GMHA FEE SCHEDULE UPDATED - JUNE 29, 2021

CHARGE CPT/HCPCS CHARGE CODE CODE DESCRIPTION RATE 01501000 ROOM & BOARD ICU$ 1,880.56 01501001 ROOM & BOARD NURSERY$ 536.20 01501002 ROOM & BOARD INTMED NURSERY$ 807.89 01501003 ROOM & BOARD NICU$ 1,219.32 01501004 ROOM & BOARD TELEMETRY$ 1,056.29 01501006 ROOM & BOARD PICU$ 1,623.29 01501008 ROOM & BOARD MED/SURG PRIVATE$ 804.94 01501009 ROOM & BOARD MED/SURG SEMI-PRI$ 731.07 01501011 ROOM & BOARD MEDICAL PRIVATE$ 868.65 01501012 ROOM & BOARD MEDICAL SEMI-PRIV$ 794.78 01501014 ROOM & BOARD PEDS PRIVATE$ 1,081.77 01501015 ROOM & BOARD PEDS SEMI-PRIVATE$ 1,007.92 01501017 ROOM & BOARD OB/GYN PRIVATE$ 887.39 01501018 ROOM & BOARD OB/GYN SEMI-PRIVA$ 813.51 01501020 ROOM & BOARD SURGICAL PRIVATE$ 846.89 01501021 ROOM & BOARD SURGICAL SEMI-PRI$ 773.02 01501055 ROOM & BOARD SNF$ 585.89 01501057 ROOM & BOARD ICF$ 486.29 01511006 ROOM & BOARD PCU$ 1,468.43 00900088 PHYSICAL EXAM-ANNUAL$ 125.42 00900178 99283 ER-OB/GYN SERVICE FEE$ 265.87 00900185 99282 ER-SPECIALTY SERVICE FEE$ 151.16 00900194 99285 ER-TRAUMA SERVICE FEE$ 1,476.89 00900227 99281 EMERGENCY ROOM$ 99.70 00900243 99284 ER-OBSERVATION SERVICE FEE$ 447.32 00900761 A4649 KNEE BRACE WRAPAROUND-XLGE$ 125.96 00900762 A4649 KNEE BRACE WRAPAROUND-MED$ 125.96 00900763 A4649 KNEE BRACE WRAPAROUND-SML$ 125.96 00900764 A4649 KEE BRACE WRAPAROUND-LGE$ 125.96 00900876 A4649 GLIDESCOPE SPECTRUM PEDS SZ-1$ 319.50 00900877 A4649 GLIDESCOPE SPECTRUM PEDS SZ-2$ 319.50 00901021 A4565 SLING ARM ENVELOPE SML$ 32.56 00901022 A4565 SLING ARM ENVELOPE MED$ 32.56 00901056 A4649 ANOSCOPE DISP$ 13.35 00901152 A4649 STRAP CLAVICLE-SMALL$ 90.22 00901153 A4649 STRAP CLAVICLE-MEDIUM$ 94.73

1 00901154 A4649 STRAP CLAVICLE-LARGE$ 94.73 00901155 A4649 STRAP CLAVICLE-XLARGE$ 94.73 00901223 A4565 SLING ARM ENVELOPE LGE$ 32.56 00901224 A4565 SLING ARM ENVELOPE XLGE$ 32.56 00901282 A4649 CATHETER BARTHOLIN GLAND 10/12$ 126.87 00901289 A4649 INTRODUCER ENDOTRACHEAL TUBE$ 30.07 00902000 A4649 MORGAN MEDI-FLO LENS$ 147.63 00909001 A4649 SET NEEDLE EZ-IO 25MM BLUE$ 625.79 00909018 A4649 SET NEEDLE EZ-IO 15MM PINK$ 625.79 00909079 A4649 SET NEEDLE EZ-IO 45MM YELLOW$ 625.79 00910047 A4649 SUCTION CUP LUCAS DISP$ 225.80 00910202 A4649 MORGAN LENS DELIVERY SET$ 42.81 00910221 A4649 SPANDAGE MTF2 /FT$ 7.04 00910222 A4649 SPANDAGE MTO1 /FT$ 7.04 00910223 A4649 SPANDAGE MTO2 /FT$ 7.04 00910224 A4649 SPANDAGE MTO3 /FT$ 7.04 00910225 A4649 SPANDAGE MTO4 /FT$ 7.04 00910226 A4649 SPANDAGE MTO5 /FT$ 7.04 00910227 A4649 SPANDAGE MTO6 /FT$ 7.04 00910228 A4649 SPANDAGE MTO7 /FT$ 7.04 00910229 A4649 SPANDAGE MT22 /FT$ 7.04 00910230 A4649 SPANDAGE MTO8 /FT$ 7.04 00910942 A4649 SET ADMIN GRAVITY FLOW$ 47.12 00911010 A4649 SPONGE RHINO ROCKET XLGE$ 108.87 00911270 A4649 GAUZE SURGITUBE 5/8/2FT$ 1.37 00911272 A4649 GAUZE SURGITUBE 1/2FT$ 1.70 00911300 A4649 SPONGE RHINO ROCKET SML$ 74.04 00911500 A4649 SPONGE RHINO ROCHET MED$ 83.52 00911800 A4649 SPONGE RHINO ROCKET LGE$ 96.80 00911891 A4649 GLIDESCOPE BFLEX 5.0 BRONCHO$ 839.25 00911892 A4649 GLIDESCOPE SPECTRUM LOPRO S3$ 245.77 00911893 A4649 GLIDESCOPE SPECTRUM LOPRO S4$ 245.77 00912140 A4649 LARYNGEAL MASK AIRWAY S-4$ 303.78 00912142 A4649 PACK NASAL RHINO 5.5CM ANT #55$ 276.60 00912147 A4649 PACK NASAL RHINO 7.5CM A-P BIL$ 197.34 00912149 A4649 PACK NASAL RHINO 7.5CM A-P BIL$ 653.63 00912150 A4649 LARYNGEAL MASK AIRWAY S-5$ 303.78 00920151 S9088 URGENT CARE FEE$ 80.41 00972941 A4649 EXTRACTOR FB OTO-RHINO REMOVER$ 512.45 01100049 MED REC COPIES 10-PER PAGE$ 2.48 01104001 ITEMIZED BILLING=1-5COPIES$ 6.70

2 01104002 ITEMIZED BILLING=>5-PER COPY$ 1.01 01195001 HOSPITAL BIRTH CERTIFICATE$ 6.70 01195002 CERTIFICATION OF DEATH$ 3.36 01300440 A4649 BILIRUBIN THERAPY$ 29.26 01300606 A4649 CHIN STRAP-MICRO$ 31.40 01300607 A4649 CHIN STRAP-SMALL$ 31.40 01300608 A4649 TUBING-CANNULA HOLDER$ 7.86 01300609 A4649 NASAL PRONG SEAL-MICRO$ 2.70 01300610 A4649 NASAL PRONG SEAL-SMALL$ 2.70 01300611 A4649 NASAAL PRONG SEAL-LARGE$ 2.70 01300700 A4649 UMBILICAL CATHETER HOLDER-MICR$ 36.99 01300701 A4649 UMBILICAL CATHETER HOLDER-SML$ 36.99 01301038 A4649 NEO-FIT ET TUBE GRIP$ 111.33 01303336 A4649 MASK BILIRUBIN$ 31.08 01310449 A4649 CANNULA NASAL CPAP SZ-0$ 117.71 01310450 A4649 CANNULA NASAL CPAP SZ-1$ 117.71 01310451 A4649 CANNULA NASAL CPAP SZ-2$ 117.71 01311865 J3490 BABY SHAMPOO 120ML$ 4.87 01332100 A4649 TRAY PER-Q-CATH SINGLE-LUMEN 2$ 292.08 01335000 A4649 TRAY NEO V-CATH SINGLE-LUMEN 2$ 741.91 01370206 A4649 ORAL-NASAL SUCTION-CRV PREEMIE$ 15.98 01370207 A4649 ORAL-NASAL SUCTION-CRV STD$ 15.98 01370710 A4649 NEONATE ET HOLDER-ULTRA$ 80.80 01370711 A4649 NEONATE ET HOLDER-MICRO$ 80.80 01370712 A4649 NEONATE ET HOLDER-SMALL$ 80.80 01370713 A4649 NEONATE ET HOLDER-LARGE$ 80.80 01370714 A4649 NEONATE ET HOLDER-X-LARGE$ 80.80 01370742 A4649 CATHETER SUCTION ARGYLE 10FR$ 88.90 01392585 92652 NB HEARING SCREEN 2ND STEP$ 146.76 01392587 92587 NB HEARING SCREEN IST STEP$ 191.65 01395001 A4649 PEDS INTUBATION KIT 3.0$ 38.07 01395002 A4649 PEDS INTUBATION KIT 3.5$ 38.07 01395003 A4649 IV PUMP SET (SYRINGE)$ 39.71 01395004 A4649 IV PUMP SET (TUBING)$ 33.09 01395005 A4649 MICROBORE 60 EXT SET$ 12.97 01395006 A4649 PEDS INTUBATION KIT 2.5$ 50.96 01395007 A4649 T-CONNECTOR WITH M.L.S.$ 9.19 01396001 A4649 MASK OXYGEN-INFANT$ 31.03 01400010 0001A PFIZER-BIONTECH VACC ADMIN IST$ 16.94 01400020 0002A PFIZER-BIONTECH VACC ADMIN 2ND$ 28.39 01400110 0011A MODERNA VACCINE ADMIN 1ST$ 16.94 01400120 0012A MODERNA VACCINE ADMIN 2ND$ 28.39

3 01400236 M0239 BAMLANIVIMAB IV INFUSE/MONITOR$ 309.60 01400310 0031A JANSSEN VACCINE ADMIN$ 28.39 01410060 10060 I&D ABSCESS; SIMPLE OR SINGLE$ 216.97 01411042 11042 DEBRIDE SUBQ TISSUE 20 SQ CM/<$ 379.28 01411043 11043 DEBRIDE MUSC/FASCIA 20 SQ CM/<$ 379.28 01411044 11044 DEBRIDE BONE 20 SQ CM/<$ 1,107.28 01411045 11045 DEB SUBQ TISSUE ADD 20 SQ CM$ 72.33 01411046 11046 DEB MUSC/FASCIA ADD 20 SQ CM$ 154.40 01411047 11047 DEB BONE ADD 20 SQ CM$ 274.83 01429105 29105 LONG ARM SPLINT (SHOULDER HAND$ 178.24 01429125 29125 SHORT ARM SPLINT STATIC$ 120.03 01429126 29126 SHORT ARM SPLINT DYNAMIC$ 146.55 01429130 29130 FINGER SPLINT STATIC$ 84.35 01429131 29131 FINGER SPLINT DYNAMIC$ 98.25 01429240 29240 STRAPPING SHOULDER$ 131.09 01429260 29260 STRAPPING ELBOW/WRIST$ 111.42 01429280 29280 STRAPPING HAND/FINGER$ 109.06 01429505 29505 LONG LEG SPLINT (THIGH/ANKLE)$ 221.64 01429515 29515 SHORT LEG SPLINT (CALF/FOOT)$ 150.42 01431500 31500 INTUBATION$ 173.84 01431603 31603 TRACHEOSTOMY EMERG TRANSTRCHL$ 866.26 01431605 31605 TRACHEOSTOMY EMERG CRICOTHYRD$ 866.26 01431622 31622 DX BRONCOSCOPE W/ WASH$ 1,413.42 01431623 31623 DX BRONCOSCOPE W/ BRUSH$ 1,413.42 01431624 31624 DX BRONCOSCOPE W/ LAVAGE$ 1,413.42 01436420 36420 VEIN ACCESS CUTDOWN <1 YR$ 176.46 01436450 36450 EXCHNG BLOOD TRNSFUSE NEWBORN$ 398.24 01436625 36625 ARTERIAL CATH/CANNULA CUTDOWN$ 286.30 01443753 43753 NG/OG PLACEMENT$ 69.39 01451701 51701 INSERT BLADDER CATHETER$ 176.46 01451702 51702 FOLEY OR I&O CATH$ 90.03 01451798 51798 BLADDER SCANNING, NON-IMAGING$ 61.64 01486580 86580 TB SKIN TEST$ 24.00 01490471 90471 IMMUNIZATION 1 VACCINE$ 28.67 01490472 90472 IMMUNIZATION EACH ADD VACCINE$ 19.62 01492950 92950 CODE 72 (ARREST) PCV$ 319.00 01492953 92953 TEMP TRANCUTANEOUS PACING$ 630.27 01492960 92960 DEFIBRILLATION/CARDIOVERSION$ 630.53 01496360 96360 IV INFUS HYDR;31 MIN TO 1 HR$ 111.63 01496361 96361 IV INFUS HYDR;EA ADD HOUR$ 40.74 01496365 96365 IV INFUS TX; UP TO 1 HOUR$ 135.75 01496366 96366 IV INFUS TX;EA ADD HOUR$ 55.07

4 01496367 96367 IV INFUS TX; ADD DRUG UP 1 HR$ 81.45 01496368 96368 IV INFUS TX;CONCURRENT INFUS$ 45.24 01496372 96372 TX INJ SQ OR IM$ 32.42 01496374 96374 TX INJ IV$ 92.78 01496375 96375 TX IV EA ADD IV NEW DRUG$ 55.07 01496376 96376 TX INJ EA ADD IV SAME DRUG$ 41.49 01524009 OBSERVATION/HOUR MED/SURG$ 30.46 01524009 OBSERVATION/HOUR MED/SURG$ 30.46 01524012 OBSERVATION/HOUR MEDICAL$ 33.12 01524012 OBSERVATION/HOUR MEDICAL$ 33.12 01524013 OBSERVATION/HOUR TELE$ 44.01 01524013 OBSERVATION/HOUR TELE$ 44.01 01524015 OBSERVATION/HOUR PEDS$ 42.00 01524015 OBSERVATION/HOUR PEDS$ 42.00 01524018 OBSERVATION/HOUR OB$ 33.88 01524018 OBSERVATION/HOUR OB$ 33.88 01524021 OBSERVATION/HOUR SURGICAL$ 32.19 01524021 OBSERVATION/HOUR SURGICAL$ 32.19 01524022 OBSERVATION/HOUR PCU$ 61.19 01524022 OBSERVATION/HOUR PCU$ 61.19 01524023 OBSERVATION/HOUR ICU$ 78.35 01524023 OBSERVATION/HOUR ICU$ 78.35 01524024 OBSERVATION/HR PICU$ 67.64 01524024 OBSERVATION/HR PICU$ 67.64 01596401 96401 CHEMO ANTINEO NONHORMON SQ/IM$ 117.93 01596402 96402 CHEMO ANTINEO HORMON SQ/IM$ 54.00 01596409 96409 CHEMO IV PUSH SGL/INIT DRUG$ 221.03 01596411 96411 CHEMO IV PUSH EA ADD DRUG$ 117.93 01596413 96413 CHEMO IV 1 HR SGL/INIT DRUG$ 357.69 01596415 96415 CHEMO IV EACH ADDL HOUR$ 54.00 01596416 96416 CHEMO IV > 8 HOURS W/PUMP$ 357.69 01596417 96417 CHEMO IV DIFF DRUG 1 HOUR$ 54.00 01596420 96420 CHEMO INTRA-ARTERIAL PUSH$ 357.69 01596422 96422 CHEMO INTRA-ARTERIAL 1 HOUR$ 357.69 01596423 96423 CHEMO INTRAARTERIAL EA ADD HR$ 54.00 01596425 96425 CHEMO ARTERIAL > 8HRS W/PUMP$ 357.69 01596446 96446 CHEMO PERITONEUM VIA PORT$ 357.69 01596450 96450 CHEMO CNS W/ SPINAL PUNCTURE$ 357.69 01596521 96521 REFILL & MAINTAIN PUMP$ 221.03 01596523 96523 IRRIGATE DRUG DELIVERY DEVICE$ 71.40 01596542 96542 CHEMO INTRAVTRCL VIA RESERVOIR$ 221.03 01599999 R&B MISCELLANEOUS FEE$ 26.25

5 01600028 DELIVERY ROOM$ 1,047.23 01600044 59025 FETAL NON-STRESS TEST$ 190.53 01600047 L&D-MAJOR SURGERY 1ST HOUR$ 1,810.71 01600105 LR-OUTPT OBSERVATION NO DELIVE$ 283.13 01600110 ABC DELIVERY$ 1,189.08 01600120 L&D-MAJOR SURGERY ADD 15 MIN$ 301.77 01600135 A4649 TUBE ENDOTRACH W/ HOLDER 3.5MM$ 52.00 01600190 A4649 TUBE ENDOTRACH UNCUFF 2.0MM$ 20.32 01600250 LABOR SPECIALTY CARE$ 1,730.64 01600291 A4649 LARYNGOSCOPE FIBEROPTIC$ 325.45 01600350 LABOR CARE$ 832.72 01600500 A4649 BALLOON POSTPARTUM BAKRI$ 1,695.25 01600709 A4649 KIT FETAL SCALP PH$ 17.77 01600805 A4649 AMNIHOOK AMNIOTIC MEMBRANE$ 13.03 01600835 A4649 RESUSCITATOR T-PIECE INFANT$ 65.54 01600836 A4649 TUBING RESUSCITATION T-PIECE$ 94.76 01600837 A4649 MASK T-PIECE 50MM$ 94.76 01600838 A4649 GAS LINE T-PIECE LONG$ 86.88 01600844 A4649 ELECTRODE FETAL SCALP$ 10.80 01600850 A4649 RETRACTOR ALEXIS O$ 382.90 01601463 A4649 PRESSURE INFUSOR BTA$ 135.12 01601850 A4649 NEEDLE SPINAL 18GAX5.0$ 85.46 01602421 A4649 TRANSWARMER TRANSPORT MAT INF$ 200.18 01604001 A4649 TUBE ENDOTRACH W/ HOLDER 2.5MM$ 54.60 01607000 A4649 SENSOR SPO2 (NONIN)-NEO/ADT$ 97.26 01610027 A4649 CATHETER IUP MONITORING$ 299.05 01610110 A4649 LARYNGEAL MASK AIRWAY SZ-1$ 311.72 01610115 A4649 LARYNGEAL MASK AIRWAY SZ-1.5$ 311.72 01610130 A4649 LARYNGEAL MASK AIRWAY SZ-3$ 311.72 01611654 A4649 MECONIUM ASPIRATOR$ 39.39 01611688 A4649 KIT OB VACUUM DELIVERY$ 445.17 01612317 A4649 SET EXTENSION MICROBORE QUAD-L$ 70.33 01612509 A4649 TRAY GENERAL CATHETERIZATION$ 364.69 01616922 A4649 SENSOR SPO2 (MASIMO)-NEO/ADT$ 154.75 01620752 A4649 BLADE SURGICAL CLIPPER #9660$ 29.91 01655501 A4649 WARMER BLANKET UNDRBDY PEDS$ 82.55 01663800 A4649 MASK T-PIECE 42MM$ 94.76 01700007 A4649 CATHETER BALLOON VERI PACE$ 1,025.12 01700009 A4649 LEAD INTRO SUBCLAVIAN 8FR$ 153.25 01700010 A4649 LEAD INTRO SUBCLAVIAN 10.5FR$ 724.57 01700011 A4649 LEAD INTRO SUBCLAVIAN 9FR$ 1,479.35 01700030 A4649 PAD DEFIBRILLATOR$ 40.77

6 01700032 A4649 ARMBOARD W/ COVER 9$ 4.59 01700033 A4649 ARMBOARD W/ COVER 18$ 6.48 01700041 A4649 SYRINGE ECCENTRIC TIP 60CC$ 5.02 01700042 A4649 SYRINGE INSULIN 1CC M/FINE$ 1.51 01700043 A4649 AIR MATTRESS MACH/D$ 15.72 01700047 B4082 TUBE NASOGAST W/ SENT 18FR$ 22.41 01700067 A4649 NEEDLE SPINAL 18GAX3-1/2$ 16.73 01700069 A4649 NEEDLE SPINAL 20GAX3-1/2$ 10.64 01700070 A4649 NEEDLE SPINAL 22GAX3-1/2$ 11.95 01700079 A4649 BAG BODY CADAVER-PEDS$ 83.54 01700085 A4649 CATHETER RADIAL ARTERY$ 64.81 01700086 A4649 TRAY CATH C/V 3-LUMEN 7FR 20CM$ 994.80 01700088 A4649 TUBING PENROSE 1X18$ 5.97 01700092 A4649 SYRINGE ASCEPTO DISP$ 34.17 01700094 A4649 TUBING PENROSE 5/16X18$ 6.01 01700095 A4649 TUBING PENROSE 3/8X18$ 12.35 01700097 A4649 SYRINGE IRRIG C/TIP 50CC$ 4.71 01700100 A4649 BAG BILE$ 21.29 01700101 A4649 GLOVES EXAM LTX PDLESS SML$ 0.76 01700102 A4649 STERI-STRIP 1/2X4$ 9.41 01700103 A4649 CATH ANGIOCATH 20GAX2$ 8.64 01700104 A4649 TUBE ENDOTRACH W/CUFF 3.5M$ 16.47 01700105 A4649 NUGAUZE PLAIN 1X5YD$ 31.95 01700107 A4649 TUBE ENDOTRACH W/CUFF 6MM$ 21.83 01700108 A4649 TUBE ENDOTRACH W/CUFF 9.5M$ 30.06 01700109 A4649 TUBE ENDOTRACH W/CUFF 8MM$ 26.08 01700110 A4649 CATH ANGIOCATH 22GAX1$ 8.89 01700111 A4649 TUBE ENDOTRACH W/CUFF 7.5MM$ 23.06 01700113 A4649 TUBE ENDOTRACH W/CUFF 7MM$ 25.13 01700114 A4649 CATH ANGIOCATH 24GAX3/4$ 10.17 01700115 L0120 CERVICAL COLLAR FOAM LGE$ 58.11 01700122 A4649 GLOVES EXAM LTX PDLESS MED$ 0.76 01700126 A4649 COLOSTOMY BAG-PEDS$ 27.07 01700131 A4649 BANDAGE ELASTOPLAST 4X5YD$ 30.12 01700140 A4649 BAG BODY CADAVER-WHITE$ 72.64 01700141 A4649 NUGAUZE IODOFORM 1X5YD$ 37.45 01700143 A4649 TUBE STOMACH 18FRX50$ 5.37 01700144 A4649 TUBE TRACHEOSTOMY 36FR SZ-8$ 610.46 01700145 A4649 STERI-STRIP 1/4X4$ 9.95 01700146 A4649 CATH ANGIOCATH 18GAX1-1/4$ 9.20 01700147 A4649 TUBE FEEDING 8FRX42$ 5.97 01700149 A4649 TUBE ENDOTRACH W/CUFF 6.5M$ 27.38

7 01700150 A4649 TUBE ENDOTRACH W/CUFF 8.5M$ 30.89 01700151 A4649 BUTTERFLY 25GA 3/4X12$ 7.70 01700152 A4649 TUBE ENDOTRACH W/CUFF 9MM$ 28.19 01700153 A4649 CATHETER SUCTION 18FR 22$ 3.02 01700154 A4649 SLIPPER NON-SKID TODDLER$ 3.27 01700155 A4649 GLOVES EXAM LTX PDLESS LGE$ 0.76 01700156 A4649 NUGAUZE IODOFORM 8X10YD$ 218.89 01700157 A4615 CANNULA NASAL O2 7FT-PEDS$ 10.90 01700158 A4615 CANNULA NASAL O2 7FT-INFANT$ 15.93 01700160 A4649 SLIPPER NON-SKID SMALL$ 3.27 01700164 A4649 SLIPPER NON-SKID ADULT XLGE$ 4.71 01700165 A4649 TUBE ENDOTRACH W/CUFF 4.5M$ 36.52 01700168 A4649 TUBE ENDOTRACH W/CUFF 10MM$ 27.69 01700169 A4649 PAD TELFA 3X8$ 0.63 01700170 B4082 TUBE NASOGAST W/ SENT 14FR$ 16.84 01700171 B4082 TUBE NASOGAST W/ SENT 16FR$ 17.23 01700172 A4624 CATHETER SUCTION 14FR 22$ 3.54 01700173 A4649 NUGAUZE PLAIN 2$ 47.26 01700174 A4649 CATH ANGIOCATH 18GAX2$ 7.08 01700175 A4649 SET UNDERWATER CHEST DRAIN$ 84.67 01700176 A4649 CATHETER SUCTION 10FR 22$ 3.62 01700177 A4649 TUBE ENDOTRACH W/CUFF 5MM$ 25.49 01700178 A4649 NUGAUZE PLAIN 1/4X5YD$ 31.31 01700179 A4649 TUBE ENDOTRACH W/CUFF 4MM$ 37.05 01700182 A4649 NUGAUZE PLAIN 1/2X5YD$ 35.10 01700184 A4649 TUBE ENDOTRACH W/CUFF 5.5M$ 26.69 01700185 A4649 TUBE ENDOTRACH UNCUFF 3.0MM$ 15.00 01700188 A4649 NUGAUZE IODOFORM 2X5YD$ 62.97 01700189 A4649 TUBE TRACHEOSTOMY 39FR SZ-10$ 353.86 01700192 A4649 TUBE TRACHEOSTOMY 30FR SZ-6$ 479.34 01700193 B4082 TUBE NASOGAST W/ SENT 12FR$ 15.79 01700196 A4649 IMMOBILIZER KNEE 26$ 425.99 01700197 A4649 IMMOBILIZER KNEE 18$ 320.88 01700200 A4649 COBAN 1$ 10.01 01700202 A4649 COBAN 2$ 16.19 01700204 A4649 COBAN 3$ 20.79 01700241 A6449 GAUZE KERLIX 4.5$ 9.63 01700249 A4649 STYLET INTUBATING 6FR$ 10.15 01700262 B4082 TUBE NASOGASTRIC 20FR-ADULT$ 674.95 01700308 A4649 BANDAGE SLING$ 7.44 01700380 A4649 GAUZE GELFOAM$ 35.92 01700384 A4649 MASK OXYGEN-PEDS$ 15.08

8 01700385 A7015 MASK AEROSOL-ADULT$ 15.08 01700389 A4565 SLING ARM$ 19.68 01700431 A4649 KIT MONITOR SORENSON$ 138.38 01700464 A4649 CATHETER SUCTION 5/6FR$ 5.31 01700466 A4649 CATHETER FOGARTY 2FR$ 193.29 01700482 A4649 TRAY C/S PACK$ 157.68 01700483 A4649 KIT FECAL MGMT FLEX-SEAL FMS$ 1,118.16 01700529 A4649 NUGAUZE IODOFORM 1/2X5YD$ 37.05 01700573 A4649 STAPLE SKIN EXTRACTOR$ 51.29 01700589 A6402 GAUZE DRESSING 2X2$ 2.86 01700605 A6402 GAUZE DRESSING 4X4$ 2.86 01700619 A6257 DRESSING TRANSP 2X3$ 1.19 01700620 A6257 DRESSING TRANSP 4X5$ 3.75 01700662 A4316 TRAY URETHRAL CATHETERIZATION$ 21.38 01700663 A4649 CATHETER THORACIC 10FR$ 26.97 01700673 A4649 ETHILON BLK MONO 30 3-0$ 24.12 01700676 A4649 SILK BLK BR 18 3-0$ 18.69 01700683 A4649 SILK BLK BR 18 4-0$ 24.60 01700685 A4649 SILK BLK BR 18 2-0$ 23.67 01700695 A4649 TUBE IV EXTENSION$ 5.05 01700699 A4649 ETHILON BLK MONO 18 4-0$ 51.44 01700796 A4649 TUBE CONNECTOR PLASTIC$ 2.60 01700800 A4649 MASK NON-REBREATHING-ADULT$ 15.46 01700846 A4649 NEEDLE INTRAOSSEOUS 16GA$ 29.09 01700860 A4649 MINICATH 19GA 7/8X12$ 10.97 01700876 A4649 MAXI-THERM LITE BLANKET DISP$ 233.35 01700928 A4649 PAD ABDOMINAL$ 2.86 01700935 A4649 NUGAUZE IODOFORM 1/4X5YD$ 33.74 01700944 A4649 PAD EYE DRESSING$ 2.86 01701024 A4649 PROTECTION PACK$ 8.94 01701076 A4649 SET IV CARTRIDGE-ADULT$ 15.26 01701078 A4649 SET IV CARTRIDGE-NEONATAL$ 15.26 01701080 A4649 SET HALF Y MEDSYSTEM III$ 47.62 01701081 A4649 SET 2 Y MEDSYSTEM III$ 89.89 01701108 A4649 SET IV BLOOD-VI9$ 18.72 01701124 A4649 SET ENEMA DISP$ 11.21 01701249 A4649 SET METRI BURRETRO$ 43.94 01701280 A4649 SET IV-PEDS$ 8.82 01701322 A4649 SET IV-ADULT$ 9.92 01701348 A4649 SET TRACHEOSTOMY CARE$ 17.00 01701412 A4649 PROBE ESOPH/RECTAL TEMP DISP$ 51.81 01701421 A4649 SITZ BATH$ 23.90

9 01701426 A4649 CAPNOMETER-ADULT$ 112.52 01701451 A4649 COLOSTOMY FLANGE-PEDS$ 34.74 01701461 A4649 COLOSTOMY FLANGE-ADULT$ 43.11 01701645 A4649 SET UP TRACTION EQUIPMENT$ 71.25 01701669 A4649 ETHILON BLK MONO 18 3-0$ 50.42 01701744 A4649 TRAY BURN DRESSING$ 28.48 01701843 A4649 TRAY IRRIGATION$ 13.95 01701876 A4649 TRAY MINOR SUTURE$ 31.35 01701921 A4649 FILTERLINE H ADULT/PEDS$ 116.95 01701923 A4649 FILTERLINE H INFANT/NEONATE$ 150.33 01702007 A4649 TRAY LUMBAR PUNCTURE-ADULT$ 60.09 01702049 A4649 TRAY LUMBAR PUNCTURE-PEDS$ 66.85 01702229 A4649 MATRIX SUTURABLE DURAGEN$ 795.87 01702261 A4649 TRU/MEASURE URI-METER W/BG$ 23.00 01702288 A4649 TUBE FEEDING 5FRX15$ 5.57 01702320 A4649 TUBE O2 CONNECTING$ 5.26 01702361 A4649 TUBE STOMACH 14FRX50$ 5.69 01702363 A4649 TUBE STOMACH 16FRX50$ 5.93 01702365 A4649 TUBE FEEDING 8FRX15$ 6.23 01702370 A4212 STYLET INTUBATING 14FR$ 24.55 01702372 A4649 STERI-STRIP 1/4X3$ 5.94 01702373 A4649 SLIPPER NON-SKID ADULT MED$ 5.28 01702376 A4649 PAD TELFA 3X4$ 1.00 01702377 A4649 NEEDLE SPINAL 22GAX1-1/2$ 13.59 01702379 A4620 MASK OXYGEN-ADULT$ 5.27 01702380 A4649 CATH ANGIOCATH 16GAX2$ 7.47 01702381 A4649 BUTTERFLY 25GA 3/8X3$ 6.60 01702383 L0120 CERVICAL COLLAR FOAM MED$ 72.64 01702384 A4649 CATHETER SUCTION 8FR 15$ 4.56 01702385 A4649 BAG BODY CADAVER-YELLOW$ 65.54 01702389 A4649 BANDAGE ELASTOPLAST 3X5YD$ 37.83 01702445 A4554 UNDERPADS$ 2.86 01702452 A4649 CATHETER UMBILICAL ART 5FR$ 14.03 01702460 A4520 BRIEF INCONTINENT ADULT$ 5.30 01702486 A4649 GAUZE XEROFORM 5X9$ 7.28 01702741 A4649 BANDAGE CASTING TAPE 3X4YD$ 22.98 01702742 A4649 BANDAGE CASTING TAPE 4X4YD$ 21.67 01702743 A4649 BANDAGE CASTING TAPE 5X4YD$ 47.90 01703010 A4649 HEEL/ELBOW PROTECTOR$ 93.63 01703036 A4649 WOUND CARE-UNDERPAD QUILTED$ 19.89 01703302 A4357 BAG URINARY DRAINAGE$ 26.06 01703369 A4649 PAD EYE SHIELD$ 8.00

10 01703591 A4649 CANNULA OXYGEN-ADULT$ 13.28 01703744 A4649 BAG BODY CADAVER-INFANT$ 24.20 01703815 A4649 TOWEL DISPOSABLE$ 6.11 01704128 A4649 IV EXTENSION W/ STP COCK$ 14.09 01704144 A4649 SET IV EXTENSION TUBING W/ CLA$ 4.85 01704186 A4649 MASK ISOLATION (100)$ 13.28 01704320 A4649 TUBE GASTROSTOMY 14FR 20CC$ 147.43 01704354 A4649 TUBE GASTROSTOMY 24FR 20CC$ 152.17 01704383 A4346 CATHETER FOLEY 24FR 30CC 3-WAY$ 143.35 01704384 A4649 KIT CATHETER CARE$ 0.87 01704391 A4346 CATHETER FOLEY 10FR 3CC$ 21.78 01704409 A4346 CATHETER FOLEY 12FR 5CC$ 21.78 01704425 A4346 CATHETER FOLEY 14FR 5CC$ 32.54 01704441 A4346 CATHETER FOLEY 16FR 5CC$ 24.51 01704466 A4346 CATHETER FOLEY 18FR 5CC$ 33.58 01704482 A4346 CATHETER FOLEY 20FR 5CC$ 24.24 01704508 A4346 CATHETER FOLEY 22FR 5CC$ 30.72 01704524 A4346 CATHETER FOLEY 24FR 5CC$ 20.99 01704540 A4346 CATHETER FOLEY 26FR 5CC$ 21.78 01704565 A4346 CATHETER FOLEY 28FR 5CC$ 21.78 01704607 A4346 CATHETER FOLEY 12FR 30CC$ 27.96 01704623 A4346 CATHETER FOLEY 14FR 30CC$ 30.10 01704649 A4346 CATHETER FOLEY 16FR 30CC$ 25.97 01704664 A4346 CATHETER FOLEY 18FR 30CC$ 34.49 01704680 A4346 CATHETER FOLEY 20FR 30CC$ 24.24 01704681 A4649 CAPNOLINE H O2 NASAL PEDS$ 123.39 01704689 A4649 CAPNOLINE H ADULT$ 109.94 01704691 A4649 CAPNOLINE H INFANT/NEONATE$ 109.94 01704706 A4346 CATHETER FOLEY 22FR 30CC$ 25.42 01704722 A4346 CATHETER FOLEY 24FR 30CC$ 25.42 01704748 A4346 CATHETER FOLEY 30FR 35CC$ 25.42 01704763 A4346 CATHETER FOLEY 28FR 30CC$ 23.98 01704789 A4346 CATHETER FOLEY 30FR 30CC$ 23.98 01704821 A4346 CATHETER FOLEY 10FR 5CC$ 27.96 01704891 A4649 SET CHEST THAL 16FR 14CM$ 792.18 01705000 A4649 STOPCOCK 3-WAY W/O EXTN$ 5.05 01705044 A4649 GEL CUSHION 6"X9"1/2"$ 174.54 01705067 A4649 DIAPER PAMPERS-TODDLER$ 12.54 01705083 A4649 TRAY SUTURE REMOVAL DISP$ 7.92 01705109 A4649 SLIPPER NON-SKID ADULT LGE$ 4.77 01705141 A4649 BREAST PUMP$ 24.74 01705182 A4649 TUBE LUKENS 14FR$ 8.97

11 01705240 A4649 SYRINGE BULB$ 16.70 01705310 A4649 CATHETER SWAN NECK CURL INFANT$ 182.91 01705311 A4649 CATHETER EXTENSION W/LL 6"$ 333.56 01705422 A4649 CATHETER PLUG$ 2.86 01705453 A4649 SET CHEST THAL 18FR 41CM$ 627.59 01705801 A4649 SHUNT LUMBAR PERITONEAL SPETZL$ 561.91 01705803 A4649 FELT ORTHO 1/4$ 28.91 01705804 A4649 FELT ORTHO 1/2$ 78.44 01705948 A4649 SET MONITORING FEM/AORTIC$ 193.31 01706008 A4649 CRASH CART$ 114.06 01706404 A4213 SYRINGE CATHETER TIP 60CC DISP$ 6.29 01706550 A4649 KIT MONITORING SKULL BOLT ICP$ 1,844.48 01706641 A4649 ETHILON BLK MONO 18 2-0$ 25.29 01707270 A4649 KIT CRANIAL ACCESS W/DRILL$ 747.48 01707316 A4649 TRAY FOLEY CATH 16FR 5CC$ 112.77 01707400 A4649 SET CATH RADIAL ART 30FR 20GA$ 231.07 01707431 A4649 TRAY CATH C-V 2-LUMEN 5FR 8CM$ 759.85 01707432 A4649 SET CATH FEMORAL ART 4FR 18CM$ 262.75 01707438 A4649 SET CATH DRAIN PL/PP 8.5F 15CM$ 770.83 01708330 A4649 CATHETER LUMBAR OPEN TIP$ 504.40 01708401 A4649 ACCUDRAIN W/ANTIREFLUX VALVE$ 733.94 01708420 A4649 SET VENTRICULAR TRAUMACATH$ 345.12 01708640 A4649 CAPNOLINE H O2 NASAL ADULT$ 123.39 01708700 A4649 BAG DRAINAGE ACCUDRAIN$ 38.46 01709020 A4649 LIMITORR VOLUME LIMIT EVD 20ML$ 733.94 01709030 A4649 INJECTION CAP$ 1.76 01709034 A4649 SPECULUM VAGINAL SML DISP$ 1.52 01709038 A4649 SPECULUM VAGINAL MED DISP$ 1.61 01709045 A4649 SPECULUM VAGINAL LGE DISP$ 1.59 01709380 A4649 BRONCHOSCOPE SWIVEL ADAPTER$ 75.05 01710000 A4649 BAG SPIKE ADAPTER NEEDLE-FREE$ 24.22 01710010 L0172 CERVICAL COLLAR PHILA SML$ 20.19 01710015 A4649 AIRWAY ORAL 40MM-NEONATAL$ 1.81 01710016 A4649 AIRWAY ORAL 60MM-PEDS$ 1.67 01710017 A4649 AIRWAY ORAL 80MM-ADULT$ 2.52 01710018 A4649 AIRWAY ORAL 90MM-ADULT$ 2.13 01710019 A4649 AIRWAY ORAL 100MM-ADULT$ 2.13 01710028 L0172 CERVICAL COLLAR PHILA MED$ 20.19 01710036 L0172 CERVICAL COLLAR PHILA LGE$ 20.19 01710120 A4649 ARMBOARD W/ COVER 2.5$ 6.52 01710121 A4649 ARMBOARD W/ COVER 4$ 6.17 01710122 A4649 ARMBOARD W/ COVER 5$ 7.61

12 01710123 A4649 ARMBOARD W/ COVER 7$ 10.36 01710136 A4649 TUBE SALEM SUMP W/ SENT 16FR$ 2.98 01710146 A6448 BANDAGE ACE 2X5YD$ 5.11 01710147 A6449 BANDAGE ACE 3X5YD$ 10.87 01710148 A4649 BANDAGE ACE 4X5YD$ 12.77 01710149 A4649 BANDAGE ACE 6X5YD$ 19.35 01710150 A6404 GAUZE STRETCH 2$ 3.37 01710151 A6404 GAUZE STRETCH 3$ 4.21 01710152 A6404 GAUZE STRETCH 4$ 4.66 01710153 A6404 GAUZE STRETCH 6$ 2.86 01710156 A4649 BANDAGE WEBRIL 2$ 2.98 01710157 A4649 BANDAGE WEBRIL 3$ 4.21 01710158 A4649 BANDAGE WEBRIL 4$ 1.93 01710159 A4649 BANDAGE WEBRIL 6$ 8.97 01710160 A4649 CATHETER THORACIC 20FR$ 21.04 01710161 A4649 CATHETER THORACIC 24FR$ 33.94 01710162 A4649 CATHETER THORACIC 28FR$ 27.39 01710163 A4649 CATHETER THORACIC 32FR$ 31.99 01710164 A4649 CATHETER THORACIC 36FR$ 20.99 01710165 A4649 CATHETER UMBILICAL ART 3.5FR$ 81.06 01710193 A4649 DRESSING BIOPATCH 1X4MM$ 47.12 01710194 A4649 DRESSING BIOPATCH 1X7MM$ 48.75 01710215 A4649 BANDAGE ELASTOPLAST 2X5YD$ 16.52 01710296 A4649 STOCKING THIGH HI-LENGTH-MED$ 48.78 01710297 A4649 STOCKING THIGH HI-LENGTH-LGE$ 54.08 01710304 A4649 PUMP ALTERNATING LEG PRESSURE$ 23.87 01710309 A4649 BANDAGE CASTING TAPE 2X 4 YD$ 25.33 01710310 A4649 BANDAGE CASTING TAPE 2X4YD$ 9.07 01710311 A4649 BANDAGE CASTING TAPE 3X 4 YD$ 40.41 01710312 A4649 BANDAGE CASTING TAPE 4X 4 YD$ 40.29 01710313 A4649 BANDAGE CASTING TAPE 5X 4 YD$ 49.55 01710314 A4649 BANDAGE PLASTER PARIS 6$ 29.60 01710325 Q4051 SPLINT ONE-STEP 2X10$ 59.65 01710330 Q4051 SPLINT ONE-STEP 3X12$ 69.20 01710335 Q4051 SPLINT ONE-STEP 4X15$ 101.87 01710340 Q4051 SPLINT ONE-STEP 5X30$ 156.36 01710341 Q4051 SPLINT ONE-STEP 5X45$ 193.39 01710386 A4649 LIMB STABILIZER WEDGE$ 48.41 01710387 A4649 VEST CRISS-CROSS RESTRAINT MED$ 145.66 01710388 A4649 VEST CRISS-CROSS RESTRAINT LGE$ 145.66 01710389 A4649 VEST CRISS-CROSS RESTRAINT XLG$ 145.66 01710390 A4649 RESTRAINT CUFF WRIST$ 239.18

13 01710391 A4649 RESTRAINT CUFF ANKLE$ 239.18 01710392 A4649 HOLDER BREEZELINE PELVIC MED$ 99.87 01710393 A4649 HOLDER BREEZELINE PELVIC LGE$ 99.87 01710440 A4649 BAG FECAL MANAGEMENT SYSTEM$ 43.81 01710445 A4649 NEEDLE-FREE VALVE ALARIS$ 12.02 01710486 A4649 KIT CATH INFANT 5FR$ 25.84 01710487 A4649 KIT CATH PEDS 8FR$ 25.84 01710499 A4649 CATHETER CONDOM$ 5.85 01710500 A4346 CATHETER FOLEY 8FR 3CC$ 39.07 01710600 A4649 KIT CEN/VEN ACCESS 2-LUMEN 9FR$ 824.07 01710668 A4649 SCALPEL BLADE #10 W/ HANDLE$ 7.04 01710669 A4649 SCALPEL BLADE #11 W/ HANDLE$ 7.04 01710671 A4649 SCALPEL BLADE #15 W/ HANDLE$ 7.04 01710725 A4649 NEEDLE GRIPPER PORT-A-CATH$ 35.44 01710733 A4649 CATHETER SUCTION DELEE 8FR$ 11.50 01710752 A4649 CATHETER THORACIC 16FR$ 42.92 01710850 L0120 CERVICAL COLLAR FOAM SML$ 25.45 01710900 A4649 ENTERAL FEEDING VALVE$ 43.95 01710909 A4649 FEMOSTOP COMPRESSION SYSTEM$ 714.43 01711092 A4649 WOUND CARE-DRESSING COLOPLAST$ 71.76 01711124 A6209 DRESSING MEPIFLEX S-FOAM 6"X6"$ 59.23 01711126 A6212 DRESSING TEGADERM F-A 5.5"X5.5$ 33.64 01711127 A6237 DRESSING TEGADERM HDC 5.25"x6"$ 24.86 01711128 A6238 DRESSING TEGADERM 6 3/4X6 3/8"$ 52.79 01711129 A6196 DRESSING ALGINATE SILVER 4"X5"$ 40.92 01711130 A4649 ELECTRODE ECG PLIA-CEL-INFANT$ 3.40 01711131 A4649 ELECTRODE EKG QUICK COMBO-PEDS$ 219.95 01711132 A4649 ELECTRODE EKG QUICK COMBO-ADUL$ 219.95 01711133 A4649 ELECTRODE LIFE PAK-ADULT$ 2.92 01711218 A4649 GAUZE PETROLATUM 1/2X72$ 11.70 01711280 A4649 GAUZE VASELINE PETROLATUM 3X9$ 4.42 01711412 A4649 BUTTERFLY 23GA 3/4X12$ 5.66 01711425 A4649 CATH ANGIOCATH 14GAX1-1/4$ 19.11 01711444 A4649 KIT IV PREP W/ CHLORAPREP$ 2.52 01711610 A4649 MASK AEROSOL-PEDS$ 7.89 01711630 A4649 MASK MULTI-VENT-PEDS$ 30.05 01711633 A4649 MASK MULTI-VENT-ADULT$ 14.55 01711634 A4649 MASK NON-REBREATHING-PEDS$ 12.10 01711653 A4649 LANCET FINGER BLOOD$ 1.02 01711691 A4649 ADAPTER OXYGEN$ 4.06 01711692 A4649 OXISENSOR-ADULT$ 134.51 01711772 A4649 UNDERGARMENT MATERNITY$ 18.12

14 01711774 A4649 PAD TELFA 2X3$ 0.59 01711880 A4649 DRAPE THYROID SHEET CONVERTORS$ 73.68 01711955 Q4049 SPLINT FINGER ALUM 1/2X9$ 12.32 01711965 Q4049 SPLINT FINGER ALUM 3/4X18$ 7.81 01711970 Q4049 SPLINT FINGER ALUM 1X18$ 30.30 01712075 A4649 STERI-STRIP 1/8X3$ 4.77 01712085 A4649 STOCKINETTE TUBULAR 2 /YD$ 1.98 01712086 A4649 STOCKINETTE TUBULAR 3 /YD$ 3.11 01712087 A4649 STOCKINETTE TUBULAR 4 /YD$ 3.64 01712088 A4649 STOCKINETTE TUBULAR 6 /YD$ 4.84 01712090 A4649 STOCKING ANTI-EMBOLECTOMY-SML$ 16.34 01712091 A4649 STOCKING ANTI-EMBOLECTOMY-MED$ 39.00 01712092 A4649 STOCKING ANTI-EMBOLECTOMY-LGE$ 19.82 01712093 A4649 STOCKING ANTI-EMBOLECTOMY-XLGE$ 33.64 01712095 A4649 STOCKING THIGH HI-LENGTH-SML$ 74.21 01712096 A4649 STOCKING THIGH HI-LENGTH-MED$ 48.78 01712097 A4649 STOCKING THIGH HI-LENGTH-LGE$ 54.08 01712140 A4649 TRACTION STRIP (SKIN TRAC) SML$ 139.58 01712145 A4649 TRACTION STRIP (SKIN TRAC) MED$ 78.95 01712150 A4649 TRACTION STRIP (SKIN TRAC) LGE$ 192.11 01712160 A4649 SUPPORT LUMBOSACRAL SML$ 356.30 01712161 A4649 SUPPORT LUMBOSACRAL MED$ 177.62 01712162 A4649 SUPPORT LUMBOSACRAL LGE$ 157.88 01712224 A4649 SET ENTERAL PUMP W/ BAG 1000CC$ 33.83 01712325 A4213 SYRINGE LUER LOCK TIP 60CC$ 3.16 01712507 A4649 TRAY BONE MARROW BIOPSY/ASP$ 205.15 01712595 A4649 TUBE CONICAL GRADUATED 50ML$ 6.17 01712724 B4082 TUBE NASOGASTRIC 8FR$ 101.91 01712729 A4649 TUBE SALEM SUMP W/ SENT 10FR$ 23.84 01712730 A4649 TUBE SALEM SUMP W/ SENT 12FR$ 24.30 01712731 A4649 TUBE SALEM SUMP W/ SENT 14FR$ 12.17 01712733 A4649 TUBE SALEM SUMP W/ SENT 18FR$ 12.81 01712829 A4649 TUBE ENDOTRACH W/ HOLDER 2.0MM$ 19.59 01712830 A4649 TUBE ENDOTRACH UNCUFF 2.5MM$ 10.06 01712836 A4649 TUBE ENDOTRACH W/ HOLDER 3.0MM$ 50.53 01712838 A4649 TUBE ENDOTRACH UNCUFF 3.5MM$ 33.51 01712895 A4649 TUBE TRACHEOSTOMY 26FR SZ-4$ 670.89 01713035 A4649 IV EXTENSION W/ LUER LOCK PEDS$ 5.99 01713041 A4554 UNDERPAD-PLUS$ 7.04 01713050 A4649 URINE COLLECTOR-PEDS$ 7.04 01713261 A4930 GLOVES SURGEON NEOPRENE SZ-6$ 8.75 01713262 A4649 GLOVES SURG S-6 N/ALLERGENIC$ 8.36

15 01713311 A4649 GLOVES SURG S-6.5 N/LATEX$ 11.88 01713361 A4930 GLOVES SURG S-7 N/LATEX$ 11.88 01713411 A4930 GLOVES SURG S-7.5 N/LATEX$ 11.88 01713461 A4930 GLOVES SURG S-8 N/LATEX$ 14.63 01713512 A4649 GLOVES SURG S-8.5 N/ALLERGIC$ 3.97 01714261 A4649 CAPNOMETER-PEDS$ 112.52 01714462 A4649 IMMOBILIZER KNEE 21$ 271.06 01716921 A4649 OXISENSOR-INFANT$ 153.12 01718301 A4649 LIMB HOLDER-FOAM CUFF$ 14.06 01721420 A4649 VALVE PEEP-PEDS$ 33.43 01722003 A4649 LARYNGOSCOPE CRV #1 DISP$ 93.95 01723646 A4649 INTRODUCER INTUBATE 14FR 65CM$ 553.63 01724601 A4649 TOOTHETTE SUCTION SYSTEM$ 14.41 01726410 A4649 COLOSTOMY CLAMP-ADULT$ 19.90 01726441 A4649 IMMOBILIZER KNEE 20$ 271.06 01728401 A4649 TUBE ENDOTRACH UNCUFF 4.0MM$ 50.75 01728431 A4649 TUBE ENDOTRACH UNCUFF 4.5MM$ 50.28 01728451 A4649 TUBE ENDOTRACH UNCUFF 5.0MM$ 54.46 01729001 A4649 TRAY DBL POLYURTH C-V CATH$ 863.25 01729002 A4649 SET ART PRESSURE C-PMS-401-FA$ 310.75 01729003 A4649 SET ART PRESSURE C-PMS-301-RA$ 275.19 01730005 A4649 CATHETER DUAL LUMEN 11.5FRX13.$ 730.65 01730007 A4649 CATHETER DUAL LUMEN 11.5FRX19.$ 776.02 01730013 A4649 LARYNGOSCOPE CRV #0 DISP$ 65.30 01730022 A4649 TRAY CATH C/V 3-LUMEN 7FR 15CM$ 994.82 01730023 A4649 LARYNGOSCOPE CRV #2 DISP$ 93.95 01730024 A4649 LARYNGOSCOPE CRV #3 DISP$ 93.95 01730025 A4649 LARYNGOSCOPE CRV #4 DISP$ 93.95 01730026 A4649 LARYNGOSCOPE STR #0 DISP$ 93.95 01730027 A4649 LARYNGOSCOPE STR #1 DISP$ 89.48 01730029 A4649 LARYNGOSCOPE STR #3 DISP$ 93.95 01730030 A4649 BLADE SCALPEL #10$ 1.51 01730031 A4649 LARYNGOSCOPE STR #4 DISP$ 93.95 01730035 A4649 BLADE SCALPEL #11$ 1.77 01730040 A4649 BLADE SCALPEL #12$ 0.95 01730045 A4649 BLADE SCALPEL #15$ 1.77 01730050 A4649 BLADE SCALPEL #20$ 1.35 01730055 A4649 BLADE SCALPEL #21$ 1.42 01730100 A4649 KIT VESSEL CATH 20GA 12CM$ 177.41 01730289 A4649 NEEDLE SPINAL 25GAX3-1/2$ 12.79 01730474 A4649 RESUSCITATOR-AMBU SET DISP-INF$ 124.33 01730477 A4649 RESUSCITATOR-AMBU SET DISP-ADU$ 206.58

16 01730479 A4649 RESUSCITATOR-AMBU SET DISP-PED$ 200.91 01731034 A6455 COBAN COMPRESSION 2-LAYER XLGE$ 104.32 01732475 A4649 PAD ARMBOARD 2"$ 18.85 01732501 A4649 SPECIMEN TRAP 40CC$ 10.89 01733305 A6250 CAVILON ADV SKIN PRO 2.7ML$ 52.54 01748768 A4623 CANNULA SHILEY 8.0MM DIC$ 17.60 01750050 A4649 SET ADMIN IV-INFUSMAT TUBING$ 39.86 01750051 A4649 SET EXTENSION-SYRINGE PUMP$ 23.05 01750994 A4649 MULTI-RING HEAD POSITIONER$ 17.17 01753177 A4649 TRAY INTRO TRACHEO 5FR 29CM$ 1,089.76 01756535 A4649 SET PNEUMOTHORAX 14FR 29CM$ 859.47 01760059 A4649 IMMOBILIZER KNEE 16$ 268.80 01760101 A4649 CALF GARMENT REGULAR 18$ 153.83 01760102 A4649 CALF GARMENT LARGE 24$ 256.44 01760105 A4649 CALF GARMENT X-LARGE$ 344.69 01761733 A4649 DRESSING MEFIX 2X11YD$ 51.40 01762482 A4649 WOUND CARE-DRESSING SACRAL 7X7$ 81.65 01764101 A4649 COLOSTOMY BAG-ADULT$ 21.56 01764800 A4649 SILK BLK BR 30 2-0$ 9.99 01766197 A4649 VALVE GASTRIC SUMP ANTI-REFLUX$ 43.35 01782003 A4649 LARYNGOSCOPE STR#2 DISP$ 93.95 01785083 A4649 EXTERNAL CSF DRAINAGE SYSTEM$ 912.88 01787970 A4649 DUODERM DRESSING 2.5X2.5$ 34.82 01787971 A4649 DUODERM DRESSING 6X6$ 54.69 01790743 A4649 TRAY CATH C-V 2-LUMEN 4FR 5CM$ 758.70 01790940 A4649 WOUND CARE-DRESSING SACRAL 4X4$ 18.94 01795004 A4649 PAD DUO THERM 14X20 DISP$ 50.31 01795005 A4649 SPECIMEN MEASURE TOILET TOP$ 5.69 01795006 A4649 KIT CATHETER FEMALE$ 54.76 01795007 A4649 CATH ANGIOCATH 20GAX1-1/4$ 11.71 01795008 A4649 K MOD HEAT THERAPY PUMP$ 2.46 01795120 A6237 DUODERM DRESSING 4X4$ 21.66 01797000 A6222 TRAY GAUZE 4X4$ 5.16 01997000 X-RAY COPY-FILM&IMAGING INIT$ 36.95 01997001 X-RAY COPY-CD$ 7.39 02000001 93880 US-EXT CAROTIDS COMPLETE BIL$ 254.11 02000003 61050 CISTERN/LAT CERVIC W/O INJ$ 91.96 02000004 76942 US-GUIDED NEEDLE PLACEMENT$ 438.53 02000006 75984 X-RAY CONTROL CATH CHANGE$ 44.68 02000012 76827 US-FETAL HEART PV/CW COMP$ 383.71 02000015 61055 CISTERN/LAT CERVIC W/ INJ$ 900.62 02000016 93882 US-EXT CAROTIDS UNIL/LIMIT$ 254.11

17 02000021 68850 INJECT FOR TEAR SAC X-RAY$ 91.96 02000022 73050 ACROMIOCLAVICULAR JT BIL$ 127.34 02000025 75630 ABD AORTOGRW/ BIL ILIOFEMORAL$ 3,431.20 02000028 92284 INJECT MYELOGRAM/CT LUMBAR$ 137.95 02000033 76825 US-FETAL HEART 2-D$ 566.52 02000035 49180 PERC NDL BX ABD/RETROPERI MASS$ 1,410.62 02000048 74022 ABDOMEN INCL CHEST PA$ 127.34 02000051 A4641 NM-RADIOPHARM COMPOUND$ 285.11 02000055 50690 INJECT FOR URETEROPYELOGRAPHY$ 183.93 02000061 75989 ABSCESS DRAIN UNDER X-RAY$ 89.32 02000064 76872 US-TRANSRECTAL$ 310.64 02000068 76830 US-NON-OB TRANSVAGINAL$ 310.64 02000070 73562 KNEE 3 VIEWS$ 127.34 02000071 75600 CT-AORTO THORA W/O SERIA$ 3,431.20 02000079 76818 US-BIOPHYSICAL PROFLW/NON-ST$ 365.46 02000080 76998 US-GUIDE INTRAOPERATIVE$ 160.37 02000086 73700 CT-LOWER EXT W/O CONTRAST$ 713.52 02000091 72131 CT-LUMBAR SPINE W/O CONTRAST$ 773.81 02000093 73701 CT-LOWER EXT W/ CONTRAST$ 797.29 02000100 70371 BARIUM SPEECH EVAL COMPLEX$ 213.79 02000105 32200 DRAINAGE OF LUNG LESION$ 183.93 02000109 19030 INJECTION FOR BREAST X-RAY$ 91.96 02000118 31899 BRONCHOSCOPY INJECT X-RAY$ 91.96 02000120 48102 PERC NEEDLE BIOPSY PANCREAS$ 1,410.62 02000126 20206 NEEDLE BIOPSY MUSCLE$ 1,410.62 02000127 50200 BIOPSY OF KIDNEY$ 1,410.62 02000129 77077 JT SURVEY SINGLE VW 2/> JTS$ 127.34 02000130 93505 BIOPSY OF HEART LINING$ 183.93 02000138 70490 CT-NECK SOFT TISSUE W/O CONT$ 340.24 02000139 73565 KNEE BOTH STANDING AP$ 74.11 02000140 72128 CT-THORACIC SPINE W/O CONTRST$ 773.81 02000144 70491 CT-NECK SOFT TISSUE W/ CONTR$ 391.69 02000146 75827 VEIN X-RAY CHEST$ 172.69 02000147 73610 ANKLE COMPLETE MIN 3 VIEWS$ 127.34 02000151 77012 CT-GUIDE NEEDLE BIOPSY$ 722.44 02000152 76948 US-GUIDE OVA ASPIRATION$ 643.77 02000162 73600 ANKLE 2 VIEWS$ 127.34 02000402 74280 COLON AIR CONTRAST W/ BARIUM$ 188.00 02000469 77072 BONE AGE STUDIES$ 110.81 02000485 77073 BONE LENGTH STUDIES$ 117.51 02000501 77075 BONE SURVEY COMPLETE$ 175.80 02000527 77076 BONE SURVEY INFANT$ 70.52

18 02000543 76499 BRONCHOGRAPHY BILATERAL$ 188.00 02000568 76499 BRONCHOGRAPHY UNILATERAL$ 117.51 02000725 74301 CHOLANGIOGRAM ADDL INTRAOP$ 140.97 02000741 74300 CHOLANGIO/PANCREATO INTRAOP$ 117.51 02000808 74290 CHOLECYSTOGRAPHY ORAL CONTRST$ 117.51 02000865 73000 CLAVICLE COMPLETE$ 110.81 02000881 74270 COLON BAR ENEMA W/OR W/O KUB$ 202.35 02000907 74430 CYSTOGRAPHY MIN 3 VIEWS$ 355.46 02000960 A4641 KIT TECHNESCAN MAG3$ 2,619.08 02000964 73070 ELBOW 2 VIEWS$ 98.48 02000980 73080 ELBOW COMPLETE MIN 3 VIEWS$ 79.57 02001004 74210 BARIUM ESOPHAGUS & PHARYNX$ 136.28 02001020 Q0092 PORTABLE BEDSIDE$ 23.52 02001129 70140 FACIAL BONES LESS 3 VIEWS$ 79.57 02001145 70150 FACIAL BONES COMP MIN 3 VWS$ 127.34 02001175 A4649 PROBE COVER ECLIPSE 2.37X9.5$ 5.17 02001186 73140 FINGERS MIN 2 VIEWS$ 98.48 02001202 76080 FISTULA/SINUS TRACT STUDY$ 117.51 02001244 73630 FOOT COMPLETE MIN 3VS$ 79.57 02001269 73650 HEEL MIN 2 VIEWS$ 98.48 02001285 73620 FOOT 2 VIEWS$ 98.48 02001301 73090 FOREARM 2 VIEWS$ 98.48 02001327 73130 HAND MINIMUM 3 VIEWS$ 110.81 02001426 73060 HUMERUS > 2 VIEWS$ 79.57 02001442 74740 HYSTEROSALPINGOGRAPHY$ 196.97 02001483 73564 KNEE 4/> VIEWS$ 127.34 02001491 73580 KNEE ARTHRO S&I$ 180.14 02001509 73560 KNEE 1 OR 2 VIEWS$ 110.81 02001582 73592 LOW EXTREMITY INFANT MIN 2VS$ 98.48 02001608 75805 LYMPHANGIO PELVIC/ABD UNILAT$ 352.51 02001624 75801 LYMPHANGIOGRAM EXTREMTY UNIL$ 164.52 02001681 70110 MANDIBLE COMPLETE MIN 4 VWS$ 127.34 02001707 70100 MANDIBLE PARTIAL LESS 4 VWS$ 79.57 02001723 70130 MASTOIDS COMP MIN 3 VS/SIDE$ 117.51 02001749 70120 MASTOIDS <3 VIEWS PER SIDE$ 84.60 02001764 72270 MYELOGRAPHY 2/> SPINAL CANAL$ 369.30 02001780 72240 MYELOGRAPHY CERVICAL$ 295.43 02001806 72265 MYELOGRAPHY LUMBOSACRAL$ 295.43 02001822 70160 NASAL BONES COMP MIN 3 VIEWS$ 79.57 02001848 70170 NASOLACRIMAL DUCT$ 94.00 02001863 70360 NECK SOFT TISSUE$ 110.81 02001905 74415 UROGRAPHY INFUSE W/NEPHRTOMO$ 352.51

19 02001921 70190 OPTIC FORAMINA$ 70.52 02001947 70200 ORBITS COMPLETE MIN 4 VIEWS$ 127.34 02001962 70220 PARANASAL SINUS COMP MIN 3VS$ 127.34 02002002 70210 PARANASAL SINUS <3 VIEWS$ 110.81 02002044 74710 PELVIMETRY W/WO PLACNTA LOCAL$ 117.51 02002069 72170 PELVIS 1 OR 2 VIEWS$ 127.34 02002085 72190 PELVIS > 3 VIEWS$ 188.00 02002101 72202 SACROILIAC JOINTS 3/> VWS$ 94.00 02002127 72220 SACRUM & COCCYX MIN 2 VIEWS$ 79.57 02002168 70370 LARYNX-PHARYNX$ 94.00 02002309 71111 RIBS BIL W/PA CHEST MIN 4VS$ 103.39 02002325 71101 RIBS UNILW/PA CHEST MIN 3VS$ 127.34 02002341 70380 SALIVARY GLAND CALCULUS$ 70.52 02002364 A4649 NEEDLE TRANSSEPTAL TSNC-18-71$ 449.76 02002365 A4649 NEEDLE TRANSSEPTAL TSNC-19-56$ 808.56 02002366 73010 SCAPULA COMPLETE$ 79.57 02002408 70240 SELLA TURCICA$ 123.09 02002424 73030 SHOULDER COMPLETE MIN 2VS$ 127.34 02002440 73020 SHOULDER 1 VIEW$ 79.57 02002465 70390 SIALOGRAPHY$ 221.57 02002481 70260 SKULL COMPLETE MIN 4 VIEWS$ 127.34 02002507 70250 SKULL LESS 4 VIEWS$ 127.34 02002523 74250 SMALL BOWEL BA W/MULTI IMAGES$ 140.97 02002549 72040 SPINE CERVICAL 2 OR 3 VIEWS$ 127.34 02002564 72052 SPINE CERVICAL 6/> VIEWS$ 140.97 02002580 72050 SPINE CERVICAL 4 OR 5 VIEWS$ 127.34 02002622 72100 SPINE L-SACRAL 2 OR 3 VIEWS$ 127.34 02002648 72120 SPINE L-SACRAL BEND 2/3 VWS$ 164.52 02002663 72110 SPINE L-SACRAL MIN 4 VIEWS$ 135.40 02002689 72080 SPINE T-LUMBAR MIN 2 VIEWS$ 79.57 02002705 72070 SPINE THORACIC 2 VIEWS$ 127.34 02002721 71130 STERNOCLAVICULAR JNT MIN 3VS$ 94.00 02002747 71120 STERNUM MIN 2 VIEWS$ 79.57 02002762 74470 RENAL CYST TRNSLUMBR CONTRST$ 1,089.76 02002788 70330 T-MANDIBULAR JT BILATERAL$ 94.00 02002887 73590 TIBIA & FIBULA 2 VIEWS$ 110.81 02002903 73660 TOES MIN 2 VIEWS$ 98.48 02002929 74450 URETHROGRAM RETROGRADE$ 355.46 02002945 74455 GU-URETHROCYSTOGRAPHY VOID$ 355.46 02002960 74240 UPPER G-I BARIUM W/O KUB$ 202.35 02003026 73092 UP EXTREMITY INFANT MIN 2VS$ 127.34 02003042 74400 IVP W/WOKUB W/WO TOMO$ 180.50

20 02003067 74425 GU-UROGRAPHY ANTEGRADE$ 355.46 02003083 74420 GU-UROGRAPHY RETROGRADE$ 355.46 02003109 75822 VENOGRAPHY EXTREMITY BIL$ 1,089.76 02003125 75825 VENOGRAM INF V CAVA W/SERIAL$ 3,431.20 02003166 75820 VENOGRAM EXTREMITY UNILATERAL$ 1,108.97 02003208 73100 WRIST 2 VIEWS$ 98.48 02003224 73110 WRIST COMPLETE MIN 3 VIEWS$ 110.81 02003281 72074 SPINE THORACIC MIN 4 VIEWS$ 140.97 02003331 75605 ANG AOR THO S&I$ 3,431.20 02003455 75625 AORTOGRA ABD SERIALOGRAPHY$ 3,431.20 02003527 A4649 SYRINGE CONTRAST 150ML/QFT ANG$ 91.90 02004230 75710 ANGIO EXTREMITY UNIL$ 3,431.20 02004321 75716 ANG EXT BIL S&I$ 3,431.20 02004503 75726 ANGIO VISCERAL SEL/SUPRASEL$ 7,135.50 02004594 75731 ANG ADR UNIL SEL S&I$ 3,431.20 02004651 75733 ANG ADR BIL SEL S&I$ 1,066.96 02004719 75736 ANG PELVIC SEL S&I$ 3,431.20 02004776 75741 ANG PUL UNIL SEL S&I$ 3,431.20 02004834 75743 ANG PUL BIL SEL S&I$ 3,431.20 02004883 76536 US-THYROID$ 190.53 02004891 75774 ANGIO SELECTIVEEA ADD VESSEL$ 213.39 02004933 76700 US-ABDOMEN (LIVERPANCREASB-D$ 231.15 02004941 76770 US-RETROPERITONEAL COMPLETE$ 190.53 02004966 76506 US-BRAIN NEWBORN$ 190.53 02004974 76805 US-OB >= 14 WKS SINGLE FETUS$ 190.53 02004984 76856 US-PELVIC(NON-OB) COMPLETE$ 190.53 02004990 70470 CT-HEAD/BRAIN W&WO CONTRAST$ 1,211.69 02005000 A4641 NM-RADIOPHARM SIMPLE TCO4$ 213.85 02005005 70450 CT-HEAD W/O CONTRAST$ 741.27 02005013 70460 CT-HEAD W/ CONTRAST$ 798.29 02005039 74170 CT-ABDOMEN W/O & W/ CONTRAST$ 1,140.41 02005047 74150 CT-ABDOMEN W/O CONTRAST$ 712.75 02005054 74160 CT-ABDOMEN W/ CONTRAST$ 784.02 02005153 72127 CT-SPINE COMBINED$ 1,140.41 02005161 72125 CT-CERVICAL SPINE/ W/O CONTRST$ 712.75 02005179 72126 CT-CERVICAL SPINE W/ CONTRAST$ 784.02 02005195 72194 CT-PELVIS COMBINED$ 1,140.41 02005203 72192 CT-PELVIS W/O CONTRAST$ 712.75 02005211 72193 CT-PELVIS W/ CONTRAST$ 784.02 02005237 71270 CT-THORAX W/O & W/ CONTRAST$ 1,140.41 02005245 71250 CT-CHEST W/O CONTRAST$ 712.75 02005252 71260 CT-CHEST W/ CONTRAST$ 784.02

21 02005278 73202 CT-UPPER EXT W&WO CONTRAST$ 1,140.41 02005286 73200 CT-UPPER EXT W/O CONTRAST$ 712.75 02005294 73201 CT-UPPER EXT W/ CONTRAST$ 784.02 02005344 76870 US-SCROTUM$ 190.53 02005428 76499 POST MORTEM BODY$ 153.01 02006987 A4649 NEEDLE BX CHIBA DCHN-21-65.5-U$ 336.22 02007762 A4649 INTRODUCER PERF RCFW-9.0-38$ 225.39 02010005 10005 FNA BX W/US GUIDE 1ST LESION$ 670.67 02010007 10007 FNA BX W/FLUOR GUIDE 1ST LES$ 670.67 02010009 10009 FNA BX W/CT GUIDE 1ST LESION$ 670.67 02010021 10021 FINE NDL ASPIRATE W/O IMAGING$ 287.87 02010030 10030 DRAINAGE SOFT TISSUE PERC$ 1,160.47 02010059 A4641 NM-RADIOPHARM THALLIUM$ 544.94 02010160 10160 PUNC ASPI OF ABSCESS HEMATOMA$ 217.04 02011014 A4641 KIT DTPA$ 596.36 02019000 19000 PUNC ASPIR BRST CYST$ 688.05 02019102 19083 PUNC ASPIR BRST CYST ADD CYST$ 1,410.62 02020001 A9576 GADOTERIDOL IV$ 265.94 02020097 Q9967 ISOVUE 300 150 ML$ 202.56 02020101 Q9967 ISOVUE 370 76% 50ML VIAL$ 47.48 02020102 Q9967 ISOVUE 370 76% 200ML BTL$ 188.27 02020220 20220 BONE BIOPSY SUPERFICIAL$ 1,107.71 02020225 20225 BONE BIOPSY DEEP$ 1,797.61 02020501 20501 SINUS TRACT INJ DIAGNOSTIC$ 398.54 02020552 20552 INJ TRIGGER POINT 1/2 MUSCLE$ 261.17 02020553 20553 INJ TRIGGER POINT 3/> MUSCLES$ 261.17 02020604 20604 ASP/INJ SML JOINT/BURSA W/US$ 285.59 02020605 20605 ARTHROCENTESIS INTRMD W/O US$ 294.82 02020606 20606 ASP/INJ ITM JOINT/BURSA W/US$ 285.59 02020610 20610 ASP/INJ MAJ JOINT/BURSA W/O US$ 285.59 02020611 20611 ASP/INJ MAJ JOINT/BURSA W/US$ 285.59 02020612 20612 ASPIRATE/INJECT GANGLION CYST$ 285.59 02020615 20615 ASP&INJ FOR TX OF BONE CYST$ 621.97 02022510 22510 PERQ CERVICOTHORACIC INJECT$ 2,830.40 02022586 22586 PRE-SACRAL FUSE W/INSTR L5-S1$ 15,868.13 02023350 23350 SHOULDER ARTHRO INJECTION$ 60.98 02024220 24220 ARTHRO-INJECT ELBOW PROCEDURE$ 398.54 02025246 25246 ARTHRO-INJECT WRIST PROCEDURE$ 398.54 02026010 26010 DRAIN FINGER ABSCESS SIMPLE$ 759.83 02026011 26011 DRAIN FINGER ABSCESS COMPLIC$ 1,121.06 02026020 26020 DRAIN HAND TENDON SHEATH EA$ 1,195.35 02026025 26025 DRAIN PALM BURSA SINGLER$ 1,161.34

22 02026030 26030 DRAIN PALM BURSA MULTIPLE$ 1,346.72 02026990 26990 DRAIN PELVIS/HIP DEEP ABSCESS$ 2,225.66 02027093 27093 HIP ARTHROGRAPHY INJ W/O ANEST$ 91.96 02027095 27095 ARTHRO-INJECT HIP ANESTHESIA$ 398.54 02027301 27301 DRAIN THIGH/KNEE DEEP ABSCESS$ 2,192.09 02027603 27603 DRAIN LEG/ANKLE DEEP ABSCESS$ 2,192.09 02027648 27648 ARTHRO-INJECT ANKLE PROCEDURE$ 398.54 02030200 A4649 SYRINGE PRESSURIZE INJECTION$ 72.96 02032400 32400 NEEDLE BIOPSY CHEST LININGNG$ 1,410.62 02032408 32408 CORE NDL BX LNG/MED PERQ$ 1,407.00 02032550 32550 INSERT TUNNEL PLEURAL CATH$ 398.54 02032551 32551 INSERTION OF CHEST TUBE OPEN$ 655.78 02032552 32552 REMOVE TUNNEL PLEURAL CATH$ 286.28 02032554 32554 THORACENTESIS W/O IMAGING$ 194.55 02032555 32555 THORACENTESIS W/IMAGING$ 655.78 02032556 32556 DRAIN PLEURA PERC W/O IMGNG$ 277.97 02032557 32557 DRAIN PLEURA PERC W/ IMGNG$ 655.78 02032560 32560 PLEURODESIS VIA TUBE/CATH$ 655.78 02032561 32561 LYSE VIA CHEST TUBE/CATH INIT$ 655.78 02032562 32562 LYSE VIA CHEST TUBE/CATH SUBQ$ 717.74 02033016 33016 PERICARDIOCENTESIS W/IMAGING$ 1,798.32 02035190 35190 REPAIR CONG A-V FISTULA EXTREM$ 4,770.37 02036000 36000 INTRO-NEEDLE/INTRACATH/VEIN$ 545.04 02036002 36002 INJ PERC EXTR ANEURYSM$ 254.02 02036005 36005 INTRO-NEEDLE CATH EXT VENO$ 545.04 02036010 36010 INTRO-CATH SUP/INF VENA CAVA$ 545.04 02036011 36011 SELECT CATH VEIN 1ST ORD FAM$ 545.04 02036012 36012 SELECT CATH VEIN 2ND ORDER$ 545.04 02036013 36013 INTRO CATH RT HEART/PULMO ART$ 545.04 02036014 36014 ANGIO-CATH PLACEMNT RT/LT PULM$ 545.04 02036015 36015 ANGIO-CATH SEG OR SUBSEG PULMO$ 545.04 02036100 36100 INTRO-NDL CATH CAROTID OR VERT$ 545.04 02036140 36140 INTRO-NDL EXTREMITY ARTERY$ 545.04 02036160 36160 INTRO-NDL CATH AORTIC LUMBAR$ 545.04 02036200 36200 INTRO-CATHETER AORTA$ 545.04 02036215 36215 ANGIO-THORACIC BRACHIO 1 ORDER$ 545.04 02036216 36216 ANGIO-THORACIC BRACHIO 2 ORDER$ 545.04 02036217 36217 ANGIO-THORACIC BRACHIO 3 ORDER$ 545.04 02036218 36218 ANGIO-THORACIC BRACHIO >3 ORDE$ 545.04 02036221 36221 NON SELECT CATH THORA AORTA$ 462.42 02036222 36222 SEL CATH CCA/IA UNI XTRCRN CAR$ 625.63 02036223 36223 SEL CATH CCA/IA UNI NTRCRN CAR$ 3,431.20

23 02036224 36224 SEL CATH ICA UNI NTRCRN CAR$ 7,135.50 02036225 36225 SEL CATH SCA UNI VERTEBRAL$ 3,431.20 02036226 36226 SELECT CATH VERTEBRAL UNIL$ 7,135.50 02036227 36227 SEL CATH ECA UNI CAROTID$ 272.03 02036228 36228 PLACE CATH INTRACRANIAL ART$ 516.84 02036245 36245 ANGIO-ABD/PELV/LE ARTERY 1 ORD$ 545.04 02036246 36246 ANGIO-ABD/PELV/LE ARTERY INITI$ 545.04 02036247 36247 ANGIO-ABD/PELV/LE ARTERY INITI$ 545.04 02036248 36248 ANGIO-ABD/PELV/LE ARTERY 3> OR$ 545.04 02036251 36251 INS CATH RENAL ART 1ST UNIL$ 3,429.87 02036252 36252 RENAL SEL CATH (1ST-ORDER) BI$ 3,431.20 02036253 36253 RENAL SEL CATH(2ND-ORDER) UNI$ 3,431.20 02036254 36254 RENAL SEL CATH (2ND-ORDER) BI$ 3,431.20 02036475 36475 ENDOVENOUS RF 1ST VEIN$ 2,868.23 02036476 36476 ENDOVENOUS RF VEIN ADD-ON$ 837.41 02036478 36478 ENDOVENOUS LASER EXT 1ST VEIN$ 2,861.66 02036481 36481 ANGIO-CATH PERCUTANEOUS PORTAL$ 545.04 02036482 36482 ENDOVEN TX CHEM ADHES 1ST VEIN$ 4,770.37 02036555 36555 CV INSERTION NON TUNNELED UN$ 1,130.37 02036556 36556 INS NON-TUNNEL CV CATH 5 YRS/>$ 1,130.37 02036557 36557 CVC TUNL W/O PORT/PUMP <5 YRS$ 2,995.66 02036558 36558 INSERT TUNNEL CV CATH AGE 5/>$ 2,996.82 02036560 36560 CVC TUNL W/ PORT/PUMP <5 YRS$ 2,995.66 02036561 36561 INSERT TUNNEL CV CATH 5YRS/>$ 2,868.23 02036563 36563 CVC INS TUNL DVC W/SUBQ PUMP$ 2,995.66 02036565 36565 ANGIO-INSERT TWIN TUNNEL LINE$ 2,996.82 02036566 36566 CVC TNL DVC 2 CATH/SITE W/PORT$ 2,995.66 02036568 36568 INSERT PICC W/O PORT/PUMP <5YR$ 1,130.37 02036569 36569 INSERT PICC W/O PORT 5 YRS/>$ 1,130.37 02036570 36570 CVC W/SUBQ PORT <5YRS OLD SIMP$ 2,995.66 02036571 36571 INSERT PICC W/ PORT 5 YRS/>$ 2,995.66 02036572 36572 INSERT PICC W/IMAGE <5YRS$ 662.04 02036573 36573 INSERT PICC W/IMG GUIDE 5YRS+$ 1,205.73 02036575 36575 REPAIR NON-TUNL/TUNL CV CATH$ 654.03 02036576 36576 REPAIR CVC W/ PORT/PUMP$ 1,129.93 02036578 36578 REPLACE CATH CVD W/ PORT$ 2,995.66 02036580 36580 REPLACE NON-TUNL CV SAME SITE$ 1,130.37 02036581 36581 REPLACE CV TUNNEL SAME SITE$ 2,996.82 02036582 36582 REPLACE TUNNELED VAD W/ PORT$ 2,995.66 02036583 36583 REPLACE TUNNEL CVAD W/PUMP$ 2,995.66 02036584 36584 REPLACE PICC SAME SITE$ 1,130.37 02036585 36585 REPLAC CVC W/SUB PRT SAME SITE$ 2,995.66

24 02036589 36589 REMOVE TUNNL CV CATH W/O PORT$ 654.03 02036590 36590 REMOVE TUNL CVC W/PORT$ 1,129.93 02036593 36593 DECLOTTING BY THROMBOLYTIC AGE$ 261.59 02036595 36595 REMOVE VIA VENOUS PERICATH$ 2,996.82 02036596 36596 REMOVE VIA VENOUS INTRACATH$ 482.87 02036597 36597 REPOSITIOIN CV LINE W/ FLURO$ 1,130.37 02036598 36598 CV CATH CONTRAST INJ EVAL$ 261.59 02036620 36620 CATH RADIAL ART PRESSURE MONIT$ 482.87 02036860 36860 DECLOTTING W/O BALLOON CATH$ 261.48 02036861 36861 EXT DECLOT W/ BALLOON CATH$ 2,995.66 02036901 36901 CATH DIALYSIS CIRCUIT/ANG/IMG$ 873.15 02036902 36902 DIALYSIS CIRCUIT W/ANGIOPLASTY$ 6,158.31 02036903 36903 DIALYSIS CIRCUIT W/STENT/IMG$ 12,446.84 02036904 36904 PERQ TRANLMN THRBECTMY D-C IMG$ 6,158.31 02036905 36905 PERQ THRBECTMY D-C ANGIOP/IMG$ 12,446.84 02037182 37182 INSERT TIPS SHUNT$ 8,875.48 02037183 37183 REVISE TIPS SHUNT$ 5,860.88 02037184 37184 PRIMARY ARTERIAL THROMBI INITI$ 4,316.27 02037185 37185 PRIMARY ARTERIAL THROMBI 2ND >$ 435.62 02037186 37186 SECONDARY TRANSLUM NONCORONARY$ 435.62 02037187 37187 PERC TRANS MECH INCL INJECT$ 435.62 02037188 37188 PERC TRANS MECH INCL INJECT RP$ 435.62 02037191 37191 INSERT ENDOVAS VENACAVA FILTER$ 4,770.37 02037192 37192 REPOSITION IVC FILTER$ 2,995.66 02037193 37193 REMOVAL ENDOVASC OF IVC FILTER$ 2,996.82 02037195 37195 INFUSION IV THROMBOLYSIS CEREB$ 260.03 02037197 37197 TRANSCATH RETRIEVAL FB PERC$ 2,996.82 02037200 37200 TRANSCATHETER BIOPSY$ 2,995.66 02037211 37211 THRMBLYSIS ART NON-COR INIT$ 1,130.37 02037212 37212 THROMBOLYSIS VENOUS INITIAL$ 1,130.37 02037213 37213 THRBLYSIS ART/VEN NO-COR SSQ$ 2,996.82 02037214 37214 THRBLYSIS CESSTION REMC CATH$ 2,996.82 02037215 37215 INTRA STENT CER ART EMBOL PROT$ 550.77 02037216 37216 TRANSCATH STENT CCA W/O EPS$ 474.69 02037217 37217 STENT PLACEMT RETRO CAROTID$ 3,108.24 02037218 37218 STENT PLACEMT ANTE CAROTID$ 3,108.24 02037220 37220 REVASC ILIAC ART UNIL W/ANGIO$ 6,080.62 02037221 37221 REVASC ILIAC UNI STNT ANGIO$ 12,897.23 02037222 37222 ILIAC REVASC ADD-ON$ 3,144.26 02037223 37223 ILIAC REVASC W/STENT ADD-ON$ 3,534.03 02037224 37224 FEM/POPL REVAS W/TLA UNIL$ 5,860.88 02037225 37225 REVASC FEM/POP UNI ATHER ANG$ 12,897.23

25 02037226 37226 REVASC FEM/POP INI STNT$ 12,897.23 02037227 37227 REVAS FEM/POP UNI STNT ATH/ANG$ 19,887.92 02037228 37228 REVAS TIB/PER UNI ANGIO INIT$ 12,897.23 02037229 37229 REVAS TIB/PER UNI ATH ANGIO$ 19,887.48 02037230 37230 REVAS TIB/PER UNI STNT ANG$ 19,887.86 02037231 37231 REVAS TIB/PER UNI STNT ATH/ANG$ 19,887.48 02037232 37232 REVASC TIB/PERO ART UNI ADD$ 3,729.90 02037233 37233 REVASC TIB/PERO UNI ATHE ADD$ 3,729.90 02037234 37234 REVASC TIB/PERO UNI STNT ADD$ 3,729.90 02037235 37235 REVA TIB/PER UNI STNT ATH ADD$ 3,729.90 02037236 37236 TRANSCATH NTRVASC INIT ART$ 12,902.25 02037237 37237 OPEN/PERQ PLACE STENT EA ADD$ 462.42 02037238 37238 OPEN/PERQ PLACE STENT SAME$ 12,902.25 02037239 37239 OPEN/PERQ PLACE STENT EA ADD$ 353.62 02037241 37241 EMBOLIZE VEN NOT HEMORRHAGE$ 12,902.25 02037242 37242 EMBOLIZE ART NOT HEMOR/TUMOR$ 12,902.25 02037243 37243 EMBOLIZE ART TUMOR/ORGANS$ 12,902.25 02037244 37244 EMBOLIZE ART/VEN HEMMORHAGE$ 12,902.25 02037248 37248 TRLUML BALL ANGIOPLAS 1ST VEIN$ 4,956.84 02037252 37252 INTRVASC US NON-CORANARY INIT$ 2,091.39 02037253 37253 INTRVASC US NONCORONARY ADDL$ 310.02 02037620 37191 IVC FILTER PARTIAL/COMPLETE$ 2,996.82 02037761 37761 LIGATE LEG VEINS OPEN$ 2,861.66 02038220 38220 BONE MARROW ASPIRATION ONLY$ 1,202.23 02038221 38221 BONE MARROW BIOPSY$ 1,107.71 02038222 38222 DX BONE MARROW BX & ASPIR$ 2,488.51 02038500 38500 OPEN BX OR EXC LN; SUPERFICIAL$ 3,140.63 02038505 38505 LYMPH NODE BX/EXC SUPERFICIAL$ 1,410.62 02038790 38790 INJECT FOR LYMPHATIC X-RAY$ 183.93 02038792 38792 RA TRACER ID OF SENTINL NODE$ 375.45 02042400 42400 SALIVARY GLAND BX NEEDLE$ 138.11 02042405 42405 INCISIONAL BX SALIVARY GLAND$ 626.96 02042550 42550 INJECTION FOR SIALOGRAPHY$ 183.93 02043194 43194 ESOPHAGOSCP TRHORAL REMOVE FB$ 1,625.02 02043195 43195 ESOPHAGOSCP BALLOON DILATE$ 3,080.79 02043196 43196 ESOPHAGOSCP GUIDE WIRE DILATE$ 3,080.79 02043212 43212 ESOPHAGOSCOPY STENT PLACEMENT$ 5,028.52 02043214 43214 ESOPHAGOSC DILATE BALLOON 30MM$ 1,625.02 02043215 43215 ESOPHAGOSCOPY FLEX REMOVE FB$ 1,625.02 02043226 43226 ESOPH ENDOSCOPY DILATION$ 1,625.02 02043245 43245 EGD DILATE GAST/DUOD STRICTURE$ 1,625.02 02043246 43246 EGD PLACE GASTROSTOMY TUBE$ 1,625.02

26 02043247 43247 EGD REMOVE FOREIGN BODY$ 809.60 02043248 43248 EGD GUIDE WIRE INSERTION$ 809.60 02043249 43249 ESOPH EGD DILATION <30MM$ 1,625.02 02043260 43260 ERCP W/SPECIMEN COLLECTION$ 3,149.03 02043262 43262 ERCP W/SPHINCTERO/PAPILLOTOMY$ 3,149.03 02043264 43264 ERCP W/REMOVE DUCT CALCULI$ 3,149.03 02043265 43265 ERCP W/LITHOTRIPSY CALCULI$ 5,019.87 02043266 43266 EGD W/ENDOSCOPIC STENT PLACE$ 5,019.87 02043274 43274 ERCP W/DUCT STENT PLACEMENT$ 5,019.87 02043275 43275 ERCP W/REMOVE FORGN BODY DUCT$ 3,149.03 02043276 43276 ERCP W/STENT EXCHANGE W/DILATE$ 5,019.87 02043277 43277 ERCP EA DUCT/AMPULLA DILATE$ 3,149.03 02043453 43453 DILATE ESOPHAGUS GUIDE WIRE$ 1,635.27 02043752 43752 NASO/ORO-GASTRIC TUBE PLACEMEN$ 142.02 02043756 43756 DUODENAL INTUB/ASPIRATE W/IMG$ 128.51 02043761 43761 REPOSITION FEED TUBE DUODENUM$ 999.17 02043762 43762 REPLACE GTUBE NO REVJ GRTC$ 267.90 02043763 43763 REPLACE GTUBE REVJ GSTRST TRC$ 267.90 02044381 44381 SML BOWEL ENDO BR/WA BAL DILAT$ 1,625.02 02044384 44384 SML BOWEL ENDO PLACE STENT$ 3,080.79 02044402 44402 COLONOSCOPY W/STENT PLCMT$ 5,028.52 02044405 44405 COLONOSCOPY W/BALLOON DILATION$ 1,036.96 02044500 44500 INTRO LONG GI TUBE(MILLER-ABB)$ 809.60 02045303 45303 PROCTOSIGMOIDOSCOPY DILATE$ 1,036.96 02045332 45332 SIGMOIDOSCOPY W/FB REMOVAL$ 1,036.96 02045340 45340 SIG W/TNDSC BALLOON DILATION$ 1,036.96 02045347 45347 SIGMOIDOSCOPY W/PLCMT STENT$ 5,028.52 02045379 45379 COLONOSCOPY W/FB REMOVAL$ 1,036.96 02045386 45386 COLONOSCOPY W/BALLOON DILATE$ 1,036.96 02045389 45389 COLONOSCOPY W/STENT PLCMT$ 5,028.52 02047000 47000 BIOPSY OF LIVER PERCUTANEOUS$ 1,410.62 02047001 47001 NEEDLE BX LIVER AT PROCEDURE$ 295.43 02047380 47380 OPEN ABLATE LIVER TUMOR RF$ 3,806.90 02047381 47381 OPEN ABLATE LIVER TUMOR CRYO$ 3,636.70 02047382 47382 PERC ABLATE LIVER TUMOR RF$ 5,256.03 02047383 47383 PERC ABLATE LIVER TUMOR CRYO$ 5,256.03 02047490 47490 CHOLECYSTOSTOMY PERCUTANEOUS$ 2,457.04 02047531 47531 INJ CHOLANGIOGRAM EXIST ACCESS$ 448.90 02047532 47532 INJ CHOLANGIOGRAM NEW ACCESS$ 2,778.60 02047533 47533 PLMT BILIARY DRAIN CATH EXT$ 2,778.60 02047534 47534 PLMT BILIARY DRN CATH INT/EXT$ 2,778.60 02047535 47535 CONVERT EXT BIL DRAIN CATH$ 2,778.60

27 02047536 47536 EXCHANGE BILIARY DRAIN CATH$ 2,778.60 02047537 47537 REMOVE BILIARY DRAIN CATH$ 616.23 02047538 47538 PERQ PLMT BIL DUCT STNT EXIST$ 5,256.03 02047539 47539 PLMT BIL STENT NEW W/O PLMT$ 5,256.03 02047540 47540 PLMT BIL STENT NEW W/ PLMT$ 5,256.03 02047541 47541 PLMT ACCESS BIL TREE SM BWL$ 2,778.60 02047542 47542 BALLN DILATE BILIARY/AMPULLA$ 346.38 02047543 47543 PERC ENDOLUM BX BILIARY TREE$ 437.33 02047544 47544 REMOVE DUCT GLBLDR CALCULI$ 573.78 02047552 47552 BILIARY ENDO PERQ DX W/SPECI$ 2,457.04 02047553 47553 BILI ENDO PERC VIA T-TUBE W/BX$ 5,488.89 02047554 47554 BILIARY ENDO PERC REMVE CALC$ 2,457.04 02047555 47555 PRQ DIL BILIARY STRICT WO STNT$ 2,457.04 02047556 47556 DILATE BILIARY STRICTR W/STENT$ 5,488.89 02047563 47563 LAPARO CHOLECYSTECTOMY/GRAPH$ 5,060.44 02048400 48400 INJECT INTRAOP PANCREATOGRAPHY$ 284.20 02049082 49082 ABD PARACENTESIS W/O IMAGE$ 616.23 02049083 49083 ABD PARACENTESIS W/ IMAGING$ 655.78 02049084 49084 PERITONEAL LAVAGE W/ IMAGING$ 616.23 02049180 49180 PERC NDL BX ABD/RETROPERI MASS$ 1,410.62 02049400 49400 INJECT AIR/CONTRAST PERITONEAL$ 482.87 02049405 49405 CATH DRAIN VISCERAL PERC$ 1,410.62 02049406 49406 DRAIN RETRO/PERITONEAL PERC$ 1,410.62 02049407 49407 DRAIN RETRO/PERITONEAL TV/TR$ 1,410.62 02049418 49418 INSERT TUN IP CATH PERC$ 3,065.25 02049419 49419 INSERT TUN IP CATH W/PORT$ 2,995.66 02049421 49421 INSERTION CATH DRAIN DIALYSIS$ 482.87 02049422 49422 REMOVE TUNNEL INTRAPERITO CATH$ 2,111.24 02049423 49423 EXCHANGE PREVIOUS DRAIN CATH$ 1,727.47 02049424 49424 ABSCESS CYST CONSTRAST INJ$ 482.87 02049427 49427 INJ TO EVAL PERITONEAL-VENOUS$ 138.15 02049440 49440 PLACE GASTROSTOMY TUBE PERC$ 1,388.60 02049441 49441 PLACE DUOD/JEJ TUBE PERQ$ 1,388.60 02049442 49442 PLACE CECOSTOMY TUBE PERQ$ 2,120.55 02049446 49446 CONVERT G-TUBE TO G-J PERC$ 1,388.60 02049450 49450 REPLACE GASTRO/CECO TUBE PERC$ 616.23 02049451 49451 REPLACE DUOD/JEJ TUBE PERC$ 616.23 02049452 49452 REPLACE GASTRO-JEJ TUBE PERC$ 654.03 02049460 49460 MECH REMOVAL OBSTRUCT MATERIAL$ 91.67 02049465 49465 FLUORO EXAM OF G-I/COLON TUBE$ 128.51 02050000 76000 FLUOROSCOPY UP TO 1 HOUR$ 221.57 02050040 76100 TOMOGRAPHY (ANATOMICAL)$ 398.17

28 02050080 50080 PERQ REMOVE KIDNEY STONE <2CM$ 8,471.33 02050081 50081 PERQ REMOVE KIDNEY STONE >2CM$ 8,471.33 02050130 70134 INTERNAL AUDITORY MEATI COMP$ 123.09 02050150 73120 HAND 2 VIEWS$ 127.34 02050187 76506 US-BRAIN INFANT$ 180.72 02050190 19281 BREAST MASS LOCALIZATION$ 278.20 02050194 76604 US-CHEST$ 180.72 02050382 50382 URETRAL STNT REMOVE AND REPLA$ 482.87 02050384 50384 URETRAL STNT REMOVAL S&I$ 482.87 02050385 50385 CHANGE STENT VIA TRANSURETH$ 2,792.80 02050386 50386 REMOVE STENT VIA TRANSURETH$ 1,792.99 02050387 50387 URETRAL NEPH REMOVE AND REPLC$ 482.87 02050389 50389 REMOVE NEPHRO TUBE W/ FLUORO$ 735.62 02050390 50390 ASPIRATE/INJ RENAL CYST/PELVIS$ 670.67 02050396 50396 MANOMETRY THRU INDWELLING CATH$ 286.39 02050430 50430 NEPHROSTOGRAM INJ NEW ACCESS$ 669.39 02050431 50431 NEPPHROSTOGRAM INJ EXIST ACCES$ 669.39 02050432 50432 PLACEMENT NEPHROSTOMY CATHETER$ 1,922.61 02050433 50433 PLMT NEPHROURETERAL CATHETER$ 1,922.61 02050434 50434 CONVERT NEPHROSTOMY CATHETER$ 669.39 02050435 50435 EXCHANGE NEPHROSTOMY CATHETER$ 669.39 02050436 50436 DILATE EXIST TRACT ENDOUROL PX$ 2,013.98 02050437 50437 DILATE XST TRC NEW ACCESS RCS$ 3,388.20 02050592 50592 PERC RF ABLATE RENAL TUMOR$ 5,060.44 02050606 50606 ENDOLUMINAL BX URTR RNL PLVS$ 420.95 02050684 50684 INJECTION OF URETER X-RAY$ 183.93 02050688 50688 CHANGE URETER TUBE$ 183.93 02050693 50693 PLMT URETER STENT PRE-EXIST$ 2,863.32 02050694 50694 PLMT URETERAL STENT PRQ NEW$ 2,863.32 02050695 50695 PLMT URETR STNT NEW W/ CATH$ 2,863.32 02050706 50706 BALLOON DILATE URTRL STRICTURE$ 510.03 02051012 A4649 KIT DMSA$ 749.92 02051018 A4649 KIT SULFUR COLLOID$ 980.96 02051019 J2805 KINEVAC (SINCALIDE) 5MCG VIAL$ 118.32 02051022 A4649 KIT ULTRA TAG RBC$ 1,045.19 02051102 51102 SUPRAPUBIC CATHETER INSERTION$ 1,843.65 02051600 51600 PREP FOR BLADDER X-RAY$ 91.96 02051605 51605 INJECT FOR URETHROCYSTOGRAPHY$ 119.26 02051610 51610 INJECT URETHRA/BLADDER X-XRAY$ 91.96 02051705 51705 CHANGE CYSTOSTOMY TUBE$ 286.39 02051710 51710 CHANGE CYSTOSTOMY TUBE COMP$ 653.78 02052310 52310 CYSTOURETHROSCOPY FB REMOVAL$ 816.53

29 02052332 52332 CYSTOURETHROSCOPY INSERT STENT$ 482.87 02053854 53854 TURP DESTRUCT BY RADFREQ GWV$ 1,860.44 02055700 55700 BIOPSY OF PROSTATE$ 1,959.63 02058345 58345 REOPEN FALLOPIAN TUBE TRANSCRV$ 2,623.01 02058970 58970 RETRIEVAL OF OOCYTE$ 633.41 02059000 59000 AMNIOCENTESIS DIAGNOSTIC$ 633.41 02059012 59012 FETAL CORD PUNCTURE PRENATAL$ 281.48 02059015 59015 CHORION BIOPSY$ 633.41 02060100 60100 THYROID BIOPSY PERCUATANEOUS$ 653.10 02060300 60300 ASPIRATE/INJ THYROID CYST$ 613.43 02061070 61070 PUNCTURE SHUNT TUBING$ 183.93 02061623 61623 ENDOVASC TEMPORARY VESSEL OCCL$ 12,178.72 02061624 61624 TRANSCATHETER OCCLUSION CNS$ 2,984.78 02061626 61626 TRANSCATH OCCLUSION NON-CNS$ 2,288.44 02061630 61630 BALLON ANGIOPLSTY INTRCRANIAL$ 3,505.43 02061635 61635 INTRACRAN ANGIOPLSTY W/STENT$ 3,775.40 02061640 61640 DILATE INTRCRN VASOSPASM INIT$ 1,628.54 02061641 61641 DILATE IC VASOSPASM ADD SAME$ 574.34 02061642 61642 DILATE IC VASOSPASM ADD DIFF$ 1,148.65 02061650 61650 INFUSION NON-THRMBLYSIS INIT$ 682.56 02061651 61651 INFUSE NON-THRMBLYSIS EA ADD$ 289.81 02062267 62267 ASPIRATE NUCLEOUS PULPOSUS$ 1,202.23 02062268 62268 PERQ ASPIRATE SPINAL CORD CYST$ 746.84 02062270 62270 LUMBAR PUNCTURE$ 499.35 02062281 62281 NEUROLYTIC INJ EPI CERV/THOR$ 413.50 02062282 62282 NEUROLYTIC INJ EPI LUMB/SACR$ 445.33 02062290 62290 INJECT SPINE DISK X-RAY LUMBAR$ 999.25 02062291 62291 INJ SPINE DISK X-RAY CERV/THOR$ 1,012.24 02062302 62302 MYELOGRAPHY LUMBAR INJECTION$ 715.18 02062303 62303 MYELOGRAPHY THORACIC INJECTION$ 715.18 02062304 62304 MYELOGRAPHY LUMBOSACRAL INJECT$ 715.18 02062305 62305 MYELOGRAPHY 2/> REGIONS$ 822.46 02062320 62320 NJX INTERLAMINAR CRV/THRC$ 409.80 02062321 62321 NJX INTERLAMINAR CRV/THRC$ 442.22 02062322 62322 NJX INTERLAMINAR LMBR/SAC$ 353.07 02062323 62323 NJX INTERLAMINAR LMBR/SAC$ 402.85 02062324 62324 NJX INTERLAMINAR CRV/THRC$ 373.92 02062325 62325 NJX INTERLAMINAR CRV/THRC$ 429.48 02062326 62326 NJX INTERLAMINAR LMBR/SAC$ 366.96 02062327 62327 NJX INTERLAMINAR LMBR/SAC$ 390.12 02062328 62328 DX LMBR SPI PNXR W/FLUOR/CT$ 634.59 02062329 62329 0HER SPI PNXR CSF FLUOR/CT$ 634.59

30 02064479 64479 INJ ANES/STRD TFRM EPI C/T 1$ 822.46 02064483 64483 INJECT FORAMEN EPIDURAL L/S$ 852.65 02068920 A4649 NEEDLE BX CHIBA DCHN-20-20.0-U$ 103.69 02070010 70010 MYELOGRAPHY POSTERIOR FOSSA$ 521.34 02070015 70015 CISTERNOGRAPHY POSITIVE CONTR$ 521.34 02070030 70030 RADIO EXAM EYE FB DETECT$ 66.02 02070310 70310 TEETH PART EXAM VIEWS$ 127.34 02071100 71100 RIBS UNILATERAL 2 VIEWS$ 89.20 02071110 71110 RIBS BILATERAL 3 VIEWS$ 127.34

31 02071275 71275 CT ANGIOGRAPHY CHEST (NON-COR)$ 1,057.11 02071551 71551 MRI-CHEST FOR HILA AND MEDIAST$ 921.06 02071552 71552 MRI-CHEST FOR HILA AND MEDIAST$ 1,250.08 02071555 71555 MRA-CHEST EXC MYOCARDIUM$ 1,697.16 02072020 72020 SPINE SINGLE SPECIFY LEVEL$ 89.20 02072072 72072 SPINE THORACIC 3 VIEWS$ 127.34 02072081 72081 SPINE ENTIRE INC SKULL 1 VW$ 112.31 02072082 72082 SPINE ENTIRE 2 OR 3 VWS$ 204.20 02072083 72083 SPINE ENTIRE 4 OR 5 VWS$ 222.08 02072084 72084 SPINE ENTIRE W/SKULL MIN 6V$ 269.29 02072114 72114 SPINE L-SACRAL COMP MIN 6VS$ 153.26 02072129 72129 CT-THORACIC SPINE W/ CONTRAST$ 512.53 02072130 72130 CT-THORACIC SPINE COMBINED$ 608.01 02072132 72132 CT-LUMBAR SPINE W/ CONTRAST$ 512.53 02072133 72133 CT-LUMBAR SPINE W&WO CONTRAST$ 608.01 02072141 72141 MRI-SPINE CERVICAL W/O CONTR$ 1,489.27 02072142 72142 MRI-SPINE CERVICAL WITH CONT$ 1,631.11 02072146 72146 MRI-SPINE THORACIC W/O CONTR$ 1,489.27 02072147 72147 MRI-SPINE THORACIC WITH CONT$ 1,631.11 02072148 72148 MRI-SPINE LUMBAR W/O CONTRAS$ 1,489.27 02072149 72149 MRI-SPINE LUMBAR WITH CONTRA$ 1,631.11 02072156 72156 MRI-CERV SPINE W&WO CONTRAST$ 2,127.54 02072157 72157 MRI-TORACIC SPINE W&WO CONTR$ 2,127.54 02072158 72158 MRI-LUMBAR SPINE W&WO CONTRST$ 2,127.54 02072159 72159 MRA-SPINE$ 1,851.12 02072191 72191 CT-PELVIS ANGIO W/&W/O DYE$ 1,333.41 02072195 72195 MRI-PELVIS W/O CONTRAST$ 745.93 02072196 72196 MRI-PELVIS$ 1,329.70 02072197 72197 MRI-PELVIS W &WO CONTRAST$ 1,101.02 02072198 72198 MRA-PELVIS$ 1,704.20 02072200 72200 SACROILIAC JOINT <3 VIEWS$ 89.20 02072255 72255 MYELOGRAPHY THORACIC$ 521.34 02072275 72275 EPIDUROGRAPHY$ 132.04 02072285 72285 DISCOGRAPHY CERV OR THORACIC$ 181.19 02072295 72295 DISCOGRAPHY-LUMBAR$ 175.71 02073040 73040 SHOULDER ARTHROGRAPHY$ 245.00 02073085 73085 ARTHROGRAPHY-ELBOW$ 283.99 02073115 73115 ARTHROGRAPHY-WRIST$ 283.99 02073206 73206 CT-UP EXTRMTY ANGIO W/O&W/DYE$ 1,170.90 02073218 73218 MRI-UPPER EXT. OTHER THAN JOIN$ 753.20 02073219 73219 MRI-UPPER EXT. OTHER THAN JOIN$ 819.86 02073220 73220 MRI-UP EXT NOT JNTW&WO CONT$ 1,329.70

32 02073221 73221 MRI-UP EXT ANY JNT WO CONTRST$ 1,329.70 02073222 73222 MRI-UPPER EXT. ANY JOINT W/ C$ 771.38 02073223 73223 MRI-UPPER EXT. ANY JOINT COMB$ 1,046.50 02073225 73225 MRA-UPPER EXTREMITY$ 1,575.92 02073501 73501 HIP UNIL W/ PELVIS 1 VW$ 76.58 02073502 73502 HIP UNIL W/ PELVIS 2-3 VWS$ 114.87 02073503 73503 HIP UNIL W/ PELVIS MIN 4 VS$ 141.68 02073521 73521 HIPS BIL W/ PELVIS 2 VIEWS$ 107.21 02073522 73522 HIPS BIL W/ PELVIS 3-4 VWS$ 128.91 02073523 73523 HIPS BIL W/ PELVIS. 5/> VWS$ 153.16 02073525 73525 HIP ARTHROGRAM$ 283.99 02073551 73551 FEMUR 1 VIEW$ 74.04 02073552 73552 FEMUR 2/> VWS$ 88.05 02073615 73615 ARTHROGRAPHY-ANKLE$ 283.99 02073702 73702 CT-LOWER EXT W&WO CONTRAST$ 608.01 02073706 73706 CT-ANGIO LOW EXT W/O&W/DYE$ 1,194.53 02073718 73718 MRI-LOWER EXT W/O CONTRAST$ 739.26 02073719 73719 MRI-LOWER EXT. OTHER THAN JOIN$ 809.58 02073720 73720 MRI-LOWER EXTREMITY EXCLUDING$ 1,329.70 02073721 73721 MRI-LOW EXT JOINT WO CONTRST$ 1,329.70 02073722 73722 MRI-LOW EXT JNT W/ CONTRAST$ 779.87 02073723 73723 MRI-LOW EXT JNT W&WO CONTRST$ 1,044.08 02073725 73725 MRA-LOWER EXT W&WO CONTRAST$ 1,792.90 02074018 74018 ABDOMEN ONE VIEW$ 98.48 02074019 74019 ABDOMEN TWO VIEWS$ 89.20 02074021 74021 ABDOMEN THREE OR > VIEWS$ 127.34 02074174 74174 CT-ABD&PELV ANGIO W/&W/O CONT$ 1,795.47 02074175 74175 CT-ABDOMEN ANGIO W/&W/O DYE$ 1,198.95 02074176 74176 CT-ABD & PELVIS W/O CONTRAST$ 502.33 02074177 74177 CT-ABD & PELVIS W/ CONTRAST$ 972.32 02074178 74178 CT-ABD & PELV W/O & W/ CONTRAS$ 1,284.69 02074181 74181 MRI-ABDOMEN W/O CONTRAST$ 1,329.70 02074182 74182 MRI-ABDOMEN W/ CONTRAST$ 901.66 02074183 74183 MRI-ABDOMEN W &WO CONTRAST$ 1,102.86 02074185 74185 MRA-ABDOMEN W & WO CONTRAST$ 1,807.18 02074190 74190 PERITONEOGRAM INJ AIR/CONTRST$ 132.04 02074220 74220 ESOPHAGUS BARIUM$ 179.64 02074221 74221 X-RAY EXAM ESOPHAGUS 2CONTRAST$ 200.90 02074230 74230 SWALLOW FUNCTION W/CINE/VIDEO$ 179.64 02074235 74235 REMOVE FB ESOPH W/BALN CATH$ 407.40 02074246 74246 UGI W/AIR CONTRST BA W/O KUB$ 142.02 02074248 74248 X-RAY EXAM SML INT FF-THRU STY$ 114.66

33 02074251 74251 SMALL BOWEL W/ MULTI IMAGES$ 278.90 02074261 74261 CT-COLONOGRAM DX W/O CONTRST$ 542.33 02074262 74262 CT-COLONOGRAPHY DX W&WO CNTR$ 613.23 02074263 74263 CT-COLONOGRAPHY SCREENING$ 98.48 02074283 74283 TX ENEMA CNTRT/AIR RXN INTUS$ 207.23 02074328 74328 ENDO CATH BILIARY DUCT SYSTEM$ 198.08 02074330 74330 ENDOCATH BILIARY/PANCREATIC$ 198.08 02074340 74340 INTRO G-I TUBE W/ FLUORO/IMGS$ 198.08 02074355 74355 PLACE ENTEROCLYSIS TUBE PERC$ 198.08 02074360 74360 INTRALUMINAL DILATION; STRICTU$ 264.10 02074363 74363 PTHD BILE DUCT STRICTURE$ 627.17 02074410 74410 UROGRAPHY INFUSION DRIP BOL$ 183.69 02074440 74440 VASOGRAPHY VESICULOGRAPHY EP$ 183.69 02074445 74445 CORPORA CAVERNOSOGRAPHY$ 84.00 02074485 74485 DILATE NEPHROSTMY URTRS/URTHR$ 146.64 02074775 74775 PERINEOGRAM SEX DETERM/ANOMAL$ 132.04 02075557 75557 MRI-CARDIAC MORPH FUNCTION W/$ 599.91 02075559 75559 MRI-CARDIAC MORPH FUNCTION W/$ 911.98 02075561 75561 MRI-CARDIAC MORPH FUNCTION CO$ 848.96 02075563 75563 MRI-CARDIAC MORPH FUNCTION CO$ 1,058.01 02075565 75565 MRI-CARDIAC VELOCITY FLOW MAP$ 132.04 02075571 75571 CT-HEART W/O DYE W/CA TEST$ 113.93 02075572 75572 CT-HEART W/ 3D IMAGE$ 332.66 02075573 75573 CT-HEART W/3D IMG CONGENITAL$ 469.01 02075574 75574 CT-ANGIO HEART/ W/3D IMAGE$ 825.31 02075635 75635 CT-ABDOMINAL ARTERIES ANGIO$ 805.32 02075705 75705 ANGIO-SPINAL SELECTIVE$ 356.92 02075746 75746 ANG-PULMO NONSELECTIVE CATH O$ 1,108.97 02075756 75756 ANGIO-INTERNAL MAMMARY$ 1,108.97 02075803 75803 LYMPHANGIOGRAPHY EXTRMTY BIL$ 132.04 02075809 75809 SHUNT EVALUATION$ 392.81 02075810 75810 SPLENOPORTOGRAPHY$ 132.04 02075840 75840 VENOGRAPHY ADRENAL UNIL SEL$ 293.28 02075842 75842 VENOGRAPHYADRENAL BIL SEL$ 330.26 02075860 75860 VENOGRAPHYVENOUS SINUS/JUGULR$ 1,108.97 02075870 75870 VENOGRAMSUPERIOR SAGITL SINUS$ 742.95 02075872 75872 VENOGRAPHY EPIDURAL$ 742.95 02075880 75880 VENOGRAPHY ORBITAL$ 198.08 02075885 75885 PERC TRANSHEP PORTOGRAM W/HDM$ 3,431.20 02075887 75887 PRQ TRANSHEP PORTOGRPHY WO HE$ 1,108.97 02075889 75889 HEPATIC VENOGRAMW/ HDM EVAL$ 3,431.20 02075891 75891 HEPATIC VENOGRAPHY W/O HEMODYN$ 3,431.20

34 02075893 75893 VENOUS SAMPLINGW/ORW/O ANGIO$ 3,431.20 02075894 75894 TRANSCATH EMBOLIZATION TX$ 132.04 02075898 75898 FOLLOW-UP ANGIOGRAPHY$ 1,108.97 02075901 75901 REMOVE OBSTRUCTION FROM CVD$ 219.98 02075902 75901 CV MECH REMOVAL OF PERICATH M$ 96.33 02075956 75956 ENDOVASC REPAIR DESC THOR AOR$ 1,309.28 02075957 75957 ENDO REP THOR AO NOT SCLV ORIG$ 1,131.04 02075958 75958 PLACE PROSTH PROX EXT THOR AO$ 751.80 02075959 75959 PLACE PROSTH DIST EXT THOR AO$ 652.64 02075970 75970 BIOPSY TRANSCATHETER$ 198.08 02076010 76010 NOSE TO RECTUM FB 1VW CHILD$ 48.06 02076086 77053 MAMMARY DUCTOGRAM SINGLE$ 332.61 02076088 77054 MAMMARY DUCTOGRAM MULTIPLE$ 460.91 02076095 19081 BX BREAST 1ST LESION STRTCTC$ 647.80 02076101 76101 COMPLX MOTION NOT UROGR UNIL$ 225.06 02076120 76120 CINERADIO/VIDEOGRAPHY$ 91.58 02076125 76125 CINERADIO/VIDEOGRAPHY ADD-ON$ 198.08 02076376 76376 3D RENDERING; INTERPRET/REPORT$ 107.86 02076380 76380 CT-LIMITED LOCALIZED FOLLOW-UP$ 198.08 02076390 76390 MR SPECTROSCOPY$ 1,588.60 02076400 77084 MRI-BONE MARROW BLOOD SUPPLY$ 1,575.92 02076510 76510 US-EYE B-SCAN/QUANTI A-SCAN$ 198.08 02076511 76511 US-OPTHALMIC DX QUANT A-SCAN$ 198.08 02076512 76512 US-OPTHALMIC DX B-SCAN$ 198.08 02076513 76513 US-EYE ANTERIOR DX B-SCAN$ 198.08 02076514 76514 US-EYE CORNEAL PACHYMETRY$ 198.08 02076516 76516 US-EYE BIOMETRY ECHO A-SCAN$ 198.08 02076519 76519 US-ECHO OPTHALMIC BIOMETRY$ 198.08 02076529 76529 US-OPTHALMIC FB LOCALIZATION$ 132.04 02076641 76641 US-BREAST UNIL COMPLETE$ 232.17 02076642 76642 TC US BREAST UNI LIMITED$ 192.06 02076705 76705 US-ABDOMEN LIMITED$ 190.53 02076775 76775 US-RETROPERITONEAL REAL TIME$ 180.72 02076776 76776 US KIDKEY TRANSPL W/DOPPLER$ 376.51 02076801 76801 US-OB <14 WKS SINGLE GESTATION$ 261.72 02076802 76802 OB US < 14 WEEKS ADDL FETUS$ 99.04 02076811 76811 US-OB REAL TIME TO INCL DET FE$ 254.11 02076812 76812 US-OB REAL TIMEINCL DET FETAL$ 99.04 02076813 76813 US-OB REAL TIME1ST TRIM FETAL$ 180.72 02076814 76814 OB US FIRST NUCHAL MEAS ADD-ON$ 108.55 02076815 76815 US-GESTATIONAL LIMITED$ 180.72 02076816 76816 OB US-FOLLOW-UP PER FETUS$ 122.86

35 02076817 76817 US-PREGNANT UTERUS TRANSVAG$ 180.72 02076819 76819 US-FETAL BIOPHYSICAL W/O NST$ 180.72 02076820 76820 UMBILICAL ART ECHO FETAL$ 122.86 02076821 76821 MIDDLE CEREBRAL ART ECHO FETAL$ 99.04 02076826 76826 US-FETAL CV REAL TIME W/2D$ 566.52 02076828 76828 US-DOPPLER ECHO FETAL PW/CW$ 122.86 02076831 76831 US-SONOHYSTEROGRAPHY SALINE I$ 254.11 02076857 76857 US-PELVIC(NON-OB) LIMIT/FF-UP$ 137.56 02076881 76881 US-EXTREMITY NON-VASC COMP$ 264.54 02076882 76882 US-EXTREMITY NON-VASC LMTD$ 122.86 02076885 76885 US-INFANT HIPS RT IMG DYNAMC$ 177.54 02076886 76886 US-INFANT HIPS REAL TIME IMAG$ 133.31 02076932 76932 US-GUIDEENDOMYOCARDIAL BIOPSY$ 132.04 02076936 76936 ECHO GUIDE FOR ARTERY REPAIR$ 391.65 02076937 76937 ULTRA-GUIDE VASCULAR ACCESS$ 60.15 02076940 76940 US-GUIDE TISSUE ABLATION$ 132.04 02076941 76941 US-GUIDE INTRAUT FETL TXFUSION$ 132.04 02076945 76945 US-GUIDE CHORIONIC VILLUS SAMP$ 132.04 02076946 76946 US-GUIDANCE AMNIOCENTESIS$ 132.04 02076965 76965 US-GUIDE INTERSTTL RADIOELEMNT$ 132.04 02076975 76975 GASTROINTESTINAL ENDOSCOPIC US$ 317.00 02076977 76977 US-BONE DENSITY PERIPHERAL$ 132.04 02077001 77001 FLUOROGUIDE FOR VEIN VEIN$ 676.21 02077002 77002 FLUOROGUIDE NEEDLE PLACEMENT$ 676.21 02077003 77003 FLUOROGUIDE FOR SPINE INJECT$ 132.04 02077011 77011 CT-GUIDE STEREOTATIC LOCALIZ'N$ 1,070.75 02077014 77014 CT-GUIDE PLCMNT RAD TX FIELDS$ 251.46 02077021 77021 MRI-GUIDANCE NEEDLE PLACEMENT$ 604.14 02077063 77063 SCREEN DIGITAL BREAST TOMO BIL$ 71.00 02077065 77065 DX MAMMO INCL CAD UNIL$ 88.73 02077066 77066 DX MAMMO INCL CAD BIL$ 132.49 02077067 77067 SCREEN MAMMO BIL INCL CAD$ 103.32 02077074 77074 BONE SURVEY LIMITED$ 184.33 02077080 77080 DEXA BONE DENSITY 1/> AXIAL$ 494.21 02077280 77280 TX RADIO SIMULATION SIMPLE$ 256.94 02077285 77285 TX RAD SIMULATION INTERMED$ 456.89 02077290 77290 TX RAD SIMULATION COMPLEX$ 729.73 02077295 77295 THERA SIMULATION-AIDED FIELD S$ 992.57 02077300 77300 RADIATION DOSIMETRY CALCULATIO$ 132.04 02077301 77301 RADIOTHERAPY PLAN INTENSITY M$ 3,126.73 02077321 77321 TELETHERAPY PORT PLAN SPECIAL$ 285.06 02077331 77331 DOSIMETRY SPECIAL SPECIFY$ 132.04

36 02077332 77332 DEVICES TREATMENT DESIGN AND$ 132.04 02077333 77333 TREATMENT DEVICES INTERMED$ 132.04 02077334 77334 TREATMENT DEVICES COMPLEX$ 204.02 02077470 77470 RO-SPECIAL TREATMENT PROCEDURE$ 407.38 02077600 77600 HYPERTHRMIA EXT SUPERF +<4CM$ 535.06 02077605 77605 HYPERTHERMIA EXTL DEEP 4+ CM$ 1,128.91 02077610 77610 HYPERTHERMIA INTERST 5/< APPL$ 942.87 02077615 77615 RO-HYPERTHERMIA VIA INTERSTIT$ 1,370.67 02077620 77620 HYPERTHERMIA INTRACAV PROBE$ 596.86 02077750 77750 INFUSE RADIOACTIVE MATERIALS$ 166.15 02077761 77761 INTRACAV RAD SOURCE SIMPLE$ 323.56 02077762 77762 INTRACAVTRY RAD APPLY INTERM$ 323.56 02077763 77763 INTRACVTRY RS APPL COMPLEX$ 601.11 02077778 77778 APPLY INTERTIT RADIAT COMPX$ 956.35 02077789 77789 RO-SURFACE APPLICATION OF RADI$ 99.31 02077790 77790 SUPERVISE HAND/LOAD RADIATION$ 132.04 02078012 78012 NM-THYROID UPTKE SL/MUL QUANT$ 224.82 02078013 78013 NM-THYROID IMAGE INC VASC FLOW$ 583.37 02078014 78014 NM-THYROID IMG W/V-FLOW QUANT$ 697.80 02078015 78015 NM-METS THYROID LIMITED$ 354.82 02078016 78016 NM-THYROID CA METS ADD IMG$ 551.63 02078018 78018 NM-THYROID CA METS WHOLE BODY$ 1,664.42 02078020 78020 NM-THYROID CA METS UPTAKE$ 142.22 02078070 78070 NM-PARATHYROID IMAGING$ 965.35 02078071 78071 NM-PARATHYROID IMG W/ SPECT$ 1,093.30 02078072 78072 NM-PARATHYROID IMG W/SPECT&CT$ 2,383.16 02078075 78075 NM-ADRENAL CORTEX/MEDULLA$ 551.63 02078102 78102 NM-BONE MARROW LIMITED$ 247.71 02078103 78103 NM-BONE MARROW MULTI AREAS$ 965.35 02078110 78110 NM-PLASMA VOL SINGLE SAMPLE$ 275.81 02078120 78120 NM-RBC VOLUME SINGLE SAMPLE$ 275.81 02078121 78121 NM-RBC VOLUME MULTI SAMPLE$ 275.81 02078122 78122 NM-WHOLE BLOOD VOLUME$ 367.76 02078140 78140 NM-RED CELL SEQUESTRATION$ 413.72 02078185 78185 NM-SPLEEN IMAGING ONLY$ 275.81 02078191 78191 NM-PLATELET SURVIVAL STUDY$ 551.63 02078195 78195 NM-LYMPHATICS/LYMPH NODE$ 413.72 02078201 78201 NM-LIVER IMAGING STATIC$ 258.34 02078202 78202 NM-LIVER IMAGING V-FLOW$ 434.77 02078215 78215 NM-LIVER/SPLEEN IMG STATIC$ 396.57 02078216 78216 NM-LIVER/SPLEEN IMGW/VAS FLOW$ 641.47 02078227 78227 HEPATOBILIARY IMAGING W/DRUG$ 1,051.12

37 02078230 78230 NM-SALIVARY GLAND IMAGING$ 275.81 02078231 78231 NM-SALIVARY GLAND SERIAL IMG$ 275.81 02078232 78232 NM-SALIVARY GLAND FUNCTION$ 298.81 02078258 78258 NM-ESOPHAGEAL MOTILITY$ 279.94 02078261 78261 NM-GASTRIC MUCOSA IMAGING$ 417.42 02078262 78262 NM-GASTRO-ESOPHAGEAL REFLUX$ 342.85 02078264 78264 NM-GASTRIC EMPTYING IMG STUDY$ 371.79 02078267 78267 NM-UREA BREATH TEST ISOTOPIC$ 228.71 02078268 78268 NM-UREA BREATH TEST ISO ANAL$ 228.71 02078278 78278 NM-ACUTE GI BLEED STUDY$ 641.47 02078290 78290 NM-INTESTINE MECKELS$ 275.81 02078291 78291 NM-PERITO-VENOUS SHUNT PATENCY$ 333.87 02078300 78300 NM-BONE SCAN LIMITED$ 570.22 02078305 78305 NM-BONE/JNT IMG MULTIPLE$ 955.06 02078306 78306 NM-WHOLE BODY BONE SCAN$ 495.45 02078315 78315 NM-BONE/JNT IMG 3 PHASE STY$ 665.11 02078351 78351 NM-BONE MINERAL 2 PHTN 1/>$ 228.71 02078428 78428 NM-CARDIAC SHUNT DETECTION$ 518.83 02078445 78445 NM-VASCULAR FLOW STUDY$ 378.39 02078451 78451 NM-MYOCARD PERF SPECT SINGLE$ 829.61 02078452 78452 NM-MYOCARD PERF SPECT MULTIPLE$ 829.61 02078453 78453 NM-MYOCARD PERF PLANAR SINGLE$ 829.61 02078454 78454 NM-MYOCARD PERF PLANAR MULTI$ 829.61 02078456 78456 NM-ACUTE VENOUS THROMBOSIS$ 673.42 02078457 78457 NM-VENOGRAM UNILATERAL$ 378.39 02078458 78458 NM-VENOGRAM BILATERAL$ 378.39 02078466 78466 NM-MYOCARD IMAG INFARCT QL/QN$ 327.30 02078468 78468 NM-MYOCARD IMAG INFARCT EJECT$ 327.30 02078469 78469 NM-MYOCARDIAL PLAN SPECT$ 495.45 02078472 78472 NM-CARDIAC BLD POOL GATED SI$ 417.40 02078473 78473 NM-CARDIAC BLD POOL 1ST MULT$ 495.45 02078481 78481 NM-CARDIAC BLD POOL 1ST SING$ 495.45 02078483 78483 NM-CARD BLOOD POOL/FL$ 356.37 02078494 78494 NM-CARDIAC BLOOD POOL GATED E$ 327.30 02078496 78496 NM-CARDIAC BLOOD POOL GATED E$ 142.22 02078580 78580 NM-PULM PERFUSION IMAGING$ 784.02 02078582 78582 PULMONARY VENT&PERF IMAGING$ 777.92 02078600 78600 NM-BRAIN IMG STATIC <4 VWS$ 712.75 02078601 78601 NM-BRAIN IMG <4VS W/VAS FLOW$ 1,073.17 02078605 78605 NM-BRAIN IMG MIN 4 STATIC VS$ 1,135.11 02078606 78606 NM-BRAIN IMG COMP W/ V-FLOW$ 1,135.11 02078610 78610 NM-BRAIN IMAGING VASCULAR$ 582.91

38 02078635 78635 NM-CSF FLOW IMG VENTRICLGRPHY$ 438.44 02078645 78645 NM-CEREBRAL FLUID FLOW SHUNT$ 438.44 02078650 78650 DETECTION AND LOCALIZATION CS$ 619.35 02078660 78660 RADIOPHARMACEUTICAL DACRYOSYST$ 232.69 02078700 78700 NM-KIDNEY IMAGING MORPHOLOGY$ 429.63 02078701 78701 NM-KIDNEY SCAN W/ VAS FLOW$ 731.71 02078707 78707 NM-KIDNEY IMG VF/FUNC SINGLE$ 737.23 02078708 78708 NM-KIDNEY IMGW/VF/FUNC SING$ 1,236.98 02078709 78709 NM-KIDNEY IMAG VASC FLOW/FUNC$ 507.52 02078725 78725 NM-KIDNEY FUNCTION NON-IMG RI$ 737.23 02078730 78730 NM-URINARY BLADDER RETENTION$ 350.82 02078740 78740 NM-URETERAL REFLUX STUDY$ 717.72 02078761 78761 NM-TESTICULAR W/ BLD FLOW$ 396.57 02078800 78800 NM-TUMOR LOCALIZATION LIMITED$ 567.57 02078801 78801 NM-TUMOR LOCALIZ'N MULTIPLE$ 1,576.75 02078802 78802 NM-RADPHARM LOCAL OF TUMOR$ 741.80 02078803 78803 NM-TUMOR LOCALIZ SPECT (3d)$ 1,029.55 02078804 78804 NM-TUMOR IMG WHOL BODY 2+ DAY$ 1,424.63 02078830 78830 NM-RADPH LOCLZJ SPECT W/CT 1$ 1,402.59 02078831 78831 RADPH LOCLZJ SPECT 2 AREA$ 1,442.07 02078832 78832 NM-RADPH LOCLZJ SPECT W/CT 2$ 1,897.40 02079005 79005 NM-RADPHARM THERAPY ORAL$ 399.48 02079101 79101 NM-RADPHARM THERAPY IV$ 399.48 02079200 79200 NM-RADIOPH RXINTRCAVITY ADMIN$ 665.78 02079300 79300 NM-RADPHARM TX INTERS COLLOID$ 399.48 02079403 79403 NM-RADIOPHARM MONOCLONAL AB TX$ 665.78 02079440 79440 NM-RADPHARM TX INTRA-ARTICLAR$ 665.78 02079445 79445 NM-RADIOPHARM TX INTRA-ART$ 399.48 02090780 A4641 NM-ISOT PULMO PERF$ 356.37 02093925 93925 US-DUPLEX LE ART COMP BIL$ 377.98 02093926 93926 US-DUPLEX LE ARTERIES UNIL$ 188.98 02093930 93930 US-DUPLEX UE ARTERIES BIL$ 377.98 02093931 93931 US-DUPLEX UE ARTERIES UNIL$ 188.98 02093975 93975 US DUPLX SCAN ART IN VEN OUT$ 489.03 02093976 93976 US DUPLX SCAN ART IN VEN OUT$ 269.05 02093980 93980 US DUPLX SCAN ART IN VEN OUT$ 206.03 02093990 93990 US DUPLX SCAN HEMO ACC (ART I$ 302.37 02095002 A9500 NM-TC CARDIOLITE$ 695.54 02095004 A9505 NM-RADIOPHARM THALLIUM$ 544.94 02095006 A4641 NM-RADIOPHARM SPECIAL$ 689.65 02096014 70336 MRI-TEMPOROMANDIBULAR JOINT$ 790.08 02096019 76810 US-OB >= 14 WKS ADDL FETUS$ 275.43

39 02096020 93970 US-DUPLEX EXTREMITY COMP BIL$ 377.98 02096030 93971 US-DUPLEX EXTREMITY UNIL$ 275.43 02096040 A9556 NM-GALLIUM RADIOPHARMACEUTIC$ 175.33 02096374 96374 THER/PROPH/DIAG INJ IV PUSH$ 398.54 02097001 76377 CT-3-D RECONSTRUCTION$ 678.70 02098001 77078 CT-BONE DENSITY STY AXIAL$ 256.21 02100001 A4649 GRID CT BIOPSY$ 48.43 02100002 A4649 CATHETER CXI-2.6-18-90 G50002$ 910.43 02100003 A4649 CATHETER CXI-2.6-18-150 G50003$ 910.43 02100007 A4649 SNARE AMPLATZ GN 4F 5MM 102CM$ 730.96 02100008 A4649 SNARE AMPLATZ GN 4F 10MM 102CM$ 905.56 02100009 A4649 SNARE AMPLATZ GN 6F 20MM 102CM$ 905.56 02100010 A4649 SNARE AMPLATZ GN 6F 25MM 102CM$ 730.96 02100013 A4649 SNARE AMPLATZ GN 6F 30MM 102CM$ 713.49 02100014 A4649 TUBE FEEDING MIC*G 14FR$ 295.19 02100015 A4649 ARGON CLEANER 15MM 65CM 7FR$ 1,945.27 02100016 A4649 TUBE FEEDING MIC*G 16FR$ 295.19 02100018 A4649 TUBE FEEDING MIC*G 18FR$ 295.19 02100020 A4649 TUBE FEEDING MIC*G 20FR$ 295.19 02100021 A4649 SNARE AMPL GN 2.3-3F 2MM 150CM$ 941.44 02100022 A4649 SNARE AMPL 2.3-3F 4MM 150CM$ 941.44 02100023 A4649 SNARE AMPL GN 2.3-3F 7MM 150CM$ 941.44 02100026 A4649 KIT BONE BX W/DRILL 11GX10CM$ 817.51 02100027 A4649 KIT BONE BX W/DRILL 11GX15CM$ 817.51 02100029 C1894 INTRODUCER SHEATH PA 30CM 8FR$ 456.71 02100037 A4649 WIRE BREAST DUALOK 20GX3.7GM$ 318.38 02100057 A4649 WIRE BREAST DUALOK 20GX5.7CM$ 318.38 02100077 A4649 WIRE BREAST DUALOK 20GX7.7CM$ 318.38 02100107 A4649 WIRE BREAST DUALOK 20GX10.7CM$ 318.38 02100121 A4649 DILATOR .038 16FR 20CM$ 50.64 02100122 A4649 STOPCOCK LARGE-BORE 1-WAY$ 39.11 02100123 C1769 GUIDEWIRE ROSEN .035INX80CM$ 74.83 02100124 A4649 BALLOON PTA 4MMX4CMX80CM$ 1,086.15 02100125 A4649 NEEDLE SINGLE WALL 18GA 9CM$ 27.84 02100126 A4649 CATHETER PIGTAIL 5FR 90CM$ 114.53 02100127 C1769 WIRE CURVED .018 145CM$ 77.74 02100128 C1769 GUIDE WIRE RUH HPWA-18-320$ 408.72 02100129 C1769 WIRE STRAIGHT .018 145CM$ 77.74 02100130 C1769 WIRE EX STRAIGHT .035 260CM$ 77.74 02100131 C1769 WIRE J GUIDEWIRE NEWTON .035$ 77.74 02100132 A4649 NEEDLE BX CHIBA 20GA 15CM$ 74.94 02100133 A4649 BALLOON OCCLCN 8.5MM 5.3-35-80$ 638.33

40 02100134 A4649 CATHETER BERENSTEIN 5FR 65CM$ 114.53 02100135 A4649 SHEATH 6FR 60CM$ 532.98 02100136 A4649 DILATOR .038 6FR 20CM$ 45.70 02100137 A4649 DILATOR .038 7FR 20CM$ 45.70 02100138 A4649 DILATOR .038 5FR 20CM$ 45.70 02100139 A4649 DILATOR .038 9FR 20CM$ 45.70 02100140 A4649 DILATOR .038 10FR 20CM$ 45.70 02100141 A4649 DILATOR .038 11FR 20CM$ 45.70 02100142 A4649 DILATOR .038 12FR 20CM$ 45.70 02100143 A4649 DILATOR .038 14FR 20CM$ 45.70 02100144 C1769 WIRE GUIDE SHORTY .018 180CM$ 578.41 02100145 A4649 COIL TORNADO 0.35 8MMX5MM$ 816.97 02100146 A4649 CATHETER OMNI SOS 5FR 80CM$ 114.53 02100147 A4649 SHEATH FLEXOR 5FR 45CM$ 478.56 02100148 A4649 CATHETER OMNI FLUSH 5FR 90CM$ 114.53 02100149 A4649 CATHETER SIM 4FR 100CM$ 114.53 02100150 A4649 DILATOR .038 18FR 20CM$ 50.64 02100151 A4649 BRUSH CYTLGY 3MM BCB-5-120-3-S$ 122.20 02100152 A4649 CATHETER VAN ANDEL 5FR$ 452.87 02100153 A4649 URETERAL CONECTR O-RING 7-10FR$ 33.94 02100154 A4649 URETERAL CONECTR O-RING 3-7FR$ 54.67 02100155 A4649 DILATOR .038 20FR 20CM$ 50.64 02100156 A4649 CATHETER VC SPECT 5-LUMEN 15CM$ 771.04 02100157 A4649 CATHETER BLRY FLEX 6.3FR 25CM$ 676.83 02100158 A4649 SHEATH PEELAWAY 9FR 15CM$ 372.59 02100159 A4649 SHEATH PEELAWAY 10FR 15.5CM$ 372.59 02100160 A4649 COIL CUSTOM .035 5CMX6MM$ 680.77 02100161 A4649 CATHETER OMNI FLUSH 5FR 65CM$ 114.53 02100162 A4649 BALLOON 5MMMX4CMX80CM$ 901.23 02100163 A4649 BALLOON 6MMX4CMX80CM$ 901.23 02100164 C1769 G12268 GW COONS .035X80CM$ 77.74 02100165 A4649 CATHETER DAV CXI 4FR 135CM$ 955.95 02100166 A4649 CATHETER DAV CXI 4FR 90CM$ 955.95 02100167 A4649 SET INTRO NON-VASCLR 21GA 15CM$ 836.42 02100168 A4649 COIL NESTER .035 14CMX6MM$ 807.65 02100169 A4649 COIL NESTER .035 14CMX8MM$ 807.65 02100170 A4649 COIL NESTER 0.15 14CMX6MM$ 807.65 02100171 A4649 COIL NESTER .035 14CMX10MM$ 807.65 02100172 A4649 COIL NESTER EMBOL 3CMX2MM$ 717.82 02100173 C1894 SHEATH 6FR 5.5CM$ 293.96 02100174 A4649 SHEATH ANSEL 2 6FR 45CM$ 489.10 02100175 A4649 SHEATH FLEXOR 6FR 45CM G22984$ 489.10

41 02100176 A4649 SHEATH PEELAWAY 16FR 15.5CM$ 362.29 02100177 A4649 SHEATH ANSEL 1 6FR 45CM$ 489.10 02100178 A4649 SHEATH FLEXOR 6FR 90CM$ 853.25 02100179 C1894 SHEATH PEELAWAY 10FR 30CM$ 407.17 02100180 A4649 INFLATION DEVICE CID-20-30 NG$ 289.00 02100181 A4649 KIT NEEDLE HASKEL$ 1,184.87 02100182 A4649 CATHETER OMNI SIZING 5FR 100CM$ 761.46 02100183 A4649 SET VENA CAVA FILTER RETRIEVAL$ 1,086.15 02100184 C1769 GUIDEWIRE AMPLATZ XSTIFF 260CM$ 77.74 02100185 C1769 GUIDEWIRE AMPLATZ XSTIFF 180CM$ 77.74 02100186 A4649 KIT HASTEL TRANSJUG ACCESS$ 1,612.63 02100187 A4649 STENT 12MMX80MMX80CM$ 1,980.01 02100188 A4649 CATHETER BILIARY AMPLATZ 10FR$ 555.05 02100189 A4649 STENT 12MMX60MMX80CM$ 1,980.01 02100190 A4649 STENT 14MMX60MMX80CM$ 1,980.01 02100191 A4649 STENT 14MMX80MMX80CM$ 1,980.01 02100192 A4649 COIL EMBOLIZATION .035 4CMX4MM$ 680.77 02100193 A4649 CATHETER SIM 1 4FR 100CM$ 114.53 02100194 A4649 CATHETER VERTEBRAL 4FR 100CM$ 114.53 02100195 A4649 STENT 6MMX60MMX80CM$ 1,964.58 02100196 A4649 STENT 6MMX80MMX80CM$ 1,964.58 02100197 A4649 STENT 8MMX60MMX80CM$ 1,964.58 02100198 A4649 STENT 8MMX80MMX80CM$ 1,964.58 02100199 A4649 COIL EMBOLIZATION 6MMX7CM$ 1,609.66 02100200 A4649 COIL EMBOLIZATION 10MMX14CM$ 1,679.78 02100201 A4649 FORCEPS GRASPING 5FR 60CMX20MM$ 945.06 02100202 A4649 COIL EMBOLZATION 0.35 5CMX8MM$ 680.77 02100203 A4649 BALLOON DILATION CATH 3MMX2CM$ 1,086.15 02100205 A4649 STENT 7FR 10MMX60MMX75CM$ 1,964.58 02100206 A4649 KIT MICROPUNCTURE NEEDLE 5FR$ 220.01 02100207 A4649 BALLOON 14MMX4XCMX80CM$ 862.69 02100208 A4649 SET GASTRO TUBE SML 14FR$ 919.71 02100209 A4649 SET GASTRO TUBE SML 18FR$ 919.71 02100210 A4649 COIL HILAL STR .018 0.5CM$ 374.16 02100211 A4649 NEEDLE SINGLE WALL 18GA$ 29.32 02100212 A4649 FORCEPS PULMONARY BX RDIAL JAW$ 247.02 02100213 A4649 NEEDLE SINGLE WALL 19GA$ 29.89 02100214 C1769 WIRE LUNDRQIST .035 145CMX15CM$ 373.73 02100215 A4649 ADAPTOR LUER LOCK PFLLC-MLL-RA$ 45.70 02100216 A4649 NEEDLE ECHO TIP 18GA 15CM$ 292.15 02100217 A4649 CATHETER CORRA 1 4FR 65CM$ 114.53 02100218 A4649 CATHETER BAL PTA 8MMX4CMX135CM$ 901.23

42 02100219 A4649 CATHETER BAL PTA 8MMX4CMX80CM$ 901.23 02100220 A4649 BALLOON 9MMX4CMX80CM$ 901.23 02100221 A4649 CATHETER FEEDING TUBE MILLER$ 337.18 02100222 A4649 KIT GASTROPEXY$ 954.06 02100223 A4649 TUBE GASTRO FEED BALLOON 16FR$ 826.08 02100224 A4649 CATHETER OMNI SOS 4FR 80CM$ 114.53 02100225 A4649 ADAPTOR TOUCHY-BORST PTBYC-RA$ 98.72 02100226 A4649 CATHETER INFSION 5FR 130CMX7CM$ 826.08 02100227 A4649 SHEATH INTRODUCER 18FR$ 372.59 02100228 A4649 SHEATH PEELAWAY 20FR 13CM$ 326.40 02100229 A4649 SHEATH PEELAWAY 14FR 15.5CM$ 362.29 02100230 A4649 STOPCOCK LOW-PRESSURE 1-WAY$ 38.13 02100231 A4649 STOPCOCK HIGH-PRESSURE 1-WAY$ 38.13 02100232 A4649 KIT ROSCH (TJ LIVER) ACCESS$ 1,331.67 02100233 A4649 COIL NESTER EMBOL 14CMX4MM$ 783.12 02100234 A4649 CATHETER N-U STENT 8.5FR 10CM$ 931.41 02100235 A4649 MICROCOIL HIAL .018IN 2CM 2M$ 319.46 02100236 A4649 BASKET 6-WIRE STONE REMOVAL$ 641.42 02100237 A4649 CATHETER GASTROJNSTMY SHETTY$ 617.54 02100238 C1894 SHEATH 11FR 13CM$ 461.34 02100239 C1894 SHEATH 9FR 30CM$ 311.50 02100240 C1894 SHEATH 9FR 30CM$ 343.43 02100241 A4649 CATHETER CV TRIPLE-LUMEN 15CM$ 641.42 02100242 A4649 CATHETER CV TRIPLE-LUMEN 20CM$ 635.74 02100243 C1894 SHEATH 6FR 13CM$ 247.34 02100244 C1894 SHEATH 8FR 30CM$ 343.43 02100245 A4649 SET LIVER BIOPSY ACCESS$ 1,402.91 02100246 A4649 SHEATH PEELAWAY 9FR 30CM$ 540.32 02100247 A4649 SHEATH PEELAWAY 11FR 30CM$ 540.32 02100248 A4649 SHEATH PEELAWAY 12FR 30CM$ 407.17 02100249 A4649 SHEATH PEELAWAY 13FR 30CM$ 440.28 02100250 A4649 SHEATH PEELAWAY 14FR 30CM$ 407.17 02100251 A4649 SHEATH PEELAWAY 16FR 30CM$ 407.17 02100252 A4649 CATHETER SIMMONS 2 5FR 100CM$ 114.53 02100253 A4649 SHEATH 5FR 13CM$ 269.58 02100254 A4649 CATHETER SIMMONS 1 5FR 100CM$ 114.53 02100255 A4649 CATHETER HEADHNTER 1 5FR 100CM$ 114.53 02100256 A4649 SHEATH 6FR 30CM$ 343.43 02100257 A4649 INTRODUCER 10FR 30CM$ 343.53 02100258 A4649 NEEDLE PERCUTANEOUS 21GA 15CM$ 29.89 02100259 A4649 SHEATH 8FR 11CM$ 269.50 02100260 C1769 WIRE NITINOL .018 125CM$ 303.09

43 02100261 A4649 SET BIOPSY Q-C 20GA 20CMX20MM$ 410.05 02100262 A4649 SET BIOPSY Q-C 18GA 20CMX20MM$ 410.05 02100263 A4649 DILATOR .038 8FR 20CM$ 45.70 02100264 A4649 SHEATH RCFW 12FR 30CM$ 677.33 02100265 A4649 SHEATH 7FR 11CM$ 293.96 02100266 A4649 CATHETER MIKAELSON 5FR$ 114.53 02100267 A4649 CATHETER STRGHT FLUSH 5FR 90CM$ 114.53 02100268 A4649 CATHETER KUMPE TORCON 5FR 65CM$ 114.53 02100269 A4649 CATHETER BLRY 8.5FR .038INX40C$ 676.83 02100270 A4649 CATHETER BLIARY FLEX 12FR 25CM$ 676.83 02100271 A4649 CATHETER MULTIDRN 8.5FR 25CM$ 604.95 02100272 A4649 CATHETER MULTIDRN 10.2FR 254CM$ 675.17 02100273 A4649 CATHETER MULTIDRN 12FR 25CM$ 612.40 02100274 A4649 CATHETER KUMPE TORCON 5FR 40CM$ 114.53 02100275 A4649 EMBOLIZATION PVA-200$ 839.03 02100276 A4649 EMBOLIZATION PVA-300$ 839.03 02100277 A4649 CATHETER NEPHROSTOMY 10FR 25CM$ 706.98 02100278 A4649 STENT URETERAL AMPZ 835FR 22CM$ 834.95 02100279 A4649 STENT URETERAL 8.5FR 24CM$ 834.95 02100281 C1769 WIRE NITINOL .018 80CM$ 625.45 02100282 A4649 SET PNEUMOTHORAZ INTRO-TIP$ 846.74 02100283 A4649 CATHETER DRAIN MLTP 8.5FR 45CM$ 666.96 02100284 A4649 SHEATH 7FR 45CM$ 434.50 02100285 A4649 CATHETER GASTRO WILLS-OGLESBY$ 818.86 02100287 C1769 WIRE AMPLATZ .035 180CMX8CM$ 160.05 02100288 A4649 SHEATH PEELAWAY 5FR$ 423.90 02100289 C1894 SHEATH 5FR 30CM$ 343.43 02100291 C1894 SHEATH 7FR 35CM$ 554.89 02100293 A4649 EMBOLIZATION PVA-700$ 839.03 02100294 A4649 SET VAS VITAL-PORT IP-S6013$ 1,329.65 02100295 A4649 STENT URETERAL 8FR 22CM$ 976.59 02100296 A4649 STENT URETERAL 8FR 24CM$ 976.59 02100297 A4649 STENT URETERAL 8FR 26CM$ 976.59 02100298 A4649 NEEDLE BIOPSY CHIBA 21GA 15CM$ 74.94 02100299 A4649 CATHETER BLRY 10FR .038INX40CM$ 676.83 02100300 C1894 SHEATH 7FR 55CM$ 434.50 02100301 A4649 CATHETER COBRA 2 5FR 65CM$ 114.53 02100302 A4649 STENT 8MMX40CMX80CM$ 1,964.58 02100304 A4649 NEEDLE CENTESIS YUEH 15CM$ 125.16 02100305 A4649 COIL EMBOL MREYE 35IN 2CM 3M$ 245.73 02100306 A4649 COIL EMBOL MREYE 35IN 3CM 4M$ 245.73 02100307 A4649 COIL EMBOL MREYE 38IN 5CM 10$ 245.73

44 02100308 A4649 COIL EMBOL MREYE 38IN 5CM 12$ 245.73 02100309 A4649 STENT VASCULAR 9MM DIA 30MM L$ 4,423.28 02100310 A4649 STENT VASCULAR 10MM DIA 30MM$ 4,423.28 02100311 A4649 STENT VASCULAR 10MM DIA 40MM$ 4,423.28 02100312 A4649 BALLOON PTA5-35-80-7-4.0$ 901.23 02100313 C1894 SHEATH 4FR 13CM$ 159.99 02100314 A4649 COIL NESTER EMBOL 7CMX2MM$ 717.82 02100316 A4649 DILATOR .035 4FR 20CM$ 70.40 02100317 A4649 CATHETER GASTROJEJUNOSTMY PEDS$ 841.64 02100318 A4649 IVC FILTER UNI-CELECT-PT$ 2,442.33 02100319 A4649 STENT 7FR 10MMX10MMX75MM$ 1,964.58 02100320 C1769 WIRE GUIDWR BENTSON .035 150CM$ 77.74 02100337 A4649 KIT PLEURX DRAINAGE VACUUM$ 290.15 02100338 A4649 LINE PLEURX LOCKABLE DRAINAGE$ 152.82 02100387 A4649 WALLSTENT ENDO 14MMX60MM 75CM$ 2,767.51 02100388 A4649 WALLSTENT ENDO 16MMX60MM 75CM$ 2,767.51 02100400 A4649 PACK CATHETER/ANGIO II$ 411.59 02100401 A4649 PACK BASIC/ANGIO$ 201.40 02100406 A4649 AZUR COIL PUSH .035 4MMX6CM$ 905.09 02100410 C1726 CATH BLN PTA ATL 14MMX6CMX80CM$ 797.94 02100411 C1726 CATH BALN PTA ATL 16MMX6CMX80M$ 1,561.23 02100412 C1726 CATH BLN PTA ATL 12MMX6CMX80CM$ 1,561.23 02100429 A4649 CATHETER TEMPO AQUA 135* 100CM$ 471.94 02100435 A4649 CATH DAWSON MUELLER 12FR 25CM$ 655.94 02100502 C1769 GLIDEWIRE 5FRX65CM COBRA CG502$ 432.87 02100507 C1769 GLIDEWIRE 5FRX65CM ANGTP CG507$ 432.87 02100508 A4649 CATHETER 5FRX100CM CG508$ 432.87 02100511 A4649 CATHETER SIM2 5FRX100CM CG511$ 432.87 02100565 A4300 CATH 1-LUMEN RAD PICC 3FR 70CM$ 686.91 02100566 A4300 CATH 1-LUMEN RADPICC 4FR 135CM$ 686.91 02100567 A4300 CATH 1-LUMEN RADPICC 4FR 70CM$ 705.94 02100569 C1725 CATH BALN MSTNG 6F .035 8X80MM$ 1,315.21 02100570 C1725 CATH BALN MTNG 6F .035 10X80MM$ 1,315.21 02100580 A4649 DIAMOND SOLID 1.50MMX145CM$ 4,404.25 02100600 A4649 SET BAG DRAIN 600ML$ 179.60 02100601 A4649 INTRODUCER CHK-FL RCFW-6.0-35$ 213.59 02100602 A4649 SET INTRODUCER W-GDE 4FR 13CM$ 118.78 02100605 A4649 TRAY BONE MARROW BX 11GA 4"$ 670.60 02100610 A4550 TRAY BONE MARROW BX 11GA 6"$ 638.68 02100615 A4649 NEEDLE BONE ASP 15GA 68MM$ 469.86 02100617 A4649 AZUR COIL DETACH .035 6MMX17CM$ 2,300.03 02100620 A4649 NEEDLE BONE ASP 15GA 90MM$ 469.86

45 02100637 A4649 STEN CVD BALN 6MMX37MM 80CM$ 4,426.19 02100691 C1769 GW BNTSON CEREBRAL .35D 145$ 63.89 02100700 A4649 BAL PTA METCR .035 8X40MMX65CM$ 721.82 02100702 A4649 BAL PTA METR .035 10X40MMX65CM$ 721.82 02100703 A4649 BAL PTA METR .035 12X40MMX65CM$ 721.82 02100704 A4649 BAL PTA METCR .035 6X80MMX90CM$ 721.82 02100705 A4649 BAL PTA METCR .035 8X80MMX90CM$ 721.82 02100706 A4649 PTA OPTA 6F 0.35 7MMX60MMX80MM$ 764.75 02100707 A4649 BAL PTA METR .035 4X60MMX135CM$ 721.82 02100708 A4649 BAL PTA METR .035 5X60MMX135CM$ 721.82 02100709 A4649 BAL PTA METR .035 6X60MMX135CM$ 721.82 02100711 A4649 AZUR HEL DETACH .018" 3MMX5CM$ 1,558.87 02100712 A4649 AZUR HEL DETACH .018" 5MMX10CM$ 1,555.72 02100713 A4649 AZUR HEL DETACH .035" 8MMX12CM$ 2,300.03 02100717 A4649 AZUR HEL DETACH .035 10MMX19CM$ 2,300.03 02100718 A4649 HYDRO MICROSP 78+/-30UM ORANGE$ 1,000.76 02100719 A4649 HYDRO MICROSP 200+/-75UM YELLW$ 1,000.76 02100720 A4649 HYDRO MICROSP 400+/-75UM BLUE$ 1,000.76 02100721 A4649 HYDRO MICROSP 600+/-75UM RED$ 1,000.76 02100722 A4649 HYDRO MICROSP 800+/-75UM GREEN$ 1,000.76 02100723 A4649 AZUR HEL PUSH .035" 5MMX10CM$ 969.51 02100724 A4649 AZUR HEL PUSH .018" 2MMX2CM$ 718.26 02100725 A4649 AZUR HEL PUSH .018" 3MMX2CM$ 718.26 02100726 A4649 AZUR HEL PUSH .018" 4MMX2CM$ 718.26 02100727 A4649 AZUR HEL PUSH .018" 3MMX4CM$ 782.68 02100728 A4649 AZUR HEL PUSH .018" 4MMX4CM$ 782.68 02100729 A4649 AZUR HEL PUSH .018" 4MMX6CM$ 847.10 02100730 A4649 AZUR HEL PUSH .018" 8MMX10CM$ 911.53 02100731 A4649 AZU HEL PUSH .018" 2MMX4CM$ 1,555.72 02100732 A4649 AZUR HEL PUSH .018" 6MMX6CM$ 847.10 02100781 A4649 CAUTERIZING PEN STERILE$ 56.15 02100785 A4649 CATH MTCROSS 3MMX80MM 90CM$ 721.82 02100786 A4649 CATH MTCROSS 5MMX60MM 135CM$ 721.82 02100794 A4649 CATHETER PTCA TAKERU 2.5X30CM$ 759.86 02100806 C1768 STENT GRAFT FLUENCY 8MM 60MM$ 4,247.79 02100812 A4649 AZUR COIL DETACH .035 8MMX12CM$ 2,300.03 02100823 A4649 SET PICC TURBO 4FR 60CM$ 760.46 02100826 A4649 STENT CVD BALN 8MMX26MM 80CM$ 3,912.77 02100837 A4649 STENT CVD BALN 7MMX37MM 80CM$ 3,912.77 02100840 A4649 SET MICROPUNCTURE ACCESS 5FR$ 397.95 02100848 A4649 DIAMOND 360 MICRO 1.25MMX145CM$ 4,404.25 02100849 A4649 DIAMOND 360 SOLID 1.25MMX145CM$ 4,404.25

46 02100852 A4649 DIAMOND 360 SOLID 2.0MMX145CM$ 4,404.25 02100870 A4649 KIT PLEURX PERITONEAL CATHETER$ 1,634.58 02100925 C1894 SHEATH INTRO .035 7FR 15.5CM$ 308.43 02100950 A4649 SYSTEM DETACHMENT INZONE 2.0$ 985.99 02100972 A4649 DILATOR .035 20CM 5FR$ 158.09 02100996 A4649 DILATOR .038 20CM 14FR$ 42.55 02100998 A4649 DILATOR 5FR X 15CM$ 25.80 02101006 C1768 STENT GRAFT FLUENCY 10MM 60MM$ 4,247.79 02101014 A4649 AZUR COIL PUSH .035 10MMX14CM$ 1,033.92 02101020 A4649 AZUR COIL PUSH .035 10MMX20CM$ 1,033.92 02101030 A4649 ONCOZENE 100+25UM 3ML$ 1,078.04 02101038 A4649 STENT CVD BALN 10MMX38MM 80CM$ 3,912.77 02101058 A4649 STENT CVD BALN 10MMX58MM 80CM$ 3,912.77 02101059 A4649 CATHETER VENOUS PIC 3FR$ 636.37 02101060 A4649 CATHETER VENOUS PIC 4FR$ 674.60 02101061 A4649 CATHETER VENOUS PIC 5FR$ 674.60 02101081 C1769 GW AMPLATZ SS FLEXTIP 3.5CM$ 381.18 02101104 A4649 ANGIO SEAL PLATEFORM VIP 8FR$ 1,211.51 02101105 C1769 GUIDEWIRE HYDRO .035X180CM$ 327.18 02101109 A4649 WALLSTENT ENDOPRO 6F 6MMX135CM$ 3,051.18 02101116 A4649 CATH 3-LUMEN MHKR 16CM 12.5F$ 588.63 02101124 A4649 CATHETER 3-LUM MHKR 24CM 12.5F$ 588.63 02101151 A4649 NEEDLE BIOPSY OSTYCUT$ 828.86 02101152 A4649 NEEDLE BIOPSY HANDGRIP$ 513.08 02101153 A4649 CATHETER BALLOON 6X4 75CM 20AT$ 1,118.44 02101155 A4649 CATHETER BALLOON CON 7MMX4MMX7$ 1,118.44 02101156 A4649 CATHETER BALLOON 10X4 75CM 20A$ 1,118.44 02101157 A4649 CATHETER BALLOON QUEST 12MMX4C$ 1,118.44 02101188 A4649 CATHETER PICC SINGLE LUMEN 5FR$ 958.79 02101200 A4649 KIT VAS PICC PED 2FR 20CM 24GA$ 312.92 02101220 A4649 ANG INTRA-AORTIC BALLOON DEVI$ 2,127.54 02101240 A4649 CATH BLIARY SKTR 40CM 12F .038$ 84.15 02101253 C1769 GW CURVED ROSEN .35IN 260CM$ 76.16 02101263 C1769 GW CURVED ROSEN .35IN 180CM$ 51.60 02101264 A4649 CATHETER HEADHUNTER 5FR .038IN$ 206.97 02101265 A4649 CATHETER SIDEWINER 5FR .038IN$ 206.97 02101268 A4649 CATHETER CORDIS COBRA 0.38INX1$ 206.97 02101272 A4649 CATHETER BERENSTEIN 5FR 100CM$ 206.97 02101295 A4649 PROBE COVER ULTRASOUND LARGE$ 108.22 02101316 A4649 TRAY CATH 3-LUM MKR 16CM 12.5F$ 745.86 02101324 A4649 TRAY CATH 3-LUM MKR 24CM 12.5F$ 745.86 02101328 A4649 DILATOR .038 20CM 18FR$ 42.55

47 02101373 A4649 NEEDLE BIOPSY COAX 19GX13.8CM$ 229.68 02101410 A4649 NEEDLE BIOPSY COAX 19GX10CM$ 129.59 02101411 A4649 CATH INTRO BRITE TIP 11CM 4FR$ 182.44 02101413 A4649 NEEDLE BIOPSY COAX 13GX13CM$ 129.59 02101416 A4649 NEEDLE BIOPSY COAX 13GX16CM$ 129.59 02101430 C1769 GLW ANG ADV .014X1CMX300CM$ 452.38 02101509 C1769 GUIDEWIRE FATHOM-16 180CM .016$ 999.55 02101514 A4649 AZUR COIL PUSH .035 15MMX14CM$ 1,033.92 02101530 A4649 SET IV ADMINISTRATION 92"$ 19.17 02101531 A4649 ANG PVA FOAM 500 G09655$ 925.55 02101615 A4649 TUBE FEEDING MIC*GJ 15CM 16FR$ 950.41 02101616 A4649 NEEDLE BX COAX 15GX13.8CM$ 223.56 02101617 A4649 NDLE BX MAX CORE INST 16GX16CM$ 659.14 02101618 A4649 NDLE BX MAX CORE INST 16GX10CM$ 659.14 02101620 A4649 ANG ANGIOGRAM PACK DISP$ 837.62 02101628 A4649 DRESSING TEGADERM 6INX6IN$ 25.04 02101629 A4649 DRESSING TEGADERM 8INX12IN$ 32.82 02101698 C1894 SHEATH INTRO 11FR .038 15.5CM$ 308.43 02101806 C1769 GLW ANG STD .018X3CMC180CM$ 431.81 02101811 C1769 GLIDEWIRE 18X180CM GW1818$ 927.51 02101812 C1769 GLIDEWIRE GOLD .018 CM1811$ 832.62 02101816 A4649 NEEDLE BX COAX 17GAX13.8CM$ 154.62 02101825 A4649 INSTR BX MIS CORE 18GAX25CM$ 309.26 02101992 A4649 DILATOR .038 25CM 9FR$ 42.55 02101995 A4649 DILATOR .038 20CM 12FR$ 42.55 02102006 A4649 PTA SABR 4F.018 2MMX60MMX150CM$ 877.59 02102010 A4649 BALLOON SABER PTA4-18-150-2-10$ 967.54 02102016 A4649 NEEDLE BIOPSY QUICKCORE 18-9.0$ 458.90 02102020 A4649 NEEDLE BIOPSY QUICKCORE 18-9.0$ 458.90 02102021 A4649 NEEDLE BX Q-CORE 18-15.0-10T$ 458.90 02102022 A4649 TUBE FEEDING MIC*J 22FR$ 802.17 02102024 A4649 TUBE FEEDING MIC*J 24FR$ 802.17 02102090 A4649 CATHETER BALLOON CUT 7MMX2CM$ 2,585.56 02102326 C1726 BALLON DILTATION CATH 5F 80CM$ 746.51 02102333 A4649 CATH BALLOON PTA5-35-80-4-8-0$ 269.59 02102346 A4649 BALLOON PTA5-35-80-6-6$ 758.53 02102347 A4649 BALLOON PTA5-35-80-6-8$ 758.53 02102352 A4649 COIL NESTER .018X5CMX5MM$ 581.22 02102361 A4649 SET CVC DBL LUMEN 6FR 60CM$ 737.71 02102379 A4649 BALLOON PTA 12MMX4CMX80CM$ 901.23 02102413 A4649 CATHETER 2.4FR MCPB2413Y$ 1,167.11 02102504 C1769 GLW ANG STD .025X3CMX150CM$ 331.45

48 02102524 C1769 GUIDEWIRE EMERALD .025INX150CM$ 209.98 02102560 C1769 GUIDEWIRE SOFT STR TIP BENTSON$ 218.81 02102640 C1769 WIRE ROSEN .035 1.5CMX180CM$ 77.74 02102694 A4649 COIL NESTER .035 14CMX6MM$ 807.65 02102703 A4649 KIT CVC 3-LUMEN 7FR 16CM ABG+$ 548.49 02102726 C1769 ANG GUIDEWIRE APTZ .035INX150$ 383.49 02102731 A4649 COIL NESTER .018X3CMX2MM$ 581.22 02102732 A4649 COIL NESTER MWCE-18-3-3$ 643.06 02102735 C1769 GUIDEWIRE EMERALD .035INX260CM$ 209.98 02102813 A4649 CATHETER MIC PROGRT 2.8FX130CM$ 1,656.15 02102947 C1894 INTRODUCER SHEATH PA 30CM 9FR$ 456.71 02102949 C1894 INTRODUCER SHEATH PA 30CM 13FR$ 456.71 02102950 C1894 INTRODUCER SHEATH PA 30CM 16FR$ 456.71 02102972 A4649 SET INTRO MICROPNCT 4FR G02972$ 532.41 02102994 C1894 SHEATH INTRODUCER .018 6F 45CM$ 440.58 02103006 A4649 PTA SABR .018 3MMX60MMX90CM$ 877.59 02103008 A4649 KIT SNARE ATRIEVE 3.2FR 150CM$ 875.78 02103010 A4649 BALLOON SABER PTA4-18-150-3-10$ 967.54 02103076 C1894 INTRODUCER SHEATH PA 30CM 10FR$ 456.71 02103208 C1894 INTRODUCER SHEATH PA 30CM 18FR$ 456.71 02103212 A4649 SET INTRO CHKFLO 30CM 5FR .038$ 422.45 02103224 C1894 INTRODUCER SHEATH PA 30CM 7FR$ 456.71 02103501 C1769 GLIDEWIRE STR 35X250CM GR03501$ 262.00 02103506 C1769 GLIDEWIRE ANG 35X180CM GR3506$ 262.00 02103508 C1769 GLIDEWIRE HYDRO .035 180CM$ 319.01 02103509 C1769 GLIDEWIRE ANG 35X260 GR3509$ 393.17 02103670 A4649 NDLE BX MIS CORE INST 20GX20CM$ 592.14 02103759 A4649 BALLOON DORADO 8MMX4CMX80CM$ 114.53 02103857 A4649 STENT VASC 6-35-80-8-60$ 1,737.03 02103902 A4649 NEEDLE SPINAL QUINCKE 22GX5IN$ 55.98 02104010 A4649 BALLON SABR PTA3.9-18-150-4-10$ 967.54 02104031 A4649 WALLSTENT ENDPRO 10F 14MMX75CM$ 3,820.16 02104033 A4649 WALLSTENT ENDPRO 10F 16MMX75CM$ 3,820.16 02104096 C1894 INTRODUCER SHEATH PA 13CM 22FR$ 294.95 02104100 A4649 CATH BLIARY SKTR 40CM 10F .038$ 84.15 02104137 A4649 SET CHEST THAL 24FR 41CM$ 652.58 02104139 A4649 SET CHEST THAL 28FR 41CM$ 652.58 02104170 A4649 NEEDLE BX COAX 19GX7.8CM$ 234.73 02104171 A4649 NEELE BX COAX 19GX17.8CM$ 234.73 02104275 C1874 STENT TIPS VIATORR 8-10MMX4CM$ 6,494.88 02104286 A4649 STENT 10MMX40MMX80CM$ 1,964.58 02104291 A4649 CATHETER ST PIER 5FR 65CM$ 142.25

49 02104324 A4649 CATHETER ARMADA 4X40MM 150CM$ 866.25 02104355 A4649 BALLOON PTA5-35-80-4-6.0$ 713.37 02104384 A4649 STENT 6MMX40MMX80CM$ 1,964.58 02104568 C1769 GUIDEWIRE STD J-TIP 0.05"X15$ 25.98 02104593 C1769 GUIDEWIRE TROCAR TIP SS 18CM$ 492.88 02104604 C1894 SHEATH INTRO 4FR 11CM$ 206.97 02104605 A4649 SHEATH BRITE TIP 6FR 5.5CM$ 1,129.66 02104606 A4649 INTRODUCER ADVANTIX 6FRX11CM$ 194.53 02104608 A4649 INTRODUCER 8FR .38INX11CM$ 53.06 02104610 C1769 GUIDEWIRE FRM J-TIP 0.038INX15$ 25.98 02104617 C1769 GUIDEWIRE STD J-TIP 0.038INX26$ 25.98 02104800 A4649 SET MICROPNCTRE 5F 10CM G48008$ 379.00 02104877 A4649 NDL THINWALL PERCUTANEOUS$ 17.19 02104897 C1894 SHEATH INTRO .035 6FR 15.5CM$ 308.43 02105018 A4649 CATHETER PALINDROME 14.5F 55CM$ 860.00 02105021 A4649 DEVICE VASCULAR MYNXGRIP 5FR$ 1,040.71 02105118 A4649 TRAY PICC DUAL LUMEN 5FR$ 954.44 02105224 A4649 BALLOON PTA5-35-135-3-4.0$ 728.75 02105229 A4649 BALLOON PTA 35X135X10X4 G52293$ 901.23 02105233 A4649 BALLOON PTA 35X80X4X4 G52332$ 901.23 02105237 A4649 BALLOON PTA 35X80X10X4 G52373$ 901.23 02105273 A4649 COIL COMPLEX 4MMX40MM$ 783.12 02105279 A4649 COIL NESTER .018 7CMX8MM$ 783.12 02105308 A4649 RETRIEVER VSCLR CLVRSNR 4-LOOP$ 1,454.20 02105610 A4649 AZUR COIL PUSH .035 6MMX10CM$ 969.51 02105625 C1769 GUIDEWIRE EXPO 5FR 100CM$ 172.06 02105703 A4649 KIT CVC 3-LUMEN 7FR 20CM ABG+$ 418.51 02105810 A4649 AZUR COIL PUSH .035 8MMX10XM$ 969.51 02105839 A4649 SET G-J 2-LUMEN C-A-COONS$ 1,192.32 02106005 A4649 CATH HNB5.0-38-100-P G06005$ 557.73 02106015 A4649 KIT SNARE ATRIEVE 6FR 100CM$ 785.66 02106036 A4649 TUBING M/M LEUR LOCK 36$ 25.95 02106048 A4649 TUBING M/M LEUR LOCK 48$ 25.95 02106080 A4649 STENT BILIARY LUM 6MMX80MMX135$ 2,696.34 02106118 A4649 TRAY PICC DUAL LUMEN 6FR$ 954.44 02106200 A4649 COIL NESTER .018X5CMX2MM$ 581.22 02106201 A4649 COIL NESTER .018X5CMX3MM$ 581.22 02106202 A4649 COIL NESTER .035X20CMX10MM$ 709.49 02106203 A4649 COIL NESTER .018X7CMX3MM$ 634.05 02106204 A4649 COIL NESTER .018X7CMX5MM$ 634.05 02106275 C1874 STENT TIPS VIATORR 8-140MMX6CM$ 6,494.88 02106339 A4649 SET DRAIN THAL .038 41CM 16FR$ 823.32

50 02106343 A4649 SET DRAIN THAL .038 41CM 18FR$ 823.32 02106345 A4649 SET DRAIN THAL .038 41CM 20FR$ 823.32 02106438 A4649 POWER INJECT PORT 9.5FR G26438$ 1,316.08 02106446 C1894 INTRODUCER SHEATH PA 13CM 24FR$ 294.95 02106447 C1894 INTRODUCER SHEATH PA 13CM 26FR$ 294.95 02106491 C1894 SHEATH INTRO .038 11FR 15.5CM$ 308.43 02106492 C1894 SHEATH INTRO .038 12FR 15.5CM$ 308.43 02106497 C1894 SHEATH INTRO .038 15FR 15.5CM$ 308.43 02106565 C1894 INTRODUCER SHEATH PA 30CM 5FR$ 456.71 02106570 C1894 INTRODUCER SHEATH 13CM 7FR$ 224.95 02106584 C1894 INTRODUCER SHEATH 55CM 6FR$ 224.95 02107030 A4649 KIT SNARE ATRIEVE 7FR 100CM$ 793.59 02107157 A4649 COIL EMBOL TORNADO .018 P4$ 319.46 02107158 A4649 MICROCOIL HIAL .018IN 3CM 3M$ 319.46 02107241 A4649 SET CHEST THAL 36FR 41CM$ 685.21 02107243 A4649 SET CHEST THAL 32FR 41CM$ 685.21 02107275 C1874 STENT TIPS VIATORR 8-10CMX7CM$ 6,494.88 02107557 C1769 GW XTRASUPORT ROADRUN. 18 180$ 348.96 02107600 A4649 INTRODUCER PERF RCFW-10.0-38$ 274.46 02107630 A4649 NDLE BX MIS CORE INST 20GX10CM$ 592.14 02108040 A4649 CATH BILIARY SKTR 40CM 8F .038$ 84.15 02108246 A4649 SET INTRO CHKFLO 13CM 7FR .038$ 422.45 02108275 C1874 STENT TIPS VIATORR 8-19MMX8CM$ 6,578.73 02108283 A4649 SET LIVER ACCESS AND BIOPSY$ 1,201.73 02108356 A4649 COIL EMBOL TORNADO .018 P5$ 319.46 02108376 A4649 CATH PICC 3FR 50CM G08376$ 620.92 02108503 A4649 CATHETER P/F 5F 110CM 10708503$ 145.85 02108701 A4649 SET ANCHOR GASTROINTESTINAL$ 799.06 02108777 C1769 GW XTRASUPORT ROADRUN. 14 180$ 348.96 02108801 C1769 GW XTRASUPORT ROADRUN. 14 300$ 375.98 02108888 A4649 CATHETER SPORTPACK 14.5FR 33CM$ 901.47 02109000 A4649 STENT CAROTID 6MM 22MM 135CM$ 2,767.51 02109001 A4649 BALN CUTTING PERI DIA 6CM 90CM$ 1,843.53 02109091 A4649 TUBE CONNECTING MALE$ 163.91 02109406 A4649 CATHETER PIG 4FR 70CM G09406$ 109.08 02109489 A4649 NEEDLE YUEH 5FR 7CM G09489$ 187.58 02109490 A4649 NEEDLE YUEH 5FR 10CM G09490$ 217.61 02109710 A4649 SET STENT AMPLATZ 8.5FR 26CM$ 795.19 02109801 A4649 DILATOR .038 20CM 8FR$ 42.55 02109803 A4649 CATHETER P/F 5F 100CM 13709803$ 831.31 02109956 C1769 GW ULTRASTIFF AMPLTZ .035IN$ 88.46 02110000 A4649 TORQUE DEVICE TD01$ 51.53

51 02110050 C1729 SET DRAIN CATH 10.2FR G10050$ 978.81 02110208 A4649 DILATOR 7-38-20 AQ HDRPHL$ 76.32 02110210 A4649 SET NEPHROSTOMY 8FR$ 952.48 02110289 A4649 DILATOR 8-38-20 AQ HDRPHL COAT$ 76.32 02110290 A4649 DILATOR AQ HYDROPHILIC 9-38-20$ 76.32 02110411 A4649 COIL EMBOL TORNADO PROX 8MM$ 319.46 02110413 A4649 COIL EMBOL TORNADO PROX 10M$ 319.46 02110415 A4649 COIL EMBOL TORNADO PROX 5MM$ 319.46 02110416 A4649 COIL EMBOL TORNADO PROX 6MM$ 319.46 02110417 A4649 COIL EMBOL TORNADO PROX 7MM$ 319.46 02110446 A4649 CATH G-J ULT MC COAXIAL$ 461.70 02110448 A4649 SET G-J COAXIAL SYSTEM$ 1,213.20 02110530 C1769 GLIDEWIRE STF SHFT .035X260CM$ 441.49 02110860 A4649 TRAPEZOID RX BSK 1.5 CHNL 3.2$ 1,070.83 02110870 A4649 TRAPEZOID RX BSK 2.0 CHNL 3.2$ 1,070.83 02110880 A4649 TRAPEZOID RX BSK 2.5 CHNL 3.2$ 1,070.83 02110958 A4649 CATH DRN CURVE 8.25CM 5FR$ 127.48 02111001 A4649 ANGIOGRAPHY FLOWSWITCH$ 199.25 02111161 A4649 COMPRESS SYSTEM FEMOSTOP PLUS$ 924.90 02111200 A4649 KIT VAS PICC PED 2FR 20CM 22GA$ 312.92 02111633 A4649 INTRODUCER 7FR X 55CM$ 196.60 02111636 A4649 INTRODUCER 6FR X 70CM$ 245.73 02111991 A4649 CATHETER CEREBRAL 5FR 100CM$ 206.43 02112057 A4649 NEEDLE BIOPSY COAXIAL$ 180.37 02112156 A4649 CATH VISCERAL KMP 5FR 65CML$ 206.43 02112421 A4649 VALVE HEMOSTATIC ROTATING$ 378.77 02112552 A4649 CATHETER BALLOON BM 5.8FR 8MMX$ 1,403.60 02113287 A4649 FILTER VENACAVA 11F 60CM L 6$ 319.46 02113720 A4649 AZUR SYSTEM 18P 2MMX2CM$ 718.26 02114025 A4649 SET NEPHRO DRN SKATER 14F 25CM$ 580.11 02114045 A4649 CATHETER VER 4F 100CM 10714045$ 145.85 02114300 A4649 STENT USE-14-300A$ 754.53 02114659 C1769 GUIDEWIRE MAGICTORQUE .035INX1$ 499.89 02115044 A4649 CATHETER BLN PTA 4F .018X150CM$ 1,235.63 02115105 A4649 INFLATION DEVICE ENCORE 26$ 916.03 02115200 A4649 ANGIASSIST MED GAS MGT SYSTEM$ 643.55 02115521 A4649 SET PNEUMOTHORAX TURNER PIG 6.$ 949.22 02115730 A4649 SHEATH PINNACLE 5FR 25CM$ 272.34 02115731 A4649 SHEATH PINNACLE 6FR 25CM$ 272.34 02116107 A4649 NDLE BX MIS CORE INST 16GX10CM$ 592.14 02116167 A4649 NDLE BX MIS CORE INST 16GX16CM$ 592.14 02118000 A4649 POWERPORT CLEARVIEW SLIM 8FR$ 1,273.39

52 02118034 A4649 NEEDLE BX Q-C 20X9X20T G27019$ 458.90 02118035 A4649 NEEDLE BX Q-CORE 20-15.0-10T$ 458.90 02118107 A4649 NDLE BX MIS CORE INST 18GX10CM$ 592.14 02118167 A4649 NDLE BX MIS CORE INST 18GX16CM$ 592.14 02118207 A4649 NDLE BX MIS CORE INST 18GX20CM$ 592.14 02118257 A4649 NDLE BX MIS CORE INST 18GX25CM$ 592.14 02118300 A4649 STENT USE-18-300A$ 754.53 02118502 A4649 CATHETER C-2 4FR 65CM 10718502$ 145.85 02118830 A4649 NEEDLE BIOPSY QUICKCORE 20-9.0$ 458.90 02118861 A4649 SET BILIARY STONE REMOVAL$ 1,325.66 02118866 A4649 SET INTRAVASCULAR RETRIEVER CU$ 1,138.22 02118867 A4649 SET INTRAVASCULAR RETRIEVER DO$ 1,342.56 02119503 A4649 CATHETER HH1 5F 100CM 10719503$ 145.85 02119630 A4649 CATHETER SPORTPACK 14.5FR 19CM$ 1,412.81 02119708 A4649 CATHETER C2 5FR 65CM 10719708$ 145.85 02120000 A4649 CATHETER ANG CXI 2.6FR 90CM$ 955.95 02120200 A4649 NEEDLE ASPIRATION CHIBA 20GX20$ 74.18 02120405 A4649 CATHETER SO-2 5F 80CM 10720405$ 145.85 02120408 A4649 CATHETER SO-0 5F 80CM 10720408$ 145.85 02120608 A4649 SHEATH BANANA PEEL 12FR 15CM$ 434.16 02121200 A4649 KIT PICC SNGL-LUM PED 3FR 60CM$ 607.28 02121520 A4649 COIL TARGET 360 NANO 1.5X2$ 3,744.55 02122102 A4649 CATHETER BER 5FR 65CM 10722102$ 145.85 02122566 A4649 STENT URETERAL 8FR 25CM$ 1,029.78 02123162 A4649 CATH CXI-2.3-14-135-269$ 948.49 02123400 A4649 CATHETER SPORTPACK 14.5FR 23CM$ 1,412.81 02123503 A4649 CATH BERENSTEIN 4FR 40CM .035"$ 58.75 02123523 A4649 COIL NESTER MWCE-35-7-3$ 775.50 02123644 C1769 GW TSHF-35-180-AUS-ST G23644$ 214.80 02123720 A4649 AZUR SYSTEM 18P 3MMX2CM$ 718.26 02126991 A4649 COIL EMBOLIZATION 10DIA 14L$ 319.46 02126992 A4649 COIL EMBOLIZATION 12DIA 14L$ 319.46 02126993 A4649 COIL NESTER MWCE-35-14-4$ 755.02 02126994 A4649 COIL EMBOLIZATION 6DIA 14L$ 319.46 02126995 A4649 COIL EMBOLIZATION 8DIA 14L$ 319.46 02127045 A4649 CATH BER 5FR 65CM 11722704$ 425.43 02127047 A4649 SET G-J 2-LUMEN ULT C-A-COONS$ 762.42 02127289 A4649 INTRODUCER VALVE CHECK-FLO$ 180.37 02127350 A4649 AZUR COIL DETACH .018 2MMX4CM$ 1,672.13 02128673 A4649 NEEDLE CENTESIS CATHETER$ 200.63 02128675 A4649 CATHETER CENTESIS YUEH 10CM 5F$ 300.28 02128700 A4649 CATHETER BILIARY DRAINAGE$ 818.80

53 02128783 C1769 GW AMPLATZ STIFF STR .035 80CM$ 498.92 02129996 A4649 INTRO 6FR X 55CM TUOHY- BORS$ 221.16 02129997 A4649 INTRO 6FR X 55CM TUOHY- BORS$ 221.16 02130022 A4649 TUBE FEEDING MIC*G 22FR$ 295.19 02130023 A4649 CATH C-V .032X7FRX20CM AK15703$ 368.58 02130110 A4649 ANGIO SEAL PLATEFORM VIP 6FR$ 1,211.51 02130162 A4649 NEEDLE BX COAX 15GAX17.8CM$ 154.62 02130181 A4649 NEEDLE BX COAX 17GAX7.8CM$ 154.62 02130182 A4649 NEEDLE BX COAX 17GAX17.8CM$ 154.62 02130248 A4649 KIT MONITOR DPT SYSTEM$ 116.72 02130260 A4649 AZUR SYSTEM 18P 3MMX4CM$ 1,672.13 02130305 A4649 CANNULA DUCTOGRAM$ 200.63 02130307 A4649 CATHETER PICC POWER DUAL 6FR$ 969.57 02130359 A4649 STENT URETERAL 6FR 22CM$ 1,088.88 02130364 A4649 KIT STENT URETERAL 8FR 28CM$ 989.90 02130365 A4649 MICRO COIL PLATINUM .018 2X5$ 609.40 02130367 A4649 MICRO COIL PLATINUM .018 2X4$ 609.40 02130368 A4649 DRAINAGE SYSTEM W/PORT SUCTION$ 273.54 02130369 A4649 DRAINAGE BAG 60ML W/TUBING$ 136.79 02130392 C1769 GUIDEWIRE ROSEN CURVED 145CM$ 254.96 02130393 C1769 GUIDEWIRE PUSHER MICROCOIL$ 337.14 02130395 C1769 GUIDEWIRE AMPLATZ ULTRASTIFF 1$ 389.00 02130397 A4649 SHEATH BRIGHT BALKIN$ 815.83 02130399 A4649 INTRODUCER FLX TUOHYBORST 7FR$ 843.62 02130402 A4649 SHEATH PINNACLE 5FR 10CM$ 306.64 02130403 A4649 SHEATH PINNACLE 6FR 10CM$ 306.64 02130404 A4649 CATHETER DRAINAGE APDL 8FR 25C$ 1,035.60 02130405 A4649 CATH DRAINAGE APDL 10FR 25CM$ 1,035.60 02130408 A4649 STENT NEPHROURETERAL 8.5F 22CM$ 1,114.76 02130409 A4649 STENT NEPHROURETERAL 8.5F 24CM$ 1,114.76 02130410 A4649 STENT NEPHROURETERAL 8FR 26CM$ 1,114.76 02130411 C1769 ANG WIRE TRANSEND 8 165CM$ 1,431.41 02130413 A4649 CATHETER BALLOON PTA 6X4.75CM$ 1,232.20 02130417 A4649 CATHETER BALLOON PTA DIL 10X4.$ 1,232.20 02130528 A4649 COIL EMBOL MWCE-18-7-6 G52738$ 745.83 02130686 A4649 SET DRAINAGE POUCH COOK$ 130.53 02130722 A4649 CATHETER PRO FUSE CT PORT 9.6F$ 361.28 02130791 C1769 WIRE GUIDE MICRO CTO 12$ 833.81 02130810 A4649 NDLE BX MAX CORE INST 18GX10CM$ 659.14 02130816 A4649 NDLE BX MAX CORE INST 18GX16CM$ 659.14 02130820 A4649 INSTR BX MIS CORE 18GAX20CM$ 309.26 02130823 A4649 BALLOON PTA4-18-170-3-20G30832$ 1,013.13

54 02130832 A4649 BALLOON PTA4-18-170-3-20G30832$ 1,013.13 02130860 A4649 SYRINGE HIGH PRESS 1ML WHITE$ 14.91 02130861 A4649 SYRINGE HIGH PRESS 3ML WHITE$ 15.11 02130862 A4649 SYRINGE HIGH PRESS 10ML RED$ 18.23 02130863 A4649 SYRINGE HIGH PRESS 20ML RED$ 19.17 02130906 A4649 SYRINGE HIGH PRESS 6ML PURPLE$ 16.71 02130933 A4649 CATH BAL PTA4-18-150-2-4 30933$ 1,034.43 02130935 A4649 BALN PTA .018 2MMX80MMX150CM$ 926.10 02130994 A4649 DILATOR .038 20CM 11FR$ 42.55 02131027 A4649 INFLATE DVC CID-20-30 G31027$ 808.70 02131200 A4649 KIT PICC DBL-LUM PED 4FR 60CM$ 607.28 02131410 A4649 NEEDLE BIOPSY MAGNUM 14GX13CM$ 189.67 02132201 A4649 CATHETER O/F 5FR 65CM 10732201$ 145.85 02132440 A4649 CATHETER COBRA C1 65CM 4FR$ 149.36 02132462 A4649 CATHETER RDC A2(1) 65CM 4FR$ 149.36 02132702 A4649 CATHETER KMP 5FR 40CM 10732702$ 145.85 02133053 A4649 DRAPE BRACHIAL ANGIO$ 8.46 02134217 A4649 PROBE COVER PRE-GELLED NON-LAT$ 19.89 02134319 A4649 CATH BAL PTA4-18-150-3-4 34319$ 1,034.43 02134321 A4649 CATH BAL PTA4-18-150-3-8 34321$ 1,034.43 02134882 A4649 SET DRAIN MULTIPURPOSE 8.5FR$ 1,053.80 02134883 A4649 SET DRAIN MULTIPURPOSE 10.2FR$ 1,053.80 02135015 A4649 CATH BER 4FR 100CM 11723501$ 425.43 02135060 C1769 GLW ANG STF .035X3CMX150CM$ 362.75 02136213 A4649 CATHETER PIG FL .035 100CM 5FR$ 92.46 02136282 C1769 GW HIGHWIRE ANGLE .035IN D 1$ 457.08 02136470 A4300 CATH BROVIAC 1-LUMEN 4.2FR$ 868.22 02137250 A4649 COIL NESTER .018X5CMX2MM$ 634.05 02137456 A4649 SET DRAINAGE 12FR 25CM G10261$ 981.89 02137508 A4649 SET BIOPSY Q-C 20GA 15CMX10MM$ 410.05 02137511 A4649 NEEDLE BX 20-15.0-20T G08790$ 468.63 02137513 A4649 NEEDLE BX Q-C 18X15X20T G08788$ 468.63 02137666 A4649 TRAPEZOID RX BSK 3.0 CHNL 3.2$ 1,070.83 02137682 A4649 CATHETER CENTESIS YUEH 7CM 5FR$ 300.28 02138049 A4649 SET DRAINAGE 8.5FR 25CM G10049$ 979.98 02138051 A4649 SET DRAINAGE LOCK 12FR 25CM$ 874.74 02138052 A4649 SET DRAINAGE 14FR 25CM G10352$ 973.14 02138087 A4649 SHEATH INTR 5FR 11CM 504-605X$ 82.49 02138370 A4649 CATH ANG CXI 2.3FR .014INX65CM$ 913.30 02138371 A4649 CATHETER CXI 2.3FR .014INX90CM$ 913.30 02138372 A4649 CATH ANG CXI 2.3FR .014INX90CM$ 913.30 02139406 A4649 SET GI SUTURE ANCHOR$ 552.97

55 02140520 A4649 AZUR COIL PUSH .035 4MMX4CM$ 840.66 02142423 A4649 COIL EMBOL MREYE 35IN 5CM 8M$ 245.73 02142467 A4649 COIL EMBOL MREYE 38IN 8CM 15$ 245.73 02142540 A4649 COIL TARGET 360 NANO 2.5X4$ 3,744.55 02142920 A4649 STENT BALLOON EXP 4MM X 16MM$ 3,428.04 02142925 A4649 STENT BILI 5/6FR 5MM DI 16MM$ 3,428.04 02142927 A4649 STENT BALLOON EXP 5MM X 24MM$ 3,428.04 02142930 A4649 STENT BILI 5/6FR 6MM DI 16MM$ 3,428.04 02142932 A4649 STENT BILI 5/6FR 6MM DI 24MM$ 3,428.04 02142936 A4649 STENT BILI 6/7FR 7MM DI 20MM$ 3,428.04 02143040 A4649 COIL TARGET 360 NANO 3X4$ 3,744.55 02143850 A4649 STENT VASCULAR 7MM DIA 30MM L$ 4,423.28 02143851 A4649 STENT VASCULAR 7MM DIA 40MM L$ 4,423.28 02143855 A4649 STENT VASCULAR 8MM DIA 30MM L$ 4,423.28 02143856 A4649 STENT VASCULAR 8MM DIA 40MM L$ 4,423.28 02143857 A4649 STENT VASCULAR 8MM DIA 60MM L$ 4,669.00 02143861 A4649 STENT VASCULAR 9MM DIA 40MM L$ 4,423.28 02143862 A4649 STENT VASCULAR 9MM DIA 60MM L$ 4,669.00 02143870 A4649 SET MICROPNCTRE 5F 10CM G43870$ 369.52 02145017 A4649 CATH HEMO PALIN 14.5FR 33CM$ 993.87 02146305 C1769 GUIDEWIRE HYDRO .035X150CM$ 626.90 02147942 A4649 INTRO MICROPUNCTURE SET 4FR$ 110.61 02150002 A4649 CATH ANG CXI-2.6-18-90-PNS$ 921.10 02150003 A4649 CATH ANG CXI-2.6-18-150-P-NS$ 921.10 02150018 A4649 SET INTRO MICROPUNCTURE 5FR$ 429.29 02150140 C1769 GW CURVED 35X145X1.5 G01382$ 179.58 02150319 A4649 BALLOON PTA4-14-170-2-20G50319$ 1,165.13 02150326 A4649 BALON PTA4-14-170-2.5-20G50326$ 1,165.13 02150333 A4649 BALLOON PTA4-14-170-3-20G50333$ 1,165.13 02151011 A4649 NEEDLE 11G AFAFLEX+CURVED NIT$ 1,394.73 02151110 A4649 TROCAR/BEVEL 11GX12CM AVAMAX$ 564.82 02151418 A4649 CATHETER VIS UNISEL I 80CM 4FR$ 149.36 02151501 A4649 CATHETER 5FR .035X65 451-501V5$ 930.66 02151515 A4649 CATHETER BRNSTEIN II 100CM 4FR$ 149.36 02152251 A4649 CATHETER BLN PTA5-35-135-4-4.0$ 758.53 02152260 A4649 BALLOON PTA5-35-135-5-8 G52260$ 810.43 02152265 A4649 BALLOON PTA5-35-135-6-4.0$ 810.43 02152266 A4649 BALLOON PTA5-35-135-6-6 G52266$ 810.43 02152267 A4649 BALLOON PTA5-35-135-3-8 G52267$ 810.43 02152268 A4649 BALLOON PTA5-35-135-6-10G52268$ 810.43 02152280 A4649 CATHETER BLN PTA5-35-135-8-6.0$ 735.09 02152281 A4649 CATHETER BLN PTA5-35-135-8-8.0$ 735.09

56 02152286 A4649 BALLOON PTA5-35-135-9-4 G52286$ 810.43 02152326 A4649 CATHETER BALLOON PTA 3MMX4CM$ 986.88 02152334 A4649 BALLOON PTA5-35-80-4-10 G52334$ 810.43 02152338 A4649 BALLOON PTA5-35-80-5-4 G52238$ 810.43 02152346 A4649 CATH BALLOON PTA 5F .035 6MM$ 860.08 02152348 A4649 BALLOON PTA5-35-80-6-10.0$ 810.43 02152352 A4649 BALLOON PTA5-35-80-7-4.0$ 810.43 02152353 A4649 CATH BALLOON PTA 5F .035 7MM$ 860.08 02152360 A4649 CATH BALLOON PTA 5F .035 8MM$ 860.08 02152367 A4649 BALLOON PTA5-35-80-9-6.0$ 722.41 02152371 A4649 BALLOON PTA5-35-80-9-14 G52371$ 810.43 02152379 A4649 BALLOON PTA5-35-80-12-4 G52379$ 810.43 02152397 A4649 CATH BALLOON PTA 6F .035 9MM$ 860.08 02152546 A4649 CATH CXI-4.0-35-90-P-NS-0$ 921.10 02152547 A4649 CATH CXI-4.0-35-90-P-NS-DAV$ 921.10 02152650 C1769 GUIDEWIRE EMERALD 5FR .035X15$ 172.06 02152730 A4649 AZUR SYSTEM 18P 4MMX6MM$ 847.10 02152737 A4649 COIL NESTER MWCE-18-7-4$ 750.54 02152739 A4649 COIL NESTER MWCE-18-7-8$ 750.54 02152742 A4649 COIL NESTER MWCE-35-7-4$ 750.54 02152743 A4649 COIL NESTER MWCE-35-7-6$ 750.54 02152939 A4649 CATHETER HMW-14-300-ST$ 888.52 02153122 A4649 SET PNEUMOTHORAX$ 783.18 02153720 A4649 COIL NESTER .018X7CMX2M$ 634.05 02155045 A4649 CATH MPA 5FR 100CM 10735504$ 177.45 02155887 A4649 SET ABSCESS DRAINAGE MALECOT$ 1,060.90 02156015 A4649 CATH MPA 5FR 65CM 10735601$ 177.45 02160267 A4649 FILTER ELITE 33MM 70CM$ 1,837.73 02160530 C1769 GLIDEWIRE STIF 35X180CM GS6506$ 380.89 02160700 A4649 BAL PTA METR .035 10X80MMX90CM$ 721.82 02160810 C1769 WIRE ANGLED GLIDE .018$ 479.21 02161410 A4649 NEEDLE BIOPSY MAGNUM 14GX16CM$ 189.67 02161610 A4649 SET GORE TIPS 16G 10FR 49CM$ 1,142.03 02162552 A4649 STOPCOCK ONE/THREE-WAY$ 28.48 02163050 C1769 GLW ANG STF .035X3CMX260CM$ 400.45 02164150 C1769 GUIDEWIRE EXPO 6FR 100CM$ 172.06 02165017 A4649 ULTRACLIP II17GX10CM$ 551.34 02165320 C1769 G02356 GW COONS .035X145CM$ 77.74 02165517 A4649 ULTRCLIP II 17GX15CM$ 551.34 02166306 A4649 ANG VENA CAVA TRAPESE-SHORT$ 2,046.44 02167630 A4649 NDLE BX MIS CORE INST 20GX16CM$ 592.14 02168110 A4649 CATHETER VENOUS PIC 6FR$ 869.15

57 02170394 A4649 SET NEPHROSTOMY ULTRATHANE$ 1,099.57 02172200 A4649 CATHETER ARMADA 4X40MM 90CM$ 866.25 02173100 A4649 WIRE BREAST DUALOK 20GX13.7CM$ 318.38 02173250 A4649 BALLOON PTA 35X80X10X4 G52373$ 901.23 02176121 A4649 ADAPTER SIDEARM$ 175.61 02176301 A4649 NEEDLE BIOPSY MAGNUM 14GX10CM$ 189.67 02176302 A4649 TUBE FEEDING MIC*J 20FR$ 802.17 02176871 A4649 SET ABSCESS DRAINAGE THAL-QUIC$ 814.05 02181811 A4649 PROBE COVER ULTSND 5.5"X58"$ 75.25 02182503 A4649 AZUR SYSTEM 18P 6MMX6CM$ 847.10 02184540 A4649 KIT RENEGADE FATHOM16 180CM$ 1,685.79 02187630 A4649 NEEDLE BX COAX 15GX7.8CM$ 242.76 02188882 A4649 CATHETER MAHURKAR 12FR 13CM$ 826.23 02189471 A4649 DRAPE BRACHIAL ANGIO 44INX31IN$ 25.45 02189597 A4649 TORQUE DEVICE$ 75.94 02190000 A4649 ARGON DEV CLEANER 9MM 65CM 6FR$ 1,590.50 02191300 A4649 BALLOON PTAX4-14-170-2-20$ 1,109.65 02193040 A4649 CATH OPTA PRO 3MMX40MM 80CM 5F$ 754.01 02194080 A4649 CATH OPTA PRO 4MMX80MM 80CM 5F$ 754.01 02194140 C1769 SET WIRE GUIDE EXCHANGE$ 840.15 02195001 A4649 ANG CONNECTING TUBE 800PS$ 43.07 02195040 A4649 CATH OPTA PRO 5MMX40MM 80CM 5F$ 754.01 02195080 A4649 CATH OPTA PRO 5MMX80MM 80CM 5F$ 754.01 02196031 A4649 NEEDLE BIOPSY QUICK-CORE$ 294.63 02196040 A4649 CATH OPTA PRO 6MMX40MM 80CM 5F$ 754.01 02196060 A4649 PTA OPTA 5F.035 6MMX60MMX110CM$ 754.01 02196065 A4649 CATH SW1 5FR 100CM 10719606$ 145.85 02196075 A4649 CATH SW2 5FR 100CM 10719607$ 145.85 02196080 A4649 PTA OPTA 6F .035 6MMX80MMX80CM$ 754.01 02197080 A4649 PTA OPTA 6F .035 7MMX80MMX80CM$ 754.01 02197200 A4649 CATHETER BILI DRN 8.5FR 40CM$ 649.64 02197250 A4649 AZUR SYSTEM 18P 8MMX10CM$ 911.53 02198035 A4649 CATH PIG 5FR 100CM 13709803$ 831.34 02298001 MIP CO-PAYMENT-ER$ 6.38 02298002 MIP CO-PAYMENT-PHARMACY$ 3.71 02318001 Q9967 ISOVUE 300 16% 1ML$ 1.06 02318002 Q9967 ISOVUE 370 76% 1ML$ 1.06 02318003 A9576 PROHANCE MULTIPACK INJ 1ML$ 2.73 02318004 A9577 MULTIHANCE INJ 1ML$ 1.06 02318005 A9578 MULTIHANCE MULTIPACK INJ 1ML$ 1.81 02318006 A9579 GADOLINIUM-BASED NOS INJ 1ML$ 2.99 02318007 Q9965 LOCM 100-199 MG/ML IODINE 1ML$ 3.43

58 02318008 Q9966 LOCM 200-299 MG/ML IODINE 1ML$ 3.54 02319001 A9537 TECHNETIUM TC 99M MEBROFENIN$ 109.50 02319002 A9567 TECHNETIUM TC 99M PENTETATE$ 3,630.69 02319003 A9540 TC 99M MACRO (MAA)$ 59.39 02319004 A9560 TECHNETIUM TC 99M LABELED RBC$ 184.91 02319005 A9569 TECHNETIUM TC 99M FANOSELOMAB$ 2,500.24 02319006 A9575 DOTAREM 376.9GM/ML 20ML VIAL$ 622.98 02319007 A9561 TECHNETIUM TC-99M OXIDRONATE$ 82.82 02319008 J2785 REGADENOSON 0.1MG INJ$ 95.48 03300001 HOSP PRIVILEGES APPL FEE$ 339.82 03300003 PT ESCORT/DAY-HI SF WADC$ 258.57 03300004 PT ESCORT/DAY-ALL OTHERS$ 221.62 03300005 PT ESCORT/DAY-CNMI$ 184.70 03303001 VTC FEE$ 177.30 03394001 OFF-ISLAND TRANSPORT-MINIMAL C$ 1,833.81 03394002 OFF-ISLAND TRANSPORT-INTERMEDI$ 3,003.33 03394003 OFF-ISLAND TRANSPORT-CRITICAL$ 4,829.16 04100068 J3490 AGENTS-FLAXEDIL 10 CC$ 12.74 04100134 J3490 AGENTS-PENTHRANE$ 20.94 04200001 J3490 ACETIC ACID 1% SOLN 1000ML$ 6.10 04200002 J2780 ZANTAC 25MG/ML 6ML VIAL$ 57.71 04200003 J3490 TIGECYCLINE 50MG VIAL$ 255.54 04200004 J3470 MAGNESIUM S04 1GM/2ML AMP$ 5.01 04200005 Q2037 INFLUENZA VACCINE .05ML DOSE$ 25.20 04200006 J3490 LACTULOSE SOLN 50% 300ML$ 16.87 04200007 J3490 KAYEXALATE SUSP 20ML$ 5.88 04200008 J3490 NICORETTE GUM$ 0.90 04200009 J8597 METOCLOPRAMIDE SOLN 10MG/10ML$ 1.31 04200010 J3490 ACETAMINOPHEN DROP 15ML$ 5.70 04200011 J3490 MORPHINE ELIX 5CC DOSE$ 4.17 04200012 J3490 KAYEXALATE POWDER 25GM$ 16.83 04200014 J3490 KAYEXALATE SUSP 10ML$ 2.91 04200016 J3490 MORPHINE 20MG/5ML ORAL UD$ 1.25 04200017 J3490 LACTULOSE SYRUP 100ML$ 17.65 04200020 J3490 ACETAMINOPHEN SYR 160MG/5ML UD$ 1.29 04200021 J1642 HEPARIN FLUSH 100U/ML 30ML$ 8.19 04200022 J3490 NITROGLYCERIN 1/150 GR 25$ 5.93 04200023 J3490 FOLIC ACID 5MG/ML 10ML VL$ 38.21 04200024 J3490 QUESTRAN POWDER 450MG$ 4.87 04200025 J3490 TIMOPTIC OPHTH 0.5% 10ML$ 86.92 04200026 J3490 ELASE OINTMENT 10 GM$ 41.63 04200027 J3490 EUCERIN CREAM 30 GM$ 3.56

59 04200028 J3490 ELASE-CHLORO OINT 10GM$ 45.45 04200029 J3490 LUBERIDERM/HC/MENTHOL 4OZ$ 22.62 04200030 J3490 ACETAMINOPHEN 325MG TABLET$ 1.29 04200031 J3490 ANTIHEMOPHILIC F8 1000IU VI$ 1,328.55 04200032 J3490 ACETAZOLAMIDE 250MG TABLET$ 1.29 04200033 J3490 KAYEXALATE W/SORBITOL 500M$ 119.39 04200034 J3490 ACTHAR LYOPHILIZED 40U 1M$ 81.68 04200035 J3490 FER-IN-SOL DROPS 50ML$ 25.73 04200037 J3490 DOCUSATE SODIUM 10MG/10ML UD$ 1.29 04200038 J3490 LACTULOSE 50CC DOSE$ 5.61 04200039 J3490 CECLOR 250MG/5ML 75ML$ 60.51 04200040 J3490 ACETEST TABLET 100'S$ 20.44 04200041 J3490 ACETIC ACID GL 99.7% 1GAL$ 35.10 04200043 J3490 ACTIVATED CHARCOAL 10GR TA$ 1.42 04200044 J7060 DEXTROSE 5% ISOLYTE P 150ML$ 11.64 04200046 J3490 DEXTROSE 5% ISOLYTE P 1000ML$ 14.27 04200047 J3490 STREPTOKINASE 750000 UNIT$ 348.58 04200048 J3490 NEO IN NORM SALINE RET 2%$ 78.57 04200049 J3490 LASIX 10MG/ML ORAL DOSE$ 0.48 04200050 J3490 ACETOHEXAMIDE 250MG TABLET$ 1.29 04200051 J3490 INTRALIPID 10% 250ML$ 33.65 04200052 J3490 ACETAZOLAMIDE 250MG$ 0.46 04200053 J3490 TEGISON 25 MG CAP$ 6.75 04200054 J3490 MERCUROCHROME 10%$ 2.61 04200055 J3490 SODIUM CL PER IV DOSE$ 1.56 04200056 J3490 POTASSIUM ACET PER IV DOSE$ 3.84 04200057 J3490 FOLIC ACID 1MG/0.5ML DOSE INJ$ 3.83 04200058 J3490 SYNALAR OINTMENT 0.025%$ 42.45 04200059 J3490 SORBITAL 25% 200ML$ 10.96 04200061 J3490 ACETONE 16OZ$ 11.45 04200062 J3490 ACETONE 60ML$ 2.61 04200063 J3490 KAYEXALATE SUSP 30ML$ 8.79 04200064 J3490 POTASSIUM CL ORAL DOSE$ 0.71 04200065 J3490 NITROGLYCERIN 1/150GR SL 2$ 10.50 04200066 J3490 DIAMOX ORAL LIQUID DOSE$ 4.17 04200067 J3490 SORBITOL 20% 30ML$ 4.17 04200068 J3490 GLYBURIDE MICRO 3MG TAB$ 2.78 04200069 J3490 HYDROCHLOROTHIAZIDE 50MG/5ML 5$ 2.26 04200070 J3490 APAP W/ CODEINE 240/24 10ML UD$ 2.76 04200072 J3490 CETAPHIL LOTION 8OZ$ 13.89 04200073 J3490 ZAROXOLYN 2.5MG TABLET$ 1.13 04200074 J3490 TENEX 1MG TABLET$ 1.10

60 04200075 J3490 MAGNESIUM S04 5GM/10ML$ 20.99 04200076 J3490 MILK OF MAGNESIA 45ML$ 0.47 04200077 J3490 SODIUM CL ORAL DOSE$ 7.13 04200079 J3490 ISOSORBIDE MONO ER 60MG TAB$ 1.68 04200080 J3490 ACETYLCYSTEINE 20% 10ML$ 22.34 04200081 J7050 NORMAL SALINE 100ML$ 10.43 04200082 J3490 CLEOCIN 300MG INJECTION$ 30.12 04200083 J3490 THORAZINE CONC DOSE$ 0.53 04200084 J3490 CALADRYL LOTION 180ML BT$ 8.82 04200085 J3490 ALDACTONE SUSP DOSE$ 2.26 04200087 J3490 AMPICILLIN 125MG/5ML DOSE$ 5.61 04200088 J3490 AMPICILLIN 250MG/5ML DOSE$ 0.90 04200089 J3490 AMOXICILLIN 250MG/5ML DOSE$ 5.33 04200090 J3490 ASPIRIN 325MG CHEW TAB$ 1.29 04200091 J3490 AMOXICILLIN 125MG/5ML DOSE$ 1.31 04200092 J3490 GOLYTELY 4L BOTTLE$ 48.05 04200093 J3490 CLOBETASOL 0.05% 30GM OINTMENT$ 16.36 04200094 J3490 CLOBETASOL 0.05% 15GM CREAM$ 9.83 04200095 J3490 CLOBETASOL 0.05% 30GM CREAM$ 12.43 04200096 J3490 ISOSORBIDE MONO ER 30MG TAB$ 2.04 04200097 J3490 CECLOR 125MG/5ML 75 ML$ 34.43 04200098 J3490 CALAN SR 240MG$ 2.63 04200099 J3490 LIORESAL ORAL LIQ DOSE$ 2.98 04200100 J3490 NEOMYCIN 2% RET ENEMA 200$ 79.12 04200102 J3490 COUMADIN 2MG TABLET$ 0.79 04200103 J3490 MOTRIN 800MG TABLET$ 1.19 04200104 J3490 VEPESID 100MG/5ML VIAL$ 286.28 04200105 J3490 CYCLOCORT 0.1% 60GM OINT$ 97.80 04200106 J3490 T/GEL SHAMPOO 4-1/2 OZ$ 16.83 04200107 J3490 LIDEX GEL 0.05% 60GM$ 92.69 04200108 J3490 INDERAL ORAL 20MG/5ML DOSE$ 2.61 04200109 J3490 NEOSYNEPHRINE NOSE DRP 1/4$ 9.20 04200110 J3490 ACNOMEL CREAM 30GM$ 6.98 04200112 J3490 SODIUM THIOSULFITE 1GM VL$ 28.05 04200113 J3490 TREXAN 50MG TABLET$ 9.52 04200114 J3490 CORDARONE 200MG TABLET$ 6.17 04200116 J3490 AMPICILLIN 2GM INJECTION$ 32.04 04200117 J3490 MUTAMYCIN 20MG INJECTION$ 1,013.63 04200120 J3490 ACTIFED SYRUP 5ML DOSE$ 1.29 04200121 J3490 ACTIFED 60MG TABLET$ 1.29 04200122 J3490 AMOXICILLIN 125MG/5ML 150ML$ 29.72 04200123 J0295 UNASYN 1.5GM VIAL$ 21.77

61 04200124 J0295 UNASYN 3GM VIAL$ 41.04 04200125 J3490 AMMONIUM CL 100MEQ/20ML VIAL$ 6.91 04200127 J3490 HEALON 150U/ML$ 306.26 04200128 J3490 ANTIHEMOPHILIC F8 520IU VI$ 670.66 04200129 J3490 ACTIVASE 50MG VIAL$ 2,598.54 04200130 J3490 ERYTHROMYCIN 200MG/5ML DOSE$ 0.83 04200131 J3490 BSS PLUS 500ML$ 211.09 04200132 J2250 VERSED 10MG/2ML VIAL$ 23.13 04200133 J3490 GLYCINE IRRIG SOLN 1.5% 4000ML$ 58.34 04200134 J3490 SOTRADECOL 3% 2ML AMP$ 19.14 04200136 J3490 CLARITHROMYCIN 250MG TAB$ 20.07 04200137 J3490 NILSTAT CREAM 15GM$ 3.37 04200138 J3490 PONTOCAINE 1% 2ML AMP$ 9.19 04200139 J3490 PANTOPRAZOLE 40MG/50ML IV SYR$ 58.61 04200140 J3490 POLY-VI-FLOR DROPS 50ML$ 18.20 04200141 J3490 CYCLOGYL 1% EYE DROP 2ML$ 15.61 04200142 J3490 VERSONATE 200MG/ML 5ML$ 53.85 04200143 J3490 CIPRO 250MG TABLET$ 5.94 04200144 J3490 VASOTEC 5MG TABLET$ 1.81 04200145 J3490 PENTAN 300MG INJ$ 455.78 04200146 J3490 VASOTEC 10MG TABLET$ 2.07 04200147 J3490 SELDANE 60MG TABLET$ 2.04 04200148 J0696 ROCEPHIN 1GM INJ$ 101.77 04200149 J3490 CIPRO 500MG TABLET$ 6.97 04200152 J3490 MEVACOR 20MG TAB$ 5.64 04200153 J3490 NOROXIN 400 MG TABLET$ 6.46 04200154 J3490 BUSPAR 5MG TABLET$ 1.52 04200155 J3490 PROZAC 20MG CAPSULE$ 4.95 04200156 J3490 ZIDOVUDINE (AZT) 100MG CAP$ 6.74 04200157 J3490 HALDOL DECANOATE 250MG/5ML VL$ 79.18 04200158 J3490 LOPRESSOR 5MG AMP$ 14.49 04200159 J3490 CHEMO COMPOUNDING$ 15.21 04200160 Q4081 EPOGEN 2000 U/ML VIAL$ 112.16 04200161 J3490 CECLOR 250MG CAPSULE$ 4.34 04200162 J0713 FORTAZ 2GM VIAL$ 106.37 04200163 J3490 AZACTAM 2GM VIAL$ 92.09 04200164 J3490 ARISTOCORT FORTE 40MG/ML$ 11.89 04200165 J3490 BACITRACIN 500U/GM 0.9GM OINT$ 0.24 04200166 J0697 CEFUROXIME 1.5GM/D5W 50ML SYR$ 74.08 04200168 J3490 DIFLUCAN 100MG TAB$ 10.28 04200169 J3490 DIFLUCAN 200 MG TAB$ 16.82 04200170 J3490 NIACIN 500MG TAB$ 1.23

62 04200171 J8560 VEPESID 50 MG CAPSULE$ 52.62 04200172 J3490 PROCARDIA XL 30MG TAB$ 1.98 04200173 J3490 MEXITIL 150MG$ 0.84 04200174 J3490 PROCARDIA XL 60MG$ 3.55 04200175 J3490 BENZOIN COMP TINCT 473ML$ 14.37 04200176 J8521 XELODA 500MG TAB$ 59.55 04200177 J1580 GENTAMICIN PREMIX 80MG INJ$ 6.64 04200178 J3490 AZACTAM 1GM VIAL$ 23.31 04200179 S0073 AZACTAM 500MG VIAL$ 12.86 04200180 J3490 CYANIDE ANTIDOTE$ 558.11 04200181 J3490 ALCOHOL ISOPROPYL 70% 1 GAL$ 24.39 04200182 J3490 ETHOMOLIN 5% INJ 2 ML$ 60.33 04200183 J3490 K-PHOS NEUTRAL$ 0.20 04200185 J3490 DEPAKOTE 250MG TABLET$ 1.64 04200186 J3490 TRASTUZUMAB 440MG VIAL$ 4,435.83 04200189 Q4081 EPOGEN 3000 UNITS$ 186.74 04200190 J3490 ALCOHOL DEHYD 98% 1ML AMP$ 6.38 04200191 J3490 ALCOHOL ETHYL 95% 1GAL$ 17.16 04200192 J3490 ALCOHOL ETHYL 100% 1GAL$ 19.04 04200193 J3490 FAT EMULSION 20% 200ML$ 22.77 04200194 Q4081 EPOGEN 4000 UNITS$ 238.29 04200195 J3490 HALCION 0.125MG TAB$ 1.86 04200196 J3490 CAPOTEN 12.5MG TABLET$ 2.57 04200197 J3490 ANUSOL HC CREAM 1% 1OZ$ 85.34 04200198 J3535 ATROVENT INHALER 14GM$ 147.37 04200199 J3490 BCG IL 81MG SVD$ 553.81 04200200 J3535 PROVENTIL .5% INHAL SOLN 20ML$ 59.93 04200201 J3490 ALLBEE WITH C CAP$ 1.29 04200202 J1205 DIURIL 500MG INJ$ 50.22 04200203 J3490 LACTULOSE SYRUP 20GM/30ML$ 4.71 04200204 J3490 CIPRO 750MG TABLET$ 24.29 04200205 J3490 TAGAMET 400MG TABLET$ 3.38 04200206 J3490 SUPRAX 400MG$ 27.96 04200207 S0191 CYTOTEC 200MCG TAB$ 3.87 04200209 J9045 PARAPLATIN 50MG VIAL$ 266.41 04200210 J3490 PRILOSEC 20MG CAPSULE$ 17.06 04200211 J3490 ALLOPURINOL 300MG TAB$ 1.29 04200212 J3490 BREVIBLOC 100MG/10ML VIAL$ 65.63 04200213 J3490 MARCAINE SPINAL 2ML AMP$ 16.95 04200214 J3490 XYLOCAINE 5% W/DEXT 2ML$ 39.59 04200215 J2704 DIPRIVAN 10MG/ML 20ML$ 61.33 04200216 J3490 SUFENTA 50MG/ML 2ML$ 111.59

63 04200217 J3490 ALFENTA 500MCG/ML 2ML AMP$ 33.38 04200218 J3490 SURVANTA 25MG/ML 8ML VIAL$ 1,271.26 04200219 J0153 ADENOCARD 3MG/ML 2ML$ 109.01 04200220 J3490 ALLOPURINOL 100MG TAB$ 1.29 04200221 J8600 ALKERAN 2MG TABLET$ 1.29 04200222 J3490 DACROISE EYE IRRIG 118ML$ 15.57 04200223 J3490 NEUPOTEN 300MCG$ 60.49 04200225 J3490 AUGMENTIN 500MG TABLET$ 15.57 04200226 J3490 AUGMENTIN 250MG TABLET$ 6.01 04200228 J1570 CYTOVENE 500MG VIAL$ 245.69 04200229 J3490 FOSCAVIR 24MG/ML 250ML$ 494.46 04200230 J3490 ALPHA-CHYMOT 750$ 40.03 04200231 J3490 MAZICON 0.5 MG VIAL$ 148.84 04200232 J3490 HYSKON 100 ML$ 164.24 04200233 J3490 FANSIDAR TABLET$ 12.98 04200234 J3490 LARIMA TABLET$ 32.47 04200235 J3490 MAVICRON 2 MG/ML 10 ML$ 33.76 04200236 J0744 CIPRO 10MG/ML 20ML INJ$ 44.92 04200237 J3030 IMITREX 6 MG INJECTION$ 182.00 04200238 J3490 INTRALIPID 20% 500ML$ 56.45 04200239 J3490 PREPIDIL CERVICAL GEL$ 208.03 04200240 J3490 ALPHA-KERI LOTION 8OZ$ 13.36 04200241 J3490 VITAMIN A 50000 UNIT CAP$ 1.29 04200243 J3490 PRIMAXIN 500MG INJECTION$ 108.57 04200244 J3490 NORVASC 2.5MG TABLET$ 4.56 04200245 J3490 NORVASC 5MG TABLET$ 4.56 04200246 J3490 NORVASC 10MG TABLET$ 7.79 04200247 J2400 NESACAINE 3% 30 ML$ 80.42 04200248 J3490 XYLOCAINE MPF 1% 10ML$ 9.67 04200249 J3490 XYLOCAINE MPF 2% 10ML$ 30.05 04200250 J3490 DOMEBORO SOLUTION 30ML$ 1.29 04200251 J3490 DANTRIUM 40MG VIAL$ 264.62 04200252 J3490 AMANTADINE 100 MG CAP$ 1.29 04200253 J3490 XYLOCAINE W/ EPI MPF 1% 30 ML$ 29.63 04200254 A4649 EMPTY TUBEX 1 ML$ 2.64 04200255 J3490 XYLOCAINE W/ EPI MPF 2% 20 ML$ 32.37 04200256 A4649 EMPTY TUBEX 2 ML$ 2.64 04200258 J3490 OPHTHALGEN 7.5 ML$ 22.95 04200259 J3490 GUAIFENESIN 100MG/5ML UD$ 5.32 04200261 J3490 HYPERAB 10 ML$ 741.36 04200262 J3490 HYPERAB 2ML VIAL$ 223.35 04200263 J3490 TRIMETHOBENZAMIDE 300MG CAP$ 2.25

64 04200264 A4246 IODINE POVIDONE 1% 1.5 GM$ 0.24 04200265 J3490 KAOLIN-PECTIN 30 ML$ 1.29 04200268 J3490 LACTIC ACID 16 OZ$ 69.85 04200269 J3490 LIDOCAINE HCL 2% 2 ML$ 2.59 04200270 S0017 AMINOCAPROIC ACID 5GM/20ML VI$ 44.61 04200271 J3490 MANGANESE 0.1 MG/ML 10 ML$ 2.59 04200273 J3490 METOPIRONE 250 MG$ 5.04 04200274 J3490 MINERAL OIL 10ML$ 4.06 04200275 J3490 PAPAVERINE HCL 30MG/ML 10ML$ 17.81 04200276 J3490 PENTOTHAL READY-TO-MIX 250MG$ 16.04 04200277 J3490 PHENOBARBITAL ELIX 30MG/7.5ML$ 3.26 04200278 J3490 KAYEXALATE POWDER 480GM$ 621.60 04200279 J3490 POTASSIUM CL ORAL 15MG$ 1.25 04200280 J3490 AMINOCAPROIC ACID 500MG TAB$ 1.29 04200281 J3490 POTASSIUM CL ORAL 30MG$ 1.25 04200282 J3490 POTASSIUM CL ORAL 40MG$ 1.25 04200285 J8999 MATULANE 50MG CAPSULE$ 2.77 04200286 J3490 ROBITUSSIN 10ML$ 1.35 04200287 J3490 ROBITUSSIN DM 10ML UD$ 2.48 04200288 J3490 SODIUM LACTATE 10 ML$ 18.74 04200289 J3490 BACTROBAN 2% 15GM 15GM$ 108.57 04200290 J3490 AMINOPHYLLINE 500MG VIAL$ 6.38 04200291 A4649 EMPTY CONTAINER STER 10ML$ 5.08 04200292 A4649 EMPTY CONTAINER STER 30ML$ 9.40 04200293 J3490 SURGILUBE 3GM$ 0.09 04200294 J3490 TETRACYCLINE 1% SOLN 4ML$ 24.10 04200295 J3490 THYMOL CRYSTAL 4OZ$ 70.29 04200296 J3490 TRIPLE-DYE 0.65ML$ 3.45 04200298 A4216 WATER STERILE 10ML INJ$ 2.58 04200299 J3490 XYLOCAINE 1.5% 20ML$ 41.84 04200300 J3490 AMINOPHYLLINE 100MG SUPP$ 3.82 04200301 J3490 ZINC GLUCONATE 100 MG$ 0.09 04200303 J3490 ACACIA GUM 1OZ$ 9.33 04200304 J3490 ACETAMINOPHEN 325MG/10ML UD$ 0.57 04200305 J3490 ACETAMINOPHEN 650MG/20ML UD$ 0.87 04200306 J3490 ACETYLCYSTEINE 10% INHAL 10ML$ 83.79 04200307 J3490 ALUM/MAGNES SIMETH-II 30ML$ 1.25 04200308 J3490 HYDROPHILIC OINTMENT 1LB$ 12.90 04200312 J3490 KAYEXALATE 1GM$ 1.64 04200314 J3490 IOPAMIDOL INJECTION$ 269.01 04200317 J3490 RENOGRAPHIN$ 22.62 04200320 J3490 AMINOPHYLLINE 100MG TABLET$ 1.29

65 04200322 J9000 DOXORUBICIN HCL 50MG INJ$ 396.22 04200329 J3490 DROTRECOGIN ALFA 20MG INJ$ 1,530.83 04200330 J3490 AMITRIPTYLINE 25MG TABLET$ 1.29 04200331 J3490 GABAPENTIN 300MG CAPSULE$ 1.56 04200333 J3490 VORICONAZOLE 50MG TAB$ 24.45 04200334 J3490 VORICONAZOLE 200MG TAB$ 99.69 04200335 J3490 VORICONAZOLE 200MG INJ$ 341.02 04200336 J3490 TDAP VACCINE 0.5ML INJ$ 130.88 04200337 J3490 ALBUTEROL 4MG TAB$ 1.29 04200338 J1642 HEPARIN FLUSH 10U/ML$ 1.44 04200340 J3490 AMMONIA AROMATIC 1 OZ$ 1.89 04200344 J3490 BECLOMETHASONE 40MCG INHAL$ 349.00 04200361 J3490 AMPHOJEL SUSP 30ML DOSE$ 1.29 04200362 J3490 KCL 40MEQ/100ML BAG INJ$ 7.77 04200370 J3490 AMPICILLIN 250MG CAPSULE$ 1.29 04200379 J3490 PANTOPRAZOLE 20MG TAB$ 10.95 04200380 J3490 AMPICILLIN 500MG CAPSULE$ 1.29 04200389 J0295 UNASYN 1.5GM INJ ADDV$ 20.82 04200390 J0295 UNASYN 3GM INJ ADDV$ 40.54 04200392 J3490 AMPICILLIN 125MG/5ML 100ML$ 10.16 04200395 J1956 LEVOFLOXACIN P/MX 250MG/50ML$ 21.07 04200396 J1956 LEVOFLOXACIN 25MG/ML 30ML SDV$ 112.26 04200397 J1956 LEVOFLOXACIN P/MX 750MG/150ML$ 78.10 04200398 J1956 LEVOFLOXACIN P/MX 500MG/100ML$ 64.55 04200399 J3490 LEVOFLOXACIN 250MG TAB$ 12.78 04200400 J3490 AMPICILLIN 250MG INJECTION$ 6.23 04200401 J3490 MAGNESIUM SULFATE 4GM/100ML$ 9.99 04200402 J3490 MAGNESIUM SULFATE 4OGM/1000ML$ 17.99 04200403 J3490 SCLEROSOL INTRAPLEURAL TALC 4G$ 528.60 04200405 90670 PNEUMOCOCCAL VAC 13-VAL 0.5ML$ 418.99 04200406 J3490 PNEUMOCOCCAL VAC 7-VALENT$ 261.59 04200410 J0290 AMPICILLIN 500MG/25MG IV SYR$ 30.18 04200411 J0290 AMPICILLIN 1GM INJECTION$ 10.29 04200414 J3490 AMPICILLIN 250MG/5ML 100ML BT$ 13.70 04200417 J3490 CLINDAMYCIN 300MG CAPSULE$ 1.44 04200419 S0178 LOMUSTINE 10MG CAP$ 39.49 04200420 S0178 LOMUSTINE 40MG CAP$ 84.67 04200424 J3490 DECADRON ELIX 0.5MG/5ML 240ML$ 18.94 04200432 J3490 DEXAMETHASONE 1MG/ML 30ML OS$ 3.30 04200433 J3490 VANCOMYCIN 1GM/D5W 200ML INJ$ 27.25 04200434 J3490 VANCOMYCIN 500MG/D5W 100ML INJ$ 21.17 04200436 J3490 DOXYCYCLINE 100MG INJ$ 144.65

66 04200440 J3490 ANALGESIC BALM-BENGAY 85GM$ 2.56 04200447 J1956 LEVOFLOXACIN 500MG VIAL$ 83.39 04200448 J9065 CLADRIBINE 1MG/ML 10ML VIAL$ 1,101.82 04200456 J3490 NEUTRA-PHOS-K 1.45GM PACKET$ 1.67 04200458 J3490 SODIUM NITRITE 300MG/10ML VIAL$ 604.83 04200460 J3490 ANUSOL SUPPOSITORY$ 8.35 04200467 J3490 RIMANTADINE 100MG TAB$ 4.12 04200468 J3490 DASATINIB 70MG TAB$ 235.41 04200469 J3490 RIBAVIRIN 200MG CAP$ 5.01 04200470 J3490 ANUSOL-HC 25MG SUPPO$ 3.82 04200471 J3490 DEXMEDETOMIDINE 400MCG/100ML P$ 280.85 04200472 J1815 INSULIN REGULAR-PER ML$ 6.87 04200475 J3490 INSULIN HUMAN NPH 70/30 10ML$ 62.98 04200480 J3490 VITAMIN C 250MG TABLET$ 1.29 04200485 J3490 DEXTROSE 20% WATER 500ML$ 46.86 04200489 J3490 DEXTROSE 10% 5ML AMP$ 3.49 04200490 J7060 DEXTROSE 5% WATER 50ML ADD-V$ 4.79 04200491 J7060 DEXTROSE 5% WATER 100ML ADD-V$ 4.91 04200495 J2260 MILRINONE 1MG/ML 10ML SDV$ 18.91 04200497 J3490 MILRINONE 20MG/100ML D5W BAG$ 36.79 04200498 J3490 CARDIOPLEGIC IRRIG SOLN 1000ML$ 108.63 04200500 J3490 ATROPINE 0.4MG/ML 1ML AMP$ 6.38 04200504 J3490 BACTROBAN NS 2% 1GM OINT$ 22.62 04200505 J3535 LEVALBUTEROL 0.63MG/3ML INHAL$ 7.25 04200506 J3490 ARSENIC TRIOXIDE 10MG/10ML VI$ 921.90 04200507 J3490 FAT EMULSION 20% 250ML$ 51.07 04200508 J3490 LORAZEPAM 4MG/ML 1ML VIAL$ 7.50 04200509 J3490 ARIPIPRAZOLE 5MG TAB$ 39.06 04200510 J3490 ATROPINE 1% OPHTH OINT 3.5GM$ 9.41 04200511 J3490 VITAMIN C DROPS-CECON 50ML$ 13.99 04200512 J3490 ATOMOXETINE 40MG CAP$ 19.31 04200514 J3490 QUETIAPINE 100MG TAB$ 15.46 04200515 J3490 HYPERLYTE CR 250 MOL$ 5.41 04200517 J3490 PEGINTERFERON ALFA-2B 50MCG$ 684.97 04200518 J3490 ARIPIPRAZOLE 15MG TABLET$ 34.91 04200519 J3490 VENLAFAXINE 75MG TABLET$ 9.39 04200520 J7636 ATROPINE 2% SOLN 5ML$ 2.32 04200521 J3490 ZIPRASIDONE 40MG CAPSULE$ 11.85 04200525 J3490 ZIPRASIDONE 80MG CAPSULE$ 11.21 04200526 J3490 FLUOXETINE 10MG CAPSULE$ 1.29 04200530 J3490 ATROPINE 1% EYE DRP 15ML$ 2.32 04200532 J3490 ATOMOXETINE 25MG CAPSULE$ 18.69

67 04200533 J3490 SERTRALINE 25MG TABLET$ 1.29 04200534 J3490 OLANZAPINE 5MG TABLET$ 19.35 04200535 J3490 OLANZAPINE 10MG TABLET$ 56.08 04200536 J3490 OLANZAPINE 15MG TABLET$ 50.80 04200537 J3490 OLANZAPINE 20MG TABLET$ 66.90 04200538 J3490 DIVALPROEX ECT 500MG TABLET$ 12.71 04200539 J3490 AZACITIDINE 100MG VIAL$ 765.11 04200540 J3490 ATROPINE 2% SOLN 15ML$ 15.74 04200541 J3490 ATROPINE 1MG/10ML ABBOJECT$ 13.70 04200542 J3490 PSEUDOEPHEDRINE 30MG/5ML 120ML$ 4.49 04200543 J3490 HEPARIN/D5W 12500U/250ML$ 13.59 04200544 J1815 INSULIN ASPART 100U/ML 10ML VI$ 389.93 04200545 J1815 INSULIN GLARCINE 100U/ML 10ML$ 359.05 04200546 J3490 LINEZOLID SUSP 100MG/5ML DOSE$ 35.98 04200547 J3490 NORTRIPTYLINE 50MG CAP$ 7.30 04200550 J3490 AURALGAN OTIC DROPS 15ML$ 7.22 04200551 J3490 CARBAMAZEPINE-XR 400MG TABLET$ 4.33 04200552 J3490 TRAZODONE 100MG TAB$ 1.29 04200556 J3490 RISPERIDONE 2MG TAB$ 16.14 04200557 J3490 RISPERIDONE 3MG TAB$ 21.83 04200558 J3490 RISPERIDONE 4MG TAB$ 29.33 04200559 J3490 PHENYTOIN SODIUM 100MG/4ML UD$ 7.04 04200560 J3490 MORPHINE 15MG TAB UD$ 1.31 04200561 J3490 MORPHINE 30MG TAB UD$ 2.33 04200562 J3490 MORPHINE 25MG/ML ORAL$ 4.97 04200563 J3490 PRUSSIAN BLUE 500MG CAP$ 9.47 04200564 J3490 CA-DTPA 1000MG/5ML AMP$ 234.93 04200565 J3490 ZN-DTPA 1000MG/5ML AMP$ 239.52 04200566 J3490 MEGESTROL SUSP 400MG/10ML$ 22.09 04200568 J3490 RANITIDINE SUSP 150MG/10ML UD$ 35.32 04200569 J3490 VALPROIC ACID SUSP 250MG/5ML$ 3.45 04200570 J3490 BACITRACIN OPHTH OINT 3.5GM$ 3.82 04200571 J3490 BACITRACIN 30GM OINTMENT$ 2.90 04200573 J3490 BUPROPION 100MG TABLET$ 1.29 04200575 J3490 BUPROPION 75MG TABLET$ 1.29 04200577 J3490 FLUTICASONE NASAL SPRAY 16GM$ 328.47 04200578 J3490 PROMETHAZINE SUPP 25MG$ 1.37 04200579 J3490 PROMETHAZINE SUPP 12.5MG$ 3.55 04200580 J3490 BACITRACIN TOP OINT 1LB$ 8.13 04200581 J3490 BACTRIM SINGLE STRENGTN TAB$ 1.29 04200582 J3490 BACTRIM DOUBLE STRENGTH TAB$ 1.29 04200583 J2405 ONDANSETRON 4MG/2ML INJ$ 17.45

68 04200586 J3490 MAGNESIUM SO4 1GM/D5W 100ML PX$ 32.83 04200587 J3490 MAGNESIUM SULFATE 2GM/50ML$ 48.21 04200589 J3490 DOBUTAMINE 500MG/D5W 500ML$ 134.24 04200590 J3490 MEGESTROL SUSP40MG/ML 480ML$ 201.46 04200592 J3490 HEPARIN 12500U/0.45% NS 250ML$ 21.83 04200593 J3490 BASALJEL CAPSULE$ 1.29 04200594 J3490 BASALJEL SUSPENSION DOSE$ 1.29 04200595 J3490 MILRINONE 40MG/200ML INJ BAG$ 159.16 04200596 J3490 ANASTROZOLE 1MG TABLET$ 26.49 04200597 A4216 NORMAL SALINE 0.9% FLUSH 5ML$ 1.84 04200598 J3490 LEVOTHYROXINE 200MCG VIAL$ 48.71 04200599 A4216 NORMAL SALINE 0.9% FLUSH 10ML$ 1.98 04200600 J3490 ZEPHIRAN AQ 1:750 1 GAL$ 2.40 04200601 J3490 LAPATINIB 250MG TABLET$ 75.19 04200603 J3490 SITAGLIPTIN 25MG TABLET$ 18.77 04200604 J3490 SITAGLIPTIN 100MG TABLET$ 18.29 04200605 J3490 IXABEPILONE KIT 15MG INJ$ 1,595.87 04200606 J3490 IXABEPILONE KIT 45MG INJ$ 4,200.56 04200607 J3490 BUMETAMIDE 2.5MG/10ML VIAL$ 6.18 04200610 J3490 BENZOIN TINCTURE 30ML$ 2.90 04200611 J3490 ONDANSETRON 4MG TABLET UD$ 1.29 04200612 J3490 TESSALON CAPSULE$ 1.29 04200618 J3490 POVIDONE 10% OINT 30GM$ 12.71 04200620 J8999 IMATINIB 400MG TABLET$ 338.09 04200621 J3490 COGENTIN 0.5MG TABLET$ 1.29 04200622 J3490 COGENTIN 1MG TAB$ 1.29 04200623 J0515 COGENTIN 1MG/ML 2ML AMP$ 5.87 04200624 J3490 FLUCYTOSINE 250MG CAP$ 67.83 04200625 J3490 MORPHINE SULF 60MG TER$ 1.28 04200629 J3490 LENALIDOMIDE 25MG CAP$ 650.79 04200630 J3490 NITAZOXANIDE 500MG TAB$ 54.25 04200632 J3490 BECLOMETHASONE 80MCG INHAL$ 254.01 04200634 J3490 POLYCITRA LIQUID 480ML BOTTLE$ 59.27 04200637 J2185 MEROPENEM 500MG VIAL$ 71.41 04200638 J3490 MEROPENEM 1GM VIAL$ 159.20 04200639 J3490 LORAZEPAM 4MG/ML 10ML VIAL$ 45.24 04200640 J3490 BETADINE AEROSOL SPRAY 90GM$ 12.55 04200641 J3490 KEPPRA SUSP 100MG/ML 480ML$ 215.38 04200642 J3490 KEPPRA 250MG TABLET$ 1.41 04200643 J3490 KEPPRA 500MG TABLET$ 0.18 04200644 J3490 REVATIO 20MG TABLET$ 30.19 04200645 J3490 LINEZOLID SUSP 100MG/5ML 150ML$ 1,079.40

69 04200647 J3490 TOLVAPTAN 15MG TABLET$ 870.53 04200648 A4216 NORMAL SALINE 0.9% FLUSH 3ML$ 4.49 04200649 J3490 BENDAMUSTINE 25MG/8ML VIAL$ 1,691.01 04200650 A4246 BETADINE SOLUTION 30ML$ 1.16 04200651 A4246 BETADINE DOUCHE CONC 8OZ$ 15.37 04200652 J3490 ALPRAZOLAM 0.25MG TAB UD$ 7.04 04200655 J3490 LISINOPRIL 2.5MG TAB UD$ 7.04 04200657 J3490 VORINOSTAT 100MG CAPSULE$ 222.90 04200658 J3490 BORTEZOMID 3.5MG SDV$ 1,852.23 04200659 J3490 DOBUTAMINE 250MG/D5W 250ML$ 42.19 04200660 A4247 BETADINE SCRUB 1OZ$ 1.29 04200661 J3490 BETAMETHASONE 3MG/ML 5ML VI$ 6.74 04200662 J3490 BETAMETHASONE TABLET$ 1.29 04200663 J3490 INTERFERON ALFA-2B 18MU/3ML IN$ 635.44 04200664 J3490 INTERFERON ALFA-2B 25MU/2.5ML$ 774.04 04200665 J3490 HEPARIN 25000U/D5W 50OML$ 33.27 04200666 J3490 HEPARIN 25000U/0.45% NS 500ML$ 21.99 04200667 J3490 PEMETREXED 100MG VIAL$ 1,225.32 04200668 J3490 PEMETREXED 500MG VIAL$ 4,767.26 04200670 J3490 VALISONE 15GM CREAM$ 16.13 04200671 J3490 VALISONE OINTMENT 15 GM$ 18.39 04200674 J3490 VICODIN 5MG-500MG TAB UD$ 7.04 04200675 J3490 NICARDIPINE/NACL .2MG/ML 200ML$ 687.48 04200676 J3490 NICARDIPINE/D5W 0.2MG/ML 200ML$ 484.45 04200677 J3490 NICARDIPINE 2.5MG/ML 10ML VIAL$ 704.91 04200680 J3490 TRAMADOL HCL 50MG TABLET UD$ 7.04 04200681 J3490 BETHANECHOL 5MG INJ$ 5.26 04200687 J3490 CEFTRIAXONE/DEXTROSE 2GM/50ML$ 117.27 04200688 J3490 CEFTRIAXONE DEX 1GM/50ML$ 58.63 04200690 J3490 BISACODYL 10MG SUPP$ 3.82 04200692 J3490 AMIODARONE P/MIX 150MG/100ML$ 173.97 04200693 J3490 AMIODARONE P/MIX 360MG/200ML$ 231.36 04200700 J3490 BISACODYL 5MG TABLET$ 1.29 04200701 J3490 BORIC ACID OPHTH OINTMENT$ 2.78 04200706 J3490 SODIUM CHLORIDE 14.6% 40ML INJ$ 7.58 04200708 J3490 HYDROCODONE/APAP 5/325MG TAB$ 4.42 04200710 J3490 BORIC ACID TOP OINT 30 GM$ 1.89 04200721 J3490 BRONKOTABS$ 1.29 04200724 J3490 DIMERCAPROL 300MG/3ML INJ$ 110.46 04200730 J8510 MYLERAN 2MG TABLET$ 1.29 04200731 J3490 CAFERGOT TABLET$ 1.29 04200740 J3490 CALADRYL CREAM 1-1/2 OZ$ 6.47

70 04200750 J3490 CALADRYL LOTION 2-1/2 OZ$ 6.98 04200760 J3490 CALAMINE LOTION 120ML BT$ 2.15 04200771 J3490 CALCIUM CL ABBOJECT 21G 10$ 12.97 04200772 J3490 CALCIUM CL 1GM/10ML SRN$ 14.61 04200773 J0610 CALCIUM GLUCONATE 1GM/10ML VI$ 6.38 04200774 J0640 CALCIUM LEUCOVORIN INJECT$ 12.55 04200775 J3490 CALCIUM GLUCONATE 500MG TAB$ 1.29 04200781 J3490 TEGRETOL 200MG TABLET$ 1.29 04200820 J3490 CASCARA EXTRACT 5ML$ 1.29 04200821 J0690 KEFZOL 500MG INJECTION$ 10.55 04200823 J0694 ANCEF 1GM INJECTION$ 20.44 04200826 J3490 SENOKOT-S 8.6MG-50MG TAB$ 1.29 04200830 J3490 CASTOR OIL 60ML$ 2.56 04200831 J3490 CLARITHROMYCIN 125MG/5ML 100ML$ 170.17 04200832 J3490 KEFLEX 125MG/5ML 100ML BT$ 15.65 04200863 J3490 CETAPRED OPHTH OINTMENT$ 16.02 04200864 J3490 VELOSEF 250MG CAPSULE$ 1.89 04200865 J3490 VELOSEF 500MG CAPSULE$ 3.68 04200869 J3490 CENTRAL VENOUS ACCESS KIT$ 32.51 04200870 J3490 CEPACOL GARGLE 120ML$ 3.68 04200880 J3490 CEPACOL SOLN 5 FL OZ$ 3.32 04200881 J3490 CHERRY SYRUP 30ML DOSE$ 1.29 04200882 J8999 LEUKERAN 2MG TABLET$ 1.29 04200890 J3490 CHLOROMYCETIN 250MG CAP$ 2.32 04200900 J3490 CHLOROMYCETIN OPHTH OINT$ 14.75 04200901 J3490 CHLOROMYCETIN OPHTH SOLN$ 19.92 04200910 J3490 CHLOROMYCETIN 150MG/5ML 60ML$ 36.70 04200911 J0720 CHLOROMYCETIN 1GM INJECT$ 20.33 04200920 J3490 CHLORASEPTIC SPRAYER 180ML$ 6.10 04200951 J3490 DIURIL 500MG TABLET$ 1.29 04200952 J3490 DECADRON 0.5MG TABLET$ 1.29 04200953 J3490 CHLOROFORM 16OZ$ 30.47 04200954 J3490 DIURIL SUSPENSION DOSE$ 1.29 04200961 J3490 TACE 12MG CAPSULE$ 1.29 04200962 J3490 PILOCARPINE 1% 15ML OPHTH$ 11.91 04200963 J3490 PILOCARPINE 4%$ 11.91 04200970 Q9967 OMNIPAQUE 300MG I/ML 150ML$ 40.81 04200980 J3490 CHLOR-TRIMETON 4MG TAB$ 1.29 04200982 J3490 CHLOR-TRIMETON 2MG/5ML SYR$ 1.29 04200985 J3490 CHLOR-TRIMETON 12MG TR CAP$ 1.29 04200990 J3230 THORAZINE 25MG/ML 1ML AMP$ 6.38 04200991 J3230 THORAZINE 25MG/ML 10ML VL$ 14.75

71 04201000 J3490 THORAZINE SYR 10MG/5ML DOSE$ 1.29 04201010 J3490 THORAZINE 10MG TABLET$ 1.29 04201020 J3490 THORAZINE 25MG TABLET$ 1.29 04201030 J3490 THORAZINE 50MG TABLET$ 1.29 04201040 J3490 THORAZINE 100MG TABLET$ 1.29 04201041 J3490 THORAZINE CONC 30MG/5ML 12$ 18.68 04201042 J3490 THORAZINE CONC 100MG/5ML$ 55.52 04201043 J3490 THORAZINE 200MG TABLET$ 1.29 04201044 J3490 THORAZINE 150MG CAPSULE$ 1.29 04201045 J3490 THORAZINE 75MG SPANSULE$ 1.29 04201047 J3490 THORAZINE 300MG SPANSULE$ 1.29 04201050 J3490 DIABINESE 250MG TABLET$ 1.29 04201052 J3490 TARACTAN 50MG TABLET$ 1.29 04201061 J3490 CIDEX GALLON$ 64.80 04201062 J3490 CLEOCIN 75MG CAPSULE$ 1.29 04201063 J3490 CLEOCIN 150MG CAPSULE$ 2.32 04201065 S0077 CLEOCIN 600MG INJECTION$ 25.89 04201066 J3490 CLEOCIN TOPICAL 1% 60ML$ 28.08 04201070 J3490 CLINITEST TABLET 24'S$ 6.10 04201071 J3490 CLINITEST TABLET$ 1.29 04201072 J3490 CLINITEST TABLET 100'S$ 11.01 04201080 J3490 CLINITEST SET$ 13.70 04201090 J3370 VANCOMYCIN 750MG/D5W 250ML$ 72.71 04201091 J3490 CLOMID 50MG TABLET$ 7.76 04201100 J3490 COAL TAR APPLICATION$ 1.29 04201105 J3490 NITROFURANTOIN 25MG/5ML 240ML$ 911.60 04201112 J0760 COLCHICINE 1MG/2ML AMP$ 6.38 04201113 J3490 COLYMYCIN-S 25MG/5ML 60ML$ 28.17 04201120 J3490 COLYMYCIN-M 150MG VIAL$ 50.31 04201127 J3490 PRAVASTATIN SODIUM 10MG TAB UD$ 3.87 04201130 J3490 COLYMYCIN-S OTIC DROP 5ML$ 13.70 04201131 J3490 AVEENO BATH 8GM PCK$ 12.55 04201132 J3490 COLLODION 30ML DOSE$ 1.68 04201141 J3490 COMBID SPANSULE$ 1.29 04201150 J3490 COMBISTIX 100'S$ 45.59 04201160 J3490 CORICIDIN-D TABLET$ 1.29 04201170 J3490 ACTH-GEL 40U/ML 5ML$ 29.67 04201191 J3490 CORYBAN-D CAPSULE$ 1.29 04201211 J3490 INTAL 20MG CAPSULE$ 1.29 04201212 J3535 INTAL (SPINHALER) INHALER$ 11.45 04201220 J3490 EURAX CREAM 60GM$ 4.84 04201221 J3490 CRYOPHAKE$ 68.60

72 04201222 J3490 CYTOXAN 50MG TABLET$ 1.51 04201224 J3490 CYTOMEL 5MCG TABLET$ 1.29 04201225 J3490 CYTOMEL 25MCG TABLET$ 1.29 04201229 J3490 VALPROIC ACID 250MG/5ML 473ML$ 48.71 04201230 J3490 PERIACTIN 4MG TABLET$ 1.29 04201232 J3490 PERIACTIN SYR 2MG/5ML DOSE$ 1.29 04201240 J3490 DAPSONE 100MG TABLET$ 1.29 04201241 J3490 DAPSONE 25MG TABLET$ 1.29 04201251 J3490 DARVOCET-N 50MG TABLET$ 1.29 04201260 J3490 DARVON COMPOUND 65 CAPSULE$ 1.29 04201262 J3490 DARVON-N 100MG TABLET$ 1.29 04201270 J3490 DELADUMONE-OB 2ML INJECT$ 57.54 04201271 J3490 PRAVASTATIN SODIUM 20MG TAB UD$ 4.25 04201280 J3490 DESENEX OINTMENT 1.8OZ$ 10.29 04201290 J3490 DESENEX POWDER 1.5OZ$ 8.25 04201310 J3490 DESITIN 40% 30GM OINTMENT$ 3.82 04201320 J1100 DECADRON 4MG/ML 1ML INJECT$ 13.84 04201321 J3490 DECADRON .1% OPHTH SOL 5ML$ 15.65 04201322 J3490 DECADRON 0.75MG TABLET$ 1.29 04201323 J3490 DECADRON 4MG/ML 5ML INJECT$ 30.62 04201324 J3490 DECADRON TURBINAIRE 12.6GM$ 40.67 04201330 J3490 ILOPAN INJ 2ML$ 9.66 04201340 J3490 LEUCOVORIN 100MG VIAL$ 10.40 04201351 J3490 DEXTROSE 50% 50ML VIAL$ 19.83 04201357 J3490 BISMUTH SUB 262MG/15ML 480ML$ 20.64 04201358 A4649 PEPTOBISMOL SUSP 30ML UD$ 7.25 04201402 J3490 DIBUCAINE 1% 30GM OINTMENT$ 5.08 04201420 J3490 BENTYL SYRUP 5ML DOSE$ 1.29 04201421 J3490 BENTYL 10MG CAPSULE$ 1.29 04201422 J0500 BENTYL 10MG/ML 2ML INJ$ 10.66 04201430 J3490 DIENESTROL VAG (DV) CREAM$ 25.17 04201441 J3490 DIETHYLSTILBESTROL 1MG TAB$ 1.29 04201460 J3490 DIGOXIN ELIX 50MCG/ML 60ML$ 5.94 04201470 J1160 DIGOXIN 0.5MG 2ML AMP$ 6.38 04201480 J3490 DIGOXIN 0.25MG TABLET$ 1.29 04201482 J3490 DRAMAMINE 50MG TABLET$ 1.29 04201490 J3490 DIMETAPP ELIXIR 30ML$ 1.51 04201491 J3490 DIMETAPP ELIXIR 5ML DOSE$ 1.29 04201500 J3490 DIMETAPP EXTENTAB$ 1.29 04201510 J3490 COLACE 50MG CAPSULE$ 1.29 04201520 J3490 COLACE 100MG CAPSULE$ 1.29 04201530 J3490 COLACE 100MG/5ML DOSE$ 8.91

73 04201532 J3370 VANCOMYCIN 1.5GM/NS 300ML$ 98.03 04201540 J3490 BENADRYL 25MG CAPSULE$ 1.29 04201550 J3490 BENADRYL 50MG CAPSULE$ 1.29 04201560 J3490 BENADRYL 2% 30GM CREAM$ 12.20 04201570 J3490 BENADRYL ELIX 12.5MG/5ML 5ML D$ 2.05 04201590 J1200 BENADRYL 50MG/ML INJECTION$ 6.38 04201600 J3490 MORPHINE 20MG/5ML 500ML OS$ 138.83 04201601 J3490 BENYLIN EXPT 5ML DOSE$ 1.29 04201610 J3490 LOMOTIL 2.5MG TABLET$ 1.29 04201621 J3490 DILANTIN 50MG INFATAB$ 1.29 04201630 J3490 DILANTIN 100MG CAPSULE$ 1.29 04201640 J3490 DILANTIN 250MG/5ML AMP$ 16.79 04201648 J3490 PHENYTOIN SUSP 125MG/5ML 240ML$ 53.09 04201650 J3490 DILANTIN SUSP 30MG/5ML DOS$ 1.29 04201661 J3490 PERSANTINE 25MG TABLET$ 1.29 04201690 J3490 DONNATAL ELIXIR 5ML DOSE$ 1.29 04201701 J3490 DONNATAL 16.2MG TABLET$ 1.29 04201710 J3490 DONNAGEL SUSPENSION DOSE$ 1.29 04201721 J3490 ACYCLOVIR 1000MG/20ML VIAL$ 158.66 04201730 J3490 DONNAGEL-PG SUSP DOSE$ 1.29 04201742 J3490 SINEQUAN 10MG CAPSULE$ 1.29 04201743 J3490 SINEQUAN 25MG CAPSULE$ 1.29 04201745 J3490 VIBRAMYCIN 100MG TABLET$ 4.57 04201746 J3490 VIBRAMYCIN SUSP 5ML DOSE$ 1.29 04201747 J3490 DRIXORAL TABLET$ 1.29 04201748 J3490 VIBRAMYCIN 100MG INJECT$ 44.22 04201749 J3490 SINEQUAN 50MG CAPSULE$ 1.29 04201750 J3490 SINEQUAN 100MG CAPSULE$ 1.51 04201760 J3490 DYAZIDE CAPSULE$ 1.29 04201770 J3490 ELASE OINTMENT 30GM$ 51.30 04201780 J3490 ELASE-CHLORO OINT 30GM$ 57.04 04201781 J3490 EMETE-CON 50MG VIAL$ 8.75 04201790 J3490 ENEMA FLEET ADULT$ 5.08 04201800 J3490 ENEMA FLEET OIL RETENTION$ 5.08 04201809 J1670 TETANUS IG 250U/2ML INJ$ 159.56 04201810 J3490 ENEMA FLEET PEDIATRIC$ 5.08 04201811 J3490 ENUCLENE 15ML$ 11.45 04201821 J3490 EPHEDRINE 25MG INJECTION$ 6.38 04201823 J3490 EPHEDRINE 25MG CAPSULE$ 1.29 04201836 J3490 EPIFRIN 1% OPHTH 5ML$ 11.29 04201840 J3490 EPINEPHRINE 1MG/ML AMP$ 6.38 04201842 J3490 EPINEPHRINE ABBOJECT 21G 1$ 14.99

74 04201843 J3490 ERGOTRATE 0.2MG TABLET$ 1.29 04201844 J3490 EPINEPHRINE 1MG/10ML SRN$ 13.36 04201851 J1364 ERYTHROMYCIN 500MG INJ$ 10.16 04201852 J3490 ERYTHROMYCIN 1GM IV$ 16.79 04201860 J3490 ERYTHROMYCIN 250MG TABLET$ 1.29 04201880 J3490 ILOSONE 100MG/ML 10ML$ 13.36 04201890 J3490 ILOSONE 125MG/5ML 100ML$ 15.50 04201900 J3490 ILOSONE 125MG CHEWABLE TAB$ 1.29 04201911 J3490 DELESTROGEN 20MG/ML 1ML$ 16.02 04201920 J3490 PREMARIN 1.25MG TABLET$ 1.29 04201922 J3490 PREMARIN 0.625MG TABLET$ 1.29 04201924 J3490 PREMARIN 2.5MG TABLET$ 1.29 04201930 J3490 EDECRIN 50MG TABLET$ 1.29 04201931 J3490 EDECRIN 50MG INJ 50ML$ 17.04 04201940 J3490 MYAMBUTOL 400MG TABLET$ 1.16 04201951 J3490 ETHER 4OZ$ 10.79 04201954 J3490 PARSIDOL 100MG TABLET$ 1.29 04201962 J3490 ETRAFON FORTE TABLE$ 1.29 04201980 J3490 EUTRON 25MG TABLET$ 1.29 04201991 J3490 FESTAL TABLET$ 1.29 04201992 J3490 BSS EYE SOLN 15ML$ 24.39 04202000 J3490 FERGON 325MG TABLET$ 1.29 04202010 J3490 FERROUS SO4 DROPS 50 ML$ 14.12 04202012 J3490 FER-IN-SOL SYRUP 5ML DOSE$ 1.29 04202020 J3490 FERROUS SULFATE 325MG TAB$ 1.29 04202030 J3490 FEOSOL SPANSULE$ 1.29 04202031 J3490 FILTER RPM$ 1.51 04202032 J3490 EFUDEX CREAM 5% 25GM$ 26.81 04202033 J3490 FLOURESCIN OPH SOL 2% 15ML$ 3.01 04202034 J3490 EFUDEX SOLN 2% 10ML$ 2.69 04202035 J3490 FLOUROURACIL 500MG/10ML VIAL$ 6.38 04202040 J3490 SYNALAR 0.025% CREAM 15GM$ 12.09 04202041 J3490 SYNALAR SOLUTION 20ML$ 15.27 04202042 J3490 SYNALAR 0.025% CREAM 30GM$ 13.99 04202060 J3490 PROLIXIN ENANTHATE DOSE$ 17.94 04202062 J3490 PROLIXIN 5MG TABLET$ 1.29 04202071 J3490 CORDRAN-SP CRM 0.05% 15GM$ 14.61 04202080 J3490 CORDRAN-SP CRM 0.025% 30GM$ 16.26 04202081 J3490 CORDRAN OINT 0.025% 30GM$ 16.26 04202090 J3490 CORDRAN-N CREAM 15GM$ 16.26 04202100 J3490 CORDRAN LOTION 0.05% 15ML$ 12.71 04202110 J3490 CORDRAN OINT 0.025% 15GM$ 14.61

75 04202112 J7120 LR 1000ML+PITOCIN 20U IV$ 23.42 04202113 J3490 FOLVITE 1MG TABLET$ 1.29 04202114 J3490 LIDEX 0.05% 15GM CREAM$ 14.75 04202120 J3490 FORMALDEHYDE 37% 1GAL$ 27.47 04202121 J3490 FORMALDEHYDE SOLN PINT$ 5.26 04202123 J3490 LASIX 100MG 10ML INJ$ 20.08 04202124 J1940 LASIX 20MG/2CC INJ$ 6.38 04202125 J3490 LASIX 20MG TABLET$ 1.29 04202150 J3490 ACETYLCYSTEINE 10% 1CC DOSE$ 3.22 04202170 J3490 GELUSIL SUSPENSION DOSE$ 1.29 04202180 J3490 GELUSIL TABLET$ 1.29 04202190 J3490 GARAMYCIN 1% CREAM 15GM$ 17.54 04202191 J3490 GARAMYCIN OPHTH SOLUTION$ 14.75 04202192 J3490 GARAMYCIN OINTMENT 15GM$ 17.54 04202193 J3490 GARAMYCIN OPHTH OINT 3.5GM$ 14.75 04202200 J1580 GARAMYCIN 80MG/2ML INJECT$ 16.79 04202202 J3490 GEOCILLIN 382MG TABLET$ 1.68 04202211 J3490 GLAUCON OPHTH SOLN 1% 10ML$ 18.80 04202212 J3490 GLAUCON OPHTH SOLN 2% 2ML$ 19.45 04202213 J3490 ROBITUSSIN EXPECTORANT 5ML$ 1.29 04202214 J3490 ROBITUSSIN DM SYRUP 5ML UD$ 1.29 04202221 J3490 GLYCERIN SOLUTION 16OZ$ 12.97 04202222 J3490 GLYCERIN SUPPOSITORY PEDS$ 3.82 04202234 J3490 ROBITUSSIN AC SYRUP 5ML UD$ 1.29 04202241 J3490 ROBINUL 1MG TABLET$ 1.29 04202243 J3490 NITROGLYCERIN 1/100 GR 100$ 5.43 04202244 J3490 NITROGLYCERIN 1/150 GR 100$ 5.43 04202245 J3490 NITROGLYCERIN 1/200 GR 100$ 5.43 04202251 J3490 ISMELIN 10MG TABLET$ 1.29 04202252 J3490 GRISEOFULVIN 250MG TABLET$ 1.29 04202253 J3490 ISMELIN 25MG TABLET$ 1.29 04202254 J3490 HALDOL 2MG TABLET$ 1.29 04202255 J3490 HALOG CREAM 0.1% 60GM$ 44.84 04202261 J3490 HALOTEX 30GM CREAM$ 26.68 04202262 J3490 HALOTHANE 250ML$ 42.77 04202290 J3490 HEB CREAM 30GM$ 1.29 04202300 J3490 PHISOHEX 30ML$ 1.29 04202321 J3490 HYDREA 500MG CAP$ 1.89 04202326 J3490 APRESOLINE 25MG TABLET$ 1.29 04202327 J0360 APRESOLINE 20MG INJECTION$ 4.95 04202328 J3490 APRESOLINE 50MG TABLET$ 1.29 04202330 J3490 HCTZ 50 MG TABLET$ 1.29

76 04202331 J3490 HYDROCORTISONE POWDER 1GM$ 9.92 04202332 J3490 HCTZ 25MG TABLET$ 1.29 04202350 J3490 HYDROCORTISONE 0.5% CRM 30GM$ 6.47 04202360 J3490 HYDROCORTISONE CRM 1% 30GM$ 7.13 04202380 J3490 SOLU-CORTEF 100MG/2ML VIAL$ 13.20 04202400 J3490 DELALUTIN 250MG/ML 5ML VL$ 20.94 04202410 J3490 VISTARIL 50MG/ML 1ML INJ$ 6.38 04202411 J3490 ATARAX SYRUP 5ML DOSE$ 1.29 04202412 J3490 ATARAX 25MG TABLET$ 1.29 04202413 J3490 ATARAX 10MG TABLET$ 1.29 04202415 J3490 TOFRANIL 25MG TABLET$ 1.29 04202416 J3490 MOTRIN 400MG TABLET$ 1.29 04202420 J3490 INDOMETHACIN 25MG CAPSULE$ 1.29 04202431 J3490 SODIUM IODIDE CRYSTAL$ 4.18 04202440 J3490 TELEPAQUE TABLET$ 1.39 04202450 J3490 PANTOPAQUE INJECTION$ 26.44 04202454 J3490 IPECAC SYRUP 30ML$ 2.69 04202460 J1750 IMFERON 10ML INJ$ 42.81 04202480 J3490 INH 50MG/5ML SOLUTION$ 1.29 04202481 J3490 INH 100MG/5ML INJECTION$ 6.38 04202490 J3490 INH 100MG TABLET$ 1.29 04202495 J3490 ISUPREL 10MG SL GLOSSET$ 1.29 04202503 J3490 ISUPREL 0.2MG INJ$ 6.38 04202504 J3490 SORBITRATE 5MG TABLET$ 1.29 04202505 J3490 ISORDIL TB 10MG$ 1.29 04202512 J3490 ISOPTO PLAIN 15ML$ 12.71 04202514 J3490 ISOPTO CETAMID 15%$ 16.02 04202516 J3490 ISOPTOCARPINE OPHT 2% 15ML$ 14.85 04202517 J3490 ISOPTOCARPINE OPHT 3% 15ML$ 15.50 04202518 J3490 ISOPTO CETAPRED 5ML$ 18.92 04202519 J3490 ISOPTO P-ES 15ML$ 19.70 04202560 J3490 KAOPECTATE SUSP 30ML$ 2.02 04202562 J3490 KARAYA GUM PWD 30GM$ 5.70 04202570 J3490 KETALAR 500MG/10ML VIAL$ 40.88 04202580 J3490 KETALAR 200MG/20ML VIAL$ 19.70 04202613 J3490 LEVOPHED 0.1% 4ML AMP$ 7.13 04202620 J3490 LIBRAX CAP$ 1.29 04202621 J3490 LIDOCAINE BRISTOJECT$ 13.36 04202630 J3490 LIDOCAINE 1% 30ML INJ$ 13.36 04202631 J2001 LIDOCAINE 2% 30ML INJ$ 13.36 04202640 J3490 LIDOCAINE 5% 35GM OINT$ 11.45 04202641 J3490 XYLOCAINE VISCOUS 2% 100ML$ 14.12

77 04202642 J3490 XYLOCAINE 2% W/ EPI 50ML$ 6.86 04202644 J3490 XYLOCAINE 1% W/ EPI 50ML$ 5.70 04202645 J3490 XYLOCAINE CARDIAC 100MG$ 14.61 04202646 J3490 XYLOCAINE JELLY 2% 30ML$ 11.34 04202648 J3490 XYLOCAINE CARD 1GM 25ML SD$ 9.92 04202650 J3490 LINCOCIN 500MG CAPSULE$ 2.05 04202651 J3490 LINCOCIN 250MG CAPSULE$ 1.31 04202660 J3490 LINCOCIN 600MG INJECTION$ 11.91 04202671 J3490 ESKALITH 300MG CAPSULE$ 1.29 04202690 J3490 SURGILUBE 4OZ$ 1.68 04202710 J3490 MAALOX SUSP PER DOSE$ 1.29 04202712 J3490 MAALOX SUSP 12OZ$ 15.27 04202740 J3490 MILK OF MAGNESIA SUSP 30ML UD$ 1.29 04202741 J3490 MILK OF MAGNESIA SUSP 60OZ$ 2.32 04202750 J3490 MAGNESIUM SO4 ABBO 10ML$ 6.38 04202751 J3490 MAGNESIUM SO4 ABBO 5ML$ 14.85 04202754 J3490 MANNITOL 20% 500ML$ 35.71 04202760 J2150 MANNITOL 25% 50ML$ 6.47 04202761 J3490 MARAX TABLET$ 1.29 04202762 J3490 MARAX DF SYRUP 5ML DOSE$ 1.29 04202770 J3490 MASSENGILL POWDER 3OZ$ 4.95 04202771 J3490 MAXITROL OPHTH SOLN 5ML$ 29.46 04202774 J3490 MAXITROL OPHTH OINT 3.5GM$ 24.93 04202781 J8597 ANTIVERT 12.5MG TABLET$ 1.29 04202782 J3490 ANTIVERT 25MG TABLET$ 1.29 04202788 J3490 BONINE 25MG CHEW TABLET$ 1.29 04202810 J3490 PROVERA 10MG TABLET$ 1.39 04202820 J3490 PONSTEL 250MG CAPSULE$ 1.29 04202830 Q9963 GASTROGRAFIN 37% 120ML$ 25.52 04202850 J3490 MEPHYTON 5MG TAB$ 1.29 04202861 J3490 MEPIVACAINE 1% 50ML$ 9.66 04202863 J3490 MEPIVACAINE 2% 50ML$ 11.18 04202891 J8999 PURINETHOL 50MG TABLET$ 1.29 04202900 J3490 LEVOCARNITINE 100MG/ML DOSE$ 1.29 04202901 J3490 LEVOCARNITINE 200MG/ML 5ML AMP$ 141.40 04202921 J3490 PHENYLEPHRINE 20MG/NSS 250ML$ 52.09 04202961 J3490 HIPREX 1GM TABLET$ 1.29 04202970 J3490 MANDELAMINE 1GM$ 1.29 04202971 J3490 ROBAXIN 500MG TABLET$ 1.29 04202980 J3490 STAPHCILLIN 1GM INJ$ 11.29 04202981 J3490 TAPAZOLE 10MG TABLET$ 1.29 04202985 J8610 METHOTREXATE 2.5MG TABLET$ 1.29

78 04202986 J9260 METHOTREXATE 50MG VIAL$ 51.69 04203003 J3490 METHANOL 473ML$ 15.74 04203020 J3490 ALDOMET 250MG TABLET$ 1.29 04203021 J3490 ALDOMET 500MG TABLET$ 1.29 04203030 J2210 METHERGINE 0.2MG/ML 1ML AMP$ 6.38 04203040 J3490 METHERGINE 0.2MG TABLET$ 1.29 04203050 J7509 MEDROL TB 4MG$ 1.29 04203060 J3490 MEDROL TOP 0.25% 30MG$ 25.67 04203061 J8999 MEGACE 40MG TABLET$ 3.59 04203070 J2920 SOLU-MEDROL 40MG VIAL$ 18.42 04203071 J3490 SOLU-MEDROL 1000MG VIAL$ 265.25 04203072 J1030 DEPO-MEDROL 40MG/ML$ 16.02 04203073 J3490 SANSERT 2MG TABLET$ 1.29 04203075 J3490 MINTEZOL SUSP 5CC DOSE$ 1.29 04203077 J3490 FLAGYL 250MG TABLET$ 2.56 04203079 J3490 MICRONEFRIN INHAL 30ML$ 24.77 04203081 J3490 MYCOLOG CREAM 15GM$ 23.63 04203091 J3490 MYDRIACYL OPHTH 0.5% 15ML$ 27.71 04203092 J3490 MYDRIACYL 1% 15ML OS$ 31.99 04203101 J3490 NALDECON SYRUP DOSE$ 1.29 04203103 J3490 NARCAN 0.4MG AMP$ 19.04 04203104 J3490 DECA-DURABOLIN 100MG/ML 2M$ 61.75 04203110 J3490 NATALIN TABLET$ 1.29 04203122 J3490 NEO-CORTEF 0.5% DROPS$ 17.77 04203150 J3490 NEO-MEDROL OINT 30 GM$ 25.67 04203160 J3490 NEOMYCIN OINTMENT 30GM$ 8.39 04203161 J3490 NEOMYCIN SOLN 125MG/5ML DOSE$ 1.29 04203163 J3490 NEOMYCIN 500MG TABLET$ 1.29 04203164 J3490 NEOMYCIN 500MG INJECTION$ 16.79 04203180 J3490 NEOSPORIN OPHTH OINT$ 9.04 04203181 J3490 NEOSPORIN OPHTH SOLN$ 11.71 04203190 J3490 TRIBIOTIC OINT 30GM$ 9.04 04203191 J3490 NEOSPORIN GU IRRIG 1ML AMP$ 6.38 04203200 J3490 NICOTINIC 50MG TABLET$ 1.29 04203204 J3490 FURADANTIN 50MG CAPSULE$ 1.29 04203220 J3490 MACRODANTIN 50MG CAP$ 1.29 04203230 J3490 MACRODANTIN 100MG CAP$ 1.51 04203231 J3490 ENALAPRIL 1MG/ML ORAL SUSP$ 10.32 04203283 J3490 NORLUTATE 5MG TABLET$ 1.29 04203285 J1800 PROPRANOLOL 1MG INJECTION$ 27.41 04203310 J3490 AVENTYL 25MG CAPSULE$ 1.29 04203370 J3490 NYSTATIN OINTMENT 15GM$ 14.61

79 04203380 J3490 NYSTATIN ORAL SUSP 60ML$ 41.76 04203390 J3490 NYSTATIN 500000U TAB$ 1.29 04203410 J3490 ORNADE SPANSULE$ 1.29 04203440 J3490 AFRIN 0.05% NASAL SPRAY 15ML$ 6.86 04203450 J3490 TETRACYCLINE 500MG CAP$ 1.29 04203452 J3490 TETRACYCLINE 250MG CAP$ 1.29 04203453 J3490 TERRAMYCIN 100MG AMP$ 6.38 04203470 J3490 TERRAMYCIN OPHTH OINT$ 9.04 04203500 J3490 TERRAMYCIN VAGINAL TAB #1$ 1.29 04203510 J2590 PITOCIN 10U/ML VIAL$ 6.38 04203511 J3490 CHOLEDYL 100MG TABLET$ 1.29 04203530 J3490 PENICILLIN G K 1MU INJ$ 6.38 04203540 J3490 PENICILLIN G K 5M U INJ$ 11.01 04203550 J3490 PENICILLIN G 400000U TAB$ 1.29 04203570 J3070 TALWIN 30MG/ML INJ$ 6.38 04203580 J3490 TALWIN-NX 50MG TABLET$ 1.29 04203590 J3490 PERI-COLACE CAPSULE$ 1.29 04203591 J3490 PERI-COLACE SYRUP 1OZ$ 1.29 04203600 J3490 PETROLATUM OINTMENT 30GM$ 1.39 04203601 J3490 PERI DIALYSIS 4.25% 2000ML$ 40.67 04203610 J3490 MINERAL OIL 30ML$ 1.39 04203661 J3490 NITRAZINE PAPER$ 19.20 04203662 J3490 PYRIDIUM 100MG TABLET$ 1.29 04203663 J3490 PYRIDIUM 200MG TABLET$ 1.29 04203680 J1610 GLUCAGON 1MG/ML INJ$ 70.93 04203682 J3490 PHENOBARBITAL ELIX 5ML DOSE$ 1.29 04203683 J3490 PHENOL CRYSTAL 1OZ$ 2.56 04203700 J3490 PENICILLIN VK 125MG/5ML 100ML$ 7.88 04203720 J3490 PENICILLIN VK 250MG TABLET$ 1.29 04203721 J3490 PENICILLIN VK 500MG TABLET$ 1.29 04203741 J3490 BUTAZOLIDIN 100MG TABLET$ 1.29 04203742 J3490 PHOSPHOLINE IODIDE .06% 5M$ 11.82 04203743 J3490 PHOSPHOLINE IODIDE.125% 5M$ 13.70 04203744 J3490 PHOSPHOLINE IODIDE .03% 5M$ 11.01 04203750 J3490 PHOSHO SODA 6OZ$ 3.32 04203770 J3430 VITAMIN K 1MG/0.5ML AMP$ 6.38 04203790 J3490 PROTENATE 5% 250ML$ 198.91 04203810 J3490 POLY-VI-SOL DROPS 50ML$ 15.09 04203821 J3490 POTABA CAPSULE$ 1.29 04203830 J3480 POTASSIUM CL 40MEQ 20ML AMP$ 7.13 04203831 J3480 POTASSIUM CL 20MEQ IV DOSE$ 6.38 04203832 J3480 POTASSIUM CL 30MEQ IV DOSE$ 6.38

80 04203833 J3490 POTASSIUM CL 20MEQ 15ML DOSE$ 1.29 04203834 J3480 POTASSIUM CL 60MEQ 30ML VL$ 6.38 04203851 J3490 EFODINE OINT 0.9GM/PK$ 1.29 04203871 J3490 PREDNISONE 5MG TABLET$ 1.29 04203880 J3490 PRIMIDONE 250MG TABLET$ 1.29 04203900 J3490 BENEMID 500MG TABLET$ 1.29 04203901 J3490 PRONESTYL 250MG INJECTION$ 1.29 04203902 J2690 PRONESTYL 100MG INJECTION$ 24.39 04203910 J0780 COMPAZINE 5MG/ML 2ML AMP$ 6.38 04203911 S0183 COMPAZINE 5MG SYRUP DOSE$ 1.29 04203912 Q0164 COMPAZINE 5MG TABLET$ 1.29 04203920 J3490 SPARINE 50MG INJECTION$ 6.38 04203930 J2550 PHENERGAN 25MG AMP$ 6.38 04203940 J2550 PHENERGAN 50MG AMP$ 6.38 04203941 J3490 PHENERGAN SYRUP 5ML$ 1.29 04203951 J3490 PROBANTHINE 15MG TABLET$ 1.29 04203970 J3490 DARVON 65MG CAPSULE$ 1.29 04203972 J3490 PROPRANOLOL 10MG TABLET$ 1.29 04203981 J3490 PROPYLTHIOURACIL 50MG TAB$ 1.29 04204000 J3490 DOCUSATE SODIUM 50MG/5ML 480ML$ 11.26 04204001 J3490 SUDAFED 30MG TABLET$ 1.29 04204010 J3490 METAMUCIL 454GM$ 1.29 04204020 J3490 PYRIDOXINE 50MG TABLET$ 1.29 04204021 J3415 PYRIDOXINE 100MG INJ$ 9.12 04204030 J3490 QUINIDIN GLUCO 80MG/ML 10M$ 16.26 04204041 J3490 QUINIDIN 200MG TABLET$ 1.29 04204050 J3490 QUIBRON CAPSULE$ 1.29 04204060 J3490 QUIBRON ELIXIR DOSE$ 1.29 04204072 J3490 RENOGRAFIN-60 50ML$ 13.70 04204080 J3490 RESERPINE INJECTION$ 6.38 04204090 J3490 RESERPINE 0.25MG TABLET$ 1.29 04204091 J3490 RIFAMPIN 300MG CAPSULE$ 3.05 04204100 J3490 ROBAXISAL TABLET$ 1.29 04204122 J3490 AZULFIDIN 500MG TABLET$ 1.29 04204130 J3490 SALICYLIC ACID POWDER 100GM$ 1.29 04204160 J3490 SCOPOLAMINE 0.4MG/1ML VIAL$ 6.38 04204161 J3490 SEBULEX SHAMPOO 120ML$ 7.62 04204162 J3490 SEBUTONE SHAMPOO 120ML$ 9.41 04204163 J3490 KWELL SHAMPOO 2OZ$ 9.78 04204165 J3490 KWELL LOTION 2OZ$ 9.78 04204171 J3490 SELSUN LOTION 2.5% 120ML$ 13.36 04204183 J3490 SEPTRA 400-80MG TABLET$ 1.29

81 04204190 J3490 SILVER NITRATE APP 100'S$ 30.37 04204196 J3490 PYRIDOXINE 12.5MG TAB$ 1.01 04204240 J3490 CLONAZEPAM 0.5MG TAB$ 1.01 04204242 J3490 SODIUM BICARB 10GR TAB$ 1.29 04204244 J3490 SODIUM BICARBONATE 5GR TAB$ 1.29 04204250 J3490 TUBERCULIN 5TU/0.1ML 1ML VIAL$ 77.48 04204251 J3490 TEGOPEN 250MG CAPSULE$ 1.76 04204253 J3490 SODIUM CL 0.9% 5ML INHAL$ 1.29 04204254 J3490 SODIUM CL INJECT 5ML$ 6.38 04204255 J1644 HEPARIN 1000 UNITS$ 10.66 04204256 J1644 HEPARIN 1000U/ML 10ML$ 10.66 04204261 J3490 S0DIUM IODIDE 1GM INJECT$ 6.38 04204266 J3490 SYNTHROID 0.1MG TABLET$ 1.29 04204267 J3490 SYNTHROID 0.15MG TABLET$ 1.29 04204268 J3490 SULFACETAMIDE 10% OP/SOL 15ML$ 14.61 04204270 J3490 PROSTAPHLIN 250MG CAP$ 1.68 04204271 J2700 PROSTAPHLIN 250MG INJECT$ 6.23 04204272 J3490 PROSTAPHLIN 250MG/5ML 100ML$ 33.79 04204273 J3490 PROSTAPHLIN 500MG INJECT$ 11.71 04204274 J3490 PROSTAPHLIN 1GM INJ$ 22.49 04204275 J3490 PROSTAPHLIN 500MG CAPSULE$ 3.05 04204281 J3490 SODIUM THIOSULFATE INJECT$ 6.38 04204292 J3490 BICILLIN LA 2.4MU/4ML INJ$ 118.92 04204293 J9040 BLEOMYCIN 15U VIAL$ 432.09 04204301 J3490 BLEOMYCIN 30U VIAL$ 158.32 04204302 J3490 CAFFEINE CIT 20MG/ML 3ML VIAL$ 174.56 04204303 J3490 CAFFEINE CITRATE 60MG/3ML OS$ 116.91 04204310 J3490 ALDACTONE 25MG TABLET$ 1.29 04204315 J3490 LEUCOVERIN CALCIUM 350MG INJ$ 58.14 04204317 J3490 LEUCOVORIN CALCIUM 5MG TAB UD$ 9.64 04204319 J3490 CETACAINE 56GM SPRAY$ 86.45 04204322 J3490 BENZOCAINE SPRAY$ 157.67 04204332 J3000 STREPTOMYCIN 1GM INJECT$ 6.38 04204333 J3490 CISPLATIN 1MG/ML 100ML VIAL$ 569.78 04204334 J0698 CEFOTAXIME 1000MG/50ML IV SYR$ 34.60 04204338 J3490 CLONAZEPAM 0.25MG TAB$ 0.91 04204340 J3490 ANECTINE 500MG VIAL$ 6.38 04204350 J3490 GANTRISIN SUSP 5ML DOSE$ 1.29 04204356 J3490 NEO/POLY/BACI 15GM OINT$ 12.82 04204357 J9120 DACTINOMYCIN 0.5MG/3ML INJ$ 62.32 04204371 J3490 SUS-PHRINE AQ SUSP INJ$ 6.38 04204384 J3490 DEXTROSE 25% 10ML INJ$ 35.97

82 04204385 J3490 DEXTROSE 50% 50ML IV SYRINGE$ 34.79 04204387 J2597 DESMOPRESSIN 4MCG/ML AMP$ 22.09 04204388 J3490 DESMOPRESSIN 40MCG/10ML VIAL$ 487.75 04204392 J3490 DIPROSONE 0.05% 45GM CREAM$ 130.26 04204402 J3490 DOXAPRAM 400MG/20ML INJ$ 143.88 04204405 J3490 DIPH-TET VACC ADULT 7.5ML VIAL$ 573.26 04204408 90714 DIP-TET VACC ADULT 0.5ML INJ$ 37.73 04204411 J3490 DACARBAZINE 200MG VIAL$ 57.17 04204425 J3490 BENZOCAINE 20% ORAL ANESTH UD$ 54.20 04204438 J3490 ALBENDAZOLE 200MG TABLET$ 35.06 04204440 J3490 TESTOSTERONE 100MG INJECT$ 11.45 04204441 J3490 TES-TAPE 100 TEST 150$ 12.71 04204442 J3490 ETHIN EST 35MCG/NORETH 0.4MG T$ 5.87 04204445 J3490 ETHIN EST 20MCG/NORETH ACET 1M$ 5.73 04204447 J3490 RITUXIMAB 10MG/ML 10ML VIAL$ 697.26 04204448 J3490 RITUXIMAB 10MG/ML 50ML VIAL$ 2,309.97 04204452 J3490 VITAMIN C 500MG/ML 50ML VIAL$ 56.18 04204454 J3490 ASCORBIC ACID 1GM/2ML AMP$ 7.42 04204458 J3490 PRAZIQUANTEL 600MG TAB UD$ 63.98 04204459 J3490 INDIGO CARMINE 8MG/ML 5ML AMP$ 34.14 04204460 J3490 METHYLENE BLUE 1% 1ML VIAL$ 73.49 04204461 J3490 TETRACAINE OPHTH SOLN 15ML$ 12.20 04204469 J3490 MITOXANTRONE 25MG/12.5ML VIAL$ 2,012.93 04204476 J3490 MYCOLOG OINTMENT 15GM$ 7.86 04204487 J3490 NALOXONE 0.4MG/ML 1ML SYR$ 6.23 04204489 J3490 CALCIUM GLUB 1.8GM/5ML 480ML B$ 55.69 04204500 J1270 DOXERCALCIFEROL 4MCG/2ML AMP$ 30.46 04204501 J3490 LABETALOL 100MG TABLET$ 1.73 04204503 J3490 LABETALOL 300MG TABLET$ 2.25 04204520 J3490 TETRACYCLINE SYR 125MG/5ML DOS$ 1.29 04204521 J3490 THIAMINE 100MG TABLET$ 1.29 04204522 J3411 THIAMINE 100MG INJECTION$ 6.38 04204524 J1580 GENTAMICIN 100MG VIAL ADV$ 8.16 04204525 J1580 GENTAMICIN 800MG/20ML VIAL$ 68.23 04204530 J3490 MERTHIOLATE 1:1000$ 1.51 04204541 J3490 MERTHIOLATE TINCTURE 30ML$ 1.89 04204542 J3490 THIOGUANINE 40MG TABLET$ 1.76 04204550 J3490 MELLARIL 25MG TABLET$ 1.29 04204560 J3490 MELLARIL 50MG TABLET$ 1.29 04204570 J3490 MELLARIL 100MG TABLET$ 1.29 04204572 J3490 NAVANE CONCENTRATE 120ML$ 91.69 04204573 J3490 NAVANE 10MG CAPSULE UD$ 1.29

83 04204574 J3490 NAVANE 20MG CAPSULE UD$ 1.51 04204580 J3490 NAVANE 2MG CAPSULE UD$ 1.29 04204581 J3490 NAVANE 1MG CAPSULE$ 1.29 04204582 J3490 NAVANE 2MG IM DOSE$ 6.38 04204590 J3490 NAVANE 5MG CAPSULE UD$ 1.29 04204591 J3490 THYROID 1GR TABLET$ 1.29 04204595 J3490 THYROID 1/4GR TABLET$ 1.29 04204600 J3490 TINVER LOTION 6OZ$ 20.33 04204601 J3490 TITRALAC 650MG TABLET$ 1.29 04204610 J3490 TOLINASE 250MG TABLET$ 1.29 04204620 J3490 ORINASE 500MG TABLET$ 1.29 04204630 J3490 TINACTIN 1% CREAM 15GM$ 10.16 04204640 J3490 TINACTIN 1% POWDER 45GM$ 6.86 04204650 J3490 TINACTIN 1% SOLN 10ML$ 8.75 04204661 J3490 KENALOG-40 1ML INJ$ 13.36 04204662 J3490 KENALOG 0.1% CREAM 30GM$ 14.85 04204670 J3490 KENALOG-10 5ML INJ$ 16.53 04204690 J3490 DYRENIUM 100MG CAPSULE$ 1.29 04204701 J1100 DEXAMETHASONE 4MG/50ML SYR$ 29.07 04204710 J3490 NAQUA 2MG TABLET$ 1.29 04204720 J1815 INSULIN REGULAR-1 UNIT$ 1.01 04204730 J3490 CERUMENEX OTIC SOLN 15ML$ 21.45 04204731 J3490 CERUMENEX OTIC SOLN 8ML$ 14.12 04204740 J3490 STELAZINE 2MG TABLET$ 1.29 04204750 J3490 STELAZINE 5MG TABLET$ 1.29 04204760 J3490 STELAZINE 10MG TABLET$ 1.29 04204762 J3490 ARTANE 5MG TABLET$ 1.29 04204763 J3490 ARTANE 2MG TABLET$ 1.29 04204771 J3490 TEMARIL 2.5MG SYRUP 5ML$ 1.29 04204772 J3490 TEMARIL 2.5MG TABLET$ 1.29 04204780 J3250 TIGAN 200MG INJECTION$ 6.38 04204782 J3490 TIGAN 100MG CAPSULE$ 1.29 04204792 J3490 TRI-VI-SOL 50ML$ 12.83 04204800 J3490 SULTRIN VAGINAL CREAM$ 28.58 04204811 J3490 TUBOCURARINE 3MG/ML 10ML$ 13.99 04204820 J3490 DOPAMINE 400MG/D5W 250ML$ 55.78 04204850 J3490 UNICAP CHEWABLE TABLET$ 1.29 04204860 J3490 UNICAP M TABLET$ 1.29 04204861 J3490 URISED TABLET$ 1.29 04204870 J3490 UNICAP T TABLET$ 1.29 04204871 J3370 VANCOCIN 500MG INJECTION$ 45.22 04204881 J3490 PITRESSIN 10 UNIT AMP$ 8.91

84 04204890 J3490 COUMADIN 5MG TABLET$ 1.29 04204900 J3490 WATER BACTERIOSTATIC 30ML$ 4.18 04204910 J3490 A&D OINTMENT 60GM$ 3.43 04204911 J3490 VITAMIN A&D OINTMENT 120GM$ 5.70 04204915 Q9967 ISOVUE 300 50ML INJ$ 88.67 04204916 Q9967 ISOVUE 200ML$ 102.55 04204920 J3490 WHITEFIELD'S OINT 1OZ$ 4.18 04204930 J3490 LANOLIN 30GM$ 2.56 04204941 J3490 X-PREP LIQUID 74ML$ 9.51 04204960 J3490 ZINC OXIDE 30GM OINT$ 1.76 04204970 J3490 ZINC OXIDE PASTE 30GM$ 2.34 04205040 J7110 DEXTRAN-75 6% NSS 500ML$ 34.29 04205050 J3490 DEXTRAN-40 DEXTROSE 5% 500ML$ 34.29 04205060 J7100 DEXTRAN-40 NSS 500ML$ 34.29 04205070 J7121 DEXTROSE 5% LR 500ML$ 17.77 04205080 J3490 DEXTROSE 5% LR 1000ML$ 22.86 04205090 J3490 DEXTROSE 5% NS 250ML$ 14.61 04205100 J3490 DEXTROSE 5% NS 500ML$ 17.77 04205110 J3490 DEXTROSE 5% NS 1000ML$ 22.86 04205114 J3490 ACETIC ACID 0.25% 1000 ML SOLN$ 8.34 04205119 J3490 ACETYLCYSTEINE 10% 30ML IH$ 30.35 04205120 J3490 DEXTROSE 5% NACL .2% 500ML$ 17.77 04205122 S5010 DEXTROSE 5% NACL .2% 1000ML$ 22.86 04205126 J3490 MUCOMYST 20% 1CC DOSE$ 1.93 04205132 J3490 BOTOX 100U INJ$ 631.07 04205134 P9046 ALBUMIN (HUMAN) 25% 20ML VIAL$ 129.82 04205138 J3490 ETHYL CHLORIDE SPRAY 105ML$ 75.35 04205140 J7042 DEXTROSE 5% NACL .45% 500ML$ 17.77 04205143 P9041 ALBUMIN 5% 50ML INJ$ 101.66 04205145 P9047 ALBUMIN (HUMAN) 25% 100ML VIAL$ 379.07 04205150 J7042 DEXTROSE 5% NACL .45% 1000ML$ 22.86 04205165 J3490 ENALAPRILAT 1.25MG/ML VIAL$ 9.40 04205166 J3490 ENALAPRILAT 2.5MG/2ML VIAL$ 14.87 04205168 J3490 ANTIHEMOPHILIC FACTOR/VW COMPL$ 1,129.12 04205169 J3490 ANTIHEMOPHILIC FACTOR/VW COMPL$ 1,976.80 04205170 J3490 DEXTROSE 5% WATER 150ML$ 14.61 04205175 J3490 ANTI-INHIB COAGULANT(FEIBA) 20$ 1,423.12 04205180 J7060 DEXTROSE 5% WATER 250 ML$ 14.61 04205190 J7060 DEXTROSE 5% WATER 500ML$ 17.77 04205200 J3490 DEXTROSE 5% WATER 1000ML$ 22.86 04205210 J3490 DEXTROSE 10% WATER 500ML$ 19.92 04205220 J3490 DEXTROSE 10% WATER 1000ML$ 25.66

85 04205230 J3490 DEXTROSE 20% WATER 500ML$ 19.92 04205231 J3490 DEXTROSE 50% 50ML VIAL$ 7.14 04205261 J3490 TRAVASOL HYPERAL 8.5% KIT$ 78.44 04205331 J3490 DEXTROSE 5% ISOLYTE P 500ML$ 19.92 04205332 J3490 DEXTROSE 5% ISOLYTE P 250ML$ 16.39 04205410 J7030 NORMAL SALINE 0.9% 1000 ML$ 25.66 04205422 J3490 SODIUM BICARB 5% 500ML$ 19.92 04205440 J1815 INSULIN ASPART-1 UNIT$ 4.44 04205450 J1815 INSULIN GLARGINE-PER ML$ 37.47 04205460 J3490 SODIUM CHLORIDE 5% 500ML$ 19.92 04205500 J3490 SODIUM LACTATE 1/6M 500ML$ 19.92 04205510 J3490 SODIUM LACTATE 1/6M 1000ML$ 25.66 04205520 A4217 WATER IRRIGATION 1500ML$ 21.38 04205530 A4217 WATER IRRIGATION 3000ML$ 25.66 04205531 J3490 NORMAL SALINE UROGAT 1500ML$ 21.38 04205600 J3490 BENDAMUSTINE 100MG/20ML VIAL$ 2,677.94 04205910 J3490 ACETAMINOPHEN SUPP 650MG$ 4.31 04205911 J3490 OSELTAMIVIR LIQ 6MG/ML 60ML$ 193.49 04205912 J3490 OSELTAMIVIR 45MG CAPSULE$ 35.10 04205913 J3490 OSELTAMIVIR 30MG CAPSULE$ 35.10 04205920 J3490 ACTH-GEL 40 UNIT DOSE$ 25.66 04205960 J3490 AKINETON 2MG TABLET$ 1.45 04205980 J3490 ALDACTAZIDE 25/25 TABLET$ 1.45 04206010 J0280 AMINOPHYLLINE 250MG VIAL$ 7.14 04206050 J0330 ANECTINE 20MG/ML 10ML INJ$ 7.14 04206080 J3490 APLISOL 1ML 10 TEST$ 7.14 04206090 J3490 ARFONAD 500MG INJECTION$ 32.05 04206101 J3490 R-GENE 10% W/ADM SET 300ML$ 105.49 04206110 J3490 ASPIRIN 60MG SUPPOSITORY$ 4.31 04206120 J3490 ASPIRIN 300MG SUPPOSITORY$ 4.31 04206140 J3490 ASPIRIN W/CODEINE 30MG TAB$ 1.45 04206160 J3490 BELLA/OPIUM SUPPOSITORY$ 4.31 04206180 J3490 BACTRIM SUSPENSION DOSE$ 1.45 04206230 J3490 BICILLIN CR 1.2MU/2ML INJ$ 14.55 04206250 J3490 BICILLIN LA 1.2MU/2ML INJ$ 16.94 04206380 J3490 CARBOCAINE 1.5% 30ML$ 10.24 04206390 J3490 CEFADYL 1GM INJECTION$ 12.69 04206400 J3490 KEPPRA 500MG/5ML VIAL$ 73.48 04206402 J3490 GLUCOSE 4GM CHEW TAB$ 1.01 04206410 J3490 CEVALIN 500MG/2ML VIAL$ 7.14 04206420 J3490 NOCTEC 500MG CAPSULE$ 1.45 04206430 J3490 NOCTEC SYRUP 5ML DOSE$ 1.69

86 04206450 90625 CHOLERA VACCINE 0.5CC DOSE$ 15.84 04206510 J3490 CODEINE ALKALINE POWDER$ 10.68 04206540 J3490 CODEINE 30MG TABLET$ 1.45 04206550 J3490 COMPAZINE 15MG SPANSULE$ 1.45 04206560 J8498 COMPAZINE 2.5MG SUPP$ 3.82 04206570 J8498 COMPAZINE 25MG SUPP$ 4.31 04206580 J8498 COMPAZINE 5MG SUPP$ 3.82 04206610 J3490 CORTISONE 25MG INJECTION$ 6.38 04206612 A4246 POVIDONE 7.5% SURG 120ML$ 3.69 04206650 J3490 CYTOXAN 500MG INJECTION$ 54.24 04206660 J3490 DALMANE 15MG CAPSULE$ 1.29 04206670 J3490 DALMANE 30MG CAPSULE$ 1.29 04206680 J3490 DANTRIUM 25MG CAPSULE$ 1.29 04206710 J3490 DELTALIN 50000IU CAPSULE$ 1.29 04206720 J2175 DEMEROL 100MG INJECTION$ 6.38 04206730 J2175 DEMEROL 25MG INJECTION$ 6.38 04206740 J2175 DEMEROL 50MG INJECTION$ 6.38 04206750 J2175 DEMEROL 75MG INJECTION$ 6.38 04206760 J3490 DEMEROL 50MG TABLET$ 1.29 04206780 J3490 DEPO-ESTRADIOL INJECTION$ 19.31 04206790 J3490 DEPO-TESTADIOL INJECTION$ 12.09 04206800 J3490 DEPO-PROVERA 100MG/ML 5ML$ 13.99 04206821 J3490 MIDODRINE 2.5MG TABLET$ 1.31 04206830 J3490 DEXEDRINE 15MG SPANSULE$ 1.29 04206860 J3490 DEXTROSE 10% INJECTION$ 6.38 04206870 J3490 DEXTROSE 50% 50ML VIAL$ 6.38 04206920 J1170 DILAUDID 2MG INJECTION$ 6.38 04206930 J3490 DIP/PERTUSSIS/TETANUS VACC$ 6.38 04206980 J3490 DOXIDAN CAPSULE$ 1.29 04206990 J3490 DRAMAMINE 50MG INJECTION$ 13.05 04207030 J3490 AZYTHROMYCIN 500MG TABLET$ 6.08 04207071 J3490 AMITRIPTYLINE 10MG TABLET$ 1.29 04207120 J3490 EQUANIL 200MG TABLET$ 1.29 04207150 J3490 ERGOTRATE INJECTION$ 6.38 04207170 J3490 ERYTHROMYCIN 200MG/5ML 100$ 16.36 04207231 J3490 HYDROCORTISONE 1% 30GM OINT$ 14.65 04207260 J3490 FIORINAL TABLET$ 1.29 04207300 J3490 FLORINEF 0.1MG TABLET$ 1.29 04207330 J3490 AMPHOTERICIN B 50MG INJECT$ 35.10 04207370 J3490 GAVISCON TABLET$ 1.29 04207387 J3490 HCTZ/TRIAMTERENE CAPSULE 25/50$ 7.04 04207390 J3490 GLYCERIN SUPPOSITORY ADULT$ 3.82

87 04207400 J3490 PRECEDEX 100MCG/ML 2ML SDV$ 328.36 04207401 J1100 DEXAMETHASONE 4MG/10ML SYR$ 29.07 04207410 J3490 HALDOL CONC 2MG/ML 120ML$ 96.27 04207430 J1630 HALDOL 5MG/ML AMP$ 6.38 04207500 J3490 HISTOPLASMIN INJECTION$ 6.38 04207510 J3490 HU-TET 250UNITS$ 12.97 04207555 J3490 DOCETAXEL 20MG/0.5ML INJECTION$ 740.17 04207556 J3490 DOCETAXEL 80MG/2ML INJECTION$ 2,555.74 04207570 J3490 HYDROCORTISONE 20MG TABLET$ 10.94 04207590 J3490 HYTAKEROL 0.25MG/ML 15ML$ 33.14 04207630 J3490 IMMUNE SERUM GLOBULIN 2ML$ 11.45 04207640 J7500 IMURAN 50MG TABLET$ 1.29 04207660 J3490 PROPRANOLOL 40MG TABLET$ 1.29 04207670 J3490 INNOVAR 2CC INJ$ 11.29 04207690 J3490 INSULIN-NPH BEEF U100 10ML$ 30.47 04207700 J3490 INSULIN-NPH PORK U100 10ML$ 55.90 04207770 J3490 ISOPTO CARPINE OPHT 1% 15ML$ 14.36 04207780 J3490 ISOPTO FRIN OPHTH SOLN$ 15.50 04207790 J3490 HOMATROPINE 5% OPHTH SOLN 5ML$ 12.71 04207800 J3490 ISOPTO TEAR OPHTH DRP 15ML$ 14.85 04207810 J3490 BABY OIL 4OZ$ 5.89 04207830 J3490 KENALOG IN ORABASE 0.1% 5GM$ 12.83 04207840 J3490 KENALOG SPRAY 23GM$ 16.66 04207850 J3490 KETOSTIX 100'S$ 25.17 04207860 J3490 KWELL CREAM 60GM$ 10.29 04207870 J3490 LACRI-LUBE 3.5GM EYE OINT$ 9.51 04207890 J3490 LASIX 40MG TABLET$ 1.29 04207900 J3490 LIBRIUM 10MG CAP$ 1.29 04207910 J3490 LIBRIUM 25MG CAP$ 1.29 04207940 J3490 LIQUIFILM 30ML$ 14.75 04207960 J3490 MARCAINE 0.75% 30ML VIAL$ 16.88 04207970 J3490 MARCAINE 0.25% 30ML VIAL$ 19.54 04208010 J3490 MESTINON 60MG TABLET$ 1.29 04208030 J3490 METHADONE 10MG TABLET$ 1.29 04208035 J3490 COLCHICINE 0.3MG TABLET$ 13.88 04208100 J3490 MINIPRESS 1MG CAPSULE$ 1.29 04208110 J3490 MINIPRESS 5MG CAPSULE$ 1.29 04208130 J3490 MORPHINE 15MG/ML INJ$ 6.38 04208140 J3490 MORPHINE 8MG INJECTION$ 6.38 04208150 J2270 MORPHINE 10MG/10ML INJ$ 6.38 04208170 J2270 MORPHINE 8MG TABLET$ 1.29 04208174 J3490 MUTAMYCIN 5MG INJECTION$ 147.83

88 04208180 J9280 MYCOSTATIN VAGINAL TAB$ 1.29 04208189 J3490 SMZ/TMP 800/600 10ML VIAL$ 13.27 04208194 J3490 CALCIUM 500MG/VIT D TABLET$ 1.29 04208195 J3490 CALCIUM 600MG+VIT D3 800IU TAB$ 1.06 04208203 J3490 DIAZEPAM 2.5MG TAB$ 1.01 04208210 J3490 NAPHCON OPHTH DROP 15ML$ 12.97 04208250 J3490 NEMBUTAL 100MG CAPSULE$ 1.29 04208260 J3490 NEMBUTAL 100MG INJECTION$ 6.38 04208270 J3490 NEMBUTAL 1GR SUPPOSITORY$ 3.82 04208330 J3490 NIPRIDE 50MG INJECTION$ 37.74 04208333 J3490 ONCOZENE 100UM 3ML SRN$ 1,039.80 04208350 P9047 ALBUMIN (HUMAN) 25% 50ML VIAL$ 131.33 04208380 P9047 INSULIN-NPH U100 10ML$ 30.47 04208410 J3490 NYSTATIN OINTMENT 30GM$ 27.06 04208421 J3490 OPTEMP EACH$ 20.08 04208440 J3490 OS-CAL 250MG TABLET$ 1.29 04208500 J3490 PAPAVERINE 150MG CAPSULE$ 1.29 04208510 J3490 PARALDEHYDE INJECTION$ 6.38 04208530 J3490 PAREGORIC 5ML DOSE$ 1.29 04208570 J3490 PENICILLIN G NA 5M U INJ$ 14.85 04208580 J3490 PENTOTHAL 1GM 2.5% KIT$ 21.60 04208590 J3490 PERCODAN TABLET$ 1.29 04208600 J3490 PERPHENAZINE 16MG TABLET$ 1.29 04208610 J3490 PERPHENAZINE 2MG TABLET$ 1.29 04208620 J3490 PERPHENAZINE 8MG TABLET$ 1.29 04208650 J3490 PHENISTIX 50'S$ 18.42 04208660 J3490 PHENOBARBITAL 130MG/ML INJ$ 6.38 04208670 J3490 PHENOBARBITAL 100MG TABLET$ 1.29 04208680 J3490 PHENOBARBITAL 30MG TABLET$ 1.29 04208710 J3490 PENICILLIN VK 250MG/5ML 20$ 11.71 04208720 J3490 PENICILLIN VK 250MG/5ML 100ML$ 10.79 04208780 J3490 POLIO VACCINE DOSE$ 7.50 04208830 J3490 POTASSIUM CL 10GR TABLET$ 1.29 04208850 J3490 PENICILLIN GK 20M U INJ$ 26.90 04208870 J7510 PREDNISOLONE 5MG TABLET$ 1.29 04208910 J3490 PREMARIN 0.3MG TABLET$ 1.29 04208920 J3490 PROLIXIN DECANOATE DOSE$ 27.30 04208930 J2680 PROLIXIN 2.5MG INJECTION$ 6.38 04208950 J3490 INSULIN-PROTAMINE ZINC DOS$ 7.76 04208970 J3490 PROTOPAM 1GM VIAL$ 12.71 04208990 J3490 PYRIBENZAMIN 50MG TABLET$ 1.29 04209000 J3490 QUESTRAN PACKET 9GM$ 2.32

89 04209010 J3490 QUINAGLUTE TABLET$ 1.16 04209020 J3490 QUININE 5GR CAPSULE$ 1.29 04209050 J1815 INSULIN-REGULAR U40 10ML$ 6.38 04209080 J3490 ACTH-GEL 80U/ML 5ML$ 26.19 04209090 J3490 RHOGAM 300MCG INJECTION$ 176.41 04209100 J3490 RITALIN 10MG TABLET$ 1.29 04209110 J3490 RITALIN 5MG TABLET$ 1.29 04209120 J2800 ROBAXIN 10ML INJ$ 5.59 04209130 J3490 ROBINUL FORTE 2MG TABLET$ 1.29 04209150 J3490 RUBELLA VACCINE DOSE$ 16.79 04209200 J3490 PHENTOLAMINE 5MG INJ$ 534.71 04209250 J3490 SECONAL 100MG CAPSULE$ 1.29 04209320 J3490 STELAZINE 2MG INJECTION$ 6.38 04209350 J3490 STRESSTAB$ 1.29 04209380 J3010 FENTANYL 0.05MG/ML 2ML AMP$ 5.08 04209390 J3490 SULTRIN VAGINAL TAB 20'S$ 25.78 04209400 J3490 SURFAK CAPSULE$ 1.29 04209410 A4649 SYRINGE U-100$ 1.29 04209412 J3490 PHENOBARBITAL 5MG/1.25ML ORAL$ 1.01 04209460 J3490 TENSILON 10MG/15ML VIAL$ 16.66 04209480 J3490 TETANUS ANTITOXIN$ 83.83 04209500 J3490 TETANUS TOXOID ABSORB 0.5ML$ 6.38 04209510 J3490 TETANUS TOXOID FLUID DOSE$ 6.38 04209550 J9340 THIOTEPA 15MG INJECTION$ 26.90 04209560 J3490 THORAZINE 25MG SUPPOSITORY$ 3.82 04209570 J3490 THORAZINE 100MG SUPP$ 3.82 04209590 J3490 THROMBOLYSIN$ 90.33 04209610 J3490 THYROLAR 1GR TABLET$ 1.29 04209640 J3490 TIGAN 200MG SUPPOSITORY$ 3.82 04209690 J3490 TRANXENE 3.75MG CAPSULE$ 1.29 04209730 J3310 TRILAFON 5MG/ML AMPULE$ 6.38 04209740 J3490 TRILAFON 2MG/5CC$ 1.29 04209800 90690 TYPHOID VAC 5CC DOSE$ 7.76 04209820 J3490 INSULIN-ULTRALENTE U100 10$ 23.88 04209880 J3490 URISPAS 100MG TABLET$ 1.29 04209900 J3490 VALISONE LOTION 20 ML$ 19.92 04209910 J3490 VALIUM 10MG INJECTION$ 6.38 04209920 J3490 VALIUM 10MG TABLET$ 1.29 04209930 J3490 VALIUM 2MG TABLET$ 1.29 04209940 J3490 VALIUM 5MG TABLET$ 1.29 04209950 J3490 AMYL NITRATE INHALATION$ 1.68 04210050 J3490 ONCOVIN 1MG/ML VIAL$ 50.56

90 04210070 J3490 WATER FOR INJECTION 5ML$ 1.89 04210090 J3490 WYCILLIN 1.2MU/2ML INJ$ 6.86 04210100 J3490 WYCILLIN 2.4M UNIT INJECT$ 13.09 04210110 J3490 WYCILIIN 600000U/ML INJ$ 6.38 04210120 J3490 WYDASE 1500 UNIT 10ML VIAL$ 18.80 04210130 J3490 XYLOCAINE CAR ARR 50MG$ 6.38 04210140 J2001 XYLOCAINE 1% 50ML$ 8.39 04210150 J3490 XYLOCAINE 2% 50ML$ 69.90 04210160 J3490 XYLOCAINE TOPICAL 4% 50ML$ 6.38 04210470 J8540 DEXAMETHASONE 0.4MG/ML OS$ 7.41 04210472 J1100 DEXAMETHASONE 10MG/ML PF SDV$ 5.15 04210500 J3490 ARIPIPRAZOLE 10MG TAB$ 55.03 04210603 J3490 ACETAMINOPHEN SUPP 325MG$ 3.82 04210605 J3490 ACETAZOLAMIDE 500MG CAP$ 1.29 04210610 J3490 ALCOHOL ISOPROPYL 70% 1 PINT$ 3.68 04210614 J3490 AMBENONIUM CHLORIDE 10MG$ 1.29 04210615 J3490 AMIKACIN 250MG/ML 2ML VIAL$ 43.69 04210616 J0278 AMIKACIN 1GM/4ML VIAL$ 85.75 04210617 J3490 AMITRIPTYLINE 50MG TABLET$ 1.29 04210618 J3490 AMMONIA INHAL SOLN 1/3CC$ 1.29 04210621 J3490 AMOXICILLIN 250MG CAPSULE$ 1.29 04210622 J3490 AMOXICILLIN 500MG CAPSULE$ 1.29 04210623 J3490 AMOXICILLIN 50MG/ML 15ML DRPS$ 10.55 04210624 J3490 AMOXICILLIN 125MG/5ML 100ML BT$ 19.70 04210626 J3490 ANTIHEMOPHLIC F8 250IU VI$ 387.51 04210627 J3490 ANTIHEMOPHILIC HEMOFIL-T$ 171.47 04210629 J3490 ANTILIRIUM 2ML INJ$ 6.38 04210631 J3490 APLISOL 5ML 50 TEST$ 27.71 04210632 J3490 AQUASOL-A 5000U DROP 30ML$ 13.99 04210633 J3490 VITAMIN C 500MG AMP$ 6.38 04210635 J3490 ASPIRIN 81MG CHEW TABLET$ 1.29 04210636 J3490 ATROPINE 1% OPHTH SOLN 15 ML$ 15.74 04210637 J7500 AZATHIOPRINE 50MG TABLET$ 1.29 04210640 J3490 BASALJEL X-STRENGTH DOSE$ 1.29 04210642 J3490 COGENTIN 2MG TAB$ 1.29 04210643 J3490 BENZOIN COMP TINCT 30ML$ 3.82 04210646 J3490 BETHANECHOL 25MG TABLET$ 1.16 04210647 J3490 BETHANECHOL 10MG TABLET$ 1.29 04210649 J3490 BREAST CREAM 2OZ MASSE$ 7.62 04210653 J3490 BURROW'S SOLN 1:40 1000ML$ 14.75 04210654 J8510 BUSULFAN 2MG TABLET$ 1.29 04210655 J3490 CALCIUM CL 10% 1GM/10ML VIAL$ 6.38

91 04210659 J3490 KEFZOL 1GM INJECTION$ 20.82 04210660 J3490 CEPACOL LOZENGE 18'S$ 1.29 04210661 J3490 LIBRIUM 5MG CAP$ 1.29 04210663 J3490 CHLORPHENIRAMINE 12MG TAB$ 1.29 04210665 J3490 CHLORPHENIRAMINE 8MG TAB$ 1.29 04210668 J3490 CIMETIDINE 300MG/2ML DOSE$ 8.39 04210669 J3490 CIMETIDINE 300MG TABLET$ 1.29 04210670 J3490 KLONOPIN 0.5MG TABLET$ 1.29 04210671 J3490 TRANXENE 7.5MG CAPSULE$ 1.29 04210673 J3490 CORTISPORIN OPHTH OINT$ 13.99 04210674 J3490 CORTISPORIN OTIC SUSP 10ML$ 17.94 04210676 J3490 CYTOSAR 100MG/5ML VIAL$ 18.04 04210677 J3490 DARVOCET-N 100MG TABLET$ 1.29 04210679 J3490 DESIPRAMINE TB-25$ 1.29 04210683 J3490 STILPHOSTEROL 0.25GM AMP$ 10.16 04210685 J1160 DIGOXIN 0.1MG INJECTION$ 6.38 04210694 J3490 ZARONTIN 250MG CAPSULE$ 1.29 04210695 J3490 LASIX 10MG/ML 60ML O/SOLN$ 20.19 04210696 J3490 HALOG CREAM 0.1% 15GM$ 18.20 04210697 J3490 HYDROCORTISONE ENEMA 60ML$ 4.05 04210698 A4244 HYDROGEN PEROXIDE 16OZ$ 2.69 04210699 J3490 IMMUNE SERUM GLOBULIN 10ML$ 34.29 04210701 J3490 TOFRANIL 10MG TABLET$ 1.29 04210706 J3490 PERI DIALYSIS 1.5% 1000ML$ 17.77 04210707 J3490 PERI DIALYSIS 4.25% 1000ML$ 25.38 04210708 J3490 INSULIN-PROTAMINE U100 10ML$ 30.47 04210709 J3490 INSULIN-REG BEEF U100 10ML$ 6.38 04210710 J3490 INSULIN-LENTE U100 10ML$ 30.47 04210712 J3490 INSULIN-SEMILENTE U100 10ML$ 30.47 04210714 J3490 INTRALIPID 10% 500ML$ 132.89 04210716 J3490 ISUPREL 1:5000 5ML AMP$ 12.32 04210718 J3490 ISUPREL MISTOMETER 10ML$ 20.33 04210719 J3490 CARBACHOL 3% 15ML OPHTH DRP$ 23.11 04210720 J3490 ISOPTOCARPINE OPHT 6% 15ML$ 17.94 04210721 J3490 ISOPTO CARBACHOL 1.5% 15ML$ 21.98 04210722 J3490 ISOPTO HOMATROPINE 5% 5ML$ 18.20 04210723 J3490 CORTISPORIN EAR SUSP 10ML$ 91.21 04210724 J3490 WATER DISTILLED 1000ML$ 22.86 04210726 A4649 FILTER IN-LINE$ 7.62 04210728 J3490 GLYCINE IRRIGATE 1500ML$ 34.45 04210729 J3490 GLYCINE IRRIGATE 2000ML$ 34.45 04210738 J7120 LACTATED RINGER'S 500ML$ 17.77

92 04210739 J7120 LACTATED RINGER'S 1000ML$ 22.86 04210741 A4217 NORMAL SALINE IRRIG 1000ML$ 22.86 04210742 A4217 NORMAL SALINE IRRIG 2000ML$ 30.47 04210744 J7050 NORMAL SALINE 0.9% 250ML$ 14.61 04210745 J7040 NORMAL SALINE 0.9% 500ML$ 17.77 04210746 J3490 SODIUM CHLORIDE UG 1500ML$ 33.03 04210748 A4217 WATER IRRIGATION 2000ML$ 20.33 04210754 J3490 DEXTROSE 50% WATER 500ML$ 30.47 04210756 J3490 KAYEXALATE POWDER 20GM$ 6.47 04210757 J3490 LIDOCAINE 4% TOP SOLN 4ML$ 16.36 04210758 J3490 LIDOCAINE 2% SOLN 20ML$ 3.43 04210759 J3490 LOXITANE 50MG CAPSULE UD$ 1.51 04210764 J3490 LOXITANE 25MG CAPSULE UD$ 1.16 04210765 J3490 LOXITANE 50MG/ML AMP$ 6.47 04210766 J3490 LEVORPHANOL 2MG AMP$ 6.38 04210768 J3490 MEASLES VACCINE DOSE$ 9.51 04210769 J3490 CARBOCAINE CA&EP 2%$ 11.18 04210770 J3490 CARBOCAINE 1% 50ML$ 9.66 04210772 J3490 ALUPENT SYRUP 5ML DOSE$ 1.29 04210773 J3490 ROBAXIN 750MG TABLET$ 1.29 04210775 J3490 MONISTAT CREAM$ 22.86 04210777 J1600 MYOCHRYSINE 50MG INJECTION$ 7.13 04210778 J3490 MULTISTIX 100'S$ 87.27 04210779 J3490 NAIL POLISH REMOVER 30ML$ 3.82 04210780 J3490 NALIDIXIC ACID 500MG TAB$ 1.29 04210781 J2710 NEOSTIGMIN 1:4000 AMP$ 6.38 04210782 J3490 NEOSPORIN FOIL PACK$ 1.29 04210787 P9045 ALBUMIN (HUMAN)5% 250ML VIAL$ 213.39 04210789 J3490 NYSTATIN 100MU VAGINAL TAB$ 1.29 04210790 J3490 OPTEMP 12'S BOX$ 240.05 04210793 J3490 PAVULON 2MG/ML 2ML AMP$ 6.74 04210795 J3490 PERI DIALYSIS 1.5% 2000ML$ 38.12 04210798 J2370 PHENYLEPHRINE 10MG/1ML INJ$ 6.38 04210801 J3490 POTASSIUM IODINE 60ML$ 5.70 04210803 J3490 MINIPRESS 2MG CAPSULE$ 1.29 04210807 J3490 SUDAFED SYRUP 5ML$ 1.29 04210808 J3490 ANTIMINTH SUSPENSION 1ML$ 1.29 04210810 J3490 RENOGRAFIN-76 50ML$ 29.72 04210812 J3490 SILVADENE CREAM 1% 20GM$ 5.87 04210813 J3490 SINEMET 10/100 TABLET$ 1.29 04210814 J3490 SINEMET 25/250 TABLET$ 1.29 04210815 J3490 SINOGRAFIN 38% 10ML VIAL$ 30.72

93 04210816 J3490 SMALLPOX VACCINE DOSE$ 6.38 04210818 J3490 SODIUM BICARB 10MEQ SYRINGE$ 14.12 04210820 J3490 SODIUM BICARB 4.2% 10ML SYR$ 5.87 04210821 A4216 SODIUM CL 10ML INJ$ 6.38 04210822 J3490 SODIUM CL 20ML INJ$ 6.38 04210823 J3490 SODIUM CL 23.4% 100ML$ 6.38 04210824 J3490 SODIUM CL 23.4% 30ML$ 6.38 04210828 J3490 PROSTAPHLIN 2GM INJECTION$ 43.21 04210833 J3490 TETRA SPINAL ANESTHETIC$ 5.94 04210835 J3490 THIMEROSAL SOLN 30ML$ 1.76 04210836 J3490 THIMEROSAL TINCTURE 30ML$ 1.76 04210839 J3490 VANCERIL 40MCG INHALER$ 37.22 04210840 J3490 VELBAN 10MG 10ML AMP$ 52.19 04210841 J3490 VITAMIN A 25000 UNIT CAP$ 1.29 04210843 J3490 Z-BEC TABLET$ 1.29 04210844 J3490 ZINCFRIN OPHTH DROPS 15ML$ 13.36 04210850 J3490 METAPREL 20MG TABLET$ 1.29 04210853 A4649 CONDOM 4'S$ 7.62 04210856 J3490 TEGOPEN 125MG/5ML 100ML$ 25.01 04210859 J3490 KEFLEX 250MG/5ML 200ML BT$ 29.34 04210862 J3430 AQUAMEPHYTON 10MG AMP$ 6.38 04210868 J3490 STELAZINE 1MG TABLET$ 1.29 04210871 J3490 DIGOXIN 0.125MG TABLET$ 1.29 04210880 J3490 CEPACOL/H2O2/NSS 1:1:1 12O$ 9.51 04210883 J3490 ACETAMINOPHEN/COD 30MG #3TAB$ 1.29 04210886 J3490 PLACEBO-EMPTY TUBEX$ 6.38 04210892 J3490 TUCKS 40'S$ 7.50 04210895 J3490 RESERPINE 1MG TABLET$ 1.29 04210910 J3490 BAKING SODA 15GM$ 1.29 04210913 J3490 PREDNISONE 10MG TABLET$ 1.29 04210916 J3490 AMPICILLIN 125MG INJ$ 6.38 04210942 J3490 ASCRIPTIN 5GR TABLET$ 1.29 04210944 J3490 MYLANTA SUSPENSION 5OZ$ 4.18 04210945 J3490 HALDOL 10MG TABLET UD$ 1.39 04210946 J3490 ASPIRIN BUFFERED 325MG TAB$ 1.29 04210948 J3490 ARALEN 500MG TABLET$ 1.51 04210949 J3490 LOXITANE 10MG CAPSULE UD$ 1.29 04210951 J3490 KAY CIEL 20MEQ/PACKET$ 1.29 04210952 J3490 SALT TABLET$ 1.29 04210954 J3490 TIGAN 100MG PED SUPP$ 3.82 04210955 J3490 THORAZINE 200MG CAPSULE$ 1.29 04210957 J3490 SODIUM CL 0.2% 1000ML$ 22.86

94 04210958 J3490 SINEQUAN 75MG CAPSULE$ 1.29 04210959 J3490 MYLANTA SUSPENSION 5CC UD$ 1.29 04210960 J3490 GELUSIL SUSPENSION 360ML$ 8.13 04210961 Q0175 TRILAFON 4MG TABLET$ 1.29 04210965 J3490 INH 300MG TABLET$ 1.29 04210966 J3490 LOXITANE-C 25MG/ML 120ML$ 154.72 04210968 J3490 MAGNESIUM SO4 50% SOL 60ML$ 1.29 04210970 J1644 HEPARIN 5000U/ML$ 7.22 04210973 J3490 VIOFORM HC MILD CRM 30GM$ 17.54 04210974 J3490 VITAMIN B12 1000MCG/ML INJ$ 6.38 04210975 J3490 L-THYROXINE 0.1MG TABLET$ 1.29 04210976 J3490 DEPO-TESTOSTERONE 200MG/ML INJ$ 11.18 04210977 J3490 AMOXICILLIN 250MG/5ML 100ML BT$ 26.10 04210978 J3490 SENOKOT 8.6MG TABLET$ 1.29 04210979 J3490 ACETAMINOPHEN 500MG TAB$ 1.29 04210980 J3490 NEO-CALGLUCON 1.8GM/5ML DOSE$ 1.29 04210981 J3490 CORN STARCH 30GM$ 2.90 04210982 J3490 CLINORIL 150MG TABLET$ 2.40 04210984 J3490 TRILAFON CON 16MG/5ML 120ML$ 26.44 04210987 J3490 THEOPHYLLINE ELIX 80MG/15ML 5M$ 1.29 04210989 J3490 PATHIBAMATE 400MG TABLET$ 1.29 04210990 J3490 ASPIRIN EC 325MG TABLET$ 1.29 04210993 J3490 CHLOR-TRIMETON 8MG REPETAB$ 1.29 04210997 J3490 GRANULEX AEROSOL 120GM$ 30.01 04211000 J3490 PHENERGAN COD SYRUP 5ML DOSE$ 1.29 04211001 J3490 NORMAL SALINE NASAL DRP 30$ 1.29 04211003 J7060 DEXTROSE 10% ISOLYTE-P 500ML$ 17.77 04211005 J3490 ISOPTOCARPINE OPHT 4% 15ML$ 15.74 04211006 J3490 DEXTROSE 10% ISOLYTE-P 250ML$ 14.61 04211007 J2270 MORPHINE 2MG INJECTION$ 6.38 04211008 J3490 ACETAMINOPHEN/COD 15MG TAB$ 1.29 04211009 J3490 LOTRIMIN 1% 30GM CREAM$ 20.94 04211010 J3490 POLYSPORIN OPHTH OINT$ 9.12 04211012 J3490 MAALOX NO.2 TABLETS$ 1.51 04211014 J3490 PHENERGAN 25MG TABLET$ 1.29 04211015 J3490 METAPREL SYRUP 5ML$ 1.29 04211017 J3490 ASPIRIN SUPPOSITORY 2GR$ 3.82 04211020 J3490 MVI CONCENTRATE 5ML$ 6.47 04211021 J3490 PHENOBARBITAL 60MG TABLET$ 1.29 04211022 J3490 ATIVAN 2MG TABLET$ 1.29 04211023 J3490 PLACEBO-CAPSULE$ 1.29 04211024 J3490 DEPAKENE 25OMG CAPSULE$ 1.29

95 04211027 J3490 LIORESAL 10MG TABLET$ 1.29 04211033 J3490 PHENERGAN CODEINE SYR 5ML$ 1.29 04211034 J3490 VIOFORM 3% OINTMENT 30GM$ 7.76 04211038 J3490 SYNTHROID 0.5MG 10ML INJ$ 63.88 04211040 S0169 ROCALTROL 0.25MCG CAPSULE$ 2.32 04211042 J3490 AVITENE 1GM JAR$ 140.97 04211045 J3490 XYLOCAINE 2GM INF 20% 10ML$ 14.61 04211048 J3490 QUINIDEX EXTENTAB$ 1.29 04211049 J3490 EYE STREAM 4OZ$ 11.29 04211050 J3490 PRED SYRUP 5MG/5ML DOSE$ 5.94 04211051 J3490 ALUMINUM 1% SOLN 60ML$ 5.94 04211052 J3490 PATHIBAMATE 200MG TABLET$ 1.29 04211056 J0595 STADOL 1MG INJECTION$ 6.38 04211057 J3490 KLONOPIN 1MG TABLET$ 1.29 04211059 J3490 DIABINESE 100MG TABLET$ 1.29 04211060 J7512 PREDNISONE 20MG TABLET$ 1.29 04211062 J3490 ANTABUSE 250MG TABLET$ 1.29 04211064 J3490 POTASSIUM CL 40MEQ 15ML DOSE$ 1.29 04211066 J3490 POLY-VI-SOL CHEW TABLET$ 1.29 04211068 J3490 PROSTIGMIN 1:1000 1ML DOSE$ 6.38 04211069 J3490 ALDOMET 250MG/5ML VIAL$ 13.09 04211070 J3490 GLYCERIN SOLUTION 30ML$ 2.90 04211071 J3490 NORPACE 100MG CAPSULE$ 1.29 04211072 J3490 NATABEC TABLET$ 1.29 04211074 J3490 EURAX LOTION 10% 60ML$ 11.01 04211075 J3490 ACETAMINOPHEN/COD 5ML UD$ 1.29 04211078 J3490 DECADRON ELIX 0.5MG/5ML DOSE$ 1.29 04211080 J3490 PROPRANOLOL 20MG TABLET$ 1.29 04211083 J3490 DEBROX 6.5% 15ML ERR DRP$ 11.91 04211084 J3490 HEPTAVAX-B 20MCG/ML 1ML$ 121.96 04211085 J9060 CISPLATIN 10MG 10ML VIAL$ 88.77 04211086 J3490 MUCOMYST 20% 10ML INHAL$ 22.34 04211092 J3490 CORGARD 40MG TABLET UD$ 1.29 04211094 J3490 BICILLIN LA 600000U/1ML$ 10.29 04211095 J1940 LASIX 40MG/4ML INJ$ 10.29 04211096 J1940 PROSTIGMIN 1:2000 AMP$ 1.29 04211097 J3490 MESTINON TIMESPAN 180MG$ 1.29 04211098 J3490 ACETAMINOPHEN SUPP 120MG$ 3.82 04211099 J3490 LASIX 80MG SYRINGE$ 16.02 04211100 J3490 SLOW K 600MG TABLET$ 1.29 04211101 J3490 HYDERGINE 1MG ORAL TABLET$ 1.29 04211103 J3490 POTASSIUM ACE 2MEQ/ML 100M$ 6.38

96 04211104 J3490 APRESOLINE 10MG TABLET$ 1.29 04211106 J3490 NAPROSYN 250MG TABLET$ 1.29 04211108 J3490 URISTIX 100'S$ 31.01 04211115 J3490 BENZAGEL 5 42.5GM$ 8.75 04211119 J3490 PAVULON 2MG/ML 5ML AMP$ 13.70 04211120 J3490 FOLVITE 1MG INJECTION$ 6.38 04211122 J3490 PROCAN SR 500MG TABLET$ 1.29 04211125 J3490 CAPOTEN 25MG TABLET$ 1.29 04211126 J3490 SODIUM CL 0.33% 500ML$ 17.77 04211127 S0030 FLAGYL P/MIX 500MG VIAL$ 44.30 04211128 J3490 VI-DAYLIN W/IRON DROPS 1ML$ 1.29 04211130 J3490 HALDOL 5MG TABLET UD$ 1.29 04211131 J3490 TICARCILLIN 3GM VIAL$ 32.39 04211132 J3490 VI-DAYLIN LIQUID 5ML DOSE$ 1.29 04211133 J3490 DESFERAL 500MG/VIAL$ 14.23 04211135 S0030 FLAGYL 500MG INJECTION$ 39.64 04211136 S0030 TUBERCULIN PPD 1TU INJECT$ 6.38 04211137 J3490 ISOPTO HOMATROPINE 2% 5ML$ 18.20 04211138 J3490 ISORDIL 5MG SL$ 1.29 04211140 J3490 TUBERCULIN PPD 5TU 0.1ML DOSE$ 6.38 04211141 J3490 VERAPAMIL 5MG/2ML AMP$ 43.21 04211142 J3490 CYCLOGYL 1% 15ML OPHTH$ 35.32 04211143 J3490 VALISONE/BALTAR 45GM$ 50.17 04211144 J3490 TUBERCULIN PPD 1ML VIAL$ 6.38 04211149 J3260 TOBRAMYCIN 80MG INJECTION$ 18.92 04211150 J3260 TERBUTALINE 1MG INJECTION$ 6.38 04211151 J3105 SALICYLIC ACID 10% 30ML$ 7.62 04211152 J3490 THYMOL/HC/CHLOROFORM 30GM$ 14.61 04211155 J3490 CYANOCOBALAMIN 1MG/ML AMP$ 6.38 04211156 J3420 PODOPHYLLUM/BENZOIN 30ML$ 12.83 04211157 J2765 REGLAN 10MG AMPULE$ 6.23 04211159 J2765 PALADAC SYRUP 5ML DOSE$ 1.29 04211162 J3490 MENTHOL/PHENOL/KENALOG$ 45.74 04211164 J3490 CHROMIUM 4MCG/ML 10ML VIAL$ 6.38 04211165 J3490 DILAUDID 2MG TABLET$ 1.29 04211166 J3490 DANOCRINE 200MG CAPSULE$ 4.05 04211167 J3490 BRETYLOL 500MG INJECTION$ 55.52 04211169 J3490 ACETIC ACID 1% 500ML$ 17.77 04211174 J3490 VITAMIN E 400IU CAPSULE$ 1.29 04211175 J3490 BCNU 100MG INJECTION$ 74.70 04211176 J3490 BUPIVACAINE W/ EPI 0.5% 10ML V$ 16.83 04211177 J3490 CATAPRES 0.2MG TABLET$ 1.29

97 04211180 J3490 SINEQUAN CONCENTRATE 120ML$ 29.72 04211181 J3490 PROCAN SR 250MG TABLET$ 1.29 04211183 J3490 SINEQUAN CONCENTRATE DOSE$ 1.29 04211184 J0698 CLAFORAN 1GM INJECTION$ 43.92 04211185 J3490 AFRINOL REPTAB$ 1.29 04211186 J3490 FELDENE 20MG CAPSULE$ 4.56 04211187 J3490 MYLANTA II SUSPENSION 150ML$ 15.27 04211188 J3490 MYLANTA II SUSPENSION 30ML UD$ 1.29 04211189 J3490 GYNE-LOTRIMIN VAG CRM 45GM$ 24.60 04211190 J3490 SPECTROBID 125MG/5ML 100ML$ 29.72 04211192 J3490 NAVANE 5MG IM DOSE$ 1.29 04211194 J3490 PRISCOLIN 25MG/ML DOSE$ 6.38 04211195 J3490 FULVICIN U/F 250MG TABLET$ 1.29 04211197 J3490 SODIUM PHOSPHATE INJECTION$ 6.38 04211199 J3490 FENTANYL 100MCG PATCH$ 102.32 04211200 J3490 FULVICIN P/G 125MG TABLET$ 1.29 04211201 J3490 DTIC DACARBAZIN INJECTION$ 24.53 04211202 J3490 MELLARIL 30MG/ML CONC 120ML$ 40.67 04211205 S0021 CEFOBID 1GM INJECTION$ 36.21 04211206 J3490 SODIUM FLUORIDE 2.2MG TAB$ 0.28 04211208 J3490 ROBINUL 0.2MG/ML INJECTION$ 6.38 04211210 J3490 CEFOBID 2GM INJECTION$ 72.41 04211218 J3490 BENZOIN TINCTURE SWABSTICK$ 2.18 04211219 J3490 ETRAFON 2-25 TABLET$ 1.29 04211220 J3490 MYAMBUTOL 100MG TABLET$ 1.29 04211222 J3490 IMMUGLOBULIN 10% 3GM/100ML IV$ 497.92 04211224 J3490 SEROMYCIN 250MG CAPSULE$ 1.68 04211225 J3490 MAALOX TABLETS NO.1$ 0.18 04211227 J3490 LIDEX 0.05% 30GM CREAM$ 30.01 04211228 J3490 HALOTESTIN 5MG TABLET$ 1.68 04211229 J3490 TRANSDERM NITRO 5 PATCH$ 4.26 04211232 J3490 LIDEX 0.05% 60GM CREAM$ 50.17 04211233 J3490 TRANSDERM NITRO 10 PATCH$ 4.79 04211235 J3490 CARMOL 10 LOTION 30GM$ 1.68 04211236 J3490 LOPRESSOR 50MG TABLET$ 1.29 04211237 J3490 COUMADIN 2.5MG TABLET$ 0.68 04211238 J3490 NITROGLYCERIN 50MG INJECT$ 105.25 04211239 J3490 DILANTIN S 125MG/5ML DOSE$ 1.29 04211240 J3490 CUPRIMINE 250MG CAPSULE$ 1.29 04211243 J3490 PHENERGAN VC SYRUP 5ML$ 1.29 04211244 J3490 FELDENE 10MG CAPSULE$ 1.76 04211245 J3490 BETADINE/SUGAR PASTE 120GM$ 13.74

98 04211247 Q0164 COMPAZINE SYR 5MG/ML 120ML$ 40.27 04211249 J3490 CARDIZEM 30MG TABLET$ 1.02 04211250 J3490 VASOPRESSIN 40UNITS/NSS 100ML$ 790.25 04211251 J3490 SUDAFED 60MG TABLET$ 1.29 04211253 J3490 ECONOPRED OPHTH 1/8% DP 5M$ 28.05 04211256 J3490 CLINORIL 200MG TABLET$ 2.98 04211259 J1410 PREMARIN 25MG INJECTION$ 100.83 04211261 J1642 HEPARIN LOCK 100U/5ML 30ML$ 8.19 04211262 J3490 PROSTIN 20MG VAG SUPP$ 132.83 04211263 J3490 KENALOG 0.025% CREAM 15GM$ 10.29 04211264 J3490 SODIUM SULAMYD 10% 15ML OPHTH$ 15.65 04211265 J3490 MYCELEX TROCHE 10MG$ 1.88 04211267 J3490 TRIAVIL 2-10 TABLET$ 1.49 04211268 J3490 MELLARIL 25MG/5ML SUSP 15M$ 1.29 04211269 J3490 DIPROSONE 0.05% LOTN 60ML$ 108.99 04211270 J3490 DIPROLENE 0.05% OINT 45GM$ 82.51 04211271 J3490 VANCENASE 25GM INHALER$ 32.54 04211272 J3490 PRAVASTATIN SODIUM 40MG TAB UD$ 7.56 04211273 J3490 SYNTHROID 0.075MG TABLET$ 0.44 04211276 J3490 SINEMET 25/100 TABLET$ 1.29 04211278 J3490 SODIUM CL 100MEQ VIAL$ 10.79 04211279 J3490 DEXTROSTIX 25'S$ 59.30 04211280 J3490 TRAVASOL HYPERAL 8.5% 500M$ 51.69 04211281 J3490 DESYREL 50MG TABLET$ 1.38 04211282 A4247 BETADINE SWABSTICK$ 0.90 04211283 J3490 CHLOROQUINE PO4 250MG TAB$ 1.29 04211284 J3490 ZINC 50MG TABLET$ 1.29 04211285 J3490 NORMODYNE 200MG TABLET$ 1.30 04211287 J3490 DEBRISAN 60GM$ 134.89 04211288 J3490 PREDNISONE LIQ 5MG/5ML DOSE$ 1.29 04211289 J3490 CHENIX 250MG TABLET$ 1.98 04211292 J3490 FURADANTIN 100MG TABLET$ 1.29 04211293 J3490 BUMEX 1MG TABLET$ 0.79 04211294 J3490 ZINC 100MG TABLET$ 0.05 04211295 J3490 SODIUM CHLORIDE 3% 500ML$ 17.77 04211296 J3490 NEO-SYNEPHRINE OPHTH 10%$ 12.09 04211297 S0171 BUMEX 0.5MG/2ML AMP$ 5.93 04211299 J3490 MIDRIN CAPSULE$ 1.29 04211300 J3490 NEO-SYNEPHRINE OPHTH 2.5%$ 11.29 04211301 J3490 FLUORI-METH SPRAY$ 18.95 04211302 J3490 INSULIN REG HUMALIN 10ML$ 48.14 04211303 J3490 LITHOBID 300MG TABLET$ 1.29

99 04211304 J3490 ORAL REHYDRATION COMPOUND$ 7.62 04211306 J3490 CECLOR 125MG/5ML 150ML$ 64.00 04211307 Q0177 VISTARIL 25MG CAPSULE$ 1.29 04211312 J3490 MELLARIL 15MG TABLET$ 1.29 04211316 J3490 HALOG OINTMENT 0.1% 15GM$ 23.37 04211317 J3490 ECONOPRED PLUS 1% OPHTH$ 30.39 04211318 J3490 MIOCHOL OPHTH SOLN 20MG 2M$ 70.10 04211320 J1170 DILAUDID 4MG INJECTION$ 6.38 04211323 J3490 MAGNESIUM CITRATE 300ML BOT$ 3.82 04211324 J3490 TRIDESILON CREAM 60GM$ 45.74 04211328 J3490 LOXITANE 5MG CAPSULE UD$ 1.29 04211331 J3490 THEO-DUR 50MG SPRINKLE$ 1.29 04211334 J3480 MICRO K 10MEQ TABLET$ 0.34 04211336 J3490 DEXTROSE 5% NACL .1% 1000M$ 26.68 04211337 J3490 REGLAN 150MG/30ML INJ$ 91.59 04211340 J3490 ALBUTEROL 2MG TABLET$ 1.29 04211341 J3490 LIDO-EPI 1% 1:100000 10ML MDV$ 10.92 04211348 J3490 SORBITOL 70% 15ML DOSE$ 1.29 04211354 J3490 DAKIN'S SOLUTION 1000ML$ 6.97 04211363 J3490 DITROPAN SYRUP 5ML DOSE$ 1.29 04211364 J3490 ASENDIN 100MG TABLET UD$ 3.78 04211367 A4217 WATER STERILE 500ML INJ$ 17.77 04211368 J3490 ALCOHOL 15% DOSE$ 1.88 04211372 J3490 MYLICON 80MG TABLET$ 0.38 04211373 J3490 NIZORAL 200MG TABLET$ 6.17 04211376 J3490 MEXITIL 200MG CAPSULE$ 1.71 04211377 J3490 MAXZIDE TABLET UD$ 1.70 04211378 J3490 GYNE-LOTRIMIN 100MG VAGTAB$ 5.97 04211379 J3490 LUDIOMIL 25MG TABLET$ 1.29 04211381 J3490 CHLOROQUINE PO4 0.5GM TAB$ 5.55 04211382 J3490 METUBINE IODINE 2MG$ 67.06 04211383 J3490 CALAN 80MG TABLET$ 1.29 04211385 J3490 TRACRIUM 10MG/ML 10ML AMP$ 63.28 04211386 J3490 CERUBIDIN 20MG VIAL$ 289.91 04211387 J3490 NAVANE 10MG IM DOSE$ 6.38 04211391 J3490 SORBITOL 20% 100ML$ 1.29 04211394 J3490 ZINC SULFATE 220MG CAP$ 0.25 04211397 J3490 SODIUM CL .33% 1000ML$ 7.99 04211398 J3490 LOTRISONE 45GM CREAM$ 72.91 04211401 J3490 DURICEF SUSP 125MG/5ML 100ML$ 59.40 04211402 J3490 MYSOLINE 250MG/5ML DOSE$ 1.30 04211403 J3490 LIDEX GEL 0.05% 15GM$ 21.60

100 04211405 J3490 CORTISONE ACETATE 25MG TAB$ 1.29 04211413 J3490 GLYCINE IRRIGATE 3000ML$ 32.56 04211417 J3490 PERCOCET 5/325MG TABLET$ 1.29 04211419 J3490 DECLOMYCIN 150MG TABLET$ 2.69 04211421 J3490 MENTHOL.15GM/PETROLATUM30G$ 13.04 04211423 J3490 SYNTHROID 0.05MG TABLET$ 1.29 04211424 J3490 MAXIDEX OPHTH OINT 3.5GM$ 17.94 04211427 J3490 ISORDIL 40MG$ 1.29 04211428 J3490 MAXIDEX OPHTH SOLN 5ML$ 22.73 04211432 J3490 METAPREL MIST REFILL$ 21.12 04211433 J3490 INTRA-SITE GEL 15GM$ 53.95 04211434 J3490 DERMASYN WOUND GEL 3OZ$ 30.48 04211435 J3490 SHOLHS SOLUTION 15ML$ 1.29 04211436 J3490 METAPREL MIST W/ ADPT$ 23.37 04211439 J3490 INTRALIPID 10% 50ML$ 76.23 04211440 J3490 MEDIHALER ISO REFILL 15ML$ 22.63 04211443 J3490 WATER STERILE 1000ML INJ$ 6.24 04211444 J3490 DUO-MEDIHALER 15ML$ 25.52 04211446 J3490 TONOCARD 400MG UD TABLET$ 2.21 04211447 J1250 DOBUTAMINE 250MG INJECTION$ 102.44 04211448 J3490 AFRIN PED NASAL DROP 20ML$ 6.38 04211449 J3490 LOPID 300 MG CAPSULE$ 1.13 04211450 J3490 TONOCARD 600MG UD TABLET$ 2.65 04211452 J0834 CORTROSYN 0.25MG 1ML INJ$ 16.99 04211453 J3490 BRONKOSOL INHALATION 10ML$ 31.40 04211454 J3490 ZINC GLUCONATE 50MG/5ML$ 0.05 04211458 J3490 CHEMO DISPENSING PIN$ 8.42 04211459 J3490 CYCLOCORT 0.1% 30GM OINT$ 46.26 04211460 J3490 VISTARIL 25MG INJECTION$ 6.08 04211461 J3490 DEXTROSE 10% NACL .2% 500M$ 8.88 04211462 J1815 INSULIN PER 1ML INJECTION$ 4.66 04211463 J3490 SODIUM CHLORIDE 0.2% 500ML$ 17.77 04211464 J3490 INSULIN-NPH HUMAN-N 10ML$ 44.49 04211465 J3490 HEPTAVAX-B 20MCG/ML 3ML$ 570.07 04211466 J3490 VIOFORM 3% CREAM 30GM$ 15.74 04211467 J3490 VISTARIL SUSP 25MG/5ML DOSE$ 2.35 04211468 J3490 V-ZIG 125 UNIT INJ$ 466.57 04211469 J0280 AMINOPHYLLINE 1MG/ML DOSE$ 2.26 04211470 J3490 CARDIZEM 60MG TABLET$ 1.67 04211472 J3490 TEGRETOL 100MG CHEW TABLET$ 1.29 04211474 J3490 KAYEXALATE POWDER 30GM$ 20.18 04211475 J3490 DEXTROSE 10% NACL .2% 250M$ 21.37

101 04211477 A4244 HYDROGEN PEROXIDE 30ML$ 0.21 04211478 J3490 SORBITOL 20% 150ML$ 5.06 04211480 J3490 DHT 0.125MG TABLET$ 1.95 04211482 J3490 PHENYLEPHRINE 2.5% 15ML OPHTH$ 30.35 04211483 J3490 ACYCLOVIR 5% 15GM OINT$ 80.23 04211484 J3490 DHT 0.2MG TABLET$ 1.98 04211495 J3490 FUROXONE 50MG/15ML 5ML DOSE$ 1.29 04211509 J3490 EPHEDRINE SO4 50MG/ML AMP$ 4.44 04211510 J3490 LEVOPROME 20MG/ML 1ML INJ$ 730.37 04211511 J3490 AVEENO BAR SOAP 3.5OZ$ 9.28 04211512 J3490 LUBRIDERM LOTION 8OZ$ 21.67 04211513 J3490 POTASSIUM PO4 40MEQ/15ML$ 16.03 04211518 J3490 HALDOL 0.5MG TABLET UD$ 1.06 04211519 J3490 MUMPS SKIN TEST 1ML$ 95.34 04211522 J3490 ACETAMINOPHEN 10GR TAB DOS$ 0.07 04211523 J3490 DURICEF 500MG CAPSULE$ 3.00 04211525 J3490 FURACIN SOLUBLE DRESS 30GM$ 6.14 04211528 J1644 HEPARIN 1000U/ML 30ML$ 29.67 04211529 J3490 CEPACOL LOZENGE EACH$ 0.08 04211531 J3490 GLUCOTROL 5MG TABLET$ 0.82 04211532 J3490 DURICEF SUSP 250MG/5ML 100ML B$ 111.51 04211533 J3490 PETROLATUM OINT FOILPC$ 0.21 04211534 J3490 SOMOPHYLLINE SOLN 1ML DOSE$ 2.45 04211535 J3490 MUCOMYST 20% 30ML INHAL$ 178.32 04211536 J3490 LEUCOVORIN 3MG/ML$ 23.30 04211537 J3490 HESPAN INFUSION 500ML$ 127.28 04211538 J3490 SODIUM CHLORIDE 0.2% 250ML$ 11.64 04211539 J3490 PARAFON FORTE TABLET$ 0.09 04211540 J3490 MICRONASE 1.25MG TABLET$ 0.47 04211543 J3490 MICRONASE 5MG TABLET$ 1.28 04211544 J3490 MICRONASE 2.5MG TABLET$ 0.75 04211551 J3490 HALOG SOLUTION 0.1% 60ML$ 104.97 04211552 J3490 WESTCORT CREAM 0.2% 45GM$ 55.92 04211555 J3490 VALISONE/15% PET/ OZ$ 42.27 04211556 J3490 POLYCILLIN 250MG/5ML 150ML$ 26.41 04211560 J3490 SYNTHROID 0.2MG TABLET$ 0.71 04211562 A4244 HYDROGEN PEROXIDE 8OZ$ 1.98 04211563 J3490 HALOG SOLUTION 0.1% 20ML$ 47.89 04211567 J3490 MYLANTA TABLET$ 0.18 04211568 J3490 ACTH-GEL 80 UNIT DOSE$ 55.84 04211570 J3490 CYCLOCORT 0.1% 15GM CRM$ 39.09 04211571 J3490 TRANSDERM SCOP DISC EACH$ 30.46

102 04211572 S0020 MARCAINE 0.5% 30ML VIAL$ 15.06 04211573 J3490 TRANSDERM NITRO 2.5 PATCH$ 4.16 04211574 J3490 ALPHA-KERI BATH OIL 8OZ$ 6.31 04211575 J3490 SODIUM CHLORIDE 5% 200ML$ 15.82 04211577 J3490 MEASLES/RUBELLA DOSE$ 80.65 04211578 J0696 ROCEPHIN 250MG VIAL$ 34.55 04211581 J3490 VIOFORM HC 1% CREAM 20GM$ 43.72 04211582 J3490 PYRIDOXINE 100MG TABLET$ 0.05 04211587 J3490 HALCION 0.5MG TABLET UD$ 1.29 04211588 J3490 ALDOMET SUSP 250MG/5ML DOSE$ 1.29 04211591 J3490 BASALJEL SUSPENSION 12OZ$ 12.18 04211592 J3490 CORDRAN CREAM 0.05% 60GM$ 63.66 04211595 J3490 THEO-DUR 200MG TABLET$ 1.29 04211596 J3490 THEO-DUR 125MG SPRINKLE$ 1.29 04211599 J3490 THEO-DUR 75MG SPRINKLE$ 1.29 04211610 J3490 WESTCORT CREAM 0.2% 60GM$ 69.13 04211611 J3490 VAPONEFRIN SOLUTION 15ML$ 33.23 04211613 J3490 PETROL W/MENTHOL 0.5% 120G$ 19.31 04211614 J3490 KENALOG 0.05% CREAM 60GM$ 86.67 04211615 J3490 DHT 0.2MG/ML 30ML$ 71.61 04211616 J3490 GLUCOTROL 10MG TABLET$ 1.49 04211617 J3490 PRED FORTE OPHTH 1% 5ML$ 30.62 04211618 J3490 INDOMETHACIN SUSP 25MG/25M$ 5.25 04211619 J3490 CARAFATE 1GM TABLET$ 1.60 04211622 J0702 CELESTONE 6MG/ML 5ML INJ$ 21.68 04211623 J0278 AMIKACIN 50MG/ML 2ML VIAL$ 67.65 04211625 J3490 ATROPINE 0.4MG TABLET$ 0.18 04211626 J3490 LIDOCAINE VISCOUS 2% 5ML U/D$ 2.33 04211630 J3490 ERYTHROMYCIN 200/5ML 200ML$ 41.11 04211634 J3490 SANDIMMUNE 100MG/ML 50ML OS$ 705.18 04211638 J3490 INSULIN-LENTE HUMAN-L 10ML$ 48.14 04211639 J2930 SOLU-MEDROL 125MG VIAL$ 7.05 04211640 J3490 YUTOPAR 150MG VIAL$ 507.43 04211642 J3490 SILVER NITRATE APP 10'S$ 2.58 04211643 J3490 TRACE ELEMENTS ADDITIVE 10ML$ 39.77 04211644 J3490 TRIPLE DYE 15ML VIAL$ 3.74 04211647 J3490 HALCION 0.25MG TABLET$ 1.39 04211648 J3490 MICRO K 8MEQ CAPSULE$ 0.29 04211649 J3490 ALBUTEROL SYR 2MG/5ML DOSE$ 4.10 04211650 S0109 METHADONE 5MG TABLET$ 0.21 04211651 J7040 NORMAL SALINE 0.45% 500ML$ 5.10 04211653 J3490 PHENOBARBITAL 15MG TABLET$ 0.02

103 04211655 J0696 ROCEPHIN 500MG VIAL$ 59.46 04211656 J3490 DEXTROSE 10% NACL .45 1000$ 12.87 04211657 J3490 MINERAL OIL DOSE$ 0.92 04211658 J3490 DEXTROSE 10% NACL .45 250M$ 8.19 04211659 J3490 NITROGLYCERIN OINT 2% 30GM$ 8.53 04211660 J3490 BETADINE DOUCHE MIXED 1000$ 6.97 04211661 J3490 TOPICORT CREAM 0.25% 60GM$ 78.31 04211662 J2720 PROTAMINE SULFATE 50MG INJ$ 15.74 04211663 J3490 BURROW'S SOLN 1:20 1000ML$ 8.68 04211664 J3490 CEPACOL/NSS 1:1 240ML$ 7.49 04211665 J3490 TRENTAL 400MG TABLET$ 1.19 04211666 J0696 ROCEPHIN 2GM VIAL$ 220.55 04211667 J3490 CALCIUM GLUCONATE 10GR TAB$ 0.22 04211668 J3490 LOTRISONE 15GM CREAM$ 37.89 04211669 J3490 NORFLEX 100MG TABLET$ 2.88 04211670 J3490 E E S DROPS 100MG/2.5 50ML$ 17.51 04211671 J3490 AMPHOJEL SUSPENSION 348ML BT$ 13.99 04211672 J3490 ASPIRIN 10GR TABLET DOSE$ 0.47 04211673 J3490 ACYCLOVIR 200MG CAPSULE$ 2.24 04211674 J3490 ACYCLOVIR 500MG 10ML VIAL$ 156.10 04211676 J3490 PITRESSIN 20U/ML VIAL$ 30.12 04211677 J3490 CECLOR 250MG/5ML 150ML$ 116.04 04211678 J3490 SILVADENE CREAM 1% 400GM$ 87.41 04211679 J3490 OS-CAL 500MG TABLET$ 0.47 04211680 J3490 DIPROLENE 0.05% 15GM OINT$ 45.08 04211681 J3490 PEDIAZOLE SUSPENSION 100ML$ 73.86 04211684 J3490 AVEENO OILATED BATH 8OZ$ 46.36 04211685 J3490 TEGRETOL 100MG/5ML DOSE$ 2.61 04211686 J3490 HALOG OINTMENT 0.1% 30GM$ 64.22 04211687 J3490 POTASSIUM CHLORIDE INJECT$ 3.14 04211688 J3490 POTASSIUM PO4 INJ DOSE$ 4.34 04211689 A4217 NORMAL SALINE IRRIG 4000ML$ 29.60 04211690 J3490 SORBITOL UROGEN 3.3% 2000ML$ 28.58 04211701 J3490 SORBITOL UROGEN 3.3% 4000ML$ 57.35 04211702 J3490 AMINOACETIC 1.5%IRR 2000ML$ 13.89 04211703 J3490 MVI CONCENTRATE DOSE$ 3.82 04211705 J3490 AMINOACETIC 1.5%IRR 4000ML$ 27.81 04211707 J3490 NEOSPORIN OINTMENT 30GM$ 15.84 04211708 J3490 FERROUS SO4 ELIX 5ML DOSE$ 1.24 04211711 J3490 OIL OF WINTERGREEN 30ML$ 1.67 04211712 J2690 PROCAINAMIDE 500MG INJECT$ 27.51 04211713 J3490 XANAX 0.5MG TABLET$ 1.46

104 04211714 J3490 MAGNESIUM S04 15GM POWDER$ 5.43 04211715 J2690 PROCAINAMIDE 1000MG INJECT$ 45.57 04211716 J3490 APLISOL 5TU/0.1ML INJECT$ 0.88 04211717 J3490 SILVADENE CREAM 1% 30GM$ 6.53 04211718 J3490 ACTIVATED CHARCOAL 25GM 120ML$ 6.57 04211719 J3490 SODIUM CL 30ML INJECTION$ 6.60 04211720 J3490 HEPARIN INJECTION$ 22.26 04211721 J3490 PAVULON 1MG/ML 10ML VIAL$ 51.88 04211723 J3490 MONISTAT-DERM CREAM 15GM$ 80.51 04211724 J3490 LIDEX 0.05% 60GM OINTMENT$ 92.69 04211725 J3490 NITROGLYCERIN MICRODRIP SE$ 29.25 04211726 J3490 DEXTROSE 10% NS 1000ML$ 13.04 04211727 J3490 DURICEF SUSP 125MG/5ML DOSE$ 2.47 04211728 J3490 DURICEF SUSP 250MG/5ML DOSE$ 5.59 04211729 J3490 NIACIN 50MG TABLET$ 0.21 04211730 J3490 QUESTRAN POWDER 180MG$ 4.87 04211731 J3490 NAFCILLIN 500MG INJECTION$ 16.34 04211732 J3490 NAFCILLIN 1GM INJECTION$ 32.33 04211734 J3490 GANTRISIN 500MG TABLET$ 0.49 04211735 J3490 MICODERM CRM 90GM$ 34.95 04211736 J3490 STOXIL OPHTH DRP 0.1% 15ML$ 48.05 04211737 J3490 HIBICLENS CLEANSER 30ML$ 2.08 04211738 J3490 TRACE ELEMENTS ADDITIVE 1ML$ 14.57 04211739 J3490 SOLU-CORTEF INJ DOSE$ 5.73 04211740 J3490 ACETAMINOPHEN 80MG CHEW TA$ 0.28 04211742 J3490 KAYEXALATE POWDER 50GM$ 33.65 04211744 J3490 ZANTAC 150MG TABLET$ 4.26 04211747 J3490 BACITRACIN 15GM OINTMENT$ 5.20 04211748 J3490 HIBICLENS CLEANSER 1GAL$ 122.51 04211750 J3490 FREAMINE HYPERAL 8.5% 500M$ 45.86 04211751 J3490 ERYC 250MG CAPSULE$ 0.92 04211754 J3490 ARISTOCORT 40MG/ML 5ML VL$ 85.40 04211756 J3490 PRIMATENE MIST W/APPLICATO$ 30.88 04211757 J3490 AMOXICILLIN 250MG/5ML 150ML$ 38.94 04211758 J3490 EMETROL SOLUTION 30ML$ 4.14 04211759 J3490 NORMAL SALINE 0.9% 30ML$ 3.48 04211760 A4217 WATER IRRIGATION 4000ML$ 29.46 04211764 J3490 DEXTROSE 10% NACL .45 500M$ 8.88 04211766 J3490 NATURACIL CHEWABLE EACH$ 0.71 04211768 J3490 HEPTAVAX-B 20MCG/ML 0.5ML$ 95.03 04211770 J0702 CELESTONE 6MG/ML 1ML INJ$ 9.36 04211773 J3490 MAGNESIUM S04 50% SOL 30ML$ 4.87

105 04211774 J3490 ACETIC ACID 0.5% SOLN 1000ML$ 5.91 04211776 J3490 HEPATITIS B IMM GLOB 0.5ML$ 102.81 04211777 J3490 CAPOTEN 50MG TABLET$ 2.48 04211781 J1810 INAPSINE 2.5MG/ML 2ML AMP$ 11.29 04211785 J3490 ACHROMYCIN OPHTH OINT$ 15.27 04211793 J3490 PEPTO BISMOL LIQUID 4OZ$ 1.29 04211795 J3490 THYMOL/HYDROCORTISONE 30GM$ 5.08 04211796 J3490 SODIUM THIOSULFATE 25% 50ML VL$ 3.82 04211799 J3490 ISOPTO HYOSCINE 0.25% 5ML$ 15.87 04211800 J3490 PYRAZINAMIDE 500MG TABLET$ 1.29 04211802 J3490 GYNE-LOTRIMIN VAG TABS 7'S$ 22.86 04211806 J3490 SODIUM CHLORIDE 2% 250ML$ 14.61 04211807 J3490 BACITRACIN OPHTH SOLN$ 25.38 04211808 J3490 BACITRACIN 50000U VIAL$ 22.86 04211809 J3490 ACETONE 30ML$ 1.29 04211810 J3490 CYLERT 18.75MG TABLET$ 1.29 04211812 J1320 AMITRIPTYLINE 10MG/ML 10ML$ 11.71 04211813 J3490 AMINOPHYLLINE 200MG TABLET$ 1.29 04211814 J3490 LIMBRITOL 10-25 TABLET$ 1.29 04211815 J3490 PROCAINAMIDE 375MG CAPSULE$ 1.29 04211817 J3490 CARMOL 20 CREAM 90GM$ 9.12 04211818 J3490 TUCKS 100 PADS$ 11.91 04211819 J3490 MOTRIN 600MG TABLET$ 1.29 04211820 A4217 WATER IRRIGATION 1000ML$ 12.71 04211821 J3490 ELIXOPHYLLIN 80MG/15ML UD$ 1.29 04211822 J3490 SODIUM ACET2MEQ/ML 20ML INJ$ 6.38 04211823 J3490 PROCARDIA 10MG CAPSULE$ 1.29 04211824 J3490 KAYEXALATE POWDER 15GM$ 4.57 04211826 J3490 VELOSEF SUSP 250MG/5ML 100ML$ 37.34 04211827 J1265 DOPAMINE 200MG$ 17.94 04211831 J1265 DOPAMINE 400MG/5ML VIAL$ 33.79 04211832 J3490 PREPARATION H OINT 30GM$ 8.25 04211833 J3490 ROBITUSSIN CF SYRUP 5ML$ 1.29 04211834 J3490 HYPERLYTE 25ML INJ$ 9.03 04211838 J3490 NEUTRA-PHOS-K CAPSULE$ 1.29 04211839 J3490 ILOTYCIN 3.5GM OPHTH OINT$ 8.25 04211842 J3490 PREGNYL 10000U VIAL$ 93.73 04211843 J3490 CYCLOGYL 0.5% OPHT DROP 15ML$ 27.96 04211844 J3490 MECLOMEN 100MG CAPSULE UD$ 1.29 04211845 J3490 VITAMIN C 500MG TABLET$ 1.29 04211846 J3490 INTRALIPID 10% 100ML$ 68.26 04211849 J3490 FILIBON F.A. TABLET$ 1.29

106 04211854 J3490 VISTARIL 100MG/2ML INJECT$ 12.71 04211855 S0139 LONITEN 10MG TABLET$ 1.29 04211857 J3490 TESTOSTERONE 200MG VIAL$ 18.92 04211858 J3490 MITHRACIN 2.5MG VIAL$ 101.63 04211859 J3490 METHYLENE BLUE 1% 10ML INJ$ 6.38 04211860 J3490 CEFADYL 2GM INJECTION$ 28.83 04211861 J3490 TOLECTIN 200MG TABLET$ 1.29 04211862 J3490 ISORDIL 20MG$ 1.29 04211863 J3490 INSULIN-REG PORK U100 10ML$ 6.38 04211864 J3490 LOTRIMIN SOLN 1% 10ML$ 14.49 04211868 A4649 VIAFLEX-EMPTY CONTAINER 250ML$ 5.69 04211869 J3490 YUTOPAR 10MG TABLET$ 2.32 04211872 J7050 NORMAL SALINE 0.9% 50ML$ 6.38 04211873 J3490 YUTOPAR 50MG AMP$ 61.99 04211875 J3490 CARMOL HC CREAM 1OZ$ 18.55 04211877 J3490 TIMOPTIC OPHTH SOLN 5ML$ 32.39 04211878 J3490 DEXTROSE 5% WATER 50ML$ 6.38 04211880 J9000 ADRIAMYCIN 10MG VIAL$ 88.54 04211881 J3490 VELOSEF 125/5ML 100ML$ 19.92 04211883 J3490 MYLANTA SUSPENSION 360ML$ 15.27 04211885 J3490 KAYEXALATE SUSP 15GM 60ML$ 13.36 04211887 J3490 PRIMAQUINE 26.3MG TABLET$ 1.29 04211888 J3490 NOLVADEX 10MG TABLET$ 3.66 04211892 J3490 TEGOPEN 500MG CAPSULE$ 3.56 04211893 J3490 KERALYT GEL 1OZ$ 17.40 04211899 J3490 ASCENDIN 50MG TABLET UD$ 1.29 04211901 J3490 SYNTHROID 0.025MG TABLET$ 1.29 04211902 J3490 SULFADIAZINE 500MG TABLET$ 1.29 04211903 J3490 DARAPRIM 25MG TABLET$ 1.29 04211904 J3490 ZINC TRACE ELEMENT 1MG/ML 10ML$ 6.38 04211905 J3490 CLEOCIN SUSP 75MG/5ML 100ML BT$ 40.67 04211906 J3490 FLEXERIL 10MG TABLET$ 1.29 04211907 J3490 MANGANESE TRACE ELEM ADDIT$ 6.38 04211908 J3490 COPPER TRACE METAL 10ML VIAL$ 6.38 04211909 J3490 PIPRACIL 4GM$ 50.31 04211910 J3490 ERYTHROMYCIN 500MG TABLET$ 1.29 04211912 J3490 CHOLEDYL PEDS SYR 5ML$ 1.29 04211913 J3490 LIDOCAINE 2GM IV$ 15.65 04211914 J3490 LITHIUM SYR 300MG/5ML$ 1.29 04211915 J3490 ATENOLOL 50MG TABLET$ 1.29 04211916 J3490 CHOLEDYL SYRUP 5ML$ 1.29 04211917 J3490 SEPTRA IV INFUSION 5ML AMP$ 24.60

107 04211918 J3490 PIPRACIL 3GM$ 39.64 04211919 J3490 PROLIXIN ELIXIR 5ML DOSE$ 1.29 04211921 J3490 CATAPRES 0.1MG TABLET$ 1.29 04211922 J8597 REGLAN 10MG TABLET$ 1.29 04211923 J3490 STELAZINE 10MG/ML 60ML$ 52.50 04211925 J3490 OPHTHALGAN EYE SOLN$ 13.20 04211926 J3490 LONITEN 2.5MG TABLET$ 1.29 04211927 J3490 HYDROCORTISONE 1% SOLN 60M$ 1.29 04211929 J3490 ACTIVATED CHARCOAL 30GM$ 1.29 04211930 J3490 SODIUM CHLORIDE 3% 200ML$ 12.71 04211931 J3490 TITRALAC LIQUID 15ML$ 1.29 04211932 J3490 VALISONE CREAM 45GM$ 32.90 04211933 J3490 CIMETIDINE 200MG TABLET$ 1.29 04211934 S0023 CIMETIDINE LIQ 300MG/5ML DOSE$ 1.89 04211936 J3490 PARLODEL 2.5MG TABLET$ 2.15 04211937 J3490 FERRO SEQUELS CAPSULE UD$ 1.29 04211938 J3490 THIAMINE 10MG TABLET$ 1.29 04211939 J3490 BORIC ACID 1% SOLN 30ML$ 6.38 04211944 J3490 ATIVAN 1MG TABLET$ 1.29 04211945 J3490 DEXTROSE 5% NACL .33% 1000ML$ 22.86 04211946 J3490 ZINC SULFATE 50MG/5ML DOSE$ 1.29 04211947 J1840 KANTREX 500MG IM$ 32.39 04211948 J2270 MORPHINE 4MG INJECTION$ 6.38 04211949 J3490 ALDACTAZIDE SOLUTION$ 1.29 04211950 J3490 OSELTAMIVIR LIQ 2.5ML DOSE$ 19.37 04211951 J3490 SUSTAIRE 100MG SR TABLET$ 1.29 04211953 J3490 GARAMYCIN 20MG/2ML INJECT$ 10.29 04211954 J2001 LIDOCAINE 1GM INFUSION$ 9.92 04211956 J3490 CENTRUM TABLET$ 1.29 04211958 J3490 NUTRACORT LOTION 1% 120ML$ 29.59 04211959 J3490 DIGOXIN 0.375MG TAB$ 1.29 04211960 J3490 TERBUTALINE 2.5MG TABLET$ 1.29 04211961 J3490 DIBENZYLINE 10MG CAPSULE$ 1.29 04211965 J3490 ISORDIL 5MG TABLET$ 1.29 04211966 J3490 INSULIN-LENTE PORK 10ML$ 55.90 04211967 J3490 DEPAKENE SYRUP 250MG/5ML UD$ 1.29 04211970 J3490 STOXIL OPHTH OINT$ 20.82 04211971 J3490 INSULIN-REGULAR U100 10ML$ 6.38 04211973 J3490 CYTARABINE 500MG VIAL$ 80.17 04211979 J3490 KAYEXALATE W/SORBITOL 200M$ 20.33 04211982 J3490 PHENAPHEN 650 W/COD CAP$ 1.29 04211985 J3490 SSKI 30ML$ 2.32

108 04211986 J3490 VERMOX 100MG CHEW TABLET$ 4.95 04211987 J3490 LASIX 80MG$ 1.29 04211988 J7060 DEXTROSE 5% WATER 100ML$ 10.16 04211989 J3490 DECADRON 4MG TABLET$ 2.15 04211990 J3490 FENTANYL 50MCG PATCH$ 53.58 04211991 J3490 STRESSTAB 600 W/ IRON$ 1.29 04211992 J3490 FENTANYL 25MCG PATCH$ 37.83 04211993 J3490 PLAQUENIL 200MG TABLET$ 1.29 04211996 J3490 LACTULOSE SYRUP 15ML$ 2.90 04211997 J3490 AQUAPHOR 1OZ$ 5.70 04211998 B4103 PEDIALYTE LIQUID 1L BT$ 6.86 04211999 J3490 DOMEBORO POWDER PACKET$ 1.29 04212000 J3490 BICILLIN CR 6000000 UNIT$ 7.88 04212002 J3490 POLY-VI-FLOR CHEW TABLET$ 1.29 04212006 J3490 DEXTROSE 10% WATER 250ML$ 14.61 04212007 J3490 TERBUTALINE 5MG TABLET$ 1.29 04212009 Q9967 OMNIPAQUE 300 61% 100ML$ 34.00 04212010 J7030 NORMAL SALINE 0.45% 1000ML$ 22.86 04212011 J3490 EPSOM SALT 1OZ$ 1.29 04212012 J3490 AVC VAGINAL CREAM 4OZ$ 20.94 04212013 J3490 APRESOLINE SUSP 25MG/5 DOS$ 1.29 04212015 J3490 ISORDIL SL 2.5MG$ 1.29 04212016 J3490 MEDIHALER ISO W/ ADPT 15ML$ 24.77 04212017 J3490 LUGOL'S SOLUTION 30ML$ 1.29 04212018 J3490 STRESSTAB W/ ZINC$ 1.29 04212019 J3490 DEBRISAN 4GM/PKT$ 9.92 04212022 J3490 SOMOPHYLLINE SOLUTION 15ML$ 1.29 04212024 J3490 SUSTAIRE 300MG SR TABLET$ 1.29 04212025 J3490 STADOL 2MG INJECTION$ 6.38 04212026 J3490 GENTIAN VIOLET 2% 30ML$ 3.32 04212027 J3490 SORBITOL 70% 50GM$ 1.29 04212028 J3490 RONDEC DROPS 30ML$ 20.33 04212029 J3490 MYLICON 40MG TABLET$ 1.29 04212030 J3490 MELLARIL 10MG TABLET$ 1.29 04212031 J3490 MYI MULTI-VITAMIN INJ$ 6.38 04212033 J3490 DITROPAN 5MG TABLET$ 1.29 04212036 J3490 METAPREL INHALAT 5% 10ML$ 16.02 04212041 J3490 VITAMIN E CREAM 120GM$ 9.92 04212043 J3490 NORMAL SALINE/H2O2 1:1 8OZ$ 9.51 04212044 J3490 BRONKOMETER AEROSOL 10ML$ 14.49 04212045 J3490 FML OPHTH SOLN 10ML$ 24.60 04212046 J3490 VINEGAR DOUCHE 16OZ$ 5.70

109 04212047 J3490 THYROID 1/2GR TABLET$ 1.29 04212049 J3490 TOPICORT CREAM 0.25% 15GM$ 14.23 04212051 J3490 DIPROSONE 0.05% 45GM OINT$ 33.14 04212052 J3490 TOFRANIL 12.5MG/ML 2ML AMP$ 6.38 04212055 J3490 NORPACE 150MG CAPSULE$ 1.29 04212056 J3490 NITRO-BID 2.5MG CAPSULE$ 1.29 04212057 J3490 SUS-PHRINE 5ML VIAL$ 45.35 04212058 J3490 KENALOG/PETROLATUM 15% 30G$ 20.33 04212059 J3490 NITRO-BID 6.5MG CAPSULE$ 1.29 04212060 J3490 NITROGLYCERIN OINT 2% 60GM$ 19.04 04212310 J3490 NORMAL SALINE 0.9% 150ML$ 9.17 04212469 J2543 ZOSYN 2.25GM INJ$ 59.57 04212471 J2543 PIPERACILLIN/ZOSYN 3.375GM VL$ 70.54 04212472 J2543 ZOSYN 4.5GM INJ$ 72.32 04212473 J3490 PIPERACILLIN/TAZO 36GM-4.5GM$ 534.10 04212530 J3490 MVI-12 2X50ML COMBO PKG INJ$ 151.91 04212563 J3490 SOLU-MEDROL 500MG VIAL$ 46.68 04212600 J3490 ACTHIB VACCINE 10MCG 0.5ML INJ$ 110.12 04212612 J3490 DINOPROSTONE VG INSERT 5MG/12M$ 98.11 04212621 J3490 DINOPROSTONE SUPP 20MG$ 392.34 04212628 J3490 NOREPINEPHRINE 16MG/D5W 250ML$ 230.86 04212655 J0572 NALOXONE 2MG/2ML SYRINGE INJ$ 77.43 04212850 J3490 SIMVASTATIN 10MG TAB UD$ 11.59 04212851 J3490 SIMVASTATIN 20MG TAB UD$ 12.68 04212852 J3490 SIMVASTATIN 40MG TAB UD$ 19.09 04212853 J3490 SIMVASTATIN 80MG TAB UD$ 27.11 04212855 J3490 LOSARTAN 25MG TAB$ 8.35 04212856 J3490 LOSARTAN 50MG TAB$ 10.71 04212857 J3490 LOSARTAN 100MG TAB$ 14.55 04212860 J3490 MIDODRINE 5MG TAB$ 8.41 04212865 S0138 FINASTERIDE 5MG TAB$ 8.88 04212870 J3490 ATORVASTATIN 10MG TAB$ 16.36 04212871 J3490 ATORVASTATIN 20MG TAB$ 22.92 04212872 J3490 ATORVASTATIN 40MG TAB$ 24.51 04212873 J3490 ATORVASTATIN 80MG TAB$ 28.74 04212875 J3490 PROPAFENONE 150MG TABLET$ 22.26 04212880 J3490 ACYCLOVIR 800MG CAPSULE$ 2.44 04212885 J3490 BUMETANIDE 1MG/4ML VIAL$ 11.32 04212895 J3490 BERINERT 500IU SDV$ 8,891.82 04212901 J3490 ETOMIDATE 2MG/ML 20ML SDV$ 96.74 04212902 J3490 ETOMIDATE 20MG/10ML AMP$ 36.32 04212905 J0694 CEFOXITIN 1GM/DEX 50ML P/MIX$ 99.12

110 04212906 J0694 CEFOXITIN 2GM/DEX 50ML P/MIX$ 157.66 04212911 J3490 HYDROCORTISONE 5MG TABLET$ 4.21 04213002 J3490 ACETAMINOPHEN 1000MG/100ML INJ$ 55.94 04213006 J3364 UROKINASE 5000 IU VIAL$ 208.33 04213008 J3490 METHOTREXATE 250MG VIAL$ 33.97 04213026 J3490 INDOCIN 1MG VIAL$ 1,055.26 04213046 J3490 MAGNESIUM SO4 10GM/20ML VIAL$ 5.01 04213053 J2270 MORPHINE ORAL SOLN 10MG/5ML 50$ 110.38 04213067 J3490 MVI PEDIATRIC 5ML INJECTION$ 18.91 04213077 J3490 MISOPROSTOL 200MCG TAB UD$ 7.58 04213080 J3490 SALMETEROL 21MCG/INH 13GM$ 138.53 04213085 J3490 MISOPROSTOL 100MCG TAB UD$ 2.73 04213092 J3490 FLUTICASONE 220MCG 12GM INHAL$ 278.73 04213099 J3490 ETOPOSIDE 500MG/25ML INJ$ 160.77 04213106 J3490 MULTITRACE-4 CONCENTRATED 10ML$ 52.45 04213107 J3490 DEXTROSE 70% IV SOLN 500ML$ 79.77 04213111 J3490 GLIPIZIDE 2.5MG TABLET$ 1.01 04213114 J0290 AMPICILLIN 2GM ADD-V$ 211.31 04213120 J1265 DOPAMINE 200MG/5ML VIAL$ 12.02 04213126 J3490 AMIODARONE 50MG/ML 3ML VIAL$ 193.17 04213127 J3490 AMIODARONE 100MG TABLET$ 1.04 04213132 J3490 KETAMINE 500MG/5ML VIAL$ 44.93 04213134 J0295 UNASYN 1500MG/50ML IV SYR$ 52.08 04213139 J3490 LIDOCAINE 1% 10ML MDV$ 5.10 04213140 J3490 LIDOCAINE 2% 10ML MDV$ 5.01 04213156 J3490 FERROUS SO4 ELIX 300MG/5ML UD$ 1.29 04213166 J0696 CEFTRIAXONE 2GM/50ML IV SYR$ 27.97 04213171 J3490 CLOPIDOGREL 75MG TAB UD$ 8.76 04213175 J3490 ANTIHEMO FACTOR-8 2000IU/VIAL$ 4,310.47 04213185 J1162 DIGIBIND 40MG INJECTION$ 755.45 04213200 J3490 GABAPENTIN 100MG CAPSULE$ 1.29 04213207 J3490 ALPRAZOLAM 2MG TAB$ 1.01 04213208 J3490 ALPRAZOLAM 1MG TAB$ 1.01 04213209 J3490 HEMABATE 250MCG/1ML INJ$ 46.45 04213210 J3490 LAMIVUDINE 150MG CAP UD$ 11.71 04213211 J3490 INDINAVIR 400MG CAP UD$ 7.37 04213213 J3490 LAMIVUDINE 10MG/ML DOSE OS$ 1.51 04213214 J3490 ZIDOVUDINE 50MG/5ML SYRUP UD$ 3.40 04213220 J1450 FLUCONAZOLE 200MG/100ML INJ$ 170.80 04213221 J3490 FLUCONAZOLE 400MG/200ML INJ$ 249.62 04213230 J3490 ENALAPRIL TAB 2.5MG UD$ 7.04 04213235 J3490 ZIDOVUDINE 200MG/20ML VIAL$ 73.45

111 04213237 J3490 LEVOTHYROXINE 112MCG TABLET$ 1.01 04213242 J3490 METOLAZONE 5MG TABLET$ 2.88 04213249 J3490 NIFEDIPINE 90NG ER TAB$ 1.07 04213250 J7509 METHYLPREDNISOL 125MG/50ML SYR$ 69.91 04213253 J3490 MESNA 100MG/ML 10ML VIAL$ 471.43 04213260 J9208 IFOSFAMIDE 1GM VIAL$ 246.93 04213270 J3490 HYDROCORTISONE 0.5% OINT 30GM$ 6.85 04213276 A4246 POVIDONE 10% TOP SOLN 120ML$ 5.80 04213277 A4246 POVIDONE 10% TOP SOLN 480ML$ 9.78 04213279 J3490 ADENOSINE 3MG/ML 20ML SDV$ 468.06 04213281 J3490 ADENOSINE 3MG/ML 30ML SDV$ 540.76 04213283 J9201 GEMCITABINE 200MG INJ$ 255.53 04213284 J3490 GEMCITABINE 1GM INJ$ 656.84 04213296 J3490 CARBOPLATIN 150MG INJECTION$ 756.39 04213299 J2704 PROPOFOL 10MG/ML 50ML VIAL$ 96.66 04213300 J9185 FLUDARABINE 50MG VIAL$ 733.11 04213301 J2704 PROPOFOL 10MG/ML 100ML VIAL$ 83.39 04213302 J3490 BREVIBLOC 10MG/ML 250ML$ 349.73 04213313 J3490 GATIFLOXACIN 200MG TAB$ 20.48 04213314 J3490 GATIFLOXACIN 400MG TAB$ 17.46 04213316 J1590 GATIFLOXACIN 400MG INJ$ 61.67 04213317 J3490 CARVEDILOL 6.25MG TAB$ 4.16 04213318 J3490 CARVEDILOL 12.5MG TAB$ 4.16 04213319 J3490 CARVEDILOL 25MG TABLET$ 4.91 04213329 J3490 DIMETHYL SULFOXIDE 50% 50ML VL$ 141.35 04213460 J3490 BOTULINUM TOXIN TYPE A 100U VI$ 1,044.30 04213490 Q2009 FOSPHENYTOIN 50MG/ML 2ML VIAL$ 65.90 04213491 Q2009 FOSPHENYTOIN 50MG/ML 10ML VIAL$ 197.66 04213495 J7644 IPRATROPIUM BR 0.02% INHAL SOL$ 4.66 04213496 J7620 DUONEB 0.5MG/0.3MG 3ML INHAL$ 1.19 04213498 J3490 SANDOSTATIN 500MCG/ML 1ML AMP$ 204.66 04213499 J3490 SANDOSTATIN 100MCG/ML 1ML AMP$ 42.74 04213500 J3490 GABAPENTIN SOL 250MG/5ML DOSE$ 1.29 04213501 J3490 LIDOCAINE MPF 1% 5ML AMP$ 14.02 04213506 J3490 SANDOSTATIN 50MCG/ML INJ$ 29.49 04213511 J3490 ONDANSETRON 2MG/ML 20ML VIAL$ 37.01 04213517 J3490 DINOPROSTONE 10MG INSERT$ 567.37 04213520 J0743 IMIPENEM 500MG/100ML IV SYR$ 59.16 04213524 J0694 CEFOXITIN 100MG/50ML IV SYR$ 54.33 04213527 J3490 BICILLIN CR 2.4MUN INJ$ 69.60 04213528 J3490 FILGASTIM 480MCG/1.6ML VIAL$ 699.28 04213537 J3490 MONSEL'S SOLUTION 60ML$ 238.76

112 04213538 J2250 MIDAZOLAM 100MG/NSS 100ML$ 225.25 04213548 J3490 AMLODIPINE 1MG/ML ORAL SUSP$ 9.33 04213565 J3490 NEVIRAPINE 200MG TABLET$ 19.54 04213566 J3490 NEVIRAPINE 50MG/5ML 240ML SUSP$ 254.07 04213591 J2270 MORPHINE 60MG/NSS 60ML$ 429.02 04213594 J3490 IBUPROPEN 100MG/5ML SUSP 120ML$ 15.73 04213609 J3490 CALCIUM ACETATE 667MG TAB UD$ 1.29 04213645 J3490 MORPHINE 15MG/ML 20ML VIAL$ 31.58 04213649 A4649 SPACER /CHAMBER FOR MDIS$ 31.45 04213651 J3490 LABETALOL 5MG/ML 20ML INJ$ 5.43 04213652 Q4081 EPOGEN 10000U/ML VIAL$ 540.00 04213659 J3490 PEDIAZOLE SUSP 5 ML DOSE$ 1.29 04213660 A4649 AEROCHAMBER W/ MASK-MEDIUM$ 227.20 04213662 J3490 AMOXIL/CLAVULINATE 400MG/5ML-5$ 197.21 04213663 J3490 AUGMENTIN 250MG/5ML 150ML BT$ 130.34 04213674 J0692 CEFEPIME 1GM VIAL$ 51.95 04213675 J2430 PAMIDRONATE DISODIUM 30 MG INJ$ 483.87 04213676 J3490 PAMIDRONATE DISODIUM 60 MG INJ$ 806.59 04213678 J3490 CEFEPIME 2GM VIAL$ 103.04 04213680 J3490 AZITHROMYCIN 100MG/5ML 15ML OS$ 73.55 04213681 J3490 AZITHROMYCIN 200MG/5ML 15ML OS$ 73.61 04213682 J3490 SOTALOL 120MG TABLET$ 7.56 04213684 J0692 CEFEPIME 2GM ADD-V$ 66.74 04213696 J7050 NORMAL SALINE 250ML ADD-V$ 13.68 04213698 J7050 NORMAL SALINE 50ML ADD-V$ 10.26 04213699 J7050 NORMAL SALINE 100ML ADD-V$ 22.95 04213700 A4217 NORMAL SALINE IRRIG 3000ML$ 32.14 04213701 J3490 PREDNISOLONE 15MG/5ML 240ML$ 27.91 04213705 J0456 AZITHROMYCIN 500MG VIAL$ 56.16 04213707 J3490 NIMODIPINE 30MG CAP UD$ 14.98 04213709 J3490 DEX/LIDO SPINAL 7.5%-5% 2ML AM$ 6.86 04213713 J3490 NICOTINE PATCH 7MG/24HR$ 5.02 04213718 J3490 PACLITAXEL 100MG INJ$ 760.12 04213721 J3490 BUPIVACAINE 0.5% 10ML INJ$ 6.24 04213722 Q4081 EPOGEN INJ 20000 UNIT/ML 1MG$ 652.27 04213725 J1650 LOVENOX 30MG/0.3ML INJ$ 105.09 04213730 J1650 ENOXAPARIN 40MG/0.4ML INJ$ 61.07 04213732 J2780 RANITIDINE 25MG/ML 2ML INJ$ 19.23 04213733 J2780 RANITIDINE 50MG/50ML IV SYR$ 70.94 04213739 J3490 LORAZEPAM 1MG/0.5ML OS UD$ 1.29 04213740 Q2039 INFLUENZA VIRUS VACC SYR-ADULT$ 68.49 04213741 J3490 INFLUENZA VACCINE NASAL SPRAY$ 96.57

113 04213744 J3490 MAGNESIUM OXIDE 400MG TAB UD$ 1.29 04213746 J3490 MIDAZOLAM 50MG/10ML INJ$ 43.56 04213748 J3490 TROPHAMINE 10% 500ML$ 152.18 04213749 J3490 MIDAZOLAM 10MG/5ML ORAL SYRUP$ 54.14 04213754 J3370 VANCOMYCIN 1.5GM/D5W 300ML$ 145.43 04213758 J3490 SODIUM BICARB 50MEQ/50ML VIAL$ 1.93 04213762 J3490 BICITRA ORAL SOLN 30ML UD$ 2.10 04213765 J0636 CALCITRIOL 1 MCG/ML AMP$ 49.31 04213768 J3490 ALTEPLASE 100 MG VIAL$ 2,902.61 04213775 J3490 SILVADENE CREAM 1% 50GM$ 4.81 04213777 J1650 LOVENOX 60MG/0.6ML INJ$ 84.21 04213778 J1650 LOVENOX 100MG/1ML INJ$ 140.36 04213779 J1650 ENOXAPARIN 80MG/0.8ML SRN$ 29.36 04213780 J1650 ENOXAPARIN 120MG/0.8ML SRN$ 35.45 04213781 J1650 ENOXAPARIN 150MG/1ML SRN$ 40.65 04213790 J3490 TRANEXAMIC ACID 1000ML/10ML IN$ 149.75 04213795 J1642 HEPARIN LOCK 50U/5ML SYRINGE$ 6.35 04213800 J3490 ROCURONIUM 10MG/ML 5ML VIAL$ 83.21 04213900 C9113 PANTOPRAZOLE 40MG VIAL$ 117.94 04214000 J3490 PANTOPRAZOLE 40MG TAB$ 3.31 04214008 J3490 LIQUID PER DOSAGE$ 1.29 04214010 J3490 LOTION OINTMENT CREAM$ 3.82 04214018 J3490 SNS FOR IRRIG 500CC$ 12.71 04214019 J3490 NACL FOR IRRIG 1500CC$ 26.68 04214020 J3490 SW FOR IRRIG 1500CC$ 22.86 04214022 J3490 SW FOR IRRIG 3000CC$ 30.47 04214040 J3490 NACL FOR IPPB$ 3.82 04214041 J3490 BRONKOSOL FOR IPPB$ 17.17 04214042 J3490 ISUPREL FOR IPPB$ 7.62 04214044 J3490 MUCOMYST FOR IPPB$ 7.62 04214046 J3490 MICRONEPHRIN FOR IPPB$ 7.62 04214117 J0610 CALCIUM GLUCONATE 1GM/50ML SYR$ 90.13 04214250 J3490 VITAMIN E DROPS 15IU/0.3ML 12M$ 90.65 04214300 J3490 VALSARTAN 40MG TAB$ 6.23 04214400 J3490 VALSARTAN 80MG TAB$ 7.44 04214500 J3490 VALSARTAN 160MG TAB$ 8.02 04214600 J3490 SEVELAMER 400MG TAB$ 3.06 04214700 J3490 SEVELAMER 800MG TAB$ 6.09 04214731 Q2039 INFLUENZA VIRUS VACC SYR-PEDS$ 82.49 04214800 J3490 ROCURONIUM 10MG/ML 10ML VIAL$ 64.83 04214900 J3490 ATENOLOL 25MG TABLET$ 1.29 04215320 J3370 VANCOMYCIN 750MG/NS 250ML$ 49.00

114 04215400 J3490 DOXAZOSIN 1MG TAB$ 1.29 04215500 J3490 DOXAZOSIN 2MG TAB$ 1.29 04215600 J3490 DOXAZOSIN 4MG TAB$ 1.29 04215668 J1815 INSULIN NPH-PER ML$ 6.47 04215700 J3490 DOXAZOSIN 8MG TAB$ 1.29 04215773 J1730 DIAZOXIDE 300MG/20ML INJ$ 191.21 04215800 J3490 DILTIAZEM CD 120MG CAP$ 2.02 04215900 J3490 DILTIAZEM CD 180MG CAP$ 2.39 04215920 J3490 PHISOHEX 150ML$ 15.30 04216100 J3490 DTAP 0.5ML INJ SDV$ 114.26 04216149 J3490 LEVOTHYROXINE 12.5MCG TABLET$ 1.01 04216175 S0077 CLINDAMYCIN 600MG ADD-V$ 22.87 04216176 S0077 CLINDAMYCIN 900MG ADD-V$ 26.37 04216177 J3490 CLINDAMYCIN P04 900MG/6ML ADDV$ 21.88 04216400 J3490 CYCLOMYDRIL OPHT DRP 2ML$ 54.12 04216500 J3490 CYCLOMYDRIL OPHT DRP 5ML$ 12.51 04216600 J3490 CEFUROXIME 1.5GM VIAL$ 57.11 04216700 J3490 CEFUROXIME PREMIX 1.5GM INJ$ 59.67 04216800 J3490 CEFUROXIME PREMIX 750MG INJ$ 57.23 04216900 J0697 CEFUROXIME 750MG VIAL$ 21.09 04217000 J3490 LOPERAMIDE 2MG CAP$ 1.29 04217100 J3490 LOPERAMIDE LIQ 1MG/5ML DOSE$ 1.29 04217154 J0690 CEFAZOLIN 2GM/50ML PMX$ 47.87 04217155 J0690 CEFAZOLIN 1GM ADD-V$ 16.05 04217156 J0690 CEFAZOLIN 2000MG/50ML IV SYR$ 31.04 04217157 J3490 CEFAZOLIN 10GM VIAL$ 48.18 04217200 J3490 POLIO VACCINE 0.5ML DOSE INJ$ 107.40 04217210 J0133 ACYCLOVIR 1000MG/150ML IV SYR$ 250.70 04217240 J3490 COAL TAR 2.5% BATH LOTION 240M$ 96.31 04217294 J3490 METFORMIN 250MG TAB$ 1.01 04217295 J3490 METFORMIN HCL 500MG TAB UD$ 1.42 04217296 J3490 METFORMIN HCL 850MG TAB UD$ 2.37 04217421 J2543 ZOSYN 3.375MG/50ML IV SYR$ 121.75 04217590 J3490 BENADRYL ELIX 12.5MG/5ML 120ML$ 3.97 04217605 J3490 RHO-D IMMUNE GLOBULIN 2500U VI$ 1,289.14 04217606 J3490 WINRHO SDF 5000IU 4.4ML INJ$ 2,201.54 04217800 J1580 GENTAMICIN PREMIX 100MG INJ$ 6.64 04217900 J3490 CLINDAMYCIN PREMIX 600MG INJ$ 48.30 04218000 J3490 CLINDAMYCIN PREMIX 900MG INJ$ 59.10 04218100 J0690 CEFAZOLIN PREMIX 1GM INJ$ 11.03 04218392 J3490 LEVOTHYROXINE 88MCG TABLET$ 1.01 04218820 J3490 IMMUNEGLOBULIN 10% 1GM/10ML$ 121.03

115 04218821 J3490 IMMUNEGLOBULIN 10% 6GM PWR INJ$ 841.72 04218822 J1575 IMMUNEGLOBULIN 10% 10GM/100ML$ 1,371.74 04218824 J3490 IMMUNEGLOBULIN 10% 2.5GM/25ML$ 594.31 04218825 J3490 IMMUNEGLOBULIN 10% 5GM/50ML$ 846.67 04219000 J3490 CEFOTAXIME PREMIX 1GM INJ$ 27.88 04219001 J3490 ASCORBIC ACID 100MG/ML OS$ 8.82 04219002 J3490 CAFFEINE CITRATE 10MG/ML OS$ 58.45 04219003 J3490 CAPTOPRIL 1MG/ML SUSP$ 8.82 04219004 J3490 CIPROFLOXACIN 50MG/ML SUSP$ 8.82 04219005 J3490 DEXAMETHASONE 4MG/ML OS$ 8.82 04219006 J3490 DILTIAZEM 12MG/ML SUSP$ 8.82 04219007 J3490 SUCRALFATE 100MG/ML SUSP$ 8.82 04219008 J3490 ETHAMBUTOL 50MG/ML SUSP$ 8.82 04219009 J3490 FOLIC ACID 1MG/ML OS$ 8.82 04219010 J3490 GABAPENTIN 100MG/ML SUSP$ 8.82 04219011 J3490 HYDROCHLOROTHIAZIDE 5MG/ML SUS$ 8.82 04219012 J3490 HYDROCORTISONE 1MG/ML SUSP$ 8.82 04219013 J3490 HYDROXYUREA 40MG/ML SUSP$ 8.82 04219014 J3490 INDOMETHACIN 5MG/ML SUSP$ 8.82 04219015 J3490 IZONIAZID 10MG/ML SYRUP$ 8.82 04219017 J3490 LEVOTHYROXINE 25MG/ML SUSP$ 8.82 04219018 J3490 LORAZEPAM 1MG/ML SUSP$ 8.82 04219019 J3490 METRONIDAZOLE 50MG/ML SUSP$ 8.82 04219020 J3490 METOPROLOL TART 10MG/ML SUSP$ 8.82 04219021 J3490 NIFEDIPINE 4MG/ML SUSP$ 8.82 04219022 J3490 OSELTAVIMIR 6MG/ML SYRUP$ 8.82 04219023 J3490 PROPRANOLOL 1MG/ML SUSP$ 8.82 04219024 J3490 PYRAZINAMIDE 10MG/ML SUSP$ 8.82 04219025 J3490 PYRIDOXINE 1MG/ML OS$ 8.82 04219026 J3490 QUETIAPINE 2.5MG/ML OS$ 8.82 04219027 J3490 RIFAMPIN 25MG/ML SUSP$ 8.82 04219028 J3490 SILDENAFIL 2.5MG/ML SUSP$ 8.82 04219029 J3490 SPIRONOLACTONE 5MG/ML SYRUP$ 8.82 04219030 J3490 URSODIOL 50MG/ML SUSP$ 8.82 04219031 J3490 ZINC GLUCONATE 10MG/ML OS$ 8.82 04219100 J3490 CEFOTAXIME PREMIX 2GM INJ$ 51.20 04219200 J3490 FAT EMULSION 10% 200ML$ 23.38 04219400 J3490 FLOVENT 110MCG 13GM INHAL$ 373.83 04219435 J3490 ATROPINE 0.05MG/ML 5ML SYRINGE$ 30.89 04219500 J3490 NITROGLYCERIN 2% 1GM OINT$ 3.20 04219600 J3490 ERLOTINIB 25MG TAB$ 100.08 04219700 J3490 ERLOTINIB 100MG TAB$ 267.44

116 04219711 J3010 FENTANYL 1000MCG/20ML VIAL$ 15.16 04220004 J8499 BARIUM EZ HD 750 96% W-W$ 19.98 04220006 J3490 BARIUM SULFATE SUSP 250ML$ 16.91 04220008 J8499 BARIUM EZ HD 764 98% W-W$ 31.71 04220012 J3490 BARIUM SULFATE SUSP 58% 1900ML$ 195.22 04220061 J3490 ERBITUX 2MG/ML 50ML VIAL$ 1,207.44 04220080 Q9963 GASTROGRAFIN 37% O/S 30ML$ 22.12 04220091 Q9967 ISOVUE 300 100ML$ 35.18 04220102 Q9967 ISOVUE 370 76% 100ML BTL$ 37.54 04220110 A9576 GADOTERIDOL 279.3MG/ML 10ML VI$ 93.92 04220120 Q9967 OMNIPAQUE 350MG I/ML 50ML$ 191.43 04220121 Q9967 OMNIPAQUE 350MG I/ML 75ML$ 307.50 04220122 Q9967 OMNIPAQUE 350MG I/ML 100ML$ 37.77 04220123 Q9967 OMNIPAQUE 350MG I/ML 125ML$ 556.22 04220124 Q9967 OMNIPAQUE 350MG I/ML 150ML$ 40.67 04220151 DISPENSING FEE-DOC$ 5.36 04220152 J3490 DAPTOMYCIN 500MG INJ$ 728.81 04220161 A4649 MICRON 15 IN-LINE FILTER SET$ 11.94 04221100 J3490 FLUOCINONIDE 0.05% 30GM OINT$ 43.61 04221490 J3490 PHENOBARBITAL 20MG/5ML 473ML$ 171.59 04221600 S0182 PROCARBAZINE 50MG CAPSULE$ 180.89 04221717 A6250 CAVILON BARRIER CREAM 10Z$ 11.28 04221800 J3490 CYSTEINE HCL 50MG/ML 10ML INJ$ 10.46 04221851 J3490 TRIAMCINOLONE 0.1% 15GM CREAM$ 2.45 04221852 J3490 TRIAMCINOLONE 0.1% 454GM CREAM$ 88.66 04221855 J3490 TRIAMCINOLONE 0.5% 15GM CREAM$ 6.73 04222116 J3535 ALBUTEROL 17GM INHALER$ 56.66 04222117 J3490 ALBUTEROL 6.7GM REFILL INHAL$ 127.97 04222373 J3490 RANITIDINE 15MG/ML SYRUP 480ML$ 575.10 04222400 J3490 ZOLEDRONIC ACID 4MG/5ML INJ$ 1,729.84 04222562 J3490 NEVIRAPINE 200 MG TAB UD$ 13.41 04222640 J3490 HYDRALAZINE 12.5MG TABLET$ 0.96 04222702 J3490 THROMBIN 5000U VIAL$ 37.98 04222703 J3490 THROMBIN 10000U/ML INJ$ 46.45 04222704 J3490 THROMBIN 20MU VIAL$ 551.39 04222715 J3490 HEPATITIS A VACCINE 1440U$ 316.94 04222922 J3490 COCAINE 10% TOP SOLN 4ML$ 51.42 04223000 J3490 FLUOXETINE SOLN 20MG/5ML UD$ 15.61 04223200 J3490 LISINOPRIL 40MG TAB$ 1.29 04223237 J3490 METOCLOPRAMIDE 5MG TABLET$ 1.01 04223300 J3490 PERMETHRIN CREAM 5% 2OZ$ 61.88 04223340 J3490 PULMOZYME 2.5ML INHAL SOLN$ 385.11

117 04223484 J0595 BUTORPHANOL 1MG/ML INJ$ 18.60 04223500 J9217 LEUPROLIDE 7.5MG INJ$ 1,250.09 04223600 J3490 LEUPROLIDE 22.5MG INJ$ 3,256.08 04223700 J3490 BEVACIZUMAB 25MG/ML 16ML INJ$ 3,391.30 04223800 J3490 BEVACIZUMAB 25MG/ML 4ML INJ$ 1,069.45 04223900 J3490 GOSERELIN 10.8MG SQ INJ$ 853.02 04224000 J3490 GOSERELIN 3.6MG SQ INJ$ 481.33 04224100 J3490 OXALIPLATIN 100MG INJ$ 2,560.15 04224200 J3490 OXALIPLATIN 50MG INJ$ 1,428.22 04224290 J0171 EPINEPHRINE 2MG/D5W 250ML$ 141.28 04224293 J3490 NYSTATIN 100000U/ML 5ML SOLN$ 5.89 04224300 J3490 PEGINTERFERON ALFA0-2B 150MCG$ 750.50 04224400 J3490 CYTARABINE 1GM SDV$ 41.50 04224700 J3490 VINORELBINE 50MG INJ$ 686.56 04224800 J9390 VINORELBINE 10MG INJ$ 108.90 04224871 J3490 HYDROCHLOROTHIAZIDE 12.5MG TAB$ 7.04 04224900 J1756 IRON SUCROSE 100MG/5ML INJ$ 148.96 04224959 J3240 THYROTROPIN ALFA INJ KIT$ 1,377.88 04225069 J3490 DAKIN'S 0.025% SOLN 500ML$ 23.47 04225090 J7510 PREDNISOLONE 5MG/5ML 500ML$ 297.42 04225200 J3490 DIP-TET VACC PEDS 0.5ML INJ$ 56.09 04225438 J1170 HYDROMORPHONE 0.5MG/0.5ML INJ$ 10.28 04225439 J1170 HYDROMORPHONE 1MG/ML INJ$ 8.96 04225500 J3490 THIABENDAZOLE 500MG CHEWTAB$ 3.45 04225600 J3490 ALPRAZOLAM 0.25MG TAB - BTL$ - 04226111 J7504 ATGAM 250MG/5ML AMP$ 620.94 04226140 J3490 ISENTRESS 400MG TABLET$ 60.95 04226145 J3490 METOPROLOL SUCC ER 25MG TAB$ 7.23 04226146 J3490 METOPROLOL SUCC ER 50MG TAB$ 7.71 04226147 J3490 METOPROLOL SUCC ER 100MG TAB$ 8.12 04226973 J3490 TRUVADA 200MG-300MG TABLET$ 138.78 04227131 J3490 TNKASE 50MG INJECTION$ 4,184.90 04227300 J3490 AUGMENTIN 875MG TAB$ 5.10 04227500 J9300 MYLOTARG 5MG VIAL$ 5,060.69 04227570 J3490 RISPERIDONE 1MG TAB$ 10.73 04227607 J3490 ERYTHROMYCIN 1GM OPHTH OINT$ 2.85 04228000 J3490 CEFDINIR 300MG CAP$ 16.13 04228100 J3490 CEFDINIR 125MG/5ML SUSP 60ML$ 136.86 04228200 J3490 TEGRETOL SUSP 200MG/10ML UD$ 4.16 04228500 J3490 WARFARIN 0.5MG TABLET$ 88.22 04228753 J3490 OXYCODONE/APAP 5/325MG TAB$ 1.06 04228800 J3490 BACTROBAN 2% 22GM OINTMENT$ 87.44

118 04229000 J3490 CLOBETASOL 0.05% 15GM OINT$ 7.99 04230000 J1642 HEPARIN LOCK 500U/5ML SYRINGE$ 2.95 04230851 S0191 MISOPROSTOL 50MG TABLET$ 5.16 04230920 J3490 FLUTICASONE 44MCG 13GM INHAL$ 174.56 04231110 J3490 FLUORESCEIN SOD OPHTH STRIP$ 4.43 04231118 J3490 LIDOCAINE(LARYNG-O-JET) 4% 5 M$ 18.57 04231261 J3490 AMIODARONE 50MG/ML 9ML VIAL$ 86.40 04231262 J3490 AMNIODARONE 50MG/ML 18ML VIAL$ 51.64 04231700 J3490 POLYVIT W/FLU/IRON 0.25MG/50ML$ 26.48 04231722 90371 HEPATITIS B IG HUMAN 5ML VIAL$ 882.88 04231780 J7613 ALBUTEROL 0.5% 2.5MG/0.5ML SOL$ 1.95 04231781 J7613 ALBUTEROL .042% 1.25MG/3ML SOL$ 4.98 04231831 J2997 ALTEPLASE/CATHFLO 2MG VIAL$ 172.49 04232071 J0696 CEFTRIAXONE 1000MG/50ML IV SYR$ 31.97 04232072 J0696 CEFTRIAXONE 1GM ADD-V$ 21.89 04232240 J3490 BENZOCAINE TOP SPRAY-PER DOSE$ 6.70 04232600 J3490 CORTISPORIN 15GM OINTMENT$ 81.52 04232642 J3490 AZTREONAM 1GM/50ML GALAXY INJ$ 99.76 04232643 J3490 AZTREONAM 2GM/50ML GALAXY INJ$ 169.16 04232661 J3490 CIPROFLOXACIN 0.3% 5ML OPTIC$ 33.77 04233000 J3490 DROTRECOGIN ALFA 5MG INJ$ 603.94 04233003 B4189 CLINIMIX S/F 4.25%/5% 2L INJ$ 167.14 04233004 B4189 CLINIMIX S/F 5%/20% 2L INJ$ 167.14 04233030 J3490 MEROPENEM 500MG/50ML PMX$ 104.17 04233031 J3490 MEROPENEM 1000MG/50ML PMX$ 140.85 04233045 J3490 ARGATROBAN 100MG/2ML 2.5ML$ 1,421.26 04233050 J3490 LIDOCAINE W/PRILOCAINE 5GM CRM$ 7.67 04233065 J2248 MICAFUNGIN 50MG VIAL$ 169.64 04233066 J2248 MICAFUNGIN 100MG VIAL$ 330.03 04233069 C9132 PROTHROMBIN COMPLEX 500IU VIAL$ 1,473.81 04233070 C9132 PROTHROMBIN COMPLEX 1000IU VL$ 2,704.50 04233080 J0572 SUBOXONE 2MG/0.5MG TABLET$ 9.99 04233081 J0574 SUBOXONE 8MG/2MG TABLET$ 13.10 04233165 J9299 NIVOLUMAB 400MG/10ML VIAL$ 4,863.97 04233166 J9299 NIVOLUMAB 40MG/4ML VIAL$ 2,091.43 04233210 J3490 MOXIFLOXACIN 400MG TABLET$ 57.59 04233255 J7189 FACTOR VII A$ 2,552.56 04233256 J7189 FACTOR VII$ 13,460.90 04233265 J2783 RASBURICASE 1.5MG VIAL$ 1,935.80 04233270 J3490 ZEGERID ORAL SUSP 20MG PACKET$ 155.85 04233285 J3490 SODIUM CITRATE 4% 250ML BAG$ 59.31 04233288 J3490 RIVAROXABAN 2.5MG TAB$ 28.64

119 04233289 J3490 RIVAROXABAN 10MG TAB$ 30.72 04233290 J8499 RIVAROXABAN 15MG TAB$ 32.66 04233291 J8499 RIVAROXABAN 20MG TAB$ 34.49 04233295 J8499 APIXABAN 2.5MG TAB$ 8.65 04233296 J8499 APIXABAN 5MG TAB$ 7.51 04233305 A6250 CAVILON ADV SKIN PROTECT 2.7ML$ 29.64 04233320 J3490 ITRACONAZOLE 100MG CAPSULE$ 49.12 04233325 J1953 LEVETIRACETAM 500MG/100ML PMIX$ 53.92 04233326 J1953 LEVETIRACETAM 1000MG/100ML PMX$ 78.68 04233330 J3490 LIDOCAINE 1% 20ML MDV$ 5.12 04233335 J3490 LIDOCAINE 1% 300MG/30ML SDV$ 16.21 04233345 J3490 TOBRAMYCIN 300MG/5ML INHAL SOL$ 62.90 04233356 J3490 MEXILETINE 200MG TABLET$ 4.05 04233360 J3490 CLONIDINE 0.1MG/DAY PATCH$ 46.27 04233365 J3490 FLUTICASONE/SALMETEROL 250/50$ 402.39 04233366 J3490 FLUTICASONE /SALMET HFA 115/21$ 759.15 04233370 A4217 ACETIC ACID 0.25% IRRIG 1000ML$ 19.57 04233379 J3490 ONCOZENE 75UM 3ML SRN$ 1,039.80 04233380 A6250 CAVILON SKIN CLEANER 8OZ$ 48.09 04233385 A4641 ETHIODIZED OIL 480MG/ML 10ML$ 1,133.54 04233390 J3490 0BARIUM SULFATE SUSP 450ML$ 36.48 04233392 A6250 CAVILON 3.25OZ CREAM$ 43.11 04233395 J3490 EMBOZENE 100UM 2ML SRN$ 706.79 04233396 J3490 EMBOZENE 500UM 2ML SRN$ 706.79 04233397 J3490 EMBOZENE 700UM 2ML SRN$ 706.79 04233398 J3490 EMBOZENE 900UM 2ML SRN$ 706.79 04233410 J8499 TICAGRELOR 90MG TAB UD$ 15.37 04233415 J0130 ABCIXIMAB 10MG/5ML VIAL$ 1,919.83 04233420 J1327 EPTIFIBATIDE 20MG/10ML VIAL$ 345.40 04233421 J1327 EPTIFIBATIDE 75MG/100ML VIAL$ 662.45 04233422 J1327 EPTIFIBATIDE 200MG/100ML VIAL$ 1,594.20 04233425 J8499 ENTRESTO 24MG/26MG TAB$ 23.65 04233426 J8499 ENTRESTO 49MG/51MG TAB$ 23.65 04233440 J3490 MEDI-HONEY GEL 1.5OZ$ 70.19 04233450 J7050 NORMAL SALINE 50ML MINI-BAG$ 18.23 04233451 J7050 NORMAL SALINE 100ML MINI-BAG$ 18.23 04233455 J7060 DEX 5% WATER 50ML MINI-BAG$ 20.41 04233456 J7060 DEX 5% WATER 100ML MIN-BAG$ 20.41 04233460 J2265 MINOCYCLINE 100MG INJ$ 435.87 04233465 J3490 SUGAMMADEX 200MG/2ML SDV$ 349.83 04233470 J3490 REMDESIVIR 100MG INJ$ 862.05 04233475 J3490 RENA-VITE 0.8MG TAB$ 0.96

120 04233480 J3490 BAMLANIVIMAB 700MG/20ML$ - 04233481 Q0245 ETESEVIMAB 700MG VIAL$ - 04233485 Q0243 IMDEVIMAB 300MG INJ$ - 04233486 33486 CASIRIVIMAB 300MG INJ$ - 04233490 J3490 FAMOTIDINE 20MG TAB$ 0.91 04233510 J1815 INSULIN GLARGINE 100U/ML 3ML$ 130.15 04233550 J7674 METHACHOLINE 100MG INH SOLN$ 199.67 04233670 90734 MENACTRA VACCINE 0.5ML SDV$ 381.02 04233770 J3490 VITAMIN D3 5000IU TABLET$ 0.96 04234859 J3490 LICE KILLING SHAMPOO 4% 60ML$ 27.51 04235000 J3490 DEPO-LUPRON 11.25MG INJ$ 2,923.56 04235161 J3490 CIPRO 200MG/D5W PREMIX 100ML$ 10.56 04235211 J3490 POLYVIT W/FLUORIDE 0.25MG/50ML$ 11.60 04235782 J3490 PERCOCET 2.5MG/162.5MG TAB$ 1.02 04236065 J3490 POLYETHELENE GLYCOL PWDR 17GM$ 5.28 04236070 J3490 PROBIOTICS ADULT$ 9.02 04236071 J3490 PROBIOTIC PEDIATRICS$ 2.50 04236075 J3490 CYCLOSERINE 250MG CAP$ 151.68 04236080 J3490 PASER 4GM GRANULES$ 37.41 04236100 J3490 KCL 20MEQ/100ML BAG INJ$ 6.38 04236211 J3490 PROSTIN VR 500MCG INJ$ 742.02 04236510 J3490 LABETALOL 5MG/ML 40ML INJ$ 13.16 04236511 J3490 LABETALOL 5MG/ML 4ML INJ$ 10.21 04236659 J0713 CEFTAZIDIME 1GM/50ML DUPLEX$ 79.66 04236660 J0713 CEFTAZIDIME 2GM/50ML DUPLEX$ 103.18 04236662 J0713 CEFTAZIDIME 2000MG/50ML IV SYR$ 54.67 04236867 J3490 METOPROLOL 25MG TAB$ 1.29 04236868 J3490 METOPROLOL 6.25MG TAB$ 1.01 04237051 J0456 AZITHROMYCIN 500MG/NS 250ML$ 34.73 04237100 J3490 DILAUDID 4MG TAB$ 3.62 04237321 J3490 RANITIDINE 50MG/0.45 NS 50ML I$ 13.84 04237322 J3490 RANITIDINE 75MG/5ML SYRUP 5ML$ 6.96 04237541 J3490 VANCOMYCIN 125MG/5ML OS$ 29.73 04237542 J3490 VANCOMYCIN 10GM VIAL$ 243.37 04237583 J3490 OXYCODONE 5MG TAB$ 1.19 04237650 J3490 PARICALCITOL 5MCG/ML INJ$ 115.27 04237720 J3490 CEFOTAN 2GM INJ$ 137.39 04238010 J3490 CISATRACURIUM 20MG/10ML$ 164.54 04239500 J3490 PROMETHAZINE W/COD 473ML OS$ 72.69 04239961 J3490 SILDENAFIL 100MG TABLET$ 42.08 04239975 J3490 BEDAQUILINE 100MG TAB$ 499.47 04240000 J3490 LEVOFLOXACIN 500MG TAB$ 12.78

121 04240006 J3490 DELFLEX 1.5% 5000ML$ 86.64 04240300 J3490 ACETAZOLIMIDE 500MG/10ML INJ$ 61.52 04241231 J3490 ZIDOVUDINE 50MG/5ML 240ML$ 151.91 04241960 J3490 PYRIDOXINE 6.25MG TAB$ 1.01 04242540 J3490 ASPIRIN EC 81MG TABLET$ 1.29 04243100 J3490 GABAPENTIN 400MG CAPSULE$ 4.44 04243111 J3490 LINEZOLID 600MG/300 ML INJ$ 245.87 04243191 J3490 CETIRIZINE(ZYRTEC) 10MG TAB$ 4.84 04243400 J3490 CLONAZEPAM 1MG TAB$ 1.01 04243600 J3490 POLYCITRA LIQUID 30ML UD$ 3.72 04244006 J0572 BUPRENORPHINE 2MG SL TAB$ 8.83 04244007 J0574 BUPRENORPHINE 8MG SL TAB$ 15.26 04244008 J3490 JEVTANA 60MG/1.5ML INJ$ 11,659.69 04244059 J3490 GRANULEX SPRAY 4 OZ$ 81.75 04244060 J3490 XENADERM 30GM OINT$ 56.86 04244061 J3490 COLLAGENASE 250U/GM 15GM OINT$ 124.15 04244062 J3490 COLLAGENASE 30GM OINTMENT$ 210.51 04244063 J3490 TEMOZOLOMIDE 20MG CAPSULE$ 111.37 04244064 J3490 TEMOZOLOMIDE 100MG CAPSULE$ 559.86 04244065 J3490 TEMOZOLOMIDE 200MG CAPSULE$ 821.54 04244066 J3490 AFFINITOR 10MG TABLET$ 560.60 04244067 J3490 HALAVEN 1MG/2ML VIAL$ 1,508.51 04244111 J3490 LINEZOLID 600MG TAB UD$ 181.73 04244500 J1815 INSULIN ASPART U-100 50U DOSE$ 19.49 04245005 J1815 INSULIN GLARGINE-1 UNIT$ 4.27 04245440 J3490 ASCORBIC ACID 1000MG TAB$ 0.96 04245604 J3490 SEVOFLURANE-15 MIN$ 18.42 04245731 J3370 VANCOMYCIN 1.25GM/NSS 250 ML$ 98.43 04246305 J3490 MELATONIN 5MG TABLET$ 1.17 04247500 J1815 INSULIN 70/30-1 UNIT$ 1.01 04247631 J0692 CEFEPIME 1000MG/50ML IV SYR$ 60.56 04249000 J1642 HEPARIN LOCK PF 10U/ML VIAL$ 25.44 04250052 A4649 SET IV EXT TUBE FILTERED$ 19.86 04250100 J3490 POTASSIUM CL 10% 40MEQ 30ML UD$ 37.18 04250110 J3490 NITROFURANTOIN 25MG/5ML DOSE$ 15.81 04250474 J3490 KEPPRA SUSP 100MG/ML 5ML UD$ 2.24 04250692 J3490 DAKIN'S 0.125% SOLN 500ML$ 23.47 04250731 J0456 AZITHROMYCIN 500MG/250ML SYR$ 62.03 04251108 90716 VARICELLA VIRUS VACC 0.5CC$ 158.72 04251211 J3490 ACETYLCYSTEINE 20% 30ML INJ$ 35.32 04253080 J3490 COLCRYS 0.6MG TABLET$ 19.25 04253100 J3490 GABAPENTIN SYRUP 473ML$ 470.54

122 04253111 J3490 LIDOCAINE-EPI MPF 1% 30ML AMP$ 5.79 04254137 J3370 VANCOMYCIN 1GM/D5W 250ML$ 72.71 04254500 J1815 INSULIN GLARCINE U-100 50U DOS$ 17.98 04255557 J3490 BECLOMETHASONE 25GM INHAL$ 306.97 04257126 S0040 TIMENTIN 3.1GM INJ$ 65.77 04257400 J1815 INSULIN 70/30-PER ML$ 6.47 04257570 A4244 3HYDROGEN PEROXIDE 3% 237ML BT$ 3.44 04258000 J3490 MORPHINE 50MG/ML 50ML VIAL$ 58.67 04258031 S0191 MISOPROSTOL 25MCG TABLET$ 5.16 04258200 J3490 WARFARIN 1MG TAB$ 1.29 04259111 J3010 FENTANYL 100MCG/50ML$ 9.86 04259231 J3490 CARBOPLATIN 450MG INJECTION$ 2,269.24 04260001 J3490 DELFLEX 2.5% 2000ML PERI SOLN$ 38.87 04260002 J3490 DELFLEX 1.5% 2000ML PERI SOLN$ 38.12 04260003 J3490 DELFLEX 4.25% 2000ML PERI SOLN$ 39.51 04260004 J3490 DELFLEX 2.5% 5000ML PERI SOLN$ 100.86 04260005 J3490 DELFLEX 4.25% 5000ML PERI SOLN$ 103.62 04260006 J3490 DELFLEX 2.5% 2500ML PERI SOLN$ 67.38 04260007 J3490 VITAMIN A 50000U/ML 2ML INJ$ 38.22 04260009 J3490 DELFLEX 4.25% 2500ML$ 142.40 04260369 J1644 HEPARIN 1000U/ML 2ML SDV$ 22.34 04260370 J1644 HEPARIN 1000U/ML 10ML MDV$ 10.21 04260419 J3490 PYRIDOXINE 25MG TAB$ 1.01 04261000 J3490 RELENZA DISKHALER 5MG$ 13.20 04261106 90707 MMR VACCINE 0.5ML SDV$ 69.45 04263111 J3490 LIDOCAINE 2% JELLY 30ML$ 30.47 04263600 J3490 TOPOTECAN 4MG VIAL$ 767.33 04263631 J0692 CEFEPIME 1GM ADD-V$ 44.22 04264000 J3490 CARVEDILOL 3.125MG TABLET UD$ 1.29 04264015 J3490 NS 3% INHALATION 15ML$ 3.05 04264100 J3490 LEVETIRACETAM 500MG/5ML PO UD$ 12.71 04264901 J3490 INFUVITE 5ML INJ$ 34.55 04265000 J3490 TAMSULOSIN 0.4MG CAP$ 8.45 04265162 J0744 CIPRO 400MG/D5W PREMIX 200ML$ 34.13 04265211 J2590 OXYTOCIN 10U/ML 10ML VIAL$ 213.22 04266020 J3490 PANAFIL 30GM OINTMENT$ 136.80 04266645 J1335 ERTAPENEM 1GM VIAL$ 200.95 04267911 J3490 GUAITUSS DM SYRUP 120ML$ 3.66 04268000 J3490 ACYCLOVIR 5% 30GM OINT$ 576.36 04268683 J3490 METOPROLOL 12.5MG TAB$ 1.01 04268890 J3490 TOCILIZUNAB 400MG/20ML INJ$ 3,018.75 04269000 J3490 GLYBURIDE MICRO 6MG TAB$ 1.29

123 04269200 J1642 HEPARIN LOCK 300U/3ML SYRINGE$ 3.02 04269250 A4217 WATER IRRIGATION 500ML$ 7.70 04270006 J3490 DELFLEX 1.5% DEX 2500ML$ 62.76 04270190 J3490 TROVAFLOXACIN 100 MG TAB UD$ 17.05 04270191 J3490 TROVAFLOXACIN 200 MG TAB UD$ 20.63 04270195 J3490 TROVAFLOXACIN 200 MG INJ$ 105.82 04270196 J3490 TROVAFLOXACIN 300 MG INJ$ 159.65 04270513 J0456 AZITHROMYCIN 500MG/D5W 250ML$ 58.43 04271100 J3490 LOPERAMIDE LIQ 1MG/5ML 120ML$ 6.99 04271119 J3010 FENTANYL 2,500MCG/50ML INJ$ 28.79 04271200 J3490 VAPONEFRIN 2.25% 0.5CC INH SOL$ 2.60 04271411 J0610 CALCIUM GLUCONATE 4.65MEQ/10ML$ 81.31 04272000 J3490 SERTRALINE 50MG TABLET$ 6.77 04273000 J3490 SERTRALINE 100MG TABLET$ 6.99 04273100 J3490 CLARITHROMYCIN 500MG TAB$ 22.34 04275413 J3370 VANCOMYCIN 1GM/NS 250ML$ 49.00 04277002 J0289 AMPHOTERICIN LIP 50MG/100ML IV$ 507.05 04277100 J1580 GENTAMICIN 80MG ADD-V$ 20.36 04277161 S0077 CLINDAMYCIN 900MG/50ML SYR$ 42.81 04277200 J3490 AMPHOTERICIN B LIPO 50MG INJ$ 245.47 04277631 J3490 AREDIA 90MG INJECTION$ 1,240.48 04278921 J0290 AMPICILLIN 1GM ADD-V$ 79.54 04278930 J3490 FONDAPARINUX 2.5MG/0.5ML VIAL$ 97.29 04278931 J3490 FONDAPARINUX 5MG/0.4ML SRN$ 237.73 04279111 J3010 FENTANYL 50MCG/ML 5ML VIAL$ 12.71 04279922 J3490 LOPINAVIR/RITONAV 200/50MG TAB$ 29.07 04280000 J3490 BENADRYL ELIX 12.5MG/5ML DOSE$ 1.29 04280001 J1990 LIBRIUM 100MG INJECTION$ 38.87 04280006 J3490 TRAMADOL 25MG TAB$ 1.01 04280007 J3490 TRETINOIN 10 MG CAP$ 43.83 04280009 Q9967 OMNIPAQUE 300MG I/ML 50ML$ 15.41 04280100 J3490 SORAFENIB 200MG TABLET$ 195.49 04280111 J3490 CORTISPORIN EAR SOLN 10ML$ 91.21 04280700 J3490 NORCO 2.5MG/162.5MG TAB$ 1.73 04280900 J3490 TRAMADOL 25MG TABLET$ 1.01 04282270 J3490 CYPROHEPTIDINE 2MG/5ML 480ML B$ 75.73 04282621 J3490 NOREPINEPHRINE 8MG/D5W 250ML$ 134.01 04283600 J2185 MEROPENEM 1000MG/50ML IV SYR$ 150.87 04285069 A4248 CHLORHEXIDINE 0.12% 15ML$ 22.09 04286651 J1815 INSULIN NPH-1 UNIT$ 1.01 04288000 J3490 NIZORAL SHAMPOO 1% 120ML$ 73.98 04289000 J3490 KETOCONAZOLE 2% 30GM CRM$ 53.45

124 04289500 J3490 LEVOTHYROXINE 100MCG VIAL$ 395.80 04289605 J3490 CHLORHEXIDINE ORAL RINSE 480ML$ 35.74 04290100 J3370 VANCOMYCIN 1.25GM/D5W 250ML$ 113.13 04290112 J0290 AMPICILLIN 500MG INJ$ 8.25 04290154 J3490 DIGOXIN ELIX 50MCG/ML 5ML DOSE$ 7.37 04290267 J3490 VINCRISTINE 2MG/2ML VIAL$ 83.94 04290676 J3490 PHENERGAN 6.25MG/5ML 120ML$ 6.97 04290930 J3370 VANCOMYCIN 500MG/100ML IV SYR$ 75.17 04290931 J3370 VANCOMYCIN 750MG INJ$ 66.40 04290940 J3490 QUETIAPINE 25MG TABLET$ 9.66 04290941 J3490 QUETIAPINE 50MG TABLET$ 15.42 04291150 J3490 TAMIFLU ORAL SUSP 6MG/ML 60ML$ 160.36 04291300 91300 PFIZER-BIONTECH COVID-19 VACC$ - 04291301 91301 MODERNA COVID-19 VACCINE$ - 04291303 91303 JANSSEN COVID-19 VACCINE$ - 04291385 J8597 METOCLOPRAMIDE 5MG/5ML SOLN 5M$ 1.29 04292211 S0032 NAFCILLIN 1000MG/50ML IV SYR$ 98.04 04292506 J3490 DAKIN'S 0.25% SOLN 500ML$ 14.65 04292588 J3490 METOPROLOL 100MG TABLET$ 1.41 04295000 J3490 OSELTAMIVIR 75MG CAPSULE$ 20.86 04295002 J3490 ACTIVATED CHARCOAL 50GM 240ML$ 32.71 04295003 A4649 AEROCHAMBER ADULT$ 74.76 04295004 A4649 AEROCHAMBER PEDS$ 74.76 04295005 J7609 ALBUTEROL .083% INHAL 3ML UD$ 1.68 04295006 J3490 ALCOHOL DENATURED 70% 1 GAL$ 110.89 04295007 J3490 AMIPAQUE 3.75ML 20ML$ 372.36 04295008 J3490 ANTIMINTH 250MG/5ML 60ML$ 160.11 04295009 J3490 AROMATIC ELIXIR 16FL OZ$ 133.38 04295010 J3490 ATROPINE 0.5MG/5ML SYRINGE$ 6.12 04295011 J3490 AUGMENTIN 125MG/5ML 100ML BT$ 38.35 04295013 A4246 BETADINE SOLUTION 60ML$ 2.91 04295014 J3490 BREVIBLOC 2.5GM/10ML$ 149.75 04295015 J3490 CALCIUM CARB 500MG CHEWTAB$ 0.32 04295016 J3490 CARDIZEM 25MG/5ML INJ$ 30.20 04295017 J3490 CARDIZEM 50MG/10ML INJ$ 54.42 04295018 J3490 CECLOR 250MG CAP UD$ 8.34 04295019 J3490 CEPHALEXIN 250MG CAPSULE$ 0.47 04295020 J3490 CEPHALEXIN 500MG CAPSULE$ 0.66 04295021 J3490 CETAPRED OPHTH 5ML$ 61.48 04295022 J3490 CHILDRENS MOTRIN 100MG/5ML$ 1.42 04295023 J3490 CHLORPROMAZINE 150MG TAB$ 1.25 04295024 J3490 CHLORPROMAZINE 300MG TAB$ 1.76

125 04295025 J3490 CHLORPROMAZINE 75MG TAB$ 1.01 04295026 J3490 CHOLESTYRAMINE 4GM PK$ 4.59 04295027 J3490 CHYMOTRYPSIN OPHTH 750U/ML$ 139.69 04295028 J3490 CIMETIDINE 300MG/5ML 240ML$ 139.99 04295029 J0744 CIPRO 10MG/ML 40ML INJ$ 116.30 04295030 J3490 CITRIC ACID 16OZ$ 101.06 04295031 J3490 CITRIC ACID CRYSTALS 1LB$ 33.76 04295032 J3490 CODEINE 30MG INJ$ 4.13 04295033 J3490 COLLODION 500ML$ 67.76 04295034 J3490 COLLODION FLEXIBLE 1PINT$ 78.25 04295035 J3490 COLLYRIUM EYE WASH 118ML$ 14.51 04295036 J3490 CORTISONE ACETATE 10MG TAB$ 0.59 04295037 J3490 CORTISPORIN EYE DROPS 5ML$ 39.09 04295038 J3490 CORTISPORIN EYE OINT 3.5GM$ 23.46 04295039 J3490 CYCLOCORT 0.1% 30GM CRM$ 60.98 04295040 J3490 CYCLOPENTOLATE 2% EYE DRP 2ML$ 40.93 04295041 J3490 DESITIN 60GM OINT$ 11.48 04295042 J3490 DICYCLOMINE 10MG/5ML 480ML$ 41.90 04295043 J3490 DIMENHYDRINATE 50MG/ML 5ML$ 22.09 04295044 J3490 DIPROLENE 0.05% 15GM CREAM$ 50.40 04295045 J2270 DURAMORPH 10MG/10ML AMP$ 45.19 04295046 J2270 DURAMORPH 5MG/10ML AMP$ 42.18 04295047 J3490 EPINEPHRINE 1MG/ML 30ML VIAL$ 16.47 04295049 J3490 EUCERIN CREAM 454GM$ 57.17 04295050 J3490 FLUANDENOLIDE 0.05% 30GM$ 69.31 04295051 J3490 FLUOCINOLONE 0.25% 15GM$ 4.38 04295052 J3490 FLUPHENAZINE 1MG TAB UD$ 2.13 04295053 J3490 FLUPHENAZINE 2.5MG TAB UD$ 3.00 04295054 J3490 HEB CREAM BASE 1LB$ 66.84 04295055 J3490 HEXAVITAMIN TABLET UD$ 1.42 04295056 J3490 HYDROCORTISONE 1%LTN 118ML$ 38.30 04295057 J3490 HYDROGEN PEROXIDE 120ML$ 2.08 04295058 J1741 IBUPROFEN 100MG/5ML UD$ 0.30 04295059 J3490 IBUPROFEN 200MG TAB UD$ 1.29 04295060 J3490 INSTA-CHAR 25GM/120ML$ 17.25 04295061 J3490 INSTA-CHAR 50GM/240ML$ 20.71 04295062 J3490 INSTA-GLUCOSE 31GM$ 12.13 04295063 J3490 IOPHENOYLATE 3ML$ 29.18 04295064 J1245 PERSANTINE 10MG/2ML IV$ 335.17 04295065 J3490 KAYEXALATE POWDER 454GM$ 266.44 04295066 J3490 LACTOSE HYD POWDER 480GM$ 538.26 04295068 J3490 LIDOCAINE 1% 2ML AMP$ 2.63

126 04295069 J3490 LIDOCAINE 2%/D5W 250ML INJ$ 40.43 04295070 J3490 LORAZEPAM 0.5MG TAB UD$ 0.25 04295071 J3490 MAZICON 0.1MG/ML 5ML VIAL$ 112.21 04295072 J3490 MECLOFENAMATE 50MG CAP$ 0.54 04295073 J0694 MEFOXIN 1GM VIAL$ 40.93 04295074 J3490 MERCURY DISTILLED 1LB$ 369.86 04295075 J3490 METAL ADD CAPS GLASS 25MM$ 0.66 04295076 J3490 METHYLTESTOSTERONE 10MG$ 0.95 04295077 J3490 METRONIDAZOLE 500MG TAB UD$ 3.09 04295078 J3490 MONSELS SOLUTION 1PINT$ 97.16 04295079 J3490 MULTIVITAMIN THERA TAB UD$ 0.27 04295080 J3490 NAPHAZOLINE EYE DROPS 15ML$ 34.69 04295081 J3490 NEUPOGEN 300MCG/ML 1ML VIAL$ 517.56 04295082 J3490 NIACIN 100MG TAB$ 0.06 04295083 J3490 NICLOCIDE 500MG TAB$ 6.71 04295084 J3490 NITROFURANTOIN 100MG CAP$ 3.50 04295085 J3490 NITROSTAT 600MCG TAB SL100$ 22.28 04295086 J3490 CALCIUM 500MG TABLET$ 0.25 04295087 J3490 PEDIAZOLE SUSPENSION 200ML$ 35.25 04295088 J3490 PILOCARPINE 5% EYEDRP 15ML$ 34.00 04295089 J3490 POTASSIUM IODIDE GRANULES$ 379.73 04295090 J3490 PRELONE 15MG/5ML SYRUP 5ML$ 1.34 04295091 J3490 PRINIVIL 10MG TABLET UD$ 3.96 04295092 J3490 PRINIVIL 5MG TAB UD$ 3.84 04295093 J3490 PROCAINAMIDE 500MG CAP$ 0.27 04295094 J3490 PROCAINE 1%(NOVOCAINE) 2ML$ 14.64 04295095 J3490 PROPOXYPHENE-N 100/650TAB$ 1.42 04295096 90675 RABIES VACCINE 2.5IU SDV$ 249.17 04295098 J3490 SODIUM THIOSULFATE 2270GM$ 115.63 04295099 J3490 SOTALOL 80MG TABLET$ 4.35 04295100 J3490 SUFENTA 100MCG/2ML AMPULE$ 102.17 04295101 J3490 SUFENTA 50MCG/1ML AMPULE$ 60.68 04295102 J3490 SUPRAX 200MG TABLET$ 6.78 04295103 A4402 SURGILUBE 4OZ$ 2.63 04295104 J3490 TETRACAINE 0.5% EYE DROPS 15ML$ 42.03 04295105 J3490 THERAPEUTIC MVI 5ML UD$ 1.71 04295106 J3490 THERMO-TAB$ 0.08 04295107 J3490 THIORIDAZINE 100MG/ML LIQ$ 22.53 04295108 J3490 TIMOLOL 10MG TAB UD$ 2.25 04295109 J3490 TIMOPTIC 0.25% EYEDRP 5ML$ 36.47 04295110 J3490 TORADOL 10MG TABLET UD$ 2.65 04295111 J1885 TORADOL 15MG/ML INJECTION$ 20.75

127 04295112 J1885 TORADOL 30MG/ML INJECTION$ 21.17 04295113 J1885 TORADOL 60MG/ML INJECTION$ 21.89 04295114 J3490 TRANXENE 3.75MG TABLET$ 0.62 04295115 J3490 TRIAMCINOLONE 4MG TABLET$ 0.38 04295116 J3490 TRIMETHOBENZAMIDE 100MG SU$ 0.79 04295117 J2250 VERSED 2MG/2ML VIAL$ 11.83 04295118 J3490 VITAMIN E 200IU CAPSULE$ 0.06 04295121 J3490 KALTOSTAT 7.5CMX12CM$ 12.96 04295122 J3490 KALTOSTAT 2GM$ 16.13 04295123 J3490 DARVON COMPOUND TABLET$ 0.44 04295124 A4649 PLASTIC ORAL SYRINGE 5ML$ 1.12 04295232 J3490 SORBITOL 70% SOLN 480ML$ 28.47 04295402 90732 PNEUMOCOCCAL VAC 23-VAL 0.5ML$ 98.62 04295522 J3490 ACETAZOLAMIDE 250MG/10ML OS$ 11.12 04295566 J3490 LINDANE 1% 60ML LOTION$ 472.27 04295701 J3490 PREMARIN VAG CREAM 42GM$ 106.94 04295730 J3490 HEP B VACC RENAL INJ$ 306.64 04295740 J3490 HEPATITIS B VACCINE 20MCG$ 110.59 04295746 J3490 HEPARIN 10000U/ML VIAL$ 3.40 04295755 J1720 HYDROCORTISONE 100MG/100ML SYR$ 88.83 04295756 J3490 SOLU-CORTEF 250MG/2ML VIAL$ 14.40 04295758 J3490 HYDROMORPHONE 1MG TAB$ 1.01 04295788 J3490 GLYCOPYRROLATE 0.2MG/ML 20ML$ 4.02 04295802 J3490 IRINOTECAN 100MG/5ML INJ$ 892.76 04295803 J1750 IRON DEXTRAN 100MG/2ML INJ$ 55.71 04295805 J3490 IRINOTECAN 40MG/2ML VIAL$ 640.32 04295845 J3490 LIDOCAINE 2% VISCOUS 15ML$ 4.12 04295869 J3490 NITROFURANTOIN 100MG CAP$ 10.40 04295885 J3490 NITROGLYCERIN 0.4MG SL TABLET$ 1.12 04295886 J3490 NITROGLYCERIN 0.4MG SL TAB$ 50.90 04295895 J3490 PHENYTOIN 100MG/2ML AMP$ 4.23 04295905 J2560 PHENOBARBITAL 65MG/ML INJ$ 7.14 04295942 J3490 THYROTROPIN 10 IU/ML AMP$ 208.35 04295968 J9320 STREPTOZOCIN 1GM INJECTION$ 182.04 04295978 A4217 NORMAL SALINE IRRIG 500ML$ 7.35 04295982 J3490 SODIUM BICARB 8.4% 50ML SYR$ 6.32 04296001 J3490 AMINOPHYLLINE 500MG/20ML INJ$ 3.75 04296002 J3490 PRINIVIL 20MG TABLET UD$ 1.93 04296003 J3490 XYLOCAINE SPINAL 1.5% 2ML$ 19.60 04296004 J3490 NORCURON 10MG INJ$ 61.69 04296005 S4995 NICOTINE GUM 2MG$ 1.01 04296006 J3490 NICOTINE PATCH 21MG$ 10.52

128 04296007 J3490 NICOTINE PATCH 14MG$ 9.65 04296008 J3490 NICOTINE PATCH 7MG$ 7.93 04296009 J3490 HYPERLYTE-R 25ML INJ$ 4.53 04296010 J2060 LORAZEPAM 2MG/ML 1ML INJ$ 12.72 04296011 J1631 HALDOL DECANOATE 50MG/5ML VL$ 111.38 04296012 Q0144 ZITHROMAX 250MG CAPSULE$ 16.30 04296013 J3490 HEPARIN 10000U/ML 4 ML$ 20.85 04296016 J3490 AQUAMEPHYTON 10MG INJ$ 12.09 04296017 J3490 INTAL INHALATION SOLN 2 ML$ 2.78 04296018 J3490 ALUMINUM AMMONIUM SO4 4OZ$ 9.49 04296019 J3230 THORAZINE 25MG/ML 2ML AMP$ 15.93 04296020 A4649 PLASTIC ORAL SYRINGE 10ML$ 1.31 04296021 A4649 PLASTIC ORAL SYRINGE 3ML$ 1.12 04296023 J3490 KENALOG 0.1% OINT 15GM$ 47.49 04296024 J3490 TOBRAMYCIN 0.3% OPH SOLN 5ML$ 82.08 04296025 J3490 LOPID 600MG TABLET$ 1.12 04296026 J3490 ROBITUSSIN AC 120ML$ 14.81 04296027 J3490 DIMETAPP ELIXIR 120ML$ 3.72 04296028 J3490 ROBITUSSIN 100MG/5ML 120ML$ 7.93 04296029 J3370 VANCOMYCIN 1GM INJECTION$ 24.44 04296030 J3490 ZARONTIN 250 MG/5 ML SUSP 5 ML$ 2.63 04296031 J3490 SUPRAX 100MG/5ML SUSP 5 ML DOS$ 12.94 04296032 J3490 TYLENOL 32MG/ML 120 ML$ 22.28 04296035 J3490 PROVERA 2.5MG TABLET$ 1.25 04296036 J3490 CISPLATIN 1MG/ML 50ML VIAL$ 559.10 04296037 J3490 PILOCARPINE 0.5% OPHTH RENAL$ 8.69 04296038 J3490 NTG 50MG/D5W 250ML$ 19.13 04296039 S0032 NAFCILLIN 2GM INJECTION$ 27.51 04296041 J0694 MEFOXIN 2GM INJECTION$ 76.59 04296043 J3490 ATROPINE 0.4MG/ML 20ML VIAL$ 4.38 04296044 J3490 DIPHENHYDRAMINE CREAM 15GM$ 12.72 04296045 J3490 METAPROTERENOL 0.4% 2.5ML$ 2.74 04296046 J3490 METAPROTERENOL 0.6% 2.5ML$ 2.15 04296047 J3490 ANALGESIC BALM 454GM$ 29.18 04296048 J3490 DICYCLOMINE 20 MG TAB$ 0.79 04296049 J9050 BICNU 100 MG INJ$ 330.88 04296050 J3490 CHLORTHALIDONE 25MG TAB$ 0.32 04296051 J3490 COLYMYCIN OTIC 10 ML$ 51.24 04296053 J3490 COUMADIN 10 MG TABLET$ 3.75 04296054 J3490 COUMADIN 7.5 MG TABLET$ 3.62 04296055 J3490 D5 1/2 NS KCL 20MEQ 1000ML$ 5.08 04296056 J3490 D5 1/4 NS KCL 20MEQ 1000ML$ 6.09

129 04296057 J3490 DEPOPROVERA 150 MG INJ$ 90.38 04296058 J3490 DEXAMETHASONE OPHTH OINT$ 8.37 04296059 J3490 DONNATAL ELIXIR 480ML$ 27.87 04296060 J3490 ERYPED DROPS 50ML$ 17.00 04296061 A4649 EVAC CONTAINER 1000ML$ 4.33 04296062 A4649 EVAC CONTAINER 500ML$ 3.83 04296063 J0713 CEFTAZIDIME 1GM INJ$ 59.29 04296064 J3490 FURACIN SOL DRESS 454GM$ 317.94 04296065 J3490 HALDOL 1MG TABLET$ 2.63 04296066 J3490 BISMUTH SUBSALIC 262MG TAB$ 0.32 04296067 J3490 BISMUTH SUBSALICYLATE 15ML DOS$ 1.22 04296068 J3490 PANCRELIPASE CAPSULE$ 0.50 04296069 J3490 AMINO ACIDS 10% 500ML INJ$ 22.64 04296070 J3490 MAGNESIUM HYDROXIDE 400MG TAB$ 0.38 04296071 J3490 TAXOL 30MG INJ$ 567.42 04296073 J3490 AMINOPHYLLINE 21MG/ML 100ML$ 4.77 04296074 J3490 BENYLIN DM 120ML$ 10.89 04296075 J3490 BENYLIN 120ML$ 3.75 04296077 J3490 MILK OF MAGNESIA 473ML$ 6.42 04296078 J3490 PHENERGAN VC 120ML$ 4.66 04296079 J3490 PHENERGAN W/ CODEINE 120ML$ 8.51 04296080 J3490 FERROUS SO4 220MG/5ML 480ML$ 5.57 04296081 J3490 TRIMETH/SULFA 8/4O/ML 100ML$ 5.73 04296082 J3490 ALBUTEROL 2MG/5ML 480ML$ 12.34 04296124 J3490 SELENIUM 40MCG/ML 10ML VIAL$ 3.62 04296847 J3490 FAT EMULSION 20% 50ML$ 25.31 04296848 J3490 FAT EMULSION 20% 100ML$ 24.86 04297000 J3490 URSODIOL 300MG CAP$ 10.29 04297001 J3490 RIFAMPIN 600MG VIAL$ 334.49 04297002 J0630 CALCITONIN 200IU/ML 2ML VIAL$ 71.28 04297003 J3490 FLUOTHANE-15 MIN$ 2.23 04297004 J3490 ETHRANE-15 MIN$ 9.48 04297005 J3490 FORANE-15 MIN$ 16.77 04297111 J3010 FENTANYL 1000MCG/NSS 100ML$ 49.83 04297961 J3490 AMPHETAMINE SALTS CMB 20MG TAB$ 1.27 04297962 J3490 AMPHETAMINE SALTS ER 30MG CAP$ 5.89 04297963 J3490 AMPHETAMINE SALTS ER 20MG CAP$ 5.89 04298000 J3490 ROSIGLITAZONE 2MG TAB$ 8.96 04299000 J3490 ROSIGLITAZONE 4MG TAB$ 12.75 05000022 92507 SPEECH THERAPY INDIVIDUAL$ 135.04 05000026 V5008 HEARING SCREENING$ 135.04 05000027 V5362 PRE-CONSULT LARYNGECTOMY$ 135.04

130 05000038 92508 SPEECH TX GROUP$ 135.04 05000039 97127 ST-COGNITIVE EVALUATION$ 67.55 05000040 92507 SPEECH TX CASE CONFERENCE$ 183.11 05000391 A4649 TRACHTALK$ 89.76 05002529 92526 ST-MODIFIED BARIUM SWALLOW STU$ 221.62 05031575 31575 ENDOSCOPIC VOICE EVAL$ 220.02 05069250 92523 SPEECH-LANGUAGE EVAL 1ST 15 M$ 67.54 05079250 92507 SPCH/LNGE COG TX INDIVIDUAL$ 67.54 05080005 L8501 PASSY MUIR SPK VALVE 005$ 359.51 05080007 L8501 PASSY MUIR SPK VALVE 007$ 490.61 05080298 V5336 PASSY MUIR VALVE ATACHMENT$ 10.15 05092506 92523 BEDSIDE DYSPHAGIA COMPREHENSIV$ 67.54 05092507 92507 SPEECH THERAPY INDIVIDUAL$ 35.97 05092520 92526 MODIFIED BARIUM SWALLOW$ 67.54 05092610 92610 ST-EVALUATION OF SWALL$ 141.21 05092611 92611 MOTION SWALLOW BY CINE/VIDEO$ 211.83 05092612 92612 ENDOSCOPY SWALLOW CINE/VIDEO$ 275.10 05092616 92616 ST-FIBEROPTIC SWALLOW W/ SENSO$ 583.60 05095003 92523 SPEECH-LANGUAGE COMPREHENSIVE$ 45.43 05096001 92507 DYSPHAGIA TX INDIVIDUAL$ 35.98 05096003 92507 COGNITIVE TX INDIVIDUAL$ 35.98 05097112 97112 ST-NEUROMUSCULAR REEDUC-15 MIN$ 65.90 05097150 97150 ST-THERAPEUTIC SERVICES GROUP$ 75.06 05097533 97533 ST-SENSORY INTEGRATION-15 MIN$ 88.65 05200023 97535 ADL TRAINING ADD 15 MIN$ 79.89 05200042 97110 CONT PASSIVE MTN EACH 15 MIN$ 107.79 05200043 97799 JOBST MEASURING$ 123.99 05200049 97799 BASE FEE PER PATIENT$ 79.89 05200056 97112 NEUROMUSC REEDUC EACH 15 MIN$ 80.44 05200057 97799 OT CASE CONFERENCE$ 183.11 05200060 97760 SPLINTING ADD'L 15 MIN$ 91.21 05200063 97110 NEUROMUSC FACIL ADD 15 MIN$ 80.44 05200064 97112 COORDINATION TEST EA 15 MIN$ 80.44 05200080 97112 COORD EXERCISE/ACT EA 15 MIN$ 79.89 05200134 A4649 DORSIFLEXION ASSIST$ 141.58 05200148 97110 MUSCLE STRENGTH ADD 15 MIN$ 79.89 05200189 97110 ROM EXERCISE ADD 15 MIN$ 79.89 05200205 97761 PROSTHETIC TRNG EACH 15 MIN$ 79.89 05200390 A4649 THERAPLAST$ 12.54 05200405 97124 EDEMA REDUCTION PER 15 MIN$ 21.01 05200406 97110 THERAPEUTIC EXER ADD 15 MIN$ 21.01 05200437 A4649 VELCRO (PER 6")$ 1.46

131 05200669 A4649 SPLINT FINGER EXT WIRE FOAM$ 40.40 05201179 97110 HAND THERAPY - 15 MIN$ 79.89 05202000 97110 ROM ACTIVITIES PER 15 MIN$ 27.33 05202010 97112 COORD/FINE MOTOR EA 15 MIN$ 24.54 05202020 97535 DAILY LIVING TRAING EA 15MIN$ 27.33 05209711 97110 MUSCLE STRENGTH EACH 15 MIN$ 80.43 05210971 97110 ROM EXERCISE EACH 15 MIN$ 80.43 05211097 97110 THERAPEUTIC EXER EACH 15 MIN$ 53.97 05229702 97022 OT-WHIRLPOOL-15 MIN$ 51.20 05249750 97760 ORTHOTICS TRNG EXT ADD 15 MI$ 80.43 05261801 A4649 ORTHOSIS FOOT-DROP$ 664.90 05282601 A4649 SPLINT FOOT PREFABRICATED$ 310.05 05292506 92523 OT-BEDSIDE DYSPHAGIA COMPREHEN$ 207.73 05292507 92507 OT-DYSPHAGIA TREATMENT$ 110.82 05292520 92526 OT-MODIFIED BARIUM SWALLOW$ 207.73 05296001 97010 FLUIDOTHERAPY 1+ AREAS$ 61.74 05296002 97018 PARAFFIN BATH TX 1+ AREAS$ 15.42 05296003 97545 WORK HARD/IND REHAB INIT 2HRS$ 46.29 05296008 A4570 SPLINT HAND PRE-FABRICATED$ 229.62 05296009 A4570 SPLINT ANTISPASTICITY$ 320.29 05296010 A4649 SPLINT ASSIST NEOPRENE$ 94.01 05297000 A4649 THERAPUTTY-3 OZ$ 22.83 05297004 A4649 THERMOPLASTIC MATERIAL-1/4 SHE$ 115.04 05297017 A4649 SILICONE GEL-SQUARE INCH$ 10.63 05297018 A4649 OTOFORM/ELASTOMER-1 OZ$ 26.10 05297020 97602 DRESSING APPLICATION$ 195.85 05297035 97035 OT-THERAPEUTIC US EACH 15 MIN$ 175.73 05297110 97110 NEUROMUSC FACIL EACH 15 MIN$ 80.43 05297112 97112 OT-NEUROMUSC REEDUC EA 15 MIN$ 53.90 05297140 97140 OT-JNT MOBILIZATION EA 15MIN$ 81.26 05297150 97150 OT-GROUP THERAPY$ 72.40 05297165 97165 OT EVAL-LOW COMPLEX 30 MIN$ 127.19 05297166 97166 OT EVAL-MOD COMPLEX 45 MIN$ 137.80 05297167 97167 OT EVAL-HIGH COMPLEX 60 MIN$ 148.39 05297168 97168 OT RE-EVAL EST PLAN CARE$ 84.57 05297504 97760 ORTHOTICS TRNG EXT 1ST 15 MI$ 80.43 05297520 97761 OT-PROSTHETIC TRNG INIT 15 MI$ 79.89 05297532 97127 OT-COGNITIVE TRAINING$ 77.23 05297535 97535 ADL TRAINING 1ST 15 MIN$ 80.43 05297542 97542 WHEELCHAIR MANAGEMENT EA 15MIN$ 88.24 05297750 97750 PHYSICAL PERF/MEASURE EA 15MIN$ 100.67 05297755 97755 ASSISTIVE TECH ASSESS EA 15MIN$ 102.52

132 05297760 97760 ORTHOTIC MANAGEMENT EA 15MIN$ 126.13 05298000 97033 OT-IONTOPHORESIS EACH 15 MIN$ 219.29 05299977 97760 SPLINTING EACH 15 MIN$ 45.23 05299999 97799 MISC OCC TX PER 15 MIN$ 21.01 05300004 94060 PEAK FLOWMETER INITIAL$ 317.43 05300007 94726 LUNG VOLUMES$ 55.37 05300008 A4649 OXYGEN ANALYSIS/ANALYSER$ 46.98 05300011 A4649 CPAP NASAL$ 55.37 05300014 94640 INCENTIVE SPIROMETRY SUBSEQUE$ 220.63 05300021 94799 WEANING PARAMETERS$ 216.06 05300025 94667 CHEST PHYSIO INITIAL$ 220.63 05300026 94799 CUFF PRESSURE MEASUREMENT$ 216.13 05300027 94799 SUCTION (PROCEDURE)$ 216.13 05300046 94060 PEAK FLOWMETER SUBSEQUENT$ 46.98 05300047 94762 O2 SATURATION CONTINUOUS$ 151.04 05300056 94761 O2 SATURATION MULTIPLE$ 46.98 05300057 94668 CHEST PHYSIO SUBSEQUENT$ 70.18 05300065 94660 CPAP TITRATION$ 434.67 05300089 94640 AEROSOL INHAL SUBSEQ$ 220.63 05300090 94642 PENTAMIDINE TREATMENT$ 46.98 05300100 A4649 CLOSED TRACH SUCT PER UNIT$ 26.07 05300105 94640 AEROSOL INHAL$ 220.63 05300106 94010 SPIROMETRY TOTAL & TIMED$ 94.59 05300110 94760 O2 SATURATION SINGLE$ 45.21 05300171 94640 INCENTIVE SPIROMETRY INITIAL$ 220.63 05300214 A4649 NEBULIZER PREFILLED$ 14.69 05300238 A4649 NEBULIZER REFILL$ 17.55 05300338 94644 BRONCHODILATOR (HHN) TX FIRST$ 176.57 05300360 94645 BRONCHODILATOR (HHN) TX EACH$ 17.77 05300383 A4649 TUBING CORRUGATED$ 15.72 05300386 A4649 AEROSOL T ADAPTOR$ 2.86 05300387 A4649 HUMIDIFIER$ 16.39 05300392 A4649 COMPRESSED AIR/HOUR$ 10.00 05300396 A4649 OXYGEN/HR-1 LITER$ 1.13 05300397 A4649 OXYGEN/HR-2 LITER$ 2.86 05300398 A4649 OXYGEN/HR-3 LITER$ 4.31 05300400 A4649 OXYGEN/HR-4 LITER$ 5.69 05300401 A4649 OXYGEN/HR-5 LITER$ 7.14 05300402 A4649 OXYGEN/HR-6 LITER$ 8.56 05300403 A4649 OXYGEN/HR-7 LITER$ 10.00 05300404 A4649 OXYGEN/HR-8 LITER$ 11.42 05300405 A4649 OXYGEN/HR-9 LITER$ 12.83

133 05300408 A4649 OXYGEN/HR-10 LITER$ 14.27 05300409 A4649 OXYGEN/HR-11 LITER$ 7.08 05300410 A4649 OXYGEN/HR-12 LITER$ 7.47 05300411 A4649 OXYGEN/HR-13 LITER$ 8.42 05300412 A4649 OXYGEN/HR-14 LITER$ 8.97 05300413 A4649 OXYGEN/HR-15 LITER$ 9.64 05300501 A4618 TUBE BREATHING HFNC ADULT$ 254.82 05300568 94640 SPUTUM INDUCTION PER TX$ 220.63 05300610 A4649 KIT NEBULIZER CONTINUOUS$ 136.61 05300742 A4619 CIRCUIT VENTILATOR-INFANT$ 52.43 05300759 A4649 OXYGEN/HR VENTILATOR$ 36.32 05300783 A4649 CONCHA PAK$ 145.35 05300798 A4649 CIRCUIT VENTILATOR-ADULT$ 74.29 05300811 A4649 FILTER PALL$ 23.97 05300825 A4649 OXYHOOD$ 14.69 05300912 A7525 MASK TRACHEOSTOMY$ 15.08 05301000 94003 VENT ASSIST & MGMT SUBSEQUENT$ 604.76 05301002 94002 VENT ASSIST & MGMT 1ST DAY$ 709.38 05301420 A4649 PEEP VALVE-ADULT$ 93.18 05302197 A4649 INCENTIVE SPIROMETER$ 74.12 05304831 A4615 CANNULA NASAL JR PEDS$ 468.08 05304832 A4649 CIRCUIT AIRVO 2 OPTIFLOW$ 656.37 05304942 A4615 CANNULA NASAL OPTFLW ADULT-SML$ 171.03 05304944 A4615 CANNULA NASAL OPTFLW ADULT-MED$ 171.03 05304950 A4649 FULL FACE MASK$ 300.99 05304953 A4649 MASK CPAP/BIPAP-PEDS$ 878.52 05307142 A4649 DRAINAGE BAG$ 11.50 05310001 A4649 MDI INLINE MULTI ADAPTOR$ 10.38 05311102 A4649 INFANT BREATHING CIRCUIT$ 397.46 05311665 A7004 HANDHELD NEBULIZER KIT$ 8.39 05313930 A4649 BIPAP CIRCUIT ADULT$ 79.56 05319250 A4649 VEST SPU WRAP-MED$ 543.76 05319251 A4649 WRAP VEST SPU-LGE$ 543.76 05321000 A4649 ADAPTER OXYGEN$ 14.89 05321289 A4649 CANNULA PREMMIES$ 108.79 05321290 A4649 CANNULA NEWBORN$ 108.79 05321291 A4649 CANNULA INFANT$ 108.79 05321762 A4649 TRESHOLD PEP VALVE$ 245.09 05325604 94660 CONT POS AIRWAY PRESSURE$ 220.63 05329799 A4649 TUBE ENDOTRACHEAL FASTENER$ 70.19 05338241 A7030 MASK CPAP FULL FACE-MED$ 790.02 05338242 A7030 MASK CPAP FULL FACE-SML$ 790.02

134 05338243 A7030 MASK CPAP FULL FACE-LGE$ 790.02 05350828 82805 VBG ANALYSIS$ 126.22 05352023 A4649 HEADGEAR BIPAP-SMALL$ 222.03 05352027 A4649 HEADGEAR BIPAP-MEDIUM$ 222.03 05352032 A4649 MASK BIPAP-PETITE$ 163.68 05352034 A4649 MASK BIPAP-SMALL$ 163.68 05352036 A4649 MASK BIPAP-MEDIUM$ 163.68 05352040 A4649 PAD SEALING BIPAP$ 24.12 05352041 A4649 MASK FACE BIPAP SIZING GAUGE$ 48.21 05356611 A4649 NEBULIZER W/ T-ADAPTOR$ 9.23 05371374 A4649 OSCILLATOR VENT CIRCUIT$ 946.53 05378022 A4649 CIRCUIT VENTILATOR-PEDS$ 122.71 05382803 82803 CAPILLARY BLOOD GAS PROCUR$ 40.70 05382805 82805 ABG ANALYSIS$ 126.22 05390483 A4615 CANNULA NASAL JR INFANT$ 468.08 05394003 94799 PIP/NIF TEST$ 55.37 05394640 94640 AEROSOL INH-SPUTUM INDUCT INI$ 220.63 05394641 94640 AEROSOL INH-SPUTUM INDUCT SUB$ 220.63 05394644 94644 CONTINUOUS INH TREATMENT 1ST$ 199.50 05394645 94645 CONTINUOUS INH TREATMENT EACH$ 72.72 05394664 94664 DEMO & EVAL UTILIZ AERO GEN M$ 220.63 05394772 94772 BREATH RECORD 12-24HR INFANT$ 1,130.15 05395805 95805 MULTIPLE SLEEP LATENCY TEST$ 956.27 05395807 95807 SLEEP STUDY ATTENDED$ 1,477.85 05395808 95808 POLYSOMNOGRAPHY 1-3$ 1,477.85 05395810 95810 SLEEP STAGE 4 PARAMETERS$ 2,521.05 05400146 97022 PT-WHIRLPOOL TX 1+ AREAS$ 65.90 05400245 97799 TRANS 5 MILE RADIUS$ 35.79 05400260 97799 TRANS P/M BEYOND 5 MILES$ 6.93 05400302 97799 CASE CONFERENCE ADD 15 MIN$ 23.06 05400394 A4649 CANE QUAD$ 247.34 05400429 A4649 THERABAND (PER 1 FT)$ 0.92 05403294 A4649 CANE WOODEN$ 57.02 05409381 A4649 STOCKINETTE TENSOGRIP S-B /FT$ 8.28 05409388 A4649 STOCKINETTE TENSOGRIP S-C /FT$ 11.60 05409389 A4649 STOCKINETTE TENSOGRIP S-D /FT$ 13.27 05410920 E0114 CRUTCHES ADJ-YOUTH$ 114.29 05410925 E0114 CRUTCHES ADJ-ADULT MED$ 126.32 05410930 A4649 CRUTCHES ADJ-ADULT LGE$ 129.39 05421179 97112 PT-NEUROMUSCULAR RETRNG-15 MIN$ 81.26 05425410 A4649 CORSET AQUAFORM SMALL$ 761.74 05425411 A4649 CORSET AQUAFORM MEDIUM$ 798.88

135 05425412 A4649 CORSET AQUAFORM LARGE$ 826.85 05470359 97035 PT-THERAPEUTIC ULTRASOUND-15 M$ 49.52 05471109 97110 PT-CONT PASSIVE MOTION-15 MIN$ 71.67 05471129 97112 PT-KINETIC EXERCISE-15 MIN$ 81.26 05475097 97750 PT-EXTREMITY ASSESSMENT-15 MIN$ 95.31 05475309 97530 PT-FUNCTIONAL TX ACTIVITY-15 M$ 81.26 05477509 97750 PT-EVALUATION/ASSESSMENT-15 MI$ 96.03 05493797 93797 CARDIAC REHAB O-P W/O EKG MON$ 138.43 05493798 93798 CARDIAC REHAB O-P W/ EKG MONI$ 138.43 05493810 A4649 STOCKINETTE TENSOGRIP S-E /FT$ 13.27 05493811 A4649 STOCKINETTE TENSOGRIP S-F /FT$ 14.94 05495003 97010 PT-HOT/COLD PACKS 1+ AREAS$ 38.62 05495005 97602 DRESSING APPLICATION$ 195.85 05495006 97014 PT-ELECTRICAL STIMULATION UNA$ 38.62 05495007 97110 THERAPEUTIC EXERCISE EA 15MIN$ 38.62 05495008 97010 FLUIDOTHERAPY 1+ AREAS$ 37.44 05495012 97799 HOME EVALUATION$ 308.92 05495013 97010 PT-HOT/COLD PACKS 1+ AREAS$ 38.62 05495016 97124 MASSAGE ADD 15 MIN$ 65.90 05495020 97018 PARAFFIN BATH TX 1+ AREAS$ 38.62 05495026 97545 WORK HARD/CONDIT 1ST 2 HOUR$ 308.92 05495027 97546 WORK HARDENING ADD 1 HOUR$ 154.48 05495028 97127 PT-COGNITIVE TRAINING$ 77.23 05495029 97116 GAIT TRAINING EACH 15 MIN$ 62.76 05497012 97012 PT-TX TRACTION 1+ AREAS$ 51.72 05497032 97032 PT-ELECTRIC STIM MNL EA 15MIN$ 57.93 05497110 97110 CARDIAC REHAB IN-PAT EA 15MIN$ 66.09 05497113 97113 PT-HYDROTX W/EXRCSE EA 15 MIN$ 76.09 05497116 97116 GAIT TRAINING INIT 15 MIN$ 38.62 05497124 97124 MASSAGE INIT 15 MIN$ 38.62 05497140 97140 MANUAL THERAPY 1/> EA 15 MIN$ 81.26 05497150 97150 PT-GROUP THERAPY$ 72.40 05497161 97161 PT EVAL-LOW COMPLEX 20 MIN$ 131.65 05497162 97162 PT EVAL-MOD COMPLEX 30 MIN$ 142.62 05497163 97163 PR EVAL-HIGH COMPLEX 45 MIN$ 153.58 05497164 97164 PT RE-EVAL EST PLAN CARE$ 89.99 05497597 97597 PT-WOUND DEBRIDE1ST 20SQCM/<$ 195.85 05497598 97598 PT-WND DEBRIDEEA ADD 20SQCM/<$ 149.24 05497761 97761 PT-PROSTHETIC TRAIN EA 15MIN$ 73.88 05497799 97799 CASE CONFERENCE INIT 15 MIN$ 40.09 05498000 97033 PT-IONTOPHORESIS EACH 15 MIN$ 219.29 05499125 A4649 FINGER COT-SML$ 12.69

136 05499126 A4649 FINGER COT-MED$ 12.69 05499127 A4649 FINGER COT-LGE$ 12.69 06000001 EF-PULMOCARE 8 OZ$ 2.76 06000002 EF-PEDIASURE 8 OZ$ 2.18 06000003 EF-SUPP-VITAL POWDER 2.79 OZ$ 5.70 06000004 WATER STERILE 1 QUART$ 8.89 06000005 EF-JEVITY RTH 1000 CC$ 14.18 06000007 DIET CONSULTATION$ 38.12 06000010 EF-SUPP-PROMOD 6.6 GM SCOOP$ 20.00 06000023 DIETARY BREAKFAST$ 8.75 06000027 EF-NEPRO 8 OZ$ 3.38 06000031 DIETARY LUNCH$ 10.79 06000040 EF-ENSURE 8 OZ$ 2.13 06000048 DIETARY DINNER$ 10.17 06000074 SUSTAGEN BY DOSAGE$ 1.98 06000086 EF-SUPP-POLYCOSE PER HALF CUP$ 1.02 06000110 SUSTACAL PUDDINGS$ 1.95 06000129 SUSTACAL 8 OZ$ 1.76 06000137 SUSTACAL 12 OZ$ 2.29 06000141 CLEAR LIQUID DIET$ 2.52 06000157 FULL LIQUID DIET$ 5.33 06000158 EF-GLUCERNA 8 OZ$ 3.91 06000222 CLEAR LIQUID W/ ROSS SLD$ 4.65 06800001 S3620 NEWBORN METABOLIC SCREEN (FIRS$ 116.12 06800002 S3620 NEWBORN METABOLIC SCREEN (SECO$ 86.37 06800007 84443 THYROID STIMULATING HORMONE$ 99.80 06800008 84702 HCG QUANTITATIVE$ 105.49 06800016 80156 CARBAMAZEPINE (TEGRETOL)$ 100.41 06800048 80051 ELECTROLYTE PROFILE$ 52.68 06800073 A4649 BAG DOUBLE-BLOOD PACK CPDA$ 86.85 06800127 MORGUE FEE PER DAY$ 21.97 06800335 80061 LIPID PROFILE(TRIGVLDLHDLLD$ 78.44 06801020 87147 SEROLOGICAL SLIDE TYPING$ 56.60 06801081 80349 THC URINE QUALITATIVE$ 42.54 06802046 86920 INCOMPATIBLE X-MATCH$ 167.67 06802112 80150 AMIKACIN PEAK$ 107.29 06803068 86927 F F P$ 145.06 06806311 86687 HTLV-I$ 80.01 06806548 84560 URIC ACID URINE$ 27.06 06806591 87449 STREP B TEST$ 39.05 06807078 87070 CULTURE WOUND$ 76.30 06807087 87070 CULTURE THROAT$ 76.30

137 06808101 80346 BENZODIAZEPINE URINE QUALITAT$ 42.54 06808707 87070 CULTURE MISCELLANEOUS$ 76.30 06809399 UNCLAIMED FETAL DISP$ 292.69 06810004 81000 URINALYSIS COMPLETE$ 15.74 06810053 81001 URINALYSIS AUTOMATED W/ MICR$ 10.46 06810108 80307 PHENCYCLIDINE(PCP) URINE QUAL$ 42.54 06810810 80361 OPIATES URINE QUALITATIVE$ 42.54 06811434 36430 ADMINISTRATION:BLD/BLD COMPONE$ 398.42 06812000 80324 AMPHETAMINES URINE QUALITATIV$ 42.54 06820102 82009 ACETONE SERUM QUALI$ 52.47 06820121 87070 CULTURE GENITAL$ 76.30 06820122 87070 CULTURE NASAL$ 76.30 06820123 87070 CULTURE RESPIRATORY$ 76.30 06820124 87070 CULTURE EYE$ 76.30 06820125 87070 CULTURE EAR$ 76.30 06820126 87070 CULTURE ENVIRONMENTAL$ 76.30 06820127 87070 CULTURE CATHETER$ 76.30 06820348 84302 SODIUM CSF$ 44.88 06820409 82040 ALBUMIN/GLOBULIN$ 26.23 06820557 80307 ALCOHOL URINE$ 39.38 06821123 80150 AMIKACIN LEVEL TROUGH$ 127.25 06821406 82140 AMMONIA$ 130.75 06821506 82150 AMYLASE BLOOD$ 39.38 06821605 82150 AMYLASE URINE$ 39.38 06822073 80329 ACETAMINOPHEN(TYLENOL)$ 109.28 06822504 82247 BILIRUBIN TOTAL SERUM$ 31.45 06822553 82248 BILIRUBIN DIRECT$ 31.45 06823106 82310 CALCIUM SERUM$ 28.88 06823353 82340 CALCIUM URINE QUALI$ 18.33 06823403 82340 CALCIUM URINE QUANTI$ 42.01 06824351 82435 CHLORIDE BLOOD$ 26.23 06824450 82436 CHLORIDE URINE$ 26.23 06824559 82438 CHLORIDE CSF$ 26.23 06824658 82465 CHOLESTEROL TOTAL$ 28.88 06825556 82550 CREATINE PHOSPHOKINASE$ 26.23 06825605 82552 CPK-MB$ 111.22 06825655 82565 CREATININE BLOOD$ 26.23 06825705 82570 CREATININE URINE$ 26.23 06825754 82575 CREATININE CLEARANCE$ 62.96 06826431 80162 DIGOXIN$ 89.76 06826553 80185 PHENYTOIN (DILANTIN)$ 154.16 06826621 80337 TRICYCLIC ANTIDEPRESS SCRN$ 115.13

138 06827057 82705 FAT FECAL QUALITATIVE$ 13.13 06827205 82728 FERRITIN$ 115.13 06828402 82374 CARBON DIOXIDE CONTENT$ 26.23 06829251 82930 GASTRIC ACID ANALYSIS$ 26.23 06829417 80170 GENTAMYCIN TROUGH$ 124.88 06829419 80170 GENTAMYCIN PEAK$ 124.88 06829458 82945 GLUCOSE URINE$ 27.06 06831604 81025 PREGNANCY TEST QUALI-URINE$ 44.58 06832754 80178 LITHIUM BLOOD$ 62.37 06835407 83540 IRON SERUM$ 39.38 06835506 83550 IRON BINDING CAPACITY TOTAL(T$ 42.01 06836207 83615 LDH BLOOD$ 26.23 06836900 83690 LIPASE$ 42.01 06837353 83735 MAGNESIUM$ 32.81 06840605 84060 PHOSPHATASE ACID TOTAL$ 42.01 06840753 84075 PHOSPHATASE ALKALINE$ 42.01 06840803 84080 PHOSPHATASE ALK ISOENZYME$ 99.45 06841009 84100 PHOSPHORUS BLOOD$ 31.45 06841058 84105 PHOSPHORUS URINE$ 31.45 06841405 84132 POTASSIUM BLOOD$ 31.45 06841454 84133 POTASSIUM URINE$ 31.45 06841553 84155 PROTEIN TOTAL BLOOD$ 26.23 06841801 84155 URINARY PROTEIN$ 42.93 06841850 86335 PROTEIN BENCE JONES$ 26.23 06841959 84155 PROTEIN BODY FLUID$ 26.23 06842957 84295 SODIUM BLOOD$ 31.45 06843005 84300 SODIUM URINE$ 31.45 06843302 82947 GLUCOSE BLOOD$ 26.23 06843401 82951 GLUCOSE TOLERANCE 3-HRS$ 78.69 06843807 82945 GLUCOSE BODY FLUID$ 26.23 06844200 80198 THEOPHYLLINE$ 109.28 06844557 84450 TRANSAMINASE AST(SGOT)$ 26.23 06844656 84460 TRANSAMINASE ALT(SGPT)$ 26.23 06844755 84478 TRIGLYCERIDES$ 39.38 06845208 84520 UREA NITROGEN BLOOD$ 26.23 06845408 84540 UREA NITROGEN URINE$ 27.31 06845505 84550 URIC ACID BLOOD$ 23.37 06849175 80184 PHENOBARBITAL$ 26.23 06850000 85002 BLEEDING TIME$ 105.49 06850208 85041 COUNT ERYTHROCYTE$ 13.13 06850307 85048 COUNT WBC BLOOD$ 13.13 06850309 89055 COUNT WBC STOOL$ 13.13

139 06850406 85007 DIFFERENTIAL$ 13.13 06850505 85018 HEMOGLOBIN ROUTINE$ 13.13 06850553 86803 HEPATITIS C VIRUS AB$ 98.78 06850554 85014 HEMATOCRIT$ 13.13 06850604 85027 HEMOGRAM (HGB HCT RBC WBC$ 20.98 06851008 38220 BONE MARROW ASPIRATION$ 1,107.71 06851057 85097 BONE MARROW SMEAR:INTERPRETATI$ 394.32 06851099 88313 BONE MARROW STAINING$ 72.73 06853509 89190 EOSINOPHIL NASAL SMEAR$ 15.74 06853625 85362 FIBRIN DEGRADATION FDP$ 42.93 06853756 85385 FIBRINOGEN QUANTITATIVE$ 52.47 06853905 85175 FIBRINOLYSIN QUAL CLOTLYSI$ 26.23 06854928 82945 GLUCOSE CSF$ 27.06 06855481 85060 RBC MORPHOLOGY$ 17.55 06855601 88319 LEUKOCYTE MYLOPEROXIDASE$ 394.32 06855801 85032 PLATELET COUNT MANUAL$ 15.74 06856106 85610 PROTHROMBIN TIME$ 26.23 06856205 85555 RED CELL FRAGILITY$ 57.71 06856213 85557 RED CELL INCUBATION$ 137.69 06856403 85045 RETICULOCYTE COUNT AUTOMATED$ 18.33 06856502 85652 SEDIMENTATION RATE ERYTHROCYT$ 18.33 06856601 85660 SICKLE CELL SOLUBILITY$ 18.33 06857302 85730 THROMBOPLASTIN TIME ACT PARTI$ 39.38 06860108 86000 AGGLUTININS FEBRILE$ 78.69 06860215 86870 ANTIBODY IDENTIFICATION$ 246.15 06860256 86886 ANTIBODY TITER RH.ET$ 246.15 06860264 86860 ANTIBODY ELUTION$ 167.67 06860272 86978 ANTIBODY ABSORPTION$ 101.92 06860280 86971 ANTIBODY DETECT W/ ENZYMES$ 167.67 06860603 86060 ANTISTREPTOLYSIN O TITER$ 52.47 06860702 86922 COMPATIBILITY TEST ANTIGLOB$ 167.67 06860710 86078 TRANSFUSION RXN WORKUP$ 246.15 06860801 86900 ABO SERUM GROUP$ 101.92 06861007 86901 RH TYPING D$ 101.92 06861106 86906 RH SUBTYPES EACH$ 101.92 06861205 86905 RBC ANTIGEN TYPING-PATIENT$ 101.92 06861403 86140 C-REACTIVE PROTEIN$ 26.23 06861502 86157 COLD AGGLUTININS$ 52.47 06862100 86592 RPR$ 21.45 06862500 86880 ANTIBODY SCRN DIR COOMBS$ 167.67 06862609 86885 AB SCREEN INDIRECT COOMBS$ 167.67 06862872 87340 HEPATITIS B SURFACE AG(HBSAG)$ 62.96

140 06862891 86704 HEPATITIS B CORE AB(HBCAB)$ 80.01 06862962 86706 HEPATITIS BS AB(HBSAB)$ 61.30 06863003 86308 HETEROPHILE ANTIBODY$ 30.14 06863524 86741 CSF DIRECT AG FOR MENINGITIDI$ 91.70 06863607 86430 LATEX FIXATION RA$ 52.47 06863805 85009 L E PREP$ 52.47 06863945 86762 RUBELLA TITER$ 119.03 06863946 86762 RUBELLA SCREEN$ 78.04 06865148 84156 PROTEIN URINE$ 27.06 06869995 86703 HIV 1/2 ANTIBODY$ 101.46 06869996 86701 HIV 1 ANTIBODY$ 98.78 06870008 87205 SMEAR STAIN FOR BACTERIA$ 26.23 06870107 87177 OVA AND PARASITE TEST$ 26.23 06870110 87210 WET MOUNT BACTERIA FUNGI$ 25.37 06870503 87040 CULTURE BLOOD DEFINITIVE$ 62.96 06870708 87070 CULTURE BODY FLUID$ 76.30 06870870 87070 CULTURE CSF$ 76.30 06870909 87070 CULTURE BACTERIAL$ 42.01 06871105 87086 URINE SCREEN COLONY COUNT$ 52.47 06871303 87088 BACTERIAL ID ADDITIONAL$ 26.23 06871857 87186 SENSITIVITY MIC$ 52.47 06873507 87166 DARKFIELD EXAMINATION$ 65.56 06880007 88000 AUTOPSY GROSS ONLY$ 524.58 06880048 80048 BASIC METABOLIC PANEL$ 93.52 06880101 80353 COCAINE URINE QUALITATIVE$ 42.54 06880205 88020 AUTOPSY EXC BRN/SPC(G+M)$ 1,049.17 06880304 88027 AUTOPSY INC BRAIN/SPC$ 1,442.64 06880353 88099 AUTOPSY SPECIAL FORMAL REQ$ 1,081.96 06881003 81003 URINALYSIS AUTO W/O SCOPE$ 8.57 06881005 88164 CYTOLOGY DIAGNOCTIC$ 26.23 06881054 88155 CYTOLOGY DX ESTROGEN INDEX$ 39.38 06881104 88104 CYTOLOGY EXC GENITAL SMEARS$ 39.19 06881302 88130 BUCCAL SMEAR CHROMATIN ID$ 52.47 06882042 82042 ALBUMIN BODY FLUID QUANT$ 27.06 06882150 82150 AMYLASE BODY FLUID$ 39.38 06882271 82271 OCCULT BLOOD GASTRIC FLUID$ 23.18 06882274 82274 BLOOD OCCULT IMMUNOASSAY QUALI$ 45.47 06882436 82436 CHLORIDE 24-HOUR URINE$ 33.80 06882508 80329 SALICYLATES URINE\BLOOD$ 78.69 06882570 82570 CREATININE BODY FLUID$ 27.06 06882962 82962 GLUCOSE BLD BY MONITOR DEVICE$ 27.11 06883001 88300 GROSS ONLY$ 39.19

141 06883012 88332 TISSUE BLOCK PREP$ 17.55 06883100 88304 TISSUE EXAM:SMALL-UNCOMPLICATE$ 86.56 06883118 88311 DECALCIFICATION:BONE$ 26.23 06883126 88312 SPECIAL STAIN:GROUP 1$ 72.73 06883159 88305 GROSS & MICRO MULT SPEC-E$ 108.19 06883202 88321 TISSUE SLIDES EACH$ 39.19 06883357 88307 GROSS & MICRO COMPLIC$ 246.15 06883605 83605 LACTIC ACID BODY FLUID$ 69.59 06883721 83721 LDL CHOLESTEROL DIRECT$ 37.45 06883880 83880 B-NATRIURETIC PEPTIDE (B-NP)$ 150.99 06884133 84133 POTASSIUM 24-HOUR URINE$ 33.80 06884156 84156 PROTEIN 24-HOUR URINE$ 30.37 06884157 84157 PROTEIN OTHER BODY FLUID$ 30.37 06884158 84157 PROTEIN CSF$ 57.46 06884300 84300 SODIUM 24-HOUR URINE$ 33.80 06884302 84302 SODIUM BODY FLUID$ 44.88 06884311 84311 CHOLESTEROL BODY FLUID$ 38.64 06884315 84315 SPECIFIC GRAVITY BODY FLUID$ 19.35 06884478 84478 TRIGLYCERIDE BODY FLUID$ 42.54 06884512 84484 TROPONIN-I QUANTITATIVE$ 78.58 06884560 84560 URIC ACID URINE 24-HR.$ 42.42 06884703 84703 HCG SERUM QUALITATIVE$ 46.39 06885025 85025 CBC W/ AUTOMATED DIFF$ 28.88 06885027 85049 PLATELET COUNT AUTOMATED$ 20.98 06885044 85044 RETICULOCYTE COUNT MANUAL$ 18.33 06885460 85460 KLEIHAUER-BETKE TEST$ 89.53 06885611 85611 PROTHROMBIN TIME MIXING STUDY$ 30.93 06885732 85732 PTT MIXING STUDY$ 30.93 06886593 86593 RPR TITER$ 57.69 06886705 86705 HEPATITIS B CORE IGM$ 30.92 06886769 86769 RAPID COVID-2 SEROLOGICAL TEST$ 107.11 06886850 86850 ANTIBODY PREWARM$ 155.44 06886903 86902 ANTIGEN SCREEN-FOR COMPATIBLE$ 101.92 06886921 86921 CROSSMATCH PREWARM$ 101.92 06886923 86923 CROSSMATCH ELECTRONIC$ 167.67 06887040 87040 CULTURE BONE MARROW$ 62.81 06887070 87070 CULTURE SPUTUM$ 76.30 06887086 87086 CULTURE URINE$ 76.30 06887103 87103 FUNGAL CULTURE BLOOD$ 97.83 06887184 87184 SUSCEPTIBILITY TEST KIRBY BAU$ 67.32 06887449 87449 CLOSTRIDIUM DIFFICILE QUALI$ 39.96 06887635 U0002 SARS-COV-2 COVID-19 AMP PRB$ 53.88

142 06887799 87799 BK VIRUS DNA QUANTITATIVE BY$ 378.34 06887804 87804 INFLUENZA A & B SCREEN QUALIT$ 116.36 06887807 87807 RESP SYNCYTIAL VIRUS QUALI$ 39.96 06889999 89060 CRYSTALS SYNOVIAL FLUID$ 81.40 06890501 89050 CELL CNT CSF$ 15.74 06890503 89050 CELL CNT SYNOVIAL FLUID$ 14.03 06890505 89050 CELL CNT OTHER BODY FLUIDS$ 15.74 06890519 89051 DIFFRENTIAL CSF$ 26.23 06890521 89051 CELL CNT W/ DIFF SYNOVIAL FL$ 26.23 06890523 89051 DIFFERENTIAL OTHER BODY FLUID$ 26.23 06891202 82270 OCCULT BLOOD FECES FAT$ 26.23 06892002 86910 PATERNITY TEST 9 ANTRS$ 131.12 06893208 89320 SEMEN ANALYSIS$ 104.95 06895001 A4649 FILTER LEUKOCYTE PALL RC10$ 403.25 06895002 A4649 LEUCOCYTE REMOVAL FILTER PL100$ 738.29 06895003 80320 ALCOHOL BLOOD: QUANTITATIVE$ 62.54 06895004 88305 BONE MARROW:CELL BLOCK$ 260.36 06895005 88313 SPECIAL STAIN:GROUP 2$ 124.22 06895006 88302 TISSUE EXAM:IDENTIFICATION$ 204.75 06895007 88309 TISSUE EXAM:RADICAL/SPECIAL$ 418.72 06895008 86985 BLOOD UNIT:SPLITTING$ 167.67 06895009 36513 PLATELET CONCENTRATE:PHERESIS$ 657.48 06895010 86965 PLATELETS:POOLED$ 167.67 06895011 36514 THERAPEUTIC PLASMAPHERESIS$ 673.61 06895012 36430 TRANSFUSION:PANEL$ 226.84 06895013 86890 AUTOLOGOUS BLOOD:PREDEPOSITED$ 203.21 06895015 80307 DRUG ABUSE SCRN:URINE/QUAL(5-6$ 108.72 06896001 A4649 BOWL:THERAPEUTIC PLASMA EXCHAN$ 866.18 06896002 A4649 SDP:PACK$ 813.35 06896003 83540 IRON:LIVER TISSUE$ 149.31 06896004 87798 HCV-RNA QUANTITATIVE BY PCR$ 260.10 06896005 87798 RSV RNA PCR (RESPI SYNCYNTIAL$ 142.49 06896006 87798 BK VIRUS DNA QUALITATIVE BY P$ 439.64 06896007 81015 URINALYSIS MICROSCOPIC$ 10.32 06896008 80307 TOX SCREEN:6 TEST (GOVGUAM)$ 39.36 06896009 80307 TOX:DRUG CONFIRM /TEST (GOVGUA$ 57.62 06896010 80307 TOX SCREEN:5 TEST (GOVGUAM)$ 36.95 06896012 86677 H. PYLORI IGA & IGG$ 66.51 06896013 86682 ECHINOCOCCUS AB IGG$ 89.31 06896014 80375 AMIODARONE LEVEL$ 32.79 06896015 84134 PRE-ALBUMIN LEVEL$ 26.78 06896021 82157 ANDROSTENEDIONE$ 80.72

143 06896022 87390 HIV-1 ANTIGEN TEST$ 178.17 06896023 88184 T4 CELL COUNT$ 246.15 06896024 82948 GLUCOSE-CHEMSTRIP$ 25.45 06896025 84479 T3 UPTAKE$ 40.74 06896026 84436 T4 TOTAL$ 40.74 06897000 81002 URINE COMPONENT$ 15.97 06897010 87207 MALARIA SMEAR$ 57.68 06897012 MORGUE PROCESSING FEE$ 73.88 06899001 P9060 FRESH FROZEN PLASMA ALIQUOT$ 576.19 06899002 P9017 FRESH FROZEN PLASMA EACH UNIT$ 1,085.05 06899003 P9011 PACKED RED CELL ALIQUOT$ 499.78 06899004 P9021 RED BLOOD CELLS EACH UNIT$ 1,085.05 06899005 P9011 BLOOD SPLIT UNIT$ 448.74 06899006 P9010 WHOLE BLOOD PER UNIT$ 1,085.05 06899007 P9019 PLATELET SINGLE ISSUE$ 1,085.05 06899008 P9034 PLATELETS PHERESIS EACH UNIT$ 1,570.76 06899014 80162 DIGOXIN LANOXIN$ 89.76 06990004 89240 LAB HANDLING FEE$ 72.73 06991955 99195 PHLEBOTOMY THERAPEUTIC$ 105.63 07000000 C1713 PIN BANTAM W/GRIPTION 44MM$ 2,215.50 07000001 A4649 SUTURE VICRYL 0 12X18 LIG$ 88.15 07000003 A4649 NERVE LOCATOR NEURO-PULSE$ 243.85 07000005 A4649 SUTURE CHROMIC 1 8X18 MO-2$ 157.58 07000010 A4649 STEM CENTRALIZER 10MM$ 634.41 07000011 A4649 SUTURE CHROMIC 1 8X18 CT-1$ 261.64 07000012 A4649 CAUTERY TIP TEFLON$ 68.09 07000013 A4649 SUTURE SILK 3-0 8X18 SH$ 142.95 07000015 A4649 MASK FACE SAFETY SHIELD$ 10.02 07000016 A4649 SUTURE SILK 2-0 8X30 SH$ 107.51 07000017 A4649 SUTURE SILK 3-0 8X30 SH$ 128.58 07000018 A4649 TUBING INSUFFLATOR PNEUMOSURE$ 12.51 07000020 A4649 LIGACLIP APPLIER TITANIUM TIM-$ 1,047.91 07000021 MINOR SURGERY 1ST 30 MIN$ 835.34 07000024 A4649 CATHETER GROSHONG 1-LUMEN 9.5F$ 1,462.69 07000025 A4649 SET INFLATION DEVICE$ 651.64 07000026 A4649 SUTURE STEEL 0 17X18$ 13.45 07000028 A4649 SUTURE STEEL 2-0 17X18$ 12.69 07000029 A4649 DAVIS LOOP ST EXT FR4-70$ 78.04 07000030 A4649 FORCEPS GRASPING FR3.7-65$ 463.62 07000031 A4649 TUBE SUCTION IRRIG W/ TIP$ 299.41 07000032 A4649 SUTURE STEEL 0 4-0 17X18$ 11.98 07000035 A4649 CUTTER LINEAR ENDO TSB-35$ 1,538.71

144 07000037 A4649 BUR ROUND FLUTED XKP 3.0MMX50M$ 949.56 07000038 A4649 BUR ROUND FLUTED XKP 3.5MMX50M$ 826.21 07000039 A4649 BUR ROUND FLUTED XKP 4.0MMX50M$ 939.27 07000040 A4649 BUR ROUND FLUTED XKP 5.0MMX50M$ 946.33 07000041 A4649 SUTURE CHROMIC 0 8X18 CT-1$ 16.41 07000042 A4649 CATHETER BROVIAC 1-LUMEN 2.7FR$ 823.88 07000043 A4649 SUTURE PLAIN 3-0 8X18 CT-1$ 109.29 07000044 A4649 SUTURE CHROMIC 0 27 XLH$ 27.76 07000045 A4649 SUTURE CHROMIC 1 27 XXLH$ 70.71 07000046 A4649 BUR ROUND XKP 3.0MMX70MM$ 945.47 07000047 MAJOR SURGERY 1ST HOUR$ 1,810.71 07000048 A4649 SUTURE CHROMIC 1 27 BP-1$ 42.63 07000050 A4649 BUR ROUND XKP 6.0MMX70MM$ 868.08 07000051 A4649 SUTURE CHROMIC 0 8X18 CT$ 89.83 07000052 L5999 PROSTHESIS HIP AUSTIN MOORE 52$ 2,401.14 07000053 A4649 DISSECTOR CURVED W/ CAUTERY$ 1,126.15 07000054 A4649 SUTURE SILK 3-0 144 REEL$ 103.29 07000055 A4649 CUTTER LINEAR TLC-55$ 1,215.40 07000056 A4649 BUR DIA ROUND XKP 7.0MMX70MM$ 995.83 07000057 A4649 BUR ACORN XKP 5.0MMX70MM$ 995.83 07000058 A4649 SUTURE NUROLON 4-0 8X18 RB-1$ 45.77 07000059 A4649 BUR MATCH HEAD XKP 3.0MMX70MM$ 875.78 07000060 A4649 STAPLER LINEAR TL-60$ 1,193.82 07000061 A4649 BUR ROUND XKP 3.5MMX90MM$ 826.21 07000062 A4649 DVT 10 GARMENT LOWER EXTRM$ 385.75 07000066 A4649 SUTURE SILK 0 17X18$ 31.63 07000067 A4649 BUR ROUND FLUTED XKP 4.0MMX110$ 896.64 07000069 A4649 BUR ROUND FLUTED XKP 6.0MMX110$ 955.21 07000070 A4649 INSTRUMENTS-ADDITIONAL$ 75.15 07000071 A4649 TRAY MINOR SET$ 250.54 07000072 A4649 TRAY MAJOR SET$ 320.40 07000073 A4649 CRANIOTOME ADT XKP 1.8MMX16MM$ 512.19 07000075 A4649 CUTTER LINEAR TLC-75$ 1,404.41 07000080 A4649 SUTURE VICRYL 0 V 8X27 MO-5$ 273.47 07000081 A4649 LIGACLIP STAINLESS STEEL MED$ 58.99 07000082 A4649 BLADE ARTHRO CUTTER AGGRES 2.5$ 673.34 07000086 A4649 SUTURE MERSILENE 10X30$ 13.03 07000088 C1713 LINER ALTRX NEUTRAL 28MMX44MM$ 1,309.88 07000089 A4649 TUBING PENROSE 5/8X18$ 8.74 07000090 A4649 STAPLER LINEAR TL-90$ 1,217.06 07000091 A4649 TUBING PENROSE 1/2X18$ 3.56 07000095 A4649 VALVULATOME 1000-95$ 1,782.08

145 07000097 C1713 ARTICUL/EZE BALL 32 +5 BR$ 1,430.63 07000099 C1713 ARTICUL/EZE BALL 32 +9 BL$ 1,430.63 07000100 A4649 TROCAR ENDOSCOPIC 11MM$ 910.22 07000101 A4649 SET SINGLE PUNCTURE INTRODUCER$ 602.42 07000102 A4649 TROCAR ENDOSCOPIC 12MM$ 916.53 07000103 A4649 SUTURE PLAIN 2-0 54REEL$ 46.52 07000104 MINOR SURGERY ADD 15 MIN$ 139.25 07000107 A4649 SUTURE PDS 0 18 ENDOLOOP$ 249.26 07000110 A4649 FIXATION DEVICE ABSTACK30 5MM$ 951.13 07000111 A4649 SUTURE CHROMIC 4-0 54 STD$ 11.70 07000112 A4649 SUTURE CHROMIC 3-0 27 TE$ 21.77 07000114 A4649 SUTURE CHROMIC 0 54 REEL$ 8.47 07000115 A4649 SUTURE CHROMIC 1 54 REEL$ 33.32 07000116 A4649 SUTURE CHROMIC 2 54 STD$ 10.66 07000120 MAJOR SURGERY ADD 15 MIN$ 301.77 07000121 A4649 SUTURE CHROMIC 4-0 27 SH$ 41.29 07000123 A4649 SUTURE CHROMIC 2-0 27 SH$ 34.01 07000124 A4649 SUTURE VICRYL 0 V 27 SH$ 15.65 07000125 A4649 SUTURE CHROMIC 1 27 SH$ 11.91 07000127 A4649 SUTURE CHROMIC 1 30 GS-12$ 23.54 07000129 A4649 SUTURE CHROMIC 1 27 MH$ 13.20 07000130 A4649 SUTURE VICRYL 2-0 U 12X18$ 121.55 07000132 A4927 GLOVES SURG S-8-1/2 SPEC$ 5.17 07000134 A4927 GLOVES SURG S-7 SPEC$ 3.90 07000135 A4927 GLOVES SURGEON S-7$ 1.72 07000138 A4927 GLOVES SURGEON S-7-1/2$ 4.83 07000139 A4649 BELT RIBS 36X42 FEMALE$ 54.76 07000140 C1713 NAIL ELASTIC TI 3.0MMX440MM$ 1,350.02 07000142 A4649 SUTURE SILK 4-0 8X18 SH$ 135.53 07000144 C1713 NAIL ELASTIC TI 3.5MMX440MM$ 1,417.21 07000145 C1713 ROD REAM 2.5MM 950MM W/BTIP$ 842.87 07000148 A4927 GLOVES SURGEON S-8-1/2$ 3.64 07000150 C1713 ROD REAM 2.5MM 950MM W/BTP EXT$ 842.87 07000151 A4649 SUTURE CHROMIC 1 12X18$ 43.91 07000154 C1721 IMPLANT DEFIBRILLATOR D154VWC$ 29,237.06 07000160 A4649 COUDE TIP HEMATURIA 22FR 30CC$ 64.51 07000163 A4927 GLOVES SURG S-7-1/2 ULTRA$ 11.91 07000166 A4927 GLOVES SURGEON S-7 ULTRA$ 4.62 07000168 A4352 CATHETER COUDE TIP 16FR 5CC$ 106.58 07000169 A4352 CATHETER COUDE TIP 18FR 5CC$ 106.58 07000170 A4652 CATHETER COUDE TIP 20FR 5CC$ 106.58 07000182 A4649 SUTURE SILK 5-0 12X18$ 9.22

146 07000184 A4649 SUTURE SILK 3-0 12X18$ 20.32 07000185 A4649 SUTURE SILK 2-0 12X18$ 19.03 07000186 A4927 GLOVES SURG S-8 SPEC$ 3.77 07000187 OR P.E. TUBE 1ST 15 MIN$ 221.03 07000201 A4649 TROCAR 5.0MMX75MM$ 811.71 07000202 C1713 NAIL FEMUR TFNA LT 10MMX400MM$ 4,758.96 07000203 OR P.E. TUBE ADD 15 MIN$ 103.15 07000208 A4649 NEEDLE VERESS 150MM DISP$ 353.43 07000210 A4649 SUTURE PDS 5-0 P-3 18$ 95.19 07000221 A4649 KIT ENDOSCOPIC LIGATOR$ 565.40 07000227 A4649 SET CONT BLADDER IRRIG$ 29.38 07000228 A4649 BLADE SURGICAL #101115$ 1.72 07000231 A4649 TUBING U.V.A.C.$ 90.16 07000232 A4649 PREP KIT WITH RESTRICTORS$ 862.26 07000233 A4649 SET TUR SINGLE$ 53.87 07000245 A4649 SUTURE CHROMIC 2-0 27 UR-5$ 19.54 07000246 A4649 SUTURE CHROMIC 0 27 UR-5$ 15.56 07000256 A4649 SUTURE CHROMIC 0 27 UR-4$ 20.57 07000258 A4649 DEVON INSTRUMENT WIPE$ 19.24 07000259 A4649 SUTURE VICRYL 2-0 U 27 CT-1$ 33.50 07000261 A4649 SUTURE VICRYL 1 U 27 CT-1$ 29.26 07000266 A4649 NEEDLE A-V FISTULA$ 5.69 07000278 A4649 NEURO PATTIE 3/4X3/4$ 19.24 07000279 A4649 NEURO PATTIE 1X1$ 19.24 07000296 A4649 CDH21 ILS$ 1,746.37 07000297 A4649 CDH25 ILS$ 1,746.37 07000298 A4649 CDH29 ILS$ 1,746.37 07000299 A4649 CDH33 ILS$ 1,746.37 07000300 A4649 STAPLER LINEAR TL-30$ 1,182.23 07000301 A4649 RELOAD STAPLER LINEAR TR-30$ 815.80 07000302 A4649 KIT SOFTCELL PERMACATH 12.5FRX$ 1,003.20 07000303 A4649 KIT SOFTCELL CATH 12.5FR 17CM$ 923.40 07000307 A4649 CATHETER ATRIA/PERIT 1.1X2.5MM$ 718.20 07000308 A4649 CATHETER VENTRICLE 1.3X2.5MM$ 718.20 07000309 A4649 VALVE POLARIS ADJUSTMENT KIT-2$ 3,604.13 07000311 A4649 VALVE POLARIS ADJSTABLE 30-200$ 4,292.40 07000312 A4649 ELECTRODE LEEP 3.0MMX12CM$ 145.26 07000313 A4649 VALVE POLARIS SPV KIT B905S$ 4,678.80 07000314 A4649 LIGACLIP TC100 SML TITANIUM$ 31.63 07000315 A4649 LIGACLIP TC200 MED TITANIUM$ 37.05 07000317 A4649 LIGACLIP TC300 LGE TITANIUM$ 49.01 07000318 A4649 LIGACLIP TC400 XLGE TITANIUM$ 64.97

147 07000320 C1713 NAIL FEMUR TFNA RT 10MMX420MM$ 4,758.96 07000325 C1713 EXT FIX MINI CARB ROD 3MMX25MM$ 260.13 07000326 A4649 ENDOLOOP VICRYL$ 231.05 07000345 C1713 EXT FIX MINI CARB ROD 3MMX45MM$ 260.13 07000350 A4649 STAPLER SKIN CLOSURE 35MM$ 286.85 07000351 A4649 RELOAD CUTTER LINEAR ENDO TR35$ 1,147.41 07000352 C1713 FEMORAL STEM TAPER SZ-2 STD$ 2,800.00 07000353 A4649 FEMORAL STEM TAPER SZ-3 STD$ 2,800.00 07000355 C1713 FEMORAL STEM TAPER SZ-4 STD$ 2,800.00 07000356 C1713 FEMORAL STEM TAPER SZ-5 STD$ 2,800.00 07000357 C1713 FEMORAL STEM TAPER SZ-6 STD$ 2,800.00 07000358 C1713 FERMORAL STEM TAPER SZ-7 STD$ 2,800.00 07000359 C1713 FEMORAL STEM TAPER SZ-8 STD$ 2,800.00 07000360 C1713 EXT FIX MINI CARB ROD 3MMX60MM$ 260.13 07000361 C1713 FEMORAL STEM TAPER SZ-10 STD$ 2,800.00 07000362 C1713 FEMORAL STEM TAPER SZ-1 HI$ 2,800.00 07000363 C1713 FEMORAL STEM TAPER SZ-2 HI$ 2,800.00 07000364 C1713 FEMORAL STEM TAPER SZ-3 HI$ 2,800.00 07000365 C1713 FEMORAL STEM TAPER SZ-4 HI$ 2,800.00 07000366 C1713 FEMORAL STEM TAPER SZ-5 HI$ 2,800.00 07000367 C1713 FEMORAL STEM TAPER SZ-6 HI$ 2,800.00 07000368 C1713 FEMORAL STEM TAPER SZ-7 HI$ 2,800.00 07000369 C1713 FEMORAL STEM TAPER SZ-8 HI$ 2,800.00 07000370 A4649 DENTAL ARCH BAR BENDICK$ 139.01 07000371 C1713 LINER ALTRX +4 NEUT 32MMX50MM$ 1,247.50 07000372 C1713 LINER ALTRX NEUTRAL 36MMX52MM$ 1,247.50 07000373 C1713 LINER ALTRX NEUTRAL 36MMX54MM$ 1,247.50 07000374 C1713 LINER ALTRX NEUTRAL 36MMX56MM$ 1,247.50 07000375 C1713 EXT FIX MINI CARB ROD 3MMX75MM$ 256.74 07000376 C1713 LINER ALTRX +4 NEUT 36MMX52MM$ 1,247.50 07000377 C1713 LINER ALTRS +4 NEUT 36MMX54MM$ 1,247.50 07000378 C1713 LINER ALTRX +4 NEUT 36MMX56MM$ 1,247.50 07000379 C1713 LINER ALTRX +4 NEUT 36MMX58MM$ 1,247.50 07000380 C1713 LINER ALTRX +4 NEUT 36MMX60MM$ 1,247.50 07000381 C1713 LINER ALTRX +4 NEUT 36MMX62MM$ 1,247.50 07000382 C1713 LINER ALTRX +4 NEUT 36MMX64MM$ 1,247.50 07000383 C1713 LINER ALTRX +4 NEUT 36MMX66MM$ 1,247.50 07000384 A4649 SMARTSET BONE CEMENT MV 40G$ 662.61 07000423 A4649 CATHETER CUTDOWN$ 5.72 07000426 A4649 SUTURE MONOCRYL 4-0 27 PS-2 N$ 91.98 07000437 A4649 SPECIMEN TRAP 40ML$ 8.68 07000441 A4649 SUTURE VICRYL 4-0 U 27 FS-1$ 33.50

148 07000448 A4649 ENDOCLIP III AUTO SUTURE 5MM$ 744.24 07000450 C1713 SCREW CANC POLARUS 5MMX40MM$ 475.81 07000461 C1779 LEAD PACEMAKER 5076-52$ 2,005.31 07000462 C1779 LEAD PACEMAKER 5076-58$ 2,005.31 07000470 A4649 BUR ROUND XKP 3.5MMX70MM$ 826.21 07000472 C1713 NAIL UNIV FEMUR 10MMX340MM$ 1,940.41 07000482 A4649 SUTURE SILK 2LR/LR DA$ 25.98 07000483 A4649 CYSTO SUPUB DRAIN #330-8$ 129.81 07000484 A4649 PACK CYSTOSCOPY$ 24.71 07000486 A4649 PACK ARTHROSCOPY$ 173.17 07000491 C1779 LEAD PACEMAKER 5568-45$ 1,847.00 07000492 A4649 SUTURE VICRYL 6-0 U 18 P-3$ 63.24 07000493 A4649 SUTURE VICRYL 5-0 U 18 P-3$ 78.95 07000496 A4649 SUTURE ETHIBOND 2 30 LR$ 21.15 07000499 A4649 LIGATURE-MERSILENE R499$ 36.99 07000500 C1713 SCREW PINN CAN 6.5MMX20MM$ 483.87 07000512 A4649 ELECTRODE LEEP 5.0MMX12CM$ 145.26 07000516 A4649 LIGACLIP LS300 LGE STEEL$ 55.56 07000520 A4649 BUR DIA ROUND XKP 3.0MMX70MM$ 910.86 07000521 A4649 PATCH HERNIA W/STRAP MED$ 1,071.63 07000522 A4649 CATHETER BROVIAC 1-LUMEN 4.2FR$ 939.67 07000527 C1713 SCREW CORTEX MD HD 1.0MMX7MM$ 318.05 07000528 C1713 SCREW CORTEX MD HD 1.0MMX8MM$ 318.05 07000529 C1713 SCREW CORTEX MD HD 1.0MMX9MM$ 318.05 07000530 C1713 SCREW CORTEX MD HD 1.0MMX10MM$ 318.05 07000531 C1713 SCREW CORTEX MD HD 1.0MMX11MM$ 318.05 07000532 C1713 SCREW CORTEX MD HD 1.0MMX12MM$ 318.05 07000533 C1713 SCREW CORTEX MD HD 1.0MMX13MM$ 318.05 07000534 C1713 SCREW CORTEX MD HD 1.0MMX14MM$ 448.32 07000535 C1713 SCREW XIA MONOAXIAL 5.5X7MM$ 2,294.80 07000540 A4649 CATHETER BROVIAC 1-LUMEN 6.6FR$ 1,017.96 07000542 A4649 CATHETER BROVIAC W/ SURECUFF 6$ 930.09 07000550 A4649 BUR DIA ROUND XKP 6.0MMX70MM$ 961.80 07000551 A4649 RELOAD CUTTER LINEAR TCR-55$ 1,036.32 07000564 A4649 DERMACARRIERS II$ 59.31 07000571 A4216 WATER DISTILLED STERILE$ 5.69 07000572 A4649 CATHETER HICKMAN 2-LUMEN 7FR$ 1,142.43 07000600 A4649 KIT CATH HICKMAN 2-LUMEN 13.5F$ 1,111.36 07000601 A4649 RELOAD STAPLER LINEAR TR-60$ 965.03 07000603 A4649 CURETTE UVAC STRAIGHT 10MM$ 18.70 07000607 A4649 MESK PERFIX PLUG 2.5X3.4CM$ 499.31 07000608 A4649 EVACUATOR SMOKE PUSHBTN PENCIL$ 244.20

149 07000619 A4649 SUTURE SILK 4-0 30 TS$ 11.84 07000621 A4649 SUTURE SILK 4-0 30 KS$ 10.12 07000622 A4649 CATHETER HICKMAN 2-LUMEN 12FR$ 1,169.04 07000623 A4649 SUTURE SILK 2-0 30 KS$ 11.51 07000626 A4649 SUTURE ETHILON 4-0 18 KS$ 11.34 07000627 A4649 SUTURE ETHILON 3-0 18 KS$ 18.65 07000630 A4649 BUR ROUND XKP 5.0MMX90MM$ 920.43 07000635 C1713 SCREW XIA MONOAXIAL 6.5X35MM$ 2,551.82 07000636 A4649 SUTURE CHROMIC 3-0 27 FS-2$ 37.67 07000638 A4649 CATHETER BILIARY STONE REMOVAL$ 974.97 07000640 A4649 BUR ROUND XKP 6.0MMX90MM$ 930.66 07000653 A4649 SUTURE VICRYL 3-0 V 27 KS$ 42.87 07000654 A4649 SUTURE VICRYL 4-0 V 27 KS$ 29.94 07000656 A4649 SUTURE VICRYL 4-0 18 PS-4$ 37.99 07000661 A4649 SUTURE ETHILON 5-0 18 FS-2$ 31.56 07000662 A4649 SUTURE ETHILON 4-0 18 FS-2$ 31.97 07000673 A4649 SUTURE ETHILON 3-0 30 FSLX$ 27.26 07000675 A4649 SUTURE SILK 3-0 30 FSL$ 12.29 07000676 A4649 SUTURE SILK 3-0 18 FSL$ 18.69 07000679 A4649 SHUNT CAROTID BYPASS 10FRX13CM$ 265.77 07000681 A4649 SHUNT CAROTID BYPASS 12FRX13CM$ 290.49 07000682 A4649 SUTURE SILK 5-0 18 FS-2$ 35.64 07000683 A4649 SUTURE SILK 4-0 18 FS-2$ 29.85 07000684 A4649 SUTURE SILK 3-0 18 FS-1$ 27.71 07000685 A4649 SUTURE SILK 2-0 18 FS$ 35.98 07000687 C1713 SCREW CORTEX MD HD 1.3MMX7MM$ 422.95 07000688 C1713 SCREW CORTEX MD HD 1.3MMX8MM$ 422.95 07000689 C1713 SCREW CORTEX MD HD 1.3MMX9MM$ 422.95 07000690 C1713 SCREW CORTEX MD HD 1.3MMX10MM$ 422.95 07000691 A4649 SUTURE VICRYL 4-0 U 27 FS-2$ 11.32 07000692 C1713 SCREW CORTEX MD HD 1.3MMX12MM$ 301.15 07000693 C1713 SCREW CORTEX MD HD 1.3MMX13MM$ 301.15 07000694 C1769 GUIDEWIRE BILIARY SS 0.035X450$ 381.37 07000696 A4649 SUTURE ETHILON 6-0 18 P-3$ 57.09 07000698 A4649 SUTURE ETHILON 5-0 18 P-3$ 64.97 07000699 A4649 SUTURE ETHILON 4-0 18 P-3$ 72.41 07000701 A4649 SUTURE PROLENE 7-0 18 DA BV-1$ 192.11 07000703 A4649 SUTURE PROLENE 6-0 30 BV-1$ 135.01 07000707 A4649 SUTURE PROLENE 6-0 24 DA CC$ 214.18 07000710 A4649 BUR MATCH HEAD XKP 3.0MMX110MM$ 883.90 07000711 A4649 TUBEGAUZE ELASTIC NET SZ 10 /Y$ 7.28 07000730 C1713 LINER ALTRX +4 NEUT 32MMX48MM$ 1,247.50

150 07000736 A4649 SUTURE SILK 4-0 18 C-3$ 115.13 07000739 A4649 SUTURE SILK 4-0 18 M-2$ 13.95 07000741 A4649 SUTURE PLAIN 4-0 12 M-1$ 23.93 07000746 C1820 ANALYZER-AV PACING SYSTEM$ 975.63 07000751 A4649 RELOAD CUTTER LINEAR TCR-75$ 1,135.81 07000754 A4649 SUTURE VICRYL 0 U 3X18 OS-6$ 135.68 07000757 A4649 SUTURE VICRYL 1 U 3X18 OS-8$ 135.68 07000771 A4649 BIPOLAR CUTTING LOOP 24/26FR$ 994.72 07000776 A4649 VACUTAINER ANAEROBIC SPEC$ 32.42 07000784 A4649 SUTURE VICRYL 3-0 V 8X27 SH$ 186.94 07000791 C1785 PACEMAKER PERM KSR 900SR$ 10,069.63 07000792 A4649 SUTURE CHROMIC 5-0 18 G-3$ 176.97 07000797 A4649 DRAIN JACKSON-PRATT 7FR ROUND$ 75.27 07000800 A4649 LIGASURE BLUNT TIP LAP$ 1,214.83 07000801 A4649 SUTURE SILK 6-0 18 BV-1$ 115.80 07000802 A4649 SUTURE CHROMIC 0 27 CT$ 32.09 07000803 A4649 SUTURE CHROMIC 1 27 CT$ 51.23 07000807 C1718 SCREW CORTEX ST 1.5MMX7MM$ 86.72 07000808 C1713 SCREW CORTEX ST 1.5MMX8MM$ 86.72 07000809 C1713 SCREW CORTEX ST 1.5MMX9MM$ 86.72 07000810 A4649 SUTURE VICRYL 3-0 V 27 CT$ 30.57 07000811 A4649 SUTURE CHROMIC 2-0 27 CT-1$ 38.39 07000812 C1713 SCREW CORTEX ST 1.5MMX12MM$ 86.72 07000813 A4649 SUTURE CHROMIC 1 27 CT-1$ 34.78 07000814 C1713 SCREW CORTEX ST 1.5MMX14MM$ 86.72 07000816 C1713 SCREW CORTEX ST 1.5MMX16MM$ 158.60 07000817 A4649 SUTURE CHROMIC 0 27 CP-1$ 4.53 07000818 C1713 SCREW CORTEX ST 1.5MMX18MM$ 158.60 07000820 C1713 ROD HUMERAL POLARUS 8MMX200MM$ 1,584.19 07000822 A4649 SUTURE VICRYL 3-0 U 27 FS-2$ 36.03 07000824 C1713 ROD HUMERAL POLARUS 8MMX240MM$ 1,411.61 07000826 C1713 ROD HUMERAL POLARUS 8MMX260MM$ 1,411.61 07000828 C1713 ROD HUMERAL POLARUS 8MMX280MM$ 1,411.61 07000830 C1713 SCREW CORTEX ST 1.5MMX30MM$ 131.11 07000831 A4649 SUTURE SILK 4-0 30 SH$ 24.35 07000832 A4649 SUTURE SILK 3-0 30 SH$ 23.30 07000833 A4649 SUTURE SILK 2-0 30 SH$ 22.43 07000836 C1721 IMPLANT DEFIB VVI D274VRC$ 24,976.04 07000837 C1721 IMPLANT DEFIB D274DRG VIRT$ 32,368.37 07000839 C1721 IMPLANT DEFIB D224TRK CONS$ 39,907.60 07000840 C1721 IMPLANT DEFIB VVI D284VRC$ 29,021.44 07000841 C1785 PACEMAKER PERM KDR 900DR$ 11,842.12

151 07000842 C1785 PACEMAKER ENPULSE E2 DRO1$ 11,188.14 07000843 C1786 PACEMAKER ENPULSE E2 SR01$ 9,604.89 07000844 C1785 PACEMAKER ENRHYTHM DUAL-CHAMBE$ 11,821.43 07000845 C1786 PACEMAKER ENRHYTHM SINGEL-CHAM$ 11,821.43 07000846 C1786 PACEMAKER SIGMA SSR303$ 6,596.74 07000847 C1785 PACEMAKER ADAPTA ADDR01$ 11,821.43 07000848 C1785 PACEMAKER VERSA VEDRO1$ 11,188.14 07000849 C1785 PACEMAKER SENSIA SESR01$ 11,284.95 07000854 A4649 SUTURE VICRYL 0 U 27$ 33.58 07000864 A4649 SUTURE CHROMIC 0 27 CTX$ 38.90 07000865 A4649 SUTURE CHROMIC 1 27 CTX$ 31.71 07000871 A4649 SUTURE SILK 4-0 30 RB-1$ 25.21 07000877 A4649 SUTURE VICRYL 0 V 27 UR-6$ 34.86 07000880 A4649 NEEDLE LOOSE EYE$ 2.87 07000883 A4649 SUTURE CHROMIC 2-0 27 CT-2$ 28.49 07000900 A4649 SUTURE PLN GUT 4-0 18" 13MM$ 67.94 07000901 A4649 RELOAD STAPLER LINEAR TR-90$ 1,021.38 07000903 A4649 SUTURE VICRYL 4-0 V 12X18$ 128.50 07000904 A4649 SUTURE CHROMIC 0 36 CTX$ 38.39 07000905 A4649 SUTURE VICRYL 2-0 V 12X18$ 124.87 07000910 A4649 SUTURE VICRYL 3-0 U 12X18$ 124.49 07000911 A4649 SUTURE ETHIBOND 2-0 8X18 CT-1$ 23.34 07000912 A4649 SUTURE VICRYL 0 U 12X18$ 112.57 07000913 A4649 SUTURE CHROMIC 2-0 36 CT$ 37.47 07000914 A4649 SUTURE VICRYL 0 U 36CT$ 30.80 07000915 A4649 SUTURE VICRYL 1 V 36 CT$ 30.11 07000922 A4649 SUTURE CHROMIC 3-0 36 CT-1$ 38.06 07000923 A4649 SUTURE CHROMIC 2-0 36 CT-1$ 55.16 07000924 A4649 SUTURE CHROMIC 0 36 CT-1$ 12.86 07000925 A4649 SUTURE CHROMIC 1 36 CT-1$ 38.06 07000930 C1713 LINER ALTRX +4 10D 28MMX46MM$ 1,309.88 07000942 A4649 RELOAD ETS 45MM 4.1MM TR45G$ 407.40 07000943 A4649 RELOAD ETS 45MM 2.5MM TR45W$ 751.62 07000945 A4649 SUTURE VICRYL 2-0 U 36 CT-1$ 32.85 07000949 A4649 VISCERA RETAINER FISH SMALL$ 196.05 07000950 A4649 VISCERA RETAINER FISH MEDIUM$ 201.40 07000951 A4649 VISCERA RETAINER FISH LARGE$ 204.47 07000952 A4649 SUTURE CHROMIC 1 8X18 MO-5$ 362.47 07000955 A4649 SUTURE VICRYL 1 U 36 CT-1$ 37.47 07000962 A4649 SUTURE VICRYL 3-0 U 36 CT$ 36.08 07000963 A4649 SUTURE VICRYL 2-0 U 36 CT$ 28.97 07000982 A4649 SUTURE CHROMIC 3-0 54 CT-1$ 59.98

152 07000983 A4649 SUTURE CHROMIC 2-0 54 CT-1$ 36.63 07001000 A4649 HEMOCONCENTRATOR HPH1000 CBP$ 952.48 07001001 C1713 PLATE KLS STR 2.3MM 16 HOLE$ 1,292.85 07001002 A4649 CATHETER PERCUTANEOUS CHOLANGI$ 189.04 07001008 A4649 BAIR BLANKET UNDERBODY 635$ 389.43 07001010 A4649 SUTURE PLAIN 4-0 54STD$ 10.06 07001011 A4649 BAIR BLANKET LOWER BODY$ 109.34 07001012 A4649 BAIR BLANKET SML LOWER BODY$ 174.94 07001013 A4649 BAIR BLANKET FULL BODY$ 87.48 07001014 A4649 BAIR BLANKET UNDERBODY 585$ 307.49 07001015 A4649 BAIR BLANKET UNDERBODY 545$ 239.07 07001020 A4649 ELECTRODE LEEP 2.0CMX1.0CM$ 145.26 07001035 A4649 SHEATH URETERAL 10/12FR 35 CM$ 897.29 07001037 A4649 CLIP RANEY/PK$ 54.84 07001038 A4649 DRILL BIT JL 1.0MMX60MM$ 707.29 07001041 A4649 DRILL BIT JL 1.3MMX65MM$ 707.29 07001042 A4649 DRILL BIT JL STOP 0.76MMX8MM$ 916.03 07001045 A4649 DRILL BIT JL STOP 0.76MMX10MM$ 916.03 07001046 A4649 DRILL BIT JL STOP 0.76MMX12MM$ 916.03 07001047 A4649 DRILL BIT JL STOP 0.76MMX14MM$ 916.03 07001048 A4649 DRILL BIT MQC 1.1MMX55MM$ 707.29 07001050 C1713 SCREW CANNUL PT 3.5MMX10MM$ 771.46 07001061 A4649 SUTURE MERSILENE 0 8X18 CT-1$ 139.34 07001100 A4649 KIT PERCUTANEOUS TRACT$ 1,989.73 07001111 A4649 SUTURE VICRYL 2-0 U 18$ 163.17 07001115 C1713 ROD HUMERAL POLARUS 11MMX150MM$ 1,717.12 07001121 A4649 SUTURE CHROMIC 3-0 54 REEL$ 36.97 07001131 A4649 SUTURE CHROMIC 2-0 54 STD$ 12.17 07001132 A4649 SUTURE CHROMIC 2-0 54 REEL$ 45.43 07001140 A4649 OXYGENATOR SX25 CBP$ 1,255.84 07001141 A4649 SUTURE PDS 2-0 27 UCL$ 58.57 07001151 A4649 SUTURE CHROMIC 1 54 STD$ 11.51 07001152 A4649 CATH CRICOTHYROTOMY UNCUFF 6MM$ 744.56 07001175 A4649 BLADE SAW GIGLI ROUND$ 112.77 07001176 A4649 DILATOR CERVICAL OS FINDER$ 23.84 07001182 C1713 PLATE DHS 135* 10 HOLE$ 1,473.35 07001200 C1894 INTRODUCER SHEATH SAFETY WIRE$ 354.84 07001212 A4649 LIGASURE SEALER CRV SML 1.8CM$ 1,031.99 07001214 A4649 SUTURE VICRYL 4-0 27 RB-1$ 35.37 07001216 A4649 CANNULA RETRO CARDIOPLEGIA CBP$ 921.93 07001217 C1713 SCREW PINN CAN 6.5MMX15MM$ 483.87 07001220 A4649 SET INTRODUCER NEEDLE 20CM$ 310.05

153 07001221 A4649 SUTURE VICRYL 3-0 V 27 SH$ 28.42 07001231 A4649 SUTURE VICRYL 2-0 V 27 SH$ 35.95 07001235 A4649 SHEATH URETERAL 12/14FR 35CM$ 897.29 07001241 A4649 SUTURE CHROMIC 0 27 SH$ 35.64 07001249 A4649 SET ADMINISTRATION HOTLINE$ 150.32 07001250 A4649 SUTURE SUPRAMID 5-0 1/2C REV C$ 39.86 07001260 A4649 SUTURE SUPRAMID 6-0 1/2C REV C$ 39.86 07001277 A4649 CANNULA TAPER TIP - ERCP$ 789.36 07001278 C1769 GUIDEWIRE HYDRA JAG 260CM ANG$ 1,482.85 07001289 C1769 GUIDEWIRE HYDRA JAG 460CM STR$ 1,482.85 07001290 A4649 KNIFE NEEDLE TRIPLE LUMEN 7FR$ 1,102.20 07001309 A4649 DRAIN JACKSON-PRATT 10MM FLAT$ 333.30 07001312 A4649 SUTURE CHROMIC 2-0 12X18$ 53.06 07001314 A4649 SUTURE GII QUICKANCHOR PLUS$ 2,939.51 07001315 C1713 FEMORAL STEM CEMENTED SZ-7 HI$ 2,940.00 07001343 A4649 SYSTEM HALO VEST LARGE$ 3,634.53 07001399 A4649 NEURO PATTIE 1/4X1/4$ 11.83 07001400 A4649 SET MULTIPLE PERFUSION-CBP$ 158.74 07001402 A4649 NEURO PATTIE 1/2X1$ 1.79 07001411 A4649 SUTURE CHROMIC 0 12X18$ 125.78 07001422 C1713 PLATE DCP NR 4.5MM 10-HOLE$ 955.65 07001430 A4649 LEAD INTRO PERCUT 7FR-BROVIAC$ 475.87 07001439 A4649 IMPLANT SUBTALAR TITANIUM$ 2,419.29 07001472 C1713 NAIL UNIV FEMUR 11MMX340MM$ 1,417.96 07001507 A4649 ELECTRODE LEEP 1.5MMX0.7CM$ 145.26 07001535 C1713 SCREW XIA MONOAXIAL 5.5X7MM$ 2,551.82 07001552 A4649 ELECTRODE NEEDLE TIP$ 9.54 07001570 C1713 FEMORAL STEM CEMENTED SZ-4 HI$ 2,940.00 07001577 A4649 REDUCER CAP ONE SEAL 5-12MM$ 88.40 07001594 A4649 SUTURE VICRYL 5-0 27 RB-1$ 34.27 07001602 A4649 FILTER BLOOD TRANSFUSION MICRO$ 117.08 07001603 A4649 SUTURE ETHILON 4-0 CLR 18 PS-$ 54.87 07001604 A4649 BRUSH CYTOLOGY-BRONCHOSCOPY 16$ 217.21 07001613 A4649 BRUSH CYTOLOGY-COLON 2.2MMX220$ 139.01 07001614 A4649 SUTURE VICRYL 5-0 U 18 PS-5$ 78.57 07001615 A4649 NEEDLE BIOPSY QUICKCORE 16-15.$ 343.65 07001620 A4649 BALLOON HP NEPHROMAX 30FR$ 3,593.53 07001626 A4649 SUTURE VICRYL 5-0 U 18 PS-3$ 73.93 07001627 A4649 SUTURE PLAIN 4-0 18 PS-2$ 36.15 07001628 A4649 SUTURE VICRYL 3-0 U 18 PS-2$ 62.60 07001635 C1713 SCREW XIA POLYAXIAL 6.5X35MM$ 2,551.82 07001640 A4649 SCREW XIA POLYAXIAL 6.5X40MM$ 2,551.82

154 07001657 A4649 WATER TRAP TUBING$ 21.07 07001663 A4649 SUTURE ETHILON 3-0 18 PS-1$ 57.03 07001665 A4649 SUTURE ETHILON 6-0 18 PS-3$ 66.78 07001666 A4649 SUTURE ETHILON 5-0 18 PS-2$ 66.15 07001667 A4649 SUTURE ETHILON 4-0 18 PS-2$ 63.54 07001669 A4649 SUTURE ETHILON 3-0 18 PS-2$ 63.48 07001674 A4649 SUTURE ETHILON 2-0 30 FSLX$ 26.61 07001690 A4649 SUTURE VICRYL 4-0 U 18 P-3$ 64.29 07001697 A4649 SUTURE ETHILON 6-0 18 P-1$ 57.17 07001698 A4649 SUTURE ETHILON 5-0 18 P-3$ 57.17 07001732 C1713 PIN SECTOR W/ GRIPTION 50MM$ 2,215.50 07001737 A4649 LIGASURE MARYLAND JAW 37CM$ 1,229.37 07001742 A4649 SUTURE VICRYL 6-0 V 12 S-29$ 205.98 07001744 A4649 SUTURE CHROMIC 7-0 18 TG100-8$ 305.88 07001750 C1713 SCREW PINN CAN 6.5MMX50MM$ 483.87 07001756 A4649 SUTURE PROLENE 10-0 12 CS-140$ 193.55 07001770 A4649 SUTURE ETHILON 10-0 12 140-6$ 159.21 07001790 A4649 SUTURE PROLENE 10-0 12 TG-160$ 97.27 07001794 A4649 SUTURE CHROMIC 6-0 18 DA S-14$ 204.97 07001795 A4649 SUTURE PROLENE 9-0 12 TG-140-$ 97.71 07001797 A4649 SUTURE CHROMIC 7-0 18 TG140-8$ 172.89 07001800 C1713 SCREW CORTEX ST 1.5MMX10MM$ 86.72 07001801 A4649 VESSELCLAMP SOFT SPRING-CBP$ 245.87 07001803 A4649 TUBE ORAL RAE CUFFED 3.0MM$ 31.47 07001808 C1713 SCREW CORTEX ST 2.0MMX8MM$ 133.21 07001810 C1713 SCREW CORTEX ST 2.0MMX10MM$ 133.21 07001812 C1718 SCREW CORTEX ST 2.0MMX12MM$ 133.21 07001814 C1713 SCREW CORTEX ST 2.0MMX14MM$ 133.21 07001816 C1713 SCREW CORTEX ST 2.0MMX16MM$ 133.21 07001818 C1713 SCREW CORTEX ST 2.0MMX18MM$ 133.21 07001820 A4649 SCREW CORTEX ST 2.0MMX20MM$ 133.21 07001822 C1713 SCREW CORTEX ST 2.0MMX22MM$ 133.21 07001824 C1713 SCREW CORTEX ST 2.0MMX24MM$ 133.21 07001826 C1713 SCREW CORTEX ST 2.0MMX26MM$ 133.21 07001828 C1713 SCREW CORTEX ST 2.0MMX28MM$ 133.21 07001830 C1713 SCREW CORTEX ST 2.0MMX30MM$ 133.21 07001835 A4649 TRAY I&D$ 23.53 07001840 C1713 SCREW CORTEX ST 3.5MMX10MM$ 112.07 07001851 A4649 SUTURE SILK 2-0 17X18$ 13.55 07001870 A4649 GLOVES SURGEON S-8$ 4.32 07001880 A4649 TRAY W/ BETADINE SKIN PREP$ 24.63 07001916 A4649 SUTURE PLAIN 6-0 18 PC-1$ 64.29

155 07001923 A4649 LIGASURE MARYLND OPEN/LAP SEAL$ 1,075.08 07001926 A4649 TRAY OB PRECIPITATE$ 78.44 07001942 A4649 TRAY PARACENTESIS$ 47.05 07001948 C1734 STEM CEMENTRALIZER 8.5CM$ 225.81 07001964 A4649 SUTURE ETHILON 4-0 18 PC-3$ 78.78 07001965 A4649 SUTURE ETHILON 5-0 18 PC-3$ 76.64 07001966 A4649 SUTURE ETHILON 6-0 18 PC-3$ 78.48 07001978 A4649 SURGIFOAM GELATIN POEDER$ 748.99 07001991 A4649 TRAY EPIDURAL ANESTHESIA$ 66.74 07001995 A4649 SUTURE ETHILON 5-0 18 PC-5$ 76.94 07002001 A4649 TKR-FEMORAL COMPONENT$ 3,654.18 07002002 A4649 TKR-TIBIAL TRAY$ 2,854.62 07002003 A4649 TKR-TIBIAL INSERT$ 1,835.17 07002004 A4649 TKR-PATELLA COMPONENT$ 1,502.03 07002005 A4649 CMT-PALACOS BONE CEMENT$ 901.86 07002006 A4649 CMT-MIXING BOWL/SPATULA$ 151.90 07002007 A4649 THR-PRESS FIT FEMORAL STEM$ 5,826.35 07002008 A4649 THR-COCR FEMORAL HEAD$ 1,502.03 07002009 A4649 THR-CERAMIC FEMORAL HEAD$ 1,895.13 07002010 A4649 THR-ACETABULAR SHELL$ 2,528.16 07002011 A4649 THR-ACETABULAR LINER$ 1,695.24 07002012 C1713 THR-BONE SCREW$ 676.41 07002013 A4649 SHK-SAWBLADE$ 911.34 07002014 A4649 TSR-GLENOID COMPONENT$ 2,310.90 07002015 A4649 TSR-HUMERAL STEM$ 4,475.08 07002016 A4649 TSR-HUMERAL HEAD$ 2,229.17 07002017 A4649 TSR-CEMENT GUN KIT$ 1,090.25 07002018 C1713 NAIL FEMUR TFNA LT 10MMX320MM$ 4,758.96 07002019 C1713 NAIL FEMUR TFNA RT 10MMX340MM$ 4,758.96 07002021 A4649 SUTURE CHROMIC GUT 5-0 RB-1 U2$ 46.35 07002022 C1713 NAIL FEMUR TFNA LT 10MMX360MM$ 4,758.96 07002023 C1713 NAIL FEMUR TFNA 10MMX360MM$ 4,758.96 07002024 C1713 NAIL FEMUR TFNA 10MMX380MM$ 4,758.96 07002025 C1713 NAIL FEMUR TFNA 10MMX380MM$ 4,758.96 07002031 A4649 SUTURE CHROMIC 4-0 27 RB-1$ 35.88 07002047 A4649 SUTURE CHROMIC 3-0 27 RB-1$ 33.23 07002048 C1713 LINER ALTRX NEUTRAL 32MMX48MM$ 1,309.88 07002050 C1713 LINER ALTRX NEUTRAL 32MMX50MM$ 1,309.88 07002052 C1713 LINER ALTRX NEUTRAL 32MMX52MM$ 1,309.88 07002054 C1713 PIN SECTOR W/ GRIPTION 54MM$ 2,215.50 07002055 A4649 BLADE HOOK ECTR$ 469.13 07002056 C1713 LINER ALTRX NEUTRAL 32MMX56MM$ 1,309.88

156 07002058 C1713 PIN SECTOR W/ GRIPTION 58MM$ 2,215.50 07002060 A4649 SUTURE SUPRAMID 6-0 3/8C TAP P$ 23.87 07002062 C1713 PIN SECTOR W/ GRIPTION 62MM$ 2,215.50 07002064 C1713 PIN SECTOR W/ GRIPTION 64MM$ 2,215.50 07002066 C1713 PIN SECTOR W/ GRIPTION 66MM$ 2,215.50 07002080 A4649 TRAY THORACENTESIS$ 224.68 07002100 C1713 PLATE ACP TETHER 20MM$ 3,180.24 07002106 A4649 CATH-URETERAL WHISTLE TIP 6FR$ 183.04 07002120 A4649 FILTER FEMORAL-2120F$ 2,060.75 07002122 A4649 TRAY TRACHEOSTOMY$ 47.05 07002130 C1713 FEMORAL STEM CEMENTED SZ-6 STD$ 2,940.00 07002148 C1713 LINER ALTRX +4 10D 32MMX48MM$ 1,309.88 07002189 A4649 TRAY VENISECTION$ 47.05 07002201 A4649 DRILL TWIST KLS 2.2MMX70MM$ 749.96 07002203 A4649 DRILL TWIST KLS 2.2MMX105MM$ 806.93 07002206 A4649 CATH-URETERAL WHISTLE TIP 6FR$ 183.04 07002210 A4649 DRESSING MICROSURG 2X4$ 7.70 07002212 A4649 MESH STRIP 6 X 2 HOLES$ 1,033.38 07002222 C1713 LINER ALTRX +4 10D 32MMX50MM$ 1,309.88 07002312 C1713 PLATE H EXT MD HD RT 1.3MM 8-H$ 839.14 07002350 A4649 EVACUATOR SMOKE CAUTERY ACCUVA$ 59.21 07002400 C1713 ARTICUL/EZE BALL 32 +13 BLK$ 1,430.63 07002440 A4649 PATTIES NEUROSURGICAL 1X3$ 10.11 07002450 A4649 RAPID HANDSWITCH$ 200.58 07002500 A4649 PATCH HERNIA W/STRAP SML$ 1,027.53 07002505 A4649 SUCTION COAGULATOR$ 129.50 07002541 C1713 SCREW CANNUL PT 4.5MMX20MM$ 973.07 07002550 C1713 SCREW PINN CAN 6.5MMX25MM$ 483.87 07002600 C1713 ROD XIA SPINAL 600MM$ 1,581.83 07002701 A4649 SUTURE VICRYL 0 U 27 CT-2$ 35.27 07002741 C1713 SCREW CANNUL FT 4.5MMX20MM$ 968.93 07002781 A4649 NEEDLE CHIBA 22GAX15CM$ 78.26 07002800 A4649 SUTURE VICRYL 8-0 V BV-130- 5$ 247.60 07002806 C1713 SCREW CORTEX MINI FRAG 6-24X2.$ 139.29 07002808 C1713 SCREW CORTEX ST 2.7MMX8MM$ 133.21 07002810 A4649 KIT PORT-A-CATH GROSHONG 8FR$ 460.96 07002812 C1713 SCREW CORTEX ST 2.7MMX12MM$ 133.21 07002814 C1713 SCREW CORTEX ST 2.7MMX14MM$ 133.21 07002816 C1713 SCREW CORTEX ST 2.7MMX16MM$ 133.21 07002818 C1713 SCREW CORTEX ST 2.7MMX18MM$ 133.21 07002820 C1713 SCREW CORTEX ST 2.7MMX20MM$ 133.21 07002822 C1713 SCREW CORTEX ST 2.7MMX22MM$ 133.21

157 07002824 C1713 SCREW CORTEX ST 2.7MMX24MM$ 133.21 07002826 C1713 SCREW CORTEX ST 2.7MMX26MM$ 133.21 07002828 C1713 SCREW CORTEX ST 2.7MMX28MM$ 133.21 07002830 C1713 SCREW CORTEX ST 2.7MMX30MM$ 133.21 07002850 A4649 SUTURE ETHILON 10-0 5 BV75-4$ 258.00 07002881 A4649 SUTURE ETHILON 11-0 5 BV50-3$ 375.67 07002956 A4649 CATHETER SET SLIT INDWELLING$ 299.66 07003000 A4649 SUTURE PLAIN 3-0 12X18$ 119.44 07003001 C1713 NAIL TIB TI CANN 10MMX270MM$ 3,359.14 07003005 C1713 NAIL TIB TI CANN 10MMX385MM$ 3,266.63 07003010 C1713 NAIL TIB TI CANN 10MMX300MM$ 3,266.63 07003015 C1713 NAIL TIB TI CANN 10MMX315$ 3,266.63 07003020 C1713 NAIL TIB TI CANN 10MMX330MM$ 2,164.13 07003025 C1713 NAIL TIB TI CANN 10MMX345MM$ 3,266.63 07003030 A4649 NEEDLE RETROBULBAR 25GAX38MM$ 28.26 07003031 A4649 SUTURE PDS 5-0 27 RB-1$ 34.19 07003039 A4649 TUBE ENDOBRONCHIAL STR LT 39FR$ 961.89 07003040 A4649 NEEDLE RETROBULBAR 23GAX38MM$ 28.26 07003041 A4649 SUTURE PDS 4-0 27 RB-1$ 33.75 07003045 C1713 NAIL TIB TI CANN 10MMX375MM$ 3,266.63 07003050 C1713 SCREW PINN CAN 6.5MMX30MM$ 483.87 07003060 A4649 CONNECTOR XIA CROSS 60MM$ 1,717.78 07003061 C1713 SCREW CANCEL PT-16 6.5MMX30MM$ 281.26 07003062 A4649 TRAY CUTDOWN-ADULT$ 28.48 07003080 C1713 NAIL TIB TI CANN 10MMX405MM$ 3,266.63 07003081 C1713 FEMORAL STEM CEMENTED SZ-2 STD$ 2,940.00 07003090 C1713 FEMORAL STEM CEMENTED SZ-3 STD$ 2,940.00 07003091 C1769 GUIDEWIRE SENSOR 0.038INX150CM$ 628.71 07003092 C1713 FEMORAL STEM CEMENTED SZ-4 STD$ 2,940.00 07003099 C1713 FEMORAL STEM CEMENTED SZ-3 HI$ 2,940.00 07003100 A4927 GLOVES SURG S-6-1/2 ULTRA$ 4.54 07003111 C1713 FEMORAL STEM CEMENTED SZ-5 STD$ 2,940.00 07003114 C1713 FEMORAL STEM CEMENTED SZ-5 HI$ 2,940.00 07003120 A4649 STAPLE ZIMALOY$ 87.27 07003122 A4649 CATHETER GROSHONG 1-LUMEN 8FR$ 1,160.02 07003135 C1713 FEMORAL STEM CEMENTED SZ-7 STD$ 2,940.00 07003146 A4649 BONE WAX$ 5.97 07003150 C1713 FEMORAL STEM CEMENTED SZ-8 STD$ 2,940.00 07003151 A4649 SUTURE VICRYL 4-0 V 27 SH$ 29.53 07003152 C1713 NAIL UNIV TIBIAL 11MMX300MM$ 1,503.68 07003175 C1713 SCREW CORT POLARUS 3.5MMX17.5M$ 475.81 07003179 C1713 FEMORAL STEM CEMENTED SZ-8 HI$ 2,940.00

158 07003200 C1713 SCREW CORT POLARUS 3.5MMX20MM$ 475.81 07003204 C1713 PIN SECTOR W/ GRIPTION 48MM$ 2,215.50 07003205 C1713 PIN SECTOR W/ GRIPTION 52MM$ 2,215.50 07003206 C1713 PIN SECTOR W/ GRIPTION 56MM$ 2,215.50 07003225 C1713 SCREW CORT POLARUS 3.5MMX22.5M$ 475.81 07003250 C1713 SCREW CORT POLARUS 3.5MMX25MM$ 475.81 07003254 C1713 LINER ALTRX NEUTRAL 32MMX54MM$ 1,309.88 07003260 A4649 BLADE DERMATONE$ 50.32 07003275 C1713 SCREW CORT POLARUS 3.5MMX27.5M$ 475.81 07003285 A4649 K-WIRE TROCAR PT 3.0MMX285MM$ 64.72 07003300 C1713 SCREW CORT POLARUS 3.5MMX30MM$ 475.81 07003325 C1713 SCREW CORT POLARUS 3.5MMX32.5M$ 475.81 07003331 A4649 BIOPSY TRU-PUNCH 1.5MM$ 15.24 07003332 A4649 BIOPSY TRU-PUNCH 3.0MM$ 15.24 07003333 A4649 BIPSY TRU-PUNCH 3.5MM$ 15.24 07003334 A4649 BIOPSY TRU-PUNCH 4.0MM$ 15.24 07003335 A4649 BIOPSY TRU-PUNCH 5.0MM$ 15.24 07003336 A4649 BIOPSY TRU-PUNCH 6.0MM$ 15.24 07003390 Q4051 PLASTER ELAST ORTHOFLEX 4"X4YD$ 67.67 07003391 A4649 SUTURE PDS 2-0 27 CT-1$ 40.99 07003392 A6454 BANDAGE COFLEX LF2 4"X5YD$ 16.39 07003393 A6455 BANDAGE COFLEX LF2 6"X5YD$ 23.03 07003409 A4649 P.E. TUBE$ 68.91 07003411 A4649 SUTURE PDS 1 27 CT-1$ 38.06 07003419 A4649 BLADE ARTHRO FULL RADIUS 2.9MM$ 530.22 07003444 A4649 BLADE ARTHRO FULL RADIUS 5.5MM$ 546.00 07003449 A4649 BLADE ARTHRO TURBO CUTTER 4MM$ 530.22 07003450 A4649 PACK LAP$ 65.32 07003451 A4649 BLADE ARTHRO ABRADER 5.5MM$ 530.22 07003452 A4649 BLADE ARTHRO ACROMINIZER 4.0MM$ 489.42 07003459 C1713 BIPOLAR SELF CENT HIP 49X28$ 947.63 07003461 A4649 SUTURE PDS 0 36 CT-1$ 62.76 07003472 C1713 NAIL UNIV FEMUR 13MMX340MM$ 1,940.44 07003476 A4649 PACK ORTHO$ 81.82 07003492 A4649 PACK PERI/GYN$ 54.46 07003500 C1713 FEMORAL STEM TAPER SZ-9 HI$ 2,800.00 07003511 A4649 SUTURE VICRYL 2-0 V 24 CT$ 31.56 07003521 A4649 SUTURE VICRYL 0 V 27 CT$ 29.26 07003539 C1713 BIPOLAR SELF CENT HIP 39X28$ 947.63 07003540 C1713 BIPOLAR SELF CENT HIP 41X28$ 947.63 07003541 C1713 BIPOLAR SELF CENT HIP 40X28$ 947.63 07003542 C1713 BIPOLAR SELF CENT 42X28$ 947.63

159 07003543 C1713 BIPOLAR SELF CENT HIP 43X28$ 947.63 07003544 C1713 BIPOLAR SELF CENT HIP 44X28$ 947.63 07003545 C1713 BIPOLAR SELF CENT HIP 45X28$ 947.63 07003546 C1713 BIPOLAR SELF CENT HIP 46X28$ 947.63 07003547 C1713 BIPOLAR SELF CENT HIP 47X28$ 947.63 07003548 C1713 BIPOLAR SELF CENT HIP 48X28$ 947.63 07003550 C1718 BIPOLAR SELF CENT HIP 50X28$ 947.63 07003551 C1713 BIPOLAR SELF CENT HIP 51X28$ 947.63 07003553 A4649 BLADE ARTHRO ABRADER 2.9MM$ 546.00 07003554 C1713 BIPOLAR SELF CENT HIP 54X28$ 947.63 07003555 C1713 BIPOLAR SELF CENT HIP 55X28$ 947.63 07003556 C1713 BIPOLAR SELF CENT HIP 65X28$ 947.63 07003557 C1713 BIPOLAR SELF CENT HIP 57X28$ 947.63 07003558 C1713 BIPOLAR SELF CENT HIP 53X28$ 947.63 07003559 C1713 BIPOLAR SELF CENT HIP 59X28$ 947.63 07003561 C1713 BIPOLAR SELF CENT HIP 61X28$ 947.63 07003590 A4649 ATTACHMENT SMOKE EVACUATOR$ 124.49 07003591 A4649 SUTURE PDS 1 36 CT$ 45.68 07003606 A4649 BLADE ARTHRO CUTTER 2.9MM$ 546.00 07003622 A4649 CATHETER GROSHONG 2-LUMEN 9.5F$ 1,160.02 07003641 A4649 SUTURE VICRYL 0 V 27 CTX$ 32.85 07003642 A4649 SUTURE VICRYL 0 36 CTX$ 34.13 07003645 A4649 TUBING STERILE SMOKE EVACUATOR$ 105.78 07003651 A4649 SUTURE VICRYL 1 V 27 CTX$ 30.45 07003662 A4649 CATHETER GROSHONG 1-LUMEN 7FR$ 1,160.02 07003680 A4649 STENT URETERAL 6FR VAR LGTH$ 1,071.16 07003681 A4649 STENT URETERAL 7FR VAR LGTH$ 1,071.16 07003700 C1734 STEM CEMENTRALIZER 15CM$ 225.81 07003701 C1713 SCREW NR SAFETY 1.9X4MM$ 247.41 07003702 C1713 SCREW NR AUTO-DRIVE 1.6X4MM$ 185.56 07003703 C1713 SCREW NR AUTO-DRIVE 1.6X5MM$ 185.56 07003704 C1713 SCREW NR AUTO-DRIVE 1.6X6MM$ 185.56 07003705 A4649 RAPID TUBING 1/4X10$ 203.73 07003706 C1734 PLATE NR MED 2-HOLE STRAIGHT$ 185.56 07003707 C1734 PLATE NR LONG 2-HOLE STRAIGHT$ 185.56 07003708 A4649 SUTURE BOOTIES$ 8.56 07003709 C1734 PLATE NR MESH 90X90MM MALLBLE$ 1,130.06 07003710 C1734 PLATE NR MESH 90X90MM RIGID$ 1,130.06 07003713 A4649 SUTURE VICRYL 1 V 36 CTX$ 32.22 07003718 A4649 PROBE ELECTRO ENDO UNDERWATER$ 427.79 07003724 A4649 RAPID TUBING 3/8X10$ 203.73 07003728 A4649 RAPID TUBING 1/4 LAP SMOKE$ 488.06

160 07003729 A4649 RAPID LASER HAND WAND$ 306.74 07003732 A4649 CASSETTE COVER$ 16.56 07003762 C1734 STEM CEMENTRALIZER 13CM$ 225.81 07003840 A4649 SUTURE SUPRAMID 4-0 3/8C BT RE$ 18.03 07003880 A4649 KIT PORTACATH 6.6FR PEDIATRIC$ 315.76 07003960 A4649 ENDOTRACHEAL TUBE CURVED REIN$ 384.38 07003965 A4649 ENDOTRACHEAL TUBE CURVED REIN$ 384.38 07004004 C1713 PLATE FX 4 HOLE 35MM$ 1,077.77 07004030 C1713 NAIL TIB TI CANN 10MMX360MM$ 3,266.63 07004050 C1713 SCREW PINN CAN 6.5MMX40MM$ 483.87 07004131 A4649 CIRCUIT BREATHING ANESTHESIA 2$ 61.04 07004132 A4649 CIRCUIT BREATHING ANESTHESIA 3$ 33.00 07004136 A4649 BLADE ARTHRO INCISOR 4.5MM$ 692.06 07004138 A4649 BLADE ARTHRO SYNOVATOR 4.5MM$ 692.06 07004150 C1713 SCREW MALLEOLAR 4.5MMX40MM$ 266.46 07004152 C1713 NAIL UNIV TIBIAL 11MMX400MM$ 1,812.14 07004161 A4649 SUTURE VICRYL 3-0 U 27 SH$ 29.53 07004171 A4649 SUTURE VICRYL 2-0 U 27 SH$ 30.30 07004190 A4649 BLADE ARTHRO SYNOVATOR 5.5MM$ 530.22 07004204 C1713 PLATE FX 4 HOLE 40MM$ 1,095.58 07004252 C1713 NAIL UNIV TIBIAL 12MMX400MM$ 1,334.03 07004267 A4649 SUTURE VICRYL 4-0 U 27 PS-2$ 61.27 07004280 A4649 BLADE ARTHRO RAZOR CUT 4.5MM$ 489.42 07004284 A4649 BLADE ARTHRO RAZOR CUT 5.5MM$ 489.42 07004306 A4649 BLADE ARTHRO ABRADER 4.0MM$ 473.63 07004343 A4649 BLADE SAW 6MMX13MM 512.77$ 284.21 07004349 A4649 BLADE ARTHRO FULL RADIUS 4.5MM$ 819.62 07004418 A4649 LIGASURE IMPACT OPN INSTRUMENT$ 1,164.75 07004472 C1713 NAIL UNIV FEMUR 14MMX340MM$ 1,330.23 07004500 A4649 SUTURE STEEL 4-0 14$ 173.41 07004537 A4649 TUBING IRRIGATION TUR 2 BTL$ 92.83 07004606 C1713 PLATE FX 6 HOLE 45MM$ 1,175.52 07004643 C1713 NAIL TIB TI CANN 12MMX300MM$ 3,266.63 07004812 C1713 SCREW CORTEX ST 3.5MMX12MM$ 232.47 07004814 C1713 SCREW CORTEX ST 3.5MMX14MM$ 112.07 07004816 C1713 SCREW CORTEX ST 3.5MMX16MM$ 112.07 07004818 C1713 SCREW CORTEX ST 3.5MMX18MM$ 112.07 07004820 C1713 SCREW CORTEX ST 3.5MMX20MM$ 112.07 07004822 C1713 SCREW CORTEX ST 3.5MMX22MM$ 112.07 07004824 C1713 SCREW CORTEX ST 3.5MMX24MM$ 115.05 07004826 C1713 SCREW CORTEX ST 3.5MMX26MM$ 86.29 07004828 C1713 SCREW CORTEX ST 3.5MMX28MM$ 74.46

161 07004830 C1713 SCREW CORTEX ST 3.5MMX30MM$ 74.46 07004832 C1713 SCREW CORTEX ST 3.5MMX32MM$ 74.46 07004834 C1713 SCREW CORTEX ST 3.5MMX34MM$ 74.46 07004836 C1713 SCREW CORTEX ST 3.5MMX36MM$ 74.46 07004838 C1713 SCREW CORTEX ST 3.5MMX38MM$ 74.46 07004840 C1713 SCREW CORTEX ST 3.5MMX40MM$ 135.36 07004842 C1713 SCREW CORTEX ST 3.5MMX42MM$ 133.21 07004845 C1713 SCREW CORTEX ST 3.5MMX45MM$ 122.67 07004846 C1713 SCREW CORTEX ST 3.5MMX46MM$ 133.21 07004848 C1713 SCREW CORTEX ST 3.5MMX48MM$ 133.21 07004850 C1713 SCREW CORTEX ST 3.5MMX50MM$ 112.07 07004948 A4649 CANNULA PERFUSION AORTIC 7MM C$ 463.35 07004961 A4649 SUTURE MERSILENE 2 30 LR/LR$ 59.04 07005000 C1713 ARTICUL/EZE M HEAD 36MM -2$ 1,430.63 07005001 A4649 SILASTIC SHEETING 0.005 NRFD$ 1,136.51 07005008 C1713 PLATE FX 8 HOLE 60MM$ 1,211.05 07005013 C1713 SCREW CANNUL PT 3.5MMX12MM$ 771.46 07005014 C1713 SCREW CANNUL PT 3.5MMX14MM$ 771.46 07005016 C1713 SCREW CANNUL PT 3.5MMX16MM$ 771.46 07005018 C1713 SCREW CANNUL PT 3.5MMX18MM$ 771.46 07005020 C1713 SCREW CANNUL PT 3.5MMX20MM$ 771.46 07005022 C1713 SCREW CANNUL PT 3.5MMX22MM$ 771.46 07005024 C1713 SCREW CANNUL PT 3.5MMX24MM$ 771.46 07005026 C1713 SCREW CANNUL PT 3.5MMX26MM$ 946.14 07005028 C1713 SCREW CANNUL PT 3.5MMX28MM$ 946.14 07005030 C1713 SCREW CANNUL PT 3.5MMX30MM$ 946.14 07005032 C1713 SCREW CANNUL PT 3.5MMX32MM$ 771.46 07005034 C1713 SCREW CANNUL PT 3.5MMX34MM$ 946.14 07005036 C1713 SCREW CANNUL PT 3.5MMX36MM$ 946.14 07005038 C1713 SCREW CANNUL PT 3.5MMX38MM$ 771.46 07005040 C1713 SCREW CANNUL PT 3.5MMX40MM$ 951.77 07005042 C1713 SCREW CANNUL PT 3.5MMX42MM$ 771.46 07005044 C1713 SCREW CANNUL PT 3.5MMX44MM$ 771.46 07005046 C1713 SCREW CANNUL PT 3.5MMX46MM$ 771.46 07005048 C1713 SCREW CANNUL PT 3.5MMX48MM$ 771.46 07005050 C1713 SCREW CANNUL PT 3.5MMX50MM$ 946.09 07005051 C1713 SCREW PINN CAN 6.5MMX55MM$ 483.87 07005060 C1713 SCREW PINN CAN 6.5MMX60MM$ 483.87 07005100 C1713 SCREW SCHANTZ 5.0MMX100MM$ 477.58 07005105 A4649 FILTER FUME BONE CEMENT$ 187.44 07005116 C1758 CATHETER URETERAL OPEN-END 6FR$ 76.08 07005125 C1713 SCREW SCHANTZ 5.0MMX125MM$ 477.58

162 07005130 C1713 SCREW MALLEOLAR 4.5MMX30MM$ 266.46 07005135 C1713 SCREW MALLEOLAR 4.5MMX35MM$ 266.46 07005140 A4649 NEEDLE SPINAL WHITACARE 22GA$ 115.82 07005145 C1713 SCREW MALLEOLAR 4.5MMX45MM$ 266.46 07005150 C1713 SCREW MALLEOLAR 4.5MMX50MM$ 266.46 07005155 C1713 SCREW MALLEOLAR 4.5MMX55MM$ 266.46 07005160 C1713 SCREW MALLEOLAR 4.5MMX60MM$ 266.46 07005165 C1713 SCREW MALLEOLAR 4.5MMX65MM$ 266.46 07005170 C1713 SCREW MALLEOLAR 4.5MMX70MM$ 266.46 07005200 C1713 SCREW CANC POLARUS 5MMX20MM$ 475.81 07005208 C1713 PLATE FX 8 HOLE 70MM$ 1,228.85 07005218 C1713 SCREW CANNUL FT 3.5MMX18MM$ 951.77 07005220 C1713 SCREW CANNUL FT 3.5MMX20MM$ 951.77 07005222 C1713 SCREW CANNUL FT 3.5MMX22MM$ 951.77 07005224 C1713 SCREW CANNUL FT 3.5MMX24MM$ 951.77 07005226 C1713 SCREW CANNUL FT 3.5MMX26MM$ 951.77 07005228 C1713 SCREW CANNUL FT 3.5MMX28MM$ 951.77 07005230 C1713 SCREW CANNUL FT 3.5MMX30MM$ 951.77 07005232 C1713 SCREW CANNUL FT 3.5MMX32MM$ 951.77 07005234 C1713 SCREW CANNUL FT 3.5MMX34MM$ 951.77 07005236 C1713 SCREW CANNUL FT 3.5MMX36MM$ 951.77 07005238 C1713 SCREW CANNUL FT 3.5MMX38MM$ 951.77 07005240 C1713 SCREW CANNUL FT 3.5MMX40MM$ 951.77 07005242 C1713 SCREW CANNUL FT 3.5MMX42MM$ 951.77 07005244 C1713 SCREW CANNUL FT 3.5MMX44MM$ 951.77 07005246 C1713 SCREW CANNUL FT 3.5MMX46MM$ 951.77 07005248 C1713 SCREW CANNUL FT 3.5MMX48MM$ 967.03 07005250 C1713 SCREW CANNUL FT 3.5MMX50MM$ 951.77 07005270 A4649 COMBITUBE ESOPHAGEAL SML ADULT$ 482.17 07005300 C1713 SCREW CANC POLARUS 5MMX30MM$ 475.81 07005310 C1781 MESH BARD 3.0"X5.4" LEFT$ 662.40 07005320 C1781 MESH BARD 3.0"X5.4" RIGHT$ 662.40 07005350 C1713 SCREW CANC POLARUS 5MMX35MM$ 475.81 07005359 A4649 BLADE ARTHRO FULL RAD CONV 4.5$ 368.40 07005400 A4649 HALO TRACTION SYSTEM-MED$ 3,802.31 07005416 C1713 PLATE FX 16 HOLE 120MM$ 1,335.43 07005433 A4649 CABLE PACING 5433A$ 211.46 07005450 C1713 SCREW CANC POLARUS 5MMX45MM$ 475.81 07005472 C1713 NAIL UNIV FEMUR 15MMX340MM$ 1,379.62 07005500 C1713 SCREW CANC POLARUS 5MMX50MM$ 475.81 07005516 C1713 SCREW LOCK TI T25 5MMX26MM$ 857.67 07005518 C1713 SCREW LOCK TI T25 5MMX28MM$ 857.67

163 07005520 C1713 SCREW LOCK TI T25 5MMX30MM$ 857.67 07005522 C1713 SCREW LOCK TI T25 5MMX32MM$ 857.67 07005524 C1713 SCREW LOCK TI T25 5MMX34MM$ 857.67 07005526 C1713 SCREW LOCK TI T25 5MMX36MM$ 857.67 07005528 C1713 SCREW LOCK TI T25 5MMX38MM$ 857.67 07005530 C1713 SCREW LOCK TI T25 5MMX40MM$ 857.67 07005532 C1713 SCREW LOCK TI T25 5MMX42MM$ 857.67 07005534 C1713 SCREW LOCK TI T25 5MMX44MM$ 857.67 07005536 C1713 SCREW LOCK TI T25 5MMX46MM$ 857.67 07005538 C1713 SCREW LOCK TI T25 5MMX48MM$ 857.67 07005540 C1713 SCREW LOCK TI T25 5MMX50MM$ 857.67 07005542 C1713 SCREW LOCK TI T25 5MMX52MM$ 857.67 07005544 C1713 SCREW LOCK TI T25 5MMX54MM$ 857.67 07005546 C1713 SCREW LOCK TI T25 5MMX56MM$ 857.67 07005548 C1713 SCREW LOCK TI T25 5MMX58MM$ 857.67 07005550 C1713 SCREW CANC POLARUS 5MMX55MM$ 475.81 07005552 C1713 SCREW LOCK TI T25 5MMX62MM$ 857.67 07005554 C1713 SCREW LOCK TI T25 5MMX64MM$ 857.67 07005556 C1713 SCREW LOCK TI T25 5MMX66MM$ 857.67 07005558 C1713 SCREW LOCK TI T25 5MMX68MM$ 857.67 07005566 C1713 SCREW LOCK TI T25 5MMX76MM$ 857.67 07005606 C1713 PLATE MANDIB R/L X-LONG$ 1,246.61 07005699 A4649 CORNEAL CROUCH PROTECTOR$ 80.70 07005806 C1713 PLATE MANDIB LT 60* 2.7MM 6-HO$ 1,118.71 07005885 A4649 BLADE GIGLI SAW$ 42.79 07005968 A4649 P.E. BOBBIN$ 86.68 07006000 A4649 BUR ROUND XKP 3.0MMX90MM$ 965.55 07006002 A4649 HOOK XIA LAMINA MEDIUM$ 2,092.53 07006004 C1713 PLATE MANDIB R/L SHORT$ 1,193.29 07006010 C1713 SCREW CANCELL FT 4.0MMX10MM$ 112.07 07006011 A4649 HOOK XIA PEDICLE LARGE$ 2,092.53 07006012 A4649 HOOK XIA PEDICLE SMALL$ 2,092.53 07006014 C1713 SCREW CANCELLOUS FT 4.0MMX14MM$ 83.74 07006016 C1713 SCREW CANCELL FT 4.0MMX16MM$ 83.74 07006018 C1713 SCREW CANCELL FT 4.0MMX18MM$ 58.87 07006019 A4649 SUTURE SUPRAMID 5-0 3/8C BT RE$ 39.82 07006020 C1713 SCREW CANCELLOUS FT 4.0MMX20MM$ 58.87 07006021 A4649 SUTURE SUPRAMID 5-0 3/8C TAP P$ 23.87 07006022 C1713 SCREW CANCELL FT 4.0MMX22MM$ 83.74 07006023 A4649 SUTURE SUPRAMID 4-0 3/8C WT RE$ 41.96 07006024 C1713 SCREW CANCELL FT 4.0MMX24MM$ 112.07 07006025 A4649 SUTURE SUPRAMID 4-0 1/2C REV C$ 41.96

164 07006026 C1713 SCREW CANCELL FT 4.0MMX26MM$ 54.97 07006028 C1713 SCREW CANCELL FT 4.0MMX28MM$ 58.87 07006030 C1713 SCREW CANCELL FT 4.0MMX30MM$ 112.07 07006032 C1719 SCREW CANCELL FT 4.0MMX32MM$ 112.07 07006035 C1713 SCREW CANCELL FT 4.0MMX35MM$ 112.07 07006036 C1713 SCREW CANCELLOUS FT 4.0MMX36MM$ 58.87 07006040 C1713 SCREW CANCELLOUS FT 4.0MMX40MM$ 83.74 07006045 C1713 SCREW CANCELLOUS FT 4.0MMX45MM$ 58.79 07006050 C1713 SCREW CANCELL FT 4.0MMX50MM$ 65.12 07006055 C1713 SCREW CANCELLOUS FT 4.0MMX55MM$ 82.72 07006060 C1713 SCREW CANCELLOUS FT 4.0MMX60MM$ 112.07 07006062 C1713 LINER ALTRX NEUTRAL 36MMX62MM$ 1,309.88 07006064 C1713 LINER ALTRX NEUTRAL 36MMX64MM$ 1,309.88 07006066 C1713 LINER ALTRX NEUTRAL 36MMX66MM$ 1,309.88 07006131 A4649 INTRODUCER PEELAWAY 6FR 13CM$ 874.82 07006152 C1713 LINER ALTRX +4 10D 36MMX52MM$ 1,309.88 07006154 C1713 LINER ALTRX +4 10D 36MMX54MM$ 1,309.88 07006156 C1713 LINER ALTRX +4 10D 36MMX56MM$ 1,309.88 07006158 C1713 LINER ALTRX +4 10D 36MMX58MM$ 1,309.88 07006160 C1713 LINER ALTRX +4 10D 36MMX60MM$ 1,309.88 07006162 C1713 LINER ALTRX +4 10D 36MMX62MM$ 1,309.88 07006164 C1713 LINER ALTRX +4 10D 36MMX64MM$ 1,309.88 07006166 C1713 LINER ALTRX 4+ 10D 36MMX66MM$ 1,309.88 07006200 C1734 STEM CEMENTRALIZER 11CM$ 225.81 07006204 C1713 PLATE MANDIB LT 60* 2.7MM 4-HO$ 1,079.13 07006300 C1713 FEMORAL STEM TAPER SZ-9 STD$ 2,800.00 07006305 A4649 SIGMOIDOSCOPE$ 21.38 07006314 A4649 SUTURE NUROLON 3-0 8X18 X-1$ 104.13 07006360 C1734 STEM CEMENTRALIZER 14CM$ 225.81 07006380 C1734 STEM CEMENTRALIZER 10.5CM$ 225.81 07006388 A4649 CHLORAPREP APPLICATOR 10.5ML$ 57.03 07006392 A4649 STEINMAN PIN CT 3.0MMX150MM$ 456.79 07006397 A4649 STONE RETRIEVER PFISTER-SHWART$ 899.76 07006495 A4649 LEAD MYOCARD PACING TEMP CBP$ 521.66 07006511 C1713 ARTICUL/EZE BALL 28 +1.5 GR$ 1,309.88 07006512 C1713 ARTICUL/EZE BALL 28 +5 BR$ 1,309.88 07006513 C1713 ARTICUL/EZE BALL 28 +8.5 BL$ 1,309.88 07006514 C1713 ARTICUL/EZE BALL 28 +12 BLK$ 1,309.88 07006515 C1713 ARTICUL/EZE BALL 28 +15.5 WH$ 1,309.88 07006530 A4649 SUTURE STEEL 5 4X18 CCS$ 283.31 07006550 A7520 TUBE TRACH XLT 8X13.3X105MM$ 769.38 07006560 A4649 CANNULA-TRACH TUBE XLT 8.0MM$ 62.09

165 07006593 C1713 EXT FIX SML CRB ROD 4MMX60MM$ 245.32 07006641 A4649 SUTURE ETHILON 2-0 18 FS$ 28.61 07006648 A4649 IOBAN ANTIMICROB INCISE DRAPE$ 70.08 07006860 A4649 TROCAR CANNULA 11MMX150MM$ 587.73 07006870 A4649 TROCAR CANNULA 12MMX150MM$ 587.73 07006901 A4649 SUTURE VICRYL 5-0 U 27 FS-2$ 32.82 07006947 C1721 IMPLANT DEFIBRILLATOR RV 6947$ 10,238.17 07006968 A4649 SCREW CORTEX MD HD 1.5MMX6MM$ 285.47 07007000 A4649 BUR DIA RD EX CRSE XKP 3.0MMX1$ 909.22 07007004 C1713 PLATE KLS 35MM 2.7 4 HOLE$ 1,095.58 07007010 C1713 SCREW CANCELL PT 4.0MMX10MM$ 112.07 07007014 C1713 SCREW CANCELL PT 4.0MMX14MM$ 112.07 07007016 C1713 SCREW CANCELL PT 4.0MMX16MM$ 112.07 07007018 C1713 SCREW CANCELL PT 4.0MMX18MM$ 112.07 07007020 C1713 SCREW CANCELL PT 4.0MMX20MM$ 112.07 07007022 A4649 SUTURE GORETEX CV-7 24 TT9$ 139.45 07007023 A4649 NEEDLE PERCUTANEOUS 18FR$ 286.40 07007024 C1713 SCREW CANCELL PT 4.0MMX24MM$ 112.07 07007026 C1713 SCREW CANCELL PT 4.0MMX26MM$ 112.07 07007028 C1713 SCREW CANCELL PT 4.0MMX28MM$ 112.07 07007030 C1713 SCREW CANCELLOUS PT 4.0MMX30MM$ 57.11 07007035 C1713 SCREW CANCELLOUS PT 4.0MMX35MM$ 57.11 07007038 C1769 GUIDEWIRE VASCATH$ 62.00 07007040 C1713 SCREW CANCELLOUS PT 4.0MMX40MM$ 97.27 07007045 C1713 SCREW CANCELLOUS PT 4.0MMX45MM$ 52.86 07007050 C1713 SCREW CANCELLOUS PT 4.0MMX50MM$ 52.86 07007131 A4649 INTRODUCER PEELAWAY 7FR 13CM$ 874.82 07007204 C1713 PLATE FX EDCP 4 HOLE 40MM$ 1,131.09 07007316 A4649 KIT FOLEY 16FR NON-LATEX$ 41.13 07007355 C1713 SCREW PINN CAN 6.5MMX35MM$ 483.87 07007391 A4649 SPLINT PLASTER SPCL 4"X15"$ 2.70 07007404 C1713 SCREW CD MICRO 1.5MMX4.0MM$ 338.36 07007405 C1713 SCREW CD MICRO 1.5MMX5.0MM$ 329.89 07007407 C1713 SCREW CD MICRO 1.5MMX7.0MM$ 338.36 07007455 C1713 SCREW PINN CAN 6.5MMX45MM$ 483.87 07007511 A4649 SUTURE CHROMIC 4-0 12 M-2/M-2$ 48.08 07007521 A4649 SUTURE CHROMIC 4-0 12 M-2$ 22.50 07007593 C1713 EXT FIX CONNECT BAR 4MMX60MM$ 114.19 07007607 C1713 SCREW CD MICRO 1.8MMX7.0MM$ 338.36 07007621 C1734 STEM CEMENTRALIZER 12CM$ 225.81 07007711 A4649 SUTURE ETHILON 10-0 8 TG160-4$ 158.45 07007717 A4649 SUTURE ETHILON 9-0 12 TG140-8$ 184.09

166 07007756 A4649 SUTURE ETHILON 10-0 12 TG160-$ 179.49 07007990 A4649 GRAFT DEBAK BIF 14MMX7MMX40CM$ 1,322.31 07007992 A4649 GRAFT DEBAK BIF 18MMX9MMX40CM$ 1,282.43 07007993 A4649 GRAFT DEBAK BIF 20MMX10MMX40MM$ 1,322.31 07007994 A4649 GRAFT DEBAK BIF 22MMX11MMX40CM$ 440.97 07007996 A4649 GRAFT DEBAK BIF 12MMX6MMX40CM$ 1,322.31 07008000 A4649 LIGACLIP STAINLESS STEEL SML$ 40.78 07008006 A4649 GRAFT DEBAK STR 6MMX75CM$ 1,034.22 07008007 A4649 GRAFT DEBAK STR 8MMX75CM$ 1,034.22 07008008 A4649 GRAFT DEBAK STR 10MMX75CM$ 1,166.20 07008009 A4649 GRAFT DEBAK STR 12MMX75CM$ 1,034.22 07008010 A4649 GRAFT DEBAK STR 14MMX65CM$ 1,034.22 07008011 A4649 GRAFT DEBAK STR 16MMX65CM$ 1,078.54 07008012 A4649 GRAFT DEBAK STR 18MMX65CM$ 1,078.54 07008013 A4649 GRAFT DEBAK STR 20MMX65CM$ 1,166.20 07008014 A4649 GRAFT DEBAK STR 22MMX65CM$ 1,034.22 07008015 A4649 GRAFT DEBAK STR 25MMX65CM$ 1,034.22 07008030 C1713 SCREW CANNUL PT 7MMX30MM$ 930.00 07008035 C1713 SCREW CANNUL PT 7MMX35MM$ 929.04 07008040 C1713 SCREW CANNUL PT 7MMX40MM$ 938.22 07008045 C1713 SCREW CANNUL PT 7MMX45MM$ 938.22 07008050 C1713 SCREW CANNUL PT 7MMX50MM$ 938.22 07008055 C1713 SCREW CANNUL PT 7MMX55MM$ 938.22 07008060 C1713 SCREW CANNUL PT 7MMX60MM$ 938.22 07008065 C1713 SCREW CANNUL PT 7MMX65MM$ 938.22 07008070 C1713 SCREW CANNUL PT 7MMX70MM$ 920.17 07008075 C1713 SCREW CANNUL PT 7MMX75MM$ 1,024.68 07008080 C1713 SCREW CANNUL PT 7MMX80MM$ 912.88 07008085 C1713 SCREW CANNUL PT 7MMX85MM$ 930.00 07008090 C1713 SCREW CANNUL PT 7MMX90MM$ 912.88 07008095 C1713 SCREW CANNUL PT 7MMX95MM$ 940.14 07008100 C1713 SCREW CANNUL PT 7MMX100MM$ 1,113.95 07008101 A4649 SUTURE CHROMIC 3-0 27 CT-1$ 30.80 07008105 C1713 SCREW CANNUL PT 7MMX105MM$ 958.79 07008110 C1713 SCREW CANNUL PT 7MMX110MM$ 938.85 07008131 A4649 INTRODUCER PEELAWAY 8FR 13CM$ 874.82 07008200 A4649 BIOPSY ENDOMETRIAL SUCTION$ 54.14 07008220 A4649 ENDOCLOSE TROCAR SITE SUTURE$ 296.35 07008302 A4649 WOUND PROTECTOR MED 5-9CM$ 1,261.82 07008303 A4649 WOUND PROTECTOR LGE 9-14CM$ 1,261.82 07008304 A4649 WOUND PROTECTOR XLGE 11-17CM$ 1,261.82 07008305 A4649 IMPLANT ORBITAL FLOOR$ 1,379.87

167 07008325 C1713 SCREW INTERFERENCE 7MMX25MM$ 967.90 07008412 A4649 SUTURE PROLENE 0 30 CT-2$ 37.74 07008421 A4649 SUTURE PROLENE 3-0 27 CT-1$ 34.86 07008422 A4649 SUTURE PROLENE 3-0 30 CT-1$ 63.87 07008424 A4649 SUTURE PROLENE 0 30 CT-1$ 33.15 07008433 A4649 SUTURE PROLENE 2-0 30 CT$ 27.49 07008434 A4649 SUTURE PROLENE 0 30 CT$ 36.87 07008435 A4649 SUTURE PROLENE 1 30 CT$ 36.63 07008441 A4649 SUTURE SILK 0 30 MH$ 30.56 07008448 A4649 SUTURE PLAIN 0 27 CT-1$ 33.15 07008500 A4649 SET LOOP CATHETER INTRODUCER$ 723.38 07008521 A4649 SUTURE PROLENE 4-0 SH/SH$ 77.65 07008523 A4649 SUTURE PROLENE 2-0 36 DA SH$ 69.63 07008525 C1713 SCREW INTERFERENCE 9MMX25MM$ 909.58 07008540 A4649 SHUNT ASCITES DENVER$ 1,835.09 07008541 A4649 SHUNT PERC ACCESS KIT DENVER$ 1,769.01 07008613 C1713 SCREW CD BONE 2.5MMX13MM$ 346.83 07008618 C1713 SCREW CD ST 2.7MMX18MM$ 370.23 07008620 C1713 SCREW CD ST 2.7MMX20MM$ 341.75 07008655 A4649 CLAMP INSERTS 86MM F/F CBP$ 299.04 07008695 A4649 SUTURE PROLENE 6-0 18 P-3$ 83.64 07008698 A4649 SUTURE PROLENE 5-0 18 P-3$ 63.95 07008705 A4649 SUTURE PROLENE 7-0 M8705$ 848.83 07008706 A4649 SUTURE PROLENE 6-0 30 DA C-1$ 63.79 07008725 A4649 SUTURE PROLENE 5-0 M8725$ 443.32 07008743 A4649 SUTURE PROLENE 8-0 24 BV-175-$ 861.45 07008756 A4649 SUTURE PROLENE 5-0 18 DA RB-1$ 47.80 07008757 A4649 SUTURE PROLENE 4-0 18 DA RB-1$ 80.38 07008762 A4649 SUTURE PROLENE 3-0 30 DA SH$ 52.65 07008800 A4649 SUTURE PROLENE 7-0 18 DA C-1$ 78.42 07008806 A4649 SUTURE PROLENE 6-0 18 DA BV-1$ 160.22 07008818 A4649 BRUSH CYTOLOGY-GI 1.8CMX160CM$ 392.97 07008830 C1713 SCREW CANNUL PT 7.3MMX30MM$ 1,026.87 07008835 C1713 SCREW CANNUL PT 7.3MMX35MM$ 1,026.87 07008840 C1713 SCREW CANNUL PT 7.3MMX40MM$ 940.14 07008845 C1713 SCREW CANNUL PT 7.3MMX45MM$ 940.14 07008848 A4649 SUTURE CHROMIC 0 27 CT-2$ 11.91 07008850 C1713 SCREW CANNUL PT 7.3MMX50MM$ 940.14 07008855 C1713 SCREW CANNUL PT 7.3MMX55MM$ 940.14 07008860 C1713 SCREW CANNUL PT 7.3MMX60MM$ 940.14 07008865 C1713 SCREW CANNUL PT 7.3MMX65MM$ 940.14 07008870 C1713 SCREW CANNUL PT 7.3MMX70MM$ 940.14

168 07008875 C1713 SCREW CANNUL PT 7.3MMX75MM$ 940.14 07008880 C1713 SCREW CANNUL PT 7.3MMX80MM$ 1,038.92 07008885 C1713 SCREW CANNUL PT 7.3MMX85MM$ 1,060.43 07008890 C1713 SCREW CANNUL PT 7.3MMX90MM$ 1,024.68 07008895 C1713 SCREW CANNUL PT 7.3MMX95MM$ 1,003.49 07008900 C1713 SCREW CANNUL PT 7.3MMX100MM$ 949.00 07008905 C1713 SCREW CANNUL PT 7.3MMX105MM$ 1,003.49 07008910 C1713 SCREW CANNUL PT 7.3MMX110MM$ 949.00 07008915 C1713 SCREW CANNUL PT 7.3MMX115MM$ 1,024.68 07008920 C1713 SCREW CANNUL PT 7.3MMX120MM$ 949.00 07008925 C1713 SCREW CANNUL PT 7.3MMX125MM$ 949.00 07008930 C1713 SCREW CANNUL 16MM TH 7.3MMX130$ 950.47 07008935 C1713 SCREW CANNUL PT 7.3MMX135MM$ 1,037.96 07008940 C1713 SCREW CANNUL PT 7.3MMX140MM$ 1,037.96 07008945 C1713 SCREW CANNUL PT 7.3MMX145MM$ 1,037.96 07008950 C1713 SCREW CANNUL PT 7.3MMX150MM$ 1,037.96 07009000 A4649 TUBING PENROSE 1/4X18$ 5.51 07009001 A4649 BONE BX EXCISOR FISHER LGE$ 281.59 07009004 A4649 PATCH GORETEX$ 1,202.18 07009010 A4649 TUBING W/ FILTER LAPAROSCOPY$ 66.31 07009032 A4649 SUTURE ETHILON 10-0 12 CS175-$ 233.97 07009045 C1713 SCREW CANNUL FT 7MMX45MM$ 958.79 07009050 C1713 SCREW CANNUL FT 7MMX50MM$ 958.79 07009055 C1713 SCREW CANNUL FT 7MMX55MM$ 929.04 07009058 A4649 SUTURE CHROMIC 1 36 CTX$ 38.34 07009060 C1713 SCREW CANNUL FT 7MMX60MM$ 929.04 07009065 C1713 SCREW CANNUL FT 7MMX65MM$ 930.00 07009070 C1713 SCREW CANNUL FT 7MMX70MM$ 938.85 07009075 C1713 SCREW CANNUL FT 7MMX75MM$ 930.00 07009080 C1713 SCREW CANNUL FT 7MMX80MM$ 947.71 07009085 C1713 SCREW CANNUL FT 7MMX85MM$ 947.71 07009090 C1713 SCREW CANNUL FT 7MMX90MM$ 912.88 07009095 C1713 SCREW CANNUL FT 7MMX95MM$ 958.79 07009100 C1713 SCREW CANNUL FT 7MMX100MM$ 958.79 07009105 C1713 SCREW CANNUL FT 7.0MMX105MM$ 1,037.96 07009131 A4649 SUTURE VICRYL 1 U 18$ 125.51 07009141 A4649 SUTURE CHROMIC 0 36 CT$ 50.01 07009150 A4649 TUBE NASAL RAE UNCUFFED 5.0MM$ 24.21 07009155 A4649 TUBE NASAL RAE UNCUFFED 5.5MM$ 10.96 07009158 A4649 SUTURE CHROMIC 1 36 CT$ 17.77 07009160 A4649 TUBE NASAL RAE UNCUFFED 6.0MM$ 10.96 07009164 A4649 TUBE NASAL RAE UNCUFFED 6.5MM$ 10.96

169 07009165 A4649 STYLET DEFIBRILLATOR LEAD 6093$ 338.36 07009365 A4649 STYLET DEFIBRILLATOR LEAD 6091$ 338.36 07009440 A4649 TUBE ORAL RAE UNCUFFED 4.0MM$ 27.06 07009505 C1713 SCREW CD MINI 2.0MMX5MM$ 296.08 07009507 C1713 SCREW CD MINI 2.0MMX7.0MM$ 296.08 07009509 C1713 SCREW CD MINI 2.0MMX9MM$ 232.63 07009511 C1713 SCREW CD MINI 2.0MMX11MM$ 232.63 07009513 C1713 SCREW CD MINI 2.0MMX13MM$ 232.63 07009515 C1713 SCREW CD MINI 2.0MMX15MM$ 232.63 07009519 C1713 SCREW CD MINI 2.0MMX19MM$ 232.63 07009530 C1713 PLATE DIS/RAD LCP NRW RT 2.4MM$ 5,220.60 07009531 C1713 PLATE DIS/RAD LCP NRW LT 2.4MM$ 5,220.60 07009630 C1713 PLATE DIS/RAD LCP 6HH RT 2.4MM$ 5,220.60 07009631 C1713 PLATE DIS/RAD LCP 6HH LT 2.4MM$ 5,220.60 07009730 C1713 PLATE DIS/RAD LCP 7HH RT 2.4MM$ 5,220.60 07009731 C1713 PLATE DIS/RAD LCP 7HH LT 2.4MM$ 5,220.60 07009850 C1713 SCREW CANNUL FT 7.3MMX50MM$ 949.00 07009855 C1713 SCREW CANNUL FT 7.3MMX55MM$ 949.00 07009860 C1713 SCREW CANNUL FT 7.3MMX60MM$ 949.00 07009865 C1713 SCREW CANNUL FT 7.3MMX65MM$ 949.00 07009870 C1713 SCREW CANNUL FT 7.3MMX70MM$ 949.00 07009875 C1713 SCREW CANNUL FT 7.3MMX75MM$ 958.57 07009880 C1713 SCREW CANNUL FT 7.3MMX80MM$ 958.57 07009885 C1713 SCREW CANNUL FT 7.3MMX85MM$ 940.14 07009890 C1713 SCREW CANNUL FT 7.3MMX90MM$ 940.14 07009895 C1713 SCREW CANNUL FT 7.3MMX75MM$ 940.14 07009900 C1713 SCREW CANNUL FT 7.3MMX100MM$ 949.00 07009905 C1713 SCREW CANNUL FT 7.3MMX105MM$ 949.00 07009910 C1713 SCREW CANNUL FT 7.3MMX110MM$ 949.00 07009915 C1713 SCREW CANNUL FT 7.3MMX115MM$ 949.00 07009920 C1713 SCREW CANNUL FT 7.3MMX120MM$ 949.00 07009925 C1713 SCREW CANNUL FT 7.3MMX125MM$ 949.00 07009930 C1713 SCREW CANNUL FT 7.3MMX130MM$ 949.00 07010002 A4649 NEEDLE VERESS 120MM DISP$ 343.67 07010014 A4649 SET URETERAL BAL DILATOR 7FR$ 914.14 07010015 A4649 SET URETERAL BAL DILATOR 5FR$ 939.04 07010016 A4352 CATHETER COUDE TIP 16FR 30CC$ 115.27 07010018 A4352 CATHETER COUDE TIP 18FR 30CC$ 115.27 07010020 A4352 CATHETER COUDE TIP 20FR 30CC$ 115.27 07010054 C1713 SCREW INTERFERENCE 8MMX25MM$ 713.52 07010100 A4649 ACUMATCH-L FEMORAL STEM 125MM$ 2,717.79 07010101 A4649 PATCH HERNIA-SMALL$ 1,183.36

170 07010105 A4649 PATCH HERNIA-MEDIUM$ 1,254.40 07010113 A4649 DRILL BIT JL 1.1MMX65MM$ 707.29 07010114 A4352 CATHETER COUDE STRAIGHT 16FR$ 448.32 07010120 A4352 CATHETER COUDE STR 20FR$ 41.85 07010134 A4649 FILTER BACTERIAL/VIRAL$ 9.65 07010141 A4649 DRILL BIT MQC 1.5MMX65MM$ 707.29 07010142 A4649 ELECTRODE PACING EXTERNAL$ 75.81 07010143 A4649 DRILL BIT JL 1.5MMX75MM$ 707.29 07010178 A4649 EZ DERM (ALL SIZES)$ 14.58 07010201 A4649 DRILL BIT MQC 2.0MMX65MM$ 241.94 07010203 A4649 DRILL BIT JL 2.0MMX75MM$ 707.29 07010220 POST-OP RECOVERY ROOM 1ST HOU$ 177.94 07010222 POST-OP RECOVERY ROOM ADD 15$ 36.95 07010313 Q4050 CAST SCOTCH PLUS 5X4$ 44.51 07010413 A4649 CIRCUIT BREATHING ANESTHESIA 1$ 37.57 07010461 A4649 CATHETER FOGARTY 4FR 80CM$ 382.83 07010463 A4649 CATHETER FOGARTY 2FR 60CM$ 303.68 07010464 A4649 CATHETER FOGARTY 3FR 80CM$ 335.30 07010465 A4649 CATHETER FOGARTY 4FR 40CM$ 334.86 07010466 A4649 CATHETER FOGARTY 5FR 80CM$ 227.94 07010467 A4649 CATHETER FOGARTY 6FR 80CM$ 568.65 07010468 A4649 CATHETER FOGARTY 7FR 80CM$ 568.65 07010491 A4649 SUTURE ETHIBOND 0 6X30$ 39.17 07010492 A4649 SUTURE ETHIBOND 3-0 36 SH1/SH$ 120.88 07010493 A4649 SUTURE ETHIBOND 3-0 36 RB1/RB$ 83.10 07010494 A4649 SUTURE PROLENE 36 RB1/RB1$ 108.08 07010511 A4346 CATHETER FOLEY 30FR 5CC$ 15.15 07010522 A4346 CATHETER FOLEY 26FR 30CC$ 15.15 07010650 A4649 CATHETER URETHRAL 8FR$ 6.23 07010655 A4649 CATHETER URETHRAL 10FR$ 5.99 07010660 A4649 CATHETER URETHRAL 12FR$ 3.94 07010665 A4649 CATHETER URETHRAL 14FR$ 5.59 07010670 A4649 CATHETER URETHRAL 16FR$ 8.13 07010671 A4649 CATHETER URETHRAL 18FR$ 7.19 07010680 A4649 CATHETER URETHRAL 20FR$ 7.11 07010690 A4649 CATHETER URETHRAL 24FR$ 3.97 07010695 A4649 CATHETER URETHRAL 26FR$ 4.12 07010717 A4649 ELECTRODE TEFL COAT CAUTERY 6$ 50.67 07010723 A4649 KIT PORT-A-CATH 9FR-UNASBL$ 1,289.60 07010724 A4649 KIT PORT-A-CATH 9FR-PREASBL$ 1,430.65 07010750 A4649 CATHETER TROCAR 10FR$ 111.93 07010790 A4649 TUBE-T CATTELL 12FR$ 130.08

171 07010791 A4649 TUBE-T CATTELL 14FR$ 130.08 07010792 A4649 TUBE-T CATTELL 16FR$ 138.23 07010793 A4649 TUBE-T CATTELL 18FR$ 139.39 07010801 A4649 EXT FIX OPEN COMPRESSOR LGE$ 1,511.62 07010811 A4649 CATHETER CHOLANGIOGRAM 16GAX30$ 102.81 07010812 A4649 SET ENDO CHOLANGIOGRAM OLSEN$ 555.73 07010842 A4649 PRESSURE MONITOR$ 278.10 07010882 A4649 RETROGRADE GUNDRY-CBP$ 967.48 07010890 C1769 GUIDE WIRE BASKET TRAPEZOID$ 1,314.93 07010908 A4649 KIT FALOPE RING BAND APPL$ 3,162.34 07011010 A4649 CHLORAPREP APPLICATOR 1.5ML$ 8.94 07011013 A4649 SUTURE MERSILENE STRIP 12 MO-$ 637.39 07011020 C1713 NAIL FEMUR TFNA 12MMX170MM$ 3,570.90 07011070 A4649 DRAPE LAPAROTOMY TRANSVERSE$ 29.49 07011075 A4649 DRAPE MAGNETIC INSTR 10X16$ 21.47 07011080 A4649 SUTURE VICRYL 0 V 8X18 MO-5$ 258.42 07011106 C1713 PLATE FX 6 HOLE 40MM 2.3MM SY$ 1,219.95 07011108 C1713 PLATE FX 8 HOLE 55MM 2.3MM SY$ 1,299.90 07011185 A4649 ANTIFOG SOLUTION FRED$ 60.80 07011215 A4649 SURGICEL 2X3$ 210.76 07011254 A4649 GUIDE PIN-TRANSTIBIAL 2.0MM$ 169.19 07011268 C1781 MESH MARLEX 3X6$ 131.82 07011270 A4649 GAUZE TUBEGAUZE W/ APPL #1$ 10.23 07011272 A4649 GAUZE TUBEGAUZE W/ APPL #2$ 12.43 07011273 A4649 GAUZE TUBEGAUZE W/ APPL #4$ 325.99 07011284 A4649 GAUZE XEROFORM 1X8$ 6.93 07011286 A4649 GAUZE RAYTECS 4X4$ 7.22 07011304 C1713 PLATE FX 4 HOLE 30MM 2.3MM SY$ 1,122.21 07011351 C1768 GRAFT GORETEX 6MMX70CM$ 2,088.79 07011352 A4649 CATHETER GROSHONG 1-LUMEN 3.5F$ 1,328.11 07011353 C1768 GRAFT GORETEX 4-7MMX40CM$ 1,753.00 07011365 A4649 GOWN SURGICAL ECLIPSE DISP-LAR$ 29.20 07011394 A4649 HEMOVAC 400ML 1/8 5 TROCAR$ 462.04 07011400 A4649 CHEST DRAIN VALVE-HEIMLICH$ 134.30 07011437 A4649 RESERVOIR JACKSON-PRATT 100CC$ 32.61 07011438 A4649 RESERVOIR JACKSON-PRATT 400CC$ 165.21 07011504 C1713 PLATE FX 4 HOLE 35MM 2.3MM SY$ 1,131.09 07011530 A4649 SUTURE VICRYL Z-0 U CT J351H$ 29.91 07011620 A4649 MASK LOW PRESSURE-NEONATAL$ 20.52 07011656 A4649 DRESSING MELOLIN 5.0CMX5.0CM$ 0.95 07011657 A4649 DRESSING MELOLIN 10CMX10CM$ 2.61 07011703 A4649 PACK EXTREMITY STERILE$ 220.70

172 07011706 C1713 PLATE FX 6 HOLE 45MM 2.3MM SY$ 1,237.72 07011745 A4649 PLATE BOVIE-INFANT$ 39.15 07011750 A4649 PLATE BOVIE-PEDIATRIC$ 28.75 07011758 A4649 PAD BOVIE-ADULT$ 60.56 07011800 C1713 SCREW CORTEX ST 1.5MMX11MM$ 158.60 07011802 A4649 CATHETER GROSHONG 1-LUMEN 8FR$ 1,328.11 07011851 A4649 CATHETER FOGARTY 5FR 23CM$ 364.42 07011852 A4649 CATHETER FOGARTY 5FR 40CM$ 682.48 07011853 A4649 CATHETER FOGARTY 6FR 23CM$ 352.32 07011861 A4649 FACE SHIELD FULL SAFETY$ 12.16 07012000 A4649 SPONGE KITNER$ 18.88 07012020 C1713 NAIL FEMUR TFNA 10MMX340MM$ 4,758.96 07012032 A4649 SUTURE SUPER QUICK ANCHOR$ 1,297.68 07012036 A4649 SUTURE TACIT QUICK ANCHOR$ 1,235.94 07012086 A4649 STOCKINETTE TUBULAR 3 /YD$ 5.01 07012087 A4649 STOCKINETTE TUBULAR 4 /YD$ 5.01 07012088 A4649 STOCKINETTE TUBULAR 6 /YD$ 6.64 07012089 A4649 STOCKINETTE TUBULAR 8 /YD$ 9.94 07012154 A4649 CANNISTER SUCTION 1200CC$ 29.15 07012155 A4649 CANNISTER SUCTION 1500CC$ 19.03 07012156 A4649 SUCTION CANNISTER 2000CC$ 23.23 07012159 A4649 SUCTION CANNISTER LINER 1500CC$ 15.06 07012174 A4649 SURGICAL SPEARS-WECK CEL$ 2.29 07012266 A4649 SUTURE MINI QUICK ANCHOR$ 1,213.33 07012500 C1781 MESH MARLEX 10"X14"$ 108.56 07012554 A4649 TRAY PEG PONSKY PULL 20FR$ 990.36 07012556 A4649 TRAY PEG PONSKY PULL 28FR$ 964.06 07012557 A4649 TRAY PEG PONSKY PULL 16FR$ 1,181.96 07012565 A4649 TRAY SPINAL ANESTHESIA-PONTOCA$ 125.95 07012568 A4649 TRAY SPINAL ANESTHESIA-MARCAIN$ 178.57 07012600 A4649 TUBING CONNECTING 1/4X6'$ 6.64 07012601 A4649 DRILL TWIST KLS 2.5MMX76MM$ 803.62 07012602 A4649 TUBING CONNECTING 1/4X12'$ 14.94 07012605 A4649 TUBING CONNECTING 3/16X6'$ 6.64 07012606 A4649 DRILL TWIST KLS 2.5MMX105MM$ 803.62 07012720 A4649 TUBE BLAKEMORE PED 12FR$ 1,134.55 07012790 A4649 SET SUCTION POOLE$ 28.83 07012795 A4649 TIP SUCTION YANKAUER$ 2.92 07012800 A4649 SET SUCTION YANKAUER$ 15.15 07012811 A4649 SUTURE MICRO QUICK ANCHOR$ 1,184.09 07012859 A4649 FIXATOR DISTAL RADIUS 200MM$ 4,054.04 07012877 A4649 SET EXTENSION SECUR-LOK MIC$ 88.83

173 07012965 A4649 TUBING PENROSE 3/4X18$ 4.82 07013035 A4649 CONNECTOR-T W/ MALE LUER$ 6.31 07013200 A4649 SMARTMIX TOWER CARTRIDGE$ 809.00 07013252 C1713 NAIL UNIV TIBIAL 12MMX315MM$ 1,334.03 07013261 A4649 GLOVES SURGEON NON-LATEX SZ-6$ 12.00 07013306 C1779 LEAD PACEMAKER 5068-58$ 1,965.73 07013355 A4649 STONE EXTRACTOR HELICAL 3-WIRE$ 838.71 07013363 A4649 GLOVES ORTHOPEDIC TRIFLEX S-7$ 6.64 07013364 A4649 GLOVES SURGEON NITRILE SZ-7$ 16.92 07013413 A4649 GLOVES ORTHOPEDIC S-7.5$ 11.91 07013414 A4649 GLOVES SURGEON NITRILE SZ-7.5$ 5.66 07013462 A4649 GLOVES SURGEON LATEX SZ-8$ 2.96 07013463 A4649 GLOVES ORTHOPEDIC S-8$ 14.48 07013511 A4649 GLOVES SURGEON NON-LATEX SZ-8.$ 16.33 07013512 A4649 GLOVES SURGEON LATEX SZ-8.5$ 3.14 07013513 A4649 GLOVES SURGEON LATEX SZ-9$ 3.16 07013537 A4649 MONSELS SOLUTION 30 CC$ 12.57 07013700 J3490 SODIUM CL IRRIG 3000CC BAG$ 35.11 07014000 A4649 BUR DIA RD EX CRSE XKP 3.0MMX5$ 848.70 07014010 A4649 SUTURE PLAIN 0 54 STD$ 14.23 07014012 C1713 SCREW FIXED ANGLE TETHER 4X12M$ 1,203.77 07014013 C1713 SCREW FIXED ANGLE TETHER 4X13M$ 1,203.77 07014016 C1713 SCREW CORTEX ASIF 4.5MMX16MM$ 99.38 07014018 C1713 SCREW CORTEX ASIF 4.5MMX18MM$ 99.38 07014020 C1713 SCREW CORTEX ASIF 4.5MMX20MM$ 99.38 07014022 C1713 SCREW CORTEX ASIF 4.5MMX22MM$ 99.38 07014024 A4649 SCREW CORTEX ASIF 4.5MMX24MM$ 99.38 07014026 C1713 SCREW CORTEX ASIF 4.5MMX26MM$ 99.38 07014028 C1713 SCREW CORTEX ASIF 4.5MMX28MM$ 99.38 07014030 C1713 SCREW CORTEX ASIF 4.5MMX30MM$ 99.38 07014032 C1713 SCREW CORTEX ASIF 4.5MMX32MM$ 99.38 07014034 C1713 SCREW CORTEX ASIF 4.5MMX34MM$ 71.03 07014036 C1713 SCREW CORTEX ASIF 4.5MMX36MM$ 52.79 07014038 C1713 SCREW CORTEX ASIF 4.5MMX38MM$ 81.21 07014040 C1713 SCREW CORTEX ASIF 4.5MMX40MM$ 99.38 07014042 C1713 SCREW CORTEX ASIF 4.5MMX42MM$ 160.24 07014044 C1713 SCREW CORTEX ASIF 4.5MMX44MM$ 160.24 07014046 C1713 SCREW CORTEX ASIF 4.5MMX46MM$ 99.38 07014048 C1713 SCREW CORTEX ASIF 4.5MMX48MM$ 49.49 07014050 C1713 SCREW CORTEX ASIF 4.5MMX50MM$ 49.49 07014052 C1713 SCREW CORTEX ASIF 4.5MMX52MM$ 99.38 07014054 C1713 SCREW CORTEX ASIF 4.5MMX54MM$ 49.49

174 07014056 C1713 SCREW CORTEX ASIF 4.5MMX56MM$ 99.38 07014058 C1713 SCREW CORTEX ASIF 4.5MMX58MM$ 99.38 07014060 C1713 SCREW CORTEX ASIF 4.5MMX60MM$ 49.49 07014062 C1713 SCREW CORTEX ASIF 4.5MMX62MM$ 99.38 07014064 C1713 SCREW CORTEX ASIF 4.5MMX64MM$ 99.38 07014066 C1713 SCREW CORTEX ASIF 4.5MMX66MM$ 99.38 07014068 C1713 SCREW CORTEX ASIF 4.5MMX68MM$ 49.49 07014070 C1713 SCREW CORTEX ASIF 4.5MMX70MM$ 49.49 07014072 C1713 SCREW CORTEX ASIF 4.5MMX72MM$ 99.38 07014080 C1713 SCREW CORTEX ASIF 4.5MMX80MM$ 181.89 07014085 C1713 SCREW CORTEX ASIF 4.5MMX85MM$ 181.89 07014090 C1713 SCREW CORTEX ASIF 4.5MMX90MM$ 181.89 07014291 A4649 ANGIOCATHETER 20GAX1-1/4$ 11.47 07014355 A4649 STONE EXTRACTOR HELICAL 4-WIRE$ 838.71 07014522 C1713 SCREW CANNUL PT 4.5MMX22MM$ 825.59 07014524 C1713 SCREW CANNUL PT 4.5MMX24MM$ 973.07 07014526 C1713 SCREW CANNUL PT 4.5MMX26MM$ 825.59 07014528 C1713 SCREW CANNUL PT 4.5MMX28MM$ 942.97 07014530 C1713 SCREW CANNUL PT 4.5MMX30MM$ 942.97 07014532 C1713 SCREW CANNUL PT 4.5MMX32MM$ 845.91 07014534 C1713 SCREW CANNUL PT 4.5MMX34MM$ 812.06 07014536 C1713 SCREW CANNUL PT 4.5MMX36MM$ 812.06 07014538 C1713 SCREW CANNUL PT 4.5MMX38MM$ 812.06 07014540 C1713 SCREW CANNUL PT 4.5MMX40MM$ 942.97 07014542 C1713 SCREW CANNUL PT 4.5MMX42MM$ 942.97 07014544 C1713 SCREW CANNUL PT 4.5MMX44MM$ 896.64 07014546 C1713 SCREW CANNUL PT 4.5MMX46MM$ 845.91 07014548 C1713 SCREW CANNUL PT 4.5MMX48MM$ 812.06 07014550 C1713 SCREW CANNUL PT 4.5MMX50MM$ 812.06 07014552 C1713 SCREW CANNUL PT 4.5MMX52MM$ 710.57 07014554 C1713 SCREW CANNUL PT 4.5MMX54MM$ 812.06 07014556 C1713 SCREW CANNUL PT 4.5MMX56MM$ 812.06 07014560 C1713 SCREW CANNUL PT 4.5MMX60MM$ 812.06 07014564 C1713 SCREW CANNUL PT 4.5MMX64MM$ 956.92 07014568 C1713 SCREW CANNUL PT 4.5MMX68MM$ 956.92 07014572 C1713 SCREW CANNUL PT 4.5MMX72MM$ 973.07 07014722 C1713 SCREW CANNUL FT 4.5MMX22MM$ 968.93 07014724 C1713 SCREW CANNUL FT 4.5MMX24MM$ 957.19 07014726 C1713 SCREW CANNUL FT 4.5MMX26MM$ 957.19 07014728 C1713 SCREW CANNUL FT 4.5MMX28MM$ 968.93 07014730 C1713 SCREW CANNUL FT 4.5MMX30MM$ 957.19 07014732 C1713 SCREW CANNUL FT 4.5MMX32MM$ 957.19

175 07014734 C1713 SCREW CANNUL FT 4.5MMX34MM$ 957.19 07014736 C1713 SCREW CANNUL FT 4.5MMX36MM$ 968.93 07014738 C1713 SCREW CANNUL FT 4.5MMX38MM$ 957.19 07014740 C1713 SCREW CANNUL FT 4.5MMX40MM$ 968.93 07014742 C1713 SCREW CANNUL FT 4.5MMX42MM$ 1,012.05 07014744 C1713 SCREW CANNUL FT 4.5MMX44MM$ 968.93 07014746 C1713 SCREW CANNUL PT 4.5MMX46MM$ 1,039.25 07014748 C1713 SCREW CANNUL FT 4.5MMX48MM$ 968.93 07014750 C1713 SCREW CANNUL FT 4.5MMX50MM$ 968.93 07014752 C1713 SCREW CANNUL PT 4.5MMX52MM$ 929.03 07014754 C1713 SCREW CANNUL FT 4.5MMX54MM$ 968.93 07014756 C1713 SCREW CANNUL FT 4.5MMX56MM$ 1,039.25 07014760 C1713 SCREW CANNUL FT 4.5MMX60MM$ 968.93 07014764 C1713 SCREW CANNUL FT 4.5MMX64MM$ 968.93 07014768 C1713 SCREW CANNUL FT 4.5MMX68MM$ 968.93 07014772 C1713 SCREW CANNUL FT 4.5MMX72MM$ 942.63 07014814 C1713 SCREW CORTEX ST 4.5MMX14MM$ 180.14 07014816 C1613 SCREW CORTEX ST 4.5MMX16MM$ 180.14 07014818 C1713 SCREW CORTEX ST 4.5MMX18MM$ 180.14 07014820 C1713 SCREW CORTEX ST 4.5MMX20MM$ 180.14 07014822 C1713 SCREW CORTEX ST 4.5MMX22MM$ 180.14 07014824 C1713 SCREW CORTEX ST 4.5MMX24MM$ 180.14 07014826 C1713 SCREW CORTEX ST 4.5MMX26MM$ 180.14 07014830 C1713 SCREW CORTEX ST 4.5MMX30MM$ 167.25 07014832 C1713 SCREW CORTEX ST 4.5MMX32MM$ 167.25 07014834 C1713 SCREW CORTEX ST 4.5MMX34MM$ 180.14 07014836 C1713 SCREW CORTEX ST 4.5MMX36MM$ 180.14 07014838 C1713 SCREW CORTEX ST 4.5MMX38MM$ 180.14 07014840 C1713 SCREW CORTEX ST 4.5MMX40MM$ 103.64 07014842 C1713 SCREW CORTEX ST 4.5MMX42MM$ 184.72 07014844 C1713 SCREW CORTEX ST 4.5MMX44MM$ 167.25 07014846 C1713 SCREW CORTEX ST 4.5MMX46MM$ 184.72 07014848 C1713 SCREW CORTEX ST 4.5MMX48MM$ 76.14 07014850 C1713 SCREW CORTEX ST 4.5MMX50MM$ 76.14 07014852 C1713 SCREW CORTEX ST 4.5MMX52MM$ 76.14 07014854 C1713 SCREW CORTEX ST 4.5MMX54MM$ 76.14 07014856 C1713 SCREW CORTEX ST 4.5MMX56MM$ 135.36 07014858 C1713 SCREW CORTEX ST 4.5MMX58MM$ 210.50 07014860 C1713 SCREW CORTEX ST 4.5MMX60MM$ 210.50 07014862 C1713 SCREW CORTEX ST 4.5MMX62MM$ 139.45 07014864 C1713 SCREW CORTEX ST 4.5MMX64MM$ 139.45 07014866 C1713 SCREW CORTEX ST 4.5MMX66MM$ 139.45

176 07014868 C1713 SCREW CORTEX ST 4.5MMX68MM$ 139.45 07014870 C1713 SCREW CORTEX ST 4.5MMX70MM$ 139.45 07014872 A4649 SCREW CORTEX ST 4.5MMX72MM$ 225.92 07015000 A4649 BUR ROUND XKP 7.0MMX70MM$ 972.21 07015106 C1713 PLATE MANDIB UNIV 3X3 2.3MM SY$ 1,371.00 07015108 C1713 PLATE MANDIBLE ANGLE KLS 4X4 2$ 1,388.75 07015110 A4649 CATH CRICOTHYROTOMY CUFF 5MM$ 1,186.36 07015150 A4649 ROTH POLYPECTOMY NET$ 161.24 07015211 A4649 DRILL TWIST KLS 1.1MMX70MM$ 719.03 07015215 A4649 DRILL TWIST KLS 1.5MMX70MM$ 719.03 07015300 C1713 FEMORAL STEM TAPER SZ-1 STD$ 2,800.00 07015412 C1713 SCREW BONE HERBERT 12MMX3MM$ 1,057.61 07015414 C1713 SCREW BONE HERBERT 14MMX3MM$ 1,057.61 07015416 C1713 SCREW BONE HERBERT 16MMX3MM$ 1,057.61 07015418 C1713 SCREW BONE HERBERT 18MMX3MM$ 1,057.61 07015420 C1713 SCREW BONE HERBERT 20MMX3MM$ 556.04 07015422 C1713 SCREW BONE HERBERT 22MM$ 495.46 07015424 C1713 SCREW BONE HERBERT 24MMX3MM$ 556.04 07015426 C1713 SCREW BONE HERBERT 26MMX3MM$ 1,057.61 07015428 C1713 SCREW BONE HERBERT 28MM$ 495.46 07015430 C1713 SCREW BONE HERBERT 30MM$ 495.46 07015516 A4649 ELECTRODE EXTENDED BLADE 6$ 44.98 07015833 A4649 PACEMAKER CABLE DISP$ 199.35 07016010 A4927 GLOVES SURG S-7-1/2 SPEC$ 4.60 07016035 C1713 SCREW CANCEL PT-16 6.5MMX35MM$ 281.26 07016037 A4649 TUBE ENDOBRONCHIAL STR LT 37FR$ 992.63 07016040 C1713 SCREW CANCEL PT-16 6.5MMX40MM$ 281.26 07016045 C1713 SCREW CANCELLOUS PT 6.5MMX45MM$ 131.11 07016055 C1713 SCREW CANCEL PT-16 6.5MMX55MM$ 281.26 07016060 C1713 SCREW CANCEL PT-16 6.5MMX60MM$ 281.26 07016065 C1713 SCREW CANCEL PT-16 6.5MMX65MM$ 281.26 07016070 C1713 SCREW CANCEL PT-16 6.5MMX70MM$ 281.26 07016075 C1713 SCREW CANCEL PT-16 6.5MMX75MM$ 281.26 07016080 C1713 SCREW CANCEL PT-16 6.5MMX80MM$ 281.26 07016090 C1713 SCREW CANCEL PT-16 6.5MMX90MM$ 310.88 07016095 C1713 SCREW CANCEL PT-16 6.5MMX95MM$ 310.88 07016201 A4649 MASK LOW PRESSURE-INFANT$ 20.52 07016202 A4649 MASK LOW PRESSURE-PEDS$ 20.52 07016203 A4649 MASK LOW PRESSURE-ADULT$ 22.12 07016204 A4649 MASK LOW PRESSURE-ADULT LGE$ 38.44 07016303 A4649 DRILL BIT JL STOP 0.76MMX6MM$ 517.70 07016396 A4649 DRILL BIT MQC 1.0MMX50MM$ 226.71

177 07016402 A4649 DRILL BIT MQC 1.3MMX55MM$ 226.71 07016671 A4649 SUTURE ETHILON 4-0 18 PS-2$ 62.53 07016961 A4649 SUTURE ETHILON 7-0 18 P-1$ 83.91 07017000 A4649 SUTURE VICRYL 4-0 U 12X18$ 138.99 07017050 C1713 SCREW CANCEL PT 6.5MMX50MM$ 131.11 07017055 C1713 SCREW CANCELLOUS PT 6.5MMX55MM$ 131.11 07017060 C1713 SCREW CANCELLOUS PT-32 6.5MMX6$ 131.11 07017065 C1713 SCREW CANCELLOUS PT-32 6.5MMX6$ 131.11 07017070 C1713 SCREW CANCELLOUS PT-32 6.5MMX7$ 131.11 07017075 C1713 SCREW CANCELLOUS PT-32 6.5MMX7$ 131.11 07017080 C1713 SCREW CANCEL PT-32 6.5MMX80MM$ 281.26 07017085 C1713 SCREW CANCEL TH-32 6.5MMX85MM$ 310.88 07017090 C1713 SCREW CANCEL TH-32 6.5MMX90MM$ 310.88 07017095 C1713 SCREW CANCEL TH-32 6.5MMX95MM$ 310.88 07017100 C1713 SCREW CANCEL TH-32 6.5MMX100MM$ 310.88 07017105 C1713 SCREW CANCEL PT-32 6.5MMX105MM$ 310.88 07017835 A4649 TUBE NASAL RAE CUFFED 3.5MM$ 38.89 07017840 A4649 TUBE NASAL RAE CUFFED 4.0MM$ 38.89 07017845 A4649 TUBE NASAL RAE CUFFED 4.5MM$ 38.89 07017861 A4649 DRILL BIT MQC 1.8MMX80MM$ 209.78 07017865 A4649 TUBE NASAL RAE CUFFED 6.5MM$ 44.82 07017867 A4649 DRILL BIT JL 1.8MMX90MM$ 707.29 07017871 A4649 DRILL BIT MQC 2.4MMX80MM$ 240.24 07017872 A4649 DRILL BIT JL 2.4MMX90MM$ 707.29 07018000 A4649 TROCAR THORACIC SLEEVE 10/12MM$ 232.63 07018025 C1713 SCREW CANCEL FT 6.5MMX25MM$ 281.26 07018030 C1713 SCREW CANCEL FT 6.5MMX30MM$ 281.26 07018035 C1713 SCREW CANCEL FT 6.5MMX35MM$ 281.26 07018040 C1713 SCREW CANCEL FT 6.5MMX40MM$ 281.26 07018069 C1713 SCREW ST TI 2 MM X 6-32 MM$ 280.06 07019000 C1713 LINER ALTRX +4 10D 28MMX44MM$ 1,309.88 07019103 A4649 BLADE SAW 10MMX26MM 519.103$ 92.45 07019105 A4649 BLADE SAW 6MMX25MM 519.230$ 456.79 07019106 A4649 BLADE SAW 20MMX50MM 519.105$ 152.27 07019330 A4649 BANDAGE COFLEX LF2 2"X5YD$ 11.25 07019412 C1713 PLATE MANDIRECON RT ANG 12 HOL$ 1,744.10 07019441 A4649 TUBE ENDOBRONCHIAL STR LT 41FR$ 661.09 07019600 C1713 SCREW CORTEX MD HD 1.3MMX11MM$ 301.15 07019608 C1713 PLATE MANDIRECON STR 8 HOLE$ 1,353.21 07019611 C1713 PLATE MANDIRECON STR 11 HOLE$ 1,406.52 07019614 C1713 PLATE MANDIRECON STR 14 HOLE$ 1,442.03 07019617 C1713 PLATE MANDIRECON STR 17 HOLE$ 1,530.88

178 07019715 C1713 PLATE MANDIRECON RT ANG 15 HOL$ 1,832.95 07019718 C1713 PLATE MANDIRECON RT ANG 18 HOL$ 1,886.25 07019902 A4649 SUTURE PDS TP-1 LOOP$ 91.18 07019912 C1713 PLATE MANDIRECON LT ANG 2.7 1$ 1,554.07 07019913 C1713 PLATE MANDIRECON KLS LT 2.7 18$ 1,680.77 07019915 C1713 PLATE MANDIRECON KLS LT 2.7 15$ 1,633.25 07020000 C1713 PIN BANTAM W/GRIPTION 46MM$ 2,215.50 07020001 C1781 MESH VENTRALIGHT ST 6" CIRCLE$ 2,387.13 07020010 C1713 NAIL FEMUR TFNA RT 10MMX400MM$ 4,758.96 07020011 A4649 GLOVES RADION-X SIZE 8$ 358.54 07020012 A4649 DERMABOND SKIN ADHESIVE$ 245.57 07020014 A7526 TUBE TRACHEOSTOMY PEDS 3.5$ 220.03 07020015 A4649 TUBE TRACHEOSTOMY PEDS 4.5$ 220.03 07020016 A4649 AIRWAY-NASOPHARYNGEAL 16FR$ 33.52 07020018 A4649 AIRWAY-NASOPHARYNGEAL 18FR$ 22.44 07020020 A4649 AIRWAY-NASOPHARYNGEAL 20FR$ 22.44 07020023 A4649 SUTURE MERSILENE STRIP R5MM$ 552.58 07020024 A4649 AIRWAY-NASOPHARYNGEAL 24FR$ 22.44 07020026 A4649 AIRWAY-NASOPHARYNGEAL 26FR$ 27.91 07020028 A4649 AIRWAY-NASOPHARYNGEAL 28FR$ 21.21 07020030 A4649 AIRWAY-NASOPHARYNGEAL 30FR$ 22.12 07020032 A4649 AIRWAY-NASOPHARYNGEAL 32FR$ 20.24 07020034 A4649 AIRWAY-NASOPHARYNGEAL 34FR$ 20.24 07020036 A4649 AIRWAY-NASOPHARYNGEAL 36FR$ 20.24 07020041 A4649 RETROPUBIC SYSTEM GYNECARE TVT$ 1,215.51 07020060 A4649 CONNECTOR TERUMO 1/4X1/4 CBP$ 67.64 07020063 A4649 TOURNICOT-SMALL$ 18.61 07020064 A4649 TOURNICOT-MEDIUM$ 24.00 07020065 A4649 TOURNICOT-LARGE$ 24.00 07020066 A4649 TOURNICOT-X-LARGE$ 24.00 07020071 A4649 SUTURE STANDARD 54$ 13.62 07020072 A4649 SUTURE LABRYNTH 12X18$ 80.62 07020074 A4649 SUTURE SUTUPAK 6-12X18$ 85.27 07020075 A4649 SET CARDIOPLEGIA 4:1 CBP$ 992.04 07020076 A4649 TUBING PRESSURE 48 CBP$ 10.98 07020077 A4649 ADAPTER MALE DBL LL CLEAR CBP$ 19.46 07020078 A4649 TABLE LINE-CAPIOX CP50 CBP$ 302.06 07020079 A4649 TRAY SKIN PREP GEL PVP CBP$ 23.77 07020081 A4649 BURR FLUTED MS 3MM SHORT$ 787.19 07020083 A4649 BURR FLUTED MS 3MM LONG$ 787.19 07020091 A4649 BIPOLAR FORCEPS CORD 12FT$ 48.71 07020092 A4649 EXTRACTOR BALLOON 15MM/18MM -$ 1,071.16

179 07020093 A4649 PROBE GOLD 10FRX300CM - ERCP$ 1,135.86 07020094 A4649 PROBE GOLD 7FRX300CM - ERCP$ 1,135.86 07020100 A4649 SUTURE PLAIN 3-0 54 REEL$ 13.70 07020101 C1713 SCREW CORTEX MD HD 2.4MMX11MM$ 318.52 07020102 C1713 SCREW CORTEX MD HD 2.4MMX12MM$ 318.52 07020103 C1713 SCREW CORTEX MD HD 2.4MMX13MM$ 318.52 07020104 C1713 SCREW CORTEX MD HD 2.4MMX14MM$ 318.52 07020106 C1713 SCREW CORTEX MD HD 2.4MMX16MM$ 318.52 07020116 A4649 CATHETER OPEN-END W/ WIRE SZ-6$ 86.45 07020122 A4649 NEEDLE CYTOLOGY TRANSBRONCHIAL$ 618.94 07020146 A4649 PROBE ARTHRO SERFAS 3.5MM 90-S$ 1,053.08 07020150 C1713 NAIL FEMUR TFNA RT 10MMX320MM$ 4,758.96 07020151 A4649 CONE BX EXCISOR FISHER MED$ 249.74 07020154 A4649 CONE BX EXCISOR FISHER MED EXT$ 249.74 07020160 A4649 CATHETER LUBRICATH 3-WAY 20FR$ 51.95 07020171 A4649 CO2-15MIN$ 9.79 07020188 C1769 GUIDEWIRE TERUMO ANGLED 0.038$ 126.85 07020212 A4649 SUTURE VICRYL 6-0 U 27 RB-1$ 30.80 07020213 A4649 SUTURE VICRYL 5-0 U 27 RB-1$ 30.01 07020226 A4649 BAG FABRIC BACK LEG$ 27.26 07020244 A4649 NEURO PATTIE 1/2X3$ 112.77 07020247 A4649 BLADE NEURO SPIRAL FLUTED$ 323.04 07020274 A4649 PROBE DOPPLER 2.3MM CBP$ 785.43 07020275 A4649 PROBE DOPPLER 3.5MM CBP$ 785.43 07020280 C1713 SCREW CORTEX 2.7MMX6MM$ 133.21 07020281 C1713 SCREW CORTEX ST 2.7MMX10MM$ 133.21 07020298 A4649 SUTURE ETHIBOND 5 LR B499T$ 80.31 07020300 A4649 CONE BX EXCISOR FISHER SML$ 249.74 07020320 A4649 LIGACLIP ERCA$ 1,021.53 07020330 A4649 SET TRACTION TONG$ 1,161.01 07020350 A4649 NEEDLE TEFLON PROBLOC 22GAX2$ 147.63 07020357 A4649 BLADE SAW SMALL BATT DRIVE 53$ 1,049.85 07020359 A4649 BLADE SAW SMALL BATT DRIVE 53$ 1,049.85 07020371 A4649 HOOK ARTHRO SERFAS 3.5MM$ 967.21 07020372 C1769 GUIDEWIRE NITINOL 15MMX14IN$ 43.16 07020375 A4649 TUBING ARTHRO STRYKER$ 532.81 07020376 A4649 BLADE ARTHRO RESECTOR 4.0MM$ 468.17 07020378 A4649 BLADE ARTHRO AGGRESSIVE PLUS 4$ 344.07 07020379 A4649 BLADE ARTHRO AGGRESSIVE PLUS 5$ 407.23 07020380 A4649 NEEDLE TEFLON PROBLOC 22GAX3$ 147.63 07020381 A4649 BLADE ARTHRO AGGRESSIVE PLUS 5$ 353.80 07020384 A4649 BLADE ARTHRO FLUTE BB 12 5.0MM$ 612.63

180 07020385 A4649 BLADE ARTHRO FLUTE BB 6 4.0MM$ 487.52 07020386 A4649 BLADE ARTHRO FLUTE BB 6 5.0MM$ 568.37 07020387 A4649 BLADE ARTHRO FLUTE BB 6 5.5MM$ 434.41 07020388 A4649 BLADE ARTHRO FLUTE RB 12 4.0MM$ 537.50 07020400 A4649 LIGACLIP LT400 XLGE TITANIUM$ 98.20 07020405 A4649 TUBE TRACHEOSTOMY NEO 3.0$ 448.32 07020406 A7520 TUBE TRACHEOSTOMY NEO 3.5$ 448.32 07020433 A4649 FIBERWIRE #2 W/TAPERED NEEDLE$ 161.99 07020434 A4649 CUTTING BUR ENT 2.3X51MM$ 511.21 07020435 A4649 CUTTING BUR ENT 3.7X51MM$ 511.21 07020436 A4649 CUTTING BUR ENT 5.0X44MM$ 511.21 07020437 A4649 CUTTING BUR ENT 6.9X44MM$ 496.18 07020438 A4649 CUTTING BUR ENT 8.5X44MM$ 548.81 07020439 A4649 IRRIGATION PUMP$ 24.48 07020444 C1713 SCREW CORTEX ST 3.5MMX44MM$ 133.21 07020466 A4649 BLADE WITH HANDLE #10$ 81.72 07020467 A4649 BLADE WITH HANDLE #11$ 81.72 07020468 A4649 BLADE WITH HANDLE #15$ 81.72 07020484 A4649 PILLOW PRONE POSITION-DISP$ 335.57 07020497 A4649 SUTURE MONOCRYL 3-0 18 PS-2$ 74.50 07020500 A4649 SET STONE EXT BAL 3-LUMEN 7.5F$ 1,036.08 07020501 A4649 STONE EXT BALLOON 3-LUMEN 7.5F$ 1,281.69 07020502 A4649 STONE EXT BALLOON 2-LUMEN 5FR$ 942.98 07020503 A4649 STONE EXT BALLOON 2-LUMEN 7FR$ 942.98 07020508 A4649 STONE EXT BASKET 4-WIRE 20MMX1$ 932.64 07020510 A4649 STONE EXT BASKET 4-WIRE 25MMX2$ 932.64 07020511 A4649 STONE EXT BASKET 4-WIRE 30MMX2$ 932.64 07020519 A4649 SUTURE ETHBND GRN 2-0 CT-2 30"$ 21.03 07020520 A4649 SYRINGE SLIP TIP 20CC$ 2.70 07020521 A4649 SYRINGE SLIP TIP 10CC$ 1.44 07020522 A4649 SYRINGE SLIP TIP 30CC$ 4.82 07020551 A4649 AORTIC PUNCH 4.0MM-CBP$ 128.99 07020552 A4649 AORTIC PUNCH 5.2MM CBP$ 253.77 07020591 A4649 FORCEP HOT BIOPSY$ 54.84 07020600 C1713 PIN SECTOR W/ GRIPTION 60MM$ 2,215.50 07020602 A4649 SUTURE GORETEX CV-6 24 TT9$ 150.86 07020604 A4649 SUTURE GORETEX CV-6 24 TT13$ 133.97 07020606 A4649 SUTURE GORETEX CV-6 24 PT9$ 170.30 07020607 A4649 GRID-VIEW SYSTEM$ 1,008.20 07020610 A4649 SUTURE GORETEX CV-6 24 TT12$ 138.23 07020655 A7520 TUBE TRACHEOSTOMY XLT 6.0MM$ 769.38 07020656 A4649 CANNULA-TRACH TUBE XLT 6.0MM$ 62.09

181 07020658 A4649 BLADE SAW SMALL BATT DRIVE 53$ 1,049.85 07020686 A4649 HEMOCLIP TITANIUM MED$ 207.31 07020687 A4649 HEMOCLIP TITANIUM LGE$ 247.26 07020688 A4649 HALO TRACTION SYSTEM-SML$ 2,683.74 07020698 A4649 SUTURE ETHIBOND 4-0 18 P-3$ 43.58 07020704 A4649 SUTURE GORETEX CV-7 24 PT9$ 140.05 07020706 A4649 SUTURE GORETEX CV-7 24 TT13$ 47.75 07020712 A4649 SUTURE GORETEX CV-7 30 TT12$ 134.52 07020726 A4649 SUTURE MICRO TAPERPOINT$ 92.84 07020730 A4649 TROCAR FIX CANNULA SHORT 12MM$ 213.39 07020750 A4649 DUALMESH GORE 1MM 26CMX34XM$ 4,270.94 07020754 A4649 BLADE SURGICAL CLIPPER #9670$ 28.61 07020756 A4649 BLADE SURGICAL CLIPPER #9600$ 23.28 07020771 A4649 BIPOLAR COAGULATION BALL 24FR$ 923.48 07020774 A4649 SUTURE PLAIN 6-0 18 G-1$ 93.06 07020779 A4649 PATCH HEMACAROTID 8$ 287.25 07020794 A4649 SUTURE CHROMIC 6-0 G6/G6 18$ 209.66 07020805 A4649 DRAIN JACKSON-PRATT 7MM FLAT$ 711.83 07020809 A4649 TUBE ENDOBRONCHIAL LT 28FR$ 661.09 07020810 A4649 TUBE ENDOBRONCHIAL STR LT 32MM$ 661.09 07020811 A4649 TUBE ENDOBRONCHIAL LT 35FR$ 661.09 07020833 A4649 SUTURE MONOCRYL 6-0 18 PC-1$ 82.40 07020834 A4649 SUTURE MONOCRYL 5-0 18 PC-1$ 82.40 07020835 A4649 SUTURE MONOCRYL 4-0 18 PC-1$ 78.00 07020845 A4649 SUTURE MONOCRYL 4-0 18 PC-3$ 82.40 07020870 A4649 STONE EXTRACTOR NO TIP 1.5FRX1$ 1,186.63 07020916 A4649 CATHETER MALECOT 24FR$ 601.44 07020925 A4649 ELECTRODE TUR HOOK 26/28FR$ 306.74 07020944 A4649 SUTURE MICRO TAPERCUT$ 307.95 07020978 A4649 SUTURE MONOCRYLYL 0 36 U CTX$ 47.26 07020991 A4649 ETHICON MONOFILAMENT LOOP S-2$ 102.81 07021000 A4649 SUTURE SILK 2-0 8X18 SH$ 134.18 07021020 C1713 NAIL FEMUR TFNA RT 10MMX300MM$ 4,758.96 07021060 C1713 SCREW CANCELL FT 4.0MMX12MM$ 112.07 07021070 C1713 SCREW CANCELL PT 4.0MMX12MM$ 118.44 07021104 C1758 CATHETER URETERAL FLEXI TIP RT$ 104.59 07021105 C1758 CATHETER URETERAL FLEXI TIP RT$ 104.59 07021106 C1758 CATHETER URETERAL FLEXI TIP RT$ 104.59 07021203 A4649 CATHETER NEURO VENT CLR 30CM$ 1,137.65 07021204 A4649 CATHETER URETERAL FLEXI TIP LT$ 104.59 07021205 C1758 CATHETER URETERAL FLEXI TIP LT$ 104.59 07021292 A4649 K-WIRE TROCAR PT 1.25MMX150MM$ 60.56

182 07021301 A4649 CATHETER NEURO D/S VLV 91CM$ 1,211.44 07021306 C1713 PLATE STR TI 6-HOLE 1.3 1.5 MM$ 897.12 07021310 A4649 ELECTRODE CUT LOOP TUR LGE 22F$ 355.28 07021312 C1713 PLATE STR TI 12-HOLE 1.3 1.5 M$ 1,044.03 07021321 C1713 PLATE H EXT MD HD LT 1.3MM 8-H$ 839.14 07021333 C1713 PLATE-T TI 3-HOLE 1.3 1.5 MM$ 1,026.29 07021334 C1713 PLATE T HEAD MD HD 1.3 4 HOLE$ 1,090.25 07021335 C1713 PLATE Y MD HD 1.3$ 1,079.59 07021380 A4649 CATHETER NEURO BA OPEN 91CM$ 1,054.61 07021410 A4649 ELECTRODE CUTTING LOOP 22FR$ 461.00 07021411 A4649 RESERVOIR SGL DOME FLAT-NEURO$ 1,150.64 07021415 A4649 CURETTE UVAC STRAIGHT 11MM$ 84.78 07021416 A4649 CURETTE UVAC STRAIGHT 12MM$ 84.78 07021504 A4649 CONNECTOR NEURO STR 17MM$ 692.66 07021507 A4649 CONNECTOR NEURO RT ANG 17.4MM$ 863.19 07021508 A4649 CATHETER FOLLOW THREADED 8FR$ 507.17 07021510 A4649 CATHETER FOLLOW THREADED 10FR$ 507.17 07021512 A4649 CATHETER FOLLOW THREADED 12FR$ 580.28 07021514 A4649 CATHETER FOLLOW THREADED 14FR$ 507.17 07021516 A4649 CATHETER FOLLOW THREADED 16FR$ 507.17 07021518 A4649 CATHETER FOLLOW THREADED 18FR$ 580.28 07021520 A4649 CATHETER FOLLOW THREADED 20FR$ 580.28 07021522 A4649 CATHETER FOLLOW THREADED 22FR$ 507.17 07021524 A4649 CATHETER FOLLOW THREADED 24FR$ 507.17 07021552 A4649 HUMID VENT HEAT/MOISTURE EXCHA$ 61.73 07021563 A4649 EVACUATOR SMOKE$ 119.98 07021592 A4649 OBTURATOR SYSTEM TVT$ 2,334.39 07021622 C1713 PLATE DCP BR 4.5MM 12 HOLE$ 952.48 07021630 A4649 RESERVOIR CATH VENT RT ANGL 3C$ 1,572.02 07021632 A4649 RESERVOIR CATH VENT RT ANGL 4C$ 1,572.02 07021634 A4649 RESERVOIR CATH VENT RT ANGL 5C$ 1,150.64 07021800 A4649 SUTURE CHROMIC 0 27 CT-1$ 45.62 07021904 A4649 CATHETER STR FILIFORM 4FR$ 296.05 07021905 A4649 CATHETER STR FILIFORM 5FR$ 296.05 07021920 A4649 SNARE POLYPECTOMY 3.0MMX230CM$ 223.10 07021921 A4649 SNARE POLYPECTOMY 2.8MMX240CM$ 302.59 07021991 A4649 WASHER 10MM$ 175.61 07021998 A4649 WASHER 7MM$ 147.14 07021999 A4649 WASHER 13MM$ 156.64 07022000 A4649 ACUMATCH-L UNIPOLAR SLEEVE$ 761.29 07022006 A4649 CATHETER SPL FILIFORM 6FR$ 363.12 07022043 A4649 ACUMATCH-L UNI PROSTHESIS 43MM$ 1,372.01

183 07022070 C1713 SCREW CANCELL PT 4.0MMX22MM$ 112.07 07022100 A4649 SUTURE CHROMIC 3-0 27 SH$ 34.93 07022103 A4649 CATHETER SPL FILIFORM 3FR$ 331.55 07022104 A4649 CATHETER SPL FILIFORM 4FR$ 296.05 07022105 A4649 CATHETER SPL FILIFORM 5FR$ 296.05 07022130 C1713 FEMORAL STEM CEMENTED SZ-6 HI$ 2,940.00 07022204 C1713 PLATE SEMI-TUBULAR DCP 4 HOLE$ 363.13 07022205 C1713 PLATE SEMI-TUBULAR DCP 5 HOLE$ 377.34 07022206 C1713 PLATE SEMI-TUBULAR DCP 6 HOLE$ 401.09 07022207 C1713 PLATE SEMI-TUBULAR DCP 7 HOLE$ 431.96 07022304 A4352 CATHETER COUDE FILIFORM 4FR$ 296.05 07022305 A4352 CATHETER COUDE FILIFORM 5FR$ 296.05 07022404 C1713 PLATE NR DCP 4.5 4-5 HOLE$ 802.20 07022405 C1713 PLATE DCP NR 4.5MM 5-HOLE$ 773.99 07022406 C1713 PLATE NARROW DCP 4.5 6-9 HOLE$ 911.34 07022407 C1713 PLATE DCP NR 4.5MM 7-HOLE$ 879.73 07022409 C1713 PLATE DCP NR 4.5MM 8-HOLE$ 879.73 07022410 C1713 PLATE NR DCP 4.5 10-12 HOLE$ 1,052.92 07022412 C1713 PLATE DCP NR 4.5MM 12-HOLE$ 987.25 07022500 A4649 SUTURE PROLENE 3-0 36 SH/SH$ 73.93 07022512 A4649 CATHETER URETHRAL 22FR$ 50.75 07022600 A4649 SUTURE SILK 3-0 30 KS$ 10.84 07022607 C1713 PLATE DCP BR 4.5MM 7-HOLE$ 991.40 07022609 C1713 PLATE DCP BR 4.5MM 9 HOLE$ 936.64 07022610 C1713 PLATE DCP BR 4.5MM 10-HOLE$ 1,099.71 07022611 A4649 CLIP DEVICE RESOL 235CM-ERCP$ 1,026.84 07022614 C1713 PLATE DCP BR 4.5MM 14-HOLE$ 1,120.30 07022616 C1713 PLATE DCP BR 16-HOLE$ 1,164.85 07022800 C1713 ROD HUMERAL POLARUS 8MMX220MM$ 1,411.61 07022901 A4649 ELECTRODE MICROTIP SPATULA$ 238.79 07022933 C1713 PLATE RECON STR 4.5 3 HOLE$ 1,218.19 07022934 C1713 PLATE RECON STR 4.5 4 HOLE$ 1,235.94 07022935 C1713 PLATE RECON STR 4.5 5 HOLE$ 1,271.48 07022940 C1713 PLATE RECON STR 4.5 10 HOLE$ 1,411.85 07023012 A4649 VALVE CYL W/ PRECHAMBER LO PRE$ 1,150.64 07023041 A4649 CATHETER NEURO VENT STR 14CM$ 964.11 07023400 A4649 TRAY UROLOGIST HEYMAN$ 1,077.44 07023470 A4649 HEMOCLIP TITANIUM SML$ 207.31 07024000 A4649 BUR DIA RD EX CRSE XKP 4.0MMX5$ 982.16 07024005 C1713 PLATE SPOON DCP 5 HOLE$ 1,129.34 07024006 C1713 PLATE SPOON DCP 6 HOLE$ 1,152.45 07024008 A4649 CATHETER BOUGIE THREADED 8FR$ 533.35

184 07024014 C1713 PLATE T DCP 4 HOLE$ 1,097.36 07024015 C1713 PLATE T DCP 5 HOLE$ 1,115.14 07024016 C1713 PLATE T DCP 6 HOLE$ 1,139.99 07024018 C1713 PLATE T DCP 8 HOLE$ 1,264.36 07024026 A4649 KIT UNISHUNT RESERVOIR 78CM$ 2,480.31 07024034 C1713 PLATE T BUTTRESS DCP 4 HOLE$ 1,223.52 07024035 C1713 PLATE T BUTTRESS DCP 5 HOLE$ 1,232.37 07024036 C1713 PLATE T BUTTRESS DCP 6 HOLE$ 1,267.92 07024044 C1713 PLATE L-BUTTRESS DCP TIBIA L/R$ 1,184.42 07024058 C1713 PLATE TIBIA HEAD BUTT 9-H LT$ 1,233.00 07024095 C1713 PLATE COND DCP RT 190MM 9 HOLE$ 1,505.69 07024110 A4649 SET BAIR FLUID WARMING #241$ 62.18 07024113 C1713 PLATE T HEAD RT ANGLE 3.5 X 3$ 1,207.50 07024114 C1713 PLATE T HEAD RT ANGLE 3.5 X 4$ 1,223.52 07024123 C1713 PLATE T HEAD OBL 3.5 X 3 HOLE$ 1,058.24 07024125 C1713 PLATE T HEAD OBL 3.5 X 5 HOLE$ 1,058.24 07024132 C1713 PLATE TUBULAR 1/3 2 HOLE$ 310.92 07024133 C1713 PLATE TUBULAR 1/3 3 HOLE$ 325.11 07024134 C1713 PLATE TUBULAR 1/3 4 HOLE$ 377.34 07024135 C1713 PLATE TUBULAR 1/3 5 HOLE$ 377.34 07024136 C1713 PLATE TUBULAR 1/3 6 HOLE$ 389.21 07024137 C1713 PLATE TUBULAR 1/3 7 HOLE$ 389.21 07024138 C1713 PLATE TUBULAR 1/3 8 HOLE$ 405.84 07024144 C1713 PLATE L-BUTTRESS DCP ANG LT 4-$ 1,082.30 07024154 C1713 PLATE L-BUTTRESS DCP ANG RT 4-$ 1,082.30 07024161 C1713 PLATE CALCANEAL 60MMX9MM$ 1,180.15 07024162 C1713 PLATE CALCANEAL 70MM$ 1,408.28 07024165 C1713 PLATE-Y CALCANEAL 87MM$ 1,188.68 07024183 C1713 PLATE CLOVERLEAF 3 HOLE$ 1,152.45 07024184 C1713 PLATE CLOVERLEAF 4 HOLE$ 1,175.52 07024203 C1713 PLATE TUBULAR 1/4 3 HOLE$ 374.98 07024204 C1713 PLATE TUBULAR 1/4 4 HOLE$ 403.47 07024205 C1713 PLATE TUBULAR 1/4 5 HOLE$ 427.19 07024206 C1713 PLATE TUBULAR 1/4 6 HOLE$ 472.29 07024207 C1713 PLATE TUBULAR 1/4 7 HOLE$ 493.66 07024208 C1713 PLATE TUBULAR 1/4 8 HOLE$ 522.13 07024231 C1713 PLATE L 2.7MM 3 HOLE 32MM LT$ 219.95 07024232 C1713 PLATE-L 27MMX32MM RT 3-HOLE$ 304.52 07024233 C1713 PLATE L OBLIQUE LT 2.7$ 320.40 07024234 C1713 PLATE L OBLIQUE RT 2.7$ 320.40 07024241 C1713 PLATE T 2.7 X 3 HOLE$ 315.67 07024313 C1713 PLATE STRAIGHT 2.0X3 HOLE$ 315.67

185 07024314 C1713 PLATE STRAIGHT 2.0X4 HOLE$ 348.89 07024315 C1713 PLATE STRAIGHT 2.0X5 HOLE$ 374.98 07024316 C1713 PLATE STRAIGHT 2.0X6 HOLE$ 412.97 07024332 C1713 PLATE-L 2.0MMX17MM RT 3-HOLE$ 304.52 07024333 C1713 PLATE L LEFT 2.0$ 315.67 07024334 C1713 PLATE L RIGHT 2.0$ 315.67 07024341 C1713 PLATE T 2.0$ 315.67 07024404 C1758 CATHETER URETERAL SPIRAL TIP 4$ 106.96 07024405 C1758 CATHETER URETERAL SPIRAL TIP 5$ 106.96 07024406 C1713 PLATE L-BUTTRESS ANG LT 6-HOLE$ 1,310.27 07024407 C1713 PLATE L-BUTTRESS ANG RT 6-HOLE$ 1,310.27 07024408 C1713 PLATE L-BUTTRESS ANG LT 7-HOLE$ 1,337.20 07024409 C1713 PLATE L-BUTTRESS ANG RT 7-HOLE$ 1,337.20 07024410 C1713 PLATE L-BUTTRESS ANG LT 8-HOLE$ 1,367.29 07024411 C1713 PLATE L-BUTTRESS ANG RT 8-HOLE$ 1,367.29 07024500 C1713 PLATE RECON STR 118MM 10 HOLE$ 1,356.77 07024501 C1713 PLATE RECON 3.5MM 130MM 11-HOL$ 1,364.10 07024502 C1713 PLATE RECON 142MM 3.5 12 HOLE$ 1,406.52 07024514 C1713 PLATE RECONSTRUCTION 4H 46MM$ 1,066.45 07024515 C1713 PLATE RECONSTRUCTION 5H 58MM$ 1,066.45 07024516 C1713 PLATE RECONSTRUCTION 6H 70MM$ 1,104.82 07024517 C1713 PLATE RECONSTRUCTION 7H 82MM$ 1,119.02 07024518 C1713 PLATE RECONSTRUCTION 8H 94MM$ 1,131.83 07024519 C1713 PLATE RECON 3.5MM 9 HOLE$ 1,240.61 07024520 C1713 PLATE RECONSTRUCTION 6H 48MM$ 1,057.55 07024521 C1713 PLATE RECONSTRUCTION 8H 64MM$ 1,045.82 07024522 C1713 PLATE RECONSTRUCTION 10H 80MM$ 1,083.14 07024523 C1713 PLATE RECONSTRUCTION 12H 96MM$ 1,102.69 07024524 C1713 PLATE RECONSTRUCTION 14H 112MM$ 1,166.66 07024605 C1758 CATHETER URETERAL CONE TIP 5FR$ 104.59 07024606 C1758 CATHETER URETERAL CONE TIP 6FR$ 62.40 07024608 A4649 CATH-URETERAL CONE TIP 8FR$ 212.44 07024800 A4649 SUTURE VICRYL 3-0 U 27 CT-1$ 29.36 07024806 C1713 PLATE 3.5X6 HOLE$ 840.15 07024807 C1713 PLATE 3.5X7 HOLE$ 873.40 07024808 C1713 PLATE 3.5X8 HOLE$ 920.84 07024809 C1713 PLATE DCP 3.5MM 9-HOLE$ 912.88 07024810 C1713 PLATE 3.5X10 HOLE$ 977.79 07024879 C1713 PLATE COND DCP LT 221MM 11-HOL$ 1,349.86 07024880 C1713 PLATE COND DCP RT 221MM 11-HOL$ 1,349.86 07025000 A4649 SUTURE VICRYL 1 U 6X18$ 70.64 07025027 C1713 NAIL UNIV TIBIAL 10MMX270MM$ 1,442.46

186 07025028 C1713 NAIL UNIV TIBIAL 10MMX285MM$ 1,442.46 07025030 C1713 NAIL UNIV TIBIAL 10MMX300MM$ 1,442.46 07025031 C1713 NAIL UNIV TIBIAL 10MMX315MM$ 1,442.46 07025033 C1713 NAIL UNIV TIBIAL 10MMX330MM$ 1,442.46 07025034 C1713 NAIL UNIV TIBIAL 10MMX345MM$ 1,334.03 07025036 C1713 NAIL UNIV TIBIAL 10MMX360MM$ 1,334.03 07025038 C1713 NAIL UNIV TIBIAL 10MMX380MM$ 1,334.03 07025040 C1713 NAIL UNIV TIBIAL 10MMX400MM$ 1,334.03 07025121 A4649 STENT MARDIS SOFT 6FRX22CM$ 982.52 07025127 C1713 NAIL UNIV TIBIAL 11MMX270MM$ 1,334.03 07025128 C1713 NAIL UNIV TIBIAL 11MMX285MM$ 1,503.68 07025130 A4649 STENT MARDIS SOFT 6FRX20CM$ 982.52 07025131 C1713 NAIL UNIV TIBIAL 11MMX315MM$ 1,503.68 07025132 A4649 STENT MARDIS SOFT 6FRX24CM$ 982.52 07025133 A4649 STENT MARDIS SOFT 6FRX26CM$ 981.02 07025134 A4649 STENT MARDIS SOFT 6FRX28CM$ 647.30 07025136 C1713 NAIL UNIV TIBIAL 11MMX360MM$ 1,334.03 07025138 C1713 NAIL UNIV TIBIAL 11MMX380MM$ 1,334.03 07025140 A4649 STENT MARDIS SOFT 7FRX20CM$ 982.52 07025141 A4649 STENT MARDIS SOFT 7FRX22CM$ 982.52 07025142 A4649 STENT MARDIS SOFT 7FRX24CM$ 982.52 07025143 A4649 STENT MARDIS SOFT 7FRX26CM$ 981.02 07025210 C1713 SCREW CANNUL FT 3.5MMX10MM$ 950.82 07025212 C1713 SCREW CANNUL FT 3.5MMX12MM$ 950.82 07025214 C1713 SCREW CANNUL FT 3.5MMX14MM$ 1,009.45 07025216 C1713 SCREW CANNUL FT 3.5MMX16MM$ 1,009.45 07025227 C1713 NAIL UNIV TIBIAL 12MMX270MM$ 1,334.03 07025228 C1713 NAIL UNIV TIBIAL 12MMX285MM$ 1,334.03 07025230 C1713 NAIL UNIV TIBIAL 12MMX300MM$ 1,334.03 07025231 A4649 STENT MARDIS FIRM 6FRX22CM$ 981.02 07025232 A4649 STENT URETERAL PERC 6FR 24CM$ 939.12 07025233 A4649 STENT MARDIS FIRM 6FRX26CM$ 982.52 07025234 A4649 STENT MARDIS FIRM 6FRX28CM$ 982.52 07025236 C1713 NAIL UNIV TIBIAL 12MMX360MM$ 1,334.03 07025238 C1713 NAIL UNIV TIBIAL 12MMX380MM$ 1,334.03 07025240 A4649 STENT MARDIS FIRM 7RX20CM$ 981.02 07025311 C1768 GRAFT GORETEX 8MMX70CM$ 2,088.79 07025327 C1713 NAIL UNIV TIBIAL 13MMX270MM$ 1,812.14 07025328 C1713 NAIL UNIV TIBIAL 13MMX285MM$ 1,368.86 07025330 C1713 NAIL UNIV TIBIAL 13MMX300MM$ 1,812.14 07025331 C1713 NAIL UNIV TIBIAL 13MMX315MM$ 1,812.14 07025333 C1713 NAIL UNIV TIBIAL 13MMX330MM$ 1,391.06

187 07025334 C1713 NAIL UNIV TIBIAL 13MMX345MM$ 1,391.06 07025336 C1713 NAIL UNIV TIBIAL 13MMX360MM$ 1,391.06 07025338 C1713 NAIL UNIV TIBIAL 13MMX380MM$ 1,332.69 07025340 C1713 NAIL UNIV TIBIAL 13MMX400MM$ 1,812.14 07025605 A4649 SURFIT FLEXIBLE WAFER$ 24.39 07025699 A4649 SURFIT DRAINABLE POUCH$ 13.69 07025901 A4649 ELECTRODE MICROTIP RT. ANGLE$ 238.79 07025928 C1713 BOLT LOCKING 4.9MMX28MM$ 493.99 07025930 C1713 BOLT LOCKING 4.9MMX30MM$ 493.99 07025932 C1713 BOLT LOCKING 4.9MMX32MM$ 493.99 07025934 C1713 BOLT LOCKING 4.9MMX34MM$ 841.66 07025936 C1713 BOLT LOCKING 4.9MMX36MM$ 493.99 07025938 C1713 BOLT LOCKING 4.9MMX38MM$ 369.25 07025940 C1713 BOLT LOCKING 4.9MMX40MM$ 933.47 07025942 C1713 BOLT LOCKING 4.9MMX42MM$ 782.46 07025944 C1718 BOLT LOCKING 4.9MMX44MM$ 554.93 07025946 C1713 BOLT LOCKING 4.9MMX46MM$ 493.99 07025948 C1713 BOLT LOCKING 4.9MMX48MM$ 493.99 07025950 C1713 BOLT LOCKING 4.9MMX50MM$ 583.67 07025954 C1713 BOLT LOCKING 4.9MMX54MM$ 583.67 07025956 C1713 BOLT LOCKING 4.9MMX56MM$ 583.67 07025958 C1713 BOLT LOCKING 4.9MMX58MM$ 693.63 07025960 C1713 BOLT LOCKING 4.9MMX60MM$ 693.63 07025964 C1713 BOLT LOCKING 4.9MMX64MM$ 619.20 07025968 C1713 BOLT LOCKING 4.9MMX68MM$ 619.20 07025972 C1713 BOLT LOCKING 4.9MMX72MM$ 619.20 07025976 C1713 BOLT LOCKING 4.9MMX76MM$ 957.19 07025980 C1713 BOLT LOCKING 4.9MMX80MM$ 925.55 07025985 A4649 BOLT LOCKING 4.9MMX85MM$ 925.55 07025990 C1713 BOLT LOCKING 4.9MMX90MM$ 925.55 07025995 C1713 BOLT LOCKING 4.9MMX95MM$ 949.11 07026000 A4649 BUR ROUND XKP 4.0MMX90MM$ 957.67 07026202 A4649 SHUNT LUMBAR PERITONEAL 80CM$ 1,636.28 07026281 A4649 TROCAR ENDOPATH XCEL 15MM$ 663.60 07027000 A4649 CRANIOTOME PED XKP 1.8MMX12MM$ 520.31 07027001 C1785 PACEMAKER VERSA VEDR0101D$ 11,188.14 07027002 C1785 PACEMAKER VERSA VEDR011D$ 11,188.14 07027003 C1785 PACEMAKER ADAPTA ADSR061$ 9,604.89 07027004 C1786 PACEMAKER ADAPTA ADSR031D$ 9,604.89 07027005 C1785 PACEMAKER ADAPTA ADSR01P1D$ 9,604.89 07027006 C1785 PACEMAKER ADAPTA ADSR011D$ 9,604.89 07027007 C1785 PACEMAKER ADAPTA ADDRL1011D$ 11,821.43

188 07027008 C1785 PACEMAKER ADAPTA ADDRL11D$ 11,821.43 07027009 C1785 PACEMAKER ADAPTA ADDR06011D$ 11,821.43 07027010 A4649 DRAIN SILICONE BLAKE 19FR$ 335.40 07027011 A4649 CATHETER CARDIOPLEGIA RETRO CB$ 271.53 07027012 C1785 PACEMAKER ADAPTA ADDR01P011D$ 11,821.43 07027013 C1785 PACEMAKER ADAPTA ADDR0311D$ 11,821.43 07027014 C1785 PACEMAKER ADAPTA ADDR0101D$ 11,821.43 07027015 C1785 PACEMAKER ADAPTA ADDR061D$ 11,821.43 07027016 C1785 PACEMAKER ADAPTA ADDR031$ 11,821.43 07027017 C1785 PACEMAKER ADAPTA ADDR01P1D$ 11,821.43 07027018 C1785 PACEMAKER ADAPTA ADDR011D$ 11,821.43 07027019 C1785 PACEMAKER ADAPTA ADDRS1011D$ 11,821.43 07027020 C1785 PACEMAKER ADAPTA ADDRS11D$ 11,821.43 07027021 C1785 PACEMAKER SENSIA SESR011D$ 8,338.28 07027022 C1785 PACEMAKER SENSIA SEDR011D$ 9,921.52 07027023 C1785 PACEMAKER SENSIA SEDR01011D$ 9,921.52 07027024 A4649 SUTURE CHROMIC 5-0 27 SH$ 11.70 07027050 A4649 ELECTRODE COAG BALL 24FR$ 801.87 07027069 A4649 ELECTRODE STRAIGHT COLD KNIFE$ 920.63 07027093 A4649 PROBE ULTRASON W/ OSC BURR TIP$ 1,512.99 07027210 A4649 CANNULA SAPHENOUS VEIN-CBP$ 191.67 07027283 A4649 GLOVES SURGEON ORTHO SZ-7$ 5.59 07027284 A4649 GLOVES SURGEON ORTHO SZ-7.5$ 5.59 07027285 A4649 GLOVES SURGEON ORTHO SZ-8$ 5.59 07027401 C1713 NAIL UNIV FEMUR 10MMX360MM$ 1,807.44 07027402 C1713 NAIL UNIV FEMUR 10MMX380MM$ 1,691.83 07027403 C1713 NAIL UNIV FEMUR 10MMX400MM$ 1,269.14 07027404 C1713 NAIL UNIV FEMUR 10MMX420MM$ 1,807.44 07027405 C1713 NAIL UNIV FEMUR 10MMX440MM$ 1,330.23 07027406 C1713 NAIL UNIV FEMUR 10MMX460MM$ 1,330.23 07027407 C1713 NAIL UNIV FEMUR 10MMX480MM$ 1,330.23 07027408 C1713 NAIL UNIV FEMUR 10MMX300MM$ 1,330.23 07027409 C1713 NAIL UNIV FEMUR 11X320-480$ 1,898.68 07027411 C1713 NAIL UNIV FEMUR 11MMX3360M$ 1,336.57 07027412 C1713 NAIL UNIV FEMUR 11MMX380MM$ 1,940.41 07027413 C1713 NAIL UNIV FEMUR 11MMX400MM$ 1,365.70 07027414 C1713 NAIL UNIV FEMUR 11MMX420MM$ 2,250.73 07027415 C1713 NAIL UNIV FEMUR 11MMX440MM$ 1,329.31 07027416 C1713 NAIL UNIV FEMUR 11MMX460MM$ 1,269.14 07027417 C1713 NAIL UNIV FEMUR 11MMX480MM$ 2,250.73 07027418 C1713 NAIL UNIV FEMUR 11MMX300MM$ 1,365.70 07027419 C1713 NAIL UNIV FEMUR 11MMX320MM$ 1,365.70

189 07027420 C1713 NAIL UNIV FEMUR 12MMX340MM$ 1,691.83 07027421 C1713 NAIL UNIV FEMUR 12MMX360MM$ 1,482.44 07027422 C1713 NAIL UNIV FEMUR 12MMX380MM$ 1,330.23 07027423 C1713 NAIL UNIV FEMUR 12MMX400MM$ 1,807.44 07027424 C1713 NAIL UNIV FEMUR 12MMX420MM$ 1,691.83 07027425 C1713 NAIL UNIV FEMUR 12MMX440MM$ 1,297.96 07027426 C1713 NAIL UNIV FEMUR 12MMX460MM$ 1,807.44 07027427 C1713 NAIL UNIV FEMUR 12MMX480MM$ 1,691.83 07027428 C1713 NAIL UNIV FEMUR 12MMX300MM$ 1,365.70 07027429 C1713 NAIL UNIV FEMUR 12MMX320MM$ 1,807.44 07027431 C1713 NAIL UNIV FEMUR 13MMX360MM$ 1,691.83 07027432 C1713 NAIL UNIV FEMUR 13MMX380MM$ 1,940.41 07027433 C1713 NAIL UNIV FEMUR 13MMX400MM$ 1,269.14 07027434 C1713 NAIL UNIV FEMUR 13MMX420MM$ 1,269.14 07027435 C1713 NAIL UNIV FEMUR 13MMX440MM$ 1,330.23 07027436 C1713 NAIL UNIV FEMUR 13MMX460MM$ 1,330.23 07027437 C1713 NAIL UNIV FEMUR 13MMX480MM$ 1,297.96 07027438 C1713 NAIL UNIV FEMUR 13MMX300MM$ 1,365.70 07027439 C1713 NAIL UNIV FEMUR 13MMX320MM$ 1,365.70 07027441 C1713 NAIL UNIV FEMUR 14MMX360MM$ 1,807.44 07027442 C1713 NAIL UNIV FEMUR 14MMX380MM$ 1,940.41 07027443 C1713 NAIL UNIV FEMUR 14MMX400MM$ 1,807.44 07027444 C1713 NAIL UNIV FEMUR 14MMX420MM$ 1,691.83 07027445 C1713 NAIL UNIV FEMUR 14MMX440MM$ 1,365.70 07027446 C1713 NAIL UNIV FEMUR 14MMX460MM$ 1,330.23 07027447 C1713 NAIL UNIV FEMUR 14MMX480MM$ 1,807.44 07027448 C1713 NAIL UNIV FEMUR 14MMX300MM$ 1,691.83 07027449 C1713 NAIL UNIV FEMUR 14MMX320MM$ 1,940.41 07027451 C1713 NAIL UNIV FEMUR 15MMX360MM$ 1,419.52 07027452 C1713 NAIL UNIV FEMUR 15MMX380MM$ 1,891.34 07027453 C1713 NAIL UNIV FEMUR 15MMX400MM$ 1,379.62 07027454 C1713 NAIL UNIV FEMUR 15MMX420MM$ 1,313.76 07027455 C1713 NAIL UNIV FEMUR 15MMX440MM$ 1,379.62 07027456 C1713 NAIL UNIV FEMUR 15MMX460MM$ 1,457.53 07027457 C1713 NAIL UNIV FEMUR 15MMX480MM$ 1,419.52 07027458 C1713 NAIL UNIV FEMUR 15MMX300MM$ 1,419.52 07027459 C1713 NAIL UNIV FEMUR 15MMX320MM$ 1,891.34 07027935 A4649 COAGULATOR 90* SERFAS ENERGY 3$ 1,083.08 07028000 C1713 SCREW LAG DHS/DCS 12.7MMX100MM$ 973.07 07028015 C1713 SCREW LAG DHS/DCS 12.7MMX115MM$ 1,093.49 07028020 C1713 SCREW LAG DHS/DCS 12.7MMX120MM$ 998.38 07028025 C1713 SCREW LAG DHS/DCS 12.7MMX125MM$ 998.38

190 07028030 C1713 SCREW LAG DHS/DCS 12.7MMX130MM$ 998.38 07028035 C1713 SCREW LAG DHS/DCS 12.7MMX135MM$ 998.38 07028050 C1713 SCREW LAG DHS/DCS 12.7MMX50MM$ 998.38 07028055 C1713 SCREW LAG DHS/DCS 12.7MMX55MM$ 988.89 07028070 C1713 SCREW LAG DHS/DCS 12.7MMX70MM$ 1,063.29 07028080 C1713 SCREW LAG DHS/DCS 12.7MMX80MM$ 1,052.58 07028085 C1713 SCREW LAG DHS/DCS 12.7MMX85MM$ 1,130.38 07028095 C1713 SCREW LAG DHS/DCS 12.7MMX95MM$ 1,098.06 07028099 C1713 SCREW COMPRESSION DHS 36MM$ 253.93 07028110 C1713 PLATE SB DHS 135 10-12 HOLE$ 1,598.40 07028111 C1713 PLATE DHS 135* 12HOLE 38MM$ 1,473.35 07028113 C1713 PLATE SB DHS 135 14-16 HOLE$ 1,854.26 07028116 C1713 PLATE DHS 135* 6 HOLE 38MMX110$ 1,253.27 07028118 C1713 PLATE DHS 135* 8 HOLE 38MMX142$ 1,424.27 07028125 C1713 PLATE DHS 140* 5 HOLE 38MMX94M$ 1,543.87 07028126 C1713 PLATE DHS 140* 6 HOLE 38MMX110$ 1,289.72 07028135 C1713 PLATE DHS 145* 5 HOLE 38MM$ 1,289.72 07028136 C1713 PLATE DHS 145* 6 HOLE 38MMX110$ 1,151.96 07028144 C1713 PLATE SB DHS 150 4-6 HOLE$ 1,406.52 07028145 C1713 PLATE DHS 150* 5 HOLE 94MM$ 1,151.96 07028146 C1713 PLATE DHS 150* 6 HOLE 110MM$ 1,151.96 07028151 A4649 HEMORRHOID O-RINGS 1-10$ 10.15 07028154 C1713 PLATE SB DHS 135 4 HOLE$ 1,406.52 07028194 C1713 PLATE DCP SB 95* 25MM 16 HOLE$ 2,036.15 07028198 C1713 PLATE DCS 95* 8 HOLE 146MM$ 1,875.51 07028541 A4649 KIT UNISHUNT RESERVOIR 102CM$ 2,573.73 07029101 A4649 WIRE CIRCLAGE W/EYE 1.0MM$ 51.27 07029102 A4649 WIRE CIRCLAGE W/EYE 1.25MM$ 51.27 07029105 A4649 WIRE CIRCLAGE COIL 1.0MM$ 42.89 07029106 A4649 WIRE CIRCLAGE COIL 1.25MM$ 42.89 07029182 C1713 PLATE DCS 95* 10 HOLE 178MM$ 1,826.42 07029206 A4649 K-WIRE TROCAR PT 0.6MMX70MM$ 47.92 07029208 A4649 K-WIRE TROCAR PT 0.8MMX70MM$ 45.68 07029210 A4649 K-WIRE TROCAR PT 1.0MMX150MM$ 56.01 07029211 A4649 K-WIRE TROCAR PT 1.0MMX285MM$ 35.32 07029213 A4649 K-WIRE TROCAR PT 1.25MMX285MM$ 66.74 07029216 A4649 K-WIRE TROCAR PT 1.6MMX150MM$ 53.29 07029218 A4649 K-WIRE TROCAR PT 1.6MMX285MM$ 66.74 07029220 A4649 K-WIRE TROCAR PT 2.0MMX150MM$ 68.34 07029221 A4649 K-WIRE TROCAR PT 2.0MMX285MM$ 68.34 07029225 A4649 K-WIRE 2.5MMX150MM$ 314.70 07029226 A4649 K-WIRE TROCAR PT 2.5MMX285MM$ 39.17

191 07029230 A4649 K-WIRE TROCAR PT 3.0MMX150MM$ 30.80 07029262 C1769 GUIDEWIRE THREADED TIP 1.25MMX$ 920.84 07029265 C1769 GUIDEWIRE THREADED TIP 2.0MMX2$ 140.43 07029268 C1769 GUIDEWIRE THREADED TIP 2.8MMX3$ 287.14 07029271 A4649 K-WIRE THREADED TROCAR 1.6X150$ 105.37 07029272 C1769 GUIDEWIRE THREADED TIP 1.6MMX1$ 208.85 07029275 A4649 K-WIRE THREADED TROCAR 2.5MMX1$ 115.82 07029276 A4649 K-WIRE THREADED TROCAR 2.5MMX2$ 121.51 07029336 A4649 STEINMAN PIN 3.5MMX150MM$ 245.32 07029340 A4649 STEINMAN PIN 4.0MMX150MM$ 245.32 07029341 A4649 STEINMAN PIN 4.0MMX180MM$ 245.32 07029342 A4649 STEINMAN PIN 4.0MMX200MM$ 245.32 07029343 A4649 STEINMAN PIN 4.5MMX300MM$ 456.79 07029345 A4649 STEINMAN PIN 4.5MMX150MM$ 456.79 07029346 A4649 STEINMAN PIN 4.5MMX180MM$ 456.79 07029347 A4649 STEINMAN PIN 4.5MMX200MM$ 456.79 07029348 A4649 STEINMAN PIN 4.5MMX250MM$ 456.79 07029350 A4649 STEINMAN PIN 4.5MMX150MM$ 456.79 07029351 A4649 STEINMAN PIN 5.0MMX180MM$ 486.40 07029352 A4649 STEINMAN PIN 5.0MMX200MM$ 486.40 07029353 A4649 STEINMAN PIN 5.0MMX250MM$ 486.40 07029354 A4649 STEINMAN PIN 5.0MMX300MM$ 456.79 07029361 A4649 STEINMAN PIN CT 3.5MMX150MM$ 456.79 07029362 A4649 STEINMAN PIN CT 4.0MMX150MM$ 456.79 07029443 C1713 SCREW SCHANTZ 4.0MMX60MM$ 298.19 07029445 C1713 EXT FIX LGE SCHANTZ SCREW 4X10$ 441.57 07029454 C1713 SCREW SCHANTZ 5.0MMX150MM$ 436.53 07029455 C1713 SCREW SCHANTZ 5.0MMX170MM$ 436.53 07029456 C1713 SCREW SCHANTZ 5.0MMX200MM$ 436.53 07029457 C1713 SCREW SCHANTZ 5.0MMX250MM$ 436.53 07029474 C1713 EXT FIX LGE SCHANTZ SCREW 4.5X$ 498.40 07029475 C1713 EXT FIX LGE SCHANTZ SCREW 4.5X$ 498.40 07029476 C1713 EXT FIX LGE SCHANTZ SCREW 4.5X$ 602.83 07030000 A4649 APEX HOLE ELIM POSITIVE STOP$ 1,563.61 07030002 A4649 KIT LEAD ADAPTER #5866-37$ 1,140.78 07030003 A4649 KIT SERVICE MEDTRONIC 5873-C$ 380.65 07030005 A4649 BUR DIA RD XKP 4.0MMX70MM$ 947.46 07030006 A4649 KIT MAHURKAR 2-LUMEN 13.5FR$ 1,075.02 07030009 A4649 CATHETER HICKMAN 2-LUMEN 13.5F$ 1,227.00 07030020 A4649 CATHETER SWAN GANZ 7.5FR$ 617.49 07030027 A4649 TRAY TRACH INTRODUCER 100-A-HC$ 1,253.07 07030028 A4649 TRAY TRACH INTRODUCER 100-HC$ 1,290.00

192 07030033 C1779 LEAD PACEMAKER SPRINT 6947-65$ 17,715.40 07030035 C1779 LEAD PACEMAKER SPRINT 6947-58$ 16,322.36 07030046 C1779 LEAD PACEMAKER 5076-45$ 2,005.31 07030047 C1779 LEAD PACEMAKER 4076-58$ 1,847.00 07030048 C1779 LEAD PACEMAKER 4076-52$ 2,005.31 07030049 C1779 LEAD PACEMAKER 5568-53$ 1,847.00 07030050 C1779 LEAD PACEMAKER 5034-53$ 2,162.16 07030051 C1779 LEAD PACEMAKER 5034-58$ 2,162.16 07030052 C1779 LEAD PACEMAKER 5554-53$ 2,251.67 07030053 C1779 LEAD PACEMAKER 4558-58$ 2,331.28 07030054 C1779 LEAD PACEMAKER 5554-45$ 2,251.67 07030055 C1779 LEAD PACEMAKER 5054-58$ 2,251.67 07030056 C1779 LEAD PACEMAKER 5054-52$ 2,420.83 07030057 C1779 LEAD PACEMAKER 5534-53$ 2,162.16 07030058 C1779 LEAD PACEMAKER 4568-53$ 2,162.16 07030060 A4649 BLADE SCALPEL #22$ 1.25 07030062 C1779 LEAD PACEMAKER 5068-52$ 2,206.92 07030073 A4649 KIT LEAD ADAPTER #5866-24$ 1,273.42 07030075 A4649 KIT LEAD END CAP #5867-3$ 238.76 07030079 C1786 PACEMAKER PERM KSR 700SR$ 10,069.63 07030080 C1785 PACEMAKER THERA SR 89661B$ 6,913.36 07030081 C1785 PACEMAKER THERA DR 7960/62B$ 10,079.86 07030082 C1785 PACEMAKER PRODIGY SR 8162B$ 9,446.56 07030083 C1785 PACEMAKER THERA SR 8962B$ 8,654.93 07030084 C1785 PACEMAKER PERM KDR 700DR$ 11,490.60 07030088 A4649 KIT STYLETTE #6082-58$ 381.37 07030089 A4649 KIT STYLETTE #6093-58$ 338.36 07030092 A4649 ELECTROCAUTERY PEN HNDSWTH$ 35.11 07030100 A4649 TROCAR 5.0MMX100MM$ 907.23 07030101 C1769 GUIDE WIRE TERUMO RADIOFUCUS$ 291.91 07030200 A4649 TROCAR 12MM$ 900.89 07030205 A4649 ELECTRODE COAGULATING LGE 22/2$ 989.97 07030210 A4649 ELECTRODE CAUTERY NEDDLE$ 18.07 07030216 A4649 NEEDLE SPINAL WHITACARE 25GAX3$ 49.41 07030294 A4649 NEEDLE KEITH 2 1/2$ 35.64 07030295 A4649 NEEDLE KEITH 2 7/8$ 28.97 07030299 A4649 NEEDLE FERGUSON 4D 4.5$ 28.01 07030300 A4649 NEEDLE FERGUSON 6.5$ 24.96 07030380 A4649 SUTURE V-LOC 180 18 P-12 3-0$ 194.20 07030400 C1713 PLATE MICRO STR 4 HOLE$ 503.15 07030455 C1713 PLATE KLS STR 1.5 4 HOLE$ 474.67 07030545 A4649 MARKER SKIN STERILE$ 18.84

193 07030570 A4649 SURGICLIP APPLIER M-9.5-SML$ 686.54 07030571 A4649 SURGICLIP APPLIER M-11-MED$ 686.54 07030575 A4649 CURETTE UVAC CURVED 8MM$ 38.51 07030580 A4649 CURETTE UVAC STRAIGHT 8MM$ 38.84 07030585 A4649 CURETTE UVAC CURVED 9MM$ 22.25 07030590 A4649 CURETTE UVAC STRAIGHT 9MM$ 23.28 07030595 A4649 CURETTE UVAC CURVED 10MM$ 25.73 07030600 C1713 PLATE MICRO STR 6 HOLE$ 550.60 07030605 A4649 CURETTE UVAC CURVED 11MM$ 25.98 07030610 A4649 TAPE UMBILICAL 1/8X18$ 2.86 07030615 A4649 CURETTE UVAC CURVED 12MM$ 16.11 07030655 C1713 PLATE KLS ELG STR 1.5 6 HOLE$ 550.60 07030755 A4649 CURETTE EAR WAX-SML$ 73.66 07030756 A4649 CURETTE EAR WAX-LGE$ 65.11 07030800 C1713 PLATE MICRO STR 8 HOLE$ 740.47 07030905 A4649 ELECTRODE TUR HOOK 22/24FR$ 659.81 07031001 A4649 CANNULA DLP-IMA 1.8 1MM TIP C$ 101.52 07031002 A4649 CATHETER ENDOSCOPIC CHOLANGIO$ 173.66 07031006 A4649 LIGATURE-MERSILENE RS20$ 481.03 07031010 A4649 NEEDLE BIOPSY TRUCUT 14GA$ 917.41 07031011 A4649 DRILL BIT MQC 1.1MMX60MM$ 230.11 07031015 A4649 DRILL BIT MQC 1.1MMX85MM$ 248.70 07031019 A4649 DRILL BIT MQC 2.0MMX100MM$ 274.08 07031020 A4649 SUTURE SUPRAMID 2-0 1/2C TA PT$ 30.70 07031021 A4649 SUTURE SUPRAMID 3-0 1/2C TA PT$ 30.70 07031022 A4649 SUTURE SUPRAMID 4-0 1/2C TA PT$ 22.94 07031025 A4649 DRILL BIT QC 2.5MMX110MM$ 151.18 07031030 A4649 NEEDLE BREAST BX LOC'ZN 20GAX3$ 186.10 07031031 A4649 DRILL BIT QC 3.2MMX145MM$ 422.72 07031035 A4649 DRILL BIT QC 3.5MMX110MM$ 148.25 07031044 A4649 DRILL BIT QC 4.5MMX145MM$ 274.08 07031050 A4649 NEEDLE BREAST BX LOC'ZN 20GAX5$ 228.42 07031063 A4649 DRILL BIT CANNULATED 5.0MM$ 897.34 07031065 A4649 DRILL BIT CANNULATED 3.2MM$ 791.78 07031066 A4649 DRILL BIT CANNULATED 4.5MM$ 912.78 07031067 A4649 DRILL BIT CANNULATED 2.7MM$ 915.93 07031070 C1713 PLATE KLS ELG L L/R 1.5$ 1,040.48 07031085 C1713 PLATE T KLS 1.5 6 HOLE$ 930.33 07031100 A4649 NEEDLE BREAST BX LOC'ZN 20GAX1$ 228.42 07031118 A4649 SPLINT NASAL W/ FELT SML$ 18.33 07031119 A4649 SPLINT NASAL W/ FELT MED$ 18.33 07031120 A4649 SPLINT NASAL W/ FELT LGE$ 18.33

194 07031121 A4570 SPLINT NASAL W/O FELT MED$ 14.63 07031122 A4649 SPLINT NASAL W/O FELT LGE$ 14.63 07031123 A4649 SPLINT NASAL W/ FOREHEAD EXT$ 16.51 07031124 A4649 SPLINT NASAL W/ FOREHEAD-XLGE$ 19.28 07031131 A4649 SPHINCTEROTOME CANNULATING - E$ 1,201.18 07031170 C1713 PLATE-L MICRO RT 1.5MM$ 912.88 07031185 C1713 PLATE XTR LONG KLS L-LEFT 1.5$ 930.33 07031310 A4649 LIGATOR ENDO 9.5-11.5MM 122CM$ 826.30 07031485 C1713 PLATE-L MICRO R/L$ 930.33 07031585 C1713 PLATE Y KLS 1.5$ 930.33 07031600 C1713 PLATE MICRO STR 16 HOLE$ 1,170.76 07031863 A4649 SUTURE PLAIN 2-0 27 FN-2$ 21.69 07032000 A4649 BLADE ARTHRO RESECTOR 3.5MM$ 652.52 07032005 C1713 SCREW CANC POLARUS 5MMX25MM$ 475.81 07032010 A4649 PATCH HERNIA-LARGE$ 1,351.26 07032070 C1713 PLATE-Y MICRO LONG$ 930.33 07032255 C1713 PLATE-DBLE-Y MICRO 1.5MM$ 927.15 07032446 A4649 SET ENDOMETRIAL SAMPLING$ 47.30 07032655 C1713 PLATE-X MICRO REGULAR$ 949.32 07033008 C1713 PLATE KLS STR 1.0MM 8 HOLE$ 928.70 07033152 C1713 NAIL UNIV TIBIAL 11MMX330MM$ 1,812.14 07033200 A4649 SMARTSET BONE CEMENT HV 40G$ 695.26 07033230 A4649 KIT SOFTCELL CATH 12.5FR 23CM$ 1,036.32 07033252 A4649 NAIL UNIV TIBIAL 12MMX330MM$ 1,330.09 07033331 A4649 BIOPSY TRU-PUNCH 2.0MM$ 15.24 07033500 A4649 GRAFT DEBAKEY BIF 16X8MM$ 529.23 07033800 A4649 GUIDE PIN DHS 2.5MMX230MM$ 252.62 07034000 A4649 BUR DIA RD EX CRSE XKP 5.0MMX5$ 948.22 07034031 A4649 VEIN STRIPPER$ 184.15 07034109 A4649 STENT METALLIC URETERAL 6FR$ 1,996.67 07034110 A4649 STENT METALLIC URETERAL 6FR$ 1,996.67 07034111 A4649 STENT METALLIC URETERAL 6FR$ 1,996.67 07034112 A4649 STENT METALLIC URETERAL 6FR$ 1,996.67 07034120 A4649 KIT SOFTCELL CATH 12.5FR 12CM$ 1,036.32 07034241 L5999 PROSTHESIS HIP AUSTIN MOORE 41$ 2,628.63 07034242 L5999 PROSTHESIS HIP AUSTIN MOORE 42$ 2,628.63 07034243 L5999 PROSTHESIS HIP AUSTIN MOORE 43$ 2,628.63 07034245 L5999 PROSTHESIS HIP AUSTIN MOORE 45$ 2,622.78 07034247 L5999 PROSTHESIS HIP AUSTIN MOORE 50$ 2,622.78 07034520 C1713 NAIL ELASTIC TI 1.5MMX300MM$ 1,232.10 07034540 C1713 NAIL TIB TI CANN 11MMX300MM$ 3,266.63 07034543 C1713 NAIL TIB TI CANN 11MMX315MM$ 3,266.63

195 07034544 C1713 NAIL ELASTIC TI 2.0MMX440MM$ 1,267.60 07034546 C1713 NAIL TIB TI CANN 11MMX330MM$ 3,266.63 07034549 C1713 NAIL TIB TI CANN 11MMX345MM$ 3,266.63 07034552 C1713 NAIL TIB TI CANN 11MMX360MM$ 3,266.63 07034555 C1713 NAIL TIB TI CANN 11MMX375MM$ 3,266.63 07034558 C1713 NAIL TIB TI CANN 11MMX390MM$ 3,266.63 07034561 C1713 NAIL TIB TI CANN 11MMX405MM$ 3,266.63 07034568 C1713 NAIL ELASTIC TI 2.5MMX440MM$ 1,313.25 07034589 C1785 PACEMAKER AZURE W1DR01 XT DR$ 10,430.21 07034629 C1713 NAIL ELASTIC TI 4.0MMX440MM$ 1,442.56 07034640 C1722 PACEMAKER AZURE W3SR01 S SR$ 7,017.41 07034643 C1713 NAIL TIB TI CANN 12MMX315MM$ 3,266.63 07034649 C1713 NAIL TIB TI CANN 12MMX345MM$ 3,266.63 07034652 C1713 NAIL TIB TI CANN 12MMX360MM$ 3,266.63 07034655 C1713 NAIL TIB TI CANN 12MMX375MM$ 3,266.63 07034658 C1713 NAIL TIB TI CANN 12MMX390MM$ 3,266.63 07034661 C1713 NAIL TIB TI CANN 12MMX405MM$ 3,266.63 07034800 A4649 SUTURE PLAIN 2-0 27 CT-1$ 33.50 07035000 A4649 BLADE ARTHRO TOMCAT 3.5MM$ 367.97 07035105 A4649 STENT MARDIS SOFT 4.8FRX20CM$ 544.68 07035501 A4649 MEDULLARY TUBE$ 905.82 07035530 C1713 BIPOLAR SELF CENT HIP 52X28$ 947.63 07035590 A4649 DRILL BIT QC 4.0MM/4.5MMX22MM$ 148.88 07036000 A4649 SUTURE SILK 4-0 17X18$ 32.27 07036196 C1713 PLATE CONDYLAR MD HD R/L 2.0$ 1,157.78 07036296 C1713 PLATE CONDYLAR MD HD RT 2.0MM$ 1,031.65 07036816 C1713 PLATE LP STR 16 HOLE$ 825.92 07037210 A4649 CANNULA BLUNT 15GAX1.5$ 7.86 07037504 C1713 PLATE H KLS 2.0$ 930.33 07037563 A4649 BLADE ARTHRO SM JT TOMCAT 3.5M$ 396.90 07037665 A4649 SYSTEM HALO VEST MEDIUM$ 3,634.53 07037704 C1713 PLATE L KLS LEFT 2.0$ 930.33 07037904 C1713 PLATE L ELG KLS RT/LT 2.0$ 930.33 07038008 C1758 CATHETER URETERAL CONE TIP 8FR$ 86.84 07038104 C1713 PLATE-L ELONG LT 2.0MM 4-HOLE$ 917.64 07038606 C1713 PLATE T KLS 2.0$ 930.33 07039000 A4649 TUBING PENROSE 7/8X18$ 6.01 07039005 C1713 PLATE Y KLS 2.0$ 930.33 07039042 C1713 PLATE COND DCP LT 9 HOLE$ 1,505.69 07039072 A4649 PROBE LITHOTRIPSY 3.5X400CM$ 1,071.87 07039352 A4649 TUBE STAINLESS 11MMX150MM$ 941.37 07039353 A4649 TUBE STAINLESS 11MMX200MM$ 941.37

196 07039354 A4649 TUBE STAINLESS 11MMX250MM$ 969.89 07039355 A4649 TUBE STAINLESS 11MMX300MM$ 969.89 07039356 A4649 TUBE STAINLESS 11MMX350MM$ 969.89 07039357 A4649 TUBE STAINLESS 11MMX400MM$ 1,001.55 07039364 A4649 EXT FIX LGE ADJUSTABLE CLAMP$ 1,363.87 07039366 A4649 EXT FIX LGE TRANSVERSE CLAMP$ 1,515.15 07039369 A4649 EXT FIX LGE OPEN CLAMP$ 1,147.10 07039371 A4649 EXT FIX LGE UNIV JOINT 2 TUBES$ 1,809.84 07039375 A4649 EXT FIX LGE UNIVERSAL CLAMP$ 1,623.74 07039390 C1713 EXT FIX CONNECT BAR 5MMX100MM$ 203.01 07039391 C1713 EXT FIX CONNECT BAR 5MMX150MM$ 203.01 07039392 C1713 EXT FIX CONNECT BAR 5MMX200MM$ 203.01 07039393 C1713 EXT FIX CONNECT BAR 5MMX250MM$ 203.01 07039394 C1713 EXT FIX CONNECT BAR 5MMX300MM$ 203.01 07039400 A4649 SPECIMEN RETRIEVAL POUCH 15MM$ 675.94 07039480 C1713 EXT FIX LGE ROD 11MMX100MM$ 1,124.01 07039481 C1713 EXT FIX LGE ROD 11MMX125MM$ 1,017.38 07039482 C1713 EXT FIX LGE ROD 11MMX150MM$ 1,017.38 07039483 C1713 EXT FIX LGE ROD 11MMX200MM$ 1,017.38 07039484 C1713 EXT FIX LGE ROD 11MMX250MM$ 1,147.10 07039485 C1713 EXT FIX LGE ROD 11MMX300MM$ 1,039.55 07039486 C1713 EXT FIX LGE ROD 11MMX350MM$ 1,039.55 07039487 C1713 EXT FIX LGE ROD 11MMX400MM$ 1,175.52 07039488 C1713 EXT FIX LGE ROD 11MMX450MM$ 1,066.46 07039489 C1713 EXT FIX LGE ROD 11MMX500MM$ 1,066.46 07039490 C1713 EXT FIX LGE ROD 11MMX550MM$ 1,094.96 07039491 C1713 EXT FIX LGE ROD 11MMX600MM$ 1,094.96 07039497 C1713 EXT FIX LGE CAP ROD 11MM$ 10.44 07039554 A4649 EXT FIX SML OPEN CLAMP 4MM/2.5$ 1,232.37 07039555 A4649 EXT FIX SML OPEN CLAMP 4MM/4MM$ 1,232.37 07039556 A4649 EXT FIX SML CLAMP 4MM/2.5MM$ 1,207.50 07039557 A4649 EXT FIX SML CLAMP 4MM/4MM$ 1,207.50 07039558 A4649 EXT FIX SML SPRING LOADED NUT$ 218.34 07039561 C1713 EXT FIX SML CRB ROD 4MMX80MM$ 245.32 07039562 C1713 EXT FIX SML CRB ROD 4MMX100MM$ 245.32 07039563 C1713 EXT FIX SML CRB ROD 4MMX120MM$ 245.32 07039565 C1713 EXT FIX SML CRB ROD 4MMX160MM$ 334.12 07039566 C1713 EXT FIX SML CRB ROD 4MMX180MM$ 334.12 07039567 A4649 EXT FIX SML CRB ROD 4MMX200MM$ 334.12 07039571 C1713 EXT FIX CONNECT BAR 4MMX80MM$ 181.89 07039572 C1713 EXT FIX CONNECT BAR 4MMX100MM$ 114.19 07039573 C1713 EXT FIX CONNECT BAR 4MMX120MM$ 114.19

197 07039575 C1713 EXT FIX CONNECT BAR 4MMX160MM$ 142.13 07039576 C1713 EXT FIX CONNECT BAR 4MMX180MM$ 236.86 07039577 C1713 EXT FIX CONNECT BAR 4MMX200MM$ 236.86 07039606 C1713 PLATE-DBLE-Y LP REGULAR$ 996.79 07040000 A4649 SUTURE CHROMIC 0 8X18 MD-5$ 209.35 07040005 C1713 ARTICUL/EZE M HEAD 36MM +12$ 1,430.63 07040020 C1713 NAIL FEMUR TFNA LT 10MMX420MM$ 4,758.96 07040076 A4649 IMPLANT PISTON FLUORO 0.6MMX4M$ 134.21 07040078 A4649 IMPLANT PISTON FLUORO 0.6MMX4.$ 134.21 07040080 A4649 IMPLANT PISTON FLUORO 0.6MMX5M$ 134.21 07040222 C1758 CATHETER URETERAL WTL LT 4FR$ 86.45 07040338 A4649 IMPLANT PISTON MCGEE 5MMX4.25M$ 777.17 07040339 A4649 IMPLANT PISTON MCGEE 5MMX4.5MM$ 777.17 07040340 A4649 IMPLANT PISTON MCGEE 5MMX4.75M$ 777.17 07040380 A4649 SUTURE V-LOC 180 GS-21 12"$ 168.97 07040415 A4649 STONE BASKET HELICAL EXPAND 21$ 1,090.51 07040422 C1713 PLATE DCP NR 4.5MM 4-HOLE$ 773.99 07040622 A4649 FORCEP COLD BIOPSY 40622$ 160.13 07040804 C1713 PLATE-Z LP R/L LONG$ 930.33 07040904 C1713 PLATE-Z LT 100* 2.0MM 4-HOLE$ 912.88 07041000 A4649 SUTURE PLAIN 0 54 REEL$ 49.14 07041002 A4649 CATHETER OPEN-END W/ WIRE SZ-4$ 86.45 07041012 A4649 BLADE ARTHRO BB 4MM 12 FLUTE$ 539.09 07041020 C1713 NAIL FEMUR TFNA 10MMX300MM$ 4,758.96 07041041 C1713 SCREW CORTEX ASIF 4.5MMX14MM$ 54.14 07041042 A4649 CATHETER BOUGIE THREADED 14FR$ 497.71 07041170 A4649 SYRINGE TOOMEY 70CC$ 21.69 07041341 A4649 CATHETER CAPD-ADULT$ 1,204.37 07041410 A4649 ELECTRODE CUTTING LOOP 24FR$ 355.28 07042000 A4649 KIT REPAIR GROSHONG 2-LUMEN 9.$ 773.59 07042011 A4649 TAPE UMBILICAL 1/8X30$ 20.20 07042021 C1713 ARTICUL/EZE BALL 32 +1 GR$ 1,430.63 07042041 A4649 BURR 4MM COARSE DIAMOND BALL$ 152.64 07042042 A4649 BURR 5MM COARSE DIAMOND BALL$ 152.64 07042043 A4649 FLUTED ROUTER 1.8MM X 16MM A$ 165.55 07042045 A4649 SUTURE PASS DRILL 1.9MM ANS$ 165.55 07042050 A4649 BURR 5MM COARSE DIAMOND BALL$ 152.64 07042051 A4649 PACK CUSTOM OPEN HEART$ 1,095.08 07042052 A4649 PACK DRAPE OPEN HEART$ 803.62 07042053 A4649 KIT E-PACK PROCEDURE$ 1,006.13 07042060 A4649 SUTURE SUPRAMID 5-0 3/8C WT RE$ 41.96 07042085 C1713 SCREW CORTEX MD HD 2.4MMX6MM$ 342.21

198 07042086 C1713 SCREW CORTEX MD HD 2.4MMX7MM$ 342.21 07042087 C1713 SCREW CORTEX MD HD 2.4MMX8MM$ 342.21 07042096 C1713 PLATE CONDYLAR MD HD RT 2.4MM$ 1,254.95 07042097 C1713 PLATE CONDYLAR MD HD LT 2.4MM$ 1,254.95 07042098 C1713 SCREW CORTEX MD HD 2.4MMX9MM$ 342.21 07042099 C1713 SCREW CORTEX MD HD 2.4MMX10MM$ 318.52 07042182 C1713 PLATE DHS 140* 4 HOLE 38MMX78M$ 1,253.27 07042800 C1713 SCREW CORTEX ST 1.5MMX24MM$ 158.60 07043000 A4649 BLADE ARTHRO CUTTER DBL BITE 4$ 511.59 07043152 C1713 NAIL UNIV TIBIAL 11MMX345MM$ 1,270.50 07043182 C1713 PLATE DHS 145* 4 HOLE 78MM$ 1,289.72 07043252 C1713 NAIL UNIV TIBIAL 12MMX345MM$ 1,334.03 07043500 A4649 GRAFT DEBAK BIF 19X9.5MM$ 529.23 07044000 A4649 BUR ACORN XKP 5.0MMX50MM$ 995.83 07044182 C1713 PLATE DHS 150* 4 HOLE 38MMX78M$ 1,151.96 07044392 A4649 STEINMAN PIN 4.5MMX120MM$ 456.79 07044800 A4649 SUTURE VICRYL 0 U 27 CT-1$ 28.49 07044916 A4649 DRILL TWIST KLS 1.5MMX50MM$ 735.95 07045000 A4649 BUR DIA RD XKP 5.0MMX70MM$ 958.59 07045100 C1721 IMPLANT DEFIBRILLATOR D154AWG$ 33,986.79 07045200 A4649 DRILL TWIST KLS 1.1MMX50MM$ 820.52 07045271 A4649 BILIARY LOCKING DEVICE-ERCP$ 134.21 07045900 A4649 CATHETER BILIARY BALLOON 4MMX4$ 1,233.69 07045920 A4352 CATHETER BILIARY BALLOON 6MMX4$ 1,233.69 07046000 A4649 SUTURE SILK 3-0 17X18$ 38.05 07046001 A4649 LARYNGEAL MASK AIRWAY SZ-2$ 190.68 07046031 C1713 PLATE STR MD HD 1.5 6 HOLE$ 1,044.03 07046032 C1713 PLATE STR MD HD 1.5 12 HOLE$ 1,102.69 07046233 C1713 PLATE T HEAD MD HD 1.5 3 HOLE$ 1,079.59 07046234 C1713 PLATE T HEAD MD HD 1.5 4 HOLE$ 1,090.25 07046480 C1713 PLATE H 1.5MM 4 HOLE$ 1,029.49 07046482 C1713 PLATE H EXT MD HD 1.5MM RT 8-H$ 1,090.25 07046483 C1713 PLATE EXT MD HD LT 1.5MM 8-HOL$ 872.97 07046593 C1713 EXT FIX SML CRB ROD 4MMX140MM$ 334.12 07046612 C1713 PLATE Y MD HD 1.5$ 1,079.59 07046911 A4649 DRILL TWIST KLS 1.5MMX105MM$ 820.52 07047000 A4649 SUTURE CHROMIC 0 27 BP-1$ 92.77 07047031 C1713 PLATE STR TI 6-HOLE 2.0 MM$ 996.79 07047032 C1713 PLATE STR TI 12-HOLE 2.0 MM$ 1,052.92 07047232 C1713 PLATE T HEAD MD HD 2.0 2 HOLE$ 1,079.59 07047233 C1713 PLATE STR TI 3-HOLE 2.0 MM$ 1,052.92 07047593 C1713 EXT FIX CONNECT BAR 4MMX140MM$ 157.06

199 07047612 C1713 PLATE Y MD HD 2.0$ 1,079.59 07048001 A4649 LARYNGEAL MASK AIRWAY SZ-2.5$ 190.68 07049000 L5999 PROSTHESIS HIP AUSTIN MOORE 49$ 2,401.14 07049600 C1713 SCREW CORTEX MD HD 1.3MMX14MM$ 301.15 07049906 C1713 PLATE STR TI 6-HOLE 2.4 MM$ 1,035.15 07049912 C1713 PLATE STR TI 12-HOLE 2.4 MM$ 1,072.47 07049913 C1713 PLATE T HEAD MD HD 2.4 2 HOLE$ 1,124.01 07049914 C1713 PLATE T HEAD MD HD 2.4 3 HOLE$ 1,143.53 07049915 C1713 PLATE Y MD HD 2.4$ 1,132.89 07049924 C1713 PLATE LC-DCP MD HD 2.4 4 HOLE$ 1,196.84 07049926 C1713 PLATE LC-DCP MD HD 2.4 6 HOLE$ 1,243.04 07049928 C1713 PLATE LC-DCP MD HD 2.4 8 HOLE$ 1,278.55 07049931 C1713 PLATE LC-DCP MD HD 2.0 4 HOLE$ 1,090.25 07049936 C1713 PLATE LC-DCP MD HD 2.0 6 HOLE$ 1,138.22 07049938 C1713 PLATE LC-DCP MD HD 2.0 8 HOLE$ 1,182.62 07050003 C1713 FEMORAL STEM TAPER SZ-10 HI$ 2,800.00 07050005 C1713 ARTICUL/EZE M HEAD 36MM +15.5$ 1,430.63 07050020 C1713 NAIL FEMUR TFNA RT 10MMX440MM$ 4,758.96 07050040 L5999 PROSTHESIS HIP AUSTIN MOORE 40$ 1,728.30 07050044 L5999 PROSTHESIS HIP AUSTIN MOORE 44$ 2,291.89 07050046 L5999 PROSTHESIS HIP AUSTIN MOORE 46$ 2,534.12 07050051 A4649 PROSTHESIS HIP AUSTIN MOORE 51$ 2,784.17 07050053 A4649 PROSTHESIS HIP AUSTIN MOORE 53$ 2,784.17 07050054 A4649 PROSTHESIS HIP AUSTIN MOORE 54$ 2,784.17 07050081 C1713 PLATE MINI 8 HOLE$ 541.12 07050100 A4649 SILASTIC SHEETING 0.007 RFD$ 1,160.27 07050101 C1769 GUIDEWIRE LUBRIGLIDE$ 214.40 07050201 A4649 BAIR HUGGER MACHINE$ 24.54 07050320 A4649 CANNULA BILIARY 5FR 0.35/200CM$ 127.66 07050401 A4649 COAGULATOR STR SERFAS ENERGY 3$ 919.75 07050500 E0830 HALO TRACTION SYSTEM-LGE$ 3,802.31 07050522 A4649 TUBE ENDOTRACH REINFORCED 7.5$ 420.07 07050553 A4649 TUBE ENDOTRACH REINFORCED 7.0$ 420.07 07050602 A4649 SET IV EXTENSION 6 PORT$ 62.76 07050696 C1713 SCREW ST TI 2.4 MM X 6-32 MM$ 389.21 07050730 C1734 PLATE NR SHORT 2-HOLE STRAIGHT$ 185.56 07050900 A4649 TUBE IRRIG W/ HANDPIECE/SMOKE$ 493.38 07050905 A4649 PROBE EHL 9FR$ 1,033.63 07051000 C1713 ARTICUL/EZE M HEAD 36MM +1.5$ 1,430.63 07051020 A4649 NEEDLE TOUHY 14GA$ 912.26 07051021 A4649 GLOVES RADIATION REDUCTION$ 649.98 07051113 A4649 WOOD DOWEL 1/2INX48IN$ 14.94

200 07051220 A4649 KIT BALLOON DILATION CATH 4CM$ 1,293.33 07051255 A4649 BLADE SAW 26MMX0.65MM 512.55$ 91.36 07051278 A4649 BLADE SAW 8MMX13MM 512.78$ 59.22 07051279 A4649 BLADE SAW 8MMX18MM 512.79$ 284.21 07051280 A4649 KIT BALLOON DILATION CATH 6CM$ 1,293.33 07051896 C1713 SCREW CORTEX MD HD 2.4MMX18MM$ 389.55 07051915 A4649 BLADE SAW 60MMX14MM 519.15$ 270.68 07051917 A4649 BLADE SAW 80MMX27MM 519.17$ 471.82 07051919 A4649 BLADE SAW 80MMX50MM 519.19$ 531.11 07051925 A4649 BLADE SAW 35MMX14MM 519.25$ 315.76 07052000 C1713 ARTICUL/EZE M HEAD 36MM +5$ 1,430.63 07052052 C1713 NAIL UNIV TIBIAL 10MMX255MM$ 1,492.83 07052096 C1713 SCREW CORTEX MD HD 2.4MMX20MM$ 389.55 07052100 A4927 GLOVES SURG S-6 ULTRA$ 13.80 07052150 C1713 SCREW MALLEOLAR 4.5MMX25MM$ 266.46 07052152 C1713 NAIL UNIV TIBIAL 11MMX255MM$ 2,106.65 07052200 C1713 PATCH HERNIA W/ STRAP LGE$ 853.10 07052252 C1713 NAIL UNIV TIBIAL 12MMX255MM$ 1,334.03 07052296 C1713 SCREW CORTEX MD HD 2.4MMX22MM$ 389.55 07052352 C1713 NAIL UNIV TIBIAL 13MMX255MM$ 1,344.38 07052496 C1713 SCREW CORTEX MD HD 2.4MMX24MM$ 389.55 07052696 C1713 SCREW CORTEX MD HD 2.4MMX26MM$ 389.55 07052896 C1713 SCREW CORTEX MD HD 2.4MMX28MM$ 389.55 07053000 C1713 ARTICUL/EZE M HEAD 36MM +8.5$ 1,430.63 07053096 C1713 SCREW CORTEX MD HD 2.4MMX30MM$ 389.55 07053296 C1713 SCREW CORTEX MD HD 2.4MMX32MM$ 434.16 07053319 A4649 KIT SOFTCELL CATH 12.5FR 19CM$ 1,051.25 07053392 A4649 STEINMAN PIN 3.5MMX120MM$ 245.32 07054000 A4649 BUR ACORN XKP 6.0MMX50MM$ 940.66 07054900 A4649 SPLINT NASAL W/AIRWAY$ 168.67 07055004 C1713 PLATE MINI 4 HOLE$ 408.20 07055008 C1713 PLATE KLS STR 2.0 8 HOLE$ 1,282.14 07055016 A4649 CATHETER WHISTLE TIP LATEX 16$ 41.04 07055018 A4649 CATHETER WHISTLE TIP LATEX 18$ 41.04 07055020 A4649 CATHETER WHISTLE TIP LATEX 20$ 41.04 07055022 A4649 CATHETER WHISTLE TIP LATEX 22$ 41.04 07055024 A4649 CATHETER WHISTLE TIP LATEX 24$ 41.04 07055026 A4649 CATHETER WHISTLE TIP LATEX 26$ 41.04 07055080 A4649 TUBE GAS SAMPLE$ 7.11 07055204 C1713 PLATE KLS ELG STR 2.0 4 HOLE$ 1,184.42 07055500 C1713 SCREW LOCK TI T25 5MMX60MM$ 857.67 07056000 A4649 BUR DIA RD EX CRSE XKP 3.0MMX9$ 967.53

201 07056082 C1718 SCREW LAG DHS/DCS 12.7MMX65MM$ 1,063.29 07057000 C1713 NAIL TIB TI CANN 10MMX390MM$ 3,266.63 07057300 C1713 LINER ALTRX NEUTRAL 36MMX58MM$ 1,247.50 07058061 C1713 SCREW CANCEL PT-16 6.5MMX8.5MM$ 310.88 07058113 C1713 PLATE KLS ELG L-ELONG RT 1.5MM$ 952.48 07058352 A4649 RELOAD ENDOPATH REG 35MM$ 920.18 07058600 A4649 TROCAR CANNULA 5MMX150MM$ 587.73 07058948 A4649 BLADE SAW STERNAL SARNS$ 507.44 07059032 A4649 BLADE SAW STERNUM$ 78.26 07059042 A4649 TROCAR NEURO SPLIT 10CM DISP$ 1,029.96 07059100 C1713 BOLT LOCKING 4.9MMX100MM$ 925.55 07059120 A4649 V-LANCE OPHTHALMIC 20GA$ 1,053.80 07059203 A4649 NEEDLE FERGUSON 2D 2.5$ 28.97 07059222 A4649 BLADE NEURO STRAIGHT FLUTED$ 1,041.02 07059522 C1713 BOLT LOCKING 4.9MMX52MM$ 460.99 07060000 A4649 PROBE INJECTION GOLD 7FR - ERC$ 1,285.41 07060003 A4649 CONNECTOR TERUMO 3/8X3/8 CBP$ 67.64 07060005 A4649 CONNECTOR TERUMO 1/2X1/2 CBP$ 67.64 07060007 A4649 CONNECTOR TERUMO W/LL 1/4X1/4$ 78.95 07060009 A4649 CONNECTOR TERUMO W/LL 3/8X3/8$ 78.95 07060010 A4649 CONNECTOR TERUMO W/LL 1/2X1/2$ 78.95 07060011 A4649 CONNECTOR TERUMO 1/4X3/8 CBP$ 67.64 07060012 A4649 CONNECTOR TERUMO 1/2X3/8 CBP$ 67.64 07060015 A4649 CONNECTOR TERUMO W/LL 1/2X3/8$ 78.95 07060016 A4649 CATHETER HICKMAN 1-LUMEN 9.6FR$ 1,455.81 07060020 A4649 NAIL FEMUR TFNA 10MMX440MM$ 4,758.96 07060069 A4649 CATHETER HICKMAN HEMO PC 13.5F$ 1,071.16 07060082 A4649 SURGICAL TOWEL ABSORBENT$ 22.04 07060100 A4649 KIT CEN/VEN ACCESS 2-LUMEN 9FR$ 732.86 07060101 A4649 BAIR BLANKET UPPER BODY$ 109.34 07060120 A4649 TRAY THORACOTOMY$ 47.05 07060127 C1713 SCREW LAG DHS/DCS 12.7MMX60MM$ 1,087.05 07060154 A4649 CATHETER FOGARTY 5FR 40CM$ 241.09 07060280 A4649 TUBE MILLER-ABBOTT 16FR$ 598.74 07060290 A4649 TUBE MILLER-ABBOTT 18FR$ 598.74 07060400 A4649 CHLORAPREP APPLICATOR 3ML$ 19.46 07060422 C1713 PLATE DCP NR 4.5MM 6-HOLE$ 879.73 07060442 C1758 CATHETER URETERAL SPIRAL TIP 6$ 106.96 07060600 C1713 LINER ALTRX NEUTRAL 36MMX60MM$ 1,309.88 07060622 C1713 PLATE DCP BR 4.5MM 6-HOLE$ 991.40 07060800 C1713 SCREW CORTEX ST 1.5MMX6MM$ 86.72 07060810 C1713 SCREW CORTEX ST 2.0MMX6MM$ 133.21

202 07060825 A4649 CHLORAPREP APPLICATOR 26ML$ 94.65 07061010 A4649 SCREW CD ST 2.7MM X 10MM$ 351.26 07061028 A4649 TUBE ENDOBRONCHIAL ANG LT 28MM$ 555.50 07061035 A4649 TUBE ENDOBRONCHIAL RT ANG LT 3$ 555.50 07061037 A4649 TUBE ENDOBRONCHIAL RT ANG LT 3$ 721.96 07061039 A4649 TUBE ENDOBRONCHIAL 2-LUMEN RT$ 771.03 07061041 A4649 TUBE ENDOBRONCHIAL 2-LUMEN RT$ 771.03 07061042 A4649 CATHETER BOUGIE THREADED 16FR$ 533.35 07061292 A4649 K-WIRE 1.6MMX150MM$ 65.96 07061320 A4649 ELECTRODE CUTTING LOOP 26FR$ 406.04 07061510 A4649 ELECTRODE EVAP WING 26FR$ 804.37 07062000 A4649 BLADE ARTHRO RESECTOR 5.5MM$ 609.64 07062026 A4649 TUBE ENDOBRONCHIAL RT ANG RT 2$ 606.60 07062035 A4649 TUBE ENDOBRONCHIAL RT ANG RT 3$ 606.60 07062500 C1713 SCREW CORTEX MD HD 1.0MMX6MM$ 318.05 07062510 A4649 ADAPTER BRONCHOSCOPE FIBEROPTI$ 127.87 07062800 C1713 SCREW CORTEX ST 1.5MMX26MM$ 131.11 07062952 C1713 BOLT LOCKING 4.9MMX26MM$ 917.12 07064800 A4649 SUTURE SILK 2 30 MH$ 9.99 07066000 A4649 BUR ROUND FLUTED XKP 3.0MMX110$ 937.71 07066201 C1769 GUIDEWIRE PFTE 0.038X150CM$ 172.90 07066396 C1713 PLATE CONDYLAR MD HD LT 1.5MM$ 1,157.78 07066496 C1713 PLATE CONDYLAR MD HD RT 1.5MM$ 1,031.65 07066660 A4649 BILIARY INFLATION DEVICE-ERCP$ 907.79 07066990 A4346 SUTURE PDS 0-CTX Z990G$ 112.38 07067041 C1713 SCREW CORTEX ASIF 4.5MMX76MM$ 181.89 07068600 C1713 SCREW CORTEX MD HD 1.3MMX6MM$ 301.15 07069018 C1713 SCREW CORTEX MD HD 1.5MMX10MM$ 203.01 07069028 A4649 SCREW CORTEX MD HD 1.5MMX20MM$ 285.47 07069118 A4649 SCREW CORTEX MD HD 1.5MMX11MM$ 203.01 07069182 C1713 PLATE DCS 95* 12 HOLE 210MM$ 1,358.10 07069218 C1713 SCREW CORTEX MD HD 1.5MMX12MM$ 203.01 07069228 C1713 SCREW CORTEX MD HD 1.5MMX22MM$ 285.47 07069318 C1713 SCREW CORTEX MD HD 1.5MMX13MM$ 285.47 07069418 C1713 SCREW CORTEX MD HD 1.5MMX14MM$ 203.01 07069428 C1713 SCREW CORTEX MD HD 1.5MMX24MM$ 203.01 07069600 C1713 SCREW CORTEX MD HD 1.3MMX16MM$ 301.15 07069608 C1713 SCREW CORTEX MD HD 2.0MMX6MM$ 216.55 07069708 C1713 SCREW CORTEX MD HD 1.5MMX7MM$ 203.01 07069808 C1713 SCREW CORTEX MD HD 1.5MMX8MM$ 203.01 07069818 C1713 SCREW CORTEX MD HD 1.5MMX18MM$ 203.01 07069896 A4649 PIN BUTTRESS MD HD 1.8X18$ 353.63

203 07069908 C1713 SCREW CORTEX MD HD 1.5MMX9MM$ 203.01 07070000 A4649 PROBE INJECTION GOLD 10FR - ER$ 1,285.41 07070003 A4649 RELOAD ENDOSTITCH 0 SILK$ 225.42 07070004 A4649 RELOAD ENDOSTITCH 2-0 SILK$ 225.42 07070012 A4649 RELOAD ENDOSTITCH 0 BRALON$ 207.93 07070016 A4649 PACK CV TUBING-CBP$ 1,322.32 07070020 C1713 NAIL FEMUR TFNA 10MMX170MM$ 3,570.90 07070053 A4649 RELOAD ENDOSTITCH 2-0 POLY$ 207.93 07070071 A4649 RELOAD ENDOSTITCH 3-0 POLY$ 207.93 07070125 A4649 ELECTRODE TUR COAG REG 26/28FR$ 329.89 07070358 A4649 CATHETER THORACIC TAPER TIP 32$ 54.39 07070432 A4649 CATHETER THORACIC RT ANG 28FR$ 78.51 07070500 A4649 ELECTRODE CUT LOOP MONO 24FR$ 801.87 07070506 A4649 ELECTRODE CUT LOOP MONO 27FR$ 925.34 07070700 A4649 TUBEGAUZE ELASTIC NET SZ 6$ 3.24 07071505 A4649 PROBE EHL 5.0FR$ 1,090.37 07071680 A4649 SUTURE ETHILON 8-0 12 TG175-8$ 163.17 07071925 A4649 ELECTRODE KNIFE 26/28FR$ 789.36 07072005 A4649 CONNECTOR Y-TUBING LGE$ 8.36 07072105 A4649 BITE BLOCK 38FR PED$ 60.14 07072305 A4649 PROBE EHL 3.3FR$ 1,090.37 07072500 A4649 LIGACLIP LS400 XLGE STEEL$ 73.63 07072600 A4649 SET LACRIMAL INTUBATION$ 734.24 07073000 A4649 SET URETHRAL DILATION$ 1,105.95 07074000 A4649 NEEDLE RETROBULBAR 23GAX35MM$ 36.15 07074031 C1713 SCREW CD MICRO 1.5MMX3.5MM$ 263.52 07074091 C1713 SCREW CD MICRO 1.5MMX9.0MM$ 279.16 07074200 A4649 BURR FLUTED MS 3MM MEDIUM$ 787.19 07074201 A4649 PAD PERINEAL POST$ 83.28 07074202 A4649 CANNULA AORTIC ROOT W/VENT CBP$ 164.94 07074204 A4649 BURR 4MM COARSE DIAMOND BALL$ 373.88 07074205 A4649 BURR 5MM EXTRA COARSE DIAMOND$ 376.79 07074206 A4649 VALVE VACUUM RELIEF CBP$ 141.71 07074207 C1734 STEM CEMENTRALIZER 9.25CM$ 225.81 07074208 A4649 KIT UNISHUNT RESERVOIR 53CM$ 2,480.31 07074209 A4649 SUTURE 0 PDS 60 TP-1$ 95.93 07074500 A4649 SET SURGILAV HANDPIECE$ 801.23 07075000 A4649 SET RENAL DILATOR$ 1,134.85 07075780 A4649 SUTURE PROLENE 4-0 RB-1 #8557$ 80.38 07076031 C1713 SCREW CD MICRO EM 1.8MMX3.5MM$ 332.27 07076051 C1713 SCREW KLS EMERG 1.8MMX5MM$ 296.08 07077028 A4649 DILATOR NEPHROSTOMY TRACT$ 1,136.63

204 07077200 A4649 NEURO PATTIE 1/2X1/2$ 19.24 07077513 A4649 BLADE MICROSHARP 5MMX1.5-CBP$ 79.98 07078100 A4649 SUTURE SILK 1 6X18$ 5.27 07078220 A4649 CANNULA AORTIC 20FR$ 365.73 07078600 A4649 NEEDLE BIOPSY ENDO HD ECHO TIP$ 1,044.23 07079006 A4649 BLADE SAW STERNUM RECIPROCATIN$ 1,029.78 07079026 A4649 TOURNIQUET DLP-CBP$ 55.69 07079364 A4649 BLADE MICRO-SHARP 15 3.0MM$ 18.49 07079365 A4649 BLADE MICRO-SHARP 15 5.0MM$ 8.87 07080000 A4649 EXTRACTOR BALLOON 9M/12M - ERC$ 1,071.16 07080001 A4649 CABLE MONOPOLAR HIGH FREQUENCY$ 105.19 07080002 A4649 PACK TRANFER FENWAL 300CC$ 34.86 07080020 A4649 ELECTRODE LEEP 2.0CMX0.8CM$ 145.26 07080035 A4649 TUBE ORAL RAE CUFFED 3.5MM$ 30.01 07080040 A4649 TUBE ORAL RAE CUFFED 4.0MM$ 30.01 07080045 A4649 TUBE ORAL RAE CUFFED 4.5MM$ 30.01 07080100 A4649 BASKET SEGURA 3.0FR 16MMX120CM$ 1,150.71 07080110 A4649 BASKET SEGURA 3.0FR 20MMX120CM$ 1,150.71 07080247 C1734 STEM CEMENTRALIZER 10CM$ 225.81 07080425 A4649 PROBE EHL 2.4FR$ 1,004.38 07080622 C1713 PLATE DCP BR 4.5MM 8 HOLE$ 936.64 07080730 C1734 PLATE NR LARGE BURR HOLE$ 618.52 07080750 C1713 SCREW LAG DHS/DCS 12.7MMX75MM$ 1,087.05 07080760 A4649 TUBEGAUZE ELASTIC NET SZ 4 /YD$ 2.76 07080796 C1713 SCREW CORTEX MD HD 2.0MMX7MM$ 216.55 07080896 C1713 SCREW CORTEX MD HD 2.0MMX8MM$ 216.55 07080900 C1713 SCREW LAG DHS/DCS 12.7MMX90MM$ 1,123.78 07080902 A4346 FALLOPE RING BAND Z990G$ 293.97 07080996 A4649 SCREW CORTEX MD HD 2.0MMX9MM$ 216.55 07081000 A4649 CUP GRADUATED 1000CC 32OZ$ 17.51 07081010 C1713 PLATE DHS 130* 10HOLE 38MM$ 1,473.35 07081014 C1713 PLATE DHS 130* 14HOLE 38MM$ 1,473.35 07081050 A4649 TUBE NASAL RAE CUFFED 5.0MM$ 44.97 07081060 A4649 SUTURE SUPRAMID 6-0 3/8C REV C$ 39.86 07081070 A4649 TUBE NASAL RAE CUFFED 7.0MM$ 44.82 07081075 A4649 TUBE NASAL RAE CUFFED 7.5MM$ 32.11 07081096 C1713 SCREW CORTEX MD HD 2.0MMX10MM$ 216.55 07081101 A4352 CATHETER COUDE STRAIGHT 18FR$ 448.32 07081105 C1713 SCREW LAG DHS/DCS 12.7MMX105MM$ 1,125.04 07081110 C1713 SCREW LAG DHS/DCS 12.7MMX110MM$ 1,125.04 07081136 C1713 SCREW LAG DHS 12.7MMX140MM$ 1,186.77 07081137 C1713 SCREW LAG DHS/DCS 12.7MMX145MM$ 1,125.04

205 07081140 C1713 PLATE DHS 135* 4 HOLE 38MMX78M$ 1,496.12 07081150 C1713 PLATE DHS 135* 5HOLE 38MMX94MM$ 1,445.55 07081196 C1713 SCREW CORTEX MD HD 2.0MMX11MM$ 216.55 07081296 C1713 SCREW CORTEX MD HD 2.0MMX12MM$ 216.55 07081396 C1713 SCREW CORTEX MD HD 2.0MMX13MM$ 216.55 07081430 A4649 BLADE ARTHRO TURBO WHISK 2.9MM$ 530.22 07081496 C1713 SCREW CORTEX MD HD 2.0MMX14MM$ 216.55 07081600 C1713 SCREW CORTEX MD HD 2.0MMX16MM$ 216.55 07081696 C1713 SCREW CORTEX MD HD 1.5MMX16M$ 203.01 07081791 A4649 KIT SHOULDER CANNULA 7CM$ 210.59 07081896 C1713 SCREW CORTEX MD HD 2.0MMX18MM$ 216.55 07081930 C1713 PLATE DCP SB 95* 25MM 14 HOLE$ 2,160.49 07081960 C1713 PLATE DCS 95* SB 6 HOLE$ 2,046.48 07082000 C1713 SCREW CORTEX ST 1.5MMX20MM$ 93.06 07082002 Q4050 CAST SCOTCH PLUS 2X4$ 38.20 07082003 Q4080 CAST SCOTCH PLUS 3X4$ 47.12 07082004 Q4080 CAST SCOTCH PLUS 4X4$ 61.95 07082096 C1713 SCREW CORTEX MD HD 2.0MMX20MM$ 336.24 07082150 A4649 BIOURETHRAL SUPPORT PELVILACE$ 2,208.79 07082200 C1713 SCREW CORTEX ST 1.5MMX22MM$ 158.60 07082296 C1713 SCREW CORTEX MD HD 2.0MMX22MM$ 336.24 07082496 C1713 SCREW CORTEX MD HD 2.0MMX24MM$ 336.24 07082696 C1713 SCREW CORTEX MD HD 2.0MMX26MM$ 336.24 07082841 C1713 SCREW CORTEX ST 4.5MMX28MM$ 167.25 07082896 C1713 SCREW CORTEX MD HD 2.0MMX28MM$ 336.24 07083005 L5999 PROSTHESIS HIP AUSTIN MOORE 38$ 2,534.12 07083096 C1713 SCREW CORTEX MD HD 2.0MMX30MM$ 336.24 07083296 C1713 SCREW CORTEX MD HD 2.0MMX32MM$ 336.24 07083371 C1713 ENDCAP TIBIAL TI T40 0MM$ 858.64 07083395 C1713 ENDCAP TIBIAL TI T40 5MM$ 946.32 07083418 C1713 ENDCAP TIBIAL TI T40 10MM$ 946.32 07083432 C1713 ENDCAP TIBIAL TI T40 15MM$ 946.32 07083456 C1713 ENDCAP TIBIAL TI T40 GRAY 0MM$ 858.64 07083470 C1713 ENDCAP TIBIAL TI T40 GRAY 5MM$ 946.32 07083494 C1713 ENDCAP TIBIAL TI T40 GRAY 10MM$ 946.32 07083510 A4649 ELECTRODE WIRE 0.35MM 28FR$ 880.91 07083517 C1713 ENDCAP TIBIAL TI T40 GRAY 15MM$ 946.32 07084000 A4649 BUR ROUND XKP 4.0MMX70MM$ 927.50 07084100 A4649 IMMOBILIZER SHOULDER UNIVERSAL$ 158.67 07084392 A4649 STEINMAN PIN 4.5MMX275MM$ 456.79 07085000 A4649 BUR ACORN XKP 6.0MMX70MM$ 954.54 07085071 C1713 SCREW CD BONE 2.3MM X 7MM$ 275.32

206 07085091 C1713 SCREW CD BONE 2.3MM X 9MM$ 284.81 07085111 C1713 SCREW CD BONE 2.3MM X 11MM$ 294.30 07085131 C1713 SCREW CD BONE 2.3MM X 13MM$ 313.28 07085151 C1713 SCREW CD BONE 2.3MM X 15MM$ 322.76 07085171 C1713 SCREW CD BONE 2.3MM X 17MM$ 351.26 07085191 C1713 SCREW CD BONE 2.3MM X 19MM$ 360.74 07085208 A4649 VESSEL LOOP REGULAR$ 177.62 07085240 A4649 VESSEL LOOP SMALL$ 16.56 07085800 C1713 SCREW CORTEX ST 1.5MMX28MM$ 131.11 07085808 A4649 TUBE LAVAGE 40FRX86$ 124.36 07085849 C1713 SCREW LOCKING TI 5.0MMX26MM$ 930.29 07085863 C1713 SCREW LOCKING TI 5.0MMX28MM$ 930.29 07085887 C1713 SCREW LOCKING TI 5.0MMX30MM$ 930.29 07085900 C1713 SCREW LOCKING TI 5.0MMX32MM$ 930.29 07085924 C1713 SCREW LOCKING TI 5.0MMX34MM$ 930.29 07085949 C1713 SCREW LOCKING TI 5.0MMX36MM$ 930.29 07085962 C1713 SCREW LOCKING TI 5.0MMX38MM$ 930.29 07085986 C1713 SCREW LOCKING 5.0MMX40MM$ 930.29 07086000 A4649 BUR ROUND FLUTED XKP 5.0MMX110$ 994.20 07086006 C1713 SCREW LOCKING TI 5.0MMX42MM$ 930.29 07086020 C1713 SCREW LOCKING TI 5.0MMX44MM$ 930.29 07086044 C1713 SCREW LOCKING TI 5.00MMX46MM$ 930.29 07086068 C1713 SCREW LOCKING TI 5.0MMX48MM$ 930.29 07086082 C1713 SCREW LOCKING TI 5.0MMX50MM$ 930.29 07086091 C1713 SCREW CD BONE 2.5MM X 9MM$ 294.30 07086105 C1713 SCREW LOCKING TI 5.0MMX52MM$ 930.29 07086121 C1713 SCREW CD ST 2.7MMX12MM$ 234.32 07086129 C1713 SCREW LOCKING TI 5.0MMX54MM$ 930.29 07086131 C1713 SCREW KLS 13X2.3$ 303.78 07086141 C1713 SCREW CD ST 2.7MMX14MM$ 234.32 07086143 C1713 SCREW LOCKING TI 5.0MMX56MM$ 930.29 07086161 C1713 SCREW CD ST 2.7MMX16MM$ 246.15 07086167 C1713 SCREW LOCKING TI 5.0MMX58MM$ 930.29 07086171 C1713 SCREW CD BONE 2.5MM X 17MM$ 360.74 07086181 C1713 SCREW LOCKING TI 5.0MMX60MM$ 930.29 07086200 A4649 TUBE ORAL RAE CUFFED 5.0MM$ 33.64 07086201 A4649 TUBE ORAL RAE CUFFED 5.5MM$ 33.64 07086202 A4649 TUBE ORAL RAE CUFFED 6.0MM$ 33.64 07086203 A4649 TUBE ORAL RAE CUFFED 6.5MM$ 33.64 07086204 A4649 TUBE ORAL RAE CUFFED 7.0MM$ 33.64 07086205 A4649 TUBE ORAL RAE CUFFED 7.5MM$ 33.64 07086206 A4649 TUBE ORAL RAE CUFFED 8.0MM$ 33.64

207 07086207 A4649 TUBE ORAL RAE CUFFED 8.5MM$ 33.64 07086208 A4649 TUBE ORAL RAE CUFFED 9.0MM$ 33.64 07086228 C1713 SCREW LOCKING TI 5.0MMX64MM$ 930.29 07086266 C1713 SCREW LOCKING TI 5.0MMX68MM$ 930.29 07086303 C1713 SCREW LOCKING TI 5.0MMX72MM$ 930.29 07086341 C1713 SCREW LOCKING TI 5.0MMX76MM$ 930.29 07086389 C1713 SCREW LOCKING TI 5.0MMX80MM$ 930.29 07086402 C1713 SCREW LOCKING TI 5.0MMX85MM$ 930.29 07086426 C1713 SCREW LOCKING TI 5.0MMX90MM$ 930.29 07088121 C1713 SCREW CD EST 32MM X 12MM$ 455.67 07088161 C1713 SCREW CD EST 32MM X 16MM$ 465.16 07089600 C1713 SCREW CORTEX MD HD 1.3MMX18MM$ 422.95 07089862 A4649 BLADE HELICAL TFNA 85MM$ 1,830.60 07090000 A4649 EXTRACTOR BALLOON 12MM/15MM -$ 1,071.16 07090020 C1713 NAIL FEMUR TFNA 11MMX170MM$ 3,570.90 07090180 A4649 PILLOW HIP ABDUCTION$ 61.29 07090181 A4649 VALVE PEEP ANESTHESIA 10CM H2O$ 74.09 07090422 C1713 PLATE DCP NR 4.5MM 9-HOLE$ 954.07 07090472 C1713 NAIL UNIV FEMUR 10MMX320MM$ 1,365.70 07091041 A4649 RETRACT-O-TAPE$ 240.05 07091246 A4649 CANNULA VENOUS 2-ST36/46FR CBP$ 274.92 07091430 A4649 PACK BASIC$ 40.51 07092100 A4927 GLOVES SURGEON S-6-1/2$ 3.54 07092120 A4649 CATHETER NIAGARA 2-LUMEN 13.5F$ 473.63 07092150 A4649 CATHETER NIAGARA 2-LUMEN 13.5F$ 473.63 07092610 A4649 EXT FIX K-WIRE THRD TIP 1.25X1$ 298.47 07092708 A4649 EXT FIX MINI K-WIRE TRD 1.6MM$ 298.10 07092800 A4649 DRILL TWIST KLS 1.8MMX34$ 761.29 07093000 A4649 HEMOVAC 400ML D.D. 1/4 19F$ 291.90 07094000 A4649 BUR ROUND XKP 5.0MMX70MM$ 911.72 07094475 C1721 IMPLANT DEFIBRILLATOR RVL 6944$ 10,238.17 07094758 C1895 LEAD DEFIBRILLATOR 694758$ 10,238.17 07094765 C1895 LEAD DEFIBRILLATOR 694765$ 10,238.17 07094771 C1713 SCREW SCHANTZ SD 4.0/3.0MMX80M$ 888.21 07094991 A4649 EXT FIX LGE CAP PIN 4.0MM$ 14.89 07094993 A4649 EXT FIX LGE CAP PIN 5.0MM$ 22.43 07095005 A4649 ENDOSHEARS 5 MM$ 1,078.98 07095007 A4649 ROTICULATOR ENDO SCIZ$ 1,108.97 07095008 A4649 V. CAVA FILT SYSTEM:FEMORAL$ 2,573.26 07095011 A4649 UTERINE MANIPULATOR$ 200.16 07095051 C1713 SCREW CD MINI 2.0MMX5MM$ 237.31 07095103 A4649 EXT FIX MINI ANGLED CONNECTING$ 337.01

208 07095125 A4649 EXT FIX MINI K-WIRE HOLD CLAMP$ 1,744.10 07095126 A4649 EXT FIX MINI K-WIRE HOLD CLAMP$ 1,744.10 07095133 A4649 EXT FIX MINI CONNECT CLAMP 3MM$ 1,678.36 07095134 A4649 EXT FIX MINI CONNECT CLAMP 3MM$ 1,678.36 07095171 C1713 SCREW CD MINI 2.0MMX17MM$ 312.97 07095597 A4649 CLAMP ADJUSTABLE 4.0MM$ 1,674.44 07095781 A4649 PROTECTIVE CAP 8MM$ 22.84 07095782 C1713 ROD DISTAL RADIUS 8MMX200MM$ 950.87 07095784 C1713 ROD DISTAL RADIUS 8MMX220MM$ 911.30 07095786 C1713 ROD DISTAL RADIUS 8MMX240MM$ 721.96 07095822 A4649 FIXATOR DISTAL RADIUS 220MM$ 4,054.04 07095824 A4649 FIXATOR DISTAL RADIUS 240MM$ 3,531.57 07096001 A4649 CORSON PROBE W/ SPIKE DISP$ 628.98 07096002 A4649 SET SUPRAPUBIC CATHERIZATION$ 199.43 07096017 A4649 MYRINGOTOMY LANCET DISP$ 103.80 07096018 A4649 POPE OTO-WICK 24MM$ 19.86 07096019 A4649 NEEDLE ENDO INJECTION$ 389.79 07096021 A4649 SHEEHY MODIFIED PORP PROST$ 560.36 07096022 A4649 SHEEHY MODIFIED TORP PROST$ 738.82 07096027 A4649 ELECTRODE Y LOOP STERILE$ 145.06 07096028 A4649 ENDOPOUCH$ 422.28 07096030 A4649 CELLSAVER COLLECTION RESERVOIR$ 565.67 07096031 A4649 CELLSAVER BASIC HIGH SPEED 125$ 774.91 07096032 A4649 CELLSAVER BASIC HIGH SPEED 225$ 751.33 07096033 A4649 CELLSAVER ASP & ANTICOAG ASSEM$ 258.71 07096038 A4649 IMMOBILIZER KNEE 24$ 180.40 07096040 A4649 CATHETER BROVIAC W/ SURECUFF 4$ 1,051.97 07096045 A4649 AUTOMATED PRESSURE INFUSION$ 610.20 07096046 A4649 SET IV FLUID WARMING DISP$ 375.50 07096048 A4649 DRESSING ADAPTIC 3X3$ 5.02 07096049 A4649 DRESSING ADAPTIC 3X8$ 11.88 07096052 A4649 NEEDLE STRT MENISCAL STITCH$ 166.15 07096120 A4649 TRAY NIAGARA CATH INSERTION 12$ 694.75 07096150 A4649 TRAY NIAGARA CATH INSERTION 15$ 694.75 07096267 A4649 FORCEPS GRASPING 3-PRONG 2.4FR$ 1,134.15 07096268 A4649 FORCEPS GRASPING 3-PRONG 3.0FR$ 1,134.15 07096269 A4649 FORCEPS GRASPING 4-PRONG 3.0FR$ 1,102.66 07097000 A4649 ELECTRODE MENISCECTOMY$ 403.86 07097001 A4649 KIT VENTRICULOSTOMY$ 1,255.58 07097003 A4649 KIT EPIDURAL CATH REPAIR$ 607.39 07097004 A4649 KIT EPIDURAL CATHETER$ 1,180.94 07097005 A4649 IRRIGATION SPIKE NONVENTED$ 39.89

209 07097006 A4649 IRRIGATION SPIKE VENTED$ 28.64 07097009 A4649 SCOPE-EQUIPMENT CHARGE$ 118.94 07097403 A4649 CATHETER CAPD-PEDIATRIC$ 572.09 07097600 A4649 SUTURE SILK 2-0 30 FSL$ 15.30 07098000 C1718 LINER ALTRX NEUTRAL 28MMX46MM$ 1,309.88 07098002 A4649 TROCAR BLUNT TIP 12 MM DISP$ 1,087.29 07098012 A4649 NEEDLE SPINAL WHITACRE 25GAX5$ 94.55 07098014 A4649 PERFORATOR CODMAN DISP$ 1,042.52 07098900 A4649 BLADE HELICAL TFNA 70MM$ 1,830.60 07098924 A4649 BLADE HELICAL TFNA 75MM$ 1,830.60 07098948 A4649 BLADE HELICAL TFNA 80MM$ 1,830.60 07098986 A4649 BLADE HELICAL TFNA 90MM$ 1,830.60 07099006 A4649 BLADE HELICAL TFNA 95MM$ 1,830.60 07099020 A4649 BLADE HELICAL TFNA 100MM$ 1,830.60 07099044 A4649 BLADE HELICAL TFNA 105MM$ 1,830.60 07099068 A4649 BLADE HELICAL TFNA 110MM$ 1,830.60 07099082 A4649 BLADE HELICAL TFNA 115MM$ 1,830.60 07099105 A4649 BLADE HELICAL TFNA 120MM$ 1,830.60 07099129 A4649 BLADE HELICAL TFNA 125MM$ 1,830.60 07099143 A4649 BLADE HELICAL TFNA 130MM$ 1,830.60 07800001 86316 CA 125$ 77.96 07800002 84588 VASOPRESSIN LEVEL$ 120.98 07800003 86628 CANDIDA ANTIBODY$ 101.78 07800004 86606 ASPERGILLUS ANTIBODY$ 58.04 07800016 83930 OSMOLALITY SERUM$ 26.23 07800108 80307 DRUG SCREEN-THERAPEUTIC & ABUS$ 384.69 07801008 80377 DIURETIC SURVEY URINE$ 368.13 07802307 82306 VITAMIN D LEVEL$ 302.34 07802538 83520 GANGLIOSIDE GQ1B IGG AB ELISA$ 255.34 07802998 80175 LAMOTRIGINE LEVEL$ 138.32 07804001 80183 TRILEPTAL LEVEL$ 234.89 07804207 84207 VITAMIN B6 LEVEL$ 225.74 07804840 80200 TOBRAMYCIN TROUGH$ 118.94 07804842 80200 TOBRAMYCIN PEAK$ 118.94 07805102 80307 DRUG CONFIRMATION:BY GC/MS$ 213.85 07806172 86603 ADENOVIRUS TITER$ 111.14 07806173 86710 INFLUENZA VIR TYPE-B TITER$ 120.89 07806174 86710 INFLUENZA VIR TYPE-A TITER$ 120.89 07806227 86696 HERPES VIR AB TYPE-II$ 100.41 07806228 86695 HERPES VIR AB TYPE-I$ 100.41 07806229 86787 VARICELLA-ZOSTER$ 118.94 07806248 84260 SEROTONIN PLATELET$ 477.67

210 07806329 86160 COMPLEMENT C-5$ 124.78 07807528 82570 URINE PROTEIN/CREATININE RATIO$ 82.73 07808352 83520 NEURON SPECIFIC ENOLASE (NSE)$ 183.53 07809768 86790 HANTAVIRUS ANTIBODY$ 219.51 07812068 86021 PROTEINASE 3 ANTIBODY (PR3)$ 118.79 07813520 83520 ANTI-GLIADIN ANTIBODY IGG$ 199.35 07815668 86651 CALIFORNIA ENCEPHALITIS AB SE$ 280.22 07816235 86235 ANTI-CENTROMERE ANTIBODY$ 120.08 07819835 83519 IGF BINDING PROTEIN 3$ 112.27 07820071 83520 SUBSTANCE P$ 752.42 07820081 83520 INTERLEUKIN-6$ 803.86 07820091 80177 LEVITIRACETAM (KEPPRA) LEVEL$ 375.14 07820141 83520 SOLUBLE LIVER AG AUTOAB$ 122.58 07820309 82030 CYCLIC AMP$ 239.91 07820835 83520 TUMOR NECROSIS FACTOR-ALPHA$ 155.14 07820850 82085 ALDOLASE$ 73.10 07820890 82088 ALDOSTERONE URINE$ 279.06 07821307 82128 AMINO ACID SCREEN$ 45.62 07821366 82135 AMINOLEVULINIC ACID(ALA)$ 135.54 07821728 82172 APOLIPOPROTEIN B$ 160.00 07822008 80345 BARBITURATE U/A QUALI$ 41.35 07822068 86022 HEPARIN INDUCED PLATELET AB$ 372.05 07822095 80342 HALOPERIDOL(HALDOL) LEVEL$ 162.35 07822124 80176 LIDOCAINE(XYLOCAINE)$ 118.94 07823080 82308 CALCITONIN LEVEL$ 184.81 07823520 83520 ANTI-GLIADIN ANTIBODY IGA$ 199.35 07823551 82355 CALCULUS (STONE) QUALI$ 52.47 07823586 86235 SCL-70 AB IGG$ 185.70 07823762 82375 CARBOXYHEMOGLOBIN LEVEL$ 92.12 07823808 82380 CAROTENE$ 65.56 07823824 82382 CATECHOLAMINES URINE$ 226.25 07823845 83835 METANEPHRINES FRACTIONATED$ 389.24 07823907 82390 CERULOPLASMIN$ 77.48 07824388 88342 ACTIN DESMIN HMB 45$ 262.64 07824807 82480 CHOLINESTERASE SERUM$ 78.69 07824861 80339 MESANTOIN$ 103.34 07825258 82525 COPPER$ 67.01 07825380 83520 GLUTAMIC ACID DECARBOXYLASE AN$ 226.00 07825668 86652 EASTERN EQUINE ENCEPHALITIS AB$ 283.55 07825951 86334 CRYOGLOBULINS$ 143.85 07826203 82615 CYSTINE URINE$ 97.98 07826363 80307 TETRAHYDRO COMPOUND URINE$ 259.43

211 07826555 80299 NORPACE LEVEL$ 103.34 07826603 80307 DRUG ABUSE SCREEN/DRUG$ 31.35 07826686 82668 ERYTHROPOIETIN SERUM$ 154.07 07826697 84202 PROTOPORPHYRINS RBC$ 114.57 07826710 82671 ESTROGEN FRACTIONATED$ 353.08 07826728 82672 ESTROGEN TOTAL$ 174.56 07827439 82607 VITAMIN B12$ 100.41 07827452 82746 FOLIC ACID (FOLATE)$ 92.12 07827466 82747 RBC FOLATE$ 154.07 07828668 86682 FILARIASIS ANTIBODY$ 111.53 07829432 82943 GLUCAGON PLASMA$ 156.01 07829478 82947 REDUCING SUBSTANCES FECAL$ 168.36 07829516 82941 GASTRIN$ 99.80 07829805 82977 GAMMA GLUTAMYLTRANSFERASE$ 41.35 07829839 83036 HEMOGLOBIN GLYCATED$ 58.44 07830027 83002 LUTEINIZING HORMONE (LH)$ 120.89 07830028 86618 LYME DISEASE AB IGG/IGM$ 156.09 07830038 83003 GROWTH HORMONE (HGH)$ 106.28 07830101 83010 HAPTOGLOBIN$ 108.72 07830209 83020 HEMOGLOBIN ELECTROPHORESIS$ 96.37 07830309 83030 HEMOGLOBIN FETAL$ 52.47 07830331 82108 ALUMINUM SERUM$ 224.31 07830332 83033 APT TEST$ 81.40 07830333 82175 ARSENIC SCREEN HAIR$ 269.20 07830334 82175 ARSENIC SCREEN NAIL$ 269.20 07830335 82175 ARSENIC URINE$ 180.88 07830515 83051 FREE HEMOGLOBIN PLASMA$ 100.41 07830701 83070 HEMOSIDERIN URINE$ 67.24 07831009 82024 ACTH BLOOD$ 228.07 07831033 84146 PROLACTIN$ 125.42 07831034 84135 PREGNANEDIOL URINE$ 166.26 07831108 82088 ALDOSTERONE SERUM$ 242.33 07831306 82383 CATECHOLAMINES PLASMA$ 188.15 07831403 80164 VALPROIC ACID(DEPAKENE)$ 109.67 07831404 80202 VANCOMYCIN PEAK$ 136.04 07831405 84585 VANILLYLMANDELIC(VMA)$ 85.55 07831406 80202 VANCOMYCIN TROUGH$ 136.04 07831454 83835 METANEPHRINES TOTAL$ 92.65 07831850 83491 17-OH CORTICOSTEROIDS$ 109.74 07831900 82530 CORTISOL FREE$ 94.08 07831959 82533 CORTISOL TOTAL$ 142.57 07832353 84233 ESTROGEN RECEPTOR ASSAY TISSU$ 353.08

212 07832451 82677 ESTRIOL URINE$ 135.42 07832453 82677 ESTRIOL BLOOD$ 117.97 07832455 82670 ESTERIOL PLACENTAL$ 148.71 07832569 86255 ANTI-PARIETAL CELL AB$ 99.92 07833105 83001 FSH SERUM$ 110.67 07833401 84138 PREGNANETRIOL$ 187.25 07833609 84244 RENIN ACTIVITY$ 131.12 07833658 86225 ANTI-DNA DOUBLE-STRANDED$ 97.98 07834052 84403 TESTOSTERONE TOTAL$ 146.83 07834981 84144 PROGESTERONE$ 110.67 07834987 83498 17-HYDROXYPROGESTERONE$ 172.61 07835198 83519 18-HYDROXYCORTICOSTERONE$ 281.49 07835208 83520 GANGLIOSIDE GQ1B IGG AB ELISA$ 271.93 07835257 83525 INSULIN LEVEL$ 68.44 07835270 86341 ISLET CELL ANTIBODY$ 137.51 07835668 86653 ST LOUIS ENCEPHALITIS AB SERU$ 270.27 07835760 80299 ISONIAZID(INH)$ 264.55 07835761 83593 17-KETOSTEROIDS FRACT URINE$ 259.43 07835862 86235 ANTI-HISTONE SERUM$ 120.08 07836057 83605 LACTIC ACID$ 67.01 07836254 80438 TRH STIMULATION PANEL 1 HOUR$ 801.87 07836255 83625 LDH ISOENZYMES$ 91.22 07836555 83655 LEAD BLOOD$ 75.55 07836556 83661 LECITHIN/SPHINGOMYELIN RATIO$ 187.25 07837058 83700 LIPOPROTEIN ELECTROPHORESIS$ 214.64 07837188 83718 HIGH DENSITY LIPID(HDL)$ 48.48 07837200 83586 17-KETOSTEROIDS$ 93.10 07838731 83873 MYELIN BASIC PROTEIN$ 141.40 07838740 83874 MYOGLOBIN SERUM$ 147.74 07838756 83874 MYOGLOBIN URINE SCREEN$ 61.30 07839153 83915 5 NUCLEOTIDASE$ 79.43 07839160 83916 OLIGOCLONAL BANDS CSF$ 131.13 07839359 83935 OSMOLALITY URINE$ 26.23 07839457 83945 OXALATE URINE$ 97.98 07840208 80343 PHENOTHIAZINES$ 56.98 07840304 84030 PKU SCREENING$ 56.98 07840663 84066 PHOSPHATASE ACID PROSTATIC$ 77.48 07841108 84110 PORPHOBILINOGEN QUANTI$ 26.23 07841115 84106 PORPHOBILINOGEN$ 44.19 07841181 84120 24-HR URINE COPROPORPHYRIN$ 163.33 07841248 84126 PORPHYRINS TOTAL$ 75.57 07841413 80188 PRIMIDONE(MYSOLINE)$ 120.89

213 07841423 80190 PROCAINAMIDE/NAPA$ 111.14 07841603 84166 PROTEIN ELECTROPHORESIS URINE$ 115.04 07841649 84153 PROSTATE SPECIFIC ANTIGEN$ 145.30 07841650 85305 PROTEIN S$ 230.17 07841651 84165 PROTEIN ELECTROPHORESIS SERUM$ 55.62 07841652 85302 PROTEIN C PLASMA$ 230.17 07842072 82963 BETA-GLUCOSIDASE LEVEL$ 221.38 07842102 84220 PYRUVATE KINASE LEVEL$ 89.67 07842303 80194 QUINIDINE$ 91.22 07842312 84681 C-PEPTIDE$ 152.13 07842313 86160 COMPLEMENT COMPONENT$ 113.59 07842346 84234 ESTROGEN & PROGEST RECEP ASSAY$ 437.33 07842659 83497 5-HIAA$ 105.27 07843118 83018 BROMIDE SERUM$ 231.67 07843755 82776 GALACTOSEMIA SCREEN$ 65.30 07844034 84402 TESTOSTERONE FREE$ 164.33 07844087 80349 THC LEVEL(CANNABUS)$ 100.41 07844251 84425 THIAMINE$ 193.07 07844341 80344 THIORIDAZINE (MELLARIL)$ 100.41 07845278 87254 CULTURE HERPES SIMPLEX VIRUS$ 273.22 07845668 86654 WESTERN EQUINE ENCEPHALITIS AB$ 298.47 07845754 82955 G6PD QUANTITATIVE$ 124.78 07845802 84580 UROBILINOGEN QUANTI$ 31.79 07846304 84630 ZINC PLASMA$ 62.74 07846734 83970 PTH C-TERMINAL$ 259.43 07847542 80162 DIGITOXIN$ 99.80 07847617 80299 DISOPYRAMIDE(NORPACE)$ 108.72 07848766 80299 METHOTREXATE LEVEL$ 130.49 07849991 87252 VIRAL CULTURE$ 509.19 07851983 83519 ALPHA SUBUNIT$ 122.63 07852083 83520 ANTI-GLUTAMIC ACID DECARBOXYLA$ 139.29 07852422 85240 FACTOR VIII$ 131.13 07853248 84235 THYROTROPIN BINDING INHIBITORY$ 448.02 07853268 86235 SJOGRENS ANTIBODY SS-B$ 112.47 07853484 85612 LUPUS ANTICOAGULANT$ 164.33 07855268 86255 ANTI-YO ANTIBODY$ 256.88 07860067 86720 LEPTOSPIRA ANTIBODY$ 106.28 07860080 86765 RUBEOLA (MEASLES) AB IGM$ 112.60 07860108 86622 BRUCELLA ANTIBODY$ 71.17 07860313 86226 ANTI-DNA SINGLE-STRANDED$ 160.42 07860503 86038 ANTINUCLEAR ANTIBODY(ANA)$ 81.26 07860636 86800 ANTI-THYROGLOBULIN$ 102.36

214 07860637 85301 ANTI-THROMBIN III EVAL$ 411.63 07860642 82103 ALPHA-1-ANTITRYPSIN TOTAL$ 104.32 07860660 82104 ALPHA-1-ANTITRYPSIN PHENO$ 149.72 07861626 86162 COMPLEMENT CH-50$ 136.86 07861634 86160 COMPLEMENT C-3$ 67.01 07861642 86160 COMPLEMENT C-4$ 71.25 07861712 86593 VDRL CSF$ 62.37 07861715 86753 PROTOZOA ANTIBODY$ 120.89 07861718 86698 HISTOPLASMA ANTIBODY IMMUN$ 135.54 07861720 86658 COXSACKIE A ANTIBODY$ 132.99 07862351 86235 ANTI-ENA(SM/RNP)ANTIBODIES$ 141.40 07862353 83520 ANTI-GLOM BSMT MEMBRANE$ 224.39 07862358 86235 J01 ANTIBODY$ 76.27 07862446 82105 ALPHA FETOPROTEIN$ 119.92 07862550 86256 ANTI-MITOCHONDRIAL AB$ 100.41 07862558 86255 ENDOMYSIAL ANTIBODY IGA (EMA)$ 138.77 07862561 86665 EPSTEIN-BARR VIRUS VCA$ 161.92 07862569 86255 ANTI-SMOOTH MUSCLE AB$ 117.97 07862570 86256 IMMUNOFLUORESCENT STY IND$ 362.30 07862806 87250 VIRAL ISOLATION$ 294.64 07862840 86756 RSV TITER$ 93.68 07862896 86707 HEPATITIS BE AB(HBEAB)$ 83.82 07862904 87350 HEPATITIS BE AG(HBEAG)$ 83.82 07862913 86708 HEPATITIS A AB(HAAB) TOTAL$ 94.07 07862991 86709 HEPATITIS A AB(HAAB) IGM$ 106.28 07863002 86644 CYTOMEGALOVIRUS AB IGG$ 166.26 07863168 82784 IGM$ 54.15 07863200 86320 IMMUNOELECTROPHORESIS$ 168.22 07863291 84466 TRANSFERRIN SERUM$ 92.12 07863326 82784 IGG$ 71.17 07863334 82784 IGA$ 71.17 07863342 82784 IGD$ 100.41 07863358 82785 IGE$ 91.22 07863378 86337 INSULIN ANTIBODY TITER$ 182.85 07863507 86664 EPSTEIN-BARR VIRUS EBNA$ 241.87 07863756 86376 ANTI-THYROID MICROSOMAL AB$ 102.36 07864210 86003 RAST ALLERGENS SERUM PER$ 60.40 07864905 86635 COCCIDIOIDES ANTIBODY$ 124.78 07865268 86255 ADRENAL ANTIBODY SCREEN$ 56.09 07865405 86735 MUMPS ANTIBODY IGM$ 118.94 07865406 83825 MERCURY BLOOD$ 157.07 07865918 86329 TEICHOIC ACID ANTIBODIES$ 117.00

215 07866004 84430 THIOCYANATE$ 144.81 07866005 86777 TOXOPLAMA ANTIBODY$ 231.12 07866006 84490 TRYPSIN FECAL$ 141.40 07866849 82378 CARCINOEMBRYONIC ANTIGEN (CEA)$ 96.95 07867368 86376 THYROID PEROXIDASE (TPO) AB$ 178.66 07867908 86790 HEPATITIS E AB IGG$ 131.89 07868128 86812 HLA-B27$ 147.74 07868286 86682 SCHISTOSOMIASIS ANTIBODY$ 78.45 07869998 86003 ALLERGEN TEST-ERI$ 60.40 07870908 87015 CULTURE ACID FAST MYCOBACTER$ 103.82 07871061 87106 FUNGAL IDENTIFICATION$ 103.82 07871105 86738 MYCOPLASMA TITER$ 100.41 07871429 86615 PERTUSSIS ANTIBODY SERUM$ 152.19 07871705 86713 LEGIONELLA ANTIBODY$ 106.28 07871741 87230 BOTULISM TOXIN SERUM$ 252.48 07871753 87230 DIFFICILE TOXIN TITER$ 141.15 07871880 80299 CEFOBID LEVEL$ 94.45 07872501 86849 CSF VIRAL STUDIES$ 261.38 07872768 86727 LYMPHOCYTIC CHORIOMENINGITIS A$ 87.87 07874498 87449 LEGIONELLA ANTIGEN URINE$ 281.69 07880100 80307 DRUG SCREEN-SEXUAL ASSAULT PRO$ 1,477.37 07880201 80201 TOPIRAMATE LEVEL$ 156.98 07880299 80329 IBUPROFEN LEVEL$ 78.12 07881210 81210 BRAF GENE ANALYSIS$ 566.59 07881275 81275 KRAS GENE ANALYSIS$ 597.18 07881311 81311 NRAS GENE ANALYSIS$ 509.82 07882010 82010 ACETONE QUANTITATIVE$ 53.58 07882017 82017 ACYLCARNITINES QUAN EA SPEC$ 164.94 07882131 82131 METHIONINE LEVEL$ 342.99 07882145 80325 DL ISOMER-AMPHETAMINE$ 441.05 07882172 82172 APOLIPOPROTEIN A1$ 104.04 07882175 82175 ARSENIC BLOOD$ 190.46 07882180 82180 VITAMIN C/ASCORBIC ACID LEVEL$ 210.30 07882239 82239 BILE ACIDS FRACTION & TOTAL$ 144.33 07882379 82379 CARNITINE (FREE&TOTAL) QUANTI$ 238.76 07882397 86316 CHROMOGRANIN A$ 181.10 07882506 82482 CHOLINESTERASE RBC$ 112.10 07882507 88267 CHROM ANALY; AF/CV 15 CELLS$ 912.30 07882542 80342 RISPERIDONE LEVEL$ 459.29 07882570 82570 CREATININE 24HR-URINE$ 30.37 07882634 82634 11-DEOXYCORTISOL$ 99.50 07882651 80327 DIHYDROTESTOSTERONE$ 263.73

216 07882652 82652 VITAMIN D (125 DIHYDROXY) SE$ 143.61 07882670 82670 ESTRADIOL$ 335.85 07882693 82693 ETHYLENE GLYCOL$ 232.59 07882726 82726 FREE FATTY ACID VERY LONG$ 608.61 07882784 82784 IGG SUBCLASSES$ 541.29 07882866 86682 TOXOCARA CANIS ANTIBODY$ 109.06 07883050 83050 METHEMOGLOBIN QUANTITATIVE$ 84.25 07883088 83088 HISTAMINE LEVEL$ 341.57 07883090 83090 HOMOCYSTEINE TOTAL$ 154.19 07883428 88342 PATHO-IMMUNOHISTOCHEMISTRY STA$ 246.15 07883516 83516 TISSUE TRANSGLUTAMINASE AB IG$ 109.79 07883518 83518 ROTAVIRUS ANTIGEN$ 75.09 07883519 83519 PTH-RELATED PROTEIN (PTH-RP)$ 217.04 07883520 80197 TACROLIMUS LEVEL$ 282.77 07883615 83615 LDH BODY FLUID$ 63.45 07883695 83695 LIPOPROTEIN A$ 216.16 07883735 83735 MAGNESIUM URINE$ 53.67 07883840 80358 METHADONE SERUM$ 154.37 07883890 81275 KRAS$ 578.80 07883896 81220 CYSTIC FIBROSIS CARRIER SCREEN$ 532.53 07883898 81479 SPINAL MUSCULAR ATROPHY-DNA TE$ 711.31 07883900 81291 MTHFR MUTATION TEST$ 324.75 07883921 83921 METHYLMALONIC ACID LEVEL$ 216.16 07883937 83937 OSTEOCALCIN$ 205.79 07883986 83986 PH FECAL$ 115.05 07884120 84119 PORPHYRIN URINE$ 162.35 07884143 84143 17-HYDROXYPREGNENOLONE$ 121.05 07884210 84210 PYRUVATE$ 119.21 07884235 84235 TSH RECEPTOR ANTIBODY$ 284.41 07884252 84252 VITAMIN B2/RIBOFLAVIN BLOOD$ 256.29 07884260 84260 SEROTONIN BLOOD$ 536.07 07884305 84305 SOMATOMEDIN C IGF-1$ 71.44 07884307 84307 SOMATOSTATIN$ 201.55 07884311 84311 ADENOSINE DEAMINASE$ 421.16 07884425 84425 VITAMIN B1/THIAMINE BLOOD$ 213.61 07884442 84442 THYROXINE BINDING GLOBULIN$ 87.18 07884445 84445 THYROID STIMULATING IMMUNE GLO$ 225.50 07884446 84446 VITAMIN E LEVEL SERUM$ 110.67 07884480 84480 T3 TOTAL$ 86.45 07884481 84481 T3 FREE$ 130.10 07884482 84482 T3 REVERSE$ 104.91 07884586 84586 VASOACTIVE INTESTINAL POLYPEPT$ 437.30

217 07884590 84590 VITAMIN A LEVEL SERUM$ 134.54 07884660 80320 METHANOL$ 205.08 07884999 84999 OSMOLALITY FECES$ 45.89 07885220 85220 FACTOR V - LEIDEN$ 459.61 07885246 85246 VON WILLEBRAND FACTOR AG$ 229.06 07885250 85250 FACTOR IX(CHRISTMAS) ASSAY$ 93.20 07885260 85260 FACTOR X ASSAY$ 358.92 07885270 85270 FACTOR XI ACTIVITY$ 174.39 07885280 85280 FACTOR XII ASSAY$ 386.10 07885291 85291 FACTOR XIII SCREEN$ 225.42 07885379 85379 D-DIMER QUANTITATIVE$ 129.79 07885397 85397 ADAMTS-13$ 338.98 07885520 85520 LOW MOLECULAR WEIGHT HEPARIN$ 162.90 07885540 85540 LEUKOCYTE ALKALINE PHOSPHATASE$ 32.15 07885549 85549 LYSOZYME$ 184.02 07885613 85613 RUSSELL VIPER VENOM TIME$ 75.76 07885668 86658 COXSACKIE B ANTIBODY$ 180.74 07885670 85670 THROMBIN TIME$ 58.20 07886000 86000 WIDAL TEST$ 118.63 07886021 86021 MYELOPEROXIDASE ANTIBODY$ 118.79 07886022 86022 PLATELET ANTIBODY INDIRECT$ 139.98 07886023 86023 PLATELET ANTIBODY DIRECT$ 122.08 07886024 86022 HEPARIN INDUCED THROMBOCYTOPEN$ 211.40 07886063 86063 STREPTOZYME$ 21.67 07886146 86146 BETA 2 GLYCOPROTEIN AB PANEL$ 455.55 07886147 86147 ANTI-CARDIOLIPIN AB PANEL$ 221.62 07886148 86148 PHOSPHATIDYLSERINE AB PANEL$ 660.96 07886160 86160 COMPLEMENT C-2$ 93.32 07886200 86200 CYCLIC CITRULLINATED PEPTIDE$ 214.37 07886235 86235 SJOGRENS ANTIBODY SS-A$ 112.47 07886255 86255 ANTI-NEURONAL ANTIBODY SCREEN$ 256.88 07886256 87081 CULTURE LEGIONELLA$ 222.36 07886257 86256 MITOCHONDRIAL ANTIBODIES$ 95.51 07886300 86300 CA 27-29$ 118.20 07886316 86316 CA 15-3$ 68.05 07886318 86318 ANTI-RIBOSOMAL P ANTIBODY$ 316.77 07886329 86329 C1 ESTERASE INHIBITOR$ 59.40 07886335 86335 IMMUNOFIXATION ELECTROPHORESIS$ 482.32 07886360 86360 T-CELLS SUBSET (CD4 CD8) COUN$ 477.86 07886376 86376 LIVER/KIDNEY MICROSOMAL AB$ 132.66 07886611 86611 BARTONELLA HENSELAE SCREEN$ 160.91 07886625 86625 CAMPYLOBACTER JEJUNI AB$ 202.31

218 07886632 86632 CHLAMYDIA DIFFERENTIATION IGM$ 73.11 07886645 86645 CYTOMEGALOVIRUS AB IGM$ 58.03 07886651 86651 CALIFORNIA ENCEPHALITIS AB CS$ 296.80 07886652 86652 EASTERN EQUINE ENCEPHALITIS AB$ 305.10 07886653 86653 ST LOUIS ENCEPHALITIS AB CSF$ 286.85 07886654 86654 WESTERN EQUINE ENCEPHALITIS AB$ 316.70 07886658 86658 ECHOVIRUS ANTIBODY$ 65.66 07886663 86663 EPSTEIN-BARR VIRUS EARLY AG$ 32.00 07886671 86671 SACCHAROMYCES CEREVISIAE AB$ 235.81 07886682 86682 CYSTICERCOSIS ANTIBODY$ 112.31 07886685 83519 ACETYLCHOLINE RECEPTOR AB$ 236.02 07886689 86689 HTLV I/II - WESTERN BLOT$ 128.69 07886694 86694 HERPES VIRUS TYPE SPECIFIC IGG$ 97.83 07886727 86727 LYMPHOCYTIC CHORIOMENINGITIS A$ 270.27 07886735 86735 MUMPS ANTIBODY IGG$ 58.03 07886747 86747 PARVOVIRUS B-19 AB IGG$ 45.35 07886750 86750 MALARIA ANTIBODY$ 518.05 07886765 86765 RUBEOLA (MEASLES) AB IGG$ 58.03 07886774 86774 TETANUS ANTIBODY$ 49.62 07886781 86780 TREPONEMA PALLIDUM (FTA-ABS)$ 54.50 07886790 86790 DENGUE FEVER ANTIBODY$ 80.56 07886793 86793 YERSINIA ANTIBODY$ 88.25 07886804 86804 HEPATITIS C AB - RIBA$ 188.30 07886941 86941 DONATH LANDSTEINER TEST$ 220.53 07887081 87081 LEPTOSPIRA CULTURE$ 107.96 07887082 87206 LEPTOSPIRA STAIN$ 91.54 07887102 87102 FUNGAL CULTURE OTHER SOURCE$ 53.07 07887109 87109 CULTURE MYCOPLASMA PNEUMONIAE$ 104.23 07887205 87205 EOSINOPHILS URINE$ 40.57 07887206 87206 AFB SMEAR$ 50.65 07887252 87252 CULTURE RESPIRATORY SYNCYTIAL$ 160.37 07887254 87254 CULTURE CYTOMEGALOVIRUS$ 127.40 07887265 87265 PERTUSSIS CULTURE & DFA$ 295.14 07887450 87450 CRYPTOCOCCUS ANTIGEN CSF$ 66.85 07887491 87491 CHLAMYDIA TRACHOMATIS-PCR$ 179.47 07887496 87496 CYTOMEGALOVIRUS DNA-PCR$ 279.96 07887522 87522 HEPATITIS C RNA QUANTITATIVE$ 477.51 07887536 87535 HIV I DNA-PCR$ 273.00 07887555 87555 M. TUBERCULOSIS COMPLEX DNA P$ 275.11 07887556 87556 M. TUBERCULOSIS AMPLIFIED RNA$ 348.36 07887591 87591 GONOCOCCUS-PCR$ 182.40 07887801 87801 HERPES SIMPLEX PCR$ 793.14

219 07887802 87801 BORDATELLA PERTUSSIS PCR$ 214.61 07887901 87901 HIV GENOTYPE$ 561.45 07887902 87902 HEPATITIS C GENOTYPE$ 1,107.55 07888230 88230 TISSUE CULTURE LYMPHOCYTE$ 400.93 07888233 88233 CHROMOSOME ANALYSIS TISSUE$ 1,482.69 07888237 88237 CHROMOSOME ANALYSIS MARROW$ 604.12 07888271 88271 HERCEPTIN-2 FISH$ 522.10 07888313 88313 RENAL BIOPSY LIGHT MICROSCOPY$ 272.95 07888323 88323 SLIDE REVIEW 1-8 SLIDES$ 270.47 07888325 88325 CONSULTATION COMPREHENSIVE$ 425.11 07888341 88341 IMMUNOHISTO AB ADD STAIN$ 185.05 07888342 88360 HERCEPTIN-2 IHC$ 397.47 07888346 88346 PATHO-STAIN IMMUNOFLUOR DIREC$ 451.04 07888348 88348 ELECTRON MICROSCOPY DIAGNOSTI$ 668.60 07888350 88350 IMMUNOFLUOR AB ADD STAIN$ 128.91 07888361 88361 TUMOR IMMUNOHISTOCHE COMPUTER$ 334.39 07888366 88366 FISH PROBE EACH STAIN$ 265.47 07889838 81240 PROTHROMBIN GENE MUTATION$ 383.02 07891538 83519 PANCREATIC POLYPEPTIDE$ 489.46 07896016 86689 HIV 1 AB:WESTERN BLOT$ 62.10 07896017 86747 PARVOVIRUS B-19 AB IGM$ 35.15 07896018 87190 SUSCEPTIBILITY:TBC$ 104.54 07896019 87045 CULTURE STOOL$ 32.27 07896020 87075 CULTURE ANAEROBIC$ 43.49 07896027 83519 SOMATOMEDIN-C$ 33.14 07896028 83505 HYDROXYPROLINE TOTAL$ 99.94 07896029 83500 HYDROXYPROLINE FREE$ 45.43 07896030 82330 CALCIUM IONIZED$ 29.83 07896033 82626 DEHYDROEPIANDROSTERONE (DHEA)$ 95.03 07896034 86692 HEPATITIS DELTA AB$ 37.46 07897001 86215 DNASE B TITER$ 53.94 07897002 87536 HIV RNA-QUANTITATIVE-PCR$ 229.06 07897003 82759 GALACTOKINASE BLOOD$ 333.32 07897004 82775 GPUT BLOOD$ 177.91 07897005 87110 CULTURE CHLAMYDIA$ 71.45 07897006 84432 THYROGLOBULIN$ 65.33 07897007 87517 HEPATITIS B VIRAL DNA:PCR$ 325.75 07897008 82542 CIPROFLOXACIN$ 91.21 07897010 80158 CYCLOSPORINE$ 101.83 07897011 83018 HEAVY METAL SCREEN URINE$ 123.01 07897012 83018 HEAVY METAL SCREEN BLOOD$ 123.01 07897013 82164 ANGIOTENSIN CONVERTING ENZYME$ 33.51

220 07897014 83918 ORGANIC ACIDS TOTAL QUANTI$ 661.71 07897016 82043 MICROALBUMIN QUANTITATIVE$ 46.95 07897017 82595 CRYOGLOBULIN QUALITATIVE$ 16.11 07897018 85245 RISTOCETIN COFACTOR$ 123.20 07897019 82507 CITRATE URINE$ 59.41 07897020 86256 ANTINEUTROPHIL CYTOPLASMIC AB$ 56.26 07897021 83864 MUCOPOLYSACCHARIDES UA QUAL$ 117.59 07897022 84081 PHOSPHATIDYLGLYCEROL$ 214.64 07897023 82128 AMINO ACID SCREEN URINE$ 31.17 07897031 82232 BETA-2 MICROGLOBULINS$ 44.13 07897032 84439 T4 FREE$ 22.54 07898000 80332 FLUOXETINE$ 46.67 07898001 86316 CA 19-9$ 50.27 07899208 80299 ERYTHROMYCIN LEVEL$ 116.06 09000002 CCPD SERVICES$ 1,170.76 09000003 POST OPERATIVE CATH CARE$ 292.69 09000005 EXIT SITE CHARGE$ 195.12 09000009 J3490 ACO-P ANTI COAG SOLUTION$ 44.93 09000010 J3490 DIANEAL SOLN 4.25% 2L BAG$ 39.08 09000011 A4649 MINICAP WITH PROVIDINE$ 3.22 09000012 J3490 DIANEAL SOLN 2.5% 2L BAG$ 39.08 09000013 J3490 DIANEAL SOLN 1.5% 2L BAG$ 39.08 09000014 A4649 ULTRA TUBING Y-SET$ 17.33 09000015 A4649 PD TRANSFER SET W/MINICAP$ 289.96 09000020 A4649 COMPACT EXCHANGE DEVICE$ 3,370.12 09000655 A4690 DIALYZER HI-FLUX$ 98.66 09094600 90999 HEMO STABIL 5 1/2 HR$ 534.57 09094601 PERI DIALYSIS NURSE T$ 216.85 09094700 90999 HEMO LTUD CARE 5 1/2$ 467.82 09095001 A4755 ARTERIAL-VENOUS TUBING$ 67.27 09095002 A4649 BICAR ON-LINE BICARBONATE$ 85.21 09096000 90935 HEMO ACUTE CARE 1HR$ 822.23 09096100 90935 HEMO ACUTE CARE UP$ 822.23 09096300 90999 HEMO EMERGENGY CARE$ 53.43 09096604 A4649 PEDS INT JUG PUNCT KIT$ 36.39 09300002 93005 EKG TRACING 12-LEAD$ 105.16 09300007 A4649 STENT DES XIENCE 2.25MMX12MM$ 2,315.25 09300008 A4649 STENT DES 2.25MMX26MM$ 2,315.25 09300010 A4649 STENT DES XIENCE 2.5MMX8MM$ 2,091.72 09300035 C1887 CATHETER EBU JL40 6FR$ 341.41 09300038 C1769 GUIDEWIRE CRN NS .014"X180CM$ 755.93 09300040 C1887 CATHETER GUIDE CURVE JL50 6FR$ 341.41

221 09300150 A4649 SHEATH RETRIEVAL BENT TIP 4FR$ 1,113.56 09300175 A4649 ROTAPRO 1.50MM PRECON BURR$ 4,989.49 09300190 A4649 SYSTEM FILTER WIRE 3.5-5.5MM$ 2,296.93 09300315 C1725 BALLOON SPRINTER NC 3MMX15MM$ 778.51 09300318 C1725 BALLOON SPRINTER NC 3MMX18MM$ 778.51 09300326 C1725 BALLOON SPRINTER NC 3MMX26MM$ 778.51 09300327 C1725 BALLOON SPRINTER NC 3MMX27MM$ 741.44 09300330 A4649 ROTA WIRE 300CM GW FLOP$ 799.94 09300385 C1769 GUIDEWIRE CRN NS .014"X180CM$ 755.93 09300573 C1725 BALLOON SPRINTER NC 2MMX15MM$ 742.00 09301220 A4649 CATHETER ASPIRATION 6FR 140CM$ 1,228.30 09301510 C1725 BALLOON SPRINTER 1.5MMX10MM$ 935.95 09301611 A4649 SHEATH BRITE TIP 6FR 11CM$ 182.44 09301711 A4649 SHEATH BRITE TIP 7FR 11CM$ 182.44 09301811 A4649 SHEATH BRITE TIP 8FR 11CM$ 182.44 09301911 A4649 SHEATH BRITE TIP 9FR 11CM$ 182.44 09302251 A4649 STENT COR DES 2.25MMX14MM$ 2,431.01 09302259 A4649 STENT DES 2.25MMX8MM$ 2,315.25 09302269 A4649 CORONARY MINITREK 1.5MMX12MM$ 892.50 09302270 A4649 CORONARY MINITREK 2.0MMX12MM$ 892.50 09302272 A4649 CORONARY TREK 2.5MMX15MM$ 892.50 09302453 C1769 GUIDEWIRE DIAG .038 260CM$ 141.18 09302454 C1769 GUIDEWIRE DIAG .032 260CM$ 141.18 09302470 A4649 STENT COR DES 2.5MMX30MM$ 2,265.64 09302471 A4649 STENT COR DES 3MMX12MM$ 2,265.64 09302480 C1725 BALLOON SPRINTER NC 2MMX12MM$ 818.06 09302481 C1725 BALLOON SPRINTER NC 2.25X12MM$ 818.06 09302482 C1725 BALLOON SPRINTER NC 2.5MMX12MM$ 818.06 09302483 C1725 BALLOON SPRINTER NC 2.5MMX15MM$ 818.06 09302484 C1725 BALLOON SPRINTER NC 2.5MMX21MM$ 818.06 09302485 C1725 BALLOON SPRINTER NC 2.5MMX27MM$ 818.06 09302486 C1725 BALLOON SPRINTER NC 2.75X12MM$ 818.06 09302487 C1725 BALLOON SPRINTER NC 2.75X15MM$ 818.06 09302488 C1725 BALLOON SPRINTER NC 2.75X21MM$ 818.06 09302489 C1725 BALLOON SPRINTER 2.75MMX9MM$ 1,642.49 09302502 A4649 STENT DES XIENCE 2.25MMX15MM$ 1,323.56 09302503 A4649 STENT DES XIENCE 2.25MMX28MM$ 1,323.56 09302505 A4649 STENT DES XIENCE 2.5MMX12MM$ 1,874.81 09302506 A4649 STENT DES XIENCE 2.75MMX15MM$ 1,323.56 09302507 A4649 STENT DES XIENCE 3.0MMX28MM$ 1,323.56 09302508 A4649 STENT DES XIENCE 3.25MMX12MM$ 1,323.56 09302512 A4649 STENT DES XIENCE 2.5MMX12MM$ 2,431.01

222 09302514 A4649 STENT COR DES 2.5MMX14MM$ 2,431.01 09302516 A4649 STENT DES XIENCE 3.5MMX28MM$ 1,323.56 09302518 A4649 STENT COR DES 2.5MMX18MM$ 2,431.01 09302520 C1725 BALLOON SPRINTER 2.5MMX20MM$ 935.95 09302521 A4649 STENT DES XIENCE 2.75MMX12MM$ 1,874.81 09302526 C1769 GUIDEWIRE DIAG .032 150CM$ 141.18 09302601 C1769 GUIDEWIRE H-TRQ ES .014X190CM$ 711.67 09302752 A4649 STENT COR DES 2.75MMX12MM$ 2,975.10 09302754 A4649 STENT COR DES 2.75MMX14MM$ 2,975.10 09302758 A4649 STENT COR DES 2.75MMX18MM$ 2,315.25 09303008 A4649 STENT DES RESOLUTE 3.0MMX8MM$ 2,265.64 09303015 A4649 STENT COR DES 3.0MMX15MM$ 2,431.01 09303018 A4649 STENT COR DES 3.0MMX18MM$ 2,091.72 09303019 C1725 BALLOON SPRINTER NC 3MMX21MM$ 818.06 09303026 A4649 STENT COR DES 3.0MMX26MM$ 2,431.01 09303215 C1725 BALLOON SPRINTER NC 3.25MMX15M$ 778.51 09303218 C1725 BALLOON SPRINTER NC 3.25MMX18M$ 778.51 09303226 C1725 BALLOON SPRINTER NC 3.25MMX26M$ 778.51 09303415 C1769 GUIDEWIRE CRN MG 130CM 1.8FR$ 755.93 09303509 C1725 BALLOON SPRINTER NC 3.5MMX9MM$ 741.44 09303512 A4649 STENT COR DES 3.5MMX12MM$ 2,431.01 09303518 A4649 STENT COR DES 3.5MMX18MM$ 2,431.01 09303526 A4649 STENT COR DES 3.5MMX26MM$ 2,431.01 09303851 C1769 GUIDEWIRE NS EXT .014"X150CM$ 158.33 09303870 A4649 CATHETER PERCUTANEOUS 11CM 7FR$ 238.31 09303871 A4649 KIT EVEREST 30 SURVIVAL$ 867.56 09304001 C1887 CATHETER GUIDE SBS4 2 S-H 6FR$ 346.16 09304007 93041 EKG RHYTHM 1-2 LEADS TRACING$ 70.18 09304015 A4649 STENT COR DES 4.0MMX15MM$ 2,431.01 09304605 C1894 INTRODUCER SHEATH W/GW 5F .038$ 140.49 09304606 A4649 SHEATH AVANTI 6FSTD$ 147.51 09304607 A4649 SHEATH AVANTI 7FSTD$ 147.51 09304608 A4649 SHEATH AVANTI 8FSTD$ 147.51 09304609 A4649 SHEATH AVANTI 9FSTD$ 147.51 09304750 A4649 KIT 3 VALVE MANIFOLD$ 768.51 09305046 C1894 SHEATH INTRODUCER AVANTI 6FR$ 254.36 09305100 A4649 ROTAPRO 1.75CM PRECON BURR$ 4,989.49 09306193 C1887 CATHETER GUIDING JR4.0 6FR$ 341.41 09306194 C1887 CATHETER GUIDING AR1.0 6FR$ 341.41 09306195 C1887 CATHETER GUIDING MB 1 6FR$ 341.41 09306350 A4649 CATHETER EMPIRA PTCA 3.5X6MM$ 706.36 09307020 A4649 CORONARY MINITREK 2.0MMX20MM$ 892.50

223 09307042 C1769 GUIDEWIRE FC JTIP .035"X145CM$ 826.55 09307114 C1769 GUIDEWIRE STEER .014 180CM$ 688.47 09307215 A4649 CORONARY TREK 2.5MMX15MM$ 892.50 09307714 C1769 GUIDEWIRE STAB J 180CM .014$ 655.25 09308351 A4649 CATHETER JL4 6FR 0.38X100CM$ 86.19 09308352 A4649 CATHETER JR4 6FR 0.38X100CM$ 86.19 09308631 C1769 GUIDEWIRE FC JTIP .035"X280CM$ 826.55 09310016 C1887 CATHETER GUIDE AL1 LT 2S-H 6FR$ 346.16 09310024 A4649 RADIAL TR BAND 21 W/INFLATOR$ 374.05 09310025 A4649 RADIAL TR BAND 29 W/INFLATOR$ 374.05 09310038 A4649 CATHETER HOCKEY STICK$ 104.56 09310124 C1769 GUIDEWIRE INTERV .014X180CM$ 463.88 09310126 C1887 CATHETER GUIDE JL 3.5 6FR$ 463.88 09310127 C1887 CATHETER GUIDE JL 3.5 5FR$ 546.19 09310128 C1887 CATHETER GUIDE HS .070 6FR$ 546.19 09310129 C1887 CATHETER GUIDE EBU 3.5$ 546.19 09310225 C1725 BALLOON SPRINTER 2.25MMX10MM$ 935.95 09310259 C1725 BALLOON SPRINTER NC 2.5MMX9MM$ 935.95 09310309 A4649 STENT COR DES 3.0MMX9MM$ 2,431.01 09310312 C1725 BALLOON SPRINTER NC 3MMX12MM$ 935.95 09310325 C1725 BALLOON SPRINTER NC 3.25MMX12M$ 935.95 09310351 C1725 BALLOON SPRINTER NC 3.5MMX12MM$ 935.95 09310387 A4649 CATHETER PERCUTANEOUS 11CM 6FR$ 238.31 09310415 C1725 BALLOON SPRINTER NC 4MMX15MM$ 935.95 09310510 A4649 GLIDESHEATH SLENDER 6FR$ 812.47 09310697 A4649 FEMO STOP II DOME$ 289.46 09312375 A4649 CATHETER EMPIRA PTCA 3.75X12MM$ 706.36 09312506 C1725 BALLOON SPRINTER NC 2.5MMX6MM$ 742.00 09312580 A4649 STENT GRAFTMASTER 2.87MMX16MM$ 3,890.21 09315350 A4649 CATHETER EMPIRA PTCA 3.5X15MM$ 706.36 09320000 A4649 STENT DES XIENCE 2.25MMX18MM$ 2,315.25 09320550 20550 INJECT TENDON SHEATH/LIGAMENT$ 285.59 09322512 A4649 STENT COR DES 2.25MMX12MM$ 2,453.06 09324501 A4649 MULTIPACK CARDIAC 6FR 5-0 .038$ 462.66 09325010 C1725 BALLOON SPRINTER SC 3.0MMX15MM$ 766.24 09325015 A4649 STENT DES XIENCE 2.5MMX15MM$ 1,874.81 09325028 A4649 STENT DES XIENCE 2.5MMX28MM$ 1,700.00 09325238 C1769 GUIDEWIRE DIAG .038 150CM$ 141.18 09325250 A4649 CATHETER EMPIRA PTCA 3.5X15MM$ 706.36 09325581 A4649 STENT GRAFTMASTER 3.5MMX19MM$ 3,890.21 09327518 A4649 STENT DES XIENCE 2.75MMX18MM$ 1,874.81 09327523 A4649 STENT DES XIENCE 2.75MMX23MM$ 1,874.81

224 09327528 A4649 STENT DES XIENCE 2.75MMX28MM$ 1,874.81 09327719 A4649 CATHETER HIFLO JR3.5 7FR 100CM$ 276.29 09327720 A4649 CATHETER JL4 7FR .038X110CM$ 206.97 09327721 A4649 CATHETER JR4 7FR .038X100CM$ 206.97 09327722 A4649 CATHETER JL5 7FR .038X100CM$ 206.97 09327723 A4649 CATHETER HIFLO JR5 7FR 100CM$ 265.25 09327740 A4649 CATHETER AL1 7FR .038X100CM$ 206.97 09327741 A4649 CATHETER AL2 7FR .038X100CM$ 206.97 09327750 A4649 CATHETER PIG 7FR .038X100CM$ 206.97 09327760 A4649 CATHETER IM 7FR .038X100CM$ 206.97 09327770 A4649 CATHETER RCB 7FR .038X100CM$ 206.97 09327772 A4649 CATHETER LCB 7FR .038X100CM$ 206.97 09327784 A4649 CATHETER MPAI 7FR .038X125CM$ 206.97 09330015 C1725 BALLOON SPRINTER SC 3.0MMX15M$ 766.24 09330016 C1887 CATHETER GUIDE AL3 LT 6FR$ 346.16 09330023 A4649 STENT DES XIENCE 3MMX23MM$ 1,874.81 09330303 A4649 CONTRAST INJECTION LINE 60"$ 219.87 09330400 A4649 CATHETER AMPLTZ SUP STIF 260CM$ 824.75 09332515 A4649 STENT DES XIENCE 3.25MMX15MM$ 1,874.81 09332518 A4649 0STENT DES XIENCE 3.25MMX18MM$ 1,874.81 09332523 A4649 STENT DES XIENCE 3.25MMX23MM$ 1,874.81 09333181 C1769 GLIDEWIRE STR .018X150CMX3CM$ 473.80 09333182 C1769 GLIDEWIRE ANG .018X150CM X3CM$ 476.07 09333184 C1769 GLIDEWIRE ST AN .018X80CMX3CM$ 476.07 09333208 33208 INSRT HEART PM ATRIAL & VENT$ 12,717.16 09333210 33210 INSERT TEMP TRNSV SNGL CHAMBER$ 8,771.39 09333211 33211 INSERT TEMP TRNSV DUAL CHAM$ 8,771.39 09333218 33218 REPAIR LEAD PACE-DEFIB ONE$ 3,144.30 09333234 33234 REMOVE 1-PACER LEAD ONLY$ 3,144.30 09333618 A4649 CATHETER SUPTR JL3.5 6FR 100CM$ 276.29 09333619 A4649 CATHETER SUPTR JR3.5 6FR 100CM$ 276.29 09333620 A4649 CATHETER SUPTR JL4 6FR 100CM$ 265.25 09333621 A4649 CATHETER SUPTR JR4 6FR 100CM$ 276.29 09333627 A4649 CATHETER SUPTR JL4.5 6FR 100CM$ 276.29 09333643 A4649 CATHETER AMPLATZ RT 6FR 2 MOD$ 296.05 09333660 A4649 CATHETER IM 6FR .038X100CM$ 206.97 09333720 A4649 CATHETER SUPTR JL4 7FR 100CM$ 276.29 09334621 A4649 CATHETER INFINITI JR4 6FR$ 265.25 09334643 A4649 CATHETER INFINITI TL 5F 100CM$ 166.37 09334670 A4649 CATHETER RCB F6INF TL 100CM$ 174.69 09338103 A4649 CATHETER RCB 6FR .038X100CM$ 430.91 09338124 A4649 CATHETER PIGTAIL 6FR 110CM$ 422.69

225 09338163 A4649 CATHETER ANGIO WR 6FR 100CM$ 85.17 09352023 A4649 CATHETER SONES 6FR 100CM$ 94.10 09353001 C1887 CATHETER GUIDE 3.5 2 S-H 6FR$ 346.16 09360012 C1769 GW PT FLOPPY STR .014 182CM$ 807.61 09360540 C1887 CATHETER GUIDE XB 3.5 LBT 5FR$ 520.18 09370110 A4649 CATHETER AMPLATZ RT 6FR$ 1,178.28 09370112 A4649 CATHETER AMPLATZ RT 6FR 12.070$ 1,178.28 09371190 A4649 SYSTEM FILTER WIRE 2.25-3.5MM$ 2,296.93 09378110 A4649 CATHETER AMPLATZ RT 7FR 1.078$ 1,178.28 09379109 C1725 BALLOON SPRINTER NC 4MMX9MM$ 935.95 09380001 C1887 CATHETER GUIDING AR2 6FR$ 329.68 09380932 A4649 CATH JDK RT 4CM 5F 100CM 0 S-P$ 94.10 09380933 A4649 CATH JDK LT 4CM 5F 100CM 0 S-P$ 94.10 09380934 A4649 CATH MLTP B1 6FR 100CM 0 S-P$ 94.10 09380935 A4649 CATH MLTP A2 5FR 100CM 2 S-P$ 94.10 09380941 A4649 CATHETER JL5 JUDKINS LT 100CM$ 258.79 09381161 A4649 CATHETER JR5 JUDKINS RT 100CM$ 258.79 09381211 A4649 CATH TIG RADIAL 6FR 100CM0$ 374.05 09381212 A4649 CATH JACKY RADIAL 6FR 100CM$ 374.05 09381213 A4649 CATH AMPLATZ LT SML AL1 100CM$ 258.79 09381214 A4649 CATH AMPLATZ LT MED AL2 100CM$ 258.79 09381235 C1887 CATHETER GUIDE SBS35 6FR$ 346.16 09381241 A4649 CATHETER PIGTAIL STR 6FR 100CM$ 258.79 09381242 A4649 CATHETER PIGTAIL ANG 6FR 100CM$ 258.79 09381302 C1887 CATHETER GUIDE JL 4.0 6FR$ 346.16 09381306 C1887 CATHETER GUIDE JR 5.0 6FR$ 346.16 09381830 C1894 INTRODUCER SHTH .038"X11CM 6FR$ 86.27 09382101 A4649 TRAY PERICARDIOCENTESIS$ 470.51 09386100 C1887 CATHETER GUIDE IM 6FR$ 346.16 09386102 C1887 CATHETER GUIDE EG 7FR$ 346.16 09387100 C1887 CATHETER GUIDE SBS4 7FR$ 341.41 09391039 C1725 BALLOON SPRINTER NC 3MMX9MM$ 935.95 09391049 C1725 BALLOON SPRINTER NC 4MMX9MM$ 741.44 09392537 92537 ELECTRONYSTAMOGRAPHY$ 244.34 09392920 92920 PRQ CARDIAC ANGIOPLAST 1 ART$ 6,180.43 09392928 92928 PRQ CARD STENT W/ANGIO I VSL$ 12,774.64 09392937 92937 PRQ REVASC BYP GRAFT 1VSL$ 12,774.64 09392943 92943 PRQ CARD REVASC CHRONIC 1 VSL$ 12,774.64 09393017 93017 CARDIO STRESS TEST TRACING$ 319.00 09393279 93279 PCMKR PROGRAM SINGLE LEAD$ 76.00 09393280 93280 PCMKR PROGRAM DUAL LEAD$ 83.03 09393281 93281 PCMKR PROGRAM MULTIPLE LEAD$ 102.72

226 09393282 93282 AICD PROGRAM SINGLE LEAD$ 94.28 09393283 93283 AICD PROGRAM DUAL LEAD$ 98.50 09393284 93284 AICD PROGRAM MULTIPLE LEAD$ 118.20 09393286 93286 PCMKR EVAL PERI-PROCEDURAL$ 45.01 09393287 93287 AICD EVAL PERI-PROCEDURAL$ 50.65 09393288 93288 PACEMAKER INTERROGATION$ 76.00 09393289 93289 AICD INTERROGATION$ 83.03 09393303 93303 TTE CONGENITAL CARDIAC COMP$ 519.46 09393304 93304 TTE CONGENITAL CARDIAC LIM/FU$ 220.79 09393306 93306 TTE W/ DOPPLER COMPLETE$ 781.32 09393307 93307 TTE W/O DOPPLER 2-D COMPLETE$ 566.52 09393308 93308 ECHO FOLLOW UP$ 254.11 09393312 93312 TRANSESOPHAGEAL ECHO COMPLETE$ 796.61 09393318 93318 TEE 2-D IMAGE ACQUISITION$ 796.61 09393320 93320 DOPPLER ECHO-PW/CW COMP$ 111.87 09393321 93321 DOPPLER ECHO-PW/CW FF-UP/LIMI$ 237.88 09393325 93325 DOPPLER ECHO-COLOR FLOW MAP$ 188.98 09393350 93350 ECHO 2-D INC STRESS TEST$ 983.26 09393351 93351 STRESS TTE COMPLETE$ 611.35 09393451 93451 ANG RIGHT HEART CATHETERIZATI$ 3,452.55 09393453 93453 R&L HEART CATH W/O CORONARY A$ 3,452.55 09393458 93458 CORS + LVG$ 6,832.28 09393459 93459 CORS + GRAFTS + LHC$ 9,505.81 09393460 93460 R&L HC + CORS +LVG$ 6,832.28 09393461 93461 R & L CORS & GRAFTS$ 9,505.81 09393503 93503 INSERTION SWANZ-GANZ MONITOR$ 2,112.04 09395812 95812 EEG PROLONGED 41-60 MIN$ 309.33 09395816 95816 EEG RECORD AWAKE AND DROWSY$ 514.15 09395819 95819 EEG RECORD AWAKE AND SLEEP$ 404.83 09395822 95822 EEG RECORD COMA OR SLEEP$ 435.87 09395824 95824 EEG CEREBRAL DEATH$ 365.44 09400003 94375 FLOW VOLUME LOOP$ 216.13 09400006 94729 DLCO$ 101.63 09400031 94727 LUNG VOLUME-FRC$ 216.13 09494060 94060 SPIROMETRY P/P BRONCHODIL$ 317.43 09494070 94070 METACHOLINE CHALLENGE$ 46.98 09494200 94200 MAXIMUM VOLUNTARY VENTILATION$ 176.57 09494620 94618 PULMONARY STRESS TEST SIMPLE$ 176.46

227