Charge Code Description CPT Charge 0.9% NACL 250ML GLASS 52.00 10% DEXTROSE 500CC 55.00 16-37 MIN. INDIVIDUAL PSYCHOTHERAPY 90832 325.00 1ST NF CARE PR 99304 177.00 1ST NF CARE PR 99305 234.00 1ST NF CARE PR 99306 306.00 38-52 MINS. INDIVIDUAL PSYCHOTHERAPY 90834 350.00 4 IN STERILE ACE 8.60 5% D/W 500CC 55.00 5% DEX/.2% NACL INJ USP 1 40.00 5% DEXTROSE & .33% NA CL( 65.00 5% DEXTROSE INJ USP 250 M 40.00 5% DEXTROSE INJECT 500ML 45.00 5,10-MTHFR 2 MUTATIONS 81291 198.28 53-67 MINS. INDIVIDUAL PSYCHOTHERAPY 90837 375.00 ABATACEPT INJ 250MG VL J0129 2,270.44 ABDOMEN 1 VIEW 74018 193.00 ABDOMEN 2 74019 246.00 ABDOMEN 3+VIEWS 74021 300.00 ABDOMEN ACUTE ABDOMEN SERIES 74022 432.00 ABDOMINAL CAT SCAN W/O CO 74150 1,712.00 ABDOMINAL CAT SCAN W/WO C 74170 2,047.00 ABDOMINAL CAT SCAN WITH C 74160 1,879.00 ABILIFY 10MG TAB 80.30 ABILIFY TAB 5 MG 107.04 ABREVA CREAM NF 55.65 ABSORPTION DRESSING 115.65 ACAPELLA MOUTHPIECE 130.35 ACARBOSE TAB 25 MG 4.00 ACETAMIN/ COD LIQ 120/12 MG/5ML 60ML BTL 61.80 ACETAMIN/ COD TAB 300/ 30 MG 6.36 ACETAMINOPHEN 80307 85.00 ACETAMINOPHEN ADULT SUP 650 mg 4.67 ACETAMINOPHEN CHILD SUP 120 MG 4.58 ACETAMINOPHEN LIQ 160 MG/5ML 4.00 ACETAMINOPHEN ORAL LIQUID 480mg/15ml 4.00 ACETAMINOPHEN TAB 325 MG 2.00 ACETAMINOPHEN TAB 500 MG 2.00 ACETAZOLAMIKE 250 MG TAB 4.00 ACETIC ACID 0.25% IRRG SOL 500ML 8.00 ACETYLCYSTEINE 20% INH/PO 200 mg/ml 4 ml 44.89 ACETYLCYSTEINE SOL 20% 6000 mg (4ML/VL) 75.02 ACHR BINDING AB 83519 99.49 ACID FAST CULTURE 87116 43.00 ACIDOPHILUS TAB 100 MG 4.00 ACITRETIN 25mg CAP 115.38 ACNE SURGERY COMEDONE REMOVAL 10040 168.95 ACT PROT C RESIST 85307 199.25 ACTEMRA INJ 400 MG VL J3262 8.62 ACTH 82024 195.47 ACTH RADIOIMMUN 82024 195.47 ACTINOMYCES (NOCARDIA) AB 86744 31.00 ACTINOMYCES (NOCARDIA)AB 86744 31.00 ACTIVASE INJ 100 MG VL J2997 137.74 Actonel Oral 35 mg Tablet (Pack of 4) 292.54 ACUTE HEPATITIS PANEL 80074 235.00 ACUTE HEPATITIS PANEL 80074 235.00 ACYCLOVIR CAP 200MG J8499 6.12 ACYCLOVIR INJ 500 MG VL J0133 76.40 ADENOSINE INJ 12 MG/4ML SR 36.42 ADENOSINE INJ 6 MG/2ML VL J0153 68.00 ADENOVIRUS PCR 87798 122.21 ADH 84588 96.00 ADH 84588 96.00 ADHESIVE SKIN 57.40 ADJUSTABLE HEMI WALKER 116.25 ADM HEP B VACC G0010 45.00 ADM INJ SUBCU O 96372 44.00 ADM PNEUMO VACC G0009 44.00 ADMIN FLU SHOT G0008 44.00 ADMIN FLU VIRUS VACCINE G0008 79.05 ADMIN PNEUMONIA VACCINE G0009 79.05 ADMN INJ IV PUSH 96374 191.09 ADRENALIN EPINEPHRINE INJ J0171 4.00 ADULT REBREATHING MASK 5.60 ADVANCED CARE PLANNING 30MIN 99497 94.00 ADVANCED CARE PLANNING ADDL 30MIN 99498 82.00 AFB CONCENTRATION 87015 38.46 AFB SMEAR 87206 34.00 AFO PLASTIC/OTH MATERIAL PREFAB L1930 704.77 AFP TUMOR MARKER 82105 105.00 AFP, MATERNAL SERUM 82105 130.00 AH50 86161 176.75 AIR CAST, UNIVERSAL SM 120.25 AIRCAST LEG BRACE 03AL 135.00 AIRCAST LEG BRACE 03AR 120.75 AIRCAST LEG BRACE 03CL 135.00 AIRCAST LEG BRACE 03CR 135.00 AIRCAST SPORT STIRRUP L. 75.40 AIRCAST UNIVERSAL LG 120.25 AIRCAST UNIVERSAL MED 120.25 ALAWAY OPTH DROPS .025% 82.88 ALBA HEEL & ELBOW PROTECT 25.35 ALBUMIN HUMAN INJ 2500MG 156.09 ALBUMIN SERUM 82040 37.00 ALBUTEROL MDI (8 GM) 81.40 ALBUTEROL SULFATE 90MCG INH 18GM 138.36 ALBUTEROL SYRUP PER 10CC 4.00 ALBUTEROL/ IPRATROPIUM 14.7 GM MDI 549.14 ALCOHOL (ETHANO G0480 79.00 ALCOHOL BLOOD TEST SUPPLI 17.35 ALCOHOL, BLOOD 80307 85.00 ALDOLASE 82085 74.00 ALDOSTERONE 82088 279.75 ALDOSTERONE 82088 280.00 ALENDRONATE TAB 70 MG 61.45 ALK PHOS ISOENZYMES 84080 94.00 ALKALINE PHOSPHATASE 84075 42.00 ALLERGEN SPECIF 86003 31.00 ALLERGY INJ, 2+ 95117 41.00 ALLERGY INJ.SNG 95115 37.03 Allergy Peanut 86003 40.00 ALLERGY SCREEN 86005 42.00 ALLERGY TEST PER ALLERGEN 86003 31.00 ALLOPURINOL TAB 100 MG 4.00 ALLOPURINOL TAB 300 MG 4.00 ALPHA 1 ANTITRYP PHENOTYP 82104 90.90 ALPHA 1 ANTITRYPSIN 82103 80.08 ALPHA-1-ANTITRYPSIN PHENOTYPE 82104 189.75 ALPHA-1-ANTITRYPSIN TOTAL 82103 73.00 ALPHA-FETOPROTE 82105 130.00 ALPRAZOLAM TAB 0.25 MG 6.64 ALTEPLASE INJ 2 MG VL J2997 442.44 AMANTADINE CAP 100 MG 9.13 AMBISOME 50 MG IV 350.00 AMBISOME INJ 50 MG VL J0289 536.95 AMBUL OR-MINOR A 1-45 MIN 1,224.00 AMBUL OR-MINOR A 46-60MIN 1,384.00 AMBUL OR-MINOR A 61-75MIN 1,524.00 AMBUL OR-MINOR A 76-90MIN 1,644.00 AMBUL OR-MINOR A 91-105MI 1,744.00 AMBUL OR-MINOR B 1-45 MIN 1,899.00 AMBUL OR-MINOR B 46-60MIN 2,059.00 AMBUL OR-MINOR B 61-75MIN 2,199.00 AMBUL OR-MINOR B 76-90MIN 2,339.00 AMBUL OR-MINOR B 91-105MI 2,479.00 AMBUL OR-MINOR C 1-45 MIN 2,574.00 AMBUL OR-MINOR C 46-60MIN 2,734.00 AMBUL OR-MINOR C 61-75MIN 2,894.00 AMBUL OR-MINOR C 76-90MIN 3,054.00 AMBUL OR-MINOR C 91-105MI 3,214.00 AMBULATORY OR MINOR B 120 2,619.00 AMBULATORY SURI L3260 24.00 AMIKACIN INJ 500mg / 2ml 38.38 AMIKACIN, PEAK or TROUGH 80150 88.46 AMINOPHYLLINE INJ 250 MG VL 54.11 AMIODARONE 82492 101.50 AMIODARONE 150MG VL J0282 20.00 AMIODARONE INJ 50 MG/1ML (9 ml VL) J0282 33.14 AMITIZA 24MCG CAP 22.27 AMITRIPTYLINE TAB 10 MG 4.00 AMITRIPTYLLINE TAB 25 MG 4.00 AMLODIPINE TAB 5 MG 6.92 AMMONIA 82140 74.00 AMNIO HOOK 5.60 AMOX/CLAV POT TAB 875/125 MG 15.15 AMOXICIL/ POT CLAV SUS 400/57 MG/50 ML 113.25 AMOXICILLIN 400MG/5ML SUS 50ML BTL 19.60 AMOXICILLIN CAP 250 MG 4.00 AMOXICILLIN SUS 125 MG/5ML (100 ML BTL) 14.36 AMOXICILLIN SUS 250 MG/5ML (80 ML BTL) 18.39 AMOXICILLIN TAB 500 MG 4.00 AMOXICILLIN TAB 875 MG 4.00 AMOXIL/CLAV 500/125MG TAB 15.14 AMPHETAMINE SALTS TAB (10 MG) 12.86 AMPHETAMINE, SERUM 82145 176.50 AMPHETAMINE, SERUM 82145 176.50 AMPHOTERICIN B INJ 50 MG VL J0285 124.88 AMPICILLIN 250 MG TAB (50 9.00 AMPICILLIN 500MG TAB 4.00 AMPICILLIN/SULB INJ 1.5GM VL J0295 63.04 AMPLIFIED PROBE TECHNIQUE, EACH ORGANISM 87798 122.00 AMPUTATION TOE INTERPHALANGEAL JOINT 28825 2,438.34 AMYLASE 82150 36.00 AMYLASE,SERUM 82150 36.00 ANA ANTINUCLEAR 86038 94.00 ANA SCREEN 86038 94.00 ANA TITER 86039 33.00 ANA TITER 86039 33.00 ANAEROBIC CULTURE 87075 72.00 ANAGRELIDE HCL CAP 0.5 MG 33.49 ANASTROZOLE TAB 1 MG J8999 62.96 ANCA 86021 258.00 ANCA MPO OR ANCA PR3 86021 97.00 ANESTHESIA CIRCUIT PEDS 25.10 ANESTHESIA GEN/LOCAL 151 791.00 ANESTHESIA GEN/LOCAL 181 868.00 ANESTHESIA GEN/LOCAL 31 462.00 ANESTHESIA GEN/LOCAL 61 562.00 ANESTHESIA GEN/LOCAL 91 638.00 ANESTHESIA GEN/LOCAL 1 - 332.00 ANESTHESIA GEN/LOCAL 121 715.00 ANESTHESIA MAC/IV SED 1 192.00 ANESTHESIA MAC/IV SED 12 415.00 ANESTHESIA MAC/IV SED 15 459.00 ANESTHESIA MAC/IV SED 18 503.00 ANESTHESIA MAC/IV SED 31 268.00 ANESTHESIA MAC/IV SED 61 326.00 ANESTHESIA MAC/IV SED 91 370.00 ANESTHESIOLOGY SUPPLIES 132.00 ANGIOTENSIN CONVERTING EN 82164 117.25 ANGIOTENSIN CONVERTING EN 82164 117.25 ANKLE FOOT ORTHOS ANK GAUNTLY PRFAB L1902 237.83 ANKLE LEFT (3 VIEWS) 73610 208.00 ANKLE LEFT(2 VIEWS) 73600 172.05 ANKLE RIGHT (2 VIEWS) 73600 172.05 ANKLE RIGHT (3 VIEWS) 73610 208.00 ANKLE STRAPPING 29540 319.24 ANKLE SUPPORT SM 55.00 ANKLE WRAP, FIGURE EIGHT 26.00 ANNUAL WELLNEST VST G0438 242.00 ANOSCOPY, DIAGN 46600 193.00 ANTEPARTUM CARE 59425 998.00 ANTEPARTUM CARE 59426 1,593.00 ANTI TISSUE TRANSGLUTAMIN 82397 151.00 ANTIBIOTIC SENS 87186 45.00 ANTIBODY IDENTI 86021 194.00 ANTIBODY, ASPIR 86606 33.00 ANTIBODY, BLAST 86612 31.00 ANTIBODY, CMV, 86645 109.00 ANTIBODY, COCCI 86635 74.97 ANTIBODY, HEPAT 86706 67.00 ANTIBODY, HEPAT 86704 77.00 ANTIBODY, HEPAT 86709 77.00 ANTIBODY, HEPAT 86803 105.00 ANTIBODY, HERPE 86695 96.00 ANTIBODY, HERPE 86696 98.00 ANTIBODY, HISTO 86698 124.00 ANTIBODY, RUBEO 86765 106.00 ANTIBODY, THYRO 86800 94.00 ANTIBODY, VARIC 86787 72.97 ANTI-DS DNA 86225 79.00 ANTI-EM HOSE, KNEE 17.35 ANTI-EM HOSE, L REG 96.50 ANTI-GBM AB 83520 107.75 ANTI-IgE 83516 159.50 ANTIMICROBIAL AGENT 87185 27.00 ANTIMICROBIAL AGENT DISK METHOD 87184 25.98 ANTIMICROBIAL AGENT DISK METHOD 87184 25.98 ANTIMICROBIAL AGENT ENZYM 87185 27.00 ANTI-MITOCHONDRIAL AB 83516 90.85 ANTI-MULLERIAN HORMONE 83516 116.00 ANTIPYRINE AND BENZOCAINE 10 ML 23.90 ANTI-SMOOTH MUSCLE AB 83516 126.75 ANTISTREPTOLYSI 86060 59.00 ANTI-THROMBIN 3 AG 85301 337.50 ANTI-THYROGLOBULIN AB 86800 94.00 AP CHEST 71045 186.00 APAP DROP 2.00 APHASIA ASSESMENT,PER HR 96105 290.77 APIXABAN 2.5MG TAB 25.14 APIXABAN 5MG TAB NF 25.14 APOLIPOPROTEIN A AND B 82172 67.02 APOLIPOPROTEIN A AND B 82172 67.00 APP LONG ARM SPLINT 29105 218.00 APP.FINGER SPLINT STATIC 29130 167.55 APPLICATION LONG LEG SPLI 29505 300.63 APPLICATION OF 29515 203.00 APPLICATION OF 29505 256.00 APPLICATION OF FOREARM CA 29075 256.00 APPLICATION RIGID TOTAL CONTACT LEG CAST 29445 566.77 APPLIER CLIP LIGOMAX 319.75 APPLIER CLIP ROT LIGACLIP 219.10 APPLY ELBOW TO 29075 278.00 APPLY FINGER SP 29130 102.00 APPLY FINGER SPLINT 29130 94.00 APPLY FINGER SPLINT 29130 130.75 APPLY FOREARM S 29125 182.00 APPLY FOREARM SPLINT 29125 167.00 APPLY FOREARM SPLINT 29125 328.93 APPLY FOREARM SPLINT 29125 328.93 APPLY LONG ARM SPLINT 29105 319.24 APPLY LONG LEG SPLINT 29505 300.63 APPLY LOWER LEG SPLINT 29515 135.35 APPLY LOWER LEG SPLINT 29515 162.78 APPLY LOWER LEG SPLINT 29515 319.24 APPLY MLTLAYR COMPRESS ARM/HAND 29584 319.24 APPLY MULTLAY COMPRS LWR LEG 29581 319.24 APPLY MULTLAYR COMPRES LEG 29581 319.24 APPLY SHORT LEG CAST 29425 237.28 APPLY SHORT LEG CAST 29425 331.00 APPLY SHOULDER 29065 318.00 APPLY SPLINT FINGER (DYNA 29131 231.45 APPLY SPLINT SHORT ARM (D 29126 231.45 APPLY TENS UNIT 64550 42.00 AQUA-MEPHYTON TAB 5 MG 36.99 AQUAPAK STERILE WATER 7.00 ARANESP 300MCG SYG INJ J0881 15.40 ARANESP INJ (200 MG SYR) J0881 14.66 ARANESP INJ (500 MCG) J0881 14.66 ARANESP INJ (60 MCG SYR) J0881 14.66 ARANESP INJ 100MCG SYG J0881 14.66 ARGINAID PKT 4.72 ARIPIPRAZOLE 15MG TAB NF 96.00 ARSENIC URINE OR BLOOD 82175 183.00 ARTERIAL DOPPLER LIMB COM 93923 591.00 ARTERIAL DOPPLER LIMB LIM 93922 362.00 ARTHRITIS CREAM W/ LIDOCAINE 4% NF 23.94 ARTIFICIAL TEARS EYE DROP 15ML 4.11 ASCA IgG OR IgA 86671 113.45 ASO 86060 59.00 ASP JOINT INJ 20600 244.70 ASPERCREME LIDOCAIN PATCH 4% NF 4.35 ASPERGILLUS AB 86606 33.00 ASPIRATION AND/ 20612 244.70 ASPIRATION OF A 10160 310.80 ASPIRIN CHEW TAB 81 MG 2.00 ASPIRIN EC TAB 81MG 2.00 ASPIRIN SUPP 300 MG 5.83 ASPIRIN TAB 325 MG 2.00 ASSAY ALKALINE 84075 42.00 ASSAY ALKALINE 84080 94.00 ASSAY BLOOD FOR 83655 80.00 ASSAY CALCIUM I 82310 34.00 ASSAY CPK IN BL 82550 35.00 ASSAY CREATINE, 82553 48.00 ASSAY IONIZED C 82330 87.00 ASSAY OF MERCURY 83825 169.00 ASSAY TOTAL EST 82672 166.00 ASSAY, BLOOD AL 82085 74.00 ASSAY, BLOOD AM 82140 74.00 ASSAY, BLOOD CE 82390 79.00 ASSAY, BLOOD CO 82525 84.00 ASSAY, BLOOD MA 83735 34.00 ASSAY, BLOOD PH 84100 32.00 ASSAY, COLUMN C 82541 48.00 ASSAY, C-PEPTID 84681 104.00 ASSAY, CREATINI 82570 41.00 ASSAY, DEHYDROE 82627 94.00 ASSAY, DIGOXIN 80162 80.00 ASSAY, DIHYDROX 82652 147.00 ASSAY, ESTRADIO 82670 191.00 ASSAY, FERRITIN 82728 85.00 ASSAY, FREE COR 82530 64.00 ASSAY, FREE TES 84402 95.00 ASSAY, FREE THY 84439 62.73 ASSAY, FREE TRI 84481 136.00 ASSAY, GAMMAGLO 82784 52.00 ASSAY, GAMMAGLO 82785 89.00 ASSAY, GGT ENZY 82977 47.00 ASSAY, GLUCOSE, 82945 43.00 ASSAY, HOMOCYST 83090 59.00 ASSAY, INSULIN, 83525 62.00 ASSAY, MICROSOM 86376 77.00 ASSAY, NATIURET 83880 125.00 ASSAY, PHENOBAR 80184 60.00 ASSAY, PITUITAR 83001 122.00 ASSAY, PITUITAR 83002 126.00 ASSAY, PLASMA C 82533 84.00 ASSAY, PROGESTE 84144 103.00 ASSAY, PROTEIN, 84157 11.00 ASSAY, PROTEIN, 84156 12.00 ASSAY, PSA, FRE 84154 110.00 ASSAY, SERUM AL 82040 37.00 ASSAY, SOMATOME 84305 96.00 ASSAY, TROPONIN 84484 34.00 ASSAY, URINE PO 84110 44.00 ASSAY, VITAMIN 82306 106.00 AST, TRANSFERAS 84450 31.00 ATENOLOL TAB 100 MG 8.96 ATENOLOL TAB 25 MG 4.00 ATORVASTATIN 10MG TAB 16.19 ATORVASTATIN TAB 20 MG 4.00 ATRAC-TAIN & 5% UREA 14.09 ATROPINE INJ 0.4 MG/ML VL 41.88 ATROPINE INJ 1 MG/ML VL J0461 54.38 ATROPINE INJ SYR 1 MG/10ML J0461 23.24 ATROPINE OPHTH SOL 1% 5ML BTL 51.00 ATROVENT INHALER 14GM 75.10 AUGMENTIN 500 MG TAB 15.12 AUTO DIFFERENTIAL 85004 19.00 AUTOMATED HEMOG 85027 43.00 AVAPRO TAB 300 MG 25.96 AVULSION NAIL P 11730 191.00 AWV SUBSEQUENT VISIT G0439 161.00 AZATHIOPRINE 82542 98.00 AZATHIOPRINE TAB 50 MG 8.44 Azithromycin 500 mg 56.04 AZITHROMYCIN INJ 500 MG VL J0456 35.00 AZITHROMYCIN SUS 100 MG/5 ML (15ML BTL) 104.64 AZITHROMYCIN SUS 200 MG/5 ML (15 ML BTL) 104.64 AZITHROMYCIN TAB 250 MG 22.17 AZTREONAM INJ 1 GM VL 110.94 B. PERTUSSIS AB IGG, IGA, 86615 138.60 B.PERTUSSIS AB IGG, IGA 86615 138.60 B12 82607 102.00 B2 GLYCOPROTEIN IGG 86146 99.00 B2 GLYCOPROTEIN IGM 86146 99.00 BAC/NEO/POLY OINT 1/32 OX PKT 2.00 BACITRACIN OIN TOP 500U/GM TUBE 10.41 BACLOFEN TAB 10 MG 4.00 BACLOFEN TAB 20 MG 15.39 BACTERIUM ANTI BODY 86609 33.00 BARIUM ENEMA 74270 465.00 BARIUM ENEMA (AC) 74280 453.00 BARIUM MEAL (NOT AC) 74240 474.00 BARIUM MEAL (UGI)(AC) 74246 512.00 BARTONELLA AB 86611 64.75 BARTONELLA AB 86611 64.75 BASIC ENTERIC PATHOGEN PANEL 87506 233.82 BASIC ENTERIC PATHOGEN PANEL 87506 233.82 BASIC METABOLIC 80048 50.00 BASIC PACK 28.25 B-COMPLEX CAP 2.00 BEHAVRAL QUALT ANALYS VOICE 92524 272.65 BELLADONNA/PB ELX 16.2MG/5 ML 53.34 BENAZEPRIL TAB 10 MG 4.00 BENEDRYL J1200 20.00 BENICAR TAB 20 MG 25.13 BENZONATATE CAP 100 MG 9.34 BETA-2 MICROGLOBULIN 82232 135.25 BETADINE SCRUB TOP 4 OZ 4.04 BETA-HYDROXYBUTYRATE (ACETONE) 82010 45.07 BETA-HYDROXYBUTYRATE (ACETONE) 82010 45.07 BETAMETHASONE 30mg/5ml INJ 35.45 Betapace 80 mg tab 10.25 BETAPASE TAB 120 MG 48.26 BETHANECHOL TAB 50 MG 17.09 BEVACIZUMAB INJ (25MG/ML) 400MG VL J9035 7,464.00 BICALUTAMIDE 50MG TAB 4.00 BICILLINLA INJ 2ML J0561 218.43 BILATERAL DUPLEX VENOUS EXTREMITY 93970 732.00 BILE ACIDS 82239 50.34 BILI LIGHT, PER HOUR 4.30 BILIRUBIN DIRECT 82248 21.18 BILIRUBIN, TOTA 82247 34.00 BILIRUBIN, TOTAL 82247 34.00 BIOFEEDBACK PERI/URO/RECTAL 90911 282.69 BIOFEEDBACK TRAINING (ANY 90901 58.64 BIOFEEDBACK TRNG. (PERINE 90911 282.69 BIOFREEZE 17.40 BIOPSY, CERVIX 57500 575.60 BIOPSY, SKIN SU 11101 125.00 BIOPSY, SKIN/SU 11100 310.80 BISACODYL SUPP 10 MG 4.27 BISACODYL TAB 5 MG 2.00 BISOPROL/ HCTZ TAB 5-6.25MG 4.53 BISOPROLOL TAB 5MG 5.41 BISOPROLOL/HCTZ TAB (10-6.25MG) NF 4.52 BITE BLOCK DISPOSABLE 6.30 BK VIRUS DNA PCR 87799 578.19 BLADDER IRRIGATION 51700 229.53 BLADDER IRRIGATION 51700 633.30 BLASTOMYCES AB 86612 31.00 BLD - LEUKO DEPLETED PRBC P9016 472.98 BLOOD ADMIN 0-2 HRS 36430 750.00 BLOOD ADMIN 2-4 HRS 36430 750.00 BLOOD ADMIN 4-6 HRS 36430 750.00 BLOOD ADMIN 6-8 HRS 36430 750.00 BLOOD ADMIN>8 HRS 36430 710.00 BLOOD COUNT, AU 85004 19.00 BLOOD CULTURE, AEROBIC 87040 63.00 BLOOD OCCULT, Q 82274 50.00 BLOOD SMEAR PER 85060 52.00 BLOOD SUGAR 82947 32.00 BLOOD TYPE: RH 86901 25.00 BLOOD TYPING, R 86901 31.80 BLOOD TYPING: ABO 86900 25.00 BLOOD TYPING:ABO 86900 105.04 BLOW BOTTLE/TRIFLOW 38.25 BMP-BASIC METABOLIC PANEL 80048 50.00 BNP-BETA NATRIURETIC PEPT 83880 125.00 BONE AGE STUDY 77072 250.96 BONE DENSITOMETRY 77080 380.00 BONE LIMITED 78300 884.00 BONE SPUR PAD 42.75 BONE TOMOGRAPHY 78320 1,386.00 BONE/JOINT IMAGING WHOLE BODY 78306 1,288.35 BONIVA INJ 1 MG J1740 300.00 BORDETELLA PARAPERTUSSIS 87798 200.00 BORDETELLA PERT.BY PCR 87798 66.50 BOTOX 100 UNIT VIAL INJ 1,390.28 BP 180 IGG AB 83516 162.20 BP 230 IGG AB 83516 162.20 BREAST LUMPECTOMY 19300 2,727.84 BUDESONIDE/FORMOTEROL MDI 80/4.5 MCG 717.00 BUMETANIDE INJ 0.25 MG/ML VL J3490 29.77 BUMETANIDE TAB 1 MG 4.36 BUN 84520 25.00 BUN (BLOOD UREA NITROGEN) 84520 25.00 BUPIVACAINE 0.25% INJ SOL. J2001 25.77 BUPIVACAINE 0.5% INJ SOL. 33.04 BUPIVACAINE 0.75% IN DEXTROSE 8.25% 28.34 BUPIVACAINE LIPOSOME 1.3% 20ML VL J3490 738.19 BUPROPION TAB 100 MG 4.24 BUPROPION TAB 75 MG 4.00 BUPROPION XL TAB 150 MG 15.66 BURN DEBRIDEMENT 16020 442.17 BURN DEPBRIDEMENT 16020 168.95 BUSPIRONE TAB 15 MG 8.08 BUSPIRONE TAB 5 MG 4.00 BUTALBITAL-ACET-CAFF 50-325-40 TAB NF 6.75 BUTTRESS SUPPORT INFERIOR 83.05 BX BREAST W/DEVICE 1ST LESION STEREO GUI 19081 3,054.00 BX BREAST W/DEVICE ADDL LESION STEREO GU 19082 2,337.00 BYSTOLIC 5MG 15.70 BYSTOLIC TAB 20 MG 15.70 C. DIFFICILE 87493 128.00 C.DIFF TOXIN GENE 87324 97.37 C.DIFF TOXIN GENE 87324 97.37 C02 CIRCUIT, CAPNOLINE H 47.85 C1 ESTERASE IN QUANT 86160 72.10 C1 ESTERASE INHIBITOR FUNC 83520 67.32 C3 86160 52.00 C3 NEF 86327 194.50 C4 86160 47.00 CA 125 86304 115.00 CA 15-3 86300 164.00 CA 19-9 86301 179.00 CA 27.29 86300 164.00 CADMIUM, URINE 82300 122.59 CALAMINE/ ZINC OX OIN 2.5 OZ TUBE 4.06 CALCITRIOL CAP 0.25MCG 5.12 CALCIUM 82310 34.00 CALCIUM & VIT D TAB 600 MG 2.00 CALCIUM CARB TAB 500 MG 2.00 CALCIUM CARBONATE SUSP 1250MG/5ML 4.00 CALCIUM CITRATE 250mg NF 2.00 CALCIUM CL 10% INJ 10 ML VL 47.00 CALCIUM GLUC 10% 10 ML VL J0610 20.00 CALCIUM RADOM URINE 82340 57.50 CALCIUM, 24 HR URINE 82340 47.00 CALCIUM, 24 HR URINE 82340 47.00 CALCIUM/MAG/ZINC TAB 2.00 CALPROTECTIN STOOL 83993 209.30 CAMPHOR-PHENOL 6.5 GM TUBE 19.12 CANALITH REPOSITIONING 95992 70.00 CANCIDAS INJ 50 MG VL J0637 789.98 CANDESARTAN-HCTZ 16/12.5 MG 18.88 CAPNOLINE SMART PLUS WITH O2 42.00 CAPTOPRIL TAB 12.5 MG 7.19 CARBAMAZEPINE SUSP 100 MG/5ML 4.00 CARBAMAZEPINE TAB 200 MG 6.73 CARBIDOPA/ LEVO ER TAB 50/200 MG 7.22 CARBIDOPA/ LEVO TAB 25/100 MG 4.00 CARBIDOPA/ LEVO TAB 25/250 MG 4.00 CARBIDOPA/LEVODOA 10/100MG TAB 4.00 CARBON MONOXIDE 82375 75.00 CARBON MONOXIDE 82375 75.00 CARDIAC CRP 86141 59.00 CARDIAC EXTENDED OUTPAIEN 99218 430.00 CARDIAC EXTENDED OUTPATIE 99218 295.00 CARDIAC PACING 92953 512.66 CARDIAC REHAB 93798 309.87 CARDIAC REHAB EVALUATION 93797 309.87 CARDIAC REHAB PHASE 3 93799 210.54 CARDIOLIPIN IGG 86147 131.00 CARDIOLIPIN ANTIBODY 86147 131.00 CARDIOLIPIN IGM 86147 131.00 CARDIOPULMONARY RESUSCITA 92950 630.00 CARDIZEM/DILTIAZEM 125MG/ 100.00 CARISOPODOL TAB 350 MG 4.00 CARNITINE 82379 252.41 CARPAL LOCK SPLINT 54.10 CARRINGTON GEL 51.80 CARVEDILOL CAP 80 MG 33.03 CARVEDILOL TAB 12.5 MG 8.54 CARVEDILOL TAB 3.125 MG 8.54 CARVEDILOL TAB 6.25 MG 8.54 CASH ORTHOSIS 297.95 CAST BOOT LG 26.90 CAST BOOT MED 26.90 CAST BOOT SMALL 26.90 CAST BOOT X-LG 26.90 CAST SHOE LG 26.90 CAST SHOE MED 26.90 CAST SHOE X-LG 26.90 CAST SHRT ARM SPLINT PED Q4024 10.00 CAST SUP LNG ARM SPLINT F Q4018 20.00 CAST SUP LNG ARM SPLINT P Q4017 15.00 CAST SUP LNG ARM SPLNT PE Q4020 10.00 CAST SUP LONG ARM ADULT F Q4006 35.00 CAST SUP SHT ARM ADULT FB Q4010 45.00 CAST SUP SHT ARM PED FBRG Q4012 10.00 CAST SUP SHT ARM PED PLAS Q4011 10.00 CAST SUP SHT ARM SPLINT F Q4022 15.00 CAST SUP SHT LEG FIBERGL Q4038 50.00 CAST SUP SHT LEG SPLNT FB Q4046 25.00 CAST SUPPLIES A4580 26.00 CASTING MATERIA A4590 84.00 CASTING, PLASTER 2INCH 18.00 CATECHOLAMINES 82384 242.00 CATECHOLAMINES 82384 242.00 CATECHOLAMINES, 24 HR. 82384 264.46 CATH (FOLEY TRAY) 34.75 CATH INTRODUCER 18G X 2 # 4.00 CATH KIT, INFANT & PEDS 6.70 CATH SET, SINGLE USE 6.55 CATH TRAY, 16 FRENCH CATH 26.65 CATH TRAY, 18 FRENCH CATH 26.10 CATHETER 18FR 5CC 12.45 CATHETER RED RUBBER 3.20 CBC HGB, HCT, WBC, AUTO DIFF 85025 45.00 CBC-HGB,HCT,WBC,AUTO DIFF 85025 45.00 CC HOLDING/TRANSFER/GT 90 99291 1,394.25 CEA 82378 115.00 CEA 82378 115.00 CEFAZOLIN 1 GM IM VL J0690 23.96 CEFAZOLIN INJ 1GM VL J0690 28.96 CEFDINIR SUS 250 MG/ 5 ML (60ML BTL) 316.00 CEFEPIME 1 GM VL 61.00 CEFEPIME INJ 1 GM VL J0692 37.10 CEFEPIME INJ 2 GM VL J0692 49.40 CEFOTETAN 1 GRAM INJ VARIABLE RATE S0074 77.69 CEFTAZIDIME INJ 1 GM VL J0713 33.50 CEFTAZIDIME INJ 2 GM VL J0713 53.00 CEFTRIAXONE IM 1 GM VL J0696 25.40 CEFTRIAXONE INJ 1 GM VL J0696 25.40 CEFTRIAXONE INJ 500 MG VL J0696 81.83 CEFTRIAXONE IVPB 1GM VL J0696 41.54 CEFUROXIME INJ 1.5 GM VL J0697 29.47 CEFUROXIME TAB 250 MG 16.99 CELECOXIB 200MG CAP 43.40 CELECOXIB CAP 100 MG 26.46 CELL COUNT MISC 89051 58.00 CENTRAL VENOUS CATH KIT-M 103.50 CENTROMERE AB. IGG 83516 84.39 CEPHALEXIN 125 MG/5ML SUSP (100 ML BTL) 32.00 CEPHALEXIN CAP 250 MG 4.00 CEPHALEXIN CAP 500 MG 5.39 CEPHALEXIN SUS 250 MG/5ML (100 ML BTL) 86.25 CERAVE OINTMENT NF 38.28 CEROVITE CITRUS LIQ 8 OZ 4.00 CERULOPLASMIN 82390 79.00 CERV SPINE, MIN 4 VWS 72050 431.00 CERVICAL COLLAR 12.20 CERVICAL COLLAR SOFT LRG 12.20 CERVICAL COLLAR SOFT MED 12.20 CERVICAL COLLAR SOFT SM 12.20 CERVICAL FLEX NONADJUSTABLE PREFAB L0120 75.89 CERVICAL ROLL 36.00 CERVICAL SPINE (5 VIEWS-O 72052 431.00 CERVICAL SPINE (AP-LAT) 72040 222.00 CETACAINE SPY 56 GM 10.86 CETIRIZINE TAB 10 MG 9.98 CH50 86162 175.25 CHANGE CYSTOMSTOMY TUBE SIMPLE 51705 215.83 CHARCOAL/ SORBITOL SUS 50 GM BTL 121.47 CHEMICAL CAUTER 17250 168.95 CHEMO INFUSION ADDTL HR 96415 110.64 CHEMO INFUSIONS 1ST HR 96413 898.59 CHEMO INJ/SUBCUTANEOUS IN 96401 195.40 CHEMO IV PUSH ADDTL DRUG 96411 226.74 CHEMO IV PUSH INITIAL 96409 516.54 CHEST (2 VIEWS) 71046 223.00 CHEST (PORTABLE) 71045 186.00 CHEST 3 VIEWS 71047 280.00 CHEST 4+ VIEWS 71048 320.00 CHEST BANDNET 19.65 CHEST CAT SCAN W CONTRAST 71260 1,879.00 CHEST CAT SCAN W/O CONTRA 71250 1,712.00 CHEST W/WO CONTRAST 71270 2,047.00 CHEST WITH OBLIQUE (3 VIEWS) 71047 280.00 CHLAMYDIA BD PROBE 87491 113.00 CHLAMYDIA CULTURE 87110 109.89 CHLAMYDIA TRACH 87491 113.00 CHLAMYDOPHILIA PNEUMONIAL 87486 91.80 CHLORDIAZEPOXIDE 10MG CAP 6.40 CHLORDIAZEPOXIDE 25MG (LIBRIUM) 4.00 CHLORDIAZEPOXIDE 5MG CAP 4.00 CHLORDIAZEPOXIDE-CLID 5/2.5 CAP 15.43 CHLORIDE 82435 19.41 CHLORPHENIRAMINE ER CAP 12 mg 4.00 CHLORPROMAZINE INJ 25 MG VL J3230 89.16 CHLORTHALIDONE TAB 25 MG 4.83 CHOLANGIOGRAM CATH LAP-13 158.00 CHOLANGIOGRAM CATHETER 143.45 CHOLANGIOGRAPHY (X-RAY BILE DUCTS/PANC) 74300 230.00 CHOLESTEROL 82465 17.52 CHOLESTEROL TOTAL 82465 18.00 CHOLESTYRAMINE 4 GM PACKET-BOX 153.75 CHOLESTYRAMINE PKT 4 GM 13.48 CHO-PAT KNEE STRAP ALL S 57.00 CHROMOGRANIN A 86316 225.00 CHRONIC CARE MNGT 20 MIN 99490 71.94 CHST TUBE THORC CATH 32FR 15.75 CILOSTAZOL 100mg TAB NF 7.30 CILOSTAZOL ORAL TAB 50mg 13.30 CIPROFLOXACIN 0.3% DRP 5ML BTL 13.60 CIPROFLOXACIN TAB 500 MG 15.30 CIPROFLOXACIN/ DEX DRP 472.19 CIPROFLOXACIN/D5W 400 mg PREMIX (200 ML) J0744 78.20 CIRCUMCISION SETUP & SUPP 52.50 CITALOPRAM TAB 20 MG 10.77 CITRATE, 24 HR URINE 82507 297.00 CITRIC ACID RANDOM URINE 82507 79.14 CITRUCEL 33.66 CK/MB 82553 48.00 CLARITHROMYCIN TAB 500 MG 15.03 CLAVICLE BRACE 17.40 CLAVICLE, LEFT 73000 192.00 CLAVICLE, RIGHT 73000 192.00 CLH DRUG TESTS 80305 66.00 CLINDAMYCIN CAP 150 MG 4.00 CLINDAMYCIN INJ 300MG J3490 31.12 CLINDAMYCIN INJ 900MG/6ML VL J3490 32.60 CLINIC LVL 1 NEW PT G0463 150.00 CLIP RESOLUTION 360 383.25 CLN (VFC) TUBERCULIN PURIFIED 86580 17.47 CLN ASSAY OF SEX HORMONE BINDING GLOBULI 84270 126.40 CLN DIPTH PERTUSSIS (DTAP) 90700 33.82 CLN DTAP-HEP B-IPV VACCINE IM 90723 87.84 CLN DTAP-IP-HI 90698 106.60 CLN DTAP-IPV 90696 57.24 CLN HAEMOPHYL (HIB) 90648 66.88 CLN HEPATITIS A 90633 37.44 CLN HPV 9 90651 244.90 CLN IADNA CYTOMEGALOVIRUS QUANTIFICATION 87497 435.25 CLN MEASLES/MUMPS 90707 82.40 CLN MENINGOCOCCAL 90734 198.00 CLN MMR VARICELLA 90710 239.29 CLN PNEUMOCOCCAL 13 90670 215.16 CLN PNEUMOCOCCAL 23 90732 113.41 CLN ROTAVIRUS VA 90680 98.57 CLN TDAP (BOOSTRIX) DIPTH/PERTU 90715 43.38 CLN TETANUS DIPH 90714 39.21 CLN TUBERCULIN PURIFIED 86580 42.14 CLN VARICELLA VI 90716 145.52 CLOBETASOL 0.05% CREAM 30gm NF 512.52 CLONAZEPAM TAB 0.5 MG 6.72 CLONIDINE TAB 0.1 MG 4.00 CLOPIDOGREL TAB 75 MG 20.44 CLORAZEPATE 7.5MG TAB 12.40 CLOSED METACARP 26600 581.00 CLOSED METATARS 28470 610.00 CLOSED PHALANGE 26720 444.00 CLOSED SHLDR DISL W MANIP 23650 774.00 CLOSED TREAT CA 25630 736.00 CLOSED TREAT DI 26755 575.00 CLOSED TREAT DI 25600 726.00 CLOSED TREAT DI 27786 773.00 CLOSED TREAT IP 26770 733.00 CLOSED TREAT ME 26700 590.00 CLOSED TREAT RA 24640 296.00 CLOSED TREAT SH 23650 839.00 CLOSED TREAT SH 23655 1,349.94 CLOSED TREAT UL 25530 673.00 CLOSED TREAT UL 25535 1,214.00 CLOSED TREAT.TALUS FX 28430 421.62 CLOSED TREATMEN 28510 335.00 CLOSED TREATMEN 28490 359.00 CLOSED TREATMEN 24500 787.00 CLOSED TREATMEN 25560 839.00 CLOSED TREATMEN 27840 1,017.00 CLOSED TREATMEN 25565 1,349.94 CLOSED TREATMEN 25565 1,593.00 CLOSED TX PHALANGEAL FX 26742 1,349.94 CLOSED TX PHALANGEAL FX 26742 1,349.94 CLOSED TX RADIAL/ULNAR FX 25565 1,472.00 CLOTEST 87449 54.00 CLOTRIMAZOLE TOP SOL 1%NF 30 ML BTL 149.46 CLOTRIMAZOLE/BETAM 0.5% CRM 15 ML TUBE 60.69 CLOTRIMAZOLE/BETAMETHASON CRM TOP 45 GRM 217.82 CLOZAPINE LEVEL 80159 140.00 CLSD TR CALC FX W/O MANIP 28400 611.78 CMP 80053 63.00 CMV ANTIBODY 86644 106.00 CMV IGG 86644 53.03 CMV IGM 86645 53.03 CMV PCR QUANT 87497 435.25 CO Q10 SOFTGEL 100MG NF 2.00 CO2 - CARBON DIOXIDE 82374 14.00 CO2- CARBON DIOXIDE 82374 14.00 COBAN DRESSING PER ROLL ( 6.40 COCCIDIOIDES AB 86635 74.97 COCK-UP WRIST SPLINT LS 61.30 COCKUP WRIST SPLNT L LG 61.30 COCKUP WRIST SPLNT L MED 61.30 COCKUP WRIST SPLNT L X-LG 61.30 COCKUP WRIST SPLNT R LG 61.30 COCKUP WRIST SPLNT R MED 61.30 COCKUP WRIST SPLNT R SM 61.30 COCKUP WRIST SPLNT R XL 61.30 COGENTIN 1MG TABS 4.00 COGENTIN 2MG (ORAL) 4.00 COGNITIVE AND COMPENSATORY ACTIVITY 1:1 97127 76.56 COGNITIVE PERFORMANCE TES 96125 323.35 COLCHICINE TAB 0.6 MG 4.00 COLD AGGLUTININS 86157 58.70 COLESTIPOL 5.05 COLLAGEN X-LINKED NTP 82523 149.75 COLLAGENASE OIN 30GM 442.37 COLLAR (PHILADELPHIA)MED 38.55 COLLAR MINI ADJUSTABLE 39.50 COLLAR PERFIT ACE ADJUSTA 33.60 COLLAR(PHILADELPHIA)SM 38.55 COLLECTION PAP Q0091 50.00 COLLECTION/HAND 99000 29.00 COLLES SPLINT (ALL SIZES) 36.65 COLON INJ INDIA INK 45381 1,971.96 COLONOSCOPY 45378 1,971.96 COLONOSCOPY FLEX WITH CONTROL BLEEDING 45382 2,117.00 COLONOSCOPY FLEXIBLE WITH BAND LIGATION 45398 2,185.03 COLONOSCOPY W/BIOPSY & PO 45385 2,042.07 COLONOSCOPY WITH BIOPSY 45380 2,002.06 COLONOSCOPY WITH POLYP RE 45385 2,011.86 COLONOSCOPY, FLEXIBLE WITH HOT BIOPSY 45384 2,720.03 COLOSTOMY FLANGE 9.95 COLOSTOMY POUCH 5.60 COMFEEL DRESSING 4 X 4 18.00 COMFEEL PASTE 49.70 COMPLEMENT, ANT 86160 52.00 COMPREHENSIVE ENTERIC PATHOGEN PANEL 87507 220.00 COMPREHENSIVE ENTERIC PATHOGEN PANEL 87507 220.00 COMPREHENSIVE M 80053 63.00 CONTACTIN-ASSOC PROTEIN-LIKE-2 IgG 86255 250.00 CONTINUOUS PASSIVE MOTION 33.85 CONTRAST BATHS-OT 97034 47.27 CONTROL NASAL HEMORRH ANT 30903 407.00 CONTROL NASAL HEMORRHAGE 30901 262.00 CONTROL NOSE BLEED 30901 328.93 CONTROL OF NOSEBLEED 30905 288.00 CONTROL OF NOSEBLEED 30905 576.00 CONVATEC STOMAHESIVE PAST 37.60 COPPER 82525 84.00 CORRECTION HAMMERTOE 28285 3,869.00 CORSAN PROBE 114.40 CORTISOL 82533 84.00 CORTISOL, SALIVA 82533 240.00 CORTROSYN 0.25 MG VL 314.16 C-PEPTIDE 84681 104.00 CPR MICROSHIELD 17.45 CRANBERRY TAB 500 MG 4.00 C-REACTIVE PROT 86140 53.00 C-REACTIVE PROT 86141 59.00 C-REACTIVE PROTEIN 86140 58.00 CREATINE KINASE(CK) 82550 35.00 CREATININE 82565 34.00 CREATININE 82565 34.00 CREATININE CLEA 82575 67.00 CREATININE CLEARANCE 82575 67.00 CREATININE, RANDOM URINE 82570 29.50 CREATININE,24HR.URINE 82570 29.50 CREON 34000 CAP NF 20.90 CREON CAP 12,000 UNIT 14.06 CRICO SET 55.15 CRITICAL CARE, FIRST HOUR 99291 733.63 CRITICAL CARE,ADD 1/2 HR 99292 311.68 CRNA FLUOROSCOPIC NEEDLE GUIDANCE 77002 150.00 CRNA LUMBAR OR SACRAL, SINGLE LEVEL 64483 800.00 CRNA MAJOR JOINT INJECTION 20610 80.00 CROSSMATCH: ALB 86921 129.18 CROSSMATCH:AHS 86922 129.18 CROSSMATCH:IS 86920 129.18 CRP 86140 53.00 CRUTCHES YOUTH 50.40 CRUTCHES, ADULT 58.45 CRUTCHES, TALL 58.45 CRYOFIBRINOGEN 89.07 CRYOGLOBULINS 82595 23.00 CRYOSURGERY, PE 54056 418.00 CRYPTOSPORIDIA 87328 68.72 CRYTO AG, STOOL 87328 68.73 C-SPINE CAT SCAN 72125 1,712.00 CT ABD & PELVIS WO 74176 3,424.00 CT ABD&PELV WCONTRAST 74177 3,758.00 CT ADB/PELVIS CT WO/W 74178 3,964.00 CT LOWER EXTREMIY W & W/O CONTRAST 73702 1,771.00 CT MAXILLOFACIAL W/O & W/CONTRAST 70488 1,873.66 CT TEMPORAL ORBIT, SELLA W/O CONTRAST 70480 1,114.25 CT TEMPORAL, ORBIT, SELLA WITH CONTRAST 70481 1,703.78 CTA ABDOMEN 74175 2,047.00 CTA ANGIO ADB&PELV 74174 3,964.00 CTA CHEST W/CONTRAST/NONCONTRAST 71275 2,315.00 CTA HEAD W/CONTRAST W/NO CONTRAST 70496 2,220.19 CTX-COLLAGEN TYPE 1 82523 147.75 CULTURE ANAEROBE IDENT EACH 87076 34.73 CULTURE BACT, STOOL SINGLE PATHOGEN 87046 54.38 CULTURE SCREEN ONLY 87081 22.00 CULTURE SPECIME 87070 60.00 CULTURE SPECIME 87075 72.00 CULTURE TYPING, 87147 19.00 CULTURE:OTHER BACTERIAL 87070 44.25 CULTURE:RESPIRATORY BACT 87070 29.00 CULTURE-BLOOD 87040 63.00 CULTURE-URINE 87086 57.00 CURRETTE ENDOMETRIAL 3.1mm 17.68 CUTURE BACTERIA 87077 55.00 CYANOCOBALAMIN( 82607 102.00 CYCLIC CITRULLINATED PEPT 86200 139.00 CYCLIC CITRULLINATED PEPTIDE ANTIBODY 86200 139.00 CYCLOBENZAPRINE TAB 10 MG 4.00 CYCLOGEL EYE DROP 1% 5 ML BTL 114.86 CYCLOSPORINE 80158 165.40 CYCLOSPORINE DRP (BOX OF 30) 308.84 CYCLOSPORINE MODIFIED 100mg CAP NF J7502 16.49 CYMBALTA CAP 60 MG 28.76 CYST POST NECK U/S 76881 403.71 CYSTOURETHROSCOPY 52000 1,800.00 CYTOMEGALOVIRUS IGG 86644 53.00 CYTOMEGALOVIRUS IGM 86645 53.00 CYTOPATH CELL ENHANCE 88112 135.52 DABIGATRAN 150MG CAP 24.03 DAIGNOSTIC MAMMO DIGTL BILATERAL IMAGING 77066 333.00 DALIRESP TAB 500 MCG 30.95 DALTEPARIN SOD PORC INJ 5000 UNT SR J1645 117.85 DANTRIUM CAP 50 MG 6.92 DANTROLENE (DANTRIUM) 20M 209.00 DANTROLENE 25MG CAP 7.76 DANTROLENE INJ 20 MG VL 264.65 DAPTOMYCIN INJ 500 MG VL J0878 1.45 DARBEPOETIN ALFA 40mcg/ML VL J0881 20.26 D-DIMER 85379 60.00 D-DIMER 85379 60.00 DEB SUBQ TISSUE 20 SQ CM/ 11042 310.80 DEBRIDE SKIN,PARTIAL 16020 168.95 DECADRON ELIX .5MG/ML 4.00 DECALCIFICATION PROCEDURE 88311 56.21 DECLOT VASCULAR DEVICE 36593 487.34 DENOSUMAB INJ (120mg) VL 4,932.79 DEPACON INJ 500 MG VL 107.54 DEPAKENE 80164 84.00 DEPO-PROVERA 1 MG J1050 0.54 DEPRO-PROVERA 1 J1050 81.00 DERMABOND ADVANCED PEN 63.15 DESTRUCT BENIGN 17000 168.95 DESTRUCT LESION 15 OR MOR 17111 246.00 DESTRUCT MALIGLES FACE/EA 17280 249.80 DESTRUCTION 2\1 17003 56.00 DETECT AGNT MULT DNA AMPL 87801 226.00 DEVELOPMENT OF COGNITIVE SKILLS EA. 15 M G0515 76.56 DEVELOPMENTAL SCREEN 96110 21.60 DEVELOPMENTAL TEST EXTEND 96111 352.26 DEXA BONE 77081 295.38 DEXAMETHASONE INJ 10 MG VL J1100 20.00 DEXAMETHASONE INJ 4 MG/vl (1ml/VL) J1100 27.92 dexamethasone MDV 20mg/5mL inj VL J1100 35.84 DEXAMETHASONE TAB 4 MG J8540 4.82 DEXLANSOPRAZOLE 30MG CAP 32.91 DEXLANSOPRAZOLE 60MG CAP 32.91 DEXTRAN 6% 500CC 70.00 DEXTROSE 10% 1000ML BAG 65.00 DEXTROSE 40% GEL 15.80 DEXTROSE 5%(.500ML) IVF NF 60.00 DEXTROSE 50% INJ 25 GM/50ML SYR J3490 44.03 DHEA-S 82627 94.00 DIABETES SELF MANAGE.-GRO G0109 30.00 DIABETES SELF MANAGEMENT G0108 58.00 DIAGNOSTIC MAMMO BILATERAL 77066 262.00 DIAGNOSTIC MAMMOGRAPHY - UNILATERAL 77065 131.00 DIAL-A-FLO REGULATOR 19.20 DIAZEPAM INJ 10 MG/2ML VL J3360 95.64 DIAZEPAM IV or IM 50mg/ml 51.89 DIAZEPAM TAB 5 MG 6.32 DICLOXACILLIN CAP 250 MG 4.00 DICLOXACILLIN CAP 500 MG 4.00 DICYCLOMINE CAP 10 MG 4.00 DICYCLOMINE INJ 20 MG/2ML VL J0500 130.58 DICYCLOMINE SYRP 10MG/5ML 6.01 DIETARY CONSULT 1 HOUR 97802 124.00 DIETARY CONSULT 1/2 HOUR 97802 62.00 DIETARY CONSULT 15 MIN 97802 31.00 DIFFERENTIAL (MANUAL) 85007 31.00 DIFFERENTIAL WB 85007 31.00 DIGIFLEX EXERCISER 43.90 DIGITAL BREAST TOMOSYNTHESIS BILATERAL 77062 50.00 DIGITAL BREAST TOMOSYNTHESIS UNILATERAL 77061 50.00 DIGOXIN 80162 80.00 DIGOXIN 100mcg/1ml inj. 253.37 DIGOXIN IVP (0.5MG AMP) (2ml/AMP) J1160 38.69 DIGOXIN SOL 0.05MG/ML 11.20 DIGOXIN TAB 0.125 MG 6.74 DIGOXIN TAB 0.25 MG 6.74 DILANTIN 250MG/5CC IM/IV 40.00 DILANTIN EXTENDED TAB 100 MG 5.93 DILANTIN LEVEL 80185 80.00 DILANTIN TAB 30 MG 5.11 DILANTIN XL CAP 30MG 5.11 DILTIAZEM TAB 60 MG 6.27 DILTIAZEM 125/25 ML INJ VL 47.82 DILTIAZEM CD CAP 180 MG 6.06 DILTIAZEM CD CAP 240 MG 8.20 DILTIAZEM ER CAP 120 MG 4.00 DILTIAZEM INJ 50 MG/10 ML VL 20.00 DILTIAZEM IVP VARIABLE DOSE/25MG 15ML J3490 33.08 DILTIAZEM TAB 30 MG 4.00 DIMETAPP LIQ 5 ML 2.00 DIPHENHYDRAMINE CAP 25 MG 4.00 DIPHENHYDRAMINE ELIX 12.5MG/5ML 2.00 DIPHENHYDRAMINE INJ 50 MG VL J1200 29.90 DIPHENOXY/ ATR TAB 2.5MG 6.88 DIPROPYLACETIC 80164 84.00 DIPYRIDAMOLE/ ASA CAP 200/25 MG 31.33 DIRECT COOMBS 86880 31.80 DIRECT LDL 83721 57.00 DIRECT LDL 83721 57.00 DISPOSABLE GRASPER 242.55 DISPOSABLE TROCAR 10/11 M 200.00 DISPOSABLE TROCAR 5MM 174.10 DISSECTORS BLUNT TIP 5MM 74.00 DITROPAN ER TAB 10 MG 13.17 DIVALPR/ VALPROIC ACID 250 MG CAP 16.75 DIVALPR/ VALPROIC ACID CA 8.63 DIVALPROEX E.R. 500MG TAB 4.00 DIVALPROEX TAB 250 MG 9.82 DOCUSATE CAP 100 MG 4.00 DONEPEZIL TAB 10 MG 23.29 Donepezil tab 5 mg 4.00 DONNATAL/ XYL/ MALX SUS 10.00 DONNATAL/ XYL/ MALX SUS 19.16 DOOR PULLEY 60.00 DOPAMINE/D5W PREMIX 400MG/250ML J1265 114.39 DOPPLER COLOR FLOW ADD-ON 93325 260.00 DOPPLER ECHO EXAM,HEART 93320 266.00 DORIBAX INJ 500MG VL J1267 125.79 DORZOLAMIDE/TIMOLOL EYE GTT 10ML BTL 220.68 DOT DRUG SCREEN 92.00 DOXAZOSIN 2MG TAB 4.50 DOXAZOSIN TAB 4 MG 15.78 DOXEPIN 10 mg CAP NF 4.00 DOXEPIN 25MG CAP 4.00 DOXEPIN LEVEL 80166 91.00 DOXYCYCLINE TAB 100 MG 9.48 DRAIN ABSCESS/L 41800 461.00 DRAIN FLAT 19.35 DRAIN ROUND 15FR 26.25 DRAIN ROUND 19FR 26.25 DRAINAGE OF HEMATOMA/FLUI 10140 2,533.65 DRAINAGE OF SKIN ABCESS 10060 246.37 DRAINAGE OF SKIN ABCESS 10060 478.98 DRAINAGE OF SKIN ABSCESS 10061 502.00 DRESS/DEBRIDE 2ND DEGREE 16020 168.95 DRESSING ACTICOAT 4X4 BURN 25.80 DRESSING KNEE/FOOT/ELBOW 12.25 DRESSING PRIMAPORE 4.40 DRESSING SILVER ALGINATE 30.95 DRESSING SORBIAN 4X4 BORDER 33.10 DRESSING, ALLEVYN 4X4 22.43 DRISDOL CAP 50,000 UNITS 9.18 DRUG ABUSE 2590 80307 85.00 DRUG OF ABUSE 80305 66.00 DRUG SCREEN QUAN LAMOTRIGINE 80175 67.91 DRUGS OF ABUSE 80305 66.00 DRUGS OF ABUSE 52 80307 131.00 DRVV TIME 85613 93.00 DRY NEEDLING 97799 15.00 DULERA MDI 100/5MCG 777.24 DULOXETINE CAP 20MG 25.63 DULOXETINE HCL 30 MG 7.68 DUPLEX CAROTID 93880 846.00 DUPLEX SCAN ART/ARTL BPGS COMPLETE 93925 521.00 DURICEF 250MG/5ML 50ML BO 69.00 DUTASTERIDE CAP 0.5 MG 18.15 EAR IRRIGATION 21.00 EAR TRAY 15.75 EBV EARLY IGG AB 86663 77.09 EBV IGG OR IGM 86665 110.00 EBV IGG OR IGM 86665 110.00 EBV NUCLEAR Ag Ab IgG 86664 81.23 ECHO 93307 1,207.17 ECHO TTHRC RT 2D - BUBBLE ECHO 93306 1,010.00 ECHO TTHRC R-T 2D W/WO MODE COMPLETE 93350 1,150.00 EDEMA GLOVE 19.00 EFFEXOR 150MG TAB 18.00 EFFEXOR ER CAP 75 MG 18.66 EFFEXOR XR CAP 150 MG 15.25 EGD 43235 1,873.22 EGD WITH BIOPSY AND CLOTE 43239 1,904.21 EGD WITH BIOPSY AND ESPH 43235 2,189.29 EGD WITH BIOPSY OR CLOTES 43239 1,904.21 EGD WITH BIOPSY,DILATATIO 43235 2,189.29 EGD WITH ESOPHAGEAL DILAT 43245 2,658.53 EKG 93005 200.00 EKG-MDCR PX G0404 200.00 ELASE OINTMENT 10GM TUBE 33.00 ELASTIC KNEE CAP 20.00 ELASTOPLAST 20.75 ELBOW, LEFT (2 VIEWS) 73070 172.05 ELBOW, LEFT (3 VIEWS) 73080 201.00 ELBOW, LEFT (4 VIEWS) 73080 201.00 ELBOW, RIGHT (2VIEWS) 73070 172.05 ELBOW, RIGHT (3 VIEWS) 73080 201.00 ELBOW, RIGHT (4 VIEWS) 73080 201.00 ELECTOLYTE PANE 80051 52.00 ELECTRIC STIM-OT 97014 42.40 ELECTRIC STIMULATION (T18 G0281 42.40 ELECTRIC STIMULATION-OT G0283 42.40 ELECTRIC STIMULATION-PT G0283 42.40 ELECTRICAL STIM MANUAL-OT 97032 49.00 ELECTRICAL STIM MANUAL-PT 97032 49.00 ELECTRICAL STIMULATION-PT 97014 42.40 ELECTROCAUTERY 17110 168.95 ELECTROCAUTERY 17110 168.95 ELECTROLYTES 80051 52.00 ELECTROPHORESIS, 24 HR UA 84166 50.00 ELECTROPHORESIS, 24 HR UA 84166 84.00 ELIGARD INJ 45 MG BX J9217 5,642.48 EMERGENCY DEPT 99281 95.00 EMERGENCY DEPT 99283 219.10 EMERGENCY DEPT 99284 355.53 EMERGENCY DEPT 99285 520.85 EMLA XYLOCAINE CREAM 2.5% TOP 6.43 EMOLLIENT/ SKIN CLEANSER 15.10 E-MYCIN SULFISOXAZALE SUS 39.00 ENA AB-ANTI-RNP 86235 86.00 ENA AB-ANTI-SM 86235 86.00 ENABLEX TAB 7.5MG 45.73 ENALAPRIL 10MG TAB NF 7.78 ENALAPRIL TAB 5 MG 6.18 ENALAPRILAT INJ 2.5MG/2ML VL 26.06 ENDOMYSIAL ABS 86255 85.00 ENDOTRACHEAL IN 31500 226.00 ENDOTRACHEAL TUBE (NON-CU 6.00 ENOXAPARIN INJ 100 MG/ML (3 ML MD VL) J1650 28.45 ENOXAPARIN INJ 100MG/ML SYR J1650 79.64 ENOXAPARIN INJ 30mg / 0.3ml 79.70 ENOXAPARIN INJ 40MG/0.4ML J1650 79.55 ENTEROSTOMY CLINIC FEE 99211 253.00 ENTEROSTOMY CLINIC FEE EA 99211 157.08 ENTEROVIRUS RNA,PCR 87498 439.97 ENTRAINMENT NEBULIZER 7.00 EOSINOPHIL SMEAR 89190 28.25 EPHEDRINE INJ 50 MG/ML AM 141.38 EPINEPHrine 1:10 000INJ (1MG/10 ML) SYG J0171 38.00 EPINEPHRINE 1:1000 INJ 1MG/ML VL J0171 20.00 EPINEPHRINE 1mg/ml SPINAL INJ 63.75 EPOETIN ALFA INJ (PER 100 J0885 29.26 EPOETIN ALFA INJ (PER 100 J0885 606.46 EPOGEN INJ (PER 1000 UNIT J0885 23.70 ER AZITHROMYCIN 250mg tab qty 2 44.34 ER PREDNISOLONE 15mg/5ml SOLUTION 30ml 43.34 ER DEPT VISIT, BRIEF 99282 124.65 ER DEPT VISIT, COMPREHNSV 99285 520.85 ER DEPT VISIT, EXTENDED 99284 355.53 ER DEPT VISIT, INTERMED 99283 219.10 ER DEPT VISIT, MINIMAL 99281 86.00 ER TRAMADOL 50mg TAB QTY 6 40.80 ER-CLASS 1 99281 155.31 ER-CLASS 2 99282 281.59 ER-CLASS 3 99283 495.30 ER-CLASS 4 99284 833.37 ER-CLASS 5 99285 1,230.05 ER-CLASS 6 99291 1,640.12 ERTAPENEM INJ 1 GM VL J1335 375.10 ERY-PED 200MG/5ML SUSPENS 16.00 ERY-TAB 333MG OR E-MYCIN 4.00 ERYTHRO/ SULF SUS 200-60O MG/5ML 45.51 ERYTHROCIN 1GM VIAL 25.00 ERYTHROMYCIN EYE OIN ** 3.08 ERYTHROMYCIN INJ 500 MG VL J1364 225.35 ERYTHROPOIETIN 82668 167.75 ESCITALOPRAM TAB 10 MG 17.28 ESMOLOL INJ 100MG/10ML VL 41.88 ESOMEPRAZOLE CAP 20 MG 28.41 ESOMEPRAZOLE CAP 40 MG 25.54 ESOMEPRAZOLE INJ 40 MG VL J3490 158.00 ESOPHOGRAM 74220 416.00 EST VISIT ASS.LIVING FAC 99335 151.00 EST VISIT ASSISTED LIVING FACILITY 99334 130.00 ESTRADIOL 82670 191.00 ESTRADIOL .5MG TAB 4.00 ESTRODERM 0.1 MG. PATCH 11.35 ESTROGEN 82672 166.00 ESTROGEN CONJ TAB 0.3 MG 19.28 ESTRONE 82679 129.09 ETHYL CHLORIDE 174.40 ETODALAC 400MG TAB 5.87 ETODOLAC (LODINE) 400MG 5.88 ETOMIDATE INJ 20MG/10ML VL 49.43 EVAC SUBUNGUAL HEMATOMA 11740 105.04 EVAC WOUND DRAIN SIL, KIT 15.95 EVAC/SUBUNGUAL HEMATOMA 11740 130.75 EVACUATION OF S 11740 105.00 EVAL OF SPEECH PRODUCTION 92522 264.35 EVALUATE SWALLOWING FUNC 92610 181.00 EVALUATE USE OF INHAL.NEB 94664 186.38 EVALUATION OF SPEECH FLUENCY 92521 324.32 EVENT MONITOR HOOK-UP 93270 198.75 EX BLES S/N/EX G2.1-3.0CM 11423 1,348.03 EX FOR NONSPEECH DEV.RX ADD 92618 95.35 EX FOR NONSPEECH DEVICE RX 92605 256.89 EX FOR SPEECH DEVICE RX 1 HR. 92607 364.97 EX.FOR SPEECH DEVICE RX.ADDL 92608 150.12 EXALON CAP 3 MG 16.97 EXAM, SYNOVIAL 89060 57.00 EXC BENIGN LESI 11400 572.85 EXC BENIGN LESI 11421 572.85 EXC BENIGN LESI 11440 572.85 EXC BENIGN LESI 11441 572.85 EXC BENIGN LESION 1.1-2.0 11442 572.85 EXC BENIGN LESION 2.1 TO 3.0 CM 11443 450.00 EXC H-F-NK-SP B9+MARG 1.1 11422 1,348.03 EXC MALIG LES FACE 2.1-3. 11643 1,348.03 EXC MALIG LESIO 11602 481.00 EXC MALIG LESIO 11600 572.85 EXC MALIG LESIO 11601 572.85 EXC MALIG LESIO 11622 572.85 EXC MALIG LESIO 11640 572.85 EXC MALIG LESIO 11603 598.00 EXC MALIG LESIO 11641 664.00 EXC MALIG LESIO 11604 792.00 EXC MALIG LESIO 11642 836.00 EXC MALIG LESIO 11620 1,348.03 EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW 5> 24073 4,037.35 EXC, TUMOR, SFT TISSUE NECK & CHEST 3cm> 21552 3,400.00 EXC. BENIGN LESION > 4.0 11406 1,348.03 EXC.MALIG LESION TRNK>4.0 11606 1,348.03 EXCISION B9 LESION MARGIN >4 CM 11426 3,048.00 EXCISION BENIGN 11401 310.80 EXCISION BENIGN 11403 572.85 EXCISION BENIGN 11404 1,348.03 EXCISION BENIGN 11420 1,348.03 EXCISION HYDROCELE UNILATERAL 55040 5,651.90 EXCISION LESION 11402 572.85 EXCISION TUMOR FACE/SCALP OVER 2 CM 21013 1,700.00 EXCISION(SKIN T 11200 179.00 Excision, tumor, back greater than 3 cm 21931 1,348.03 EXCISSION TUMOR FACE/SCALP LESS THAN 2CM 21011 1,500.00 EXELON PATCH TOP 4.6 MG 51.77 EXELON PATCH TOP 9.5 MG 51.77 EXPOSURE PANEL 114.00 EXTENDED OP CARE (EACH AD 99218 267.76 EXTRACTOR KATZ FOREIGN BODY 133.95 EXTREME/TRUNK, EX. HAND 95831 40.86 EZETIMIBE TAB 10 MG 41.40 FACIAL BONES (2 VIEWS) 70140 188.00 FACIAL BONES (4 VIEWS) 70150 301.00 FACIAL BONES (5 VIEWS) 70150 150.00 FACTOR 5 LEIDEN MUT ANAL 81241 476.00 FACTOR 5 LEIDEN MUT ANAL 81241 476.00 FACTOR 8 85240 224.05 FACTOR 8 ASSAY 85240 232.22 FACTOR 8 ASSAY 85240 232.22 FACTOR H 86160 96.25 FAMILY PSYCHOTHERAPY W/ PATIENT PRESENT 90847 375.00 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 90846 375.00 FAMOTIDINE TAB 20 MG 6.96 FARXIGA 5mg TAB NF 55.75 FATTY ACID PROFILE 82726 79.84 FBS 82947 32.00 FECAL BLOOD SCRN IA G0328 39.00 FECAL FAT QUANTITATIVE 82710 113.92 FECAL LEUKOCYTES 89055 111.40 FECAL REDUCING SUBSTANCE 84376 91.40 FEEDING TUBE (ARGYLE) 2.45 FELBAMATE 82542 120.00 FELDENE 20MG TAB (PIROXIC 10.04 FELODIPINE TAB 5 MG 4.96 FEMALE CATH KIT 7.25 FENOFIBRATE 200 mg CAP 12.60 FENOFIBRATE B 4 MG CAP 7.80 FENOFIBRATE TAB 160MG 9.51 FENTANYL INJ PER 0.1MG (1ml/VL) J3010 20.96 FENTANYL PAT (12MCG/HLR) 66.91 FENTANYL PAT (25 MCG/HR) 69.80 FENTANYL PAT (75 MCG/HR) 183.92 FENTANYL PATCH TOP 50MCG 122.65 FENWAL Y-TYPE SET 16.65 FERAHEME INJ 510MGVL/17ML Q0138 1,968.24 FERREX FORTE CAP (150 MG) 4.00 FERREX TAB 150 MG 4.00 FERRIC CARBOXYMALTOSE 2,309.80 FERRITIN 82728 85.00 FERROUS SULF LIQ 220 MG/5ML (BTL) 4.00 FERROUS SULF TAB 325 MG 4.00 FERROUS SULFATE 65MG TAB 4.00 FETAL NON-STRESS TEST 59025 337.83 FEXOFENADINE TAB 60 MG 5.59 FEXOFENADINE TAB (180 MG) 9.68 FIBERCON TAB 4.00 FIBRINOGEN 85384 76.75 FIBRINOGEN 85384 76.75 FILGRASTIM INJ 300 MCG/1 ML SYR 737.82 FILGRASTIM INJ 480MCG/0.8 ML SYR 1,231.67 FILLOPE RINGS, PAIR-STERI 63.95 FILTERED EXTENSION SET 17.00 FINASTERIDE TAB 5 MG 12.61 FINGER DISLOCATION TREAT 26775 926.71 FINGER STICK BLOOD SUGAR 82962 20.00 FINGER, LEFT MIN 2 VIEWS 73140 172.05 FINGER, RIGHT MIN 2 VIEWS 73140 172.05 FINGERKNUCKLE BENDER SPLI 42.85 FIRST DEGREE BURN 16000 168.95 FIRST DEGREE BURN 16000 168.95 FLAGYL 375 MG TAB (METRON 8.20 FLAT WART DESTR 17110 209.00 FLAVOXATE TAB 100 MG 5.85 FLECANIDE 100MG TAB 10.92 FLEET PHOS SOL ENEMA 14.36 FLEX SIG w/ POLYP REMOVAL 45338 2,037.55 FLEXIBLE SIGMOIDOSCPY 45330 1,383.00 FLEXIFLOW PUMP/DAY 14.10 FLEXION EXTENSION KNEE 291.45 FLEXITAINER 17.75 FLORAJEN 3 460MG CAP 4.00 FLOURESCENT NON 86255 85.00 FLOW CYTOMETRY, ADDIT.MAR 88185 41.50 FLOW CYTOMETRY, INTERP 88189 41.50 FLOW CYTOMETRY,1ST MARKER 88184 215.43 FLU VACCINE 90686 55.00 FLU VACCINE 6-35MO 90685 55.00 FLU VACCINE HIGH DOSE 90662 62.00 FLUCONAZOLE 100MG IN 50ML 0.9% NACL 60.00 FLUCONAZOLE 100MG TAB NF 26.26 Fluconazole 150mg tablet 42.03 FLUCONAZOLE 200MG/100ML IV J1450 97.38 FLUCONAZOLE INJ 400 MG/200 ML NACL J1450 76.80 FLUCONAZOLE TAB 200 MG 42.97 FLUDROCORT AC TAB 0.1 MG 6.39 FLUMAZENIL INJ 0.1 MG/ML VL J3490 40.34 FLUOCINONIDE 0.05% OIN 60 ML TUBE 238.21 FLUORESCEIN STRIP 4.00 FLUORIDE VARNISH 14.00 FLUOROMETHOLONE OPHT 0.1% 10 ML BTL 34.10 FLUOROSCOPIC NEEDLE GUIDANCE 77002 300.00 FLUOROURACIL INJ 500MG/5 ML VL J9190 19.98 FLUOXETINE CAP 10 MG 10.39 FLUOXETINE CAP 20 MG 9.94 FLUOXETINE ORAL SOLUTION 20mg/5ml 19.67 FLURAZEPAM CAP 15MG 4.00 FLURAZEPAM CAP 30 MG 4.00 FLURORESCEIN OPHTH STRIP 4.00 FLUSH HEP-LOCK 100 UNT/5 ML SYR 10.74 FLUTICAS/ SALMET MDI 250/50MG 394.16 FLUTICAS/ SALMET MDI 500/50 MG 623.52 FLUTICASONE MDI 110 MCG 466.16 FLUTICASONE NAS SPR 16ML BTL 40.66 FLUTICASONE-VILANTEROL 200-25MG INH NF 848.50 FLUVASTATIN CAP 20 MG 18.36 FLUZONE VAX 3YR+ INTRAMUS Q2039 55.00 FNA WITH IMAGING GUIDANCE 10022 572.85 FOLIC ACID 82746 95.00 FOLIC ACID INJ 5MG/ML VL 33.54 FOLIC ACID TAB 1 MG 2.00 FOLIC ACID, RBC 82746 78.80 FOLIC ACID;SERU 82746 95.00 FOLLOWUP HOSP CARE, BRIEF 99231 110.17 FOLLOWUP HOSP CARE, INTER 99232 199.53 FOOT ARCH SUPPORT REMOVAL PREM L3030 217.20 FOOT DROP 78.15 FOOT LONGITUDE/METATARSAL SUPP L3020 564.71 FOOT LONGITUDINAL ARCH SUPPORT L3010 495.95 FOOT ORTHOTICS (DRESS FLE 237.65 FOOT ORTHOTICS (SPORTHOTI 280.25 FOOT ORTHOTICS GOLDEN FIT 228.10 FOOT, LEFT (2 VIEWS) 73620 172.05 FOOT, LEFT (3 VIEWS) 73630 192.00 FOOT, RIGHT (2 VIEWS) 73620 172.05 FOOT, RIGHT (3 VIEWS) 73630 192.00 FORANE GAS PER USE 19.00 FOREARM, LEFT 73090 183.00 FOREARM, RIGHT 73090 183.00 FOREIGN BODY REMOVAL EAR 69200 160.27 FOREIGN BODY REMOVAL EAR 69200 328.93 FORTEO INJ 20MCG/DOSE PEN J3110 2,984.68 FOSINOPRIL 20MG TAB 4.76 FOSPHENYTOIN INJ 500 MG VL S0078 129.48 FRACTURE PHALANX/MANIPUL 26725 533.85 FRACTURE PHALANX/MANIPUL 26725 838.42 FRACTURE/DISL OF SHOULDER 23655 1,349.94 FREE CORTISOL 82530 157.25 FREE PSA 84154 110.00 FREE T3 84481 136.00 FREE T4-THYROID II PROFIL 84439 62.73 FRUCTOSAMINE 82985 44.00 FSH 83001 122.00 FUNGAL CULTRUE, OTHER 87102 71.00 FUNGAL CULTURE SKIN, HAIR 87101 48.00 FUNGAS / MOLD ID 87107 70.64 FUNGUS ID 87106 52.00 FUNGUS ID 87106 52.00 FURADANTIN SUSP PER 10 CC 4.95 FUROSEMIDE INJ 100 MG/10ML VL J1940 484.23 FUROSEMIDE INJ 20MG/2ML VL J1940 28.58 FUROSEMIDE INJ 40 MG/4ML VL J1940 31.31 FUROSEMIDE ORAL SOL. 10mg/ml NF 27.30 FUROSEMIDE TAB 20 MG 4.00 FUROSEMIDE TAB 40 MG 4.00 FUSILEV INJ 50 MG VL J0641 240.00 FX CLO CLAVICLE 23500 561.00 FX DISTAL RADIU 25605 1,349.94 FX DISTAL RADIU 25605 1,349.94 FX DISTAL RADIU 25605 1,349.94 FX PHALANX WO M 26750 502.00 G-6-PD 82955 136.25 G-6-PD 82955 136.25 GABAPENTIN CAP 100 MG 4.00 GABAPENTIN CAP 300 MG 5.51 GABAPENTIN CAP 400 MG 6.38 GAD-OMNISCAN PER 1 ML A9579 19.00 GAD-OMNISCAN PER 1ML A9579 16.25 GAIT TRAINING, EA 15 MIN 97116 75.00 GAMMAGARD INJ (1 GM VL) 1,310.37 GAMUNEX INJ 10 GM/100ML BTL J1561 2,356.77 GAMUNEX INJ 20GM/200ML BTL J1561 6,079.20 GAMUNEX INJ 5 GM/50ML BTL J1561 1,269.71 GASTRIC FEEDING TUBE 45.00 GAVISCON LIQ 4.00 GAVISCON SUS 15ML 4.00 GC BY BD 87591 151.00 GEL IMMUNODIFFUSION 86331 33.00 GEL TUBING SILOPAD 20.65 GEMFIBROZIL TAB 600 MG 9.72 GEMZAR INJ 1GM VL J9201 180.00 GEMZAR INJ 200MG VL J9201 256.80 GENERAL ANESTHESIA RECOVE 156.00 GENERAL ANESTHESIA RECOVE 227.00 GENERAL ANESTHESIA RECOVE 291.00 GENERAL ANESTHESIA RECOVE 348.00 GENERAL ANESTHESIA RECOVE 441.00 GENERAL ANESTHESIA REVOCE 398.00 GENERAL HEALTH 80050 91.00 GENERAL HEALTH PANEL 40.00 GENERAL ID 87077 55.00 GENTAMICIN 80170 72.00 GENTAMICIN INJ 80MG/2 ML VL J1580 25.81 GENTAMICIN OPHTH SOL 0.3% 5 ML BTL 25.57 GENTAMICIN OPTH OINT 0.3% 3.5GM TUBE 101.26 GENTIAN VIOLET 1% TOP 4.04 GEODON CAP 60 MG 32.27 GESTATIONAL DIABETES SCRN 82950 41.00 GGTP 82977 47.00 GIARDIA ANTIGEN 87329 75.01 GLIADIN ABS, IGG OR IGA 83516 118.00 GLIADIN PEPTIDE SCREEN 82397 54.60 GLIADIN PEPTIDE SCREEN 82397 54.60 GLIMEPIRIDE ORAL 2MG TAB 7.00 GLIMEPIRIDE TAB 4 MG 4.91 GLIPIZIDE 5 MG TAB 4.00 GLIPIZIDE ER TAB 2.5 MG 4.76 GLIPIZIDE TAB 10 MG 4.00 GLIPIZIDE TAB ER 5 MG 4.00 GLUCAGON EMERG KIT (1MG) J1610 660.22 GLUCAGON SURGERY INJ 1MG 493.62 GLUCOSAMINE CAP 500 MG 4.00 GLUCOSE BLOOD T 82962 20.00 GLUCOSE TEST 82950 41.00 GLUCOSE TOLERAN 82951 95.00 GLUCOSE TOLERANCE TEST-3 82951 95.00 GLYBURIDE TAB 2.5 MG 4.00 GLYCATED (HGB) 83036 59.00 GLYCATED HGB - A1C 83036 59.00 GLYCERIN SUP ADULT 4.00 GLYCERIN SUPP PEDIATRIC 4.12 GLYCIN 1.5% IRRIGATION 29.45 GLYCINE IRRIGATION SOLUTION 48.42 GLYCOPROTEIN EL 82985 44.00 GLYCOPYRROLATE INJ 0.2 MG (2ml/VL) 86.12 GRAM STAIN 87205 32.00 GRASPER, TRIPOD 193.40 GRAVITY FEEDING BAG 8.00 GRIPPER 20GX3/4 PORTA CA 19.75 GRIPPER PORT A CA 20GX1 19.75 GROUP PSYCHOTHERAPY 90853 295.00 GTT (EACH ADDITIONAL SAMP 82952 32.00 GTT-ADDED SAMPL 82952 32.00 GUAIFEN/ COD LIQ 100-10MG/5 ML 6.65 GUAIFEN/ DM LIQ 100-10 MG/5ML 4.00 GUAIFENESIN SURP 100 MG/5 ML 4.00 GUANFACINE ER 1 MG TAB 18.88 GUANFACINE TAB 1MG 4.00 GUEST MEALS 5.00 GUIAFENESIN 400MG TAB 4.00 H. PYLORI AG, STOOL 87338 120.78 H. PYLORI AG, STOOL 87338 120.78 H. PYLORI IGG 86677 116.00 H. PYLORI IGM 86677 229.00 HALOPERIDOL INJ 5 MG/ML VL J1630 25.76 HALOPERIDOL INTENSOL 2 MG/ML (120ML BTL) 43.20 HALOPERIDOL TAB 1 MG 4.00 HALOPERIDOL TAB 1 MG 4.00 HAND WITH BILAT COMP 95832 42.78 HAND, LEFT (2 VIEWS) 73120 159.00 HAND, LEFT MIN 3 VIEWS 73130 209.00 HAND, RIGHT (2 VIEWS) 73120 159.00 HAND, RIGHT MIN 3 VIEWS 73130 209.00 HANTA VIRUS AB IgG OR IgM 86790 110.30 HAPTOGLOBIN 83010 82.25 HB DUCT SYS W GB 78227 1,069.11 HBSAB 86706 67.00 HCG QUANTITATIVE 84702 106.00 HCG TUMOR MARKER 84702 93.25 HCG-SCREEN,SERUM 84703 53.41 HDL 83718 34.56 HEAD CAT SCAN W/O CONTRAS 70450 1,512.00 HEAD CAT SCAN W/WO CONTRA 70470 1,879.00 HEAD CAT SCAN WITH CONTRA 70460 1,647.00 HEAD HALTER 7.50 HEALTH RISK ASSESSMENT 99420 20.00 HEEL LIFT SMALL 25.45 HEEL LIFT, LARGE 25.45 HEEL LIFT, MEDIUM 25.45 HEEL, LEFT 73650 168.00 HEEL, RIGHT 73650 168.00 HELICOBACTER PY 86677 116.00 HEMATOCRIT 85014 15.00 HEMATOCRIT BLOO 85014 15.00 HEMOCHOMATOSIS GENE ANAL 81256 403.00 HEMOCHROMATOSIS GENE ANAL 81256 402.50 HEMOCLIP, LARGE 73.75 HEMOCLIP, MEDIUM 49.20 HEMOCULT 82270 22.00 HEMOGLOBIN 85018 15.00 HEMOGLOBIN ELECT 83020 138.00 HEMOGRAM 85027 43.00 HEMOPHILUS ETES 87181 98.27 HEMOPHILUS INFLU B AB 86684 160.25 HEMOPHILUS INFLUB AB 86684 160.25 HEMO-VAC 7.60 HEP A IGM AB 86709 77.00 HEP A TOTAL AB 86708 113.00 HEP A VACCINE ADULT 90632 129.00 HEP B CORE AB, TOTAL 86704 77.00 Hep B w/ Titer 67.00 HEP BE AG 87350 101.00 HEP BS AG 87340 53.00 HEP C GENOTYPE 87902 904.89 HEP C RNA QUAL 87521 261.00 HEP C RNA QUAL 87521 261.00 HEPARIN ANTI-XA 85520 160.05 HEPARIN INJ 5,000 UNT/ML (1ML/VL) J1644 71.90 HEPARIN/0.45% NaCL IVPB PREMIX 250 ml J1644 95.16 HEPATIC FUNCTIO 80076 52.00 HEPATITIS A ANTIBODY HAAB 86708 113.00 HEPATITIS A VAC 90632 74.88 HEPATITIS B 90744 34.30 HEPATITIS B CORE IGM AB 86705 139.00 HEPATITIS B CORE IGM AB 86705 139.00 HEPATITIS B DNA PCR 87517 275.00 HEPATITIS B SERIES 90715 165.00 HEPATITIS B VAC 90746 67.80 HEPATITIS BE AB 86707 101.00 HEPATITIS C ANTIBODY 86803 105.00 HEPATITIS C VIRUS RNA 87522 458.44 HEPATOBILLIARY 78226 1,018.00 HERPES 1 IGG 86695 84.25 HERPES 1 IGM 86696 47.25 HERPES 2 IGG 86696 84.25 HERPES 2 IGM 86695 60.72 HERPES 6 AB, IGG OR IGM 86790 76.00 HERPES 6 AB,IGG OR IGM 86790 76.00 HERPES IGM AB SCREEN 86694 140.75 HERPES SIMPLEX TEST 86694 96.00 HETASTARCH 6% INJ VARIABLE RATE 114.00 HGB (Clinic) 85018 15.00 HIGH FLOW SET 127.75 HIGH-RISK ANTEPARTUM CARE H1001 5.00 HINGED KNEE SUPPORT ALL S 72.75 HINGED KNEE SUPPORT W/POP 145.90 HIP LEFT (2 VIEWS) 73502 209.00 HIP LEFT (AP ONLY) 73501 172.05 HIP RIGHT (2 VIEWS) 73502 209.00 HIP RIGHT (AP ONLY) 73501 172.05 HISTAMINE RELEASE 86343 40.00 HISTONE ABS 83516 70.50 HISTOPLASMA AB quant (x3) 86698 21.20 HISTOPLASMA ANTIGEN, URINE 87385 156.10 HIV SCREEN REFLEX TO CONFIRM 87389 57.79 HIV SCREEN REFLEX TO CONFIRM 87389 57.79 HLA B27 86812 203.58 HLA TYPING, A, 86812 203.58 HLA-B27 AG 86812 203.58 HLA-DQ TYPING 81376 386.30 HOLTER MONITOR HOOKUP/SCN 93226 345.00 HOME VISIT EST PATIENT LEVEL 1 99347 158.01 HOME VISIT EST PT MOD-HI SEVERITY 40 MIN 99349 280.00 HOME VISIT-LOW COMPLEXITY 99348 239.00 HOMOCYSTEINE 83090 59.00 HORSESHOE PATELLA SUPPORT 85.70 HOSP DC DAY MANAGEMENT 99238 198.33 HOSP DISCHG,30+ MIN 99239 290.92 HOSPICE ACUTE CARE 561.00 HOSPICE RESPITE CARE Q5005 161.00 HOSPITAL DISCHARGE 99238 195.00 HOSPITAL DISCHARGE 99239 250.00 HPV DNA 87624 266.94 HPV DNA 87624 266.94 HSV by PCR 87529 169.60 HUMAN GROWTH HORMONE 83003 128.00 HUMAN GROWTH HORMONE 83003 128.00 HUMULIN L INSULIN 10CC BO 79.18 HYDRALAZINE 100MG TAB 4.05 HYDRALAZINE INJ 20MG/ML VL J0360 56.00 HYDRALAZINE TAB 10 MG 4.00 HYDRALAZINE TAB 50 MG 4.00 HYDROCHLOROTHIAZIDE TAB 25 MG 4.00 HYDROCOD/ ACET TAB 10-325 MG 10.40 HYDROCOD/ ACET TAB 5/500MG 6.00 HYDROCOD/ ACET TAB 7.5-325 MG 6.77 HYDROCODONE ELIXIR PER CC 19.20 HYDROCODONE/APAP 5/325 TAB 6.62 HYDROCODONE/IBUP 7.5/200 10.59 HYDROCORTISONE 1.0% CRM 19.41 HYDROCORTISONE 2.5% CRM 261.99 HYDROCORTISONE 20MG TABLET NF 4.35 HYDROCORTISONE INJ 250 MG VL J1720 88.57 HYDROCORTISONE SUPP 25 MG 43.28 HYDROMORPHONE 2mg TAB 7.49 HYDROMORPHONE 4MG TABS 6.69 HYDROMORPHONE INJ 50mg/5ml NF 68.25 HYDROMORPHONE INJ 1 MG VL J1170 39.22 HYDROMORPHONE INJ 2 MG/ML VL J1170 34.92 HYDROPHILIC POLYMER 10.18 HYDROPRES 25 MG TAB 4.00 HYDROXYCHLOROQUINE TAB 200 MG 17.56 HYDROXYPROGESTERONE-17A 83498 207.00 HYDROXYUREA CAP 500 MG 5.90 HYDROXYZINE CAP 25 MG 4.00 HYDROXYZINE HCI TAB 25MG 4.00 HYDROXYZINE INJ 25MG/ML VL J3410 80.50 HYDROXYZINE TAB 10MG 4.00 HYOSCYAMINE 0.125MG SL TAB NF 4.00 HYOSCYAMINE SOLN 0.125 MG/ML (15 ML BTL) 11.20 I & D ABSCESS SKIN 10060 259.69 I & D SKIN ABSCESS SKIN 10060 404.35 I&D BARTHOLIN CYST 56420 255.02 I&D BARTHOLIN CYST 56420 355.68 I&D COMPLICATED 10061 545.00 I&D HEMORRHOI 46083 414.00 I&D SIMPLE OR S 10060 240.00 IBUPROFEN SUS 100 MG/5ML 2.00 IBUPROFEN TAB 200MG 2.00 IBUPROFEN TAB 600 MG 4.00 IBUPROFEN TAB 800 MG 4.00 IDENTIFICATION, 87076 34.73 IGA 82784 53.25 IgD 82784 59.11 IGE 82785 89.00 IGF BINDING PROTEIN 3 83519 100.28 IGF-1 84305 96.00 IGFBP-1 83519 100.28 IGG 82784 52.00 IGM 82784 53.25 IM/SUBCUTANEOUS INJECTION 96372 133.67 IMIPENEM/CILAS INJ 500MG VL J0743 89.00 IMM DEF PANEL PART 1 86355 91.20 IMM DEF PANEL PART 2 86357 91.20 IMM DEF PANEL PART 3 86359 91.20 IMM DEF PANEL PART 4 86360 91.20 IMM DEF PANEL PART 5 88187 91.20 IMMUN ADMIN, IN 90474 26.00 IMMUNE GLOBULIN 10% 5 GR./50ML BTL J1459 1,570.40 IMMUNE GLOBULIN 40 GRAM / 400 ML BTL J1459 14,000.00 IMMUNIZATION ADMIN OVER 18 90472 24.00 IMMUNIZATION ADMIN OVER 18 90471 44.00 IMMUNOASSAY FOR 86304 115.00 IMMUNOASSAY, AN 83516 90.85 IMMUNOASSAY, AN 83519 99.49 IMMUNOASSAY, IN 86317 178.00 IMMUNOASSY FOR 86301 179.00 Immunocytochemistry 88342 215.43 IMMUNODIFFUSION 86331 33.00 IMMUNOFIXATION 86334 42.00 IMMUNOFIXATION SERUM 86334 42.00 IMMUNOFIXATION URINE 86335 82.08 IMODIUM A D CAP (2MG) 5.46 IMODIUM SUSP. 1 MG/7.5ML 4.00 INCIS/REMOVE FOREIGN BODY 10120 564.48 INCISE & DRAIN 56420 338.00 INCISE/DRAIN CO 68020 808.37 INCISION & DRAINAGE OF CYST 10080 572.85 INCISION & DRAINAGE OF CYST 10080 572.85 INCISION & REMO 10120 310.80 INCISION OF LIN 41010 1,138.18 INDAPAMIDE/LOZOL 2.5 MG 4.00 INDOMETHACIN CAP 25 MG 4.00 INDWELILNG CATH INSERT 51702 328.93 INFECT ANTIGEN 87493 128.00 INFECT ANTIGEN, 87329 39.00 INFECT ANTIGEN, 87400 42.00 INFECT ANTIGEN, 87420 47.00 INFECT ANTIGEN, 87804 48.00 INFECT ANTIGEN, 87340 53.00 INFECT ANTIGEN, 87880 64.00 INFECT ANTIGEN, 87299 74.00 INFECT ANTIGEN, 87522 140.00 INFECTIOUS ANTI 87807 39.00 INFLUENZA A and B by NAD 87502 115.00 INFLUENZA A (H1 G9141 14.00 INFLUENZA A DFA 87276 36.00 INFLUENZA B DFA 87275 36.00 INFLUENZA SCREEN 87804 48.00 INFLUENZA VACC. ADMIN. G0008 88.50 INFUVITE INJ 2 VL SET 50.34 INHALATION SOLUTION 0.9% 6.25 INIT NB EM PER DAY HOSP 99460 266.81 INIT PM E/M NEW PAT 1-4 Y 99382 199.00 INIT PM E/M NEW PAT 65+ Y 99387 306.00 INIT PM E/M NEW PAT INF 99381 182.00 INITIAL HOSP CARE INTERM 99222 376.82 INITIAL HOSP CARE, BRIEF 99221 276.14 INITIAL HOSP CARE, EXTEND 99223 554.96 INITIAL HOSPITAL CARE-HIGH COMPLEXITY 99223 442.00 INITIAL HOSPITAL CARE-LOW COMPLEXITY 99221 213.00 INITIAL HOSPITAL CARE-MOD COMPLEXITY 99222 330.00 INITIAL OBS CARE 99218 200.00 INITIAL OBS CARE 99220 442.00 INITIAL ORTHOTIC TRAINING 97760 75.00 INITIAL ORTHOTIC TRAINING AND FIT 97760 75.00 INITIAL PROS TRAIN INIT. (15 MIN) 97761 75.00 INITIAL UPDRAFT TREATMNT 94640 86.19 INJ DIAZEPAM UP TO 5MG J3360 7.00 INJ OCCIPITAL N 64405 310.00 INJ TRIGGER POINT 1/2MUSC 20552 606.63 INJ. TEND. SHEA 20550 244.70 INJECT NERVE BL 64402 314.00 INJECTION SNGL/ 20552 244.70 INJECTION SNGL/ 20553 517.00 INJECTION SNGL/MLT TRIG 20552 244.70 INJECTION, CEFA J0690 13.96 INJECTION, DEXA J1100 6.98 INJECTION, ENOX J1650 28.45 INJECTION, INTR 11900 168.95 INJECTION, INTR 11901 168.95 INJECTION, METH J1030 45.14 INJECTION, METH J1040 70.31 INJECTION, ONDA J2405 9.00 INJECTION, PROC J0780 7.00 INJECTION, TEND 20551 244.70 INJECTION, TOBR J3260 5.00 INS - LEVEMIR INJ 300U/3ML J1815 211.29 INS - NOVOLOG 3 ML PEN 100 U/ML J1815 259.92 INS - NPH HUMAN INJ 100U/ML J1815 168.24 INS- ASPART INJ 100 UNT/ML J1815 625.26 INS- HUMULIN N PEN INJ 100 UNIT/ML 168.24 INS- LANTUS SOLO PEN 100UNIT/ML 130.33 INS- LANTUS SOLO PEN 100UNIT/ML 224.06 INS- LISPRO INJ 100 UNT/ML 623.35 INS- NOVOLIN R INJ 100UNIT/ML (10ml/VL) J1815 327.43 INS- NPH HUMAN/ REG HUMULIN 70/30 PEN 351.19 INS- REG HUMAN INJ 100 UNIT/ML 351.19 INSERT BLADDER CATHETER 51701 328.93 INSERT NON-INDW 51701 216.00 INSERT TEMP IND 51703 331.00 INSERTION BIRTH CONTROL IMPLANT 11981 700.00 INSERTION INTRAUTERINE DEVICE IUD 58300 130.10 INS-HUMALOG 75/25 PEN 129.78 INS-HUMULIN 70/30 (100u/mL) J1815 351.19 INS-NOVOLOG 70/30 PEN J1815 259.92 INSULIN 83525 62.00 INTEGRILIN INJ 20MG/ML VL J1327 499.80 INTER JT CYST 20605 244.70 INTER.REPAIR 12.6-20.0CM 12035 754.44 INTERFERON BETA 1A INJ 3O MCG VL J9212 2,039.84 INTERJECT,CONTRAST INJ TH 126.00 INTERLINK VENTED NITROGLY 21.25 INTERMEDICATE SUTURE LACE 12031 448.41 INTIAL OBS CARE 99219 329.00 INTMD REPAIR FACE 12051 472.06 INTMD REPAIR FACE 12051 472.06 INTMD WND REPAIR FACE M/M 12053 595.15 INTMD WND REPAIR FACE M/M 12054 624.89 INTMD WND REPAIR FACE/MM 12051 506.62 INTMD WND REPAIR FACE/MM 12054 624.89 INTMD WND REPAIR N-HF 12041 476.50 INTMD WND REPAIR S/TR/EXT 12034 511.00 INTMD WND REPAIR S/TR/EXT 12034 564.11 INTMD WND REPAIR S/TR/EXT 12032 597.09 INTMD WND REPSIR FACE 12052 567.13 INWELILNG CATH - COMPLEX 51703 282.69 IODINE 83789 74.30 IONIZED CALCIUM 82330 87.00 IONTOPHORESIS, EA 15M-OT 97033 84.08 IONTOPHORESIS-15 MIN 97033 84.08 IPECAC LIQ 4.00 IPPE MEDICARE G0402 216.00 IPPE NEW MEDICA G0344 178.00 IPRATROPIUM/ALBUTEROL 20MCG/100MCG MDI 253.50 IRIN0TECAN 40 MG/2ML VL J9206 57.60 IRON 83540 45.00 IRON BINDING CA 83550 45.00 IRON DEXTRAN INJ (PER 50MG VL J1750 93.20 IRON SUCROSE INJ 100 MG/5 ML VL J1756 114.00 IRR - EYE WASH 4 OZ 8.64 IRREGULAR ANTIBODY SCREEN 86850 55.00 IRRIGATION 0.9% SOD CHLOR 16.90 IRRIGATION WATER 1500CC 27.45 ISLET CELL AB 86341 181.50 ISOLATION (DAILY) 46.30 ISOPTO CARPIN 1% EYE GTTS 33.20 ISOSORBIDE DINITRATE TAB 20 MG 4.77 ISOSORBIDE MONO ER TAB 30 MG 6.64 ITRACONAZOLE 81247 70.86 IV CATH AUTOGUARD 16 X 1. 7.70 IV CATHETER-ALL SIZES 2.80 IV HYDRATION ADDTL HR 96361 81.34 IV HYDRATION INITIAL 96360 270.23 IV INFSN SEQUENTIAL DRUG 96367 133.67 IV INFUSION ADDTL HRS 96366 81.34 IV INFUSION CONCURRENT 96368 59.00 IV INFUSION INITIAL 96365 433.38 IV PUSH DIFFERENT DRUG 96375 131.34 IV PUSH SAME DRUG 96376 65.00 IV PUSH/INITIAL 96374 270.23 IV PYELOGRAM 74400 560.00 IV THER. UP TO 1HR. 96365 194.03 IVF - 0.9% NS WITH POTASSium 1000ml Bag J3480 60.00 IVF - NORM M 5% BAG [1000 60.00 IVF D5 1/2 NS WITH POTAssium 1000ml Bag J3480 60.00 IVF- DEX 5%/ 0.45% SOD CL 60.00 IVF- DEX 5%/ 0.9% SOD CL J7042 60.00 IVF- DEX 5%/ LACT RING [1 60.00 IVF- DEX 5%/ W 250 ML J7060 60.00 IVF- DEXTROSE 5% [100 ML] 60.00 IVF- DEXTROSE 5% [1000 ML 60.00 IVF- LACTATED RINGERS [10 60.00 IVF- SOD CL 0.45% [1000 M 60.00 IVF- SOD CL 0.9% [100 ML] J7030 60.00 IVF- SOD CL 0.9% [100 ML] 60.00 IVF- SOD CL 0.9% [1000 ML 60.00 IVF- SOD CL 0.9% [250 ML] 60.00 IVF- SOD CL 0.9% [500 ML] 60.00 JAW (4 VIEWS) 70110 262.00 JAW <4 VIEWS 70100 135.12 JCV ANTIBODY 86711 1,969.38 JEVITY CAN [8 OZ] 4.00 JO-1 ANTIBODY 86235 215.25 JOBST COMPRESSION STOCKIN 138.10 JOBST THIGH LENGTH STOCKI 237.00 JOINT FLUID CELL COUNT 89051 58.00 JOINT FLUID CRYSTALS 89060 57.00 JOINT FLUID GLUCOSE 82945 43.00 JOINT FLUID MUCIN 83872 23.00 JOINT FLUID TOTAL PROTEIN 84157 11.00 KANAMYCIN 1GM 65.00 K-DUR 20 SR TAB (20 MEQ) 4.00 KENALOG 10MG J3301 10.15 KEPPRA 80177 95.25 KEPPRA 80177 95.25 KEPPRA TAB 500 MG 4.00 KEPPRA XR TAB 500 MG 25.67 KETAMINE 50MG/ML IV VL 24.00 KETAMINE INJ 50 MG/ML 10MLVL J3490 20.06 KETAMINE INJ 500mg/5ml 35.76 KETOROLAC DRP 0.5% 3 ML BTL 64.97 KETOROLAC INJ 15 MG VL J1885 33.50 KETOROLAC INJ 30 MG VL J1885 35.00 KETOROLAC INJ 60 MG VL J1885 38.75 KIDNEY IMG MORPH VASC FLOW W/RX 78708 1,251.00 KIDNEY/LIVER MICROSAMAL 86376 137.50 KING AIRWAY- ALL SIZES 63.00 KIT WOUND MGMT MINI W/BAG 237.00 KLING ROLL TO 6 INCHES 8.80 KLONOPIN 80154 105.00 KNEE BRACE (CARTILAGE-ALL 54.00 KNEE BRACE SMALL 39.80 KNEE IMOBILIZER LG 39.80 KNEE IMOBILIZER MED 39.80 KNEE IMOBILIZER X-LG 39.80 KNEE LEFT (1 OR 2 VIEWS) 73560 199.00 KNEE LEFT (3 VIEWS) 73562 200.00 KNEE LEFT (4 VIEWS) 73564 216.00 KNEE LENGTH SUPPORT W/ZIP 154.55 KNEE RIGHT (1 OR 2 VIEWS) 73560 199.00 KNEE RIGHT (3 VIEWS) 73562 200.00 KNEE RIGHT (4 VIEWS) 73564 216.00 KNEE STRAPPING 29530 130.75 KOH PREP 87220 51.57 KOH PREP 87220 51.57 KUB 74018 193.00 K-WIRES 29.00 KYTRIL INJ 1 MG VL J1626 78.95 L3-SACRUM CAT SCAN 72131 1,712.00 LABETALOL INJ 5 MG/1 ML VL 32.21 LABETALOL TAB 200 MG 4.00 LAC-HYDRIN FIVE LOTION 8OZ. 34.11 LACOSAMIDE 80299 143.46 LACTIC ACID 83605 63.00 LACTIC ADIC 83605 63.00 LACTULOSE LIQ 10 GM/15ML 10.05 LAMICTAL 82542 102.00 LAMOTRIGINE 100MG TAB 19.00 LANSOPRAZOLE CAP 30 MG 16.99 LAPAROSCOPIC CHOLECYSTECTOMY 47562 6,886.00 LAPAROTOMY PACKI 45.00 LATANOPROST 0.005% EYE GT 48.76 LATERAL PATELLA KNEE 67.15 LATUDA 10mg (HALF OF 20mg) 73.40 LAY CLO 12.6CM - 20.0CM 12035 737.00 LAY CLOS 2.5 CM 12031 421.00 LAYER CLOSURE F 12052 310.80 LAYER CLOSURE FACE,EY/NOS 12052 567.13 LAYER CLOSURE N 12044 587.00 LAYER CLOSURE O 12041 476.00 LAYER CLOSURE S 12034 572.00 LDH-LACTATE DEHYDROGENASE 83615 33.00 LDH-LACTATE DEHYDROGENASE 83615 33.00 LEAD 83655 80.00 LEAD, URINE 83655 92.00 LEAD, VENOUS 83655 23.31 LEFLUNOMIDE TAB 20 MG 49.27 LEGIONELLA IgG 86713 72.50 LEGIONELLA IgM 86713 141.24 LEGIONELLA AG-URINE 87450 88.50 LEGIONELLA IGG 86713 132.00 LEPTOSPIRA AB 86720 112.05 LETROZOLE 2.5MG TAB NF 54.40 LEUCINE-RICH GLIOMA INACT PROTEIN-1 IgG 86255 250.00 LEUCOVORIN INJ (200 MG VL J0640 75.81 LEUCOVORIN INJ (500 MG VL J0640 188.90 LEUKOCYTE COUNT 89055 18.00 LEVALBUTEROL TARTRATE HFA INHALER 40.92 LEVETIRACETAM 750MG TAB 19.04 LEVINE TUBE 5.60 LEVOFLOXACIN INJ 250 MG J1956 92.08 Levofloxacin IVPB 500 MG/100ml D5W PreM J1956 112.71 LEVOFLOXACIN TAB 500 MG 50.46 LEVONORGESTREL (IUD) 52MG J7298 1,372.80 Levophed 1 MG/mL (4 mL VL) 74.56 LEVOTHYROXINE TAB 100 MCG 4.00 LEVOTHYROXINE TAB 25 MCG 4.00 LEVOTHYROXINE TAB 50 MCG 4.00 LEVOTHYROXINE TAB 88 MCG 4.00 LH 83002 126.00 LH-TANNER STAGES 83002 137.30 LIDOCAINE 1% ING 50mg/5ml 28.86 LIDOCAINE 1% INJ (10MG) J3490 34.90 LIDOCAINE 2% VISCOUS BTL 4.00 LIDOCAINE 2GM/ D5W PREMIX J2001 84.48 LIDOCAINE 5% PATCH 11.38 LIDOCAINE HCL 0.5% 50ML J3490 36.59 LIDOCAINE INJ 100 MG/5ML VL J2001 34.40 LIDOCAINE INJ SOLUTION 2% J3490 27.95 LIDOCAINE JELLY 2% (5ML) 23.40 LIDOCAINE MPF/EPI 2%INJ 20MG/ML 67.16 LIDOCAINE/ EPI 1% INJ (10 J3490 33.50 LIDOCAINE/ EPI 2% INJ J3490 33.68 LIMITED PELVIC ULTRASOUND 76857 270.15 LINACLOTIDE 72mcg CAP NF 46.45 LINAGLIPTIN 5 MG TAB 49.38 LINEZOLID/D5W PREMIX 600MG/300ML J2020 285.00 LIOTHYRONINE 50MCG TAB 6.36 LIPASE 83690 41.00 LIPASE 83690 41.00 LIPID II 80061 80.00 LIPID PANEL 80061 80.00 LIPOPROTEIN A 83695 143.00 LISDEXAMFETAMINE 50mg CAP NF 41.40 LISINOPRIL TAB 20 MG 4.00 LISINOPRIL TAB 5 MG 4.00 LITHIUM 80178 48.00 LITHIUM QUANTIT 80178 48.00 LIVER PROFILE 80076 52.00 LMA UNIQUE EMERGENCY KIT 58.00 LOCM 300-399 MG/ML IODINE Q9967 3.00 LONG ARM SPLINT 29105 237.00 LORATADINE TAB 10 MG 2.00 LORATADINE/PSEUDOEPHEDRINE ER 10MG/240MG 2.00 LORAZAEPAM 20mg/10ml INJECTION VL J2060 33.60 LORAZEPAM INJ 2 MG/ML VL J2060 20.90 LORAZEPAM INJECTION 2MG J2060 20.00 LORAZEPAM INTENSOL SUSP 2 MG/ML (30ML) 150.09 LORAZEPAM TAB 0.5 MG 6.70 LORTAB SOL.7.5/500/15ML 19.19 LOSARTAN TAB 25 MG 6.71 LOVASTATIN 40 MG TAB 4.00 LOVASTATIN TAB 20 MG 9.49 LOWER EXTREMITY W/CONTRAS 73701 1,512.00 LOWER EXTREMITY W/O CONTR 73700 1,544.00 LOWER LEG LEFT (2 OR 3 VI 73590 199.00 LOWER LEG RIGHT (2 OR 3 V 73590 199.00 LUMBAR OR SACRAL, SINGLE LEVEL W/ IMAGE 64483 1,200.00 LUMBAR SPINE (5 VIEWS-OBL 72110 327.00 LUMBAR SPINE (AP-LAT) 72100 265.00 LUMIGAN OPTHALMIC SOL. 7.5 ML BTL 1,165.10 LUNESTA TAB 2 MG 56.45 LUNG PERFUSION 78580 897.00 LUNG PERFUSION AND VENT 78582 1,069.11 LUPRON DEPOT 22.5MG INJ J9217 9,191.95 LURASIDONE HCL 20MG TAB 100.66 LUTEIN 10MG TAB 2.00 LUTEIN CAP 20 MG 2.00 LYME DISEASE AB, IMMUNOBLOT 86617 99.37 LYME DISEASE IGG 86617 96.45 LYME DISEASE IGM 86617 96.45 LYME DX AB SCREEN 86618 133.70 LYME DX AB SCREEN 86618 133.70 LYME TITRE, ANTI 86617 96.45 MAG HYD/ AL HYD/ SIM SUS 4.00 MAG HYD/ AL HYD/ SIM SUS (30 ML/CP) 4.00 MAG SULFATE 50% INJ 2 ML VL J3475 25.69 MAGNESIUM 83735 34.00 MAGNESIUM CITRATE SOL 4.68 MAGNESIUM OXIDE TAB 400 MG 4.00 MAGNESIUM SULFATE 2G/50ML INJ. 51.59 MAGNESIUM TAB 128 MG PER 2 TABLETS 4.00 MAGNESIUM, 24 HR URINE 83735 37.00 MAJOR JOINT INJ 20610 244.70 MAJOR JOINT INJ 20610 244.70 MAJOR JOINT INJ W/O GUIDANCE 20610 100.00 MALARIA SMEARS 87207 66.63 MALE/FEMALE STERIL CAP 1.60 MAMMOGRAPHY 77067 450.00 MANGANESE 83785 259.43 MANNITOL 25% INJ 50ML VL J2150 27.88 MANUAL DIFF REFLEX 85007 14.52 MANUAL THERAPY TECHNIQUES 97140 75.00 MARCAINE 0.5% INJ WITH EP J2001 28.53 MARCAINE LOCAL EACH ADD C 1.15 MARIJUANA-URINE G0431 166.22 MATTRESS FOAM EGGCRATE 48.40 MAX FAC CT W/CONTRAST 70487 1,647.00 MAX FACE CAT SCAN W/O CON 70486 1,512.00 MEAS POST VOIDING- BLADDER SCANNING 51798 172.81 MEASUREMENT OF 94760 39.00 MECLIZINE TAB 25 MG 4.00 MEDICAL ALERT S5161 32.00 MEDICAL DIRECTOR FEE 400.00 MEDROXYPROGESTERONE 10MG TAB 4.00 MEDROXYPROGESTONE TAB 5 MG 4.00 MEFOXIN 2GM VIAL 50.00 MEGESTROL ORAL SUSPENSION 400mg/ 10ml 401.86 MEGESTROL TAB 40 MG 5.47 MELATONIN 1mg TAB NF 2.00 MELATONIN 5MG TAB 4.00 MELOXICAM TAB 7.5 MG 12.39 MEMANTINE TAB 10 MG 26.68 MENINGOCOCCAL RECOMBINANT PROTEIN 90620 198.00 MEPERIDINE INJ 50 MG/ML (1ML/VL) J2175 37.88 MEPILEX DRESSING 3X3 9.95 MEPILEX DRESSING 4X4 13.52 MEPROBAMATE 200 MG TAB 4.00 MERCURY URINE OR BLOOD 83825 169.00 MEROPENEM INJ 1 GM VL J2185 100.43 MEROPENEM INJ 500 MG VL J2185 102.00 MEROPENEM INJ. 500MG IN 50ML.9% NACL 128.38 MESALAMINE TAB 400 MG 8.72 MESH 3X6 CM 123.40 MESH PROCEED VENTRAL 4.3 x 4.3 cm 552.45 MESH PROCEED VENTRAL 6.4 x 6.4 cm 660.75 METANEPHRINES 24 HR UA 83835 189.66 METANEPHRINES 24 HR URINE 83835 353.00 METANEPHRINES, PLASMA FR. 83835 234.00 METANEPRHINES, PLASMA FR 83835 234.00 METASTATIC BONE SURVEY 77075 667.50 METFORMIN ER TAB 500 MG 5.35 METFORMIN TAB 500 MG 4.00 METFORMIN TAB 850 MG 4.79 METHADONE 5 MG TAB 6.27 METHADONE TAB (10 MG) 6.30 METHOCARBAMOL TAB 750 MG 4.00 METHOTREXATE 2.5 mg TAB NF 14.26 METHOTREXATE INJ 50MG VL J9250 33.20 METHOTREXATE SO J9250 3.00 METHYL PREDNISOLONE DOSE PK 5.72 METHYLMALONIC ACID 83921 132.77 METHYLMALONIC ACID 83921 132.77 METHYLPHENIDATE ER 36MB TAB 25.74 METHYLPREDNISOLONE INJ 1 GM VL J2930 176.77 METHYLPREDNISOLONE INJ 40MG/ML VL J2920 46.10 METHYLPREDNISOLONE INJ 500 MG VL J2930 83.80 METHYLPREDNISOLONE INJ 80 MG/ML VL J1020 75.02 METOCLOPRAMIDE INJ 10MG/2 ML VL J2765 32.07 METOCLOPRAMIDE LIQ SYRUP 4.00 METOCLOPRAMIDE TAB 5 MG 4.00 METOLAZONE TAB 2.5 MG 10.31 METOPROLOL INJ 5 MG/5ML VL J3490 29.70 METOPROLOL SUCC ER TAB 50 MG 4.22 METOPROLOL TAB 25MG 4.00 METOPROLOL TAR TAB 50 MG 4.00 METOPROLOL XL TAB 25 MG 4.22 Metronidazole 500mg tablet 5.84 METRONIDAZOLE TAB 250 MG 4.00 METRONIDAZOLE/ SOD PREMIX 500MG/100ML J3490 71.00 MIC SENSITIVITY 87186 45.00 MICAFUNGIN 100ML VIAL J2248 536.12 MICROALBUMIN, 24HR URINE 82043 101.30 MICROALBUMIN, S 82044 41.00 MICROALBUMIN, UA 82044 41.00 MICROALBUMIN/ CREAT RATIO 82043 77.00 MICRO-DRIP SET 13.50 MICRO-GUARD ANTIFUNGAL PW 19.47 MICROSCOPIC EXA 81015 25.00 MICROSCOPIC, URINE 81015 25.00 MIDAZOLAM 2mg/2ml INJECTION 20.78 MIDAZOLAM 5MG/ML INJ. VL J2250 4.00 MIDAZOLAM INJ 5 MG/5ML VL J2250 6.73 MIDAZOLAM SYRP 2MG/ML 20.67 MIDODRINE 10MG TAB NF 19.35 MIDODRINE 5MG TAB 8.13 MIDODRINE TAB 2.5 MG 5.73 MILK OF MAGNESIASUS (2400/30 ML DOSE) 4.00 MINERAL OIL [30ML] ** 2.00 MINIDRIP CONTINUOUS FLO S 28.80 MINOCYCLINE 100MG CAP 13.32 MINOCYCLINE 50MG CAP 6.79 MINOR PX RM AMBULATORY SU 537.00 MINOR PX RM AMBULATORY SU 713.00 MINOR PX RM AMBULATORY SU 816.00 MINOR PX RM-AMBULATORY SU 285.00 MINOXIDIL TAB 2.5 MG 4.00 MIRABEGRON ER 50MG TAB NF 42.31 MIRTAZAPINE 15MG TAB 4.18 MIRTAZAPINE TAB 30 MG 11.18 MITT SPLIT 67.05 MMR 2 VACCINE 0.5ML VL 168.73 MODAFANIL 200 MG TAB 100.00 MOEXIPRIL 15MB TAB 5.82 MOMETASONE/FORMATOTEROL MDI 200/5MCG 777.24 MONO TEST 86308 37.00 MONO TEST 86308 37.00 MONTELUKAST TAB 10 MG 16.97 MORGAN MEDI-FLOW LENS 59.80 MORPHINE 7.5mg TAB (1/2 OF 15mg) 6.26 MORPHINE 25MG/ML VL 51.15 MORPHINE INJ 10 MG/ML (1ML/SYR) J2270 26.77 MORPHINE INJ 2 MG/ML (1ml/VL) J2270 39.47 MORPHINE INJ 4 MG/ML (1ML/VL) J2270 35.87 MORPHINE ORAL SOLUTION 20mg/5ml 58.53 MORPHINE PER (15MG/ML 20 J2270 54.00 MORPHINE SOLN 5 MG/ 0.25ml (30 ML BTL) 73.29 MORPHINE SULF INJ 5MG/ML (1ml/VL) J2270 39.47 MORPHINE SULFATE 15MG (MS TAB 4.00 MORPHINE SULFATE 30MG TAB 6.85 MORPHINE SULFATE ER TAB 15 MG 13.38 MOTION FLUOROSCOPY/SWALLOW 92611 217.44 MOUTH MAGIC SWISH 4 OZ BT 34.20 MOXIFLOXACIN/ NACL 400 MG/250ML J2280 243.81 MRA:CAROTIDS 70549 2,160.00 MRA-CIRCLE OF WILLISBRAIN 70544 2,160.00 MRI PELVIS W/O CONTRAST MATERIAL 72195 2,403.11 MRI:FACE W/WO 70543 2,572.00 MRI-ABDOMEN 74181 2,349.00 MRI-ANGIO LOWER EXTREMITY 73725 1,933.00 MRI-BRAIN 70551 2,517.00 MRI-BRAIN W/WO CONTRAST 70553 2,852.00 MRI-C-SPINE 72141 2,349.00 MRI-C-SPINE W/WO 72156 2,683.00 MRI-C-SPINE WITH CONTRAST 72142 2,376.00 MRI-LOWER EXT.W/WO 73720 2,052.00 MRI-LOWER EXTREMITY W/O 73718 2,181.00 MRI-LOWER EXTREMITY (JOIN 73721 1,846.00 MRI-L-SPINE 72158 2,683.00 MRI-LUMBAR SPINE 72148 2,349.00 MRI-LUMBAR SPINE WITH CON 72149 2,376.00 MRI-ORB,FACE,NECK 70540 2,349.00 MRI-PELVIS 72196 2,511.00 MRI-THORACIC SPINE 72146 2,349.00 MRI-THORACIC SPINE WITH C 72147 2,376.00 MRI-TMJ 70336 1,293.00 MRI-T-SPINE W/WO 72157 2,592.00 MRI-UPPER EXT W/O 73218 2,181.00 MRI-UPPER EXTREMITIES 73220 2,683.00 MRI-UPPER EXTREMITY (JOIN 73221 1,846.00 MRSA SCREEN 87081 37.00 MS CONTIN 30 MG TAB 18.00 MUCINEX TAB 1200 MG 4.00 MUCINEX TAB 600 MG 4.00 MULTIPLE CLIP APPLIER 340.35 MULTIVITAMIN CHILDRENS CHEWABLE TAB NF 2.00 MULTIVITAMIN TAB 2.00 MUMPS AB IGG OR IGM 86735 95.00 MUMPS AB IGG OR IGM 86735 95.00 MUPIROCIN OIN 2% 4.97 MUSCLE TEST TOTAL BODY EX 95833 62.04 MUSCLE TEST TOTAL BODY IN 95834 84.40 MUSCLE TESTING, MANUAL, H 95832 42.78 MYCOBACTERIAL CULTURE 87118 155.27 MYCOPLASMA PNEUMONIAL 87581 420.00 MYCOPLASMA/UREAPLASMA CUL 87109 129.25 MYOGLOBIN 83874 179.00 MYOGLOBIN 83874 179.00 MYRBETRIQ 25mg TAB NF 42.31 MYSOLINE 80188 117.30 N BLOCK INJ TRIGEMINAL 64400 314.00 NA PENTOTHOL 500MG/2.5% K 18.00 NABUMETONE TAB 500 MG 5.18 NaCL 0.9% MINI BAG IVF 250ML J7050 60.00 NADOLOL TAB 80 MG 16.14 NAFCILLIN SODIUM INJ 1GM VL S0032 63.80 NAFCILLIN SODIUM INJ 2 GM VL 98.18 NALOXONE INJ 0.4 MG/ML VL J2310 79.31 NALTREXONE 50mg TAB NF 17.10 NAPROXEN TAB 220 MG 2.00 NAPROXEN TAB 500 MG 5.36 NASAL BONES 70160 219.00 NASAL HEMORRHAG 30901 284.00 NASAL WAND REFLEX ULTRA45 324.00 NATEGLINIDE TAB 120MG 17.95 NATURE THROID TAB 81.25MG NF 4.00 NECK SOFT TISSUE 70360 188.86 NEEDLE VERESS 14G EXTRALO 75.00 NEEDLE, VERESS #S100000 75.00 NEG PRESS WOUND TX < 50 C 97605 245.89 NEG PRESS WOUND TX > 50 C 97606 364.85 NEG PRESSURE WOUND NON DME >50 SQ CM 97608 477.02 NEG PRESSURE WOUND THERAPY UNDER 50 SQCM 97607 624.50 NEISSERIA GONOR 87591 151.00 NEO/ BAC/ POLY/ DEX OIN 88.00 NEO/ POLY /BAC/ZINC OINT 113.90 NEO/ POLY/ GRAM DRP (EYE) 50.60 NEO/ POLY/ HC DRP SUS 187.54 NEOPRENE KNEE SLEEVE SM 30.00 NEOSTIGMINE IVP VARIABLE DOSE 1mg/ml J2710 49.25 NEO-SYNEPHRINE 1% INJ 10MG/ML VL J2370 33.77 NEULASTA 6MG SQ SYR 6,296.00 NEUPOGEN 300MCG/1 ML VL 406.00 NEUR RE-ED(PNF/BIOFDBK) 97112 75.00 NEUROMUS RE-ED (EA 15 MIN 97112 75.00 NEURONAL (V-G) K+ CH AB 83519 147.22 NEURONTIN 82542 102.00 NEUROPLASTY/TRANSPOS MED NERV CARPAL TUN 64721 2,936.59 NEW ELBOW BRACE 180.40 NEW OV-FOCUSED 99201 78.00 NF CARE HI SEVERITY 99306 449.78 NIACIN TAB 250 MG 2.00 NIASPAN ER TAB 500 MG 18.61 NICARDIPINE INJ 2.5MG/ML VL 81.09 NICORETTE GUM 2 MG 4.00 NICOTINE & METABOLITES, SERUM 80323 90.59 NICOTINE PAT 14 MG/HR 6.43 NICOTINE PAT 21 MG/24HR 6.43 NICOTINE PAT 7 MG/24HR 7.56 NICOTINE SCREEN 80323 42.00 NIFEDIPINE ER 90MG TAB 10.25 NIFEDIPINE XL TAB 30 MG 5.25 NIMBEX 2MG/ML IV 47.00 NITRO-BID 2% OINT TUBE 5.17 NITROBID OINTMENT 2% 30GM 18.00 NITROFURANTION CAP 50 MG 11.06 NITROFURANTION MACRO CAP 20.70 NITROFURANTOIN CAP 100 MG 15.06 NITROGLYCERIN BOTTLE (0.4MG TAB) 25 TABS 77.02 NITROGLYCERIN PREMIX 50 MG/250ML BTL 141.16 NITROGLYCERIN TAB 0.4 MG 4.11 NITROPRESS INJ 50MG/2ML VL 704.00 NITRO-TRANSDERM 0.1 MG/HR 5.58 NITRO-TRANSDERM PAT 0.2MG/HR 4.85 NITRO-TRANSDERM PAT 0.4MG/HR 5.54 NMO ANTIBODY 83520 406.08 NMO EVALUATION IgG 86255 245.00 NON-SPECIFIED BACTERIA AB 86609 33.00 NON-SPEECH DEVICE SERVICE 92606 205.79 NORMODYN 100MG TAB 4.00 NOROVIRUS 87798 122.00 NORTRIPTYLINE CAP 25 MG 4.00 NORTRIPTYLINE CAP 50 MG 4.00 NORTRIPTYLINE CAP 75 MG 16.87 NP THYROID 60mg TAB NF 4.00 NU GAUZE 1/2 8.70 NUCLEAR ANTIGEN ANTIBODY 86235 86.00 NUCYNTA 1/2 OF 50mg=25mg NF 19.89 NUCYNTA 50mg TAB NF 26.84 NUPERCANAL OINTMENT APPLI 1.60 NURSE ANESTHETIST (PER UN 87.00 NURSING FAC CARE SUBSEQ 99307 121.14 NURSING FAC CARE SUBSEQ 99308 186.10 NURSING FAC CARE UNIT 99304 250.55 NURSING FAC CARE UNIT 99305 352.27 NURSING SERV DI 99315 173.00 NYSTATIN CRM 30GM 3.36 NYSTATIN PWD 100,000 UNT 54.92 NYSTATIN SUS 100,000 UNT 4.70 O & P 87177 72.00 OB 1 80055 158.00 OB 1ST TRIMESTER 76801 434.00 OB PANEL 80055 158.00 OB TRANSVAG 76817 403.71 OB U/S LTD. 76815 251.06 OBS CARE DISCHARGE 99217 198.78 OBS CARE LIMITED 99218 267.76 OBS CARE, EXTENDED 99220 504.22 OBS CARE, INTERMED 99219 367.61 OBS/ADMIT SAME DAY HIGH 99236 613.81 OBS/ADMIT SAME DAY, LOW 99234 374.58 OBS/ADMIT/SAME DAY,MOD 99235 494.02 OBSERVATION CARE 99217 193.00 OBSERVATION PER HR/ DIREC G0379 983.55 OBSERVATION PER HR/ ER G0378 29.83 OBSERVATION/HOSP CARE 50 MIN 99235 483.00 OBSTETRIC CARE 643.00 OCC HEALTH - FLU VACCINE INS BILL 90686 55.00 OCC HEALTH - HEPATITIS ADMINISTRATION 90471 58.20 OCC HEALTH CASE MANAGEMEN 55.00 OCC HEALTH FIRST AID W/CP 49.00 OCC HEALTH INJECTION FEE 90471 8.00 OCC HEALTH PRE-EMP PHYSIC 60.00 OCC HEALTH-FLU VACCINE ADMIN 90471 58.20 OCC HEALTH-FLU VACCINE SP BILL 90686 30.00 OCC HEALTH-SITE VISIT 75.00 OCC HLTH FIRST AID CLASS 38.00 OCC HLTH FITNESS TEST 11.00 OCC HLTH- TB SKIN TEST 86580 42.14 OCC HLTH-CPR CLASS 38.00 OCCULT BLOOD FECES (ONE S 82270 13.74 OCCULT BLOOD FECES (SET O 82272 13.74 OCCULT BLOOD-URINE 81002 10.80 OCTREOTIDE SYR 0.1MG/ML J2354 43.70 OCUVITE WITH LUTEIN TAB 2.00 OFLOXACIN 0.3% DRP (EAR) 228.60 OLANZAPINE 10MG TAB 59.75 OLANZAPINE DISINTERGARATI 279.84 OLANZAPINE INJ 10 MG VL J3490 115.45 OLANZAPINE TAB 2.5 MG 37.32 OLEIC ACID LIQ 1 PT BTL 85.50 OMEGA-3-ACID CAP 1 GM 4.00 OMEPRAZOLE CAP 20 MG 4.46 OMNICEF CAP 300 MG 15.34 OMNIPEN-N 500 MG IM OR IV 34.00 ONCOLOGY CLINIC VISIT G0463 150.00 ONDANSETRON 40 mg/20 ml MDV J2405 20.00 ONDANSETRON INJ 4 MG/ML (1ML/VL) J2405 23.42 ONDANSETRON TAB 4 MG 69.34 ONDANSETRON TAB 8 MG 123.78 OP SITE 2.70 OP VISIT,OBS CARE LOW 99213 141.04 OP VISIT,OBS CARE MED 99214 217.35 ORAJEL TUBE 14.24 ORAL MOTOR EXERCISES ROM 97110 86.27 ORARISK HPV 87621 175.00 ORARISK HPV 175.00 ORGANISM TYPING 87147 19.00 ORPHENADRINE INJ 60MG/2ML VL 85.83 ORTH/PROSTHETIC CHECKOUT 97530 75.00 OS-CAL 250/250 MG TAB 3.00 OSELTAMIVIR 30 MG CAP 42.54 OSELTAMIVIR 6MG/ML SUSP 364.52 OSELTAMIVIR CAP 45 MG 42.54 OSELTAMIVIR CAP 75 MG 46.37 OSMOLALITY- URINE 83935 36.00 OSMOLALITY-SERUM 83930 37.00 OSMOLALITY-URINE 83935 36.00 OT EVAL HIGH COMPLEX 60 MIN 97167 150.00 OT EVAL LOW COMPLEX 30 MIN 97165 150.00 OT EVAL MOD COMPLEX 45 MIN 97166 150.00 OT RE-EVAL EST PLAN CARE 97168 130.00 OT-MANUAL THERAPY TECHNIQ 97140 75.00 OV COMP/HIGH CO 99215 200.00 OV COMP/MOD COM 99204 264.00 OV DET/LOW N PT 99203 174.00 OV DETAILED/MOD 99214 133.00 OV EXP PROB/LOW 99213 86.00 OV EXP ST FD NP 99202 123.00 OV FOC EST PT 99212 66.00 OV MINIMAL 99211 53.00 OVA AND PARASIT 87177 72.00 OXALATE, 24 HR URINE 83945 118.00 OXIMETRY ADHESIVE 5.25 OXIMETRY OVERNIGHT 94762 198.75 OXISENSO, INFANT 43.85 OXISENSOR, PEDS D20 44.00 OXYBUTYNIN ER TAB (5MG) 13.91 OXYBUTYNIN ER TAB 10 MG 47.82 OXYBUTYNIN TAB (5 MG) 4.00 OXYBUTYNIN XL 15MG TAB 13.50 OXYCODONE CAP 5 MG 6.55 OXYCODONE TAB 10 MG 24.11 OXYCONTIN 80mg TAB 73.74 OXYCONTIN TAB 40 MG 31.09 OXYFAST SOL 20MG/ ML (30 ML BTL) 686.50 OXYGEN ONE TIME FEE 266.22 OXYGEN, PER HOUR 26.00 OXYMETAZOLINE 0.05% SPR 6.15 OXYTOCIN INJ 10 UNT/ML VL J2590 70.40 P.I.P.E. SPLINT 66.55 PACERONE TAB 200 MG 13.29 PANCREATIC ELASTASE 82656 268.80 PANTOPRAZOLE DR 20MG TAB 15.80 PANTOPRAZOLE INJ 40MJ VIAL NF 41.25 PARAFFIN BATH THERAPY 97018 36.00 PARAFFIN BATH THERAPY-OT 97018 36.00 PARANEOPLASTIC AUTOANTIBODY 86255 273.08 PARASITE ID-BUG 87168 30.00 PARATHYROID PLANAR IMAGING 78070 829.82 PARE/CUT BENIGN 11055 168.95 PARING/CUTTING LESION 2-4 11056 168.95 PAROVIRUS ANTIBODY 86747 106.00 PAROXETINE TAB 20 MG 11.16 PARTIAL THROMBOPLASTIN TI 85730 52.00 PARVOVIRUS GG IGM 86747 106.00 PAS ANTI-EMBOLISM WRAPS 107.00 PAS KNEE LNGHT STOCK. L 99.00 PAS KNEE LNGTH STOCK.XL 99.00 PATELLAR KNEE SUPPORT 79.00 PATELLAR STABILZER 50.60 PATERNITY COLLECTION FEE 16.00 PAVULON VIAL 4MG 90.00 PEAK PRE/POST BD 94060 295.86 PEDIALYTE LIQ 1 LIT 19.74 PEGFILGRASTIM INJ 6 MG J2505 10,702.26 PEGS ELECTROLYTE SOL (1GAL) 120.00 PELVIC & BREAST G0101 72.00 PELVIS (1 OR 2 VIEWS) 72170 226.00 PELVIS (3 VIEWS) 72190 263.00 PELVIS CAT SCAN W/O CONTR 72192 1,712.00 PELVIS W/WO CONTRAST 72194 1,917.00 PELVIS WITH CONTRAST 72193 1,879.00 PENICILLIN G BENZATHINE 600,000 U/ML IM 270.77 PENICILLIN G PROC INJ 300000 UNITS VL J2510 111.63 PENICILLIN V K TAB 250 MG 4.76 PENROSE DRAIN, STERILE 1/2 " LATEX FREE 12.50 PEPTO BISMOL OTC 30 ML DOSE 2.00 PERFORATED LOCKUP WRIST S 7.45 PERICARE OINTMENT 16.30 PERIPHERAL SMEAR 85060 52.00 PERMAX 0.25 MG TAB 9.00 PERQ DEVICE PLACEMENT BREAST LOC 1ST LES 19281 1,551.00 PERQ DEVICE PLACEMENT BREAST LOC EA LESI 19282 1,282.00 PFT PRE/POST BD 94060 406.20 PFT SCREEN 94010 266.22 PHENAZOPYRIDINE 95MG TAB OTC 2.00 PHENAZOPYRIDINE TAB 100MG 4.00 PHENAZOPYRIDINE TAB 200MG 9.60 PHENERGAN J2550 26.66 PHENERGAN/CODEINE 5ML 22.59 PHENOBARBITAL 80184 95.45 PHENOBARBITAL INJ 130 MG/ML VL J2560 169.00 PHENOBARBITAL LIQ 60 MG/15 ML 7.78 PHENTOLAMINE INJ VARIABLE DOSE 5 MG VL J2760 989.00 PHENYLEPHRINE 0.5% NASAL SPRAY 11.40 PHENYTOIN CAP 100 MG 4.00 PHENYTOIN SUS 125 MG/5ML 9.67 PHENYTOIN;TOTAL 80185 80.00 PHILADELPHIA CERVICAL COL 38.55 PHILLIPS MOM 30CC 4.00 PHLEBOTOMY 99195 245.97 PHOS/SOD/POTAS ORAL PWDR 280/160/250MG 4.00 PHOSPHA 250 NEUTRAL TAB NF 4.00 PHOSPHATIDYLETHANOL (PETH) 80321 146.59 PHOSPHOROUS, 24 HR UA 84105 33.00 PHOSPHORUS SERUM 84100 32.00 PH-STOOL 83986 14.64 PHY PERF TEST ( EA 15 MIN 97750 50.00 PHYS-ER CHILD RADIAL HEAD 24640 580.00 PHYSICAL PRFORM TEST (EA 97750 75.00 PHYSICIAN REST BED 99336 337.42 PILLOW COMFORT PLUS ELBOW & HEEL 57.60 PILLOW THERAPEUTIC 94.80 PINWORM EXAM 87172 39.20 PINWORM EXAM 87172 39.20 PIOGLITAZONE TAB 15 MG 21.02 PIOGLITAZONE TAB 30 MG 71.26 PIPERACILLIN/ TAZO INJ 3.375 GM VL J2543 66.16 PIPERACILLIN/ TAZO INJ 4.5 GM VL J2543 83.36 PIPERACILLIN/TAZO INJ 2.25 GM VL J2543 56.25 PIROXICAM CAP 40 MG 17.95 PLASTER CAST SHORT LEG 57.25 PLASTER SPLINT 15.75 PLATELET COUNT 85049 18.87 PLETAL TAB 100 MG 7.30 PM 1-4 YRS. EST 99392 172.00 PM 18-39 EST 99395 206.00 PM 40-64 EST PT 99396 206.00 PM 5-11 YRS EST 99393 172.00 PM 65+ EST PT 99397 233.00 PM EST 12-17 YR 99394 177.00 PM INFANT EST 99391 147.00 PNEUMATIC ANKLE L4350 116.00 PNEUMONIA VACC.ADMIN. G0009 133.67 POLIOVIRUS IPV SC/IM 90713 64.00 POLYETHYLENE GLYC PWD [11 7.48 POLYSACCARIDE 150 MG TAB 4.00 POLYSOMNOGRAM 95810 2,342.31 PORT DRAW 36591 242.94 PORT FLUSH ONLY 96523 196.78 PORT PLACEMENT (FLUO FOR VEIN DEVICE) 77001 175.56 POSACONAZOLE 80299 182.43 POST OP SHOE WOMENS LG 34.45 POST-OP SHOE WOMENS MED 13.95 POST-OPSHOE MENS MED 17.80 POSTPARTUM CHECK 59430 379.26 POST-SURGICAL SHOE 20.30 POTASSIUM 84132 32.00 POTASSIUM BLOOD 84132 32.00 POTASSIUM CHLORIDE CAP 10MG 4.00 POTASSIUM CHLORIDE SOL 20 MEQ/15ML 16.25 POTASSIUM CITRATE 10 MEQ TAB 9.82 POTASSIUM CL INJ 20 MEQ/10 ML VL J3480 23.60 POTASSIUM CL TAB 10 MEQ 6.01 POTASSIUM CL TAB 8 MEQ 4.00 POTASSIUM, 24 HR URINE 84133 26.05 POWER MOBILITY DEVICE FOR G0372 30.00 PR-3 86021 194.00 PRAMIPEXOLE 0.125MG TAB NF 13.37 PRAVASTATIN 40MG TAB NF 19.16 PRAVASTATIN 80MG TAB 19.16 PRAVASTATIN TAB 10 MG 11.57 PRAZOSIN TAB 1 MG 7.25 PREALBUMIN 84134 89.00 PREDNISOLONE 15MG/5ML SOL 9.63 PREDNISOLONE SOL 5 MG/5ML 16.35 Prednison 20mg tablet 11.04 PREDNISONE 1mg TAB NF J7512 4.00 PREDNISONE TAB 10 MG 4.00 PREDNISONE TAB 5 MG 4.00 PRE-EMPLOYMENT DRUG SCREE 80.00 PREGABALIN 75 mg CAP 29.43 PREGABALIN CAP 150 MG 26.75 PREGABALIN CAP 25 MG 26.75 PREGABALIN CAP 50 MG 26.75 PREGNANCY TEST 81025 37.00 PREGNANCY TEST 84703 60.00 PREGNANCY TEST 84703 60.00 PRESERVISION AREDS 2 FORMULA SOFT GEL NF 2.00 PRESERVISION TAB 4.00 PREV VISIT NEW AGE 12-17 99384 219.00 PREV VISIT NEW AGE 18-39 99385 250.00 PREV VISIT NEW AGE 40-64 99386 273.00 PREV VISIT NEW AGE 5-11 99383 195.00 PREVNAR 13 VACCINE 532.10 PRIMARY IV SET MICRODRIP 5.20 PRIMIDONE 50MG TAB 4.00 PRINCIPEN INJ 1 GM VL J0290 41.60 PRIVATE CARE 766.00 PRIVIGEN 10 GM/100ML VL J1459 3,500.00 PRIVIGEN INJ 20GM/200ML VL J1459 7,000.00 PROAMATINE 5MG TAB 8.00 PROBE ADULT SP02 28.00 PROBE FINGER ADULT OXISEN 31.00 PROBE INFANT SP02 37.00 PROBE PEDIATRIC SP02 28.00 PROBE PEDS OXISENSOR 31.00 PROBE, DISPOSABLE 5MM/32C 65.00 PROCAL AMINE 1000CC 89.00 PROCALCITONIN 84145 261.22 PROCARDIA XL 60 MG ORAL CAP 13.00 PROCHLORPERAZINE INJ 10 MG/2 ML VL J0780 75.50 PROCHLORPERAZINE SUPP 25 MG 37.75 PROCHLORPERAZINE TAB 5 MG 4.00 Procrit 20000/mL VL J0885 90.99 PROCRIT 3000 units/ml 232.99 PROCTOSCOPIC EXAM SUPPLIE 25.60 PROGESTERONE 84144 103.00 PROGESTERONE 100MG CAP 8.53 PROLACTIN 84146 136.00 PROLACTIN 84146 136.00 PROLENE MESH 6X6 PMH C1781 158.00 PROLENE MESH PHSE C1781 288.00 PROLENE MESH PHSL C1781 288.00 PROLENE MESH PHSM C1781 288.00 PROLIA INJ 60 MG SYR J0897 2,362.02 Promethazine DM oral syrup 4.00 PROMETHAZINE INJ 25 MG/ML VL J2550 24.74 PROMETHAZINE LIQ 6.25 MG/5 ML 22.05 PROMETHAZINE SUP 12.5 MG 53.12 PROMETHAZINE SUP 25 MG 17.79 PROMETHAZINE TAB 25 MG 4.00 PROPAFENONE 225mg 9.32 PROPAFENONE 300mg TAB NF 11.88 PROPAFENONE CAP 150MG 20.26 PROPARACAINE 0.5% EYE GTT 15 ML BTL 87.74 PROPOFOL INJ 10 MG/ML (200 MG/20ML VL) J2704 38.00 PROPOXYPHEN/ ACET TAB [10 6.66 PROPOXYPHENE CAP [65 MG] 6.33 PROPRANOLOL 40MG TAB 4.00 PROPRANOLOL ER 60MG 8.23 PROPRANOLOL LA CAP 80 MG 9.63 PROPRANOLOL TAB 10 MG 4.00 PROSIGHT (OCUVITE) TAB 4.00 PROSTATE CA SCREENING DRE G0102 43.00 PROTAMINE SULF INJ 250 MG J2720 116.88 PROTECTORS, ELBOW OR HEEL 2.70 PROTEIN C ACTIVITY 85303 174.00 PROTEIN C ANTIGEN 85302 126.17 PROTEIN C, ACTIVITY 85303 174.00 PROTEIN FREE LIGHT CHAINS 83883 166.25 PROTEIN S ACTIVITY 85306 203.00 PROTEIN S ANTIGEN 85305 237.00 PROTEIN S, FREE 85306 203.00 PROTEIN,TOTAL U 84155 37.00 PROTEIN; ELECTR 84165 65.00 PROTEIN-QUANTITATIVE UA 84156 41.50 PROTHROMBIN TIM 85610 23.00 PROTHROMBIN TIME (PT) 85610 23.00 PROTONIX ORAL SUSP PKT NF 51.65 PROTONIX TAB 40 MG 15.80 PSA 84153 92.33 PSA 84153 92.33 PSA-SCREENING G0103 92.33 PSEUDO-CHLOR CAP 4 MG/ 60 MG 2.00 PSYLLIUM CAPSULE NF 4.00 PSYLLIUM PWD 2.00 PT EVAL HIGH COMPLEX 45 MIN 97163 150.00 PT EVAL LOW COMPLEX 20 MIN 97161 150.00 PT EVAL MOD COMPLEX 30 MIN 97162 150.00 PT RE-EVAL EST PLAN CARE 97164 125.00 PTH INTACT 83970 207.22 PTH INTACT 83970 207.22 PTH RELATED PROTEIN 82397 311.54 PTT CONFIMATION 85732 57.00 PTT-SANFORD 85730 51.00 PUNCH BIOPSY 3mm 13.88 PUNCH BIOPSY 5mm 6.75 PUNCTURE DRAINAGE OF LESI 10160 310.80 Q FEVER ANTIBODIES 86638 36.00 QUANTIFERON GOLD TB TEST 86480 188.75 QUANTITATIVE HC 84702 106.00 QUETIAPINE 100MG TAB 20.57 QUETIAPINE TAB 200 MG 45.28 QUETIAPINE TAB 25 MG 15.11 QUINAPRIL 20MG TAB NF 4.89 QUINAPRIL 40MG TAB NF 4.89 QUINAPRIL TAB 10 MG 4.89 R O M WALKER 204.25 R.A. LATEX 86430 45.00 RA FACTOR TITER 86431 47.00 RA, JOINT FLUID 86430 38.00 RABAVERT INJ 1 ML VL 793.79 RABBIES VACCINE IM 90675 404.40 RABIES AB 86382 201.75 RABIES AB 86382 201.75 RABIES IMM.GLOB IM ADMIN. 90376 640.95 RABIES IMMUNE GLOBULIN IN SYR J1460 1,639.07 RADIOLOGICAL EXAM SURGICAL SPECIMEN 76098 486.69 RADIOPHAR I 123 (100) MOBILE A9516 170.00 RADIOPHAR Tc66m ALBUMIN MOBILE A9540 76.74 RADIOPHAR Tc99m LABEL RBC MOB A9560 65.00 RADIOPHAR Tc99m MERITIATIDE MOB A9562 323.00 RADIOPHAR Tc99m MIBI 1 MOB A9500 80.00 RADIOPHAR Tc99m PENTETATE-DTPA A9567 91.98 RADIOPHARM Tc99m SULFER COLLOID A9541 65.00 RADIOPHARTc99m A9512 65.00 RALOXIFENE TAB 60 MG 23.76 RAMELTEON 8MG TAB NF 45.32 RAMIPRIL CAP 10 MG 8.87 RAMIPRIL CAP 2.5 MG 9.40 RANDOM URINE CHLORIDE 82436 21.00 RANDOM URINE POTASSIUM 84133 21.00 RANDOM URINE PROTEIN/CREA 84156 34.00 RANDOM URINE SODIUM 84300 24.93 RANITIDINE TAB 150 MG 4.00 RANITIDINE/ NACL INJ 50 MG/2ML VL J2780 39.34 RECOVERY ROOM 1-30MIN 348.00 RECOVERY ROOM 121-150MIN 735.00 RECOVERY ROOM 151-180MIN 818.00 RECOVERY ROOM 181-210MIN 880.00 RECOVERY ROOM 211-240MIN 922.00 RECOVERY ROOM 31-60MIN 547.00 RECOVERY ROOM 61-90MIN 630.00 RECOVERY ROOM 91-120MIN 703.00 REDUCE ANKLE DISLOCATION 27842 1,349.94 REDUCE ANKLE DISLOCATON 27842 1,349.94 REDUCE ELBOW DISLOCATION WITH ANESTHESIA 24605 1,349.94 REDUCE ELBOW DISLOCATION WITH ANESTHESIA 24605 3,033.00 REDUCE FRACTURE TOE 28515 289.22 REDUCE FRACTURE TOE 28515 289.22 REFRESH PLUS 0.5% EYE DRO 42.36 REMERON 7.5MG TAB 4.00 REMICADE INJ 100 MG VL J1745 2,348.87 REMINYL 8MG TABLET 12.39 REMOVAL FB, CONJUNCTIVA 65205 154.00 REMOVAL FOREIGN BODY CORNEA 65220 330.01 REMOVAL FOREIGN BODY CORNEA 65220 330.01 REMOVAL FOREIGN BODY EYE 65205 251.78 REMOVAL FOREIGN BODY HAND 20520 1,348.03 REMOVAL FOREIGN BODY HAND 20520 1,922.73 REMOVAL IMPACT.CERUMEN / INSTRUMENT 69210 95.01 REMOVAL IMPACT.CERUMEN / INSTRUMENT 69210 160.32 REMOVAL IMPACTE 69210 115.00 REMOVAL IMPACTED CERUMEN IRR/LAV UNILAT 69209 55.96 REMOVAL OF FOOT FOREIGN B 28190 2,063.64 REMOVAL OF FOOT FORGEIN B 28190 572.85 REMOVAL OF NAILPLATE 11730 183.00 REMOVAL OF SKIN TAGS 11200 196.64 REMOVAL TUN CTRP VAD W PORT/PUMP REMOVAL 36590 1,092.00 REMOVE BIRTH CONT IMPLANT 11982 330.01 REMOVE CONTRACEPTIVE CAP 11976 572.85 REMOVE EYELID FOREIGN BOD 67938 314.19 REMOVE EYELID FOREIGN BOD 67938 917.00 REMOVE FOREIGN BODY/EYE 65222 159.45 REMOVE INTRAUTERINE DEVIC 58301 275.76 REMOVE NASAL FOREIGN BODY 30300 347.88 REMOVE NASAL FOREIGN BODY 30300 347.88 REMOVE OBJECT F 65205 169.00 REMOVE OBJECT F 69200 276.00 REMOVE OBJECT F 65220 330.01 REMOVE OBJECT F 30300 453.00 REMOVE OBJECT F 28190 779.00 REMOVE RECTUM O 45915 936.39 REMOVER PREP SOLUTION 18.00 RENAL FUNCTION PANEL 80069 52.00 RENAL FUNCTON PANEL 80069 51.50 RENIN 84244 159.75 RENIN ACTIVITY 84244 160.00 RENVELA 800MG TAB 15.30 RENVELLA TAB 800 MG 20.32 REPAGLINIDE TAB 2 MG 22.52 REPAIR COMPLEX 13101 579.00 REPAIR COMPLEX SCALLP/ARM/LEG 2.6-7.5 CM 13121 1,322.00 REPAIR COMPLEX SCALP/ARM. LEG 2.6-7.5 CM 13121 1,322.00 REPAIR FACE,EAR 12013 421.00 REPAIR INITIAL INGUINAL HERNIA 5 AND UP 49505 5,080.00 REPAIR INTERMEDIATE 12031 549.08 REPAIR LAYER CL 12032 573.00 REPAIR LAYER CLOSUR TRUNK 12032 546.00 REPAIR MOUTH LA 40830 446.00 REPAIR OF NAIL 11760 488.20 REPAIR OF NAILBED 11760 488.20 REPAIR OF NAILBED 11760 488.20 REPAIR RECUR FEMORAL HERNIA, REDUCIBLE 49555 4,500.00 REPAIR RECURRENT INGUINAL HERNIA 49520 6,661.22 REPAIR SCALP 20.0-30cm 12006 343.86 REPAIR SCALP 20.1-30cm 12006 597.09 REPAIR SIMPLE 12002 370.00 REPAIR SIMPLE 2.5 cm 12001 322.00 REPAIR SIMPLE 2.6-5.0 CM 12013 383.00 REPAIR SIMPLE F 12011 370.00 REPAIR SIMPLE FACE E,N,L 12011 168.95 REPAIR SUPERFICIAL LACER. 12005 364.85 REPAIR SUPERFICIAL WOUND 12014 234.92 REPAIR SUPERFICIAL WOUND 12001 275.43 REPAIR SUPERFICIAL WOUND( 12005 498.00 REPAIR SUPERFICIAL WOUNDS 12004 238.48 REPAIR SUPERFICIAL WOUNDS 12002 245.89 REPAIR SUPERFICIAL WOUNDS 12011 245.89 REPAIR SUPERFICIAL WOUNDS 12014 245.89 REPAIR SUPERFICIAL WOUNDS 12013 245.89 REPAIR UMBILICAL HERNIA 5 YR/> REDUCIBLE 49585 4,542.41 REPAIR WOUND DEHISCENCE SIMPLE CLOSURE 12020 1,365.63 REPAIR WOUND DEHISCENCE SIMPLE CLOSURE 12020 1,365.63 REPAIR(COMPLEX 13132 1,258.00 REPAIR(LAYER FA 12051 517.00 REPINIROLE 1MG TAB NF 10.00 RESPIRATORY PROBE 87633 571.72 REST BED - PRIVATE ROOM 400.00 RETICULOCYTE CO 85045 35.00 RETICULOCYTE COUNT 85045 35.00 RHEUMATOID FACT 86430 45.00 RHEUMATOID FACT 86431 47.00 RHINO RAPID 4.5cm 128.45 RHINO ROCKET SLIMLINE LAR 35.90 RHINO ROCKET, MEDIUM 32.50 RHINO ROCKET, SMALL 31.35 RHINO, RAPID 6CM SINU KIT 159.25 RHINO,RAPID 5.5CM 124.60 RHINO,RAPID 7.5CM 128.45 RHOGAM 300MCG J2790 263.00 RIBS BILATERAL WITH PA CHEST MIN 4 VIEW 71111 367.00 RIBS LEFT (2 OR 3 VIEWS) 71100 247.00 RIBS RIGHT (2 OR 3 VIEWS) 71100 247.00 RIBS WITH PA CHEST LEFT 71101 289.00 RIBS WITH PA CHEST RIGHT 71101 289.00 RICKETTSIAL ABS 86757 220.60 RIFAXIMIN 550MG TAB 131.70 RINGERS INJ 1000CC 65.00 RISPERIDONE 1MG TAB 18.20 RISPERIDONE TAB 0.5 MG 17.09 RITALIN 82542 124.00 RITUXAN INJ 100 MG VL J9310 2,168.12 RITUXAN INJ 500 MG VL J9310 10,840.56 RIVAROXABAN 15mg NF TAB 50.29 RIVAROXABAN 20MG TAB NF 50.29 RMVL FOREIGN BODY MOUTH SIMPLE 40804 743.49 RMVL FOREIGN BODY MOUTH SIMPLE 40804 743.49 ROCATROL CAP 0.25 MCG 5.12 ROCEPHIN 250 MG J0696 11.72 ROCURONIUM INJ 10 MG/ML (5 ML VL) 40.32 ROM MEASURE/REPORT, HAND- 95852 24.00 ROM, EXT/TRUNK EXC HAND 95851 32.00 ROM, HANDS, BILAT. COMP. 95852 24.00 ROPINIROLE TAB 0.5 MG 20.23 ROPINIROLE TAB 3 MG 20.98 ROPINOROLE 2MG TAB 10.02 ROSUVASTATIN TAB 20 MG 5.78 ROSUVASTATIN TAB 5 MG 31.31 ROTOVIRUS (EIA) 87425 98.00 ROTOVIRUS (EIA) 87425 98.00 RSV 87280 47.00 RSV SCREEN 87807 39.00 RT- ALBUTEROL NEB 0.63MG/3ML 25.55 RT- ALBUTEROL NEB 2.5MG/3 ML J7613 25.41 RT- ALBUTEROL/ IPRATROPI 2.5-0.5 MG/3 ML 25.77 RT- ARFORMOTEROL NEB 15MCG/2ML 30.18 RT- BUDESONIDE NEB 0.5 MG/2ML J7626 41.75 RT- IPRATROPIUM NEB 0.02% 25.53 RT- LEVALBUTEROL NEB 1.25 MG (3ML/PC) 33.94 RT- RACEPINEPHRINE NEB 2.25% 25.44 RT- SOD CHLORIDE 0.9% NEB 25.06 RUBELLA AG SCREEN 86762 58.00 RUBELLA ANTIBODY 86762 62.00 RUBEOLA (MEASLES) IgG AB 86765 134.50 SACRO LUMBAR SUPPORT 52.80 SACROILIAC JOINTS 3 OR MORE VIEWS 72202 228.29 SACRUM/COCCYX 72220 195.00 SALICYLATE 80307 85.00 SALINE NASAL SPRAY 4.06 SALIVA ALCOHOL 80320 16.00 SAOCHAROMYES BOULARDII 250MG CAP 5.52 SAVELLA 50mg TAB NF 20.93 SBSQ HOSP CARE,EXTENDED 99233 286.34 SBSQ NF CARE PR 99307 100.00 SBSQ NF CARE PR 99308 151.00 SBSQ NF CARE PR 99309 209.00 SBSQ NF CARE PR 99310 276.00 SBSQ NF CARE, NEW PROB 99309 245.33 SCAPULA, LEFT 73010 211.00 SCAPULA, RIGHT 73010 211.00 SCLERODERMA AB 86235 157.00 SCOLIOSIS SURVEY 72081 205.00 SCOPOLAMINE TRANSDERM PATCH 1.5/72HR 51.11 SCREENING DGTL TOMOSYNTHESIS BILATERAL 77063 50.00 SCREENING MAMMO - BILATERAL DIGTL IMAG 77067 450.00 SCREENING SFOB (ONE SET) 82270 13.74 SCREENING SFOB (SET OF 3) 82270 22.00 SCRN COLONOSCOPY G0121 1,940.19 SCRN COLONOSCOPY-HI RISK G0105 1,940.19 SEBOFORANE GAS PER USE 125.00 SED RATE 85651 32.00 SEDIMENTATION RATE (ESR) 85651 32.00 SELDANE, PER TAB 4.00 SELECTIVE DEBRIDEMENT < 2 97597 364.85 SELECTIVE DEBRIDEMENT >20 97598 442.17 SELEGILINE 5MG TAB NF 9.22 SELF PAY COMPLETE BLOOD COUNT (CBC) 15.00 SELF PAY COMPREHENSIVE LAB PROFILE (CMP 20.00 SELF PAY FREE T4 (FT4) 15.00 SELF PAY GENERAL HEALTH PANEL 70.00 SELF PAY GLUCOSE (GLU) 10.00 SELF PAY LIPID PANEL 25.00 SELF PAY TSH 25.00 SELF PAY VITAMIN D 60.00 SELF-CARE/HOME MANAGEMENT 97535 75.00 SELF-CARE/HOME MANAGEMENT 97535 75.00 SEMI-PRIVATE CARE 716.00 SENIOR LIFE OUTPATIENT CLINIC VISIT G0463 113.69 SENIOR LIFE TELEHEALTH FACILITY FEE Q3014 50.00 SENNA-GEN 8.6 TAB 2.00 SENNA-S LAX TAB 2.00 SENSORCAINE 0.5% PLAIN 30 21.00 SENSORY INTEGRATION 97533 83.27 SENSORY INTEGRATIVE TECHN 97533 79.81 SERNA LOTION 8oz BOTTLE 15.60 SEROTONIN 84260 229.00 SEROTONIN 84260 229.00 SERTRALINE TAB 100 MG 13.42 SERTRALINE TAB 50 MG 4.00 SERUM IRON 83540 45.00 SEVOFLURANE 250 ML 1.31 SEVOFLURANE INH 250 ML 1.00 SEX HORMONE BINDING GLOBU 84270 126.40 SGOT (AST) 84450 31.00 SGPT TRANSAMIN 84460 31.00 SGPT (ALT) 84460 31.00 SHAVE LES HAND 1.1/ 2.0CM 11307 177.27 SHAVE LESION FA 11310 178.00 SHAVE LESION FA 11311 219.00 SHAVE LESION, S 11305 168.95 SHAVE SKIN LESI 11301 180.00 SHAVE SKIN LESION 11302 225.00 SHAVELESS,NECK 0.6/1.0 CM 11306 168.95 SHAVING EPIDERM 11300 168.95 SHILEY INNER CANNULA 119.60 SHLDR. IMMOB. CHILDRENS 36.75 SHORT ARM SLINT ADULT Q4021 59.00 SHOULDER, LEFT (2 VIEWS) 73030 221.00 SHOULDER, LEFT 1 VIEW 73020 172.05 SHOULDER, RIGHT (2 VIEWS) 73030 221.00 SHOULDER, RIGHT 1 VIEW 73020 172.05 SHUNTOGRAM INDWELLING NONVASCULAR SHUNT 75809 414.00 SICKLE CELL SCREEN 85660 39.56 SICKLE CELL SCREEN 85660 39.56 SI-LOC BRACE L/XL 81.75 SI-LOC BRACE S/M 74.95 SILVER NITRATE STK 4.67 SILVER SULFADIAZINE 1% CRM 400 GM 190.78 SILVER SULFADIAZINE 1% CRM 50 GM 45.36 SIM REPAIR 2.5 12001 350.00 SIMETHICONE 80MG TAB 2.00 SIMETHICONE DRP 40 MG/0.6ML 2.00 SIMPLE REPAIR 12.6cm 12016 364.85 SIMPLE REPAIR 12.6cm 12016 382.37 SIMPLE REPAIR 7.6-12.5CM 12004 257.25 SIMPLE REPAIR FACE 5.1&7. 12014 495.00 SIMPLE REPAIR FACE 7.5cm 12015 281.85 SIMPLE REPAIR FACE 7.5cm 12015 364.85 SIMPLE REPAIR H 12004 446.00 SIMPLE REPAIR(SC,N,T,H,F) 12002 341.00 SIMVASTATIN TAB 10MG 11.16 SIMVASTATIN TAB 20 MG 19.68 SINUS SERIES 70220 282.00 SINUS TRACT INJECTION 76080 689.88 SINUS-SINGLE VIEW 70210 210.00 SITAGLIPTIN TAB 100 MG 51.55 SITAGLIPTIN TAB 50 MG 51.55 SITE VISIT (EA 15 MIN)-OT 97537 81.74 SITZ BATH, DISPOSABLE 28.55 SJOGRENS AB-ANTI-SSA 86235 86.00 SJOGRENS AB-ANTI-SSB 86235 86.00 SKIN FUNGI CULTURE 87101 48.00 SKIN MARKER & RULER 4.25 SKIN STAPLER 3M 19.50 SKIN STAPLER DISPOSABLE 19.05 SKULL (2 VIEWS) 70250 208.00 SKULL (4 VIEWS) 70260 291.00 SKULL (5 VIEWS) 70260 300.00 SLEF PAY HEMOGLOBIN A1C (HGBA1C) 20.00 SLING A4565 27.00 SLOW FE TAB 45MG 4.00 SMALL BOWEL SERIES 74250 428.00 SMEAR, STAIN & 87210 31.00 SMEAR, STAIN & 87205 32.00 SMEAR, STAIN & 87206 53.00 SMOKING CESS.COUNS.>10 MI 99407 70.57 SMOKING CESS.COUNS.3-10MI 99406 33.12 SMOOTH MUSCLE ANTIBODY 86255 72.93 SNARE POLYPECTOMY 61.25 SNARE-CAPTIVATOR II 56.25 SNF DISCHARGE DAY 30 MIN 99315 196.93 SNF FAC DISCHG 31+MIN 99316 283.81 SOD BICARB INJ SYR 50 MEQ (50ML) 24.29 SOD POLY SULF SUS 15GM/60mL 21.60 SODIUM 84295 20.31 SODIUM 84295 20.31 SODIUM BICARBONATE 650MG TAB 4.00 SODIUM CHLORIDE TAB 1 GM 4.00 SODIUM HYDROCHLOR SOLN 0.5% 34.01 SODIUM HYPOCHLORITE .125%SOLN 34.01 SODIUM, 24 HR UA 84300 32.00 SODIUM, 24 HR UA 84300 32.00 SODIUM, RANDOM URINE 84300 12.75 SOFT TISSUE NECK CAT SCAN 70491 1,647.00 SOFT TISSUE NECK CAT SCAN 70492 1,879.00 SOFT TISSUE NECK CT W/O 70490 1,512.00 SOFT TISSUE NECK MRI 70549 2,629.00 SOLU MEDROL INJ 125 MG VL J2930 49.06 SOLU-CORTEF INJ 100 MG VL J1720 60.30 SOLU-MEDROL 40mg ING 38.05 SORBSAN DRESSING 19.00 SPEC REPORTS IN 99080 20.00 SPECIAL STAIN GROUP 2 88313 71.00 SPECIAL STAINS 88312 135.52 SPEECH SOUND LANG. COMPREHENSION 92523 547.42 SPEECH/HEARING EVALUATION 92523 447.91 SPEECH/HEARING THERAPY 92507 211.18 SPEECH-GEN DEV.TX 92609 315.28 SPENCO HEEL SUPPORT 50.30 SPEP 84165 65.00 SPERM CHECK 89300 37.65 SPHINCTEROTOMY ANDAL DIVISION SPHINCTER 46080 2,315.63 SPINE INJECTIONS (FLUOROGUIDE FOR SPINE) 77003 213.87 SPINE THRC LUMBR CRV SAC 2/3 VIEW 72082 351.00 SPINE XRAY 1 VIEW SPECIFY LEVEL 72020 195.00 SPIRAL ELECTRODE 18.10 SPIRIVA INHALER KIT 300.00 SPIRONOLAC/ HCTZ TAB 25/25MG 6.14 SPIRONOLACTONE TAB 25 MG 4.00 SPLINT A4570 14.00 SPLINT A4570 27.00 SPLINT A4570 30.00 SPLINT A4570 51.00 SPLINT A4570 68.00 SPLINT STRAP, HEAVY DUTY 8.00 SPLIT NIGHT/CPAP BIPAP 95811 2,500.00 SPORT-PX 25.00 SPOT, INDICATOR MARKE 68.25 SRP AUTOANTIBODIES 86235 133.00 STABILITY THREAD 23.05 STANDARD FLOW SET 40.30 STANDARD FLOW SET W/EXTEN 5.15 STAT TEMP II 7.20 STERNUM (2 VIEWS) 71120 215.00 STICK ASSAY OF 82948 22.00 STONE ANALYSIS 82365 106.00 STOOL CULTURE 2 87046 18.00 STOOL CULTURE F 87045 18.00 STOOL CULTURE, 87046 18.00 STOOL-CULTURE 1 87045 18.00 STRAPPING (ELBOW OR WRIST 29260 231.45 STRAPPING (HAND OR FINGER 29280 231.45 STRAPPING ELBOW / WRIST 29260 78.88 STRAPPING ELBOW / WRIST 29260 167.55 STRAPPING OF CHEST 29200 135.42 STRAPPING OF KNEE 29530 105.04 STRAPPING OF SHOULDER 29240 139.00 STREP PNEUMO IgG-14 SEROTYPES 86317 32.21 STREP PNEUMO IgG-23 SEROTYPES 86317 31.14 STREP PNEUMONAL-AG,URINE 87450 53.06 STREP SCREEN 87880 64.00 STRESS TEST W/ SUPER, INTERPRET, REPORT 93015 700.00 STRESS TEST WITH EKG TRACING AND MONITOR 93017 750.00 STRESS TEST WITH SUPERVISION 93016 172.00 SUB Q SET 7.60 SUB UPDRAFT TREATMENT 94640 186.38 SUB.OBS CARE 99225 207.60 SUBCLAVIAN CATHETER 20.40 SUBSEQUENT HOSPITAL CARE - HIGH COMPLEXI 99234 384.00 SUBSEQUENT HOSPITAL CARE-HIGH COMPLEXITY 99233 226.00 SUBSEQUENT HOSPITAL CARE-LOW COMPLEXITY 99231 109.00 SUBSEQUENT HOSPITAL CARE-MOD COMPLEXITY 99232 160.00 SUBSEQUENT OBS CARE 99224 113.50 SUBSEQUENT OBS CARE 99224 113.50 SUBSEQUENT OBS CARE 99225 207.60 SUBSEQUENT OBS CARE 99226 299.16 SUBSEQUENT VISIT PROSTHETIC OR ORTHOTIC 97763 75.00 SUBSEQUENT VISIT PROSTHETIC OR ORTHOTIC 97763 75.00 SUCCINYLCHOLINE INJ 200MG/10 MG VL J0330 87.54 SUCRALFATE TAB 1 GM 4.00 SUCTION CATHETER 1.90 SUCTION SET STERILE 3.40 SUDAFED (PSEUDOEPH) TAB 3 3.00 SULFACETAMIDE EYE GTTS 122.00 SULFAMETH/ TMP TAB 400-80MG 4.00 SULFAMETH/ TMP DS TAB 800-160MG 7.32 SULFAMETH/ TMP SUS 200-40MG/5ML 9.11 SULFAMETHOXAZOLE/TMP INJ 80-16MG/ML NF 57.62 SULFASALAZINE 500 mg TAB NF 4.00 SULINDAC 200MG TAB NF 4.80 SUMATRIPTAN INJ 6 MG/0.5ML VL J3030 215.50 SUPHEDRINE 12 HR TAB 4.00 SUPHEDRINE/PSEUDOPEDRINE 30MG TAB 4.00 SUPRAPUBIC CATHETHER SET 131.35 SURG PATH-GROSS ONLY 88300 46.84 SUTURE 0 SILK A306H 4.75 SUTURE 3-0 PROLENE 8522H 16.00 SUTURE 6-0 PROLENE 8695G 12.00 SUTURE CHROMIC 3-0 G122H 7.10 SUTURE CHROMIC 4-0 793G 5.15 SUTURE CHROMIC GUT O 39.30 SUTURE CLOSURE OF WOUND 12035 675.00 SUTURE ETHILON 3-0 1669H 11.45 SUTURE ETHILON 3-0 1691H 10.75 SUTURE ETHILON 4-0 1667G 10.70 SUTURE ETHILON 4-0 1667G 10.70 SUTURE ETHILON 5-0 1855G 11.80 SUTURE ETHILON 6-0 1665G 12.45 SUTURE MONOCRYL 0 Y606H 8.10 SUTURE MONOCRYL 3-0 MCP427H 18.00 SUTURE MONOCRYL 3-0 Y416H 6.80 SUTURE MONOCRYL 4-0 18.65 SUTURE MONOCRYL 4-0 Y426H 15.70 SUTURE MONOCRYLO 7.40 SUTURE MONOSOF 3-0 SN-663 4.60 SUTURE NUROLON D 28.80 SUTURE PDS2 2340H 10.08 SUTURE PDSII 2-0 8.65 SUTURE POLYSORB 2-0 24.00 SUTURE POLYSORB 3-0 #GL-6 23.00 SUTURE PROLENE 0 8424H 8.50 SUTURE PROLENE 1-0 8425H 8.60 SUTURE PROLENE 2.0 8411H 8.55 SUTURE PROLENE 3-0 8687H 10.05 SUTURE PROLENE 4-0 8557H 16.00 SUTURE PROLENE 4-0 8682G 11.70 SUTURE PROLENE 5-0 8681G 10.05 SUTURE PROLENE 5-0 8686G 14.00 SUTURE PROLENE 6-0 8680G 12.00 SUTURE SILK 2.0 5.80 SUTURE SURGIPRO 5.0 SP 10.05 SUTURE SURGIPRO 5-0 12.95 SUTURE VICRYL 0 8.90 SUTURE VICRYL 2-0 7.15 SUTURE VICRYL 2-0 J333H 5.95 SUTURE VICRYL 3-0 J104T 14.20 SUTURE VICRYL 3-0 J4164 7.25 SUTURE, 0 MAXON 8.00 SUTURE, 1 MAXON 8.00 SUTURE, 4-0 ETHILON 662G 4.60 SUTURE, ETHILON 5-0 661G 4.60 SUTURE, ETHILON 5-0 698G 11.50 SUTURE, PLAIN GUT 5-0 19.00 SUTURE, SURGILON 2-0 18.80 SUTURE, VICRYL 2-0 J317H 12.65 SUTURE, VICRYL 3-0 6.30 SUTURE, VICRYL 5-0 J506G 10.05 SUTURE,SURGIPRO 5.0 XP 12.95 SUTURE,VICRYL 3-0 J416H 5.35 SUTURE-VICRYL 4-0 J496G 10.20 SW & PSYCH SRVC EA 15 MIN G0409 27.66 SWING-BED CARE 608.60 SWING-BED CARE PRIVATE 651.10 SYMBICORT MDI 160/ 4.5MCG 563.62 SYNERCID 500mg INJ J2770 944.96 SYPHILIS SEROLOGY 86592 35.00 SYPHILIS TEST 86592 35.00 SYRINGE 60CC/GAUGE ASSEMB 115.50 SYSTANE EYE DROPS 20.88 SYSTANE NIGHTIME EYE OINTMENT 27.69 T 3 84480 94.00 T UPTAKE 84479 23.00 T.P.N. SOLUTION 322.00 T3 84480 94.00 T3, REVERSE 84482 196.06 T3,REVERSE 84482 196.06 T4 THYROID TEST 84436 41.00 TACROLIMUS 80197 206.00 TAMOXIFEN TAB 10 MG 7.58 TAMSULOSIN CAP 0.4 MG 16.83 TAPE,KINESIO 1-12 INCHES 39.10 TAPERED ELASTIC FINGER SL 3.30 TC-99M MEBROFENIN DX UP TO 15 MCI A9537 167.09 TC-99M OXIDRONATE DIAGNOSTIC TO 30 A9561 227.88 TC-99M SESTAMIBI DX PER STUDY DOSE A9500 213.20 TDAP VACCINE IM 32.83 TED HOSE REG X-LG 96.50 TED HOSE THIGH LONG LG 96.50 TED HOSE THIGH LONG MED 96.50 TED HOSE THIGH LONG SM 96.50 TED HOSE THIGH REG SM 96.50 TED HOSE THIGH SHOR MED 96.50 TED HOSE THIGH SHORT LG 96.50 TED HOSE THIGHSHORT SM 48.00 TED HOSE THIGHT REG MED 96.50 TEGRETOL 80156 91.00 TEGRETOL LEVEL( 80156 91.00 TEGRETOL TAB 200 MG 4.00 TEKTURNA TAB 150 MG 19.81 TEMAZEPAM 30MG CAP NF 6.88 TEMAZEPAM TAB 15MG 4.00 TENDON SHEATH INCISION 26055 3,546.60 TENECTEPLASE INJ 1 MG (50 MG SYR) J3101 197.00 TENNIS ELBOW SUPP LG 15.00 TENNIS ELBOW SUPP X-LG 15.00 TENNIS ELBOW SUPP:SM 15.00 TERAZOSIN 2mg CAPSULE NF 5.78 TERAZOSIN 2MG CAP 7.50 TERAZOSIN CAP 1 MG 6.42 TERAZOSIN CAP 5 MG 6.42 TERBINAFINE 1% 36.00 TERBINAFINE 1% [1 OZ TUB 36.12 TERBUTALINE INJ 1 MG/ML VL J3105 34.40 TEST FOR MICROA 82043 115.00 TESTOSTERONE TO 84403 174.00 TESTOSTERONE; FREE 84402 150.00 TESTOSTERONE; TOTAL 84403 174.00 TETANUS AB 86774 138.00 TETANUS IMM GLOB INJ [250 J1670 1,155.52 TETANUS IMMUNE GLOBULIN TIG HUMAN IM 90389 313.97 TETANUS/DIP VAC.<7 LESS 90702 82.00 TET-DIP PERTUSSIS .5ML 108.00 THEOPHYLLINE 80198 72.00 THEOPHYLLINE ER TAB 300MG 4.00 THER ACT DIR (EA 15MIN) - 97530 75.00 THERABAND PER FOOT 1.60 THERAPEUTIC ACT DIRECT (E 97530 75.00 THERAPEUTIC EX (EA 15 MIN 97110 75.00 THERAPEUTIC EX (EA 15 MIN 97110 75.00 THERAPEUTIC PRO INJ 96372 44.00 THIAMINE (VITAMIN B1) 84425 160.00 THIAMINE (VITAMIN B1) 84425 160.00 THICK IT 23.15 THIN PREP PAP-MDCR G0145 95.20 THIN PREP PAP-XIX 88175 95.20 THIOPURINE 82542 102.00 THIOPURINE 82542 253.50 THORACIC RIB BE L0210 50.00 THORACIC SPINE 72072 302.00 THREE PHASE BONE 78315 1,386.00 THROMBOPLASTIN 85730 52.00 THROMBOPLASTIN TIME 85732 57.00 THUMB SPICA SPLINT 87.05 THUMB SUPPORT NEOPRONE 35.30 THUMBSPLINT 67.60 THYROGLOBULIN TUMOR MARKE 84432 101.00 THYROID PEROXIDASE AB(TPO 86376 131.75 THYROID STIMULA 84443 91.00 THYROID UPTAKE W/BLOOD FLOW SNGL/MULT QU 78014 1,026.74 THYROID-TC99M 78012 532.00 THYROTROPIN ALPHA 1.1MG INJ. 3,030.72 THYROTROPIN RECEPTOR AB 83520 172.00 THYROXINE,4 84436 41.00 TIBC 83550 45.00 TIGECYCLINE IN 50 MG VL J3243 451.94 TIMOLOL 0.5% OPTH 97.50 TIOTROPIUM INH CAPSULE 18 MCG 61.81 TIOTROPIUM MDI INH KIT 219.02 TISSUE EXAM LEVE IV 88305 141.06 TISSUE EXAM LEVEL II 88302 73.00 TISSUE EXAM LEVEL III 88304 87.68 TISSUE TRANSFER 14040 1,568.43 TISSUE TRANSGLUTAMINASE IgG 83516 83.00 TIZANIDINE 2MG TAB 4.89 TIZANIDINE 4MG CAP 5.86 TOBRAMYCIN 80200 51.50 TOBRAMYCIN 1.2 GM VL J3260 480.00 TOBRAMYCIN ING/200MG/30mL 3.31 TOBRAMYCIN INJ 80mg/ 2ml J3260 32.20 TOBRAMYCIN/ DEX DRP (EYE) 145.12 TOCAR REDUCER 5MM 23.00 TOCILIZUMAB 200MG/10ML IV J3262 2,286.97 TOCILIZUMAB 80MG/4ML IV J3262 970.30 TOES, LEFT MIN 2 VIEWS 73660 166.00 TOES, RIGHT MIN 2 VIEWS 73660 166.00 TOLTERODINE CAP 4 MG 43.80 TOLTERODINE TAB 2 MG 43.80 TONSIL COBLATOR EVAC 70 411.25 TOPAMAX 80201 94.50 TOPAMAX 80201 94.50 TOPIRAMATE TAB 100 MG 18.60 TOPIRAMATE TAB 125 MG 55.83 TOPIRAMATE TAB 25 MG 10.23 TORADOL-15MG J1885 7.82 TORSEMIDE 10mg TAB NF 4.00 TOTAL BODY, EXE HAND 95833 62.04 TOTAL BODY, INCL HANDS 95834 84.40 TOTAL PROTEIN 84155 37.00 TPMT ENZYME 82657 290.40 TPN 1200 ML 885.00 TRACEOSTOMY CARE SUPPLIES 38.25 TRACRIUM PER VIAL INJ (OR 81.80 TRACTION, MECHANICAL 97012 44.11 TRAMADOL TAB 50 MG 6.80 TRANDATE(LABETALOL HCL) 5 3.30 TRANEXAMIC ACID 1000mg/ml 78.20 TRANS CARE MGMT 14 DAY DISCHARGE 99495 293.00 TRANS CARE MGMT 7 DAY DISCHARGE 99496 414.00 TRANSFERRIN 84466 86.00 TRANSFERRIN 84466 86.00 TRANSTUZUMAB INJ 440 MG VL J9355 10,651.72 TRAUMA RESPON W/HOSP CIRT G0390 2,773.44 TRAVOPROST DRP (EYE) 367.74 TRAZODONE TAB 50 MG 4.00 TREAT ELBOW DIS 24600 1,040.00 TREAT ELBOW DISLOCATION 24640 520.38 TREAT ELBOW DISLOCATION 24640 520.38 TREAT FINGER DISLOCATION 26770 675.58 TREAT FINGER DISLOCATION 26770 675.58 TREAT FINGER DISLOCATION 26775 1,071.10 TREAT FRACTURE RADIUS/ULN 25605 1,403.28 TREAT KNUCKLE DISLOCATION 26705 1,349.94 TREAT KNUCKLE DISLOCATION 26705 1,349.94 TREAT RADIUS FRACTURE 24650 214.90 TREAT SHOULDER DISLOCATIO 23655 2,872.79 TREAT SWALLOWING DYSFUNC 92526 233.38 TREATMENT ROOM-MISC NURS 99211 157.08 TREPONEMA PALLIDUM AB 86780 91.90 TREPONEMA PALLIDUM AB 86780 91.90 TRIAMCINOLONE ACET CRM 0.1% 12.87 TRIAMCINOLONE INH 302.62 TRIAMCINOLONE INJ 40 MG/ML (1ML/VL) J3301 48.08 TRIAMCINOLONE MDI IN 324.92 TRIAMTER/ HCTZ CAP 37.5/25 MG 4.00 TRIAMTER/HCTZ CAP 50/25 MG 4.00 TRIAZOLAM 0.25MG TAB 20.67 TRICHOMONAS by NAD 87661 215.04 TRICHOMONAS BY NAD 87661 215.04 TRICHROME STAIN 87209 67.00 TRICHROME STAIN 87209 67.00 TRICOR 200 MG TAB 19.12 TRIGLYCERIDES 84478 24.30 TRILEPTAL 83789 118.80 TRIM NAILS G0127 55.96 TRIM NONDYSTROP 11719 63.00 TRIMALLEOLAR FRAC W/MANIPULATION 27818 1,349.94 TRIMALLEOLAR FRAC.W/MANIPULATION 27818 1,346.76 TRIMETHOPRIM TAB 100 MG 4.00 TRIPLE AB OIN TOP 0.01 OZ 2.00 TRIPLE ANTIBIOTIC OINTMEN 14.12 TROCAR 5mm RETIEVAL SYSTEM 73.50 TROCAR 5X100 Kii FISO 2-THR 122.50 TROCAR 5X100 Kii SLEEVE Z-THR 65.65 TROCAR 10/11MM (VERSA STE 194.00 TROCAR 10mm RETRIEVAL SYSTEM 73.50 TROCAR 11 X100 Kii FIOS Z-THR 122.50 TROCAR 12 X100 Kii FIOS Z-THR 122.50 TROCAR 12MM (VERSA STEP) 212.00 TROCAR 12X100 Kii BALLOON BLUNT TIP 122.50 TROCAR 5MM (VERSA STEP) 198.00 TROCAR BLUNTPORT 5MM-12MM 204.00 TROCAR EXTRA LONG 12MM (V 212.00 TROCAR EXTRA LONG 5MM (VE 193.00 TROCAR REDUCER 16.10 TROPONIN 84484 34.00 TROSPIUM ER 60 MG CAP 20.21 TRYPTASE 83520 172.00 TRYPTASE 83520 202.00 TSH 84443 91.00 T-SPINE CAT SCAN 72128 1,512.00 TUBARINE PER VIAL 14.75 TUBERCULIN PPD INJ 10 TU/0.1ML 86580 43.25 TUBES (EAR) 67.95 TUBES T-EAR MODIFIED 101.60 TUBIGRIP SIZE E 4.80 TUBIGRIP SIZE F 5.00 TUBULAR DRESSING 12.25 TUCKS 11.40 TUSSIONEX SUSP 10/8 MG/5ML 30.67 TYMPANOMETRY 92567 62.00 UA 81001 32.00 UGI W AIR & BA W SBFT 74249 459.00 ULNAR DEVIATION SPLINT 63.70 ULORIC 80mg TAB 38.45 ULORIC TAB 40 MG 38.45 ULTRAFORM WHEEL CHAIR CUS 107.05 ULTRASONIC GUIDANCE INTRAOPERATIVE 76998 200.00 ULTRASOUND AAA SCREENING 76706 370.00 ULTRASOUND ABD.LTD. 76705 413.00 ULTRASOUND ABDOMINAL (WAI 76700 517.00 ULTRASOUND AORTA 76775 370.00 ULTRASOUND BREAST UNILATERAL COMPLETE 76641 391.00 ULTRASOUND FOLLOW-UP OB 76816 329.44 ULTRASOUND HEAD/NECK THYR 76536 403.71 ULTRASOUND OBSTETRIC 76805 410.73 ULTRASOUND PELVIC -WAIST 76856 472.00 ULTRASOUND RENAL 76775 370.00 ULTRASOUND SCROTUM 76870 391.00 ULTRASOUND SPECIFIC ORAGA 76775 369.00 ULTRASOUND TRANSVAG PELVI 76830 378.00 ULTRASOUND, EA 15M-OT 97035 36.00 ULTRASOUND-15 MIN 97035 36.00 UNILATERAL DUPLEX VENOUS EXTREMITY 93971 336.67 UNISOM TAB 25 MG 2.00 UNIV RIB BELT WOMENS 6.55 UNIVERSAL KNEE SUPPORT 40.15 UNIVERSAL VIAL ADAPTER 4.85 UNLISTED (SPECIFY TYPE & 97039 32.00 UNLISTED FLUORO PROCEDURE 76496 151.54 UNNA BOOT APPLI 29580 153.00 UNNA BOOT STRAPPING 29580 319.24 UPDRAFT TX 94640 86.19 UPPER ARM, LEFT (2 VIEWS) 73060 208.00 UPPER ARM, RIGHT (2 VIEWS 73060 208.00 UPPER EXTREMITY W/O CONTR 73200 2,081.00 UPPER LEG LEFT (2 VIEWS) 73552 227.00 UPPER LEG RIGHT (2 VIEWS) 73552 227.00 UREA NITROGEN, URINE 84540 25.00 URETHRAL DILIT.FEMAL:INIT 53660 136.32 URETHRAL DILIT.FEMALE:SUB 53661 105.04 URGENT CARE OFFICE OP EST 10 MIN 99212 66.00 URGENT CARE OFFICE OP EST 15 MIN 99213 86.00 URGENT CARE OFFICE OP EST 25 MIN 99214 217.35 URGENT CARE OFFICE OP NEW 20 MIN 99202 123.00 URGENT CARE OFFICE OP NEW 30 MIN 99203 174.00 URGENT CARE OFFICE OP NEW 45 MIN 99204 264.00 URIC ACID 84550 31.00 URIC ACID BLOOD 84550 31.00 URIC ACID, 24 HR UA 84560 42.00 URINALYSIS AUTO 81003 30.00 URINALYSIS, NON 81002 15.00 URINALYSIS, NON 81000 40.00 URINALYSIS-DIPSTICK ONLY 81002 15.00 URINALYSIS-ROUTINE 81000 40.00 URINE 5HIAA 83497 121.00 URINE BACTERIA 87086 57.00 URINE ID (PRESUMPTIVE) 87088 54.00 URINE ID (PRESUMPTIVE) 87088 54.00 URINE-DRUG SCREENING COLL 16.00 URO-JET SYR 5 ML 5.76 UROSTOMY POUCH 14.70 URSODEOXYCHOLIC 300mg CAP NF 22.05 US SOFT TISSUE EXT LIM 76882 369.00 USE OF SPEECH DEVICE SERVICE 92609 315.28 UTERINE ASPIRA 58100 291.00 V - HEPATITIS B SERIES WI 30.28 V FEND IV/PER 10 MG 13.30 VAC- INFLUENZA VIRUS INJ 90686 118.50 VAC- PNEUMOCOCCAL 23 INJ 90732 42.68 VAC- TETAN/ DIPH/Pertussis injection 90715 141.07 VAC- TETANUS/Diph 90714 110.08 VAC VAQTA 50U/ML VL 207.29 VAC-BOOSTRIX T-DAP INJ 239.01 VACCINATION EA ADD'L VACC 90472 79.05 VACCINE ADMIN EACH ADDITIONAL VACC/TOXOI 90461 24.00 VACCINE ADMIN W/ PROFESSIONAL THRU 18 90460 44.00 VACCINE ADMINISTRATION 90471 133.67 VAGINAL DELIVERY ONLY 59409 2,272.77 VAGINAL DELIVERY ONLY 59409 4,363.65 VALACYCLOVIR 500mg TAB 21.21 VALACYCLOVIR TAB 1GM 75.16 VALPROATE SOD INJ 500MG/5ML VL 40.10 VALPROIC ACID 250MG/5ML 4.00 VALSARTAN TAB 80 MG 26.67 VALTURNA TAB 300/320 MG 16.52 VANCOCIN, VANCOMYCIN 125M 21.00 VANCOMYCIN 80202 83.00 VANCOMYCIN INJ 1 GM VL J3370 57.24 VANCOMYCIN INJ 500 MG VL J3370 25.20 VANCOMYCIN, PEAK 80202 83.00 VANCOMYCIN, TROUGH; 80202 83.00 VASELINE .60 OZ TUBE 3.00 VASELINE GAUZE SMALL TRAY 4.30 VASOLEX ONT (60 GM TUBE) 164.25 VASOPNEUMATIC DEVICE-OT 97016 50.55 VECURONIUM INJ 20MG/20ML VL 73.12 VELCADE INJ (0.1 MG) 3.5MG VL J9041 4,632.00 VENIPUNCTURE 36415 19.00 VENIPUNCTURE 36415 19.00 VENLAFAXINE ER, EFFECOR XR 225MG 37.78 VENLAFAXINE XR CAP 37.5 MG 45.22 VENLAFAXINE XR CAP 75 MG 50.67 VENO PIGGY WITH IVEX FILT 18.65 VENOSET 78 SEC W/CLAMP VE 11.05 VENOSET 78 W/CLAMP VENTED 14.25 VENOSET PIGGYBACK W/CLAMP 12.60 VENOSET SECONDARY PIGGYBA 10.60 VENTI-MASK 10.60 VENTURI MASK 9.50 VERAPAMIL 80MG TAB 4.00 VERAPAMIL ER 120MG TAB 9.27 VERAPAMIL ER TAB 240 MG 6.54 VERAPAMIL INJ 2.5 MG/ML VL 69.44 VERAPAMIL TAB 80 MG 4.00 VERCURONIUM(NORCURON)1MG- 36.00 VERESS NEEDLE 99.80 VESICARE 10 MG TAB 41.17 VESICARE TAB (5 MG) 41.17 VET SAMPLE 16.00 VFC VACCINE ADMIN 90460 19.68 VICTOZA PEN 18mg/3ml 610.50 VIDEO SWALLOW (CINE/VID X-RAY THROAT) 74230 250.96 VIILBRY TAB 40 MG 29.83 VINCRISTINE 1MG 200.00 VIP 84586 311.25 VISINE ADVANCED RELIEF .028 oz 5.28 VISTARIL 25 MG. J3410 5.00 VIT- B-1 INJ 100 MG/ML VL J3411 51.09 VIT- B-1 TAB 100 MG 2.00 VIT- B-12 INJ 1000 MCG/ML 1ML/VL J3420 41.85 VIT- B-12 TAB 500 MCG 2.00 VIT B-6 TAB 4.00 VIT- C TAB 500 MG 2.00 VIT- D 3 CAP 1000 UNT 2.00 VIT- D 3 CAP 400 UNT 2.00 VIT- E CAP 400 UNT 2.00 VIT- K INJ 10 MG/ML (1ml/VL) J3430 153.15 VIT.D1,25 DIHYDROXY 82652 147.00 VITA B12 J3420 41.85 VITAMIN A 84590 164.00 VITAMIN B 12 TAB 500 MCG 4.00 VITAMIN B12 100MG TAB 2.00 VITAMIN B3 (NIACIN) 84591 292.33 VITAMIN B6 84207 396.00 VITAMIN C 82180 205.50 VITAMIN C 82180 205.50 VITAMIN D.25 82306 106.00 VITAMIN D25 OH D2,D3 82306 155.08 VITAMIN D3 CAP 5000 IU 2.00 VITAMIN E 84446 133.00 VITAMIN K 1MG/0.5ML AMPULE J3430 32.75 VITAMIN K PER 1 J3430 5.00 VMA 84585 133.00 VONWILLEBRAND ANTIGEN 85246 144.33 VORICONAZOLE 200MG TAB NF 139.31 VORICONAZOLE INJ 200MG VL VARIABLE RATE J3465 370.93 VORICONAZOLE LEVEL 80299 92.51 VORICONAZOLE, SERUM 80299 92.51 VRE SCREEN 87081 37.00 VRIGENE DNA ID 87149 39.25 VZV by PCR 87798 121.20 VZV IgG OR IgM ABS 86787 72.97 VZV SCREEN 86787 72.97 WALKING BOOT NON-PNEUMATIC PREFAB CUSTOM L4386 228.99 WALKING HEEL, CHILD 11.40 WARFARIN TAB 1 MG 4.00 WARFARIN TAB 5 MG 11.10 WARM & FORM BRACE ALL SIZ 87.90 WARM & FORM BRACE INSERT 65.80 WATER BACT INJ 20.00 WATER STERILE INJ[10ML] 20.00 WBC 85048 29.00 WBC 85048 29.00 WEDGE EXCISION 11765 310.80 WELCHOL 625 MG 16.66 WEST NILE IgG 86789 85.80 WEST NILE IgM 86788 67.55 WEST NILE VIRUS 86788 67.55 WEST NILE VIRUS 86789 85.80 WET PREP 87210 31.00 WHEEL CHAIR MANAGEMENT-15 97542 50.00 WHEEL CHAIR MGMT/PROPUL ( 97542 50.00 WHIRLPOOL 97022 61.00 WHIRLPOOL THERAPY-OT 97022 61.00 WORK/COMM REINTEG (EA 15 97537 75.00 WOUND CARE (EA 15 MIN)-OT 97799 38.00 WOUND CARE NON-SELECT 97602 364.85 WOUND CLOSURE BY ADHESIVE G0168 73.86 WOUND CLOSURE BY ADHESIVE G0168 161.00 WOUND DRAINAGE COLLECTOR 33.20 WOUND EXPLORATION, TRAUMA 20103 955.08 WOUND EXPLORATION, TRAUMA 20103 2,533.65 WOUND SUCTION KIT 30.65 WRIST BRACE ADJ .RS 16.00 WRIST BRACE ADJ RL 16.00 WRIST BRACE ADJ RM 16.00 WRIST BRACE ADJ. LS 16.00 WRIST BRACE ADJ.LL 16.00 WRIST BRACE LS 16.00 WRIST BRAS ADJ.LM 16.00 WRIST HAND FINGER ORTHOTIC RIGID W/O JNT L3808 482.69 WRIST HAND FINGER ORTHOTIC RIGID W/O JNT L3808 482.69 WRIST SPLINT WITH THUMB S 110.50 WRIST, LEFT (2 VIEWS) 73100 155.00 WRIST, LEFT MIN 3 VIEWS 73110 201.00 WRIST, RIGHT (2 VIEWS) 73100 155.00 WRIST, RIGHT MIN 3 VIEWS 73110 201.00 XARELTO 10 MG TAB 50.29 XEROFORM DRESSING 2X2 2.35 XEROFORM DRESSING 5X9 2.85 X-RAY EXAM OF SHOULDERS 73050 151.54 XYLOCAINE 1% PLAIN 30ML 9.00 XYLOCAINE 1-2% W/WO EPIN. 21.00 XYLOCAINE 2% ADDITIONAL C 1.15 YEAST CULTURE 87070 43.00 ZAFIRLUKAST 20MG TAB 8.65 ZANTAC 150 MG/ 6 ML J2780 39.34 ZINC OXIDE 20% OIN 12.40 ZINC SULFATE CAP 220 MG 2.00 ZINC, SERUM 84630 64.60 ZINC, SERUM 84630 64.60 ZIPRASIDONE 40MG CAP 26.59 ZIPRASIDONE HCL 20MG TAB 26.59 ZOLADEX INJ 10.8 MG VL J9202 2,591.80 ZOLEDRONIC ACID INJ 5MG/100 ML BTL J3489 818.00 ZOLPIDEM ER TAB 12.5 MG 18.37 ZOLPIDEM TAB 5 MG J3490 18.48 ZOMETA INJ 4MG/5ML VL J3489 2,123.26 ZONEGRAN 82542 181.00 ZYPREXA 15 MG 40.41 ZYVOX IV PREMIX 600MG/300ML D5W J2020 348.00