INTERNAL HCPCS CODE DESCRIPTION CHARGE CHARGE NUMBER LAB 10001 84060 ACID PHOSPHATASE #829642 68.5 10002 82040 ALBUMIN SERA 69.5 10003 84075 ALKALINE PHOSPHATASE 52.5 10004 82150 AMYLASE 7 80.5 10009 82088 ALDOSTERONE, SERUM #004374 498 10011 86060 ASO TITER #006031 119.5 10013 84600 ALCOHOL, METHYL #017699 219 10014 87116 AFB CULTURE AND SMEAR/ #183753 165 10015 86901 BLOOD TYPING-RH (D) 23 10016 87206 ACID FAST STAIN #008618 73 10017 82247 TOTAL BILIRUBIN 50.5 10018 86900 BLOOD TYPING-ABO 23 10019 85002 BLEEDING TIME 50.5 10020 84520 BUN 43.5 10022 82607 VITAMIN B-12 115 10026 82310 CALCIUM,TOTAL 39 10027 85025 CBC W/COMP DIFF 69.5 10028 82380 CAROTENE #001529 138.5 10029 82435 CHLORIDE SERUM 80.5 10030 82465 CHOLESTEROL 50.5 10032 82550 CPK, TOTAL 67.5 10033 82565 CREATININE 44.5 10034 82575 CREATININE CLEARANCE #003004 80.5 10035 82378 CEA #002139 169 10036 87070 CULTURE SPUTUM & GRAM STAIN 51.5 10037 82552 CPK ISOENZYMES #002154 123.5 10038 82355 CALCULUS ANALYSIS #120790 142 10039 82382 CATECHOLAMINES,RANDOM URINE #316203 179.5 10040 82533 CORTISOL,TOTAL 175.5 10041 85007 DIFFERENTIAL 22 10044 80162 DIGOXIN/LANOXIN LEVEL 152 10045 80185 DILANTIN, QUANT 105.5 10048 P9016 PRBC'S 326.5 10050 36430 BLOOD ADMINISTRATION 262.5 10051 86022 PLATELETS APHERESIS 1112 10054 83700 ELECTROPHORESIS, LIPOPROTEIN #235036 165 10055 83020 ELECTROPHORESIS, HEMOGLOBIN 82.5 10056 80307 ETHANOL, QUANT. 173.5 10057 87106 FUNGAL ID #390 167 10058 86780 FTA-ABS #006379 118 10059 82746 FOLATE (FOLIC ACID) SERUM 68.5 10062 82941 GASTRIN SERUM #004390 95.5 10063 87205 GRAM STAIN 42 10064 85014 HCT 28 10065 85018 HEMOGLOBIN 28 10066 84702 HCG, QUANT. #004416 185 10067 81025 HCG,BETA SCREEN SERUM 98 10068 86812 HLA-B27 ANTIGEN #006924 336 10069 86694 HERPES SIMPLEX I &II IGM #165180 85.5 10070 83491 17-HYDROXYCORTICOSTEROIDS 24UR #806730 151 10071 80074 HEPATITIS PANEL 4 #303744 321 10072 83010 HAPTOGLOBIN #001628 60.5 10073 86320 IMMUNOELECTROPHORESIS SERUM #001495 230.5 10074 83540 IRON #001339 59 10075 83550 IRON BINDING CAP. #001321 86.5 10076 83525 INSULIN 118 10077 87220 KOH PREP 28 10078 83582 17 KETOSTEROIDS 24 HR URINE #806813 149 10079 83615 LDH SERA 54 10080 85345 LEE-WHITE CLOTTING TIME 32 10081 83690 LIPASE 77.5 10082 82150 AMYLASE FLUID #088062 80.5 10086 80178 LITHIUM #007708 80.5 10087 83655 ADULT LEAD, BLOOD #007625 118 10093 86308 MONO TEST 63.5 10095 87210 N/S PREP 28 10096 82270 OCCULT BLOOD 33 10097 83930 OSMOLALITY (SERUM) #002071 89 10098 83935 OSMOLALITY (URINE) #003434 89 10099 84030 PKU 72 10100 85049 PLATELET COUNT 56 10101 84132 POTASSIUM 48 10103 85610 PROTIME 54 10104 85730 PTT 57 10105 80184 PHENOBARBITAL #007823 78.5 10106 84100 PHOSPHORUS 52.5 10107 84156 PROTEIN, TOTAL URINE #003129 68.5 10108 84165 PROTEIN ELECTROPHORESIS 24 HR UR #267245 119.5 10109 83970 PARATHYROID HORMONE & CAL. #054601 464 10111 84146 PROLACTIN #004465 132 10112 80192 PROCAINAMIDE #007252 98 10116 86430 RA TEST #006502 57 10117 85045 RETICULOCYTE COUNT #005280 50.5 10118 84244 RENIN, RIA #002006 251 10119 86762 RUBELLA IGG,IGM #262303 52.5 10120 85652 SED RATE AUTOMATED 41 10121 84450 SGOT / AST 67.5 10122 84460 SGPT / ALT 80.5 10123 84295 SODIUM 57 10124 82945 GLUCOSE/SPINAL FLUID 50.5 10125 G0480 SALICYLATES 115 10126 89051 CELL COUNT SEROUS FLD #005240 48 10127 84479 T3 74 10128 84436 T4 80.5 10131 84155 PROTEIN, TOTAL 60.5 10132 84478 TRIGLYCERIDES 74 10133 80198 THEOPHYLLINE (AMINOPHYLLINE 110 10134 80156 TEGRETOL 161 10135 81001 URINALYSIS AUTO W/MIC 44.5 10136 84550 URIC ACID 56 10140 G6031 VALIUM, QUANT. #007989 202 10141 84585 VMA 24 HOUR URINE #004143 95.5 10142 86592 VDRL (RPR) #012005 57 10143 85048 WBC 24 10144 80168 ZARONTIN LEVEL #007443 185 10147 80061 LIPID PANEL 238 10150 84403 TESTOSTERONE 176.5 10152 93010 EKG WITH PROF FEE 62.5 10153 84157 PROTEIN SPINAL FLUID #002055 63.5 10154 80170 GENTAMICIN PEAK 110 10155 86038 ANA SCREEN #164947 75 10156 86160 COMPLEMENT C-3 #006452 75 10157 86160 COMPLEMENT COMPONENT C4 #001834 75 10159 86235 SMRNP ANTIBODY #006338 98 10164 86376 THYROID ANTIBODIES #006684 69.5 10165 84300 URINE NA+-24 HOUR #003178 42 10166 84133 URINE K+ 24 HR #003186 42 10167 86376 THYROID PEROXIDASE #006676 91 10168 87340 HBsAg #006510 48 10169 85303 PROTEIN C ACTIVITY #117705 104.5 10170 86870 ANTIBODY INDENTIFICATION PANEL 99 10173 82105 MATERNAL TRIPLE TEST (AFP) #010801 241 10174 88262 CHROMOSOME BLOOD#511035 491.5 10175 86147 CARDIOLIPIN ANTIBODIES #161950 93 10177 81050 VOL./TIMED COLLECTION 21 10178 82128 AMINO ACID MSUD #700190 65 10179 87634 RSV BY ALERE i 115 10180 83615 LDH FLUID #100156 39 10181 82945 GLUCOSE FLUID(QUANT)17425 50.5 10182 82248 DIRECT BILIRUBIN 60.5 10183 82948 GLUCOMETER SUPPLY 38 10184 G0480 ACETAMINOPHEN LEVEL (TYLENOL) 150 10185 84202 PROTOPORPHRIN,RBC;QUANT #010165 91 10189 86022 PLATELET ANTIBODY #014086 233 10190 85220 FACTOR V 302 10191 82784 IMMUNOGLOBULIN A #001784 65 10192 82103 ALHPA 1 ANTITRYPSIN #001982 92 10193 84260 SEROTONIN #120204 208 10195 86225 DOUBLE STRAIN DNA AB #096339 59 10196 86235 ENA 1 OF 2 99 10197 84154 FREE PSA #480947 115 10198 82010 KETONE SERUM 806443 279.5 10201 86317 TETANUS AB #163691 47 10203 87522 HEP C GENOTYPE #550475 651 10204 87177 CRYPTOSPORIDIUM #183020 33.5 11000 87177 OVA & PARASITES #008623 104.5 11001 82104 ALPHA-1-ANTITRYPSIN PHENOTYPE #095653 86.5 11002 82693 ETHYLENE GLYCOL #071654 90 11003 85305 PROTEIN S AG #164517 69.5 11010 80173 HALDOL LEVEL #070482 254 11021 86701 HIV-1/2 DIFFERENTIAL #083904 167 11023 82672 ESTROGEN, TOTAL #004549 75 11024 80188 MYSOLINE #007856 104.5 11025 84144 PROGESTERONE 154 11026 80299 NORPACE #007864 155.5 11027 82140 AMMONIA #007054 132 11028 G0480 THC #791566 147 11029 84066 PROSTATIC ACID PHOS. #004747 105.5 11030 83735 MAGNESIUM 65 11031 80299 COUMADIN #071423 173.5 11032 86757 ROCKY MOUNTAIN FEVER G,M #247494 151 11033 86735 MUMPS VIRUS AB, IGG #096552 118 11034 83718 HDL CHOLESTEROL 65 11035 82570 URINE CREATININE/RANDOM #013672 52.5 11036 36415 VENIPUNCTURE, ROUTINE 20 11038 82375 CARBON MONOXIDE BLOOD #007187 80.5 11039 82374 CARBON DIOXIDE 56 11040 86850 ANTIBODY SCREENING RBC EACH SERUM TECHNI 50.5 11041 86337 INSULIN ANTIBODY #141598 91 11042 82670 ESTRADIOL #4021 95.5 11043 84153 PSA PROSTATE SPECIFIC ANTIGEN 168 11044 PHLEBOTOMY BAGS (DISP.) LAB SUPPLIES 39 11045 G6030 AMITRYPTYLINE #007476 136 11048 80154 DIAZEPAM #007989 149 11049 86663 EPSTEIN-BARR ANTIBODIES, ACUTE #219311 261.5 11050 82728 FERRITIN 39 11052 86713 LEGIONELLA, TOTAL ANTIBODY #164616 309.5 11053 86738 MYCOPLASMA PNEUMONIAE AB #163758 145 11054 G6037 NORTRIPTYLINE #007393 176.5 11055 89060 CRYSTALS #133005 94.5 11056 87324 CLOSTRIDIUM DIFF. TOXIN 086207 193.5 11057 83001 FSH 123.5 11058 83002 LH 142 11060 82977 GGT 56 11061 86317 RUBELLA TITER INDEX 86.5 11063 85660 SICKLE CELL SCREEN #005223 49.5 11065 80164 DEPEKENE (VALPROIC ACID) 135 11066 80194 QUINIDINE #007831 134 11069 82525 COPPER #001586 117 11070 82390 CERULOPLASMIN #001560 107 11072 G6032 DESIPRAMINE #007765 208 11073 G6036 IMIPRAMINE #007468 105.5 11074 85230 COAG FACTOR VII #800599 312.5 11075 85260 COAG FACTOR X #086306 312.5 11077 84600 ISOPROPYL ALCHOL (BLOOD) #017681 145 11079 P9017 PLASMA-FRESH FROZEN 99 11080 85384 FIBRINOGEN #001610 99 11081 83921 METHYLMALONIC ACID #706961 86.5 11083 86603 ADENOVIRUS ANTIBODIES #096065 173.5 11084 G0480 TRICYCLIC SCREEN #007690 47 11085 80346 KLONOPIN #071712 51.5 11086 84120 PORPHYRINS,TOTAL #823239 65 11087 89190 NASAL SMEAR FOR EOSINOPHILS 48 11088 86603 A-TYPICAL PNEUMONIA ANTIBODY PANEL 340 11089 80150 AMIKACIN #007203 126 11090 G0404 EKG INITIAL PREVENTIVE SCREENING EXAM 137.5 11091 G0403 EKG PRO FEE INITIAL PREVENTIVE SCREENING 62.5 11093 80069 RENAL FUNCTION PANEL 48 11094 86618 LYME AB #258004 116 11095 PATERNAL DNA 939 11200 82175 ARSENIC BLOOD #007245 92 11201 83655 LEAD ADULT #007625 92 11202 83825 MERCURY #810259 92 11203 86325 IMMUNOELECTROPHORESIS-URINE #123034 188 11204 84560 URIC ACID-24 HR URINE #003418 32 11205 82340 CALCIUM-24 HR URINE #003269 32 11206 83945 OXALATE-24 HR URINE #003970 72 11209 82530 CORTISOL URINE FREE RANDOM 147 11210 82626 DHEA-SERUM #004100 74 11211 84105 URINE PHOSPHATE- 24HR #003251 41 11212 86140 C-REACTIVE PROTEIN #006627 86.5 11213 80299 FELBAMATE-SELBATOL #716530 139.5 11214 85305 PROTEIN-S-TOTAL #164517 258 11218 87102 CULTURE, FUNGAL #188243 136 11220 84022 PROLIXIN - (FLUPHENAZINE) #706887 160 11221 84630 ZINC #001800 76 11223 84540 URINE 24HR UREA NITROGEN #003541 50.5 11224 87252 CULTURE VIRAL #008573 525.5 11225 87101 FUNGAL CULTURE SKIN/HAIR/NAIL #008482 91 11226 82043 24 MICROALB/CREAT RATIO #140095 51.5 11227 80200 TOBRAMYCIN PEAK 52.5 11228 83835 METANEPHRINES TOTAL 24UR #004234 61.5 11230 82383 CATECHOLAMINES PLASMA #084152 161 11232 87088 CULTURE URINE 72 11233 87101 FUNGUS (MYCOLOGY) CULTURE #008482 54 11236 82705 FECAL FAT #001677 87.5 11237 89055 FECAL WBC #008656 38 11238 80299 NEURONTIN LEVEL #716811 189 11239 86706 HEPATITIS B SURFACE ANTIBODY #006530 60.5 11240 86003 COLLECTION FEE 25 11243 86304 CA 125 #002303 147 11245 80202 VANCOMYCIN PEAK 109 11247 86255 MITOCHONDRIAL AB #006650 33.5 11253 86255 SMOOTH MUSCLE AB #006643 33.5 11254 87651 RAPID STREP A 98 11255 G6034 DOXEPIN LEVEL #007609 102.5 11256 82553 CK-MB 91 11257 85240 VON WILLEBRAND PANEL #500247 132 11301 83036 HEMOGLOBIN A1C 95.5 11302 82379 CARNITINE TOTAL AND FREE #706500 49.5 11303 82384 CATECHOLAMINES F&T 24UR #004176 169 11304 85245 COAG.FACTOR VIII #086264 302 11305 85250 COAG.FACTOR IX #086298 302 11306 85270 COAG.FACTO XI #086314 302 11307 85280 COAG.FACTO XII #086322 302 11308 86904 ANTIGEN TYPING 262.5 11310 86860 ELUTION TECHNIQUE 157.5 11316 86906 RH PHENOTYPE 109 11317 86787 VARICELLA ZOSTER VIRUS #235945 87.5 11318 83497 HIAA(24HR URINE) #004069 24 11319 89190 CULTURE NASAL 61.5 11320 86709 HEPATITIS A IGM ANITBODY #006734 117 11321 86162 CH50 #001941 116 11354 86255 NEUTROPHIL CYTOPLASMIC AB #163873 38 11356 87220 SCABIES MITE EXAM #188615 60.5 11357 87522 HEPATITIS C ANTIBODY #140659 261.5 11359 83090 HOMOCYSTIENE #706994 56 11364 85705 LUPUS ANTICOAGULANT COMP #117054 111 11368 85302 PROTEIN C ANTIGEN #080465 75 11369 83520 LIPOPROTEIN A #120188 42 11370 85306 PROTEIN S ACTIVITY #164525 94.5 11372 82043 MICROALBUMIN URINE 24 HR.#140050 38 11373 86704 HEPATITIS B CORE AB IGM #016881 75 11376 83605 LACTIC ACID 52.5 11379 G0103 PSA PROSTATE SPECIFIC ANTIGEN ANNUAL 168 11382 87070 CULTURE THROAT 61.5 11383 87070 CULTURE WOUND 42 11384 87070 CULTURE EAR 61.5 11385 87070 CULTURE EYE 42 11386 87070 CULTURE UPPER RESP 61.5 11387 87045 CULTURE STOOL #008144 66.5 11388 87040 CULTURE BLOOD #008300 102.5 11389 87186 SENSITIVITY MIC/PLATE 78.5 11390 87076 ORGANISM I.D. 60.5 11391 87070 CSF CULTURE #180802 61.5 11392 87070 CULTURE GENITAL #008334 61.5 11393 87070 THORACENTESIS CULTURE 61.5 11394 87070 JOINT FLUID CULTURE 51.5 11397 87075 ANAEROBIC CULTURE #008904 109 11399 81005 KETONES (ACETEST) UA 15 11400 86677 H. PYLORI (QL)IN-HOUSE 169 11405 84075 ALKALINE PHOSPHATASE ISOENZYMES #001612 33.5 11411 99195 THERAPEUTIC PHLEBOTOMY 113.5 11414 82952 GLUCOSE TOLERANCE 3 HR 103.5 11415 87800 GC/CHLAMYDIA PROBE #183194 68.5 11416 83874 MYOGLOBIN 95.5 11417 86003 COLLECTION FEE 10 26.5 11418 81000 URINE DIPSTICK 15 11419 85025 CBC WITH REFLEX TO MANUAL DIFF 82.5 11421 82085 ALDOLASE #002030 37 11425 82024 ADRENOCORTICOTROPHIC HORMONE #004440 219 11427 84134 PREALBUMIN #016931 98 11428 82300 CADMIUM (BLOOD) #085340 241 11429 87110 CHLAMYDIA CULTURE #008565 135 11430 86747 PARVOVIRUS B19 G,M #163303 77.5 11433 87070 AEROBIC AND ANAEROBIC CULT. 56 11436 86157 COLD HEMAGLUTININS #006353 50.5 11436 86157 COLD HEMAGLUTININS #006353 50.5 11441 84600 PHENOL #790400 66.5 11442 86800 THYROGLOBULIN-ANTIBODY #006685 101.5 11445 86648 DIPTHERIA #163709 228 11446 87081 GP B STREP #188130 49.5 11448 86631 CHLAMYDIA IGG #138222 121.5 11449 86644 CYTOMEGALOVIRUS PCR #138693 99 11450 86695 HERPES SIMPLEX I & II IGG #164905 98 11458 86765 RUBEOLA #260034 135 11459 86641 CRYPTOCOCCAL #082891 145 11460 84439 T4, FREE 121.5 11462 80299 LAMICTAL (LAMOTRIQINE) #716944 155.5 11463 84484 TROPONIN I 143 11465 P9036 PLATELET PHERESIS (IRRADIATED) 1112 11467 86804 HEPATITIS C VIRAL LOAD #551300 153 11468 80051 ELECTROLYTES PANEL 86.5 11469 80048 BASIC METABOLIC PANEL (BASIC) 117 11470 80053 COMPREHENSIVE METABOLIC (COMP.) 205 11471 80076 HEPATIC FUNCTION PANEL 152 11472 86301 CARBOHYDRATE ANTIGEN 19-9 #002261 209.5 11473 84481 T3 FREE #010389 147 11475 82955 GLUCOSE-6-PHOSPHATE DEHYDROGENASE 001917 91 11476 80152 ELAVIL LEVEL #007476 136 11482 80307 DRUG SCREEN IN-HOUSE URINE 111 11483 84446 VITAMIN E #081000 58 11502 80200 TOBRAMYCIN TROUGH 52.5 11503 80202 VANCOMYCIN TROUGH 66.5 11504 80170 GENTAMICIN TROUGH 110 11507 G0480 NICOTINE LEVEL - URINE #716555 257 11508 83625 LDH ISOENZYMES #001842 102.5 11509 86900 .ABO GROUP 44.5 11510 86901 .RH TYPE 31 11511 86850 .AB SCREEN 54 11532 86606 FUNGAL ANTIBODIES 265884 66.5 11533 86606 ASPERGILLUS ANTIBODIES #164285 90 11534 86612 BLASTOMYCES #164293 76 11535 86635 COCCDIOIDES #139172 68.5 11536 86698 HISTOPLASMA #138635 75 11537 85810 VISCOSITY, SERUM #004861 68.5 11539 83986 STOOL PH #010991 19 11543 82951 FASTING GLUCOSE 48 11555 83880 BNP 128 11556 86300 CA 27.29 #140293 99 11557 80158 CYCLOSPORINE #706556 69.5 11558 82668 ERYTHROPOIETIN #140277 75 11562 80361 HYDROCODONE #803301 170 11565 80299 CORDARONE/AMIODARONE #706705 102.5 11566 84305 SOMATOMEDIN-C IGF-I 205 11567 86817 NARCOLEPSY EVALUATION #167139 326.5 11569 86790 WEST NILE VIRUS #138842 233 11570 83890 CYSTIC FIBROSIS PROFILE #480533 437 11571 84466 TRANSFERRIN #004937 32 11572 G6031 XANAX, ALPRAZOLAM #842039 155.5 11573 83003 HUMAN GROWTH HORMONE #004275 42 11575 86777 TOXOPLASMA #31867 32 11576 86778 TOXOPLASMA IgM 96651 39 11578 82785 IGE #002170 65 11581 82947 GLUCOSE 1 HOUR OB 41 11582 82947 GLUCOSE 41 11583 87103 FUNGAL CULTURE BLOOD #008482 42 11587 85549 LYSOZYME,SERUM #080713 72 11588 82088 ALDOSTERONE,URINE 24HR #004291 122.5 11590 83735 MAGNESIUM,URINE 24HR #281872 30 11591 83516 SYSTEMIC LUPUS ERYTHEMATOSUS(SLE) 231888 179.5 11593 83516 T-TRANSGLUTAMASE AB 143 11594 80197 TACROLIMUS #700248 236 11595 G0480 FENTANYL, URINE #761141 200 11596 86331 HYPERSENSITIVE PNEUMONITISIS PANEL 152 11597 87502 INFLUENZA SCREEN A+B 130 11599 80102 COCAINE METABOLITE CONFIRM #071324 61.5 11600 84238 ACETYLCHOLINE RECEPTOR ANTIBODIES #08590 268 11602 85379 D-DIMER 236 11603 80299 OXCARBAZEPINE #716928 59 11605 82570 IMMUNOELECTROPHORESIS UR 24 #003467 188 11606 G0480 OPIATE POST MORTUM 365.5 11607 G0480 OPIATE SCREEN BLOOD #791575 109 11608 87425 ROTAVIRUS EIA STOOL #006866 65 11609 86611 CAT SCRATCH ANTIBODIES #163162 143 11610 87491 CHLAMYDIA/GC NAA UR #183194 540 11611 84425 VIT B1 THIAMINE #121186 250 11613 84207 VIT B6 #004655 109 11614 83516 ANTIGLIADIN ANTIBODIES G,A #163402 90 11615 86702 HIV 2 #138901 236 11616 86340 INTRINSIC FACTOR AB #010413 209.5 11619 G6056 OXYCODONE SCREEN URINE #737648 93 11620 86003 ALLERGEN (5) MOLDS #602904 740 11621 80361 OXYCODONE SERUM #071538 206 11625 80299 LAXATIVE SCREEN #810200 341.5 11626 82306 VIT D 25-HYDROXY 66.5 11627 82652 VIT D 1-25-DIHYDROXY #500600 73 11628 82310 URINE CALCIUM 24 HOUR #003269 39 11629 80177 LEVETIRACETAM S/ KEPPRA #716936 153 11630 82157 ANDROSTENEDIONE #004705 52.5 11840 87522 HCV QUANTASURE PLUS #550080 162.5 11841 80299 SIROLIMUS (RAPAMUNE) BLOOD#716712 140.5 11842 80299 SIROLIMUS (RAPAMUNE) BLOOD #716712 140.5 11843 84206 PROINSULIN #140533 204 11845 83519 ALPHA SUBUNIT (FREE) #140269 204 11846 82131 CYSTINE 24HR URINE #700195 204 11847 86677 H. PYLORI QUAN. 169 11848 87015 CONCENTRATION FOR INFECTIOUS AGENTS 29 11849 86255 FLUORESCENT AND/OR FAST STAIN BACT FUNGI 158.5 11851 86147 CARDIOLIPIN ANTIBODIES IGA #161836 93 11852 86317 TETANUS ANTIBODIES #163691 47 11853 82679 ESTRONE #500634 66.5 11854 82677 ESTRIOL #004614 66.5 11856 84402 FREE TESTOSTERONE #070195 176.5 11857 85302 PROTIEN C ANTIGEN TEST #080465 60.5 11858 85305 PROTEIN S ANTIGEN #164517 79.5 11859 85306 FREE PROTEIN S ANTIGEN #336028 79.5 11860 82105 ALPHA-FETOPROTEIN TETRA PROFILE #017319 100.5 11864 84402 FREE TOTAL TESTOSTERONE #070195 176.5 11865 85660 HEMOGLOBIN SOLUBILITY PRO. 005330 176.5 11866 84597 VITAMIN K 1 #121200 281.5 11867 86615 BORDETELLA IGA & IGG #326938 174.5 11868 86615 BORDETELLA IGG #161745 174.5 11869 83519 GAD #146035 273 11870 86615 BORDETELLA IGM #161752 174.5 11872 86003 COLLECTION 4PM FEE 50.5 11873 87046 E-COLI-SHIGA #180935 66.5 11874 82565 GLOMERULAR FILT.#100768 34.5 11875 82175 HEAVY METAL, 24UR/RAND, #335622 198 11879 82175 NEURONAL NUCLEAR #10999 QUEST 198 11880 86757 IGG ROCKY MOUNT.#016592 151 11881 84443 FAST TSH 147 11882 87340 HEPATITIS B SURFACE ANTIGEN #006510 60.5 11884 82043 MICROALBUMIN/CREAT RATIO #140285 38 11886 84255 SELENIUM #716910 86.5 11887 86664 CYTOMEGALOVIRUS IGM &IGG #221085 48 11888 86665 EPSTEIN BAR IGG,AB/VIRAL CAPSID #096230 48 11889 86665 EPSTEIN BAR IGM #8426 48 11890 88271 URINE FISH 169 11891 88271 FISH CLL #510340 693.5 11893 86038 ANA SCREEN REFLEX #164880 75 11894 86735 MUMPS IGM #160499 118 11895 86735 MUMPS IGG & IGM #262295 118 11896 86800 ANTITHYROGLOBULIN # 006685 34.5 11897 86308 MONO QUALITA. #006189 34.5 11898 86666 EHRLICHIOSIS #164680 34.5 11899 86757 ROCKY MOUNTAIN FEVER IGG #016592 151 11900 82943 GLUCAGON PLASMA #004622 151 11901 84586 VIP PLASMA #010397 262.5 11902 82107 AFP-L3% # 141300 320 11903 83498 17-HYDROXYPROGESTRONE # 070085 189 11904 82746 FOLATE SERUM 320 11907 80342 CLOZAPINE #706440 156.5 11908 82150 AMYLASE ISOENZYMES #123110 156.5 11909 84432 THYROGLOBULIN QUAN. #070125 235 11910 86800 THYROGLOBULIN QUAN. #070125 235 11911 84157 PROTEIN TOTAL BODY FLU. #019588 86.5 11912 83525 INSULIN FREE AND TOTAL #501561 118 11913 86618 LYME AB/WESTREN BLOT #160325 116 11922 86664 EPSTEIN BAR IGG NUCLEAR AG AB #010272 48 11923 86663 EPSTEIN BAR IGG AB TO EARLY AG #096248 48 11924 82533 CORTISOL,AM TOTAL. 175.5 11925 82533 CORTISOL,PM 175.5 11926 84402 FREE DIRECT TESTOSTERONE #070195 176.5 11927 82175 HEAVY METAL #042580 198 12031 87070 BODY FLUID CULTURE VIRAL #180802 61.5 12035 86706 HBV FOLLOW UP PROFILE #140810 152 12036 86706 VIRAL LESION CULT #008573 152 12037 87255 VIRAL LESION CULT 4 12040 82652 25 HYDROXYVITAMIN D2 D3 081950 315.5 12042 82542 ZONISAMIDE #37852 237 12047 82507 CITRATE URINE 24 #242388 257 12051 G0480 PREGABALIN (LYRICA) #808320 232 12056 86038 CHLORINATED PESTICIDES #810059 380.5 12057 80201 TOPIRAMATE (TOPOAMAX) #716285 201 12058 87077 URINE ID&SENS/LABCORP/182261 75 12067 86609 NEISSERIA GONOR. SERUM #825086 56 12068 86022 HEPARIN-INDUCED PLAT.ANTIB.#150075 382.5 12071 83516 GLIADIN IGG #161687 79.5 12072 83516 GLIADIN IGA #161646 79.5 12073 83516 TIS. TRANSGLU. (tTG) IGA #164640 89 12074 83516 RETICULIN ANTI IGA #161760 107 12075 87205 GRAM STAIN #008540 42 12081 82784 CELIAC DISEASE COMP. PROFILE #165142 54 12088 83930 ANTIDIURETIC HORMONE PROFILE #010447 69.5 12092 G0480 CANNABINOID SCREEN BLD. #791566 152 12093 84482 REVERSE T3 #070104 102.5 12094 86141 CRP CARDIAC #120766 29 12095 84402 TESTOSTERONE FREE &TOTAL #070195 83.5 12098 83874 MYOGLOBIN RANDOM URINE #003079 36 12099 82172 APOLIPOPROTEIN A-1 #016873 33.5 12100 83520 TRYPTASE #004280 145 12103 83655 LEAD PEDIATRIC 717009 92 12114 86301 CARBO ANTIGEN CA19-19 #002261 169 12116 89051 CELL COUNT SYNOVIAL FLUID #005231 63.5 12124 82164 ANGIOTENSIN-CONVERTING ENZYME #010116 68.5 12129 82330 CALCIUM IONIZED #004804 121.5 12131 87802 BETA STREP (GROUP B) #018804 207 12137 80307 DRUG ABUSE PANEL, SERUM 700841 376.5 12143 84166 URINE 24 ELECTRO. #003368 215 12167 G0480 BENZODIAZEPINES, BLOOD #791710 169 12169 87385 URINE HISTO ANTIGEN TEST 823203 198 12178 83021 HEMOGLOBINOPATHY PROFILE #122101 244.5 12180 84402 TESTOSTERONE FREE BOUND #501247 126 12181 84133 POTASSIUM URINE #343709 93 12182 82436 CHLORIDE URINE 24 HR #003524 93 12183 84300 SODIUM URINE #300068 93 12184 84600 DRUG SCREEN BLOOD #700886 173.5 12189 86300 CANCER ANTIGEN CA 15-3 #143404 147 12197 83520 SOLUBLE TRANSFERRIN RECEPTOR #143305 217 12203 82947 GLUCOSE 2 HOUR 54 12204 87077 CULTURE ID AND SENSITIVITY #182261 75 12205 82627 DHEA-SULFATE #004020 173.5 12206 83021 HEMOGLOBINOPATHY PROFILE WITH SOL.121679 151 12217 87177 GIARDIA LAMBLIA EIA #180935 175.5 12222 87300 HSV, DFA #008508 125 12225 G6056 MORPHINE QUANTITATION #890367 221 12228 84075 BONE SPECIFIC ALK PHOS.#513002 169 12229 83937 OSTEOCALCIUM BONE #010249 186 12239 84305 IGF-1 #010363 205 12241 86301 CA 19-9 #002261 147 12247 82232 BETA 2 MICROGLOBULIN #010181 62.5 12248 86631 CHLAMYDIA TRACH #806649 75 12249 86677 H. PYLORI ANTIBODIES # 163683 285 12254 87169 PARASITE ID PANEL #008219 112.5 12255 84703 HCG BETA SCREEN URINE 98 12261 80188 PRIMIDONE LEVEL # 007856 128 12262 86235 ANTI RNP #016353 161 12264 86200 ANTI CCP #164914 186 12266 87385 HISTOPLASMA URINE #823203 166 12269 87798 PERTUSSIS / BORDETELLA #138677 161 12276 84702 HCG GESTATIONAL TABLE 154 12277 86360 HELPER/ SUPPRESS RATIO PROF.#505040 211 12279 80048 SHORTNESS OF BREATH PANEL 690.5 12280 86403 STREPTOZYME #006007 161 12281 83891 HEP B GENOTYPE # 551750 161 12288 82985 FRUCTOSAMINE #100800 32 12289 86735 BABESIA MICROTI ANTIBODIES #138315 186 12292 85303 PROTEIN C & S LEVEL #337394 104.5 12294 82784 IgG SUBCLASSES PANEL #209601 297.5 12299 82785 IMMUNOGLOBULIN IgE #002170 84.5 12303 82105 ALPHA-FETOPROTEIN TUMOR MARKER #002253 100.5 12309 83018 COBALT #071506 195.5 12316 84156 PROTEIN, ELECTRO. SERUM # 001487 68.5 12319 82525 URINE 24 COPPER #003343 117 12321 85410 ALPHA2 ANTIPLASMA # 117739 169 12322 86671 SACCHAROMYCES IGA/IGG #164657 416.5 12327 84252 VIT B2 #123220 109 12331 87522 HEPATITIS C QUAN. #550080 261.5 12332 87517 HEPATITIS B QUAN. #551610 261.5 12333 87389 HIV-1/2 4TH GENERATION #083935 167 12337 87169 STOOL PARASITE ID #008219 112.5 12338 89060 CRYSTAL SYNOVIAL/JOINT FLUID #005355 112.5 12339 87449 NOROVIRUS RT-PCR STOOL #138307 250 12340 84153 FRACTIONATED PSA #070195 168 12343 87070 BRONCHWASH C&S #188177 51.5 12344 87077 12644 75 12345 86146 BETA-2-GLYCOPROTEIN I G,A,M #163915 150 12348 82525 COPPER, RBC #081162 76 12349 84630 ZINC, RBC #070029 76 12350 84630 ZINC,RANDOM/ 24 URINE #003434 76 12351 82525 COPPER, RAN/URINE/CREAT. #003343 76 12351 82525 COPPER, RAN/URINE/CREAT. #003343 76 12352 80053 COMP. GLOMERULAR FILT. PANEL #322000 34.5 12353 86658 COXSACKIE A ANTIBODY #163275 169 12361 82565 CREATININE WITH GLOMERULAR FILT#100768 169 12368 82150 AMYLASE ISOENZYMES W/REFLEX #806832 169 12369 86708 HEPATITIS A ANITBODY #006726 117 12370 87522 HEP C,VIRAL RNA REFLEX GENO.#550090 117 12371 83014 H. PYLORI- BREATH TEST #180836 226 12372 G0480 URINE BENZO QUANT #071308 153 12378 87521 HEPATITIS C QUALIT.#550713 261.5 12380 83721 DIRECT LDL #120295 54 12381 85306 PROTEIN S ACTIVITY #164525 104.5 12382 82784 IMMUNOFIXATION IFE PANEL #001685 170 12387 86972 CELL SEPARATION 127 12388 86976 ANTIBODY TITRATION 91 12389 86255 NEURONAL NUCLEAR ANTIBODY #808966 243.5 12390 83520 GANGLIOSIDE GM-1 #808631 396.5 12393 83520 MYELIN ASSOC. GLYCOPROTEIN #808973 310.5 12397 83993 CALPROTECTIN STOOL #123255 396.5 12398 82656 PANCREATIC ELASTASE-1 #123234 605.5 12399 82785 RESP. ALLERGY AREA 5 #602632 815.5 12401 86003 ALLERGY PANEL ANIMAL #602620 142 12402 86003 HYMENOPTERA ALLERGY PNL #067710 142 12403 86003 ALLERGENS(5) GRAINS #641696 142 12404 86003 ALLERGENS (5) VEGETABLES #641704 142 12405 86003 ALLERGENS (5) SALAD #641712 142 12406 86003 ALLERGENS (13) NUTS 142 12407 87070 BACTERIAL CULT. AER. SPECIAL #008649 170 12409 82272 OCCULT BLOOD DIAGNOSTIC 33 12410 86316 CHROMOGRANIN A, #140848 226 12411 82017 ACYLCARNITINE, PLASMA #070228 340 12412 82261 BIOTINIDASE #402362 221 12413 83918 ORGANIC ACIDS, URINE #716720 511.5 12417 80069 GLOMERULAR FILT(eGFR) #100768 52.5 12418 83883 KAPPA/LAMBA LIGHT CHAINS #121137 52.5 12419 P9022 WASHED PRBC'S 565.5 12420 86902 ANTIGEN SURCHARGE #330 136 12421 81225 CLOPIDOGREL #511710 169 12423 82570 PROTEIN ELECTROPHORESIS W/SCAN #261511 119.5 12426 81241 FACTOR V LEIDEN MUTATION #511154 170 12427 81400 PROTHROMBIN-19911A-G MUTATION #511162 507.5 12428 83051 HEMOGLOBIN PLASMA #005595 46 12429 86200 CCP ANTIBODY #164914 136 12435 86003 LATEX K82 IgE #650390 31 12437 86335 IMMUNOGLOBULINS PANEL #001768 49.5 12438 83898 CYSTIC FIBROSIS GENE SEQUENCE #252763 5655 12440 80074 HEP. PANEL ACUTE #322744 101.5 12441 83872 SYNOVIAL FLUID CELL CT, #032714 46 12444 87254 VARICELLA-ZOSTER CUL #186031 170 12445 82139 AMINO ACID LC/MS 700068 370 12446 84120 PYRUVIC ACID # 004788 31 12447 87491 CHLAMYDIA TRACH DNA #188078 170 12449 84560 URIC ACID SYNOVIAL FLUID # 019505 7 12450 86157 COLD AGG. TITER QUANT. 29 12452 82040 BORRELIA BURGDORFERI ANTIBODY #905175 636 12453 84376 STOOL REDUCING SUBSTANCES #5022 38 12454 80299 DRUG ANALYSIS UNKNOWN QUAL. (LABCORP) 287 12455 G0480 DRUG PAIN MANG. PROFILE # 764131 371.5 12456 P9040 PRBC'S IRRADIATED 437 12457 82570 PROTEIN ELECTROPHORESIS RAD.URINE 337834 119.5 12460 83516 LUPUS (12) PANEL #364668 437 12472 G0480 DRUG PAIN MANG.BUP. URINE #763400 371.5 12473 80299 METHOTREXATE #007658 39.5 12474 86361 T-HELPER (CD4 LYMPH) #505078 69 12475 80069 RENAL FUN.PAN eGFR #322777 17.5 12476 80307 CITY URINE DRUG SCREEN 20 12477 G0480 HAIR DRUG SCREEN #6945 1584.5 12478 83789 URINE IODINE RANDOM #070163 164.5 12479 84140 PREGNENOLONE LC/MS/MS #140707 143.5 12480 82570 METHYLMALONIC ACID, URINE #716365 49.5 12482 83090 HOMOCYSTEINE RAND. URINE #716290 280.5 12483 84155 SERUM PROTEIN ELE.REFLEX.#123026 22 12485 86157 COLD HEMAGGLUTININS #006353 14.5 12486 84270 SHGB # 082016 43 12487 87798 B.PERTUSSIS/PARAPERTUSSIS #138677 325 12489 84311 PHOSPHOLIPIDS #001727 135.5 12491 80299 RITALIN-METHYLPHENIDATE #791170 180.5 12492 86638 Q FEVER REFLEX TITERS # 806606 119.5 12493 83519 TSH ANTIBODY #201959 451.5 12494 G0480 CANNABINOID SCREEN URINE #071454 60.5 12495 84145 PROCALCITONIN # 164750 546.5 12496 87081 MRSA SCREEN CULTURE #183467 106 12497 87081 CULTURE GROUP B STREP #188130 23 12498 84120 PORPHYRINS FRACT. 24 URINE #003194 46.5 12499 80197 PROGRAF (FK506) #700248 104 12500 G0480 PPX=Q #737472 147 12501 83883 FREE KAPPA &LAMBDA K/L RATIO #121228 492 12502 82365 STONE ANALYSIS #120790 47.5 12503 85520 ANTI TEN-A #117101 303.5 12504 87106 YEAST ID # 182212 106 12505 86000 FRANCISELLA TULARENIS #823263 146 12506 82310 URINE CALCIUM RANDOM #013706 15 12507 G0461TC IMMUNOCHEM STAIN #1 103 12508 82952 GLUCOSE TOLERANCE 2 HR 103.5 12509 83925 MEPERIDINE #007534 164 12511 81256 HEMOCHROMATOSIS DNA #511345 331 12512 87081 NEISSERIA GONOR CULT #008128 39.5 12514 87502 INFLUENZA A H1N1 PCR #186205 518 12515 84105 PHOSPHORUS RANDOM UR #013714 13 12516 83789 DRUG PAIN MANG. GABAPENTIN #70205 191 12517 82507 STONERISK #261289 159 12518 84133 POTASSIUM 24 HR URINE #003186 20.5 12519 84300 SODIUM 24 HR URINE #003178 20.5 12520 82340 URORISK DIAGNOSTIC PROFILE #242339 220 12521 82042 ALBUMIN PERITONEAL FLUID # 315780 11 12522 85520 HEPARIN ANTI-XA #117101 294 12523 83883 RETINOL BINDING PROTEIN #123060 173 12524 86706 HEP-B SURFACE ANTI-QUANT. #006395 20.5 12525 82726 LONG FATTY ACID #831503 552 12526 83835 METANEPHRINES PLASMA #121806 367 12527 82383 TOTAL CATECHOLAMINES PLASMA #18463 161 12528 86355 T AND B LYMPH/ NAT.KILLER #505015 920.5 12532 83516 TISSUE (tTG) ANTIBODIES IgG IgA #307560 119 12533 86255 ENDOMYSIAL ANTIBODY IgA #164996 88 12534 87497 CMV DNA QN PCR # 139149 384 12535 87338 H-PYLORI ANTIGEN STOOL #180764 119 12539 80299 ZIPRASIDONE #847525 220 12540 83789 RISPERIDONE #716563 241 12541 82570 URINE SODIUM & CREAT. 24HR #379768 9 12542 82340 URINE CALCIUM & CREAT. 24HR #038596 17.5 12543 82507 URINE CITRIC ACID & CREAT. 24HR #121202 26 12544 86200 RA DIAG. PANEL #164065 204 12545 86317 S. PNEUM. IGG #816756 204 12546 83789 PAIN MGMT, RITALINIC ACID #791170 204 12547 82570 URINE CREATININE/ 24 HOUR #003012 52.5 12548 86317 STREP.PNEU.IGG MAID #16963 768.5 12549 86003 PEANUT F13 IGE #602451 23.5 12550 86480 QUANTIFERON TB GOLD #182879 163 12551 86777 TOXOPLASMA ANTIBODY IGG #006478 30 12552 86644 CYTOMEGALOVIRUSANTIBODY IGG #006494 19.5 12553 87901 HIV-1 GENOTYPE #551697 1133 12554 87903 PHENOSENSE #551800 3116 12555 87497 CYTOMEGALOVIRUS DNA QUAN PCR #139149 225.5 12556 G0461TC IMMUNOCHEM STAIN ANY ADD. SAME SITE 99 12558 81479 IBD SGI DIAGNOSTIC PANEL 1596.5 12559 G6046 HYDROMORPHONE #814715 155.5 12560 84480 T3 TOTAL #002188 9.5 12562 G0480 DRUG PAIN MANG. 10 # 789119 235 12563 G0480 LABCORP UDS SENDOUT. 476 12564 83721 LDL 50.5 12565 83516 TIS-TRANSGLUTAMASE AB IgG #164988 143 12566 83519 IGF BINDING PROTEIN-1 #140822 94 12567 82310 PTH INTACT AND CALCIUM #054601 44 12568 88184 CD3 PANEL #096834 187 12571 87535 HIV-1 RNA QUAL. #139350 625 12572 87541 LEGIONELLA, DNA QL.PCR-SPUTUM #080987 400 12573 87449 LEGIONELLA, ANTIGEN EIA #182246 63 12574 86403 STREP PNEUMONIAE ANTIGEN. #018788 105 12575 84300 URINE NA+ RANDOM #13326 42 12576 81206 BCR-ABLI AND BCR-2 #480481 750 12578 81270 JAK2 V617F # 489395 812 12579 89325 SPERM ANTIBODY IgA IgG #808813 76 12580 86161 C1 INHIBITOR FUNCTIONAL ##120220 44 12581 83519 PTH RELATED PROTEIN #503380 150 12582 84540 URINE UREA NITROGEN RDM.#013508 12 12583 84156 URINE PROTEIN TOTAL RANDOM# 013664 7.5 12584 84311 FUNGITELL-SERUM #284526 750 12585 84431 ASPIRIN RESISTANCE B2 #501620 278 12586 G0480 BENZODIAZEPINES SERUM # 007898 177.5 12587 G0480 OPIATES SERUM #790554 275 12588 87536 HIV1RNA QNT PCR #550430 760 12589 83993 FECAL CALPROTECTIN #123255 350 12590 86308 HETEROPHILE, MONO SCREEN #006189 13 12591 82495 CHROMIUM SERUM # 071522 45 12592 84591 VITAMIN B3 #070115 445 12593 86430 RF SYNOVIAL FLUID #161463 160 12594 80358 METHADONE CONF UR #700070 125 12595 G6053 METHADONE CONF. SERUM # 007781 125 12596 82374 URINE BICARBONATE #825440 140 12597 83615 LD PERITONEAL FLUID #100156 95 12598 84157 PROTEIN TOTAL PERITONEAL FLUID #019588 6 12599 82150 AMYLASE PERITONEAL FLUID #088062 12 12600 82378 CEA PERITONEAL FLUID #142331 21 12601 82945 GLUCOSE PERITONEAL FLUID #019497 11 12602 82523 COLLAGEN TYPE 1 CTX #500089 173 12603 82523 N-TELOPEPTIDE SERUM #140830 328 12604 86003 PEANUT TOTAL WITH REFLEX #603916 63 12605 84143 17-HYDROXPREGNENOLONE #140715 215 12610 83735 MAGNESIUM RBC #080283 22 12611 83520 VASCULAR -VEGF #117006 421 12612 82491 COENZYME Q10 #120251 140 12613 82180 VITAMIN -C #001479 17 12614 82172 HCV FIBROSURE # 550123 721 12615 80299 ITRACONAZOLE #700282 171 12617 G0480 COCAINE METABOLITE SCREEN #701861 142 12618 87798 TROPHERYMA DNA PCR #800340 425 12619 86021 INFLAMMATORY BOWEL DISE #164830 686 12620 86255 HU ANTIBODY SRN REFLEX WEST BLOT 808988 222 12621 87015 MYCOBACT.CULT.FLUOROCHROME SMEAR#4554 37 12622 82978 GLUTATHIONE TOTAL #007700 180 12623 83986 PH BODY FLUID #011254 123 12624 83880 BNP NT PRO 487 12625 80369 BACLOFEN (LIORESAL) SERUM # 80833 500 12626 80369 BACLOFEN (LIORESAL) URINE #809635 542 12629 87260 VIRUS RESPIRATORY PANEL # 186296 500 12630 87799 EPSTEIN BAR QUAN PCR # 138230 600 12631 87799 BKQUANT PCR #138962 907 12632 83789 IODINE SER/PLAS #070034 155 12633 86632 CHLAMYDIA IGM PNEU AB #138338 382 12634 86160 C1q QUANT # 016824 50 12635 82656 ELASTASE STOOL #123234 525 12640 88342 FECAL CHYMOTRYPSIN # 213092 100 12641 81291 MTHFR # 511238 208 12642 81403 KIR # 168257 1000 12643 84156 PROTEIN-CREATININE RAND. URINE # 003129 138 12644 86160 C1 ELASTASE INHIBITOR FUNC.# 4648 59 12645 86003 PEDIATRIC 0-3 ALLERGEN PROFILE #671935 50 12646 83520 IGF BINDING PROTEIN-3 #140152 115 12647 82610 CYSTATIN C # 121251 338 12648 83915 5 NUCLEOTIDASE # 001701 61 12649 82164 ANGIOTENSIN CONVERTING ENZYME #010116 22 12650 86606 FUNGAL ANTIBODIES QUANT.#091454 337 12651 87507 GI PROFILE STOOL # 183480 1625 12652 87633 RESPIRATORY VIRUS PROFILE # 139250 1225 12653 86256 ANTIMYOCARDIAL ANTIBODIES # 085910 35 12654 82172 NASH FIBROSURE #550140 707 12655 80299 VORICONAZOLE #700353 810 13600 80323 URINE NICOTI ANABAS COTININE #070114 300 13601 83520 INTERLEUKIN 2 SERUM #140912 304 13602 83520 INTERLEUKIN 2 RECEPTOR #142455 396 13603 87799 EPSTEIN BAR QUAN DNA PCR # 139490 WB 1088 13604 82523 PINP # 140850 464 13635 82585 CRYOFIBRINOGEN, QUAL #080317 18.24 13636 86235 ANTIEXTRACTABLE NUCLEAR AG #006338 56 13637 84999 OSMOLALITY (FECAL) #120071 25 13638 83631 LACTOFERRIN FECAL QUAN#123016 332 13639 86704 HEPATITIS ANTI HBC # 006718 18 13640 86682 TOXOCARA ANTIBODY ELISA #34304 87 13641 82175 HEAVY METAL II #070813 198 13642 87624 HPV TISSUE #503500 454 13643 80299 FLECAINIDE (TAMBOCOR) # 085662 118 13644 87798 PLASMODIUM SP PCR # 139475 325 13645 85007 PERIPHERAL SMEAR CONSULT 22 13646 86008 ALPHA GAL IGE #80ALPHA GAL IGE #806562 142 13647 86003 ALLERGENS 12 ENV. # 602032 142 13648 82785 ALLERGENS CHILD FOOD PROFILE # 602988 142 13649 86003 ALLERGENS PROFILE FISH # 601013 70 13650 86003 ALLERGENS PROFILE SHELLFISH # 062695 90 13651 83525 ISLET CELLDYSFUNCTION GROUP 1 #500757 270 13652 87070 LEGIONELLA, SPECIES CULTURE #086868 133 13654 86403 STREP PNEUMONIAE ANTIGEN URINE #183009 105

RADIOLOGY 40001 70260 SKULL MIN 4V 264.5 40002 70150 FACIAL BONES(COM)3V MIN 300.5 40004 70160 NASAL BONE(COM)3V MIN 208 40005 70220 SINUSES (COM)3V MIN 264.5 40009 70200 ORBITS COMPLETE 4V MIN 264.5 40013 72220 SACRUM/COCCYX 2V MIN 188.5 40014 72070 T-SPINE 2V 257.5 40015 72052 C-SPINE COMPLETE 251.5 40016 72100 L-SPINE 2-3 VIEWS 235.5 40019 73610LT ANKLE MIN 3V LT 212 40021 73552LT FEMUR 2V LT 212 40025 73630LT FOOT MIN 3V LT 235.5 40026 73501 HIP UNI 1V LT W/PELVIS 104 40027 73502 HIP MIN 2V LT W/PELVIS 197 40031 73562LT KNEE 3V LT 198.5 40034 73590LT TIB/FIB 2V LT 185 40036 73560LT PATELLA LEFT 261 40039 73660LT TOES 2V MIN LEFT 180 40040 72170 PELVIS 1-2V 212 40042 73000LT CLAVICLE LT 160 40047 73080LT ELBOW MIN 3V LT 198.5 40050 73140 FINGERS MIN 2V LT 160 40054 73090LT FOREARM 2V LT 185 40059 73130LT HAND MIN 3V LT 198.5 40062 73060LT HUMERUS MIN 2V LT 197 40066 73030LT SHOULDER MIN 2V LT 197 40071 73110LT WRIST 3V MIN LT 198.5 40074 73010LT SCAPULA COMPLETE LT 160 40075 73010RT SCAPULA COMPLETE RT 160 40078 73050 A/C JOINTS BIL 160 40079 71100LT RIBS UNI 2V LT 279.5 40080 71101LT RIBS UNI W/CXR 3V LT 210 40081 71045 CHEST SINGLE VIEW 185 40082 71046 CHEST PA/LAT 2 VIEWS 227 40083 71047 CHEST PA/LAT/DECUBITIS 235.5 40084 71045 PORTABLE CHEST SINGLE VIEW 227 40085 71101RT RIBS UNI W/CXR 3V RT 210 40086 74018 ABDOMEN SINGLE VIEW 134.5 40087 74019 ABDOMEN SUP/ERECT/DECUB 210 40088 74270 BARIUM ENEMA/COLON 317.5 40090 74247 UGI SERIES W/KUB 498.5 40092 74250 SMALL BOWEL FOLLOW THRU 317.5 40093 74410 IVP 317.5 40094 74220 BA SWALLOW/ESOPHAGUS 317.5 40097 74022 AAS/INCLUDING CXR 363 40098 72040 C-SPINE 2-3V 164 40099 72082 SCOLIOSIS STUDY 225 40100 74249 UGI W/SBFT 479 40101 76010 BABYGRAM 190 40102 72020 SPINE SINGLE VIEW 84 40103 77075 SKELETAL SURVEY (METS) 286 40104 70110 MANDIBLE MIN 4V 263.5 40105 71048 CHEST 2V W/LORD VIEWS 186.5 40106 71048 CHEST 2V W/OBLIQUE VIEWS 186.5 40107 71100RT RIBS UNI 2V RT 279.5 40108 77080 DXA BONE DENSITY, HIP, PELVIS,SPINE 214.5 40109 77081 DXA BONE DENSITY,RADIUS, WRIST, HEEL 164 40110 72200 SI JOINTS < 3 VIEWS 133 40111 77086 DXA IVA, VERTEBRAL FX ASSESSMENT 113.5 40112 73092 INFANT UPPER EXTREMITY 185 40113 73592 INFANT LOWER EXTREMITY 185 40114 73502 PEDIATRIC PELVIS 185 40115 70100 EYE EXAM DETECTION FOREIGN OBJECT 216.5 40116 72110 L-SPINE(COM) W/OBLIQUE 347.5 40117 70330 TMJ BILATERAL 330.5 40118 72072 T-SPINE 3V 341.5 40119 74176 CT ABD AND PELVIS W/O CONTRAST 1361 40120 74177 CT ABD AND PELVIS W/CONTRAST 2097 40121 74178 CT ABD/PEL W/W-O CONTRAST 2662.5 40122 76857 US PELVIS- LIMITED OR F/U 400 40123 77075 BONE AGE STUDIES 221.5 40124 76857 US SOFT TISSUE PELVIC WALL 400 40125 73206 CTA UPPER EXTREMITY 1175.5 40126 73706 CTA LOWER EXTREMITY 1175.5 40127 74175 CTA ABDOMEN 1175.5 40128 75635 CTA ABDOMINAL AORTA WITH RUNOFFS 1175.5 40129 70486 CT SINUS W-O CONTRAST 1079.5 40130 70487 CT SINUS W/CONTRAST 1301.5 40131 70488 CT SINUS W/W-O CONTRAST 1306 40132 72131 CT SACRUM/COCCYX W-O CONTRAST 1388.5 40192 71275 CTA CHEST PE W/WO CONTRAST 1632.5 40195 73503 HIP BI-LAT MIN 4V W/PELVIS 370 41085 71110 RIBS BILATERAL 3V 272.5 41268 70496 CTA HEAD 1175.5 41269 70498 CTA NECK W/WO CONTRAST 1175.5 41287 71275 CTA CHEST PE W/ CONTRAST 1632.5 41288 70498 CTA NECK WITH CONTRAST 1175.5 41289 71275 CTA CHEST 1632.5 41350 74150 CT ABD W-O CONTRAST 1301.5 41351 74160 CT ABD W/CONTRAST 1486.5 41352 74170 CT ABD W/W-O CONTRAST 1634.5 41353 71250 CT CHEST W-O CONTRAST 1301.5 41354 71260 CT CHEST W/CONTRAST 1449.5 41355 71270 CT CHEST W/W-O CONTRAST 1359 41356 70450 CT HEAD OR BRAIN W-O CONTRAST 1079.5 41357 70460 CT HEAD W/CONTRAST 1301.5 41358 70470 CT HEAD W/W-O CONTRAST 1486.5 41359 72125 CT C-SPINE W-O CONTRAST 1079.5 41360 72126 CT C-SPINE W/CONTRAST 1301.5 41361 72127 CT C-SPINE W/W-O CONTRAST 1486.5 41362 73200 CT UPPER EXT W-O CONTRAST 794.5 41363 73201 CT UPPER EXT W/CONTRAST 950 41364 73202 CT UPPER EXT W/W-O CONTRAST 1359 41365 72192 CT PELVIS W-O CONTRAST 1301.5 41366 72193 CT PELVIS W/CONTRAST 1486.5 41367 72194 CT PELVIS W/W-O CONTRAST 1634.5 41368 70360 NECK SOFT TISSUE 160 41369 73650LT HEEL CAL MIN 2V LT 160 41371 71120 STERNUM 2V MIN 160 41373 70480 CT ORBIT,IAC,ST,PT FOSSA W-O CONTRAST 766.5 41374 72128 CT T-SPINE W-O CONTRAST 918 41375 72129 CT T-SPINE W/CONTRAST 1359 41376 72130 CT T-SPINE W/W-O CONTRAST 1359 41377 72131 CT L-SPINE W-O CONTRAST 1388.5 41378 72132 CT L-SPINE W/CONTRAST 1359 41379 72133 CT L-SPINE W/W-O CONTRAST 1359 41380 70488 CT FACIAL/ W/W-O CONTRAST 1306 41381 70486 CT FACIAL W-O CONTRAST 1079.5 41382 70490 CT NECK ST W-O CONTRAST 931 41383 70481 CT ORBIT,IAC,ST,PT FOSSA W/CONTRAS 1080.5 41384 70482 CT ORBIT,IAC,ST,PT FOSSA W/W-O 1359 41385 70491 CT NECK ST W/CONTRAST 992.5 41386 70487 CT FACIAL W/CONTRAST 1301.5 41387 73700 CT LOWER EXT W-O CONTRAST 794.5 41388 73701 CT LOWER EXT W/CONTRAST 950 41389 73702 CT LOWER EXT W/W-O CONTRAST 1359 41390 72192 CT HIP W-O CONTRAST 931 41391 72193 CT HIP W/CONTRAST 950 41392 72194 CT HIP W/W-O CONTRAST 1359 41396 70492 CT NECK ST W/WO CONTRAST 1342 42000 76700 US ABDOMEN COMPLETE 703 42003 76856 US PELVIC TRANSABDOMINAL ONLY 568.5 42004 76705 US GALLBLADDER 568.5 42005 76705 US PANCREAS 466.5 42006 76705 US RIGHT UPPER QUADRANT 568.5 42007 76775 US RENALS 568.5 42008 76775 US AORTA 568.5 42009 76536 US THYROID 568.5 42010 76641 US BREAST COMPLETE 568.5 42011 74280 BARIUM ENEMA W/AIR 491.5 42013 76536 US SOFT TISSUE HEAD/NECK 641 42014 93880 US DUP CAROTID BIL 552.5 42015 76870 US SCROTUM & CONTENTS 568.5 42016 93970 US DUP EXT VEIN BIL 428 42017 76881 US SOFT TISSUE LOWER EXTREMITY 568.5 42018 76830 US PELVIC TRANSVAGINAL ONLY 568.5 42019 93971 US DUP EXT VEIN UNI 286.5 42021 76705 US ABDOMEN LIMITED 272.5 42022 76882 US SOFT TISSUE AXILLA 286.5 42024 76815 US OB LIMITED FETUS 314.5 42025 76705 US SOFT TISSUE ABDOMINAL WALL 568.5 42026 76604 US SOFT TISSUE UPPER BACK 381 42028 76705 US SOFT TISSUE LOWER BACK 272.5 42029 76857 US SOFT TISSUE BUTTOCK 400 42030 76857 US SOFT TISSUE PERINEUM 400 42031 76881 US SOFT TISSUE UPPER EXTREMITY 568.5 42032 76882 US SOFT TISSUE GROIN 286.5 42033 76706 US AORTA SCREEN 204 42034 76604 US SOFT TISSUE CHEST 381 42036 93925 US DUP EXT ART BIL 593.5 42037 93926 US DUP EXT ART UNILATERAL 494.5 42038 73010LT SCAPULA LT 155.5 42039 93882 US DUP EXTRACRANIAL ARTERIES 373 42040 51798 US BLADDER 167 48819 73610RT ANKLE MIN 3V RT 212 48821 73552RT FEMUR 2V RT 212 48825 73630RT FOOT MIN 3V RT 235.5 48826 73501 HIP UNI 1V RT W/PELVIS 104 48827 73502 HIP MIN 2V RT W/PELVIS 197 48831 73562RT KNEE 3V RT 198.5 48834 73590RT TIB/FIB 2V RT 185 48836 73560RT PATELLA RIGHT 261 48837 73565 KNEE BILATERAL 198.5 48839 73660RT TOES 2V MIN RIGHT 180 48842 73000RT CLAVICLE RT 160 48847 73080RT ELBOW MIN 3V RT 198.5 48850 73140 FINGERS MIN 2V RIGHT 160 48854 73090RT FOREARM 2V RT 185 48857 72170 PELVIS MINIMUM 3V (Ortho) 212 48859 73130RT HAND MIN 3V RT 198.5 48862 73060RT HUMERUS MIN 2V RT 197 48866 73030RT SHOULDER MIN 2V RT 197 48871 73110RT WRIST 3V MIN RT 198.5 49969 73650RT HEEL CAL MIN 2V RT 160 49970 76856 US PELVIC COMPLETE- TRANSABD/TRANSVAG 568.5

MEDICATIONS 70000 J7030 NORMAL SALINE 0.45%-1000 ML INJ 46.5 70000 J7030 NORMAL SALINE 0.45%-1000 ML INJ 46.5 70000 J7030 NORMAL SALINE 0.45%-1000 ML INJ 46.5 70000 J7030 NORMAL SALINE 0.45%-1000 ML INJ 46.5 70000 J7030 NORMAL SALINE 0.45%-1000 ML INJ 46.5 70001 J7030 NORMAL SALINE 0.9%:100ML 5 70001 J7030 NORMAL SALINE 0.9%:100ML 5 70001 J7030 NORMAL SALINE 0.9%:100ML 5 70001 J7030 NORMAL SALINE 0.9%:100ML 5 70003 J7042 DEXTROSE 5% & 0.225% SOD CHLOR 1000ML 43 70003 J7042 DEXTROSE 5% & 0.225% SOD CHLOR 1000ML 43 70003 J7042 DEXTROSE 5% & 0.225% SOD CHLOR 1000ML 43 70003 J7042 DEXTROSE 5% & 0.225% SOD CHLOR 1000ML 43 70004 J7070 DEXTROSE 5% & 0.45% SOD CHLOR 1000ML 43 70004 J7070 DEXTROSE 5% & 0.45% SOD CHLOR 1000ML 43 70004 J7070 DEXTROSE 5% & 0.45% SOD CHLOR 1000ML 43 70004 J7070 DEXTROSE 5% & 0.45% SOD CHLOR 1000ML 43 70005 J7070 DEXTROSE 5%(D5W) 1000ML 39.5 70005 J7070 DEXTROSE 5%(D5W) 1000ML 39.5 70005 J7070 DEXTROSE 5%(D5W) 1000ML 39.5 70005 J7070 DEXTROSE 5%(D5W) 1000ML 39.5 70006 J7042 DEXTROSE 5% (D5W) 500ML 33.5 70006 J7042 DEXTROSE 5% (D5W) 500ML 33.5 70006 J7042 DEXTROSE 5% (D5W) 500ML 33.5 70006 J7042 DEXTROSE 5% (D5W) 500ML 33.5 70007 J7070 DEXTROSE 5% (D5W) 250ML 33.5 70007 J7070 DEXTROSE 5% (D5W) 250ML 33.5 70007 J7070 DEXTROSE 5% (D5W) 250ML 33.5 70007 J7070 DEXTROSE 5% (D5W) 250ML 33.5 70008 DEXTROSE 10% (D10W)-1000ML 45 70008 DEXTROSE 10% (D10W)-1000ML 45 70008 DEXTROSE 10% (D10W)-1000ML 45 70009 J7120 DEXTROSE 5% & LACTATED RINGERS 1000ML 50.5 70009 J7120 DEXTROSE 5% & LACTATED RINGERS 1000ML 50.5 70009 J7120 DEXTROSE 5% & LACTATED RINGERS 1000ML 50.5 70009 J7120 DEXTROSE 5% & LACTATED RINGERS 1000ML 50.5 70011 J7120 LACTATED RINGERS-1000ML 45 70011 J7120 LACTATED RINGERS-1000ML 45 70011 J7120 LACTATED RINGERS-1000ML 45 70011 J7120 LACTATED RINGERS-1000ML 45 70014 NEOSPORIN G.U. IRRIGATION SOL: 1 AMP 65.91 70015 J7030 NORMAL SALINE 0.9%:1000ML 15 70015 J7030 NORMAL SALINE 0.9%:1000ML 15 70015 J7030 NORMAL SALINE 0.9%:1000ML 15 70015 J7030 NORMAL SALINE 0.9%:1000ML 15 70016 J7040 NORMAL SALINE 0.9%:500ML 33.5 70016 J7040 NORMAL SALINE 0.9%:500ML 33.5 70016 J7040 NORMAL SALINE 0.9%:500ML 33.5 70016 J7040 NORMAL SALINE 0.9%:500ML 33.5 70017 J7050 NORMAL SALINE 0.9%:50ML 5 70017 J7050 NORMAL SALINE 0.9%:50ML 5 70017 J7050 NORMAL SALINE 0.9%:50ML 5 70017 J7050 NORMAL SALINE 0.9%:50ML 5 70018 J7030 NORMAL SALINE 0.9%:150ML 35 70018 J7030 NORMAL SALINE 0.9%:150ML 35 70018 J7030 NORMAL SALINE 0.9%:150ML 35 70018 J7030 NORMAL SALINE 0.9%:150ML 35 70021 SODIUM CHLORIDE 0.9%(FOR IRRG)-1500ML 72.5 70021 SODIUM CHLORIDE 0.9%(FOR IRRG)-1500ML 72.5 70021 SODIUM CHLORIDE 0.9%(FOR IRRG)-1500ML 72.5 70021 SODIUM CHLORIDE 0.9%(FOR IRRG)-1500ML 72.5 70021 SODIUM CHLORIDE 0.9%(FOR IRRG)-1500ML 72.5 70022 SODIUM CHLORIDE 0.9%(FOR IRRG)-500ML 41.5 70022 SODIUM CHLORIDE 0.9%(FOR IRRG)-500ML 41.5 70022 SODIUM CHLORIDE 0.9%(FOR IRRG)-500ML 41.5 70022 SODIUM CHLORIDE 0.9%(FOR IRRG)-500ML 41.5 70023 STERILE WATER (FOR IRRG)-1500ML 68 70023 STERILE WATER (FOR IRRG)-1500ML 68 70023 STERILE WATER (FOR IRRG)-1500ML 68 70023 STERILE WATER (FOR IRRG)-1500ML 68 70024 STERILE WATER (FOR IRRG)-500ML 40.5 70024 STERILE WATER (FOR IRRG)-500ML 40.5 70024 STERILE WATER (FOR IRRG)-500ML 40.5 70024 STERILE WATER (FOR IRRG)-500ML 40.5 70025 STERILE WATER (FOR IRRG)-1000ML 26 70025 STERILE WATER (FOR IRRG)-1000ML 26 70025 STERILE WATER (FOR IRRG)-1000ML 26 70025 STERILE WATER (FOR IRRG)-1000ML 26 70027 J7070 DEXTROSE 5% (D5W) 100ML 39 70027 J7070 DEXTROSE 5% (D5W) 100ML 39 70027 J7070 DEXTROSE 5% (D5W) 100ML 39 70027 J7070 DEXTROSE 5% (D5W) 100ML 39 70115 J7030 TPN (TOTAL PARENTERAL NUTRITION) 150 70123 FLUCONAZOLE (DIFLUCAN) SUSP 40MG/ML 9.34 70142 NIACIN/LOVASTATIN(ADVICOR)TAB 500MG/20MG 9.22 70225 AMLODIPINE/VALSAR(EXFORGE)TAB 5/160MG 6.6 70227 PATADAY (OLOPATADINE) 0.2% 66.5 70457 J2020 LINEZOLID (ZYVOX) IVPB 600MG/300ML 79 70546 ZIPRASIDONE HCL (GEODON) CAP 20MG 13 70547 ACETAMINOPHEN (TYLENOL ES)TAB 500MG 1 70550 GERITOL TONIC 15 ML 1.5 70551 DOCUSATE SOD (COLACE) 50MG/5ML 5 ML 1.5 70552 BENEFIBER POWDER (UNFLAVORED) 10ML 1.5 70553 DELSYM (DEXTROMETHORPHAN) SUSP 10 ML 2.13 70554 CITROMA (MAGNESIUM CITRATE)CHERRY 300ML 4.5 70555 NAPROXEN (NAPROSYN) SUSP 125MG/5ML: 5 ML 2 70556 NARIZ LIQUID : 5 ML 2 70558 PAROXETINE (PAXIL) SUSP 10MG/5ML: 5 ML 7.53 70560 PREDNISOLONE (PRELONE)SYRUP 15MG/5ML:5ML 4 70561 SENNA (SENOKOT) SYRUP : 5 ML 1.5 70562 SORBITOL SOLUTION 70% : 15 ML 1.5 70563 OXCARBAZEPINE(TRILEPTAL)SUSP 300MG/5ML 7.5 70565 JEVITY 1.5 CAL 1000 ML 40 70566 J0461 ATROPINE SULF INJ SYRINGE 1MG/10ML 10.5 70567 PROCAINAMIDE INJ : 100 MG/ML 13 70568 POTASSIUM CL INJ PREMIX : 20mEq/100ML 8.5 70569 NAFCILLIN INJ : 1 GM 22 70571 LORAZEPAM (ATIVAN) TAB : 2 MG 3.5 70572 CANDESARTAN (ATACAND) TAB 8 MG 4.5 70573 DEXAMETHASONE (DECADRON) TAB 0.5 MG 1.5 70574 DEXAMETHASONE (DECADRON) TAB 1.5 MG 1.5 70575 GLIPIZIDE(GLUCOTROL XL) EX-REL TAB 2.5MG 1.5 70576 BENAZEPRIL (LOTENSIN) TAB 40 MG 3 70577 NITROFURANTOIN (MACRODANTIN) CAP : 25 MG 3 70578 IBUPROFEN (MOTRIN) TAB 200MG 1.5 70580 BALMEX CREAM 85 GMS 9 70582 CALMOSEPTINE OINTMENT 71 GMS 10.2 70583 BETAMETHASONE DIPR(DIPROSONE)0.05%CR 81.5 70584 PREMARIN TAB : 0.45 MG 3.3 70585 MEDROXYPROGESTERONE(PROVERA)TAB: 5 MG 1.5 70586 MEDROXYPROGESTERONE(PROVERA)TAB: 2.5 MG 1.5 70587 AMLODIPINE (NORVASC) TAB 10 MG 6 70588 FLUPHENAZINE (PROLIXIN) TAB 1 MG 1.5 70589 TRIAMCINOLONE (KENALOG) 0.1% CR 80 GMS 16.5 70590 TRIAMCINOLONE (KENALOG) 0.1% CR 454 GMS 55.62 70591 EUCERIN CREME 113 GMS 15.55 70592 DAKIN'S SOLUTION HALF STRENGTH 473 ML 20.12 70593 ETHYL CHL TOP ANESTHET SKIN REFRIGERANT 66.35 70597 TOBRADEX OPTH OINT 3.5 GMS 208.93 70598 TYLENOL EX STRENGTH LIQ 500MG/15ML 2 70599 QUININE (QUALAQUIN) CAP : 324 MG 11 70600 PAROXETINE (PAXIL) CR TAB : 12.5 MG 5 70601 PRAMIPEXOLE (MIRAPEX) TAB : 0.5 MG 6.95 70602 LISINOPRIL (ZESTRIL) TAB : 40 MG 3.7 70603 DILTIAZEM(CARDIZEM SR)ER CAP 60MG 2.5 70604 MOEXIPRIL (UNIVASC) TAB : 7.5 MG 3.5 70606 GUANFACINE (TENEX) TAB 2 MG 3 70607 CARBAMAZEPINE(TEGRETOL XR) ER TAB 200MG 2.9 70609 BISOPROLOL/HCTZ(ZIAC) TAB 10MG/6.25MG 2.9 70610 ARIPIPRAZOLE (ABILIFY) TAB 15 MG 33.3 70612 ZOLPIDEM (AMBIEN) TAB 10 MG 11.6 70613 FENOFIBRATE (TRIGLIDE) TAB 160 MG 9.65 70614 LISINOPRIL/HCTZ(ZESTORETIC)TAB:10/12.5MG 2.8 70615 OLMESARTAN (BENICAR) TAB : 40 MG 4.95 70616 MONTELUKAST (SINGULAIR) CHEW TAB : 5 MG 12.38 70617 NATEGLINIDE (STARLIX) TAB : 60 MG 3.75 70620 CALCITONIN-SALMON(FORTICAL)NS 2200IU/ML 157 70621 OYSTER SHELL CA(OS-CAL)WITH VIT D:500MG 1.5 70622 RIVASTIGMINE (EXELON) PATCH 9.5MG/24HRS 18.03 70623 LANSOPRAZOLE (PREVACID) SOLUTAB 15 MG 16 70624 J1650 ENOXAPARIN (LOVENOX) INJ 80 MG/0.8 ML 18 70625 OXYBUTYNIN (DITROPAN XL) ER TAB: 5 MG 8 70626 CURASOL GEL 90 GMS 35.45 70628 J3489 ZOLEDRONIC ACID (RECLAST) INJ 5MG/100ML 2635 70633 CEREFOLIN TABLET 4 70637 RISPERIDONE (RISPERDAL) TAB : 0.25 MG 9.89 70638 CALCIUM ACETATE (PHOSLO) GELCAP 667 MG 2.14 70641 CYCLOPHOSPHAMIDE(CYTOXAN)TAB 25 MG 5 70643 BIMATOPROST(LUMIGAN)OPHTH 0.03% 2.5ML 199.73 70644 OLANZAPINE/FLUOXETINE(SYMBYAX): 12/25MG 40 70645 NICORETTE GUM : 2MG 113.98 70646 VALSARTAN (DIOVAN) TAB 160MG 5.75 70647 ENDOCET (PERCOCET) TAB 10MG/325MG 4.44 70651 NICOTINE TRANSDERMAL SYSTEM : 14MG PATCH 5.45 70652 BUDESONIDE/FORMOTEROL(SYMBICORT) 80/4.5 300 70654 CLONAZEPAM(KLONOPIN)ORAL DIS TABS 0.25MG 3.25 70655 SOTALOL (BETAPACE) TAB 80MG 6.41 70656 PYRIDOSTIGMINE(MESTINON)TAB : 60MG 1.75 70661 MORPHINE(MS CONTIN)EX-REL TAB : 60 MG 8.27 70662 MORPHINE IMMEDIATE-REL TAB: 15MG 2 70664 OXYCODONE TABLET : 30 MG 3.4 70665 CARBAMIDE PEROX(DEBROX)6.5%EARDROPS 15ML 6.2 70666 SULFASALAZINE(AZULFIDINE)TABLET: 500MG 2 70667 NASOHIST-DM 3-2-1MG/ML : 30 ML 85.98 70668 CLOTRIMAZOLE TROCHE 10 MG 4.02 70670 ONDANSETRON (ZOFRAN) TAB : 8MG 2 70671 VENLAFAXINE(EFFEXOR XR)EX-REL CAP 37.5MG 8.34 70672 HYDROCORTISONE (CORTEF) TABLETS 10 MG 1.5 70673 DULOXETINE(CYMBALTA)CAP 20 MG 8.56 70675 ROPINIROLE(REQUIP)TABLET: 0.25 MG 2 70677 TOBI SOLUTION FOR INHALATION 300MG/5ML 205.04 70678 NEBIVOLOL(BYSTOLIC)TAB 5 MG 4.58 70679 LEVALBUTEROL(XOPENEX)HFA INH 45mcg 15gms 136.7 70680 ROPINIROLE (REQUIP) TABLET : 1 MG 6.79 70681 ALOE VESTA PROTECTIVE OINTMENT 226 GMS 20.05 70682 ALOE VESTA PERINEAL/SKIN CLEANSER 236 ML 5.65 70683 CHLORPHENIRAMINE (CHLORTRIMETON)TAB 4MG 1.5 70684 LEVOTHYROXINE (SYNTHROID) TAB 88 MCG 1.5 70686 HYDROMET SYRUP 5MG & 1.5MG/5ML 2.33 70687 GABAPENTIN (NEURONTIN) SOL 250MG/5ML 3.78 70688 DTAP(ADACEL) INJ 0.5ML 93 70689 LOTEPREDNOL (LOTEMAX) OPTH SUS 0.5%: 5ML 133.5 70690 RENAL CAPS (NEPHROCAPS) : SOFTGEL 1.5 70691 PROPAFENONE (RYTHMOL SR) EX-REL : 425 MG 19.73 70692 NASOHIST DM PEDIATRIC DROPS :1MG/2MG/3MG 85.98 70694 TELMISARTAN (MICARDIS) TAB 80 MG 5.29 70695 NIACIN EX-REL (NIASPAN) TABLET : 750MG 7.69 70696 BUPROPION XL TAB 150MG (ONCE DAILY DOSE) 11.31 70697 FERREX (NIFEREX 150 FORTE) CAP 150 FORTE 2 70698 FISH OIL SOFTGELS 1000MG 1.5 70699 REPAGLINIDE (PRANDIN) TAB : 2MG 3.48 70700 CALCIUM CHLORIDE INJ 10% 100MG/ML 10ML 2.5 70701 AMLODIPINE/VALSART(EXFORGE) TAB 5/320MG 8.86 70703 VITAMIN D TABLET 400 IU 1.5 70704 VITAMIN E SOFTGEL 400 IU 1.5 70705 CYANOCOBALAMIN(VITAMIN B12)TAB 1000MCG 1.5 70707 EPINEPHRINE 1:10000INTRACARDIAC 1MG/10ML 16.8 70709 FENOLDOPAM (CORLOPAM) INJ 20MG/2ML 1583.75 70710 J0561 PENICILLIN G (BICILLIN L-A)INJ 1.2MU/2ML 143.4 70712 DOPAMINE 40MG/ML INJ 200MG/5ML 3 70715 TESTOSTERONE CYP INJ 200MG/ML 81.13 70718 CEFIXIME (SUPRAX) ORAL SUSP 200MG/5ML 41.24 70720 PHENAPHTHAZINE (NITRATEST) PAPER : 71.3 70721 AMOXICILLIN/CLAVUL(AUGMENTIN) 600MG/5ML 6.36 70722 CEFADROXIL (DURICEF)ORAL SUSP:500MG/5ML 10.52 70723 LINEZOLID (ZYVOX) ORAL SUSP 100MG/5ML 39.93 70725 ARFORMOTEROL(BROVANA)INH SOL 15MCG/2ML 14.4 70726 J1815 REG INSULIN (NOVOLIN R) 100U/ML 1.75 70727 J1815 INSULIN GLAR(LANTUS)INJ 100U/ML 5 UNITS 2 70728 J1815 NPH/REG INS (NOVOLIN 70/30) 100U/ML: 5 U 1.75 70730 J1815 NPH INSULIN (NOVOLIN N) 100U/ML : 5 U 1.75 70731 J1815 INSULIN ASPART (NOVOLOG) INJ 100U/ML 2 70732 J1815 NOVOLOG MIX 70/30 100U/ML INJ : 5 UNITS 2 70733 INSULIN DETEMIR (LEVEMIR) 100U/ML 5 U 2 70735 J1815 HUMALOG MIX 75/25 INSULIN INJ 100U/ML 5U 2 70737 AVEENO MOISTURIZING BAR 1 BAR 5.65 70738 OXYCONTIN TAB : 80MG 28.73 70739 COCAINE TOPICAL SOL 4% 40MG/ML 22.1 70743 BENZOIN COMPOUND 59ML 7.5 70744 DERMA GRAN OINT 113GMS 16.13 70745 BENZOCAINE(HURRICAINE) TOP ANES SP 1 ML 1.5 70747 NOREPINEPHRINE (LEVOPHED) INJ : 4MG/4ML 25.58 70748 PHENYLEPHRINE(NEO-SYNEPHRINE)1% INJ: 1ML 20.58 70749 ETOMIDATE (AMIDATE) INJ SDV 20MG/10ML 80.94 70750 RIFAMPIN INJECTION : 600MG/10ML 408.9 70752 IMMUNE GLOBULIN(HUMAN)IV(CARIMUNE) 12GMS 1770 70753 IMMUNE GLOBULIN(HUMAN)IV(CARIMUNE) 3 GMS 442.5 70754 NYSTATIN OINTMENT : 15 GMS 7.5 70755 MICONAZOLE NITRATE 2% CREAM : 15 GMS 8.75 70757 METRONIDAZOLE(VANDAZOLE)VAG 0.75% 70GM 183.05 70758 TERCONAZOLE(ZAZOLE)VAG CR 0.4% 45GMS 80 70760 ARGINAID (ARGININE INTENSIVE DRINK MIX) 2 70761 GLUCERNA SHAKE 240ML 4.39 70762 FIBERSOURCE HN 1000ML 9.5 70763 AMMONIA INHALANT AMPULES 1 AMP 1.5 70764 EYE WASH (STERILE EYE IRRIG SOL) 120 ML 5 70765 CYCLOSPORINE(RESTASIS)OPTH 0.05% 30VIALS 321.15 70766 KETOTIFEN (ZADITOR) OPTH SOL 5ML 29.75 70767 SYSTANE LUBRICANT EYE DROPS 15ML 21.33 70769 POLYMYX/TRIMETH (POLYTRIM) OP SOL: 10ML 12 70770 CHLORAMPHENICOL INJECTION 1 GM 109.58 70771 SALSALATE (DISALCID) TAB : 750MG 1.5 70772 OSMOPREP TABLET : 1.5GMS 4.5 70773 VORICONAZOLE (VFEND) INJECTION 200MG 250 70774 TRICOR TAB 48MG 3.5 70775 J3490 NITROGLYCERIN SUBLINGUAL SPRAY 0.4MG:1EA 475.43 70776 AMOXICILLIN ORAL SUSPENSION 400MG/5ML 1.5 70777 RISEDRONATE (ACTONEL) TABLET 150 MG 198.5 70779 NISOLDIPINE (SULAR) TABLET : 8.5MG 8.95 70780 PHENYLEPHRINE TABLET : 10MG 1.75 70781 DESVENLAFAXINE (PRISTIQ) ER TAB 50MG 20.55 70782 OXYBUTYNIN (DITROPAN XL)EX-REL TAB: 10MG 8.22 70783 WARFARIN (COUMADIN) TAB 1MG 2.37 70784 LIPOSYN III 10% (IV FAT EMULSION): 250ML 55.38 70785 SYMBYAX CAPSULE : 3MG / 25MG 20.65 70786 CLINIMIX E 5/25 (AMINO ACIDS/DEX) 500ML 100.06 70787 RISPERIDONE (RISPERDAL) ORAL SOL: 1MG/ML 12.38 70788 MESALAMINE (ROWASA) ENEMA : 4GM / 60ML 39.5 70789 DEXAMETHASONE (DECADRON) OPTH SOL 5ML 18.1 70790 COLESEVELAM (WELCHOL) TABLET 625MG 3.14 70793 METHIMAZOLE (TAPAZOLE) TAB 5MG 2 70794 ONDANSETRON (ZOFRAN) ODT 4MG 2 70795 PEPCID ORAL LIQUID : 40MG/5ML 39.98 70796 RIFAMPIN INJECTION : 600 MG/VIAL 408.9 70797 RONDEC-DM SYRUP 5ML 2.75 70798 NEPHRO-VITE TABLET : 1.5 70799 ZOVIRAX OINT 5% PER APPLICATION 12.69 70800 DIVALPROEX (DEPAKOTE) ER TABLET 250MG 4.62 70801 MUPIROCIN (BACTROBAN) 2% 1 APPLICATION 2 70802 LUBIPROSTONE (AMITIZA) GELCAP 8 MCG 9.68 70803 CYTOMEL TABLET 5MCG 2.01 70804 ARIPIPRAZOLE (ABILIFY) TABLET 5MG 38.76 70805 NABUMETONE (RELAFEN) TABLET : 750MG 3.83 70806 GANCICLOVIR (CYTOVENE) INJECTION 500MG 189.16 70807 LAMOTRIGINE (LAMICTAL) TABLET 25MG 10.4 70808 J0713 CEFTAZIDIME (TAZICEF) INJECTION 1GM 28.01 70809 METOPROLOL (LOPRESSOR) TAB : 25MG 2 70812 NASOFED SUSP : 50MG/5ML 2 70813 LEUKERAN TAB 2MG 8.2 70814 BONIVA TAB 150MG 278.62 70815 FEMARA (LETROZOLE) TABLET 2.5MG 33.27 70817 CYCLOSPORINE CAPSULE 25MG 3.44 70818 MYCOPHENOLATE (CELLCEPT) TAB 500MG 21.51 70819 SOMATROPIN (HUMATROPE) INJ 6MG 866 70820 LEVETIRACETAM (KEPPRA) SOLN 500MG/5ML 8.02 70821 ITRACONAZOLE (SPORANOX) ORAL 50MG/5ML 15.36 70822 MYOFLEX CREAM 10% 90 GMS 6.5 70823 ANASTRAZOLE (ARIMIDEX) TABLET 1MG 25.01 70824 VANCOMYCIN (VANCOCIN) CAPSULE 125MG 13 70825 PROPAFENONE (RYTHMOL SR) CAP : 225MG 13.08 70826 ITCH-X SPRAY 60ML 8.81 70827 MUCINEX DM TABLET : 600MG/30MG 1.5 70828 NEPAFENAC (NEVANAC) OPTH SUSP 0.1% : 3ML 141.65 70830 ARIPIPRAZOLE (ABILIFY) TAB 2MG 31 70831 OLMESARTAN (BENICAR) TAB 5MG 5.21 70832 90649 GARDASIL (HPV VACCINE) SDV 0.5ML 129.56 70833 TETRACAINE OPTH SOL 0.5% 1 DROP 1.5 70834 FENOFIBRIC ACID (TRILIPIX) CAP 135MG 10.5 70835 BIOTENE MOUTH MOISTURIZER 45ML 12.73 70836 ZIPRASIDONE (GEODON) CAP 80MG 21.63 70837 MUCINEX D TABLET ER : 600MG/60MG 2 70838 QUETIAPINE (SEROQUEL XR) TAB : 200MG 21.82 70839 BABY ORAJEL 9.28 70840 MORPHINE ORAL SOLUTION : 10MG/5ML 2.5 70843 PREGABALIN (LYRICA) CAPSULE : 75MG 6.53 70844 TYLENOL ORAL SUSP 160MG/5ML 120ML 14.53 70845 BRIMONIDINE (ALPHAGAN P) OPTH 0.1% 5ML 130.82 70846 CITALOPRAM (CELEXA) ORAL SOL 10MG/5ML 6.12 70847 CHLORDIAZ/AMIT(LIMBITROL) TAB 5/12.5MG 2.1 70848 VALPROATE SODIUM 500MG / NS 100ML 25.2 70849 HYDROXYZINE (VISTARIL) HCL INJ 25MG/ML 28.5 70850 LEVETIRACETAM (KEPPRA) INJ 500MG/5ML 128.66 70852 ESOMEPRAZOLE (NEXIUM) CAP 20MG 12.75 70853 ERGOCALCIFEROL (VITAMIN D) CAP 50,000U 4.21 70854 THEOPHYLLINE (THEO-24) EX-REL TAB 400MG 2.8 70860 URSODIOL (ACTIGALL) CAPSULE 300MG 6.44 70861 GLYBURIDE/METFORMIN(GLUCOVANCE) 2.5/500 2.62 70862 LIDOCAINE (XYLOCAINE) TOPICAL SOL 4% 1ML 2 70863 RIZATRIPTAN (MAXALT) TABLET : 10MG 64.34 70867 ESCITALOPRAM (LEXAPRO) ORAL SOL 5MG/5ML 7.21 70872 AMPICILLIN INJECTION 2 GMS 41.88 70874 BUTALBITAL/ASA/CAFF (FIORINAL) CAP 2.77 70875 CLINIMIX E (AA 5%/D25W/LYTES/CA) 1000ML 100.52 70877 INTRALIPID (LIPID EMULSION) 20% 100ML 48.07 70878 PROPRANOLOL (INDERAL LA) ER CAP 60MG 3.46 70879 MEPERIDINE (DEMEROL) TABLET 50MG 2 70880 CHLORASEPTIC LOZENGE 7.3 70881 OMEPRAZOLE (PRILOSEC) CAPSULE : 20MG 4.5 70882 RYZOLT TABLET : 200MG 16.99 70883 CALCITONIN-SAL(MIACALCIN) INJ 200IU/ML 88.43 70884 ZOLEDRONIC ACID (ZOMETA) INJ 4MG/5ML 2179.25 70887 METOPROLOL (TOPROL-XL) ER TAB 25MG 3 70888 DOCUSATE SOD (DOS) CAPSULE 250MG 1.5 70889 GLYBURIDE/METFORMIN (GLUCOVANCE) 5/500MG 2.57 70890 PROBENECID TABLET : 500MG 2.5 70891 DISOPYRAMIDE (NORPACE CR) ER CAP 100MG 4.73 70892 MEPERIDINE (DEMEROL) INJ 100MG/ML 88.6 70893 Q-TAPP (DIMETAPP) ELIXIR 1.5 70894 SODIUM CHLORIDE TABLET : 1GM 1.25 70895 DEXTROSE 5% (D5W) (GLASS BOTTLE) 250ML 15.46 70896 TOPIRAMATE (TOPAMAX) TABLET 25MG 7.2 70897 NS 1000ML / KCL 20MEQ 5.4 70925 LEVALBUTEROL(XOPENEX)INH SOL 1.25MG/3ML 19 70928 SODIUM CHLORIDE INH SOL 0.9% : 3ML 1.25 70929 J7611 ALBUTEROL (PROVENTIL) INH SOL 2.5MG/3ML 2 70930 IPRATRO/ALBUT 0.5/3MG(DUONEB) 3ML 5.26 70932 MYLANTA 5ML 2.5 70935 RACEPINEPHRINE INH SOL 11.25MG/0.5ML 3.42 70936 BUDESONIDE (PULMICORT) RESP 0.5MG/2ML 22.59 70937 LEVALBUTEROL(XOPENEX)INH SOL 0.63MG/3ML 11.09 70938 LEVALBUTEROL(XOPENEX)INH SOL 0.31MG/3ML 12 70938 LEVALBUTEROL(XOPENEX)INH SOL 0.31MG/3ML 12 70940 BUDESONIDE(PULMICORT)INH SUSP 0.25MG/2ML 17.45 70941 IPRATROPIUM(ATROVENT)INH SOL 0.5MG/2.5ML 3.3 70942 CROMOLYN (INTAL) INH SOL 20MG/2ML 4 70943 ALBUTEROL INH SOL 0.5% 2.5MG/0.5ML 2.25 70945 TRAMADOL (RYZOLT) ER TABLET 300MG 18.99 70951 OMEGA-3-ACID ETHYL EST (LOVAZA) CAP: 1GM 4.12 70952 FOLBEE (FOLIC ACID/B6/B12)2.5/25/1MG TAB 1.75 70953 IBUPROFEN (MOTRIN) DROPS 50MG/1.25ML 1.5 70955 J1756 IRON SUCROSE (VENOFER) INJ 100MG/5ML 206.4 70961 QUETIAPINE (SEROQUEL) TABLET : 100MG 14.32 70962 FERREX (NIFEREX 150) CAPSULE 3.18 70963 ALBUTEROL (ACCUNEB) INH SOL 0.63MG/3ML 4.15 70965 MEMANTINE (NAMENDA)ORAL SOL 2MG/ML: 5ML 14.75 70972 RIVASTIGMINE (EXELON) CAP 4.5MG 11.21 70973 CARBIDOPA/LEVO (SINEMET CR) 50/200MG 4.35 70974 FEBUXOSTAT (ULORIC) TABLET 40MG 13.73 70980 LANTHANUM (FOSRENOL) CHEW TAB 500MG 19.05 70990 CHLOROPHYLL TABLET 3 MG 1 70991 B-COMPLEX 100 TR TABLET 1 70998 POLYMYXIN B INJ : 500,000 UNITS 40.95 70999 GCP TOPICAL SOLUTION 140.9 71000 HYDROMORPHONE HCL 50MG/5ML AMPULE 17 71001 FEXOFENADINE HCL (ALLEGRA) TAB 180MG 7.5 71002 PIOGLITAZONE HCL (ACTOS) TAB 30MG 16 71003 LEVOFLOXACIN (LEVAQUIN) TAB 250MG 2 71004 LEVOFLOXACIN (LEVAQUIN) TAB 500MG 4 71005 J1956 LEVOFLOX/D5W(LEVAQUIN) 500MG/100ML IVPB 35 71006 RIVASTIGMINE TARTRATE(EXELON)CAP : 1.5MG 7.5 71007 APAP/DIPYRIDAMOLE(AGGRENOX)CAP 25/200MG 5 71008 HYDROCODONE/APAP ELIXIR 6.88 71014 TIZANIDINE (ZANAFLEX) TAB 4MG 3.5 71025 J3490 LABETALOL (NORMODYNE)INJ MDV 5MG/ML 12.5 71028 J7050 NORMAL SALINE 0.9%:250ML 21.5 71028 J7050 NORMAL SALINE 0.9%:250ML 21.5 71028 J7050 NORMAL SALINE 0.9%:250ML 21.5 71028 J7050 NORMAL SALINE 0.9%:250ML 21.5 71045 METFORMIN HCL (GLUCOPHAGE) TAB : 850MG 3.5 71110 DUTASTERIDE (AVODART) GCAP 0.5MG 8.15 71111 OXCARBAZEPINE (TRILEPTAL) TAB : 150MG 3 71112 LINEZOLID (ZYVOX) TAB : 600MG 204.95 71113 MORPHINE EX-REL (AVINZA) CAP : 30MG 9.5 71115 TOPIRAMATE (TOPAMAX) TAB 50MG 14.38 71117 DULOXETINE HCL (CYMBALTA) CAP 60MG 9 71122 CIPROFLOX/DEXAMET (CIPRODEX) OTIC 7.5ML 274.35 71123 SUMATRIPTAN (IMITREX) TABLET 50MG 50.28 71135 NIACIN (NIASPAN) EX-REL TAB : 500MG 6.45 71225 RAMELTEON (ROZEREM) TAB : 8MG 9 71235 FENTANYL TRANS(DURAGESIC)PTCH 12MCG/HR 34 71299 TOLTERODINE TARTRATE(DETROL LA)CAP 4MG 9 71329 CARVEDILOL (COREG CR) CAP 20MG 10.18 71332 CARVEDILOL (COREG CR) CAP 10MG 10.18 71447 NATEGLINIDE (STARLIX) TAB : 120MG 3 71448 METAXALONE (SKELAXIN) TAB : 800MG 9.8 71452 SEVELAMER (RENAGEL) TAB : 400MG 2.6 71456 METHADONE TABLET : 10MG 2 71458 NEFAZODONE HCL (SERZONE) TAB : 100MG 3.5 71462 BISMUTH SUB(PEPTO-BISMO)CHEW TAB 262MG 1 71469 CARVEDILOL (COREG CR) CAP 40MG 10.58 71635 DARIFENACIN (ENABLEX) TAB 7.5MG 9.78 71659 PREGABALIN (LYRICA) CAP : 25MG 5.33 71698 PROVENTIL HFA INHALER:90MCG 105.5 72009 VECURONIUM (NORCURON) 1MG/ML INJ 10MG 10 72011 LIDOCAINE HCL JELLY 2%: 30ML 41.68 72047 J0696 AMPICILLIN INJ 250MG 7.83 72104 METRONIDAZOLE (FLAGYL) INJ : 500MG/100ML 12.5 72113 NICOTINE TRANSDERMAL SYSTEM : 7MG PATCH 7.36 72114 VARENICLINE (CHANTIX) TAB 0.5MG 5.25 72115 BACITRACIN 500U/GM OINT 14GM 9.5 72116 AMMONIUM LAC CR(LACHYDRINE)140GM 12% 50.18 72121 OCUVITE TABLET 1.5 72147 TRAVOPROST (TRAVATAN)OPTH 0.004% 5ML 387.95 72156 LEVETIRACETAM (KEPPRA) TAB 500MG 7.78 72165 J0696 AMPICILLIN SODIUM INJ 500MG 12.19 72187 GABAPENTIN (NEURONTIN) CAPS 100MG 2 72194 J3490 DILTIAZEM (CARDIZEM) INJECTION 25MG/5ML 15 72223 MELOXICAM (MOBIC) TAB : 7.5MG 7.83 72236 OLOPATADINE (PATANOL) OPHTH:0.1% 233.03 72254 DULOXETINE (CYMBALTA) CAP 30MG 1.2 72258 ZOLPIDEM TARTRATE(AMBIEN CR)TAB 6.25MG 8.63 72336 ZIPRASIDONE HCL (GEODON) CAP 60MG 16.3 72443 DIAPER RASH OINT(DESITIN OINT) 4OZ 11 72444 TELMISARTAN (MICARDIS) TAB 40MG 5.36 72445 ENTACAPONE (COMTAN) TAB 200MG 5.5 72449 CELECOXIB (CELEBREX) CAP 200MG 5 72458 INDINAVIR (CRIXIVAN) CAPSULE 400MG 7.75 72461 FORMOTEROL (FORADIL) 12MCG/CAP INHALER 92 72487 VENLAFAXINE (EFFEXOR XR) CAP 75MG 8 72489 LAMIVUDINE (EPIVIR) TABLET 150MG 18.32 72498 PRIMIDONE PRIMIDONE 250MG 1.5 72506 J3486 ZIPRASIDONE (GEODON) INJ 20MG/ML 53.23 72513 J1642 HEPARIN(HEPARIN LOCK)FLUSH SYRN 5 ML 1.68 72548 ONDANSETRON HCL (ZOFRAN) TAB : 4MG 2 72556 GALANTAMINE (RAZADYNE) TAB 4MG 3.25 72558 ZONISAMIDE (ZONEGRAN) CAP 100MG 5.49 72635 PERMETHRIN 5% CRM(ELIMITE CM) 60GM 73.13 72653 ARIPIPRAZOLE (ABILIFY) TAB 10MG 2.13 72654 TOLTERODINE TARTRATE(DETROL LA)TAB 2MG 4.5 72659 J1815 FORTEO INJECTION 20MCG / DOSE 4917 72847 PRAMIPEXOLE (MIRAPEX) TAB : 0.25MG 6.1 72889 AMOXICILLIN/CLAVUL(AUGMENTIN) 400MG/5ML 8.8 72958 B-COMPLEX WITH VITAMIN C 1.5 73001 NASACORT AQ NASAL SPRAY:16.5G 238.75 73005 ACETAMINOPHEN(TYLENOL)SUPP 120MG 2.5 73006 ACETAMINOPHEN (TYLENOL) SUPP 650MG 1.5 73011 J0171 EPINEPHRINE 1:1000 (1MG/ML) INJ 1ML 4.44 73012 METFORMIN HCL (GLUCOPHAGE) TAB : 500MG 2 73013 OXYMETAZOLINE HCL(NASAL DECONGEST) 0.05% 5.13 73017 P9047 ALBUMIN(HUMAN)25% (12.5GMS) 50 ML 150 73018 NITROGLYCERIN INJ : 50MG/10ML 17.5 73019 CLARITHROMYCIN (BIAXIN)SUSP 250MG/5ML 10.36 73020 FENTANYL TRANS(DURAGESIC)PTCH 50MCG/HR 65.9 73022 CEFPROZIL (CEFZIL) ORAL SUSP 250MG/5ML 9.48 73024 FOSINOPRIL (MONOPRIL) TAB 10MG 3 73025 FELODIPINE (PLENDIL) TAB 5MG 2.5 73027 LISINOPRIL (ZESTRIL) TAB : 5MG 2.5 73028 EMOLLIENT/SKIN CLEAN(KERI MOIS) 15OZ 17.2 73039 J0280 AMINOPHYLLINE SDV 250MG/10ML 3 73040 SERTRALINE HCL (ZOLOFT) TAB 100MG 2.5 73043 NAPROXEN SODIUM (ANAPROX) TAB : 275MG 3 73048 RAMIPRIL (ALTACE) CAPS : 5MG 3 73052 HYDROCORTISONE (ANUSOL-HC) SUPP 25MG 1.5 73054 PROCTOZONE-HC CR(ANUSOL-HC) 2.5% 30GMS 62.38 73055 AMITRIPTYLINE HCL (ELAVIL) TAB 10MG 1.5 73056 PROPRANOLOL HCL (INDERAL) TAB : 20MG 1.5 73057 86580 TUBERCULIN PUR PRO D(TUBERSOL) 0.1ML 13.12 73062 ACYCLOVIR (ZOVIRAX) SUSP 200MG/5ML 3 73063 J0360 HYDRALAZINE (APRESOLINE)INJ 20MG/ML 1ML 45 73064 J3430 PHYTONADIONE (VITAMIN K1) INJ 10MG/ML 59.26 73065 J3430 PHYTONADIONE(VITAMIN K1)NEONAT 1MG/0.5ML 14.56 73066 DOPAMINE INJ 800MG/5ML 32.5 73071 SILVER SULFADIAZINE 1%(SILVADENE)CM:50GM 20.55 73073 ASPIRIN SUPPOSITORY (5 GRAINS) 300 MG 2.5 73074 ASPIRIN SUPPOSITORY (10 GRAINS) 600 MG 2.9 73075 ASPIRIN (ASA)EC TAB 325MG 1.5 73082 ASPIRIN (BABY ASA) CHEW TAB 81MG 1.5 73085 ATARAX SYRUP 10/MG/5 ML PER TSP.- 5ML 2 73086 SIMVASTATIN (ZOCOR) TAB : 10MG 8 73087 DILTIAZEM HCL (CARDIZEM CD) CAP 120MG 3 73088 HYDROXYZINE HCL (ATARAX) TAB 50MG 3 73089 PAROXETINE HCL (PAXIL) TAB : 20MG 7.5 73090 LORAZEPAM (ATIVAN) TAB : 1MG 1.5 73091 LACTULOSE SOLN 10GM/15ML 1.5 73092 FIBERCON 1.5 73097 J0461 ATROPINE INJ 0.4MG/ML 1ML 2.5 73098 AMOXICILLIN/POT CLAV(AUGMENTIN)TAB 250MG 8 73099 AMOXICILLIN/POT CLAV(AUGMENTIN)TAB 500MG 9 73100 AMOXICILLIN/CLAVUL(AUGMENTIN) 250MG/5ML 10.62 73102 DILTIAZEM HCL (CARDIZEM CD) CAP 300MG 7.5 73106 SODIUM CHLORIDE (AYR SALINE)SPRAY 0.65% 5.25 73107 SULINDAC (CLINORIL) TAB : 200MG 1.5 73116 CEFAZOLIN(KEFZOL)INJ 1GM 19 73117 PEPCID SUSP PER 5ML 34 73119 FLUMAZENIL (ROMAZICON) MDV 0.5MG/5ML 48 73121 FENOPROFEN CALCIUM (NALFON) TAB 600MG 1.5 73122 DIPHENHYDRA HCL(BANOFEN)LIQD 30ML 4.5 73123 DIPHENHYDRA HCL(BANOFEN)LIQD 15ML 2.5 73124 DIPHENHYDRA HCL(BANOFEN)LIQD 5ML 1.5 73125 J1200 DIPHENHYDRAMINE (BENADRYL) INJ 50MG/ML 6 73127 J2405 ONDANSETRON (ZOFRAN) INJ 2MG/ML 2 73128 DILTIAZEM HCL (CARDIZEM CD) CAP 240MG 5 73131 AMOXICILLIN 125MG/5ML SUSP 5ML 1.5 73132 ENALAPRILAT (VASOTEC) INJ 2.5MG/2ML 21.5 73133 NITROGLYCERIN/D5W INJ : 25MG/250ML 27.5 73139 AMOXICILLIN 250MG/5ML SUSP 5ML 1.5 73152 J0558 BICILLIN C-R 900/300 INJ 1.2MU/2ML 143.4 73154 IBUPROFEN(MOTRIN)SUSP 100MG/5ML 2 73156 J3105 TERBUTALINE (BRETHINE) INJ SDV 1MG/ML 17.08 73157 TERBUTALINE SULFATE(BRETHINE) TAB 2.5MG 1.5 73158 TERBUTALINE SULFATE (BRETHINE) TAB 5MG 1.5 73162 BUMETANIDE (BUMEX) INJ 0.25MG/ML 1MG/4ML 5 73163 BUMETANIDE (BUMEX) TAB 1MG 2 73164 BUMETANIDE (BUMEX) TAB 0.5MG 1.5 73166 GUAIFEN/COD CHERATUSSIN AC 100 1.5 73169 90658 INFLUENZA VACCINE (PATIENTS) 0.5ML 30 73170 BISOPROLOL/HCTZ (ZIAC) TAB 2.5MG/6.25MG 2.5 73171 VERAPAMIL (CALAN) TAB 80MG 1.5 73173 CALCIUM GLUCONATE INJ 10% SDV 10ML 5 73175 CAPTOPRIL (CAPOTEN) TAB 25MG 2.5 73178 SUCRALFATE (CARAFATE) TAB : 1GM 3 73182 CLONIDINE HCL (CATAPRES) TAB 0.1MG 4.5 73183 CLONIDINE HCL (CATAPRES) TAB 0.2MG 2.5 73184 CEFACLOR (CECLOR) CAPS 250MG 9 73187 J1644 HEPARIN SODIUM INJECTION 5000 UNITS/ML 12.99 73190 TRAMADOL HCL (ULTRAM) TAB 50MG 2 73192 J2765 METOCLOPRAMIDE (REGLAN)INJ SDV: 10MG/2ML 5 73193 WATER STERILE - INJECTION WATE 1.5 73194 J3360 DIAZEPAM (VALIUM) INJ 5MG/ML 4.5 73199 CLARITIN D TAB 120MG/5MG 4.5 73200 CEROVITE (CENTRUM) TAB 1.5 73201 SILVER SULFADIAZINE 1%(SILVADENE)CM:400G 87.73 73202 FLUOXETINE (PROZAC) CAP 10MG 6.5 73208 HYDROXYZINE PAMOATE (VISTARIL)CAP 25MG 1.5 73213 PHENOL CHLORASEPTIC SPRAY : 177ML 13.75 73216 J2001 LIDOCAINE / D5W PREMIX INJ 47.5 73219 J2270 MORPHINE SULF 20ML MDV : 50MG/ML 30 73223 CITROMA (MAGNESIUM CITRATE)LEMON 300ML 4.5 73224 J0698 CEFOTAXIME (CLAFORAN) INJ 1GM 73.5 73225 CLINDAMYCIN (CLEOCIN) IVPB 600MG/50ML 93 73227 SULINDAC SULINDAC 200MG 5 73228 CLONAZEPAM (KLONOPIN) TAB 0.5MG 2 73229 CLONAZEPAM (KLONOPIN) TAB 1MG 2 73230 CLARITHROMYCIN (BIAXIN) TAB 500MG 13 73236 J1450 FLUCONAZOLE (DIFLUCAN) INJ 200MG/100ML 85 73237 J0515 BENZTROPINE (COGENTIN) INJ 2MG/2ML 196.38 73241 COLCHICINE TAB 0.6MG 14.79 73247 PROCHLORPERAZINE MAL(COMPAZINE)TAB: 10MG 2.5 73252 PROCHLORPERAZINE (COMPAZINE) SUPP : 25MG 9 73258 TROLAMINE SALICYLATE CR(ASPERCREME) 10% 6.38 73259 ORPHENADRINE (NORFLEX) EX-REL TAB: 100MG 6 73260 NADOLOL (CORGARD) TAB : 40MG 3.5 73266 CLONIDINE(CATAPRES-TTS 1)PATCH 0.1MG/24 36.13 73270 WARFARIN SODIUM (COUMADIN) TAB 5MG 2 73272 DIHYDROERGOTAMINE MESYLATE(DHE) 1MG/ML 139.3 73273 J3420 CYANOCOBALAMIN(B12)INJ1000 MCG/ML 6 73277 NITROGLYCERIN (NITRO-BID) CAPS : 6.5MG 1.5 73279 NITROGLYCERIN (NITRO-BID) CAPS : 2.5MG 1.5 73280 LIDOCAINE HCL VISCOUS 20MG/ML 1.5 73287 AMLODIPINE BESYLATE (NORVASC) TAB 5MG 4.5 73288 PREDNISOLONE(PRED FORTE)1%OPHT SUSP:5ML 20 73291 AMPICILLIN/SULBACTAM(UNASYN)INJ 1.5GM 28.5 73295 FUROSEMIDE (LASIX) TAB 40MG 1.5 73296 FUROSEMIDE (LASIX) TAB 20MG 1.5 73297 FUROSEMIDE (LASIX) TAB 80MG 1.5 73304 TIMOLOL (TIMOPTIC) 0.5% OPTH SOL 5 ML 42.5 73308 J2175 MEPERIDINE HCL (DEMEROL) CARP : 50MG/ML 4.99 73309 J2175 MEPERIDINE INJ (DEMEROL) CARP : 75MG/ML 4.44 73310 J2175 MEPERIDINE INJ (DEMEROL) CARP : 100MG/ML 4.78 73316 ESTRADIOL CYP (DEPO-ESTRADIOL) 5MG/ML 27.39 73317 J1030 METHYLPREDNISOL(DEPO-MEDROL) 40MG/ML 31.36 73320 TRAZODONE (DESYREL) TAB 100MG 3.5 73321 J7042 DEXTROSE 50%/WATER (D50) SYRN 25GM 17 73323 CHLORPROPAMIDE (DIABENESE) TAB 250MG 2.5 73324 ACETAZOLAMIDE (DIAMOX) TAB 250MG 1.5 73325 ACETAZOLAMIDE(DIAMOX SEQUELS)CAP 500MG 3.5 73328 BETHANECHOL CHL(URECHOLINE) TAB 25MG 1.5 73332 TORSEMIDE (DEMADEX) TAB 20MG 2.05 73333 THIAMINE (VITA B1) CAPSULE 100MG 1.5 73335 BENAZEPRIL (LOTENSIN) TAB 10MG 3 73336 KETOPROFEN (ORUDIS) CAPS 75MG 3.5 73337 PHENYTOIN EXT (DILANTIN) CAP :100MG 1.5 73339 J1165 PHENYTOIN (DILANTIN) INJ 50MG/ML 2ML 10 73341 PHENYTOIN (DILANTIN) SUSP 125MG/5ML 3.4 73345 HYDROMORPHONE (DILAUDID) TAB 2MG 2 73360 LOSARTAN POTASSIUM (COZAAR) TAB : 25MG 4.5 73368 BELLADONNA/PB (DONNATAL) ELIX 5ML 2.5 73369 LANSOPRAZOLE (PREVACID) CAP 30MG 14.15 73374 DIMENHYDRINATE (DRAMAMINE) TAB 50MG 1.5 73375 ADENOSINE(ADENOCARD)INJ 3MG/ML 6MG/2ML 138.92 73384 TRIAMTERENE/HCTZ(DYAZIDE)CAP 37.5MG/25MG 2 73388 SPIRONOLACTONE (ALDACTONE) TAB : 50MG 3.5 73412 LACTOSE FREE FOOD (ENSURE) LIQ 8OZ 3.88 73413 FERROUS SULFATE LIQD 220MG/5ML 1.5 73417 ERYTHROMYCIN (E.E.S.) SUSP 200MG/5ML 2 73422 LACTOSE FREE FOOD(ENSURE PLUS) 8OZ 4.45 73424 J0171 EPINEPHRINE 1:10000(0.1MG/ML) 1MG/10ML 17.5 73426 ERYTHROMYCIN OPTH OINT 5MG/GM 3.5GMS 30 73432 PIROXICAM (FELDENE) CAP 20MG 7.92 73434 DORZOLAMIDE HCL (TRUSOPT) OPTH 2% 171.08 73435 J2997 ALTEPLASE (ACTIVASE) 1MG/ML 100MG 21193.5 73439 FERROUS SULFATE TAB 325MG 1.5 73441 BUTAL/APAP/CAFF(FIORICET)TAB 50/325/40MG 1.5 73442 COD/ASA/BUTALB/CAFF(FIORINAL W/COD)CAP 5 73445 FLUORESCEIN SOD (FLU-GLO)OPTH STRIP 1.0M 1.5 73447 IMIPRAMINE HCL (TOFRANIL) TAB 10MG 1.5 73457 GUAIFEN/DM (ROBITUSSIN DM)SYRP 5ML 1.5 73461 PRAZOSIN HCL (MINIPRES) CAP : 5MG 2.5 73465 GUAIFENESIN (ROBITUSSIN)SYRP 5ML 1.5 73467 GENTAMICIN 80MG/50ML IVPB 10.5 73471 GENTAMICIN OPHTHALMIC SOL 5ML 12 73475 GELATIN SPONGE ABSORB(GELFOAM) 7MM 24.65 73476 GELATIN SPONGE ABSORBABLE (GEL 23 73484 GLIPIZIDE (GLUCOTROL) TAB 5MG 1.5 73488 GLYCERIN (INFANT) (FLEET) SUPPOSITORY 1.5 73490 GLYCERIN (ADULT) (FLEET) SUPPOSITORY 1.5 73491 GRANULEX PER CAN (4OZ) 89.5 73495 CLOTRIMAZOLE (GYNE-LOTRIMIN) VAG 45GM 20 73497 TRIAZOLAM 0.125MG TAB 2.5 73498 HALOPERIDOL (HALDOL) TAB 0.5MG 1.5 73499 HALOPERIDOL (HALDOL) TAB 1MG 2 73500 HALOPERIDOL (HALDOL) TAB 2MG 1.5 73501 HALOPERIDOL (HALDOL) TAB 5MG 3 73506 J1630 HALOPERIDOL (HALDOL) INJ 5MG/ML 42.51 73510 J1644 HEPARIN SODIUM INJ 10,000 UNITS/ML 9.5 73514 CHLORPROPAMIDE (DIABENESE) TAB 100MG 1.5 73523 HYDROCORTISONE CREAM 28GM 1% 5 73535 LOPERAMIDE (IMODIUM) CAP 2MG 2.5 73536 AZATHIOPRINE (IMURAN) TAB 50MG 3.5 73537 PROPRANOLOL HCL 10 MG 1.5 73538 PROPRANOLOL HCL 20MG TAB 1.5 73539 THEO 24(THEOPHYLLINE) CAP 300MG 6.68 73540 PROPRANOLOL HCL (INDERAL LA) CAP : 80MG 3 73541 PROPRANOLOL HCL (INDERAL LA) CAP : 120MG 4.5 73542 J1800 PROPRANOLOL (INDERAL) INJ AMP 1MG/ML 25.2 73544 INDOMETHACIN 25MG CAPS 2.5 73546 INDOMETHACIN (INDOCIN) CAP 75MG 6 73551 ISOSORBIDE MONONITRATE(IMDUR)TAB 60MG 3 73553 CEFPROZIL (CEFZIL) SUSP 125MG/5ML 5.27 73556 ISONIAZID (INH) TAB 300MG 1.5 73557 NATURAL BALANCE TEARS 15ML 10 73558 DEXTRAN 70/HP-M-CELL(NATUR BAL 1.5 73564 VALACYCLOVIR (VALTREX) TAB 500MG 16.25 73570 BISMUTH SUBSALICY(KAOPECTATE) 15ML 1.5 73571 BISMUTH SUBSALICY(KAOPECTATE) 5ML 1.5 73574 METHYLDOPA (ALDOMET) TAB : 250MG 1.5 73576 SULFACETAMIDE/PRED(BLEPHAMIDE)OINT:0.2% 141.73 73577 CARBIDOPA/LEVODOPA(SINEMET CR)TAB 25/100 2.5 73578 CEPHALEXIN (KEFLEX) ORAL SUSP 125MG/5ML 2 73579 METIPRANOLOL OPHTHALMIC SOL 0.3% : 5ML 27.03 73583 CEPHALEXIN (KEFLEX) ORAL SUSP 250MG/5ML 2 73586 J0690 CEFAZOLIN (KEFZOL) INJ 500MG 21.5 73589 TRIAMCINOLONE (KENALOG CRM) 15GM 0.1% 14.18 73590 KENALOG CREAM 0.1% PER APPLICATION 2 73592 J3301 TRIAMCINOLONE (KENALOG) INJ SUS 40MG/ML 30.35 73596 LINDANE LOTION 60ML:1% 325.58 73597 LINDANE SHAMPOO 1%: 60ML 342.15 73601 ACIDOPHILUS/BULGARICUS (LACTINEX) 1 PKT 2.5 73602 DIGOXIN (LANOXIN) TAB 0.125MG 1.5 73603 DIGOXIN (LANOXIN) TAB 0.25MG 1.5 73604 DIGOXIN 0.05MG/ML SOLN 60ML 61.5 73605 DIGOXIN 0.05MG/ML SOLN 30CC 31 73606 DIGOXIN 0.05MG/ML SOLN 15CC 16 73607 DIGOXIN (LANOXIN)0.05MG/ML ORAL SOL 5ML 5 73608 J1160 DIGOXIN (LANOXIN) INJ 0.25MG/ML 2ML 5.5 73609 J1162 DIGOXIN IMMUNE FAB (DIGIFAB) 40MG/4ML 6455 73621 J1940 FUROSEMIDE (LASIX) INJ 40MG/4ML 5 73629 FLUOCINONIDE(LIDEX)CRM 0.05% 15GM 33.9 73631 AMITRIP HCL/CHLOR(LIMBITROL)TAB 12.5/5MG 2.5 73632 VITAMIN B-12 500MCG TAB 1.5 73634 J2010 LINCOMYCIN (LINCOCIN) INJ : 300MG/ML 25 73636 LITHIUM CARBONATE CAP : 300MG 1.5 73638 DIPHENOXY/ATROP(LOMOTIL)TAB 2.5MG/0.025 2 73639 WATER STERILE - INJECTION WATE 1.5 73640 NICOTINE TRANSDERMAL SYSTEM : 21MG PATCH 5.5 73643 METOPROLOL (LOPRESSOR) TAB : 50MG 2 73645 METOPROLOL (LOPRESSOR) INJ : 5MG/5ML 10.4 73648 CLOTRIMAZOLE (LOTRIMIN) 1% CRM 15GM 11.25 73652 CLOTRI/BETAMET (LOTRISONE) CR 15 GMS 57.18 73660 MAGNESIUM HYDROX/AL(MAALOX PLUS): 12OZ 14.38 73661 MAGNESIUM HYDROX/AL(MAALOX): 30ML 2 73662 MAGNESIUM HYDROX/AL(MAALOX): 15ML 1.5 73663 MAGNESIUM HYDROX/AL(MAALOX PLUS): 30ML 1.5 73664 NITROFURANTOIN (MACRODANTIN) CAP : 50MG 2.5 73665 NITROFURANTOIN (MACRODANTIN) CAP : 100MG 4.5 73666 J3475 MAGNESIUM SULFATE SDV : 5GM/10ML 5 73672 J2150 MANNITOL 25% SDV : 12.5GM/50ML 12.5 73680 TRIAMTERENE/HCTZ(MAXZIDE)TAB 75MG/50MG 2.5 73688 MEGESTROL (MEGACE) TAB : 40MG 3 73689 CEFOXITIN (MEFOXIN) INJECTION 1 GM 54 73698 PHYTONADIONE (VITAMIN K) TAB 5MG 143 73700 PSYLLIUM/SUCROSE(METAMUCIL)PWD :PER OZ 3.5 73701 PSYLLIUM/SUCROSE(METAMUCIL)PWD: 15ML 2 73702 PSYLLIUM/SUCROSE(METAMUCIL)PWD : 5ML 1.5 73704 METHYLERGONOVINE(METHERGINE)INJ:0.2MG/ML 13.62 73705 METHOTREXATE (TREXALL) TAB : 2.5MG 10 73711 GLYBURIDE (MICRONASE) TAB 5MG 2.5 73713 MAGNESIUM HYDROX(MILK OF MAG) : 30ML 2 73714 MAGNESIUM HYDROX(MILK OF MAG) : 15ML 1.5 73715 MINERAL OIL : 473ML 13.5 73716 MINERAL OIL PER OZ: 30ML 2 73717 PRAZOSIN HCL (MINIPRES) CAP : 1MG 1.5 73718 PRAZOSIN HCL 5MG CAPS 3 73719 MINOCYCLINE (MINOCIN) CAP : 50MG 4.25 73721 CLONIDINE(CATAPRES TTS-2)PATCH 0.2MG/24 108.67 73731 MICONAZOLE VAG CREAM (MONISTAT): 2% 12.98 73735 IBUPROFEN (MOTRIN) TAB 800MG 1.5 73736 IBUPROFEN (MOTRIN) TAB 400MG 1.5 73737 IBUPROFEN (MOTRIN) TAB 600MG 1.5 73738 MORPHINE ER 15(MS CONTIN) TAB 2.5 73739 MORPHINE ER (MS CONTIN) TAB : 30MG 2 73740 J2270 MORPHINE SULFATE CARP INJ : 15MG/ML 15 73741 LIDOCAINE/EPINE 2% INJ : 20MG/ML 4 73742 LIDOCAINE/EPINE 1% INJ :10MG/ML 8 73749 TRIAM ACE LOTION(KENALOG LOT)60ML 0.1% 106.1 73751 NYSTATIN/TRIAM CR(MYCOLOG):30GMS 105 73752 J1170 HYDROMORPHONE INJ (DILAUDID)CARP 2MG/ML 4.83 73759 NYSTOP(NYSTATIN)POWDER 69 73760 FENTANYL TRANS(DURAGESIC)PTCH 25MCG/HR 39.5 73766 SIMETHICONE (MYLICON 80) CHEW TAB : 80MG 1.5 73767 PRIMIDONE (MYSOLINE) TAB : 250 MG 2.49 73768 KETOCONAZOLE (NIZORAL) SHAMPOO 2% 120ML 69.38 73772 GLIPIZIDE (GLUCOTROL XL) TAB 5MG 1.5 73773 FENOPROFEN CALCIUM 600MG 3 73774 PRAVASTATIN (PRAVACHOL) TAB : 20MG 8.17 73775 NAPROXEN (NAPROSYN) TAB : 250MG 3 73776 NAPROXEN (NAPROSYN) TAB : 375MG 4.5 73777 NAPROXEN (NAPROSYN) TAB : 500MG 4.5 73778 J2310 NALOXONE (NARCAN) INJ SDV 0.4MG/ML 18.97 73781 KETOCONAZOLE (NIZORAL) CREAM 30GM 56.64 73784 THIOTHIXENE (NAVANE) CAP 2MG 1.5 73785 THIOTHIXENE (NAVANE) CAP 5MG 2.5 73790 J3260 TOBRAMYCIN (NEBCIN) MDV 80MG/2ML 28.5 73791 J3260 TOBRAMYCIN (NEBCIN) IVPB 80MG/100ML 27.91 73792 CETIRIZINE (ZYRTEC) TAB 10MG 6.21 73793 CHLORDIA/AMITR(LIMBITROL)TAB 10MG/25MG 3.5 73797 MEGESTROL ACE(MEGACE)40MG/ML SUSP:5ML 7.5 73798 NEOM/POLYM/DEXAM (MAXITROL)OP SUSP: 5ML 20 73805 NEOMYC/BACITRA/POLYMY(NEOSPORIN) 0.9GM 1.5 73807 NEOMY/POLY/GRAM (NEOSPORIN) OP SOL :10ML 30 73808 NEFAZODONE HCL NEFAZODONE HCL 5 73811 NEOMYC/BACITRA/POLYMY(NEOSPORIN OI) 15GM 9.35 73812 NEOMY/POLYM (NEOSPORIN G.U.)IRRIG :1 ML 50.39 73815 NEO-SYNEPHERINE SPRAY 0.25%(MILD):15ML 9.68 73818 NEO-SYNEPHERINE 1/2% SPRAY(REGULAR):15ML 9.68 73819 NEO-SYNEPHERIN 1%SPRAY (X-STRENGTH):15ML 10.85 73823 NIACIN (VITA B3)TAB : 100MG 1.5 73824 IRON POLY/B12/FA(FERREX 150 FO 1.5 73827 MISOPROSTOL (CYTOTEC) TAB : 100MCG 2 73829 NITROGLYCERIN(NITROQUICK)SL TAB: 0.4MG 2 73831 NITROLINGUAL(NITROGLYCERIN)SPRAY:400MCG 7.92 73833 NITROGLYCERIN (NITRO-BID) 2% OINT 4.9 73834 KETOCONAZOLE (NIZORAL) TAB 200MG 8 73843 DISOPYRAMIDE PHOS (NORPACE) CAP 150MG 2.5 73848 DIBUCAINE 1% OINTMENT(NUPERCAINE) 28GM 8.73 73849 FLUVASTATIN SODIUM (LESCOL) CAP 40MG 5 73850 J2300 NALBUPHINE HCL 10MG/ML AMPS 10 73851 J2300 NALBUPHINE (NUBAIN) INJ : 20MG/ML 12.05 73863 CHLORDIAZEPOXIDE HCL (LIBRIUM) CAP 5MG 1.5 73864 LEVOTHYROXINE (SYNTHROID)TAB 125MCG 1.5 73873 OYSTER SHELL CALCIUM(OSCAL)TAB 500 MG 1.5 73878 PYRAZINAMIDE TAB : 500MG 3.5 73879 NORTRIPTYLINE HCL (PAMELOR) CAP : 25MG 3 73882 CHLORZOXAZONE (PARAFON) TAB 500MG 2.5 73889 HYDROXYCHLOROQUINE(PLAQUENIL)TAB 200MG 3.08 73892 ELECTROLYTE (PEDIALYTE) SOL 1000ML 6 73892 ELECTROLYTE (PEDIALYTE) SOL 1000ML 6 73892 ELECTROLYTE (PEDIALYTE) SOL 1000ML 6 73892 ELECTROLYTE (PEDIALYTE) SOL 1000ML 6 73894 PENICILLIN V K ORAL SUSP : 125MG/5ML 1.5 73895 PENICILLIN V POTASSIUM 125MG/5 2 73896 PENICILLIN V POTASSIUM 125MG/5 1.5 73897 PENICILLIN V K ORAL SUSP : 250MG/5ML 2 73899 PENICILLIN V POTASSIUM 250MG/5 1.5 73906 TEMAZEPAM (RESTORIL) CAP 7.5 MG 22.79 73913 MARINOL (DRONABINOL) CAP : 2.5MG 17.42 73916 DIPYRIDAMOLE (PERSANTINE) TAB 75MG 2.5 73920 J2270 MORPHINE SULFATE CARP INJ : 8MG/ML 8 73921 PROMETHAZINE (PHENERGAN) SUPP : 12.5MG 10 73922 PROMETHAZINE (PHENERGAN) SUPP : 25MG 11.12 73925 CEFPROZIL 125MG/5ML POSR 52.5 73926 NYSTATIN 100MU/GM CR (NYSTATIN) : 30 GM 14.9 73928 PHENOBARBITAL TAB : 32.4MG 2 73929 PHENOBARBITAL TAB : 97.2MG 2 73930 PHENOBARBITAL 20MG/5ML ELIX :30CC 2.5 73931 PHENOBARBITAL 20MG/5ML ELIX : 15CC 2 73932 PHENOBARBITAL 20MG/5ML ELIX: 5ML 2 73936 PIPERACILLIN (PIPRACIL) INJ : 3GM 68 73937 CEFPROZIL 250MG/5ML POSR 102.5 73938 J2590 OXYTOCIN (PITOCIN) INJECTION : 10 U/ML 16.41 73953 J3480 POTASSIUM CHLORIDE SDV 40MEQ / 20ML 3 73954 PREDNISONE (DELTASONE) TAB 5MG 1.5 73955 PREDNISONE (DELTASONE) TAB 10MG 1.5 73956 PREDNISONE (DELTASONE) TAB : 20MG 1.5 73958 ESTROGEN (PREMARIN)TAB 0.625MG 1.5 73959 ESTROGEN (PREMARIN) TAB 0.3MG 1.5 73961 ESTROGEN CONJUG (PREMARIN)0.62 42.5GM 255.93 73962 J0743 IMIPENEM/CILASTATIN(PRIMAXIN)INJ 500MG 139.42 73963 AMPICILLIN (PRINCIPEN) CAP 250MG 2 73969 PRODERM 55.5 73969 PRODERM 55.5 73969 PRODERM 55.5 73971 J2720 PROTAMINE SULFATE INJ. : 10MG/ML 12.5 73972 NIFEDIPINE (PROCARDIA) CAP : 10MG 2 73982 RISPERIDONE (RISPERDAL) TAB : 2 MG 20.62 73984 NORMAL SALINE 100ML PARTIAL FILL 39 73984 NORMAL SALINE 100ML PARTIAL FILL 39 73984 NORMAL SALINE 100ML PARTIAL FILL 39 73987 FENTANYL TRANS(DURAGESIC)PTCH 75MCG/HR 100.62 73993 METOPROLOL (TOPROL XL)TAB : 100MG 2.5 73999 TEMAZEPAM (RESTORIL) CAP 15MG 1.79 74000 TEMAZEPAM (RESTORIL) CAP 30MG 2.08 74001 J2790 RHO D IMMUNE GLOBULIN(RHOGAM):300MCG 176.4 74002 RIFAMPIN (RIFADIN) CAPS : 300MG 9 74007 METHYLPHENIDATE (RITALIN) TAB : 5MG 2 74010 METHOCARBAMOL (ROBAXIN) TAB : 500MG 1.5 74011 METHOCARBAMOL (ROBAXIN) TAB : 750MG 2 74013 ESTRADIOL(ESTRACE) TAB 2MG 2 74018 GUAIFEN/COD (ROBITUSSIN AC)SYRP 30ML 7 74019 GUAIFEN/COD (ROBITUSSIN AC) SYPR 15ML 3 74020 GUAIFEN/COD (ROBITUSSIN AC)SYRP 5ML 2 74027 J0696 CEFTRIAXONE (ROCEPHIN) INJ 1GM 3 74038 SULFAMETH/TRIMETH(SEPTRA)INJ: 80MG/16MG 4.43 74040 OXAZEPAM 10MG CAPS 2 74046 SILVER NITRATE APPLICATOR:75% 1.5 74047 CARBIDOPA/LEVODOPA(SINEMET)TAB 10/100MG 2.5 74048 CARBIDOPA/LEVODOPA(SINEMET)TAB 25/100MG 2.5 74049 CARBIDOPA/LEVODOPA(SINEMET)TAB 25/250MG 3 74053 DOXEPIN HCL (SINEQUAN) CAP 75MG 3 74056 POTASSIUM CHLORIDE (KLOR-CON) TAB: 8MEQ 1.5 74060 SODIUM BICARBONATE TAB : 650MG 1.5 74061 J1885 SODIUM BICARBONATE SYR 0.9MEQ/ML:50ML 17.5 74062 SODIUM CHLORIDE 0.9% MDV 2 74063 LAMOTRIGINE (LAMICTAL) TAB 100MG 7 74064 METHYLCELLULOSE(CITRUCEL)PWD : 479GM 1.5 74067 J1720 HYDROCORT (SOLU-CORTEF) INJ 100MG/2ML 10.24 74068 J2920 METHYLPRED (SOLU-MEDROL)INJ : 40MG/ML 11.31 74069 J2930 METHYLPRED (SOLU-MEDROL) INJ : 1 GRAM 125 74071 CARISOPRODOL (SOMA) TAB 350MG 2 74072 RAMIPRIL (ALTACE) CAPS : 2.5MG 2.5 74073 METOPROLOL (TOPROL XL)TAB : 50MG 2 74074 GABAPENTIN (NEURONTIN) CAPS 300MG 4.5 74075 HYDRALAZINE (APRESOLINE) TAB 10 MG 1.5 74076 AZITHROMYCIN (ZITHROMAX)SUSP 200MG/5ML 6.51 74085 POTASSIUM IODIDE (SSKI)DROPS: 30ML 15 74086 POTASSIUM IODIDE (SSKI)DROP: PER 10 GTTS 2 74087 J0595 BUTORPHANOL (STADOL) INJ 2MG/ML 18.28 74094 PSEUDOEPHEDRINE HCL (SUDAFED) TAB : 30MG 1.5 74095 PSEUDOEPHEDRINE HCL (SUDAFED) TAB : 60MG 1.5 74096 PSEUDOEPHEDRINE HCL(SUDAFED)SYRP: 30ML 2.5 74097 PSEUDOEPHEDRINE HCL(SUDAFED)SYRP: 15ML 1.5 74098 PSEUDOEPHEDRINE HCL (SUDAFED)SYRP: 5ML 1.5 74102 TETRACYCLINE HCL (SUMYCIN) CAP 250MG 1.5 74103 ATENOLOL (TENORMIN) TAB 25MG 2.5 74104 OXAZEPAM 15MG CAPS 1.5 74105 DOCUSATE CA (SURFAK) GCAP 240MG 1.5 74108 NUTRITION SUPPLE/FIBER(GLUCERNA) 8OZ 7.33 74109 AMANTADINE HCL (SYMMETREL) CAP 100MG 2.5 74110 LEVOTHYROXINE(SYNTHROID)(200MCG) 0.2 MG 2.5 74111 LEVOTHYROXINE (SYNTHROID)TAB 50MCG 1.5 74112 LEVOTHYROXINE (SYNTHROID)TAB 100MCG 1.5 74114 CIMETIDINE (TAGAMET) TAB 300MG 3 74115 CIMETIDINE (TAGAMET) TAB 400MG 6 74120 PENTAZOCINE/APAP(TALACEN)TAB: 25MG/650MG 3 74122 PENTAZO/NALOX HCL(TALWIN NX)TAB:50/0.5MG 4.86 74128 BENZONATATE (TESSALON) CAP 100MG 2 74129 CARBAMAZEPINE (TEGRETOL) TAB 200MG 2 74134 ATENOLOL (TENORMIN) TAB 50MG 2.5 74149 J1670 TETANUS DIPH TOXOID (ADULT) Td 0.5ML 40 74153 SENNOSIDES (SENOKOT) TAB : 8.6MG 1.5 74154 J3411 THIAMINE (VITA B1) 100MG/ML INJ 2ML 43.53 74155 THEOPHYLLINE 200MG 5.44 74158 AMIODARONE HCL(CORDARONE)TAB 200MG 13 74162 NAPROXEN (NAPROSYN) EC TAB : 500MG 5 74163 CHLORPROMAZINE HCL 50MG 2 74175 THYROID TAB 1GR 1.5 74181 TICARCILLIN/POT CLAVULAN(TIMENTIN) 3.1G 57.5 74182 TIMOLOL (TIMOPTIC-XE) 0.5%OP GEL SOL 5ML 80.95 74188 ISOSORBIDE MONONITRATE (ISMO) TAB 20MG 3 74189 PENTOXIFYLLINE (TRENTAL) TAB : 400MG 2.5 74190 PERPHEN/AMITRIP HCL(TRIAVIL)TAB:2MG/10MG 2.5 74191 PERPHEN/AMITRIP HCL(TRIAVIL)TAB:2MG/25MG 2 74192 PERPHEN/AMITRIP HCL(TRIAVIL)TAB:4MG/25MG 3 74194 TRIMETHOPRIM 100MG TAB 1.5 74195 FERROUS/VIT C/B12-IF/FA(TRINSICON)CAP 1.5 74198 SCOPOLAMINE (TRANSDERM SCOP) PATCH:1.5MG 22.14 74199 NITROGLYCERIN (MINITRAN) PATCH :0.2MG/HR 4.5 74200 NITROGLYCERIN PATCH : 0.4MG/HR 4.62 74201 NITROGLYCERIN (MINITRAN) PATCH: 0.6MG/HR 5 74202 TRIPLE DYE APPLICATORS PER APPLICATION 1.5 74207 HYDROCOD/CHLOR POLY(TUSSIONEX)SUSP 30ML 13.5 74208 HYDROCOD/CHLOR POLY(TUSSIONEX)SUSP 15ML 7 74209 HYDROCOD/CHLOR POLY(TUSSIONEX)SUSP 5ML 2.5 74211 ACETAMINOPHEN (TYLENOL) TAB 325MG 1.5 74216 ACETAMINOPHEN (TYLENOL)SUSP 160MG/5ML 1.5 74222 APAP W/CODEINE(TYLENOL W/COD) 300MG-30MG 2 74224 COD/ACETAMIN(ACETA W/COD)SOLN 30CC 10 74225 COD/ACETAMIN(ACETA W/COD)SOLN 15ML 4.5 74226 APAP/CODEINE (TYLENOL/CODEINE)SOLN 5ML 2 74227 OXYCODONE/APAP (TYLOX) CAP : 5MG/500MG 2.5 74228 OXAPROZIN (DAYPRO) TAB : 600MG 4.5 74229 LORATADINE (CLARITIN) TAB 10MG 2 74238 FLAVOXATE HCL (URISPAS) TAB 100MG 2.5 74240 DIAZEPAM (VALIUM) TAB 2MG 1.5 74241 DIAZEPAM (VALIUM) TAB 5MG 1.5 74242 DIAZEPAM (VALIUM) TAB 10 MG 2 74243 KETOPROFEN (ORUDIS) CAP 50MG 3 74259 ALBUTEROL SULFATE (PROVENTIL) TAB 2MG 1.5 74261 VENTOLIN HFA INHALER 90MCG 126 74262 ALBUTEROL SULFATE 2MG/5ML SYRP 5ML 1.5 74270 HYDROXYZINE PAMOATE(VISTARIL) CAP 100MG 3.5 74271 J0698 CEFOTAXIME (CLAFORAN)INJ 500MG 28.5 74272 PYRIDOXINE HCL (VITAMIN B6) TAB : 50MG 1.5 74273 ASCORBIC ACID (VITAMIN C) TAB 500MG 1.5 74277 WATER BACTERIOSTATIC - INJECT 1.5 74278 WATER BACTERIOSTATIC - INJECT 2 74279 SUCRALFATE (CARAFATE) SUSP : 1GM/10ML 8.25 74290 ALPRAZOLAM (XANAX) TAB 0.5MG 2.5 74291 J2001 LIDOCAINE HCL 1%(XYLOCAINE)MDV : 10MG/ML 8 74292 J2001 LIDOCAINE HCL(XYLOCAINE) 10MG/ 1 74293 J2001 LIDOCAINE HCL 2%(XYLOCAINE)INJ: 20MG/ML 10 74294 J2001 LIDOCAINE (XYLOCAINE) : 20MG/ML 1 74297 LIDOCAINE HCL 2% INJ : 100MG/5ML 9.5 74300 NITROCELLULOSE (NEW SKIN):1OZ 10.4 74301 LIDOCAINE HCL VISCOUS : 100ML 39.5 74302 LIDOCAINE HCL VISCOUS SOLN : 30ML 13 74303 LIDOCAINE HCL VISCOUS SOLN: 15ML 7 74304 LIDOCAINE HCL VISCOUS SOLN: 5ML 2.5 74307 RANITIDINE HCL (ZANTAC) TAB 150MG 2 74308 J2780 RANITIDINE (ZANTAC) INJ : 50MG/2ML 15.57 74311 METOLAZONE (ZAROXOLYN) TAB 5MG 2 74312 Z-BEC TAB 1.5 74313 J2543 PIPERACILLIN/TAZOBACTAM(ZOSYN)INJ:3.375G 15 74314 ZINC OXIDE 20% OINT 28GM 4.5 74316 ACYCLOVIR SODIUM(ZOVIRAX) INJ 500MG 205.5 74318 ALLOPURINOL (ZYLOPRIM) TAB 100MG 1.5 74320 FAMCICLOVIR (FAMVIR) TAB 500MG 24.5 74332 ESZOPICLONE (LUNESTA) TAB 1MG 13.19 74368 CETIRIZINE (ZYRTEC) SYRP 5MG/5ML 3.8 74380 BISMUTH SUBSAL(PEPTO-BISMOL)SUSP 15ML 1.5 74387 LIDOCAINE (LIDODERM) PATCH: 5% 17.88 74403 POTASSIUM CHLORIDE 20MEQ/15ML 3.5 74404 POTASSIUM CHLORIDE 20MEQ/15ML 2 74405 POTASSIUM CHLORIDE 20MEQ/15ML 1.5 74409 J2780 PANTOPRAZOLE (PROTONIX) IV : 40MG 10 74410 BISMUTH SUBSALICY(KAOPECTATE) 8OZ 16 74411 FLUPHENAZINE (PROLIXIN) TAB 10MG 4.21 74412 J2680 FLUPHENAZINE (PROLIXIN DEC)INJ 25MG/ML 50 74418 PROPYLTHIOURACIL TAB : 50 MG 1.5 74423 TOLMETIN SODIUM (TOLECTIN DS) CAP 400MG 3 74426 ETODOLAC (LODINE) TAB 400 MG 3.5 74427 GLIPIZIDE (GLUCOTROL XL) TAB 10MG 2.5 74428 ZOLPIDEM (AMBIEN) TAB 5MG 3 74429 CALCITRIOL (ROCALTROL) CAP 0.25MCG 3.2 74430 FLUPHENAZINE (PROLIXIN) TABLET 5MG 3.35 74431 SALMETEROL XINAFOATE (SEREVENT):50MCG 233.78 74432 J1885 KETOROLAC (TORADOL) TAB 10MG 4.5 74434 AMPICILLIN (PRINCIPEN) CAP 500MG 2 74435 DILTIAZEM HCL (CARDIZEM) TAB 60MG 2.5 74436 CLINDAMYCIN HCL (CLEOCIN) CAP 150MG 5 74438 J2175 MEPERIDINE INJ (DEMEROL) CARP : 25MG/ML 4.66 74440 TICLOPIDINE HCL (TICLID) TAB 250MG 2 74442 HYOSCYAMINE SULFATE(LEVSIN)DROPS 15ML 36.5 74444 J0713 CEFTAZIDIME (FORTAZ)INJ 1GM 43.5 74448 LABETALOL HCL (NORMODYNE) TAB 200MG 2 74449 NORPACE CR 150MG CAP 4.73 74451 PENICILLIN G POT(PFIZERPEN)INJ: 20MU 74 74454 ALBUTEROL SULFATE (PROVENTIL) TAB 4MG 2 74455 J2250 MIDAZOLAM (VERSED) INJ 10ML MDV 1MG/ML 3.5 74459 AMOXICIL/CLAVULA(AUGMENTIN) 125MG/5ML 2.23 74461 BUSPIRONE HCL (BUSPAR) TAB 5MG 2.5 74462 BUSPIRONE HCL (BUSPAR) TAB 10MG 4.5 74465 KENALOG LOTION 0.1% PER 15ML 65 74469 CLEMASTINE FUMARATE (TAVIST) TAB 1.34MG 2.5 74472 ENALAPRIL MALEATE (VASOTEC) TAB 5MG 3.5 74473 TYLENOL INFANT'S DROPS 80MG/0.8ML 2 74474 FLECAINIDE ACETATE (TAMBOCOR) TAB 50MG 3 74476 ALBUTEROL INH SOL 0.5%(5MG/ML)CONC 20ML 42.5 74478 J1610 GLUCAGON HUMAN EMERGENCY KIT 1MG 264.68 74479 SENNOSIDES/DOCUS(SENOKOT-S)TAB:8.6/50MG 1.5 74481 FENTANYL TRANS(DURAGESIC)PTCH 100MCG/HR 133.4 74483 SODIUM CHLORIDE (FOR IRRG)1000ML 4.8 74483 SODIUM CHLORIDE (FOR IRRG)1000ML 4.8 74483 SODIUM CHLORIDE (FOR IRRG)1000ML 4.8 74483 SODIUM CHLORIDE (FOR IRRG)1000ML 4.8 74484 AZTREONAM (AZACTAM) INJ 1GM 106.64 74486 MUPIROCIN OINT 2%(BACTROBAN) 22GM 14.2 74487 TRIHEXYPHENIDYL HCL (ARTANE) TAB 2MG 1.5 74488 FAMOTIDINE (PEPCID) TAB 20MG 7 74489 METOCLOPRAMIDE (REGLAN) TAB : 5MG 1.5 74490 ACETAMINOPHEN (TYLENOL) SUPP 325MG 2 74491 TRIAMCINOLONE ACETONIDE (AZMACORT) 20G 357.28 74492 DIPHENHYDRAMINE CREAM (BENADRYL 28.3 GM 3.7 74497 J0696 CEFTRIAXONE (ROCEPHIN)INJ 500MG 75.5 74499 THEOPHYLLINE (THEO-DUR) TAB 300MG 2 74501 TOBRAMYCIN (TOBREX) OP SOL 0.3% 5ML 30 74502 ALPRAZOLAM (XANAX) TAB 0.25MG 2 74504 VERAPAMIL (CALAN SR) TAB 240MG 3.5 74505 GLYBURIDE (DIABETA) TABLET 5MG 2 74507 J7070 DEXTROSE 5% (D5W) 50ML 40 74507 J7070 DEXTROSE 5% (D5W) 50ML 40 74507 J7070 DEXTROSE 5% (D5W) 50ML 40 74507 J7070 DEXTROSE 5% (D5W) 50ML 40 74508 SODIUM CHLORIDE 3% INJ (500 ML) 33.5 74508 SODIUM CHLORIDE 3% INJ (500 ML) 33.5 74508 SODIUM CHLORIDE 3% INJ (500 ML) 33.5 74508 SODIUM CHLORIDE 3% INJ (500 ML) 33.5 74511 VERAPAMIL (CALAN)INJ (2.5MG/ML) 5MG/2ML 4.82 74512 CIPROFLOXACIN (CIPRO) TAB 500MG 2 74513 DICLOFENAC (VOLTAREN) TAB 50 MG 3 74514 LORAZEPAM (ATIVAN) TAB : 0.5MG 1.5 74520 J0696 CEFTRIAXONE (ROCEPHIN) INJ 250MG 57.5 74521 IPRATROPIUM BROMIDE (ATROVENT) 17MCG 250.1 74524 DM/PE/PYRIL (CODITUSS DM)LIQD 10/5/8MG 1.5 74529 DICLOFENAC (VOLTAREN) TAB 75 MG 4.5 74530 J1250 DOBUTAMINE HCL SDV 250MG/20ML 61.5 74532 CIPROFLOXACIN (CIPRO) TAB 250MG 10 74533 FLUOXETINE HCL (PROZAC) CAP 20MG 9.5 74535 TORSEMIDE TORSEMIDE 100MG 9.5 74539 J0561 PENICILLIN G (BICILLIN L-A) 600,000U/ML 71.67 74543 NYSTATIN 100MU/ML SUSP : 5ML 2 74545 NIFEDIPINE (PROCARDIA ER) TAB : 30MG 5 74547 SUPRAX SUSP (50ML) : 100MG/5ML 256.42 74548 SUPRAX SUSP : 100MG/5ML 32.05 74549 FLURBIPROFEN (ANSAID) TAB 100MG 2.75 74550 LOSARTAN /HCTZ (HYZAAR)TAB 50/12.5MG 4.5 74552 PHISOHEX CLEANSER 3%:5OZ 53.75 74554 VANCOMYCIN (VANCOCIN) CAP 250MG 81.48 74555 GLYBURIDE (MICRONASE) TAB 2.5MG 1.5 74556 NIFEDIPINE (PROCARDIA ER) TAB : 60MG 10.5 74557 GLYBURIDE (DIABETA) TABLET 2.5MG 1.5 74562 MULTIVITAMIN (INFUVITE) ADLT VIAL: 10ML 15.53 74568 TIMOLOL (TIMOPTIC) 0.25% OPH SOL 5 ML 37.5 74571 J2250 MIDAZOLAM (VERSED) INJ SDV 2MG/2ML 4.6 74572 CYPROHEPTADINE HCL 2MG/5ML SYRP 5ML 1.5 74573 GENTAMICIN OPHTH OINT 0.3% 3.5GMS 30 74574 HYDROXYZINE PAMOATE(VISTARIL)CAP 50MG 1.5 74575 ISOSORBIDE DINITRATE (ISORDIL)TAB 10MG 1.5 74577 PROMETHAZINE (PHENERGAN) TAB : 25MG 1.5 74579 GENTAMICIN SULFATE 0.30% DROP 32.5 74580 J1885 KETOROLAC (TORADOL) INJ 60MG/ML 7.15 74581 POTASSIUM (MICRO-K) CAP 10MEQ 2 74586 METRONIDAZOLE (FLAGYL)TAB 500MG 2 74587 CEPHALEXIN (KEFLEX) CAP 250MG 2 74588 DIPHENHYDRAMINE HCL(BENADRYL)CAP 25MG 1.5 74589 MECLIZINE (ANTIVERT) TAB 25MG 1.5 74590 PHENAZOPYRIDINE HCL(PYRIDIUM)TAB : 100MG 1.5 74592 NEO/POLY/HC (CORTISPORIN)OTIC SUSP 10ML 61.6 74594 HYDROXYZINE HCL (ATARAX) TAB 10MG 1.5 74595 ISOSORBIDE DINITRATE TAB 5MG 1.5 74596 METOCLOPRAMIDE (REGLAN) TAB : 10MG 1.5 74597 PROCHLORPERAZINE MAL(COMPAZINE)TAB : 5MG 1.5 74598 THIORIDAZINE HCL (MELLARIL) TAB 10MG 1.5 74601 LEVOTHYROXINE (SYNTHROID)TAB 150MCG 1.5 74602 J1240 DIMENHYDRINATE(DRAMAMINE)MDV 50MG/ML 19.95 74603 DIPHENHYDRAMINE HCL(BENADRYL)CAP 50MG 1.5 74604 ENALAPRIL MALEATE (VASOTEC) TAB 10MG 3.5 74605 NIZATIDINE (AXID) CAP : 150MG 5.97 74606 FLUCONAZOLE (DIFLUCAN) TAB 100MG 27 74609 SUMATRIPTAN (IMITREX) INJ 6MG/0.5ML 17.95 74610 CHLORTHALIDONE (HYGROTON) TAB 50MG 1.5 74612 AMITRIPTYLINE HCL (ELAVIL) TAB 25MG 1.5 74613 AMITRIPTYLINE HCL (ELAVIL) TAB 50MG 1.5 74614 CEPHALEXIN MONOHYDRATE 250MG/5 50.5 74616 J3410 HYDROXYZINE HCL INJ SDV 50MG/ML 1ML 5 74617 FINASTERIDE (PROSCAR) TAB 5MG 8.49 74618 J0780 PROCHLORPERAZINE (COMPAZINE)INJ:10MG/2ML 10.5 74621 DOXEPIN HCL (SINEQUAN) CAP 10MG 1.5 74622 DIPYRIDAMOLE (PERSANTINE) TAB 25MG 1.5 74624 BISACODYL (DULCOLAX) TAB 5MG 1.5 74625 CEPHALEXIN (KEFLEX) CAP 500MG 4.5 74626 DICYCLOMINE (BENTYL) INJ 20MG/2ML 2ML 80.91 74627 PROPRANOLOL (INDERAL) TAB : 40MG 1.5 74630 J3370 VANCOMYCIN HCL IV PWD FOR SOLN 750MG 23.65 74631 J3370 VANCOMYCIN HCL INJ 500MG 71 74632 HYDROXYZINE HCL (ATARAX) TAB 25MG 2 74633 TETRACYCLINE HCL (SUMYCIN) CAP 500MG 1.5 74634 AMOXICILLIN (AMOXIL) CAP 500MG 1.5 74636 DILTIAZEM HCL (CARDIZEM SR) CAP 90MG 4.5 74638 LISINOPRIL (ZESTRIL) TAB 10MG 3 74639 AMOXICILLIN TRIHYDRATE 250MG/5 15 74640 SULFAMETHOX/TMP(BACTRIM DS)TAB:800/160MG 2.5 74641 CYPROHEPTADINE (PERIACTIN) TAB 4MG 1.5 74642 INDOMETHACIN (INDOCIN) CAP 25MG 2 74643 DOXEPIN HCL (SINEQUAN) CAP 25MG 1.5 74644 THIORIDAZINE HCL (MELLARIL) TAB 25MG 1.5 74645 DIPHENOXYLATE/ATROPINE ORAL SOLN 5 ML 2 74647 LOPERAMIDE HCL(IMODIUM AD) : 1MG/7.5ML 1.5 74648 DOXYCYCLINE (VIBRAMYCIN) CAP 100MG 1.5 74649 DOXYCYCLINE (VIBRAMYCIN) CAP 50MG 1.5 74650 J3230 CHLORPROMAZINE(THORAZINE)INJ 50MG/2ML 31.16 74652 TAMOXIFEN CITRATE (NOLVADEX) TAB 10MG 7 74653 ERGOLOID MESYLATES TAB 1MG 7.78 74655 FEXOFENADINE HCL (ALLEGRA) TAB 60MG 3 74656 ADRENALIN (EPINEPHRINE)NASAL SOL 1MG/ML 2.1 74660 VERAPAMIL (CALAN SR) TAB 180MG 4.5 74661 J2550 PROMETHAZINE (PHENERGAN)AMPS :25MG/ML 9.5 74662 J2540 PENICILLIN G POT(PFIZERPEN)INJ: 5MU 2 74664 METOCLOPRAMIDE(REGLAN)SYRP: 5MG/5ML 2 74668 MAGNESIUM CHLORIDE (SLOW-MAG) TAB : 64MG 1.5 74669 CHLORDIAZEPOXIDE/CLIDINIUM(LIBRAX)CAP 3.92 74670 TRAZODONE (DESYREL) TAB 50MG 2 74671 CHLORPROMAZINE (THORAZINE)TAB 25MG 1.5 74672 J1100 DEXAMETHASONE(DECADRON)INJ MDV 4MG/ML 6 74676 POTASSIUM CHLORIDE (K-DUR) TAB : 20MEQ 2 74677 POTASSIUM CHL 20% ORAL SOLN : 40MEQ/15ML 1.5 74678 FOLIC ACID TAB 1MG 1.5 74680 AMPICILLIN 250MG/5ML SUSP 5ML 1.5 74682 AMPICILLIN 125MG/5ML SUSP 5ML 1.5 74683 BISACODYL (DULCOLAX) SUPP 10MG 1.5 74684 SULFAMET/TMP(BACTRIM)SUSP 200MG/40MG 10.05 74685 J0698 CEFOTAXIME (CLAFORAN) INJ 2GM 39 74686 HYDRALAZINE HCL (APRESOLINE) TAB 25MG 1.5 74690 PROMETHAZINE W/COD SYR : 5ML 1.5 74691 PROMETHAZINE(PHENERGAN)VC PLAIN : 5ML 1.5 74692 PENICILLIN V POTASSIUM 500MG 1.5 74693 HYOSCYAMINE (LEVSIN) DROPS 1ML 6.7 74694 SIMETHICON(INFANT GS RLF) DROPS: PER ML 1.5 74695 CHLORDIAZEPOXIDE HCL CAP 25MG (LIBRIUM) 1.5 74697 TERAZOSIN HCL (HYTRIN) CAP 1MG 3.5 74700 FLUDROCORTISONE(FLORINEF) TAB 0.1MG 2 74701 THEOPHYL ANHYDR(ELIXOPHYL)ELIX 5ML 1.5 74702 CHLORPROMAZINE (THORAZINE)TAB 50MG 1.5 74704 DEXAMETHASONE (DECADRON) TAB 0.75MG 1.5 74705 AMOXICILLIN (AMOXIL) CAP 250MG 1.5 74708 HYDROCHLOROTHIAZIDE (HCTZ) TAB 25MG 1.5 74711 POTASSIUM CHL 10% ORAL SOLN : 20MEQ/15ML 3.26 74712 ENDOCET (PERCOCET) TAB 5MG/325MG 2 74714 DOCUSATE SODIUM (COLACE) GCAP 100MG 1.5 74719 QUINAPRIL HCL (ACCUPRIL) TAB 20MG 4.58 74722 INDAPAMIDE (LOZOL) TAB 2.5MG 2.5 74724 DICYCLOMINE HCL (BENTYL) TAB 20MG 1.5 74725 DEXAMETHASONE (DECADRON) TAB 4MG 1.5 74726 TERAZOSIN HCL (HYTRIN) CAP 5MG 4.5 74728 PHENOBARBITAL TAB : 64.8MG 1.5 74729 GUANFACINE HCL (TENEX) TAB 1MG 3 74731 FUROSEMIDE ORAL SOLN 10MG/ML 1.5 74734 SPIRONOLACTONE (ALDACTONE) TAB : 25MG 1.5 74735 J1580 GENTAMICIN (GARAMYCIN) MDV 80MG/2ML 3 74736 PREDNISOLONE SOD PHOS(PEDIAPRED):5MG/5ML 1.5 74738 CALCIUM CARBONATE (TUMS) 500MG 1.5 74741 GLYCOPYRROLATE(ROBINUL) INJ 0.2MG/ML 2.25 74743 VERAPAMIL (CALAN ) ER TAB 120MG 2.35 74744 J0330 SUCCINYLCHOLINE(ANECTINE)INJ 200MG/10ML 10.16 74746 J2710 NEOSTIGMINE INJ : 0.5MG/ML 4.5 74752 LOVASTATIN (MEVACOR) TAB : 20MG 9.5 74753 LINDANE LOTION 1%: 60ML 342.15 74754 DOXEPIN HCL (SINEQUAN) CAP 50MG 1.5 74757 HYDRALAZINE (APRESOLINE) TAB 50MG 1.5 74758 SODIUM CHLORIDE (FOR IRRG) 3000ML 58 74758 SODIUM CHLORIDE (FOR IRRG) 3000ML 58 74758 SODIUM CHLORIDE (FOR IRRG) 3000ML 58 74758 SODIUM CHLORIDE (FOR IRRG) 3000ML 58 74760 PROMETHAZINE PLAIN 6.25MG/5ML SYRP: 5ML 1.5 74769 BACLOFEN TAB 10MG 1.5 74770 IMIPRAMINE HCL (TOFRANIL) TAB 25MG 1.5 74771 LACTOSE FREE FOOD(JEVITY)LIQD 1.5CAL 5.95 74774 IMIPRAMINE HCL (TOFRANIL) TAB 50MG 1.5 74775 BENZTROPINE MESYLATE(COGENTIN) TAB 1MG 1.5 74776 CLINDAMYCIN (CLEOCIN)INJ 150MG/ML 4.6 74779 90746 HEPATITIS B VACCINE(ENGERIX-B) 20MCG/ML 116 74780 DEPAKENE SYRP(VALPROIC) 250MG/5ML PER TS 2 74783 CARBAMAZEPINE (TEGRETOL) SUSP 5ML 1.5 74786 WARFARIN SODIUM (COUMADIN) TAB 2MG 2 74788 GEMFIBROZIL (LOPID) TAB 600MG 3.5 74790 DOXAZOSIN MESYLATE (CARDURA) TAB 2MG 3 74792 PROPRANOLOL HCL (INDERAL) TAB : 10MG 1.5 74797 ALPRAZOLAM (XANAX) TAB 1MG 3 74799 SERTRALINE HCL (ZOLOFT) TAB 50MG 2.5 74800 CEFPROZIL (CEFZIL) TAB 500MG 3 74802 ISOSORBIDE DINITRATE (ISORDIL)TAB 20MG 1.5 74803 LINDANE SHAMPOO 60ML:1% 325.58 74805 CYCLOBENZAPRINE (FLEXERIL) TAB 10MG 4.5 74808 CHARCOAL/SORBITOL(ACTIDOSE)SUSP 120ML 27 74809 J0696 CEFTRIAXONE (ROCEPHIN) INJ 2GM 7 74814 NABUMETONE (RELAFEN) TAB : 500MG 3.5 74815 AZITHROMYCIN (ZITHROMAX) TAB 250MG 2.8 74817 FLURAZEPAM HCL (DALMANE) CAPS 15MG 1.5 74818 PRENATAL RX (NATALINS) TAB: 1.5 74821 CLORAZEPATE (TRANXENE)TAB 7.5MG 3.99 74826 MECLOFENAMATE (MECLOMEN) CAP : 100MG 8.92 74827 SODIUM POLY SULFONATE SUSP : 15GM/60ML 21 74828 PCA PUMP PER 24 HOURS 64 74829 PCA DELIVERY SET W/ SPIKE 31.5 74830 PCA SOF-SET #111 35 74831 DEXTROSE 5%(D5W)MINI BAG 50ML 28.5 74831 DEXTROSE 5%(D5W)MINI BAG 50ML 28.5 74831 DEXTROSE 5%(D5W)MINI BAG 50ML 28.5 74831 DEXTROSE 5%(D5W)MINI BAG 50ML 28.5 74832 DEXTROSE 5%(D5W)MINI BAG 100ML 28.5 74832 DEXTROSE 5%(D5W)MINI BAG 100ML 28.5 74832 DEXTROSE 5%(D5W)MINI BAG 100ML 28.5 74832 DEXTROSE 5%(D5W)MINI BAG 100ML 28.5 74833 J7050 NORMAL SALINE MINI BAG:50ML 28.5 74833 J7050 NORMAL SALINE MINI BAG:50ML 28.5 74833 J7050 NORMAL SALINE MINI BAG:50ML 28.5 74833 J7050 NORMAL SALINE MINI BAG:50ML 28.5 74834 J7050 NORMAL SALINE MINI BAG:100ML 7 74834 J7050 NORMAL SALINE MINI BAG:100ML 7 74834 J7050 NORMAL SALINE MINI BAG:100ML 7 74834 J7050 NORMAL SALINE MINI BAG:100ML 7 74835 J2300 NALBUPHINE (NUBAIN) INJ : 10MG/ML 6.83 74891 CANDESARTAN CILEXETIL(ATACAND)TAB 4MG 4.5 74895 J2360 ORPHENADRINE (NORFLEX) INJ : 60MG/2ML 78.75 74908 J0885 EPOETIN ALFA (PROCRIT) 20,000U/ML 650 74909 J0282 AMIODARONE HCL 50MG/ML SDV 150MG/3ML 20 74929 CARVEDILOL (COREG) TAB 3.125MG 5.34 74939 CARVEDILOL (COREG) TAB 6.25MG 5.34 74953 MAGIC MOUTH WASH : 5ML DOSE 3.55 74970 J2505 PEGFILGRASTIM (NEULASTA)SYR : 6MG/0.6ML 10093 74994 J2800 METHOCARBAMOL(ROBAXIN)INJ 100MG/ML:10ML 83.88 74998 NITROFURANTOIN (MACROBID) CAP : 100MG 5 74999 PILOCARPINE HCL 4% OPHTHALMIC SOL: 15ML 27.88 75104 ATENOLOL/CHLORTH(TENORETIC)TAB 50/25 2.5 75108 NUTRITIONAL SUPPLE(GLUCERNA)LIQ: 1000ML 41 75112 LEVOTHYROXINE (SYNTHROID) TAB 112 MCG 1.5 75114 QUETIAPINE (SEROQUEL) TAB : 25MG 4.5 75122 MINOXIDIL TAB : 10MG 3.23 75123 MINOXIDIL TAB : 2.5MG 1.5 75127 J1626 GRANISETRON (KYTRIL) INJ 1MG/ML 72 75141 OXYCONTIN TAB : 40MG 16.03 75184 J0744 CIPROFLO/D5W(CIPRO)IVPB 400MG/200ML 116.5 75234 MULTIVIT/FE/MIN (CENTRUM) LIQD 2 75252 AMANTADINE(SYMMETREL)SYRUP 50MG/5ML 2.5 75421 ADVAIR DISKUS 500/50MCG 507.9 75430 DEXTROSE (GLUTOSE) 40% ORAL GEL 15GM 12 75444 J0713 CUBICIN INJ 500MG 493.73 75445 OLMESARTAN MEDOXOMIL (BENICAR)TAB : 20MG 4 75479 MOXIFLOXACIN HCL (VIGAMOX) 0.5%OPTH 3ML 169.43 75487 ALBUTEROL SULFATE 0.83MG/ML AM 6.5 75487 ALBUTEROL SULFATE 0.83MG/ML AM 6.5 75493 NICARDIPINE (CARDENE) AMP 2.5MG/ML 25MG 598.91 75499 DONEPEZIL (ARICEPT) TAB 5MG 16 75521 A4216 NORMAL SALINE FLUSH PREFILLED SYRN: 10ML 1.53 75523 CALCIUM /VITA D (CALTRATE)TAB 600MG 1 75546 NUTRITIONAL SUPPLEMENT(PROTEIN): 45 75598 J0456 AZITHROMYCIN(ZITHROMAX) INJ 500MG 89.85 75655 FEXOFEN/PSEUDOE(ALLEGRA-D)TAB 60MG/120MG 3.5 75656 FLUNISOLIDE NASAL SOL(NASALIDE) 0.025% 116.23 75665 RISPERIDONE (RISPERDAL) TAB : 1 MG 11.54 75669 WARFARIN SODIUM (COUMADIN) TAB 3MG 2 75689 HYDROCORTISONE CREAM 30GM 2.5% 25 75784 ZINC SULFATE 220MG 1.5 75847 GENTAMICIN CREAM 15GM 0.1% 80 75874 NITROGLYCERIN (MINITRAN) PATCH: 0.3MG/HR 7.89 75879 RISPERDAL TABLET : 0.5MG 12.76 75886 SODIUM CHLORIDE (AYR SALINE) 0.65% 50ML 5.95 75888 FLOVENT HFA 110MCG INHALER 12G 321.68 75899 90675 RABAVERT- RABIES VACCINE : 1ML 700 75907 J0885 EPOETIN ALFA (PROCRIT) 40,000 UNITS/ML 1172 75987 PANTOPRAZOLE (PROTONIX) TAB : 40MG 2 76048 J2920 METHYLPREDN (SOLU-MEDROL)INJ: 125MG/2ML 19.33 76063 J0360 VASOPRESSIN INJ 20 UNITS /ML 18.9 76112 LUBIPROSTONE (AMITIZA) CAP 24MCG 10.65 76114 TRIAM ACE CM(KENALOG CM)15GM 0.5% 12.85 76123 DILTIAZEM HCL (CARDIZEM CD) CAP 180MG 3.5 76141 OXYCONTIN TAB : 20MG 9.04 76152 SIMVASTATIN (ZOCOR) TAB : 40MG 13.35 76182 LATANOPROST(XALATAN)OP SOL 125MCG/2.5ML 188.03 76184 NAFCILLIN INJ : 2GM 16.5 76213 FLUTICASONE PROPIONATE (FLONASE) 50MCG 17.18 76224 GRANISETRON (KYTRIL) TABLET 1MG 147.52 76245 ROSIGLITAZONE MALEATE (AVANDIA)TAB : 4MG 9 76254 IRBESARTAN (AVAPRO) TAB 150MG 4.5 76332 G.I. COCKTAIL 30 ML 15 76341 TRANDOLAPRIL/VERAPAMIL(TARKA)TAB 2/240MG 5 76417 J2060 LORAZEPAM (ATIVAN) INJ 2MG/ML 6.5 76421 OFLOXACIN (FLOXIN)OTIC SOL 0.3% 5 ML 158.6 76425 SANTYL OINTMENT : 15GMS 147.55 76442 OLANZA/FLUOXETINE HCL(SYMBYAX)CAP:6/25MG 21.5 76449 FLUVASTATIN (LESCOL XL)TAB 80MG 7 76451 PROCTOFOAM 100 76452 BRIMONIDINE TARTRATE(ALPHAGAN P)OPTH .15 132.98 76455 J0696 FAMOTIDINE /NACL (PEPCID) IV 20MG/50ML 14.41 76458 PREDNISONE (DELTASONE) TAB : 1MG 1.5 76487 APRACLONIDINE(IOPIDINE) 0.5% OP SOL 5ML 208.93 76497 OLANZAPINE (ZYPREXA) TAB 5MG 21 76521 OXYBUTYRIN CHL(DITROPAN) TAB : 5MG 1.5 76533 CLONIDINE(CATAPRES TTS-3)PATCH 0.3MG/24 138.31 76554 RISEDRONATE SODIUM (ACTONEL) TAB : 35MG 51.5 76555 ALBUTEROL SULFATE ER TAB 4MG 2.5 76559 J3490 FOLIC ACID INJ MDV 5MG/ML 7.79 76587 TOBRAMYCIN/DEXAM(TOBRADEX) OPH SOL 2.5ML 90 76588 OXYCONTIN TAB : 10MG 4.5 76589 TERBINAFINE (LAMISIL) TAB 250MG 32.65 76598 CLINDAMYCIN (CLEOCIN) SUSP 75MG/5ML 6.36 76633 GABAPENTIN (NEURONTIN) CAPS 400MG 5 76652 ALPRAZOLAM (XANAX) TAB 2MG 4.9 76659 RIVASTIGMINE TARTRATE (EXELON) CAP : 6MG 7.5 76666 MIACALCIN NASAL SPRAY 2ML 100.5 76695 SILDENAFIL (REVATIO) TAB : 20MG 2 76698 SOLIFENACIN SUCCINATE (VESICARE)TAB:10MG 9 76778 J2310 NALOXONE (NARCAN) PREFILLED : 2MG/2ML 75 76807 CIPROFLOXACIN (CILOXAN)0.3% OP SOL 2.5ML 63.5 76812 ATORVASTATIN CALCIUM (LIPITOR)TAB 10MG 7.98 76879 MONTELUKAST (SINGULAIR) TAB 10MG 9.5 76895 J0150 ADENOSINE(ADENOCARD)INJ 3MG/ML 12MG/4ML 265.3 76939 UROGESIC-BLUE(UTIRA-C)TAB 1.65 76981 OSELTAMIVIR (TAMIFLU) SUSP 6MG/ML 22.58 76984 RALOXIFENE (EVISTA) TAB 60MG 10.25 76989 DOXAZOSIN MESYLATE (CARDURA) TAB 4MG 3.5 76995 BENEPROTEIN POWDER 7GM PKT 1.5 76999 ACETYLCYSTEINE(MUCOMYST)20%200MG/ML 10ML 22 77005 J1956 LEVOFLO/D5W (LEVAQUIN) 750MG/150ML IVPB 35 77599 ZAFIRLUKAST (ACCOLATE) TAB 20MG 3 77621 EZETIMIBE/SIMVASTAT(VYTORIN)TAB10/20MG 8.33 77698 HYDROCO/IBUPROFEN(VICOPRO)TAB 7.5/200MG 3 77721 ATORVASTATIN CALCIUM (LIPITOR)TAB 40MG 10.83 77777 ETODOLAC (LODINE XL) TAB 600MG 10 77889 SULFACETAMIDE SODIUM 10% OP SOL 15ML 87 77897 J1650 ENOXAPARIN (LOVENOX) INJ 30MG/0.3ML 7 77898 ZANAMIVIR (RELENZA)INHALER 5MG/DOSE 167.98 77954 ROPINIROLE HCL REQUIP 0.5MG 5.29 77988 RIVASTIGMINE TARTRATE (EXELON) CAP : 3MG 7.5 77989 OSELTAMIVIR PHOSPHATE(TAMIFLU)CAP 75MG 24.82 77995 RIVASTIGMINE PATCH 4.6MG/24HR 17.18 77998 J1650 ENOXAPARIN (LOVENOX) INJ 100MG/1ML 23 77999 J1650 ENOXAPARIN (LOVENOX) INJ 40MG/0.4ML 10 78005 J2280 MOXIFLOXACIN (AVELOX)PREMIX 400MG/250ML 128.1 78126 J1815 EXENATIDE (BYETTA) 5MCG/0.02ML 1.2ML 698.56 78154 PREGABALIN (LYRICA) CAP : 100MG 5.33 78251 TRIPROLIDINE HCL(ZYMINE)LIQD 5ML 1.78 78351 MAGIC BUTT CREAM 60 78401 CEFDINIR (OMNICEF) ORAL SUSP 125MG/5ML 10.63 78445 ROSUVASTATIN (CRESTOR) TAB : 10MG 8 78449 BISOPROLOL FUMARATE (ZEBETA) TAB 5MG 4.5 78451 SIMETHICONE(INFANT GS RLF)40MG: 30ML 20 78461 TRANDOLAPRIL (MAVIK) TAB 2MG 3.01 78462 ROSIGLITAZONE MALEATE(AVANDIA)TAB: 2MG 6.23 78471 RABEPRAZOLE SODIUM (ACIPHEX) TAB : 20MG 13 78475 CELECOXIB (CELEBREX) CAP 100MG 5 78479 QUETIAPINE FUMARATE (SEROQUEL) TAB:200MG 22.76 78541 TAMSULOSIN (FLOMAX) CAP 0.4MG 2 78546 HYDROMORPHONE(DILAUDID)MDV 2MG/ML 20ML 42 78547 NAPROXEN (ALEVE) TAB 220MG 1.5 78549 J0696 AMPICILLIN SODIUM INJ 1GM 21.6 78554 EZETIMIBE/SIMVASTAT(VYTORIN)TAB 10/40MG 8 78555 BUPROPION HCL SR TAB 150MG (BID DOSING) 5 78559 90732 PNEUMOCOCCAL VAC (PNEUMOVAX 23) : 0.5ML 92 78586 CROMOLYN (NASALCROM) NS 40MG/ML 26ML 32.5 78664 SODIUM HYPOCHLORITE(DAKINS SOL) 16OZ .5% 2 78669 Q9951 IOPAMIDOL (ISOVUE-370) 76% BTT 291.5 78669 Q9951 IOPAMIDOL (ISOVUE-370) 76% BTT 291.5 78745 ALBUTEROL/IPRAT(COMBIVENT)INHALER 14.7GM 275.03 78771 MAGNESIUM OXIDE (MAG-OX) TAB : 400MG 1.5 78854 J7606 TIOTROPIUM (SPIRIVA) HANDIHALER 18MCG 102.95 78855 CHLORPROPAMIDE CHLORPROPAMIDE 1.5 78864 TRIAZOLAM (HALCION) TAB 0.25MG 1.68 78877 ISOSORBIDE MONO (IMDUR) TAB 30MG 4.5 78879 GUAIFENESIN (MUCINEX) TAB 600MG 1 78880 AMOXICILLIN/POT CLAV(AUGMENTIN)TAB 875MG 6.97 78884 GLIMEPIRIDE (AMARYL) TAB 2MG 1.5 78888 EMOLLIENT/SKIN CLEANSER (SWEEN CM)12OZ 20.55 78894 CLOTRIMAZOLE TOP SOL 30ML 1% 38.8 78897 FENOFIBRATE (TRICOR) TAB 145MG 9.5 78899 CARVEDILOL (COREG) TAB 12.5MG 5.34 78921 J0295 AMPICILLIN/SULBACTAM(UNASYN)INJ 3GM 53 78945 ADVAIR DISKUS 100/50MCG 288.5 78954 PILOCARPINE HCL (SALAGEN) TAB : 5MG 4.5 78965 J2993 RETEPLASE (RETAVASE) : 20 UNIT KIT 13246.8 78986 Q9951 IOPAMIDOL ISOVUE-300 61% SDV 146 78986 Q9951 IOPAMIDOL ISOVUE-300 61% SDV 146 78988 LIDOCAINE/PRILOCAINE(EMLA CR)1GM 2.5% 3.83 78989 MOMETASONE FUROATE(NASONEX) :50MCG 234.4 79011 J0171 EPINEPHRINE 1:1000 INJ 30ML 1MG/ML 2.5 79125 MONTELUKAST SODIUM (SINGULAIR) PCKT :4MG 9.33 79144 SONATA 10MG CAP 7.5 79148 MIRTAZAPINE (REMERON) TAB : 15MG 6.79 79214 SIMVASTATIN (ZOCOR) TAB : 80MG 13.35 79339 DOMEBORA ASTRINGENT SOL 1PKT 3 79412 COSOPT OPHTH SOL 2.88 79445 ACEBUTOLOL (SECTRAL) CAPS 200MG 4.5 79447 POLYETHYLENE GLYCOL (MIRALAX) : 17GM 3.5 79449 DIPHENOXYLATE/ATROPINE 0.025MG 24.5 79457 SITAGLIPTIN (JANUVIA) TAB : 50MG 28 79478 BISOPROLOL FUMURATE (ZEBETA) TAB 10MG 3.5 79487 OFLOXACIN (OCUFLOX) 0.30% OP SOL: 5ML 20 79554 MEMANTINE HCL (NAMENDA) TAB : 10MG 2 79559 VALSARTAN (DIOVAN) TAB 80MG 4.5 79599 LORATADINE (CLEARATADINE)SYRUP : 5MG/5ML 4.5 79687 EZETIMIBE/SIMVASTAT(VYTORIN)TAB 10/80MG 8.33 79778 CARVEDILOL (COREG) TAB 25MG 5.34 79811 BISOPROLOL/HCTZ (ZIAC) TAB 5MG/6.25MG 3.5 79841 TETRACAINE HCL 0.50% DROP 15ML 20 79847 J1650 ENOXAPARIN (LOVENOX) INJ 60MG/0.6ML 15 79848 J7626 BUDESONIDE (PULMICORT) FLEXHALER 180MCG 334.75 79854 CITALOPRAM (CELEXA) TAB 20MG 6.13 79855 J0595 BUTORPHANOL (STADOL) INJ 1MG/1ML 12.88 79856 CLOPIDOGREL (PLAVIX) TAB 75MG 12.65 79877 CILOSTAZOL (PLETAL) TAB 100 MG 4.56 79878 IBUPROFEN(MOTRIN)SUSP 100MG/5ML 30ML 6 79885 EPLERENONE (INSPRA) TAB 25MG 10.25 79897 VITAMIN E SOFTGEL 200 IU 1.5 79899 IBUPROFEN(MOTRIN)SUSP 100MG/5ML 2 79910 DESLORATADINE (CLARINEX)TAB 5MG 6 79911 ESOMEPRAZOLE (NEXIUM) CAPS 40MG 12 79914 PAROXETINE HCL (PAXIL CR) TAB : 37.5MG 8 79916 TRAMADOL (ULTRACET) TAB 37.5MG/325MG 3 79917 VERAPAMIL (VERELAN) PM CAP 100MG 4 79918 CETIRIZINE/PSE (ZYRTEC-D) TAB 5MG/120MG 3.25 79952 FENOFIBRATE (TRICOR) TAB 160MG 9 79966 LOSARTAN POTASSIUM (COZAAR) TAB : 50MG 4.5 79986 DEFINITY (DX. IMAGING INHANCER) 2ML 310.5 79987 EZETIMIBE (ZETIA) TAB 10MG 6.5 79991 ADVAIR DISKUS 250/50MCG 311.6 79992 ELIDEL CREAM 1%:30GM 202.4 79994 ESCITALOPRAM OXALATE (LEXAPRO) TAB 10MG 6.5 79995 AMOXICILLIN/POT(AUGMENTIN XR)TAB 1000MG 7.5 79996 METFORMIN HCL(GLUCOPHAGE XR) TAB : 500MG 2 79997 PAROXETINE HCL (PAXIL CR) TAB : 25MG 8

SLEEP STUDY 150001 95810 SLEEP STUDY NIGHT 1 1926 150002 95811 SLEEP STUDY NIGHT 2 1926 150003 95811 SPLIT NIGHT SLEEP STUDY 1926 150004 92610 EVALUATION SWALLOW FUNCTION 303 150005 92526 ORAL FUNCTION TX (SWALLOW) 140.5 150006 96105 ASSESS. OF APHASIA EA 60 MIN 154 150007 92607 EVALUATION FOR SPEECH DEVICE, 1ST HR 243 150008 92609 USE OF SPEECH DEVICE, TX 128 150009 G0399 SLEEP STUDY UNATT&RESP EFFT 450 PHYSICAL THERAPY 160001 97001 PHYSICAL TX. EVAULATION 235 160002 97164 RE-EVALUATION 142 160003 97110GP THER EX EA 15 MIN 108 160011 97116 GAIT TRAINING, EACH 15 MINUTES 88.5 160013 97035 ULTRASOUND, EACH 15 MINUTES 113.5 160015 97033 PHONOPHORESIS, EACH 15 MINUTES 142 160016 G0283 ELEC STIM (UNATTENDED) 108 160017 97032 E-STIM, EACH 15 MINUTES 108 160018 97010 HOT PACK 108 160020 97010 COLD PACK 108 160022 97022 FULL BODY WHIRLPOOL 119.5 160023 97022 EXTREMITY WHIRLPOOL 96 160024 97597 SELECT DEBRIDE 160.5 160027 97018 PARAFFIN 89.5 160028 97124 MASSAGE, EACH 15 MINUTES 108 160029 97124 ICE MASSAGE, EACH 15 MINUTES 108 160030 64550 APPLICATION OF TENS 117 160032 97012GP MECHANICAL TRACTION 108 160033 97760 JOBST MEASUREMENT 142 160034 97761 PROS TRAIN EA 15 MIN 108 160037 97535 ADL TRAINING, EACH 15 MINUTES 88.5 160043 97033 IONTOPHORESIS EA 15 MIN 118.5 160046 97001 TENS EVALUATION 235 160047 97022 STERILE FULL BODY WHIRLPOOL 157 160048 97022 STERILE EXTREMITY WHIRLPOOL 108 160049 97110 HOME EXER PROGRAM EA 15 MIN 108 160050 97760 ORTHOTIC FITTING, EACH 15 MINUTES 108 160051 29580 UNNA BOOT 93 160058 97530 THER ACT EA 15 MIN 123.5 160060 97750 PHYS PERFORM TEST EA 15 MIN 149.5 160062 97164 PT RE-EVAL 142 160063 90901 BIOFEEDBACK TRAINING BY ANY MODALITY 118.5 160064 97034 CONTRAST BATH, EACH 15 MINUTES 60 160065 97112 NEUROMUSCULAR RE-ED EA 15 MIN 108 160066 97140 MAN THER MOB EA 15 MIN 108 160067 97140 MAN THER LYMPH DRAIN EA 15 MIN 108 160068 97140 MAN THER MAN EA 15 MIN 108 160069 97140 MANUAL TRACTION, EACH 15 MINUTES 88.5 160070 97537 COMMUNITY REINTEGRATION, EACH 15 MINUTES 108 160071 97542 WHEELCHAIR TRAINING, EACH 15 MINUTES 108 160073 95831 MANUAL MUSCLE TESTING EXTREMITY 142 160074 95832 MANUAL MUSCLE TESTING HAND 142 160075 95851 ROM MEASUREMENT, EACH EXTREMITY EXC HAND 142 160076 95852 ROM MEASUREMENT, EACH HAND 142 160077 97750 FCE EA 15 MIN 1216 160078 97545 WORK HARDENING, FIRST TWO HOURS 533 160079 97546 WORK HARDENING, EACH ADDITIONAL HOUR 266 160081 16020 BURN DEBRIDEMENT, SMALL AREA 142 160082 97537 WORK REINTEGRAT EA 15 MIN 108 160161 97161 PT EVAL LOW COMPLEX 20 MIN 235 160162 97162 PT EVAL MOD COMPLEX 30 MIN 235 160163 97163 PT EVAL HIGH 20 MIN 235

RESPIRATORY THERAPY 170003 82803 ABG ANALYSIS 196 170004 92950 CARDIOPULMONARY RESUSCITATION 660 170026 94667 CHEST PT INITIAL 89.5 170027 94668 CHEST PT SUBSEQUENT 59 170028 94010 PULMONARY FUNCTION TEST 88.5 170050 95816 EEG 464.5 170056 83986 Ph LEVEL ANALYSIS (FLUID) 22 170057 94640 EzPap TREATMENT INITIAL 59 170058 99201 OTHER OUTPATIENT VISIT 107 170059 G0237 THER PROC STRG ENDUR 62.5 170060 G0238 PULMONARY REHAB 62.5 170075 94664 PATIENT DEMO/EVAL 49.5 170090 94660 SUBSEQUENT BI-PAP 186.5 170092 94645 CONTINUOUS NEB SUBSEQUENT 42.5 171000 ADULT NASAL CANNULA 6.5 171001 PEDIATRIC O2 CANNULA 11.5 171002 MEDIUM O2 MASK 8.5 171003 PEDIATRIC O2 MASK 11.5 171004 ADULT REGULAR 100% NRB 14.5 171005 02 TUBING 5.5 171006 ELONGATED AEROSOL MASK 6.5 171007 ACAPELLA 74.5 171008 PRE-FILLED O2 HUMIDIFIERS 21 171009 BLOOD GAS KIT EACH 21 171010 NEBULIZER CAP FOR Na CHLORIDE 23 171011 VENTURI MASK 15.5 171012 REGULAR AEROSOL MASK ADULT 20 171013 CROUP TENT CANOPY 106 171014 VENTILATOR CIRCUIT 52.5 171015 INCENTIVE DEEP BREATHING INST. 20 171017 .45 SALINE NEBULIZER KIT 10.5 171020 94002 VOLUME VENTILATOR INITIAL 923 171021 94003 SUBSEQUENT VOLUME VENTILATOR 403 171023 ADULT BAG MASK 160.5 171029 IPPB MASK (DISP.) 20 171030 ALUPENT .2 CC 7.5 171032 PALM CUP PERCUSSOR 18.5 171033 PEDIATRIC BAG MASK 165 171035 FACE MASK TENT 5.5 171036 E-Z WRAP 7.5 171037 HAND HELD MISTY NEB 7.5 171038 NEONATE BAG MASK 159 171039 TRACH VENTURI MASK 10.5 171040 P.F.T. FILTER 12.5 171041 BI-PAP HEAD STRAP 20 171042 BI-PAP CIRCUITS 30 171043 Bact.Filter 18.5 171045 94760 PULSEOXIMETRY-SINGLE DETERMINANT 64.5 171046 94762 PULSEOXIMETRY-CONTINUOUS INITIAL 136 171047 94660 BI-PAP INITIAL 368.5 171049 LARGE NASAL BIPAP MASK 35 171050 USN DISP. CUP & LID 6.5 171052 MUSCLE TRAINER 85 171053 CLOSED SUCTION CATH 21" LENGTH 48.5 171054 POCKET PEAK FLOW METER 77.5 171055 STERILE O2 INHALATION (VENT) 6.5 171057 02 CANNULA 14 FT 10.5 171058 94761 PULSE OXIMETRY-MULT DETERMINANTS INITIAL 72 171059 36600 ARTERIAL PUNCTURE 62.5 171060 94060 PULMONARY FUNCTION PRE/POST 180 171061 94010 PRE AND POST PEAK FLO INITIAL 76.5 171063 CLOSED SUCTION (DIRECT. TIP) 31 171064 STERILE WATER INH. 2000 ML. EA. 10.5 171065 DISPOSIBLE WATER TRAP 6.5 171066 CHAMBER AUTO FEED 36 171067 VENTILATOR BACTERIA FILTER 18.5 171068 J7614 XOPENEX PER AMPULE 8.5 171071 93225 HOLTER RECORDING DIGITAL 145 171072 93226 HOLTER ANALYSIS REPORT 219.5 171082 93227 HOLTER PROFESSIONAL FEE 166 171083 93270 C E M HOOK-UP 89 171085 93922 ANKLE BRACHIAL INDEX 324 171088 HME FILTER 6.5 171089 CO2 DETECTOR 22 171090 MDI Spacer 12.5 171091 HME FILTER 10.5 171102 MEDIUM NASAL BI-PAP MASK 35 171103 MED/SMALL NASAL BI-PAP MASK 35 171104 LARGE FULL FACE BI-PAP MASK 89.5 171105 MEDIUM FULL FACE BI-PAP MASK 89.5 171106 PFT FILTER 35 171107 NEBULIZER CAP FOR 1000ML BOTTLE 23 171109 Closed Suction Cath (12in length) 48.5 171110 Pediatric Aerosol Mask 6.5 171120 ADHESIVE BASE FOR ET TUBE HOLDER 4.5 171122 SMALL ADULT AEROSOL MASK 6.5 171124 94640 XOPENEX NEB TX 1.25 INITIAL 59 171125 94640 DUONEB TX INITIAL 59 171126 94640 ALBUTEROL NEB TX 0.005 INITIAL 59 171127 94640 PULMICORT NEB TX 0.25 INITIAL 59 171128 94640 ADVAIR DPI 100/50 INITIAL 59 171129 94640 SPIRIVA DPI INITIAL 59 171130 94640 SYMBICORT MDI 80/4.5 INITIAL 59 171131 94640 XOPENEX NEB TX 0.63 INITIAL 59 171132 94640 XOPENEX NEB TX 0.31 INITIAL 59 171133 94640 PULMICORT NEB TX 0.5 INITIAL 59 171134 94640 ALBUTEROL NEB TX 0.083 INITIAL 59 171135 94640 RACEMIC EPI NEB TX 2.25 INITIAL 59 171136 94640 ATROVENT NEB TX INITIAL 59 171137 94640 NORMAL SALINE NEB TX INITIAL 59 171138 94640 MUCOMYST 2 ML NEB TX INITIAL 59 171139 94640 ALBUTEROL (ACCUNEB 0.63) INITIAL 59 171140 94640 DECADRON NEB TX INITIAL 59 171141 94640 TOBRAMYCIN NEB TX INITIAL 59 171142 94640 ADVAIR MDI 250/50 INITIAL 59 171143 94640 ADVAIR MDI 500/50 INITIAL 59 171144 94640 SYMBICORT MDI 160/4.5 INITIAL 59 171145 94640 COMBIVENT MDI INITIAL 59 171146 94640 FLOVENT MDI 44 MCG INITIAL 59 171147 94640 FLOVENT MDI 110 MCG INITIAL 59 171148 94640 FLOVENT MDI 220 MCG INITIAL 59 171149 94640 PULMICORT FLEXHALER 90 MCG INITIAL 59 171150 94640 PULMICORT FLEXHALER 180 MCG INITIAL 59 171151 94640 VENTOLIN HFA INITIAL 59 171152 94640 SUBSEQUENT ADVAIR DPI 59 171153 94640 RESPIRATORY (PRN) TX INITIAL 59 171154 94642 PENTAM NEB TX 300MG (PENTAMIDINE) 241.5 171156 94640 SUBSEQUENT ALBUTEROL NEB 59 171159 94640 SUBSEQUENT COMBIVENT MDI 59 171160 94640 SUBSEQUENT DECADRON NEB TX 59 171161 94640 SUBSEQUENT DUONEB TX 59 171162 94640 SUBSEQUENT EzPap TREATMENT 59 171163 94640 SUBSEQUENT FLOVENT MDI 59 171166 94640 SUBSEQUENT MUCOMYST 2 ML NEB TX 59 171167 94640 SUBSEQUENT NORMAL SALINE NEB TX 59 171168 94640 SUBSEQUENT PULMICORT FLEXHALER 59 171169 94640 SUBSEQUENT PULMICORT NEB TX 59 171170 94640 SUBSEQUENT RACEMIC EPI NEB TX 59 171171 94640 SUBSEQUENT SPIRIVA DPI 59 171172 94640 SUBSEQUENT SYMBICORT MDI 59 171173 94640 SUBSEQUENT TOBRAMYCIN NEB TX 59 171175 94640 SUBSEQUENT VENTOLIN HFA 59 171176 94640 SUBSEQUENT XOPENEX NEB TX 59 171177 94640 NEB WITH LIDOCANE 59 171178 94640 SUBSEQUENT ATROVENT NEB TX 59 171200 BITE BLOCK 6.5 171201 VENT CIRCUIT PATIENT VALVE 36.5 171202 94640 EzPap SUBSEQUENT TX 59 171204 94640 ULTRA SONIC NEBULIZER SUBSEQUENT TX 59 171205 94010 SUBSEQUENT PEAK FLO TX 76.5 171206 94761 PULSE OXIMETRY-SUBSEQUENT MULTIPLE 72 171207 94762 PULSE OXIMETRY-SUBSEQUENT CONTINUOUS 136 171210 94640 ALBUTEROL (ACCUNEB 1.25) INITIAL 59 171211 94640 SUBSEQUENT (ACCUNEB) TX 59 171212 94640 SUBSEQUENT AEROSOL TX 59 171213 94640 AEROSOL TX INITIAL 59 171214 94640 ATROVENT MDI INITIAL 59 171215 94640 SUBSEQUENT ATROVENT MDI 59 171216 94667 ACAPELLA INITIAL 89.5 171217 94668 SUBSEQUENT ACAPELLA 59 171218 94640 DULERA INHALER INITIAL TX 59 171219 94640 SUBSEQUENT DULERA INHALER 59 171220 SMALL FULL FACE BI-PAP MASK 89.5 171221 RESPIRONICS BATERIA FILTER 25.5 171222 PREFILL NEB KIT 11.5 171223 94640 TUDORZA PRESSAIR TX INITIAL 59 171224 94640 SUBSEQUENT TUDORZA PRESSAIR TX 59 171225 RESPIRGARD II NEB. 47 171227 94640 BROVANA INITIAL 59 171228 94640 SUBSEQUENT BROVANA 59 171229 94667 FLUTTER VALVE INITIAL 89.5 171230 94668 FLUTTER VALVE SUBSEQUENT 59 171231 SM VOL NEBULIZER 6.5 171233 94640 XOPENEX 1.25 NEB/ ATROVENT INITIAL 59 171234 94640 SUBSEQUENT XOPENEX 1.25 NEB / ATROVENT 59 171235 94640 BREO INITAL DPI 59 171236 94640 BREO SUBSEQUENT DPI 59 171237 94640 PULMOZYME NEB TX INITIAL 59 171238 94640 SUBSEQUENT PULMOZYME NEB TX 59 171239 94640 STIOLOTO RESPIMAT INH INITIAL 59 171240 94640 SUBSEQUENT STIOLTO RESPIMAT INH 59 171241 94640 STIOLTO RESPIMAT INITAL DPI 59 171242 94640 STIOLTO RESPIMAT SUBSEQUENT DPI 59 171243 94640 INCRUSE INITAL DPI 59 171244 94640 INCRUSE SUBSEQUENT DPI 59 171245 94640 QVAR 80 INHALER INITIAL 59 171246 94640 QVAR 80 INHALER SUBSEQUENT 59 171248 94640 TRELEGY DPI INITIAL 59 171249 94640 SUBSEQUENT TRELEGY DPI 59

CARDIOLOGY 210001 93306 2 D-M-MODE ECHO-DOPPLER AND COLOR FLOW 1043 210001 93306 2 D-M-MODE ECHO-DOPPLER AND COLOR FLOW 1043 210001 93306 2 D-M-MODE ECHO-DOPPLER AND COLOR FLOW 1043 210002 DOPPLER 347.5 210003 COLOR FLOW 482.5 210004 93015 TREADMILL 414 210004 93015 TREADMILL 414 210004 93015 TREADMILL 414 210005 93017 STRESS ECHO CINE 414 210005 93017 STRESS ECHO CINE 414 210007 93307 TTE W/O DOPPLER COMPLETE 748.5 210007 93307 TTE W/O DOPPLER COMPLETE 748.5 210007 93307 TTE W/O DOPPLER COMPLETE 748.5 210008 93308 ECHO F/U OR LIMITED 636 210008 93308 ECHO F/U OR LIMITED 636 210008 93308 ECHO F/U OR LIMITED 636 210008 93308 ECHO F/U OR LIMITED 636 211220 93350 STRESS ECHO COMPLETE. 940 211220 93350 STRESS ECHO COMPLETE. 940 211221 93320 STRESS ECHO COMPLETE. 352.5 211221 93320 STRESS ECHO COMPLETE. 352.5 211222 93350 STRESS TEST CINE 940 211222 93350 STRESS TEST CINE 940 211222 93350 STRESS TEST CINE 940 211223 93017 STRESS TEST TRACING ONLY W/O INTER/REPOR 426.5 211223 93017 STRESS TEST TRACING ONLY W/O INTER/REPOR 426.5

AMBULANCE SERVICE 240006 A0425 BLS MILEAGE - PER MILE 14.5 240011 A0425 ALS MILEAGE - PER MILE 14.5 240015 A0420 WAIT TIME-(1/2) HOUR INCREMENTS-ER 71 240025 A0428 Ambulance, Basic Life Support, Non-Emerg 333.5 240030 A0429 Ambulance, Basic Life Support, Emergency 540 240035 A0426 Ambulance, Advanced Life Sprt, Non-Emerg 556.5 240040 A0427 Ambulance, Advanced Life Lvl1, Emergency 662.5 240045 A0433 Ambulance, Advanced Life Support, Level2 951.5 240050 A0434 Specialty Care Transport 1117.5

CENTRAL SUPPLY 250001 AIR FLOTATION MATTERSS EACH 177 250002 *4 X 4 (STERILE) PKG 10 13 250006 FOLEY TRAY W/0 FOLEY 43.5 250007 AIRWAY EACH NEONATAL 5 250010 AMNIHOOK EACH 8 250011 ASEPTO SYRINGE DISP EACH 10 250017 BARD FOLEY KIT EACH 23 250021 BETADINE EZ SCRUB BRUSH EACH 2 250025 BILLI MASK EACH 15.5 250028 CENTRAL VENOUS KIT EACH 155.5 250029 CHEST DRAIN VALVE EACH 48.5 250033 URINARY DRAINAGE SYSTEM EACH 28 250034 COLD PACK EACH 3 250036 CATH CLAMP 28 250037 CONNECTIVE TUBING PER ROLL 44 250044 TAPE DURAPORE PER 1 IN ROLL 9 250045 TAPE DURAPORE PER 3 IN ROLL 23 250046 TAPE DURAPORE PER 2 IN ROLL 15 250047 EAR SYRINGE DISP EACH 12.5 250048 ELASTIC BANDAGE (ACE) PER 2 IN 8 250049 ELASTIC BANDAGE (ACE) PER 3 IN 10 250050 ELASTIC BANDAGE (ACE) PER 4 IN 13 250051 ELASTIC BANDAGE (ACE) PER 6 IN 13.5 250052 ELASTIKON TAPE PER 2" ROLL 15.5 250054 TAPE ELASTIKON PER 4 IN ROLL 36 250056 ELECTRODES PER PKG 18.5 250057 ENEMA DISP EACH 7 250058 ENDOTRACHEA TUBE # 6.5 EACH 33 250061 EYE PAD EACH 3 250063 ENEMA (FLEETS) 8 250064 ENEMA (FLEETS PED) EACH 7 250065 ENEMA (FLEETS MINERAL OIL) EACH 9.5 250066 FOLEY CATH W/5 CC BULB 12 FR EA 33 250067 FOLEY CATH W/3 CC BULB 8 FR EA 67.5 250068 FOLEY CATH W/30 CCBULB (16) EA 54.5 250070 FOLEY CATH W/30 CC BULB 16 FR 3-WAY 79.5 250071 FOLEY CATH TRAY # 16 FR EA 80.5 250074 IODOFORM GAUZE 1/4 IN PER BOTTLE 26 250075 IODOFORM GAUZE 1/2 IN PER BOTTLE 29 250076 IODOFORM GAUZE 1 IN PER BOTTLE 29 250080 INJECTION CAP NEEDLES EACH 5 250081 IRRIGATION TRAY(URINE) 12 250083 BLADDER IRRIGATION SET EACH 34 250087 KLING PER 2 IN ROLL 7.5 250088 KLING PER 3 IN ROLL 9 250089 KLING PER 4 IN ROLL 10 250100 MID STREAM CATCH KIT EACH 7 250101 MUCOUS SPECIMEN TRAP EACH 15.5 250104 O B PACK DISP EACH 30 250109 TAPE MICROPORE PER 3" ROLL 17 250112 PENROSE DRAIN EACH 4 250115 PLASTIBELL EACH 15.5 250117 PHISOHEX EZ SCRUB BRUSH EACH 3 250118 POSEY VEST SM EACH 92.5 250127 MONTGOMERY STRAP EA 9.5 250128 SALEM SUMP TUBE EACH 15.5 250129 ANOSCOPE EACH 5 250131 SCALPEL #10 EACH 8 250134 CUP STERILE SPEC 6 250135 NEEDLE SPINAL 22 1 1/2 IN 12.5 250136 STAPLE REMOVAL KIT EACH 23.5 250137 STERI-STRIP PER PKG 3 - 1/4 8 250138 STERI-STRIP PER PKG 3- 1/2 11.5 250139 GLOVES STERILE # 5 1/2 PER PAIR 6 250143 STOMA BAG EA 11.5 250146 STOMACH TUBE 12 FR. 7.5 250147 STRAIGHT CATH TRAY EACH 24.5 250148 SUCTION CATH EACH 9.5 250149 SUCTION CATH KIT EACH 9.5 250150 SUCTION JAR DISP EACH 18.5 250153 SURGIPAD EACH 4.5 250154 SURGICAL DRESSING 4X6 EA 8 250158 T PAD EACH 91.5 250159 TELFA PAD 3X4 EA 3.5 250160 TEXAS CATHETER EACH 8 250164 TRACHEA CLEAN KIT EACH 23.5 250165 TROCAR CATHETER 16 FR. EACH 83.5 250166 TRIANGULAR BANDAGE EACH 11.5 250167 TRIANGULAR GRAD EACH 4 250169 UNDERWATER DRAINAGE EACH 93.5 250170 UNNA CAST DRESSING EACH 71.5 250171 URINE BAG (LEG BAG) EACH 23.5 250173 UROLOGICAL FILTER (URINE STRAINER) EACH 8 250175 VAGINAL IRRG TRAY EACH 15.5 250176 VASOLINE GAUZE EACH 1X36 9 250180 FLEXIFLO W/STYLET 8 FR 70 250205 INTUBATING STYLET 14 FR (DISP) 18.5 250210 *3 0 CHROMIC GUT 16.5 250223 ELECTROSURGICAL PADS (DISP) 13.5 250224 CUTTING LOOP ELECTRODES 28 FR. 193 250225 SWITCH PEN (DISP.) 27 250226 ANESTHESIA FACE MASK (ADULT) 21 250247 ATHLETIC SUPPORTER 28 250254 BLOOD PUMP SET 79.5 250255 YANKUER TIP 6 250257 CATH PLUG (STERILE) 4 250264 * 1 CHROMIC GUT ( BP NDL.) 59 250290 FEEDING TUBE 5 FR. 4 250304 *5 0 CHROMIC GUT (P-3 ) 30 250305 VENOSET 78 33 250306 GASTROSTOMY TUBE 16 FR 133 250308 THERMAL LUMBAR SUPPORT 75 250309 ANKLE STIRRUP BRACE 141 250312 VASOLINE GAUZE 3X36 8 250315 WRIST SPLINT 141 250316 BIOPSY VALVE EA 12.5 250317 CYTOLOGY BRUSH 52 250319 ABD. STRAPS OB 25 250320 *6 0 SILK (C-2 CUTTING NDL) 23 250321 ONE STEP SCOTCHCAST 3 IN EA 36 250323 STANDARD RAPE KIT (DISP.) 36 250324 SYRINGE TOOMEY 70 CC 12.5 250325 UTILITY BOWL 32 OZ. EACH 4 250329 YANKUER SUCTION EA 26 250330 THOMAS E T TUBE HOLDER 13 250333 SUCTION CATH(DELEE) 14.5 250334 SUB CLAVIAN 14 GA 5 1/- IN 26 250338 DRAIN SPONGE 2/EA 3.5 250347 ALUMAFOAM 5.5 250348 LEG WALKER MED 201 250350 PATELLA KNEE SUPPORT 121.5 250351 CASH ORTHO BRACE 576 250355 TRIPLE LUMEN 7 FR TRAY 158.5 250357 TEGADERM DRESSING (4X4) 9 250360 CATH LEG STRAP 23.5 250362 OXISENSOR DISP ADULT 56.5 250368 INTERCATH 14 GA 15.5 250369 INTERCATH 16 GA SAFETY 15.5 250370 INTERCATH 18 GA 15.5 250371 INTERCATH 22 GA 15.5 250388 NEEDLE SPINAL 22 3 1/2 IN 12 250389 NEEDLE SPINAL 20 4 1/2 IN 12.5 250390 NEEDLE SPINAL 20 3 1/2 IN 12.5 250391 SUB CLAVIAN 16 GA 5 1/4 IN 26 250392 SUB CLAVIAN 19 GA 12 IN 26 250393 FLEXIFLO W/STYLET 10 FR 72 250394 FLEXIFLO W/STYLET 12 FR 70 250402 FOLEY CATH TRAY # 18 FR 80.5 250404 THERMAL LUMBAR INSERT 52.5 250408 UMBILICAL TAPE PER ROLL 58 250415 BETADINE SOL PER 8 OZ 5 250427 OTOSCOPE TIPS ADULT PER PKG 25 104 250428 OTOSCOPE TIPS PED PER PKG 25 66 250430 TAPE MICROPORE PER 1 IN ROLL 9 250431 TAPE TRANSPORE PER 1 IN ROLL 9 250434 STOCKINETTE 2 IN PER ROLL 19 250435 STOCKINETTE 3 IN PER ROLL 25 250436 STOCKINETTE 4 IN PER ROLL 63 250437 STOCKINETTE 6 IN PER ROLL 94 250441 T PAD XL EACH 91.5 250443 PORT A CATH 20-1 IN 32 250448 CONNECTOR (TUBING) 5 250450 LATEX TUBING PER ROLL 121.5 250457 STRESS TEST KIT EA 16.5 250475 *6 0 ETHILON (PS3 CUTTING NDL) 12.5 250479 *4 0 BIOSYN (CV-23 TAPER NDL.) 9 250481 THUMB SPICA 41 250482 EVACUATED CONTAINERS 11.5 250483 BLOOD COLLECTION SET 5 250484 ONE STEP SCOTCHCAST 4 IN EA 35 250485 KNEE SUPPORT UNIVERSAL 48.5 250486 KNEE SUPPORT WITH OPEN PATELLA 40 250487 DERMABOND(LIQUIBAND)PER EA 79.5 250488 TRACHEOSTOMY TUBE HOLDER 12.5 250489 TAPE HYPAFIX PER 4 IN ROLL 28 250492 TAPE MEDIPORE PER 2 IN ROLL 16.5 250495 INTERCATH 18 GA SAFETY 6 250496 INTERCATH 20 GA SAFETY 6.5 250497 INTERCATH 22 GA SAFETY 6 250498 INTERCATH 24 GA SAFETY 6 250499 RHINO ROCKET EA 27 250500 TRIPLE LUMEN PED TRAY 158.5 250506 SHOULDER IMMOBILIZER SM 117.5 250509 *4 0 Vicryl(P3 CUTTING NDL) 12.5 250510 *5 0 Vicryl(PS3 CUTTING NDL) 12.5 250511 *3 0 Vicryl(PS2 CUTTING NDL) 12.5 250512 MORGAN LENS 46.5 250513 MORGAN DELIVERY SET 17.5 250515 BIOPSY PUNCH 5 250516 SCOTCHCAST 5" PER ROLL 48.5 250519 SKIN STAPLER-STAPLES 23.5 250520 FOLEY CATH LATEX FREE 11 250522 CENTRAL VENOUS DRESSING KIT 12 250523 NITRO SET VENTED 33 250524 AUTO PULSE LIFE BANDS 313.5 250525 CLOSED WOUND SUCTION KIT 17.5 250526 MICRO FILTER EXTENSION 26 250527 BETADINE SWAB PER PKG/3 3 251001 *5 0 SILK (CUTICULAR 18 IN FS 2 NEEDLE) 12.5 251002 *4 0 SILK (CUTICULAR 18 IN FS 2 NEEDLE) 12.5 251003 *3 0 SILK (CUTICULAR 18 IN FS 1 NEEDLE) 12.5 251004 *2 0 SILK (CUTICULAR 18 IN) 12.5 251009 *6 0 ETHILON (CUTICULAR 18 IN FS 3 NDL) 12.5 251010 *5 0 ETHILON (CUTICULAR 18 IN FS 2 NDL) 12.5 251011 *4 0 ETHILON (CUTICULAR 18 IN FS 2 NEED) 12.5 251012 *3 0 ETHILON (CUTICULAR 18 IN FS 1 NDL) 12.5 251013 *6 0 ETHILON (PLASTIC 18 IN P-3 NDL) 29 251014 *5 0 ETHILON (PLASTIC 18 IN P-3 NDL) 29 251015 *4 0 ETHILON (PLASTIC 18 IN P 3 NDL) 29 251016 STOPCOCK (DISP.) 4 251025 PLEUR EVAC PER UNIT 461.5 251029 TELEMETRY POUCHES 16.5 251036 *4 0 GUT CHROMIC (URL CUT 27 IN FS2 ND) 13.5 251037 *5 0 GUT CHROMIC (URL CUT 27") FS 2 NE 13.5 251038 *3 0 GUT CHROMIC (CUTICULAR 27 IN FS2 N) 13.5 251040 *4 0 CHROMIC (PLASTIC 18 IN P-3 NDL) 29 251042 *5 0 SILK (PLASTIC 18 IN P3 NEEDLE) 29 251473 TELFA PAD 3X8 EA 4.5 252020 WALKING HEEL 26 252021 PAMPERS 4 21.5 252023 CAST PADDING PER ROLL 12 252025 SCOTCHCAST 2 IN PER ROLL 51.5 252026 SCOTCHCAST 3 IN PER ROLL 62 252027 SCOTCHCAST 4 IN PER ROLL 81.5 252029 PLASTER BANDAGE 3 IN. PER ROLL 7 252030 PLASTER BANDAGE 4 IN. PER ROLL 10.5 252500 ABDOMINAL BINDER 142 252504 SACRAL LUMBAR PELVIC BELT 243 252505 NOZ STOP EA 99 252507 SACRAL BELT 221.5 252511 54150 CIRCUMCISION 2005.5 252515 LUMBAR PUNCTURE (DISP) 104 252516 SPIKE SET(KANGROO) 16.5 252517 TRACHEOTOMY TUBE 199 252518 SUTURE REMOVAL SET 11.5 252522 ARM IMMOBILIZER 117.5 252523 ARM IMMOBILIZER 117.5 252524 ARM SLING PADDED 48.5 252525 ARM SLING STRAP SM 29 252526 SLING AND SWATHE 113.5 252527 WRIST AND FOREARM RT.10 IN SPLINT 125.5 252528 CLAVICAL SPLINT XXS 84.5 252529 FINGER SPLINT 56.5 252530 FINGER GUARD 4 PRONG EA 9.5 252531 ANKLE BRACE 137 252536 CASTBOOT (CLOSED TOE) 99 252538 HEEL PILLOW PROTECTOR EA 75 252539 KNEE BRACE HINGED EA 406 252540 L1810 KNEE IMMOBILIZER 183.5 252542 TED HOSE SM KNEE HIGH 97 252544 CERVICAL COLLAR (FOAM)SM 82.5 252546 ARM SLING SM 23.5 252547 ARM SLING CHILD 45.5 252548 INTERCATH 20 GA 15.5 252549 INTERCATH 14 GA SAFETY 15.5 252550 LEG WALKER SM 201 252551 LEG WALKER LG 201 252554 CERVICAL COLLAR (FOAM)MED 82.5 252555 CERVICAL COLLAR (FOAM)LG 82.5 252558 POSEY VEST MED EACH 92.5 252559 POSEY VEST LG EACH 92.5 252568 CLAVICAL SPLINT XS 84.5 252569 CLAVICAL SPLINT SM 84.5 252570 CLAVICAL SPLINT MED 84.5 252571 CLAVICAL SPLINT LG 84.5 252572 CLAVICAL SPLINT XXL 84.5 252573 ARM SLING MED 23.5 252574 A4565 ARM SLING LG 23.5 252575 GASTROSTOMY TUBE 22 FR 133 252576 GASTROSTOMY TUBE 24 FR 133 252577 PORT A CATH 20-5/8 IN 32 252578 PORT A CATH 20-1 1/4 IN 32 252579 PORT A CATH 19-1 1/4 IN 32 252580 PORT A CATH 22-5/8 IN 32 252581 SCALPEL #11 EACH 9 252582 SCALPEL #15 EACH 8 252583 SCALPEL #21 EACH 8 252586 GLOVES STERILE # 6 PER PAIR 6 252587 GLOVES STERILE # 6 1/2 PER PAIR 6 252588 GLOVES STERILE # 7 PER PAIR 6 252589 GLOVES STERILE # 7 1/2 PER PAIR 6 252590 GLOVES STERILE # 8 PER PAIR 6 252591 GLOVES STERILE # 8 1/2 PER PAIR 6 252592 GLOVES STERILE # 9 PER PAIR 6 252593 INJECTION CAP W/NDL EACH 5 252594 INTUBATING STYLET 6 FR (DISP) 18.5 252595 AIRWAY EACH SM CHILD 5 252596 AIRWAY EACH SM ADULT 5 252597 AIRWAY EACH MED ADULT 5 252599 FOLEY CATH 14 FR LATEX FR 65 252600 FOLEY CATH 18 FR LATEX FR 65 252601 FOLEY CATH W/3 CC BULB 10 FR EA LF 65 252602 FOLEY CATH W/5 CC BULB 14 FR EA 33 252603 FOLEY CATH W/5 CC BULB 18 FR EA 33 252604 FOLEY CATH W/5 CC BULB 20 FR EA 33 252605 FOLEY CATH W/5 CC BULB 22 FR EA 33 252606 FOLEY CATH W/5 CC BULB 24 FR EA 33 252607 FOLEY CATH W/30 CC BULB 18 FR 3-WAY 79.5 252608 FOLEY CATH W/30CC BULB 20 FR 3-WAY 79.5 252609 FOLEY CATH W/30 CC 22 BULB FR 3-WAY 79.5 252610 FOLEY CATH W/30 CC BULB 24 FR 3-WAY 79.5 252611 FOLEY CATH W/30 CC BULB 18 FR EA 33 252612 FOLEY CATH W/30 CC BULB 20 FR EA 33 252613 FOLEY CATH W/30 CC BULB 24 FR EA 33 252614 SHOULDER IMMOBILIZER MED 117.5 252615 SHOULDER IMMOBILIZER LG 117.5 252616 ENDOTRACHEA TUBE # 7.0 EACH 33 252617 OXISENSOR DISP PED 56.5 252618 CERVICAL COLLAR (FOAM)MED 82.5 252619 CERVICAL COLLAR (FOAM)LG 82.5 252620 SHOULDER IMMOBILIZER XL 117.5 252621 ENDOTRACHEA TUBE # 7.5 EACH 33 252622 ENDOTRACHEA TUBE # 8.0 EACH 33 252623 ENDOTRACHEA TUBE # 8.5 EACH 33 252624 WRIST AND FOREARM LF.10 IN SPLINT 125.5 252625 WRIST AND FOREARM RT.7 IN SPLINT 125.5 252626 WRIST AND FOREARM LF.7 IN SPLINT 125.5 252627 ENDOTRACHEA TUBE # 6.0 EACH UNCUFFED 33 252628 TED HOSE LG KNEE HIGH 97 252629 TED HOSE XL KNEE HIGH 97 252633 UROSTOMY BAG EACH 11.5 252634 GEMSTAR PCA PUMP SET 32.5 252637 T PAD (GAYMAR) EACH 91.5 252638 Y TYPE EXT SET 91.5 252639 GASTROSTOMY TUBE 18 FR 133 252640 GASTROSTOMY TUBE 20 FR 133 252641 TROCAR CATH. 10 FR 133 252642 BIOPATCH 20.5 252643 FOLEY CATH W/1.5 CC BULB 6 FR EA 67.5 252644 SUB CLAVIAN 10 GA 3.00 IN 26 252645 TROCAR CATH. 8 FR. 133 252646 TROCAR CATH.28 FR. 133 252647 TROCAR CATH.20 FR. 133 252648 TROCAR CATH.24 FR. 133 252649 CATH .KIT FEMALE 23.5 252651 DECLOGGER FEEDING TUBE 15.5 252652 WASHCLOTH DISP. 15.5 252655 FENWALL BLOOD COMONENT SET(PLASMA) 14.22 252656 ILLINOIS NEEDLE(I&O) 154.5 252657 HARE TRACTION SPLINT PED 309 252658 POWER PORT A CATH 20-1 IN 32 252659 FEEDING TUBE 5 FR. 72 252660 EZ-IO NDL 45MM 222.5 252661 SANI WIPES 18.5 252662 FOLEY CATH W/30 CC BULB 26FR EA 33 252663 QUAD LUMEN 113 252664 FOLEY CATH W/30 CC BULB 22 FR EA 33 252686 ENDOTRACHAL TUBE# 3.0 7.6 252688 STAT PADS ADULT 110 252689 PEDI STAT PADS 35 252690 MOORE OTOSCOPE TIPS 2.5MM 35 252691 MOORE OTOSCOPE TIPS 4.0MM 35 252695 ENDOTRACHA TUBE # 4.0 10.07 252696 SHOULDER PULLEY 17.1 252697 ENDOTRACHEA TUBE # 5.0 5 252700 THUMB SPICA SM LEFT 35 252701 THUMB SPICA LG LEFT 35 252702 THUMB SPICA SM RIGHT 35 252703 THUMB SPICA LG RIGHT 35 252704 TABLE PAPER 18" 35 252705 TABLE PAPER 21" 35 252706 STETHOSCOPE RED 35 252707 FENESTRATED DRAPE 35 252708 DRAPE SHEET 40X48 35 252709 TUBULAR DRESSING SZ 1 35 252710 W/A VAGINAL SPEC. MED 35 252711 ISOLATION GOWNS 35 252712 VERRUCA FREEZE 35 252713 STARBURST ELECTODES 2" 35 252714 STARBURST ELECTODES 2.75 35 252715 THERMOMETER ORAL 6 252716 THERMOMETER RECTAL 6 252717 BOVIE TIP 6 252718 EMESIS BAGS 6 252719 HUGGIES WIPES 6 252720 PAMPER WIPES 6 252721 GLOVES NITRLE XL 6 252722 IV TUBING CHANGE 6 252723 N95 FACE MASK REG 6 252724 N95 FACE MASK SM 6 252725 TROCAR 12FR 6 252726 THERA PUTTY RED 6 252727 THERA PUTTY YELLOW 6 252728 THERA PUTTY GREEN 6 252729 THERA BAND BLUE 6 252730 THERA TUBE RED 6 252731 ORANGE BIO BAG 8X12 6 252732 ORANGE BIO BAG 14X19 6 252733 OXISENSOR DISP INFANT 56.5 252734 EXAM GOWN 56.5 252735 LINT FREE OR TOWEL 56.5 252736 THERA BAND RED 6 252737 THERABAND GREEN 56.5 252738 ULTRASOUND GEL PT 6 252739 ENDOTRACHEAL TUBE 4.0 CUFFED 6 252740 ENDOTRACHEAL TUBE 3.5 6 252742 GASTROSTOMY TUBE 26 FR 133 252743 KING AIRWAY 3 36 252744 KING AIRWAY 4 36 252745 KING AIRWAY 5 36 252746 ENDOTROL 6.0 52 252747 AIRWAY LG ADULT 6 252748 ENDOTRACHAL TUBE 5.5 CUFFED 6 252749 KING AIRWAY 2.0 82 252750 KING AIRWAY 2.5 82 252752 COBAN 2" 6 252753 VAGINAL SPECULUM SM (MOORE) 6 252754 VAGINAL SPECULUM MED (MOORE) 6 252755 ENDOTRACHAL TUBE 4.5 UNCUFFED 82 252756 ENDOTRACHAL TUBE 5.5 UNCUFFED 82 252758 W/A VAGINAL SPEC. SMA 35 252760 QUICK COMBO ADULT 56 252761 QUICK COMBO PED 80 252762 PLEURX DRAINAGE 270 252763 EZ-IO NDL 15MM 222.5 252764 EZ-IO NDL 25MM 222.5 252769 HIBICLENS 15 252770 SELF CATH 14FR 16IN 15 252771 EAR CURETTE WHITE 15 252772 EAR CURETTE BLUE 15 252773 ENDOTRACHEA TUBE # 5.0 UNCUFFED 5 252776 60 GTT PRIMARY SET 36 252780 MULTI LUMEN CENTRAL VENOUS CATH KIT 260 252783 *2 0 GUT CHROMIC (CUTICULAR 27 IN FS1 N) 20.5 252784 *2 0 ETHILON (CUTICULAR 18 IN FS NDL) 12.5 252785 PULL UP TRAINING PANTS 2T-3T GIRL 12.5 252788 PULL UP TRAINING PANTS 3T-4T GIRL 12.5 252789 PULL UP TRAINING PANTS 4T-5T GIRL 12.5 252793 BURETROL SOL SET 46.6 252794 ENDOTRACHEA TUBE # 6.0 CUFFED 33 252795 8FR FEEDING TUBE 33 252796 SUCTION TUBE ATTACHMENT DEVICE 7 252797 PED ELECTRODE 7 252798 HEEL PROTECTOR UNIVERSAL 8.14 252799 AQUACEL SACRAL 25 252800 HEART START DEFIB PAD 101 252801 HEART START DEFIB PAD INFANT 52 253014 WHIRLPOOL PER TREATMENT 18.5 253020 SURGICAL DRESSING 8X6 EACH 10 253021 EXTENSION SET 26 253023 INTERCATH 20 GA 14.5 253025 IV PUMP SET 77 253026 IV START PACK 10 253027 PRIMARY PIGGYBACK VENOSET 78.5 253028 SECONDARY PIGGYBACK VENOSET 23.5 253029 IV CARE KIT 10 253030 IV SITE DRESSING 5 253033 DIAL-A-FLO EXT SET 43.5 253034 ANKLE & WRIST RESTRAINT 46.5 253036 SUCTION CATH KIT & H20 19.5 253037 KERLIX 4 IN PER ROLL 12 253039 ELECTRODES (MONITOR) PER PKG 3 5.5 253040 DUODERM EA 34 253041 THORACENTESIS TRAY (DISP) 185.5 253043 *4 0 SILK (PLASTIC 18 IN P3 NEEDLE) 29 253044 VASOLINE GAUZE 1X8 EA 8 253049 ISOLATION DAILY CHARGE 219

EMERGENCY ROOM 260000 OBSERVATION, DIRECT ADMIT 64.5 260001 OBSERVATION LEVEL 1 19.5 260002 G0378 OBSERVATION LEVEL 2 28 260003 G0378 OBSERVATION LEVEL 3 28 260013 TREATMENT ROOM SPECIALTY SERVICES 32 260014 59409 EMERGENCY DELIVERY 1392.5 260425 29425 APPLICATION SHORT LEG CAST 257.5 260624 31624 DX BRONCHOSCOPE/LAVAGE 1184 261001 99281 LEVEL 1 - ER FACILITY FEE 99 261002 99282 LEVEL 2 - ER FACILITY FEE 123.5 261003 99283 LEVEL 3 - ER FACILITY FEE 194.5 261004 99284 LEVEL 4 - ER FACILITY FEE 317.5 261005 99285 LEVEL 5 - ER FACILITY FEE 494.5 262634 STOMAAHESIVE WAFER EA 11.5 262990 90471 IMMUNIZATION ADMINISTATION 70.5 262991 90472 IMMUNIZATION ADMINISTATION, ADD/SUBSEQ 58.5 262992 92977 INFUSION THROMBOLYTIC 678 262993 36000 INSERTION OF HEP LOCK 58.5 263000 96375 IV PUSH, EACH ADDITIONAL,SUBCU OR INTRAM 82 263001 96374 IV PUSH SINGLE OR INITIAL DRUG 138.5 263002 96372 THERAPEUTIC OR DIAGN INJ,SUBCU OR INTRAM 38.5 263003 96373 THERAPEUTIC OR DIAGN INJ. INTRA-ARTERIAL 38.5 263006 REPAIR OF LACERATION 41.5 263007 32554 THORACENTESIS W/O IMAGING 482 263008 BRONCHOSCOPY 41.5 263009 69210 REMOVAL CERUMEN 47 263010 43760 CHANGE GASTROSTOMY TUBE 244.5 263011 11730 REMOVAL OF NAIL PLATE 133 263012 49082 PARACENTESIS ABDOMINAL NO IMAGING 472 263014 SPLINT APPLICATION 34 263015 SILVADINE TREATMENT 34 263016 90471 TETANUS ADMINISTRATION 29 263017 51702 INSERTION FOLEY CATHETER 85 263018 DRESSING CHANGE 34 263019 REPLACEMENT CAST 34 263020 96523 PORTACATH FLUSH 70.5 263021 20520 REMOVAL OF FOREIGN BODY 487.5 263022 INCISION AND DRAINAGE 93.5 263023 NASAL PACKING 34 263024 43752 INSERTION OF NG TUBE 41.5 263025 31500 INSERTION OF ET TUBE 347 263027 JOINT INJECTION 34 263028 G0379 DIRECT ADMIT TO OBSERVATION 41.5 263029 96372 IM ANTIBOTIC 10 263030 FRACTURE TX 34 263031 62270 SPINAL TAP 158.5 263032 36556 INSERT NON-TUNNEL CV CATH 962.5 263033 WOUND DEBRIDEMENT 34 263034 INITIAL TX, BURN 34 263035 SUBSEQ TX,BURN 34 263039 MEDICAL ASSESSMENT 30 263040 51701 INSERTION STRAIGHT CATHETER 76.5 263041 96376 IV PUSH,SAME DRUG, EACH ADDIT, SQ OR IM 82 263042 32551 THORACOSTOMY/CHEST TUBE INSERTION 375.5 263043 49083 PARACENTESIS ABD WITH IMAGING 1009.5 263101 96360 IV INFUSION, HYDRATION, UP TO 1 HR 162.5 263102 96361 IV INFUSION, HYDRATION, 2-8 HOURS 102 263103 96365 IV INFUSION,FOR THERAPY, UP TO I HOUR 174.5 263104 96366 IV INFUSION,FOR THERAPY, 2 TO 8 HOURS 82 263105 96367 ADDITIONAL SEQUENTIAL INFUSION 1 HOUR 112.5 263106 96368 CONCURRENT INFUSION 78.5 264000 96375 IV PUSH, EACH ADDITIONAL,SUBCU OR INTRAM 50 264001 96374 IV PUSH SINGLE OR INITIAL DRUG 106.5 264002 96372 THERAPEUTIC OR DIAGN INJ,SUBCU OR INTRAM 38.5 264041 96376 IV PUSH,SAME DRUG, EACH ADDIT, SQ OR IM 50 264101 96360 IV INFUSION, HYDRATION, UP TO 1 HR 130.5 264102 96361 IV INFUSION, HYDRATION, 2-8 HOURS 38.5 264103 96365 IV INFUSION,FOR THERAPY, UP TO I HOUR 142.5 264104 96366 IV INFUSION,FOR THERAPY, 2 TO 8 HOURS 50 264105 96367 ADDITIONAL SEQUENTIAL INFUSION 1 HOUR 81 264106 96368 CONCURRENT INFUSION 47 264990 90471 IMMUNIZATION ADMINISTATION 38.5 264991 90472 IMMUNIZATION ADMINISTATION, ADD/SUBSEQ 27 264992 92977 INFUSION THROMBOLYTIC 646.5 264993 36000 INSERTION OF HEP LOCK 27 266600 26600 TREATMENT OF METACARPAL FX 199

PRO FEE 270001 12001 SIMPLE REPAIR 267.5 270002 12002 SIMPLE REPAIR 300.5 270003 17003 CRYOSURGERY PREMALIGNANT 2ND-14TH LESION 25 270004 12004 SIMPLE REPAIR 366.5 270005 12005 SIMPLE REPAIR 396.5 270006 12006 SIMPLE REPAIR 617 270007 12007 SIMPLE REPAIR 667 270011 12011 SIMPLE REPAIR 285 270013 12013 SIMPLE REPAIR 334.5 270014 12014 SIMPLE REPAIR 400 270015 12015 SIMPLE REPAIR 437 270016 12016 SIMPLE REPAIR 683.5 270017 12017 SIMPLE REPAIR 883 270018 12018 SIMPLE REPAIR 1150 270020 12020 TX OF WOUND DEHISCENCE, SIMPLE 435 270031 12031 LAYER CLOSURE S,T,E 300.5 270032 12032 LAYER CLOSURE 350 270034 12034 LAYER CLOSURE 501 270035 12035 LAYER CLOSURE 600.5 270036 12036 LAYER CLOSURE 733 270040 10040 ACNE SURGERY 171 270041 12041 LAYER CLOSURE 334.5 270042 12042 LAYER CLOSURE 400 270044 12044 LAYER CLOSURE 534.5 270045 12045 LAYER CLOSURE 649 270051 12051 LAYER CLOSURE 288 270052 12052 LAYER CLOSURE 418.5 270053 12053 LAYER CLOS FACE,EARS,EYELIDS,NOSE,LIPS 534.5 270054 12054 LAYER CLOS FACE,EARS,EYELIDS,NOSE,LIPS 649 270055 12055 LAYER CLOS FACE,EARS,EYELIDS,NOSE,LIPS 851 270060 10060 DRAINAGE OF SKIN ABSCESS SIMPLE OR SINGL 191.2 270061 10061 DRAINAGE SKIN ABSCESS COMPLICATED OR MUL 225 270065 29065 APPLICATION;PLASTER SHOULDER TO HAND 93.5 270070 51702 CATHETERIZATION, URETHA; SIMPLE 68.5 270083 46320 EXCISION OF THROMBOSED HEMORRHOID 219.38 270090 28190 REMOVAL OF FOREIGN BODY, FOOT;SUBCUTANEO 300.5 270100 17000 CRYOSURGERY PREMALIGNANT 1 LESION 78 270104 17004 CRYOSURGERY PREMALIGNANT 15 OR > LESIONS 184 270105 29105 APPLICATION OF LONG ARM SPLINT 151.5 270110 17110 CRYOSURGERY BENIGN LESION 1-14 158.83 270111 17111 CRYOSURGERY BENIGN LESION 15 OR > 196.2 270120 10120 REMOVAL OF FOREIGN BODY 168 270121 10021 FNA W/O IMAGE 135.5 270124 28124 PARTIAL REMOVAL OF TOE 702 270125 29125 APPLICATION OF SHORT ARM SPLINT - STATIC 169 270126 29126 APPLICATION OF SHORT ARM SPLINT-DYNAMIC 118 270140 10140 DRAINAGE OF HEMATOMA/FLUID 375 270150 28150 REMOVAL OF TOE 664 270160 10160 PUNCTURE ASPIRATION OF ABCESS 168 270190 10121 INCISION & REMOVAL OF FOREIGN BODY COMPL 384 270200 69200 REMOVAL FOREIGN BODY FROM EAR 118 270205 65205 REMOVAL FOREIGN BODY FROM EYE` 101.5 270208 28208 REPAIR OR SUTURE OF EXTENSOR TENDON FOOT 851 270210 69210 REMOVAL IMPACTED CERUMEN 85 270231 99224 SUBSEQUENT OBV CARE -1 86 270232 99225 SUBSEQUENT OBV CARE -2 117 270233 99226 SUBSEQUENT OBV CARE -3 172 270251 41251 SUTURE OF TONGUE LP,NECK,TRUNK,EXT, 282 270258 30300 REMOVAL FOREIGN BODY FROM NOSE 151.5 270260 29260 STAPPING, ELBOW OR WRIST 79 270261 17261 DESTRUCTION OF SKIN LESIONS 215 270300 11300 SHAVING EPIDERMAL DERMAL LESION 0.5CMOR< 123.5 270328 27328 EXC THIGH/KNEE TUM DEEP < 5CM 598 270400 11400 EXCISION BENIGN LESION TRUNK,ARM,LEG 124.5 270401 11401 EXCISION BENIGN LESION TRUNK,ARM,LEG 270.5 270402 11402 EXCISION BENIGN LESION TRUNK,ARM,LEG 252 270403 11403 EXCISION BENIGN LESION TRUNK,ARM,LEG 300.5 270404 11404 EXCISION BENIGN LESION TRUNK,ARM,LEG 350 270405 29405 APPLICATION OF SHORT LEG CAST 124.5 270406 11406 EXCISION BENIGN LESION TRUNK,ARM,LEG 517.5 270420 11420 EXC. BENIGN LESION SCALP,NECK,HANDS,FEET 168 270421 11421 EXC. BENIGN LESION SCALP,NECK,HANDS,FEET 233 270422 11422 EXC. BENIGN LESION SCALP,NECK,HANDS,FEET 267.5 270423 11423 EXC H-F-NK-SP B9+MARG 2.1-3CM 334.5 270424 11424 EXC H-F-NK-SP B9 + MARG 3.1-4CM 400 270425 29425 APPLICATION SHORT LEG CAST 107 270426 11426 EXC. BENIGN LESION SCALP,NECK,HANDS,FEET 649 270440 11440 EXC. FACE-MM B9+MARG 0.5/ 4 139 271075 29075 APPLICATION-SHORT ARM CAST 87 271100 11100 BIOSPY OF SKIN, SINGLE LESION 138 271101 11101 BIOSPY OF SKIN, ADDITIONAL LESION 109 271105 43753 GASTRO INTUB W/ASP 151.5 271115 41115 EXCISION LINGUAL FRENUM 310.5 271200 11200 REMOVAL OF SKIN TAGS 132.5 271201 11201 REMOVAL OF SKIN TAGS ADD ON 44.65 271500 31500 EMERGENCY INTUBATION 224 271600 20600 ARTHROCENTESIS - ASPIR/INJ SMALL JOINT 101.5 271624 31624 DX BRONCHOSCOPE/LAVAGE 283 271750 11750 REMOVAL OF NAIL BED 274.5 271751 28820 AMPUTATION TOE METATARSOPHALANGEAL JOINT 362.5 271752 28810 AMPUTATION METATARSAL WITH TOE SINGLE 466 272046 12046 LAYER CLOS NECK,HANDS,FEET,EXT GENITALIA 801.5 272103 20103 EXPLORATION OF PENETRATING WOUND EXTREMI 934 272202 32554 THORACENTESIS W/O IMAGING 213 272510 54150 CIRCUMCISION WITH REGIONAL BLOCK 228 272511 54161 CIRCUMCISION PATIENT OLDER THAN 28DAYS 401.2 273012 49082 ABD PARACENTESIS 170.24 273021 20520 REMOVAL OF FOREIGN BODY 342 273024 43752 INSERTION OF NG TUBE 88.5 273043 49083 PARACENTESIS ABD WITH IMAGING 267 273100 13100 REPAIR,COMPLEX,TRUNK 450.5 273120 13120 REPAIR,COMPLEX,SCALP,ARMS,AND/OR LEGS 484.5 273121 13121 REPAIR,COMPLEX,SCALP,ARMS,,AND/OR LEGS 667 273131 13131 REPAIR,COMPLEX,FOREHEAD,CHEEKS,CHIN,MOUT 405 273132 13132 REPAIR,COMPLEX,FOREHEAD,CHEEKS,CHIN,MOUT 643 273150 13150 REPAIR,COMPLEX,EYELIDS,NOSE,EARS&LIPS 649 273600 53600 DILATION URETHRAL STRICTURE MALE INITIAL 152.25 273650 23650 TREATMENT OF SHOULDER DISLOCATION W/O AN 633.5 274200 24200 REMOVAL FOREIGN BODY UPPER EXTREMITY 285 274600 24600 TREATMENT OF CLOSED ELBOW DISLOCATON;WIT 749.5 274655 24655 TX OF CLOSED RADIUS HEAD FX W/ MANIPULAT 539.5 275100 15100 SKIN SPLT GRFT TRNK/ARM/LEG 679.23 275115 15115 EPIDRM A-GRAFT FACE/NCK/HF/G 722.11 275240 15240 SKIN GRAFT FULL THICKNESS 950 275530 25530 CLOSE FX TREATMENT ULNA W/O MANIPULATION 418.5 275560 25560 CLOSE FX TREATMENT RADIAL & ULNA W/O MAN 534.5 275600 25600 CLOSE FX TREATMENT DISTAL RADIAL W/O MAN 410 275605 25605 CLOSE FX TREATMENT DISTAL RADIAL W/MANIP 1150 276020 16020 DRESSING/DEBRID. BURNS<5% 120.5 276040 46040 INC & DRAIN OF PERIRECTAL ABCESS 783.5 276160 26160 REMOVAL TENDON SHEATH LESION 330 276405 56405 I&D VULVA / PERINEUM 255 276488 36556 INSERT NON-TUNNEL CV CATH 250.5 276600 26600 TREATMENT OF METACARPAL FX 271 276641 26641 CL REDUC DISLOCATION-HA , 454.5 277930 67930 LINEAR REP LID LAC 567.5 278090 28090 REMOVAL OF FOOT LESION 308 278500 38500 BIOPSY / REMOVAL LYMPH NODES 393 279201 99201 OBSERVATION SUBSQ, LEVEL 1 70.5 279202 99202 OBSERVATION SUBSQ, LEVEL 2 95.5 279203 99203 OBSERVATION SUBSQ, LEVEL 3 120.5 279217 99217 OBSERVATION CARE DISCHARGE 158.5 279218 99218 OBSERVATION INITIAL CARE, LEVEL 1 158.5 279219 99219 OBSERVATION INITIAL CARE, LEVEL 2 223 279220 99220 OBSERVATION INITIAL CARE, LEVEL 3 285 279221 99221 INITIAL HOSPITAL CARE-1 164 279222 99222 INITIAL HOSPITAL CARE-2 218.5 279223 99223 INITIAL HOSPITAL CARE-3 269.5 279231 99231 SUBSEQUENT HOSPITAL CARE-1 86 279232 99232 SUBSEQUENT HOSPITAL CARE-2 117 279233 99233 SUBSEQUENT HOSPITAL CARE-3 172 279234 99234 OBSERVATION A&D, SAME DAY LEVEL 1 212.5 279235 99235 OBSERVATION A&D, SAME DAY LEVEL 2 286 279236 99236 OBSERVATION A&D, SAME DAY LEVEL 3 360.5 279238 99238 HOSPITAL DISCHARGE <30 134 279239 99239 HOSPITAL DISCHARGE >30 165 279240 29240 APPLICATION FIGURE 8 SPLINT 118 279251 99251 INITIAL INPT CONSULT, LEVEL 1 70.5 279252 99252 INITIAL INPT CONSULT LEVEL 2 108 279253 99253 INITIAL INPT CONSULT LEVEL 3 146 279291 99291 CRITICAL CARE - PRO FEE FIRST HOUR 583 279292 99292 CRITICAL CARE - PRO FEE EA ADD 1/2 HR 245.5 279301 99318 NURSING FACILITY ANNUAL EXAM 103.5 279303 99303 NURSING FACILITY ADMIT/READMIT 191.5 279304 99304 INITIAL NF E/M 25 MIN 156.5 279305 99305 INITIAL NF E/M 35 MIN 211.5 279306 99306 INITIAL NF E/M 45 MIN 264 279310 99307 SUBSQT NRS FACL 10 MIN 68.5 279311 99308 SUBSQT NRS FACL 15 MIN 73.5 279312 99309 SUBSQT NRS FACL 25 MIN 87 279313 99310 SUBSQT NRS FACL 35 MIN 111 279315 99315 NURSING FACL D/C <30MIN 119.5 279316 99316 NURSING FACL D/C >30MIN 150.5 279317 99337 DOMICILIARY VISIT E/M ESTAB PT 109 279354 99354 PROLONG PHYSICIAN SX, OP 30-74 MINUTES 229 279355 99355 PROLONG PHYSICIAN SX, OP EA. ADD. 30 MIN 227

PULMONARY CLINIC 420001 99211 E & M - EST. LEVEL 1 46 420002 99212 E & M - EST. LEVEL 2 83 420003 99213 E & M - EST. LEVEL 3 97 420004 99214 E & M - EST. LEVEL 4 133 420005 99215 E & M - EST. LEVEL 5 171

OCCUPATIONAL THERAPY 450001 97003 OT EVALUATION 221.5 450002 97004 OT RE-EVALUATION 133.5 450003 95831 MUSCLE TESTING EXTREMITIES 80 450004 95851 ROM TESTING-EXTREMITY 60.5 450005 97535 SELF CARE/HOME MANAGEMENT 80 450006 97542 WHEELCHAIR MGMT/PRPL TRAINING 66.5 450007 97112 NEURO RE-EDUCATION 74.5 450008 97762 ORTHO CHECKOUT ESTABLISHED PT 66.5 450009 97760 ORTHO FITTING AND TRAINING 80 450010 97532 COGNITIVE SKILLS DEVELOPMENT 66.5 450011 97533 SENSORY INTEGRATIVE TECHNIQUE 105 450012 97110 THERAPEUTIC EXERCISES 93.5 450013 97150 THERAPEUTIC EXERCISES (GROUP) 83.5 450014 97530 THERAPEUTIC ACTIVITIES 93.5 450015 97537 COMMUNITY/WORK REINTEGRATION 74.5 450016 97545 WORK HARDENING, FIRST TWO HOURS 329.5 450017 97546 WORK HARDENING, EACH ADDITIONAL HOUR 197.5 450018 97035 ULTRASOUND, EACH 15 MINUTES 105 450019 97033 PHONOPHORESIS, EACH 15 MINUTES 138 450022 97010 MOIST HEAT 105 450023 97018 PARAFFIN 87 450024 97033 IONTOPHORESIS EA 15 MIN 115.5 450025 97010 COLD PACK 105 450028 97124 MASSAGE, EACH 15 MINUTES 105 450029 97124 ICE MASSAGE, EACH 15 MINUTES 105 450032 97034 CONTRAST BATH, EACH 15 MINUTES 58.5 450165 97165 OT EVAL LOW COMPLEX 30 MIN 245 450166 97166 OT EVAL MOD COMPLEX 45 MIN 245 450167 97167 OT EVAL HIGH COMPLEX 60 MIN 245

PROCEDURES 600060 10060 DRAINAGE SKIN ABSCESS SIMPLE OR SINGLE 249.5 600061 10061 DRAINAGE SKIN ABSCESS COMPLICATED OR MUL 297.5 600140 10140 DRAINAGE OF HEMATOMA/FLUID 950 601000 17000 DESTRUCT PREMALG LESION 125 601010 41010 INCISION OF TONGUE FOLD 986 601020 16020 DRESS/DEBRID P-THICK BURNS 319.5 601042 11042 DEB SUB Q TISSUE 20 SQ CM/< 465 601055 11055 TRIM SKIN LESION 104.5 601200 11200 REMOVAL OF SKIN TAGS 4.0CM 1162 601420 11420 EXC H/F/NK/SP B9+MARG 0.5/< 615.5 601421 11421 EXC H/F/NK/SP B9+MARG 0.6-1 CM 597.5 601422 11422 EXC H/F/NK/SP B9+MARG 1.1-2CM 628.5 601423 11423 EXC H-F-N-SP B9+MARG 2.1-3CM 1320.5 601424 11424 EXC H-F-NK--SP B9 + MARG 3.1-4CM 978.5 601426 11426 EXC H-F-NK-SP B9+MARG >4CM 1599 601440 11440 EXC FACE-MM B9+MARG 0.5/< CM 399.5 601441 11441 EXC FACE-MM B9+MARG 0.6-1CM 624 601442 11442 EXC FACE-MM B9+MARG 1.1-2CM 1084.5 601443 11443 EXC FACE-MM B9+MARG 2.1-3CM 442.5 601600 11600 EXC TR EXT MAL+MARG 0.5 CM/< 1453.5 601601 11601 EXC TR EXT MAL+MARG 0.6-1 CM 379 601602 11602 EXC TR EXT MAL+MARG 1.1-2 CM 480.5 601603 11603 EXC TR EXT MAL+MARG 2.1-3 752.5 601604 11604 EXC TR EXT MAL+MARG 3.1-4 CM 798 601606 11606 EXC TR EXT MAL+MARG 3.1-4 CM 1307.5 601610 20610 DRAIN/INJECT JOINT/BURSA 374.5 601621 11621 EXC S/N/H/F/G MAL+MARG 0.6-1 577 601622 11622 EXC S/N/H/F/G MAL+MARG 1.1-2 810 601623 11623 EXC S/N/H/F/G MAL+MARG 2.1-3CM 1170.5 601624 11624 EXC S/N/H/F/G MAL+MARG 3.1-4 CM 1259.5 601640 11640 EXC F/E/E/N/L MAL+MARG 0.5 CM< 637 601641 11641 EXC F/E/E/N/L MAL+MARG 0.6-1 702.5 601642 11642 EXC F/E/E/N/L MAL+MARG 1.1-2 716.5 601643 11643 EXC F/E/E/N/L MAL MRG 2.1-3CM 908.5 601644 11644 EXC F/E/E/N/L MAL + MARG 3.1-4 CM 795 601646 11646 EXC F/E/E/N/L MAL MRG > 4CM 1591.5 601732 11732 REMOVAL OF NAIL PLATE ADD ON 85.5 601750 11750 REMOVAL OF NAIL BED 529 601760 27760 CLTX MEDIAL ANKLE FX 443 601982 11982 REMOVE DRUG IMPLANT DEVICE 474 602005 12005 RPR S/N/A/GEN/TRK12.6-20.0CM 304.5 602011 12011 RPR F/E/E/N/L/M 2/5CM/< 216.5 605100 15100 SKIN SPLT GRAFT TRNK/ARM/LEG 1447.5 605115 15115 EPIDRM A-GRAFT FACE/NCK/HF/G 877 606160 26160 REMOVAL TENDON SHEATH LESION 971.5 606405 56405 I&D VULVA / PERINUEM 284.5 607000 11000 DEBRIDE INFECTED SKIN 247.5 607328 27328 EXC THIGH/KNEE TUM DEEP <5CM 1053 608090 28090 REMOVAL OF FOOT LESION 982 608124 28124 PARTIAL REMOVAL OF TOE 2146.5 608150 28150 REMOVAL OF TOE 2206 608500 38500 BIOPSY / REMOVAL LYMPH NODES 1995 500002 59050 FETAL MONITOR SERVICE 73 440000 59025 FETAL NON-STRESS TEST 37