Mnemonic Name Charge AmountEffectiveDate 9 ORT TJ ART SURFACE FEM $1,765.80 1/1/19 100 MISC NO CHG $0.20 1/1/20 118 LAP ANTIFOG $7.06 1/1/20 120 APPLICATOR Q-TIP STERILE 6 $0.07 1/1/20 121 BAG PATIENT $0.21 1/1/20 124 ENDO ALLIANCE INFLAT SYRNG DEV $176.70 1/1/20 126 BANDAGE SOFT KLING 2 $1.88 1/1/20 127 BANDAGE SOFT KLING 4 $2.60 1/1/20 129 SUTURE BONE WAX 2.5QM $28.57 1/1/20 132 BANDAGE ACE 2 VELCRO $2.06 1/1/20 133 BANDAGE ACE 3 VELCRO $2.72 1/1/20 137 CLOSURE STERI-STRIP 1X5 $10.39 1/1/20 141 DRESSING STRATASORB 4 X 4 $9.25 1/1/20 142 CLOSURE STERI-STRIP 1/4X3 BRN $3.33 1/1/20 144 CLOSURE STERI-STRIP 1/2X4 $5.28 1/1/20 145 BANDAGE ESMARK 4 X 9 $8.81 1/1/20 146 BANDAGE ESMARK 6 X 12 $13.00 1/1/20 148 BANDAGE KERLIX 4 1/2 X 4.1 YD $3.70 1/1/20 150 BANDAGE SOFT KLING 3 $2.23 1/1/20 151 CLOSURE STERI-STRIP 1/4X3 $3.31 1/1/20 153 CLOSURE STERI-STRIP 1/8X3 $3.00 1/1/20 154 BANDAGE TUBEGAUZE SZ 3 $0.01 1/1/20 155 BASIN EMESIS $0.41 1/1/20 156 BEDPAN $2.92 1/1/20 157 ADHESIVE SKIN DERMABOND ADVANC $103.54 1/1/20 158 BENZOIN TINC SWAB $2.09 1/1/20 159 SUTURE NEEDLE 1/2 CIRCLE TAPER $18.35 1/1/20 160 BINDER ABDOMINAL 4-PANEL $59.28 1/1/20 165 BLADE SCALPEL SURGICAL 10 $1.78 1/1/20 167 BLADE SCALPEL SURGICAL 11 $1.78 1/1/20 168 SUTURE VICRYL 5-0 S-24 $69.59 1/1/20 169 BLADE SCALPEL SURGICAL 12 $1.71 1/1/20 170 SUTURE VICRYL 6-0 S-29 $63.75 1/1/20 171 BLADE SCALPEL SURGICAL 15 $1.78 1/1/20 173 SUTURE VICRYL 8-0 TG-160-6 $113.19 1/1/20 175 SUTURE VICRYL 8-0 TG-140-8 $75.84 1/1/20 177 SUTURE CHROMIC 2-0 CT-1 $16.10 1/1/20 178 BLADE TONGUE STER. 6 $0.15 1/1/20 179 SUTURE CHROMIC 2-0 CT-2 $16.58 1/1/20 181 SUCTION CANISTER LINER 1500CC $7.27 1/1/20 182 SUTURE CHROMIC 2-0 SH $16.11 1/1/20 184 SUCTION CANISTER LINER 3000CC $8.92 1/1/20 187 SUTURE CHROMIC 3-0 PS-2 $32.69 1/1/20 190 SUTURE CHROMIC 3-0 SH $16.58 1/1/20 191 RESP CANNULA NASAL W/7' TUBE $1.71 1/1/20 193 SUTURE CHROMIC 4-0 P-3 $36.94 1/1/20 195 SUTURE CHROMIC 4-0 PS-2 $34.32 1/1/20 200 SUTURE CHROMIC 4-0 RB-1 $17.40 1/1/20 204 SUTURE CHROMIC 5-0 P-3 $33.70 1/1/20 205 SUTURE CHROMIC 5-0 RB-1 $12.67 1/1/20 206 CAST PADDING DELTA ROLL 4 $5.04 1/1/20 207 SUTURE CHROMIC 6-0 G6 $70.53 1/1/20 209 SUTURE CHROMIC 6-0 S-14 $108.55 1/1/20 212 CAST PADDING NONSTERILE 4 $8.58 1/1/20 213 SUTURE CHROMIC 0 CT-1 $16.58 1/1/20 214 CAST PADDING NONSTERILE 6 $12.99 1/1/20 219 SUTURE VICRYL 2-0 FS-1 UND $11.85 1/1/20 220 CAST PADDING STERILE 3 WEBRIL $8.53 1/1/20 222 SUTURE VICRYL 2-0 FSL UND $12.00 1/1/20 225 SUTURE VICRYL 6-0 S-24 $79.22 1/1/20 228 CAST PLASTER X FAST 2 $4.21 1/1/20 230 CAST PLASTER X FAST 3 $5.27 1/1/20 231 CAST PLASTER X FAST 4 $7.22 1/1/20 232 CAST PLASTER X FAST 6 $9.96 1/1/20 234 CAST PLASTER SPLNT 4X15 $0.77 1/1/20 236 CAST PLASTER SPLNT 3X15 $0.74 1/1/20 238 SUTURE ETHIBOND 1 0S-4 $14.17 1/1/20 239 CAST PLASTER SPLNT FAST 5X30 $1.59 1/1/20 240 SUTURE ETHIBOND 0 CT-1 $9.64 1/1/20 242 CAST TAPE DELTA WHITE 3X4YDS $18.94 1/1/20 243 SUTURE ETHIBOND 1 0S-6 $13.65 1/1/20 244 CAST TAPE DELTA WHITE 4X4YDS $16.36 1/1/20 246 SUTURE ETHILON 3-0 KS $9.00 1/1/20 247 CATH FOLEY 10 FR 3CC $40.67 1/1/20 249 SUTURE ETHILON 3-0 PS-1 $23.89 1/1/20 250 CATH FOLEY 2-WAY 16 FR 5CC $18.97 1/1/20 253 SUTURE ETHILON 4-0 P-3 $23.00 1/1/20 254 CATH FOLEY 2-WAY 18 FR 5CC $18.97 1/1/20 255 SUTURE ETHILON 4-0 PS-2 $21.89 1/1/20 257 SUTURE ETHILON 5-0 P-3 $20.52 1/1/20 258 SUTURE ETHILON 5-0 PC-3 $24.27 1/1/20 261 SUTURE ETHILON 5-0 PS-2 $19.86 1/1/20 263 SUTURE ETHILON 6-0 P-1 $20.61 1/1/20 264 CATHETER TRAY FOLEY 16 FR $27.39 1/1/20 265 SUTURE ETHILON 6-0 PC-3 $22.94 1/1/20 267 SUTURE ETHILON 7-0 P-6 $22.69 1/1/20 268 CATHETER RED RUBBER 14FR $1.99 1/1/20 269 SUTURE ETHILON 8-0 BV130-5 $73.75 1/1/20 270 CATHETER RED RUBBER 16FR $1.99 1/1/20 283 THORACIC CATHETER 24 FR $33.88 1/1/20 285 CAUTERY CORD BI-POLAR $18.23 1/1/20 287 CAUTERY BLADE EXTENDED TIP $18.95 1/1/20 288 CAUTERY NEEDLE EXTENDED TIP $18.00 1/1/20 290 CAUTERY PENCIL HAND CONTROL $17.28 1/1/20 293 CAUTERY NEEDLE COATED $26.48 1/1/20 300 CAUTERY TIP CLEANER $1.40 1/1/20 302 CAUTERY HIGH TEMP FINE TIP DSP $62.00 1/1/20 303 SUTURE MERSILENE 5-0 S-14 $77.63 1/1/20 304 SUTURE MONOCRYL 3-0 PS-2 $31.10 1/1/20 307 SUTURE MONOCRYL 4-0 PS-2 $31.43 1/1/20 308 CHUX UNDERPAD 23 X 36 $1.32 1/1/20 309 SUTURE MONOCRYL 5-0 P-3 $31.25 1/1/20 311 ORT SMARTNAIL 1.5MM X 25MM $7.83 1/1/20 315 SUTURE NYLON 10-0 CU-8 $160.21 1/1/20 319 SUTURE PDS II 4-0 PS-2 CLR $30.18 1/1/20 320 SUTURE PDS II 5-0 P-3 CLR $25.00 1/1/20 323 SUTURE PDS II 4-0 SH-1 $17.88 1/1/20 325 CUP DENTURE $0.55 1/1/20 326 SUTURE PLAIN 4-0 SC-1 $19.32 1/1/20 327 CONRAY 50 ML $80.04 1/1/20 329 ENDO BRUSH CYTOLOGY $64.60 1/1/20 330 SUTURE PLAIN 5-0 FAST ABS PC-1 $36.40 1/1/20 331 IRRIGATION DECANTER SPIKE $4.11 1/1/20 332 SUTURE PLAIN 6-0 FAST ABS PC-1 $37.55 1/1/20 333 UNDERWEAR XTRA PROTECTIVE LRG $2.60 1/1/20 335 ENDO DILATOR ESOPH 10-11-12MM $1,058.85 1/1/20 336 SUTURE PROLENE 2-0 FS $14.99 1/1/20 337 ENDO DILATOR ESOPH 12-13.5-15M $824.27 1/1/20 339 ENDO DILATOR ESOPH 15-16.5-18M $950.25 1/1/20 340 SUTURE PROLENE 0 CT-2 $13.29 1/1/20 341 ENDO DILATOR ESOPH 18-19-20MM $950.25 1/1/20 342 SUTURE PROLENE 0 SH $18.78 1/1/20 343 SUTURE PROLENE 1 CT-1 $13.59 1/1/20 344 ENDO DILATOR PYLO/COLONIC 18MM $1,008.00 1/1/20 345 SUTURE PROLENE 2-0 SH $18.56 1/1/20 346 ENDO DILATOR PYLO/COLONIC 10MM $1,099.03 1/1/20 347 SUTURE PROLENE 3-0 PS-1 $27.69 1/1/20 348 ENDO DILATOR PYLO/COLONIC 12MM $1,099.03 1/1/20 349 SUTURE PROLENE 3-0 PS-2 $26.29 1/1/20 350 ENDO DILATOR PYLO/COLONIC 15MM $1,008.00 1/1/20 351 SUTURE PROLENE 3-0 SH $19.18 1/1/20 353 SUTURE PROLENE 4-0 P-3 $24.58 1/1/20 355 DRAIN SNYDER HEMO 1/8 $79.00 1/1/20 356 SUTURE PROLENE 4-0 PS-2 $31.43 1/1/20 359 DRAIN BLAKE 15 FR $91.92 1/1/20 360 SUTURE PROLENE 6-0 P-1 $29.00 1/1/20 362 SUTURE PROLENE 10-0 CIF-4 $134.87 1/1/20 363 DRAIN PENROSE STR 1/4 X 12 $1.93 1/1/20 364 DRAIN RESEVOIR $24.93 1/1/20 365 SUTURE PROLENE 4-0 P-3 CLR $32.42 1/1/20 367 SUTURE PROLENE 5-0 P-3 CLR $29.00 1/1/20 368 DRESSING ADAPTIC 3 X 8 $5.11 1/1/20 370 SPONGE GAUZE STERILE TRAY 4X4 $2.72 1/1/20 371 SUTURE SILK 0 STRANDS $5.22 1/1/20 372 DRESSING ADAPTIC 3 X 3 $1.68 1/1/20 373 SUTURE SILK 2-0 SH $6.98 1/1/20 375 SUTURE SILK 2-0 STRANDS $8.26 1/1/20 376 SPONGE GAUZE STERILE 2 X 2 $0.37 1/1/20 380 SUTURE SILK 3-0 SH $6.99 1/1/20 381 DRESSING TELFA 2 X 3 $0.61 1/1/20 382 SUTURE SILK 3-0 STRANDS $9.80 1/1/20 385 DRESSING TEGADERM 2 3/8X2 3/4 $2.06 1/1/20 387 SUTURE SILK 3-0 X-1 $9.26 1/1/20 390 DRESSING XEROFORM 1 X 8 $3.32 1/1/20 391 SUTURE SILK 4-0 P-3 $21.00 1/1/20 392 DRESSING XEROFORM 5 X 9 $6.60 1/1/20 393 SUTURE SILK 4-0 SH $8.16 1/1/20 394 SUTURE SILK 4-0 STRANDS $11.51 1/1/20 395 DRESSING ABD 5 X 9 $0.47 1/1/20 397 SYRINGE EAR 2 OZ $3.18 1/1/20 398 SUTURE SILK 5-0 P-3 $19.00 1/1/20 401 SUTURE SILK 6-0 P-1 $19.00 1/1/20 406 ORT WIRE 26G/18" $41.79 1/1/20 407 BLADE BEAVER 64 ROUND TIP $11.24 1/1/20 408 ORT WIRE 28G/18" $40.96 1/1/20 409 BLADE BEAVER 67 CURVED TIP $11.24 1/1/20 413 ENT BLADE XOMED 40 DEGREE CVD $1,008.00 1/1/20 414 SUTURE TI-CRON 5 HOS-14 $23.00 1/1/20 418 ENT SPLINT DENVER SMALL/MED $266.00 1/1/20 419 SUTURE VICRYL 2-0 CT-2 UND $8.82 1/1/20 420 ENT SPLINT DENVER LARGE $246.00 1/1/20 421 SUTURE VICRYL 3-0 CT-2 UND $8.53 1/1/20 422 ENT SPLINT DOYLEII NASAL SEPTL $236.00 1/1/20 426 SUTURE VICRYL 3-0 PS-1 UND $24.28 1/1/20 428 SUTURE VICRYL 3-0 PS-2 UND $21.74 1/1/20 431 INSTRUMENT WIPE $5.32 1/1/20 432 SUTURE VICRYL 4-0 P-3 UND $24.04 1/1/20 433 ENT PK KENNEDY SINUS $120.26 1/1/20 434 SUTURE VICRYL 4-0 PS-2 UND $21.89 1/1/20 435 SUTURE VICRYL 4-0 STRANDS UND $11.26 1/1/20 436 ENT PK MEROCEL $84.00 1/1/20 437 SUTURE VICRYL 5-0 P-3 UND $24.27 1/1/20 438 SUTURE VICRYL 5-0 PS-2 UND $22.12 1/1/20 440 SUTURE VICRYL 6-0 P-3 UND $21.97 1/1/20 441 ENT TUBE MYRING ARMSTRNG PLN $51.95 1/1/19 442 SUTURE VICRYL 0 CT-2 UND $8.62 1/1/20 445 SUTURE VICRYL 2-0 SH $8.27 1/1/20 446 ENT TUBE MYRING DONALDSON #2 $83.00 1/1/19 447 SUTURE VICRYL 2-0 STRANDS $11.64 1/1/20 448 SUTURE VICRYL 2-0 UR-6 $10.36 1/1/20 449 SUTURE VICRYL 3-0 SH $8.29 1/1/20 450 ENT TUBE MYRING PAPARELLA 1.4 $99.00 1/1/19 451 SUTURE VICRYL 3-0 STRANDS $13.47 1/1/20 453 ENT TUBE MYRING REUTER BOBBIN $102.10 1/1/19 454 SUTURE VICRYL 4-0 RB-1 $9.87 1/1/20 457 SUTURE VICRYL 4-0 SH $9.83 1/1/20 461 SUTURE VICRYL 1 CT-1 $8.75 1/1/20 462 SUTURE VICRYL 0 CT-1 $8.39 1/1/20 463 SUTURE ETHIBOND 2-0 SH $11.71 1/1/20 465 ORT WIRE 18G/18" $37.00 1/1/20 467 RETRIEVE HOFFEE SUTURE $306.28 1/1/20 470 PASSER SUTURE SWANSON $416.00 1/1/20 471 SUTURE PDS II 1 CTX $15.00 1/1/20 472 SUTURE TAPE UMBILICAL COTTON $7.19 1/1/20 473 PACK KNEE ARTHROSCOPY $367.24 1/1/20 474 PACK CYSTO $38.37 1/1/20 475 DRAPE STERI SM $6.13 1/1/20 477 DRAPE C-ARM 42 X 64 $16.14 1/1/20 478 DRAPE STERI $14.64 1/1/20 479 ENT TUBE MYRING RICHARDS MOD T $119.04 1/1/19 480 DRAPE STERI U $21.81 1/1/20 482 DRAPE EAR MISCROSCOPE $43.08 1/1/20 483 ENT TUBE MYRING ROCK $117.81 1/1/19 484 DRAPE STERI MED $11.00 1/1/20 485 DRAPE LASER ARM 7 X 55 $12.96 1/1/20 488 PACK ENT II $85.00 1/1/20 491 GOWN SURGICAL SMARTGOWN XL $20.00 1/1/20 492 ENT BLADE MYRING V MUELLER $149.72 1/1/20 494 DRAPE LITHOTOMY W/FLUID POUCH $73.62 1/1/20 495 PACK EYE CUSTOM $1,204.81 1/1/20 496 PACK SET UP $15.63 1/1/20 497 ENT BLADE MYRING BEAVER ANGLED $34.28 1/1/20 498 DRAPE EXTREMITY BILATERAL $43.00 1/1/20 499 DRAPE EXTREMITY $36.40 1/1/20 500 DRAPE FANFOLD 40 X 70 $8.56 1/1/20 501 SHEET LAP T $35.76 1/1/20 502 ENT DRESSING NASAL HOLDER $26.32 1/1/20 503 SHEET LAVH $96.06 1/1/20 504 SHEET SPLIT $30.86 1/1/20 507 SHEET TRANSVERSE LAP $44.56 1/1/20 508 SHEET UNDER BUTTOCKS W/POUCH $15.36