91$ EZETIMIBE=ZETIA 10 MG TAB 18.91$ 13.24$ FAMOTIDINE 20MG TAB 1.75$ 1.22$ FAMVIR 500MG TABLET 22.10$ 15.47$ FEMARA=LETROZOLE 2.5 MG TAB 4.60$ 3.22$

FENOFIBRATE=TRICOR 145 MG TAB 29.57$ 20.70$ FENOFIBRATE=TRICOR 48 MG TAB 11.80$ 8.26$ FENTANYL 75MCG PATCH 1,276.54$ 893.58$ FENTANYL PATCH 100MCG 1,948.74$ 1,364.12$ FENTANYL PATCH 25MCG 474.70$ 332.29$ FERROUS SULFATE 325 MG EC TAB 1.40$ 0.98$ FIBERCON 625 MG TABLET UD 1.60$ 1.12$ FIORICET W/CODEINE 30MG CAP 219.26$ 153.49$ FIORINAL TABLET UD 112.65$ 78.85$ FLAGYL=METRONIDAZOLE 250MG TAB 5.30$ 3.71$ FLEXERIL 10MG ER START PACK X3 1.60$ 1.12$ FLONASE NASAL SPRAY 0.05% 16GM 333.80$ 233.66$ FLORINEF ACETATE 0.1 MG TAB 6.30$ 4.41$ FLOVENT 44MCG INHALER 1,029.58$ 720.71$ FLUOCINONIDE CREAM 0.05% 15 GM 467.30$ 327.11$ FLUOROMETHOLONE 0.1% OPTH SOL 789.93$ 552.95$ FLUOXETINE 20MG CAP 1.50$ 1.05$ FLUPHENAZINE=PROLIXIN 5 MG TAB 3.40$ 2.38$ FLUTICASONE 0.05% CREAM 332.10$ 232.47$ FLUTICASONE 220MCG MDI 2,129.97$ 1,490.98$ FLUTICASONE HFA 110MCG INHALER 1,367.73$ 957.41$ FOLIC ACID 1 MG TABLET 1.27$ 0.89$ FOLIC ACID 400 MCG TABLET 0.78$ 0.54$ FOLTX TABLET 8.00$ 5.60$ FUROSEMIDE (LASIX) 20 MG TAB 1.65$ 1.15$ FUROSEMIDE (LASIX) 40 MG TAB 1.37$ 0.96$ GABAPENTIN 300MG CAP 1.90$ 1.33$ GABAPENTIN 400MG CAP 2.24$ 1.57$ GABEPENTIN 100MG CAP 4.31$ 3.01$ GEMFIBROZIL (LOPID) 600 MG TAB 4.70$ 3.29$ GENEYE OPHT DROPS 0.05% 15 ML 14.00$ 9.80$ GENTAMICIN TOP OINT 0.1% 15 GM 478.90$ 335.23$ GI COCKTAIL (ER ONLY) 168.32$ 117.82$ GLIMEPIRIDE=AMARYL 1 MG TAB 1.74$ 1.22$ GLUCOPHAGE 850MG TAB 1.79$ 1.25$ GLUCOSE GEL 40% 29.40$ 20.58$ GLUCOTROL (GLIPIZIDE) 10MG TAB 5.94$ 4.16$ GLUCOTROL (GLIPIZIDE) 5 MG TAB 3.68$ 2.58$ GLUCOTROL XL 10 MG TABLET 5.40$ 3.78$ GLUCOTROL XL 2.5 MG TABLET 5.40$ 3.78$ GLUCOTROL XL 5MG TABLET 3.95$ 2.77$ GLYBURIDE (MICRONASE) 2.5 MG 3.20$ 2.24$ GLYCERIN ADULT SUPP 10.80$ 7.56$ GLYCERIN PEDIATRIC SUPP 7.50$ 5.25$ GLYCERIN-WITCH HAZEL 50% PADS 4.20$ 2.94$ GLYCOPYRROLATE 1MG TAB 10.10$ 7.07$ GUAIFENESIN 600MG TAB 8.91$ 6.24$

HALDOL (HALOPERIDOL) 0.5MG TAB 3.50$ 2.45$ HALDOL (HALOPERIDOL) 1 MG TAB 4.49$ 3.14$ HALDOL (HALOPERIDOL) 2 MG TAB 6.17$ 4.32$ HALDOL (HALOPERIDOL) 5 MG TAB 8.73$ 6.11$ HYDRALAZINE (APRESOLINE) 10 MG 1.81$ 1.27$ HYDRALAZINE (APRESOLINE) 25 MG 1.57$ 1.10$ HYDROCHLOROTHIAZIDE 25MG TAB 1.66$ 1.16$ HYDROCODONE/APAP 10-325MG TAB 44.44$ 31.11$ HYDROCORTISONE 0.5% CREAM 30.40$ 21.28$ HYDROCORTISONE 1% OINTMENT 14.50$ 10.15$ HYDROCORTISONE 2.5% CREAM 423.80$ 296.66$ HYDROCORTISONE 25MG SUPPOSITORY 152.70$ 106.89$ HYOSCYAMINE 0.125MG SL TAB 5.13$ 3.59$ HYTRIN (TERAZOSIN) 1 MG TABLET 1.97$ 1.38$ HYTRIN (TERAZOSIN) 5 MG TABLET 1.72$ 1.20$ HYZAAR=LOSARTEN/HCTZ TABLET 2.43$ 1.70$ IBUPROFEN 100MG/5ML PER ML 0.38$ 0.26$ IBUPROFEN 200MG TAB 0.73$ 0.51$ IBUPROFEN 600MG TAB 1.80$ 1.26$ IBUPROFEN 800MG TAB 2.10$ 1.47$ IMDUR 30MG TABLET 4.56$ 3.19$ IMDUR 60MG TABLET 4.73$ 3.31$ IMIPRAMINE (TOFRANIL) 10MG TAB 2.05$ 1.44$ IMIPRAMINE (TOFRANIL) 25MG TAB 4.55$ 3.19$ IMITREX 20 MG NASAL SPRAY 309.40$ 216.58$ INDERAL (PROPRANOLOL) 10MG TAB 3.09$ 2.16$ INDERAL (PROPRANOLOL) 20MG TAB 2.98$ 2.08$ INDERAL (PROPRANOLOL) 40MG TAB 5.05$ 3.54$ INDERAL LA 80 MG CAPSULE 18.00$ 12.60$ INDOCIN 50 MG SUPP 278.95$ 195.27$ INDOMETHACIN=INDOCIN 25 MG CAP 2.65$ 1.86$ INDOMETHACIN=INDOCIN 50 MG CAP 3.30$ 2.31$ IPRATROPIUM HFA 17MCG INHALER 1,952.48$ 1,366.73$ ISMO 20MG TAB 4.88$ 3.41$ ISONIAZID 300 MG TABLET 9.40$ 6.58$ ISOPTO CARPINE OPHT DROPS 1% 397.20$ 278.04$ ISORDIL 10 MG TABLET 7.72$ 5.40$ ISORDIL 20 MG TABLET 7.53$ 5.27$ ISORDIL 40 MG SA TABLET 17.90$ 12.53$ KEFLEX 500 MG ER START PACK X4 2.80$ 1.96$ KENALOG IN ORABASE 0.1% 5 GM 405.10$ 283.57$ KLONOPIN (CLONAZEPAM) .5MG TAB 1.49$ 1.05$ K-PHOS NEUTRAL 250 MG TABLET 3.89$ 2.72$ LACTAID (LACTASE) 3000U TABLET 1.80$ 1.26$ LACTATED RINGERS 500ML 5.23$ 3.66$ LACTINEX TABLETS 3.57$ 2.50$ LACTULOSE 10GM/15ML 0.15$ 0.10$

LAMICTAL=LAMOTRIGINE 25 MG TAB 29.42$ 20.60$ LAMISIL CREAM 1% 30GM 97.70$ 68.39$ LAMOTRIGINE 100MG TAB 2.29$ 1.60$ LANOLIN TOPICAL OINTMENT 18.49$ 12.94$ LANOXIN (DIGOXIN) 0.25 MG TAB 11.58$ 8.10$ LANTHANUM CARBONATE 500MG TAB 92.67$ 64.87$ LEVAQUIN 250 MG TABLET 5.56$ 3.89$ LEVAQUIN 500 MG TABLET 8.56$ 5.99$ LEVETIRACETAM 250MG TAB 2.09$ 1.46$ LEVOTHROID 0.05 MG TABLET 10.30$ 7.21$ LEVOTHROID 0.1 MG TABLET 10.33$ 7.23$ LEVOTHROID 0.112MG TABLET 10.11$ 7.08$ LEVOTHROID 0.125 MG TABLET 10.48$ 7.33$ LEVOTHROID 0.15 MG TABLET 10.36$ 7.25$ LEVOTHROID TAB 0.175MG 10.06$ 7.04$ LIDODERM 5% TRANSDERMAL PATCH 99.73$ 69.81$ LINEZOLID 600MG TAB 100.20$ 70.14$ LISINOPRIL 10MG TAB 1.41$ 0.98$ LISINOPRIL 20MG TAB 1.38$ 0.97$ LISINOPRIL 5MG TAB 1.47$ 1.03$ LITHOBID 300 MG SA TABLET 3.88$ 2.72$ LOPERAMIDE (IMODIUM) 2 MG CAP 6.57$ 4.60$ LOPRESSOR 100 MG TABLET 8.17$ 5.72$ LORAZEPAM (ATIVAN) 1 MG TABLET 11.83$ 8.28$ LORAZEPAM 0.5MG TAB 11.49$ 8.04$ LOSARTAN 50MG TAB 1.57$ 1.10$ LOTENSIN (BENAZEPRIL) 5 MG TAB 5.69$ 3.98$ LOXITANE 10 MG CAPSULE 6.10$ 4.27$ LOZOL (INDAPAMIDE) 2.5 MG TAB 5.80$ 4.06$ LUVOX 50MG TABLET 6.90$ 4.83$ MAALOX PLUS 30 ML U.D. 20.85$ 14.59$ MACROBID 100 MG CAPSULE 22.90$ 16.03$ MAGNESIUM SULFATE PWD (EPSOM SALT 12.20$ 8.54$ MAG-OX 400MG TABLET 1.76$ 1.23$ MAXZIDE 25/37.5 MG TABLET 3.57$ 2.50$ MECLIZINE (ANTIVERT) 25 MG TAB 7.42$ 5.20$ MEDROL 4 MG TABLET 18.49$ 12.95$ MEGACE 40 MG TABLET 6.30$ 4.41$ MELATONIN 1 MG TAB 0.86$ 0.60$ MEMANTINE 10MG TAB 4.40$ 3.08$ MENTHOL LOZENGE 1.99$ 1.40$ MEPHYTON=PHYTONADIONE 5 MG TAB 267.00$ 186.90$ MESTINON 60 MG TABLET 9.70$ 6.79$ MESTINON TIMESPAN 180 MG TAB 179.50$ 125.65$ METAMUCIL PKT 4.40$ 3.08$ METFORMIN 500MG TAB 1.15$ 0.81$ METHADONE 10MG TABLET 26.28$ 18.40$

METHADONE HCL 5 MG TABLET 33.35$ 23.34$ METHADONE INTENSOL 10 MG/ML LIQ 683.74$ 478.62$ METHERGINE 0.2 MG TABLET 335.58$ 234.90$ METHOCARBAMOL 500MG TAB 2.56$ 1.79$ METHYLDOPA (ALDOMET) 250MG TAB 2.60$ 1.82$ METOCLOPRAMIDE=REGLAN 10MG TAB 1.99$ 1.39$ METOCLOPRAMIDE=REGLAN 5 MG TAB 2.00$ 1.40$ METOPROLOL 25 MG TAB 2.97$ 2.08$ METOPROLOL 50MG ER TAB 7.31$ 5.12$ METOPROLOL TARTRATE 50MG TAB 1.55$ 1.08$ METROGEL VAGINAL GEL 0.75% 70G 774.30$ 542.01$ METRONIDAZOLE 0.75% TOP GEL 904.90$ 633.43$ METRONIDAZOLE 500MG TAB 7.68$ 5.37$ MEXITIL (MEXILETINE) 150MG CAP 11.20$ 7.84$ MEXITIL (MEXILETINE) 200MG CAP 13.40$ 9.38$ MICARDIS=TELMISARTAN 40 MG TAB 33.95$ 23.76$ MICATIN TOP POWDER 2% 45 GM 25.80$ 18.06$ MICRO-K (KCL) 8 MEQ SA CAPSULE 7.17$ 5.02$ MIDAZOLAM 2MG/ML SYRUP 527.86$ 369.50$ MILK OF MAGNESIA 30 ML UD 18.00$ 12.60$ MINERAL OIL 30 ML 6.50$ 4.55$ MINOCYLINE=MINOCIN 50 MG CAPS 2.37$ 1.66$ MINOXIDIL 2.5 MG TAB 2.27$ 1.59$ MIRAPEX=PRAMPEXOLE 0.25 MG TAB 2.51$ 1.76$ MONISTAT 3 VAG SUPP 200 MG 226.70$ 158.69$ MONISTAT 7 VAG CREAM 2% 45 GM 47.30$ 33.11$ MONISTAT 7 VAG SUPP 100 MG 5.60$ 3.92$ MONOPRIL (FOSINOPRIL) 10MG TAB 3.21$ 2.25$ MORPHINE ER 15MG TAB 112.73$ 78.91$ MORPHINE SOLUTION 10MG/5ML 5ML 114.85$ 80.39$ MOTRIN (IBUPROFEN) 400 MG TAB 2.69$ 1.88$ MS CONTIN 100MG 434.60$ 304.22$ MS CONTIN 30 MG SA TABLET 122.03$ 85.42$ MYCOPHENOLATE=MYFORTIC 180 MG TAB 33.17$ 23.22$ MYCOSTATIN 100000U/GM 15GM 277.10$ 193.97$ MYSOLINE (PRIMADONE) 50 MG TAB 5.09$ 3.57$ NABUMETONE 500MG TABLET 2.92$ 2.04$ NALTREXONE 50 MG TAB 19.60$ 13.72$ NAPROSYN (NAPROXEN) 250 MG TAB 1.88$ 1.32$ NAPROSYN (NAPROXEN) 375 MG TAB 1.90$ 1.33$ NAPROSYN (NAPROXEN) 500 MG TAB 2.90$ 2.03$ NASALCROM NASAL SPRAY 13 ML 78.00$ 54.60$ NEOMYCIN SULFATE 500 MG TABLET 12.20$ 8.54$ NEPHROCAP=FA/VIT B COMP W-C 9.20$ 6.44$ NEPTAZANE 50MG TAB 68.99$ 48.29$ NIACIN 50 MG TABLET 3.30$ 2.31$ NIACIN 500MG 1.18$ 0.83$

NIASPAN 500 MG TABLET 41.11$ 28.78$ NICODERM 14MG/24HR PATCH 16.60$ 11.62$ NICODERM 21MG/24HR PATCH 17.30$ 12.11$ NICODERM 7MG/24HR PATCH 16.59$ 11.61$ NICORETTE 2 MG GUM 3.50$ 2.45$ NITRO-DUR 0.1MG/HR PATCH 11.30$ 7.91$ NITRO-DUR 0.2MG/HR PATCH 12.60$ 8.82$ NITRO-DUR 0.4MG/HR PATCH 11.90$ 8.33$ NITROFURANTOIN MACRO 50MG CAP 13.34$ 9.34$ NITROGLYCERIN 2% UD OINT 27.70$ 19.39$ NITROGLYCERIN 2.5 MG SA CAP 3.40$ 2.38$ NITROSTAT 0.4 MG SUBL TAB X 25 8.88$ 6.22$ NOLVADEX (TAMOXIFEN) 10MG TAB 4.70$ 3.29$ NORPACE CR 150 MG CAP 32.00$ 22.40$ NORTRIPTYLINE=PAMELOR 25MG CAP 2.93$ 2.05$ NORVASC TAB 10MG 2.00$ 1.40$ NORVASC TAB 5MG 1.75$ 1.22$ NS SYRINGE 17.85$ 12.49$ NYSTATIN 500,000 UN/5 ML UD 8.70$ 6.09$ NYTATIN TOPICAL ONITMENT 30GM 278.00$ 194.60$ OCUVITE TABLET 1.49$ 1.04$ OLANZAPINE 5MG ODT 32.36$ 22.65$ OLANZAPINE 5MG TAB 3.85$ 2.70$ OLMESARTAN=BENICAR 20 MG TAB 47.77$ 33.44$ OSTELTAMIR=TAMOFLU 75 MG CAP 92.71$ 64.90$ OXYBUTYNIN 5MG TAB 1.48$ 1.04$ OXYCODONE I.R. 5 MG TABLET 31.32$ 21.92$ OXYCONTIN 10 MG TABLET 318.05$ 222.63$ OXYCONTIN 20 MG T.R. TABLET 583.22$ 408.25$ OXYCONTIN=OXYCODONE CR 40 MG TAB 1,018.25$ 712.78$ OXYMETAZOLINE 0.05% 15 ML SPRAY 10.09$ 7.06$ OYSTER SHELL CALCIUM 500MG TAB 1.01$ 0.71$ PAMELOR=NORTRIPTYLINE 10MG CAP 4.93$ 3.45$ PAROXETINE 20MG TAB 2.70$ 1.89$ PATANOL 564.90$ 395.43$ PAXIL (PAROXETINE) 10MG TAB 8.23$ 5.76$ PEDIAPRED 5ML UNIT DOSE 28.16$ 19.71$ PEN VK 125MG/5ML SUSP PER ML 0.36$ 0.25$ PENICILLIN VK 250MG ER START PACK 18.20$ 12.74$ PENTASA 24.28$ 17.00$ PERCOCET 5/325 TABLET 29.28$ 20.50$ PERIDEX 0.12% PER ML 0.07$ 0.05$ PH CLONIDINE 0.1 MG TAB 2.00$ 1.40$ PH DIPHENHYDRAMINE 25MG CAP 1.40$ 0.98$ PH DIPHENHYDRAMINE 50MG CAP 1.60$ 1.12$ PH PHENYLEPHRINE HCL 0.5% 29.80$ 20.86$ PHENAZOPYRIDINE HCL 100 MG TAB 8.11$ 5.68$

PHENERGAN 25 MG SUPP 131.42$ 91.99$ PHENERGAN SUPP 12.5MG 136.33$ 95.43$ PHENOBARBITAL 20MG/5ML UD ELIX 80.50$ 56.35$ PHENOBARBITAL 97.2MG TAB 92.93$ 65.05$ PHENOL SPRAY (CHLORASEPTIC) 17.80$ 12.46$ PHENOPBARBITAL 32.4 MG TAB 37.75$ 26.42$ PHENYLEPHRINE 0.25% NASAL SPRAY 29.80$ 20.86$ PHENYLEPHRINE 0.5% NASAL SPRAY 29.80$ 20.86$ PHENYLEPHRINE 1% NASAL SPRAY 33.20$ 23.24$ PHOS-LO 667MG TABLETS 13.14$ 9.20$ PHOS-NAK POWDER PACKET 4.71$ 3.30$ PILOCARPINE 5 MG TAB 12.10$ 8.47$ PINDOLOL (VISKEN) 5 MG TABLET 9.60$ 6.72$ PLAQUENIL 200 MG TABLET 4.02$ 2.82$ PLENDIL (FELODIPINE) 2.5MG TAB 10.40$ 7.28$ PLENDIL (FELODIPINE) 5 MG TAB 10.06$ 7.04$ PLETAL=CILOSTAZOL 100 MG TAB 6.25$ 4.38$ POLYCITRA SYRUP 30 ML 16.50$ 11.55$ POLYETHYLENE GLYCOL 3350 17GM PWD 16.45$ 11.52$ POLYTRIM OPHT DROPS 10 ML 140.70$ 98.49$ POTASSIUM CHLORIDE 10% 15ML UD 39.15$ 27.40$ POTASSIUM CHLORIDE 10MEQ CAP 6.83$ 4.78$ POTASSIUM CHLORIDE 20MEQ TAB 5.90$ 4.13$ PRAZOSIN (MINIPRESS) 1 MG CAP 5.55$ 3.88$ PRAZOSIN (MINIPRESS) 2 MG CAP 7.82$ 5.47$ PRAZOSIN (MINIPRESS) 5MG CAP 12.65$ 8.86$ PREGABALIN 75MG CAP 56.51$ 39.56$ PREGABALIN=LYRICA 100 MG CAP 55.91$ 39.13$ PREGABALIN=LYRICA 25 MG CAP 50.30$ 35.21$ PREPARATION H CREAM 52.40$ 36.68$ PREPARATION H SUPP 2.34$ 1.64$ PRIMIDONE (MYSOLINE) 250MG TAB 6.10$ 4.27$ PROAMATINE=MIDODRINE 5 MG TAB 13.99$ 9.79$ PROBENECID (BENEMID) 500MG TAB 5.74$ 4.02$ PROBENECID W/COLCHICINE TABLET 7.90$ 5.53$ PROMETHAZINE HCL 25 MG TABLET 4.00$ 2.80$ PROMETHAZINE W/COD 5ML UD 19.17$ 13.42$ PROPAFENONE=RYTHMOL SR 325 MG CAP 59.00$ 41.30$ PROPYLTHIOURACIL 50 MG TABLET 7.40$ 5.18$ PROSCAR (FINASTERIDE) 5 MG TAB 15.70$ 10.99$ PROTONIX=PANTOPRAZOLE 40MG TAB 3.60$ 2.52$ PROVERA 10MG TAB 3.29$ 2.30$ PROVERA 2.5 MG TABLET 2.06$ 1.44$ PROVIGIL=MODAFINIL 200 MG TAB 1,241.38$ 868.96$ PROZAC (FLUOXETINE) 10 MG CAP 1.50$ 1.05$ PSEUDOEPHEDRINE HCL 30 MG TAB 0.84$ 0.59$ PYRIDOXINE (VIT B-6) 50 MG TAB 2.82$ 1.98$

PYRIDOXINE 25 MG TAB 1.05$ 0.73$ QUETIAPINE 25MG TAB 3.07$ 2.15$ QUINAPRIL 20MG TABLET 2.53$ 1.77$ REMERON 15MG TABLET 4.17$ 2.92$ REMERON SOLTAB 30 MG 18.60$ 13.02$ REMINYL=GALANTAMINE 4 MG TAB 13.43$ 9.40$ RENAGEL=SEVELAMER 800 MG TAB 34.32$ 24.03$ REQUIP=ROPINIROLE 0.5 MG TAB 5.53$ 3.87$ RETROVIR=ZIDOVUDINE 300 MG TAB 10.90$ 7.63$ RIFADIN (RIFAMPIN) 300 MG CAP 10.32$ 7.23$ RIFAXIMIN=XIFAXAN 200 MG TAB 151.10$ 105.77$ RISPERDAL 1MG TABLET 4.92$ 3.44$ RISPERIDONE 1MG/ML ORAL SOLN 35.99$ 25.20$ RISPERIDONE 2MG TAB 5.24$ 3.67$ RITALIN 10 MG TABLET 80.24$ 56.17$ RITALIN=METHYLPHENIDATE 5 MG 58.93$ 41.25$ RIVASTIGMINE=EXELON 1.5MG CAP 13.27$ 9.29$ RIZATRIPTAN 5MG ODT 18.12$ 12.68$ ROBAXIN-750 MG TABLET 2.83$ 1.98$ ROBITUSSIN AC (GENERIC) UD 5CC 5.53$ 3.87$ ROPINIROLE=REQUIP 2 MG TAB 5.34$ 3.74$ ROWASA ENEMA 4GM/60ML 178.20$ 124.74$ ROXANOL 20 MG/ML ORAL SOLN 56.37$ 39.46$ ROXICODONE 20MG/ML 1 ML 577.56$ 404.29$ RYTHMOL 150 MG TABLET 7.50$ 5.25$ SALSALATE 500MG TAB 14.60$ 10.22$ SANDOSTATIN 0.5 MG/ML 1 ML AMP 343.60$ 240.52$ SANTYL TOP OINTMENT 30 GM 1,415.55$ 990.88$ SENISPAR=CINACALCET 30 MG TAB 187.15$ 131.00$ SENNA 8.6 MG TAB 1.14$ 0.80$ SERAX (OXAZEPAM) 10 MG CAPSULE 49.65$ 34.76$ SERAX (OXAZEPAM) 15 MG CAPSULE 61.20$ 42.84$ SEREVENT DISKUS 50 MCG INH 1,215.60$ 850.92$ SERTRALINE 50MG TAB 2.80$ 1.96$ SILDENAFIL=REVATIO 20 MG TAB 8.67$ 6.07$ SILVADENE CREAM 50GM JAR 164.40$ 115.08$ SILVER NITRATE APPLICATOR 6.37$ 4.46$ SIMETHICONE 40MG/0.6ML PER ML 1.05$ 0.74$ SIMETHICONE 80MG TAB 0.96$ 0.67$ SIMVASTATIN 10MG TAB 2.40$ 1.68$ SIMVASTATIN 20MG TAB 2.18$ 1.52$ SINEMET-25/100 TABLET 2.34$ 1.64$ SINEMET-25/250 TABLET 2.94$ 2.06$ SINGULAIR=MONTELUKAST 10MG TAB 3.89$ 2.72$ SINGULAIR=MONTELUKAST 5 MG TAB 5.03$ 3.52$ SITAGLIPTIN=JANUVIA 50 MG TAB 109.66$ 76.76$ SKELAXIN=METAXALONE 400 MG TAB 61.10$ 42.77$

SLO-NIACIN CR 250MG TABLET 1.07$ 0.75$ SLOW FE 160 MG SA TABLET 1.49$ 1.04$ SLOW-MAG 64 MG SA TABLET 1.81$ 1.27$ SOD POLYSTYRENE 60CC 1.33$ 0.93$ SOD POLYSTYRENE SULF 60 ML 77.66$ 54.36$ SODIUM BICARBONATE 650 MG TAB 0.81$ 0.57$ SODIUM CHLORIDE 1 GM TABLET 1.62$ 1.13$ SODIUM CHLORIDE NASAL SPRAY 9.00$ 6.30$ SOL SORBITOL 3000CC BAG 2.02$ 1.41$ SPIRIVA=TIOTROPIUM 18MCG INH 453.90$ 317.73$ SPIRONOLACTONE 25 MG TABLET 1.80$ 1.26$ SSD TOP CREAM 1% 400 GM 339.10$ 237.37$ SSD TOP CREAM 1% 50 GM 151.10$ 105.77$ STARLIX=NATEGLINIDE 120 MG TAB 14.00$ 9.80$ STRATTERA=ATOMOXETINE 10 MG CAP 93.19$ 65.23$ STROMECTOL=IVERMECTIN 3 MG TAB 36.58$ 25.61$ STUARTNATAL 1+1 TABLET 2.30$ 1.61$ SULFACETAMIDE NA 10% OPHTH SOL 337.40$ 236.18$ SULFAMETHOXA/TRIMETH 800-160MG TA 2.57$ 1.80$ SULFAMETHOXAZOLE/TRIMETHOPRIM SUS 3.35$ 2.34$ SULFASALAZINE 500MG TAB 3.98$ 2.78$ SULINDAC (CLINORIL) 200 MG TAB 11.00$ 7.70$ SUMATRIPTAN 25MG TABLET 17.78$ 12.45$ SUMYCIN 125 MG/5 ML SYRUP 30ML 136.60$ 95.62$ SUSTIVA=EFAVIRENZ 200 MG CAP 81.50$ 57.05$ SYNTHROID 0.088 MG TABLETS 10.10$ 7.07$ TAMBOCOR (FLECAINIDE)100MG TAB 13.80$ 9.66$ TAMSULOSIN 0.4MG CAP 5.94$ 4.16$ TAPAZOLE 10 MG TABLET 3.96$ 2.77$ TAPAZOLE 5MG TAB 3.89$ 2.72$ TEGRETOL 100 MG CHEW TABLET 5.23$ 3.66$ TEGRETOL XR 100 MG TABLET 10.09$ 7.06$ TEMAZEPAM (RESTORIL) 15 MG CAP 16.65$ 11.65$ TERAZOSIN 2MG CAP 3.09$ 2.17$ THEO-DUR 100MG 5.20$ 3.64$ THEO-DUR 300 MG SA TABLET 5.40$ 3.78$ THEOPHYLLINE 400MG ER TAB 11.04$ 7.72$ THERAPEUTIC B COMPLEX W/C CAP 1.30$ 0.91$ THERAPEUTIC MULTIVITAMIN TAB 1.39$ 0.97$ THIAMINE (VIT B-1) 100 MG TAB 2.76$ 1.93$ TINCTURE OF BENZOIN 60 ML 59.30$ 41.51$ TOLNAFTATE 1% CREAM 22.80$ 15.96$ TOPAMAX=TOPIRAMATE 100 MG TAB 2.83$ 1.98$ TOPIRAMATE 25MG TAB 2.00$ 1.40$ TOPROL-XL=METOPROLOL 25 MG TAB 9.28$ 6.50$ TORADOL (KETOROLAC) 10 MG TAB 38.80$ 27.16$ TRAMADOL 50MG TAB 11.34$ 7.94$

TRANDATE (LABETALOL) 200MG TAB 6.34$ 4.44$ TRANDATE=LABETALOL 100 MG TAB 4.81$ 3.37$ TRANDOLAPRIL 2 MG TAB 4.84$ 3.39$ TRANSDERM-SCOP 1.5 MG TD PATCH 238.90$ 167.23$ TRAZODONE (DESYREL) 100 MG TAB 2.25$ 1.58$ TRAZODONE (DESYREL) 50 MG TAB 2.17$ 1.52$ TRENTAL 400 MG SA TABLET 5.40$ 3.78$ TRIAMCINOLONE 0.1% CREAM 80 GM 134.60$ 94.22$ TRIAMCINOLONE ACET CRM.1% 15GM 51.30$ 35.91$ TRIAMCINOLONE ACET CRM.5% 15GM 68.63$ 48.04$ TRIAZOLAM (HALCION) 0.125MG 260.02$ 182.01$ TRIFLUOPERAZINE=STELAZINE 1 MG 5.80$ 4.06$ TRIFLUOPERAZINE=STELAZINE 5 MG 10.91$ 7.64$ TRIHEXYPHENIDYL=ARTANE 2MG TAB 1.73$ 1.21$ TRILEPTAL=OXCARBAMAZEPINE 150 MG 4.00$ 2.80$ TRUVADA 200-300 MG TAB 335.60$ 234.92$ TUSSIONEX ORAL SUSP 5 ML 250.80$ 175.56$ TYLENOL #3 ER START PACK X 6 17.60$ 12.32$ UNIVASC 7.5MG TABLET 8.70$ 6.09$ UROCIT-K 540 MG SA TABLET 8.18$ 5.72$ VALACYCLOVIR=VALTREX 500MG TAB 21.62$ 15.14$ VALGANCICLOVIR 450MG TAB 285.65$ 199.96$ VALSARTAN 80MG CAP 4.16$ 2.91$ VARENICLINE=CHANTIX 0.5 MG TAB 52.85$ 36.99$ VARENICLINE=CHANTIX 1 MG TAB 49.29$ 34.50$ VASOTEC (ENALAPRIL) 10 MG TAB 5.21$ 3.65$ VASOTEC (ENALAPRIL) 5 MG TAB 5.90$ 4.13$ VEETIDS (PEN VK) 250 MG TABLET 4.90$ 3.43$ VEETIDS (PEN VK) 500 MG TABLET 8.97$ 6.28$ VENLAFAXINE 25MG TABLET 9.10$ 6.37$ VENLAFAXINE ER 75MG CAP 4.51$ 3.16$ VERAPAMIL (ISOPTIN) 40 MG TAB 1.78$ 1.25$ VERELAN PM 100 MG CAP 14.35$ 10.05$ VFEND=VORICONAZOLE 200 MG TAB 170.20$ 119.14$ VIT B COMPLEX W/C, FOLIC ACID, FE 8.88$ 6.22$ VITAMIN D 50000IU CAPSULE 11.50$ 8.05$ VITAMIN E 200IU CAPSULE 2.45$ 1.72$ VITAMIN E 400 IU CAPSULE 1.50$ 1.05$ VOLTAREN (DICLOFENAC) 25MG TAB 9.55$ 6.69$ WELCHOL=COLESEVELAM 625MG TAB 30.11$ 21.08$ WELLBUTRIN 100 MG TABLET 7.54$ 5.27$ XANAX 0.25 MG TABLET 9.59$ 6.72$ XANAX 0.5MG TAB 9.66$ 6.76$ ZANAFLEX 4MG TABLET 7.23$ 5.06$ ZAROXOLYN 5MG TAB 17.70$ 12.39$ ZAROXOLYN TAB 2.5MG 15.79$ 11.05$ ZINC CHELATED 50 MG TABLET 1.20$ 0.84$

ZINC OXIDE 20% (DESITIN) OINT 22.78$ 15.95$ ZINC OXIDE TOP OINTMENT 30 GM 27.70$ 19.39$ ZINC SULFATE 220 MG CAPSULE 1.91$ 1.34$ ZIPRASIDONE 20MG CAP 10.98$ 7.68$ ZIPRASIDONE=GEODON 80 MG CAP 14.36$ 10.05$ ZOFRAN TABLET 4 MG 4.88$ 3.42$ ZOLOFT 100MG 2.77$ 1.94$ ZOLPIDEM 5MG TAB 11.04$ 7.73$ ZOMIG=ZOLMITRIPTAN 2.5MG TAB 489.75$ 342.83$ ZYRTEC TAB 10MG 2.40$ 1.68$ ZZ SUS EXT TUBING 20 4.61$ 3.23$ 752724018 PACU LEVEL 1-1ST 30 MIN 478.00$ 334.60$ 752724019 PACU LEVEL 1-ADDL MIN 4.78$ 3.35$ 752724020 PACU LEVEL 2-1ST 30 MIN 574.00$ 401.80$ 752724021 PACU LEVEL 2-ADDL MIN 5.74$ 4.02$ 752724022 PACU LEVEL 3-1ST 30 MIN 689.00$ 482.30$ 752724023 PACU LEVEL 3-ADDL MIN 6.89$ 4.82$ 752724024 PACU LEVEL 4-1ST 30 MIN 827.00$ 578.90$ 752724025 PACU LEVEL 4-ADDL MIN 8.27$ 5.79$ 752724026 PACU LEVEL 5-1ST 30 MIN 992.00$ 694.40$ 752724027 PACU LEVEL 5-ADDL MIN 9.92$ 6.94$ 752724028 PACU PHASE II RECOVERY 1ST 30 MIN 478.00$ 334.60$ 752724029 PACU PHASE II RECOVERY ADDL MIN 4.78$ 3.35$ PACU LEVEL 1-1ST 30 MIN 478.00$ 334.60$ PACU LEVEL 1-1ST 30 MIN 478.00$ 334.60$ PACU LEVEL 1-ADDL MIN 4.78$ 3.35$ PACU LEVEL 1-ADDL MIN 4.78$ 3.35$ PACU LEVEL 2-1ST 30 MIN 574.00$ 401.80$ PACU LEVEL 2-1ST 30 MIN 574.00$ 401.80$ PACU LEVEL 2-ADDL MIN 5.74$ 4.02$ PACU LEVEL 2-ADDL MIN 5.74$ 4.02$ PACU LEVEL 3-1ST 30 MIN 689.00$ 482.30$ PACU LEVEL 3-1ST 30 MIN 689.00$ 482.30$ PACU LEVEL 3-ADDL MIN 6.89$ 4.82$ PACU LEVEL 3-ADDL MIN 6.89$ 4.82$ PACU LEVEL 4-1ST 30 MIN 827.00$ 578.90$ PACU LEVEL 4-1ST 30 MIN 827.16$ 579.01$ PACU LEVEL 4-ADDL MIN 8.27$ 5.79$ PACU LEVEL 4-ADDL MIN 8.29$ 5.80$ PACU LEVEL 5 ADDITIONAL MIN 39.30$ 27.51$ PACU LEVEL 5-1ST 30 MIN 992.00$ 694.40$ PACU LEVEL 5-1ST 30 MIN 992.00$ 694.40$ PACU LEVEL 5-ADDL MIN 9.92$ 6.94$ PACU LEVEL 5-ADDL MIN 9.92$ 6.94$ PACU PAHSE II RECOVERY ADDL MIN 4.78$ 3.35$ PACU PHASE II RECOVERY 1ST 30 MIN 478.00$ 334.60$ PACU PHASE II RECOVERY-1ST 30 MIN 478.00$ 334.60$

PACU PHASE II RECOVERY-ADDL MIN 4.78$ 3.35$ OB O/P AMNIOCENTESIS 2,018.00$ 1,412.60$ LABOR LEVEL 1 PER HOUR 168.00$ 117.60$ LABOR LEVEL II PER HOUR 199.00$ 139.30$ LABOR LEVEL III PER HOUR 265.00$ 185.50$ LABOR LEVEL IV PER HOUR 332.00$ 232.40$ DELIVERY LEVEL I PER HOUR 3,988.00$ 2,791.60$ DELIVERY LEVEL II PER HOUR 5,409.00$ 3,786.30$ DELIVERY OUTSIDE HOSPITAL 3,807.00$ 2,664.90$ FETAL DEMISE LEVEL I 3,988.00$ 2,791.60$ FETAL DEMISE LEVEL II 5,409.00$ 3,786.30$ CIRCUMCISION, NEWORN 7,505.00$ 5,253.50$ CIRCUMCISION, NEWORN 7,505.00$ 5,253.50$ 12 LEAD EKG 325.00$ 227.50$ ECG RECORDING >48 HOURS 409.00$ 286.30$ ECG RECORDING >48 HRS 409.00$ 286.30$ ECG UP TO 48 HRS RECORDING 685.00$ 479.50$ EKG 325.00$ 227.50$ HL ECG 24HR MICROPRCESS 325.00$ 227.50$ EEG ASLEEP/AWAKE 732.00$ 512.40$ ENDO PROCEDURE LEVEL 1-1ST 30 MIN 3,583.00$ 2,508.10$ ENDO PROCEDURE LEVEL 1-ADDL MIN 35.83$ 25.08$ ENDO PROCEDURE LEVEL 2-1ST 30 MIN 4,300.00$ 3,010.00$ ENDO PROCEDURE LEVEL 2-ADDL MIN 43.00$ 30.10$ APPL OF LOW COST SKIN SUB GRFT 1,781.00$ 1,246.70$ APPLIC RIGID TOT CONTACT LEG CAST 925.00$ 647.50$ APPLIC SKN SUB GRFT TRNK/ARM/LEG 5,829.00$ 4,080.30$ APPLICATION OF COMPRESSION WRAP 530.00$ 371.00$ APPLICATION OF SKIN GRFT ADDL 103.00$ 72.10$ APPLICATION OF SKIN SUB GRFT 72.00$ 50.40$ APPLICATION OF SKIN SUB HD/NK/FC 5,829.00$ 4,080.30$ APPLICATION OF UNNA BOOT 530.00$ 371.00$ CHEMICAL CAUTERY OF WOUND 605.00$ 423.50$ DEBRIDE BONE EA ADDL <=20SQCM 415.00$ 290.50$ DEBRIDE MUSCLE/FASC EA AD <=20CM 232.00$ 162.40$ DEBRIDE TISSUE EA ADDL <=20SQCM 109.00$ 76.30$ DEBRIDE TISSUE/MUSCLE 1,173.00$ 821.10$ DEBRIDEMENT OF NAIL 6 OR MORE 217.00$ 151.90$ DEBRIDEMENT OF NAILS 1-5 217.00$ 151.90$ DEBRIDEMENT SKIN 1ST 20 SQ CM 605.00$ 423.50$ DEBRIDEMENT SKIN EA ADDL 20 SQ CM 48.00$ 33.60$ DEBRIDEMENT SKIN/TISSUE 1,173.00$ 821.10$ DRESSINGS/DEBRID OF P/THICK BURNS 605.00$ 423.50$ EXCISION OF BENIGN LES 2.1-3.0 CM 3,423.00$ 2,396.10$ FETAL NON STRESS TEST 542.00$ 379.40$ INCISION AND DRAINAGE OF ABSCESS 671.00$ 469.70$ INTERMEDIATE WOUND REPAIR <2.5CM 911.00$ 637.70$

NEG PRESSURE WND VAC >50CM 605.00$ 423.50$ NEG PRESSURE WOUND THERAPY<=50CM 408.00$ 285.60$ NEG PRESSURE WOUND THERAPY<=50CM 408.00$ 285.60$ NSW DEBRIDE W/TOPICAL OINT APPLIC 605.00$ 423.50$ PARING CALLUS >4 LESIONS 605.00$ 423.50$ PARING CALLUS 2-4 LESIONS 605.00$ 423.50$ PARING CALLUS SINGLE LESION 408.00$ 285.60$ REMOVAL OF NAIL PLATE 605.00$ 423.50$ TRIMMING OF NAILS 217.00$ 151.90$ WOUND CARE OUTPATIENT CLINIC VISIT 199.00$ 139.30$ WOUND CARE OUTPATIENT VISIT EST COMPLEX 630.00$ 441.00$ CVU OBSERVATION PER DAY 1,973.92$ 1,381.74$ ICU OBSERVATION PER DAY 3,090.49$ 2,163.34$ ICU TELE OBSERVATION PER DAY 2,237.66$ 1,566.36$ MED/ONC TELE OBSERVATION PER DAY 1,715.04$ 1,200.53$ MEDICAL/ONCOLOGY OBS PER DAY 1,308.41$ 915.89$ PEDIATRICS OBSERVATION PER DAY 961.85$ 673.29$ SURG/TELE OBSERVATION PER DAY 1,437.69$ 1,006.38$ SURGICAL OBSERVATION PER DAY 1,139.94$ 797.95$ TCU OBSERVATION PER DAY 1,747.65$ 1,223.35$ TELEMETRY OBSERVATION PER DAY 1,692.82$ 1,184.97$ W&C NON OB OBSERVATION PER DAY 958.99$ 671.30$ W&C OBSTETRICS OBS PER DAY 908.26$ 635.78$ NS ACUTE HEMODIALYSIS 1/2 1,270.02$ 889.01$ CAPD INPATIENT 801.00$ 560.70$ NS ACUTE HEMODIALYSIS 1/1 1,271.00$ 889.70$ NS PERITONEAL DIALYSIS CCPD 801.00$ 560.70$ DIAGNOSTIC INTEVIEW/REPORT 514.00$ 359.80$ FAMILY THER W/O PT 45-50MIN 413.00$ 289.10$ FAMILY THER W/PT 45-50 MIN 429.00$ 300.30$ INDIV THER 60 MIN 512.00$ 358.40$ INDIVIDUAL THER 45-50 MIN 341.00$ 238.70$ INDIVIDUAL THERPY 20-30 MIN 256.00$ 179.20$ PSYCH TESTING 322.00$ 225.40$ ANALYZE NEUROSTIM NO PROG 409.00$ 286.30$ ANALYZE NEUROSTIM W/PROG 531.00$ 371.70$ ARTERIAL DOPPLER LOWER EXTREMITY 1,570.00$ 1,099.00$ ARTERIAL DOPPLER UPPER EXTREMITTY 785.00$ 549.50$ COMPLETE BILAT DOPPLER STDY 467.00$ 326.90$ RT ATERIAL DOPPLER UPPER EXT 558.00$ 390.60$ US ABDOMINAL VESSELS 785.00$ 549.50$ US ARTERIES 558.00$ 390.60$ US BILATERAL ANKLE BRACH INDICES 467.00$ 326.90$ US CAROTID BILATERAL 1,570.00$ 1,099.00$ US CAROTID UNILATERAL 785.00$ 549.50$ US DUPLEX ARTERIAL FLOW 785.00$ 549.50$ US DUPLEX ARTERIAL FLOW LMTD 785.00$ 549.50$

US FISTULA ACCESS 558.00$ 390.60$ US VEINS 558.00$ 390.60$ US VENOUS DOPPLER LOWER EXT 1,570.00$ 1,099.00$ AIC APPLICATION ON BODY INJECTOR 111.00$ 77.70$ HYPERBARIC O2 CHAMBER EA 30MIN 453.00$ 317.10$ NS PLASMA PHERESIS 4,371.00$ 3,059.70$ PHLEBOTOMY PER UNIT 326.00$ 228.20$ PHLEBOTOMY THERAPEUTIC 326.00$ 228.20$ 2 WEST SEMI PRIVATE-NON OB 84.00$ 58.80$ DIABETES EDU GRP/30MIN 29.00$ 20.30$ DIABETES EDUCATION 30 MIN 109.00$ 76.30$ MEDICAL NUTRITION THERAPY 2ND REF 56.00$ 39.20$ MEDICAL NUTRITION THERAPY INITIAL ASSESS 15 MIN 67.00$ 46.90$ CARDIAC REHAB 428.00$ 299.60$ CARDIAC REHAB MONITOR 428.00$ 299.60$ GROUP THERAPY 45-50 MIN 103.00$ 72.10$

DRGAverage

Charge/ DRGABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY MS 24,474 ACUTE & SUBACUTE ENDOCARDITIS W CC MS 7,804 ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION MS 16,162 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC MS 60,722 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC MS 143,102 ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W/O CC/MCC MS 15,880 ACUTE MAJOR EYE INFECTIONS W/O CC/MCC MS 7,390 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC MS 25,418 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC MS 34,365 ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC MS 25,067 ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC MS 44,554 ADMIT FOR RENAL DIALYSIS MS 15,399 ADRENAL & PITUITARY PROCEDURES W CC/MCC MS 55,667 AFTERCARE W CC/MCC MS 25,319 AFTERCARE W/O CC/MCC MS 7,752 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC MS 19,933 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC MS 40,267 AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC MS 18,550 AICD GENERATOR PROCEDURES MS 192,696 ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY MS 36,156 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC MS 39,660 ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC MS 22,609 ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA MS 14,756 ALLERGIC REACTIONS W MCC MS 47,927 ALLERGIC REACTIONS W/O MCC MS 20,208 AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W CC MS 42,798 AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W MCC MS 75,738 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC MS 57,642 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC MS 108,921 AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W/O CC/MCC MS 30,845 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC MS 63,309 AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC MS 28,110 ANAL & STOMAL PROCEDURES W CC MS 42,058 ANAL & STOMAL PROCEDURES W/O CC/MCC MS 17,987 ANGINA PECTORIS MS 40,932 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC MS 152,240 AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC MS 95,339 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W CC MS 35,028 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W MCC MS 82,139 APPENDECTOMY W COMPLICATED PRINCIPAL DIAG W/O CC/MCC MS 27,647 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W CC MS 26,432 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W MCC MS 54,319 APPENDECTOMY W/O COMPLICATED PRINCIPAL DIAG W/O CC/MCC MS 22,960 ATHEROSCLEROSIS W/O MCC MS 13,639 BACK & NECK PROC EXC SPINAL FUSION W CC MS 44,144 BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM MS 75,507 BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC MS 34,202 BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC MS 122,628 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC MS 250,839 BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC MS 95,698 BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC MS 20,573

BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC MS 90,908 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC MS 62,842 BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC MS 187,283 BONE DISEASES & ARTHROPATHIES W MCC MS 26,148 BONE DISEASES & ARTHROPATHIES W/O MCC MS 15,011 BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC MS 35,518 BRONCHITIS & ASTHMA W CC/MCC MS 20,397 BRONCHITIS & ASTHMA W/O CC/MCC MS 14,890 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC MS 16,777 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC MS 30,098 CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC MS 13,871 CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC MS 21,222 CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC MS 19,633 CARDIAC DEFIB IMPLANT W CARDIAC CATH W AMI/HF/SHOCK W MCC MS 332,138 CARDIAC DEFIB IMPLANT W CARDIAC CATH W/O AMI/HF/SHOCK W MCC MS 274,271 CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W MCC MS 214,121 CARDIAC DEFIBRILLATOR IMPLANT W/O CARDIAC CATH W/O MCC MS 199,398 CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC MS 48,368 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC MS 155,686 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC MS 208,657 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC MS 131,666 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC MS 155,235 CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC MS 82,059 CAROTID ARTERY STENT PROCEDURE W CC MS 76,252 CAROTID ARTERY STENT PROCEDURE W/O CC/MCC MS 39,138 CELLULITIS W MCC MS 41,046 CELLULITIS W/O MCC MS 21,503 CERVICAL SPINAL FUSION W CC MS 62,376 CERVICAL SPINAL FUSION W MCC MS 92,105 CERVICAL SPINAL FUSION W/O CC/MCC MS 48,049 CESAREAN SECTION W CC/MCC MS 31,602 CESAREAN SECTION W/O CC/MCC MS 28,027 CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC MS 27,357 CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT MS 18,314 CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC MS 50,993 CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC MS 21,154 CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC MS 95,746 CHEST PAIN MS 19,401 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC MS 50,044 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC MS 92,643 CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC MS 31,021 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC MS 27,772 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC MS 30,548 CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC MS 24,853 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC MS 38,880 CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC MS 30,219 CIRRHOSIS & ALCOHOLIC HEPATITIS W CC MS 29,093 CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC MS 58,130 CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC MS 11,952 COAGULATION DISORDERS MS 30,582 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W CC MS 103,298 COMBINED ANTERIOR/POSTERIOR SPINAL FUSION W/O CC/MCC MS 82,044 COMPLICATED PEPTIC ULCER W CC MS 25,074

COMPLICATED PEPTIC ULCER W MCC MS 40,356 COMPLICATED PEPTIC ULCER W/O CC/MCC MS 17,342 COMPLICATIONS OF TREATMENT W CC MS 32,556 COMPLICATIONS OF TREATMENT W MCC MS 60,094 COMPLICATIONS OF TREATMENT W/O CC/MCC MS 14,164 CONCUSSION W/O CC/MCC MS 2,064 CONNECTIVE TISSUE DISORDERS W CC MS 32,263 CONNECTIVE TISSUE DISORDERS W MCC MS 128,964 CONNECTIVE TISSUE DISORDERS W/O CC/MCC MS 20,629 CORONARY BYPASS W CARDIAC CATH W MCC MS 142,985 CORONARY BYPASS W CARDIAC CATH W/O MCC MS 117,821 CORONARY BYPASS W PTCA W MCC MS 226,861 CORONARY BYPASS W PTCA W/O MCC MS 188,944 CORONARY BYPASS W/O CARDIAC CATH W MCC MS 103,353 CORONARY BYPASS W/O CARDIAC CATH W/O MCC MS 99,540 CRANIAL & PERIPHERAL NERVE DISORDERS W MCC MS 44,337 CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC MS 20,559 CRANIAL/FACIAL PROCEDURES W/O CC/MCC MS 35,769 D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W CC/MCC MS 22,906 DEEP VEIN THROMBOPHLEBITIS W CC/MCC MS 42,633 DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC MS 55,822 DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC MS 92,980 DENTAL & ORAL DISEASES W CC MS 19,370 DENTAL & ORAL DISEASES W MCC MS 29,184 DENTAL & ORAL DISEASES W/O CC/MCC MS 17,742 DEPRESSIVE NEUROSES MS 12,228 DIABETES W CC MS 23,139 DIABETES W MCC MS 31,985 DIABETES W/O CC/MCC MS 18,192 DIGESTIVE MALIGNANCY W CC MS 19,565 DIGESTIVE MALIGNANCY W MCC MS 54,480 DIGESTIVE MALIGNANCY W/O CC/MCC MS 38,584 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC MS 17,106 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC MS 40,923 DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC MS 66,531 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC MS 19,366 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC MS 70,468 DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC MS 11,132 DISORDERS OF THE BILIARY TRACT W CC MS 33,266 DISORDERS OF THE BILIARY TRACT W MCC MS 62,495 DISORDERS OF THE BILIARY TRACT W/O CC/MCC MS 11,265 DYSEQUILIBRIUM MS 14,538 EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC MS 38,402 EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC MS 34,612 ECMO OR TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W MAJ O.R. 369,379 ECTOPIC PREGNANCY MS 24,278 ENDOCRINE DISORDERS W CC MS 27,940 ENDOCRINE DISORDERS W MCC MS 52,013 ENDOCRINE DISORDERS W/O CC/MCC MS 14,055 EPISTAXIS W MCC MS 13,249 EPISTAXIS W/O MCC MS 8,081 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC MS 25,592 ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC MS 16,274

EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W CC MS 57,763 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W MCC MS 122,428 EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC MS 37,785 EXTRACRANIAL PROCEDURES W CC MS 51,807 EXTRACRANIAL PROCEDURES W MCC MS 104,581 EXTRACRANIAL PROCEDURES W/O CC/MCC MS 37,151 EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE MS 11,358 FEVER MS 13,824 FOOT PROCEDURES W CC MS 25,655 FOOT PROCEDURES W MCC MS 40,906 FOOT PROCEDURES W/O CC/MCC MS 40,744 FRACTURES OF FEMUR W/O MCC MS 15,334 FRACTURES OF HIP & PELVIS W MCC MS 28,097 FRACTURES OF HIP & PELVIS W/O MCC MS 17,795 FULL TERM NEONATE W MAJOR PROBLEMS MS 10,668 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC MS 31,638 FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC MS 16,077 G.I. HEMORRHAGE W CC MS 25,424 G.I. HEMORRHAGE W MCC MS 46,198 G.I. HEMORRHAGE W/O CC/MCC MS 14,074 G.I. OBSTRUCTION W CC MS 14,610 G.I. OBSTRUCTION W MCC MS 36,370 G.I. OBSTRUCTION W/O CC/MCC MS 12,508 HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC MS 40,752 HAND PROCEDURES FOR INJURIES MS 28,169 HEADACHES W MCC MS 17,823 HEADACHES W/O MCC MS 12,250 HEART FAILURE & SHOCK W CC MS 25,524 HEART FAILURE & SHOCK W MCC MS 34,607 HEART FAILURE & SHOCK W/O CC/MCC MS 16,730 HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC MS 44,498 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC MS 27,320 HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC MS 27,226 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC MS 53,329 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC MS 75,679 HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC MS 46,293 HIV W EXTENSIVE O.R. PROCEDURE W MCC MS 38,246 HIV W MAJOR RELATED CONDITION W MCC MS 37,156 HIV W OR W/O OTHER RELATED CONDITION MS 32,553 HYPERTENSION W MCC MS 25,730 HYPERTENSION W/O MCC MS 18,695 HYPERTENSIVE ENCEPHALOPATHY W CC MS 25,593 HYPERTENSIVE ENCEPHALOPATHY W MCC MS 23,943 HYPERTENSIVE ENCEPHALOPATHY W/O CC/MCC MS 12,475 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC MS 16,658 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC MS 33,168 INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC MS 15,291 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC MS 51,884 INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC MS 131,159 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC MS 25,442 INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC MS 24,232 INFLAMMATORY BOWEL DISEASE W CC MS 18,641 INFLAMMATORY BOWEL DISEASE W MCC MS 22,238

INFLAMMATORY BOWEL DISEASE W/O CC/MCC MS 19,653 INGUINAL & FEMORAL HERNIA PROCEDURES W CC MS 31,813 INGUINAL & FEMORAL HERNIA PROCEDURES W MCC MS 106,900 INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC MS 18,824 INTERSTITIAL LUNG DISEASE W MCC MS 34,773 INTERSTITIAL LUNG DISEASE W/O CC/MCC MS 17,204 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS MS 19,592 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC MS 36,679 INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC MS 18,685 ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA W THROMBOLYTIC A MS 57,468 KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC MS 55,867 KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC MS 33,524 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC MS 32,303 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC MS 31,397 KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC MS 36,369 KIDNEY & URINARY TRACT INFECTIONS W MCC MS 25,733 KIDNEY & URINARY TRACT INFECTIONS W/O MCC MS 18,552 KIDNEY & URINARY TRACT NEOPLASMS W CC MS 26,501 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W MCC MS 17,868 KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC MS 31,417 KNEE PROCEDURES W PDX OF INFECTION W CC MS 50,094 KNEE PROCEDURES W PDX OF INFECTION W MCC MS 75,754 KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC MS 29,667 KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC MS 46,609 KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC MS 35,773 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC MS 35,487 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC MS 56,146 LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC MS 28,801 LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA MS 53,477 LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC MS 64,709 LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC MS 24,999 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC MS 56,238 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC MS 101,145 LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC MS 42,286 LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W MCC MS 100,752 LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC MS 27,099 LYMPHOMA & NON-ACUTE LEUKEMIA W MCC MS 61,914 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W MCC MS 68,143 LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER PROC W/O CC/MCC MS 32,639 LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC MS 50,385 MAJOR BLADDER PROCEDURES W CC MS 52,776 MAJOR BLADDER PROCEDURES W/O CC/MCC MS 54,955 MAJOR CHEST PROCEDURES W CC MS 56,974 MAJOR CHEST PROCEDURES W MCC MS 121,470 MAJOR CHEST PROCEDURES W/O CC/MCC MS 38,747 MAJOR CHEST TRAUMA W CC MS 28,269 MAJOR CHEST TRAUMA W MCC MS 38,862 MAJOR ESOPHAGEAL DISORDERS W CC MS 26,316 MAJOR ESOPHAGEAL DISORDERS W MCC MS 25,838 MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC MS 23,908 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC MS 22,559 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC MS 48,215 MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC MS 13,319

MAJOR HEAD & NECK PROCEDURES W CC/MCC OR MAJOR DEVICE MS 45,371 MAJOR HEAD & NECK PROCEDURES W/O CC/MCC MS 27,427 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC MS 33,934 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC MS 86,371 MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC MS 32,878 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC MS 99,558 MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O M MS 59,520 MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES MS 62,000 MAJOR MALE PELVIC PROCEDURES W CC/MCC MS 40,585 MAJOR MALE PELVIC PROCEDURES W/O CC/MCC MS 38,880 MAJOR SKIN DISORDERS W/O MCC MS 9,610 MAJOR SMALL & LARGE BOWEL PROCEDURES W CC MS 64,681 MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC MS 128,315 MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC MS 39,876 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC MS 19,564 MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC MS 37,937 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC MS 27,543 MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC MS 6,348 MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC MS 23,326 MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC MS 53,197 MALIGNANT BREAST DISORDERS W MCC MS 51,563 MEDICAL BACK PROBLEMS W MCC MS 21,841 MEDICAL BACK PROBLEMS W/O MCC MS 18,945 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC MS 35,571 MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC MS 30,978 MINOR BLADDER PROCEDURES W CC MS 28,197 MINOR BLADDER PROCEDURES W MCC MS 30,004 MINOR SKIN DISORDERS W/O MCC MS 14,364 MINOR SMALL & LARGE BOWEL PROCEDURES W CC MS 33,775 MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC MS 17,494 MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC MS 28,109 MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC MS 16,255 MOUTH PROCEDURES W CC/MCC MS 54,403 MOUTH PROCEDURES W/O CC/MCC MS 39,327 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC MS 44,202 MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC MS 29,951 MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC MS 58,237 NEONATE W OTHER SIGNIFICANT PROBLEMS MS 8,022 NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY MS 6,015 NERVOUS SYSTEM NEOPLASMS W MCC MS 38,568 NERVOUS SYSTEM NEOPLASMS W/O MCC MS 21,609 NEUROLOGICAL EYE DISORDERS MS 16,217 NEUROSES EXCEPT DEPRESSIVE MS 20,481 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC MS 44,967 NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC MS 19,775 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W CC MS 33,465 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W MCC MS 61,954 NON-EXTENSIVE O.R. PROC UNRELATED TO PRINCIPAL DIAGNOSIS W/O CC/MCC MS 19,021 NON-MALIGNANT BREAST DISORDERS W CC/MCC MS 36,631 NON-MALIGNANT BREAST DISORDERS W/O CC/MCC MS 4,134 NONSPECIFIC CEREBROVASCULAR DISORDERS W CC MS 28,829 NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC MS 16,397 NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC MS 39,397

NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC MS 44,529 NONTRAUMATIC STUPOR & COMA W MCC MS 151,148 NONTRAUMATIC STUPOR & COMA W/O MCC MS 21,634 NORMAL NEWBORN MS 5,349 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC MS 81,746 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W MCC MS 73,750 O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC MS 79,581 O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS MS 46,136 ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY MS 66,308 OSTEOMYELITIS W CC MS 21,944 OSTEOMYELITIS W MCC MS 60,161 OSTEOMYELITIS W/O CC/MCC MS 37,231 OTHER ANTEPARTUM DIAGNOSES W MEDICAL COMPLICATIONS MS 16,825 OTHER ANTEPARTUM DIAGNOSES W/O MEDICAL COMPLICATIONS MS 7,698 OTHER CARDIOTHORACIC PROCEDURES W MCC MS 118,358 OTHER CARDIOTHORACIC PROCEDURES W/O MCC MS 134,752 OTHER CIRCULATORY SYSTEM DIAGNOSES W CC MS 23,350 OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC MS 80,748 OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC MS 11,880 OTHER CIRCULATORY SYSTEM O.R. PROCEDURES MS 65,663 OTHER DIGESTIVE SYSTEM DIAGNOSES W CC MS 18,492 OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC MS 52,062 OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC MS 11,694 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC MS 55,865 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC MS 66,946 OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC MS 19,701 OTHER DISORDERS OF NERVOUS SYSTEM W CC MS 33,904 OTHER DISORDERS OF NERVOUS SYSTEM W MCC MS 32,552 OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC MS 16,069 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC MS 13,613 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC MS 19,018 OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC MS 13,295 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W CC/MCC MS 32,301 OTHER EAR, NOSE, MOUTH & THROAT O.R. PROCEDURES W/O CC/MCC MS 29,684 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC MS 51,705 OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC MS 72,969 OTHER FACTORS INFLUENCING HEALTH STATUS MS 17,912 OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC MS 84,306 OTHER HEART ASSIST SYSTEM IMPLANT MS 387,058 OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC MS 89,207 OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W MCC MS 84,215 OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC MS 12,189 OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC MS 23,071 OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC MS 43,091 OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC MS 19,584 OTHER KIDNEY & URINARY TRACT PROCEDURES W CC MS 47,384 OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC MS 73,894 OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC MS 82,286 OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC MS 147,841 OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC MS 60,014 OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC MS 17,395 OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC MS 39,133 OTHER MULTIPLE SIGNIFICANT TRAUMA W CC MS 19,773

OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC MS 28,989 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC MS 53,844 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC MS 118,512 OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC MS 40,697 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC MS 32,372 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC MS 42,521 OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC MS 16,056 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC MS 21,272 OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC MS 37,948 OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W CC MS 39,810 OTHER O.R. PROCEDURES FOR INJURIES W CC MS 54,674 OTHER O.R. PROCEDURES FOR INJURIES W MCC MS 159,463 OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC MS 50,894 OTHER RESP SYSTEM O.R. PROCEDURES W CC MS 44,728 OTHER RESP SYSTEM O.R. PROCEDURES W MCC MS 86,583 OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC MS 39,344 OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC MS 18,260 OTHER SKIN, SUBCUT TISS & BREAST PROC W CC MS 39,682 OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC MS 70,431 OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC MS 36,711 OTHER VASCULAR PROCEDURES W CC MS 64,766 OTHER VASCULAR PROCEDURES W MCC MS 72,803 OTHER VASCULAR PROCEDURES W/O CC/MCC MS 52,959 OTITIS MEDIA & URI W MCC MS 15,833 OTITIS MEDIA & URI W/O MCC MS 14,235 PANCREAS, LIVER & SHUNT PROCEDURES W CC MS 66,791 PANCREAS, LIVER & SHUNT PROCEDURES W MCC MS 208,735 PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC MS 128,193 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC MS 27,670 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC MS 58,453 PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC MS 11,820 PERC CARDIOVASC PROC W DRUG-ELUTING STENT W/O MCC MS 113,044 PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC MS 80,409 PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC MS 78,745 PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTER MS 155,144 PERCUTANEOUS CARDIOVASCULAR PROCEDURES W NON-DRUG-ELUTING STENT W MCC OR 4+ A MS 111,564 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM MS 62,663 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC MS 62,253 PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC MS 34,718 PERIPHERAL VASCULAR DISORDERS W CC MS 19,087 PERIPHERAL VASCULAR DISORDERS W MCC MS 26,436 PERIPHERAL VASCULAR DISORDERS W/O CC/MCC MS 21,958 PERITONEAL ADHESIOLYSIS W CC MS 41,480 PERITONEAL ADHESIOLYSIS W MCC MS 67,559 PERITONEAL ADHESIOLYSIS W/O CC/MCC MS 38,377 PERMANENT CARDIAC PACEMAKER IMPLANT W CC MS 104,297 PERMANENT CARDIAC PACEMAKER IMPLANT W MCC MS 114,521 PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC MS 84,997 PLEURAL EFFUSION W CC MS 17,016 PLEURAL EFFUSION W MCC MS 31,490 PLEURAL EFFUSION W/O CC/MCC MS 13,468 PNEUMOTHORAX W CC MS 17,989 PNEUMOTHORAX W MCC MS 34,450

PNEUMOTHORAX W/O CC/MCC MS 18,499 POISONING & TOXIC EFFECTS OF DRUGS W MCC MS 48,977 POISONING & TOXIC EFFECTS OF DRUGS W/O MCC MS 20,374 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC MS 34,237 POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC MS 18,345 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC MS 36,509 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC MS 43,088 POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC MS 23,322 POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE MS 49,460 POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE MS 8,670 PREMATURITY W MAJOR PROBLEMS MS 9,842 PREMATURITY W/O MAJOR PROBLEMS MS 7,101 PSYCHOSES MS 28,461 PULMONARY EDEMA & RESPIRATORY FAILURE MS 29,419 PULMONARY EMBOLISM W MCC MS 35,967 PULMONARY EMBOLISM W/O MCC MS 17,160 RECTAL RESECTION W CC MS 53,312 RECTAL RESECTION W MCC MS 101,524 RECTAL RESECTION W/O CC/MCC MS 44,938 RED BLOOD CELL DISORDERS W MCC MS 29,136 RED BLOOD CELL DISORDERS W/O MCC MS 23,920 RENAL FAILURE W CC MS 22,905 RENAL FAILURE W MCC MS 36,438 RENAL FAILURE W/O CC/MCC MS 14,796 RESPIRATORY INFECTIONS & INFLAMMATIONS W CC MS 32,429 RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC MS 45,926 RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC MS 19,316 RESPIRATORY NEOPLASMS W CC MS 22,469 RESPIRATORY NEOPLASMS W MCC MS 41,041 RESPIRATORY SIGNS & SYMPTOMS MS 25,717 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS MS 77,598 RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS MS 186,994 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC MS 11,678 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MCC MS 16,284 RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC MS 23,237 REVISION OF HIP OR KNEE REPLACEMENT W CC MS 105,285 REVISION OF HIP OR KNEE REPLACEMENT W MCC MS 75,849 REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC MS 83,470 SALIVARY GLAND PROCEDURES MS 20,592 SEIZURES W MCC MS 33,890 SEIZURES W/O MCC MS 15,383 SEPTIC ARTHRITIS W CC MS 43,581 SEPTIC ARTHRITIS W MCC MS 18,903 SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS MS 179,392 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC MS 44,346 SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC MS 23,948 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC MS 56,916 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC MS 52,505 SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC MS 28,070 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC MS 27,798 SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC MS 20,293 SIGNS & SYMPTOMS W MCC MS 56,541 SIGNS & SYMPTOMS W/O MCC MS 17,925

SIMPLE PNEUMONIA & PLEURISY W CC MS 24,191 SIMPLE PNEUMONIA & PLEURISY W MCC MS 34,210 SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC MS 16,351 SKIN DEBRIDEMENT W CC MS 33,583 SKIN DEBRIDEMENT W MCC MS 52,349 SKIN DEBRIDEMENT W/O CC/MCC MS 17,758 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC MS 36,297 SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC MS 94,881 SKIN GRAFTS FOR INJURIES W CC/MCC MS 55,421 SKIN ULCERS W CC MS 38,831 SKIN ULCERS W MCC MS 47,180 SOFT TISSUE PROCEDURES W CC MS 38,594 SOFT TISSUE PROCEDURES W MCC MS 61,033 SOFT TISSUE PROCEDURES W/O CC/MCC MS 30,677 SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC MS 111,369 SPINAL FUSION EXCEPT CERVICAL W MCC MS 136,769 SPINAL FUSION EXCEPT CERVICAL W/O MCC MS 77,115 SPINAL PROCEDURES W MCC MS 41,555 SPLENECTOMY W/O CC/MCC MS 21,900 STOMACH, ESOPHAGEAL & DUODENAL PROC W CC MS 52,669 STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC MS 144,447 STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC MS 35,025 SYNCOPE & COLLAPSE MS 19,697 TENDONITIS, MYOSITIS & BURSITIS W MCC MS 28,751 TENDONITIS, MYOSITIS & BURSITIS W/O MCC MS 22,191 THREATENED ABORTION MS 5,523 THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W CC MS 36,794 THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W/O CC/MCC MS 30,455 TRACH W MV >96 HRS OR PDX EXC FACE, MOUTH & NECK W/O MAJ O.R. MS 220,066 TRACHEOSTOMY FOR FACE,MOUTH & NECK DIAGNOSES W MCC MS 78,320 TRANSIENT ISCHEMIA W/O THROMBOLYTIC MS 16,457 TRANSURETHRAL PROCEDURES W CC MS 34,750 TRANSURETHRAL PROCEDURES W MCC MS 74,054 TRANSURETHRAL PROCEDURES W/O CC/MCC MS 33,930 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC MS 36,342 TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC MS 24,045 TRAUMATIC INJURY W/O MCC MS 13,650 TRAUMATIC STUPOR & COMA, COMA <1 HR W CC MS 29,572 TRAUMATIC STUPOR & COMA, COMA >1 HR W CC MS 4,525 UNCOMPLICATED PEPTIC ULCER W MCC MS 24,089 UNCOMPLICATED PEPTIC ULCER W/O MCC MS 33,342 UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC MS 44,779 URETHRAL STRICTURE MS 32,975 URINARY STONES W/O ESW LITHOTRIPSY W MCC MS 23,287 URINARY STONES W/O ESW LITHOTRIPSY W/O MCC MS 20,913 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC MS 69,766 UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC MS 30,755 VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC MS 23,882 VAGINAL DELIVERY W COMPLICATING DIAGNOSES MS 15,861 VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C MS 21,590 VAGINAL DELIVERY W STERILIZATION &/OR D&C MS 20,716 VAGINAL DELIVERY W/O COMPLICATING DIAGNOSES MS 12,555 VIRAL ILLNESS W MCC MS 33,958

VIRAL ILLNESS W/O MCC MS 19,260 VIRAL MENINGITIS W CC/MCC MS 43,447 VIRAL MENINGITIS W/O CC/MCC MS 18,553 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC MS 59,008 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC MS 90,512 WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC MS 71,916 WOUND DEBRIDEMENTS FOR INJURIES W CC MS 70,746