Billing Information- Please understand that the prices included in our list of charges are not what your insurance will pay and not reflective of what your actual financial responsibility will be. The amount collected may be less than the amount listed based on our contractual agreements with payers such as Medicare, Medicaid, commercial insurance companies and eligibility for our financial assistance program.

SERVICE CHARGE CODE SERVICE DESCRIPTION PRICE1 111 AIRSPLINT FULL 107.50 112 AIRSPLINT 1/2 L 77.05 121 ARM SLING CRADLE XL 22.20 123 ARM SLING POUCH XL 19.65 124 ARM SLING MED 19.65 125 ARM SLING LG 19.65 128 WRIST & FOREARM SM L 30.40 145 ELASTIC WRIST P 39.90 152 CAST BOOT EX SMALL 59.00 160 FLEX CUFF ELBOW ORTH 304.15 162 FOOT ORTHO WEDGE 92.40 163 TIB FIB SM CHILD 128.90 310 PRIVATE ROOM 770.00 311 SEMI PRIVATE 770.00 400 BREAST BIOPSY 622.15 412 EKG 90.60 413 EKG SCREENING FOR MC 90.60 430 PREMARIN 0.3 TAB 12.10 439 SPEECH TX INDIVIDUAL 162.65 440 SPEECH TX GROUP 66.70 441 TX SWALLOW DYSFUNCTI 186.50 582 PREDNISONE TAB 5MG 1.95 790 CHOLECYSTECTOMY CRNA 1,174.95 810 COLONOSCOPY CRNA 691.00 840 APPENDECTOMY CRNA 1,036.85 50140 IV BL SET NEEDLELESS 12.95 58661 LAP OVARIAN ECT 6,800.30 60745 SI LOC PELVIC SUPPOR 105.80 100049 SENSOR DISP BED 65.70 103184 NOVASOURCE RENAL FOR 12.20 150006 PULSE OXI 1 PER DAY 18.55 150010 OBSERVATION ROOM 1HR 32.00 150128 COUDE INSERTED 370.85 150129 VAGINAL DELIVERY 4,440.00 150130 DELIVERY OF PLACENTA 4,424.95 150131 LUMBAR PUNCTURE 1,075.15 150135 GASTRIC INTUBATION 554.60 150137 I&D PERINEAL ABSCESS 585.20 150138 I&D BARTHOLINS GLAND 403.70 150139 TEMP TRANSCUTANEOUS 1,021.25 150140 CARDIOVERSION EXTERN 1,021.35 150141 THROMBOLYSIS COR IV 914.45 150142 VENTILATOR INITIAL D 899.55 150143 EPISIOTOMY 4,429.90 150145 DENTAL BLOCK 551.40 150146 REGIONAL NERVE BLOCK 1,355.75 150147 DIGITAL NERVE BLOCK 1,076.20 150148 REMOVAL FB EMBEDDED 555.55 150149 REMOVAL FB CORNEA 558.65 150150 BLOOD GLUCOSE 10.25 150191 THROMBOLYSIS CVA 820.45 150200 LACERATION REPAIR 406.10 150201 REMOVAL FB SUBCUTANE 617.95 150202 SHAVING OF LES 0.6-1 397.85 150203 EXC BENIGN LES 1.1-2 1,143.90 150204 I&D BREAST 2,623.85 150205 WOUND EXPLOR CHEST 3,029.50 150206 APPLY SHORT ARM SPLI 291.75 150207 APPL SPLNT SHORT ARM 169.40 150208 APPLY FINGER SPLINT 176.95 150209 APPLICAT FINGER SPLI 169.40 150210 APPLY SHORT LEG SPLI 331.95 150211 TRACH TUBE CHANGE 467.30 150212 NASOTRACH CATH ASPIR 429.85 150213 BLOOD TRANSFUSION 752.25 150214 SIMPLE LAC 402.80 150215 CATHETERIZATION SIMP 271.30 150216 REMOVAL IMPACT CERUM 171.20 150217 REMOVAL IMPACT CERUM 101.30 150218 REMOVAL FB EAR 291.90 150219 DEBRIDE SKIN & TISSU 590.15 150220 IV ADM INITIAL 476.85 150221 ANTIBIOTIC INJECTION 183.75 150222 D T INJ < 7YR 74.35 150223 D T INJ > 7 YR 112.90 150224 PULSE OXI CONTIN >6H 182.80 150225 PULSE OXI MULTI/EXER 72.30 150226 T T INJ 167.00 150227 IV HYDRATION 5 38.45 150471 MODERATE SED ADD 30 30.95 150472 MOD SED OTHER PHY <5 288.70 150473 MOD SED OTHER PHY >5 237.30 150474 NEWBORN RESUSCITATIO 1,021.35 150500 I&D VULVA/PERINEUM 691.00 160001 FLU SHOT ADMINISTRAT 11.15 160003 H1N1 VAC ADMISTRATIO 12.40 161405 EMPTY VAC BOTTLES 38.25 200042 SURG ROOM BASE AMT 2,705.70 200043 CATARACT CRNA 256.90 200115 SURG PROC TREAT ROOM 198.65 200116 EXC MAL LESION 2.1-3 1,216.10 200117 SURGICAL PROCEDURE 155.05 200118 US GUIDE THYROID BX 247.85 200119 US GUIDE BREAST BX 1 3,554.20 200120 US GUIDE BREAST BX 2 1,772.65 200131 ESOPHAGOSCOPY 817.40 200166 CYSTOSCOPY 899.85 200204 RECOVERY RM 30MIN 288.40 200205 RECTAL DILATION 3,369.75 200206 RECTAL DILATION CRNA 321.30 200239 SURG ROOM ADD 15 MIN 676.40 200500 ENSURE CHOCOLATE 4.80 200502 1698-G ETHILON SUTUR 16.30 220000 RECOVERY RM EA ADD15 74.00 230331 TENDON EXTENS TOE 2,989.35 230335 I&D ULCERS LOWER EXT 2,942.05 230336 I & D DEEP ABCESS 3,090.85 230337 I & D DEEP ABCESS CR 218.55 260001 LOCAL ANESTHESIA 164.85 260002 ANES/EXTREME AGE CRN 76.25 260003 ANES/EMERGENCY CRNA 153.35 260004 ANES CRNA 15 MIN 76.25 260005 P3 PHYSICAL STA CRNA 76.25 260006 P4 PHYSICAL STA CRNA 153.35 260007 P5 PHYSICAL STA CRNA 229.60 260008 EXCIS BREA MASS CRNA 229.60 260009 DEBRIDEMENT KNEE 231.85 260010 OOPHORECTOMY CRNA 459.75 260012 ANES MAT ADD 15 MIN 63.35 260013 TONSILECTOMY CRNA 459.75 260014 COLONOSCOPY SCR CRNA 383.20 260015 EGD CRNA 383.20 260016 APPENDECTOMY CRNA 459.75 260017 TUBAL CRNA 459.75 260018 AXILLARY CRNA 229.60 260019 UMBILICAL HERN CRNA 306.10 260020 GANGLION CYST CRNA 229.60 260021 PEG CRNA 383.20 260022 TAH CRNA 459.75 260023 GALL BLADDER CRNA 536.55 260024 HEMORRHOIDECTOM CRNA 383.20 260025 COLECTOMY CRNA 459.75 260026 INGUINAL HERNIA CRNA 306.10 260027 BMT CRNA 383.20 260028 CYSTOCELE CRNA 229.60 260029 ANES MATERIAL BASE C 402.30 260030 TONSILECTOMY 2,419.85 260031 OMENTUMECTOMY 2,849.20 260032 MASTECTOMY CRNA 383.20 260033 APPENDECTOMY 3,295.50 260034 TUBAL 2,369.95 260035 AXILLARY 845.80 260036 UMBILICAL HERNIA 2,914.75 260037 SPINAL ANES TRAY 139.00 260038 GANGLION CYST 1,471.05 260039 PEG 929.05 260040 HEMORRHOIDS 2,297.70 260041 INGUINAL HERNIA 5,143.80 260042 BMT 1,561.95 260043 CYSTOCELE 2,272.65 260044 INTEGUMENT I/D CRNA 229.60 260045 BIER BLOCK 383.20 260046 EXCISION BREAST MASS 1,607.50 260047 LAP CHOLECYSTECTOMY 5,432.80 260048 VENTRAL HERNIA 4,556.10 260049 PROCTOPLASTY 2,297.70 260050 FISTULECTOMY 2,297.70 260051 TAH 10,814.70 260052 COLECTOMY 12,066.00 260053 OOPHORECTOMY 1,047.50 260054 VENTRAL HERNIA CRNA 459.75 260055 OMENTUMECTOMY CRNA 536.55 260056 MASTECTOMY 3,066.45 260057 PROCTOPLASTY CRNA 383.20 260058 D & C CRNA 229.60 260059 THYROIDECTOMY CRNA 459.75 260060 INTUBATION EMER CRNA 459.75 260061 TIB FIB ADULT K 191.05 260062 DIAG SPINAL CRNA 383.20 260063 CIRCUMCISION CRNA 229.60 260064 EXPLORATORY LAP CRNA 459.75 260065 EXP LAP ENTEROADHES 3,995.25 260066 LAP CYSTECTOMY 3,995.25 260067 FISTULECTOMY CRNA 383.20 260068 PILONIDAL CYSTECTOMY 1,161.80 260069 PILONIDAL CYST CRNA 383.20 260070 EXCISION CYST CHEST 1,002.25 260071 EXC CYST CHEST CRNA 459.75 260072 HYDROCELECTOMY CRNA 229.60 260073 HYDROCELECTOMY 1,744.80 260074 EXCIS ABD MASS CRNA 229.60 260075 VEIN STRIPPING CRNA 229.60 260076 VEIN STRIPPING 1,930.80 260077 EXC ELBOW BURSA 1,556.60 260078 EXC ELBOW BURSA CRNA 229.60 260079 BRONCHOSCOPY CRNA 459.75 260080 AMP BELOW KNEE EXT CRNA 306.10 260081 EXC ABD WALL MASS 1,105.50 260082 FEMORAL HERNIA 3,086.40 260083 FEMORAL HERNIA CRNA 306.10 260084 EXC NECK MASS 414.70 260085 EXC NECK MASS CRNA 383.20 260086 REMOVAL NEUROMA 414.70 260087 REMOVAL NEUROMA CRNA 383.20 260088 AMP BELOW KNEE EXT 5,792.40 260089 EXC NECK MASS NERVE 1,503.95 260090 CONIZATION OF CERVIX 2,078.80 260091 D & C 2,692.45 260092 VASECTOMY 2,473.30 260093 VASECTOMY CRNA 229.60 260094 REMOVAL FB FINGER 1,532.05 260095 REMOVAL FB FINGER CR 229.60 260096 EXC LESION EYELID 760.25 260097 EXC MALIG LES 1.1-2 553.20 260098 SKIN GRAFT 1,507.00 260099 EXC MAL LESION > 4CM 1,822.80 260100 EXC BASAL CELL TEMPL 553.45 260101 EXC BASAL CELL TEMPL CRNA 383.20 260102 REVISION OF AMP FING 1,531.80 260103 ANES OPEN FINGER HAN 229.60 260104 EXP FINGER W EXCISIO 884.65 260105 SIGMOID RESECT COLOS 14,737.95 260106 EXC TONSIL CYST CRNA 459.75 260107 REPAIR SIGMOID DIV C 383.20 260108 EXC TONSIL CYST 974.70 260109 REPAIR SIGMOID DIVER 14,737.95 260110 REPAIR SIGMOID CRNA 383.20 260111 HEMICOLECTOMY W ILEO 14,737.95 260112 COLOSTOMY CRNA 459.75 260113 FLEX SIGMOIDOSCOPY C 383.20 260114 EXCISION THIGH CYST 1,548.95 260115 EXC CYST THIGH CRNA 229.60 260116 EXPLORATION TOE MASS 553.20 260117 EXC BENIGN LESION>4. 1,936.40 260118 EXC LESION BACK CRNA 229.60 260119 EXC THYROID NODULE 4,796.40 260120 EXC THYROID NODULE C 459.75 260121 REMOVAL NAIL 691.00 260122 LAP W COLON REANASTM 14,737.95 260123 PORT A CATH INSERTIO 2,070.65 260124 REVISION OF STUMP 2,595.15 260125 REVISION OF STUMP CR 306.10 260126 LAP W COLON REANAS C 459.75 260127 SYNOVECTOMY 1,915.00 260128 SYNOVECTOMY CRNA 229.60 260129 EXC BENIGN LES 1.1-2 691.00 260130 BIOPSY/EXC OF LYMPH 2,543.95 260131 BIOPSY/EXC LYMPH CRN 459.75 260132 EXC LESION 1.1-2 CRN 383.20 260133 LAPROSCOPY 4,244.25 260134 REMOVAL PORT A CATH 1,027.00 260135 FULL THICKNESS GRAFT 2,575.15 260136 EXC MALIG LES 3.1-4 1,382.65 260137 AMP ABOVE KNEE CRNA 383.20 260138 AMP ABOVE KNEE 5,792.40 260139 EXC BENIGN LES 2.1-3 691.00 260140 EXC BENIGN LES 3.1-4 1,382.65 260141 EXC THIGH MASS CRNA 229.60 260142 LAYER CLOSURE 2.5/< 1,382.65 260143 EXC MAL LES 1.1-2 CM 373.65 260144 ENTEROLYSIS 7,332.40 260145 EXC LESION LEG 229.60 260146 COLORRHAPHY W/O COLO 14,737.95 260147 EXC TUMOR SFT TIS BA 2,278.60 260148 UPPER POSTER ABD CRN 383.20 260149 DEBRIDE SKIN & SUB T 222.85 260150 DEBRIDE SKIN TIS MUS 222.85 260151 DEBRIDEMENT CRNA 229.60 260152 EXC BENIG LES 2.1-3 459.75 260153 EXC LES PENILE/PERIA 1,585.85 260154 EXC LES PEN/PERI 229.60 260155 EXC LESION SHOULDER 229.60 260156 PHARYNGOSTOMY SEC SU 4,358.80 260157 PHARYNGOSTOMY CRNA 459.75 260158 AMP TOE 2,989.35 260159 AMP TOE CRNA 229.60 260160 EXC MAL LESION 0.6-1 1,216.10 260161 EXC BASAL CELL EYEBR 2,575.15 260162 EXC BGN LES FACE 1.1 1,216.10 260163 EXC CYST CHEST WALL 2,853.70 260164 REPAIR AMPUTA FINGER 1,231.00 260165 ESOPHAGOSCOPY W BIOP 1,253.75 260166 I&D ABCESS CRNA 229.60 260167 ANT/POST COLPORRHAPH 4,013.85 260168 FRENOTOMY 2,444.05 260169 EXC SYNOVIAL CYST FI 2,397.60 260170 REMOVAL FB FOOT SUBC 302.95 260171 REMOVAL FB FOOT CRNA 229.60 260172 COLECTOMY W ANASTOMO 15,397.75 260173 ADDITIONAL RESECTION 10,998.20 260174 APPENDECTOMY ADDITIO 7,332.40 260175 CECOSTOMY 14,737.95 260176 CECOSTOMY CRNA 459.75 260177 FRENECTOMY 981.70 260178 FRENECTOMY CRNA 459.75 260179 EXC CHEST WALL TUMOR 2,357.05 260180 EXC CHEST WALL TUM C 459.75 260182 LAP SALPINGOOPHERECT CRNA 459.75 260183 EXC POST LEG TUMOR 2,357.05 260184 LAP SALPINGOOPHERECT 6,800.30 260185 EVAC BUTTOCK HEMATOM 3,146.95 260186 C-1 INHIBITOR BY EIA 118.70 260187 PINWORM EXAM 53.40 260188 EXC BNGN LES <.5 FAC 637.60 260189 TOPAMAX 716285 101.30 260190 SENSITIVITIES MANUAL 66.35 260191 AMP METATARSAL 2,989.35 260192 AMP METATARSAL CRNA 229.60 260193 ARTHROTOMY METATARSO 2,989.35 260194 ARTHROTOMY METATAR C 229.60 260195 THYROID LOBECT/CONTR 6,108.65 260196 THYROID LOBECT/CONTC 459.75 260197 SIGMOID REMOVE TUMOR 1,186.85 260198 EXC BEN LES TRUNK >4 2,357.05 260199 EXC B LES TRUNK >4 C 229.60 260200 DEBRID SKIN TIS MU C 229.60 260202 COLECTOMY W CECOST C 459.75 260203 DERMABOND REPAIR LAC 114.80 260204 EVAC BUTTOCK HEMAT C 459.75 260205 EXC LIPOMA PARALUMBA 159.25 260206 EXC LIPOMA ADD'L 127.20 260207 REMOVAL FB FOOT DEEP 2,357.05 260208 REMOV FB FOOT DEEP C 229.60 260209 GANGLION CYST FOOT C 229.60 260210 LAP APPENDECTOMY 5,153.10 260211 EXC BONY FRAG TOE 2,989.35 260212 I&D TOE 256.60 260213 I&D TOE CRNA 383.20 260214 EXC BONY FRAG TOE CR 306.10 260215 REMOVAL FB HAND 302.95 260216 REMOVAL FB FOREARM 2,517.45 260217 BIOPSY TEMPORAL ARTE 2,356.80 260218 EXP LAPROTOMY COLOST 7,332.40 260219 EVAC HEMATOMA LOW EX 1,695.05 260220 OVARIAN CYSTECTOMY 6,800.30 260221 CYSTECTOMY CRNA 459.75 260222 EXC SHOULDER MAS SUB 256.60 260223 EXC SHOULDER MASS 459.75 260224 BARTHOLIN CYST 3,048.45 260225 THYROID LOBECTOMY 4,796.40 260226 BARTHOLIN CYST CRNA 229.60 260227 EXC TUMOR SHOULDER 2,357.05 260228 EXC MAL LES FACE <.5 1,216.10 260229 EXC SUBMANDIBULAR MA 2,444.05 260230 EXC SUBMABDIBULAR MA 383.20 260231 EXC BASAL CELL NASAL 383.20 260232 EXC ULCERS FOOT 1,231.00 260233 ANES OPEN PROC FOOT 229.60 260234 DEBRIDEMENT CHRON WO 3,146.95 260235 SUTURE SM INTESTINE 14,737.95 260236 SUTURE LG INTESTINE 14,737.95 260237 APPENDECTOMY RUPTURE 11,438.55 260238 EXC BASAL CELL LIP 3,402.65 260239 CONIZATION CERVIX CRNA 229.60 260240 EXC EAR HEMANGIOMA 2,121.60 260241 EXC EAR HEMANGIOMA CRNA 383.20 260242 EXC BEGNIG LES 0.6-1 557.10 260243 REPAIR ANEURYSM TEMP 5,837.15 260244 EXP WOUND ABDOMEN 2,562.75 260245 EXP WOUND ABD CRNA 1,115.95 260246 PROCTECTOMY CRNA 52.00 260247 PROCTECTOMY 7,830.70 260248 INCISIONAL HERNIA CRNA 44.70 260249 INCISIONAL HERNIA 4,224.85 260250 MESH IMPLANT 4,570.10 260251 TARSAL TUNNEL RELEAS 2,541.65 260252 TARSAL TUNNEL CRNA 223.10 260253 PELVIC SEROMA DRAINA 1,821.35 260254 PELVIC SEROMA DRAINA CRNA 223.10 260255 EXC PLANTAR MASS FOO 1,087.50 260256 EXC PLANTAR MASS FOO 371.95 260257 LIVER BIOPSY 7,546.00 260258 LIVER BIOPSY CRNA 520.80 260259 COLONOSCOPY RECT SIG 1,415.25 260260 CHOLECYSTECTOMY COMP 10,677.95 260261 ESOPHAGOSCOP W POLYP 1,360.70 260262 EGD W CAUTERIZATION 1,190.80 260265 TRANSFER SKIN PEDICL 2,440.90 260266 HEMICOLECTOMY CRNA 520.80 260267 GASTRODUODENOTOMY 15,661.15 260268 PORT-A-CATH INSERT C 297.35 260269 FISSURECTOMY 3,785.65 260270 GASTRODUODENOTOMY CR 520.80 260271 TONSIL SECONDARY SUR 4,358.80 260272 ORCHIECTOMY 3,184.90 260273 ORCHIDECTOMY CRNA 223.10 260274 EXP LAP EXP CELIOTOM 12,813.65 260275 EVAC HEMATOMA CRNA 223.10 260276 EXC LIPOMA LEG 1,936.40 260277 EXC LIPOMA LEG CRNA 223.10 260278 EXP LAP STRICTUROPLA 13,098.40 260279 EXC LABIAL CYST CRNA 371.95 260280 MARSHALL MARCHETTI K 4,983.15 260281 MARSHALL MARCHETTI K CRNA 446.25 260282 COLONOSCOPY W BIOPSY 1,379.00 260283 EXC MASS FINGER CRNA 223.10 260284 I&D ABD WALL ABSCESS 471.60 260285 I&D ABD ABSCESS CRNA 297.35 260286 EXC DESTRUCT WARTS 108.30 260287 EXC PELVIC WARTS CRN 223.10 260288 COLONOSCOPY HOT FRCP 1,532.05 260289 COLONOSCOPY SNARE 1,532.05 260290 POST CIRCUMCISION BL 676.40 260291 EVAC HEMATOMA ABD 1,695.05 260292 LAP VENTRAL HERNIA 5,552.65 260293 BOWEL RESECTION PART CRNA 520.80 260294 STRANGULATED FEMORAL 4,466.00 260295 BOWEL RESECTION PART 10,677.95 260296 EXC CLAVICLE MASS CRNA 371.95 260297 EXC SQ CELL NECK >4 2,738.65 260298 EXC LES LIP <0.5CM 650.30 260299 DEBR SKIN PARTIAL CR 371.95 260300 D&C CERVICAL POLYP 2,692.45 260301 I&D SUPRALEVATOR ABC 2,085.30 260302 GASTROJEJUNOSOTMY 15,661.15 260303 GASTROJEJUNOSOTMY CR 520.80 260304 I&D & REMOVAL FB 2,942.05 260305 PERIANAL MASS BX CRN 371.95 260306 COLOSTOMY 14,737.95 260307 REPAIR AMP FINGER CR 212.70 260308 I&D SUPRALEVATOR ABC 371.95 260309 SURGICAL PREP/GRAFT 669.10 260310 COLECTOMY PART W/END 15,397.75 260311 COLECTOMY HARTMANN P 520.80 260312 EVAC HEMATOMA BREAST 1,695.05 260320 EXC ANAL TUMOR 3,715.55 260321 EXC ANAL TUMOR CRNA 371.95 260322 BURSECTOMY 3,743.75 260323 BURSECTOMY CRNA 223.10 260324 EXC LES >4 CM ARM 223.10 260325 EXC LESION TONGUE CR 459.75 260330 DEBRIDE SKIN MUS BON 609.15 260331 EXC SUPRACLAVIC MASS 3,144.65 260332 REPAIR NAIL AVULSION 182.05 260333 ANES TENDON FOOT 229.60 260334 ANES EXTREMITY PROC 229.60 260335 EXC MELANOMA UPP EXT 229.60 260336 EXC SUPRACLAV MASS C 446.25 260337 DEBRIDE INFECTED SKI 194.70 260338 EXC LESION FOOT 3,660.65 260339 EXC LESION FOOT CRNA 223.10 260340 INGUINAL EXPLORATION 4,130.35 260341 INGUINAL EXPLOR CRNA 520.80 260342 CLOSURE OF ENTEROSTO 12,101.70 260343 CLOSURE OF ENTEROSTO CRNA 446.25 260344 EXC SHOULDER MAS DEE 3,422.30 260345 EXC NASAL NODULE 725.35 260346 EXC NASAL NODULE CRN 354.20 260347 EXC FOOT MASS 3,486.25 260348 EXC BENIGN LES HAND 354.20 260349 REPAIR TONGUE LAC 1,416.70 260350 REPAIR TONGUE LAC CRNA 354.20 260351 EXC BASAL CELL CHEST 212.70 260352 REMOVE FB FOREARM 212.70 260353 EXC MASS UPPER EXT 212.70 260354 EXC VAGINAL MASS 1,585.85 260355 EXC VAGINAL MASS CRN 202.55 260356 EXC LESION CHEEK CRN 337.35 260360 EXP UPPER EXT MASS 3,630.30 260361 EXP UPPER EXT MASS C 212.70 260362 I&D ABCESS LIP 443.70 260363 I&D ABCESS LIP CRNA 354.20 260364 REMOVE FB LEG 763.65 260365 REMOVE FB LEG CRNA 212.70 260366 EXC MASS HAND 2,822.50 260367 EXC LES EXTERNAL EAR 2,121.60 260368 EXC LES EXTERNAL EAR 337.35 260369 CHEST WALL BIOPSY 3,351.15 260370 CHEST WALL BX CRNA 337.35 260371 EXC NEVUS TOE 1,420.60 260372 BX INGUINAL MASS 226.25 260373 EXC LES LOWER EXT 337.35 260374 WOUND EXP CHEST 1,180.30 260375 I & D REMOVE FB ARM 229.60 260376 REMOVE FB SUBCUT NEC 619.55 260377 REMOVE FB SUB NECK C 202.55 260378 LAPAROSCOPY BILOMA CRNA 404.65 260379 LAPAROSCOPY BILOMA 5,534.95 260380 EXC BUTTOCK SUB MASS 192.75 260381 SPLEENECTOMY 10,814.70 260382 SPLEENECTOMY CRNA 449.90 260383 PERIRECTAL ABSCESS CRNA 321.30 260384 PERIRECTAL ABSCESS 4,460.10 260385 EXC LESION EYELID 385.45 260386 BIOPSY MUSCLE DEEP 30,137.75 260387 BIOPSY MUSCLE DEEP C 298.55 260390 SCROTAL EXPLORATION 4,021.40 260391 SCROTAL EXPLOR CRNA 184.50 260395 ANORECTAL PROCEDURE 298.55 260400 PROCTOSCOPY 1,140.40 260401 LAP SALPINGECTOMY 9,224.10 260402 LAP SALPINGECTOMY CR 385.45 260403 DRAIN FINGER ABSCESS 522.05 260404 I&D HEMATOMA, SEROMA 435.05 260410 EXC CYST FINGER 1,471.05 260420 SURGICAL PREP/GRAFT CRNA 173.85 260425 EXC TUMOR SFT TIS AB 4,550.10 260426 EXC TUMOR ABD WALL 289.80 260427 EXC TUMOR SFT TISS F 3,090.85 260500 WOUND EXPLOR EXTREMI 2,316.05 260600 PECTINOTOMY 4,770.25 260601 PECTINOTOMY CRNA 257.50 261000 I&D HEMATOMA BREAST 3,124.10 261300 SPINAL TAP CRNA 231.85 270000 1 U PRONE CRNA 371.95 270001 3 U VASECTOMY CRNA 223.10 270002 5 U BIER BLOCK 371.95 270003 5 U AKA 297.35 270005 MASTECTOMY SIMPLE 223.10 270006 LOWER LEG VEIN LIGME 223.10 270007 UPPER LEG VEIN LIGME 223.10 270008 ADJACENT TISSUE TRAN 4,356.25 270009 EXC SCROTAL MASS 5,681.35 270010 EXC SCROTAL MASS CRN 168.80 270040 BX SUPRACLAVICULAR N 698.50 270041 BX SUPRACLAVICULAR N CRNA 159.15 270049 EXC TUMOR THIGH/KNEE 5,699.45 270099 EGD & COLONSCOPY CRN 434.25 270100 CONDYLOMA 4,085.15 270101 CONDYLOMA CRNA 273.15 270103 LARYNGOSCOPY CRNA 327.80 270260 ILESTOMY 8,993.15 270261 ILESTOMY CRNA 218.55 270304 I&D APPEND ABSCESS C 309.00 270305 I&D APPENDIX ABSCESS 3,016.45 270450 DEBRIDE BURN <4% BOD 257.50 270451 DRESS/DEBRIDE PARTIA 435.05 290281 DRAINAGE OF LYMPH NO 3,151.40 290282 EXC MASS FINGER 2,397.60 290283 I & D SCROTAL SPACE 3,493.15 290291 EXC LESION SCALP 371.95 290292 EGD BARRETT'S ESOPHA 6,708.85 290294 EXC CLAVICLE MASS 3,142.35 290295 EXC BREAST CYST 7,024.20 290300 COLONOSCOPY DX CRNA 383.20 300012 SINUSES < 3 VIEW 117.55 300013 PROCAINAMIDE PRONEST 95.65 300020 CHEST 2 VIEW 111.95 300034 FISTULA/SINUS TRACT 167.70 300038 24 HR UA CATECHOLAMI 135.05 300039 24 HR UA DESOXYCORTI 356.55 300047 CHEST 1 VIEW 88.05 300050 PROCALCITONIN (PCT) 85.20 300051 24 HR UA METANEPHRIN 182.05 300055 CEPHALOGRAM ORTHO 79.05 300056 24 HR UA ORGANIC ACI 194.10 300059 C-SPINE 2 OR 3 VIEW 80.45 300061 24 HR UA COPPER 99.05 300071 STERNUM MIN 2 VIEW 88.90 300095 CT LIMITED STUDY 451.60 300101 L SPINE FLEX & EXT 234.70 300128 BARIUM ENEMA W/AC W/ 416.40 300144 ESOPHAGUS 195.25 300152 CHOLANGIO/PANCREAT O 195.25 300179 CT HEAD W CONTRAST 813.75 300180 CT LOWER EXT W/O CON 703.20 300209 IVP W/WO TOMO 284.50 300217 UGI W/O AIR CONT W/K 207.35 300225 SMALL INTESTINE 288.40 300268 ABD 1 VIEW 137.00 300276 ANKLE 3 VIEWS 90.25 300292 FEMUR 2 VIEW 90.25 300306 FOOT 3 VIEWS 90.25 300349 KNEE 1-2 VIEW 97.90 300357 KNEE 3 VIEW 79.05 300365 TIBIA & FIBULA 2 VIE 95.10 300373 US EXT ART ARM BILAT 260.55 300381 AP PELVIS 1 OR 2 VIE 79.90 300438 TOES 2 VIEW 90.25 300446 HEEL 2 VIEW 79.05 300450 EXP WOUND FOOT CRNA 173.85 300451 EXC TUMOR SFT TISS F 173.85 300454 ELBOW 3 VIEW 90.25 300462 CLAVICLE COMPLETE 79.05 300470 ELBOW 2 VIEW 79.05 300489 FOREARM 2 VIEW 90.25 300500 HAND 3 VIEW 95.10 300527 HUMERUS MIN 2 VIEW 85.80 300535 SCAPULA COMP 81.55 300543 SHOULDER 2 OR > VIEW 119.25 300544 SHOULDER 1 VIEW 104.10 300551 WRIST 3 VIEW 95.35 300578 AC JTS BIL W/W/O WGT 86.35 300608 FACIAL BONES MIN 3VI 156.15 300624 MANDIBLE 4 VIEW 127.95 300640 NASAL BONES 3 VIEW 117.55 300691 SINUSES 3 VIEW COMPL 130.25 300705 TMJ BILATERAL 117.55 300713 C-SPINE COMPLETE 137.55 300799 C-SPINE 4 VIEWS 137.55 300802 SOFT TISSUE NECK 104.95 300810 T-SPINE 3 VIEW 117.55 300829 S I JOINT > 3 VIEW 90.25 300845 SACRUM & COCCYX 2 VI 97.90 300853 OSSEOUS SURVEY COMPL 346.65 300926 HIP 2 VIEW UNILATERA 113.10 300934 HIP 1 VIEW UNILATERA 95.95 300993 MAMMOGRAM DX BILATER 144.60 301001 MANDIBLE < 4 VIEW 79.05 301002 RIBS UNILAT 3 VIEW 130.25 301003 L-SPINE MIN 4 VIEW 143.80 301008 INFANT LOWER EXT 2V 137.85 301009 AAS FLT/UP/DECUB/W/P 164.85 301010 BARIUM ENEMA W/WO KU 250.75 301011 REPAIR INTERMED WOUN 618.85 301012 RESECTION OF LIP 4,380.90 301013 ABD COMP W/DECUB/ERC 143.80 301015 CYSTOGRAPHY MIN 3V 284.50 301057 L-SPINE 2 OR 3 VIEW 123.30 301058 HIPS BIL MIN 2V EA 117.55 301059 UGI W/AIR CONT W/KUB 288.40 301060 UGI W/O AC W/SM INTE 299.35 301065 SCOLOSIS 1 VIEW 117.55 301066 SKULL < 4 VIEWS 117.55 301068 STERNAL CLAVICLE JTS 92.80 301070 CT HEAD W/O CONTRAST 813.75 301071 ORBITS MIN 4 VIEW 117.55 301072 SKULL 4 VIEW 153.90 301073 CARPAL TUNNEL 1,336.50 301074 CIRCUMCISION 1,476.40 301075 CARPAL TUNNEL CRNA 229.60 301078 MAMMO GUID NDL PLC 336.25 301079 VENOGRAM EXTREMITY 1 541.35 301081 PRE-OP NEEDLE PLACEM 391.65 301111 MAMMOGRAM DX UNILATE 92.80 301112 MAMMOGRAM ADD VIEW 92.80 301114 US AORTA 270.70 301115 US AORTA SCREENING 270.70 337077 FLOW CYTOMETRY 9-15 836.25 349461 HEADSTRAP 14.90 360000 FECES CULTURE 136.75 360001 B PERTUSSIA 086173 91.45 360002 B PERTUSSIS AB IGG Q 26.70 360003 BRUCELLA ABORTUS AB 41.35 360004 E AMEBIASIS AB 167.10 360006 BRUCELLA AGGLUT IGM 68.05 360007 CRYSTAL ID 35.45 360008 ETHYLENE GLYCOL SERU 63.10 360010 CRYPTOSPORIDIUM DIRE 283.85 360024 PATH PAP SMEAR 88174 130.25 360025 PANCREATIC ELASTASE 709.85 360066 FREPONEMAL AB 006379 61.40 360074 24HR UR 17 KETOGENIC 77.65 360090 ESTROGEN RECEPTORS 419.50 360104 DOXEPIN LEVEL ADAPIN 77.65 360112 VIRUS CULTURE 008573 134.75 360113 VIRUS ISOLAT CENTRIF 93.65 360114 VIRUS ISOLATION/ID 162.30 360120 ANDROGEN SEX HORMONE 91.45 360121 ANCA VASCULITIDES 199.45 360139 ADRENAL CORTIC 170.80 360145 DEBRIDE & REPAIR AMP 3,090.85 360250 DEBRIDE MUSCLE 20SQ 796.55 360251 DEBRIDE MUSCLE CRNA 173.85 370001 VITAMIN B 12 SERUM 106.35 370002 CSF DIFF 51.45 370003 ABG 132.80 370004 CREATININE URINE 32.10 370005 EHRLICHIA CHAFFEENSE 449.00 370006 LUTEINIZING HORMONE 94.25 370007 BENCE JONES PROTEIN 120.65 370008 ELECTROLYTES PANEL 113.10 370009 BRONCHOSCOPY 817.40 370011 RMSF IGG 016592 87.80 370012 CULTURE OTHER SOURCE 136.75 370013 ENDOSCOPY 929.05 370015 HEP B CORE AB TOTAL 82.15 370016 HEP B CORE IGM 79.60 370017 LAPROSCOPIC SURGERY 178.15 370018 3-0 VICRYL 27 14.35 370019 VITAMIN A LC 95.35 370020 ANTIBODY ID 251.25 370021 LIVER KIDNEY MICROS 106.90 370022 CULTURE IMMUNOLOGIC 32.35 370023 SENSITIVITY MLC 54.00 370024 LINEAR STAPLER 55mm 229.65 370025 ASPERGILLUS 125.25 370026 BLASTOMYCES 107.20 370027 CANDIDA 99.60 370028 COCCIDIOIDES 95.10 370029 HISTOPLASMA 103.80 370030 BOVIE EXTENDED 14.30 370033 FUNGUS CULT ALL SPEC 110.25 370034 VISCOSITY LEVEL 138.70 370035 CA 19-9 002261 98.15 370037 SENS BETA LACTAMASE 32.35 370038 CALPROTECTIN FECAL 89.15 370039 VITAMIN 30.05 370040 LINEAR STAPLER TP60 446.00 370041 CREATINE SER 002402 22.20 370043 ENTEROVIRUS RT-PCR 144.05 370048 LINEAR CUT 55MM 106.35 370049 LINEAR CUTTER 45MM 282.20 370061 HEMOSURE OCCULT 69.20 370064 ARM SLING PEDIATRIC 33.75 370102 AMEBIASIS AG 193.00 370112 SEX HORMONE BIND GLO 169.65 370118 URINE CULTURE 77.65 370119 GIARDIA AG STOOL EIA 104.95 370126 GRAM STAIN 37.70 370127 GONADOTROPIN 110.25 370128 INHIBIN A 110.25 370130 GRAM FLUOR/ACID FAST 36.25 370134 MORGUE STORAGE 148.85 370150 BLEEDING TIME 52.00 370177 CBC AUTOMATED 104.65 370178 ZSTAT FLU A & B 48.65 370179 CBC AUTO W DIFF 96.80 370180 ZONISAMIDE SERUM 161.75 370182 FLU SWAB 46.70 370200 STREP SCREEN CULTURE 77.65 370201 STOOL WBC 27.00 370202 STOOL SODIUM RANDOM 112.85 370203 STOOL POTASSIUM RAND 109.45 370204 STOOL OSMOLAITY 91.70 370205 STOOL SALMONELLA SHI 38.50 370206 STOOL VIBRIO 38.50 370207 STOOL ECOLI 38.50 370208 CAMPRYOBACTOER 54.35 370209 STOOL YERSINIA 38.50 370210 STOOL INFECTIOUS NOS 54.85 370215 LEE-WHITE COAGULATIO 37.70 370223 BLOOD SMEAR DIFF WBC 33.75 370224 BLOOD SMEAR PERIPHER 64.35 370225 CHROMOSOME ANA COUNT 769.50 370226 MOLECULAR CYTO INTER 174.75 370227 CHROMOSOME ANA +KARO 109.20 370228 MOLECULAR DX MUTATIO 73.15 370258 FIBRINOGEN ACTIVITY 51.45 370266 HEMOGLOBIN BLOOD 21.95 370267 HEMOGLOBIN FREE 60.70 370290 HCT 21.95 370312 PLATELET COUNT AUTO 28.40 370339 PT 38.85 370347 PTT 52.00 370355 RBC AUTOMATED 25.90 370356 RBC PROTOPORPHYRIN F 65.30 370363 RETICULOCYTES AUTOMA 42.50 370364 T CELL ABSOLUTE CD4 125.25 370365 FLOW CYTOMETRY CELL 83.85 370366 T CELLS TOTAL 176.45 370367 FLOW CYTOMETRY 16 > 66.35 370368 FLOW CYTOMETRY ADD'L 45.55 370371 RBC SED RATE AUTOMAT 38.85 370373 GENERAL HEALTH PANEL 320.50 370376 T PALLIDUM SCREEN CA 33.20 370377 T-PALLIDUM AB 006379 33.20 370378 CHROMOSOME MICROARRA 6,567.35 370381 MOLECULAR DX ENZYMAT 20.55 370382 CYTOPATHOLOGY SELECT 113.35 370383 FLOW CYTO INTERPRET 41.05 370384 TISSUE CULTURE NEO 440.10 370398 WBC AUTOMATED 21.95 370428 AMYLASE 24.20 370452 BILIRUBIN DIRECT 19.10 370453 BILE ACID 010330 78.75 370487 CALCIUM TOTAL SERUM 19.10 370488 CALCITONIN LEVEL 350.05 370517 CHOLESTEROL TOTAL 15.75 370526 D DIMER QNT 119.25 370527 HIV RNA BY PCA QUAN 438.95 370528 HISTONE DIMER AUTO A 149.70 370533 CREATININE BLOOD 19.10 370541 CREATININE CLEARANCE 88.05 370542 CYCLIC AMP 108.85 370543 CREATININE OTHER SOU 21.95 370545 UREA NITROGEN 013508 20.00 370567 GLUTAMIC ACID DECARB 296.60 370568 GLUCOSE 15.75 370576 GLUCOSE TOL 3 HR 97.05 370592 LACTIC ACID DEHYDR 22.50 370593 LACOSAMIDE 081264 86.35 370606 LIPASE 27.25 370649 PKU 79.60 370657 ACID PHOS TOT 001388 69.75 370665 ALKA PHOS 19.10 370666 ALPRAZOLAM QNT 127.20 370667 ALPRAZOLAM 810021 135.90 370673 INORGANIC PHOSPHOROU 17.70 370674 PHOSPHORUS INORGANIC 236.40 370681 POTASSIUM SERUM 15.75 370683 MOLECULAR DX REVERSE 119.25 370684 MOLECULAR DX ID SEQU 119.25 370703 TOTAL PROTEIN/SERUM 15.75 370711 SGOT/AST 19.10 370722 NEPHELOMETRY 75.10 370746 SGPT/ALT 24.35 370754 THROAT CULTURE 66.35 370762 SODIUM SERUM 17.70 370770 T-3 UPTAKE 001156 62.15 370771 FREE T-3 94.80 370772 TRIIODOTHYRONINE T3 73.70 370773 T-3 REVERSE 070104 66.35 370800 BUN 15.75 370819 URIC ACID BLOOD 15.75 370820 UROBILINOGEN QLT 8.10 370821 SUBOXONE LEVEL 74.55 370835 PREGNANCY TEST QLT 70.35 370886 FEBRILE AGGLU COMP 60.95 370894 HSV CULTURE TYPING 147.70 370895 HERPES 2 IGG 163033 134.20 370901 HSV 2 IGM 1 134.20 370902 HISTAMINE 144600 125.00 370908 URINE W/MICRO AUTO 36.00 370909 URINE W/O MICRO 30.90 370910 BK QUANT PCR UR 177.20 370911 BK QUANT PCR SER 177.20 370912 IMMUKNOW 284529 358.50 370932 E COLI TYPING 52.90 370933 EHRLICHIA CHAFFEENSI 252.05 370935 REPTILASE TEST 51.45 370936 HIV 1+ 2 71.70 370940 BLOOD CULTURE 88.05 370967 TESTOSTERONE TOTAL 167.40 370983 KLONEPIN LEVEL 49.25 370991 STREPTOZYME 53.40 371011 DISOPYRAMIDE 007864 72.30 371033 COLD AGGULTININS 77.65 371041 COOMBS DIRECT 40.80 371068 CONGENTIN 78.20 371069 SMEAR SPECIAL STAIN 35.45 371070 CONCENTRATION INF AG 35.45 371072 SMEAR COMPLEX SPECIA 74.30 371073 GIARDIA 104.95 371106 MONOTEST 40.80 371107 CHLORIDE SPINAL FL 38.85 371108 24HR UA HEAVY ME QNT 149.95 371109 MONONUCLEAR CELL ANT 112.55 371110 C REACTION PROTEIN 45.85 371111 TULAREMIA AGGLUTININ 38.85 371112 ALDOLASE 64.10 371113 CSF CELL CT 59.00 371114 C-REACTIVE PROTEIN 53.40 371115 BETA-HYDROXYBUTYRIC 60.20 371116 ASO TITER 006031 41.60 371117 ENCEPHALITIS CALIF 149.95 371118 ENCEPHALITIS EAST EQ 149.95 371119 ENCEPHALITIS ST LOUI 149.95 371120 ENCEPHALITIS WEST EQ 149.95 371122 CSF PROTEIN 102.10 371125 EN. HISTOLYTICA 53.70 371126 COBALT 149.95 371130 RA LATEX 40.80 371159 GLUCOSE 1 HR POST DO 97.05 371160 SEMEN ANAL COUNT &MO 53.70 371161 SELENIUM BLOOD 76910 120.40 371165 GASTRIN 004390 97.05 371173 RAPID PLASMA REAGEN 41.60 371174 VASO INTESTINAL POLY 90.00 371211 CROSSMATCH AHG 83.55 371212 ABO GROUP 33.20 371213 OXALATE 24 HR URINE 71.45 371215 SICKLE CELL SCREEN 35.45 371216 CKBC ABO GROUP 44.15 371217 CKBC RH TYPE 44.15 371218 CKBC RH PHENO 46.95 371219 CKBC ANTIGEN TYPE 30.90 371220 CKBC AB ABSORP 121.35 371221 CKBC DIRECT AHG 88.05 371222 CKBC AB SCREEN 143.20 371223 CKBC AB PANEL 275.20 371224 CKBC AB ELUTION 113.35 371225 CKBC CROSSMATCH 198.35 371226 CKBC AB TITRATION 81.30 371227 CKBC AG SURCHARGE 1 68.70 371228 OXCARBAZEPINE 137.55 371229 CKBC AG SURCHARGE 2 297.35 371230 CKBC AG SURCHARGE 3 215.25 371231 CKBC CELL SEPARATION 163.20 371232 CKBC LEWIS SURCHARGE 88.90 371233 SHRIMP 068114 53.40 371234 CKBC RED BLOOD CELL 570.30 371238 RH FACTOR 25.30 371239 FFP THAWING EA UNIT 39.90 371241 RH PHENOTYPE COMPLET 36.85 371262 DHEA SULFATE 004020 81.90 371263 DEXAMETHASONE 500118 256.60 371320 SULFONAMIDES URINE 152.20 371327 MYOGLOBIN 74.55 371335 PAMELOR 81.55 371336 CRP CARDIO 120766 87.50 371337 P & C ANCA 269.25 371378 RIMSO 50 1,151.80 371394 SEMEN ANALYSIS PRESE 59.00 371408 VMA URINE RAND 75.65 371513 DEPAKENE/VALPORIC AC 89.75 371548 COMP METABOLIC PANEL 157.00 371556 KETONES QUAL 36.55 371557 KEPPRA LEVEL SERUM 126.55 371558 KAPPA LAMBDA LT CHAI 99.05 371580 CPK 20.80 371645 FE 44.70 371661 RSV AG, OIA 68.70 371726 T4, TOTAL 25.60 371727 TSH 3RD GENERATION 194.10 371742 SPECIFIC GRAVITY UA 18.00 371769 CSF GLUCOSE 38.85 371831 ALBUMIN SERUM 17.70 371832 ALBUMIN FLUID 24.20 371833 ALBUMIN URINE 23.90 371882 RBC ANTIBODY SCREEN 60.70 371939 BETA HCG QN 004416 83.85 371940 BETA-2 MICROGLOBULIN 83.55 371941 BENZODIAZEPINE SERUM 139.55 371943 BENZODIAZEPINE URINE 139.55 371944 BETA 2 GLYCOPROTEIN 110.85 371946 URINE CLONAZEPAM 139.55 371955 DIGOXIN 105.80 372000 ACETAMINOPHEN/TYLENO 106.35 372003 PTH 191.30 372004 FLEX SIGMOID W/POLYP 813.50 372005 CALAN LEVEL 135.05 372006 24 HR URINE CALCIUM 36.55 372008 LIPOPROTEIN ELECTROP 86.35 372009 LIPOPROTEIN A 120188 150.55 372010 ALDOSTERONE 203.40 372011 CHLORPROMAZINES 67.50 372012 GROWTH HORMONE 83.25 372013 G C SCREEN 77.65 372014 BRONCHOSCOPY W/BRUSH 959.80 372015 PARATHYROID RELATED 240.30 372016 GTT EA ADDL >3 SPECI 20.80 372017 CHLAMYDIA IGG ANTIBO 67.00 372018 24 HR UREA CLEARANCE 75.95 372021 RAPID PLASMA REAGIN 20.55 372022 PTH RELAT PEP 503380 61.40 372100 LIPOPROTEIN-ASSOCIAT 142.95 372123 CRITHIDIA DNA 831802 167.70 372129 PT DEBRIDEMENT 77.05 372161 TRIGLYCERIDES 20.80 372162 TRIGLYCERIDES FLUID 85.80 372197 LEPTOSPIRA AB 164970 56.80 372234 SALICYLATE 103.80 372250 ALDOSTERONE 24HR UA 357.60 372264 IGG CSF 012211 103.25 372266 GLOMERULAR FILTRATIO 49.75 372310 24 HR HYDROXYPROLINE 160.35 372311 24 HR UA VMA 75.65 372366 RENAL FUNCTION PANEL 75.40 372367 SOLUBLE TRANSFERRIN 151.40 372447 BROMIDE LEVEL 49.25 372448 LYME DISEASE CONFIRM 83.25 372449 LYME DISEASE 161992 114.80 372450 OXYCONTIN SERUM 138.70 372451 OXYCODONE/OXYMORPHIN 110.00 372463 HISTOPLASMA AB & AG 99.30 372464 HISTOPLASMA AG 163.20 372465 COMPLEMENT FIXATION 41.90 372467 HISTOPLASMA DNA PCR 163.20 372471 STONE ANALYSIS 93.40 372498 URINE DRUG SCREEN 117.00 372499 URINE COCAINE 071324 69.20 372544 CEA 125.25 372579 SPUTUM CULTURE 123.30 372595 GLUCOSE 2 HR 97.05 372609 WOUND CULTURE 152.50 372633 PROTEIN ELECT SERUM 60.20 372634 BNP TEST 93.65 372635 B CELLS TOTAL 176.45 372636 NK CELLS TOTAL 176.45 372639 INFECTIOUS AGENT AMP 182.30 372644 INFECTIOUS AGENT 50.10 372676 LITHIUM 59.45 372692 TRIMETHADIONE QNT 83.85 372722 MAGNESIUM 56.30 372723 MANGANESE BLOOD 286.15 372724 PLASMODIUM PCR 174.75 372725 PLASMENOGEN ACT INHI 168.50 372726 ALPHA Z ANTIPLASMIN 202.55 372749 LYMES AB SCREEN 90.25 372750 LYMES AB PCR 185.70 372765 FECAL FAT QUAL 69.20 372811 TISSUE EXAM, KOH 37.70 372838 FLUOR AND/OR ACID 36.55 372854 AMMONIA/NH3 88.05 372855 CLOZAPINE 706440 113.10 372862 LDH ISOENZYME PANEL 89.15 372870 RUBELLA TITER STATE 236.65 372871 RUBELLA VIRUS IGM 98.15 372872 RUBEOLA (STATE) 76.25 372873 RUBELLA IGG 006197 45.55 372874 RUBEOLA IGG 096560 74.55 372876 FACTOR IX ACTIVITY 107.50 372877 GAMMAGLOBULIN 52.65 372880 ELECTROPHORETIC FRAC 97.90 372882 EPSTEIN BARR NUCLEAR 86.35 372884 RUBEOLA AB, IGM 74.55 372889 PHENOBARBITAL 98.15 372890 PHENYTOIN FREE 46.70 372891 PHENCYCLIDINE URINE 224.25 372892 PHENYTOIN TOTAL 57.75 372927 FLEX SIGMOIDOSCOPY 541.05 372935 PROLACTIN 004465 102.10 372951 FUNGUS CULTURE 115.05 372953 FUNGUS UNSPECIFIED 155.30 372994 SMEAR, WET MOUNT INF 28.70 373001 CORTISOL URINE FREE 108.05 373003 GENTAMICIN PK 007162 118.20 373004 GENTAMICIN TR 007163 118.20 373005 OSMOLALITY SERUM 65.05 373006 OSMOLALITY URINE 65.05 373008 TEGRETOL QNT 97.05 373009 NP CULTURE 95.35 373010 NEBCIN PK 007154 123.30 373011 TACROLIMUS FK506 PRO 354.20 373013 BUPRENORPHINE LEVEL 96.20 373014 NEBCIN TROUGH 007155 123.30 373015 TRYPSIN 010355 32.35 373016 SENSITIVITY MIC 66.35 373017 ELAVIL ENDEP ETRAPON 90.60 373020 BUPRENORPHINE & META 332.85 373028 THEOPHYLLINE SERUM 97.05 373029 THEBAINE SCREEN 300.25 373036 CT C-SPINE W/O CONTR 813.75 373044 CSF CULTURE 167.40 373087 PROTEIN URINE QUANT 68.35 373095 AMYLASE URINE RANDOM 43.05 373100 RAST OYSTER 31.25 373101 RAST CRAB 31.25 373168 ESTRIOL SERUM 115.30 373214 URINE URIC ACID 44.45 373222 DILANTIN TOTAL 84.40 373265 CORTISOL PLASMA TOTA 102.95 373266 CORTISOL SALIVARY 156.15 373281 LEAD 65.05 373304 PATH SPEC FROZEN 1ST 37.70 373305 PATH SPEC FROZEN ADD 13.20 373306 PATH I 88300 41.05 373307 PATH II 88302 105.20 373308 PATH III 88304 126.25 373309 PATH IV 88305 124.55 373310 PATH V 88307 299.05 373311 PATH VI 88309 414.40 373312 PATH CYTO FNA 57.75 373313 PATH INTERP & REPORT 197.50 373314 PATH IMMUNOHISTO 1ST 184.25 373315 PATH DECALCIFICATION 41.05 373316 PATH SPECIAL STAIN 63.10 373317 PATH SPECIAL STAIN G 63.10 373318 PATH IMMUNOHISTO 2ND 184.25 373320 PATH SURGICAL CONSUL 100.00 373321 PATH EXAM ARCHIVE TI 66.95 373333 IMMUNOASSAY FOR ANAL 463.70 373354 FOLLICLE STIM HORMON 78.50 373362 ACID PHOS RIA PROSTA 122.60 373365 CBC WITH IPF 120.65 373389 FLUOR NONINFECT TITE 69.75 373390 FLUOR NONINFECT AB 167.70 373392 WESTERN BLOT 14.60 373398 RAST SHRIMP 31.25 373399 RAST LOBSTER 31.25 373405 SPERMATOCELECTOMY 6,128.80 373410 SPERMATOCELECTOMY CR 163.90 373419 GLYCOHEMOGLOBIN 78.75 373427 QUINIDINE 007831 85.80 373435 CPK MB 112.85 373443 C DIFF TOXIN 77.65 373444 C DIFFICILE DNA AMPL 136.75 373451 VENIPUNCTURE 8.75 373452 RUSSELL VIPER VENOM 45.30 373453 THROMBIN TIME PLASMA 27.25 373454 JOBST GARMENT 531.80 373455 THROMBOPLASTIN INHIB 45.55 373456 THROMBOPLASTIN TIME 30.65 373479 CULTURE C DIFF 104.95 373486 PROSTATE SCREENING 141.20 373487 PROSTATE DIAGNOSTIC 141.20 373524 AFB CULTURE 115.05 373541 HEMOGLOBIN S CHROMAT 41.90 373542 HGB ELECTROPHORESIS 68.35 373583 TSH 60.95 373591 MELLARIL LEVEL 83.85 373605 COLONOSCOPY W/POLYPE 1,532.05 373613 COLONOSCOPY 1,037.10 373656 CHOLESTEROL DHDL 30.90 373664 ALCOHOL BLOOD 106.35 373680 ELECTROPHORESIS IMMO 56.80 373710 OVA & PARA DIRECT 71.45 373870 DRUG SCREEN 16.30 373871 DRUG PROFILE URINE 147.05 373874 HAIR STANDARD DRUG S 97.35 373877 HAIR FOLLICLE 12 PAN 662.05 373915 CERULOPLASMIN SERUM 55.35 373923 HAPTOGLOBIN 001628 98.15 374000 ANA 164855 79.30 374001 RAPID STREP 62.15 374002 DNA SINGLE AB 161422 51.75 374003 ROBAXIN LEVEL 146.00 374004 BILIRUBIN TOTAL 23.05 374005 TIBC 72.85 374006 LORAZEPAM LEVEL 137.00 374007 HIV SCREEN W CONFIRM 212.70 374010 ZARONTIN 007443 74.30 374011 PENICILLIN G ALLERGY 50.65 374012 ERYTHROMYCIN ALLERGY 58.50 374013 SEPTRA ALLERGY 155.60 374015 5-HIAA 48.10 374016 TOBRAMYCIN SERUM TRO 68.05 374017 ANA IFA 164947 79.30 374040 FOLATE SERUM 88.05 374075 CT HEAD W&WO CONTRAS 1,391.15 374083 HEP B SURFACE AB QN 48.35 374084 HEP BE ANTIGEN 82.15 374085 HEP B SURFACE AB QL 48.35 374086 HEP B SURFACE AG 45.55 374087 HEP C AB 48.35 374088 HEP C VIRAL LOAD 442.05 374089 HCV RNA PCR QN RFX G 431.10 374090 HEP C GENOTYPE 615.65 374091 HEP C VIRAL RNA QL 436.45 374092 HEP C RIBA 143991 178.15 374094 HEP C VIRUS 966.20 374097 HARMONY PRENATAL TES 477.45 374099 YERSINIA IGM IMMUBLO 57.05 374113 HEP A ANTIBODY TOTAL 77.65 374114 HEP B DNA VIRAL TAGM 426.25 374115 HEP DELTA VIRUS AB 168.80 374121 PROGESTERONE 004317 88.05 374156 IGG QUAN SERUM 80.45 374157 RAST PEANUT IGG 81.55 374158 RAST PEANUT IGE 29.55 374210 IGM QUAN SERUM 72.85 374211 IGM CSF 100123 103.25 374212 IGM AB 58.50 374229 ALKA PHOSP ISOENZYME 289.80 374237 STREP TYPING 63.35 374261 IGA QUAN SERUM 80.45 374262 ENDOMYSIAL IGA ANTIB 163.45 374263 GLIADIN AB IGG IGA 238.35 374264 IGA CSF 100115 103.25 374326 ROTAVIRUS 79.30 374327 ROHYPNOL FLUNITRAZEP 245.10 374328 URINE MDMA 071306 106.60 374329 GHB 273.20 374350 DHEA SERUM 004100 145.45 374377 IGE TOTAL 002170 76.80 374378 CHROMOSOME ANA/ADD'L 136.20 374379 CYTOGENETICS INTERP 211.60 374380 MOLECULAR CYTO DNA P 71.15 374381 INTERPHASE IN SITU 164.85 374385 IGE 76.80 374415 FERRITIN 88.05 374416 FENTANYL URINE 148.25 374432 GLUCOSE 6-PHOS 68.35 374675 TISS TRANSGLUTAMINAS 187.40 374676 TISSUE CULTURE 461.20 374677 TISSUE CULT SOLID TU 375.15 390000 NEW PT 1-4YR PHYSICA 58.00 390001 NEW PT 5-11YR PHYSIC 58.00 390002 NEW PT 12-17 YR PHYS 58.00 390003 NEW PT 18-39YR PHYSI 58.00 390004 NEW PT 40-64 YR PHYS 58.00 390005 NEW PT 65-+ YR PHYSI 58.00 390006 EST PT <1YR PHYSICAL 58.00 390007 EST PT 1-4 YR PHYSIC 58.00 390008 EST PT 5-11YR PHYSIC 58.00 390009 EST PT 12-17YR PHYSI 58.00 390010 EST PT 18-39YR PHYSI 58.00 390011 EST PT 40-64YR PHYSI 58.00 390012 EST PT 65+ PHYSICAL 58.00 390013 WORK RELATED PHYSICA 58.00 390014 CDL PHYSICAL 115.90 400001 TRACH TUBE HI VOL 8 9.25 400002 WALKER SPLINT 110.00 400003 EXTERNAL PACE ELECTR 124.05 400004 RADIAL ART CATH SET 36.55 400005 THORACENTESIS TRAY 100.10 400006 JAMSHIDI NEEDLE 141.50 400007 NASOGASTRI FEED TUBE 37.95 400008 TWIN CATH.(ARRO 28.45 400009 LUMBAR ROLL 1/2 41.90 400012 PCA PT CONTROL 88.30 400014 TRACH CLEAR JACKSON 52.00 400019 MULTI LUMEN PEDIATRI 135.05 400020 AQUA MEPHYTON 15.75 400021 LUMBAR ROLL 37.40 400022 ALDACTONE 25MG TAB 1.55 400023 ROBINUL .2MG/ML 12.65 400025 ATROPINE 1MG VIAL 42.50 400029 KNEE STOCK OPEN TOE 205.95 400030 HYDROCORTISONE 1% CR 13.50 400032 HYDROCORTISONE1/2%CR 10.10 400034 DUODERM EXTRA THIN 16.30 400036 THIAMINE B-1 AMP 32.00 400038 VITAMIN B-12 INJ 25.60 400039 MULTI-LUMEN CAT 158.10 400041 BUMEX 0.5MG AMP 7.30 400042 PROVENTIL INHALER 82.45 400043 LARYNGOSCOPE BLADE 14.60 400045 CEFZIL 125/5 150CC 65.10 400048 CLEOCIN 150MG CAP 3.65 400052 CARDIZEM 50MG/ML10ML 14.05 400053 DIPRIVAN 20ML AMP 21.10 400055 COLACE 100MG CAP 1.55 400056 JEVITY 7.05 400057 JAMSHIDI NEEDLE 8 GA 141.50 400059 PULMOCARE 9.25 400061 MARLEX MESH 3X6 118.05 400062 CARDURA 2MG TAB 11.65 400064 ANTIVENOM POLYVALENT 852.25 400068 BEDPAD EGGSHELL 2" 25.90 400069 BUSPAR 5MG TAB 2.35 400070 DEXAMETHASONE 0.5MG 28.95 400071 KETALAR 50MG/CC VIL 46.15 400072 CIPRO 250 MG TAB 16.60 400074 EZM PECUGUIDE 10" 70.15 400075 AIRWAY SUPRAGLOTTIC4 56.05 400078 AMOXIL 250 MG CAP 1.55 400080 TEGADERM 4X4 4.05 400082 MONOPTY BIOPSY 149.10 400084 FLAGYL TABLET 250MG 1.70 400085 FLAGYL PREMIX 36.05 400088 GLYCERIN PED SUP 3.10 400089 GLUCERNA 63.60 400091 MONTGOMERY STRA 10.40 400094 INTERNAL FEED TUBE10 34.40 400097 PRISOLEC 20MG 16.00 400098 LACTINEX TABLET 1.55 400100 ARTERY VENOUS CATH 57.35 400102 LASIX 20MG TABLET 1.55 400107 EES 400 TAB 3.65 400108 METHYLENE BLUE 1ML A 23.85 400110 MVI-12 VIAL 37.50 400114 MYLICON 80 TAB 1.55 400117 NITROGLYCER .6MG SLT 7.30 400124 REGLAN 5MG TAB 2.80 400125 REGITINE INJ VIAL 556.20 400126 SOD BICARB 4.2% P-S 40.05 400127 DEPO MEDROL 40MG INJ 32.25 400128 SOLU-MEDROL 125MG 35.90 400130 SOLU-MEDROL 500MG 36.20 400131 SOMA TAB 2.20 400132 SURFAK CAP 240MG 1.70 400134 SYNTHROID O.1MG TAB 1.75 400138 TORADOL 30MG INJ 10.65 400141 PHENERGAN 12.5MG SUP 54.70 400142 WELLBUTRIN 100MG TA 4.40 400144 VITAMIN B-1 100MG TA 1.95 400152 INFED INJ 49.15 400154 IMMODIUM 2MG CAP 2.65 400156 INDERAL 1MG/1CC AMP 29.65 400157 KLONOPIN 1MG TAB 2.85 400160 PAMELOR 25MG CAP 2.70 400162 ANTIVERT 25MG TAB 2.65 400166 CALCIUM GLUCONATE 10 32.95 400167 DOPRAM 20MG/ML 229.60 400172 LANOXIN 0.5MG/2ML IN 11.55 400176 SODIUM CHLORIDE .9% 11.35 400179 SOLU CORTEF 100MG 49.80 400194 AQUA MEPHYTON 10MG 178.85 400195 ACETAMINOPHEN SUP120 3.10 400196 ACETAMINOPHEN 325MG 3.10 400197 ADENOCARD 6MG 20.85 400200 HYDROXYZINE 10MG/5CC 19.40 400201 ATIVAN INJ 14.60 400202 BACTRIM SUSP 100CC 25.90 400203 BACTRIM IV INJ 5CC 46.45 400206 BENADRYL 12.5/5 EL 8.05 400209 BENTYL 20MG/2CC AMP 91.15 400211 DIPROLENE 45 GR CR 50.65 400213 AMINOPHYLLINE 25 INJ 12.95 400215 ALUPENT INHALER 173.55 400220 BRETHINE 1MG AMPULE 14.85 400223 AZMACORT INH 604.90 400226 CALCIUM CL 10% P-5 71.65 400243 CIPRO 400MG PREMIX 23.15 400246 COCAINE 4%TOP SOLN 488.70 400247 ZOSYN 2.25GM INJ 12.95 400250 COGENTIN 2MG TAB 1.60 400252 COLCHICINE 1MG AMP 29.80 400256 COMPAZINE 25MG SUP 38.90 400259 CORTROSYN 0.25MG 395.15 400260 COUMADIN 2MG TAB 8.00 400270 DIPRIVAN 50ML KIT 23.30 400273 DIAMOX 250MG TAB 9.15 400274 DURICEF 500MG CAP 15.15 400275 CIPRO 500MG TAB 19.05 400277 DIFLUCAN 200MG INJ 55.60 400280 NIACIN 50MG TAB 1.95 400281 CARDIZEM CD 180MG 5.55 400284 DILANTIN 100MG CAP 5.05 400285 DITROPAN 5MG TAB 1.55 400303 BENADRYL 50 MG/ML 11.35 400305 BACITRACIN TOP OINT 12.95 400318 FERGON TAB 1.70 400322 FERROUS SULF 300MG 1.55 400324 FLEET PHOS SODA 14.35 400337 POT.CL 20MEG VIAL 11.35 400340 GLUCAGON 1GM INJ 636.30 400343 GLUCAGON PLAS 004622 27.25 400357 HYTRIN 1MG TAB 5.00 400360 FIBERCON TABS 1.70 400363 LOPRESSOR 50MG TAB 1.55 400365 MAALOX PLUS SUSP 9.05 400368 PANCREASE CAPS 2.70 400380 MINERAL OIL OZ 2.00 400388 PEPCID 20MG TAB 5.35 400392 MOTRIN 400MG TAB 1.55 400397 NEOSPORIN OINT PACKE 6.20 400399 NEOMYCIN SULF 500MG 5.00 400409 NITROGLYCER .4MG SLT 79.30 400412 NORVASC 5MG TAB 5.05 400430 PREDNISONE TAB 20MG 1.55 400434 PRENATAL TAB 1.70 400435 PYRIDIUM TAB 100MG 3.85 400437 ROMAZICON 5ML INJ 25.25 400442 ROBITUSSIN 100MG/5ML .95 400460 TAGAMET 300MG 43.85 400464 TEGRETOL TAB 200MG 3.45 400466 TENORMIN 25MG TAB 2.50 400467 SYNTHROID 0.025MG TB 1.55 400469 THEO 24 300 MG 6.45 400471 PHENERGAN 25MG TAB .80 400472 PHENERGAN 25MG SUPP 54.70 400475 PHENOBARB 130MG VIAL 77.15 400488 TOFRANIL 25MG TABLET 3.40 400493 HCTZ 25MG TAB 1.55 400494 IMITREX INJ 262.65 400495 IMDUR 120MG TAB 6.35 400501 SLO MAG TAB 1.95 400502 PEDIAZOLE SUSP 100CC 61.65 400518 TENORMIN TAB 50MG 3.50 400522 DIGOXIN .25MG TAB 1.70 400526 BACTORBAN OINTMENT 95.95 400538 CATAPRESS TTS 1 102.45 400545 REGLAN 10MG TABS 1.55 400570 MILK OF MAGNESIA 7.20 400582 PREDNISONE 5MG TAB 3.65 400585 ENSURE PUDDING 9.25 400586 JUVEN 7.60 400587 AUGMENTIN 25 50MG 367.25 400595 SILVADENE 1% 46.70 400596 LOTRISONE 15 GRAM 62.50 400604 PROVENTIL SYRUP 8.50 400609 BUMEX 1MG TAB 3.35 400610 PRAVACHOL 20MG TAB 11.20 400612 MAGNESIU SO4 4GM P-S 90.05 400614 LASIX 10MG/CC ORAL 6.75 400619 MUCOMYST 20%SOLN 37.90 400627 QUELICIN 200MG/10CC 74.05 400630 CORTISPORIN OTIC LIQ 289.75 400642 ISORDIL 20MG TAB 1.95 400643 MANNITOL 25% 1MG INJ 13.70 400646 AUGMENTIN 250MG TAB 15.75 400648 DOBUTREX 250MG VIAL 20.55 400649 ROBAXIN INJ 1GM/10CC 129.40 400651 GLUCOTROL 1.55 400653 CECLOR 250 MG CAP 6.70 400656 ISMO 20MG TAB 2.45 400664 PROVENTIL 2MG TAB 19.75 400667 DIGOXIN 0.125MG TAB 7.10 400669 DEMEROL 50 INJ 13.55 400674 CALAN SR 180 MG 7.65 400676 ATROVENT INHALER 103.25 400678 ACTIDOSE/SORBITOL 125.10 400696 LASIX 40 MG TAB 1.55 400698 QUINIDINE 200MG TAB 1.95 400702 TORADOL 10MG TAB 3.40 400703 SINEQUAN CAP 10MG 1.95 400706 METHOTREXATE 50MG 14.95 400710 DILANTIN 125/5SUSP 26.65 400711 AMPICILLIN 250MG CAP 1.70 400714 DEMEROL 25MG INJ 22.05 400730 NORCURON 10MG 22.25 400733 SINEMET 25/100 TAB 2.50 400734 ISORDIL 10MG TAB 3.85 400735 PHENOBARBITAL 30MG 2.55 400739 PHENOBARB ELIX 2.10 400742 RONDEC DM SYR 27.25 400745 LASIX 2OMG/2CC AMP 15.25 400749 TETRACYCLINE 250MGIM 1.70 400750 GEMFIBROZIL 600MG 3.70 400752 MOTRIN 600MG TAB 1.55 400753 MOTRIN 800MG TAB 1.95 400756 DEXAMETHASONE 4MG 3.70 400761 VANCOCIN 125MG 96.70 400764 LIDOCAINE URO-JET 23.75 400768 THEO-DUR 300MG TAB 2.10 400772 MAGNESIU S04 1GM AMP 11.35 400779 HALDOL 1MG TAB 1.55 400789 MORPHINE 10MG/ML VIA 23.75 400790 ROBITUSSIN DM SYR 2.25 400792 NEOSPORIN OPTH SOL 115.60 400793 LOMOTIL 2,5MG TABLET 2.65 400794 ALBUTEROL SOLN 20ML 65.55 400801 DONNATAL ELIX 30ML 205.95 400806 CATAPRES 0.1MG TAB 1.55 400815 CARDIZEM CD 120MG 1.55 400821 ZOSYN 3.75GRAM 13.60 400824 HALDOL 5MG AMPULE 22.75 400839 ALBUTEROL INH SOLNUB 2.45 400841 LIORESAL 10MG TAB 1.55 400848 REGLAN 2CC AMP 10MG 11.35 400851 BIAXIN 500MG TAB 18.95 400852 TEGRETOL SUSP 15.75 400856 EPINEPHRINE CARDIAC 11.35 400857 REGLAN SYRUP 6.85 400858 BABY ASPIRIN 81MG 1.55 400863 DANTRIUM 25MG CAP 5.95 400865 NAPROSYN 250 TAB 2.70 400877 PEDIAPRED 5MG LIQ 15.15 400879 BUPIVACAINE HCL 0.5% 18.75 400880 FERROUS SULFATE ELIX 7.05 400881 DIFLUCAN 100MG TAB 27.05 400883 THEO-DUR 200MG TAB 2.15 400884 ATARAX 10MG TAB 2.20 400895 PROCARDIA XL 30MG 5.10 400899 PROCARDIA 10MG CAP 3.65 400900 COLACE SYR 2.15 400905 ECHO 2D LIMITED 420.40 400906 MONISTAT VAG SUPP. 20.20 400911 NYSTATIN ORAL SUSP 5.10 400913 ECHO DOPPLER LIMITED 420.40 400918 AURALGAN EAR DROPS 36.90 400921 DOPPLER COLOR FLOW 420.40 400922 PONTOCAINE .5% MONO 34.05 400924 DOPAMINE 200MG/SML 12.40 400926 NITROGLYCER SR 2.5MG 1.70 400935 MUMPS VIRUS IGG 67.00 400938 MUMPS STATE 36.55 400942 ISUPREL INJ 208.45 400945 ATROVENT SOLN UD 4.05 400948 CLEOCIN 300MG/2CC 6.80 400949 AUGMENTIN 125/5 75CC 144.35 400954 DESYREL 50MG TAB 1.55 400958 DESTIN OINT 4OZ 10.15 400960 DARVOCET-N 100 TABS 1.70 400962 ELAVIL 50MG TAB 2.45 400964 ELAVIL 10MG TAB 1.95 400965 ENSURE 6.80 400967 SYNTHROID 0.05MG TAB 1.55 400970 HEPARIN 1000 U/MLINJ .25 400972 KAOPECTATE 3OZ 7.55 400975 RESTORIL 15 CAP 2.65 400984 MYCELEX TROCHE 4.50 400986 MYCOLOG ONT. 15G TBE 345.85 400991 PILOCARPINE 1% 0.5 304.55 400993 NUBAIN 10MG AMP 13.40 400995 PREDNISONE 10MG TAB 1.55 401000 SYMMETREL CAP 100MG 9.25 401001 ALDOMET INJ 250MG 148.30 401006 SUBLIMAZE AMP 2CC 27.25 401008 PHENERGAN 50MG SUP 26.40 401012 TAGAMET 400MG TAB 6.45 401018 PERIACTIN 4MG TAB 3.30 401020 INDERAL 10MG TABLET 1.55 401021 ENSURE PLUS 6.80 401022 PROMOTE 2.20 401026 2 CAL HN 4.40 401027 MYCOLOG CR 15 GRAM 345.85 401042 AMPICILLIN 500MG CAP 9.10 401043 FLUPHENAZINE 5 MG 4.40 401045 SORBITOL 70% SYR 5.70 401053 KENALOG 40MG VIAL 34.70 401054 HYZAAR TAB 13.75 401055 KENALOG 40MG/ML 34.55 401056 NAFCILLIN INJ 1GM 45.10 401057 STADOL 2MG INJ 18.05 401061 PENICILLIN VK 500MG 2.10 401062 DONNATAL TABS 1.95 401063 EEG AWAKE/DROWSY 811.80 401064 COUMADIN 5MG TAB 8.55 401066 MELLARIL 50MG TAB 2.20 401070 BENTYL 20MG CAP 1.85 401072 PRINIVIL 10MG TAB 1.60 401076 MYLICON DROPS 10OZ .55 401092 LEVOPHED 4CC AMP 75.00 401099 MONISTAT VAG CR 27.30 401100 QUANTIFERON-TB GOLD 296.85 401102 FOLIC ACID 1MG TAB 1.55 401103 MELLARIL 25MG TAB 1.95 401104 QUANTITATION OF DRUG 65.05 401105 SILVADENE CR 400GR 196.45 401106 FLEXERIL 10MG TAB 1.55 401108 AEROBID INH 377.85 401111 COMPAZINE 5MG TAB 1.90 401113 ZAROXYLN 2.5MG TAB 10.15 401115 NITROGLYCER SR 6.5MG 1.95 401119 MAXITROL OPMT DROPS 61.40 401120 CARDIZEM 30MG TAB 1.95 401132 AFRIN NASAL SPRAY 6.20 401133 LIBRAX CAP 2.55 401141 DILANTIN 100MG AMP 7.05 401144 CALAN SR 120 MG 4.40 401145 CAPOTEN 12.5MG TAB 5.30 401160 CEFTIN 250 MG 13.55 401163 PNEUMOVAX 23 350.45 401167 MONOPRIL 10MG TAB 5.60 401169 NITRO SPRAY 635.60 401172 NEUTRA PHOS CAP 1.95 401175 CARAFATE 1MG TAB 1.55 401177 TETANUS TOX ADSOR 102.10 401183 PROSTIGMIN 1;1MVIL 3.15 401189 PROSURE 7.30 401192 DILANTIN 250MG AMP 2.25 401193 SUPLENA 10.95 401201 ATIVAN 1MG TAB 1.55 401202 AMOXIL 500MG CAP 1.95 401204 CAPOTEN 25MG TAB 2.70 401206 MICRONASE 5MG TAB 2.70 401216 BICILLIN CR 1.2HIL V 20.00 401218 LOTENSN 20MG TAB 3.40 401223 MULTIVITAMIN ELIXIR 7.05 401225 TIMOPTIC 0.5% OP SOL 52.55 401230 LASIX 40MG/4CC AMP 5.65 401235 ERYTHROMYCIN 1GM VIA 69.60 401239 TIGAN 2CC AMPOULE 12.40 401247 BRETHINE 5MG TAB 20.50 401255 PROZAC 20 MG CAP 7.65 401259 CATAPRESS TTS 2 172.45 401261 NARCAN 0.4 MG/ML 58.65 401262 NARCAN 2 MG 33.30 401265 AMITIZA 24 MCG CAP 22.90 401266 SODIUM ACE 2MEQ/ML 11.70 401267 NEOSPORIN OPHTH SOLN 80.50 401268 CLINDAMYCIN 150MG/ML 6.10 401269 CALTRATE 600 MG TABS 1.95 401270 CELEBREX 100MG CAPS 9.80 401271 CELEXA 20 MG TABS 8.30 401273 DULCOLAX 5 MG TAB 1.55 401275 ESTRADERM 0.1MG/24HR 37.70 401276 FERRLECIT 12.5MG/ML 23.60 401278 LOVENOX 120MG/0.8ML 5.55 401279 MAXIPIME 2 GM INJ 36.30 401280 MOTRIN 200MG TABS 1.95 401281 NITRODUR 0.1MG/HR PT 6.20 401282 NITRODUR 0.2MG/HR PT 6.20 401283 ASPIRIN 325MG TABLET 1.55 401284 BENICAR 20MG TABLET 17.80 401285 OSCAL 500MG W/VIT D 1.55 401286 OXYCONTIN 10MG TABLE 13.95 401287 PERCOCET 10/325MG TB 10.95 401288 PERSANTINE 25MG TAB 1.95 401289 PLETAL 100MG TABLET 7.05 401290 PRINIVIL 5 MG TABLET 1.55 401291 PROVERA 10MG TABLET 1.95 401292 REQUIP 0.5MG TABLET 11.80 401293 DOXEPIN 25 MG CAPS 2.55 401294 SINGULAIR 4MG TABLET 21.05 401295 SENNA S 8.6-50MG TAB 1.95 401296 SOLU-CORTEF 250MG 92.15 401297 SYNTHROID 137MG TAB 2.10 401298 TAMBOCOR 50 MG TAB 6.25 401299 THERAGRAN MVI TAB 1.55 401300 THERAGRAN W/MINERALS 1.95 401301 PATIENTS HOME MED 3.90 401302 TIMETIN 3.1 55.70 401308 URECHOLINE 25MG TAB 8.10 401311 TRACE METALS VIAL 12.05 401322 VALIUM TABLET 2MG 1.95 401323 VALIUM TABLET 5MG 1.55 401328 VALIUM 10MG/2CC AMP 101.40 401330 TRANXENE 7.5MG CAP 12.65 401334 VASELINE 1OZ TUBE 6.20 401335 MAX TAB 3.90 401336 VERELAN PM 200MG CAP 12.65 401337 LORTAB 10/500MG TAB 1.95 401338 COLACE 250MG CAPS 1.55 401339 CORGARD 20 MG TABS 19.10 401341 TRENTAL 400 MG TAB 4.65 401344 TUBERCULIN SKIN TEST 28.75 401346 LOPRESSOR INJ 11.35 401348 TRANDATE INJ 12.55 401352 TUSSIONEX SUSPENSION 10.30 401353 VASOTEC 2.5 MG TAB 3.90 401355 TYLENOL 325MG TABLET 1.55 401357 TYLENOL EX-STR 500MG 1.55 401358 VASOTEC 5 MG TAB 3.65 401362 TYLENOL #3 TABLET 1.95 401364 VERMOX 100MG CHEWABL 22.20 401367 VIBRAMYCIN 100MG CAP 17.25 401368 VIBRAMYCIN SUSP 60CC 92.30 401370 VIBRAMYCIN 100MG VIL 89.55 401371 TYLENOL 4 OZ ELIX 3.10 401373 VICODIN TABLET 1.70 401375 TYLENOL & CODEINE EL 4.60 401376 VERAPAMIL INJ 12.05 401377 TYLENOL DROPS 8.10 401378 ZANTAC 50 MG INJ 47.80 401379 TYLOX CAP 1.60 401383 VISINE EYE DROPS 22.20 401385 VISKEN 5MG TAB 4.40 401391 HYDROXYZINE 50MG IM 41.25 401393 CYMBALTA 30 MG CAP 23.80 401394 DECADRON 0.5 MG TAB .75 401396 VITAMIN E. 100IU CAP .75 401397 DIABETA 3MG TABLET 2.45 401398 DIABETA 5 MG TABLET 1.65 401407 XANAX 0.25MG TAB 2.00 401409 XANAX 0.5 MG TAB. 2.40 401413 LIDOCAINE 2% JELLY 68.90 401421 ZANTAC 150MG TABLET 1.55 401422 ZAROXOLYN TAB 5MG 6.45 401428 ZINACEF 750MG VIAL 27.85 401431 ZINACEF 1.5GM VIAL 44.35 401433 ZINC 50MG TABLET .25 401435 ZYLOPRIM 100MG TAB 1.55 401436 ASPIRIN 5GR SUP 1.70 401438 ASPIRIN 10GR SUP 4.65 401440 DEMEROL 75 INJ 21.35 401443 ZITHROMAX 250 MG 13.00 401445 LIBRIUM 25MG CAPSULE 2.05 401448 LIDOCAINE HCL 100 MG 11.35 401450 RIFAMPIN 300 6.45 401451 DUODERM CGF 6X6 27.10 401456 COUMADIN 2.5MG TAB 8.25 401459 MORPHIN ORAL 20MG/CC 34.60 401462 ERYTHROMYCIN OP OINT 16.40 401463 INDOCIN 25MG CAPSULE 1.55 401464 KEFLEX 500 MG CAP 6.80 401465 ATROPINE INJ .1MG 34.30 401470 CLARITIN 10 MG TAB 2.15 401486 BACTERIOST WATER INJ 11.35 401499 GI COCKTAIL 14.85 401502 COMPAZINE 10MG AMP 68.60 401503 CALAN SR 240MG TAB 6.10 401506 DILANTIN 50MG INFATA 3.65 401509 HALDOL 5MG TABLET 5.45 401515 PERCOCET 4.20 401516 GYNE-LOTRIMIN VAG CR 24.70 401517 LASIX 10MG INJ 4.25 401519 KEFLEX 250 MG CAP 2.10 401523 VENT MGMT IP SUBQ D 317.10 401528 MOTRIN 5/15 ML 20.25 401529 EDECRIN 25MG TABLET 7.05 401530 KDUR 20MEQ TABLET 9.00 401531 EMEND 40 MG CAPS 203.75 401532 KLOR-CON 8 MEQ 1.95 401533 KLOR-CON 10MEQ TAB 1.90 401534 CHLORPROMAZ 25MG INJ 106.45 401535 KAYEXALATE 15GM SOLN 34.75 401536 BUMEX 1MG INJ 11.35 401539 FENTANYL TRANSDERMAL 63.80 401540 KEFLEX SUSP 250MG/5M 88.85 401541 LEXAPRO 10 MG TAB 13.35 401542 LOZOL 1.25MG TAB 4.50 401543 MEDROL 4 MG TABLET 1.95 401544 MICARDIS 20MG TABLET 20.55 401545 MIRAPEX 0.5MG TABLET 9.05 401546 MOBIC 15 MG TABLET 18.30 401547 AMBIEN 5MG 14.25 401548 ROCEPHIN 500MG INJ 5.65 401549 LIPOSYN 10% 50.65 401551 FENTANYL TDS PATCH 120.15 401552 KEFLEX SUSP 34.30 401553 LYRICA 200MG CAPS 11.20 401554 MUCINEX DM TABLET 1.75 401555 MUCINEX 600MG TABLET 1.55 401556 NAMENDA 5 MG TABLET 2.95 401557 NIACIN CR 250MG CAP 1.95 401558 VISTARIL 25MG CAP 1.55 401561 LIPOSYN 20% 95.65 401565 VOLTAREN 75MG TABLET 3.90 401566 WELLBUTRIN SR 150MG 2.25 401567 ZOCOR 5 MG TAB 7.55 401568 ZOLOFT 100 MG TAB 10.95 401569 CARAFATE SUS 1G/10ML 20.80 401571 MS CONTIN 30 MG 10.45 401576 ROCEPHIN 250MG INJ 11.35 401577 ZOFRAN 4 MG INJ 11.35 401578 ARTIFICIAL TEARS 10.40 401579 BLEPH 10% SOLN 188.50 401580 CYCLOPENTOLATE 1% 50.45 401581 EYEWASH 10.65 401582 ULTANE SOLN 28.55 401583 MIDODRINE 5MG TAB 10.10 401584 ZOVIRAX SUSP 10Z 87.25 401589 PURALUBE TEARS 14.60 401590 REFRESH TEARS 0.5% 29.25 401591 SANCTURA 20 MG TAB 10.70 401592 TRAVATAN Z .OO4% SOL 655.00 401593 VIGAMOX 0.5% SOLN 609.05 401594 LIDOCAINE VISC 2% 4.40 401595 HEPARIN 5000 INJ 2.25 401596 VERSED 2MG/WML 11.35 401600 NITRO DRIP 200MCG/ML 119.40 401603 VITAMIN A&D OINTMENT 9.95 401604 STARLIX 120 MG TAB 6.60 401605 STRATTERA 25MG CAP 20.25 401606 TAPAZOLE 5 MG TAB 1.70 401607 HEPARIN 10,000 INJ 27.05 401610 BACTRIM DS 1.55 401613 LIDOCAINE 5% OINT 926.95 401614 LOVAZA 1 GM CAPS 5.10 401615 MECLOFENAMATE 100MG 14.60 401616 MMR II RUBELLA VIRUS 261.55 401617 MORPHINE 10MG/ML INJ 11.35 401618 RENO-60 60% INJ 66.70 401623 TRIAMCINOLONE CREAM 17.25 401625 TOPROL XL 25 MG TAB 3.45 401626 TNKASE 50 MG KIT 14,587.10 401627 SALIVA SUBSTITUTE 7.05 401628 SOD BICARBON 650MG 1.55 401629 NIASPAN 500 MG TAB 13.10 401630 NIASPAN 1000 MG TAB 15.45 401631 CETACAINE SPRAY APP 244.05 401637 SELENIUM 2.5% LOTION 43.85 401638 SOD BICARB 8.4% SOLN 35.90 401639 MYAMBUTOL 400MG TAB 6.80 401640 ELIDEL 1% CREAM 522.45 401641 DIBUCAINE 1% OINTMEN 19.80 401642 CAPSAICIN CREAM .075 103.80 401643 ALDOMET 250 MG TAB 1.55 401647 MACROBID 100MG CAPSU 10.45 401648 AZACTAM 53.75 401649 CECLOR 375/5ML SUSP 89.05 401650 COLESTID 1 GM TAB 4.15 401651 CIPRO HC 0.2-1% SUSP 995.50 401652 NEO-SYNEPHR 10MG/ML 12.05 401653 KWELL 1% SHAMPOO 502.25 401654 MOTRIN 100MG/5ML SUS 2.65 401656 CEFOTAN 1 GM 142.65 401659 TIKOSYN 250 MCG 19.65 401660 NITROQUICK 0.4 MG 146.00 401661 TETANUS AND DIPTHERI 87.20 401663 CORTISPORIN OTIC SOL 311.10 401664 AMMONIA AROMATIC 6.20 401665 DURICEF 250MG/5ML SU 163.20 401667 MORPHINE PCA SYRINGE 19.10 401670 KETALAR 50 MG 19.65 401672 AMOXIL 400MG/5ML 9.50 401673 AREDIA 90 MG SOLR 531.20 401674 ATARAX 25 MG/ML 12.65 401675 AYR SALINE SPRAY 7.35 401676 BETADINE 10% SOLN 16.15 401677 BETASEPT SURG SCRUB 50.65 401678 B & O 15-A SUPPRETTE 12.40 401679 MAG CITRATE 6.20 401683 METHOTREXATE 2.5MG 12.05 401684 CHLORAL HYD 500MG/5M 3.40 401685 COLESTID 5 GM GRAN 5.85 401686 CRITIC-AID 20% PSTE 28.05 401687 CYTRA K CRYSTALS 3.40 401688 METHYLIN 5 MG TAB 1.70 401689 ERYTHROMYC TOP 2% 165.70 401690 ETHEZYME 830 OINT 175.80 401695 ZOLOFT 50 MG 9.25 401697 NIFEREX 1.95 401698 RELAFEN 500 MG TAB 4.80 401699 CENTRUM SILVER VITAM 1.55 401702 VERSED SYRUP 1 MG 3.90 401704 EYTHL CHLORIDE 108.10 401705 FORANE SOLN 13.35 401706 GLUTOSE 15 40% GEL 12.15 401707 IMMODIUM 1 MG/5ML 6.60 401711 D5 1/2 + KCL20 13.20 401714 NIX 30.85 401715 INAPSINE 2.5 MG/ML 14.05 401716 METHADONE 10 MG TAB 1.55 401717 EPIDRIN CAPS 2.70 401718 NITROPRESS 25 MG/ML 1,112.40 401721 TICLID 7.05 401722 MAXITROL 135.95 401725 POTASSIUM PHOS INJ 54.00 401728 ENSURE POWDER 37.70 401729 ATROPINE SULF 0.4MG 11.35 401730 PROCTOSOL 2.5% CREAM 254.95 401731 ENSURE LIQUID 5.60 401739 ENSURE 237ML LIQUID 5.60 401740 GLUCERNA SHAKE LIQD 6.80 401741 JUVEN/HMB 7.80 401742 NYSTATIN CREAM 30GM 81.10 401743 NYSTATIN OINT 15GM 54.05 401745 PAXIL TAB 20MG 8.60 401747 TOBREX OPHTH SOLUTIO 45.35 401750 ZITHROMAX IM 22.25 401751 OPTICROM 4 % SOLN 143.45 401752 PROVIGIL 200 MG TAB 27.05 401753 RESTORIL 7.5 MG CAP 37.15 401754 TWOCAL HN 1000ML 25.00 401755 TWOCAL HN 237ML 7.05 401756 ACTIDOSE AQUA 50GM 125.10 401759 NOVOLIN N INSULIN 2.55 401761 COUMADIN 7.5 MG TAB 11.45 401763 XENADERM 30 GM 238.60 401764 ZITHROMAX 100 MG/5ML 107.75 401770 HEP B VACCINE 211.80 401771 NOVOLIN 70/30 INSULI 25.50 401773 SODIUM CHLORIDE CONC 12.40 401776 BOUDREAUX BUTT PASTE 7.45 401777 ASACOL 400 MG TAB 9.50 401778 FEMARA 2.5 MG TAB 71.70 401780 ZANTAC 150MG GRANULE 36.45 401781 PREVACID CAP 15MG 23.05 401782 ZYRTEC 8.75 401783 NOVOLIN R INSULIN 2.55 401785 THORAZINE 100MG TABS 20.45 401787 SODIUM CHLORIDE 50ML 36.05 401788 FLEETS ENEMA 6.20 401789 NEURONTIN 300MG CAP 4.20 401790 ASCORBIC ACID 500MG 1.55 401791 PHENERGAN 25MG/ML 11.35 401794 MEGACE 400MG/10ML 13.10 401801 TORADOL 30MG/ML INJ 13.50 401802 ROCEPHIN 1 GM INJ 2.85 401803 TYLENOL 650 MG SUPP 3.10 401806 FLORINEF 0.1MG TAB 2.45 401807 NOVOLIN R SLIDING 11.35 401812 NITROGLYCERIN 0.4 PT 6.70 401813 GEODON 60 MG CAP 44.45 401814 ATIVAN 2MG/ML INJ 11.35 401818 ALUPENT 7.80 401821 COLCHICINE 0.6MG TAB 25.15 401822 DYNACIRC 5.10 401823 POTASSIUM 20 MEQ OS 16.75 401824 ACCUHIST PDX 276.30 401825 CORTEF 10 MG TAB 1.70 401826 THORAZINE 25 MG/ML 106.45 401833 ROCALTROL 0.25MG CAP 4.80 401835 AEROHIST TAB 5.35 401836 ANTIVERT 12.5 MG TAB 2.70 401837 ZONEGRAN 100 MG CAP 8.45 401838 THIAMINE 100 MG TAB 1.55 401841 LUVOX TAB 50 MG 9.80 401843 HUMALOG INSULIN 11.35 401845 VITAMIN D 400 CAP 1.55 401846 AGGRASTAT 0.25MG INJ 1,600.05 401848 DEXFERRUM 50 MG/ML 156.40 401849 HEP LOC 10UN/ML 10ML 1.45 401851 D10% 500ML 46.35 401852 RISPERDAL 1 MG 14.00 401854 LORIZEPAM 0.5MG TAB 1.55 401856 DAPSONE 25MG TABLETS 1.95 401859 D5W 1/2 NS +10 KCL 46.35 401860 BISAC-EVAC 10MG SUPP 3.10 401861 D10% 1000ML 28.30 401862 D5WNS+KCL 40MEQ 1000 56.65 401865 D5W GLASS 500ML 41.90 401867 RACEPINEPHRINE INH S 6.20 401868 CRCON 20 CAPS 4.80 401871 SANDOSTATIN 918.65 401872 APRESOLINE 10 MG TAB 1.65 401873 TRIPLE TEST 133.05 401874 TRYPTASE 004280 128.90 401876 LOVENOX 30MG INJ 5.55 401879 UNIPHYLL 400 MG 5.85 401881 NASONEX INHALER 17GM 705.00 401882 LEVAQUIN 250MG INJ 43.25 401884 AMITRIPTYLINE 25MG T 1.95 401885 FORTICAL 200UN 3.7ML 317.90 401886 FOSAMAX 35MG TAB 81.30 401890 LEVAQUIN 500MG IV PM 68.00 401891 RHINOCORT NASAL INHA 602.30 401894 DITROPAN XL 5MG TAB 12.65 401895 BUDESONIDE 20.55 401897 GENTAMICIN 0.3% O.O. 61.70 401898 GENTAMICIN 0.3% O.S. 67.05 401900 FOLIC ACID 5MG/ML 10 99.00 401902 LEVAQUIN 500 MG TAB 54.00 401904 FORTAZ 1 GM ADD-VANT 27.00 401908 GEODON 40 MG CAP 25.30 401909 GUAIFENEX PSE 600-60 1.95 401910 HIBICLENS 4% LIQ 473 86.40 401911 CHLORTHALIDONE 25MG 7.05 401912 ERYTHROMYCIN 500MG 282.25 401913 ZYPREXA 5MG TAB 39.90 401918 LOVENOX 60 MG INJ 5.55 401921 IBDOMETHACIN 50MG CA 2.45 401922 NEOSPORIN IRRIG 1ML 116.55 401929 ATARAX 25MG TABS 1.55 401930 PLENDIL 5MG TAB 4.85 401933 NS 0.9% IRRIG 500ML 46.35 401934 STERILE H20 INJ 20ML 11.35 401938 IMDUR 30MG TAB 5.15 401942 SULAR 18.55 401943 VICOPROFEN TAB 16.00 401944 D5WNS20KCL IV FLUID 45.00 401946 ACEBUTOLOL 2OOMG CAP 4.15 401947 FIORICET TAB 5.20 401951 SERZONE 100MG TABS 5.85 401952 MEPHYTON 5MG TAB 224.45 401955 MARINOL 5 MG CAP 43.85 401956 THEOPHYLLINE 100 MG 1.95 401960 SOLU MEDROL 40MG 22.30 401961 ZOCOR 20 MG 15.20 401963 SYNTHROID 0.075MG 1.70 401964 PYRIDOXINE 100 MG 56.35 401975 CLOTRIMAZOLE CR 1% 18.50 401977 DIOVAN 80 MG CAPS 13.50 401979 CARDIZEM 100 MG INJ 44.80 401980 LEVAQUIN 750 PREMIX 68.00 401981 FOLICACID 400MCG TAB 1.70 401989 PLAVIX 75MG 21.05 401990 FLOVENT INHALER 781.10 401991 APRESOLINE 20MG INJ 163.95 401992 PROCRIT 10 VIAL 846.40 401993 COMTAN 200 MG TAB 19.10 401994 CARBATROL 200 MG TAB 7.30 401999 NS 1000 +KCL 20MEQ 56.65 402000 CARDIZEM 25MG INJ 11.35 402009 GLUCOTROL XL TAB 5MG 2.20 402014 ATACARD 16MG TAB 12.65 402017 NACL 4MEQ/ML (100ML) 12.65 402018 CLEOCIN 600MG PREMIX 65.95 402022 COREG 12.5MG 5.95 402024 CATAPRES 0.2MG TABS 1.60 402026 ALPHAGAN 100.90 402028 FOLTX 3.65 402029 DIPROLENE CREAM 15 G 153.05 402030 FLOVENT 220 INHALER 1,213.25 402031 FLUVIRIN INJ VACCINE 57.05 402034 ZOCOR 10 MG TABS 8.60 402040 PANGESTYME CAPSULE 1.70 402041 ACYCLOVIR 500 MG INJ 69.75 402042 FLEXBUMIN 25% INJ 357.55 402045 ERYTHROMYCIN 161.20 402046 LOTENSIN 10 MG 3.65 402047 CARRAFOAM SC KIT 44.45 402050 AVAPRO 150MG TAB 11.80 402051 AVELOX 400 MG TAB 92.50 402052 ENALAPRIL 20 MG TAB 8.55 402053 LACTAID TABS 1.95 402054 ALBUTEROL 1.25MG NEB 6.20 402055 GLUCERNA 1.0 CAN 11.20 402056 NIZORAL CREAM 30GM 165.90 402057 AUGUMENTIN 15.60 402058 VITAMIN E CAPS 1.70 402061 ANZEMET 12.5MG INJ 36.00 402064 KRISTALOSE PACKET 25.00 402065 NORTRIPTYLINE10MGCAP 1.55 402070 PEPTO-BISMOL TAB 1.70 402076 ESTROGEN TOTAL 87.50 402078 LOVENOX 150 MG INJ 83.45 402080 TRIAMCINOLONE CR 11.50 402081 HYTRIN 4.95 402087 PROTONIX 40MG INJ 18.55 402088 HEPARIN PREMIX BAG 21.95 402089 D5W/LMD 500 ML 154.70 402090 LIDOCAINE PREMIX 46.35 402092 COZAAR 50MG 6.95 402099 ZINC SULFATE 220MG 1.55 402100 CLOSED TX SHOULDER 525.60 402101 MYCOPLASMA PNEUMONIA 59.00 402102 CLOSED TX SHOULDER CRNA 231.85 402103 CELLCEPT 200.60 402104 COZAAR 25MG 5.15 402107 CARRASYN V HYDROGE 3 68.70 402108 COREG 6.25 MG 5.95 402109 TUMS ROLL 6.20 402111 RETAVASE 10 MG INJ 18,126.05 402112 KCL 20 MEQ PREMIX 36.05 402113 KCL 10 MEQ PREMIX 36.05 402114 D51/2NS20KCL1000ML 56.65 402117 FOSAMAX 12.40 402118 PHOSLO 667MG 2.70 402123 AMOXICILLIN SUS 12.10 402124 D51/2NS40KCL 1000 ML 56.65 402125 NS 100 ML ADV 36.05 402126 NS 50 ML ADV 36.05 402129 PLAQUINIL 200 MG TAB 13.75 402132 DURAGESIC 100MCG PAT 243.25 402133 SINGULAIR 10MG TAB 17.45 402134 DEMECLOCYCLINE 150MG 29.10 402135 MOBIC 7.5 CAP 9.50 402136 NS 250 ML ADV 46.35 402137 D50% 500 ML 43.05 402138 D20W 500 ML GLASS 41.90 402147 EXELON 3MG TAB 15.75 402148 D5W 0.3NS 500ML 50.65 402156 SUDAFED 1.70 402158 HYDROGEN PEROXIDE 6.20 402159 D5W 50 ML 36.05 402160 D5W 100 ML 36.05 402162 D5W 250 ML 50.65 402164 BIAXIN 125 SUS 100ML 98.75 402167 AMARYL 4MG TAB 3.75 402168 COUMADIN 1MG TAB 1.90 402171 D5W 500 ML 46.35 402172 NS 40 KCL 1000 ML 56.65 402173 PREVALITE POWDER 5.85 402174 LR 1000 ML 56.65 402179 NAPROSYN EC 500MG 4.10 402181 CLEOCIN 600 ADD-VANT 38.85 402184 NS 250 ML 46.35 402185 NS 500 ML 46.35 402186 NS 100 ML 36.05 402187 ZOVIRAX 500 INJ 19.40 402188 MEGACE 397.00 402189 ARICEPT 24.05 402196 SERZONE LEVEL 129.65 402197 AMOX400/CLAV57 SUSP 116.65 402198 0.45 NS 500 ML 46.35 402199 ZINACEF 750 MG INJ 19.75 402201 DEPAKOTE 5.45 402203 ACTIGALL 300MG CAPS 9.80 402204 LEVAQUIN 25MG/ML VIA 174.50 402207 ZANAFLEX 4MG TAB 8.75 402208 NS IRR 3000 ML 56.65 402209 POLYSPORIN OINT 88.45 402212 MASTISOL LIQUID ADH 7.20 402215 CILOXAN OPTH SOL 2.5 26.55 402221 STERILE WATER 1000ML 56.65 402222 ACETIC ACID 1000 ML 56.65 402223 ORAJEL 13.00 402224 TOPROLXL 50M 3.45 402225 FLONASE NASAL SPRAY 232.55 402228 ANCEF 1GM ADD-VANTAG 5.65 402229 SYNTHROID 0.125MG 4.40 402230 NASACORT AQ 44MCG 474.10 402232 NS IRR 1500 ML 56.65 402233 SW IRR 1500 ML 56.65 402234 D51/2NS 500 ML 50.65 402235 LEVSIN TAB 1.80 402238 IMMUNODIFFUSION 63.35 402239 SEROQUEL 25MG TABS 11.65 402241 VASOTEC 1.25MG INJ 11.40 402242 TOBREX 80.0 MG 12.55 402243 GALANTAMINE 4MG TAB 10.95 402244 D5W 1000 ML 56.65 402245 LR 500 ML 46.35 402246 D5WNS 1000 ML 56.65 402247 VISINE DROPS 6.80 402251 SEROQUEL 100MG TABS 24.70 402256 D5LR 1000 ML 56.65 402257 D5W1/4NS 1000 ML 56.65 402258 KETOCONAZOLE SHAMP 96.45 402262 ETODOLAC 400 MG 4.80 402266 TAMIFLU CAP 47.75 402268 D5W1/2NS 1000 ML 56.65 402269 KALETRA 100-25 TABS 14.55 402273 LEVSIN 0.125MG TAB 1.95 402276 LOVENOX 40MG INJ 5.55 402277 DETROL 2MG 10.70 402278 AVANDIA 4MG TAB 16.85 402280 NACL 5% 500 ML 46.35 402281 ISOVUE 41% BOTTLE 328.25 402282 LEVOTHYROXINE 200INJ 166.95 402283 RETROVIR TAB 6.85 402286 CALTRATE +D 600 TAB 1.95 402288 PEPCID 20 MG IVPB PM 17.80 402289 VANCOMYCIN 1GM ADD-V 29.70 402291 INSULIN GLARGINE 100 49.95 402292 MAGIC MOUTHWASH 185.40 402293 VIT B6 50 MG TAB 1.55 402294 D5W1/2NS 30KCL 56.65 402295 NEUPOGEN 300 MG 965.40 402302 LARYNGOSCOPY 344.70 402304 VESICARE 5 MG 34.55 402305 ASP EC 81 MG TAB 1.55 402306 ASA EC 325 MG TAB 1.55 402307 FISH OIL 100 MG CAP 1.55 402309 HEPARIN FOR CVC 100U 14.05 402311 CARRASMART FOAM 4X4 35.15 402312 NICODERM 14MG PATCH 7.75 402316 KEPPRA 500 MG INJ 14.15 402317 ZOLOFT 50 MG TAB 1.55 402318 D5W NS +20 IV 1000 46.35 402319 D50 AMP 1.20 402321 ACCOLATE 20 MG TAB 6.10 402324 GARAMYCIN 80MG ADD-V 11.35 402328 PROSCAR 5 MG TAB 9.75 402329 D5W 1/2NS+10K 1000ML 56.65 402330 BICILLIN 1.2 INJ 583.50 402331 NORFLEX 60 INJ 68.60 402333 DAYPRO 5.85 402337 ZOVIRAX 400MG TABS 6.70 402339 VASOTEC 10 MG TAB 5.00 402343 WELCHOL 625 MG TAB 5.60 402344 PREDFORTE OPHTH 1% 170.90 402352 NEOSPRORIN TUBE 21.85 402353 PIROXICAM 10 MG CAP 10.10 402354 MORPHINE 2MG/ML INJ 11.70 402355 AMANTADINE SYRUP 16.60 402356 VOLTAREN 0.1% OPHTH 89.15 402359 VASELINE JELLY 13OZ 12.10 402365 TINACTIN POWDERS 20.80 402366 LORATADINE SYRUP 7.60 402367 METAMUCIL PACKETS 1.95 402369 COMBIVENT 929.65 402372 TPN ELECTROLYTES 20M 24.30 402374 TRICOR 15.90 402376 HALDL DEC 50 INJ 208.45 402377 PREMARIN 25 MG INJ 1,100.55 402378 JANUVIA 50 MG TAB 53.10 402379 1/2 NS 20 KCL 1000ML 56.65 402382 AMARYL 1MG TAB 1.55 402386 PROMETH/COD SYRUP 1.70 402387 FOSPHENYTOIN INJ 54.90 402389 HEP B IMMUNE GLOBULI 567.60 402390 ASPIRIN 300 MG SUPP 4.50 402391 EPIVIR 150 MG TABS 26.40 402393 GLUCOPHAGE 2.05 402394 PROZAC 10MG 9.80 402397 MS CONTIN 25MG TABS 12.15 402398 TRICYCLIC ANTIDEPRES 114.80 402400 RISPERDONE 0.25MG TA 12.00 402401 XYLOCAINE MPF 4% INJ 23.25 402402 EPINEPHRINE PF INJ 14.90 402403 HOMATROPINE 5% DROPS 142.40 402404 PILOCARPINE 4% SOLN 326.55 402405 TESSALON 7.70 402408 KLONOPIN 0.5MG TAB 2.20 402409 OXYCONTIN 20MG TABS 26.05 402410 LOVENOX 80MG INJ 5.55 402412 LABETALOL 200 MG TAB 10.75 402413 TOBRADEX OPHTH OINT 798.30 402414 CILOSTAZOL 50 MG TAB 5.60 402415 FLURBIPROFEN OPH SOL 27.00 402419 LEVBID ER 3.90 402420 PHENERGAN 12.5 MG TA 1.95 402421 MAG OX TABS 400MG 1.55 402422 APHTHASOL OINT 85.25 402424 NAFCILLIN 2 G INJ 81.55 402425 PROMETH SYRUP 6.20 402426 OXYTOCIN 10 UNIT INJ 11.35 402427 VASOPRESSIN INJ 17.25 402429 SALSALATE 2.45 402435 MAXIPIME 1 GM INJ 22.25 402436 INVANZ 1 G ADV 500.85 402437 LUDIOMIL 50 MG TAB 4.80 402438 KEFZOL 1 GM PM 36.05 402441 TIGAN 5.20 402443 UNASYN 1.5 GM ADV IV 35.75 402444 MAXZIDE 25 2.70 402446 CUBICIN 500 MG INJ V 1,651.70 402447 CLEOCIN 600 INJ 13.65 402448 HYDROCORTISONE 1% 14.80 402451 EMEND 40 MG CAP 265.00 402455 UNASYN 3 GM ADVANTAG 29.10 402456 ACCUPRIL 10MG 4.15 402458 PREGNANCY TEST URINE 24.45 402460 ESTRADIOL 0.5 MG TAB 1.70 402461 CHARCOAL EZ PELLETS 1,363.45 402462 CHLORASEPTIC 9.00 402463 CLINDAMYCIN 300MG IV 11.45 402465 ZOFRAN 4MG PO 68.85 402466 LITHIUM CARB 300 CAP 1.55 402467 0.9% NA CHLOR 1000ML 56.65 402468 SYNTHROID 88MCG 4.35 402472 BENADRYL CREAM TOP 12.45 402473 BICILLIN LA 600000 U 336.90 402474 HVA 24 HR URINE 260.80 402477 SANTYL 812.70 402478 ACETAMINOPHEN ORAL S 3.65 402481 SPORANOX 100MG CAPS 32.35 402484 POLYTRIM OPHTH SOLN 39.75 402485 XIFAXAN 200 MG 13.75 402486 CLINIMIX E 4.25/10 256.70 402487 BACTRIM SUSP UD 28.10 402493 TOBRADEX OPTH SOLN 588.25 402495 ELIMITE CREAM 382.40 402496 EMPTY EVAC CONT 1000 22.15 402497 XYLOCAINE 0.5% INJ 19.10 402498 VENTOLIN HFA INHALER 79.40 402499 AMPHOTERICIN 50 MG 140.90 402500 ALTACE 2.5MG 8.10 402501 UNIVASC 3.65 402505 REMERON 15MG TABS 3.20 402507 DETROL LA 4MG TAB 27.00 402508 PANGESTYME CN 20 CAP 6.80 402509 ABREVA CREAM 55.10 402510 COLYTE ORAL SOLN 159.55 402512 ALTACE 8.45 402515 CLAFORAN 1GM ADD-VAN 12.80 402516 NEURONTIN 400 MG 6.10 402519 GLUCOSAMINE SULFATE 1.95 402521 AMIODARONE 900 MG IN 52.60 402522 DEPAKOTE 125 MG CAP 4.35 402523 GLUCOTROL XL 2.45 402526 XANAX 1 MG 2.70 402527 ROCEPHIN 1GM ADD-VAN 3.45 402528 FLOMAX 0.4MG 13.00 402533 ARTIFICIAL TEARS SOL 19.65 402534 OXACILILN 1 GRAM INJ 44.80 402535 AMICAR 13.20 402539 SYNTHROID 0.112MG 2.05 402540 DECADRON NA PHO4 4MG 2.85 402543 ALLEGRA 180MG TAB 8.45 402544 BICITRA ORAL SOL 6.70 402545 CORTISPORIN OPTH ONT 200.95 402546 FAMVIR 250 MG TAB 19.50 402547 VITAMIN B1 WHOLE BLD 81.55 402551 EVISTA 60MG 26.70 402552 MELLARIL 10 MG TABS 1.95 402553 XALATAN OPHTH SOLN 294.35 402554 VITAMIN B2 269.25 402555 LIPITOR 40 MG TAB 17.70 402556 EPHEDRINE 50 MG 40.20 402557 ADRENALIN 1 MG SYR 16.90 402558 PROTOPAM 1 G INJ 321.45 402559 PROCAINAMIDE 500 MG 75.10 402565 BETAPACE 80 MG TABS 7.20 402567 DIOVAN 160MG TAB 11.50 402568 CA 15-3 143404 46.70 402569 BIO GLO STRIPS 6.20 402570 PROGESTERONE INJ 119.75 402571 SOD BICARB 22.90 402575 ZINC OXIDE OINTMENT 13.50 402577 COSOPT OPHTH SOLUTIO 208.50 402578 INVEGA 6 MG TAB 114.75 402579 NOVOLOG 102.15 402580 PROTAMINE 250 MG 130.15 402581 SULFASALAZINE 500 MG 1.70 402582 TETANUS & DIP 90.85 402583 VERAPAMIL 80 MG TAB 1.75 402584 PREMARIN 4.40 402585 NICODERM 21 6.60 402586 ALLEGRA 60MG CAPS 5.35 402587 AMPICILLIN 1 GM ADD 10.95 402588 MORPHINE TUBEX 4MG 11.70 402589 NEO-SYNEPHRINE 1% 15 11.70 402592 TERBINAFINE 250MG TB 45.30 402593 PANCREASE MT 10 CAP 5.10 402594 ISONAZID 300 MG TAB 1.60 402595 AMANTADINE 100 MG TB 7.80 402596 DEPO ESTRADIOL INJ 78.10 402597 SENNOKOT 1.55 402604 XYLOCAINE 1%+EPI 11.35 402605 MINOXIDIL 2.5 MG TAB 1.85 402606 ZADITOR EYE DROP 37.65 402607 FORTAZ 1 GM INJ 15.55 402608 ULTRAM 2.40 402609 GOLYTELY 71.05 402613 ROBITUSSIN AC 4OZ 1.95 402616 MIOCHOL OPHTH SOLN 196.95 402617 KEPPRA 250 MG TAB 1.80 402618 NORVASC 10 MG TAB 1.95 402619 D 25 AMP 31.00 402620 DEMADEX 2.50 402622 SINEMET CR 25/100 2.55 402623 CORDARONE 200MG TAB 10.45 402624 PRIMAXIN 500MG ADD-V 18.00 402627 MIRTAZAPINE/REMERON 10.10 402628 POV/IODINE OINT 10.20 402629 PRANDIN 0.5 MG TAB 23.85 402630 PREVACID 15 SOLUTAB 51.30 402631 PRIMAXIN 500 ADV 75.10 402632 TAMBOCOR 10.40 402637 AMOXIL 250MG/5ML SUS 16.40 402638 MIDODRINE 2.5MG TAB 3.70 402639 ROPINIROLE 0.25MG TA 7.70 402640 PREDNISONE 5 MG LIQ 4.10 402641 LIDEX CREAM 153.30 402642 CEFTRIAXONE 1 GM PM 71.70 402644 CATECHOLAMINES PLASM 114.25 402645 CATECHOLAMINES RANDO 114.25 402649 ESTAB PT COMPREHENSI 128.90 402650 TORADOL 30MG INJ 16.85 402653 CD4/CD8 T-HELP 7924 398.40 402655 TORADOL 60MG INJ 16.85 402656 JEJUNOSTOMY KIT 591.75 402661 BENADRYL 50 INJ 13.50 402662 PHENERGAN 25 INJ 13.50 402663 PORPHYRINS TOTAL SER 36.55 402665 HIV VIRAL LOAD 29273 376.15 402668 NASAL PAC 7.5 CM A/P 101.30 402673 BICILLIN LA 6M INJ 122.60 402674 TRANSPEC DEVICE 61.65 402676 HOMOCYSTEINE LEVEL 208.45 402677 M. PNEUMONIAE IGM AB 81.55 402678 BIPAP INITIATION/MGT 317.35 402680 CHANTIX 9.00 402681 AMIODARONE 900MG IV 101.85 402687 HEP C QUANTIFICATION 373.10 402689 UDS COLLECTION FEE 22.20 402690 H PYLORI IGG QN 52.65 402691 CHAIN OF CUSTODY UDS 179.45 402693 F202-IGE CASHEW NUT 53.40 402697 BICILLIN LA 2.4 INJ 21.35 402698 F369-IGE CATFISH 53.40 402700 24HR UR KETOSERIODS 51.75 402704 ANKLE FOOT ORTH 157.00 402705 UDS/MTD 92.30 402710 PCP GC/MS 071464 166.00 402712 CT NECK W & WO CONTR 1,426.55 402713 BZO GC/MS QNT 166.00 402714 ANTI GAD 251.00 402715 COC GC/MS URINE 166.00 402721 DEPOPROVERA 150MG IN 302.35 402722 GLUCOSE TOL 5 HR 111.95 402723 FACTOR X 086306 271.80 402726 AMP GC/MS 158.10 402727 BAR GC/MS 166.00 402728 ENDO CLIP APPLI 476.05 402729 URINE METH SCREEN GC 166.00 402733 FLU VACCINE 28.10 402736 URINE EOSINOPHIL 42.50 402737 CAUTERIZATION NASAL 211.30 402739 F003-IGE CODFISH 53.40 402740 CASTING TAPE 2X3 1/2 23.05 402741 F001-IGE EGGWHITE 53.40 402745 PNEUMONIA VACCINE 274.35 402746 F201_IGE PECAN NUT 53.40 402748 SEROTONIN SERUM 184.80 402749 GASTROSTOMY TUBE CHA 240.55 402750 ANA CENTROMERE 111.40 402751 PNEUMOCOCCAL VAC ADM 33.20 402752 CASTING TAPE 1X1 3/4 20.00 402753 MUGGA DOSE 266.15 402757 ROCEPHIN 1 GM INJ 13.50 402758 FLU VACCINE < 3YR OL 19.10 402760 PHOSPHOLIPID AB PANE 330.90 402761 CYSTS REMOVAL BACK 191.85 402762 PHOSPHOLIPIDS 001727 50.65 402763 MOLECULAR DX ISO/EXT 20.00 402764 0 VICRYL 36 TA 14.90 402765 MUGGA'S 1,154.80 402769 TETANUS DIP INJ 164.00 402770 GLUCOSE 2 HR PP 57.75 402771 PLATELET ASSOC IGG 548.60 402773 REMOVAL CYSTS FACE 382.15 402775 CAFFEINE 071258 58.75 402776 BONE SCAN LIMITED 705.15 402777 ALLERGY TEST SPECIFI 53.40 402781 AEROSOL TX 7.55 402782 KNEE SLEEVE W REMOVA 122.35 402783 10CM POWERGLIDE BASI 155.30 402785 CHOLINESTERASE SERUM 71.45 402786 MOLECULAR DX INTERP 20.00 402787 MOLECULAR DX SEPARAT 110.85 402788 MOLECULAR DX AMPLIFI 119.25 402793 PEAK FLOW 7.55 402795 10CM POWERGLIDE FULL 200.60 402797 SPYRO LACES 14.60 402799 ANTI YO AB 229.30 402800 ANTI-RIBOSOMAL P AB 45.00 402801 ANTIHISTONE AB 161.50 402804 COMFORT SHIELD 8.75 402805 GLUCOSE FINGERSTICK 7.55 402806 KNEE HINGED STABLIZE 169.95 402808 RAST #7904 204.25 402809 PNEUMOCYSTIS CARINI 142.90 402811 ANTI-J0 01 161455 262.25 402812 MRI LOW EXT JOINT WO 1,562.20 402813 KIDNEY W/FLOW & FUNC 949.85 402817 HEMATOCRIT 7.55 402818 MRI CERVICAL WO 1,562.20 402819 511SD DILAT TROCAR 191.30 402820 PROSTATE PROFILE 79.60 402821 MRI UP EXT JOINT WO 1,562.20 402825 S PNEUMONIAE ANTIGEN 231.30 402829 HEMOCULT 7.55 402830 NEW PT <1YR PHYSICAL 61.65 402831 CARB AG CA 19-9 88.65 402832 CYCLOSPORINE A (B) 121.60 402833 SKIN LES <0.5CM SCAL 382.15 402834 CCP AB IGG/IGA 148.25 402835 CA 27-29 74.30 402836 FACTOR IX INHIBITOR 213.80 402837 RBC ULTRA KIT 260.00 402841 PREGNACY TEST URINE 7.55 402842 CITRIC ACID 24HR UA 129.65 402843 CUSTOM STOCKING 186.90 402844 ALLERGY INJ 1 ONLY 8.75 402845 NON/IONIC CON CT 131.10 402846 ALLERGY INJ 2 0R > 17.40 402847 FACTOR X ACTIVITY 118.70 402848 PTT SUBSTITUTION EAC 304.40 402852 AMINOLEVULINIC ACID 74.80 402853 QUICK STREP 7.55 402856 ISOPRPOYL ACETONE ET 59.00 402857 NON/IONIC CON IVP 115.30 402858 FACTOR XI ACTIVITY 222.60 402859 QUETIAPINE (SEROQUEL 78.50 402861 CARDIOLITE 214.65 402864 PORPHOBILINOGEN UA Q 47.80 402865 TB SKIN TEST 11.50 402866 IRRADIATION 92.30 402867 PORPHYRINS FRACT URI 89.15 402868 BARBITUATES 72.60 402869 SWAL FUNC W/CINE/VID 208.20 402870 FACTOR II 175.25 402871 FACTOR V 222.60 402872 HEEL PAD SORBOT 59.95 402873 FACTOR IX 236.05 402876 HEP A IGM ANTIBODIES 43.05 402877 URINE DIPSTICK 7.55 402878 LEUKOCYTE FILTER PLT 90.25 402880 THC CONFIRM BLOOD 66.35 402881 ERYTHROPOIETIN 187.15 402882 CANNABINOIDS SERUM 256.90 402883 HEP BE AB 36.55 402884 WET MOUNT 14.35 402885 APRESOLINE 25MG TAB 1.55 402889 VENIPUNCTURE RHC ONL 7.55 402891 FACTOR VII 800599 236.05 402892 PROTEIN C ANTIGEN 262.50 402893 PROTEIN S ACTIVITY 65.55 402894 KOH PREP 14.35 402896 PROTOZOA UNSPECIFIED 46.95 402900 NEW PT BRIEF EXAM 64.10 402901 LAC REPAIR SIMPLE 53.40 402902 PREALBUMIN 016931 71.15 402906 MYELIN BASIC PRO CSF 196.65 402907 OLIGOCLONAL BANDS 170.80 402908 KNEE STABILIZER 224.80 402911 AMYLASE ISOENZYMES 101.30 402912 NEW PT LIMITED EXAM 88.90 402913 LAC REPAIR COMPLEX 115.05 402914 IMMUNO COMP PANEL 488.15 402916 FLUID URIC ACID 36.55 402917 IMMUNOFIXATION SERUM 189.60 402918 IMMUNOFIXATION OTHER 249.05 402920 PARENTAL TESTING 31.50 402923 STABILIZER W DONUT B 133.90 402924 NEW PT INTERMEDIATE 113.35 402925 LAC REPAIR INTERMEDI 76.50 402926 GABAPENTIN NEURONTIN 81.00 402927 VARICELLA Z IGG AB 68.05 402929 C1 INH ELISA FUNCTIO 142.65 402930 NEURON SPEC ENOL SER 154.70 402931 NEURON SPEC ENOL CSF 189.60 402932 KNEE PCL SUPPORT LG 132.25 402936 NEW PT EXTENDED EXAM 136.45 402937 SUTURE REMOVAL 24.45 402938 ECHO 2D W/WO M MODE 444.05 402939 COCAINE SERUM LEVEL 274.35 402940 HEP BE ANTIGEN LC 95.95 402941 VARICELLA Z IGM AB 72.60 402942 MUMPS IGM AB 160499 65.55 402943 MYCOBACTERIUM BY PCR 423.80 402944 OSTOMY POUCH 1" 4602 16.00 402948 NEW PT COMPREHENSIVE 161.20 402949 ENDOPATH TROCAR 512H 123.90 402951 PARATHYROID INTACT LC 131.10 402952 HEP BE AB 006635 50.05 402953 C1 INH QUANATITATIVE 68.05 402954 PTH N TERMINAL 131.10 402955 MOLECULAR DX DOT/SLO 93.40 402956 OSTOMY WAFER 2-3/4 10.45 402960 ESTAB PT BRIEF EXAM 32.35 402961 #G697G 6-0 ETHILON 14.90 402962 ECHO DOPPLER 584.10 402965 C1 QUANT 016824 133.90 402966 MOLECULAR DX NUC ACI 2.70 402967 MOLECULAR DX AMP NCM 93.40 402968 N-TELOPEPTIDE 126.95 402972 ESTAB PT LIMITED EXA 56.80 402973 CRICOTHYROTOMY CATH 410.50 402974 HEP PROFILE ACUTE 192.50 402976 Q C CULTURE 016774 102.45 402977 CYSTIC FIBROSIS ANAL 268.65 402980 MOLECULAR DX AMP TAR 141.50 402984 ESTAB PT INTERMEDIAT 65.05 402985 LUPUS PROFILE 395.60 402986 MOLECULAR SEP ID HR 70.65 402988 TUMOR MARKER HCG QNT 49.50 402989 CHLAMYDIA TRAC -LCR 111.65 402990 INJECTION RHC 14.05 402992 JEJUNOSTOMY TUBE 18F 465.40 402996 ESTAB PT EXTENDED EX 96.45 402997 NUCLEOTIDASE, 5 SER 86.60 402998 EXTRACTABLE NUCLEAR 483.65 403001 VQ LUNG 1,409.95 403003 RENAL SCAN 705.15 403004 RHC VISIT 30.65 403006 TOBRADEX OPHTH SUSP 293.60 403007 BSS PLUS IRR SOLN 201.40 403008 PHENYLEPHRINE OP SOL 46.40 403009 PROPARACAINE OPH SOL 135.55 403010 MARCAINE 0.5% INJ 11.35 403011 INTRAOCULAR LENS 1,593.95 403012 FLUCONAZOLE 100 PREM 67.50 403013 GARDASIL INJ 1,176.15 403014 BOOSTRIX VACCINE 147.15 403015 HAVRIX 720 ELU VAC 118.00 403016 PEDIARIX VACCINE 283.00 403017 PEDVAXHIB 94.50 403018 INFANRIX VACCINE 87.80 403019 MENACTRA VACCINE 430.75 403020 ROTATEQ VACCINE 306.90 403021 DEXAMETHASONE 4MG IN 14.05 403022 METAMUCIL FIBER PKT 1.55 403024 NS IRR 250 ML 46.35 403025 ST WATER IRR 1000 ML 56.65 403026 ARIXTRA 2.5 MG INJ 197.00 403030 BUMEX 2.5 MG INJ 19.45 403031 NS 50 ML MINIBAG 36.05 403032 CAPSAICIN CREAM 6.80 403033 POLY IRON 150 MG 1.55 403034 MIRALAX PWD 5.80 403035 DIBUCAINE 1% TOP 23.30 403036 VARIVAX VACCINE 451.95 403037 RETAVASE HALF KIT 9,062.80 403038 PREVNAR 13 688.00 403039 CRITIC AID CLEAR AF 30.40 403040 REMOVE DURAGESIC PT 6.20 403041 FLUZONE MDV 6-35MO 38.90 403042 TRIHEXPHENIDYL 2 MG 1.70 403043 NS 1000 ML IRR BTL 56.65 403044 LIDOCAINE JELLY 2% 24.10 403050 ATARAX 50MG/ML 8.35 403051 LIDOCAINE 1% 91.15 403052 ROCEPHIN 250ML 13.50 403053 HYPERTET S/D INJ 1,846.70 403054 ROCEPHIN 500 ML 13.50 403055 VIT B 12 INJ 39.20 403056 ZOFRAN 4 INJ 6.20 403057 GENTAMICIN 80 13.50 403058 NITROFURANTOIN 100 11.50 403059 BONIVA 3 MG INJ 559.10 403061 PRADAXA 150 MG CAP 14.90 403062 LOVENOX 300 MG INJ 947.45 403063 VANCO PER PHARMACY 14.05 403066 REQUIP 2 MG TAB 2.70 403067 LEVAQUIN 250 MG TAB 45.45 403069 AREDIA 90 MG INJ 13.30 403072 FLUZONE 36 MO + PFS 45.85 403075 UNASYN 1.5 GM VIAL 23.90 403076 COLISTIN 150 MG VIAL 120.15 403077 ROCEPHIN 2 GM 49.20 403078 ZOSTAVAX VACCINE 725.95 403081 TYGACIL 422.85 403082 NS 100 ML MINIBAG 36.05 403083 OCTREOTIDE 100 MCG 12.95 403084 AMIKACIN INJ 90.90 403085 PRADAXA 75 MG 24.75 403087 DEXTROSE 500 ML VIV 46.35 403088 ZOVIRAX OINTMENT 1,232.30 403089 TOPAMAX 25 MG TAB 6.50 403090 CLEOCIN ORAL SUSP 215.80 403091 NUTREN 1.0 FIBER LIQ 6.20 403092 TAMIFLU 6MG SUSP 506.80 403093 GLUCERNA 1.5 10.95 403094 GLUCOSAMINE 500 MG 1.55 403098 QUESTRAN PACKET 10.40 403100 CT UPPER EXT W/O CON 488.15 403101 IPPE MEDICARE 113.35 403102 OPTIMENTAL SUPP 103.15 403103 DIFLUCAN 400 MG INJ 46.35 403104 ANNUAL WELLNESS 1ST 119.25 403105 ANNUAL WELLNESS SUBS 59.70 403106 CT UPPER EXT W/CONTR 1,139.95 403108 OSMITROL 335.25 403109 MEDIHONEY 53.40 403110 DIPRIVAN 10MG/ML 65.30 403112 GEODON 20 MG CAP 71.30 403113 PHENYLEPHRINE 10% OP 148.30 403114 HYDROCODONE 10/325 T 1.75 403115 ALLERGEN SPEC QUALIT 43.30 403116 NORCO 7.5 MG TAB 1.90 403117 ALLERGEN SPEC IGG QN 68.20 403118 HLA-B (IR) 167292 426.40 403119 VERSED SYRUP UD 15.10 403120 HLA DRB1 (IR) 167259 468.00 403123 PROVENTIL NEBS 3.40 403126 CRITIC AID OINTMENT 30.30 403127 CRITIC PASTE 31.55 403128 UREA 20% CREAM 38.20 403129 NORCO 5 MG TAB 1.65 403130 VERAPAMIL 120 MG 7.15 403131 FORTAZ 2 G 40.80 403132 BRILINTA 90 MG TAB 21.80 403133 XYLOCAINE 0.5% MPF 46.65 403134 ERYTAB 250 MG 27.30 403135 AZACTAM 2 GM INJ 215.05 403136 NS 0.9% 1.55 403137 HEPARIN 50 UNITS/ML 46.35 403138 PROCAINAMIDE 1 GRAM 320.25 403139 LIPIDS 20% 171.25 403140 PEPTAMEN 1.5 26.15 403141 COMBIVENT RESP 1,130.30 403142 ATROPINE 0.5 MG INJ 30.80 403143 XIFAXAN 550 MG TAB 135.65 403144 ELIQUIS 2.5 MG TAB 25.90 403145 RABAVERT INJ 1,032.25 403146 AMINOCAPROIC ACID 24.30 403147 XARELTO 10 MG PO 51.80 403148 METHYLENE BLUE 10 ML 521.70 403149 VALIUM 2.5 RECTAL GL 870.10 403150 CREON 6000 5.00 403151 HYDROXYUREA 500 MG C 4.70 403153 ARICEPT 10 MG TAB 24.75 403154 ROBINUL 1 ML INJ 48.20 403156 MACROBID 100 MG CAP 10.90 403165 VFEND 200 MG INJ 604.50 403166 OXYCODONE 15 MG TAB 5.75 403167 ISOSOURCE 1.5 CAL 5.00 403168 RENVELA 800 MG 21.50 403169 ZIRGAN OPHTH GEL 1,058.20 403171 BOOST PLUS 4.35 403174 VASOLEX TOP 86.95 403175 FERAHEM 3,168.45 403176 AUGMENTIN 500 MG TAB 11.70 403177 ZOSYN 4.5 GM VIAL 50.95 403178 NEOSTIGMINE 1 MG/ML 170.20 403181 TROPICAMIDE 1% OPHTH 30.90 403182 DIABETISOURCE AC LIQ 9.50 403183 DALVANCE 500 MG INJ 5,690.65 403184 ZOSYN 3.375 GM ADV 38.20 403185 LACTIC ACID LOTION 72.25 403186 MORPHINE 25 MG/ML VL 11.35 403189 SODIUM THIOSULFATE 66.75 403200 CADMIUM 100.75 403201 PATH FROZ SEC 1ST 113.35 403202 PATH FROZ SEC ADDITI 41.05 403203 PATH EXAM SEL 88365 98.75 403250 C1 ESTERASE INHIBITO 59.00 403265 MORPHINE 4 MG INJ 11.35 403281 OCREVUS 300 MG 60,255.00 403289 PENTASA 500 MG CAP 17.35 403291 PEPTAMEN AF 27.70 403301 NEULASTA 6 MG 20,655.60 403312 FENTANYL 50 MCG/ML 11.35 403313 CATHFLO ACTIVASE 567.55 403314 TEFLARO 600 MG INJ 650.55 403324 PREMARIN CREAM 1,205.40 403331 GARDISIL 9 INJ 759.15 403351 FLULAVAL 63.75 403361 BENLYSTA 400 MG INJ 6,310.20 403362 BETADINE 5 % OPHTH 47.70 403363 ALBUMIN 1,112.40 403367 NUTREN 1.O 6.70 403384 ETHAMBUTOL 400MG TAB 5.15 403482 BENLYSTA 120 MG 1,893.15 403500 PATH TUMOR IMMUNOHIS 124.55 403501 PATH TUMOR IMMUNO 195.25 403550 CLOSED TX ELBOW 553.35 403552 TRUMENBA INJ 494.95 403553 ACTHIB VACCINE 59.05 403564 VFEND 50 MG TAB 74.65 403583 IMPACT 1.5 6.20 403587 NABI HB IMMUNE GLOB 2,485.70 403612 PROVAYBLUE 0.5% 691.30 403614 TROPICAMIDE 0.5% 80.20 403623 DURAMORPH 5 MG INJ 93.10 403638 WARFARIN PER PHARMAC 1.55 403673 NUTREN 2.0 6.20 403678 NUTREN PULMONARY 6.20 403681 SYNTHROID 100MCG INJ 403.25 403689 CEFPODOXIME 100 MG 20.80 403693 RECLAST 1,854.00 403702 ALLERGEN SPEC IGE QN 68.45 403762 BOOST GLUCOSE VAN 5.95 403763 BOOST PLUS SWB 4.35 403764 FIBERSOURCE HN 3.95 403800 CARB AB 19-9 SERIAL 88.65 403801 ENTYVIO 300 MG IV 21,740.20 403806 OFIRMEV INJ 148.85 403807 MARCAINE 0.75 % INJ 13.50 403808 MARCAINE 0.75% INJ 14.40 403809 VENOFER 185.40 403821 PROLIA 60 MG INJ 4,388.60 403822 ADRENALIN 1 MG VIAL 55.45 403823 PROTONIX GRANULES 53.20 403827 KETALAR 100 MG/ML 36.60 403862 MYCAMINE 100 MG INJ 693.40 403863 LINCOCIN 600 MG INJ 46.60 403900 T CELLS ABS/CD4 &CD8 220.00 404000 MORPHOMETRIC ANALYSI 177.80 404001 ANTITRYPSIN DEF DNA 686.55 404002 MULTIPLEX PROBE STAI 411.15 404015 OLANZAPINE(ZYPREXA) 81.55 404041 BARBITURATE SCREEN U 110.00 404043 BACTERIUM NOT ELSE S 60.95 405001 PREGABALIN 808320 238.35 405041 NEUTRALIZATION TEST 77.70 405042 TRANSCORTIN (CORTISO 82.70 405043 ESTRONE 114.70 406007 AMINO ACID PROFILE Q 10.70 406008 AMINO ACID 1 QUAN 73.40 406009 CALICUM URINE QUAN 17.15 406010 ORGANIC ACID ANALYIS 86.10 406011 CITRATE 120.90 406012 PHOSPHORUS URINE 22.50 406014 HAEMOPHILUS INFLUENZ 68.95 406070 ISOHEMAGGLUTININ TIT 37.15 406071 ISLET CELL AB 97.35 406072 IODINE 070034 71.45 407041 PROCARDIA ER 30 MG 4.50 408001 IN SITU HYBRIDIZATIO 199.60 409296 CAUTERY CONCEPT 32.75 409390 VACCINE 1 92.05 409391 VACCINE ADDITIONAL 12.40 409675 TRIMETHOPRIM 100 MG 2.25 409738 HAVRIX 1440 250.05 409739 ADACEL INJECTION 349.75 409740 IPOL VACCINE 118.05 409741 MENOMUNE VAC INJ 489.35 409742 TYPHIM VACCINE 271.25 412010 THYROID 1 GR 1.95 421272 CENESTIN 0.625 MG TB 11.80 429388 AIRWAY ADAPTER KIT I 89.50 430186 GRANIX INJ 1,482.80 436085 BEXSERO 1,191.20 444441 LACTULOSE 10 GM/15ML 2.50 450275 MEPITEL DRESSING 3X4 16.35 460001 ADVAIR INHALER 562.60 460002 ADVAIR 100/50 562.60 460003 NATRECOR 1.5MG-5ML 4,042.70 460004 LIBRIUM 5MG 2.50 460005 DOPAMINE PREMIX 122.15 460006 DOBUTAMINE PREMIX 87.80 460007 ASTELIN INHALER 472.40 460008 SEREVENT DIS 405.70 460009 ADVAIR 500/50 916.95 460010 DYNACRIC 5MG CAP 10.70 460012 ATROPINE SULFATE 1% 180.40 460017 FOSAMAX 70MG TAB 63.30 460018 ELOCON CREAM 186.90 460021 MIRALAX POWDER 3.60 460022 MINOXIDIL 10 MG TAB 4.80 460024 VITAMIN A 1.55 460025 PAXIL 25MG CR TAB 15.45 460026 EFFEXOR 75MG XR 14.40 460028 AGRYLIN 0.5MG TAB 34.50 460030 HUMALOG 75/25 INSULI 52.80 460031 LESCOL XL 80MG TAB 25.90 460034 VALTREX 500 MG TAB 22.30 460035 ZETIA 10MG TAB 31.75 460038 WELLBUTRIN XL 150MG 24.20 460040 EFFEXOR XZ CAP 42.55 460046 MICARDIS 40MG TAB 20.55 460047 INVANZ 1 GM VIAL 238.50 460048 ACTONEL 35 MG TAB 118.45 460050 GLUCOPHAGE 500MG TAB 2.15 460052 POLYMYXIN B INJ 47.05 460053 PANTOPRAZOLE SODIUM 12.60 460056 OXICILLIN 2GM INJ 10.95 460057 MERREM 500 INJ 10.80 460062 MEROPENUM 1GM VIAL 4.00 460063 POTASSIUM ACETATE 2 .60 460064 DEBROX OTIC SOL 6.20 460070 CANCIDAS INJ 156.15 460071 TOPAMAX 100 MG TAB 28.70 460078 DIAMOX 500 INJ 139.40 460079 NIACIN 500 MG 1.60 460081 EXELON 1.5MG CAP 12.80 460083 LIDODERMA 5% PATCH 28.95 460084 CEDAX 400MG CAP 60.95 460085 DAKIN O.5% SOLUTION 31.50 460087 PATANOL 0.1% OPTHSOL 1,016.55 460088 XOPENEX 1.25MG AMP 20.70 460089 ACTOS 45MG TAB 36.55 460091 CASODEX 50 MG 68.95 460093 EFFEXOR 75MG 6.75 460094 GEODAN 20MG 184.20 460095 ALPHAGAN P 606.85 460096 CIPROFLOX 0.3 OTIC S 393.90 460097 ETOMIDATE 20MG INJ 28.95 460099 MYLANTA SUSP 7.55 460100 NICOTINE 7 MG 24HR P 7.75 460101 LUMIGAN OPTH SOL 370.40 460102 KEPPRA 500MG TAB 17.15 460104 CRESTOR 10MG TAB 16.30 460106 SPIRIVA INHALER 292.05 460108 OPTIVAR OPTH SOL 554.35 460109 CALCIUM CARBO 500MG 1.95 460114 TRILEPTAL 150MG CAP 10.40 460117 ACULAR 0.5% OPTH SOL 150.55 460121 UROXATRAL 10MG TAB 77.60 460126 MORPHINE 8MG INJ 11.70 460128 CYMBALTA 60MG CAP 14.60 460129 TRAVATAN OPTH DROPS 426.25 460130 NEUT 4% SOL 5ML 29.10 460135 CLINDAMYCIN 900 MG 16.30 460139 AVODART O.5MG CAP 18.70 460140 ARIPIPRAZOLE TAB 5MG 120.40 460141 FORADIL INHALER 243.20 460142 ZOVIRAX 5%CR 5GM TUB 489.70 460143 FAMVIR 500MB TAB 54.60 460147 EPLERENONE 25MG TAB 25.90 460148 ZYMAR SOL 0.3% 294.05 460149 DESONIDE 0.05% CR 59.70 460151 PULMICORT TURBALR 744.65 460153 ACTIQ 400MG LOLLIPOP 87.80 460158 OMNICEF 125MG/5ML 165.50 460159 JEVITY PLUS LIQ 8 0Z 1.70 460163 PERIDEX ORAL RINSE 39.90 460164 ZYVOX 600MG TAB 390.35 460165 PAMINE 2.5MG TAB 8.45 460168 VYTORIN 10MG TAB 16.00 460172 TAZORAC 0.1% 30GM CR 511.55 460176 OMNICEF 300 MG CAP 16.25 460178 STALEVO 150MG TAB 11.50 460179 .9% SOD CHLORIDE IRR 56.65 460186 ZYRTEC LIQ 30ML 9.00 460190 FENTANYL TOP 12MCG/H 62.70 460191 FENTANYL 0.05MG/ML 11.35 460192 NITRO-BID 7.70 460195 ENABLEX 7.5MG RAB 20.55 460196 NOVOLOG 70/30 ING 53.00 460198 ASMANEX INHALER 327.55 460199 TRICOR TAB 8.45 460200 GENTEAL EYE GEL 13.95 460203 LYRICA 75 MG CAP 30.30 460204 LYRICA 50 MG CAP 30.30 460205 VYTORIN 10/40MG 16.00 460207 XOPENEX HFA MDI 210.75 460209 BACTROBAN 34.70 460210 CICLOPIROX 0.77% CRE 85.55 460212 COREG 25 MG 8.10 460213 LEVEMIR INSULIN 103.70 460214 LIPITOR 80MG 5.95 460216 ZYPREXA 2.5MG 34.50 460217 LISINOPRIL 4.05 460219 COREG 3.125 MG 6.50 460220 NAMENDA 10 MG 2.95 460221 ARICEPT 10MG 24.05 460222 ALLANDERM OINT 249.55 460225 MICARDIS 80 MG 20.55 460227 LOPRESSOR 25MG TAB 1.55 460234 PRELONE 15MG/5ML 44.60 460236 DEPAKOTE ER 250 MG 10.40 460237 RISPERDAL .5 MG 18.30 460241 HCTZ 12.5 1.95 460245 VITAMIN B12 1000MG 1.55 460247 CORTANE B DROPS 65.30 460250 PERCOCET 7.5/325 MG 8.40 460251 MUPIROCIN NASAL OINT 63.30 460252 RESTASIS 0.05% 14.60 460253 TEKTURNA 150MG 14.10 460254 OXYCODONE HCL 26.60 460256 DIGOXIN 0.125MG/2.5M 5.85 460257 .45 SODIUM CHLORIDE 56.65 460258 .3 SODIUM CHLORIDE 56.65 460259 RANOLAZINE ER 500MG 22.05 460262 AVELOX 400MG IV 47.30 460263 CHANTIX .5 MG 19.40 460267 JANUVIA 100 MG 26.40 460270 ZYVOX IV 600MG 164.80 460271 TAMIFLU SUSP 5ML 178.15 460272 SYNTHROID 200MG INJ 81.00 460273 BACTROBAN CREAM 386.05 460545 PARATHYROID SCAN 512.65 490008 DIAL A FLO REGULATOR 14.20 490016 I V FILTER #458 16.00 490024 ANESTHESIA SET 9.50 490032 Y BLOOD SET 16.85 490040 EXTENSION SET 5.60 490059 IV TUB SEC NEEDLELES 5.30 490067 DEAVER T TUBE 16FR 51.45 490068 NEUPOGEN 480 MCG 1,860.70 490075 TUBIGRIP SIZE L 13.75 490083 SMARTSITE W/NEEDLE 6.80 490105 ORAL AIRWAY 40M 2.20 490121 EXT SET STR 2ML/LL 9.00 490122 TUBING EXTENS DRAIN 8.16 490156 MED BIPAP MASK 71.55 490164 HALO 90 ULTRA ABLATI 3,709.70 490172 COMFORT SHIELD AMERI 12.65 490180 I V DRESSING 8.75 490199 IV ARM BOARD SH 2.25 490202 IV ARM BOARD LONG 3.40 490288 PRESSURE MANOMETER 57.75 490296 LMB SPRING PIP EXTEN 53.40 490318 SUBCLAVEN SET 25BOX 37.40 490326 ANKLE FOOT ORTH 2 157.00 490334 CUTDOWN CATHETER 7.05 490342 OXISENSOR ADULT 34.40 490350 OXIMETER SENSOR 35.45 490369 OXIMETER SENSOR INFA 43.85 490377 16FR FOLEY CATH 88.90 490384 PROPOFOL 100 ML 103.80 490385 70 MM ORAL AIRWAY 1.45 490393 DRESSING NON-AD 3X16 7.05 490394 DRESSING MEPILEX LIT 12.30 490415 SUCTION CATH. 14FR 2.10 490423 CEEA STAPLER 31MM 1,662.10 490431 SCAPLEL 11 ALTERNATE 5.10 490432 CROFAB 11,568.95 490435 THIGH STOCKING SM SH 27.70 490458 SALEM SUMP TUBE 16FR 8.45 490466 COUDE CATH. 12F 46.15 490474 FOLEY CATH 8FR 22.55 490482 FOLEY CATH 12FR 5CC 12.75 490490 22FR 3 WAY CATH 42.50 490504 FOLEY CATH TRAY 16FR 23.85 490512 SUCTION KIT 3.40 490520 LEG DRAIN BAG 12.39 490539 DRAINAGE BAG 12.05 490547 DRAINAGE BAG UR 23.05 490548 DOUBLE LUMEN TUBING 53.70 490549 FOAM ESI DRESSING KI 93.15 490555 MALE EXT. CATH 6.45 490563 MUCUS SPEC TRAY 5.80 490571 FEMALE CATH. KI 10.10 490598 UTILITY CATH 10FR 2.65 490601 SPINAL NEEDLE 20SX6 16.60 490628 DRESSING AQUA 6X6 84.10 490635 AEROSOL DRAINAGE SYS 9.50 490636 TRACH TUBE 5MM 5.75 490652 ENEMA BAG 4.80 490660 BULB IRR. SYRINGE 4.85 490679 SPUTUM COL SYS 6.50 490687 IRR TRAY W/BULB SYRI 7.25 490695 URINE CATCH KIT 3.70 490709 PED. URINE BAG 2.40 490717 SPECIMAN PAN 1.95 490733 DISP INNER CANNULA 126.00 490741 PHILLIPS URETER 8FR 193.00 490768 HEAVY DRAIN PACK 10.10 490776 ENTERNAL FEED TUBE10 23.05 490814 CATH PLUG 2.80 490857 CATHETER STRAP 13.20 490873 MEDIUM BACK BRACE 94.25 490874 MEDELA Y CONNECTOR 16.35 490903 TRACHEOSTOMY CARE TR 7.80 490938 VAGINAL IRR. TRAY 8.10 490954 6X8 TEGADERM 10.10 490955 5X5 GENTLE BORDER DR 10.90 490962 TIEMAN COUDE CATH 12 20.55 490970 8CM POWERGLIDE BASIC 155.30 490989 TRANSFER BELT LONG 25.00 491012 OSTOMY WAFER SUREFIT 9.35 491047 PLAIN PACKING STRIP 1/4x5 11.45 491055 TRANSFER STANDARD 15.90 491071 TRACH TUBE CUFFED 5 8.45 491098 HAND MITT 31.00 491101 16 FR FOLEY LATEX FR 13.40 491128 SUCTION CATH 12FR TV 2.45 491136 TUR SET 20 34.30 491144 CYSTOSCOPY IRR SET 17.40 491152 PELVIC BELT MED 47.80 491179 ENDOTRACHAEL INTUBAT 469.75 491187 YANKAUER SUCTIO 2.20 491195 SUCTION CANISTE 11.45 491209 CONNECT TUBE 6' 3.65 491225 NASOPHARYNGEAL AIRWA 12.45 491233 SALEM SUMP 8FR 25.35 491241 5.5 TRACH TUBE 8.45 491268 TRACH TUB UNCUF 4.5 5.75 491276 TRACH TUBE SHILEY 4 117.55 491284 KNOBBLE MASSAGE TOOL 29.55 491292 MONITORING ELECTRODE 2.70 491306 MONITOR ELECTRODE PE 1.25 491314 ORAL AIRWAY 60MM 2.20 491720 SOLUCORTEF INJ 32.10 491721 SCALPEL # 11 4.60 491748 FEED TUBE DECLOGGER 19.65 491756 DILITATION SYRINGES 144.35 491780 DISP. PUDENAL BLOCK 24.70 491799 MARLEX MESH 2X1 266.70 491802 KNEE SLEEVE X LG 43.30 491810 COLOSTOMY POUCH 3.65 491829 PETRO GAUZE TUBE 4.00 491830 PERFORATED DRAIN 66.35 491853 XEROFORM DRESSI 22.20 491861 STYLET PED. 5FR 16.85 491888 PETRO GAUZE 6X36 7.55 491896 BOVIE GROUND PAD 14.35 491918 EAR SYRINGE 1 0 6.50 491926 KNEE HIGH STOCKING 25.55 491969 RECTAL TUBE 5.40 492019 DEAVER T TUBE 8FR 37.70 492035 FEEDING TUBES 5.85 492043 BULB SYRINGE 3OZ 6.80 492078 SALEM SUMP 10 FR 12.15 492086 LINEAR STAPLER 55M 1,012.65 492094 UNDERPAD 9.25 492116 LACERATION TRAY 19.05 492159 4X4 STERILE GAUZE 6.00 492167 HEEL & ELBOW PAD 27.60 492191 HUBER NEEDLE 25.90 492205 DECUBITUS PAD 3 106.05 492248 BED PAD EGGSHELL 61.55 492264 WOUND SUCTION MED 125.75 492299 ELASTIC BANDAGE 2" 4.80 492345 IV START PACK 5.00 492353 SITZ BATH MEDIPK 10.95 492361 18 FR FOLEY LATEX FR 13.00 492388 AIRWAY ADAPTER KIT I 2 89.50 492396 HYDROGEL CLEAR 4X4 83.25 492418 AIRSPLINT FULL ARM 74.30 492426 NASOPHARYNGEAL 34FR 13.20 492434 NASOPHARYNGEAL 32FR 12.80 492450 NASOPHARYNGEAL 28FR 18.55 492469 POSY SELF-RELEAS BEL 30.90 492493 OSTOMY POUCH CL 8.75 492507 OSTOMY GASKET 14.60 492508 EAKIN RING 11.50 492523 HUBER NEEDLE WING 20 15.95 492531 FACE MASK INFANT 20.00 492558 POSEY SELF REL XL 42.15 492566 DISP. CIRCUMSCISION 104.95 492574 PLASTER BANDAGE 2" 8.45 492582 PLASTER BANDAGE 3" 8.75 492590 PLASTER BANDAGE 4" 12.90 492612 PLASTER BANDAGE 5" 9.00 492655 PLASTER BANDAGE 6" 10.10 492671 SM REG STOCKING 28.05 492728 STOCKING X-LG.-REG 16.70 492736 CONFORM BANDAGE 2" 2.10 492744 CONFORM BANDAGE 1 2.80 492745 AMYL NITRITE INH 2.20 492752 CONFORM BANDAGE 2 3.15 492760 CONFORM BANDAGE 3 5.00 492761 CYANIDE ANTIDOTE KIT 1,646.60 492779 ADAPTIC DRESSING 3X3 1.95 492787 ADAPTIC DRESSIN 4.80 492795 BIOPSY NEED 20G X5CM 68.05 492796 BIOPSY NEEDLE TEMNO 125.65 492809 #1407 NEBULIZER HUDS 7.05 492817 DUOFLEX WIREGUIDE 38.50 492818 SURGILUBE 9.30 492825 SURGICAL HEMOSTAT 226.10 492833 ENDOTRACHEAL TUBE MO 16.30 492841 4X4 GAUZE 10'5 5.85 492876 TRIPAQUE GZ 4X8 7.30 492884 KERLIX 2.60 492892 CASTING TAPE 4X3 1/2 37.70 492906 BREATH CIR PEDIATRIC 25.60 492914 BREATH CIRCUIT 14.50 492930 LUMBAR TRAY INFANT 66.05 492949 ADULT LUMBAR TRAY 50.05 492957 SUTURE 5.0 CHROMIC C 24.70 492973 OSTOMY WAFER 2 1/4 8.60 492981 WRIST LACE UP SH RTM 51.45 493007 SUTURE STRIP 1/4x3 3.95 493015 SUTURE STRIP 1/2x4 5.55 493023 TRACH TUBE 9MM CUFF 8.45 493031 OMNIFIX TAPE 23.05 493058 LMA DISPOSABLE 35.75 493066 TRACH HOLDER PEDIATR 18.00 493074 TRACH TUBE DBL CANNU 263.05 493104 SUCTION CATH 6FR 2.45 493112 GUIDEL AIRWAY 6.10 493120 CANNULA TRACH 6 145.45 493139 INTERTRACH CANNULA D 17.70 493147 TRACH TUBE 3MM CUFF 9.25 493155 ORAL AIRWAY 90M .90 493163 SKIN STAPLER & STAPL 142.90 493171 31MM HALO 360 ABLATI 3,246.80 493198 16-18 FEEDING TUBE 16.35 493228 TOE NAIL REMOVAL TRA 198.10 493244 TRACH TUBE 5.5M 5.45 493260 POSEY MED. VEST 43.30 493279 HEMI ARM SLING 74.30 493317 TUBIGRIP EB SIZE J 10.40 493333 IV BURETTE NEEDLELES 18.95 493376 TODDLER MASK SZ 3 8.45 493384 FACE MASK ADULT 13.25 493392 SURGICAL MARK P 9.00 493393 SURGIWAND 2 W/ CAUT 350.20 493406 VAGINAL SPECULUM 13.45 493414 SIGMOIDOSCOPIC SUCTI 21.95 493422 HULKA CLIP 119.65 493430 #774G 6-0 PLAIN GUT 31.75 493449 BOVIE PENCIL 50 11.90 493457 KNEE IM W/PATEL 16" 102.70 493465 ELASTIC WRIST ORTHOS 59.45 493473 WRISTLET W/THUMB 65.80 493481 ENDOTRACH NAS TUB 7M 17.35 493503 ENDOTRACHEAL TU 20.55 493511 TUBIGRIP EB SIZE D 5.85 493546 PROSTAT SUPPL CHERRY 6.20 493562 AIRWAY SUPRAGLOT 2.5 91.15 493589 SUTURE TRAY 37.15 493600 LACERATION BASIN 30.40 493619 THROAT IRR TRAY 7.55 493627 TRACHEOTOMY TRAY 33.75 493635 MATTRESS VINYL STATI 79.60 493643 VENESECTION TRAY 30.40 493651 EZM PERCU GUIDE 506.45 493678 EYE TRAY 8.45 493686 EAR TRAY 8.45 493687 INDIGO CARMINE 30.45 493694 SALEM SUMP 14 FR 14.35 493708 TEGADERM DRESSING 13.20 493724 BONE MARROW TRAY 33.75 493732 THORANCENTESIS TRAY 34.55 493767 RAPE TRAY 30.40 493783 LSO BACK BRACE MED 89.00 493791 FINGER SPLINT 1 1/2x9 8.10 493805 MRI DUAL LUMEN 9.5 1,943.70 493813 ENDO TRACH TUBE 7.5 21.65 493814 ENTROPIAN REPAIR 3,062.20 493815 ENTROPIAN REPAIR CRN 273.15 493821 EAR IRRIGATION TRAY 14.90 493856 URETERAL DRAIN SET 106.05 493864 NASAL PACKAGE TRAY 8.45 493872 CAST REMOVAL TRAY 45.55 493937 3224 STOMA POUCH 2" 9.00 493938 SENSOR PAD SINGLE US 54.35 493939 3226 STOMA POUCH 3" 9.00 493945 SPUTUM VEST XL 182.30 494003 OSTOMY POUCH 41/2" 4.15 494030 PORTEX SUCTN CATH 8 2.60 494054 RIB BELT MALE 64.35 494062 0 ETHIBOND 18 7.55 494070 4X4 GAUZE STERI 13.75 494089 LATEX FREE 14FR FOLE 19.65 494097 ENSURE STRAWBERRY 6.80 494100 WAL-PIL-O NECK 110.25 494127 3M SURGICAL MASK 54.35 494135 TRACH TUBE 3MM UNCUF 5.60 494143 TRACH TUBE 4MM UNCUF 5.75 494151 VAGINAL SPEC SMALL 12.40 494178 THUMB ORTHOSIS 39.10 494186 VEIN STRIPPER C 48.10 494194 5-0 ETHILON 28.95 494196 KNEE BRACE 123.45 494197 CYSTOMANNOMETER 48.10 494199 TEGADERM 2X2 1.20 494200 4-0 VICRYL TAPE 14.60 494201 HALO 60 ABLATION CAT 2,899.35 494202 HALO CAP SMALL 88.65 494203 #888760831 4-0 DEXON 17.40 494208 FINGER SPLINT FOAM 1 26.95 494216 SUGGS IRR. CATH 84.40 494224 LARYNGEAL STANDARD B 89.50 494232 TRACH HOLDER ADULT 15.30 494240 #L112G 3-0 CHROMIC 15.45 494259 AIRWAY SUPRAGLOTTIC3 69.45 494267 PCAY CONNECTOR SET 23.90 494275 PCA EXTENSION SET 10.10 494283 BLOOD SET (PUMP 37.15 494291 IV TUB PRIM NEEDLELE 15.15 494305 IV TUBING SECONDARY 7.30 494321 TRACH TUBE CUFFED 3 15.75 494348 3.5 FR URI CATH KIT 68.50 494364 4.5 CUFFED TRACH TUB 8.45 494372 FEEDING TUBE 8F 3.65 494380 POSEY TORSO SUPP XL 62.40 494399 POSEY TORSO SUPP XXL 66.35 494410 SHORT ARM CAST 59.45 494496 ARM SLING CRADL M 18.00 494518 #9061G 10-0 ETHILON 59.45 494542 NASOPHARYNGEAL 24 FR 13.50 494550 METACARPAL SPLINT 52.90 494577 ARM SLING POUCH S 8.10 494585 WRIST&FOREARM CH-LEF 33.75 494593 WRIST & FOREARM PED 39.90 494615 ANATOMICAL MASK 14.90 494623 ANKLE FOOT ORTHOSIS 85.65 494712 TROCAR W DILAT TIP 141.50 494720 CAST BOOT XLG 38.50 494739 PICC STAT LOCK +ANC 20.35 494755 STYLET ADULT 14FR 10.30 494800 NEOPRENE ANKLE SM-SU 43.30 494802 HEMOVAC SUB 76.80 494807 DEAVER T TUBE 18FR 29.55 494808 BLOOD SET W/PUM 18.55 494809 12 FR SALEM SUMP 12.15 494810 TEMPUR FOAM BLUE MED 5.60 494811 MED WALK HEELS 11.50 494812 10 FR FOLEY CATH LAT 13.30 494814 TEMPUR FOAM PINK SOF 5.60 494815 TIB FIB CHILD K 168.80 494818 TIB FIB YOUTH H 199.45 494819 CUT LOOP ELECTR 223.65 494820 SERPETINE SMALL 18.55 494821 POSEY X-LG. VES 44.15 494822 SACRO LUMBAR SU 71.70 494825 SHOULDER IMMOBILIZER 122.70 494826 RIB BELT FEMALE 23.05 494827 RIB MELT MALE 20.55 494828 ABDOMINAL BINDER 46-62 36.45 494830 4-0 NUROLON 18 22.20 494831 2-0 STAINLESS STEEL 18.85 494832 DUROFLEX WIRE GUI 35 45.85 494836 TRACH TUBE UNCUF 3.5 5.75 494837 FINGER SPLINT 4 13.75 494839 FINGER SPLINT W/VELC 29.55 494840 PICC LINE 3FR KIT 402.65 494841 FACE MASK ADULT LG 18.30 494842 TRACH TUBE CUFFED 4 15.75 494844 SMALL DRESSING 8.10 494845 MEDIUM DRESSING 10.10 494846 LARGE DRESSING 14.05 494847 2-0 SILK 48.10 494872 VON WILLEBRAN ANTIGE 247.35 497016 VASOPNEUMATIC DEVICE 49.25 500007 FORTAZ 500MG 24.45 500012 DILANTIN 50MG CHEW 3.65 500013 LOVENOX 10 5.55 500014 REMICADE 10 MG 433.05 500070 VICRYL 13.75 500089 2-0 VICRYL 18 57.75 500097 #J259H 2-0 VICRYL 10.10 500100 2-0 ETHILON 22.20 500105 TRACH TUBE 3.5 8.45 500106 TRACH TUBE 4.5 8.45 500119 #664H 2-0 ETHILON 12.10 500127 #663H 3-0 ETHILON 8.10 500135 #662H 4-0 ETHILON 8.25 500143 661-H 5-0 SUTURE 8.65 500151 697-G 6-0 ETHILON 21.05 500178 #1665G 6-0 ETHILON 12.35 500186 #1696G 7-0 ETHILON 21.05 500194 #5A86G SILK SUTUPAK 13.20 500208 #680H SILK SUTURE 5.85 500216 #K835H 1-SILK 10.95 500224 #5A 67 G SILK SUTURE 24.20 500232 2-0 SILK SUTURE 11.20 500240 #CO22 T SILK SUTURE 41.05 500241 6 FR ET TUBE STYLET 9.70 500267 #K833H 2-0 SILK 5.75 500283 #685H 2-0 SILK 10.95 500291 #K8323H 3-0 SILK 6.25 500305 #622H 3-0 SILK 11.80 500313 #5A 64 H SILK SUTURE 7.05 500321 #684H SILK SUTURE 7.05 500380 #629H SILK SUTURE 8.10 500399 #C014T 4-0 SILK 45.30 500402 #K871H 4-0 SILK 10.40 500410 #5A63H 4-0 SILK 13.50 500429 #621H SILK SUTURE 5.85 500437 #719 G SILK SUTURE 6.10 500445 #682G SILK SUTURE 7.30 500461 #K880H SILK SUTURE 6.10 500488 #706 G SILK SUTURE 24.20 500518 #C522 G NUROLON SUTU 24.70 500526 #692H DERMAL SUTURE 5.85 500534 #812-H CHROMIC 11.75 500542 #813H CHROMIC 12.35 500550 1 CHROMIC GUT 10.40 500569 #G123H 2-O CHROMIC 11.20 500577 #837 H CHROM SUTURE 11.50 500585 #G122H 3-0 CHROMIC 11.55 500593 #G181H 4-0 CHROMIC 16.00 500607 #G121H 4-0 CHROMIC 11.50 500615 #5114H CHROM SUTURE 7.30 500623 #818H CHROM SUTURE 4.15 500631 #5113H CHROM SUTURE 7.05 500658 #816H 2-0 CHROMIC 12.90 500666 #991H CHROM SUTURE 5.85 502573 NEPHROVIT 1.60 520004 2-0 CHROMIC GUT 10.40 520012 #932H CHROM SUTURE 4.15 520020 #962H CHROM SUTURET 4.15 520039 #990H CHROM GUT SUT 15.75 520047 #793 G CHROMIC SUTUR 39.10 520055 #855H PLAIN GUT SUT 7.05 520071 #898H PLAIN GUT SUTU 8.75 520098 #5103H PLAIN GUT SUT 7.30 520144 #N863H 2-0 PLAIN GUT 16.30 520152 #H823H PLAIN GUT SUT 8.10 520160 #843H PLAIN GUT SUT 7.30 520179 3-0 PLAIN GUT 2 11.50 520187 3-0 PLAIN GUT 14.05 520195 #899H PLAIN GUT SUTU 7.30 520217 #5102HPLAIN GUT SUT 7.30 520225 1L102G PLAIN GUT SUT 7.30 520233 #5101H PLAIN GUT SUT 7.05 520241 4-0 PLAIN GUT 2 13.50 520268 #8434H PROLENE SUTUR 10.10 521000 ABDUCTION PILLOW 6 106.90 530018 #84234 PROLENE 9.30 530026 #8422H PROLENE SUTUR 7.05 530042 #8683H 4-0 PROLENE 14.05 530050 #8661G PROLENE SUTUR 10.10 530069 #5526G SURG STEEL SU 22.75 530077 ABDOMINAL BINDER 60-75 79.90 530085 #5530G SURG STEEL SU 22.75 530093 3-0 PLAIN GUT T 12.10 530100 G8983 BODY POS D/C .00 530101 G8984 CARRY CURRENT .00 530102 G8985 CARRY GOAL STA .00 530103 G8986 CARRY D/C STAT .00 530104 G8987 SELF CARE CURR .00 530105 G8988 SELF CARE GOAL .00 530106 G8989 SELF CARE D/C .00 530107 #7756-61 DEXON SUTUR 9.00 530108 G8990 OTHER PT/OT CU .00 530109 G8991 OTHER PT/OT GO .00 530110 G8992 OTHER PT/OT CU .00 530111 G8993 SUB PT/OT CURR .00 530112 G8994 SUB PT/OT GOAL .00 530113 G8995 SUB PT/OT D/C .00 530114 G8996 SWALLOW CURREN .00 530115 #7267-71 DEXON SUTUR 4.15 530116 G8997 SWALLOW GOAL S .00 530117 G8998 SWALLOW D/C ST .00 530118 G8999 MOTOR SPEECH C .00 530119 G9186 MOTOR SPEECH G .00 530120 G9158 MOTOR SPEECH D .00 530121 G9159 LANG COMP CURR .00 530122 G9160 LANG COMP GOAL .00 530123 #7002-51 DEXON SUTUR 4.15 530124 G9161 LANG COMP D/C .00 530125 G9162 LANG EXPRESS C .00 530126 G9163 LANG EXPRESS G .00 530127 G9164 LANG EXPRESS D .00 530128 G9165 ATTEN CURRENT .00 530129 G9166 ATTEN GOAL STA .00 530130 G9167 ATTEN D/C STAT .00 530131 #7216-41 DEXON SUTUR 4.15 530132 G9168 MEMORY CURRENT .00 530133 G9169 MEMORY GOAL ST .00 530134 G9170 MEMORY D/C STA .00 530135 G9171 VOICE CURRENT .00 530136 G9172 VOICE GOAL STA .00 530137 G9173 VOICE D/C STAT .00 530138 G9174 SPEECH LANG CU .00 530139 G9175 SPEECH LANG GO .00 530140 G9176 SPEECH LANG D/ .00 530158 #7229-31 DEXON SUTUR 5.85 530166 5-0 DEXON 14.05 530174 EASYCAP AIRWAY DET P 39.40 530182 LIGACLIP MED. 10.95 530190 NASAL CO2 ADULT SAMP 77.25 530298 COMBITUBE KIT 151.40 530299 HIP ABDUCTION LEFT 186.45 530300 HIP ABDUCTION PELVIC 261.65 530301 HEEL & ELBOW SMALL 17.30 530302 TEGADERM 2 3/8 2 3/4 1.85 530328 STOCKING S THIGH OPT 287.85 530336 BIPAP VISION DIS CIR 22.50 540005 KNEE STABILIZER X-LG 153.35 540021 HEEL M B WONDERZORB 82.45 540064 TRACH TUBE 2.0 UNCUF 5.85 540080 HEEL LARGE BLUE 82.45 560000 SPINAL NEEDLE #842 10.10 560001 LIGACLIP MED-LG 33.45 560002 FIBEROPTIC ADAP 52.65 560003 CATH WORD BARTHOLIN 79.60 560004 MEPITEL 2X3 DRESSING 14.60 560005 #G695G 5-0 ETHILON 14.70 560006 4-0 VICRYL 18 23.05 560007 J215-H 3-0 VICRYL 13.20 560008 TUBIGRIP SIZE 3 5.92 560009 NEEDLE GUIDE COVER K 58.75 560010 HALO CAP MEDIUM 88.65 560011 HALO GUIDE WIRE S 275.45 560012 CONNECT TUBE 18 2.20 560013 KNEE STABLIZER XLG 124.30 560014 KNEE STABLIZER XXLG 124.30 560016 #C045G 0-SILK 46.70 560017 SACRO LUMBAR SUPPORT 110.85 560019 FILTERED EXT SET 1.2 22.20 560020 STYLET 10 FR 14.25 560021 MEPILEX 6X6 DRESSING 24.09 560022 12 FR FOLEY CATH 15.15 560023 PORTEX SUCTN CATH 10 2.20 560024 POSEY SM.VEST R 43.05 560026 EYE SHIELD ALUMINUM 7.05 560027 ENTERNAL FEED BAG 18.30 560029 3-WAY CATH 18FR 36.85 560032 PED AEROSOL MASK 5.10 560035 TIEMAN COUDE CATH 20 21.05 560037 FLUID TOTALPROTEIN 34.55 560039 MECLIZINE SERUM 151.40 560040 WEST NILE VIRUS 200.60 560041 HSV 1 IGM 81.90 560044 HSV QUANTIFICATION 203.10 560047 UMBILICAL TAPE 9.00 560049 10 FR LATEX FREE CAT 4.65 560050 FLUID LDH 100156 34.55 560051 PED O2 MASK ELONGATE 9.00 560052 TROCAR CATH 28 FR 49.15 560054 VITAMIN B-6 004655 107.50 560055 CT LOWER EXT W/CONTR 829.75 560057 14 FR LATEX FREE CAT 3.90 560060 ANTI SS A/ANTI SS B 143.45 560062 OXYGEN TUBING 2.60 560063 FLUID AMYLASE 088062 38.25 560064 PED 02 MASK ELONG HI 15.75 560065 NASOPHARYNGEAL 14F 13.50 560066 TOXO AB IGM 096651 86.35 560068 BENECALORIE 4.40 560069 ANTISCLERODERMA-70 74.30 560072 OSTOMY POUCH 2 3/4 H 8.75 560073 NASOPHARYNGEAL 18F 13.50 560074 #888676134 4-0 DEXON 17.95 560075 EZ -IO 45MM NEEDLE 281.40 560077 FLUID PH 011254 36.00 560078 TRACH SUCT SYS SUPPL 65.80 560081 TEGADERM LARGE 5.85 560082 GLUTEN AB 36.00 560086 MYOGLOBIN URINE 82.95 560087 4-0 DEXON 18 C 19.10 560088 IV ARM BOARD PED 1.70 560089 BAIR HUGGER FUL 20.60 560090 VAGINAL CULTURE 136.75 560092 PARVO VIRUS B19 IGG 59.45 560093 PARVO VIRUS B19 IGM 111.65 560094 VITAMIN K 326.65 560095 VORICONAZOLE 700353 579.65 560096 CHEMILUMINESCENT 67.00 560098 OP VISIT 110.55 560099 EYE PRESS PATCH 19.35 560100 POWER GLIDE CATH DRE 19.10 560102 AQUACELL DRESSING 39.40 560103 KNEE BRACE HINGED CI 176.95 560104 KNEE BRACE MED WECAR 347.75 560107 G8978 MOBILITY CURRE .00 560108 G8979 MOBILITY GOAL .00 560109 G8980 MOBILITY D/C S .00 560110 G8981 BODY POS CURRE .00 560111 ENDOPATH NEEDLE120MM 117.25 560112 G8982 BODY POS GOAL .00 560113 POSEY SELF REL WRAP 41.90 560114 TRACH TUBE SHILEY 5 117.55 560115 MITROCHONDRIAL AB 52.35 560116 KLEIHAUER-BETKE STAI 70.05 560117 NBT 211.30 560118 SINEMET 3.50 560119 MITROCHONDRIAL M2 AU 132.80 560121 68 KILO DALTON PROTE 49.50 560122 NAPHTHALENE URINE 176.20 560126 EZ STABILIZER 57.25 560128 LARYNGEAL CHANNELED 72.30 560129 VENOUS BIL EXT PHYSI 215.25 560130 DTPA DOSE 229.60 560132 NATURA KILLER CELLS 204.55 560137 IV ARM BOARD PE 3.15 560138 LATEX FREE 10 FR FOL 18.55 560139 COMPRESS EDEMA GLOVE 46.15 560140 HUBER NEEDLE 22X3/4 13.35 560141 LARYNGEAL MASK #4 45.00 560143 DTPA LUNG DOSE 271.80 560149 FEATHER ECONOMY REAC 32.90 560150 XEROFORM PETRO DRESS 6.10 560151 DEWRAP 3-LAYER COMPR 36.25 560152 FRUCTOSAMINE 100800 47.80 560153 WRIST SUPPORT M 119.25 560154 ARTERIAL STUDY W/EXE 321.30 560155 MAA LUNG PERFUS DOSE 418.40 560156 LEUK/LYMP EVAL TISS 79.60 560163 825 TRACH TUBE CUFFE 8.75 560164 ENDOPATH DISSEC 397.60 560165 NEOPRENE KNEE OPENXL 53.40 560166 LAP SPONGE 7.25 560167 CHOLETEC HIDA DOSE 63.10 560173 ENDO PROBE MONO 68.05 560174 METATARSAL CUSHION S 32.35 560175 SUTURE DEXON S BGE 18.85 560177 CONNECT 5 IN 1 STERI 4.80 560178 TROPONIN QUANT 101.00 560179 SULFUR COLLOID 129.40 560185 SKIN STAPLER LD 660.70 560187 IODOFORM PACKING STR 1/2 12.65 560188 OTHER OUTPATIENT VIS 311.05 560189 INJECTION 165.90 560191 TC PERTECHNETATE 266.15 560193 TROP I SKBL 93.15 560197 LAP CHOLANGIOGR 125.30 560198 US GROIN W/VAS DUP 259.65 560199 NU GAUZE 1/4" IODOFO 12.25 560200 PRIM ALTERNATE #1528 20.55 560201 5-0 DEXON 18 P 29.25 560202 ABDOMINAL PAD 5X9 DE .75 560203 HDP BONE DOSE TECHNE 56.80 560204 US GROIN NON VASCULA 193.25 560205 EDUCATION SUPPLIES 76.25 560211 URINE METHADONE 110.00 560212 STOCKING MD-LONG OPE 268.15 560213 SUPRAPUBIC INTRODUCE 175.05 560214 DX ANKLE BRACE LARGE 63.35 560217 URINE METHADONE W CO 240.80 560219 METANEPHRINES PLASMA 295.95 560220 METHANOL SERUM017699 49.50 560221 IONTOPHORESIS E 36.55 560222 N-METHYLHISTAMINE UA 82.95 560223 HYDROCODONE SERUM 125.25 560224 HYDROCODONE 847279 110.00 560225 A B I 371.65 560226 HYDROCODONE 808028 332.85 560227 METHADONE SER 007781 77.35 560228 MMT BODY EXC HANDS 80.45 560229 CONNECT TUBE 10 3.90 560236 RENTAL BED 163.75 560237 LOWER ARTERIAL STUDY 371.65 560239 STOOL PH 79.30 560240 MMT BODY INC HANDS 101.00 560241 STOOL REDUCING SUBST 65.05 560242 RENTAL AIR MATTRESS 89.50 560243 CPM RENTAL 374.20 560244 PH & REDUC SUB STOOL 25.90 560245 FIBRINOGEN FDP 44.45 560246 MAX VOLUNTARY VENTIL 82.95 560248 RESOURCE HI PRO ORAN 1.55 560250 FECAL FAT QUANTATIVE 210.75 560252 CONTRAST BATH 15MIN 70.35 560258 TOTAL VITAL CAPACITY 88.05 560260 BASIC METABOLIC PANE 131.95 560261 VITAMIN E 070140 99.30 560262 STRONGYLOIDES IGG 207.10 560263 BARTONELLA HENSELAE 243.10 560264 OT THER ACT 67.25 560268 PRO INSULIN 297.65 560270 DLCO 143.80 560271 H PYLORI ANTIBODIES 164.60 560272 H PYLORI AG STOOL 213.80 560275 H PYLORI IGM 163204 145.45 560276 GROUP THERAPY PER SE 44.70 560277 H PYLORI, BREATH 1,067.80 560278 H PYLORI, BREATH-ADM 57.75 560282 LUNG NITROGEN WASHOU 165.70 560283 INTRISIC FACTOR BLOC 136.20 560285 DF COLLECTION MAIL O 30.90 560293 LYMES TITER 80.45 560295 WOUND SUCTION CANIST 128.90 560296 LIPID PANEL 223.65 560298 LIPOPROTEIN NMR 238.35 560300 SURGIMESH 1/2 OVALE 583.50 560301 EXTREMITY STUDY ABI 200.60 560302 SURGIMESH 10/15 901.75 560303 SURGIMESH 14/15 1,538.30 560304 SURGIMESH 30X30 1,856.55 560305 M PNEUMO AB-COMP FIX 161.20 560306 SURGIMESH PLUG/PATCH 795.65 560307 LINEAR CUT VASC 1,123.00 560308 ARTERIAL PUNCTURE 17.70 560310 LAMICTAL 716944 105.80 560311 LACTOFERRIN FECAL QL 101.85 560312 US ANTERIOR ABD WALL 171.35 560313 LACTOFERRIN FECAL QN 101.85 560317 LEGIONELLA TITER AB 287.25 560318 PULMONARY COMPLIANCE 165.70 560319 ALPHA 1 ANTITRYPSIN 103.25 560321 CARBOXYHEMOGLOBIN QN 95.95 560322 ALPHA 1 TRYPSIN PHEN 178.90 560323 CARBON DIOXIDE 17.70 560325 CAROTENE 001529 52.90 560327 CARNITINE TOTAL & FR 114.80 560329 0 VICRYL URO 27 14.05 560332 DRAIN TRACH SPONGE .95 560341 0 PROLENE 30 T 14.35 560344 #566 TRANSPEC W/O PE 59.20 560345 MARLEX MESH SOFT PRE 178.35 560346 FINGER MIN 2 VIEW 79.05 560347 US GUIDED NEEDLE BX 212.95 560348 ZINC SERUM PLASMA 50.05 560349 ZINC URINE 50.05 560356 AMIODARONE LEVEL 86.35 560357 FOOT STABILIZER 298.55 560358 WANCHIK RESTING SPLI 139.80 560359 HLA RA PANEL 141.20 560360 E-BARR AB SC/COMP 82.45 560361 EPSTEIN BARR IGM AB 60.70 560362 EPSTEIN BARR IGG AB 60.70 560363 ENZYMATIC DIGESTION 20.00 560364 MUTATION SCANNING 82.95 560367 0 SILK 30 CUTT 10.10 560368 17-OH-PROGESTERONE 126.55 560369 SYNOVIAL FLUID CELL 52.90 560370 SINGLE AMPLIFICATION 82.95 560371 US GUIDED ASPIRATION 212.95 560377 ENDOPATH TROCAR 11mm 252.70 560379 3-WAY FOLEY CAT 24FR 46.70 560380 WRIST SPLINT COMFORT 73.15 560381 SCLERODERMA AB SCL70 242.00 560383 14FR 30CC 2WAY FOLEY 15.85 560384 FREE CARBAMAZEPINE Q 149.70 560389 #8833H 2-0 PROLENE 12.30 560390 SNARE DISPOSABLE 32.05 560391 ANDROSTENEDIONE 95.95 560392 ESTRADIOL SERUM 117.95 560393 SMOOTH MUSCLE ABS 254.05 560394 ESTRADIOL SERUM MS 117.95 560395 ESTRADIOL SENSITIVE 117.95 560396 TOTAL VOLUME URINE 47.80 560401 4-0 POLYSORB 60 19.10 560402 HOT BIOPSY FORCEPS 60.70 560403 ANTITHROMBIN ACTIV 447.95 560404 DIGITAL BOWEL STIMUL 66.70 560405 DORSO-LUMBAR SUPPORT 176.70 560406 ALPHA SUB PIT QNT 161.75 560408 AEROBIC ISOLATE 14.60 560415 PROTEIN C ACTIVITY 214.40 560416 BOVIE GROUND PAD PED 21.65 560417 HEIMLICH CHEST 81.60 560418 VARICELLA Z. IGG IGM 254.40 560419 VARICELLA Z (STATE) 69.20 560421 PROTEIN C ACTIVATED 64.65 560425 0 VICRYL 27 TA 14.05 560426 BASIC PACK KIM 36.70 560427 PROTEIN S TOTAL 214.40 560428 SACRO LUMBAR SUPPORT 151.90 560429 NASAL PACK PEDIATRIC 28.95 560431 TOXO AB IGG 006478 64.10 560432 CULTURE TYPING 14.60 560437 #8832H 3-0 PROLENE 14.35 560438 TRACH TUBE TIES MED 3.80 560439 PROTEIN S FREE 214.40 560441 CHLORIDE URINE 18.00 560442 ELECTRICAL STIM MANU 102.70 560444 SOTALOL 163.75 560445 SOL TRANSFERRIN REC 305.85 560446 SOMATOMEDIN C IGF-1 103.25 560449 #J417H 2-0 VICRYL 6.50 560450 RESUSCITATOR PE w/mask 52.95 560452 ACETYLCHOLINE BLOCK 141.50 560453 CRYPTOSPORIDIUM SMEA 46.15 560454 GIARDIA LAMBLIA AG S 102.70 560456 GAS LIQ CHROMOTOGRAP 14.60 560459 EZ-IO 25 MM NEEDLE 281.40 560460 IV CATHETER 22G 7.55 560462 IV CATHETER 24G 8.45 560463 IV CATHETER 18G 7.30 560464 ROTICULATOR STA 1,192.50 560465 IV CATHETER 20G 7.30 560466 IV CATHETER 14G 7.30 560467 INFUSION SET 25G 3/ 3.90 560468 INFUSION SET 23G 3/4 3.65 560469 INFUSION SET 19G DES 3.65 560470 INFUSION SET 19 1.95 560471 INFUSION SET 21 3.65 560475 SUCTION CATH. 18FR. 2.45 560476 LEGIONELLA AG URINE 231.85 560477 LEGIONELLA IGM ANTIB 147.70 560479 ACETCHOLINE BINDING 169.40 560480 ACETCHOLINE MODULATI 169.40 560481 SALEM SUMP TUBE 18FR 8.45 560482 COUDE CATH. 14F 28.20 560483 COUDE CATH. 16F 28.20 560484 COUDE CATH. 18F 30.40 560485 ENDO MULTISEAL 33.75 560486 ABDOMINAL BINDER 75-84 51.75 560487 FOLEY CATH 14FR 8.30 560488 FOLEY CATH 16FR 13.00 560489 FOLEY CATH 18FR 5CC 13.15 560490 FOLEY CATH 20 F 30cc 21.05 560491 FOLEY CATH 22FR 24.45 560492 3-WAY FOLEY CAT 22FR 46.70 560493 FOLEY CATH TRAY 25.65 560495 UTILITY CATH 12FR 2.65 560496 UTILITY CATH 14FR 2.65 560497 LINEAR CUTVASC 411.65 560498 UTILITY CATH 12FR 2.70 560499 OSTOMY 2 3/4 12IN DR 10.60 560503 DINO OXYGEN MASK 8.75 560505 CHG DRESSING GARDIVA 28.05 560511 DIAL A FLOW ALTERNAT 21.95 560514 IODOFORM PACKING STR 1 12.75 560515 PLAIN PACKING STRIP NuGauze 13.50 560517 NU GAUZE 2" IODOFORM 17.40 560518 PLAIN PACKING STRIP 1/2x5 11.35 560519 3-WAY CATH 16F 35.15 560520 SHILEY TRACH DISP 8 16.85 560521 4-0 CHROMIC LIG 14.05 560523 TRANXENE 61.65 560524 OSTEOCALCIN SER 164.85 560526 MMT EXT/TRUNK 67.25 560527 CHLORIDE BLOOD 38.85 560528 TRACH TUBE 6MM cuff 8.45 560529 TRACH TUBE 6.5M cuff 8.75 560530 TRACH TUBE 7MM 8.75 560531 TRACH TUBE 7.5M 8.75 560532 TRACH TUBE 8MM 8.75 560534 TRACH TUBE REPLACEME 225.35 560535 CUT LOOP 28FR R 223.65 560536 VITAMIN D 1,25-DIHYD 332.25 560538 MMT HAND 55.35 560541 TRACH TUBE CUFF 9.5 9.00 560542 TRACH TUBE 6.5M uncuff 7.30 560543 TRACH TUBE 6MM uncuff 5.60 560544 ORAL AIRWAY 80MM #3 1.40 560546 ORAL AIRWAY 100 .90 560547 CUT LOOP BLADDE 229.60 560548 SCALPEL #15 4.60 560549 SCALPEL #10 PER 5.00 560550 PT MANUAL THERAPY 102.70 560551 BOVIE GROUND PA 12.65 560552 STOMACH TUBE 18FR 5.10 560554 DEAVER T TUBE 12FR 30.65 560555 DEAVER T TUBE 10FR 25.60 560556 DEAVER T TUBE 14FR 20.75 560557 LINEAR CUTRELOA 240.05 560559 DEAVER T-TUBE 16FR 25.60 560560 VITAMIN D 25-HYDROXY 321.30 560562 OSTOMY SKIN BA 2 3/4 27.85 560563 CD4 HELPER/T-CELL CT 167.10 560564 STOCKING MED.RE 28.95 560565 STOCKING LG.REG 28.05 560566 STOCKING LG.-LO 28.05 560567 STOCKING X-LG. 48.70 560568 TRIPAQUE GAUZE 4X4 13.50 560569 VALVED AEROSOL TTEE 10.95 560571 HEEL INSERT MED 52.65 560572 PARATHYROID INTACT 190.80 560573 SKIN STAPLER 16.10 560574 POSEY LG. VEST 43.85 560575 TRH STIMULATION PANE 160.35 560576 ADAPTER Y PORT CONNE 20FR 25.30 560577 POLYP NET RETRIEVAL 223.10 560578 FACE MASK CHILD SCEN 16.30 560579 TREPONEMA PALLIDUM 30.40 560581 PEZZAR CATHETER 24FR 71.45 560583 NASAL PACKING (DRAWS 60.20 560593 ENDO-CLOSE TRACH SIT 147.70 560598 CURETTE DISP DERMAL 8.05 560599 FLOWTRON CALF GARMET 63.85 560600 GASTROSTOMY 18F 102.05 560601 GASTROSTOMY 20F 100.25 560602 ENDOPATH TROCAR 12mm 71.94 560607 TRACH TUBE CUFFED 7 116.50 560608 HERPES 1 IGG 164897 120.40 560609 HEEL PROTECTOR 61.40 560610 SIGMOIDSCOPE DISPOSA 14.05 560611 RA QUANT 161463 33.20 560612 HERP AB 1&2 163014 90.00 560615 HERPES 1&2 DNA PCR 144.05 560616 VIRUS AB 52.00 560617 SM RNP AB/SMITH TEST 158.10 560618 FULL FACE MASK LG 34.55 560619 SKELETAL MUSCLE AB 78.75 560620 SACRO LUMBAR LG 169.95 560621 SACRO LUMBAR X- 116.75 560622 HSV 1/2 IGG EVAL W R 90.00 560623 HAND MITT END FINGER 75.10 560625 PELVIC BELT X-L 73.40 560626 PELVIC BELT SMA 66.05 560627 PELVIC BELT LAR 65.55 560628 AIRSPLINT 1/2 A 83.55 560630 #16676 4-0 ETHILON 13.30 560631 FINGER SPLINT 1 1 5/8 11.80 560632 FINGER SPLINT 2 2 1/2 5.15 560633 FINGER SPLINT 2 COT 7.30 560634 FINGER SPLINT 3 4.90 560635 LATEX FREE 16FR FOLE 15.15 560636 LATEX FREE 18FR FOLE 15.15 560638 ARM SLING CRADL S 16.30 560639 ARM SLING CRADL L 18.00 560641 HANDCONE 50.65 560642 ARM SLING POUCH M 10.40 560643 ARM SLING POUCH L 13.75 560644 CATH SECURE TUBE HOL 8.05 560647 WRIST BRACE D RING L 101.00 560648 WRIST BRACE D RING R 101.00 560653 KNEE SLEEVE W/POLYME 133.90 560656 HSV 2 IGM 2 81.90 560657 ELASTIC WRIST S 42.50 560661 ELASTIC WRIST M 79.30 560662 #J493G 5-0 16.85 560665 ADVANCE PLUS CATH KI 16.30 560668 CAST BOOT SMALL 34.05 560669 CAST BOOT MEDIU 34.05 560670 CAST BOOT LARGE 38.50 560671 US UPPER EXT ART UNI 259.65 560672 PATELLA KNEE ME 34.55 560673 PATELLA KNEE SUPPORT 34.55 560674 SPLINTER REMOVAL KIT 13.50 560675 GIGLI SAW BLADE 84.40 560677 FOGARTY BALLOON PR 6 119.55 560678 FOGARTY BALLOON PR 5 197.65 560680 TIB FIB YOUTH K 178.15 560681 TIB FIB HIP-LENGTH A 169.95 560682 SERPETINE MEDIU 18.55 560683 SERPETINE LARGE 18.55 560684 FINGER MEDIUM B 14.05 560685 FINGER LARGE BA 15.75 560686 FINGER SPLINT L 30.40 560687 EXTRICATION PED 52.00 560688 EXTRICATION MED 61.90 560691 NEPRO 4.40 560692 CREATININE K ISOENZY 58.75 560693 GREAT SHAKE 4 OZ 1.70 560694 BOOST 4.20 560695 KNEE IMMOBILIZER 24" 96.20 560696 KNEE IMMOBILIZER 28" 107.50 560697 J494G 4-0 VICRYL SUT 17.70 560701 MASK INF CUSHION RES 17.70 560702 NEEDLE 120MM VERRSE 67.50 560703 #1893G 3-0 ETHILON 18.85 560707 P & PD SUBSEQUENT 42.75 560709 PIVOT 1.5 CAL 21.35 560712 TPMT 510750 84.65 560713 #J260H 0-VICRYL 6.50 560714 IV TUBE PRIM.W/ 32.60 560715 PARIETAL CELL AB 101.00 560716 GASTRO OCCULT 24.20 560717 INTUBATION 469.75 560725 GROSHONG CATH. 8 851.15 560726 UTILITY CATH 8FR 2.60 560727 HEEL INSERT LAR 52.65 560728 SLEEPMASK GEL MOJO M 89.15 560729 RESOURCE FRUIT DRINK 5.10 560730 PROSTHETIC TRAINING 67.25 560731 CO2 ANALYZE 82.95 560733 PEDISURE 4.80 560734 IGG W SUB CLASSES 184.80 560738 UTILITY CATH 16FR 2.65 560739 PROVALE DRINK CUP 5C 126.55 560740 METHYMALONIC ACID QU 274.85 560741 JEJUNOSTOMY (BA 711.25 560742 PT THER ACTIVITY 67.25 560743 NEB TREAT SUBSEQUENT 84.40 560744 URINE MAGNESIUM 38.50 560745 LINEAR CUT 35MM GI/C 897.30 560746 IMMUNOGLOBULINS 92.30 560748 PROSTAT SUPPLEMENT 5.60 560749 #894H 0-CHROMIC 12.65 560750 GEL HEEL PILLOW 90.00 560751 #8886753823 5-0DEXON 23.20 560754 WORK INTEGRATION/TAS 67.25 560755 MDI SUBSEQUENT 84.40 560756 H INFLUENZAE B AB 143.80 560757 NICOTINE URINE 75.10 560758 NEUTROPHIL CYTOPLASM 329.75 560759 NICOTINE/METABOLITE 123.80 560760 NEUTROPHIL OXIDATIVE 181.15 560761 0 CHROMIC GUT T 12.90 560762 PYLORIC COLON DIL 20 626.25 560763 HEMOVAC 100ML W 10mm 96.00 560764 LIGACLIP SMALL 20.55 560765 CRYOGLOBULIN 001594 84.65 560766 PT W/C MGT 50.65 560767 ISOSOURCE 3.90 560768 CEEA 28MM STAPLE 2,264.10 560770 CRYOFIBRINOGEN QUALI 46.70 560773 #885H 1-CHROMIC 14.05 560774 BAER HUGGER HALF BOD 28.70 560776 5-0 PROLENE 71.15 560778 WORK HARDENING/CONDI Initial 215.25 560779 WORK HARDENING/CONDI Add 79.90 560785 #J232H 3-0 VICRYL 7.10 560786 ROTICULATOR STAPLER 1,577.15 560787 HALOPERIDOL 070482 80.45 560788 6-0 PROLENE 149.95 560789 #1650 HUD SS WATER T 12.90 560792 PARASITE ID 008219 43.05 560793 HEEL & ELBOW LARGE 17.30 560794 HEEL & ELBOW XL 15.85 560797 #C063T 3-0 SILK 46.15 560798 MALE EXTERNAL CATH L 6.45 560799 ASPIRATING ND. 34.80 560800 ANGIOTENSIN 1 CONVER 63.35 560801 HEEL & ELBOW MEDIUM 17.95 560802 PT ORTHOTIC MGT 50.65 560804 THYROXIN BINDING GLO 82.45 560808 RISPERDIONE 716563 180.10 560810 FOLEY CATH 10F 23.20 560811 VON WILLEBRAN ANALY 195.25 560812 STRIATED MUSCLE AB 72.60 560813 #037-28 HUD BOT W/AD 18.85 560814 VOLTAGE GATED CA AB 332.85 560817 ROSIDAL 10CM WRAP 28.70 560821 MEPILEX 4X12 WOUND B 22.35 560822 TIEMAN COUDE CATH 14 21.05 560823 #J258H 3-0 VICRYL 6.90 560824 CYSTO-HYPAQUE 30% 59.00 560825 #J603H 0-VICRYL 8.10 560826 DEV COG SKILLS PROB 75.40 560834 TIEMAN COUDE CATH 16 21.05 560835 GROSHONG CATH. 1 1,034.30 560836 CAST PADDING 3" 6.80 560837 #132 SAFETY DRAIN 19.65 560838 PT RE-EVAL 205.70 560841 CRUTCHES CHILD 56.80 560845 TRACH CANNULA DISP 124.30 560846 TIEMAN COUDE CATH 18 21.05 560847 GROSHONG CATH. 2 1,575.70 560848 RESTON FOAM DSG PAD 17.40 560849 AIRWAY SUPRAGLOTTIC2 91.15 560852 HEP D TOTAL 284452 89.75 560853 MICRO ALBUMIN UA QNT 67.00 560857 SPU WRAPPED VEST SMA 174.50 560858 TROCAR CATH 32 FRENC 50.60 560859 PHOSPHATIDYLSERINE A 375.85 560860 MARLEX MESH KEYHOLE 288.15 560861 RITALIN METHYLPHENID 151.40 560862 WOUND MGMT SELECT<20 82.95 560863 RIFAMPIN 810931 295.15 560864 ID NUCLEIC PROBE 14.60 560869 KNEE SUP ARCUS ELA M 118.70 560870 ADAPTER/TRACH JACKSN 52.00 560872 4X4 OPTIFOAM 15.85 560873 PED NASAL CANNULA 11.20 560875 APPLY FOREARM SPLINT 175.25 560876 APPLICATION FINGER S 175.25 560877 STRAP OF ELBOW/WRIST 175.25 560878 STRAP OF HAND/FINGER 175.25 560879 STRAPPING OF KNEE 175.25 560880 BACK BRACE 94.25 560882 #J270H 0-VICRYL 6.95 560883 OSTOMY DUOLOCK POUCH 7.30 560884 FLUID CELL COUNT/DIF 62.40 560885 NEBULIZER MULTI FIT 20.00 560886 STRAPPING ANKLE/FOOT 175.25 560887 SEROUS FLUID CELL CT 62.40 560889 STRAPPING OF TOES 175.25 560890 APPLICATION PASTE BO 175.25 560892 LEGIONELLA ANTIGEN 97.05 560894 STRAPPING OF HIP 193.00 560896 FLUID GLUCOSE 019497 32.10 560897 VENTILATOR HUMIDIFIE 64.10 560898 MECKEL SCAN 661.75 560904 SLEEPMASK GEL MOJO S 269.85 560916 #1854G 4-0 ETHILON 14.85 560924 #U204H 3-0 CHROMIC 14.90 560932 JEJUNAL FEED TU 200.05 560991 APPLY SPLINT STRAPPI 175.25 560992 ELEC STIM WOUND ULCE 57.35 560993 ELEC STIM WOUND OTHE 40.80 561035 TROCAR CATH 16 FRENC 52.00 561065 CONSULTATION CRNA 135.05 570001 UNDER BRACE SLEEVE 96.20 570002 IV SMARTSITE VALVE P 5.10 570004 IV MACROBORE EXT SET 10.40 570005 NEOPRENE BACK INSERT 66.35 570006 IV ANES TUBING 11.05 570008 URETERAL DRAINAGE BA 32.35 570009 #1654G 4-0 CHROMIC 23.90 570011 PISTON IRR. SYR .40 570012 #8697G 6-0 PROLENE 29.80 570013 KNEE IMMOBILIZER 16" 97.35 570014 GASTRIC LAVAGE KIT 40.20 570015 PETRO GZ. 3X18 3.75 570016 #L113G 2-0 CHROMIC 18.00 570017 #L114G 0-CHROMIC 11.55 570018 SIZE 3 TRACHEOSTOMY 173.05 570019 SIZE 6 TRACHEOSTOMY 91.10 570020 SIZE 7 TRACHEOSTOMY 99.20 570021 TRACH MINI KIT 97.90 570022 FLOTRON GARMENT BARI 109.70 570023 2-0 SILK 30 LA 16.00 570024 SUCTION TUBE AT 10.95 570025 #810H 3-0 CHROMIC 13.20 570026 0 ETHIBOND 58.25 570027 TELEMETRY ELECT 2.70 570028 MORGAN THERAPEUTIC L 76.60 570029 2-0 DEXON T12 G 16.00 570030 4-0 VICRYL V-34 17.40 570031 TRACH TUBE TIE LARGE 8.10 570032 #811H SUTURE CT-1 11.90 570050 HYDROFERA BLUE 20.85 570100 METHAMPHETAMINE CONF 240.20 580092 CHLAMYDIA BY DNA PRO 84.65 580093 CHLAMYDIA DNA PCR 145.75 580094 NEISSERIA GONORRHOEA 145.75 580104 LACT RINGERS 1000CC 20.55 580171 ACAPELLA DH PEP THER 133.60 580503 HALO 90 ABLATION CAT 3,256.35 580504 ESOPHAGIAL STETHOSCO 10.05 580506 BUBBLE HUMIDIFIER 11.15 580507 #C013T 3-0 SILK 40.20 580508 RESUSCITATOR AD w/mask 39.10 585503 AMINO 8.5% 121.35 590053 N T CATH ASPIRATION 169.95 590059 CANNULA CUFF SINISTR 126.00 590093 CHLAMYDIA TRACHOMATI 198.35 590121 I&D ABSCESS SINGLE 302.95 590134 02 MASK PEDIATRIC 7.05 590142 OXYGEN PER HOUR 7.30 590177 NASAL CANNULA 2.55 590207 USN TUBE 2.70 590312 O2 SET UP 47.55 590371 VOLDYNE EXERCISER 25.90 590398 SVN CIRCUIT 4.40 590436 SPIROMETERY BASIC 86.10 590441 FLUORO GUIDE CVC PLC 141.50 590460 P & PD INITIAL 56.05 590495 O2 HUMIDIFIER 17.70 590533 VENT MGMT IP INIT DA 883.20 590592 SPUTUM COLL/INDUCTIO 42.75 590606 VENTURI 02 MASK 7.75 590622 VENTILATOR TUBE SET 12.65 590657 O2 MASK ADULT 4.40 590754 NEB TX 1 PER DAY 105.20 590757 MECH CHEST OSCILLATI 136.75 590771 AEROSOL MASK 2.55 590772 CRYPTOCOCCUS ANTIGEN LC 81.30 590773 PROZAC LEVEL FLUOXET 140.95 590776 CRYPTOCOCCUS ANTIGEN 81.30 590783 TRACH MASK ADULT 5.40 590784 CSF VDRL 006445 45.30 590787 CT ORBITS W/WO CONTR 1,426.55 590792 WRIST 2 VIEW 77.65 590794 TESTOSTERONE FREE 107.50 590804 OPIATES/BENZO GC/MS 332.85 590806 6X6 OPTIFOAM 21.85 590807 AMIKACIN 156.15 590809 G G T 33.10 590811 CT SELLA W/WO CONTRA 1,426.55 590816 SKIN MARKER UNSTERIL 2.85 590818 INDIA INK CSF 008672 52.90 590820 DNA AB NATIVE/DOUBLE 483.65 590821 MAMMOGRAM SCREENING 104.65 590825 DIRECT LDL 48.35 590826 DIGITAL DX UNI MAMMO 272.60 590828 DIGITAL MAMMO ADD VI 272.60 590829 CAD SCREENING 67.00 590830 VITAMIN D SERUM 269.25 590831 SODIUM URINE 25.60 590832 UA ORGANIC ACID QUAN 235.20 590835 CT P FOSSA W/WO CONT 1,426.55 590837 US RUQ 272.65 590839 CAD DX 69.45 590841 DIGITAL SCR UNI MAMM 213.55 590842 LEGIONELLA PANEL 244.70 590843 POTASSIUM URINE 25.60 590844 DIGITAL MAMMO SCREEN 357.35 590845 DIGITAL DX BIL MAMMO 398.40 590848 DEXA SCAN 224.80 590849 DEXA SCAN VFA 289.20 590852 SACRO LUMBAR XX 171.35 590854 CRAMER HEEL CUP 27.00 590856 SYNOVIAL FLUID CRYST 92.30 590859 CT MASTOID W/WO CONT 1,426.55 590865 WHOLE BODY BONE SCAN 744.80 590869 RENIN ACTIVITY 78.75 590872 US GALLBLADDER 252.05 590873 ORGANISM ID YEAST 35.15 590876 LYSOZYME SERUM 69.75 590879 CHLAMYDIA CULTURE 175.80 590880 HEPATITIS PANEL 183.75 590881 #J489G 6-0 VICRYL 24.45 590883 CT MAXILLOFACIAL WO 797.70 590890 ANTICARDIOLIPIN AB 178.15 590893 #J490G 6-0 VICRYL 16.30 590901 LIVER/SPLEEN SCAN 705.15 590902 ANTITHROMBIN AG 493.00 590904 HEMOSIDERIN 52.65 590905 #G666G 5-0 ETHILON 13.40 590908 CT GUIDED BIOPSY 789.00 590913 HIDA SCAN W/WO 758.55 590915 PT IONTO 102.70 590916 LEGIONELLA 162.65 590921 US SACRAL DIMPLE 262.50 590924 T-SPINE 2 VIEW 97.35 590925 GASTRIC EMPTYING 758.55 590926 HUBER NEEDLE 20X1-1/ 15.75 590927 T-SPINE 4 VIEW 146.00 590928 GASTRIC ANALYSIS EAC 162.65 590929 #888720421 5-0 DEXON 20.00 590932 SCAPEL ALTERNATE #15 5.10 590934 CT F/U LOCAL LIMITED 487.65 590938 INSULIN 004333 47.55 590939 PCA INFUSOR 6/B 103.80 590940 CT SINUS & FACIAL WO 878.15 590941 6-0 DEXON T-30 18.30 590942 COPPER 001586 55.35 590944 AMERIGEL HYDROGEL DR 12.90 590949 GI BLEED STUDY 911.95 590950 INSULIN AUTO AB 98.15 590951 C-ARM IN SUR < 1 HR 139.80 590952 INSULIN TOTAL 46.15 590953 CYSTO (DISP.OR ) PAC 28.70 590954 COMPLEMNT TOTAL CH5O 106.35 590955 CT NECK W/O CONTRAST 813.75 590956 14 FR 5CC FOLEY CATH 13.40 590958 COMPLEMENT C2 161414 59.00 590960 INSULIN FREE 54.60 590961 LUNG SCAN PERFUSION 705.15 590964 CT L-SPINE W/O CONTR 895.95 590965 TRACH TUBE HI VOL 7 9.25 590968 SYNOVIAL FL ANA 6398 82.15 590971 CMV IGG 006494 71.45 590973 LUNG SCAN VENTILATIO 705.15 590974 HEMOVAC 100ML W 7mm 129.15 590977 ARSENIC BLD 007245 114.80 590979 CT NECK W CONTRAST 813.75 590980 APOLIPOPROTEIN 65.15 590983 CMV IGM 096727 71.45 590984 CMV IGG REFLEX IGM 87.80 590985 CMV PCR QN 138610 498.00 590986 LEGIONELLA BY DFA 94.25 590987 US TRANSVAG/PELVIS 439.20 590988 CT CHEST W/O CONTRAS 813.75 590989 AERO CHAMBERS W MASK 78.75 590992 CMV PCR QL 138693 393.90 590993 KNEE COMP 4 OR > VI 106.60 590995 SKINSLEEVE LEG 29.55 590997 CT CHEST W/WO CONTRA 1,391.15 590999 CT PELVIS W/WO CONTR 1,391.15 591000 CT CHEST W CONTRAST 813.75 591001 AERO CHAMBERS W/O MK 35.45 591003 CMV NEG LABELED CKBC 86.60 591005 IV CATHETER 14GX5 1/ 27.85 591006 US BREAST UNI OR BIL 221.40 591007 NEOPRENE KNEE X 201.45 591008 HAND 2 VIEWS 79.05 591009 HLA CROSSMATCH CKBC 211.85 591010 PRIMIDONE LEVEL 110.85 591011 US RENAL 201.70 591012 CT T-SPINE W/O CONTR 895.95 591013 US AXILLARY 192.75 591021 RENAL LASIX 881.25 591022 24 HR URINE PHOS 38.50 591027 CHEST 2VIEW W APICAL 145.75 591029 US KIDNEY W ARTERIAL 343.00 591030 US KID OR AORTA LIMI 270.70 591031 FLUTTER VALVE 148.85 591032 KNEES AP STANDING 79.05 591033 TESTICULAR W/FLOW 842.75 591036 CT ABD W/O CONTRAST 813.75 591037 ANTIDIURETIC HORMONE 169.65 591040 ADENOVIRUS 67.00 591043 IV TUBE SEC ALTERNAT 1.45 591045 CMG 74.80 591047 ENTEROVIRUS 67.75 591048 CT ABD W CONTRAST 813.75 591049 HEPATIC FUNCTION PAN 216.10 591050 HOLTER MONITORING 388.30 591051 CHEST 2VIEW W/OBL 181.80 591052 ANTIBODY INFLUENZA V 70.35 591053 CT AORTA 893.60 591055 LYMPHOCYTIC CHORIOME 67.00 591056 FOOT 2 VIEWS 79.05 591060 CT PELVIS W/O CONTRA 895.95 591061 SULFONYLUREA HYPOGLY 224.25 591067 SUCTION POLY-TRAP 41.05 591069 CTA HEAD 955.55 591070 FELBATOL LEVEL 131.95 591071 CTA NECK 955.55 591072 CT PELVIS W CONTRAST 895.95 591073 TRACH TUBE UNCUF 2.5 5.75 591074 X-RAY SURGICAL SPECI 89.75 591075 CHEST SPECIAL VIEWS 95.10 591076 CTA CHEST 955.55 591077 CTA UPPER EXTREMITY 955.55 591078 CTA ABD AORTA 955.55 591079 HIVOJEN CONFIRMATION 236.65 591081 CTA LOWER EXTREMITY 955.55 591082 CTA ABDOMEN 776.45 591084 E-BARR VIRUS 204.25 591085 WEIL FELIX SWAM FT B 93.40 591091 YANKEUR UNVENTED 2.20 591093 CT LOWER EXT W/WO 870.30 591094 SLEEPMASK GEL MOJO L 269.85 591096 CT ABD W/WO CONTRAST 1,568.40 591097 CA 125 002303 190.45 591098 PELVIC TRACTION 111.95 591099 OB SURVEY LIMITED 271.25 591102 US SCROTUM/TESTES 221.40 591103 EXECU DRY DRESSING 11.25 591106 ENDOPOUCH W/INT 181.80 591108 C3 SERUM 006452 90.00 591109 LACTIC ACID 75.95 591110 IV NITRO NEEDLELESS 13.60 591115 ADAPTER Y PORT CONNE 16FR 22.20 591117 US PREG UTERUS >=14W 229.85 591119 1" STERILE PENROSE T 2.20 591120 C4 SERUM 001834 86.10 591121 NORTRIPLYLINE AVENTY 95.10 591122 BABYGRAM 180.10 591124 NOROVIRUS DETECTION 145.45 591127 BILE BAG 19OZ 34.30 591128 URETHROCYSTOGRAM VOI 284.50 591131 8 FR FOLEY CATH LATE 16.60 591132 NASOPHRAYN AIRWAY 34.05 591133 CHROMIUM 071522 173.05 591134 CHROMOSOME ANA 15-20 493.50 591138 US EXTREM NON-VASCUL 532.90 591143 ANKLE STABILIZER VLO 106.90 591144 THYROID PEROXIDASE 100.40 591149 UGI W/AIR CONT W/SBF 272.05 591151 FLOW VOLUME LOOP 82.95 591152 US PELVIS LIMIT / FU 221.40 591154 ENDOPATH GRASPE 313.95 591156 PLATELETS 119.90 591157 PLATELETS PHERESIS 766.45 591159 RIBS BILAT 4 OR > 160.95 591165 SPIROMETERY PRE-POST 162.90 591166 ENDO LAPAROSCOP 1,340.20 591167 12 FR LATEX FREE CAT 4.65 591169 IMAVATE PRESOMIAC 95.10 591170 EYE FOR FOREIGN BODY 90.25 591171 SPINE ENTIRE AP/LAT 253.75 591174 US CYST ASPIRATION 201.70 591175 DUOFLEX SPRING WIREG 45.85 591176 US TRANSRECTAL-PROST 266.45 591181 KLONOPIN LEVEL 94.50 591184 CLOTEST 267.00 591187 MED NUTRITION INITIA 52.00 591189 MED NUTRITION REASSE 44.70 591191 MED NUTRITION GROUP 44.70 591192 ACID FAST CULTURE BM 73.15 591194 MASTOIDS 3 OR MORE V 160.95 591195 SPINE 1 SPEC LEVEL 89.75 591196 US GUIDE FOR VAS ACC 108.30 591199 VALVE HASSON TROCAR 1,112.80 591200 US SPINE 301.90 591203 ACTIVASE 100MG. 326.30 591204 LEUK ALK PHOS STAIN 65.05 591205 BALLARD SX CATH 52.90 591208 LEUKOCYTE HISTAMINE 57.20 591211 OPTI-FLOW 25G GI NEE 203.40 591214 ENDO PROBE RT.A 175.00 591216 NON-REBREATHING MASK 7.70 591217 HEATER COLUMN 54.00 591223 ADULT CANNULA SAMPLI 10.40 591226 ENDO PROBE CURV 175.00 591228 CERULOPLASMIN 74.30 591229 1500 ML S WATER 19.10 591234 CPR 732.10 591238 ENDO CHOLANGIOG 218.05 591240 PEAK FLOW MEASUREMEN 46.95 591241 MDI 1 PER DAY 105.20 591242 FACIAL BONE 1 OR 2 V 90.25 591251 TRANSFERRIN 0043937 63.60 591252 PEAK FLOW METER 67.00 591253 VANCOMYCIN 89.75 591258 US CAROTIDS DUPLEX 656.70 591259 URINE MESCALINE 173.05 591260 HLA CLASS 2 ONE ANTI 233.50 591261 HLA CLASS 2 ONE ALLE 277.60 591262 ENDO THREAD 10/ 26.40 591264 VENOGRAM EXTREMITY 2 1,083.00 591265 EASYCAP AIRWAY DET A 39.40 591268 C PAP MASK LARGE 86.60 591271 ACETYL 353.65 591272 CT POST PROCESSING 232.40 591274 ENDOPATH,CLIP-A 173.94 591276 MEXILETINE 135.05 591281 INFLUENZA A&B AG 119.65 591282 US CAROTID DUP UNILA 221.40 591287 C-PEPTIDE SERUM 110.00 591288 US ABDOMEN COMPLETE 272.65 591289 WOUND MGMT NON-SELEC 16.30 591290 NEG PRESS WOUND <50 167.10 591291 PELVIS AP & FROG 94.25 591292 NEG PRESS WOUND >50 170.50 591294 US EXTREM ART LEG 1 259.65 591295 US EXT ART ARM LIMIT 259.65 591296 CT CYST ASPIRATION 767.05 591300 US THYROID/NECK 221.40 591302 US PARATHYROID 221.40 591306 US EXTREM ART LEG BI 508.15 591307 LIGHTED STYLET 104.40 591310 ENDOPATH PERCUT 236.65 591312 US SINGLE ORGAN 252.05 591313 M. PNEUMONIAE IGG AB 59.45 591317 RETICULIN AB 114.80 591319 PLATELET ANTIBODY 204.25 591321 24 HR QUAN CYSTINE 122.85 591322 ENDO PROBE PLUS 103.85 591324 24 HR UREA NITROGEN 35.75 591325 DESIPRAMINE SERUM 94.25 591330 DNA HISTONE AB 146.85 591333 24 HR UA PORPHYRINE 97.90 591334 LINEAR STAPLER 75mm 296.10 591335 DNA AB'S SINGLE STRA 115.30 591338 CT ORBITS W/O CONTRA 813.75 591339 PLASMA PORPHYRINS 279.15 591343 PURACOL + AG WOUND D 31.05 591345 LEGIONELLA AB PNEUMO 187.65 591346 INTRALUMINAL STAPLER H29 988.75 591347 IMMUNOASSAY FOR INFE 56.80 591348 LEMS AUTO AB 140640 386.05 591349 IMMUNOASSAY ANALYTE 521.65 591353 IMMUNOASSAY QUANT NO 160.05 591357 HYDROXYCORTICOSTERIO 90.60 591358 OSTOMY POUCH 2 16.85 591362 CT SELLA W/O CONTRAS 813.75 591367 SERUM ETHYLENE GLYCO 57.35 591368 ALPHA FETOPROTEIN 139.55 591370 IGD QUAN SERUM 52.35 591372 US TRANSABD/PELVIS 270.70 591379 FLEXIBLE SOCK AID 48.25 591380 HLA-B27 ANTIGEN 358.20 591381 US INFANT BIL HIPS 275.20 591382 PHLEBOTOMY, THERAPEU 47.55 591386 CT P FOSSA W/O CONTR 895.95 591387 UPPER EXT INFANT 2VI 95.95 591391 3.5 FR URI CATH 40.80 591392 24 HR HOMOVAN 231.00 591393 CT ABD/PLV W CONTR 942.30 591394 CT ABD/PEL W/O CONTR 1,024.20 591395 CT ABD/PEL W/WO CON 1,696.65 591396 CALCIUM IONIZED 86.10 591401 CT ABD/PEL W/O 1,360.70 591403 NEOPRENE KNEE ( 201.45 591410 CT MASTOID W/O CONTR 813.75 591411 KNEE SL OPEN PAT XXL 86.95 591415 TRACHEOSTOMY TUBE HO 17.40 591416 OXYCODONE LEVEL QNT 250.75 591418 AIRWAY SUPRAGLOTTIC5 79.05 591419 OXYCONTIN QNT 712349 161.75 591420 T4 FREE 95.95 591426 US EXTREM VEINS UNIL 355.90 591428 VITAMIN C 001479 56.55 591430 HEEL WEDGE 25.90 591431 SKIN LES <0.5CM TRUN 382.15 591438 US EXTREM VEINS BILA 554.25 591439 FLUOROSCOPY 1HR OR< 236.40 591440 FACTOR VIII AG 240.55 591442 HEEL LIFT 31.50 591444 FACTOR XIII 086330 169.95 591451 CAPNO-CHECK PAT ATT 29.80 591452 FACTOR VIII INHIBITO 213.80 591454 CSF BACTERIAL ANTIGE 200.90 591455 Q-FEVER IGG 016774 102.45 591456 URINE HEMOSIDERIN QL 75.40 591458 HISTAMINE DET URINE 115.05 591459 PYRUVIC ACID BLOOD 51.45 591460 BONE MINERAL DENSITY 532.60 591463 ANKLE 2 VIEWS 79.05 591464 BONE DENSITY POST PR 305.60 591467 EPSTEIN-BARR DNA QUA 956.40 591468 THYROID ANTIBODIES 86.10 591471 THYROGLOBULIN QUAN 197.20 591473 OSSEOUS SURVEY INFAN 137.55 591475 THYROGLOBULIN AB 144.85 591478 PHONOPHORESIS 15MIN 102.70 591480 GASTROSTOMY KIT 456.75 591484 THYROID STIM IMMUNOG 534.85 591488 THYROID SCAN 705.15 591490 2-0 VICRYL 27 13.20 591491 MERCURY BLOOD 085324 108.30 591492 MERCAPTOPURINE/IMURA 126.00 591499 PELVIS/HIP INF/CHILD 87.50 591500 US SOFT TISS MASS EX 190.55 591501 HISTOPLASMA IMMUNOFU 54.35 591502 2-0 PLAIN GUT 12.40 591503 URINE IMMUNOELECTROP 110.00 591504 US SOFT TISS BACK 190.55 591513 TOTAL GLOBULIN 32.60 591520 BONE SCAN 3 PHASE 758.55 591527 0 PLAIN GUT 27 11.80 591903 CT MAXILLOFACIAL W/C 781.00 592000 M TUBERCULOSI 183712 93.65 592001 M AVIUM COMP 183713 93.65 592003 AFB ID BY DNA PROBE 93.65 592004 M GORDONAE 183715 93.65 592005 OTHER 183714 93.65 592006 CT LUNG SCREENING 159.15 592100 HOME SLEEP STUDY 546.65 603654 DURAMORPH 10 MG INJ 64.20 614309 0.25% ACETIC ACID IR 60.70 630100 MRI TEMPOROMANDIBULA 1,562.20 630101 MRI ORBIT FACE WO 1,562.20 630102 MRI ORBIT FACE WITH 2,196.40 630103 MRI ORBIT FACE W/WO 2,649.65 630104 MRA HEAD WO 1,562.20 630105 MRA HEAD WITH 2,196.40 630106 MRA HEAD W/WO 2,649.65 630107 MRA NECK WO 1,562.20 630108 MRA NECK WITH 2,196.40 630109 MRA NECK W/WO 2,649.65 630110 MRI BRAIN WO 1,562.20 630111 MRI BRAIN WITH 2,196.40 630112 MRI BRAIN W/WO 2,649.65 630113 MRI CERVICAL WITH 2,196.40 630114 MRI CERVICAL W/WO 2,649.65 630115 MRI THORACIC WO 1,562.20 630116 MRI THORACIC W 2,196.40 630117 MRI THORACIC W/WO 2,649.65 630118 MRI LUMBAR WO 1,562.20 630119 MRI LUMBAR WITH 2,196.40 630120 MRI LUMBAR W/WO 2,649.65 630121 MRI PELVIS WO 1,562.20 630122 MRI PELVIS WITH 2,196.40 630123 MRI PELVIS W/WO 2,649.65 630124 MRI UP EXT NOT JOINT WO 1,562.20 630125 MRI UP EXT NOT JOINT W 2,196.40 630126 MRI UP EXT NOT JOINT W/W 2,649.65 630127 MRI UP EXT JOINT WIT 2,196.40 630128 MRI UP EXT JOINT WWO 2,649.65 630129 MRI LOW EXT NOT JOIN WO 1,562.20 630130 MRI LOW EXT NOT JOIN W 2,196.40 630131 MRI LOW EXT NOT JOIN W/W 2,649.65 630132 MRI LOW EXT JOINT W 2,196.40 630133 MRI LOW EXT JOINT WW 2,649.65 630134 MRI ABDOMEN WO 1,562.20 630135 MRI ABDOMEN WITH 2,196.40 630136 MRI ABDOMEN W/WO 2,649.65 630137 MRA ABDOMEN 2,649.65 650000 PACKED RED CELLS 442.85 650001 IRRADIATED PACKED CE 570.30 650002 PLATE PHER LEUK REDU 819.95 650003 PLATE PHERESIS IRRAD 842.75 650004 PLATE LEUK REDUC IRR 1,299.70 650005 PLATE PHER LEU RE IR 896.45 650006 PLATELETS IRRADIATED 193.55 650007 WASHED IRR PACKED CE 1,039.95 650073 DIAZIPAM LEVEL VALIU 98.15 650074 FRESH FROZEN PLASMA 132.25 650075 FRESH FZ PLASMA JUMB 282.50 650076 FRESH FZ PLASMA MEDI 202.85 660000 PLATELET LEUK REDUCE 735.50 665000 PROFORE DRESSING 33.45 665001 COBAN WRAP 47.50 665002 COBAN LIGHT COMPRESS 47.55 666001 LUMBAR ROLL 3/4 39.10 666002 ENDO THREAD 10-12MM 37.15 666005 512XD TROCAR 199.20 666006 LINEAR STAPLER 35MM 897.30 666014 ADHESIVE MEDICAL SPR 46.95 666015 FOOT SPLINT/BRACE 77.35 666016 UNNA BOOT 3 (M 37.40 666020 LIGACLIP LARGE 16.00 666021 LINEAR CUTTER 157.90 666026 SACRO LUMBAR SUPP XL 74.00 666027 INFUSION SET 23 2.20 666029 JEJUNOSTOMY 14FR KIT 400.95 666033 DISP CYTOLOGY BRUSH 64.35 666034 1/2" STERILE PENROSE 1.70 666035 3X3 GENTLE BORDER DR 13.00 666036 8 FR LATEX FREE CATH 4.15 666037 INFUSION SET 27 GA 5.60 666041 INCONTINENCE CLAMP 146.00 666042 HEAT MOIST EXCHANGER 100.40 666043 #834 2-0 CHROMIC SUT 12.40 666044 22MM PROVOX BUTTON 19.40 666051 REACHER 119.65 666052 NASAL PAC 4.5 ANTERI 91.45 666054 IV CATH AUTOGUARD 20 9.00 666056 SHIELDS BRACE LG 197.20 666057 4X4 KERLIX GAUZE 13.75 666059 HEEL LIFT MED RED 82.45 666060 ANKLE FOOT ORTHOSIS 2 103.25 666061 PHIL SM CERV COLLAR 61.90 666062 OSTOMY SKIN BARRIER 17.60 666063 POSEY ROLL BELT 67.50 666064 CO2 SAMPLING LINE 81.95 666065 SZ 7 POWER STEP 51.75 666066 QUILTED LIMB HOLDER 20.80 666067 SZ 6 POWER STEP 71.45 666069 #ATW35 LINEAR CUTTER 542.05 666070 LINEAR STAPLER 30MM TR30 58.70 666073 #834H 0-PROLENE 12.90 666074 ELASTIC WRIST SM LEF 33.75 666077 SHILEY CUFF SZ 8 126.00 666080 KNEE IM W/PATELL 24" 148.00 666082 SACRO LUMBAR MED SUP 139.55 666083 COBAN 2IN BANDAGE 6.25 666084 XL SHORT THIGH STOCK 56.55 666085 SACRO LUMBAR INSERT 127.70 666086 HALO GUIDE WIRE 360.20 666087 SWEDISH PILLOW MED 115.05 666088 SZ 10 POWER STEP 55.70 666089 UNIVERSAL ARM SLING 73.15 666090 HIP KIT 6 103.50 666091 JEJINOSTOMY REPAIR K 224.80 666097 AMERIGEL 2X2 DRESSIN 12.50 666098 IV CATH AUTO GUARD14 8.45 666099 PHILADELPHIA MED COL 61.90 666100 SZ 9 POWER STEP 51.75 666101 DORSO LUMBAR SUPP 23 178.15 666103 SACRO LUMBAR XLG SUP 113.35 666104 EYE SHIELD METAL 7.30 666105 SNAIRE WIRE #6 36.00 666106 QUICK COMBO ADULT 96.80 666107 PICC LINE CONNECT 3F 49.50 666110 SACRO LUM SUPP MD/LG 111.65 666111 NASOPHARYNGEAL 22 FR 13.15 666113 QUICK COMBO PEDIATRI 110.85 666114 SACRO LUMBAR 9" SUPP 83.55 666116 ROCKET SOCK LG RT 121.35 666117 ADAPTER JEJUNOSTOMY 35.75 666118 LIQUID SKIN PROTECTA 17.40 666119 DERMABOND ADHESIVE 65.85 666120 LINEAR CUT TR35W 334.25 666122 IV CATH AUTOGUARD 16 8.45 666124 SACRO LUMBAR SUPP 10 117.25 666125 1/4" STERILE PENROSE 3.90 666126 HARRIS HEMI ARM SLIN 73.15 666127 ROCKET SOCK LG LEFT 121.35 666128 SUCTION COAGULATOR 24.40 666129 4X4 KERLIX NON STERI 18.85 666131 MARLEX MESH PLUG LG 711.90 666132 MARLEX MESH PLUG MED 600.50 666133 CHANNEL CATH 3,545.25 666134 SUSPENSION BOOT 18.15 666135 3/4" STERILE PENROSE 2.20 666136 EYE SPONGE 14.35 666137 SMALL LONG THIGH STO 48.95 666138 DRESSING ADHESIVE SA 27.85 666139 18MM HALO 360 ABLATI 3,246.80 666140 PHILADELPHIA LG COLL 61.90 666141 RESOLUTION CLIP 406.00 666142 W/F RT UNIV COCKUP S 9.00 666143 NASOPHARYNGEAL 26FR 13.50 666144 ANKLE/FOOT ORTHOSIS 170.50 666145 KNEE BRACE XLG ROLYA 153.35 666147 MEPITEL ONE 4X7.2IN 26.05 666148 #G3234 2-0 PLAIN GUT 14.35 666149 INTRODUC ET BOUGIE15 23.90 666150 CATH TUBE HOLDER STR 6.85 666151 ELBOW ADAPTER 4.40 666152 TUBIGRIP EB SIZE F 6.60 666153 QUICKTRACH PED 386.30 666154 HEEL GUARD 97.35 666155 CENTRAL LINE DRESSIN 43.60 666156 PED VENTI MASK 14.35 666157 TUBE SENGSTAKEN BLAK 480.00 666158 24 G IV CATH W/INFUS 17.40 666159 EXT SET WINGED 14.90 666160 COMPRESSION BANDAGE 63.10 666161 PYLOR COLON DIL 15MM 495.50 666162 SILVER EST PATC 51.20 666163 SKIN PREP 1-STE 171.60 666167 NASAL PAC 5.5 ANTERI 94.50 666171 NASOPHARYNGEAL 2OF 13.50 666174 PEZZAR CATH 30FR 42.50 666175 ENDO BLUNT DISSECTOR 49.50 666176 SNARE WIRE #8 215.80 666177 MEPITL DRESSING 8X12 129.15 666178 5FR INFANT CATH KIT 16.90 666179 LG VAG SPEC 11.50 666180 J434H 4-0 VICRYL SUT 8.20 666181 7IN EXTENSION SET 10.40 666182 PULLEY KIT W STRAP 56.05 666184 PRISMA WOUND CARE 33.50 666185 HEEL LIFT LG RED 82.45 666186 NEOPRENE KNEE SUP XL 113.90 666187 #8423H 2-0 PROLENE 9.20 666188 20-22 FR DECLOGGER T 17.35 666190 5X9 ABD PAD STERILE 1.05 666191 HALO 360 SIZING BALL 865.75 666192 #J306H 2-0 VICRYL 10.10 666193 LATEX FREE 12FR FOLE 19.65 666194 SYRINGE 12CC 20 28.95 666195 ARM SLING CVA ROPYAN 56.55 666196 HEEL LIFTS SM 29.80 666197 WOUND IRRIGATION SYS 8.10 666198 PULSAVAC HAND C 128.90 666199 PULSAVAC DUAL S 89.15 666200 PULSAVAC FAN SP 55.70 666201 PULSAVAC INTRAM 61.90 666202 TENNIS EL STRAP W/FO 92.30 666203 HAPAD METATAR SUPP M 25.00 666204 PEDIALYTE 4OZ 207.65 666205 ROCKET SOC MED RT 109.20 666206 ENDO CURVE ELECT 5MM 163.75 666207 LINEAR STAPLER 90MM 352.50 666208 SYRINGE 3CC (SA 91.15 666209 HEEL LIFTS LG 29.80 666211 XSM RIGHT ARTHRITIS 188.45 666212 SYRINGE 60CC LU 36.25 666213 KNEE BRACE LT XL TAN 122.35 666214 IV ACCESS SYSTEM POS 15.45 666215 SCARO LUMBAR SUPP 12 107.50 666216 HEEL LIFT SM 34.05 666217 MONITORING ELECT EA 2.45 666218 KNEE BRACE ACL SUPPO 1,799.40 666219 A70-RT WOMENS 8-10 134.20 666220 MARKER SKIN REG TIP 5.85 666221 LINEAR CUT RELOAD GI 331.45 666222 NEONATAL NASAL CANNU 15.75 666223 MED SHORT THIGH STOC 28.05 666224 SACRO LUMBAR 11IN XL 119.25 666225 AIRWAY ADAPT KIT A/P 89.50 666227 #1647G 7-0 ETHILON 20.80 666230 REDUCER CAP 20.55 666233 28MM HALO 360 ABLATI 3,246.80 666235 ORTHOGLASS PER FOOT 9.75 666236 FLEXIBLE LEG LIFTER 20.00 666237 #K873H 2-0 SILK SUTU 11.80 666238 #512SD TROCAR 255.45 666239 IV GRAVITY SET 9.35 666240 EYE PACK 270.10 666241 ORTHO CASH BACK BRAC 456.10 666243 BLOOD WARM EXT PED S 48.95 666244 BLOOD WARM EXT STAND 39.25 666245 BLOOD WARM HI FLOW S 46.95 666247 ENDO FORM 2X2 DRESSI 35.58 666248 PICC LINE KIT 392.55 666250 PYLOR COLON DIL 12MM 495.50 666251 25MM HALO 360 ABLATI 3,246.80 666253 ENDOPATH CLIP 471.25 666254 KNEE IMMOB W/PAT 28" 170.80 666255 SM HEEL LIFT 41.35 666256 #699H 4-0 ETHILON 13.69 666257 WRIST LACE UP RT XLG 51.45 666258 PRESSURE LINE ADAPTE 4.40 666259 FOLEY COUDE CATH 16F 67.50 666260 CO2 TUBING 45.30 666262 HEEL LIFT MED 29.80 666263 PYLORIC COLON DIALAT 661.75 666264 ORAL AIRWAY 50MM 2.15 666265 KID O2 BEAR NEBULIZE 58.00 666266 SKINSLEEVE ARM 26.50 666267 MEN'S SHOULD IMMOBIL 41.60 666268 ANKLE BRACE SMALL 71.45 666269 36 FR THORACIC CATH 19.10 666270 EAR SYRINGE 2OZ 3.30 666271 J415H ETHILON SUTURE 13.50 666273 ALARM BELT VELCRO 99.05 666274 TENNIS ELBOW SM LEFT 31.50 666275 METATARSAL CUSHION L 32.35 666276 16 FR LATEX FREE CAT 3.90 666278 SUTURE CT-2-26MM VIC 12.90 666279 IV ACTH AUTOGUARD 18 8.45 666281 ENDO DISSECTOR 5MM 313.15 666282 LINEAR STAPLER 30MM TL30 286.45 666284 LINEAR STAP RELOAD60 221.15 666285 ENDO GRASPER 5MM 313.15 666286 ANKLE FOOT ORTHOS RT 172.15 666287 SALEM SUMP 6FR 31.25 666288 MED STRAP HOLSTER 282.80 666289 SACRO LUMBAR SUPPORT 90.25 666290 #L111G 4-0 CHROMIC 16.00 666291 7730G 6-0 SILK SUTUR 25.00 666293 NEOPRENE KNEE BUT XL 68.70 666295 CO2 TUBE W/ANTIFOG 45.20 666296 QUICKTRACH ADULT 386.30 666299 PICC LINE CONNECT 4F 77.05 666300 POWDER STOMAHESIVE P 20.50 666301 POWER GLIDE 20G 188.85 666302 TUBIGRIP SIZE G 7.40 666303 CLEANING TOOL/BLOOD 15.75 666304 HEMOSTAT GEL FOAM 92.30 666305 SURGICAL BLADE 104.65 666306 NASAL CO2 SAMPLE LIN 84.40 666307 ENDOLOOP LIGA E210 126.55 666309 CYSITONE 23 GAUGE 25.30 666310 PYLOR COLON DIL 18MM 495.50 666311 ELASTIC WRIST LG LEF 79.30 666312 ELBOW PAD 38.55 666313 OSTOMY POUCH DR 21/4 8.45 666314 OSTOMY POUCH DR 12IN 9.25 666315 OSTOMY STOM SKIN BAR 12.40 666316 VELFOAM 2 X5' R 64.10 666318 ENDO POUCH 49.50 666319 RESUSCITATOR NEO NAT 61.90 666320 FOLEY COUDE CATH 18F 67.25 666321 SKIN MARKER ALTERNAT 3.65 666322 CHILD METAL EYE PATC 14.35 666323 LINEAR STAPLER TR90 113.35 666324 #7799G 10-0 ETHILON 101.85 666325 LEFT ROCKET SOCK 99.05 666326 G698G 5-0 ETHILON 16.00 666327 CASTING TAPE 3X3 1/2 28.70 666328 ASPIRATOR W TRAP 23.05 666329 RIGHT ROCKET SOCK 121.85 666330 REG XXL THIGH STOCKI 50.05 666332 LINEAR CUT 35MM TSW 863.75 666333 NEOPRENE KNEE LG 155.60 666334 PRO ENDO POUCH 107.35 666336 DIGIFLEX 5LB EXERCIS 65.80 666337 TONSIL SPONGE 8.10 666338 #J547G 8-0 VIGRYL SU 73.40 666340 COMPRESSION SOCKS 137.00 666341 ANKLE FOOT ORTHESIS 140.15 666342 J401G VICRYL SUTURE 68.35 666343 ELASTIC WRIST LG RT 79.30 666344 #7538-31 4-0 DEXON 31.25 666345 PULLEY KIT W FRAME 73.15 666346 HUBER NEEDLE 22X1WIN 16.05 666347 DIGIFLEX 7LB EXERCIS 80.20 666348 DIGIFLEX 3LB EXERCIS 63.10 666349 IV EXTENS SET SM WPO 10.25 666350 2-0 SILK TAPER 11.50 666351 XL ANKLE BRACE 49.25 666353 LATEX FREE 8FR FOLEY 18.55 666354 #G323H 2-0 PLAIN GUT 18.05 666355 RESTORE WOUND DRESS 32.10 666356 LG SHORT THIGH STOCK 28.05 666357 PT PACKAGE WIDE 78.75 666358 FLOWTRON LARGE 84.40 666359 EASY-IO 15MM NEEDLE 281.40 666360 IV CATH AUTOGUARD 24 8.45 666361 WRIST BRACE PEDIATRI 115.05 666362 DUO DERM 6X6 21.95 666363 SACRO LUMBAR SUP XXL 153.05 666364 FEED BAG 9.20 666365 SZ 8 POWER STEP 51.75 666366 3-WAY FOLEY 20FR DOV 44.45 666367 SACRO LUMBAR XXL 55.70 666369 SACRO LUMBAR SM-MED 101.30 666370 SACRO LUMBAR 11IN LG 101.30 666371 REINFORCED KNEE SLEV 78.20 666372 BALOON EXP DILATOR 613.15 666373 SKIN SLEEVE SMALL 25.70 666374 EX SM CLAVICLE STRAP 33.20 666375 ECONOSOC 82.45 666376 IV AUTO CATH 22G 9.00 666378 TRACH TUBE 7MM N CUF 6.80 666379 SPU WRAP VEST MED 150.40 666380 SPU WRAP VEST LARGE 166.85 666381 WALKER BOOT 112.55 666388 BARD SOFT MESH 113.30 666450 HAND SPLINT 80.20 707526 KCL 20MEQ PIGGYBACK 33.75 710008 PT EVAL MODERATE 308.35 710009 PT EVAL LOW 265.20 710011 PT EVAL HIGH 397.85 710024 PT PHYS PERF 174.15 710032 SELF CARE/HOME MGMT 60.70 710113 PT MASSAGE 15 MIN 72.00 710121 PARAFFIN BATH 34.05 710156 ROM HAND 39.10 710166 50ML ADV 9.00 710167 100 ML ADVANTAGE MIN 9.25 710180 PT ULTRASOUND 102.70 710199 ROM EXT/TRUNK 75.95 710288 PT NEUROMUS RE-ED 72.00 710296 PT TRACTION 77.05 710326 PT ESTIM ATTENDED 52.35 710327 ESTIM UNATTENDED 40.80 710407 PT WHIRLPOOL 59.00 710423 LS SUPPORT MEASURE 68.70 710512 PT THER EXC 60.70 710513 PT GAIT TRAINING 102.70 710515 MEASURE JOBST STOCKI 60.20 710516 THERA EXERCISE 15 EA 65.30 710517 OT THER EX 65.30 710519 APPLICATION TENS 55.35 710521 ORTHO MGMT & TRAIN15 60.70 710600 PT TENS-0278T 102.70 710601 PT GROUP 51.75 710709 DEX 5% 0.9%NS +KCL20 10.40 711509 NS 1000 +KCL 20MEQ 9.50 713836 NORMAL SALINE 1500 18.85 713906 STERILE H20 1000 IJ 60.70 713916 STERILE H20 IRR 1500 60.70 741803 LMD 10% W 5% D 500CC 107.20 765103 HEPARIN GTTS 21.95 770229 AMINOSYN II 103.00 771503 MANNITOL 20% 500 184.00 780824 DOP 400 MG -500 ML 45.30 780924 DOP 800MG 500ML 71.15 790409 DEX 5% 1/2 NS +KCL40 9.00 792202 D5W 250 ML 47.25 792203 D5W 500 ML 47.25 792209 D5W 1000 ML 60.70 792313 D5W 50 ML 33.75 792323 D5W 100 ML 33.75 792337 DEXTROSE 5 100ML 19.10 792409 D5W 1/4 NSS 1000 ML 60.70 792603 D5.45NS 500ML 47.25 792609 D5W 1/2 NSS 1000 ML 60.70 792909 D5W LR 1000 ML 60.70 793003 10% DEXTROSE 500 ML 20.00 793009 10% DEXTROSE 1000ML 7.05 793124 LIDOCAINE 0.4%/W D5 47.25 794109 D5W NSS 1000 ML 60.70 794110 HEPARIN FLUSH 100 U 11.50 795303 LACT RINGERS 500 ML 47.25 795309 LACT RINGERS 1000 ML 60.70 797208 NACL 3000 31.75 797408 GLYCINE 3000 ML 40.20 798302 0.9% NSS 250 ML 47.25 798303 0.9% NSS 500 ML 14.90 798309 0.9% NSS 1000 ML 7.30 798436 IV SOLUTION 19.65 798437 NS 100ML 7.30 798503 0.45% NACL 500 ML 47.25 798509 0.45% NACL 1000 ML 7.30 799309 D5 1/2 NS W 10 KCL 9.00 800005 IV ADD SEQUENTIAL DR 116.75 800006 IV THERAPY INITIAL 1 449.45 800007 IV ADMINISTRATION OP 476.85 800008 EMERGENCY ROOM 1 195.35 800009 EMERGENCY ROOM II 325.20 800010 EMERGENCY ROOM III 480.45 800011 EMERGENCY ROOM IV 705.35 800017 IV INFUSION 1HR/LESS 496.35 800018 EMERGENCY ROOM V 1,037.00 800019 IV INFUSION >1HR OP 83.25 800340 SPEECH EVAL SOUND PR 296.40 800341 SPEECH EVAL LANG COM 602.90 800342 SPEECH EVAL ANALYSIS 289.55 800348 SPEECH EVAL FLUENCY 327.55 800349 MOD BA SWALLOW STUDY 320.50 800350 BEDSIDE SWALLOW EVAL 291.75 800351 EVAL NON-SPEECH-GENE 71.45 800352 THER SERV NON-SPEECH 35.75 800353 EVAL SP GEN DEV 1HR 301.30 800354 EVAL SP GEN DEV ADDL 66.35 800356 ASSESS APHASIA HOUR 179.85 800357 TRAINING SPEECH GEN 132.55 800358 STANDADRIZED COGNITI 372.90 800359 DEVELOPMENTAL TESTIN 181.50 800360 DEVELOPMENT OF COGNI 85.70 800401 COGNITIVE THERAPY 90.10 999117 OT GROUP 51.75 999400 MOBILITY CURRENT OT .00 999401 MOBILITY GOAL OT .00 999402 MOBILITY DC OT .00 999403 BODY POSITION CUR OT .00 999404 BODY POSITION GOA OT .00 999405 BODY POSITION D/C OT .00 999406 CARRY CURRENT OT .00 999407 CARRY GOAL OT .00 999408 CARRY D/C OT .00 999409 SELF CARE CURRENT OT .00 999410 SELF CARE GOAL OT .00 999411 SELF CARE D/C OT .00 999412 OTHER CURRENT OT .00 999413 OTHER GOAL OT .00 999414 OTHER D/C OT .00 999415 OTHER CURR SUBSEQ OT .00 999416 OTHER GOAL SUBSEQ OT .00 999417 OTHER D/C SUBSEQ OT .00 999430 OT EVAL MODERATE 308.35 999431 OT RE-EVAL 205.70 999432 OT EVAL LOW 265.20 999433 OT EVAL HIGH 397.85 999434 OT GAIT TRAINING 102.70 999904 OT NEURORE-ED 72.00 999905 OT MASSAGE 72.00 999906 OT ORTHO MGMT/TRAIN 58.00 999907 PROSTHETIC TRAIN 15M 64.10 999908 OT SELF CARE/ADL 54.00 999909 OT COMM/WORK 64.10 999910 OT W/C MGMT 48.65 999911 CK/OUT ORTHO/PROST 48.65 999912 OT PHYS PEF 60.70 999913 OT COGNITIVE SKILLS 72.30 999914 OT PARRAFIN 34.05 999916 OT MANUAL THER 102.70 999999 CAST PADDING 4" 5.85 1500100 OBSERVATION 1HR MC 32.00 1500101 OBS DIRECT ADMIT 176.70 3010003 SEMI PVT ROOM 770.00 3010004 PVT ROOM 770.00 3010007 CHEST TUBE PLACEMENT 1,450.90 3010019 WOUND CARE SELECTIVE 80.45 3010036 SWING BED REVENUE 361.00 3699291 CRITICAL CARE 1ST HR 1,458.05 3699292 CRITICAL CARE ADD HR 673.30 4017158 ZEMURON INJ 60.75 4018594 AGGRENOX CAP 21.35 4018719 LORTAB 7.5 1.95 4018958 PULMICORT NEB 34.50 4019071 ZITHROMAX SUSP 250MG 107.80 4019436 METAXALONE 800MG TAB 17.40 4019550 SCOPOLAMINE TOP 78.95 4021277 GLUCOSAM CHONDROITIN 1.95 4021713 EMLA CREAM 142.35 4022190 ZOCOR 40MG TAB 15.20 4023020 XOPENEX .63MG NEB 20.65 4023875 BUPIVACAINE 0.75% IN 16.55 4024469 CORDARONE 150MG INJ 2.70 4024824 LIDOCAINE HCL 2%INJ 11.95 4025425 ACTOS 15 MG TAB 17.55 4025540 ZEBETA 5MG TAB 4.15 4025664 NYSTATIN POWDER 115.70 4025789 NEURONTIN 100MG 1.80 4025904 CEFZIL SUSP 50 MG 150.55 4026142 CELEBREX 200MG CAP 22.50 4026266 ANUSOL H 44.55 4026381 AMIKIN 250MG INJ 18.55 5600000 LG BIPAP MASK 82.95 5912878 24 HR URINE 5-(HIAA) 99.05