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AMBULANCE SERVICE ALS - EMERGENT AMB AMBULANCE 540 A0427 1,503.50 AMBULANCE SERVICE ALS 1 AMB AMBULANCE 540 A0426 949.50 AMBULANCE SERVICE ALS 2 AMB AMBULANCE 540 A0433 2,176.00 AMBULANCE SERVICE BLS - EMERGENT AMB AMBULANCE 540 A0429 1,266.00 AMBULANCE SERVICE BLS AMB AMBULANCE 540 A0428 790.00 AMBULANCE GROUND MILEAGE, ALS AMB AMBULANCE 540 A0425 28.00 SPECIAL CARE TRANSPORT AMB AMBULANCE 540 A0434 2,571.00

31500 INTUBATION EMERG PR ANES SURGERY 963 31500 425.00 VENIPUNCTURE BY HC PRO FE ANES SURGERY 963 36410 28.50 INSERT NON TUNNEL CATH ANES SURGERY 963 36556 295.50 62270 SPINAL PUNCTURE DX ANES SURGERY 963 62270 235.00 FEMORAL NERVE BLOCK PF ANES SURGERY 963 64447 1,447.00 PERIPHERAL NERVE BLOCK PF ANES SURGERY 963 64450 136.50 64415 ANES SINGLE NERVE BLOCK INJECTION ANES SURGERY 963 64415 198.00

RBC'S/ LEUKO DEPLETED BB LAB 390 J3490 485.50 FRESH FROZEN PLASMA BB LAB 390 J3490 250.00 PLATELETS-PHERESIS BB LAB 390 J3490 1,274.00 RBC, IRRADIATED, LEUKO BB LAB 390 J3490 551.00 BLOOD PRODUCT (CYRO) CHARGE BB LAB 390 J3490 675.50 PLATELET IRRADIATED BB LAB 390 J3490 1,500.50 ABG - COMPLETE CR CARDOPULMONARY 301 82803 177.50 ABG, ARTERIAL PUNCTURE CR CARDOPULMONARY 300 36600 34.50 ABG, O2 SAT CR CARDOPULMONARY 301 82810 22.50 ABG, PCO2 CR CARDOPULMONARY 301 82803 56.50 ABG, PH CR CARDOPULMONARY 301 82800 44.00 ABG, PO2 CR CARDOPULMONARY 301 82803 99.00 BALLARD SWIVEL CR CARDOPULMONARY 410 15.50 BI PAP CR CARDOPULMONARY 410 94002 1,472.50 BI PAP/ PER SUB DAY CR CARDOPULMONARY 410 94003 1,472.50 CARDIO RESUSCITATION CR CARDOPULMONARY 410 159.50 CONT NEB PER HR/MX/DLY CR CARDOPULMONARY 410 94640 595.00 ENDOTR SUCT DAILY CHARGE CR CARDOPULMONARY 410 67.50 ENDOTRACHEAL INTUBATION CR CARDOPULMONARY 410 31500 570.50 INCENTIVE SPIRO THERAPY CR CARDOPULMONARY 410 94799 436.00

1 MECH VENT INITIAL DAY CR CARDOPULMONARY 410 94002 1,472.50 MECH VENT/SUB CR CARDOPULMONARY 410 94003 1,472.50 NASOTRACHEAL SUCTIONING CR CARDOPULMONARY 410 31720 596.00 OXYGEN ANALYZER--CONT CR CARDOPULMONARY 410 40.50 P D & P SUBSEQUENT CR CARDOPULMONARY 410 94668 336.00 PEP THERAPY CR CARDOPULMONARY 410 94667 336.00 RESP MDI CR CARDOPULMONARY 410 94664 596.00 RESP NEBS CR CARDOPULMONARY 410 94664 596.00 TECH ASST SURG C SECTION CR CARDOPULMONARY 410 76.50 TRACHEAL LAVAGE & SUCTION CR CARDOPULMONARY 410 64.00 VEST THERAPY CR CARDOPULMONARY 410 94667 336.00 VEST THERAPY SUBQ CR CARDOPULMONARY 410 94668 336.00 CARBON MONOXIDE CR CARDOPULMONARY 460 82375 61.50 END TIDAL CO2 CR CARDOPULMONARY 460 94770 747.00 HOME OXYGEN EVALUATION CR CARDOPULMONARY 410 94618 315.00 METH HGB CR CARDOPULMONARY 460 83050 61.50 NOCTURNAL OXIMETRY I NPT CR CARDOPULMONARY 460 94762 409.00 OXIMETRY, PER HR CR CARDOPULMONARY 460 39.50 SPIROMETRY, BASIC CR CARDOPULMONARY 460 94010 409.00 PULMONARY FUNCTION TEST (PFT) CR CARDOPULMONARY 460 94060 747.00 EVENT MONITOR RECORDING CR CARDOPULMONARY 480 93270 121.00 EVENT MONITOR ANALYSIS CR CARDOPULMONARY 480 93271 368.00 EKG PROCEDURE CR CARDOPULMONARY 730 93005 168.00 RHYTHM ECG STRIP/1 MINUTE CR CARDOPULMONARY 730 93041 168.00 HOLTER UP TO 48HRS WITH SCAN & REPORT CR CARDOPULMONARY 731 93226 315.00 HOLTER MONITOR UP TO 48 HR RECORDING CR CARDOPULMONARY 731 93225 315.00 EXERCISE OXIMETRY CR CARDOPULMONARY 460 94761 72.00 PULSE OXIMETRY CR CARDOPULMONARY 460 94760 42.00 LDR NEONATE RESUSCITATION CR CARDOPULMONARY 410 99465 157.00 SPUTUM INDUCTION CR CARDOPULMONARY 410 89220 64.00 CONTINUOUS NEB (INITIAL) CR CARDOPULMONARY 410 94644 336.00 CONTINUOUS NEB EACH ADDL HOUR CR CARDOPULMONARY 410 94645 48.00 CPAP INITIATION AND MANAGEMENT CR CARDOPULMONARY 410 94660 596.00 LDR - ATTEND DELIVERY (REQUESTED BY PHY) CR CARDOPULMONARY 410 99464 225.00 TRANSTRACHEAL PERCUTANEOUS VENTILATION CR CARDOPULMONARY 410 31730 4,230.00

ABG - BICARB CR CARDOPULMONARY 301 82374 29.50 IRHYTHM ECG HOOK UP / RECORDING CR CARDOPULMONARY 730 0296T 355.00 ABG, SAMPLE KIT CR CARDOPULMONARY 270 31.50 AIRWAY, NASAL\ORAL CR CARDOPULMONARY 270 19.50 AIRWAY, ORAL CR CARDOPULMONARY 270 22.50 AMBU BAG CR CARDOPULMONARY 270 29.50

2 AMBU BAG DISPOSIBLE CR CARDOPULMONARY 270 95.50 AMBU BAG MASK- ALL SIZES CR CARDOPULMONARY 270 49.50 BALLARD SUCT. CATH CR CARDOPULMONARY 270 81.00 BI PAP CIRCUIT CR CARDOPULMONARY 270 36.50 BVM, DISPOSABLE NEO-NATAL CR CARDOPULMONARY 270 78.00 CIRCUIT, MECH VENT CR CARDOPULMONARY 270 125.50 CONNECTING TUBE, OXYGEN CR CARDOPULMONARY 270 17.00 CONNECTING TUBE-10FT CR CARDOPULMONARY 270 28.00 CONNECTING TUBE-25FT CR CARDOPULMONARY 270 40.50 CONT. NEB SETUP CR CARDOPULMONARY 270 127.50 ENVIRONMENT TENT/SET-UP CR CARDOPULMONARY 270 74.00 H2O STER/DIST ALL SIZES/E CR CARDOPULMONARY 270 21.50 HUMIDVENT CR CARDOPULMONARY 270 22.50 HYPERTONIC SALINE 15ML/3% CR CARDOPULMONARY 270 21.50 INTUBATION TUBE CR CARDOPULMONARY 270 36.50 MASK, AEROSOL CR CARDOPULMONARY 270 29.50 MASK, FACE TENT CR CARDOPULMONARY 270 31.50 MASK, NONREBREATHER CR CARDOPULMONARY 270 31.50 MASK, PEDIATRIC CR CARDOPULMONARY 270 29.50 MASK, SIMPLE OXYGEN CR CARDOPULMONARY 270 29.50 MASK, TOTAL FACE BIPAP CR CARDOPULMONARY 270 174.00 NEOPUFF CIRCUIT CR CARDOPULMONARY 270 24.50 OXIMETER PROBE NEONATAL CR CARDOPULMONARY 270 132.00 OXIMETER PROBE PED CR CARDOPULMONARY 270 101.00 OXYMIZER CR CARDOPULMONARY 270 52.00 PEF METER CR CARDOPULMONARY 270 101.00 SALINE ALL SIZES CR CARDOPULMONARY 270 21.50 TRACH COLLAR CR CARDOPULMONARY 270 36.50 VEST FULL CR CARDOPULMONARY 270 273.50 VEST WRAP CR CARDOPULMONARY 270 187.50 THERAPEUTIC PROCEDURE STRENGTH / ENDURAN CR CARDOPULMONARY 410 G0237 102.00 VEST HFCWC CR CARDOPULMONARY 410 94669 596.00 IRHYTHM ECG REVIEW AND INTERPRETATION CRDP CARDOPULMONARY 960 0298T 50.00 TRAY ARTHROGRAM CS SUPPLIES 270 9.00 2 X 2 DRESSING CS SUPPLIES 270 12.00 4 X 4 4 PLY EACH 2/PKG CS SUPPLIES 270 13.00 4 X 4 STERILE DRESSING/10 CS SUPPLIES 270 21.50 ABD BINDER, DALE 62x75 CS SUPPLIES 270 149.50 ACE WRAP ALL SIZES CS SUPPLIES 270 22.50 AIR WALKER (REBOUND) LOW CS SUPPLIES 270 122.50 BINDER, ABDOMINAL SURGICA CS SUPPLIES 270 149.50

3 CATH, FOLEY ALL SIZES CS SUPPLIES 270 61.50 CATH, LEG BAG CS SUPPLIES 270 19.50 CATH, MINI CS SUPPLIES 270 15.50 CATH, SECURE FOR LEG BAG CS SUPPLIES 270 10.00 CERVICAL, COLLAR FOAM CS SUPPLIES 270 42.00 CERVICAL, COLLAR STIFF CS SUPPLIES 270 101.00 COLOSTOMY BAG CS SUPPLIES 270 40.50 DRESSING CHANGE - LARGE CS SUPPLIES 270 46.50 DRESSING CHANGE - MEDIUM CS SUPPLIES 270 22.50 DRESSING CHANGE - SMALL CS SUPPLIES 270 12.00 DRESSING, BIOCLUSIVE 4X5 CS SUPPLIES 270 18.00 EYE PATCH, EA CS SUPPLIES 270 13.00 GLOVE, STER. MICROTOUCH CS SUPPLIES 270 13.00 IMMOBILIZER BOOT 79-95415 CS SUPPLIES 270 85.50 KCI PROVENA DISP VAC CS SUPPLIES 270 1,010.50 SALINE 1000CC CS SUPPLIES 270 19.50 SHOTS BIOCLUSIVE 4X5 CS SUPPLIES 270 18.00 SHOTS FOLEY CATH CS SUPPLIES 270 61.50 SHOTS NEDDLE HUEBER CS SUPPLIES 270 17.00 SHOTS SKIN PREP NO-STING CS SUPPLIES 270 8.00 SHOTS STATLOCK PICC SECU CS SUPPLIES 360 44.00 SHOTS SURG SCRUB SPONGE CS SUPPLIES 270 17.00 SHOTS SUTURE REMOVAL KIT CS SUPPLIES 270 12.00 SLING CS SUPPLIES 270 49.50 SPLINT, ANKLE AIR CS SUPPLIES 270 189.00 SPLINT, ANKLE ELAS WRAP CS SUPPLIES 270 31.50 SPLINT, FINGER-ALUM CS SUPPLIES 270 13.00 SPLINT, FINGER-FROG CS SUPPLIES 270 18.00 SPLINT, FOREARM #12-01T00 CS SUPPLIES 270 42.00 SPLINT, LONG ARM CS SUPPLIES 270 128.50 SPLINT, LONG LEG CS SUPPLIES 270 155.50 SPLINT, POSTERIOR CS SUPPLIES 270 82.50 SPLINT, SHORT ARM CS SUPPLIES 270 98.00 SPLINT, SHORT LEG CS SUPPLIES 270 136.50 SPLINT, SUGAR TONG SH ARM CS SUPPLIES 270 54.50 SUCTION CANNISTER CS SUPPLIES 270 19.50 SUCTION,TUBING 10' CS SUPPLIES 270 13.00 SYRINGE ALL CS SUPPLIES 270 13.00 TED HOSE KNEE LGTH/PR CS SUPPLIES 270 58.00 TRAY, BREAST LOC CS SUPPLIES 270 58.00 TUBE, NASAL GASTRIC CS SUPPLIES 270 19.50 UNNABOOT CS SUPPLIES 270 35.50 4 CATH, INDWELLING TRAY CS SUPPLIES 270 A4312 70.00 SPLINT CS SUPPLIES 270 A4570 28.00 SPLINT, FINGER-VELCRO #39 CS SUPPLIES 270 A4570 37.50 SPLINT, FORE & WRIST w/VE CS SUPPLIES 270 A4570 74.00 SMALL JNT IMPLANT CS SUPPLIES 278 C1776 1,229.00 CRUTCHES COMPLETE CS SUPPLIES 270 151.00 BREAST PUMP KIT CS SUPPLIES 270 E0602 75.00 BREAST PUMP, MEDELA ELEC. CS SUPPLIES 271 E0603 290.00 SPLINT, KNEE UNIVERSAL CS SUPPLIES 270 64.50 SPLINT ANKLE STABILING SU CS SUPPLIES 270 71.00 CAST SHOE/KOOL KOLOR 1487 CS SUPPLIES 274 70.00 SHOE, MED/SURG POST-OP CS SUPPLIES 274 70.00 SHOULDER ABDUCTION FIG 8 CS SUPPLIES 270 231.00 SPLINT, SHOULDER IMMOB CH CS SUPPLIES 270 141.50 SPLINT, 10 LACE-UP WRIST CS SUPPLIES 270 44.50 SPLINT, WRIST COCK-UP CS SUPPLIES 270 76.50 SPLINT, WRIST-ELASTIC CS SUPPLIES 270 37.50 WRIST SUPPORT ELASTIC CS SUPPLIES 270 32.50 WRIST/ FOREAREM ELASTIC CS SUPPLIES 270 25.00 SPLINT, THUMB SPICA BRACE CS SUPPLIES 270 44.00 SPLINT, ANKLE 79-81197 CS SUPPLIES 270 71.00 SPLINT, ANKLE SUPPORT CS SUPPLIES 270 82.50 MAXTRAX AIR WALKER #79-95 CS SUPPLIES 270 99.00 INTRAOCULAR, CILCO-UV LEN CS SUPPLIES 276 V2632 2,325.00 .45NS 1000ML CS SUPPLIES 260 8.00 .45NS 500ML CS SUPPLIES 260 7.00 .9NS 1000ML CS SUPPLIES 260 7.00 .9NS 100ML CS SUPPLIES 260 6.00 .9NS 100ML ADVANTAGE CS SUPPLIES 260 12.00 .9NS 250ML CS SUPPLIES 260 6.00 .9NS 500ML CS SUPPLIES 260 6.00 .9NS 50ML CS SUPPLIES 260 6.00 .9NS 50ML ADVANTAGE CS SUPPLIES 260 12.00 .9NS IRRIGATION 3000ML CS SUPPLIES 260 27.00 .9NS IRRIGATION BTL 1000ML CS SUPPLIES 260 8.00 20MEQ KCL / .9NS 1000ML CS SUPPLIES 260 10.00 20MEQ KCL / D5W / .45NS 1000ML CS SUPPLIES 260 9.00 2VIEW SPECIMENT COLLECT CS SUPPLIES 270 122.00 ADHESIVE SPO2, ADULT CS SUPPLIES 270 54.00 ADHESIVE SPO2, NEONATE CS SUPPLIES 270 65.00 ADHESIVE SPO2, PEDIATRIC CS SUPPLIES 270 54.00 ANGIOCATH 16GA X 3.25 CS SUPPLIES 270 88.00 5 ANOSCOPE W/ LIGHT CS SUPPLIES 270 34.00 ARNDT ENDO BRONC BLOCKER CS SUPPLIES 270 730.00 ART LINE CS SUPPLIES 270 500.00 ARTERIAL BLOOD GAS KIT CS SUPPLIES 270 6.00 ARTERIAL LINE CS SUPPLIES 270 123.00 BALLOON VIEW SPACEMAKER CS SUPPLIES 270 1,077.00 BLOOD / FLUID SET RAPID INFUSE LVL 1 CS SUPPLIES 270 228.00 BLOOD TUBE CITRATE, 1.8ML BLUE CS SUPPLIES 270 20.00 BLOOD TUBE EDTA 3ML, LAVENDER CS SUPPLIES 270 392.00 BLOOD TUBE HEMOGARD, 2ML GREY CS SUPPLIES 270 400.00 BLOOD TUBE HEPARIN 5ML, GREEN CS SUPPLIES 270 551.00 BLOOD TUBE LITHIUM HEP 2ML, GREEN CS SUPPLIES 270 551.00 BLOOD TUBE PST, AMBER CS SUPPLIES 270 120.00 BLOOD TUBE SERUM 4ML, GREEN CS SUPPLIES 270 509.00 BLOOD TUBE SERUM 5ML, RED CS SUPPLIES 270 523.00 BONE MARROW BIOPSY TRAY CS SUPPLIES 270 138.00 BREAST PUMP, SEND HOME PNSA CS SUPPLIES 270 686.00 CAPIO SLIM CS SUPPLIES 270 416.00 CARTER THOMPSON CLOSURE DEVICE CS SUPPLIES 270 440.00 CHOLANGIOGRAM CATHETER 4.5FR CS SUPPLIES 270 256.00 CLIP APPLIER 10MM CS SUPPLIES 270 437.00 CLIP APPLIER, 5MM CS SUPPLIES 270 726.00 CORRECT CLIP CS SUPPLIES 270 221.00 COVAC 70DEG COBLATION WAND CS SUPPLIES 270 1,117.00 COVAC 90DEG COBLATION WAND CS SUPPLIES 270 1,117.00 CROSSFIX MENISCAL REPAIR CURVE CS SUPPLIES 270 1,760.00 CROSSFIX PROCEDURE KIT CS SUPPLIES 270 820.00 CT SYRINGE, DUAL, SPIKE CS SUPPLIES 270 1,052.00 CT SYRINGE, SINGLE, SPIKE CS SUPPLIES 270 1,608.00 CVC CATH 7FR 3LUM CS SUPPLIES 270 419.00 CVC CATH 8FR 16CM 4LUM CS SUPPLIES 270 491.00 CVC CATH 8FR 20CM 4LUM CS SUPPLIES 270 491.00 D5W / .2NS 1000ML CS SUPPLIES 260 8.00 D5W / .4 LIDOCAINE 500ML CS SUPPLIES 260 21.00 D5W / .45NS 1000ML CS SUPPLIES 260 8.00 D5W / .9NS 1000ML CS SUPPLIES 260 8.00 D5W / .9NS 500ML CS SUPPLIES 260 7.00 D5W / LR 1000ML CS SUPPLIES 260 8.00 D5W / LR 500ML CS SUPPLIES 260 6.00 D5W 1000ML CS SUPPLIES 260 7.00 D5W 100ML CS SUPPLIES 260 6.00 D5W 100ML ADVANTAGE CS SUPPLIES 260 12.00 6 D5W 250ML CS SUPPLIES 260 7.00 D5W 500ML CS SUPPLIES 260 7.00 D5W 50ML CS SUPPLIES 260 6.00 D5W 50ML ADVANTAGE CS SUPPLIES 260 12.00 DRAIN DRAIN, MINI EXPRESS CS SUPPLIES 270 290.00 DRESSING, POLYMEM MAX 8X8 CS SUPPLIES 270 22.00 DRESSING, POLYMEM MAX SILVER 8X8 CS SUPPLIES 270 143.00 DRY SUCTION CHEST DRAIN CS SUPPLIES 270 183.00 DYONIC SHAVER FULL RADIUS 4.5 CS SUPPLIES 270 298.00 DYONIC SHAVER FULL RADIUS 4.5 CS SUPPLIES 270 234.00 DYONICS ABRADER 4.0 CS SUPPLIES 270 260.00 DYONICS ABRADER 5.5 CS SUPPLIES 270 273.00 DYONICS MENISCAL STRAIGHT CS SUPPLIES 270 1,165.00 DYONICS NOTCHBLASTER 4.0 CS SUPPLIES 270 273.00 DYONICS SHAVER FULL RADIUS 5.5 CS SUPPLIES 270 260.00 ELECTRO CAUTERY PEN CS SUPPLIES 270 53.00 ELECTRODE BLADE 6.5" CS SUPPLIES 270 14.00 ELECTRODE BLADE CLEAN 1" CS SUPPLIES 270 22.00 ELECTRODE NEEDLE 2.8" CS SUPPLIES 270 15.00 EMERGENT INFUSION DEVICE 6FR CS SUPPLIES 270 90.00 EMERGENT INFUSION DEVICE 8FR CS SUPPLIES 270 157.00 ENDO DISSECT 5MM CS SUPPLIES 270 483.00 ENDO MINI SHEAR 5MM CS SUPPLIES 270 483.00 ENDO PEANUT CS SUPPLIES 270 229.00 ENDO RETRACTOR 10MM CS SUPPLIES 270 391.00 ENDOSTITCH SUTRE DEVICE CS SUPPLIES 270 758.00 ENDOSTITCH SUTURE ABS 3/0 CS SUPPLIES 270 196.00 ENDOSTITCH SUTURE NON 2/0 CS SUPPLIES 270 196.00 EPIDURAL KIT CS SUPPLIES 270 140.00 EPIX LAP GRAPERS 5MM CS SUPPLIES 270 317.00 EVEREST BIPO SHEARS CS SUPPLIES 270 976.00 EZ DISK BARIUM TABS CS SUPPLIES 270 400.00 EZ GAS GRANULE TABS CS SUPPLIES 270 11.00 FEMALE CATH KIT CS SUPPLIES 270 31.00 FINGER COT, LRG CS SUPPLIES 270 4.00 FINGER COT, MED CS SUPPLIES 270 4.00 FINGER COT, SMALL CS SUPPLIES 270 4.00 FINGER COT, XL CS SUPPLIES 270 4.00 FINGER FROG SPLINT LRG CS SUPPLIES 270 4.00 FINGER FROG SPLINT MED CS SUPPLIES 270 4.00 FINGER FROG SPLINT SM CS SUPPLIES 270 4.00 FINGER PROTECTOR LRG CS SUPPLIES 270 4.00 7 FINGER PROTECTOR SM CS SUPPLIES 270 4.00 FINGER PROTECTOR SM/MED CS SUPPLIES 270 4.00 FINGER PROTECTOR XL CS SUPPLIES 270 4.00 FINGER SPLINT CURVED LRG CS SUPPLIES 270 4.00 FINGER SPLINT CURVED MED CS SUPPLIES 270 4.00 FINGER SPLINT CURVED SM CS SUPPLIES 270 4.00 FINGER SPLINT CURVED SM/MED CS SUPPLIES 270 4.00 FINGER SPLINT CURVED XL CS SUPPLIES 270 4.00 FISTULA / WOUND SYSTEM 4X6 CS SUPPLIES 270 670.00 FISTULA / WOUND SYSTEM 6X8 CS SUPPLIES 270 1,043.00 FISTULA / WOUND SYSTEM 8X11 CS SUPPLIES 270 1,090.00 FIXATION TACKER, 30 SET CS SUPPLIES 270 2,898.00 FLOSEAL 10ML CS SUPPLIES 270 1,504.00 FOLEY CATH TRAY 14FR CS SUPPLIES 270 89.00 FOLEY CATH TRAY INFANT CS SUPPLIES 270 8.00 FOLEY CATH TRAY PEDIATRIC CS SUPPLIES 270 8.00 GELPOINT ACCESS SYS CS SUPPLIES 270 2,700.00 GELPORT 120MM CS SUPPLIES 270 2,100.00 GENESYS PROCEDURE SET CS SUPPLIES 270 4,761.00 GIA STAPLE RELOAD 60 X 3.8 CS SUPPLIES 270 254.00 GIA STAPLE RELOAD 80 X 3.8 CS SUPPLIES 270 371.00 GIA STAPLER 60 X 3.8 CS SUPPLIES 270 483.00 GIA STAPLER 80 X 3.8 CS SUPPLIES 270 2,186.00 GLIDESCOPE BLADE, SIZE GVL 3 CS SUPPLIES 270 90.00 GLIDESCOPE BLADE, SIZE GVL 4 CS SUPPLIES 270 90.00 GLIDESCOPE BLADE, SIZE LOPRO 1 CS SUPPLIES 270 260.00 GLIDESCOPE BLADE, SIZE LOPRO 2 CS SUPPLIES 270 260.00 GLIDESCOPE BLADE, SIZE LOPRO 3 CS SUPPLIES 270 200.00 GLIDESCOPE BLADE, SIZE LOPRO 4 CS SUPPLIES 270 200.00 GOLD PROBE INJECTION NEEDLE CS SUPPLIES 270 908.00 HARMONIC FOCUS SHEAR 9MM CS SUPPLIES 270 4,015.00 HARMONIC LAP SHEAR 5MM CS SUPPLIES 270 3,540.00 HEADGEAR W/ MAK, LARGE CS SUPPLIES 270 144.00 HEADGEAR W/ MASK, MEDIUM CS SUPPLIES 270 144.00 HEADGEAR W/ MASK, SMALL CS SUPPLIES 270 144.00 HEMACLEAR BLACK / WHITE CS SUPPLIES 270 245.00 HEMACLEAR F/A CS SUPPLIES 270 262.00 HEMACLEAR ORANGE CS SUPPLIES 270 245.00 HEMACLEAR PINK CS SUPPLIES 270 175.00 HEMACLEAR YELLOW CS SUPPLIES 270 190.00 HEMORRHOID STAPLER 3MM CS SUPPLIES 270 1,573.00 HEWSON SUTURE RETRIEVER CS SUPPLIES 270 950.00 8 INFUSION SET 3SPIKE BELMONT CS SUPPLIES 270 331.00 INLET CLOSURE CS SUPPLIES 270 145.00 INR TESTING STRIPS CS SUPPLIES 270 310.00 INSTINCT RESOLUTION CLIP CS SUPPLIES 270 1,048.00 INSUFFLATION NEEDLE 120MM CS SUPPLIES 270 65.00 INTERDRY CS SUPPLIES 270 242.00 INTERJET INJECTION NEEDLE, 25GA CS SUPPLIES 270 151.00 INTERPULSE HANDPIECE W/ TUBE CS SUPPLIES 270 165.00 IV FILTER .2 MICRON CS SUPPLIES 270 12.00 KATZ EXTRACTOR, OTO FOREIGN BODY CS SUPPLIES 270 259.00 KII BALLOON 12X100 BLUNT TIP CS SUPPLIES 270 115.00 KII FIOS SLEEVE 5X100 CS SUPPLIES 270 38.00 KII FIOS TROCAR 12X100 CS SUPPLIES 270 125.00 KII FIOS TROCAR 12X100 W/ OBTUR CS SUPPLIES 270 125.00 KII FIOS TROCAR 12X150 W/ OBTUR CS SUPPLIES 270 115.00 KII FIOS TROCAR 5X100 CS SUPPLIES 270 75.00 KII FIOS TROCAR 5X100 W/ OBTUR CS SUPPLIES 270 75.00 KII FIOS TROCAR 5X150 W/ OBTUR CS SUPPLIES 270 75.00 KII FIOS TROCAR BALLOON 12X130 CS SUPPLIES 270 115.00 KII OPTICAL TROCAR 15X100 CS SUPPLIES 270 230.00 LIGASURE CURVED LRG JAW SEALER CS SUPPLIES 270 2,456.00 LIGASURE DOLPHIN SEALER CS SUPPLIES 270 3,757.00 LIGASURE MARYLAND JAW SEALER CS SUPPLIES 270 1,974.00 LIGIGATOR O RING BANDS CS SUPPLIES 270 4.00 LIQUID EZ PAQUE BARIUM SUSP CS SUPPLIES 270 28.00 LIQUID POLIBAR 1900ML CS SUPPLIES 270 26.00 LR 1000ML CS SUPPLIES 270 8.00 LUMBAR PUNCTURE TRAY CS SUPPLIES 270 42.00 MAGENVIST 20ML CS SUPPLIES 270 369.00 MALECOT DRAIN 16FR CS SUPPLIES 270 125.00 MALECOT DRAIN 24FR CS SUPPLIES 270 125.00 MENISCAL KNOT PUSHER CS SUPPLIES 270 500.00 METZ SCISSOR HOOK SU CS SUPPLIES 270 414.00 METZ SCISSORS SU CS SUPPLIES 270 414.00 MICRO INTRODUCER KIT 4.5FR CS SUPPLIES 270 144.00 MICRO INTRODUCER KIT 5FR CS SUPPLIES 270 493.00 MINI GRASPER CS SUPPLIES 270 840.00 MRI SYRINGE, DUAL, SPIKE CS SUPPLIES 270 134.00 MULTIFIX SUTURE DEVICE CS SUPPLIES 270 3,300.00 NASAL CPAP MASK M/L CS SUPPLIES 270 64.00 NASAL CPAP MASK S/M CS SUPPLIES 270 64.00 NEEDLE EZ IO 15MM CS SUPPLIES 270 546.00 9 NEEDLE EZ IO 25MM CS SUPPLIES 270 546.00 NEEDLE EZ IO 45MM CS SUPPLIES 270 546.00 NEEDLE HUBER 20GA X .5 CS SUPPLIES 270 79.00 NEEDLE HUBER 20GA X .75 CS SUPPLIES 270 76.00 NEEDLE HUBER 20GA X 1 CS SUPPLIES 270 76.00 NEEDLE HUBER 20GA X 1.5 CS SUPPLIES 270 63.00 OBTRYX II HALO CS SUPPLIES 270 4,158.00 OPUS MAGNUM KNOTLESS IMPLANT CS SUPPLIES 270 2,067.00 OSTOMY COMBO KIT 2.25 CS SUPPLIES 270 4.00 OSTOMY COMBO KIT 2.75 CS SUPPLIES 270 4.00 OSTOMY DRAIN POUCH 57MM CS SUPPLIES 270 4.00 OXIMIZER, ADULT CS SUPPLIES 270 101.00 PAINBUSTER, SILVER SOAKER CS SUPPLIES 270 554.00 PARACERVICAL PUDENDAL BLOCK TRAY CS SUPPLIES 270 33.00 PICC CATH 4FR SINGLE CS SUPPLIES 270 844.00 PICC CATH 5FR DUAL CS SUPPLIES 270 890.00 PIGTAIL DRAIN 10FR CS SUPPLIES 270 395.00 PIGTAIL DRAIN 6FR CS SUPPLIES 270 412.00 PIGTAIL DRAIN 8FR CS SUPPLIES 270 412.00 PLEURX CATH KIT CS SUPPLIES 270 2,300.00 PLEURX DRAIN KIT 1000ML CS SUPPLIES 270 295.00 PNEUMOTHORAX TRAY CS SUPPLIES 270 730.00 POLYGRAB TRIPOD FORCEPS CS SUPPLIES 270 334.00 POST OP SHOE LRG CS SUPPLIES 270 23.00 POST OP SHOE MED CS SUPPLIES 270 23.00 POST OP SHOE SM CS SUPPLIES 270 23.00 POST OP SHOE XL CS SUPPLIES 270 23.00 POWERPORT 8FR, MRI CS SUPPLIES 270 3,199.00 POWERPORT 8FR, MRI GROS UNFILL CS SUPPLIES 270 3,492.00 POWERPORT 8FR, MRI GROSHONG CS SUPPLIES 270 3,492.00 POWERWAND CATH 3FR CS SUPPLIES 270 360.00 POWERWAND CATH XL 4FR 10CM CS SUPPLIES 270 500.00 POWERWANDCATH XL 4FR 8CM CS SUPPLIES 270 500.00 PRO NOX CIRCUIT, MEDIUM MASK CS SUPPLIES 270 4.00 PURSTING 65 MONO 2/0 CS SUPPLIES 270 781.00 QUICKANCHOR GII CS SUPPLIES 270 1,680.00 RANGER FLUID WARMING SET CS SUPPLIES 270 134.00 RAPID EXCHANGE CATHETER CS SUPPLIES 270 54.00 RAPID RHINO ANTERIOR MED CS SUPPLIES 270 356.00 RAPID RHINO ANTERIOR POSTERIOR CS SUPPLIES 270 367.00 RAPID RHINO ANTERIOR SM CS SUPPLIES 270 356.00 READICAT BARIUM SUSP VANILLA CS SUPPLIES 270 10.00 10 RELIATACK RELOAD 5 DEEP CS SUPPLIES 270 522.00 RELIATACK RELOAD 8 DEEP CS SUPPLIES 270 855.00 RELOAD TA DST 30 X 3.5 CS SUPPLIES 270 194.00 RELOAD TA DST 30 X 4.8 CS SUPPLIES 270 194.00 RELOAD TA DST 60 X 3.5 CS SUPPLIES 270 219.00 RELOAD TA DST 60 X 4.8 CS SUPPLIES 270 219.00 RETRIEVAL SYS 1000 CS SUPPLIES 270 275.00 RETROGRADE LIGAMENT KNIFE CS SUPPLIES 270 1,200.00 RINHO ROCKET LARGE CS SUPPLIES 270 182.00 RINHO ROCKET MEDIUM CS SUPPLIES 270 147.00 RINHO ROCKET SMALL CS SUPPLIES 270 121.00 ROTICULATOR 55 X 3.5 STAPLER CS SUPPLIES 270 788.00 ROTICULATOR 55 X 4.8 STAPLER CS SUPPLIES 270 788.00 ROTICULATOR RELOAD 30 X 2.0 CS SUPPLIES 270 773.00 ROTICULATOR RELOAD 30 X 2.5 CS SUPPLIES 270 601.00 ROTICULATOR RELOAD 30 X 3.5 CS SUPPLIES 270 601.00 ROTICULATOR RELOAD 45 X 4.8 CS SUPPLIES 270 721.00 ROTICULATOR RELOAD 60 X 3.5 CS SUPPLIES 270 856.00 ROTICULATOR RELOAD 60 X 4.8 CS SUPPLIES 270 898.00 SAFESET TUBING CS SUPPLIES 270 20.00 SHEATH INTRODUCER, 4FR CS SUPPLIES 270 33.00 SHEATH INTRODUCER, 6FR CS SUPPLIES 270 33.00 SHEATH INTRODUCER, 8FR CS SUPPLIES 270 33.00 SHEATH INTRODUCER, 8FR W/ OBTR CS SUPPLIES 270 83.00 SHEATH INTROUDCER, 11FR CS SUPPLIES 270 33.00 SPINAL TRAY, PENCAN CS SUPPLIES 270 98.00 SPLINT, ANKLE FLOAM 10" CS SUPPLIES 270 92.00 SPLINT, ANKLE LRG CS SUPPLIES 270 60.00 SPLINT, ANKLE MED CS SUPPLIES 270 60.00 SPLINT, ANKLE SM CS SUPPLIES 270 60.00 SPLINT, ARM SLING L CS SUPPLIES 270 8.00 SPLINT, ARM SLING M CS SUPPLIES 270 8.00 SPLINT, ARM SLING SM CS SUPPLIES 270 8.00 SPLINT, KNEE 16" CS SUPPLIES 270 70.00 SPLINT, KNEE 20" CS SUPPLIES 270 70.00 SPLINT, KNEE 24" CS SUPPLIES 270 82.00 SPLINT, SHOULDER IMMOB CS SUPPLIES 270 37.00 SPLINT, SOFT CERVICAL COLLAR 2.5" CS SUPPLIES 270 18.00 SPLINT, SOFT CERVICAL COLLAR 3" CS SUPPLIES 270 13.00 SPLINT, SOFT CERVICAL COLLAR 4" CS SUPPLIES 270 14.00 SPLINT, THUMB SPICA CS SUPPLIES 270 52.00 SPLINT, WRIST LEFT L CS SUPPLIES 270 33.00 11 SPLINT, WRIST LEFT M CS SUPPLIES 270 37.00 SPLINT, WRIST LEFT S CS SUPPLIES 270 33.00 SPLINT, WRIST RIGHT L CS SUPPLIES 270 33.00 SPLINT, WRIST RIGHT M CS SUPPLIES 270 33.00 SPLINT, WRIST RIGHT S CS SUPPLIES 270 33.00 STAPLER CEEA CIRCULAR 28MM CS SUPPLIES 270 1,152.00 STAPLER CEEA CIRCULAR 31MM CS SUPPLIES 270 1,152.00 STAPLER CEES CIRCULAR 25MM CS SUPPLIES 270 1,152.00 STAPLER CIRCULAR 25 X 4.8 CS SUPPLIES 270 1,230.00 STAPLER CIRCULAR 28 X 4.8 CS SUPPLIES 270 1,230.00 STAPLER TA DST 30 X 3.5 CS SUPPLIES 270 444.00 STAPLER TA DST 30 X 4.8 CS SUPPLIES 270 444.00 STAPLER TA DST 60 X 3.5 CS SUPPLIES 270 1,296.00 STAPLER TA DST 60 X 4.8 CS SUPPLIES 270 1,296.00 STERILE BLOOD TUBE PACK CS SUPPLIES 270 6.00 STERILE WATER INJECTION 1000ML CS SUPPLIES 270 14.00 STERILE WATER IRRIGATION 1000ML CS SUPPLIES 270 7.00 SURGICLIP APP 13" CS SUPPLIES 270 267.00 SURGICLIP APP 9" CS SUPPLIES 270 267.00 SURGICLIP APP 9.75" CS SUPPLIES 270 307.00 SURGIWAND SUCTION IRR 5MM CS SUPPLIES 270 801.00 SURGIWAND SUCTION IRR 5MM W/ L CS SUPPLIES 270 801.00 SURUTRE, POLYPRO 0 36" TAPERCUT CS SUPPLIES 270 192.00 SUTURE RETRIEVER CS SUPPLIES 270 208.00 THAL QUICK 14FR TRAY CS SUPPLIES 270 608.00 THAL QUICK 16FR TRAY CS SUPPLIES 270 605.00 THORA VENT 11FR 10CM CS SUPPLIES 270 960.00 THORA VENT 11FR 13CM CS SUPPLIES 270 960.00 THORA VENT 13FR 10CM CS SUPPLIES 270 960.00 THORACENTESIS / PARACENTESIS TRAY CS SUPPLIES 270 132.00 THORACENTESIS TRAY CS SUPPLIES 270 348.00 THORAVENT 13FR 13CM CS SUPPLIES 270 960.00 TK TI KNOT DEVICE CS SUPPLIES 270 700.00 TK TI KNOT SUTURE REOAD CS SUPPLIES 270 200.00 TRACH 6MM CUFF CS SUPPLIES 270 132.00 TRACH 6MM FENESTRATED CS SUPPLIES 270 117.00 TRACH 6MM UNCUFF CS SUPPLIES 270 113.00 TRACH 7MM CUFF CS SUPPLIES 270 132.00 TRACH 7MM FENESTRATED CS SUPPLIES 270 117.00 TRACH 7MM UNCUFF CS SUPPLIES 270 113.00 TRACH 8MM CUFF CS SUPPLIES 270 132.00 TRACH 8MM FENESTRATED CS SUPPLIES 270 116.00 12 TRACH 8MM UNCUFF CS SUPPLIES 270 113.00 TRACH PERCUTANEOUS 6MM CS SUPPLIES 270 195.00 TRACH PERCUTANEOUS 8MM CS SUPPLIES 270 195.00 TRACH SHILEY 6MM CUFF CS SUPPLIES 270 161.00 TRACH SHILEY 6MM FENESTRATED CS SUPPLIES 270 175.00 TRACH SHILEY 6MM UNCUFF CS SUPPLIES 270 156.00 TRACH SHILEY 8MM CUFF CS SUPPLIES 270 161.00 TRACH SHILEY 8MM FENESTRATED CS SUPPLIES 270 175.00 TRACH SHILEY 8MM UNCUFF CS SUPPLIES 270 156.00 TUM-E-VAC 32FR CS SUPPLIES 270 234.00 ULTRAFIX MENISCAL CURVED CS SUPPLIES 270 1,165.00 UNIVERSAL STAPLE HANDLE CS SUPPLIES 270 1,472.00 UNNA BOOT, 3" CS SUPPLIES 270 84.00 URETHRAL CATH TRAY CS SUPPLIES 270 9.00 UROMETER CS SUPPLIES 270 17.00 UROSTOMY DRAIN POUCH 57MM CS SUPPLIES 270 3.00 VENT SPIKE ADAPTER CS SUPPLIES 270 7.00 VOLUMEN BARIUM SUSP CS SUPPLIES 270 71.00 WALKING BOOT LRG CS SUPPLIES 270 175.00 WALKING BOOT MED CS SUPPLIES 270 175.00 WALKING BOOT SMALL CS SUPPLIES 270 175.00 WALKING BOOT XL CS SUPPLIES 270 175.00 WAYNE PNUEMO SET 14FR CS SUPPLIES 270 734.00 WAYNE PNUEMO TRAY 14FR CS SUPPLIES 270 734.00 CT HEAD W/OUT CONTRAST CT IMAGING 350 70450 1,210.00 CT HEAD W/CONTRAST CT IMAGING 350 70460 1,597.00 CT HEAD W/O, W CONTRAST CT IMAGING 350 70470 1,748.00 CT ORBITS, FACIAL, MASTOIDS W/O CONTRAST CT IMAGING 350 70480 912.00 CT SINUS COMPLETE W/O CONTRAST CT IMAGING 350 70486 1,042.00 CT SINUS SCREEN W/O CONTRAST CT IMAGING 350 76380 883.50 CT MAX/FACIAL W CONTRAST CT IMAGING 350 70487 1,803.50 CT NECK W/O CONTRAST CT IMAGING 350 70490 941.50 CT NECK W/ CONTRAST CT IMAGING 350 70491 1,420.50 CT NECK W/WO CONTRAST CT IMAGING 350 70492 1,420.50 CTA HEAD WITH CONTRAST CT IMAGING 350 70496 2,286.50 CTA NECK W/CONTRAST CT IMAGING 350 70498 2,694.50 CT CHEST W/OUT CONTRAST CT IMAGING 350 71250 1,377.00 CT CHEST W/CONTRAST CT IMAGING 350 71260 1,664.50 CT CHEST W/O - W CONTRAST CT IMAGING 350 71270 2,076.50 CTA CHEST (NONCORONARY) CT IMAGING 350 71275 2,158.50 CT CERVICAL SP WO/CONTRAST CT IMAGING 350 72125 1,289.00 CT CERVICAL W/ CONTRAST CT IMAGING 350 72126 1,619.50 13 CT CERVICAL WO/W CONTRAST CT IMAGING 350 72127 1,962.00 CT THORACIC SP W/O CONTRAST CT IMAGING 350 72128 1,487.00 CT THORACIC WITH CONTRAST CT IMAGING 350 72129 1,886.50 CT LUMBAR SP WO/CONTRAST CT IMAGING 350 72131 1,487.00 CT LUMBAR W/CONTRAST CT IMAGING 350 72132 1,886.50 CT LUMBAR WO/W CONTRAST CT IMAGING 350 72133 2,816.00 CT PELVIS W/OUT CONTRAST CT IMAGING 350 72192 1,289.00 CT PELVIS W/CONTRAST CT IMAGING 350 72193 1,619.50 CT UPPER EXTREM W/O CT IMAGING 350 73200 1,208.50 CT UPPER EXTREMITY W/WO CONTRAST CT IMAGING 350 73202 1,861.50 CT LOWER EXTREM. W/O CT IMAGING 350 73700 1,208.50 CT LOWER EXTREM W/CONTRAST CT IMAGING 350 73701 1,533.50 CT LOWER EXTREMITY W/WO CONTRAST CT IMAGING 350 73702 1,861.50 CTA LOWER EXTREMITY CT IMAGING 350 73706 307.50 CT ABD W/OUT CONTRAST CT IMAGING 350 74150 1,289.00 CT ABD. W/CONTRAST CT IMAGING 350 74160 1,619.50 CT ABDOMEN W/WO CONTRAST CT IMAGING 350 74170 2,536.00 CTA ABDOMEN/PELVIS CT IMAGING 350 74174 1,154.50 CTA ABD CT IMAGING 350 74175 2,449.50 CT ABD & PELVIS W/O CONTRAST CT IMAGING 350 74176 2,981.00 CT ABD & PELVIC W/ CONTRAST CT IMAGING 350 74177 2,981.00 CT ABD & PELVIS WO/W CONTRAST CT IMAGING 350 74178 4,147.00 CT GUIDED BIOPSY CT IMAGING 350 77012 1,625.50 LOW DOSE CT LUNG CANCER SCREEN CT IMAGING 350 G0297 199.00 CT FOLLOW UP / LIMITED STUDY CT IMAGING 350 76380 501.00 CT MAX/FACIAL WITHOUT CONTRAST CT IMAGING 350 70486 1,042.00 CT MAX/FACIAL W/WO CONTRAST CT IMAGING 350 70488 1,803.50 CT PELVIS W/WO CONTRAST CT IMAGING 360 72194 2,536.00 CT THORACIC SPINE W/WO CONTRAST CT IMAGING 350 72130 2,816.00 CTA UPPER EXTREMITY CT IMAGING 350 73206 307.50 CTA PELVIS CT IMAGING 350 72191 786.50 CT ORBITS, FACIAL, MASTOIDS W CONTRAST CT IMAGING 350 70481 808.00 CT ORBITS, FACIAL, MASTOIDS W/WO CONTRAS CT IMAGING 350 70482 808.00 CT UPPER EXTREMITY WITH CONTRAST CT IMAGING 350 73201 808.00 CTA ABDOMEN/AORTA WITH RUNOFF CT IMAGING 350 75635 808.00 DEXA DUAL ENERGY X-RAY AB DEXA IMAGING 320 77080 366.00 DEXA VERTEBRAL FRACTURE ASSESSMENT DEXA IMAGING 320 77086 557.00 MNT ASSESMT/INTERVNT INDIV EA 15 MIN DIET DIETICIAN ASSESSMENT 942 97802 95.50 MNT RE-ASSESMT/INTERVNT INDIV EA 15 MIN DIET DIETICIAN ASSESSMENT 942 97803 40.50 MNT SUBS VISIT FOR CHANGE DX DIET DIETICIAN ASSESSMENT 942 G0270 82.50 DIABETIC EDUCATION INDIVIDUAL 30 MIN DIET DIETICIAN ASSESSMENT 942 G0108 74.50

14 DIABETIC EDUCATION GROUP 30 MIN DIET DIETICIAN ASSESSMENT 942 G0109 82.00 GROUP NUTRITION THERAPY 30 MIN DIET DIETICIAN ASSESSMENT 942 97804 44.50 STRESS ECHO ECHO IMAGING 482 93350 1,555.00 ECHO PW, CW DOPPLER ECHO IMAGING 483 93306 1,555.50 ECHO FOLLOW-UP/LIMITED STUDY ECHO IMAGING 483 93308 742.50 ECHO TEE ECHO IMAGING 483 93312 1,555.00 ECHO TEE PROBE PLACEMENT ECHO IMAGING 483 93313 1,555.00 ECHO TEE REPORT / IMAGE ECHO IMAGING 483 93314 436.00 ECHO CONGENITAL TEE ECHO IMAGING 483 93315 1,555.00 ECHO TEE PROBE PLACEMENT ECHO IMAGING 483 93316 1,555.00 ECHO TEE LV FUNCTION/THERAPEUTIC ECHO IMAGING 483 93318 1,555.00 ECHO ECG MONITORING ECHO IMAGING 483 93351 1,555.00 ECHO 3D RENDERING WITH WORKSTATION ECHO IMAGING 483 76376 39.00 ECHO 3D REDNERGIN WITHOUT WORKSTATION ECHO IMAGING 483 76377 92.00 EMERGENCY VISIT - LIMITED ED EMERGENCY ROOM 450 99281 165.00 EMERGENCY VISIT - LOW ED EMERGENCY ROOM 450 99282 398.50 EMERGENCY VISIT - MODERATE ED EMERGENCY ROOM 450 99283 700.50 EMERGENCY VISIT - HIGH ED EMERGENCY ROOM 450 99284 1,136.50 EMERGENCY VISIT - COMPREHENSIVE ED EMERGENCY ROOM 450 99285 1,665.00 CRITICAL CARE INIT 30-74 MIN ED EMERGENCY ROOM 450 99291 2,345.00 CRITICAL CARE EA ADDL 30 MIN ED EMERGENCY ROOM 450 99292 163.50 TRAUMA RESPONSE TEAM W/CC ED EMERGENCY ROOM 684 G0390 1,340.00 ED SURG PROCEED FIRST 15 MIN ED EMERGENCY ROOM 450 264.00 EMERGENCY VISIT, TRAUMA, COMPREHENSIVE ED EMERGENCY ROOM 684 99285 1,665.00 ED TRAUMA, CRITICAL CARE INIT 30-74 MIN ED EMERGENCY ROOM 684 99291 2,345.00 ED, TRAUMA, CRITICAL CARE EA ADDL 30 MIN ED EMERGENCY ROOM 684 99292 163.50 EMERGENCY VISIT, TRAUMA - LIMITED ED EMERGENCY ROOM 684 99281 165.00 EMERGENCY VISIT, TRAUMA - LOW ED EMERGENCY ROOM 684 99282 398.50 EMERGENCY VISIT, TRAUMA - MODERATE ED EMERGENCY ROOM 684 99283 700.50 EMERGENCY VISIT, TRAUMA - HIGH ED EMERGENCY ROOM 684 99284 1,136.50 ABD PARACENTESIS W/O IMAGING ED EMERGENCY ROOM 450 49082 2,376.50 AMPUTATION FINGER PRI OR ED EMERGENCY ROOM 450 26951 8,454.00 ANASCOPY ED EMERGENCY ROOM 750 46600 336.00 SPLINT FINGER STATIC ED EMERGENCY ROOM 450 29130 179.00 SPLINT SHORT ARM DYNAMIC ED EMERGENCY ROOM 450 29126 336.00 SPLINT FINGER DYNAMIC ED EMERGENCY ROOM 450 29131 179.00 SPLIT LONG LEG ED EMERGENCY ROOM 450 29505 433.00 APPLICATION LONG ARM CAST ED EMERGENCY ROOM 450 29065 758.50 ARTERIAL CATHETERIZATION ED EMERGENCY ROOM 450 36620 64.00 ARTHROCENTESIS, ASP SM JO ED EMERGENCY ROOM 450 20600 782.50 ARTHROCENT ASP/INJ MAJ JNT W/US ED EMERGENCY ROOM 450 20611 782.50

15 PUNCTURE ASPRIATION OF ABCESS ED EMERGENCY ROOM 450 10160 993.50 ASPIRATION BLADDER SUPRAP ED EMERGENCY ROOM 450 51102 94.00 BLEPHAROTOMY DRN ABS EYEL ED EMERGENCY ROOM 450 67700 855.50 BRONCHOOSCOPE/ ALVEOLAR L ED EMERGENCY ROOM 450 31624 4,230.50 BURNS / SMALL ED EMERGENCY ROOM 450 16020 540.00 CARDIOVERSION ED EMERGENCY ROOM 450 92960 1,638.50 CHANGE CYCTOSTOMY TUBE, S ED EMERGENCY ROOM 450 51705 734.00 CIRCUMCISION W/CLAMP ED EMERGENCY ROOM 450 54150 5,419.50 CLSD TX DISL THUMB W/MAN EA W/O ANES ED EMERGENCY ROOM 450 26670 687.00 CLSD TX TIBIAL SHAFT FX W/MANIP ED EMERGENCY ROOM 450 27752 4,314.50 CLSD DISLOC HIP W/ANES ED EMERGENCY ROOM 450 27252 4,314.50 CLSD W/MANIP RADIAL HEAD ED EMERGENCY ROOM 450 24655 4,314.50 CLSD DISL SHLDR W/MANIP W/ANES ED EMERGENCY ROOM 450 23655 4,314.50 CLSD ELBOW DISLOCATION ED EMERGENCY ROOM 450 24600 687.00 CLSD METACARPAL SINGLE ED EMERGENCY ROOM 450 26600 687.00 CLSD FX PHALANGEAL W/MANI ED EMERGENCY ROOM 450 26725 687.00 CLSD TX DISTAL FIBULAR FX W/MANIP ED EMERGENCY ROOM 450 27788 687.00 CLSD DISTAL RADIAL W/MANIP ED EMERGENCY ROOM 450 25605 4,314.50 CLSD TX BI ANKLE FX W/MANIP ED EMERGENCY ROOM 450 27810 4,314.50 CLSD DSLOC TEMPOR MANDIBU ED EMERGENCY ROOM 450 21480 687.00 CLSD TX TRI ANKLE FX W/MANIP ED EMERGENCY ROOM 450 27818 4,314.50 CLSD TX CLAVICULAR FX W/MANIP ED EMERGENCY ROOM 450 23505 4,314.50 CLSD FX ARTICULAR W/MANI ED EMERGENCY ROOM 450 26742 4,314.50 CLSD FX DISTAL PHALANGEAL W/MANI EA ED EMERGENCY ROOM 450 26755 687.00 CLSD TX FEMORAL FX PROX E ED EMERGENCY ROOM 450 27232 12,826.50 CLSD TX HUMERAL FX W/O MANIP ED EMERGENCY ROOM 450 23600 687.00 CLSD TX MCP DISL SNGL W/ ED EMERGENCY ROOM 450 26705 4,314.50 CLSD TX PROX HUM FX W/MANIP ED EMERGENCY ROOM 450 23605 4,026.00 CLSD TX RAD HD FX W/MANIP ED EMERGENCY ROOM 450 24650 687.00 CLSD TX RADIAL SHAFT W/MANIP ED EMERGENCY ROOM 450 25505 4,314.50 CLSD TX TIBIAL SHAFT FX W/O MANIP ED EMERGENCY ROOM 450 27750 687.00 CLSD TX GRTR HUM FX W/MANIP ED EMERGENCY ROOM 450 23625 4,314.50 CLSD METACARPAL W/MANUPUL EA BONE ED EMERGENCY ROOM 450 26605 687.00 CLSD W/MANIP RADIAL & ULNA ED EMERGENCY ROOM 450 25565 4,314.50 CLSD W/MANI HUMERAL SHAFT ED EMERGENCY ROOM 450 24505 4,314.50 COMPLEX DRAINAGE ED EMERGENCY ROOM 450 10180 7,430.00 CONTROL NOSEBLEED ANTERIOR COMPLEX ED EMERGENCY ROOM 450 30903 336.00 CPR ED EMERGENCY ROOM 450 92950 795.50 DEB SKIN BONE AT FX SITE ED EMERGENCY ROOM 450 11012 7,430.00 DEBRIDEMENT INFECTED SKIN ED EMERGENCY ROOM 450 11000 1,560.50 DEBRIDEMENT SKIN, SUB TIS ED EMERGENCY ROOM 450 11042 993.50 DRAIN ABSCES DENOTOALVEOL ED EMERGENCY ROOM 450 41800 336.00 16 DRAIN EXT EAR ABCESS/HEMA ED EMERGENCY ROOM 450 69000 1,831.00 DRAIN FINGER ABCESS, SIMP ED EMERGENCY ROOM 450 26010 540.00 DRAIN LOWER LEG LESION ED EMERGENCY ROOM 761 27603 5,715.50 DRAIN PERITONSILLAR ABCES ED EMERGENCY ROOM 450 42999 570.50 ARTHROCENT ASP/INJ MAJ JNT W/O US ED EMERGENCY ROOM 450 20610 782.50 DRAINAGE ABD ABSCESS ED EMERGENCY ROOM 761 49406 4,308.00 DRAINAGE OF GLAND ED EMERGENCY ROOM 450 56420 514.00 I&D SUBCUT ABSCESS COMPL ED EMERGENCY ROOM 450 10061 993.50 DUPLX SCN EXTM VEINS UNIILATERAL ED EMERGENCY ROOM 920 93971 299.50 DX GASTRIC INTUBATION SNG ED EMERGENCY ROOM 450 43754 795.50 BLOOD TRANSFUSION ED EMERGENCY ROOM 391 36430 1,199.00 ECHO TRANSTHORACIC LTD ED EMERGENCY ROOM 483 93308 742.50 INSERT FOLEY CATHETER ED EMERGENCY ROOM 450 51702 336.00 ED IV INFN THER/PROPH ADDL SEQ FIRST HR ED EMERGENCY ROOM 450 96367 148.50 ED IV INFUSION HYDRATION EA ADDL HR ED EMERGENCY ROOM 450 96361 157.00 ED IV INFUSION HYDRATION FIRST HR ED EMERGENCY ROOM 450 96360 298.50 ED IV INFUSION THER/PROPH EA ADDL HR ED EMERGENCY ROOM 450 96366 111.50 ED IV INFUSION THER/PROPH FIRST HR ED EMERGENCY ROOM 450 96365 611.00 ED IV NFS THERAPY PROPH CONCUR ED EMERGENCY ROOM 450 96368 138.00 ED THER PROPH EA SEQL IV PUSH SBST/DRUG ED EMERGENCY ROOM 450 96376 81.00 ED THER PROPH IV PUSH SINGLE/1ST SBST ED EMERGENCY ROOM 450 96374 81.00 ED THER INJ IV PUSH EA NEW DRUG ED EMERGENCY ROOM 450 96375 34.50 ED THER PROPH INJ SUBQ/IM ED EMERGENCY ROOM 450 96372 31.50 ED US ABDOMEN LTD ED EMERGENCY ROOM 402 76705 366.00 ED US CHEST W/RT DOCUMENTATI ED EMERGENCY ROOM 402 76604 299.50 ED US EXTREM NON VASC LTD ED EMERGENCY ROOM 402 76882 315.50 ED US NECK OR SOFT TISSUE ED EMERGENCY ROOM 450 76536 390.50 ED US PELVIC LTD ED EMERGENCY ROOM 402 76857 315.50 ED US PREG UTERUS LTD ED EMERGENCY ROOM 402 76815 326.00 ED US RETROPERITONEAL LTD ED EMERGENCY ROOM 402 76775 366.00 EGD FLEXIBLE ED EMERGENCY ROOM 450 43235 2,376.50 EPIDURAL BLOOD PATCH ED EMERGENCY ROOM 450 62273 1,737.00 ESOPHAGEAL DILATION UNGUIDED ED EMERGENCY ROOM 450 43450 2,061.00 NAIL PART, EXCISION ED EMERGENCY ROOM 450 11750 993.50 REM FB CORNEAL W/SLIT LAMP ED EMERGENCY ROOM 450 65222 336.00 FINE NEEDLE ASP W/IMAGING ED EMERGENCY ROOM 761 10022 1,831.00 FINE NEEDLE ASP W/O IMAG ED EMERGENCY ROOM 450 10021 993.50 FINGER AMPUTATION W/FLAPS ED EMERGENCY ROOM 450 26952 8,454.00 GASTRIC INTUBATION & ASPIR ED EMERGENCY ROOM 450 43753 795.50 GASTROSTOMY TUBE CHANGE ED EMERGENCY ROOM 450 43760 734.00 I&D ABSCESS, PERITONSIL ED EMERGENCY ROOM 450 42700 570.00 I&D OF SUBCUTANEOUS LES ED EMERGENCY ROOM 450 10060 540.00 17 I&D PILONIDAL CYST ED EMERGENCY ROOM 450 10080 1,831.00 I&D SUBLINGUAL HEMATOMA ED EMERGENCY ROOM 450 11740 336.00 I&D UPPER ARM OR ELBOW, BURSA ED EMERGENCY ROOM 450 23931 4,308.50 I&D VULVA ED EMERGENCY ROOM 450 56405 858.00 I&D PERIANAL ABSCESS ED EMERGENCY ROOM 450 46050 2,269.00 INJ ANES AGT DIGITAL NRV ED EMERGENCY ROOM 450 64455 782.50 INJ SENTINEL NODE ID ED EMERGENCY ROOM 761 38792 1,117.00 ARTHROCENT ASP/INJ INT JNT W/O US ED EMERGENCY ROOM 450 20605 782.50 INJ SINGLE/MLT TRIGGER PT 1/2 MUSC ED EMERGENCY ROOM 450 20552 782.50 INJECTION, TRIGGER POINT ED EMERGENCY ROOM 450 64400 782.50 INSERT NON TUN CATH W/SUBQ ED EMERGENCY ROOM 450 36570 7,966.50 INSERT NON TUNNEL CATH ED EMERGENCY ROOM 450 36556 3,141.50 PICC / MIDLINE INSERT <5 YEARS ED EMERGENCY ROOM 450 36569 3,141.50 INSERT PLEURAL CATH ED EMERGENCY ROOM 450 32550 9,304.00 INTUBATION, ENDOTRACHEAL ED EMERGENCY ROOM 450 31500 570.50 LARYNOGOSCOPY INDIRECT DX ED EMERGENCY ROOM 450 31505 502.00 R/INT SCALP, NECK 20.1-30.0 CM ED EMERGENCY ROOM 450 12036 1,560.50 SPINAL PUNCTURE LUMBAR DX ED EMERGENCY ROOM 450 62270 1,737.00 MOD SED OTH PHYS EA ADDL 15 MIN ED EMERGENCY ROOM 450 99157 82.00 MOD SED OTH PHYS INIT 15 MIN 5/> YR ED EMERGENCY ROOM 450 99156 132.00 SURGICAL PROC ON THE FOOT AND TOES ED EMERGENCY ROOM 450 28495 687.00 MOD SED SAME PHYS EA ADDL 15 MINS ED EMERGENCY ROOM 450 99153 154.50 MOD SED SAME PHYS INIT 15 MIN <5 YR ED EMERGENCY ROOM 450 99151 154.50 MOD SED SAME PHYS INIT 15 MIN 5/> YR ED EMERGENCY ROOM 450 99152 154.50 NASEL HEM ANT CONTROL UNL ED EMERGENCY ROOM 450 30901 336.00 NERVE BLOCK OTHER PERIPHERAL ED EMERGENCY ROOM 450 64450 1,737.00 NERVE BLOCK (FEMORAL) SINGLE ED EMERGENCY ROOM 450 64447 1,737.00 NERVE BLOCK FACIAL ED EMERGENCY ROOM 450 64402 336.00 NG TUBE PLACEMENT ED EMERGENCY ROOM 450 43752 1,055.00 NERVE BLOCK GREATER OCCIPITAL NERVE ED EMERGENCY ROOM 450 64405 782.50 OSTEOPATHIC MANI TX 1-2 BODY REG ED EMERGENCY ROOM 450 98925 86.00 ABD PARACENTESIS W/IMAGING ED EMERGENCY ROOM 761 49083 2,376.50 PERCUT FLUID DRN SOFT TIS ED EMERGENCY ROOM 450 10030 1,434.00 PLACE NEEDLE/INTRA INFUSI ED EMERGENCY ROOM 450 36680 1,055.00 PORTACATH IMPLANT 5 YR/> ED EMERGENCY ROOM 450 36558 7,966.50 POST VOID RESIDUAL URINE/BLADDER CAP ED EMERGENCY ROOM 450 51798 179.00 R/CMPLX EYE, EAR, LIP 2.6-7.5 CM ED EMERGENCY ROOM 450 13152 1,560.50 R/CMPLX EYE, EAR, LIP 1.1-2.5 CM ED EMERGENCY ROOM 450 13151 1,560.50 R/CMPLX FACE, HANDS, FT 2.6-7.5 CM ED EMERGENCY ROOM 450 13132 1,560.50 R/CMPLX FACE, HANDS, FT 1.1-2.5 CM ED EMERGENCY ROOM 450 13131 993.50 R/CMPLX SCALP, LIMB 2.6-7.5 CM ED EMERGENCY ROOM 450 13121 1,560.50 R/CMPLX SCALP, LIMB EA ADDL 5 CM/< ED EMERGENCY ROOM 450 13122 500.00 18 R/INT NECK, LIMBS EXT MUSC ED EMERGENCY ROOM 450 20553 782.50 TUBE THORACOSTOMY ED EMERGENCY ROOM 450 32551 3,141.50 CLSD TX VERTEBRAL FX ED EMERGENCY ROOM 450 22310 572.00 ED INSERT STR CATH ED EMERGENCY ROOM 450 51701 279.00 CLSD TX TARSAL BNE DISLO ED EMERGENCY ROOM 450 28540 686.00 CLSD TX OF FEM FX, PROXIMAL END W/O MAN ED EMERGENCY ROOM 450 27230 468.00 ED CLTX SHOULDER DISL W/FX HUMERAL TUBRS ED EMERGENCY ROOM 450 23665 4,314.00 REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE ED EMERGENCY ROOM 450 49451 2,376.00 TX, SUPERFICIAL WOUND DEHISCENCE; SIMPLE ED EMERGENCY ROOM 450 12020 1,560.00 TX, SUPERFICIAL WOULD DEHISCENCE; W/PACK ED EMERGENCY ROOM 450 12021 993.00 CLOSED TX, METACARPOPHALANGEAL DISLOCATI ED EMERGENCY ROOM 450 26700 687.00 WEDGE EXC SKIN NAIL FOLD ED EMERGENCY ROOM 450 11765 933.00 INCISION THROMBOSED HEMORRHOID, EXTERNAL ED EMERGENCY ROOM 450 46083 733.00 R/INT NECK, LIMES EXT 20.1 - 30.0 CM ED EMERGENCY ROOM 450 12046 993.00 TREATMENT OF TOE FRACTURE ED EMERGENCY ROOM 450 28515 686.00 EDP EMERGENCY VISIT - LIMITED EDP EMERGENCY ROOM- PROFESSIONAL 981 99281 140.00 EDP EMERGENCY VISIT - LOW EDP EMERGENCY ROOM- PROFESSIONAL 981 99282 193.50 EDP EMERGENCY VISIT - MODERATE EDP EMERGENCY ROOM- PROFESSIONAL 981 99283 296.00 EDP EMERGENCY VISIT - HIGH EDP EMERGENCY ROOM- PROFESSIONAL 981 99284 406.50 EDP EMERGENCY VISIT - COMPREHENSIVE EDP EMERGENCY ROOM- PROFESSIONAL 981 99285 520.00 EDP CRITICAL CARE INIT 30-74 MIN EDP EMERGENCY ROOM- PROFESSIONAL 981 99291 570.50 EDP CRITICAL CARE EA ADDL 30 MIN EDP EMERGENCY ROOM- PROFESSIONAL 981 99292 407.50 EDP ABD PARACENTESIS W/O IMAGING EDP EMERGENCY ROOM- PROFESSIONAL 981 49082 216.50 EDP SPLINT FINGER STATIC EDP EMERGENCY ROOM- PROFESSIONAL 981 29130 101.00 EDP SPLINT SHORT ARM DYNAMIC EDP EMERGENCY ROOM- PROFESSIONAL 981 29126 124.50 EDP SPLINT FINGER DYNAMIC EDP EMERGENCY ROOM- PROFESSIONAL 981 29131 83.50 EDP SPLIT LONG LEG EDP EMERGENCY ROOM- PROFESSIONAL 981 29505 162.00 EDP APPLICATION LONG ARM CAST EDP EMERGENCY ROOM- PROFESSIONAL 981 29065 225.00 EDP ARTHROCENT ASP/INJ MAJ JNT W/US EDP EMERGENCY ROOM- PROFESSIONAL 981 20611 162.50 20 EDP PUNCTURE ASPRIATION OF ABCESS EDP EMERGENCY ROOM- PROFESSIONAL 981 10160 321.00 EDP BURNS / SMALL EDP EMERGENCY ROOM- PROFESSIONAL 981 16020 193.50 EDP CARDIOVERSION EDP EMERGENCY ROOM- PROFESSIONAL 981 92960 461.50 EDP CHANGE CYSTOSTOMY TUBE, S EDP EMERGENCY ROOM- PROFESSIONAL 981 51705 141.50 EDP CLSD TX DISL THUMB W/MAN EA W/O ANES EDP EMERGENCY ROOM- PROFESSIONAL 981 26670 406.50 EDP CLSD TX TIBIAL SHAFT FX W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 27752 1,419.00 EDP CLSD DISLOC HIP W/ANES EDP EMERGENCY ROOM- PROFESSIONAL 981 27252 746.50 EDP CLSD W/MANIP RADIAL HEAD EDP EMERGENCY ROOM- PROFESSIONAL 981 24655 1,215.00 EDP CLSD DISL SHLDR W/MANIP W/ANES EDP EMERGENCY ROOM- PROFESSIONAL 981 23655 1,236.50 EDP CLSD ELBOW DISLOCATION EDP EMERGENCY ROOM- PROFESSIONAL 981 24600 608.50 EDP CLSD METACARPAL SINGLE EDP EMERGENCY ROOM- PROFESSIONAL 981 26600 279.50 EDP CLSD FX PHALANGEAL W/MANI EDP EMERGENCY ROOM- PROFESSIONAL 981 26725 491.50 EDP CLSD TX DISTAL FIBULAR FX W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 27788 543.50 EDP CLSD DISTAL RADIAL W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 25605 543.50 EDP CLSD TX BI ANKLE FX W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 27810 1,351.50 EDP CLSD DSLOC TEMPOR MANDIBU EDP EMERGENCY ROOM- PROFESSIONAL 981 21480 377.00 EDP CLSD TX TRI ANKLE FX W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 27818 257.50 EDP CLSD TX CLAVICULAR FX W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 23505 543.50 EDP CLSD FX ARTICULAR W/MANI EDP EMERGENCY ROOM- PROFESSIONAL 981 26742 491.50 EDP CLSD FX DISTAL PHALANGEAL W/MANI EA EDP EMERGENCY ROOM- PROFESSIONAL 981 26755 550.00 EDP CLSD TX FEMORAL FX PROX E EDP EMERGENCY ROOM- PROFESSIONAL 981 27232 1,916.00 EDP CLSD TX HUMERAL FX W/O MANIP EDP EMERGENCY ROOM- PROFESSIONAL 972 23600 771.50 EDP CLSD TX MCP DISL SNGL W/ EDP EMERGENCY ROOM- PROFESSIONAL 981 26705 961.00 EDP CLSD TX PROX HUM FX W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 23605 1,099.00 EDP CLSD TX RAD HD FX W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 24650 691.00 EDP CLSD TX RADIAL SHAFT W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 25505 491.50 EDP CLSD TX TIBIAL SHAFT FX W/O MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 27750 849.50 EDP CLSD TX GRTR HUM FX W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 23625 733.50 EDP CLSD METACARPAL W/MANUPUL EA BONE EDP EMERGENCY ROOM- PROFESSIONAL 981 26605 851.50 EDP CLSD W/MANIP RADIAL & ULNA EDP EMERGENCY ROOM- PROFESSIONAL 981 25565 543.50 EDP CLSD W/MANI HUMERAL SHAFT EDP EMERGENCY ROOM- PROFESSIONAL 981 24505 543.50 EDP CONTROL NOSEBLEED ANTERIOR COMPLEX EDP EMERGENCY ROOM- PROFESSIONAL 981 30903 346.50 EDP CPR EDP EMERGENCY ROOM- PROFESSIONAL 981 92950 659.00 EDP DEBRIDEMENT SKIN, SUB TIS EDP EMERGENCY ROOM- PROFESSIONAL 981 11042 148.50 EDP DRAIN ABSCES DENOTOALVEOL EDP EMERGENCY ROOM- PROFESSIONAL 981 41800 417.00 EDP DRAIN PERITONSILLAR ABCES EDP EMERGENCY ROOM- PROFESSIONAL 981 42999 128.50 EDP ARTHROCENT ASP/INJ MAJ JNT W/O US EDP EMERGENCY ROOM- PROFESSIONAL 981 20610 179.50 EDP DRAINAGE OF GLAND EDP EMERGENCY ROOM- PROFESSIONAL 981 56420 309.00 EDP I&D SUBCUT ABSCESS COMPL EDP EMERGENCY ROOM- PROFESSIONAL 981 10061 548.50 EDP DUPLX SCN EXTM VEINS UNILATERAL EDP EMERGENCY ROOM- PROFESSIONAL 981 93971 56.50 EDP DX GASTRIC INTUBATION SNG EDP EMERGENCY ROOM- PROFESSIONAL 981 43754 95.00 EDP BLOOD TRANSFUSION EDP EMERGENCY ROOM- PROFESSIONAL 981 36430 84.50 21 EDP ECHO TRANSTHORACIC LTD EDP EMERGENCY ROOM- PROFESSIONAL 981 93308 52.50 EDP INSERT FOLEY CATHETER EDP EMERGENCY ROOM- PROFESSIONAL 981 51702 140.00 EDP ED US ABDOMEN LTD EDP EMERGENCY ROOM- PROFESSIONAL 981 76705 61.00 EDP ED US CHEST W/RT DOCUMENTATI EDP EMERGENCY ROOM- PROFESSIONAL 972 76604 69.00 EDP ED US EXTREM NON VASC LTD EDP EMERGENCY ROOM- PROFESSIONAL 981 76882 63.00 EDP ED US NECK OR SOFT TISSUE EDP EMERGENCY ROOM- PROFESSIONAL 981 76536 128.50 EDP ED US PELVIC LTD EDP EMERGENCY ROOM- PROFESSIONAL 981 76857 64.00 EDP ED US PREG UTERUS LTD EDP EMERGENCY ROOM- PROFESSIONAL 981 76815 173.00 EDP ED US RETROPERITONEAL LTD EDP EMERGENCY ROOM- PROFESSIONAL 981 76775 58.50 EDP EPIDURAL BLOOD PATCH EDP EMERGENCY ROOM- PROFESSIONAL 981 62273 295.50 EDP NAIL PART, EXCISION EDP EMERGENCY ROOM- PROFESSIONAL 981 11750 612.50 EDP REM FB CORNEAL W/SLIT LAMP EDP EMERGENCY ROOM- PROFESSIONAL 981 65222 157.50 EDP FINE NEEDLE ASP W/IMAGING EDP EMERGENCY ROOM- PROFESSIONAL 981 10022 174.50 EDP FINE NEEDLE ASP W/O IMAG EDP EMERGENCY ROOM- PROFESSIONAL 981 10021 223.00 EDP GASTRIC INTUBATION & ASPIR EDP EMERGENCY ROOM- PROFESSIONAL 981 43753 61.50 EDP GASTROSTOMY TUBE CHANGE EDP EMERGENCY ROOM- PROFESSIONAL 981 43760 125.00 EDP I&D ABSCESS, PERITONSIL EDP EMERGENCY ROOM- PROFESSIONAL 981 42700 443.50 EDP I&D OF SUBCUTANEOUS LES EDP EMERGENCY ROOM- PROFESSIONAL 981 10060 292.50 EDP I&D SUBUNGUAL HEMATOMA EDP EMERGENCY ROOM- PROFESSIONAL 981 11740 148.50 EDP I&D UPPER ARM OR ELBOW, BURSA EDP EMERGENCY ROOM- PROFESSIONAL 981 23931 408.00 EDP I&D VULVA EDP EMERGENCY ROOM- PROFESSIONAL 981 56405 350.50 EDP I&D PERIANAL ABSCESS EDP EMERGENCY ROOM- PROFESSIONAL 981 46050 307.00 EDP INJ ANES AGT DIGITAL NRV EDP EMERGENCY ROOM- PROFESSIONAL 981 64455 103.50 EDP ARTHROCENT ASP/INJ INT JNT W/O US EDP EMERGENCY ROOM- PROFESSIONAL 981 20605 445.50 EDP INJ SINGLE/MLT TRIGGER PT 1/2 MUSC EDP EMERGENCY ROOM- PROFESSIONAL 981 20552 119.50 EDP INJECTION, TRIGGER POINT EDP EMERGENCY ROOM- PROFESSIONAL 981 64400 140.00 EDP INSERT NON TUNNEL CATH EDP EMERGENCY ROOM- PROFESSIONAL 981 36556 445.50 EDP PICC / MIDLINE INSERT >/5 YEARS EDP EMERGENCY ROOM- PROFESSIONAL 981 36569 2,507.50 EDP INTUBATION, ENDOTRACHEAL EDP EMERGENCY ROOM- PROFESSIONAL 981 31500 406.50 EDP LARYNOGOSCOPY INDIRECT DX EDP EMERGENCY ROOM- PROFESSIONAL 981 31505 186.50 EDP R/INT SCALP, NECK 20.1-30.0 CM EDP EMERGENCY ROOM- PROFESSIONAL 981 12036 929.00 EDP SPINAL PUNCTURE LUMBAR DX EDP EMERGENCY ROOM- PROFESSIONAL 981 62270 371.00 EDP MOD SED OTH PHYS INIT 15 MIN 5/> YR EDP EMERGENCY ROOM- PROFESSIONAL 981 99156 165.00 EDP MOD SED SAME PHYS EACH ADDL 15 MINS EDP EMERGENCY ROOM- PROFESSIONAL 981 99153 27.00 EDP MOD SED SAME PHYS INIT 15 MIN <5 YR EDP EMERGENCY ROOM- PROFESSIONAL 981 99151 59.50 EDP MOD SED SAME PHYS INIT 15 MIN 5/> YR EDP EMERGENCY ROOM- PROFESSIONAL 981 99152 31.00 EDP NASEL HEM ANT CONTROL UNL EDP EMERGENCY ROOM- PROFESSIONAL 981 30901 250.00 EDP NERVE BLOCK OTHER PERIPHERAL EDP EMERGENCY ROOM- PROFESSIONAL 981 64450 250.00 EDP NERVE BLOCK (FEMORAL) SINGLE EDP EMERGENCY ROOM- PROFESSIONAL 981 64447 193.50 EDP NERVE BLOCK FACIAL EDP EMERGENCY ROOM- PROFESSIONAL 981 64402 229.00 EDP NG TUBE PLACEMENT EDP EMERGENCY ROOM- PROFESSIONAL 981 43752 132.00 EDP NERVE BLOCK GREATER OCCIPITAL NERVE EDP EMERGENCY ROOM- PROFESSIONAL 981 64405 174.50 22 EDP OSTEOPATHIC MANI TX 1-2 BODY REG EDP EMERGENCY ROOM- PROFESSIONAL 981 98925 59.00 EDP ABD PARACENTESIS W/IMAGING EDP EMERGENCY ROOM- PROFESSIONAL 981 49083 339.00 EDP PERCUT FLUID DRN SOFT TIS EDP EMERGENCY ROOM- PROFESSIONAL 981 10030 394.50 EDP POST VOID RESIDUAL URINE/BLADDER CAP EDP EMERGENCY ROOM- PROFESSIONAL 981 51798 39.00 EDP R/CMPLX EYE, EAR, LIP 2.6-7.5 CM EDP EMERGENCY ROOM- PROFESSIONAL 981 13152 1,419.00 EDP R/CMPLX EYE, EAR, LIP 1.1-2.5 CM EDP EMERGENCY ROOM- PROFESSIONAL 981 13151 1,041.00 EDP R/CMPLX FACE, HANDS, FT 2.6-7.5 CM EDP EMERGENCY ROOM- PROFESSIONAL 981 13132 870.00 EDP R/CMPLX FACE, HANDS, FT 1.1-2.5 CM EDP EMERGENCY ROOM- PROFESSIONAL 981 13131 888.50 EDP R/CMPLX SCALP, LIMB 2.6-7.5 CM EDP EMERGENCY ROOM- PROFESSIONAL 981 13121 991.00 EDP R/CMPLX SCALP, LIMB EA ADDL 5 CM/< EDP EMERGENCY ROOM- PROFESSIONAL 981 13122 344.00 EDP R/INT NECK, LIMBS EXT MUSC EDP EMERGENCY ROOM- PROFESSIONAL 981 20553 85.00 EDP TUBE THORACOSTOMY EDP EMERGENCY ROOM- PROFESSIONAL 981 32551 567.50 EDP WEDGE EXC SKIN NAIL FOLD EDP EMERGENCY ROOM- PROFESSIONAL 981 11765 212.00 EDP R/INT NECK, LIMBS EXT 20.1-30.0 CM EDP EMERGENCY ROOM- PROFESSIONAL 981 12046 989.00 EDP INJ TENDON EDP EMERGENCY ROOM- PROFESSIONAL 981 20551 141.50 EDP CLSD DISL SHLDR GT W/MANIP EDP EMERGENCY ROOM- PROFESSIONAL 981 23665 1,177.00 EDP CLSD DISLOC HIP W/O ANESTH EDP EMERGENCY ROOM- PROFESSIONAL 981 27250 1,388.50 EDP VENIPUNCTURE CUTDOWN <1YR OLD EDP EMERGENCY ROOM- PROFESSIONAL 981 36420 323.00 EDP TONOMETRY EDP EMERGENCY ROOM- PROFESSIONAL 981 92100 171.00 CLSD TX TARSAL BNE DISLO EDP EMERGENCY ROOM- PROFESSIONAL 981 28540 525.00 I & D EPIDIDYMIS, TESTIS, SCROTAL SPACE EDP EMERGENCY ROOM- PROFESSIONAL 981 54700 650.00 EDP BLEPHAROTOMY DRN ABS EYEL EDP EMERGENCY ROOM- PROFESSIONAL 981 67700 351.00 EDP CLOSED W/ MANI SMALL TOE EACH EDP EMERGENCY ROOM- PROFESSIONAL 981 28515 428.00 PF CLSD TX OF FEM FX, PROXIMAL END W/O M EDP EMERGENCY ROOM- PROFESSIONAL 981 27230 1,412.00 PF REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE EDP EMERGENCY ROOM- PROFESSIONAL 981 49451 277.00 EDP TX, SUPERFICIAL WOUND DEHISCENCE, SI EDP EMERGENCY ROOM- PROFESSIONAL 981 12020 567.00 EDP, TX, SUPERFICIAL WOUND DEHISCENCE, W EDP EMERGENCY ROOM- PROFESSIONAL 981 12021 412.00 EDP CLOSED TX, METACARPOPHALANGEAL DISCL EDP EMERGENCY ROOM- PROFESSIONAL 981 26700 907.00 VENIPUNCTURE BY HC PROFESSIONAL EDP EMERGENCY ROOM- PROFESSIONAL 981 36410 28.50 PF SURGICAL PROC ON THE FOOT AND TOES EDP EMERGENCY ROOM- PROFESSIONAL 981 28495 449.00 PF INCISION THROMBOSED HEMORRHOID, EXTER EDP EMERGENCY ROOM- PROFESSIONAL 981 46083 322.00 PF ABD PARACENTESIS HSP HOSPITALIST 987 49083 328.50 PF ASP ABSCESS, HEMATOMA, CY HSP HOSPITALIST 987 10160 285.50 PF ATHROCENTESIS, MAJ JNT/BU HSP HOSPITALIST 987 20610 139.00 PF CARDIOVERSION HSP HOSPITALIST 987 92960 330.50 PF ENDOTRACHEAL INTUBATION HSP HOSPITALIST 987 31500 425.00 PF INJ ANESTH AGNT PUDENTAL HSP HOSPITALIST 987 64430 242.50 PF OBSERV/IP HOSPITAL CARE (A&D) 55 MIN HSP HOSPITALIST 987 99236 651.00 24 PF OBSERV/IP HOSPITAL CARE (A&D) 40 MIN HSP HOSPITALIST 987 99234 396.50 PF OBSERV/IP HOSPITAL CARE (A&D) 50 MIN HSP HOSPITALIST 987 99235 504.50 PF CRITICAL CARE INIT 30-74 MIN HSP HOSPITALIST 987 99291 662.50 PF CRITICAL CARE EA ADDL 30 MIN HSP HOSPITALIST 987 99292 332.00 PF INITIAL IP CONSULT NEW/EST PT 80 MIN HSP HOSPITALIST 987 99254 501.00 PF INITIAL IP CONSULT NEW/EST PT 20 MIN HSP HOSPITALIST 987 99251 146.50 PF INITIAL IP CONSULT NEW/EST PT 40 MIN HSP HOSPITALIST 987 99252 224.00 PF INITIAL IP CONSULT NEW/EST PT 55 MIN HSP HOSPITALIST 987 99253 345.00 PF HOSPITAL DISCH DAY MGMT 30 MIN/< HSP HOSPITALIST 987 99238 218.00 PF HOSPITAL DISCH DAY MGMT > 30 MIN HSP HOSPITALIST 987 99239 321.50 PF PROLONGED IP SERVICE FIRST HR HSP HOSPITALIST 987 99356 275.00 PF HOSPITAL INITIAL CARE/DAY 70 MIN HSP HOSPITALIST 987 99223 604.00 PF HOSPITAL INITIAL CARE/DAY 30 MIN HSP HOSPITALIST 987 99221 301.00 PF HOSPITAL INITIAL CARE/DAY 50 MIN HSP HOSPITALIST 987 99222 407.00 PF OBSERV INITIAL CARE/DAY 30 MIN HSP HOSPITALIST 987 99218 297.50 PF OBSERV INITIAL CARE/DAY 50 MIN HSP HOSPITALIST 987 99219 405.50 PF OBSERV CARE DISCHARGE MANAGEMENT HSP HOSPITALIST 987 99217 218.00 PF OBSERV INITIAL CARE/DAY 70 MIN HSP HOSPITALIST 987 99220 555.00 PF PROLONGED IP SERVICE EA ADDL 30 MIN HSP HOSPITALIST 987 99357 276.00 PF HOSPITAL SBSQ CARE/DAY 35 MINUTES HSP HOSPITALIST 987 99233 310.50 PF HOSPITAL SBSQ CARE/DAY 15 MINUTES HSP HOSPITALIST 987 99231 117.00 PF HOSPITAL SBSQ CARE/DAY 25 MINUTES HSP HOSPITALIST 987 99232 217.00 PF OBSERV SBSQ CARE/DAY 15 MIN HSP HOSPITALIST 987 99224 119.00 PF OBSERV SBSQ CARE/DAY 25 MIN HSP HOSPITALIST 987 99225 218.00 PF OBSERV SBSQ CARE/DAY 35 MIN HSP HOSPITALIST 987 99226 313.00 PF INSERT NON TUNNEL CATH AGE 5 YR/> HSP HOSPITALIST 987 36556 295.50 PF MOD SED SAME PHYS INIT 15 MIN 5/> YR HSP HOSPITALIST 964 99152 38.00 PF MOD SED SAME PHYS EACH ADDL 15 MINS HSP HOSPITALIST 964 99153 32.50 PF REP CMPLX TRNK 1.1-2.5 CM HSP HOSPITALIST 987 13100 619.00 PF THORACENTESIS W/USG HSP HOSPITALIST 987 32555 338.50 PF INTERLAMINAR EPIDURAL THORACIC HSP HOSPITALIST 987 62324 275.00 PF CPR HSP HOSPITALIST 987 92950 659.00 PF ADVANCE CARE PLANNING HSP HOSPITALIST 987 99497 237.00 INTENSIVE CARE ROOM (ICU) ICU ICU 200 4,050.00 INTERMEDIATE ICU ROOM (IMCU) ICU ICU 206 3,625.00 VENIPUNCTURE LAB LABORATORY 300 36415 31.50 I STAT BASIC LAB LABORATORY 300 80047 61.50 BASIC METABOLIC PANEL LAB LABORATORY 300 80048 61.50 ELECTROLYTE PANEL LAB LABORATORY 300 80051 50.50 COMP METABOLIC PANEL LAB LABORATORY 301 80053 72.00 LIPID PANEL LAB LABORATORY 300 80061 95.50 RENAL FUNCTION PANEL LAB LABORATORY 300 80069 61.50 25 HEPATIC FUNCTION PANEL LAB LABORATORY 300 80076 61.50 CARBAMEZAPINE (TEGRETOL) LAB LABORATORY 300 80156 102.50 DIGOXIN LAB LABORATORY 300 80162 90.50 DEPAKENE (VALP ACID) LAB LABORATORY 300 80164 101.00 GENTAMICIN PEAK LAB LABORATORY 300 80170 107.00 GENTAMICIN, TROUGH LAB LABORATORY 300 80170 107.00 LITHIUM LAB LABORATORY 300 80178 65.00 PHENYTOIN (DILANTIN) LAB LABORATORY 300 80185 68.50 VANCOMYCIN, THROUGH LAB LABORATORY 300 80202 95.50 ACETAMINOPHEN LAB LABORATORY 300 80307 109.00 URINE, DRUGS ABUSE SCREEN LAB LABORATORY 300 80307 141.00 ALCOHOL (ETHANOL) LAB LABORATORY 300 80320 102.50 SALICYLATE, SERUM LAB LABORATORY 300 80329 107.00 UA COMPLETE LAB LABORATORY 300 81000 44.00 UA CHEM ONLY LAB LABORATORY 307 81002 31.50 UA MICRO ONLY LAB LABORATORY 300 81015 31.50 PREGNANCY TEST URINE LAB LABORATORY 301 81025 61.50 BETAHYDROXYBUTYRATE LAB LABORATORY 300 82010 58.00 ALBUMIN LAB LABORATORY 300 82040 36.50 MICROALBUMIN LAB LABORATORY 300 82044 34.50 AMMONIA LAB LABORATORY 300 82140 94.00 AMYLASE LAB LABORATORY 301 82150 61.50 BILIRUBIN, TOTAL LAB LABORATORY 301 82247 36.50 BILIRUBIN, TOTAL PEDIATRIC LAB LABORATORY 301 82247 36.50 BILIRUBIN, DIRECT LAB LABORATORY 301 82248 36.50 GASTROCULT LAB LABORATORY 300 82271 25.50 VITAMIN D 25-HYDROXY LAB LABORATORY 300 82306 115.00 CALCIUM, SERUM LAB LABORATORY 301 82310 37.50 CALCIUM IONIZED (WB) LAB LABORATORY 301 82330 90.50 CALCIUM IONIZED ISTAT LAB LABORATORY 301 82330 90.50 CALCIUM, URINE LAB LABORATORY 301 82340 37.50 CARBOXYHEMOGLOBIN WB LAB LABORATORY 300 82375 38.00 CHOLESTEROL LAB LABORATORY 300 82465 31.50 CREATINE KINASE (CK) TOTAL LAB LABORATORY 300 82550 65.00 CREATINE KINASE (CK) MB LAB LABORATORY 300 82553 79.50 CREATININE SERUM LAB LABORATORY 300 82565 37.50 CREATININE, URINE 24HR LAB LABORATORY 300 82570 34.50 CREATININE CLEARANCE LAB LABORATORY 300 82575 67.50 VITAMIN B-12 LAB LABORATORY 300 82607 107.00 FERRITIN LEVEL LAB LABORATORY 300 82728 101.00 FOLATE LAB LABORATORY 300 82746 102.50 PH CORD ARTERIAL LAB LABORATORY 300 82800 61.50 26 PH CORD VENOUS LAB LABORATORY 300 82800 61.50 pH VENOUS WHOLE BLOOD LAB LABORATORY 300 82800 61.50 pH,VENOUS ISTAT LAB LABORATORY 300 82800 61.50 BLOOD GAS, VENOUS LAB LABORATORY 301 82803 78.50 BLOOD GAS, VENOUS ISTAT LAB LABORATORY 301 82803 78.50 BLOOD GASES LAB LABORATORY 301 82803 78.50 GLUCOSE, CSF LAB LABORATORY 300 82945 29.50 GLUCOSE, OTHER FLUID LAB LABORATORY 300 82945 29.50 GLUCOSE, SERUM LAB LABORATORY 300 82947 29.50 GLUCOSE, FINGERSTICK LAB LABORATORY 300 82948 31.50 GLUCOSE 1 HR PRENATAL POS LAB LABORATORY 300 82950 70.00 GLUCOSE 2 HR POST DOSE LAB LABORATORY 300 82950 70.00 GLUCOSE TOL 3SP+DRK LAB LABORATORY 300 82951 67.50 GLUCOSE TOL TEST, 3 SPEC LAB LABORATORY 300 82951 53.50 GLUCOSE TOL TEST, ADD'T S LAB LABORATORY 300 82952 29.50 GGT LAB LABORATORY 300 82977 50.50 GLYCOSYLATED HEMOGLOBIN A1C LAB LABORATORY 300 83036 67.50 METHEMOGLOBIN LAB LABORATORY 300 83050 81.00 IRON LAB LABORATORY 300 83540 61.50 IRON BINDING CAPACITY LAB LABORATORY 300 83550 59.50 LACTATE LAB LABORATORY 301 83605 75.00 FECAL LACTOFERRIN LAB LABORATORY 300 83630 58.00 LIPASE LAB LABORATORY 301 83690 82.50 LDL DIRECT LAB LABORATORY 300 83721 54.50 MAGNESIUM, OB LAB LABORATORY 301 83735 49.50 MAGNESIUM, SERUM LAB LABORATORY 301 83735 49.50 PRO-BNP (NATIURETIC PEPTI LAB LABORATORY 300 83880 203.50 ALKALINE PHOSPHATASE LAB LABORATORY 300 84075 37.50 PHOSPHORUS LAB LABORATORY 300 84100 37.50 POTASSIUM-K LAB LABORATORY 300 84132 34.50 PROCALCITONIN LAB LABORATORY 300 84145 141.50 PSA, TOTAL LAB LABORATORY 300 84153 115.00 PROTEIN, SERUM LAB LABORATORY 300 84155 36.50 PROTEIN 24HR URINE LAB LABORATORY 300 84156 42.00 PROTEIN, URINE LAB LABORATORY 300 84156 24.50 PROTEIN, URINE TOTAL LAB LABORATORY 300 84156 25.50 PROTEIN, CSF LAB LABORATORY 300 84157 25.50 SODIUM - NA LAB LABORATORY 300 84295 36.50 TESTOSTERONE, TOTAL LAB LABORATORY 300 84403 170.00 THYROXINE, FREE LAB LABORATORY 300 84439 67.50 THYROID STIMULAT HORMONE LAB LABORATORY 300 84443 110.50 AST LAB LABORATORY 300 84450 37.50 27 ALT LAB LABORATORY 300 84460 42.00 TRANSFERRIN CALCULATION LAB LABORATORY 300 84466 72.00 TRIGLYCERIDES LAB LABORATORY 300 84478 42.00 TRIIODOTHYRONINE (T3) FREE LAB LABORATORY 300 84481 88.50 TROPONIN I - L LAB LABORATORY 301 84484 140.00 BUN LAB LABORATORY 300 84520 31.50 URIC ACID LAB LABORATORY 300 84550 49.50 BETA HCG QUANTITATIVE LAB LABORATORY 300 84702 75.00 PREGNANCY TEST SERUM LAB LABORATORY 301 84703 61.50 HEMATOCRIT LAB LABORATORY 300 85014 34.50 HEMOGLOBIN LAB LABORATORY 300 85018 42.00 CBC LAB LABORATORY 305 85025 70.00 CBC WITH NO DIFF LAB LABORATORY 305 85027 35.50 PLATELET COUNT LAB LABORATORY 300 85032 31.50 RETICULOCYTE COUNT LAB LABORATORY 300 85045 35.00 IMMATURE PLATELET FRACTION LAB LABORATORY 300 85055 84.50 D-DIMER, QUANTITATIVE LAB LABORATORY 300 85378 98.00 FIBRINOGEN LAB LABORATORY 305 85384 48.50 PROTIME LAB LABORATORY 305 85610 36.50 ESR WESTERGREN LAB LABORATORY 300 85652 37.50 APTT LAB LABORATORY 305 85730 53.50 C-REACTIVE PROTEIN LAB LABORATORY 300 86140 54.50 MONO TEST LAB LABORATORY 300 86308 50.50 H. PYLORI LAB LABORATORY 300 86317 101.00 RHEUMATOID FACTOR LAB LABORATORY 300 86431 56.50 RPR, SERUM LAB LABORATORY 300 86592 49.50 CYTOMEGALO CMV AB IgM LAB LABORATORY 300 86645 62.50 HIV 1, 2 COMBO ANTIBODIES LAB LABORATORY 300 86703 71.00 MUMPS IGG LAB LABORATORY 300 86735 40.50 RUBELLA AB IgG LAB LABORATORY 300 86762 65.00 MEASLES TITER LAB LABORATORY 300 86765 71.00 VARICELLA ZOSTER TITER LAB LABORATORY 300 86787 112.50 ANTIBODY SCREEN LAB LABORATORY 300 86850 82.50 DIRECT ANTIGLOBULIN TEST LAB LABORATORY 300 86880 50.00 TYPING (ABO) LAB LABORATORY 300 86900 36.50 TYPING (RH) LAB LABORATORY 300 86901 36.50 CROSS MATCH IMMEDIATE SPI LAB LABORATORY 300 86920 388.00 CROSS MATCH MTS 1 LAB LABORATORY 300 86921 388.00 CROSS MATCH MTS 2 LAB LABORATORY 300 86921 388.00 CROSS MATCH MTS 3 LAB LABORATORY 300 86921 388.00 CROSS MATCH MTS 4 LAB LABORATORY 300 86921 388.00 CROSS MATCH MTS 5 LAB LABORATORY 300 86921 388.00 28 CROSS MATCH MTS 6 LAB LABORATORY 300 86921 388.00 FFP THAWING LAB LABORATORY 300 86927 646.50 BLOOD CULTURE # 2 LAB LABORATORY 306 87040 101.00 BLOOD CULTURE #1 LAB LABORATORY 306 87040 101.00 CULTURE, BACTERIAL LAB LABORATORY 300 87070 66.50 CULTURE BODY FLUID LAB LABORATORY 300 87070 121.50 CULTURE EAR LAB LABORATORY 300 87070 66.50 CULTURE EYE LAB LABORATORY 300 87070 66.50 CULTURE VAGINA LAB LABORATORY 300 87070 66.50 CULTURE WOUND LAB LABORATORY 300 87070 108.00 CULTURE, ROUTINE LAB LABORATORY 300 87070 50.50 CULTURE, SPUTUM LAB LABORATORY 300 87070 66.50 MICRO ID LAB LABORATORY 300 87077 47.50 UREASE LAB LABORATORY 300 87077 188.00 CULTURE MRSA SCREEN LAB LABORATORY 300 87081 72.00 CULTURE, R/O YEAST LAB LABORATORY 300 87081 84.00 GROUP B STREP CULTURE LAB LABORATORY 300 87081 71.00 CULTURE, THROAT LAB LABORATORY 300 87081 53.50 URINE CULTURE LAB LABORATORY 300 87086 64.00 BLOOD CULTURE ID by PCR LAB LABORATORY 306 87150 130.00 SENSITIVITY GRAM NEG LAB LABORATORY 306 87186 61.50 SENSITIVITY TESTING LAB LABORATORY 306 87186 61.50 SUSCEPTIBILITIES, MIC LAB LABORATORY 300 87186 58.00 GRAM STAIN LAB LABORATORY 306 87205 42.00 KOH PREP LAB LABORATORY 300 87210 42.00 HEPATITIS B SURFACE AG LAB LABORATORY 300 87340 74.00 IA AB HIV-1&2 COMBO LAB LABORATORY 300 87389 89.50 RSV PCR LAB LABORATORY 300 87420 101.00 QUICK STREP W CULTURE LAB LABORATORY 300 87430 65.00 LEGIONELLA ANTIGEN URINE LAB LABORATORY 300 87449 92.00 STREP PNEUMO ANTIGEN LAB LABORATORY 300 87449 86.00 CHLAMYDIA AMP PROBE LAB LABORATORY 300 87491 110.50 C. DIFF.TOXIGINIC LAB LABORATORY 300 87493 175.00 FLU A/B PCR LAB LABORATORY 300 87502 315.50 GI PANEL PCR LAB LABORATORY 300 87507 1,544.00 RESPIRATORY VIRUS PANEL P LAB LABORATORY 300 87633 1,544.00 STREP A PCR LAB LABORATORY 300 87651 130.00 CELL COUNT & DIFF, BODY F LAB LABORATORY 300 89050 53.50 CELL COUNT, CSF LAB LABORATORY 300 89051 49.50 EOSINOPHIL SMEAR, NASAL LAB LABORATORY 300 89190 48.50 SEMEN ANALYSIS (SEARCH) LAB LABORATORY 300 89321 42.00 PHLEBOTOMY (THERAPEUTIC) LAB LABORATORY 300 99195 315.50 29 PSA, SCREENING LAB LABORATORY 301 G0103 115.00 FECAL OCCULT BLOOD 1 LAB LABORATORY 300 G0328 38.50 FECAL OCCULT BLOOD 2 LAB LABORATORY 300 G0328 38.50 OCCULT BLOOD, FECAL IA LAB LABORATORY 300 G0328 38.50 DNA COLLECT / DNA DIAGNOS LAB LABORATORY 300 25.00 DRUG SCREEN COLLECTION LAB LABORATORY 300 30.00 DRUG SCRN COLL/HIGH VOLUM LAB LABORATORY 300 22.00 PRENATAL PANEL #3 LAB LABORATORY 300 80055 176.00 AMNIOSURE ROM LAB LABORATORY 300 84112 245.00 CBC AUTO DIFF (PRENATAL) LAB LABORATORY 305 85025 29.00 CHLORIDE LAB LABORATORY 300 82435 17.00 CO2 (CARBON DIOXIDE) LAB LABORATORY 300 82374 50.50 CEREBROSPINAL FLUID CULTURE LAB LABORATORY 300 87070 32.00 HDL LAB LABORATORY 300 83718 58.00 STREP A ANTIGEN (W/O CULTURE) LAB LABORATORY 300 87430 65.00 NEISSERIA GONORRHOEAE AMP PCR LAB LABORATORY 300 87591 130.00 CREATININE LAB LABORATORY 300 82570 19.50 DRUGS OF ABUSE PANEL 12, USCREEN QUALITA LAB LABORATORY 300 80300 235.00 TRAMADOL, SCREEN & CONFIRMATION, URINE LAB LABORATORY 300 80307 205.50 IMMUNOGLOBULIN PANEL LABR LABORATORY 300 82784 144.00 MANUAL DIFF, PATH REVIEW LABR LABORATORY 300 85060 46.00 ANTI-THROID PEROXIDASE AB LABR LABORATORY 300 86376 101.00 FLOW CYTOMETRY, EACH ADDE LABR LABORATORY 300 88185 49.50 GLUCOSE, SERUM LABR LABORATORY 300 82947 29.50 CHOLESTEROL TOTAL LABR LABORATORY 300 82465 15.50 SERUM PROTEIN ELECTROPHO LABR LABORATORY 300 84165 13.00 ALBUMIN OTHR SOURCE, QUANTITATIVE LABR LABORATORY 300 82042 19.50 BILIRUBIN TOTAL LABR LABORATORY 300 82247 17.50 ALKALINE PHOSPHATASE LABR LABORATORY 300 84080 18.50 LACTATE DEHYDROGENASE LDH LABR LABORATORY 300 83615 21.50 THYROXINE (T4) LABR LABORATORY 300 84436 53.50 TRIIODOTHYRONINE (T3) UPTAKE LABR LABORATORY 300 84479 81.00 TRIGLYCERIDES LABR LABORATORY 300 84478 20.50 FAT, TOTAL, STOOL LABR LABORATORY 300 82710 108.00 CREATININE LABR LABORATORY 300 82570 16.00 GLYCOSYLATED HEMOGLOBIN A1C LABR LABORATORY 300 83036 34.50 VITAMIN C (ASCORBIC ACID) LABR LABORATORY 300 82180 36.50 PROTEIN, TOTAL LABR LABORATORY 300 84155 14.00 CERULOPLASM LABR LABORATORY 300 82390 97.00 COPPER, SERUM PLASMA LABR LABORATORY 300 82525 44.00 CRYOGLOBULINS, QUALITIATIVE LABR LABORATORY 300 82595 50.50 ALKALINE PHOSPHATASE ISOENZYMES LABR LABORATORY 300 84075 58.00 30 HAPTOGLOBIN LABR LABORATORY 300 83010 44.50 FECAL FATS QUALITATIVE LABR LABORATORY 301 82705 19.00 5-NUCLEOTIDASE LABR LABORATORY 300 83915 47.50 PHOSPHOLIPIDS LABR LABORATORY 300 84311 24.50 THYROXINE BINDING GLOBULIN LABR LABORATORY 300 84442 48.50 IMMUNOGLOBULIN G TOTAL LABR LABORATORY 300 82784 65.00 IMMUNOGLOBULIN A LABR LABORATORY 300 82784 22.50 IMMUNOGLOBULIN M LABR LABORATORY 300 82784 34.50 ZINC, SERUM LABR LABORATORY 300 84630 64.00 COMPLEMENT C4 LABR LABORATORY 300 86160 42.50 GLUCOSE 6 PHOS DEHYDROGEN LABR LABORATORY 300 82955 36.00 COMPLEMENT CH-50, TOTAL LABR LABORATORY 300 86162 89.00 GGT LABR LABORATORY 300 82977 25.50 ALPHA-1-ANTITRYPSIN SERUM LABR LABORATORY 300 82103 47.50 RENIN ACTIVITY LABR LABORATORY 300 84244 77.50 ALDOLASE LABR LABORATORY 300 82085 66.50 OSMOLALITY LABR LABORATORY 300 83930 70.00 CARCINOEMBRYONIC (CEA) LABR LABORATORY 300 82378 67.00 CREATINE KINASE (CK) ELECTROPHORESIS LABR LABORATORY 300 82552 132.00 IMMUNOGLOBULIN E, TOTAL LABR LABORATORY 300 82785 58.00 IMMUNOGLOBULIN E LABR LABORATORY 300 82785 34.50 TRIIOTOTHYRONINE (T3) LABR LABORATORY 300 84480 50.00 ALFA FETOPROTEIN LABR LABORATORY 300 82105 56.50 CARBOHYDRATE ANTIGEN (CA) 19-9 LABR LABORATORY 300 86301 73.50 CANCER ANTIGEN 125 LABR LABORATORY 300 86304 319.50 CREATININE CLEARANCE LABR LABORATORY 300 82570 16.50 CREATININE 24 HR URINE LABR LABORATORY 300 82570 18.50 PORPHOBILINOGEN, URINE LABR LABORATORY 300 84110 90.50 MYOGLOBIN, URINE LABR LABORATORY 300 83874 98.00 SODIUM UR 24 HR LABR LABORATORY 300 84300 15.50 POTASSIUM, 24-HOUR URINE LABR LABORATORY 300 84133 13.00 PORPHYRINS, URINE LABR LABORATORY 300 84120 128.50 PHOSPHORUS, URINE 24 Hr LABR LABORATORY 300 84105 54.50 CALCIUM, URINE LABR LABORATORY 300 82340 18.50 PROTEIN, URINE LABR LABORATORY 300 84156 13.00 CALCIUM UR 24 HR LABR LABORATORY 300 82340 22.50 COPPER, 24HR URINE LABR LABORATORY 300 82525 76.50 URIC ACID - URINE (24HR) LABR LABORATORY 300 84560 18.00 OSMOLALITY, URINE LABR LABORATORY 300 83935 24.00 UREA NITROGEN 24HR LABR LABORATORY 300 84540 17.00 OXALATE LABR LABORATORY 300 83945 48.00 DHEA SULFATE LABR LABORATORY 300 82627 79.50 31 CORTISOL, EA LABR LABORATORY 300 82533 57.50 5-HIAA QUANT 24HR URINE LABR LABORATORY 300 83497 45.50 DHEA LABR LABORATORY 300 82626 98.50 VANILLYLMANDELIC ACID (VMA) - URINE LABR LABORATORY 300 84585 71.50 CATECHOLAMINES, FRAC, UR LABR LABORATORY 300 82384 89.00 EISINOPHIL CATIONIC PROTE LABR LABORATORY 300 86849 43.00 NEUROMYELITIS OPTICA, IGG AUTOANTIBODIES LABR LABORATORY 300 83520 52.00 TESTOSTERONE LABR LABORATORY 300 84403 166.50 TESTOSTERONE, T&F ADULT MALES LABR LABORATORY 300 84403 96.00 METANEPHRINS FRAC, QUANT, LABR LABORATORY 300 83835 60.00 GROWTH HORMONE LABR LABORATORY 300 83003 59.00 TRYPTASE LABR LABORATORY 300 83520 47.50 LUTEINIZING HORMONE LABR LABORATORY 300 83002 113.50 ALDOSTERONE- URINE(24 Hr) LABR LABORATORY 300 82088 151.00 FSH LABR LABORATORY 300 83001 58.50 PROGESTERONE LABR LABORATORY 300 84144 73.50 INSULIN LABR LABORATORY 300 83525 40.50 ALDOSTERONE LABR LABORATORY 300 82088 144.00 ALDOSTERONE, LC/MS LABR LABORATORY 300 82088 144.00 GASTRIN LABR LABORATORY 300 82941 113.50 BETA HCG QUANTITATIVE LABR LABORATORY 300 84702 53.00 CORTISOL, URINARY FREE 24 LABR LABORATORY 300 82530 94.00 ADRENOCORTICOTROPIC ACTH LABR LABORATORY 300 82024 136.50 PROLACTIN LABR LABORATORY 300 84146 68.50 ESTRADIOL LABR LABORATORY 300 82670 98.50 ESTROGEN, TOTAL LABR LABORATORY 300 82672 76.50 BETA HCG, QUALITATIVE TUMOR MARKER LABR LABORATORY 300 84702 89.50 ESTRONE LABR LABORATORY 300 82679 88.50 FERRITIN LABR LABORATORY 300 82728 42.00 ESTROGEN, FRACTIONATED LABR LABORATORY 300 82671 301.00 ESTRIOL LABR LABORATORY 300 82677 85.50 C1 ESTERASE INHIBITOR TOTAL LABR LABORATORY 300 86160 44.50 VITAMIN B-6 LABR LABORATORY 300 84207 104.50 ANDROSTENDIONE LABR LABORATORY 300 82157 128.50 PYRUVIC ACID LABR LABORATORY 300 84210 50.50 CALCIUM, IONIZED, SERUM LABR LABORATORY 301 82330 90.50 VISCOSITY LABR LABORATORY 300 85810 86.00 CALCITONIN LABR LABORATORY 300 82308 72.00 TRANSFERRIN LABR LABORATORY 300 84466 45.00 CBC LABR LABORATORY 300 85025 28.00 RED BLOOD CELL COUNT LABR LABORATORY 300 85041 10.50 HEMOGLOBIN LABR LABORATORY 300 85018 8.00 32 HEMATOCRIT LABR LABORATORY 300 85014 7.00 SED RATE NON-AUTO LABR LABORATORY 300 85651 12.50 HEMOGLOBIN SOLUBILITY LABR LABORATORY 300 85660 17.00 BODY FLUID CELL COUNT LABR LABORATORY 300 89051 19.50 CRYSTAL EXAM SYNOVIAL FLU LABR LABORATORY 300 89060 25.50 STREPTOLYSIN O ANTIBODY LABR LABORATORY 300 86060 54.50 RPR LABR LABORATORY 300 86592 15.00 ENA ANTIBODY LABR LABORATORY 300 86235 19.50 COLD AGGLUTININS LABR LABORATORY 300 86157 52.00 FLUORESCENT TREPONOMAL AB LABR LABORATORY 300 86780 79.50 HEPATITIIS B IMMUNITY SCREEN LABR LABORATORY 300 86706 76.50 COMPLEMENT C3 LABR LABORATORY 300 86160 42.50 TOXOPLASMA AB IgG LABR LABORATORY 300 86777 44.00 CYTOMEGALOVIRUS (CMV) AB LABR LABORATORY 300 86644 72.00 RHEUMATOID FACTOR LABR LABORATORY 300 86431 20.00 HEP B SURFACE AG (HBsAg) LABR LABORATORY 300 87340 36.50 ANTI-HBS (HBsAb) QUANT LABR LABORATORY 300 86317 38.00 HETEROPHILE ABS SCREEN LABR LABORATORY 300 86308 18.50 HEPATITIS BE ANTIGEN LABR LABORATORY 300 87350 40.50 HEPATITIS BE ANTIBODY LABR LABORATORY 300 86707 41.00 SMOOTH MUSCLE ANTIBODY LABR LABORATORY 300 83516 84.50 MITROCHONDRIAL ANTIBODY LABR LABORATORY 300 83516 79.50 THYROID PEROXIDASE ABS LABR LABORATORY 300 86376 51.50 THYROGLOBULIN AB THYROID LABR LABORATORY 300 86800 211.00 THYROGLOBIN LABR LABORATORY 300 84432 56.50 THYROGLOBILIN ABS LABR LABORATORY 300 86800 59.00 HEP B CORE AB, TOTAL LABR LABORATORY 300 86704 42.50 HEPATITIS A VIRUS AB TOTAL LABR LABORATORY 300 86708 43.50 HEPATITIS A VIRUS AB IgM LABR LABORATORY 300 86709 36.00 THYROGLOBULIN ANTIBODY LABR LABORATORY 300 86376 192.50 HLA-B27 LABR LABORATORY 300 86812 155.50 HLA-B*5701 GENOTYPING LABR LABORATORY 300 81381 334.00 LACOSAMIDE LABR LABORATORY 300 80339 48.50 LIDOCAINE LEVEL LABR LABORATORY 300 80176 111.00 ARSENIC, QUANT, 24HR URINE LABR LABORATORY 300 82175 67.00 VOLATILES WHOLE BLOOD LABR LABORATORY 300 84600 57.00 ARSENIC, BLOOD LABR LABORATORY 300 82175 67.00 THEOPHYLLINE LABR LABORATORY 300 80198 102.50 NORTRIPTYLINE LABR LABORATORY 300 80335 205.50 PHENYTOIN (DILANTIN) LABR LABORATORY 300 80185 42.00 CARBAMAZEPINE SERUM/PLASMA LABR LABORATORY 300 80156 51.50 SOLUBLE LIVER AG AB IgG LABR LABORATORY 300 83516 82.60 33 ZARONTIN LABR LABORATORY 300 80168 126.00 AMTRIPTYLINE / NORTRIPTYLINE LEVEL LABR LABORATORY 300 80335 66.50 LEAD, WHOLE BLOOD (ADULT) LABR LABORATORY 300 83655 43.00 METHADONE & METABOLITE LABR LABORATORY 300 80358 145.50 PHENOBARBITAL LABR LABORATORY 300 80184 101.00 ZONISAMIDE LABR LABORATORY 300 80203 116.00 ANEROBIC CULTURE LABR LABORATORY 300 87075 29.00 FUNGUS STAIN LABR LABORATORY 300 87206 19.00 STOOL CULTURE - PANEL LABR LABORATORY 300 87045 90.50 ORGANISM ID LABR LABORATORY 300 87046 33.50 SIGA TOXIN LABR LABORATORY 300 87427 42.50 MALARIA EXAM, BLOOD LABR LABORATORY 300 87207 70.00 CYTOMEGALOVIRUS (CMV) CULTURE LABR LABORATORY 300 87252 84.50 VIRAL IDENTIFICATION LABR LABORATORY 300 84252 69.00 WORM IDENTIFICATION LABR LABORATORY 300 87169 15.00 HVS CULTURE REFLEX TO TYP LABR LABORATORY 300 87255 132.00 REFERRED ORGANISM ID BY SEQUENCING 2 LABR LABORATORY 300 81025 26.00 AEROBIC ORGANISM IDENTIFICATION LABR LABORATORY 300 87077 30.00 FUNGUS ID, MOLD LABR LABORATORY 300 87107 259.00 FUNGUS CULTURE LABR LABORATORY 300 87101 27.00 GRAM STAIN LABR LABORATORY 300 87205 15.50 CONFIRMATORY TYPING FA LABR LABORATORY 300 87140 35.50 CHLAMYDIA CULTURE LABR LABORATORY 300 87110 59.50 VIRAL CULTURE, NON RESP LABR LABORATORY 300 87252 94.00 ACID FAST SMEAR CULTURE LABR LABORATORY 300 87116 18.50 O/P DIRECT SMEAR LABR LABORATORY 300 87177 31.50 STAIN COMPLEX LABR LABORATORY 300 87209 63.50 PARASITE PINWORM (ENTEROBIUS VERMICULARI LABR LABORATORY 300 87172 36.50 AEROBIC ORGANISM CULTURE LABR LABORATORY 300 87070 30.50 REFERRED BACTERIAL, FACULATIVE ANAEROBE LABR LABORATORY 300 87077 30.00 MIC SUSCEPTIBILITY TEST LABR LABORATORY 300 87186 30.50 CYTOLOGY, BRONCHIAL WASH LABR LABORATORY 310 88112 106.00 CYTOLOGY BODY FLUIDS LABR LABORATORY 300 88160 165.00 C-PEPTIDE, SERUM LABR LABORATORY 300 84681 73.50 ANGIOTENSIN CONVERTING EN LABR LABORATORY 300 82164 51.50 BETA 2 MICROGLOBULIN LABR LABORATORY 300 82232 56.50 OSTEOCALIN (BONE GLA PROTEIN) LABR LABORATORY 300 83937 110.50 EEPSTEIN-BARR NUCLEAR ANTIGEN AB IgG LABR LABORATORY 300 86664 102.50 THYROTROPIN RECEPTOR ABS LABR LABORATORY 300 83520 45.50 PSA TOTAL LABR LABORATORY 300 84153 65.00 INSULIN LIKE GROWTH FACTO LABR LABORATORY 300 84305 75.00 TRIIODOTHYRONINE (T3) FREE LABR LABORATORY 300 84481 60.00 34 VASOACTIVE INTESTINAL POLYPEPTIDE (VIP) LABR LABORATORY 300 84586 125.00 MYOGLOBIN, SERUM LABR LABORATORY 300 83874 124.00 INTRINSIC FACTOR BLOCKING ANTIBODIES, QU LABR LABORATORY 300 86340 47.00 MELANOCYTE STIM HOMONE (A LABR LABORATORY 300 83519 47.50 ANTIDIURETIC HORMONE (ADH) LABR LABORATORY 300 84588 126.00 PH BODY FLUID LABR LABORATORY 300 83986 12.50 RPR W/REFLEX LABR LABORATORY 300 86592 15.00 ANTIHISTONE ABS LABR LABORATORY 300 86235 64.00 ANTI CHROMATIN LABR LABORATORY 300 86235 56.50 SJOGREN ANTIB SS-A LABR LABORATORY 300 86235 56.50 SJOGREN'S ANTI SS-B LABR LABORATORY 300 86235 56.50 ANTI RIBOSOMAL P ABS LABR LABORATORY 300 83516 40.50 URIC ACID URINE LABR LABORATORY 300 84560 18.00 pH URINE LABR LABORATORY 300 83986 13.50 SODIUM URINE LABR LABORATORY 300 84300 17.00 POTASSIUM, URINE LABR LABORATORY 300 84133 50.50 CALCIUM, URINE LABR LABORATORY 300 82340 22.50 CHLORIDE-URINE RANDOM LABR LABORATORY 300 82436 34.50 PROTEIN ELECTROPHORESIS, URINE LABR LABORATORY 300 84166 66.50 URINE CREATININE RANDOM LABR LABORATORY 300 82570 18.50 GROWTH HORMONE (HGH) 1 LABR LABORATORY 300 83003 59.00 GROWTH HORMONE (HGH) 2 LABR LABORATORY 300 83003 59.00 GROWTH HORMONE (HGH) 3 LABR LABORATORY 300 83003 59.00 ANTITHROMBIN III ACTIVITY LABR LABORATORY 300 85300 42.00 THROMBIN TIME LABR LABORATORY 300 85670 18.00 PARATHYROID HORMONE (PTH) LABR LABORATORY 300 83970 176.00 ANTI-RIBONUCLEIC PROTEIN LABR LABORATORY 300 86235 56.50 RNP ANTIBODIES LABR LABORATORY 300 86235 66.50 ANTI-SMITH LABR LABORATORY 300 86235 56.00 SMITH/RNP ANTIBODIES LABR LABORATORY 300 86235 66.50 HEP B CORE AB, IGM LABR LABORATORY 300 86705 41.50 PREALBUMIN LABR LABORATORY 300 84134 51.50 QUAD MARKER SCREEN LABR LABORATORY 300 81511 235.00 VITAMIN A SERUM LABR LABORATORY 300 84590 41.00 METHANOL, QUANTITATIVE LABR LABORATORY 300 80320 205.50 ETHANOL WHOLE BLOOD LABR LABORATORY 300 80320 205.50 ANTISCLERODERMA 70 ABS LABR LABORATORY 300 86235 56.50 SCL-70 (ANTISCLERODERMA-70 ANTIBODIES) LABR LABORATORY 300 86235 66.50 PRIMIDONE, SERUM LABR LABORATORY 300 80188 80.50 GP B STREP BY PCR LABR LABORATORY 300 87653 70.50 MERCURY, URINE LABR LABORATORY 300 83825 60.50 GLUCOSE BODY FLUID LABR LABORATORY 300 82945 13.50 35 URIC ACID BODY FLUID LABR LABORATORY 300 84560 16.50 PROTEIN, BODY FLUID LABR LABORATORY 300 84157 61.50 CBC WITH NO DIFF LABR LABORATORY 300 85027 20.00 THYROGLOBULIN EVALUATION LABR LABORATORY 300 86800 56.00 MICROSOMAL ABS LABR LABORATORY 300 86376 51.50 TESTOSTERONE T&F, FEMALE & CHILDREN LABR LABORATORY 300 84403 91.00 LEFLUNOMIDE LABR LABORATORY 300 80375 231.00 ZINC WHOLE BLOOD LABR LABORATORY 300 84630 35.00 IODINE LABR LABORATORY 300 83789 72.50 TESTOSTERONE TOTAL LABR LABORATORY 300 84403 91.00 NICOTINE AND METABOLITES QUANTITATIVE UR LABR LABORATORY 300 80323 205.50 17-OH PROGESTERONE LABR LABORATORY 300 83498 96.00 BUPRENORPHINE & METABOLITE LABR LABORATORY 300 80348 219.50 TRIIODOTHYRONINE (T3) REVERSE LABR LABORATORY 300 84482 55.50 NIACIN LABR LABORATORY 300 84425 170.00 THYROGLOBULIN BY LCMS LABR LABORATORY 300 84432 59.50 VITAMIN E (ALPHA AND GAMMA TOCOPHEROL) LABR LABORATORY 300 84446 44.00 IODINE, URINE LABR LABORATORY 300 83789 72.50 CARBAMAZEPINE FREE LABR LABORATORY 300 80157 102.50 VALPROIC ACID, FREE SERUM LABR LABORATORY 300 80165 48.00 CADMIUM LABR LABORATORY 300 82300 71.00 NICOTINE AND METABOLITES LABR LABORATORY 300 80323 206.00 AMPHETAMINE CONFIRMATION, LABR LABORATORY 300 80324 205.50 BARBITURATES CONFIRMATION LABR LABORATORY 300 80345 189.00 THC CONFIRMATION, URINE LABR LABORATORY 300 80349 205.50 COCAINE CONFIRMATION- URINE LABR LABORATORY 300 80353 189.00 OPIATE CONFIRMATION LABR LABORATORY 300 80361 188.00 COBALT, SERUM OR PLASMA LABR LABORATORY 300 83018 39.50 CHROMIUM LABR LABORATORY 300 82495 35.50 ETHYLENE GLYCOL, SERUM OR PLASMA LABR LABORATORY 300 82693 158.50 CLONAZEPAM LABR LABORATORY 300 80346 205.50 PHENCYCLIDINE CONFIRMATION LABR LABORATORY 300 83992 174.00 DRUG TEST 9 PANEL LABR LABORATORY 300 80307 180.00 CRYOFIBRINOGEN LABR LABORATORY 305 82585 53.50 LYSOZYME (MURAMIDASE) LABR LABORATORY 300 85549 27.00 VITAMIN E LEVEL LABR LABORATORY 300 84446 44.00 COPPER, WHOLE BLOOD LABR LABORATORY 300 82525 46.00 VIT-D 1, 25-DIHYDROXY LABR LABORATORY 300 82652 121.00 HISTAMINE DETERMINATION, WHOLE BLOOD LABR LABORATORY 300 83088 38.50 VITAMIN D, 25-HYDROXY LABR LABORATORY 300 82306 85.00 SEX HORMONE BIND GLOBULIN LABR LABORATORY 300 84270 71.00 ADRENAL TOTAL AUTOANTIBODIES LABR LABORATORY 300 86255 42.50 36 TREPONEMA PALLIDUM ABS LABR LABORATORY 300 86780 47.00 ANTIGLOMERULAR BASEMENT MEMBRANE ANTIBOD LABR LABORATORY 300 83516 43.00 CRYPTOCOCCUS ANTIBODIES, QUANTITATIVE LABR LABORATORY 300 86641 51.00 RABIES AB NEUTRALIZATION LABR LABORATORY 300 86382 52.00 HIV AG/AB (4th GEN) EIA, REFLEX TO CONFI LABR LABORATORY 300 87389 85.00 HIV-1 AB LABR LABORATORY 300 86701 28.00 HIV-2 AB LABR LABORATORY 300 86702 43.50 CATECHOLAMINES, FRACTIONA LABR LABORATORY 300 82384 89.50 MERCURY, WHOLE BLOOD LABR LABORATORY 300 83825 60.50 ACETYLCHOLINE RECEPTOR BINDING LABR LABORATORY 300 83519 47.50 AChR BINDING ABS, SERUM LABR LABORATORY 300 83519 55.50 ACETYLCHOLINE RECEPTOR BLOCKING LABR LABORATORY 300 83519 47.50 AChR BLOCKING ABS, SERUM LABR LABORATORY 300 83519 55.50 AChR MODULATING AUTOAB LABR LABORATORY 300 83519 97.50 ACETYLCHOLINE (AChR) RBAP LABR LABORATORY 300 83519 200.50 FACTOR II ACTIVITY LABR LABORATORY 300 85210 224.00 FACTOR V ACTIVITY LABR LABORATORY 300 85220 56.50 FACTOR VIII (AHG), 1-ST LABR LABORATORY 300 85240 56.50 VON WILLEBRAND FACTOR ANT LABR LABORATORY 300 85246 81.50 FACTOR IX ACTIVITY LABR LABORATORY 300 85250 185.50 LEGIONELLA SPECIES CULTURE LABR LABORATORY 300 87081 89.50 AMYLASE, BODY FLUID LABR LABORATORY 300 82150 23.00 ADENOVIRUS ANTI, IgG, IgM LABR LABORATORY 300 86603 121.00 EPSTEIN BARR, VCA, IGG LABR LABORATORY 300 86665 64.00 EPSTEIN-BARR EARLY ANTIGEN AB, IgG LABR LABORATORY 300 86663 153.00 ANTI DS DNA LABR LABORATORY 300 86225 43.50 ANTI DNA AB, (DOUBLE STRAND) LABR LABORATORY 300 86225 48.50 AMINOLEVULINIC ACID, (ALA) 24 Hr Urine LABR LABORATORY 300 82135 79.50 Referred Minimum Inhibitory Conc. (MIC), LABR LABORATORY 300 87186 32.50 COXSACKIE B-1 ANTIBODY LABR LABORATORY 300 86658 48.50 COXSACKIE B-2 ANTIBODY LABR LABORATORY 300 86658 48.50 COXSACKIE B-3 ANTIBODY LABR LABORATORY 300 86658 48.50 COXSACKIE B-24ANTIBODY LABR LABORATORY 300 86658 48.50 COXSACKIE B-5 ANTIBODY LABR LABORATORY 300 86658 48.50 COXSACKIE B-6 ANTIBODY LABR LABORATORY 300 86658 48.50 RUBELLA AB IgM, QUANTITATIVE LABR LABORATORY 300 86762 98.00 TOXOPLASMA AB IGM LABR LABORATORY 300 86778 44.00 POLIOVIRUS ANTIBODIES LABR LABORATORY 300 86658 231.00 CANDIDA ANITBODY LABR LABORATORY 300 86628 38.50 CMV ANTIBODY, IGM QUANTITATIVE LABR LABORATORY 300 86645 20.50 EPSTEIN BARR VCA, IGM LABR LABORATORY 300 86665 64.00 VARICELLA ZOSTER AB IgM I LABR LABORATORY 300 86787 112.50 37 LD BODY FLUID LABR LABORATORY 300 83615 21.50 POTASSIUM, BODY FLUID LABR LABORATORY 300 84133 13.00 SODIUM BODY FLUID LABR LABORATORY 300 84302 17.50 CREATININE, BODY FLUID LABR LABORATORY 300 82570 19.50 CORTISOL, AM LABR LABORATORY 300 82533 57.50 KLEIHAUER BETKE STAIN LABR LABORATORY 300 85460 98.00 EOSINOPHIL EXAM, URIN E LABR LABORATORY 300 87205 16.00 JAK2 EXON 12-14 MUTATION LABR LABORATORY 300 81403 336.00 D-DIMER LABR LABORATORY 300 85379 36.00 FIBRIN SPLIT PRODUCTS (FDP) LABR LABORATORY 300 85362 89.50 HEXAGONAL PHASE PHOSPHOLIPID LABR LABORATORY 300 85598 67.00 THROMBOPLASTIN INHABIT TISSUE LABR LABORATORY 300 85705 30.00 PTT SUBSTITUTION PLASMA EACH LABR LABORATORY 300 85732 20.00 PROTHROMIN TIME LABR LABORATORY 300 85610 12.00 PLASMA THROMBIN TIME LABR LABORATORY 300 85670 18.00 PARTIAL THROMBOPLASTIN TIME LABR LABORATORY 300 85730 22.50 LOW MOLECULAR WEIGHT HEPARIN LABR LABORATORY 300 85520 163.50 APPT PLASMA LABR LABORATORY 300 85730 21.00 PROTEIN C, FUNCTIONAL LABR LABORATORY 300 85303 49.00 ACTIVATED PROTEIN C RE LABR LABORATORY 300 85307 54.00 RUSSELL VIPER VENOM TIME LABR LABORATORY 300 85613 22.50 dRVVT LABR LABORATORY 300 85613 33.50 SEROTONIN WHOLE BLOOD LABR LABORATORY 300 84260 109.00 NMR LIPOPROFILE LABR LABORATORY 300 83704 79.50 SEROTONIN, SERUM LABR LABORATORY 300 84260 49.50 C1 ESTERASE INHIBITOR, FU LABR LABORATORY 300 86161 81.00 COENZYME Q-10, TOTAL LABR LABORATORY 300 82542 64.00 C-REACTIVE PROTEIN HIGH SENSITIVE LABR LABORATORY 300 86141 45.50 CALCULUS, STONE ANAYLSIS LABR LABORATORY 300 82365 72.00 HEMOGLOBINOPATHY EVAL LABR LABORATORY 300 83021 67.00 KAPPA LIGHT CHAINS LABR LABORATORY 300 83883 50.50 LAMBDA AG LABR LABORATORY 300 88185 18.00 VITAMIN B1, WHOLE BLOOD LABR LABORATORY 300 84425 75.00 VITAMIN K LABR LABORATORY 300 84597 174.00 NEPHLOMETRY EA, FREE K LABR LABORATORY 300 83883 48.00 NEPHLOMETRY EA, FREE L LABR LABORATORY 300 83883 48.00 METANEPHRINES, PLASMA LABR LABORATORY 300 83835 153.00 LABR LABORATORY 300 83835 333.50 ALPHA 2-MACCROGLOBULIN LABR LABORATORY 300 83883 48.50 IF ELECTROPHORESIS OTHER LABR LABORATORY 300 86335 91.00 PROTEIN ELECTROPHORESIS W IFE REFLEX, UR LABR LABORATORY 300 84166 63.00 IGA SUBCLASSES 1 & 2 LABR LABORATORY 300 82784 34.50 38 CARBOHYDRATE-DEFICIENT TRANS (CDT), ADUL LABR LABORATORY 300 82373 67.00 VITAMIN B2 (RIBOFLAVIN) LABR LABORATORY 300 84252 109.00 PANCREATIC ELASTACE, FECA LABR LABORATORY 300 82656 319.00 CALPROTECTIN FECAL LABR LABORATORY 300 83993 323.00 ALBUMIN SER LABR LABORATORY 300 82040 36.50 ALBUMIN CSF LABR LABORATORY 300 82042 23.50 IGG SER LABR LABORATORY 300 82784 34.50 IGG CSF LABR LABORATORY 300 82784 34.50 MYELIN BASIC PROTEIN CSF LABR LABORATORY 300 83873 53.00 OGILOCLONAL IMMUNE (BANDS) LABR LABORATORY 300 83916 68.00 EBV QUANT PCR LABR LABORATORY 300 87799 151.50 EBV QUAL PCR LABR LABORATORY 300 87798 123.50 VARICELLA ZOSTER VIRUS PC LABR LABORATORY 300 87798 213.50 POLIO VIRUS 3 AB LABR LABORATORY 300 86658 40.00 ENTEROVIRUS BY PCR LABR LABORATORY 300 87498 70.50 B PERTUSSI, PCR LABR LABORATORY 300 87798 70.50 B PARAPERTUSSIS, PCR LABR LABORATORY 300 87798 70.50 BK VIRUS QUANT UR, REALTI LABR LABORATORY 300 87799 151.50 BKV, QUANT BY PCR, BLOOD LABR LABORATORY 300 87799 279.00 WEST NILE VIRUS AB IgG LABR LABORATORY 300 86789 44.00 WEST NILE VIRUS AB IGM LABR LABORATORY 300 86788 52.00 CMV BY PCR LABR LABORATORY 300 87496 70.50 HHV 6 BY PCR LABR LABORATORY 300 87532 70.50 HSV BY PCR LABR LABORATORY 300 87529 124.00 HSV TYPE 2 AMPLIFIED PR LABR LABORATORY 300 87529 124.00 HIV-1 QUALITATIVE RNA LABR LABORATORY 300 87535 123.50 JC VIRUS DNA, PCR, WHOLE BLOOD LABR LABORATORY 300 87798 130.00 BK VIRUS, PCR, URINE LABR LABORATORY 300 87799 308.50 WEST NILE VIRUS RNA RT-PCR LABR LABORATORY 300 87798 130.00 ROMA OVARIAN CANCER TEST LABR LABORATORY 310 81500 336.00 MICROALBUMIN 24HR URINE LABR LABORATORY 300 82043 20.50 INSULIN-LIKE GROWTH FACTOR BINDING PROTE LABR LABORATORY 300 83520 52.00 ALPHA SUBUNIT, FREE 9ENDO LABR LABORATORY 300 83520 45.50 ERYTHROPOIETIN, SERUM LABR LABORATORY 300 82668 95.50 CANCER ANTIGEN 27-29 LABR LABORATORY 300 86300 64.00 PROINSULIN LABR LABORATORY 300 84206 72.00 HEPATITIS C VIRUS AB LABR LABORATORY 300 86803 50.50 PREGNENOLONE LABR LABORATORY 300 84140 128.50 17-HYDROXYPREGNENOLONE, QUANT LABR LABORATORY 300 84143 80.50 THYROID STIMULAT IMMUNOGLUBIN LABR LABORATORY 300 84445 179.50 ACTH STIMULATION CORTISOL 2 SPECIMENS LABR LABORATORY 300 80400 115.50 HEPATITIS B VIRUS (HBV) QUANT. PCR, NGI, LABR LABORATORY 300 87517 243.00 39 INSULIN-LIKE GROWTH FACTOR BINDING PROTE LABR LABORATORY 300 83519 55.50 CHROMOGRANIN A LABR LABORATORY 300 86316 73.00 B-TYPE NATRIURETIC PEPTID LABR LABORATORY 300 83880 367.50 CROSS LINK N-TELEPEPTIDE LABR LABORATORY 300 82523 119.40 ANTI PHOSPHOLIPASE A2 REP LABR LABORATORY 300 86255 112.50 INSULIN ABS LABR LABORATORY 300 86337 75.00 GAD AUTOANTIBODY LABR LABORATORY 300 86431 19.50 CANCER ANTIGEN 15-3 LABR LABORATORY 300 86300 103.50 HEPATITIS C VIRUS (HCV) TO QUANT REAL TI LABR LABORATORY 300 86803 53.00 HISTAMINE LABR LABORATORY 300 83088 38.50 TESTOSTERONE FREE LABR LABORATORY 300 84402 90.00 TESTOSTERONE BIOAVAILABE LABR LABORATORY 300 84410 187.00 PANCREATIC POLYPEPTIDE LABR LABORATORY 300 83519 291.50 LEPTIN LABR LABORATORY 300 83520 52.00 INHIBIN A LABR LABORATORY 300 86336 46.00 SERUM, IMMUNOFIXATION LABR LABORATORY 300 86334 79.00 ALBUMIN 24 HR LABR LABORATORY 300 82043 20.50 HEPARIN IND THROMBOCY AB LABR LABORATORY 300 86022 236.00 HEPATITIS B CORE ANTIBODY WITH REFLEX LABR LABORATORY 300 86704 42.50 RUBEOLA ANTIBODIES IgM LABR LABORATORY 300 86765 45.50 LYME DISEASE ANTIBODIES WESTERN LABR LABORATORY 300 86618 110.50 MUMPS ANTIBODY IgM LABR LABORATORY 300 86735 46.00 LYME DISEASE AB IgG LABR LABORATORY 300 86617 57.50 LYME DISEASE AB IgM LABR LABORATORY 300 86617 57.50 IGG, SUBCLASS 1 LABR LABORATORY 300 82787 28.50 IgG SUBCLASS 2 LABR LABORATORY 300 82787 48.00 IgG, SUBCLASS 3 LABR LABORATORY 300 82787 28.50 IgG, SUBCLASS 4 LABR LABORATORY 300 82787 28.50 ISLET CELL ANTIBODY IgG LABR LABORATORY 300 86341 70.00 JO-1 ANTIBODY IgG LABR LABORATORY 300 86235 56.50 RA QUANT FLUID HAI LABR LABORATORY 300 86430 19.50 DEAMINATED GLIA ABS IGA LABR LABORATORY 300 83516 40.50 DEAMINATED GLIA ABS IGG LABR LABORATORY 300 83516 40.50 BORDATELLA PERTUSIS IGG LABR LABORATORY 300 86615 84.00 B PERTUSSIS IgG AB LABR LABORATORY 300 86615 84.00 BORDATELLA PERTUSIS IGM LABR LABORATORY 300 86615 84.00 B PERTUSSIS IgM AB LABR LABORATORY 300 86615 84.00 CARDIOLIPIN AB, IGG LABR LABORATORY 300 86147 90.00 CARDIOLIPIN AB, IGM LABR LABORATORY 300 86147 90.00 ANTICARDIOLIPIN ABS, IgA, LABR LABORATORY 300 86147 90.00 ANTICHITOBIOSIDE CARBO ANITBODY LABR LABORATORY 300 83516 45.25 ANTILAMINARIBIOSIDE CARBO ANTIBODY LABR LABORATORY 300 83516 45.25 40 ANTIMANNOBIOSIDE CARBO ANTIBODY LABR LABORATORY 300 83516 45.25 ANTI S.CEREVISIAE ANTIBODY LABR LABORATORY 300 86671 45.25 ANCA SCREEN REFLEX LABR LABORATORY 300 86255 139.00 H. PYLORI, IgG ABS LABR LABORATORY 300 86677 51.50 C-ANCA LABR LABORATORY 300 86256 42.50 P-ANCA LABR LABORATORY 300 86256 42.50 ANCA SCREEN LABR LABORATORY 300 86021 42.50 C.ALBICANS AB IGG LABR LABORATORY 300 86628 37.00 C.ALBICANS AB IGM LABR LABORATORY 300 86628 37.00 C.ALBICANS AB IGA LABR LABORATORY 300 86628 37.00 HERPES SIMPLEX TYPE 2 IGG LABR LABORATORY 300 86696 42.00 HERPES SIMPLEX TYPE 2 ABS LABR LABORATORY 300 86696 68.50 B. HENSELAE IGG LABR LABORATORY 300 86611 32.00 B. HENSELAE IGM LABR LABORATORY 300 86611 32.00 B. QUINTANA IGG LABR LABORATORY 300 86611 32.00 B. QUINTANA IGM LABR LABORATORY 300 86611 32.00 H. PYLORI, IgA ABS LABR LABORATORY 300 86677 51.50 INFECTIOUS AGT OPTHO DE LABR LABORATORY 300 87899 40.00 H. PYLORI, IgM ABS LABR LABORATORY 300 86677 51.50 M PNEUMONIAE IgM ABS LABR LABORATORY 300 86738 47.00 COXSACKIE A7 IgG LABR LABORATORY 300 86658 48.50 COXSACKIE A9 IgG LABR LABORATORY 300 86658 48.50 COXSACKIE A16 IgG LABR LABORATORY 300 86658 48.50 COXSACKIE A24 IgG LABR LABORATORY 300 86658 48.50 COXSACKIE A7 IgM LABR LABORATORY 300 86658 48.50 COXSACKIE A9 IgM LABR LABORATORY 300 86658 48.50 COXSACKIE A16 IgM LABR LABORATORY 300 86658 48.50 COXSACKIE A24 IgM LABR LABORATORY 300 86658 48.50 PARVOVIRUS B-19 IgG, IgM LABR LABORATORY 300 86747 28.00 LYME DISEASE IgM BY WESTERN LABR LABORATORY 300 86617 68.50 LYME DISEASE ANTIBODIES LABR LABORATORY 300 86618 52.00 TETANUS AB LABR LABORATORY 300 86774 67.00 TETANUS ANTITOXOID AB I LABR LABORATORY 300 86317 53.00 DIPTHERIA AB LABR LABORATORY 300 86648 67.00 DIPHTHERIA ANTITOXOID A LABR LABORATORY 300 86317 53.00 M PNEUMONIAE IgG ABS LABR LABORATORY 300 86738 47.00 ANTIMYELPEROXIDASE (MPO LABR LABORATORY 300 83520 45.50 ANTIPROTEINASE 3 (PR-3) LABR LABORATORY 300 83520 45.50 BETA 2 GLYCOPROTEIN IGG LABR LABORATORY 300 86146 90.00 BETA 2 GLYCOPROTEIN IGA LABR LABORATORY 300 86146 90.00 BETA 2 GLYCOPROTEIN IGM LABR LABORATORY 300 86146 90.00 LIVER/KIDNEY MICROSOME LABR LABORATORY 300 86376 74.50 41 BORDETELLA PERTUSSIS AB LABR LABORATORY 300 86615 84.00 B PERTUSSIS IgA AB LABR LABORATORY 300 86615 84.00 VON WILLENBRAND RISTOCETIN COFACTOR (VWF LABR LABORATORY 300 85245 81.00 PROTEIN S, TOTAL LABR LABORATORY 300 85306 57.00 PROTEIN S, FREE LABR LABORATORY 300 85306 57.00 PROTEIN S ACTIVITY LABR LABORATORY 300 85306 301.00 BRUCELLA TOTAL AG AGGLUTIN LABR LABORATORY 300 86622 31.00 TISSUE TRANSGLUTAMINASE, IGA LABR LABORATORY 300 83516 53.50 SACCHARORMYCES CEREVISIAE IgG LABR LABORATORY 300 86671 45.50 SACCHAROMYCES CEREVISIAE, IgA LABR LABORATORY 300 86671 58.50 HGE IgM TITER LABR LABORATORY 300 86666 36.00 HGE IgG TITER LABR LABORATORY 300 86666 36.00 E. CHAFFEENIS (HME) IgG TITER LABR LABORATORY 300 86666 36.00 E. CHAFFEENSIS (HME) IgM TITER LABR LABORATORY 300 86666 36.00 HERPES SIMPLEX VIRUS AB 1/2, IGM LABR LABORATORY 300 86694 53.50 ANT-CENTROMERE ABS LABR LABORATORY 300 86235 56.50 ANA MULTIPLEX, QUAL LABR LABORATORY 300 86038 42.50 ANA W/REFLEX TO ENA LABR LABORATORY 300 86038 42.00 ANTINUCLEAR ABS (ANA) LABR LABORATORY 300 86038 42.00 HERPES SIMPL TYPE 1 AB LABR LABORATORY 300 86695 46.50 ANTI-CCP (CYCLIC CITRULLI LABR LABORATORY 300 86200 45.50 ANTINUCLEAR AB (ANA) LABR LABORATORY 300 86038 42.50 TISSUE TRANSGLUTAMINASE, IGG LABR LABORATORY 300 83516 53.50 ENDOMYSAL ANTIBODY IgA LABR LABORATORY 300 86256 61.50 HERPES SIMPL TYPES 1/2, ABS IgM LABR LABORATORY 300 86694 51.00 HLA CLASS II LO RES TY LABR LABORATORY 300 81377 324.50 HLA CLASS II HI RES TYP LABR LABORATORY 300 81383 385.50 CANDIDA SPECIES LABR LABORATORY 300 87480 72.50 VAGINAL PATHOGENS BY DNA LABR LABORATORY 300 87800 71.00 GARDNERELLA VAGINITIS P LABR LABORATORY 300 87510 71.00 TRICHOMONAS VAGINALIS P LABR LABORATORY 300 87660 71.00 PNEUMOCYSTIS JIROVECII (DFA) LABR LABORATORY 300 87281 62.50 SUSCEPTIBILITY TEST, ANAE LABR LABORATORY 300 87186 30.50 HELIBACTER PYLORI AG STOOL LABR LABORATORY 300 87338 42.50 BODY FLUID CULTURE, STERI LABR LABORATORY 300 87070 30.50 LOWER RESPIRATORY CULTURE LABR LABORATORY 300 87070 32.00 H.PYLORI UREA BREATH TEST LABR LABORATORY 300 83013 247.00 ANTIFUNGAL SUSCEPTIBILITY LABR LABORATORY 300 87186 30.50 MIC ANTIFUNGAL AMPHOTERIC LABR LABORATORY 300 87186 31.00 GIARDIA LAMBLIA AG DET/EI LABR LABORATORY 300 87329 94.00 Referred Fungus/Yeast Identification LABR LABORATORY 300 87106 60.50 ANTIFUNGAL SUSCEPTIBILITY LABR LABORATORY 300 87186 30.50 42 AEROBIC ORGANISM IDENTIFICATION LABR LABORATORY 300 87077 28.50 SPUTUM CULTURE REFLEX AFTER GRAM STAIN E LABR LABORATORY 300 87205 16.00 CULTURE, SPUTUM LABR LABORATORY 300 87070 66.50 AFB CULTURE LABR LABORATORY 300 87116 38.00 MTB SUSCEPTIBILITY BROTH LABR LABORATORY 300 87188 21.00 MTB AST CONFIRMATION LABR LABORATORY 300 87190 18.00 YEAST ONLY CULTURE LABR LABORATORY 300 87102 52.00 MAC SUSCEPTIBILITY BROTH LABR LABORATORY 300 87186 32.50 NOCARDIA SUSCEPTABILITY BROTH LABR LABORATORY 300 87186 32.50 REF ORGANISM ID BY SEQUENCING REFLEX AST LABR LABORATORY 300 87153 356.00 QUANTIFERON -TB GOLD LABR LABORATORY 300 86480 219.00 QUANTIFERON - TB GOLD PLUS LABR LABORATORY 300 86480 219.00 QUANTIFERON - TB GOLD PLUS (CLIENT INCUB LABR LABORATORY 300 86480 219.00 RAPID GROWER SUSCEPTIBILITY LABR LABORATORY 300 87186 32.50 REFERRED SLOW GROWER BROTH SUSCEPTIBILIT LABR LABORATORY 300 87186 32.50 S. PNEUMONIA AG URINE OR LABR LABORATORY 300 87899 42.00 CRYPTOCOCCUS AG CSF LABR LABORATORY 300 87899 40.00 CRYPTOCOCCUS AG TITER C LABR LABORATORY 300 87899 40.00 CRYPTOSPORIDIUM ANTIGEN LABR LABORATORY 300 87328 50.50 CRYPTOCOCCUS AG SER LABR LABORATORY 300 87899 40.00 CRYPTOCOCCUS AG TITER S LABR LABORATORY 300 87899 40.00 MIC ANTIFUNGAL 9 DRUG PA LABR LABORATORY 300 87186 31.00 TISSUE GRINDING LABR LABORATORY 300 87176 28.00 CONC.INFECT AGENT ANY LABR LABORATORY 300 87015 54.00 QUANTIFERON -TB GOLD (CLIENT INCUBATED) LABR LABORATORY 300 86480 219.00 HISTOPLASMA GALACTOMANNAN ANTIGEN EIA, S LABR LABORATORY 300 87385 37.00 BACTERIAL ID BY PCR LABR LABORATORY 300 87798 70.50 SPUTUM CONCENTRATION LABR LABORATORY 300 87015 23.50 ACID FAST BACILLI DNA PCR LABR LABORATORY 300 87556 385.00 ASPERGILLUS GALACTOMANNAN AG LABR LABORATORY 300 87305 365.00 MUMPS VIRAL CULTURE LABR LABORATORY 300 87254 60.00 CHLAMYDIA TRACHOMATIS, CONJUNCTIVAL SWAB LABR LABORATORY 300 87491 130.00 N. GON AMP PROBE LABR LABORATORY 300 87591 110.50 FUNGUS CULTURE, HAIR, NAI LABR LABORATORY 300 87101 29.00 PARASITE, ARTHROPOD ID LABR LABORATORY 300 87168 49.50 CHLAMYDIA TRACH AMP PRO LABR LABORATORY 300 87491 108.00 HERPESEVIRUS 6 ABS, IGG LABR LABORATORY 300 86790 40.00 HERPESEVIRUS 6 ABS, IGM LABR LABORATORY 300 86790 40.00 CELL COUNT BODY FLUID LABR LABORATORY 300 89051 19.50 LABR LABORATORY 300 89051 19.50 CYTOMEGALOVIRUS (CMV) AB LABR LABORATORY 300 86644 53.50 PROTEIN ELECTR, SERUM W I LABR LABORATORY 300 84165 70.00 43 ANA LABR LABORATORY 300 86038 42.00 B. BURGDORFERI IGG LABR LABORATORY 300 86618 53.00 B. BURGDORFERI IGM LABR LABORATORY 300 86618 53.00 FOLATE, HEMOLYSATE LABR LABORATORY 300 82747 70.75 LIPID PANEL LABR LABORATORY 300 80061 47.50 COMP METABOLIC PANEL LABR LABORATORY 300 80053 37.00 HEPATITIS PANEL, ACUTE LABR LABORATORY 300 80074 168.50 CORTISOL, TOTAL LABR LABORATORY 300 82533 57.50 CD 10 AG LABR LABORATORY 300 88185 18.00 CD 103 AG LABR LABORATORY 300 88185 18.00 CD 117 AG LABR LABORATORY 300 88185 18.00 CD 11B AG LABR LABORATORY 300 88185 18.00 CD 11C AG LABR LABORATORY 300 88185 18.00 CD 13 AG LABR LABORATORY 300 88185 18.00 CD 14 AG LABR LABORATORY 300 88185 18.00 CD 15 AG LABR LABORATORY 300 88185 18.00 CD 16 AG LABR LABORATORY 300 88185 18.00 CD 22 AG LABR LABORATORY 300 88185 18.00 CD 23 AG LABR LABORATORY 300 88185 18.00 CD 3 AG LABR LABORATORY 300 88185 18.00 CD 33 AG LABR LABORATORY 300 88185 18.00 CD 34 AG LABR LABORATORY 300 88185 18.00 CD 38 AG LABR LABORATORY 300 88185 18.00 CD 4 AG LABR LABORATORY 300 88185 18.00 CD 45 AG LABR LABORATORY 300 88185 18.00 CD 5 AG LABR LABORATORY 300 88185 18.00 CD 56 AG LABR LABORATORY 300 88185 18.00 CD 57 AG LABR LABORATORY 300 88185 18.00 CD 64 AG LABR LABORATORY 300 88185 18.00 CD 7 AG LABR LABORATORY 300 88185 18.00 CD 8 AG LABR LABORATORY 300 88185 18.00 CD 2 AG LABR LABORATORY 300 88185 18.00 FMC-7 AG LABR LABORATORY 300 88185 18.00 HLA-DR AG LABR LABORATORY 300 88185 18.00 BCR/ABL BY PCR LABR LABORATORY 300 81206 252.00 PSA FREE LABR LABORATORY 300 84154 65.00 BCR/ABL1 MAJOR BREAK PT LABR LABORATORY 300 81206 521.00 BCR/ABL1 MINOR BREAK PT LABR LABORATORY 300 81207 460.50 FLOW CYTO 1st MKR LABR LABORATORY 311 88184 489.00 JAK2 EXON 12 MUTATION ANALYSIS LABR LABORATORY 300 81403 463.00 FLOW CYTO 2-10 MKRS LABR LABORATORY 311 88185 65.00 FLOW CYTO 2-20 MKRS LABR LABORATORY 311 88185 65.00 44 THROMBIN/ANTITHROMBIN C LABR LABORATORY 300 83520 45.50 COLLAGEN CROSS LINKS LABR LABORATORY 300 82523 66.00 21-HYDROXYLASE ANTIBODY LABR LABORATORY 300 83519 55.50 GLYCOMARK LABR LABORATORY 300 84378 41.00 DEXAMETHASONE (ENDOCRINE SCIENCES) LABR LABORATORY 300 80375 180.00 MMP-9 (MATRIX METALLPROTI LABR LABORATORY 300 83520 180.00 DIHYDROTESTOSTERONE LABR LABORATORY 300 80327 71.00 CORTISOL, SALIVA LABR LABORATORY 300 82533 94.00 ANTI MULLERIAN HORMONE LABR LABORATORY 300 83520 143.00 TSH RECEPTOR AB (TRAb) LABR LABORATORY 300 83520 47.50 11-DESOXYCORTISOL (SPECIFIC-S) LABR LABORATORY 300 82634 211.00 PT FRAGMENT 1&2 MOAB LABR LABORATORY 300 83520 45.50 ESTRONE BY TMS LABR LABORATORY 300 82679 88.50 INSULIN, BOUND LABR LABORATORY 300 83527 45.50 INSULINE, TOTAL LABR LABORATORY 300 83525 40.50 PHOSPHOLIPID NEUTRILIZATION LABR LABORATORY 300 85598 63.50 APPT PLASMA FRACTIONS E LABR LABORATORY 300 85732 23.00 PTH RELATED PEPTIDE, PLASMA LABR LABORATORY 300 82397 50.00 BILE ACIDS FRACTIONATED LABR LABORATORY 300 82542 60.00 INFLIXIMAB CONCENTRATION LABR LABORATORY 300 80299 47.00 INFLIXIMAB ANTIBODY LABR LABORATORY 300 82397 44.00 THIOPURINE METABOLITES LABR LABORATORY 300 80299 48.50 ADALIMUMAB CONCENTRATION LABR LABORATORY 300 80299 47.00 ANTI-ADALIMUMAB ANTIBODY LABR LABORATORY 300 82397 44.00 CORTISOL, FREE EQUILIBRIUM DIALYSIS LC/M LABR LABORATORY 300 82530 62.00 25-HYDROXY VITAMIN D (FRA LABR LABORATORY 300 82306 85.00 THIOPURINE METHYLTRANSFERASE LABR LABORATORY 300 81335 437.00 EDOXABAN, ANTI-XA LABR LABORATORY 300 85130 163.50 14.3.3 ETA (RHEUMATOID AR LABR LABORATORY 300 83520 45.50 HELPER T-LYMPH MARKER CD4 LABR LABORATORY 300 86361 95.00 T CELL SUBSETS LABR LABORATORY 300 86360 104.50 NATURAL KILLER CELLS LABR LABORATORY 300 86357 133.50 B CELLS,TOTAL COUNT LABR LABORATORY 300 86355 133.50 MONO NUCLEAR CELL AG NOS EA 1 LABR LABORATORY 300 86356 83.00 MONO NUCLEAR CELL AG NOS EA 2 LABR LABORATORY 300 86356 83.00 MONO NUCLEAR CELL AG NOS EA 3 LABR LABORATORY 300 86356 83.00 TOTAL T CELL COUNT LABR LABORATORY 300 86359 116.00 T CELLS ABSOLUTE CD4/CD8 CT W/RATIO LABR LABORATORY 300 86360 145.00 ERTHROCYTE TPMT ENZ ACTIV LABR LABORATORY 300 82657 56.00 CHROMOSOME ANALYSIS- WHOLE BLOOD LABR LABORATORY 300 88264 482.00 TISSUE CULTURE LYMPHOCYTENON-NEO LABR LABORATORY 300 88230 360.00 FACTOR V (LEIDEN GENE ANA LABR LABORATORY 300 81241 216.00 45 FACTOR II (PROTHROMBIN) LABR LABORATORY 300 81240 174.00 MTHFR 2 MUTULATIONS LABR LABORATORY 300 81291 148.50 HEMOCHROMATOSIS MUTATION LABR LABORATORY 300 81256 216.00 CLOPIDOGRELCYP2C19 GENOTYPING LABR LABORATORY 300 81225 728.00 FRAGILE X INTERPRETATION LABR LABORATORY 300 G0452 104.50 BONE SPECIFIC ALKALINE PH LABR LABORATORY 300 84080 128.00 HEP C RNA BY PCR ULTRA SE LABR LABORATORY 306 87522 346.50 HEPATITIS C VIRUS RNA QUA LABR LABORATORY 300 87522 151.50 APOLIPOPROTEIN LABR LABORATORY 300 82172 54.50 TRANSFERASE ASPARTATE A LABR LABORATORY 300 84450 18.50 TRANSFERASE ALANINE AMI LABR LABORATORY 300 84460 18.50 HCV RT PCR QUANT NON GRAPH REFLEX LABR LABORATORY 300 87522 151.50 HPE E445(HCV) Genotyping, LABR LABORATORY 300 87902 909.50 PHENOTYPE INFECTIOUS AGENT DRUG LABR LABORATORY 300 87900 402.00 HEP C VIRUS GENOTYPING LABR LABORATORY 300 87902 803.50 HEPATITIS C VIRUS RNA QUA LABR LABORATORY 300 87521 123.50 HIV I (HIV-1), QUANT, RNA LABR LABORATORY 300 87536 300.50 QUANTITATIVE, RNA PCR LABR LABORATORY 300 87536 315.50 HEP B VIRAL DNA BY PCR LABR LABORATORY 300 87517 243.00 HEP B VIRUS (HBV) QUANT, LABR LABORATORY 300 87517 151.50 HIV GENOSURE (R) MG LABR LABORATORY 300 87900 402.00 HEP B (HBV), QUANT, DNA REAL-TIME PCR LABR LABORATORY 300 87517 243.00 HIV GENOSURE MG LABR LABORATORY 300 87901 954.00 HIV, GENOTYPE PLUS LABR LABORATORY 300 87901 546.50 ALLERGEN, PEANUTS LABR LABORATORY 300 86003 19.00 ALLERGEN, EGG WHITE IGE LABR LABORATORY 300 86003 19.00 ALLERGEN, MILK LABR LABORATORY 300 86003 19.00 ALLERGEN, CAT DANDER LABR LABORATORY 300 86003 19.00 ALLERGEN, ALTERNARIA ALTERNATA LABR LABORATORY 300 86003 19.00 ALLERGEN, DOG DANDER LABR LABORATORY 300 86003 19.00 ALLERGEN, SOYBEAN LABR LABORATORY 300 86003 19.00 ALLERGEN, WHEAT IGE LABR LABORATORY 300 86003 19.00 ALLERGEN, CORN LABR LABORATORY 300 86003 19.00 ALLERGEN, CORN LABR LABORATORY 300 86003 19.00 ALLERGEN, CASHEW LABR LABORATORY 300 86003 19.00 ALLERGEN, CLADOSPORIUM HE LABR LABORATORY 300 86003 19.00 ALLERGEN, RAGWEED, SHORT LABR LABORATORY 300 86003 19.00 ALLERGEN, CODFISH LABR LABORATORY 300 86003 19.00 ALLERGEN, DERMATOPHAGOIDE LABR LABORATORY 300 86003 19.00 ALLERGEN, TOMATO LABR LABORATORY 300 86003 19.00 ALLERGEN, PECAN NUT LABR LABORATORY 300 86003 19.00 ALLERGEN, ASPERGILLUS FUMIGATUS LABR LABORATORY 300 86606 29.50 46 ALLERGEN, ORANGE LABR LABORATORY 300 86003 19.00 ALLERGEN, SHRIMP LABR LABORATORY 300 86003 19.00 ALLERGEN, DERMATOPHAGOIDES FARINAE LABR LABORATORY 300 86003 19.00 ALLERGEN, ELM, AMERICAN LABR LABORATORY 300 86003 19.00 ALLERGEN, BRAZIL NUT LABR LABORATORY 300 86003 19.00 ALLERGEN, SCALLOP LABR LABORATORY 300 86003 19.00 ALLERGEN, ALMOND LABR LABORATORY 300 86003 19.00 ALLERGEN, OAK, WHITE LABR LABORATORY 300 86003 19.00 ALLERGEN, HAZELNUT (FILBERT) LABR LABORATORY 300 86003 19.00 ALLERGEN, PIGWEED, ROUGH LABR LABORATORY 300 86003 19.00 ALLERGEN, SESAME IgE LABR LABORATORY 300 86003 19.00 ALLERGEN, PISTACHIO NUT LABR LABORATORY 300 86003 19.00 ALLERGEN, COCKROACH, GERM LABR LABORATORY 300 86003 19.00 ALLERGEN, MAPLE / BOX ELD LABR LABORATORY 300 86003 19.00 ALLERGEN, CEDAR, MOUNTAIN LABR LABORATORY 300 86003 19.00 ALLERGEN, CHOCOLATE / CACAO LABR LABORATORY 300 86003 19.00 ALLERGEN, CRAB LABR LABORATORY 300 86003 19.00 ALLERGEN, LOBSTER LABR LABORATORY 300 86003 19.00 ALLERGEN, PORK LABR LABORATORY 300 86003 19.00 ALLERGEN, POTATOE - WHITE LABR LABORATORY 300 86003 19.00 ALLERGEN, PENICILLIUM CHR LABR LABORATORY 300 86003 19.00 ALLERGEN, BARLEY LABR LABORATORY 300 86003 19.00 ALLERGEN, BETA-LACTOGLOBULIN LABR LABORATORY 300 86003 19.00 ALLERGEN, TIMOTHY GRASS LABR LABORATORY 300 86003 19.00 ALLERGEN, BEEF LABR LABORATORY 300 86003 19.00 ALLERGEN, TUNA LABR LABORATORY 300 86003 19.00 ALLERGEN, RICE LABR LABORATORY 300 86003 19.00 ALLERGEN, COCONUT LABR LABORATORY 300 86003 19.00 ALLERGEN, STRAWBERRY LABR LABORATORY 300 86003 19.00 ALLERGEN, OYSTER LABR LABORATORY 300 86003 19.00 ALLERGEN, THISTLE, RUSSIAN LABR LABORATORY 300 86003 19.00 ALLERGEN, GREEN PEA LABR LABORATORY 300 86003 19.00 ALLERGEN, COTTONWOOD LABR LABORATORY 300 86003 19.00 ALLERGEN, GARLIC LABR LABORATORY 300 86003 19.00 ALLERGEN, RYE LABR LABORATORY 300 86003 19.00 ALLERGEN, WHITE BEAN LABR LABORATORY 300 86003 19.00 ALLERGEN, CLAM LABR LABORATORY 300 86003 19.00 ALLERGEN, WALNUTS LABR LABORATORY 300 86003 19.00 ALLERGEN, MUGWORT LABR LABORATORY 300 86003 19.00 ALLERGEN, SHEEP SORREL LABR LABORATORY 300 86003 19.00 ALLERGEN, GREY ALDER LABR LABORATORY 300 86003 19.00 ALLERGEN, OAT LABR LABORATORY 300 86003 19.00 47 ALLERGEN, CASEIN LABR LABORATORY 300 86003 19.00 ALLERGEN, YEAST LABR LABORATORY 300 86003 19.00 ALLERGEN, MACADAMIA NUT LABR LABORATORY 300 86003 19.00 ALLERGEN, LATEX LABR LABORATORY 300 86003 19.00 ALLERGEN, MOUSE URINE LABR LABORATORY 300 86003 19.00 ALLERGEN, ALPHA-LACTALBUMIN LABR LABORATORY 300 86003 19.00 ALLERGEN, CHEDDAR CHEESE LABR LABORATORY 300 86003 19.00 ALLERGEN, BLUE (mold cheese) LABR LABORATORY 300 86003 19.00 ALLERGEN, MUSTARD LABR LABORATORY 300 86003 19.00 ALLERGEN, MANGO LABR LABORATORY 300 86003 19.00 ALLERGEN, BANANA LABR LABORATORY 300 86003 19.00 ALLERGEN, MUSHROOM LABR LABORATORY 300 86003 19.00 ALLERGEN, LETTUCE LABR LABORATORY 300 86003 19.00 ALLERGEN, PAPAYA LABR LABORATORY 300 86003 19.00 ALLERGEN, HONEYBEE LABR LABORATORY 300 86003 19.00 ALLERGEN, HORNET, WHITE FACE LABR LABORATORY 300 86003 19.00 ALLERGEN, YELLOW JACKET LABR LABORATORY 300 86003 19.00 ALLERGEN, PAPER WASP LABR LABORATORY 300 86003 19.00 ALLERGEN, HORNET, YELLOW LABR LABORATORY 300 86003 19.00 ALLERGEN, BUMBLEBEE LABR LABORATORY 300 86003 19.00 ASPERGILLUS NIGER LABR LABORATORY 300 86606 56.00 ALLERGEN, ASH, WHITE LABR LABORATORY 300 86003 19.00 ALLERGEN, COMMON SILVER B LABR LABORATORY 300 86003 19.00 ALLERGEN, NETTLE LABR LABORATORY 300 86003 19.00 ALLERGEN PRO, MILK, IgE W/COMPONENT REFL LABR LABORATORY 300 86003 19.00 SACCHAROMONAOSPORA VIRIDIS PRE AB, IGG LABR LABORATORY 300 86602 38.00 THERMOACTINOMYCES CANDIDUS PRE AB, IGG LABR LABORATORY 300 86602 38.00 ASPERGILLUS FLAVUS LABR LABORATORY 300 86606 53.00 PNEUMONTIS PANEL HYPER SE LABR LABORATORY 300 86331 613.00 AMINO ACIDS, QUANTITATIVE LABR LABORATORY 300 82139 524.00 METHADONE CONFIRMATION URINE LABR LABORATORY 300 80358 157.00 TACROLIMUS, WHOLE BLOOD LABR LABORATORY 300 80197 48.50 ITRACONAZOLE LABR LABORATORY 300 80299 196.00 VORICONAZOLE LABR LABORATORY 300 80299 56.00 THC, MS, WB/SP REFLEC (ME LABR LABORATORY 300 G0480 303.00 DRUGS OF ABUSE SCREEN 11 LABR LABORATORY 300 80307 95.50 DRUG SCREEN 7 WITH REFLEX, BLOOD LABR LABORATORY 300 80307 303.00 OXYCODONE/OXYMORPHONE SCREEN LABR LABORATORY 300 80307 303.00 PHENCYCLIDINE (PCP), SCREEN ONLY, URINE LABR LABORATORY 300 80307 215.50 CLOZAPINE LABR LABORATORY 300 80159 57.00 CLOMIPRAMINE & METABOLITE LABR LABORATORY 300 80299 61.50 CARNITINE, FREE & TOTAL LABR LABORATORY 300 82379 72.00 48 CYCLOSPORINE, WHOLE BLOOD LABR LABORATORY 300 80158 67.00 METHYLMALONIC ACID, SERUM LABR LABORATORY 300 83921 58.00 HOMOCYSTEINE, PLASMA LABR LABORATORY 300 83090 59.50 TOPIRAMATE (TOPAMAX) LABR LABORATORY 300 80201 85.00 RISPERIDONE AND METABOLITE LABR LABORATORY 300 80342 101.00 SIROLIMUS LABR LABORATORY 300 80195 147.50 MUMPS VIRUS AB, IgG LABR LABORATORY 300 86735 40.50 GABBPENTIN LABR LABORATORY 300 80355 76.50 SELENIUM,SERUM OR PLASMA LABR LABORATORY 300 84255 90.00 OXCABAZEPINE, SERUM OR PL LABR LABORATORY 300 80183 47.00 LEVETIRACETAM (KEPPRA) LEVEL LABR LABORATORY 300 80177 80.50 LAMICTAL/LAMOTRIGINE LABR LABORATORY 300 80175 108.00 LEAD, BLOOD (PEDIATRIC), LABR LABORATORY 300 83655 43.00 METHYLENEIIOXYAMPHETAMI (MDMA) LABR LABORATORY 300 80359 205.50 ANTI-DEPRESSANT SCREEN, URINE LABR LABORATORY 300 80307 215.50 ETHYL GLUCURONIDE - ETHYL SULFATE LABR LABORATORY 300 80307 205.50 ETHYL GLUCURONIDE LC/MS/MS LABR LABORATORY 300 80307 206.00 OPIATE CONFIRMATION (4 Drug) LABR LABORATORY 300 80361 205.50 DRUGS OF ABUSE, UR (9 Drugs) (MS Conf) LABR LABORATORY 300 80307 205.50 ACETYL FENTANYL, URINE CONFIRMATION LABR LABORATORY 300 80354 205.50 GHB GAMMA HYDROXYBUTYRIC ACID, SCREEN A LABR LABORATORY 300 80307 215.50 UA BUPRENORPHINE SCREEN LABR LABORATORY 300 80307 180.00 OXYCODONE, QUANT, URINE LABR LABORATORY 300 83945 138.00 BENZODIAZEPINES CONFIRM URINE LABR LABORATORY 300 80348 205.50 DRUG CONFIRMATION LABR LABORATORY 300 80307 205.50 CLOBZAM SERUM/PLASMA LABR LABORATORY 300 80339 206.00 KETAMINE, NORKETAMINE QUA LABR LABORATORY 300 80357 303.00 FENTANYL URINE QUANTITATIVE LABR LABORATORY 300 80354 205.50 MECONIUM DRUG SCRN IV LABR LABORATORY 300 80307 237.00 Drug Screen, (10 Drug Classes), BLOOD LABR LABORATORY 300 80307 205.50 Drug Screen, (8 Drug Classes), Blood LABR LABORATORY 300 80307 205.50 TITANIUM, SERUM OR PLASMA LABR LABORATORY 300 83018 39.50 DRUGS OF ABUSE PANEL 9 LABR LABORATORY 300 80307 277.00 MAGNESIUM (Mg) RBC LABR LABORATORY 301 83735 95.00 HYDROCODONE AND METABOLIT LABR LABORATORY 300 80361 205.50 IBD GENE ANALYSIS LABR LABORATORY 300 81479 59.00 IMMUNOASSAY, EA ANTIBODY LABR LABORATORY 300 83520 52.00 RETICULIN ANTIBODIES LABR LABORATORY 300 86255 42.50 DNASE SENSATIVE ANTIBODY LABR LABORATORY 310 88350 117.00 ICAN, VCAM, SSA LABR LABORATORY 300 82397 44.00 ALPHA GAL IGE LABR LABORATORY 300 86003 19.00 17-KETOSTEROIDS, URINE LABR LABORATORY 300 83586 79.50 49 MORPHINE , TOTAL URINE LABR LABORATORY 300 80361 257.50 NAPROXEN LABR LABORATORY 300 80329 180.00 QUETIAPINE LABR LABORATORY 300 80342 171.00 ROHYPNOL-FLUNITRAZPAM SERUM OR PLASMA LABR LABORATORY 300 80346 303.00 AMPHETAMINES SERUM/PLASMA LABR LABORATORY 300 80324 286.00 ARSENIC SERUM/PLASMA LABR LABORATORY 300 82175 67.00 ETHYLENE GLYCOL, QUANTITATIVE LABR LABORATORY 300 82693 158.50 SCHISTOSOMA IGG ABS LABR LABORATORY 300 86682 128.50 OLANZAPINE LABR LABORATORY 300 80342 240.50 CLONAZEPAM, URINE LABR LABORATORY 300 80346 205.50 PNEUMOCOCCAL AB TYPE 9N LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 12F LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 14 LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 17F LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 19F LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 2 LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 20 LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 22F LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 23F LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 26 6B LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 34 10A LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 43 11A LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 5 LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 54 15B LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 57 19A LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 66 9V LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 70 33F LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 1 LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 4 LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 8 LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 51 7F LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 56 18C LABR LABORATORY 300 86317 46.00 PNEUMOCOCCAL AB TYPE 3 LABR LABORATORY 300 86317 46.00 SOMATOSTATIN LABR LABORATORY 300 84307 119.00 URINE N-METHYLHISTAMINE LABR LABORATORY 300 82542 60.00 SULFONYLUREA ANALYSIS SERUM OR PLASMA LABR LABORATORY 300 80375 388.00 LISTERIA ANTIBODY-SERUM BY CF LABR LABORATORY 300 86723 57.50 TREPONEMA AB IGM LABR LABORATORY 300 86780 46.50 TREPONEMA AB IGG LABR LABORATORY 300 86780 46.50 CHIKUNGUNYA VIRUS RNA QUAL PCR, SERUM LABR LABORATORY 300 87798 350.00 ALPHA-1-ANTITRYPSIN PHENOTYPING LABR LABORATORY 300 82104 50.00 CHIKUNGUNYA VIRUS IGG ANTIBODY LABR LABORATORY 300 86790 45.50 50 CHIKUNGUNYA VIRUS IGM ANTIBODY LABR LABORATORY 300 86790 45.50 DENGUE VIRUS ANTIBODIES LABR LABORATORY 300 86790 59.50 BILIRUBIN, TOTAL BODY FLUID LABR LABORATORY 300 82247 36.50 BETA 2 TRANSFERRIN, BODY FLUID LABR LABORATORY 300 86335 109.00 VIRUS ABS NOS, IGG LABR LABORATORY 300 86790 45.50 VIRUS ABS NOS, IGM LABR LABORATORY 300 86790 45.50 RABIES ANTIBODY TITER LABR LABORATORY 300 86790 79.50 MERCURY QUANT LABR LABORATORY 300 83825 57.50 B. BURGDORFERI, TICK TESTING LABR LABORATORY 300 86617 57.50 DNA ABS NATIVE OR DBL S LABR LABORATORY 300 86225 48.50 URTICARIA CHRONIC INDEX LABR LABORATORY 300 86352 629.50 LEUKOCYTE HISTAMINE RELEA LABR LABORATORY 300 86343 134.00 ADRENOCORTICOTROPIC HORMONE LABR LABORATORY 300 82024 190.50 BODY FLUID ALBUMIN LABR LABORATORY 300 82040 36.50 AMYLASE BODY FLUID LABR LABORATORY 301 82150 61.50 GASTROCCULT LABR LABORATORY 300 82271 25.50 BODY FLUID CEA LABR LABORATORY 300 82378 67.00 URINE CHLORIDE LABR LABORATORY 300 82436 34.50 CORTISOL LABR LABORATORY 300 82533 94.00 CHYLOMICRON SCREEN LABR LABORATORY 300 82664 65.50 GLUCOSE, BODY FLUID LABR LABORATORY 300 82945 29.50 LD LABR LABORATORY 306 83615 61.50 LIPASE LABR LABORATORY 301 83690 82.50 PH, BODY FLUID LABR LABORATORY 300 83986 64.50 URINE POTASSIUM LABR LABORATORY 300 84133 50.50 PROTEIN, BODY FLUID LABR LABORATORY 300 84157 61.50 SLIDE REVIEW, PATHOLOGIST LABR LABORATORY 300 85007 46.00 PROTIME & PTT LABR LABORATORY 305 85730 53.50 HEP C ANTIBODY LABR LABORATORY 300 86803 53.00 ANTIBODY SCREEN LABR LABORATORY 300 86850 82.50 ANTIBODY IDENTIFICATION LABR LABORATORY 300 86870 120.00 TYPING ABO LABR LABORATORY 300 86900 36.50 TYPING RH LABR LABORATORY 300 86901 36.50 RBC ANTIGEN TYPING LABR LABORATORY 300 86905 104.50 CONC. INFECT AGENT ANY LABR LABORATORY 300 87015 54.00 CULTURE BODY FLUID LABR LABORATORY 300 87070 32.00 ANAEROBIC CULTURE BILL LABR LABORATORY 300 87075 29.00 AEROBIC ID 1 BILL ONLY LABR LABORATORY 300 87077 30.00 FUNGUS CULTURE LABR LABORATORY 300 87101 49.50 FUNGUS CULTURE LABR LABORATORY 300 87102 92.00 YEAST ID LABR LABORATORY 300 87106 120.00 FUNGUS ID MOLD LABR LABORATORY 300 87107 107.00 51 ACID FAST SMEAR CULTURE LABR LABORATORY 300 87116 144.00 SMEAR DIRECT MICRO LABR LABORATORY 300 87205 31.50 ACID FAST SMEAR LABR LABORATORY 300 87206 19.00 LEGIONELLA PNEUMOPHILA DF LABR LABORATORY 300 87278 127.50 VAGINITIS BY DNA PROBE LABR LABORATORY 300 87480 72.50 VAGINITIS BY DNA PROBE LABR LABORATORY 300 87510 72.50 RESPIRATORY VIRUS PANEL LABR LABORATORY 300 87633 647.50 VAGINITIS BY DNA PROBE LABR LABORATORY 300 87660 72.50 CYTOLOGY BODY FLUIDS LABR LABORATORY 300 88160 165.00 PNEUMOCTSTIS/FUNGUS GMS LABR LABORATORY 300 88312 84.00 CELL COUNT / DIFF, BODY FLUID LABR LABORATORY 300 89050 53.50 CELL COUNT, BODY FLUID LABR LABORATORY 300 89051 22.50 CRYSTAL ID LABR LABORATORY 300 89060 26.50 TYPE ABO NO SCREEN ORDERED LABR LABORATORY 300 86900 36.50 TYPE RH NO SCREEN ORDERED LABR LABORATORY 300 86901 36.50 CONC. INFECT AGENT ANY LABR LABORATORY 300 87015 54.00 RESPIRATORY CULTURE LABR LABORATORY 300 87070 32.00 RESPIRATORY SMEAR LABR LABORATORY 300 87205 16.00 LABOR/DELIV/RECOV/ LD LABOR AND DELIVERY 722 2,205.00 DELIVERY OF PLACENTA LD LABOR AND DELIVERY 724 59414 6,818.50 EXTERNAL CEPHALIC VERSION LD LABOR AND DELIVERY 761 59412 7,263.50 FETAL MONITOR EXTERNAL 1-6 HRS LD LABOR AND DELIVERY 270 90.50 FETAL MONITOR EXTERNAL 24 HRS LD LABOR AND DELIVERY 270 163.50 INJ ANESTH AGNT PUDENTAL LD LABOR AND DELIVERY 761 64430 2,148.50 NON-STRESS TEST LD LABOR AND DELIVERY 721 59025 482.50 OB CHECK EACH ADDITIONAL HR LD LABOR AND DELIVERY 724 S4005 50.00 OB CHECK FIRST HOUR LD LABOR AND DELIVERY 761 S4005 312.00 MAMMO DX UNILATERAL CAD MAMM IMAGING 401 77065 328.50 MAMMO DX BILATERAL CAD MAMM IMAGING 401 77066 508.00 MAMMO SCREEN BILATERAL CAD MAMM IMAGING 403 77067 409.50 MAMMOGRAPHY SPECIMEN EACH (1 VIEW) MAMM IMAGING 320 76098 684.50 MAMMO LOCALIZATION BREAST LOC FIRST MAMM IMAGING 401 19281 542.00 MAMMO LOCALIZATION BREAST LOC EA ADDITIO MAMM IMAGING 401 19282 154.50 MRI FACE/NECK/ORBITS W/O CONTRAST MRI IMAGING 610 70540 1,896.50 MRI FACE/NECK/ORBITS W & W/O CONTRAST MRI IMAGING 610 70543 2,787.00 MRA HEAD W/O CONTRAST MRI IMAGING 610 70544 1,817.00 MRI BRAIN W/O CONTRAST MRI IMAGING 610 70551 1,869.50 MRI BRAIN WITH CONTRAST MRI IMAGING 610 70552 2,243.50 MRI BRAIN W/O & W CONTRAST MRI IMAGING 610 70553 3,977.00 MRI CHEST W/O CONTRAST MRI IMAGING 610 71550 1,781.00 MRI CHEST WO/W CONTRAST MRI IMAGING 610 71552 1,256.50 MRI C-SPINE W / O CONTRAST MRI IMAGING 610 72141 1,896.50 52 MRI T-SPINE W / O CONTRAST MRI IMAGING 610 72146 2,065.00 MRI L-SPINE W / O CONTRAST MRI IMAGING 610 72148 2,043.50 MRI L-SPINE W/ CONTRAST MRI IMAGING 610 72149 2,970.50 MRI C-SPINE W / WO COMBO MRI IMAGING 610 72156 2,785.50 MRI T-SPINE W/W/O COMBO MRI IMAGING 610 72157 3,977.00 MRI L-SPINE W / W/O COMBO MRI IMAGING 610 72158 3,977.00 MRI PELVIS W/O CONTRAST MRI IMAGING 610 72195 601.50 MRI PELVIS W/CONTRAST MRI IMAGING 610 72196 1,256.50 MRI PELVIS WO/W CONTRAST MRI IMAGING 610 72197 1,256.50 MRI UPPER EXTR W/O CONTRAST MRI IMAGING 610 73218 1,315.50 MRI UPPER EXTR W/CONTRAST MRI IMAGING 610 73219 1,581.00 MRI UPP EXTR WO/W CONTRAST MRI IMAGING 610 73220 1,969.50 MRI UPPER JOINT W/O CONTRAST MRI IMAGING 610 73221 1,581.00 MRI UPPER JOINT W/CONTRAST MRI IMAGING 610 73222 1,817.00 MRI UPP JOINT WO/W CONTRAST MRI IMAGING 610 73223 1,969.50 MRI LOW EXTR W/O CONTRAST MRI IMAGING 610 73718 742.00 MRI LOW EXTR WITH CONTRAST MRI IMAGING 610 73719 1,501.00 MRI LOWER EXTREMITY WO/W CONTRAST MRI IMAGING 610 73720 1,969.50 MRI LOW JOINT W/O CONTRAST MRI IMAGING 610 73721 1,095.00 MRI LOW JOINT W/CONTRAST MRI IMAGING 610 73722 1,280.00 MRI LOW JOINT WO/W CONTRAST MRI IMAGING 610 73723 1,969.50 MRI ABDOMEN W/O CONTRAST MRI IMAGING 610 74181 2,043.50 MRI ABDOMEN W/CONTRAST MRI IMAGING 610 74182 1,256.50 MRI ABDOMEN W/O & W CONTRAST MRI IMAGING 320 74183 3,955.50 MRA CAROTID / NECK W/WO CONTRAST MRI IMAGING 610 70549 2,197.00 MRA CAROTID/NECK W/CONTRAST MRI IMAGING 610 70548 1,644.50 MRA CAROTID / NECK WO CONTRAST MRI IMAGING 610 70547 1,644.50 MRA/V HEAD WITH CONTRAST MRI IMAGING 610 70545 1,817.00 MRA/V HEAD W/WO CONTRAST MRI IMAGING 610 70546 2,192.00 MRA/V HEAD WITHOUT CONTRAST MRI IMAGING 610 70544 1,817.00 MRA PELVIS W OR W/O CONTRAST MRI IMAGING 610 72198 1,256.50 MRI TEMPOROMANDIBULAR JOINT MRI IMAGING 610 70336 1,113.50 MRI CERVICAL SPINE WITH CONTRAST MRI IMAGING 610 72142 2,270.50 MRI THORACIC SPINE WITH CONTRAST MRI IMAGING 610 72147 2,970.50 MRI FACE/NECK/ORBITS WITH CONTRAST MRI IMAGING 610 70542 2,270.50 MRI BRACHIAL PLEXUS W/WO CONTRAST MRI IMAGING 610 71552 1,256.50 MRI SACRAL PLEXUS WO CONTRAST MRI IMAGING 610 72195 601.50 MRA ABDOMEN W OR WO CONTRAST MRI IMAGING 610 74185 927.00 MRA UPPER EXTREMITY W OR WO MRI IMAGING 610 73225 952.00 MRI BREAT BILATERAL W OR WO MRI IMAGING 610 77059 1,352.00 MRI BREAST UNILATERAL W OR WO MRI IMAGING 610 77058 1,359.00 MRI BREAST BIOPSY UNILATERAL MRI IMAGING 610 19085 4,308.00 53 MRI CHEST WITH CONTRAST MRI IMAGING 610 71551 2,179.00 MRI CARDIAC WITHOUT CONTRAST MRI IMAGING 610 75557 742.00 MRI CARDIAC W/WO CONTRAST MRI IMAGING 610 75561 1,458.00 NM THYR IMAG W/UPTKE MULT NM IMAGING 340 78014 1,117.00 NM PARATHYROID IMAG NM IMAGING 340 78070 1,117.00 NM LYMPH NODE IMAGING NM IMAGING 340 78195 1,448.00 NM HEPATOBILIARY NM IMAGING 340 78226 1,117.00 NM HEPATOBILIARY W/EF NM IMAGING 340 78227 1,448.00 NM GASTRIC EMPTYING STUDY NM IMAGING 340 78264 1,117.00 NM BONE/JT IMAG MULT NM IMAGING 340 78305 1,117.00 NM BONE/JT IMAG WB NM IMAGING 340 78306 1,117.00 NM BONE/ JT IMAG 3 PHASE NM IMAGING 340 78315 1,117.00 NM BONE/ JT IMAG SPECT NM IMAGING 340 78320 1,448.00 NM PERF SPECT SNGL R OR S NM IMAGING 340 78451 3,844.00 NM PERF MULT R OR S NM IMAGING 340 78452 3,844.00 NM PULM PERF VENT AEROSOL NM IMAGING 340 78582 1,390.50 NM TC99 SESTAMIBI NM IMAGING 343 A9500 203.00 NM TC99 MYOVIEW NM IMAGING 343 A9502 203.00 NM TC99 MEDRONATE/ DOSE NM IMAGING 343 A9503 46.00 NM 1123 NA IODIDE/100 UCI NM IMAGING 343 A9516 188.00 NM TC99 MEBROFEN/ TO15MCI NM IMAGING 343 A9537 180.00 NM TC99 MAAG/TO 10 MCI NM IMAGING 343 A9540 66.00 NM SULF COLLOID/TO 20MCI NM IMAGING 343 A9541 324.00 NM TC99 SULF COLL/TO20MCI NM IMAGING 343 A9541 864.00 NM TC99PENTETATE/TO 75MCI NM IMAGING 343 A9567 125.50 NM MUGA NM IMAGING 340 78472 1,266.00 NM GI BLEED IMAGING NM IMAGING 340 78278 1,040.50 NM LUNG VENTILATION AND PERFUSION NM IMAGING 340 78582 1,448.00 NM THYROID SCAN ONLY NM IMAGING 340 78013 578.00 NM SENTINAL NODE INJECTION NM IMAGING 340 38792 1,117.00 NM LIVER/SPLEEN NM IMAGING 340 78215 1,117.00 NM MECKLES NM IMAGING 340 78290 1,117.00 NM TC99 LBLD RBC NM IMAGING 343 A9560 222.00 NM TC99 PERTECHNETA/ MCI NM IMAGING 343 A9512 44.50 NURSERY NSRY NURSERY 170 864.00 NURSERY W/O MOTHER NSRY NURSERY 170 1,111.00 NURSERY W/ISOLATION NSRY NURSERY 170 1,357.50 AUDIOGICAL EXAM NSRY NURSERY 471 92559 86.00 PRIVATE ROOM NUR NURSING 110 1,695.00 IV INFUSION HYDRATION 1ST HR NUR NURSING 260 96360 310.00 IV INFUSION HYDRATION EA ADDL HR NUR NURSING 260 96361 157.00 IV INFUSION THER/PROPH 1ST HR NUR NURSING 260 96365 611.00 54 IV INFUSION THER/PROPH EA ADDL HR NUR NURSING 260 96366 111.50 IV INFN THER/PROPH ADDL SEQ 1ST HR NUR NURSING 260 96367 148.50 IV NFS THERAPY PROPH CONCUR NUR NURSING 260 96368 138.00 THERAPEUTIC PROPH INJ SUBQ/IM NUR NURSING 260 96372 31.50 THER PROPH IV PUSH SINGLE/1ST SBST NUR NURSING 260 96374 81.00 THERAPEUTIC INJ IV PUSH EA NEW DRUG NUR NURSING 260 96375 34.50 THER PROPH EA SEQL IV PUSH SBST/DRUG NUR NURSING 260 96376 81.00 BLADDER SCAN NUR NURSING 761 51798 148.50 AVULSION NAIL PLATE PAR/COMP SIMPLE 1 NUR NURSING 761 11730 540.00 CARDIOVERSION NUR NURSING 761 92960 1,638.50 BLOOD TRANSFUSION NUR NURSING 391 36430 1,199.00 ASP ABSCESS, HEMATOMA, CYST NUR NURSING 761 10160 993.50 ATHROCENTESIS, MAJOR JOINT/BU NUR NURSING 761 20610 782.50 ENDOTRACHAEL INTUBATION EMERGENCY NUR NURSING 761 31500 570.50 TUBE THORACOSTOMY NUR NURSING 761 32551 3,141.50 INSERT NON-TNLD CVAD 5+YR NUR NURSING 761 36556 1,819.00 PICC / MIDLINE INSERT >5 YEARS NUR NURSING 761 36569 3,141.50 DX LUMBAR PUNCTURE NUR NURSING 761 62270 1,737.00 INJECT EPIDURAL BLOOD PATCH NUR NURSING 761 62273 1,737.00 ARTHRO/INJ MAJ JNT W/US GUIDE NUR NURSING 761 20611 651.00 INSTILLATION VIA CHEST TUBE NUR NURSING 761 32562 1,631.00 BRONCHOSCOPY W/WASH OR BRUSH COLLECTION NUR NURSING 761 31623 3,525.00 VACCINE ADMINSTRATION PER VACCINE NUR NURSING 771 90471 25.50 FLU CLINIC (18 & OVER) VACCINE ADMIN NUR NURSING 771 90471 13.00 FLU CLINIC (UNDER 18) VACCINE ADMIN NUR NURSING 771 90460 13.00 RHOGAM ADMINIS FULL DOSE NUR NURSING 771 90384 20.50 INSERT FOLEY CATH NUR NURSING 761 51702 336.00 BX BONE, DEEP TROCAR/NEEDLE NUR NURSING 761 20225 3,590.00 OB ROOM OB OBSTETRICS 112 1,469.50 LACTATION CONSULTATION OB OBSTETRICS 942 S9443 274.50 OB THER PROPH IV PUSH SINGLE/1ST SBST OB OBSTETRICS 724 96374 81.00 OB THERAPEUTIC PROPH INJ SUBQ/IM OB OBSTETRICS 260 96372 31.50 OB CHECK IV INFUSION HYDRATION 1ST HR OB OBSTETRICS 724 96360 310.00 OB CHK IV INFUSION HYDRATN EA ADDL HR OB OBSTETRICS 724 96361 157.00 OB CHK IV INFUSION THER/PROPH 1ST HR OB OBSTETRICS 724 96365 611.00 OB CHK IV INFUSION THER/PROPH EA ADDL HR OB OBSTETRICS 724 96366 111.50 OB IV INFUSION THER/PROPH 1ST HR OB OBSTETRICS 724 96365 611.00 OBSERVATION RM RATE 1ST HR OBS NURSING 762 G0378 320.50 OBSERVATION RM RATE EACH ADDL HR OBS NURSING 762 G0378 49.50 OBSERVATION DIRECT ADMIT OBS NURSING 762 G0379 198.50 OT LOW COMPLEXITY OT OCCUPATIONAL THERAPY 434 97165 213.00 OT MODERATE COMPLEXITY OT OCCUPATIONAL THERAPY 434 97166 213.00 55 OT HIGH COMPLEXITY OT OCCUPATIONAL THERAPY 434 97167 213.00 OT RE-EVALUATION OT OCCUPATIONAL THERAPY 434 97168 144.50 OT THERAPY ACTIVITY EACH 15 MIN OT OCCUPATIONAL THERAPY 430 97535 101.50 OT NEUROMUSCULAR REEDUCATION OT OCCUPATIONAL THERAPY 430 97112 72.00 OT THERAPEUTIC EXERCISE OT OCCUPATIONAL THERAPY 430 97110 131.50 OT SELF CARE EACH 15 MIN. OT OCCUPATIONAL THERAPY 430 97535 101.50 OT COGNITIVE RETRAINING EACH 15 MIN. OT OCCUPATIONAL THERAPY 430 G0515 86.00 ECHO DEFINITY 1ML (PERFLUTREN) PHAR PHARMACY 255 J3490 390.68 MRI MAGNEVIST DYE 20ML PHAR PHARMACY 250 153.15 GASTROVIEW 30ML PHAR PHARMACY 255 69.54 1/2 NS 1000ML INJ SOLN PHAR PHARMACY 250 68.28 1/2NS 500ML INJ SOLN PHAR PHARMACY 250 68.08 A&D OINTMENT - 30GM TOP PHAR PHARMACY 250 5.73 ABILIFY 10MG TAB PHAR PHARMACY 250 17.62 ABILIFY 2MG TAB PHAR PHARMACY 250 22.02 ABILIFY 5 MG TAB PHAR PHARMACY 250 15.33 ACCOLATE 20 MG TAB PHAR PHARMACY 250 6.45 ACCU-CHEK PHAR PHARMACY 300 82948 19.00 ACCUPRIL 20 MG TAB PHAR PHARMACY 250 5.97 ACETADOTE 200MG/ML 30ML V PHAR PHARMACY 636 J0132 259.85 ACETYLCYCTEINE 200MG/ML 4 PHAR PHARMACY 250 23.85 ACETYLCYSTEINE PHAR PHARMACY 250 4.77 ACETYLCYSTENIE 200mg/mlIV PHAR PHARMACY 250 185.46 ACTIDOSE 50 GM PHAR PHARMACY 250 23.30 ACTIDOSE-AQUA 50 GM PHAR PHARMACY 250 27.50 ACTIVASE 50 MG IV PHAR PHARMACY 636 J2997 1,567.30 ACTOS 45 MG TAB PHAR PHARMACY 250 11.33 ACTOS 15 MG TAB PHAR PHARMACY 250 8.75 ADACEL VACCINE PHAR PHARMACY 250 90715 58.84 ADENOCARD 6MG/2ML IVP PHAR PHARMACY 636 J0153 25.08 ADVAIR 100/50 INHALER PHAR PHARMACY 250 17.09 ADVAIR 250/50 - 28 DOSE PHAR PHARMACY 250 17.09 AEROCHAMBER W/O MASK PHAR PHARMACY 250 15.75 AEROCHAMBER W/SMALL MASK PHAR PHARMACY 250 36.00 AEROCHAMBER W/MED MASK PHAR PHARMACY 250 41.70 AFRIN 15ml PHAR PHARMACY 250 14.31 AGGRENOX 200/25 CAP PHAR PHARMACY 250 7.23 AKWA TEARS OPHTH OINT PHAR PHARMACY 250 6.74 ALBUMIN 12.5 - 25% 50 ML PHAR PHARMACY 636 P9047 142.63 ALBUMIN 25% 100ML IV PHAR PHARMACY 250 P9047 205.91 ALCAINE OPTH SOL 0.5% PHAR PHARMACY 250 6.86 ALDACTONE 50 MG TAB PHAR PHARMACY 250 5.53 56 ALDACTONE 100 MG PHAR PHARMACY 250 5.53 ALDACTONE 25 MG TAB PHAR PHARMACY 250 5.18 ALEVE 220MG PHAR PHARMACY 250 4.56 ALLEGRA 180 MG TAB PHAR PHARMACY 250 7.33 ALTACE 5 MG CAP PHAR PHARMACY 250 6.52 ALUPENT 0.6% NEBS PHAR PHARMACY 250 5.68 AMARYL 2 MG TAB PHAR PHARMACY 250 5.06 AMARYL 4 MG TAB PHAR PHARMACY 250 5.06 AMARYL 1 MG TAB PHAR PHARMACY 250 5.32 AMBIEN 10 MG TAB PHAR PHARMACY 250 8.55 AMBIEN 5 MG TAB PHAR PHARMACY 250 9.71 AMIDATE 20MG/ML PHAR PHARMACY 250 26.28 AMIODARONE PREMIX 150MG/1 PHAR PHARMACY 250 102.93 AMMONIA INHALANT PHAR PHARMACY 250 3.72 AMMONIUM LACTATE CRM 12% PHAR PHARMACY 250 21.95 AMOXIL 125MG/5ML 150 ML E PHAR PHARMACY 250 39.50 AMOXIL 250 MG CHEW PHAR PHARMACY 250 5.04 AMOXIL 250MG/5ML 150ML PHAR PHARMACY 250 5.01 AMOXIL 250MG/5ML 150 ML E PHAR PHARMACY 250 29.50 AMOXIL 500 MG CAP PHAR PHARMACY 250 5.06 AMPICILLIN 1 GM IVPB PHAR PHARMACY 250 71.75 AMPICILLIN 2 GM IVPB PHAR PHARMACY 250 74.48 AMPICILLIN 500 MG - IVPB PHAR PHARMACY 250 69.30 ANCEF 1 GM VIAL - IM PHAR PHARMACY 250 J0690 22.82 ANCEF 1 GM VIAL - IVPB PHAR PHARMACY 250 J0690 73.14 ANCEF 500 MG IVPB PHAR PHARMACY 250 J0690 73.26 ANECTINE 200 MG/10ML - IV PHAR PHARMACY 250 J0330 18.41 ANTIVERT 12.5 MG TAB PHAR PHARMACY 250 5.24 ANTIVERT 25 MG TAB PHAR PHARMACY 250 5.01 ANUSOL-HC 25 MG SUPP PHAR PHARMACY 250 5.03 APRESOLINE 50 MG TAB PHAR PHARMACY 250 5.25 APRESOLINE 10 MG TAB PHAR PHARMACY 250 5.14 APRESOLINE 20MG/ML - IM/I PHAR PHARMACY 636 J0360 21.74 APRESOLINE 25 MG TAB PHAR PHARMACY 250 5.18 AQUAPHOR OINT - 1.75OZ PHAR PHARMACY 250 5.00 ARANESP 100MCG/0.5ML PFS PHAR PHARMACY 636 J0881 424.34 ARANESP 25mcg/0.4ml PFS PHAR PHARMACY 250 119.53 ARICEPT 5 MG TAB PHAR PHARMACY 250 10.43 ARICEPT 10MG TAB UD PHAR PHARMACY 250 5.29 ARIMIDEX 1 MG TAB PHAR PHARMACY 250 13.65 ARIXTRA 2.5MG PFS PHAR PHARMACY 250 35.12 ARMOUR THYROID 30 MG PHAR PHARMACY 250 5.17 57 ARTANE 2 MG TAB PHAR PHARMACY 250 5.00 ASACOL 400 MG TAB PHAR PHARMACY 250 6.16 ASPIRIN 300 MG SUPP PHAR PHARMACY 250 5.24 ASPIRIN 325 MG TAB PHAR PHARMACY 250 4.99 ASPIRIN 325MG EC TAB PHAR PHARMACY 250 5.00 ASPIRIN 81 MG - CHEWABLE PHAR PHARMACY 250 5.00 ASPIRIN 81MG EC TAB PHAR PHARMACY 250 5.12 ASTRAMORPH 10MG/10ML - IV PHAR PHARMACY 636 J2274 22.01 ATARAX 25 MG TAB PHAR PHARMACY 250 5.32 ATARAX 10 MG TAB PHAR PHARMACY 250 5.18 ATARAX 50 MG TAB PHAR PHARMACY 250 5.40 ATIVAN 0.5 MG TAB PHAR PHARMACY 250 5.18 ATIVAN 1 MG TAB PHAR PHARMACY 250 5.24 ATIVAN 1 MG #4 ER PHAR PHARMACY 250 13.87 ATIVAN 2MG/ML INJ. PHAR PHARMACY 250 J2060 17.20 ATIVAN DRIP 20mg/100ml PHAR PHARMACY 250 J2060 91.94 ATROPINE 1% SOLN OPH PHAR PHARMACY 250 5.45 ATROPINE 0.4MG/ML PHAR PHARMACY 250 J0461 17.42 ATROPINE 1MG/10ML ABBOJEC PHAR PHARMACY 250 J0461 18.29 ATROPINE 1MG/ML - IV PHAR PHARMACY 250 J0461 17.42 ATROVENT 0.02% NEB PHAR PHARMACY 250 5.12 AUGMENTIN 250MG/5ML 75 ML PHAR PHARMACY 250 77.28 AUGMENTIN 500 MG TAB PHAR PHARMACY 250 10.17 AUGMENTIN 875 MG TAB PHAR PHARMACY 250 6.13 AVAPRO 150 MG TAB PHAR PHARMACY 250 6.77 AVODART 0.5 MG CAP PHAR PHARMACY 250 8.25 AYR NASAL GEL PHAR PHARMACY 250 18.89 AZACTAM 1 GM IVPB PHAR PHARMACY 250 91.80 AZACTAM 2 GM VIAL PHAR PHARMACY 250 109.77 AZOPT 1% OPHTH PHAR PHARMACY 250 6.20 AZULFIDINE 500 MG TAB PHAR PHARMACY 250 5.11 BACID CAP PHAR PHARMACY 250 5.11 BACITRACIN PLAIN ONT 15 G PHAR PHARMACY 250 14.68 BACITRACIN ZINC OINT - 15 PHAR PHARMACY 250 5.17 BACITRACIN ZINC OINT - UD PHAR PHARMACY 250 5.12 BACTERIOSTATIC SODIUM CHL PHAR PHARMACY 250 16.89 BACTROBAN OINT 2% - 22GM PHAR PHARMACY 250 6.74 BAYHEP B VACCINE IM PHAR PHARMACY 636 90371 157.06 BENADRYL 25 MG CAP PHAR PHARMACY 250 5.00 BENADRYL 12.5MG/5ML PHAR PHARMACY 250 5.44 BENADRYL 25 MG #4 PHAR PHARMACY 250 5.13 BENADRYL 50 MG CAP PHAR PHARMACY 250 4.99 58 BENADRYL INJ 50MG/ML PHAR PHARMACY 250 J1200 17.19 BENEPROTEIN (INSTANT POWD PHAR PHARMACY 250 5.43 BENICAR 20 MG TAB PHAR PHARMACY 250 6.44 BENTYL 10MG CAP PHAR PHARMACY 250 5.04 BENTYL 20 MG PHAR PHARMACY 250 5.54 BENTYL INJ 10MG/ML PHAR PHARMACY 250 J0500 38.48 BETAPACE 120 MG TAB PHAR PHARMACY 250 5.29 BETAPACE 40 MG TABLET PHAR PHARMACY 250 6.22 BETAPACE 80 MG TAB PHAR PHARMACY 250 5.07 BETOPTIC-S 0.25% OPTH PHAR PHARMACY 250 8.20 BIAXIN 250 MG TAB PHAR PHARMACY 250 9.25 BICILLIN L-A 1.2MU PHAR PHARMACY 250 J0561 112.19 BICITRA SOL. 15 ML PHAR PHARMACY 250 5.26 BONIVA 1 mg/ 1ml PHAR PHARMACY 636 J1740 513.50 BONIVA 3MG/3ML PFS PHAR PHARMACY 636 J1740 503.76 BOOST PHAR PHARMACY 250 5.12 BRETHINE 1MG/ML - SQ PHAR PHARMACY 250 J3105 37.38 BREVIBLOC 100MG/ML IVPB PHAR PHARMACY 250 79.41 BREVIBLOC 250MG/ML IVPB PHAR PHARMACY 250 187.98 BUMEX 1MG/4ML INJ PHAR PHARMACY 250 17.56 BUMEX 1 MG TAB PHAR PHARMACY 250 6.63 BUMEX 1MG/4ML IV PHAR PHARMACY 250 17.56 BUSPAR 10 MG TAB PHAR PHARMACY 250 5.01 BUSPAR 15 MG TAB PHAR PHARMACY 250 5.70 BUSPAR 5 MG TAB PHAR PHARMACY 250 5.29 BYSTOLIC 10MG TABLET PHAR PHARMACY 250 6.23 CALCITROL 0.25mcg PHAR PHARMACY 250 5.08 CALCIUM 500 MG PHAR PHARMACY 250 5.00 CALCIUM CARBONATE 6OOMG W PHAR PHARMACY 250 4.96 CALCIUM CHLORIDE 1GM/10M PHAR PHARMACY 250 17.37 CALCIUM CHLORIDE 10% ABBO PHAR PHARMACY 250 18.47 CALCIUM GLUCONATE 1GM/10M PHAR PHARMACY 250 J0610 17.77 CALMOSEPTINE OINT 4 OZ PHAR PHARMACY 250 4.99 CANCIDAS 50MG PHAR PHARMACY 250 204.01 CARAFATE 1 GM TAB PHAR PHARMACY 250 6.40 CARAFATE 1GM/10ML SUSP. PHAR PHARMACY 250 6.17 CARDIZEM 125 MG/25 ML IVP PHAR PHARMACY 250 71.29 CARDIZEM 25MG/5ML - IVP PHAR PHARMACY 250 23.26 CARDIZEM 25MG/5ML - IVPB PHAR PHARMACY 250 70.71 CARDIZEM 30 MG TAB PHAR PHARMACY 250 5.03 CARDIZEM 50MG/10ML - IVP PHAR PHARMACY 250 18.46 CARDIZEM 50MG/10ML - IVPB PHAR PHARMACY 250 70.66 59 CARDIZEM 60 MG TAB PHAR PHARMACY 250 5.08 CARDIZEM 90 MG TAB PHAR PHARMACY 250 5.12 CARDIZEM CD 120 MG CAP PHAR PHARMACY 250 5.82 CARDIZEM CD 180 MG CAP PHAR PHARMACY 250 6.11 CARDIZEM CD 240 MG CAP PHAR PHARMACY 250 6.86 CARDIZEM CD 300 MG CAP PHAR PHARMACY 250 6.21 CARDIZEM CD 360 MG CAP PHAR PHARMACY 250 8.51 CARDURA 1 MG TAB PHAR PHARMACY 250 5.06 CARDURA 4 MG TAB PHAR PHARMACY 250 5.08 CARDURA 8 MG TAB PHAR PHARMACY 250 5.06 CATAPRES 0.1 MG TAB PHAR PHARMACY 250 5.01 CATAPRES 0.2 MG TAB PHAR PHARMACY 250 5.04 CATAPRES TTS-1 PATCHES TO PHAR PHARMACY 250 26.87 CATAPRES TTS-2 PATCH TOP PHAR PHARMACY 250 33.09 CATAPRES TTS-3 PATCH TOP PHAR PHARMACY 250 56.74 CATHFLO ACTIVASE 2 MG IV PHAR PHARMACY 250 J2997 85.05 CATHFLO ACTIVASE 2MG IV PHAR PHARMACY 636 J2997 103.50 CEFOTAN 1GM - IVPB PHAR PHARMACY 250 73.31 CEFOTAN 2GM - IVPB PHAR PHARMACY 250 83.87 CEFOTAN 2gm/50ml/PREMIX PHAR PHARMACY 250 92.55 CEFTIN 250 MG TAB PHAR PHARMACY 250 13.07 CEFTIN 500 MG TAB PHAR PHARMACY 250 19.74 CELEBREX 100 MG CAP PHAR PHARMACY 250 6.86 CELEBREX 200 MG CAP PHAR PHARMACY 250 9.50 CELESTONE SOLUSPAN 6MG/M PHAR PHARMACY 250 J0702 23.40 CELEXA 10 MG TAB PHAR PHARMACY 250 7.90 CELEXA 20 MG TAB PHAR PHARMACY 250 8.09 CELEXA 40 MG TAB PHAR PHARMACY 250 9.39 CELLCEPT 250MG PHAR PHARMACY 250 8.92 CENOLATE 500MG/ML INJ PHAR PHARMACY 250 19.70 CEPACOL LOZENGE PHAR PHARMACY 250 5.10 CEREBYX 100MG/2ML - IM/IV PHAR PHARMACY 636 Q2009 42.22 CEREBYX 500MG/10ML - IV PHAR PHARMACY 636 Q2009 86.56 CERVIDIL 10 MG SUPP PHAR PHARMACY 250 237.42 CETACAINE SPRAY PHAR PHARMACY 250 7.84 CHANTIX 0.5MG TAB PHAR PHARMACY 250 6.98 CHANTIX 1 MG TAB PHAR PHARMACY 250 6.98 CHAPSTICK NON-PET BASE) O PHAR PHARMACY 270 6.49 CHRONULAC SYRUP 10GM/15ML PHAR PHARMACY 250 4.97 CILOXAN 0.3% OPTH PHAR PHARMACY 250 9.85 CIPRO 200 MG/100 ML IV PHAR PHARMACY 250 J0744 71.35 CIPRO 250 MG TAB PHAR PHARMACY 250 5.06 60 CIPRO 400MG/200 ML IVPB PHAR PHARMACY 250 J0744 73.76 CIPRO 400MG/40 ML IVPB PHAR PHARMACY 250 J0744 77.49 CIPRO 500 MG #3 PHAR PHARMACY 250 13.81 CIPRO 500 MG TAB PHAR PHARMACY 250 5.82 CIPRO I.V. INJ 400MG VL I PHAR PHARMACY 250 J0744 77.44 CITRACAL + D TAB PHAR PHARMACY 250 5.03 CLAFORAN 1GM - IM PHAR PHARMACY 250 J0698 20.58 CLAFORAN 1GM - IVPB PHAR PHARMACY 250 J0698 71.08 CLAFORAN 2GM IV PHAR PHARMACY 250 J0698 72.16 CLARITIN 10 MG TAB PHAR PHARMACY 250 5.20 CLARITIN CHILDS SYRUP 5ML PHAR PHARMACY 250 18.43 CLARITIN D 24H TAB PHAR PHARMACY 250 9.49 CLEOCIN 150 MG #8 PHAR PHARMACY 250 26.00 CLEOCIN 150MG CAP PHAR PHARMACY 250 5.82 CLEOCIN 300MG. TAB PHAR PHARMACY 250 8.37 CLEOCIN 300MG/2ML INJ PHAR PHARMACY 250 71.09 CLEOCIN 300MG/50ML D5W PR PHAR PHARMACY 250 75.34 CLEOCIN 600MG/50 ML IVPB PHAR PHARMACY 250 84.98 CLEOCIN 900MG/50 ML IVPB PHAR PHARMACY 250 81.73 CLEOCIN PEDI SUSP 100ML PHAR PHARMACY 250 68.66 CLINORIL 200 MG TAB PHAR PHARMACY 250 5.17 COGENTIN 1 MG TAB PHAR PHARMACY 250 5.05 COLACE 100 MG CAP PHAR PHARMACY 250 5.00 COLACE 50MG/5ML LIQUID PHAR PHARMACY 250 4.53 COLCHICINE 0.6 MG TAB PHAR PHARMACY 250 5.07 COMBIVENT INHALER PHAR PHARMACY 250 5.56 COMPAZINE 10 MG TAB PHAR PHARMACY 250 5.03 COMPAZINE 10MG/2ML - IM/I PHAR PHARMACY 250 J0780 18.24 CORDARONE 100 MG TAB PHAR PHARMACY 250 8.00 CORDARONE 150MG/3ML INJ PHAR PHARMACY 636 J0282 78.65 CORDARONE 200 MG TAB PHAR PHARMACY 250 5.35 CORDARONE 900MG/18ML/IVP PHAR PHARMACY 250 70.50 COREG 12.5 MG TAB PHAR PHARMACY 250 6.74 COREG 25 MG TAB PHAR PHARMACY 250 6.63 COREG 3.125 MG TAB PHAR PHARMACY 250 7.21 COREG 6.25 MG TAB PHAR PHARMACY 250 7.09 CORGARD 40MG PHAR PHARMACY 250 5.14 CORTEF 10 MG TAB PHAR PHARMACY 250 5.41 CORTEF 20 MG TAB PHAR PHARMACY 250 5.83 CORTISPORIN OPHTH SUSP PHAR PHARMACY 250 39.40 CORTISPORIN OTIC SUSP ER PHAR PHARMACY 250 32.61 CORTROSYN 0.25MG/2ML - IV PHAR PHARMACY 636 J0834 89.81 61 COUMADIN 5 MG TAB PHAR PHARMACY 250 5.07 COUMADIN 1 MG TAB PHAR PHARMACY 250 4.99 COUMADIN 10 MG TAB PHAR PHARMACY 250 5.13 COUMADIN 2 MG TAB PHAR PHARMACY 250 7.18 PULMICORT FLEXHALER 180MCG/ACT PHAR PHARMACY 250 1.00 COUMADIN 2.5 MG TAB PHAR PHARMACY 250 5.06 COUMADIN 3 MG TAB PHAR PHARMACY 250 4.99 COUMADIN 4 MG TAB PHAR PHARMACY 250 4.99 COUMADIN 7.5 MG TAB PHAR PHARMACY 250 5.01 COZAAR 25 MG TAB PHAR PHARMACY 250 6.69 COZAAR 50 MG TAB PHAR PHARMACY 250 6.77 CRESTOR 10 MG TAB PHAR PHARMACY 250 8.37 CUBICIN 1 MG IV PHAR PHARMACY 636 J0878 1.01 CYCLOGEL 1% OPTH 2ml ER PHAR PHARMACY 250 14.70 CYCLOGYL 1% OPTH PHAR PHARMACY 250 6.40 CYMBALTA 20 MG PHAR PHARMACY 250 8.54 CYMBALTA 30 MG PHAR PHARMACY 250 10.17 CYTOMEL 5 MCG TAB PHAR PHARMACY 250 5.59 CYTOTEC 100 MCG TAB PHAR PHARMACY 250 6.17 CYTOTEC 200MCG PHAR PHARMACY 250 6.73 D10W 1000ML PHAR PHARMACY 250 67.93 D10W 250 ML PHAR PHARMACY 250 67.70 D5 1/2NS 1000ML PHAR PHARMACY 250 67.88 D5 1/2NS 500ML PHAR PHARMACY 250 68.14 D5 1/2NS W/20KCL - 1000ML PHAR PHARMACY 250 68.32 D5 1/4NS 1000ML PHAR PHARMACY 250 68.21 D5LR 1000ML PHAR PHARMACY 250 J7120 67.99 D5LR 500ML PHAR PHARMACY 250 68.09 D5NS 1000ML PHAR PHARMACY 250 68.38 D5NS 500ML PHAR PHARMACY 250 J7042 68.15 D5W 1000ML PHAR PHARMACY 250 J7070 67.02 D5W 100ML PHAR PHARMACY 250 67.96 D5W 100ML BAXTER PHAR PHARMACY 250 68.60 D5W 250ML PHAR PHARMACY 250 67.70 D5W 500ML PHAR PHARMACY 250 67.03 D5W 50ML PHAR PHARMACY 250 67.96 DABIGATRAN ETEXILATE 75 PHAR PHARMACY 250 9.75 DALIRESP 500mcg TAB PHAR PHARMACY 250 9.82 DEAPACON 500MG/ 5ML PHAR PHARMACY 250 31.93 DEBROX EAR DROPS PHAR PHARMACY 250 14.54 DECADRON 0.1% OPTH PHAR PHARMACY 250 15.64 DECADRON 10MG/ML VIAL PO PHAR PHARMACY 250 5.93 62 DECADRON 4 MG TAB PHAR PHARMACY 250 5.20 DECADRON INJ 10MG/ML INJ PHAR PHARMACY 636 J1094 17.82 DECADRON INJ 4MG/ML INJ PHAR PHARMACY 250 J1094 17.13 DELTASONE 1 MG PHAR PHARMACY 250 5.12 DELTASONE 10 MG TAB PHAR PHARMACY 250 5.12 DELTASONE 20 MG TAB PHAR PHARMACY 250 5.01 DELTASONE 5 MG TAB PHAR PHARMACY 250 5.00 DELTASONE 50 MG TAB PHAR PHARMACY 250 5.64 DEMADEX 20MG TAB PHAR PHARMACY 250 9.09 DEMEROL 50MG/ML INJ PHAR PHARMACY 250 J2175 17.54 DEMEROL 75MG/ML INJ PHAR PHARMACY 250 J2175 17.48 DEPAKENE 250 MG TAB PHAR PHARMACY 250 5.24 DEPAKOTE 125 MG SPRINKLES PHAR PHARMACY 250 5.64 DEPAKOTE 250 MG TAB PHAR PHARMACY 250 6.57 DEPAKOTE 500 MG TAB PHAR PHARMACY 250 7.96 DEPAKOTE DR 125MG TAB PHAR PHARMACY 250 4.70 DEPAKOTE ER 500 MG PHAR PHARMACY 250 7.76 DEPO-MEDROL 80MG/ML - IM PHAR PHARMACY 250 J3490 42.13 DEPO-PROVERA 150MG - IM PHAR PHARMACY 250 46.66 DEPO-TESTOSTERONE 200MG/M PHAR PHARMACY 250 J1071 39.72 DERMA BOND PHAR PHARMACY 250 46.50 DETROL 2 MG TAB PHAR PHARMACY 250 7.15 DETROL LA 2 MG CAP PHAR PHARMACY 250 8.95 DETROL LA 4 MG CAP PHAR PHARMACY 250 10.69 DEXTROSE 25GM/50ML ABBOJE PHAR PHARMACY 250 18.64 DEXTROSE INJ 50% IV PHAR PHARMACY 250 19.22 DIAMOX 500MG IV PHAR PHARMACY 250 J1120 36.68 DIFLUCAN 100 MG TAB PHAR PHARMACY 250 5.17 DIFLUCAN 150 MG TAB PHAR PHARMACY 250 5.47 DIFLUCAN 200 MG TAB PHAR PHARMACY 250 5.19 DIFLUCAN 200MG/100ML SODI PHAR PHARMACY 250 J1450 71.22 DIFLUCAN 400MG/200ML/IV PHAR PHARMACY 250 J1450 73.82 DILANTIN 100 MG PHAR PHARMACY 250 5.35 DILANTIN 100MG/2ML - IM PHAR PHARMACY 250 J1165 19.86 DILANTIN 100MG/2ML - IVPB PHAR PHARMACY 250 J1165 69.03 DILANTIN 50 MG PHAR PHARMACY 250 5.41 DILAUDID 2 MG TAB PHAR PHARMACY 250 5.12 DILAUDID 10MG/50ML PCA PHAR PHARMACY 250 J1170 77.49 DILAUDID 2 MG/ML SQ/IM/IV PHAR PHARMACY 250 J1170 18.24 DILAUDID 4 MG TAB PHAR PHARMACY 250 5.76 DILAUDID 4 MG/ML - SQ/IM PHAR PHARMACY 250 J1170 17.54 DIOVAN 160 MG TAB PHAR PHARMACY 250 7.00 63 DIOVAN 4mg TAB PHAR PHARMACY 250 7.39 DIOVAN 80 MG TAB PHAR PHARMACY 250 6.86 DIPRIVAN 200MG/20ML - IVP PHAR PHARMACY 250 74.42 DIPROLENE AF CREAM 0.05% PHAR PHARMACY 250 16.26 DITROPAN 5 MG TAB PHAR PHARMACY 250 5.12 DITROPAN XL 10 MG TAB PHAR PHARMACY 250 7.49 DITROPAN XL 5 MG TAB PHAR PHARMACY 250 8.25 DOBUTAMINE 250mg/250ml IV PHAR PHARMACY 250 71.84 DOPAMINE 400MG/250ML INJ PHAR PHARMACY 250 J1265 74.14 DORYX 100 MG TAB PHAR PHARMACY 250 5.04 DOXYCYCL HYC INJ 100MG PHAR PHARMACY 250 71.38 DULCOLAX 10 MG SUPP PHAR PHARMACY 250 5.99 DULCOLAX 5 MG TAB PHAR PHARMACY 250 5.64 DULERA 100 MCG/5MCG MDI PHAR PHARMACY 250 204.00 DULERA 200MCG/5MCG MDI PHAR PHARMACY 250 204.00 DUONEB NEBS PHAR PHARMACY 250 5.97 DURAGESIC 100 MCG/HR PATC PHAR PHARMACY 250 58.21 DURAGESIC 12MCG/HR TRANS PHAR PHARMACY 250 9.38 DURAGESIC 25UG/H PATCH TO PHAR PHARMACY 250 12.49 DURAGESIC 50UG/H PATCH TO PHAR PHARMACY 250 18.13 DURAGESIC 75UG/HR PATCH T PHAR PHARMACY 250 27.62 DYNAPEN 500 MG CAP PHAR PHARMACY 250 5.44 EFFEXOR 25 MG TAB PHAR PHARMACY 250 8.32 EFFEXOR 37.5 MG PHAR PHARMACY 250 6.85 EFFEXOR 75 MG TAB PHAR PHARMACY 250 7.38 EFFEXOR XR 150 MG CAP PHAR PHARMACY 250 9.06 EFFEXOR XR 37.5 MG CAP PHAR PHARMACY 250 8.73 EFFEXOR XR 75 MG CAP PHAR PHARMACY 250 8.66 ELAVIL 10 MG TAB PHAR PHARMACY 250 5.00 ELAVIL 100 MG TAB PHAR PHARMACY 250 5.07 ELAVIL 25 MG TAB PHAR PHARMACY 250 5.87 ELAVIL 50 MG TAB PHAR PHARMACY 250 5.83 ELIQUIS 2.5 MG TAB PO PHAR PHARMACY 250 8.67 ELIQUIS 5MG TAB PHAR PHARMACY 250 9.08 EMLA CREAM 2.5% TOP PHAR PHARMACY 250 45.10 EMPTY EVACUAT CONT 1000ML PHAR PHARMACY 270 21.89 ENGERIX-B 20MCG/ML ADULT PHAR PHARMACY 250 90746 68.38 ENGERIX-B PEDIATRIC 10MCG PHAR PHARMACY 636 90744 28.29 ENSURE 8 oz PHAR PHARMACY 250 4.67 ENTOCORT EC 3 MG CAP PHAR PHARMACY 250 9.64 EPHEDRINE SU INJ 50MG/ML PHAR PHARMACY 250 19.34 EPINEPHRINE 1:10,000 ABBO PHAR PHARMACY 250 J0171 18.35 64 EPINEPHRINE 1:1000 AMP PHAR PHARMACY 250 J0171 19.72 EPINEPHRINE 1:1000/1MG 30 PHAR PHARMACY 250 J0171 67.75 EPINEPHRINE DRIP 2mg/250m PHAR PHARMACY 250 J0171 70.24 EPOGEN 10,000 U/ML SQ PHAR PHARMACY 636 J0885 141.08 ERYPED 400mg/5ml 100ml PHAR PHARMACY 250 9.99 ERYTHROMYCIN 0.5% OPTH OI PHAR PHARMACY 250 5.41 ERYTHROMYCIN 0.5% OPTH OI PHAR PHARMACY 250 6.01 ERYTHROMYCIN OPHTH OINT E PHAR PHARMACY 250 14.62 ESTRACE 1 MG TAB PHAR PHARMACY 250 5.78 ESTRACE 2 MG TAB PHAR PHARMACY 250 4.98 ESTRADIOL 0.5 MG TABLET PHAR PHARMACY 250 6.14 ESTRADIOL 1MG PHAR PHARMACY 250 6.34 EVACU PHAR PHARMACY 250 J0690 74.19 EVISTA 60 MG TAB PHAR PHARMACY 250 8.37 EXCEDRIN PHAR PHARMACY 250 4.97 EXELON 3MG PHAR PHARMACY 250 9.06 FACTOR IX COMPLEX PER IU PHAR PHARMACY 636 J7194 1.10 FENTANYL DRIP 1000mcg/100 PHAR PHARMACY 250 J3010 78.27 FERGON 300 MG TAB PHAR PHARMACY 250 5.10 FEROSUL PHAR PHARMACY 250 7.22 FERROUS SULFATE 325 MG TA PHAR PHARMACY 250 5.06 FIBERCON TAB PHAR PHARMACY 250 5.06 FISH OIL CAP PHAR PHARMACY 250 4.55 FLAGYL 250 MG TAB PHAR PHARMACY 250 5.06 FLAGYL 500 MG TAB PHAR PHARMACY 250 5.58 FLAGYL 500MG/100ML INJ PHAR PHARMACY 250 68.45 FLEET MINERAL OIL ENEMA PHAR PHARMACY 250 6.16 FLEET PEDIA-LAX ENEMA 2.2 PHAR PHARMACY 250 5.79 FLEET REG ENEMA PHAR PHARMACY 250 5.58 FLEXERIL 10 MG TAB PHAR PHARMACY 250 5.00 FLEXERIL 10MG #4 PHAR PHARMACY 250 13.77 FLEXERIL 5 MG PHAR PHARMACY 250 5.14 FLOMAX 0.4 MG CAP PHAR PHARMACY 250 8.02 FLORASTOR 25 MG CAPS PHAR PHARMACY 250 5.87 FLORINEF 0.1 MG TAB PHAR PHARMACY 250 5.26 FLOVENT 110 MCG INHALER PHAR PHARMACY 250 6.12 FLUNISOLIDE NASAL SOLN PHAR PHARMACY 250 4.56 FLUOCINIONIDE ONT 0.05% 1 PHAR PHARMACY 250 37.22 FLUOR-I-STRIPS PHAR PHARMACY 250 5.13 FLUZONE HD PFS 2017-2018 PHAR PHARMACY 636 90662 52.00 FLUZONE QUAD 2017-2018 PHAR PHARMACY 636 90688 17.00 FLUZONE QUAD 6-35 MO 2017 PHAR PHARMACY 636 90685 17.00 65 FOLIC ACID 1 MG TAB PHAR PHARMACY 250 5.03 FOLIC ACID 0.4 MG PHAR PHARMACY 250 5.03 FOLIC ACID 5MG/ML IM/IV/S PHAR PHARMACY 250 30.81 FORTAZ 1GM - IM PHAR PHARMACY 250 J0713 28.43 FORTAZ 1GM - IVPB PHAR PHARMACY 250 J0713 78.93 FORTAZ 2GM - IVPB ONLY PHAR PHARMACY 250 J0713 84.48 FOSAMAX 10 MG TAB PHAR PHARMACY 250 7.79 FOSAMAX 35 MG TAB PHAR PHARMACY 250 24.85 FOSAMAX 70 MG TAB PHAR PHARMACY 250 24.27 GARDASIL VACCINE PHAR PHARMACY 636 90649 163.66 GAS-X 125MG PHAR PHARMACY 250 4.69 GELFOAM POWDER 1GM ENVELO PHAR PHARMACY 250 59.76 GELFOAM SIZE 100 SPONGE PHAR PHARMACY 250 25.29 GENTAK OPHT SOLN ER PHAR PHARMACY 250 32.02 GENTAMICIN 0.3% OPTH SOL PHAR PHARMACY 250 6.11 GENTAMICIN 20 MG/2ML IM PHAR PHARMACY 250 J1580 20.60 GENTAMICIN 20 MG/2ML IVPB PHAR PHARMACY 250 J1580 72.26 GENTAMICIN 80 MG/2ML IM PHAR PHARMACY 250 J1580 39.13 GENTAMICIN 80 MG/2ML IVPB PHAR PHARMACY 250 J1580 111.67 GEODON 20 MG PHAR PHARMACY 250 10.13 GEODON 20MG SDV IM PHAR PHARMACY 250 J3486 147.31 GI COCKTAIL PHAR PHARMACY 250 6.20 GLUCAGON 1MG/ML - SQ/IM PHAR PHARMACY 636 J1610 109.62 GLUCOPHAGE 1000 MG TAB PHAR PHARMACY 250 5.07 GLUCOPHAGE 500 MG TAB PHAR PHARMACY 250 6.07 GLUCOPHAGE 500 MG XR TAB PHAR PHARMACY 250 5.12 GLUCOPHAGE 850 MG TAB PHAR PHARMACY 250 5.93 GLUCOSAMINE SULFATE 500 M PHAR PHARMACY 250 5.00 GLUCOTROL 5 MG TAB PHAR PHARMACY 250 6.05 GLUCOTROL 10 MG TAB PHAR PHARMACY 250 5.05 GLUCOTROL XL 2.5 MG TAB PHAR PHARMACY 250 5.47 GLUCOTROL XL 10 MG TAB PHAR PHARMACY 250 5.47 GLUCOTROL XL 5 MG TAB PHAR PHARMACY 250 5.18 GLUTOSE 15GM TUBE PHAR PHARMACY 250 7.67 GLYCERIN SUPP-PEDIATRIC PHAR PHARMACY 250 4.55 HALDOL 0.5 MG PHAR PHARMACY 250 4.99 HALDOL 1 MG TAB PHAR PHARMACY 250 7.38 HALDOL 2MG/ML 15ML ORAL S PHAR PHARMACY 250 4.72 HALDOL 5 MG/ML INJ PHAR PHARMACY 250 J1630 17.71 HAVRIX A VACCINE IM PHAR PHARMACY 250 90632 69.62 HEMABATE 250 MCG/ML IM PHAR PHARMACY 250 82.04 HEPARIN 10 U/ML - IVP PHAR PHARMACY 250 J1642 18.99 66 HEPARIN 10,000 U/ML IV/S PHAR PHARMACY 250 J1644 17.26 HEPARIN 100 U/ML - IVP PHAR PHARMACY 250 J1644 16.85 HEPARIN 25,000 U/500ML PHAR PHARMACY 250 J1644 70.03 Heparin 5000 Units/ml Inj PHAR PHARMACY 636 J1644 17.57 HEPARIN 5ML PHAR PHARMACY 250 16.90 HEPATITIS-B VAC.EACH/IJ PHAR PHARMACY 636 90746 89.00 HIBICLENS (CHLORHEX 4%) PHAR PHARMACY 250 10.46 HIBICLENS 4% 4OZ PHAR PHARMACY 250 6.31 HURRICAINE SPRAY 20% PHAR PHARMACY 250 64.51 HYCODAN (hydromet syp) UD PHAR PHARMACY 250 7.97 HYCODAN SYRUP 2 OZ ER PHAR PHARMACY 250 18.82 HYDREA 500 MG CAP PHAR PHARMACY 250 5.25 HYDROCODONE/APAP 7.5/325M PHAR PHARMACY 250 7.26 HYDROCORTISONE CR. 1% - 3 PHAR PHARMACY 250 5.93 HYDROCORTISONE OINT 1% - PHAR PHARMACY 250 5.90 HYDRODIURIL 12.5 MG PHAR PHARMACY 250 5.06 HYDRODIURIL 25 MG TAB PHAR PHARMACY 250 4.97 HYGROTON 25 MG PHAR PHARMACY 250 5.05 HYPERTONIC SALINE 3% - 50 PHAR PHARMACY 250 J7131 67.74 HYTRIN 1 MG CAP PHAR PHARMACY 250 7.15 HYTRIN 5 MG CAP PHAR PHARMACY 250 5.11 IMDUR 30 MG TAB PHAR PHARMACY 250 7.13 IMDUR 60 MG TAB PHAR PHARMACY 250 8.14 IMITREX 50 MG TAB PHAR PHARMACY 250 34.98 IMITREX 6 MG/0.5 ML - SQ PHAR PHARMACY 636 J3030 109.79 IMODIUM 2 MG CAP PHAR PHARMACY 250 6.78 IMODIUM SOLUTION PHAR PHARMACY 250 7.03 IMPACT PHAR PHARMACY 250 10.10 INDERAL 10 MG PHAR PHARMACY 250 4.97 INDERAL 20 MG TAB PHAR PHARMACY 250 5.00 INDERAL 40 MG TAB PHAR PHARMACY 250 5.00 INDERAL LA 60MG PHAR PHARMACY 250 6.28 INDERAL LA 80 MG CAP PHAR PHARMACY 250 6.41 INDOCIN 25 MG CAP PHAR PHARMACY 250 5.14 INDOCIN 50 MG CAP PHAR PHARMACY 250 5.04 INFED 100 MG/2 ML - IV/IM PHAR PHARMACY 636 J1750 46.48 INH 300MG. TAB. PHAR PHARMACY 250 5.12 INJ ALPHA-1-PROT INHIB 10 PHAR PHARMACY 636 J0256 531.00 INJ BUPIVICAINE LIPO 1 MG PHAR PHARMACY 636 C9290 364.50 INJ OXYCODONE 10 UNITS/ML PHAR PHARMACY 250 75.20 INJ TETANUS IMMUNE GLOB U PHAR PHARMACY 636 J1670 379.41 INJ VERCURONIUM BROMIDE 2 PHAR PHARMACY 250 22.23 67 INSULIN DRIP 100U /100ML PHAR PHARMACY 250 80.92 INTRALIPID 20% PHAR PHARMACY 250 78.75 INVANZ 1 GM IVPB PHAR PHARMACY 250 122.10 ISOPTIN SR 120 MG TAB PHAR PHARMACY 250 5.43 ISOPTIN SR 180 MG TAB PHAR PHARMACY 250 5.18 ISORDIL 10 MG TAB PHAR PHARMACY 250 5.06 IV CEFTRIAXONE 2GM/50ML P PHAR PHARMACY 636 J0696 82.78 IV MAG SULFATE 500MG PHAR PHARMACY 636 J3475 78.98 JANUVIA 100MG TAB PHAR PHARMACY 250 11.40 KAYEXALATE 15 GM/60 ML PHAR PHARMACY 250 7.43 KCL [20 MEQ/10 ML] INJ PHAR PHARMACY 250 J3480 16.90 KCL 20MEQ/100ML IVPB HIGH PHAR PHARMACY 250 68.80 KCL 40 MEQ/20 ML - IV PHAR PHARMACY 250 16.96 K-DUR 10 MEQ TAB PHAR PHARMACY 250 5.06 K-DUR 20 MEQ TAB PHAR PHARMACY 250 5.24 K-DUR LIQ.20 MEQ/15ML PHAR PHARMACY 250 5.27 KEFLEX 125 MG/5 ML 100ML PHAR PHARMACY 250 9.67 KEFLEX 250 MG CAP PHAR PHARMACY 250 5.05 KEFLEX 250 MG/5 ML 100ML PHAR PHARMACY 250 9.96 KEFLEX 500 MG #4 PHAR PHARMACY 250 16.75 KEFLEX 500 MG CAP PHAR PHARMACY 250 5.32 KENALOG 0.1% CR 15GM ER PHAR PHARMACY 250 14.40 KENALOG 0.1% CREAM - 15 G PHAR PHARMACY 250 5.19 KENALOG 40 MG/ML - IM (5M PHAR PHARMACY 636 J3301 82.91 KENALOG 40 MG/ML 1ML IM PHAR PHARMACY 636 J3301 25.07 KEPPRA 500 MG PHAR PHARMACY 250 7.81 KEPPRA 500mg/5ml VIAL IV PHAR PHARMACY 636 J1953 22.43 KEPPRA ORAL SOLN 100MG/ML PHAR PHARMACY 250 4.65 KETALAR 500 MG/5ML PHAR PHARMACY 250 24.09 K-HOS NEUTRAL 250 MG PHAR PHARMACY 250 5.15 KLONOPIN 0.5 MG TAB PHAR PHARMACY 250 5.06 KLONOPIN 1.0 MG TAB PHAR PHARMACY 250 5.06 KLOR-CON 8 MEQ TAB PHAR PHARMACY 250 5.00 KLOR-CON PWDR PHAR PHARMACY 250 5.95 K-PHOS NEUTRAL 250MG TAB PHAR PHARMACY 250 6.62 K-PHOS ORIGINAL 500MG TAB PHAR PHARMACY 250 4.97 LAMICTAL 100 MG TAB PHAR PHARMACY 250 9.35 LAMICTAL 200mg PHAR PHARMACY 250 4.69 LAMICTAL 200MG TAB UD PHAR PHARMACY 250 5.12 LAMICTAL 25 MG TAB PHAR PHARMACY 250 8.80 LANOXIN 0.125 MG TAB PHAR PHARMACY 250 5.17 LANOXIN 0.25 MG TAB PHAR PHARMACY 250 5.18 68 LANOXIN INJ 0.25MG/ML PHAR PHARMACY 250 J1160 17.25 LANSINOH BREAST CREAM TOP PHAR PHARMACY 250 5.25 LANTUS INSULIN PHAR PHARMACY 250 J1815 25.64 LASIX 100 MG/10ML IVP PHAR PHARMACY 250 J1940 16.95 LASIX 20 MG TAB PHAR PHARMACY 250 5.00 LASIX 20mg/2ml INJ PHAR PHARMACY 250 16.88 LASIX 40 MG TAB PHAR PHARMACY 250 5.00 LASIX 40 MG/4ML PHAR PHARMACY 250 J1940 16.90 LASIX 80 MG TAB PHAR PHARMACY 250 5.04 LET TOPICAL SYRINGE PHAR PHARMACY 250 15.97 LEVAQUIN 250 MG TAB PHAR PHARMACY 250 16.52 LEVAQUIN 250ML/50ML PREMI PHAR PHARMACY 250 75.20 LEVAQUIN 500 MG TAB PHAR PHARMACY 250 26.41 LEVAQUIN 500 MG/100ML IVP PHAR PHARMACY 250 J1956 112.82 LEVAQUIN 750MG/150ML IVPB PHAR PHARMACY 250 J1956 123.22 LEVEMIR FLEX PEN 100U/3ML PHAR PHARMACY 250 38.59 LEVETIRACETAM 250 TAB PHAR PHARMACY 250 5.14 LEVOPHED 1 MG/ML - IVPB PHAR PHARMACY 250 69.44 LEVSIN 0.125 MG TAB PHAR PHARMACY 250 5.32 LEXAPRO 10 MG TAB PHAR PHARMACY 250 7.61 LEXAPRO 20 MG PHAR PHARMACY 250 7.73 LIBRIUM 25 MG CAP PHAR PHARMACY 250 5.18 LIDOCAIN/D5W INJ 4 MG/ML PHAR PHARMACY 250 J2001 69.77 LIDOCAINE 2% ABBOJECT PHAR PHARMACY 250 J2001 17.96 LIDOCAINE 5% OINTMENT PHAR PHARMACY 250 5.17 LIDOCAINE JELLY 2% PHAR PHARMACY 250 5.18 LIDOCAINE JELLY 2% 30 ML PHAR PHARMACY 250 11.05 LIDOCAINE VISCOUS 2% 100M PHAR PHARMACY 250 6.92 LIDODERM 5% PATCH TOP PHAR PHARMACY 250 11.33 LIORESAL 10 MG TAB PHAR PHARMACY 250 5.18 LIORESAL 20 MG TAB PHAR PHARMACY 250 5.35 LIPITOR 10 MG TAB PHAR PHARMACY 250 7.85 LIPITOR 20 MG TAB PHAR PHARMACY 250 9.04 LIPITOR 40 MG TAB PHAR PHARMACY 250 13.70 LITHIUM 150 MG CAP PHAR PHARMACY 250 5.86 LITHIUM 300 MG CAP PHAR PHARMACY 250 12.02 LOMOTIL TAB PHAR PHARMACY 250 5.82 LOPID 600 MG TAB PHAR PHARMACY 250 5.19 LOPRESSOR 100 MG TAB PHAR PHARMACY 250 5.06 LOPRESSOR 25 MG TAB PHAR PHARMACY 250 5.06 LOPRESSOR 25mg ER PHAR PHARMACY 250 5.40 LOPRESSOR 5 MG/5ML - IVP PHAR PHARMACY 250 18.87 69 LOPRESSOR 50 MG TAB PHAR PHARMACY 250 5.47 LORTAB ELIXIR PHAR PHARMACY 250 5.31 LORTAB ELIXIR 15ml UD PHAR PHARMACY 250 8.38 LOTENSIN 10 MG TAB PHAR PHARMACY 250 5.41 LOTENSIN 20 MG TAB PHAR PHARMACY 250 5.05 LOTRIMIN CREAM 1% TOP PHAR PHARMACY 250 5.00 LOTRISONE CRM 1% 15GM PHAR PHARMACY 250 29.35 LOVENOX 100 MG/1ML SQ PHAR PHARMACY 250 J1650 89.05 LOVENOX 120MG/0.8 ML SQ PHAR PHARMACY 250 J1650 103.56 LOVENOX 150MG/ML PHAR PHARMACY 250 J1650 125.33 LOVENOX 30 MG/0.3ML SQ PHAR PHARMACY 250 J1650 40.55 LOVENOX 40 MG/0.4ML SQ PHAR PHARMACY 250 J1650 57.07 LOVENOX 60MG/0.6ML SQ PHAR PHARMACY 250 J1650 71.62 LOVENOX 80 MG/0.8ML SQ PHAR PHARMACY 250 J1650 86.12 LR 1000ML PHAR PHARMACY 250 J7120 67.92 LR 500ML PHAR PHARMACY 250 J7120 67.82 LUGOL'S SOLUTION PHAR PHARMACY 250 38.00 LUNESTA 2MG PHAR PHARMACY 250 9.27 LYRICA 25 MG PHAR PHARMACY 250 6.94 LYRICA 75 MG PHAR PHARMACY 250 7.11 MAALOX 30 ML UD PHAR PHARMACY 250 5.15 MAALOX PLUS PHAR PHARMACY 250 7.06 MACROBID 100 MG CAP PHAR PHARMACY 250 6.07 MACRODANTIN 100 MG CAP PHAR PHARMACY 250 6.05 MAG CITRATE ORAL SOL PHAR PHARMACY 250 5.97 MAG SULFATE 1 GM/2ML - IV PHAR PHARMACY 250 J3475 21.48 MAGIC MOUTHWASH FORMULA PHAR PHARMACY 250 6.35 MAGNESIUM 250 MG TABS PHAR PHARMACY 250 4.97 MAGNESIUM SO4 1GM/100ML PHAR PHARMACY 250 J3475 73.95 MAGNESIUM SULFATE PHAR PHARMACY 250 67.97 MAG-OX 400 MG TAB PHAR PHARMACY 250 5.19 MARCAINE 0.25% MDV PHAR PHARMACY 250 18.13 MARCAINE 0.5% MDV - IV PHAR PHARMACY 250 38.74 MARCAINE 0.5% SDV - IV PHAR PHARMACY 250 19.60 MARCAINE 0.75% SDV - IV PHAR PHARMACY 250 19.92 MARCAINE 0.75% W/DEX SDV PHAR PHARMACY 250 19.59 MARCAINE W/EPI .25% MDV - PHAR PHARMACY 250 20.32 MARCAINE W/EPI 0.5% MDV - PHAR PHARMACY 250 28.91 MARCAINE W/EPI 0.5% SDV - PHAR PHARMACY 250 19.95 MARINOL 5 MG CAP PHAR PHARMACY 250 14.58 MASTISOL AMPS TOP PHAR PHARMACY 250 6.98 MAXALT 10MG TAB PHAR PHARMACY 250 31.06 70 MAXIPIME 1GM IVPB PHAR PHARMACY 250 84.31 MAXIPIME 2 GM PHAR PHARMACY 250 J0692 101.35 MAXITROL OPTH OINT PHAR PHARMACY 250 7.01 MAXZIDE 37.5/25 MG TAB PHAR PHARMACY 250 5.05 MAXZIDE 75/50 MG TAB PHAR PHARMACY 250 5.41 MEGACE 40 MG TAB PHAR PHARMACY 250 5.47 MEGACE SUSPENSION 40MG/ML PHAR PHARMACY 250 6.71 MELATONIN 3MG PHAR PHARMACY 250 4.55 MENINGOCOCCAL VACCINE PHAR PHARMACY 636 90733 139.25 MENOMUNE VACCINE PHAR PHARMACY 250 90733 145.33 MERREM 1 GM VIAL IVPB PHAR PHARMACY 636 J2185 77.08 MERREM 500 MG IVPB PHAR PHARMACY 250 85.37 METAMUCIL PHAR PHARMACY 250 5.27 METHADONE 10 MG TABS PHAR PHARMACY 250 5.34 METHADONE 40 MG TAB PHAR PHARMACY 250 5.14 METHADONE 5 MG TABS PHAR PHARMACY 250 5.19 METHERGINE 0.2 MG TAB PHAR PHARMACY 250 5.86 METHERGINE 0.2 MG/ML - IV PHAR PHARMACY 250 J2210 21.68 METHOTREXATE 2.5 MG TAB PHAR PHARMACY 250 8.72 METHYLENE BLUE 1% - IV PHAR PHARMACY 636 Q9968 17.77 MEVACOR 20 MG TAB PHAR PHARMACY 250 5.50 MEVACOR 40 MG PHAR PHARMACY 250 5.86 MIACALCIN NASAL SPRAY PHAR PHARMACY 250 8.13 MICRONASE 5 MG TAB PHAR PHARMACY 250 5.12 MIDAMOR 5MG TAB PHAR PHARMACY 250 8.00 MIDODRINE 5MG TAB PHAR PHARMACY 250 5.33 MINERAL OIL PHAR PHARMACY 250 4.95 MINIPRES 1 MG CAP PHAR PHARMACY 250 5.05 MINIPRESS PHAR PHARMACY 250 6.65 MINIPRESS 2 MG PHAR PHARMACY 250 5.90 MINOCIN 100MG TAB PHAR PHARMACY 250 4.73 MIOCHOL E OPTH 1% PHAR PHARMACY 250 35.05 MIRALAX PACKETS PHAR PHARMACY 250 8.16 MIRAPEX 0.125 MG TAB PHAR PHARMACY 250 7.21 MIRAPEX 0.25 MG TAB PHAR PHARMACY 250 7.72 MIRAPEX 1 MG PHAR PHARMACY 250 7.72 M-M-R VACCINE SQ PHAR PHARMACY 250 90707 80.76 MOBIC 15MG. TAB PHAR PHARMACY 250 9.70 MOBIC 7.5 MG TAB PHAR PHARMACY 250 8.14 MODAFINIL 100MG TAB PHAR PHARMACY 250 17.69 MOM 30 ML PHAR PHARMACY 250 6.40 MORPHINE 10 MG/ML -INJ PHAR PHARMACY 250 J2270 18.24 71 MORPHINE 15 MG TAB IMMED PHAR PHARMACY 250 5.29 MORPHINE 2 MG/ML - INJ PHAR PHARMACY 250 J2270 17.60 MORPHINE 4 MG/ML - INJ PHAR PHARMACY 250 J2270 17.60 MORPHINE 50 MG/50 ML PCA PHAR PHARMACY 250 J2274 77.20 MORPHINE DRIP 100MG/100ML PHAR PHARMACY 250 85.56 MORPHINE ORAL SOL 10MG/5M PHAR PHARMACY 250 5.21 MOTRIN 100MG/5ML SUSP PHAR PHARMACY 250 5.59 MOTRIN 200 MG TAB PHAR PHARMACY 250 5.00 MOTRIN 400 MG TAB PHAR PHARMACY 250 5.93 MOTRIN 600 MG #4 PHAR PHARMACY 250 15.25 MOTRIN 600 MG TAB PHAR PHARMACY 250 5.47 MOTRIN 800 MG TAB PHAR PHARMACY 250 5.18 MOVE FREE TAB PHAR PHARMACY 250 5.12 MS CONTIN 15 MG TAB PHAR PHARMACY 250 5.61 MS CONTIN 30 MG TAB PHAR PHARMACY 250 6.51 MUCINEX 600 MG LA TAB PHAR PHARMACY 250 5.35 MUCOMYST 10% SOLN PHAR PHARMACY 250 14.98 MUCOMYST 20% SOL PHAR PHARMACY 250 9.10 MULTIVITAMIN INJECTABLE PHAR PHARMACY 250 20.50 MULTIVITAMIN - LIQUID PO PHAR PHARMACY 250 11.64 MULTIVITAMINS W/MINERALS PHAR PHARMACY 250 5.00 MULTIVITAMINS TAB PHAR PHARMACY 250 5.00 MYAMBUTAL 400mg TABLET PHAR PHARMACY 250 5.92 MYCELEX TROCHE 10 MG TAB PHAR PHARMACY 250 6.72 MYDRIACYL 0.5% OPTH SOL PHAR PHARMACY 250 7.31 MYDRIACYL 1% OPTH SOL PHAR PHARMACY 250 7.21 MYLANTA PHAR PHARMACY 250 5.45 MYLICON 80 MG TAB PHAR PHARMACY 250 4.98 MYLICON DROPS PHAR PHARMACY 250 4.98 MYSOLINE 50 MG TAB PHAR PHARMACY 250 5.41 NAFCILLIN 2 GM - IVPB PHAR PHARMACY 250 88.69 NAMENDA 10 MG TAB PHAR PHARMACY 250 7.79 NAMENDA 5MG TAB PHAR PHARMACY 250 7.56 NAPROSYN 250 MG TAB PHAR PHARMACY 250 5.01 NAPROSYN 500 MG TAB PHAR PHARMACY 250 5.12 NARCAN 0.4 MG/ML - IM/SQ/ PHAR PHARMACY 250 J2310 31.29 NARCAN 2 MG/2ML ABBOJECT PHAR PHARMACY 250 J2310 31.34 NAROPIN 2 MG/ML 0.2% IV PHAR PHARMACY 250 22.85 NEOMYCIN 500 MG TAB PHAR PHARMACY 250 6.34 NEOSPORIN OINTMENT UD PHAR PHARMACY 250 5.99 NEOSTIGMINE METH to 0.5mg PHAR PHARMACY 250 J2710 17.56 NEO-SYNEPHRINE 10 MG/ML - PHAR PHARMACY 250 J2370 16.90 72 NEO-SYNEPHRINE 10mg/5ml V PHAR PHARMACY 250 17.85 NEO-SYNEPHRINE NASAL SPRA PHAR PHARMACY 250 11.93 NEUPOGEN 300 MCG/ML SQ PHAR PHARMACY 636 J1442 242.81 NEURONTIN 100 MG TAB PHAR PHARMACY 250 5.05 NEURONTIN 250MG/5ML PHAR PHARMACY 250 5.66 NEURONTIN 300 MG CAP PHAR PHARMACY 250 5.80 NEURONTIN 400 MG TAB PHAR PHARMACY 250 7.38 NEURONTIN 600 MG TAB PHAR PHARMACY 250 5.54 NEUTRAPHOS PKT PHAR PHARMACY 250 5.22 NEXIUM 20 mg SUSPENSION PHAR PHARMACY 250 7.27 NF PHAR PHARMACY 250 4.95 NICODERM CQ 14 MG PATCH PHAR PHARMACY 250 10.11 NICODERM CQ 21 MG PATCH PHAR PHARMACY 250 7.15 NICODERM CQ 7 MG PATCH PHAR PHARMACY 250 8.22 NICORETTE 2 MG GUM PHAR PHARMACY 250 5.15 NIMBEX 20mg/10ml PHAR PHARMACY 250 18.19 NITRO-BID OINT. 2% 30 GM PHAR PHARMACY 250 5.10 NITROGLYCERIN 0.4 MG THP PHAR PHARMACY 250 24.34 NITROGLYCERIN 50 MG/250ML PHAR PHARMACY 250 75.14 NITROSPRAY PHAR PHARMACY 250 6.49 NITROSTAT 0.4 MG PHAR PHARMACY 250 5.30 NODOZ (CAFFEINE) 200 mg PHAR PHARMACY 250 4.62 NOLVADEX 10 MG TAB PHAR PHARMACY 250 5.12 NORCO 10/325 MG TABLETS PHAR PHARMACY 250 5.33 NORCO 5/325 6PK/ER PHAR PHARMACY 250 14.61 NORCO 5/325MG TAB PHAR PHARMACY 250 4.55 NORCO 7.5MG/325MG ER PHAR PHARMACY 250 5.23 NORCURON 10 MG/10ML - IVP PHAR PHARMACY 250 19.12 NOREPINEPHRINE DRIP 8mg/2 PHAR PHARMACY 250 69.90 NORFLEX 30 MG/ML - INJ PHAR PHARMACY 250 J2360 37.11 NORMODYNE 100MG/20ML INJ PHAR PHARMACY 250 68.52 NORMODYNE 20mg/4ml INJ. PHAR PHARMACY 250 34.59 NORMODYNE 5 MG/ML - INJ PHAR PHARMACY 250 17.79 NORTRIPTYLINE 10 MG TAB PHAR PHARMACY 250 5.05 NORTRIPTYLINE 25 MG TAB PHAR PHARMACY 250 5.06 NORVASC 10 MG TAB PHAR PHARMACY 250 7.27 NORVASC 2.5 MG TAB PHAR PHARMACY 250 6.57 NORVASC 5 MG TAB PHAR PHARMACY 250 6.98 NOVOLIN 70/30 INSULIN - M PHAR PHARMACY 636 J1817 17.77 NOVOLIN N - NPH INSULIN PHAR PHARMACY 636 J1817 17.77 NOVOLIN R - REGULAR INSU PHAR PHARMACY 636 J1817 17.77 NOVOLOG INSULIN 10ML PHAR PHARMACY 250 J1815 21.11 73 NS 100 ML BAG SOLN PHAR PHARMACY 250 67.96 NS 100 ML-BAXTER SOLN PHAR PHARMACY 250 68.60 NS 1000 ML BAG SOLN PHAR PHARMACY 250 J7030 67.02 NS 150 ML BAG SOLN PHAR PHARMACY 250 67.69 NS 250 ML BAG SOLN PHAR PHARMACY 250 J7050 69.94 NS 50 ML- BAXTER SOLN PHAR PHARMACY 250 68.60 NS 500 ML BAG SOLN PHAR PHARMACY 250 J7040 67.03 NS 5O ML BAG SOLN PHAR PHARMACY 250 67.96 NUBAIN 10 MG/ML - IM/SQ/I PHAR PHARMACY 250 J2300 18.21 NUPERCANIAL 1% OINTMENT PHAR PHARMACY 250 14.73 NYSTATIN 15 GM OINT PHAR PHARMACY 250 5.84 NYSTATIN CR. 100,00U/GM 1 PHAR PHARMACY 250 6.07 NYSTATIN TOP. POWDER PHAR PHARMACY 250 5.31 OCTREOTIDE DRIP 1000mcg/2 PHAR PHARMACY 250 J2354 98.66 OCUFEN 0.03% OPTH PHAR PHARMACY 250 10.34 OFIRMEV 1000mg VIAL PHAR PHARMACY 250 30.81 OFLOXACIN OTIC SOLN 0.3% PHAR PHARMACY 250 19.05 ORENCIA 250MG PHAR PHARMACY 636 J0129 599.20 OXYCODONE 5 MG TAB PHAR PHARMACY 250 5.58 OXYCONTIN 10MG TAB PHAR PHARMACY 250 6.11 OXYCONTIN 20 MG TAB PHAR PHARMACY 250 7.15 OXYCONTIN 40 MG TAB PHAR PHARMACY 250 10.37 OYSCO-D 500 MG TAB PHAR PHARMACY 250 4.97 PACERONE 200MG.TAB PHAR PHARMACY 250 5.35 PANCREASE EC TAB PHAR PHARMACY 250 5.49 PAXIL 10 MG TAB PHAR PHARMACY 250 8.25 PAXIL 20 MG TAB PHAR PHARMACY 250 8.48 PAXIL 30 MG TAB PHAR PHARMACY 250 8.48 PAXIL 40 MG TAB PHAR PHARMACY 250 8.72 PEDIALYTE 8 oz PHAR PHARMACY 250 5.73 PEDIALYTE FREEZER POP 2.1 PHAR PHARMACY 250 5.33 PEDIALYTE LIQUID 1 LITER PHAR PHARMACY 250 15.82 PEDIAPRED 5 MG/5ML LIQUID PHAR PHARMACY 250 4.99 PEG-3350 PHAR PHARMACY 250 21.44 PEN VEE K 500 MG TAB PHAR PHARMACY 250 5.76 PEN VK 250MG/5ML 100 ML E PHAR PHARMACY 250 19.25 PEN VK 500 MG #4 PHAR PHARMACY 250 18.00 PENCILLIN G [1 MILLION U PHAR PHARMACY 250 J0558 71.46 PEPCID 20 MG TAB PHAR PHARMACY 250 5.00 PEPCID 20 MG/2ML - IV PHAR PHARMACY 250 17.19 PEPCID 40 MG TAB PHAR PHARMACY 250 8.59 PEPTO BISMOL PHAR PHARMACY 250 5.02 74 PEPTO BISMOL TAB PHAR PHARMACY 250 4.99 PERCOCET 5MG/325MG ER #6 PHAR PHARMACY 250 14.54 PERCOCET TAB PHAR PHARMACY 250 5.47 PERSANTINE 75 MG TAB PHAR PHARMACY 250 5.18 PHENERGAN 12.5 MG SUPP PHAR PHARMACY 250 7.21 PHENERGAN 25 MG #4 PHAR PHARMACY 250 13.00 PHENERGAN 25 MG SUPP PHAR PHARMACY 250 7.32 PHENERGAN 25 MG TAB PHAR PHARMACY 250 5.47 PHENERGAN 25 MG/ML - INJ PHAR PHARMACY 250 J2550 17.23 PHENERGAN 50 MG/ML - IM PHAR PHARMACY 250 J2550 17.34 PHENOBARBITAL 30 MG TAB PHAR PHARMACY 250 5.01 PHENOBARBITAL 60 MG/ML - PHAR PHARMACY 250 J2560 19.23 PHENOBARBITAL 64.8 MG TAB PHAR PHARMACY 250 4.97 PHENYLEPHRINE 10ml/ml 1ml PHAR PHARMACY 250 22.53 PHENYLEPHRINE NASEL SPRAY PHAR PHARMACY 250 14.95 PHOSLO 667MG TAB PHAR PHARMACY 250 5.29 PITOCIN 10 U/ML INJ PHAR PHARMACY 250 J2590 17.77 PLAN B 07.5mg BO (OTC) PHAR PHARMACY 250 50.20 PLAQUENIL 200 MG TAB PHAR PHARMACY 250 7.21 PLAVIX 75 MG TAB PHAR PHARMACY 250 10.17 PLENDIL 2.5MG ER TAB PHAR PHARMACY 250 5.17 PLETAL 50 MG PHAR PHARMACY 250 7.01 PNEUMOVAX-23 VACCINE SQ PHAR PHARMACY 636 90732 45.00 POLYMIXIN B 500,000 - IVP PHAR PHARMACY 250 79.00 POLYSPORIN OINT - 15GM PHAR PHARMACY 250 11.12 POLYSPORIN OINT - UD PHAR PHARMACY 250 5.99 POLYTRIM OPTH SOL PHAR PHARMACY 250 6.34 POM PHAR PHARMACY 250 4.95 POTASSIUM PHOSPHATE 15 MM PHAR PHARMACY 250 16.84 PPD TEST PHAR PHARMACY 302 86580 19.33 PRADAXA 150mg UD CAP PHAR PHARMACY 250 7.89 PRAVACHOL 20 MG TAB PHAR PHARMACY 250 7.50 PRAVACHOL 40 MG PHAR PHARMACY 250 11.13 PRAZOSIN 5MG PHAR PHARMACY 250 5.40 PRECEDEX 100mcg/ml 2ML VI PHAR PHARMACY 250 141.44 PRED FORTE 1% OPTH PHAR PHARMACY 250 9.01 PREDNISONE 50 MG #4 PHAR PHARMACY 250 13.25 PRELONE SYRUP 15 MG/5ML L PHAR PHARMACY 250 5.12 PREMARIN 0.3 MG TAB PHAR PHARMACY 250 6.34 PREMARIN VAG CREAM W/APP PHAR PHARMACY 250 99.66 PREVNAR 13 PHAR PHARMACY 250 90670 161.59 PRILOSEC 20MG OTC PHAR PHARMACY 250 7.90 75 PRIMAXIN 500 MG - IVPB PHAR PHARMACY 250 J0743 102.69 PRINIVIL 10 MG TAB PHAR PHARMACY 250 5.03 PRINIVIL 40 MG TAB PHAR PHARMACY 250 5.11 PRIVIGIN 10 GM PHAR PHARMACY 636 J1459 1.00 PROCARDIA 10 MG TAB PHAR PHARMACY 250 5.10 PROCARDIA XL 30 MG TAB PHAR PHARMACY 250 5.85 PROCARDIA XL 90 MG TAB PHAR PHARMACY 250 8.07 PROGRAF 1MG PHAR PHARMACY 636 J7507 9.53 PROLIA 1MG PHAR PHARMACY 636 J0897 1,031.95 PROPOFOL 10MG/ML 100ML PHAR PHARMACY 250 78.22 PROPOFOL 10MG/ML 50ML PHAR PHARMACY 250 72.60 PROSCAR 5 MG TAB PHAR PHARMACY 250 8.17 PROTAMINE 10MG/ML - IV PHAR PHARMACY 250 21.02 PROTONIX 40 MG TAB PHAR PHARMACY 250 6.70 PROTONIX 40 MG VIAL PHAR PHARMACY 250 24.33 PROTONIX DRIP 160mg/250ml PHAR PHARMACY 250 S0164 84.67 PROVERA 5 MG TAB PHAR PHARMACY 250 5.15 PROVIGIL TAB 200 MG TAB PHAR PHARMACY 250 10.85 PROZAC 10 MG CAP PHAR PHARMACY 250 5.05 PROZAC 20 MG CAP PHAR PHARMACY 250 7.09 PROZAC 40 MG CAP PHAR PHARMACY 250 5.97 PULMICORT 0.25MG RESPULES PHAR PHARMACY 250 9.93 PULMICORT RESPULES 0.25 M PHAR PHARMACY 250 9.25 PULMICORT RESPULES 0.5MG/ PHAR PHARMACY 250 11.64 PYRIDIUM 100 MG TAB PHAR PHARMACY 250 5.06 PYRIDIUM 200 MG #4 PHAR PHARMACY 250 13.25 PYRIDIUM 200 MG TAB PHAR PHARMACY 250 5.13 QUESTRAN PKTS 4 GM PHAR PHARMACY 250 6.14 QVAR 40MCG INHALER PHAR PHARMACY 250 5.57 QVAR 80 mcg INHALER PHAR PHARMACY 250 6.25 Q-VAR 80 MCG INHALER PHAR PHARMACY 250 5.64 RABAVERT PHAR PHARMACY 250 90675 215.00 RACEPINEPHRINE 2.25% INHA PHAR PHARMACY 250 6.05 RANEXA SA 500 MG PHAR PHARMACY 250 8.29 RECLAST PHAR PHARMACY 636 J3489 1,588.72 RECOMBIVAX HB VACCINE - A PHAR PHARMACY 250 59.91 REGADENOSON 0.4 MG/5ML PHAR PHARMACY 636 J2785 244.15 REGLAN 10 MG TAB PHAR PHARMACY 250 5.00 REGLAN 10 MG/2ML - INJ PHAR PHARMACY 250 J2765 16.90 REGLAN 10MG/10ML UD PHAR PHARMACY 250 5.70 REGLAN 5 MG TAB PHAR PHARMACY 250 5.12 RELAFEN 500 MG TAB PHAR PHARMACY 250 5.47 76 RELISTOR 12mg/0.6ml INJ PHAR PHARMACY 250 70.52 REMERON 15 MG TAB PHAR PHARMACY 250 5.12 REMERON 30 MG TAB PHAR PHARMACY 250 5.21 REMICADE 100 MG PHAR PHARMACY 636 J1745 1,135.60 REQUIP 0.25 MG TAB PHAR PHARMACY 250 7.24 REQUIP 0.5MG PHAR PHARMACY 250 4.55 REQUIP 1 MG PHAR PHARMACY 250 6.94 REQUIP 2 MG TAB PHAR PHARMACY 250 7.24 RESTORIL 15 MG CAP PHAR PHARMACY 250 5.05 RIBAVIRIN 200 MG CAP PHAR PHARMACY 250 5.59 RIFADIN 300 MG CAP PHAR PHARMACY 250 6.35 RISPERDAL 0.25 MG TAB PHAR PHARMACY 250 8.60 RISPERDAL 0.5 MG TAB PHAR PHARMACY 250 9.01 RISPERDAL 1 MG TAB PHAR PHARMACY 250 15.68 RISPERDAL 2 MG TAB PHAR PHARMACY 250 11.12 ROBAXIN 500MG PHAR PHARMACY 250 5.11 ROBAXIN 750 MG TAB PHAR PHARMACY 250 5.12 ROBINUL 0.2 MG/ML - IM PHAR PHARMACY 250 17.54 ROBINUL 0.2 MG/ML - IVP PHAR PHARMACY 250 18.90 ROBITUSSIN 200MG/10ml UD PHAR PHARMACY 250 5.50 ROBITUSSIN AC LIQUID PHAR PHARMACY 250 4.98 ROBITUSSIN DM LIQ PHAR PHARMACY 250 5.82 ROBITUSSIN PLAIN PHAR PHARMACY 250 5.77 ROCEPHIN 1 GM - IM PHAR PHARMACY 636 J0696 20.80 ROCEPHIN 1 GM - IVPB PHAR PHARMACY 250 J0696 77.52 ROCEPHIN 1 GM PREMIX PHAR PHARMACY 250 J0696 88.05 ROCEPHIN 250 MG - IM PHAR PHARMACY 250 J0696 18.76 ROCEPHIN 250 MG IVPB PHAR PHARMACY 250 J0696 81.90 ROCEPHIN 2GM IVPB PHAR PHARMACY 250 79.06 ROCEPHIN 500 MG - IM PHAR PHARMACY 250 J0696 20.03 ROCEPHIN INJ 500 MG IVPB PHAR PHARMACY 250 J0696 80.39 ROMAZICON 0.5 MG/5ML INJ PHAR PHARMACY 250 28.27 ROMAZICON INJ 0.1 MG/ML PHAR PHARMACY 250 107.38 SALSALATE 500 MG TAB PHAR PHARMACY 250 5.03 SANDOSTATIN 100 MCG/ML - PHAR PHARMACY 250 22.71 SENEKOT 8.6MG TAB PHAR PHARMACY 250 5.00 SENSORCAINE MPF 25% PHAR PHARMACY 250 24.04 SEPTRA DS #3 PHAR PHARMACY 250 12.75 SEPTRA DS TAB PHAR PHARMACY 250 5.06 SEPTRA INJ - IVPB PHAR PHARMACY 250 67.12 SEPTRA SUSP 2 OZ ER PHAR PHARMACY 250 19.50 SEPTRA SUSP 40 MG/5ML LIQ PHAR PHARMACY 250 5.06 77 SEROQUEL 25 MG TAB PHAR PHARMACY 250 7.09 SEROQUEL 100 MG TAB PHAR PHARMACY 250 8.95 SEROQUEL 200 MG TAB PHAR PHARMACY 250 11.82 SERZONE 100 MG TAB PHAR PHARMACY 250 6.59 SILVADENE 1% 25 GM CRM PHAR PHARMACY 250 5.06 SILVADENE 1% CREAM 400 GR PHAR PHARMACY 250 15.80 SILVADENE 1% CRM ER PHAR PHARMACY 250 22.75 SILVER NITRATE STICK PHAR PHARMACY 250 6.41 SINCALIDE INJ 5MCG PHAR PHARMACY 636 J2805 96.91 SINEMET 10/100 TAB PHAR PHARMACY 250 5.12 SINEMET 25/100 TAB PHAR PHARMACY 250 5.12 SINEMET 25/250 TAB PHAR PHARMACY 250 6.11 SINEMET CR 50/200 TAB PHAR PHARMACY 250 6.28 SINEMET ER 25/100 MG PHAR PHARMACY 250 5.10 SINEQUAN 10 MG CAP PHAR PHARMACY 250 5.04 SINEQUAN 100 MG CAP PHAR PHARMACY 250 5.12 SINEQUAN 25 MG CAP PHAR PHARMACY 250 5.05 SINEQUAN 75 MG CAP PHAR PHARMACY 250 5.12 SINGULAIR 10 MG TAB PHAR PHARMACY 250 10.72 SINGULAIR 5 MG TAB PHAR PHARMACY 250 8.39 SKELAXIN 800MG. TAB PHAR PHARMACY 250 7.64 SOD BICARB 8.4% PEDIATRIC PHAR PHARMACY 250 20.03 SOD. BICARB 8.4% 50ML A PHAR PHARMACY 250 18.88 SODIUM BICARBONATE 8.4% 5 PHAR PHARMACY 250 17.02 SODIUM CHLOR.4MEQ/ML30ML PHAR PHARMACY 250 16.55 SODIUM CHLORIDE 0.9% 10ML PHAR PHARMACY 250 16.84 SODIUM CHLORIDE 0.9% NEBS PHAR PHARMACY 250 5.01 SODIUM CHLORIDE 1 GM TAB PHAR PHARMACY 250 5.00 SODIUM PHOSPHATES 15ML - PHAR PHARMACY 250 17.62 SOL PHAR PHARMACY 250 5.57 SOLU-CORTEF 100 MG/2ML - PHAR PHARMACY 250 J1720 19.05 SOLU-MEDROL 1000 MG/8ML PHAR PHARMACY 250 J2930 85.15 SOLU-MEDROL 125 MG/2ML I PHAR PHARMACY 250 J2930 22.69 SOLU-MEDROL 40 MG/ML IV/ PHAR PHARMACY 250 J2920 19.17 SOMA 350 MG TABS PHAR PHARMACY 250 5.20 SPIRIVA 18 MCG/PUFF INHAL PHAR PHARMACY 250 12.26 STADOL 2MG/ML - IM/IV PHAR PHARMACY 250 J0595 18.18 STUARTNATAL TAB PHAR PHARMACY 250 5.55 SUBLIMAZE 100 MCG/2ML INJ PHAR PHARMACY 250 J3010 17.95 SUBLIMAZE 250 MCG/5 ML - PHAR PHARMACY 250 J3010 17.71 SUBLIMAZE 500MCG/50ML PCA PHAR PHARMACY 250 74.88 SUDAFED 30 MG TAB PHAR PHARMACY 250 5.13 78 SUFENTANIL 100 MCG/2ML - PHAR PHARMACY 250 34.88 SULF-10 OPHTH ER PHAR PHARMACY 250 14.89 SUPRANE INHALATION SOLUTI PHAR PHARMACY 250 146.47 SURFAK 240 MG CAP PHAR PHARMACY 250 5.14 SYMBICORT 160mcg/4.5 MCG PHAR PHARMACY 250 15.29 SYMBICORT 80/45 INH 60 IN PHAR PHARMACY 250 6.39 SYMMETREL 100 MG CAP PHAR PHARMACY 250 5.59 SYNTHROID 0.025 MG TAB PHAR PHARMACY 250 5.07 SYNTHROID 0.05 MG - TAB PHAR PHARMACY 250 5.29 SYNTHROID 0.075 MG TAB PHAR PHARMACY 250 5.11 SYNTHROID 0.088 MG TAB PHAR PHARMACY 250 5.11 SYNTHROID 0.1 MG TAB ( PHAR PHARMACY 250 5.11 SYNTHROID 0.112 MG TAB PHAR PHARMACY 250 5.47 SYNTHROID 0.125 MG TAB PHAR PHARMACY 250 5.13 SYNTHROID 0.137 MG TABLET PHAR PHARMACY 250 6.51 SYNTHROID 0.15 MG TAB PHAR PHARMACY 250 5.14 SYNTHROID 0.175 MG TAB PHAR PHARMACY 250 6.69 SYNTHROID 0.2 MG TAB PHAR PHARMACY 250 5.19 SYNTHROID 100 mcg/VIAL PHAR PHARMACY 250 92.80 SYSTANE EYE DROPS PHAR PHARMACY 250 5.47 TAMBOCOR 100 MG TAB PHAR PHARMACY 250 5.27 TAMBOCOR 50 MG TAB PHAR PHARMACY 250 5.36 TAMIFLU 30MG TAB PHAR PHARMACY 250 17.10 TAMIFLU 75 MG CAP PHAR PHARMACY 250 12.53 TAMIFLU SUSP 6MG/ML PHAR PHARMACY 250 J3490 158.00 TAPAZOLE 10 MG TAB PHAR PHARMACY 250 6.05 T-D ADULT 0.5ML PHAR PHARMACY 250 90714 38.13 TEGRETOL 100 MG TAB PHAR PHARMACY 250 5.11 TEGRETOL 200 MG TAB PHAR PHARMACY 250 5.00 TELARO 600MG/ML PHAR PHARMACY 250 J0712 203.67 TENORMIN 100 MG TAB PHAR PHARMACY 250 5.06 TENORMIN 25 MG TAB PHAR PHARMACY 250 5.06 TENORMIN 50 MG TAB PHAR PHARMACY 250 5.00 TESSALON PERLES 100 MG CA PHAR PHARMACY 250 5.24 TETRACAINE 20mg / 2ml AMP PHAR PHARMACY 250 24.20 THEO-DUR 100 MG TAB PHAR PHARMACY 250 5.33 THEO-DUR 300 MG TAB PHAR PHARMACY 250 5.86 THIAMINE 100 MG TAB PHAR PHARMACY 250 5.77 THIAMINE 2OO MG/2ML - IM/ PHAR PHARMACY 250 J3411 24.96 THORAZINE 25 MG PHAR PHARMACY 250 5.13 THROMBIN 10,000U/VIAL PHAR PHARMACY 250 145.51 THROMBIN 5000 UNITS PHAR PHARMACY 250 134.55 79 TIMOPTIC 0.5% OPTH SOL PHAR PHARMACY 250 5.07 TOBRAMYCIN 0.3% ER PHAR PHARMACY 250 14.66 TOPAMAX 100 MG TAB PHAR PHARMACY 250 10.51 TOPAMAX 25 MG TAB PHAR PHARMACY 250 6.71 TOPROL XL 100MG TAB PHAR PHARMACY 250 6.28 TOPROL XL 50 MG TAB PHAR PHARMACY 250 6.69 TORADOL 10 MG TAB PHAR PHARMACY 250 5.06 TORADOL 15MG/ML INJ PHAR PHARMACY 250 17.36 TORADOL 30 MG/ML - INJ PHAR PHARMACY 250 J1885 17.31 TORADOL 60 mg/2ml INJ IM PHAR PHARMACY 250 25.26 TPN PHAR PHARMACY 250 425.00 TRAMADOL 50MG THP #4 PHAR PHARMACY 250 13.78 TRANDATE 100 MG TAB PHAR PHARMACY 250 5.06 TRANDATE 200 MG TAB PHAR PHARMACY 250 5.10 TRANEXAMIC ACID 1000mg/10 PHAR PHARMACY 250 58.93 TRANSDERM-SCOP PATCH PHAR PHARMACY 250 14.63 TRAVATAN 2.5ML 0.004% PHAR PHARMACY 250 7.17 TRAZODONE 100 MG TAB PHAR PHARMACY 250 5.77 TRAZODONE 150 MG TAB PHAR PHARMACY 250 5.06 TRAZODONE 25 MG TAB PHAR PHARMACY 250 5.00 TRAZODONE 50 MG TAB PHAR PHARMACY 250 5.06 TRENTAL 400 MG TAB PHAR PHARMACY 250 5.17 TRICOR 48MG PHAR PHARMACY 250 6.00 TRICOR NFE 145 MG TAB PHAR PHARMACY 250 8.69 TRILAFON 2 MG TAB PHAR PHARMACY 250 5.15 TRILEPTAL 150 MG TAB PHAR PHARMACY 250 6.22 TRYPAN BLUE PHAR PHARMACY 636 Q9968 64.00 TUCKS PAD PHAR PHARMACY 250 4.99 TUMS 500 MG TAB PHAR PHARMACY 250 5.04 TUSSIONEX SUSP PHAR PHARMACY 250 7.21 TYENOL 160MG/5ML PHAR PHARMACY 250 5.63 TYLENOL #3 #6 ER PHAR PHARMACY 250 14.19 TYLENOL #3 TAB PHAR PHARMACY 250 5.06 TYLENOL 325 MG TAB PHAR PHARMACY 250 4.97 TYLENOL 500 MG - TAB PHAR PHARMACY 250 5.00 TYLENOL 500MG/5ML LIQUID PHAR PHARMACY 250 4.62 TYLENOL c COD SOLU UD PHAR PHARMACY 250 5.85 TYLENOL SUPPOSITORY 120 PHAR PHARMACY 250 5.10 TYLENOL SUPPOSITORY 325 M PHAR PHARMACY 250 5.13 TYLENOL SUPPOSITORY 650 M PHAR PHARMACY 250 5.46 TYLENOL W/COD ELIX PHAR PHARMACY 250 5.05 TYLENOL WITH COD ELIXIR 2 PHAR PHARMACY 250 14.10 80 ULORIC 40mg TAB PHAR PHARMACY 250 11.29 ULTANE INHALATION SOLUTIO PHAR PHARMACY 250 5.72 ULTRAM 50 MG TAB PHAR PHARMACY 250 5.82 UNASYN 1.5 GM - IVPB PHAR PHARMACY 250 J0295 75.80 UNASYN 3 GM - IVPB PHAR PHARMACY 250 75.58 UROXATRAL SR 10MG PHAR PHARMACY 250 7.85 VALCOMYCIN 1.25GM PREMIX PHAR PHARMACY 636 J3370 80.17 VALIUM 10 MG TAB PHAR PHARMACY 250 5.06 VALIUM 2 MG TAB PHAR PHARMACY 250 5.06 VALIUM 5 MG TAB PHAR PHARMACY 250 5.06 VALIUM 5 MG/ML - 2ML CARP PHAR PHARMACY 250 4.85 VALIUM 5 MG/ML - INJ PHAR PHARMACY 250 J3360 18.64 VALTREX 1000 MG PHAR PHARMACY 250 16.81 VANCOMYCIN 1 GM IVPB PHAR PHARMACY 250 J3370 74.52 VANCOMYCIN 1.5GM PREMIX PHAR PHARMACY 250 J3370 84.34 VANCOMYCIN 125MG/5ML PO PHAR PHARMACY 250 19.04 VANCOMYCIN 1GM PREMIX PHAR PHARMACY 636 J3370 78.89 VANCOMYCIN 2.5 GM/500 ML PHAR PHARMACY 250 89.35 VANCOMYCIN 500 MG - IVPB PHAR PHARMACY 636 J3370 84.63 VANCOMYCIN 750MG IVPB PHAR PHARMACY 636 J3370 77.00 VANCOMYCIN HCL 750MG VIAL PHAR PHARMACY 250 70.56 VANTIN 200 MG TAB PHAR PHARMACY 250 8.19 VARIVAX PHAR PHARMACY 250 90716 129.18 VASELINE - 30GM PHAR PHARMACY 250 4.96 VASOPRESSIN 20 U/ML - IM/ PHAR PHARMACY 250 17.77 VASOTEC 1.25 MG INJ PHAR PHARMACY 250 18.05 VASOTEC 20 MG PHAR PHARMACY 250 6.22 VASOTEC 5 MG TAB PHAR PHARMACY 250 6.17 VECURONIUM PHAR PHARMACY 250 18.87 VENOFER 100 MG/5ML IV PHAR PHARMACY 636 J1756 112.98 VENOFER IVPB 200mg/100ml PHAR PHARMACY 636 J1756 160.25 VENTOLIN 0.5% INH SOL PHAR PHARMACY 250 6.98 VENTOLIN 0.083% NEBS PHAR PHARMACY 250 5.24 VENTOLIN HFA INHA 8GM ER PHAR PHARMACY 250 30.42 VENTOLIN HFA INHALER 18GM PHAR PHARMACY 250 50.95 VENTOLIN HFA INHALER 8 GM PHAR PHARMACY 250 4.78 VERSED 10MG/1ML - IM/IV PHAR PHARMACY 250 J2250 18.56 VERSED 2ML/2ML SYRINGE PHAR PHARMACY 250 19.40 VERSED 5 MG/5ML - IM/IV PHAR PHARMACY 250 J2250 18.58 VERSED DRIP 100mg/250ml PHAR PHARMACY 250 J2250 218.96 VESICARE 5 MG PHAR PHARMACY 250 8.54 VFEND 200 MG IV PHAR PHARMACY 636 J3465 175.84 81 VFEND 200 MG TAB PHAR PHARMACY 250 39.81 VIBRA-TABS 100 MG TABS PHAR PHARMACY 250 5.04 Vilazodone HCL 20 mg PHAR PHARMACY 250 11.78 VIOKASE TABS - (PANCRELIP PHAR PHARMACY 250 5.59 VISTARIL 25 MG CAP PHAR PHARMACY 250 5.26 VISTARIL 25MG/ML 1ML PHAR PHARMACY 250 19.96 VISTARIL 50 MG CAP PHAR PHARMACY 250 5.03 VIT B COMPLEX PHAR PHARMACY 250 4.96 VIT B-12 100 MCG PHAR PHARMACY 250 5.91 VIT B-12 IM/SC PHAR PHARMACY 250 J3420 17.08 VIT B-6 50 MG TAB PHAR PHARMACY 250 4.97 VITAMIN B-12 500 MCG TAB PHAR PHARMACY 250 4.96 VITAMIN C 250 MG TAB PHAR PHARMACY 250 5.00 VITAMIN C 500 MG TAB PHAR PHARMACY 250 5.06 VITAMIN D 1000 IU TAB PHAR PHARMACY 250 4.52 VITAMIN D 400 IU CAP PHAR PHARMACY 250 5.00 VITAMIN E 400 IU CAP PHAR PHARMACY 250 5.00 VITAMIN K 1 MG/0.5ML NEON PHAR PHARMACY 250 J3430 22.64 VITAMIN K 10 MG/ML INJ PHAR PHARMACY 250 J3430 22.82 VITTAMIN D 50,000 UNITS C PHAR PHARMACY 250 5.60 VOLTAREN 75 MG TAB PHAR PHARMACY 250 5.47 VYTORIN 10MG/20MG TAB PHAR PHARMACY 250 14.53 WELLBUTRIN 75 MG TAB PHAR PHARMACY 250 5.17 WELLBUTRIN SR 100 MG TAB PHAR PHARMACY 250 5.76 WELLBUTRIN SR 150 MG TAB PHAR PHARMACY 250 5.82 WELLBUTRIN XL 150 MGTAB PHAR PHARMACY 250 8.72 XANAX 0.25 MG TAB PHAR PHARMACY 250 5.00 XANAX 0.5 MG TAB PHAR PHARMACY 250 5.58 XANAX 1.0 MG TAB PHAR PHARMACY 250 5.72 XARELTO 15MG TAB PHAR PHARMACY 250 13.57 XARETTO 10MG PHAR PHARMACY 250 12.04 XIFAXAN 550 MG TABLET PHAR PHARMACY 250 30.83 XOPENEX 1.25 MG/3ML INH S PHAR PHARMACY 250 8.29 XYLOCAINE MPF 2% 20ml/m PHAR PHARMACY 250 18.32 XYLOCAINE 1% - IV/IM PHAR PHARMACY 250 J2001 17.37 XYLOCAINE 1% MPF - IV/IM PHAR PHARMACY 250 J2001 26.12 XYLOCAINE 2% - IV/IM PHAR PHARMACY 250 J2001 16.83 XYLOCAINE 2% MPF - IV/IM PHAR PHARMACY 250 17.20 XYLOCAINE 2% VISCOUS - 20 PHAR PHARMACY 250 5.70 XYLOCAINE 4% TOP SOL PHAR PHARMACY 250 8.58 LIDOCAINE 1% W/EPI 20ML MDV INJ PHAR PHARMACY 250 22.46 XYLOCAINE W/EPI 1% MPF - PHAR PHARMACY 250 22.40 82 XYLOCAINE W/EPI 2% - IV/I PHAR PHARMACY 250 18.07 XYLOCAINE W/EPI 2% MPF - PHAR PHARMACY 250 31.26 ZANAFLEX 4 MG TAB PHAR PHARMACY 250 5.29 ZANTAC 150 MG TAB PHAR PHARMACY 250 5.24 ZANTAC 50 MG/2ML - IM/IV PHAR PHARMACY 250 J2780 17.48 ZANTAC 50 MG/2ML - IVPB PHAR PHARMACY 250 J2780 67.98 ZANTAC SYRUP 15 MG/ML PHAR PHARMACY 250 5.15 ZAROXOLYN 2.5MG PHAR PHARMACY 250 5.68 ZAROXOLYN 5 MG TAB PHAR PHARMACY 250 5.73 ZEBETA 5MG PHAR PHARMACY 250 5.53 ZEMURON 10 MG/ML - IV PHAR PHARMACY 250 40.86 ZESTRIL 10 MG TAB PHAR PHARMACY 250 5.06 ZESTRIL 2.5 MG TAB PHAR PHARMACY 250 5.00 ZESTRIL 20 MG TAB PHAR PHARMACY 250 5.14 ZESTRIL 5 MG TAB PHAR PHARMACY 250 5.06 ZETIA 10 MG TAB PHAR PHARMACY 250 9.03 ZINC 220 MG TAB PHAR PHARMACY 250 4.97 ZINC 50MG TAB PHAR PHARMACY 250 4.55 ZINC LOZENGE PHAR PHARMACY 250 5.00 ZINC OXIDE OINT - 2 OZ PHAR PHARMACY 250 5.83 ZITHROMAX 250 MG TAB PHAR PHARMACY 250 15.27 ZITHROMAX 100MG/5 ML 15 M PHAR PHARMACY 250 55.75 ZITHROMAX 200 MG/5ML 15ML PHAR PHARMACY 250 J0456 25.36 ZITHROMAX 200MG/5ML 15 ML PHAR PHARMACY 250 J0456 66.25 ZITHROMAX 500 MG - IV PHAR PHARMACY 250 J0456 105.10 ZITHROMAX 500 MG TAB PHAR PHARMACY 250 7.00 ZITHROMAX 500MG PREMIX IV PHAR PHARMACY 250 J0456 83.88 ZOCOR 10 MG TAB PHAR PHARMACY 250 7.49 ZOCOR 20 MG TAB PHAR PHARMACY 250 6.53 ZOCOR 40 MG TAB PHAR PHARMACY 250 9.38 ZOFRAN 4 MG ODT TAB PHAR PHARMACY 250 5.27 ZOFRAN 4 MG TAB PHAR PHARMACY 250 20.19 ZOFRAN 4 MG/2ML - INJ PHAR PHARMACY 636 J2405 31.15 ZOFRAN 4MG ODT #4 PHAR PHARMACY 250 14.29 ZOLOFT 100 MG TAB PHAR PHARMACY 250 5.24 ZOLOFT 25 MG TAB PHAR PHARMACY 250 5.07 ZOLOFT 50 MG TAB PHAR PHARMACY 250 5.07 ZOMIG 5 MG TAB PHAR PHARMACY 250 25.02 ZOSTAVAX PHAR PHARMACY 250 90736 201.81 ZOSTRIX 0.025% CREAM PHAR PHARMACY 250 10.64 ZOSYN 2.25 GM - IVPB PHAR PHARMACY 250 J2543 81.32 ZOSYN 2.25 GM INJ PHAR PHARMACY 250 J2543 30.82 83 ZOSYN 3.375 GM - IVPB PHAR PHARMACY 250 J2543 91.47 ZOSYN 4.5 GM IVPB PHAR PHARMACY 250 J2543 94.12 ZOVIRAX IV 500 INJ PHAR PHARMACY 250 J0133 69.90 ZOVIRAX 1000MG/20ML VIAL PHAR PHARMACY 250 76.33 ZOVIRAX 200 MG CAPSULE PHAR PHARMACY 250 5.08 ZOVIRAX 400 MG CAP PHAR PHARMACY 250 5.51 ZOVIRAX 800 MG TAB PHAR PHARMACY 250 6.22 ZYLOPRIM 300 MG TAB PHAR PHARMACY 250 5.12 ZYLOPRIM 100 MG TAB PHAR PHARMACY 250 5.70 ZYPREXA 10 MG TAB PHAR PHARMACY 250 15.97 ZYPREXA 2.5 MG TAB PHAR PHARMACY 250 11.56 ZYPREXA 5 MG TAB PHAR PHARMACY 250 12.72 ZYRTEC 10 MG TAB PHAR PHARMACY 250 7.24 ZYVOX 600 MG IVPB PHAR PHARMACY 636 J2020 149.36 ZYVOX 600 MG TAB PHAR PHARMACY 250 84.06 INJ RHOGAM 300 MCG PHAR PHARMACY 250 J2790 130.00 RHOGAM INJECTION PHAR PHARMACY 636 J2790 265.00 *BLOOD GLUCOSE MONITORING PHAR PHARMACY 250 J3490 19.69 *EMOLLIENT - OINTMENT** PHAR PHARMACY 250 J3490 4.99 0.9 % SODIUM CHLORIDE IV 100 ML PHAR PHARMACY 250 J3490 8.03 0.9 % SODIUM CHLORIDE IV 1000 ML PHAR PHARMACY 250 J7030 6.83 0.9 % SODIUM CHLORIDE IV 150 ML PHAR PHARMACY 250 J3490 10.75 0.9 % SODIUM CHLORIDE IV 250 ML PHAR PHARMACY 250 J7050 8.48 0.9 % SODIUM CHLORIDE IV 50 ML PHAR PHARMACY 250 J3490 3.24 0.9 % SODIUM CHLORIDE IV 500 ML PHAR PHARMACY 250 J7040 5.84 3 % SODIUM CHLORIDE INH SOLN PHAR PHARMACY 250 J3490 7.90 7 % SODIUM CHLORIDE INH SOLN PHAR PHARMACY 250 J3490 7.23 A&D OINTMENT 30 GM PHAR PHARMACY 250 J3490 43.29 ABATACEPT INJ 250 MG PHAR PHARMACY 636 J3490 1,785.90 ABSORBABLE GELATIN POWDER ENVELOPE 1 GM PHAR PHARMACY 250 J3490 165.61 ABSORBABLE GELATIN SPONGE 12-7MM PHAR PHARMACY 250 J3490 9.39 ABSORBABLE GELATIN SPONGE COMPRESSED SIZ PHAR PHARMACY 250 J3490 110.42 ACARBOSE TAB 50 MG PHAR PHARMACY 250 J3490 7.88 ACEBUTOLOL CAP 200 MG PHAR PHARMACY 250 J3490 8.93 ACETAMINOPHEN 500 MG/15ML ORAL SOLUTION PHAR PHARMACY 250 J3490 5.06 ACETAMINOPHEN CHEW TAB 80 MG PHAR PHARMACY 250 J3490 6.79 ACETAMINOPHEN DRP 80 MG/0.8 ML PHAR PHARMACY 250 J3490 5.07 ACETAMINOPHEN ES LIQ 500 MG/15 ML PHAR PHARMACY 250 J3490 5.25 ACETAMINOPHEN INJ 1000 MG/ML PHAR PHARMACY 636 J0131 160.00 ACETAMINOPHEN LIQ 160 MG/5 ML PHAR PHARMACY 250 J3490 7.06 ACETAMINOPHEN SUPP 120 MG PHAR PHARMACY 250 J3490 7.47 ACETAMINOPHEN SUPP 325 MG PHAR PHARMACY 250 J3490 7.57 84 ACETAMINOPHEN SUPP 650 MG PHAR PHARMACY 250 J3490 7.59 ACETAMINOPHEN TAB 325 MG PHAR PHARMACY 250 J3490 6.76 ACETAMINOPHEN TAB 500 MG PHAR PHARMACY 250 J3490 6.78 ACETAMINOPHEN/COD ELIX 120/12 MG - 120 M PHAR PHARMACY 253 J3490 46.31 ACETAMINOPHEN/COD ELIX 120/12 MG - 5 ML PHAR PHARMACY 250 J3490 8.05 ACETAMINOPHEN/COD TAB 300/30 MG PHAR PHARMACY 250 J3490 8.18 ACETAMINOPHEN/COD TAB 300/60 MG PHAR PHARMACY 250 J3490 5.14 ACETAMINOPHEN/COD TAB 325/30 MG ER PK PHAR PHARMACY 253 J3490 46.16 ACETAZOLAMIDE CAP 500 MG PHAR PHARMACY 250 J3490 6.42 ACETAZOLAMIDE INJ 500 MG PHAR PHARMACY 636 J3490 162.19 ACETAZOLAMIDE TAB 250 MG PHAR PHARMACY 250 J3490 11.13 ACETIC ACID/HYDROCORTISONE OTIC 15 ML PHAR PHARMACY 250 J3490 35.70 ACETYLCHOLINE 1 % OPTH PHAR PHARMACY 250 J3490 54.60 ACETYLCYSTEINE 10% INH 100 MG/ML - 30 ML PHAR PHARMACY 636 J7608 15.41 ACETYLCYSTEINE 20% INH 200 MG/ML - 30 ML PHAR PHARMACY 636 J7608 23.22 ACETYLCYSTEINE 20% INH 200 MG/ML - 4 ML PHAR PHARMACY 250 J7608 27.36 ACETYLCYSTEINE INJ 6 GM/30 ML PHAR PHARMACY 250 J3490 322.84 ACYCLOVIR 5% CREAM - 5 GM PHAR PHARMACY 250 J3490 20.72 ACYCLOVIR 5% OINT - 15 GM PHAR PHARMACY 250 J3490 124.63 ACYCLOVIR 5% OINT - 3 GM PHAR PHARMACY 250 J3490 50.80 ACYCLOVIR CAP 200 MG PHAR PHARMACY 250 J8499 8.75 ACYCLOVIR CAP 400 MG PHAR PHARMACY 250 J8499 9.61 ACYCLOVIR INJ 1000 MG PHAR PHARMACY 250 J3490 75.23 ACYCLOVIR INJ 500 MG PHAR PHARMACY 250 J0133 125.50 ACYCLOVIR SUSP 200 MG/5 ML PHAR PHARMACY 250 J8499 44.49 ACYCLOVIR SUSP 80 MG/ML PHAR PHARMACY 250 J3490 18.00 ACYCLOVIR TAB 800 MG PHAR PHARMACY 250 J3490 5.05 ADALIMUMAB INJ 40 MG PHAR PHARMACY 250 J3490 798.07 ADENOSINE INJ 6 MG/2 ML PHAR PHARMACY 250 J3490 29.04 AEROCHAMBER W/LARGE MASK PHAR PHARMACY 250 J3490 21.50 AEROCHAMBER W/MED MASK PHAR PHARMACY 250 J3490 59.40 AEROCHAMBER W/O MASK PHAR PHARMACY 250 J3490 70.44 AEROCHAMBER W/SMALL MASK PHAR PHARMACY 250 J3490 56.71 ALBUMIN BUMINATE 25% 12.5 GM - 50 ML PHAR PHARMACY 250 J3490 169.47 ALBUTEROL 10 MG / IPRATROPIUM 1MG CONT PHAR PHARMACY 250 J3490 7.05 ALBUTEROL 0.083% NEB SOLN PHAR PHARMACY 250 J7613 11.00 ALBUTEROL 0.5% INH SOLN PHAR PHARMACY 250 J7611 60.56 ALBUTEROL 10 MG CONT MED PHAR PHARMACY 250 J3490 7.05 ALBUTEROL 15 MG/ IPRATROPIUM 1 MG HIGH PHAR PHARMACY 250 J3490 62.27 ALBUTEROL 5 MG/IPRATROPIUM 1 MG - CONT L PHAR PHARMACY 250 J3490 7.05 ALBUTEROL INH 18 GM ER PHAR PHARMACY 250 J3490 68.94 ALBUTEROL INH 8 GM PHAR PHARMACY 250 J3490 77.85 85 ALBUTEROL INH 8 GM ER PHAR PHARMACY 253 J3490 77.85 ALBUTEROL INH 8.5 GM PHAR PHARMACY 250 J3490 69.87 ALBUTEROL REPATABS 4 MG PHAR PHARMACY 250 J3490 15.63 ALBUTEROL SOLN 2 MG/5 ML PHAR PHARMACY 250 J3490 10.69 ALBUTEROL TAB 2 MG PHAR PHARMACY 250 J3490 5.00 ALBUTEROL TAB 4 MG PHAR PHARMACY 250 J3490 14.60 ALENDRONATE TAB 10 MG PHAR PHARMACY 250 J3490 10.63 ALENDRONATE TAB 35 MG PHAR PHARMACY 250 J3490 34.28 ALENDRONATE TAB 5 MG PHAR PHARMACY 250 J3490 10.63 ALENDRONATE TAB 70 MG PHAR PHARMACY 250 J3490 34.28 ALFUZOSIN ER TAB 10 MG PHAR PHARMACY 250 J3490 7.33 ALLOPURINOL TAB 100 MG PHAR PHARMACY 250 J3490 7.22 ALLOPURINOL TAB 300 MG PHAR PHARMACY 250 J3490 7.78 ALPHA-1 PROTEINASE INHIBITOR HUMAN INJ PHAR PHARMACY 636 J0257 795.40 ALPHA-PROTEINASE INHIBITOR (HUMAN) INJ 1 PHAR PHARMACY 636 J0256 701.14 ALPRAZOLAM TAB 0.25 MG PHAR PHARMACY 250 J3490 8.55 ALPRAZOLAM TAB 0.5 MG PHAR PHARMACY 250 J3490 8.68 ALPRAZOLAM TAB 1.0 MG PHAR PHARMACY 250 J3490 5.72 ALTEPLASE INJ 2 MG PHAR PHARMACY 250 J2997 266.37 ALTEPLASE INJ 50 MG PHAR PHARMACY 250 J2997 7,205.99 ALUM HYD/MAG TRIS LIQ PHAR PHARMACY 250 J3490 6.72 ALUM HYD/MAG TRIS TAB PHAR PHARMACY 250 J3490 6.79 ALUM/MAG HYD/SIMETHICONE PHAR PHARMACY 250 J3490 6.71 ALUMINUM HYDROXIDE SUSP PHAR PHARMACY 250 J3490 8.23 ALVIMOPAN CAP 12 MG PHAR PHARMACY 250 J3490 261.01 AMANTADINE CAP 100 MG PHAR PHARMACY 250 J3490 9.41 AMIKACIN INJ 1 GM/4 ML PHAR PHARMACY 250 J3490 134.73 AMILORIDE TAB 5 MG PHAR PHARMACY 250 J3490 7.05 AMILORIDE/HCTZ TAB 5/50 MG PHAR PHARMACY 250 J3490 5.12 AMINOPHYLLINE INJ 250 MG/10 ML PHAR PHARMACY 250 J0280 113.49 AMINOPHYLLINE INJ 500 MG/20 ML PHAR PHARMACY 250 J0280 95.69 AMIODARONE DRIP 900 MG/18 ML PHAR PHARMACY 250 J3490 122.59 AMIODARONE INJ 150 MG/3 ML PHAR PHARMACY 250 J0282 97.40 AMIODARONE PREMIX 150 MG/100 ML PHAR PHARMACY 250 J0282 151.18 AMIODARONE TAB 100 MG PHAR PHARMACY 250 J3490 16.70 AMIODARONE TAB 200 MG PHAR PHARMACY 250 J3490 7.49 AMIODARONE/D5W IVPB 900 MG/500 ML PHAR PHARMACY 250 J3490 96.39 AMITRIPTYLINE TAB 10 MG PHAR PHARMACY 250 J3490 7.12 AMITRIPTYLINE TAB 100 MG PHAR PHARMACY 250 J3490 5.07 AMITRIPTYLINE TAB 25 MG PHAR PHARMACY 250 J3490 7.55 AMITRIPTYLINE TAB 50 MG PHAR PHARMACY 250 J3490 8.26 AMLODIPINE TAB 10 MG PHAR PHARMACY 250 J3490 9.73 86 AMLODIPINE TAB 2.5 MG PHAR PHARMACY 250 J3490 9.02 AMLODIPINE TAB 5 MG PHAR PHARMACY 250 J3490 8.90 AMLODIPINE/BENAZEPRIL CAP 10/20 MG PHAR PHARMACY 250 J3490 7.09 AMLODIPINE/BENAZEPRIL CAP 5/10 MG PHAR PHARMACY 250 J3490 6.67 AMLODIPINE/BENAZEPRIL CAP 5/20 MG PHAR PHARMACY 250 J3490 7.78 AMMONIA INHALANT PHAR PHARMACY 250 J3490 7.38 AMMONIUM LACTATE 12% CRM PHAR PHARMACY 250 J3490 17.82 AMOXICILLIN CAP 250 MG PHAR PHARMACY 250 J3490 5.19 AMOXICILLIN CAP 500 MG PHAR PHARMACY 250 J3490 7.27 AMOXICILLIN CHEW 250 MG PHAR PHARMACY 250 J3490 7.60 AMOXICILLIN ER PACK 500 MG (4 CAPS) PHAR PHARMACY 253 J3490 45.23 AMOXICILLIN LIQ 125 MG/5 ML - 150 ML PHAR PHARMACY 250 J3490 48.77 AMOXICILLIN LIQ 250 MG/5 ML - 150 ML PHAR PHARMACY 250 J3490 52.75 AMOXICILLIN SUSP 125 MG/5 ML - 150 ML ER PHAR PHARMACY 253 J3490 48.77 AMOXICILLIN SUSP 250 MG/5 ML - 150 ML ER PHAR PHARMACY 250 J3490 52.75 AMOXICILLIN SUSP 400 MG/5 ML - 75 ML PHAR PHARMACY 250 J3490 5.10 AMOXICILLIN SUSP 400 MG/5 ML - 75 ML ER PHAR PHARMACY 250 J3490 15.83 AMOXICILLIN TAB 875 MG PHAR PHARMACY 250 J3490 7.92 AMOXICILLIN/CLAVULANATE ES SUSP 600 MG/5 PHAR PHARMACY 250 J3490 61.17 AMOXICILLIN/CLAVULANATE SUSP 125 MG/5 ML PHAR PHARMACY 250 J3490 15.69 AMOXICILLIN/CLAVULANATE SUSP 125 MG/5 ML PHAR PHARMACY 250 J3490 65.41 AMOXICILLIN/CLAVULANATE SUSP 250 MG/5 ML PHAR PHARMACY 250 J3490 189.67 AMOXICILLIN/CLAVULANATE SUSP 250 MG/5 ML PHAR PHARMACY 253 J3490 189.67 AMOXICILLIN/CLAVULANATE TAB 250 MG PHAR PHARMACY 250 J3490 14.66 AMOXICILLIN/CLAVULANATE TAB 500 MG PHAR PHARMACY 250 J3490 11.79 AMOXICILLIN/CLAVULANATE TAB 875 MG PHAR PHARMACY 250 J3490 13.49 AMOXICILLIN/CLAVULANATE XR TAB 1000/62.5 PHAR PHARMACY 250 J3490 16.09 AMOXIL PEDIATRIC DROPS 50 MG/ML PHAR PHARMACY 250 J3490 16.42 AMPHOTERICIN B LIPOSOME INJ 50 MG PHAR PHARMACY 250 J3490 494.51 AMPICILLIN INJ 1 GM PHAR PHARMACY 250 J0290 30.07 AMPICILLIN INJ 500 MG PHAR PHARMACY 250 J0290 24.96 AMPICILLIN IVPB 1 GM PHAR PHARMACY 250 J0290 106.17 AMPICILLIN IVPB 2 GM PHAR PHARMACY 250 J0290 117.68 AMPICILLIN IVPB 500 MG PHAR PHARMACY 250 J0290 101.06 AMPICILLIN/SULBACTAM IVPB 3 GM PHAR PHARMACY 636 J0295 118.30 AMYLASE/LIPASE/PROTEASE CAP 20 MG PHAR PHARMACY 250 J3490 4.94 AMYLASE/LIPASE/PROTEASE DR CAP PHAR PHARMACY 250 J3490 9.19 ANASTROZOLE TAB 1 MG PHAR PHARMACY 636 J8999 9.48 ANTACID OF CHOICE PHAR PHARMACY 250 J3490 4.95 ANTIPYRINE/BENZOCAINE PHAR PHARMACY 250 J3490 20.69 APIXABAN TAB 2.5 MG PHAR PHARMACY 250 J3490 17.98 APIXABAN TAB 5 MG PHAR PHARMACY 250 J3490 17.98 87 APRACLONIDINE 0.5% OPTH PHAR PHARMACY 250 J3490 81.76 APREPITANT CAP 40 MG PHAR PHARMACY 250 J3490 197.45 AQUAPHOR OINT 1.75 OZ PHAR PHARMACY 250 J3490 43.44 ARIPIPRAZOLE TAB 10 MG PHAR PHARMACY 250 J3490 49.89 ARIPIPRAZOLE TAB 15 MG PHAR PHARMACY 250 J3490 37.59 ARIPIPRAZOLE TAB 2 MG PHAR PHARMACY 250 J3490 49.78 ARIPIPRAZOLE TAB 5 MG PHAR PHARMACY 250 J3490 49.89 ARTIFICIAL SALIVA PHAR PHARMACY 250 J3490 22.40 ARTIFICIAL TEARS OPHTH OINTMENT PHAR PHARMACY 250 J3490 48.47 ASA/CAFFEINE/BUTALBITAL CAP 325/40/50 MG PHAR PHARMACY 250 J3490 16.02 ASA/CAFFEINE/BUTALBITAL/CODEINE CAP 325/ PHAR PHARMACY 250 J3490 25.16 ASCORBIC ACID INJ 500 MG/ML PHAR PHARMACY 250 J3490 165.24 ASCORBIC ACID TAB 250 MG PHAR PHARMACY 250 J3490 6.73 ASCORBIC ACID TAB 500 MG PHAR PHARMACY 250 J3490 6.78 ASCRIPTIN TAB 325 MG PHAR PHARMACY 250 J3490 5.41 ASENAPINE SL TAB 10 MG PHAR PHARMACY 250 J3490 36.24 ASMANEX TWISTHALER 14 DOSE PHAR PHARMACY 250 J3490 10.90 ASPIRIN CHEW TAB 81 MG PHAR PHARMACY 250 J3490 6.82 ASPIRIN EC TAB 325 MG PHAR PHARMACY 250 J3490 6.77 ASPIRIN EC TAB 81 MG PHAR PHARMACY 250 J3490 6.75 ASPIRIN SUPP 300 MG PHAR PHARMACY 250 J3490 8.65 ASPIRIN SUPP 600 MG PHAR PHARMACY 250 J3490 8.72 ASPIRIN TAB 325 MG PHAR PHARMACY 250 J3490 6.71 ASPIRIN/CITRIC ACID/SOD BICARB TAB PHAR PHARMACY 250 J3490 5.07 ASPIRIN/DIPYRIDAMOLE TAB 200/25 MG PHAR PHARMACY 250 J3490 81.12 ASSESS CENTRAL LINE DRESSING PHAR PHARMACY 250 J3490 4.95 ASSESS IV SITE PHAR PHARMACY 250 J3490 4.95 ATENOLOL INJ 5 MG/10 ML PHAR PHARMACY 250 J3490 24.42 ATENOLOL TAB 100 MG PHAR PHARMACY 250 J3490 8.70 ATENOLOL TAB 25 MG PHAR PHARMACY 250 J3490 7.77 ATENOLOL TAB 50 MG PHAR PHARMACY 250 J3490 7.89 ATENOLOL/HCTZ TAB 50/25 MG PHAR PHARMACY 250 J3490 5.13 ATOMOXETINE CAP 60 MG PHAR PHARMACY 250 J3490 17.12 ATORVASTATIN TAB 10 MG PHAR PHARMACY 250 J3490 7.36 ATORVASTATIN TAB 20 MG PHAR PHARMACY 250 J3490 7.39 ATORVASTATION TAB 40 MG PHAR PHARMACY 250 J3490 7.84 ATOVAQUONE SUSP 750 MG/5 ML PHAR PHARMACY 250 J3490 36.74 ATOVAQUONE/PROGUANIL TAB 65.5/25 MG PHAR PHARMACY 250 J3490 9.82 ATROPINE 1% OPHTH SOLN PHAR PHARMACY 250 J3490 118.71 ATROPINE INJ 0.4 MG/ML PHAR PHARMACY 636 J0461 30.80 ATROPINE INJ 0.4 MG/ML - 20 ML PHAR PHARMACY 250 J0461 75.74 ATROPINE INJ 1 MG/ML PHAR PHARMACY 636 J0460 37.54 88 ATROPINE INJ 1 MG/ML ABBOJECT PHAR PHARMACY 636 J0461 33.97 ATROPINE IVP 1 MG/ML PHAR PHARMACY 636 J0461 37.54 AURODEX OTIC SOLN PHAR PHARMACY 250 J3490 20.79 AVITENE FLOUR JAR 1 GM PHAR PHARMACY 250 J3490 123.77 AZATHIOPINE TAB 50 MG PHAR PHARMACY 250 J3490 9.53 AZITHROMYCIN IVPB 500 MG PHAR PHARMACY 250 J0456 107.13 AZITHROMYCIN SUSP 100 MG/5 ML - 15 ML PHAR PHARMACY 636 Q0144 90.21 AZITHROMYCIN SUSP 100 MG/5 ML - 15 ML ER PHAR PHARMACY 253 Q0144 90.21 AZITHROMYCIN SUSP 200 MG/5 ML - 15 ML PHAR PHARMACY 250 Q0144 90.21 AZITHROMYCIN SUSP 200 MG/5 ML - 15 ML ER PHAR PHARMACY 253 Q0144 90.21 AZITHROMYCIN SUSP 200 MG/5 ML - 22.5 ML PHAR PHARMACY 250 J3490 53.68 AZITHROMYCIN TAB 250 MG PHAR PHARMACY 250 Q0144 16.64 AZITHROMYCIN TAB 500 MG PHAR PHARMACY 250 J3490 27.65 AZITHROMYCIN ZPAK (#6 - 250 MG TABS) PHAR PHARMACY 636 J0456 58.19 AZTREONAM IVPB 1 GM PHAR PHARMACY 250 J3490 148.37 AZTREONAM IVPB 2 GM PHAR PHARMACY 250 J3490 203.31 BACITRACIN INJ 50,000 UNITS PHAR PHARMACY 250 J3490 36.94 BACITRACIN OPHTH OINT 3.5 GM PHAR PHARMACY 250 J3490 43.33 BACITRACIN PLAIN OINT 15 GM ER PHAR PHARMACY 250 J3490 48.09 BACITRACIN ZINC OINT - UD PHAR PHARMACY 250 J3490 43.39 BACITRACIN ZINC OINT 15 GM PHAR PHARMACY 250 J3490 44.94 BACITRACIN ZINC POLYMIXIN B SULFA OPTH O PHAR PHARMACY 250 J3490 22.35 BACITRACIN ZINC POLYMIXIN B SULFA OPTH O PHAR PHARMACY 250 J3490 15.98 BACLOFEN TAB 10 MG PHAR PHARMACY 250 J3490 7.37 BACLOFEN TAB 20 MG PHAR PHARMACY 250 J3490 5.64 BACTERIOSTATIC NORMAL SALINE INJ 0.9% PHAR PHARMACY 250 J3490 20.81 BACTERIOSTATIC WATER INJ 30 ML PHAR PHARMACY 250 J3490 20.93 BCOC PHAR PHARMACY 250 J3490 4.95 BECAPLERMIN GEL 0.01% PHAR PHARMACY 250 J3490 11,522.51 BECLOMETHASONE INH 40 MCG PHAR PHARMACY 250 J3490 316.81 BECLOMETHASONE INH 80 MCG PHAR PHARMACY 250 J3490 43.67 BECLOMETHASONE NASAL SPRAY PHAR PHARMACY 250 J3490 90.63 BELLADONNA/OPIUM SUPP 16.2/60 MG PHAR PHARMACY 250 J3490 52.74 BENAZEPRIL TAB 10 MG PHAR PHARMACY 250 J3490 8.10 BENAZEPRIL TAB 20 MG PHAR PHARMACY 250 J3490 8.10 BENAZEPRIL TAB 5 MG PHAR PHARMACY 250 J3490 5.06 BENZOCAINE /BUTAMBEN/TETRACAINE SPRAY PHAR PHARMACY 250 J3490 60.21 BENZOCAINE 20 % SPRAY PHAR PHARMACY 250 J3490 18.01 BENZOCAINE SPRAY 20 % PHAR PHARMACY 250 J3490 83.90 BENZOIN TINCTURE PHAR PHARMACY 250 J3490 43.34 BENZONATATE PERLES CAP 100 MG PHAR PHARMACY 250 J3490 7.43 BENZTORPINE INJ 2 MG/2 ML PHAR PHARMACY 636 J0515 107.90 89 BENZTROPINE TAB 0.5 MG PHAR PHARMACY 250 J3490 7.48 BENZTROPINE TAB 1 MG PHAR PHARMACY 636 J0515 7.24 BETADINE OINT 30 GM PHAR PHARMACY 250 J3490 6.58 BETADINE OINT UD PHAR PHARMACY 250 J3490 4.95 BETAMETHASONE 0.05 % OINT 15 GM PHAR PHARMACY 250 J3490 48.93 BETAMETHASONE AUGMENTED 0.05 % CRM 15 GM PHAR PHARMACY 250 J3490 111.76 BETAMETHASONE AUGMENTED 0.05 % OINT 50 G PHAR PHARMACY 250 J3490 143.49 BETAMETHASONE SOD PHOS/ACETATE SOLUSPAN PHAR PHARMACY 250 J3490 35.67 BETAMETHASONE VALERATE 0.1% CRM 15 GM PHAR PHARMACY 250 J3490 5.98 BETAMETHASONE VALERATE 0.1% CRM 45 GM PHAR PHARMACY 250 J3490 7.00 BETAXOLOL 0.25% OPTH PHAR PHARMACY 250 J3490 78.94 BETHANECHOL TAB 10 MG PHAR PHARMACY 250 J3490 12.57 BICALUTAMIDE TAB 50 MG PHAR PHARMACY 250 J3490 17.79 BIMATOPROST 0.01 % OPHTH SOLN 2.5 ML PHAR PHARMACY 250 J3490 333.94 BIMATOPROST 0.03 % OPTH SOLN PHAR PHARMACY 250 J3490 1,702.28 BISACODYL SUPP 10 MG PHAR PHARMACY 250 J3490 7.05 BISACODYL TAB 5 MG PHAR PHARMACY 250 J3490 6.79 BISMATROL/BISMUTH PHAR PHARMACY 250 J3490 7.23 BISMUTH SAL TAB 262 MG PHAR PHARMACY 250 J3490 6.85 BISOPROLOL TAB 10 MG PHAR PHARMACY 250 J3490 8.33 BISOPROLOL TAB 5 MG PHAR PHARMACY 250 J3490 8.58 BLOOD ADMINISTRATION PHAR PHARMACY 250 J3490 4.95 BOWEL CARE ASSESSMENT PHAR PHARMACY 250 J3490 4.95 BRIMONIDINE 0.1 % OPHTH SOLN 5 ML PHAR PHARMACY 250 J3490 279.32 BRIMONIDINE 0.15 % OPTH SOLN 5 ML PHAR PHARMACY 250 J3490 258.73 BRIMONIDINE 0.2 % OPTH SOLN 5 ML PHAR PHARMACY 250 J3490 87.21 BRINZOLAMIDE 1 % OPTH SOLN PHAR PHARMACY 250 J3490 504.69 BROMFENAC 0.09% OPTH SOLN PHAR PHARMACY 250 J3490 9.59 BROMOCRIPTINE TAB 2.5 MG PHAR PHARMACY 250 J3490 15.13 BUDESONIDE EC CAP 3 MG PHAR PHARMACY 250 J3490 40.16 BUDESONIDE FLEXHALER 180 MCG PHAR PHARMACY 250 J3490 215.22 BUDESONIDE FLEXHALER 90 MCG PHAR PHARMACY 250 J3490 164.13 BUDESONIDE INH 200 MCG PHAR PHARMACY 636 J7627 5.77 BUDESONIDE INH NASAL SPRAY PHAR PHARMACY 250 J3490 68.46 BUDESONIDE INH RESPULES 0.25 MG/2 ML PHAR PHARMACY 250 J7626 19.47 BUDESONIDE INH RESPULES 0.5 MG/2 ML PHAR PHARMACY 250 J7626 21.73 BUDESONIDE/FORMOTEROL INH 160/4.5 MCG PHAR PHARMACY 250 J3490 402.55 BUDESONIDE/FORMOTEROL INH 80/4.5 MCG PHAR PHARMACY 250 J3490 355.59 BUMETAMIDE INJ 0.25 MG/ML PHAR PHARMACY 250 J3490 20.03 BUMETAMIDE INJ 1 MG/4 ML PHAR PHARMACY 250 J3490 22.41 BUMETAMIDE IVPB 0.25 MG/ML PHAR PHARMACY 250 J3490 20.03 BUMETAMIDE IVPB 1 MG/4 ML PHAR PHARMACY 250 J3490 99.16 90 BUMETANIDE TAB 1 MG PHAR PHARMACY 250 J3490 8.16 BUPIVACAINE INJ 0.25% MDV PHAR PHARMACY 250 J3490 22.27 BUPIVACAINE INJ 0.25% MPF 30 ML PHAR PHARMACY 250 J3490 21.67 BUPIVACAINE INJ 0.5 % MDV PHAR PHARMACY 250 J3490 24.59 BUPIVACAINE INJ 0.5 % SDV PHAR PHARMACY 250 J3490 21.95 BUPIVACAINE INJ 0.75% MPF 30 ML PHAR PHARMACY 250 J3490 24.28 BUPIVACAINE INJ 0.75% W/DEX SDV PHAR PHARMACY 250 J3490 26.24 BUPIVACAINE INJ W/EPI 0.25 % MPF 30 ML PHAR PHARMACY 250 J3490 19.11 BUPIVACAINE INJ W/EPI 0.25% MDV PHAR PHARMACY 250 J3490 38.98 BUPIVACAINE INJ W/EPI 0.5% MPF 30 ML PHAR PHARMACY 250 J3490 22.93 BUPIVACAINE LIPOSOME INJ 13.3 MG/ML 10 m PHAR PHARMACY 250 J3490 293.75 BUPIVACAINE LIPOSOME INJ 13.3 MG/ML 20 M PHAR PHARMACY 250 J3490 528.07 BUPIVACAINE NJ W/EPI 0.5% MDV PHAR PHARMACY 250 J3490 28.38 BUPRENORPHINE INJ 0.3 MG/ML PHAR PHARMACY 636 J0592 44.54 BUPRENORPHINE PATCH 10 MCG/HR PHAR PHARMACY 250 J3490 68.75 BUPROPION SR TAB 100 MG PHAR PHARMACY 250 J3490 8.96 BUPROPION SR TAB 150 MG PHAR PHARMACY 250 J3490 7.64 BUPROPION TAB 100 MG PHAR PHARMACY 250 J3490 8.12 BUPROPION TAB 75 MG PHAR PHARMACY 250 J3490 7.76 BUPROPION XL TAB 150 MG PHAR PHARMACY 250 J3490 13.71 BUSPIRONE TAB 10 MG PHAR PHARMACY 250 J3490 8.50 BUSPIRONE TAB 15 MG PHAR PHARMACY 250 J3490 9.41 BUSPIRONE TAB 5 MG PHAR PHARMACY 250 J3490 7.73 BUTORPHANOL INJ 1 MG/ML PHAR PHARMACY 636 J0595 26.47 CA++ ELECTROLYTE REPLACEMENT PHAR PHARMACY 250 J3490 4.95 CAFFEINE CITRATE INJ 60 MG/3 ML PHAR PHARMACY 250 J3490 64.97 CAFFEINE TAB 200 MG PHAR PHARMACY 250 J3490 7.01 CAFFEINE/SODIUM BENZOATE INJ 125/125 MG PHAR PHARMACY 250 J3490 48.48 CAL CARBONATE/VIT D TAB 500 MG/200 IU PHAR PHARMACY 250 J3490 6.74 CALAMINE 8%/ZINC OXIDE 8% LOT 6 OZ PHAR PHARMACY 250 J3490 43.26 CALCITONIN-SALMON NASAL SPRAY PHAR PHARMACY 250 J3490 200.70 CALCITRIOL CAP 0.25 MCG PHAR PHARMACY 250 J3490 8.14 CALCITRIOL INJ 1 MCG/ML PHAR PHARMACY 636 J0636 31.65 CALCITROL TAB 0.25 MCG PHAR PHARMACY 250 J3490 5.37 CALCIUM + VITAMIN D TAB 500 MG/200 IU PHAR PHARMACY 250 J3490 6.82 CALCIUM ACETATE GELCAPS 667 MG PHAR PHARMACY 250 J3490 8.07 CALCIUM CARBONATE ES TAB 1000 MG PHAR PHARMACY 250 J3490 6.78 CALCIUM CARBONATE TAB 500 MG PHAR PHARMACY 250 J3490 6.78 CALCIUM CARBONATE TAB 648 MG PHAR PHARMACY 250 J3490 5.58 CALCIUM CHLORIDE INJ 1 GM/ML PHAR PHARMACY 250 J3490 126.35 CALCIUM CHLORIDE INJ 10% ABBOJECT PHAR PHARMACY 250 J3490 32.80 CALCIUM CITRATE TAB 200 MG PHAR PHARMACY 250 J3490 5.64 91 CALCIUM GLUCONATE INJ 1 GM/10 ML PHAR PHARMACY 250 J3490 109.91 CALCIUM OYSTER SHELL TAB 500 MG PHAR PHARMACY 250 J3490 6.82 CALCIUM W/VIT D TAB 250 MG PHAR PHARMACY 250 J3490 6.71 CALCIUM-SODIUM DRESSING 2X2 TOP PHAR PHARMACY 250 J3490 50.42 CALCIUM/VITAMIN D3 TAB PHAR PHARMACY 250 J3490 9.27 CANDESARTAN CILEXETIL TAB 16 MG PHAR PHARMACY 250 J3490 11.14 CANDESARTAN CILEXETIL TAB 32 MG PHAR PHARMACY 250 J3490 15.51 CAPSAICIN 0.025% CRM PHAR PHARMACY 250 J3490 43.46 CAPTOPRIL TAB 12.5 MG PHAR PHARMACY 250 J3490 8.79 CAPTOPRIL TAB 25 MG PHAR PHARMACY 250 J3490 8.94 CAPTOPRIL TAB 50 MG PHAR PHARMACY 250 J3490 10.59 CAPTOPRIL TAB 6.25 MG PHAR PHARMACY 250 J3490 5.00 CAPTOPRIL/HCTZ TAB 25/15 MG PHAR PHARMACY 250 J3490 5.13 CARBACHOL OPHTH 0.01% 1.5 ML PHAR PHARMACY 250 J3490 19.34 CARBAMAZEPINE LIQ 100 MG/5 ML PHAR PHARMACY 250 J3490 7.81 CARBAMAZEPINE TAB 100 MG PHAR PHARMACY 250 J3490 7.55 CARBAMAZEPINE TAB 200 MG PHAR PHARMACY 250 J3490 8.96 CARBAMAZEPINE XR CAP 100 MG PHAR PHARMACY 250 J3490 9.10 CARBAMAZEPINE XR TAB 100 MG PHAR PHARMACY 250 J3490 8.76 CARBAMAZEPINE XR TAB 200 MG PHAR PHARMACY 250 J3490 9.10 CARBAMIDE PEROXIDE OTIC 6.5% PHAR PHARMACY 250 J3490 45.49 CARBIDOPA/LEVODOPA CR TAB 50/200 MG PHAR PHARMACY 250 J3490 9.25 CARBIDOPA/LEVODOPA ER TAB 25/100 MG PHAR PHARMACY 250 J3490 7.81 CARBIDOPA/LEVODOPA TAB 10/100 MG PHAR PHARMACY 250 J3490 8.23 CARBIDOPA/LEVODOPA TAB 25/100 MG PHAR PHARMACY 250 J3490 7.49 CARBIDOPA/LEVODOPA TAB 25/250 MG PHAR PHARMACY 250 J3490 7.84 CARBOPROST TROMETHAMINE INJ 250 MCG/ML PHAR PHARMACY 250 J3490 591.80 CARISOPRODOL TAB 350 MG PHAR PHARMACY 250 J3490 8.64 CARVEDILOL CR CAP 20 MG PHAR PHARMACY 250 J3490 8.82 CARVEDILOL ER CAP 40 MG PHAR PHARMACY 250 J3490 9.02 CARVEDILOL SA CAP 10 MG PHAR PHARMACY 250 J3490 21.52 CARVEDILOL TAB 12.5 MG PHAR PHARMACY 250 J3490 9.52 CARVEDILOL TAB 25 MG PHAR PHARMACY 250 J3490 9.52 CARVEDILOL TAB 3.125 MG PHAR PHARMACY 250 J3490 9.52 CARVEDILOL TAB 6.25 MG PHAR PHARMACY 250 J3490 9.52 CASPOFUNGIN INJ 50 MG PHAR PHARMACY 250 J3490 457.92 CEFACLOR CAP 250 MG PHAR PHARMACY 250 J3490 9.37 CEFADROXIL CAP 5 MG PHAR PHARMACY 250 J3490 4.95 CEFAZOLIN INJ 1 GM PHAR PHARMACY 250 J0690 21.69 CEFAZOLIN INJ 500 MG PHAR PHARMACY 250 J3490 23.37 CEFAZOLIN IVPB 1 GM PHAR PHARMACY 250 J0690 97.79 CEFAZOLIN IVPB 500 MG PHAR PHARMACY 250 J3490 99.47 92 CEFAZOLIN PREMIX 1 GM PHAR PHARMACY 250 J0690 105.01 CEFAZOLIN PREMIX 2 GM/50 ML PHAR PHARMACY 636 J0690 109.96 CEFDINIR CAP 300 MG PHAR PHARMACY 250 J3490 13.58 CEFDINIR SUSP 125 MG/5 ML - 60 ML PHAR PHARMACY 250 J3490 7.83 CEFEPIME IVPB 1 GM PHAR PHARMACY 636 J0692 104.82 CEFEPIME IVPB 2 GM PHAR PHARMACY 250 J0692 111.28 CEFIXIME TAB 400 MG PHAR PHARMACY 250 J3490 4.95 CEFOTAXIME INJ 1 GM PHAR PHARMACY 250 J0698 98.68 CEFOTAXIME IVPB 1 GM PHAR PHARMACY 250 J3490 98.68 CEFOTAXIME IVPB 2 GM PHAR PHARMACY 250 J0698 103.20 CEFOTETAN INJ 1 GM PHAR PHARMACY 250 J3490 50.10 CEFOTETAN INJ 2 GM PHAR PHARMACY 250 J3490 147.50 CEFOTETAN IVPB 1 GM PHAR PHARMACY 250 J3490 126.20 CEFOTETAN IVPB 2 GM PHAR PHARMACY 250 J3490 223.60 CEFPODOXIME TAB 200 MG PHAR PHARMACY 250 J3490 18.08 CEFPROZIL TAB 250 MG PHAR PHARMACY 250 J3490 12.59 CEFTAROLINE FOSAMIL INJ 600 MG PHAR PHARMACY 250 J0712 378.66 CEFTAZIDIME INJ 1 GM PHAR PHARMACY 250 J0713 27.42 CEFTAZIDIME IVPB 1 GM PHAR PHARMACY 250 J0713 103.52 CEFTAZIDIME IVPB 2 GM PHAR PHARMACY 636 J0713 112.90 CEFTRAOLINE FOSAMIL INJ 400 MG PHAR PHARMACY 250 J3490 217.13 CEFTRIAXONE INJ 1 GM PHAR PHARMACY 636 J0696 80.90 CEFTRIAXONE INJ 250 MG PHAR PHARMACY 636 J0696 20.23 CEFTRIAXONE INJ 500 MG PHAR PHARMACY 636 J0696 55.22 CEFTRIAXONE IVPB 1 GM PHAR PHARMACY 636 J0696 157.00 CEFTRIAXONE IVPB 2 GM PHAR PHARMACY 636 J0696 218.08 CEFTRIAXONE IVPB 250 MG PHAR PHARMACY 636 J0696 96.33 CEFTRIAXONE IVPB 500 MG PHAR PHARMACY 636 J0696 131.32 CEFTRIAXONE PREMIX 1 GM PHAR PHARMACY 636 J0696 113.87 CEFTRIAXONE PREMIX 2 GM/50 ML PHAR PHARMACY 636 J0696 124.58 CEFUROXIME INJ 1.5 GM PHAR PHARMACY 250 J3490 102.39 CEFUROXIME TAB 250 MG PHAR PHARMACY 250 J3490 12.61 CEFUROXIME TAB 500 MG PHAR PHARMACY 250 J3490 29.55 CELECOXIB CAP 100 MG PHAR PHARMACY 250 J3490 12.57 CELECOXIB CAP 200 MG PHAR PHARMACY 250 J3490 16.90 CELESTONE IVPB 3 MG/ML PHAR PHARMACY 250 J0702 155.56 CEOTETAN PREMIX 2 GM/50 ML PHAR PHARMACY 250 S0074 131.25 CEPACOL LOZENGE PHAR PHARMACY 250 J3490 6.93 CEPASTAT LOZENGE PHAR PHARMACY 250 J3490 6.88 CEPHALEXIN CAP 250 MG PHAR PHARMACY 250 J3490 7.60 CEPHALEXIN CAP 250 MG ER (#4) PHAR PHARMACY 250 J3490 13.87 CEPHALEXIN CAP 500 MG PHAR PHARMACY 250 J3490 8.34 93 CEPHALEXIN CAP 500 MG ER (#4) PHAR PHARMACY 253 J3490 50.65 CEPHALEXIN SUSP 125 MG/5 ML - 100 ML PHAR PHARMACY 250 J3490 43.56 CEPHALEXIN SUSP 125 MG/5 ML - 100 ML ER PHAR PHARMACY 250 J3490 43.56 CEPHALEXIN SUSP 250 MG/5 ML - 100 ML PHAR PHARMACY 250 J3490 43.63 CEPHALEXIN SUSP 250 MG/5 ML - 75 ML ER PHAR PHARMACY 253 J3490 81.96 CEROVITE MULTI VITAMINS TAB PHAR PHARMACY 250 J3490 6.74 CETIRIZINE SOLN 1 MG/ML 4 OZ PHAR PHARMACY 250 J3490 17.03 CETIRIZINE TAB 10 MG PHAR PHARMACY 250 J3490 9.96 CEVIMELINE CAP 30 MG PHAR PHARMACY 250 J3490 9.03 CHANGE FEEDING TUBE PHAR PHARMACY 250 J3490 4.95 CHANTIX 0.5MG AND 1.0 MG STARTER PAK PHAR PHARMACY 250 J3490 11.51 CHARCOAL/AQUA SUSP 25 GM PHAR PHARMACY 250 J3490 82.68 CHARCOAL/AQUA SUSP 50 GM PHAR PHARMACY 250 J3490 97.02 CHARCOAL/SORBITOL LIQ 25 GM PHAR PHARMACY 250 J3490 82.68 CHARCOAL/SORBITOL LIQ 50 GM PHAR PHARMACY 250 J3490 97.02 CHLORDIAZEPOXIDE CAP 10 MG PHAR PHARMACY 250 J3490 5.08 CHLORDIAZEPOXIDE CAP 25 MG PHAR PHARMACY 250 J3490 7.27 CHLORDIAZEPOXIDE CAP 5 MG PHAR PHARMACY 250 J3490 8.16 CHLORDIAZEPOXIDE INJ 100 MG/ML PHAR PHARMACY 250 J3490 40.60 CHLORDIAZEPOXIDE/CLIDINIUM CAP 5/2.5 MG PHAR PHARMACY 250 J3490 13.62 CHLORHEXIDINE GLUCONATE SOLN 4% 4 OZ PHAR PHARMACY 250 J3490 43.32 CHLORHEXIDINE GLUCONATE SOLN 4% 8 OZ PHAR PHARMACY 250 J3490 8.87 CHLORHEXIDINE ORAL RINSE PHAR PHARMACY 250 J3490 9.76 CHLOROPROCAINE INJ 3% PHAR PHARMACY 250 J3490 25.66 CHLOROQUINE PHOS TAB 500 MG PHAR PHARMACY 250 J3490 13.99 CHLORPROMAZINE INJ 25 MG/ML PHAR PHARMACY 636 J3230 65.42 CHLORPROMAZINE TAB 100 MG PHAR PHARMACY 250 J3490 17.13 CHLORPROMAZINE TAB 25 MG PHAR PHARMACY 250 J3490 16.98 CHLORPROMAZINE TAB 50 MG PHAR PHARMACY 636 J3230 12.52 CHLORPROPAMIDE TAB 250 MG PHAR PHARMACY 250 J3490 10.11 CHLORTHALIDONE TAB 25 MG PHAR PHARMACY 250 J3490 8.32 CHOLECALCIFEROL CAP 5000 UN PHAR PHARMACY 250 J3490 6.77 CHOLECALCIFEROL TAB 1000 IU PHAR PHARMACY 250 J3490 6.73 CHOLECALCIFEROL TAB 400 IU PHAR PHARMACY 250 J3490 6.72 CHOLESTYRAMINE PKTS 4 GM PHAR PHARMACY 250 J3490 11.23 CHONDROITIN SULFATE OPTH PHAR PHARMACY 250 J3490 71.83 CHORIONIC GONADOTROPIN INJ 10000 UN PHAR PHARMACY 250 J3490 105.19 CILOSTAZOL TAB 100 MG PHAR PHARMACY 250 J3490 9.15 CILOSTAZOL TAB 50 MG PHAR PHARMACY 250 J3490 9.15 CIMETIDINE INJ 300 MG/2 ML PHAR PHARMACY 250 J3490 16.50 CIMETIDINE TAB 300 MG PHAR PHARMACY 250 J3490 5.33 CIMETIDINE TAB 400 MG PHAR PHARMACY 250 J3490 5.60 94 CIMETIDINE TAB 800 MG PHAR PHARMACY 250 J3490 5.18 CIPROFLOXACIN INJ 200 MG PHAR PHARMACY 250 J3490 69.44 CIPROFLOXACIN INJ 400 MG PHAR PHARMACY 250 J3490 95.14 CIPROFLOXACIN INJ 400 MG/40 ML PHAR PHARMACY 250 J3490 68.96 CIPROFLOXACIN OPTH 0.3% 5 ML PHAR PHARMACY 253 J3490 106.95 CIPROFLOXACIN PREMIX 200 MG/100 ML PHAR PHARMACY 250 J0744 98.98 CIPROFLOXACIN PREMIX 400 MG/200 ML PHAR PHARMACY 250 J0744 102.12 CIPROFLOXACIN SUSP 250 MG/5 ML - 100 ML PHAR PHARMACY 250 J3490 146.81 CIPROFLOXACIN TAB 250 MG PHAR PHARMACY 250 J3490 14.04 CIPROFLOXACIN TAB 500 MG PHAR PHARMACY 250 J3490 6.98 CIPROFLOXACIN TAB 500 MG ER (#3) PHAR PHARMACY 253 J3490 64.93 CIPROFLOXACIN TAB 750 MG PHAR PHARMACY 250 J3490 9.59 CISATRACURIUM INJ 20 MG/10 ML PHAR PHARMACY 250 J3490 63.47 CITALOPRAM SOLN 10 MG/5 ML PHAR PHARMACY 250 J3490 355.60 CITALOPRAM TAB 10 MG PHAR PHARMACY 250 J3490 9.96 CITALOPRAM TAB 20 MG PHAR PHARMACY 250 J3490 10.32 CITALOPRAM TAB 40 MG PHAR PHARMACY 250 J3490 11.39 CITRUCEL PKT PHAR PHARMACY 250 J3490 6.72 CLARITHROMYCIN SUSP 125 MG/5 ML - 50 ML PHAR PHARMACY 250 J3490 44.91 CLARITHROMYCIN SUSP 250 MG/5 ML - 50 ML PHAR PHARMACY 250 J3490 45.87 CLARITHROMYCIN TAB 250 MG PHAR PHARMACY 250 J3490 14.79 CLARITHROMYCIN TAB 500 MG PHAR PHARMACY 250 J3490 14.79 CLEMASTINE TAB 1.34 MG PHAR PHARMACY 250 J3490 4.95 CLINDAMYCIN CAP 150 MG PHAR PHARMACY 250 J3490 8.24 CLINDAMYCIN CAP 150 MG ER (#8) PHAR PHARMACY 253 J3490 55.63 CLINDAMYCIN CAP 300 MG PHAR PHARMACY 250 J3490 11.70 CLINDAMYCIN INJ 300 MG/2 ML PHAR PHARMACY 250 J3490 23.82 CLINDAMYCIN PALMITATE SUSP 100 ML ER PHAR PHARMACY 253 J3490 126.78 CLINDAMYCIN PREMIX 300 MG/50 ML PHAR PHARMACY 250 J3490 108.37 CLINDAMYCIN PREMIX 600 MG/50 ML PHAR PHARMACY 250 J3490 112.38 CLINDAMYCIN PREMIX 900 MG/50 ML PHAR PHARMACY 250 J3490 116.21 CLINDAMYCIN VAG CRM 2% PHAR PHARMACY 250 J3490 56.32 CLOBETASOL PROPIONATE OINT 0.05% 15 GM PHAR PHARMACY 250 J3490 322.37 CLOBETASOL PROPIONATE OINT 0.05% 30 GM PHAR PHARMACY 250 J3490 167.03 CLONAZEPAM TAB 0.5 MG PHAR PHARMACY 250 J3490 7.66 CLONAZEPAM TAB 1 MG PHAR PHARMACY 250 J3490 8.92 CLONIDINE PATCH 0.2 MG/DAY PHAR PHARMACY 250 J3490 118.34 CLONIDINE PATCH 0.3 MG/DAY PHAR PHARMACY 250 J3490 147.42 CLONIDINE INJ 0.1 MG/ML PHAR PHARMACY 250 J3490 23.06 CLONIDINE PATCH 0.1 MG/DAY PHAR PHARMACY 250 J3490 87.85 CLONIDINE TAB 0.1 MG PHAR PHARMACY 250 J3490 7.01 CLONIDINE TAB 0.2 MG PHAR PHARMACY 250 J3490 7.12 95 CLOPIDOGREL TAB 75 MG PHAR PHARMACY 250 J3490 12.56 CLORAZEPATE TAB 7.5 MG PHAR PHARMACY 250 J3490 11.52 CLOTRIMAZOLE CRM 1 % PHAR PHARMACY 250 J3490 43.61 CLOTRIMAZOLE TAB 10 MG PHAR PHARMACY 250 J3490 8.61 CLOTRIMAZOLE VAG CRM 1 % PHAR PHARMACY 250 J3490 6.93 CLOTRIMAZOLE VAG CRM 1 % PHAR PHARMACY 250 J3490 8.32 CLOTRIMAZOLE VAG TABS 200 MG PHAR PHARMACY 250 J3490 7.81 CLOTRIMAZOLE/BETAMETHASONE 1%/0.05% CRM PHAR PHARMACY 250 J3490 26.16 CLOTRIMAZOLE/BETAMETHASONE CRM 15 GM PHAR PHARMACY 250 J3490 45.06 CLOTRIMAZOLE/BETAMETHASONE CRM 45 GM PHAR PHARMACY 250 J3490 5.87 CLOTRIMAZOLE/BETAMETHASONE LOT 30 ML PHAR PHARMACY 250 J3490 49.91 CLOVE OIL PHAR PHARMACY 250 J3490 44.38 CLOZAPINE TAB 100 MG PHAR PHARMACY 250 J3490 5.85 CLOZAPINE TAB 25 MG PHAR PHARMACY 250 J3490 5.30 COCAINE SOLN 4 % PHAR PHARMACY 250 J3490 22.38 CODEINE SOLN 15 MG/5 ML PHAR PHARMACY 250 J3490 4.95 CODIEINE TAB 15 MG PHAR PHARMACY 250 J3490 8.85 COLA SYRUP PHAR PHARMACY 250 J3490 46.56 COLCHICINE TAB 0.6 MG PHAR PHARMACY 250 J3490 15.68 COLESTIPOL PKT 5 GM PHAR PHARMACY 250 J3490 11.98 COLESTIPOL TAB 1 GM PHAR PHARMACY 250 J3490 5.41 COLLAGENASE OINT 30 MG PHAR PHARMACY 250 J3490 12.28 COMBIVENT RESPIMAT PHAR PHARMACY 250 J3490 645.23 COMPLETE NUTRITIONAL DRINK PHAR PHARMACY 250 J3490 5.12 CONIVAPTAN IVPB 20 MG/100 ML PHAR PHARMACY 250 J3490 1,155.57 CONJ ESTROGENS/MEDROXYPROGESTERONE TAB 0 PHAR PHARMACY 250 J3490 17.31 CONJ ESTROGENS/MEDROXYPROGESTERONE TAB 0 PHAR PHARMACY 250 J3490 17.31 CONJUGATED ESTROGENS VAG CRM/APP PHAR PHARMACY 250 J3490 581.62 COSYNTROPIN INJ 0.25 MG/ML PHAR PHARMACY 250 J3490 191.26 COUMADIN REMINDER TO CHECK FOR DOSE PHAR PHARMACY 250 J3490 4.95 CROMOLYN NEB 20 MG/2 ML PHAR PHARMACY 636 J7631 11.27 CROMOLYN OPTH SOLN 4 % 10 ML PHAR PHARMACY 250 J3490 93.34 CROTALIDAE POLYVALENT IMMUNE FAB (OVINE) PHAR PHARMACY 250 J3490 5,263.22 CYANOCOBALAMIN INJ 1000 MCG PHAR PHARMACY 250 J3420 30.19 CYANOCOBALAMIN TAB 100 MCG PHAR PHARMACY 250 J3490 7.10 CYANOCOBALAMIN TAB 500 MCG PHAR PHARMACY 250 J3490 7.12 CYCLOBENZAPRINE TAB 10 MG PHAR PHARMACY 250 J3490 8.32 CYCLOBENZAPRINE TAB 10 MG ER (#4) PHAR PHARMACY 253 J3490 49.17 CYCLOBENZAPRINE TAB 5 MG PHAR PHARMACY 250 J3490 8.37 CYCLOPENTOLATE OPTH 1 % PHAR PHARMACY 250 J3490 15.50 CYCLOSPORINE OPTH EMULSION 0.05% UD PHAR PHARMACY 250 J3490 56.96 CYGLOPENTOLATE OPTH 1 % 2 ML ER PHAR PHARMACY 250 J3490 65.23 96 CYPROHEPTADINE TAB 4 MG PHAR PHARMACY 250 J3490 8.13 D10W 1000 ML PHAR PHARMACY 250 J3490 103.60 D10W 250 ML PHAR PHARMACY 250 J3490 103.60 D5 1/2NS 1000 ML PHAR PHARMACY 250 J7799 7.49 D5 1/2NS 500 ML PHAR PHARMACY 250 J7799 6.53 D5 1/2NS W/20KCL 1000 ML PHAR PHARMACY 250 J3490 8.19 D5 1/4NS 1000 ML PHAR PHARMACY 250 J7799 8.61 D5LR 1000 ML PHAR PHARMACY 250 J7121 102.69 D5LR 500 ML PHAR PHARMACY 250 J7121 8.30 D5NS 1000 ML PHAR PHARMACY 250 J7042 102.24 D5NS 500 ML PHAR PHARMACY 250 J7042 25.56 D5W 100 ML PHAR PHARMACY 250 J7060 3.74 D5W 100 ML BAXTER PHAR PHARMACY 250 J3490 68.60 D5W 1000 ML PHAR PHARMACY 250 J7060 7.03 D5W 250 ML PHAR PHARMACY 250 J7060 5.48 D5W 50 ML BAXTER PHAR PHARMACY 250 J3490 68.60 D5W 50 ML IVPB PHAR PHARMACY 250 J7060 22.80 D5W 500 ML PHAR PHARMACY 250 J7060 5.68 DABIGATRAN ETEXILATE CAP 150 MG PHAR PHARMACY 250 J3490 17.48 DABIGATRAN ETEXILATE CAP 75 MG PHAR PHARMACY 250 J3490 17.48 DALBAVANCIN INJ 500 MG PHAR PHARMACY 636 J0875 2,575.26 DALTEPARIN INJ 10000 IU/ML PHAR PHARMACY 250 J3490 74.91 DALTEPARIN INJ 2500 IU/0.2 ML PHAR PHARMACY 250 J3490 35.02 DALTEPARIN INJ 5000 IU/0.2ML PHAR PHARMACY 250 J3490 47.82 DALTEPARIN INJ 7500 IU/0.3 ML PHAR PHARMACY 250 J3490 40.48 DANTROLENE CAP 25 MG PHAR PHARMACY 250 J3490 8.13 DANTROLENE INJ 20 MG PHAR PHARMACY 250 J3490 238.37 DAPTOMYCIN IVPB 500 MG PHAR PHARMACY 636 J0878 815.05 DARBEPOETIN ALFA PFS 150 MCG/0.3 ML PHAR PHARMACY 636 J0881 1,895.24 DARBEPOETIN INJ 100 MCG/0.5 ML PHAR PHARMACY 636 J0881 1,269.83 DARBEPOETIN INJ 200 MCG/0.4 ML PHAR PHARMACY 636 J0881 697.65 DARBEPOETIN INJ 25 MCG/0.42 ML PHAR PHARMACY 636 J0881 331.72 DARBEPOETIN INJ 300 MCG/0.6 ML PHAR PHARMACY 636 J0881 986.94 DARBEPOETIN INJ 40 MCG/0.4 ML PHAR PHARMACY 636 J0881 261.26 DARBEPOETIN INJ 40 MCG/ML PHAR PHARMACY 636 J0881 194.40 DARBEPOETIN INJ 60 MCG/0.3 ML PHAR PHARMACY 636 J0881 272.82 DARBEPOETIN INJ 60 MCG/ML PHAR PHARMACY 636 J0881 769.51 DARIFENACIN ER TAB 15 MG PHAR PHARMACY 250 J3490 21.58 DARIFENACIN TAB 7.5 MG ER PHAR PHARMACY 250 J3490 27.22 DEHYDRATED ALCOHOL INJ 5 ML PHAR PHARMACY 250 J3490 39.06 DENOSUMAB INJ 60 MG/ML PHAR PHARMACY 636 J0897 1,931.68 DESFLURANE INH SOLN PHAR PHARMACY 250 J3490 265.61 97 DESIPRAMINE TAB 25 MG PHAR PHARMACY 250 J3490 10.18 DESIPRAMINE TAB 50 MG PHAR PHARMACY 250 J3490 11.77 DESLORATADINE TAB 5 MG PHAR PHARMACY 250 J3490 7.28 DESMOPRESSIN INJ 4 MCG/ML PHAR PHARMACY 250 J3490 35.63 DESMOPRESSIN TAB 0.1 MG PHAR PHARMACY 250 J3490 10.49 DESOXIMETASONE CRM 0.25 % - 15 GM PHAR PHARMACY 250 J3490 64.17 DESOXIMETASONE CRM 0.25 % - 60 GM PHAR PHARMACY 250 J3490 13.25 DESVENLAFAXINE SUCC TAB 50 MG PHAR PHARMACY 250 J3490 14.87 DEXAMETHASONE 0.1% OPTH PHAR PHARMACY 250 J3490 130.34 DEXAMETHASONE INJ 0.5 MG/5 ML PHAR PHARMACY 250 J3490 17.53 DEXAMETHASONE INJ 10 MG/ML PHAR PHARMACY 250 J1100 21.88 DEXAMETHASONE INJ 10 MG/ML - 10 ML PHAR PHARMACY 250 J1100 36.52 DEXAMETHASONE INJ 4 MG/ML PHAR PHARMACY 636 J1094 22.58 DEXAMETHASONE INJ 4 MG/ML - 5 ML PHAR PHARMACY 636 J1100 21.68 DEXAMETHASONE ORAL CONC 1 MG/ML 30 ML PHAR PHARMACY 250 J8540 15.35 DEXAMETHASONE TAB 0.5 MG PHAR PHARMACY 250 J3490 5.01 DEXAMETHASONE TAB 0.75 MG PHAR PHARMACY 250 J3490 5.06 DEXAMETHASONE TAB 1 MG PHAR PHARMACY 250 J8540 7.19 DEXAMETHASONE TAB 1.5 MG PHAR PHARMACY 250 J8540 7.43 DEXAMETHASONE TAB 2 MG PHAR PHARMACY 250 J3490 5.53 DEXAMETHASONE TAB 4 MG PHAR PHARMACY 250 J8540 8.31 DEXMEDETOMIDINE INJ 200 MCG/2 ML PHAR PHARMACY 250 J3490 132.83 DEXMEDETOMIDINE IVPB 400 MCG/NS OR D5W 1 PHAR PHARMACY 250 J3490 159.12 DEXTROMETHORPHAN ER PHAR PHARMACY 250 J3490 53.37 DEXTROSE 10 % INJ 500 MG/5 ML PHAR PHARMACY 250 J3490 17.67 DEXTROSE 25 GM/50 ML ABBOJECT PHAR PHARMACY 250 J3490 31.97 DEXTROSE INFANT PFS 25 % 250 MG/ML PHAR PHARMACY 250 J3490 32.53 DEXTROSE INJ 50% 25GM 50ML PHAR PHARMACY 250 J3490 23.39 DIAZEPAM CARPUJECT 5 MG/ML - 2 ML PHAR PHARMACY 250 J3490 40.32 DIAZEPAM INJ 10 MG/2 ML PHAR PHARMACY 636 J3360 42.12 DIAZEPAM RECTAL GEL 2.5 MG PHAR PHARMACY 250 J3490 465.97 DIAZEPAM TAB 10 MG PHAR PHARMACY 250 J3490 5.06 DIAZEPAM TAB 2 MG PHAR PHARMACY 250 J3490 8.02 DIAZEPAM TAB 5 MG PHAR PHARMACY 250 J3490 8.12 DIBUCAINE 1% OINT 1 OZ PHAR PHARMACY 250 J3490 43.53 DICLOFENAC GEL 1 % 100 MG PHAR PHARMACY 250 J3490 7.44 DICLOFENAC TAB 50 MG PHAR PHARMACY 250 J3490 10.41 DICLOFENAC TAB 75 MG PHAR PHARMACY 250 J3490 9.08 DICLOFENAC XR TAB 100 MG PHAR PHARMACY 250 J3490 7.81 DICLOXACILLIN CAP 250 MG PHAR PHARMACY 250 J3490 8.55 DICLOXACILLIN CAP 500 MG PHAR PHARMACY 250 J3490 5.44 DICYCLOMINE CAP 10 MG PHAR PHARMACY 250 J3490 7.50 98 DICYCLOMINE INJ 10 MG/ML PHAR PHARMACY 250 J0500 148.52 DICYCLOMINE TAB 20 MG PHAR PHARMACY 250 J3490 7.17 DIGOXIN CAP 0.05 MG PHAR PHARMACY 250 J3490 5.19 DIGOXIN CAP 0.1 MG PHAR PHARMACY 250 J3490 5.21 DIGOXIN INJ 0.5 MG/2 ML PHAR PHARMACY 250 J3490 27.91 DIGOXIN SOLN 0.125 MG/2.5 ML PHAR PHARMACY 250 J3490 45.37 DIGOXIN TAB 0.125 MG PHAR PHARMACY 250 J3490 8.96 DIGOXIN TAB 0.25 MG PHAR PHARMACY 250 J3490 5.17 DIHYDROERGOTAMINE MESYLATE INJ 1 MG/ML PHAR PHARMACY 250 J3490 231.29 DILTAIZEM TAB 30 MG PHAR PHARMACY 250 J3490 6.93 DILTIAZEM CD CAP 120 MG PHAR PHARMACY 250 J3490 8.22 DILTIAZEM CD CAP 180 MG PHAR PHARMACY 250 J3490 7.25 DILTIAZEM CD CAP 240 MG PHAR PHARMACY 250 J3490 7.51 DILTIAZEM CD CAP 300 MG PHAR PHARMACY 250 J3490 10.31 DILTIAZEM CD CAP 360 MG PHAR PHARMACY 250 J3490 8.96 DILTIAZEM ER CAP 420 MG PHAR PHARMACY 250 J3490 6.93 DILTIAZEM INJ 125 MG/25 ML PHAR PHARMACY 250 J3490 105.41 DILTIAZEM INJ 25 MG/5 ML PHAR PHARMACY 250 J3490 22.90 DILTIAZEM INJ 50 MG/10 ML PHAR PHARMACY 250 J3490 23.93 DILTIAZEM IVPB 25 MG/5 ML PHAR PHARMACY 250 J3490 23.75 DILTIAZEM IVPB 50 MG/10 ML PHAR PHARMACY 250 J3490 23.93 DILTIAZEM TAB 60 MG PHAR PHARMACY 250 J3490 7.07 DILTIAZEM TAB 90 MG PHAR PHARMACY 250 J3490 5.18 DIMENHYDRANATE TAB 50 MG PHAR PHARMACY 250 J3490 7.07 DINOPROSTONE SUPP 10 MG PHAR PHARMACY 250 J3490 612.65 DIPHENHYDRAMINE CAP 25 MG PHAR PHARMACY 636 Q0163 6.75 DIPHENHYDRAMINE CAP 25 MG ER (#4) PHAR PHARMACY 253 Q0163 43.68 DIPHENHYDRAMINE CAP 50 MG PHAR PHARMACY 636 Q0163 6.76 DIPHENHYDRAMINE CRM 2 % PHAR PHARMACY 250 J3490 43.43 DIPHENHYDRAMINE GEL 2 % PHAR PHARMACY 250 J3490 4.95 DIPHENHYDRAMINE INJ 50 MG/ML PHAR PHARMACY 250 J1200 23.46 DIPHENHYDRAMINE LIQ 12.5 MG/5 ML UD PHAR PHARMACY 250 Q0163 10.19 DIPHENHYDRAMINE LIQ 12.5/5 ML - 16 OZ PHAR PHARMACY 250 J3490 4.97 DIPHENOXYLATE/ATROPINE TAB 2.5 MG PHAR PHARMACY 250 J3490 8.87 DIPYRIDAMOLE TAB 25 MG PHAR PHARMACY 250 J3490 8.12 DIPYRIDAMOLE TAB 50 MG PHAR PHARMACY 250 J3490 8.99 DIPYRIDAMOLE TAB 75 MG PHAR PHARMACY 250 J3490 9.77 DISOPYRAMIDE CR CAP 150 MG PHAR PHARMACY 250 J3490 11.24 DISULFIRAM TAB 250 MG PHAR PHARMACY 250 J3490 12.12 DIVALPROEX DR TAB 500 MG PHAR PHARMACY 250 J3490 8.61 DIVALPROEX CAP 125 MG PHAR PHARMACY 250 J3490 5.57 DIVALPROEX DR TAB 125 MG PHAR PHARMACY 250 J3490 7.88 99 DIVALPROEX DR TAB 250 MG PHAR PHARMACY 250 J3490 9.04 DIVALPROEX N ER TAB 500 MG PHAR PHARMACY 250 J3490 12.18 DOBUTAMINE IVPB 250 MG/250 ML D5W PHAR PHARMACY 250 J3490 75.29 DOBUTAMINE IVPB 500 MG/250 ML PHAR PHARMACY 250 J1250 151.51 DOCUSATE CALCIUM CAP 240 MG PHAR PHARMACY 250 J3490 7.16 DOCUSATE CALCIUM SOLN 50 MG/5 ML PHAR PHARMACY 250 J3490 5.65 DOCUSATE SODIUM CAP 100 MG PHAR PHARMACY 250 J3490 6.74 DOCUSATE SODIUM CAP 250 MG PHAR PHARMACY 250 J3490 4.98 DOCUSATE SODIUM LIQ 100 MG/10 ML PHAR PHARMACY 250 J3490 6.87 DOCUSATE SODIUM/SENNA CAP 50/8.6 MG PHAR PHARMACY 250 J3490 5.64 DOLASETRON INJ 12.5 MG PHAR PHARMACY 250 J3490 114.07 DOLASETRON TAB 50 MG PHAR PHARMACY 636 J1260 123.13 DOLUTEGRAVIR TAB 50 MG PHAR PHARMACY 250 J3490 95.98 DOMEBORO PKT PHAR PHARMACY 250 J3490 5.67 DONEPEZIL TAB 10 MG UD PHAR PHARMACY 250 J3490 18.35 DONEPEZIL TAB 5 MG PHAR PHARMACY 250 J3490 6.91 DONNATAL ELIXIR 4 OZ PHAR PHARMACY 250 J3490 6.44 DONNATAL TAB PHAR PHARMACY 250 J3490 4.97 DOPAMINE IVPB 400 MG/250 ML PHAR PHARMACY 636 J1265 114.80 DORNASE ALFA INJ 2.5 MG/2.5 ML PHAR PHARMACY 250 J7639 192.40 DORZOLAMIDE /TIMOLOL OPTH 22.3 MG/6.8 MG PHAR PHARMACY 250 J3490 134.13 DORZOLAMIDE OPTH SOLN 2 % 10 ML PHAR PHARMACY 250 J3490 133.13 DOUBLE ANTIBIOTIC OINT 15 GM PHAR PHARMACY 250 J3490 43.68 DOUBLE ANTIBIOTIC OINT UD PHAR PHARMACY 250 J3490 43.77 DOXAPRAM INJ 20 MG/ML PHAR PHARMACY 250 J3490 22.75 DOXAPRAM IVPB 20 MG/ML PHAR PHARMACY 250 J3490 98.85 DOXAZOSIN TAB 1 MG PHAR PHARMACY 250 J3490 8.06 DOXAZOSIN TAB 2 MG PHAR PHARMACY 250 J3490 8.06 DOXAZOSIN TAB 4 MG PHAR PHARMACY 250 J3490 8.08 DOXAZOSIN TAB 8 MG PHAR PHARMACY 250 J3490 5.83 DOXEPIN CAP 10 MG PHAR PHARMACY 250 J3490 7.55 DOXEPIN CAP 100 MG PHAR PHARMACY 250 J3490 5.42 DOXEPIN CAP 25 MG PHAR PHARMACY 250 J3490 7.82 DOXEPIN CAP 50 MG PHAR PHARMACY 250 J3490 5.21 DOXEPIN CAP 75 MG PHAR PHARMACY 250 J3490 5.95 DOXERCALCIFEROL CAP 0.5 MCG PHAR PHARMACY 250 J3490 9.74 DOXYCYCLINE CAP 100 MG PHAR PHARMACY 250 J3490 14.14 DOXYCYCLINE INJ 100 MG PHAR PHARMACY 250 J3490 134.16 DOXYCYCLINE TAB 100 MG PHAR PHARMACY 250 J3490 10.22 DOXYLAMINE/PYRIDOXINE TAB 10/10 MG PHAR PHARMACY 250 J3490 17.78 DRESSING CHANGE - LARGE PHAR PHARMACY 250 J3490 39.75 DRESSING CHANGE - MEDIUM PHAR PHARMACY 250 J3490 19.19 100 DRESSING CHANGE - SMALL PHAR PHARMACY 250 J3490 10.17 DRONABINOL CAP 2.5 MG PHAR PHARMACY 250 J3490 15.63 DRONABINOL CAP 5 MG PHAR PHARMACY 250 J3490 23.27 DRONEDARONE TAB 400 MG PHAR PHARMACY 250 J3490 9.12 DROPERIDOL INJ 2.5 MG/ML PHAR PHARMACY 636 J1790 24.04 DTAP - PEDIATRIC VACCINE PHAR PHARMACY 250 J3490 95.54 DTAP-HEP B-IPV PHAR PHARMACY 250 J3490 142.36 DULOXETINE CAP 20 MG PHAR PHARMACY 250 J3490 9.04 DULOXETINE CAP 30 MG PHAR PHARMACY 250 J3490 14.67 DULOXETINE CAP 60 MG PHAR PHARMACY 250 J3490 14.67 DUODERM DRESSING 4 X 4 EXTRATHIN PHAR PHARMACY 250 J3490 48.56 DURADRIN CAP PHAR PHARMACY 250 J3490 5.47 DUTASTERIDE CAP 0.5 MG PHAR PHARMACY 250 J3490 17.05 EDROPHONIUM INJ 10 MG/ML PHAR PHARMACY 250 J3490 25.08 ELECTROLYTES 4.24/5 1000 ML PHAR PHARMACY 250 J3490 85.01 ELEMENTAL IRON TAB 150 MG PHAR PHARMACY 250 J3490 4.64 EMLA CRM 2.5 % PHAR PHARMACY 250 J3490 45.41 EMTRICATABINE/ENOFOVIR TAB 200/300 MG PHAR PHARMACY 250 J3490 96.96 ENALAPRIL TAB 10 MG PHAR PHARMACY 250 J3490 8.44 ENALAPRIL TAB 2.5 MG PHAR PHARMACY 250 J3490 5.17 ENALAPRIL TAB 20 MG PHAR PHARMACY 250 J3490 5.15 ENALAPRIL TAB 5 MG PHAR PHARMACY 250 J3490 8.77 ENALAPRILAT INJ 1.25 MG/ML PHAR PHARMACY 250 J3490 23.99 ENALAPRILAT INJ 2.5 MG/2 ML PHAR PHARMACY 250 J3490 27.90 ENEMA MINERAL OIL PHAR PHARMACY 250 J3490 10.04 ENEMA REGULAR PHAR PHARMACY 250 J3490 5.90 ENOXAPARIN INJ 100 MG/ML PHAR PHARMACY 250 J3490 152.81 ENOXAPARIN INJ 120 MG/0.8 ML PHAR PHARMACY 636 J1650 179.62 ENOXAPARIN INJ 150 MG/ML PHAR PHARMACY 636 J1650 219.77 ENOXAPARIN INJ 30 MG/0.3 ML PHAR PHARMACY 250 J3490 55.06 ENOXAPARIN INJ 40 MG/0.4 ML PHAR PHARMACY 250 J3490 67.07 ENOXAPARIN INJ 60 MG/0.6 ML PHAR PHARMACY 636 J1650 99.29 ENOXAPARIN INJ 80 MG/0.8 ML PHAR PHARMACY 250 J3490 139.30 ENTACAPONE TAB 200 MG PHAR PHARMACY 250 J3490 7.78 EPHEDRINE SULFATE INJ 10 MG/ML - 5 ML PHAR PHARMACY 250 J3490 129.83 EPHEDRINE SULFATE INJ 50 MG/ML PHAR PHARMACY 250 J3490 91.09 EPINEPHRINE DRIP 2 MG IN 250 ML NS OR D5 PHAR PHARMACY 250 J3490 98.51 EPINEPHRINE INJ 0.15 MG PHAR PHARMACY 250 J3490 510.79 EPINEPHRINE INJ 1:1000/1 MG/ML PHAR PHARMACY 636 J0171 43.20 EPINEPHRINE INJ 1:10000 ABBOJECT PHAR PHARMACY 250 J3490 26.39 EPINEPHRINE INJ 1 MG/ML - 30 ML PHAR PHARMACY 250 J3490 326.07 EPINEPHRINE INJ DEVICE 1:1000 0.3 MG PHAR PHARMACY 250 J3490 351.66 101 EPLERENONE TAB 25 MG PHAR PHARMACY 250 J3490 7.27 EPOETIN INJ 10000 U/ML PHAR PHARMACY 636 J0885 434.70 EPOETIN INJ 2000 U/ML PHAR PHARMACY 636 J0885 41.40 EPOETIN INJ 3000 U/ML PHAR PHARMACY 636 J0885 61.39 EPOETIN INJ 4000 U/ML PHAR PHARMACY 636 J0885 66.32 EPOETIN INJ 40000 U/ML PHAR PHARMACY 636 J0885 1,681.70 EPTIFIBATIDE INJ 0.75 MG/ML - 100 ML PHAR PHARMACY 250 J3490 898.23 EPTIFIBATIDE INJ 2 MG/ML - 10 ML PHAR PHARMACY 250 J3490 322.03 ERGOCALCIFEROL CAP 50000 IU PHAR PHARMACY 250 J3490 9.35 ERTAPENEM IVPB 1 GM PHAR PHARMACY 636 J1335 303.04 ERYTHROMYCIN 0.5% OPTH OINT 3.5GM PHAR PHARMACY 250 J3490 68.83 ERYTHROMYCIN 0.5% OPTH OINT NEWBORN PHAR PHARMACY 250 J3490 59.96 ERYTHROMYCIN INJ 500 MG PHAR PHARMACY 250 J3490 215.36 ERYTHROMYCIN OPHTH OINT ER PHAR PHARMACY 253 J3490 67.43 ERYTHROMYCIN SUSP 200 MG/5 ML - 100 ML PHAR PHARMACY 250 J3490 49.32 ERYTHROMYCIN SUSP 400 MG/5 ML - 100 ML PHAR PHARMACY 250 J3490 41.19 ERYTHROMYCIN TAB 250 MG PHAR PHARMACY 250 J3490 10.59 ERYTHROMYCIN TAB 250 MG ER (#4) PHAR PHARMACY 250 J3490 36.10 ERYTHROMYCIN TAB 333 MG PHAR PHARMACY 250 J3490 5.18 ERYTHROMYCIN TAB 400 MG PHAR PHARMACY 250 J3490 5.08 ERYTHROMYCIN TAB 500 MG PHAR PHARMACY 250 J3490 5.14 ESCITALOPRAM TAB 10 MG PHAR PHARMACY 250 J3490 12.59 ESCITALOPRAM TAB 20 MG PHAR PHARMACY 250 J3490 12.85 ESGIC (BUTALBITAL/APAP/CAFFEINE) TAB PHAR PHARMACY 250 J3490 15.22 ESMOLOL IVPB 100 MG/10 ML PHAR PHARMACY 250 J3490 106.90 ESMOLOL IVPB 2500 MG/250 ML PHAR PHARMACY 250 J3490 850.90 ESOMEPRAZOLE CAP 40 MG PHAR PHARMACY 250 J3490 7.11 ESOMEPRAZOLE INJ 40 MG PHAR PHARMACY 250 J3490 22.57 ESOMEPRAZOLE PKT 20 MG PHAR PHARMACY 250 J3490 21.29 ESTRADIOL PAT 0.05 MG PHAR PHARMACY 250 J3490 348.57 ESTRADIOL PAT 0.075 MG PHAR PHARMACY 250 J3490 4.96 ESTRADIOL PAT 0.1 MG PHAR PHARMACY 250 J3490 93.96 ESTRADIOL PAT 0.1 MG E PHAR PHARMACY 250 J3490 73.00 ESTRADIOL TAB 0.5 MG PHAR PHARMACY 250 J3490 7.43 ESTRADIOL TAB 1 MG PHAR PHARMACY 250 J3490 7.61 ESTRADIOL TAB 2 MG PHAR PHARMACY 250 J3490 7.42 ESTRADIOL VAG CREAM 0.01% PHAR PHARMACY 250 J3490 18.66 ESTRATEST HS TAB 0.625/1.25 PHAR PHARMACY 250 J3490 6.57 ESTRATEST TAB 1.25/2.5 PHAR PHARMACY 250 J3490 6.04 ESTROGEN CONJUGATED TAB 0.625 MG PHAR PHARMACY 250 J3490 6.15 ESTROGEN/METHYL TESTOSTERONE TAB 1.25/2. PHAR PHARMACY 250 J3490 6.00 ESTROGENS CONJUGATED TAB 1.25 PHAR PHARMACY 250 J3490 6.69 102 ESTROGENS INJ 25 MG PHAR PHARMACY 250 J3490 498.66 ESTROGENS TAB 0.3 MG PHAR PHARMACY 250 J3490 15.34 ESTROGENS TAB 0.45 MG PHAR PHARMACY 250 J3490 6.85 ESTROGENS TAB 0.625 PHAR PHARMACY 250 J3490 15.34 ESTROGENS TAB 0.9 MG PHAR PHARMACY 250 J3490 6.16 ESTROGENS TAB 1.25 MG PHAR PHARMACY 250 J3490 15.34 ESTROPIAPATE TAB 0.75 MG PHAR PHARMACY 250 J3490 8.17 ESTROPIPATE TAB 1.5 MG PHAR PHARMACY 250 J3490 7.43 ESZOPICLONE TAB 2 MG PHAR PHARMACY 250 J3490 23.39 ESZOPICLONE TAB 3 MG PHAR PHARMACY 250 J3490 9.28 ETHACRYNIC ACID TAB 25 MG PHAR PHARMACY 250 J3490 38.94 ETHAMBUTOL TAB 400 MG PHAR PHARMACY 250 J3490 7.95 ETHYL CHLORIDE PHAR PHARMACY 250 J3490 43.64 ETOMIDATE INJ 2 MG/ML - 10 ML PHAR PHARMACY 250 J3490 27.91 ETOMIDATE INJ 2 MG/ML - 20ML PHAR PHARMACY 250 J3490 33.97 ETOMIDATE INJ 2 ML PHAR PHARMACY 250 J3490 42.48 EVACUATED CONTAINER 1000 ML PHAR PHARMACY 250 J3490 57.50 EVACUATED CONTAINER 500 ML PHAR PHARMACY 250 J3490 44.74 EYE STREAM OPTH PHAR PHARMACY 250 J3490 72.81 EZETIMIBE TAB 10 MG PHAR PHARMACY 250 J3490 25.27 EZETIMIBE/SIMVASTATIN TAB 10/20 MG PHAR PHARMACY 250 J3490 25.10 EZETIMIBE/SIMVASTATIN TAB 10/40 MG PHAR PHARMACY 250 J3490 21.64 FACTOR IX COMPLEX INJ 500 IU PHAR PHARMACY 250 J3490 1,152.28 FAMCICLOVIR TAB 500 MG PHAR PHARMACY 250 J3490 23.78 FAMOTIDINE INJ 20 MG/2 ML PHAR PHARMACY 250 J3490 20.30 FAMOTIDINE TAB 10 MG PHAR PHARMACY 250 J3490 5.01 FAMOTIDINE TAB 20 MG PHAR PHARMACY 250 J3490 8.73 FAMOTIDINE TAB 20 MG ER (#4) PHAR PHARMACY 250 J3490 16.00 FAMOTIDINE TAB 40 MG PHAR PHARMACY 250 J3490 8.59 FEBUXOSTAT TAB 40 MG PHAR PHARMACY 250 J3490 23.95 FELODIPINE TAB 10 MG PHAR PHARMACY 250 J3490 10.35 FELODIPINE TAB 2.5 MG PHAR PHARMACY 250 J3490 8.72 FELODIPINE TAB 5 MG PHAR PHARMACY 250 J3490 8.63 FEMARA TAB 2.5 MG PHAR PHARMACY 250 J3490 5.06 FENOFIBRATE TAB 145 MG PHAR PHARMACY 250 J3490 13.63 FENOFIBRATE TAB 160 MG PHAR PHARMACY 250 J3490 9.89 FENOFIBRATE TAB 48 MG PHAR PHARMACY 250 J3490 9.26 FENTANYL DRIP 1000 MCG/100 ML PHAR PHARMACY 250 J3490 78.27 FENTANYL INJ 100 MCG/2 ML PHAR PHARMACY 250 J3490 22.61 FENTANYL INJ 250 MCG/5 ML PHAR PHARMACY 636 J3010 23.07 FENTANYL INJ 50 MCG/ML - 10 ML PHAR PHARMACY 250 J3490 19.47 FENTANYL INJ 50 MCG/ML PF 5 ML PHAR PHARMACY 250 J3490 21.10 103 FENTANYL LOZ 200 MCG PHAR PHARMACY 250 J3490 12.96 FENTANYL PAT 100 MCG/HR PHAR PHARMACY 250 J3490 116.10 FENTANYL PAT 12 MCG/HR PHAR PHARMACY 250 J3490 71.58 FENTANYL PAT 25 MCG/HR PHAR PHARMACY 250 J3490 72.88 FENTANYL PAT 50 MCG/HR PHAR PHARMACY 250 J3490 96.60 FENTANYL PAT 75 MCG/HR PHAR PHARMACY 250 J3490 97.39 FENTANYL PCA 500 MCG/50 ML PHAR PHARMACY 250 J3490 101.23 FENTANYL/BUPIVICAINE 500 MCG/0.0625 % EP PHAR PHARMACY 250 J3490 95.30 FERRIC SUBSULFATE SOLN 500 ML PHAR PHARMACY 250 J3490 62.74 FERROUS GLUCONATE TAB 325 MG PHAR PHARMACY 250 J3490 6.79 FERROUS SULFATE ELIX 220 MG/5 ML PHAR PHARMACY 250 J3490 6.81 FERROUS SULFATE TAB 160 MG PHAR PHARMACY 250 J3490 6.77 FERROUS SULFATE TAB 325 MG PHAR PHARMACY 250 J3490 6.84 FESOTERODINE FUMERATE ER TAB 8 MG PHAR PHARMACY 250 J3490 13.34 FESOTERODINE FUMERATE SA TAB 4 MG PHAR PHARMACY 250 J3490 13.34 FEXOFENADINE TAB 180 MG PHAR PHARMACY 250 J3490 7.25 FEXOFENADINE TAB 60 MG PHAR PHARMACY 250 J3490 8.57 FEXOFENADINE/PSEUDOEPHEDRINE TAB PHAR PHARMACY 250 J3490 8.60 FIBERCON TAB PHAR PHARMACY 250 J3490 6.84 FILGRASTIM INJ 300 MCG/ML PHAR PHARMACY 250 J3490 527.80 FILGRASTIM INJ 480 MCG/1.6 ML PHAR PHARMACY 250 J1442 829.19 FINASTERIDE TAB 5 MG PHAR PHARMACY 250 J3490 10.94 FLECAINIDE TAB 100 MG PHAR PHARMACY 250 J3490 11.51 FLECAINIDE TAB 50 MG PHAR PHARMACY 250 J3490 12.15 FLEET PEDIATRIC SALINE ENEMA 2.25 OZ PHAR PHARMACY 250 J3490 6.72 FLEXBUMIN 25% 25 GM 100ML PHAR PHARMACY 250 J3490 167.72 FLUCONAZOLE SUSP 40 MG/ML PHAR PHARMACY 250 J3490 48.26 FLUCONAZOLE TAB 100 MG PHAR PHARMACY 250 J3490 19.53 FLUCONAZOLE TAB 150 MG PHAR PHARMACY 250 J3490 25.45 FLUCONAZOLE TAB 200 MG PHAR PHARMACY 250 J3490 28.66 FLUCONAZOLE/D5W IVPB 200 MG/100 ML PHAR PHARMACY 250 J3490 95.30 FLUCONAZOLE/NS IVPB 200 MG/100 ML PHAR PHARMACY 250 J3490 103.00 FLUCONAZOLE/NS IVPB 400 MG/200 ML PHAR PHARMACY 250 J3490 106.43 FLUDROCORTISONE TAB 0.1 MG PHAR PHARMACY 250 J3490 8.84 FLUMAZENIL INJ 0.1 MG/ML PHAR PHARMACY 250 J3490 29.96 FLUMAZENIL INJ 0.5 MG/5 ML PHAR PHARMACY 250 J3490 21.21 FLUNISOLIDE INH PHAR PHARMACY 636 J7641 43.70 FLUNISOLIDE NASAL SOLN 0.025% PHAR PHARMACY 250 J3490 138.80 FLUOCINOLONE TOPICAL SOLN 0.01% PHAR PHARMACY 250 J3490 47.28 FLUOCINONIDE OINT 0.05% 15 GM PHAR PHARMACY 250 J3490 170.28 FLUOCINONIDE OINT 0.05% 60 GM PHAR PHARMACY 250 J3490 424.36 FLUORACAINE OPTH SOLN PHAR PHARMACY 250 J3490 9.18 104 FLUORESCEIN OPHTH STRIPS PHAR PHARMACY 250 J3490 43.54 FLUOXETINE CAP 10 MG PHAR PHARMACY 250 J3490 9.66 FLUOXETINE CAP 20 MG PHAR PHARMACY 250 J3490 10.04 FLUOXETINE CAP 40 MG PHAR PHARMACY 250 J3490 5.47 FLUPHENAZINE TAB 5 MG PHAR PHARMACY 250 J3490 8.48 FLURBIPROFEN 0.03% OPH 2.5ML ER PHAR PHARMACY 250 J3490 101.42 FLUTICASONE FUMERATE MDI ER PHAR PHARMACY 250 J3490 193.62 FLUTICASONE FUMERATE NASAL SPRAY PHAR PHARMACY 250 J3490 6.45 FLUTICASONE INH 110 MCG PHAR PHARMACY 250 J3490 436.41 FLUTICASONE INH 220 MCG 12 GM PHAR PHARMACY 250 J3490 653.93 FLUTICASONE INH 44 MCG 10.6 GM PHAR PHARMACY 250 J3490 336.93 FLUTICASONE PROPIONATE NASAL SPRAY PHAR PHARMACY 250 J3490 158.06 FLUTICASONE/SALMETEROL INH 100/50 MG PHAR PHARMACY 250 J3490 288.45 FLUTICASONE/SALMETEROL INH 250/50 MG PHAR PHARMACY 250 J3490 288.45 FLUTICASONE/SALMETEROL INH 500/50 MG PHAR PHARMACY 250 J3490 442.89 FLUVASTATIN CAP 20 MG PHAR PHARMACY 250 J3490 7.27 FLUVASTATIN CAP 40 MG PHAR PHARMACY 250 J3490 6.79 FLUVASTATIN XL CAP 80 MG PHAR PHARMACY 250 J3490 7.95 FLUVOXAMINE TAB 100 MG PHAR PHARMACY 250 J3490 5.30 FLUVOXAMINE TAB 50 MG PHAR PHARMACY 250 J3490 10.15 FOLIC ACID INJ 5 MG/ML PHAR PHARMACY 250 J3490 26.31 FOLIC ACID TAB 0.4 MG PHAR PHARMACY 250 J3490 6.74 FOLIC ACID TAB 1 MG PHAR PHARMACY 250 J3490 6.82 FOMEPIZOLE INJ 1.5 GM/1.5 ML PHAR PHARMACY 250 J3490 1,620.26 FONDAPARINUX INJ 2.5 MG/0.5 ML PHAR PHARMACY 250 J1652 92.62 FONDAPARINUX INJ 7.5 MG/0.6 ML PHAR PHARMACY 250 J1652 192.22 FORMOTEROL FUMARATE INH 12 MCG (#50) PHAR PHARMACY 250 J3490 8.04 FOSINOPRIL TAB 10 MG PHAR PHARMACY 250 J3490 9.41 FOSINOPRIL TAB 20 MG PHAR PHARMACY 250 J3490 8.29 FOSPHENYTOIN INJ 100 MG/2 ML PHAR PHARMACY 250 J3490 43.26 FOSPHENYTOIN INJ 500 MG/10 ML PHAR PHARMACY 250 Q2009 179.84 FUROSEMIDE INJ 40 MG/4 ML PHAR PHARMACY 250 J3490 39.11 FUROSEMIDE DRIP 1000 MG IN 100 ML PHAR PHARMACY 250 J3490 152.02 FUROSEMIDE ELIX 10 MG/ML PHAR PHARMACY 250 J3490 57.05 FUROSEMIDE INJ 100 MG/10 ML PHAR PHARMACY 636 J1940 24.71 FUROSEMIDE INJ 20 MG/2 ML PHAR PHARMACY 250 J3490 24.62 FUROSEMIDE TAB 20 MG PHAR PHARMACY 250 J3490 6.89 FUROSEMIDE TAB 40 MG PHAR PHARMACY 250 J3490 6.93 FUROSEMIDE TAB 80 MG PHAR PHARMACY 250 J3490 8.81 GABAPENTIN CAP 100 MG PHAR PHARMACY 250 J3490 7.48 GABAPENTIN CAP 300 MG PHAR PHARMACY 250 J3490 8.54 GABAPENTIN CAP 400 MG PHAR PHARMACY 250 J3490 7.02 105 GABAPENTIN SOLN 250 MG/5 ML PHAR PHARMACY 250 J3490 8.82 GABAPENTIN TAB 600 MG PHAR PHARMACY 250 J3490 9.95 GADAPENTETATE DIMEGLUMINE INJ 10 ML PHAR PHARMACY 250 J3490 25.97 GALANTAMINE TAB 4 MG PHAR PHARMACY 250 J3490 7.83 GATIFLOXACIN INJ 200 MG/100 ML PHAR PHARMACY 250 J3490 83.91 GATIFLOXACIN INJ 400 MG/200 ML PHAR PHARMACY 250 J3490 102.72 GATIFLOXACIN OPTH 0.3% 5 ML PHAR PHARMACY 250 J3490 75.04 GATIFLOXACIN TAB 200 MG PHAR PHARMACY 250 J3490 14.56 GATIFLOXACIN TAB 400 MG PHAR PHARMACY 250 J3490 14.07 GEMFIBROZIL TAB 600 MG PHAR PHARMACY 250 J3490 9.96 GENACED (ACETA/ASA/CAFF) TAB PHAR PHARMACY 250 J3490 7.09 GENTAMICIN 0.1% OINT 15 GM PHAR PHARMACY 250 J3490 87.57 GENTAMICIN 0.3 % OPTH SOLN 5 ML PHAR PHARMACY 253 J3490 72.46 GENTAMICIN INJ 20 MG/2 ML PHAR PHARMACY 250 J1580 25.39 GENTAMICIN INJ 80 MG/2 ML PHAR PHARMACY 250 J1580 24.24 GENTAMICIN IVPB 20 MG/2 ML PHAR PHARMACY 250 J1580 101.49 GENTAMICIN IVPB 80 ML/2 ML PHAR PHARMACY 250 J1580 100.34 GENTAMICIN OPHTH OINT ER PHAR PHARMACY 250 J3490 90.97 GENTAMICIN OPHTH SOLN ER PHAR PHARMACY 250 J3490 72.46 GI COCKTAIL 30 ML PHAR PHARMACY 250 J3490 7.00 GLATIRAMER ACETATE INJ 20 MG PHAR PHARMACY 250 J3490 201.49 GLIMEPIRIDE TAB 1 MG PHAR PHARMACY 250 J3490 7.23 GLIMEPIRIDE TAB 2 MG PHAR PHARMACY 250 J3490 7.88 GLIMEPIRIDE TAB 4 MG PHAR PHARMACY 250 J3490 5.11 GLIPIZIDE TAB 10 MG PHAR PHARMACY 250 J3490 7.49 GLIPIZIDE TAB 5 MG PHAR PHARMACY 250 J3490 7.19 GLIPIZIDE XL TAB 10 MG PHAR PHARMACY 250 J3490 7.78 GLIPIZIDE XL TAB 2.5 MG PHAR PHARMACY 250 J3490 7.24 GLIPIZIDE XL TAB 5 MG PHAR PHARMACY 250 J3490 7.66 GLUCAGON INJ 1 MG/ML PHAR PHARMACY 250 J3490 296.33 GLUCAGON KIT 1 MG/ML PHAR PHARMACY 250 J3490 296.33 GLUCOPHAGE ER TAB 750 MG PHAR PHARMACY 250 J3490 5.03 GLUCOSAMINE CAP 500 MG PHAR PHARMACY 250 J3490 6.78 GLUCOSAMINE/CHONDROITIN TAB 500/400 MG PHAR PHARMACY 250 J3490 8.02 GLUCOSE GEL 15 GM PHAR PHARMACY 250 J3490 12.06 GLUCOSE TAB 4 GM (#10) PHAR PHARMACY 250 J3490 6.96 GLYBURIDE TAB 1.25 MG PHAR PHARMACY 250 J3490 7.06 GLYBURIDE TAB 2.5 MG PHAR PHARMACY 250 J3490 7.10 GLYBURIDE TAB 3 MG PHAR PHARMACY 250 J3490 7.50 GLYBURIDE TAB 5 MG PHAR PHARMACY 250 J3490 7.01 GLYBURIDE/METFORMIN TAB 1.25/250 MG PHAR PHARMACY 250 J3490 5.47 GLYBURIDE/METFORMIN TAB 2.5/500 MG PHAR PHARMACY 250 J3490 8.79 106 GLYBURIDE/METFORMIN TAB 5/500 MG PHAR PHARMACY 250 J3490 5.24 GLYCERIN SUPP ADULT PHAR PHARMACY 250 J3490 6.96 GLYCERIN SUPP PEDIATRIC PHAR PHARMACY 250 J3490 6.82 GLYCOPYRROLATE INJ 0.2 MG/ML PHAR PHARMACY 250 J3490 31.79 GOLDEN AGE LIQ PHAR PHARMACY 250 J3490 11.64 GUAIFENESIN LA TAB 600 MG PHAR PHARMACY 250 J3490 7.33 GUAIFENESIN LIQ PHAR PHARMACY 250 J3490 43.40 GUAIFENESIN SOLN 200 MG/10 ML UD PHAR PHARMACY 250 J3490 6.86 GUAIFENESIN TAB 200 MG PHAR PHARMACY 250 J3490 4.95 GUAIFENESIN TAB 400 MG PHAR PHARMACY 250 J3490 7.21 GUAIFENESIN/DEXTROMETHORPHAM TAB 600/30 PHAR PHARMACY 250 J3490 7.52 GUAIFENESIN/DEXTROMETHORPHAN LIQ PHAR PHARMACY 250 J3490 7.00 GUANFACINE TAB 1 MG PHAR PHARMACY 250 J3490 7.99 HALCINONIDE OINT 0.1 % 30 GM PHAR PHARMACY 250 J3490 287.17 HALFLYTELY & BISACODYL KIT PHAR PHARMACY 250 J3490 60.57 HALLS COUGH DROPS PHAR PHARMACY 250 J3490 6.85 HALOBETASOL CRM 0.05 % PHAR PHARMACY 250 J3490 37.16 HALOPERIDOL INJ 5 MG/ML PHAR PHARMACY 250 J1630 20.96 HALOPERIDOL SOLN 2 MG/ML 15 ML PHAR PHARMACY 250 J3490 9.08 HALOPERIDOL TAB 0.5 MG PHAR PHARMACY 250 J3490 7.09 HALOPERIDOL TAB 1 MG PHAR PHARMACY 250 J3490 7.31 HALOPERIDOL TAB 2 MG PHAR PHARMACY 250 J3490 5.18 HALOPERIDOL TAB 5 MG PHAR PHARMACY 250 J3490 5.00 HEMORRHOIDAL OINT PHAR PHARMACY 250 J3490 43.41 HEP A&B COMBO VACCINE PHAR PHARMACY 250 J3490 181.84 HEPARIN INJ 10 U/ML PHAR PHARMACY 250 J3490 21.73 HEPARIN INJ 100 U/ML PHAR PHARMACY 250 J3490 16.90 HEPARIN INJ 10000 U/ML PHAR PHARMACY 636 J1644 27.71 HEPARIN INJ 500 U/5 ML PHAR PHARMACY 250 J3490 24.02 HEPARIN INJ 5000 U/1 ML PHAR PHARMACY 250 J3490 23.22 HEPARIN IVPB 25000 U/500 ML PHAR PHARMACY 250 J1644 105.37 HEPATITIS A 1440 EL. U PHAR PHARMACY 250 J3490 129.08 HEPATITIS A 720 EL.U PHAR PHARMACY 250 J3490 124.16 HEPATITIS B IMMUNE GLOBULIN PHAR PHARMACY 636 J3490 288.56 HEPATITIS B PEDIATRIC PHAR PHARMACY 250 J3490 93.12 HEPATITIS B VACCINE - ADULT-PF PHAR PHARMACY 250 J3490 119.48 HEPATITIS B VACCINE ADULT PHAR PHARMACY 250 J3490 111.34 HEPATITIS B VACCINE PEDIATRIC MERCK PHAR PHARMACY 250 J3490 30.96 HETASTARCH INJ 6 % 500 ML PHAR PHARMACY 250 J3490 130.36 HOMATROPINE HYDROBROMIDE OPHTH SOLN 5 % PHAR PHARMACY 250 J3490 71.26 HUMAN INSULIN INJ PHAR PHARMACY 250 J3490 17.77 HUMAN PAPILOMVIRUS VACCINE (GARDASIL ) PHAR PHARMACY 250 J3490 369.68 107 HYCOMINE SYRUP PHAR PHARMACY 250 J3490 4.95 HYDOROCODONE/HOMATROPINE SYRUP 5 MG/1.5 PHAR PHARMACY 253 J3490 58.18 HYDRALAZINE INJ 20 MG/ML PHAR PHARMACY 636 J0360 38.41 HYDRALAZINE TAB 10 MG PHAR PHARMACY 250 J3490 7.25 HYDRALAZINE TAB 25 MG PHAR PHARMACY 250 J3490 6.89 HYDRALAZINE TAB 50 MG PHAR PHARMACY 250 J3490 5.17 HYDROCHLOROTHIAZIDE CAP 12.5 MG PHAR PHARMACY 250 J3490 7.26 HYDROCHLOROTHIAZIDE TAB 25 MG PHAR PHARMACY 250 J3490 6.86 HYDROCHLOROTHIAZIDE TAB 50 MG PHAR PHARMACY 250 J3490 5.06 HYDROCODONE/APAP SOLN 10/300 MG - 15 ML PHAR PHARMACY 250 J3490 12.23 HYDROCODONE/APAP SOLN 7.5/325 MG - 15 ML PHAR PHARMACY 250 J3490 7.09 HYDROCODONE/APAP SOLN 7.5/500 MG - 15 ML PHAR PHARMACY 250 J3490 5.31 HYDROCODONE/APAP SOLN 7.5/500 MG UD PHAR PHARMACY 250 J3490 8.38 HYDROCODONE/APAP TAB 10/325 MG PHAR PHARMACY 250 J3490 8.15 HYDROCODONE/APAP TAB 10/500 MG PHAR PHARMACY 250 J3490 5.08 HYDROCODONE/APAP TAB 5/325 MG PHAR PHARMACY 250 J3490 7.24 HYDROCODONE/APAP TAB 5/325 MG ER 6 PHAR PHARMACY 253 J3490 46.53 HYDROCODONE/APAP TAB 7.5/325 MG PHAR PHARMACY 250 J3490 7.53 HYDROCODONE/APAP TAB 7.5/500 MG PHAR PHARMACY 250 J3490 5.04 HYDROCODONE/CHLORPHENIRAMINE SUSP 10/8 M PHAR PHARMACY 250 J3490 12.30 HYDROCODONE/GUAIFENESIN SYRUP 5/100 MG - PHAR PHARMACY 250 J3490 5.00 HYDROCODONE/HOMAPTROPINE SYRUP 5/1.5 MG PHAR PHARMACY 250 J3490 8.04 HYDROCORTISONE 0.5 % CRM 30 GM PHAR PHARMACY 250 J3490 43.55 HYDROCORTISONE 0.5 % OINT PHAR PHARMACY 250 J3490 5.82 HYDROCORTISONE 1 % CRM 30 GM PHAR PHARMACY 250 J3490 43.40 HYDROCORTISONE 1 % RECT CRM PHAR PHARMACY 250 J3490 12.50 HYDROCORTISONE 1 % RECT FOAM PHAR PHARMACY 250 J3490 29.71 HYDROCORTISONE 1 % RECT KIT 30 GM PHAR PHARMACY 250 J3490 46.09 HYDROCORTISONE 2.5 % CRM PHAR PHARMACY 250 J3490 58.05 HYDROCORTISONE 2.5 % RECT CRM PHAR PHARMACY 250 J3490 10.61 HYDROCORTISONE ENEMA 100 MG/60 ML PHAR PHARMACY 250 J3490 14.77 HYDROCORTISONE INJ 100 MG/2 ML PHAR PHARMACY 250 J3490 62.42 HYDROCORTISONE INJ 250 MG/2 ML PHAR PHARMACY 250 J3490 59.17 HYDROCORTISONE SUPP 25 MG PHAR PHARMACY 250 J3490 37.19 HYDROCORTISONE TAB 10 MG PHAR PHARMACY 250 J3490 9.39 HYDROCORTISONE TAB 20 MG PHAR PHARMACY 250 J3490 8.15 HYDROCORTISONE TAB 5 MG PHAR PHARMACY 250 J3490 8.90 HYDROCORTISONE/ACETIC ACID OTIC SOLN 1 % PHAR PHARMACY 250 J3490 5.62 HYDROGEN PEROXIDE 1.5% RINSE (MINT) 16 O PHAR PHARMACY 250 J3490 49.60 HYDROGEN PEROXIDE 3 % LIQ PHAR PHARMACY 250 J3490 5.70 HYDROMORPHONE INJ 2 MG/ML TUBEX PHAR PHARMACY 250 J3490 21.35 HYDROMORPHONE INJ 4 MG/ML TUBEX PHAR PHARMACY 250 J1170 23.16 108 HYDROMORPHONE PCA 10 MG/50 ML PHAR PHARMACY 250 J1170 117.26 HYDROMORPHONE TAB 2 MG PHAR PHARMACY 250 J3490 8.65 HYDROMORPHONE TAB 4 MG PHAR PHARMACY 250 J3490 6.97 HYDROXYCHLOROQUINE TAB 200 MG PHAR PHARMACY 250 J3490 12.19 HYDROXYUREA CAP 500 MG PHAR PHARMACY 250 J3490 8.41 HYDROXYZINE ELIX 10 MG/5 ML PHAR PHARMACY 250 J3490 11.52 HYDROXYZINE INJ 100 MG/2 ML PHAR PHARMACY 636 J3410 90.93 HYDROXYZINE INJ 25 MG/ML PHAR PHARMACY 250 J3410 51.61 HYDROXYZINE NJ 50 MG/ML PHAR PHARMACY 250 J3490 20.67 HYDROXYZINE PAM CAP 25 MG PHAR PHARMACY 250 J3490 7.09 HYDROXYZINE PAM CAP 25 MG ER (#4) PHAR PHARMACY 250 J3490 18.75 HYDROXYZINE PAM CAP 50 MG PHAR PHARMACY 250 J3490 7.12 HYDROXYZINE TAB 10 MG PHAR PHARMACY 250 J3490 7.06 HYDROXYZINE TAB 100 MG PHAR PHARMACY 250 J3490 8.29 HYDROXYZINE TAB 25 MG PHAR PHARMACY 250 J3490 7.22 HYDROXYZINE TAB 50 MG PHAR PHARMACY 250 J3490 5.40 HYOSCYAMINE SULFATE ORAL DROPS 15 ML PHAR PHARMACY 250 J3490 96.09 HYOSCYAMINE TAB 0.125 MG PHAR PHARMACY 250 J3490 7.83 HYOSCYAMINE TAB 0.375 MG PHAR PHARMACY 250 J3490 8.84 HYRDOCORTISONE 1 % OINT - 30 GM PHAR PHARMACY 250 J3490 43.41 IBANDRONATE INJ 3 MG/3 ML PFS PHAR PHARMACY 250 J1740 699.37 IBUPROFEN CHEW TAB 50 MG PHAR PHARMACY 250 J3490 5.06 IBUPROFEN SUSP 100 MG/5 ML UD PHAR PHARMACY 250 J3490 6.91 IBUPROFEN TAB 200 MG PHAR PHARMACY 250 J3490 6.76 IBUPROFEN TAB 400 MG PHAR PHARMACY 250 J3490 6.98 IBUPROFEN TAB 600 MG PHAR PHARMACY 250 J3490 7.18 IBUPROFEN TAB 600 MG ER (#4) PHAR PHARMACY 253 J3490 43.37 IBUPROFEN TAB 800 MG PHAR PHARMACY 250 J3490 7.27 IBUTILIDE FUMARATE IVPB PHAR PHARMACY 636 J1742 826.00 IMIPENEM/CILASTIN IVPB 500 MG PHAR PHARMACY 250 J3490 71.18 IMIPRAMINE TAB 10 MG PHAR PHARMACY 250 J3490 5.18 IMIPRAMINE TAB 25 MG PHAR PHARMACY 250 J3490 5.17 IMIPRAMINE TAB 50 MG PHAR PHARMACY 250 J3490 5.30 IMMUNE GLOBUIN IV HUMAN 12 GM PHAR PHARMACY 636 J1566 1,956.80 IMMUNE GLOBULIN INJ (HUMAN) 10 GM PHAR PHARMACY 250 J1459 117.58 IMMUNE GLOBULIN INJ (HUMAN) 10% 20 GM/20 PHAR PHARMACY 250 J3490 3,080.28 IMMUNE GLOBULIN INJ (HUMAN) 5% 10 GM/200 PHAR PHARMACY 250 J1568 2,397.49 IMMUNE GLOBULIN INJ 10 GM PHAR PHARMACY 250 J3490 188.80 IMMUNE GLOBULIN INJ 10 GM/100 ML PHAR PHARMACY 636 J1561 904.28 IMMUNE GLOBULIN INJ 10% DIF 10 GM/100 ML PHAR PHARMACY 250 J3490 1,587.69 IMMUNE GLOBULIN VACC PHAR PHARMACY 250 J3490 109.92 IMPACT PHAR PHARMACY 250 J3490 54.70 109 INDAPAMIDE TAB 1.25 MG PHAR PHARMACY 250 J3490 8.60 INDAPAMIDE TAB 2.5 MG PHAR PHARMACY 250 J3490 7.81 INDIGOTIN DISULFONATE 0.8% INJ 5 ML PHAR PHARMACY 250 J3490 20.14 INDINAVIR CAP 400 MG PHAR PHARMACY 250 J3490 17.63 INDOMETHACIN CAP 25 MG PHAR PHARMACY 250 J3490 7.22 INDOMETHACIN CAP 50 MG PHAR PHARMACY 250 J3490 5.18 INDOMETHACIN SR CAP 75 MG PHAR PHARMACY 250 J3490 7.18 INFLIXIMAB INJ 100 MG PHAR PHARMACY 636 J1745 1,982.36 INSULIN ASPART (RDNA ORIGIN) PHAR PHARMACY 250 J1815 21.36 INSULIN ASPART INJECTION 100 UNITS/ML PHAR PHARMACY 253 J1815 199.64 INSULIN DETEMIR 100 UNITS/ML 10 ML PHAR PHARMACY 250 J1817 42.76 INSULIN DETEMIR FLEX PEN INJ 100 UN/ML PHAR PHARMACY 250 J1817 161.43 INSULIN GLARGINE INJ 100 U/ML PHAR PHARMACY 250 J3490 40.80 INSULIN GLIMEPIRIDE INJ 70/30 MIX PHAR PHARMACY 250 J1817 30.15 INSULIN HUMAN NPH INJ 100 U/ML PHAR PHARMACY 250 J1817 30.15 INSULIN LENTE INJ 100 U/ML PHAR PHARMACY 250 J3490 24.96 INSULIN LISPRO INJ 100 U/ML PHAR PHARMACY 250 J3490 21.72 INSULIN LISPRO INJ 75/25 MIX PHAR PHARMACY 636 J1815 22.73 INSULIN REGULAR HUMAN INJ 100 U/ML PHAR PHARMACY 636 J1815 20.13 INTRALIPID 20% 250ML PHAR PHARMACY 250 J3490 161.63 INTRAVENOUS FAT EMULUSION 20% PHAR PHARMACY 250 J3490 82.59 IOHEXOL INJ 240 MG/ML 10 ML PHAR PHARMACY 250 J3490 101.02 IPECAC SYRUP 1 OZ PHAR PHARMACY 250 J3490 7.44 IPRATROPIUM 0.02 % NEB SOLN PHAR PHARMACY 636 J7644 8.47 IPRATROPIUM BROMIDE/ALBUTEROL NEB SOLN 0 PHAR PHARMACY 250 J3490 9.64 IPRATROPIUM INH PHAR PHARMACY 636 J7644 623.96 IPRATROPIUM/ALBUTEROL INH PHAR PHARMACY 250 J3490 288.97 IPRATROPUIM NASAL SPRAY PHAR PHARMACY 636 J7644 68.60 IRBESARTAN TAB 150 MG PHAR PHARMACY 250 J3490 10.83 IRBESARTAN TAB 300 MG PHAR PHARMACY 250 J3490 18.34 IRBESARTAN TAB 75 MG PHAR PHARMACY 250 J3490 10.62 IRBESARTIN/HCTZ TAB 150/12.5 MG PHAR PHARMACY 250 J3490 18.42 IRON DEXTRAN INJ 100 MG/2 ML PHAR PHARMACY 250 J3490 61.87 IRON SUCROSE IVPB 100 MG/5 ML PHAR PHARMACY 250 J1756 99.82 IS PHAR PHARMACY 250 J3490 4.95 ISOFLURANE INH SOLN 100 ML PHAR PHARMACY 250 J3490 15.84 ISONIAZID TAB 300 MG PHAR PHARMACY 250 J3490 7.37 ISOSORBIDE DINITRATE TAB 10 MG PHAR PHARMACY 250 J3490 8.37 ISOSORBIDE DINITRATE TAB 20 MG PHAR PHARMACY 250 J3490 5.00 ISOSORBIDE DINITRATE TAB 40 MG PHAR PHARMACY 250 J3490 9.39 ISOSORBIDE DINITRATE TAB 5 MG PHAR PHARMACY 250 J3490 19.88 ISOSORBIDE MONONITRATE ER TAB 120 MG PHAR PHARMACY 250 J3490 10.64 110 ISOSORBIDE MONONITRATE TAB 20 MG PHAR PHARMACY 250 J3490 7.68 ISOSORBIDE MONONITRATE TAB 30 MG PHAR PHARMACY 250 J3490 8.90 ISOSORBIDE MONONITRATE TAB 60 MG PHAR PHARMACY 250 J3490 9.38 ISOSULFAN BLUE 1% (FOR LYMPHOGRAPHY) PHAR PHARMACY 250 J3490 348.96 ITRACONAZOLE CAP 100 MG PHAR PHARMACY 250 J3490 10.57 IVSTOP PHAR PHARMACY 250 J3490 4.95 JEVITY LIQ PHAR PHARMACY 250 J3490 6.65 K+ ELECTROLYTE PROTOCOL REPLACEMENT PHAR PHARMACY 250 J3490 4.95 K-LYTE TAB 25 MEQ PHAR PHARMACY 250 J3490 5.38 KAOPECTATE LIQ PHAR PHARMACY 250 J3490 7.42 KETAMINE INJ 10 MG/ML 2 ML/0.9 % NS SYR PHAR PHARMACY 250 J3490 23.89 KETAMINE INJ 10 MG/ML 5 ML/0.9 % NS SYR PHAR PHARMACY 250 J3490 29.77 KETAMINE INJ 500 MG/5 ML PHAR PHARMACY 250 J3490 34.98 KETOCONAZOLE 2 % CRM 30 GM PHAR PHARMACY 250 J3490 45.58 KETOCONAZOLE TAB 200 MG PHAR PHARMACY 250 J3490 10.95 KETOPROFEN CAP 75 MG PHAR PHARMACY 250 J3490 17.28 KETOROLAC INJ 15 MG/ML PHAR PHARMACY 250 J1885 20.72 KETOROLAC INJ 30 MG/ML PHAR PHARMACY 250 J1885 21.58 KETOROLAC INJ 60 MG/2 ML PHAR PHARMACY 250 J1885 29.12 KETOROLAC TAB 10 MG PHAR PHARMACY 250 J3490 9.59 KETOROLAC TROMETHAMINE 0.5% OPTH SOLN 5 PHAR PHARMACY 250 J3490 187.16 KETOTIFEN FUMERATE (ALAWAY) OPTH SOLN 5 PHAR PHARMACY 250 J3490 64.63 L.E.T.S. SYRINGE PHAR PHARMACY 250 J3490 45.11 LABETALOL INJ 100 MG/20 ML PHAR PHARMACY 250 J3490 37.54 LABETALOL INJ CARTRIDGE 20 MG/4 ML PHAR PHARMACY 250 J3490 29.94 LABETOLOL INJ 5 MG/ML PHAR PHARMACY 250 J3490 19.29 LABETOLOL IVPB 250 MG/NS OR D5W 250 ML PHAR PHARMACY 250 J3490 69.52 LABETOLOL TAB 100 MG PHAR PHARMACY 250 J3490 9.76 LABETOLOL TAB 200 MG PHAR PHARMACY 250 J3490 11.39 LACRI-LUBE OPTH OINT PHAR PHARMACY 250 J3490 51.98 LACTASE ENZYME TAB PHAR PHARMACY 250 J3490 6.86 LACTATED RINGERS INJ 1000ML PHAR PHARMACY 250 J7120 102.27 LACTATED RINGERS INJ 500 ML PHAR PHARMACY 250 J7120 6.39 LACTOBACILLUS ACIDOPHILUS PHAR PHARMACY 250 J3490 7.41 LACTULOSE SYRUP 10 GM/15 ML UD PHAR PHARMACY 250 J3490 6.73 LACTULOSE SYRUP 20 GM/30 ML UD PHAR PHARMACY 250 J3490 6.73 LAMOTRIGINE TAB 100 MG PHAR PHARMACY 250 J3490 7.00 LAMOTRIGINE TAB 200 MG PHAR PHARMACY 250 J3490 15.45 LAMOTRIGINE TAB 25 MG PHAR PHARMACY 250 J3490 12.29 LANOLIN BREAST CRM PHAR PHARMACY 250 J3490 43.62 LANSOPRAZOLE CAP 15 MG PHAR PHARMACY 250 J3490 14.32 LANSOPRAZOLE CAP 30 MG PHAR PHARMACY 250 J3490 14.32 111 LANSOPRAZOLE INJ 30 MG PHAR PHARMACY 250 J3490 71.35 LANSOPRAZOLE SOLUTAB 30 MG PHAR PHARMACY 250 J3490 9.30 LATANOPROST 0.005 % OPTH SOLN PHAR PHARMACY 250 J3490 171.18 LAXATIVE/ENEMA/SUPPOSITORY PHAR PHARMACY 250 J3490 4.50 LEUPROLIDE INJ 3.75 MG PHAR PHARMACY 636 J1950 956.51 LEVALBUTEROL HFA MDI PHAR PHARMACY 250 J3490 5.29 LEVALBUTEROL INH SOLN 0.63 MG/3 ML PHAR PHARMACY 250 J3490 9.38 LEVALBUTEROL INH SOLN 1.25 MG/0.5 ML PHAR PHARMACY 250 J3490 11.20 LEVETIRACETAM ORAL SOLN 100 MG/ML 480 M PHAR PHARMACY 250 J3490 500.96 LEVETIRACETAM INJ 500 MG/5 ML PHAR PHARMACY 250 J3490 31.77 LEVETIRACETAM TAB 250 MG PHAR PHARMACY 250 J3490 10.17 LEVETIRACETAM TAB 500 MG PHAR PHARMACY 250 J3490 10.95 LEVETIRACETAM/NACL PREMIX 500 MG/0.82 % PHAR PHARMACY 250 J1953 143.22 LEVOBUNOLOL 0.5 % OPTH SOLN PHAR PHARMACY 250 J3490 50.75 LEVOCABASTINE 0.05 % OPTH SOLN PHAR PHARMACY 250 J3490 46.38 LEVOCARNITINE TAB 330 MG PHAR PHARMACY 250 J3490 8.28 LEVOFLOXACIN IVPB 500 MG/100 ML PHAR PHARMACY 636 J1956 112.90 LEVOFLOXACIN IVPB 750 MG/150 ML PHAR PHARMACY 636 J1956 112.90 LEVOFLOXACIN PREMIX 250 MG/50 ML PHAR PHARMACY 250 J1956 106.43 LEVOFLOXACIN TAB 250 MG PHAR PHARMACY 250 J3490 26.52 LEVOFLOXACIN TAB 500 MG PHAR PHARMACY 250 J3490 29.34 LEVONORGESTREL TAB 1.5 MG PHAR PHARMACY 250 J3490 59.21 LEVOPHED DRIP 8 MG IN 250 ML D5W PHAR PHARMACY 250 J3490 153.36 LEVOTHYROXINE INJ 100 MCG PHAR PHARMACY 250 J3490 189.65 LEVOTHYROXINE INJ 200 MCG/5 ML PHAR PHARMACY 250 J3490 360.26 LEVOTHYROXINE TAB 0.025 MG PHAR PHARMACY 250 J3490 7.28 LEVOTHYROXINE TAB 0.05 MG PHAR PHARMACY 250 J3490 7.36 LEVOTHYROXINE TAB 0.075 MG PHAR PHARMACY 250 J3490 7.43 LEVOTHYROXINE TAB 0.088 MG PHAR PHARMACY 250 J3490 7.44 LEVOTHYROXINE TAB 0.1 MG PHAR PHARMACY 250 J3490 7.44 LEVOTHYROXINE TAB 0.112 MG PHAR PHARMACY 250 J3490 7.56 LEVOTHYROXINE TAB 0.125 MG PHAR PHARMACY 250 J3490 8.60 LEVOTHYROXINE TAB 0.137 MG PHAR PHARMACY 250 J3490 7.59 LEVOTHYROXINE TAB 0.15 MG PHAR PHARMACY 250 J3490 7.60 LEVOTHYROXINE TAB 0.175 MG PHAR PHARMACY 250 J3490 7.78 LEVOTHYROXINE TAB 0.2 MG PHAR PHARMACY 250 J3490 7.54 LIDOCAINE 0.5 % INJ MPF PHAR PHARMACY 250 J3490 28.33 LIDOCAINE 1 % 20ML MDV INJ PHAR PHARMACY 250 J3490 23.79 LIDOCAINE 1% W/EPI 30ML MDV INJ PHAR PHARMACY 250 J3490 19.29 LIDOCAINE 1 % INJ 2ML MPF PHAR PHARMACY 250 J3490 22.32 LIDOCAINE 2 % ABBOJECT PHAR PHARMACY 250 J3490 24.24 LIDOCAINE 2 % INJ PHAR PHARMACY 250 J3490 24.42 112 LIDOCAINE 2 % INJ MPF 5 ML PHAR PHARMACY 250 J2001 23.87 LIDOCAINE 2 % JELLY PHAR PHARMACY 250 J3490 44.29 LIDOCAINE 2 % JELLY 30 ML PHAR PHARMACY 250 J3490 43.80 LIDOCAINE 2 % JELLY 5 ML PHAR PHARMACY 250 J3490 44.29 LIDOCAINE 2 % JELLY SYRINGE 20 MG/ML 10 PHAR PHARMACY 250 J3490 44.28 LIDOCAINE 2 % SOLN PHAR PHARMACY 250 J3490 23.85 LIDOCAINE 2 % VISCOUS 100 ML PHAR PHARMACY 250 J3490 43.33 LIDOCAINE 2 % VISCOUS 20 ML PHAR PHARMACY 250 J3490 43.29 LIDOCAINE 2% INJ MPF PHAR PHARMACY 250 J2001 23.14 LIDOCAINE 2%/EPINEPHRINE 1:1000 /TETRACA PHAR PHARMACY 250 J3490 16.55 LIDOCAINE 4 % CRM PHAR PHARMACY 250 J3490 45.55 LIDOCAINE 4 % SOLN PHAR PHARMACY 250 J3490 43.56 LIDOCAINE 5 % INJ MPF PHAR PHARMACY 250 J3490 19.38 LIDOCAINE 5 % OINT PHAR PHARMACY 250 J3490 469.69 LIDOCAINE 5 % OINT 35.4 GM PHAR PHARMACY 250 J3490 83.90 LIDOCAINE 5% - DEXTROSE 7.5% INJ PHAR PHARMACY 250 J3490 26.39 LIDOCAINE IVPB 4 MG/ML IN D5W PHAR PHARMACY 250 J2001 103.62 LIDOCAINE PATCH 5 % PHAR PHARMACY 250 J3490 46.01 LIDOCAINE VISCOUS 2 % UD PHAR PHARMACY 250 J3490 5.82 LIDOCAINE W/EPI 1 % INJ MPF PHAR PHARMACY 250 J3490 35.65 LIDOCAINE W/EPI 2 % INJ MPF PHAR PHARMACY 250 J3490 44.42 LIDOCAINE/EPINEPHRINE 0.075/0.025 % OPHT PHAR PHARMACY 250 J3490 43.26 LINACLOTIDE CAP 145 MCG PHAR PHARMACY 250 J3490 27.54 LINEZOLID IVPB 600 MG PHAR PHARMACY 250 J2020 224.40 LINEZOLID TAB 600 MG PHAR PHARMACY 250 J3490 253.14 LIOTHYRONINE TAB 25 MCG PHAR PHARMACY 250 J3490 10.76 LIOTHYRONINE TAB 5 MCG PHAR PHARMACY 250 J3490 7.76 LIQUIBAND PHAR PHARMACY 250 J3490 46.71 LISINOPRIL TAB 10 MG PHAR PHARMACY 250 J3490 7.38 LISINOPRIL TAB 2.5 MG PHAR PHARMACY 250 J3490 7.61 LISINOPRIL TAB 20 MG PHAR PHARMACY 250 J3490 8.47 LISINOPRIL TAB 40 MG PHAR PHARMACY 250 J3490 7.73 LISINOPRIL TAB 5 MG PHAR PHARMACY 250 J3490 7.86 LITHIUM CAP 150 MG PHAR PHARMACY 250 J3490 6.88 LITHIUM CAP 300 MG PHAR PHARMACY 250 J3490 6.97 LITHIUM SR TAB 300 MG PHAR PHARMACY 250 J3490 7.32 LITHIUM SR TAB 450 MG PHAR PHARMACY 250 J3490 7.41 LOPERAMIDE CAP 2 MG PHAR PHARMACY 250 J3490 7.87 LOPERAMIDE SOLN 1 MG/7.5 ML PHAR PHARMACY 250 J3490 7.56 LORATADINE CHILDREN'S SYRUP 4 OZ ER PHAR PHARMACY 250 J3490 54.53 LORATADINE D TAB 12 H PHAR PHARMACY 250 J3490 5.95 LORATADINE D TAB 24 H PHAR PHARMACY 250 J3490 8.04 113 LORATADINE TAB 10 MG PHAR PHARMACY 250 J3490 7.77 LORATIDINE REDI-TABS 10 MG PHAR PHARMACY 250 J3490 7.80 LORAZEPAM DRIP 20 MG IN 100 ML PHAR PHARMACY 250 J3490 109.35 LORAZEPAM ER PACK TAB 1 MG (#4) PHAR PHARMACY 253 J3490 43.80 LORAZEPAM INJ 2 MG/ML PHAR PHARMACY 250 J3490 20.60 LORAZEPAM TAB 0.5 MG PHAR PHARMACY 250 J3490 7.20 LORAZEPAM TAB 1 MG PHAR PHARMACY 250 J3490 7.83 LORAZEPAM TAB 2 MG PHAR PHARMACY 250 J3490 5.37 LOSARTAN TAB 25 MG PHAR PHARMACY 250 J3490 8.86 LOSARTAN TAB 50 MG PHAR PHARMACY 250 J3490 7.78 LOSARTAN/HCTZ TAB 20/25 MG PHAR PHARMACY 250 J3490 10.62 LOSARTAN/HCTZ TAB 50/12.5 MG PHAR PHARMACY 250 J3490 13.32 LOVASTATIN TAB 20 MG PHAR PHARMACY 250 J3490 8.39 LOVASTATIN TAB 40 MG PHAR PHARMACY 250 J3490 12.44 MAALOX/BENADRYL/LIDOCAINE PHAR PHARMACY 250 J3490 7.21 MAGNESIUM CITRATE ORAL SOLN 297 ML PHAR PHARMACY 250 J3490 6.24 MAGNESIUM HYDROXIDE 2400 MG 30 ML PHAR PHARMACY 250 J3490 9.84 MAGNESIUM HYDROXIDE/ALUMINUM HYDROXIDE E PHAR PHARMACY 250 J3490 43.26 MAGNESIUM HYDROXIDE/ALUMINUM HYDROXIDE E PHAR PHARMACY 250 J3490 43.25 MAGNESIUM HYDROXIDE/ALUMINUM HYDROXIDE P PHAR PHARMACY 250 J3490 6.82 MAGNESIUM OXIDE TAB 400 MG PHAR PHARMACY 250 J3490 6.94 MAGNESIUM SULF INJ 1 GM/2 ML PHAR PHARMACY 250 J3490 21.57 MAGNESIUM SULF INJ 25 GM/50 ML PHAR PHARMACY 250 J3490 19.01 MAGNESIUM SULF INJ 5 GM/10 ML PHAR PHARMACY 250 J3490 97.92 MAGNESIUM SULF IVPB 20 GM/500 ML WATER PHAR PHARMACY 250 J3475 104.17 MAGNESIUM SULF PREMIX 1 GM/100 ML PHAR PHARMACY 250 J3475 107.08 MAGNESIUM SULF PREMIX 2 GM/50 ML PHAR PHARMACY 250 J3475 121.04 MAGNESIUM TAB 250 MG PHAR PHARMACY 250 J3490 6.74 MAGNESIUM TAB 64 MG PHAR PHARMACY 250 J3490 6.83 MANNITOL INJ 12.5 GM/50 ML PHAR PHARMACY 250 J3490 22.56 MASTISOL LIQ 2 OZ PHAR PHARMACY 250 J3490 46.40 MEASLES, MUMPS & RUBELLA PHAR PHARMACY 250 J3490 79.35 MEASLES/MUMPS/VARICELLA PHAR PHARMACY 250 J3490 364.64 MEBENDAZOLE TAB 100 MG PHAR PHARMACY 250 J3490 10.58 MECLIZINE TAB 12.5 MG PHAR PHARMACY 250 J3490 7.63 MECLIZINE TAB 25 MG PHAR PHARMACY 250 J3490 7.83 MECLOFENAMATE CAP 100 MG PHAR PHARMACY 250 J3490 5.29 MEDROXYPROGESTERONE INJ 150 MG PHAR PHARMACY 636 J1055 91.74 MEDROXYPROGESTERONE TAB 10 MG PHAR PHARMACY 250 J3490 5.28 MEDROXYPROGESTERONE TAB 2.5 MG PHAR PHARMACY 250 J3490 5.12 MEDROXYPROGESTERONE TAB 5 MG PHAR PHARMACY 250 J3490 7.33 MEGESTRAL TAB 40 MG PHAR PHARMACY 250 J3490 8.53 114 MEGESTROL ACETATE SUSP 40 MG/ML PHAR PHARMACY 250 J3490 59.17 MELATONIN TAB 3 MG PHAR PHARMACY 250 J3490 6.86 MELOXICAM TAB 15 MG PHAR PHARMACY 250 J3490 9.70 MELOXICAM TAB 7.5 MG PHAR PHARMACY 250 J3490 10.86 MEMANTINE TAB 10 MG PHAR PHARMACY 250 J3490 14.91 MEMANTINE TAB 5 MG PHAR PHARMACY 250 J3490 14.91 MENINGOCOCCAL CONJUGATE VACCINE PHAR PHARMACY 250 J3490 206.76 MENINGOCOCCAL GROUP B VACCINE PFS PHAR PHARMACY 250 J3490 286.68 MENINGOCOCCAL POLYSACCHARDE COMBINED VAC PHAR PHARMACY 250 J3490 217.86 MENTHOL/CAMPHOR OINT 1 OZ PHAR PHARMACY 250 J3490 15.66 MEPERIDINE INJ 100 MG/ML PHAR PHARMACY 636 J2175 22.90 MEPERIDINE INJ 50 MG/ML PHAR PHARMACY 250 J3490 29.96 MEPERIDINE INJ 75 MG/ML PHAR PHARMACY 250 J3490 18.64 MEPERIDINE PCA 500 MG/50 ML BAXTER PHAR PHARMACY 250 J2175 114.51 MEPERIDINE TAB 50 MG PHAR PHARMACY 250 J3490 5.29 MEPIVACAINE INJ 1.5 % MPF PHAR PHARMACY 250 J3490 20.50 MEPIVACAINE INJ 2 % MDV PHAR PHARMACY 250 J3490 16.64 MERCAPTOPURINE TAB 100 MG PHAR PHARMACY 250 J3490 6.24 MEROPENEM IVPB 1 GM PHAR PHARMACY 250 J3490 127.44 MEROPENEM IVPB 500 MG PHAR PHARMACY 250 J3490 111.28 MEROPENUM PREMIX 1 GM/50 ML PHAR PHARMACY 250 J3490 91.09 MESALAMINE CAP 250 MG PHAR PHARMACY 250 J3490 5.72 MESALAMINE CR CAP 500 MG PHAR PHARMACY 250 J3490 16.50 MESALAMINE DR CAP 400 MG PHAR PHARMACY 250 J3490 12.42 MESALAMINE RECTAL SUSP 60 ML PHAR PHARMACY 250 J3490 237.04 MESALAMINE SUPP 500 MG PHAR PHARMACY 250 J3490 9.32 METAMUCIL PKT PHAR PHARMACY 250 J3490 7.29 METAPROTERENOL INH PHAR PHARMACY 636 J7669 41.60 METAPROTERENOL NEBS 0.6 % PHAR PHARMACY 636 J7669 5.68 METAXALONE TAB 400 MG PHAR PHARMACY 250 J3490 15.31 METAXALONE TAB 800 MG PHAR PHARMACY 250 J3490 14.62 METFORMIN TAB 1000 MG PHAR PHARMACY 250 J3490 8.54 METFORMIN TAB 500 MG PHAR PHARMACY 250 J3490 6.80 METFORMIN TAB 850 MG PHAR PHARMACY 250 J3490 8.30 METFORMIN XR TAB 500 MG PHAR PHARMACY 250 J3490 8.49 METHADONE TAB 10 MG PHAR PHARMACY 250 J3490 7.10 METHADONE TAB 40 MG PHAR PHARMACY 250 J3490 5.14 METHADONE TAB 5 MG PHAR PHARMACY 250 J3490 7.21 METHENAMINE TAB 0.5 GM PHAR PHARMACY 250 J3490 7.88 METHIMAZOLE TAB 10 MG PHAR PHARMACY 250 J3490 7.72 METHOCARBAMOL INJ 100 MG/ML PHAR PHARMACY 636 J2800 19.35 METHOCARBAMOL TAB 500 MG PHAR PHARMACY 250 J3490 7.25 115 METHOCARBAMOL TAB 750 MG PHAR PHARMACY 250 J3490 7.67 METHOTREXATE INJ 250 MG/10 ML PF PHAR PHARMACY 250 J3490 33.62 METHOTREXATE INJ 50 MG/2 ML PF PHAR PHARMACY 250 J3490 21.73 METHOTREXATE TAB 2.5 MG PHAR PHARMACY 250 J3490 15.09 METHYL SALICYLATE 18.3% OINT PHAR PHARMACY 250 J3490 43.35 METHYLDOPA TAB 250 MG PHAR PHARMACY 250 J3490 5.13 METHYLDOPA TAB 500 MG PHAR PHARMACY 250 J3490 5.17 METHYLENE BLUE 1 % INJ PHAR PHARMACY 250 J3490 46.14 METHYLERGONOVINE INJ 0.2 MG/ML PHAR PHARMACY 250 J3490 50.95 METHYLERGONOVINE TAB 0.2 MG PHAR PHARMACY 250 J3490 107.29 METHYLNALTREXONE BROMIDE INJ 12 MG/0.6 M PHAR PHARMACY 250 J3490 195.17 METHYLPHENIDATE TAB 10 MG PHAR PHARMACY 250 J3490 5.68 METHYLPHENIDATE TAB 54 MG PHAR PHARMACY 250 J3490 17.33 METHYLPREDNISOLONE 4 MG TABS #21 DOSEPAK PHAR PHARMACY 250 J3490 4.95 METHYLPREDNISOLONE ACETATE INJ 40 MG/ML PHAR PHARMACY 250 J3490 33.08 METHYLPREDNISOLONE ACETATE INJ 80 MG/ML PHAR PHARMACY 250 J3490 167.32 METHYLPREDNISOLONE SUCCINATE INJ 1000 MG PHAR PHARMACY 636 J2930 110.81 METHYLPREDNISOLONE SUCCINATE INJ 125 MG/ PHAR PHARMACY 250 J1030 34.68 METHYLPREDNISOLONE SUCCINATE INJ 40 MG/M PHAR PHARMACY 250 J1030 28.74 METHYLPREDNISOLONE SUCCINATE INJ 500 MG/ PHAR PHARMACY 636 J2930 46.53 METHYLPREDNISOLONE SUCCINATE IVPB 1000 M PHAR PHARMACY 250 J3490 829.45 METHYLPREDNISOLONE TAB 4 MG PHAR PHARMACY 250 J3490 8.61 METOCLOPRAMIDE ER PK 10 MG (#4) PHAR PHARMACY 253 J3490 6.87 METOCLOPRAMIDE INJ 10 MG/2 ML PHAR PHARMACY 250 J3490 24.43 METOCLOPRAMIDE TAB 10 MG PHAR PHARMACY 250 J3490 6.87 METOCLOPRAMIDE TAB 5 MG PHAR PHARMACY 250 J3490 6.87 METOCLORPAMIDE LIQ 10 MG/10 ML PHAR PHARMACY 250 J3490 7.70 METOLAZONE 2.5 MG PHAR PHARMACY 250 J3490 10.16 METOLAZONE TAB 0.5 MG PHAR PHARMACY 250 J3490 9.86 METOLAZONE TAB 10 MG PHAR PHARMACY 250 J3490 10.49 METOLAZONE TAB 5 MG PHAR PHARMACY 250 J3490 6.19 METOPROLOL INJ 5 MG/5 ML PHAR PHARMACY 250 J3490 20.60 METOPROLOL SUCCINATE ER TAB 100 MG PHAR PHARMACY 250 J3490 9.20 METOPROLOL SUCCINATE ER TAB 25 MG PHAR PHARMACY 250 J3490 8.36 METOPROLOL SUCCINATE ER TAB 50 MG PHAR PHARMACY 250 J3490 8.36 METOPROLOL TARTRATE TAB 50 MG PHAR PHARMACY 250 J3490 7.55 METOPROLOL TARTRATE TAB 100 MG PHAR PHARMACY 250 J3490 7.92 METOPROLOL TARTRATE TAB 25 MG PHAR PHARMACY 250 J3490 7.07 METRONIDAZOLE GEL 0.75 GM (45 GM) PHAR PHARMACY 250 J3490 48.69 METRONIDAZOLE INJ 500 MG/100 ML PHAR PHARMACY 250 J3490 98.82 METRONIDAZOLE SOLN 50 MG/ML PHAR PHARMACY 250 J3490 47.05 METRONIDAZOLE TAB 250 MG PHAR PHARMACY 250 J3490 7.47 116 METRONIDAZOLE TAB 500 MG PHAR PHARMACY 250 J3490 7.94 METRONIDAZOLE VAG GEL PHAR PHARMACY 250 J3490 249.06 MEXILETINE CAP 150 MG PHAR PHARMACY 250 J3490 5.29 MEXILETINE CAP 200 MG PHAR PHARMACY 250 J3490 5.12 MG++ ELECTROLYTE PROTCOL PHAR PHARMACY 250 J3490 4.95 MICAFUNGIN INJ 100 MG PHAR PHARMACY 250 J2248 397.32 MICAFUNGIN INJ 50 MG PHAR PHARMACY 250 J2248 246.22 MICONAZOLE NITRATE 2% CRM PHAR PHARMACY 250 J3490 43.44 MICONAZOLE SUPP 200 MG PHAR PHARMACY 250 J3490 20.82 MICONAZOLE VAG CRM PHAR PHARMACY 250 J3490 6.78 MIDAZOLAM DRIP 100 MG IN 250 ML PHAR PHARMACY 250 J3490 117.58 MIDAZOLAM INJ 10 MG/ML PHAR PHARMACY 636 J2250 18.56 MIDAZOLAM INJ 2 MG/2 ML PHAR PHARMACY 250 J2250 21.51 MIDAZOLAM INJ 5 MG/5 ML PHAR PHARMACY 636 J2250 22.27 MIDAZOLAM SYRUP 2 MG/ML PHAR PHARMACY 250 J3490 10.69 MIDODRINE TAB 5 MG PHAR PHARMACY 250 J3490 10.34 MIGLITOL TAB 25 MG PHAR PHARMACY 250 J3490 5.63 MILRINONE LACTATE /D5W IVPB 20 MG/100 ML PHAR PHARMACY 250 J3490 119.68 MINERAL OIL HEAVY PHAR PHARMACY 250 J3490 6.99 MINERAL OIL STERILE PHAR PHARMACY 250 J3490 45.49 MINOCYCLINE CAP 100 MG PHAR PHARMACY 250 J3490 11.27 MINOXIDIL TAB 10 MG PHAR PHARMACY 250 J3490 5.51 MINOXIDIL TAB 5 MG PHAR PHARMACY 250 J3490 5.40 MIRTAZAPINE SOLTAB 15 MG PHAR PHARMACY 250 J3490 7.30 MIRTAZAPINE SOLTAB 30 MG PHAR PHARMACY 250 J3490 7.37 MIRTAZAPINE TAB 15 MG PHAR PHARMACY 250 J3490 10.54 MIRTAZAPINE TAB 30 MG PHAR PHARMACY 250 J3490 10.46 MISOPROSTOL TAB 100 MCG PHAR PHARMACY 250 J3490 8.01 MISOPROSTOL TAB 200 MCG PHAR PHARMACY 250 J3490 9.28 MITOMYCIN INJ 0.03% 5 MG PHAR PHARMACY 250 J3490 65.22 MIVACURIUM INJ 2 MG/ML PHAR PHARMACY 250 J3490 20.65 MODAFINIL TAB 100 MG PHAR PHARMACY 250 J3490 36.41 MODAFINIL TAB 200 MG PHAR PHARMACY 250 J3490 10.85 MOEXIPRIL TAB 15 MG PHAR PHARMACY 250 J3490 8.65 MOEXIPRIL TAB 7.5 MG PHAR PHARMACY 250 J3490 8.56 MOISTURIZING CRM 4 OZ PHAR PHARMACY 250 J3490 43.34 MOMETASONE FUROATE INH PWD 220 MCG 60 DO PHAR PHARMACY 250 J3490 7.27 MOMETASONE FUROATE NASAL SPRAY PHAR PHARMACY 250 J3490 43.66 MOMETASONE FURoATE/FORMOTEROL FUMARATE I PHAR PHARMACY 250 J3490 383.83 MOMETASONE FUROATE/FORMOTEROL FUMERATE I PHAR PHARMACY 250 J3490 383.83 MONTELUKAST TAB 10 MG PHAR PHARMACY 250 J3490 14.31 MONTELUKAST TAB 4 MG PHAR PHARMACY 250 J3490 14.31 117 MONTELUKAST TAB 5 MG PHAR PHARMACY 250 J3490 13.46 MORPHINE DRIP 100 MG/100 ML PHAR PHARMACY 250 J3490 85.56 MORPHINE INJ 10 MG/10 ML PHAR PHARMACY 636 J2270 30.94 MORPHINE INJ 10 MG/ML TUBEX PHAR PHARMACY 250 J3490 23.12 MORPHINE INJ 2 MG/ML PHAR PHARMACY 250 J3490 23.06 MORPHINE INJ 4 MG/ML PHAR PHARMACY 250 J3490 24.27 MORPHINE INJ PF 0.5 MG/ML 10 ML SDV PHAR PHARMACY 250 J3490 22.56 MORPHINE IR TAB 10 MG PHAR PHARMACY 250 J3490 13.06 MORPHINE IR TAB 15 MG PHAR PHARMACY 250 J3490 7.91 MORPHINE PCA 50 MG/50ML NS/D5W PHAR PHARMACY 250 J3490 110.61 MORPHINE SOLN 10 MG/5 ML UD PHAR PHARMACY 250 J3490 7.96 MORPHINE SOLN 20 MG/ML PHAR PHARMACY 250 J3490 8.36 MORPHINE SR TAB 15 MG PHAR PHARMACY 250 J3490 8.54 MORPHINE SR TAB 30 MG PHAR PHARMACY 250 J3490 8.71 MORPHINE SR TAB 60 MG PHAR PHARMACY 250 J3490 5.83 MORRHUATE INJ 50 MG/ML PHAR PHARMACY 250 J3490 73.17 MOXIFLOXACIN 0.5% OPTH SOLN 3 ML PHAR PHARMACY 250 J3490 165.58 MOXIFLOXACIN INJ 400 MG/250 ML PHAR PHARMACY 250 J2280 26.44 MOXIFLOXACIN TAB 400 MG PHAR PHARMACY 250 J3490 19.16 MULTI VITAMINS TAB PHAR PHARMACY 250 J3490 6.75 MULTI VITAMINS W/FLUORIDE 0.25 MG TAB PHAR PHARMACY 250 J3490 21.27 MULTI VITAMINS W/IRON TAB PHAR PHARMACY 250 J3490 6.72 MUPIROCIN 2 % CRM (15 GM) PHAR PHARMACY 250 J3490 8.27 MUPIROCIN 2 % OINT (22 GM) PHAR PHARMACY 250 J3490 44.01 MVI INJ PHAR PHARMACY 250 J3490 35.37 MYCOPHENOLATE MOFETIL CAP 250 MG PHAR PHARMACY 250 J3490 12.03 NABUMETONE TAB 500 MG PHAR PHARMACY 250 J3490 8.44 NABUMETONE TAB 750 MG PHAR PHARMACY 250 J3490 8.01 ACETYLCYSTEINE CAP 600 MG PHAR PHARMACY 250 J3490 6.77 NADOLOL TAB 20 MG PHAR PHARMACY 250 J3490 15.03 NADOLOL TAB 40 MG PHAR PHARMACY 250 J3490 12.04 NADOLOL TAB 80 MG PHAR PHARMACY 250 J3490 13.93 NAFCILLIN INJ 1 GM PHAR PHARMACY 250 J3490 42.61 NAFCILLIN INJ 2 GM PHAR PHARMACY 250 J3490 65.71 NAFCILLIN IVPB 1 GM PHAR PHARMACY 250 J3490 118.71 NAFCILLIN IVPB 2 GM PHAR PHARMACY 250 J3490 141.81 NALBUPHINE INJ 10 MG/ML PHAR PHARMACY 250 J3490 24.87 NALBUPHINE INJ 20 MG/ML PHAR PHARMACY 250 J3490 29.08 NALMEFENE INJ 100 MCG/ML PHAR PHARMACY 250 J3490 20.80 NALOXONE INJ 0.02 MG/ML PHAR PHARMACY 250 J3490 16.50 NALOXONE INJ 0.4 MG/ML PHAR PHARMACY 250 J3490 44.60 NALOXONE INJ 2 MG/2 ML ABBOJECT PHAR PHARMACY 250 J3490 72.35 118 NAPHAZOLINE/PHENIRAMINE OPTH SOLN PHAR PHARMACY 250 J3490 55.39 NAPROXEN CR TAB 500 MG PHAR PHARMACY 250 J3490 9.31 NAPROXEN EC TAB 375 MG PHAR PHARMACY 250 J3490 8.84 NAPROXEN ER PKT 500 MG (#4) PHAR PHARMACY 250 J3490 8.34 NAPROXEN TAB 220 MG PHAR PHARMACY 250 J3490 6.78 NAPROXEN TAB 250 MG PHAR PHARMACY 250 J3490 7.74 NAPROXEN TAB 375 MG PHAR PHARMACY 250 J3490 6.91 NAPROXEN TAB 500 MG PHAR PHARMACY 250 J3490 8.34 NAPROXEN TAB 550 MG PHAR PHARMACY 250 J3490 6.77 NASALIDE NASAL SPRAY PHAR PHARMACY 250 J3490 52.80 NATEGLINIDE TAB 120 MG PHAR PHARMACY 250 J3490 12.73 NATURAL ICE LIP BALM PHAR PHARMACY 250 J3490 43.78 NEBIVOLOL TAB 10 MG PHAR PHARMACY 250 J3490 13.74 NEBIVOLOL TAB 5 MG PHAR PHARMACY 250 J3490 13.87 NEFAZODONE TAB 100 MG PHAR PHARMACY 250 J3490 13.15 NEFAZODONE TAB 150 MG PHAR PHARMACY 250 J3490 13.27 NEFAZODONE TAB 200 MG PHAR PHARMACY 250 J3490 13.40 NEOMYCIN TAB 500 MG PHAR PHARMACY 250 J3490 8.53 NEOMYCIN/POLYMIXIN/HCT OPTH SUSP PHAR PHARMACY 250 J3490 252.62 NEOMYCIN/POLYMIXIN/HCT OTIC SUSP PHAR PHARMACY 250 J3490 178.83 NEOMYCIN/POLYMYXIN B/DEXAMETHASONE OPTH PHAR PHARMACY 250 J3490 70.15 NEOMYCIN/POLYMYXIN B/DEXAMETHASONE OPTH PHAR PHARMACY 250 J3490 48.59 NEOMYCIN/POLYMYXIN B/HC OTIC SUSP ER PHAR PHARMACY 253 J3490 178.83 NEOSTIGMINE INJ 1 MG/ML PHAR PHARMACY 636 J2710 19.47 NEOSTIGMINE INJ 5 MG/10 ML MDV PHAR PHARMACY 636 J2710 46.49 NEPHRO-VITE TAB PHAR PHARMACY 250 J3490 6.88 NEUTRAPHOS TAB 250 MG (8 MMOL) PHAR PHARMACY 250 J3490 8.84 NICARDIPINE INJ 25 MG/10 ML PHAR PHARMACY 250 J3490 130.89 NICARDIPINE IVPB 25 MG/250 ML NS/D5W PHAR PHARMACY 250 J3490 130.89 NICARDIPINE SR TAB 30 MG PHAR PHARMACY 250 J3490 10.99 NICOTINE CQ PAT 14 MG PHAR PHARMACY 250 J3490 46.63 NICOTINE CQ PAT 21 MG PHAR PHARMACY 250 J3490 46.63 NICOTINE CQ PAT 7 MG PHAR PHARMACY 250 J3490 46.63 NICOTINE GUM 2 MG PHAR PHARMACY 250 J3490 7.27 NICOTINE LOZ 2 MG PHAR PHARMACY 250 J3490 7.35 NICOTINE SYSTEM INH PHAR PHARMACY 250 J3490 7.09 NICOTINIC ACID SR TAB 250 MG PHAR PHARMACY 250 J3490 6.80 NICOTINIC ACID SR TAB 500 MG PHAR PHARMACY 250 J3490 6.84 NICOTINIC ACID TAB 500 MG PHAR PHARMACY 250 J3490 6.75 NIFEDIPINE CAP 10 MG PHAR PHARMACY 250 J3490 9.33 NIFEDIPINE CAP 20 MG PHAR PHARMACY 250 J3490 11.13 NIFEDIPINE ER TAB 30 MG PHAR PHARMACY 250 J3490 8.46 119 NIFEDIPINE XL TAB 30 MG PHAR PHARMACY 250 J3490 8.47 NIFEDIPINE XL TAB 60 MG PHAR PHARMACY 250 J3490 24.02 NIFEDIPINE XL TAB 90 MG PHAR PHARMACY 250 J3490 26.68 NISOLDIPINE ER TAB 8.5 MG PHAR PHARMACY 250 J3490 14.96 NISOLPIDINE ER TAB 10 MG PHAR PHARMACY 250 J3490 17.95 NISOLPIDINE ER TAB 20 MG PHAR PHARMACY 250 J3490 17.95 NITAZOXANIDE TAB 500 MG PHAR PHARMACY 250 J3490 175.24 NITROFURANTOIN CAP 100 MG PHAR PHARMACY 250 J3490 11.24 NITROFURANTOIN CAP 50 MG PHAR PHARMACY 250 J3490 10.93 NITROFURANTOIN GEL CAP 100 MG PHAR PHARMACY 250 J3490 11.83 NITROGLYCERIN 2 % OINT (30 GM) PHAR PHARMACY 250 J3490 45.15 NITROGLYCERIN BTL TAB 0.4 MG (#25) PHAR PHARMACY 250 J3490 44.62 NITROGLYCERIN CAP 6.5 MG PHAR PHARMACY 250 J3490 7.77 NITROGLYCERIN INJ 50 MG/250 ML PHAR PHARMACY 250 J3490 126.35 NITROGLYCERIN IVPB 5 MG/ML PHAR PHARMACY 250 J3490 97.31 NITROGLYCERIN PAT 0.1 MG PHAR PHARMACY 250 J3490 45.74 NITROGLYCERIN PAT 0.2 MG PHAR PHARMACY 250 J3490 46.74 NITROGLYCERIN PAT 0.4 MG PHAR PHARMACY 250 J3490 46.17 NITROGLYCERIN PAT 0.6 MG PHAR PHARMACY 250 J3490 47.49 NITROGLYCERIN SA CAP 2.5 MG PHAR PHARMACY 250 J3490 7.90 NITROGLYCERIN SPRAY PHAR PHARMACY 250 J3490 308.98 NITROGLYCERIN TAB 0.3 MG PHAR PHARMACY 250 J3490 7.32 NITROGLYCERIN TAB 0.4 MG PHAR PHARMACY 250 J3490 8.07 NITROGLYCERINE 2 % OINT UD PHAR PHARMACY 250 J3490 46.95 NITROPRUSSIDE DRIP 50 MG IN 250 ML PHAR PHARMACY 250 J3490 579.93 NITROPRUSSIDE IVPB 50 MG/2 ML PHAR PHARMACY 250 J3490 579.93 NIZATIDINE CAP 150 MG PHAR PHARMACY 250 J3490 9.92 NOREPINEPHRINE BITARTRATE INJ 4 MG/4 ML PHAR PHARMACY 250 J3490 51.71 NOREPINEPHRINE BITARTRATE IVPB 1 MG/ML PHAR PHARMACY 250 J3490 84.40 NORTRIPTYLINE CAP 10 MG PHAR PHARMACY 250 J3490 7.68 NORTRIPTYLINE CAP 25 MG PHAR PHARMACY 250 J3490 7.48 NORTRIPTYLINE CAP 50 MG PHAR PHARMACY 250 J3490 10.41 NOVOLIN INSULIN DRIP 100 UNITS IN 100ML PHAR PHARMACY 250 J1820 41.27 NS W/KCL 20MEQ 1000ML IV PHAR PHARMACY 250 J3480 32.54 NUTRITION ENSURE 8 OZ PHAR PHARMACY 250 J3490 5.12 NUTRITION ULTRACAL 8 OZ PHAR PHARMACY 250 J3490 43.25 NUTRITIONAL FIBER 7.2 OZ PHAR PHARMACY 250 J3490 7.16 NYSTATIN SUSP 100000 UNITS 60 ML PHAR PHARMACY 250 J3490 7.07 NYSTATIN CRM 15 GM PHAR PHARMACY 250 J3490 78.59 NYSTATIN OINT 15 GM PHAR PHARMACY 250 J3490 44.75 NYSTATIN POWD 15 GM PHAR PHARMACY 250 J3490 93.69 NYSTATIN SUSP 500000 UNITS/5 ML PHAR PHARMACY 250 J3490 45.31 120 NYSTATIN VAG TABS PHAR PHARMACY 250 J3490 7.50 NYSTATIN/TRIAMCINALONE CRM 15 GM ER PHAR PHARMACY 250 J3490 53.29 OCTREOTIDE INJ 100 MCG/ML PHAR PHARMACY 636 J2354 35.08 OCTREOTIDE INJ 50 MCG/ML PHAR PHARMACY 636 J2354 26.29 OCTREOTIDE INJ 500 MCG/ML PHAR PHARMACY 636 J2354 99.32 OFLOXACIN OTIC SOLN 0.3 % PHAR PHARMACY 253 J3490 251.01 OLANZAPINE INJ 10 MG PHAR PHARMACY 250 J3490 74.91 OLANZAPINE ODT TAB 5 MG PHAR PHARMACY 250 J3490 30.01 OLANZAPINE TAB 10 MG PHAR PHARMACY 250 J3490 39.45 OLANZAPINE TAB 2.5 MG PHAR PHARMACY 250 J3490 21.73 OLANZAPINE TAB 5 MG PHAR PHARMACY 250 J3490 24.49 OLMESARTAN TAB 20 MG PHAR PHARMACY 250 J3490 15.15 OLOPATADINE OPTH SOLN 0.1 % 5 ML PHAR PHARMACY 250 J3490 131.85 OLOPATADINE OPTH SOLN 0.1% 5 ML ER PHAR PHARMACY 250 J3490 131.85 OMEGA-3 FATTY ACID CAP 1000 MG PHAR PHARMACY 250 J3490 6.77 OMEPRAZOLE CAP 20 MG PHAR PHARMACY 250 J3490 10.98 ONABOTULINUMTOXIN A INJ 100 UNITS PHAR PHARMACY 250 J3490 990.26 ONABOTULINUMTOXIN A INJ 50 UNITS PHAR PHARMACY 250 J3490 553.93 ONDANSETRON ER PKT ODT 4 MG (#4) PHAR PHARMACY 253 J3490 163.10 ONDANSETRON INJ 4 MG/2 ML PHAR PHARMACY 250 J3490 19.99 ONDANSETRON ODT TAB 4 MG PHAR PHARMACY 250 J3490 7.69 ONDANSETRON ODT TAB 8 MG PHAR PHARMACY 250 J3490 56.70 ONDANTRESAN ODT TAB 4 MG PHAR PHARMACY 250 J3490 36.71 ORAL ELECTROLYTE MAINTENANCE SOLN 2.1 OZ PHAR PHARMACY 250 J3490 5.26 ORPHENADRINE INJ 60 MG/2 ML PHAR PHARMACY 250 J3490 48.92 ORTHO CEPT TAB PHAR PHARMACY 250 J3490 9.78 ORTHO CYCLEN TAB PHAR PHARMACY 250 J3490 9.57 ORTHO TRI CYCLEN TAB PHAR PHARMACY 250 J3490 9.47 OSELTAMIVIR CAP 75 MG PHAR PHARMACY 250 J3490 27.51 OSELTAMIVIR SUSP 6 MG/ML PHAR PHARMACY 250 J3490 288.69 OSELTAMVIR TAB 30 MG PHAR PHARMACY 250 J3490 25.79 OSMITROL INJ 20 % - 500 ML PHAR PHARMACY 250 J3490 49.81 OXANDROLONE TAB 2.5 MG PHAR PHARMACY 250 J3490 17.03 OXAPROZIN TAB 600 MG PHAR PHARMACY 250 J3490 11.62 OXCARBAZEPINE TAB 150 MG PHAR PHARMACY 250 J3490 8.75 OXCARBAZEPINE TAB 300 MG PHAR PHARMACY 250 J3490 19.99 OXCODONE CR TAB 40 MG PHAR PHARMACY 250 J3490 20.69 OXYBUTYNIN TAB 5 MG PHAR PHARMACY 250 J3490 7.52 OXYBUTYNIN XL TAB 10 MG PHAR PHARMACY 250 J3490 11.12 OXYBUTYNIN XL TAB 5 MG PHAR PHARMACY 250 J3490 10.83 OXYCODONE CR TAB 10 MG PHAR PHARMACY 250 J3490 12.79 OXYCODONE CR TAB 20 MG PHAR PHARMACY 250 J3490 18.05 121 OXYCODONE SOLN 5 MG/5 ML UD PHAR PHARMACY 250 J3490 9.71 OXYCODONE TAB 5 MG PHAR PHARMACY 250 J3490 8.42 OXYCODONE/APAP CAP 5/500 MG PHAR PHARMACY 250 J3490 6.51 OXYCODONE/APAP ER PKT TAB 5 MG/325 MG (# PHAR PHARMACY 250 J3490 9.53 OXYCODONE/APAP TAB 5/325 MG PHAR PHARMACY 250 J3490 8.24 OXYCODONE/ASA TAB 4.88/325 MG PHAR PHARMACY 250 J3490 8.22 OXYMETAZOLINE NAS SPRAY 0.05 % 15 ML ER PHAR PHARMACY 253 J3490 46.00 OXYMETAZOLINE NAS SPRAY 12 HR PHAR PHARMACY 250 J3490 45.96 OXYTOCIN INJ 10 UNITS/ML PHAR PHARMACY 250 J2590 100.55 OXYTOCIN PREMIX 10 UNITS/1000 ML LR PHAR PHAR PHARMACY 250 J2590 109.84 P-EPHED/CETIRIZINE TAB 12 HR PHAR PHARMACY 250 J3490 11.64 PALIVIZUMAB INJ 100 MG PHAR PHARMACY 250 J3490 4,591.15 PAMIDRONATE DISSODIUM INJ 3 MG/ML PHAR PHARMACY 636 J2430 97.35 PANCRELIPASE CAP 3000 UNITS PHAR PHARMACY 250 J3490 8.69 PANCRELIPASE TAB PHAR PHARMACY 250 J3490 16.06 PANCURONIUM INJ 1 MG/ML 10 ML PHAR PHARMACY 250 J3490 19.79 PANTAPRAZOLE DRIP 160 MG IN 250 ML NS PHAR PHARMACY 250 J3490 127.44 PANTOPRAZOLE INJ 40 MG PHAR PHARMACY 250 J3490 27.10 PANTOPRAZOLE TAB 40 MG PHAR PHARMACY 250 J3490 12.19 PAPAIN-UREA OINT 30 GM PHAR PHARMACY 250 J3490 6.71 PAPAIN/UREA/CHLOROPHYLLIN COPPER OINT 30 PHAR PHARMACY 250 J3490 6.43 PAROXETINE CR TAB 12.5 MG PHAR PHARMACY 250 J3490 14.20 PAROXETINE CR TAB 25 MG PHAR PHARMACY 250 J3490 14.53 PAROXETINE TAB 10 MG PHAR PHARMACY 250 J3490 10.22 PAROXETINE TAB 20 MG PHAR PHARMACY 250 J3490 7.07 PAROXETINE TAB 30 MG PHAR PHARMACY 250 J3490 10.48 PAROXETINE TAB 40 MG PHAR PHARMACY 250 J3490 10.56 PEDIATRIC ELECTROLYTE SOLUTION 1000 ML PHAR PHARMACY 250 J3490 18.94 PEDIATRIC ELECTROLYTE SOLUTION 240 ML PHAR PHARMACY 250 J3490 43.25 PEG -3350 AND ELECTROLYTES FOR ORAL SOLU PHAR PHARMACY 250 J3490 21.44 PEGFILGRASTIM INJ PHAR PHARMACY 636 J2505 10,088.66 PEN G BENZATHINE INJ 1.2 MILLION UNITS PHAR PHARMACY 250 J3490 273.33 PEN G BENZATHINE INJ 600000 UNITS PHAR PHARMACY 250 J3490 165.85 PENICILLIN G INJ 1 MILLION UNITS PHAR PHARMACY 250 J3490 310.94 PENICILLIN G INJ 5 MILLION UNITS PHAR PHARMACY 250 J3490 115.58 PENICILLIN VK ER PK SUSP 250 MG/5 ML 100 PHAR PHARMACY 253 J3490 57.03 PENICILLIN VK ER PK TAB 250 MG (#4) PHAR PHARMACY 250 J3490 6.48 PENICILLIN VK ER PK TAB 500 MG (#4) PHAR PHARMACY 253 J3490 49.52 PENICILLIN VK SUSP 250 MG/5 MG 100 ML PHAR PHARMACY 250 J3490 43.38 PENICILLIN VK TAB 250 MG PHAR PHARMACY 250 J3490 7.57 PENICILLIN VK TAB 500 MG PHAR PHARMACY 250 J3490 7.74 PENTAMIDINE INJ 300 MG PHAR PHARMACY 250 J7676 364.82 122 PENTAZOCINE/APAP TAB 50/325 MG PHAR PHARMACY 250 J3490 11.02 PENTOXIFYLINE ER TAB 400 MG PHAR PHARMACY 250 J3490 8.71 PENTOXYFYLLINE TAB 400 MG PHAR PHARMACY 250 J3490 8.71 PERAMIVIR INJ 200 MG/20 ML PHAR PHARMACY 250 J3490 606.87 PERGOLIDE MESYLATE TAB 0.05 MG PHAR PHARMACY 250 J3490 6.52 PERGOLIDE MESYLATE TAB 0.25 MG PHAR PHARMACY 250 J3490 6.87 PERMETHRIN 5 % CRM 60 GM PHAR PHARMACY 250 J3490 209.89 PERPHENAZINE TAB 2 MG PHAR PHARMACY 250 J3490 9.11 PERPHENAZINE TAB 4 MG PHAR PHARMACY 250 J3490 9.52 PERPHENAZINE TAB 8 MG PHAR PHARMACY 250 Q0175 11.08 PERPHENIZINE TAB 16 MG PHAR PHARMACY 250 J3490 11.63 PETROLEUM FREE LIP BALM PHAR PHARMACY 250 J3490 7.85 PHENASEPTIC SPRAY 6 OZ PHAR PHARMACY 250 J3490 46.56 PHENAZOPYRIDINE ER PK TAB 200 MG (#4) PHAR PHARMACY 253 J3490 62.63 PHENAZOPYRIDINE TAB 100 MG PHAR PHARMACY 250 J3490 9.92 PHENAZOPYRIDINE TAB 200 MG PHAR PHARMACY 250 J3490 11.54 PHENELZINE TAB 15 MG PHAR PHARMACY 250 J3490 10.60 PHENOBARBITAL INJ 65 MG/ML PHAR PHARMACY 250 J3490 52.63 PHENOBARBITAL TAB 100 MG PHAR PHARMACY 250 J3490 8.69 PHENOBARBITAL TAB 30 MG PHAR PHARMACY 250 J3490 7.30 PHENOBARBITAL TAB 64.8 MG PHAR PHARMACY 250 J3490 8.83 PHENTOLAMINE MESYLATE INJ 5 MG PHAR PHARMACY 250 J2760 705.84 PHENYLEPHRINE DRIP 50 MG IN 250 ML NS PHAR PHARMACY 250 J3490 273.45 PHENYLEPHRINE INJ 10 MG/ML 1 ML PHAR PHARMACY 250 J3490 28.72 PHENYLEPHRINE INJ 10 MG/ML 5 ML PHAR PHARMACY 250 J3490 54.69 PHENYLEPHRINE INJ 100 MCG/ML 10 ML PHAR PHARMACY 250 J3490 88.91 PHENYLEPHRINE NAS SPRAY 1 % 30 ML PHAR PHARMACY 250 J3490 6.93 PHENYLEPHRINE OPTH SOLN 10 % 5 ML PHAR PHARMACY 250 J3490 15.67 PHENYLEPHRINE OPTH SOLN 2.5 % 2 ML PHAR PHARMACY 250 J3490 70.60 PHENYLEPHRNE NAS SPRAY 0.5 % PHAR PHARMACY 250 J3490 48.36 PHENYTOIN CAP 100 MG PHAR PHARMACY 250 J3490 7.68 PHENYTOIN INJ 100 MG/2 ML PHAR PHARMACY 250 J3490 21.05 PHENYTOIN INJ 250 MG/5 ML PHAR PHARMACY 250 J3490 19.61 PHENYTOIN IVPB 100 MG/2 ML PHAR PHARMACY 250 J3490 97.15 PHENYTOIN IVPB 250 MG/5 ML PHAR PHARMACY 250 J3490 106.84 PHENYTOIN SUSP 125 MG/5 ML PHAR PHARMACY 250 J3490 7.74 PHENYTOIN TAB 30 MG PHAR PHARMACY 250 J3490 8.41 PHENYTOIN TAB 50 MG PHAR PHARMACY 250 J3490 7.75 PHOS-NAK PKT 250 MG (8 MMOL) PHAR PHARMACY 250 J3490 7.39 PHOS-NAK TAB 250 MG (8 MMOL) PHAR PHARMACY 250 J3490 7.83 PHOSPHO SODA ENEMA PHAR PHARMACY 250 J3490 7.29 PHYSOSTIGMINE INJ 1 MG/ML PHAR PHARMACY 250 J3490 49.00 123 PHYTONADIONE INJ 1 MG/0.5 ML PHAR PHARMACY 250 J3490 25.89 PHYTONADIONE INJ 10 MG/ML PHAR PHARMACY 250 J3490 96.98 PHYTONADIONE TAB 5 MG PHAR PHARMACY 250 J3490 69.35 PILOCARPINE OPTH SOLN 0.5 % PHAR PHARMACY 250 J3490 7.79 PILOCARPINE OPTH SOLN 1 % 15 ML PHAR PHARMACY 250 J3490 170.92 PILOCARPINE OPTH SOLN 2 % PHAR PHARMACY 250 J3490 5.08 PILOCARPINE TAB 5 MG PHAR PHARMACY 250 J3490 8.87 PINDOLOL TAB 10 MG PHAR PHARMACY 250 J3490 9.11 PIOGLITAZONE TAB 15 MG PHAR PHARMACY 250 J3490 16.13 PIOGLITAZONE TAB 30 MG PHAR PHARMACY 250 J3490 30.09 PIOGLITAZONE TAB 45 MG PHAR PHARMACY 250 J3490 22.34 PIPERACILLIN/TAZOBACTAM INJ 2.25 GM PHAR PHARMACY 250 J3490 106.22 PIPERACILLIN/TAZOBACTAM IVPB 2.25 GM PHAR PHARMACY 250 J2543 110.07 PIPERACILLIN/TAZOBACTAM IVPB 3.375 GM PHAR PHARMACY 250 J2543 112.90 PIPERACILLIN/TAZOBACTAM IVPB 4.5 GM PHAR PHARMACY 250 J2543 132.22 PIRBUTEROL ACETATE INH PHAR PHARMACY 250 J3490 136.28 PIROXICAM CAP 10 MG PHAR PHARMACY 250 J3490 10.20 PIROXICAM CAP 20 MG PHAR PHARMACY 250 J3490 12.73 PNEUMOCCAL 13-VALENT CONJUGATE VACCINE PHAR PHARMACY 250 G8864 309.78 PNEUMOCOCCAL VACCINE PHAR PHARMACY 250 J3490 180.92 PO4 ELECTROLYTE PROTOCOL PHAR PHARMACY 250 J3490 4.95 POLIO VIRUS VACCINE PHAR PHARMACY 250 J3490 70.47 POLYETHYLENE GLYCOL 3350 PKT PHAR PHARMACY 250 J3490 8.90 POLYETHYLENE GLYCOL OPTH SOLN PHAR PHARMACY 250 J3490 48.82 POLYMIXIN B IVPB 500000 UNITS PHAR PHARMACY 250 J3490 36.80 POLYSACCHARIDE/IRON COMPLEX CAP 150 MG PHAR PHARMACY 250 J3490 6.77 POSITIVE PRESSURE CAPS PHAR PHARMACY 250 J3490 4.95 POTASSIUM ACID PHOSPHATE TAB 500 MG (16 PHAR PHARMACY 250 J3490 7.51 POTASSIUM CHLORIDE INJ 20 MEQ/10 ML PHAR PHARMACY 636 J3480 23.81 POTASSIUM CHLORIDE INJ 40 MEQ/20 ML PHAR PHARMACY 636 J3480 21.56 POTASSIUM CHLORIDE IVPB 20 MEQ/100 ML PHAR PHARMACY 250 J3490 100.78 POTASSIUM CHLORIDE LIQ 20 MEQ/15 ML PHAR PHARMACY 250 J3490 37.41 POTASSIUM CHLORIDE PWD 20 MEQ PHAR PHARMACY 250 J3490 21.15 POTASSIUM CHLORIDE TAB 10 MEQ PHAR PHARMACY 250 J3490 7.85 POTASSIUM CHLORIDE TAB 20 MEQ PHAR PHARMACY 250 J3490 8.03 POTASSIUM CHLORIDE TAB 8 MEQ PHAR PHARMACY 250 J3490 7.57 POTASSIUM IODIDE SOLN 1 GM/ML PHAR PHARMACY 250 J3490 24.14 POTASSIUM PHOSPHATE INJ 15 MM/5 ML PHAR PHARMACY 250 J3490 42.95 POVIDONE/IODINE SOLN 10 % 120 ML PHAR PHARMACY 250 J3490 15.28 PPN PHAR PHARMACY 250 J3490 424.00 PRAMIPEXOLE TAB 0.125 MG PHAR PHARMACY 250 J3490 11.05 PRAMIPEXOLE TAB 0.5 MG PHAR PHARMACY 250 J3490 17.20 124 PRAMIPEXOLE TAB 1 MG PHAR PHARMACY 250 J3490 8.05 PRAMIPEXOLE TAB 1.5 MG PHAR PHARMACY 250 J3490 17.72 PRAMPIEXOLE TAB 0.25 MG PHAR PHARMACY 250 J3490 10.62 PRAVASTATIN TAB 10 MG PHAR PHARMACY 250 J3490 10.59 PRAVASTATIN TAB 20 MG PHAR PHARMACY 250 J3490 10.05 PRAVASTATIN TAB 40 MG PHAR PHARMACY 250 J3490 13.11 PRAZOSIN CAP 1 MG PHAR PHARMACY 250 J3490 7.90 PRAZOSIN CAP 2 MG PHAR PHARMACY 250 J3490 8.47 PRAZOSIN CAP 5 MG PHAR PHARMACY 250 J3490 9.63 PREDNISOLONE ER PK OPTH SOLN 1 % PHAR PHARMACY 250 J3490 117.74 PREDNISOLONE OPTH SOLN 1 % PHAR PHARMACY 253 J3490 117.74 PREDNISOLONE SYRUP 15 MG/5 ML PHAR PHARMACY 250 J3490 9.29 PREDNISOLONE SYRUP 5 MG/5 ML PHAR PHARMACY 250 J3490 12.19 PREDNISONE ER PK TAB 50 MG (#4) PHAR PHARMACY 253 J3490 45.50 PREDNISONE TAB 1 MG PHAR PHARMACY 250 J3490 7.06 PREDNISONE TAB 10 MG PHAR PHARMACY 636 J7512 7.05 PREDNISONE TAB 20 MG PHAR PHARMACY 636 J7512 7.07 PREDNISONE TAB 5 MG PHAR PHARMACY 636 J7512 7.03 PREDNISONE TAB 50 MG PHAR PHARMACY 636 J7512 7.25 PREGABALIN CAP 25 MG PHAR PHARMACY 250 J3490 18.70 PREGABALIN CAP 75 MG PHAR PHARMACY 250 J3490 19.90 PRENATAL VITAMINS TAB PHAR PHARMACY 250 J3490 6.79 PRIMIDONE TAB 50 MG PHAR PHARMACY 250 J3490 7.76 PRINIVIL/HCTZ TAB 10/12.5 MG PHAR PHARMACY 250 J3490 8.20 PRINIVIL/HCTZ TAB 20/12.5 MG PHAR PHARMACY 250 J3490 28.17 PRINIVIL/HCTZ TAB 20/25 MG PHAR PHARMACY 250 J3490 28.17 PROBENECID TAB 500 MG PHAR PHARMACY 250 J3490 8.01 PROCAINAMIDE ER TAB 1000 MG PHAR PHARMACY 250 J3490 5.50 PROCAINAMIDE ER TAB 500 MG PHAR PHARMACY 250 J3490 5.19 PROCAINAMIDE INJ 100 MG/ML PHAR PHARMACY 636 J2690 156.38 PROCAINE INJ 10 % PHAR PHARMACY 250 J3490 19.64 PROCHLORPERAZINE INJ 10 MG/2 ML PHAR PHARMACY 250 J3490 48.92 PROCHLORPERAZINE SUPP 25 MG PHAR PHARMACY 250 J3490 23.20 PROCHLORPERAZINE SUPP 5 MG PHAR PHARMACY 250 J3490 6.94 PROCHLORPERAZINE TAB 10 MG PHAR PHARMACY 250 J3490 7.90 PROCHLORPERAZINE TAB 5 MG PHAR PHARMACY 250 J3490 7.49 PROGESTERONE MICRONIZED CAP 100 MG PHAR PHARMACY 250 J3490 9.52 PROMETHAZINE ER PK TAB 25 MG (#6) PHAR PHARMACY 253 J3490 48.10 PROMETHAZINE INJ 25 MG/ML PHAR PHARMACY 250 J3490 20.41 PROMETHAZINE INJ 50 MG/ML PHAR PHARMACY 250 J3490 25.24 PROMETHAZINE SUPP 12.5 MG PHAR PHARMACY 250 J3490 30.53 PROMETHAZINE SUPP 25 MG PHAR PHARMACY 250 J3490 30.53 125 PROMETHAZINE SYRUP 6.25 MG PHAR PHARMACY 250 J3490 7.01 PROMETHAZINE TAB 25 MG PHAR PHARMACY 250 J3490 7.97 PROMETHAZINE/CODEINE ELIX PHAR PHARMACY 250 J3490 7.16 PROPAFENONE SR CAP 225 MG PHAR PHARMACY 250 J3490 17.32 PROPAFENONE SR CAP 325 MG PHAR PHARMACY 250 J3490 20.16 PROPAFENONE TAB 150 MG PHAR PHARMACY 250 J3490 8.89 PROPARACAINE OPHTH SOLN 0.5 % 15 ML PHAR PHARMACY 250 J3490 43.44 PROPOFOL INJ 1 % 100 ML PHAR PHARMACY 250 J3490 145.62 PROPOFOL INJ 1 % 20 ML PHAR PHARMACY 250 J3490 28.72 PROPOFOL INJ 1 % 50 ML PHAR PHARMACY 250 J3490 42.62 PROPRANOLOL CAP 120 MG PHAR PHARMACY 250 J3490 10.71 PROPRANOLOL INJ 1 MG/ML PHAR PHARMACY 250 J3490 31.95 PROPRANOLOL LA CAP 60 MG PHAR PHARMACY 250 J3490 10.86 PROPRANOLOL LA CAP 80 MG PHAR PHARMACY 250 J3490 98.21 PROPRANOLOL TAB 10 MG PHAR PHARMACY 250 J3490 7.16 PROPRANOLOL TAB 20 MG PHAR PHARMACY 250 J3490 7.38 PROPRANOLOL TAB 40 MG PHAR PHARMACY 250 J3490 7.65 PROPRANOLOL TAB 80 MG PHAR PHARMACY 250 J3490 7.90 PROPYLTHIOURACIL TAB 50 MG PHAR PHARMACY 250 J3490 7.90 PROTAMINE INJ 10 MG/ML PHAR PHARMACY 636 J2720 78.58 PROTEIN POWDER INSTANT PKT 7 GM PHAR PHARMACY 250 J3490 5.42 PROTHROMBIN COMPLEX CONC HUMAN INJ 1000 PHAR PHARMACY 250 J3490 3,825.48 PROTHROMBIN COMPLEX CONC HUMAN INJ 500 U PHAR PHARMACY 250 J3490 2,257.24 PSEUDOEPHEDRINE SYRUP PHAR PHARMACY 250 J3490 7.81 PSEUDOEPHEDRINE TAB 30 MG PHAR PHARMACY 250 J3490 7.85 PSEUDOEPHEDRINE TAB 60 MG PHAR PHARMACY 250 J3490 7.76 PSEUDOEPHEDRINE/DEXTROMETHO PHAR PHARMACY 250 J3490 9.28 PYRAZINAMIDE TAB 500 MG PHAR PHARMACY 250 J3490 10.54 PYRIDOSTIGMINE TAB 60 MG PHAR PHARMACY 250 J3490 29.97 PYRIDOXINE TAB 50 MG PHAR PHARMACY 250 J3490 6.83 QUETIAPINE TAB 100 MG PHAR PHARMACY 250 J3490 15.39 QUETIAPINE TAB 200 MG PHAR PHARMACY 250 J3490 23.08 QUETIAPINE TAB 25 MG PHAR PHARMACY 250 J3490 7.16 QUETIPINE ER TAB 150 MG PHAR PHARMACY 250 J3490 30.52 QUINAPRIL TAB 10 MG PHAR PHARMACY 250 J3490 14.52 QUINAPRIL TAB 20 MG PHAR PHARMACY 250 J3490 8.34 QUINAPRIL TAB 5 MG PHAR PHARMACY 250 J3490 14.52 QUINIDINE GLUCONATE ER TAB 324 MG PHAR PHARMACY 250 J3490 18.89 QUINIDINE GLUCONATE IVPB 80 MG/ML PHAR PHARMACY 250 J3490 98.02 QUINIDINE TAB 200 MG PHAR PHARMACY 250 J3490 7.10 QUINIDINE TAB 300 MG PHAR PHARMACY 250 J3490 7.46 QUININE SULFATE CAP 260 MG PHAR PHARMACY 250 J3490 5.12 126 QUININE SULFATE CAP 325 MG PHAR PHARMACY 250 J3490 16.21 RABEPRAZOLE TAB 20 MG PHAR PHARMACY 250 J3490 22.11 RABIES IMMUNE GLOBULIN (HUMAN) 150 UNITS PHAR PHARMACY 250 J3490 542.81 RABIES IMMUNE GLOBULIN (HUMAN) 2 ML PHAR PHARMACY 250 J3490 592.81 RABIES VACCINE PHAR PHARMACY 250 J3490 238.40 RABIES VACCINE PHAR PHARMACY 250 J3490 563.63 RACEPINEPHRINE INH SOLN 2.25 % PHAR PHARMACY 250 J3490 9.11 RALOXIFENE TAB 60 MG PHAR PHARMACY 250 J3490 16.29 RAMELTEON TAB 8 MG PHAR PHARMACY 250 J3490 27.04 RAMIPRIL CAP 10 MG PHAR PHARMACY 250 J3490 18.52 RAMIPRIL CAP 5 MG PHAR PHARMACY 250 J3490 9.24 RAMIPRIL TAB 1.25 MG PHAR PHARMACY 250 J3490 8.75 RAMIPRIL TAB 2.5 MG PHAR PHARMACY 250 J3490 9.12 RANITIDINE INJ 150 MG/6 ML PHAR PHARMACY 250 J3490 17.90 RANITIDINE INJ 50 MG/2 ML PHAR PHARMACY 636 J2780 39.85 RANITIDINE SYRUP 15 MG/ML PHAR PHARMACY 250 J3490 16.66 RANITIDINE TAB 150 MG PHAR PHARMACY 250 J3490 6.96 RANOLAZINE SA TAB 500 MG PHAR PHARMACY 250 J3490 16.30 REGADENOSON INJ 0.4 MG/5 ML PHAR PHARMACY 636 J2785 411.65 REMIFENTANIL INJ 2 MG PHAR PHARMACY 250 J3490 210.71 REPAGLINDE TAB 1 MG PHAR PHARMACY 250 J3490 11.62 REPAGLINIDE TAB 0.5 MG PHAR PHARMACY 250 J3490 7.60 REPAGLINIDE TAB 2 MG PHAR PHARMACY 250 J3490 11.62 RESPIRATORY MDI PHAR PHARMACY 250 J3490 11.50 RESPIRATORY NEBS PHAR PHARMACY 250 J3490 72.25 RHOGAM INJ PHAR PHARMACY 250 J3490 148.76 RIBAVIRIN CAP 200 MG PHAR PHARMACY 250 J3490 20.05 RIFAMPIN CAP 300 MG PHAR PHARMACY 250 J3490 8.48 RIFAMPIN INJ 600 MG 20 ML PHAR PHARMACY 250 J3490 342.37 RIFAXIMIN TAB 550 MG PHAR PHARMACY 250 J3490 65.81 RIFAXMIN TAB 200 MG PHAR PHARMACY 250 J3490 28.29 RISEDRONATE TAB 30 MG PHAR PHARMACY 250 J3490 90.12 RISEDRONATE TAB 35 MG PHAR PHARMACY 250 J3490 90.12 RISEDRONATE TAB 5 MG PHAR PHARMACY 250 J3490 18.62 RISPERIDONE LA INJ 25 MG/2 ML PHAR PHARMACY 250 J2794 751.83 RISPERIDONE M TAB 0.5 MG PHAR PHARMACY 250 J3490 13.31 RISPERIDONE M TAB 1 MG PHAR PHARMACY 250 J3490 14.10 RISPERIDONE TAB 0.25 MG PHAR PHARMACY 250 J3490 11.51 RISPERIDONE TAB 0.5 MG PHAR PHARMACY 250 J3490 11.99 RISPERIDONE TAB 1 MG PHAR PHARMACY 250 J3490 12.82 RISPERIDONE TAB 2 MG PHAR PHARMACY 250 J3490 35.62 RISPERIDONE TAB 3 MG PHAR PHARMACY 250 J3490 40.67 127 RIVAROXABAN TAB 10 MG PHAR PHARMACY 250 J3490 29.26 RIVAROXABAN TAB 15 MG PHAR PHARMACY 250 J3490 29.26 RIVASTIGIMINE CAP 4.5 MG PHAR PHARMACY 250 J3490 9.83 RIVASTIGMINE CAP 1.5 MG PHAR PHARMACY 250 J3490 12.97 RIVASTIGMINE CAP 3 MG PHAR PHARMACY 250 J3490 12.97 RIVASTIGMINE PAT 4.6 MG/24 HR PHAR PHARMACY 250 J3490 78.09 RIZATRIPTAN TAB 10 MG PHAR PHARMACY 250 J3490 51.47 ROBITUSSIN DAC LIQ PHAR PHARMACY 250 J3490 5.83 ROBITUSSIN/CODEINE LIQ PHAR PHARMACY 250 J3490 8.47 ROCURONIUM INJ 50 MG/5 ML PHAR PHARMACY 250 J3490 33.16 ROFECOXIB TAB 12.5 MG PHAR PHARMACY 250 J3490 5.06 ROFECOXIB TAB 25 MG PHAR PHARMACY 250 J3490 5.06 ROFLUMILAST TAB 500 MCG PHAR PHARMACY 250 J3490 25.57 ROPINIROLE TAB 0.25 MG PHAR PHARMACY 250 J3490 7.48 ROPINIROLE TAB 0.5 MG PHAR PHARMACY 250 J3490 10.06 ROPINIROLE TAB 1 MG PHAR PHARMACY 250 J3490 7.61 ROPINIROLE TAB 2 MG PHAR PHARMACY 250 J3490 15.77 ROPINIROLE TAB 5 MG PHAR PHARMACY 250 J3490 16.11 ROPIVACAINE INJ 2 MG/ML 0.2 % PHAR PHARMACY 250 J3490 34.66 ROPIVACAINE INJ 5 MG/ML 0.5 % 20 ML PHAR PHARMACY 250 J3490 42.42 ROPIVACAINE INJ 5 MG/ML 0.5 % 30 ML PHAR PHARMACY 250 J3490 29.12 ROSIGLITAZONE TAB 2 MG PHAR PHARMACY 250 J3490 13.02 ROSIGLITAZONE TAB 4 MG PHAR PHARMACY 250 J3490 16.00 ROSIGLITAZONE TAB 8 MG PHAR PHARMACY 250 J3490 20.36 ROSUVASTATIN TAB 10 MG PHAR PHARMACY 250 J3490 8.64 SACCHAROMYCES BOULARD LYO CAP 250 MG PHAR PHARMACY 250 J3490 7.58 SALINE NASAL GEL 22 ML PHAR PHARMACY 250 J3490 50.30 SALINE NASAL SPRAY PHAR PHARMACY 250 J3490 46.03 SALMETEROL INH PHAR PHARMACY 250 J3490 402.19 SALMETEROL XINAFOATE DISK 28 DOSE PHAR PHARMACY 250 J3490 56.06 SALMETEROL XINAFOATE DISK 50 MCG 60 DOSE PHAR PHARMACY 250 J3490 16.82 SALSALATE TAB 500 MG PHAR PHARMACY 250 J3490 7.12 SALSALATE TAB 750 MG PHAR PHARMACY 250 J3490 7.71 SANDOSTATIN DRIP 1000 MCG IN 250 ML PHAR PHARMACY 250 J2354 179.65 SCOPALAMINE OPTH SOLN 0.25 % PHAR PHARMACY 250 J3490 7.14 SCOPALAMINE PATCH PHAR PHARMACY 250 J3490 77.66 SECOBARBITAL CAP 100 MG PHAR PHARMACY 250 J3490 61.99 SELEGILINE TAB 5 MG PHAR PHARMACY 250 J3490 9.79 SENNA CONCENTRATE TAB 8.6 MG PHAR PHARMACY 250 J3490 6.79 SENNA CONCENTRATE/DOCUSATE TAB PHAR PHARMACY 250 J3490 6.86 SERTRALINE TAB 100 MG PHAR PHARMACY 250 J3490 7.23 SERTRALINE TAB 25 MG PHAR PHARMACY 250 J3490 7.23 128 SERTRALINE TAB 50 MG PHAR PHARMACY 250 J3490 7.23 SEVELAMER CARBONATE TAB 800 MG PHAR PHARMACY 250 J3490 15.81 SEVOFLURANE INJ SOLN PHAR PHARMACY 250 J3490 214.08 SILDENAFIL TAB 20 MG PHAR PHARMACY 250 J3490 8.57 SILVER ANTIMICROBIAL WOUND GEL SR PHAR PHARMACY 250 J3490 84.40 SILVER NITRATE STICK PHAR PHARMACY 250 J3490 44.22 SILVER SULFADIAZINE CRM 1 % 20 GM PHAR PHARMACY 250 J3490 68.21 SILVER SULFADIAZINE CRM 1 % 400 GM PHAR PHARMACY 250 J3490 130.71 SILVER SULFADIAZINE CRM 1 % 50 GM PHAR PHARMACY 250 J3490 63.60 SILVER SULFADIAZINE CRM 1 % ER PHAR PHARMACY 253 J3490 56.68 SILVER SULFADIAZINE CRM 1000 GM PHAR PHARMACY 250 J3490 43.43 SILVER SULFADIAZINE CRM 20 GM PHAR PHARMACY 250 J3490 44.49 SILVER SULFADIAZINE CRM 400 GM PHAR PHARMACY 250 J3490 43.85 SILVER SULFADIAZINE CRM 50 GM PHAR PHARMACY 250 J3490 43.69 SIMETHICONE DROPS PHAR PHARMACY 250 J3490 47.89 SIMETHICONE TAB 125 MG PHAR PHARMACY 250 J3490 7.03 SIMETHICONE TAB 80 MG PHAR PHARMACY 250 J3490 6.81 SIMVASTATIN TAB 10 MG PHAR PHARMACY 250 J3490 10.45 SIMVASTATIN TAB 20 MG PHAR PHARMACY 250 J3490 6.97 SIMVASTATIN TAB 40 MG PHAR PHARMACY 250 J3490 13.32 SINCALIDE INJ 5 MCG PHAR PHARMACY 636 J2805 182.51 SITAGLIPTIN TAB 100 MG PHAR PHARMACY 250 J3490 29.83 SITAGLIPTIN TAB 50 MG PHAR PHARMACY 250 J3490 29.83 SOD CHLORIDE INJ 4 MEQ/ML 30 ML PHAR PHARMACY 250 J3490 19.26 SOD SULF, POTASSIUM SULF, MAGNESIUM SUL PHAR PHARMACY 250 J3490 190.39 SOD SULFACETAMIDE OPTH 105 ER PHAR PHARMACY 253 J3490 125.39 SODIUM HYPOCHLORITE SOLN 0.5 % PHAR PHARMACY 250 J3490 43.27 SODIUM BICARB INJ 4.2 % INFANT ABBOJECT PHAR PHARMACY 250 J3490 36.49 SODIUM BICARB INJ 8.4 % 50 ML ABBOJECT PHAR PHARMACY 250 J3490 36.09 SODIUM BICARB INJ 8.4 % PEDIATRIC ABBOJE PHAR PHARMACY 250 J3490 41.73 SODIUM BICARB IVPB 8.4 % 50 ML PHAR PHARMACY 250 J3490 127.28 SODIUM BICARB TAB 325 MG (5 GR) PHAR PHARMACY 250 J3490 6.76 SODIUM BICARB TAB 650 MG (10 GR) PHAR PHARMACY 250 J3490 6.76 SODIUM CHLORIDE INJ 0.45 % 1000 ML PHAR PHARMACY 250 J3490 26.98 SODIUM CHLORIDE INJ 0.45 % 500 ML PHAR PHARMACY 250 J7799 68.08 SODIUM CHLORIDE INJ 0.9 % 10 ML (FLUSH) PHAR PHARMACY 250 A4216 20.66 SODIUM CHLORIDE INJ 3 % 500 ML PHAR PHARMACY 250 J7799 103.92 SODIUM CHLORIDE NEBS 0.9 % PHAR PHARMACY 250 J3490 6.76 SODIUM CHLORIDE TAB 1 GM PHAR PHARMACY 250 J3490 6.80 SODIUM CITRATE/CITRIC ACID SOLN 15 ML PHAR PHARMACY 250 J3490 6.94 SODIUM FERRIC GLUCONATE COMPLEX IN SUCRO PHAR PHARMACY 636 J2916 105.40 SODIUM PHOSPHATES INJ 15 ML PHAR PHARMACY 250 J3490 42.57 129 SODIUM POLYSTYRENE SULFONATE SUSP 15 GM/ PHAR PHARMACY 250 J3490 21.84 SOLIFENACIN SUCCINATE TAB 5 MG PHAR PHARMACY 250 J3490 26.28 SORBITOL SOLN 70 % PHAR PHARMACY 250 J3490 5.15 SOTALOL TAB 120 MG PHAR PHARMACY 250 J3490 11.29 SOTALOL TAB 40 MG PHAR PHARMACY 250 J3490 10.20 SOTALOL TAB 80 MG PHAR PHARMACY 250 J3490 10.14 SPIRONOLACTONE TAB 100 MG PHAR PHARMACY 250 J3490 5.78 SPIRONOLACTONE TAB 25 MG PHAR PHARMACY 250 J3490 7.31 SPIRONOLACTONE TAB 50 MG PHAR PHARMACY 250 J3490 7.86 SPIRONOLACTONE/HCTZ TAB 25/25 MG PHAR PHARMACY 250 J3490 5.19 STERILE CENTRAL LINE DRESSING PHAR PHARMACY 250 J3490 4.95 STERILE WATER INJ 10 ML PHAR PHARMACY 250 A4216 24.66 STERILE WATER INJ 1000 ML PHAR PHARMACY 250 A4217 68.20 STRONG IODINE SOLN 14 ML PHAR PHARMACY 250 J3490 83.64 SUCCINYLCHOLINE INJ 200 MG/10 ML PHAR PHARMACY 250 J0330 50.02 SUCRALFATE SUSP 1 GM/10 ML PHAR PHARMACY 250 J3490 23.09 SUCRALFATE TAB 1 GM PHAR PHARMACY 250 J3490 7.13 SUCROSE SOLN 15 ML PF PHAR PHARMACY 250 J3490 5.59 SUFENTANIL INJ 100 MCG/ML PHAR PHARMACY 250 J3490 32.26 SUFENTANIL INJ 50 MCG/ML PHAR PHARMACY 250 J3490 22.08 SUGAMMADEX INJ 500 MG/5 ML PHAR PHARMACY 250 J3490 300.21 SULFACETAMIDE NA AND PREDNISOLONE ACETAT PHAR PHARMACY 250 J3490 107.28 SULFACETAMIDE OPTH OINT 10 % PHAR PHARMACY 250 J3490 45.77 SULFACETAMIDE OPTH SOLN 10 % PHAR PHARMACY 250 J3490 125.39 SULFAMETHOXAZOLE/TRIMETHOPRIM ER PK (#3) PHAR PHARMACY 253 J3490 50.63 SULFAMETHOXAZOLE/TRIMETHOPRIM SUSP ER PK PHAR PHARMACY 253 J3490 80.04 SULFASALAZINE TAB 500 MG PHAR PHARMACY 250 J3490 7.44 SULINDAC TAB 150 MG PHAR PHARMACY 250 J3490 7.10 SULINDAC TAB 200 MG PHAR PHARMACY 250 J3490 8.31 SUMATRIPTAN INJ 6 MG/0.5 ML PHAR PHARMACY 250 J3030 133.49 SUMATRIPTAN TAB 50 MG PHAR PHARMACY 250 J3490 40.55 SYMPT.X.G.I. (DIETARY) 15 GM PHAR PHARMACY 250 J3490 8.19 TACROLIMUS CAP 0.5 MG PHAR PHARMACY 250 J7507 9.69 TACROLIMUS CAP 1 MG PHAR PHARMACY 250 J7507 16.34 TAMOXIFEN TAB 10 MG PHAR PHARMACY 250 J3490 9.24 TAMSULOSIN CAP 0.4 MG PHAR PHARMACY 250 J3490 12.36 TEARS - ARTIFICIAL OPTH SOLN PHAR PHARMACY 250 J3490 47.68 TEGASEROD MALEATE TAB 6 MG PHAR PHARMACY 250 J3490 7.98 TELAVANCIN INJ 250 MG PHAR PHARMACY 250 J3490 793.10 TELAVANCIN INJ 750 MG PHAR PHARMACY 250 J3490 793.10 TELITHROMYCIN TAB 400 MG PHAR PHARMACY 250 J3490 16.76 TELMISARTAN TAB 40 MG PHAR PHARMACY 250 J3490 17.45 130 TELMISARTAN TAB 60 MG PHAR PHARMACY 250 J3490 7.68 TEMAZEPAM CAP 15 MG PHAR PHARMACY 250 J3490 6.90 TEMAZEPAM CAP 30 MG PHAR PHARMACY 250 J3490 8.81 TENECTEPLASE INJ 50 MG/10 ML PHAR PHARMACY 250 J3490 9,492.03 TERAZOSIN CAP 1 MG PHAR PHARMACY 250 J3490 8.85 TERAZOSIN CAP 2 MG PHAR PHARMACY 250 J3490 8.85 TERAZOSIN CAP 5 MG PHAR PHARMACY 250 J3490 8.64 TERBINAFINE CRM 1 % 12 GM PHAR PHARMACY 250 J3490 44.20 TERBINAFINE TAB 250 MG PHAR PHARMACY 250 J3490 24.30 TERBUTALINE INJ 1 MG/ML PHAR PHARMACY 636 J3150 48.09 TERBUTALINE TAB 2.5 MG2.5 MG PHAR PHARMACY 250 J3490 14.02 TERBUTALINE TAB 5 MG PHAR PHARMACY 250 J3490 15.64 TERCONAZOLE 7 VAG CRM PHAR PHARMACY 250 J3490 10.02 TERIPARATIDE INJ 750 MCG/3 ML PHAR PHARMACY 250 J3490 42.22 TESTOSTERONE CYPIONATE INJ 200 MG/ML PHAR PHARMACY 250 J1071 48.90 TET TOXOID/DIPTH/PERTUSSIS VACCINE PHAR PHARMACY 250 J3490 89.91 TETANUS DIPTHERIA TOXOID VACCINE 0.5 ML PHAR PHARMACY 250 J3490 57.69 TETANUS IMMUNE GLOBULIN VACCINE PHAR PHARMACY 250 J1670 823.86 TETANUS TOXOID CONJUGATE VACCINE PHAR PHARMACY 250 J3490 44.76 TETRACAINE INJ 20 MG/2 ML PHAR PHARMACY 250 J3490 79.90 TETRACAINE OPTH SOLN 0.5 % PHAR PHARMACY 250 J3490 57.43 TETRACYCLINE CAP 250 MG PHAR PHARMACY 250 J3490 18.65 TETRACYCLINE CAP 500 MG PHAR PHARMACY 250 J3490 27.90 TETRAHYDRAZOLINE OPTH SOLN PHAR PHARMACY 250 J3490 51.72 TETRAHYDROZOLINE OPTH SOLN 0.05 % 15 ML PHAR PHARMACY 250 J3490 43.39 THEOPHYLLINE CAP 200 MG PHAR PHARMACY 250 J3490 7.42 THEOPHYLLINE CAP 300 MG PHAR PHARMACY 250 J3490 7.61 THEOPHYLLINE ER TAB 100 MG PHAR PHARMACY 250 J3490 9.92 THEOPHYLLINE ER TAB 200 MG PHAR PHARMACY 250 J3490 7.42 THEOPHYLLINE ER TAB 300 MG PHAR PHARMACY 250 J3490 7.61 THEOPHYLLINE ER TAB 450 MG PHAR PHARMACY 250 J3490 5.58 THEOPHYLLINE INJ 800 MG/500 ML PHAR PHARMACY 250 J3490 69.67 THEOPHYLLINE LIQ 80 MG/15 ML PHAR PHARMACY 250 J3490 47.95 THIAMINE INJ 200 MG/2 ML PHAR PHARMACY 250 J3411 35.77 THIAMINE TAB 100 MG PHAR PHARMACY 250 J3490 7.11 THIETHYLPERAZINE INJ 10 MG/2 ML PHAR PHARMACY 250 J3490 16.50 THIETHYLPERAZINE TAN 10 MG PHAR PHARMACY 250 J3490 5.56 THIOPENTAL SODIUM INJ KIT 25 MG/ML PHAR PHARMACY 250 J3490 21.39 THIORIDAZINE TAB 100 MG PHAR PHARMACY 250 J3490 8.15 THIORIDAZINE TAB 25 MG PHAR PHARMACY 250 J3490 7.82 THIOTHIXENE CAP 10 MG PHAR PHARMACY 250 J3490 13.57 THROMBIN INJ 10000 UNITS PHAR PHARMACY 250 J3490 145.51 131 THROMBIN INJ 5000 UNITS PHAR PHARMACY 250 J3490 159.22 THYROID TAB 120 MG (2 GR) PHAR PHARMACY 250 J3490 8.96 THYROID TAB 30 MG (1/2 GR) PHAR PHARMACY 250 J3490 7.68 THYROID TAB 60 MG ( 1 GR) PHAR PHARMACY 250 J3490 7.04 TICLOPIDINE TAB 250 MG PHAR PHARMACY 250 J3490 7.00 TIGECYCLINE INJ 50 MG PHAR PHARMACY 636 J3243 348.03 TIMOLOL MALEATE OPTH SOLN 0.5 % PHAR PHARMACY 250 J3490 66.13 TIMOLOL MALEATE XE OPTH SOLN 0.5 % PHAR PHARMACY 250 J3490 158.10 TIMOLOL OPTH SOLN 0.25 % PHAR PHARMACY 250 J3490 63.44 TINCTURE OF OPIUM PHAR PHARMACY 250 J3490 16.25 TINIDAZOLE TAB 500 MG PHAR PHARMACY 250 J3490 19.05 TIOTROPIUM BROMIDE INH 4 GM PHAR PHARMACY 250 J3490 685.87 TIOTROPIUM INH PWD 18 MCG PHAR PHARMACY 250 J3490 170.52 TIZANIDINETAB 4 MG PHAR PHARMACY 250 J3490 8.73 TOBRADEX OPTH SUSP PHAR PHARMACY 250 J3490 124.96 TOBRADEX OPTH SUSP 2.5 ML ER PHAR PHARMACY 250 J3490 55.78 TOBRAMYCIN INJ 1.2 GM PHAR PHARMACY 250 J3490 154.68 TOBRAMYCIN INJ 80 MG/ 2 ML PHAR PHARMACY 636 J3260 97.08 TOBRAMYCIN IVPB 80 MG/ML PHAR PHARMACY 636 J3260 97.08 TOBRAMYCIN OPTH OINT 0.3 % PHAR PHARMACY 250 J3490 9.68 TOBRAMYCIN OPTH SOLN 0.3 % PHAR PHARMACY 250 J3490 89.03 TOBRAMYCIN OPTH SOLN 0.3 % 5 MOL ER PHAR PHARMACY 253 J3490 52.40 TOBRAMYCIN/DEXAMETHASONE OPTH OINT PHAR PHARMACY 250 J3490 26.34 TOCILIZUMAB INJ 400 MG/20 ML PHAR PHARMACY 636 J3262 3,624.63 TOLTERODINE LA CAP 2 MG PHAR PHARMACY 250 J3490 24.94 TOLTERODINE LA CAP 4 MG PHAR PHARMACY 250 J3490 26.35 TOLTERODINE TAB 2 MG PHAR PHARMACY 250 J3490 11.26 TOPIRAMATE TAB 100 MG PHAR PHARMACY 250 J3490 15.04 TOPIRAMATE TAB 25 MG PHAR PHARMACY 250 J3490 9.42 TORSEMIDE TAB 10 MG PHAR PHARMACY 250 J3490 8.58 TORSEMIDE TAB 20 MG PHAR PHARMACY 250 J3490 7.79 TPA ALTEPLASE INJ 50 MG PHAR PHARMACY 636 J2997 7,129.89 TPA ALTEPLASE INJ 100 MG PHAR PHARMACY 250 J2997 14,316.85 TPA ALTEPLASE INJ 2 MG FLUSH PHAR PHARMACY 250 J2997 266.37 TPN PHAR PHARMACY 250 J3490 99.83 TRAMADOL TAB 50 MG PHAR PHARMACY 250 J3490 7.86 TRAMADOL TAB 50 MG ER (#4) PHAR PHARMACY 253 J3490 47.53 TRAMADOL/APAP TAB 37.5/325 MG PHAR PHARMACY 250 J3490 8.07 TRANDOLAPRIL TAB 1 MG PHAR PHARMACY 250 J3490 7.55 TRANDOLAPRIL TAB 2 MG PHAR PHARMACY 250 J3490 8.36 TRANDOLAPRIL TAB 4 MG PHAR PHARMACY 250 J3490 5.39 TRANEXAMIC ACID INJ 100 MG/ML 10 ML PHAR PHARMACY 250 J3490 52.66 132 TRAVOPROST OPTH SOLN 0.004 % 2.5 ML PHAR PHARMACY 250 J3490 318.37 TRAZODONE TAB 100 MG PHAR PHARMACY 250 J3490 7.75 TRAZODONE TAB 150 MG PHAR PHARMACY 250 J3490 5.28 TRAZODONE TAB 25 MG PHAR PHARMACY 250 J3490 5.27 TRAZODONE TAB 50 MG PHAR PHARMACY 250 J3490 7.28 TRIAMCINALONE LOT 0.1 % 60 ML PHAR PHARMACY 250 J3490 52.76 TRIAMCINOLONE ACETONIDE CRM 0.5 % 15 GM PHAR PHARMACY 250 J3490 45.28 TRIAMCINOLONE ACETONIDE SUSP 40 MG/ML 10 PHAR PHARMACY 250 J3301 30.49 TRIAMCINOLONE CRM 0.025 % 15 GM PHAR PHARMACY 250 J3490 43.64 TRIAMCINOLONE CRM 0.1 % 15 GM PHAR PHARMACY 253 J3490 51.09 TRIAMCINOLONE CRM 0.1 % 15 GM ER PHAR PHARMACY 250 J3490 48.48 TRIAMCINOLONE CRM 0.1 % 80 GM PHAR PHARMACY 250 J3490 43.47 TRIAMCINOLONE INH PHAR PHARMACY 250 J3490 42.35 TRIAMCINOLONE INJ 40 MG/ML PHAR PHARMACY 636 J3301 34.14 TRIAMCINOLONE INJ 40 MG/ML 5 ML PHAR PHARMACY 636 J3301 34.38 TRIAMCINOLONE NASAL INHALER PHAR PHARMACY 250 J3490 43.26 TRIAMCINOLONE NASAL SPRAY PHAR PHARMACY 250 J3490 24.84 TRIAMCINOLONE OINT 0.1 % 15 GM PHAR PHARMACY 250 J3490 43.74 TRIAMCINOLONE OINT 1 % 80 GM PHAR PHARMACY 250 J3490 26.23 TRIAMTERENE CAP 50 MG PHAR PHARMACY 250 J3490 22.17 TRIAMTERENE/HCTZ CAP 37.5/25 MG PHAR PHARMACY 250 J3490 7.22 TRIAMTERENE/HCTZ TAB 37.5/25 MG PHAR PHARMACY 250 J3490 7.22 TRIAMTERENE/HCTZ TAB 75/50 MG PHAR PHARMACY 250 J3490 8.19 TRIAZOLAM TAB 0.25 MG PHAR PHARMACY 250 J3490 9.34 TRIETHANOLAMINE OTIC SOLN PHAR PHARMACY 250 J3490 54.74 TRIFLUOPERAZINE TAB 10 MG PHAR PHARMACY 250 J3490 10.84 TRIFLUOPERAZINE TAB 2 MG PHAR PHARMACY 250 J3490 8.43 TRIFLUOPERAZINE TAB 5 MG PHAR PHARMACY 250 J3490 10.12 TRIHEXYPHENIDYL TAB 2 MG PHAR PHARMACY 250 J3490 7.43 TRIHEXYPHENIDYL TAB 5 MG PHAR PHARMACY 250 J3490 7.18 TRIMETHOBENZAMIDE CAP 100 MG PHAR PHARMACY 250 J3490 4.95 TRIMETHOBENZAMIDE CAP 250 MG PHAR PHARMACY 250 J3490 5.64 TRIMETHOBENZAMIDE INJ 200 MG/2 ML PHAR PHARMACY 636 J3250 29.33 TRIMETHOBENZAMIDE SUPP 100 MG PHAR PHARMACY 250 J3490 5.53 TRIMETHOBENZAMIDE SUPP 200 MG PHAR PHARMACY 250 J3490 5.17 TRIMETHOPRIM/POLYMIXIN B OPTH SOL PHAR PHARMACY 253 J3490 60.84 TRIMETHOPRIM/SULFAMETHOXIZOLE DS TAB PHAR PHARMACY 250 J3490 9.15 TRIMETHOPRIM/SULFAMETHOXIZOLE INJ PHAR PHARMACY 250 J3490 115.39 TRIMETHOPRIM/SULFAMETHOXIZOLE SUSP 40 MG PHAR PHARMACY 250 J3490 18.96 TRIPLE ANTIBIOTIC OINT 15 GM PHAR PHARMACY 250 J3490 6.96 TRIPLE ANTIBIOTIC OINT 30 GM PHAR PHARMACY 250 J3490 43.56 TRIPLE ANTIBIOTIC OINT 7.5 GM PHAR PHARMACY 250 J3490 7.01 133 TRIPLE ANTIBIOTIC OINT UD PHAR PHARMACY 250 J3490 5.99 TROLAMINE SALICYLATE CRM 10 % PHAR PHARMACY 250 J3490 16.17 TROPICAMIDE OPTH SOLN 0.5 % PHAR PHARMACY 250 J3490 56.71 TROPICAMIDE OPTH SOLN 1 % PHAR PHARMACY 250 J3490 107.34 TROSPIUM TAB 20 MG PHAR PHARMACY 250 J3490 7.91 TRYPAN BLUE OPTH SOLN 0.06 % 0.5 ML PHAR PHARMACY 250 J3490 124.93 TUBERCULIN VACCINE PHAR PHARMACY 250 J3490 44.07 TYPHOID VI POLYSACCHARIDE VACCINE PHAR PHARMACY 250 J3490 173.43 ULTRACAL LITER PHAR PHARMACY 250 J3490 11.33 UNASYN IVPB 1.5 GM PHAR PHARMACY 250 J0295 107.40 URISED TAB PHAR PHARMACY 250 J3490 5.49 URSODIOL CAP 300 MG PHAR PHARMACY 250 J3490 16.59 VALACYCLOVIR TAB 1000 MG PHAR PHARMACY 250 J3490 15.03 VALACYCLOVIR TAB 500 MG PHAR PHARMACY 250 J3490 16.42 VALDECOXIB TAB 10 MG PHAR PHARMACY 250 J3490 8.05 VALDECOXIB TAB 20 MG PHAR PHARMACY 250 J3490 7.96 VALPROATE SODIUM INJ 500 MG/5 ML PHAR PHARMACY 250 J3490 105.95 VALPROIC ACID SOLN 250 MG/5 ML PHAR PHARMACY 250 J3490 6.90 VALPROIC ACIDCAP 250 MG PHAR PHARMACY 250 J3490 7.76 VALSARTAN TAB 160 MG PHAR PHARMACY 250 J3490 6.84 VALSARTAN TAB 40 MG PHAR PHARMACY 250 J3490 11.92 VALSARTAN TAB 80 MG PHAR PHARMACY 250 J3490 6.86 VALSARTAN/HCTZ TAB 160/12.5 MG PHAR PHARMACY 250 J3490 6.80 VANCOMYCIN CAP 125 MG PHAR PHARMACY 250 J3490 57.52 VANCOMYCIN CAP 250 MG PHAR PHARMACY 250 J3490 101.87 VANCOMYCIN INJ 750 MG PHAR PHARMACY 250 J3370 110.78 VANCOMYCIN IVPB 1 GM PHAR PHARMACY 636 J3370 120.82 VANCOMYCIN IVPB 2 GM/NS 500 ML PHAR PHARMACY 250 J3370 131.62 VANCOMYCIN IVPB 500 MG PHAR PHARMACY 636 J3370 106.43 VANCOMYCIN PREMIX 1 GM PHAR PHARMACY 250 J3370 117.58 VANCOMYCIN PREMIX 1.25 GM/NS 250 ML PHAR PHARMACY 250 J3370 95.21 VANCOMYCIN PREMIX 1.5 GM/NS 250 ML PHAR PHARMACY 250 J3370 122.36 VANCOMYCIN PREMIX 750 MG/NS 250 ML PHAR PHARMACY 250 J3370 110.47 VANCOMYCIN SOLN 125 MG/2.5 ML PHAR PHARMACY 250 J3490 11.57 VANCOMYCIN SOLN 250 MG/5 ML PHAR PHARMACY 250 J3490 48.12 VARENCLINE TAB 1 MG PHAR PHARMACY 250 J3490 18.27 VARENICLINE TAB 0.5 MG PHAR PHARMACY 250 J3490 18.27 VARICELLA VIRUS VACCINE PHAR PHARMACY 250 J3490 227.77 VASOCON-A OPTH SOLN PHAR PHARMACY 250 J3490 14.83 VASOPRESSIN DRIP 40 UNITS/NS OR D5W 250 PHAR PHARMACY 250 J3490 635.69 VASOPRESSIN INJ 20 UNITS/ML PHAR PHARMACY 250 J3490 289.30 VECURONIUM BROMIDE INJ 10 MG/10 ML PHAR PHARMACY 250 J3490 25.82 134 VECURONIUM INJ 1 MG/ML 20 ML PHAR PHARMACY 250 J3490 35.18 VECURONIUM INJ 10 MG/10 ML PHAR PHARMACY 250 J3490 27.42 VENLAFAXINE TAB 25 MG PHAR PHARMACY 250 J3490 9.47 VENLAFAXINE TAB 37.5 MG PHAR PHARMACY 250 J3490 9.38 VENLAFAXINE TAB 75 MG PHAR PHARMACY 250 J3490 9.63 VENLAFAXINE XR CAP 150 MG PHAR PHARMACY 250 J3490 13.53 VENLAFAXINE XR CAP 37.5 MG PHAR PHARMACY 250 J3490 12.30 VENLAFAXINE XR CAP 75 MG PHAR PHARMACY 250 J3490 7.53 VENOFER IVPB 200 MG IN 100 ML PHAR PHARMACY 636 J1756 256.72 VERAPAMIL ER TAB 180 MG PHAR PHARMACY 250 J3490 8.63 VERAPAMIL ER TAB 240 MG PHAR PHARMACY 250 J3490 5.28 VERAPAMIL INJ 2.5 MG/ML PHAR PHARMACY 250 J3490 70.98 VERAPAMIL SR TAB 120 MG PHAR PHARMACY 250 J3490 8.13 VERAPAMIL SR TAB 180 MG PHAR PHARMACY 250 J3490 6.44 VERAPAMIL SR TAB 240 MG PHAR PHARMACY 250 J3490 10.10 VERAPAMIL TAB 120 MG PHAR PHARMACY 250 J3490 7.70 VERAPAMIL TAB 80 MG PHAR PHARMACY 250 J3490 7.46 VEST THERAPY - RESP THERAPY PHAR PHARMACY 250 J3490 4.95 VILAZODONE TAB 20 MG PHAR PHARMACY 250 J3490 20.08 VISCOELASTIC OPTH SYSTEM PHAR PHARMACY 250 J3490 101.50 VITAMIN B COMPLEX TAB 0.8 MG PHAR PHARMACY 250 J3490 6.91 VITAMIN B COMPLEX W/C-FA TAB 0.8 MG PHAR PHARMACY 250 J3490 6.89 VITAMIN E CAP 100 UNITS PHAR PHARMACY 250 J3490 6.73 VITAMIN E CAP 400 IU PHAR PHARMACY 250 J3490 6.86 VITAMIN SUPPLEMENT PHAR PHARMACY 250 J3490 6.88 VORICONAZOLE INJ 200 MG PHAR PHARMACY 636 J3465 260.12 VORICONAZOLE TAB 200 MG PHAR PHARMACY 250 J3490 113.77 WARFARIN TAB 1 MG PHAR PHARMACY 250 J3490 10.02 WARFARIN TAB 10 MG PHAR PHARMACY 250 J3490 11.86 WARFARIN TAB 2 MG PHAR PHARMACY 250 J3490 10.17 WARFARIN TAB 2.5 MG PHAR PHARMACY 250 J3490 10.27 WARFARIN TAB 3 MG PHAR PHARMACY 250 J3490 10.29 WARFARIN TAB 4 MG PHAR PHARMACY 250 J3490 10.30 WARFARIN TAB 5 MG PHAR PHARMACY 250 J3490 10.42 WARFARIN TAB 7.5 MG PHAR PHARMACY 250 J3490 11.67 WHITE PETROLATUM OINT 30 GM PHAR PHARMACY 250 J3490 46.70 WHITE PETROLATUM OINT UD PHAR PHARMACY 250 J3490 4.99 WITCH HAZEL-GLYCERIN CLEANSING PADS PHAR PHARMACY 250 J3490 46.55 ZAFIRLUKAST TAB 20 MG PHAR PHARMACY 250 J3490 11.42 ZALEPLON CAP 10 MG PHAR PHARMACY 250 J3490 24.08 ZIAC TAB 2.5 MG PHAR PHARMACY 250 J3490 10.43 ZIAC TAB 5 MG PHAR PHARMACY 250 J3490 10.43 135 ZIDOVUDINE CAP 100 MG PHAR PHARMACY 250 J3490 6.92 ZINC CAP 220 MG PHAR PHARMACY 250 J3490 6.76 ZINC CAP 50 MG PHAR PHARMACY 250 J3490 4.99 ZINC GLUCONATE GLYCINE LOZENGE PHAR PHARMACY 250 J3490 6.74 ZINC OXIDE OINT PHAR PHARMACY 250 J3490 5.04 ZINC OXIDE OINT 60 GM PHAR PHARMACY 250 J3490 8.30 ZINC/MENTHOL OINT PHAR PHARMACY 250 J3490 43.32 ZIPRASIDONE CAP 20 MG PHAR PHARMACY 250 J3490 18.63 ZIPRASIDONE CAP 80 MG PHAR PHARMACY 250 J3490 21.18 ZIPRASIDONE INJ 20 MG PHAR PHARMACY 250 J3486 99.31 ZOLEDRONIC ACID INJ 4 MG/5 ML PHAR PHARMACY 250 J3490 393.27 ZOLEDRONIC ACID INJ 5 MG/100 ML PHAR PHARMACY 636 J3488 660.73 ZOLMITRIPTAN TAB 5 MG PHAR PHARMACY 250 J3490 39.82 ZOLPIDEM TAB 10 MG PHAR PHARMACY 250 J3490 7.84 ZOLPIDEM TAB 5 MG PHAR PHARMACY 250 J3490 7.83 ZONISAMIDE TAB 100 MG PHAR PHARMACY 250 J3490 9.65 ZOSTER VACCINE LIVE PHAR PHARMACY 250 J3490 379.59 ZYVOX SUSP 100 MG/5 ML PHAR PHARMACY 250 J3490 397.20 ZOSTER VACCINE RECOMB PHAR PHARMACY 636 245.27 INDIGOTINDISULFONATE 0.8% INJ 40 MG/5 ML PHAR PHARMACY 636 296.78 MELATONIN TAB 10 MG PHAR PHARMACY 250 6.91 PULMICORT FLEXHALER 180MCG/ACT PHAR PHARMACY 250 414.12 ANORO ELLIPTA INH PHAR PHARMACY 250 53.95 CIPROFLOXACIN 0.3 % OPTH SOL 5ML PHAR PHARMACY 250 106.95 OFLOXACIN OTIC 0.3% SOL 5ML PHAR PHARMACY 250 251.01 SULFACETAMIDE OPTH SOL 10% ER PK PHAR PHARMACY 250 1.00 BUPRENORPHINE/NALOXONE 8MG/2MG SL TAB PHAR PHARMACY 250 21.72 HYDROMORPHONE INJ 1MG/ML TUBEX PHAR PHARMACY 250 24.16 ACETYLCYSTEINE 10% INH 100MG/ML 4ML VIAL PHAR PHARMACY 250 J7608 20.11 METHYLENE BLUE 0.5% 50MG/10ML AMP PHAR PHARMACY 250 J3490 320.31 HYDROMORPHONE INJ 2MG/ML PHAR PHARMACY 636 24.45 LIDOCAINE 1% MPF 5ML PFS PHAR PHARMACY 250 J3490 29.30 DDAVP 0.01% NASAL SPRAY PHAR PHARMACY 250 J3490 374.86 LIDOCAINE 1% IM/IV SDV 30ML PHAR PHARMACY 250 J3490 24.54 VANCOMYCIN 1GM/200ML IVPB PHAR PHARMACY 250 J3370 133.57 GOLIMUMAB 12.5MG/4ML VIAL PHAR PHARMACY 636 J3490 2,896.63 DESMOPRESSIN 0.2MG TAB UD PHAR PHARMACY 250 J3490 10.50 ALBUTEROL INH 8.5 GM PHAR PHARMACY 250 J3490 139.50 CLOBETASOL PROPIONATE CR 0.05% 30GM PHAR PHARMACY 250 J3490 54.75 FLUORESCEIN/PROPARACAINE OPTH PHAR PHARMACY 250 J3490 55.56 TINIDAZOLE 500MG PHAR PHARMACY 250 J3490 20.36 FAMOTIDINE 20MG/50ML IVPB PHAR PHARMACY 250 J3490 102.88 136 INFLUENZA VACCINE HI DOSE 65YRS AND OLDE PHAR PHARMACY 636 90686 94.68 INFLUENZA VACCINE PEDIATRIC PFS 6MOS-35M PHAR PHARMACY 250 J3490 49.94 INFLUENZA VACCINE 18YRS AND OLDER PHAR PHARMACY 636 90682 94.68 FLUTICASONE FUROATE/VILANTEROL 100-25 MC PHAR PHARMACY 250 J3490 50.82 FLUTICASONE FUROATE/VILANTEROL 200-25MCG PHAR PHARMACY 250 J3490 50.82 INFLUENZA QUAD VACCINE PFS 2018-2019 PHAR PHARMACY 250 90688 47.86 STERILE WATER 20ML VIAL PHAR PHARMACY 250 J3490 21.01 0.9% SODIUM CHLORIDE 20ML VIAL PHAR PHARMACY 250 J3490 21.05 Haloperidol IVP 5 mg/mL PHAR PHARMACY 636 J1630 20.96 INSULIN ASPART/PROTA 100 UNITS/ML PHAR PHARMACY 250 J3490 199.64 NS IV 50 ML PLUS PHAR PHARMACY 250 J3490 8.03 NS IV 100 ML PLUS PHAR PHARMACY 250 J3490 8.03 NS 10 ML VIAL PHAR PHARMACY 250 J3490 20.22 METHYLPREDNISOLONE SUCCINATE INJ 125MG PHAR PHARMACY 250 J1030 34.68 METHYLPREDNISOLONE SUCCINATE INJ 40MG PHAR PHARMACY 250 J1030 28.74 KETOROLAC INJ 15MG/ML PHAR PHARMACY 250 J1885 20.72 KETOROLAC INJ 30MG/ML PHAR PHARMACY 250 J1885 27.10 PROCHLORPERAZINE INJ 10MG/2ML PHAR PHARMACY 250 J3490 48.92 METOCLOPRAMIDE INJ 10MG/2ML PHAR PHARMACY 250 J3490 20.81 DIPHENHYDRAMINE ING 50MG/ML PHAR PHARMACY 250 J1200 23.46 CHONDROITIN/SOD HYALURONATE 40/30MG PHAR PHARMACY 250 J3490 507.69 CHONDROITIN/SOD HYALURONATE 40-30MG PHAR PHARMACY 250 J3490 450.12 HYDROMORPHONE IM 1MG/ML TUBEX PHAR PHARMACY 250 J1170 24.16 HYDROMORPHONE IM 2MG/ML PHAR PHARMACY 250 J1170 24.45 ONDANSETRON IM 4MG/2ML PHAR PHARMACY 250 J3490 19.50 BUPIVACAINE IV 0.25% MPF 30ML PHAR PHARMACY 250 J3490 21.67 DEXAMETHASONE PO 10MG/ML PHAR PHARMACY 250 J1100 9.55 FENTANYL INH 100MCG/2ML PHAR PHARMACY 250 J3490 22.06 BUPIVACAINE IV 0.5% MPF 30ML PHAR PHARMACY 250 J3490 21.95 BUPIVACAINE INJ 0.5% W/EPI MPF 30ML PHAR PHARMACY 250 J3490 22.93 MORPHINE INJ 10MG/10ML PHAR PHARMACY 250 J2270 30.94 NS IRR 3000ML PHAR PHARMACY 250 J3490 1.00 DEXAMETHASONE IV 4MG/ML PHAR PHARMACY 250 J1094 22.58 DEXAMETHASONE INJ 10MG/ML PHAR PHARMACY 250 J1100 21.88 INDIGOTINDISULFONATE 0.8% INJ 40MG/5ML PHAR PHARMACY 250 J3490 296.78 METHYLENE BLUE 0.5% INJ 50MG/10ML PHAR PHARMACY 250 J3490 320.31 MORPHINE IM 4MG/ML PHAR PHARMACY 250 J3490 24.27 SUFENTANIL 250MCG/5ML PHAR PHARMACY 250 J3490 56.70 LORAZEPAM IVP 2MG/ML PHAR PHARMACY 250 J3490 21.61 MORPHINE INJ 2MG/ML PHAR PHARMACY 250 J3490 24.27 DIGOXIN IM 500 MCG/2 ML PHAR PHARMACY 250 J3490 27.91 B.S.S. SOLUTION 500ML PHAR PHARMACY 250 1.00 137 GUAIFENESIN XR TAB 1200MG PHAR PHARMACY 250 J3490 7.70 EPI 1:1,000 INJ 30ML PHAR PHARMACY 250 326.07 NALOXONE IM 0.4MG/ML PHAR PHARMACY 250 44.60 MESALAMINE DR TAB 800MG PHAR PHARMACY 250 21.14 INFLIXIMAB (INFLECTRA) PHAR PHARMACY 636 1,624.35 Vivotif (typhoid vaccine) PHAR PHARMACY 636 121.74 LIDOCAINE 1% INJ 50 ML MDV PHAR PHARMACY 250 23.54 DARBEPOETIN INJ 40 MCG/ 0.4 ML PHAR PHARMACY 636 519.35 HYDROMORPHONE INJ 1 MG/ML VIAL PHAR PHARMACY 250 25.06 HYDROMORPHONE IM 1 MG/ML VIAL PHAR PHARMACY 250 25.06 INFLUENZA VACCINE 6 MONTHS & OLDER 2018 PHAR PHARMACY 636 90686 46.00 ALCON BSS PHAR PHARMACY 250 J3490 16.70 PROVISC PHAR PHARMACY 250 J3490 302.40 Duovisc PHAR PHARMACY 250 J3490 341.84 AMIODARONE 150 MG/3 ML IVP PHAR PHARMACY 250 22.39 CLONIDINE TAB 0.3 MG PHAR PHARMACY 250 7.33 ESCITALOPRAM TAB 5 MG PHAR PHARMACY 250 12.76 ABIRATERONE ACETATE TAB 500 MG PHAR PHARMACY 250 282.28 HYDRALAZINE TAB 100 MG PHAR PHARMACY 250 7.06 HYDROCHLOROTHIAZIDE TAB 12.5 MG PHAR PHARMACY 250 7.26 LAMOTRIGINE ER TAB 200MG PHAR PHARMACY 250 26.83 LYSINE TAB 500MG PHAR PHARMACY 250 6.77 MELATONIN TAB 1 MG PHAR PHARMACY 250 1.00 MELATONIN TAB 5 MG PHAR PHARMACY 250 7.32 PRAVASTATIN TAB 80 MG PHAR PHARMACY 250 13.15 OMEPRAZOLE CAP 40 MG PHAR PHARMACY 250 15.61 SPIRONOLACTONE TAB 100 MG PHAR PHARMACY 250 8.61 CARIPRAZINE CAP 3 MG PHAR PHARMACY 250 71.38 TRANEXAMIC ACID INTRANASAL 1000 MG/10 ML PHAR PHARMACY 250 135.90 ATOMOXETINE CAP 60 MG PHAR PHARMACY 250 27.52 METHSUXIMIDE CAP 300 MG PHAR PHARMACY 250 13.58 FLOSEAL PHAR PHARMACY 250 1.00 HEP B RECOMB-ADJU ADULT PHAR PHARMACY 250 37.60 Calcitonin 200U/ml 2 ml vial PHAR PHARMACY 250 4,387.28 DOXAZOSIN 8 MG TAB PHAR PHARMACY 250 8.69 BUPROPION ER 300 MG TAB PHAR PHARMACY 250 13.11 VENLAFAXINE ER 150 MG TAB PHAR PHARMACY 250 16.84 BUPRENORPHINE/NALOXONE 8 MG/2 MG FILM PHAR PHARMACY 250 20.86 BUPRENORPHINE SL 2 MG TAB PHAR PHARMACY 250 13.27 BUPRENORPHINE/NALOXONE FILM 2 MG/0.5 MG PHAR PHARMACY 250 15.04 GASTROVIEW 120ML PHAR PHARMACY 255 154.32 ISOVUE 370 100ML PHAR PHARMACY 255 177.00 138 ISOVUE 370 75ML PHAR PHARMACY 255 137.80 OPTIRAY 320 100ML PHAR PHARMACY 255 J3490 159.62 OPTIRAY 320 150ML PHAR PHARMACY 255 J3490 221.43 OPTIRAY 320 50ML PHAR PHARMACY 255 J3490 89.72 Succinylcholine 20 mg PHAR PHARMACY 636 J0330 6.46 INJECTION, DEXAMETHASONE 1 MG PHAR PHARMACY 636 J1100 2.12 Fentanyl Injection per 100 mcg PHAR PHARMACY 636 J3010 22.61 PT LOW COMPLEXITY PT PHYSICAL THERAPY 424 97161 213.00 PT MODERATE COMPLEXITY PT PHYSICAL THERAPY 424 97162 213.00 PT HIGH COMPLEXITY PT PHYSICAL THERAPY 424 97163 213.00 PT RE-EVALUATION PT PHYSICAL THERAPY 424 97164 213.00 THERAPEUTIC EXERCISE EACH 15 MIN PT PHYSICAL THERAPY 420 97110 131.50 NEUROMUSCULAR REEDUCATION EACH 15 MIN PT PHYSICAL THERAPY 420 97112 72.00 GAIT TRAINING AMBULATION EACH 15 MIN PT PHYSICAL THERAPY 420 97116 75.00 MASSAGE PT PHYSICAL THERAPY 420 97124 72.00 PT MANUAL THERAPY EACH 15 MIN PT PHYSICAL THERAPY 420 97140 96.50 PT ACTIVITY DIRECT PT CONTACT EA 15 MIN PT PHYSICAL THERAPY 420 97530 101.50 PF US BLADDER RADP IMAGING- PROFESSIONAL 972 76857 90.00 PF US GALLBLADDER RADP IMAGING- PROFESSIONAL 972 76705 140.00 PF US LIVER RADP IMAGING- PROFESSIONAL 972 76705 140.00 PF US MEDICARE AAA SCREENING RADP IMAGING- PROFESSIONAL 972 76706 79.50 PF US OB >14 WEEKS TRANSAMBD W/ADD GESTA RADP IMAGING- PROFESSIONAL 972 76810 229.00 PF US SPLEEN RADP IMAGING- PROFESSIONAL 972 76705 140.00 PF US THYROID RADP IMAGING- PROFESSIONAL 972 76536 129.50 PF ECHO STRESS CONTRAST RADP IMAGING- PROFESSIONAL 972 93352 101.00 PF ECHO EGG MONITORING RADP IMAGING- PROFESSIONAL 972 93351 258.00 PF ECHO TEE SEPTAL DEFECT/VALVE REPAIR C RADP IMAGING- PROFESSIONAL 972 93355 688.00 PF ECHO 3D RENDERING WITH WORKSTATION RADP IMAGING- PROFESSIONAL 972 76376 30.00 PF ECHO 3D RENDERING WITHOUT WORKSTATION RADP IMAGING- PROFESSIONAL 972 76377 120.00 PF CT HEAD W/OUT CONTRAST RADP IMAGING- PROFESSIONAL 972 70450 201.50 PF CT HEAD W/CONTRAST RADP IMAGING- PROFESSIONAL 972 70460 267.50 PF CT HEAD W/O, W CONTRAST RADP IMAGING- PROFESSIONAL 972 70470 299.50 PF CT ORBITS, FACIAL, MASTOIDS W/O CONTR RADP IMAGING- PROFESSIONAL 972 70480 302.00 PF CT SINUS COMPLETE W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 70486 267.50 PF CT SINUS SCREEN W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 76380 267.50 PF CT MAX/FACIAL W CONTRAST RADP IMAGING- PROFESSIONAL 972 70487 285.00 PF CT NECK W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 70490 304.50 PF CT NECK W/ CONTRAST RADP IMAGING- PROFESSIONAL 972 70491 325.50 PF CT NECK W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 70492 613.00 PF CTA HEAD WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 70496 414.50 PF CTA NECK W/CONTRAST RADP IMAGING- PROFESSIONAL 972 70498 416.00 PF CT CHEST W/OUT CONTRAST RADP IMAGING- PROFESSIONAL 972 71250 272.00 139 PF CT CHEST W/CONTRAST RADP IMAGING- PROFESSIONAL 972 71260 292.00 PF CT CHEST W/O - W CONTRAST RADP IMAGING- PROFESSIONAL 972 71270 325.50 PF CTA CHEST (NONCORONARY) RADP IMAGING- PROFESSIONAL 972 71275 395.50 PF CT CERVICAL SP WO/CONTRAST RADP IMAGING- PROFESSIONAL 972 72125 272.00 PF CT CERVICAL W/ CONTRAST RADP IMAGING- PROFESSIONAL 972 72126 286.00 PF CT THORACIC SP W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 72128 272.00 PF CT THORACIC WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 72129 288.50 PF CT LUMBAR SP W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 72131 272.00 PF CT LUMBAR W/CONTRAST RADP IMAGING- PROFESSIONAL 972 72132 286.00 PF CT LUMBAR WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 72133 299.50 PF CT PELVIS W/OUT CONTRAST RADP IMAGING- PROFESSIONAL 972 72192 257.50 PF CT PELVIS W/CONTRAST RADP IMAGING- PROFESSIONAL 972 72193 274.00 PF CT UPPER EXTREM W/O RADP IMAGING- PROFESSIONAL 972 73200 257.50 PF CT UPPER EXTREMITY W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 73202 286.00 PF CT LOWER EXTREM W/O RADP IMAGING- PROFESSIONAL 972 73700 257.50 PF CT LOWER EXTREM W/CONTRAST RADP IMAGING- PROFESSIONAL 972 73701 274.00 PF CT LOWER EXTREMITY W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 73702 288.50 PF CTA LOWER EXTREMITY RADP IMAGING- PROFESSIONAL 972 73706 284.00 PF CT ABD W/OUT CONTRAST RADP IMAGING- PROFESSIONAL 972 74150 280.50 PF CT ABD W/ CONTRAST RADP IMAGING- PROFESSIONAL 972 74160 302.00 PF CT ABDOMEN W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 74170 331.50 PF CTA ABDOMEN/PELVIS RADP IMAGING- PROFESSIONAL 972 74174 360.00 PF CTA ABD RADP IMAGING- PROFESSIONAL 972 74175 447.50 PF CT ABD & PELVIS W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 74176 553.00 PF CT ABD & PELVIC W/ CONTRAST RADP IMAGING- PROFESSIONAL 972 74177 553.00 PF CT ABD & PELVIC WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 74178 830.00 PF CT GUIDED BIOPSY RADP IMAGING- PROFESSIONAL 972 77012 274.00 PF CTA PELVIS RADP IMAGING- PROFESSIONAL 972 72191 297.50 PF CT LOW DOSE LUNG CANCER SCREEN RADP IMAGING- PROFESSIONAL 972 G0297 155.00 PF CT FOLLOW UP/LIMITED STUDY RADP IMAGING- PROFESSIONAL 972 76380 230.00 PF CT MAX/FACIAL WITHOUT CONTRAST RADP IMAGING- PROFESSIONAL 972 70486 267.50 PF CT MAX/FACIAL W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 70488 285.00 PF CT PEVLIS W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 72194 286.00 PF CT THORACIC SPINE W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 72130 299.50 PF CTA UPPER EXTREMITY RADP IMAGING- PROFESSIONAL 972 73206 284.00 PF CT ORBITS, FACIAL, MASTOIDS W CONTRAS RADP IMAGING- PROFESSIONAL 972 70481 209.00 PF CT ORBITS, FACIAL, MASTOIDS W/WO CONT RADP IMAGING- PROFESSIONAL 972 70482 219.00 PF CT UPPER EXTREMITY WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 73201 176.00 PF CTA ABDOMEN/AORTA WITH RUNOFF RADP IMAGING- PROFESSIONAL 972 75635 358.00 PF DEXA DUAL ENERGY X-RAY AB RADP IMAGING- PROFESSIONAL 972 77080 49.50 PF DEXA VERTEBRAL FRACTURE ASSESSMENT RADP IMAGING- PROFESSIONAL 972 77086 40.00 PF MAMMO DX UNILATERAL CAD RADP IMAGING- PROFESSIONAL 972 77065 122.50 140 PF MAMMO DX BILATERAL CAD RADP IMAGING- PROFESSIONAL 972 77066 204.50 PF MAMMO SCREEN BILATERAL CAD RADP IMAGING- PROFESSIONAL 972 77067 158.50 PF MAMMOGRAPHY SPECIMEN EACH (1 VIEW) RADP IMAGING- PROFESSIONAL 972 76098 38.00 PF MRI FACE/NECK/ORBITS W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 70540 318.50 PF MRI FACE/NECK/ORBITS W & W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 70543 505.50 PF MRA HEAD W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 70544 283.00 PF MRI BRAIN W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 70551 348.50 PF MRI BRAIN WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 70552 421.00 PF MRI BRAIN W/O & W CONTRAST RADP IMAGING- PROFESSIONAL 972 70553 555.00 PF MRI CHEST W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 71550 343.00 PF MRI CHEST WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 71552 303.50 PF MRI C-SPINE W / O CONTRAST RADP IMAGING- PROFESSIONAL 972 72141 375.50 PF MRI T-SPINE W / O CONTRAST RADP IMAGING- PROFESSIONAL 972 72146 375.50 PF MRI L-SPINE W / O CONTRAST RADP IMAGING- PROFESSIONAL 972 72148 348.50 PF MRI L-SPINE W/ CONTRAST RADP IMAGING- PROFESSIONAL 972 72149 421.00 PF MRI C-SPINE W/ WO COMBO RADP IMAGING- PROFESSIONAL 972 72156 604.50 PF MRI T-SPINE W/W/O COMBO RADP IMAGING- PROFESSIONAL 972 72157 604.50 PF MRI L-SPINE W/ W/O COMBO RADP IMAGING- PROFESSIONAL 972 72158 555.00 PF MRI PELVIS W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 72195 189.50 PF MRI PELVIS W/CONTRAST RADP IMAGING- PROFESSIONAL 972 72196 232.50 PF MRI PELVIS WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 72197 303.50 PF MRI UPPER EXTR W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 73218 318.50 PF MRI UPPER EXTR W/CONTRAST RADP IMAGING- PROFESSIONAL 972 73219 381.00 PF MRI UPP EXTR WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 73220 323.00 PF MRI UPPER JOINT W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 73221 318.50 PF MRI UPPER JOINT W/ CONTRAST RADP IMAGING- PROFESSIONAL 972 73222 381.00 PF MRI UPP JOINT WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 73223 505.50 PF MRI LOW EXTR W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 73718 196.00 PF MRI LOW EXTR WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 73719 381.00 PF MRI LOWER EXTR / WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 73720 381.00 PF MRI LOW JOINT W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 73721 318.50 PF MRI LOW JOINT W/CONTRAST RADP IMAGING- PROFESSIONAL 972 73722 381.00 PF MRI LOW JOINT WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 73723 508.50 PF MRI ABDOMEN W/O CONTRAST RADP IMAGING- PROFESSIONAL 972 74181 345.00 PF MRI ABDOMEN W/CONTRAST RADP IMAGING- PROFESSIONAL 972 74182 231.00 PF MRI ABDOMEN W/O & W CONTRAST RADP IMAGING- PROFESSIONAL 972 74183 531.00 PF MRA CAROTID/NECK W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 70549 424.00 PF MRA CAROTID/NECK W/CONTRAST RADP IMAGING- PROFESSIONAL 972 70548 283.00 PF MRA CAROTID/NECK WO CONTRAST RADP IMAGING- PROFESSIONAL 972 70547 280.50 PF MRA/V HEAD WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 70545 283.00 PF MRA/V HEAD W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 70546 424.00 PF MRA/V HEAD WITHOUT CONTRAST RADP IMAGING- PROFESSIONAL 972 70544 283.00 141 PF MRA PELVIS W OR WO CONTRAST RADP IMAGING- PROFESSIONAL 972 72198 239.00 PF MRI TEMPOROMANDIBULAR JOINT RADP IMAGING- PROFESSIONAL 972 70336 220.00 PF MRI CERVICAL SPINE WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 72142 453.50 PF MRI THORACIC SPINE WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 72147 453.50 PF MRI FACE/NECK/ORBITS WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 70542 381.00 PF MRI BRACHIAL PLEXUS W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 71552 303.50 PF MRI SACRAL PLEXUS WO CONTRAST RADP IMAGING- PROFESSIONAL 972 72195 189.50 PF MRA ABDOMEN W OR WO CONTRAST RADP IMAGING- PROFESSIONAL 972 74185 270.00 PF MRA UPPER EXTREMITY W OR WO RADP IMAGING- PROFESSIONAL 972 73225 259.00 PF MRI BREAT BILATERAL W OR WO RADP IMAGING- PROFESSIONAL 610 77059 246.00 PF MRI BREAST UNILATERAL W OR WO RADP IMAGING- PROFESSIONAL 610 77058 246.00 PF MRI BREAST BIOPSY UNILATERAL RADP IMAGING- PROFESSIONAL 972 19085 559.00 PF MRI CHEST WITH CONTRAST RADP IMAGING- PROFESSIONAL 972 71551 258.00 PF MRI CARDIAC WITHOUT CONTRAST RADP IMAGING- PROFESSIONAL 972 75557 261.00 PF MRI CARDIAC W/WO CONTRAST RADP IMAGING- PROFESSIONAL 972 75561 386.00 PF MRI CARDIAC VELOCITY FLOW MAPPING RADP IMAGING- PROFESSIONAL 972 75565 37.00 PF NM THYRO IMAGE W/UP, MULT RADP IMAGING- PROFESSIONAL 972 78014 230.00 PF NM PARATHYROID IMAGING RADP IMAGING- PROFESSIONAL 972 78070 229.00 PF NM LYMPH NODE IMAGING RADP IMAGING- PROFESSIONAL 972 78195 231.00 PF NM HEPATOBILIARY RADP IMAGING- PROFESSIONAL 972 78226 237.50 PF NM HEPATOBILIARY W/EF RADP IMAGING- PROFESSIONAL 972 78227 237.50 PF NM GASTRIC EMPTYING STUDY RADP IMAGING- PROFESSIONAL 972 78264 218.00 PF NM BONE IMAGING MULTIPLE RADP IMAGING- PROFESSIONAL 972 78305 231.00 PF NM BONE IMAGING WHOLE BOD RADP IMAGING- PROFESSIONAL 972 78306 245.00 PF NM BONE IMAGING 3 PHASE RADP IMAGING- PROFESSIONAL 972 78315 231.00 PF NM BONE IMAGING, TOMOGRAP RADP IMAGING- PROFESSIONAL 972 78320 279.50 PF NM PULM PERF VENT AEROSOL RADP IMAGING- PROFESSIONAL 972 78582 293.50 PF NM PERF SPECT SNGL R OR S RADP IMAGING- PROFESSIONAL 972 78451 203.00 PF NM PERF MULT R OR S RADP IMAGING- PROFESSIONAL 972 78452 239.00 PF US PERC BREAST BIOPSY RADP IMAGING- PROFESSIONAL 972 19083 481.00 PF US NECK OR SOFT TISSUE RADP IMAGING- PROFESSIONAL 972 76536 129.50 PF US CHEST RADP IMAGING- PROFESSIONAL 972 76604 69.00 PF US BREAST UNILATERAL COMPLETE RADP IMAGING- PROFESSIONAL 972 76641 121.00 PF US BREAST UNILATERAL LIMITED RADP IMAGING- PROFESSIONAL 972 76642 126.50 PF US ABDOMINAL COMPLETE RADP IMAGING- PROFESSIONAL 972 76700 190.50 PF US APPENDIX RADP IMAGING- PROFESSIONAL 972 76705 140.00 PF US ABDOMEN LIMITED RADP IMAGING- PROFESSIONAL 972 76705 140.00 PF US AORTA SCREENING RADP IMAGING- PROFESSIONAL 972 76706 79.50 PF US RENAL RADP IMAGING- PROFESSIONAL 972 76770 174.50 PF US OB < 14 WEEKS RADP IMAGING- PROFESSIONAL 972 76801 230.00 PF US OB <14 WKS EA ADDL GEST RADP IMAGING- PROFESSIONAL 972 76802 197.00 PF US OB > 14 WEEKS RADP IMAGING- PROFESSIONAL 972 76805 230.00 142 PF US OB LIMITED RADP IMAGING- PROFESSIONAL 972 76815 151.50 PF US OB FOLLOW UP RADP IMAGING- PROFESSIONAL 972 76816 199.50 PF US OB TRANSVAGINAL RADP IMAGING- PROFESSIONAL 972 76817 174.50 PF US FETAL BIO PRO/ w/o RADP IMAGING- PROFESSIONAL 972 76819 247.00 PF US PELVIC TRANSVAGINAL RADP IMAGING- PROFESSIONAL 972 76830 162.00 PF US PELVIC COMPLETE RADP IMAGING- PROFESSIONAL 972 76856 162.00 PF US PELVIC LIMITED RADP IMAGING- PROFESSIONAL 972 76857 90.00 PF US SCROTAL RADP IMAGING- PROFESSIONAL 972 76870 151.50 PF US SHOULDER RADP IMAGING- PROFESSIONAL 972 76881 144.50 PF US EXTREM NON VASC RADP IMAGING- PROFESSIONAL 972 76881 144.50 PF US EXT LTD NON VASCULA RADP IMAGING- PROFESSIONAL 972 76882 144.00 PF US GUIDANCE/BX/ASP/LOC RADP IMAGING- PROFESSIONAL 972 76942 158.50 PF US CAROTID/DUPLEX BIL RADP IMAGING- PROFESSIONAL 972 93880 144.00 PF US ART LIMITED LOW EXTREM RADP IMAGING- PROFESSIONAL 972 93926 64.50 PF US PERIPHERAL BILATERAL VASC COMPLETE RADP IMAGING- PROFESSIONAL 972 93970 115.00 PF US PERIPHERAL VASC UNILATERAL/LIMITED RADP IMAGING- PROFESSIONAL 972 93971 108.00 PF US ARTERIAL EXTREMITY LIMITED UPPER RADP IMAGING- PROFESSIONAL 972 93922 64.50 PF US AXILLA RADP IMAGING- PROFESSIONAL 972 76882 144.00 PF PERQ PLCMT BREAST LOC DEV EA ADDL RADP IMAGING- PROFESSIONAL 972 19282 131.00 PF PERQ BREAST LOC DEV PLCMT FIRST US RADP IMAGING- PROFESSIONAL 972 19285 225.50 PF US ABDOMEN DOPPLER RADP IMAGING- PROFESSIONAL 972 93975 742.00 PF US OBSTETRIC DOPPLER RADP IMAGING- PROFESSIONAL 972 76820 366.00 PF US PELVIC DOPPLER RADP IMAGING- PROFESSIONAL 972 93976 366.00 PF MANDIBLE RADP IMAGING- PROFESSIONAL 972 70110 59.00 PF FACIAL BONES 2 VIEWS RADP IMAGING- PROFESSIONAL 972 70140 46.00 PF FACIAL 4 VIEWS RADP IMAGING- PROFESSIONAL 972 70150 61.00 PF NASAL RADP IMAGING- PROFESSIONAL 972 70160 41.00 PF ORBITS 4 VIEW COMPLETE RADP IMAGING- PROFESSIONAL 972 70200 66.00 PF SINUSES (1 VIEW LIMITED) RADP IMAGING- PROFESSIONAL 972 70210 40.00 PF SINUS SERIES 4 VIEWS (COMPLETE) RADP IMAGING- PROFESSIONAL 972 70220 59.00 PF SKULL 2 VIEWS (LIMITED) RADP IMAGING- PROFESSIONAL 972 70250 54.50 PF SKULL 4 VIEWS (ROUTINE) RADP IMAGING- PROFESSIONAL 972 70260 81.00 PF TMJs RADP IMAGING- PROFESSIONAL 972 70328 42.50 PF NECK (SOFT TISSUE) 2 VIEW RADP IMAGING- PROFESSIONAL 972 70360 41.00 PF CHEST (1 VIEW) RADP IMAGING- PROFESSIONAL 972 71045 42.50 PF CHEST (2 VIEW) RADP IMAGING- PROFESSIONAL 972 71046 52.00 PF CHEST 3 VIEW API LOR D RADP IMAGING- PROFESSIONAL 972 71047 63.00 PF RIBS UNI w/PA CHEST 4V RADP IMAGING- PROFESSIONAL 972 71101 63.00 PF RIBS BI w/PA CHEST 8 VIEW RADP IMAGING- PROFESSIONAL 972 71111 63.00 PF STERNUM RADP IMAGING- PROFESSIONAL 972 71120 48.50 PF STERNO-CLAVICULAR RADP IMAGING- PROFESSIONAL 972 71130 52.00 PF C-SPINE 2 VIEWS (LIMITED) RADP IMAGING- PROFESSIONAL 972 72040 52.00 143 PF C-SPINE 3 VIEWS RADP IMAGING- PROFESSIONAL 972 72040 52.00 PF C-SPINE 5 VIEWS (ROUTINE) RADP IMAGING- PROFESSIONAL 972 72050 72.50 PF C-SPINE 7 VIEWS (FLEX/EXT RADP IMAGING- PROFESSIONAL 972 72052 86.00 PF THORACIC SPINE 2 VIEW RADP IMAGING- PROFESSIONAL 972 72070 52.00 PF THORACIC SPINE (3 VIEWS) RADP IMAGING- PROFESSIONAL 972 72072 52.00 PF THORACOLUMBAR JCT RADP IMAGING- PROFESSIONAL 972 72080 52.00 PF SCOLIOSIS SCREEN 4 VIEWS RADP IMAGING- PROFESSIONAL 972 72083 67.00 PF LUMBAR SPINE 2 VIEWS RADP IMAGING- PROFESSIONAL 972 72100 41.00 PF LUMBAR SPINE 3 VIEWS RADP IMAGING- PROFESSIONAL 972 72100 52.00 PF LUMBAR SPINE 5 VIEWS RADP IMAGING- PROFESSIONAL 972 72110 72.50 PF LUMBAR SPINE 7 VIEW COMPLETE RADP IMAGING- PROFESSIONAL 972 72114 86.00 PF PELVIS RADP IMAGING- PROFESSIONAL 972 72170 41.00 PF S-I JOINTS 4 VIEWS RADP IMAGING- PROFESSIONAL 972 72202 46.00 PF SACRUM & COCCYX 3 VIEWS RADP IMAGING- PROFESSIONAL 972 72220 41.00 PF CLAVICLE (2 VIEWS) RADP IMAGING- PROFESSIONAL 972 73000 38.00 PF SCAPULA RADP IMAGING- PROFESSIONAL 972 73010 41.00 PF SHOULDER (1 VIEW) RADP IMAGING- PROFESSIONAL 972 73020 36.00 PF SHOULDER (2 VIEWS) RADP IMAGING- PROFESSIONAL 972 73030 42.50 PF SHOULDER (3/4 VIEWS) RADP IMAGING- PROFESSIONAL 972 73030 42.50 PF SHOULDER ARTHOGRAM RADP IMAGING- PROFESSIONAL 972 73040 129.50 PF A-C JOINTS RADP IMAGING- PROFESSIONAL 972 73050 48.50 PF HUMERUS RADP IMAGING- PROFESSIONAL 972 73060 41.00 PF ELBOW (2 VIEWS) RADP IMAGING- PROFESSIONAL 972 73070 36.00 PF ELBOW (3/4 VIEWS) RADP IMAGING- PROFESSIONAL 972 73080 41.00 PF FOREARM (2 VIEWS) RADP IMAGING- PROFESSIONAL 972 73090 25.50 PF INFANT UPPER EXT 2 V RADP IMAGING- PROFESSIONAL 972 73092 38.00 PF WRIST (2 VIEWS) RADP IMAGING- PROFESSIONAL 972 73100 38.00 PF WRIST & NAVICULAR 4 VIEWS RADP IMAGING- PROFESSIONAL 972 73110 41.00 PF WRIST (3 VIEWS) RADP IMAGING- PROFESSIONAL 972 73110 41.00 PF WRIST ARTHROGRAM RADP IMAGING- PROFESSIONAL 972 73115 86.00 PF HAND (2 VIEWS) RADP IMAGING- PROFESSIONAL 972 73120 38.00 PF HAND (3 VIEW) RADP IMAGING- PROFESSIONAL 972 73130 41.00 PF FINGER 2 VIEW RADP IMAGING- PROFESSIONAL 972 73140 32.00 PF FINGER 3 VIEW RADP IMAGING- PROFESSIONAL 972 73140 32.00 PF HIP (PELVIS/LATERAL) RADP IMAGING- PROFESSIONAL 972 73501 28.50 PF HIP 1 VIEW RADP IMAGING- PROFESSIONAL 972 73501 28.50 PF HIP 2 (10X12) RADP IMAGING- PROFESSIONAL 972 73502 49.50 PF HIP PINNING 2V RADP IMAGING- PROFESSIONAL 972 73502 68.50 PF PELVIS/BILATERAL HIPS RADP IMAGING- PROFESSIONAL 972 73521 62.00 PF HIP ARTHOGRAM RADP IMAGING- PROFESSIONAL 972 73525 88.00 PF FEMUR 2V RADP IMAGING- PROFESSIONAL 972 73552 41.00 PF KNEE (2 VIEWS) RADP IMAGING- PROFESSIONAL 972 73560 41.00 144 PF KNEE (3 VIEWS) RADP IMAGING- PROFESSIONAL 972 73562 42.50 PF KNEE w/PATELLA 5 VIEWS RADP IMAGING- PROFESSIONAL 972 73564 52.00 PF KNEE (4 VIEWS) RADP IMAGING- PROFESSIONAL 972 73564 52.00 PF LOWER LEG RADP IMAGING- PROFESSIONAL 972 73590 41.00 PF INFANT LOWER EXT 2 V RADP IMAGING- PROFESSIONAL 972 73592 41.00 PF ANKLE (2 VIEWS) RADP IMAGING- PROFESSIONAL 972 73600 41.00 PF ANKLE (3 VIEWS) RADP IMAGING- PROFESSIONAL 972 73610 41.00 PF FOOT (2 VIEW) RADP IMAGING- PROFESSIONAL 972 73620 38.00 PF FOOT (3 VIEW) RADP IMAGING- PROFESSIONAL 972 73630 41.00 PF OS CALSIS (HEEL) RADP IMAGING- PROFESSIONAL 972 73650 38.00 PF TOE 2 VIEW RADP IMAGING- PROFESSIONAL 972 73660 32.00 PF TOE 3 VIEW RADP IMAGING- PROFESSIONAL 972 73660 32.00 PF ABDOMEN KUB RADP IMAGING- PROFESSIONAL 972 74018 42.50 PF ABDOMEN (2 VIEW) RADP IMAGING- PROFESSIONAL 972 74019 63.00 PF ABDOMEN (3 VIEW) RADP IMAGING- PROFESSIONAL 972 74022 75.00 PF ABDOMEN (4 VIEW ABD S) RADP IMAGING- PROFESSIONAL 972 74022 75.00 PF ESOPHAGUS WITH FLUORO RADP IMAGING- PROFESSIONAL 972 74220 109.00 PF UPPER GI RADP IMAGING- PROFESSIONAL 972 74240 163.50 PF UPPER GI WITH SBFT RADP IMAGING- PROFESSIONAL 972 74245 215.50 PF UPPER GI WITH AIR RADP IMAGING- PROFESSIONAL 972 74246 163.50 PF SMALL BOWEL ONLY RADP IMAGING- PROFESSIONAL 972 74250 110.50 PF LOWER GI/ BARIUM ENEMA RADP IMAGING- PROFESSIONAL 972 74270 163.50 PF LOWER GI/BARIUM ENEMA/AIR RADP IMAGING- PROFESSIONAL 972 74280 231.00 PF OPERATIVE CHOLANGIOGRAM RADP IMAGING- PROFESSIONAL 972 74300 86.00 PF IVP RADP IMAGING- PROFESSIONAL 972 74400 116.00 PF CYSTOGRAM RADP IMAGING- PROFESSIONAL 972 74430 76.50 PF FLUOROSCOPY PER 1/2 HOUR RADP IMAGING- PROFESSIONAL 972 76000 40.00 PF SINGLE/EXTRA VIEW RADP IMAGING- PROFESSIONAL 972 77077 74.00 PF INJECTION/ASPIRATION LARGE JOINT RADP IMAGING- PROFESSIONAL 972 20610 224.50 PF X-RAY BONE LENGTH STUDY RADP IMAGING- PROFESSIONAL 972 77073 66.00 PF X-RAY CHEST 4 VIEW WITH OBLIQUES RADP IMAGING- PROFESSIONAL 972 71048 93.00 PF X-RAY CHEST INFANT CROUP 4 VIEW RADP IMAGING- PROFESSIONAL 972 71048 93.00 PF X-RAY HYSTEROSALPINGOGRAM RADP IMAGING- PROFESSIONAL 972 74740 90.00 PF X-RAY INJECT/ASPIRATION INTER JOINT RADP IMAGING- PROFESSIONAL 972 20605 133.00 PF X-RAY INJECTION/ASPIRATION SMALL JOIN RADP IMAGING- PROFESSIONAL 972 20600 133.00 PF X-RAY KNEE W/PATELLA 5 VIEW RADP IMAGING- PROFESSIONAL 972 73564 34.00 PF X-RAY ORBIT FOREIGN BODY RADP IMAGING- PROFESSIONAL 972 70030 41.00 PF X-RAY OSSEOUS BONE SURVEY COMPLETE RADP IMAGING- PROFESSIONAL 972 77075 324.00 PF X-RAY OSSEOUS BONE SURV LIMITED METS RADP IMAGING- PROFESSIONAL 972 77074 108.00 PF X-RAY RETROGRADE UROGRAPHY RADP IMAGING- PROFESSIONAL 972 74420 87.50 PF X-RAY SPINE 1 VIEW RADP IMAGING- PROFESSIONAL 972 72020 36.00 PF X-RAY VOIDING CYSTOURETHROGRAM RADP IMAGING- PROFESSIONAL 972 74455 81.00 145 PF LUMBAR PUNCTURE RADP IMAGING- PROFESSIONAL 972 62270 235.00 PF ECHO PW, CW DOPPLER RADP IMAGING- PROFESSIONAL 972 93306 222.00 PF ECHO FOLLOW-UP/LIMITED STUDY RADP IMAGING- PROFESSIONAL 972 93308 78.00 PF STRESS ECHO RADP IMAGING- PROFESSIONAL 972 93350 215.00 PF ECHO TEE RADP IMAGING- PROFESSIONAL 972 99312 331.00 PF ECHO TEE PROBE PLACEMENT RADP IMAGING- PROFESSIONAL 972 93313 36.00 PF ECHO TEE REPORT / IMAGE RADP IMAGING- PROFESSIONAL 972 93314 276.00 PF ECHO CONGENITAL TEE RADP IMAGING- PROFESSIONAL 972 93315 391.00 PF ECHO CONGENITAL TEE PROBE PLACEMENT RADP IMAGING- PROFESSIONAL 972 93316 83.00 PF ECHO CONGENITAL TEE REPORT / IMAGE RADP IMAGING- PROFESSIONAL 972 93317 280.00 PF ECHO TEE LV FUNCTION/THERAPEUTIC RADP IMAGING- PROFESSIONAL 972 93318 317.00 PF CT CERVICAL WO/W CONTRAST RADP IMAGING- PROFESSIONAL 972 72127 182.00 PF PICC LINE PRO FEE RADP IMAGING- PROFESSIONAL 972 36569 289.50 PF RADIOACTIVE TRACER ID SEN RADP IMAGING- PROFESSIONAL 972 38792 425.00 PF PERC. BIOPSY RADP IMAGING- PROFESSIONAL 972 47000 457.00 PF PLCMNT BREAST LOC DEVICE W/MAMMO RADP IMAGING- PROFESSIONAL 972 19281 256.00 PF NM MUGA RADP IMAGING- PROFESSIONAL 972 78472 272.00 PF NM GI BLEED IMAGING RADP IMAGING- PROFESSIONAL 972 78278 266.50 PF NM LUNG VENTILATION AND PERFUSION RADP IMAGING- PROFESSIONAL 972 78582 293.50 PF NM THYROID SCAN ONLY RADP IMAGING- PROFESSIONAL 972 78013 198.50 PF NM SENTINAL NODE INJECTION RADP IMAGING- PROFESSIONAL 972 38792 425.00 PF NM LIVER/SPLEEN RADP IMAGING- PROFESSIONAL 972 78215 72.00 PF NM MECKLES RADP IMAGING- PROFESSIONAL 972 78290 101.00 PF X-RAY ANKLE ARTHROGRAM RIGHT RADP IMAGING- PROFESSIONAL 972 73615 87.00 PF X-RAY ELBOW ARTHROGRAM RADP IMAGING- PROFESSIONAL 972 73085 73,085.00 PF X-RAY BARIUM ENEMA COLORECTAL CA SCRE RADP IMAGING- PROFESSIONAL 972 G0122 150.00 PF X-RAY KNEE ARTHROGRAM RADP IMAGING- PROFESSIONAL 972 73580 87.00 PF US SPINAL CANAL RADP IMAGING- PROFESSIONAL 972 76800 178.00 PF PERQ BREAST LOC DEV PLCMT EA ADDIT RADP IMAGING- PROFESSIONAL 972 19286 130.00 PF US PERC BREAST BIOPSY ADDITIONAL RADP IMAGING- PROFESSIONAL 972 19084 240.00 PF FLUORO GUIDED NEEDLE PLACEMENT RADP IMAGING- PROFESSIONAL 972 77002 85.00 PF FLUROGUIDE FOR SPINE INJECTION RADP IMAGING- PROFESSIONAL 972 77003 90.00 PF MYELOGRAPHY VIA LUMBAR INJ CERVICAL RADP IMAGING- PROFESSIONAL 972 62302 373.00 PF MYELOGRAPHY VIA LUMBAR INJ THORACIC RADP IMAGING- PROFESSIONAL 972 62303 373.00 PF MYELOGRAPHY VIA LUMBAR INJ LUMBOSACRA RADP IMAGING- PROFESSIONAL 972 62304 365.00 PF MYELOGRAPHY VIA LUMBAR INJ 2+ REGIONS RADP IMAGING- PROFESSIONAL 972 62305 381.00 PF US EXTREMITY ARTERIAL STUDY RADP IMAGING- PROFESSIONAL 972 93923 66.00 PF BONE AGE STUDY RADP IMAGING- PROFESSIONAL 972 77072 29.00 RECOVERY ROOM 1 - 30 MINUTES RCVY SURGERY 710 277.50 RECOVERY ROOM 31 - 60 MINUTES RCVY SURGERY 710 419.50 RECOVERY ROOM 61 - 90 MINUTES RCVY SURGERY 710 561.50 RECOVERY ROOM 91 - 120 MINUTES RCVY SURGERY 710 703.50 146 RECOVERY ROOM 121 - 150 MINUTES RCVY SURGERY 710 845.50 RECOVERY ROOM 151 - 180 MINUTES RCVY SURGERY 710 987.50 RECOVERY ROOM 181 - 210 MINUTES RCVY SURGERY 710 1,129.50 RECOVERY ROOM 211 - 240 MINUTES RCVY SURGERY 710 1,271.50 RECOVERY ROOM 241 - 270 MINUTES RCVY SURGERY 710 1,413.50 RECOVERY ROOM 271 - 300 MINUTES RCVY SURGERY 710 1,555.50 RECOVERY ROOM 301 - 330 MINUTES RCVY SURGERY 710 1,697.50 RECOVERY ROOM 331 - 360 MINUTES RCVY SURGERY 710 1,839.50 SWING BED DAILY RATE SB NURSING 120 710.00 SHOTS UNNA BOOT APPLICATION LEFT SHOT OUTPATIENT THERAPY 510 29580 406.50 SHOTS IV PIGGY BACK TUBI SHOT OUTPATIENT THERAPY 250 18.00 SHOTS IV PUMP TUBING SHOT OUTPATIENT THERAPY 250 56.50 SHOTS IV PUMP SHOT OUTPATIENT THERAPY 250 25.50 SHOTS IV PUMP TUBING SHOT OUTPATIENT THERAPY 270 56.50 SHOTS VENIPUNCTURE SHOT OUTPATIENT THERAPY 300 36415 9.00 SHOTS CAP BLOOD COLLECT SHOT OUTPATIENT THERAPY 300 36416 29.50 SHOTS PICC REMOVAL SHOT OUTPATIENT THERAPY 510 36589 1,450.00 SHOTS COLLECTION FROM PIC SHOT OUTPATIENT THERAPY 300 36592 40.50 SHOTS INSERT FOLEY CATH SHOT OUTPATIENT THERAPY 510 51702 336.00 SHOTS BLADDER SCAN SHOT OUTPATIENT THERAPY 402 51798 148.50 SHOTS IV INFUSION HYDRATION 1ST HR SHOT OUTPATIENT THERAPY 510 96360 310.00 SHOTS IV INFUSION HYDRATION EA ADDL HR SHOT OUTPATIENT THERAPY 510 96361 157.00 SHOTS IV INFUSION THER/PROPH 1ST HR SHOT OUTPATIENT THERAPY 510 96365 611.00 SHOTS IV INFUSION THER/PROPH EA ADDL HR SHOT OUTPATIENT THERAPY 510 96366 111.50 SHOTS IV INFN THER/PROPH ADDL SEQ 1ST HR SHOT OUTPATIENT THERAPY 510 96367 148.50 SHOTS IV NFS THERAPY PROPH CONCUR SHOT OUTPATIENT THERAPY 510 96368 138.00 SHOTS THERAPEUTIC PROPH INJ SUBQ/IM SHOT OUTPATIENT THERAPY 510 96372 31.50 SHOTS THER PROPH IV PUSH SINGLE/1ST SBST SHOT OUTPATIENT THERAPY 510 96374 81.00 SHOTS NEG PRESS WND TX W/DME50 SQ CM SHOT OUTPATIENT THERAPY 761 97606 827.00 SHOTS ESTABLISHED PATIENT VISIT SHOT OUTPATIENT THERAPY 510 G0463 139.00 SHOTS INR FINGERSTICK SHOT OUTPATIENT THERAPY 305 85610 36.50 SHOTS WOUND CARE SHOT OUTPATIENT THERAPY 510 97602 106.00 SHOTS NEG PRESS WNTX W/DISP 50 SQ CM SHOT OUTPATIENT THERAPY 510 97608 827.00 SHOTS IV PUSH EACH ADDITIONAL SHOT OUTPATIENT THERAPY 510 96376 81.00 SHOTS INSERT STRAIGH CATHERTER SHOT OUTPATIENT THERAPY 510 51701 279.00 SHOTS INJ IV EACH ADDITIONAL SHOT OUTPATIENT THERAPY 510 96375 34.50 SHOTS UNNA BOOT APPLICATION RIGHT SHOT OUTPATIENT THERAPY 510 29580 406.50 SHOTS BLOOD DRAW FROM PORT SHOT OUTPATIENT THERAPY 761 36591 336.00 SHOTS IRRIGATE DRUG DELIVERY SYSTEM SHOT OUTPATIENT THERAPY 260 96523 179.00 SHOTS DECLOT VASCULAR DEVICE SHOT OUTPATIENT THERAPY 761 36593 551.50 147 SHOTS NEW PT UP TO 10 MIN. SHOT OUTPATIENT THERAPY 510 99201 94.00 SHOTS NEW PT 11-20 MIN. SHOT OUTPATIENT THERAPY 510 99202 180.00 SHOTS NEW PT 21 - 30 MIN. SHOT OUTPATIENT THERAPY 510 99203 209.00 SHOTS NEW PT 31-45 MIN. SHOT OUTPATIENT THERAPY 510 99204 295.00 SHOTS NEW PT 46-60 MIN. SHOT OUTPATIENT THERAPY 510 99205 468.00 SHOTS EST PT 5 MIN. SHOT OUTPATIENT THERAPY 510 99211 64.00 SHOTS EST PT 6 - 10 MIN. SHOT OUTPATIENT THERAPY 510 99212 102.50 SHOTS EST PT 11-15 MIN. SHOT OUTPATIENT THERAPY 510 99213 143.50 SHOTS EST PT 16-25 MIN. SHOT OUTPATIENT THERAPY 510 99214 215.00 SHOTS EST PT 26-40 MIN. SHOT OUTPATIENT THERAPY 510 99215 338.00 ALLEVYN GNTL AG 2X2 SHOT OUTPATIENT THERAPY 270 42.00 ALLEVYN SILICONE 6X6 SHOT OUTPATIENT THERAPY 270 20.00 ALLEVYN ADH 5X5 SHOT OUTPATIENT THERAPY 270 12.00 ALLEVYN SILICONE 2X4 SHOT OUTPATIENT THERAPY 270 7.00 ALLEVYN ADH 3X3 SHOT OUTPATIENT THERAPY 270 9.00 ALLEVYN SILICONE 2X2 SHOT OUTPATIENT THERAPY 270 9.00 TENDERWET DRESSINGS 3X3 SHOT OUTPATIENT THERAPY 270 17.00 PURACOL PLUS 4.5X4.5 SHOT OUTPATIENT THERAPY 270 74.00 PURACOL PLUS AG 4.2X4.5 SHOT OUTPATIENT THERAPY 270 107.00 REMEDY SKIN PROTECTANT SHOT OUTPATIENT THERAPY 270 32.00 REMEDY SKIN CREAM 4OZ SHOT OUTPATIENT THERAPY 270 17.00 REMEDY CALAZIME PASTE SHOT OUTPATIENT THERAPY 270 30.00 REMEDY SKIN CREAM 2OZ SHOT OUTPATIENT THERAPY 270 32.00 MEPITEL SILICON 3 X 4 SHOT OUTPATIENT THERAPY 270 23.00 WIC 3X3 CAVITY FILLER SHOT OUTPATIENT THERAPY 270 40.00 WIC 3X3 CAVITY FILLER SILVER SHOT OUTPATIENT THERAPY 270 33.00 DRESSING OVAL SHAPES SIZE 1 SHOT OUTPATIENT THERAPY 270 16.00 DRESSING OVAL SHAPES SIZE 3 SHOT OUTPATIENT THERAPY 270 39.00 DRESSING OVAL SHAPES SIZE 5 SHOT OUTPATIENT THERAPY 270 67.00 DRESSING OVAL SHAPES SIZE 8 SHOT OUTPATIENT THERAPY 270 135.00 DUODERM CGF 4X4 SHOT OUTPATIENT THERAPY 270 14.00 DUODERM ULTRA THIN 2X4 SHOT OUTPATIENT THERAPY 270 7.00 DERMAGEL PADS 4X4 SHOT OUTPATIENT THERAPY 270 33.00 AQUACELL AG SILVER 4X5 SHOT OUTPATIENT THERAPY 270 13.00 MEPITAC TAPE 1.6 SHOT OUTPATIENT THERAPY 270 37.00 MEPITAC TAPE .8 SHOT OUTPATIENT THERAPY 270 4.00 OPTILOCK 8X12 SHOT OUTPATIENT THERAPY 270 4.00 OPTILOCK 6X10 SHOT OUTPATIENT THERAPY 270 14.00 OPTILOCK 5X5 SHOT OUTPATIENT THERAPY 270 28.00 OPTILOCK 4X4 SHOT OUTPATIENT THERAPY 270 25.00 OPTILOCK 3X3 SHOT OUTPATIENT THERAPY 270 11.00 PURACOL PLUS 4.2X4.5 SHOT OUTPATIENT THERAPY 270 10.00 148 MAXSORB AG 4X4 SHOT OUTPATIENT THERAPY 270 8.00 MEPILEX AG BORDER 4X4 SHOT OUTPATIENT THERAPY 270 74.00 MEPILEX AG BORDER 3X3 SHOT OUTPATIENT THERAPY 270 30.00 MEDIHONEY 2X2 SHOT OUTPATIENT THERAPY 270 30.00 MEDIHONEY GEL SHOT OUTPATIENT THERAPY 270 42.00 MEDIHONEY 4X5 SHOT OUTPATIENT THERAPY 270 29.00 MEDIHONEY 2.8X2.8 SHOT OUTPATIENT THERAPY 270 140.00 MEDIHONEY 4.5X4.5 SHOT OUTPATIENT THERAPY 270 80.00 VERSIVA 4X4 SHOT OUTPATIENT THERAPY 270 37.00 NORMAGEL SHOT OUTPATIENT THERAPY 270 95.00 POLYMEM DOT SHOT OUTPATIENT THERAPY 270 160.00 POLYMEM 1X3 SHOT OUTPATIENT THERAPY 270 8.00 POLYMEM 4X4 SHOT OUTPATIENT THERAPY 270 9.00 STRTUSORB SHOT OUTPATIENT THERAPY 270 9.00 POLYMEM AG 4X4 SHOT OUTPATIENT THERAPY 270 23.00 POLYMEM 3X3 SHOT OUTPATIENT THERAPY 270 4.00 POLYMEM 4X4 SHOT OUTPATIENT THERAPY 270 22.00 POLYMEM 2X2 DOT SHOT OUTPATIENT THERAPY 270 16.00 POLYMEM 6X6 ISLAND SHOT OUTPATIENT THERAPY 270 4.00 OPTIFOAM SACRUM SHOT OUTPATIENT THERAPY 270 6.00 MAXSORB EXTRA AG SHOT OUTPATIENT THERAPY 270 7.00 SILVASORB PERFORATED SHEET 4.25X4.25 SHOT OUTPATIENT THERAPY 270 51.00 SILVASORB PERFORATED SHEET 4X10 SHOT OUTPATIENT THERAPY 270 39.00 MEPILEX AG BORDER 4X10 SHOT OUTPATIENT THERAPY 270 111.00 SKINTEGRITY CLEANSER 8OZ SHOT OUTPATIENT THERAPY 270 19.00 REMEDY CLEAR AID OINTMENT SHOT OUTPATIENT THERAPY 270 23.00 REMEDY ANTIFUNGAL CREAM SHOT OUTPATIENT THERAPY 270 30.00 ENLUXTRA 4X4 SHOT OUTPATIENT THERAPY 270 23.00 ENLUXTRA 6X6 SHOT OUTPATIENT THERAPY 270 4.00 SORBACT HYDRO 2.8X3.3 SHOT OUTPATIENT THERAPY 270 29.00 SORBACT HYDRO 5.5X5.5 SHOT OUTPATIENT THERAPY 270 506.00 SORBACT HYDRO 7.5X7.5 SHOT OUTPATIENT THERAPY 270 36.00 SORBACT SILTEC 5X5 SHOT OUTPATIENT THERAPY 270 129.00 SORBACT SILTEC 6X6 SHOT OUTPATIENT THERAPY 270 29.00 SORBACT PAD 4X4 SHOT OUTPATIENT THERAPY 270 51.00 SORBACT PAD 4X8 SHOT OUTPATIENT THERAPY 270 45.00 SORBACT WCL 8X8 SHOT OUTPATIENT THERAPY 270 99.00 SILTEC PLUS FOAM 4X4 SHOT OUTPATIENT THERAPY 270 36.00 SILTEC PLUS FOAM 6X4 SHOT OUTPATIENT THERAPY 270 41.00 SILTEC PLUS FOAM 8X8 SHOT OUTPATIENT THERAPY 270 12.00 EPIONA 4X4 SHOT OUTPATIENT THERAPY 270 51.00 SACHET S 4X4 SHOT OUTPATIENT THERAPY 270 20.00 149 SACHET S 8X8 SHOT OUTPATIENT THERAPY 270 99.00 SACHET S 12X8 SHOT OUTPATIENT THERAPY 270 44.00 SACHET XL 18X10 SHOT OUTPATIENT THERAPY 270 114.00 SACHET STAR 3" SHOT OUTPATIENT THERAPY 270 155.00 SACHET STAR 5.5" SHOT OUTPATIENT THERAPY 270 227.00 CUTIMED SILTEC SORBACT 3X3 SHOT OUTPATIENT THERAPY 270 26.00 CUTIMED SILTEC SORBACT 5X5 SHOT OUTPATIENT THERAPY 270 129.00 CUTIMED SILTEC SORBACT 7" SHOT OUTPATIENT THERAPY 270 29.00 CUTIMED SILTEC B 7.5 X 7.5 SHOT OUTPATIENT THERAPY 270 105.00 CUTIMED SILTEC B 5 X 5 SHOT OUTPATIENT THERAPY 270 57.00 CUTIMED SILTEC B 17.5 X 17.5 SHOT OUTPATIENT THERAPY 270 12.00 CUTIMED SILTEC B 9 X 9 SHOT OUTPATIENT THERAPY 270 29.00 CUTIMED SACRUM 17 X 17 SHOT OUTPATIENT THERAPY 270 27.00 CUTIMED SACRUM 23 X 23 SHOT OUTPATIENT THERAPY 270 56.00 CUTIMED SORBACT WCL 4" SHOT OUTPATIENT THERAPY 270 31.00 CUTIMED SORBACT HYDRO 3X3 SHOT OUTPATIENT THERAPY 270 23.00 CUTIMED SORBACT HYDRO 5X5 SHOT OUTPATIENT THERAPY 270 506.00 CUTIMED EPIONA 2 SHOT OUTPATIENT THERAPY 270 36.00 CUTIMED SORBION SORBACT 4X4 SHOT OUTPATIENT THERAPY 270 48.00 CUTIMED SORBION SORBACT 4X8 SHOT OUTPATIENT THERAPY 270 248.00 CUTIMED SORBION SORBACT 8X8 SHOT OUTPATIENT THERAPY 270 33.00 CUTIMED SORBACT PAD 4X4 SHOT OUTPATIENT THERAPY 270 37.00 CUTIMED SORBION SORBACT 4X8 SHOT OUTPATIENT THERAPY 270 109.00 CUTIMED SORBION SORBACT 8X12 SHOT OUTPATIENT THERAPY 270 78.00 CUTIMED SORBACT WCL 4X5 SHOT OUTPATIENT THERAPY 270 115.00 CUTIMED SORBACT WCL 6X6 SHOT OUTPATIENT THERAPY 270 15.00 FILTER DISK 5 MICRON SHOT OUTPATIENT THERAPY 270 14.00 MEDIGRIP SIZE D 3" SHOT OUTPATIENT THERAPY 270 8.00 MEDIGRIP SIZE E 3.5" SHOT OUTPATIENT THERAPY 270 8.00 MEDIGRIP SIZE F 4" SHOT OUTPATIENT THERAPY 270 62.00 MEDIGRIP SIZE G 4.75 SHOT OUTPATIENT THERAPY 270 13.00 MEPILEX BRDER 4X4 SHOT OUTPATIENT THERAPY 270 36.00 MEPILEX BRDER 6X6 SHOT OUTPATIENT THERAPY 270 36.00 ALLEVYN 3X3 SHOT OUTPATIENT THERAPY 270 36.00 ALLEVYN BRDER 4X4 SHOT OUTPATIENT THERAPY 270 11.00 MAXSORB RIBBON SHOT OUTPATIENT THERAPY 270 27.00 DUODERM 6X6 SHOT OUTPATIENT THERAPY 270 4.00 POLYMEM SILVER 8X8 SHOT OUTPATIENT THERAPY 270 143.00 POLYMEM SILVER 4X12 SHOT OUTPATIENT THERAPY 270 200.00 MEPITEL 2X3 SHOT OUTPATIENT THERAPY 270 16.00 MEPILEX 6X6 SHOT OUTPATIENT THERAPY 270 36.00 DURAFIBER .75 X 18 SHOT OUTPATIENT THERAPY 270 12.00 150 VERSATEL 4X7 SHOT OUTPATIENT THERAPY 270 41.00 MAXSORB 6X6 SHOT OUTPATIENT THERAPY 270 154.00 MAXSORB 8X12 SHOT OUTPATIENT THERAPY 270 132.00 MEPILEX AG 8X8 SHOT OUTPATIENT THERAPY 270 130.00 RETENTION TUBE BLUE SHOT OUTPATIENT THERAPY 270 3.00 RETENTION TUBE YELLOW SHOT OUTPATIENT THERAPY 270 3.00 POLYMEM MAX 4X4, PINK SHOT OUTPATIENT THERAPY 270 66.00 POLYMEM MAX 4X4, SILVER SHOT OUTPATIENT THERAPY 270 44.00 ALLEVYN GTL BRD 8X8 SHOT OUTPATIENT THERAPY 270 44.00 AQUAPHOR OINTMENT 1.75OZ SHOT OUTPATIENT THERAPY 270 30.00 REMEDY PHYTOPLEX CREAM, 2OZ SHOT OUTPATIENT THERAPY 270 11.00 SILVASORB GEL, .25OZ SHOT OUTPATIENT THERAPY 270 57.00 MAXORB EX AG, 4X4 SHOT OUTPATIENT THERAPY 270 13.00 SPEECH THERAPY EVALUATION ST SPEECH THERAPY 444 92506 413.50 SPEECH THERAPY ACTIVITY EACH 15 MIN ST SPEECH THERAPY 441 92507 196.00 SPEECH THERAPY SWALLOW EVALUATION ST SPEECH THERAPY 444 92610 187.50 ASSESSMENT OF APHASIA ST SPEECH THERAPY 444 96105 271.00 STANDARDIZED TESTING COGNITIVE PERFORM ST SPEECH THERAPY 444 96125 296.00 THERAPY INTERVENT COGNITIVE FUNCTION ST SPEECH THERAPY 441 97127 125.00 TX SPEECH COMM / PROCESS DIS IND ST SPEECH THERAPY 441 92507 196.00 EVALUATION SPEECH FLUENCY ST SPEECH THERAPY 444 92521 285.00 EVALUATION SPEECH PRODUCTION COMPREHENSI ST SPEECH THERAPY 444 92523 494.00 BEHAVIOR ANALYSIS VOICE/RESONANCE ST SPEECH THERAPY 441 92524 220.00 TX SWALLOWING DYSFUNCTION ST SPEECH THERAPY 441 92526 214.00 EVAL SPEECH FLUENCY ST SPEECH THERAPY 444 92521 285.00 IMG GUIDED DRAIN BY CATH SUR SURGERY 360 10030 1,434.00 I&D ABSCESS, SIMPLE/SINGL SUR SURGERY 360 10060 443.00 I&D ABCESS COMP/MULTI SUR SURGERY 360 10061 636.50 PILONIDAL CYSTECTOMY SUR SURGERY 360 10080 440.50 REMOVAL OF FOREIGN BODY SUR SURGERY 360 10121 4,507.50 INCISION & DRAINAGE SUR SURGERY 360 10140 3,312.00 I&D CMPLX POST OP WND INF SUR SURGERY 360 10180 5,715.50 DEBRIDMENT EXT INF SKN UP SUR SURGERY 360 11000 1,205.00 DEBRIDEMENT WOUND SUR SURGERY 360 11042 514.00 DEBRIDE MUSCLE/FASCIA 20 SUR SURGERY 360 11043 1,186.00 DEBRIDE BONE 1ST 20 SQCM SUR SURGERY 360 11044 3,289.00 DEBRIDE SUBQ TISSE ADNL 2 SUR SURGERY 360 11045 627.00 DEBRIDE MSCLE/FACIA EA AD SUR SURGERY 360 11046 192.50 BX SKIN SUBQ SINGLE LESIO SUR SURGERY 360 11100 623.50 SKN BX SUBQ//MUCOUS MEMB SUR SURGERY 360 11101 777.50 REM SKIN TAGS UPTO 15 SUR SURGERY 360 11200 407.00 EXC B9 LEISION TAL 0.5CM SUR SURGERY 360 11400 1,331.50 151 EXC BENIGN LESION 2.1-3.0 SUR SURGERY 360 11403 1,924.00 EXC CYST/ MASS /LESION /L SUR SURGERY 360 11406 4,576.00 EXC BENIGN LES 0.5CM OR < SUR SURGERY 360 11420 3,289.00 EXS B9 LESION SNFG 0.6-1. SUR SURGERY 360 11421 2,605.50 EXCIS B9 LESION SNHFG 2.1 SUR SURGERY 360 11423 2,605.50 EXC SKIN FOR AXIL HIDRADE SUR SURGERY 360 11450 4,791.50 EXC MAL LESION TAL 4 CM SUR SURGERY 360 11606 3,912.00 EXC NAIL MATRIX PERM REM, SUR SURGERY 360 11750 777.50 EXC PILONIDAL CYST EXTEN SUR SURGERY 360 11771 4,695.50 EXC PILONIDAL CYST SUR SURGERY 360 11772 7,429.00 REMOVE IMPLTED CONTRACEPT SUR SURGERY 360 11976 1,525.00 REP INTERMED WND SATE 2.5 SUR SURGERY 360 12032 777.50 REP CMPLX TRNK 1.1-2.5 CM SUR SURGERY 360 13100 1,205.00 REP CMPLX TRUNK 2.6 TO 7. SUR SURGERY 360 13101 1,205.00 REP COMPLEX TRNK ADDNL 5 SUR SURGERY 360 13102 392.00 SECONDARY CLS SURG WND CM SUR SURGERY 360 13160 3,797.50 ADJ TISS TRNSFR TRNK 10. SUR SURGERY 360 14001 3,797.50 ADJ TISSUE TSFR S/A/L 10 SUR SURGERY 360 14020 3,418.00 AUTOGRAFT FSEME 1ST 100 S SUR SURGERY 360 15135 6,661.00 BX BREAST CORE W/O IMG SUR SURGERY 360 19100 2,606.50 BREAST BIOSPY SUR SURGERY 360 19101 6,381.00 NIPPLE DUCT EXLORE SUR SURGERY 360 19110 6,647.50 EXC CYST, FIRIBROMA, B9 T SUR SURGERY 360 19120 6,647.50 EXC BREAST LESION OPN SNG SUR SURGERY 360 19125 7,262.50 GYNECOMASTECTOMY SUR SURGERY 360 19300 6,052.50 BREAST LUMPECTOMY SUR SURGERY 360 19301 6,381.00 BREAST LUMP W/SENT NODE SUR SURGERY 360 19302 11,219.50 MASTECTOMY SMPL COMPLETE SUR SURGERY 360 19303 12,106.50 MASTECTOMY, SUBCUTANEOUS SUR SURGERY 360 19304 6,647.50 MASTECTOMY MOD RADICAL W/ SUR SURGERY 360 19307 12,106.50 MASTOPEXY SUR SURGERY 360 19316 11,754.50 REDUCTION MAMMOPLASTY SUR SURGERY 360 19318 11,754.50 BREAST RECONSTRUCTION W/T SUR SURGERY 360 19357 26,696.50 RECON BREAST W/OTH TECHNIQUE SUR SURGERY 360 19366 11,677.00 REV RECONSTRUCTED BREAST SUR SURGERY 360 19380 12,815.00 I&D SFT TISS ABSCESS SUBF SUR SURGERY 360 20005 4,695.50 PERCUT NDL BX MUSCLE SUR SURGERY 360 20206 2,605.50 REM FB MUSCLE/TENDON CMPL SUR SURGERY 360 20525 5,715.50 ASPIRATION KNEE BURSA SUR SURGERY 360 20610 666.00 INJ GR TORCHANTER BURSA SUR SURGERY 360 20610 594.50 REMOVAL OF HARDWARE SUR SURGERY 360 20680 5,958.50 EXC TUMOR SUBQ FACE/SCALP SUR SURGERY 360 21011 3,289.00 152 BX SOFT TISSUE NECK/THORA SUR SURGERY 360 21550 2,606.50 EXC TUMOR NECK/ANT THORAX SUR SURGERY 360 21555 3,289.00 EXC SFT TISS TUMR SQ BACK SUR SURGERY 360 21930 3,289.00 EXC TUMOR BAK/FLNK SUBQ 3 SUR SURGERY 360 21931 4,695.50 EXC TUMOR BAK/FLNK INTRAM SUR SURGERY 360 21933 4,695.50 EXC SOFT TISS TUMR SUBQ A SUR SURGERY 360 22902 3,289.00 EXC TUMOR ABDOMINAL SUBQ SUR SURGERY 360 22903 4,695.50 REM SUBDELTOID CALCAREOUS SUR SURGERY 360 23000 1,142.50 EXC SOF TIS TUMR SHLDR SU SUR SURGERY 360 23073 5,715.50 CLAVICULECTOMY PARTIAL SUR SURGERY 360 23120 6,485.00 SHOULDER ACROMIOPLASTY SUR SURGERY 360 23130 11,797.00 REP RUPTURED ROTATOR CUFF SUR SURGERY 360 23410 16,495.50 ROTATOR CUFF REPAIR SUR SURGERY 360 23412 11,864.50 ORIF CLAVICLE / SHOULDER SUR SURGERY 360 23515 16,679.50 TX HUMERUS FRACTURE SUR SURGERY 360 23615 23,448.50 OPN TX GREATER TUBEROSITY SUR SURGERY 360 23630 16,495.50 SHOULDER MANI W/FXN (NON SUR SURGERY 360 23700 3,640.00 ELBOW ARTROTOMY W/REM OF SUR SURGERY 360 24000 6,485.00 EXCISION OLECRANON BURSA SUR SURGERY 360 24105 5,727.50 EXC/CURETTAGE BNE CYST/B9 SUR SURGERY 360 24120 6,485.00 MANIPULATION ELBOW W/ANES SUR SURGERY 360 24300 3,237.50 TENODESIS AT ELBOW SUR SURGERY 360 24340 13,887.50 OLECRANON TENDON RELEASE SUR SURGERY 360 24341 11,797.00 FASCIOTOMY FOREARM DECOMP SUR SURGERY 360 24495 13,887.50 ORIF HUMERUS SUR SURGERY 360 24515 23,448.50 CLSD TX HUMERAL FX W/MANI SUR SURGERY 360 24535 3,237.50 TX HUMERAL FX W/PERC FXN SUR SURGERY 360 24538 7,952.50 OPN TX ULNAR FX PROXMAL SUR SURGERY 360 24685 13,746.00 INS EXT TENDON SHEATH WRI SUR SURGERY 360 25000 4,026.00 I&D FOREARM/WRIST DEEP AB SUR SURGERY 360 25028 6,485.00 EXC/CURETTAGE BONE CYST R SUR SURGERY 360 25120 6,485.00 OPN REDUCT RAD/ULN SHFT F SUR SURGERY 360 25575 13,887.50 CLSD TX DISTAL RADIAL FX SUR SURGERY 360 25600 686.00 TX RADIAL FX W/PERC FXN SUR SURGERY 360 25606 7,952.50 OPN TX DIS RAD FX EA/ES W SUR SURGERY 360 25607 16,494.50 OPN TX DIS RAD FX IA/ES 2 SUR SURGERY 360 25608 16,494.50 OPN TX DIST RAD FX IA/ES SUR SURGERY 360 25609 16,495.50 ORIF WRIST SUR SURGERY 360 25628 11,998.00 DUPUYTRENS CONTRACTURE RE SUR SURGERY 360 26040 4,280.00 TNDN SHEATH INCISION SUR SURGERY 360 26055 4,026.00 EXC TUMR/VASC MALFORM <1. SUR SURGERY 360 26115 3,590.00 FASCIECTOMY PALM WOW Z-PL SUR SURGERY 360 26121 6,485.00 153 SYNOVECTOMY TNDN SHTH PAL SUR SURGERY 360 26145 3,237.50 CLSD TX METACARPAL FX W/M SUR SURGERY 360 26605 516.00 ORIF FINGER SUR SURGERY 360 26615 11,998.00 PERC INT FXN CARPO/META D SUR SURGERY 360 26676 6,296.00 HEMIARTHROPLASTY HIP PART SUR SURGERY 360 27125 15,526.00 ARTHROPLASTY HIP SUR SURGERY 360 27130 15,526.00 CLS TX PROX FEM FX W/O M SUR SURGERY 360 27230 468.00 REP FEM FX PROXIMAL NECK SUR SURGERY 360 27235 13,746.00 OPN TX PROX FEM END W/FXN SUR SURGERY 360 27236 15,450.00 TX FEM FX W/IMPLANT SUR SURGERY 360 27244 20,017.50 I&D DEEP ABSCESS BURSA, K SUR SURGERY 360 27301 3,912.00 ARTHROTOMY KNEE W/FB REM SUR SURGERY 360 27310 6,485.00 ARTHROTOMY KNEE W/JNT EXP SUR SURGERY 360 27331 7,952.50 EXC PREPATELLAR BURSA SUR SURGERY 360 27340 6,626.50 LIGAMENT RECONSTRUCT KNEE SUR SURGERY 360 27428 26,959.00 CAPSULOTOMY POST CAPSULAR SUR SURGERY 360 27435 7,952.50 ARTHROPLASTY KNEE SUR SURGERY 360 27447 15,526.00 REVISION KNEE ARTHOPLASTY SUR SURGERY 360 27487 16,605.50 OPN TX FEM SHFT FX W/IMPL SUR SURGERY 360 27506 18,448.50 I&D LEG/ANKLE DEEP ABCESS SUR SURGERY 761 27603 5,715.50 BX SOFT TISS LEG/ANKLE DE SUR SURGERY 360 27614 5,715.50 EXC LESION TENDN LEG/ANKL SUR SURGERY 360 27630 4,831.00 EXC TUM SFT TISS LEG/ANK SUR SURGERY 360 27634 5,715.50 PARTIAL EXCN BONE TIBIA SUR SURGERY 360 27640 5,765.00 ACHILLES TENDON REPAIR SUR SURGERY 360 27650 11,797.00 OPN REP ACHILLES TNDN W/G SUR SURGERY 360 27652 13,887.50 TRNSFR/TRNSPLNT SNGL TNDN SUR SURGERY 360 27691 13,887.50 RPR PRIMARY ANKLE LIG COL SUR SURGERY 360 27695 14,929.00 ORIF DISTRAL FEMUR / TIB SUR SURGERY 360 27758 11,998.00 OPN TX MED MALLEOLUS FX W SUR SURGERY 360 27766 6,967.00 OPN TX DIS TIB FX SUR SURGERY 360 27792 16,495.50 ORIF ANKLE SUR SURGERY 360 27814 11,998.00 OPN TX TRIMALLEOLAR W/O I SUR SURGERY 360 27822 13,887.50 AMPUTATION LEG THRU FIBUL SUR SURGERY 360 27880 15,450.00 INCISION BONE CORTEX FOOT SUR SURGERY 360 28005 6,626.50 FASCIOTOMY FOOT/TOE SUR SURGERY 360 28008 4,026.00 TENOTOMY PERCUT TOE SINGL SUR SURGERY 360 28010 3,595.00 EXC TMR SFT FT/TOE 1.5CM SUR SURGERY 360 28041 5,715.50 EXC TUMR SOFT TISS FOOT/T SUR SURGERY 360 28045 6,191.00 NEURECTOMY - PROCEDURE SUR SURGERY 360 28055 4,769.50 PLANTAR FACIOTOMY SUR SURGERY 360 28060 5,633.00 EXC INTERDIGITAL NEROMA S SUR SURGERY 360 28080 4,831.00 154 EXC FT LES TENDN, SHTH, C SUR SURGERY 360 28090 4,830.00 EXC BNE B9 CYST FT/ANKLE SUR SURGERY 360 28104 6,485.00 OSTECTOMY PART 5TH METACA SUR SURGERY 360 28110 4,831.00 OSTECTOMY COMP METATARSAL SUR SURGERY 360 28111 6,485.00 OSTECTOMY EXCN W META HEA SUR SURGERY 360 28112 7,044.00 OSTECTOMY METATARSAL HD T SUR SURGERY 360 28112 7,044.00 OSTECTOMY 5TH METATARSAL SUR SURGERY 360 28113 4,026.00 OSTECTOMY, CALCANEUS SUR SURGERY 360 28119 7,952.50 EXC/SAUCER BONE TALAS/CAL SUR SURGERY 360 28120 7,044.00 OSTECTOMY SUR SURGERY 360 28122 5,633.00 EXC PART BONE PHALANX TOE SUR SURGERY 360 28124 3,595.00 REP FLEX TENDON FOOT W/O SUR SURGERY 360 28200 6,485.00 REP EXT TENDN FOOT EA SUR SURGERY 360 28208 7,952.50 OPN TENOTOMY EXTENSOR TOE SUR SURGERY 360 28234 4,831.00 DIV PLANTAR FASCIA/MUSCLE SUR SURGERY 360 28250 6,485.00 CORRECTION HAMMERTOE SUR SURGERY 360 28285 6,485.00 HALLUX REPAIR SUR SURGERY 360 28291 13,888.50 BUNIONECTOMY SUR SURGERY 360 28292 8,289.00 CORRECTION BUNION W/OSTEO SUR SURGERY 360 28296 7,952.50 HALLUX VALGUS W/0 SESAMOI SUR SURGERY 360 28297 23,448.50 COR HALLUX VAL W/PROX PHA SUR SURGERY 360 28298 13,887.50 CORR BUNION DBLE OSTEOTOM SUR SURGERY 360 28299 7,952.50 OSTEOTOMY METATARSAL, NOT SUR SURGERY 360 28308 6,626.50 OSTEOTOMY PROX PHAL 1ST T SUR SURGERY 360 28310 7,951.50 SESAMOIDECTOMY 1ST TOE SUR SURGERY 360 28315 4,026.00 OPN TX METATARSAL FX EA SUR SURGERY 360 28485 13,077.00 ARTHRODESIS GREAT TOE MPJ SUR SURGERY 360 28750 14,931.00 AMPUTATION FOOT TRANSMETA SUR SURGERY 360 28805 6,626.50 AMPUTATION , TOE SUR SURGERY 360 28820 6,485.00 AMPUTATION TOE AT IP JNT SUR SURGERY 360 28825 4,026.00 ARTHRO SHLDER SURG LTD SUR SURGERY 360 29822 6,626.50 CARPAL TINNEL RELEASE END SUR SURGERY 360 29848 4,826.50 ARTHROSCOPY KNEE W\REM FB SUR SURGERY 360 29874 7,044.00 ARTHRO KNEE SURG SYNOVEC SUR SURGERY 360 29875 7,952.50 ARTHRO KNEE SURG ABRSN/ML SUR SURGERY 360 29879 7,952.50 ARTHRO KNEE W/MENISECTOMY SUR SURGERY 360 29880 6,626.50 ARTHRO KNEE SURG W/MEN SUR SURGERY 360 29881 7,951.50 KNEE ARTHROSCOPY SURG W/M SUR SURGERY 360 29882 7,951.50 ACL RECONSTRUCTION SUR SURGERY 360 29888 22,184.50 EMERGENCY INTUBATION SUR SURGERY 360 31500 470.50 LARYNGOSCOPY DX SUR SURGERY 360 31575 391.00 BRONCH W/GUIDANCE DX W/CE SUR SURGERY 360 31622 3,444.00 155 BRONCH W/ALVEOLOR LAVAGE SUR SURGERY 360 31624 2,919.00 PROCEDURE RM-BRONCHSCOPY SUR SURGERY 750 31625 2,619.00 BRONCH W/GUIDANCE AND BX SUR SURGERY 360 31628 6,612.50 BRONCHCOSCOPY W/NDLE ASP SUR SURGERY 360 31629 5,510.50 BRONCH W/NEEDLE ASP BX SUR SURGERY 750 31633 77.00 BRONCHOSCOPY W/REM OF FB SUR SURGERY 360 31635 3,377.50 REM TUNNELED PLEURAL CATH SUR SURGERY 761 32552 1,819.00 THORACENTESIS SUR SURGERY 360 32554 1,386.50 THORACENTESIS W/IMG GUIDE SUR SURGERY 761 32555 1,182.50 PLEURAL DRN W/CATH W/O IM SUR SURGERY 360 32556 3,341.50 INS CATH UMB VEIN DX OR T SUR SURGERY 360 36510 145.00 INSERT NON-TUNNELED CVC 5 SUR SURGERY 360 36556 2,385.50 INSRT CVA W/PORT 5 Y/O OR SUR SURGERY 360 36561 7,460.00 PICC / MIDLINE INSERT >5 YEARS SUR SURGERY 360 36569 3,141.50 REPLC TUNNLD CVA W/IMPL S SUR SURGERY 360 36582 6,638.00 REM TUNNELED CVA DEVICE SUR SURGERY 360 36590 2,863.50 ART LINE PLACEMENT SUR SURGERY 360 36620 141.00 TEMPORAL ARTERY BIOPSY SUR SURGERY 360 37609 4,507.50 BX/EXC LYMPH NODE OPN SUP SUR SURGERY 360 38500 6,647.50 EXC CERVICAL LYMPH NODE SUR SURGERY 360 38510 6,248.00 AXILLARY LYMPH NODE BIOPS SUR SURGERY 360 38525 6,248.00 INTEROP ID SENTINAL NODE SUR SURGERY 360 38900 6,061.00 INCISION LINGUAL FRENUM SUR SURGERY 360 41010 2,315.50 ESOPHAGOSCOPY W/FB REM SUR SURGERY 360 43194 3,009.00 ESOPHAGPSCOPY / SPOT SUR SURGERY 360 43201 2,213.50 ESOPAGOSCOPY W/BX SUR SURGERY 750 43202 3,550.50 TIF (FUNDOLPLICATION) SUR SURGERY 360 43210 17,724.00 ESOPHAGOSCOPY W/DILATION SUR SURGERY 360 43220 3,009.00 PROCEDURE RM-GASTROSCOPY SUR SURGERY 360 43227 3,612.00 EGD FLEX W/BALLOON DIL 30 SUR SURGERY 750 43233 3,611.00 EGD DX W/SPEC COLLECT IF SUR SURGERY 750 43235 2,213.50 UPPER GI & ESOPHAGOSCOPY/ SUR SURGERY 360 43236 2,213.50 PROCEDURE RM-GASTROSCOPY/ SUR SURGERY 750 43239 2,213.50 EGD FLEX W/TUBE/CAT/ PLAC SUR SURGERY 360 43241 3,550.50 EGD FLEX W/DILATION SUR SURGERY 750 43245 2,479.50 PEG TUBE PLACEMENT SUR SURGERY 360 43246 2,213.50 FLEX EGD W/REM OF FB SUR SURGERY 360 43247 1,940.50 EGD FLEX W/DIL OVER GW SUR SURGERY 360 43248 2,061.00 UPPER GI ENDOSCOPY SUR SURGERY 750 43248 2,298.00 PROCEDURE RM-GASPROSCOPY/ SUR SURGERY 750 43249 2,213.50 EGD FLEX W/REM TUMR/POLYP SUR SURGERY 360 43250 3,612.00 EGD FLEX W/REM TUMR/POLY SUR SURGERY 360 43251 3,612.00 156 EGD, FLEX BLEEDING CONTRO SUR SURGERY 750 43255 3,009.00 LAP EPIGASTRIC FUNDOPLAST SUR SURGERY 360 43280 22,775.00 LAP REP PARAESOPHAGEAL HE SUR SURGERY 360 43281 15,164.50 LAP REP PARAESOPHAGEAL HE SUR SURGERY 360 43282 22,763.00 ESOPHAGEAL DILATION W/BOU SUR SURGERY 360 43450 2,061.00 OPN GASTROSTOMY W/O CON G SUR SURGERY 360 43830 5,478.00 REV GASTRO ANASTOMOSIS SUR SURGERY 360 43860 23,058.50 ENTEROLYSIS SUR SURGERY 360 44005 16,450.50 DUODENOTOMY FOR EXPLORATI SUR SURGERY 360 44010 15,924.00 LAP RED VOLVULUS INTERNL SUR SURGERY 360 44050 14,092.50 ENTERECTOMY, SNGL RESECTI SUR SURGERY 360 44120 21,736.50 ENTERECTOMY SM INTES, EA SUR SURGERY 360 44121 8,419.50 ENTEROENTER0STOMY ANASTOM SUR SURGERY 360 44130 23,058.50 MOB SPLENIC FLEX W/PART C SUR SURGERY 360 44139 30,063.00 COLECTOMY PART W/ANASTOMO SUR SURGERY 360 44140 30,063.00 COLECTOMY PART W/COLOSTOM SUR SURGERY 360 44143 30,063.00 COLECTOMY W/ILEOCOLOSTOMY SUR SURGERY 360 44160 20,625.50 LAP SURG ENTROLYSIS (FREE SUR SURGERY 360 44180 11,068.00 LAP COLOSTOMY/CECOSTOMY SUR SURGERY 360 44188 21,630.00 LAP ENTERECTOMY RESECT SM SUR SURGERY 360 44202 23,059.50 SURG LAP PARTIAL COLECTOM SUR SURGERY 360 44204 30,063.00 SURG LAP TAKE DWN SPLENIC SUR SURGERY 360 44213 19,834.50 LAPAROSCOPIC INT SURG NOS SUR SURGERY 360 44238 11,168.50 OPN PLCMENT ENTERO/CECOST SUR SURGERY 360 44300 18,432.50 REVISION OF ILEOSTOMY COM SUR SURGERY 360 44314 18,282.50 COLOSTOMY/CECOSTOMY SKN L SUR SURGERY 360 44320 17,429.50 COLONOSCOPY THRU STOMA DX SUR SURGERY 360 44388 2,499.50 REP SM BOWEL PERF ONE PER SUR SURGERY 360 44602 30,063.00 CLOSE ENTEROSTOMY LG OR S SUR SURGERY 360 44620 18,433.00 UNLISTED SM INST PROCEDUR SUR SURGERY 360 44799 1,861.00 EXC MESENTERY LESION SUR SURGERY 360 44820 19,289.50 SUTURE MESENTERY SUR SURGERY 360 44850 154.50 APPENDECTOMY OPEN SUR SURGERY 360 44950 6,603.00 APPENDECTOMY W/RUPT AND P SUR SURGERY 360 44960 9,483.00 APPENDECTOMY LAPAROSCOPIC SUR SURGERY 360 44970 11,928.00 SIGMOIDOSCOPY SUR SURGERY 750 45330 1,775.50 SIGMOIDOSCOPY/BIOPSY SUR SURGERY 750 45331 1,445.50 SIGMOIDOSCOPY/POLYP REMOV SUR SURGERY 750 45333 2,369.50 SIGMOIDOSCOPY / INJECTION SUR SURGERY 360 45335 1,445.50 FELEX SIG W/POLYP REM SNA SUR SURGERY 360 45338 2,334.00 PROCEDURE RM-COLONOSCOPY SUR SURGERY 750 45378 1,812.00 PROCEDURE RM-COLONSCOPY/C SUR SURGERY 750 45380 2,330.50 157 COLONSCOPY FLEX / INJECTI SUR SURGERY 360 45381 2,330.50 COLONOSCOPY CONTR BLEEDIN SUR SURGERY 360 45382 2,082.50 COLONOSCOPY W/LES REM HOT SUR SURGERY 750 45384 2,499.50 COLONOSCOPY W/TUMR/LESION SUR SURGERY 750 45385 2,498.50 COLONOSCOPY W/BALLOON DIL SUR SURGERY 750 45388 2,499.50 COLONOSCOPY W/BAND LIGATI SUR SURGERY 750 45398 2,498.50 REM FECAL IMPACTION OR FB SUR SURGERY 360 45915 2,334.00 DX ANORECTAL EXAM SURG W/ SUR SURGERY 360 45990 5,765.00 I&D ISCHIO/PERIRECTAL ABS SUR SURGERY 360 46040 2,334.00 I & D ISCHIORECTAL SUR SURGERY 360 46060 3,031.00 FISSURECTOMY SUR SURGERY 360 46200 4,595.50 LIGATION OF HEMORRHOIDS SUR SURGERY 750 46221 1,500.00 EXCISE EXTERNAL PAPILLAE SUR SURGERY 360 46230 6,166.00 HEMORRHOIDECTOMY SUR SURGERY 360 46255 6,069.00 HEMORRHOI IN/EX 2 OR > GR SUR SURGERY 360 46260 7,722.50 ANAL FISTULOTOMY SUR SURGERY 360 46270 6,069.00 CLS RECTAL FISTULA W/FLAP SUR SURGERY 360 46288 7,723.50 CHEMODENERVATION ANAL SPH SUR SURGERY 360 46505 4,595.50 ANOSCOPY SUR SURGERY 360 46600 168.50 ANOSCOPY W/DILATION SUR SURGERY 360 46604 2,334.00 ANOSCOPY W/BX SNGL OR MUL SUR SURGERY 360 46606 2,334.00 ANOPLASTY FOR STRICTURE, SUR SURGERY 360 46700 5,765.00 DEST ANAL LESION(S), SMPL SUR SURGERY 360 46910 3,797.50 HEMORRHOIDECTOMY LIG 2+CO SUR SURGERY 360 46946 4,595.50 BX LIVER WEDGE SUR SURGERY 360 47100 16,452.50 LAP CHOLECYSTECTOMY SUR SURGERY 360 47562 13,282.00 CHOLECYSTECTOMY LAPARO SUR SURGERY 360 47563 11,928.00 LAP CHOLECYST W/COMMON DU SUR SURGERY 360 47564 13,282.00 CHOLECYSTECTOMY SUR SURGERY 360 47600 16,452.50 OPN CHOLECYSTECTOMY SUR SURGERY 360 47605 17,353.50 SUTURE EXTRAHEP BILI DUCT SUR SURGERY 360 47900 24,720.00 LAP EXPLORE CELIOTOMY W/W SUR SURGERY 360 49000 30,063.00 REOPEN LAPAROTOMY SUR SURGERY 360 49002 13,390.00 OPN DRAIN PERITONEAL ABS/ SUR SURGERY 360 49020 13,000.00 PARACENTESIS W/IMG GUIDAN SUR SURGERY 360 49083 2,376.50 PERITONEAL LAVAGE SUR SURGERY 360 49084 1,861.00 OPEN EXC ABD TUMORS/CYSTS SUR SURGERY 360 49203 9,471.00 LAPAROSCOPY DIAGNOSTIC SUR SURGERY 360 49320 9,636.00 LAP SURGICAL W/BX SUR SURGERY 360 49321 11,068.00 LAP W/ASPIRATION OF CAVIT SUR SURGERY 360 49322 11,068.00 GUIDED CATH DRN PERITONEA SUR SURGERY 360 49406 4,308.00 HERNIA REPAIR OLDER 5 YEA SUR SURGERY 360 49505 6,347.00 158 HERNIA ING REPAIR OPEN SUR SURGERY 360 49507 8,247.50 REP REC ING HERNIA SUR SURGERY 360 49520 8,672.50 RPR 1ST FEM HERNIA REDUCI SUR SURGERY 360 49550 6,996.00 HERNIA INCISION REP OPEN SUR SURGERY 360 49560 8,247.50 REP HERNIA VENTRAL/INCISI SUR SURGERY 360 49561 7,226.50 REP RECUR INCISIONAL HERN SUR SURGERY 360 49566 8,672.50 IMPLANT MESH/OTH PROSTH H SUR SURGERY 360 49568 3,335.50 REP UMB HERNIA >5Y/O RED SUR SURGERY 360 49585 7,227.50 HERNIA UMBILICAL REPAIR O SUR SURGERY 360 49587 8,247.50 HERNIA ING REPAIR LAP SUR SURGERY 360 49650 11,928.00 LAP SURG RECURRENT ING HE SUR SURGERY 360 49651 13,282.00 HERNIA UMB / VENT REP OPE SUR SURGERY 360 49652 17,724.00 LAP RPR HERNIA UMB/VENT/E SUR SURGERY 360 49653 11,068.00 HERNIA INCISION REPAIR/LA SUR SURGERY 360 49654 17,724.00 LAP SURG REP INCISIONAL H SUR SURGERY 360 49655 22,775.00 OMENTAL FLAP INTRA-ABDOMI SUR SURGERY 360 49905 23,836.50 PROCEDURE RM-CYSTOSCOPY SUR SURGERY 750 52000 1,855.50 CIRCUMICISION w REG CLAMP SUR SURGERY 360 54150 136.50 CIRCUMICISION/UP TO 28 DA SUR SURGERY 360 54160 101.00 CIRCUMICISION 28 DAYS OR SUR SURGERY 360 54161 174.00 EXCISION HYDROCELE SUR SURGERY 360 55040 7,614.00 ANTERIOR COLPORRHAPHY SUR SURGERY 360 57240 8,894.00 POSTERIOR COLPORRHAPHY SUR SURGERY 360 57250 8,894.00 A & P WITH ENTEROCELE SUR SURGERY 360 57265 11,317.00 COLPOPEXY, VAGINAL SUR SURGERY 360 57282 11,317.00 PELVIC EXAM W/ANESTHESIA SUR SURGERY 360 57410 6,052.00 BIOPSY CERVIX SINGLE/MULT SUR SURGERY 360 57500 1,637.50 COLD KNIFE CONE OFCERVIX SUR SURGERY 360 57520 5,154.50 D & C SUR SURGERY 360 58120 5,154.50 TOTAL ABD HYSTERECTOMY SUR SURGERY 360 58150 22,408.50 VAGINAL HYSTERECTOMY <250 SUR SURGERY 360 58260 8,894.00 VAG HYST INC/TUBES & OVAR SUR SURGERY 360 58262 8,649.00 IUD REMOVAL SUR SURGERY 360 58301 409.00 HYSTROSCOPY ENDOBXOR D&C SUR SURGERY 360 58558 5,754.50 HYSTROCOPE w ABLATION SUR SURGERY 360 58563 9,597.50 TUBAL LIGATION OPEN SUR SURGERY 360 58600 8,894.00 TUBAL INTERUPTION SUR SURGERY 360 58605 1,815.00 LIG/TRSECT FALLOPIN TUBE SUR SURGERY 360 58611 1,815.00 LAP SURG W/LYSIS OF ADHES SUR SURGERY 360 58660 11,068.00 LAP SURG W/REM ADNEXAL ST SUR SURGERY 360 58661 13,282.00 LAP SURG W/FULGRAT OVIDUC SUR SURGERY 360 58670 11,068.00 SALPINGO/OOPHERECTOMPY LA SUR SURGERY 360 58720 20,996.50 159 OOPHORECTOMY TOT OR PART SUR SURGERY 360 58940 16,887.50 LAP FOR ECTOPIC PREGNANCY SUR SURGERY 360 59151 11,928.00 CURETTAGE POSTPARTUM SUR SURGERY 360 59160 5,546.50 INSERT CERVICAL DILATOR SUR SURGERY 360 59200 733.50 VAGINAL DELIVERY ONLY SUR SURGERY 360 59409 5,148.00 CESAREAN DELIVERY ONLY SUR SURGERY 360 59514 10,041.50 TX INCOMP ABORTION ANY TR SUR SURGERY 360 59812 5,546.50 SURG TX INCOMP ABORTION SUR SURGERY 360 59820 5,237.00 PART THYROID LOBECTOMY UN SUR SURGERY 360 60212 11,168.50 TOT THYROID LOBECTOMY UNI SUR SURGERY 360 60220 11,068.00 THYROIDECTOMY SUR SURGERY 360 60252 11,141.50 THYROIDECTOMY CERVICAL AP SUR SURGERY 360 60271 10,987.00 LUMBAR PUNCTURE DIAGNOSTI SUR SURGERY 360 62270 1,737.00 INJ EPIDURAL W/O GUIDE SUR SURGERY 360 62326 1,698.50 INJ ANESTH AGNT PUDENTAL SUR SURGERY 360 64430 1,698.50 INJ ANESTH AGNT PARACERVI SUR SURGERY 360 64435 1,348.50 INJ TRANSFORM ANES/LUM SUR SURGERY 360 64483 1,839.50 TAP BLOCK SUR SURGERY 360 64486 1,699.50 CUBITAL TUNNEL RELEASE SUR SURGERY 360 64718 4,769.50 CARPAL TUNNEL RELEASE SUR SURGERY 360 64721 4,769.50 CATARACT SURG, SIMPLE SUR SURGERY 360 66984 4,176.50 US PICC GUIDANCE SUR SURGERY 402 76937 520.50 NEG PRESSURE WND TX W/DME 50 SQ CM SUR SURGERY 360 97606 827.00 MOD SED SAME PHYS INIT 15 MIN 5/> YR SUR SURGERY 370 99152 154.50 MOD SED SAME PHYS EACH ADDL 15 MINS SUR SURGERY 370 99153 154.50 ACTIFUSE LARGE SUR SURGERY 278 2,732.50 ALLOGRAFT TISSUE NON-HUMA SUR SURGERY 278 3,525.50 EXE NAIL AND MATRIX PERM SUR SURGERY 360 777.50 FLOSEAL 10 ML SUR SURGERY 278 712.00 IMPLANT, HAMMER TOE SUR SURGERY 278 2,624.00 INTRAMEDULARY FIXATION DE SUR SURGERY 278 8,569.50 KNEE PROSTHESIS TOTAL SUR SURGERY 278 10,830.50 K-WIRE SUR SURGERY 278 19.50 K-WIRE SUR SURGERY 278 360.50 TOTAL HIP PROSTHESIS LI SUR SURGERY 278 6,427.00 TUBE, FEEDING IMPLNT SUR SURGERY 278 53.50 ORTHO NAIL SUR SURGERY 278 C1713 2,451.00 PLATE L1 SUR SURGERY 278 C1713 160.50 PLATE L2 SUR SURGERY 278 C1713 268.00 PLATE L3 SUR SURGERY 278 C1713 375.00 CATHETER, INFUSION CENTRA SUR SURGERY 278 C1751 605.00 160 CATHETER, INFUSION CENTRA SUR SURGERY 278 C1751 580.50 IMPLANTABLE PORT SUR SURGERY 278 C1751 1,012.00 ADHESION BARRIER SUR SURGERY 278 C1765 308.00 IMPLANT, REG GREAT TOE SUR SURGERY 278 C1776 3,454.50 JOINT PROTHESIS SUR SURGERY 278 C1776 3,044.00 IMPLANTABLE PORT SUR SURGERY 278 C1788 775.50 IMPLANTABLE PORT SUR SURGERY 278 C1788 2,053.00 COLONSCOPY SCRN HIGH RISK SUR SURGERY 750 G0105 1,812.00 COLONSCOPY SCREEN NON HIGH RISK SUR SURGERY 750 G0121 1,812.00 ALLOPATCH HD PER SQCM SUR SURGERY 636 Q4128 62.00 LAP ILE OR JEJUNOSTOMY SUR SURGERY 360 44187 19,000.00 LAP PROC ABD, PERITO, AND OMEN NOS SUR SURGERY 360 49329 11,954.00 COMBINED A/P COLPORRHAPHY SUR SURGERY 360 57260 13,140.00 STEROID INJ SNGL TENDON SHEATH SUR SURGERY 360 20550 782.00 ARTHROPLASTY THUMB CARPOMETA JNT TA SUR SURGERY 360 25447 7,044.00 TRNSFR/TRSPLT EA TENDON W/O FREE GRAFT SUR SURGERY 360 26480 7,044.00 BX VULVA/RERINEUM INITIAL SUR SURGERY 360 56605 1,532.00 IMPLANTABLE MARKER SUR SURGERY 360 2,200.00 BX VULVA/RERINEUM EA ADDNL LESION SUR SURGERY 360 56606 250.00 PLATE L4 SUR SURGERY 278 C1713 482.00 PLATE L5 SUR SURGERY 278 C1713 589.00 PLATE L6 SUR SURGERY 278 C1713 696.50 INCISION THROMBOSED HEMOR SUR SURGERY 360 46083 733.00 WRIST ARTHRODESIS W/GRAFT SUR SURGERY 360 25810 32,351.00 UNLISTED PROCED NECK/THORAX SUR SURGERY 360 21899 570.00 OSTEOTOMY, CALCANEUS W/WO FIX SUR SURGERY 360 28300 17,917.00 OMENTECTOMY RESECTION OF OMENTUM SUR SURGERY 360 49255 29,389.00 INTRAMEDULLARY NAILING OF INTERTROCHANTE SUR SURGERY 360 27245 15,090.00 REMOVAL OF PERITONEAL FOREIGN BODY SUR SURGERY 360 49402 9,304.00 EXCISION BENIGN SKIN LESION 3.1 - 4.0 CM SUR SURGERY 360 11404 3,590.00 ARTHROSCOPY SHOULDER SYNOVECTOMY PARTIAL SUR SURGERY 360 29820 17,917.00 EXIC TUMOR SOFT TISSUE THIGH/KNEE 3CM/> SUR SURGERY 360 27337 7,430.00 HEMORRHOIDOPEXY STAPLING SUR SURGERY 360 46947 7,400.00 CLTX SHOULDER DISL W/FX HUMERAL TUBRST W SUR SURGERY 360 23665 4,314.00 I&D BELOW FASCIA, FOOT MULTIPLE AREAS SUR SURGERY 360 28003 8,454.00 TISSUE TRANSFER ANY 30.1 - 60 SQ CM SUR SURGERY 360 14301 8,662.00 TISSUE TRANSFER ADDL 30 SQ CM SUR SURGERY 360 14302 150.00 HEMORRHOIDECTOMY, INTERNAL, BY LIGATION SUR SURGERY 360 46945 7,400.00 EXCISION, TUMOR, SOFT TISSUE OF FOREARM SUR SURGERY 360 25071 4,308.00 ARTHROSCOPY, KNEE WITH MENISCUS REPAIR SUR SURGERY 360 29883 8,454.00 REPAIR RECURRENT INCISIONAL OR VENTRAL H SUR SURGERY 360 49565 14,345.00 REPAIR EPIGASTRIC HERNIA; INCARCERATED O SUR SURGERY 360 49572 9,304.00 161 AMPUTATION METATARSAL, W/TOE SINGLE SUR SURGERY 360 28810 4,026.00 METATARSECTOMY SUR SURGERY 360 28140 4,831.00 CLOSED TX CLAVICULAR FRACTURE SUR SURGERY 360 23505 4,314.50 COLECTOMY, PARTIAL; W/COLOPROCTOSTOMY SUR SURGERY 360 44145 30,063.00 COLPORRHAPHY, SUTURE OF INJURY OF VAGINA SUR SURGERY 360 57200 7,263.00 MANIPULATION, KNEE JOINT UNDER GEN ANEST SUR SURGERY 360 27570 4,314.00 FASCIECTOMY, PARTIAL PALMAR W/RELEASE 1 SUR SURGERY 360 26123 8,454.00 FASCIECTOMY PARTIAL PALMAR EA ADDITIONAL SUR SURGERY 360 26125 150.00 TAP BLOCK BILATERAL: BY INJECTION(S) SUR SURGERY 360 64488 1,700.00 UNLISTED PROCEDURE, TRACHEA, BRONCHI SUR SURGERY 360 31899 502.00 SINGLE NERVE BLOCK INJECTION ARM NERVE SUR SURGERY 360 64415 2,148.00 PICC REMOVAL SUR SURGERY 360 36589 1,450.00 ANAL FISTULOTOMY SUR SURGERY 360 46275 7,400.00 CHOLEDOCHOTOMY OR CHOLEDOCHOSTOMY W EXPL SUR SURGERY 360 47420 15,090.00 CATARACT SURGER, COMPLEX SUR SURGERY 360 66982 6,140.00 CLOSED TX DISTAL RAD FX W/MAN SUR SURGERY 360 25605 4,314.00 DRAIN OVARIAN ABSCESS ABD APPROACH SUR SURGERY 360 58822 12,132.00 COLPOSCOPY W/UPPER VAG CERV BIOPSY SUR SURGERY 360 57460 7,263.00 COLOECTAL CANCER SCREENING, BARIUM ENEMA SUR SURGERY 750 G0120 1,196.00 MESH, BIOLOGIC 13 X 15 SUR SURGERY 272 C1781 11,515.00 MESH, BIOLOGIC 13 X 22 SUR SURGERY 272 C1781 16,738.00 MESH, BIOLOGIC 7 X 10 U SHAPE SUR SURGERY 272 C1781 2,794.00 PRESSFIT STEM 2 SUR SURGERY 272 5,475.00 PRESSFIT STEM 3 SUR SURGERY 272 5,475.00 PRESSFIT STEM 4 SUR SURGERY 272 5,475.00 PRESSFIT STEM 5 SUR SURGERY 272 5,477.00 PRESSFIT STEM 6 SUR SURGERY 272 5,475.00 PRESSFIT STEM 7 SUR SURGERY 272 5,477.00 PRESSFIT STEM 8 SUR SURGERY 272 5,475.00 SPACER 0 SUR SURGERY 272 1,011.00 SPACER +5 SUR SURGERY 272 1,011.00 SPACER +10 SUR SURGERY 272 1,011.00 SPACER -3 SUR SURGERY 272 1,011.00 MODULAR CATHCART HEAD 41 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 42 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 43 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 44 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 45 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 46 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 47 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 48 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 49 SUR SURGERY 272 1,878.00 162 MODULAR CATHCART HEAD 50 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 51 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 52 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 54 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 56 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 58 SUR SURGERY 272 1,878.00 MODULAR CATHCART HEAD 60 SUR SURGERY 272 1,878.00 IMPLANT, HT 2STEP 3.4 X 8 SUR SURGERY 272 2,685.00 IMPLANT, HT 2STEP 3.4 X 10 SUR SURGERY 272 2,685.00 IMPLANT, HT 2STEP 3.4 X 12 SUR SURGERY 272 2,685.00 IMPLANT, HT 2STEP 4.5 X 8 SUR SURGERY 272 2,685.00 IMPLANT, HT 2STEP 4.5 X 10 SUR SURGERY 272 2,685.00 IMPLANT, HT 2STEP 4.5 X 12 SUR SURGERY 272 2,685.00 CSS CANNULATED SCREW 2.0 X 7MM SUR SURGERY 272 C1713 573.00 CSS CANNULATED SCREW 2.0 X 8MM SUR SURGERY 272 C1713 573.00 CSS CANNULATED SCREW 2.0 X 9MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 10MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 11MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 12MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 13MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 14MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 15MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 16MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 17MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 18MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 19MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 20MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 21MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 30MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 35MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 40MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 45MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.0 X 50MM SUR SURGERY 272 C1713 573.00 CSS CANNULAT SCREW 2.5 X 10MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 12MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 14MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 16MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 18MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 20MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 22MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 24MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 26MM SUR SURGERY 272 C1713 645.00 163 CSS CANNULAT SCREW 2.5 X 28MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 30MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 32MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 34MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 36MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 38MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 40MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 42MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 44MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 46MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 48MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 2.5 X 50MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 12MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 14MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 16MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 18MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 20MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 22MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 24MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 26MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 28MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 30MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 32MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 34MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 36MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 38MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 40MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 42MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 44MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 46MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 48MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.0 X 50MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 12MM SUR SURGERY 272 645.00 CSS CANNULAT SCREW 3.5 X 14MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 16MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 18MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 20MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 22MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 24MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 26MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 28MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 30MM SUR SURGERY 272 C1713 645.00 164 CSS CANNULAT SCREW 3.5 X 32MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 34MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 36MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 38MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 40MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 42MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 44MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 46MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 48MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 3.5 X 50MM SUR SURGERY 272 C1713 645.00 CSS CANNULAT SCREW 4.0 X 14MM SUR SURGERY 272 C1713 657.00 CSS CANNULAT SCREW 4.0 X 16MM SUR SURGERY 272 C1713 657.00 CSS CANNULAT SCREW 4.0 X 18MM SUR SURGERY 272 C1713 873.00 CSS CANNULAT SCREW 4.0 X 20MM SUR SURGERY 272 C1713 945.00 CSS CANNULAT SCREW 4.0 X 22MM SUR SURGERY 272 C1713 1,053.00 CSS CANNULAT SCREW 4.0 X 24MM SUR SURGERY 272 C1713 1,161.00 CSS CANNULAT SCREW 4.0 X 26MM SUR SURGERY 272 C1713 1,269.00 CSS CANNULAT SCREW 4.0 X 28MM SUR SURGERY 272 C1713 1,377.00 CSS CANNULAT SCREW 4.0 X 30MM SUR SURGERY 272 C1713 1,485.00 CSS CANNULAT SCREW 4.0 X 32MM SUR SURGERY 272 C1713 1,593.00 CSS CANNULAT SCREW 4.0 X 34MM SUR SURGERY 272 C1713 1,701.00 CSS CANNULAT SCREW 4.0 X 36MM SUR SURGERY 272 C1713 1,809.00 CSS CANNULAT SCREW 4.0 X 38MM SUR SURGERY 272 C1713 1,917.00 CSS CANNULAT SCREW 4.0 X 40MM SUR SURGERY 272 C1713 2,025.00 CSS CANNULAT SCREW 4.0 X 42MM SUR SURGERY 272 C1713 2,133.00 CSS CANNULAT SCREW 4.0 X 44MM SUR SURGERY 272 C1713 2,241.00 CSS CANNULAT SCREW 4.0 X 46MM SUR SURGERY 272 C1713 2,349.00 CSS CANNULAT SCREW 4.0 X 48MM SUR SURGERY 272 C1713 2,457.00 CSS CANNULAT SCREW 4.0 X 50MM SUR SURGERY 272 C1713 2,565.00 CAN SCREW PART THRD 3.5 X 10MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 12MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 14MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 16MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 18MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 20MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 22MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 24MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 26MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 28MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 30MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 32MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 34MM SUR SURGERY 272 C1713 999.00 165 CAN SCREW PART THRD 3.5 X 36MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 38MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 40MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 42MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 44MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 46MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 48MM SUR SURGERY 272 C1713 999.00 CAN SCREW PART THRD 3.5 X 50MM SUR SURGERY 272 C1713 999.00 CAN SCREW SHRT THRD 4.0 X 10MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 12MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 14MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 16MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 18MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 20MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 22MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 24MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 26MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 28MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 30MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 32MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 34MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 36MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 38MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 40MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 42MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 44MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 46MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 48MM SUR SURGERY 272 C1713 981.00 CAN SCREW SHRT THRD 4.0 X 50MM SUR SURGERY 272 C1713 981.00 WASHER 3.5/4.0 X 7MM SUR SURGERY 272 133.00 GUIDEWIRE THRD 1.25 X 150MM SUR SURGERY 272 448.00 CORTEX SCREW 3.5 X 10MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 12MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 14MM SUR SURGERY 272 C1713 135.00 CORTEX SCREW 3.5 X 16MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 18MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 20MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 22MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 24MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 26MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 28MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 32MM SUR SURGERY 272 C1713 117.00 166 CORTEX SCREW 3.5 X 36MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 40MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 45MM SUR SURGERY 272 C1713 117.00 CORTEX SCREW 3.5 X 50MM SUR SURGERY 272 C1713 117.00 CAN SCREW FULL THRD 4.0 X 14MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 16MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 18MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 20MM SUR SURGERY 272 C1713 37.00 CAN SCREW FULL THRD 4.0 X 22MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 24MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 26MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 28MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 30MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 32MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 36MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 40MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 45MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 50MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 55MM SUR SURGERY 272 C1713 98.00 CAN SCREW FULL THRD 4.0 X 60MM SUR SURGERY 272 C1713 98.00 CAN SCREW PART THRD 4.0 X 12MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 14MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 16MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 18MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 20MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 22MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 24MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 26MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 28MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 30MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 35MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 40MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 45MM SUR SURGERY 272 C1713 981.00 CAN SCREW PART THRD 4.0 X 50MM SUR SURGERY 272 C1713 981.00 PLATE, 1/3 TUBULAR 2 HOLE SUR SURGERY 272 C1713 171.00 PLATE, 1/3 TUBULAR 3 HOLE SUR SURGERY 272 C1713 177.00 PLATE, 1/3 TUBULAR 4 HOLE SUR SURGERY 272 C1713 204.00 PLATE, 1/3 TUBULAR 5 HOLE SUR SURGERY 272 C1713 206.00 PLATE, 1/3 TUBULAR 6 HOLE SUR SURGERY 272 C1713 206.00 PLATE, 1/3 TUBULAR 7 HOLE SUR SURGERY 272 C1713 213.00 PLATE, 1/3 TUBULAR 8 HOLE SUR SURGERY 272 C1713 213.00 PLATE, RIGHT ANG T, 3SHAFT 3 HEAD SUR SURGERY 272 C1713 396.00 167 PLATE, RIGHT ANG T, 4SHAFT 4HEAD SUR SURGERY 272 C1713 396.00 PLATE, OBLIQUE T, 3SHAFT 3HEAD SUR SURGERY 272 C1713 666.00 PLATE, OBLIQUE T, 5SHAFT 3HEAD SUR SURGERY 272 C1713 726.00 PLATE, DCP 3.5MM 6 HOLE SUR SURGERY 272 C1713 501.00 PLATE, DCP 3.5MM 7 HOLE SUR SURGERY 272 C1713 477.00 PLATE, DCP 3.5MM 8 HOLE SUR SURGERY 272 C1713 480.00 PLATE, DCP 3.5MM 10 HOLE SUR SURGERY 272 C1713 480.00 K WIRE, TRCR 150MM X 1.25 SUR SURGERY 272 456.00 K WIRE, TRCR 150MM X 1.6 SUR SURGERY 272 456.00 K WIRE, TRCR 150MM X 2.0 SUR SURGERY 272 456.00 CAN SCREW 16MM THRD 6.5 x 30MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 35MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 40MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 45MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 50MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 55MM SUR SURGERY 272 C1713 1,380.00 CAN SCREW 16MM THRD 6.5 x 60MM SUR SURGERY 272 C1713 1,380.00 CAN SCREW 16MM THRD 6.5 x 65MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 70MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 75MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 80MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 85MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 90MM SUR SURGERY 272 C1713 2,952.00 CAN SCREW 16MM THRD 6.5 x 95MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 100MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 X 105MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 110MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 115MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 120MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 125MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 130MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 X 135MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 X 140MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 145MM SUR SURGERY 272 C1713 831.00 CAN SCREW 16MM THRD 6.5 x 150MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 45MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 50MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 55MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 60MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 65MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 70MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 75MM SUR SURGERY 272 C1713 831.00 168 CAN SCREW 32MM THRD 6.5 X 80MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 85MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 90MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 95MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 100MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 105MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 110MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 115MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 120MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 125MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 130MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 135MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 140MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 145MM SUR SURGERY 272 C1713 831.00 CAN SCREW 32MM THRD 6.5 X 150MM SUR SURGERY 272 C1713 831.00 WASHER 6.5/7.3 X 13MM SUR SURGERY 272 139.00 CAN SCREW 16MM THRD 7.3 x 30MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 35MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 40MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 45MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 50MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 55MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 60MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 65MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 70MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 75MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 80MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 85MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 90MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 95MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 100MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 X 105MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 110MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 115MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 120MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 125MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 130MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 X 135MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 X 140MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 145MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.3 x 150MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 45MM SUR SURGERY 272 C1713 852.00 169 CAN SCREW 32MM THRD 7.3 X 50MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 55MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 60MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 65MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 70MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 75MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 80MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 85MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 90MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 95MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 100MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 105MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 110MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 115MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 120MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 125MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 130MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 135MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 140MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 145MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.3 X 150MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 20MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 25MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 30MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 35MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 40MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 45MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 50MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 55MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 60MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 65MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 70MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 75MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 80MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 85MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 90MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 95MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 100MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 105MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 110MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 115MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 120MM SUR SURGERY 272 C1713 852.00 170 CAN SCREW FULL THRD 6.5 X 125MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 6.5 X 130MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 20MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 25MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 30MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 35MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 40MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 45MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 50MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 55MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 60MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 65MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 70MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 75MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 80MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 85MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 90MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 95MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 100MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 105MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 110MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 115MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 120MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 125MM SUR SURGERY 272 C1713 852.00 CAN SCREW FULL THRD 7.3 X 130MM SUR SURGERY 272 C1713 852.00 CORTEX SCREW TI 2.0 X 6MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 8MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 10MM SUR SURGERY 272 C1713 732.00 CORTEX SCREW TI 2.0 X 12MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 14MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 16MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 18MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 20MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 22MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 24MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 26MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 28MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 30MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 32MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 34MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 36MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.0 X 38MM SUR SURGERY 272 C1713 159.00 171 CORTEX SCREW TI SELFTAP 2.0 X 10MM SUR SURGERY 272 C1713 732.00 CORTEX SCREW TI SELFTAP 2.0 X 12MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 14MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 16MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 18MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 20MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 22MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 24MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 26MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 28MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 30MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 32MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 34MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 36MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI SELFTAP 2.0 X 38MM SUR SURGERY 272 C1713 159.00 CORTEX SCREW TI 2.7 X 6MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 8MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 10MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 12MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 14MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 16MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 18MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 20MM SUR SURGERY 272 C1713 65.00 CORTEX SCREW TI 2.7 X 22MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 24MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 26MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 28MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 30MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 32MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 34MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 36MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 38MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI 2.7 X 40MM SUR SURGERY 272 C1713 195.00 CORTEX SCREW TI SELFTAP 2.7 X 16MM SUR SURGERY 272 C1713 780.00 PLATE, TI 1/4 TUBULAR 3 HOLE SUR SURGERY 272 C1713 261.00 PLATE, TI 1/4 TUBULAR 4 HOLE SUR SURGERY 272 C1713 261.00 PLATE, TI 1/4 TUBULAR 5 HOLE SUR SURGERY 272 C1713 275.00 PLATE, TI 1/4 TUBULAR 6 HOLE SUR SURGERY 272 C1713 297.00 PLATE, TI 1/4 TUBULAR 7 HOLE SUR SURGERY 272 C1713 297.00 PLATE, TI 1/4 TUBULAR 8 HOLE SUR SURGERY 272 C1713 297.00 PLATE, TI 2.7 OBLIQUE L LEFT SUR SURGERY 272 C1713 191.00 PLATE, TI 2.7 OBLIQUE L RIGHT SUR SURGERY 272 C1713 191.00 172 PLATE, TI 2.7 T SHAFT 3 HOLE SUR SURGERY 272 C1713 191.00 PLATE, TI 2.7 CONDYLAR LEFT 7 HOLE SUR SURGERY 272 C1713 936.00 PLATE, TI 2.7 CONDYLAR RIGHT 7 HOLE SUR SURGERY 272 C1713 1,104.00 PLATE, TI 2.7 STRAIGHT 2.0MM 20 HOLE SUR SURGERY 272 C1713 777.00 PLATE, TI 2.7 STRAIGHT 1.5MM 20 HOLE SUR SURGERY 272 C1713 2,520.00 PLATE, TI 2.0 T 9SHAFT 3HEAD SUR SURGERY 272 C1713 678.00 PLATE, TI 2.0 T 9SHAFT 4HEAD SUR SURGERY 272 C1713 735.00 PLATE, TI H 2.0MM 4 HOLE SUR SURGERY 272 C1713 936.00 PLATE, TI H 1.5MM 4 HOLE SUR SURGERY 272 C1713 936.00 PLATE, TI 2.0 CONDYLAR LEFT 7 HOLE SUR SURGERY 272 C1713 936.00 PLATE, TI 2.0 CONDYLAR RIGHT 7 HOLE SUR SURGERY 272 C1713 936.00 PLATE, TI 1.5 T 9SHAFT 3HOLE SUR SURGERY 272 C1713 678.00 PLATE, TI 1.5 T 9SHAFT 4HOLE SUR SURGERY 272 C1713 735.00 PLATE, TI 1.5 CONDYLAR LEFT 7 HOLE SUR SURGERY 272 C1713 936.00 PLATE, TI 1.5 CONDYLAR RIGHT 7 HOLE SUR SURGERY 272 C1713 936.00 CAN SCREW 16MM THRD 7.0 X 30MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 35MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 40MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 45MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 50MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 55MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 60MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 65MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 70MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 75MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 80MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 85MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 90MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 95MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 100MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 105MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 110MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 115MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 120MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 125MM SUR SURGERY 272 C1713 852.00 CAN SCREW 16MM THRD 7.0 X 130MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 45MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 50MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 55MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 60MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 65MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 70MM SUR SURGERY 272 C1713 852.00 173 CAN SCREW 32MM THRD 7.0 X 75MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 80MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 85MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 90MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 95MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 100MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 105MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 110MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 115MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 120MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 125MM SUR SURGERY 272 C1713 852.00 CAN SCREW 32MM THRD 7.0 X 130MM SUR SURGERY 272 C1713 852.00 MESH, PARIETENE DS 20 X 15 SUR SURGERY 272 C1781 2,939.00 MESH, PARIETENE DS 30 X 20 SUR SURGERY 272 C1781 5,830.00 MESH, SYMBOTEX 9CM SUR SURGERY 272 C1781 1,603.00 MESH, SYMBOTEX 30 X 20 SUR SURGERY 272 C1781 10,293.00 MESH, SYMBOTEX 25 X 20 SUR SURGERY 272 C1781 7,510.00 MESH, SYMBOTEX 20 X 15 SUR SURGERY 272 C1781 5,189.00 MESH, SYMBOTEX 15CM SUR SURGERY 272 C1781 4,230.00 MESH, SYMBOTEX 12CM SUR SURGERY 272 C1781 3,452.00 MESH, SYMBOTEX 15 X 10 SUR SURGERY 272 C1781 2,220.00 MESH, PARIETEX 15 X 9 SUR SURGERY 272 C1781 1,378.00 MESH, PARIETEX 6.6CM SUR SURGERY 272 C1781 2,960.00 MESH, PARIETEX 15 X 10 SUR SURGERY 272 C1781 2,984.00 MESH, PROGRIP 15 X 10 SUR SURGERY 272 C1781 1,668.00 MESH, PARIETEX 15 X 15 SUR SURGERY 272 C1781 2,093.00 MESH, PARIETEX POLY 15 X 10 SUR SURGERY 272 C1781 842.00 MESH, PARIETEX POLY 20 X 20 SUR SURGERY 272 C1781 1,102.00 MESH, ULTRAPRO LARGE SUR SURGERY 272 C1781 1,499.00 MESH, ULTRAPRO MEDIUM SUR SURGERY 272 C1781 1,497.00 MESH, PERFIX LIGHT PLUG SMALL SUR SURGERY 272 C1781 474.00 MESH, PERFIX LIGHT PLUG MEDIUM SUR SURGERY 272 C1781 1,020.00 MESH, PERFIX LIGHT PLUG LARGE SUR SURGERY 272 C1781 1,032.00 MESH, PERFIX LIGHT PLUG XL SUR SURGERY 272 C1781 1,203.00 MESH, VENTRALEX ST SMALL SUR SURGERY 272 C1781 1,862.00 MESH, VENTRALEX ST MEDIUM SUR SURGERY 272 C1781 2,235.00 MESH, VENTRIO ST SMALL SUR SURGERY 272 C1781 2,614.00 MESH, VENTRIO ST MEDIUM SUR SURGERY 272 C1781 3,594.00 MESH, VENTRIO ST LARGE SUR SURGERY 272 C1781 2,925.00 ACTIFUSE BONE GRAFT 2.6ML SUR SURGERY 272 3,000.00 ACTIFUSE BONE GRAFT 8ML SUR SURGERY 272 4,650.00 ALLOGRAFT, BONE CAN CRUSH 30CC SUR SURGERY 272 1,424.00 174 FELT, PTFE 2.5 X 15.2 SUR SURGERY 272 599.00 BIOZORB MARKER 2 X 2 X 1 SUR SURGERY 272 3,300.00 BIOZORB MARKER 2 X 3 SUR SURGERY 272 3,300.00 BIOZORB MARKER 3 X 3 SUR SURGERY 272 3,300.00 BIOZORB MARKER 2 X 2 SUR SURGERY 272 3,300.00 PLATE DVR ANATOMIC EXTENDED RIGHT SUR SURGERY 272 3,493.00 CORT SCREW, 3.5X10 SUR SURGERY 272 450.00 CORT SCREW 3.5X12 SUR SURGERY 272 450.00 CORT SCREW 3.5X13 SUR SURGERY 272 450.00 CORT SCREW 3.5X14 SUR SURGERY 272 450.00 CORT SCREW 3.5X15 SUR SURGERY 272 450.00 CORT SCREW 3.5X16 SUR SURGERY 272 450.00 CORT SCREW 3.5X18 SUR SURGERY 272 450.00 PLATE, DVR AN STD LEFT SUR SURGERY 272 3,493.00 PLATE, DVR AN NAR LEFT SUR SURGERY 272 3,493.00 PLATE, DVR AN NAR RIGHT SUR SURGERY 272 3,493.00 PLATE, DVR AN NAR SRT LEFT SUR SURGERY 272 2,952.00 PLATE, DVR AN NAR SRT RIGHT SUR SURGERY 272 2,952.00 TLT HIP IMPLT CERAMIC SUR SURGERY 272 17,500.00 FEMORAL NAIL SYSTEM SUR SURGERY 272 9,750.00 PLATE, DVR AN STD RIGHT SUR SURGERY 272 3,493.00 PLATE, DVR AN SRT LEFT SUR SURGERY 272 3,493.00 PEG, SMOOTH 2X24 SUR SURGERY 272 450.00 PEG, THRD 2.5X20 SUR SURGERY 272 450.00 PEG, THRD 2.5X22 SUR SURGERY 272 450.00 PEG, SMOOTH 2X22 SUR SURGERY 272 450.00 PLATE, CLAVICLE 10H 121MM SUR SURGERY 272 4,551.00 SCREW, CORTEX 2.7X16 SUR SURGERY 272 160.00 SCREW, CORTEX 2.7X18 SUR SURGERY 272 160.00 SCREW, CORTEX 3.5X14 SUR SURGERY 272 160.00 SCREW, CORTEX 2.7X20 SUR SURGERY 272 160.00 SCREW, CORTEX 3.5X16 SUR SURGERY 272 160.00 SCREW, CORTEX 3.5X18 SUR SURGERY 272 160.00 TIBAL IMPLANT, EXO 8MM SUR SURGERY 272 2,400.00 TIBAL IMPLANT, EXO 12MM SUR SURGERY 272 2,400.00 FEMORAL IMPLANT, EXO 9MM SUR SURGERY 272 2,400.00 ALLOGRAFT, ANTERIOR TIBIALS TENDON SUR SURGERY 272 5,186.00 ALLOGRAFT, POSTERIOR TIBIALIS TENDON SUR SURGERY 272 4,583.00 SCREW,LAG 8X105MM SUR SURGERY 272 1,905.00 SCREW, LAG 8X90 SUR SURGERY 272 1,905.00 SCREW, CORTEX 4.5X38MM SUR SURGERY 272 132.00 SCREW, CORTEX 4.5X40MMM SUR SURGERY 272 132.00 175 SCREW, CORTEX 4.5X42MM SUR SURGERY 272 132.00 PLATE, DHS 4 HOLE 38MM SUR SURGERY 272 2,934.00 SURGI-VEST, 38-48" SUR SURGERY 272 410.00 ANAL FISTULA PLUG SUR SURGERY 272 2,960.00 TKA ITOTAL IMPLANTS SUR SURGERY 272 16,125.00 FGT IMPLANT SIZE 20 SUR SURGERY 272 3,561.00 FGT IMPLANT SIZE 30 SUR SURGERY 272 3,561.00 FGT IMPLANT SIZE 40 SUR SURGERY 272 3,561.00 IMPLANT HT 2STEP SUR SURGERY 272 2,685.00 G TUBE 18FR SUR SURGERY 272 155.00 G TUBE 24FR SUR SURGERY 272 155.00 ANCHOR, SUTURE, 2MM BLUE SUR SURGERY 272 2,334.00 ANCHOR, SUTURE 2MM BLACK/BLUE SUR SURGERY 272 3,112.00 ANCHOR, SUTURE 4.5 POPLOCK SUR SURGERY 272 1,721.00 US PERC BR/BIOPSY US IMAGING 402 19083 1,404.50 US NECK OR SOFT TISSUE US IMAGING 402 76536 390.50 US CHEST US IMAGING 402 76604 291.00 US BREAST UNILATERAL COMPLETE US IMAGING 402 76641 320.50 US BREAST UNILATERAL LIMITED US IMAGING 402 76642 320.50 US ABDOMINAL COMPLETE US IMAGING 402 76700 547.50 US APPENDIX US IMAGING 402 76705 424.50 US ABDOMEN LIMITED US IMAGING 402 76705 424.50 US AORTA SCREENING US IMAGING 402 76706 273.00 US RENAL US IMAGING 402 76770 419.00 US OB <14 WEEKS US IMAGING 402 76801 485.00 US OB <14 WKS EA ADDL GEST US IMAGING 402 76802 319.50 US OB > 14 WEEKS US IMAGING 402 76805 495.50 US OB LIMITED US IMAGING 402 76815 326.00 US OB FOLLOW-UP US IMAGING 402 76816 326.00 US OB TRANSVAGINAL US IMAGING 402 76817 356.50 US FETAL BIO PRO/ w/o US IMAGING 402 76819 373.00 US PELVIC TRANSVAGINAL US IMAGING 402 76830 349.00 US PELVIC COMPLETE US IMAGING 402 76856 412.00 US PELVIC LIMITED US IMAGING 402 76857 315.50 US SCROTAL US IMAGING 402 76870 392.50 US SHOULDER US IMAGING 402 76881 412.00 US EXTREM NON VASC US IMAGING 402 76881 412.00 US EXT LTD NON VASCULA US IMAGING 402 76882 315.50 US GUIDANCE/BX/ASP/LOC US IMAGING 402 76942 522.00 US CAROTID/DUPLEX BIL US IMAGING 921 93880 972.50 US ART LIMITED LOW EXTREM US IMAGING 921 93926 532.00 US PERIPHERAL BILATERAL VASC COMPLETE US IMAGING 921 93970 1,067.50 176 US PERIPHERAL VASC UNILATERAL/LIMITED US IMAGING 921 93971 857.00 TRAY, BREAST NEEDLE LOCAL US IMAGING 270 116.50 PUNCTURE ASPIRATION US IMAGING 402 10160 372.50 PERQ BREAST LOC DEV PLCMT FIRST US US IMAGING 320 19285 421.00 US ABDOMEN DOPPLER US IMAGING 400 93975 600.50 US ARTERIAL EXTREMITY LIMITED UPPER US IMAGING 402 93922 532.00 US AXILLA US IMAGING 402 76882 315.50 US BLADDER US IMAGING 402 76857 315.50 US GALLBLADDER US IMAGING 402 76705 424.50 US LIVER US IMAGING 402 76705 424.50 US MEDICARE AAA SCREENING US IMAGING 402 76706 273.00 US OB >14 WEEKS TRANSABD W/ ADD GESTATIO US IMAGING 402 76810 356.50 US OBSTETRIC DOPPLER US IMAGING 402 76820 356.50 US PELVIC DOPPLER US IMAGING 402 93976 600.50 US SPLEEN US IMAGING 402 76705 424.50 US THYROID US IMAGING 402 76536 390.50 US SPINAL CANAL US IMAGING 402 76800 366.00 US EXTREMITY ARTERIAL STUDY US IMAGING 402 93923 436.00 MANDIBLE XRAY IMAGING 320 70110 284.50 FACIAL BONES 2 VIEWS XRAY IMAGING 320 70140 177.50 FACIAL 4 VIEWS XRAY IMAGING 320 70150 284.50 NASAL XRAY IMAGING 320 70160 217.00 ORBITS 4 VIEW COMPLETE XRAY IMAGING 320 70200 343.50 SINUSES (1 VIEW LIMITED) XRAY IMAGING 320 70210 128.50 SINUS SERIES 4 VIEWS (COMPLETE) XRAY IMAGING 320 70220 279.50 SKULL 2 VIEWS (LIMITED) XRAY IMAGING 320 70250 192.50 SKULL 4 VIEWS (ROUTINE) XRAY IMAGING 320 70260 225.00 TMJs XRAY IMAGING 320 70328 277.00 NECK (SOFT TISSUE) 2 VIEW XRAY IMAGING 320 70360 149.50 CHEST (1 VIEW) XRAY IMAGING 320 71045 170.00 CHEST (2 VIEW) XRAY IMAGING 320 71046 237.00 CHEST 3 VIEW API LOR D XRAY IMAGING 320 71047 354.00 RIBS UNI w/PA CHEST 4V XRAY IMAGING 320 71101 343.50 RIBS BI w/PA CHEST 8 VIEW XRAY IMAGING 320 71111 328.50 STERNUM XRAY IMAGING 320 71120 252.50 STERNO-CLAVICULAR XRAY IMAGING 320 71130 213.00 C-SPINE 2 VIEWS (LIMITED) XRAY IMAGING 320 72040 230.50 C-SPINE 3 VIEWS XRAY IMAGING 320 72040 283.00 C-SPINE 5 VIEWS (ROUTINE) XRAY IMAGING 320 72050 447.50 C-SPINE 7 VIEWS (FLEX/EXT XRAY IMAGING 320 72052 538.00 THORACIC SPINE 2 VIEW XRAY IMAGING 320 72070 218.00 THORACIC SPINE (3 VIEWS) XRAY IMAGING 320 72072 358.00 177 THORACOLUMBAR JCT XRAY IMAGING 320 72080 410.00 SCOLIOSIS SCREEN 4 VIEWS XRAY IMAGING 320 72083 410.00 LUMBAR SPINE 2 VIEWS XRAY IMAGING 320 72100 233.00 LUMBAR SPINE 3 VIEWS XRAY IMAGING 320 72100 291.50 LUMBAR SPINE 5 VIEWS XRAY IMAGING 320 72110 391.50 LUMBAR SPINE 7 VIEW COMPLETE XRAY IMAGING 320 72114 615.50 PELVIS XRAY IMAGING 320 72170 162.00 S-I JOINTS 4 VIEWS XRAY IMAGING 320 72202 247.00 SACRUM & COCCYX 3 VIEWS XRAY IMAGING 320 72220 198.50 CLAVICLE (2 VIEWS) XRAY IMAGING 320 73000 179.50 SCAPULA XRAY IMAGING 320 73010 179.50 SHOULDER (1 VIEW) XRAY IMAGING 320 73020 165.00 SHOULDER (2 VIEWS) XRAY IMAGING 320 73030 198.50 SHOULDER (3/4 VIEWS) XRAY IMAGING 320 73030 284.50 SHOULDER ARTHOGRAM XRAY IMAGING 320 73040 538.50 A-C JOINTS XRAY IMAGING 320 73050 247.00 HUMERUS XRAY IMAGING 320 73060 217.00 ELBOW (2 VIEWS) XRAY IMAGING 320 73070 158.00 ELBOW (3/4 VIEWS) XRAY IMAGING 320 73080 206.50 FOREARM (2 VIEWS) XRAY IMAGING 320 73090 186.50 INFANT UPPER EXT 2 V XRAY IMAGING 320 73092 179.50 WRIST (2 VIEWS) XRAY IMAGING 320 73100 166.50 WRIST & NAVICULAR 4 VIEWS XRAY IMAGING 320 73110 211.00 WRIST (3 VIEWS) XRAY IMAGING 320 73110 211.00 WRIST ARTHROGRAM XRAY IMAGING 320 73115 808.00 HAND (2 VIEWS) XRAY IMAGING 320 73120 158.00 HAND (3 VIEW) XRAY IMAGING 320 73130 203.50 FINGER 2 VIEW XRAY IMAGING 320 73140 166.50 FINGER 3 VIEW XRAY IMAGING 320 73140 203.50 HIP (PELVIS/LATERAL) XRAY IMAGING 320 73501 186.50 HIP 1 VIEW XRAY IMAGING 320 73501 186.50 HIP 2 (10X12) XRAY IMAGING 320 73502 217.00 HIP PINNING 2V XRAY IMAGING 320 73502 587.00 PELVIS/BILATERAL HIPS XRAY IMAGING 320 73521 334.50 HIP ARTHOGRAM XRAY IMAGING 320 73525 1,458.00 FEMUR 2V XRAY IMAGING 320 73552 186.50 KNEE (2 VIEWS) XRAY IMAGING 320 73560 186.50 KNEE (3 VIEWS) XRAY IMAGING 320 73562 202.00 KNEE w/PATELLA 5 VIEWS XRAY IMAGING 320 73564 284.50 KNEE (4 VIEWS) XRAY IMAGING 320 73564 254.00 LOWER LEG XRAY IMAGING 320 73590 186.50 INFANT LOWER EXT 2 V XRAY IMAGING 320 73592 186.50 178 ANKLE (2 VIEWS) XRAY IMAGING 320 73600 186.50 ANKLE (3 VIEWS) XRAY IMAGING 320 73610 186.50 FOOT (2 VIEW) XRAY IMAGING 320 73620 166.50 FOOT (3 VIEW) XRAY IMAGING 320 73630 203.50 OS CALSIS (HEEL) XRAY IMAGING 320 73650 158.00 TOE 2 VIEW XRAY IMAGING 320 73660 166.50 TOE 3 VIEW XRAY IMAGING 320 73660 203.50 ABDOMEN KUB XRAY IMAGING 320 74018 198.50 ABDOMEN (2 VIEW) XRAY IMAGING 320 74019 265.00 ABDOMEN (3 VIEW) XRAY IMAGING 320 74022 432.50 ABDOMEN (4 VIEW ABD S) XRAY IMAGING 320 74022 432.50 ESOPHAGUS WITH FLUORO XRAY IMAGING 320 74220 432.50 UPPER GI XRAY IMAGING 320 74240 490.00 UPPER GI WITH SBFT XRAY IMAGING 320 74245 938.00 UPPER GI WITH AIR XRAY IMAGING 320 74246 538.00 SMALL BOWEL ONLY XRAY IMAGING 320 74250 432.50 LOWER GI/ BARIUM ENEMA XRAY IMAGING 320 74270 490.00 LOWER GI/BARIUM ENEMA/AIR XRAY IMAGING 320 74280 587.00 OPERATIVE CHOLANGIOGRAM XRAY IMAGING 320 74300 497.50 IVP XRAY IMAGING 320 74400 496.50 CYSTOGRAM XRAY IMAGING 320 74430 304.50 C-ARM SURG FLOROSCOPY XRAY IMAGING 320 76000 520.00 FLUOROSCOPY PER 1/2 HOUR XRAY IMAGING 320 76000 233.00 SINGLE/EXTRA VIEW XRAY IMAGING 320 77077 101.00 INJECTION/ASPIRATION LARGE JOINT XRAY IMAGING 320 20610 531.00 BONE LENGTH STUDY XRAY IMAGING 320 77073 470.50 CHEST 4 VIEW WITH OBLIQUES XRAY IMAGING 320 71048 237.00 CHEST INFANT CROUP 4 VIEW XRAY IMAGING 320 71048 237.00 HYSTEROSALPINGOGRAM XRAY IMAGING 320 74740 74,740.00 INJECTION/ASPIRATION INTER JOINT XRAY IMAGING 320 20605 667.00 X-RAY INJECTION/ASPERATION SMALL JOINT XRAY IMAGING 320 20600 667.00 ORBIT FOREIGN BODY XRAY IMAGING 320 70030 202.00 X-RAY OSSEOUS BONE SURVEY COMPLETE XRAY IMAGING 320 77075 1,101.00 X-RAY OSSEOUS BONE SURVEY LIMITED (METS) XRAY IMAGING 320 77074 363.50 X-RAY RETROGRADE UROGRAPHY XRAY IMAGING 320 74420 398.00 X-RAY SPINE 1 VIEW XRAY IMAGING 320 72020 166.50 X-RAY VOIDING CYSTOGRAMS XRAY IMAGING 320 74455 460.50 LUMBAR PUNCTURE XRAY IMAGING 320 62270 1,737.00 ANKLE ARTHROGRAM RIGHT XRAY IMAGING 320 73615 1,458.00 ELBOW ARTHROGRAM XRAY IMAGING 320 73085 1,458.00 BARIUM ENEMA COLORECTAL CA SCREEN XRAY IMAGING 320 G0122 651.00 X-RAY KNEE ARTHROGRAM XRAY IMAGING 320 73580 1,458.00 179 FLUORO GUIDANCE NEEDLE PLACEMENT XRAY IMAGING 320 77002 195.00 FLUROGUIDE FOR SPINE INJECTION XRAY IMAGING 320 77003 190.00 MYELOGRAPHY VIA LUMBAR INJ CERVICAL XRAY IMAGING 320 62302 2,179.00 MYELOGRAPHY VIA LUMBAR INJ THORACIC XRAY IMAGING 320 62303 2,179.00 MYELOGRAPHY VIA LUMBAR INJ LUMBOSACRAL XRAY IMAGING 320 62304 2,179.00 MYELOGRAPHY VIA LUMBAR INJ 2+ REGIONS XRAY IMAGING 320 62305 2,179.00 BONE AGE STUDY XRAY IMAGING 320 77072 366.00 STRESS TEST XRAY IMAGING 480 93015 795.50 TRAY, IV SETUP/X-RAY XRAY IMAGING 270 58.00

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