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Item Master CPT Code Charge 6090610 COMPREHENSIVE

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Item Master CPT Code Charge 6090610 COMPREHENSIVE Item Number Item Description - Item Master CPT Code Charge 6090610 COMPREHENSIVE METABOLIC PANEL w/ Reflex- 80053 103.88 6202327 WIRE SYNT TIT KIRS TROC PT 1.25MM DIA 15 L8699 0 5387 NF-Premarin Oral Tablet 0.9MG 0 5398 NF-Falmina Tab 0.2MF-0.1MG 0 5517 NF-LaMICtal XR Extended Release Tab 100M 0 6130 NF-Nuedexta Oral Capsule 20MG-10MG 0 5992 NF-Terazosin HCl Oral Capsule 2MG 0 6203390 DRAIN 19 FR JACKSON-PRATT SU130-1325 0 5288 RXNF Minocycline HCl Capsule 50MG 0 5310 RXNF oxyMORphone HCl Tab ER 15MG 0 5388 RXNF aMILoride HCl Tablet 5MG 0 5564 NF- Felodipine Tablet ER 5MG 0 6213174 ANSPACH BURR 6MM FLUTED BALL MIA166B 298.36 8015007 SCREW SOF 4 X 11MM ZEPHIR C1713 1052.52 8025916 BIT 2.3 205.8 8026081 SA6AT5 CORRECTIVE LENS V2787 440 6200062 SUCTION IRRIGATOR SURGIFLEX 007200-903 0 5287 RXNF PARoxetine HCL Tab ER 25MG 0 6215042 SUTURE 3-0 VICRYL PS-2 J497G 0 6138 NF-Adderall XR Oral Cap ER 30MG 0 8015008 SCREW SOF 4 X 13MM ZEPHIR C1713 1052.52 5337 NF-Systane Ophth Solution 0 3774 RXNF Premarin Oral Tablet 0.9MG 0 6162 RXNF Chloroquine Phosphate Tablet 250 0 5756 RXNF Ziprasidone HCl Oral Capsule 20MG 0 8015009 SCREW SOF 4 X 15MM ZEPHIR C1713 1052.52 5427 RXNF Glyxambi Oral Tablet 25MG-5MG 0 8025918 BIT 2.5 205.8 5959 NF-EXCEDRIN EXTRA STRENGTH 250MG-250MG-6 0 5428 NF-Glyxambi Oral Tablet 25MG-5MG 0 5273 NF-Lansoprazole Oral Cap DR 30MG 0 5429 NF-Glyxambi Oral Tablet 25MG-5MG 0 8015391 WASHER TRI MED 180.2 5504 RXNF Movantik Oral Tablet 25MG 0 5336 RXNF Acebutolol HCl Capsule 200MG 0 2290384 erythromycin 0.5% ophth OINT 3.5 gm 0 5399 RXNF Alendronate Sod Oral Tablet 35MG 0 6233 RXNF Azopt Ophth Suspension 1% 0 5440 NF-CeleBREX Capsule 100MG 0 6208621 PIN SET UNIVERSAL II ECLIPSE 786 5935 RXNF Lopreeza Oral Tablet 0.5MG-0.1MG 0 5297 RXNF Systane Balance Ophth Soln 0.6% 0 6090638 C TRACHOMATIS PCR (co)- 87491 217.77 5184 RXNF CeleBREX Oral Capsule 100MG 0 6090483 SLIDE REVIEW (confirmation)- 85008 54.8 2291553 *ceFAZolin 1 gm/iso-osmotic 50 ml -PREOP J0690 0 5519 RXNF LaMICtal XR ER Tab 100MG 0 5439 RXNF Hyoscyamine Sulfate Tab ER 0.375 0 6213904 BRACE KNEE HINGED XX-LARGE - SPEARFISH 0 3709 RXNF Systane Ophth Solution 0.4%-0.3% 0 3396 RXNF Terazosin HCl 2MG ORAL CAP 0 5469 RXNF MonoNessa Oral Tab 35MCG/0.25MG 0 6205908 BLADE CASPAR BLADE 11MM 5100-134-11 276.99 8015016 PLATE SOF 40MM TITANIUM ALLOY ZEPHIR C1713 2466.03 5259 NF-ZENPEP CAP DR 16000U-3000U-10000U 0 8025782 KIT SPECTRA TRIAL 172.5 5563 RXNF Pantoprazole Sodium Tab EC 20MG 0 6209549 BIT TWIST DRILL 3 OVER 16 0 8025834 PROGRAMER KIT SPECTRA L8681 3580 5258 NF-ZENPEP ORAL DELAYED RELEASE CAPSULE 0 5980 RXNF Lotemax Ophth Suspension 0.5% 0 1203953 HUDSON MODIFIED TRINKLE 0 4373 NF-Zenpep Oral Delayed Release Capsule 0 5645 NF-oxyMORphone Hydrochloride Tab ER 20MG 0 6115 NF-Captopril Oral Tablet 25MG 0 6205909 BLADE CASPAR BLADE 12MM 5100-134-12 276.99 8015018 PLATE SOF 45MM TITANIUM ALLOY ZEPHIR C1713 2466.03 6201872 BLADE 10 0 6205712 CANNULA, 4" F/CETACAINE SPRAY 0 5864 NF-COLD & ALLERGY ORAL TABLET 4MG-10MG 0 1200448 ZIMMER CUTTING GUIDES 0 5260 RXNF Zytiga Oral Tablet 250MG 0 6079 NF-Depakene Syrup 250MG/5ML 0 6213691 SPLINT FINGER CURVED 6" PAD UC 0 6116 RXNF Captopril Oral Tablet 25MG 0 5274 NF-Citracal Cal Citr Petites 200IU-200MG 0 6090602 Path - Non GYN Cytology- 0 8025215 APPLICATION SPRAY KIT 78.96 5275 NF-Citracal + D Tablet 0 5470 NF-Amitiza Liquid Capsule 24MCG 0 1209745 NASAL ENDO EUSTACHIAN TUBE C9745 6404.06 1200650 PAPENDICK ROTATOR TOTE 0 5277 NF-diltiaZEM HCl Tablet 120MG 0 1244820 EXCISION OF LESION OF MESENTERY 44820 10099 6220200 INFLATION DEVICE FOR EBD 74.2 5311 RXNF Tetrahydrozoline HCl Opth Soln 0.05 0 5430 RXNF Orphenadrine Citrate ER Tab 100MG 0 5477 RXNF Nature-Throid Oral Tablet 146.25MG 0 6200180 S&N SMALL WRIST STABILIZATION KIT 164 5086 RXNF Amitiza Liquid Capsule 24MCG 0 6208097 SHAVER 4.0 ACROMIONIZER 72200724 0 6213808 TRICHOMONAS CONTROL KIT 0 5518 RXNF LaMICtal XR ER Tablet 25MG 0 3041 RXNF AMPHETAMINE SALTS 30MG ER CAP 0 5471 NF-Synthroid Tablet 175MCG 0 6140 RXNF Nature-Throid 48.75 mg TAB 0 8015021 PLATE SOF 52.5MM TITANIUM ALLOY ZEPHIR C1713 3898.23 6205910 BLADE CASPAR BLADE 13MM 5100-134-13 291.9 6202999 TUBE FEEDING 3.5 FR. 8888261206 0 5755 RXNF Divalproex Sodium Tab ER 500MG 0 2291031 *ceFAZolin 2 gm/D5W 50 ml (Ancef) J0690 0 5612 RXNF Butorphanol Tartrate Spray 10MG/ML 0 6090639 N GONORRHOEAE PCR (co)- 87591 217.77 5520 RXNF Citalopram HCl Tab 10MG 0 5478 NF-Nateglinide Oral Tablet 120MG 0 5787 RXNF Nateglinide Oral Tablet 60MG 0 6205911 BLADE CASPAR BLADE 14MM 5100-134-14 291.9 2291552 *ceFAZolin 2 gm/D5W 50 ml-PREOP (Ancef) J0690 0 6204775 BRUSH INTRAMEDULLARY 6198-1-514 0 2291760 *ceFAZolin 3 gm/D5W 100 ml-PREOP (Ancef) J0690 0 8015025 PLATE SOF 62.5 TIT ALOY ZEPH C1713 3898.23 3355 RXNF Lansoprazole 15mg DR Capsule 0 8015026 PLATE SOF 65 TIT ALOY ZEPH C1713 3898.23 6002 RXNF levETIRAcetam Oral Soln 100MG/1ML 0 8080228 RESTERILIZABLE GEL SIZER RSZ-1409 L8699 800 6206461 LSO SAGITTAL CONTROL BRACE 446.42 5546 RXNF guanFACINE HCl Tablet 2MG 0 6151 NF-Adderall XR Oral Capsule ER 25MG 0 3351 NF-VALPROIC ACID 250MG ORAL CAPSULE, LIQ 0 6201913 BLADE BEAVER 4mm SHARP ROUND 0 6204773 BLADE CASPAR BLADE 9MM 5100-134-9 291.9 6131 RXNF Nuedexta Oral Capsule 20MG-10MG 0 8015074 SCREW SOF CANC 4.0x13MM TIT ALLOY ZEPHI C1713 868.14 5788 RXNF Nitroglycerin Cap ER 2.5MG 0 5278 NF-Lansoprazole Oral Cap DR 30MG 0 5413 NF-Norethindrone Oral Tablet 0.35MG 0 5954 NF-Levalbuterol Inh/Neb Soln 1.25MG/0.5M 0 3684 NF-Calcitriol Liq Cap 0.25MCG 0 5562 RXNF Nortrel 1/35 Tablet 0 8015076 PLATE SOF 37.5 MM TITANIUM ALLOY ZEPHIR C1713 2466.03 6090270 GLUCOSE CSF- 82945 58.9 6213161 BONE CORTICAL BUTTON 8 MM L8699 845.46 6203037 DRESSING UNSTERILE 6" CAST PADDING 0 5604 RXNF Norethindrone Acetate Tablet 5MG 0 6003 RXNF lamoTRIgine ODT 200MG 0 6102 RXNF Ziprasidone HCl Oral Capsule 60MG 0 6090684 GLUCOSE BODY FLUID- 82945 58.9 5659 RXNF Glatiramer SQ Inj 20MG/1MG 0 6210878 SUTURE 5-0 POLYSORB DX16 18IN UNDYED 0 5367 NF-Forteo Subcutaneous Solution 250MCG/1 0 6200330 MASK NON REBREATHING 0 6213876 MASK YELLOW EARLOOP LATEX FREE BHUC 0 8020065 SCREW STRY XIA MONOAXIAL 4.5 x 40MM C1713 2275.25 5995 NF-Estradiol TD Patch ER 0.0375MG/24Hrs 0 6215131 BLADE HIP CURVED MITEK 260003 508 5366 RXNF Forteo Subcutaneous Soln 250MCG/1ML 0 2469 RXNF Felodipine 5 mg TAB ER 0 8020066 SCREW STRY XIA MONOAXIAL 4.5 x 45MM C1713 2275.25 6216001 GRAFCO SILVER NITRATE APPLICATOR 0 5611 RXNF Salagen Oral Tablet 7.5MG 0 5955 RXNF Methotrexate 2.5 mg TAB 0 5368 RXNF Dalfampridine Oral ER Tablet 10mg 0 5613 RXNF Lacrisert Ophthalmic Device 5MG 0 5261 RXNF Trifluoperazine HCl Tablet 5MG 0 2310811 MDA ANS LOWER INTST ENDO PX NOS 00811 52 6202944 DRESSING IODOFORM 1IN PACKING 0 8026037 COCHLEAR BAHA DISPOSABLE KIT 11960 2291046 cefotaxime 2gm/iso-osmotic 50ml PRE-OP J0698 0 5472 RXNF Synthroid Tablet 175MCG 0 6310 NF-Sotalol HCl Tablet 160MG 0 8020069 SCREW STRY XIA MONOAXIAL 5.5 X 40MM C1713 2275.25 5347 RXNF Ziprasidone HCl Capsule 40MG 0 6213743 BLADE DERMA 8/50 BHUC 0 8020070 SCREW STRY XIA MONOAXIAL 5.5 x 45MM C1713 2275.25 8040469 CERVICAL DISC PROSTHESIS 15X19X6 C1889 7875 6090631 CHLAMYDIA AND GONORRHOEAE PCR- 0 6090700 Centromere Antibodies, IgG- 86337 88.36 6203493 SUTURE 2-0 SOFSILK V20 30IN GS833 0 6211522 GLOVE NITRILE EXAM X-SM 0 6203651 INSORB 30 ABSORBABLE SKIN STAPLER 91.86 8015204 INTER FIX CAGE 18 X 20 LOW PROFILE L8699 18213.27 1200185 D FROMM NDL HOLDERS AND FINGER 0 2320952 CRNA ANS HYSTEROSCOPY/HYSTEROSALPINOGRAP 00952 50 6090632 C TRACHOMATIS PCR- 87491 217.77 8080503 BONE VOID FILLER 5CC STIMULAN BEAD C1713 2217.52 1237565 LIGATION INTERNAL JUGULAR VEIN 37565 5708 2019361 PC BREAST RECON W/LATISSIMUS DORSI FLAP 19361 1075 2291035 cefTAZidime /NS 1 gm/50 ml (Fortaz) J0713 0 1183 desmopressin acetate 4 mcg/ml 10 ml VIAL J2597 1581 5279 NF-Atorvastatin Calcium Oral Tab 10MG 0 8020077 SCREW STRY XIA MONOAXIAL 6.5 x 55mm C1713 2275.25 5938 RXNF potassium chloride SOLN 20 mEq/15ml 0 5280 NF-Methocarbamol Tablet 500MG 0 6202290 POVIDONE IODINE, 3 OZ (NURSE MUST PULL) 0 5414 NF-Carvedilol Oral Tablet 25MG 0 5939 NF-potassium chloride Oral Soln 20MEQ/15 0 5141 RXNF Adderall XR 25 mg CAP 0 8015080 INTERFIX CAGE 14 X 23 L8699 10026.24 2290302 ceFOXitin 1 gm VIAL (Mefoxin) J0694 31 6090633 N GONORRHOEAE PCR- 87591 217.77 6213577 STYLET FLEXI SLIP 12F -ANESTH. 0 2290316 chloroprocaine 3% VIAL 20 ml (Nesacaine) J2400 88 5852 NF-TraZODone HCl Oral Tablet 150MG 0 6080 RXNF Valproic Acid Syrup 250MG/5ML 0 5720 NF-Chlorhexidine Gluconate Liquid 0.12% 0 5940 NF-Ribavirin Capsule 200MG 0 2290318 chlorproMAZINE 25 mg/ml AMP 1 ml J3230 78 2291036 cefTAZidime /NS 2 gm/50 ml (Fortaz) J0713 0 6004 RXNF lamoTRIgine ODT 25MG 0 8020080 SCREW STRY XIA MONOAXIAL 7.5 x 35MM C1713 2275.25 2290344 meperidine 100 mg/ml CARPUJECT (Demerol) J2175 42 5757 NF-Creon Oral Delayed Release Capsule 0 2290345 methylPREDNISolone acet 40mg/ml VIAL 1ml J1030 38 5528 RXNF Suboxone SL Film 8MG-2MG 0 5441 RXNF Evista Tablet 60MG 0 6208082 STETHOSCOPE ESOPHAGEAL TEMP PRB 18F 0 5820 RXNF Menest Tablet 0.625MG 0 6213984 WIRE SYNT GUIDE 2.8MM L8699 0 99024 CONTRACT MANAGEMENT BHO 0 8015102 INTERFIX CAGE 20 X 26 L8699 10026.24 5721 NF-Sprintec Tablet 0 5758 RXNF Creon Oral Delayed Release Capsule 0 6213441 TOURNI-COT DIGI LG 0 6132 NF-Folic Acid Oral Tablet 1MG 0 6206071 SHARPS CONTAINER RED 3 GALLON ANESTHESIA 0 2290399 flumazenil 0.1 mg/ml VIAL 5ml (Romazicon 0 5312 NF-Lisinopril-HCTZ Oral Tablet 10MG-12.5 0 2190112 US NON VASCULAR LOWER JOINT BILAT 76881 649.32 2290406 furosemide 10mg/ml 2ml VIAL
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