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6/25/2007 CHARGEMASTER LISTING Mnemonic Description Dept Rev Cd Charge 301000140 ICU/CCU CRITICAL CARE ROOM 10.3010 200 $ 8,868.00 301000230 TRANSFUSION THERAPY 0-3 HR 10.3010 391 $ 700.00 301000235 TRANSFUSION THERAPY 3-6 HR 10.3010 391 $ 930.00 301000240 TRANSFUSION THERAPY >6 HR 10.3010 391 $ 1,164.00 301000306 INFUSION SEQUENTIAL 1ST HOUR 10.3010 260 $ 158.00 301000307 INFUSION THERAPY 1ST HOUR 10.3010 260 $ 315.00 301000308 INFUSION HYDRATION 1ST HOUR 10.3010 260 $ 315.00 301000309 INFUSION THERAPY ADD'L HRS 10.3010 260 $ 190.00 301000310 INFUSION HYDRATION ADD'L HOUR 10.3010 260 $ 190.00 301000330 ICU/CCU-DCU BOARDER 10.3010 206 $ 6,603.00 301000370 RECOVERY PHASE II / HR 10.3010 710 $ 741.00 301000380 RECOVERY PHASE III / HR 10.3010 710 $ 99.00 301000390 ICU WEST 10.3010 200 $ 8,868.00 301000410 ICU/CCU-M/S BOARDER 10.3010 121 $ 2,374.00 301007100 MINOR SURGERY LEV 1 10.3010 360 $ 1,102.00 301007200 MINOR SURGERY LEV 2 10.3010 360 $ 1,779.00 301066000 ICU/CCU OUTPATIENT IN BED 10.3010 719 $ - 301080100 ICU/CCU OBSERVATION / HR 10.3010 762 $ 251.00 301090782 IM INJECTION 10.3010 761 $ 101.00 301090784 IV INJECTION 10.3010 761 $ 101.00 301090785 IV INJECTION ADD'L SEQUENTIAL 10.3010 761 $ 101.00 301090788 IM INJECTIN - ANTIBIOTIC 10.3010 761 $ 101.00 301099200 DEFENSE AUDIT ADJUSTMENT 10.3010 200 $ - 301500230 TRANSFUSION THERAPY 0-3 HR 10.3015 391 $ 700.00 301500235 TRANSFUSION THERAPY 3-6 HR 10.3015 391 $ 930.00 301500240 TRANSFUSION THERAPY >6 HR 10.3015 391 $ 1,164.00 301500302 CONSCIOUS SEDATION 10.3015 761 $ 449.00 301500306 INFUSION SEQUENTIAL 1ST HOUR 10.3015 260 $ 158.00 301500307 INFUSION THERAPY 1ST HOUR 10.3015 260 $ 315.00 301500308 INFUSION HYDRATION 1ST HOUR 10.3015 260 $ 315.00 301500309 INFUSION THERAPY ADD'L HRS 10.3015 260 $ 190.00 301500310 INFUSION HYDRATION ADD'L HOUR 10.3015 260 $ 190.00 301500370 RECOVERY PHASE II / HR 10.3015 710 $ 741.00 301500380 RECOVERY PHASE III / HR 10.3015 710 $ 99.00 301501140 NTSICU CRITICAL CARE ROOM 10.3015 200 $ 8,868.00 301501330 NTSICU-DCU BOARDER 10.3015 206 $ 6,603.00 301501410 NTSICU-M/S BOARDER 10.3015 121 $ 2,374.00 301507100 MINOR SURGERY LEV 1 10.3015 360 $ 1,102.00 301507200 MINOR SURGERY LEV 2 10.3015 360 $ 1,779.00 301567000 NU/TR OUTPATIENT IN BED 10.3015 719 $ - 301580090 TRAUMA OBSERVATION / HR 10.3015 762 $ 277.00 301590782 IM INJECTION 10.3015 761 $ 101.00 301590784 IV INJECTION 10.3015 761 $ 101.00 301590785 IV INJECTION ADD'L SEQUENTIAL 10.3015 761 $ 101.00 301590788 IM INJECTIN - ANTIBIOTIC 10.3015 761 $ 101.00 307000020 AABR HEARING SCREEN 10.3070 471 $ 148.00 307000100 CS MISC STERILE 10.3070 272 $ - 307000200 CS MISC UN-STERILE 10.3070 271 $ - 307000306 INFUSION SEQUENTIAL 1ST HOUR 10.3070 260 $ 158.00 307000307 INFUSION THERAPY 1ST HOUR 10.3070 260 $ 286.00 307000308 INFUSION HYDRATION 1ST HOUR 10.3070 260 $ 315.00 307000309 INFUSION THERAPY ADD'L HRS 10.3070 260 $ 172.00 307000310 INFUSION HYDRATION ADD'L HOUR 10.3070 260 $ 190.00 307000370 RECOVERY PHASE II / HR 10.3070 710 $ 673.00 307000380 RECOVERY PHASE III / HR 10.3070 710 $ 90.00 307007100 MINOR SURGERY 10.3070 360 $ 1,151.00 307023000 LIC NURSERY NIC 1 10.3070 172 $ 1,227.00 307024000 NEWBORN LIC NURSERY NIC 2 10.3070 172 $ 1,871.00 307030210 BREAST EXPRESION UNIT 10.3070 271 $ 79.00 307030215 BREAST SHIELDS 10.3070 271 $ 26.00 307030220 30 DAY FEEDING TUBE 10.3070 271 $ 91.00 307030225 HABERMAN FEEDER 10.3070 271 $ 51.00 307046000 NEWBORN LIC NURSERY NIC 3 10.3070 174 $ 3,052.00 307047000 NEWBORN LIC NURSERY NIC 4 10.3070 174 $ 4,938.00 307048000 NEWBORN ROOM 10.3070 171 $ 1,202.00 307049000 NEWBORN BORDER NEONATAL 10.3070 172 $ 1,120.00 307080010 NICU OBSERVATION / HR 10.3070 762 $ 251.00 307090782 IM INJECTION 10.3070 761 $ 91.00 307090784 IV INJECTION 10.3070 761 $ 91.00 307090785 IV INJECTION ADD'L SEQUENTIAL 10.3070 761 $ 101.00 307090788 IM INJECTION - ANTIBIOTIC 10.3070 761 $ 101.00 313010055 TELEMETRY 10.3150 730 $ 395.00 315000230 TRANSFUSION THERAPY 0-3 HR 10.3150 391 $ 700.00 315000235 TRANSFUSION THERAPY 3-6 HR 10.3150 391 $ 930.00 315000240 TRANSFUSION THERAPY >6 HR 10.3150 391 $ 1,164.00 315000302 CONSCIOUS SEDATION 10.3150 761 $ 449.00 315000306 INFUSION SEQUENTIAL 1ST HOUR 10.3150 260 $ 158.00 315000307 INFUSION THERAPY 1ST HOUR 10.3150 260 $ 315.00 315000308 INFUSION HYDRATION 1ST HOUR 10.3150 260 $ 315.00 315000309 INFUSION THERAPY ADD'L HRS 10.3150 260 $ 190.00 315000310 INFUSION HYDRATION ADD'L HOUR 10.3150 260 $ 190.00 315000370 RECOVERY PHASE II / HR 10.3150 710 $ 741.00 315000380 RECOVERY PHASE III / HR 10.3150 710 $ 99.00 315002130 DCU ROOM 10.3150 206 $ 6,603.00 315002140 ADMIT UNIT - OBS 10.3150 990 $ - 315002141 ADMIT UNIT - MS BOARDER 10.3150 990 $ - 315002142 ADMIT UNIT - DCU 10.3150 990 $ - 315002143 ADMIT UNIT - OUTPATIENT 10.3150 990 $ - 315002410 DCU-M/S BOARDER 10.3150 121 $ 2,374.00 315007100 MINOR SURGERY 10.3150 360 $ 1,102.00 315010055 TELEMETRY 10.3150 730 $ 395.00 315047000 NEWBORN LIC NURSERY NIC 4-DCU 10.3150 174 $ 4,938.00 315063000 DCU O/P IN BED 10.3150 719 $ - 315080050 DCU OBSERVATION / HR 10.3150 762 $ 146.00 315090379 DIRECT ADMIT HOSPITAL OBS 10.3530 762 $ 94.00 315090782 IM INJECTION 10.3150 761 $ 101.00 315090784 IV INJECTION 10.3150 761 $ 101.00 315090785 IV INJECTION ADD'L SEQUENTIAL 10.3150 761 $ 101.00 315090788 IM INJECTIN - ANTIBIOTIC 10.3150 761 $ 101.00 315099206 DEFENSE AUDIT ADJUSTMENT 10.3150 206 $ - 317000230 TRANSFUSION THERAPY 0-3 HR 10.3170 391 $ 700.00 317000235 TRANSFUSION THERAPY 3-6 HR 10.3170 391 $ 930.00 317000240 TRANSFUSION THERAPY > 6 HR 10.3170 391 $ 1,164.00 317000302 CONSCIOUS SEDATION 10.3170 761 $ 449.00 317000306 INFUSION SEQUENTIAL 1ST HOUR 10.3170 260 $ 158.00 317000307 INFUSION THERAPY 1ST HOUR 10.3170 260 $ 315.00 317000308 INFUSION HYDRATION 1ST HOUR 10.3170 260 $ 315.00 317000309 INFUSION THERAPY ADD'L HRS 10.3170 260 $ 190.00 317000310 INFUSION HYDRATION ADD'L HOUR 10.3170 260 $ 190.00 317000370 RECOVERY PHASE 2 / HR 10.3170 710 $ 741.00 317000380 RECOVERY PHASE 3 / HR 10.3170 710 $ 202.00 317000500 COH MED/SURG OBS / HR 10.3170 762 $ 99.00 317000515 COH M/S ACUTE RM 10.3170 121 $ 2,374.00 317000520 COH M/S LEVEL 2 RM 10.3170 121 $ 2,374.00 317000525 COH M/S OUTPT IN BED 10.3170 719 $ - 317007100 MINOR SURGERY 10.3170 360 $ 1,102.00 317090782 IM INJECTION 10.3170 761 $ 101.00 317090784 IV INJECTION 10.3170 761 $ 101.00 317090785 IV INJECTION ADD'L SEQUENTIAL 10.3170 761 $ 101.00 317090788 IM INJECTION - ANTIBIOTIC 10.3170 761 $ 101.00 317100230 TRANSFUSION THERAPY 0-3 HR 10.3171 391 $ 700.00 317100235 TRANSFUSION THERAPY 3-6 HR 10.3171 391 $ 930.00 317100240 TRANSFUSION THERAPY >6 HR 10.3171 391 $ 1,164.00 317100255 CHEMOTHERAPY-SIMPLE 10.3171 331 $ 319.00 317100257 CHEMO CHEMO IV PUSH 10.3171 331 $ 94.00 317100258 CHEMO CHEMO IV PUSH ADD'L 10.3171 331 $ 94.00 317100260 CHEMOTHERAPY-SIMPLE-CX 10.3171 331 $ 633.00 317100265 CHEMOTHERAPY-INFUSION 0-1 HR 10.3171 335 $ 393.00 317100266 CHEMOTHERAPY ADD'L HRS 10.3171 335 $ 433.00 317100267 CHEMOTHERAPY ADD'L SEQUNTIAL 10.3171 335 $ 217.00 317100302 CONSCIOUS SEDATION 10.3171 761 $ 449.00 317100306 INFUSION SEQUENTIAL 1ST HOUR 10.3171 260 $ 158.00 317100307 INFUSION THERAPY 1ST HOUR 10.3171 260 $ 315.00 317100308 INFUSION HYDRATION 1ST HOUR 10.3171 260 $ 315.00 317100309 INF THERAPY ADD'L HRS 10.3171 260 $ 190.00 317100310 INFUSION HYDRATION ADD'L HOUR 10.3171 260 $ 190.00 317100311 MAINTENANCE IMPLANTABLE PUMP 10.3171 761 $ 114.00 317100315 REFILL IMPLANTABLE PUMP 10.3171 761 $ 185.00 317100370 RECOVERY PHASE II / HR 10.3171 710 $ 741.00 317100380 RECOVERY PHASE III / HR 10.3171 710 $ 99.00 317102130 DCU ROOM - 3RD 10.3171 206 $ 6,603.00 317107100 MINOR SURGERY 10.3171 360 $ 1,102.00 317111000 3RD MED SURG ACUTE ROOM 10.3171 121 $ 2,374.00 317119050 3RD MED/SURG LEVEL 2 ROOM 10.3171 121 $ 2,374.00 317154000 3RD PEDIATRIC ROOM 10.3171 123 $ 2,374.00 317155000 3RD PEDIATRIC ROOM 10.3171 206 $ 3,163.00 317155555 3RD OUTPAT IN BED 10.3171 719 $ - 317156000 3RD PEDIATRIC SPECIAL ROOM 10.3171 203 $ 5,509.00 317180000 3RD FL OBSERVATION / HR 10.3171 762 $ 99.00 317190782 IM INJECTION 10.3171 761 $ 101.00 317190784 IV INJECTION 10.3171 761 $ 101.00 317190785 IV INJECTION ADD'L SEQUENTIAL 10.3171 761 $ 101.00 317190788 IM INJECTIN - ANTIBIOTIC 10.3171 761 $ 101.00 317300011 TREATMENT ROOM 10.3173 761 $ 19.00 317300012 TREATMENT ROOM - EXTENDED 10.3173 761 $ 50.00 317300230 TRANSFUSION THERAPY 0-3 HR 10.3173 391 $ 700.00 317300235 TRANSFUSION THERAPY 3-6 HR 10.3173 391 $ 930.00 317300240 TRANSFUSION THERAPY >6 HR 10.3173 391 $ 1,164.00 317300255 CHEMOTHERAPY-SIMPLE 10.3173 331 $ 319.00 317300257 CHEMO CHEMO IV PUSH 10.3173 331 $ 94.00 317300258 CHEMO CHEMO IV PUSH ADD'L 10.3173 331 $ 94.00 317300260 CHEMOTHERAPY-SIMPLE-CX 10.3173 331 $ 633.00 317300265 CHEMOTHERAPY-INFUSION 0-1 HR 10.3173 335 $ 393.00 317300266 CHEMOTHERAPY ADD'L HRS 10.3173 335 $ 433.00 317300267 CHEMOTHERAPY ADD'L SEQUNTIAL 10.3173 335 $ 217.00 317300285 CHEMOTHERAPY-INFUSION 0-1 HR-C 10.3173 335 $ 784.00 317300286 CHEMOTHERAPY ADD'L HRS - CX 10.3173 335 $ 641.00 317300302 CONSCIOUS SEDATION 10.3173 761 $ 449.00 317300306 INFUSION SEQUENTIAL 1ST HOUR 10.3173 260 $ 158.00 317300307 INFUSION THERAPY 1ST HOUR 10.3173 260 $ 315.00 317300308 INFUSION HYDRATION 1ST HOUR 10.3173 260 $ 315.00 317300309 INFUSION THERAPY ADD'L HRS 10.3173 260 $ 190.00 317300310 INFUSION HYDRATION ADD'L HOUR 10.3173 260 $ 190.00 317300311 INFUSION THERAPY 1ST HR - CX 10.3173 260 $ 578.00 317300313 INFUSION THERAPY ADD'L HR - CX 10.3173 260 $ 190.00 317300370 RECOVERY PHASE II / HR 10.3173 710 $ 741.00 317300380 RECOVERY PHASE III / HR 10.3173 710 $ 99.00 317307100 MINOR SURGERY 10.3173 360 $ 1,102.00 317310060 INF-BLOOD 1 UNIT 10.3173 391 $ 266.00 317310065 INF-BLOOD 2 UNITS 10.3173 360 $ 530.00 317313000 4TH M/S ACUTE ROOM 10.3173 121 $ 2,374.00 317314000 M/S ONCOLOGY LEVEL 2 10.3173 127 $ 2,374.00 317322000 NEW BORN CARE (4TH FLOOR) 10.3173 171 $ 1,319.00 317354000 4TH PEDIATRIC ROOM 10.3173 123 $ 2,450.00 317360000 4TH M/S OUTPATIENT IN BED 10.3173 719 $ - 317380020 M/S ONCOLOGY OBSERVATION / HR 10.3173 762 $ 99.00 317390782 IM INJECTION 10.3173 761 $ 101.00 317390784 IV INJECTION 10.3173 761 $ 101.00 317390785 IV INJECTION ADD'L SEQUENTIAL 10.3173 761 $ 101.00 317390788 IM INJECTION - ANTIBIOTIC 10.3173 761 $ 101.00 317900230 TRANSFUSION THERAPY 0-3 HR 10.3179 391 $ 700.00 317900235 TRANSFUSION THERAPY 3-6 HR 10.3179 391 $ 930.00 317900240 TRANSFUSION THERAPY >6 HR 10.3179 391 $ 1,164.00 317900255 CHEMOTHERAPY-SIMPLE 10.3179 331 $ 319.00 317900257 CHEMO CHEMO IV PUSH 10.3179 331 $ 94.00 317900258 CHEMO CHEMO IV PUSH ADD'L 10.3179 331 $ 94.00 317900260 CHEMOTHERAPY-COMPLEX-CX 10.3179 331 $ 633.00 317900265 CHEMOTHERAPY-INFUSION 0-1 HR 10.3179 335 $ 393.00 317900266 CHEMOTHERAPY ADD'L HRS 10.3179 335 $ 433.00 317900267 CHEMOTHERAPY ADD'L SEQUNTIAL 10.3179 335 $ 217.00 317900302 CONSCIOUS SEDATION 10.3179 761 $ 449.00 317900306 INFUSION SEQUENTIAL 1ST HOUR 10.3179 260 $ 158.00 317900307 INFUSION THERAPY 1ST HOUR 10.3179 260 $ 315.00 317900308 INFUSION HYDRATION 1ST HOUR 10.3179 260 $ 315.00 317900309 INFUSION THERAPY ADD'L HRS 10.3179 260 $ 190.00 317900310 INFUSION HYDRATION ADD'L HOUR 10.3179 260 $ 190.00 317900370 RECOVERY PHASE II / HR 10.3179 710 $ 741.00 317900380 RECOVERY PHASE III / HR 10.3179 710 $ 99.00 317902410 DCU FIRST FLOOR 10.3150 206 $ 6,603.00 317907100 MINOR SURGERY 10.3179 360 $ 1,102.00 317910060 INF-BLOOD 1 UNIT 10.3179 391 $ 266.00 317910065 INF-BLOOD 2 UNITS 10.3179 391 $ 530.00 317910068 INF-BLOOD 3 UNITS 10.3179 391 $ 690.00 317912000 MEDICAL EAST M/S ACUTE ROOM 10.3179 121 $ 2,374.00 317959000 MEDICAL EAST OUPATIENT IN BED 10.3179 719 $ - 317969000 AMB SERV MED/SURG LEV 1 10.3179 121 $ 2,374.00 317980010 MEDICAL EAST OBSERVATION / HR 10.3179 762 $ 99.00 317990782 IM INJECTION 10.3179 761 $ 101.00 317990784 IV INJECTION 10.3179 761 $ 101.00 317990785 IV INJECTION ADD'L SEQUENTIAL 10.3179 761 $ 101.00 317990788 IM INJECTION - ANTIBIOTIC 10.3179 761 $ 101.00 317999218 OBSERVATION BED 10.3179 762 $ - 329000230 TRANSFUSION THERAPY 0-3 HR 10.3173 391 $ 700.00 329000235 TRANSFUSION THERAPY 3-6 HR 10.3173 391 $ 930.00 329000240 TRANSFUSION THERAPY >6 HR 10.3173 391 $ 1,164.00 329000255 CHEMOTHERAPY-SIMPLE 10.3173 331 $ 319.00 329000257 CHEMO CHEMO IV PUSH 10.3173 331 $ 94.00 329000258 CHEMO CHEMO IV PUSH ADD'L 10.3173 331 $ 94.00 329000260 CHEMOTHERAPY-SIMPLE-CX 10.3173 331 $ 633.00 329000265 CHEMOTHERAPY-INFUSION 0-1 HR 10.3173 335 $ 393.00 329007100 MINOR SURGERY 10.3173 360 $ 1,102.00 329016000 PEDIATRIC ROOM (4TH) 10.3173 123 $ 2,450.00 329017000 PEDIATRIC AC-M 10.3173 123 $ 3,163.00 329018000 PEDIATRIC AC-H 10.3173 123 $ 5,509.00 329051000 PED MED/SURG ACUTE ROOM 10.3173 121 $ 2,374.00 329052000 OBSTETRICS ROOM (4TH FLOOR) 10.3173 122 $ 2,377.00 329058000 PEDS OUTPAT IN BED 10.3173 719 $ - 329080030 4TH FLOOR OBSERVATION 10.3173 762 $ 99.00 334007100 ASSIST W PROCEDURE LEVEL 1 10.3340 360 $ 1,102.00 334007200 ASSIST W PROCEDURE LEVEL 2 10.3340 360 $ 1,779.00 334025804 PSYCHOSOCIAL-EVAL 10.3340 914 $ 367.00 334026182 CLINICIAN-FAMILY THRPY 10.3340 916 $ 434.00 334026257 CLINICIAN-IND THERAPY 10.3340 914 $ 278.00 334070500 BEHAVIORAL HEALTH ROOM 10.3340 124 $ 2,807.00 334070600 PSYCHIATRIC LEVEL 2 ROOM 10.3340 124 $ 3,592.00 334070700 PSYCHIATRIC LEVEL 3 ROOM (1-1) 10.3340 124 $ 4,925.00 334090817 PSYCHOTHERAPY 20 - 30 MIN 10.3340 961 $ 207.00 334090819 PSYCHOTHERAPY 45 - 50 MIN 10.3340 961 $ 323.00 334090822 PSYCHOTHERAPY 75 - 80 MIN 10.3340 961 $ 579.00 334099221 INITIAL EVAL - LOW COMPLEXITY 10.3340 961 $ 385.00 334099222 INITIAL EVAL - MOD COMPLEXITY 10.3340 961 $ 450.00 334099223 INITIAL EVAL - HIGH COMPLEXITY 10.3340 961 $ 579.00 334099231 SUBSEQUENT CARE - LOW COMPLEXI 10.3340 961 $ 201.00 334099232 SUBSEQUENT CARE - MOD COMPLEXI 10.3340 961 $ 207.00 334099233 SUBSEQUENT CARE - HIGH COMPLEX 10.3340 961 $ 323.00 334099238 IP DISCHARGE 30 MIN OR LESS 10.3340 961 $ 249.00 334099239 IP DISCHARGE > 30 MIN 10.3340 961 $ 307.00 334099251 IP CONSULTATION - MINOR 10.3340 961 $ 271.00 334099252 IP CONSULTATION - LOW SEVERITY 10.3340 961 $ 294.00 334099253 IP CONSULTATION - MOD SEVERITY 10.3340 961 $ 385.00 334099254 IP CONSULTATION - HIGH SEVERIT 10.3340 961 $ 531.00 334099255 IP CONSULTATION - COMPLEX 10.3340 961 $ 718.00 334570500 BEHAVIORAL HEALTH ROOM-PSYCHNE 10.3340 124 $ 2,807.00 338000306 INFUSION SEQUENTIAL 1ST HOUR 10.3380 260 $ 158.00 338000307 INFUSION THERAPY 1ST HOUR 10.3380 260 $ 315.00 338000308 INFUSION HYDRATION 1ST HOUR 10.3380 260 $ 315.00 338000309 INFUSION THERAPY ADD'L HRS 10.3380 260 $ 172.00 338000310 MAINTENANCE IMPLANTABLE PUMP 10.3380 761 $ 114.00 338000370 RECOVERY PHASE II 10.3380 710 $ 673.00 338000380 RECOVERY PHASE III / HR 10.3380 710 $ 90.00 338007100 MINOR SURGERY 10.3380 360 $ 1,001.00 338052000 OBSTETRICS ROOM 10.3380 122 $ 2,377.00 338052010 OBSTETRICS ROOM - ACTIVE LDR 10.3380 122 $ 2,158.00 338053000 OB MED/SURG ACUTE ROOM 10.3380 121 $ 2,374.00 338057000 OB PEDIATRIC ROOM 10.3380 123 $ 2,450.00 338062000 OB OUTPT IN A BED 10.3380 500 $ - 338080040 OB OBSERVATION / HR 10.3380 762 $ 89.00 338090782 IM INJECTION 10.3380 761 $ 91.00 338090784 IV INJECTION 10.3380 761 $ 91.00 338090785 IV INJECTION ADD'L SEQUENTIAL 10.3380 761 $ 101.00 338090788 IM INJECTION - ANTIBIOTIC 10.3380 761 $ 91.00 344000024 IP REHAB PPS CMG/HIPPS CODE 10.3440 128 $ - 344007100 ASSIST W PROCEDURE LEVEL 1 10.3440 360 $ 1,102.00 344007200 ASSIST W PROCEDURE LEVEL 2 10.3440 360 $ 1,779.00 344010010 SPECIAL PROC./ROOM 1/2H 10.3440 761 $ 203.00 344030500 REHAB ACUTE ROOM 10.3440 128 $ 2,653.00 344030600 REHAB LEVEL 2 ROOM 10.3440 128 $ 3,702.00 344030700 REHAB LEVEL 3 ROOM 10.3440 128 $ 3,966.00 353000011 TREATMENT ROOM 10.3530 761 $ 68.00 353000020 AABR HEARING SCREEN 10.3530 471 $ 148.00 353007100 MINOR SURGERY 10.3530 360 $ 1,102.00 353010010 CIRC ROOM PER 1/2 HR 10.3530 361 $ 150.00 353022000 NEWBORN CARE 10.3530 171 $ 1,319.00 353057000 NURSERY PEDIATRICS 10.3530 123 $ 2,450.00 353065000 CONTINUING CARE NRSY - C 10.3530 172 $ 2,108.00 353080080 NEWBORN OBSERVATION / HR 10.3530 762 $ 70.00 401000001 I&O PROCEDURE 0-1 HR 10.4010 761 $ 48.00 401000002 I&O PROCEDURE 1-2 HR 10.4010 761 $ 160.00 401000010 UNLISTED EMERGENCY DEPT 10.4010 450 $ - 401000041 ECG W ST INTERP/HR 10.4010 730 $ 258.00 401000080 PRIVATE PHYSICIAN CLINIC VISIT 10.4010 761 $ 105.00 401000085 LEGAL BLOOD DRAW 10.4010 450 $ 123.00 401000089 MEDICAL CLEARANCE (C) 10.4010 450 $ 330.00 401000220 IMMUNIZATION ADMINISTRATION 10.4010 450 $ 46.00 401000230 INFUSION THERAPY (ED) 1ST HOUR 10.4010 260 $ 491.00 401000231 INFUSION THERAPY ADD'L HRS 10.4010 260 $ 190.00 401000232 INF THERAPY ADD HR X2 (PANEL) 10.4010 450 $ - 401000233 INF THERAPY ADD HR X3 (PANEL) 10.4010 450 $ - 401000234 INF THERAPY ADD HR X4 (PANEL) 10.4010 450 $ - 401000240 TRANSFUSION THERAPY 1-2 HRS 10.4010 391 $ 734.00 401000260 TRANSFUSION THERAPY 2-4 HRS 10.4010 391 $ 1,100.00 401000261 INFUSION HYDRATION 1ST HOUR 10.4010 260 $ 491.00 401000262 INFUSION SEQUENTIAL 1ST HOUR 10.3010 260 $ 158.00 401000263 INFUSION HYDRATION ADD'L HOUR 10.4010 260 $ 190.00 401000270 ED IV INJECTION 10.4010 450 $ 114.00 401000271 ED IV INJECTION-SUBSEQUENT 10.4010 450 $ 104.00 401000272 ED IV INJECTION X2 (PANEL) 10.4010 450 $ - 401000273 ED IV INJECTION X3 (PANEL) 10.4010 450 $ - 401000274 ED IV INJECTION X4 (PANEL) 10.4010 450 $ - 401000278 IM INJECTION - ANTIBIOTIC 10.4010 450 $ 104.00 401000280 ED TETANUS VACCINE-IM 10.4010 450 $ 59.00 401000290 ED IM/SQ INJECTION 10.4010 450 $ 114.00 401000292 ED IM/SQ INJECTION X2 (PANEL) 10.4010 450 $ - 401000293 ED IM/SQ INJECTION X3 (PANEL) 10.4010 450 $ - 401000294 ED IM/SQ INJECTION X4 (PANEL) 10.4010 450 $ - 401000300 OBSERVATION 10.4010 762 $ 99.00 401000310 M/S ACUTE ROOM 10.4010 121 $ 2,374.00 401000320 DCU ROOM 10.4010 206 $ 6,603.00 401000330 ICU/CCU CRITICAL CARE ROOM 10.4010 200 $ 8,868.00 401000340 OBSTETRICS ROOM 10.4010 122 $ 2,374.00 401000350 PEDIATRIC ROOM 10.4010 123 $ 2,374.00 401000360 PSYCHIATRIC ROOM 10.4010 124 $ 2,807.00 401000999 ED TRIAGE ONLY 10.4010 450 $ - 401001100 ED- LEVEL 1 CARE 10.4010 450 $ 208.00 401001101 ED-LEVEL 1 CARE (25) 10.4010 450 $ 208.00 401002000 ED - LEVEL 2 10.4010 450 $ 346.00 401002001 ED-LEVEL 2 (25) 10.4010 450 $ 346.00 401002100 ED - LEVEL 3 10.4010 450 $ 861.00 401002101 ED-LEVEL 3 (25) 10.4010 450 $ 861.00 401003100 ED-LEVEL 4 10.4010 450 $ 1,444.00 401003102 ED-LEVEL 4 (25) 10.4010 450 $ 1,444.00 401004100 ED - LEVEL 5 10.4010 450 $ 2,001.00 401004101 ED-LEVEL 5 (25) 10.4010 450 $ 2,001.00 401004503 ED URINE SCREEN 10.4010 300 $ 40.00 401004504 ED URINE PREGNANCY 10.4010 300 $ 54.00 401004580 ED RAPID STREP TEST 10.4010 300 $ 57.00 401005100 ED - LEVEL 6 10.4010 450 $ 3,644.00 401005101 ED-LEVEL 6 (25) 10.4010 450 $ 3,644.00 401006100 ED TRAUMA CARE 10.4010 450 $ 6,559.00 401006101 ED-TRAUMA CARE (25) 10.4010 450 $ 3,748.00 401006200 ED CRITICAL CARE 10.4010 450 $ 3,645.00 401007100 OP SURG LEVEL 1 10.4010 450 $ 1,363.00 401007200 OP SURG LEVEL 2 10.4010 450 $ 2,203.00 401007300 OP SURG LEVEL 3 10.4010 450 $ 3,033.00 401007410 ER PROCEDURE LEVEL 1 10.4010 450 $ 74.00 401007420 ER PROCEDURE LEVEL 2 10.4010 450 $ 151.00 401007430 ER PROCEDURE LEVEL 3 10.4010 450 $ 245.00 401007440 ER PROCEDURE LEVEL 4 10.4010 450 $ 332.00 401007450 ER PROCEDURE LEVEL 5 10.4010 450 $ 498.00 401007460 ER PROCEDURE LEVEL 6 10.4010 450 $ 743.00 401007470 ER PROCEDURE LEVEL 7 10.4010 450 $ 1,055.00 401007480 ER PROCDURE LEVEL 8 10.4010 450 $ 1,845.00 401007490 ER PROCEDURE LEVEL 9 10.4010 450 $ 3,357.00 401007510 CARDIOVERSION 10.4010 450 $ 777.00 401013100 ED-SEXUAL ASSAULT EXAM 10.4010 450 $ 715.00 401055555 OUTPAT IN BED 10.4010 719 $ - 401093000 EKG TRACING ONLY (ED ONLY) 10.4010 730 $ 213.00 401099450 DEFENSE AUDIT ADJUSTMENT 10.4010 450 $ - 401305198 TRAUMA ACT MINOR 10.4013 682 $ 6,599.00 401305199 TRAUMA ACT MINOR (PANEL) 10.4013 682 $ - 401305298 TRAUMA ACT MODERATE 10.4013 682 $ 17,399.00 401305299 TRAUMA ACT MODERATE (PANEL) 10.4013 682 $ - 401305398 TRAUMA ACT MAJOR 10.4013 682 $ 25,405.00 401305399 TRAUMA ACT MAJOR (PANEL) 10.4013 682 $ - 401307420 ORTHO CAST/SPLINT SIMPLE 10.4013 360 $ 151.00 401307440 ORTHO CAST/SPLINT COMPLEX 10.4013 360 $ 332.00 401399212 ORTHOPEDIC VISIT SIMPLE 10.4013 761 $ 50.00 401399213 ORTHOPEDIC VISIT EXTENDED 10.4013 761 $ 61.00 401500010 UNLISTED ER PHYSICIAN SVC **.4015 981 $ - 401501001 DEBRIDE EACH ADD **.4015 981 $ 20.00 401501041 DEBRIDE FULL THICKNESS **.4015 981 $ 52.00 401501042 DR-DEBRIDE SQ **.4015 981 $ 68.00 401501051 PAR/CUR 2-4 BENIGN LES **.4015 981 $ 65.00 401501052 PAR/SUR 5+ BE **.4015 981 $ 75.00 401501731 DR-AVULS, NB 2ND **.4015 981 $ 39.00 401501732 AVUL NP EA AD **.4015 981 $ 32.00 401502021 ED DR-WOUND DEHISCENCE W PACK **.4015 981 $ 100.00 401502035 ED DR-SUTDBLS/A/T/E 12.6-20.0 **.4015 981 $ 312.00 401502036 ED DR-SUTDBLSATE 20.1-30 NF **.4015 981 $ 360.00 401502037 ED DR SUTURE >30CM INTERMED **.4015 981 $ 375.00 401502045 ED DR-SUT DBL NHFG 12.6-20.0 **.4015 981 $ 274.00 401502046 ED DR-SUT DBL NHFG 20.1-30.0 **.4015 981 $ 391.00 401506406 ED DR-OTH VENIP < AGE 3 **.4015 981 $ 12.00 401506490 ED DR-CUTDOWN < 5 **.4015 981 $ 149.00 401506491 ED DR-CUTDOWN > 5 **.4015 981 $ 152.00 401510040 ED DR-ACNE SURGERY **.4015 981 $ 61.00 401510042 ED DR-SUT DBL NHFG 2.6-7.5 **.4015 981 $ 226.00 401510051 ED DR-SUT DBL FACE 2.5 **.4015 981 $ 211.00 401510052 ED DR-SUT DBL FACE 2.6-5.0 **.4015 981 $ 226.00 401510053 ED DR-SUT DBL FACE 5.1-7.5 **.4015 981 $ 260.00 401510054 ED DR-SUT DBL FACE 7.6-12.5 **.4015 981 $ 325.00 401510058 ED DR - I&D ABS/CYS **.4015 981 $ 216.00 401510059 ED DR - I&D AB/CST **.4015 981 $ 116.00 401510060 ED DR - I&D AB/CST (PANEL) **.4015 981 $ - 401510061 ED DR - I&D ABS/CYS (PANEL) **.4015 981 $ - 401510075 ED DR-I&D PIL C **.4015 981 $ 219.00 401510079 ED DR-I&D PIL/CY **.4015 981 $ 127.00 401510080 ED DR-I&D PIL/CY (PANEL) **.4015 981 $ - 401510081 ED DR-I&D PIL C (PANEL) **.4015 981 $ - 401510101 ED DR-PEN WOUND EXP, CHEST **.4015 981 $ 232.00 401510102 PEN WOUND EXP, ABD/FLAN/BAC **.4015 981 $ 284.00 401510103 PEN WOUND EXP, EXTREMITY **.4015 981 $ 382.00 401510118 ED DR-I&D FB SQ COM **.4015 981 $ 255.00 401510119 ED DR-REM FB SQ **.4015 981 $ 91.00 401510120 ED DR-REM FB SQ (PANEL) **.4015 981 $ - 401510121 ED DR-I&D FB SQ COM (PANEL) **.4015 981 $ - 401510139 ED DR-I&D HEMATOMA **.4015 981 $ 81.00 401510140 ED DR-I&D HEMATOMA (PANEL) **.4015 981 $ - 401510159 ED DR-PUNCTURE ABSC **.4015 981 $ 93.00 401510160 ED DR-PUNCTURE ABSC (PANEL) **.4015 981 $ - 401510179 ED DR-I&D POST-OP WOUND COMP **.4015 981 $ 157.00 401510180 EDP-I&D POST-OP WND CMP(PANEL) **.4015 981 $ - 401510906 ED DR-EPITX P SUB **.4015 981 $ 202.00 401510999 ED DR-DEBRIDE UP TO **.4015 981 $ 38.00 401511000 ED DR-DEBRIDE UP TO (PANEL) **.4015 981 $ - 401511001 ED DR-DEBRIDE EA AD (PANEL) **.4015 981 $ - 401511005 ED DR-SUT SINGLE NF 12.6-20.0 **.4015 981 $ 228.00 401511006 ED DR-SUT SINGLE NF 20.1-30.0 **.4015 981 $ 290.00 401511007 SUTURE, >30 CM REPAIR SIMPLE **.4015 981 $ 300.00 401511014 ED DR SUT S/G 5.1-7.5 **.4015 981 $ 197.00 401511015 ED DR SUT S/F 7.6-12.5 **.4015 981 $ 250.00 401511016 ED DR SUT S/F 12.6-20.0 **.4015 981 $ 325.00 401511017 SUTURE 20.1-30CM REPAIR SIMPLE **.4015 981 $ 425.00 401511018 SUTURE >30 CM REPAIR SIMPLE **.4015 981 $ 550.00 401511032 ED DR-SUT DBL S/A/T/E 2.6-7.5 **.4015 981 $ 236.00 401511039 ED DR DEBRIDE PARTIAL THICK **.4015 981 $ 40.00 401511040 EDP DEBRIDE PART THICK (PANEL) **.4015 981 $ - 401511041 DEBRIDE FULL THICKNESS (PANEL) **.4015 981 $ - 401511042 ED DR-DEBRIDE SQ (PANEL) **.4015 981 $ - 401511047 SUTURE > 30CM REP INTERMED **.4015 981 $ 423.00 401511049 ED DR-PAR/CUR 1 LEISON **.4015 981 $ 45.00 401511050 ED-PAR/CUR 1 LEISON (PANEL) **.4015 981 $ - 401511051 PAR/CUR 2-4 BENIGN LES (PANEL) **.4015 981 $ - 401511052 ED DR-PAR/SUR 5+ BE (PANEL) **.4015 981 $ - 401511055 ED DR-SUT DBL FACE 12.6-20.0 **.4015 981 $ 369.00 401511056 SUTURE 20.1-30.0 REP INTERMED **.4015 981 $ 491.00 401511057 SUTURE >30 REPAIR INTERMED **.4015 981 $ 556.00 401511091 ED DR-SUT SING. NF 2.6-7.5 **.4015 981 $ 155.00 401511101 ED DR-SUT C/TRNK 2.6-7.5 **.4015 981 $ 232.00 401511102 ED DR-SUT C/TRNK ADD 5 CM **.4015 981 $ 200.00 401511121 ED DR-SUT C/SCP/ARM/LG 2.6-7 **.4015 981 $ 364.00 401511122 SUT C/SCP/ARM/LG ADD 5CM **.4015 981 $ 200.00 401511132 ED DR-SUT C/NHFG 2.6-7.5 **.4015 981 $ 499.00 401511151 ED DR-SUT C/EYE/NOSE/EAR **.4015 981 $ 411.00 401511152 SUT 2.5-7.6 C/EYE/NOSE/EAR **.4015 981 $ 563.00 401511160 SECOND CLOSE DEHI EXT-COMPL **.4015 981 $ 647.00 401511199 ED DR-REMOVAL OF SKIN TAGS **.4015 981 $ 46.00 401511200 EDP-REMOV SKIN TAGS (PANEL) **.4015 981 $ - 401511729 ED DR-AVULSION NAIL **.4015 981 $ 87.00 401511730 ED DR-AVULSION NAIL (PANEL) **.4015 981 $ - 401511731 ED DR-AVULS, NB 2ND (PANEL) **.4015 981 $ - 401511732 ED DR-AVUL NP EA AD (PANEL) **.4015 981 $ - 401511739 ED DR-EVAC SUBUNGUAL HEMA **.4015 981 $ 30.00 401511740 EDP-EVAC SUBUNG HEMA (PANEL) **.4015 981 $ - 401511749 ED DR-EXCISION NAIL **.4015 981 $ 150.00 401511750 ED DR-EXCISION NAIL (PANEL) **.4015 981 $ - 401511759 ED DR-REPAIR NAIL BED **.4015 981 $ 157.00 401511760 ED DR-REPAIR NAIL BED (PANEL) **.4015 981 $ - 401512000 ED DR-SUT SING. NONFACE 2.5 **.4015 981 $ 122.00 401512001 EDP-SUT SING NONFACE2.5(PANEL) **.4015 981 $ - 401512002 EDP-SUT SING NF2.6-7.5(PANEL) **.4015 981 $ - 401512003 ED DR-SUT SINGLE NF 7.5-12.5 **.4015 981 $ 183.00 401512004 EDP-SUT SING NF7.5-12.5(PANEL) **.4015 981 $ - 401512005 SUT SING NF 12.6-20.0 (PANEL) **.4015 981 $ - 401512006 EDP-SUT SING NF20.1-30(PANEL) **.4015 981 $ - 401512007 SUT>30 CM REPAIR SIMP(PANEL) **.4015 981 $ - 401512010 ED DR-SUT S/F 2.5 **.4015 981 $ 130.00 401512011 ED DR-SUT S/F 2.5 (PANEL) **.4015 981 $ - 401512012 ED DR SUT S/F 2.6-5 **.4015 981 $ 165.00 401512013 ED DR SUT S/F 2.6-5 (PANEL) 10.4010 450 $ - 401512014 ED DR SUT S/G 5.1-7.5 (PANEL) **.4015 981 $ - 401512015 ED DR SUT S/F 7.6-12.5 (PANEL) **.4015 981 $ - 401512016 EDP SUT S/F 12.6-20.0 (PANEL) **.4015 981 $ - 401512017 SUT20.1-30CM REP SIMP(PANEL) **.4015 981 $ - 401512018 SUT>30 CM REP SIMPLE(PANEL) **.4015 981 $ - 401512019 ED DR-WOUND DEHISCENCE SIMPLE **.4015 981 $ 181.00 401512020 EDP-WND DEHIS SIMPLE (PANEL) **.4015 981 $ - 401512021 EDP-WND DEHIS W/PACK (PANEL) **.4015 981 $ - 401512030 ED DR-SUT DBL S/A/T/E 2 **.4015 981 $ 164.00 401512031 EDP-SUT DBL S/A/T/E 2 (PANEL) **.4015 981 $ - 401512032 SUT DBL S/A/T/E 2.6-7.5(PANEL) **.4015 981 $ - 401512033 ED DR-SUT DBL S/A/T/E 7.6-12.5 **.4015 981 $ 240.00 401512034 SUT DBL S/A/T/E7.6-12.5(PANEL) **.4015 981 $ - 401512035 SUT DBL S/A/T/E/12.6-20(PANEL) **.4015 981 $ - 401512036 SUT DBL SATE20.1-30 NF(PANEL) **.4015 981 $ - 401512037 SUT>30CM INTERMED (PANEL) **.4015 981 $ - 401512040 ED DR-SUT DBL N/HN/FT GYN 2.5 **.4015 981 $ 180.00 401512041 SUT DBL N/HN/FT GYN (PANEL) **.4015 981 $ - 401512042 SUT DBL NHFG 2.6-7.5 (PANEL) **.4015 981 $ - 401512043 ED DR-SUT DBL NHFC 7.6-12.5 **.4015 981 $ 261.00 401512044 SUT DBL NHFC7.6-12.5 (PANEL) **.4015 981 $ - 401512045 SUT DBL NHFG 12.6-20.0(PANEL) **.4015 981 $ - 401512046 SUT DBL NHFC 20.1-30.0(PANEL) **.4015 981 $ - 401512047 SUTURE>30CM REP INTERM(PANEL) **.4015 981 $ - 401512050 ED DR-SUT DBL FACE 2.5 **.4015 981 $ 211.00 401512051 ED DR-SUT DBL FACE 2.5 (PANEL) **.4015 981 $ - 401512052 SUT DBL FACE 2.6-5.0 (PANEL) **.4015 981 $ - 401512053 SUT DBL FACE 5.1-7.5 (PANEL) **.4015 981 $ - 401512054 SUT DBL FACE 7.6-12.5 (PANEL) **.4015 981 $ - 401512055 SUT DBL FACE 12.6-20.0 (PANEL) **.4015 981 $ - 401512056 SUT 20.1-30 REP INTERM (PANEL) **.4015 981 $ - 401512057 SUT>30 REPAIR INTERM (PANEL) **.4015 981 $ - 401513099 ED DR-SUT C/TRNK 1.1-2.5 **.4015 981 $ 170.00 401513100 SUT C/TRNK 1.1-2.5 (PANEL) **.4015 981 $ - 401513101 SUT C/TRNK 2.6-7.5 (PANEL) **.4015 981 $ - 401513102 SUT C/TRNK ADD 5 CM (PANEL) **.4015 981 $ - 401513119 ED DR-SUT C/SCP/ARM/LG 1.1-2 **.4015 981 $ 283.00 401513120 SUT C/SCP/ARM/LG 1.1-2 (PANEL) **.4015 981 $ - 401513121 SUT C/SCP/ARM/LG 2.6-7 (PANEL) **.4015 981 $ - 401513122 SUT C/SCP/ARM/LG ADD5CM(PANEL) **.4015 981 $ - 401513130 ED DR-SUT C.NHFG 1.1-2 **.4015 981 $ 326.00 401513131 ED DR-SUT C.NHFG 1.1-2 (PANEL) **.4015 981 $ - 401513132 SUT C/NHFG 2.6-7.5 (PANEL) **.4015 981 $ - 401513149 ED DR-SUT C/EYELID/NOSE/E **.4015 981 $ 355.00 401513150 SUT C/EYELID/NOSE/E (PANEL) **.4015 981 $ - 401513151 SUT C/EYE/NOSE/EAR (PANEL) **.4015 981 $ - 401513152 SUT2.5-7.6C/EYE/NSE/EAR(PANEL **.4015 981 $ - 401513159 2ND CLSE DEHI EXT-COMPL(PANEL) **.4015 981 $ 647.00 401513160 2ND CLSE DEHI EXT-COMPL(PANEL) **.4015 981 $ - 401515999 ED DR-BURN TNIT T **.4015 981 $ 49.00 401516000 ED DR-BURN TNIT T (PANEL) **.4015 981 $ - 401516010 BURN DSG/DEB, INITIAL (Panel) **.4015 981 $ - 401516011 ED DR-I&D FING ABSC, COMPLEX **.4015 981 $ 181.00 401516015 BURN DSG/DEB W/ANSTH (PANEL) **.4015 981 $ - 401516019 ED DR-BURN DRG/DE SMALL **.4015 981 $ 78.00 401516020 BURN DRG/DE SMALL (PANEL) **.4015 981 $ - 401516024 ED DR-BURN DRG/DE MEDIUM **.4015 981 $ 94.00 401516025 BURN DRG/DE MEDIUM (PANEL) **.4015 981 $ - 401516029 ED DR-BURN LARGE **.4015 981 $ 120.00 401516030 ED DR-BURN LARGE (PANEL) **.4015 981 $ - 401516556 ED DR-CVP PERC > 5 **.4015 981 $ 175.00 401517266 RED PROS HIP DISL W/ANES **.4015 981 $ 575.00 401518999 ED DR-PUNC/ASP BREAST CYST **.4015 981 $ 49.00 401519000 PUNC/ASP BREAST CYST (PANEL) **.4015 981 $ - 401519081 PARACENT/PERITON LAV SUBS **.4015 981 $ 95.00 401519282 EMER MD FEE EXP-LOW COMP **.4015 981 $ 75.00 401519283 EMER MD FEE EXP-LOW-MOD COM **.4015 981 $ 125.00 401519284 EMER MD FEE DETAIL MOD COMP **.4015 981 $ 200.00 401519285 EMER MD FEE COMPRE-HI COMP **.4015 981 $ 275.00 401519291 CRITICAL CARE **.4015 981 $ 400.00 401519999 ED DR-I&D SOFT TISS ABSCESS, S **.4015 981 $ 117.00 401520000 I&D SOFT TISS ABSCESS (PANERL) **.4015 981 $ - 401520004 ED DR-I&D SOFT TISS ABSCESS, C **.4015 981 $ 251.00 401520005 SOFT TISS ABSCESS (PANEL) **.4015 981 $ - 401520099 ED DR-PENETRATING WOUND EXPLOR **.4015 981 $ 729.00 401520100 PENETRATING WUND EXPL (PANEL) **.4015 981 $ - 401520101 PEN WOUND EXP/CHEST (PANEL) **.4015 981 $ - 401520102 PEN WOUND EXP ABD/FLAN (PANEL) **.4015 981 $ - 401520103 PEN WOUND EXP EXTREM (PANEL) **.4015 981 $ - 401520519 ED DR-REM FB/MUSCLE SIMPLE **.4015 981 $ 102.00 401520520 REM FB/MUSC SIMPLE (PANEL) **.4015 981 $ - 401520524 ED DR-REM FB/MUSCLE COMPLEX **.4015 981 $ 276.00 401520525 REM FB/MUSCLE COMPLEX (PANEL) **.4015 981 $ - 401520549 ED DR-TRIGGER PT **.4015 981 $ 49.00 401520550 ED DR-TRIGGER PT (PANEL) **.4015 981 $ - 401520551 ED DR-INJ SINGLE TENDON(PANEL) **.4015 981 $ - 401520552 ED DR-INJ SINGLE TENDON **.4015 981 $ 87.00 401520599 ED DR-AS/INJ JNT SM JOINT **.4015 981 $ 57.00 401520600 AS/INJ JNT SM JOINT (PANEL) **.4015 981 $ - 401520604 ED DR-AS/INJ JNT INTER. JOINT **.4015 981 $ 60.00 401520605 AS/INJ JNT INTER JOINT (PANEL) **.4015 981 $ - 401520609 ED DR-ASP/INJ MAJOR JOINT **.4015 981 $ 70.00 401520610 ASP/INJ MAJ JOINT (PANEL) **.4015 981 $ - 401521309 ED DR-FX CARE NAS **.4015 981 $ 60.00 401521310 ED DR-FX CARE NAS (PANEL) **.4015 981 $ - 401521314 ED DR-NASAL BONE FX CARE-W/STA **.4015 981 $ 156.00 401521315 NASL BONE FX W/STAB (PANEL) **.4015 981 $ - 401521336 ED DR-NASAL SEPTAL FX CARE **.4015 981 $ 272.00 401521337 NASAL SEPTAL FX CARE (PANEL) **.4015 981 $ - 401521479 MANDIBLE REDUCTION **.4015 981 $ 75.00 401521480 MANDIBLE REDUCTION (PANEL) **.4015 981 $ - 401521799 ED DR-FX CARE RIB **.4015 981 $ 130.00 401521800 ED DR-FX CARE RIB (PANEL) **.4015 981 $ - 401521819 ED DR-STERNUM FX CARE **.4015 981 $ 130.00 401521820 ED DR-STERNUM FX CARE (PANEL) **.4015 981 $ - 401522304 ED DR-VERT PROC FX CARE **.4015 981 $ 215.00 401522305 VERT PROC FX CARE (PANEL) **.4015 981 $ - 401523499 ED DR-FX CARE CLAVICLE **.4015 981 $ 260.00 401523500 ED DR-FX CARE CLAVICLE (PANEL) **.4015 981 $ - 401523504 ED DR-FX CARE CLAVICLE W/M **.4015 981 $ 303.00 401523505 FX CARE CLAVICLE W/M (PANEL) **.4015 981 $ - 401523519 ED DR-RED STERNOCLAV DIS. W/O **.4015 981 $ 170.00 401523520 RED STERNOCLAV W/O ANES(PANEL) **.4015 981 $ - 401523524 ED DR-RED STERNOCLAV DIS. W/MA **.4015 981 $ 266.00 401523525 RED STERNOCLAV W/MA (PANEL) **.4015 981 $ - 401523539 ED DR-RED A/C DIS, W/O MAN **.4015 981 $ 262.00 401523540 RED A/C DIS W/O MAN (PANEL) **.4015 981 $ - 401523544 ED DR-RED A/C DIS, W/MAN **.4015 981 $ 251.00 401523545 RED A/C DIS W/MAN (PANEL) **.4015 981 $ - 401523569 ED DR-SCAP FX CARE, W/O MAN **.4015 981 $ 191.00 401523570 SCAP FX CARE W/O MAN (PANEL) **.4015 981 $ - 401523574 ED DR-SCAP FX CARE, W/MAN **.4015 981 $ 330.00 401523575 SCAP FX CARE W/MAN (PANEL) **.4015 981 $ - 401523599 ED DR-FX CARE HUMERUS **.4015 981 $ 379.00 401523600 ED DR-FX CARE HUMERUS (PANEL) **.4015 981 $ - 401523604 ED DR-HUM FX CARE, W/MAN **.4015 981 $ 476.00 401523605 HUM FX CARE W/MAN (PANEL) **.4015 981 $ - 401523649 ED DR-REDUC SHLDR **.4015 981 $ 348.00 401523650 ED DR-REDUC SHLDR (PANEL) **.4015 981 $ - 401523654 ED DR-RED SHLDR DISLOC, W/ANES **.4015 981 $ 489.00 401523655 RED SHLDR DISLO W/ANES (PANEL) **.4015 981 $ - 401524499 ED DR-HUM SHAFT FX CARE, W/O M **.4015 981 $ 383.00 401524500 HUM SHFT FX CRE W/O M (PANEL) **.4015 981 $ - 401524504 ED DR-HUM SHAFT FX CARE, W/MAN **.4015 981 $ 475.00 401524505 HUM SHFT FX W/MAN (PANEL) **.4015 981 $ - 401524599 ED DR-RED, DISL ELB **.4015 981 $ 292.00 401524600 ED DR-RED, DISL ELB (PANEL) **.4015 981 $ - 401524604 ED DR-RED ELBOW DISLOC, W/ANES **.4015 981 $ 365.00 401524605 RED ELBW DISLOC W/ANES (PANEL) **.4015 981 $ - 401524639 ED DR-REDUC/RAD/S **.4015 981 $ 125.00 401524640 ED DR-REDUC/RAD/S (PANEL) **.4015 981 $ - 401524649 ED DR-FX CARE RADIAL HEA **.4015 981 $ 162.00 401524650 FX CARE RADIAL HEAD (PANEL) **.4015 981 $ - 401524654 ED DR-PROX RADIUS FX CARE, W/M **.4015 981 $ 359.00 401524655 PROX RAD FX CARE W/M (PANEL) **.4015 981 $ - 401524669 ED DR-PROX ULNA FX CARE, W/O M **.4015 981 $ 218.00 401524670 PROX ULN FX CRE W/O M (PANEL) **.4015 981 $ - 401525499 ED DR-RAD SHAFT FX CARE, W/O M **.4015 981 $ 175.00 401525500 RAD SHFT FX CRE W/O M (PANEL) **.4015 981 $ - 401525504 ED DR-RAD SHAFT FX CARE, W/MAN **.4015 981 $ 424.00 401525505 RAD SHFT FX CRE W/MAN (PANEL) **.4015 981 $ - 401525529 ED DR-ULN SHAFT FX CARE, W/O M **.4015 981 $ 161.00 401525530 ULN SHFT FX CRE W/O M (PANEL) **.4015 981 $ - 401525534 ED DR-ULN SHAFT FX CARE, W/MAN **.4015 981 $ 581.00 401525535 ULN SHFT FX CRE W/MAN (PANEL) **.4015 981 $ - 401525559 ED DR-FX CARE RAD **.4015 981 $ 229.00 401525560 ED DR-FX CARE RAD (PANEL) **.4015 981 $ - 401525564 ED DR-FX CARE RAD/U **.4015 981 $ 503.00 401525565 ED DR-FX CARE RAD/U (PANEL) **.4015 981 $ - 401525599 ED DR-FX CARE DISTAL RAD **.4015 981 $ 313.00 401525600 FX CARE DIST RAD (PANEL) **.4015 981 $ - 401525604 ED DR-DIST RAD FX CARE, W/MAN **.4015 981 $ 473.00 401525605 DIST RAD FX CARE W/MAN (PANEL) **.4015 981 $ - 401525621 ED DR-FX CARE NAVICULAR **.4015 981 $ 182.00 401525622 FX CARE NAVICULAR (PANEL) **.4015 981 $ - 401525623 ED DR-NAVICULAR FX CARE, W/MAN **.4015 981 $ 309.00 401525624 NAVICULAR FX CARE W/MAN (PANEL **.4015 981 $ - 401525649 ED DR-FX CARE ULNAR/STYL **.4015 981 $ 212.00 401525650 FX CARE ULNAR/STYL (PANEL) **.4015 981 $ - 401525659 ED DR-RED RADIOCARPAL DISL **.4015 981 $ 309.00 401525660 RED RADIOCARPAL DISL (PANEL) **.4015 981 $ - 401525674 ED DR-RED RADIOULNAR DISL **.4015 981 $ 331.00 401525675 RED RADIOULNAR DISL (PANEL) **.4015 981 $ - 401526009 ED DR-I&D FING ABSC, SIMPLE **.4015 981 $ 82.00 401526010 I&D FING ABSC SIMPLE (PANEL) **.4015 981 $ - 401526011 I&D FING ABSC COMPLEX (PANEL) **.4015 981 $ - 401526409 ED DR-EXT TEND RE **.4015 981 $ 950.00 401526410 ED DR-EXT TEND RE (PANEL) **.4015 981 $ - 401526599 ED DR-FX CARE MET **.4015 981 $ 257.00 401526600 ED DR-FX CARE MET (PANEL) **.4015 981 $ - 401526604 BOXER'S FX, REDUCTION **.4015 981 $ 361.00 401526605 BOXER'S FX, REDUCTION (PANEL) **.4015 981 $ - 401526640 ED DR-RED THUMB DISL **.4015 981 $ 233.00 401526641 ED DR-RED THUMB DISL (PANEL) **.4015 981 $ - 401526669 ED DR-RED CAR/METCAR DIS W/O A **.4015 981 $ 214.00 401526670 RED CAR/METC DIS W/O A (PANEL) **.4015 981 $ - 401526674 ED DR-RED CAR/METCAR DISL W/AN **.4015 981 $ 440.00 401526675 RED CAR/MET DISL W/AN (PANEL) **.4015 981 $ - 401526699 ED DR-RED METCAR/PHA DIS W/O A **.4015 981 $ 370.00 401526700 RED METCAR/PHA W/O A (PANEL) **.4015 981 $ - 401526704 ED DR-RED METCAR/PHAL DISL W/A **.4015 981 $ 282.00 401526705 RED MET/PHAL DIS W/A (PANEL) **.4015 981 $ - 401526719 ED DR-FX CARE PHAL/PROX **.4015 981 $ 237.00 401526720 FX CARE PHAL/PROX (PANEL) **.4015 981 $ - 401526724 ED DR-FX CARE PHAL WITH MANIP **.4015 981 $ 414.00 401526725 FX CARE PHAL W MANIP (PANEL) **.4015 981 $ - 401526749 ED DR-FX CARE PHAL/DISTA **.4015 981 $ 211.00 401526750 FX CARE PHAL/DISTA (PANEL) **.4015 981 $ - 401526754 ED DR-DIS PHAL FX CAR W/MAN, E **.4015 981 $ 195.00 401526755 DIS PHAL FX CAR W/MAN (PANEL) **.4015 981 $ - 401526769 ED DR-REDUC/INTERPHAL/W/M **.4015 981 $ 310.00 401526770 REDUC/INTERPHAL/W/M (PANEL) **.4015 981 $ - 401526774 ED DR-RED IP DISL FING, W/ANES **.4015 981 $ 225.00 401526775 RED IP DISL FING W/ANS (PANEL) **.4015 981 $ - 401527249 ED DR-RED HIP DISL, W/O ANES **.4015 981 $ 655.00 401527250 RED HIP DIS W/O ANES (PANEL) **.4015 981 $ - 401527251 ED DR-RED HIP DISL, W/ANES **.4015 981 $ 697.00 401527252 RED HIP DISL W/ANES (PANEL) **.4015 981 $ - 401527264 ED DR-RED PROS HIP DISL, W/O A **.4015 981 $ 553.00 401527265 RED PROS HIP DIS W/O A (PANEL) **.4015 981 $ - 401527266 RED PROS HIP DISL W/ANE(PANEL) **.4015 981 $ - 401527549 ED DR-REDUCTION PATELLA **.4015 981 $ 394.00 401527550 REDUCTION PATELLA (PANEL) **.4015 981 $ - 401527551 ED DR-RED KNEE DISL, W/ANES **.4015 981 $ 536.00 401527552 RED KNEE DISL W/ANES (PANEL) **.4015 981 $ - 401527559 PATELLAR REDUCTION **.4015 981 $ 397.00 401527560 PATELLAR REDUCTION (PANEL) **.4015 981 $ - 401527561 ED DR-RED PATELLAR DISL, W/ANE **.4015 981 $ 538.00 401527562 RED PATEL DISL W/ANE (PANEL) **.4015 981 $ - 401527749 ED DR-TIB SHAFT FX CARE, W/O M **.4015 981 $ 329.00 401527750 TIB SHFT FX CARE W/O M (PANEL) **.4015 981 $ - 401527752 TIBIA REDUCT W MANIPULATION **.4015 981 $ 520.00 401527759 ED DR-FX CARE DISTAL TIB **.4015 981 $ 209.00 401527760 FX CARE DISTAL TIB (PANEL) **.4015 981 $ - 401527779 ED DR-FIB PROX/SHAFT FX CARE **.4015 981 $ 328.00 401527780 FIB PROX/SHAFT FX CARE (PANEL) **.4015 981 $ - 401527785 ED DR-FX CARE DISTAL FIB **.4015 981 $ 347.00 401527786 FX CARE DISTAL FIB (PANEL) **.4015 981 $ - 401527839 ED DR-RED ANKLE DISL, W/O ANES **.4015 981 $ 473.00 401527840 RED ANKLE DISL W/O ANES(PANEL) **.4015 981 $ - 401527841 ED DR-RED ANKLE DISL, W/ANES **.4015 981 $ 396.00 401527842 RED ANKL DISL W/ANES (PANEL) **.4015 981 $ - 401528125 EMERGENCY PHYSICIAN FEE (25) **.4015 981 $ 50.00 401528189 ED DR-REM SQ FB, FOOT **.4015 981 $ 101.00 401528190 ED DR-REM SQ FB, FOOT (PANEL) **.4015 981 $ - 401528225 EMER MD FEE EXP-LOW COMP (25) **.4015 981 $ 75.00 401528325 EMER MD FEE EXP-LOW-MOD COM (2 **.4015 981 $ 125.00 401528425 EMER MD FEE DETAIL MOD COMP (2 **.4015 981 $ 200.00 401528469 ED DR-FX CARE METATARSAL **.4015 981 $ 251.00 401528470 FX CARE METATARSAL (PANEL) **.4015 981 $ - 401528474 ED DR-METATARS FX CARE W/MAN E **.4015 981 $ 199.00 401528475 METATARS FX CARE W/MAN (PANEL) **.4015 981 $ - 401528489 ED DR-FX CARE GREAT TOE **.4015 981 $ 157.00 401528490 FX CARE GREAT TOE (PANEL) **.4015 981 $ - 401528494 ED DR-GREAT TOE FX CARE, W/MAN **.4015 981 $ 102.00 401528495 GREAT TOE FX CARE W/MAN(PANEL) **.4015 981 $ - 401528509 ED DR-FX CARE TOE **.4015 981 $ 155.00 401528510 ED DR-FX CARE TOE (PANEL) **.4015 981 $ - 401528514 ED DR-TOE FX CARE, W/MAN, EACH **.4015 981 $ 96.00 401528515 TOE FX CARE W/MAN EA (PANEL) **.4015 981 $ - 401528525 EMER MD FEE COMPRE-HI COMP (25 **.4015 981 $ 275.00 401528539 ED DR-RED TARSAL DISL, W/O ANE **.4015 981 $ 107.00 401528540 RED TARS DISL W/O ANE (PANEL) **.4015 981 $ - 401528544 ED DR-RED TARSAL DISL, W/ANES **.4015 981 $ 178.00 401528545 RED TARS DISL W/ANES (PANEL) **.4015 981 $ - 401528569 ED DR-RED TALOTARSA DISL W/O A **.4015 981 $ 118.00 401528570 RED TALOTAR DISL W/O A (PANEL) **.4015 981 $ - 401528574 ED DR-RED TALOTARSAL DISL, W/A **.4015 981 $ 298.00 401528575 RED TALOTARS DISL W/A (PANEL) **.4015 981 $ - 401528599 ED DR-RED TARSOMET DISL, W/O A **.4015 981 $ 103.00 401528600 RED TARSOMET DIS W/O A (PANEL) **.4015 981 $ - 401528604 ED DR-RED TARSOMET DISL, W/ANE **.4015 981 $ 243.00 401528605 RED TARSOMET DIS W/ANE (PANEL) **.4015 981 $ - 401528629 ED DR-RED METATARPHAL DIS W/O **.4015 981 $ 158.00 401528630 RED METATARPHAL DIS W/O(PANEL) **.4015 981 $ - 401528634 ED DR-RED METATARPHAL DISL W/A **.4015 981 $ 126.00 401528635 RED METATARPHAL DIS W/A(PANEL) **.4015 981 $ - 401528659 ED DR-RED IP DISL TOE, W/O ANE **.4015 981 $ 132.00 401528660 RED IP DIS TOE W/O A (PANEL) **.4015 981 $ - 401528664 ED DR-RED IP DISL TOE, W/ANES **.4015 981 $ 113.00 401528665 RED IP DIS TOE W/A (PANEL) **.4015 981 $ - 401529064 ED DR-CAST LONG ARM **.4015 981 $ 62.00 401529065 ED DR-CAST LONG ARM (PANEL) **.4015 981 $ - 401529074 ED DR-CAST SHORT ARM **.4015 981 $ 52.00 401529075 ED DR-CAST SHORT ARM (PANEL) **.4015 981 $ - 401529084 ED DR-CAST HAND **.4015 981 $ 53.00 401529085 ED DR-CAST HAND (PANEL) **.4015 981 $ - 401529104 ED DR-SPLINT LONG ARM **.4015 981 $ 79.00 401529105 ED DR-SPLINT LONG ARM (PANEL) **.4015 981 $ - 401529124 ED DR-SPLINT SHORT ARM **.4015 981 $ 55.00 401529125 ED DR-SPLINT SHORT ARM (PANEL) **.4015 981 $ - 401529126 CRITICAL CARE (25) **.4015 981 $ 400.00 401529129 ED DR-SPLINT FINGER **.4015 981 $ 30.00 401529130 ED DR-SPLINT FINGER (PANEL) **.4015 981 $ - 401529226 ED DR-CRIT CARE-ADD'L 1/2 HR ( **.4015 981 $ 200.00 401529344 ED DR-CAST LONG LEG **.4015 981 $ 92.00 401529345 ED DR-CAST LONG LEG (PANEL) **.4015 981 $ - 401529354 ED DR-CAST LL WALK **.4015 981 $ 100.00 401529355 ED DR-CAST LL WALK (PANEL) **.4015 981 $ - 401529364 ED DR-CAST CYLINDER **.4015 981 $ 78.00 401529365 ED DR-CAST CYLINDER (PANEL) **.4015 981 $ - 401529404 ED DR-CAST SHORT LEG **.4015 981 $ 61.00 401529405 ED DR-CAST SHORT LEG (PANEL) **.4015 981 $ - 401529424 ED DR-CAST SL WALK **.4015 981 $ 73.00 401529425 ED DR-CAST SL WALK (PANEL) **.4015 981 $ - 401529504 ED DR-SPLINT LONG LEG **.4015 981 $ 70.00 401529505 ED DR-SPLINT LONG LEG (PANEL) **.4015 981 $ - 401529514 ED DR-SPLINT SHORT LEG **.4015 981 $ 67.00 401529515 ED DR-SPLINT SHORT LEG (PANEL) **.4015 981 $ - 401529699 ED DR-CAST REM/BIV, GAUN/BOOT/ **.4015 981 $ 35.00 401529700 CAST REM/BIV GAUN/BOOT (PANEL) **.4015 981 $ - 401529704 ED DR-CAST REMOV/BIV, ARM/LEG **.4015 981 $ 65.00 401529705 CAST REMOV/BIV ARM/LEG (PANEL) **.4015 981 $ - 401529729 ED DR-CAST WINDOW **.4015 981 $ 41.00 401529730 ED DR-CAST WINDOW (PANEL) **.4015 981 $ - 401529999 ED DR-I&D NASAL ABS/HEM, INTER **.4015 981 $ 79.00 401530000 I&D NASAL ABS/HEM INT (PANEL) **.4015 981 $ - 401530019 ED DR-I&D NASAL ABS/HEM, SEPTU **.4015 981 $ 80.00 401530020 I&D NASAL ABS/HEM SEPT (PANEL) **.4015 981 $ - 401530299 ED DR-REM FB NASA **.4015 981 $ 164.00 401530300 ED DR-REM FB NASA (PANEL) **.4015 981 $ - 401530309 ED DR-REM NASAL FB, W/ANES **.4015 981 $ 173.00 401530310 REM NASAL FB W/ANES (PANEL) **.4015 981 $ - 401530900 ED DR-EPISTAXIS SIMPLE/CAUTER **.4015 981 $ 80.00 401530901 EPISTAX SIMPLE/CAUTER (PANEL) **.4015 981 $ - 401530902 ED DR-EPISTAXIS COMP/CAUT/PA **.4015 981 $ 125.00 401530903 EPISTAX COMP/CAUT/PA (PANEL) **.4015 981 $ - 401530904 ED DR-EPISTAXIS PST CAUT/PACK **.4015 981 $ 200.00 401530905 EPISTAX PST CAUT/PACK (PANEL) **.4015 981 $ - 401530906 ED DR-EPITX P SUB (PANEL) **.4015 981 $ - 401531499 ED DR-INTUBATION **.4015 981 $ 200.00 401531500 ED DR-INTUBATION (PANEL) **.4015 981 $ - 401531504 ED DR-LARYNCOSCOPY **.4015 981 $ 39.00 401531505 ED DR-LARYNCOSCOPY (PANEL) **.4015 981 $ - 401531510 ED DR-LARYNGOSCOP **.4015 981 $ 146.00 401531511 ED DR-LARYNGOSCOP (PANEL) **.4015 981 $ - 401531574 ED DR-FIBER LARYNG, DIAG **.4015 981 $ 125.00 401531575 FIBER LARYNG DIAG (PANEL) **.4015 981 $ - 401531576 ED DR-FIBER LARYNG W/FB REM **.4015 981 $ 256.00 401531577 FIBER LARYNG W/FB REM (PANEL) **.4015 981 $ - 401531602 ED DR-TRACH EMERG **.4015 981 $ 415.00 401531603 ED DR-TRACH EMERG (PANEL) **.4015 981 $ - 401531604 ED DR-TRACH/CRICH **.4015 981 $ 370.00 401531605 ED DR-TRACH/CRICH (PANEL) **.4015 981 $ - 401531999 ED DR-THORACENTESIS **.4015 981 $ 115.00 401532000 ED DR-THORACENTESIS (PANEL) **.4015 981 $ - 401532001 ED DR-THORACENTESIS W/TUB INS **.4015 981 $ 170.00 401532002 THORACENTES W/TUB INS (PANEL) **.4015 981 $ - 401532019 ED DR-TUBE THORAC **.4015 981 $ 320.00 401532020 ED DR-TUBE THORAC (PANEL) **.4015 981 $ - 401532109 ED DR-THORACOTOMY W/CONTRL HEM **.4015 981 $ 1,239.00 401532110 THORACOT W/CONTRL HEM (PANEL) **.4015 981 $ - 401532159 ED DR-THORACOTOMY W/CARD MASS **.4015 981 $ 914.00 401532160 THORACOT W/CARD MASS (PANEL) **.4015 981 $ - 401533009 ED DR-PERICARDIOC **.4015 981 $ 180.00 401533010 ED DR-PERICARDIOC (PANEL) **.4015 981 $ - 401533011 ED DR-PERICARDIOCENT, SUBSEQU **.4015 981 $ 130.00 401533209 ED DR-TEMPORARY PACER **.4015 981 $ 319.00 401533210 ED DR-TEMPORARY PACER (PANEL) **.4015 981 $ - 401536399 ED DR-VENIPUNC <3YR **.4015 981 $ 11.00 401536400 ED DR-VENIPUNC <3YR (PANEL) **.4015 981 $ - 401536404 ED DR-VENIP <3Y SCP **.4015 981 $ 20.00 401536405 ED DR-VENIP <3Y SCP (PANEL) **.4015 981 $ - 401536406 OTH VENIPUNCT <AGE 3 (PANEL) **.4015 981 $ - 401536409 ED DR-VENIP 3+ SK **.4015 981 $ 14.00 401536410 ED DR-VENIP 3+ SK (PANEL) **.4015 981 $ - 401536419 ED DR-VENPNC CD <1Y **.4015 981 $ 72.00 401536420 ED DR-VENPNC CD <1Y (PANEL) **.4015 981 $ - 401536424 ED DR-VENPC CD 1+ **.4015 981 $ 38.00 401536425 ED DR-VENPC CD 1+ (PANEL) **.4015 981 $ - 401536487 ED CR-CVP RECUT < 5 **.4015 981 $ 112.00 401536488 ED CR-CVP RECUT < 5 (PANEL) **.4015 981 $ - 401536489 ED DR-CVP PERC > 5 (PANEL) **.4015 981 $ - 401536490 ED DR-CUTDOWN < 5 (PANEL) **.4015 981 $ - 401536491 ED DR-CUTDOWN > 5 (PANEL) **.4015 981 $ - 401536599 ED DR-ABG DRAW **.4015 981 $ 29.00 401536600 ED DR-ABG DRAW (PANEL) **.4015 981 $ - 401536619 ED DR-ARTLINE PER **.4015 981 $ 125.00 401536620 ED DR-ARTLINE PER (PANEL) **.4015 981 $ - 401536624 ED DR-ARTLINE CUT **.4015 981 $ 142.00 401536625 ED DR-ARTLINE CUT (PANEL) **.4015 981 $ - 401536679 ED DR-INTRAOSSEOUS **.4015 981 $ 150.00 401536680 ED DR-INTRAOSSEOUS (PANEL) **.4015 981 $ - 401541249 TONGUE LACERATION REPAIR <2.5 **.4015 981 $ 195.00 401541250 TONGUE LACERATION REPAIR <2.5 **.4015 981 $ - 401541251 TONGUE LACERATION REPAIR >2.5 **.4015 981 $ 290.00 401541252 TONGUE LACERATION REPAIR >2.5 **.4015 981 $ - 401542699 ED DR-I&D PERITON ABSCESS **.4015 981 $ 184.00 401542700 ED DR-I&D PERITON ABSCESS (PAN **.4015 981 $ - 401542959 ED DR-OROPHAR HEMOR **.4015 981 $ 160.00 401542960 ED DR-OROPHAR HEMOR (PANEL) **.4015 981 $ - 401543199 ED DR-ESOPHAGOSCOPY **.4015 981 $ 166.00 401543200 ED DR-ESOPHAGOSCOPY (PANEL) **.4015 981 $ - 401543214 ED DR-ESOPHAGOSCOPY W/FB REM **.4015 981 $ 272.00 401543215 ED ESOPHAGOS W/FB REM (PANEL) **.4015 981 $ - 401543759 ED DR-GASTROSTOMY TUBE CHANGE **.4015 981 $ 100.00 401543760 ED DR-GASTROSTOMY TUBE CHANGE **.4015 981 $ - 401545899 ED DR-RED RECT PROLAPSE W/ANES **.4015 981 $ 113.00 401545900 ED DR-RED RECT PROLAPSE W/ANES **.4015 981 $ - 401545914 ED DR-REM FECAL IMPACT/FB **.4015 981 $ 139.00 401545915 ED DR-REM FECAL IMPACT (PANEL) **.4015 981 $ - 401546049 ED DR-I&D PERIANAL **.4015 981 $ 114.00 401546050 ED DR-I&D PERIANAL (PANEL) **.4015 981 $ - 401546319 ED DR-HEMORR ENUC **.4015 981 $ 137.00 401546320 ED DR-HEMORR ENUC (PANEL) **.4015 981 $ - 401546599 ED DR-ANOSCOPY DX **.4015 981 $ 49.00 401546600 ED DR-ANOSCOPY DX (PANEL) **.4015 981 $ - 401546899 ED DR-DESTRUCT LESION ANUS, SI **.4015 981 $ 96.00 401546900 ED DR-DESTRUCT LESION ANUS, SI **.4015 981 $ - 401546909 ED DR-DESTRUCT LES ANUS, ELECT **.4015 981 $ 101.00 401546910 ED DR-DESTRUCT LES ANUS, ELECT **.4015 981 $ - 401549079 ED DR-PARACENT/PERITON LAV, IN **.4015 981 $ 106.00 401549080 ED DR-PARACENT/PERITON LAV, IN **.4015 981 $ - 401549081 PARACENT/PERITON LAV SU(PANEL) **.4015 981 $ - 401550999 ED DR-BLADDER ASPIRATION, NEED **.4015 981 $ 60.00 401551000 ED DR-BLADDER ASPIRATION, NEED **.4015 981 $ - 401551004 ED DR-BLAD ASP, TROC/INTRACATH **.4015 981 $ 69.00 401551005 ED BLAD ASP TROC/CATH (PANEL) **.4015 981 $ - 401551009 ED DR-BLAD ASP W/SUP CATH INS **.4015 981 $ 208.00 401551010 ED DR-BLAD ASP W/SUP CATH INS **.4015 981 $ - 401551599 ED DR-BLAD INJECT FOR IMAGING **.4015 981 $ 54.00 401551600 ED DR-BLAD INJECT FOR IMAGING **.4015 981 $ - 401551699 ED DR-BLADDER IRRIGATION **.4015 981 $ 45.00 401551700 ED DR-BLADDER IRRIGATION (PANE **.4015 981 $ - 401551704 ED DR-CYSTO TUB CHANGE, SIMP **.4015 981 $ 56.00 401551705 ED DR-CYSTO TUB CHANGE, SIMP ( **.4015 981 $ - 401551709 ED DR-CYSTO TUB CHANGE, COMP **.4015 981 $ 82.00 401551710 ED DR-CYSTO TUB CHANGE, COMP ( **.4015 981 $ - 401553599 ED DR-DIL URETH STRIC SND/DIL **.4015 981 $ 63.00 401553600 ED DR-DIL URETH STRIC SND/DIL **.4015 981 $ - 401553619 ED DR-DIL URETH STRIC FIL/FOL **.4015 981 $ 85.00 401553620 ED DR-DIL URETH STRIC FIL/FOL **.4015 981 $ - 401553669 ED DR-CATH SIMPLE **.4015 981 $ 28.00 401553670 ED DR-CATH SIMPLE (PANEL) **.4015 981 $ - 401553674 ED DR-CATH COMPLE **.4015 981 $ 90.00 401553675 ED DR-CATH COMPLE (PANEL) **.4015 981 $ - 401554000 ED DR-SLIT PREPUCE, NON-NEWBOR **.4015 981 $ 141.00 401554001 ED DR-SLIT PREPUCE, NON-NEWBOR **.4015 981 $ - 401554049 ED DR-DESTRUCT LESION(S), PENI **.4015 981 $ 65.00 401554050 ED DR-DESTRUCT LESION(S), PENI **.4015 981 $ - 401554234 ED DR-INJ CORP CAVERN W/PHARM **.4015 981 $ 65.00 401554235 ED DR-INJ CORP CAVERN W/PHARM **.4015 981 $ - 401555099 ED DR-I&D SCROTAL WALL ABSCESS **.4015 981 $ 128.00 401555100 ED DR-I&D SCROTAL WALL ABSCESS **.4015 981 $ - 401556404 ED DR-I&D VULVA/PERINEAL ABSCE **.4015 981 $ 87.00 401556405 ED DR-I&D VULVA/PERINEAL ABSCE **.4015 981 $ - 401556419 ED DR-I&D BARTH GLAND ABSCESS **.4015 981 $ 85.00 401556420 ED DR-I&D BARTH GLAND ABSCESS **.4015 981 $ - 401557409 ED DR-PELVIC EXAM W/ANES **.4015 981 $ 97.00 401557410 ED DR-PELVIC EXAM W/ANES (PANE **.4015 981 $ - 401557414 ED DR-REM VAG FB W/ANES **.4015 981 $ 115.00 401557415 ED DR-REM VAG FB W/ANES (PANEL **.4015 981 $ - 401558300 ED DR-REMOVAL IUD **.4015 981 $ 70.00 401558301 ED DR-REMOVAL IUD (PANEL) **.4015 981 $ - 401559299 ED DR-EPISIOTOMY **.4015 981 $ 134.00 401559300 ED DR-EPISIOTOMY (PANEL) **.4015 981 $ - 401559408 ED DR-VAG DELIV ONLY **.4015 981 $ 1,138.00 401559409 ED DR-VAG DELIV ONLY (PANEL) **.4015 981 $ - 401562269 ED DR-LUMBAR PUNC **.4015 981 $ 150.00 401562270 ED DR-LUMBAR PUNC (PANEL) **.4015 981 $ - 401564399 ED DR-INJECT ANES TRIGEM NERVE **.4015 981 $ 63.00 401564400 ED DR-INJECT ANES TRIGEM NERVE **.4015 981 $ - 401564419 ED DR-NERVE BLC ICT **.4015 981 $ 86.00 401564420 ED DR-NERVE BLC ICT (PANEL) **.4015 981 $ - 401564449 PERIPHERAL NERVE BLOCK **.4015 981 $ 93.00 401564450 PERIPHERAL NERVE BLOCK (PANEL) **.4015 981 $ - 401565204 ED DR-REM FB CONJ SIMPLE **.4015 981 $ 50.00 401565205 ED DR-REM FB CONJ SIMPLE (PANE **.4015 981 $ - 401565209 ED DR-REM FB CONJ COMPLEX **.4015 981 $ 62.00 401565210 ED DR-REM FB CONJ COMPLEX (PAN **.4015 981 $ - 401565219 ED DR-REM FB CORN SIMPLE **.4015 981 $ 75.00 401565220 ED DR-REM FB CORN SIMPLE (PANE **.4015 981 $ - 401565221 ED DR-REM FB CORN COMPLEX **.4015 981 $ 100.00 401565222 ED DR-REM FB CORN COMPLEX (PAN **.4015 981 $ - 401565434 RUST RING REMOVAL **.4015 981 $ 100.00 401565435 RUST RING REMOVAL (PANEL) **.4015 981 $ - 401568999 ED DR-I&D EXT EAR ABS/HEM, SIM **.4015 981 $ 74.00 401569000 ED DR-I&D EXT EAR ABS/HEM, SIM **.4015 981 $ - 401569004 ED DR-I&D EXT EAR ABS/HEM, COM **.4015 981 $ 126.00 401569005 ED DR-I&D EXT EAR ABS/HEM, COM **.4015 981 $ - 401569019 ED DR-I&D EXT AUD CANAL ABS/HE **.4015 981 $ 78.00 401569020 ED DR-I&D EXT AUD CANAL ABS/HE **.4015 981 $ - 401569199 ED DR-REM FB EAR **.4015 981 $ 74.00 401569200 ED DR-REM FB EAR (PANEL) **.4015 981 $ - 401569204 ED DR-REM FB EXT AUD CANAL W/A **.4015 981 $ 110.00 401569205 ED DR-REM FB EXT AUD CANAL W/A **.4015 981 $ - 401569209 ED DR-REM CERUMEN **.4015 981 $ 47.00 401569210 ED DR-REM CERUMEN (PANEL) **.4015 981 $ - 401590780 I.V. INFUSION THERARPY **.4015 981 $ 55.00 401590781 I.V. INFUSION THERAPY-ADDL HR **.4015 981 $ 28.00 401590782 ED DR-INJECTION,SQ/IM **.4015 981 $ 5.00 401590783 ED DR-INJECTION, INTRA-ART **.4015 981 $ 20.00 401590784 ED DR-INJECTION, INTRAVEN **.4015 981 $ 24.00 401590788 ED DR-INJECTION ANTIBIOTIC, IM **.4015 981 $ 6.00 401590801 ED DR-PSYCH EVAL **.4015 981 $ 201.00 401591105 GASTRIC LAVAGE **.4015 981 $ 50.00 401592000 SEXUAL ASSAULT EXAM **.4015 981 $ 200.00 401592001 ED DR-SEXUAL ASSAULT (PANEL) **.4015 981 $ - 401592140 TONOMETRY / EYE **.4015 981 $ 84.00 401592950 ED DR-CPR **.4015 981 $ 300.00 401592953 ED DR-TEMP TRANSCUT PACING **.4015 981 $ 27.00 401592960 ED DR-CARDIOVERSI **.4015 981 $ 250.00 401592971 ED DR-CARDIOASSIST,EXTERNAL **.4015 981 $ 136.00 401592977 THROMBOLYSIS **.4015 981 $ 455.00 401593503 SWAN-GANZ CATHETER **.4015 981 $ 258.00 401593922 ED DR-ANKLE/BRACHIAL INDICES **.4015 981 $ 27.00 401599052 ED DR-NIGHT SERVICE **.4015 981 $ 17.00 401599141 CONSCIOUS SEDATION - IV **.4015 981 $ 175.00 401599142 CONSCIOUS SEDATION - PO/RECTAL **.4015 981 $ 150.00 401599175 ED DR-IPECAC OBSE **.4015 981 $ 70.00 401599236 ADMIT FOR OBSERVATION **.4015 981 $ 307.00 401599281 EMERGENCY PHYSICIAN FEE **.4015 981 $ 50.00 401599282 EMER MD FEE EXP-LOW COMP **.4015 981 $ 75.00 401599283 EMER MD FEE EXP-LOW-MOD COM **.4015 981 $ 125.00 401599284 EMER MD FEE DETAIL MOD COMP **.4015 981 $ 200.00 401599285 EMER MD FEE COMPRE-HI COMP **.4015 981 $ 275.00 401599288 ED DR FEE-EMS DIRECTION **.4015 981 $ 120.00 401599291 CRITICAL CARE **.4015 981 $ 400.00 401599292 ED DR-CRIT CARE-EACH ADD'L 1/2 **.4015 981 $ 200.00 401599354 ED DR-DETENT-FIRST HOUR **.4015 981 $ 132.00 401599355 ED DR-DETENT-EACH ADD'L 30 MIN **.4015 981 $ 129.00 401599371 ED DR-TELEPHONE CALL-BRIEF **.4015 981 $ 30.00 401599372 ED DR-TELEPHONE CALL-INTERMEDI **.4015 981 $ 60.00 401599373 ED DR-TELEPHONE CALL-COMPLEX **.4015 981 $ 90.00 404000010 UNLISTED AMBULANCE SERVICES 10.4040 540 $ - 404000100 BLS EMERGENCY 10.4040 540 $ 959.00 404000101 BLS NON-EMERGENCY 10.4040 540 $ 959.00 404000102 ALS 1 EMERGENCY 10.4040 540 $ 1,471.00 404000103 ALS 1 NON-EMERGENCY 10.4040 540 $ 1,471.00 404000104 ALS 2 10.4040 540 $ 1,471.00 404000105 SPECIAL CARE TRANSPORT 10.4040 540 $ 1,471.00 404000106 MILEAGE-AMB 10.4040 540 $ 32.00 404000107 EMERGENCY - AMB 10.4040 540 $ 198.00 404000108 OXYGEN - AMB 10.4040 540 $ 148.00 404000200 GUERNEY - VAN 10.4040 540 $ 105.00 404000201 WC - VAN 10.4040 540 $ 59.00 404000202 MILEAGE - VAN 10.4040 540 $ 5.00 404000204 OXYGEN - VAN 10.4040 540 $ 26.00 404007000 LIFELINE UNLISTED 10.4040 946 $ - 404007010 LIFELINE SERVICE-LOCAL 10.4040 946 $ 36.00 404007015 LIFELINE SERVICE PER MTH 10.4040 946 $ 39.00 404007017 LIFELINE SERVICES-VOICE LOCAL 10.4040 946 $ 44.00 404007018 LIFELINE VOICE-LONG DISTANCE 10.4040 946 $ 49.00 404007019 LIFELINE SERVICE PHONE 10.4040 946 $ 52.00 404007020 LIFELINE INSTALLATION 10.4040 946 $ 62.00 404007030 LIFELINE HELP BUTTON 10.4040 946 $ 157.00 404100010 UNLISTED AMBULANCE 10.4041 540 $ - 404100100 BLS EMERGENCY 10.4041 540 $ 1,200.00 404100101 BLS NON-EMERGENCY 10.4041 540 $ 1,200.00 404100102 ALS 1 EMERGENCY 10.4041 540 $ 1,200.00 404100103 ALS 1 NON-EMERGENCY 10.4041 540 $ 1,200.00 404100104 ALS 2 10.4041 540 $ 1,200.00 404100105 SPECIAL CARE TRANSPORT 10.4041 540 $ 1,200.00 404100106 MILEAGE - AMB 10.4041 540 $ 24.00 404200005 UNLISTED AIR AMBULANCE 10.4042 545 $ - 404200030 MILEAGE-UNLOADED 10.4042 542 $ 24.00 404200050 NIGHT CALL (7PM-7AM) 10.4042 545 $ 351.00 404200075 TRANSPORT ISOLETTE 10.4042 546 $ 388.00 404200305 UNLISTED - ROTARY 10.4042 542 $ - 404200310 LIFT OFF - ROTARY 10.4042 542 $ 8,100.00 404200335 MILEAGE - ROTARY 10.4042 542 $ 165.00 404200350 NIGHT (1900-0700)- ROTARY 10.4042 542 $ 404.00 404400010 UNLISTED AMBULANCE 10.4044 540 $ - 404400100 BLS EMERGENCY 10.4044 540 $ 1,200.00 404400101 BLS NON-EMERGENCY 10.4044 540 $ 1,200.00 404400102 ALS 1 EMERGENCY 10.4044 540 $ 1,200.00 404400103 ALS 1 NON-EMERGENCY 10.4044 540 $ 1,200.00 404400104 ALS 2 10.4044 540 $ 1,095.00 404400105 SPECIAL CARE TRANSPORT 10.4044 540 $ 1,095.00 404400106 MILEAGE - AMB 10.4044 540 $ 24.00 404500010 UNLISTED AMBULANCE 10.4045 540 $ - 404500100 BLS EMERGENCY 10.4045 540 $ 2,012.00 404500101 BLS NON-EMERGENCY 10.4045 540 $ 2,012.00 404500102 ALS 1 EMERGENCY 10.4045 540 $ 2,012.00 404500103 ALS 1 NON-EMERGENCY 10.4045 540 $ 2,012.00 404500104 ALS 2 10.4045 540 $ 2,012.00 404500105 SPECIAL CARE TRANSPORT 10.4045 540 $ 1,749.00 404500106 MILEAGE - AMB 10.4045 540 $ 40.00 408000091 TRAVEL - 15 MIN 10.4080 510 $ 28.75 408000095 AMB GLUCOSE MNTR SQ TO 72 HR 10.4080 510 $ 300.00 408000097 FITNESS EVENT - CLIENT 10.4080 510 $ 400.00 408010000 DIABETIC NURSE EDUCATION/CONSU 10.4080 942 $ - 408020052 DIAB SELF-MGMT TRAIN INIT 30 M 10.4080 942 $ 82.00 408020053 DIAB SELF-MGMT TRAIN 30 MIN 10.4080 942 $ 82.00 408020054 DIAB SELF-MGMT TRAIN ANN. 30 M 10.4080 942 $ 82.00 408020076 DIAB SELF-MGMT TRAIN INIT 30 M 10.4080 942 $ 48.10 408020079 DIAB SELF-MGNT TRAINING INTL 7 10.4080 942 $ 205.00 408020081 DIAB SELF-MGMT TRAIN 30 MIN 10.4080 942 $ 48.10 408020083 DIAB SELF-MGMT TRAIN INIT 135 10.4080 942 $ 369.00 408020084 DIAB SELF-MGMT TRAIN INIT 60 M 10.4080 942 $ 164.00 408020085 DIAB SELF-MGMT TRAIN INIT 90 M 10.4080 942 $ 246.00 408020086 DIAB SELF-MGMT TRAIN INT 120 M 10.4080 942 $ 328.00 408020087 DIAB SELF-MGMT TRAIN INT 150 M 10.4080 942 $ 410.00 408020088 DIAB SELF-MGMT TRAIN INT 180 M 10.4080 942 $ 492.00 408020089 DIAB SELF-MGMT TRAIN INT 105 M 10.4080 942 $ 287.00 408020090 DIAB SELF-MGMT TRAINING 105 MI 10.4080 942 $ 287.00 408020092 DIAB SELF-MGMT TRAINING 30 MIN 10.4080 942 $ 82.00 408020093 DIAB SELF-MGMT TRAINING 40 MIN 10.4080 942 $ 123.00 408020094 DIAB SELF-MGMT TRAINING 60 MIN 10.4080 942 $ 164.00 408020095 DIAB SELF-MGMT TRAINING 90 MIN 10.4080 942 $ 246.00 408020096 DIAB SELF-MGMT TRAINING 120 MI 10.4080 942 $ 328.00 408020097 DIAB SELF-MGMT TRAINING 150 MI 10.4080 942 $ 410.00 408020098 DIAB SELF-MGMT TRAINING 180 MI 10.4080 942 $ 492.00 408020099 DIAB SELF-MGMT TRAINING 75 MIN 10.4080 942 $ 205.00 408020135 DIAB SELF-MGMT TRAINING 135 MI 10.4080 942 $ 369.00 408020140 ADULT DSME INDIV EACH 15 MIN 10.4080 942 $ 41.00 408020145 ADULT DSME GRP 2-4 EACH 30 MIN 10.4080 942 $ 48.10 408020150 ADULT DSME GRP 5-8 EACH 30 MIN 10.4080 942 $ 48.10 408083036 HGB A1C 10.4080 301 $ 24.50 408090801 IP EDUCATION 1/1 EACH 15 MIN 10.4080 942 $ - 408090802 MED NUTR THERAPY INIT INDIV 15 10.4080 942 $ 31.20 408090803 MED NUTR THERAPY INIT F/U 15 M 10.4080 942 $ 31.20 408090804 MED NUTR THERAPY GROUP 30 MIN 10.4080 942 $ 49.40 408091802 MED NUTR THERAPY INIT INDIV 15 10.4080 982 $ 31.20 408091803 MED NUTR THERAPY INIT F/U 15 M 10.4080 982 $ 31.20 408091804 MED NUTR THERAPY GROUP 30 MIN 10.4080 982 $ 49.40 408099211 CLINIC VISIT 10.4080 761 $ 35.00 408099244 MED NUTR THERAPY-THERAPY/MOD 10.4080 942 $ 124.80 408099245 MED NUTR THERAPY-THERAPY/COM 10.4080 942 $ 156.00 408099270 MED NUTR THER REASSESS-IND 15 10.4080 982 $ 31.20 408099271 MED NUTR THER REASSESS-GRP 30 10.4080 982 $ 49.40 408150108 SS-H.ED 15 MINUTES RN 10.4080 942 $ 33.00 408150117 SS-INITIAL H. ED 30 MINUTES RN 10.4080 942 $ 70.00 408150141 SS-INT COMP NUT/PSY/H.ED 90 MI 10.4080 761 $ 191.00 408150158 SS-CLIENT ORIENT 15 MIN RN 10.4080 761 $ 33.00 408150166 SS-INT H.ED ASSESS 15 MIN RN 10.4080 761 $ 35.00 408150174 SS-POSTPART H.ED 15 MIN RN 10.4080 761 $ 33.00 408150175 SS-POSTPART H.ED 30 MIN RN 10.4080 761 $ 66.00 408150176 SS-POSTPART H.ED 45 MIN RN 10.4080 761 $ 99.00 408150177 SS-POSTPART H.ED 60 MIN RN 10.4080 761 $ 132.00 408150209 SS-LIM FU 15 MIN RD 10.4080 761 $ 33.00 408150217 SS-INITIAL NUTR 30 MIN 10.4080 761 $ 70.00 408150273 SS-INIT NUTR ASSESS 15 MIN RD 10.4080 761 $ 35.00 408150281 SS-POSTPART NUTR 15 MIN RD 10.4080 761 $ 33.00 408150308 SS-LIM FU 15 MIN MSW 10.4080 761 $ 33.00 408150316 SS-INITIAL PSYSOC 30 MIN MSW 10.4080 761 $ 70.00 408150356 SS-INIT PSYSOC ASSESS 15 MIN M 10.4080 761 $ 35.00 408150372 SS-POSTPART PSYSOC 15 MIN MSW 10.4080 761 $ 33.00 408150400 SS-PERINATAL EDUC. IND 10.4080 761 $ 33.00 408150406 SS-PRENATAL VITAMINS 300 10.4080 250 $ 45.00 408150710 SS-INT H.ED ASSESS 45 MIN RN 10.4080 761 $ 105.00 408150712 SS-INT H.ED ASSESS 60 MIN RN 10.4080 761 $ 140.00 408150714 SS-INT H.ED ASSESS 75 MIN RN 10.4080 761 $ 175.00 408150716 SS-INT H.ED ASSESS 90 MIN RN 10.4080 761 $ 210.00 408150718 SS-H.ED 30 MIN RN 10.4080 761 $ 66.00 408150720 SS-H.ED 45 MIN RN 10.4080 761 $ 99.00 408150722 SS-H.ED 60 MIN RN 10.4080 761 $ 132.00 408150724 SS-H.ED 75 MIN RN 10.4080 761 $ 165.00 408150726 SS-H.ED 90 MIN RN 10.4080 761 $ 198.00 409507420 ORTHO CAST/SPLINT SIMPLE 10.4095 360 $ 151.00 409507440 ORTHO CAST/SPLINT COMPLEX 10.4095 360 $ 332.00 409599202 ORTHOPEDIC VISIT SIMPLE-NEW PT 10.4095 761 $ 79.00 409599203 ORTHOPED VISIT EXTEND-NEW PT 10.4095 761 $ 94.00 409599212 ORTHOPEDIC VISIT SIMPLE-EST PT 10.4095 761 $ 55.00 409599213 ORTHOPED VISIT EXTEND-EST PT 10.4095 761 $ 67.00 417098865 PREMPRO 0.625-5MG TABLET 10.4710 637 $ - 418000060 ACETAMINAPHEN SUPPOSITORY 120M 10.4180 637 $ 3.00 418000061 EMLA CREAM 10.4180 637 $ 12.00 418000062 PREDNISOLONE-PRELONE 10.4180 637 $ 3.00 418000063 ALBUTEROL SYRUP 10.4180 637 $ 3.00 418000065 IBUPORPHEN LIQUID 10.4180 637 $ 3.00 418000066 PREDNISOLONE-ORAPRED 10.4180 637 $ 3.00 418000067 PREDNISOLONE-PEDIPRED 10.4180 637 $ 3.00 418000068 ACETAMINAPHEN LIQUID 10.4180 637 $ 3.00 418000070 L.A.BACILLIN 10.4180 637 $ 33.00 418000071 XOPENEX INHALED 10.4180 637 $ 7.00 418000072 LIDOCAINE 1% 10.4180 250 $ 3.00 418000073 SILVADENE CREAM 10.4180 637 $ 3.00 418000074 ANTIPYRINE/BENZOCAINE OTIC SOL 10.4180 637 $ 3.00 418000075 SILVER NITRATE STICK 10.4180 637 $ 4.00 418000076 IRON DEXTRAN 50MG/ML 10.4180 636 $ 55.00 418000077 DEPO MEDROL 80MG/ML 10.4180 636 $ 17.00 418000078 ACETAMINAPHEN SUPPOSITORY 325M 10.4180 637 $ 3.00 418000079 PHENERGAN SUPPOSITORY 25MG 10.4180 637 $ 7.00 418000080 LIQUID NITROGEN 10.4180 250 $ 22.00 418000085 EDC TRAY 10.4180 272 $ 32.00 418000090 BIOPSY TRAY 10.4180 272 $ 36.00 418005400 BENEDRYL ELIXIR 10.4180 637 $ 3.00 418005430 BENEDRYL INJ 50MG/ML 10.4180 636 $ 21.00 418010000 FACILITY FEE 10.4180 510 $ 38.00 418010250 EARLY/PERIODIC SCR DIAG TX 1 1 10.4180 984 $ 145.00 418011040 DEBRIDEMENT SKIN PART. THICKNE 10.4180 983 $ 55.00 418011246 FAMILY PLANNING (99384) 10.4180 515 $ 22.00 418012001 SUTURED LACERATION 10.4180 515 $ 135.00 418012246 FAMILY PLANNING (99394) 10.4180 515 $ 22.00 418014040 PHENERGAN SUPPOSITORY 12.5MG 10.4180 637 $ 7.00 418019381 CHDP INFANT <1YR NEW PT-PANEL 10.4180 515 $ 128.00 418019382 CHDP CHILD 1-4 NEW PT-PANEL 10.4180 515 $ 133.00 418019383 CHDP CHILD 5-11 NEW PT-PANEL 10.4180 515 $ 137.00 418019384 CHDP ADOL 12-17 NEW PT-PANEL 10.4180 515 $ 154.00 418019391 CHDP INFANT <1YR EST PT-PANEL 10.4180 515 $ 110.00 418019392 CHDP CHILD 1-4 EST PT-PANEL 10.4180 515 $ 110.00 418019393 CHDP CHILD 5-11 EST PT-PANEL 10.4180 515 $ 122.00 418019394 CHDP 12-17 YRS EST PT-PANEL 10.4180 515 $ 130.00 418019701 DPT VACCINATION 10.4180 636 $ 25.00 418019702 DT VACCINATION 10.4180 636 $ 25.00 418019707 MMR VACCINATION 10.4180 636 $ 63.00 418019710 PREVNAR VACCINATION NON-VFC 10.4180 636 $ 134.00 418019712 OPV VACCINATION 10.4180 636 $ 25.00 418019713 IPV VACCINATION 10.4180 636 $ 39.00 418019716 VARICELLA NON-VFC 10.4180 636 $ 84.00 418019718 TD 10.4180 636 $ 25.00 418019720 TETRAMUNE VACCINATION 10.4180 636 $ 25.00 418019724 FLU VACCINE 6-35 MONTHS 10.4180 636 $ 25.00 418019744 HEP B 0-11 YRS 10.4180 636 $ 25.00 418019745 HEP B 11-19 YRS 10.4180 636 $ 25.00 418019747 HIB TITER VACCINATION 10.4180 636 $ 35.00 418019748 HEP B/HIB NON-VFC 10.4180 636 $ 69.00 418019749 DTAP VACCINATION 10.4180 636 $ 25.00 418020043 ARMSLING 10.4180 271 $ 19.00 418020053 SPLINT FINGER 10.4180 271 $ 4.00 418020055 DRESSING CHANGE 10.4180 272 $ 14.00 418029381 CHDP INFANT <1YR NEW PT 10.4180 515 $ 90.00 418029382 CHDP EARLY CHILD 1-4 NEW PT 10.4180 515 $ 95.00 418029383 CHDP LATE CHILD 5-11 NEW PT 10.4180 515 $ 99.00 418029384 CHDP ADOL 12-17 NEW PT 10.4180 515 $ 116.00 418029391 CHDP INFANT <1YR EST PT 10.4180 515 $ 72.00 418029392 CHDP EARLY CHILD 1-4 EST PT 10.4180 515 $ 72.00 418029393 CHDP LATE CHILD 5-11 EST PT 10.4180 515 $ 84.00 418029394 CHDP ADOL 12-17YRS EST PT 10.4180 515 $ 92.00 418029701 DPT VACCINATION VFC 10.4180 636 $ 25.00 418029707 MMR VACCINATION VFC 10.4180 636 $ 25.00 418029710 PREVNAR VACCINATION VFC 10.4180 636 $ 25.00 418029712 OPV VACCINATION VFC 10.4180 636 $ 25.00 418029713 IPV VACCINATION VFC 10.4180 636 $ 25.00 418029714 HUMAN PAPILLOMAVIRUS VZ VFC 10.4180 250 $ 25.00 418029715 ROTAVIRUS VFC 10.4180 250 $ 25.00 418029716 VARICELLA VFC 10.4180 636 $ 25.00 418029720 TETRAMUNE VACCINATION VFC 10.4180 636 $ 25.00 418029724 FLU VACCINE VFC 10.4180 636 $ 25.00 418029730 FLUMIST VFC 10.4180 250 $ 9.00 418029732 MCV4-MENACTA VFC 10.4180 250 $ 9.00 418029734 TDAP VFC 10.4180 250 $ 9.00 418029736 MMRV VFC 10.4180 250 $ 9.00 418029744 HEP B 0-11 YRS VFC 10.4180 636 $ 25.00 418029745 HEP B 11-19 YRS VFC 10.4180 636 $ 25.00 418029747 HIB TITER VACCINATION VFC 10.4180 636 $ 25.00 418029748 HEP B/HIB VFC 10.4180 636 $ 25.00 418029749 DTAP VACCINATION VFC 10.4180 636 $ 25.00 418029921 EXAM/TX ROOM-BRIEF 10.4180 515 $ 35.00 418030009 BANDAGE ACE 10.4180 271 $ 7.00 418030013 SUTURE REMOVAL TRAY 10.4180 272 $ 41.00 418030029 SYRINGE BULB EAR 10.4180 272 $ 8.00 418030100 HYDROGEN PEROXIDE 10.4180 637 $ 3.00 418030107 URINARY CATHETERIZATION KIT 10.4180 272 $ 6.00 418030122 TRANSPARENT DRESSING 10.4180 272 $ 6.00 418030151 STERI STRIPS 10.4180 272 $ 9.00 418037500 EARLY/PERIODIC SCR DIAG TX 1/2 10.4180 984 $ 53.00 418040500 NEBULIZER KIT 10.4180 270 $ - 418040501 TRAY BURN 10.4180 272 $ 19.00 418060030 SPORT/CAMP PHYSICAL 10.4180 515 $ 22.00 418065000 EARLY/PERIODIC SCR DIAG TX 1 H 10.4180 984 $ 92.00 418069210 EAR IRRIGATION 10.4180 515 $ 78.00 418070038 PEDI-U BAG 10.4180 515 $ 12.00 418079246 FAMILY PLANNING (99204) 10.4180 515 $ 22.00 418080311 INITIAL LACTATION CONSULT-CCC 10.4180 515 $ 27.00 418080315 FOLLOW-IP LACTATION CONSULT-CC 10.4180 515 $ 27.00 418081000 UA 10.4180 300 $ 15.00 418082270 OCCULT BLOOD 10.4180 300 $ 19.00 418083655 SPECIMEN COLLECTION FOR LEAD T 10.4180 300 $ 28.00 418085018 HGB 10.4180 300 $ 18.00 418086580 PPD 10.4180 300 $ 29.00 418086585 TINE 10.4180 302 $ 22.00 418086588 QUICK STREP 10.4180 300 $ 37.00 418090001 OFFICE VISIT MINIMAL-NEW-CCC 10.4180 515 $ 27.00 418090002 OFFICE VISIT PROB FOCUSED NEW- 10.4180 515 $ 64.00 418090003 OFFICE VISIT EXP PROBLEM NEW-C 10.4180 515 $ 96.00 418090004 OFFICE VISIT INTERMED NEW-CCC 10.4180 515 $ 142.00 418090011 OFFICE VISIT MINIMAL EST-CCC 10.4180 515 $ 16.00 418090012 OFFICE VISIT PROB FOCUSED EST- 10.4180 515 $ 41.00 418090013 OFFICE VISIT EXP PROBLEM EST-C 10.4180 515 $ 47.00 418090014 OFFICE VISIT INTERMED EST-CCC 10.4180 515 $ 69.00 418090015 OFFICE VISIT EXTENSIVE EST-CCC 10.4180 515 $ 134.00 418090041 CONSULT-PROBLEM FOCUSED-CCC 10.4180 515 $ 75.00 418090043 CONSULTATIONS DETAILED-CCC 10.4180 515 $ 154.00 418090044 CONSULT-COMPREHENSIVE-CCC 10.4180 515 $ 226.00 418090201 OFFICE VISIT MIN NEW-PANEL 10.4180 510 $ 66.00 418090202 OFF VST PROB FOCUSED NEW-PANEL 10.4180 510 $ 103.00 418090203 OFF VST EXP PROBLEM NEW-PANEL 10.4180 510 $ 135.00 418090204 OFF VST INTERMED NEW-PANEL 10.4180 510 $ 181.00 418090211 OFFICE VISIT MIN EST-PANEL 10.4180 510 $ 55.00 418090212 OFF VST PROB FOC EST-PANEL 10.4180 510 $ 80.00 418090213 OFF VST EXP PROB EST-PANEL 10.4180 510 $ 86.00 418090214 OFF VST INTERMED EST-PANEL 10.4180 510 $ 108.00 418090215 OFF VST EXTENSIVE EST-PANEL 10.4180 510 $ 173.00 418090241 CONSULT - PROBLFOC-PANEL 10.4180 510 $ 114.00 418090243 CONSULTATIONS DETAILED-PANEL 10.4180 510 $ 193.00 418090244 CONSULT - COMPREHENSIVE-PANEL 10.4180 510 $ 265.00 418090311 INITIAL LACTATION CONS-PANEL 10.4180 510 $ 66.00 418090315 FOLLOW-UP LACTATION CONS-PANEL 10.4180 510 $ 66.00 418090471 ADMIN OF 1 OR COMBO VACCINATIO 10.4180 636 $ 14.00 418090472 ADMIN OF ADDITIONAL VACCINATIO 10.4180 636 $ 14.00 418090660 FLUMIST NON-VFC 10.4180 250 $ - 418090698 TDAP NON-VFC 10.4180 636 $ 57.00 418090710 MMRV NON-VFC 10.4180 636 $ 59.50 418090730 HEPATITIS A VACCINE VFC 10.4180 250 $ 25.00 418090731 HEP A NON-VFC 10.4180 636 $ 84.00 418090733 MCV4-MENACTA NON-VFC 10.4180 636 $ 80.00 418090810 INTERACTIVE PSYCHOTHERAPY 30 M 10.4180 984 $ 75.00 418090812 INTERACTIVE PSYCHOTHERAPY 50 M 10.4180 984 $ 107.00 418091015 PEAK FLOW METER 10.4180 460 $ 43.00 418091999 ALBUTEROL INHALED 10.4180 637 $ 6.00 418092081 VISION SCREENING 10.4180 920 $ 29.00 418092551 AUDIO SCREEN 10.4180 471 $ 36.00 418092567 TYMPANOGRAM 10.4180 471 $ 36.00 418094060 SPIROMETRY 10.4180 515 $ 58.00 418094150 SPIROMETRY, VITAL CAPACITY TOT 10.4180 515 $ 7.00 418094640 NEBULIZED TREATMENT 10.4180 410 $ - 418095115 ALLERGEN IMMUNOTHERAPY 10.4180 515 $ 64.00 418096110 DEVELOP TEST 10.4180 440 $ 64.00 418099001 CLINIC ROOM 10.4180 510 $ 41.00 418099201 OFFICE VISIT MINIMAL NEW 10.4180 515 $ 39.00 418099202 OFFICE VISIT PROB FOCUSED NEW 10.4180 515 $ 39.00 418099203 OFFICE VISIT EXP PROBLEM NEW 10.4180 515 $ 39.00 418099204 OFFICE VISIT INTERMEDIATE NEW 10.4180 515 $ 39.00 418099205 OFFICE VISIT INTERMEDIATE NEW 10.4180 515 $ 39.00 418099211 OFFICE VISIT MINIMAL EST 10.4180 515 $ 39.00 418099212 OFFICE VISIT PROB FOCUSED EST 10.4180 515 $ 39.00 418099213 OFFICE VISIT EXP PROBLEM EST 10.4180 515 $ 39.00 418099214 OFFICE VISIT INTERMEDIATE EST 10.4180 515 $ 39.00 418099215 OFFICE VISIT EXTENSIVE EST 10.4180 515 $ 39.00 418099241 CONSULT - PROBLEM FOCUSED 10.4180 515 $ 39.00 418099242 OFFICE CONSLT PROB FOCUSED ST 10.4180 515 $ 56.00 418099243 CONSULTATIONS DETAILED 10.4180 515 $ 39.00 418099244 CONSULT - COMPREHENSIVE 10.4180 515 $ 39.00 418099245 OFFICE CONSLT COMP COMP HIGH 10.4180 515 $ 86.00 418099311 INITIAL LACTATION CONSULTATION 10.4180 515 $ 39.00 418099315 FOLLOW-UP LACTATION CONSULTATI 10.4180 515 $ 39.00 418099354 PROLONGED PHYSICIAN-SERVICE 10.4180 515 $ 56.00 418099355 PROLONGED PHYSICIAN SERVICE 10.4180 515 $ 28.00 418099363 TERBUTALINE-BREATHINE 1MG/ML 10.4180 636 $ 26.00 418099381 PHYSICAL INFANT < 1YR NEW 10.4180 515 $ 124.00 418099382 PHYSICAL CHILD 1-4 YRS NEW 10.4180 515 $ 130.00 418099383 PHYSICAL CHILD 5-11 YRS NEW 10.4180 515 $ 134.00 418099384 PHYSICAL ADOLESCENT > 12 NEW 10.4180 515 $ 151.00 418099391 PHYSICAL INFANT < 1YR EST 10.4180 515 $ 107.00 418099392 PHYSICAL CHILD 1-4 YRS EST 10.4180 515 $ 107.00 418099393 PHYSICAL CHILD 5-11 YRS EST 10.4180 515 $ 118.00 418099394 PHYSICAL ADOLESCENT > 12 EST 10.4180 515 $ 128.00 418099608 DECARDRON INJ 4MG/ML 10.4180 636 $ 19.00 418099630 IMMUNE GLOBULIN 2ML 10.4180 636 $ 62.00 418099635 EPINEPHRINE 1-1000 1MG/ML 10.4180 636 $ 19.00 418099640 SUSPHRINE SUSPENSION 1-200/.3M 10.4180 636 $ 29.00 418099650 ROCEPHINE INJ 250MG/ML 10.4180 636 $ 54.00 418100001 MISCELLANEOUS ITEM 10.4181 983 $ - 418100003 STERILE BASIN 10.4181 983 $ 8.00 418100021 SUTURE TRAY 10.4181 272 $ 19.00 418100359 CRUTCHES 10.4181 983 $ 95.00 418100419 EAR TRAY 10.4181 272 $ 58.00 418100435 EYE TRAY 10.4181 272 $ 58.00 418100566 M-M-R II VACCINE 10.4181 250 $ 103.00 418100610 MEDICARE INIT PREVENT EXAM 10.4181 983 $ 200.00 418101224 CYANOCOBALAMIN 1000MCG INJ 1ML 10.4181 636 $ 34.50 418101237 VALIUM 10MG/2ML SYRINGE 10.4181 636 $ 45.00 418101238 NALOXONE 0.4MG/ML INJ 10.4181 250 $ 41.50 418101317 HEPATITIS B VACCINE PEDIATRIC 10.4181 636 $ 50.50 418101553 TETANUS/DIPHTHER TOX ADUL .5ML 10.4181 636 $ 20.00 418102790 CEFAZOLIN 1GM INJ 10.4181 636 $ 70.50 418103060 CEFTRIAXONE 1GM INJ 10.4181 636 $ 266.00 418103070 CEFTRIAXONE 250MG INJ 10.4181 636 $ 99.00 418103075 CEFTRIAXONE 500MG INJ 10.4181 636 $ 179.50 418103265 CHICKEN POX VACC INJ 10.4181 250 $ 86.00 418104204 DRESSINGS 10.4181 272 $ 47.00 418104450 VITAMIN B 12 INJ (CYANOCO) 10.4181 250 $ 30.00 418104940 DEXAMETHASONE 4MG/ML INJ 10.4181 636 $ 41.50 418104980 DEXTROSE 50% SYRG 50ML 10.4181 250 $ 45.00 418105430 DIPHENHYDRAMINE 50MG INJ 10.4181 636 $ 41.50 418106220 EPINEPHRINE 1MG/ML INJ 10.4181 636 $ 10.00 418106560 ESTRADIOL VALERATE 10MG 10.4181 250 $ 75.00 418107187 CASE MANAGEMENT / BCEDP 10.4181 983 $ 35.00 418107500 FACILITY FEE 10.4181 983 $ 41.00 418107805 HEPATITIS A VACC PED 0.5ML 10.4181 250 $ 11.00 418107806 HEPATITIS A VACC ADULT 1ML 10.4181 250 $ 49.50 418107810 HEPATITIS B IMMUNE GLOBULIN 10.4181 636 $ 59.00 418108270 VISTARIL 50MG INJ 10.4181 636 $ 31.25 418108465 INFLUENZA VACCINE > 3 YRS 10.4181 636 $ 18.00 418109007 KETOROLAC 60MG INJ 10.4181 636 $ 88.00 418109963 DEP-PROVERA 150MG 10.4181 636 $ 296.00 418109993 MENINGOCOCAL VACCINE 10.4181 250 $ 80.00 418110002 ANTI-COAG CLINIC VISIT 10.4181 983 $ 35.00 418110006 CHDP COMPREHENSIVE EXAM 12-20 10.4181 983 $ 90.00 418110010 ANTI-COAG INITIAL VISIT 10.4181 983 $ 66.00 418110014 CHDP COMPREHENSIVE EXAM 5-11 10.4181 983 $ 79.00 418110022 CHDP COMPREHENSIVE EXAM 1-4 10.4181 983 $ 75.00 418110030 CHDP COMPREHENSIVE EXAM 0-11MO 10.4181 983 $ 70.00 418110054 CHDP ROUTINE EXAM 12-20 YRS 10.4181 983 $ 64.00 418110055 CHDP ROUTINE VISIT AGE 5-11 10.4181 983 $ 67.00 418110060 I&D ABSCESS 10.4181 983 $ 120.00 418110063 CHDP ROUTINE VISIT AGE 1-4 10.4181 983 $ 63.00 418110071 CHDP ROUTINE VISIT 0-11 MONTHS 10.4181 983 $ 58.00 418110080 INCISION DRAINAGE PILONIDAL CY 10.4181 983 $ 77.00 418110089 CHDP SNELLEN EYE TEST AGE 7& 10.4181 983 $ 2.00 418110097 CHDP SNELLEN EYE TEST 3-6 10.4181 983 $ 8.00 418110105 CHDP AUDIOMETRIC TEST 10.4181 983 $ 17.00 418110121 CHDP TB-MANTOUX TEST 10.4181 983 $ 14.00 418110139 CHDP HEMOGLOBIN OR HEMATOCRIT 10.4181 983 $ 6.00 418110147 CHDP URINE DIPSTICK 10.4181 983 $ 4.00 418110188 CHDP G C CULTURE 10.4181 983 $ 13.00 418110196 CHDP PAP SMEAR 10.4181 983 $ 21.00 418110204 CHDP PKU TEST 10.4181 983 $ 9.00 418110212 CHDP URINALYSIS 10.4181 983 $ 8.00 418110220 CHDP IMMUNIZATION POLIO/TORP 10.4181 983 $ 14.00 418110238 CHDP IMMUNIZATION DPT 10.4181 983 $ 14.00 418110246 CHDP IMMUNIZATION MMR 10.4181 983 $ 14.00 418110252 WIC ELIGIBILITY 10.4181 983 $ 9.00 418110253 CHDP IMMUNIZATION HIB 10.4181 983 $ 14.00 418110390 INJECTION IM/SQ 10.4181 510 $ 18.00 418110570 DEPO MEDROL 80MG INJ 10.4181 636 $ 135.00 418110600 METHYLPRED SUCC 40MG INJ 10.4181 636 $ 45.00 418111000 DEBRIDEMENT OF SKIN 10.4181 983 $ 35.00 418111050 CAUTERIZATION 10.4181 983 $ 69.00 418111100 SKIN BIOP/SUBQ/MUCUS MEM SING 10.4181 983 $ 118.00 418111101 BIOPSY LESION, EACH ADDITIONAL 10.4181 983 $ 28.00 418111200 REMOVAL OF SKIN TAGS 10.4181 983 $ 95.00 418111300 SHAVING LESION 0.5CM OR LESS 10.4181 983 $ 67.00 418111301 SHAVING LESION 0.6-1.0CM 10.4181 983 $ 131.00 418111302 SHAVING LESION 1.1-2.0CM 10.4181 983 $ 166.00 418111303 SHAVING LESION OVER 2.0CM 10.4181 983 $ 229.00 418111400 EXCISION BENIGN LESION 0.5CM-< 10.4181 983 $ 118.00 418111401 EXCISION BENIGN LESION 0.6CM-1 10.4181 983 $ 164.00 418111402 EX BENIGN LES 1.1-2.0CM 10.4181 983 $ 208.00 418111403 EXCISION BENIGN LESION 2.1-3CM 10.4181 983 $ 260.00 418111404 EX BENIGN LES 3.1-4.0CM 10.4181 983 $ 304.00 418111406 EXCISION BENIGN LESION OVER 4 10.4181 983 $ 400.00 418111420 EX BENIGN LES 0.5CM 10.4181 983 $ 139.00 418111600 EX. MALIGNANT LESION 0.5CM OR< 10.4181 983 $ 215.00 418111601 EX. MALIGNANT LESION 0.6-1.0CM 10.4181 983 $ 278.00 418111602 EX. MALIGNANT LESION 1.1-2.0CM 10.4181 983 $ 333.00 418111603 EX. MALIGNANT LESION 2.1-3.0CM 10.4181 983 $ 395.00 418111604 EX. MALIGNANT LESION 3.1-4.0CM 10.4181 983 $ 444.00 418111606 EX. MALIGNANT LESION 4.1CM OR> 10.4181 983 $ 570.00 418111720 NAIL TRIM OR DEBRIDEMENT 10.4181 983 $ 46.00 418111730 NAIL AVULS. 1ST PLATE 10.4181 983 $ 153.00 418111731 NAIL AVULS. 2ND PLATE 10.4181 983 $ 92.00 418111732 NAIL AVULS. 3RD PLATE 10.4181 983 $ 69.00 418111750 EXCISION OF NAIL 10.4181 983 $ 329.00 418111975 NORPLANT INSERTION 10.4181 983 $ 551.00 418111976 NORPLANT REMOVAL 10.4181 983 $ 224.00 418112001 LACERATION SIMPLE TO 2.5CM 10.4181 983 $ 107.00 418112002 LACERATION SIMPLE 2.6-7.5 10.4181 983 $ 116.00 418112570 PEN G/BENZATHINE 1200MU INJ 10.4181 636 $ 51.00 418112640 BICILLIN CR 1200MU/2ML INJ 10.4181 636 $ 56.00 418113380 PHEUMOCOCCAL INJECTION 10.4181 983 $ 23.00 418113384 POLIO INJ VACC. 0.5ML 10.4181 250 $ 35.00 418114050 PROMETHAZINE 25MG INJ 10.4181 636 $ 45.00 418114080 PROMETHAZINE 50MG INJ 10.4181 636 $ 45.00 418115040 PROMETHAZINE 25MG INJ 10.4710 636 $ 45.00 418115534 IMITREX 10.4181 250 $ 152.00 418115890 TETANUS IMMUNE GLOB. 250 UNIT 10.4181 636 $ 249.50 418116000 BURN 1ST DEGREE (SMALL) 10.4181 983 $ 96.00 418116020 DEBRIDE AND/OR DRESS BURN 10.4181 983 $ 77.00 418116025 BURN(MEDIUM) DRESSING OR DEBRI 10.4181 983 $ 174.00 418116030 BURN(LARGE) DRESSING OR DEBRID 10.4181 983 $ 216.00 418116760 KENALOG 40MG/ML INJ (TAC) 10.4181 636 $ 67.50 418117000 DESTR. BENIGN LESION - SINGLE 10.4181 983 $ 122.00 418117001 DESTR. 2ND & 3RD FACE 10.4181 983 $ 70.00 418117002 DESTR. OVER 3 FACE 10.4181 983 $ 35.00 418117003 DESTR. BENIGN LESION - 2 TO 14 10.4181 983 $ 17.00 418117100 CRYO DESTRO NON FACE 10.4181 983 $ 70.00 418117101 CRYO DESTR 2ND LES. 10.4181 983 $ 51.00 418117102 CRYO DEST. TO 15 10.4181 983 $ 17.00 418117104 CRYO DEST. NON FACE OVER 15 10.4181 983 $ 244.00 418117110 DESTR. WART OR MOLLUSCUM 10.4181 983 $ 122.00 418117111 DESTR. WART/MOLLUSCUM 15+ 10.4181 983 $ 171.00 418119710 CHDP PREVNAR VACCINATION 10.4181 636 $ 14.00 418119712 CHDP HEP B VACCINE, PRE. EX 10.4181 250 $ 14.00 418119716 CHDP VARICELLA NON-VFC 10.4181 636 $ 14.00 418119747 HIB TITER VACCINATION 10.4181 636 $ 35.00 418120550 INJECTION TRIGGER POINT 10.4181 983 $ 83.00 418120600 ASP./INJ SMALL JOINT 10.4181 983 $ 95.00 418120605 ASP./INJ INTERMEDIATE JOINT 10.4181 983 $ 110.00 418120610 ASP./INJ MAJOR JOINT 10.4181 983 $ 119.00 418124640 REDUCT SUBLX RADIAL HEAD/CHILD 10.4181 983 $ 72.00 418128490 FRACTURE GREAT TOE 10.4181 983 $ 119.00 418129105 SPLINT LONG ARM 10.4181 983 $ 119.00 418129125 SPLINT SHORT ARM 10.4181 983 $ 105.00 418129130 APPLICATION OF FINGER SPLINT 10.4181 983 $ 28.00 418129381 CHDP INFANT <1YR NEW PT 10.4181 983 $ 90.00 418129382 CHDP CHILD 1-4 NEW PT 10.4181 983 $ 95.00 418129383 CHDP CHILD 5-11 NEW PT 10.4181 983 $ 99.00 418129384 CHDP ADOL 12-17 NEW PT 10.4181 983 $ 116.00 418129391 CHDP INFANT<1YR EST PT 10.4181 983 $ 72.00 418129392 CHDP CHILD 1-4 EST PT 10.4181 983 $ 72.00 418129393 CHDP CHILD 5-11 EST PT 10.4181 983 $ 84.00 418129394 CHDP ADOL 12-17YRS EST PT 10.4181 983 $ 92.00 418129505 SPLINT LONG LEG 10.4181 983 $ 162.00 418129515 SPLINT SHORT LEG 10.4181 983 $ 122.00 418129700 CAST REMOVAL 10.4181 983 $ 54.00 418129710 PREVNAR VACCINATION VFC 10.4181 636 $ 107.80 418129716 VARICELLA VFC 10.4181 636 $ 93.00 418129747 HIB TITER VACCINATION VFC 10.4181 636 $ 25.00 418130300 FOREIGN BODY REMOVAL-NOSE 10.4181 983 $ 62.00 418130349 OXYGEN 10.4181 272 $ 48.00 418130901 NOSE CAUTERIZE 10.4181 983 $ 141.00 418130905 EPISTAXIS-POSTERIOR 10.4181 983 $ 118.00 418136000 IV START 10.4181 983 $ 55.00 418136415 BLOOD DRAW 10.4181 983 $ 15.00 418142930 PREGNANCY TEST URINE 10.4181 983 $ 54.00 418153085 CONVENIENCE VISIT 10.4181 983 $ 58.00 418154184 IV TRAY 10.4181 272 $ 58.00 418154390 LACERATION TRAY 10.4181 272 $ 112.00 418155440 CRASH CART 10.4181 272 $ 479.00 418155502 STERILE INSTRUMENT 10.4181 983 $ 17.00 418156420 I&D BARTHOLINS CYST 10.4181 983 $ 185.00 418156605 BIOPSY VULVA 10.4181 983 $ 155.00 418157160 INSERTION PESSARY 10.4181 983 $ 95.00 418157170 DIAPHRAGM FIT/INSTRU. 10.4181 983 $ 109.00 418157452 COLPOSCOPY 10.4181 983 $ 166.00 418157454 COLPOSCOPY W/BIOPSY 10.4181 983 $ 228.00 418157500 BIOPSY CERVIX 10.4181 983 $ 120.00 418157511 CRYO. CAUNT. CERV. BENIGN 10.4181 983 $ 230.00 418158100 ENDROMETRIAL BIOPSY 10.4181 983 $ 136.00 418160010 DMV PHYSICAL (18-39) 10.4181 983 $ 68.00 418160012 DMV PHYSICAL (40-64) 10.4181 983 $ 68.00 418160030 SPORT/CAMP PHYSICAL 10.4181 983 $ 28.00 418160160 5% DEXTROSE 50ML 10.4181 636 $ 44.50 418160480 LACTATED RINGERS 1000ML 10.4181 636 $ 90.00 418160550 NACL 0.9% 1000ML 10.4181 636 $ 90.00 418164450 NERVE BLOCK DIGITAL 10.4181 983 $ 141.00 418165205 F.B. REMOVAL-SCLERAL/CONJ SUPE 10.4181 983 $ 42.00 418165220 F.B. REMOVAL-SCLERAL/CONJUNCTI 10.4181 983 $ 47.00 418166020 LIDOCAINE (XYLOCAINE) 10.4181 983 $ 25.00 418168250 BREAST SMEAR CYTOLOGY 10.4181 983 $ 23.00 418168280 FINE NEEDLE ASPIRATION CYTOLOG 10.4181 983 $ 30.00 418168290 MISCELLANEOUS FLUID CYTOLOGY 10.4181 983 $ 26.00 418168300 MISCELLANEOUS SMEAR CYTOLOGY 10.4181 983 $ 14.00 418169200 FOREIGN BODY REM.-EAR 10.4181 983 $ 61.00 418169210 IMPACTED CERUMEN ONE OR BOTH 10.4181 983 $ 86.00 418170090 OCCULT BLOOD. 10.4181 983 $ 6.00 418170093 OCCULT BLOOD X2 10.4181 983 $ 12.00 418170094 OCCULT BLOOD X3 10.4181 983 $ 2.00 418170105 PARASITE IDENTIFICATION 10.4181 983 $ 4.00 418170110 PINWORM PREPARATION 10.4181 983 $ 6.00 418170115 CRYPROSPORIDIUM EXAM 10.4181 983 $ 13.00 418170175 SPERM COUNT 10.4181 983 $ 9.00 418170303 PELVIC SETUP 10.4181 983 $ 58.00 418179201 NEW PATIENT BRIEF (AC) 10.4181 983 $ 85.00 418179202 NEW PATIENT LIMITED (AC) 10.4181 983 $ 105.00 418179203 NEW PATIENT INTERMEDIATE (AC) 10.4181 983 $ 136.00 418179204 NEW PATIENT EXTENDED (AC) 10.4181 983 $ 200.00 418179205 NEW PATIENT COMPREHENSIVE (AC) 10.4181 983 $ 264.00 418179211 ESTAB/BRIEF (AC) 10.4181 983 $ 57.00 418179212 ESTAB/LIMITED (AC) 10.4181 983 $ 81.00 418179213 ESTAB/INTERMEDIATE (AC) 10.4181 983 $ 100.00 418179214 ESTAB/EXTENDED (AC) 10.4181 983 $ 132.00 418179215 ESTAB/COMPREHENSIVE (AC) 10.4181 983 $ 188.00 418180100 DRUG SCREEN 10.4181 983 $ 96.00 418181002 URINE DIPSTICK 10.4181 983 $ 19.00 418181025 PREGNANCY TEST 10.4181 983 $ 95.00 418182270 OCCULT BLOOD 10.4181 983 $ 21.00 418185018 HEMOGLOBIN 10.4181 983 $ 12.00 418186510 PROTIME 10.4181 305 $ 24.50 418186580 PPD 10.4181 983 $ 10.00 418186588 RAPID STREP 10.4181 300 $ 35.00 418187081 RAPID STREP TEST 10.4181 983 $ 99.00 418187205 WET MOUNT 10.4181 983 $ 33.00 418187210 WET MOUNT-KOH 10.4181 983 $ 33.00 418190493 PRE OP H&P 10.4181 983 $ 270.00 418190501 SCHOOL SPORTS PHYSICAL 10.4181 983 $ 47.00 418190505 PHYSICAL OTHER 10.4181 983 $ 183.00 418190701 DTP AGES 0-19 10.4181 983 $ 15.00 418190707 MMR AGES 0-19 10.4181 983 $ 59.50 418190710 CHDP DPT/HIB 10.4181 983 $ 14.00 418190712 POLIO VACCINE AGES 0-19 10.4181 983 $ 15.00 418190718 TD AGES 0-19 10.4181 983 $ 15.00 418190728 PPD TUBERLCULIN 10.4181 983 $ 10.00 418190730 CHDP HEP A NON-VFC 10.4181 636 $ 14.00 418190731 CHDP HEP B VACCINE, PRE. EX 10.4181 983 $ 14.00 418190732 CHDP HEP B VACCINE, POST EX. 10.4181 983 $ 14.00 418190749 ADMIN. OF MEDS 10.4181 983 $ 36.00 418190780 IV THERAPY 1ST HOUR 10.4181 260 $ 261.00 418192552 AUDIOMETER TEST 10.4181 471 $ 33.00 418193000 EKG 12 LEAD TRACING ONLY - LMS 10.4181 730 $ - 418193005 EKG 10.4181 730 $ 160.00 418194664 NEB MED TREATMENT,INITIAL 10.4181 983 $ 67.00 418194665 NEB MED TREATMENT,ADDITIONAL 10.4181 983 $ 32.00 418199000 LAB PROCESSING FEE 10.4181 983 $ - 418199195 THERAPEUTIC PHYLEBOTOMY 10.4181 940 $ 85.00 418199201 NEW PATIENT BRIEF 10.4181 983 $ 85.00 418199202 NEW PATIENT LIMITED 10.4181 983 $ 105.00 418199203 NEW PATIENT INTERMEDIATE 10.4181 983 $ 136.00 418199204 NEW PATIENT EXTENDED 10.4181 983 $ 200.00 418199205 NEW PATIENT COMPREHENSIVE 10.4181 983 $ 264.00 418199211 ESTAB/BRIEF 10.4181 983 $ 57.00 418199212 ESTAB/LIMITED 10.4181 983 $ 81.00 418199213 ESTAB/INTERMEDIATE 10.4181 983 $ 100.00 418199214 ESTAB/EXTENDED 10.4181 983 $ 132.00 418199215 ESTAB/COMPREHENSIVE 10.4181 983 $ 188.00 418199216 TREATMENT ROOM 10.4181 510 $ 35.00 418199354 PROLONGED SERVICE 10.4181 983 $ 193.00 418199358 MAMMOGRAM FILM REVIEW 10.4181 761 $ 55.00 418199381 PHYSICAL INFANT > 1YR NEW 10.4181 983 $ 125.00 418199382 PHYSICAL CHILD 1-4 YRS NEW 10.4181 983 $ 130.00 418199383 PHYSICAL CHILD 5-11 YRS NEW 10.4181 983 $ 134.00 418199384 PHYSICAL ADOLESCENT >12 NEW 10.4181 983 $ 151.00 418199391 PHYSICAL INFANT < 1YR EST 10.4181 983 $ 107.00 418199393 PHYSICAL CHILD 5-11 YRS EST 10.4181 983 $ 118.00 418199394 PHYSICAL ADOLESCENT>12 EST 10.4181 983 $ 128.00 418199401 COUNSELING 15 MINS 10.4181 983 $ 74.00 418199402 COUNSELING 30 MINS 10.4181 983 $ 107.00 418199403 COUNSELING 45 MINS 10.4181 983 $ 140.00 418199404 COUNSELING 60 MINS 10.4181 983 $ 174.00 418300220 PASSPORT VISIT 1-30 MIN 10.4183 510 $ - 418300221 PASSPORT VISIT 31-60 MIN 10.4183 510 $ - 418300610 MEDICARE INIT PREVENT (PANEL) 10.4183 510 $ 200.00 418300611 MEDICARE INIT PREVENT EXAM TC 10.4183 510 $ 129.00 418300612 MEDICARE INIT PREVENT EXAM 10.4183 983 $ 71.00 418310002 ANTI-COAG CLINIC VISIT 10.4183 510 $ 48.00 418310060 SIMPLE I&D (PANEL) 10.4183 510 $ 321.00 418310061 COMPLEX/MULTI I&D (PANEL) 10.4183 510 $ 331.00 418310062 COMPLEX/MULTI I&D 10.4183 983 $ 160.00 418310064 SIMPLE I&D TC 10.4183 510 $ 161.00 418310065 SIMPLE I&D 10.4183 983 $ 160.00 418310066 COMPLEX/MULTI I&D-TC 10.4183 510 $ 171.00 418310080 INCIS DRAIN PILONID CYs(PANEL) 10.4183 510 $ 256.00 418310084 INCISION DRAINAGE PILONIDAL CY 10.4183 983 $ 85.00 418310085 INCIS DRAIN PILONIDAL CYST- TC 10.4183 510 $ 171.00 418310120 FOREIGN BDY REMOV SUBQ(PANEL) 10.4183 510 $ 260.00 418310124 FOREIGN BODY REMOVAL SUB Q 10.4183 983 $ 89.00 418310125 FOREIGN BODY REMOVAL SUB Q-TC 10.4183 510 $ 171.00 418310140 HEMATOMA / SEROMA (PANEL) 10.4183 510 $ 266.00 418310141 HEMATOMA / SEROMA 10.4183 983 $ 89.00 418310145 HEMATOMA / SEROMA - TC 10.4183 510 $ 177.00 418310380 IV INJECTION 10.4183 510 $ 41.00 418310381 IV INJECTION ADD'L SEQUENTIAL 10.4183 761 $ 41.00 418310390 INJECTION IM/SQ 10.4183 510 $ 23.00 418310391 INJECTION IM/SQ-SUBSEQUENT 10.4183 510 $ 25.00 418311000 DEBRIDMENT OF SKIN (PANEL) 10.4183 510 $ 191.00 418311004 DEBRIDMENT OF SKIN 10.4183 983 $ 39.00 418311005 DEBRIDMENT OF SKIN-TC 10.4183 510 $ 153.00 418311100 BIOPSY SKIN, SUBCUT (PANEL) 10.4183 510 $ 135.00 418311101 BIOPSY SKIN EACH ADD LOCATION 10.4183 983 $ 19.00 418311102 BIOPSY SKIN, SUBCUT-TC 10.4183 510 $ 54.00 418311104 BIOPSY SKIN, SUBCUT 10.4183 983 $ 82.00 418311153 LAC INTERM FACE 5.1-7.5CM - TC 10.4183 510 $ 198.00 418311201 BASIC EXAM - TC 10.4183 510 $ 45.00 418311202 NEW PT EXAM PROBLEM - TC 10.4183 510 $ 45.00 418311203 NEW PT INTERMED EXAM - TC 10.4183 510 $ 45.00 418311204 NEW PT EXTEND EXAM - TC 10.4183 510 $ 45.00 418311205 NEW PT COMPREHEN EXAM 10.4183 983 $ 245.00 418311211 ESTABLISHED BRIEF EXAM - TC 10.4183 510 $ 45.00 418311212 ESTAB PT/EPAN PROBLEM - TC 10.4183 510 $ 45.00 418311213 EST PT INTERMED EXAM - TC 10.4183 510 $ 45.00 418311214 ESTAB PT EXTENDED EXAM - TC 10.4183 510 $ 45.00 418311215 ESTAB PT COMP EXAM 10.4183 983 $ 161.00 418311730 AVULSION OF NAIL (PANEL) 10.4183 510 $ 309.00 418311734 AVULSION OF NAIL 10.4183 983 $ 77.00 418311740 EVAC. SUBUNG HEMATOMA (PANEL) 10.4183 510 $ 87.00 418311744 EVAC. SUBUNGUAL HEMATOMA 10.4183 983 $ 25.00 418311745 EVAC. SUBUNGUAL HEMATOMA-TC 10.4183 510 $ 63.00 418311750 EXC. INGROWN TOENAIL (PANEL) 10.4183 510 $ 310.00 418311754 EXC. INGROWN TOENAIL 10.4183 983 $ 77.00 418311755 AVULSION OF NAIL - TC 10.4183 510 $ 233.00 418312001 LACER SIMPLE TO 2.5CM (PANEL) 10.4183 510 $ 314.00 418312002 LACER SIMPLE 2.6 - 7.5 (PANEL) 10.4183 510 $ 336.00 418312003 LACERATION SIMPLE TO 2.5CM -TC 10.4183 510 $ 198.00 418312004 LACER SIMPLE 7.6-12.5CM(PANEL) 10.4183 510 $ 360.00 418312005 LACERATION SIMPLE TO 2.5CM 10.4183 983 $ 117.00 418312006 LACERATION SIMPLE 2.6 - 7.5 10.4183 983 $ 126.00 418312007 LACERATION SIMPLE 2.6-7.5-TC 10.4183 510 $ 210.00 418312008 LACERATION SIMPLE 7.6-12.5CM 10.4183 983 $ 151.00 418312009 LACER SIMPLE 7.6-12.5CM-TC 10.4183 510 $ 210.00 418312011 LACER FACE TO 2.5CM (PANEL) 10.4183 510 $ 330.00 418312013 LACER FACE 2.6 TO 5.0CM(PANEL) 10.4183 510 $ 331.00 418312014 LACER SIM. FACE 5.1-7.5(PANEL) 10.4183 510 $ 362.00 418312015 LACER SIM FACE 7.6-12.5(PANEL) 10.4183 510 $ 417.00 418312016 LACERATION FACE TO 2.5CM-TC 10.4183 510 $ 210.00 418312017 LACERATION FACE 2.6 TO 5.0CM 10.4183 983 $ 134.00 418312018 LACERATION SIM. FACE 5.1-7.5 10.4183 983 $ 165.00 418312019 LACERATION SIM. FACE 7.6-12.5 10.4183 983 $ 207.00 418312020 LACER SIM FACE 7.6-12.CM - TC 10.4183 510 $ 210.00 418312031 LACER INTERM TO 2.5CM (PANEL) 10.4183 510 $ 349.00 418312032 LACER INTERM 2.6-7.5CM (PANEL) 10.4183 510 $ 379.00 418312033 LACER INTERM TO 2.5CM - TC 10.4183 510 $ 198.00 418312034 LAC INTERM 7.6-12.5CM (PANEL) 10.4183 510 $ 411.00 418312035 LACERATION INTERM. TO 2.5CM 10.4183 983 $ 152.00 418312036 LACERATION INTERM. 2.6-7.5CM 10.4183 983 $ 170.00 418312037 LACERATION INTERM. 2.6-7.5CM-T 10.4183 510 $ 210.00 418312038 LAC. INTERM. 7.6-12.5CM 10.4183 983 $ 202.00 418312039 LAC. INTERM. 7.6-12.5CM-TC 10.4183 510 $ 210.00 418312041 INTERM H/F TO 2.5 W/BLK(PANEL) 10.4183 510 $ 352.00 418312042 LAC INTERM H/F2.6-7.5CM(PANEL) 10.4183 510 $ 397.00 418312044 LAC. INTERM. H/F TO 2.5CM 10.4183 983 $ 188.00 418312045 INTERM. H/F TO 2.5 W/BLOCK TC 10.4183 361 $ 198.00 418312046 LAC. INTERM. H/F 2.6 TO 7.5CM 10.4183 983 $ 188.00 418312047 LAC INTERM H/F 2.6-7.5CM TC 10.4183 510 $ 210.00 418312051 LAC INTERM FACE TO 2.5 (PANEL) 10.4183 510 $ 373.00 418312052 LAC INTERM FACE 2.6-5.0(PANEL) 10.4183 510 $ 384.00 418312053 LAC INTERM FACE 5.1-7.5(PANEL) 10.4183 510 $ 409.00 418312054 LAC INTRM FACE 7.6-12.5(PANEL) 10.4183 510 $ 444.00 418312055 LAC. INTERM. FACE TO 2.5CM TC 10.4183 510 $ 198.00 418312056 LAC. INTERM. FACE 2.6-5.0CM 10.4183 983 $ 187.00 418312057 LAC. INTERM. FACE 5.1-7.5CM 10.4183 983 $ 212.00 418312058 LAC. INTERM. FACE 7.6-12.5CM 10.4183 983 $ 235.00 418312059 LAC. INTERM. FACE 7.6-12.5CM-T 10.4183 510 $ 210.00 418312111 LACER FACE TO 2.5CM 10.4183 983 $ 121.00 418312113 LACER FACE 2.6 TO 5.0CM - TC 10.4183 510 $ 198.00 418312114 LACER SIM FACE 5.1-7.5CM - TC 10.4183 510 $ 198.00 418312152 LACER INTERM FACE 2.6-5.0 TC 10.4183 510 $ 198.00 418312153 LAC INTERM FACE TO 2.5CM 10.4183 983 $ 176.00 418316020 TREATMENT BURN SMALL (PANEL) 10.4183 510 $ 201.00 418316023 TREATMENT OF BURN, SMALL 10.4183 983 $ 49.00 418316024 TREATMENT OF BURN, SMALL-TC 10.4183 510 $ 153.00 418316025 TREATMENT BURN, MED (PANEL) 10.4183 510 $ 246.00 418316029 TREATMENT BURN, MED 10.4183 983 $ 117.00 418316030 TREATMENT BURN, MED-TC 10.4183 510 $ 130.00 418317000 DESTRUC LESION 1ST LES (PANEL) 10.4183 510 $ 88.00 418317003 DESTRUCT EA ADD LES (PANEL) 10.4183 510 $ 56.00 418317004 DESTRUCTION OF LESION, 1ST LES 10.4183 983 $ 40.00 418317005 DESTRUCTION OF LESION, 1ST-TC 10.4183 510 $ 48.00 418317007 DESTRUCTION EA. ADDITIONAL LES 10.4183 983 $ 9.00 418317008 DESTRUCTION EA. ADD LESION-TC 10.4183 510 $ 48.00 418319087 WC DUPLICATE REPORT 10.4183 420 $ 13.00 418319200 BASIC EXAM 10.4183 983 $ 49.00 418319201 NEW PT EXPANDED PROBLEM 10.4183 983 $ 71.00 418319202 NEW PT. INTERMEDIATE EXAM 10.4183 983 $ 105.00 418319203 NEW PT. EXTENDED EXAM 10.4183 983 $ 175.00 418319204 NEW PT EXTENDED EXAM 10.4183 983 $ 176.00 418319205 NEW PT COMPREHENSIVE EXAM-TC 10.4183 510 $ 48.00 418319210 ESTABLISHED BRIEF EXAM 10.4183 983 $ 18.00 418319211 ESTABLISHED BRIEF EXAM 10.4183 983 $ 44.00 418319212 EST PT/EXPANDED PROBLEM 10.4183 983 $ 65.00 418319213 ESTABLISHED PT INTERMED EXAM 10.4183 983 $ 100.00 418319214 EST. PT EXTENDED EXAM 10.4183 983 $ 161.00 418319215 EST. PT COMPREHENSIVE EXAM-TC 10.4183 510 $ 48.00 418320270 SUP-TISSUE ADHESIVE 10.4183 510 $ 76.00 418320550 TRIGGER POINT INJECT (PANEL) 10.4183 510 $ 232.00 418320554 TRIGGER POINT INJECTION 10.4183 983 $ 49.00 418320555 TRIGGER POINT INJECTION-TC 10.4183 510 $ 183.00 418320605 ARTHROCENTESIS-INTERMED(PANEL) 10.4183 510 $ 355.00 418320606 ARTHROCENTESIS INTERMED - TC 10.4183 510 $ 172.00 418320610 ARTHROCENT-MAJ JOINT (PANEL) 10.4183 510 $ 235.00 418320611 ARTHROCENTESIS-INTERMEDIATE 10.4183 983 $ 183.00 418320614 ARTHROCENTESIS-MAJOR JOINT 10.4183 983 $ 52.00 418320615 ARTHROCENTESIS-MAJOR JOINT-TC 10.4183 510 $ 183.00 418323500 CLAVIC FRACTURE W/O MAN(PANEL) 10.4183 510 $ 336.00 418323504 CLAVICULAR FRACTURE W/O MAN. 10.4183 983 $ 197.00 418323505 CLAVICULAR FRACTURE W/O MAN.-T 10.4183 510 $ 140.00 418323650 REDUCTION OF SHOULDER (PANEL) 10.4183 510 $ 436.00 418323654 REDUCTION OF SHOULDER 10.4183 983 $ 297.00 418323655 REDUCTION OF SHOULDER-TC 10.4183 510 $ 140.00 418324640 RED SUBLX RAD HEAD/CHLD(PANEL) 10.4183 510 $ 192.00 418324644 REDUCT SUBLX RADIAL HEAD/CHILD 10.4183 983 $ 78.00 418324645 REDUCT SUBLX RADIAL HEAD/CHILD 10.4183 510 $ 114.00 418325500 TX RAD FRACTURE W/O MAN(PANEL) 10.4183 510 $ 417.00 418325504 TX RADIAL FRACTURE W/O MAN. 10.4183 983 $ 230.00 418325505 TX RADIAL FRACTURE W/O MAN.-TC 10.4183 510 $ 187.00 418325600 TX DIST RAD FRACT W/O (PANEL) 10.4183 510 $ 435.00 418325604 TX DISTAL RADIAL FRACTURE W/O 10.4183 983 $ 249.00 418325605 TX DISTAL RADIAL FRACT W/O MAN 10.4183 510 $ 187.00 418326600 HAND FRAC W/O MANIP (PANEL) 10.4183 510 $ 382.00 418326601 HAND FRAC W MANIP (PANEL) 10.4183 510 $ 558.00 418326604 HAND FRACTURES W/O MANIPULATIO 10.4183 983 $ 205.00 418326605 HAND FRACTURE W MANIPULATION 10.4183 983 $ 372.00 418326606 HAND FRACTURE W MANIP-TC 10.4183 510 $ 187.00 418326611 HAND FRAC W/O MANIP - TC 10.4183 510 $ 177.00 418326700 HAND DISLOCAT W MANIP (PANEL) 10.4183 510 $ 414.00 418326701 HAND DISLOCATION W MANIP -TC 10.4183 510 $ 187.00 418326711 HAND DISCLOCAT W MANIP 10.4183 983 $ 228.00 418326720 FINGER SHAFT FRACTURE (PANEL) 10.4183 510 $ 284.00 418326724 FINGER SHAFT FRACTURE 10.4183 983 $ 145.00 418326725 FINGER SHAFT FRACTURE-TC 10.4183 510 $ 140.00 418326750 DIST FING FRX W/O MAN (PANEL) 10.4183 510 $ 309.00 418326751 DIST FING FX W/O MAN 10.4183 983 $ 170.00 418326755 DISTAL FINGER FRACTURE W/O MAN 10.4183 983 $ 170.00 418326756 DISTAL FINGER FRACT W/O MAN-TC 10.4183 510 $ 140.00 418327560 CLOSED TX PATEL DISLOC(PANEL) 10.4183 510 $ 530.00 418327564 CLOSED TX PATELLA DISLOCATION 10.4183 983 $ 344.00 418327565 CLOSED TX PATELLA DISLOCATION- 10.4183 510 $ 187.00 418328400 CALCAN FRACT W/O MAN (PANEL) 10.4183 510 $ 469.00 418328404 CALCANEAL FRACTURE W/O MAN. 10.4183 983 $ 283.00 418328405 CALCANEAL FRACTURE W/O MAN.-TC 10.4183 510 $ 187.00 418328490 FRACTURE GREAT TOE (PANEL) 10.4183 510 $ 270.00 418328491 FRACTURE GREAT TOE 10.4183 983 $ 131.00 418328495 FX. GREAT TOE W/MANIP (PANEL) 10.4183 510 $ 297.00 418328496 FRACTURE GREAT TOE-TC 10.4183 510 $ 140.00 418328499 FX. GREAT TOE W/MANIPULATION 10.4183 983 $ 158.00 418328500 FX. GREAT TOE W/MANIPULATION-T 10.4183 510 $ 140.00 418328510 TOE FRACTURE EA W/O MAN(PANEL) 10.4183 510 $ 269.00 418328513 TOE FRACTURE, EACH, W/O MAN. 10.4183 983 $ 130.00 418328514 TOE FRACTURE EACH W/O MAN.-TC 10.4183 510 $ 140.00 418328515 TOE FRACT W/MANIP (PANEL) 10.4183 510 $ 291.00 418328519 TOE FRACTURE W/MANIPULATION, E 10.4183 983 $ 152.00 418328520 TOE FRACT W/MANIP EA-TC 10.4183 510 $ 140.00 418329075 APPLIC SHORT ARM CAST (PANEL) 10.4183 510 $ 204.00 418329079 APPLICATION SHORT ARM CAST 10.4183 983 $ 53.00 418329080 APPLICATION SHORT ARM CAST-TC 10.4183 510 $ 152.00 418329085 APP HAND/LOW F ARM CAST(PANEL) 10.4183 510 $ 210.00 418329089 APPLICATION HAND/LOW FORARM CA 10.4183 983 $ 59.00 418329090 APP HAND/LOW FOREARM CAST-TC 10.4183 515 $ 152.00 418329105 APP LONG ARM SPLINT (PANEL) 10.4183 510 $ 205.00 418329109 APPLICATION LONG ARM SPLINT 10.4183 983 $ 54.00 418329110 APPLICATION LONG ARM SPLINT-TC 10.4183 510 $ 152.00 418329125 APPL SHORT ARM SPLINT (PANEL) 10.4183 510 $ 188.00 418329128 APPLICATION SHORT ARM SPLINT 10.4183 983 $ 37.00 418329129 APPLICATION SHORT ARM SPLINT-T 10.4183 510 $ 152.00 418329130 APP FINGER SPLINT (PANEL) 10.4183 510 $ 181.00 418329134 APPLICATION FINGER SPLINT 10.4183 983 $ 30.00 418329135 APPLICATION FINGER SPLINT-TC 10.4183 510 $ 152.00 418329405 APPL SHORT LEG CAST (PANEL) 10.4183 510 $ 210.00 418329409 APPLICATION SHORT LEG CAST 10.4183 983 $ 59.00 418329410 APPLICATION SHORT LEG CAST-TC 10.4183 510 $ 152.00 418329505 APPL LONG LEG SPLINT (PANEL) 10.4183 510 $ 137.00 418329509 APPLICATION LONG LEG SPLINT 10.4183 983 $ 43.00 418329510 APPLICATION LONG LEG SPLINT-TC 10.4183 510 $ 95.00 418329515 APP SHORT LEG SPLINT (PANEL) 10.4183 510 $ 138.00 418329519 APPLICATION SHORT LEG SPLINT 10.4183 983 $ 44.00 418329520 APPLICATION SHORT LEG SPLNT-TC 10.4183 510 $ 95.00 418329700 CAST REMOVAL (PANEL) 10.4183 510 $ 131.00 418329704 CAST REMOVAL 10.4183 983 $ 37.00 418329705 CAST REMOVAL-TC 10.4183 510 $ 95.00 418330300 FOREIGN BDY REMOV-NOSE (PANEL) 10.4183 510 $ 212.00 418330304 FOREIGN BODY REMOVAL-NOSE 10.4183 983 $ 67.00 418330305 FOREIGN BODY REMOVAL-NOSE-TC 10.4183 510 $ 145.00 418330901 EPITAXIS-ANTERIOR (PANEL) 10.4183 510 $ 264.00 418330905 EPITAXIS-POSTERIOR (PANEL) 10.4183 510 $ 319.00 418330906 EPITAXIS-ANTERIOR-TC 10.4183 510 $ 191.00 418330909 EPITAXIS-POSTERIOR 10.4183 983 $ 129.00 418330910 EPITAXIS-POSTERIOR-TC 10.4183 510 $ 191.00 418330911 EPISTAXIS - ANTERIOR 10.4183 983 $ 74.00 418332001 SIMPLE TO 2.5CM W/BLCK (PANEL) 10.4183 510 $ 314.00 418332002 SIMPLE 2.6-7.5CM W/BLK (PANEL) 10.4183 510 $ 336.00 418332005 SIMPLE TO 2.5CM W/BLOCK 10.4183 983 $ 117.00 418332006 SIMPLE 2.6-7.5CM W/BLOCK 10.4183 983 $ 126.00 418332007 SIMPLE 2.6-7.5CM W/BLOCK-TC 10.4183 510 $ 210.00 418332011 SIMPLE TO 2.5CM W/BLK - TC 10.4183 510 $ 198.00 418332041 INTERM H/F TO 2.5 W/BLK(PANEL) 10.4183 510 $ 362.00 418332042 INTERM H/F2.5-7.5 W/BLK(PANEL) 10.4183 510 $ 397.00 418332045 INTERM. H/F TO 2.5 W/BLOCK 10.4183 983 $ 165.00 418332046 INTERM. H/F 2.5-7.5 W/BLOCK 10.4183 983 $ 188.00 418332047 INTERM. H/F 2.5-7.5 W/BLOCK-TC 10.4183 510 $ 210.00 418336415 BLOOD SPECIMEN COLLECTION 10.4183 300 $ 15.00 418346320 EXC EXT THROMB HEMOR (PANEL) 10.4183 510 $ 343.00 418346324 EXC. EXT. THROMBOTIC HEMORRHOI 10.4183 983 $ 142.00 418346325 EXC. THROMBOTIC HEMORRHOID-TC 10.4183 510 $ 202.00 418346600 ANOSCOPY (PANEL) 10.4183 510 $ 30.00 418346604 ANOSCOPY 10.4183 983 $ 30.00 418346605 ANOSCOPY-TC 10.4183 510 $ - 418350010 EXAM/TREATMENT ROOM MODERATE 10.4183 510 $ 64.00 418350020 EXAM/TREATMENT ROOM BRIEF 10.4183 510 $ 48.00 418350029 ADULT IMMUN/TRAV CLIN 1-3 IZs 10.4183 983 $ 30.00 418350030 EXAM/TREATMENT ROOM EXTENDED 10.4183 510 $ 88.00 418356420 I&D BARTHOLIN'S GLAND (PANEL) 10.4183 510 $ 320.00 418356424 I&D BARTHOLIN'S GLAND 10.4183 983 $ 115.00 418356425 I&D BARTHOLIN'S GLAND-TC 10.4183 510 $ 205.00 418360010 DMV PHYSICAL (18-39) 10.4183 983 $ 75.00 418360012 DMV PHYSICAL (40-64) 10.4183 983 $ 75.00 418360020 PHYSICAL (1-4) 10.4183 983 $ 71.00 418360021 PHYSICAL (5-11) 10.4183 983 $ 71.00 418360022 PHYSICAL (12-17) 10.4183 983 $ 71.00 418360023 PHYSICAL (18-39) 10.4183 983 $ 71.00 418360024 PHYSICAL (40-64) 10.4183 983 $ 71.00 418360025 PHYSICAL (65-) 10.4183 983 $ 71.00 418360030 SPORTS / SCHOOL PHYSICAL 10.4183 983 $ 30.00 418360042 ADLT IMMUN/TRAVEL CLIN (PANEL) 10.4183 510 $ 78.00 418360043 ADULT IMMUN/TRAV CLIN 3+ IZs 10.4183 510 $ 126.00 418360045 TRAVEL/IMMUNIZATION CLINIC ADD 10.4183 510 $ 25.00 418362271 LUMBAR PUNCTURE - MINOR SURG 10.4183 510 $ 281.00 418362272 LUMB PUNCT THERAP (PANEL) 10.4183 510 $ 445.00 418362273 LUMBAR PUNCT THERAPEUTIC 10.4183 983 $ 165.00 418364450 DIGITAL BLOCK (PANEL) 10.4183 510 $ 359.00 418364454 DIGITAL BLOCK 10.4183 983 $ 74.00 418364455 DIGITAL BLOCK-TC 10.4183 510 $ 285.00 418365205 FB REMOV-SCLER/CONJ SUP(PANEL) 10.4183 510 $ 227.00 418365206 F.B. REMOVAL-SCLER/CONJ -TC 10.4183 510 $ 45.00 418365210 FB REM-SCLER/CONJUNCT I(PANEL) 10.4183 510 $ 279.00 418365214 F.B. REMOVAL-SCLERAL/CONJUNCTI 10.4183 983 $ 52.00 418365215 F.B. REMOVAL-SCLERAL/CONJUNCT- 10.4183 983 $ 182.00 418365217 F.B. REMOVAL-SCLERAL/CONJUNCT- 10.4183 510 $ 227.00 418365220 FOREIGN BODY REM-CORNEA(PANEL) 10.4183 510 $ 270.00 418365222 RMV FB CORN W/SLT LMP (PANEL) 10.4183 510 $ 281.00 418365224 FOREIGN BODY REM.-CORNEA 10.4183 983 $ 43.00 418365225 FOREIGN BODY REM.-CORNEA-TC 10.4183 510 $ 227.00 418365226 RMV FB CORNEAL W/ SLIT LAMP 10.4183 983 $ 54.00 418365227 RMV FB CORNEAL W/SLIT LAMP-TC 10.4183 510 $ 227.00 418365435 RMV CORNEAL EPITHELIUM (PANEL) 10.4183 510 $ 599.00 418365439 RMV CORNEAL EPITHELIUM 10.4183 983 $ 61.00 418365440 RMV CORNEAL EPITHELIUM-TC 10.4183 510 $ 539.00 418369200 FOREIGN BODY REM.-EAR (PANEL) 10.4183 510 $ 154.00 418369204 FOREIGN BODY REM.-EAR 10.4183 983 $ 66.00 418369205 FOREIGN BODY REM.-EAR-TC 10.4183 510 $ 88.00 418369210 RMV IMPACTED-CERUMEN (PANEL) 10.4183 510 $ 128.00 418369214 RMV IMPACTED-CERUMEN 10.4183 983 $ 40.00 418369215 RMV IMPACTED-CERUMEN-TC 10.4183 510 $ 88.00 418381002 URINALYSIS W/O MICRO 10.4183 300 $ 31.00 418381015 URINALYSIS WITH MICRO 10.4183 300 $ 34.00 418381025 PREGNANCY TEST-URINE 10.4183 300 $ 46.00 418382270 OCCULT BLOOD, FECES 10.4183 300 $ 25.00 418382948 GLUCOSE 10.4183 300 $ 34.00 418385013 SPUN MICRO HEMATROCRIT 10.4183 300 $ 31.00 418385018 HEMOGLOBIN 10.4183 300 $ 34.00 418386580 PPD SKIN TEST 10.4183 300 $ 10.00 418386588 RAPID STREP 10.4183 300 $ 41.00 418387210 WET MOUNT 10.4183 300 $ 46.00 418387220 KOH PREP 10.4183 300 $ 46.00 418389203 E/M FIRST AID 10.4183 983 $ 130.00 418390471 ADMIN IMMUNIZATION, INJECTION 10.4183 510 $ 23.00 418390472 ADMIN OF ADDITIONAL VACCINATIO 10.4183 636 $ 14.00 418390780 IV INFUSION FIRST HOUR 10.4183 510 $ 286.00 418390781 IV INFUSION ADD'L HRS 10.4183 260 $ 172.00 418390782 IM THERAPEUTIC INJECTION 10.4183 983 $ 22.00 418390788 IM/SQ INJECTION 10.4183 510 $ 25.00 418390791 INFUSION HYDRATION 1ST HOUR 10.4183 260 $ 315.00 418390792 INFUSION HYDRATION ADD'L HOUR 10.4183 260 $ 190.00 418393000 EKG TRACING ONLY 10.4183 730 $ 111.00 418393005 EKG TRACING ONLY 10.4183 510 $ 111.00 418394010 PULMONARY FUNCT. TEST 10.4183 460 $ 107.00 418394664 NEB MED TREATMENT 10.4183 761 $ - 418394666 NEB MED TUBING 10.4183 272 $ 64.00 418399048 PHONE CALL 15 MIN EMPLY/AGNCY 10.4183 983 $ 26.00 418399080 SPECIAL REPORT 10.4183 983 $ 71.00 418399081 REQUIRED REPORT 10.4183 983 $ 22.00 418399082 MD FINAL DISCHARGE REPORT 10.4183 983 $ 22.00 418399087 SPECIAL REPORT 7 PAGE 10.4183 983 $ 187.00 418399201 BASIC EXAM (PANEL) 10.4183 510 $ 94.00 418399202 NEW PT EXPAN PROBLEM (PANEL) 10.4183 510 $ 115.00 418399203 NEW PT INTERMEDI EXAM (PANEL) 10.4183 510 $ 149.00 418399204 NEW PT. EXTENDED EXAM (PANEL) 10.4183 510 $ 221.00 418399205 NEW PT COMPREHEN EXAM (PANEL) 10.4183 510 $ 292.00 418399207 EXAM ROOM BRIEF 10.4183 510 $ 48.00 418399208 EXAM ROOM 10.4183 761 $ 48.00 418399209 EXAM ROOM EXTENDED 10.4183 510 $ 48.00 418399211 ESTABLISHED BRIEF EXAM (PANEL) 10.4183 510 $ 89.00 418399212 ESTAB PT/EXPAN PROBLEM (PANEL) 10.4183 510 $ 110.00 418399213 EST PT INTERMED EXAM (PANEL) 10.4183 510 $ 145.00 418399214 ESTAB PT EXTENDED EXAM (PANEL) 10.4183 510 $ 206.00 418399215 ESTAB PT COMP EXAM (PANEL) 10.4183 510 $ 209.00 418399354 PROLONGED SERVICE FIRST HOUR 10.4183 983 $ 190.00 418399361 TEAM MEDICAL CONFERENCE 10.4183 983 $ 132.00 418399371 PHONE CALL-MD-SIMPLE 10.4183 983 $ 40.00 418500610 MEDICARE INIT PREVENT (PANEL) 10.4185 510 $ 200.00 418500611 MEDICARE INIT PREVENT EXAM TC 10.4185 510 $ 129.00 418500612 MEDICARE INIT PREVENT EXAM 10.4185 983 $ 71.00 418510060 SIMPLE I&D (PANEL) 10.4185 510 $ 321.00 418510061 COMPLEX/MULTI I&D (PANEL) 10.4185 510 $ 331.00 418510062 COMPLEX/MULTI I&D 10.4185 983 $ 160.00 418510064 SIMPLE I&D - TC 10.4185 510 $ 161.00 418510065 SINPLE I&D 10.4185 983 $ 160.00 418510066 COMPLEX/MULTI I&D-TC 10.4185 510 $ 171.00 418510080 INCIS DRAIN PILONID CYS(PANEL) 10.4185 510 $ 256.00 418510084 INCISION DRAINAGE PILONIDAL CY 10.4185 983 $ 85.00 418510085 INCISION DRAIN PILONIDAL CYST- 10.4185 510 $ 171.00 418510120 FOREIGN BOD REMOV SUB Q(PANEL) 10.4185 510 $ 260.00 418510124 FOREIGN BODY REMOVAL SUB Q 10.4185 983 $ 89.00 418510125 FOREIGN BODY REMOVAL SUB Q-TC 10.4185 510 $ 171.00 418510140 HEMATOMA / SEROMA (PANEL) 10.4185 510 $ 266.00 418510141 HEMATOMA / SEROMA 10.4185 983 $ 89.00 418510145 HEMATOMA / SEROMA - TC 10.4185 510 $ 177.00 418510380 IV INJECTION 10.4185 510 $ 41.00 418510381 IV INJECTION ADD'L SEQUENTIAL 10.4185 761 $ 41.00 418510390 INJECTION IM/SQ 10.4185 510 $ 25.00 418510391 INJECTION IM/SQ - SUBSEQUENT 10.4185 510 $ 25.00 418511000 DEBRIDMENT OF SKIN (PANEL) 10.4185 510 $ 191.00 418511004 DEBRIDMENT OF SKIN 10.4185 983 $ 39.00 418511005 DEBRIDMENT OF SKIN-TC 10.4185 510 $ 153.00 418511100 BIOPSY SKIN, SUBCUT (PANEL) 10.4185 510 $ - 418511101 BIOPSY SKIN EACH ADD LOCATION 10.4185 983 $ 19.00 418511102 BIOPSY SKIN, SUBCUT-TC 10.4185 510 $ 54.00 418511104 BIOPSY SKIN, SUBCUT 10.4185 983 $ 82.00 418511153 LAC INTERM FACE 5.1-7.5CM - TC 10.4185 510 $ 198.00 418511201 BASIC EXAM - TC 10.4185 510 $ 45.00 418511202 NEW PT EXAM PROBLEM - TC 10.4185 510 $ 45.00 418511203 NEW PT INTERMED EXAM - TC 10.4185 510 $ 45.00 418511204 NEW PT EXTEND EXAM - TC 10.4185 510 $ 45.00 418511205 NEW PT COMPREHEN EXAM 10.4185 983 $ 245.00 418511211 ESTABLISHED BRIEF EXAM - TC 10.4185 510 $ 45.00 418511212 ESTAB PT/EPAN PROBLEM - TC 10.4185 510 $ 45.00 418511213 EST PT INTERMED EXAM - TC 10.4185 510 $ 45.00 418511214 ESTAB PT EXTENDED EXAM - TC 10.4185 510 $ 45.00 418511215 ESTAB PT COMP EXAM 10.4185 983 $ 161.00 418511730 AVULSION OF NAIL (PANEL) 10.4185 510 $ - 418511734 AVULSION OF NAIL 10.4185 983 $ 77.00 418511735 AVULSION OF NAIL-TC 10.4185 510 $ 77.00 418511740 EVAC SUBUNG HEMATOMA (PANEL) 10.4185 510 $ 87.00 418511744 EVAC. SUBUNGUAL HEMATOMA 10.4185 983 $ 25.00 418511745 EVAC. SUBUNGUAL HEMATOMA-TC 10.4185 510 $ 63.00 418511750 EXC. INGROWN TOENAIL (PANEL) 10.4185 510 $ 310.00 418511754 EXC. INGROWN TOENAIL 10.4185 983 $ 77.00 418511755 AVULSION OF NAIL - TC 10.4185 510 $ 233.00 418512001 LACERAT SIMP TO 2.5CM (PANEL) 10.4185 510 $ 314.00 418512002 LACER SIMP 2.6-7.5 (PANEL) 10.4185 510 $ 336.00 418512003 LACER SIMPLE TO 2.5CM - TC 10.4185 510 $ 198.00 418512004 LACER SIMP 7.6-12.5CM (PANEL) 10.4185 510 $ 360.00 418512005 LACERATION SIMPLE TO 2.5CM 10.4185 983 $ 117.00 418512006 LACERATION SIMPLE 2.6 - 7.5 10.4185 983 $ 126.00 418512007 LACERATION SIMPLE 2.6-7.5-TC 10.4185 510 $ 210.00 418512008 LACERATION SIMPLE 7.6-12.5CM 10.4185 983 $ 151.00 418512009 LACERATION SIMPLE 7.6-12.5CM-T 10.4185 510 $ 210.00 418512011 LACER FACE TO 2.5CM (PANEL) 10.4185 510 $ 330.00 418512013 LACER FACE 2.6-5.0CM (PANEL) 10.4185 510 $ 331.00 418512014 LACER SIM FACE 5.1-7.5 (PANEL) 10.4185 510 $ 362.00 418512015 LACER SIM FACE 7.6-12.5(PANEL) 10.4185 510 $ 417.00 418512016 LACERATION FACE TO 2.5CM-TC 10.4185 510 $ 210.00 418512017 LACERATION FACE 2.6 TO 5.0CM 10.4185 983 $ 134.00 418512018 LACERATION SIM. FACE 5.1-7.5 10.4185 983 $ 165.00 418512019 LACERATION SIM. FACE 7.6-12.5 10.4185 983 $ 207.00 418512020 LACERATION SIM. FACE 7.6-12.5- 10.4185 510 $ 210.00 418512031 LACER INTERM TO 2.5CM (PANEL) 10.4185 510 $ 349.00 418512032 LACER INTER 2.6-7.5CM (PANEL) 10.4185 510 $ 379.00 418512033 LACER INTERM TO 2.5CM - TC 10.4185 510 $ 198.00 418512034 LAC INTERM 7.6-12.5CM (PANEL) 10.4185 510 $ 411.00 418512035 LACERATION INTERM. TO 2.5CM 10.4185 983 $ 152.00 418512036 LACERATION INTER. 2.6-7.5CM 10.4185 983 $ 170.00 418512037 LACERATION INTER. 2.6-7.5CM-TC 10.4185 510 $ 210.00 418512038 LAC. INTERM. 7.6-12.5CM 10.4185 983 $ 202.00 418512039 LAC. INTERM. 7.6-12.5CM-TC 10.4185 510 $ 210.00 418512041 LAC INTERM H/F TO 2.5CM(PANEL) 10.4185 510 $ 352.00 418512042 LAC INTERM H/F2.6-7.5CM(PANEL) 10.4185 510 $ 397.00 418512044 LAC. INTERM. H/F TO 2.5CM 10.4185 983 $ 188.00 418512045 INTERM. H/F TO 2.5 W/BLOCK TC 10.4185 361 $ 198.00 418512046 LAC. INTERM. H/F 2.6 TO 7.5 CM 10.4185 983 $ 188.00 418512047 LAC. INTER. H/F 2.6 TO 7.5 CM- 10.4185 510 $ 210.00 418512051 LAC INTER FACE TO 2.5CM(PANEL) 10.4185 510 $ 373.00 418512052 LAC INTER FACE2.6-5.0CM(PANEL) 10.4185 510 $ 384.00 418512053 LAC INTER FACE5.1-7.5CM(PANEL) 10.4185 510 $ 409.00 418512054 LAC INTER FACE 7.6-12.5(PANEL) 10.4185 510 $ 444.00 418512055 LAC. INTERM. FACE TO 2.5CM TC 10.4185 510 $ 198.00 418512056 LAC. INTERM. FACE 2.6-5.0CM 10.4185 983 $ 187.00 418512057 LAC. INTERM. FACE 5.1-7.5CM 10.4185 983 $ 212.00 418512058 LAC. INTERM. FACE 7.6-12.5CM 10.4185 983 $ 235.00 418512059 LAC. INTERM. FACE 7.6-12.5CM-T 10.4185 510 $ 210.00 418512111 LACER FACE TO 2.5CM 10.4185 983 $ 121.00 418512113 LACER FACE 2.6 TO 5.0CM - TC 10.4185 510 $ 198.00 418512114 LACER SIM FACE 5.1-7.5CM - TC 10.4185 510 $ 198.00 418512152 LACER INTERM FACE 2.6-5.0 TC 10.4185 510 $ 198.00 418512153 LAC INTERM FACE TO 2.5CM 10.4185 983 $ 176.00 418516020 TREATMENT BURN SMALL (PANEL) 10.4185 510 $ 201.00 418516023 TREATMENT OF BURN, SMALL 10.4185 983 $ 49.00 418516024 TREATMENT OF BURN, SMALL-TC 10.4185 510 $ 153.00 418516025 TREATMENT BURN, MED (PANEL) 10.4185 510 $ 246.00 418516029 TREATMENT BURN, MED 10.4185 983 $ 117.00 418516030 TREATMENT BURN, MED-TC 10.4185 510 $ 130.00 418517000 DESTRUC LESION 1ST LES (PANEL) 10.4185 510 $ 87.00 418517003 DESTRUC EA ADD LES (PANEL) 10.4185 510 $ 56.00 418517004 DESTRUCTION OF LESION, 1ST LES 10.4185 983 $ 40.00 418517005 DESTRUCT OF LESION, 1ST-TC 10.4185 510 $ 48.00 418517007 DESTRUCTION EA. ADDITIONAL LES 10.4185 983 $ 9.00 418517008 DESTRUCT EA. ADD LESION-TC 10.4185 510 $ 48.00 418519200 BASIC EXAM 10.4185 983 $ 49.00 418519201 NEW PT., EXPANDED PROBLEM 10.4185 983 $ 69.00 418519202 NEW PT. INTERMEDIATE EXAM 10.4185 983 $ 105.00 418519203 NEW PT. EXTENDED EXAM 10.4185 983 $ 175.00 418519204 NEW PT EXTENDED EXAM 10.4185 983 $ 176.00 418519205 NEW PT COMPREHENSIVE EXAM-TC 10.4185 510 $ 48.00 418519210 ESTABLISHED BRIEF EXAM 10.4185 983 $ 18.00 418519211 ESTABLISHED BRIEF EXAM 10.4185 983 $ 44.00 418519212 EST PT/EXPANDED PROBLEM 10.4185 983 $ 62.00 418519213 ESTABLISHED PT INTERMED EXAM 10.4185 983 $ 100.00 418519214 EST. PT EXTENDED EXAM 10.4185 983 $ 161.00 418519215 EST PT COMPREHENSIVE EXAM-TC 10.4185 510 $ 48.00 418520270 SUP-TISSUE ADHESIVE 10.4185 510 $ 76.00 418520550 TRIGGER POINT INJECT (PANEL) 10.4185 510 $ 232.00 418520554 TRIGGER POINT INJECTION 10.4185 983 $ 49.00 418520555 TRIGGER POINT INJECTION-TC 10.4185 510 $ 183.00 418520605 ARTHROCENT-INTERMED (PANEL) 10.4185 510 $ 355.00 418520606 ARTHROCENTESIS INTERMED - TC 10.4185 510 $ 172.00 418520610 ARTHROCENT-MAJOR JOINT (PANEL) 10.4185 510 $ 235.00 418520611 ARTHROCETESIS-INERMEDIATE 10.4185 983 $ 183.00 418520614 ARTHROCENTESIS-MAJOR JOINT 10.4185 983 $ 52.00 418520615 ARTHROCENTESIS-MAJOR JOINT-TC 10.4185 510 $ 183.00 418523500 CLAVIC FX W/O MAN (PANEL) 10.4185 510 $ 336.00 418523504 CLAVICULAR FRACTURE W/O MAN. 10.4185 983 $ 197.00 418523505 CLAVICULAR FRACTURE W/O MAN.-T 10.4185 510 $ 140.00 418523650 REDUCTION OF SHOULDER (PANEL) 10.4185 510 $ 436.00 418523654 REDUCTION OF SHOULDER 10.4185 983 $ 297.00 418523655 REDUCTION OF SHOULDER-TC 10.4185 510 $ 140.00 418524640 RED SUBLX RAD HEAD/CHLD(PANEL) 10.4185 510 $ 192.00 418524644 REDUCT SUBLX RADIAL HEAD/CHILD 10.4185 983 $ 78.00 418524645 REDUCT SUBLX RADIAL HEAD/CHILD 10.4185 510 $ 114.00 418525500 TX RAD FX W/O MAN (PANEL) 10.4185 510 $ 417.00 418525504 TX RADIAL FRACTURE W/O MAN. 10.4185 983 $ 230.00 418525505 TX RADIAL FRACTURE W/O MAN.-TC 10.4185 510 $ 187.00 418525600 TX DISTAL RAD FX W/O (PANEL) 10.4185 510 $ 435.00 418525604 RX DISTAL RADIAL FRACTURE W/O 10.4185 983 $ 249.00 418525605 RX DISTAL RADIAL FRACT W/O MAN 10.4185 510 $ 187.00 418526600 HAND FX W/O MANIP (PANEL) 10.4185 510 $ 382.00 418526601 HAND FX W MANIP (PANEL) 10.4185 510 $ - 418526604 HAND FRACTURE W/O MANIPULATION 10.4185 983 $ 205.00 418526605 HAND FRACTURE W MANIPULATION 10.4185 983 $ 372.00 418526606 HAND FRACTURE W MANIP-TC 10.4185 510 $ 187.00 418526611 HAND FRAC W/O MANIP - TC 10.4185 510 $ 177.00 418526700 HAND DISLOC W MANIP (PANEL) 10.4185 510 $ 414.00 418526701 HAND DISLOCATION W MANIP -TC 10.4185 510 $ 187.00 418526711 HAND DISCLOCAT W MANIP 10.4185 983 $ 228.00 418526720 FINGER SHAFT FRACTURE (PANEL) 10.4185 510 $ 284.00 418526724 FINGER SHAFT FRACTURE 10.4185 983 $ 145.00 418526725 FINGER SHAFT FRACTURE-TC 10.4185 510 $ 140.00 418526726 DISTAL FINGER FRACT W/O MAN.-T 10.4185 510 $ 140.00 418526750 DIST FINGER FX W/O MAN(PANEL) 10.4185 510 $ - 418526751 DIST FING FX W/O MAN 10.4185 983 $ 170.00 418527560 CLSD TX PATEL DISLOC (PANEL) 10.4185 510 $ 530.00 418527564 CLOSED TX PATELLA DISLOCATION 10.4185 983 $ 344.00 418527565 CLOSED TX PATELLA DISLOCATION- 10.4185 510 $ 187.00 418528400 CALCAN FX W/O MANIP (PANEL) 10.4185 510 $ 469.00 418528404 CALCANEAL FRACTURE W/O MAN. 10.4185 983 $ 283.00 418528405 CALCANEAL FRACTURE W/O MAN.-TC 10.4185 510 $ 187.00 418528490 FRACTURE GREAT TOE (PANEL) 10.4185 510 $ 270.00 418528491 FRACTURE GREAT TOE 10.4185 983 $ 131.00 418528495 FX GREAT TOE W/MANIP (PANEL) 10.4185 510 $ 297.00 418528496 FRACTURE GREAT TOE-TC 10.4185 510 $ 140.00 418528499 FX. GREAT TOE W/MANIPULATION 10.4185 983 $ 158.00 418528500 FX. GREAT TOE W/MANIPULATION-T 10.4185 510 $ 140.00 418528510 TOE FX EACH W/O MANIP (PANEL) 10.4185 510 $ 269.00 418528513 TOE FRACTURE, EACH, W/O MAN. 10.4185 983 $ 130.00 418528514 TOE FRACTURE, EACH, W/O MAN.-T 10.4185 510 $ 140.00 418528515 TOE FX W/MANIP EACH (PANEL) 10.4185 510 $ 291.00 418528519 TOE FRACTURE W/MANIPULATION,EA 10.4185 983 $ 152.00 418528520 TOE FRACTURE W/MANIP,EA-TC 10.4185 510 $ 140.00 418529075 APP SHORT ARM CAST (PANEL) 10.4185 510 $ 204.00 418529079 APPLICATION SHORT ARM CAST 10.4185 983 $ 53.00 418529080 APPLICATION SHORT ARM CAST-TC 10.4185 510 $ 152.00 418529085 APP HND/LOW FOREARM CST(PANEL) 10.4185 510 $ 210.00 418529089 APPLICATION HAND/LOW FOREARM C 10.4185 983 $ 59.00 418529090 APP HAND/LOW FOREARM CAST-TC 10.4185 510 $ 152.00 418529105 APP LONG ARM SPLINT (PANEL) 10.4185 510 $ 205.00 418529109 APPLICATION LONG ARM SPLINT 10.4185 983 $ 54.00 418529110 APPLICATION LONG ARM SPLINT-TC 10.4185 510 $ 152.00 418529125 APP SHORT ARM SPLINT (PANEL) 10.4185 510 $ 188.00 418529128 APPLICATION SHORT ARM SPLINT 10.4185 983 $ 37.00 418529129 APPLICATION SHORT ARM SPLINT-T 10.4185 510 $ 152.00 418529130 APPFINGER SPLINT (PANEL) 10.4185 510 $ 181.00 418529134 APPLICATION FINGER SPLINT 10.4185 983 $ 30.00 418529135 APPLICATION FINGER SPLINT-TC 10.4185 510 $ 152.00 418529405 APP SHORT LEG CAST (PANEL) 10.4185 510 $ 210.00 418529409 APPLICATION SHORT LEG CAST 10.4185 983 $ 59.00 418529410 APPLICATION SHORT LEG CAST-TC 10.4185 510 $ 152.00 418529505 APP LONG LEG SPLINT (PANEL) 10.4185 510 $ 137.00 418529509 APPLICATION LONG LEG SPLINT 10.4185 983 $ 43.00 418529510 APPLICATION LONG LEG SPLINT-TC 10.4185 510 $ 95.00 418529515 APP SHORT LEG SPLINT (PANEL) 10.4185 510 $ 138.00 418529519 APPLICATION SHORT LEG SPLINT 10.4185 983 $ 44.00 418529520 APPLICATION SHORT LEG SPLINT-T 10.4185 510 $ 95.00 418529700 CAST REMOVAL (PANEL) 10.4185 510 $ 131.00 418529704 CAST REMOVAL 10.4185 983 $ 37.00 418529705 CAST REMOVAL-TC 10.4185 510 $ 95.00 418530300 FOREIGN BDY REMOV-NOSE (PANEL) 10.4185 510 $ 212.00 418530304 FOREIGN BODY REMOVAL-NOSE 10.4185 983 $ 67.00 418530305 FOREIGN BODY REMOVAL-NOSE-TC 10.4185 510 $ 145.00 418530901 EPITAXIS-ANTERIOR (PANEL) 10.4185 510 $ 264.00 418530905 EPITAXIS-POSTERIOR (PANEL) 10.4185 510 $ 319.00 418530906 EPITAXIS-ANTERIOR-TC 10.4185 510 $ 191.00 418530909 EPITAXIS-POSTERIOR 10.4185 983 $ 129.00 418530910 EPITAXIS-POSTERIOR-TC 10.4185 510 $ 191.00 418530911 EPISTAXIS - ANTERIOR 10.4185 983 $ 74.00 418532001 SIMPLE TO 2.5CM W/BLCK (PANEL) 10.4185 510 $ - 418532002 SIMPLE 2.6-7.5CM W/BLCK(PANEL) 10.4185 510 $ - 418532005 SIMPLE TO 2.5CM W/BLOCK 10.4185 983 $ 117.00 418532006 SIMPLE 2.6-7.5CM W/BLOCK 10.4185 983 $ 126.00 418532007 SIMPLE 2.6-7.5CM W/BLOCK-TC 10.4185 510 $ 210.00 418532011 SIMPLE TO 2.5CM W/BLK - TC 10.4185 510 $ 198.00 418532041 INTER H/F TO 2.5 W/BLK (PANEL) 10.4185 510 $ - 418532042 INTER H/F 2.5-7.5 W/BLK(PANEL) 10.4185 510 $ - 418532045 INTERM H/F 2.5 W/BLOCK 10.4185 983 $ 165.00 418532046 INTERM. H/F 2.5-7.5 W/BLOCK 10.4185 983 $ 188.00 418532047 INTERM. H/F 2.5-7.5 W/BLOCK-TC 10.4185 510 $ 210.00 418536415 BLOOD SPECIMEN COLLECTION 10.4185 300 $ - 418546320 EXC EXT THROMB HEMORR (PANEL) 10.4185 510 $ 343.00 418546324 EXC. EXT. THROMBOTIC HEMORRHOI 10.4185 983 $ 142.00 418546325 EXC. THROMBOTIC HEMORRHOID-TC 10.4185 510 $ 202.00 418546600 ANOSCOPY (PANEL) 10.4185 510 $ 30.00 418546604 ANOSCOPY 10.4185 983 $ 30.00 418546605 ANOSCOPY-TC 10.4185 510 $ - 418550010 EXAM/TREATMENT ROOM MODERATE 10.4185 510 $ 64.00 418550020 EXAM/TREATMENT ROOM BRIEF 10.4185 510 $ 48.00 418550029 ADULT IMMUN/TRAVEL CLINIC 10.4185 983 $ 64.00 418550030 EXAM/TREATMENT ROOM EXTENDED 10.4185 510 $ 88.00 418556420 I&D BARTHOLIN'S GLAND (PANEL) 10.4185 510 $ - 418556424 I&D BARTHOLIN'S GLAND 10.4185 983 $ 115.00 418556425 I&D BARTHOLIN'S GLAND-TC 10.4185 510 $ 205.00 418560010 DMV PHYSICAL (18-39) 10.4185 983 $ 75.00 418560012 DMV PHYSICAL (40-64) 10.4185 983 $ 75.00 418560020 PHYSICAL (1-4) 10.4185 983 $ 71.00 418560021 PHYSICAL (5-11) 10.4185 983 $ 71.00 418560022 PHYSICAL (12-17) 10.4185 983 $ 71.00 418560023 PHYSICAL (18-39) 10.4185 983 $ 71.00 418560024 PHYSICAL (40-64) 10.4185 983 $ 71.00 418560025 PHYSICAL (65-) 10.4185 983 $ 71.00 418560030 SPORTS / SCHOOL PHYSICAL 10.4185 983 $ 30.00 418560042 ADLT IMMUN/TRAV CLINIC (PANEL) 10.4185 510 $ - 418560043 ADULT IMMUN/TRAVEL CLINIC-EXT 10.4185 983 $ 74.00 418560045 TRAVEL/IMMUNIZATION CLINIC ADD 10.4185 510 $ 49.00 418560047 TRAVEL/IMMUNIZATION CL. ADD'L 10.4185 510 $ 25.00 418562271 LUMBAR PUNCTURE-MINOR SURG 10.4185 360 $ 281.00 418562272 LUMBAR PUNCT THERAPEUT (PANEL) 10.4185 510 $ - 418562273 LUMB PUNCT THERAPEUTIC 10.4185 983 $ 165.00 418564450 DIGITAL BLOCK (PANEL) 10.4185 510 $ 359.00 418564454 DIGITAL BLOCK 10.4185 983 $ 74.00 418564455 DIGITAL BLOCK-TC 10.4185 510 $ 285.00 418565205 FB REMOV-SCLER/CONJ SUP(PANEL) 10.4185 510 $ 227.00 418565206 F.B. REMOVAL-SCLER/CONJ -TC 10.4185 510 $ 45.00 418565210 FB REMOV-SCLER/CONJUNC (PANEL) 10.4185 510 $ 279.00 418565214 F.B. REMOVAL-SCLERAL/CONJUNCTI 10.4185 983 $ 52.00 418565215 F.B. REMOVAL-SCLERAL/CONJUNCT- 10.4185 983 $ 182.00 418565217 F.B. REMOVAL-SCLERAL/CONJUNCT- 10.4185 510 $ 227.00 418565220 FOREIGN BDY REM-CORNEA (PANEL) 10.4185 510 $ 270.00 418565222 RMV FB CORN W/SLIT LMP (PANEL) 10.4185 510 $ 281.00 418565224 FOREIGN BODY REM.-CORNEA 10.4185 983 $ 43.00 418565225 FOREIGN BODY REM.-CORNEA-TC 10.4185 510 $ 227.00 418565226 RMV FB CORNEAL W/SLIT LAMP 10.4185 983 $ 54.00 418565227 RMV FB CORNEAL W/SLIP LAMP-TC 10.4185 510 $ 227.00 418565435 RMV CORNEAL EPITHELIUM (PANEL) 10.4185 510 $ 599.00 418565439 RMV CORNEAL EPITHELIUM 10.4185 983 $ 61.00 418565440 RMV CORNEAL EPITHELIUM-TC 10.4185 510 $ 539.00 418569200 FOREIGN BODY REM.-EAR (PANEL) 10.4185 510 $ 154.00 418569204 FOREIGN BODY REM.-EAR 10.4185 983 $ 66.00 418569205 ROREIGN BODY REM.-EAR-TC 10.4185 510 $ 88.00 418569210 RMV IMPACTED-CERUMEN (PANEL) 10.4185 510 $ 128.00 418569214 RMV IMPACTED-CERUMEN 10.4185 983 $ 40.00 418569215 RMV IMPACTED-CERUMEN-TC 10.4185 510 $ 88.00 418581002 URINALYSIS W/O MICRO 10.4185 300 $ 31.00 418581015 URINALYSIS WITH MICRO 10.4185 300 $ 34.00 418581025 PREGNANCY TEST-URINE 10.4185 300 $ 46.00 418582270 OCCULT BLOOD, FECES 10.4185 300 $ 25.00 418582948 GLUCOSE 10.4185 300 $ 34.00 418585013 SPUN MICRO HEMATOCRIT 10.4185 300 $ 31.00 418585018 HEMOGLOBIN 10.4185 300 $ 34.00 418586580 PPD SKIN TEST 10.4185 300 $ 10.00 418586588 RAPID STREP 10.4185 300 $ 41.00 418587210 WET MOUNT 10.4185 300 $ 46.00 418587220 KOH PREP 10.4185 300 $ 46.00 418589203 E/M FIRST AID 10.4185 983 $ 130.00 418590465 FLU IMMUNIZATION, INJECTION 10.4185 510 $ 10.00 418590471 ADMIN IMMUNIZATION, INJECTION 10.4185 510 $ 23.00 418590780 IV INFUSION FIRST HOUR 10.4185 510 $ 286.00 418590781 INFUSION THERAPY ADD'L HRS 10.4185 260 $ 172.00 418590788 IM/SQ INJECTION 10.4185 510 $ 25.00 418590791 INFUSION HYDRATION 1ST HOUR 10.4185 260 $ 315.00 418590792 INFUSION HYDRATION ADD'L HOUR 10.4185 260 $ 190.00 418593000 EKG TRACING ONLY 10.4185 730 $ 111.00 418593005 EKG TRACING ONLY 10.4185 510 $ 111.00 418594664 NEB MED TREATMENT 10.4185 761 $ - 418594666 NEB MED TUBING 10.4185 510 $ 64.00 418599024 POSTOPERATIVE F/U VISIT 10.4185 983 $ - 418599201 BASIC EXAM (PANEL) 10.4185 510 $ - 418599202 NEW PT EXPANDED PROB (PANEL) 10.4185 510 $ - 418599203 NEW PT INTERMED EXAM (PANEL) 10.4185 510 $ - 418599204 NEW PT. EXTENDED EXAM (PANEL) 10.4185 510 $ - 418599205 NEW PT COMPREHEN EXAM (PANEL) 10.4185 510 $ - 418599207 EXAM ROOM BRIEF 10.4185 510 $ 48.00 418599208 EXAM ROOM 10.4185 510 $ 48.00 418599209 EXAM ROOM EXTENDED 10.4185 510 $ 48.00 418599211 ESTABLISHED BRIEF EXAM (PANEL) 10.4185 510 $ - 418599212 ESTABL PT/EXPAND PROB (PANEL) 10.4185 510 $ - 418599213 EST PT INTERMED EXAM (PANEL) 10.4185 510 $ - 418599214 ESTAB PT EXTENDED EXAM (PANEL) 10.4185 510 $ - 418599215 EST PT COMPREHEN EXAM (PANEL) 10.4185 510 $ - 418599354 PROLONGED SERVICE FIRST HOUR 10.4185 983 $ 190.00 419001128 TRAY LUMBAR PUNCTURE 10.4630 279 $ 130.00 419001999 MINOR SURGERY RADIOLOGY 10.4630 360 $ 558.00 419004000 ISOVUE M 200 10.4630 636 $ 436.00 419005072 MD GASTROVIES 120ML 10.4630 255 $ 283.00 419005104 TRAY - ARTHROGRAM 10.4630 272 $ 152.00 419027096 INJ SI JOINT 10.4630 361 $ 836.00 419030028 CONRAY 30 - 50CC 10.4630 250 $ 114.00 419037430 CONRAY 60 - 50CC 10.4630 250 $ 62.00 419043752 FLOURO CATH PLACEMENT 10.4630 361 $ 357.00 419044038 INJ ANTEGRADE STICK 10.4630 361 $ 1,139.00 419044050 INJ. VENOGRAM EXTREMITY 10.4630 361 $ 910.00 419044056 INJ PERC BILIARY TUBE PLACEMNT 10.4630 361 $ 1,773.00 419044162 INJ ANTEGRADE PYELOGRAM 10.4630 361 $ 368.00 419044166 EPIDUROGRAPHY 10.4630 320 $ 920.00 419044167 INJ EPIDUROGRAPHY 10.4630 361 $ 443.00 419044175 FACET BLOCK CERVICAL 10.4630 320 $ 920.00 419044176 FACET BLOCK CERVICAL ADD'L 10.4630 320 $ 920.00 419044177 INJ FACET BLOCK CERVICAL 10.4630 361 $ 443.00 419044178 INJ FACET BLOCK CERVICAL AD 10.4630 361 $ 443.00 419048400 INJECT T-TUBE CHOLE 10.4630 361 $ 531.00 419051600 INJECT CYSTOGRAPHY 10.4630 361 $ 1,047.00 419062310 INJ EPIDUROGRAPHY CERVICAL 10.4630 361 $ 420.00 419064475 INJ FACET BLOCK LUMBAR 10.4630 361 $ 443.00 419064476 INJ FACET BLOCK LUMBAR ADD 10.4630 361 $ 443.00 419066666 MASTER - FLUOROSCOPY 10.4630 320 $ - 419070030 EYE, FOREIGN BODY DETECT XRAY 10.4630 320 $ 493.00 419070100 MANDIBLE, UNIT LIM/UNI XRAY 10.4630 320 $ 250.00 419070110 MANDIBLE COMPLETE XRAY 10.4630 320 $ 377.00 419070140 FACIAL BONES LIMIT XRAY 10.4630 320 $ 279.00 419070150 FACIAL BONES COMPLETE, XRAY 10.4630 320 $ 334.00 419070160 NASAL BONES, XRAY 10.4630 320 $ 250.00 419070210 SINUSES PARANASAL LIMIT XRAY 10.4630 320 $ 227.00 419070220 SINUSES PARANASAL COMPLETE XRA 10.4630 320 $ 388.00 419070250 SKULL UNIT LIMITED XRAY 10.4630 320 $ 251.00 419070260 SKULL COMPLETE XRAY 10.4630 320 $ 504.00 419070300 TEETH SINGLE VIEW XRAY 10.4630 320 $ 98.00 419070310 TEETH PARTIAL STUDY XRAY 10.4630 320 $ 168.00 419070320 TEETH FULL MOUTH XRAY 10.4630 320 $ 311.00 419070328 TMJ OPEN & CLOSED UNILAT XRAY 10.4630 320 $ 235.00 419070330 TMJ OPEN & CLOSE BILAT XRAY 10.4630 320 $ 376.00 419070331 TMJ ARTHROGRAM UNILAT XRAY 10.4630 320 $ 773.00 419070332 TMJ ARTHROGRAM BILAT XRAY 10.4630 320 $ 1,536.00 419070355 ORTHOPANTOGRAM XRAY 10.4630 320 $ 227.00 419070360 NECK SOFT TISSUE XRAY 10.4630 320 $ 168.00 419070380 SALIVARY GLND FOR CALCUL 10.4630 320 $ 426.00 419070500 OCC HEALTH CHEST X-RAY 10.4630 324 $ 68.00 419070501 OCC HEALTH LUMBAR SPINE 10.4630 324 $ - 419070502 OCC HEALTH CERVICAL SPINE 10.4630 324 $ - 419071010 CHEST SINGLE VIEW XRAY 10.4630 324 $ 213.00 419071020 CHEST TWO VIEWS XRAY 10.4630 324 $ 239.00 419071021 CHEST - W/ APICAL LORDOTIC 10.4630 324 $ 520.00 419071025 CHEST - W/ OBLIQUES 10.4630 324 $ 632.00 419071035 CHEST DECUBITUS 10.4630 324 $ 315.00 419071037 CHEST 3V (PA-INS/EXP & LAT) 10.4630 324 $ 632.00 419071100 RIBS UNILAT W/PA CHEST XRAY 10.4630 320 $ 439.00 419071102 RIBS - UNILATERAL 10.4630 320 $ 257.00 419071110 RIBS BILATERAL WITH PA CHEST 10.4630 320 $ 504.00 419071120 STERNUM XRAY 10.4630 320 $ 282.00 419071130 XRAY-STERNOCLAVICULAR JOINTS 10.4630 320 $ 271.00 419072020 SPINE ANY LEVEL 1 VIEW XRAY 10.4630 320 $ 171.00 419072040 SPINE CERVICAL-- 2 OR 3 VIEW 10.4630 320 $ 270.00 419072050 SPINE, CERVICAL COMPLETE X-RAY 10.4630 320 $ 377.00 419072052 SPN, CERV W/OBLIQ FLX X-RAY 10.4630 320 $ 477.00 419072070 SPINE THORA-INCH SWIMMRS X-RAY 10.4630 320 $ 303.00 419072080 THORACOLUMBAR AP & LAT X-RAY 10.4630 320 $ 307.00 419072090 SPINE SCOLIOSIS STUDY 10.4630 320 $ 412.00 419072100 SPINE, LUMBOSACRL AP/LAT X-RAY 10.4630 320 $ 289.00 419072110 SPINE LUMBAR COMPLETE W/ OBLIQ 10.4630 320 $ 447.00 419072120 SPINE LUMBOSACRAL BEND ONLY 10.4630 320 $ 668.00 419072170 PELVIS, LIMITED AP ONLY X-RAY 10.4630 320 $ 239.00 419072190 PELVIS COMPLETE X-RAY 10.4630 320 $ 323.00 419072202 SACROILIAC JT COMPLETE X-RAY 10.4630 320 $ 297.00 419072220 SACRUM + COCCYX X-RAY 10.4630 320 $ 277.00 419073000 CLAVICLE X-RAY 10.4630 320 $ 247.00 419073010 SCAPULA X-RAY 10.4630 320 $ 274.00 419073020 SHOULDER, LIMITED X-RAY 10.4630 320 $ 227.00 419073030 SHOULDER COMPLETE X-RAY 10.4630 320 $ 283.00 419073050 XRAY-A/C JOINTS 10.4630 320 $ 278.00 419073060 HUMERUS, INCL BTH JOINTS X-RAY 10.4630 320 $ 249.00 419073070 ELBOW, LIMITED (AP&LAT) X-RAY 10.4630 320 $ 223.00 419073080 ELBOW, COMPLETE X-RAY 10.4630 320 $ 264.00 419073090 FOREARM, AP & LAT VIEWS 10.4630 320 $ 244.00 419073100 WRIST, LIMITED AP & LAT X-RAY 10.4630 320 $ 175.00 419073110 WRIST, COMPLETE X-RAY 10.4630 320 $ 270.00 419073120 HAND, LIMITED X-RAY 10.4630 320 $ 209.00 419073130 HAND, COMPLETE X-RAY 10.4630 320 $ 270.00 419073140 FINGER(S) X-RAY 10.4630 320 $ 228.00 419073500 HIP UNILATERAL ONE VIEW 10.4630 320 $ 185.00 419073510 HIP UNILATERAL TWO VIEWS 10.4630 320 $ 289.00 419073520 HIP BILATERAL WITH AP PELVIS 10.4630 320 $ 274.00 419073530 HIP, DURING OPERATION X-RAY 10.4630 320 $ 730.00 419073550 FEMUR, AP & LAT VIEWS X-RAY 10.4630 320 $ 271.00 419073560 KNEE LIMITED 2 VIEW 10.4630 320 $ 233.00 419073564 KNEE COMPLETE WITH OBLIQUES 10.4630 320 $ 348.00 419073590 TIBA & FIBULA W/AP & LAT X-RAY 10.4630 320 $ 244.00 419073600 ANKLE, LIMITED AP & LAT X-RAY 10.4630 320 $ 223.00 419073610 ANKLE, COMPLETE X-RAY 10.4630 320 $ 270.00 419073620 FOOT, LIMITED AP & LAT X-RAY 10.4630 320 $ 213.00 419073630 FOOT, COMPLETE X-RAY 10.4630 320 $ 263.00 419073650 CALCANUS ( HEEL) 10.4630 320 $ 211.00 419073660 TOE(S) X-RAY 10.4630 320 $ 224.00 419074000 ABDOMEN, SINGLE VIEW X-RAY 10.4630 320 $ 255.00 419074020 ABDOMEN COMPLETE X-RAY 10.4630 320 $ 315.00 419074022 ABDOMINAL SERIES - ACUTE 10.4630 320 $ 962.00 419074300 CHOLANGIOGRAPHY, OPER IN X-RAY 10.4630 320 $ 462.00 419074301 CHOLANGIOGRAM, OR ADD SET X-RA 10.4630 320 $ 260.00 419074399 ERCP RADIOGRAPHIC PROC. X-RAY 10.4630 320 $ 1,083.00 419074420 UROGRAPHY RETROGRADE 10.4630 320 $ 730.00 419074430 CYSTOGRAPHY 10.4630 320 $ 132.00 419075797 ANGIOGRAM, OPER X-RAY 10.4630 320 $ 898.00 419076000 FLUORO, UP TO 1 HOUR X-RAY 10.4630 320 $ 1,060.00 419076001 FLUORO GREATER THAN 1 HOUR XRA 10.4630 320 $ 1,589.00 419076004 NEEDLE PLACEMENT GUIDANCE 10.4630 320 $ 1,060.00 419076005 FACET BLOCK LUMBAR 10.4630 320 $ 920.00 419076006 FACET BLOCK LUMBAR ADDL 10.4630 320 $ 920.00 419076020 BONE AGE STUDIES 10.4630 320 $ 412.00 419076040 SCANOGRAM/LEG LENGTH 10.4630 320 $ 531.00 419076060 BONE SURVEY COMPLETE 10.4630 320 $ 1,185.00 419076061 BONE STUDY--LIMITED 10.4630 320 $ 198.00 419076065 BONE SURVEY - CHILD 10.4630 320 $ 553.00 419076095 SURG SPEC RAD X-RAY 10.4630 320 $ 209.00 419077000 UNLISTED X-RAY 10.4630 320 $ - 419077010 PORT MANDIBLE--LIMITED 10.4630 320 $ 596.00 419077011 PORT MANDIBLE--COMPLETE 10.4630 320 $ 710.00 419077014 PORT FACIAL BONES--LIMITED 10.4630 320 $ 596.00 419077015 PORT FACIAL BONES--COMPLETE 10.4630 320 $ 710.00 419077021 PORT PARANASAL SINUS 10.4630 320 $ 513.00 419077025 PORT SKULL--LIMITED 10.4630 320 $ 526.00 419077026 PORT SKULL--COMPLETE 10.4630 320 $ 791.00 419077101 PORT CHEST- SINGLE VIEW 10.4630 320 $ 526.00 419077102 PORT CHEST-- TWO VIEWS 10.4630 320 $ 526.00 419077202 SPINE PORTABLE ANY LEVEL 10.4630 320 $ 596.00 419077203 SPINE PORTABLE ANY LEVEL IN OR 10.4630 320 $ 596.00 419077204 PORT SPINE CERVICAL 2 VIEW 10.4630 320 $ 596.00 419077207 THORACIC SPINE PORTABLE 10.4630 320 $ 632.00 419077210 LUMBAR SPINE PORTABLE 10.4630 320 $ 637.00 419077217 PORT PELVIS-- ONE VIEW 10.4630 320 $ 542.00 419077219 PORT PELVIS-- COMPLETE 10.4630 320 $ 665.00 419077302 PORT SHOULDER 10.4630 320 $ 461.00 419077306 PORT HUMERUS 10.4630 320 $ 538.00 419077307 PORT ELBOW-LIMITED 10.4630 320 $ 538.00 419077308 PORT ELBOW-COMPLETE 4VIEW 10.4630 320 $ 587.00 419077309 PORT FOREARM 10.4630 320 $ 538.00 419077310 PORT WRIST-LIMITED 10.4630 320 $ 438.00 419077311 PORT WRIST-COMPLETE 10.4630 320 $ 596.00 419077312 PORT HAND-LIMITED 10.4630 320 $ 510.00 419077313 PORT HAND-COMPLETE 10.4630 320 $ 596.00 419077314 PORT FINGER(S) 10.4630 320 $ 502.00 419077350 PORT HIP-LIMITED 10.4630 320 $ 454.00 419077351 PORT HIP-COMPLETE 10.4630 320 $ 637.00 419077352 PORT HIP--BILATERAL 10.4630 320 $ 710.00 419077355 PORT FEMUR 10.4630 320 $ 596.00 419077356 PORT KNEE--LIMITED 10.4630 320 $ 440.00 419077357 PORT KNEE-COMPLETE 10.4630 320 $ 425.00 419077359 PORT TIBIA & FIBULA 10.4630 320 $ 538.00 419077360 PORT ANKLE- 2 VIEW 10.4630 320 $ 519.00 419077361 PORT ANKLE-COMPLETE 10.4630 320 $ 596.00 419077362 PORT FOOT-LIMITED 10.4630 320 $ 504.00 419077363 PORT FOOT-COMPLETE 10.4630 320 $ 582.00 419077366 PORT TOE(S) 10.4630 320 $ 493.00 419077370 PORT CALCANEUS 10.4630 320 $ 513.00 419077400 PORT ABDOMEN 1 VIEW 10.4630 320 $ 563.00 419077402 PORT ABDOMEN-COMPLETE 10.4630 320 $ 604.00 419077440 PORT UROGRAPHY 10.4630 320 $ 730.00 419077777 MASTER - GENERAL DIAGNOSTIC 10.4630 320 $ - 419100400 PATHOLOGY SPEC COLLECTION 10.4191 270 $ 89.00 419100500 STEREO BRST BX W MRKR (PANEL) 10.4191 360 $ - 419100502 STEREO BRST BX W MRKR 10.4191 360 $ 1,274.00 419100510 STEREO BRST BX NO MRKR (PANEL) 10.4191 360 $ - 419100512 STEREO BRST BX NO MRKR 10.4191 360 $ 874.00 419100520 US BRST BX W MRKR (PANEL) 10.4191 360 $ - 419100522 US BRST BX W MRKR 10.4191 360 $ 2,155.00 419100530 US BRST BX NO MRKR (PANEL) 10.4191 360 $ - 419100532 US BRST BX NO MRKR 10.4191 360 $ 1,755.00 419100540 US BRST NDL COR W MRKR (PANEL) 10.4191 360 $ - 419100542 US BRST NDL CORE W MRKR 10.4191 360 $ 2,155.00 419100550 US BRST NDL COR NO MRKR(PANEL) 10.4191 360 $ - 419100552 US BRST NDL CORE NO MRKR 10.4191 360 $ 1,755.00 419100562 BRST CYST ASPIRATION 10.4191 360 $ 1,500.00 419106000 BZZ GUIDE NEEDLE 14G 10.4191 272 $ 39.00 419106001 BZZ GUIDE NEEDLE 20G 10.4191 272 $ 39.00 419106002 BZZ GUIDE PROBE DISP 11G 10.4191 272 $ 103.00 419106003 BZZ MAMMOTOME MULTI 11G 10.4191 272 $ 962.00 419106004 BZZ MAMMOTOME MULTI 14G 10.4191 272 $ 962.00 419106005 BZZ MICROMARK 11G STEREO 10.4191 278 $ 755.00 419106006 BZZ MONOPTY GUN 14X10CM 10.4191 272 $ 400.00 419106007 BZZ NEEDLE BIOPSY 14X10CM MAX 10.4191 272 $ 425.00 419106008 BZZ NEEDLE BIOPSY 14X16CM MAX 10.4191 272 $ 425.00 419106009 BZZ NEEDLE BIOPSY 14X20CM MAX 10.4191 272 $ 425.00 419106010 BZZ MICROMARK 11G US 10.4191 278 $ 755.00 419106011 BZZ TRACKER COIL 2MM X 2 CM 10.4191 272 $ 1,021.00 419106012 BZZ TRACKER COIL 2MM X CM 10.4191 272 $ 1,021.00 419106013 BZZ MAMMOTOME HH PROBE 11G 10.4191 272 $ 1,569.00 419106014 BZZ MAMMOTOME ST PROBE 11G 10.4191 272 $ 1,531.00 419106015 BZZ MAMMOTOME VACUUM SET US 10.4191 272 $ 174.00 419106016 BZZ MAMMOTOME VAC SET ST 10.4191 272 $ 174.00 419106017 BZZ ULTRA GEL MARK US 10.4191 278 $ 755.00 419106018 BZZ ULTRA GEL MARK ST 10.4191 278 $ 755.00 419106020 BZZ SENO VACUUM ASSIST DEVICE 10.4191 272 $ 1,743.00 419106030 BZZ SENO NEEDLE GUIDE 10.4191 272 $ 94.00 419106040 BZZ NEEDLE LOC MANAN 21GX3CM 10.4191 272 $ 228.00 419106050 BZZ NEEDLE MONOPTY 14GX16CM 10.4191 272 $ 754.00 419109618 BCEDP FOLLOW UP ASSURE F/U 10.4191 401 $ 68.00 419119000 PUNCTURE ASPIRATION CYST 10.4191 361 $ 490.00 419119001 ADD'L ASPIRATION CYST 10.4191 361 $ 211.00 419119100 BREAST BX, NEEDLE CORE 10.4191 361 $ 1,437.00 419119101 BREAST BX INCISONAL 10.4191 361 $ 4,116.00 419119290 PLACEMENT NEEDLE LOCALIZATION 10.4191 361 $ 461.00 419119295 PLACEMENT LOCALIZATION CLIP-ST 10.4191 361 $ 461.00 419119296 PLACEMENT LOCALIZATION MARKER- 10.4191 361 $ 461.00 419120010 INTIAL EVALUATION 10.4191 510 $ 286.00 419120015 LYMPH TREATMENT ROOM 10.4191 510 $ 186.00 419120017 LYMPH ROOM GARMENT ARM 10.4191 510 $ 101.00 419120018 LYMPH ROOM GARMENT LEG 10.4191 510 $ 114.00 419120019 LYMPH ROOM MISC 10.4191 510 $ 149.00 419120020 LYMPH F/U VIST 10.4191 510 $ 84.00 419129317 BCEDP CASE MANAGE 10.4191 510 $ 96.00 419155555 MASTER - MAMMOGRAPHY 10.4191 401 $ - 419160955 ADD'L STEREO LOCAL 10.4191 320 $ 940.00 419160965 ADD'L NEEDLE LOC. SITE 10.4191 320 $ 504.00 419169425 PREOP LOCALIZATION--US 10.4191 402 $ 1,285.00 419176086 MAMMARY DUCTOGRAM SINGLE 10.4191 401 $ 479.00 419176088 MAMMARY DUCTOGRAM MULTIPLE 10.4191 401 $ 572.00 419176090 MAMMO UNILATERAL DIAG. 10.4191 401 $ 223.00 419176091 DIAGNOSTIC MAMMOGRAPHY 10.4191 401 $ 260.00 419176092 SCREENING MAMMOGRAPHY 10.4191 403 $ 131.00 419176095 STEREO. LOCAL., EACH LESION 10.4191 320 $ 1,726.00 419176096 PREOP LOCALIZATION--XRAY 10.4191 320 $ 967.00 419176098 SPECIMEN X-RAY EXAML 10.4191 320 $ 136.00 419176100 **CONTRACT SCREENING MAMMOGRAM 10.4191 403 $ - 419176645 ULTRASOUND BREAST BILATERAL 10.4191 402 $ 531.00 419176646 ULTRASOUND BREAST UNILATERAL 10.4191 402 $ 1,063.00 419176938 ULTRASOUND CYST ASPIRATION 10.4191 402 $ 845.00 419176942 ULTRASOUND BIOPSY BREAST 10.4191 402 $ 845.00 419188888 MASTER - ULTRASOUND 10.4191 402 $ - 419190706 SUPPLY MISC. 10.4191 272 $ - 419190710 ADD'L MICRO CLIP 10.4191 272 $ 479.00 419191005 ADD'L BX BREAST NEEDLE CORE 10.4191 361 $ 623.00 419191015 ADD'L BREAST BX INCISIONAL 10.4191 361 $ 623.00 419200100 MATERIAL-DEPOSIT NON-REFUNDABL 10.4192 990 $ 61.00 419200101 MBSRC/CLASS FEE 10.4192 990 $ - 419200200 STRESS REDUCTION CPT 99412 10.4192 990 $ 20.00 419200300 DX EXIT INTERVIEW CPT 90801 10.4192 990 $ 84.00 419200400 STRESS REDUCTION-CPT 99078 10.4192 990 $ 20.00 419200500 STRESS REDUCTION DX-CPT 99078 10.4192 990 $ 18.00 419200600 DX EXIT INTERVIEW-CPT 90801 10.4192 990 $ 55.00 419200700 STRESS REDUCTION CPT 99078 10.4192 990 $ 14.00 419200800 GROUP PSYCHOTHERAPY 10.4192 990 $ 20.00 419200900 TEAM CASE CONF COORD PHYS 10.4192 510 $ 100.58 419200905 TEAM CASE CONF COORD AHP 10.4192 510 $ 72.00 419200910 ROOM CHARGE 10.4192 510 $ 30.00 419200915 TEAM CASE CONF PARTICIPANT 10.4192 510 $ 50.29 419200920 RN ASSESSMENT 10.4192 510 $ 16.80 419200925 MSW ASSESSMENT 10.4192 510 $ 16.80 419200930 TEAM CASE CONF PARTICIPANT, RN 10.4192 510 $ 8.40 419200935 TEAM CASE CONF PARTICIPANT, MS 10.4192 510 $ 8.40 419200940 TEAM CASE CONF PARTICIPANT, AH 10.4192 510 $ 8.40 419200945 INTERMEDIATE LEVEL REPORT 10.4192 510 $ 30.00 419200950 COMPREHENSIVE LEVEL REPORT 10.4192 510 $ 54.00 419200955 TELEPHONE CONSULT, AHP 10.4192 510 $ 8.40 419200960 CLEFT PALATE CONF INTERMED 10.4192 510 $ - 419200965 CLEFT PALATE CONF COMPREHEN 10.4192 510 $ - 419236410 VENIPUNCTURE/LIVER CLINIC 10.4192 510 $ 13.00 419290801 DIAGNOSTIC INTAKE INTERVIEW 10.4192 990 $ 84.00 419299202 LIVER CLINIC VISIT-NEW PT 10.4192 510 $ 79.00 419299212 LIVER CLINIC VISIT-EST PT 10.4192 761 $ 55.00 419310002 ANTI-COAG CLINIC VISIT 10.4193 510 $ 35.00 419310010 ANTI-COAG INITIAL VISIT 10.4193 510 $ 66.00 419310390 INJECTION IM/SQ 10.4193 510 $ 18.00 419336415 DRAW FEE 10.4193 300 $ 10.00 419385610 PROTIME 10.4193 305 $ 24.50 419386510 PROTIME 10.4193 305 $ 24.50 419800240 LAB DRAW - PERIPHERAL 10.4198 300 $ 17.00 419800306 INFUSION SEQUENTIAL 1ST HOUR 10.4198 260 $ 158.00 419800307 INFUSION THERAPY 1ST HOUR 10.4198 260 $ 315.00 419800308 INFUSION HYDRATION 1ST HOUR 10.4198 260 $ 315.00 419800309 INFUSION THERAPY ADD'L HRS 10.4198 260 $ 190.00 419800310 INFUSION HYDRATION ADD'L HOUR 10.4198 260 $ 190.00 419800311 INFUSION THERAPY 1ST HR - CX 10.4198 260 $ 578.00 419800313 INF THER ADD'L HRS(CX) 10.4198 260 $ 190.00 419800410 IVIG INFUSION 10.4198 260 $ 165.00 419807100 ASSIST W PROCEDURE LEVEL 1 10.4198 360 $ 918.00 419807200 ASSIST W PROCEDURE LEVEL 2 10.4198 360 $ 1,482.00 419810010 CLINIC VISIT 0-15 MIN 10.4198 510 $ 116.00 419810015 LAB W VAD MAINTENANCE (PANEL) 10.4198 761 $ - 419810020 CLINIC VISIT 15-45 MIN 10.4198 510 $ 174.00 419810025 CLINIC VISIT 45-90 MIN 10.4198 510 $ 235.00 419810030 CLINIC VISIT - NEW PATIENT 10.4198 510 $ 271.00 419810060 TRANSFUSION THERAPY 0-3 HR 10.4198 391 $ 700.00 419810061 TRANSFUSION THERAPY 3-6 HR 10.4198 391 $ 930.00 419810062 TRANSFUSION THERAPY > 6 HR 10.4198 391 $ 1,164.00 419810064 TRANSFUSION THERAPY 0-3 HR CX 10.4198 391 $ 1,047.00 419810066 TRANSFUSION THERAPY 3-6 HR CX 10.4198 391 $ 1,280.00 419810068 TRANSFUSION THERAPY >6 HR CX 10.4198 391 $ 1,511.00 419810070 LONG ARM CATHETER INSERTION 10.4198 761 $ 759.00 419810071 LONG ARM CATH (PANEL) 10.4198 761 $ - 419810075 THERAPEUTIC PHLEBOTOMY 10.4198 761 $ 227.00 419810076 THERAPEUTIC PHLEBOTOMY-CX 10.4198 761 $ 304.00 419810080 CHEMO IM / SQ 10.4198 331 $ 266.00 419810081 CHEMO IV PUSH INITIAL 10.4198 331 $ 104.00 419810082 CHEMOTHERAPY-SIMPLE-CX 10.4198 331 $ 633.00 419810084 CHEMO IV PUSH SUBSEQUENT DRUG 10.4198 331 $ 94.00 419810085 CHEMOTHERAPY-INFUSION 0-1 HR 10.4198 335 $ 449.00 419810086 CEMOTHERAPY ADD'L HRS 10.4198 335 $ 433.00 419810087 CHEMOTHERAPY ADD'L SEQUENTIAL 10.4198 335 $ 217.00 419810140 CHEMOTHERAPY-INFUSION 0-1 HR-C 10.4198 335 $ 836.00 419810141 CHEMOTHERAPY ADD'L HRS - CX 10.4198 335 $ 641.00 419810300 ASSESSMENT IMPLANT REFILL 10.4198 761 $ 74.00 419810301 MAINTENANCE IMPLNT PMP (PANEL) 10.4198 761 $ - 419810302 ASSESS IMPLANT REFILL (PANEL) 10.4198 761 $ 350.00 419810303 MAINT IMPLNT PMP-CX (PANEL) 10.4198 761 $ - 419810304 ASSES IMPLANT REFILL-CX(PANEL) 10.4198 761 $ - 419810305 PROGRAM PUMP-CX 10.4198 761 $ 323.00 419810306 PROGRAM PUMP 10.4198 761 $ 40.00 419810380 IV INJECTION INITIAL 10.4198 761 $ 101.00 419810381 IV INJECTION SUBSEQUENT DRUG 10.4198 761 $ 101.00 419810390 INJECTION IM/SQ 10.4198 761 $ 101.00 419810500 BONE MARROW NEEDLE BIOPSY 10.4198 361 $ 438.00 419810501 BONE MARROW ADDITIONAL SITE 10.4198 761 $ 220.00 419830335 SUPP-LONG ARM CATH INSERTION T 10.4198 270 $ 482.00 419830349 SUPP-OXYGEN 1-4 HRS 10.4198 270 $ 82.00 419830354 SUPP-OXYGEN 4-12 HRS 10.4198 270 $ 184.00 419830375 LONG ARM CATHETER INSERTION SU 10.4198 272 $ 423.00 419830376 PICC MICROINTRODUCER 10.4198 279 $ 129.00 419830385 MICROINTRODUCER 10.4198 272 $ 219.00 419836430 TRANSFUSION THERAPY 0-3 HR 10.4198 391 $ 700.00 419836550 DECLOT VAD 10.4198 761 $ 150.00 419862272 LUMBAR PUNCTURE THERAPEUTIC 10.4198 361 $ 307.00 419862367 PUMP READING ONLY 10.4198 761 $ 250.00 419862368 PROGRAM PUMP 10.4198 761 $ 275.00 419880426 SUPP-LUMBAR PUNCTURE-ADULT 10.4198 270 $ 170.00 419890471 FLU IMMUNIZATION, INJECTION 10.4198 510 $ 101.00 419890472 IMMUNIZATION SUBSEQUENT 10.4198 510 $ 101.00 419890760 HYDRATION IV INFUSION - INIT 10.4198 260 $ 315.00 419890761 HYDRATE IV INFUSION - ADD-ON 10.4198 260 $ 190.00 419890765 INFUSION THERAPY 1ST HOUR 10.4198 260 $ 315.00 419890766 INFUSION THERAPY ADD'L HRS 10.4198 260 $ 190.00 419890767 INFUSION SEQUENTIAL 1ST HOUR 10.4198 260 $ 190.00 419890768 INFUSION SEQUENTIAL ADD'L HRS 10.4198 260 $ 190.00 419890772 INJECTION IM/SQ 10.4198 761 $ 101.00 419890774 IV INJECTION INITIAL 10.4198 761 $ 101.00 419890775 IV INJECTION SUBSEQUENT DRUG 10.4198 761 $ 101.00 419890788 IM INJECTION - ANTIBIOTIC 10.4198 761 $ 101.00 419895115 SINGLE ALLERGEN IMMUNO. INJ. 10.4198 761 $ 59.00 419895117 TWO OR MORE ALLERGEN IMMUNO. I 10.4198 761 $ 88.00 419896401 CHEMO IM / SQ 10.4198 331 $ 266.00 419896402 CHEMO INJ IM/SQ HORMONE 10.4198 761 $ 266.00 419896409 CHEMO IV PUSH INITIAL 10.4198 331 $ 120.00 419896411 CHEMO IV PUSH SUBSEQUENT DRUG 10.4198 331 $ 120.00 419896413 CHEMOTHERAPY-INFUSION 0-1 HR 10.4198 335 $ 449.00 419896415 CEMOTHERAPY ADD'L HRS 10.4198 335 $ 433.00 419896417 CEMOTHERAPY ADD'L HRS 10.4198 335 $ 433.00 419896445 CHEMOTHERAPY, INTRACAVITARY 10.4198 335 $ 475.00 419899195 THERAPEUTIC PHLEBOTOMY 10.4198 761 $ 227.00 419899203 NEW PATIENT - NON CHEMO 10.4198 510 $ 200.00 419899204 CLINIC VISIT - NEW PATIENT 10.4198 510 $ 271.00 419899212 CLINIC VISIT 0-15 MIN 10.4198 510 $ 116.00 419899213 CLINIC VISIT 15-45 MIN 10.4198 510 $ 174.00 419899214 CLINIC VISIT 45-90 MIN 10.4198 510 $ 235.00 419899215 CLINIC VISIT 45-90 MIN 10.4198 510 $ 271.00 420000005 MINI SURGICAL PROCEDURE 10.4200 360 $ 2,252.00 420000010 TREATMENT ROOM I 10.4200 510 $ 209.00 420000015 TREATMENT ROOM II 10.4200 510 $ 370.00 420000206 FUNDUS PHOTOS 10.4200 920 $ 412.00 420000305 RETINAL ANGIO ONE EYE 10.4200 920 $ 366.00 420000308 INFUSION THERAPY 0-1 HR 10.4200 260 $ 315.00 420000309 INFUSION THERAPY ADD'L HRS 10.4200 260 $ 190.00 420000310 INFUSION THERAPY ADD'L HRS 10.4200 260 $ 190.00 420000311 INFUSION HYDRATION ADD'L HOUR 10.4200 260 $ 190.00 420000400 TRANSFUSION THERAPY 0-3 HR 10.4200 391 $ 699.00 420000404 RETINAL ANGIO BOTH EYES 10.4200 920 $ 549.00 420000410 TRANSFUSION THERAPY 3-6 HR 10.4200 391 $ 930.00 420000420 TRANSFUSION THERAPY > 6 HR 10.4200 391 $ 1,163.00 420000430 TRANSFUSION THERAPY 0-3 HR CX 10.4200 391 $ 1,045.00 420000440 TRANSFUSION THERAPY 3-6 HR CX 10.4200 391 $ 1,279.00 420000450 TRANSFUSION THERAPY >6 HR CX 10.4200 391 $ 1,509.00 420002000 OP SURGERY 0<1 HR 10.4200 360 $ 5,367.00 420002010 OP SURGERY (MINUTES) 10.4200 360 $ 63.00 420002012 DENTAL SURGERY 0<1 HR 10.4200 360 $ 2,055.00 420002014 DENTAL SURGERY > 1HR 10.4200 360 $ 4,099.00 420002020 OP LASER SURGERY 0<1 HR 10.4200 360 $ 2,547.00 420002030 OP LASER SURGERY (MINUTES) 10.4200 360 $ 41.00 420002032 LITHOTRIPSY SURGERY 0<1 HR 10.4200 790 $ 6,495.00 420002034 LITHOTRIPSY SURGERY (MINUTES) 10.4200 790 $ 55.00 420002036 LITHOTRIPSY SURG BILAT 0<1 HR 10.4200 790 $ 9,795.00 420002038 LITHOTRIPSY SURG BILAT (MIN) 10.4200 790 $ 55.00 420002040 RECOVERY ROOM 0<1 HR 10.4200 710 $ 688.00 420002050 RECOVERY ROOM (MINUTES) 10.4200 710 $ 7.00 420002060 GENERAL ANESTHESIA 0<1 HR 10.4200 370 $ 732.00 420002070 GENERAL ANESTHESIA (MINUTES) 10.4200 370 $ 8.00 420002780 LASER EYE LEVEL II 10.4200 360 $ 1,788.00 420004000 ISOVUE M 200 100ML 10.4200 636 $ 435.00 420004001 ISOVUE M 300 100ML 10.4200 636 $ 435.00 420010090 RN FIRST ASSIST-SDS / MIN 10.4200 360 $ 1.72 420022030 O/P SURGERY - 2 PEOPLE (MINUTE 10.4200 360 $ 117.00 420023030 O/P SURGERY - 3 PEOPLE (MINUTE 10.4200 360 $ 121.00 420024030 O/P LASER SURGERY 10.4200 360 $ 123.00 420081025 SDS URINE PREGNANCY 10.4200 300 $ 54.00 420090870 ECT INITIAL SEIZURE 10.4200 901 $ 1,823.00 420090871 ECT ADDITIONAL (SAME DAY) 10.4200 901 $ 911.00 420095972 ANALYZE NEUROSTIM CMPLX 1ST HR 10.4200 481 $ 260.00 420095973 ANALYZ NEUROSTIM CMPLX ADD 30M 10.4200 481 $ 130.00 420100010 M-ADHESION BARRIER 10.4200 278 $ - 420100030 M-ANCHOR/SCREW BN/BN-TIS/BN 10.4200 278 $ - 420100050 M-CATH- BAL DIL- NON-VASCULAR 10.4200 279 $ - 420100070 M-CATH- DRAINAGE 10.4200 279 $ - 420100110 M-CATH- HEMODIALY-LONG-TERM 10.4200 278 $ - 420100150 M-CATH- INTRAVAS ULTRASOUND 10.4200 279 $ - 420100170 M-CATH- THROMBECT/EMBOLECT 10.4200 279 $ - 420100230 M-CATH-HEMODIALY-SHORT-TERM 10.4200 279 $ - 420100250 M-CATHETER- INTRASPINAL 10.4200 279 $ - 420100270 M-CATHETER- URETERAL 10.4200 279 $ - 420100290 M-CLOSURE DEV- VASC 10.4200 278 $ - 420100310 M-CONN TISS- HUMAN(INC FASCIA) 10.4200 278 $ - 420100330 M-CONN TISS- NON-HUMAN 10.4200 278 $ - 420100350 M-ENDOVAS NON-CARDIAC ABL CATH 10.4200 279 $ - 420100370 M-GENERATOR- NEUROSTIM- IMP 10.4200 278 $ - 420100390 M-GRAFT- VASCULAR 10.4200 278 $ - 420100410 M-INF PUMP- PROGRAMMABLE 10.4200 278 $ - 420100430 M-INTRO/SHEATH-FIXED-PEEL-AWAY 10.4200 279 $ - 420100450 M-INTRO/SHEATH-STRBLE-NON-PEEL 10.4200 279 $ - 420100470 M-JOINT DEVICE (IMPLANTABLE) 10.4200 278 $ - 420100472 M-FINGER JOINT 10.4200 278 $ - 420100490 M-LEAD- NEUROSTIMULATOR 10.4200 278 $ - 420100550 M-MESH (IMPLANTABLE) 10.4200 278 $ - 420100570 M-PORT- INDWELLING- IMP 10.4200 278 $ - 420100590 M-PROSTHESIS- BREAST- IMP 10.4200 278 $ - 420100610 M-PROSTHESIS- PENILE- INFLATAB 10.4200 278 $ - 420100630 M-STENT- COATED/COV W/DEL SYS 10.4200 278 $ - 420100650 M-STENT- NON-COAT/COV W/O DEL 10.4200 278 $ - 420121208 SYNERGY NEUROSTIM GENERATOR 10.4200 278 $ 37,088.00 420200001 MT MISC SURG SUPPLIES 10.4200 272 $ - 420200010 SUPPLY - CONVERSION 10.4200 272 $ - 420200020 IMPLANT MISCELLANEOUS 10.4200 278 $ - 420200077 CATHETER, URETERAL OPEN-END 10.4200 279 $ 536.00 420200081 CATHETER, URETERAL CONETIP 10.4200 279 $ 348.00 420200086 CATHETER, URETERAL FLEXITIP 10.4200 279 $ 227.00 420200095 CATHETER, URETERAL SPIRAL 10.4200 279 $ 246.00 420200103 CATHETER,URETERAL WHISTLE 10.4200 279 $ 212.00 420200145 BLAKE DRAIN 10.4200 270 $ 348.00 420200710 BIO-INTERFERENCE SCREW 10.4200 278 $ 1,460.00 420200712 TIBIAL TUNNEL CANNULA 10.4200 279 $ 2,205.00 420200714 6TH FINGER KNOT PUSHER 10.4200 272 $ 933.00 420200716 SUTURE LASSO W/WIRE LOOP 10.4200 272 $ 1,109.00 420200718 FASTAK SUTURE ANCHOR 10.4200 278 $ 1,635.00 420200722 CORKSCREW SUTURE LASSO 10.4200 278 $ 1,518.00 420200724 CORKSCREW SUTURE ANCHOR 10.4200 278 $ 2,159.00 420200726 BIO-CORKSCREW SUTURE ANCHOR 10.4200 278 $ 2,714.00 420200730 STAR SLEEVE 10.4200 272 $ 816.00 420200732 FIBER WIRE 10.4200 278 $ 235.00 420200736 CAPS X-ARTHROWAND 10.4200 272 $ 3,091.00 420200738 THE WEDGE 10.4200 278 $ 1,987.00 420200742 MENISCUS REPAIR NEEDLE 10.4200 272 $ 299.00 420200744 MENISCECTOMY ELECTRODE 10.4200 272 $ 373.00 420200746 ROTATOR CUFF REPAIR SUT RETRIE 10.4200 272 $ 478.00 420200748 MINI QUICK ANCHOR 10.4200 278 $ 2,380.00 420200752 SHOULDER IMMOBILIZER W/FOAM ST 10.4200 271 $ 175.00 420200754 KNEE BRACE W/HINGE 10.4200 271 $ 1,132.00 420200776 DIAMOND BUR 10.4200 272 $ 1,005.00 420200778 IC GREEN STAIN 10.4200 250 $ 432.00 420200780 WALL GRAFT-STANDARD 6MM X 10MM 10.4200 278 $ 1,575.00 420200784 FASTIN ANCHORS 10.4200 278 $ 1,283.00 420200788 EXPRESS SEW SUTURE NEEDLE 10.4200 272 $ 1,109.00 420200790 CANNULA / LONG 5.7 10.4200 272 $ 267.00 420200792 BLADE/LONG MED AGGRESS W/STOP 10.4200 272 $ 394.00 420200796 ABLATOR 60-DEG / 90-DEG 10.4200 272 $ 1,646.00 420200802 NEBULIZER 10.4200 272 $ 26.00 420200812 DERMABOND 10.4200 636 $ 325.00 420200903 ARTHREX CORING REAMER 10.4200 272 $ 893.00 420200905 ARTHREX KNOT PUSHER 10.4200 272 $ 343.00 420200907 ARTHRO WAND 10.4200 272 $ 851.00 420200908 ALLODERM 1X4/102007 10.4200 278 $ 1,030.00 420200910 ALLODERM 2X4CM/102012 10.4200 278 $ 1,804.00 420200912 ALLODERM 3X7CM/102021 10.4200 278 $ 1,919.00 420200914 ARTHREX FIBERWIRE 10.4200 278 $ 66.00 420200916 ARTHREX ANCHOR CORKSCREW 10.4200 278 $ 824.00 420200918 ARTHREX CANNULA 10.4200 272 $ 85.00 420200920 ARTHREX FASTAK ANCHOR 2.8MM 10.4200 278 $ 618.00 420200922 ASH SPLIT CATH WITH CUFF 10.4200 278 $ 1,827.00 420200924 BIO CORKSCREW 10.4200 278 $ 1,030.00 420200926 BONE MATRIX GEL 10CC GRAFTON 10.4200 278 $ 3,165.00 420200928 BONE PUTTY DBX 1CC/038010 10.4200 278 $ 751.00 420200930 BONE PUTTY DBX 5CC/038050 10.4200 278 $ 2,305.00 420200932 CANNULA 10.4200 279 $ 91.00 420200934 CARTICEL TRANSPORT KIT/80001 10.4200 272 $ 2,060.00 420200936 CATH HICKMAN DUAL LUMEN 9FR 10.4200 278 $ 591.00 420200938 CATH HICKMAN SINGLE LUMEN 10.4200 278 $ 614.00 420200940 CATH HICKMAN TRIPLE 13.5FR 10.4200 278 $ 774.00 420200942 CATH INTRODUCER PEEL APART 10.4200 279 $ 188.00 420200944 CATH TAUT/20018-M55/TAUT 10.4200 279 $ 129.00 420200946 CATH BALLOON DILATION 10.4200 279 $ 1,032.00 420200948 CATH CAUD-ACATH RACZ 19 10.4200 279 $ 282.00 420200950 CATH COUDE 10.4200 279 $ 41.00 420200952 CATH COUNCIL 10.4200 279 $ 73.00 420200958 CATH DIALYSIS HEMOGLIDE 10.4200 279 $ 1,260.00 420200960 CATH EMBOLECTOMY 10.4200 278 $ 238.00 420200968 CATH EPIDURAL TUN LXL RACZ 10.4200 279 $ 297.00 420200970 CATH FLEXI TIP 4FR 10.4200 279 $ 39.00 420200972 CATH GROSHONG DUAL V/C 9.5 10.4200 278 $ 1,424.00 420200974 CATH GROSHONG PICC 8SINGLE 10.4200 278 $ 1,159.00 420200976 CATH HEMOGLIDE PC2/5664232 10.4200 278 $ 1,260.00 420200978 CATH PERITONEAL CURLED 10.4200 278 $ 328.00 420200980 CATH SG TD 7F 10.4200 279 $ 183.00 420200982 CATH THORACIC 28 FR 10.4200 279 $ 25.00 420200984 CATH URETERAL 10.4200 279 $ 102.00 420200988 CHOLANGIOCATH 10.4200 279 $ 256.00 420200990 CLIP WOUND 10.4200 278 $ 5.00 420200992 CLOSURE INTRAVASCULAR CATH 10.4200 279 $ 2,503.00 420200994 DRAIN BLAKE 10.4200 279 $ 107.00 420200996 DRAIN HEMOVAC 10.4200 279 $ 64.00 420200998 DRAIN JACKSON-PRATT 10.4200 279 $ 23.00 420201000 ENDOCATCH 10.4200 272 $ 383.00 420201002 ENDOCLIP 10.4200 278 $ 405.00 420201004 FALOPE-RING 10.4200 278 $ 175.00 420201006 FLOSEAL 10.4200 279 $ 3,313.00 420201008 GAIT IMPLANT 10.4200 278 $ 1,145.00 420201010 INTRO PERC LEAD 10.5 FR/6210-S 10.4200 278 $ 119.00 420201012 INTRODUCER SHEATH 10.4200 279 $ 42.00 420201014 KIT HIP ARTHROSCOPY 10.4200 272 $ 1,717.00 420201016 K-WIRE 10.4200 278 $ 71.00 420201018 MESH COMPOSIX 3 X 6/0113360 10.4200 278 $ 1,058.00 420201020 MESH COMPOSIX 4 X 8/0113480 10.4200 278 $ 1,529.00 420201022 MESH COMPOSIX 6 X 8/0113680 10.4200 278 $ 2,129.00 420201024 MESH KUGAL COMPOSIX OVAL 10.4200 278 $ 2,880.00 420201026 MESH KUGAL HERNIA PATCH SMALL 10.4200 278 $ 1,117.00 420201028 MESH MARLEX 10 X 14/0122660 10.4200 278 $ 505.00 420201030 MESH MARLEX 3 X 6/0112680 10.4200 278 $ 247.00 420201032 MESH MARLEX PLUG 10.4200 278 $ 670.00 420201034 MITEK FASTIN RC/222721 10.4200 278 $ 824.00 420201036 MITEK KNOTLESS ANCHHOR/212029 10.4200 278 $ 2,592.00 420201038 MITEK MINI ANCHOR #2-0/212033 10.4200 278 $ 1,241.00 420201040 MITEK QUICK ANCHOR 1.3/212866 10.4200 278 $ 1,204.00 420201042 MITEK THREADED ANCHOR 10.4200 278 $ 526.00 420201044 MORGAN-MEDI FLOW LENS/MT 100 10.4200 278 $ 69.00 420201046 NORIAN BONE VOID FILLER 3 CC 10.4200 278 $ 2,278.00 420201048 NORIAN BONE VOID FILLER 5 CC 10.4200 278 $ 2,399.00 420201050 NORIAN DELIVERY SYRINGE 10.4200 272 $ 728.00 420201052 OPUS M CONNECTOR/OM8007 10.4200 278 $ 464.00 420201054 OPUS MAGNUM IMPLANT/OM1500 10.4200 278 $ 1,237.00 420201056 OPUS SUTURE CARTRIDGE/OM8071 10.4200 278 $ 515.00 420201058 OROTHO SORB PIN 40X1.3/84-1052 10.4200 278 $ 172.00 420201060 ORTHO SORB PIN 40X2MM/84-2052 10.4200 278 $ 584.00 420201062 PERMACATH TRAY 40/8817749001 10.4200 278 $ 858.00 420201064 PORT DUAL MRI 9.5/0605900 10.4200 278 $ 1,896.00 420201066 PORT SINGLE MRI PLASTIC 10.4200 278 $ 1,282.00 420201068 PROS EAR APPLEBAUM 14-0957 10.4200 278 $ 1,684.00 420201070 PROS EAR APPLEBAUM/14-0956 10.4200 278 $ 1,401.00 420201072 PROS EAR CAPCEL PART/11-12095 10.4200 278 $ 1,030.00 420201074 PROS EAR SHEEHY/11-12362 10.4200 278 $ 905.00 420201076 PROS EAR SHEEHY/11-12363 10.4200 278 $ 875.00 420201078 PROS TUBE MILLEN THIN HEAD/056 10.4200 278 $ 1,556.00 420201080 ROD HUNTER TENDON 10.4200 278 $ 1,260.00 420201082 SCREW DELTA 11MM X 35MM 10.4200 278 $ 847.00 420201084 SPINECATH CATHETER 10.4200 279 $ 3,114.00 420201086 STAR SLEEVE AR1606 10.4200 279 $ 297.00 420201088 STONE BASKET 10.4200 279 $ 778.00 420201090 STRAIGHT SHOT 10.4200 279 $ 322.00 420201092 SUTURE CORKSCREW 10.4200 278 $ 572.00 420201094 SUTURE LASSO 10.4200 272 $ 412.00 420201096 SUTURE PASSER 10.4200 272 $ 169.00 420201098 SUTURE RETRIEVER 10.4200 272 $ 129.00 420201100 SYNTHES SCREW CORTICAL 10.4200 278 $ 69.00 420201104 SYNTHES PLATE MINI FRAG 10.4200 278 $ 135.00 420201106 SYNTHES CLOVERLEAF PLATE 10.4200 278 $ 650.00 420201108 SYNTHES PLATE LC-DCP 10.4200 278 $ 458.00 420201110 SYNTHES PLATE L-OBLIQUE 10.4200 278 $ 109.00 420201112 SYNTHES PLATE TUBULAR 10.4200 278 $ 195.00 420201114 SYNTHES SCREW CANCELLOUS 4.0 10.4200 278 $ 59.00 420201116 SYNTHES SCREW CANNULATED 10.4200 278 $ 828.00 420201118 SYNTHES PLATE T SM 10.4200 278 $ 454.00 420201120 SYNTHES WASHER 10.4200 278 $ 79.00 420201122 TRAY CHEST DRAIN SNGL 10.4200 279 $ 130.00 420201124 TRAY CVP MULTI-LUMEN 7F-3L 10.4200 279 $ 255.00 420201126 TRAY EPIDURAL CATHETER DISP 10.4200 279 $ 90.00 420201128 TRAY LUMBAR PUNCTURE 10.4200 279 $ 54.00 420201130 TRAY PERCUTANEOUS INTRA 8.5 10.4200 279 $ 103.00 420201132 TRAY PERMACATH 40CM DUAL 10.4200 278 $ 1,052.00 420201134 TROCAR CHEST 10.4200 279 $ 87.00 420201136 TUBE BOBBIN COLLAR/145289 10.4200 278 $ 90.00 420201138 TUBE EAR ACTIVENT/10-37005 10.4200 278 $ 31.00 420201140 TUBE EAR GOUDE-T12/10-16010 10.4200 278 $ 15.00 420201142 TUBE EAR REUTER/10-27006 10.4200 278 $ 20.00 420201144 TUBE EAR T 6016/10-56016 10.4200 278 $ 23.00 420201146 URETERAL STENT 10.4200 278 $ 590.00 420201148 VERSASTEP 10.4200 279 $ 251.00 420201150 IOL 10.4200 276 $ 614.00 420201152 STRYKER SCREW WEDGE 10.4200 278 $ 504.00 420201154 GRAFT PTFE 4-7 MMX45CM/S47045 10.4200 278 $ 573.00 420201156 GRAFT PTFE 4-7MMX40CM/V47040L 10.4200 278 $ 378.00 420201158 GRAFT PTFE 6MMX10CM/V06010L 10.4200 278 $ 143.00 420201160 GRAFT PTFE 6MMX40CM/V06040L 10.4200 278 $ 326.00 420201162 MENISCUS ARROW 10.4200 278 $ 160.00 420201164 ZIMMER PLATE 4935 10.4200 278 $ 187.00 420201166 ZIMMER SCREW CORTICAL 10.4200 278 $ 25.00 420201168 ZIMMER SCREW CANCELLOUS 10.4200 278 $ 22.00 420201170 SYNTHES SCREW SELF CORT 4.5 10.4200 278 $ 20.00 420201172 SYNTHES SCREW MALLEOLAR 10.4200 278 $ 23.00 420201174 SYNTHES SCREW CANC 6.5 10.4200 278 $ 29.00 420201200 HASSON BLUNTPOINT 10.4200 272 $ 294.00 420201202 TRIAL LEAD 4-CHANNEL 10.4200 278 $ 3,134.00 420201204 TRIAL LEAD 8-CHANNEL 10.4200 278 $ 3,917.00 420201206 4 ELECTRODE LEAD 10.4200 278 $ 5,109.00 420201208 8 ELECTRODE LEAD 10.4200 278 $ 7,729.00 420201210 IMPLANTABLE PULSE GENERATOR 10.4200 278 $ 32,839.00 420201212 PATIENT PROGRAMMER 10.4200 279 $ 3,655.00 420201214 NEUROSTIMULATOR EX RECHARGER 10.4200 271 $ 2,520.00 420201216 SINGLE 8 EXTENSION 10.4200 278 $ 2,819.00 420201218 BIO FASTAK 10.4200 278 $ 1,024.00 420201220 NEUROSTIM GENESIS 8 10.4200 278 $ 23,641.00 420201222 NEUROSTIMULATOR GENESIS XP 8 10.4200 278 $ 30,211.00 420201224 NEUROSTIM PROGRAMER GENESIS QL 10.4200 279 $ 3,143.00 420201226 NEUROSTIM PROGRAMER GENESIS 10.4200 279 $ 3,131.00 420201228 ALCON - IOL 10.4200 276 $ 648.00 420207001 ACCU CHECK STRIP/LANCET 10.4200 271 $ 28.00 420209211 BRIDAL VEIL 10.4200 270 $ 32.00 420209213 ENDOCLIP 10.4200 278 $ 1,817.00 420209215 ENDOSHEARS 10.4200 270 $ 1,851.00 420209217 BEAVER BLADE 6400 10.4200 270 $ 49.00 420209229 SCREW, SYNTHES SELF TAPPING 10.4200 278 $ 313.00 420210579 ESWL MOBILE 10.4200 790 $ 6,384.00 420210587 ESWL ADDITIONAL LOCATION 10.4200 790 $ 3,012.00 420210595 ESWL REPEAT 10.4200 790 $ 6,023.00 420210605 TRANSURETH MICRO HYPERTHERMIA 10.4200 360 $ 23,728.00 420210802 SHEA DRILL COVER 10.4200 270 $ 187.00 420213190 PLATE, NARROW SCP 4.5MM 5 HOLE 10.4200 278 $ 1,111.00 420213198 PLATE ONE-THIRD TUBULAR 5-HOLE 10.4200 278 $ 538.00 420213320 CANCELL 4.0MMX22MM (SHORT THRD 10.4200 278 $ 170.00 420213363 SCREW, CORTICAL 1.5MM X 12MM 10.4200 278 $ 166.00 420213372 SCREW CORTICAL 2.0MM X 12 MM 10.4200 278 $ 166.00 420213375 SCREW, CORTICAL 2.0MM X 18MM 10.4200 278 $ 166.00 420213379 SCREW, CORTICAL 2.7 X 10MM 10.4200 278 $ 161.00 420213380 SCREW, CORTICAL 2.7 X 12MM 10.4200 278 $ 161.00 420213381 SCREW, CORTICAL 2.7 X 14MM 10.4200 278 $ 161.00 420213382 SCREW, CORTICAL 2.7 X 16MM 10.4200 278 $ 161.00 420213383 SCREW, CORTICAL 2.7 X 18MM 10.4200 278 $ 161.00 420213384 SCREW, CORTICAL 2.7 X 20MM 10.4200 278 $ 161.00 420213389 CORT 3.5MM X 100MM FINE THREAD 10.4200 278 $ 235.00 420215001 IV SOLUTIONS (ALL) 10.4200 258 $ 17.00 420215110 ALLODERM 1X4 10.4200 278 $ 3,130.00 420215120 ALLODERM 2X4 10.4200 278 $ 5,468.00 420215130 ALLODERM 3X7 10.4200 278 $ 7,595.00 420215222 CATHETER GROSHONG 8FR 10.4200 278 $ 3,030.00 420215224 CATHETER GROSHONG 9.5FR 10.4200 278 $ 3,436.00 420215226 CATHETER X-PORT 10.4200 278 $ 3,619.00 420215228 ALLOGRAFT (ACHILLES) 10.4200 278 $ 5,289.00 420215229 ALLOGRAFT (PATELLAR) 10.4200 278 $ 8,821.00 420215240 CATHETER CURL 10.4200 278 $ 1,768.00 420215250 CATHETER UNIV WEDGE 10.4200 279 $ 218.00 420215320 ELECTRODE LEEP LOOP 10.4200 272 $ 350.00 420215330 ELECTRODE POWERBALL 10.4200 272 $ 2,104.00 420215340 ELECTODE ROLLERBALL 10.4200 272 $ 1,686.00 420215350 ENDO CATCH 10.4200 272 $ 1,274.00 420215370 E-Z DERM 10.4200 272 $ 1,467.00 420215390 GLIDE WIRE 10.4200 279 $ 612.00 420215400 GOODE T-TUBE 10.4200 272 $ 488.00 420215410 GRAFT STEPPED 4 TO 7 X 45 10.4200 278 $ 7,788.00 420215420 GRAFT STRAIGHT 6 X 40 10.4200 278 $ 4,571.00 420215480 IODOFORM PACKING 10.4200 272 $ 106.00 420215510 LASER TUBING 10.4200 272 $ 122.00 420215540 MARLEX MESH PLUG S/M/L 10.4200 278 $ 2,603.00 420215550 MARLEX MESH PLUG XLG 10.4200 278 $ 4,935.00 420215560 MCGHAN IMPLANT FILL KIT 10.4200 272 $ 271.00 420215580 MENISCUS ARROW 10.4200 272 $ 1,945.00 420215610 MINI SUTURE MITEK 10.4200 272 $ 3,206.00 420215630 MITEK SUTURE 10.4200 272 $ 3,130.00 420215700 PROBE 10MM 10.4200 272 $ 1,398.00 420215710 PROBE 5MM 10.4200 272 $ 1,398.00 420215840 STENT HYDROPLUS 10.4200 278 $ 1,860.00 420215850 STENT URETERAL 10.4200 278 $ 2,072.00 420215900 TRU-CUT NEEDLE 10.4200 272 $ 283.00 420215970 X-SPAN 10.4200 271 $ 69.00 420218080 TOURNIQUET, DISPOSABLE STERILE 10.4200 272 $ 591.00 420220065 BLEDSOE BRACE BOOT 10.4200 271 $ 936.00 420220068 ANKLE BRACE 10.4200 272 $ 672.00 420220081 WALKER EQUALIZER 10.4200 272 $ 943.00 420220092 CATH FOLEY TRAY 10.4200 272 $ 202.00 420220096 CATH HICKMAN SINGLE LUMEN 10.4200 278 $ 2,246.00 420220102 CATH PERITONEAL CURLED 10.4200 278 $ 1,117.00 420220176 LR 1000 7953-09 10.4200 258 $ 8.00 420220222 STOCKINGS - PRESSURE 10.4200 271 $ 632.00 420220445 SUCTION SIGMOIDOSCOPIC 10.4200 258 $ 33.00 420222016 ASC PLDS 10.4200 272 $ 2,442.00 420230011 BONE WAX 10.4200 279 $ 97.00 420230018 BLOOD SET (MCGRAW) 10.4200 272 $ 227.00 420230028 FLEXISPLINT INSERT FOAM 10.4200 272 $ 145.00 420230103 ATHLETIC SUSPENSORY 10.4200 271 $ 126.00 420230270 PEDI AMBU BAG 10.4200 271 $ 480.00 420231130 HYPERTHERMIA CATHETER 10.4200 279 $ 2,189.00 420240035 SOLUTION, LR 3000CC 10.4200 258 $ 17.00 420249000 CATH LINK IMPLANTED PORT 10.4200 278 $ 7,333.00 420250048 GUIDE WIRES 10.4200 279 $ 308.00 420250221 ARTHREX FASTAK ANCHOR 2.8MM 10.4200 278 $ 618.00 420253216 BARDPORT IMPLANTED X-PORT 10.4200 278 $ 1,400.00 420260028 SCREW, CORTICAL 10.4200 278 $ 172.00 420260042 HEMOVAC MED-LG 10.4200 272 $ 204.00 420260045 HEMOVAC EVACUATORS 10.4200 272 $ 195.00 420260054 PIN K-WIRE PLAIN 10.4200 278 $ 43.00 420260085 PIN K-WIRE THREADED 10.4200 278 $ 175.00 420260155 JACKSON PRATT RESERVOIR 10.4200 272 $ 124.00 420260156 J-P SUCTION DRAIN 10.4200 272 $ 246.00 420260214 B.S.S. PLUS IRRIG FOR EYES 10.4200 250 $ 78.00 420260230 PLATE STANDARD ECT 10.4200 278 $ 874.00 420260393 PLATE SYNTHES 241 10.4200 278 $ 653.00 420260402 OXYGEN TRANSDUCER DISP. 10.4200 272 $ 356.00 420260426 STAPLES 35W DISP 10.4200 272 $ 193.00 420260663 SCREW HEBERT 10.4200 278 $ 2,251.00 420260672 CATH CHOLEY TAUT 10.4200 272 $ 175.00 420279221 SOL D5W 150CC 10.4200 258 $ 74.00 420279829 SOL RINGERS INJ 1000 10.4200 258 $ 74.00 420279909 SOL STERILE H2O 1000 10.4200 258 $ 74.00 420289925 SUCTION, RECTAL 10.4200 271 $ 64.00 420289960 REUTER BOBBIN TUBE 10.4200 278 $ 210.00 420289980 SIGMOIDOSCOPE, DISPOSABLE 10.4200 272 $ 64.00 420289985 MARLEX MESH, SMALL SHEET 10.4200 278 $ 2,808.00 420298000 HEMOCLIP GUN AND CLIPS 10.4200 272 $ 28.00 420298002 DRAPE, BILATERAL EXTREMITY 10.4200 272 $ 276.00 420298004 NEUROSTIMULATOR CABLE CONNECT 10.4200 272 $ 836.00 420298006 BONE FROZEN SEMI-TENDINOUS 10.4200 278 $ 2,942.00 420298008 ARTHREX BIO SCREW 10.4200 278 $ 1,003.00 420298010 ARTHREX IMPLANT SUTURE 10.4200 278 $ 138.00 420298012 INTRODUCER SHEATH 10.4200 279 $ 222.00 420298014 MESH VETRALEX SMALL 10.4200 278 $ 1,528.00 420298016 MESH PROLENE 10.4200 278 $ 708.00 420298018 TRIAL CATHETER THERACATH 10.4200 279 $ 88.00 420298020 NEEDLE SUTURE DBL-ARMED LONG 10.4200 279 $ 209.00 420298022 HANDPIECE SHARPSHOOTER DISP 10.4200 279 $ 652.00 420299920 SCREW KURASAKA 10.4200 278 $ 2,348.00 420299921 GRAFT PASSER ST SHOT 10.4200 279 $ 952.00 420299928 ELECTRODE LOOP 90 DEGREE DEEP 10.4200 272 $ 1,037.00 420299937 ENDOCATCH 10.4200 279 $ 2,210.00 420299950 EYE LENS,CATARACT 10.4200 276 $ 1,485.00 420299952 IOL, S-R 10.4200 276 $ 844.00 420299958 MENISCUS MENDER 10.4200 272 $ 1,492.00 420299960 HEWSON PASSER 10.4200 272 $ 959.00 420299976 MC GHAN BREAST IMPLANT STYLE 4 10.4200 278 $ 8,959.00 420299978 KIT RIGIDFIX FEMORAL 10.4200 278 $ 1,104.00 420299980 SCREW INTRAFIX 10.4200 278 $ 773.00 420299981 BIO-SUTURE TAK SUTURE ANCHOR 10.4200 278 $ 1,024.00 420299982 BIOZIP ANCHOR 10.4200 278 $ 819.00 420299984 BONE ACHILLES 10.4200 278 $ 3,663.00 420299986 ARTHREX CANNULA 10.4200 279 $ 418.00 420299988 SYNTHES PIN TITANIUM 10.4200 278 $ 177.00 420299990 SYNTHES PLATE DISTAL RADIUS 10.4200 278 $ 1,874.00 420299992 SYNTHES SCREW 2.4MM 10.4200 278 $ 218.00 420299994 SYNTHES SCREW CORTICAL 10.4200 278 $ 165.00 420299995 NEUROSTIMULATOR - RECHARGEABLE 10.4200 278 $ 30,605.00 420299996 NEUROSTIMULATOR PROGRAMER 10.4200 279 $ 3,134.00 420299997 NEUROSTIMULATOR EX RECHARGER 10.4200 271 $ 5,371.00 420299998 NEUROSTIMULATOR LEAD 10.4200 278 $ 4,965.00 420299999 NEUROSTIMULATOR COIL EXTENSION 10.4200 278 $ 2,441.00 420300302 CONSCIOUS SEDATION 10.4200 761 $ 408.00 420303000 EKG TRACING ONLY 10.4200 730 $ 207.00 420350100 RECOVERY ROOM (MINUTES) 10.4200 710 $ 16.00 420376000 FLUOROSCOPY <1 HR 10.4200 320 $ 961.00 420376001 FLUOROSCOPY >1 HR 10.4200 320 $ 1,443.00 420390782 IM/SQ INJECTION 10.4200 761 $ 90.00 420390784 IV INJECTION 10.4200 761 $ 90.00 420390785 IV INJECTION ADD'L SEQUENTIAL 10.4200 761 $ 101.00 420399926 CONSULTATION PHYSICIAN VISIT 10.4200 510 $ 102.00 420399928 PAIN BLOCK (ACUTE CARE) 10.4200 360 $ 1,869.00 421040001 ANES-SPINAL 10.4200 370 $ 839.00 421040002 ANES-REGIONAL NERVE BLOCK 10.4200 370 $ 590.00 421040003 ANES - LOCAL ANESTHETIC 10.4200 370 $ 455.00 421040005 ANES-MONITORED ANES CARE 10.4200 370 $ 506.00 421040030 ANES-GENERAL ANESTHESIA (MINUT 10.4200 370 $ 17.00 429080005 DISCHARGE HOLD ROOM 10.3179 121 $ - 429600999 OSTOMY/WD SERV(CONTRACT) 15 MI 10.4296 761 $ 50.00 429601000 MRSA CLINIC 10.4296 761 $ - 429620011 PEDIATRIC CLINIC VISIT 10.4296 761 $ 101.00 429650000 CLINIC BASIC VISIT 10.4296 761 $ 75.00 429650030 CLINIC VISIT 30 MIN 10.4296 761 $ 126.00 429650045 CLINIC VISIT 45 MIN 10.4296 761 $ 191.00 429650060 CLINIC VISIT 60 MIN 10.4296 761 $ 259.00 429650090 CLINIC VISIT 90 MIN 10.4296 761 $ 326.00 429650230 CLINIC COMPLEX 30 MIN 10.4296 761 $ 245.00 429650245 CLINIC COMPLEX 45 MIN 10.4296 761 $ 380.00 429650260 CLINIC COMPLEX 60 MIN 10.4296 761 $ 515.00 429650290 CLINIC COMPLEX 90 MIN 10.4296 761 $ 653.00 429651030 INFUSION THERAPY 1ST HOUR 10.4296 260 $ 261.00 429651031 INFUSION HYDRATION 1ST HOUR 10.4296 260 $ 261.00 429651040 IV INJECTION 10.4296 761 $ 83.00 429651041 IV INJECTION ADD'L SEQUENTIAL 10.4296 761 $ 83.00 429651050 INJECTION IM/SQ 10.4296 761 $ 83.00 429651060 INFUSION THERAPY ADD'L HRS 10.4296 260 $ 157.00 429651061 INFUSION HYDRATION ADD'L HOUR 10.4296 260 $ 157.00 429660030 PHYSICIAN CLINIC VISIT 30 MIN 10.4296 761 $ 126.00 429660045 PHYSICIAN CLINIC VISIT 45 MIN 10.4296 761 $ 191.00 429660060 PHYSICIAN CLINIC VISIT 60 MIN 10.4296 761 $ 245.00 429660090 PHYSICIAN CLINIC VISIT 90 MIN 10.4296 761 $ 326.00 429670030 POST PROCED RECOVERY ADD 30 MI 10.4296 710 $ 68.00 429670060 POST PROCED RECOVERY 1-60 MIN 10.4296 710 $ 259.00 429670100 MINOR SURG 1 10.4296 360 $ 653.00 429670115 ENTERSTOMAL THERAPIST CONSULT, 10.4296 750 $ 198.00 429670120 ENTERSTOMAL THERAPY PHONE CONS 10.4296 750 $ 26.00 429670127 ET MILEAGE (CONTRACT) 10.4296 761 $ - 429670200 MINOR SURG 2 10.4296 360 $ 1,891.00 429670300 MINOR SURG 3 10.4296 360 $ 2,604.00 429699202 LIVER CLINIC VISIT-NEW PT 10.4296 510 $ 79.00 429699212 LIVER CLINIC VISIT-EST PT 10.4296 761 $ 55.00 431000600 PHONE CALL 10.4310 651 $ - 431000601 HOSPICE HHA VISIT 10.4310 651 $ - 431000602 HOSPICE HMKR VISIT 10.4310 651 $ - 431000603 HOSPICE MSW VISIT 10.4310 651 $ - 431000604 HOSPICE NURSING VISIT 10.4310 651 $ - 431000605 HOSPICE OT VISIT 10.4310 651 $ - 431000606 HOSPICE PT VISIT 10.4310 651 $ - 431000608 HOSPICE RT VISIT 10.4310 651 $ - 431000610 HOSPICE ST VISIT 10.4310 651 $ - 431000655 HOSPICE INPATIENT RESPITE CARE 10.4310 655 $ 183.00 431000657 HOSPICE PHYSICIAN SERVICES 10.4310 657 $ - 431000699 HOSPICE LONG TERM RM & BRD SNF 10.4310 658 $ 145.43 431000700 DUAL ROLE VISIT 10.4310 651 $ - 431006510 ROUTINE CARE HOME 10.4310 651 $ 177.00 431006511 ROUTINE CARE ASST LIVE 10.4310 651 $ 177.00 431006512 ROUTINE CARE SNF 10.4310 651 $ 177.00 431006520 CONT HOME CARE 15 MIN HOME 10.4310 652 $ 43.00 431006521 CONT HOME CARE 15 MIN ASST LIV 10.4310 652 $ 43.00 431006522 CONT HOME CARE 15 MIN SNF 10.4310 652 $ 43.00 431006561 HOSPICE GEN INPATIENT CARE SNF 10.4310 656 $ 788.00 431006562 HOSPICE GEN INP CARE HOSP 10.4310 656 $ 788.00 431006563 HOSPICE GEN INP CARE INP HOSPC 10.4310 656 $ 788.00 439000010 TREATMENT ROOM I 10.4390 761 $ 249.00 439000015 TREATMENT ROOM II 10.4390 761 $ 490.00 439000020 PASSPORT VISIT 0-30 MIN 10.4390 761 $ - 439000021 PASSPORT VISIT 31-60 MIN 10.4390 761 $ - 439000034 AMBULATORY CARE 0-2 HR 10.4390 710 $ 1,479.00 439000042 AMBULATORY CARE ADD 1/2 HR 10.4390 710 $ 101.00 439000044 AMBULATORY CARE ADD 1 HR 10.4390 710 $ 202.00 439000210 CLINIC VISIT 0-15 MIN 10.4390 510 $ 116.00 439000215 CLINIC VISIT-BRIEF 15-45 MIN 10.4390 510 $ 114.00 439000220 CLINIC VISIT-INTERMED 45-90 MI 10.4390 510 $ 235.00 439000225 CLINIC VISIT-COMPREHENSIVE >90 10.4390 510 $ 324.00 439000230 TRANSFUSION THERAPY 0-3 HR 10.4390 391 $ 700.00 439000235 TRANSFUSION THERAPY 3-6 HR 10.4390 391 $ 930.00 439000240 TRANSFUSION THERAPY >6 HR 10.4390 391 $ 1,164.00 439000245 LONG ARM CATHETER INSERTION 10.4390 761 $ 759.00 439000250 THERAPEUTIC PHLEBOTOMY 10.4390 761 $ 274.00 439000255 CHEMOTHERAPY-SIMPLE 10.4390 331 $ 319.00 439000257 CHEMO CHEMO IV PUSH 10.4390 331 $ 104.00 439000258 CHEMO CHEMO IV PUSH ADD'L 10.4390 331 $ 104.00 439000260 CHEMOTHERAPY-SIMPLE-CX 10.4390 331 $ 633.00 439000265 CHEMOTHERAPY-INFUSION 0-1 HR 10.4390 335 $ 393.00 439000266 CHEMOTHERAPY ADD'L HRS 10.4390 335 $ 433.00 439000267 CHEMOTHERAPY ADD'L SEQUENTIAL 10.4390 335 $ 217.00 439000307 INFUSION THERAPY 1ST HOUR 10.4390 260 $ 315.00 439000308 INFUSION HYDRATION 1ST HOUR 10.4390 260 $ 315.00 439000309 INFUSION THERAPY ADD'L HRS 10.4390 260 $ 190.00 439000310 MAINTENANCE IMPLANTABLE PUMP 10.4390 761 $ 114.00 439000311 INFUSION HYDRATION ADD'L HOUR 10.4390 260 $ 190.00 439000315 REFILL IMPLANTABLE PUMP 10.4390 761 $ 185.00 439000409 IVIG INFUSION 10.4390 260 $ 165.00 439000410 M/S ACUTE ROOM 10.4390 121 $ 2,374.00 439007001 ACCU CHECK STRIP/LANCET 10.4390 271 $ 15.00 439007100 MINOR SURGERY I 10.4390 360 $ 614.00 439010012 SPECIAL PROC/TX ROOM 1/2 HOUR 10.4390 761 $ 247.00 439010035 INF-BLOOD/CHEMO FOLLOWUP 10.4390 761 $ 156.00 439010040 INF-PLATELET ADMINISTRATION 10.4390 761 $ 175.00 439010045 INF-CRYOPRECIPITATE ADMIN 10.4390 761 $ 175.00 439010060 INF-BLOOD 1 UNIT 10.4390 761 $ 340.00 439010065 INF-BLOOD 2 UNITS 10.4390 761 $ 679.00 439010068 INF-BLOOD 3 UNITS 10.4390 761 $ 886.00 439030035 BLOCK 10.4390 360 $ 1,237.00 439030095 PARACENTESIS 10.4390 360 $ 798.00 439030100 THORACENTESIS 10.4390 360 $ 798.00 439080005 AMB SRV HOLDING O/P IN BED 10.4390 990 $ - 439090782 IM/SQ INJECTION 10.4390 761 $ 101.00 439090784 IV INJECTION 10.4390 761 $ 101.00 439090785 IV INJECTION ADD'L SEQUENTIAL 10.4390 761 $ 101.00 439090788 IM INJECTION - ANTIBIOTIC 10.4390 761 $ 101.00 439092960 CARDIOVERSION - EXTERNAL 10.4390 480 $ 1,114.00 439099100 CONSCIOUS SEDATION 0-1 HR 10.4390 761 $ 336.00 439099200 CONSCIOUS SEDATION > 1HR 10.4390 761 $ 700.00 440000011 OB TREATMENT ROOM 10.4400 761 $ 68.00 440000103 OB EXAM RM-SIMPLE EVAL/TX 0-4 10.4400 761 $ 326.00 440000105 OB EXAM RM-COMPLEX EV/TX 0-4HR 10.4400 761 $ 451.00 440000110 OB EXAM RM-SIMPLE EVAL/TX 4-8H 10.4400 761 $ 494.00 440000111 OB EXAM RM-SIMPLE EV/TX 8-16HR 10.4400 761 $ 1,005.00 440000115 OB EXAM RM-COMPLEX EV/TX 4-8H 10.4400 510 $ 774.00 440000118 OB EXAM RM-COMPLEX EV/TX 8-16H 10.4400 761 $ 1,554.00 440000119 OB EXAM RM-COMPLEX EV/TX 16-24 10.4400 761 $ 2,328.00 440000206 LACTATION RM-BREAST PUMP ELECT 10.4400 720 $ 114.00 440000211 EXTERNAL VERSION 10.4400 361 $ 1,102.00 440000302 CONSCIOUS SEDATION 10.4400 761 $ 449.00 440000306 INFUSION SEQUENTIAL 1ST HOUR 10.4400 260 $ 158.00 440000307 INFUSION THERAPY 1ST HOUR 10.4400 260 $ 315.00 440000308 INFUSION HYDRATION 1ST HOUR 10.4400 260 $ 315.00 440000309 INFUSION THERAPY ADD'L HRS 10.4400 260 $ 190.00 440000310 INFUSION HYDRATION ADD'L HOUR 10.4400 260 $ 190.00 440007100 MINOR SURGERY 10.4400 360 $ 1,102.00 440007200 ASSIST W PROCEDURE LEVEL 2 10.4400 360 $ 1,779.00 440010101 DELIVERY LEVEL 2 10.4400 720 $ 2,152.00 440010301 DELIVERY LEVEL 3 /HR 10.4400 720 $ 2,293.00 440010401 DELIVERY LEVEL 4 /HR 10.4400 720 $ 2,433.00 440010501 DELIVERY LEVEL 5 /HR 10.4400 720 $ 2,573.00 440010601 DELIVERY LEVEL 6 /HR 10.4400 720 $ 2,711.00 440010701 DELIVERY LEVEL 7 /HR 10.4400 720 $ 2,848.00 440010801 DELIVERY LEVEL 8 10.4400 720 $ 2,989.00 440030101 INTERMEDIATE CARE LDR/HR 10.4400 720 $ 159.00 440030201 INTENSIVE CARE LDR/HR 10.4400 720 $ 223.00 440050050 PRE-OP PROCEDURE ROOM 10.4400 720 $ 264.00 440052100 LABOR & DELIVERY INPT ROOM CHA 10.4400 122 $ 2,374.00 440060350 OB SURGERY BASIC PER MIN 10.4400 360 $ 33.00 440060450 OB SURG LEVEL 3 PER MIN 10.4400 360 $ 41.00 440060550 OB SURG LEVEL 4 PER MIN 10.4400 360 $ 47.00 440060650 OB SURG LEVEL 5 PER MIN 10.4400 360 $ 53.00 440060750 OB SURG LEVEL 6 PER MIN 10.4400 360 $ 59.00 440060850 OB SURG LEVEL 7 PER MIN 10.4400 360 $ 65.00 440070100 RECOVERY 0-1 HR 10.4400 710 $ 558.00 440070200 RECOVERY 1-4 HR 10.4400 710 $ 1,114.00 440070300 RECOVERY COMPLEX 0-1 HR 10.4400 710 $ 1,114.00 440070400 RECOVERY COMPLEX 1-4 HR 10.4400 710 $ 2,230.00 440080060 LABOR & DELIVERY OUTPATIENT 10.4400 761 $ - 440080101 OB SURGERY RECOVERY 10.4400 710 $ 142.00 440090782 IM INJECTION 10.4400 761 $ 101.00 440090784 IV INJECTION 10.4400 761 $ 101.00 440090785 IV INJECTION ADD'L SEQUENTIAL 10.4400 761 $ 101.00 440090788 IM INJECTION - ANTIBIOTIC 10.4400 761 $ 101.00 442001000 CARDIAC SURGERY SCH 0<1 HR 10.4420 360 $ 9,644.00 442001010 CARDIAC SURGERY SCH (MINUTES) 10.4420 360 $ 125.00 442001020 CARDIAC LASER SURGERY 0<1 HR 10.4420 360 $ 11,572.00 442001030 CARDIAC LASER SURGERY MINUTES 10.4420 360 $ 135.00 442001040 CARDIAC SURGERY UNSCH 0<1 HR 10.4420 360 $ 11,165.00 442001050 CARDIAC SURGERY UNSCH MINUTES 10.4420 360 $ 137.00 442001060 SURGRY SCHEDULED 0<1 HR 10.4420 360 $ 6,739.00 442001070 SURGERY SCHEDULED (MINUTES) 10.4420 360 $ 80.00 442001080 LASER SURGERY 0<1 HR 10.4420 360 $ 7,135.00 442001090 LASER SURGERY (MINUTES) 10.4420 360 $ 93.00 442001100 SURGERY UNSCHEDULED 0<1 HR 10.4420 360 $ 8,192.00 442001110 SURGERY UNSCHEDULED MINUTES 10.4420 360 $ 75.00 442001120 PERFUIONIST SCHED O<1 HR 10.4420 360 $ 1,447.00 442001130 PERFUSIONIST SCHEDULED (MIN) 10.4420 360 $ 17.00 442001140 PERFUSIONIST UNSCHED 0<1 HR 10.4420 360 $ 2,040.00 442001150 PERFUSIONIST UNSCHED MINUTES 10.4420 360 $ 24.00 442001160 GENERAL ANESTHESIA 0<1 HR 10.4420 370 $ 1,636.00 442001170 GENERAL ANESTHESIA (MINUTES) 10.4420 370 $ 20.00 442010090 RN FIRST ASSIST-MAIN OR / MIN 10.4420 360 $ 1.72 442014001 OB SPINAL 10.4420 370 $ 657.00 442014003 OB EPIDURAL 10.4420 370 $ 657.00 442014100 OB ANESTHESIA (MINUTES) 10.4420 370 $ 16.00 442020005 CARD SURG (ANGIO) 10.4420 360 $ 15,460.00 442031010 PERFUSIONIST SVC (MINUTES) 10.4420 360 $ 17.00 442040001 SPINAL 10.4420 370 $ 558.00 442040002 REGIONAL NERVE BLOCK 10.4420 370 $ 392.00 442040003 LOCAL ANESTHETIC 10.4420 370 $ 303.00 442040005 MONITORED ANESTHESIA CARE 10.4420 370 $ 336.00 442040030 GENERAL ANESTHESIA (MINUTES) 10.4420 370 $ 19.00 442040100 CARD SURG X 4-S (MINUTES) 10.4420 360 $ 125.00 442041010 PERFUSIONIST NS (MINUTES) 10.4420 360 $ 18.00 442043030 SURG SER X 3-S (MINUTES) 10.4420 360 $ 80.00 442044030 LASER SURGERY 10.4420 360 $ 93.00 442050015 CON'T GENERAL ANES(MINUTES) 10.4420 370 $ 19.00 442050100 CARD SURG X4-NS (MINUTES) 10.4420 360 $ 137.00 442073030 SURG SER X 3NS (MINUTES) 10.4420 360 $ 75.00 442076000 FLUOROSCOPY <1 HR 10.4420 320 $ 1,058.00 442076001 FLUOROSCOPY >1 HR 10.4420 320 $ 1,588.00 442095972 ANALYZE NEUROSTIM CMPLX 1ST HR 10.4420 481 $ 286.00 442095973 ANALYZ NEUROSTIM CMPLX ADD 30M 10.4420 481 $ 143.00 442099360 DEFENSE AUDIT ADJUSTMENT 10.4420 360 $ - 442100001 MISCELLANEOUS 10.4420 270 $ - 442100002 PROSTHESIS MISCELLANEOUS 10.4420 278 $ - 442100003 GRAFT MISCELLANEOUS 10.4420 270 $ - 442100004 SCREW MISCELLANEOUS 10.4420 278 $ - 442100010 M-ADHESION BARRIER 10.4420 278 $ - 442100030 M-ANCHOR/SCREW BN/BN-TIS/BN 10.4420 278 $ - 442100050 M-CATH- BAL DIL- NON-VASCULAR 10.4420 279 $ - 442100070 M-CATH- DRAINAGE 10.4420 279 $ - 442100090 M-CATH- EP- OTHR THAN COOL-TIP 10.4420 279 $ - 442100110 M-CATH- HEMODIALY-LONG-TERM 10.4420 278 $ - 442100130 M-CATH- INF- PER/CENT/MIDLINE 10.4420 278 $ - 442100150 M-CATH- INTRAVAS ULTRASOUND 10.4420 279 $ - 442100170 M-CATH- THROMBECT/EMBOLECT 10.4420 279 $ - 442100190 M-CATH- TRANS ATHERECTOMY- DIR 10.4420 279 $ - 442100210 M-CATH- TRANSLUMIN NON-LASER 10.4420 279 $ - 442100230 M-CATH-HEMODIALY-SHORT-TERM 10.4420 279 $ - 442100250 M-CATHETER- INTRASPINAL 10.4420 279 $ - 442100270 M-CATHETER- URETERAL 10.4420 279 $ - 442100290 M-CLOSURE DEV- VASC 10.4420 278 $ - 442100310 M-CONN TISS- HUMAN(INC FASCIA) 10.4420 278 $ - 442100330 M-CONN TISS- NON-HUMAN 10.4420 278 $ - 442100350 M-ENDOVAS NON-CARDIAC ABL CATH 10.4420 279 $ - 442100370 M-GENERATOR- NEUROSTIM- IMP 10.4420 278 $ - 442100390 M-GRAFT- VASCULAR 10.4420 278 $ - 442100410 M-INF PUMP- PROGRAMMABLE 10.4420 278 $ - 442100430 M-INTRO/SHEATH-FIXED-PEEL-AWAY 10.4420 279 $ - 442100450 M-INTRO/SHEATH-STRBLE-NON-PEEL 10.4420 279 $ - 442100470 M-JOINT DEVICE (IMPLANTABLE) 10.4420 278 $ - 442100472 M-FINGER JOINT 10.4420 278 $ - 442100490 M-LEAD- NEUROSTIMULATOR 10.4420 278 $ - 442100510 M-LEAD- PMKR- TRANSVEN VDD 10.4420 278 $ - 442100530 M-LEAD- PMKR/AICD COMBINATION 10.4420 278 $ - 442100550 M-MESH (IMPLANTABLE) 10.4420 278 $ - 442100570 M-PORT- INDWELLING- IMP 10.4420 278 $ - 442100590 M-PROSTHESIS- BREAST- IMP 10.4420 278 $ - 442100610 M-PROSTHESIS- PENILE- INFLATAB 10.4420 278 $ - 442100630 M-STENT- COATED/COV W/DEL SYS 10.4420 278 $ - 442100650 M-STENT- NON-COAT/COV W/O DEL 10.4420 278 $ - 442100670 M-PROBE- CRYOABLATION 10.4420 278 $ - 442105010 MAMMOSITE CATHETER (RAD ONCOLO 10.4420 279 $ 12,085.00 442105020 DISSECTING WIRE PASS DRILL 2.0 10.4420 279 $ 947.00 442110009 CATH OTD SWAN/93A741H-7.5 10.4420 279 $ 2,988.00 442110042 MAC 2 LUMEN CNTRAL 7-8FR/AK-11 10.4420 272 $ 1,017.00 442110045 ENDOBRONCH BLOCKER/C-AEBS-9.0- 10.4420 272 $ 1,251.00 442110046 ENDOBRACH BLOCKER/C-AEBS-9.0-6 10.4420 272 $ 1,251.00 442111002 CATH EMBOLECTOMY 3 - 5 FR 10.4420 279 $ 550.00 442111019 CELL SAVER ASPIRATION/CSP-208 10.4420 272 $ 429.00 442111031 FELT DACRON/007839 10.4420 278 $ 399.00 442111032 FELT TEFLON/007837 10.4420 278 $ 1,273.00 442111033 FOGARTY INSERTS 86MM/A0803 10.4420 279 $ 265.00 442111037 PATCH GORE 1X15X20/1415020010 10.4420 278 $ 8,974.00 442111039 SHUNT CAROTID BYPASS 10.4420 279 $ 458.00 442111050 BARD SAUVAGE FILAM FABRIC/0078 10.4420 278 $ 1,379.00 442111053 CELL SAVER RESERVOIR/220 10.4420 272 $ 608.00 442111055 PTFE VG 10.4420 278 $ 2,945.00 442111059 PTFE 4-7MMX45CM/S47045 10.4420 278 $ 4,972.00 442111060 PTFE REM RG 10.4420 278 $ 7,185.00 442112022 CATH COUDE 18FR 5CC/0112L18 10.4420 272 $ 419.00 442112027 CATH DUAL LUMEN/405-100 10.4420 278 $ 598.00 442112048 CATH URETERAL 10.4420 279 $ 368.00 442112107 GLIDE WIRE ANG OR STR 10.4420 279 $ 454.00 442112141 PENILE CM BELT CUFF 10.4420 278 $ 13,876.00 442112146 PENILE BALLOON 10.4420 278 $ 11,005.00 442112148 PENILE 800 CONTROL PUMP 10.4420 278 $ 15,602.00 442112149 PENILE ACCESS KIT 700/72401850 10.4420 279 $ 1,233.00 442112150 PENILE ACCESS KIT 800/72401685 10.4420 279 $ 5,717.00 442112175 STENT HYDRDOPLUS 10.4420 278 $ 1,612.00 442112191 STENT URETERAL 10.4420 278 $ 2,172.00 442112207 VESICA PBNS KIT/820-100 10.4420 279 $ 7,164.00 442112223 GUIDE WIRE COATED 10.4420 279 $ 446.00 442112255 CATH BALL DILL 10.4420 279 $ 2,537.00 442112260 IN-FST S-TAP BONE SCREW/783511 10.4420 278 $ 3,010.00 442112264 SPEEDTAC 10.4420 278 $ 2,819.00 442112268 INFAST INSERTER/C SCREW/783522 10.4420 278 $ 6,809.00 442112277 STENT URETERAL DIVERSION 10.4420 278 $ 2,015.00 442112311 REPLIFORM 2X7CM/820-241 10.4420 278 $ 4,390.00 442112370 PENILE RESERVOIR 10.4420 278 $ 7,929.00 442112373 PENILE 15CM CYL W/PUMP 10.4420 278 $ 29,273.00 442113002 BLADE ULTRA POINT/37-7100 10.4420 272 $ 110.00 442113018 ENDOSTAT .04MM/0010-0622 10.4420 279 $ 3,010.00 442113028 PROS NCUS-ROBINSON 5.0/N1686C1 10.4420 278 $ 1,297.00 442113037 SINUSTENT KENNEDY/470530 10.4420 278 $ 468.00 442113072 EMG ENDOTRACH TUBE 6MM/82-2930 10.4420 272 $ 2,172.00 442113073 EMG ENDOTRACHEAL TUBE/82-29307 10.4420 272 $ 2,172.00 442113074 EMG ENDOTRACHEAL TUBE/82-29308 10.4420 272 $ 2,172.00 442114040 X PROS EAR DELA CR 10.4420 278 $ 1,640.00 442114068 X PROS EAR SHEEHY 10.4420 278 $ 3,121.00 442114084 X TUBE EAR 10.4420 278 $ 217.00 442114091 STAPES SHORT WEHRS INCUS/14088 10.4420 278 $ 4,181.00 442114100 SILASTIC SHEETING .040/20-3004 10.4420 278 $ 1,393.00 442114104 PLT STRAIGHT 4H BAR 8MM/54-051 10.4420 278 $ 775.00 442114124 SCR BONE 1.7X5MM/52-81705 10.4420 278 $ 509.00 442114134 PLATE STRAIGHT 16H REG/01-0821 10.4420 278 $ 1,042.00 442114135 PLATE STRAIGHT 6H REG/01-08206 10.4420 278 $ 745.00 442114136 PLATE STRAIGHT 4H MED/01-08203 10.4420 278 $ 682.00 442114137 PLATE STRAIGHT 4H REG/01-08204 10.4420 278 $ 631.00 442114140 PLATE DBL Y-SHAPE REG/01-08260 10.4420 278 $ 1,559.00 442114152 SCREW SELF-TAP 2.0MM 10.4420 278 $ 454.00 442114173 PLATE STRAIGHT 4H SHORT/54-150 10.4420 278 $ 2,310.00 442114177 PLATE STRAIGHT 6H MEDIUM/54-15 10.4420 278 $ 3,394.00 442114181 PLATE C-SHAPE 4 HOLES/54-15094 10.4420 278 $ 2,945.00 442114185 SCREW BONE 2.3MM 10.4420 278 $ 553.00 442114193 SCREW BONE 2.7MM 10.4420 278 $ 606.00 442114199 PLATE STRAIGHT 6H 40MM/01-0864 10.4420 278 $ 2,292.00 442114203 PLATE CURVED 4HOLES 39MM/01-08 10.4420 278 $ 2,939.00 442114217 TI MESH SCREW 10.4420 278 $ 526.00 442116445 BLADE INFERIOR TURB 2MM/18-820 10.4420 272 $ 1,528.00 442117006 ASC ENDO BABCOCK/174001 10.4420 272 $ 1,114.00 442117008 ASC ENDO GIA 2.5 CART/030333 10.4420 278 $ 2,537.00 442117009 ASC ENDO GIA 30-2.5 CART/03080 10.4420 278 $ 1,805.00 442117010 ASC ENDO GIA 30-2.5 GUN/030811 10.4420 278 $ 3,836.00 442117011 ASC ENDO GIA 30-3.5 CART/03080 10.4420 278 $ 1,212.00 442117012 ASC ENDO GIA 30-3.5 GUN/030813 10.4420 278 $ 3,836.00 442117014 ASC ENDO STITCH INS/173016 10.4420 272 $ 1,710.00 442117015 ASC ENDOSTICH HANDPIECE/173024 10.4420 272 $ 488.00 442117018 ASC ENDOCLIP L/176625 10.4420 278 $ 1,421.00 442117019 ASC ENDOCLIP ML/176615 10.4420 278 $ 1,246.00 442117024 ASC ENDOSHEARS/176643 10.4420 272 $ 1,766.00 442117025 ASC GIA 60 GUN/030676 10.4420 278 $ 1,353.00 442117026 ASC GIA 60 INSERT/030678L 10.4420 278 $ 764.00 442117027 ASC GIA 80 3.8 GUN/031738 10.4420 278 $ 3,119.00 442117028 ASC GIA 80 3.8 INSERT/031739 10.4420 278 $ 590.00 442117029 ASC GIA 80 4.8 GUN/031748 10.4420 278 $ 3,432.00 442117030 ASC GIA 80 4.8 INSERT/031749 10.4420 278 $ 1,584.00 442117032 ASC PURSE STRING 45/020730 10.4420 272 $ 443.00 442117033 ASC PURSE STRING 65/020242 10.4420 272 $ 798.00 442117037 ASC ROTICULATOR GRASPER/174233 10.4420 272 $ 1,583.00 442117040 ASC STAPLER CEEA 28/111859 10.4420 278 $ 6,798.00 442117044 ASC STAPLER CEEA 31/111989 10.4420 278 $ 2,471.00 442117046 ASC STAPLER CEEA 21/111983 10.4420 278 $ 4,709.00 442117047 ASC STAPLER LDS/092001 10.4420 278 $ 1,901.00 442117049 ASC STAPLER VCS GRAFT/132905 10.4420 278 $ 3,588.00 442117056 ASC TA 30-3.5/015427 10.4420 278 $ 721.00 442117057 ASC TA 30-4.8/015433 10.4420 278 $ 721.00 442117058 ASC TA 30-V3-015441L 10.4420 278 $ 1,104.00 442117059 ASC TA 55-3.5/015451 10.4420 278 $ 774.00 442117060 ASC TA 55-4.8/015458 10.4420 278 $ 774.00 442117061 ASC TA 90-3.5/015477 10.4420 278 $ 1,505.00 442117062 ASC TA 90-4.8/015485 10.4420 278 $ 786.00 442117063 ASC TA 90B 4.8 STAPLES/015888L 10.4420 278 $ 4,532.00 442117070 CATH HICKMAN 10.4420 278 $ 3,469.00 442117081 HANDPIECE TRIPLE OPTION/130321 10.4420 272 $ 789.00 442117135 SEPRA FILM/431102 10.4420 278 $ 2,099.00 442117145 CHOLANGIOCATH 16GA/374014 10.4420 272 $ 181.00 442117148 ASC ENDO RETRACT 10MM/176647 10.4420 272 $ 3,272.00 442117169 SKIN STAPLER/528235 10.4420 279 $ 176.00 442117191 ROTICULATOR 10.4420 278 $ 3,275.00 442117192 STAPLER CRVD CIRCULAR 21MM/CDH 10.4420 278 $ 3,438.00 442117193 STAPLER CRVD CIRCULAR 25MM/CDH 10.4420 278 $ 3,438.00 442117194 STAPLE CRVD CIRCULAR 29MM/CDH2 10.4420 278 $ 4,121.00 442117195 STAPLER CRVD CIRCULAR 33MM/CDH 10.4420 278 $ 3,438.00 442117199 LINEAR CUTTER RELOAD 55MM/TCR5 10.4420 278 $ 791.00 442117200 LINEAR CUTTER 55MM/TLC55 10.4420 278 $ 1,425.00 442117201 LINEAR CUTTER 75MM/TLC75 10.4420 278 $ 820.00 442117202 ENDOPATH LINEAR CUTTER /TR352 10.4420 278 $ 1,187.00 442117203 ENDOPATH ETS LINEAR 35MM/TSW35 10.4420 278 $ 2,527.00 442117205 ENDOPATH ETS LINEAR 35MM/TSB35 10.4420 278 $ 2,906.00 442117206 LINEAR CUTTER RELOAD 75MM/TCR7 10.4420 278 $ 1,146.00 442117208 LINEAR CUTTER BLUE 75MM/TRT75 10.4420 278 $ 1,505.00 442117209 LINEAR CUTTER/TLC10 10.4420 278 $ 3,559.00 442117210 LINEAR RELOAD 30-3.5 BLUE/XR30 10.4420 278 $ 674.00 442117211 LINEAR RELOADABLE 30MM/TX30B 10.4420 278 $ 1,572.00 442117212 LINEAR RELOAD 30MM GREEN/XR30G 10.4420 278 $ 801.00 442117213 LINEAR RELOADABLE 30MM/TX30G 10.4420 278 $ 1,341.00 442117214 STAPLER LINEAR WHITE 30MM/XR30 10.4420 278 $ 687.00 442117215 LINEAR RELOAD 30-3.5 WHITE/TX3 10.4420 278 $ 1,481.00 442117216 LINEAR RELOAD 60-3.5 BLUE/XR60 10.4420 278 $ 718.00 442117217 LINEAR RELOADABLE 60MM/TX60B 10.4420 278 $ 1,385.00 442117218 STAPLER LINEAR RELOAD 90-3.5/T 10.4420 278 $ 885.00 442117219 STAPLER LINEAR RELOAD 90MM/TL9 10.4420 278 $ 1,648.00 442117222 STAPLER RELOAD/XR60G 10.4420 278 $ 718.00 442117223 STAPLER GUN 60MM GREEN/TX60G 10.4420 278 $ 1,385.00 442117224 STAPLER CUTTER RELOAD/TCR10 10.4420 278 $ 2,067.00 442117234 ASH SPLIT CATH WITH CUFF/ASPC3 10.4420 278 $ 4,655.00 442117235 HARMONIC SCALPEL 5MM/LCS-B5 10.4420 272 $ 4,775.00 442117241 FILSHIE CLIP/AVM-851J 10.4420 278 $ 480.00 442117242 HICHMAN DUAL LUMEN 13.5/060066 10.4420 278 $ 2,035.00 442117247 PERISTRIPS 10.4420 278 $ 621.00 442117251 BICOAG CUTTING FORCEP/3006 10.4420 272 $ 1,275.00 442117257 ASC ROTICULATOR 30-4.8/017617 10.4420 278 $ 4,923.00 442117261 TVT DEVICE/810041 10.4420 279 $ 6,952.00 442117268 CATH SWAN-GANZ 7.5/931HF75 10.4420 279 $ 703.00 442118045 GRAFT INTRALUMINAL 10.4420 278 $ 6,004.00 442118087 HEMASHIELD 0.8CMX0.75CM/019509 10.4420 278 $ 1,627.00 442118094 GRAFT HEMASHIELD 10 TO 30 MM 10.4420 278 $ 6,949.00 442118249 ALLODERM 3CMX7CM/102021 10.4420 278 $ 6,577.00 442119064 CATH SWAN PTD 7FR/93-20OH-7FR 10.4420 279 $ 4,237.00 442119086 MARKER VOSS CORONARY/40149 10.4420 272 $ 181.00 442119102 PATCH GORE .6X10X15/1710015006 10.4420 278 $ 12,964.00 442119114 STERNA-BAND SUTURE/B220 10.4420 278 $ 388.00 442119138 STERNAL CABLE/400-454 10.4420 278 $ 1,146.00 442119144 CELL SAVER BASIC HI-SPEED PAC/ 10.4420 272 $ 2,007.00 442119158 CLIP SMALL AUTOMATIC/523701 10.4420 278 $ 813.00 442119161 VALVE 17MM/17 AHP-505 17MM 10.4420 278 $ 28,310.00 442119164 AIRWY EXCHANGER CATH/C-CAE-11- 10.4420 272 $ 564.00 442119171 PLUERX CATHETER KIT/50-7000 10.4420 272 $ 3,523.00 442119172 KIT DRAINAGE PLUERX/50-7500 10.4420 272 $ 723.00 442119180 SOL CARTRIDGE 10ML/BG3010-5-HU 10.4420 279 $ 5,717.00 442119218 MARKER RING ANASTOMOSIS/8400-1 10.4420 278 $ 101.00 442119226 CLAMP VEIN 5.0-12.0MM/ES-100 10.4420 279 $ 703.00 442119239 PROBE ABLATION/FLEX 4 10.4420 272 $ 15,634.00 442121003 BLADE BEAVER NEURO/370120 10.4420 272 $ 407.00 442121009 BONE BLOCK ILIUM MED/910-310 10.4420 278 $ 6,419.00 442121014 BONE HUMAN DOWEL14M/100209/100 10.4420 278 $ 5,990.00 442121016 BONE ILIAC CREST WEDGE/100408 10.4420 278 $ 7,039.00 442121058 CLIP SUGITA ANEURYSM/07-940-30 10.4420 278 $ 3,812.00 442121112 DURA-GUARD 8X14/DG-0814SN 10.4420 278 $ 4,227.00 442121116 LUMBAR CATH ACCESS KIT/910-121 10.4420 272 $ 1,584.00 442121117 LUMBAR DRAINAGE KIT/EDM/46442 10.4420 272 $ 7,872.00 442121118 LUMBAR EXT DRAINAGE(EDS)/910-1 10.4420 272 $ 1,481.00 442121127 NERVE LOCATOR-NEURO PULSE/0003 10.4420 272 $ 640.00 442121138 SHUNT CONNECTOR STR/45103 10.4420 278 $ 691.00 442121141 SHUNT CSF-PERITON 10.4420 278 $ 1,686.00 442121149 SHUNT DELTA LEVEL 10.4420 278 $ 10,277.00 442121159 NUKNIT SURGICEL/1943 10.4420 278 $ 506.00 442121164 FASCIA LATA 10.4420 278 $ - 442121171 SCREW DISTRACTION 14MM/ 10.4420 278 $ 1,233.00 442121174 ILIAC CREST WEDGE 13-15MM/1004 10.4420 278 $ 6,522.00 442121203 FIBULAR SHAFT 10.4420 278 $ 5,889.00 442121208 SYNERGY NEUROSTIM GENERATOR 10.4420 278 $ 37,088.00 442121210 SURGICEL FIBRILLAR/1961 10.4420 278 $ 652.00 442121212 SYNERGY PLUG ACCESSORY KIT/355 10.4420 278 $ 1,911.00 442121234 FLOSEAL/FO5-6 10.4420 278 $ 1,848.00 442122000 A GUIDE PIN THREAD 3.2MM/14012 10.4420 278 $ 130.00 442122032 ACU ENDO BUTON 4X12/013816 10.4420 278 $ 1,756.00 442122038 FIXATION POST 10.4420 278 $ 1,452.00 442122100 CANNULA TIB TUNNEL/AR-1802D 10.4420 279 $ 458.00 442122102 8MM OATS HARVESTER/AR-1980-08S 10.4420 279 $ 7,499.00 442122108 ANCHOR CORKSCREW 10.4420 278 $ 2,166.00 442122110 ACUTRAK GUIDE WIRE/WS-1106ST 10.4420 279 $ 166.00 442122111 BIO-INTERFERENCE SCREW 10.4420 278 $ 2,055.00 442122127 ACUTRAK BONE SCREW 10.4420 278 $ 3,499.00 442122132 CORING REAMER 10MM/AR-1224S 10.4420 279 $ 2,886.00 442122136 9X20 CANN-INTERFERENCE/AR-1390 10.4420 278 $ 1,465.00 442122162 ACUTRAK MINI BONE 10.4420 278 $ 3,268.00 442122179 BIOMET DRILL BIT/25-424508 10.4420 272 $ 1,022.00 442122180 BIOMET DRILL BIT/25-42509 10.4420 272 $ 993.00 442122192 BIOMET HEAD 10.4420 278 $ 7,384.00 442122207 CENTRALIZER 10.4420 278 $ 11,411.00 442122236 BIOMET SHELL 10.4420 278 $ 7,557.00 442122259 BIOMET 28MM LINER SZ28/105908 10.4420 278 $ 5,843.00 442122272 BIOMET DISTAL CNTRLZR 10.4420 278 $ 985.00 442122291 BIOMET TI SCREW 10.4420 278 $ 1,371.00 442122304 FINNED TIBIAL TRAY 63MM TO 83M 10.4420 278 $ 6,654.00 442122347 STEM EXTN 10.4420 278 $ 8,235.00 442122382 A SCREW CANCELOUS 10.4420 278 $ 2,320.00 442122414 ARCOM PATELLA 10.4420 278 $ 3,311.00 442122462 TRI SPIKE W/APEX SHL 10.4420 278 $ 4,981.00 442122512 DSTL FMRL AUG 75X10MM/145354 10.4420 278 $ 6,583.00 442122585 BIONX ARROW 10MM/531110 10.4420 278 $ 1,770.00 442123026 K-WIRE PLAIN 10.4420 278 $ 176.00 442123045 K-WIRE THRD 10.4420 278 $ 309.00 442123252 D STRAIGHTSHOT 10.5/5391-55-00 10.4420 272 $ 879.00 442123253 STRAIGHTSHOT 9.5 10.4420 279 $ 879.00 442123261 DEPUY KNEE-4/K-4 10.4420 278 $ 13,303.00 442125002 CABLE DBL TI/C CRIMP 10.4420 278 $ 4,229.00 442125004 CABLE SNG TI/C CRIMP 10.4420 278 $ 4,018.00 442125092 TSRH SCREW 10.4420 278 $ 2,973.00 442125094 DA SCREW 6.5 X 35 TO 40MM 10.4420 278 $ 2,973.00 442125108 DA PLATE 25MM - 50MM 10.4420 278 $ 8,382.00 442125122 ATLANTIS PLATE 10.4420 278 $ 8,869.00 442125144 ATLANTIS CANCELOUS SCREW 10.4420 278 $ 2,346.00 442125180 SCR CANC AXIS 3.5X14MM/870.214 10.4420 278 $ 2,346.00 442125191 ZEPHIR 3.5X13MM CANC SCR/87921 10.4420 278 $ 2,007.00 442125192 ZEPHIR ANT CERV PLT 22.5/87990 10.4420 278 $ 6,987.00 442125198 CD HORIZON M8 ROD 5.5MM 10.4420 278 $ 3,025.00 442125199 HORIZON M8 BREAKOFF SCR/859.85 10.4420 278 $ 1,273.00 442125203 ZEPHIR ANT CER PLT 25MM/879902 10.4420 278 $ 8,382.00 442125205 ZEPHIR ANT CER PLT 32.5MM/8799 10.4420 278 $ 9,028.00 442125213 ANTERIOR CERV PLATE 10.4420 278 $ 8,382.00 442125230 BOME SCREW 4.0MMX13MM/8792713 10.4420 278 $ 2,300.00 442125231 BONE SCREW 3.5 -4.0MM 10.4420 278 $ 2,758.00 442125233 PREFIXATION PIN/8796003 10.4420 278 $ 932.00 442125270 M8 MULTI AXIAL SCREW 10.4420 278 $ 7,511.00 442125300 REDUCED CONNECT 10.4420 278 $ 6,670.00 442125302 3.0CMX5.5MM BENT ROD/8370030 10.4420 278 $ 2,320.00 442125303 5.0CMX5.5MM BENT ROD/8370050 10.4420 278 $ 2,380.00 442125304 6.0CMX5.5MM BENT ROD/8370060 10.4420 278 $ 2,380.00 442125305 8.0CMX5.5MM BENT ROD/8370080 10.4420 278 $ 2,429.00 442125308 4.0CMX5.5MM PRE-CUT ROD/837004 10.4420 278 $ 2,320.00 442125309 DA LOCK SCREW 10.4420 278 $ 422.00 442125310 PRECUT BENT ROD 7.0CMX5.5/8370 10.4420 278 $ 2,380.00 442125311 AXIS CANC SCR 4.0X16MM/870.316 10.4420 278 $ 2,447.00 442125327 OSTEOFIL ICM MOLDABLE 50MM/002 10.4420 278 $ 3,002.00 442125328 OSTEOFIL ICM MOLDABLE 90MM/002 10.4420 278 $ 5,143.00 442126017 H CABLE D-M 10.4420 278 $ 3,163.00 442126018 CEMENT BONE/6191-1-001 10.4420 278 $ 1,132.00 442126022 H CFX ALTA ROD LEFT/5229-1-360 10.4420 278 $ 12,651.00 442126350 H PROS DURA TIB BP M2/6632-3-4 10.4420 278 $ 8,159.00 442126452 H PROS KIN+SPACE LLT/6477-7-24 10.4420 278 $ 9,253.00 442126687 H SLEEVE DM 1.6S.S./3704-1-100 10.4420 278 $ 1,848.00 442126690 H SLEEVE DM 2.0 VIT/6704-4-020 10.4420 278 $ 773.00 442126692 H WIRE ORTHO.032X18/6704-1-018 10.4420 278 $ 356.00 442126760 H PROS DURA TIB IN16L/6642-1-8 10.4420 278 $ 5,992.00 442126840 O SHELL 66MM/2053-2066 10.4420 278 $ 8,986.00 442126887 PCA REV TIB INS RT SM/6728-1-7 10.4420 278 $ 7,734.00 442128318 J PROS FEM SIGMA SZ1.5L/96-002 10.4420 278 $ 26,213.00 442129004 BLADE FLEX OST 10FLT/6079-6-51 10.4420 272 $ 1,229.00 442129047 BONE POWDER CORTICAL DEMIN/120 10.4420 278 $ 3,494.00 442129054 STRUT CORT-CANC 6CMX08MM/10060 10.4420 278 $ 7,938.00 442129073 MITEK THREADED ANCHOR 10.4420 278 $ 1,399.00 442129087 ORTHOFIX TAPERED TROCAR/13540 10.4420 278 $ 954.00 442129102 BONE DISTAL 1/3 FEMUR 10.4420 278 $ 25,216.00 442129108 STAPLE COVENTRY 10.4420 278 $ 582.00 442129128 BONE FEM HEAD/150100/550100 10.4420 278 $ 8,315.00 442129141 RADIOLUCENT WRIST KIT/99-36501 10.4420 278 $ 7,137.00 442129142 ANKLE RETRACTOR FOOT STRAP/014 10.4420 272 $ 652.00 442129151 BONE PUTTY 10CC/038100 10.4420 278 $ 2,950.00 442129152 BONE PUTTY 5CC DBX/038050 10.4420 278 $ 2,299.50 442129153 BONE PUTTY 1CC DBX/038010 10.4420 278 $ 1,949.00 442129159 ACHILLES TEN W/CALCANEOUS/1302 10.4420 278 $ 3,663.00 442131020 O DISTAL SPACER 12MM/1067-0012 10.4420 278 $ 648.00 442131021 PROS DIST SPACER 10.4420 278 $ 774.00 442131085 PROS FEM HEAD 10.4420 278 $ 4,230.00 442131123 PROS HIP STEM #8.30/6051-0830 10.4420 278 $ 17,589.00 442131172 PROS KNEE PATELLA 10.4420 278 $ 6,269.00 442131223 PROS KNEE TIB TRA 10.4420 278 $ 8,204.00 442131227 O PORS KNEE TIB TRA#7/7115-000 10.4420 278 $ 6,756.00 442131248 PROS ODC HIP STEM 10.4420 278 $ 5,839.00 442131249 O PORS ODC HIP STEM #6/6070-06 10.4420 278 $ 6,094.00 442131250 PROS ODC HIP STEM #7/6070-0730 10.4420 278 $ 6,094.00 442131287 PROS PSL SHELL 10.4420 278 $ 7,161.00 442131420 PROS UNIV HEAD 10.4420 278 $ 6,004.00 442131437 O SCREW CANCELOUS 10.4420 278 $ 867.00 442131474 PRO OSTEON GRANULES 15CC/5G15 10.4420 278 $ 6,906.00 442131476 PRO OSTEON IMPLANT 10X10X10/5B 10.4420 278 $ 2,711.00 442131477 PRO OSTEON IMPLANT10X10X40/5B0 10.4420 278 $ 7,370.00 442131527 PROS SCORPIO TIB 10.4420 278 $ 5,761.00 442131550 PROS SCORPIO PAT 10.4420 278 $ 4,159.00 442131564 PROS SCORPIO FEM 10.4420 278 $ 10,957.00 442131567 OSTEONICS HIP-1/H-1 10.4420 278 $ 23,646.00 442131578 PROS ODC UNI HEAD 10.4420 278 $ 3,083.00 442131819 PROS FEM BONE BLOCK/7910-1208L 10.4420 278 $ 5,394.00 442131884 PROS CONSTRAINED LINERS 10.4420 278 $ 15,234.00 442131946 PROS FEM COMP 10.4420 278 $ 8,960.00 442131964 PROS TIB INSERT 10.4420 278 $ 5,761.00 442131991 PROS HUMERAL HEAD 10.4420 278 $ 8,705.00 442132009 PROS HUMERAL COMPONENT 10.4420 278 $ 16,695.00 442132025 BONE PLUG SZ 10.4420 278 $ 839.00 442132054 STEM OMNIFIT CEMENTED 10.4420 278 $ 11,881.00 442132066 HALF PIN 5X150/5018-5-150 10.4420 278 $ 978.00 442132101 SHOULDER PEGGED GLENOID/5361-6 10.4420 278 $ 8,765.00 442132102 SHOULDER HUM OFFSET HD/5352-45 10.4420 278 $ 9,395.00 442132153 ACCOLADE HIP STEM 10.4420 278 $ 15,718.00 442132201 CROSSFIRE SERIES INSRT/2041C 10.4420 278 $ 5,815.00 442132219 ACETAB DOME HOLE PLUG/2060-000 10.4420 278 $ 775.00 442133009 R STAPLE FIX LG/12-8696 10.4420 278 $ 1,782.00 442133021 NAIL REV 11X21/7112 9003 10.4420 279 $ 9,212.00 442134010 S CLAMP TUBE TO TUBE 10.4420 278 $ 4,444.00 442134012 S CLAMP UNIVERSAL 10.4420 279 $ 5,204.00 442134017 S COVER BURR HOLE 6H 17/421.09 10.4420 278 $ 1,963.00 442134019 S GUIDE WIRE 1.25MM/292.62 10.4420 279 $ 171.00 442134021 S GUIDE WIRE THREAD 2.0MM/292. 10.4420 279 $ 387.00 442134022 S GUIDE WIRE THREAD 2.8MM/292. 10.4420 279 $ 424.00 442134047 S PIN STEINMAN 10.4420 278 $ 640.00 442134061 S PLATE 1/3 TUBULAR 10H/241.40 10.4420 278 $ 562.00 442134065 S PLATE 1/3 TUBULAR 10.4420 278 $ 526.00 442134085 S PLATE 2.0 STRAIGHT 10.4420 278 $ 522.00 442134091 S PLATE 2.0MM ADAPTION/447.38 10.4420 278 $ 3,661.00 442134094 S PLATE 2.4 LC-DCP S4H36/449.1 10.4420 278 $ 3,810.00 442134149 S PLATE CALCANEAL Y 87MM/241.6 10.4420 278 $ 3,494.00 442134184 S PLATE CRANIAL 1.3X12/421.022 10.4420 278 $ 371.00 442134186 S PLATE CRANIAL 1.3X95/421.010 10.4420 278 $ 3,360.00 442134199 S PLATE DCP 2.0 7HOLE 37/243.5 10.4420 278 $ 1,461.00 442134255 S PLATE L-OBLIQ 2 7H L/447.52 10.4420 278 $ 1,949.00 442134270 S PLATE LC-DCP 10.4420 278 $ 1,212.00 442134296 S PLATE MAX 2 20H/447.10 10.4420 278 $ 3,831.00 442134306 S PLATE MINI DCP 10.4420 278 $ 2,072.00 442134333 S PLATE RECON 10.4420 278 $ 2,901.00 442134355 S PLATE T 2.7 3H 32MM/242.41 10.4420 278 $ 456.00 442134364 S PLATE T SM RT 3HX3HX50/241.1 10.4420 278 $ 913.00 442134371 S PLATE T-BUTT 8H 144MM/240.30 10.4420 278 $ 3,569.00 442134374 S PLATE X-PLATE 2.0MM 4H/447.8 10.4420 278 $ 1,987.00 442134381 S PLATE ZYGOMA 10.4420 278 $ 1,889.00 442134387 S ROD CONN 4X140 SM EXFIX/395. 10.4420 279 $ 534.00 442134410 S SCREW 2.0MM TO 3.5MM 10.4420 278 $ 699.00 442134447 S SCREW CANC 4.0 10.4420 278 $ 203.00 442134533 S SCREW CANC 6.5 10.4420 278 $ 349.00 442134578 S SCREW CANN 6.5 10.4420 278 $ 1,518.00 442134681 S SCREW CANN 4.5 10.4420 278 $ 686.00 442134700 S SCREW CANN 7.0 10.4420 278 $ 2,096.00 442134773 S SCREW CORT 1.5 10.4420 278 $ 198.00 442134786 S SCREW CORT 2.0 - 3.5 10.4420 278 $ 198.00 442134888 S SCREW CORT 4.5 10.4420 278 $ 183.00 442134922 S SCREW CRANIAL 1.3MM 10.4420 278 $ 679.00 442134931 S SCREW DHS LAG 10.4420 278 $ 2,419.00 442134950 S SCREW DHS/OCS COMP/280.99 10.4420 278 $ 388.00 442134970 S SCREW SCHANZ 10.4420 278 $ 737.00 442134986 S TUBE 10.4420 279 $ 2,033.00 442134992 S WASHER 10.4420 278 $ 255.00 442134994 S WASHER SPIKED 10.4420 278 $ 453.00 442135030 S PLATE-Y 2.0MM 1X3 HOLES/447. 10.4420 278 $ 1,887.00 442135071 S LOCKING BOLTS 10.4420 278 $ 1,409.00 442135102 S TIBIAL NAIL 10.4420 278 $ 6,708.00 442135168 S WIRE TO RING CLAMP 10.4420 279 $ 5,108.00 442135169 S RING TO ROD CLAMP/393.436 10.4420 279 $ 5,859.00 442135170 S GUIDE WIRE SMOOTH 1.8MM/292. 10.4420 278 $ 636.00 442135177 S HYBRID FIXATOR 3/4 RING/393. 10.4420 279 $ 3,192.00 442135181 S END CAP EXT GREEN/458.120 10.4420 279 $ 1,066.00 442135183 S END CAP EXT 10MM GREEN/459.0 10.4420 279 $ 1,393.00 442135218 SCREW CORTSELF-TAP4.5MM 10.4420 278 $ 237.00 442135259 S CANN FEM NAIL 10.4420 278 $ 7,460.00 442135331 S SCREW 2.4X12MM/401.612 10.4420 278 $ 596.00 442135341 S BUTTRESS PIN 10.4420 278 $ 526.00 442135383 S DISTAL PLT DORSAL RIGHT/442. 10.4420 278 $ 5,059.00 442135384 S DISTAL PLT VOLAR/442.471 10.4420 278 $ 4,546.00 442135386 S DISTAL PLT VOLAR LEFT/481.48 10.4420 278 $ 4,546.00 442135420 S TI FEM NAIL 11X360MM/450.808 10.4420 278 $ 9,052.00 442135436 TI DISTAL FEM NAIL 12X360/450. 10.4420 278 $ 9,052.00 442135459 TI LOCKING SCREW 10.4420 278 $ 1,788.00 442135467 S END CAP AQUA/450.896 10.4420 278 $ 1,469.00 442135539 S PLATE DHS 10.4420 278 $ 3,511.00 442135546 SCR 2.4MM SELF-TAP 10.4420 278 $ 675.00 442135564 S TI STRT 1.5MM PLATE/446.031 10.4420 278 $ 1,433.00 442135566 SCR TI CORTEX 1.5MM 10.4420 278 $ 556.00 442135603 S K-WIRE 10.4420 278 $ 429.00 442135632 SCR CANN 16MM THREAD 10.4420 278 $ 2,096.00 442135640 SCR CANN 32MM THREAD 10.4420 278 $ 2,096.00 442135670 S 2.4MM LC-DCP 6H/449.926 10.4420 278 $ 2,633.00 442135674 S 2.0MM LC-DCP 10.4420 278 $ 2,033.00 442135678 S 2.0MM TI CORT SCR/401.826.96 10.4420 278 $ 538.00 442135682 2.0MM STRAIGHT PLATE 6H/447.03 10.4420 278 $ 1,578.00 442135684 2.0MM T-PLATE 2H/447.232 10.4420 278 $ 1,727.00 442135707 SCREW CORT SELF-TAP 10.4420 278 $ 235.00 442135713 209.885/SCR CANN 7.3X32MM THRE 10.4420 278 $ 1,746.00 442135720 CALCANEAL LOCK PLT 10.4420 278 $ 4,769.00 442135742 SCR LOCKING SLFTAP 3.5MM 10.4420 278 $ 857.00 442135755 SCR MOD 2.0MM 10.4420 278 $ 488.00 442135768 SCREW 2.7MM 10.4420 278 $ 472.00 442135769 SCREW 3.5MM 10.4420 278 $ 193.00 442137003 BLADE SAW GIGLI 300MM/2808-001 10.4420 272 $ 281.00 442137005 Z CEMENT BONE 60/30 KIT/1102-1 10.4420 278 $ 1,805.00 442137010 Z HIP ACET SHELL 10.4420 278 $ 7,764.00 442137086 Z KNEE FEM MED 10.4420 278 $ 13,436.00 442137134 Z PROS NEX ART SF 10.4420 278 $ 6,371.00 442137149 Z PROS NEX FEM 10.4420 278 $ 11,390.00 442137160 Z PROS NEX FLAT TIB 10.4420 278 $ 8,687.00 442137172 Z PROS NEXGEN PAT 10.4420 278 $ 3,795.00 442137220 Z PROS NEX STMD TIB 10.4420 278 $ 7,652.00 442137254 Z STATAK SOFT TISDSUE 10.4420 278 $ 2,959.00 442137262 Z FEM CEMENT RESTRICT/5069-51 10.4420 278 $ 385.00 442137268 Z ROD HARR COMP-DIST 10.4420 278 $ 3,701.00 442137323 Z BLADE PAT REAM 46/5120-95-46 10.4420 278 $ 1,246.00 442137325 Z CUTTER MICRO-MILL/5052-204 10.4420 278 $ 1,051.00 442137357 Z PROS NEX STEM TIB 10.4420 278 $ 7,953.00 442137381 Z PROS NEX KNEE 10.4420 278 $ 11,049.00 442137388 KNEE TIB SERIES 2 10MM/5788-50 10.4420 278 $ 5,909.00 442137410 STEM FEM 10.4420 278 $ 12,101.00 442137426 Z PROS VERSYS/7818 10.4420 278 $ 3,125.00 442137444 Z PROS VERSYS/7859 10.4420 278 $ 742.00 442137446 Z DISTAL CENTRALIZER 11MM/7859 10.4420 278 $ 742.00 442137455 Z PROS VERSYS/8018 10.4420 278 $ 3,872.00 442137529 Z PROS LPS FEM 10.4420 278 $ 11,079.00 442137577 Z PROS LPS ARTSF 10.4420 278 $ 5,989.00 442137626 Z PROS LCCK FEM 10.4420 278 $ 18,821.00 442137642 Z PROS NEX ST STEM 10.4420 278 $ 5,901.00 442137675 Z PROS HALF WEDGE 10.4420 278 $ 8,284.00 442137700 Z PROS BLOCK TIB 10.4420 278 $ 8,284.00 442137723 Z PROS NEX PRC 10.4420 278 $ 5,771.00 442137724 Z PROS NEX 10.4420 278 $ 5,771.00 442137761 Z SCREW/6250-65 10.4420 278 $ 903.00 442137765 Z PROS VERSYS FEM HEAD 10.4420 278 $ 3,872.00 442137807 Z KNEE TIB 10.4420 278 $ 9,618.00 442137808 Z PROS FEM STEM SZ 10.4420 278 $ 7,750.00 442137823 CABLE-READY GRIP SYSTM 10.4420 278 $ 3,406.00 442137842 PLT 7H STR 3.5MM/1179-005-07 10.4420 278 $ 2,040.00 442137843 PLT 8H STR 3.5MM/1179-005-08 10.4420 278 $ 2,565.00 442137874 KNEE TIB MED 10.4420 278 $ 9,618.00 442145682 STEIN THD 2.8MMDX229MM/262-005 10.4420 278 $ 213.00 442145687 STD B BDY LG JNCT STD/9990-18- 10.4420 278 $ 25,539.00 442145695 Z TRILOGY LINER/6141-70-28 10.4420 278 $ 9,297.00 442145696 PAT KNEE SYS 19MM MED/5876-36- 10.4420 278 $ 14,602.00 442145698 Z GTR W/4 CABLE/2232-02-05 10.4420 278 $ 12,362.00 442145782 Z NAIL CAP 10.4420 278 $ 1,439.00 442145786 AUTO TRANSFUSION SET/2555-115- 10.4420 279 $ 5,148.00 442145793 SPONGE KEEL SINGLE/4301-34-01 10.4420 272 $ 801.00 442145794 SPONGE PRESSURIZER/4301-35-01 10.4420 272 $ 412.00 442145798 46MM GLEN W/52MM PEGS/4302-46- 10.4420 278 $ 8,908.00 442145799 52MM GLEN W/46MM PEGS/4302-52- 10.4420 278 $ 9,297.00 442146097 POROUS STEM LG/9981-150-33 10.4420 278 $ 21,633.00 442146129 SCR CORT/C LOW PROFILE 10.4420 278 $ 373.00 442146132 6.5MM CANC SCR/4865-095-02 10.4420 278 $ 385.00 442146141 XLPE 10DEG POLY LINER/6310-50- 10.4420 278 $ 9,450.00 442146142 Z SHORT GTR W/CABLE/2232-02-04 10.4420 278 $ 8,821.00 442146144 XLPE 10D POLY LINER/6310-50-36 10.4420 278 $ 11,079.00 442146148 FEM HEAD 7.0 TO 10.5 10.4420 278 $ 6,155.00 442146154 POLY LINER 10.4420 278 $ 9,450.00 442146197 ARTHREX STAR SLEEVE/AR-1606 10.4420 278 $ 742.00 442146205 BIPOLAR METAL SHELL 10.4420 278 $ 3,338.00 442146206 LINER ASSY/5001 10.4420 278 $ 2,208.00 442150001 ABLATION DEVICE FLEX 10 10.4420 272 $ 10,742.00 442150006 ABLATION DEVICE FLEX 2 10.4420 272 $ 5,013.00 442150011 ABLATION DEVICE FLEX 4 10.4420 272 $ 7,878.00 442150016 ACROBAT V OFF-PUMP STAB SYS 10.4420 272 $ 3,423.00 442150021 ARTHREX CORING REAMER 10.4420 272 $ 893.00 442150026 ARTHREX DRILL&WIRE/AR1978 10.4420 272 $ 526.00 442150031 ARTHREX OATS HARVESTER 10.4420 272 $ 2,140.00 442150036 ARTHRO WAND 10.4420 272 $ 1,287.00 442150041 CAPIO DEVICE 10.4420 279 $ 670.00 442150046 CELL SAVER RESERVOIR 10.4420 272 $ 183.00 442150051 CELL SAVER ASSEMBLY BASIC 10.4420 272 $ 68.00 442150056 CELL SAVER HI-SPEED PAC/263 10.4420 272 $ 366.00 442150061 CELL SAVER PACK OPEN HEART 10.4420 272 $ 618.00 442150066 CELL SAVER SMALL BOWL/261 10.4420 272 $ 366.00 442150071 CRYOLIFE SOLUTIONS CART 10.4420 272 $ 1,860.00 442150081 ELECTROHYD LITHOTRIPTER 10.4420 279 $ 486.00 442150086 ENDO BABCOCK 10.4420 272 $ 380.00 442150091 ENDO RETRACT 10.4420 272 $ 841.00 442150096 ENDOSTAT 10.4420 272 $ 847.00 442150101 ENDOSTAT ADD-STAT 10.4420 272 $ 2,641.00 442150106 GORE SMOOTHER 10.4420 272 $ 723.00 442150121 VASOVIEW BISECTOR/USB10243 10.4420 279 $ 2,071.00 442150136 PERFORATOR DISP/26-1221 10.4420 279 $ 746.00 442150141 PROCEDURE SET THERMABLATOR 10.4420 279 $ 2,189.00 442150151 TVT DEVICE/810041 10.4420 272 $ 2,743.00 442150156 VASOVIEW KIT WITH MARTINI TIP 10.4420 279 $ 2,899.00 442150161 ACE CANNULATED SCREW 6.5 10.4420 278 $ 837.00 442150171 ACUFEX FIXATION POST 10.4420 278 $ 499.00 442150176 ACUFEX SCREW 10.4420 278 $ 545.00 442150181 ALLODERM 1X4/102007 10.4420 278 $ 1,030.00 442150186 ALLODERM 2X4CM/102012 10.4420 278 $ 1,804.00 442150191 ALLODERM 3X7CM/102021 10.4420 278 $ 1,919.00 442150196 A-MED VASCULAR CANNULA 10.4420 279 $ 1,374.00 442150201 ANTEPLEGIA AORTIC CATH 14GA 10.4420 279 $ 83.00 442150206 ARTERIAL CANNULA 10.4420 279 $ 797.00 442150211 ARTHREX ANCHOR CORKSCREW 10.4420 278 $ 824.00 442150216 ARTHREX CANNULA 7MM X 70MM 10.4420 279 $ 91.00 442150221 ARTHREX FASTAK ANCHOR 2.8MM 10.4420 278 $ 618.00 442150226 ASH SPLIT CATH /C CUFF/ASPC32 10.4420 278 $ 1,827.00 442150231 BALLOON EPISTAXIS/N3414 10.4420 279 $ 107.00 442150236 BARD SAUVAGE FABRIC 10.4420 278 $ 114.00 442150241 BIO CORKSCREW 10.4420 278 $ 1,099.00 442150246 BIO FASTAK 10.4420 278 $ 1,030.00 442150251 BONE CANC CHIPS 30CC 10.4420 278 $ 1,667.00 442150256 BONE CANC CHIPS/400145 10.4420 278 $ 985.00 442150261 BONE DOWEL 10.4420 278 $ 2,129.00 442150266 BONE ILIAC CREST WEDGE 13-15 10.4420 278 $ 2,354.00 442150271 BONE ILIUM TRICORT STRIP 2.2CM 10.4420 278 $ 3,472.00 442150276 BONE MATRIX GEL 10CC 10.4420 278 $ 3,089.00 442150281 BONE PLUG 10.4420 278 $ 316.00 442150286 BONE POWDER CORT 10 CC 10.4420 278 $ 999.00 442150291 BONE PUTTY DBX 5CC/038050 10.4420 278 $ 2,305.00 442150301 BONE STRUT CORT-CANC 6X8 10.4420 278 $ 2,385.00 442150306 BONE WAX (24BX)/0102975 10.4420 279 $ 18.00 442150311 CANNULA 10.4420 279 $ 160.00 442150316 CANNULA FEM 22FR/FEM11022V 10.4420 279 $ 843.00 442150321 CANNULA JEHLE 9/32/35 10.4420 279 $ 616.00 442150326 CANNULA VENOUS/VFEM031 10.4420 279 $ 1,008.00 442150341 CAROTID BYPASS SHUNT 10.4420 279 $ 34.00 442150346 CARPAL PROSTHESIS 10.4420 278 $ 2,641.00 442150351 CATH EPIDURAL FLEX-TIP\EC-0550 10.4420 279 $ 53.00 442150356 CATH HICKMAN DUAL 9FR 10.4420 278 $ 591.00 442150361 CATH HICKMAN SINGLE/0600562 10.4420 278 $ 614.00 442150366 CATH INTRODUCER PEEL/0601440 10.4420 279 $ 188.00 442150371 CATH LEONARD 10FR/60034-2 10.4420 278 $ 412.00 442150376 CATH MEDIASTINAL SIL. 34MM 10.4420 279 $ 66.00 442150381 CATH NEPHMALECOT 14FR/410-104 10.4420 279 $ 261.00 442150391 CATH SUPRA RUTNER BALL/018916 10.4420 279 $ 210.00 442150396 CATH TAUT/20018-M55/TAUT 10.4420 279 $ 129.00 442150401 CATH BALLOON DILATION 10.4420 279 $ 1,240.00 442150411 CATH COUNCIL 10.4420 279 $ 55.00 442150416 CATH DIALYS HEMOGLIDE/5664192 10.4420 278 $ 1,260.00 442150421 CATH EMBOLECTOMY 10.4420 279 $ 129.00 442150426 CATH GROSHONG DUAL V/C 9.5FR 10.4420 278 $ 1,424.00 442150431 CATH GROSHONG PICC 4 FR.SIN 10.4420 278 $ 385.00 442150436 CATH GROSHONG PICC 8FR SIN 10.4420 278 $ 1,159.00 442150441 CATH HEMATURIA FOLEY 10.4420 279 $ 535.00 442150446 CATH HEMOGLIDE PC2 KT/5664232 10.4420 278 $ 1,260.00 442150451 CATH HICKMAN 13.5 FR./0600662 10.4420 278 $ 572.00 442150456 CATH IRRIGATION 10.4420 279 $ 53.00 442150461 CATH MALECOT 10.4420 279 $ 86.00 442150466 CATH MUSHROOM 10.4420 279 $ 39.00 442150471 CATH PERITONEAL CURLED 10.4420 278 $ 328.00 442150476 CATH RETROGRADE/RC2014M 10.4420 279 $ 430.00 442150481 CATH RIGHT ANGLE 36FR 10.4420 279 $ 42.00 442150486 CATH SG TD 7F 10.4420 279 $ 183.00 442150491 CATH SG VIP 7.5F CO 10.4420 279 $ 183.00 442150496 CATH SG VIP 8F CARDIAC OUTPUT 10.4420 279 $ 893.00 442150501 CATH SUPRAPUBIC 16FR STAMEY 10.4420 279 $ 165.00 442150506 CATH SWAN-GANZ 7.5/931HF75 10.4420 279 $ 229.00 442150511 CATH THORACIC 10.4420 279 $ 31.00 442150516 CATH THORACIC SILICONE 10.4420 279 $ 59.00 442150521 CATH URETERAL 10.4420 279 $ 103.00 442150526 CATH VENOUS THIN-FLEX 10.4420 279 $ 129.00 442150531 CHOLANGIOCATH 4FR 2L60CM 10.4420 279 $ 256.00 442150601 CLAMP VASCULAR 10.4420 279 $ 229.00 442150606 CLIP 1/2 FORCE SPRING/G6052 10.4420 279 $ 76.00 442150611 CLIP ANEURYSM YASARGIL 10.4420 278 $ 1,132.00 442150616 CLIP MULTI SM/1205 10.4420 279 $ 40.00 442150621 CLIP SPRING SURGICAL/CSOFT6 10.4420 279 $ 36.00 442150626 CLIP WOUND 10.4420 278 $ 5.00 442150631 CLOSURE INTRAVASCUAR CATH 10.4420 279 $ 2,503.00 442150636 COMPRESSOR OPEN/395.51 10.4420 278 $ 1,807.00 442150641 CONDYLAR PROSTHESIS 10.4420 278 $ 893.00 442150646 CV TUNNELER 10.4420 272 $ 125.00 442150651 DENVER PERITONEO/42-4000 10.4420 278 $ 2,347.00 442150656 DENVER SHUNT COMP/42-3019 10.4420 278 $ 34.00 442150666 DUAL LUMEN INFUS CATH/ML-00702 10.4420 279 $ 134.00 442150671 DRAIN BLAKE FLUTED 10FR/2186 10.4420 279 $ 108.00 442150676 DRAIN CONSTAVAC 1/4/225-416-00 10.4420 279 $ 458.00 442150681 DRAIN SUMP TRIPLE/0080400 10.4420 279 $ 190.00 442150686 DURAGEN 1 X 1/ID1101 10.4420 278 $ 640.00 442150691 DURAGEN 3 X 3/ID3301 10.4420 278 $ 1,942.00 442150696 DURAGEN 4 X 5/ID4501 10.4420 278 $ 3,107.00 442150701 DURAGUARD 8X14/DG-0814S 10.4420 278 $ 1,648.00 442150706 EEA STAPLER 10.4420 278 $ 1,215.00 442150711 ENDO STITCH HAND/173016 10.4420 278 $ 507.00 442150716 ENDO STITCH INS/173024 10.4420 278 $ 92.00 442150721 ENDOCATCH/ECATCH10G 10.4420 272 $ 383.00 442150726 ENDOCLIP 10.4420 278 $ 405.00 442150731 ENDOGIA FIXATION ADD UNIT 10.4420 272 $ 870.00 442150736 ENDOGIA IMPLANTED FIXATION 10.4420 278 $ 1,386.00 442150741 ENDOLOOP 10.4420 278 $ 153.00 442150746 ENDOSTICH 10.4420 278 $ 629.00 442150751 EYE SPHERE 10.4420 278 $ 68.00 442150756 FASCIA LATA 10CMX25MM 10.4420 278 $ 691.00 442150761 FASCIA LATA 180X65 NEURO 10.4420 278 $ 2,143.00 442150766 FASCIA LATA 5CMX52MM SMALL 10.4420 278 $ 1,149.00 442150771 FELT DACRON/007839USCI 10.4420 278 $ 572.00 442150776 FELT TEFLON/007837 10.4420 278 $ 472.00 442150781 FIBRILLAR/1961 10.4420 278 $ 206.00 442150786 FIBULAR BONE 10X9-13/100421 10.4420 278 $ 1,951.00 442150791 FIBULAR BONE 4X14-18 10.4420 278 $ 1,974.00 442150796 FIBULAR BONE 6X14-18/100730 10.4420 278 $ 2,020.00 442150801 FINGER PROSTHESIS 10.4420 278 $ 1,992.00 442150806 FIXATION STAPLE 10.4420 278 $ 157.00 442150811 FLOSEAL/934056 10.4420 279 $ 669.00 442150816 FOGARTY BILIARY 10.4420 279 $ 240.00 442150821 GIA INSERT 10.4420 278 $ 846.00 442150826 GIA STAPLER 10.4420 278 $ 630.00 442150831 GRAFT INTRALUMINAL 10.4420 278 $ 1,829.00 442150836 GRAFTJACKET 5 X 5/86005X05 10.4420 278 $ 5,127.00 442150841 GREAT TOE PROSTHESIS 10.4420 278 $ 2,641.00 442150846 HEMASHIELD PATCH 8X75 10.4420 278 $ 347.00 442150851 HINGE TOE PROSTHESIS 10.4420 278 $ 1,808.00 442150856 ICP EXT DRAINAGE SET-INS-8601 10.4420 279 $ 537.00 442150861 ILA RELOAD 10.4420 278 $ 497.00 442150866 IMPLANT OCULAR/991055 10.4420 278 $ 343.00 442150871 IMPLANT ORBITAL FLOOR/E5608 10.4420 278 $ 98.00 442150876 INFAST INSERT/C SCR/72403885 10.4420 278 $ 2,589.00 442150881 INNERDYNE MINISTEP/MS101008 10.4420 278 $ 332.00 442150886 INTRO PERC LEAD 10.5 10.4420 278 $ 119.00 442150891 INTRO PERC LEAD/6209-S5 9 10.4420 278 $ 192.00 442150896 INTRO PERITONEAL TAUT 6 FR 10.4420 279 $ 62.00 442150901 INTRO CORDIS 8FR/501-6084 10.4420 279 $ 52.00 442150906 KIT CRANIOPLASTIC/43-1050 10.4420 278 $ 2,153.00 442150911 KIT IABP DATA 10.4420 279 $ 342.00 442150921 KIT OLM INTERCRANIAL/TEMP 10.4420 279 $ 2,274.00 442150926 KIT POST CRANI PRESSURE 10.4420 279 $ 2,198.00 442150931 KIT SHUNT EMERGENCY/33234 10.4420 279 $ 252.00 442150936 KIT TRANS TRIPLE LUM/PX3X3 10.4420 279 $ 134.00 442150941 K-WIRE 10.4420 278 $ 71.00 442150946 K-WIRE CALIBRATED 10.4420 278 $ 168.00 442150951 KYPHOPLASTY BONE BX DEVICE 10.4420 278 $ 595.00 442150956 KYPHOPLASTY INTRO SYSTEM 10.4420 278 $ 9,805.00 442150961 KYPHOPLASTY KIT/KPT2002 10.4420 278 $ 9,892.00 442150966 LDS STAPLER 10.4420 278 $ 688.00 442150971 LOCKING NUT 4.5 CORT/219.96 10.4420 278 $ 94.00 442150981 MCGHAN EXP TISSUE/67-133 10.4420 278 $ 3,365.00 442150986 MCGHAN IMPLANT 110/27-110121 10.4420 278 $ 2,761.00 442150991 MCGHAN IMPLANT 110/27-110151 10.4420 278 $ 2,761.00 442150996 MCGHAN IMPLANT 110/27-110181 10.4420 278 $ 2,761.00 442151001 MCGHAN IMPLANT 131/37-131600 10.4420 278 $ 3,434.00 442151006 MCGHAN IMPLANT 133/37-133700 10.4420 278 $ 3,434.00 442151011 MCGHAN IMPLANT 133/37-133800 10.4420 278 $ 3,434.00 442151016 MCGHAN IMPLANT 363/27-363311 10.4420 278 $ 2,589.00 442151021 MCGHAN IMPLANT 400/27-110481 10.4420 278 $ 2,761.00 442151026 MCGHAN IMPLANT 400/27-120501 10.4420 278 $ 2,761.00 442151031 MCGHAN IMPLANT 450/27-110451 10.4420 278 $ 3,021.00 442151036 MCGHAN IMPLANT 468/27-468231 10.4420 278 $ 2,243.00 442151041 MCGHAN IMPLANT 468/27-468351 10.4420 278 $ 2,243.00 442151046 MCGHAN TISSUE EXP 400/67-133 10.4420 278 $ 3,365.00 442151051 MCGHAN TISSUE EXP 700/67-133 10.4420 278 $ 2,761.00 442151056 MCGHAN IMP 270-300/27-168271 10.4420 278 $ 2,071.00 442151061 MEDTRONIC CATH W PUMP 10.4420 278 $ 1,950.00 442151066 MEDTRONIC CATHETER PASSER 10.4420 278 $ 448.00 442151071 MEDTRONIC DUALSCREEN/3628 10.4420 278 $ 4,282.00 442151076 MEDTRONIC EXT 25CM/7495-25 10.4420 278 $ 2,267.00 442151081 MEDTRONIC LEAD PISCES COMP 10.4420 278 $ 3,838.00 442151086 MEDTRONIC PUMP MORPH/862718 10.4420 278 $ 23,051.00 442151091 MENTOR IMPLANT 250/350-1635 10.4420 278 $ 2,598.00 442151096 MESH COMPOSIX 10X14/0113114 10.4420 278 $ 3,472.00 442151101 MESH COMPOSIX 12X12/0113112 10.4420 278 $ 4,007.00 442151106 MESH COMPOSIX 3X6/0113360 10.4420 278 $ 1,058.00 442151111 MESH COMPOSIX 4 X 8/0113480 10.4420 278 $ 1,529.00 442151116 MESH COMPOSIX 6 X 8/0113680 10.4420 278 $ 2,129.00 442151121 MESH COMPOSIX 8 X 10/0113810 10.4420 278 $ 3,192.00 442151126 MESH DUAL PLUS 1DLMCP03 10.4420 278 $ 2,020.00 442151131 MESH DUAL PLUS 1DLMCP04 10.4420 278 $ 2,823.00 442151136 MESH DUAL PLUS 1DLMCP06 10.4420 278 $ 3,374.00 442151141 MESH DUAL PLUS 1DLMCP07 10.4420 278 $ 4,689.00 442151146 MESH KUGAL CIRCLE LG/0010104 10.4420 278 $ 2,216.00 442151151 MESH KUGAL COMP OV/0010-205 10.4420 278 $ 2,880.00 442151156 MESH KUGAL HERNIA PATCH 10.4420 278 $ 1,117.00 442151161 MESH KUGAL OVAL LG/0010102 10.4420 278 $ 2,527.00 442151166 MESH KUGEL 3 X 3/0010103 10.4420 278 $ 1,310.00 442151171 MESH KUGEL HERNIA MED. OVAL 10.4420 278 $ 1,365.00 442151176 MESH KUGEL OVAL LG/0010-102 10.4420 278 $ 1,625.00 442151181 MESH KUGEL PATCH CIRCLE LG 10.4420 278 $ 2,216.00 442151182 MESH KUGEL PATCH CIRCLE LG 10.4420 278 $ 3,030.00 442151186 MESH MARLEX 10 X 14/0122660 10.4420 278 $ 505.00 442151191 MESH MARLEX 3 X 6/0112680 10.4420 278 $ 247.00 442151196 MESH MARLEX PLUG 10.4420 278 $ 670.00 442151197 MESH MARLEX PLUG XL 10.4420 278 $ 1,494.00 442151201 MESH PATCH GORE 1 X 15 X 20 10.4420 278 $ 2,740.00 442151206 MESH PATCH GORE 6 X 10 X 15 10.4420 278 $ 3,647.00 442151211 MESH VICRYL COATED 12 X 12 10.4420 278 $ 2,269.00 442151216 MITEK FASTIN ANCHOR 10.4420 278 $ 870.00 442151221 MITEK KNOTLESS ANCH/212029 10.4420 278 $ 2,592.00 442151226 MITEK MINI ANCHOR #0/212466 10.4420 278 $ 169.00 442151231 MITEK MINI ANCHOR #2-0/212033 10.4420 278 $ 1,241.00 442151236 MITEK QUICK ANCHOR #2/212393 10.4420 278 $ 168.00 442151241 MITEK QUICK ANCH 1.3/212866 10.4420 278 $ 1,204.00 442151246 MITEK SUPER ANCHOR #2/ 10.4420 278 $ 178.00 442151251 MITEK SUPER ANCHOR #2/212032 10.4420 278 $ 912.00 442151256 MITEK THREADED ANCHOR 10.4420 278 $ 888.00 442151261 MOSS G-TUBE PEG KIT/PEG-18 10.4420 279 $ 1,328.00 442151266 NAIL FLEXIBLE 10.4420 278 $ 307.00 442151271 NEEDLE BIOPSY 14X6 TRUCUT 10.4420 272 $ 71.00 442151281 NUT LG EX FIX/393.43 10.4420 279 $ 109.00 442151286 NUT SM EX FIX/395.58 10.4420 278 $ 76.00 442151291 O RESTRICT MED UNIV/B000-0240 10.4420 278 $ 614.00 442151296 SYNTHES OPEN COM EX FIX/393.76 10.4420 279 $ 1,008.00 442151301 OSTEO SET BONE GRAFT 25CC 10.4420 278 $ 3,399.00 442151306 OSTEO SET BONE GRAFT 5CC 10.4420 278 $ 2,054.00 442151311 PACING LEADS 10.4420 278 $ 126.00 442151316 PATCH FABRIC 2"" X 2"" /00794 10.4420 278 $ 219.00 442151321 PATCH FELT 2"" X 2"" /007977 10.4420 278 $ 99.00 442151326 PATCH GORE 15CM 10.4420 278 $ 3,175.00 442151331 PATCH GORE 20CM 10.4420 278 $ 3,365.00 442151336 PERICARDUIM 6X8/PC608N 10.4420 278 $ 1,260.00 442151341 PERMACATH TRAY/8817749001 10.4420 278 $ 858.00 442151346 PISCES LEAD 28CM/3887-28 10.4420 278 $ 3,838.00 442151351 PLATE LINK 01 10.4420 278 $ 1,237.00 442151356 PLATE LINK 02 10.4420 278 $ 1,374.00 442151361 PLATE LINK 03 10.4420 278 $ 1,512.00 442151366 PLATE LINK 04 10.4420 278 $ 1,648.00 442151391 PLEURX CATHETER KIT/50-7000 10.4420 279 $ 1,145.00 442151396 PORT DUAL MRI 9.5/0605900 10.4420 278 $ 1,896.00 442151401 PORT SINGLE MRI PLASTIC 10.4420 278 $ 1,282.00 442151406 PRO OSTEON 12X25X25/5RB075 10.4420 278 $ 2,968.00 442151411 PROS TOP PORP 6.6MM/140859 10.4420 278 $ 1,447.00 442151416 PROS TOP TORP 10MM/140856 10.4420 278 $ 1,447.00 442151421 PROS DE LA CRUZ 10.4420 278 $ 480.00 442151426 PROS EAR APPLEBAUM 14-0957 10.4420 278 $ 1,684.00 442151431 PROS EAR APPLEBAUM/14-0956 10.4420 278 $ 1,401.00 442151436 PROS EAR BRACKMANN/11-12303 10.4420 278 $ 670.00 442151441 PROS EAR CAPCEL PART/11-12095 10.4420 278 $ 1,030.00 442151446 PROS EAR CAUSSE TOT/11-12195 10.4420 278 $ 1,296.00 442151451 PROS EAR FISCH PISTON/11-56234 10.4420 278 $ 472.00 442151456 PROS EAR INCUS FLEX SM/0579 10.4420 278 $ 1,594.00 442151461 PROS EAR INCUS FLEX ST/0580 10.4420 278 $ 1,594.00 442151466 PROS EAR MALLEUS STAP/11-56297 10.4420 278 $ 3,547.00 442151471 PROS EAR MALLEUS/11-12190 10.4420 278 $ 1,054.00 442151476 PROS EAR MIDDLE PART/11-13005 10.4420 278 $ 916.00 442151481 PROS EAR MIDDLE TOT/11-13000 10.4420 278 $ 927.00 442151486 PROS EAR MORETZ CAM/11-12182 10.4420 278 $ 965.00 442151491 PROS EAR MORETZ MUSH/11-12172 10.4420 278 $ 965.00 442151496 PROS EAR MORETZ MUSH/11-12175 10.4420 278 $ 1,183.00 442151501 PROS EAR MORETZ OFF/11-56358 10.4420 278 $ 522.00 442151506 PROS EAR MORETZ PEG/11-56304 10.4420 278 $ 618.00 442151511 PROS EAR MORETZ PORP/11-56359 10.4420 278 $ 564.00 442151516 PROS EAR MORETZ/11-12185 10.4420 278 $ 1,075.00 442151521 PROS EAR SHEEHY/11-12362 10.4420 278 $ 905.00 442151526 PROS EAR SHEEHY/11-12363 10.4420 278 $ 875.00 442151531 PROS EAR STAPES 4.0/11-33032 10.4420 278 $ 509.00 442151536 PROS EAR VENT M BOBB/10-0247 10.4420 278 $ 43.00 442151541 PROS GRATE MALLEUS TO STAPES 10.4420 278 $ 737.00 442151546 PROS INCUS-ROB 4.0/N168CIA 10.4420 278 $ 476.00 442151551 PROS INCUS-ROB 5.0/N1686C11 10.4420 278 $ 303.00 442151556 PROS MED WEHR INCUS/70140984 10.4420 278 $ 1,485.00 442151561 PROS POLYCEL STRUT 6310 10.4420 278 $ - 442151566 PROS LONG WEHRS INCUS 10.4420 278 $ 1,401.00 442151571 PROS ROB 4.5 S-STM S-W 10.4420 278 $ 311.00 442151576 PROS ROB 5.0 N-STM LGW 10.4420 278 $ 311.00 442151581 PROS ROB MOON LIPY/1133009 10.4420 278 $ 509.00 442151586 PROS SHT WEHRS INCUS 10.4420 278 $ 1,401.00 442151591 PROS STRUT 6312 10.4420 278 $ - 442151596 PROS TUBE MILLEN THIN /0567 10.4420 278 $ 1,556.00 442151601 PROTACK 10.4420 278 $ 1,092.00 442151606 PURSE STRING 10.4420 278 $ 264.00 442151611 RADIAL HEAD PROSTHESIS 10.4420 278 $ 1,877.00 442151616 REPLIFORM 2X7 820241 10.4420 278 $ 1,946.00 442151621 REPLIFORM 4X7 820243 10.4420 278 $ 2,054.00 442151626 RICHARDS FIXATION STAPLE 10.4420 278 $ 674.00 442151631 ROTICULATOR GRASPER 10.4420 272 $ 338.00 442151636 ROTICULATOR STAPLER 10.4420 278 $ 2,032.00 442151641 RUSH ROD 10.4420 278 $ 211.00 442151691 SCLERAL BUCKLING COMP 10.4420 278 $ 174.00 442151696 SHEATH URETERAL ACCESS 10.4420 279 $ 1,209.00 442151701 SHUNT /PL-33--C9230Z6A 10.4420 278 $ 87.00 442151706 SHUNT CAROTID ARTERY 10.4420 278 $ 118.00 442151711 SHUNT CAROTID JAVID 17F 10.4420 278 $ 247.00 442151716 SHUNT CORONARY GUIDANT 10.4420 278 $ 422.00 442151721 SHUNT GOTT ANEURYSM 10.4420 278 $ 1,243.00 442151726 SILASTIC SHEETING .040 10.4420 278 $ 412.00 442151731 SKULL PINS DISPOSABLE 10.4420 279 $ 96.00 442151736 STEALTH INSERT 10.4420 272 $ 67.00 442151741 STEALTH LATIS INSERTS 10.4420 272 $ 84.00 442151751 STENT URETERAL 10.4420 278 $ 590.00 442151756 STERNAL CABLE 10.4420 278 $ 89.00 442151761 STONE BASKET 10.4420 279 $ 872.00 442151766 STRAIGHT SHOT 10.4420 279 $ 322.00 442151971 TA STAPLER 10.4420 278 $ 675.00 442151976 THORACOPORT 10.4420 279 $ 68.00 442151981 TISSUE EXP 550CC/SRV-1207 10.4420 278 $ 2,106.00 442151986 TRAPEZIUM PROSTHESIS 10.4420 278 $ 1,877.00 442151991 TRAY CVP MULTI-LUMEN 7F-3L 10.4420 279 $ 255.00 442151996 TRAY MAHURKAR 10.4420 278 $ 340.00 442152001 TRAY MULTI-LUMEN 12FR-3L 10.4420 279 $ 338.00 442152006 TROCHAR CHEST 10.4420 279 $ 67.00 442152011 HIP UNIPOLAR 10.4420 278 $ 1,095.00 442152016 TUBE EAR STR SHANK .9/10-28100 10.4420 278 $ 36.00 442152021 TUBE EAR T 6016/10-56016 10.4420 278 $ 23.00 442152026 TUBE ENDO EMG 6MM 82-29306 10.4420 279 $ 1,017.00 442152031 TUBE ENDO EMG 7MM 82-29307 10.4420 279 $ 939.00 442152036 TUBE ENDO EMG 8MM 82-29308 10.4420 279 $ 1,017.00 442152041 TUBE T 10.4420 279 $ 33.00 442152046 TUBE TRACH 10.4420 279 $ 123.00 442152066 VALVE OVERPRESSURE SAFETY 10.4420 279 $ 91.00 442152076 VAN SONNENBERG ONE STEP 10.4420 279 $ 166.00 442152081 VASCUGUARD/VG-0209N 10.4420 278 $ 710.00 442152086 VENOUS CANNULA 10.4420 279 $ 843.00 442152091 VERSASTEP 10.4420 279 $ 251.00 442152096 WRIST JOINT PROSTHESIS 10.4420 278 $ 2,710.00 442152100 ABLATOR 10.4420 272 $ 621.00 442152102 ACUTRAK BONE SCREW 10.4420 278 $ 1,420.00 442152104 ACUTRAK MINI BONE SCREW 10.4420 278 $ 1,299.00 442152106 ANCHOR BIOZIP 10.4420 278 $ 861.00 442152108 ANCHOR KNOTLESS 10.4420 278 $ 801.00 442152110 ANNULOPLASTY BAND 10.4420 278 $ 6,995.00 442152112 ARTHREX BIO-INTERFERENCE 10.4420 278 $ 594.00 442152114 ARTHREX CHON DART/AR-4005B-18 10.4420 278 $ 526.00 442152116 ARTHREX OSTEO FLAP/AR-4009S 10.4420 278 $ 893.00 442152118 ARTHREX OSTEO FLAP/AR-4095S 10.4420 278 $ 2,267.00 442152120 ARTHREX PLATE 10.4420 278 $ 1,992.00 442152122 ARTHREX SCREW 10.4420 278 $ 847.00 442152124 ARTHREX SCREW CANNULATED 10.4420 278 $ 435.00 442152126 ARTHREX TISSUE TAC 10.4420 278 $ 102.00 442152128 ARTHREX TRANSFIXAR 10.4420 278 $ 1,260.00 442152130 ARTHROTEK MENIS STAPLE 11 10.4420 278 $ 504.00 442152132 ARTHROTEK MENIS STAPLE 13 10.4420 278 $ 1,648.00 442152134 ARTHROTEK MENIS STAPLE SIN 10.4420 278 $ 783.00 442152136 ARTHROTEK STAPLE GUN 10.4420 278 $ 307.00 442152138 AUSTIN MOORE 10.4420 278 $ 1,808.00 442152140 BIONIX MENISCUS ARROW 10.4420 278 $ 668.00 442152142 BIONIX WEDGE 10.4420 278 $ 982.00 442152144 CANNULA CON 10.4420 279 $ 1,191.00 442152146 DANEK CABLE DOUBLE 10.4420 278 $ 1,687.00 442152148 DANEK CABLE SINGLE 10.4420 278 $ 1,319.00 442152150 DANEK CONNECTOR 10.4420 278 $ 2,623.00 442152152 DANEK CONNECTOR TSRH 10.4420 278 $ 2,116.00 442152154 DANEK NUT 10.4420 278 $ 408.00 442152156 DANEK PINS 10.4420 278 $ 229.00 442152158 DANEK PLATE ANT CERV 10.4420 278 $ 3,151.00 442152160 DANEK SCREW AXIS 10.4420 278 $ 925.00 442152162 DANEK PLATE AXIS 10.4420 278 $ 2,188.00 442152164 DANEK PLATE CROSSLINK 10.4420 278 $ 3,363.00 442152166 DANEK PLATE ZEPHIR 10.4420 278 $ 3,360.00 442152168 DANEK ROD 10.4420 278 $ 1,117.00 442152170 DANEK SCREW 10.4420 278 $ 146.00 442152172 DANEK SCREW ATLANTIS 10.4420 278 $ 1,109.00 442152174 DANEK SCREW CANC 10.4420 278 $ 1,109.00 442152176 DANEK SCREW M8 10.4420 278 $ 3,025.00 442152178 DANEK SCREW TSRH 10.4420 278 $ 1,571.00 442152180 DANEK SCREW ZEPHIR 10.4420 278 $ 1,377.00 442152182 DANEL SCREW EX POST 10.4420 278 $ 1,058.00 442152184 DEPUY PLATE ANT CERV 10.4420 278 $ 3,196.00 442152186 DEPUY SCREW LOCKING 10.4420 278 $ 1,474.00 442152188 DEPUY SCREW POLY 10.4420 278 $ 2,881.00 442152190 FASTIN 10.4420 278 $ 824.00 442152192 GRAFT EXS DACRON 10.4420 278 $ 3,089.00 442152194 GRAFT HEMASHIELD 10.4420 278 $ 2,027.00 442152196 GRAFT HEMASHIELD HMDVB 10.4420 278 $ 2,038.00 442152198 GRAFT HEMASHIELD HMDVS 10.4420 278 $ 1,936.00 442152200 GRAFT HEMASHIELD HVAN 10.4420 278 $ 2,192.00 442152202 GRAFT MWDVB 10.4420 278 $ 2,166.00 442152204 GRAFT PTFE/RRT06060070L 10.4420 278 $ 2,548.00 442152206 GRAFT PTFE/RRT08020030L 10.4420 278 $ 1,956.00 442152208 GRAFT PTFE/RRT08070070L 10.4420 278 $ 2,548.00 442152210 GRAFT PTFE/S0604 10.4420 278 $ 1,659.00 442152212 GRAFT PTFE/S47045 10.4420 278 $ 1,805.00 442152214 GRAFT PTFE/V06010L 10.4420 278 $ 595.00 442152216 GRAFT PTFE/V06040L 10.4420 278 $ 1,360.00 442152218 GRAFT PTFE/V47040L 10.4420 278 $ 1,379.00 442152220 GRANULES OSTEOSTIM 7.5/9020 10.4420 278 $ 2,152.00 442152222 HAND INNOVATIONS PLATE 10.4420 278 $ 2,054.00 442152224 HAND INNOVATIONS SCREW 10.4420 278 $ 320.00 442152226 HOWMEDICA NAIL FEMORAL 10.4420 278 $ 3,313.00 442152228 HOWMEDICA NAIL TIBIAL 10.4420 278 $ 3,151.00 442152230 HOWMEDICA SCREW 10.4420 278 $ 604.00 442152232 HYDRASORB DEVICE 10.4420 278 $ 8,382.00 442152234 MEDTRONIC EXTENDER 10.4420 278 $ 385.00 442152236 MEDTRONIC LOCKING SCREW 10.4420 278 $ 458.00 442152238 MEDTRONIC ROD 10.4420 278 $ 1,220.00 442152240 MEDTRONIC VERTEX SCREW 10.4420 278 $ 2,158.00 442152242 MITEK BIO-INTRAFIX 10.4420 278 $ 783.00 442152244 MITEK INTRAFIX 10.4420 278 $ 655.00 442152246 MITRAL RING 10.4420 278 $ 7,419.00 442152248 NEUFFELD PIN 10.4420 278 $ 258.00 442152250 ORTHOFIX KIT ANKLE/99-90647 10.4420 278 $ 4,297.00 442152252 ORTHOFIX KIT ANKLE/99-91547 10.4420 278 $ 11,056.00 442152254 ORTHOFIX WRIST FIX/99-36501 10.4420 278 $ 2,984.00 442152256 OSTEOFORM 90X90MM/218-2006 10.4420 278 $ 3,004.00 442152258 OSTEOMED PLATE BUR/218-0034 10.4420 278 $ 756.00 442152260 OSTEOMED PLATE BUR/218-0061 10.4420 278 $ 777.00 442152262 OSTEOMED PLATE BUR/218-0032 10.4420 278 $ 732.00 442152264 OSTEOMED PLATE MESH/218-0036 10.4420 278 $ 1,196.00 442152266 OSTEOMED PLATE SQUARE/218-0020 10.4420 278 $ 621.00 442152268 OSTEOMED PLATE 10H/218-0038 10.4420 278 $ 487.00 442152270 OSTEOMED PLATE 2H/218-0026 10.4420 278 $ 175.00 442152272 OSTEOMED PLATE 2H/218-0024 10.4420 278 $ 171.00 442152274 OSTEOMED PLATE 5H/218-0030 10.4420 278 $ 245.00 442152276 OSTEOMED PLATE Y DBL/218-0028 10.4420 278 $ 690.00 442152278 OSTEOMED SCREW 10.4420 278 $ 181.00 442152284 PATCH IMPRA 10.4420 278 $ 733.00 442152286 PENIILE RES 50ML/72402940 10.4420 278 $ 2,985.00 442152288 PENILE ACCES KIT 700/72401850 10.4420 278 $ 1,099.00 442152290 PENILE CYLINDER 10.4420 278 $ 6,861.00 442152292 PENILE CYLINDER W/PUMP 10.4420 278 $ 11,775.00 442152426 PENILE CYLINDER-PUMP SET/98161 10.4420 278 $ 6,895.00 442152428 PENILE IMPLANT RES65/72402970 10.4420 278 $ 2,914.00 442152430 PENILE RES 100/72402960 10.4420 278 $ 3,380.00 442152432 PENILE RES/9060K 10.4420 278 $ 3,552.00 442152434 PENILE RES/9075K 10.4420 278 $ 2,554.00 442152436 PENILE RES 100/72401130 10.4420 278 $ 2,985.00 442152438 PLATE ANG 6H 40MM/01-08669 10.4420 278 $ 3,037.00 442152440 PLATE CURV 6H 39MM/01-08680 10.4420 278 $ 1,109.00 442152442 PLATE CURV 6H 49MM/01-08682 10.4420 278 $ 1,233.00 442152444 PLATE L-SHAPE LT/01-08233 10.4420 278 $ 361.00 442152446 PLATE L-SHAPE RT/01-08232 10.4420 278 $ 467.00 442152448 PLATE 16 HOLE 12MM/54-08658 10.4420 278 $ 1,366.00 442152450 PLATE 4 HOLE MED./01-08203 10.4420 278 $ 252.00 442152452 PLATE 4 HOLE REG./01-08204 10.4420 278 $ 224.00 442152454 PLATE 4 HOLE35MM/01-08640 10.4420 278 $ 1,086.00 442152456 PLATE 6 HOLE 40MM/01-08642 10.4420 278 $ 693.00 442152458 PLATE 6 HOLE 50MM/01-08646 10.4420 278 $ 1,086.00 442152460 PLATE 6 HOLE REG. 2.0/01-08206 10.4420 278 $ 322.00 442152462 PLATE 8 HOLE 60MM/01-08650 10.4420 278 $ 953.00 442152464 PLATE Y-SHAPE REG/01-08260 10.4420 278 $ 572.00 442152466 PRO OSTEON GRAN 15CC/5RG15 10.4420 278 $ 1,739.00 442152468 PRO OSTEON GRAN 30CC/5RG30 10.4420 278 $ 2,330.00 442152470 PRO OSTEON IMP 10X10X10/5RB010 10.4420 278 $ 783.00 442152472 PRO OSTEON IMP 10X10X40/5RB040 10.4420 278 $ 1,967.00 442152474 PRO OSTEON IMP 12X25X25/5RB075 10.4420 278 $ 2,968.00 442152476 PUTTY OSTEOSTIM DBM 10 CC/9090 10.4420 278 $ 3,423.00 442152478 PUTTY OSTEOSTIM DBM 3 CC/9083 10.4420 278 $ 2,060.00 442152480 RAPIDLOC 10.4420 278 $ 790.00 442152482 RAPIDLOC APPLIER 10.4420 272 $ 454.00 442152484 RESERVOIR OMAYA 10.4420 278 $ 1,000.00 442152486 RESERVOIR RICKHAM 10.4420 278 $ 708.00 442152488 SHUNT CONNECTOR 10.4420 278 $ 481.00 442152490 SHUNT CSF - PERITONEAL 10.4420 278 $ 412.00 442152492 SHUNT CSF - VENTRICULAR OPUS 10.4420 278 $ 435.00 442152494 SHUNT CSF - VENTRICULAR 10.4420 278 $ 687.00 442152496 SHUNT CSF/SML/24027-5/PS MED 10.4420 278 $ 3,106.00 442152498 SHUNT CSF-LUMBOPERIT/44410 10.4420 278 $ 1,374.00 442152500 SHUNT DELTA 10.4420 278 $ 3,452.00 442152502 SHUNT PASSER 10.4420 278 $ 1,187.00 442152504 SHUNT RESERVOIR 10.4420 278 $ 824.00 442152506 SHUNT TUNNELER 10.4420 278 $ 1,233.00 442152508 SHUNT VALVE DELTA 10.4420 278 $ 3,127.00 442152510 SHUNT VALVE WITH CATHETER 10.4420 278 $ 3,244.00 442152512 SHUNT VENTRICULAR 10.4420 278 $ 549.00 442152514 SLINGSHOT 10.4420 278 $ 1,017.00 442152516 SLINGSHOT T LOOP PASS 10.4420 278 $ 568.00 442152518 STEINMAN PIN 10.4420 278 $ 236.00 442152520 STRYKER NAIL GAMMA 10.4420 278 $ 3,151.00 442152522 STRYKER PLATE 3-D 10.4420 278 $ 824.00 442152524 STRYKER PLATE ANGLED 10.4420 278 $ 1,456.00 442152526 STRYKER PLATE BAR 10.4420 278 $ 476.00 442152528 STRYKER PLATE C-SHAPE 10.4420 278 $ 1,113.00 442152530 STRYKER PLATE DOUBEL Y-SHAPE 10.4420 278 $ 599.00 442152532 STRYKER PLATE L-SHAPE 10.4420 278 $ 452.00 442152534 STRYKER PLATE ORBITAL 10.4420 278 $ 455.00 442152536 STRYKER PLATE SQUARE 10.4420 278 $ 436.00 442152538 STRYKER PLATE STRAIGHT 10.4420 278 $ 1,698.00 442152540 STRYKER PLATE T-SHAPE 10.4420 278 $ 475.00 442152542 STRYKER PLATE Y-SHAPE 10.4420 278 $ 536.00 442152544 STRYKER SCREW 10.4420 278 $ 137.00 442152546 STRYKER SCREW DISTAL 10.4420 278 $ 504.00 442152548 STRYKER SCREW LAG 10.4420 278 $ 1,126.00 442152550 STRYKER SCREW WEDGE 10.4420 278 $ 504.00 442152552 SURE CLOSE 10.4420 279 $ 2,066.00 442152554 SYNTHES NAIL FEMORAL 10.4420 278 $ 4,110.00 442152556 SYNTHES PLATE ORBIT 11H/420.2 10.4420 278 $ 756.00 442152558 SYNTHES BAR 10.4420 278 $ 172.00 442152560 SYNTHES BLADE HELICAL 10.4420 278 $ 1,930.00 442152562 SYNTHES PLATE BLADE 10.4420 278 $ 1,583.00 442152564 SYNTHES CLAMP 10.4420 278 $ 1,826.00 442152566 SYNTHES END CAP 10.4420 278 $ 558.00 442152568 SYNTHES HOOK 10.4420 278 $ 199.00 442152570 SYNTHES K-WIRE 10.4420 278 $ 1,463.00 442152572 SYNTHES LOCKING BOLT 10.4420 278 $ 558.00 442152574 SYNTHES LOCKING SCREW 10.4420 278 $ 658.00 442152576 SYNTHES NAIL FEMORAL CANN 10.4420 278 $ 2,823.00 442152578 SYNTHES NAIL TIBIAL 10.4420 278 $ 2,837.00 442152582 SYNTHES PIN TITANIUM 10.4420 278 $ 192.00 442152584 SYNTHES PLATE 1.0 T 10H/420.70 10.4420 278 $ 683.00 442152586 SYNTHES PLATE 1.0 ORBIT/420.40 10.4420 278 $ 2,399.00 442152588 SYNTHES PLATE 1.0 X-5H/420.81 10.4420 278 $ 614.00 442152590 SYNTHES PLATE 1.0 Y/420.62 10.4420 278 $ 691.00 442152592 SYNTHES PLATE 1.5 20H90/450.10 10.4420 278 $ 966.00 442152594 SYNTHES PLATE 2.0 4H 22/449.04 10.4420 278 $ 958.00 442152596 SYNTHES PLATE 2.0 4H 25/449.05 10.4420 278 $ 1,002.00 442152598 SYNTHES PLATE 2.0 6H 35/449.06 10.4420 278 $ 1,071.00 442152600 SYNTHES PLATE 2.0 ZYG 5H/343.4 10.4420 278 $ 136.00 442152602 SYNTHES PLATE 2.0 20H/451.101 10.4420 278 $ 1,246.00 442152604 SYNTHES PLATE 2.4 LC-DCP/449.1 10.4420 278 $ 1,433.00 442152606 SYNTHES PLATE 2.4 RECON/449.62 10.4420 278 $ 2,030.00 442152608 SYNTHES PLATE 2.4 RECON/449.70 10.4420 278 $ 2,881.00 442152610 SYNTHES PLATE 2.4 RECON/449.87 10.4420 278 $ 3,178.00 442152612 SYNTHES PLATE 2.4 RECON/449.88 10.4420 278 $ 3,178.00 442152614 SYNTHES PLATE 2.4 UNI FX/449.8 10.4420 278 $ 1,988.00 442152616 SYNTHES PLATE 2.4 UNI FX/449.8 10.4420 278 $ 2,147.00 442152618 SYNTHES PLATE ACF 10.4420 278 $ 2,889.00 442152620 SYNTHES PLATE ADAPTION/420.10 10.4420 278 $ 1,717.00 442152622 SYNTHES PLATE BOX 10.4420 278 $ 605.00 442152624 SYNTHES PLATE CALCANEAL 10.4420 278 $ 2,152.00 442152626 SYNTHES PLATE CALCANEAL LONG 10.4420 278 $ 1,739.00 442152628 SYNTHES PLATE CERVICAL 10.4420 278 $ 572.00 442152630 SYNTHES PLATE CLOVERLEAF 10.4420 278 $ 650.00 442152632 SYNTHES PLATE COND 10.4420 278 $ 1,241.00 442152634 SYNTHES PLATE CRANIAL 10.4420 278 $ 540.00 442152636 SYNTHES PLATE CRANIAL STRUT 10.4420 278 $ 1,506.00 442152638 SYNTHES PLATE DBL-Y /420.68 10.4420 278 $ 435.00 442152640 SYNTHES PLATE DCP 10.4420 278 $ 1,754.00 442152642 SYNTHES PLATE DCP 2.7 10.4420 278 $ 403.00 442152644 SYNTHES PLATE DCS 10.4420 278 $ 2,182.00 442152646 SYNTHES PLATE DHS 10.4420 278 $ 1,790.00 442152650 SYNTHES PLATE DISTAL RADIUS 10.4420 278 $ 2,029.00 442152651 SYNTHES PLATE DIST RAD VOLAR 10.4420 278 $ 2,078.00 442152652 SYNTHES PLATE H-1.0 TIT/420.84 10.4420 278 $ 389.00 442152654 SYNTHES PLATE H-1.0 TIT/420.85 10.4420 278 $ 435.00 442152656 SYNTHES PLATE HUMERUS 10.4420 278 $ 3,509.00 442152658 SYNTHES PLATE L-1.0 TIT/420.55 10.4420 278 $ 412.00 442152660 SYNTHES PLATE L-BUTT 10.4420 278 $ 1,076.00 442152664 SYNTHES PLATE LC-DCP 10.4420 278 $ 514.00 442152666 SYNTHES PLATE LC-DCP BRD 10.4420 278 $ 627.00 442152668 SYNTHES PLATE LC-DCP NAR 10.4420 278 $ 494.00 442152670 SYNTHES PLATE LCP 10.4420 278 $ 987.00 442152672 SYNTHES PLATE LCP BRD 10.4420 278 $ 2,180.00 442152674 SYNTHES PLATE LCP COND 10.4420 278 $ 3,521.00 442152676 SYNTHES PLATE LCP NAR 10.4420 278 $ 2,020.00 442152678 SYNTHES PLATE LCP TIBIAL 10.4420 278 $ 3,183.00 442152680 SYNTHES PLATE LISS 10.4420 278 $ 3,569.00 442152682 SYNTHES PLATE L-OBLIQ 1.5/446. 10.4420 278 $ 458.00 442152684 SYNTHES PLATE L-OBLIQUE 10.4420 278 $ 146.00 442152686 SYNTHES PLATE MAX 346/347 10.4420 278 $ 481.00 442152688 SYNTHES PLATE MAX 443 10.4420 278 $ 627.00 442152690 SYNTHES PLATE MAX 446/447 10.4420 278 $ 1,397.00 442152692 SYNTHES PLATE MAX 449 10.4420 278 $ 1,717.00 442152694 SYNTHES PLATE MED WALL/420.45 10.4420 278 $ 1,969.00 442152698 SYNTHES PLATE MINI FRAG 10.4420 278 $ 195.00 442152700 SYNTHES PLATE RECON 10.4420 278 $ 1,099.00 442152702 SYNTHES PLATE RECON LCP 10.4420 278 $ 1,818.00 442152704 SYNTHES PLATE SEMI-TUBULAR 10.4420 278 $ 152.00 442152706 SYNTHES PLATE T 10.4420 278 $ 668.00 442152708 SYNTHES PLATE T LCP 10.4420 278 $ 2,257.00 442152710 SYNTHES PLATE T OBLIQUE 10.4420 278 $ 1,277.00 442152712 SYNTHES PLATE T RIGHT ANGLE 10.4420 278 $ 1,374.00 442152714 SYNTHES PLATE T SM 10.4420 278 $ 328.00 442152716 SYNTHES PLATE T SM OBLIQUE 10.4420 278 $ 567.00 442152718 SYNTHES PLATE T-BUTT 10.4420 278 $ 811.00 442152720 SYNTHES PLATE TUBULAR 10.4420 278 $ 217.00 442152722 SYNTHES PLATE TUBULAR /C COLL 10.4420 278 $ 574.00 442152724 SYNTHES PLATE VISE SNG/393.45 10.4420 278 $ 322.00 442152726 SYNTHES PLATE Y-PLATE 1.5/446. 10.4420 278 $ 481.00 442152728 SYNTHES PLATE Y-PLATE 2.0/447. 10.4420 278 $ 524.00 442152730 SYNTHES PLATE ZYGOMA 4H/443.44 10.4420 278 $ 627.00 442152732 SYNTHES PLATE ZYGOMA 6H/443.46 10.4420 278 $ 458.00 442152734 SYNTHES ROD CONNECTOR 10.4420 278 $ 118.00 442152736 SYNTHES SCREW 10.4420 278 $ 188.00 442152738 SYNTHES SCREW 2.0MM 10.4420 278 $ 175.00 442152740 SYNTHES SCREW 2.4MM 10.4420 278 $ 237.00 442152742 SYNTHES SCREW CANC 4.0 10.4420 278 $ 64.00 442152744 SYNTHES SCREW CANC 6.5 10.4420 278 $ 121.00 442152746 SYNTHES SCREW CANN 10.4420 278 $ 742.00 442152748 SYNTHES SCREW CANN 7.0 / 7.3 10.4420 278 $ 951.00 442152750 SYNTHES SCREW CANN TITANIUM 10.4420 278 $ 664.00 442152752 SYNTHES SCREW CERVICAL 10.4420 278 $ 609.00 442152754 SYNTHES SCREW CONICAL CANN 10.4420 278 $ 879.00 442152756 SYNTHES SCREW CORT 1.5 10.4420 278 $ 68.00 442152758 SYNTHES SCREW CORT 2.0 10.4420 278 $ 84.00 442152760 SYNTHES SCREW CORT 2.4 SELF 10.4420 278 $ 263.00 442152762 SYNTHES SCREW CORT 2.7 10.4420 278 $ 69.00 442152764 SYNTHES SCREW CORT 3.5 10.4420 278 $ 45.00 442152766 SYNTHES SCREW CORTICALEX 10.4420 278 $ 179.00 442152768 SYNTHES SCREW CORTICALEX 10.4420 278 $ 246.00 442152770 SYNTHES SCREW CRANIAL 10.4420 278 $ 1,204.00 442152772 SYNTHES SCREW DHS LAG 10.4420 278 $ 1,136.00 442152774 SYNTHES SCREW DHS/DCS COMP 10.4420 278 $ 126.00 442152776 SYNTHES SCREW EMERGENCY 10.4420 278 $ 140.00 442152778 SYNTHES SCREW LOCKING 4.0 10.4420 278 $ 510.00 442152780 SYNTHES SCREW LOCKING 5.0 10.4420 278 $ 660.00 442152782 SYNTHES SCREW LOCK CANN 7.3 10.4420 278 $ 952.00 442152784 SYNTHES SCREW LOCKING SELF 10.4420 278 $ 437.00 442152786 SYNTHES SCREW MALLEOLAR 10.4420 278 $ 95.00 442152788 SYNTHES SCREW MINI 10.4420 278 $ 175.00 442152790 SYNTHES SCREW SELF SHANZ 10.4420 278 $ 551.00 442152792 SYNTHES SCREW SELF 4.5 10.4420 278 $ 121.00 442152794 SYNTHES SCREW SELF CORT 3.5 10.4420 278 $ 84.00 442152796 SYNTHES SCREW SHAFT 10.4420 278 $ 48.00 442152798 SYNTHES SCREW SHAFT 5.0 10.4420 278 $ 517.00 442152800 SYNTHES SCREW SHANZ 10.4420 278 $ 274.00 442152802 SYNTHES SPIRAL LOCK 10.4420 278 $ 1,598.00 442152804 SYNTHES TUBE 10.4420 279 $ 931.00 442152806 SYNTHES WASHER 10.4420 278 $ 103.00 442152808 SYNTHES WIRE 10.4420 278 $ 633.00 442152810 SYNTHES CLAMP/393.464 10.4420 279 $ 1,940.00 442152812 SYTNEHS PLATE L-4.0/420.54 10.4420 278 $ 412.00 442152814 SYTNEHS PLATE MESH/420.00 10.4420 278 $ 2,175.00 442152816 SYNTHES PLATE ZYGOMA6H/343.46 10.4420 278 $ 481.00 442152818 SYNTHES PLATE MED WALL/420.44 10.4420 278 $ 1,969.00 442152820 TAC WAND 10.4420 272 $ 1,447.00 442152822 TIMESH PLATE 10.4420 278 $ 448.00 442152824 TIMESH SCREW 10.4420 278 $ 131.00 442152826 TISSUE MEND 10.4420 278 $ 6,015.00 442152828 VALVE AORTIC EXPANDED 10.4420 278 $ 11,570.00 442152830 VALVE AORTIC MAGNA 10.4420 278 $ 13,884.00 442152832 VALVE CARP/ED AORTIC 10.4420 278 $ 12,084.00 442152834 VALVE CARP/ED MITRAL 10.4420 278 $ 12,084.00 442152836 VALVE FREE STYLE 10.4420 278 $ 15,170.00 442152838 VALVE MITRAL EDWARDS 10.4420 278 $ 13,160.00 442152840 VALVE MITRAL ST JUDE 10.4420 278 $ 10,798.00 442152842 VALVE MOSAIC 10.4420 278 $ 15,170.00 442152844 VALVE REGENT 10.4420 278 $ 11,698.00 442152846 VALVE SHUNT HAKIM 10.4420 278 $ 1,867.00 442152848 VAPOR TIP/225301 10.4420 272 $ 595.00 442152850 ZIMMER PLATE DISTAL 10.4420 278 $ 1,967.00 442152852 ZIMMER ASSEMBLIES/2232-01-13 10.4420 278 $ 1,991.00 442152854 ZIMMER ASSEMBLIES/2232-01-18 10.4420 278 $ 1,163.00 442152856 ZIMMER ASSEMBLIES/2232-01-28 10.4420 278 $ 1,351.00 442152858 ZIMMER ASSEMBLIES/2232-02-18 10.4420 278 $ 1,991.00 442152860 ZIMMER ASSEMBLIES/2232-02-28 10.4420 278 $ 1,374.00 442152862 ZIMMER AUTO TRANSFUSION SET 10.4420 279 $ 8,905.00 442152866 ZIMMER BUTTON 5.0/2232-01-28 10.4420 278 $ 234.00 442152868 ZIMMER CABLE /C GRIP/2232-02-0 10.4420 278 $ 4,978.00 442152870 ZIMMER CEMENT BONE KIT/1102-13 10.4420 278 $ 440.00 442152872 ZIMMER CEMENT BONE/1101-08 10.4420 278 $ 706.00 442152874 ZIMMER CEMENT REMOVAL KIT 10.4420 278 $ 3,095.00 442152876 ZIMMER CEMENT RESTRICTOR 10.4420 278 $ 925.00 442152878 ZIMMER CLAMP 10.4420 279 $ 2,934.00 442152880 ZIMMER COLLAGRAFT STRIP/1103-0 10.4420 278 $ 932.00 442152882 ZIMMER COLLAGRAFT KIT LG/1103- 10.4420 278 $ 2,945.00 442152884 ZIMMER COLLAGRAFT KIT ST/1103- 10.4420 278 $ 1,113.00 442152886 ZIMMER END CAP 10.4420 278 $ 696.00 442152888 ZIMMER FIXATION STAPLE 10.4420 278 $ 111.00 442152890 ZIMMER GTR CABLE/2232-04-18 10.4420 278 $ 1,163.00 442152892 ZIMMER GTR CABLE/2232-05-18 10.4420 278 $ 824.00 442152894 ZIMMER GTR LONG/2232-02-01 10.4420 278 $ 3,002.00 442152896 ZIMMER GTR SHORT/2232-02-02 10.4420 278 $ 2,093.00 442152898 ZIMMER HARRINGTON COMPONENT 10.4420 278 $ 939.00 442152900 ZIMMER HOOK 10.4420 278 $ 1,350.00 442152902 ZIMMER K-WIRE 10.4420 278 $ 265.00 442152904 ZIMMER NAIL CAP 10.4420 278 $ 458.00 442152906 ZIMMER NAIL FEMORAL 10.4420 278 $ 2,737.00 442152910 ZIMMER NAIL TIBIAL 10.4420 278 $ 3,151.00 442152912 ZIMMER NUT 10.4420 278 $ 183.00 442152914 ZIMMER PALM PUMP 10.4420 279 $ 2,096.00 442152916 ZIMMER PLATE 4915 10.4420 278 $ 476.00 442152918 ZIMMER PLATE 4920 10.4420 278 $ 440.00 442152920 ZIMMER PLATE 4927 10.4420 278 $ 425.00 442152922 ZIMMER PLATE 4935 10.4420 278 $ 778.00 442152924 ZIMMER PLATE 4945 10.4420 278 $ 870.00 442152926 ZIMMER PLATE 6H/2232-03-01 10.4420 278 $ 2,194.00 442152928 ZIMMER PLATE 8H/2232-03-02 10.4420 278 $ 2,123.00 442152930 ZIMMER PLATE10H/2232-03-03 10.4420 278 $ 2,596.00 442152932 ZIMMER PLATE BRIDGE 10.4420 278 $ 893.00 442152934 ZIMMER PLATE BUTT 10.4420 278 $ 2,088.00 442152936 ZIMMER PLATE CABLE/2232-03-18 10.4420 278 $ 815.00 442152938 ZIMMER PLATE COMPRESSION 10.4420 278 $ 1,060.00 442152940 ZIMMER PLATE DISTAL 10.4420 278 $ 2,134.00 442152942 ZIMMER PLATE ECT 10.4420 278 $ 334.00 442152944 ZIMMER PLATE ECT COND BUTT 10.4420 278 $ 1,663.00 442152946 ZIMMER PLATE FIBULAR 10.4420 278 $ 1,657.00 442152948 ZIMMER PLATE MINI 10.4420 278 $ 316.00 442152950 ZIMMER PLATE RECON 10.4420 278 $ 1,172.00 442152952 ZIMMER PLATE SUPRACONDYLAR 10.4420 278 $ 1,942.00 442152954 ZIMMER PLATE TIBIAL PLATEAU 10.4420 278 $ 2,012.00 442152956 ZIMMER RECON WASHER 10.4420 278 $ 114.00 442152958 ZIMMER SCREW 10.4420 278 $ 152.00 442152960 ZIMMER SCREW 6250/7250 10.4420 278 $ 435.00 442152962 ZIMMER SCREW CANCELLOUS 10.4420 278 $ 91.00 442152966 ZIMMER SCREW CANCELLOUS 6.5 10.4420 278 $ 366.00 442152968 ZIMMER SCREW CANNULATED 10.4420 278 $ 471.00 442152970 ZIMMER SCREW CANNULATED 7.0 10.4420 278 $ 587.00 442152972 ZIMMER SCREW COMPRESSION 10.4420 278 $ 134.00 442152974 ZIMMER SCREW CORTICAL 10.4420 278 $ 428.00 442152976 ZIMMER SCREW CORTICALICAL 10.4420 278 $ 50.00 442152978 ZIMMER SCREW HERBERT WHIPPLE 10.4420 278 $ 1,382.00 442152980 ZIMMER SCREW LAG 10.4420 278 $ 717.00 442152982 ZIMMER SCREW MALLEOLAR 10.4420 278 $ 83.00 442152984 ZIMMER SCREW PERIARTICULAR 10.4420 278 $ 96.00 442152986 ZIMMER SCREW RECON 10.4420 278 $ 742.00 442152988 ZIMMER WASHER 10.4420 278 $ 64.00 442152990 ZIMMER WIRE 10.4420 278 $ 219.00 442153000 KNEE CEMENTED 10.4420 278 $ 8,476.00 442153001 KNEE CEMENTED-POSTERIOR STABIL 10.4420 278 $ 10,218.00 442153002 KNEE FLEX 10.4420 278 $ 10,105.00 442153003 KNEE HIGH FLEX 10.4420 278 $ 10,575.00 442153004 HIP CEMENTED 10.4420 278 $ 10,340.00 442153005 HIP METAL / METAL 10.4420 278 $ 14,916.00 442153006 HIP CERAMIC / CERAMIC 10.4420 278 $ 14,916.00 442153007 HIP PRESS FIT 10.4420 278 $ 13,513.00 442153008 SHOULDER HEMI 10.4420 278 $ 8,515.00 442153009 SHOULDER TOTAL 10.4420 278 $ 10,105.00 442153010 HIP UNIPOLAR 10.4420 278 $ 2,751.00 442153011 HIP UNIPOLAR W/FRACTURE STEM 10.4420 278 $ 3,275.00 442153012 HIP BIPOLAR 10.4420 278 $ 4,192.00 442153014 HIP BIPOLAR W/FRACTURE STEM 10.4420 278 $ 5,502.00 442153016 KNEE UNIPOLAR 10.4420 278 $ 7,860.00 442153030 HASSON BLUNTPOINT 10.4420 272 $ 294.00 442153032 BONE FEMORAL CORTICAL STRUT 10.4420 278 $ 3,131.00 442153034 CORNERSTON L-ASR FREE 10.4420 278 $ 2,823.00 442153036 DRAIN JP CARDIO 19FR 10.4420 279 $ 87.00 442153038 OSTEOMED VISIDISK 10.4420 278 $ 507.00 442153040 GRAFT TIBIALIS TENDON ANTERIOR 10.4420 278 $ 3,745.00 442153042 KNIFE BAYONET 10.4420 272 $ 1,255.00 442153044 MEDI STEM VERIG SMART CARD 10.4420 272 $ 7,208.00 442153046 MESH KUGEL CIRCLE COMPOSIX 10.4420 278 $ 1,943.00 442153048 MESH OSTEOFORM 40X40 10.4420 278 $ 2,736.00 442153050 MESH OSTEOFORM 90X90 10.4420 278 $ 3,568.00 442153052 MESH OSTEOFORM 165X95 10.4420 278 $ 5,080.00 442153054 OSTEOMED MESH PLATE 111X119MM 10.4420 278 $ 2,715.00 442153056 OSTEOMED MESH PLATE 74X50MM 10.4420 278 $ 2,164.00 442153058 DANEK METRX TUBE 7MM 10.4420 278 $ 1,168.00 442153060 OSTEOMED PLATE 2X4/218-0060 10.4420 278 $ 762.00 442153062 OSTEOMED PLATE 21X33/218-0048 10.4420 278 $ 1,036.00 442153064 OSTEOMED PLATE 25MM GAP/218-42 10.4420 278 $ 461.00 442153066 OSTEOMED PLATE 30X48/218-0050 10.4420 278 $ 1,160.00 442153068 OSTEOMED PLATE 25MM GAP/218-44 10.4420 278 $ 531.00 442153070 OSTEOMED PLATE 25MM GAP/218-46 10.4420 278 $ 623.00 442153072 OSTEOMED PLATE BUR HOLE/218-62 10.4420 278 $ 729.00 442153074 PRO OSTEON GRANULES 5CC/5RG05 10.4420 278 $ 992.00 442153076 G PROS STAPES WEHRS INCUS 10.4420 272 $ 1,523.00 442153078 REV CEMENT MIXING SYSTEM 10.4420 272 $ 415.00 442153080 RING ANNULOPLASTY 10.4420 272 $ 5,502.00 442153082 SYNTHES SLEEVE 10.4420 279 $ 1,097.00 442153085 FEMORAL CANNULA KIT 10.4420 279 $ 1,358.00 442153087 SPY GEAR KIT 10.4420 279 $ 1,672.00 442153089 TMR ABLATION 10.4420 279 $ 6,275.00 442153100 SHUNT RESERVOIR - CODMAN 10.4420 278 $ 1,575.00 442153102 DRAINAGE SYSTEM CATHETER 10.4420 279 $ 521.00 442153104 DURAFORM 4X4 10.4420 278 $ 2,552.00 442153106 DURAFORM 3X3 10.4420 278 $ 1,799.00 442153108 DURAFORM 1X3 10.4420 278 $ 1,112.00 442153110 SHUNT CATHETER 10.4420 278 $ 1,220.00 442153112 SHUNT CATHETER KIT 10.4420 278 $ 1,596.00 442153114 SHUNT HAKIM 10.4420 278 $ 3,516.00 442153116 SHUNT HAKIM VALVE/RES 10.4420 278 $ 7,921.00 442153118 REUTERBOBBIN 10.4420 278 $ 20.00 442153120 GOUDE T 10.4420 278 $ 14.00 442153122 MESH VETRALEX 10.4420 278 $ 1,827.00 442153123 MESH VENTRALEX SMALL 10.4420 278 $ 1,528.00 442153124 MESH COMPOSIX EX 6X8 10.4420 278 $ 2,363.00 442153125 HARMONIC SCALPEL TIP 10.4420 272 $ 527.00 442153126 MESH COMPOSIX EX 7X9 10.4420 278 $ 3,131.00 442153127 HEARTSTRING KIT/HSK-2043 10.4420 272 $ 1,881.00 442153128 MESH COMPOSIX EX 8X10 10.4420 278 $ 3,249.00 442153129 SLING PERIGEE 10.4420 278 $ 4,179.00 442153130 GRAFT SURGISIS HERNIA 13X1 10.4420 278 $ 2,646.00 442153132 GRAFT SURGISIS HERNIA 20X2 10.4420 278 $ 4,140.00 442153134 GRAFT SURGISIS HERNIA 13X2 10.4420 278 $ 2,908.00 442153136 STAPLER PROXIMATE 10.4420 278 $ 1,626.00 442153138 CEMENT BONE/C TOBRAMYCIN 10.4420 278 $ 1,689.00 442153140 CEMENT BONE 10.4420 278 $ 374.00 442153142 BONE FROZEN FEMUR PROX 10.4420 278 $ 7,263.00 442153144 BONE FROZEN FEMUR SHAFT 10.4420 278 $ 3,453.00 442153146 BONE FROZEN SEMI-TENDINOUS 10.4420 278 $ 2,756.00 442153148 BONE FROZEN TENDON 10.4420 278 $ 5,678.00 442153150 ETHICON EEA STAPLER 10.4420 278 $ 1,984.00 442153152 COMPOSIX SMALL OVAL 10.4420 278 $ 1,780.00 442153154 COMPOSIX LARGE OVAL 10.4420 278 $ 3,296.00 442153156 KUGEL OVAL 10.4420 278 $ 1,245.00 442153158 SLING GRAFT 10.4420 278 $ 2,520.00 442153160 DURAFORM 4X5CM 10.4420 278 $ 2,552.00 442153162 DURAFORM 1X3CM 10.4420 278 $ 912.00 442153164 DURAFORM 3X3CM 10.4420 278 $ 1,843.00 442153166 SURGIWRAP 10.4420 278 $ 836.00 442153168 NORIAN BONE VOID FILLER 3 CC 10.4420 278 $ 1,679.00 442153170 NORIAN DELIVERY SYRINGE 10.4420 272 $ 698.00 442153172 RADIESSE VOCAL CORD INJ 1ML 10.4420 279 $ 1,233.00 442153174 VAD TUBING 10.4420 272 $ 3,472.00 442153176 ESSURE 10.4420 278 $ 3,013.00 442153178 PROS WEHR SING-NOTCH 10.4420 278 $ 1,867.00 442153180 ENDO CLIP ETHICON 10.4420 278 $ 552.00 442153182 TROCAR,ENDO BLADELESS 10.4420 272 $ 273.00 442153184 TROCAR,ENDO OBTURATOR 10.4420 272 $ 213.00 442153186 SCISSORS,DISPOSABLE W/ MONO 10.4420 272 $ 307.00 442153190 LAP GIA REFILL 10.4420 278 $ 449.00 442153192 GRASPER 5MM W/RATCHET HANDLE 10.4420 272 $ 288.00 442153194 ENDOPATH LINEAR CUTTER 10.4420 278 $ 1,114.00 442153196 POUCH,ENDO RETRIEVAL 10.4420 272 $ 376.00 442153198 SHEARS,HARMONIC SCALPEL,HAND 10.4420 272 $ 1,580.00 442153200 LAP GIA STAPLE REFILL 10.4420 278 $ 1,363.00 442153202 ACUSEAL PATCH 10.4420 278 $ 836.00 442153204 REPLIFORM 10.4420 278 $ 1,969.00 442153206 TI-KNOT DEVICE 10.4420 278 $ 564.00 442153208 TI-KNOT RELOAD 10.4420 278 $ 125.00 442153210 OPUS CONNECTOR / OM8007 10.4420 278 $ 424.00 442153212 OPUS MAGNUM IMPLANT / OM 1500 10.4420 278 $ 1,128.00 442153214 OPUS SUTURE CARTRIDGE 10.4420 278 $ 470.00 442153216 BARDPORT IMPLANTED X-PORT 10.4420 278 $ 1,400.00 442153218 INFUSE BMP 10.4420 278 $ 11,985.00 442153219 INFUSE BMP SMALL 10.4420 278 $ 9,432.00 442153220 CORNERSTONE GRAFT 5X11X11 10.4420 278 $ 2,693.00 442153222 PALACOS G BONE CEMENT 10.4420 278 $ 1,150.00 442153224 PALACOS R BONE CEMENT 10.4420 278 $ 314.00 442153226 WITTMAN PATCH 10.4420 272 $ 3,773.00 442153228 ORBITO-ZYGO IMPLANT 10.4420 278 $ 1,588.00 442153230 SALUTE Q RING 10.4420 278 $ 1,359.00 442153232 BLOOD REINFUSION SYSTEM 10.4420 272 $ 565.00 442153234 OPTIWAVE 980 10.4420 279 $ 9,563.00 442153236 MENISCUS REPAIR NEEDL-LINVATEC 10.4420 272 $ 121.00 442153240 GORE RINGED GRAFT 10.4420 278 $ 1,632.00 442153242 GORE INTERGUARD KNITTED 6-10 10.4420 278 $ 1,430.00 442153244 GORE INTERGUARD KNITTED 12-24 10.4420 278 $ 1,858.00 442153246 GORE INTERGUARD 10.4420 278 $ 951.00 442153248 NORIAN BONE VOID FILLER 5 CC 10.4420 278 $ 3,183.00 442153250 NORIAN BONE VOID FILLER 10CC 10.4420 278 $ 6,314.00 442153252 GAP PLATE 25MM 10.4420 278 $ 397.00 442153254 GAP PLATE 35MM 10.4420 278 $ 460.00 442153256 GAP PLATE 45MM 10.4420 278 $ 543.00 442153258 SUB-TEMPORAL PLATE 21X33MM 10.4420 278 $ 1,045.00 442153260 SUB-TEMPORAL PLATE 30X48MM 10.4420 278 $ 1,104.00 442153262 QUAD PLATE 2X4 HOLE 10.4420 278 $ 669.00 442153264 BURR HOLE PLATE - X-LRG 10.4420 278 $ 819.00 442153266 MESH PLATE 74X50MM 10.4420 278 $ 1,954.00 442153268 MESH PLATE 111X119MM 10.4420 278 $ 2,488.00 442153270 OSTEOFORM MESH MALLEAB 40X40MM 10.4420 278 $ 2,249.00 442153272 OSTEOFORM MESH 40X40MM 10.4420 278 $ 2,520.00 442153274 OSTEOFORM MESH MALLEAB 90X90MM 10.4420 278 $ 2,620.00 442153276 OSTEOFORM MESH 90X90MM 10.4420 278 $ 3,144.00 442153278 OSTEOFORM MESH FORMED 165X95MM 10.4420 278 $ 5,049.00 442153280 APPLIED TROCAR 10.4420 279 $ 219.00 442153282 APPLIED NEEDLE 10.4420 279 $ 50.00 442153284 HASSON BALLOON BLUNT TIP 10.4420 279 $ 418.00 442153286 MAMMOSITE APPLICATOR 10.4420 278 $ 7,205.00 442153288 TROCAR STRUCTURAL 10.4420 279 $ 910.00 442153290 TROCAR DISSECTOR BALLOON 10.4420 279 $ 1,126.00 442153292 DANEK BREAKOFF SET SCREW 10.4420 278 $ 688.00 442153294 DANEK PREBENT ROD 10.4420 278 $ 1,146.00 442153296 DANEK ROD 10.4420 278 $ 1,544.00 442153298 DANEK CROSSLINK FIXED 10.4420 278 $ 3,022.00 442153300 DANEK MULTI AXIAL SCREW 10.4420 278 $ 2,762.00 442153302 DANEK CROSSLINK MULTI 10.4420 278 $ 3,487.00 442153304 GELPORT 10.4420 279 $ 2,002.00 442153306 TROCAR 10.4420 279 $ 130.00 442153308 SLEEVE 10.4420 279 $ 25.00 442153310 BIOGLUE 5ML 10.4420 272 $ 1,990.00 442153312 BIOGLUE 10ML 10.4420 272 $ 2,776.00 442153314 LIGASURE 10.4420 272 $ 1,695.00 442153316 END CAP - HOWMEDICA 10.4420 278 $ 604.00 442153318 MINI PLATE - STRYKER 10.4420 278 $ 298.00 442153320 CLAMP HOWMEDICA 10.4420 279 $ 2,782.00 442153322 EX-FIXATION KIT ZIMMER 10.4420 279 $ 2,653.00 442153324 PIN HOWMEDICA 10.4420 278 $ 426.00 442153326 POST HOWMEDICA 10.4420 279 $ 320.00 442153328 CLAMP HOWMEDICA 10.4420 279 $ 1,688.00 442153330 COUPLER HOWMEDICA 10.4420 279 $ 1,599.00 442153332 POLYESTER MESH 10.4420 278 $ 395.00 442153334 ARTHREX BIO SCREW 10.4420 278 $ 1,003.00 442153336 ARTHREX IMPLANT SUTURE 10.4420 278 $ 138.00 442153338 TROCAR - APPLIED 10.4420 279 $ 222.00 442153340 BONE FILLER ALPHA 2.5CC 10.4420 278 $ 1,332.00 442153342 BONE FILLER ALPHA 5CC 10.4420 278 $ 1,794.00 442153344 BONE FILLER ALPHA 10CC 10.4420 278 $ 2,862.00 442153346 SLING APOGEE 10.4420 278 $ 3,655.00 442153348 MESH PROLENE 10.4420 278 $ 708.00 442153350 BONE MATRIX GRAFT 10.4420 278 $ 3,087.00 442153352 STAPLER ENDO TA GUN 10.4420 278 $ 920.00 442153354 STAPLER ENDO TA INSERT 10.4420 278 $ 409.00 442153356 HOWMEDICA CABLE 10.4420 278 $ 1,438.00 442153358 GPS CONCENTRATE 10.4420 278 $ 1,463.00 442153360 GPS SPRAY KIT 10.4420 279 $ 355.00 442153362 TROCAR KIT 10.4420 279 $ 502.00 442153364 MESH PARIETEX 4 INCH 10.4420 278 $ 1,806.00 442153366 MESH PARIETEX 3 INCH 10.4420 278 $ 1,317.00 442153368 MESH PARIETEX 5 INCH 10.4420 278 $ 326.00 442153370 MESH - PARIETEX MESH 8 INCH 10.4420 278 $ 2,183.00 442153372 MESH - PARIETEX MESH 12 INCH 10.4420 278 $ 3,773.00 442153373 ABLATION FLEXVIEW FLEX 10 10.4420 279 $ 14,125.00 442153374 VASOVIEW 7 EVH 10.4420 279 $ 527.00 442153376 LIGASURE OPEN ELECTRODE GYN 10.4420 272 $ 897.00 442153378 SHUNT VALVE PRESS FIX 70MM 10.4420 278 $ 2,220.00 442153380 CANNULA RETROGRADE 10.4420 279 $ 398.65 442153382 ATLANTIS SELFDRILLING SCREW 10.4420 278 $ 1,377.00 442700034 EXTENDED RECOVERY 0-2 HRS 10.4427 710 $ 1,478.00 442700100 RECOVERY ROOM 0<1 HR 10.4427 710 $ 1,280.00 442700110 RECOVERY ROOM (MINUTES) 10.4427 710 $ 18.00 442700120 RECOVERY ROOM PHASE 2 (MIN) 10.4427 710 $ 10.00 442700130 RECOVERY ROOM CRITICAL 0<1 HR 10.4427 710 $ 2,556.00 442700140 RECOVERY CRITICAL (MINUTES) 10.4427 710 $ 28.00 442700150 RECOVERY ROOM CRIT PHASE 2-MIN 10.4427 710 $ 16.00 442700306 INFUSION SEQUENTIAL 1ST HOUR 10.4427 260 $ 158.00 442700307 INFUSION THERAPY 1ST HOUR 10.4427 260 $ 315.00 442700308 INFUSION HYDRATION 1ST HOUR 10.4427 260 $ 315.00 442700309 INFUSION THERAPY ADD'L HRS 10.4427 260 $ 190.00 442700310 INFUSION HYDRATION ADD'L HOUR 10.4427 260 $ 190.00 442707100 MINOR SURGERY I 10.4427 360 $ 614.00 442740100 RECOVERY ROOM 0-1 HRS 10.4427 710 $ 1,407.00 442740200 RECOVERY ROOM 1-2 HRS 10.4427 710 $ 2,262.00 442740400 RECOVERY ROOM 2-4 HRS 10.4427 710 $ 2,545.00 442790100 RECOVERY CRITICAL 0-1 HRS 10.4427 710 $ 2,812.00 442790200 RECOVERY CRITICAL 1-2 HRS 10.4427 710 $ 3,486.00 442790400 RECOVERY CRITICAL 2-4 HRS 10.4427 710 $ 3,951.00 442790782 IM/SQ INJECTION 10.4427 761 $ 99.00 442790784 IV INJECTION 10.4427 761 $ 99.00 442790785 IV INJECTION ADD'L SEQUENTIAL 10.4427 761 $ 99.00 442799710 DEFENSE AUDIT ADJUSTMENT 10.4427 360 $ - 445014001 OB SPINAL 10.4400 370 $ 332.00 445014003 OB EPIDURAL 10.4400 370 $ 332.00 445014100 OB ANESTHESIA (MINUTES) 10.4400 370 $ 9.00 445040001 SPINAL 10.4400 370 $ 466.00 445040002 REGIONAL NERVE BLOCK 10.4400 370 $ 326.00 445040003 LOCAL ANESTHETIC 10.4400 370 $ 251.00 445040005 MONITORED ANESTHESIA CARE (MAC 10.4400 370 $ 425.00 445040030 GENERAL ANESTHESIA (MINUTES) 10.4400 370 $ 18.00 445050015 CON'T GENERAL ANESTH (MINUTES) 10.4400 370 $ 8.00 447000001 MED/SURG SUPPLIES 10.4470 270 $ - 447000020 KIT COLOSTOMY/ILEO 2 1/4/2 3/4 10.4470 270 $ 491.00 447000022 KIT FECAL MGMT FLEXI-SEAL 10.4470 270 $ 607.00 447000027 ZEROFLOW GAUZE DRESSING STERIL 10.4470 272 $ 16.00 447000028 COVADERM 4X8 WOUND DRESSING ST 10.4470 272 $ 27.00 447000029 COVADERM 4X4 WOUND DRESSING ST 10.4470 272 $ 17.00 447000030 POUCH 2 3/4 DRAIN OSTOMY 10.4470 270 $ 34.00 447000031 COVADERM 6X8 WOUND DRESSING ST 10.4470 272 $ 51.00 447000032 POUCH 2 1/4 DRAIN OSTOMY 10.4470 270 $ 34.00 447000036 WAFER CONVEX CUT TO FIT 10.4470 270 $ 110.00 447000045 POUCH UROSTOMY 10.4470 270 $ 51.00 447000065 KIT IRRIG COLOSTOMY 10.4470 270 $ 326.00 447000085 ADHESIVE MED SPRAY 10.4470 270 $ 249.00 447000100 PASTE STOMAHESIVE 10.4470 270 $ 145.00 447000126 ADAPTER UROSTOMY DRAIN TUBE 10.4470 270 $ 40.00 447000130 BELT OSTOMY 10.4470 270 $ 108.00 447000135 CLAMP POUCH DRAINABLE 10.4470 270 $ 28.00 447000300 PACERMAKER 10.4470 270 $ - 447002001 SURGIPAD ABD 10.4470 270 $ 9.00 447002002 ADAPTIC GAUZE 10.4470 270 $ 17.00 447002003 BANDAGE X-SPAN 10.4470 270 $ 16.00 447002004 PACKING ADAPTIC 10.4470 270 $ 77.00 447002005 DRSG FLEXDERM 4X5 10.4470 270 $ 68.00 447002006 DRESSING FOAM ALLEVYN 10.4470 272 $ 141.00 447002007 DRESSING HEMOSTASIS 10.4470 272 $ 411.00 447002045 VAC THERAPY DRESSINGS 10.4470 270 $ 478.00 447002046 VAC THERAPY CANNISTER 10.4470 270 $ 423.00 447004341 CORSET PENDULOUS LG CAMP 21 10.4470 271 $ 466.00 447004342 CORSET PENDULOUS EX LG CAMP 21 10.4470 271 $ 466.00 447004343 CORSET REGULAR LG CAMP 21 10.4470 271 $ 406.00 447004344 CORSET REGULAR EX LG CAMP 21 10.4470 271 $ 406.00 447007009 CATH RECTAL 30FR/50-75CC 10.4470 270 $ 478.00 447010001 BED BIODYNE WITH SCALE 10.4470 270 $ 1,860.00 447010002 BED BIODYNE 10.4470 270 $ 1,703.00 447010003 PUMP PCA INFUSER SYSTEM 10.4470 270 $ - 447010004 BED TRIADYNE 10.4470 270 $ 2,238.00 447010006 ISOLATION CART 10.4470 270 $ - 447010007 BED BARIKARE 10.4470 270 $ 1,587.00 447010008 BP MONITOR 10.4470 270 $ - 447010009 ICP MONITOR CAMINO 10.4470 270 $ - 447010011 PUMP INTRAVENOUS INFUSION 10.4470 270 $ - 447010012 PUMP HEAT THERAPY (K-PAD) 10.4470 270 $ - 447010013 BARIAIR BED 10.4470 270 $ 1,539.00 447010014 BED BURKE 10.4470 270 $ 1,011.00 447010015 HYPO-HYPER THERMIA MACHINE DAI 10.4470 270 $ - 447010017 PUMP BREAST 10.4470 270 $ - 447010018 JACUZZI SMALL 10.4470 270 $ - 447010020 TONGS INSERTION 10.4470 270 $ 599.00 447010023 GW TONG MRI INSERTION 10.4470 270 $ 5,769.00 447010024 BED ROTO REST 10.4470 270 $ 2,011.00 447010025 HAIR CLIPPERS 10.4470 270 $ - 447010027 DUAL TEMP MACHINE (COLD THERAP 10.4470 270 $ - 447010028 WALKER (IN HOSPITAL USE ONLY) 10.4470 270 $ - 447010032 PUMP HEAT THERAPY SETUP 10.4470 270 $ - 447010033 WANDERGUARD SIGNAL DEVICE DAIL 10.4470 271 $ - 447010037 BED STRYKER FRAME 10.4470 270 $ 145.00 447010039 PUMP FEEDING 10.4470 270 $ - 447010041 SEQUENTIAL COMPRESSION DEVICE 10.4470 270 $ - 447010042 SLEEVE COMPRESSION LG THIGH 10.4470 271 $ 586.00 447010043 MATTRESS FIRST STEP 10.4470 270 $ 420.00 447010044 BED KINAIR III 10.4470 270 $ 833.00 447010045 BED DYNA PLUS 10.4470 270 $ 571.00 447010046 BED KINAIR III WITH SCALE 10.4470 270 $ 929.00 447010047 SLEEVE COMPRESSION LG. CALF 10.4470 271 $ 396.00 447010049 EMG MACHINE 10.4470 270 $ - 447010050 MATTRESS Q2 10.4470 270 $ 854.00 447010051 SLEEVE COMPRESSION THIGH OR FO 10.4470 271 $ 467.00 447010052 OVERLAY, LOW AIR LOSS DISP 10.4470 271 $ 398.00 447010070 VACUUM ASSISTED CLOSURE 10.4470 270 $ 794.00 447020001 SPECIAL ORTHO BRACE-SUPP 10.4470 270 $ - 447020002 ASPEN COLLAR 10.4470 271 $ 827.00 447020003 SCOTCH CAST COLORED 10.4470 271 $ - 447020004 CERVICAL THORACIC ORTHOSIS 10.4470 271 $ 2,883.00 447020010 ABDUCTION SPLINT PEHR 10.4470 270 $ 1,250.00 447020015 ABDUCTION PILLOW 10.4470 270 $ 820.00 447020052 ABDUCTION SUPPORT SHOULDER 10.4470 270 $ 491.00 447020055 PAD FOR DUAL TEMP MACHINE 10.4470 270 $ 494.00 447020067 BRACE KIT HUMERAL FRACTURE 10.4470 270 $ 794.00 447020077 ORTHOSIS T WALKER 10.4470 271 $ 791.00 447020078 BUNNY BOOT COMPLETE 10.4470 270 $ 412.00 447020079 BRACE KNEE 10.4470 270 $ 1,246.00 447020080 CRYOCUFF KNEE LG, MED. 10.4470 270 $ 947.00 447020081 BRACE BOOT SHORT TERM SM/MD/LG 10.4470 270 $ 507.00 447020135 HALO SKULL PIN X-LONG 10.4470 272 $ 869.00 447020136 HALO CROWN 10.4470 270 $ 5,341.00 447020137 HALO VEST CLASSIC II 10.4470 270 $ 7,070.00 447020138 HALO REPLACEMENT LINER 10.4470 270 $ 574.00 447020158 SPLINT POST TIB-FIB 10.4470 270 $ 437.00 447020350 SET QUICK PRESSURE MONITOR 10.4470 270 $ 604.00 447030049 KIT INTRAOSSEOUS 10.4470 270 $ 695.00 447030052 TUBE TRACH SCT SHILEY 10.4470 270 $ 394.00 447030067 TRACH SPEAKING TUBE 10.4470 270 $ 385.00 447030073 TUBE BLAKEMORE 10.4470 270 $ 1,893.00 447030083 TRAY PERCUTANEOUS TRACH SET 10.4470 272 $ 2,088.00 447030084 TUBE JEJUNOSTOMY 10.4470 270 $ 2,281.00 447030104 NEEDLE JELCO 10.4470 270 $ 34.00 447030122 I.V. TRANSPARENT DRESSING 10.4470 270 $ - 447030164 CATH PERITONEAL CURLED 10.4470 270 $ 850.00 447030169 TUBE LARYNGECTOMY 10.4470 270 $ 3,479.00 447030171 TUBE TRACH METAL 10.4470 270 $ 794.00 447030172 CATH GARD 10.4470 270 $ 148.00 447030173 TUBE STAY-PUT NASOJEJUNAL 10.4470 272 $ 1,508.00 447030176 TUBE TRACH PORTEX 10.4470 270 $ 703.00 447030180 I.V. EXTENSION TUBING 10.4470 270 $ 16.00 447030199 I.V. START PACK DISP 10.4470 270 $ 23.00 447030213 TUBE MIC GASTROSTOMY 10.4470 270 $ 509.00 447030216 KIT VENTRICULAR CATH ASS 10.4470 270 $ 947.00 447030222 CATH EPISTAT KIT 10.4470 270 $ 703.00 447030223 TUBE MINNESOTA 10.4470 270 $ 2,341.00 447030243 I.V. T-ADAPTER WITH EXTENSION 10.4470 270 $ 49.00 447030249 FEMOSTOP 10.4470 272 $ 831.00 447030264 KIT CURL 10.4470 270 $ 1,296.00 447030266 TUBE TRACH SHILEY 10.4470 270 $ 703.00 447030270 AMBU-BAG DISP 10.4470 270 $ - 447030278 EXTERNAL DRAINAGE SET EDS 10.4470 270 $ 895.00 447030280 GROSHONG 5FR PICC DUAL 10.4470 270 $ 1,541.00 447030283 PORT SINGLE PLASTIC MRI 10.4470 278 $ 2,614.00 447030285 TRAY CHEST DRAIN SINGLE 10.4470 270 $ 720.00 447030286 TRAY REPLC BAG ATS 10.4470 270 $ 794.00 447030287 TRAY CHEST DRAIN INF 10.4470 270 $ 922.00 447030289 LEVEL-I DISP SET 10.4470 270 $ 820.00 447030294 BAG RENWAL ANTICOAGULANT 10.4470 272 $ 62.00 447030305 PAD PRE FORM DISP 10.4470 270 $ 720.00 447030309 TUBE ENDO TRACH EMT 10.4470 270 $ - 447030310 KIT REPAIR GROSHONG 10.4470 270 $ 922.00 447030313 KIT POST CRANI PRESSURE 10.4470 270 $ 3,233.00 447030314 KIT INTRACRANIAL PRESSURE 10.4470 270 $ 3,606.00 447030315 KIT VENTRICULAR BOLT 10.4470 270 $ 3,479.00 447030318 DRAINAGE KIT PLEURIX 10.4470 272 $ 424.00 447030326 KIT PERICARDIOCENTESIS 10.4470 270 $ 1,605.00 447030331 CATH HICKMAN TRIPLE 13.5F 10.4470 270 $ 2,320.00 447030333 TRAY VEN A CATH 2FR 10.4470 270 $ 767.00 447030334 GROSHONG 4FR PICC SINGLE 10.4470 270 $ 1,047.00 447030337 PACK TUBAL 10.4470 270 $ 578.00 447030338 GROSHONG 3FR PICC SINGLE 10.4470 270 $ 1,201.00 447030339 MAC 2 CENTRAL LINE AK-11142 10.4470 270 $ 824.00 447030342 TUBE TRACH JACKSON X-LONG 10.4470 270 $ 1,346.00 447030343 KIT HICKMAN REPAIR/ADAPTER 10.4470 270 $ 1,144.00 447030344 CATH HICKMAN DUAL 9FR 10.4470 270 $ 1,494.00 447030348 BOX SWAN-GANZ 10.4470 270 $ 1,588.00 447030349 BOX ARTERIAL LINE 10.4470 270 $ 869.00 447030350 BOX PACEMAKER 10.4470 270 $ 1,346.00 447030353 BOX BLAKEMORE 10.4470 270 $ 4,476.00 447030355 BOX CHEST TUBE INSERTION 10.4470 272 $ 1,392.00 447030356 BOX BONE MARROW 10.4470 270 $ 947.00 447030357 BOX GROSHONG CENTRAL LINE 10.4470 270 $ 456.00 447030363 BOX LIVER BIOPSY 10.4470 270 $ 352.00 447030365 BOX NEONATAL CHEST TUBE 10.4470 270 $ 850.00 447030368 BOX PERCUTANEOUS TRACHEOSTOMY 10.4470 270 $ 2,612.00 447030369 BOX STEINMAN INSERTION 10.4470 270 $ 491.00 447030370 BOX ICP/TWIST DRILL 10.4470 270 $ 2,189.00 447030371 BOX OPEN HEART PO 10.4470 270 $ 1,643.00 447030374 BOX THORACOTOMY EMERGENCY 10.4470 270 $ 1,588.00 447030375 BOX LONG ARM CATHETER 10.4470 272 $ 217.00 447030381 BOLT ADAPTER CAMINO 10.4470 270 $ 541.00 447030388 CO2 DETECTOR 10.4470 270 $ 168.00 447030390 GROSHONG REPAIR KIT 10.4470 270 $ 996.00 447030397 BOX PEDI SWAN/GANZ/ARTLINE 10.4470 270 $ 1,095.00 447030399 PORT DUAL PLASTIC MRI 10.4470 270 $ 5,988.00 447030401 CATHETER GROSHONG X-LONG 5 FR 10.4470 272 $ 1,050.00 447030601 CATH S-G VIP 93A-831 H 10.4470 270 $ 604.00 447033001 CATHETER SCOOP I-II 10.4470 270 $ 1,296.00 447033006 SCOOP OP PROCEDURE TRAY 10.4470 272 $ 1,988.00 447035932 BOWEL STIMULATOR 10.4470 271 $ 499.00 447035964 BALL SPLINT 10.4470 271 $ 424.00 447036633 SPLINT HAND SMALL,MD,LG,LF,RT 10.4470 271 $ 501.00 447036634 SPLINT HAND UNIVERSAL LF,RT 10.4470 271 $ 436.00 447036650 SPLINT ANTI SPASTIC ALL SIZES 10.4470 271 $ 437.00 447046442 LUMBAR DRAINAGE KIT / 46442 10.4470 272 $ 983.00 447050003 CATH S-G 93-116-4FR 10.4470 270 $ 695.00 447050007 CATH PACING ANTICUBITAL 10.4470 270 $ 1,392.00 447050008 CATH S-G 93-110-5FR 10.4470 270 $ 618.00 447050010 CATH S-G THERMODILUTION 10.4470 270 $ 574.00 447050011 CATH S-G 93-132-5FR PED 10.4470 270 $ 2,044.00 447050018 CATH S-G 93-111-7FR 10.4470 270 $ 467.00 447050020 ELECTRODE PACING BARD 10.4470 270 $ 820.00 447050021 GROSHONG SINGLE CV CATH 10.4470 270 $ 3,479.00 447050022 GROSHONG DUAL CV CATH 10.4470 270 $ 4,097.00 447050035 CATH PACING FEMORAL 10.4470 270 $ 947.00 447050068 KIT IABP DATA 9.5FR 10.4470 270 $ 342.00 447050069 INTRODUCER PERCOR 10.4470 270 $ 555.00 447050084 KIT IABP INSERTION 10.4470 270 $ 1,192.00 447050099 R2 PAD SET PEDIATRI DEFIB PADS 10.4470 271 $ 196.00 447050102 PERICARDIAL DRAIN 10.4470 270 $ 745.00 447058749 VAIL BED (REHAB) 10.4470 270 $ 108.00 447060179 CATH SUPRAPUBIC STAMEY 10.4470 279 $ 423.00 447060215 OXIMETRIX CATHETER 10.4470 270 $ 2,137.00 447060252 TUBE THOW G-JEJUNOSTOMY 10.4470 270 $ 2,044.00 447060254 TUBE THOW GASTROINTESTINAL 10.4470 270 $ 1,246.00 447060501 SURG SUPPLIES-1 10.4470 270 $ 2,238.00 447060649 TUBE MOSS 18FR 10.4470 270 $ 2,437.00 447070009 CATH RECTAL 30FR/50-75CC 10.4470 270 $ 478.00 447070021 FILIFORMS STERILE 10.4470 270 $ 520.00 447070100 KIT SENSOR INJECTATE LIDCO 10.4470 272 $ 561.00 447070110 SENSOR LITHIUM LIDCO 10.4470 272 $ 446.00 447070120 LUMBAR DRAINAGE KIT/46442 10.4470 272 $ 1,368.00 447080102 CATH HICKMAN 7FR DUAL 10.4470 270 $ 2,281.00 447080108 BOX INTUBATION 10.4470 270 $ 507.00 447080114 TRAY CHEST DRAIN/ATS DBL 10.4470 270 $ 996.00 447080121 TRAY CVP ANTISEPIC 10.4470 270 $ 869.00 447080122 TRAY CVP 5FX2 ARROW CATH 10.4470 270 $ 820.00 447080432 TRAY ARROW DISP 10.4470 270 $ 443.00 447080434 TRAY GASTRIC LAVAGE 10.4470 270 $ 625.00 447080458 TRAY VCP ARROW3 16GAX12 10.4470 272 $ 155.00 447080459 TRAY THORACENTESIS DISP 10.4470 270 $ 399.00 447080460 TRAY JAMASHIDI SOFT TISSUE 10.4470 270 $ 449.00 447080465 TRAY HEMODIALYSIS SUBCLAVIAN 10.4470 270 $ 533.00 447080466 TRAY HEMODIALYSIS FEMORAL 10.4470 270 $ 394.00 447080467 TRAY MAHURKAR SUBCLAVIAN 10.4470 270 $ 895.00 447080468 TRAY MAHURKAR FEMORAL 10.4470 270 $ 895.00 447080472 TRAY BONE MARROW DISP 10.4470 270 $ 535.00 447080473 TRAY MULTILUMEN 12FR 10.4470 270 $ 922.00 447080478 TRAY PERITONEAL LAVAGE DISP 10.4470 270 $ 409.00 447080480 TRAY PERMACATH 40CM DUAL 10.4470 270 $ 2,612.00 447087000 BRACE SOMI 10.4470 274 $ 1,366.00 447087001 BRACE JEWETT MED 10.4470 271 $ 1,034.00 447087002 BRACE JEWETT LG 10.4470 271 $ 1,034.00 447087003 BRACE CASH STANDARD 10.4470 271 $ 1,034.00 447087004 BRACE CASH LG 10.4470 274 $ 1,034.00 447087005 COLLAR MIAMI J STOUT 10.4470 271 $ 511.00 447087006 COLLAR MIAMI J SUPER SHORT 10.4470 274 $ 382.00 447087007 COLLAR MIAMI J MED 10.4470 274 $ 511.00 447087008 COLLAR MIAMI J STANDARD 10.4470 271 $ 511.00 447090002 CATH GUIDING 6.8FR COOK 10.4470 270 $ 947.00 447090003 CATH COOK 10.4470 270 $ 252.00 447090004 DRAPE DISP 3/4 SHEET 10.4470 270 $ 65.00 447090006 NEEDLE BIOPSY ACHIEVE 20GA X 6 10.4470 271 $ 458.00 447090007 DILATOR VESSEL 10.4470 270 $ 118.00 447090008 SYRINGE CLEARVU DISP 10.4470 270 $ 65.00 447090011 TUBE SYRINGE FILL 10.4470 270 $ 9.00 447090012 NEEDLE BIOPSY CHIBA 10.4470 270 $ 234.00 447090013 KIT BIOPSY GUIDANCE 10.4470 270 $ 202.00 447090014 COILS TORNADO 10.4470 270 $ 895.00 447090016 OCCLUDING SPRING EMBOLUS 10.4470 270 $ 290.00 447090017 CATH BALLOON OCCLUSION 10.4470 270 $ 494.00 447090018 CATH BALLOON DILATATION 10.4470 270 $ 2,612.00 447090019 SNARES TRACKER 10.4470 270 $ 3,479.00 447090020 SET PNEUMOTHORAX 10.4470 270 $ 968.00 447090021 KIT NEEDLE GUIDE ACUSON 10.4470 270 $ 299.00 447090022 NEEDLE BIOPSY 20GA U/S 10.4470 270 $ 308.00 447090024 VAN SONNENBERG SUMP KIT 10.4470 270 $ 1,346.00 447090025 NEEDLE HAWKINS-AKIN 10.4470 270 $ 374.00 447090027 TUBING H-P CORDIS 10.4470 270 $ 282.00 447090028 BARIUM ENEMA PREP KIT 10.4470 270 $ 43.00 447090030 COPE CATHETERS 10.4470 270 $ 794.00 447090031 CATH INFUSION 10.4470 270 $ 2,612.00 447090032 COOK MICRO PUNCTURE SET 10.4470 270 $ 362.00 447090033 TORGUE DEVICE 10.4470 270 $ 135.00 447090034 STIFFENER FOR TIPS 10.4470 270 $ 251.00 447090035 TUBE DUODENOGRAPHY 10.4470 270 $ 895.00 447090036 COOK SHEATH VCF 10.4470 270 $ 333.00 447090037 NEEDLE LEE BIOPSY 10.4470 270 $ 165.00 447090038 KIT CORE BIOPSY SYSTEM 10.4470 270 $ 895.00 447090039 CATH GUIDEZILLA 10.4470 270 $ 996.00 447090041 NEEDLE WESTCOTT BIOPSY 10.4470 270 $ 161.00 447090043 CORE WIRE KATZEN 10.4470 270 $ 362.00 447090046 MEDITECH BILIARY CATH 10.4470 270 $ 869.00 447090049 ADAPTER Y GATEWAY 10.4470 270 $ 362.00 447090050 TUBE CRIMPING 10.4470 270 $ 87.00 447090051 GUIDEWIRE TIP DEFLECTOR 10.4470 270 $ 507.00 447090052 SNARES 10M/15M 10.4470 270 $ 2,485.00 447090054 TUBE GASTROENTERIC 10.4470 270 $ 1,541.00 447090055 STENT VASCULAR/BALLOON 10.4470 278 $ 9,407.00 447090057 MOLNAR 10.4470 270 $ 120.00 447090058 PERCUFIX CATH CUFF KIT 10.4470 270 $ 213.00 447090059 STENT VASCULAR 10.4470 278 $ 7,537.00 447090060 NEEDLE OSTY-CORE BONE BIOPSY 10.4470 272 $ 467.00 447090061 ENEMA RING 10.4470 270 $ 85.00 447090062 NEEDLE MAX-CORE 10CM 10.4470 272 $ 274.00 447090064 RENAL DILATOR SET 10.4470 270 $ 2,238.00 447090065 DRAPE FLUORO 10.4470 270 $ 37.00 447090066 DILATATION NEPHROSTOMY SET 10.4470 270 $ 2,189.00 447090068 KIT SAFETY WIRE GUIDE 10.4470 270 $ 399.00 447090069 HEMOSTASIS VALVE 10.4470 270 $ 132.00 447090070 BILIARY BASKET DISP 10.4470 270 $ 2,387.00 447090073 INDEFLATOR WITH GUAGE 10.4470 270 $ 850.00 447090074 SET RETRIEVAL TRAKER 10.4470 270 $ 4,476.00 447090075 NEEDLE PENCIL POINT DISP 10.4470 270 $ 183.00 447090076 CATH GLIDEX APDL 10.4470 270 $ 4,097.00 447090077 NEEDLE TROCAR 10.4470 270 $ 385.00 447090078 ACCUSTICK INTRODUCER SYSTEM 10.4470 270 $ 922.00 447090081 CATH GLIDEX APD 10.4470 270 $ 3,606.00 447090083 GUIDEWIRE TAD 10.4470 270 $ 996.00 447090084 NEEDLE SIALOGRAPHY 10.4470 270 $ 257.00 447090085 GUIDEWIRE SUPERSTIFF 10.4470 270 $ 947.00 447090086 CATH MEW INFUSION 10.4470 270 $ 850.00 447090088 WIRE GLIDE 10.4470 270 $ 587.00 447090089 TRACKER WIRE 10.4470 270 $ 1,745.00 447090090 MONOPTY BIOPSY INST DISP 10.4470 270 $ 467.00 447090092 NEEDLE ENTRY ANGIOGRAPHIC 10.4470 270 $ 108.00 447090093 SYRINGE CT TRI-PAK 10.4470 270 $ 143.00 447090095 CATH TRACHER 24 10.4470 270 $ 2,990.00 447090096 TRACKER COILS 2MM-4MM 10.4470 270 $ 968.00 447090098 KATZEN WIRE 10.4470 270 $ 2,238.00 447090099 SET SUTURE ANCHOR 10.4470 270 $ 604.00 447090100 BILIARY BASKET 6 WIRES 10.4470 270 $ 2,437.00 447090101 CATH ATHRECTOMY 10.4470 270 $ 6,205.00 447090102 MOTOR DRIVE PA4100 10.4470 270 $ 1,296.00 447090103 TRACKER COIL PUSHER-16 10.4470 279 $ 1,192.00 447090105 INTRODUCER LONG 10.4470 270 $ 527.00 447090106 STENT URETERAL 10.4470 278 $ 1,494.00 447090107 STENT BILIARY WALL 10.4470 278 $ 17,529.00 447090108 BIODYNE PVA-300-500 10.4470 270 $ 1,296.00 447090111 NEPHROSTOMY TRACT DILATOR 10.4470 270 $ 1,985.00 447090113 GUIDEWIRE KIT ACS 10.4470 270 $ 503.00 447090115 NEEDLE SMART 10.4470 270 $ 947.00 447090116 ASAP 18G BIOPSY SYSTEM 10.4470 270 $ 745.00 447090117 NAVIGUIDE WIRE 10.4470 270 $ 62.00 447090118 SET INTRAVASCULAR RETRIEVE 10.4470 270 $ 7,357.00 447090119 BASKET BILIARY 9MM/15MM/20MM 10.4470 270 $ 2,437.00 447090120 SHEATH FLEXIBLE 10.4470 270 $ 618.00 447090121 SET TRANSJUGULAR ACCESS TIPS 10.4470 270 $ 3,108.00 447090122 CATH NEPHROSTOMY FLEXIMA 10.4470 270 $ 922.00 447090123 HEMOCATH 10.4470 270 $ 2,137.00 447090124 SET GASTROSTOMY 10.4470 270 $ 1,443.00 447090127 DIAMOND BALL 120 10.4470 270 $ 2,737.00 447090128 CATH GUIDING 9FR 10.4470 270 $ 895.00 447090129 NEEDLE CHIBA BIOPSY 10.4470 270 $ 234.00 447090130 STENT BILIARY WALL 10.4470 278 $ 15,868.00 447090131 STENT BILIARY WALL 8X20 10.4470 278 $ 11,396.00 447090132 STENT VASCULAR ON BALLOON 10.4470 278 $ 7,357.00 447090133 STENT 3CM 4MM-9MM 10.4470 278 $ 7,646.00 447090134 STENT PREMOUNTED 10MM 10.4470 278 $ 9,089.00 447090135 STENT 3CM 8MM-12MM 10.4470 278 $ 6,781.00 447090136 STENT 30MM 8MM-12MM 10.4470 278 $ 8,081.00 447090137 CATH CHEST DRAIN W/TIP 10.4470 270 $ 1,144.00 447090138 CONTAMINATION SHEATH 110 10.4470 270 $ 947.00 447090139 PREDATOR BALLOON 3.0MM 10.4470 270 $ 3,363.00 447090140 GUIDEWIRE TORQUE 10.4470 270 $ 745.00 447090141 NEEDLE TRU-GUIDE 10.4470 270 $ 213.00 447090142 CATH INFUSION 5FR 10.4470 270 $ 947.00 447090143 STENT WALL 160CM 10.4470 278 $ 10,099.00 447090144 STABILIZER .14 WIRE 10.4470 270 $ 1,095.00 447091070 ADAPTER ETCO2 10.4470 270 $ 194.00 447091071 ADAPTER CO2 LOWDEAD SPACE 10.4470 270 $ 249.00 447097140 CPM MACHINE DAILY-USE 10.4470 271 $ - 447099075 CPM MACHINE SET-UP 10.4470 271 $ - 447099270 DEFENSE AUDIT ADJUSTMENTS 10.4470 270 $ - 447099999 EMPLOYEE HEALTH PROGRAM SUPP 10.4470 270 $ - 450000001 MT LAB ITEMS 10.4500 300 $ - 450000500 CBC WITH AUTO DIFFERENTIAL 10.4500 305 $ 135.30 450000503 CBC COMPLETE W AUTO PLT CNT 10.4500 305 $ 135.30 450000505 MANUAL DIFFERENTIAL 10.4500 305 $ 6.60 450000510 HEMOGRAM 10.4500 305 $ 127.60 450000515 BODY FLUID CELL COUNT 10.4500 309 $ 172.70 450000520 PERICARDIAL FLUID CELL COUNT 10.4500 309 $ 172.70 450000522 PERITONEAL LAVAGE CELL COUNT 10.4500 309 $ 172.70 450000525 SPINAL FLUID CELL COUNT 10.4500 309 $ 163.90 450000530 RETICULOCYTE - AUTOMATED 10.4500 305 $ 61.60 450000535 PLATELET - MAN 10.4500 305 $ 130.90 450000540 SEDIMENTATION RATE 10.4500 305 $ 46.20 450000545 A.P.T. TEST 10.4500 301 $ 271.70 450000550 SUGAR WATER 10.4500 305 $ 235.40 450000555 FETAL STAIN 10.4500 301 $ 271.70 450000560 MALARIAL STAIN 10.4500 306 $ 172.70 450000565 SICKLE QUICK 10.4500 305 $ 205.70 450000570 LEUKOCYTE ALK. PTASE. 10.4500 305 $ 305.80 450000575 EOSINOPHILS-BODY FLUID 10.4500 309 $ 172.70 450000580 BRONCHEO-ALVEOLAR LAVAGE CELL 10.4500 309 $ 172.70 450000590 EOSINOPHIL COUNT, TOTAL 10.4500 309 $ 172.70 450000595 RAPE EXAM 10.4500 306 $ 172.70 450000600 FERN TEST 10.4500 306 $ 150.70 450000610 COMPLEMENT COMPONENT 3 10.4500 300 $ 110.00 450000620 COMPLEMENT COMPONENT 4 10.4500 300 $ 110.00 450001005 PROTHROMBIN TIME 10.4500 305 $ 60.50 450001010 PARTIAL THROMBOPLASTIN (PTT) 10.4500 305 $ 185.90 450001011 PTT HEPARIN ALG. 10.4500 305 $ 185.90 450001015 FIBRINOGEN 10.4500 305 $ 198.00 450001020 THROMBIN TIME (TT) 10.4500 305 $ 187.00 450001025 FIBRIN SPLIT PRODUCTS 10.4500 305 $ 225.50 450001030 ACT (ACTIVATED CLOT TIME) 10.4500 305 $ 310.20 450001035 BLEEDING TIME 10.4500 305 $ 301.40 450001040 CIRC. ANTICOAG SCREEN 10.4500 305 $ 372.90 450001045 ANTITHROMBIN III 10.4500 300 $ 225.50 450001050 D-DIMER 10.4500 305 $ 225.50 450001505 URINALYSIS, ROUTINE 10.4500 307 $ - 450001508 UA MICROSCOPIC EXAM REFLEX CHA 10.4500 307 $ 46.20 450001509 UA WITHOUT MICRO 10.4500 307 $ 85.80 450001510 URINE CHEM SCREEN 10.4500 307 $ 103.40 450001515 URINALYSIS W/MICRO 10.4500 307 $ 44.00 450001525 URINE PH 10.4500 307 $ 92.40 450001528 URINE KETONES - DIPSTICK 10.4500 307 $ 96.80 450001530 URINE SPECIFIC GRAVITY 10.4500 307 $ 88.00 450001540 OCCULT BLOOD - OTHER 10.4500 301 $ 116.60 450001545 REDUCING SUBSTANCES 10.4500 307 $ 96.80 450001550 FAT SCREEN, RANDOM 10.4500 309 $ 150.70 450001555 SWEAT CHLORIDE 10.4500 309 $ 238.70 450001560 CRYSTAL EXAM 10.4500 309 $ 171.60 450001565 PYLORITEK 10.4500 302 $ 115.50 450001570 BILE FOR CHOL. CRYSTALS 10.4500 309 $ 171.60 450001575 FLUID BILE 10.4500 301 $ 58.30 450001600 OCCULT BLOOD - STOOL. 10.4500 301 $ 35.20 450001602 OCCULT BLOOD STOOL - POC 10.4500 301 $ - 450001605 OCCULT BLOOD - URINE 10.4500 301 $ 116.60 450001610 OCCULT BLOOD - GASTRIC 10.4500 301 $ 116.60 450001620 URINALYSIS, CULTURE IF INDICAT 10.4500 307 $ 198.00 450001830 PLATELET FUNCTION ASSAY 10.4500 300 $ 88.00 450002005 MENINGITIS LATEX PANEL 10.4500 302 $ 742.50 450002010 C. DIFFICILE TOXIN A 10.4500 306 $ 154.00 450002015 COLD AGGLUTININS 10.4500 302 $ 140.80 450002020 C-REACTIVE PROTEIN, QUANTITATI 10.4500 302 $ 150.70 450002025 CRYPTOCOCCAL AG LATEX 10.4500 302 $ 171.60 450002030 FEBRILE AB DETECTION 10.4500 302 $ 240.90 450002035 HAPTOGLOBIN 10.4500 301 $ 154.00 450002040 MONO LATEX (MONOSPOT) 10.4500 302 $ 46.20 450002045 RA LATEX SLIDE-QUAL. 10.4500 302 $ 150.70 450002048 RA TITER. 10.4500 302 $ 225.50 450002050 RSV 10.4500 302 $ 271.70 450002055 HCG,SERUM QUALITATIVE 10.4500 301 $ 204.60 450002060 HCG,URINE QUALITATIVE 10.4500 307 $ 150.70 450002065 GROUP A STREP SCREEN 10.4500 302 $ 136.40 450002080 STREPTOZYME SLIDE TEST 10.4500 302 $ 150.70 450002085 HIV SCREEN 10.4500 301 $ 119.90 450002090 HEP. B SUFACE AG. 10.4500 302 $ 231.00 450002095 INFLUENZA A/B ANTIGEN 10.4500 302 $ 121.00 450002096 INFLUENZA A - CHARGE 10.4500 302 $ 97.90 450002097 INFLUENZA B AG - CHARGE 10.4500 30 $ 97.90 450002100 H. PYLORI IGG AB 10.4500 302 $ 150.70 450002110 HIV 1/2 RAPID SCREEN 10.4500 300 $ 120.00 450003505 CHEM PANEL W/HDL 10.4500 300 $ - 450003510 CHEM 20 10.4500 301 $ - 450003515 ER 12 PANEL 10.4500 301 $ 317.90 450003525 RENAL FUNCTION PANEL 10.4500 301 $ 320.10 450003530 LIPID PANEL 10.4500 301 $ 223.30 450003540 HEPATIC FUNCTION PANEL 10.4500 301 $ 79.20 450003550 ACUTE 4 10.4500 300 $ - 450003555 ELECTROLYTE PANEL 10.4500 300 $ - 450003557 ELECTROLYTES 10.4500 301 $ 68.20 450003560 D-XYLOSE ABSORBTION TEST 10.4500 301 $ 275.00 450003562 TOTAL BILIRUBIN - CHARGE 10.4500 301 $ 150.70 450003563 DIRECT BILIRUBIN - CHARGE 10.4500 301 $ 75.90 450003565 BILI PANEL, NEONATAL 10.4500 301 $ - 450003568 BILI (NEONATAL), REFLEX ALBUMI 10.4500 300 $ - 450003570 GEST GLUC TOLERANCE 10.4500 301 $ 135.30 450003575 GEST DIABETES SCREEN 10.4500 301 $ 135.30 450003580 GLUCOSE 2HR TOLER. (PANEL) 10.4500 300 $ - 450003585 GLUCOSE 3HR TOLER. (PANEL) 10.4500 300 $ - 450003590 GLUCOSE 4HR TOLER. (PANEL) 10.4500 300 $ - 450003595 GLUCOSE 5HR TOLER. (PANEL) 10.4500 300 $ - 450003600 GLUCOSE 6HR TOLER. (PANEL) 10.4500 300 $ - 450003605 LACTOSE TOLERANCE 10.4500 301 $ 772.20 450003610 GASTRIC ANALYSIS 10.4500 301 $ 223.30 450003615 IRON PANEL 10.4500 301 $ 92.40 450003620 FASTING GLUCOSE TOLERAN 10.4500 301 $ 129.80 450003621 FASTING GLUCOSE GEST TO 10.4500 301 $ 129.80 450003622 GLUCOSE, FASTING 10.4500 301 $ 129.80 450003625 30 MINUTE GLUCOSE 10.4500 301 $ - 450003630 1HR GLUCOSE TOLERAN 10.4500 301 $ 238.70 450003631 1 HR GLUCOSE GEST TOLERANCE 10.4500 301 $ 107.80 450003635 2HR GLUCOSE TOLERAN 10.4500 301 $ 41.80 450003636 2HR GLUCOSE GEST TO 10.4500 301 $ 238.70 450003637 GLUCOSE - 2HR PP 10.4500 301 $ 130.90 450003640 3HR GLUCOSE TOLERAN 10.4500 301 $ 39.60 450003641 3HR GLUCOSE GEST TO 10.4500 301 $ 39.60 450003645 4HR GLUCOSE TOLERAN 10.4500 301 $ 44.00 450003650 5HR GLUCOSE TOLERAN 10.4500 301 $ 39.60 450003655 6HR GLUCOSE TOLERAN 10.4500 301 $ 48.40 450003660 CSF CHEMISTRIES 10.4500 300 $ - 450003665 BASIC METABOLIC PANEL 10.4500 301 $ 166.10 450003670 COMPREHENSIVE 12 CHEM PANEL 10.4500 301 $ 229.90 450003671 COMP METABOLIC CHARGE 10.4500 300 $ 229.90 450003680 COMP/CK PANEL 10.4500 301 $ - 450003681 CK CHARGE 10.4500 301 $ 170.50 450003685 COMP/PHOS PANEL 10.4500 301 $ - 450003686 PHOS CHARGE 10.4500 301 $ 170.50 450003691 LD CHARGE 10.4500 301 $ 170.50 450003692 URIC ACID CHARGE 10.4500 301 $ 170.50 450003693 GGT CHARGE 10.4500 301 $ 170.50 450003705 GLUCOSE 10.4500 301 $ 118.80 450003707 KETONE, QUALITATIVE 10.4500 301 $ 52.80 450003710 KETONES 10.4500 301 $ 204.60 450003715 UREA NITROGEN 10.4500 301 $ 118.80 450003720 CREATININE 10.4500 301 $ 118.80 450003725 SODIUM 10.4500 301 $ 111.10 450003730 POTASSIUM 10.4500 301 $ 111.10 450003735 CHLORIDE 10.4500 301 $ 111.10 450003740 BICARBONATE (TOTAL CO2) 10.4500 301 $ 111.10 450003745 CALCIUM 10.4500 301 $ 55.00 450003750 PHOSPHOROUS 10.4500 301 $ 55.00 450003755 MAGNESIUM 10.4500 301 $ 74.80 450003760 URIC ACID 10.4500 301 $ 55.00 450003765 TRIGLYCERIDES 10.4500 301 $ 55.00 450003770 CHOLESTEROL 10.4500 301 $ 66.00 450003775 HDL CHOLESTEROL 10.4500 301 $ 55.00 450003780 BILIRUBIN - TOTAL 10.4500 301 $ 53.90 450003785 BILIRUBIN, DIRECT 10.4500 301 $ 75.90 450003790 ALK PHOSPHATASE 10.4500 301 $ 53.90 450003795 HEAT STABLE ALK PHOS 10.4500 301 $ - 450003800 GAMMA GT 10.4500 301 $ 53.90 450003805 AST (SGOT) 10.4500 301 $ 53.90 450003810 ALT (SGPT) 10.4500 301 $ 53.90 450003815 LDH 10.4500 301 $ 188.10 450003820 CPK 10.4500 301 $ 141.90 450003825 AMYLASE 10.4500 301 $ 74.80 450003830 TOTAL PROTEIN 10.4500 301 $ 188.10 450003835 ALBUMIN 10.4500 301 $ 53.90 450003845 AMMONIA 10.4500 301 $ 238.70 450003850 SERUM OSMOLALITY 10.4500 301 $ 172.70 450003855 LIPASE 10.4500 301 $ 74.80 450003860 IRON 10.4500 301 $ 36.30 450003865 TIBC 10.4500 301 $ 36.30 450003870 LITHIUM LEVEL 10.4500 301 $ 188.10 450003875 LACTATE 10.4500 301 $ 225.50 450003885 LEAD 10.4500 301 $ 90.20 450003905 CSF GLUCOSE 10.4500 301 $ 161.70 450003910 CSF PROTEIN 10.4500 301 $ 161.70 450003915 URINE OSMOLALITY 10.4500 301 $ 172.70 450003920 URINE PROTEIN 10.4500 301 $ 188.10 450003925 URINE PROTEIN 12HR 10.4500 301 $ 188.10 450003930 URINE PROTEIN 24HR 10.4500 301 $ 188.10 450003935 URINE SODIUM 10.4500 301 $ 172.70 450003940 URINE SODUIM 12HR 10.4500 301 $ 172.70 450003945 URINE SODIUM 24HR 10.4500 301 $ 172.70 450003950 URINE POTASSIUM 10.4500 301 $ 172.70 450003955 URINE POTASSIUM 12HR 10.4500 301 $ 172.70 450003960 URINE POTASSIUM 24HR 10.4500 301 $ 172.70 450003965 URINE CREATININE 10.4500 301 $ 181.50 450003970 URINE CREATININE 12HR 10.4500 301 $ 181.50 450003975 URINE CREATININE CLEAR - 12HR 10.4500 301 $ 289.30 450003980 URINE CLEAR-CORRECTED 12HR 10.4500 301 $ 289.30 450003985 URINE CREATININE 24HR 10.4500 301 $ 181.50 450003990 URINE CREATININE CLEAR - 24HR 10.4500 301 $ 289.30 450003995 URINE CLEAR-CORRECTED 24HR 10.4500 301 $ 289.30 450004000 URINE UREA NITROGEN 10.4500 301 $ 130.90 450004005 URINE UREA NIT. 12HR 10.4500 301 $ 130.90 450004010 URINE UREA NIT. 24HR 10.4500 301 $ 130.90 450004015 URINE AMYLASE 10.4500 301 $ 188.10 450004020 URINE AMYLASE 12HR 10.4500 301 $ 188.10 450004025 URINE AMYLASE 24HR 10.4500 301 $ 188.10 450004030 URINE CALCIUM 10.4500 301 $ 130.90 450004035 URINE CALCIUM 12HR 10.4500 301 $ 130.90 450004040 URINE CALCIUM 24HR 10.4500 301 $ 130.90 450004045 URINE PHOSPHOROUS 10.4500 301 $ 130.90 450004050 URINE PHOSPHOROUS 12HR 10.4500 301 $ 130.90 450004055 URINE PHOSPHOROUS 24HR 10.4500 301 $ 130.90 450004060 URINE GLUCOSE 10.4500 301 $ 130.90 450004065 URINE GLUCOSE 12HR 10.4500 301 $ 130.90 450004070 URINE GLUCOSE 24HR 10.4500 301 $ 130.90 450004075 URINE URIC ACID 10.4500 301 $ 130.90 450004080 URINE URIC ACID 12HR 10.4500 301 $ 130.90 450004085 URINE URIC ACID 24HR 10.4500 301 $ 130.90 450004088 URINE VOLUME 12HR 10.4500 307 $ - 450004089 URINE VOLUME 24HR 10.4500 307 $ - 450004090 TRYPSIN (STOOL) 10.4500 301 $ 206.80 450004095 PH - FLUID 10.4500 301 $ 96.80 450004100 SPECIFIC GRAVITY - FLUID 10.4500 301 $ 96.80 450004105 URINE MAGNSEIUM, RANDOM 10.4500 301 $ 188.10 450004110 MAGNESIUM, 12HR URINE 10.4500 301 $ 188.10 450004115 MAGNESIUM, 24HR URINE 10.4500 301 $ 188.10 450004335 FLUID GLUCOSE 10.4500 301 $ 130.90 450004340 FLUID TOTAL PROTEIN 10.4500 301 $ 188.10 450004345 FLUID LDH 10.4500 301 $ 188.10 450004350 AMYLASE - FLUID 10.4500 301 $ 188.10 450004355 CARDIOPLEGIA K+ 10.4500 301 $ 172.70 450004360 ALBUMIN, FLUID 10.4500 301 $ 188.10 450004365 CREATININE, FLUID 10.4500 301 $ 181.50 450004370 TRIGLYCERIDES, FLUID 10.4500 301 $ 188.10 450004375 CHOLESTEROL, FLUID 10.4500 301 $ 188.10 450004465 GLUCOSE - C 10.4500 301 $ 130.90 450004466 PROTEIN - C 10.4500 301 $ 188.10 450004469 SODIUM - C 10.4500 301 $ 122.10 450004470 POTASSIUM - C 10.4500 301 $ 122.10 450004471 UREA NITROGEN - C 10.4500 301 $ 122.10 450004472 CREATININE - C 10.4500 301 $ 188.10 450004473 SODIUM CHARGE 10.4500 301 $ 122.10 450004474 IONIZED CALCIUM - C 10.4500 301 $ 130.90 450004475 GLUCOSE - CHARGE 10.4500 301 $ 122.10 450004505 ACETAMINOPHEN 10.4500 301 $ 271.70 450004510 TROUGH AMIKACIN 10.4500 301 $ 258.50 450004515 PEAK AMIKACIN 10.4500 301 $ 231.00 450004520 RANDOM AMIKACIN 10.4500 301 $ 231.00 450004525 CARBAMAZEPINE 10.4500 301 $ 247.50 450004530 CORTISOL, SERUM 10.4500 301 $ 90.00 450004535 DISOPHYRAMIDE 10.4500 301 $ 271.70 450004540 DIGOXIN 10.4500 301 $ 247.50 450004545 ETHANOL 10.4500 301 $ 271.70 450004550 TROUGH GENTAMICIN 10.4500 301 $ 271.70 450004555 PEAK GENTAMICIN 10.4500 301 $ 271.70 450004560 RANDOM GENTAMICIN 10.4500 301 $ 271.70 450004570 LIDOCAINE 10.4500 301 $ 271.70 450004575 METHOTREXATE 10.4500 301 $ 271.70 450004580 PROCAINAMIDE & NAPA 10.4500 301 $ 271.70 450004590 PHENOBARBITAL 10.4500 301 $ 247.50 450004593 PRIMIDONE 10.4500 301 $ 271.70 450004595 PHENYTOIN 10.4500 301 $ 247.50 450004600 QUINIDINE 10.4500 301 $ 258.50 450004605 SALICYLATE 10.4500 301 $ 247.50 450004610 THEOPHYLLINE 10.4500 301 $ 247.50 450004615 TROUGH TOBRAMYCIN 10.4500 301 $ 271.70 450004620 PEAK TOBRAMYCIN 10.4500 301 $ 271.70 450004625 RANDOM TOBRAMYCIN 10.4500 301 $ 271.70 450004630 VALPROIC ACID 10.4500 301 $ 271.70 450004635 TROUGH VANCOMYCIN 10.4500 301 $ 271.70 450004640 PEAK VANCOMYCIN 10.4500 301 $ 271.70 450004645 RANDOM VANCOMYCIN 10.4500 301 $ 271.70 450004660 TSH 10.4500 301 $ 255.20 450004662 FREE T4 10.4500 301 $ 75.90 450004664 THYROID SCREEN 10.4500 301 $ 243.10 450004665 QUANT. B-HCG 10.4500 301 $ 107.80 450004670 CK-MB 10.4500 301 $ 243.10 450004671 TOTAL CK 10.4500 300 $ 243.10 450004675 TROPONIN I 10.4500 301 $ 271.70 450004685 MYOGLOBIN 10.4500 301 $ 271.70 450004690 ISOENZYME CPK/LDH TOTALS 10.4500 301 $ - 450004696 CPK ISO SCAN 10.4500 301 $ - 450004697 LDH ISO SCAN 10.4500 301 $ - 450004700 FERRITIN 10.4500 301 $ 271.70 450004715 VITAMIN B12 10.4500 301 $ 110.00 450004720 FOLATE, SERUM 10.4500 301 $ 110.00 450004725 URINE TOX SCREEN 10.4500 301 $ - 450004728 NEONATAL DRUG SCREEN 10.4500 300 $ - 450004730 AMPHETAMINE - URINE 10.4500 300 $ 60.00 450004735 URINE BARBITURATE 10.4500 300 $ 60.00 450004740 URINE BENZODIAZEPINE 10.4500 300 $ 60.00 450004745 CANNABINOID - URINE 10.4500 300 $ 60.00 450004750 COCAINE META - URINE 10.4500 300 $ 60.00 450004755 OPIATE META - URINE 10.4500 300 $ 60.00 450004760 ETHANOL TOX SCREEN ANALYTE 10.4500 301 $ 130.90 450004770 PHENCYCLIDINE 10.4500 300 $ 60.00 450004775 OXYCODONE - URINE 10.4500 300 $ 60.00 450004780 PROPOXYPHENE - URINE 10.4500 300 $ 60.00 450004785 METHAMPHET - URINE 10.4500 300 $ 60.00 450004790 METHADONE - URINE 10.4500 300 $ 60.00 450004805 ABG 10.4500 301 $ 305.80 450004807 VENOUS O2 SATURATION 10.4500 301 $ 115.50 450004810 CAPILLARY BLOOD GAS 10.4500 301 $ 305.80 450004816 SODIUM, NOVA 10.4500 301 $ 122.10 450004817 POTASSIUM, NOVA 10.4500 301 $ 122.10 450004818 CHLORIDE, NOVA 10.4500 301 $ 122.10 450004819 GLUCOSE, NOVA 10.4500 301 $ 122.10 450004820 NOVA LYTES 10.4500 300 $ - 450004825 IONIZED CALCIUM 10.4500 301 $ 130.90 450004830 HEART SURGERY PANEL 10.4500 300 $ - 450004834 CARDIAC SURGERY PANEL 10.4500 300 $ 255.20 450004835 NEONATE PH/CORD BLOOD GASES 10.4500 301 $ 278.30 450004840 TROPONIN SERIES 10.4500 301 $ 271.70 450004845 3HR TROPONIN 10.4500 301 $ 271.70 450004850 6HR TROPONIN I 10.4500 301 $ 271.70 450004855 9HR TROPONIN 10.4500 301 $ 271.70 450004870 CARDIAC ISOENZYME 10.4500 301 $ - 450004895 TRICYCLIC ANTIDEPRESSANTS 10.4500 300 $ 60.00 450004900 HGB A1C 10.4500 301 $ 101.20 450004905 PSA 10.4500 301 $ 271.70 450004910 BNP 10.4500 301 $ 271.70 450004915 CRP HIGH SENSITIVITY 10.4500 302 $ 150.70 450004930 FETAL FIBRONECTIN 10.4500 301 $ 468.60 450005500 CULTURE BETA STREP, THROAT 10.4500 302 $ 101.20 450005505 CULTURE GROUP B STREP, VAGINAL 10.4500 302 $ 150.70 450005510 CULTURE, E. COLI 0157-H7 10.4500 306 $ 150.70 450005515 CULTURE, PERTUSSIS 10.4500 306 $ 255.20 450005520 CULTURE, YERSINIA 10.4500 306 $ 150.70 450005525 CULTURE, AUTOPSY. 10.4500 306 $ - 450005530 CULTURE, TRANSFUSION REACTION. 10.4500 306 $ - 450005535 CULTURE, ABDOMINAL. 10.4500 306 $ - 450005540 CULTURE, BLOOD 10.4500 306 $ 135.30 450005545 CULTURE--BRONCH WASH. 10.4500 306 $ - 450005550 CULTURE -CSF 10.4500 306 $ - 450005555 CULTURE, CATH TIP. 10.4500 306 $ - 450005560 CULTURE, FLUID 10.4500 306 $ 271.70 450005565 CULTURE, JOINT 10.4500 306 $ - 450005570 CULTURE, OTHER 10.4500 306 $ 135.30 450005575 CULTURE, PERICARDIAL 10.4500 306 $ - 450005580 CULTURE, RESPIRATORY 10.4500 306 $ 111.10 450005585 CULTURE, STOOL 10.4500 306 $ 145.20 450005590 CULTURE, THROAT 10.4500 306 $ 111.10 450005595 CULTURE, TISSUE/BONE. 10.4500 306 $ - 450005600 CULTURE, URINE 10.4500 306 $ 245.30 450005605 CULTURE, VAGINAL/CERVICAL 10.4500 306 $ 111.10 450005610 CULTURE, ENVIRONMENTAL 10.4500 306 $ - 450005615 MRSA/ORSA SCREEN 10.4500 306 $ 145.20 450005620 VRE SCREEN 10.4500 306 $ 145.20 450005625 CULTURE, FUNGAL 10.4500 306 $ 111.10 450005635 GRAM STAIN 10.4500 306 $ 150.70 450005640 SALINE WET MOUNT 10.4500 306 $ 70.40 450005646 CONCENTRATED FLOURESCENT AFB S 10.4500 306 $ 292.60 450005650 KOH PREP 10.4500 306 $ 70.40 450005655 STOOL FOR LEUKOCYTES 10.4500 306 $ 130.90 450005660 STOOL FOR CRYPTOSPORIDIUM 10.4500 306 $ 93.50 450005665 OVA & PARASITES 10.4500 306 $ 117.70 450005667 STOOL GIARDIA/CRYPTOSPORIDIUM 10.4500 306 $ 154.00 450005670 ARTHROPOD EXAM 10.4500 300 $ 70.40 450005680 CULTURE, GC SCREEN 10.4500 306 $ 150.70 450005685 MIC PANEL 10.4500 306 $ 200.20 450005686 PUBLIC HEALTH HANDLING FEE 10.4500 300 $ - 450005687 SPUTUM CULTURE CREDIT - MIXED 10.4500 300 $ 255.20 450005690 SENPAN (CHARGE FOR K-B/E TEST) 10.4500 306 $ 188.10 450005692 CULT URINE, PRESUMPTIVE ISO. I 10.4500 306 $ 24.20 450005694 LATEX TYPING STREP/E.COLI 10.4500 302 $ 24.20 450005695 CULTURE, BLOOD FOR FUNGUS 10.4500 306 $ 255.20 450005697 CULT BACTI DEFINITIVE ISOLATE 10.4500 306 $ 27.50 450005700 CULTURE -PLUG BRUSH 10.4500 306 $ - 450005705 RENAL BX. 10.4500 306 $ - 450005710 CULTURE -TRACHIAL ASPIRATE 10.4500 306 $ - 450005715 CULTURE, NEONATE SCREEN 10.4500 306 $ 145.20 450005720 PINWORM PREP 10.4500 300 $ 136.40 450005725 ANAEROBE ID PANEL 10.4500 306 $ 108.90 450005730 CULTURE STOOL ADDIT PATHOGENS 10.4500 306 $ 18.70 450005735 FUNGI IDENTIFICATION - YEAST 10.4500 306 $ 108.90 450007005 CSF PANEL. 10.4500 300 $ - 450007006 CSF PANEL 10.4500 300 $ - 450007014 NBS ADJUST (PANEL) 10.4500 300 $ - 450007015 NEWBORN SCREEN (PANEL) 10.4500 300 $ - 450007016 NEWBORN SCREEN PROCESSING FEE 10.4500 300 $ 7.70 450007017 REFERRAL PROCESSING - STANDARD 10.4500 300 $ - 450007018 REFERRAL PROCESSING - BEAR GUL 10.4500 300 $ - 450007019 REFERRAL PROCESSING - UPS 10.4500 300 $ - 450007020 PREALBUMIN 10.4500 301 $ 188.10 450007021 DRAW FEE 10.4500 300 $ 15.40 450007022 ARTERIAL DRAW 10.4500 300 $ 51.70 450007025 SENDOUT TEST 5 10.4500 300 $ - 450007040 PHENYLALANINE (NEWBORN SCREEN) 10.4500 301 $ 20.35 450007045 TYROSINE (NEWBORN SCREEN) 10.4500 301 $ 20.35 450007050 TRANSFERASE (NEWBORN SCREEN) 10.4500 301 $ 20.35 450007055 TSH (NBS) 10.4500 301 $ 20.35 450007060 HGB CHROMATOGRAPHY (NEWBORN SC 10.4500 301 $ 20.35 450007065 HEPATITIS A ANTIBODY IGM 10.4500 300 $ 110.00 450007070 HEP B CORE ANTIBODY- IGM 10.4500 300 $ 90.00 450007075 HEPATITIS B SURFACE ANTIBODY 10.4500 300 $ 90.00 450007080 HEAPTITIS B SURFACE ANTIGEN 10.4500 300 $ 90.00 450007085 HEPATITIS C ANTIBODY 10.4500 300 $ 110.00 450007090 ACUTE HEPATITIS PANEL 10.4500 300 $ 300.00 450009999 MISC--SEE COMMENTS 10.4500 300 $ - 450082105 AFP, TUMOR MARKER 10.4500 300 $ 150.00 450082378 CEA 10.4500 300 $ 150.00 450082670 ESTRADIOL 10.4500 300 $ 90.00 450083001 FOLLICLE STIMULATING HORMONE 10.4500 300 $ 90.00 450083002 LUTEINIZING HORMONE 10.4500 300 $ 90.00 450084144 PROGESTERONE 10.4500 300 $ 90.00 450084480 TOTAL TRIIODOTHYRONINE 10.4500 300 $ 90.00 450084481 FREE TRIIODOTHYRONINE 10.4500 300 $ 90.00 450086301 TUMOR ANTIGEN CA 19-9 10.4500 300 $ 190.00 450086304 TUMOR ANTIGEN CA 125 10.4500 300 $ 190.00 450087181 ANTIMICROBIAL AGENT AGAR DILUT 10.4500 306 $ 4.40 450087184 MICROBE SUSCEPTIBLE - DISK 10.4500 306 $ 13.20 450087205 GRAM STAIN 10.4500 306 $ 17.60 450087425 STOOL ROTAVIRUS ANTIGEN 10.4500 300 $ 154.00 450099300 DEFENSE AUDIT ADJUSTMENT 10.4500 300 $ - 452000100 SPECIMEN COLL KIT - ER 10.4500 270 $ 65.00 452000200 SPECIMEN COLL KIT - POST PARTU 10.4500 270 $ 65.00 452000300 SPECIMEN COLL KIT - LABOR & DE 10.4500 270 $ 65.00 452000400 SPECIMEN COLL KIT - SURGERY 10.4500 270 $ 69.00 452000500 SPECIMEN COLL KIT - RAD ONC 10.4500 270 $ 65.00 452000600 SPECIMEN COLL KIT - XRAY 10.4500 270 $ 69.00 452000700 SPECIMEN COLL KIT - GI 10.4500 270 $ 69.00 452000800 SPECIMEN COLL KIT - RESP THERA 10.4500 270 $ 65.00 452000900 SPECIMEN COLL KIT - NURSING UN 10.4500 270 $ 65.00 452000999 SPECIMEN COLL KIT - OTHER 10.4500 270 $ 65.00 452085060 BLOOD SMEAR PREPARATION 10.4500 305 $ 52.80 452085095 BONE MARROW ASPIRATION 10.4500 305 $ 275.00 452085097 BONE MARROW PREPARATION 10.4500 305 $ 106.70 452085102 BONE MARROW BIOPSY 10.4500 310 $ 306.90 452088108 CYTO SMEAR-CONC TECH 10.4500 311 $ 41.80 452088161 CYTOPATH SMEAR, OTHER SOURCE 10.4500 311 $ 24.20 452088162 CYTOPATH SMEAR, OTHER SOURCE-E 10.4500 311 $ 44.00 452088170 FINE NEEDLE ASPIRATION 10.4500 311 $ 37.40 452088172 EVALUATION OF SMEAR 10.4500 311 $ 56.10 452088173 INTERPRETATION OF SMEAR 10.4500 311 $ 56.10 452088180 CELL MARKER STUDY (AB) 10.4500 310 $ 78.10 452088182 CELL MARKER STUDY 10.4500 310 $ 78.10 452088300 SURGICAL PATH,GROSS-LEVEL 1 10.4500 310 $ 20.90 452088302 TISSUE EXAM BY PATHOLOGIST-LEV 10.4500 310 $ 64.90 452088304 TISSUE EXAM BY PATHOLOGIST-LEV 10.4500 310 $ 41.80 452088305 TISSUE EXAM BY PATHOLOGIST-LEV 10.4500 310 $ 64.90 452088307 TISSUE EXAM BY PATHOLOGIST-LEV 10.4500 310 $ 136.40 452088309 TISSUE EXAM BY PATHOLOGIST-LEV 10.4500 310 $ 194.70 452088311 DECALCIFY TISSUE 10.4500 310 $ 9.90 452088312 SPECIAL STAINS 10.4500 310 $ 47.30 452088313 SPECIAL STAINS-GROUP 2 10.4500 310 $ 81.40 452088319 ENZYME HISTOCHEMISTRY 10.4500 310 $ 147.40 452088321 MICROSLIDE CONSULTATION 10.4500 310 $ 141.90 452088323 MICROSLIDE CONSULT 10.4500 310 $ 79.20 452088325 COMPREHENSIVE REVIEW OF DATA 10.4500 310 $ 226.60 452088329 PATHOLOGY CONSULT IN SURGERY 10.4500 310 $ 88.00 452088331 PATH CONSULT IN SURGERY-FROZ S 10.4500 310 $ 44.00 452088332 PATH CONSULT IN SURG-FROZEN AD 10.4500 310 $ 20.90 452088342 IMMUNOCYTOCHEMISTRY 10.4500 310 $ 79.20 452088348 ELECTRON MICROSCOPY 10.4500 310 $ 478.50 453000001 SEND OUT - NO CHARGE 10.4500 300 $ - 453000100 5-5HIAA-QUANTITATIVE 24 HOUR 10.4500 300 $ 16.80 453000110 ACETYLCHOLINE RECEPT AB (PANEL 10.4500 300 $ - 453000120 ADENOVIRUS ANTIBODY (PANEL) 10.4500 300 $ - 453000130 5-ADRENOCORTICOTROPIC HORMONE 10.4500 300 $ 21.00 453000140 AFB CULTURE AND STAIN (PANEL) 10.4500 300 $ - 453000150 V-AFP-TUMOR MARKER 10.4500 300 $ 14.00 453000160 5-ALDOLASE 10.4500 300 $ 7.00 453000170 5-ALDOSTERONE 10.4500 300 $ 16.50 453000180 ALK PHOS ISOENZYMES (PANEL) 10.4500 300 $ - 453000190 5-ALPHA 2 ANTIPLASMIN 10.4500 300 $ 36.60 453000200 5-ALPHA1ANTITRYPSIN 10.4500 300 $ 7.50 453000210 D-AMIKACIN LEVEL PEAK 10.4500 300 $ 52.46 453000220 D-AMIKACIN LEVEL TROUGH 10.4500 300 $ 52.46 453000230 D-AMIKACIN LEVEL- RANDOM 10.4500 300 $ 52.46 453000240 5-AMINO ACIDS QUANT- PLASMA 10.4500 300 $ 90.00 453000250 5-AMINO ACIDS QUANT- URINE 10.4500 300 $ 90.00 453000260 5-ANGIOTENSIN CONVERTING ENZYM 10.4500 300 $ 16.20 453000270 5-ANTINUCLEAR SCREEN 10.4500 300 $ 7.00 453000271 5-ANTINUCLEAR AB TITER 10.4500 300 $ 11.25 453000272 5-CHLAMYDIA / GC DNA PROBE 10.4500 300 $ 46.50 453000280 5-ANTISTREPTOLYSIN O ANTIBODY 10.4500 300 $ 9.90 453000290 ANTITHROMBIN III (PANEL) 10.4500 300 $ - 453000300 ASPERGILLUS ABS BY CF/ ID (PAN 10.4500 300 $ - 453000310 5-B. BURGDORFERI AB- ELISA(CSF 10.4500 300 $ 9.00 453000320 BARTONEL HENSL AB IGG-IGM (PAN 10.4500 300 $ - 453000330 5-BETA 2 GLYCOPROTEIN AB- IGA 10.4500 300 $ 19.50 453000340 5-BETA2GLYCOPROTEIN I AB IGG/I 10.4500 300 $ 39.00 453000350 5-BETA2MICROGLOBULIN 10.4500 300 $ 12.00 453000360 5-BETAHCG- QUANT TUMOR MARKER 10.4500 300 $ 12.90 453000370 BORDETEL PERTUS AB-IGG/M (PANE 10.4500 300 $ - 453000380 BORDETEL PERTUS BY PCR (PANEL) 10.4500 300 $ - 453000390 5-BORRELIA BURGDORFERI ABS-TOT 10.4500 300 $ 9.00 453000400 BRUCELLA AB- IGG/ IGM (PANEL) 10.4500 300 $ - 453000410 5-C1 ESTERASE INHIBITOR 10.4500 300 $ 27.30 453000420 5-CAMPYLOBACT JEJUNI ANTBDY 10.4500 300 $ 109.10 453000430 V-CANCER ANTIGEN 125 10.4500 300 $ 12.50 453000440 5-CANCER ANTIGEN 153 10.4500 300 $ 13.50 453000450 5-CANCER ANTIGEN 199 10.4500 300 $ 15.00 453000460 5-CANCER ANTIGEN 27.29 10.4500 300 $ 15.00 453000470 V-CARCINOEMBRYONIC ANTIGEN 10.4500 300 $ 12.50 453000480 CARDIOLIPIN ABS IGG/IGM (PANE 10.4500 300 $ - 453000490 5-CARNITINE- FREE AND TOTAL 10.4500 300 $ 24.00 453000500 5-CARNITINE- TOTAL 10.4500 300 $ 12.00 453000510 5-CATECHOLAMINES-FRACTION URIN 10.4500 300 $ 31.80 453000520 CD4 AND CD8 ABSOLUTE (PANEL) 10.4500 300 $ - 453000530 CD4 LYMPHOCYTE SUBSET (PANEL) 10.4500 300 $ - 453000540 5-CELIAC DISEASE PANEL 10.4500 300 $ 9.90 453000550 5-CERULOPLASMIN 10.4500 300 $ 9.00 453000560 CHLAMYDIA AB IGG/IGM (PANEL) 10.4500 300 $ - 453000570 5-CHLORIDE- URINE 10.4500 300 $ 8.40 453000580 5-CHROMOGRANIN A 10.4500 300 $ 45.90 453000590 CHROMOSOME ANALYSIS- BLD (PANE 10.4500 300 $ - 453000600 CK ISOENZYMES (PANEL) 10.4500 300 $ - 453000610 COCCIDIOIDES AB - CSF (PANEL) 10.4500 300 $ - 453000620 COCCIDIOIDES ABS- IGG/IGM (PAN 10.4500 300 $ - 453000630 5-COMPLEMENT ACTIVITY- TOTAL E 10.4500 300 $ 8.75 453000640 5-COMPLEMENT COMPONENT 3 10.4500 300 $ 7.00 453000650 COMPLEMENT COMPONENT 3 & 4 (PA 10.4500 300 $ - 453000660 5-COMPLEMENT COMPONENT 4 10.4500 300 $ 7.00 453000670 5-COPPER LEVEL 10.4500 300 $ 13.50 453000680 CORTISOL STIMULATION TEST (PAN 10.4500 300 $ - 453000690 V-CORTISOL- SERUM 10.4500 300 $ 9.00 453000700 5-CORTISOL-24 HOUR URINE 10.4500 300 $ 16.50 453000710 5-CPEPTIDE 10.4500 300 $ 12.00 453000720 5-CRYOGLOBULIN- QUANTITATIVE 10.4500 300 $ 9.00 453000730 5-CYCLIC CITRUL PEPTIDE AB- IG 10.4500 300 $ 22.50 453000740 CYSTIC FIBROSIS MUTATION (PANE 10.4500 300 $ - 453000750 CYTOGENETICS (PANEL) 10.4500 300 $ - 453000760 CYTOMEG VIRUS ABS- IGG/IGM (P 10.4500 300 $ - 453000770 5-DEHYDROEPIANDROSTERONE 10.4500 300 $ 15.00 453000780 5-DHEA SULFATE- SERUM 10.4500 300 $ 12.00 453000790 DRUG ANALYSIS- SERUM (PANEL) 10.4500 300 $ - 453000800 5-DSDNA AB- IGG 10.4500 300 $ 12.00 453000810 5-ENDOMYSIAL ANTIBODY 10.4500 300 $ 9.00 453000820 EPSTEIN BARR VIRUS AB (PANEL) 10.4500 300 $ - 453000830 5-EPSTEIN BARR VIRUS BY PCR 10.4500 300 $ 75.00 453000840 5-ERYTHROPOIETIN 10.4500 300 $ 24.00 453000850 V-ESTRADIOL 10.4500 300 $ 21.34 453000860 EXTRACT NUCLEAR AG ABS 5 (PANE 10.4500 300 $ - 453000870 FACTOR V LEIDEN BY PCR/FRET (P 10.4500 300 $ - 453000880 5-FACTOR VIII ACTIVITY 10.4500 300 $ 19.50 453000890 D-FK 506 (TACROLIMUS) 10.4500 300 $ 110.08 453000900 FLOW CYTOMETRY (PANEL) 10.4500 300 $ - 453000910 V-FOLATE 10.4500 300 $ 8.82 453000920 V-FOLLICLE STIMULATING HORMONE 10.4500 300 $ 7.76 453000930 5-FREE T3 10.4500 300 $ 10.75 453000940 5-GABAPENTIN LEVEL 10.4500 300 $ 19.50 453000950 5-GASTRIN 10.4500 300 $ 13.50 453000960 GBM ANTIBODY (PANEL) 10.4500 300 $ - 453000970 GC / CHLAMYDIA DNA PROBE (PANE 10.4500 300 $ - 453000980 5-GIARDIA ANTIGEN 10.4500 300 $ 15.00 453000990 GLIADIN ANTIBODY- IGA & IGG (P 10.4500 300 $ - 453001000 5-GLUCOSE6PHOS DEHYDROGENASE 10.4500 300 $ 15.00 453001010 5-GLUTAMIC ACID DECARBOXYLASE 10.4500 300 $ 42.00 453001020 5-GROWTH HORMONE 10.4500 300 $ 15.00 453001030 5-HAPTOGLOBIN 10.4500 300 $ 9.50 453001040 HEAVY METALS - BLOOD (PANEL) 10.4500 300 $ - 453001050 5-HELICOBACTER PYLORI ANTIGEN 10.4500 300 $ 49.50 453001060 5-HEMOGLOBIN ELECTROPHORESIS 10.4500 300 $ 15.00 453001070 5-HEMOGLOBIN- PLASMA 10.4500 300 $ 15.30 453001080 5-HEMOGLOBIN- SERUM 10.4500 300 $ 15.30 453001090 5-HEMOSIDERIN- URINE 10.4500 300 $ 9.00 453001100 5-HEPARIN ASSOCIATED AB DETECT 10.4500 300 $ 160.00 453001110 5-HEPATITIS A ANTIBODY IGM 10.4500 300 $ 10.50 453001120 5-HEPATITIS A ANTIBODY- TOTAL 10.4500 300 $ 8.75 453001130 5-HEPATITIS B CORE ANTIBODY 10.4500 300 $ 6.30 453001140 5-HEPATITIS B CORE IGM 10.4500 300 $ 17.15 453001150 5-HEPATITIS B SURFACE ANTIBODY 10.4500 300 $ 7.00 453001160 5-HEAPTITIS B SURFACE ANTIGEN 10.4500 300 $ 7.00 453001170 5-HEPATITIS C GENOTYPE 10.4500 300 $ 120.00 453001180 5-HEPATITIS C RNA QUANT BDNA 10.4500 300 $ 141.00 453001190 5-HEPATITIS C RNA- QUANT BY PC 10.4500 300 $ 117.00 453001200 5-HEPATITIS C VIRUS ANTIBODY 10.4500 300 $ 11.50 453001210 5-HEPATITIS PANEL- ACUTE 10.4500 300 $ 42.00 453001220 HERPES CULT REFLX TYPING (PANE 10.4500 300 $ - 453001230 5-HIV AB I/II 10.4500 300 $ 7.50 453001231 5-HIV AB CONFIRM WEST BLOT 10.4500 300 $ 48.00 453001240 5-HIV RNA (PCR) 10.4500 300 $ 120.00 453001250 5-HLA B27 10.4500 300 $ 32.40 453001260 5-HOMOCYSTEINE 10.4500 300 $ 19.50 453001270 HSV 1& 2 AB IGG/IGM-SERUM (PAN 10.4500 300 $ - 453001280 HSV 1& 2 ABS- IGG/IGM-CSF (PAN 10.4500 300 $ - 453001290 5-HSV 1 AND 2 ANTIBODY- IGG 10.4500 300 $ 12.00 453001300 5-HSV 1 AND 2 ANTIBODY- IGM 10.4500 300 $ 12.00 453001310 5-HSV 1 AND 2 IGG AB- CSF 10.4500 300 $ 15.00 453001320 5-HSV 1 AND 2 IGM AB- CSF 10.4500 300 $ 12.00 453001330 HYPERSENSITIVITY PNEUMONITIS(P 10.4500 300 $ - 453001340 IGG SUBCLASSES (PANEL) 10.4500 300 $ - 453001350 IMMUNOELECTROPHS- 24HR UR (PAN 10.4500 300 $ - 453001360 IMMUNOELECTROPH-SERUM (PANEL) 10.4500 300 $ - 453001370 IMMUNOELECTROPH-SPOT UR (PANEL 10.4500 300 $ - 453001380 5-IMMUNOGLOBULIN A 10.4500 300 $ 6.00 453001390 5-IMMUNOGLOBULIN E 10.4500 300 $ 8.75 453001400 5-IMMUNOGLOBULIN G 10.4500 300 $ 6.00 453001410 IMMUNOGLOBULIN IGG/A/M (PANEL) 10.4500 300 $ - 453001420 5-IMMUNOGLOBULIN M 10.4500 300 $ 6.00 453001430 INFLUENZA A&B VIRUS ABS (PANEL 10.4500 300 $ - 453001440 5-INFLUENZA A IGG ANTIBODY 10.4500 300 $ 8.10 453001450 5-INFLUENZA A IGM ANTIBODY 10.4500 300 $ 8.10 453001460 5-INFLUENZA B IGG ANTIBODY 10.4500 300 $ 8.10 453001470 5-INFLUENZA B IGM ANTIBODY 10.4500 300 $ 8.10 453001480 INSECTICIDE EXPOSURE (PANEL) 10.4500 300 $ - 453001490 5-INSULIN ANTIBODY 10.4500 300 $ 39.00 453001500 5-INSULIN- FASTING 10.4500 300 $ 9.00 453001510 5-INSULIN- RANDOM 10.4500 300 $ 9.00 453001520 5-LACTIC ACID- CSF 10.4500 300 $ 7.20 453001530 5-LAMOTRIGINE (LAMICTAL) LEVEL 10.4500 300 $ 21.30 453001540 5-LEAD- WHOLE BLOOD VENOUS 10.4500 300 $ 7.00 453001550 5-LEGIONELLA ANTIBODY 10.4500 300 $ 11.10 453001560 5-LEGIONELLA PNEUMOPHILA DFA 10.4500 300 $ 37.20 453001570 5-LIPOPROTEIN ELECTROPHORESIS 10.4500 300 $ 51.60 453001580 LUPUS ANTICOAGULANT (PANEL) 10.4500 300 $ - 453001590 V-LUTEINIZING HORMONE 10.4500 300 $ 25.88 453001600 5-M.TUBERCULOSIS DETECTION- CS 10.4500 300 $ 194.70 453001610 5-MEASLES (RUBEOLA) AB- IGG 10.4500 300 $ 10.20 453001620 MEASLES (RUBEOLA) AB- IGG/IGM 10.4500 300 $ - 453001630 5-MEASLES (RUBEOLA) AB- IGM 10.4500 300 $ 10.20 453001640 5-METANEPHRINES- URINE FRACTIO 10.4500 300 $ 22.50 453001650 5-METHYLMALONIC ACID- SERUM 10.4500 300 $ 24.00 453001660 MICROALBUMIN URINE (PANEL) 10.4500 300 $ - 453001670 5-MITOCHONDRIAL M2 AB- IGG 10.4500 300 $ 10.00 453001680 MULTIPLE SCLEROSIS (PANEL) 10.4500 300 $ - 453001690 5-MUMPS VIRUS IGG ANTIBODY 10.4500 300 $ 9.00 453001700 5-MUMPS VIRUS IGM ANTIBODY 10.4500 300 $ 9.00 453001710 5-MYCOPHENOLIC ACID 10.4500 300 $ 30.00 453001720 MYCOPLAS- PNEUMON ABS-G/M (PAN 10.4500 300 $ - 453001730 5-MYELOPEROXIDASE AB 10.4500 300 $ 14.40 453001740 5-MYOGLOBIN- URINE 10.4500 300 $ 12.90 453001750 5-ANCA ANTIOBODY SCREEN 10.4500 300 $ 24.00 453001751 5-ANCA IgG TITER 10.4500 300 $ 40.20 453001754 5-CRYOGLOB IgG TITER 10.4500 300 $ 9.90 453001755 5-CRYOGLOB IgM TITER 10.4500 300 $ 9.90 453001756 5-CRYOGLOB IgA TITER 10.4500 300 $ 9.90 453001757 5-ENDOMYSIAL AB IgA TITER 10.4500 300 $ 40.20 453001760 5-NICOTINE AND COTININE META- 10.4500 300 $ 67.71 453001770 5-ORGANIC ACIDS- URINE 10.4500 300 $ 120.00 453001780 5-OXALATE- 24 HOUR URINE 10.4500 300 $ 14.40 453001790 5-OXCARBAZEPINE METABOLITE 10.4500 300 $ 24.00 453001800 PARVOVIRUS B19 AB- IGG IGM (PA 10.4500 300 $ - 453001810 PHOSPHATIDLYSERINE ANTIB (PAN 10.4500 300 $ - 453001820 5-PHOSPHOLIPIDS LEVEL 10.4500 300 $ 24.60 453001830 Z-PLATELET FUNCTION ASSAY 10.4500 300 $ 54.10 453001840 V-PROGESTERONE LEVEL 10.4500 300 $ 13.65 453001850 V-PROLACTIN LEVEL 10.4500 300 $ 15.00 453001860 5-PROTEIN C- FUNCTIONAL 10.4500 300 $ 24.00 453001870 PROTEIN C/S - FUNCTIONAL (PANE 10.4500 300 $ - 453001880 PROTEIN ELECTROPH-SERUM (PANEL 10.4500 300 $ - 453001890 5-PROTEIN S- FUNCTIONAL 10.4500 300 $ 39.00 453001900 PROTHROMBIN GENE MUTAT (PANEL) 10.4500 300 $ - 453001910 PSA FREE AND TOTAL (PANEL) 10.4500 300 $ - 453001920 PTH INTACT WITH CALCIUM (PANEL 10.4500 300 $ - 453001930 5-RENIN ACTIVITY 10.4500 300 $ 13.50 453001940 5-RIBONUCLEIC PROTEIN (ENA)- I 10.4500 300 $ 13.50 453001950 5-RIBOSOMAL P PROTEIN AB 10.4500 300 $ 24.00 453001960 V-ROTAVIRUS- STOOL 10.4500 300 $ 8.70 453001970 5-RPR- REFLEX TITER 10.4500 300 $ 6.00 453001980 5-RUBELLA IgG ANTIBODY 10.4500 300 $ 9.00 453001990 5-SCL70 (SCLERODERMA) AB- IGG 10.4500 300 $ 13.50 453002000 5-SERINE PROTEASE3 ANTIBODY 10.4500 300 $ 14.40 453002010 5-SIROLIMUS (RAPAMUNE) LEVEL 10.4500 300 $ 60.00 453002020 5-SMITH ANTIBODY- IGG 10.4500 300 $ 13.50 453002030 5-SMOOTH MUSCLE AB 10.4500 300 $ 13.80 453002031 5-SMOOTH MUSCLE IgG TITER 10.4500 300 $ 40.20 453002040 5-SSA (RO) ANTIBODY- IGG 10.4500 300 $ 13.50 453002050 5-SSB (LA) ANTIBODY- IGG 10.4500 300 $ 13.50 453002060 5-STRIATED MUSCLE ANTIBODY 10.4500 300 $ 16.50 453002070 TESTOSTERONE-FREE&TOTAL (PANEL 10.4500 300 $ - 453002080 5-TESTOSTERONE- TOTAL 10.4500 300 $ 12.60 453002090 5-TESTOSTERONE-FREE 10.4500 300 $ 13.50 453002095 5-TESTOSTERONE FEMALE/CHILD 10.4500 300 $ 35.10 453002100 5-THYROGLOBULIN ANTIBODY 10.4500 300 $ 9.00 453002110 THYROGLOBULIN LEVEL (PANEL) 10.4500 300 $ - 453002120 THYROID ANTIBODIES (PANEL) 10.4500 300 $ - 453002130 5-THYROID PEROXIDASE ANTIBODY 10.4500 300 $ 9.00 453002140 5-THYROID STIMULATING IMMUNOGL 10.4500 300 $ 69.00 453002150 5-THYROXINE (T4) 10.4500 300 $ 6.30 453002160 5-TOTAL T3 10.4500 300 $ 5.60 453002170 TOXOPLAMSA GONDII AB IGG IGM ( 10.4500 300 $ - 453002180 5-TRANSFERRIN 10.4500 300 $ 9.00 453002190 5-TRYPTASE 10.4500 300 $ 119.10 453002200 5-VANILLYLMANDELIC ACID-URINE 10.4500 300 $ 16.80 453002210 VAP CHOLESTEROL (PANEL) 10.4500 300 $ - 453002220 VARICELLA ZOSTER AB IGG IGM (P 10.4500 300 $ - 453002230 5-VASOACTIVE INTESTINAL PEPTID 10.4500 300 $ 28.50 453002240 5-VDRL- CSF 10.4500 300 $ 6.00 453002250 B-VDRL- SERUM 10.4500 300 $ 5.00 453002260 VIRAL CULTURE (PANEL) 10.4500 300 $ - 453002270 5-VISCOSITY- SERUM 10.4500 300 $ 10.50 453002280 5-VIT D 1-25 DIHYDROXY 10.4500 300 $ 30.00 453002290 V-VITAMIN B12 LEVEL 10.4500 300 $ 5.82 453002300 5-VITAMIN B6 LEVEL 10.4500 300 $ 17.10 453002310 5-VITAMIN D- 25HYDROXY 10.4500 300 $ 19.50 453002320 5-VITAMIN E LEVEL 10.4500 300 $ 15.00 453002330 VON WILLEBRAND FACT ASSAY(PANE 10.4500 300 $ - 453002340 WEST NILE AB PANEL CSF (PANEL) 10.4500 300 $ - 453002350 5-WEST NILE VIRUS AB IGG CSF 10.4500 300 $ 25.39 453002360 5-WEST NILE VIRUS AB IGG IGM 10.4500 300 $ 27.50 453002370 5-WEST NILE VIRUS AB IGM CSF 10.4500 300 $ 16.50 453002380 5-WEST NILE VIRUS ANTIBODY IGG 10.4500 300 $ 25.39 453002390 5-WEST NILE VIRUS ANTIBODY IGM 10.4500 300 $ 16.50 453002400 5-ZINC LEVEL 10.4500 300 $ 10.50 453080074 5-ACUTE HEPATITIS PANEL 10.4500 300 $ 42.00 453080100 5-DRUG SCREEN- QUALITATE/MULTI 10.4500 300 $ 21.38 453080101 5-DRUG SCREEN- QUALITATE/ADD 10.4500 300 $ 21.38 453080150 5-ASSAY OF AMIKACIN 10.4500 300 $ 12.60 453080197 D-ASSAY OF TACROLIMUS 10.4500 300 $ 100.00 453080299 5-QUANTITATIVE ASSAY- DRUG 10.4500 300 $ 19.50 453082024 5-ASSAY OF ACTH 10.4500 300 $ 25.50 453082040 5-ASSAY OF SERUM ALBUMIN 10.4500 300 $ 9.90 453082042 5-ASSAY OF URINE ALBUMIN 10.4500 300 $ 9.90 453082043 5-MICROALBUMIN- QUANTITATIVE 10.4500 300 $ 5.63 453082085 5-ASSAY OF ALDOLASE 10.4500 300 $ 7.00 453082088 5-ASSAY OF ALDOSTERONE 10.4500 300 $ 16.50 453082103 5-ALPHA-1-ANTITRYPSIN- TOTAL 10.4500 300 $ 7.50 453082105 5-ALPHA-FETOPROTEIN- SERUM 10.4500 300 $ 14.00 453082139 5-AMINO ACIDS- QUAN- 6 OR MORE 10.4500 300 $ 90.00 453082164 5-ANGIOTENSIN I ENZYME TEST 10.4500 300 $ 16.20 453082175 5-ASSAY OF ARSENIC 10.4500 300 $ 18.50 453082232 5-ASSAY OF BETA-2 PROTEIN 10.4500 300 $ 12.00 453082306 5-ASSAY OF VITAMIN D 10.4500 300 $ 19.50 453082310 5-ASSAY OF CALCIUM 10.4500 300 $ 9.75 453082378 V-CARCINOEMBRYONIC ANTIGEN 10.4500 300 $ 12.50 453082379 5-ASSAY OF CARNITINE 10.4500 300 $ 24.00 453082384 5-ASSAY- THREE CATECHOLAMINES 10.4500 300 $ 31.80 453082390 5-ASSAY OF CERULOPLASMIN 10.4500 300 $ 9.00 453082436 5-ASSAY OF URINE CHLORIDE 10.4500 300 $ 8.40 453082480 5-ASSAY- SERUM CHOLINESTERASE 10.4500 300 $ 13.05 453082482 5-ASSAY- RBC CHOLINESTERASE 10.4500 300 $ 13.05 453082525 5-ASSAY OF COPPER 10.4500 300 $ 13.50 453082530 5-CORTISOL- FREE 10.4500 300 $ 16.50 453082533 V-TOTAL CORTISOL 10.4500 300 $ 9.00 453082534 V-TOTAL CORTISOL - ADD 10.4500 300 $ 9.00 453082550 5-ASSAY OF CK (CPK) 10.4500 300 $ 9.00 453082552 5-ASSAY OF CPK IN BLOOD 10.4500 300 $ 9.00 453082570 5-ASSAY OF URINE CREATININE 10.4500 300 $ 5.63 453082595 5-ASSAY OF CRYOGLOBULIN 10.4500 300 $ 9.00 453082607 V-VITAMIN B-12 10.4500 300 $ 5.82 453082626 5-DEHYDROEPIANDROSTERONE 10.4500 300 $ 15.00 453082627 5-DEHYDROEPIANDROSTERONE 10.4500 300 $ 12.00 453082652 5-ASSAY OF DIHYDROXYVITAMIN D 10.4500 300 $ - 453082668 5-ASSAY OF ERYTHROPOIETIN 10.4500 300 $ - 453082670 V-ASSAY OF ESTRADIOL 10.4500 300 $ 21.34 453082746 V-BLOOD FOLIC ACID SERUM 10.4500 300 $ 8.82 453082783 5-ASSAY OF GAMMAGLOB IGM ADD 10.4500 300 $ 6.00 453082784 5-ASSAY OF GAMMAGLOBULIN IGM 10.4500 300 $ 6.00 453082785 5-ASSAY OF GAMMAGLOBULIN IGE 10.4500 300 $ 8.75 453082787 5-IGG 1- 2- 3 OR 4- EACH 10.4500 300 $ 14.40 453082788 5-IGG 1- 2- 3 OR 4- ADD 10.4500 300 $ 14.40 453082941 5-ASSAY OF GASTRIN 10.4500 300 $ 13.50 453082955 5-ASSAY OF G6PD ENZYME 10.4500 300 $ 15.00 453083001 V-GONADOTROPIN (FSH) 10.4500 300 $ 7.76 453083002 V-GONADOTROPIN (LH) 10.4500 300 $ 25.88 453083003 5-ASSAY- GROWTH HORMONE (HGH) 10.4500 300 $ 15.00 453083010 5-ASSAY OF HAPTOGLOBIN- QUANT 10.4500 300 $ 9.50 453083021 5-HEMOGLOBIN CHROMOTOGRAPHY 10.4500 300 $ 15.00 453083051 5-ASSAY OF PLASMA HEMOGLOBIN 10.4500 300 $ 15.30 453083070 5-ASSAY OF HEMOSIDERIN- QUAL 10.4500 300 $ 9.00 453083090 V-ASSAY OF HOMOCYSTINE 10.4500 300 $ 19.50 453083497 5-ASSAY OF 5-HIAA 10.4500 300 $ 16.80 453083516 5-IMMUNOASSAY- NONANTIBODY 10.4500 300 $ 9.00 453083517 5-IMMUNOASSAY- NONANTIBODY ADD 10.4500 300 $ 12.00 453083519 5-IMMUNOASSAY- NONANTIBODY 10.4500 300 $ 42.00 453083520 5-IMMUNOASSAY- RIA 10.4500 300 $ 119.10 453083525 5-ASSAY OF INSULIN 10.4500 300 $ 9.00 453083605 5-ASSAY OF LACTIC ACID 10.4500 300 $ 7.20 453083655 5-ASSAY OF LEAD 10.4500 300 $ 7.00 453083715 5-ASSAY OF BLOOD LIPOPROTEINS 10.4500 300 $ 51.60 453083716 5-ASSAY OF BLOOD LIPOPROTEINS 10.4500 300 $ 47.50 453083825 5-ASSAY OF MERCURY 10.4500 300 $ 7.00 453083835 5-ASSAY OF METANEPHRINES 10.4500 300 $ 22.50 453083873 5-ASSAY OF CSF PROTEIN 10.4500 300 $ 20.70 453083874 5-ASSAY OF MYOGLOBIN 10.4500 300 $ 12.90 453083883 5-ASSAY- NEPHELOMETRY NOT SPEC 10.4500 300 $ 16.79 453083884 5-ASSAY- NEPHELOMETRY ADD 10.4500 300 $ 19.37 453083887 5-ASSAY OF NICOTINE 10.4500 300 $ 67.71 453083890 5-MOLECULE ISOLATE 10.4500 300 $ 42.50 453083892 5-MOLECULAR DIAGNOSTICS 10.4500 300 $ 42.50 453083894 5-MOLECULE GEL ELECTROPHOR 10.4500 300 $ 10.50 453083896 5-MOLECULAR DIAGNOSTICS 10.4500 300 $ 7.38 453083897 5-MOLECULAR DIAGNOSTICS - ADD 10.4500 300 $ 7.38 453083898 5-MOLECULE NUCLEIC AMPLI 10.4500 300 $ 7.38 453083901 5-MOLECULE NUCLEIC AMPLI 10.4500 300 $ 42.50 453083912 5-GENETIC EXAMINATION 10.4500 300 $ 7.38 453083916 5-OLIGOCLONAL BANDS 10.4500 300 $ 39.00 453083918 5-ORGANIC ACIDS- TOTAL- QUANT 10.4500 300 $ 120.00 453083921 5-ORGANIC ACID- SINGLE- QUANT 10.4500 300 $ 24.00 453083945 5-ASSAY OF OXALATE 10.4500 300 $ 14.40 453083970 5-ASSAY OF PARATHORMONE 10.4500 300 $ 9.75 453084075 5-ASSAY ALKALINE PHOSPHATASE 10.4500 300 $ 8.55 453084080 5-ASSAY ALKALINE PHOSPHATASES 10.4500 300 $ 8.55 453084144 V-ASSAY OF PROGESTERONE 10.4500 300 $ 13.65 453084146 V-ASSAY OF PROLACTIN 10.4500 300 $ 15.00 453084153 5-ASSAY OF PSA- TOTAL 10.4500 300 $ 11.25 453084154 5-ASSAY OF PSA- FREE 10.4500 300 $ 11.25 453084156 5-ASSAY OF PROTEIN, URINE 10.4500 300 $ 5.63 453084160 5-ASSAY OF PROTEIN- ANY SOURCE 10.4500 300 $ 6.13 453084165 5-PROTEIN E-PHORESIS- SERUM 10.4500 300 $ 6.13 453084207 5-ASSAY OF VITAMIN B-6 10.4500 300 $ 17.10 453084238 5-ASSAY- NONENDOCRINE RECEPTOR 10.4500 300 $ 36.00 453084239 5-ASSAY- NONENDOCRINE RECEPTOR 10.4500 300 $ 36.00 453084244 5-ASSAY OF RENIN 10.4500 300 $ 13.50 453084270 5-ASSAY OF SEX HORMONE GLOBUL 10.4500 300 $ 18.60 453084311 5-SPECTROPHOTOMETRY 10.4500 300 $ 12.00 453084402 5-ASSAY OF TESTOSTERONE 10.4500 300 $ 13.50 453084403 5-ASSAY OF TOTAL TESTOSTERONE 10.4500 300 $ 12.60 453084432 5-ASSAY OF THYROGLOBULIN 10.4500 300 $ 17.40 453084436 5-ASSAY OF TOTAL THYROXINE 10.4500 300 $ 6.30 453084445 5-ASSAY OF TSI 10.4500 300 $ 69.00 453084446 5-ASSAY OF VITAMIN E 10.4500 300 $ 15.00 453084466 5-ASSAY OF TRANSFERRIN 10.4500 300 $ 9.00 453084478 5-ASSAY OF TRIGLYCERIDES 10.4500 300 $ 47.50 453084480 5-ASSAY- TRIIODOTHYRONINE (T3) 10.4500 300 $ 5.60 453084481 5-FREE ASSAY (FT-3) 10.4500 300 $ 10.75 453084585 5-ASSAY OF URINE VMA 10.4500 300 $ 16.80 453084586 5-ASSAY OF VIP 10.4500 300 $ 28.50 453084630 5-ASSAY OF ZINC 10.4500 300 $ 10.50 453084681 5-ASSAY OF C-PEPTIDE 10.4500 300 $ 12.00 453084702 5-CHORIONIC GONADOTROPIN TEST 10.4500 300 $ 12.90 453085240 5-BLOOD CLOT FACTOR VIII TEST 10.4500 300 $ 19.50 453085245 5-BLOOD CLOT FACTOR VIII TEST 10.4500 300 $ 19.50 453085246 5-BLOOD CLOT FACTOR VIII TEST 10.4500 300 $ 39.00 453085300 5-ANTITHROMBIN III TEST 10.4500 300 $ 24.60 453085301 5-ANTITHROMBIN III TEST 10.4500 300 $ 24.60 453085303 5-BLOOD CLOT INHIBITOR TEST 10.4500 300 $ 24.00 453085306 5-BLOOD CLOT INHIBITOR TEST 10.4500 300 $ 39.00 453085410 5-FIBRINOLYTIC ANTIPLASMIN 10.4500 300 $ 36.60 453085576 Z-BLOOD PLATELET AGGREGATION 10.4500 300 $ 54.10 453085610 5-PROTHROMBIN TIME 10.4500 300 $ 9.70 453085613 5-RUSSELL VIPER VENOM- DILUTED 10.4500 300 $ 9.70 453085730 5-THROMBOPLASTIN TIME- PARTIAL 10.4500 300 $ 9.70 453085810 5-BLOOD VISCOSITY EXAMINATION 10.4500 300 $ 10.50 453086003 5-ALLERGEN SPECIFIC IGE 10.4500 300 $ 16.85 453086004 5-ALLERGEN SPECIFIC IGE ADD 10.4500 300 $ 16.85 453086022 5-PLATELET ANTIBODIES 10.4500 300 $ 160.00 453086060 5-ANTISTREPTOLYSIN O- TITER 10.4500 300 $ 9.90 453086146 5-GLYCOPROTEIN ANTIBODY 10.4500 300 $ 39.00 453086147 5-CARDIOLIPIN ANTIBODY 10.4500 300 $ 12.60 453086148 5-PHOSPHOLIPID ANTIBODY 10.4500 300 $ 19.50 453086149 5-PHOSPHOLIPID ANTIBODY ADD 10.4500 300 $ 19.50 453086159 5-COMPLEMENT- ANTIGEN - ADD 10.4500 300 $ 27.30 453086160 5-COMPLEMENT- ANTIGEN 10.4500 300 $ 27.30 453086162 5-COMPLEMENT- TOTAL (CH50) 10.4500 300 $ 8.75 453086225 5-DNA ANTIBODY 10.4500 300 $ 12.00 453086235 5-NUCLEAR ANTIGEN ANTIBODY 10.4500 300 $ 24.00 453086236 5-NUCLEAR ANTIGEN ANTIBODY ADD 10.4500 300 $ 10.88 453086255 5,V-FLUORESCENT ANTIBODY- SCRE 10.4500 300 $ 8.75 453086256 5-FLUORESCENT ANTIBODY- GBM 10.4500 300 $ 141.25 453086300 5-IMMUNOASSAY- TUMOR- CA 15-3 10.4500 300 $ 15.00 453086301 5-IMMUNOASSAY- TUMOR- CA 19-9 10.4500 300 $ 15.00 453086316 5,V-IMMUNOASSAY- TUMOR OTHER 10.4500 300 $ 12.50 453086317 5-IMMUNOASSAY-INFECTIOUS AGENT 10.4500 300 $ 10.50 453086331 5-IMMUNODIFFUSION OUCHTERLONY 10.4500 300 $ 10.50 453086332 5-IMMUNODIFFUSION OUCHTER ADD 10.4500 300 $ 10.50 453086334 5-IMMUNOFIX E-PHORESIS- SERUM 10.4500 300 $ 14.12 453086335 5-IMMUNFIX E-PHORSIS/URINE/CSF 10.4500 300 $ 19.27 453086337 5-INSULIN ANTIBODIES 10.4500 300 $ 39.00 453086359 5-T CELLS- TOTAL COUNT 10.4500 300 $ 21.75 453086360 5-T CELL- ABSOLUTE COUNT/RATIO 10.4500 300 $ 21.75 453086376 5-MICROSOMAL ANTIBODY 10.4500 300 $ 9.00 453086592 V,B-BLOOD SEROLOGY- QUALITATIV 10.4500 300 $ 5.00 453086603 5-ADENOVIRUS ANTIBODY 10.4500 300 $ 10.50 453086604 5-ADENOVIRUS ANTIBODY - ADD 10.4500 300 $ 10.50 453086606 5-ASPERGILLUS ANTIBODY 10.4500 300 $ 12.00 453086607 5-ASPERGILLUS ANTIBODY - ADD 10.4500 300 $ 12.00 453086611 5-BARTONELLA ANTIBODY 10.4500 300 $ 11.10 453086612 5-BARTONELLA ANTIBODY - ADD 10.4500 300 $ 11.10 453086615 5-BORDETELLA ANTIBODY 10.4500 300 $ 18.00 453086616 5-BORDETELLA ANTIBODY - ADD 10.4500 300 $ 18.00 453086618 5-LYME DISEASE ANTIBODY 10.4500 300 $ 9.00 453086622 5-BRUCELLA ANTIBODY 10.4500 300 $ 16.80 453086623 5-BRUCELLA ANTIBODY - ADD 10.4500 300 $ 16.80 453086631 5-CHLAMYDIA ANTIBODY 10.4500 300 $ 9.00 453086632 5-CHLAMYDIA IGM ANTIBODY 10.4500 300 $ 9.00 453086633 5-CHLAMYDIA ANTIBODY - ADD 10.4500 300 $ 9.00 453086634 5-CHLAMYDIA IGM ANTIBODY-ADD 10.4500 300 $ 9.00 453086635 5-COCCIDIOIDES ANTIBODY 10.4500 300 $ 10.50 453086636 5-COCCIDIOIDES ANTIBODY-ADD 10.4500 300 $ 10.50 453086644 5-CMV ANTIBODY 10.4500 300 $ 10.80 453086645 5-CMV ANTIBODY- IGM 10.4500 300 $ 10.80 453086663 5-EPSTEIN-BARR ANTIBODY 10.4500 300 $ - 453086664 5-EPSTEIN-BARR ANTIBODY 10.4500 300 $ 9.60 453086665 5-EPSTEIN-BARR ANTIBODY 10.4500 300 $ 9.60 453086666 5-EPSTEIN-BARR ANTIBODY - ADD 10.4500 300 $ 9.60 453086667 5-EPSTEIN-BARR ANTIBODY - ADD 10.4500 300 $ 9.60 453086694 5-HERPES SIMPLEX TEST 10.4500 300 $ 12.00 453086695 5-HERPES SIMPLEX TEST - ADD 10.4500 300 $ 12.00 453086703 V-HIV-1/HIV-2- SINGLE ASSAY 10.4500 300 $ 12.41 453086704 5-HEP B CORE ANTIBODY- TOTAL 10.4500 300 $ 6.30 453086705 5-HEP B CORE ANTIBODY- IGM 10.4500 300 $ 17.15 453086706 5-HEP B SURFACE ANTIBODY 10.4500 300 $ 7.00 453086708 5-HEP A ANTIBODY- TOTAL 10.4500 300 $ 8.75 453086709 5-HEP A ANTIBODY- IGM 10.4500 300 $ 10.50 453086710 5-INFLUENZA VIRUS ANTIBODY 10.4500 300 $ 8.10 453086711 5-INFLUENZA VIRUS ANTIBODY - A 10.4500 300 $ 8.10 453086713 5-LEGIONELLA ANTIBODY 10.4500 300 $ 11.10 453086735 5-MUMPS ANTIBODY 10.4500 300 $ 9.00 453086738 5-MYCOPLASMA ANTIBODY 10.4500 300 $ 10.50 453086739 5-MYCOPLASMA ANTIBODY-ADD 10.4500 300 $ 10.50 453086747 5-PARVOVIRUS ANTIBODY 10.4500 300 $ 16.50 453086748 5-PARVOVIRUS ANTIBODY - ADD 10.4500 300 $ 16.50 453086762 V-RUBELLA ANTIBODY 10.4500 300 $ 9.50 453086765 5-RUBEOLA ANTIBODY 10.4500 300 $ 10.20 453086766 5-RUBEOLA ANTIBODY - ADD 10.4500 300 $ 10.20 453086778 5-TOXOPLASMA ANTIBODY- IGM 10.4500 300 $ 10.50 453086787 5-VARICELLA-ZOSTER ANTIBODY 10.4500 300 $ 10.50 453086788 5-VARICELLA-ZOSTER ANTIB-ADD 10.4500 300 $ 10.50 453086790 5-VIRUS ANTIBODY NOS 10.4500 300 $ 16.50 453086791 5-VIRUS ANTIBODY NOS - ADD 10.4500 300 $ 16.50 453086800 5-THYROGLOBULIN ANTIBODY 10.4500 300 $ 9.00 453086803 5-HEPATITIS C AB TEST 10.4500 300 $ 11.50 453086812 5-HLA TYPING- A- B- OR C 10.4500 300 $ 32.40 453087015 5-SPECIMEN CONCENTRATION 10.4500 300 $ 18.30 453087106 B-FUNGI ID - PUBLIC HEALTH DEP 10.4500 300 $ 10.00 453087116 5-AFB CULTURE 10.4500 300 $ 48.00 453087206 5-AFB STAIN 10.4500 300 $ 18.30 453087252 5-VIRUS INOCULATION- TISSUE 10.4500 300 $ 12.00 453087253 5-VIRUS INOCULATE TISSUE- ADDL 10.4500 300 $ 12.00 453087278 5-LEGION PNEUMOPHILIA AG- IF 10.4500 300 $ 37.20 453087329 5-GIARDIA AG- EIA 10.4500 300 $ 15.00 453087338 5-HPYLORI- STOOL- EIA 10.4500 300 $ 49.50 453087340 5-HEPATITIS B SURFACE AG- EIA 10.4500 300 $ 7.00 453087425 V-ROTAVIRUS AG- EIA 10.4500 300 $ 8.70 453087449 5-AG DETECT NOS- EIA- MULT 10.4500 300 $ 109.10 453087491 V-CHYLMD TRACH- DNA- AMP PROBE 10.4500 300 $ 31.53 453087522 5-HEPATITIS C- RNA- QUANT 10.4500 300 $ 141.00 453087536 5-HIV-1- DNA- QUANT 10.4500 300 $ 120.00 453087556 5-M.TUBERCULO- DNA- AMP PROBE 10.4500 300 $ 198.70 453087591 V-N.GONORRHOEAE- DNA- AMP PROB 10.4500 300 $ 31.53 453087798 5-DETECT AGENT NOS- DNA- AMP 10.4500 300 $ 32.25 453087799 5-DETECT AGNT NOS-DNA-AMP-ADD 10.4500 300 $ 32.25 453087902 5-GENOTYPE- DNA- HEPATITIS C 10.4500 300 $ - 453088180 5-CELL MARKER STUDY 10.4500 300 $ 24.00 453088181 5-CELL MARKER STUDY - ADD 10.4500 300 $ 24.00 453088184 E-FLOWCYTOMETRY/ TC- 1 MARKER 10.4500 300 $ 105.00 453088185 E-FLOWCYTOMETRY/TC- ADD-ON 10.4500 300 $ 105.00 453088187 E-FLOWCYTOMETRY/READ- 2-8 10.4500 300 $ 105.00 453088188 E-FLOWCYTOMETRY/READ- 9-15 10.4500 300 $ 105.00 453088189 E-FLOWCYTOMETRY/READ- 16 & > 10.4500 300 $ 105.00 453088230 5-TISSUE CULTURE- LYMPHOCYTE 10.4500 300 $ 87.50 453088237 E-TISSUE CULTURE- BONE MARROW 10.4500 300 $ 275.00 453088262 E,5-CHROMOSOME ANALYSIS- 15-20 10.4500 300 $ 275.00 453088280 5-CHROMOSOME KARYOTYPE STUDY 10.4500 300 $ 87.50 453088291 5-CYTO/MOLECULAR REPORT 10.4500 300 $ 12.00 453096147 5-CARDIOLIPIN ANTIBODY ADD'L 10.4500 300 $ 12.60 454000001 MT TEST HEMATOLOGY CHARGES 10.4540 300 $ - 454000016 TRANSFUSE CRYOPRECIPITATE 10.4540 391 $ - 454000106 JUMBO FFP 10.4540 300 $ - 454000301 CHARGE - ABO TYPING 10.4500 300 $ 36.30 454000302 CHARGE - DIRECT COOMBS 10.4500 300 $ 75.90 454000303 CHARGE - RH TYPING 10.4500 300 $ 36.30 454000304 CHARGE - AB ID 10.4500 300 $ 240.90 454000306 CHARGE - FETAL SCREEN 10.4500 301 $ 60.50 454000308 CHARGE - THAW JUMBO FFP 10.4500 300 $ 6.60 454000309 CHARGE - AB SCREEN WITH XM 10.4500 300 $ 59.40 454000310 CHARGE - AB SCREEN 10.4500 300 $ 60.50 454000311 CHARGE - PRE WARM AB SCREEN 10.4500 300 $ 24.20 454000312 CHARGE - THAW FFP 10.4500 300 $ 6.60 454000313 CHARGE - RBC ALIQUOT 10.4540 380 $ 82.00 454000314 CHARGE - IMMEDIATE SPIN 10.4500 300 $ 24.20 454000315 CHARGE - CROSSMATCH 10.4500 300 $ 103.40 454000316 CHARGE - UNIT TESTED CMV NEG 10.4540 302 $ 40.00 454000317 CHARGE - IRR/HLA MATCHING 10.4540 300 $ 268.00 454000319 CHARGE - 1 CRYO 10.4540 390 $ 75.00 454000322 CHARGE - 8 POOLED PLATELETS 10.4540 300 $ 471.00 454000323 CHARGE - MEDICARE AT 10.4540 390 $ 320.00 454000324 CHARGE - AUTOLOGOUS RBC 10.4540 390 $ - 454000325 CHARGE - AUTOLOGOUS WHOLE BLOO 10.4540 380 $ - 454000326 CHARGE - AUTOLOGOUS FFP 10.4540 380 $ - 454000327 CHARGE-CRYO-POOR PLASMA 10.4540 380 $ 95.00 454000328 CHARGE - DIRECTED RBC 10.4540 380 $ 300.00 454000329 CHARGE-FREASH FROZEN PLASMA 10.4540 390 $ 75.00 454000330 CHARGE-GRANULOCYTES PHERESIS 10.4540 380 $ 1,500.00 454000331 CHARGE - MICRHOGAM 10.4540 250 $ 53.90 454000332 CHARGE - HLA PLATELETPHERESIS 10.4540 380 $ 862.00 454000333 CHARGE - IRR/HLA PLATELETPHERE 10.4540 390 $ 970.00 454000334 CHARGE - PLATELETPHERESIS 10.4540 390 $ 670.00 454000335 CHARGE - IRR PLATELETPHERESIS 10.4540 390 $ 720.00 454000336 CHARGE-PLTPHERESIS IRRAD ALB 10.4540 390 $ 812.00 454000337 CHARGE - PLATELET CONCENTRATE 10.4540 390 $ 54.00 454000338 CHARGE - XM PLATELETPHERESIS 10.4540 390 $ 712.00 454000339 CHARGE - IRR XM PLATELETPHERES 10.4540 390 $ 820.00 454000341 CHARGE - IRRADIATED RBC 10.4540 390 $ 298.00 454000342 CHARGE -DEGLYCED RBC 10.4540 390 $ 378.00 454000343 CHARGE - RHOGAM 10.4540 636 $ 140.00 454000344 CHARGE - WASHED RBC 10.4540 390 $ 278.00 454000345 CHARGE - IRRADIATED WASHED RBC 10.4540 390 $ 328.00 454000346 CHARGE - PLATELET CROSSMATCH 10.4500 300 $ 117.70 454000347 CHARGE - THAW 10 CRYO 10.4500 300 $ 59.40 454000348 CHARGE - THAW 1 CRYO 10.4500 300 $ 6.60 454000350 CHARGE - THAW 8 CRYO 10.4500 300 $ 47.30 454000351 CHARGE - POOL 8 PLATELETS 10.4500 300 $ 47.30 454000352 CHARGE - THAW CRYO-POOR PLASMA 10.4500 300 $ 6.60 454000359 CHARGE - RBC 10.4540 390 $ 248.00 454000360 CHARGE - AG TYPING 10.4500 300 $ 55.00 454000361 CHARGE - AB TITER 10.4500 300 $ 80.30 454000365 CHARGE-JUMBO FRSH FRZN PLASM 10.4540 390 $ 254.00 454009503 FRESH FROZEN PLASMA-CRYO POOR 10.4540 390 $ 95.00 454030000 WHOLE BLOOD. 10.4540 390 $ 228.00 454030025 PACKED RED CELLS 10.4540 390 $ 211.00 454030300 PLATELETS 10.4540 390 $ 83.00 454086965 POOL PLATELETS PER UNIT 10.4500 302 $ 4.40 457000306 INFUSION SEQUENTIAL 1ST HOUR 10.4570 260 $ 158.00 457000307 INFUSION THERAPY 1ST HOUR 10.4570 260 $ 315.00 457000308 INFUSION HYDRATION 1ST HOUR 10.4570 260 $ 315.00 457003208 PERM PACEMAKER DDD W/LEAD 10.4570 480 $ 5,659.00 457022520 PERCUT VERTEBROPLASTY THOR 10.4570 361 $ 558.00 457022521 PERCUT VERTEBROPLASTY LUMB 10.4570 361 $ 558.00 457022522 PERCUT VERTEBROPLASTY ADD'L 10.4570 361 $ 558.00 457032002 PC CHEST TUBE INSERTION 10.4570 361 $ 533.00 457033010 PERICARDIOCENTESIS 10.4570 361 $ 6,152.00 457033100 CARDIOVERSION - EXTERNAL 10.4570 480 $ 1,114.00 457033206 I OR R PP W ATRIAL LEAD 10.4570 361 $ 5,023.00 457033207 I OR R PP W VENTRICULAR LEAD 10.4570 361 $ 5,023.00 457033208 I OR R PP W ATRIAL/VENT LEAD 10.4570 480 $ 5,659.00 457033210 TEMPORARY PACING LEAD INSERT 10.4570 361 $ 1,858.00 457033211 ER-PLSE GENERATOR REPL DUAL CH 10.4570 361 $ 7,054.00 457033212 I OR R GEN ONLY SINGLE CH 10.4570 361 $ 5,023.00 457033213 I OR R GEN ONLY DUAL CH 10.4570 361 $ 5,023.00 457033214 UPGRADE SINGLE TO DUAL SYSTEM 10.4570 361 $ 5,659.00 457033215 REPO OF PP OR ICD A OR V LEAD 10.4570 361 $ 7,772.00 457033216 INSERT SINGLE LEAD PP OR ICD 10.4570 361 $ 5,023.00 457033217 INSERT DUAL LEADS PP OR ICD 10.4570 361 $ 5,659.00 457033218 REPAIR SGL LEAD PP OR ICD 10.4570 361 $ 1,858.00 457033220 REPAIR DUAL LEADS PP OR ICD 10.4570 361 $ 1,858.00 457033222 REV / RELOC SKIN POCKET PP 10.4570 361 $ 4,942.00 457033223 REV / RELOC SKIN POCKET ICD 10.4570 361 $ 4,942.00 457033224 INSRT LV LEAD EXISTING PP ICD 10.4570 361 $ 4,942.00 457033225 INSRT LV PACING SYS PP ICD 10.4570 361 $ 5,500.00 457033226 REPOS LV LEAD EXISTING PP ICD 10.4570 361 $ 2,420.00 457033233 PERMANENT PACEMAKER REMOVAL 10.4570 361 $ 5,023.00 457033234 PACEMAKER REMOVAL-SINGLE LEAD 10.4570 361 $ 3,080.00 457033235 PACEMAKER REMOVAL-DUAL LEAD 10.4570 361 $ 5,023.00 457033239 INSERTION SINGLE ICD G0297 10.4570 361 $ 3,080.00 457033240 INSERTION DUAL ICD G0298 10.4570 361 $ 3,300.00 457033241 REMOVAL SINGLE/DUAL SYS W ICD 10.4570 361 $ 3,300.00 457033244 TRANSVEN EXTRACT ICD ELCTRDS 10.4570 361 $ 2,200.00 457033248 INSRT/REPOSIT SINGLE ICD G0299 10.4570 361 $ 3,080.00 457033249 INSRT/REPOS LD&DUAL ICD G0300 10.4570 361 $ 3,080.00 457033282 IMPLANT LOOP RECORDER 10.4570 361 $ 2,167.00 457033284 LOOP RECORDER REMOVE 10.4570 361 $ 2,167.00 457033300 INSRT/REPOSIT LEAD & DUAL ICD 10.4570 361 $ 3,080.00 457034802 ENDOVAS REPAIR AAA 10.4570 361 $ 3,446.00 457034900 ENDOVAS REPAIR ILLIAC ANS 10.4570 361 $ 2,915.00 457035470 PTA TIBIA 10.4570 361 $ 1,620.00 457035471 PTA RENAL 10.4570 361 $ 4,013.00 457035472 PTA AORTIC 10.4570 361 $ 1,620.00 457035473 PTA ILLIAC 10.4570 361 $ 2,480.00 457035474 PTA FEM POP 10.4570 361 $ 1,620.00 457035475 PTA BRACHIAL CEPH VES 10.4570 361 $ 554.00 457035476 PTA VENOUS 10.4570 361 $ 2,480.00 457035490 PERC TRNS LM PER ATHRCT RENAL 10.4570 361 $ 5,280.00 457035492 PERC TRNS LM PER ATHRCT ILLIAC 10.4570 361 $ 5,280.00 457035493 PERC TRNS LM PER ATHRCT FEMPOP 10.4570 361 $ 5,280.00 457035495 PERC TRNS LM PER ATHRCT TIBTRK 10.4570 361 $ 5,280.00 457036005 INJECTION EXT VENOGRAPHY 10.4570 361 $ 424.00 457036010 VENCAVAGRAM INF/SUP 10.4570 361 $ 798.00 457036011 CATH PLC 1ST ORD REN/JUG 10.4570 361 $ 734.00 457036012 CATH PLC 2ND ORD 10.4570 361 $ 734.00 457036014 CATH PLC PULMPNARY ART 10.4570 361 $ 526.00 457036015 CATH PLC PULMONARY ART SEG 10.4570 361 $ 1,083.00 457036120 EST ACC TO ART-BRACH 10.4570 361 $ 1,139.00 457036140 EST ACC TO ART-EXTREMITY 10.4570 361 $ 1,139.00 457036200 CATH PLC ABD AORTA 10.4570 361 $ 1,004.00 457036215 IR INJ CEREBRAL 1ST ORDER 10.4570 361 $ 2,208.00 457036216 IR INJ CEREBRAL 2ND ORDER 10.4570 361 $ 1,482.00 457036217 IR INJ CEREBRAL 3RD ORDER 10.4570 361 $ 1,766.00 457036218 IR INJ CEREBRAL 4TH ORDER 10.4570 361 $ 1,755.00 457036245 CATH PLC 1ST ORD AA OR LE 10.4570 361 $ 1,419.00 457036246 CATH PLC 2ND ORD AA OR LE 10.4570 361 $ 2,571.00 457036247 CATH PLC 3RD ORD AA OR LE 10.4570 361 $ 2,571.00 457036489 INSERTION OF VENOUS CATHETER 10.4570 361 $ 885.00 457037201 TRANSCATH THROM INFUSION 10.4570 361 $ 2,226.00 457037205 TRANSCATH PLC INT V STENTS 10.4570 361 $ 1,620.00 457037206 TRANSCATH PLC INT V STENTS ADD 10.4570 361 $ 1,620.00 457037620 IR INJ. I.V.C. FILTER PLACEMEN 10.4570 361 $ 3,773.00 457041000 LT HEART CATH DISCONTINUED A/A 10.4570 481 $ 6,919.00 457041001 ER-LT HEART CATH DISCONTINUED 10.4570 481 $ 8,397.00 457041002 RT/LT HEART CATH DISCONTINUED 10.4570 481 $ 8,596.00 457041003 ER-RT/LT HEART CATH DISCONT A/ 10.4570 481 $ 10,857.00 457041004 RT HEART CATH DISCONTINUED A/A 10.4570 481 $ 7,014.00 457041005 ER-RT HEART CATH DISCONTINUED 10.4570 481 $ 7,826.00 457041006 RT HRT CATH/TRANS LT HRT DIS A 10.4570 481 $ 8,596.00 457041007 ER-RT HRT CATH/TRANS LT HRT DI 10.4570 481 $ 8,596.00 457041008 BILAT CORON ANGIO DISCONT A/A 10.4570 481 $ 5,607.00 457041009 ER BIL CORON ANGIO DISCONT A/A 10.4570 481 $ 8,147.00 457041010 UNILAT CORON ANGIO DISCONT A/A 10.4570 481 $ 2,446.00 457041011 ER-UNILAT CORON ANGIO DISCONT 10.4570 481 $ 2,446.00 457041012 LV ANGIOGRAM DISCONTINUED A/A 10.4570 481 $ 1,401.00 457041013 ER-LV ANGIOGRAM DISCONTINUED A 10.4570 481 $ 1,807.00 457041014 CORONARY ANGIOPLASTY DISCONT. 10.4570 480 $ 17,350.00 457041015 ER-CORON ANGIOPLASTY DISCONT. 10.4570 480 $ 20,583.00 457041016 CORONARY STENT DISCONTINUED A/ 10.4570 480 $ 17,350.00 457041017 ER-CORON STENT DISCONTINUED A/ 10.4570 480 $ 20,583.00 457041018 LT HRT CATH-NO LV ACCESS DIS A 10.4570 480 $ 6,919.00 457041019 ER-LT HRT CATH-NO LV ACC DISC 10.4570 480 $ 8,397.00 457063541 PUL. ARTERY ANGIOGRAM ADDL STU 10.4570 480 $ 2,079.00 457063545 UNILAT CORONARY INJ.(ADD'L STU 10.4570 481 $ 2,446.00 457071034 FLOURO EXAM CHEST 10.4570 324 $ 655.00 457071049 ER-CORONARY STENT DES PRIMARY 10.4570 481 $ 14,331.00 457071050 ER-CORONARY STENT DES EA ADD'L 10.4570 481 $ 2,931.00 457071051 ER-CORONARY STENT DES PRIM-LD 10.4570 481 $ 14,331.00 457071052 ER-CORONARY STENT DES PRIM-RC 10.4570 481 $ 14,331.00 457071053 ER-CORONARY STENT DES PRIM-LCX 10.4570 481 $ 14,331.00 457071054 ER-CORONARY STENT DES ADD -LD 10.4570 481 $ 3,152.00 457071055 ER-CORONARY STENT DES ADD - RC 10.4570 481 $ 3,152.00 457071056 ER-CORONARY STENT DES ADD -LCX 10.4570 481 $ 3,152.00 457071090 FLUORO - PACEMAKER INSERTION 10.4570 320 $ 257.00 457075605 SUP & INTERP ANG THOR ARCH 10.4570 320 $ 2,076.00 457075625 SUP & INTERP ABD AORTA 10.4570 320 $ 2,076.00 457075630 SUP & INTERP AA/ILLIOFEM/LX 10.4570 320 $ 2,167.00 457075650 SUP & INTERP CERVICOCEREBRAL 10.4570 320 $ 840.00 457075658 SUP & INTERP BRACHIAL RETRO 10.4570 361 $ 2,076.00 457075660 SUP & INTERP EX CAROTID SELECT 10.4570 361 $ 1,158.00 457075662 SUP & INTERP BILAT CAROTID 10.4570 361 $ 2,076.00 457075665 SUP & INTERP CAROTID CEREB UNI 10.4570 320 $ 2,076.00 457075671 SUP & INTERP BILAT CAROTID 10.4570 320 $ 2,076.00 457075676 SUP & INTERP UNI LAT CAROTID 10.4570 361 $ 1,887.00 457075680 SUP & INTERP BILAT CAROTID 10.4570 323 $ 2,076.00 457075710 SUP & INTERP UNI LAT EXTREMITY 10.4570 320 $ 2,076.00 457075716 SUP & INTERP BILAT EXTREMITY 10.4570 320 $ 2,076.00 457075722 SUP & INTERP UNI LAT RENAL 10.4570 320 $ 1,579.00 457075724 SUP & INTERP BILAT RENAL 10.4570 320 $ 2,076.00 457075774 SUP & INTERP EACH ADD'L VESSL 10.4570 361 $ 1,158.00 457075896 SUP & INTERP THROMBOLYSIS 10.4570 320 $ 3,456.00 457075898 THROMBOLYSIS-FOLLOWUP 10.4570 320 $ 141.00 457075933 TRANS LUM ARTHRECTOMY EA ADD V 10.4570 320 $ 2,096.00 457075954 SUP & INTERP REPAIR ILLIAC ART 10.4570 361 $ 531.00 457075960 SUP & INTERP STENT PLC OTHER 10.4570 320 $ 1,863.00 457075962 SUP & INTERP PTA PERIPHERAL 10.4570 320 $ 2,596.00 457075964 SUP & INTERP PTA PERIPH EA VES 10.4570 320 $ 2,096.00 457075966 SUP & INTERP PTA RENAL OR VISC 10.4570 320 $ 2,096.00 457075992 TRANS LUM ARTHRECTOMY 10.4570 320 $ 2,096.00 457076000 PC FLUOROSCOPY 0-60 MINUTES 10.4570 320 $ 1,060.00 457076499 PULMONARY VENOGRAPHY 10.4570 320 $ 898.00 457080001 CCL HOLD UNIT 10.4570 762 $ - 457081000 ER-LT HEART CATH-NO LV ACCESS 10.4570 480 $ 8,397.00 457081001 ER-LEFT HEART CATHETERIZATION 10.4570 480 $ 8,397.00 457081002 RT/LT HEART CATHETERIZATION 10.4570 480 $ 10,857.00 457081010 ER-BILAT CORONARY ANGIO PRIMAR 10.4570 480 $ 8,147.00 457081011 ER-UNILAT CORONARY ANGIO INJEC 10.4570 480 $ 2,039.00 457081012 ER-L.V. ANGIOGRAM INJECTION 10.4570 480 $ 1,807.00 457081013 ER-BYPASS GRAFT ANGIOGRAM INJE 10.4570 480 $ 2,826.00 457081014 ER-ARTERIAL/I.M.A. ANGIOGRAM 10.4570 480 $ 2,826.00 457081018 ER-SUPRA-VAL AORTOGRAM 10.4570 480 $ 2,128.00 457081019 ER-PULMONARY ANGIOGRAM INJ ONL 10.4570 480 $ 7,826.00 457081022 ER-RIGHT HEART CATH ONLY 10.4570 481 $ 7,826.00 457081023 ER-SWAN-GANZ CATH INSERTION 10.4570 480 $ 2,374.00 457081024 ER-PERICARDIOCENTESIS 10.4570 481 $ 7,826.00 457081030 ER-INTRACORONARY THROMBOLYSIS 10.4570 480 $ 3,552.00 457081031 ER-THROMB.VIA VEIN 10.4570 480 $ 3,552.00 457081032 ER-CARDIAC CATH ADD'L 1/4 HOUR 10.4570 481 $ 1,080.00 457081037 ER-PERM PACEMAKER INSERT ATRIA 10.4570 361 $ 6,559.00 457081038 ER-PERM PACEMAKER INSERT VENTR 10.4570 361 $ 6,559.00 457081039 ER-PERM PACEMAKER INSERTION DD 10.4570 361 $ 7,054.00 457081040 ER-PULSE GENERATOR SINGLE CHAM 10.4570 361 $ 6,559.00 457081041 ER-PLSE GENERATOR REPL DUAL CH 10.4570 361 $ 7,054.00 457081042 ER-PACEMAKER UPGRADE SING TO D 10.4570 361 $ 7,054.00 457081043 ER-LEAD REPO/REPL/INSERT>15D,S 10.4570 361 $ 6,559.00 457081044 ER-LEAD REPO/REPL/INSERT>15D,D 10.4570 361 $ 7,054.00 457081045 ER-PERM PACEMAKER REMOV,PULS G 10.4570 361 $ 6,559.00 457081046 ER-INSERT VEN CATH/CVP MEASURE 10.4570 361 $ 954.00 457081047 ER-CORONARY ANGIOPLASTY PRIMAR 10.4570 480 $ 20,583.00 457081048 ER-COR PTCA EA VES/EA ADD'L VE 10.4570 480 $ 4,208.00 457081049 ER-CORONARY STENT, PRIMARY 10.4570 480 $ 20,583.00 457081050 ER-CORONARY STENT EA ADDITIONA 10.4570 480 $ 4,208.00 457081051 ER-CORONARY STENT PRIMARY-LD 10.4570 480 $ 20,583.00 457081052 ER-CORONARY STENT PRIMARY-RC 10.4570 480 $ 20,583.00 457081053 ER-CORONARY STENT PRIMARY-LCX 10.4570 480 $ 20,583.00 457081054 ER-CORONARY STENT ADD'L VES-LA 10.4570 480 $ 4,526.00 457081055 ER-CORONARY STENT ADD'L VES-RC 10.4570 480 $ 4,526.00 457081056 ER-CORONARY STENT ADD'L VES-LC 10.4570 480 $ 4,526.00 457081057 ER-CORONARY ANGIOPLASTY-LAD 10.4570 480 $ 20,583.00 457081058 ER-CORONARY ANGIOPLASTY-RC 10.4570 480 $ 20,583.00 457081059 ER-CORONARY ANGIOPLASTY-LCX 10.4570 480 $ 20,583.00 457081060 ER-CV INFUSN LINE/GROSH/PORTS/ 10.4570 481 $ 6,787.00 457081061 ER-CORONARY ANGIO ADD'L VES-LA 10.4570 480 $ 4,526.00 457081062 ER-CORONARY ANGIO ADD'L VES-RC 10.4570 480 $ 4,526.00 457081063 ER-SURGICAL ADD'L 1/4 HOUR 10.4570 480 $ 976.00 457081064 ER-CORONARY ANGIO ADD'L VES-LC 10.4570 480 $ 4,526.00 457081999 CARDIAC CATH ADD'L QTR. HR. 10.4570 481 $ - 457082070 CV INFUSION/GROSH/PORTS/ETC 10.4570 481 $ 5,023.00 457082810 OXYGEN SATURATION X1 10.4570 300 $ 48.00 457082811 OXYGEN SATURATION X2 10.4570 300 $ 96.00 457082812 OXYGEN SATURATION X3 10.4570 300 $ 145.00 457082813 OXYGEN SATURATION X4 10.4570 300 $ 193.00 457082814 OXYGEN SATURATION X5 10.4570 300 $ 239.00 457082815 OXYGEN SATURATION X6 10.4570 300 $ 285.00 457082816 OXYGEN SATURATION X7 10.4570 300 $ 335.00 457082817 OXYGEN SATURATION X8 10.4570 300 $ 385.00 457085347 ACTIVATED CLOTTING TIME 10.4570 300 $ 59.00 457090472 ADMIN PNEUMOCCAL VACCINE 10.4570 510 $ 23.00 457090784 IV INJECTION 10.4570 270 $ 91.00 457090785 IV INJECTION ADD'L SEQUENTIAL 10.4570 761 $ 91.00 457092890 CORONARY ROTABLATION ADDL VES- 10.4570 480 $ 3,671.00 457092891 CORONARY ROTABLATION ADD'L VES 10.4570 480 $ 3,671.00 457092892 CORONARY ROTABLATION ADDL VES- 10.4570 480 $ 3,671.00 457092893 ER-CORONARY ROTABLAT. ADL VES- 10.4570 480 $ 3,671.00 457092894 ER-CORONARY ROTABLAT. ADL VES- 10.4570 480 $ 3,671.00 457092897 ER-CORONARY ROTABLAT. ADL VES- 10.4570 480 $ 3,671.00 457092910 CORONARY STENT PRIMARY-LAD 10.4570 480 $ 17,350.00 457092911 CORONARY STENT PRIMARY-RC 10.4570 480 $ 17,350.00 457092912 CORONARY STENT PRIMARY-LCX 10.4570 480 $ 17,350.00 457092920 CORONARY STENT ADD'L VES-LAD 10.4570 480 $ 4,208.00 457092921 CORONARY STENT ADD'L VES-RC 10.4570 480 $ 4,208.00 457092922 CORONARY STENT ADD'L VES-LCX 10.4570 480 $ 4,208.00 457092930 CORONARY ANGIOPLASTYS PRIMARY- 10.4570 480 $ 17,350.00 457092931 CORONARY ANGIOPLASTY PRIMARY-R 10.4570 480 $ 17,350.00 457092932 CORONARY ANGIOPLASTY PRIMARY-L 10.4570 480 $ 17,350.00 457092941 CORONARY ANGIOPLASTY ADDL VES- 10.4570 480 $ 4,208.00 457092942 CORONARY ANGIOPLASTY ADD'L VES 10.4570 480 $ 4,208.00 457092943 CORONARY ANGIOPLASTY ADDL VES- 10.4570 480 $ 4,208.00 457092953 TEMPORARY EXTERNAL PACING 10.4570 480 $ 241.00 457092960 CARDIOVERSION - EXTERNAL 10.4570 480 $ 1,114.00 457092961 CARDIOVERSION - INTERNAL 10.4570 480 $ 1,114.00 457092973 CORONARY THROMBECTOMY TRANSLUM 10.4570 481 $ 898.00 457092975 INTRA CORONARY THROMBOLYSIS 10.4570 480 $ 3,525.00 457092977 THROMBOLYSIS VIA VEIN 10.4570 480 $ 3,525.00 457092978 IVUS CORO. VESSEL GRAFTS 10.4570 480 $ 2,977.50 457092979 IVUS EACH ADD'L VESSEL 10.4570 480 $ 3,000.00 457092980 CORONARY STENT PRIMARY 10.4570 480 $ 17,350.00 457092981 CORONARY STENT ADD'L VES 10.4570 480 $ 4,526.00 457092982 CORONARY ANGIOPLASTY 10.4570 480 $ 17,350.00 457092984 CORONARY ANGIOPLASTY--ADD'L 10.4570 480 $ 4,526.00 457092990 CORONARY ROTABLATION PRIMARY-L 10.4570 480 $ 16,219.00 457092991 CORONARY ROTABLATION PRIMARY-R 10.4570 480 $ 16,219.00 457092992 CORONARY ROTABLATION PRIMARY-L 10.4570 480 $ 16,219.00 457092993 ER-CORONARY ROTABLATION PRIME- 10.4570 480 $ 16,219.00 457092994 ER-CORONARY ROTABLATION PRIME- 10.4570 480 $ 16,219.00 457092995 ROTABLATION 10.4570 480 $ 16,219.00 457092997 ER-CORONARY ROTABATION PRIME-L 10.4570 480 $ 16,219.00 457093001 CORONARY STENT DES PRIM-LAD 10.4570 481 $ 12,080.00 457093002 CORONARY STENT DES PRIM-RC 10.4570 481 $ 12,080.00 457093003 CORONARY STENT DES PRIM-LCX 10.4570 481 $ 12,080.00 457093004 CORONARY STENT DES ADD VES-LAD 10.4570 481 $ 2,931.00 457093005 CORONARY STENT DES ADD VES-RC 10.4570 481 $ 2,931.00 457093006 CORONARY STENT DES ADD VES-LCX 10.4570 481 $ 2,931.00 457093007 CORONARY STENT DES PRIMARY 10.4570 481 $ 12,080.00 457093008 CORONARY STENT DES ADD'L VES 10.4570 481 $ 3,152.00 457093025 MICROVOLT T-WAVE ASSESS 10.4570 480 $ 545.00 457093501 RIGHT HEART CATHETERIZATION 10.4570 480 $ 7,014.00 457093503 SWAN-GANZ INSERTION 10.4570 480 $ 2,265.00 457093505 ENDOMYCARDIAL BIOPSY 10.4570 480 $ 5,200.00 457093508 LT HEART CATH-NO LV ACCESS 10.4570 480 $ 6,919.00 457093510 LEFT HEART CATH, RETRO/PERC 10.4570 481 $ 6,919.00 457093511 LEFT HEART CATH BY CUTDOWN 10.4570 481 $ 6,919.00 457093524 TRANSSEPTAL LEFT HEART CATH 10.4570 481 $ 6,919.00 457093526 RT/LT HEART CATH, RETRO 10.4570 481 $ 8,596.00 457093527 RT/LT HEART CATH, TRANSEPTAL L 10.4570 481 $ 8,596.00 457093536 INTRA AORTIC BALLOON INSERTION 10.4570 480 $ 2,265.00 457093539 ARTERIAL/I.M.A. ANGIOGRAPHY 10.4570 480 $ 2,265.00 457093540 BYPASS GRAFT ANGIOGRAPHY 10.4570 480 $ 2,265.00 457093541 PUL. ARTERY ANGIOGRAM INJ. ONL 10.4570 480 $ 4,977.00 457093542 RIGHT VENTRICULAR ANGIOGRAPHY 10.4570 480 $ 1,858.00 457093543 LEFT VENTRICULAR ANGIOGRAPHY 10.4570 481 $ 1,401.00 457093544 AORTOGRAPHY ILIAC INJ/SUPRAVAL 10.4570 480 $ 1,581.00 457093545 BILATERAL CORONARY ANGIOGRAM 10.4570 481 $ 5,607.00 457093548 RENAL ANGIOGRAM 10.4570 320 $ 1,581.00 457093555 VENTRICULAR INJECTION 10.4570 481 $ 1,133.00 457093556 CORONARY/ARTERY INJECTION 10.4570 481 $ 1,698.00 457093571 I/C DOPPLER DERIVED PRESSURE 10.4570 481 $ 764.00 457093572 I/C DOPPLER DERIVED PRESS ADD 10.4570 481 $ 667.00 457093600 BUNDLE OF HIS RECORDING 10.4570 480 $ 3,273.00 457093602 INTRA-ATRIAL RECORDING 10.4570 480 $ 2,272.00 457093603 RT VENTRICULAR RECORDING 10.4570 480 $ 2,931.00 457093609 MAP TACHYCARDIA - ADD 10.4570 480 $ 5,497.00 457093610 INTRA-ATRIAL PACING 10.4570 480 $ 2,955.00 457093612 INTRA-VENTRICULAR PACING 10.4570 480 $ 3,261.00 457093613 ELECTROPHYS MAP 3D ADD ON 10.4570 480 $ 3,249.00 457093615 ESOPHAG REC ATRIAL W/WO VENT 10.4570 480 $ 1,165.00 457093616 ESOPHAG REC WITH PACING 10.4570 480 $ 1,754.00 457093618 HEART RHYTHM PACING 10.4570 480 $ 6,627.00 457093619 COMP EP EVAL W/O ARR.INDUCT 10.4570 480 $ 12,807.00 457093620 COMP EP EVAL W ARR INDUCT 10.4570 480 $ 13,618.00 457093621 COMP EP EVAL W LA REC & PAC 10.4570 480 $ 2,472.00 457093622 COMP EP EVAL W LV PACING/RCRD 10.4570 480 $ 3,649.00 457093623 STIMULATION PACING HEART 10.4570 480 $ 3,355.00 457093624 EP FOLLOWUP PACING/RECORDING 10.4570 480 $ 5,650.00 457093631 INTRAOP MAPPING 10.4570 480 $ 1,165.00 457093640 HEART PACING - MAPPING 10.4570 480 $ 10,040.00 457093641 PACING/MAPPING TEST ICD GEN 10.4570 480 $ 6,968.00 457093642 EP EVAL S/DL ICD PACING THRESH 10.4570 480 $ 5,745.00 457093650 INTRACARDIAC ABLATION AV NODE 10.4570 480 $ 12,347.00 457093651 INTRACARD ABLATION SVT/AFIB 10.4570 480 $ 19,103.00 457093652 INTRACARDIAC ABLATION TRT VT 10.4570 480 $ 20,775.00 457093660 TILT TABLE EVAL 10.4570 480 $ 2,225.00 457093662 INTRACARDIAC ECG (ICE) 10.4570 480 $ 3,296.00 457093743 ANALYZE HT PACE DEVICE DUAL 10.4570 480 $ 545.00 457109600 DEF ABLAT BRAIDED TIP ALL 10.4570 279 $ 2,476.00 457109601 DEF ABLAT BRAIDED <19 ELECTROD 10.4570 279 $ 2,476.00 457109610 BI DIR ABLAT CATHETERS ALL 10.4570 279 $ 2,535.00 457109620 DUAL SENSOR TIP ABLATION CATH 10.4570 279 $ 2,939.00 457109630 OCTAPOLAR DEFLECTABLE CATH 6FR 10.4570 279 $ 1,433.00 457109640 DECAPOLAR DEFLECTABLE CATH 6FR 10.4570 279 $ 1,559.00 457109644 NAVISTAR 4MM ALL CURVES CATH 10.4570 279 $ 5,502.00 457109646 NAVISTAR 8MM ALL CURVES CATH 10.4570 279 $ 6,288.00 457109650 COMPLI SOFT TIP CATH 5FR 10.4570 279 $ 435.00 457109660 JOSEPHSON CATHETER 6FR 10.4570 279 $ 723.00 457109670 CHRISTA 3MM TIP CATH 7FR 10.4570 279 $ 2,895.00 457109680 COURNAND 8 ELECTRODE CATHETER 10.4570 279 $ 909.00 457109690 QUAD CABLE 10.4570 272 $ 772.00 457109700 DECA CABLE 10.4570 272 $ 772.00 457109710 CARTO REFERENCE PATCH 10.4570 272 $ 1,672.00 457109720 SAFL FAST CATH INTRO 8FR 10.4570 279 $ 729.00 457120100 ADAPTA DR PACEMAKER 10.4570 275 $ 11,696.00 457120110 ADAPTA SR PACEMAKER 10.4570 275 $ 10,377.00 457120111 ADAPTA DR PACING LEAD 10.4570 278 $ 523.00 457120112 SENSIA DR PACING LEAD 10.4570 278 $ 525.00 457120113 SENSIA SR PACING LEAD 10.4570 278 $ 1,047.00 457120115 VIRTUOSO DR FIDELIS LEAD 10.4570 278 $ 4,063.00 457120116 VIRTUOSO DR PACING LEAD 10.4570 278 $ 525.00 457120117 VIRTUOSO VR FIDELIS LEAD 10.4570 278 $ 4,108.00 457120120 ENRHYTHM DR PACEMAKER 10.4570 275 $ 11,696.00 457120130 VERSA DR PACEMAKER 10.4570 275 $ 10,423.00 457120140 SENSIA DR PACEMAKER 10.4570 275 $ 9,915.00 457120150 SENSIA SR PACEMAKER 10.4570 275 $ 9,330.00 457120160 VIRTUOSO DR PACEMAKER 10.4570 275 $ 38,498.00 457120170 VIRTUOSO VR DEFIB-PACER 10.4570 275 $ 32,866.00 457120180 ENTRUST AT PACEMAKER 10.4570 275 $ 38,498.00 457120190 ENTRUST VR DEFIB-PACER 10.4570 275 $ 32,866.00 457120200 MAXIMO DR DEFIB-PACER 10.4570 275 $ 38,377.00 457120201 MAXIMO DR FIDELIS LEAD 10.4570 278 $ 637.00 457120202 MAXIMO ATRIAL PACING LEAD 10.4570 278 $ 525.00 457120203 MAXIMO SR FIDELIS LEAD 10.4570 278 $ 4,049.00 457120210 MAXIMO SR DEFIB-PACER 10.4570 275 $ 31,215.00 457120220 CONCERTO DEFIB-PACER 10.4570 275 $ 46,821.00 457120230 INSYNCH SENTRY DEFIB-PACER 10.4570 275 $ 46,821.00 457120231 INSYNCH SENTRY FIDELIS LEAD 10.4570 278 $ 11,433.00 457120232 INSYNCH A/V PACING LEAD 10.4570 278 $ 525.00 457120240 INSYNCH MAXIMO DEFIB-PACER 10.4570 275 $ 44,740.00 457120241 INSYNCH MAXIMO FIDELIS LEAD 10.4570 278 $ 11,396.00 457120250 INSYNCH III DEFIB-PACER 10.4570 275 $ 20,806.00 457120251 INSYNCH III FIDELIS LEAD 10.4570 278 $ 6,215.00 457120260 ADAPTA DR PACEMAKER (PANEL) 10.4570 275 $ - 457120270 ADAPTA SR PACEMAKER (PANEL) 10.4570 275 $ - 457120271 ADAPTA PACING LEAD 10.4570 278 $ 521.00 457120272 ADAPTA SR PACING LEAD 10.4570 278 $ 1,045.00 457120280 VERSA DR PACEMAKER (PANEL) 10.4570 275 $ - 457120290 SENSIA DR PACEMAKER (PANEL) 10.4570 275 $ - 457120300 SENSIA SR PACEMAKER (PANEL) 10.4570 275 $ - 457120310 VIRTUOSO DR PACEMAKER (PANEL) 10.4570 275 $ - 457120320 VIRTUOSO DR PACEMAKER (PANEL) 10.4570 275 $ - 457120330 ENTRUS AT PACEMAKER (PANEL) 10.4570 275 $ - 457120331 ENTRUST AT FIDELIS LEAD 10.4570 278 $ 4,063.00 457120332 ENTRUST AT PACING LEAD 10.4570 278 $ 525.00 457120333 ENTRUST VR FIDELIS LEAD 10.4570 278 $ 4,108.00 457120340 ENTRUS VR PACEMAKER (PANEL) 10.4570 275 $ - 457120350 MAXIMO DR PACEMAKER (PANEL) 10.4570 275 $ - 457120360 MAXIMO SR PACEMAKER (PANEL) 10.4570 275 $ - 457120370 MAXIMO DR PACEMAKER (PANEL) 10.4570 275 $ - 457120371 CONCERTO FIDELIS LEAD 10.4570 278 $ 11,433.00 457120372 MAXIMO A/V PACING LEAD 10.4570 278 $ 525.00 457120380 INSYNCH SENT PACEMAKER (PANEL) 10.4570 275 $ - 457120390 INSYNCH MAXIMO PACER (PANEL) 10.4570 275 $ - 457120400 INSYNCH III PACEMAKER (PANEL) 10.4570 275 $ - 457120410 SELECT SECURE LEAD LEAD 10.4570 278 $ 2,458.00 457120420 SELECTSITE CATHETER 10.4570 278 $ 1,054.00 457120430 CAPSURE SERIES LEAD 10.4570 278 $ 2,107.00 457120440 SUREFIX LEAD 10.4570 278 $ 2,351.00 457120450 FIDELIS SERIES LEAD 10.4570 278 $ 12,970.00 457120460 SPRINT QUATRO SECURE RV 10.4570 278 $ 12,466.00 457120470 CV LEAD 4194 SERIES 10.4570 278 $ 5,370.00 457120480 ATTAIN OTW LV LEADS 10.4570 278 $ 4,730.00 457120490 REVEAL PLUS LOOP RECORDER 10.4570 278 $ 7,833.00 457130283 PORT SINGLE PLASTIC MRI 10.4570 272 $ 2,614.00 457130399 PORT DUAL PLASTIC MRI 10.4570 270 $ 5,988.00 457140210 ATTAIN LV LEAD 4193 10.4570 278 $ 7,265.00 457142000 BI-VENTRICULAR PACEMAKER 10.4570 275 $ 34,778.00 457142010 ATTAIN LV LEAD 2187 10.4570 278 $ 6,999.00 457142020 ATTAIN LV LEAD 2188 10.4570 278 $ 6,288.00 457142022 LV CORONARY VENOUS LEAD 10.4570 278 $ 5,669.00 457142024 ATTAIN ACCESS DELIV SYSTEM 10.4570 272 $ 1,931.00 457142026 ATTAIN VENOGRAM BALLOON 10.4570 279 $ 444.00 457142028 ATTAIN OTW LV CV LEAD 10.4570 278 $ 4,255.00 457142029 ATTAIN LV CV LEAD 2187 10.4570 278 $ 3,905.00 457142030 ATTAIN LV CV LEAD 2188 10.4570 278 $ 3,232.00 457142040 LD GUIDE WIRE 10.4570 279 $ 134.00 457142050 LD CATHETER 10.4570 279 $ 411.00 457142051 SILVERHAWK ATHRCT CATH ALL SZ 10.4570 279 $ 7,219.00 457142060 LD INTRO SHEATH 10.4570 279 $ 3,665.00 457142080 EP CATHETER 10.4570 279 $ 4,274.00 457150029 FILTER MOBIN-UDDIN 10.4570 272 $ 4,544.00 457150032 PACEMAKER 8400-8402 10.4570 275 $ 29,453.00 457150036 LEAD UNIPOLAR PACING 10.4570 278 $ 7,246.00 457150040 FEMORAL WORKSTATION 10.4570 272 $ 6,441.00 457150048 GUIDE WIRES 10.4570 279 $ 134.00 457150053 PACEMAKER 7005 & 7006 10.4570 275 $ 37,129.00 457150064 PERCLOSE-PROSTAR XL/PLUS 8-10F 10.4570 279 $ 3,233.00 457150065 PERCLOSE TECHSTAR 6FR 10.4570 272 $ 2,366.00 457150066 LEAD INTRODUCER PERMANENT 10.4570 270 $ - 457150067 CATH S-G 93-200H 7FR 10.4570 272 $ 2,422.00 457150068 KIT IABP DATA 9.5FR 10.4570 270 $ 8,102.00 457150075 PACEMAKER 8420-223 10.4570 275 $ 28,807.00 457150088 VENTRICULAR BIOPSY FORCEP 10.4570 272 $ 1,885.00 457150106 PACEMAKER LEAD TARGET TIP 4011 10.4570 278 $ 5,712.00 457150107 PACEMAKER LEAD TARGET TIP 4081 10.4570 278 $ 6,013.00 457150108 PACEMAKER LEAD SCREW IN 10.4570 278 $ 6,614.00 457150109 PACEMAKER LEAD CAPSURE STEROID 10.4570 278 $ 6,812.00 457150110 PACEMAKER (PROGRAMMABLE) MINIX 10.4570 275 $ 20,041.00 457150111 PACEMAKER (PROGRAMMABLE) MINIX 10.4570 275 $ 23,478.00 457150112 PACEMAKER (PROGRAMMABL)MICROMI 10.4570 275 $ 25,767.00 457150113 PACEMAKER RATE RESPONSIV ACTIV 10.4570 275 $ 27,199.00 457150114 PACEMAKER RATE RESPONSIVE LEGE 10.4570 275 $ 28,488.00 457150115 PACEMAKER (DUAL CHAMBER) 10.4570 275 $ 30,920.00 457150116 GUIDENT PUSAR MAX DR 10.4570 275 $ 32,062.00 457150121 CAPSURE FIX PACING LEAD 10.4570 278 $ 2,283.00 457150160 MARQUIS DR DEFIB-PACER 10.4570 275 $ 44,719.00 457150162 MARQUIS VR DEFIB-PACER 10.4570 275 $ 41,753.00 457150170 MAXIMO DR DEFIB-PACER 10.4570 275 $ 44,719.00 457150172 MAXIMO VR DEFIB-PACER 10.4570 275 $ 41,753.00 457150174 INTRINSIC DR DEFIB-PACER 10.4570 275 $ 50,600.00 457150180 FIDELIS LEAD-DEFIB SINGLE COIL 10.4570 278 $ 13,500.00 457150182 FIDELIS LEAD-DEFIB DUAL COIL 10.4570 278 $ 13,500.00 457150184 SPRINT LEAD-DEFIB DUAL COIL 10.4570 278 $ 13,201.00 457150186 SPRINT LEAD-DEFIB SINGLE COIL 10.4570 278 $ 13,201.00 457150188 RV LEAD-DEFIB DUAL COIL SILICN 10.4570 278 $ 13,201.00 457150189 SPRINT LEAD-DEFIB TINED SINGLE 10.4570 278 $ 13,201.00 457150200 CAPSURE CARDIAC SENSING LEAD 10.4570 278 $ 4,168.00 457150219 PROBE BALLOON CATHETER 10.4570 272 $ 6,512.00 457150230 FILTERWIRE EMB PROTECTIVE SYST 10.4570 278 $ 4,548.00 457150239 CORDIS BALLOON ANGIOPLASTY 10.4570 272 $ 6,652.00 457150240 ANGIOPLASTY BALLOON I 10.4570 272 $ 6,714.00 457150241 ANGIOPLASTY BALLOON II 10.4570 272 $ 6,912.00 457150242 ANGIOPLASTY BALLOON III 10.4570 272 $ 7,218.00 457150247 GUARDWIRE PLUS SYSTEM 10.4570 279 $ 6,108.00 457150249 PRESS GUIDEWIRE/DOPPLER FLOWIR 10.4570 279 $ 2,607.00 457150250 ANGIOPLASTY BALLOON D1 10.4570 279 $ 2,129.00 457150251 ROTABLATOR BURR 10.4570 272 $ 10,022.00 457150254 CUTTING BALLOON 10.4570 272 $ 5,252.00 457150270 FRONTRUNNER X39 CTO CATH-140CM 10.4570 279 $ 3,785.00 457150272 FRONTRUNNER MICROGLIDE CATH-12 10.4570 279 $ 1,337.00 457150274 FRONTRUNNER X39 CTO CATH-90CM 10.4570 279 $ 3,785.00 457150300 IVUS CATHETER 10.4570 272 $ 2,201.00 457150301 CORONARY STENT 9MM 10.4570 278 $ 8,746.00 457150302 IVUS MEGASONICS CATHETER 10.4570 272 $ 3,235.00 457150303 CORONARY STENT 15MM 10.4570 278 $ 9,713.00 457150304 CORONARY STENT 18MM 10.4570 278 $ 10,194.00 457150305 CORONARY STENT 24MM 10.4570 278 $ 11,159.00 457150306 CORONARY STENT 30MM 10.4570 278 $ 11,643.00 457150307 CORONARY STENT 12MM 10.4570 278 $ 9,230.00 457150308 JOSTENT - GRAFTMASTER 10.4570 278 $ 8,020.00 457150310 GLIDE WIRE ANGLED 35 10.4570 279 $ 124.00 457150312 SUPPLY-LONG GUIDEWIRE 10.4570 270 $ - 457150316 STABLILIZER GUIDEWIRE .014/300 10.4570 279 $ 1,375.00 457150317 WHOLEY GUIDEWIRE 10.4570 279 $ 227.00 457150318 EP GUIDEWIRE 10.4570 279 $ 48.00 457152030 ATTAIN LV CV LEAD 2187 10.4570 278 $ 3,905.00 457160279 ANGIOPLASTY STANDBY SUPL. 10.4570 272 $ 2,654.00 457160281 IMAGER CATH ALL SIZES 10.4570 279 $ 533.00 457160282 GLIDEWIRE 10.4570 279 $ 180.00 457160283 MACH 1 6F GUIDES ALL SIZES 10.4570 279 $ 355.00 457160284 ROSEN GUIDEWIRE 180 10.4570 279 $ 56.00 457160285 ROSEN GUIDEWIRE 360 10.4570 279 $ 76.00 457160286 AMPLATZ GUIDEWIRE 10.4570 279 $ 188.00 457160287 THRUWAY GUIDEWIRE ALL SIZES 10.4570 279 $ 355.00 457160288 V18 GUIDEWIRE 10.4570 279 $ 420.00 457160289 V18 GUIDEWIRE 10.4570 279 $ 153.00 457160290 MAGIC TORQUE WIRE 10.4570 279 $ 151.00 457160291 SYNERGY BALLOON CATH 10.4570 279 $ 776.00 457160292 STERLING MONORAIL BALLOON 10.4570 279 $ 1,036.00 457160293 EXPRESS SD STENT 10.4570 279 $ 3,465.00 457160294 EXPRESS LD STENT 10.4570 279 $ 3,465.00 457160295 QUICK CROSS CATH 10.4570 279 $ 621.00 457160296 ANG GLIDEWIRE 10.4570 279 $ 199.00 457160297 DESTINATION SHEATH ALL SIZES 10.4570 279 $ 472.00 457170010 INSYNC II ICD - OTHER 10.4570 278 $ 61,081.00 457170012 INSYNC III PACEMAKER - OTHER 10.4570 275 $ 28,071.00 457170014 INSYNC MAXIMO ICD - OTHER 10.4570 275 $ 63,948.00 457170016 INSYNC SENTRY ICD - OTHER 10.4570 278 $ 72,467.00 457170100 PERCLOSE A-V CLOSURE DEVICE 10.4570 279 $ 2,366.00 457170200 ROTABLATOR ARTHRECTOMY CATHETE 10.4570 279 $ 10,022.00 457170202 ASPIRATION CATHETER 6FR 10.4570 279 $ 1,890.00 457170300 MEDTRONIC AVE GT1 GUIDE WIRE 10.4570 279 $ 1,246.00 457170400 MEDTRONIC AVE 5F-9F GUIDE CATH 10.4570 279 $ 1,494.00 457170500 LEAD,PACEMAKER CAPSURE SP 10.4570 278 $ 5,712.00 457170501 LEAD,PACEMAKER 10.4570 278 $ 200.00 457170600 KAPPA 400SR PACEMAKER 10.4570 275 $ 32,062.00 457170700 KAPPA DR PACEMAKER 10.4570 275 $ 32,062.00 457170770 KAPPA SR PACEMAKER 10.4570 275 $ 32,062.00 457170780 ENTHYTHM DR PACEMAKER 10.4570 275 $ 47,131.00 457170790 ENPULSE 2 DR PACEMAKER 10.4570 275 $ 40,078.00 457170792 ENPULSE SR PACEMAKER 10.4570 275 $ 37,513.00 457170800 KAPPA 700 SR PACEMAKER 10.4570 275 $ 32,062.00 457170900 KAPPA 700 D PACEMAKER 10.4570 275 $ 32,062.00 457171000 KAPPA 700 VDD PACEMAKER 10.4570 275 $ 32,062.00 457171100 SIGMA 200D PACEMAKER 10.4570 275 $ 32,062.00 457171200 SIGMA 200 DR PACEMAKER 10.4570 275 $ 32,062.00 457171300 SIGMA 200 SR PACEMAKER 10.4570 275 $ 32,062.00 457171400 SIGMA 300 SR PACEMAKER 10.4570 275 $ 32,062.00 457171500 SIGMA 300 D PACEMAKER 10.4570 275 $ 32,062.00 457171700 STENT,CORONARY BX VELOCITY 8MM 10.4570 278 $ 6,193.00 457171701 STENT,CORONARY BX VELOCITY 13M 10.4570 278 $ 6,887.00 457171702 STENT,CORONARY BX VELOCITY 18M 10.4570 278 $ 7,197.00 457171703 STENT,CORONARY BX VELOCITY 23M 10.4570 278 $ 8,131.00 457171704 STENT,CORONARY BX VELOCITY 28M 10.4570 278 $ 8,755.00 457171705 STENT,CORONARY BX VELOCITY 33M 10.4570 278 $ 9,059.00 457171710 STENT,CORONARY PIXEL 2.0 X 8MM 10.4570 278 $ 6,129.00 457171711 STENT,CORONARY PIXEL 2.25 X 8M 10.4570 278 $ 6,129.00 457171712 STENT,CORONARY PIXEL 2.5 X 8MM 10.4570 278 $ 6,129.00 457171713 STENT,CORONARY PIXEL 2.0 X 13M 10.4570 278 $ 6,129.00 457171714 STENT,CORONARY PIXEL 2.25 X 13 10.4570 278 $ 6,129.00 457171715 STENT,CORONARY PIXEL 2.5 X 13M 10.4570 278 $ 6,129.00 457171716 STENT,CORONARY PIXEL 2.0 X 18M 10.4570 278 $ 6,129.00 457171717 STENT,CORONARY PIXEL 2.25 X 18 10.4570 278 $ 6,129.00 457171718 STENT,CORONARY PIXEL 2.5 X 18M 10.4570 278 $ 6,129.00 457171719 STENT,CORONARY PIXEL 2.0 X 23M 10.4570 278 $ 6,129.00 457171720 STENT,CORONARY PIXEL 2.25 X 23 10.4570 278 $ 6,129.00 457171721 STENT,CORONARY PIXEL 2.5 X 23M 10.4570 278 $ 6,129.00 457171722 STENT,CORONARY PIXEL 2.0 X 28M 10.4570 278 $ 6,129.00 457171723 STENT,CORONARY PIXEL 2.25 X 28 10.4570 278 $ 6,129.00 457171724 STENT,CORONARY PIXEL 2.5 X 28M 10.4570 278 $ 6,129.00 457171726 DRIVER MX STENT 3.0-4.0/9-30 M 10.4570 278 $ 3,797.00 457171800 KAPPA 400 DR PACEMAKER 10.4570 275 $ 32,062.00 457171900 KAPPA 600 DR PACEMAKER 10.4570 275 $ 32,062.00 457172300 STENT,CORONARY S670 OTW 9MM 10.4570 278 $ 6,810.00 457172301 STENT, CORONARY S670 OTW 12MM 10.4570 278 $ 7,151.00 457172302 STENT,CORONARY S670 OTW 15MM 10.4570 278 $ 7,318.00 457172303 STENT,CORONARY S670 OTW 18MM 10.4570 278 $ 7,488.00 457172304 STENT,CORONARY S670 OTW 24MM 10.4570 278 $ 8,508.00 457172305 STENT,CORONARY S670 OTW 30MM 10.4570 278 $ 8,847.00 457172400 STENT,CORONARY S660 OTW 9MM 10.4570 278 $ 6,810.00 457172401 STENT,CORONARY S660 OTW 12MM 10.4570 278 $ 7,151.00 457172402 STENT,CORONARY S660 OTW 15MM 10.4570 278 $ 7,318.00 457172403 STENT,CORONARY S660 OTW 18MM 10.4570 278 $ 7,488.00 457172404 STENT,CORONARY S660 OTW 24MM 10.4570 278 $ 8,508.00 457172405 REVEAL CARDIAC RECORDER 10.4570 278 $ 13,837.00 457172408 STENT, CORONARY EXPRESS 10.4570 278 $ 3,421.00 457172440 CYPHER DRUG ELUTING STENT 10.4570 278 $ 11,263.00 457172450 STENT, BIODIVYSIO 2.0MM X 10MM 10.4570 278 $ 3,233.00 457172451 STENT, BIODIVYSIO 2.0MM X 15MM 10.4570 278 $ 3,233.00 457172452 STENT, BIODIVYSIO 2.0MM X 18 M 10.4570 278 $ 3,233.00 457172453 STENT, BIODIVYSIO 2.25MM X 10M 10.4570 278 $ 3,233.00 457172454 STENT, BIODIVYSIO 2.25MM X X15 10.4570 278 $ 3,233.00 457172455 STENT, BIODIVYSIO 2.25MM X 18M 10.4570 278 $ 3,233.00 457172500 DRUG ELUTING STENT 2.5 x 8-32 10.4570 278 $ 7,968.00 457172700 SIGMA 300DR,PMKER 10.4570 275 $ 32,062.00 457180050 NON IONIC CONTRAST 100ml 10.4570 636 $ 436.00 457190100 XMI CATHETER 10.4570 279 $ 4,861.00 457190110 XVG CATHETER 10.4570 272 $ 4,861.00 457190210 LEAD CLIPPER 10.4570 272 $ 213.00 457190220 COIL EXPANDER 10.4570 272 $ 226.00 457190230 STYLET WIRES 10.4570 279 $ 160.00 457190240 SOF-GRIP HEMOSTAT 10.4570 272 $ 217.00 457190250 PIN VISE 10.4570 272 $ 251.00 457190260 LIBERATOR LOCKING STYLET 10.4570 272 $ 1,384.00 457190270 BYRD POLYPROP DILATOR 7-13 FR 10.4570 279 $ 479.00 457190280 BYRD POLYPRO DILAT 7-13 FR EXL 10.4570 279 $ 537.00 457190290 BYRD TEFLON DILATOR 10.4570 279 $ 479.00 457190300 BYRD TELESCOPING DILATOR 10.4570 279 $ 812.00 457190310 NEEDLES EYE SNARE RET SET 13MM 10.4570 279 $ 2,384.00 457190320 NEEDLES EYE SNARE13M FEM SHTH 10.4570 279 $ 1,492.00 457190330 NEEDLES EYE SNARE RET SET 20MM 10.4570 279 $ 2,384.00 457190340 NEEDLES EYE SNARE20M FEM SHTH 10.4570 279 $ 1,492.00 457190350 CURVED INNER FEM SHEATH 10.4570 279 $ 621.00 457190360 CURVED 16 FR INTRO SHEATH SET 10.4570 279 $ 1,233.00 457190361 7FR CROSSOVER SHEATH 10.4570 279 $ 388.00 457190362 6FR SHEATH SHUTTLE 10.4570 278 $ 601.00 457190363 5FR SOS OMNI 10.4570 272 $ 102.00 457190370 24CM CURVED PEEL-AWY INTRO SET 10.4570 279 $ 275.00 457190380 FAST CATH INTRODUCER 8FR 60CM 10.4570 279 $ 821.00 457190382 FAST CATH INTRODUCER 8FR 63CM 10.4570 279 $ 798.00 457190384 FAST CATH INTROD 8FR 63CM SR4 10.4570 279 $ 798.00 457190390 TRANSEPTAL NEEDLES BRK/BRK 10.4570 279 $ 1,065.00 457190400 OPTIRAY 320 50ML 10.4570 636 $ 218.00 457190410 ATLANTIS SR PRO IVUS CATH 10.4570 272 $ 2,247.00 457190415 DIS PULL BACK SLED 10.4570 272 $ 222.00 459000010 TREATMENT ROOM I 10.4590 510 $ 209.00 459000015 TREATMENT ROOM II 10.4590 510 $ 370.00 459000099 EKG TRACING CLINICAL TRIAL 10.4590 730 $ - 459003000 EKG TRACING ONLY 10.4590 730 $ 194.00 459003001 EKG - PHYS. INTERP. & REPORT 11.4590 985 $ 70.00 459003002 DOBUTAMINE STRESS ECHO - PANEL **.4590 482 $ - 459003003 EXERCISE STRESS ECHO - PANEL **.4590 482 $ - 459003004 EKG PANEL (CARDIOLOGY) **.4590 730 $ - 459003005 EKG PANEL (EMERGENCY DEPT) **.4590 730 $ - 459003006 STRESS ECHO/DOBUT PROF (PANEL) **.4590 482 $ - 459003007 ECHO 2D / COLOR - (PANEL) **.4590 482 $ - 459003012 TRANSTELEPHONIC EVENT/MONITOR 10.4590 480 $ 1,353.00 459003014 TRANS.EVENT/PHYS. INTERPRET. R 11.4590 985 $ 76.00 459003016 STRESS TEST/PHYSICIAN SUPERVIS 11.4590 985 $ 59.00 459003017 STRESS TEST / TRACING ONLY 10.4590 482 $ 545.00 459003018 STRESS TEST/INTERP AND REPORT 11.4590 985 $ 59.00 459003020 PHARMACOLOGIC STRESS/PHYS.SUPE 11.4590 985 $ 59.00 459003021 PHARMACOLOGIC STRESS TEST 10.4590 482 $ 626.00 459003022 PHARM. STRESS/INTERP./REPORT 11.4590 985 $ 59.00 459003023 STRESS/NUCLEAR PRO FEES(PANEL) **.4590 482 $ - 459003230 HOLTER/24 HOUR - PANEL **.4590 730 $ - 459003231 HOLTER/24HR/SETUP/DISCONNECT 10.4590 731 $ 435.00 459003232 HOLTER/24HR/ANALYSIS/REPORT 10.4590 731 $ 525.00 459003233 HOLTER/24HR/PRO FEE 11.4590 985 $ 109.00 459003269 KING OF HEARTS - PANEL **.4590 730 $ - 459003270 KING OF HEARTS/SETUP/RECORDING 10.4590 730 $ 557.00 459003271 KING OF HEARTS/RECEIVE/ANALYSI 10.4590 730 $ 653.00 459003272 TRANSTELEPHONIC (PANEL) 10.4590 480 $ - 459003278 SIGNAL AVERAGED ECG 10.4590 730 $ 641.00 459003279 SIGNAL AVERAGED ECG - PRO FEE 11.4590 985 $ 76.00 459003300 ECHO CARDIOGRAM (PANEL) 10.4590 480 $ - 459003302 ECHO CONGEN. HEART COMPL. PRO 11.4590 985 $ 244.00 459003303 ECHO/CONGENITAL HEART COMPLETE 10.4590 483 $ 1,047.00 459003304 ECHO/CONGENITAL/LIMITED 10.4590 483 $ 1,022.00 459003305 ECHO/CONGENITAL/LIMITED - PRO 11.4590 985 $ 194.00 459003306 ECHOCARDIOGRAM COMPLETE / PROF 11.4590 985 $ 244.00 459003307 ECHOCARDIOGRAM COMPLETE 10.4590 483 $ 910.00 459003308 ECHOCARDIOGRAM (2-D) LIMITED 10.4590 483 $ 890.00 459003309 ECHOCARDIOGRAM (2-D) LIM./PRO 11.4590 985 $ 194.00 459003310 COLOR DOPPLER PRO FEE 11.4590 985 $ 76.00 459003314 TRANSESOPHAGEAL ECHOCARDIOGRAM 10.4590 483 $ 2,112.00 459003317 TRANSESOPHAGEAL ECHO CONGENITA 10.4590 483 $ 2,112.00 459003319 DOPPLER ECHO COMPLETE - PRO FE 11.4590 985 $ 76.00 459003320 DOPPLER ECHO COMPLETE 10.4590 483 $ 327.00 459003325 COLOR DOPPLER 10.4590 480 $ 385.00 459003326 PRO FEE ECHO COMPLETE (PANEL) 10.4590 480 $ - 459003327 PRO FEE 2D/DOPLLER/COL (PANEL) 10.4590 480 $ - 459003350 STRESS ECHO 10.4590 483 $ 989.00 459003351 STRESS ECHO - PRO FEE 11.4590 985 $ 244.00 459003659 TILT TABLE STUDY - PRO FEE 11.4590 985 $ 420.00 459003660 TILT TABLE STUDY 10.4590 482 $ 1,691.00 459003661 TILT TABLE STUDY/WITH MEDICATI 10.4590 482 $ 1,691.00 459003662 TILT TABLE WITH MEDS - PRO FEE 11.4590 985 $ 420.00 459003730 PACER ANALYSIS 10.4590 730 $ - 459003731 PACER ANALYSIS/DUAL CHAMBER 10.4590 921 $ 277.00 459003732 PACER/DUAL/REPROGRAMMING 10.4590 921 $ 277.00 459003733 TRANSTELEPHONIC/PACER/DUEL 10.4590 921 $ 213.00 459003734 PACER ANALYSIS/SINGLE CHAMBER 10.4590 921 $ 213.00 459003735 PACER SINGLE/REPROGRAMMING 10.4590 921 $ 237.00 459003736 TRANSTELEPHONIC/PACER/SINGLE 10.4590 921 $ 213.00 459003737 TRANSTELEPHON/PACER/SINGLE/PRO 11.4590 985 $ 59.00 459003738 TRANSTELEPHON/PACER/DUEL/PRO F 11.4590 985 $ 59.00 459009082 TRAVEL/MILEAGE/OUTSIDE FACILIT 10.4590 270 $ - 459014698 PEDIATRIC/ADULT PULSE OXIMETRY 10.4590 460 $ 121.00 459014699 ADULT PULSE OXIMETRY 10.4590 460 $ 121.00 459020011 EXAM VISIT - PEDIATRIC 10.4590 761 $ 112.00 459020012 EXAM VISIT - ADULT 10.4590 510 $ 131.00 459020013 CLINIC VISIT 10.4590 510 $ 82.00 459023276 HOLTER SCANNING/ANALYSIS/OUTSI 10.4590 730 $ 71.00 459023277 HOLTER PHYSICIAN'S REPT/OUTSID 10.4590 730 $ 71.00 459024700 ADULT CLINIC VISIT 10.4590 480 $ - 459033010 ECG INTERP/OUTSIDE FACILITY 10.4590 730 $ 29.00 459033012 TRANSTELEPHONIC/OUTSIDE FACILI 10.4590 730 $ 142.00 459033307 ECHO/TECH/OUTSIDE FACILITY 10.4590 730 $ 71.00 459053017 STRESS TEST/OUTSIDE FACILITY 10.4590 482 $ 315.00 459053224 SCAN AND ANALYSIS (OUTSIDE FAC 10.4590 480 $ 71.00 459053277 READING FEE 10.4590 480 $ 62.00 459053307 ECHO READ FEE/OUTSIDE 10.4590 730 $ 257.00 459053309 ECHO CONTRAST 10.4590 636 $ 447.00 459093352 CONTRACT STRESS STATISTICS ONL 10.4590 480 $ - 459099480 DEFENSE AUDIT ADJUSTMENT 10.4590 480 $ - 461008607 ELECTMGRAPH,1 EX 10.4610 922 $ 487.00 461008615 ELECTMGRAPH,2 EX 10.4610 922 $ 829.00 461008631 ELECTMGRAPH,3 EX 10.4610 922 $ 1,059.00 461008649 ELECTMGRAPH,4 EX 10.4610 922 $ 1,414.00 461008698 EMG THORACIC PARASPINAL 10.4610 922 $ 339.00 461008763 H-REFLEX,GASTROC 10.4610 922 $ 195.00 461009001 NRV COND (MOTOR) 10.4610 922 $ 221.00 461009043 NRV COND (SENSORY/MIXED) 10.4610 922 $ 221.00 461009357 NRV COND (MOTOR WITH F) 10.4610 922 $ 195.00 461051785 EMG-SPHINCTER 10.4610 922 $ 1,906.00 461051792 BC-BULBOCAVERNOSUS REFLEX 10.4610 922 $ 1,940.00 461095867 EMG-CRANIAL 10.4610 922 $ 364.00 461095868 EMG-BILATERAL 10.4610 922 $ 451.00 461095869 EMG-THORACIC PARASPINAL 10.4610 922 $ 139.00 461095870 EMG-LIMITED OTHER 10.4610 922 $ 139.00 461095872 EMG-SINGLE FIBER 10.4610 922 $ 382.00 461095923 SUDOMOTOR-SSR 10.4610 922 $ 1,421.00 461095933 OBICULARIS BLINK 10.4610 922 $ 503.00 461095936 H-REFLEX (OTHER) 10.4610 922 $ 139.00 461095937 NEUROMUSC JUNCT-REP STIM 10.4610 922 $ 226.00 462000110 POLYSOMNOGRAPHY ROUTINE <6 HRS 10.4620 740 $ 2,571.00 462000120 POLYSOMNOGRAPHY ROUTINE 6-8 HR 10.4620 740 $ 2,756.00 462000130 POLYSOMNOGRAPHY ROUTINE >8 HRS 10.4620 740 $ 2,940.00 462000190 POLYSOMNOGRAPHY-C-PAP 8HRS 10.4620 740 $ 3,123.00 462010052 APNEA EVAL/LIMITED SLEEP STUDY 10.4620 740 $ 1,693.00 462012585 AUDITORY WORKUP 10.4620 740 $ 435.00 462015810 POLYSOMNOGRAPHY - C-PAP 10.4620 740 $ 720.00 462015815 POLYSOMNOGRAPHY-SPLIT/CPAP ADD 10.4620 740 $ 3,496.00 462015822 EEG - MINI SPHENODIAL 10.4620 740 $ 828.00 462054779 24 HOUR AMBULATORY EEG 10.4620 740 $ 1,250.00 462092280 VISUAL EVOKED RESPONSE 10.4620 922 $ 435.00 462092585 BAER - AUDITORY BRAINSTEM RESP 10.4620 471 $ 435.00 462095805 MULTIPLE SLEEP LATENCY TEST-3N 10.4620 740 $ 1,301.00 462095806 MULTIPLE SLEEP LATENCY TEST-4N 10.4620 740 $ 1,734.00 462095807 MULTIPLE SLEEP LATENCY TEST-5N 10.4620 740 $ 2,167.00 462095810 POLYSOMNOGRAPHY & ADDL HOURS 10.4620 740 $ 648.00 462095812 EEG SLEEP DEPRIVED FULL NIGHT 10.4620 740 $ 1,250.00 462095813 EEG-EXTENDED MONITORING >1HOUR 10.4620 740 $ 828.00 462095814 EEG-EXTENDED MONITOR W VIDEO 10.4620 740 $ 1,250.00 462095815 EEG SLEEP DEPRIVED HN 10.4620 740 $ 828.00 462095816 EEG WAKE 10.4620 740 $ 691.00 462095822 EEG WAKE AND SLEEP 10.4620 740 $ 828.00 462095823 EEG-SLEEP ONLY 10.4620 740 $ 828.00 462095824 EEG CEREBRAL DEATH 10.4620 740 $ 828.00 462095825 EEG WAKE AND SLEEP WITH MSP'S 10.4620 740 $ 1,034.00 462095850 INTRA-OPERATIVE MONITORING/30M 10.4620 740 $ - 462095925 SOMATOSENSORY TESTING (SSER) 10.4620 922 $ 1,443.00 462095926 SOMATOSENSORY TESTING (SER) 10.4620 922 $ 1,443.00 462095927 SOMATOSENSORY TESTING TRNK/HD 10.4620 922 $ 1,443.00 462095999 UNLISTED NEURO DIAG PROC 10.4620 740 $ - 463000001 MT XRAY CHARGES 10.4630 320 $ - 463000366 ZZ GUIDE WIRE,35X180 BENTSON 10.4630 272 $ 304.00 463000385 ZZ GUIDE WIRE,35X180 SUPER STI 10.4630 279 $ 665.00 463001128 TRAY LUMBAR PUNCTURE 10.4630 279 $ 143.00 463005072 MD GASTROVIES 120ML 10.4630 255 $ 283.00 463005104 TRAY - ARTHROGRAM 10.4630 272 $ 152.00 463005751 XZZ ADAPTER CATH LG 10.4630 272 $ 16.00 463005752 XZZ NEEDLE LOC MANAN 21X3CM 10.4630 272 $ 228.00 463005753 XZZ NEEDLE LOC MANAN 21X5CM 10.4630 272 $ 228.00 463005754 XZZ NEEDLE LOC MANAN 21X7CM 10.4630 272 $ 228.00 463005755 XZZ NEEDLE LOC MANAN 21X10CM 10.4630 272 $ 228.00 463005756 XZZ NEEDLE LOC MANAN 21X13CM 10.4630 272 $ 228.00 463005757 XZZ RING ENEMA 10.4630 272 $ 98.00 463005758 XZZ TRAY ARTHROGRAM 10.4630 272 $ 170.00 463005759 XZZ TRAY MYELOGRAM 10.4630 272 $ 170.00 463005760 XZZ TUBE BILBAO DOTTER 200 10.4630 272 $ 854.00 463005761 XZZ TUBE BILBAO DOTTER 600 10.4630 272 $ 854.00 463005762 XZZ TUBE CTU CONNECTING 10.4630 272 $ 142.00 463005763 XZZ CATH HYSTEROSALPINGOGRAPHY 10.4630 272 $ 484.00 463017439 XR ERCP 10.4630 320 $ 1,148.00 463019030 XR INJECT DUCTOGRAM 10.4630 361 $ 202.00 463019290 XR MAMMOGRAPHY PLACE NEEDLE LO 10.4630 361 $ 461.00 463019291 XR MAMMOGRAPHY ADD'L LESION LO 10.4630 361 $ 187.00 463020501 XR INJECT SINUS TRACT 10.4630 361 $ 488.00 463020610 XR INJECTION/ARTHROCENTESIS 10.4630 361 $ 604.00 463020612 NEEDLE ASPIRATION 10.4630 361 $ 604.00 463023350 XR INJECT SHOULDER ARTHRO 10.4630 361 $ 486.00 463024220 XR INJECT ELBOW ARTHRO 10.4630 361 $ 572.00 463025246 XR INJECT WRIST ARTHRO 10.4630 361 $ 637.00 463027093 XR INJECT HIP ARTHRO 10.4630 361 $ 604.00 463027370 XR INJECT KNEE ARTHRO 10.4630 361 $ 538.00 463027648 XR INJECT ANKLE ARTHRO 10.4630 361 $ 572.00 463030026 XR BX - OTHER THAN LUNG 10.4630 320 $ 730.00 463030032 XR TUBE PLACEMENT-- ENTEROCLYS 10.4630 750 $ 385.00 463032020 XR TUBE THORACOSTOMY 10.4630 361 $ 920.00 463033002 XR CONRAY 30 - 50CC 10.4630 250 $ 114.00 463036000 XR INJECT VENOGRAM EXTREMITY 10.4630 361 $ 910.00 463036005 XR CATHOGRAM 10.4630 361 $ 424.00 463037033 XR CONRAY 60 - 20CC 10.4630 250 $ 44.00 463037361 XR CONRAY 60 - 10CC 10.4630 250 $ 44.00 463037422 XR GASTROVIEW ORAL SOLUTION 12 10.4630 250 $ 283.00 463037429 XR ORAGRAFIN - 6 TAB/PKG 10.4630 250 $ 57.00 463037430 XR CONRAY 60 - 50CC 10.4630 250 $ 62.00 463037443 XR CYSTO CONRAY II - 500ML 10.4630 250 $ 349.00 463037565 XR HYPAQUE 76 - 50CC 10.4630 320 $ 92.00 463037597 XR CONRAY 43 - 50CC 10.4630 250 $ 102.00 463043246 XR NASOGASTRIC TUBE PLACEMENT 10.4630 361 $ 357.00 463043752 FLOURO CATH PLACEMENT 10.4630 361 $ 357.00 463044038 INJ ANTEGRADE STICK 10.4630 361 $ 1,139.00 463044050 INJ. VENOGRAM EXTREMITY 10.4630 361 $ 910.00 463044056 INJ PERC BILIARY TUBE PLACEMNT 10.4630 361 $ 1,773.00 463044059 IR NEPHROSTOGRAM 10.4630 320 $ 168.00 463044162 INJ ANTEGRADE PYELOGRAM 10.4630 361 $ 368.00 463044166 EPIDUROGRAPHY 10.4630 320 $ 920.00 463044167 INJ EPIDUROGRAPHY 10.4630 361 $ 443.00 463044168 EPIDUROGRAPHY SELECTIVE 10.4630 320 $ 920.00 463044170 EPIDUROGRAPHY SELECTIVE ADDTL 10.4630 320 $ 920.00 463044175 FACET BLOCK CERVICAL 10.4630 320 $ 920.00 463044176 FACET BLOCK CERVICAL ADD'L 10.4630 320 $ 920.00 463044177 INJ FACET BLOCK CERVICAL 10.4630 361 $ 443.00 463044178 INJ FACET BLOCK CERVICAL AD 10.4630 361 $ 443.00 463044186 SI JOINT INJECTION 10.4630 320 $ 836.00 463047427 XR HYPAQUE POWDER 250GM CAN 10.4630 250 $ 398.00 463048400 INJECT T-TUBE CHOLE 10.4630 361 $ 531.00 463049400 XR INJECT, PERITONEAL CAVITY 10.4630 361 $ 619.00 463050390 XR INJECT RENAL CYST PELVIS 10.4630 361 $ 541.00 463050394 XR INJECT NEPHROSTOGRAM 10.4630 361 $ 368.00 463051600 XR INJECT CYSTOGRAPHY 10.4630 361 $ 1,047.00 463051610 XR INJECT RETRO URETHROCYST 10.4630 361 $ 504.00 463055300 XR VASOTOMY FOR VASOGRAMS 10.4630 361 $ 393.00 463055555 MASTER - MAMMOGRAPHY 10.4630 401 $ - 463058340 XR INJ HYSTEROSALPINGOGRAPHY 10.4630 361 $ 85.00 463061055 XR INJECT MYELO CERVICAL 10.4630 361 $ 477.00 463062270 XR LUMBAR PUNCTURE 10.4630 361 $ 368.00 463062273 XR LUMBAR BLOOD PATCH 10.4630 361 $ 368.00 463062284 XR INTRATHECAL INJECTION 10.4630 361 $ 558.00 463062310 INJ EPIDUROGRAPHY CERVICAL 10.4630 361 $ 462.00 463064475 INJ FACET BLOCK LUMBAR 10.4630 361 $ 443.00 463064476 INJ FACET BLOCK LUMBAR ADD 10.4630 361 $ 443.00 463066666 MASTER - FLUOROSCOPY 10.4630 321 $ - 463070030 XR EYE - FOREIGN BODY DETECTIO 10.4630 320 $ 526.00 463070100 XR MANDIBLE - LIMITED 10.4630 320 $ 596.00 463070110 XR MANDIBLE - COMPLETE 10.4630 320 $ 710.00 463070120 XR MASTOIDS - UNILATERAL 10.4630 320 $ 412.00 463070130 XR MASTOIDS - BILATERAL 10.4630 320 $ 623.00 463070140 XR FACIAL BONES - LIMITED 10.4630 320 $ 596.00 463070150 XR FACIAL BONES - COMPLETE 10.4630 320 $ 710.00 463070160 XR NASAL BONES 10.4630 320 $ 608.00 463070190 XR OPTIC FORAMINA 10.4630 320 $ 412.00 463070200 XR ORBITS COMPLETE - 4VW MIN 10.4630 320 $ 526.00 463070210 XR PARANASAL SINUS, LIMITED 10.4630 320 $ 513.00 463070220 XR PARANASAL SINUS, COMPLETE 10.4630 320 $ 715.00 463070240 XR SELLA TURCICA 10.4630 320 $ 368.00 463070250 XR SKULL LIMITED 10.4630 320 $ 526.00 463070260 XR SKULL COMPLETE 10.4630 320 $ 791.00 463070300 XR TEETH, SINGLE VIEW 10.4630 320 $ 297.00 463070310 XR TEETH, PARTIAL STUDY 10.4630 320 $ 380.00 463070320 XR TEETH, FULL MOUTH 10.4630 320 $ 558.00 463070328 XR TMJ OPEN & CLOSED - UNILATE 10.4630 320 $ 354.00 463070330 XR TMJ OPEN & CLOSED -BILATERA 10.4630 320 $ 531.00 463070332 XR TMJ ARTHROGRAM 10.4630 320 $ 1,414.00 463070355 XR ORTHOPANTOGRAM 10.4630 320 $ 187.00 463070360 XR SOFT TISSUE NECK 10.4630 320 $ 218.00 463070380 SALIVARY GLND FOR CALCUL 10.4630 320 $ 426.00 463070390 XR SIALOGRAPHY 10.4630 320 $ 730.00 463071010 XR CHEST - SINGLE VIEW 10.4630 324 $ 513.00 463071020 XR CHEST - TWO VIEW 10.4630 324 $ 526.00 463071021 XR CHEST - W/ APICAL LORDOTIC 10.4630 324 $ 572.00 463071025 XR CHEST - W/ OBLIQUES 10.4630 324 $ 632.00 463071029 FLOURO CHEST 10.4630 324 $ 655.00 463071030 XR CHEST - FOUR VIEW 10.4630 324 $ 632.00 463071034 XR CHEST - W/ FLUORO 10.4630 324 $ 655.00 463071035 XR CHEST - W/DECUB(S) 10.4630 324 $ 632.00 463071036 XR BX - FLU LOCLN INTHR LESION 10.4630 320 $ 203.00 463071037 XR CHEST 3V (PA-INS/EXP & LAT) 10.4630 324 $ 632.00 463071038 XR BRONCHOSCOPY WITH FLUOROSCO 10.4630 360 $ 1,060.00 463071100 XR RIBS - UNILATERAL W/PA CHES 10.4630 320 $ 807.00 463071102 XR RIBS - UNILATERAL W/O CHEST 10.4630 320 $ 257.00 463071110 XR RIBS - BILATERAL W/ PA CHES 10.4630 320 $ 924.00 463071111 XR RIBS - BILATERAL W/O CHEST 10.4630 320 $ 317.00 463071120 XR STERNUM 10.4630 320 $ 411.00 463071130 XR STERNOCLAVICULAR JTS 10.4630 320 $ 412.00 463072020 XR SPINE ANY LEVEL - 1 VIEW 10.4630 320 $ 411.00 463072040 XR SPINE CERVICAL- 2 OR 3 VIEW 10.4630 320 $ 596.00 463072050 XR SPINE CERVICAL-COMP AP/LAT/ 10.4630 320 $ 725.00 463072052 XR SPINE CERVICAL COMP W/FLEX& 10.4630 320 $ 846.00 463072070 XR SPINE THORACIC INC. SWIMMER 10.4630 320 $ 632.00 463072080 XR THORACOLMBR AP/LAT 10.4630 320 $ 632.00 463072090 XR SPINE SCOLIOSIS STUDY 10.4630 320 $ 242.00 463072100 XR SPINE LUMBOSACRAL- 2 OR 3 V 10.4630 320 $ 637.00 463072110 XR SPINE LUMBOSACRAL COMP W/OB 10.4630 320 $ 840.00 463072114 XR SPINE LUMBOSACRAL COMP W/BE 10.4630 320 $ 953.00 463072120 XR SPINE LUMBOSACRAL BEND ONLY 10.4630 320 $ 668.00 463072170 XR PELVIS 1 VIEW 10.4630 320 $ 542.00 463072190 XR PELVIS-- 2 VIEWS 10.4630 320 $ 665.00 463072202 XR SACROILIAC JTS COMPLETE 10.4630 320 $ 629.00 463072220 XR SACRUM + COCCYX 10.4630 320 $ 608.00 463072240 XR MYELOGRAM - CERVICAL 10.4630 320 $ 596.00 463072255 XR MYELOGRAM - THORACIC 10.4630 320 $ 542.00 463072265 XR MYELOGRAM - LUMBAR 10.4630 320 $ 510.00 463072270 XR MYELOGRAM - ALL LEVELS 10.4630 320 $ 765.00 463072275 VERTEBROPLASTY - LUMBAR 10.4630 320 $ 1,105.00 463072285 DISKOGRAPHY CERVICAL 10.4630 320 $ 1,105.00 463072295 DISKOGRAPHY LUMBAR 10.4630 320 $ 1,105.00 463073000 XR CLAVICLE 10.4630 320 $ 271.00 463073010 XR SCAPULA 10.4630 320 $ 582.00 463073020 XR SHOULDER LIMITED 10.4630 320 $ 461.00 463073030 XR SHOULDER COMPLETE 10.4630 320 $ 623.00 463073040 XR SHOULDER ARTHRO 10.4630 320 $ 266.00 463073050 XR AC JOINTS-- BILAT 10.4630 320 $ 454.00 463073060 XR HUMERUS 10.4630 320 $ 538.00 463073070 XR ELBOW LIMITED-- 2 VIEW 10.4630 320 $ 538.00 463073080 XR ELBOW COMPLETE--4 VIEW 10.4630 320 $ 582.00 463073085 XR ELBOW - ARTHRO 10.4630 320 $ 266.00 463073090 XR FOREARM 10.4630 320 $ 538.00 463073092 XR EXTREMITY UPPER - INFANT 2V 10.4630 320 $ 170.00 463073100 XR WRIST LIMITED-- 2 VIEW 10.4630 320 $ 438.00 463073110 XR WRIST COMPLETE-- 4 VIEW 10.4630 320 $ 596.00 463073115 XR WRIST ARTHROGRAM 10.4630 320 $ 202.00 463073120 XR HAND LIMITED-- 2 VIEW 10.4630 320 $ 510.00 463073130 XR HAND COMPLETE-- 3 VIEW 10.4630 320 $ 596.00 463073140 XR FINGER(S) 10.4630 320 $ 502.00 463073500 XR HIP UNILATERAL-- 1 VIEW 10.4630 320 $ 454.00 463073510 XR HIP UNILATERAL-- 2 VIEW 10.4630 320 $ 637.00 463073520 XR HIP BILATERAL W/ AP PELVIS 10.4630 320 $ 710.00 463073525 XR HIP ARTHROGRAM 10.4630 320 $ 266.00 463073530 XR HIP - DURING OPERATION 10.4630 320 $ 773.00 463073540 XR HIP & PELVIS-INFANT/CHILD 10.4630 320 $ 526.00 463073550 XR FEMUR - AP & LAT 10.4630 320 $ 596.00 463073560 XR KNEE--- 2 VIEW 10.4630 320 $ 440.00 463073562 XR KNEE COMP--3 VIEW 10.4630 320 $ 519.00 463073564 XR KNEE--COMPLETE (INC OBLIQUE 10.4630 320 $ 519.00 463073580 XR KNEE ARTHROGRAM 10.4630 320 $ 332.00 463073590 XR TIBIA AND FIBULA 10.4630 320 $ 538.00 463073592 XR EXTREMITY LOWER - INFANT 2V 10.4630 320 $ 538.00 463073600 XR ANKLE LIMITED-- 2 VIEW 10.4630 320 $ 519.00 463073610 XR ANKLE COMPLETE--3 VIEW 10.4630 320 $ 596.00 463073615 XR ANKLE - ARTHROGRAPHY 10.4630 320 $ 266.00 463073620 XR FOOT LIMITED-- 2 VIEW 10.4630 320 $ 504.00 463073630 XR FOOT COMPLETE-- 3 VIEW 10.4630 320 $ 580.00 463073650 XR CALCANEUS (HEEL) 10.4630 320 $ 513.00 463073660 XR TOE(S) 10.4630 320 $ 493.00 463074000 XR ABDOMEN - SINGLE VIEW 10.4630 320 $ 563.00 463074010 XR ABDOMEN--AP WITH OBLIQUE 10.4630 320 $ 604.00 463074020 XR ABDOMEN - COMPLETE 10.4630 320 $ 632.00 463074022 XR ABDOMINAL SERIES - ACUTE 10.4630 320 $ 962.00 463074190 XR PERITONEOGRAM 10.4630 320 $ 266.00 463074220 XR ESOPHAGRAM 10.4630 320 $ 568.00 463074230 XR SWALLOWING FUCT W/VIDEO 10.4630 320 $ 565.00 463074242 XR UGI 10.4630 320 $ 739.00 463074243 UGI W/O AR 10.4630 320 $ 739.00 463074245 XR UGI W/ SMALL BOWEL 10.4630 320 $ 769.00 463074246 XR UGI W/AIR CON 10.4630 320 $ 739.00 463074250 XR SM BOWEL INDEPENDENT STUDY 10.4630 320 $ 704.00 463074251 XR SM BOWEL VIA ENTEROCLYSIS T 10.4630 320 $ 392.00 463074270 XR COLON - BARIUM ENEMA 10.4630 320 $ 611.00 463074280 XR COLON - AIR CONTR W/ BARIUM 10.4630 320 $ 704.00 463074290 XR CHOLECYSTOGRAPHY 10.4630 320 $ 668.00 463074291 XR CHOLECYSTOGRAPHY - REPEAT 10.4630 320 $ 399.00 463074300 XR CHOLANGIOGRAM - OPER INITIA 10.4630 320 $ 563.00 463074301 XR CHOLANGIOGRAM - OPER ADDITI 10.4630 320 $ 279.00 463074305 XR CHOLE T-TUBE POST-OP 10.4630 320 $ 101.00 463074320 CHOLANGIOGRAM TRANSHEPATIC 10.4630 320 $ 519.00 463074340 XR INSERTION GI TUBE W/ FLUORO 10.4630 320 $ 746.00 463074400 XR UROGRAPHY EXCR IVP 10.4630 320 $ 757.00 463074402 IVP W/ TOMOGRAMS 10.4630 320 $ 757.00 463074406 XR UROGRAPHY HYPERTENSIVE 10.4630 320 $ 920.00 463074415 XR UROGRAPHY INFERIOR NEPHROTO 10.4630 320 $ 1,207.00 463074420 XR UROGRAPHY RETROGRADE 10.4630 320 $ 730.00 463074425 XR UROGRAPHY ANTEGRADE 10.4630 320 $ 168.00 463074427 LOOPOGRAM 10.4630 320 $ 168.00 463074430 XR URINARY CYSTOGRAPHY 10.4630 320 $ 132.00 463074440 XR VASOGRAPHY 10.4630 320 $ 146.00 463074450 XR URETHROCYST- RETROGRADE 10.4630 320 $ 185.00 463074455 XR URETHROCYST - VOIDING 10.4630 320 $ 203.00 463074457 VCUG W/ FLOUROSCOPY 10.4630 320 $ 203.00 463074471 XR RENAL CYST - TRANSLUMBAR 10.4630 320 $ 158.00 463074710 XR PELVIMETRY 10.4630 320 $ 542.00 463074740 XR HYSTEROSALPINGOGRAM 10.4630 320 $ 733.00 463075710 XR PORT OPERATIVE ANGIOGRAM 10.4630 320 $ 538.00 463075970 XR VENOGRAM EXT- UNILATERAL 10.4630 320 $ 123.00 463075971 XR VENOGRAM EXTREMITY BILATERA 10.4630 320 $ 186.00 463076000 XR FLUOROSCOPY - 0-60 MINUTES 10.4630 320 $ 1,060.00 463076001 XR FLUOROSCOPY-GREATER THAN 60 10.4630 320 $ 1,589.00 463076003 XR INJ DISCECTOMY 10.4630 320 $ 836.00 463076004 XR NEEDLE PLACEMENT GUIDANCE 10.4630 320 $ 1,060.00 463076005 FACET BLOCK LUMBAR 10.4630 320 $ 920.00 463076006 FACET BLOCK LUMBAR ADDL 10.4630 320 $ 920.00 463076010 XR NOSE TO RECTUM - CHILD 10.4630 320 $ 380.00 463076012 VERTEBROPLASTY--THORACIC 10.4630 320 $ 1,105.00 463076020 XR BONE AGE STUDIES 10.4630 320 $ 412.00 463076040 XR SCANOGRAM/LEG LENGTH 10.4630 320 $ 531.00 463076041 XR LEG--STANDING FULL LENGTH 10.4630 320 $ 531.00 463076060 XR BONE SURVEY COMPLETE 10.4630 320 $ 1,185.00 463076061 XR BONE STUDY--LIMITED 10.4630 320 $ 198.00 463076065 XR BONE SURVEY - CHILD 10.4630 320 $ 553.00 463076082 XR FISTULA SINUS TRACT 10.4630 320 $ 132.00 463076086 XR DUCTOGRAM - UNILATERAL 10.4630 320 $ 326.00 463076088 XR DUCTOGRAM - BILATERAL 10.4630 320 $ 649.00 463076090 XR MAMMOGRAPHY - UNILATERAL 10.4630 320 $ 156.00 463076091 XR MAMMOGRAPHY- DIAGNOSTIC 10.4630 320 $ 303.00 463076092 XR MAMMOGRAPHY SCREEN 10.4630 320 $ 159.00 463076095 XR SPECIMEN 10.4630 320 $ 146.00 463076096 XR MAMMOGRAPHY - LOCALIZATION 10.4630 320 $ 967.00 463076100 XR TOMOGRAPHY 10.4630 320 $ 1,589.00 463076102 TOMOGRAMS 1-4 FILMS 10.4630 320 $ 1,589.00 463076103 TOMOGRAMS 11 PLUS FILMS 10.4630 320 $ 1,589.00 463076104 TOMOGRAMS 5-10 FILMS 10.4630 320 $ 1,589.00 463076170 XR SUB STUDIES PER FILM 10.4630 320 $ 112.00 463077010 XR PORT MANDIBLE--LIMITED 10.4630 320 $ 596.00 463077011 XR PORT MANDIBLE--COMPLETE 10.4630 320 $ 710.00 463077014 XR PORT FACIAL BONES--LIMITED 10.4630 320 $ 596.00 463077015 XR PORT FACIAL BONES--COMPLETE 10.4630 320 $ 710.00 463077021 XR PORT PARANASAL SINUS 10.4630 320 $ 513.00 463077025 XR PORT SKULL--LIMITED, 2 VIEW 10.4630 320 $ 526.00 463077026 XR PORT SKULL--COMPLETE 10.4630 320 $ 791.00 463077030 XR PORT TEETH-- SINGLE VIEW 10.4630 320 $ 380.00 463077031 XR PORT TEETH--PARTIAL STUDY 10.4630 320 $ 380.00 463077101 XR PORT CHEST- SINGLE VIEW 10.4630 320 $ 526.00 463077102 XR PORT CHEST-- TWO VIEWS 10.4630 320 $ 526.00 463077103 XR PORT CHEST--W/ DECUB 10.4630 320 $ 632.00 463077202 XR PORT SPINE ANY LEVEL, ONE V 10.4630 320 $ 411.00 463077203 XR PORT SPINE(S) IN OR, ANY LE 10.4630 320 $ 596.00 463077204 XR PORT SPINE CERVICAL 2 VIEW 10.4630 320 $ 596.00 463077207 XR PORT SPINE, THORACIC 10.4630 320 $ 632.00 463077210 XR PORT SPINE, LUMBAR 10.4630 320 $ 637.00 463077217 XR PORT PELVIS-- ONE VIEW 10.4630 320 $ 542.00 463077219 XR PORT PELVIS-- COMPLETE 10.4630 320 $ 665.00 463077300 XR PORT CLAVICLE 10.4630 320 $ 531.00 463077302 XR PORT SHOULDER 10.4630 320 $ 461.00 463077306 XR PORT HUMERUS 10.4630 320 $ 538.00 463077307 XR PORT ELBOW-LIMITED, 2 VIEW 10.4630 320 $ 538.00 463077308 XR PORT ELBOW-COMPLETE 4VIEW 10.4630 320 $ 587.00 463077309 XR PORT FOREARM 10.4630 320 $ 538.00 463077310 XR PORT WRIST--LIMITED, 2 VIEW 10.4630 320 $ 596.00 463077311 XR PORT WRIST--COMPLETE, 3 VIE 10.4630 320 $ 596.00 463077312 XR PORT HAND--LIMITED, 2 VIEW 10.4630 320 $ 510.00 463077313 XR PORT HAND--COMPLETE, 3 VIEW 10.4630 320 $ 596.00 463077314 XR PORT FINGER(S) 10.4630 320 $ 502.00 463077350 XR PORT HIP--UNILATERAL, 1 VIE 10.4630 320 $ 454.00 463077351 XR PORT HIP--UNILATERAL, 2 VIE 10.4630 320 $ 637.00 463077352 XR PORT HIP--BILATERAL 10.4630 320 $ 710.00 463077355 XR PORT FEMUR 10.4630 320 $ 596.00 463077356 XR PORT KNEE--LIMITED 10.4630 320 $ 440.00 463077357 XR PORT KNEE--COMPLETE, 3 VIEW 10.4630 320 $ 519.00 463077359 XR PORT TIBIA & FIBULA 10.4630 320 $ 538.00 463077360 XR PORT ANKLE- 2 VIEW 10.4630 320 $ 519.00 463077361 XR PORT ANKLE-COMPLETE, 3 VIEW 10.4630 320 $ 596.00 463077362 XR PORT FOOT-LIMITED, 2 VIEW 10.4630 320 $ 504.00 463077363 XR PORT FOOT--COMPLETE, 3 VIEW 10.4630 320 $ 580.00 463077366 XR PORT TOE(S) 10.4630 320 $ 493.00 463077370 XR PORT CALCANEUS 10.4630 320 $ 513.00 463077400 XR PORT ABDOMEN 1 VIEW 10.4630 320 $ 563.00 463077401 XR PORT ABDOMEN W/OBLIQUES 10.4630 320 $ 604.00 463077402 XR PORT ABDOMEN, 2 VIEWS 10.4630 320 $ 935.00 463077440 XR PORT UROGRAPHY, EXCR IVP 10.4630 320 $ 935.00 463077777 MASTER - GENERAL DIAGNOSTIC 10.4630 321 $ - 463080010 XR ERCP 10.4630 320 $ 1,148.00 463080030 XR CONRAY 30 - 50CC 10.4630 250 $ 114.00 463080031 XR ISOVUE M 200 100ML 10.4630 250 $ 436.00 463080032 XR ISOVUE M 300 100ML 10.4630 636 $ 436.00 463080040 XR CONRAY 60 - 20CC 10.4630 250 $ 44.00 463080050 XR CONRAY 60 - 10CC 10.4630 250 $ 44.00 463080060 XR GASTROVIEW ORAL SOLUTION 12 10.4630 250 $ 283.00 463080080 XR CONRAY 60 - 50CC 10.4630 250 $ 62.00 463080090 XR CYSTO CONRAY II - 500ML 10.4630 250 $ 349.00 463080300 XR HYPAQUE POWDER 250GM CAN 10.4630 250 $ 398.00 463080500 XR PORT MANDIBLE--LIMITED 10.4630 320 $ 596.00 463080510 XR PORT MANDIBLE--COMPLETE 10.4630 320 $ 710.00 463080520 XR PORT FACIAL BONES--LIMITED 10.4630 320 $ 596.00 463080540 XR PORT PARANASAL SINUS 10.4630 320 $ 513.00 463080550 XR PORT SKULL--LIMITED, 2 VIEW 10.4630 320 $ 526.00 463080590 XR PORT CHEST- SINGLE VIEW 10.4630 320 $ 526.00 463080600 XR PORT CHEST-- TWO VIEWS 10.4630 320 $ 526.00 463080610 XR PORT CHEST--W/ DECUB 10.4630 320 $ 632.00 463080620 XR PORT SPINE ANY LEVEL, ONE V 10.4630 320 $ 411.00 463080625 XR PORT SPINE(S) IN OR, ANY LE 10.4630 320 $ 596.00 463080630 XR PORT SPINE CERVICAL 2 VIEW 10.4630 320 $ 596.00 463080640 XR PORT SPINE, THORACIC 10.4630 320 $ 632.00 463080650 XR PORT SPINE, LUMBAR 10.4630 320 $ 637.00 463080660 XR PORT PELVIS-- ONE VIEW 10.4630 320 $ 542.00 463080670 XR PORT PELVIS-- COMPLETE 10.4630 320 $ 665.00 463080680 XR PORT CLAVICLE 10.4630 320 $ 531.00 463080690 XR PORT SHOULDER 10.4630 320 $ 461.00 463080700 XR PORT HUMERUS 10.4630 320 $ 538.00 463080710 XR PORT ELBOW-LIMITED, 2 VIEW 10.4630 320 $ 538.00 463080720 XR PORT ELBOW-COMPLETE 4VIEW 10.4630 320 $ 587.00 463080730 XR PORT FOREARM 10.4630 320 $ 538.00 463080740 XR PORT WRIST--LIMITED, 2 VIEW 10.4630 320 $ 596.00 463080750 XR PORT WRIST--COMPLETE, 3 VIE 10.4630 320 $ 596.00 463080760 XR PORT HAND--LIMITED, 2 VIEW 10.4630 320 $ 510.00 463080770 XR PORT HAND--COMPLETE, 3 VIEW 10.4630 320 $ 596.00 463080780 XR PORT FINGER(S) 10.4630 320 $ 502.00 463080790 XR PORT HIP--UNILATERAL, 1 VIE 10.4630 320 $ 454.00 463080800 XR PORT HIP--UNILATERAL, 2 VIE 10.4630 320 $ 637.00 463080820 XR PORT FEMUR 10.4630 320 $ 596.00 463080830 XR PORT KNEE--LIMITED 10.4630 320 $ 440.00 463080850 XR PORT TIBIA & FIBULA 10.4630 320 $ 538.00 463080851 XR PORT OPERATIVE ANGIOGRAM 10.4630 320 $ 538.00 463080855 XR PORT CALCANEUS 10.4630 320 $ 513.00 463080860 XR PORT ANKLE- 2 VIEW 10.4630 320 $ 519.00 463080870 XR PORT ANKLE-COMPLETE, 3 VIEW 10.4630 320 $ 596.00 463080880 XR PORT FOOT-LIMITED, 2 VIEW 10.4630 320 $ 504.00 463080890 XR PORT FOOT--COMPLETE, 3 VIEW 10.4630 320 $ 580.00 463080900 XR PORT TOE(S) 10.4630 320 $ 493.00 463080910 XR PORT ABDOMEN 1 VIEW 10.4630 320 $ 563.00 463080930 XR PORT ABDOMEN, 2 VIEWS 10.4630 320 $ 935.00 463087240 XR OMNIPAQUE 240 - 20CC 10.4630 250 $ 319.00 463087565 XR OPTIRAY 320 - 30ML 10.4630 636 $ 436.00 463087566 XR OPTIRAY 320 - 50CC 10.4630 636 $ 477.00 463087577 XR OPTIRAY 320 - 100CC 10.4630 636 $ 924.00 463099320 DEFENSE AUDIT ADJUSTMENT 10.4630 320 $ - 463099995 XR CLAVICLE 10.4630 320 $ 271.00 463100400 CBR PATHOLOGY SPEC COLLECTION 10.4630 270 $ 77.00 463117439 CXR ERCP 10.4630 320 $ 1,148.00 463119030 CBR INJ DUCTOGRAM 10.4630 361 $ 326.00 463119290 CBR INJ NEEDLE LOCALIZATION 10.4630 361 $ 377.00 463119291 CBR INJ LESION LOC ADD'L 10.4630 361 $ 303.00 463120010 CBR INITIAL EVALUATION 10.4630 761 $ 250.00 463120501 CXR INJECT SINUS TRACT 10.4630 361 $ 488.00 463123350 CXR INJECT SHOULDER ARTHRO 10.4630 361 $ 486.00 463124220 CXR INJECT ELBOW ARTHRO 10.4630 361 $ 572.00 463125246 CXR INJECT WRIST ARTHRO 10.4630 361 $ 637.00 463127093 CXR INJECT HIP ARTHRO 10.4630 361 $ 604.00 463127370 CXR INJECT KNEE ARTHRO 10.4630 361 $ 538.00 463127648 CXR INJECT ANKLE ARTHRO 10.4630 361 $ 572.00 463130026 CXR BX - OTHER THAN LUNG 10.4630 320 $ 730.00 463130032 CXR TUBE PLACEMENT-- ENTEROCLY 10.4630 361 $ 385.00 463132020 CXR TUBE THORACOSTOMY 10.4630 361 $ 935.00 463133002 CXR CONRAY 30 - 50CC 10.4630 250 $ 94.00 463136000 CXR INJECT VENOGRAM EXTREMITY 10.4630 361 $ 910.00 463137033 CXR CONRAY 60 - 20CC 10.4630 250 $ 54.00 463137361 CXR CONRAY 60 - 10CC 10.4630 250 $ 44.00 463137422 CXR MD GASTROVIEW - 120 BOTTLE 10.4630 250 $ 283.00 463137429 CXR ORAGRAFIN - 6 TAB/PKG 10.4630 250 $ 48.00 463137430 CXR CONRAY 60 - 50CC 10.4630 250 $ 62.00 463137443 CXR CYSTO CONRAY 11- 500ML 10.4630 250 $ 349.00 463137597 CXR CONRAY 43 - 50CC 10.4630 250 $ 85.00 463140220 RXR PARANASAL SINUSES COMPLT 10.4630 320 $ 715.00 463141010 RXR CHEST SINGLE VIEW 10.4630 324 $ 513.00 463141020 RXR CHEST,TWO VIEWS 10.4630 324 $ 528.00 463141100 RXR RIBS UNILAT W/PA CHEST 10.4630 320 $ 807.00 463141110 RXR RIBS, BILATERAL 10.4630 320 $ 924.00 463141120 RXR STERNUM 10.4630 320 $ 411.00 463142020 RXR SPINE ANY LEVEL (1 VIEW) 10.4630 320 $ 411.00 463142040 RXR SPINE CERVICAL AP AND LAT 10.4630 320 $ 596.00 463142070 RXR SPINE THORA-INCLSWIMMRS 10.4630 320 $ 632.00 463142100 RXR SPINE LUMBOSACRAL AP AND L 10.4630 320 $ 637.00 463143020 RXR SHOULDER, LIMITED 10.4630 320 $ 461.00 463143030 RXR SHOULDER, COMPLETE 10.4630 320 $ 623.00 463143060 RXR HUMERUS, INCL BTH JOINTS 10.4630 320 $ 538.00 463143070 RXR ELBOW, LIMITED (AP&LAT) 10.4630 320 $ 538.00 463143080 RXR ELBOW, COMPLETE 10.4630 320 $ 582.00 463143110 RXR WRIST,COMPLETE 10.4630 320 $ 596.00 463143130 RXR HAND, COMPLETE 10.4630 320 $ 596.00 463143246 CXR GASTROTUBE DIRECT PLACEMEN 10.4630 361 $ 357.00 463143500 RXR HIP,UNILATERAL 10.4630 320 $ 454.00 463143550 RXR FEMUR, AP & LAT VIEWS 10.4630 320 $ 596.00 463143560 RXR KNEE, LIMITED AP&LAT 10.4630 320 $ 440.00 463143562 RXR KNEE, W/OBLIQUES 10.4630 320 $ 519.00 463143564 RXR KNEE, COMPLETE 10.4630 320 $ 519.00 463143590 RXR TIBIA & FIBULA W/AP & LAT 10.4630 320 $ 538.00 463143610 RXR ANKLE, COMPLETE 10.4630 320 $ 572.00 463143630 RXR FOOT,COMPLETE 10.4630 320 $ 580.00 463144000 RXR ABDOMEN-SINGLE VIEW 10.4630 320 $ 563.00 463144020 RXR ABDOMEN-- COMPLETE 10.4630 320 $ 632.00 463144230 RXR SWALLOWING FUCT.W/VIDEO 10.4630 320 $ 565.00 463147101 RXR PORT CHEST SINGLE VIEW 10.4630 324 $ 526.00 463147202 RXR PORT SPINE ANY LEVEL, 1 VI 10.4630 320 $ 200.00 463147300 RXR PORT CLAVICLE 10.4630 320 $ 531.00 463147302 RXR PORT SHOULDER 10.4630 320 $ 461.00 463147350 RXR PORT HIP, UNILATERAL 1 VIE 10.4630 320 $ 454.00 463147351 RXR PORT HIP, UNILATERAL 2 VIE 10.4630 320 $ 637.00 463147356 RXR PORT KNEE, LIMITED 10.4630 320 $ 440.00 463147359 RXR PORT TIBIA & FIBULA 10.4630 320 $ 565.00 463147361 RXR PORT ANKLE, COMPLETE 3 VIE 10.4630 320 $ 596.00 463147427 CXR HYPAQUE POWDER 250GM CAN 10.4630 250 $ 398.00 463148400 CXR INJECT T-TUBE CHOLE 10.4630 361 $ 514.00 463149400 CXR INJECT, PERITONEAL CAVITY 10.4630 361 $ 619.00 463150390 CXR INJECT RENAL CYST PELVIS 10.4630 361 $ 541.00 463150394 CXR INJECT NEPHROSTOGRAM 10.4630 361 $ 368.00 463151600 CXR INJECT CYSTOGRAPHY 10.4630 361 $ 1,047.00 463151610 CXR INJECT RETRO URETHROCYST 10.4630 361 $ 504.00 463155300 CXR VASOTOMY FOR VASOGRAMS 10.4630 361 $ 393.00 463155555 COH MASTER BREAST INTERVENTION 10.4630 401 $ - 463158340 CXR INJ HYSTEROSALPINGOGRAM 10.4630 361 $ 85.00 463160955 CBR STEREO LOC, ADD'L 10.4630 320 $ 818.00 463160965 CBR PREOP NEEDLE LOC, ADD'L 10.4630 320 $ 436.00 463161055 CXR INJECT MYELO CERVICAL 10.4630 361 $ 477.00 463162270 CXR LUMBAR PUNCTURE 10.4630 361 $ 368.00 463162284 CXR INTRATHECAL INJECTION 10.4630 361 $ 558.00 463166666 COH MASTER FLUOROSCOPY 10.4630 321 $ - 463170030 CXR EYE - FOREIGN BODY DETECTI 10.4630 320 $ 526.00 463170100 CXR MANDIBLE - LIMITED 10.4630 320 $ 596.00 463170110 CXR MANDIBLE - COMPLETE 10.4630 320 $ 710.00 463170120 CXR MASTOIDS - UNILATERAL 10.4630 320 $ 412.00 463170130 CXR MASTOIDS - BILATERAL 10.4630 320 $ 623.00 463170140 CXR FACIAL BONES - LIMITED 10.4630 320 $ 596.00 463170150 CXR FACIAL BONES - COMPLETE 10.4630 320 $ 710.00 463170160 CXR NASAL BONES 10.4630 320 $ 608.00 463170190 CXR OPTIC FORAMINA 10.4630 320 $ 412.00 463170200 CXR ORBITS COMPLETE - 4 VW MIN 10.4630 320 $ 553.00 463170210 CXR PARANASAL SINUS, LIMITED 10.4630 320 $ 513.00 463170220 CXR PARANASAL SINUS, COMPLETE 10.4630 320 $ 715.00 463170240 CXR SELLA TURCICA 10.4630 320 $ 368.00 463170250 CXR SKULL LIMITED 10.4630 320 $ 526.00 463170260 CXR SKULL COMPLETE 10.4630 320 $ 791.00 463170300 CXR TEETH, SINGLE VIEW 10.4630 320 $ 297.00 463170310 CXR TEETH, PARTIAL STUDY 10.4630 320 $ 380.00 463170320 CXR TEETH, FULL MOUTH 10.4630 320 $ 558.00 463170328 CXR TMJ OPEN & CLOSED--UNILATE 10.4630 320 $ 354.00 463170330 CXR TMJ OPEN & CLOSED--BILATER 10.4630 320 $ 531.00 463170332 CXR TMJ ARTHROGRAM 10.4630 320 $ 1,414.00 463170350 CXR CEPHALOGRAM 10.4630 320 $ 84.00 463170355 CXR ORTHOPANTOGRAM 10.4630 320 $ 329.00 463170360 CXR SOFT TISSUE NECK 10.4630 320 $ 218.00 463170380 CXR SALIVARY GLND FOR CALCULI 10.4630 320 $ 426.00 463170390 CXR SIALOGRAPHY 10.4630 320 $ 730.00 463171010 CXR CHEST - SINGLE VIEW 10.4630 324 $ 513.00 463171020 CXR CHEST - TWO VIEW 10.4630 324 $ 239.00 463171021 CXR CHEST - W/ APICAL LORDOTIC 10.4630 324 $ 520.00 463171025 CXR CHEST - W/ OBLIQUES 10.4630 324 $ 632.00 463171030 CXR CHEST - FOUR VIEW 10.4630 324 $ 632.00 463171035 CXR CHEST - W/ DECUB 10.4630 324 $ 315.00 463171037 CHEST 3V (PA-INS/EXP & LAT) 10.4630 324 $ 632.00 463171100 CXR RIBS - UNILATERAL W/PA CHE 10.4630 320 $ 439.00 463171102 CXR RIBS - UNILATERAL W/O CHES 10.4630 320 $ 256.00 463171110 CXR RIBS - BILATERAL W/PA CHES 10.4630 320 $ 504.00 463171111 CXR RIBS - BILATERAL W/O CHEST 10.4630 320 $ 488.00 463171120 CXR STERNUM 10.4630 320 $ 282.00 463171130 CXR STERNOCLAVICULAR JTS 10.4630 320 $ 271.00 463172020 CXR SPINE ANY LEVEL - 1 VIEW 10.4630 320 $ 171.00 463172040 CXR SPINE CERVICAL - 2 VIEW 10.4630 320 $ 270.00 463172050 CXR SPINE CERVICL COMP AP,LAT, 10.4630 320 $ 376.00 463172052 CXR SPINE CERVIC COMP W/FLEX&E 10.4630 320 $ 476.00 463172070 CXR SPINE THORA-INCL SWIMMERS 10.4630 320 $ 303.00 463172080 CXR THOROCOLUMBAR AP AND LAT 10.4630 320 $ 307.00 463172090 CXR SPINE SCOLIOSIS STUDY 10.4630 320 $ 412.00 463172100 CXR SPINE LUMBOSCACRAL--2 VIEW 10.4630 320 $ 289.00 463172110 CXR SPINE LUMBOSACRAL COMP W/O 10.4630 320 $ 447.00 463172114 CXR SPINE LUMBOSACRAL COMP W/B 10.4630 320 $ 953.00 463172120 CXR SPINE LUMBOSACRAL BEND ONL 10.4630 320 $ 668.00 463172170 CXR PELVIS 1 VIEW 10.4630 320 $ 239.00 463172190 CXR PELVIS COMPLETE 10.4630 320 $ 322.00 463172202 CXR SACROILIAC JTS COMPLETE 10.4630 320 $ 297.00 463172220 CXR SACRUM & COCCYX 10.4630 320 $ 276.00 463173000 CXR CLAVICLE 10.4630 320 $ 246.00 463173010 CXR SCAPULA 10.4630 320 $ 274.00 463173020 CXR SHOULDER LIMITED 10.4630 320 $ 227.00 463173030 CXR SHOULDER COMPLETE 10.4630 320 $ 283.00 463173050 CXR AC JOINTS - BILATERAL 10.4630 320 $ 277.00 463173060 CXR HUMERUS 10.4630 320 $ 249.00 463173070 CXR ELBOW LIMITED - 2 VIEW 10.4630 320 $ 222.00 463173080 CXR ELBOW COMPLETE - 4 VIEW 10.4630 320 $ 264.00 463173090 CXR FOREARM 10.4630 320 $ 244.00 463173092 CXR EXTREMITY UPPER - INFANT 2 10.4630 320 $ 265.00 463173100 CXR WRIST LIMITED-- 2 VIEW 10.4630 320 $ 175.00 463173110 CXR WRIST COMPLETE--4 VIEW 10.4630 320 $ 270.00 463173120 CXR HAND LIMITED - 2 VIEW 10.4630 320 $ 209.00 463173130 CXR HAND COMPLETE - RIGHT 10.4630 320 $ 250.00 463173140 CXR FINGER(S) 10.4630 320 $ 228.00 463173500 CXR HIP UNILATERAL - 1 VIEW 10.4630 320 $ 185.00 463173510 CXR HIP UNILATERAL - 2 VIEW 10.4630 320 $ 289.00 463173520 CXR HIP BILATERAL W/ AP PELVIS 10.4630 320 $ 274.00 463173525 CXR HIP ARTHROGRAM 10.4630 320 $ 266.00 463173530 CXR HIP - DURING OPERATION 10.4630 320 $ 773.00 463173540 CXR HIP & PELVIS-INFANT/CHILD 10.4630 320 $ 526.00 463173550 CXR FEMUR - AP & LAT 10.4630 320 $ 271.00 463173560 CXR KNEE - 2 VIEW 10.4630 320 $ 233.00 463173562 CXR KNEE COMP - 3 VIEW 10.4630 320 $ 425.00 463173564 CXR KNEE - COMPLETE(INC OBLIQU 10.4630 320 $ 348.00 463173590 CXR TIBIA AND FIBULA 10.4630 320 $ 244.00 463173592 CXR EXTREMITY LOWER - INFANT 2 10.4630 320 $ 538.00 463173600 CXR ANKLE LIMITED - 2 VIEW 10.4630 320 $ 222.00 463173610 CXR ANKLE COMPLETE - 3 VIEW 10.4630 320 $ 270.00 463173615 CXR ANKLE - ARTHROGRAPHY 10.4630 320 $ 266.00 463173620 CXR FOOT LIMITED - 2 VIEW 10.4630 320 $ 212.00 463173630 CXR FOOT COMPLETE - 3 VIEW 10.4630 320 $ 263.00 463173650 CXR CALCANEUS (HEEL) 10.4630 320 $ 210.00 463173660 CXR TOE(S) 10.4630 320 $ 224.00 463174000 CXR ABDOMEN - SINGLE VIEW 10.4630 320 $ 255.00 463174010 CXR ABDOMEN - AP WITH OBLIQUE 10.4630 320 $ 604.00 463174020 CXR ABDOMEN - COMPLETE 10.4630 320 $ 315.00 463174022 CXR ABDOMINAL SERIES - ACUTE 10.4630 320 $ 962.00 463175970 CXR EXTREMITY VENOGRAM - UNILA 10.4630 320 $ 101.00 463175971 CXR EXTREMITY VENOGRAM - BILAT 10.4630 320 $ 186.00 463176000 CXR FLUOROSCOPY - 0-60 MINUTES 10.4630 320 $ 1,060.00 463176001 CXR FLUOROSCOPY-GREATER THAN 6 10.4630 320 $ 1,589.00 463176010 CXR NOSE TO RECTUM - CHILD 10.4630 320 $ 380.00 463176020 CXR BONE AGE STUDIES 10.4630 320 $ 412.00 463176040 CXR BONE LENGTH - LWR EXTREMIT 10.4630 320 $ 531.00 463176041 CXR STANDING FULL LENGTH--LWR 10.4630 320 $ 531.00 463176060 CXR METASTATIC BONE SURV COM 10.4630 320 $ 1,185.00 463176061 CXR BONE STUDY - LIMITED 10.4630 320 $ 319.00 463176065 CXR BONE SURVEY - CHILD 10.4630 320 $ 553.00 463176082 CXR FISTULA SINUS TRACT 10.4630 320 $ 132.00 463176086 CBR DUCTOGRAM SINGLE 10.4630 320 $ 522.00 463176088 CBR DUCTOGRAM MULTIPLE 10.4630 320 $ 1,042.00 463176090 CBR DIAGNOSTIC MAMMO-UNILATERA 10.4630 320 $ 203.00 463176091 CBR DIAGNOSTIC MAMMOGRAM 10.4630 320 $ 250.00 463176092 CBR SCREENING MAMMOGRAM 10.4630 320 $ 131.00 463176095 CBR STEREO LOC, EACH LESION 10.4630 320 $ 1,503.00 463176096 CBR PREOP NEEDLE LOCALIZATION 10.4630 320 $ 1,298.00 463176098 CBR SPECIMEN XRAY 10.4630 320 $ 119.00 463176100 CXR TOMOGRAPHY 10.4630 320 $ 1,060.00 463176170 CXR SUB STUDIES PER FILM 10.4630 320 $ 92.00 463177010 CXR PORT MANDIBLE--LIMITED 10.4630 320 $ 596.00 463177011 CXR PORT MANDIBLE--COMPLETE 10.4630 320 $ 710.00 463177014 CXR PORT FACIAL BONES--LIMITED 10.4630 320 $ 390.00 463177015 CXR PORT FACIAL BONES--COMPLET 10.4630 320 $ 710.00 463177021 CXR PORT PARANASAL SINUS 10.4630 320 $ 513.00 463177025 CXR PORT SKULL--LIMITED, 2 VIE 10.4630 320 $ 526.00 463177026 CXR PORT SKULL--COMPLETE 10.4630 320 $ 791.00 463177030 CXR PORT TEETH--SINGLE TEETH 10.4630 320 $ 380.00 463177031 CXR PORT TEETH--PARTIAL STUDY 10.4630 320 $ 380.00 463177101 CXR PORT CHEST - SINGLE VIEW 10.4630 320 $ 526.00 463177102 CXR PORT CHEST-- TWO VIEWS 10.4630 320 $ 526.00 463177103 CXR PORT CHEST-- W/DECUB 10.4630 320 $ 632.00 463177202 CXR PORT SPINE ANY LEVEL, 1 VI 10.4630 320 $ 411.00 463177203 CXR PORT SPINE(S) IN OR ANY LE 10.4630 320 $ 596.00 463177204 CXR PORT SPINE CERVICAL 2 VIEW 10.4630 320 $ 596.00 463177207 CXR PORT SPINE, THORACIC 10.4630 320 $ 632.00 463177210 CXR PORT SPINE, LUMBAR 10.4630 320 $ 637.00 463177217 CXR PORT PELVIS--ONE VIEW 10.4630 320 $ 542.00 463177219 CXR PORT PELVIS--COMPLETE 10.4630 320 $ 665.00 463177300 CXR PORT CLAVICLE 10.4630 320 $ 531.00 463177302 CXR PORT SHOULDER 10.4630 320 $ 461.00 463177306 CXR PORT HUMERUS 10.4630 320 $ 538.00 463177307 CXR PORT ELBOW-LIMITED, 2 VIEW 10.4630 320 $ 538.00 463177308 CXR PORT ELBOW-COMPLETE 4 VIEW 10.4630 320 $ 587.00 463177309 CXR PORT FOREARM 10.4630 320 $ 538.00 463177310 CXR PORT WRIST--LIMITED, 2 VIE 10.4630 320 $ 596.00 463177311 CXR PORT WRIST--COMPLETE, 3 VI 10.4630 320 $ 596.00 463177312 CXR PORT HAND--LIMITED, 2 VIEW 10.4630 320 $ 510.00 463177313 PORT HAND--COMPLETE - 3 VIEW 10.4630 320 $ 596.00 463177314 CXR PORT FINGER(S) 10.4630 320 $ 502.00 463177350 CXR PORT HIP--UNILATERAL, 1 VI 10.4630 320 $ 454.00 463177351 CXR PORT HIP--UNILATERAL, 2 VI 10.4630 320 $ 637.00 463177352 CXR PORT HIP--BILATERAL 10.4630 320 $ 710.00 463177355 CXR PORT FEMUR 10.4630 320 $ 596.00 463177356 CXR PORT KNEE--LIMITED 10.4630 320 $ 366.00 463177357 CXR PORT KNEE--COMPLETE, 3 VIE 10.4630 320 $ 425.00 463177359 CXR PORT TIBIA & FIBULA 10.4630 320 $ 538.00 463177360 CXR PORT ANKLE - 2 VIEW 10.4630 320 $ 519.00 463177361 CXR PORT ANKLE-COMPLETE, 3 VIE 10.4630 320 $ 596.00 463177362 CXR PORT FOOT-LIMITED, 2 VIEW 10.4630 320 $ 504.00 463177363 CXR PORT FOOT--COMPLETE, 3 VIE 10.4630 320 $ 580.00 463177366 CXR PORT TOE(S) 10.4630 320 $ 493.00 463177370 PORT CALCANEUS 10.4630 320 $ 513.00 463177400 CXR PORT ABDOMEN 1 VIEW 10.4630 320 $ 563.00 463177401 CXR PORT ABDOMEN W/OBLIQUES 10.4630 320 $ 604.00 463177402 CXR PORT ABDOMEN, 2 VIEWS 10.4630 320 $ 935.00 463177440 CXR PORT UROGRAPHY, EXCR IVP 10.4630 320 $ 935.00 463177777 COH MASTER GENERAL DIAGNOSTIC 10.4630 321 $ - 463180590 CXR PORT CHEST - SINGLE VIEW 10.4630 320 $ 526.00 463180660 CXR PORT PELVIS--ONE VIEW 10.4630 320 $ 542.00 463180710 CXR PORT ELBOW-LIMITED, 2 VIEW 10.4630 320 $ 538.00 463180730 CXR PORT FOREARM 10.4630 320 $ 538.00 463180800 CXR PORT HIP--UNILATERAL, 2 VI 10.4630 320 $ 637.00 463180850 CXR PORT TIBIA & FIBULA 10.4630 320 $ 538.00 463180880 CXR PORT FOOT-LIMITED, 2 VIEW 10.4630 320 $ 504.00 463187240 CXR OMNIPAQUE 240 - 020 ML 10.4630 250 $ 319.00 463187565 CXR OPTIRAY 320 - 30CC 10.4630 636 $ 436.00 463187566 CXR OPTIRAY 320 - 50CC 10.4630 636 $ 477.00 463187577 CXR OPTIRAY 320 - 100CC 10.4630 636 $ 924.00 463190710 CBR MICRO CLIP, ADD'L 10.4630 270 $ 396.00 463191015 CBR BIOPSY INCISIONAL ADD'L 10.4630 361 $ 541.00 463199995 CXR CLAVICLE 10.4630 320 $ 412.00 463200200 ZZ ADAPTER,CATH ANGIODYNAMICS 10.4632 272 $ 636.00 463200201 ZZ ADAPTER,GATEWAY 10.4632 272 $ 400.00 463200202 ZZ BALLOON,3MMX2CMX80CM 10.4632 279 $ 304.00 463200203 ZZ BALLOON,3MMX4CMX80CM 10.4632 279 $ 304.00 463200204 ZZ BALLOON,4MMX4CMX75CM BD 10.4632 279 $ 2,896.00 463200205 ZZ BALLOON,4MMX4CMX120CM BD 10.4632 279 $ 2,896.00 463200206 ZZ BALLOON,5MMX2CMX75CM BD 10.4632 279 $ 2,896.00 463200207 ZZ BALLOON,5MMX4CMX75CM BD 10.4632 279 $ 2,896.00 463200208 ZZ BALLOON,5MMX4CMX120CM UT 10.4632 279 $ 2,731.00 463200209 ZZ BALLOON,6MMX2CMX40CM UT 10.4632 279 $ 2,731.00 463200210 ZZ BALLOON,6MMX4CMX75CM BM 10.4632 279 $ 2,731.00 463200211 ZZ BALLOON,6MMX4CMX120CM PEMT 10.4632 279 $ 2,595.00 463200212 ZZ BALLOON,6MMX2CMX75CM BD 10.4632 279 $ 2,896.00 463200213 ZZ BALLOON,6MMX4CMX75CM BD 10.4632 279 $ 2,896.00 463200214 ZZ BALLOON,7MMX2CMX75CM BD 10.4632 279 $ 2,896.00 463200215 ZZ BALLOON,7MMX4CMX75CM BD 10.4632 279 $ 2,896.00 463200216 ZZ BALLOON,7MMX4CMX75CM PEMT 10.4632 279 $ 2,595.00 463200217 ZZ BALLOON,8MMX2CMX40CM BM 10.4632 279 $ 2,804.00 463200218 ZZ BALLOON,8MMX4CMX40CM BM 10.4632 279 $ 2,804.00 463200219 ZZ BALLOON,8MMX4CMX75CM GLIDE 10.4632 279 $ 2,731.00 463200220 ZZ BALLOON,8MMX3CMX75CM 7F PEM 10.4632 279 $ 3,314.00 463200221 ZZ BALLOON,8MMX3CMX75CM BD 10.4632 279 $ 2,896.00 463200222 ZZ BALLOON,8MMX4CMX75CM BD 10.4632 279 $ 2,896.00 463200223 ZZ BALLOON,8MMX4CMX120CM BD 10.4632 279 $ 2,896.00 463200224 ZZ BALLOON,8MMX3CMX75CM PEMT 10.4632 279 $ 2,737.00 463200225 ZZ BALLOON,8MMX4CM MEADOX 10.4632 279 $ 2,647.00 463200226 ZZ BALLOON,8MMX8CMX75CM BM 10.4632 279 $ 2,896.00 463200227 ZZ BALLOON,9MMX4CMX75CM BD 10.4632 279 $ 2,896.00 463200228 ZZ BALLOON,10MMX4CMX75CM BM 10.4632 279 $ 2,896.00 463200229 ZZ BALLOON,10MMX3CMX100CM PEMT 10.4632 279 $ 2,737.00 463200230 ZZ BALLOON,10MMX4CMX75CM BD 10.4632 279 $ 2,896.00 463200231 ZZ BALLOON,10MMX4CMX120CM BD 10.4632 279 $ 2,896.00 463200232 ZZ BALLOON,10MMX8CMX40CM BM 10.4632 279 $ 2,896.00 463200233 ZZ BALLOON,10MMX8CMX75CM BM 10.4632 279 $ 2,896.00 463200234 ZZ BALLOON,10MMX4CMX75CM PEMT 10.4632 279 $ 2,370.00 463200235 ZZ BALLOON,12MMX4CMX75CM 6F AX 10.4632 279 $ 2,315.00 463200236 ZZ BALLOON,12MMX4CMX75CM XXL 10.4632 279 $ 2,737.00 463200237 ZZ BALLOON,14MMX4CMX75CM 6FAXM 10.4632 279 $ 2,265.00 463200238 ZZ BALLOON,15MMX4CMX75CM PEMT 10.4632 279 $ 2,370.00 463200239 ZZ BALLOON,18MMX4CMX75CM PEMT 10.4632 279 $ 2,370.00 463200240 ZZ BALLOON,20MMX4CMX75CM PEMT 10.4632 279 $ 2,370.00 463200241 ZZ BALLOON,OCCLUSION 8.5 65CM 10.4632 279 $ 2,152.00 463200242 ZZ BALLOON,OCCLUSION 20MMX2CMX 10.4632 279 $ 2,201.00 463200243 ZZ BALLOON,OCCLUSION 27MMX2CMX 10.4632 272 $ 2,201.00 463200244 ZZ BALLOON,OCCLUSION ARROW 10.4632 272 $ 552.00 463200245 ZZ BALLOON,TEGWIRE 3MMX2CM 10.4632 279 $ 5,362.00 463200246 ZZ BALLOON,TEGWIRE 4MMX2CM 10.4632 279 $ 5,362.00 463200247 ZZ BASKET,BILIARY 15MM 10.4632 272 $ 2,737.00 463200248 ZZ BASKET,BILIARY 20MM 10.4632 272 $ 2,737.00 463200249 ZZ BASKET,BILIARY 9MM 10.4632 272 $ 2,737.00 463200250 ZZ BASKET,BILIARY OVERWIRE 4.5 10.4632 272 $ 2,719.00 463200251 ZZ BASKET,BILIARY OVERWIRE 2.5 10.4632 272 $ 1,763.00 463200252 ZZ CATH,SIM 1,4F,MALLINKRODT 10.4632 272 $ 279.00 463200253 ZZ CATH,SIM 1,SF COOK 10.4632 272 $ 281.00 463200254 ZZ CATH,JB2 5F 10.4632 272 $ 281.00 463200255 ZZ CATH,APDL 10F 10.4632 272 $ 835.00 463200256 ZZ CATH,APDL 10 WITH TIE 10.4632 279 $ 1,021.00 463200257 ZZ CATH,APDL 12F WITH TIE 10.4632 272 $ 1,021.00 463200258 ZZ CATH,APDL 8F 10.4632 272 $ 835.00 463200259 ZZ CATH,8F WITH TIE 10.4632 272 $ 1,021.00 463200260 ZZ CATH,ATHRECTOMY 9F 6MM 10.4632 272 $ 6,717.00 463200261 ZZ CATH,BERENSTEIN SF 100CM .0 10.4632 272 $ 281.00 463200262 ZZ CATH,BERENSTEIN 5FX40CM 10.4632 272 $ 281.00 463200263 ZZ CATH,BERENSTEIN 5FX65CM 10.4632 272 $ 281.00 463200264 ZZ CATH,BILIARY CAM LOK 8.5F 10.4632 272 $ 1,021.00 463200265 ZZ CATH,BILIARY CAM LOK 14F 10.4632 272 $ 991.00 463200266 ZZ CATH,CHANG C6.5F 10.4632 272 $ 281.00 463200267 ZZ CATH,CHANG2 6.5F 10.4632 272 $ 281.00 463200268 ZZ CATH, COBRA 5.5F 65CM 2S 10.4632 272 $ 281.00 463200269 ZZ CATH,COBRA 5.5FX65CM NS 10.4632 272 $ 281.00 463200270 ZZ CATH,COBRA 5.5FX80CM 2S 10.4632 272 $ 281.00 463200271 ZZ CATH,FISHER 8F 10.4632 272 $ 281.00 463200272 ZZ CATH,GENSINI 10.4632 272 $ 281.00 463200273 ZZ CATH,GLIDE VERT SF 10.4632 272 $ 398.00 463200274 ZZ CATH,APDL GLIDEX 10.3F 10.4632 272 $ 943.00 463200275 ZZ CATH,APDL GLIDEX 8.5F 10.4632 272 $ 1,021.00 463200276 ZZ CATH,GROHLMANN GAC 6.7F 10.4632 272 $ 281.00 463200277 ZZ CATH,GROHLMANN 6.7F 10.4632 272 $ 281.00 463200278 ZZ CATH,GUIDING 6.8F 10.4632 272 $ 1,272.00 463200279 ZZ CATH,GUIDING 7FX90CM 10.4632 272 $ 1,434.00 463200280 ZZ CATH,GUIDING OVER THE HUMP 10.4632 272 $ 1,434.00 463200281 ZZ CATH,COBRA 5.5FX80CM NS 10.4632 272 $ 281.00 463200282 ZZ CATH,GUIDING MPA 9F 10.4632 272 $ 991.00 463200283 ZZ CATH,GUIDING C1 7FX55CM 10.4632 272 $ 1,272.00 463200284 ZZ CATH,GUIDING C1 8FX55CM 10.4632 272 $ 1,272.00 463200285 ZZ CATH,GUIDING STRAIGHT 8FX90 10.4632 272 $ 1,712.00 463200286 ZZ CATH,GUIDING T1 7FX55CM 10.4632 272 $ 1,272.00 463200287 ZZ CATH,GUIDING T1 8FX55CM 10.4632 272 $ 1,272.00 463200288 ZZ CATH, H1 5.5FX30CM 10.4632 272 $ 281.00 463200289 ZZ CATH,H1 5.5FX100CM 10.4632 272 $ 281.00 463200290 ZZ CATH, HN1 5.5X100CM 10.4632 272 $ 281.00 463200291 ZZ CATH,INFUSION MTI 100CMX10C 10.4632 272 $ 1,047.00 463200292 ZZ CATH,INFUSION MTI 100CMX20C 10.4632 272 $ 1,047.00 463200293 ZZ CATH,INFUSION ANGIO 135CMX2 10.4632 279 $ 2,607.00 463200294 ZZ CATH,INFUSION ANGIO 135CMX3 10.4632 279 $ 2,607.00 463200295 ZZ CATH,INFUSION MTI 40CMX20CM 10.4632 272 $ 2,201.00 463200296 ZZ CATH,INFUSION ANGIO 45CMX20 10.4632 279 $ 2,607.00 463200297 ZZ CATH,INFUSION ANGIO 45CMX10 10.4632 279 $ 2,607.00 463200298 ZZ CATH,INFUSION MTI 65CMX10CM 10.4632 272 $ 1,047.00 463200299 ZZ CATH,INFUSION MTI 65CMX20CM 10.4632 272 $ 1,047.00 463200300 ZZ CATH,JBI 5.5FX100CM 10.4632 272 $ 281.00 463200301 ZZ CATH,INF MEWISSEN 65CMX10CM 10.4632 272 $ 281.00 463200302 ZZ CATH,INF MEWISSEN 100CMX10C 10.4632 272 $ 1,021.00 463200303 ZZ CATH,INF MEWISSEN 100CMX5CM 10.4632 272 $ 1,021.00 463200304 ZZ CATH,INF MEWISSEN 65CMX5CM 10.4632 272 $ 1,021.00 463200305 ZZ CATH,NEPHROSTOMY COOK 10F 10.4632 272 $ 879.00 463200306 ZZ CATH,NEPHROSTOMY 10F WITH T 10.4632 272 $ 943.00 463200307 ZZ CATH,NEPHROSTOMY 10.2F COOK 10.4632 272 $ 879.00 463200308 ZZ CATH, OVER THE HUMP BALKIN 10.4632 272 $ 613.00 463200309 ZZ CATH,PIGTAIL 4FX65CM 10.4632 272 $ 281.00 463200310 ZZ CATH,PIGTAIL 4FX90CM 10.4632 272 $ 281.00 463200311 ZZ CATH,PIGTAIL 5FX70CM 10.4632 272 $ 281.00 463200312 ZZ CATH,PIGTAIL 5FX100CM 10.4632 272 $ 281.00 463200313 ZZ CATH,PIGTAIL 7FX100CM 10.4632 272 $ 281.00 463200314 ZZ CATH,ROSCH SPLENIC 6.5F 10.4632 272 $ 281.00 463200315 ZZ CATH,SIM II 5FX100CM 10.4632 272 $ 281.00 463200316 ZZ CATH,SIM III 5.5FX100CM 10.4632 272 $ 281.00 463200317 ZZ CATH,SOS 5FX80CM 10.4632 272 $ 230.00 463200318 ZZ CATH,STRAIGHT 5FX100CMX.038 10.4632 272 $ 281.00 463200319 ZZ CATH,STRAIGHT 5FX100CMX.035 10.4632 272 $ 281.00 463200320 ZZ CATH,VERTEBRAL 5FX100CM MAL 10.4632 272 $ 281.00 463200321 ZZ CATH,VONSONNENBERG SUMP 12F 10.4632 272 $ 879.00 463200322 ZZ COILS,.035 3MMX4CM 10.4632 272 $ 281.00 463200323 ZZ COILS,.035 5MMX5CM 10.4632 272 $ 366.00 463200324 ZZ COILS,.038 5MMX5CM 10.4632 272 $ 366.00 463200325 ZZ COILS,.038 8MMX5CM 10.4632 272 $ 366.00 463200326 ZZ COILS,.038 5MMX3CM 10.4632 272 $ 366.00 463200327 ZZ COILS,.038 10MMX5CM 10.4632 272 $ 366.00 463200328 ZZ COILS,.038 12MMX5CM 10.4632 272 $ 366.00 463200329 ZZ COILS,.038 15MMX8CM 10.4632 272 $ 366.00 463200330 ZZ COILS,.038 15MMX15MM 10.4632 272 $ 366.00 463200331 ZZ COILS,.035 8MMX5CM 10.4632 272 $ 366.00 463200332 ZZ COILS,.038 10MMX8CM 10.4632 272 $ 366.00 463200333 ZZ COILS,.018 TORNADO 4/2 10.4632 272 $ 991.00 463200334 ZZ COILS,TORNADO 6/2 10.4632 272 $ 991.00 463200335 ZZ SHEATH,CONTAMINATION 110CM 10.4632 272 $ 167.00 463200336 ZZ SHEATH,CONTAMINATION 80CM 10.4632 272 $ 167.00 463200337 ZZ SHEATH,24F 10.4632 272 $ 425.00 463200338 ZZ WIRE,KATZEN CORE 10.4632 272 $ 373.00 463200339 ZZ DILATOR,10F 10.4632 272 $ 108.00 463200340 ZZ DILATOR,12F 10.4632 272 $ 108.00 463200341 ZZ DILATOR,14F 10.4632 272 $ 108.00 463200342 ZZ DILATOR,4F 10.4632 272 $ 108.00 463200343 ZZ DILATOR,5F 10.4632 272 $ 108.00 463200344 ZZ DILATOR,6F 10.4632 272 $ 108.00 463200345 ZZ DILATOR,7F 10.4632 272 $ 108.00 463200346 ZZ DILATOR,8F 10.4632 272 $ 108.00 463200347 ZZ DILATOR,9F 10.4632 272 $ 108.00 463200348 ZZ DRAPE,FLUORO 10.4632 272 $ 40.00 463200349 ZZ FILTER,GREENFIELD FEM OVERW 10.4632 278 $ 11,889.00 463200350 ZZ FILTER,GREENFIELD JUG OVERE 10.4632 278 $ 11,889.00 463200351 ZZ FILTER,VENA TECH 10.4632 278 $ 9,685.00 463200352 ZZ FLOWSWITCH 10.4632 272 $ 108.00 463200353 ZZ GLIDE WIRE,25 10.4632 279 $ 436.00 463200354 ZZ GLIDE WIRE,38 10.4632 279 $ 433.00 463200355 ZZ GLIDE WIRE,35 ANGLED 10.4632 279 $ 489.00 463200356 ZZ GLIDE WIRE,35X260 ANGLED 10.4632 279 $ 674.00 463200357 ZZ GLIDE WIRE,35X180 ANGLED 10.4632 279 $ 595.00 463200358 ZZ GLIDE WIRE,35 LT 10.4632 279 $ 507.00 463200359 ZZ GLIDE WIRE,35 STRAIGHT 10.4632 279 $ 489.00 463200360 ZZ GLIDE WIRE,35X145 SUPER STI 10.4632 279 $ 674.00 463200361 ZZ GLIDE WIRE,35X260 SUPER STI 10.4632 279 $ 674.00 463200362 ZZ GUIDE WIRE,18 10.4632 279 $ 829.00 463200363 ZZ GUIDE WIRE,25 10.4632 272 $ 165.00 463200364 ZZ GUIDE WIRE,32 BENTSON 10.4632 272 $ 253.00 463200365 ZZ GUIDE WIRE,35X60 10.4632 279 $ 281.00 463200366 ZZ GUIDE WIRE,35X180 BENTSON 10.4632 272 $ 304.00 463200367 ZZ GUIDE WIRE,35 LT 10.4632 272 $ 203.00 463200368 ZZ GUIDE WIRE,35X3J 10.4632 272 $ 224.00 463200369 ZZ GUIDE WIRE,35X1.5J 10.4632 272 $ 224.00 463200370 ZZ GUIDE WIRE,35 BENTSON 10.4632 279 $ 304.00 463200371 ZZ GUIDE WIRE,38 BENTSON 10.4632 272 $ 281.00 463200372 ZZ GUIDE WIRE,38 TIP DEFLECTIN 10.4632 279 $ 578.00 463200373 ZZ GUIDE WIRE,KATZEN 6CM 10.4632 279 $ 2,423.00 463200374 ZZ GUIDE WIRE,KATZEN 12CM 10.4632 279 $ 2,423.00 463200375 ZZ GUIDE WIRE,KATZEN 9CM 10.4632 279 $ 2,423.00 463200376 ZZ GUIDE WIRE,35X7.5J 10.4632 272 $ 226.00 463200377 ZZ GUIDE WIRE,35X15J 10.4632 272 $ 226.00 463200378 ZZ GUIDE WIRE,35X480 10.4632 272 $ 558.00 463200379 ZZ GUIDE WIRE,ROAD RUNNER 180 10.4632 279 $ 400.00 463200380 ZZ GUIDE WIRE,ROADRUNNER 145 10.4632 279 $ 400.00 463200381 ZZ GUIDE WIRE,ROSEN 35 10.4632 272 $ 333.00 463200382 ZZ GUIDE WIRE,ROSEN 38 10.4632 272 $ 281.00 463200383 ZZ GUIDE WIRE,35X260 SUPER STI 10.4632 279 $ 628.00 463200384 ZZ GUIDE WIRE,35X145 SUPER STI 10.4632 279 $ 425.00 463200385 ZZ GUIDE WIRE,35X180 SUPER STI 10.4632 279 $ 604.00 463200386 ZZ GUIDE WIRE,18 COOK 10.4632 272 $ 165.00 463200387 ZZ HEMOCATH 10.4632 272 $ 2,370.00 463200388 ZZ HEMOSTASIS VALVE 10.4632 272 $ 132.00 463200389 ZZ INDEFLATOR 10.4632 272 $ 1,100.00 463200390 ZZ OMTRAPDICER 9F STIFF 10.4632 272 $ 995.00 463200391 ZZ INTRODUCER 8.5F STIFF 10.4632 272 $ 463.00 463200392 ZZ KIT,PERCUFIX CUFF 10.4632 272 $ 226.00 463200393 ZZ KIT,Y-ADAPTER 10.4632 272 $ 184.00 463200394 ZZ MOLNAR DISC 10F 10.4632 272 $ 120.00 463200395 ZZ MOLNAR DISC 8F 10.4632 272 $ 120.00 463200396 ZZ NEEDLE,19G SELDINGER 10.4632 272 $ 120.00 463200398 ZZ NEEDLE-CHIBA 10.4632 272 $ 184.00 463200399 ZZ NEEDLE,PENCIL POINT 5 10.4632 272 $ 184.00 463200400 ZZ NEEDLE,PENCIL POINT 7 10.4632 272 $ 184.00 463200401 ZZ NEEDLE,SHEATH TROCAR 10.4632 272 $ 354.00 463200402 ZZ NEEDLE,SINGLE WALL 10.4632 272 $ 49.00 463200403 ZZ NEEDLE,SMART 10.4632 272 $ 2,942.00 463200410 ZZ PVA,BIODYNE 200/300 10.4632 272 $ 1,158.00 463200411 ZZ PVA,BIODYNE 300/50 10.4632 272 $ 1,158.00 463200412 ZZ PVA,BIODYNE 300/500 10.4632 272 $ 1,158.00 463200413 ZZ PVA,BIODYNE 50 10.4632 272 $ 1,158.00 463200414 ZZ PVA,BIODYNE 500/700 10.4632 272 $ 1,158.00 463200415 ZZ PVA,BIODYNE 700/1000 10.4632 272 $ 1,158.00 463200416 ZZ SET,ACCUSTICK 10.4632 272 $ 995.00 463200417 ZZ SET,BASIN 10.4632 272 $ 184.00 463200418 ZZ SET,GASTROSTOMY 10.4632 272 $ 1,494.00 463200419 ZZ SET,LIVER BX 10.4632 272 $ 3,314.00 463200420 ZZ SET,MICROPUNCTURE SF 10.4632 272 $ 423.00 463200421 ZZ SET,SUTURE ANCHOR 10.4632 272 $ 618.00 463200422 SET HASKAL TIPPS W GUIDE WIRES 10.4632 279 $ 2,047.50 463200423 ZZ SHEATH,7FX45CM 10.4632 272 $ 184.00 463200424 ZZ SHEATH,6FX25CM 10.4632 272 $ 499.00 463200425 ZZ SHEATH,6F GLIDE 10.4632 272 $ 345.00 463200426 ZZ SHEATH,7FX25CM 10.4632 272 $ 516.00 463200427 ZZ SHEATH,8FX25CM 10.4632 272 $ 516.00 463200428 ZZ SHEATH,8FX45CM 10.4632 272 $ 400.00 463200429 ZZ SHEATH,9FX25CM 10.4632 272 $ 406.00 463200430 ZZ SHEATH,9FX80CM 10.4632 272 $ 674.00 463200431 ZZ SHEATH,10FX45CM 10.4632 272 $ 628.00 463200432 ZZ SHEATH,6F FLEXIBLE 10.4632 272 $ 628.00 463200433 ZZ SHEATH,7F FLEXIBLE 10.4632 272 $ 628.00 463200434 ZZ SHEATH,6FX30CM 10.4632 272 $ 555.00 463200435 ZZ SHEATH,7FX30CM 10.4632 272 $ 555.00 463200436 ZZ SHEET,3/4 10.4632 272 $ 74.00 463200437 ZZ SNARE,10MM 10.4632 272 $ 2,702.00 463200438 ZZ SNARE,15MM 10.4632 272 $ 2,702.00 463200439 ZZ STENT,1.28CM 8-12 10.4632 278 $ 6,660.00 463200440 ZZ STENT,3CM 8-12 10.4632 278 $ 7,556.00 463200441 ZZ STENT,3CM 4-9 10.4632 278 $ 8,918.00 463200442 ZZ STENT,4CM 4-9 10.4632 278 $ 8,400.00 463200443 ZZ STENT,MOUNTED 1.5X5MM 10.4632 278 $ 8,114.00 463200444 ZZ STENT,MOUNTED 3CM 4-9 8MM B 10.4632 278 $ 10,713.00 463200445 ZZ STENT,WALL 12MMX40MMX110CM 10.4632 278 $ 11,350.00 463200446 ZZ STENT,WALL 8MMX40MMX110CM 10.4632 278 $ 11,350.00 463200447 ZZ STENT,WALL 10MMX42MMX110CM 10.4632 278 $ 11,350.00 463200448 ZZ STENT,WALL 16MMX45MMX110CM 10.4632 278 $ 11,350.00 463200449 ZZ STENT,WALL 6MMX45MMX110CM 10.4632 278 $ 11,350.00 463200450 ZZ STENT,WALL 8MMX60MMX110CM 10.4632 278 $ 11,350.00 463200451 ZZ STENT,WALL 12MMX60MMX110CM 10.4632 278 $ 11,350.00 463200452 ZZ STENT,WALL 16MMX60MMX110CM 10.4632 278 $ 11,350.00 463200453 ZZ STENT,WALL 10MMX68MMX110CM 10.4632 278 $ 11,350.00 463200454 ZZ STENT,WALL 10MMX94MMX110CM 10.4632 278 $ 11,350.00 463200455 ZZ STENT,WALL 10MMX20MMX110CM 10.4632 278 $ 11,350.00 463200456 ZZ STENT,WALL 8MMX20MMX110CM 10.4632 278 $ 11,350.00 463200457 ZZ STENT,WALL 8MMX80MMX110CM 10.4632 278 $ 3,281.00 463200458 ZZ STENT,WALL 8MMX20MMX160CM 10.4632 278 $ 12,614.00 463200459 ZZ STENT,WALL 10MMX40MMX160CM 10.4632 278 $ 12,614.00 463200460 ZZ STENT,WALL 8MMX40MMX160CM 10.4632 278 $ 12,614.00 463200461 ZZ STENT,WALL 8MMX60MMX160CM 10.4632 278 $ 12,614.00 463200462 ZZ STENT,WALL 14MMX40MMX110CM 10.4632 278 $ 3,281.00 463200463 ZZ STENT,URETERAL 8FX28CM 10.4632 278 $ 1,652.00 463200464 ZZ STENT,URETERAL 10.4632 278 $ 1,652.00 463200465 ZZ STENT,URETERAL 7FX26CM 10.4632 278 $ 3,034.00 463200466 ZZ STOPCOCK,5F 10.4632 272 $ 49.00 463200467 ZZ STOPCOCK,3 WAY 10.4632 272 $ 49.00 463200468 ZZ SYRINGE,150CC 10.4632 272 $ 77.00 463200469 ZZ SYRINGE,CONTRAST 10.4632 272 $ 143.00 463200470 ZZ TORQUE,DEVICE 10.4632 272 $ 143.00 463200471 ZZ TRACKER,CATH 25 10.4632 272 $ 3,856.00 463200472 ZZ TRACKER,CATH 18X125 HIFLOW 10.4632 272 $ 2,370.00 463200473 ZZ TRACKER,CATH 18X150 10.4632 272 $ 3,034.00 463200474 ZZ TRACKER,CATH 18X125 UNI 10.4632 272 $ 3,034.00 463200475 ZZ TRACKER,CATH FAST TRACKER 3 10.4632 272 $ 3,856.00 463200476 ZZ TRACKER,CATH FAST TRACKER 1 10.4632 272 $ 3,856.00 463200477 ZZ TRACKER,COIL 2MMX2CM 10.4632 272 $ 1,021.00 463200478 ZZ TRACKER,COIL 4MMX2CM 10.4632 272 $ 799.00 463200479 ZZ TRACKER,COIL 4MMX3CM 10.4632 272 $ 1,021.00 463200480 ZZ TRACKER,COIL 5MMX5CM 10.4632 272 $ 1,021.00 463200481 ZZ TRACKER,COIL PUSHER-16 10.4632 272 $ 1,158.00 463200482 ZZ TRACKER,RETRIEVAL SET 10.4632 272 $ 4,958.00 463200483 ZZ TRACKER,SNARE 10MM 10.4632 272 $ 3,856.00 463200484 ZZ TRACKER,SNARE 15MM 10.4632 272 $ 3,856.00 463200485 ZZ TRACKER,WIRE DASHER 10 10.4632 272 $ 1,985.00 463200486 ZZ TRACKER,WIRE SEEKER 14 10.4632 272 $ 1,930.00 463200487 ZZ TRACKER,WIRE SEEKER 16 10.4632 272 $ 1,930.00 463200488 ZZ TRACKER,WIRE TAPER 16 10.4632 272 $ 1,930.00 463200489 ZZ TRAY,ANGIOGRAPHY 10.4632 272 $ 908.00 463200490 ZZ TUBE,CRIMPING CT20 10.4632 272 $ 92.00 463200491 ZZ TUBE,CRIMPING CT30 10.4632 272 $ 92.00 463200492 ZZ TUBE,CTU CONNECTING 10.4632 272 $ 167.00 463200493 ZZ TUBE,GASTROENTERIC 10.4632 272 $ 2,039.00 463200494 ZZ TUBE,SYRINGE FILL 10.4632 272 $ 15.00 463200495 ZZ TUBE,CORDIS H-P 10.4632 272 $ 290.00 463200496 ZZ GUIDE WIRE,MAGNUM 10.4632 272 $ 1,158.00 463200497 ZZ GUIDE WIRE,OCCLUDING BALL 6 10.4632 272 $ 943.00 463200498 ZZ TUBE,GASTROSTOMY 10.4632 272 $ 1,652.00 463200499 ZZ TUBE,HI PRESSURE NAMIC 10.4632 272 $ 26.00 463200500 ZZ SET,VASCULAR ACCESS MEDI 10.4632 272 $ 5,231.00 463200501 ZZ SET,VASCULAR ACCESS SIMMS 10.4632 272 $ 5,231.00 463200502 ZZ OCCLUDING BALLOON WIRE 45CM 10.4632 272 $ 947.00 463200503 ZZ OCCLUDING BALLOON WIRE 135C 10.4632 272 $ 947.00 463200504 ZZ TUBING, BIFURCATION 10.4632 272 $ 257.00 463200505 ZZ CONNECTING DUAL CHECK ANGIO 10.4632 272 $ 605.00 463200506 ZZ TUBE GJ 22F 10.4632 272 $ 2,420.00 463200507 ZZ TUBE GJ 18F 10.4632 272 $ 2,420.00 463200508 ZZ VASOSEAL 1 10.4632 272 $ 2,204.00 463200509 ZZ VASOSEAL 2 10.4632 272 $ 2,204.00 463200510 ZZ VASOSEAL 3 10.4632 272 $ 2,204.00 463200511 ZZ VASOSEAL 4 10.4632 272 $ 2,204.00 463200512 ZZ ARROW CATH 10.4632 279 $ 5,730.00 463200513 ZZ BALLOON,6MMX2CMX40CM BM 10.4632 279 $ 2,514.00 463200514 ZZ BALLOON, 6MMX2CMX40CM BM 10.4632 272 $ 2,514.00 463200515 ZZ BALLOON, 14MMX4CMX75CM XXL 10.4632 272 $ 2,514.00 463200516 ZZ BALLOON,7MMX4CMX120CM BD 10.4632 279 $ 2,820.00 463200517 ZZ BALLOON, 10MMX4CMX75CM 7FBM 10.4632 279 $ 2,514.00 463200518 ZZ BALLOON, 10MMX4CMX75CM 5.8F 10.4632 279 $ 2,514.00 463200519 ZZ CATH, INFUSION ANGIO 135CMX 10.4632 279 $ 2,255.00 463200520 ZZ CATH, INFUSION MTI 100MCX10 10.4632 272 $ 1,020.00 463200521 ZZ CATH, GUIDING MP HS 8FX100C 10.4632 279 $ 1,183.00 463200522 ZZ CATH, GUIDING DAV COOK 8FX5 10.4632 279 $ 926.00 463200523 ZZ SHEATH, OVER THE HUMP 7F 10.4632 279 $ 599.00 463200524 ZZ COILS, .038 3MMX4CM 10.4632 272 $ 359.00 463200525 ZZ CATH, INFUSION MTI 40CMX10C 10.4632 272 $ 1,020.00 463200526 ZZ DRAPE, SPECIAL 10.4632 272 $ 143.00 463200527 ZZ GUIDE WIRE, 035X80CM BENTSO 10.4632 272 $ 206.00 463200528 ZZ GUIDE WIRE, OCCLUDING BALL 10.4632 272 $ 879.00 463200529 ZZ NEEDLE, 18G SELDINGER 10.4632 272 $ 107.00 463200530 ZZ SET, PERC NEPH COOK 10.4632 272 $ 879.00 463200531 ZZ STENT, WALL 7MMX40MMX110CM 10.4632 278 $ 11,062.00 463200532 ZZ STENT, WALL 14MMX40MMX110CM 10.4632 278 $ 11,062.00 463200533 ZZ TRACKER, TURBO 18 150CM 10.4632 272 $ 3,083.00 463200534 ZZ TUBE, GASTROENTERIC 22F 10.4632 272 $ 1,987.00 463200535 ZZ ANGIOJET 10.4632 279 $ 5,952.00 463200536 ZZ T SHEETS 10.4632 272 $ 168.00 463200537 ZZ PREP PACKS 10.4632 272 $ 50.00 463200538 ZZ NEEDLE, 11G VERTEBROPLASTY 10.4632 272 $ 328.00 463200539 ZZ NEEDLE 13GX10 VERTEBROPLAST 10.4632 272 $ 328.00 463200540 ZZ NEEDLE, 13GX15 VERTEBROPLAS 10.4632 272 $ 328.00 463200541 ZZ VERTEBROPLASTY GLUE 10.4632 272 $ 2,151.00 463200542 ZZ BALLOON, FOGERTY 10.4632 272 $ 595.00 463200543 ZZ CATH, COBRA 1 65CM 2S 10.4632 272 $ 281.00 463200544 ZZ SHEATH, 10FX45CM 10.4632 272 $ 406.00 463200545 ZZ CATH, INF 5FX40CMX11CM 10.4632 272 $ 1,047.00 463200546 ZZ SHEATH, PEEL AWAY 26F 10.4632 272 $ 471.00 463200547 ZZ CATH, INF ANGIO 135CMX10CM 10.4632 279 $ 2,607.00 463200548 ZZ CATH, INF MTI 65X5 10.4632 272 $ 1,047.00 463200549 ZZ MOTOR, ARROW 10.4632 272 $ 578.00 463200550 ZZ BALLOON, 6MMX2CMX40CMBD 10.4632 279 $ 2,896.00 463200551 ZZ BALLOON, 6MMX4CMX75CMPEMT 10.4632 279 $ 2,737.00 463200552 ZZ BALLOON, 8MMX2CMX40CMBD 10.4632 279 $ 2,896.00 463200553 ZZ GUIDE, WIRE 25X145 10.4632 272 $ 216.00 463200554 ZZ BALLOON, 4MMX2CMX75CMBD 10.4632 279 $ 2,896.00 463200555 ZZ STENT,WALL 6MMX20MMX100CM 10.4632 278 $ 11,350.00 463200556 ZZ STENT, WALL 7MMX20MMX100CM 10.4632 278 $ 11,350.00 463200557 ZZ STENT WALL 7MMX40CMX160CM 10.4632 278 $ 12,614.00 463200558 ZZ BALLOON, 10MMX8CMX55CN NEPH 10.4632 279 $ 2,737.00 463200559 ZZ CATH, GUIDING 6F X 55CM 10.4632 272 $ 1,272.00 463200560 ZZ BALLOON, 5MMX2CMX40CMBD 10.4632 279 $ 2,896.00 463200561 ZZ SHEATH, PEEL AWAY 9FX15CM 10.4632 272 $ 406.00 463200562 ZZ GLIDE, WIRE 35X8OCM SS 10.4632 279 $ 578.00 463200563 ZZ TRACKER, WIRE FAST DASHER 1 10.4632 272 $ 1,930.00 463200564 ZZ BALLOON, 7MMX2CMX40CMBD 10.4632 279 $ 2,896.00 463200565 ZZ NEEDLE, SINGLE WALL 5CM 10.4632 272 $ 107.00 463200566 ZZ CATH, INF ANGIO 90CMX50CM 10.4632 279 $ 1,005.00 463200567 ZZ CATH, INF ANGIO 90CMX30CM 10.4632 279 $ 1,272.00 463200568 ZZ CATH, INF ANGIO 90CMX10CM 10.4632 279 $ 1,272.00 463200569 ZZ CATH, INF ANGIO 90CMX5CM 10.4632 279 $ 1,272.00 463200570 ZZ SHEATH, SHORT 6F 10.4632 279 $ 144.00 463200571 ZZ STENT, CORINTHIAN 6CM 10.4632 278 $ 10,944.00 463200572 ZZ STENT, CORINTHIAN 4CM 10.4632 278 $ 10,944.00 463200573 ZZ STENT, CORINTHIAN MTD 6MM 10.4632 278 $ 10,944.00 463200574 ZZ SHEATH, PEEL AWAY 8F 10.4632 272 $ 425.00 463200575 ZZ BALLOON, TEG WIRE 6MMX2CM 10.4632 279 $ 5,362.00 463200576 ZZ BALLOON, TEG WIRE 5MMX2CM 10.4632 279 $ 5,362.00 463200577 ZZ SET, DUAL GUIDE 10.4632 272 $ 995.00 463200578 ZZ SNARE, 25MM 10.4632 272 $ 2,702.00 463200579 ZZ CLOT BUSTER 10.4632 272 $ 5,730.00 463200580 ZZ INDEFLATOR, MERIT 10.4632 272 $ 1,100.00 463200581 ZZ STENT, WALL 8X66X110 10.4632 279 $ 11,350.00 463200582 ZZ BALLOON,4X2X40BD 10.4632 278 $ 2,896.00 463200583 ZZ BALLOON, 5X2X120BD 10.4632 279 $ 2,896.00 463200584 ZZ BALLOON, 6X6X75BD 10.4632 279 $ 2,896.00 463200585 ZZ BALLOON, 16X4X75XXL 10.4632 279 $ 2,896.00 463200586 ZZ CATH, GUIDING 8FX80CM DAV 10.4632 279 $ 1,272.00 463200587 ZZ CATH, INFUSION ANGIO 90X20 10.4632 279 $ 1,272.00 463200588 ZZ CATH, SIM2 7F 10.4632 272 $ 281.00 463200589 ZZ CATH, VAN ANDEL 6.3F 10.4632 279 $ 281.00 463200590 ZZ CATH, VAN ANDEL 7F 10.4632 272 $ 281.00 463200591 ZZ CATH, VAN ANDEL 10F 10.4632 272 $ 281.00 463200592 ZZ COIL, 038 5MMX8CM 10.4632 272 $ 366.00 463200593 ZZ COIL, TORNADO 3/2 10.4632 272 $ 991.00 463200594 ZZ CATH, 7F BERENSTEIN USCI 10.4632 272 $ 281.00 463200595 ZZ CATH, H1 5.5F 30CM 10.4632 272 $ 281.00 463200596 ZZ CATH, MALECOT 24F 10.4632 272 $ 943.00 463200597 ZZ CATH, MALECOT STENT 24F 10.4632 272 $ 943.00 463200598 ZZ BALLOON, 6X4X120UT 10.4632 272 $ 2,896.00 463200599 ZZ CATH, GUIDING 8FX55CM HS 10.4632 279 $ 1,272.00 463200600 ZZ GLIDE WIRE 35X80 SS 10.4632 279 $ 489.00 463200601 ZZ STENT-URETERAL 8X24 CM 10.4632 278 $ 1,651.00 463200602 ZZ STEN, WALL 10X42X160 10.4632 278 $ 11,350.00 463200603 ZZ TOUGHY BORST 10.4632 272 $ 82.00 463200604 ZZ ADAPTER, MALECOT 10.4632 272 $ 82.00 463200605 ZZ STENT, 1.5CM 4-9 10.4632 278 $ 8,400.00 463200606 ZZ VERTEBRAPLASTY BARIUM TRACE 10.4632 272 $ 533.00 463200607 ZZ INTRODUCER, FLEXOR 7F 10.4632 272 $ 385.00 463200608 ZZ CATH, SIZING PIGTAIL 5F 10.4632 272 $ 324.00 463200609 ZZ VERTEBRAPLASTY, INJECTOR SY 10.4632 272 $ 5,730.00 463200610 ZZ CATH INF 90X5 PULSE 10.4632 279 $ 2,607.00 463200611 ZZ CATH, INF 90X20 PULSE 10.4632 279 $ 2,607.00 463200612 ZZ BALLOON, 12X2X75 BD 10.4632 279 $ 2,896.00 463200613 ZZ CATH VERT 5F 10.4632 272 $ 217.00 463200614 ZZ SYRINGE, 1CC VERTENRAPLASTY 10.4632 272 $ 36.00 463200615 ZZ SHEATH, FLEXOR 7F 10.4632 272 $ 528.00 463200616 ZZ VERTEBRAPLASTY CEMENT SYSTE 10.4632 272 $ 3,554.00 463200617 ZZ TRAY ARTHROGRAM 10.4632 272 $ 152.00 463200618 ZZ NEEDLE, COAXIAL 19G 10.4632 272 $ 123.00 463200619 ZZ CATH, INF 135X10 PULSE SPRA 10.4632 279 $ 1,272.00 463200620 ZZ CATH, INF 135X30 PULSE SPRA 10.4632 279 $ 1,272.00 463200621 ZZ CATH, INF MINI MEWI 180X5 10.4632 272 $ 1,152.00 463200622 ZZ CATH, INF MINI MEWI 180X10 10.4632 272 $ 1,152.00 463200623 ZZ MIXEVAC 10.4632 272 $ 345.00 463200624 ZZ STENT,WALL 8X40X160 10.4632 278 $ 12,614.00 463200625 ZZ STENT,WALL 8X40X160 10.4630 278 $ 12,614.00 463200626 ZZ STENT,COR.MTD.3X6 10.4632 278 $ 10,944.00 463200627 ZZ STENT,COR.MTD.3X8 10.4632 278 $ 10,944.00 463200628 ZZ STENT,COR.MTD.4X6 10.4632 278 $ 10,944.00 463200629 ZZ STENT,COR.MTD.4X8 10.4632 278 $ 10,944.00 463200630 ZZ CATH, 6F DRAINAGE 10.4632 272 $ 630.00 463200631 ZZ COVER EQUIPMENT 14 INCH 10.4632 272 $ 27.00 463200632 ZZ STENT,COR.MTD.6X6 10.4632 278 $ 10,944.00 463200633 ZZ GLIDEWIRE, 260 .018 10.4632 279 $ 769.00 463200634 ZZ WALLGRAFT, 6X20 10.4632 278 $ 11,519.00 463200635 ZZ WALLGRAFT, 7X20 10.4632 278 $ 11,519.00 463200636 ZZ WALLGRAFT, 8X20 10.4632 278 $ 11,519.00 463200637 ZZ WALLGRAFT, 9X20 10.4632 278 $ 11,519.00 463200638 ZZ WALLGRAFT, 10X20 10.4632 278 $ 11,519.00 463200639 ZZ WALLGRAFT, 12X30 10.4632 278 $ 11,519.00 463200640 ZZ CATH, INF COOK 5X40X15 10.4632 272 $ 912.00 463200641 ZZ DRAPE, LEAD SHIELD 10.4632 272 $ 27.00 463200642 ZZ GUIDE WIRE .018 PLAT 10.4632 272 $ 191.00 463200643 ZZ CATHETER, BALLOON TALON 4X2 10.4632 272 $ 2,371.00 463200644 ZZ BALLOON, TALON 6X2X90 10.4632 272 $ 2,371.00 463200645 ZZ BALLOON, TALON 5X2X90 10.4632 272 $ 2,371.00 463200646 ZZ STENT, ROYAL MTD 4X14 10.4632 278 $ 8,170.00 463200647 ZZ STENT, ROYAL MTD. 6X19 10.4632 278 $ 8,170.00 463200649 ZZ STENT, ROYAL MTD. 7X19 10.4632 278 $ 8,170.00 463200650 ZZ FILTER, SIMON NITINOL FEMOR 10.4632 278 $ 8,170.00 463200651 ZZ SET, MICROPUNCTURE 4F 10.4632 272 $ 350.00 463200652 ZZ SET, MICROPUNCTURE SS 5F 10.4632 272 $ 422.00 463200653 ZZ CATH, INF. ANGIO 45X5 UNI 10.4632 272 $ 1,219.00 463200654 ZZ CATH, INF. ANGIO 45X10 UNI 10.4632 272 $ 1,219.00 463200655 ZZ CATH, 5F KMP 120CM 10.4632 272 $ 203.00 463200656 ZZ VASOSEAL 10.4632 272 $ 1,790.00 463200657 ZZ EMBOSPHERE 100-300 10.4632 272 $ 1,569.00 463200658 ZZ EMBOSPHERE 300-500 10.4632 272 $ 1,569.00 463200659 ZZ EMBOSPHERE 500-700 10.4632 272 $ 1,569.00 463200660 ZZ EMBOPSHERE 700-900 10.4632 272 $ 1,569.00 463200661 ZZ EMBOSPHERE 900-1200 10.4632 272 $ 1,569.00 463200662 ZZ SET, SAFETY WIRE COOK 10.4632 272 $ 561.00 463200663 ZZ SHEATH, 6F SHORT COOK 10.4630 272 $ 335.00 463200664 ZZ SHEATH, 8F SHORT COOK 10.4632 272 $ 304.00 463200665 ZZ STENT, ROYAL MOUNTED 5MMX14 10.4632 272 $ 8,170.00 463200666 ZZ WALLGRAFT, 12X50 10.4632 272 $ 10,018.00 463200667 ZZ SET,MICROPUNCTURE 4FLONG NE 10.4632 272 $ 352.00 463200668 ZZ VERTEBRAPLASTY CEMENT DELIV 10.4632 272 $ 3,917.00 463200669 ZZ BALLOON, 10MMX8CMX40CM 10.4632 272 $ 1,714.00 463200670 ZZ NEEDLE,VERTEBRAPLASTY 1GGX1 10.4632 272 $ 365.00 463200671 ZZ CATHETER, GUIDING AML 1 10.4632 272 $ 1,094.00 463200672 ZZ CATHETER,DRAINAGE 8F SMALL 10.4632 272 $ 697.00 463200673 ZZ GUIDEWIRE, MCNAMARA 18 10.4632 272 $ 1,069.00 463200674 ZZ BALLOON, TALON 7X2X90 10.4632 272 $ 2,371.00 463200675 ZZ CATH, GUIDING 5FX55 RAABE 10.4632 272 $ 549.00 463200676 ZZ CATH, GUIDING 6FX55 RAABE 10.4632 272 $ 549.00 463200677 ZZ STENT, GENESIS 10MMX27MM 10.4632 272 $ 5,385.00 463200678 ZZ STENT, GENESIS MOUNTED 7MMX 10.4632 272 $ 6,983.00 463200679 ZZ STENT, GENESIS MOUNTED5MMX2 10.4632 272 $ 6,983.00 463200680 ZZ STENT, WALL 6MMX20MMX160CM 10.4632 272 $ 12,614.00 463200681 ZZ STENT, ROYAL 6MMX14MM 10.4632 272 $ 8,170.00 463200682 ZZ CATH, GUIDING 8FX90CM 10.4632 272 $ 701.00 463200683 ZZ CAHT, INFUSION PROSTREAM 9C 10.4632 272 $ 1,082.00 463200684 ZZ CATH, INFUSION PROSTREAM 12 10.4632 272 $ 1,082.00 463200685 ZZ STENT EXPRESS 6X37X75 10.4632 278 $ 7,264.00 463200686 ZZ STENT 8X37X75 10.4632 278 $ 7,264.00 463200687 ZZ EXPRESS STENT 6X17X75 10.4632 278 $ 6,745.00 463200688 ZZ STENT EXPRESS 8X27X75 10.4632 278 $ 7,264.00 463200689 ZZ STENT EXPRESS 7X27X75 10.4632 278 $ 7,264.00 463200690 ZZ STENT EXPRESS 10.4632 278 $ 6,745.00 463200691 ZZ STENT EXPRESS 8X27X135 10.4632 278 $ 7,264.00 463200692 ZZ STENT EXPRESS 6X27X135 10.4632 278 $ 7,264.00 463200693 ZZ DILATOR GLIDE 5F 10.4632 272 $ 94.00 463200694 ZZ DILATOR GLIDE 6F 10.4632 272 $ 94.00 463200695 ZZ DILATOR GLIDE 7F 10.4632 272 $ 94.00 463200696 ZZ COIL NESTOR 4MM 10.4632 272 $ 564.00 463200697 ZZ COIL NESTER 6MM 10.4632 272 $ 564.00 463200698 ZZ COIL NESTER 8MM 10.4632 272 $ 564.00 463200699 ZZ TRACKER, RENEGADE 10.4632 272 $ 1,958.00 463200700 ZZ FILTER, TULIP FEMORAL 10.4632 278 $ 4,901.00 463200701 ZZ SHEALTH, FLEXOR 10F X 80 10.4632 272 $ 553.00 463200702 ZZ CATHETER, GUIDING 9F X 90 10.4632 279 $ 899.00 463200703 ZZ NEEDLE, VERTEBROPLASTY 11GX 10.4632 272 $ 226.00 463200704 ZZ CATHETER, 8F SMALL PIG DRAI 10.4632 272 $ 609.00 463200705 ZZ SET MICROPUNCTURE 5F COOK E 10.4632 272 $ 293.00 463200706 ZZ CATHETER, INF PROSTREAM 5CM 10.4632 279 $ 1,031.00 463200707 ZZ FILTER,SIMON NITINOL JUGULA 10.4632 278 $ 5,271.00 463200708 ZZ VERTEBROPLASTY CEMENT DEL S 10.4632 272 $ 2,747.00 463200709 ZZ SHEATH, 7F X 80CM RAABE 10.4632 272 $ 609.00 463200710 ZZ CATHETER, BALLOON 6X2X120 B 10.4632 279 $ 1,999.00 463200712 ZZ STENT EXPESS 8X17X135 10.4632 278 $ 6,552.00 463200713 STENT EXPRESS 6X27X135 10.4632 278 $ 6,552.00 463200714 ZZ STENT 6X17X135 10.4632 278 $ 6,552.00 463200715 ZZ SET BARD MICRO INTRO 5.5F 10.4632 272 $ 192.00 463200716 ZZ STENT,ZILVER 8MMX40MM 10.4632 278 $ 7,120.00 463200717 ZZ STENT,ZILVER 8MMX60MM 10.4632 278 $ 7,120.00 463200718 ZZ PUMP,ANGIOJET INF CATH 10.4632 279 $ 376.00 463200719 ZZ CATH,ANGIOJET 6FX120CM 10.4632 279 $ 3,601.00 463200720 ZZ CATH,ANGIOJET 6FX50CM 10.4632 279 $ 3,601.00 463200721 ZZ STENT,EXPRESS 18 5X19X90 10.4632 278 $ 7,073.00 463200722 ZZ STENT,EXPRESS 5X15X90 10.4632 278 $ 7,214.00 463200723 ZZ STENT,EXPRESS 18 6X14X90 10.4632 278 $ 7,214.00 463200724 ZZ STENT,EXPRESS 6X18X90 10.4632 278 $ 7,214.00 463200725 ZZ STENT,EXPRESS 6MMX27MMX75CM 10.4630 278 $ 6,552.00 463200726 ZZ CATH,BALLOON 6X2X50 10.4630 279 $ 1,375.00 463200727 ZZ CATH,BALLOON CONQUEST 10.4630 279 $ 1,375.00 463200728 ZZ CATH,BALLOON CONQUEST 8X4X7 10.4630 279 $ 1,375.00 463200729 ZZ CATH,BALLOON CONQUEST 12X4X 10.4630 279 $ 1,375.00 463200732 ZZ DISECTOMY CANNULA 10.4632 272 $ 3,018.00 463200733 CATHETER POLAR 5MMX8CM 80-120 10.4632 279 $ 2,131.00 463200734 ZZ POLAR CATH 5X4X80 10.4630 279 $ 3,018.00 463200735 ZZ CATHETER POLAR 10.4632 279 $ 2,607.00 463200736 CATH POLAR 6MMX8MM 80-120 10.4630 279 $ 2,232.00 463200737 ZZ POLAR CATH 6X4X80 10.4630 279 $ 3,018.00 463200739 ZZ POLAR CATH INFLATION DEVICE 10.4632 279 $ 3,641.00 463200740 ZZ POLAR CATH NITROUS OXIDE 10.4630 279 $ 344.00 463200741 ZZ POLAR CATH BATTERY 10.4632 272 $ 1,314.00 463200742 ZZ STENT-URETERAL 8FX24CM 10.4632 278 $ 909.00 463200743 ZZ STENT-URETERAL 8FX26CM 10.4632 278 $ 909.00 463200744 ZZ CATHETER-ANSEL 6F 55CM 10.4630 279 $ 359.00 463200745 ZZ CATHETER VANANDEL 6F 10.4632 279 $ 359.00 463200746 ZZ CATH,BALLOON CUTTING 6MM 10.4630 279 $ 3,050.00 463200747 ZZ CATH,BALLOON CUTTING 7MM 10.4630 279 $ 3,050.00 463200748 ZZ BALLOON 10X4X75 CONQUEST 10.4632 279 $ 1,375.00 463200753 ZZ SNARE 12 MM 10.4632 272 $ 1,580.00 463200754 ZZ SNARE 9MM 10.4632 272 $ 1,580.00 463200755 ZZ SNARE 6F 12MM 10.4632 272 $ 1,924.00 463200756 ZZ SNARE 6F 18MMX24MM 10.4632 272 $ 1,924.00 463200757 ZZ ANGIOSEAL 6FR 10.4632 272 $ 1,047.00 463200758 ZZ BALLOON MAVERICK 2MMX2CM 10.4632 279 $ 1,633.00 463200759 ZZ BALLOON USSV 10.4632 279 $ 2,070.00 463200762 ZZ STENT,SMART 10.4632 278 $ 5,940.00 463200763 ZZ SHEATH SHUTTLE 10.4632 272 $ 839.00 463200764 ZZ CATHETER,BILIARY 10.4632 272 $ 432.00 463200765 ZZ STENT PRECISE 10.4632 278 $ 7,507.00 463200766 ZZ FILTER WIRE 10.4632 278 $ 5,180.00 463200767 ZZ STENT SMART 10.4632 278 $ 5,940.00 463200768 ZZ SHEATH DESTINATION 6F 10.4632 272 $ 930.00 463200769 ZZ SHEATH RETRIEV FILTER WIRE 10.4632 279 $ 452.00 463200770 ZZ STENT MONORAIL 10.4632 278 $ 5,414.00 463200775 ZZ VASCULAR CLOSURE 6F 10.4632 272 $ 1,460.00 463200776 ZZ VASCULAR CLOSURE DEVICE 10.4632 272 $ 1,460.00 463200777 ZZ BALLOON EQUALIZ 33MMX65CM 10.4632 279 $ 1,443.00 463200802 CATHETER POLAR 3.5-4MMX4-8CM 10.4632 279 $ 2,352.00 463200804 ZZ CATHETER,JB/H1 10.4632 279 $ 200.00 463200808 ZZ CATHETER,ROBERTS 10.4632 279 $ 54.00 463200810 ZZ BALLOON-USSV 6X2X150 10.4632 279 $ 1,845.00 463200812 ZZ BALLOON-USSV 7X2X150 10.4632 279 $ 1,845.00 463200814 ZZ SHEATH, 16F 10.4632 272 $ 562.00 463200816 ZZ SHEATH, 22F 10.4632 272 $ 967.00 463200850 ZZ GUIDE WIRE,LUNDERQUIS 260CM 10.4632 279 $ 254.00 463200900 ZZ STENT,GFT VIATORR 6/2CMX10M 10.4632 621 $ 8,515.00 463200901 ZZ CATH, OUTBACK 10.4632 621 $ 5,341.00 463200902 ZZ CATH, FRONTRUNNER 90CM 10.4632 621 $ 2,738.00 463200903 ZZ CATH,FRONTRUNNER GUIDE 80CM 10.4632 621 $ 1,045.00 463200904 ZZ CATH, FRONTRUNNER 120CM 10.4632 621 $ 1,045.00 463200905 ZZ BALLOON 6X4X40 10.4632 621 $ 852.00 463201010 ZZ ACCUNET VASCULAR FILTER 10.4632 278 $ 4,175.00 463201020 ZZ ACCULINK STENT - STRAIGHT 10.4632 278 $ 5,242.00 463201030 ZZ ACCULINK STENT - TAPERED 10.4632 278 $ 5,753.00 463201555 ZZ GUIDE WIRE,THRUWAY 10.4632 279 $ 399.00 463201708 ZZ FILTER,RECOVERY 10.4632 278 $ 3,752.00 463201709 ZZ FILTER RECOVERY 10.4632 279 $ 300.00 463201710 ZZ FILTER TULIP JUGULAR 10.4632 279 $ 2,528.00 463201712 ZZ STENT, FLUENCY 10.4632 278 $ 5,363.00 463201720 ZZ STENT COVERED - VIABAHN 10.4632 278 $ 5,581.00 463201730 ZZ STENT COVERED - VIATORR 10.4632 278 $ 8,109.00 463201738 ZZ STENT-ATRIUM 7X22MMX80CM 10.4632 278 $ 6,157.00 463201739 ZZ STENT-ATRIUM 100X38MMX80CM 10.4632 278 $ 6,550.00 463201740 ZZ STENT COVERED - ATRIUM 10.4632 278 $ 6,505.00 463201742 ZZ STENT-GRAFT BIFURCATED 10.4632 278 $ 17,063.00 463201744 ZZ STENT-GRAFT CONTRALATERAL 10.4632 278 $ 8,827.00 463201746 ZZ STENT-ILIAC EXTENDER 10.4632 278 $ 6,188.00 463201748 ZZ STENT-AORTIC EXTENDER 10.4632 278 $ 6,188.00 463201999 MINOR SURGERY RADIOLOGY 10.4632 360 $ 558.00 463202010 ZZ ADAPTER CATH LG 10.4632 272 $ 16.00 463202020 ZZ CATH,VONSONNENBERG 18-22F 10.4632 272 $ 768.00 463202030 ZZ NEEDLE, CHIBA 18-22G 10.4632 272 $ 210.00 463202040 ZZ NEEDLE, SPINAL 18-22G 10.4632 272 $ 51.00 463202050 ZZ TRAY LUMBAR PUNCTURE 10.4632 272 $ 130.00 463202060 ZZ TRAY MYELOGRAM 10.4632 272 $ 170.00 463204000 ISOVUE M 200 10.4632 636 $ 436.00 463222899 IR KYPHOPLASTY 10.4632 320 $ 2,187.00 463237184 IR INJ MECH ART THROMBECTOMY 10.4632 361 $ 2,226.00 463237185 IR ADD MECH ART THROMBECTOMY 10.4632 361 $ 2,226.00 463237188 IR INJ MECH VENOUS THROMBECT 10.4632 361 $ 2,226.00 463237195 IR INJ THROMBOLYSIS CEREBRAL 10.4632 361 $ 5,526.00 463237215 IR CAROTID STENT ALL INCLUSIVE 10.4632 361 $ 6,000.00 463237216 IR STENT PLACE CERV CAROTID 10.4632 361 $ 1,620.00 463237280 ZZ BALLOON,RELIANT 10.4632 279 $ 445.00 463242050 LD CATHETER 10.4632 279 $ 411.00 463243752 FLOURO CATH PLACEMENT 10.4632 361 $ 357.00 463244000 IR FLUOROSCOPY 0-60 MINUTES 10.4632 320 $ 1,060.00 463244001 IR FLUOROSCOPY GREATER THAN 60 10.4632 320 $ 1,589.00 463244002 IR ABSCESS DRAIN 10.4632 320 $ 519.00 463244003 IR INJ. ABSCESS DRAINAGE 10.4632 361 $ 3,341.00 463244004 IR ANGIO ABDOMINAL AORTA 10.4632 320 $ 2,076.00 463244005 IR ANGIO VISCERAL 10.4632 320 $ 2,076.00 463244006 IR ANGIO ADDITIONAL VESSELS 10.4632 320 $ 840.00 463244007 IR ANGIO AIF W/RUNOFF 10.4632 320 $ 2,167.00 463244008 IR ANGIO THORACIC ARCH 10.4632 320 $ 2,076.00 463244009 IR ANGIO CAROTID-BILATERAL 10.4632 320 $ 2,076.00 463244010 IR ANGIO CAROTID-UNILATERAL 10.4632 320 $ 2,076.00 463244011 IR ANGIO EXTREMITY-UNILATERAL 10.4632 320 $ 2,076.00 463244012 IR ANGIO PULMONARY-BILATERAL 10.4632 320 $ 2,076.00 463244013 IR ANGIO PULMONARY-UNILATERAL 10.4632 320 $ 2,076.00 463244014 IR ANGIO RENAL BILATERAL 10.4632 320 $ 2,076.00 463244015 IR ANGIO RENAL-UNILATERAL 10.4632 320 $ 1,579.00 463244016 IR ANGIO VERTEBRAL 10.4632 320 $ 2,076.00 463244017 IR ARTERIOVENOUS SHUNT 10.4632 320 $ 508.00 463244018 IR BILIARY DRAINAGE 10.4632 320 $ 891.00 463244019 IR INJ. BILIARY CATH CHANGE 10.4632 361 $ 1,207.00 463244020 IR BILIARY DUCT DILATE 10.4632 361 $ 999.00 463244021 IR BILIARY DUCT/STENT DILATE 10.4632 361 $ 555.00 463244022 IR BILIARY STONE REMOVAL 10.4632 320 $ 288.00 463244023 IR INJ. AXILLARY STICK 10.4632 361 $ 1,139.00 463244024 IR BX LUNG FLUORO 10.4632 320 $ 203.00 463244025 IR BX LIVER TRANSJUGULAR 10.4632 320 $ 2,076.00 463244026 IR BX OTHER THAN LUNG 10.4632 320 $ 730.00 463244027 IR INJ. 1ST ORDER RENAL/VISC. 10.4632 361 $ 1,419.00 463244028 IR INJ. 3RD ORDER RENAL/VISC. 10.4632 361 $ 2,571.00 463244029 IR INJ. 2ND ORDER RENAL/VISC. 10.4632 361 $ 2,571.00 463244030 IR INJ. 2ND ORDER PULMONARY 10.4632 361 $ 526.00 463244031 IR INJ. 3RD ORDER PULMONARY 10.4632 361 $ 1,083.00 463244032 IR INJ. 1ST ORDER VENOUS 10.4632 361 $ 734.00 463244033 IR INJ. 2ND ORDER VENOUS 10.4632 361 $ 734.00 463244034 IR BILIARY T-TUBE CHOLE 10.4632 320 $ 131.00 463244035 IR CONRAY 43-50CC VIAL 10.4632 255 $ 102.00 463244036 IR EMBOLIZATION 10.4632 320 $ 3,977.00 463244037 IR INJ. BILIARY STONE EXTRAC. 10.4632 361 $ 2,088.00 463244038 IR INJ. ANTEGRADE STICK 10.4632 361 $ 1,139.00 463244039 IR VENOGRAM UPPER EXT-BILATERA 10.4632 320 $ 237.00 463244040 IR VENOGRAM UPPER EXT--UNILATE 10.4632 320 $ 123.00 463244041 IR INJ. PERC. GASTROTUBE PLACE 10.4632 361 $ 357.00 463244042 IR GASTROTUBE PERC PLACEMENT 10.4632 320 $ 519.00 463244043 IR VENOGRAM HEPATIC 10.4632 320 $ 2,076.00 463244044 IR HEXABRIX-50CC 10.4632 636 $ 553.00 463244045 IR CONRAY 60 - 50CC 10.4632 255 $ 62.00 463244046 IR INJ. PTA BRACHIAL CEPH. VES 10.4632 361 $ 554.00 463244047 IR INJ. NEPHROSTOGRAM 10.4632 361 $ 368.00 463244048 IR INJ. T-TUBE CHOLE 10.4632 361 $ 531.00 463244049 IR INJ. TRANSHEPATIC CHOLE 10.4632 361 $ 608.00 463244050 IR INJ. VENOGRAM EXTREMITY 10.4632 361 $ 910.00 463244051 IR INJ. I.V.C. FILTER PLACEMEN 10.4632 361 $ 3,773.00 463244052 IR INJ. A-V SHUNT 10.4632 361 $ 1,492.00 463244053 IR INJ. PERC. NEPHROSTOMY PLAC 10.4632 361 $ 891.00 463244054 IR INJ. VENCAVAGRAM INF/SUP 10.4632 361 $ 798.00 463244055 IR INJ. 1ST ORDER ABDOMINAL AR 10.4632 361 $ 1,004.00 463244056 IR INJ. PERC. BILIARY TUBE PLA 10.4632 361 $ 1,773.00 463244057 IR INJ. PERC. BILIARY INT./EXT 10.4632 361 $ 999.00 463244058 IR INJ. NEPHROSTENT PLACEMENT 10.4632 361 $ 1,707.00 463244059 IR NEPHROSTOGRAM 10.4632 320 $ 168.00 463244060 IR INJ. NEPHROSTOMY TUBE CHANG 10.4632 361 $ 1,074.00 463244061 IR OPTIRAY 320 - 30CC 10.4632 636 $ 436.00 463244062 IR OPTIRAY 320 - 100CC 10.4632 636 $ 924.00 463244063 IR OPTIRAY 320 - 50CC 10.4632 636 $ 477.00 463244064 IR BILIARY PERC. INT/EXT TUBE 10.4632 320 $ 1,005.00 463244065 IR FILTER IVC PLACEMENT 10.4632 320 $ 2,076.00 463244066 IR NEPHROSTOMY TUBE PLACEMENT 10.4632 320 $ 510.00 463244067 IR INJ. GASTROTUBE PLACEMENT P 10.4632 361 $ 1,762.00 463244068 IR INJ. PORTAL VEIN 10.4632 361 $ 2,527.00 463244069 IR TRANSHEPATIC PORTOGRAPHY 10.4632 320 $ 2,076.00 463244070 IR PTA ADDITIONAL PERIPHERAL 10.4632 320 $ 2,096.00 463244071 IR PTA ADDITIONAL VISCERAL 10.4632 320 $ 1,052.00 463244072 IR INJ. PTA AORTA 10.4632 361 $ 1,620.00 463244073 IR PTA ILIAC 10.4632 320 $ 2,596.00 463244074 IR INJ. PTA FEM-POP 10.4632 361 $ 1,620.00 463244075 IR INJ. PTA ILIAC 10.4632 361 $ 2,480.00 463244076 IR PTA RENAL VISCERAL 10.4632 320 $ 2,596.00 463244077 IR INJ. PTA RENAL/VISCERAL 10.4632 361 $ 4,013.00 463244078 IR INJ. PTA TIBIAL 10.4632 361 $ 1,620.00 463244079 IR VENORGRAM RENAL BILATERAL 10.4632 320 $ 1,579.00 463244080 IR VENOGRAM RENAL UNILATERAL 10.4632 320 $ 1,148.00 463244081 IR RENIN STUDY 10.4632 320 $ 1,579.00 463244082 IR CONRAY 30 - 50CC 10.4632 250 $ 114.00 463244083 IR INJ. CEREBRAL 1ST ORDER 10.4632 361 $ 2,208.00 463244084 IR INJ. CEREBRAL 2ND ORDER 10.4632 361 $ 1,482.00 463244085 IR INJ. CEREBRAL 3RD ORDER 10.4632 361 $ 1,766.00 463244086 IR INJ. CEREBRAL 4TH ORDER 10.4632 361 $ 1,755.00 463244087 IR THROMBOLYSIS-FOLLOWUP 10.4632 320 $ 141.00 463244088 IR THROMBOLYSIS 10.4632 320 $ 3,456.00 463244089 IR INTRACRANIAL EMBOLOZATION 10.4632 361 $ 734.00 463244090 IR INJ. EMBOLIZATION 10.4632 361 $ 5,563.00 463244091 IR INJ. NON CEREBRAL OCCLUSION 10.4632 361 $ 734.00 463244092 IR INJ. STENT VASCULAR 10.4632 361 $ 1,620.00 463244093 IR INJ. STENT VASCULAR ADD'L 10.4632 361 $ 1,620.00 463244094 IR INJ. THROMBOLYSIS 10.4632 361 $ 2,226.00 463244095 IR BILIARY TRANSHEPATIC CHOLE 10.4632 320 $ 519.00 463244096 IR NEPHROSTOMY TUBE CHANGE 10.4632 320 $ 324.00 463244097 IR NEPHROSTENT PLACEMENT 10.4632 320 $ 4,032.00 463244098 IR STENT VASCULAR PLACEMENT 10.4632 320 $ 1,863.00 463244099 IR VENACAVAGRAM-INFERIOR 10.4632 320 $ 2,076.00 463244100 IR VENACAVAGRAM-SUPERIOR 10.4632 320 $ 1,579.00 463244102 IR INJ. VENO EXTREMITY 10.4632 361 $ 910.00 463244103 IR STENT VASCULAR PLACEMENT AD 10.4632 320 $ 1,863.00 463244104 IR PTA FEM-POP 10.4632 320 $ 2,123.00 463244105 IR PTA TIBIAL 10.4632 320 $ 2,095.00 463244106 IR PTA AORTA 10.4632 320 $ 2,095.00 463244107 IR BILIARY TUBE CHANGE 10.4632 320 $ 249.00 463244108 IR DISKOGRAM CERVICAL 10.4632 320 $ 1,105.00 463244109 IR INJ. DISKOGRAPHY CERVICAL 10.4632 361 $ 558.00 463244110 IR DISKOGRAPHY LUMBAR 10.4632 320 $ 1,105.00 463244111 IR INJ. DISKOGRAPHY LUMBAR 10.4632 361 $ 558.00 463244112 IR PTA VENOUS 10.4632 320 $ 2,596.00 463244113 IR INJ. PTA VENOUS 10.4632 361 $ 2,480.00 463244114 IR RENAL CYST ASPIRATION 10.4632 320 $ 519.00 463244115 IR INJ. RENAL CYST ASPIRATION 10.4632 361 $ 3,341.00 463244116 IR VERTEBROPLASTY-- LUMBAR 10.4632 320 $ 1,105.00 463244117 IR VERTEBROPLASTY ADD'L--LUMBA 10.4632 320 $ 1,105.00 463244118 IR AV FISTUL DECLOT ALL INCLUS 10.4632 320 $ 4,226.00 463244119 IR NEEDLE PLACEMENT LUNG BIOPS 10.4632 361 $ 345.00 463244120 IR VERTEBROPLASTY--THORACIC 10.4632 320 $ 1,105.00 463244121 IR VERTEBROPLASTY ADD'L--THORA 10.4632 320 $ 1,105.00 463244122 IR INJ. VERTEBROPLASTY--THORAC 10.4632 361 $ 558.00 463244123 IR INJ. VERTEBROPLASTY--LUMBAR 10.4632 361 $ 558.00 463244124 IR INJ. VERTEBROPLASTY--ADD'L 10.4632 361 $ 558.00 463244125 IR CATHOGRAM 10.4632 361 $ 424.00 463244126 IR CHEST TUBE INSERTION 10.4632 361 $ 533.00 463244127 IR US GUIDANCE 10.4632 402 $ 637.00 463244128 IR TRANSLUMBAR AORTA 10.4632 361 $ 1,419.00 463244129 IR ANGIO ARCH FOR CAROTIDS 10.4632 320 $ 840.00 463244130 IR ANGIO BRACHIAL RETROGRADE 10.4632 361 $ 2,076.00 463244131 IR ANGIO CAROTID EXT. UNI. 10.4632 361 $ 1,158.00 463244132 IR ANGIO CAROTID EXT. BIL. 10.4632 361 $ 2,076.00 463244133 IR ANGIO CAROTID CERVICAL BIL. 10.4632 323 $ 2,076.00 463244134 IR ANGIO CAROTID CERVICAL UNI. 10.4632 361 $ 1,887.00 463244135 IR ANGIO SPINAL 10.4632 361 $ 2,076.00 463244136 IR ANGIO EXTREMITY BILATERAL 10.4632 320 $ 2,076.00 463244137 IR ANGIO ADRENAL UNI. 10.4632 361 $ 1,158.00 463244138 IR ANGIO ADREANL BIL. 10.4632 361 $ 2,076.00 463244139 IR ANGIO PELVIC 10.4632 361 $ 2,076.00 463244140 IR PULMONARY NONSELECTIVE 10.4632 361 $ 2,076.00 463244141 IR ANGIO EACH ADDITIONAL VESSE 10.4632 361 $ 1,158.00 463244142 IR VENOGRAM ADRENAL UNI. 10.4632 361 $ 1,158.00 463244143 IR VENOGRAM ADRENAL BIL. 10.4632 361 $ 2,076.00 463244144 IR VENOGRAM SINUS OR JUGULAR 10.4632 361 $ 2,076.00 463244145 IR VENOGRAM SUPERIOR SINUS 10.4632 361 $ 2,076.00 463244146 IR VENOGRAM EPIDURAL 10.4632 361 $ 2,076.00 463244147 IR VENOGRAM ORBITAL 10.4632 361 $ 2,076.00 463244148 IR GASTROSTOMY TUBE CHANGE 10.4632 361 $ 519.00 463244149 IR ENTEROCLYSIS TUBE PLACEMENT 10.4632 361 $ 644.00 463244150 IR LOOPOGRAM 10.4632 361 $ 1,707.00 463244151 IR RENAL CYST STUDY 10.4632 320 $ 519.00 463244152 IR ANTEGRADE PYELOGRAM 10.4632 361 $ 168.00 463244153 IR NEPHROSTOMY TRACT DILATION 10.4632 361 $ 368.00 463244154 IR URETERAL DILATION] 10.4632 361 $ 405.00 463244155 IR INJ. EMBOLIZATION EXTRACRAN 10.4632 361 $ 5,543.00 463244156 IR FOREIGN BODY REMOVAL 10.4632 320 $ 2,076.00 463244158 IR INJ. GASTROSTOMY TUBE CHANG 10.4632 361 $ 519.00 463244159 IR INJ. ENTEROCLYSIS TUBE PLAC 10.4632 361 $ 644.00 463244160 IR INJ. LOOPOGRAM 10.4632 361 $ 422.00 463244161 IR INJ. RENAL CYST 10.4632 361 $ 2,076.00 463244162 IR INJ. ANTEGRADE PYELOGRAM 10.4632 361 $ 368.00 463244163 IR INJ. NEPHROSTOMY DILATION 10.4632 361 $ 1,201.00 463244164 IR INJ. URETERAL DILATION 10.4632 361 $ 1,201.00 463244165 IR INJ. FOREIGN BODY REMOVAL 10.4632 361 $ 1,103.00 463244166 IR EPIDUROGRAPHY 10.4632 320 $ 920.00 463244167 IR INJ. EPIDUROGRAPHY 10.4632 361 $ 443.00 463244168 IR EPIDUROGRAPHY SELECTIVE 10.4632 320 $ 920.00 463244169 IR INJ. EPIDUROGRAPHY SELECTIV 10.4632 361 $ 443.00 463244170 IR EPIDUROGRAPHY SELECTIVE ADD 10.4632 320 $ 920.00 463244173 IR ANGIO BRONCHIAL/INTERCOSTAL 10.4632 320 $ 2,076.00 463244174 IR INJ. RENIN 10.4632 361 $ 734.00 463244175 IR FACET BLOCK CERVICAL 10.4632 320 $ 920.00 463244176 IR FACET BLOCK CERVICAL ADD'L 10.4632 320 $ 920.00 463244177 IR INJ FACET BLOCK CERVICAL 10.4632 361 $ 443.00 463244178 IR INJ FACET BLOCK CERVICAL AD 10.4632 361 $ 443.00 463244179 IR PICC LINE INSERTION 10.4632 361 $ 701.00 463244180 IR TIPSS 10.4632 361 $ 11,777.00 463244181 IR TIPSS REVISION 10.4632 361 $ 7,180.00 463244182 IR INJ STENT GRAFT 10.4632 361 $ 3,446.00 463244183 IR ANGIO STENT GRAFT 10.4632 361 $ 796.00 463244184 IR INJ STENT GRAFT LEG 10.4632 361 $ 2,915.00 463244185 IR ANGIO STENT GRAFT LEG 10.4632 361 $ 531.00 463244186 IR SI JOINT INJECTION 10.4630 320 $ 836.00 463244188 IR PERCUTANEOUS DISCECTOMY 10.4630 320 $ 836.00 463244190 IR PTA ARTERIAL FISTULA 10.4632 323 $ 5,400.00 463244191 IR PTA VENOUS FISTULA 10.4632 323 $ 5,400.00 463244195 IR INJ DISKECTOMY 10.4632 761 $ 4,200.00 463244200 IR BLOOD PATCH 10.4632 320 $ 920.00 463244202 XR INJ BLOOD PATCH 10.4630 361 $ 368.00 463244203 CATH BALLOON, 5x2x75 CONQUEST 10.4632 621 $ 1,065.09 463244204 CATHETER, GUIDING RAABE 7F 10.4632 621 $ 283.00 463244444 MASTER - INTERVENTIONAL RADIOL 10.4632 321 $ - 463264475 IR INJ. FACET BLOCK LUMBAR 10.4632 361 $ 443.00 463264476 IR INJ. FACET BLOCK LUMBAR ADD 10.4632 361 $ 443.00 463264484 IR INJ EPIDUROGRAPHY ADDL LEVL 10.4632 361 $ 443.00 463271029 FLOURO CHEST 10.4632 324 $ 655.00 463275962 PTA- BRACHIOCEPHALIC 10.4632 320 $ 2,095.00 463276005 IR FACET BLOCK LUMBAR 10.4632 320 $ 920.00 463276006 IR FACET BLOCK LUMBAR ADDITION 10.4632 320 $ 920.00 463290784 IV INJECTION 10.4630 510 $ 101.00 463290785 IV INJECTION ADD'L SEQUENTIAL 10.4630 761 $ 101.00 463311111 COH MASTER REHABILITATION 10.4630 321 $ - 463370030 EYE - FOREIGN BODY DETECTIO 10.4630 320 $ 526.00 463370100 RXR MANDIBLE,LIMITED OR UNI 10.4630 320 $ 596.00 463370110 RXR MANDIBLE-COMPLETE 10.4630 320 $ 710.00 463370140 FACIAL BONES - LIMITED 10.4630 320 $ 596.00 463370150 ZYGOMATIC ARCHES 10.4630 320 $ 710.00 463370160 NASAL BONES 10.4630 320 $ 608.00 463370210 RXR PARANASAL SINUSES, LIMIT 10.4630 320 $ 513.00 463370220 RXR PARANASAL SINUSES COMPLT 10.4630 320 $ 715.00 463370250 SKULL LIMITED 10.4630 320 $ 526.00 463370260 RXR SKULL, COMPLETE 10.4630 320 $ 791.00 463370328 TMJ OPEN & CLOSED- UNILATE 10.4630 320 $ 354.00 463370330 TMJ OPEN & CLOSED -BILATERA 10.4630 320 $ 531.00 463370360 RXR SOFT TISSUE NECK 10.4630 320 $ 218.00 463370380 SALIVARY GLND FOR CALCUL 10.4630 320 $ 426.00 463371010 RXR CHEST SINGLE VIEW 10.4630 324 $ 513.00 463371020 RXR CHEST,TWO VIEWS 10.4630 324 $ 528.00 463371021 RXR CHEST W/APICAL LORDOTIC 10.4630 324 $ 572.00 463371025 RXR CHEST, WITH OBLIQUES 10.4630 324 $ 632.00 463371035 RXR CHEST SPEC VW,DECUT/BUCK 10.4630 324 $ 632.00 463371037 CHEST 3V (PA-INS/EXP & LAT) 10.4630 324 $ 632.00 463371100 RXR RIBS UNILAT W/PA CHEST 10.4630 320 $ 807.00 463371102 RXR RIBS, UNILATERAL W/O CHEST 10.4630 320 $ 393.00 463371110 RXR RIBS, BILATERAL 10.4630 320 $ 924.00 463371111 RXR RIBS, BILATERAL W/O CHEST 10.4630 320 $ 488.00 463371120 RXR STERNUM 10.4630 320 $ 411.00 463371130 STERNOCLAVICULAR JTS 10.4630 320 $ 412.00 463372020 RXR SPINE ANY LEVEL (1 VIEW) 10.4630 320 $ 411.00 463372040 RXR SPINE CERVICAL AP AND LAT 10.4630 320 $ 596.00 463372050 RXR SPINE CERVICAL COMPLETE 10.4630 320 $ 725.00 463372052 RXR SPINE CERV COMP W/FLEX-X 10.4630 320 $ 846.00 463372070 RXR SPINE THORA-INCLSWIMMRS 10.4630 320 $ 632.00 463372080 RXR SPINE THORACOLUMBR AP/LAT 10.4630 320 $ 632.00 463372090 SPINE SCOLIOSIS STUDY 10.4630 320 $ 412.00 463372100 RXR SPINE LUMBOSACRAL AP AND L 10.4630 320 $ 637.00 463372110 RXR SPINE LUMOSACRAL COMP W/OB 10.4630 320 $ 840.00 463372114 RXR SPINE LUMBOSACRAL COMP W/B 10.4630 320 $ 953.00 463372120 RXR SPINE LUMBOSACRAL BEND ONL 10.4630 320 $ 668.00 463372170 RXR PELVIS, LIMITED,AP ONLY 10.4630 320 $ 542.00 463372190 RXR PELVIS,COMPLETE 10.4630 320 $ 665.00 463372202 RXR SACROILIAC JTS COMPLETE 10.4630 320 $ 629.00 463372220 RXR SACRUM + COCCYX 10.4630 320 $ 608.00 463373000 CLAVICLE, UNILATERAL 10.4630 320 $ 271.00 463373010 RXR SCAPULA 10.4630 320 $ 5,718.00 463373020 RXR SHOULDER, LIMITED 10.4630 320 $ 461.00 463373030 RXR SHOULDER, COMPLETE 10.4630 320 $ 623.00 463373060 RXR HUMERUS, INCL BTH JOINTS 10.4630 320 $ 538.00 463373070 RXR ELBOW, LIMITED (AP&LAT) 10.4630 320 $ 538.00 463373080 RXR ELBOW, COMPLETE 10.4630 320 $ 582.00 463373090 RXR FOREARM,AP&LAT VIEWS 10.4630 320 $ 538.00 463373100 RXR WRIST,LIMITED AP & LAT 10.4630 320 $ 438.00 463373110 RXR WRIST,COMPLETE 10.4630 320 $ 596.00 463373120 RXR HAND, LIMITED 10.4630 320 $ 510.00 463373130 RXR HAND, COMPLETE 10.4630 320 $ 596.00 463373140 RXR FINGER(S) 10.4630 320 $ 502.00 463373500 RXR HIP,UNILATERAL 10.4630 320 $ 454.00 463373510 RXR HIP,COMPLETE BILAT W/AP PE 10.4630 320 $ 710.00 463373550 RXR FEMUR, AP & LAT VIEWS 10.4630 320 $ 596.00 463373560 RXR KNEE, LIMITED AP&LAT 10.4630 320 $ 440.00 463373562 RXR KNEE, W/OBLIQUES 10.4630 320 $ 519.00 463373564 RXR KNEE, COMPLETE 10.4630 320 $ 519.00 463373590 RXR TIBIA & FIBULA W/AP & LAT 10.4630 320 $ 538.00 463373600 RXR ANKLE, LIMITED,AP & LAT 10.4630 320 $ 310.00 463373610 RXR ANKLE, COMPLETE 10.4630 320 $ 572.00 463373620 RXR FOOT, LIMITED-AP&LAT 10.4630 320 $ 504.00 463373630 RXR FOOT,COMPLETE 10.4630 320 $ 580.00 463373650 RXR CALCANEUS(HEEL) 10.4630 320 $ 513.00 463373660 RXR TOES(S) 10.4630 320 $ 493.00 463374000 RXR ABDOMEN-SINGLE VIEW 10.4630 320 $ 563.00 463374020 RXR ABDOMEN-- COMPLETE 10.4630 320 $ 632.00 463374022 ABDOMINAL SERIES - ACUTE 10.4630 320 $ 962.00 463374230 RXR SWALLOWING FUCT.W/VIDEO 10.4630 320 $ 565.00 463376020 BONE AGE STUDIES 10.4630 320 $ 412.00 463376040 SCANOGRAM/LEG LENGTH 10.4630 320 $ 531.00 463376060 BONE SURVEY COMPLETE 10.4630 320 $ 1,185.00 463376061 BONE STUDY--LIMITED 10.4630 320 $ 198.00 463376065 BONE SURVEY - CHILD 10.4630 320 $ 553.00 463377010 PORT MANDIBLE--LIMITED 10.4630 320 $ 596.00 463377011 PORT MANDIBLE--COMPLETE 10.4630 320 $ 710.00 463377014 PORT FACIAL BONES--LIMITED 10.4630 320 $ 596.00 463377015 PORT FACIAL BONES--COMPLETE 10.4630 320 $ 710.00 463377021 PORT PARANASAL SINUS 10.4630 320 $ 513.00 463377025 PORT SKULL--LIMITED 10.4630 320 $ 526.00 463377026 PORT SKULL--COMPLETE 10.4630 320 $ 791.00 463377101 RXR PORT CHEST SINGLE VIEW 10.4630 324 $ 526.00 463377102 RXR PORT CHEST TWO VIEW 10.4630 324 $ 526.00 463377103 RXR PORT CHEST WITH DECUB 10.4630 324 $ 632.00 463377202 RXR PORT SPINE ANY LEVEL, 1 VI 10.4630 320 $ 200.00 463377204 RXR PORT SPINE, CERVICAL 2 VIE 10.4630 320 $ 596.00 463377207 RXR PORT SPINE THORACIC 10.4630 320 $ 632.00 463377210 RXR PORT SPINE, LUMBAR 10.4630 320 $ 637.00 463377217 RXR PORT PELVIS, ONE VIEW 10.4630 320 $ 542.00 463377219 PORT PELVIS-- COMPLETE 10.4630 320 $ 665.00 463377300 RXR PORT CLAVICLE 10.4630 320 $ 531.00 463377302 RXR PORT SHOULDER 10.4630 320 $ 461.00 463377306 RXR PORT HUMERUS 10.4630 320 $ 538.00 463377307 RXR PORT ELBOW, LIMITED 2 VIEW 10.4630 320 $ 538.00 463377308 RXR PORT ELBOW, COMPLETE 4 VIE 10.4630 320 $ 531.00 463377309 RXR PORT FOREARM 10.4630 320 $ 538.00 463377310 RXR PORT WRIST, LIMITED 2 VIEW 10.4630 320 $ 596.00 463377311 RXR PORT WRIST, COMPLETE 3 VIE 10.4630 320 $ 596.00 463377312 RXR PORT HAND, LIMITED 2 VIEW 10.4630 320 $ 510.00 463377313 RXR PORT HAND, COMPLETE 3 VIEW 10.4630 320 $ 596.00 463377314 PORT FINGER(S) 10.4630 320 $ 502.00 463377350 RXR PORT HIP, UNILATERAL 1 VIE 10.4630 320 $ 454.00 463377351 RXR PORT HIP, UNILATERAL 2 VIE 10.4630 320 $ 637.00 463377352 PORT HIP--BILATERAL 10.4630 320 $ 710.00 463377355 RXR PORT FEMUR 10.4630 320 $ 596.00 463377356 RXR PORT KNEE, LIMITED 10.4630 320 $ 440.00 463377357 RXR PORT KNEE, COMPLETE 3 VIEW 10.4630 320 $ 519.00 463377358 PORT TIBIA & FIBULA - RIGHT 10.4630 320 $ 538.00 463377359 RXR PORT TIBIA & FIBULA 10.4630 320 $ 565.00 463377360 RXR PORT ANKLE, LIMITED 10.4630 320 $ 519.00 463377361 RXR PORT ANKLE, COMPLETE 3 VIE 10.4630 320 $ 596.00 463377362 RXR PORT FOOT, LIMITED 2 VIEW 10.4630 320 $ 504.00 463377363 RXR PORT FOOT, COMPLETE 3 VIEW 10.4630 320 $ 580.00 463377366 PORT TOE(S) 10.4630 320 $ 493.00 463377370 PORT CALCANEUS 10.4630 320 $ 513.00 463377400 RXR PORT ABDOMEN 1 VIEW 10.4630 320 $ 563.00 463377402 RXR PORT ABDOMEN, 2 VIEWS 10.4630 320 $ 935.00 464000011 RADIATION THERAPY TX RM 10.4642 510 $ 57.00 464000022 RAD THER - EXAMINING ROOM 10.4642 510 $ 101.00 464000030 INJECTION IM/SUB Q 10.4642 510 $ 101.00 464007100 MINOR SURGERY 1 10.4642 360 $ 614.00 464007200 MINOR SURGERY 2 10.4642 360 $ 1,617.00 464007300 MINOR SURGERY 3 10.4642 360 $ 2,227.00 464010310 INFUSION THERAPY 0-1 HRS 10.4642 260 $ 315.00 464010311 INFUSION HYDRATION 1ST HOUR 10.4642 260 $ 315.00 464019201 OFFICE VISIT - NEW SIMPLE 10.4642 510 $ 94.00 464019202 OFFICE VISIT - NEW EXPANDED 10.4642 510 $ 115.00 464019203 OFFICE VISIT - NEW DETAILED 10.4642 510 $ 149.00 464019204 OFFICE VISIT - NEW COMPREHEN 10.4642 510 $ 221.00 464019205 OFFICE VISIT - HIGH COMPLEXITY 10.4642 510 $ 292.00 464019212 ESTAB EXPANDED PROBLEM - PC 10.4642 510 $ 88.00 464019213 ESTAB INTERMEDIATE EXAM - PC 10.4642 510 $ 93.00 464019214 ESTAB EXTENDED EXAM - PC 10.4642 510 $ 156.00 464019242 ESTAB EXPANDED CONSULT -PC 10.4642 510 $ 79.00 464019243 ESTAB EXPANDED CONSULT - PC 10.4642 510 $ 79.00 464019244 ESTAB EXTENDED CONSULT - PC 10.4642 510 $ 156.00 464030340 CONRAY (BLAD) 149MG/ML 60ML 10.4642 636 $ 120.00 464030342 OPTIRAY(VEIN)300-349MG 100ML 10.4642 636 $ 924.00 464030349 OXYGEN 0-4 HRS 10.4642 270 $ 82.00 464031575 LRYNGOSCOPY, DIAGNOSTIC 10.4642 361 $ 196.00 464070450 CT HEAD/BRAIN W/O CONTRAST 10.4642 351 $ 1,811.00 464070460 CT HEAD/BRAIN W CONTRAST 10.4642 351 $ 1,811.00 464071250 CT CHEST W/O CONTRAST 10.4642 350 $ 2,361.00 464072125 CT SPINE, CERVICAL W/O CONTRAS 10.4642 350 $ 2,853.00 464072126 CT SPINE, CERVICAL W CONTRAST 10.4642 350 $ 2,853.00 464072128 CT SPINE, THORACIC W/O CONTRAS 10.4642 350 $ 2,853.00 464072129 CT SPINE, THORACIC W CONTRAST 10.4642 350 $ 2,853.00 464072131 CT SPINE, LUMBAR W/O CONTRAST 10.4642 350 $ 2,853.00 464072132 CT SPINE, LUMBAR W CONTRAST 10.4642 350 $ 2,853.00 464072192 CT PELVIS W/O CONTRAST 10.4642 350 $ 1,967.00 464072193 CT PELVIS W/CONTRAST 10.4642 350 $ 1,967.00 464073200 CT UPPER EXTREMETIES W/O CONTR 10.4642 350 $ 1,898.00 464073201 CT UPPER EXTREMETIES W CONTRAS 10.4642 350 $ 1,898.00 464073700 CT LOWER EXTREMETIES W/O CONTR 10.4642 350 $ 1,898.00 464073701 CT LOWER EXTREMETIES W CONTRAS 10.4642 350 $ 1,898.00 464074150 CT ABDOMEN W/O CONTRAST 10.4642 350 $ 2,023.00 464074160 CT ABDOMEN W CONTRAST 10.4642 350 $ 2,023.00 464076375 3-D RECONSTRUCTION 10.4642 350 $ 655.00 464076873 US PROSTATE, IMPLANTS 10.4642 402 $ 1,328.00 464077014 CT PLACEMENT OF RAD FIELDS 10.4642 350 $ 619.00 464077280 SIMULATION - SIMPLE 10.4642 333 $ 538.00 464077285 SIMULATION - INTERMEDIATE 10.4642 333 $ 806.00 464077290 SIMULATION - COMPLEX 10.4642 333 $ 1,073.00 464077295 3D RECONSTRUCTION & SIMULATION 10.4642 333 $ 4,721.00 464077299 UNLISTED PROC/CLINICAL TX PLAN 10.4642 333 $ - 464077300 BASIC DOSIMETRY CALCULATION 10.4642 333 $ 315.00 464077301 IMRT TREATMENT PLAN 10.4642 333 $ 6,679.00 464077305 TELETHERAPY ISODOSE - SIMPLE 10.4642 333 $ 680.00 464077310 TELETHERAPY ISODOSE - INTERMED 10.4642 333 $ 949.00 464077315 TELETHERAPY ISODOSE - COMPLEX 10.4642 333 $ 1,214.00 464077321 SPECIAL TELETHERAPY PLAN 10.4642 333 $ 1,817.00 464077326 BRACHYTHERAPY ISODOSE - SIMPLE 10.4642 333 $ 884.00 464077327 BRACHYTHERAPY ISODOSE - INTERM 10.4642 333 $ 1,214.00 464077328 BRACHYTHERAPY ISODOSE - COMPLE 10.4642 333 $ 1,543.00 464077331 INVIVO DOSIMETRY 10.4642 333 $ 295.00 464077332 BEAM SHAPING DEVICE - SIMPLE 10.4642 333 $ 334.00 464077333 BEAM SHAPING DEVICE - INTERMED 10.4642 333 $ 440.00 464077334 BEAM SHAPING DEVICE - COMPLEX 10.4642 333 $ 884.00 464077336 PHYSICS CONSULT - CONTINUING 10.4642 333 $ 440.00 464077370 PHYSICS CONSULT - SPECIAL 10.4642 333 $ 574.00 464077399 UNLISTED PROC.-PHYSICS,DOS,DEV 10.4642 333 $ - 464077401 ORTHOVOLTAGE PER DAY 10.4642 333 $ 264.00 464077402 MEGAVOLT/SIMPLE PER DAY/04MEV 10.4642 333 $ 368.00 464077403 RAD TREAT SIMPLE 6-10 MV 10.4642 333 $ 472.00 464077404 MEGAVOLT/INTERMED PER DAY/ 20M 10.4642 333 $ 621.00 464077405 RAD TREAT SIMPLE 11-19 MV 10.4642 333 $ 558.00 464077407 MEGAVOLT/INTERMED PER DAY/04ME 10.4642 333 $ 371.00 464077408 RAD TREAT INTERMED 6-10 MV 10.4642 333 $ 510.00 464077409 MEGAVOLT/INTERM PER DAY/20MEV 10.4642 333 $ 570.00 464077410 RAD TREAT INTERMED 11-19 MV 10.4642 333 $ 609.00 464077412 MEGAVOLT/COMPLEX PER DAY/04MEV 10.4642 333 $ 414.00 464077413 RAD TREAT COMPLEX 6-10 MV 10.4642 333 $ 548.00 464077414 MEGAVOLT/COMPLEX PER DAY/ 20ME 10.4642 333 $ 659.00 464077415 RAD TREAT COMPLEX 11-19 MV 10.4642 333 $ 659.00 464077416 MEGAVOLT/COMPLEX PER DAY/20MEV 10.4642 333 $ 593.00 464077417 PORT FILM 10.4642 333 $ 141.00 464077418 DAILY IMRT TREATMENT FRACTION 10.4642 333 $ 2,227.00 464077421 STEREO LOCAL OF TARGET VOLUMES 10.4642 333 $ 289.00 464077470 SPECIAL TREATMENT PROCEDURE 10.4642 333 $ 644.00 464077499 UNLISTED PROC/THER TX MGMT 10.4642 333 $ - 464077750 INFUSION OR INSTILLATION 10.4642 260 $ 440.00 464077761 INTRACAV.RADIOELE.APPL-SIMPLE 10.4642 333 $ 1,369.00 464077762 INTRACAV.RADIOELE.APPL-INTERME 10.4642 333 $ 1,644.00 464077763 INTRACAV.RADIOELE.APPL-COMPLEX 10.4642 333 $ 2,367.00 464077776 INTERSTIT.RADIOELE.APPL-SIMPLE 10.4642 333 $ 2,324.00 464077777 INTERSTIT.RADIOELE.APPL-INTERM 10.4642 333 $ 2,735.00 464077778 INTERSTIT.RADIOELE.APPL-COMPLE 10.4642 333 $ 3,831.00 464077781 HDR SIMPLE 1-4 DWELL POINTS 10.4642 342 $ 2,253.00 464077782 HDR INTERMEDIATE 5-8 DWELL POI 10.4642 342 $ 2,386.00 464077783 HDR COMPLEX 9-12 DWELL POINTS 10.4642 342 $ 2,518.00 464077784 HDR 12+ DWELL POINTS 10.4642 342 $ 3,181.00 464077789 RADIOELE SURFACE APPLICATION 10.4642 333 $ 224.00 464077790 RADIOELE SUPVSN/HAND/LOAD 10.4642 333 $ 884.00 464077799 BRACHYTHERAPY - UNLISTED 10.4642 333 $ - 464079000 HYPERTHYROID - INITIAL 10.4642 333 $ 224.00 464079001 HYPERTHYROID - SUBSEQUENT 10.4642 333 $ 224.00 464079030 THYROID CANCER ABLATION 10.4642 333 $ 440.00 464079900 RADIOACTIVE MATERIAL 10.4642 333 $ - 464079999 RADIONUC THERAPY - UNLISTED 10.4642 333 $ - 464080003 RADIATION THERAPY CONSULT 10.4642 510 $ - 464080100 RADIOELEMENTS/BRACHYTHERAPY EA 10.4642 278 $ 43.00 464080110 BRACHYTHERAPY SEED, IODINE-125 10.4642 278 $ 147.00 464080120 BRACHYTHERAPY SEED, PALLADIUM- 10.4642 278 $ 182.00 464080130 BRACHYTHER SEED, MENTOR PDGOLD 10.4642 278 $ - 464080140 BRACHYTHER SEED, MENTOR IOGOLD 10.4642 278 $ - 464080150 BRACHYTHER SEED, PSA IODINE 10.4642 278 $ 147.00 464080160 BRACHYTHER SEED, PSA PALLADIUM 10.4642 278 $ 182.00 464080200 RADIOELEMENTS I-131 PER MCI 10.4642 636 $ 48.00 464080201 RADIOELEMENTS STRONTIUM89 PER 10.4642 636 $ 2,620.00 464080202 RADIOELEMENTS CESIUM 137 10.4642 333 $ 120.00 464080203 BRACHYTHER I-192 ALPHA OMEGA E 10.4642 279 $ 109.00 464080210 BRACHYTHERAPY SEED I-125 PSA E 10.4642 278 $ 147.00 464080220 BRACHYTHER SD PALLADIUM103 PSA 10.4642 278 $ 182.00 464080230 BRACHYTHER SD MENTOR GOLD I-12 10.4642 278 $ 147.00 464080240 BRACHYTHER SD MNTOR GOLD PD-10 10.4642 278 $ 182.00 464080250 BRACHYTHER SD I-125 AMER EA 10.4642 278 $ 147.00 464080260 BRACHYTHER SD PALLAD 103 OTHER 10.4642 278 $ 182.00 464090784 IV INJECTION 10.4642 510 $ 101.00 464090785 IV INJECTION ADD'L SEQUENTIAL 10.4642 761 $ 101.00 464099212 ESTAB EXPANDED PROBLEM - TC 10.4642 510 $ 88.00 464099213 ESTAB INTERMEDIATE EXAM - TC 10.4642 510 $ 93.00 464099214 ESTAB EXTENDED EXAM - TC 10.4642 510 $ 156.00 464099215 ESTAB HIGH COMPLX EXAM - TC 10.4642 510 $ 236.16 464099242 ESTAB EXPANDED CONSULT - TC 10.4642 510 $ 79.00 464099243 ESTAB INTERMEDIATE CONSULT - T 10.4642 510 $ 101.00 464099244 ESTAB EXTENDED CONSULT - TC 10.4642 510 $ 156.00 464099245 HIGH COMPLEXITY CONSULTATION 10.4642 761 $ 478.00 464200307 INFUSION THERAPY 1ST HOUR 10.4642 260 $ 315.00 464200308 INFUSION HYDRATION 1ST HOUR 10.4642 260 $ 315.00 464200309 INFUSION THERAPY ADD'L HRS 10.4642 260 $ 190.00 464200310 INFUSION HYDRATION ADD'L HOUR 10.4642 260 $ 190.00 464280252 TRIDIUM 192 HDR SOURCE 10.4642 279 $ 350.00 465000001 NM ISOTOPE I-123/99MTC PERTECH 10.4630 636 $ 296.00 465000002 NM ISOTOPE 99MTC PERTECH 10.4630 250 $ 202.00 465000003 NM ISOTOPE I-131/99MTC PERTECH 10.4630 636 $ 589.00 465000004 NM ISOTOPE 201 THALL CHLOR/99 10.4630 636 $ 440.00 465000005 NM ISOTOPE 99MTC DTPA 10.4630 636 $ 231.00 465000006 NM ISOTOPE 99MTC SULFER COLLOI 10.4630 636 $ 329.00 465000007 NM ISOTOPE I-125 RISA 10.4630 250 $ 1,229.00 465000008 NM ISOTOPE I-125 RISA/CR-51 10.4630 250 $ 3,153.00 465000009 NM ISOTOPE CR-51 10.4630 250 $ 1,720.00 465000010 NM ISOTOPE 99MTC CHOLETEC 10.4630 636 $ 329.00 465000011 NM ISOTOPE CO57IF/CO58 DICOPAC 10.4630 636 $ 1,109.00 465000012 NM ISOTOPE CO57IF 10.4630 636 $ 1,229.00 465000013 NM ISOTOPE 99MTC LABEL RBC 10.4630 636 $ 329.00 465000014 NM ISOTOPE 99MTC HDP 10.4630 636 $ 329.00 465000015 NM ISOTOPE 99MTC PYP 10.4630 636 $ 329.00 465000016 NM ISOTOPE 201 THALLOUS CHLORI 10.4630 636 $ 589.00 465000017 NM ISOTOPE 99MTC MAA 10.4630 250 $ 329.00 465000018 NM ISOTOPE 133 XENON GAS 10.4630 636 $ 202.00 465000019 NM ISOTOPE 99MTC MAA/133 XENON 10.4630 250 $ 329.00 465000020 NM ISOTOPE 99MTC HMPAO 10.4630 250 $ 1,967.00 465000021 NM ISOTOPE INDIUM 111 DTPA 10.4630 636 $ 2,455.00 465000023 NM ISOTOPE GALLIUM 67 10.4630 636 $ 589.00 465000024 NM ISOTOPE IN111 LABEL LEUKOCY 10.4630 636 $ 2,581.00 465000025 NM ISOTOPE 99MTC CARDIOLITE 10.4630 636 $ 1,019.00 465000026 NM ISOTOPE I-123 10.4630 636 $ 296.00 465000028 NM ISOTOPE UNLISTED 10.4630 250 $ - 465000029 NM ISOTOPE 99MTC ULTRATAG 10.4630 636 $ 329.00 465000030 NM ISOTOPE 99MTC LABELED LEUKO 10.4630 250 $ 2,581.00 465000031 NM ISOTOPE I-131 MIBG 10.4630 636 $ 5,031.00 465000032 NM ISOTOPE IN 111 ONCOSCINT 10.4630 636 $ 3,656.00 465000033 NM ISOTOPE IN111 OCTREOTIDE 10.4630 636 $ 4,779.00 465000034 NM ISOTOPE 99MTC MYOVIEW 10.4630 636 $ 1,019.00 465000035 NM ISOTOPE ARCITUMOMAB 10.4630 636 $ 3,656.00 465000036 NM RADIOELEMENT I 131 (PER MCI 10.4630 636 $ 171.00 465000037 NM RADIOELEMENT STRONTIOUM 89 10.4630 636 $ 171.00 465000038 NM RADIOELEMENT I-131 CAP 1-5 10.4630 344 $ 171.00 465000039 NM RADIOELEMENT I-131 CAP ADD' 10.4630 344 $ 35.00 465000040 NM ISOTOPE 99MTC ACUTECT 10.4630 255 $ 3,032.00 465000101 NM ISOTOPE I- 123 PER 100UCI 10.4630 636 $ 296.00 465000102 NM ISOTOPE PERTECH 99MTC 10.4630 636 $ 333.00 465000103 NM ISOTOPE I-131 10.4630 636 $ 589.00 465000104 NM ISOTOPE 201THALCHLOR/99 PER 10.4630 636 $ 440.00 465000105 NM ISOTOPE DTPA 99MTC PER MCI 10.4630 636 $ 18.00 465000106 NM ISOTOPE SULFUR COLLOID PER 10.4630 636 $ 101.00 465000107 NM ISOTOPE HSA I-125 10.4630 250 $ 1,229.00 465000108 NM ISOTOPE 125RISA/51 CR 10.4630 250 $ 3,149.00 465000109 NM ISOTOPE CR 51 10.4630 250 $ 1,720.00 465000110 NM ISOTOPE CHOLTEC 99MTC PER M 10.4630 636 $ 92.00 465000111 NM ISOPTOPE DICOPAC PER O.5 MC 10.4630 636 $ 1,109.00 465000112 NM ISOTOPE CO57IF PER 0.5MCI 10.4630 636 $ 1,229.00 465000113 NM ISOTOPE LABEL RBC PER MCI 10.4630 636 $ 21.00 465000114 NM ISOTOPE HDP PER MCI 10.4630 636 $ 29.00 465000115 NM ISOTOPE PYP 99MTC 10.4630 636 $ 329.00 465000116 NM ISOTOPE THALL CHLORIDE PER 10.4630 636 $ 151.00 465000117 NM ISOTOPE MAA 99MTC 10.4630 250 $ 329.00 465000118 NM ISOTOPE XENON PER 10 MCI 10.4630 636 $ 202.00 465000119 NM ISOTOPE MAA/XENON 10.4630 250 $ 329.00 465000120 NM ISOTOPE HMPAO 99MTC 10.4630 250 $ 1,967.00 465000121 NM ISOTOPE INDIUM DTPA PER 0.5 10.4630 636 $ 2,886.00 465000123 NM ISOTOPE GALLIUM 67 PER MCI 10.4630 636 $ 105.00 465000124 NM ISOTOPE IN 111 LEUC PER 0.5 10.4630 636 $ 7,869.00 465000125 NM ISOTOPE CARDIOLITE PER DOSE 10.4630 636 $ 1,019.00 465000126 NM ISOTOPE I-123 PER 100 UCI 10.4630 636 $ 296.00 465000127 NM ISOTOPE 99MTC MAG 3 PER MCI 10.4630 636 $ 236.00 465000129 NM ISOTOPE ULTRATAG PER MCI 10.4630 636 $ 105.00 465000130 NM ISOTOPE 99MTC LABEL LEUCOCY 10.4630 250 $ 2,983.00 465000131 NM ISOTOPE I-131 MIGB PER 0.5 10.4630 636 $ 5,031.00 465000132 NM ISOTOPE ONCOSINCT PER DOSE 10.4630 636 $ 7,869.00 465000133 NM ISOTOPE OCTREOTIDE PER 3MCI 10.4630 636 $ 9,276.00 465000134 NM ISOTOPE 99MTC MYOVIEW PER D 10.4630 636 $ 1,019.00 465000135 NM ARCITUMOMAB PER VIAL 10.4630 636 $ 3,656.00 465000140 NM ISOTOPE ACUTECT 10.4630 636 $ 3,032.00 465022222 MASTER - NUCLEAR MEDICINE 10.4630 340 $ - 465076002 NM COMPUTER ANALYSIS - COMPLEX 10.4630 340 $ 257.00 465076003 NM COMPUTER ANALYSIS - LIMITED 10.4630 340 $ 157.00 465077470 NM RADIOELEMENT SPEC TREAT PRO 10.4630 333 $ 644.00 465077790 NM RADIOELEMENT SUPVSN/HAND/LO 10.4630 333 $ 884.00 465078000 NM THYROID - UPTAKE - SINGLE 10.4630 340 $ 213.00 465078001 NM THYROID - UPTAKE - MULTIPLE 10.4630 340 $ 311.00 465078006 NM THYROID - IMAGING W/ UPTAKE 10.4630 340 $ 746.00 465078010 NM THYROID - IMAGING ONLY 10.4630 340 $ 467.00 465078016 NM METASCAN 10.4630 340 $ 1,207.00 465078018 NM THYROGEN METASCAN 10.4630 340 $ 1,390.00 465078070 NM THYROID - PARATHYROID SCAN 10.4630 340 $ 866.00 465078075 NM ADRENAL IMAGING 10.4630 340 $ 889.00 465078104 NM BONE - MARROW 10.4630 340 $ 746.00 465078110 NM BLOOD VOLUME--PLASMA 10.4630 340 $ 481.00 465078111 NM BLOOD VOLUME--DOUBLE 10.4630 340 $ 1,237.00 465078120 NM BLOOD VOLUME--RBC 10.4630 340 $ 759.00 465078185 NM SPLEEN SCAN 10.4630 340 $ 574.00 465078195 NM LYMPHATIC/LYMPH GLAND IMAGI 10.4630 340 $ 730.00 465078202 NM LIVER IMAG - VASCULAR FLO 10.4630 340 $ 542.00 465078205 NM LIVER IMAG - VASCULAR FLO W 10.4630 340 $ 972.00 465078206 NM-LIVER/SPLEEN WITH SPECT 10.4630 340 $ 1,367.00 465078215 NM LIVER/SPLEEN 10.4630 340 $ 718.00 465078220 NM BILIARY (LIVER FUNCTION) 10.4630 340 $ 704.00 465078221 NM BILIARY WITH EF 10.4630 340 $ 1,050.00 465078270 NM SCHILLING W & W/O IF 10.4630 340 $ 1,161.00 465078271 NM SCHILLING W/ INTRINSIC FACT 10.4630 340 $ 1,564.00 465078280 NM GI BLEED IMAGING 10.4630 340 $ 1,513.00 465078281 NM GI BLEED FOLLOW-UP 10.4630 340 $ 490.00 465078287 NM GI REFLUX STUDY 10.4630 340 $ 568.00 465078291 NM SHUNTOGRAM--LEVEEN/PV 10.4630 340 $ 690.00 465078296 NM SALIVARY GLAND 10.4630 340 $ 710.00 465078297 NM MECKELS SCAN 10.4630 340 $ 624.00 465078299 NM GASTRIC EMPTYING 10.4630 340 $ 1,177.00 465078300 NM BONE SCAN - LIMITED 10.4630 340 $ 784.00 465078307 NM BONE SCAN - WHOLE BODY 10.4630 340 $ 1,367.00 465078310 NM BONE - THREE PHASE STUDY 10.4630 340 $ 1,137.00 465078320 NM BONE - SPECT 10.4630 340 $ 1,367.00 465078407 NM MYOCARD INFARCT SCAN 10.4630 340 $ 976.00 465078408 NM MYOCARD PERF--REST OR STRES 10.4630 340 $ 946.00 465078409 NM MYOCARDIAL PERFUSION SCAN 10.4630 340 $ 1,397.00 465078410 NM MYCARD PERF W/GSPECT 10.4630 340 $ 1,653.00 465078411 NM MYOCARD PERF WITH SPECT 10.4630 340 $ 1,653.00 465078412 NM MYOCARD INFARCT SCAN W/ SPE 10.4630 340 $ 1,228.00 465078413 NM CARD WALL MOTION--1ST PASS 10.4630 340 $ 608.00 465078414 NM MYOCARD REST OR STRESS W/SP 10.4630 340 $ 1,197.00 465078455 NM VENOUS THROMBOSIS STUDY 10.4630 340 $ 935.00 465078478 NM MYOCARD PERFUS W/ WALL MOTI 10.4630 340 $ 257.00 465078480 NM MYCOCARDIAL PERF W/ EF 10.4630 340 $ 257.00 465078494 NM CARD WALL MOTION EXERCISE F 10.4630 340 $ 743.00 465078495 NM VASCULAR FLOW IMAGING 10.4630 340 $ 989.00 465078496 NM CARD WALL MOTION--RESTING 10.4630 340 $ 1,470.00 465078497 NM CARD WALL MOTION EXERCISE 10.4630 340 $ 2,199.00 465078498 NM CARDIAC SHUNT STUDY 10.4630 340 $ 609.00 465078580 NM LUNG--PERFUSION SCAN 10.4630 340 $ 879.00 465078581 NM LUNG--AEROSOL MULTI PROJECT 10.4630 340 $ 879.00 465078582 NM LUNG--VENTILATION 10.4630 340 $ 820.00 465078597 NM LUNG ASPIRATION 10.4630 340 $ 1,185.00 465078598 NM LUNG--VENT & PERF (V/Q SCAN 10.4630 340 $ 1,284.00 465078605 NM BRAIN SCAN 10.4630 340 $ 808.00 465078606 NM BRAIN--CBF AND BRAIN SCAN 10.4630 340 $ 1,097.00 465078607 NM BRAIN SCAN W/ SPECT 10.4630 340 $ 1,367.00 465078610 NM BRAIN--BLOOD FLOW 10.4630 340 $ 734.00 465078630 NM CISTERNOGRAPHY 10.4630 340 $ 1,069.00 465078645 NM SHUNTOGRAM--VENT-PERIT 10.4630 340 $ 513.00 465078650 NM CNS LEAK STUDY 10.4630 340 $ 538.00 465078700 NM RENAL 10.4630 340 $ 596.00 465078701 NM RENAL & RBF SCAN 10.4630 340 $ 704.00 465078707 NM RENOGRAM & RENAL SCAN 10.4630 340 $ 697.00 465078708 NM REN,RENAL,RBF WITH PHARM 10.4630 340 $ 1,380.00 465078709 NM REN,RENAL,RBF W/WO PHARM 10.4630 340 $ 2,758.00 465078710 NM RENAL SCAN WITH SPECT 10.4630 340 $ 954.00 465078715 NM RENAL BLOOD FLOW 10.4630 340 $ 596.00 465078740 NM CYSTO/URETERAL REFLUX 10.4630 340 $ 697.00 465078797 NM REN,RENAL,RBF W/O PHARM 10.4630 340 $ 1,380.00 465078798 NM CYSTOGRAPHY 10.4630 340 $ 513.00 465078800 NM TUMOR IMAGING - LIMITED 10.4630 340 $ 513.00 465078801 NM TUMOR IMAGING - WHOLE BODY 10.4630 340 $ 1,832.00 465078802 NM ABCESS IMAGING - WHOLE BODY 10.4630 340 $ 920.00 465078803 NM TUMOR IMAGING - SPECT 10.4630 340 $ 1,169.00 465078804 MIBG SCAN, I131 10.4630 340 $ 1,832.00 465078805 NM ABCESS IMAGING - LIMITED 10.4630 340 $ 513.00 465078897 NM TESTICULAR PERF STUDY 10.4630 340 $ 633.00 465078999 NM UNLISTTED PROCEDURE 10.4630 340 $ - 465083019 NM CARBON14-UREA BREATH TEST 10.4630 300 $ 435.00 465090784 IV INJECTION 10.4630 510 $ 101.00 465090785 IV INJECTION ADD'L SEQUENTIAL 10.4630 761 $ 101.00 465099211 NM TREATMENT ROOM 10.4630 761 $ 57.00 466011111 MASTER - MRI 10.4660 610 $ - 466030000 MRI GADOLIDIUM CONTRAST 05CC 10.4660 250 $ 215.00 466030001 MRI GADOLIDIUM CONTRAST 10CC 10.4660 250 $ 433.00 466030002 MRI GADOLIDIUM CONTRAST 15CC 10.4660 250 $ 645.00 466030003 MRI GADOLIDIUM CONTRAST 20CC 10.4660 250 $ 860.00 466070336 MRI TMJ 10.4660 610 $ 1,642.00 466070539 MRI ORBIT/FACE/NECK 10.4660 610 $ 2,979.00 466070541 MRI MRA HEAD ONLY (C.O.W.) 10.4660 610 $ 1,434.00 466070542 MRI MRA NECK (CAROTID) 10.4660 610 $ 1,434.00 466070543 MRI BRAIN VENOUS 10.4660 610 $ 1,434.00 466070549 MRI BRAIN W/O CONTRAST 10.4660 611 $ 2,831.00 466070554 MRI BRAIN W/ & W/O CONTRAST 10.4660 611 $ 2,979.00 466071553 MRI CHEST 10.4660 610 $ 2,979.00 466071554 MRI MRA CHEST 10.4660 610 $ 1,434.00 466071557 MRI BREAST 10.4660 610 $ 1,642.00 466072135 MRI SPINE CERVICAL W/O CONTRAS 10.4660 612 $ 2,979.00 466072139 MRI SPINE CERVICAL W/ CONTRAST 10.4660 612 $ 3,128.00 466072141 MRI SPINE METASTATIC SURVEY 10.4660 612 $ 3,842.00 466072146 MRI SPINE THORACIC W/O CONTRAS 10.4660 612 $ 2,979.00 466072151 MRI SPINE THORACIC W/ CONTRAST 10.4660 612 $ 3,128.00 466072153 MRI SPINE LUMBAR W/O CONTRAST 10.4660 612 $ 2,979.00 466072155 MRI THORACIC SPINE W & W/O CON 10.4660 612 $ 3,842.00 466072156 MRI CERV SPINE W & W/O CONTRAS 10.4660 612 $ 3,842.00 466072157 MRI SPINE LUMBAR W/ CONTRAST 10.4660 612 $ 3,128.00 466072158 MRI MRA SPINE 10.4660 612 $ 1,434.00 466072159 MRI LUMBAR SPINE W & W/O CONTR 10.4660 612 $ 3,842.00 466072197 MRI PELVIS 10.4660 610 $ 2,979.00 466072198 MRI MRA PELVIS 10.4660 610 $ 1,434.00 466073219 MRI EXTREMITY UPPER - NON-JOIN 10.4660 610 $ 2,979.00 466073221 MRI EXTREMITY UPPER - ANY JOIN 10.4660 610 $ 1,642.00 466073225 MRI MRA UPPER EXT W/ CONTRAST 10.4660 610 $ 1,434.00 466073226 MRI MRA UPPER EXT W/O CONTRAST 10.4660 610 $ 1,434.00 466073227 MRI MRA UPPER EXT W/WO CONTRAS 10.4660 610 $ 3,799.00 466073719 MRI EXTREMITY LOWER - NON-JOIN 10.4660 610 $ 2,979.00 466073722 MRI EXTREMITY LOWER - ANY JOIN 10.4660 610 $ 1,192.00 466073725 MRI MRI LOWER EXT W/ CONTRAST 10.4660 610 $ 1,434.00 466073726 MRI MRA LOWER EXT W/O CONTRAST 10.4660 610 $ 1,434.00 466073728 MRI MRA LOWER EXT W/WO CONTRAS 10.4660 610 $ 2,408.00 466074180 MRI ABDOMEN 10.4660 610 $ 2,979.00 466074185 MRI MRA ABDOMEN 10.4660 610 $ 1,434.00 466076390 MRI SPECTROSCOPY 10.4660 610 $ 1,434.00 467001999 MINOR SURGERY RADIOLOGY 10.4630 360 $ 558.00 467005500 UZZ COVER,STERILE PROBE 10.4630 272 $ 108.00 467005501 UZZ GEL,STERILE 10.4630 272 $ 16.00 467005502 UZZ,KIT SUPPORT QUICK CLIP 10.4630 272 $ 168.00 467005503 UZZ NEEDLE,ACHIEVE BX 20GX6CM 10.4630 272 $ 435.00 467005504 UZZ NEEDLE,ASAP 15G 10.4630 272 $ 555.00 467005505 UZZ NEEDLE,CORE BX KIT 15G 10.4630 272 $ 880.00 467005506 UZZ NEEDLE,MAX CORE 14GX10CM 10.4630 272 $ 816.00 467005507 UZZ NEEDLE,MONOPTY 18GX10CM 10.4630 272 $ 754.00 467005508 UZZ NEEDLE,MONOPTY 14GX16CM 10.4630 272 $ 754.00 467005510 UZZ TRAY ARTHROGRAM 10.4630 272 $ 159.00 467005520 UZZ TRAY LUMBAR PUNCTURE 10.4630 272 $ 130.00 467005530 UZZ ADAPTER CATH LG 10.4630 272 $ 16.00 467005532 UZZ NEEDLE MAX CORE 14GX10CM 10.4630 272 $ 425.00 467005534 UZZ NEEDLE MAX CORE 18GX10CM 10.4630 272 $ 443.00 467005536 UZZ TRAY ARTHROGRAM 10.4630 272 $ 152.00 467005538 UZZ NEEDLE TEMNO 20GX6CM 10.4630 272 $ 435.00 467005540 UZZ NEEDLE YVEH CENTESIS CATH 10.4630 272 $ 210.00 467005542 UZZ TRAY THORACENTESIS 10.4630 272 $ 380.00 467005543 UZZ TRAY AMNIOCENTESIS 10.4630 272 $ 152.00 467005544 UZZ NEEDLE CHIBA 22GX6CM 10.4630 272 $ 210.00 467005546 UZZ NEEDLE CHIBA 22GX5CM 10.4630 272 $ 210.00 467019100 US BIOPSY BREAST 10.4630 361 $ 828.00 467021550 US BIOPSY NECK / CHEST 10.4630 361 $ 828.00 467032000 US THORACENTESIS PUNCTURE 10.4630 361 $ 745.00 467032405 US BIOPSY LUNG 10.4630 361 $ 828.00 467047000 US BIOPSY LIVER 10.4630 361 $ 828.00 467048100 US BIOPSY PANCREAS 10.4630 361 $ 828.00 467050200 US BIOPSY RENAL 10.4630 361 $ 828.00 467059000 US AMNIOCENTESIS SURGICAL 10.4630 361 $ 675.00 467060001 US BIOPSY THYROID 10.4630 361 $ 828.00 467060100 US BIOPSY THYROID 10.4630 361 $ 828.00 467070000 US PARACENTESIS PUNCTURE 10.4630 361 $ 422.00 467070001 US BREAST NEEDLE WIRE PLACE PR 10.4630 402 $ 1,285.00 467070002 US ART SEGMENTAL PRES, EXT EXE 10.4630 402 $ 1,462.00 467070003 US ART DUPLEX SCAN-LWR EXT BIL 10.4630 402 $ 1,590.00 467070004 US ART DUPLEX SCAN-LWR EXT UNI 10.4630 402 $ 1,590.00 467070005 US EXTREMITY - NONVASCULAR 10.4630 402 $ 794.00 467070010 US PARACENTESIS PUNCTURE 10.4630 361 $ 422.00 467070100 US PARACENTESIS EXTENDED 10.4630 361 $ 422.00 467076506 US NEONATAL BRAIN 10.4630 402 $ 730.00 467076535 US THYROID 10.4630 402 $ 589.00 467076536 US SMALL PART 10.4630 402 $ 589.00 467076604 US CHEST 10.4630 402 $ 574.00 467076645 US BREAST 10.4630 402 $ 508.00 467076700 US ABDOMEN SURVEY - COMPLETE 10.4630 402 $ 1,114.00 467076705 US ABDOMEN SURVEY - LIMITED 10.4630 402 $ 807.00 467076730 US RENAL/BLADDER 10.4630 402 $ 589.00 467076765 US AORTA 10.4630 402 $ 589.00 467076778 US KIDNEY TRANSPLANT - COLOR F 10.4630 402 $ 828.00 467076801 US FETAL <14WKS--SINGLE GESTAT 10.4630 402 $ 759.00 467076802 US FETAL <14WKS-EA ADDL GESTAT 10.4630 402 $ 366.00 467076810 US FETAL AGE - COMPLETE 10.4630 402 $ 759.00 467076811 US FETAL >14WKS-SINGLE GESTATI 10.4630 402 $ 759.00 467076812 US FETAL >14WKS-EA ADDL GESTAT 10.4630 402 $ 759.00 467076815 US FETAL AGE - PLAC LOC/POS ON 10.4630 402 $ 481.00 467076816 FETAL AGE LIMITED 10.4630 402 $ 438.00 467076817 US FETAL AGE--TRANSVAGINAL 10.4630 402 $ 864.00 467076818 US FETAL BIOPHYSICAL PROFILE 10.4630 402 $ 553.00 467076820 DOPPLER- OBSTETRIC 10.4630 402 $ 503.00 467076850 US PELVIC - NON-OBSTETRIC 10.4630 402 $ 522.00 467076870 US TESTICULAR 10.4630 402 $ 355.00 467076872 US PROSTATE 10.4630 402 $ 1,328.00 467076934 US PARACENTESIS 10.4630 402 $ 954.00 467076935 US THORACENTESIS 10.4630 402 $ 954.00 467076936 US PSEUDOANEURYSM 10.4630 921 $ 912.00 467076939 US CYST ASPIRATION 10.4630 402 $ 1,146.00 467076947 US AMNIOCENTESIS 10.4630 402 $ 319.00 467076960 US ULTRASOUND GUIDANCE 10.4630 402 $ 637.00 467076961 LIVER MARKINGS FOR BIOPSY 10.4630 402 $ 637.00 467076965 US INTERSTITIAL GUIDE 10.4630 402 $ 1,241.00 467076986 US BIOPSY BRAIN 10.4630 402 $ 1,859.00 467076991 US PELVIC W/ TRANSVAGINAL 10.4630 402 $ 864.00 467076998 DOPPLER- MISCELLANEOUS 10.4630 402 $ 536.00 467076999 US MISCELLANEOUS OR UNLISTED 10.4630 402 $ - 467088888 MASTER - ULTRASOUND 10.4630 402 $ - 467093870 US CAROTID DUPLEX - BILATERAL 10.4630 921 $ 1,146.00 467093871 US CAROTID DUPLEX - UNILATERAL 10.4630 402 $ 554.00 467093886 US TRANSCRANIAL DOPPLER 10.4630 402 $ 1,490.00 467093910 US ART SEGMENTAL PRESSURE-LWR 10.4630 921 $ 1,146.00 467093922 US ARTERIAL DOPPLER (ABI ONLY) 10.4630 402 $ 919.00 467093930 US ART DUPLEX SCAN-UPR EXT BIL 10.4630 402 $ 1,590.00 467093931 US ART DUPLEX SCAN-UPR EXT UNI 10.4630 402 $ 1,590.00 467093950 US VENOUS DOPPLER--BILATERAL 10.4630 921 $ 919.00 467093951 US VENOUS DOPPLER--UNILATERAL 10.4630 921 $ 514.00 467093965 DOPPLER- PELVIS (VENOUS) 10.4630 921 $ 835.00 467093975 US ABDOMINAL COLOR FLOW 10.4630 402 $ 828.00 468000001 MT TEST CT CHARGES 10.4630 352 $ - 468001999 MINOR SURGERY RADIOLOGY 10.4630 360 $ 507.00 468005000 CZZ CATH,8F WITH TIE 10.4630 272 $ 892.00 468005001 CZZ CATH,APDL 10 WITH TIE 10.4630 272 $ 892.00 468005002 CZZ CATH,APDL 10F 10.4630 272 $ 726.00 468005003 CZZ CATH,APDL 12F WITH TIE 10.4630 272 $ 892.00 468005004 CZZ CATH,APDL 8F 10.4630 272 $ 726.00 468005005 CZZ CATH,APDL GLIDEX 10.3F 10.4630 272 $ 822.00 468005006 CZZ CATH,APDL GLIDEX 8.5F 10.4630 272 $ 778.00 468005007 CZZ CATH, CHEST 1F WITH TIP 10.4630 272 $ 892.00 468005008 CZZ CATH,NEPHROSTOMY 10.2F COO 10.4630 272 $ 768.00 468005009 CZZ CATH,NEPHROSTOMY 10F WITH 10.4630 272 $ 943.00 468005010 CZZ CATH,NEPHROSTOMY COOK 10F 10.4630 272 $ 768.00 468005011 CZZ CATH,VONSONNENBERG CHEST 1 10.4630 272 $ 768.00 468005012 CZZ CATH VONSONNENBERG CHEST 1 10.4630 272 $ 768.00 468005013 CZZ DILATOR, 10F 10.4630 272 $ 92.00 468005014 CZZ DILATOR, 12F 10.4630 272 $ 92.00 468005015 CZZ DILATOR, 14F 10.4630 272 $ 92.00 468005016 CZZ DILATOR,4F 10.4630 272 $ 92.00 468005017 CZZ DILATOR, 5F 10.4630 272 $ 92.00 468005018 CZZ DILATOR,6F 10.4630 272 $ 92.00 468005019 CZZ DILATOR,7F 10.4630 272 $ 92.00 468005020 CZZ DILATOR,8F 10.4630 272 $ 92.00 468005021 CZZ DILATOR,9F 10.4630 272 $ 92.00 468005022 CZZ FLOWSWITCH 10.4630 272 $ 92.00 468005023 CZZ GLIDE WIRE,35 ANGLED 10.4630 272 $ 425.00 468005024 CZZ GLIDE WIRE,35 LT 10.4630 272 $ 433.00 468005025 CZZ GLIDE WIRE,35X145 SUPER ST 10.4630 272 $ 587.00 468005026 CZZ GUIDE WIRE,35 BENTSON 10.4630 272 $ 267.00 468005027 CZZ GUIDE WIRE,35 LT 10.4630 272 $ 177.00 468005028 CZZ GUIDE WIRE,35X1.5J 10.4630 272 $ 193.00 468005029 CZZ GUIDE WIRE,35X145 SUPER ST 10.4630 272 $ 374.00 468005030 CZZ GUIDE WIRE,35X3J 10.4630 272 $ 193.00 468005031 CZZ KIT, PERCUFIX CUFF 10.4630 272 $ 193.00 468005032 CZZ NEEDLE,ASAP 15G 10.4630 272 $ 574.00 468005033 CZZ NEEDLE ASAP 18GX10CM 10.4630 272 $ 574.00 468005034 CZZ NEEDLE,ASAP 18GX15CM 10.4630 272 $ 712.00 468005035 CZZ NEEDLE,ASAP BIOPSY KIT 10.4630 272 $ 210.00 468005036 CZZ NEEDLE,CHIBA COOK 22X5 10.4630 272 $ 210.00 468005037 CZZ NEEDLE,CHIBA COOK 22X10 10.4630 272 $ 210.00 468005038 CZZ NEEDLE,CHIBA COOK 22X15 10.4630 272 $ 210.00 468005039 CZZ NEEDLE,CHIBA COOK 22X20 10.4630 272 $ 210.00 468005040 CZZ NEEDLE,CHIBA HAVEL 18X6 10.4630 272 $ 210.00 468005041 CZZ NEEDLE,CHIBA HAVEL 20X6 10.4630 272 $ 210.00 468005042 CZZ NEEDLE,CHIBA HAVEL 22X6 10.4630 272 $ 210.00 468005045 CZZ NEEDLE, FIELD LEE BX 17X9 10.4630 272 $ 143.00 468005046 CZZ NEEDLE,HAWKINS-AKINS 18X15 10.4630 272 $ 350.00 468005048 CZZ NEEDLE,MAX-CORE 18X10CM 10.4630 272 $ 443.00 468005049 CZZ NEEDLE,MAX-CORE 18X16CM 10.4630 272 $ 443.00 468005050 CZZ NEEDLE,OSTY-CORE 16X12.5 10.4630 272 $ 443.00 468005051 CZZ NEEDLE,OSTY-CORE 16X16 10.4630 272 $ 443.00 468005052 CZZ NEEDLE,SHEATH TROCAR 10.4630 272 $ 354.00 468005058 CZZ NEEDLE-SPINAL 22X8 10.4630 272 $ 132.00 468005059 CZZ NEEDLE,SPINAL 22GX5 10.4630 272 $ 51.00 468005060 CZZ NEEDLE,SPINAL 18GX4 10.4630 272 $ 51.00 468005061 CZZ NEEDLE,TRU GUIDE CO BX 18X 10.4630 272 $ 198.00 468005062 CZZ NEEDLE,TRU GUIDE CO BX 18X 10.4630 272 $ 198.00 468005063 CZZ SET,ACCUSTICK 10.4630 272 $ 869.00 468005064 CZZ SYRINGE CT TRIPAK 200 10.4630 272 $ 128.00 468005065 CZZ TRAY ARTHROGRAM 10.4630 272 $ 176.00 468005066 CZZ TUBE,CTU CONNECTING 10.4630 272 $ 144.00 468005067 CZZ NEEDLE, COAXIAL 19G 10.4630 272 $ 123.00 468005070 CZZ CATH VONSONNENBERG SUMP12F 10.4630 272 $ 768.00 468005072 MD GASTROVIES 120ML 10.4630 255 $ 257.00 468005074 CZZ NEEDLE ACHIEVE BX 20GX6CM 10.4630 272 $ 435.00 468005076 CZZ NEEDLE ASAP 15G 10.4630 272 $ 555.00 468005078 CZZ NEEDLE CORE BX KIT 15G 10.4630 272 $ 880.00 468005080 CZZ NEEDLE COAXIAL 19G 10.4630 272 $ 123.00 468005082 CZZ NEEDLE MAX-CORE 14GX10CM 10.4630 272 $ 425.00 468005084 CZZ NEEDLE MONOPTY 14GX16CM 10.4630 272 $ 754.00 468005086 CZZ NEEDLE MONOPTY 18GX10CM 10.4630 272 $ 754.00 468005088 CZZ NEEDLE SPINAL 20-22G 10.4630 272 $ 51.00 468005092 CZZ NEEDLE PTC SPINAL 22GX6CM 10.4630 272 $ 51.00 468005096 CZZ NEEDLE TRU GUIDE CO BX 18G 10.4630 272 $ 198.00 468005098 OPTIRAY 320 50ML 10.4630 255 $ 433.00 468005100 ACCUSTICK INTRODUCER SYSTEM 10.4630 272 $ 995.00 468005102 SET MICROPUNCTURE 5F COOK 10.4630 272 $ 293.00 468005104 TRAY - ARTHROGRAM 10.4630 272 $ 152.00 468005106 TUBE CTU CONNECTING 10.4630 272 $ 167.00 468019000 CT ASPIRATION LIVER CYST 10.4630 761 $ 1,262.00 468019100 CT BX BREAST 10.4630 361 $ 326.00 468019200 CT BX PELVIC MASS 10.4630 350 $ 502.00 468019210 CT INJ BIOPSY PELVIC MASS 10.4630 761 $ 840.00 468020206 CT BX MUSCLE 10.4630 361 $ 326.00 468020220 CT BX BONE SUPERFICIAL 10.4630 361 $ 326.00 468020225 CT BX BONE DEEP 10.4630 361 $ 326.00 468021550 CT BIOPSY NECK / CHEST 10.4630 361 $ 828.00 468027040 BIOPSY SOFT TIS PELV HIP SUPER 10.4630 361 $ 326.00 468027096 CT INJ SI JOINT 10.4630 361 $ 836.00 468027097 INJ SI JOINT 10.4630 361 $ 836.00 468032400 CT BX PLEURAL 10.4630 361 $ 326.00 468032405 CT BX LUNG 10.4630 361 $ 326.00 468033333 MASTER - CT 10.4630 350 $ - 468038221 CT BONE MARROW NEEDLE BIOPSY 10.4630 361 $ 438.00 468038505 CT BX LYMPH 10.4630 361 $ 326.00 468040001 CT FACE & SIN FULL W/ CONTRAST 10.4630 351 $ 1,811.00 468040002 CT FACE & SIN FULL W&W/O CONTR 10.4630 351 $ 2,085.00 468040011 CT NEEDLE PLACEMENT 10.4630 350 $ 973.00 468040012 CT SELLA ORBIT POS FOS TEMP W& 10.4630 351 $ 2,085.00 468040014 CT SELLA ORBIT POS FOS TEMP W/ 10.4630 351 $ 1,811.00 468040020 CT FACE & SIN FULL W/O CONTRAS 10.4630 351 $ 1,811.00 468040021 CT FACE & SIN LMTD W/O CONTRAS 10.4630 351 $ 772.00 468040023 CT SINUS VIEWPOINT 10.4630 351 $ 516.00 468040024 CT MAXILLO FACIAL 10.4630 351 $ 516.00 468040025 CT RENAL COLIC UNENHANCED 10.4630 352 $ 1,837.00 468040030 CT ABDOMEN AND PELVIS 10.4630 352 $ 3,547.00 468040035 CT AORTA LIMITED 10.4630 352 $ 624.00 468040040 CT ABDOMEN 10.4630 352 $ 3,089.00 468040042 CT ABD (INCL SPEC ORGAN) 10.4630 352 $ 3,547.00 468040051 CT BRAIN LESION LOCALIZATION 10.4630 351 $ 2,085.00 468040052 CT SELLA ORBIT POS FOS TEMP W/ 10.4630 351 $ 1,811.00 468047000 CT BX LIVER 10.4630 361 $ 326.00 468048102 CT BX PANCREAS 10.4630 361 $ 326.00 468049180 CT BX ABDOMINAL OR RETROPERITO 10.4630 361 $ 326.00 468050200 CT BX RENAL 10.4630 361 $ 176.00 468060100 CT BX THYROID 10.4630 361 $ 326.00 468062269 CT BX SPINAL CORD 10.4630 361 $ 326.00 468062281 CT EPIDURAL NERVE BLOCK 10.4630 361 $ 1,663.00 468070001 CT BRAIN W/O - CLINICAL TRIAL 10.4630 351 $ - 468070022 CT BRAIN--VIEWPOINT/VOYAGER 10.4630 351 $ 1,811.00 468070023 CT BRAIN WITH CONTRAST 10.4630 351 $ 1,811.00 468070024 CT BRAIN WITHOUT CONTRAST 10.4630 351 $ 1,811.00 468070025 CT BRAIN WITH & WITHOUT CONTRA 10.4630 351 $ 2,085.00 468070026 CT SPINE LUMBAR W/O CONTRAST 10.4630 352 $ 2,853.00 468070027 CT SPINE LUMBAR POST INJECTION 10.4630 352 $ 2,853.00 468070028 CT LUMBAR--VIEWPOINT/VOYAGER 10.4630 352 $ 2,853.00 468070496 CT CTANGIO HEAD 10.4630 352 $ 2,901.00 468070498 CT CTANGIO NECK 10.4630 352 $ 2,713.00 468070999 CT NECK SCAN W/CONTRAST 10.4630 351 $ 1,898.00 468071199 CT THORAX W/ CONTRAST 10.4630 352 $ 2,361.00 468071200 CT THORAX W/O CONTRAST 10.4630 351 $ 2,361.00 468071275 CT CTANGIO CHEST 10.4630 352 $ 3,176.00 468072125 CT SPINE CERVICAL W/O CONTRAST 10.4630 352 $ 2,853.00 468072126 CT SPINE CERVICAL POST INJECTI 10.4630 352 $ 2,853.00 468072127 CT CERVICAL--VIEWPOINT/VOYAGER 10.4630 352 $ 2,853.00 468072191 CT CTANGIO PELVIS 10.4630 352 $ 3,176.00 468072192 CT PELVIS W/O CONTRAST 10.4630 352 $ 1,414.00 468072994 CT SPINE THORACIC W/O CONTRAST 10.4630 352 $ 2,853.00 468072996 CT SPINE THORACIC POST INJECIO 10.4630 352 $ 2,853.00 468073000 CT RECONSTRUCTION 10.4630 352 $ 469.00 468073200 CT EXTREM-UPPER W/CONTRAST 10.4630 352 $ 1,166.00 468073206 CT CTANGIO EXT UPPER 10.4630 352 $ 2,713.00 468073499 CT EXTREMITIES - UPPER 10.4630 352 $ 1,898.00 468073706 CT CTANGIO EXT LOWER 10.4630 352 $ 2,713.00 468073999 CT EXTREMITIES - LOWER 10.4630 352 $ 1,898.00 468074099 CT ABDOMEN--LIMITED 10.4630 352 $ 2,085.00 468074175 CT CTANGIO ABDOMEN 10.4630 352 $ 3,907.00 468074399 CT ABDOMEN WITH LIMITED PELVIS 10.4630 352 $ 3,341.00 468074499 CT PELVIS 10.4630 352 $ 2,361.00 468074599 CT ABDOMEN AND PELVIS--LIMITED 10.4630 352 $ 3,144.00 468074699 CT ABD (INCL PELVIS & SPEC ORG 10.4630 352 $ 3,998.00 468074799 CT KIDNEY 10.4630 352 $ 2,361.00 468075635 CT CTANGIO ABDOMINAL AORTA 10.4630 352 $ 3,907.00 468076365 CT ASPIRATION 10.4630 350 $ 973.00 468076370 CT DRAINAGE 10.4630 350 $ 973.00 468076376 CT RECONSTRUCTION - LTD 10.4630 350 $ 275.00 468099071 CT OPTIRAY 320 - 30CC 10.4630 636 $ 436.00 468099072 CT OPTRIRAY 320 - 50CC 10.4630 636 $ 477.00 468099073 CT OPTRIRAY 320 - 100CC 10.4630 636 $ 924.00 468099074 CT OPTIRAY 320 - 150CC 10.4630 636 $ 1,397.00 468099080 CT CONRAY 60 - 50CC 10.4630 250 $ 41.00 468099081 CT CONRAY 60 - 100CC 10.4630 250 $ 82.00 468099082 CT CONRAY 60 - 150CC 10.4630 250 $ 120.00 468099991 CT BX LUNG 10.4630 361 $ 326.00 468099992 CT BX LIVER 10.4630 361 $ 326.00 468099993 CT BX RENAL 10.4630 361 $ 176.00 468200100 PET ISOTOPE F18FDG 10.4660 636 $ 657.00 468200102 PET ISOTOPE F18 SODIUM FLOURID 10.4660 250 $ - 468278459 PET CARDIAC VIABILITY-INCON SP 10.4660 404 $ 4,099.00 468278460 PET CARDIAC VIABILITY-REVASCUR 10.4660 404 $ 4,099.00 468278608 PET BRAIN METABOLISM 10.4660 404 $ 4,099.00 468278609 PET BRAIN PERFUSION 10.4660 404 $ 4,099.00 468278810 PET WB PULMONARY NODULE 10.4660 404 $ 4,099.00 468278811 PET WB NON SMALL CELL LUNG 10.4660 404 $ 4,099.00 468278812 PET WB COLORECTAL 10.4660 404 $ 4,099.00 468278813 PET WB LYMPHOMA 10.4660 404 $ 4,099.00 468278814 PET WB MELANOMA 10.4660 404 $ 4,099.00 468278815 PET WB ONCOLOGY 10.4660 404 $ 4,099.00 468278816 PET WB MELANOMA, DIAGNOSIS 10.4660 404 $ 4,099.00 468278817 PET WB MELANOMA, INITIAL STAGI 10.4660 404 $ 4,099.00 468278818 PET WB MELANOMA, RESTAGING 10.4660 404 $ 4,099.00 468278819 PET WB MELANOMA, NONCOVERED NO 10.4660 404 $ 4,099.00 468278820 PET WB LYMPHOMA, DIAGNOSIS 10.4660 404 $ 4,099.00 468278821 PET WB LYMPHOMA, INITIAL STAGI 10.4660 404 $ 4,099.00 468278822 PET WB LYMPHOMA, RESTAGING 10.4660 404 $ 4,099.00 468278823 PET WB HEAD & NECK, DIAGNOSIS 10.4660 404 $ 4,099.00 468278824 PET WB HEAD & NECK, INITIAL ST 10.4660 404 $ 4,099.00 468278825 PET WB HEAD & NECK, RESTAGING 10.4660 404 $ 4,099.00 468278826 PET WB ESOPHAGEAL, DIAGNOSIS 10.4660 404 $ 4,099.00 468278827 PET WB ESOPHAGEAL, INITIAL STA 10.4660 404 $ 4,099.00 468278828 PET WB ESOPHAGEAL, RESTAGING 10.4660 404 $ 4,099.00 468278831 PET WB LUNG NSC, DIAGNOSIS 10.4660 404 $ 4,099.00 468278832 PET WB LUNG NSC, INITIAL STAGI 10.4660 404 $ 4,099.00 468278833 PET WB LUNG NSC, RESTAGING 10.4660 404 $ 4,099.00 468278834 PET WB COLORECTAL, DIAGNOSIS 10.4660 404 $ 4,099.00 468278835 PET WB COLORECTAL, INITIAL STA 10.4660 404 $ 4,099.00 468278836 PET WB COLORECTAL, RESTAGING 10.4660 404 $ 4,099.00 468278842 PET BREAST STAGING/RESTAGING 10.4660 404 $ 4,099.00 468278843 PET BREAST RESPONSE TO TREATME 10.4660 404 $ 4,099.00 471000001 MT PHARMACY CHARGES - TEST 10.4710 250 $ - 471000002 LEVOFLOXACIN 750MG TABLET 10.4710 637 $ - 471000005 PHARMACY 10.4710 250 $ - 471000006 TERAZOSIN 2MG CAPSULE 10.4710 637 $ - 471000008 WARFARIN 3MG TABLET 10.4710 637 $ - 471000009 WARFARIN 6MG TABLET 10.4710 637 $ - 471000010 A&D OINT 60 GM 10.4710 637 $ - 471000011 THEOPHYLLINE 80MG/15ML 10.4710 637 $ - 471000013 HEP-LOCK 100U/ML 10ML MDV 10.4710 636 $ - 471000015 ABCIXIMAB INJ 10MG 10.4710 636 $ - 471000016 POLYGAM S/D 2.5GM 10.4710 636 $ - 471000017 POLYGAM S/D 5GM 10.4710 636 $ - 471000018 POLYGAM S/D 10GM 10.4710 636 $ - 471000019 GAMMAGARD S/D 2.5GM 10.4710 636 $ - 471000020 ABSOLUTE ALCOHOL INJ 1 ML 10.4710 250 $ - 471000021 GAMMAGARD S/D 5GM IVIG 10.4710 636 $ - 471000022 GAMMAGARD S/D 10GM IVIG 10.4710 636 $ - 471000023 GAMMAR-P 2.5GM IVIG 10.4710 636 $ - 471000024 GAMMAR-P 5GM IVIG 10.4710 636 $ - 471000025 ACARBOSE 50MG TAB 10.4710 637 $ - 471000027 VENOGLOBULIN S 10% 5GM IVIG 10.4710 636 $ - 471000028 VENOGLOBULIN S 10% 10GM IVIG 10.4710 636 $ - 471000029 ACCOLATE 20MG TABLET 10.4710 637 $ - 471000030 ACCUCHECK SETUP/USE DRUG KIY 10.4710 250 $ - 471000032 ACCUTANE 10MG CAPSULE 10.4710 637 $ - 471000033 ACCUTANE 20MG CAPSULE 10.4710 637 $ - 471000034 ACETIC ACID OTIC SOLN 15ML 10.4710 637 $ - 471000038 ACCU-CHEK ADVANTAGE STRIPS 350 10.4710 250 $ - 471000040 ACEBUTOLOL 200MG CAP 10.4710 637 $ - 471000043 ALOMIDE 0.1% OPHTH SOLN 10ML 10.4710 637 $ - 471000044 RAMIPRIL 5MG CAPSULE 10.4710 637 $ - 471000045 AMOXICILLIN 125MG/5ML 150ML 10.4710 637 $ - 471000046 AMOXICILLIN 125MG/5ML 100ML 10.4710 637 $ - 471000049 AMOXICILLIN 250MG/5ML 150ML 10.4710 637 $ - 471000051 ANA-KIT 10.4710 250 $ - 471000052 VITAMIN A 25,000U CAPSULE 10.4710 637 $ - 471000056 AUGMENTIN-125 SUSP 150ML 10.4710 637 $ - 471000057 AUGMENTIN-125 SUSP 100ML 10.4710 637 $ - 471000058 AUGMENTIN-200 CHEW TAB 10.4710 637 $ - 471000059 AUGMENTIN-200 SUSP 100ML 10.4710 637 $ - 471000060 ACETAMINOPHEN 120MG SUPP 10.4710 637 $ - 471000061 AUGMENTIN-200 SUSP 50ML 10.4710 637 $ - 471000062 AUGMENTIN-200 SUSP 75ML 10.4710 637 $ - 471000063 AUGMENTIN-250 SUSP 75ML 10.4710 637 $ - 471000064 AUGMENTIN-250 SUSP 150ML 10.4710 637 $ 25.50 471000065 AUGMENTIN-400 SUSP 50ML 10.4710 637 $ - 471000067 AUGMENTIN 400 TAB 10.4710 637 $ - 471000068 AVONEX 30MCG KIT 10.4710 636 $ - 471000070 ACETAMINOPHEN 325MG SUPP 10.4710 637 $ 9.50 471000071 BACTROBAN 2% OINTMENT 30GM 10.4710 637 $ - 471000079 BETAMETHSONE DIPR.05% OINT45GM 10.4710 637 $ - 471000080 ACETAMINOPHEN 325MG TAB 10.4710 637 $ - 471000081 BETAMETHASONE DIPR.05% CR45GM 10.4710 637 $ - 471000082 BETIMOL 0.5% OPHTH SOLN 10ML 10.4710 637 $ - 471000086 CASODEX 50MG TABLET 10.4710 636 $ - 471000090 ACETAMINOPHEN 500MG CAP 10.4710 637 $ - 471000092 CEFZIL 250MG/5ML 50ML 10.4710 637 $ - 471000094 CEPHALEXIN 250MG/5ML 200ML 10.4710 637 $ - 471000095 CETAPHIL CLEANSER 480ML 10.4710 637 $ - 471000098 CHLORPHENIRAMINE SR 12MG TABLE 10.4710 637 $ - 471000099 CLARITIN SYRUP 1MG/ML 10.4710 637 $ - 471000100 ACETAMINOPHEN 650MG SUPP 10.4710 637 $ - 471000105 CLEOCIN 2% VAGINAL CREAM 40GM 10.4710 637 $ - 471000110 ACETAMINOPHEN 80MG CHEW TAB 10.4710 637 $ - 471000111 CLIMARA 0.05 PATCH 10.4710 637 $ - 471000112 CLIMARA 0.1 PATCH 10.4710 637 $ - 471000115 CLOBETASOL 0.05% OINTMENT 30GM 10.4710 637 $ - 471000116 CLOBETASOL 0.05% OINT 45GM 10.4710 637 $ - 471000118 CLOBETASOL 0.05% OINT 15GM 10.4710 637 $ - 471000119 CLOMIPHENE CITRATE 50MG TABLET 10.4710 637 $ - 471000120 ACETAMINOPHEN DRPS 15ML 10.4710 637 $ - 471000121 CLONAZEPAM 2MG TABLET 10.4710 637 $ - 471000123 CLOTRIMAZOLE 1% CREAM 30GM 10.4710 637 $ - 471000125 CORMAX 0.05% SOLN 25ML 10.4710 637 $ - 471000128 CUTIVATE 0.005% OINT 60GM 10.4710 637 $ - 471000129 CUTIVATE 0.05% CREAM 30GM 10.4710 637 $ - 471000135 CYTOTEC 100MCG TABLET 10.4710 637 $ - 471000137 CYTOVENE 250MG CAPSULE 10.4710 637 $ - 471000140 CAPITAL W/CODEINE SUSP. 10.4710 637 $ - 471000142 DDAVP RHINAL 2.5ML / 0.01% 10.4710 637 $ - 471000144 DECONSAL II TABLET 10.4710 637 $ - 471000148 REVIA 50MG TAB 10.4710 637 $ - 471000151 RHINOCORT NSL 50MCG INHALER 10.4710 637 $ - 471000152 DEPAKENE 250MG/5ML SYRUP 10.4710 637 $ - 471000153 DEPAKOTE 125MG EC TABLET 10.4710 250 $ - 471000154 DERMA-SMOOTHE/FS SOLN 0.01% 12 10.4710 637 $ - 471000155 ROWASA RECTAL 500MG SUPP #24 10.4710 637 $ - 471000160 ACETAMINOPHEN/COD 15MG TAB 10.4710 637 $ - 471000162 DESOWEN 0.05% CREAM 60GM 10.4710 637 $ - 471000166 DESOWEN 0.05% LOTION 60ML 10.4710 637 $ - 471000168 DESOWEN 0.05% OINTMENT 60GM 10.4710 637 $ - 471000170 ACETAMINOPHEN/COD 30MG TAB 10.4710 637 $ 12.00 471000173 SLOW-FE 160MG TAB 10.4710 637 $ - 471000174 DEXEDRINE 10MG SPANSULE 10.4710 637 $ - 471000176 DEXEDRINE 15MG SPANSULE 10.4710 637 $ - 471000177 DEXEDRINE 5MG SPANSULE 10.4710 637 $ - 471000178 SOD SULF 10%/SULF 5% LOTION 30 10.4710 637 $ - 471000179 DIZAC 10MG/2ML AMPULE 10.4710 250 $ - 471000180 ACETAMINOPHEN/COD 60MG TAB 10.4710 637 $ - 471000183 DIFLUCAN 150MG TABLET 10.4710 637 $ - 471000184 DIFLUCAN 200MG TABLET 10.4710 637 $ - 471000188 DIOVAN 80MG CAPSULE 10.4710 637 $ - 471000191 DIPROLENE 0.05% OINTMENT 15GM 10.4710 637 $ - 471000192 DIPROLENE AF 0.05% CREAM 45GM 10.4710 637 $ - 471000193 DOVONEX OINTMENT 30GM 10.4710 637 $ - 471000194 DOVONEX OINTMENT 60GM 10.4710 637 $ - 471000195 DOXEPIN ORAL CONC10MG/ML 120ML 10.4710 637 $ - 471000197 DRY EYES 3.5GM OINTMENT 10.4710 637 $ - 471000198 DURA-TAP/PD CR CAPSULE 10.4710 637 $ - 471000199 CELLCEPT 250MG CAPSULE 10.4710 636 $ - 471000200 ACETAZOLAMIDE 250MG TAB 10.4710 637 $ - 471000201 SODIUM FLUORIDE 1.1MG CHEW TAB 10.4710 637 $ - 471000204 DICLOXACILLIN 62.5MG/5ML 100ML 10.4710 637 $ - 471000206 SPECTAZOLE 1% CREAM 15GM 10.4710 637 $ - 471000209 SPECTAZOLE 1% CREAM 85GM 10.4710 637 $ - 471000210 ACETAZOLAMIDE 500MG CAP 10.4710 637 $ - 471000215 SULFACEDT-R LOTION 25GM 10.4710 637 $ - 471000217 EFFEXOR 50MG TABLET 10.4710 637 $ - 471000219 EFUDEX 5% CREAM 25GM 10.4710 637 $ - 471000220 ACETAZOLAMIDE 500MG INJ 10.4710 636 $ - 471000222 ELOCON 0.1% CREAM 45GM 10.4710 637 $ - 471000223 ACETIC ACID HC OS 10ML 10.4710 637 $ 35.50 471000224 EMGEL 2% 27GM 10.4710 637 $ - 471000225 ACETYLCHOLINE OS 2ML 10.4710 250 $ - 471000232 EPIPEN EZ ADULT INJ 10.4710 637 $ - 471000235 ERYCETTE 2% TOWELETTES 60'S 10.4710 637 $ - 471000237 ESTACE VAGINAL CREAM 42GM 10.4710 637 $ - 471000239 ESTRATEST HS TABLET 10.4710 637 $ - 471000240 ACETYLCYSTEINE 20% 30ML 10.4710 637 $ - 471000241 ESTRATEST TABLET 1.25/2.5 10.4710 637 $ - 471000242 FAMVIR 125MG TABLET 10.4710 637 $ - 471000244 FLAREX OPH SUSP 0.1% 5ML 10.4710 637 $ - 471000245 FLOVENT 220MCG 13GM MDI 10.4710 637 $ - 471000247 FLOVENT 110MCG 13GM MDI 10.4710 637 $ - 471000248 FLOVENT 44MCG 13GM MDI 10.4710 637 $ - 471000249 FLUOCINONIDE 0.05% CREAM 30GM 10.4710 637 $ - 471000251 FLUOCINONIDE 0.05% CREAM 60GM 10.4710 637 $ - 471000252 FML FORTE SUSP 10ML 10.4710 637 $ - 471000253 FULVICIN P/G 125MG TABLET 10.4710 637 $ - 471000255 FUROXONE 100MG TABLET 10.4710 637 $ - 471000261 GLIPIZIDE 10MG TABLET 10.4710 637 $ - 471000263 GLUCAGON EMERGENCY KIT 1MG INJ 10.4710 636 $ - 471000271 GUAIFENESIN W/DM 600-30MG TABL 10.4710 637 $ - 471000272 HALDOL DECANOATE 50MG/ML 1ML I 10.4710 250 $ - 471000276 HUMALOG LISPRO 10ML 10.4710 637 $ - 471000277 HYTONE 2.5% LOTION 59ML 10.4710 637 $ - 471000279 IMITREX 50MG TABLET 10.4710 637 $ - 471000282 INDAPAMIDE 1.25MG TABLET 10.4710 637 $ - 471000285 ACTIVATED CHARCOAL W/SORB 50GM 10.4710 250 $ 69.00 471000287 ISOPTO HYOSCINE 0.25% OS 5ML 10.4710 637 $ - 471000288 LAC-HYDRIN 12% LOTION 400ML 10.4710 637 $ - 471000289 LAC-HYDRIN 12% LOTION 225ML 10.4710 250 $ - 471000290 ACTIVATED CHARCOAL 50GM 10.4710 250 $ - 471000292 LAMISIL 1% CREAM 15GM 10.4710 637 $ - 471000293 LAMISIL 1% CREAM 30GM 10.4710 637 $ - 471000294 LAMISIL 250MG TABLET 10.4710 637 $ - 471000295 LESCOL 40MG CAPSULE 10.4710 637 $ - 471000296 LEVAQUIN 500MG TABLET 10.4710 637 $ - 471000297 LEVBID 0.375MG CAPSULE 10.4710 637 $ - 471000299 LIDEX 0.05% GEL 15GM 10.4710 637 $ - 471000300 ACYCLOVIR 200MG CAP 10.4710 637 $ - 471000301 LIDEX 0.05% GEL 30GM 10.4710 637 $ - 471000303 ACYCLOVIR 800MG TAB 10.4710 637 $ - 471000304 OGEN 3MG TAB 10.4710 637 $ - 471000305 ACYCLOVIR 200MG/5ML SUSP 60ML 10.4710 637 $ - 471000306 LIPITOR 10MG TABLET 10.4710 637 $ - 471000309 ETODOLAC 400MG TABLET 10.4710 637 $ - 471000310 ACYCLOVIR 5% OINT 15GM 10.4710 637 $ - 471000311 ORAGRAFIN CAPSULE 10.4710 637 $ - 471000315 ORTHO-EST 0.625 MG TAB 10.4710 637 $ - 471000320 ACYCLOVIR 500MG INJ 10.4710 636 $ - 471000330 ADENOSINE 6MG INJ 10.4710 636 $ 213.00 471000331 ORVAL 21 PILPAK 10.4710 637 $ - 471000332 LUVOX 50MG TABLET 10.4710 637 $ - 471000333 OXYCONTIN 10MG TAB 10.4710 637 $ - 471000334 LUVOX 100MG TABLET 10.4710 637 $ - 471000340 PANCREASE MT 10 CAPS 10.4710 637 $ - 471000341 MACROBID 100MG CAPSULE 10.4710 637 $ - 471000343 PAXIL 10MG TAB 10.4710 637 $ - 471000344 PRENATAL 1+1 VITAMIN TABLET 10.4710 637 $ - 471000345 PAXIL 30MG TAB 10.4710 637 $ - 471000349 PEPCID 40MG TAB 10.4710 637 $ - 471000353 T-STAT PADS 2% WIPE #60 10.4710 637 $ - 471000354 PEPTO-BISMOL CHEW TAB 300MG 10.4710 250 $ - 471000356 MAVIK 2MG TABLET 10.4710 637 $ - 471000358 MAVIK 1MG TABLET 10.4710 637 $ - 471000361 MAXAIR AUTOHALER 14GM 10.4710 637 $ - 471000363 MAXAIR 14ML 10.4710 637 $ - 471000366 TEMOVATE SCALP 0.05% LOTION 25 10.4710 637 $ - 471000370 ALBUMIN 25% 50ML 10.4710 636 $ - 471000371 MENEST 0.625MG 10.4710 637 $ - 471000372 TEMOVATE 0.05% GEL 30GM 10.4710 637 $ - 471000373 MEPHYTON 5MG TABLET 10.4710 637 $ - 471000375 ALBUMIN 5% 12.5GM/250ML 10.4710 636 $ - 471000380 ALBUTEROL 2MG TAB 10.4710 637 $ - 471000383 METROGEL 0.75% 30GM 10.4710 637 $ - 471000385 METROGEL VAGINAL 0.75% 70GM 10.4710 637 $ - 471000390 ALBUTEROL 2MG/5ML 10.4710 637 $ - 471000393 THIOTHIXENE 1MG CAP 10.4710 637 $ - 471000397 THOMSON'S ENEMA 10.4710 250 $ - 471000400 ALBUTEROL 4MG TAB 10.4710 637 $ - 471000401 MYCOSTATIN PASTILLE 200MU 10.4710 637 $ - 471000403 TIAZAC 240MG CAP 10.4710 637 $ - 471000404 NASACORT 55MCG/SYRAY 10GM CAN 10.4710 637 $ - 471000406 TIMOPTIC-XE OPHTH0.5% SOLN 5ML 10.4710 637 $ - 471000408 NASAREL 0.025% NS 25ML 10.4710 637 $ - 471000412 NATALINS RX TABLET 10.4710 250 $ - 471000416 NEPHRO-VITE TABLET 10.4710 637 $ - 471000420 ALBUTEROL INH SOL 0.083% 3ML 10.4710 250 $ 17.50 471000423 TRIAMCINOLONE 0.025% OINT 80GM 10.4710 637 $ - 471000426 NIX CREME RINSE 1% LOTION 60ML 10.4710 637 $ - 471000429 NIZORAL 2% CREAM 30GM 10.4710 637 $ - 471000430 ALBUTEROL ORAL INHALER 17GM 10.4710 637 $ - 471000433 NORFLEX 100MG TABLET 10.4710 637 $ - 471000445 ALENDRONATE 10MG TAB 10.4710 637 $ - 471000446 BUNNELL'S TOPICAL SOLN 1000ML 10.4710 637 $ - 471000450 ALFENTANIL 500MCG INJ 10.4710 250 $ - 471000459 TRIMETHOPRIM 100MG TABLET 10.4710 637 $ - 471000463 ORUVAIL 200MG CAPSULE 10.4710 637 $ - 471000466 PENICILLIN VK 250MG/5ML 200ML 10.4710 637 $ - 471000470 ALLOPURINOL 100MG TAB 10.4710 637 $ - 471000471 PLENDIL 2.5MG TABLET 10.4710 637 $ - 471000475 POLYSPORIN POWDER 10GM 10.4710 637 $ - 471000477 PRED-FORTE 10ML 10.4710 637 $ - 471000478 PRED-FORTE 15ML 10.4710 637 $ - 471000480 ALLOPURINOL 300MG TAB 10.4710 637 $ - 471000484 UC SOLUTION 500ML 10.4710 250 $ - 471000486 ULTRASE MT20 CAPSULE 10.4710 637 $ - 471000487 ULTRAVATE 0.05% CREAM 15GM 10.4710 637 $ - 471000488 ULTRAVATE 0.05% CREAM 50GM 10.4710 637 $ - 471000489 ULTRAVATE 0.05% OINTMENT 50GM 10.4710 637 $ - 471000491 UNIVASC 7.5MG TABLET 10.4710 637 $ - 471000493 VANCENASE POCKETHALER 7GM 10.4710 637 $ - 471000495 ALPROSTADIL 500MCG INJ 10.4710 636 $ - 471000496 VASOCIDIN 5ML 10.4710 637 $ - 471000500 ALPRAZOLAM 0.25MG TAB 10.4710 637 $ - 471000501 VESANOID 10MG CAPSULE 10.4710 637 $ - 471000502 VEXOL 1% SUSP 5ML 10.4710 637 $ - 471000504 VICODIN TUSS SYRUP 1ML 10.4710 637 $ - 471000506 NIFEREX 150 CAPSULE 10.4710 637 $ - 471000508 VITAMIN A 10,000U CAPSULE 10.4710 637 $ - 471000509 VITAMIN E 400IU CAPSULE 10.4710 637 $ - 471000510 ALPRAZOLAM 0.5MG TAB 10.4710 637 $ - 471000511 VITAMIN E CREAM 60GM 10.4710 637 $ - 471000513 DICLOFENAC 100MG TABLET CR 10.4710 637 $ - 471000515 WESTCORT 0.2% CREAM 15GM 10.4710 637 $ - 471000516 VANCOMYCIN 1GM/20ML 10.4710 637 $ - 471000518 XALATAN 0.005% 2.5ML 10.4710 637 $ - 471000519 LIDOCAINE 5% OINT 35GM 10.4710 637 $ - 471000520 ALPRAZOLAM 1MG TAB 10.4710 637 $ - 471000521 ZERIT 40MG CAPSULE 10.4710 637 $ - 471000522 ZERIT 15MG CAPSULE 10.4710 637 $ - 471000523 ZERIT 20MG CAPSULE 10.4710 637 $ - 471000525 AZITHROMYCIN 100MG/5ML 15ML 10.4710 637 $ - 471000530 ALTEPLASE 50MG INJ 10.4710 636 $ - 471000532 ALTEPLASE 100MG INJ 10.4710 636 $ - 471000533 ZOCOR 20MG TABLET 10.4710 637 $ - 471000534 ZOCOR 40MG TABLET 10.4710 637 $ - 471000539 ZYFLO 600MG TABLET 10.4710 637 $ - 471000541 ZYRTEC 1MG/ML SYRUP 1ML 10.4710 637 $ - 471000542 ZYRTEC 10MG TABLET 10.4710 637 $ - 471000543 KIT-NARCAN,ROMAZICON,VECURONIU 10.4710 250 $ - 471000544 PACLITAXEL ANAPHYLACTIC KIT 10.4710 636 $ - 471000547 STERILE WATER FOR INJ 20ML 10.4710 250 $ - 471000548 BACTERIOSTATIC WATER 30ML 10.4710 250 $ - 471000551 HYDROMORPHONE 4MG INJ 10.4710 250 $ - 471000552 IMDUR 30MG TABLET 10.4710 637 $ - 471000553 TUMS 500 TABLET 10.4710 637 $ - 471000554 COUMADIN 4MG TABLET 10.4710 637 $ - 471000555 HYDROGEN PEROXIDE 3% SOLN 240M 10.4710 637 $ 14.50 471000556 VITAMIN K1 INJ 1MG 10.4710 636 $ 55.00 471000557 VITAMIN K1 10MG INJ 10.4710 636 $ - 471000559 HESPAN 500ML 10.4710 250 $ - 471000561 LABELS, NOTE DOSE GREEN FOR C/ 10.4710 250 $ - 471000562 DIP-TET INJECTION 0.5ML 10.4710 636 $ - 471000565 HAEMOPHILUS B VACCINE 0.5ML 10.4710 250 $ - 471000566 M-M-R II VACCINE 10.4710 250 $ 60.00 471000570 ALUM HYDROX CONC 600MG/5ML 10.4710 637 $ - 471000578 D5W 1/4NS W/KCL 10MEQ/L 1000ML 10.4710 260 $ - 471000580 AMANTADINE 50MG/5ML 60ML 10.4710 637 $ - 471000581 MANNITOL 20% 500ML C/S 10.4710 250 $ - 471000583 D5W 250ML C/S 10.4710 250 $ - 471000584 D5W 500ML C/S 10.4710 250 $ - 471000585 NS 500ML C/S 10.4710 250 $ - 471000586 NS 250ML C/S 10.4710 250 $ - 471000587 CALCIUM GLUCONATE 4.65MEQ/10ML 10.4710 636 $ - 471000588 MAGNESIUM SULFATE 8MEQ/2ML 10.4710 250 $ - 471000589 ULTANE INHAL ANESTHETIC 250ML 10.4710 250 $ - 471000590 AMANTADINE LF 100MG CAP 10.4710 637 $ - 471000593 NISOLDIPINE 10MG TAB 10.4710 637 $ - 471000594 FEXOFENADINE 60MG CAPSULE 10.4710 637 $ - 471000597 NICARDIPINE SR 60MG CAPSULE 10.4710 637 $ - 471000598 MINERAL OIL U/D 30ML 10.4710 637 $ - 471000599 JAPANESE B ENCEPHALITIS VACC. 10.4710 250 $ 118.00 471000600 AMIKACIN 1000MG INJ 10.4710 636 $ - 471000601 SAQUINAVIR 200MG CAPSULE 10.4710 637 $ - 471000602 DALTEPARIN 2,500U/SYR 10.4710 636 $ - 471000603 ZOSYN 4.5GM VIAL 10.4710 636 $ - 471000605 PATIENT OWN MEDICATIONS STORED 10.4710 250 $ - 471000607 OXYCONTIN 20MG TAB 10.4710 637 $ - 471000610 AMIKACIN 500MG INJ 10.4710 636 $ - 471000611 CEREBYX 500MG/10ML 10.4710 636 $ - 471000613 FLEET PREP #1 KIT 10.4710 637 $ - 471000619 STOMATITIS SUSPENSION 180ML 10.4710 637 $ - 471000620 AMILORIDE 5MG TAB 10.4710 637 $ - 471000621 SODIUM CHLORIDE 0.9% 1000ML C/ 10.4710 636 $ - 471000622 CODEINE SULFATE 30MG TABLET 10.4710 637 $ - 471000624 MULTIVITAMIN LIQUID 5ML 10.4710 637 $ - 471000625 ALLBEE W/C 10.4710 637 $ - 471000626 COREG 3.125MG TABLET 10.4710 637 $ - 471000627 COREG 6.25MG TAB 10.4710 637 $ - 471000628 CLONIDINE 1MG/10ML INJECTION 10.4710 250 $ - 471000629 DILACOR XR 120MG CAP 10.4710 637 $ - 471000631 CARDIZEM CD 120MG CAP 10.4710 637 $ - 471000632 DOXIL 20MG VIAL 10.4710 636 $ - 471000633 ISORDIL 40MG TABLET 10.4710 637 $ - 471000634 SYNTHROID 0.112MG TABLET 10.4710 637 $ - 471000641 0.45% NACL 1000ML IV SOLUTION 10.4710 250 $ - 471000643 LEVSIN 0.5MG INJECTION 10.4710 250 $ - 471000645 TETRACAINE OPHTH 0.5% SOLN 15M 10.4710 637 $ - 471000646 DONEPEZIL 5MG TABLET 10.4710 637 $ - 471000647 D5W ALCOHOL 5% 1000ML C/S 10.4710 258 $ - 471000648 HEP-LOCK 10U/ML 10ML 10.4710 636 $ - 471000650 AMINOCAPROIC ACID SYR 250MG/1M 10.4710 637 $ - 471000652 PRIMACOR 10MG/10ML INJECTION 10.4710 636 $ - 471000654 YELLOW FEVER VACCINE 10.4710 250 $ 88.50 471000655 IMOVAX RABIES VAC 10.4710 636 $ 314.50 471000656 BOTOX INJECTION 100UNITS 10.4710 636 $ - 471000657 HYCAMTIN 4MG VIAL 10.4710 636 $ - 471000658 MACRODANTIN MCR 50MG CAP CR 10.4710 637 $ - 471000659 NAVELBINE 50MG/5ML INJ 10.4710 636 $ - 471000660 ANINOCAPROIC ACID 500MG TAB 10.4710 637 $ - 471000661 NEUPOGEN 480MCG/1.6ML INJ 10.4710 636 $ - 471000663 OXANDRIN 2.5MG TABLET 10.4710 637 $ - 471000664 CYLERT 75MG TABLET 10.4710 637 $ - 471000666 MITOXANTRONE 20MG/10ML INJ 10.4710 636 $ - 471000669 COREG 25MG TABLET 10.4710 637 $ - 471000670 AMINOCAPROIC ACID 250MG/ML 10M 10.4710 250 $ - 471000671 COMBIVENT MDI 14.7GM 10.4710 637 $ - 471000672 WELLBUTRIN 100MG CR 10.4710 637 $ - 471000673 ALPHAGAN EYE DROPS 5ML 10.4710 637 $ - 471000674 CRIXIVAN 400MG CAPSULE 10.4710 637 $ - 471000675 CRIXIVAN 200MG CAPSULE 10.4710 637 $ - 471000676 RETROVIR 300MG TABLET 10.4710 637 $ - 471000677 VIDEX 100MG TABLET CHEW 10.4710 637 $ - 471000678 VIDEX 25MG TABLET CHEW 10.4710 637 $ - 471000680 AMINOGLUTETHIMIDE 250MG TAB 10.4710 637 $ - 471000681 LIORSESAL 50MCG AMP INTRATHEC 10.4710 636 $ - 471000682 HEPATIT B IMMUN GLOB 20MCG/ML 10.4710 636 $ - 471000683 ATROVENT NASAL 0.03% 30ML 10.4710 637 $ - 471000684 TYPHOID VACCINE 25MCG/0.5ML 10.4710 250 $ 56.00 471000685 LIPOSOME 5MG/ML 20ML 10.4710 636 $ - 471000686 MULTIVITAMIN TABLET 10.4710 637 $ - 471000687 WELLBUTRIN 150MG TAB CR 10.4710 637 $ - 471000688 LOXITANE 25MG CAPSULE 10.4710 637 $ - 471000689 MICONAZOLE 2% POWDER 30GM 10.4710 637 $ - 471000691 LOVENOX 40MG SYRINGE 10.4710 636 $ - 471000694 LEVAQUIN 500MG VIAL 10.4710 636 $ - 471000695 ZINECARD 250MG INJ 10.4710 636 $ - 471000698 ACETYLCYSTEINE 20% 10ML 10.4710 637 $ - 471000699 ACETYLCYSTEINE 10% 10ML 10.4710 250 $ 55.50 471000702 FLOLAN INJ 10.4710 250 $ - 471000703 ASCORB ACID INJ 500MG/2ML 30ML 10.4710 250 $ - 471000705 GLIMEPIRIDE 1MG TABLET 10.4710 637 $ - 471000706 FLOLAN 500MCG VIAL 10.4710 636 $ - 471000707 STERILE DILUENT / FLOLAN 50ML 10.4710 250 $ - 471000708 NORMOSOL R 1000ML C/S 10.4710 250 $ - 471000709 NORMOSOL-R 1000ML 10.4710 250 $ - 471000710 AMINOPHYLLINE 500MG INJ 20ML 10.4710 636 $ - 471000713 MELATONIN 3MG TABLET 10.4710 637 $ - 471000714 SODIUM BICARBONATE 325MG TABLE 10.4710 637 $ - 471000715 NEVIRAPINE 200MG TABLET 10.4710 637 $ - 471000716 NELFINAVIR 250MG TABLET 10.4710 637 $ - 471000717 ZIDOVUDINE-LAMIVUD 300/150 TAB 10.4710 637 $ - 471000719 PROLASTIN 1000MG VIAL 40 ML 10.4710 636 $ - 471000721 TED HOSE KNEE HIGH XLGE/REG 10.4710 250 $ - 471000722 OXYCODONE 5MG TAB 10.4710 637 $ - 471000723 DEPACON 500MG INJ 5ML 10.4710 250 $ - 471000725 BACTROBAN NASAL OINT 1GM 10.4710 637 $ - 471000727 REGULAR BATH GRANULES 10.4710 637 $ - 471000730 AMIODARONE 200MG TAB 10.4710 637 $ - 471000731 AMIODARONE 150MG INJ / 3ML 10.4710 636 $ - 471000734 OXACILLIN 1GM INJECTION 10.4710 636 $ - 471000735 HYDROCHLORIC ACID SOLUTION 10.4710 250 $ - 471000736 GLYCERIN INFANT SUPP 10.4710 637 $ - 471000737 FLUOROURACIL INJ(SYR)500MG 10.4710 636 $ - 471000738 VINCRISTINE INJECTION 1MG/ML 10.4710 636 $ - 471000739 VINBLASTINE INJECTION 1MG/ML 10.4710 636 $ - 471000740 AMITRIPTYLINE 100MG INJ 10ML 10.4710 636 $ - 471000741 ACYCLOVIR 5% OINTMENT 3GM 10.4710 637 $ - 471000743 ALCOHOL PRODUCTS ELIXER 10.4710 637 $ - 471000745 NEOSPORIN OPHTH SOLN 10ML 10.4710 637 $ - 471000746 PCA MORPHINE 10MG/ML CARTRIDGE 10.4710 636 $ - 471000747 SINGULAIR 10MG TABLET 10.4710 637 $ - 471000748 PLAVIX 75MG TABLET 10.4710 637 $ - 471000749 KCL FRUIT PACKET 10.4710 637 $ - 471000751 STREPTOZOCIN 1GM INJ 10.4710 636 $ - 471000752 RITUXAN 100MG INJ / 10ML 10.4710 636 $ 1,363.18 471000754 CYTARABINE SYR 100MG/2ML 5ML 10.4710 636 $ - 471000756 GEMZAR 200MG INJECTION 10.4710 636 $ - 471000759 DEPO-MEDROL 40MG INJ / 1ML 10.4710 636 $ - 471000760 AMITRIPTYLINE 10MG TAB 10.4710 637 $ - 471000761 FLOMAX 0.4MG CAP CR 24HR 10.4710 637 $ - 471000762 AVAPRO 150MG TABLET 10.4710 637 $ - 471000764 VITAMIN D 400IU TABLET 10.4710 637 $ - 471000765 BUSPAR 15MG TABLET 10.4710 637 $ - 471000766 CIPRO 500MG #4 PACKAGE 10.4710 637 $ - 471000767 VALACYCLOVIR 500MG TABLET 10.4710 637 $ - 471000769 TIROFIBAN 12.5GM/50ML 10.4710 636 $ - 471000770 AMITRIPTYLINE 25MG TAB 10.4710 637 $ - 471000771 FORTOVASE 200MG CAPSULES LF 10.4710 637 $ - 471000772 SALAGEN 5MG TAB 10.4710 637 $ - 471000773 EFFEXOR XR 37.5MG CAPSULE CR 10.4710 637 $ - 471000774 ZYPREXA 5MG TABLET 10.4710 637 $ - 471000776 ZOMIG 2.5MG TABLET 10.4710 637 $ - 471000778 PREMPRO 0.625-5MG TABLET 10.4710 637 $ - 471000780 AMITRIPTYLINE 50MG TAB 10.4710 637 $ - 471000785 NEUMEGA 5MG INJ 10.4710 636 $ - 471000786 TROVAN 100MG TAB 10.4710 637 $ - 471000787 TROVAN 200MG TAB 10.4710 637 $ - 471000792 VASOTEC 20MG TABLET 10.4710 637 $ - 471000794 PARNATE 10MG TABLET 10.4710 637 $ - 471000795 AMLODIPINE 5MG TAB 10.4710 637 $ - 471000797 TAKE HOME PRESCRIPTION 10.4710 253 $ - 471000799 LOVENOX 60MG/0.6ML 0.6ML 10.4710 636 $ - 471000800 AMMONIA INH 10.4710 250 $ - 471000801 LOVENOX 80MG/0.8ML 0.8ML 10.4710 636 $ - 471000802 LOVENOX 100MG/ML / 1ML 10.4710 636 $ - 471000803 RETROVIR INJECTION 200MG/20ML 10.4710 250 $ - 471000805 PHENYLEPHRINE 10MG/ML 5ML INJ 10.4710 636 $ - 471000807 PULMICORT TURBOHALER POWDER 10.4710 637 $ - 471000809 LORTAB 2.5MG TABLET 10.4710 250 $ - 471000810 ACETIC ACID IRRIGATION 10.4710 250 $ - 471000816 ASENDIN 100MG TABLET 10.4710 637 $ - 471000817 ASENDIN 25MG TABLET 10.4710 637 $ - 471000818 IOPIDINE 0.5% OPHTH SOLN 5ML 10.4710 637 $ - 471000819 RIDAURA 3MG CAPSULE 10.4710 637 $ - 471000830 AMOSAN ORAL RINSE POWDER 10.4710 637 $ - 471000833 DEXTROSE 5% 25ML 10.4710 250 $ - 471000837 LOPROX 1% CREAM 15GM 10.4710 637 $ - 471000845 NALFON 200MG CAPSULE 10.4710 637 $ - 471000846 FLUPHENAZINE 10MG TABLET 10.4710 637 $ - 471000847 FLUPHENAZINE 5MG TABLET 10.4710 637 $ - 471000848 LUVOX 25MG TABLETS 10.4710 637 $ - 471000849 GENTIAN VIOLET 1% SOLN 30ML 10.4710 637 $ - 471000850 AMOXICILLIN 250MG CAP 10.4710 637 $ - 471000853 GRISEFULVIN 125MG/5ML SUS 120M 10.4710 637 $ - 471000858 HYDROGEN PEROXIDE 3% SOLN 120M 10.4710 250 $ - 471000863 LYSINE 500MG TAB 10.4710 637 $ - 471000864 LACTULOSE 20GM/30ML U/D 10.4710 637 $ - 471000865 MANNITOL 20% 250ML BAG 10.4710 250 $ - 471000867 LUDIOMIL 75MG TABLET 10.4710 637 $ - 471000868 MECLOMEN 50MG CAPSULE 10.4710 637 $ - 471000869 MECLOMEN 100MG CAPSULE 10.4710 637 $ - 471000872 SERENTIL 10MG TABLET 10.4710 637 $ - 471000876 LOTRIMIN AF 2% SPRAY 113GM 10.4710 637 $ - 471000877 MONISTAT -3 COMBO PACK 10.4710 637 $ - 471000878 MUMPSVAX SDV 10.4710 250 $ - 471000881 MOBAN 10MG TABLET 10.4710 637 $ - 471000882 MOBAN 25MG TABLET 10.4710 637 $ - 471000885 AUGMENTIN CHEW 10.4710 637 $ - 471000889 ZYPREXA 2.5MG TABLET 10.4710 637 $ - 471000890 AMOXICIL/CLAV 250MG CHEW 10.4710 637 $ - 471000895 TRILAFON 8MG TABLET 10.4710 637 $ - 471000896 PRAMOSONE 2.5% LOTION 120ML 10.4710 637 $ - 471000898 DORAL 15MG TABLET 10.4710 637 $ - 471000899 SEBULEX SHAMPOO 210ML 10.4710 637 $ - 471000900 AMOXICIL/CLAV 125MG/5ML 75ML 10.4710 637 $ - 471000903 TESTOSTERONE 100MG/ML 10ML INJ 10.4710 250 $ - 471000904 X-PREP KIT 75ML 10.4710 637 $ - 471000906 VITAMIN E OIL 60ML 10.4710 637 $ - 471000908 UREA 20% CREAM 90GM 10.4710 637 $ - 471000914 TRIAMCINOLONE 0.1% LOTION 60ML 10.4710 637 $ - 471000916 TRIFLUOPERAZINE 10MG TABLET 10.4710 637 $ - 471000918 TRIFLUOPERAZINE 2MG TABLET 10.4710 637 $ - 471000920 AMOXICIL/CLAV 250MG/5ML 100ML 10.4710 637 $ - 471000921 ACCUZYME OINTMENT 30GM 10.4710 637 $ - 471000925 ALUM AMMONIUM PWDR 120GM 10.4710 250 $ - 471000930 AMOXICIL/CLAV 500MG TAB 10.4710 637 $ - 471000932 AVEENO ANTI-ITCH CREAM 30GM 10.4710 637 $ - 471000933 BELLERGAL-S TABLET 10.4710 637 $ - 471000934 BENZOIN TINCTURE 60ML 10.4710 250 $ - 471000935 AMOXICIL/CLAV 875MG TAB 10.4710 637 $ - 471000936 PERTUSSIN 15MG/5ML 120ML 10.4710 637 $ - 471000937 BETADINE VAGINAL GEL 90GM 10.4710 637 $ - 471000938 BETADINE SPRAY 90ML 10.4710 637 $ - 471000940 AMPHOTERICIN B 50MG INJ 10.4710 636 $ - 471000945 AMPHOTERICIN B 0.1MG/ML 240ML 10.4710 637 $ - 471000946 CEENU 100MG CAPSULE 10.4710 637 $ - 471000950 AMPICILLIN 125MG INJ 10.4710 636 $ - 471000952 CLOZARIL 25MG TABLET 10.4710 637 $ - 471000953 CLOZARIL 100MG TABLET 10.4710 637 $ - 471000955 COGNEX 10MG CAPSULE 10.4710 637 $ - 471000956 COLLODION FLEXIBLE LIQ 120ML 10.4710 637 $ - 471000965 CYCLOGYL OPHTH 0.5% SOLN 15ML 10.4710 250 $ - 471000967 CYCLOGYL OPHTH 1% SOLN 5ML 10.4710 250 $ - 471000968 CYCLOGYL OPHTH 2% SOLN 2ML 10.4710 250 $ - 471000970 AMPICILLIN 1GM INJ 10.4710 636 $ - 471000980 DIPRIVAN 500MG/50ML VIAL 10.4710 250 $ - 471000981 DIPRIVAN 1000MG/100ML 100ML 10.4710 250 $ - 471000982 CYLERT 18.75MG TABLET 10.4710 637 $ - 471000983 CYLERT 37.5MG TABLET 10.4710 637 $ - 471000984 EYE STREAM OPTN 30ML 10.4710 637 $ - 471000985 DARVON-N 100MG TABLET 10.4710 637 $ - 471000988 ACETIC ACID/ALUM ACETATE 60ML 10.4710 637 $ - 471000990 AMPICILLIN 250MG CAP 10.4710 637 $ - 471000994 ERGOTRATE 0.2MG/ML 1ML AMP 10.4710 250 $ - 471000995 ESTINYL 0.02MG TABLET 10.4710 637 $ - 471000996 EVISTA 60MG TABLET 10.4710 637 $ - 471001000 AMPICILLIN 250MG INJ 10.4710 636 $ - 471001005 FLUOTHANE 100% 125ML 10.4710 250 $ - 471001008 LMD W DEXTROSE 500ML 10.4710 250 $ - 471001010 AMPICIL SUSP 250MG/5ML 100ML 10.4710 637 $ - 471001011 GLYCINE 1.5% IRRIGATION 1500ML 10.4710 250 $ - 471001012 GLYTUSS 200MG TABLET 10.4710 637 $ - 471001013 GRANULEX SPRAY 120ML 10.4710 637 $ - 471001014 HALOTESTIN 2MG TABLET 10.4710 637 $ - 471001015 HALOTESTIN 5MG TABLET 10.4710 637 $ - 471001018 HUMATE-P 500U INJECTION 10.4710 636 $ - 471001020 AMPICILLIN 2GM INJ 10.4710 636 $ - 471001025 INFLAMASE MILD OPHTH SUSP 5ML 10.4710 637 $ - 471001027 HUMULIN 50-50 INSUL 100U/10ML 10.4710 637 $ - 471001028 ISOPTO CETAMIDE 15% 5ML 10.4710 637 $ - 471001029 ISOPTO FRIN 0.12% 15ML 10.4710 637 $ - 471001030 ISOPTO PLAIN 15ML 10.4710 637 $ - 471001033 KARAYA GUM 120GM POWDER 10.4710 250 $ - 471001034 LAMICTAL 25MG TABLET 10.4710 637 $ - 471001035 AMPICILLIN 500MG INJ 10.4710 636 $ - 471001040 AMPICILLIN 500MG CAP 10.4710 637 $ - 471001044 LOXITANE 5MG CAPSULE 10.4710 637 $ - 471001052 METIMYD 3.5GM OPHTH OINT 10.4710 637 $ - 471001060 AMPICILLIN/SULB 1.5GM INJ 10.4710 636 $ - 471001061 MONSEL'S SOLUTION 500ML 10.4710 637 $ - 471001064 MYDFRIN 2.5% OPHTH SOLN 5ML 10.4710 250 $ - 471001067 EFFEXOR XR 75MG TAB 10.4710 637 $ - 471001070 AMPICILLIN/SULB 3GM INJ 10.4710 636 $ - 471001073 PHISODERM SOLN REG 480ML 10.4710 637 $ - 471001076 PHOSPHOLINE IODIDE 0.125% 5ML 10.4710 637 $ - 471001077 PHOSPHOLINE IODIDE 0.25% 5ML 10.4710 637 $ - 471001080 AMRINONE 100MG INJ / 20ML 10.4710 250 $ - 471001083 POLY-PRED LIQUIFILM 5ML SUSP 10.4710 637 $ - 471001086 NORFLEX 60MG/2ML INJECTION 2ML 10.4710 250 $ - 471001090 AMYL NITRATE INH 0.3ML 10.4710 250 $ - 471001095 ANALGESIC OTIC SOLN 10ML 10.4710 637 $ 12.00 471001097 OPTICROM OPHTH 4% 10ML 10.4710 637 $ - 471001100 ANTIVENIN CROTALIDEA INJ 10.4710 250 $ - 471001104 P6E1 OPHTH SOLN 15ML 10.4710 637 $ - 471001110 ANTIVENIN SPIDER BITE 2.4MU 10.4710 250 $ - 471001111 NASONEX NASAL SPRAY 17GM 10.4710 637 $ - 471001114 NATACYN 5% OPHTH SUSP 15ML 10.4710 637 $ - 471001115 NEPTAZANE 25MG TABLET 10.4710 637 $ - 471001117 NIMBEX 10MG/5ML INJECTION 5ML 10.4710 250 $ - 471001119 REMERON 15MG TABLET 10.4710 637 $ - 471001120 ANUSOL HC-1% CRM 30GM 10.4710 637 $ - 471001122 REVEX 100MCG INJECTION / 1ML 10.4710 250 $ - 471001123 REVEX 2MG/2ML INJECTION / 2ML 10.4710 250 $ - 471001125 ANUSOL HC-2.5% CRM 20 TO 30GM 10.4710 637 $ - 471001128 ROBITUSSIN-PE SYRUP 120ML 10.4710 637 $ - 471001130 ANUSOL HC SUPP 10.4710 637 $ - 471001132 PROVISC 10MG/ML 0.85ML INJECTI 10.4710 636 $ - 471001133 PRAMOSONE 2.5% CREAM 30GM 10.4710 637 $ - 471001134 PRIMAQUINE 26.3MG TABLET 10.4710 637 $ - 471001140 MICROFIBULAR COLAGEN 1GM DRSG 10.4710 250 $ - 471001144 VASOCON-A 15ML 10.4710 637 $ - 471001145 VIDEX 50MG CHEWABLE 10.4710 637 $ - 471001146 VITAMIN E 1000U CAP ALPHA LF 10.4710 637 $ - 471001149 ZANAFLEX 4MG TABLET 10.4710 637 $ - 471001150 ANUSOL SUPP 10.4710 637 $ - 471001151 ZARONTIN 250MG CAP 10.4710 637 $ - 471001152 APROTININ 1MMU/100ML 100ML 10.4710 636 $ - 471001153 APROTININ 2MMU/200ML 200ML 10.4710 636 $ - 471001155 STELAZINE 20MG/10ML INJECTION 10.4710 250 $ - 471001161 SEBUTONE SHAMPOO 120ML 10.4710 637 $ - 471001162 SEROQUEL 25MG TABLET 10.4710 637 $ - 471001165 SURGILUBE JELLY 120GM 10.4710 637 $ - 471001166 SURMONTIL 25MG CAPSULE 10.4710 637 $ - 471001167 SURMONTIL 50MG CAPSULE 10.4710 637 $ - 471001169 LORAZEPAM 2MG/ML ORAL LIQUID 10.4710 637 $ - 471001170 ARTIFICIAL TEARS 15ML 10.4710 637 $ - 471001172 LIDOCAINE 1% IN CAPSAICIN 60GM 10.4710 637 $ - 471001174 INTRON A 1MMU/0.1ML 2.5ML 10.4710 636 $ - 471001175 AKINETON 2MG TABLET 10.4710 637 $ - 471001177 GLUCOSE BY FINGERSTICK (UNIT) 10.4710 250 $ - 471001178 ZOLOFT 25MG TABLET 10.4710 637 $ - 471001180 ASCORBID ACID 250MG TAB 10.4710 637 $ - 471001182 TRASTUZMAB 440MG INJ / 20ML 10.4710 636 $ - 471001183 VITAMIN B-12 1MG TAB 10.4710 250 $ - 471001184 CELEXA 20MG TABLET 10.4710 637 $ - 471001185 REQUIP 0.5MG TABLETS 10.4710 637 $ - 471001188 NITROSTAT 0.4MG TAB SUBLINGUAL 10.4710 637 $ - 471001189 CONTIGEN IMPLANT KIT 10.4710 278 $ - 471001191 ABSOLUTE ALCOHOL 5ML INJ 10.4710 250 $ - 471001192 DETROL 1MG TAB 10.4710 637 $ - 471001193 DETROL 2MG TAB 10.4710 637 $ - 471001194 TEGRETOL XR 400MG TAB CROSM 10.4710 637 $ - 471001198 VICOPROFEN 5-200MG TABLET 10.4710 637 $ 23.00 471001199 IMMUNE GLOBULIN I.V. 1GM 10.4710 636 $ - 471001200 ASCRIPTIN TAB 325MG 10.4710 637 $ - 471001202 ASPARAGINASE 10,000IU INJ 10.4710 636 $ - 471001204 REMICADE 100MG AMPOULE / 10ML 10.4710 636 $ - 471001205 ASPERCREME 37.5GM 10.4710 637 $ - 471001206 VOLTAREN OPHTH 0.1% 5ML 10.4710 637 $ - 471001207 DIPRIVAN 10MG/ML SYRINGE 50ML 10.4710 250 $ - 471001208 MEDTRONIC PUMP INFO N/CHG 10.4710 250 $ - 471001210 ASPIRIN 300MG SUPP 10.4710 637 $ - 471001211 AMARYL 2MG TABLET 10.4710 637 $ - 471001215 ZITHROMAX I.V. 500MG INJ 10.4710 636 $ - 471001216 MERREM 1GM INJECTION 10.4710 250 $ - 471001217 BSS PLUS 500ML OPTH IRRIG 10.4710 637 $ - 471001219 MUSTARGEN 10MG VIAL 10.4710 636 $ - 471001220 ASPIRIN 325MG TAB 10.4710 637 $ - 471001221 CAMPTOSAR 100MG INJ / 5ML INJ 10.4710 636 $ - 471001222 FLOXURIDINE 500MG INJ 10.4710 636 $ - 471001224 CYANOCOBALAMIN 1000MCG INJ 1ML 10.4710 636 $ 34.50 471001225 HEALON 10MG/ML 0.85ML 10.4710 250 $ - 471001226 HEALON-GV 1.4% 0.85ML 10.4710 250 $ - 471001228 SPORANOX 10MG/ML 150ML 10.4710 637 $ - 471001229 PRANDIN 1MG TABLET 10.4710 637 $ - 471001230 ASPIRIN 600MG SUPP 10.4710 637 $ - 471001231 PRANDIN 2MG TABLET 10.4710 637 $ - 471001234 LORTAB LIQUID 15ML U/D 10.4710 637 $ - 471001236 TYLENOL ELIXIR W/COD 15ML 10.4710 637 $ 12.00 471001237 VALIUM 10MG/2ML SYRINGE 10.4710 636 $ 45.00 471001239 XYLOCAINE 2% JELLY 5ML 10.4710 637 $ 59.00 471001243 FENTANYL 100MCG/2ML STERILE PA 10.4710 636 $ - 471001246 SENSORCAINE 0.5% MPF 30ML 10.4710 250 $ 69.50 471001248 TORADOL 30MG/ML 1ML VIAL 10.4710 636 $ - 471001250 ASPIRIN 81MG TAB 10.4710 637 $ - 471001251 ASPIRIN 81MG EC TAB 10.4710 637 $ - 471001252 CAPITAL W/CODEINE SUSP 5ML 10.4710 637 $ - 471001255 CORTISPORIN OTIC SUSP 1ML 10.4710 637 $ 39.50 471001258 NEOSPORIN OPHTH SUSP 10ML 10.4710 637 $ - 471001262 CORTISPORIN OTIC SOLN 10ML 10.4710 637 $ - 471001263 REFLUDAN 50MG VIAL 10.4710 636 $ - 471001264 ANTICOAGUL SOD CITRATE 4% 30ML 10.4710 250 $ - 471001265 ARIMIDEX 1MG TABLET 10.4710 636 $ - 471001270 ASPIRIN EC 325MG TAB 10.4710 637 $ - 471001271 MOTRIN SUSP 20MG/ML 1ML 10.4710 637 $ - 471001272 TRANDATE 5MG/ML INJECTION 10.4710 636 $ 45.00 471001273 NORCURON 20MG VIAL 10.4710 250 $ - 471001275 CALC DISOD VERSENAT 1000MG/5ML 10.4710 636 $ - 471001276 SYNTHROID 75MCG TABLET 10.4710 637 $ - 471001281 EMLA ANESTHETIC DISC PATCH 10.4710 637 $ - 471001283 LIDOCAINE 1% 20ML VIAL 10.4710 250 $ - 471001284 NORCO 10MG TABLET 10.4710 637 $ - 471001287 CELEBREX 100MG CAPSULE 10.4710 637 $ - 471001288 CELEBREX 200MG CAPSULE 10.4710 637 $ - 471001289 SEROQUEL 100MG TABLET 10.4710 637 $ - 471001290 ASPIRIN/COD 30MG TAB 10.4710 637 $ - 471001294 GUAIFEN W/COD UD 5ML 10.4710 637 $ - 471001295 LIDOCAINE 1% W/EPI 20ML 10.4710 250 $ - 471001296 TUMS CHEWABLE 200MG TAB 10.4710 637 $ - 471001297 METHADONE 1MG/ML ORAL LIQ 10.4710 637 $ - 471001298 HEPARIN 1,000U/1ML VIAL 30ML 10.4710 636 $ - 471001299 EPOGEN 20,000U/ML 1ML VIAL 10.4710 636 $ - 471001300 ASPIRIN/COD #4 60MG TAB 10.4710 637 $ - 471001301 NEMBUTAL SODIUM 50MG/ML 50ML V 10.4710 250 $ - 471001305 ALTEPLASE 50MG/50ML 10.4710 250 $ - 471001307 FIORICET W/CODEINE 30MG CAP 10.4710 637 $ - 471001308 RESTORIL 7.5MG CAPSULE 10.4710 637 $ - 471001309 OXY CONTIN 80MG TABLETCR 12HR 10.4710 637 $ - 471001314 LITHIUM CARBONATE 150MG CAP 10.4710 637 $ - 471001315 ATENOLOL 5MG INJ / 10ML 10.4710 250 $ - 471001316 SELF MEDICATION COMPLIANCE CHE 10.4710 637 $ - 471001317 HEPATITIS B VACCINE PEDIATRIC 10.4710 636 $ 50.50 471001318 MARINOL 2.5MG CAP 10.4710 636 $ - 471001319 AVANDIA 2MG TABLET 10.4710 637 $ - 471001320 ATENOLOL 100MG TAB 10.4710 637 $ - 471001321 AVANDIA 4MG TABLET 10.4710 637 $ - 471001323 MORPHINE SULFATE 10MG/ML CARPU 10.4710 636 $ - 471001324 DIAZEPAM 10MG CARPUJECT / 2ML 10.4710 636 $ - 471001325 ATENOLOL 25MG TAB 10.4710 637 $ 17.50 471001326 VERSED 5MG/ML 1ML VIAL 10.4710 636 $ - 471001338 TOPAMAX 25MG TABLET 10.4710 637 $ - 471001339 NORVIR 100MG CAPSULE 10.4710 637 $ - 471001342 CYANIDE ANTIDOTE KIT 10.4710 250 $ - 471001343 LORAZEPAM 2MG/ML 10ML VIAL 10.4710 250 $ - 471001350 ATROPINE 0.4MG/ML 10ML 10.4710 636 $ - 471001351 ALTEPLASE RECOMBINANT 5MG/5ML 10.4710 636 $ - 471001353 AVANDIA 8MG TAB 10.4710 637 $ - 471001354 ATACAND 16MG TAB 10.4710 637 $ - 471001355 ATROPINE 1MG SYR / 10ML 10.4710 636 $ 45.00 471001356 BAG BALM 30GM OINTMENT 10.4710 637 $ - 471001357 EPIDUR(OB)FENTANYL W/BUP 100ML 10.4710 250 $ - 471001358 SEREVENT DISKUS 50MCG #60 10.4710 637 $ - 471001359 VITAMIN C 1000MG/2ML AMPOULE 10.4710 250 $ - 471001360 ATROPINE 1% OPTH SOLN 15ML 10.4710 637 $ - 471001361 VENTOLIN 6.8G METERED DOSE INH 10.4710 637 $ - 471001362 SEREVENT DISKUS 50MCG 28'S 10.4710 637 $ - 471001363 CLIMARA 0.025MG/DAY PATCH 10.4710 637 $ - 471001368 SEROMYCIN 250MG CAPSULE 10.4710 637 $ - 471001369 SUPRANE 240ML INH SOLN 10.4710 250 $ - 471001371 LIDOCAINE 2% W/EPI 10ML 10.4710 250 $ - 471001372 LIDOCAINE HCL/DEXTROSE 2ML INJ 10.4710 250 $ - 471001373 LIDOCAINE 2% 30ML VIAL 10.4710 250 $ - 471001374 SODIUM CHLORIDE 0.9% 20ML VIAL 10.4710 250 $ - 471001375 BACITRACIN OINTMENT FOILS 10.4710 637 $ - 471001376 ROBINUL 0.2MG/ML 5ML VIAL 10.4710 250 $ - 471001377 TETRACAINE 1% 2ML INJ 10.4710 250 $ - 471001378 AMINOPHYLLINE 250MG/10ML VIAL 10.4710 636 $ - 471001379 LUBRITEARS OINTMENT 3.5GM 10.4710 637 $ - 471001381 XYLOCAINE 2% W/EPI 20ML AMPULE 10.4710 250 $ - 471001382 XYLOCAINE 1.5% W/EPI 5ML AMPUL 10.4710 250 $ - 471001383 OPIUM TINCTURE 100MG/ML 118ML 10.4710 637 $ - 471001384 CHERRY SYRUP 480 ML 10.4710 637 $ - 471001388 ALTEPLASE RECOMBINANT 2MG SYRI 10.4710 636 $ - 471001389 ALTEPLASE RECOMBINANT 1-10MG S 10.4710 636 $ - 471001390 ATROPINE 1MG/ML INJ 10.4710 636 $ 34.50 471001391 GLIMEPIRIDE 4MG TABLET 10.4710 637 $ - 471001392 WATER FOR IRRIGATION 1000ML 10.4710 250 $ - 471001393 TAXOTERE 20MG VIAL 10.4710 636 $ - 471001394 FLUCONAZOLE SUSP 40MG/ML 35ML 10.4710 637 $ - 471001395 FLUCONAZOLE 10MG/ML SUSP 35ML 10.4710 637 $ - 471001397 TRIAMCINOLONE 0.1% OINT 80GM 10.4710 637 $ - 471001398 TRIAMCINOLONE 0.1% CREAM 80GM 10.4710 637 $ - 471001400 AURALGAN OTIC 15ML 10.4710 637 $ - 471001401 ACTOS 15MG TABLET 10.4710 637 $ - 471001402 ACTOS 30MG TABLET 10.4710 637 $ - 471001403 ACTOS 45MG TABLET 10.4710 637 $ - 471001405 DITROPAN XL 5MG CR TAB 10.4710 637 $ - 471001406 DITROPAN XL 10MG CR TABLET 10.4710 637 $ - 471001408 ARAVA 10MG TABLET 10.4710 637 $ - 471001409 ARAVA 20MG TABLET 10.4710 637 $ - 471001411 EPOETIN ALPHA 40,000U/1ML VIAL 10.4710 636 $ - 471001412 ADDERAL 10MG TABLET 10.4710 637 $ - 471001413 SIMPLE SYRUP 480ML 10.4710 637 $ - 471001414 ADDERALL 5MG TABLET 10.4710 637 $ - 471001415 THYROGEN 1.1MG INJ 10.4710 636 $ - 471001416 NEOSPORIN OINT 30GM 10.4710 637 $ - 471001417 TEMODAR 5MG CAPSULES 10.4710 636 $ - 471001418 TEMODAR 20MG CAPSULE 10.4710 636 $ - 471001419 TEMODAR 100MG CAPSULES 10.4710 636 $ - 471001421 DAUNORUBICIN LIPOSOM 50MG/25ML 10.4710 636 $ - 471001422 RIFAMPIN SYRUP 10MG/ML 240ML 10.4710 637 $ - 471001423 TAMIFLU 75MG CAPSULE 10.4710 637 $ - 471001429 TORSEMIDE 50MG/5ML INJECTION 10.4710 250 $ - 471001431 ISOPROTERENOL HCL.02% SYR 5ML 10.4710 250 $ - 471001432 TEQUIN 200MG TABLET 10.4710 637 $ - 471001433 LOTRISONE CREAM 45GM 10.4710 637 $ - 471001434 VIOXX 12.5MG TABLET 10.4710 637 $ - 471001436 ABACAVIR 300MG TAB 10.4710 637 $ - 471001437 ZALCITABINE 0.75MG TABLET 10.4710 637 $ - 471001438 ZALCITABINE 0.375MG TABLET 10.4710 637 $ - 471001439 AMPRENAVIR 50MG CAPSULE LF 10.4710 637 $ - 471001440 AGENERASE 150MG CAPSULE LF 10.4710 637 $ - 471001441 AGENERASE ORAL 15MG/ML 240ML 10.4710 637 $ - 471001442 SUSTIVA 50MG CAPSULE 10.4710 637 $ - 471001443 SUSTIVA 100MG CAPSULE 10.4710 637 $ - 471001444 RESCRIPTOR 200MG TABLET 10.4710 637 $ - 471001446 LIDOCAINE 2% W/BICARB INJ 10.4710 250 $ - 471001447 LIDOCAINE 2% W/EPI INJ 10.4710 250 $ - 471001448 LEVAQUIN 250MG TABLET 10.4710 637 $ - 471001449 CAPECITABINE 150MG TABLET 10.4710 636 $ - 471001450 AZATHIOPRINE 50MG TAB 10.4710 636 $ - 471001451 CAPEITABINE 500MG TABLET 10.4710 636 $ - 471001453 AZATHIOPRINE 100MG INJ 10.4710 636 $ - 471001454 ZEMPLAR 5MCG INJECTION / 1ML 10.4710 636 $ - 471001455 AZITHROMYCIN 250MG TABLET 10.4710 637 $ - 471001456 XYLOCAINE 1.5% 10ML 10.4710 250 $ - 471001458 LIDOCAINE 1% AMPOULE 30ML 10.4710 250 $ - 471001460 AZTREONAM 1GM INJ 10.4710 250 $ - 471001462 EUCERIN CREAM 57GM 10.4710 637 $ - 471001464 PROCTOCREAM-HC 2.5% CREAM 30GM 10.4710 637 $ - 471001465 NEORAL ORAL SUSP 50ML 10.4710 637 $ - 471001468 ALLEGRA-D TAB CR 10.4710 637 $ - 471001469 XYLOCAINE MPF 1% VIAL 10.4710 250 $ - 471001470 AZTREONAM 2GM INJ 10.4710 250 $ - 471001471 CEFTIN SUSP 250MG/5ML 100ML 10.4710 637 $ - 471001472 CEFTIN 250MG/5ML 50ML SUSP 10.4710 637 $ - 471001473 AQUAPHOR OINTMENT 50GM TUBE 10.4710 637 $ - 471001474 PROGRAF 1MG CAPSULE 10.4710 636 $ - 471001475 AGGRENOX 200-25MG CAPSULE 10.4710 637 $ - 471001477 MORPHINE SULFATE 10MG VIAL 10.4710 636 $ - 471001479 ARTHROTEC EC 50MG TAB 10.4710 637 $ - 471001480 ARTHROTEC 75MG TAB EC 10.4710 637 $ - 471001481 RETAVASE 1UNIT/ML INJECTION 10.4710 636 $ - 471001482 MICARDIS 40MG TABLET 10.4710 637 $ - 471001484 RETAVASE HALF-KIT 5U/5ML 5ML 10.4710 636 $ - 471001485 AZOPT OPHTH 1% SUSP 10ML 10.4710 637 $ - 471001486 CAFCIT 60MG/3ML INJECTION 10.4710 636 $ - 471001487 ALTACE 1.25MG CAPSULE 10.4710 637 $ - 471001489 VERSED 5MG/ML 5ML 10.4710 250 $ - 471001490 BACITRACIN 50,000U INJ 50ML 10.4710 250 $ - 471001491 LEVOBUNOLOL .5% OPHTH SOL 10ML 10.4710 637 $ - 471001492 TEVETEN 600MG TABLET 10.4710 637 $ - 471001493 ALTACE 10MG CAPSULE 10.4710 637 $ - 471001494 SONATA 5MG CAPSULE 10.4710 637 $ - 471001495 MAXALT MLT 10MG DISP TAB 10.4710 637 $ - 471001496 GABITRIL 4MG TABLET 10.4710 637 $ - 471001497 MIRAPEX 0.25MG TABLET 10.4710 637 $ - 471001498 MIRAPEX 1MG TABLET 10.4710 637 $ - 471001500 BACITRACIN OINTMENT 30GM 10.4710 637 $ - 471001501 COSOPT 5ML SOLN 10.4710 637 $ - 471001502 MAXALT MLT 5MG DISP TAB 10.4710 637 $ - 471001503 BACITRACIN OPTH OINT 3.5GM 10.4710 637 $ - 471001504 MAXALT 5MG TABLET MLT 10.4710 637 $ - 471001505 ZOSYN 2.25G VIAL 10.4710 636 $ - 471001510 POLYMYXIN/BACITRACIN 15GM OINT 10.4710 637 $ - 471001511 FOSAMAX 5MG TABLET 10.4710 637 $ - 471001512 FOSAMAX 40MG 10.4710 637 $ - 471001513 VESANOID 10MG CAPSULE 10.4710 250 $ - 471001515 POLYMYXIN/BACITRAC 3.5GM OINT 10.4710 637 $ - 471001518 PENTOSAN POLYSULFATE 100MG CAP 10.4710 637 $ - 471001519 PROAMATINE 2.5MG TABLET 10.4710 637 $ - 471001520 BACLOFEN 10MG TAB 10.4710 637 $ - 471001521 PROAMATINE 5MG TABLET 10.4710 637 $ - 471001522 LAMOTRIGINE 100MG TABLET 10.4710 637 $ - 471001523 PRANDIN 0.5MG TABLET 10.4710 637 $ - 471001524 LIDODERM 5% PATCH 10.4710 250 $ - 471001525 BACLOFEN 0.5MG/ML 20ML 10.4710 636 $ - 471001527 LIORESAL INTRATHEC 1000MCG/5ML 10.4710 636 $ - 471001528 ALLEGRA 180MG TAB 10.4710 637 $ - 471001530 BAG BALM OINTMENT 300GM 10.4710 637 $ - 471001531 BACTROBAN OINTMENT 2% 22GM 10.4710 637 $ - 471001533 TRIAMCINOLONE 0.1% CREAM 30GM 10.4710 637 $ - 471001535 BANANA FLAKES PACKET 1 EA 10.4710 637 $ - 471001545 FLOVENT 110MCG INHALER 7.9G 10.4710 637 $ - 471001546 VITAMIN A INJ 50,000U/ML 2ML 10.4710 250 $ - 471001547 ALBUMIN 25% 25GM/100ML 10.4710 636 $ - 471001548 LUPRON DEPOT 11.25MG 10.4710 636 $ - 471001549 LUPRON DEPOT 7.5MG 10.4710 636 $ - 471001550 BECLOMETHASONE AQ SPRY 25GM 10.4710 637 $ - 471001551 CISPLATIN 100MG VIAL 100ML 10.4710 636 $ - 471001552 CISPLATIN 50MG VIAL 50ML 10.4710 636 $ - 471001553 TETANUS/DIPHTHER TOX ADUL .5ML 10.4710 636 $ 20.00 471001554 TETANUS TOXOID 0.5ML INJ 10.4710 636 $ - 471001555 ZYVOX IV 200MG/100ML INJECTION 10.4710 636 $ - 471001556 ZYVOX IV 600MG INJECTION 300ML 10.4710 636 $ - 471001557 ZYVOX 600MG TAB 10.4710 637 $ - 471001558 SYNAGIS 50MG INJECTION 10.4710 636 $ - 471001559 SYNAGIS 100MG INJECTION 10.4710 636 $ - 471001561 TYLENOL W/COD ELIX 5ML 10.4710 637 $ - 471001564 LEVALBUTEROL 1.25MG/3ML 10.4710 637 $ - 471001565 XOPENEX 0.63MG/3ML 10.4710 637 $ - 471001566 ACTONEL 5MG TAB 10.4710 637 $ - 471001567 FERRIC GLUCONAT INJ 62.5MG/5ML 10.4710 636 $ - 471001570 BECLOMETHASONE INHAL 16.8GM 10.4710 637 $ - 471001571 CIPRO-HC OTIC SUSP 10ML 10.4710 637 $ - 471001575 MENEST 0.3MG TAB 10.4710 637 $ - 471001576 FLOXIN OTIC SOLN 5ML 10.4710 637 $ - 471001578 OXYTOCIN 100U/10ML VIAL 10.4710 250 $ - 471001580 BELLADONA/OPIUM SUPP 1 EA 10.4710 637 $ - 471001581 PATANOL OPHTH 0.1% SOLN 5ML 10.4710 637 $ - 471001582 GELFOAM POWDER 1GM 10.4710 250 $ - 471001583 COUMADIN PER PHARMACY PROTOCOL 10.4710 250 $ - 471001584 CYCLOKAPRON 100MG/ML 10ML 10.4710 250 $ - 471001585 DEXAMETHASONE 10MG INJ 10.4710 636 $ - 471001587 LIDOCAINE 2% 20ML 10.4710 250 $ - 471001590 LIDOCAINE 2% W/EPI 20ML 10.4710 250 $ - 471001591 CELLCEPT 500MG INJECTION 10.4710 250 $ - 471001592 EXELON 1.5MG CAPSULE 10.4710 637 $ - 471001593 EXELON 3MG CAPSULE 10.4710 637 $ - 471001596 PROMETHAZINE VC W/COD S 120ML 10.4710 637 $ - 471001597 MORPHINE SULFATE 2MG INJ 1ML 10.4710 636 $ - 471001598 BUDESONIDE INHAL SUSP .5MG 2ML 10.4710 250 $ 35.00 471001599 NUBAIN 20MG INJECTION 1ML 10.4710 250 $ - 471001600 BEN GAY OINT 37.5 GM 10.4710 637 $ - 471001601 ATACAND 8MG TABLET 10.4710 637 $ - 471001602 SALINE 0.9% 3ML FOR R/T 10.4710 637 $ - 471001603 BENAZEPRIL 5MG TAB 10.4710 637 $ - 471001604 CAFCIT ORAL 60MG/3ML SDV 3ML 10.4710 637 $ - 471001605 BENAZEPRIL 10MG TAB 10.4710 637 $ - 471001606 LYMPHOCYT IMMUN GLOB 250MG/5ML 10.4710 636 $ - 471001610 BENZALKONLIUM CHLOR SOLN 236ML 10.4710 250 $ - 471001612 METAXALONE 400MG TABLET 10.4710 637 $ - 471001613 FLOVENT 44 MDI 7.9GM 10.4710 637 $ - 471001615 PAXIL ORAL SUSP 2MG/ML 250ML 10.4710 637 $ - 471001617 SANDOGLOBULIN 6GM VIAL 100ML 10.4710 636 $ - 471001619 MONSEL'S PASTE 8ML 10.4710 637 $ - 471001621 DILAUDID PCA 2MG/ML 30ML 10.4710 250 $ - 471001622 ALFENTA 1000MCG/2ML 10.4710 250 $ - 471001623 LOMOTIL ORAL LIQUID 5ML U/D 10.4710 637 $ - 471001624 PHENOBARBITAL 60MG ELIXIR 15ML 10.4710 637 $ - 471001625 PROMETHAZINE W/COD SYRUP 5ML 10.4710 637 $ 17.00 471001626 METHIMAZOLE 10MG TAB 10.4710 637 $ - 471001628 EFFEXOR XR 150MG CAP 10.4710 637 $ - 471001630 BENZOCAINE LIQ 9ML 9.3ML 10.4710 637 $ - 471001631 NAVELBINE 10MG INJ 1ML 10.4710 636 $ - 471001632 TIKOSYN 125MCG CAP 10.4710 637 $ - 471001633 TIKOSYN 250MCG CAPSULE 10.4710 637 $ - 471001634 TIKOSYN 500MCG CAPSULE 10.4710 637 $ - 471001635 TETRACAINE/DEXTROSE 10% KIT EA 10.4710 250 $ - 471001636 ESKALITH 450MG TABLET CR 10.4710 637 $ - 471001637 RENAGEL 800MG TAB 10.4710 637 $ - 471001638 AGRYLIN 0.5MG CAP 10.4710 637 $ - 471001640 BENZOCAINE ORAL SPRY 60ML 10.4710 637 $ - 471001641 CARBOPLATIN INJECTION 150MG 10.4710 636 $ - 471001642 CARBOPLATIN INJECTION 450MG 10.4710 636 $ - 471001643 CYCLOPHOSPHAMIDE INJ 1GM 10.4710 636 $ - 471001644 CYCLOPHOSPHAMIDE INJ 200MG 10.4710 250 $ - 471001645 CYCLOPHOSPHAMIDE INJ 500MG 10.4710 636 $ - 471001646 CYTARABINE INJ 1GM 10.4710 636 $ - 471001647 CYTARABINE INJ 2GM 10.4710 636 $ - 471001648 CYTARABINE INJ 500MG/25ML 10.4710 636 $ - 471001649 DACARBAZINE INJ 200MG 10.4710 636 $ - 471001650 IDARUBICIN INJ 10MG/10ML 10.4710 636 $ - 471001651 IDAMYCIN PFS 20MG 20ML 10.4710 636 $ - 471001652 DOXORUBICIN INJ 50 MG/25ML 10.4710 636 $ - 471001653 DOXORUBICIN INJ 20 MG/10ML 10.4710 636 $ - 471001654 DOXORUBICIN INJ 200 MG/100ML 10.4710 636 $ - 471001655 DOXORUB LIPOSOM INJ 50MG/25ML 10.4710 636 $ - 471001656 ETOPOSIDE INJ 500MG/25ML 10.4710 636 $ - 471001657 ETOPOSIDE INJ 1000MG/50ML 10.4710 636 $ - 471001658 ETOPOSIDE INJ 200MG/20ML 10.4710 636 $ - 471001659 FLUOROURACIL INJ 1000MG / 20ML 10.4710 636 $ - 471001660 BENZONATATE 100MG CAP 10.4710 637 $ - 471001662 GEMCITABINE INJ 1000MG 10.4710 636 $ - 471001663 SUBY'S G IRRIGATION 1000ML 10.4710 250 $ - 471001664 VINCRISTINE INJECTION 2MG/2ML 10.4710 636 $ - 471001666 MITOMYCIN INJECTION 20 MG 10.4710 636 $ - 471001667 MITOMYCIN INJECTION 40MG 10.4710 636 $ - 471001668 MITOXANTRONE INJ 25MG/12.5ML 10.4710 636 $ - 471001669 MITOXANTRONE INJ 30MG/15ML 10.4710 636 $ - 471001670 RITUXIMAB INJECTION 500MG/50ML 10.4710 636 $ - 471001671 PACLITAXEL INJ 100 MG/16.7ML 10.4710 636 $ - 471001672 PACLITAXEL INJ 300MG/50ML 10.4710 636 $ - 471001675 VITAMIN B-12 100MCG TABLET 10.4710 637 $ - 471001676 ZITHROMAX 200MG/5ML 30ML BOTTL 10.4710 637 $ - 471001677 COLLAGEN HEMOSTAT SPONGE 12EA 10.4710 250 $ - 471001678 MYLOTARG 5MG/5ML 10.4710 636 $ - 471001679 BIAXIN SUSP 125MG/5ML 50ML 10.4710 637 $ - 471001681 BIAXIN 250MG/5ML 50ML SUSP 10.4710 637 $ - 471001682 ARGININE 10% 300ML 10.4710 636 $ - 471001683 PLETAL 50MG TAB 10.4710 637 $ - 471001684 PLETAL 100MG TAB 10.4710 637 $ - 471001685 PROTONIX 40MG TAB 10.4710 637 $ - 471001686 CILOXAN OPHTH 0.3% 3.5GM OINT 10.4710 637 $ - 471001687 METHADONE INTENSOL 10MG/ML 10.4710 637 $ - 471001688 METFORMIN XR 500MG 24HR TABLET 10.4710 637 $ - 471001689 AVELOX 400MG TABLET 10.4710 637 $ - 471001690 BENZTROPINE 1MG TAB 10.4710 637 $ - 471001691 CYCLOPHOSPHAMIDE 50MG TABLET 10.4710 636 $ - 471001693 MIRTAZAPINE SOLUTAB 30MG 10.4710 637 $ - 471001694 MIRTAZAPINE SOLUTAB 15MG 10.4710 637 $ - 471001695 PROVIGIL 100MG TAB 10.4710 637 $ - 471001696 HYDROXYZINE PAMOATE 25MG CAP 10.4710 637 $ - 471001700 BENZTROPIN 2MG INJ 10.4710 636 $ 88.00 471001701 FLOVENT 220MCG INHALER 7.9GM 10.4710 637 $ - 471001702 IMITREX NASAL 20MG SPRAY 10.4710 637 $ - 471001709 KERI LOTION 195ML 10.4710 637 $ - 471001711 DEXTROSE 10% AMPOULE 5ML 10.4710 250 $ - 471001715 BERACTANT 8ML VIAL 10.4710 250 $ - 471001716 GEODON 20MG CAP 10.4710 637 $ - 471001717 GEODON 40MG CAP 10.4710 637 $ - 471001720 BETAMETHASONE 6MG/ML INJ 5ML 10.4710 636 $ - 471001721 LAMICTAL 200MG TAB 10.4710 637 $ - 471001722 REMERON 30MG TABLET 10.4710 637 $ - 471001723 BETAMETHASONE 0.05% OINT 15GM 10.4710 637 $ - 471001724 REMERON 45MG TABLET 10.4710 637 $ - 471001726 CROFAB 1GM VIAL 10.4710 250 $ - 471001727 BETAMETHASONE 0.1%CRM 15GM 10.4710 637 $ - 471001728 COMTAN 200MG TABLET 10.4710 637 $ - 471001729 VIOXX 50MG TAB 10.4710 637 $ - 471001730 BETAXOLOL 0.5% OS 5ML 10.4710 250 $ - 471001731 CALCIUM CHLORIDE 13.6MEQ/10ML 10.4710 250 $ - 471001733 STARLIX 60MG TABLET 10.4710 637 $ - 471001734 PULMICORT RESPULES 0.25MG/2ML 10.4710 637 $ 34.50 471001735 BETAXOLOL 0.25% OS 5ML 10.4710 637 $ - 471001736 MIRALAX 17GM PACKET 10.4710 637 $ - 471001737 MEPRON 750MG/5ML SUSP UNIT DOS 10.4710 637 $ - 471001738 NIASPAN 500MG TABLET 10.4710 637 $ - 471001739 CLEAR EYES 30ML 10.4710 637 $ - 471001740 BETHANECHOL 10MG TAB 10.4710 637 $ - 471001741 LANTUS INSULIN 100U/ML 10ML VI 10.4710 637 $ - 471001742 AMOXIL 875MG TABLET 10.4710 637 $ - 471001743 NEURONTIN 600MG TABLET 10.4710 637 $ - 471001745 SINGULAIR 4MG CHEWABLE TAB 10.4710 637 $ - 471001747 DETROL LA 2MG CAPSULE 10.4710 637 $ - 471001748 DETROL LA 4MG CAPSULE 10.4710 637 $ - 471001749 ZADITOR 0.025% OPHTH DROPS 5ML 10.4710 637 $ - 471001750 BETHANECHOL 25MG TAB 10.4710 637 $ - 471001751 THYROLAR-1 TABLET 10.4710 637 $ - 471001753 RENAGEL 400MG TAB 10.4710 637 $ - 471001754 TRILEPTAL 150MG TAB 10.4710 637 $ - 471001756 LIPITOR 40MG TAB 10.4710 637 $ - 471001757 LIPITOR 80MG TAB 10.4710 637 $ - 471001758 LORAZEPAM 2MG/ML INJ 1ML 10.4710 636 $ 45.00 471001763 PROTONIX 40MG IV 10.4710 636 $ - 471001764 MOBIC 7.5MG TABLET 10.4710 637 $ - 471001765 LIDO-EPI-TETRACAINE SOLN 5ML 10.4710 250 $ - 471001766 FOSAMAX 35MG TABLET 10.4710 637 $ - 471001767 FOSAMAX 70MG TABLET 10.4710 637 $ - 471001768 LEVOTHYROXINE 137MCG TABLET 10.4710 637 $ - 471001769 TOPAMAX 100MG TABLET 10.4710 637 $ - 471001774 TOLCAPONE 100MG TABLET 10.4710 637 $ - 471001779 MILK OF MAG CONC 10ML CUP 10.4710 637 $ - 471001780 BICITRA LIQ 480ML 10.4710 637 $ - 471001781 ADVAIR DISKHALER 100/50MCG #28 10.4710 637 $ - 471001782 ADVAIR 250/50MCG DISKHALER #28 10.4710 637 $ - 471001783 ADVAIR 500/50 (FLOV/SERE) #28 10.4710 637 $ - 471001785 PRECEDEX 200MCG/2ML AMPOULE 10.4710 250 $ - 471001786 INTEGRILIN 200MG/100ML 10.4710 636 $ - 471001788 LIDOCAINE VISCOUS 2% 100ML 10.4710 250 $ - 471001789 AMIFOSTINE 500MG INJ 10.4710 250 $ - 471001790 BISACODYL EC 5MG TAB 10.4710 637 $ - 471001791 INTEGRILIN 2MG/ML (NO CHARGE) 10.4710 636 $ - 471001792 HUMALOG MIX 75/25 INSULIN 10ML 10.4710 637 $ - 471001793 HEXTEND 500ML 10.4710 250 $ - 471001794 MSA - MSG SOLUTION 250ML 10.4710 250 $ - 471001795 METOCLOPRAMIDE LIQ 10MG/10ML 10.4710 637 $ - 471001796 ACETAMINOPHEN SUSP 480MG/15ML 10.4710 637 $ - 471001797 IBUPROFEN 200MG/10ML SUSP 10.4710 637 $ 7.50 471001799 DIAZEPAM 5MG/5ML ORAL SYRUP 10.4710 637 $ - 471001800 BISACODYL SUPP 10.4710 637 $ 4.50 471001801 CARDIOPLEGIC SOLN 50ML 10.4710 250 $ - 471001802 CARDIOPLEGIC MAINT SOLN 201ML 10.4710 250 $ - 471001803 CARDENE 25MG VIAL/10ML 10.4710 250 $ - 471001804 ULTIVA 2MG INJ 10.4710 250 $ - 471001806 VITAMIN E 100U CAPSULE 10.4710 637 $ - 471001807 NEXIUM 20MG TAB 10.4710 637 $ - 471001808 NEXIUM 40MG CAP 10.4710 637 $ - 471001810 BREVIBLOC 2500MG/250ML BAG 10.4710 250 $ - 471001811 THROMBIN 20,000 UNIT KIT 10.4710 250 $ - 471001813 MORPHINE SULFATE IR 10MG TAB 10.4710 637 $ - 471001814 GEODON 60MG TAB 10.4710 637 $ - 471001816 GEODON 80MG CAP 10.4710 637 $ - 471001817 TRILEPTAL 300MG TAB 10.4710 637 $ - 471001818 ADDERALL XR 30MG CAP 10.4710 637 $ - 471001819 RISPERDAL 0.5MG TAB 10.4710 637 $ - 471001820 BLEOMYCIN 15U INJ 10.4710 636 $ - 471001821 STARLIX 120MG TAB 10.4710 637 $ - 471001822 WELCHOL 625MG TAB 10.4710 637 $ - 471001823 ANGIOMAX 250MG VIAL 10.4710 250 $ - 471001826 TRICOR 145MG TABLET 10.4710 637 $ - 471001828 MAXIPIME 1GM VIAL 10.4710 636 $ - 471001830 SULFA/PREDNISOLONE 3.5GM 10.4710 637 $ - 471001834 REGRANEX .01% GEL 15GM 10.4710 637 $ - 471001837 ACTONEL 30MG TAB 10.4710 637 $ - 471001839 ZOFRAN ORAL 4MG/5ML LIQUID 50M 10.4710 637 $ - 471001840 SULFA/PREDNISOLONE OS 5ML 10.4710 637 $ - 471001841 XIGRIS 5MG INJECTION 10.4710 250 $ - 471001842 XIGRIS 20MG INJECTION 10.4710 250 $ - 471001845 ETHANOLAMINE OLEATE 5% 2ML AMP 10.4710 250 $ - 471001846 TOPROL XL 25MG TABLETY 10.4710 637 $ - 471001848 LOVENOX 120MG SYRINGE 0.8ML 10.4710 636 $ - 471001849 LOVENOX 150MG SYRINGE 1ML 10.4710 636 $ - 471001851 ZOMETA 4MG INJECTION 10.4710 636 $ - 471001853 OXYCODONE 15MG TABLET 10.4710 637 $ - 471001854 HYDROCODONE/ACET 7.5/325MG TAB 10.4710 637 $ - 471001856 NATRECOR 1.5MG INJ 10.4710 636 $ - 471001858 OXYCONTIN CR 40MG TAB 10.4710 637 $ - 471001859 PAMIDRONATE 90MG INJ 10.4710 636 $ - 471001862 ADDERALL XR 20MG CAP 10.4710 637 $ - 471001863 FORADIL AEROLIZER 12MCG CAP 10.4710 637 $ - 471001864 BIAXIN XL 500MG TAB 10.4710 637 $ - 471001865 DDAVP 0.2MG TAB 10.4710 637 $ - 471001867 CONCERTA CR 36MG TAB 10.4710 637 $ - 471001868 CONCERTA CR 54MG TAB 10.4710 637 $ - 471001869 FOLTX TAB 10.4710 637 $ - 471001871 FONDAPARINUX SOD 2.5MG SYR.5ML 10.4710 636 $ - 471001872 D5/LR W/KCL 20MEQ 1000ML 10.4710 250 $ - 471001873 NS WITH KCL 20MEQ 1000ML 10.4710 250 $ - 471001874 D5NS WITH KCL 20MEQ 1000ML 10.4710 250 $ - 471001875 DUOVISC SYSTEM 0.55ML INJ 10.4710 250 $ - 471001877 VIVELLE DOT 0.1MG PATCH 10.4710 637 $ - 471001878 VIVELLE DOT 0.05MG PATCH 10.4710 637 $ - 471001879 VIVELLE DOT 0.075MG PATCH 10.4710 637 $ - 471001880 BROMOCRIPTINE 2.5MG TAB 10.4710 637 $ - 471001881 VIVELLE DOT 0.0375MG PATCH 10.4710 637 $ - 471001883 BEXTRA 10MG TABLET 10.4710 637 $ - 471001884 LEUCOVORIN 100MG VIAL 10.4710 636 $ - 471001885 LEUCOVORIN 350MG VIAL 10.4710 636 $ - 471001886 ARANESP 25MCG VIAL 1ML 10.4710 636 $ - 471001887 ARANESP 100MCG VIAL 1ML 10.4710 636 $ - 471001888 METHADONE 40MG TABLET 10.4710 637 $ - 471001889 ZOFRAN 8MG ODT 10.4710 637 $ - 471001890 BROMOCRIPTINE 5MG TAB 10.4710 637 $ - 471001891 INTRON A 25MMU 10.4710 636 $ - 471001892 INTRON A 18MMU 10.4710 636 $ - 471001895 PENTOSTATIN 10MG INJECTION 10.4710 636 $ - 471001896 PROTONIX SUS CMPND 400MG/200ML 10.4710 637 $ - 471001898 NEULASTA 6MG SYR 0.6ML 10.4710 636 $ - 471001899 CHLORAL HYDRATE SYR 500MG/5ML 10.4710 637 $ - 471001900 BROMPHENIRAMINE ELIXIR 10.4710 637 $ - 471001901 ZEMURON 50MG/5ML 10.4710 250 $ - 471001902 TEGRETOL XR 100MG 10.4710 637 $ - 471001903 OXALIPLATIN 50MG VIAL 10.4710 636 $ - 471001904 OXALIPLATIN 100MG VIAL 10.4710 636 $ - 471001905 LEXAPRO 10MG TABLET 10.4710 637 $ - 471001906 LEXAPRO 20MG TABLET 10.4710 637 $ - 471001907 MAGNESIUM 4GM/100ML BAG 10.4710 250 $ - 471001908 CANCIDAS 70MG VIAL 10.4710 250 $ - 471001909 CANCIDAS 50MG VIAL 10.4710 250 $ - 471001910 BSS OPTH SOL 15ML 10.4710 637 $ - 471001911 PAXIL CR 12.5MG 10.4710 637 $ - 471001912 BSS OPTH SOLN 500ML 10.4710 250 $ - 471001913 PAXIL CR 25MG 10.4710 637 $ - 471001914 DEPAKOTE ER 500MG 10.4710 637 $ - 471001915 BACTROBAN CREAM 15GM 10.4710 637 $ - 471001916 TRICOR 48MG TABLET 10.4710 637 $ - 471001917 PANCURONIUM 10MG VIAL 10.4710 250 $ - 471001919 BOSENTAN 62.5MG TABLET 10.4710 637 $ - 471001921 AVELOX 400MG/250ML BAG 10.4710 250 $ - 471001922 ARGATROBAN 250MG/2.5ML VIAL 10.4710 636 $ - 471001923 GEODON 20MG INJ 10.4710 636 $ - 471001924 CHLORASEPTIC SPRAY 20ML 10.4710 637 $ - 471001925 ALPHAGAN P 5ML 10.4710 637 $ - 471001926 NEUMEGA 5MG INJECTION 10.4710 636 $ - 471001927 CAMPATH 30MG INJECTION 10.4710 636 $ - 471001928 CEREBYX PE 100MG VIAL 10.4710 250 $ - 471001929 LUPRON DEPOT 3-MONTH 22.5MG 10.4710 636 $ - 471001931 FENOLDOPAM 10MG INJ 10.4710 250 $ - 471001932 BUSULFEX 60MG INJ 10.4710 636 $ - 471001933 DEPOCYT 50MG INJ 10.4710 636 $ - 471001934 MAALOX SUSP 150ML 10.4710 637 $ - 471001935 MAALOX SUSP 30ML 10.4710 637 $ 9.00 471001936 FOLIC ACID 0.4MG TABLET 10.4710 637 $ - 471001937 BAYGAM 2ML 10.4710 250 $ 61.00 471001938 BAYGAM 10ML 10.4710 250 $ - 471001939 INTRON A 6MMU/ML 3ML 10.4710 636 $ - 471001940 BUMETANIDE 1MG TAB 10.4710 637 $ - 471001941 LUPRON DEPOT 30MG 10.4710 636 $ - 471001942 REMINYL 4MG TABLET 10.4710 637 $ - 471001943 DOCUSATE ENEMA 5ML 10.4710 637 $ - 471001944 CALADRYL CLEAR 180ML 10.4710 637 $ - 471001945 LUPRON DEPOT PED 15MG 10.4710 636 $ - 471001946 RACEPINEPHRINE 11.25MG/0.5ML 10.4710 637 $ 19.00 471001947 ALBUTEROL 2.5MG/0.5ML INHALANT 10.4710 250 $ 17.50 471001948 FASLODEX 250MG INJ 10.4710 636 $ - 471001949 MORPHINE SULF IR 15MG 10.4710 637 $ - 471001950 BUMETANIDE 1MG INJ 10.4710 636 $ - 471001951 HEPARIN 2000UNITS/2ML PF 10.4710 250 $ - 471001952 COSYNTROPIN 1MCG/ML 10.4710 250 $ - 471001954 COSYNTROPIN 1MCG/ML 10.4710 250 $ - 471001955 RHOGAM INJECTION 10.4710 250 $ - 471001956 SANDOSTATIN INJECTION 0.2MG/ML 10.4710 250 $ - 471001957 FLOLAN DILUENT 50ML 10.4710 250 $ - 471001958 ZELNORM 6MG TABLET 10.4710 637 $ - 471001959 ZELNORM 2MG TABLET 10.4710 637 $ - 471001960 BUMETANIDE 2.5MG INJ 10.4710 250 $ - 471001961 ADDERAL XR 15MG 10.4710 637 $ - 471001962 PROGLYCEM SUSPENSION 30ML 10.4710 637 $ - 471001963 WINE 10.4710 637 $ - 471001964 ALCOHOL FOR ORAL CONSUMPTION 10.4710 637 $ - 471001965 HEPARIN 2U/ML 500ML 10.4710 250 $ - 471001966 VANCOMYCIN PHARMACY PROTOCOL 10.4710 250 $ - 471001967 AMINOGLYCOSIDE PHARMACY PROTOC 10.4710 250 $ - 471001968 BENICAR 20MG TABLET 10.4710 637 $ - 471001970 CORMAX CREAM 45GM 10.4710 637 $ - 471001971 AVINZA 30MG CAPSULE 10.4710 637 $ - 471001972 TETRACYCLINE SUSP 125MG/5ML 10.4710 637 $ - 471001973 UROKINASE 250,000UNITS 10.4710 250 $ - 471001974 THEO-24 400MG 10.4710 637 $ - 471001975 ZOFRAN 2MG INJECTION 10.4710 636 $ 91.50 471001976 PANHEMATIN 313MG 10.4710 636 $ - 471001977 ADDERALL XR 10MG 10.4710 637 $ - 471001978 ZOLADEX 10.8MG IMPLANT 10.4710 636 $ - 471001979 HEPARIN 1000UNITS/ML 1ML VIAL 10.4710 636 $ - 471001981 ANGIOMAX 250MG (STUDY DRUG) 10.4710 250 $ - 471001982 ADENOCARD 12MG SYRINGE 10.4710 250 $ - 471001983 ANTITHROMBIN III(HUMAN) 10.4710 636 $ - 471001984 SPOT ENDOSCOPIC MARKER 10.4710 250 $ - 471001985 ORA-PLUS SUSPENSION 10.4710 250 $ - 471001986 MYLANTA SUSPENSION 10.4710 637 $ - 471001987 NOVO SEVEN 1.2MG 10.4710 636 $ - 471001988 KONYNE 80 500UNIT 10.4710 636 $ - 471001989 EPTIFIBATIDE 20MG 10.4710 636 $ - 471001990 BUPIVACAINE 0.25% SDV 10.4715 250 $ 66.00 471001991 VORICONAZOLE 200MG INJ 10.4710 250 $ - 471001992 LESCOL XL 80MG 10.4710 637 $ - 471001993 LUMIGAN 0.03% EYE DROPS 10.4710 637 $ - 471001994 ZETIA 10MG TABLET 10.4710 637 $ - 471001995 KEPPRA 500MG TABLET 10.4710 637 $ - 471001996 KEPPRA 250MG TABLET 10.4710 637 $ - 471001997 SUCRALFATE 1GM SUSPENSION 10.4710 637 $ - 471001998 VALTREX 1GM TABLET 10.4710 637 $ - 471001999 VFEND 50MG TABLETS 10.4710 637 $ - 471002000 BUPIVACAINE 0.25% SDV STR 10.4710 250 $ - 471002001 VFEND 200MG TABLET 10.4710 637 $ - 471002002 AUGMENTIN XR 1000MG 10.4710 637 $ - 471002003 LUMIGAN OPHTH DROPS 10.4710 637 $ - 471002004 RISPERDAL 0.25MG TABLET 10.4710 637 $ - 471002005 CEFOTAXIME 500MG 10.4710 636 $ - 471002006 MICARDIS 80MG TABLET 10.4710 637 $ - 471002007 EFFEXOR 75MG TABLET 10.4710 637 $ - 471002008 KYTRIL 1MG INJECTION 10.4710 636 $ - 471002009 SOLU-MEDROL 125MG/2ML INJ 10.4710 636 $ - 471002010 ALBENZA 200MG TABLET 10.4710 637 $ - 471002011 PROTONIX 20MG TABLET 10.4710 637 $ - 471002012 THIOTEPA 15MG INJECTION 10.4710 636 $ - 471002013 ZONEGRAN 100MG CAPSULE 10.4710 637 $ - 471002014 CILOXAN EYE DROPS 2.5ML 10.4710 637 $ - 471002015 MAXALT 10MG TABLET 10.4710 637 $ - 471002016 NOVOLOG INSULIN 10ML 10.4710 637 $ - 471002018 STERILE TALC 5GM POWDER 10.4710 250 $ - 471002019 WELLBUTRIN XL 300MG 10.4710 637 $ - 471002020 STRATTERA 10MG 10.4710 637 $ - 471002021 STRATTERA 18MG 10.4710 637 $ - 471002022 ABILIFY 5MG TABLET 10.4710 637 $ - 471002023 STRATTERA 25MG CAPSULE 10.4710 637 $ - 471002024 STRATTERA 40MG CAPSULE 10.4710 637 $ - 471002025 STRATTERA 60MG CAPSULE 10.4710 637 $ - 471002026 ABILIFY 10MG TABLET 10.4710 637 $ - 471002027 ABILIFY 15MG TABLET 10.4710 637 $ - 471002028 GAMUNEX 10% 100ML 10.4710 636 $ - 471002030 BUPIVACAINE 0.5% SDV 30ML 10.4710 250 $ - 471002031 GLUCOTROL XL 2.5MG TAB 10.4710 637 $ - 471002032 DEPAKOTE ER 250MG TAB 10.4710 637 $ - 471002033 EDECRIN 25MG TABLET 10.4710 637 $ - 471002034 RENACIDIN IRRIGATION 500ML 10.4710 250 $ - 471002035 METHOTREXATE 50MG VIAL 10.4710 636 $ - 471002036 CONCERTA 18MG TABLET 10.4710 637 $ - 471002037 ZYPREXA ZYDIS 5MG TAB 10.4710 637 $ - 471002038 SALINE FLUSH SYRINGE 10ML 10.4710 250 $ 34.50 471002039 INSULIN PUMP (PT OWN) INJ 10.4710 250 $ - 471002040 BUPIVACAINE 0.5% SDV STRL 30ML 10.4710 250 $ - 471002041 SUSTIVA 600MG TABLET 10.4710 637 $ - 471002042 CILOXAN 5ML 10.4710 637 $ - 471002043 ERBITUX 100MG/50ML INJ 10.4710 636 $ - 471002044 ANDROGEL 5GM GEL 10.4710 637 $ - 471002046 ANDRODERM 5MG PATCH 10.4710 637 $ - 471002047 TED HOSE XL TO REG 10.4710 271 $ - 471002048 WELLBUTRIN XL 150MG 10.4710 637 $ - 471002049 GAMUNEX 5GM VIAL 10.4710 636 $ - 471002050 SIPRIVA 18MCG 10.4710 259 $ - 471002051 METAPROTERENOL 10MG/2.5ML SOLN 10.4710 250 $ - 471002052 IVANZ 1GM 10.4710 636 $ - 471002053 DURACLON 500MCG/10ML 10.4710 636 $ - 471002054 PHENYLEPHRINE 1% NSL SPRY 15ML 10.4710 259 $ - 471002055 RIBAVIRAN 200MG CAP 10.4710 637 $ - 471002056 VIDEX 400MG CAP 10.4710 637 $ - 471002057 NOVOLOG MIX 10/30 10ML 10.4710 637 $ - 471002058 IMITREX 100MG TAB 10.4710 637 $ - 471002059 REMERON 45MG SOLTAB 10.4710 637 $ - 471002060 TRAVATAN 2.5ML 10.4710 637 $ - 471002061 KALETRA 133-33MG CAP 10.4710 637 $ - 471002062 AVASTIN 100MG INJ 10.4710 636 $ - 471002063 AVASTN 400MG INJ 10.4710 636 $ - 471002064 ZOMIG 5MG TAB 10.4710 637 $ - 471002066 GRISEOFULVIN 50MG TAB 10.4710 637 $ - 471002067 GRISEOFULVIN 250MG TAB 10.4710 637 $ - 471002068 SULFAMYLON 50GM PACKET 10.4710 637 $ - 471002069 XOPENEX 1.25MG/0.5 ML SOLN 10.4710 637 $ - 471002070 BUPIVACAINE 0.75% SDV 10.4710 250 $ - 471002071 VIREAD 300MG TAB 10.4710 637 $ - 471002072 TESTOSTERONE 1% GEL 25mg/2.5gm 10.4710 637 $ - 471002073 NACL 0.9% 3000ML 10.4710 250 $ - 471002074 CARNITOR 300MG TAB 10.4710 637 $ - 471002075 PREVACID 30MG SOLUTAB 10.4710 637 $ - 471002076 SKELAXIN 800MG 10.4710 637 $ - 471002077 EVOXAC 30MG 10.4710 637 $ - 471002079 NAMENDA 5MG 10.4710 637 $ - 471002080 BUPIVACAINE 0.75% SDV STRL 10.4710 250 $ - 471002081 NAMENDA 10MG 10.4710 637 $ - 471002082 PAIN COCKTAIL-REHAB STANDARD 10.4710 637 $ - 471002083 PAIN COCKTAIL-DR OTANI MIX 10.4710 637 $ - 471002084 AMPICILLIN 1 GM / 50ML 10.4710 636 $ - 471002085 AMPICILLIN INJ 2GM / 100ML 10.4710 636 $ - 471002087 DOBUTAMINE INJ 500MG / 250ML 10.4710 636 $ - 471002088 DIOVAN 40MG 10.4710 637 $ - 471002089 SENSIPAR 60MG 10.4710 637 $ - 471002090 BUPIVACAINE/EPI 0.25% SDV 10.4710 250 $ - 471002091 CRESTOR 20MG 10.4710 637 $ - 471002092 EXLAX 10.4710 637 $ - 471002093 EMEND 80MG CAP 10.4710 637 $ - 471002094 EMEND 125MG CAP 10.4710 637 $ - 471002095 DANTRIUM 100MG CAP 10.4710 637 $ - 471002096 DOPAMINE INJ 800MG / 250ML 10.4710 636 $ - 471002097 DOPAMINE INJ 400MG / 200ML 10.4710 636 $ - 471002098 NTG 50MG/250ML 10.4710 250 $ - 471002099 CYMBALTA 30MG CAP 10.4710 637 $ - 471002100 BUPIVACAINE/EPI 0.25% SP 10.4710 250 $ - 471002101 TUMS EX TAB 10.4710 637 $ - 471002102 ALTIMA 500MG 10.4710 636 $ - 471002103 ZOFRAN ODT 4MG 10.4710 637 $ 79.50 471002104 HEPARIN 50,000 U / 100ML 10.4710 636 $ - 471002105 CRESTOR 10MG 10.4710 637 $ - 471002106 PROMETRIUM 200MG 10.4710 637 $ - 471002107 SENSIPAR 30MG 10.4710 637 $ - 471002108 ZOVIRAX 5% CREAM 2GM 10.4710 637 $ - 471002109 PROMETRIUM 100MG CAP 10.4710 637 $ - 471002110 AUGMENTIN ES 600 SUSP 150ML 10.4710 637 $ - 471002111 COLAZAL 750MG 10.4710 637 $ - 471002112 ACETADOTE 600MG INJECTION 10.4710 636 $ - 471002113 ROBITUSSIN DM 15ML 10.4710 637 $ - 471002114 CYMBALTA 60MG CAP 10.4710 637 $ - 471002115 SANDOSTATIN 5MG VIAL 10.4710 636 $ - 471002116 KETEK 400MG TAB 10.4710 637 $ - 471002117 DEXTROSE 25% 10ML SYRINGE 10.4710 250 $ - 471002118 VENOFER 100MG/5ML VIAL 10.4710 250 $ - 471002119 SODIUM BICARB 4.2% 5ML 10.4710 250 $ - 471002120 PILOCARPINE 2% OPTH 2ML 10.4710 637 $ - 471002121 VIDEX EC 250MG CAP 10.4710 637 $ - 471002122 CALCIUM CARB SUSP 5ML 10.4710 637 $ - 471002123 DIPHENHYDRAMINE 25MG ELIXER 10.4710 637 $ 7.00 471002124 GUIAIFENESIN 200MG ELIXER 10.4710 637 $ - 471002125 NYSTATIN ORAL SUSP 5ML 10.4710 637 $ - 471002126 FERROUS SULF 300MG ELIXER 10.4710 637 $ - 471002127 ACETAMINOPHEN ELIXIR 10ML UD 10.4710 637 $ - 471002128 MULTIVIT LIQ 5ML 10.4710 637 $ - 471002129 FOSCAVIR 6000MG/250ML 10.4710 250 $ - 471002130 BUPIVACAINE/EPI 0.5% SDV 10.4710 250 $ - 471002131 METOPROLOL 25 MG TABLET 10.4710 637 $ - 471002132 PROCAN SR 500MG 10.4710 637 $ - 471002133 DILAUDID 500MG VIAL 10.4710 250 $ - 471002134 VIDAZA 100MG VIAL 10.4710 636 $ - 471002135 DILANTIN 300MG SUSP 10.4710 637 $ - 471002136 BISOPROLOL 10MG TAB 10.4710 637 $ - 471002137 REQUIP 0.35MG 10.4710 637 $ - 471002138 NEOSYNEPHRINE 0.5% NASAL DRPS 10.4710 637 $ - 471002139 BISOPROLO 5MG TAB 10.4710 637 $ - 471002140 BUPIVACAINE/EPI 0.5% SDV 10.4710 250 $ - 471002141 AVAPRO 75MG 10.4710 637 $ - 471002142 TYSABRI 300MG 10.4710 637 $ - 471002143 DOMEBORO PACKETS 10.4710 637 $ - 471002144 ZINC CHLORIDE 10MG VIAL 10.4710 250 $ - 471002145 AMOXICILLIN 400MG/5ML 100ML 10.4710 637 $ - 471002146 CARBAMAZEPINE 100MG/5ML 60ML 10.4710 637 $ - 471002148 ROBITUSSIN DM SF/AF SYS 118ML 10.4710 637 $ 43.50 471002150 DAPSONE 100MG TAB 10.4710 637 $ - 471002151 SODIUM BENZOATE 5GM INJ 10.4710 636 $ - 471002152 COAL TAR SHAMPOO 10.4710 637 $ - 471002153 TED HOSE, X-LARGE/LONG 10.4710 271 $ - 471002154 ALBUTEROL PF 1.25MG/3ML R/T 10.4710 250 $ 21.00 471002155 OLANZAPINE 10MG INJ 10.4710 636 $ - 471002156 ETODOLAC XL 500MG TAB 10.4710 637 $ - 471002157 ABRAXANE 100MG 10.4710 636 $ - 471002158 HYALURONIDASE 150UNITS/ML 10.4710 636 $ - 471002160 CARBIDOPA 25MG TAB 10.4710 637 $ - 471002161 DULOXETINE 20MG CAP 10.4710 637 $ - 471002162 EPLERENONE (INSPRA) 25MG TAB 10.4710 637 $ - 471002163 DOXERCALCIFEROL 0.5MCG CAP 10.4710 637 $ - 471002164 DARBEPOETIN ALFA 150MCG/0.3ML 10.4710 636 $ - 471002165 DARBEPOETIN 60MCG/0.3ML INJ 10.4710 636 $ - 471002166 DABEPOETIN 200MCG/0.4ML 10.4710 636 $ - 471002167 DARBEPOETIN 300MCG/0.6ML 10.4710 636 $ - 471002168 PRIMAXIN 250MG VIAL 10.4710 636 $ - 471002169 PROVIGIL 200MG TAB 10.4710 637 $ - 471002170 BUPIVACAINE/EPI 0.75% SDV 10.4710 250 $ - 471002171 SEROQUEL 200MG TAB 10.4710 637 $ - 471002172 SPIRIVA HANDHELD DEVICE 10.4710 272 $ - 471002173 TRIAMTERENE-HCTZ 50-25MG CAP 10.4710 637 $ - 471002174 D5W /40 KCL 1000 (PANEL) 10.4710 272 $ - 471002175 D5NS / 40KCL 1000 (PANEL) 10.4710 272 $ - 471002176 NS /40 KCL 1000 (PANEL) 10.4710 272 $ - 471002180 BUPIVACAINE/EPI 0.75% SDV 10.4710 250 $ - 471002185 BUPIVACAINE/GLUCOSE 2MG 10.4710 250 $ - 471002188 NACL 0.4 / 20 KCL 1000 (PANEL) 10.4710 272 $ - 471002190 BUPRENORPHINE 0.3MG INJ 10.4710 250 $ - 471002194 BUPROPION 75MG TAB 10.4710 637 $ - 471002195 BUPROPION 100MG TAB 10.4710 637 $ - 471002200 BUSPIRONE 10MG TAB 10.4710 637 $ - 471002210 BUSPIRONE 5MG TAB 10.4710 637 $ - 471002220 BUSULFAN 2MG TAB 10.4710 636 $ - 471002228 BUTORPHANOL 1MG/ML INJ 10.4710 636 $ 88.00 471002230 BUTORPHANOL 2MG/ML INJ 10.4710 250 $ - 471002234 BENXOCAINE 7.5% 7.5GM GEL 10.4710 637 $ - 471002240 BUTORPHANOL NASAL SPRAY 2.5ML 10.4710 637 $ - 471002260 ABU. PUMP TUBING CHARGE 10.4710 272 $ - 471002310 CAFFEINE/SOD BENZOATE .5GM INJ 10.4710 250 $ - 471002320 CALAMINE LOT 120ML 10.4710 637 $ - 471002330 CALAMINE/DIPHENHY 180ML 10.4710 637 $ - 471002340 CALCITONIN 400U INJ 10.4710 636 $ - 471002341 CALCITONIN NASAL SPRAY 3.7ML 10.4710 637 $ - 471002350 CALCITRIOL 0.25MCG CAP 10.4710 637 $ - 471002360 CALCITRIOL 1MCG/ML INJ 10.4710 636 $ - 471002365 CALCIUM ACETATE 667MG TAB 10.4710 637 $ - 471002370 CALCIUM 500MG TABIN D TAB 10.4710 637 $ - 471002380 CALCIUM 250MG TAB W/VIT D 10.4710 637 $ - 471002385 CALCIUM CARB 1250MG TAB 10.4710 637 $ - 471002387 CALCIUM CARB 650MG TAB 10.4710 637 $ - 471002388 CALCIUM CARB SUSP 1.25GM/5ML 10.4710 637 $ - 471002389 CALCIUM CARB/SIMETHICONE SUSP 10.4710 637 $ - 471002390 CALCIUM CHLOR 1GM SYRG 10.4710 250 $ - 471002400 CALCIUM CHLOR INJ 1GM/10ML INJ 10.4710 250 $ - 471002440 CALCIUM GLUC INJ 1GM/10ML INJ 10.4710 636 $ - 471002452 CALCIUM LACT 650MG TAB 10.4710 637 $ - 471002475 CALMOSEPTINE OINT 113 GM 10.4710 637 $ - 471002485 CANDIDA SKIN TEST 0.2MG/0.1ML 10.4710 250 $ - 471002490 CAPSAICIN CRM 45GM 10.4710 637 $ - 471002500 CAPTOPRIL 100MG TAB 10.4710 637 $ - 471002510 CAPTOPRIL 12.5MG TAB 10.4710 637 $ - 471002520 CAPTOPRIL 25MG TAB 10.4710 637 $ - 471002530 CAPTOPRIL 50MG TAB 10.4710 637 $ - 471002540 CARBACHOL 0.01% OS UD 1.5ML 10.4710 250 $ - 471002545 CARBACHOL 1.5% OS 15ML 10.4710 637 $ - 471002550 CARBAMAZEPINE 100MG TAB 10.4710 637 $ - 471002560 CARBAMAZEPINE 100MG/5ML 10.4710 637 $ - 471002570 CARBAMAZEPINE 200MG TAB 10.4710 637 $ - 471002580 CARBAMIDE OTIC SOL 15ML 10.4710 637 $ 11.50 471002590 CARBIDOPA/LEVODOPA 10-100 TAB 10.4710 637 $ - 471002600 CARBIDOPA/LEVODOPA 25-100 TAB 10.4710 637 $ - 471002610 CARBIDOPA/LEVODOPA 25-250 TAB 10.4710 637 $ - 471002615 CARBIDOPA/LEVODOPA CR TAB 10.4710 637 $ - 471002616 CARBIDOPA/LEVODOPA 50/200 10.4710 637 $ - 471002640 CARBOPLATIN 50MG INJ 10.4710 636 $ - 471002645 CARBOPROST 250MCG INJ 10.4710 250 $ - 471002650 CARDIOPLEGIC SOL 3000ML 10.4710 250 $ - 471002660 CARISOPRODOL 350MG TAB 10.4710 637 $ - 471002670 CARMUSTINE 100MG INJ 10.4710 636 $ - 471002673 CARTEOLOL O.S. 5ML 10.4710 637 $ - 471002675 CARTEOLOL 2.5MG TAB 10.4710 637 $ - 471002790 CEFAZOLIN 1GM INJ 10.4710 636 $ 70.50 471002820 CEFAZOLIN 500MG INJ 10.4710 636 $ - 471002850 CEFOTAXINE 1GM INJ 10.4710 636 $ - 471002880 CEFOTAXIME 2GM INJ 10.4710 636 $ - 471002910 CEFOTETAN 1GM INJ 10.4710 250 $ - 471002930 CEFOTETAN 2GM INJ 10.4710 250 $ - 471002950 CEFOXITIN 1GM INJ 10.4710 636 $ - 471002970 CEFOXITIN 2GM INJ 10.4710 636 $ - 471002990 CEFPROZIL 250MG/5ML 100ML 10.4710 637 $ - 471003000 CEFTAZIDIME 1GM INJ 10.4710 636 $ - 471003030 CEFTAZIDIME 2GM INJ 10.4710 636 $ - 471003060 CEFTRIAXONE 1GM INJ 10.4710 636 $ - 471003061 CEFTRIAXONE 1GM / VIAL 10.4710 636 $ - 471003065 CEFTRIAXONE 2GM INJ / VIAL 10.4710 636 $ - 471003066 CEFTRIAXONE 2GM / VIAL 10.4710 636 $ - 471003070 CEFTRIAXONE 250MG INJ 10.4710 636 $ 99.00 471003075 CEFTRIAXONE 500MG INJ 10.4710 636 $ 179.50 471003080 CEFUROXIME 1.5GM INJ 10.4710 636 $ - 471003100 CEFUROXIME 1.5GM / VIAL 10.4710 636 $ - 471003107 CEFUROXIME 125MG/5ML 100ML 10.4710 637 $ - 471003110 CEFUROXIME 250MG TAB 10.4710 637 $ - 471003130 CEFUROXIME 750MG INJ 10.4710 636 $ - 471003160 THROAT LOZ ANESTHETIC 10.4710 637 $ - 471003190 CEPHALEXIN 250MG CAP 10.4710 637 $ - 471003200 CEPHALEXIN 250MG/5ML 100ML 10.4710 637 $ - 471003220 CEPHALEXIN 500MG CAP 10.4710 637 $ - 471003230 CERUMENEX OTIC 12ML 10.4710 637 $ - 471003240 CETACAINE SPRY 56GM 10.4710 637 $ - 471003250 CETAPHIL LOTION 480ML 10.4710 637 $ - 471003265 CHICKEN POX VACC INJ 10.4710 250 $ 86.00 471003270 CHLORAL HYDRATE 500MG CAP 10.4710 637 $ - 471003290 CHLORAMPHENICOL OPTH 15ML 10.4710 637 $ - 471003305 CHLORAMPHENICOL 1.25% IRR 20ML 10.4710 250 $ - 471003320 CHLORAMPHENICOL 1GM INJ 10.4710 636 $ - 471003340 CHLORASEPTIC LOZ 1 EA 10.4710 637 $ - 471003350 CHLORASEPTIC SPRY 180ML 10.4710 637 $ - 471003370 CHLORDIAZEPOXIDE 10MG CAP 10.4710 637 $ - 471003380 CHLORDIAZEPOXIDE 25MG CAP 10.4710 637 $ - 471003390 CHLORDIAZEPOXIDE 5MG CAP 10.4710 637 $ - 471003400 CHLORDIAZEPOXIDE/CLIDINIU CAP 10.4710 637 $ - 471003410 CHLORHEXIDINE RINSE 473ML 10.4710 637 $ - 471003415 CHLORHEXIDINE CLEANS 120ML 10.4710 637 $ - 471003425 CHLOROPROCAINE 1% MDV 30ML 10.4710 636 $ - 471003430 CHLOROPROCAINE 2% SDV 30ML 10.4710 636 $ - 471003440 CHLOROPROCAINE MPF 3% 30ML 10.4710 636 $ - 471003450 CHLOROQUINE 500MG TAB 10.4710 637 $ - 471003455 RAPAMUNE 1MG (SIROLIMUS) TAB 10.4710 637 $ - 471003460 CHLOROTHIAZIDE 250MG TAB 10.4710 637 $ - 471003480 CHLOROTHIAZIDE 500MG TAB 10.4710 637 $ - 471003485 CHLOROTHIAZIDE 500MG INJ 10.4710 636 $ - 471003490 CHLORPHENIRAMINE 2MG/5ML 118ML 10.4710 637 $ - 471003500 CHLORPHENIRAMINE 4MG TAB 10.4710 637 $ - 471003510 CHLORPHENIRAMINE SR 8MG CAP 10.4710 637 $ - 471003520 CHLORPROMAZINE 10MG TAB 10.4710 636 $ - 471003545 CHLORPROMAZINE 100MG SUPP 10.4710 637 $ - 471003550 CHLORPROMAZINE 25MG TAB 10.4710 637 $ - 471003560 CHLORPROMAZINE 10MG/5ML 120ML 10.4710 637 $ - 471003575 CHLORPROMAZINE 25MG/ML INJ 2ML 10.4710 636 $ - 471003590 CHLORPROMAZINE 50MG TAB 10.4710 637 $ - 471003600 CHLORPROPAMIDE 100MG TAB 10.4710 637 $ - 471003610 CHLORPROPAMIDE 250MG TAB 10.4710 637 $ - 471003635 CHLORTHALIDONE 25MG TAB 10.4710 637 $ - 471003640 CHLORTHALIDONE 50MG TAB 10.4710 637 $ - 471003650 CHLORZOXAZONE 500MG TAB 10.4710 637 $ - 471003660 CHOLESTRYAMINE 4GM PKT 10.4710 637 $ - 471003700 CIMETIDINE 1200MG/8ML INJ 10.4710 250 $ - 471003710 CIMETIDINE 200MG TAB 10.4710 637 $ - 471003720 CIMETIDINE 300MG TAB 10.4710 637 $ 17.50 471003725 CIMETIDINE 300MG INJ 10.4710 636 $ - 471003750 CIMETIDINE 300MG/NSS 50ML 10.4710 250 $ - 471003770 CIMETIDINE 800MG TAB 10.4710 637 $ - 471003780 CIPROFLOXACIN 250MG TAB 10.4710 637 $ - 471003790 CIPROFLOXACIN 500MG TAB 10.4710 637 $ - 471003803 CIPROFLOXACIN 200MG INJ 10.4710 636 $ - 471003805 CIPROFLOXACIN 400MG INJ 10.4710 636 $ - 471003822 CLADRIBINE 1MG/ML 10ML 10.4710 636 $ - 471003823 CLARITHROMYCIN 250MG TAB 10.4710 637 $ - 471003825 CLARITHROMYCIN 500MG TAB 10.4710 637 $ - 471003826 CLARITHROMYCIN 125MG/5ML 100ML 10.4710 637 $ - 471003827 CLARITHROMYCIN 250MG/5ML 100ML 10.4710 637 $ - 471003850 CLINDAMYCIN 150MG CAP 10.4710 637 $ - 471003860 CLINDAMYCIN 300MG INJ 10.4710 250 $ - 471003870 CLINDAMYCIN 600MG INJ 10.4710 250 $ - 471003880 CLINDAMYCIN 75MG/5ML SUS 100ML 10.4710 637 $ - 471003890 CLINDAMYCIN 900MG INJ 10.4710 250 $ - 471003910 CLOBETASOL 0.05% CRM 15GM 10.4710 637 $ - 471003916 CLOMPRAMINE 25MG CAP 10.4710 637 $ - 471003917 CLOMPRAMINE 50MG CAP 10.4710 637 $ - 471003918 CLOMIPRAMINE 75MG CAP 10.4710 637 $ - 471003920 CLONAZEPAM 0.5MG TAB 10.4710 637 $ - 471003930 CLONAZEPAM 1MG TAB 10.4710 637 $ - 471003940 CLONIDINE 0.1MG PATCH 10.4710 637 $ - 471003950 CLONIDINE 0.1MG TAB 10.4710 637 $ - 471003960 CLONIDINE 0.2MG PATCH 10.4710 637 $ - 471003970 CLONIDINE 0.2MG TAB 10.4710 637 $ - 471003980 CLONIDINE 0.3MG PATCH 10.4710 637 $ - 471003990 CLORAZEPATE 3.75MG TAB 10.4710 637 $ - 471004000 CLORAZEPATE 7.5MG TAB 10.4710 637 $ - 471004010 CLOTRIMAZOLE 100MG VAG TAB 10.4710 637 $ - 471004030 CLOTRIMAZOLE CRM 15GM 10.4710 637 $ - 471004040 CLOTRIMAZOLE SOL 10ML 10.4710 637 $ - 471004050 CLOTRIMAZOLE TROCHE 10MG 10.4710 637 $ - 471004060 CLOTRIMAZOLE VAG CRM 45GM 10.4710 637 $ - 471004070 CLOTRIMAZOLE/BETAMETHASONE 15G 10.4710 637 $ - 471004100 COCAINE 4% SOL 4ML 10.4710 250 $ - 471004120 COCCI SPHERULIN 1-10 0.1ML 10.4710 250 $ - 471004130 COCCI SPHERULIN 1-100 0.1ML 10.4710 250 $ - 471004140 CODEINE PHOS 30MG INJ 10.4710 636 $ - 471004150 CODEINE PHOS 30MG TAB 10.4710 637 $ - 471004160 CODEINE PHOS 60MG INJ 10.4710 636 $ - 471004170 CODEINE PHOS 60MG TAB 10.4710 637 $ - 471004180 COLCHICINE 0.5MG TAB 10.4710 637 $ - 471004190 COLCHICINE 0.6MG TAB 10.4710 637 $ - 471004200 COLCHICINE 1MG/2ML INJ 10.4710 636 $ - 471004210 COLCHICINE/PROBENECID 500 TAB 10.4710 637 $ - 471004220 COLESTIPOL PKT 5GM 10.4710 637 $ - 471004240 COLY-MYCIN OTIC SOLN 10ML 10.4710 637 $ - 471004250 CONJUGATED ESTROG 0.3MG TAB 10.4710 637 $ - 471004260 CONJUGATED ESTROG 0.625MG 10.4710 637 $ - 471004263 CONJUGATED ESTROG 0.9MG T 10.4710 637 $ - 471004270 CONJUGATED ESTROG 1.25MG 10.4710 637 $ - 471004280 CONJUGATED ESTROG 2.5MG T 10.4710 637 $ - 471004285 CONJUGATED ESTROG CRM 42.5GM 10.4710 637 $ - 471004287 CONJUGATED ESTROG 25MG/5ML 10.4710 636 $ - 471004300 CORTISONE 25MG TAB 10.4710 637 $ - 471004305 CORTISONE ACET 5MG TAB 10.4710 637 $ - 471004320 CORTISPORIN OINT 15GM 10.4710 637 $ - 471004330 CORTISPORIN OPTH 3.5GM 10.4710 637 $ - 471004332 GATIFLOXACIN 400MG TAB 10.4710 637 $ - 471004340 CORTISPORIN OPTH 7.5ML 10.4710 637 $ - 471004343 ANTIHEMOPHILIC FACTOR 8 1000U 10.4710 636 $ - 471004350 CORTISPORIN OTIC SOL 10ML 10.4710 637 $ - 471004370 COSYNTROPIN 0.25MG/ML INJ 10.4710 636 $ - 471004385 CREON-10 CAP 10.4710 637 $ - 471004410 CROMOLYN INH SOL UD 20MG/2ML 10.4710 250 $ - 471004420 CROMOLYN NASAL SOL 13ML 10.4710 637 $ - 471004430 CROMOLYN ORAL INHALER 8.1GM 10.4710 637 $ - 471004440 CYANOCOBAL. 1,000MCG INJ 10.4710 636 $ - 471004460 CYCLOBENZAPRINE 10MG TAB 10.4710 637 $ - 471004470 CYCLOMYDRIL OPTH SOL UD 2ML 10.4710 250 $ - 471004475 CYCLOMYDRIL OPTH SOL 5ML 10.4710 250 $ - 471004480 CYCLOPENTOLATE 1% OS 2ML 10.4710 250 $ - 471004490 CYCLOPENTOLATE 2% OS 5ML 10.4710 250 $ - 471004495 CYCLOPHOSPHAMIDE 25MG TAB 10.4710 636 $ - 471004500 CYCLOPHOSPHAMIDE 100MG INJ 10.4710 636 $ - 471004542 CYCLOSPORINE MICRO 25MG CAP 10.4710 636 $ - 471004544 CYCLOSPORINE MICRO 100MG CAP 10.4710 637 $ - 471004546 CYCLOSPORINE 25MG CAP 10.4710 636 $ - 471004548 CYCLOSPORINE 100MG CAP 10.4710 636 $ - 471004550 CYCLOSPORINE 50MG INJ 10.4710 636 $ - 471004555 CYPROHEPTADINE 4MG TAB 10.4710 637 $ - 471004556 ACEBUTOLOL(SECTRAL) 400MG CAP 10.4710 637 $ - 471004560 CYTARABINE 100MG INJ 10.4710 636 $ - 471004580 DACARBAZINE 100MG INJ 10.4710 636 $ - 471004600 IRRIGATING EYE WASH 120ML 10.4710 637 $ 16.50 471004610 DACTINOMYCIN 0.5MG INJ 10.4710 636 $ - 471004620 DAKIN'S SOL 1000ML 10.4710 637 $ - 471004630 DANTROLENE 20MG INJ 10.4710 250 $ - 471004633 DANTROLENE 25MG CAP 10.4710 637 $ - 471004635 DANTROLENE 50MG CAP 10.4710 637 $ - 471004637 DAPSONE 25MG TAB 10.4710 637 $ - 471004640 DAUNORUBICIN 20MG INJ 10.4710 636 $ - 471004642 DANAZOL 50MG CAP 10.4710 637 $ - 471004643 DANAZOL 100MG CAP 10.4710 637 $ - 471004644 DANAZOL 200MG CAP 10.4710 637 $ - 471004650 DEFEROXAMINE 500MG INJ 10.4710 636 $ - 471004680 DEMECLOCYCLINE 150MG TAB 10.4710 637 $ - 471004690 DEMECLOCYCLINE 300MG TAB 10.4710 637 $ - 471004695 DENTURE ADHESIVE CRM 75GM 10.4710 637 $ - 471004697 DENTURE CLEANSER TAB 10.4710 637 $ - 471004698 DORNASE ALFA INH SOLN 2.5ML 10.4710 637 $ - 471004780 DESIPRAMINE 100MG TAB 10.4710 637 $ - 471004781 DESIPRAMINE 10MG TAB 10.4710 637 $ - 471004790 DESIPRAMINE 25MG TAB 10.4710 637 $ - 471004800 DESIPRAMINE 50MG TAB 10.4710 637 $ - 471004805 DESITIN OINT 30GM 10.4710 637 $ - 471004810 DESMOPRESSIN 4MCG INJ 10.4710 636 $ - 471004815 DESMOPRESSIN 40MCG 10ML INJ 10.4710 636 $ - 471004820 DESMOPRESSIN NASAL 2.5ML 10.4710 637 $ - 471004825 DESONIDE 0.05% CRM 15GM 10.4710 637 $ - 471004830 DEXAMETHASONE 0.1% OS 5ML 10.4710 637 $ - 471004840 DEXAMETHASONE 0.5MG TAB 10.4710 637 $ - 471004850 DEXAMETHASONE 0.5MG/5ML LIQUID 10.4710 636 $ - 471004890 DEXAMETHASONE 1MG TAB 10.4710 636 $ - 471004900 DEXAMETHASONE 1MG/ML LIQ 30ML 10.4710 636 $ - 471004910 DEXAMETHASONE 20MG/5ML INJ 10.4710 636 $ 45.00 471004930 DEXAMETHASONE 4MG TAB 10.4710 636 $ - 471004940 DEXAMETHASONE 4MG/ML INJ 10.4710 636 $ 41.50 471004945 DEXAMETHASONE 4MG/ML INJ 10.4710 636 $ - 471004955 DEXTRAN 70 100ML 10.4710 250 $ - 471004960 DEXTROAMPHETAMINE 5MG TAB 10.4710 637 $ - 471004975 DEXTROSE 50% 50ML VIAL 10.4710 250 $ - 471004980 DEXTROSE 50% SYRG 50ML 10.4710 250 $ 45.00 471004990 DIAZEPAM 10MG TAB 10.4710 637 $ - 471005000 DIAZEPAM 2MG TAB 10.4710 637 $ - 471005010 DIAZEPAM 5MG TAB 10.4710 637 $ 23.00 471005020 DIAZEPAM INJ 10MG 10.4710 636 $ - 471005030 DIAZOXIDE 300MG INJ 10.4710 636 $ - 471005040 DIBUCAINE OINT 30GM 10.4710 637 $ - 471005050 DICLOFENAC 25MG TAB 10.4710 637 $ - 471005051 DICLOFENAC OPTH SOLN 2.5ML 10.4710 637 $ - 471005055 DICLOFENAC 50MG TAB 10.4710 637 $ - 471005056 DICLOFENAC 75MG TAB 10.4710 637 $ - 471005070 DICLOXACILLIN 250MG CAP 10.4710 637 $ - 471005080 DICLOXACILLIN 500MG CAP 10.4710 637 $ - 471005090 DICLOXACILLIN 62.5MG/5ML 100ML 10.4710 637 $ - 471005100 DICYCLOMINE 10MG CAP 10.4710 637 $ - 471005110 DICYCLOMINE 10MG/ML INJ 10.4710 636 $ - 471005120 DICYCLOMINE 20MG TAB 10.4710 637 $ - 471005150 DIFLUNISAL 250MG TAB 10.4710 637 $ - 471005160 DIFLUNISAL 500MG TAB 10.4710 637 $ - 471005170 DIGOXIN ELIX 50MCG/ML 60ML 10.4710 637 $ - 471005180 DIGOXIN 0.125MG TAB 10.4710 637 $ - 471005200 DIGOXIN 0.25MG TAB 10.4710 637 $ 5.00 471005210 DIGOXIN 0.5MG INJ 10.4710 636 $ 45.00 471005230 DIGOXIN IMMUNE FAB 40MG INJ 10.4710 636 $ - 471005240 DIHYDROERGOTAMINE 1MG/ML 10.4710 636 $ 46.00 471005255 DILTIAZEM 25MG INJ 10.4710 250 $ - 471005257 DILTIAZEM 50MG INJ 10.4710 250 $ - 471005260 DILTIAZEM 30MG TAB 10.4710 637 $ - 471005270 DILTIAZEM 60MG TAB 10.4710 637 $ - 471005280 DILTIAZEM 90MG TAB 10.4710 637 $ - 471005300 DILTIAZEM SR 60MG CAP 10.4710 637 $ - 471005310 DILTIAZEM SR 90MG CAP 10.4710 637 $ - 471005312 DILTIAZEM CD 180MG CAP 10.4710 637 $ - 471005314 DILTIAZEM CD 240MG CAP 10.4710 637 $ - 471005316 DILTIAZEM CD 300MG CAP 10.4710 637 $ - 471005340 DIMENHYDRINATE 50MG TAB 10.4710 637 $ - 471005382 DINOPROSTONE 20MG SUPP 10.4710 250 $ - 471005383 DINOPROSTONE 10MG INSERT 10.4710 250 $ - 471005387 DINOPROSTONE 0.5MG GEL 3GM 10.4710 250 $ - 471005400 DIPHENHYDRAMINE ELIX 12.5MG 10.4710 637 $ - 471005410 DIPHENHYDRAMINE 25MG CAP 10.4710 637 $ 4.00 471005430 DIPHENHYDRAMINE 50MG INJ 10.4710 636 $ 41.50 471005435 DIPHENHYDRAM CRM 15GM 10.4710 637 $ - 471005440 DIPHENHYDRAMINE SYRUP 12.5MG 10.4710 637 $ - 471005460 DIPHENOXY/ATROPINE 2.5MG TAB 10.4710 637 $ 12.00 471005470 DIPIVEFRIN 0.1% OS 5ML 10.4710 637 $ - 471005475 DPT VACC 5ML 10.4710 250 $ - 471005480 DIPTHERIA AND TETANUS 0.5ML 10.4710 636 $ - 471005485 DIPYRIDAMOLE 10MG INJ 10.4710 636 $ - 471005490 DIPYRIDAMOLE 25MG TAB 10.4710 637 $ - 471005520 DISOPYRAMIDE 100MG CAP 10.4710 637 $ - 471005530 DISOPYRAMIDE 150MG CAP 10.4710 637 $ - 471005540 DISOPYRAMIDE CR 100MG CAP 10.4710 637 $ - 471005550 DISOPYRAMIDE CR 150MG CAP 10.4710 637 $ - 471005555 DISULFIRAM 250MG TAB 10.4710 637 $ - 471005560 DIVALPROEX 250MG TAB 10.4710 637 $ - 471005570 DIVALPROEX 500MG TAB 10.4710 637 $ - 471005575 DIVALPROEX SPRINKLE 125MG 10.4710 637 $ - 471005580 DOBUTAMINE 250MG INJ 10.4710 636 $ - 471005585 DOBUTAMINE 250MG/D5W 250ML 10.4710 636 $ - 471005590 DOCUSATE CALCIUM 240MG CAP 10.4710 637 $ - 471005600 DOCUSATE SODIUM 100MG CAP 10.4710 637 $ - 471005610 DOCUSATE 20MG/5ML SYRUP 10.4710 637 $ - 471005620 DOCUSATE SODIUM 250MG CAP 10.4710 637 $ - 471005630 DOCUSATE 100MG/10ML LIQUID 10.4710 637 $ - 471005650 BURROWS EFF TAB 10.4710 637 $ - 471005670 DONNATAL ELIXIR 10ML 10.4710 637 $ 4.00 471005671 DONNATAL/LIDO/MYLANTA MIX 30ML 10.4710 637 $ 52.00 471005680 DONNATAL TAB 10.4710 637 $ - 471005700 DOPAMINE 400MG/5ML INJ 10.4710 636 $ - 471005701 DORZOLAMIDE OPTH SOL 5ML 10.4710 637 $ - 471005705 MEDTRONIC PUMP PROGRAMING FEE 10.4710 250 $ - 471005710 DOXAPRAM 400MG/20ML INJ 10.4710 250 $ - 471005713 DOXAZOSIN 2MG TAB 10.4710 637 $ - 471005730 DOXEPIN 10MG CAP 10.4710 637 $ - 471005740 DOXEPIN 150MG CAP 10.4710 637 $ - 471005750 DOXEPIN 25MG CAP 10.4710 637 $ - 471005760 DOXEPIN 50MG CAP 10.4710 637 $ - 471005780 DOXORUBICIN 10MG INJ 10.4710 636 $ - 471005810 DOXYCYCLINE 100MG INJ 10.4710 250 $ - 471005820 DOXYCYCLINE 100MG TAB 10.4710 637 $ - 471005840 DOXYCYCLINE 50MG CAP 10.4710 637 $ - 471005860 DRONABINOL 5MG CAP 10.4710 637 $ - 471005890 DROPERIDOL 25MG/10ML INJ 2ML 10.4710 636 $ - 471005900 DROPERIDOL 5MG/2ML INJ 10.4710 636 $ 46.50 471005920 ECONAZOLE 1% CRM 30GM 10.4710 637 $ - 471005940 EDROPHONIUM 10MG INJ 10.4710 250 $ - 471005950 EDROPHONIUM 150MG INJ 10.4710 250 $ - 471005955 ELASE OINT 10.4710 637 $ - 471005956 LIDOCAINE/PRILOCAINE CRM 30GM 10.4710 250 $ - 471005957 LIDO/PRILOCAINE CRM 5GM 10.4710 250 $ - 471005970 EMETROL SOL 118ML 10.4710 637 $ - 471005975 ENALAPRIL 1.25MG INJ 10.4710 250 $ - 471005980 ENALAPRIL 2.5MG INJ 10.4710 250 $ - 471005990 ENALAPRIL 10MG TAB 10.4710 637 $ - 471005995 ENALAPRIL 2.5MG TAB 10.4710 637 $ - 471006000 ENALAPRIL 5MG TAB 10.4710 637 $ - 471006030 ENEMA ADULT 133ML 10.4710 637 $ 20.00 471006040 ENEMA BISACODYL 37ML 10.4710 637 $ - 471006060 ENEMA CHILD 66.6ML 10.4710 637 $ - 471006070 EMEMA HYDROCORT 100MG/60ML 10.4710 637 $ - 471006075 ENEMA MESALAMINE 4GM/60ML 10.4710 637 $ - 471006080 ENEMA MINERAL OIL 133ML 10.4710 637 $ - 471006090 ENEMA POLYST SULFON 30GM/120ML 10.4710 250 $ - 471006105 ENOXAPARIN 30MG INJ 10.4710 636 $ - 471006180 EPHEDRINE 25MG CAP 10.4710 637 $ - 471006190 EPHEDRINE 50MG/ML INJ 10.4710 250 $ - 471006200 EPINEPHRINE 0.5% OS 15ML 10.4710 637 $ - 471006210 EPINEPHRINE 1MG SYRG 10.4710 250 $ - 471006220 EPINEPHRINE 1MG/ML INJ 10.4710 636 $ 10.00 471006230 EPINEPHRINE 30MG/30ML INJ 10.4710 636 $ - 471006235 EPINEPHRINE NASAL 30MG/30ML 10.4710 637 $ - 471006250 EPSOM SALT 1816GM 10.4710 637 $ - 471006260 ERGOCALCIFEROL DRPS 8MU/ML 60M 10.4710 637 $ - 471006265 ERGOLOID 1MG TAB 10.4710 637 $ - 471006270 METHERGINE 0.2MG INJ 10.4710 636 $ - 471006280 ERGONOVINE MALEATE 0.2MG 10.4710 637 $ - 471006290 ERGOTAMINE 2MG SL TAB 10.4710 637 $ - 471006300 ERGOTAMINE/CAFFEINE SUPP 10.4710 637 $ - 471006310 ERGOTAMINE/CAFFINE TAB 10.4710 637 $ - 471006335 ERYTHROMYCIN LACTOB 500MG 10.4710 636 $ - 471006350 ERYTHROMYCIN 200MG/5ML SUSP 10.4710 637 $ - 471006370 ERYTHRO BASE 250MG CAP 10.4710 637 $ - 471006410 ERYTHRO ETHYL 400MG TAB 10.4710 637 $ - 471006420 ERYTHROMYCIN 400MG/5ML SUSP 10.4710 637 $ - 471006430 ERYTHRO BASE 500MG TAB 10.4710 637 $ - 471006440 ERYTHROMYCIN OO 3.5GM 10.4710 637 $ - 471006450 ERYTHROMYCIN OPTH OINT UD 1GM 10.4710 637 $ 15.00 471006460 ERYTHROMYCIN/SULFISOXAZOL 5ML 10.4710 637 $ - 471006470 EPOETIN ALFA 2,000 UNIT 1ML 10.4710 636 $ - 471006480 EPOETIN ALFA 4,000 UNIT 1ML 10.4710 636 $ - 471006485 EPOETIN ALFA 10,000 UNIT 1ML 10.4710 636 $ - 471006490 ESMOLOL 10MG/ML INJ 10ML 10.4710 250 $ - 471006500 ESMOLOL 250MG/ML INJ 10ML 10.4710 250 $ - 471006510 ESTRADIOL 0.05 PATCH 10.4710 637 $ - 471006520 ESTRADIOL 0.1 PATCH 10.4710 637 $ - 471006530 ESTRADIOL 1MG TAB 10.4710 637 $ - 471006535 ESTRADIOL 2MG TAB 10.4710 637 $ - 471006545 ESTRADIOL CYPIONATE 25MG 10.4710 636 $ - 471006550 ESTRADIOL VALERATE 20MG/ML 10M 10.4710 636 $ - 471006560 ESTRADIOL VALERATE 40MG/ML 10M 10.4710 636 $ - 471006565 ESTROG/MEDROXY 0.625/2.5 TAB 10.4710 637 $ - 471006570 ESTRONE 0.75MG TAB 10.4710 637 $ - 471006580 ESTRONE 1.5MG TAB 10.4710 637 $ - 471006610 ETHACRYNIC ACID 50MG INJ 10.4710 250 $ - 471006625 ETHAMBUTOL 400MG TAB 10.4710 637 $ - 471006630 ETHIODOL INJ 10ML 10.4710 250 $ - 471006645 ETHOSUXIMIDE 250MG/5ML SUSP 10.4710 637 $ - 471006650 ETHYL CHLORIDE SPRY 105ML 10.4710 637 $ - 471006670 ETIDRONATE 200MG TAB 10.4710 637 $ - 471006680 ETIDRONATE 300MG INJ 6ML 10.4710 636 $ - 471006683 ETODOLAC 200MG CAP 10.4710 250 $ - 471006685 ETODOLAC 300MG CAP 10.4710 637 $ - 471006687 ETOMIDATE 2MG/ML 10ML INJ 10.4710 250 $ - 471006688 ETOMIDATE 2MG/ML 20ML INJ 10.4710 250 $ - 471006695 ETOPOSIDE 100MG/5ML 10.4710 636 $ - 471006700 ETOPOSIDE 50MG CAP 10.4710 636 $ - 471006710 EUCERIN OINT 120GM 10.4710 637 $ - 471006712 EUCERIN LOT 240ML 10.4710 637 $ - 471006723 FAMCICLOVIR 500MG TAB 10.4710 637 $ - 471006730 FAMOTIDINE 20MG TAB 10.4710 637 $ 19.00 471006740 FAMOTIDINE 20MG/2ML INJ 10.4710 250 $ - 471006765 FELODIPINE 5MG TAB 10.4710 637 $ - 471006780 FENOPROFEN 600MG TAB 10.4710 637 $ - 471006785 FENTANYL 25MCG/HR PATCH 10.4710 637 $ - 471006786 FENTANYL 50MCG/HR PATCH 10.4710 637 $ - 471006787 FENTANYL 75MCG/HR PATCH 10.4710 637 $ - 471006788 FENTANYL 100MCG/HR PATCH 10.4710 637 $ - 471006790 FENTANYL 1000MCG/20ML INJ 10.4710 636 $ - 471006800 FENTANYL 100MCG/2ML INJ 10.4710 636 $ - 471006810 FENTANYL 250MCG/5ML INJ 10.4710 636 $ - 471006840 FERROUS GLUC 325MG TAB 10.4710 637 $ - 471006890 FERROUS SULF DRPS 125MG/ML 10.4710 637 $ - 471006900 FERROUS SULF 325MG TAB 10.4710 637 $ - 471006903 FIBERCON TAB 500MG 10.4710 637 $ - 471006905 FILGRASTIM 300MCG INJ 10.4710 636 $ - 471006907 FINASTERIDE 5MG TAB 10.4710 637 $ - 471006910 FIORICET TAB 10.4710 637 $ - 471006940 FLAVOXATE 100MG TAB 10.4710 637 $ - 471006950 FLECAINIDE 100MG TAB 10.4710 637 $ - 471006960 FLECAINIDE 50MG TAB 10.4710 637 $ - 471006963 FLUCONAZOLE 100MG TAB 10.4710 637 $ - 471006966 FLUCONAZOLE 200MG INJ/NS 100ML 10.4710 636 $ - 471006970 FLUCYTOSINE 250MG CAP 10.4710 637 $ - 471006980 FLUCYTOSINE 500MG CAP 10.4710 637 $ - 471006985 FLUDARABINE 50MG INJ 10.4710 636 $ - 471006990 FLUDROCORTISONE 0.1MG TAB 10.4710 637 $ - 471006995 FLUMAZENIL 0.5MG INJ 10.4710 250 $ 363.00 471007000 FLUNISOLIDE NASAL 25ML 10.4710 637 $ - 471007010 FLUNISOLIDE ORAL INHALER 7GM 10.4710 636 $ - 471007015 FLUNISOLIDE-M ORAL INHALER 7GM 10.4710 637 $ - 471007020 FLUOCINOLONE CRM 15GM 10.4710 637 $ - 471007030 FLUOCINOLONE OINT 15GM 10.4710 637 $ - 471007040 FLUOCINONIDE .05% CRM 15GM 10.4710 637 $ - 471007043 FLUOCINONIDE .05% OINT 15GM 10.4710 637 $ - 471007045 FLOUCINONIDE-E CRM 15GM 10.4710 637 $ - 471007050 FLOUCINONIDE TOP SOL 60ML 10.4710 637 $ - 471007060 FLOURESCEIN 2% OS UD 1ML 10.4710 637 $ - 471007070 FLOURESCEIN OPTH STRIP 9MG 10.4710 637 $ - 471007075 FLOURESCEIN SODIUM 10% IN 5ML 10.4710 250 $ - 471007078 FLOURI-METHANE SPRAY 103ML 10.4710 637 $ - 471007080 FLOUROMETHOLONE 0.1% OS 5ML 10.4710 637 $ - 471007090 FLOUROMETHOLONE 0.25% OS 5ML 10.4710 637 $ - 471007111 FLUOROURACIL 500MG/10ML INJ 10.4710 636 $ - 471007115 FLUOXETINE 10MG CAP 10.4710 637 $ - 471007120 FLUOXETINE 20MG CAP 10.4710 637 $ - 471007125 PROZAC 20MG/5ML SYRUP 10.4710 637 $ - 471007130 FLUOXYMESTERONE 10MG TAB 10.4710 637 $ - 471007143 FLUPHENZINE 25MG/10ML IN 10.4710 250 $ - 471007150 FLUPHENAZINE 1MG TAB 10.4710 637 $ - 471007153 FLUPHENAZINE 2.5MG TAB 10.4710 637 $ - 471007160 FLURAZEPAM 15MG CAP 10.4710 637 $ - 471007170 FLURAZEPAM 30MG CAP 10.4710 637 $ - 471007180 FLURBIPROFEN 0.03% OS 2.5ML 10.4710 637 $ - 471007185 FLUTAMIDE 125MG CAP 10.4710 637 $ - 471007186 FLUTICASONE NASAL SPRAY 10.4710 637 $ - 471007188 FLUVASTATIN 20MG CAP 10.4710 637 $ - 471007190 FOLIC ACID 1MG TAB 10.4710 637 $ - 471007200 FOLIC ACID 50MG/10ML INJ 10.4710 250 $ - 471007205 FOSINOPRIL 10MG TAB 10.4710 637 $ - 471007207 FOSINOPRIL 20MG TAB 10.4710 637 $ - 471007210 FUROSEMIDE 100MG INJ 10.4710 636 $ - 471007220 FUROSEMIDE 10MG/ML ORAL 10.4710 250 $ - 471007230 FUROSEMIDE 20MG TAB 10.4710 637 $ - 471007240 FUROSEMIDE 20MG INJ 10.4710 636 $ 34.50 471007250 FUROSEMIDE 40MG TAB 10.4710 637 $ - 471007260 FUROSEMIDE 40MG INJ 10.4710 636 $ 34.50 471007290 GABAPENTIN 100MG CAP 10.4710 637 $ - 471007292 GABAPENTIN 400MG CAP 10.4710 637 $ - 471007293 GABAPENTIN 300MG CAP 10.4710 637 $ - 471007295 GANCICLOVIR 500MG INJ 10.4710 636 $ - 471007300 GAVISCON LIQ 10.4710 637 $ - 471007310 GAVISCON TAB 10.4710 637 $ - 471007320 GELFILM 10.4710 637 $ - 471007330 GELFOAM 100 SPONGE 10.4710 250 $ - 471007340 GELFOAM 7MM SPONGE 10.4710 250 $ - 471007355 GEMFIBROZIL 600MG TAB 10.4710 637 $ - 471007360 GENTAMICIN 0.1% CRM 15GM 10.4710 637 $ - 471007370 GENTAMICIN 20MG/2ML INJ 10.4710 636 $ - 471007380 GENTAMICIN 4MG INTRATHECAL 10.4710 250 $ - 471007400 GENTAMICIN 80MG VIAL 10.4710 636 $ 34.50 471007410 GENTAMICIN OO 3.5GM 10.4710 637 $ - 471007420 GENTAMICIN OS 5ML 10.4710 637 $ - 471007430 GLIPIZIDE 5MG TAB 10.4710 637 $ - 471007435 GLIPIZIDE XL 5MG TAB 10.4710 637 $ - 471007440 GLUCAGON 1MG INJ 10.4710 636 $ 387.00 471007460 GLYBURIDE 1.25MG TAB 10.4710 637 $ - 471007470 GLYBURIDE 2.5MG TAB 10.4710 637 $ - 471007475 GLYBURIDE 3MG TAB 10.4710 637 $ - 471007480 GLYBURIDE 5MG TAB 10.4710 637 $ - 471007481 GLYCERIN SUPP 10.4710 637 $ - 471007485 GLYCOPYRROLATE 0.2MG/ML I 10.4710 250 $ - 471007490 GLYCOPYRROLATE 4MG/20ML IN 10.4710 250 $ - 471007500 GLYCOPYRROLATE 1MG TAB 10.4710 637 $ - 471007510 GO-LYTELY 4000ML 10.4710 637 $ - 471007533 GOSERLIN 3.6MG IMPLANT 10.4710 636 $ - 471007535 GUAIFENESIN LA 600MG 10.4710 637 $ - 471007540 GUAIFENESIN DM 60ML 10.4710 637 $ - 471007550 GUAIFENESIN SYRUP 100MG/5ML 10.4710 637 $ - 471007560 GUAIFENESIN/COD SYRUP 10.4710 637 $ - 471007570 GUANABENZ ACET 4MG TAB 10.4710 637 $ - 471007577 GUANFACINE 1MG TAB 10.4710 637 $ - 471007600 HALOPERIDOL 1MG TAB 10.4710 637 $ - 471007620 HALOPERIDOL 2MG/ML ORAL 10.4710 637 $ - 471007630 HALOPERIDOL 5MG TAB 10.4710 637 $ - 471007640 HALOPERIDOL 5MG/ML INJ 10.4710 636 $ 88.00 471007650 HALOTHANE INH ANESTHESIA 250ML 10.4710 250 $ - 471007660 HCTZ 25MG TAB 10.4710 637 $ - 471007680 HCTZ/TRIAMTERENE 25/50 CAP 10.4710 637 $ - 471007685 HCTZ/TRIAMTERENE 37/25 TAB 10.4710 637 $ - 471007710 HEPARIN 1000U/ML 30 ML 10.4710 636 $ - 471007730 HEPARIN 10,000U/ML INJ 1ML 10.4710 636 $ - 471007750 HEPARIN 20,000U/ML INJ 1ML 10.4710 636 $ - 471007751 HEPARIN 25,000U/250ML 10.4710 636 $ - 471007755 HEPARIN 5,000U/ML INJ 10.4710 636 $ - 471007760 HEPARIN 5,000U/0.5ML SYRG 10.4710 636 $ - 471007780 HEPARIN 1,000UNITS/ML MDV 10ML 10.4710 636 $ - 471007790 HEPARIN 100U/ML 30ML INJ 10.4710 636 $ - 471007793 HEPARIN PF 100U/ML SDV 1ML 10.4710 636 $ - 471007805 HEPATITIS A VACC PED 0.5ML 10.4710 250 $ 11.00 471007806 HEPATITIS A VACC ADULT 1ML 10.4710 250 $ 49.50 471007810 HEPATITIS B IMMUNE GLOBULIN 10.4710 636 $ 59.00 471007822 HEPATITIS B VAC ADLT 20MCG/1ML 10.4710 636 $ - 471007825 HEXACHLOROPHENE CLEANSER 10.4710 637 $ - 471007828 HISTOPLASMIN INJ 0.1ML 10.4710 250 $ - 471007830 CHLORHEXIDINE CLEANS PKT 10.4710 637 $ - 471007835 HOMATROPINE 2% OS 5ML 10.4710 637 $ - 471007836 HOMATROPINE 5% OS 5ML 10.4710 637 $ - 471007855 VISCOAT INJ 0.5ML 10.4710 250 $ - 471007860 HYCODAN SYRP ML 5MG/5ML 10.4710 637 $ - 471007870 HYCODAN 5MG TAB 10.4710 637 $ - 471007880 HYDRALAZINE 10MG TAB 10.4710 637 $ - 471007890 HYDRALAZINE 20MG INJ 10.4710 636 $ - 471007900 HYDRALAZINE 25MG TAB 10.4710 637 $ - 471007915 LORTAB LIQUID 1ML 10.4710 637 $ - 471007920 HYDROCODONE/APAP 5/500MG TAB 10.4710 637 $ 17.00 471007925 HYDROCODONE/APAP 7.5/500MG TAB 10.4710 637 $ - 471007950 HYDROCORT 1% CRM 30GM 10.4710 637 $ - 471007960 HYDROCORT 1% OINT 30GM 10.4710 637 $ - 471007970 HYDROCORT 10% FOAM 20GM 10.4710 637 $ - 471007975 HYDROCORT LOTN 120ML 10.4710 637 $ - 471007990 HYDROCORTISONE 20MG TAB 10.4710 637 $ - 471008010 HYDROCORT SUCC 1GM INJ 10.4710 636 $ - 471008020 HYDROCORT SUCC 100MG INJ 10.4710 636 $ 45.00 471008040 HYDROCORT SUCC 500MG INJ 10.4710 636 $ - 471008060 PRAMOXINE HC FOAM 10GM 10.4710 637 $ - 471008090 HYDROMORPHONE 2MG INJ 10.4710 636 $ - 471008091 HYDROMORPHONE 1MG/ML SYRINGE 10.4710 250 $ - 471008100 HYDROMORPHONE 2MG TAB 10.4710 637 $ - 471008140 HYDROMORPHONE 4MG TAB 10.4710 637 $ - 471008145 HYDROMORPHONE 1MG/ML PCA 30ML 10.4710 250 $ - 471008147 5MG/ML HYDROMORPHONE PCA 30ML 10.4710 250 $ - 471008148 HYDROMORPHONE 10MG/ML PCA 30ML 10.4710 250 $ - 471008150 HYDROMORPHONE HP 10MG INJ 10.4710 250 $ - 471008160 HYDROMORPHONE HP 50MG INJ 10.4710 250 $ - 471008185 HYDROXYCHLOROQUINE 200MG 10.4710 637 $ - 471008190 HYDROXYUREA 500MG CAP 10.4710 636 $ - 471008200 HYDROXYZINE 100MG INJ 10.4710 636 $ - 471008210 HYDROXYZINE 10MG TAB 10.4710 637 $ - 471008220 HYDROXYZINE 10MG/5ML ELIXIR 10.4710 637 $ - 471008230 HYDROXYZINE 25MG CAP 10.4710 637 $ - 471008240 HYDROXYZINE 25MG INJ 10.4710 636 $ - 471008250 HYDROXYZINE 25MG/5ML SUSP 10.4710 637 $ - 471008270 HYDROXYZINE 50MG INJ 10.4710 636 $ 34.50 471008280 HYOSCYAMINE 0.125MG TAB 10.4710 637 $ 7.00 471008285 HYOSCYAMINE 0.375MG CAP 10.4710 637 $ - 471008290 HYOSCYAMINE 0.125MG/ML 15ML 10.4710 637 $ - 471008300 IBERET 500MG TAB 10.4710 637 $ - 471008310 IBERET-FOLIC 500 TAB 10.4710 637 $ - 471008320 IBUPROFEN 200MG TAB 10.4710 637 $ - 471008330 IBUPROFEN 400MG TAB 10.4710 637 $ - 471008340 IBUPROFEN 600MG TAB 10.4710 637 $ - 471008344 IBUTILIDE 0.1MG/ML 10ML SDV 10.4710 636 $ - 471008346 IDARUBICIN 5MG INJ 10.4710 636 $ - 471008355 IFOSFAMIDE 1GM INJ 10.4710 636 $ - 471008360 IMIPENEM-CILAST INJ 500MG 10.4710 636 $ - 471008370 IMIPRAMINE 10MG TAB 10.4710 637 $ - 471008380 IMIPRAMINE 25MG TAB 10.4710 637 $ - 471008400 IMMUNE GLOBULIN IV 5GM 50ML 10.4710 636 $ - 471008403 IMMUNE GLOBULIN IV 2.5GM 50ML 10.4710 636 $ - 471008405 IMMUNE GLOBULIN 2ML INJ 10.4710 636 $ - 471008407 IMMUNE GLOBULIN 10ML 10.4710 636 $ - 471008410 INDAPAMIDE 2.5MG TAB 10.4710 637 $ - 471008420 INDIGO CARMINE 5ML INJ 10.4710 250 $ - 471008424 INDOMETHACIN 1MG INJ 10.4710 250 $ - 471008425 INDOMETHACIN SUSP 25MG/5ML 10.4710 637 $ - 471008430 INDOMETHACIN 25MG CAP 10.4710 637 $ - 471008440 INDOMETHACIN 50MG CAP 10.4710 637 $ - 471008450 INDOMETHACIN 50MG SUPP 10.4710 637 $ - 471008460 INDOMETHACIN SR 75MG CAP 10.4710 637 $ - 471008465 INFLUENZA VACCINE 0.5ML 10.4710 636 $ 23.50 471008480 INSULIN HUMAN LENTE 10ML 10.4710 637 $ - 471008490 INSULIN HUMAN NPH 10ML 10.4710 637 $ 32.00 471008495 INSUL HUMAN NPH/REG 70/30 10ML 10.4710 637 $ - 471008499 INSULIN R 0-100U 10ML 10.4710 637 $ 32.00 471008500 INSULIN HUMAN REGULAR 10ML 10.4710 637 $ - 471008511 INSULIN ULTRA LENTE 10ML 10.4710 637 $ - 471008525 INTERFERON ALFA-2B 3MU 10.4710 636 $ - 471008526 INTERFERON ALFA-2B 5MU 10.4710 636 $ - 471008555 IODINE MILD TINCTURE 30ML 10.4710 637 $ - 471008556 IODINE STRONG SOL 60ML 10.4710 637 $ - 471008560 IPECAC SYRP 42MG 30ML 10.4710 250 $ 21.50 471008570 IPRATROPIUM ORAL INHALER 14GM 10.4710 637 $ - 471008575 IPRATROPIUM 0.5MG/2.5ML SOLN 10.4710 637 $ 25.50 471008576 IPRATROPIUM 0.06% NASAL 15ML 10.4710 637 $ - 471008580 IRON DEXTRAN 100MG INJ 10.4710 636 $ - 471008625 ISOETHARINE INH SOL 10ML 10.4710 250 $ - 471008635 ISOFLURANE INH ANESTHESIA 100M 10.4710 250 $ - 471008640 ISONIAZID 100MG TAB 10.4710 637 $ - 471008650 ISONIAZID 300MG TAB 10.4710 637 $ - 471008660 ISOPROTERENOL 1MG INJ 10.4710 250 $ - 471008680 ISOSORBIDE 10MG SL TAB 10.4710 637 $ - 471008710 ISOSORBINE 20MG TAB 10.4710 637 $ - 471008715 ISOSORBIDE MONO 20MG TAB 10.4710 637 $ - 471008717 ISOSORBIDE MONO 60MG TAB 10.4710 637 $ - 471008720 ISOSORBIDE 30MG TAB 10.4710 637 $ - 471008740 ISOSORBIDE 5MG SL TAB 10.4710 637 $ - 471008750 ISOSORBIDE 5MG TAB 10.4710 637 $ - 471008760 ISOSORBIDE TEMBIDS 40MG T 10.4710 637 $ - 471008765 ISOTRETINOIN 40MG CAP 10.4710 637 $ - 471008785 ISOXSUPRINE 10MG TAB 10.4710 637 $ - 471008786 ISOXSUPRINE 20MG TAB 10.4710 637 $ - 471008787 ISRADIPINE 2.5MG TAB 10.4710 637 $ - 471008795 ITRACONAZOLE 100MG CAP 10.4710 637 $ - 471008800 KANAMYCIN 1GM INJ 10.4710 636 $ - 471008850 KCL 10MEQ TAB 10.4710 637 $ - 471008856 FLUCONAZOLE 400MG/NS 200ML INJ 10.4710 636 $ - 471008877 TOBRAMYCIN 300MG/5ML INJ 10.4710 636 $ - 471008890 KCL 20MEQ LIQ 10.4710 637 $ - 471008910 KCL 20MEQ TAB 10.4710 637 $ - 471008920 KCL 25MEQ POWDER 10.4710 637 $ - 471008940 KCL 40MEQ LIQ 10.4710 637 $ - 471008970 KETAMINE 500MG INJ 10.4710 250 $ - 471008980 KETOCONAZOLE CRM 15GM 10.4710 637 $ - 471008985 KETOCONAZOLE SHAMPOO 120M 10.4710 637 $ - 471008990 KETOCONAZOLE 200MG TAB 10.4710 637 $ - 471008995 KETOPROFEN 50MG CAP 10.4710 637 $ - 471009000 KETOPROFEN 75MG CAP 10.4710 637 $ - 471009004 KETOROLAC INJ 15MG 10.4710 636 $ - 471009007 KETOROLAC 60MG INJ 10.4710 636 $ 88.00 471009008 KETOROLAC 0.5% O.S. 5ML 10.4710 637 $ - 471009010 L-THYROXINE 0.025MG TAB 10.4710 637 $ - 471009020 L-THYROXINE 0.05MG TAB 10.4710 637 $ - 471009023 L-THYROXINE 0.088MG TAB 10.4710 637 $ - 471009025 L-THYROXINE 0.125MG TAB 10.4710 637 $ - 471009030 L-THYROXINE 0.15MG TAB 10.4710 637 $ - 471009040 L-THYROXINE 0.1MG TAB 10.4710 637 $ - 471009050 L-THYROXINE 0.2MG TAB 10.4710 637 $ - 471009070 L-THYROXINE 200 MCG INJ 10.4710 250 $ - 471009080 L-THYROXINE 500MCG INJ 10.4710 250 $ - 471009090 LABETALOL 100MG INJ 10.4710 636 $ - 471009100 LABETALOL 100MG TAB 10.4710 637 $ - 471009120 LABETALOL 200MG TAB 10.4710 637 $ - 471009135 LACTASE TAB 10.4710 637 $ - 471009140 LACTOBACILLUS TAB 10.4710 250 $ - 471009143 LACTOBACILLUS PKT 10.4710 637 $ - 471009150 LACTULOSE SYRUP 10GM/15ML 10.4710 637 $ - 471009155 LAMIVUDINE 150MG TAB 10.4710 637 $ - 471009160 LAMPRENE 50MG CAP 10.4710 637 $ - 471009169 LANSOPRAZOLE 30MG CAP 10.4710 637 $ - 471009172 LANSINOH CRM .25OZ 10.4710 637 $ - 471009173 LANTISEPTIC OINT 70GM 10.4710 637 $ - 471009180 LEUCOVORIN 50MG INJ 10.4710 636 $ - 471009190 LEUCOVORIN 5MG TAB 10.4710 637 $ - 471009195 LEUCOVORIN 25MG TAB 10.4710 637 $ - 471009200 LEUKERAN 2MG TAB 10.4710 636 $ - 471009210 LEUPROLIDE 14MG KIT INJ 10.4710 636 $ - 471009215 LEUPROLIDE 3.75MG KIT 10.4710 636 $ - 471009219 LEVOBUNOLOL .25% OS 5ML 10.4710 637 $ - 471009220 LEVOBUNOLOL 0.5% OS 5ML 10.4710 637 $ - 471009230 LEVORPHANOL 2MG INJ 10.4710 250 $ - 471009250 LIDOCAINE 0.5% MDV 50ML 10.4710 250 $ - 471009260 LIDOCAINE 0.5% SDV 50ML 10.4710 250 $ - 471009280 LIDOCAINE 1% MDV 30ML 10.4710 250 $ - 471009285 LIDOCAINE 1% MDV 50ML 10.4710 250 $ - 471009290 LIDOCAINE 1% SDV 5ML 10.4710 250 $ - 471009300 LIDOCAINE 1% SDV STRL 30ML 10.4710 250 $ - 471009310 LIDOCAINE 1.5% AMP STRL 20ML 10.4710 250 $ - 471009320 LIDOCAINE 1.5% SDV 10ML 10.4710 250 $ - 471009330 LIDOCAINE 100MG SYRG 10.4710 636 $ - 471009340 LIDOCAINE PF 2% 5ML 10.4710 250 $ - 471009350 LIDOCAINE 2% MDV 50ML 10.4710 250 $ - 471009360 LIDOCAINE 2% SDV 10ML 10.4710 250 $ 38.50 471009370 LIDOCAINE 2GM SYRG 10.4710 250 $ - 471009380 LIDOCAINE 4% TOP 50ML 10.4710 250 $ 63.50 471009385 LIDOCAINE PF 4% 5ML INJ 10.4710 250 $ 23.00 471009400 LIDOCAINE JELLY 30ML 10.4710 250 $ - 471009430 LIDOCAINE UROJET 10ML JELLY 10.4710 250 $ - 471009440 LIDOCAINE VISC 100ML SOLN 10.4710 637 $ - 471009445 AVITENE WEB 70X35 MM 10.4710 272 $ - 471009450 LIDOCAINE VISC 2% UD 20ML LIQ 10.4710 637 $ 19.00 471009460 LIDOCAINE/EPI 0.5% MDV 50ML 10.4710 250 $ - 471009480 LIDOCAINE/EPI 1% MDV 50ML 10.4710 250 $ - 471009490 LIDOCAINE/EPI 1% SDV 30ML 10.4710 250 $ - 471009500 LIDOCAINE/EPI 1.5% AMP 30ML 10.4710 250 $ - 471009510 LIDOCAINE/EPI 1.5% SDV 30ML 10.4710 250 $ - 471009525 LIDOCAINE/EPI 2% MDV 50ML 10.4710 250 $ - 471009526 LOSARTAN 25MG TAB 10.4710 637 $ - 471009527 LOSARTAN 50MG TAB 10.4710 637 $ - 471009530 LIDOCAINE/EPI 2% SDV 20ML 10.4710 250 $ - 471009560 LIOTHYRONINE 25MCG 10.4710 637 $ - 471009567 ALBUTEROL SR 4MG TAB 10.4710 637 $ - 471009570 LIOTHYRONINE 5MCG TAB 10.4710 637 $ - 471009580 LISINOPRIL 10MG TAB 10.4710 637 $ - 471009590 LISINOPRIL 5MG TAB 10.4710 637 $ - 471009610 LITHIUM 300MG CAP 10.4710 637 $ - 471009615 LITHIUM SR 300MG TAB 10.4710 637 $ - 471009619 MAGIC / CLARKS MOUTH WASH 10.4710 637 $ - 471009620 LITHIUM 300MG/5ML 10.4710 637 $ - 471009625 LOMUSTINE 10MG CAP 10.4710 636 $ - 471009626 LOMUSTINE 40MG CAP 10.4710 637 $ - 471009630 LOPERAMIDE 2MG/10ML ELIX 10.4710 637 $ - 471009640 LOPERAMIDE 2MG CAP 10.4710 637 $ - 471009645 LORATADINE 10MG TAB 10.4710 637 $ - 471009647 LORAT/PSEUDO 10/240 TAB 10.4710 637 $ - 471009650 LORAZEPAM 0.5MG TAB 10.4710 637 $ - 471009660 LORAZEPAM 1MG TAB 10.4710 637 $ - 471009690 LORAZEPAM 2MG TAB 10.4710 637 $ - 471009720 LOVASTATIN 20MG TAB 10.4710 637 $ - 471009725 LOXAPINE 10MG CAP 10.4710 637 $ - 471009747 LUBRIDERM LOTN 300ML 10.4710 637 $ - 471009750 LYMPHAZURIN 1% INJ 5ML 10.4710 250 $ - 471009770 MAALOX PLUS 30ML SUSP 10.4710 637 $ - 471009780 MAALOX PLUS ES 30ML SUSP 10.4710 637 $ - 471009787 MULTIVITAMIN DROPS 50ML INFANT 10.4710 637 $ - 471009790 MAFENIDE CRM 57GM 10.4710 637 $ - 471009800 MAG CITRATE 300ML 10.4710 637 $ - 471009812 MAGNESIUM CHLOR 64MG TAB 10.4710 637 $ - 471009817 MAGNESIUM OXIDE 400MG TAB 10.4710 637 $ - 471009820 MAGNESIUM SULF 50% 2ML IN 10.4710 636 $ - 471009830 MAGNESIUM SULF 50% 10ML IN 10.4710 250 $ - 471009840 MANNITOL 12.5GM INJ 10.4710 250 $ - 471009850 MAPROTILINE 25MG TAB 10.4710 637 $ - 471009860 MAPROTILINE 50MG TAB 10.4710 637 $ - 471009870 MAXITROL 003.5GM OINT 10.4710 637 $ - 471009875 ANTICOAGULANT CPD SOLN 500ML 10.4710 250 $ - 471009880 MAXITROL OPHTH SUSP 5ML 10.4710 637 $ - 471009895 MMR VACC 10.4710 250 $ 59.50 471009900 MEBENDAZOLE 100MG TAB 10.4710 637 $ - 471009920 MECLIZINE 12.5MG TAB 10.4710 637 $ - 471009927 TRIAMCINOLONE HEXA 20MG/ML INJ 10.4710 636 $ - 471009930 MECLIZINE 25MG TAB 10.4710 637 $ - 471009935 MEDICATED LIP BALM 6GM OINT 10.4710 637 $ - 471009950 MEDROXYPROGEST 2.5MG TAB 10.4710 637 $ - 471009963 MEDROXYPROGEST 150MG INJ 10.4710 636 $ - 471009965 MEDROXYPROGESTERONE 400MG INJ 10.4710 636 $ - 471009968 MEDRYSONE OPTH SUSP 5ML 10.4710 637 $ - 471009969 MEDTRONIC PUMP KIT REFILL 10.4710 250 $ - 471009975 MEGESTROL 40MG/ML 10.4710 637 $ - 471009980 MEGESTROL 40MG TAB 10.4710 637 $ - 471009985 MELPHALAN INJ 50MG 10.4710 636 $ - 471009990 MELPHALAN 2MG TAB 10.4710 636 $ - 471009993 MENINGOCOCAL VACCINE 10.4710 250 $ 80.00 471009994 TPN FORMULA 1000ML INJ 10.4710 636 $ - 471009995 TPN 2000ML BAG 10.4710 250 $ - 471009996 TPN FORMULA 3000ML INJ 10.4710 636 $ - 471009997 MESNA 100MG/ML INJ/ 10ML 10.4710 636 $ - 471010000 MEPERIDINE 100MG INJ 10.4710 636 $ 34.50 471010010 MEPERIDINE 100MG TAB 10.4710 637 $ - 471010030 MEPERIDINE 10MG/ML PCA 30ML 10.4710 636 $ - 471010040 MEPERIDINE 25MG INJ 10.4710 636 $ - 471010050 MEPERIDINE 50MG INJ 10.4710 636 $ 34.50 471010060 MEPERIDINE 50MG TAB 10.4710 637 $ - 471010099 ZEMPLAR 2MCG INJECTION / 1ML 10.4710 636 $ - 471010105 MEPIVACAINE 1% 30ML SDV I 10.4710 250 $ - 471010110 MEPIVACAINE 1% 50ML MDV 10.4710 250 $ - 471010120 MEPIVACAINE 2% 20ML SDV I 10.4710 250 $ - 471010130 MEPIVACAINE 2% 50ML 10.4710 250 $ - 471010145 MEPROBAMATE 200MG TAB 10.4710 637 $ - 471010150 MEPROBAMATE 400MG TAB 10.4710 637 $ - 471010160 MERCAPTOPURINE 50MG TAB 10.4710 637 $ - 471010167 MESALAMINE 500MG SUPP 10.4710 637 $ - 471010168 MESALAMINE 400MG TAB 10.4710 637 $ - 471010169 MESALAMINE 250MG CAP 10.4710 637 $ - 471010170 METAPROTERENOL 10MG TAB 10.4710 637 $ - 471010180 METAPROTERENOL 10MG/5ML SYR 10.4710 637 $ - 471010190 METAPROTERENOL 20MG TAB 10.4710 637 $ - 471010200 METAPROTERENOL INH 50MG/1ML 10.4710 637 $ - 471010210 METAPROTERENOL INH SOL UD 10.4710 636 $ - 471010220 METAPROTERENOL ORAL INHAL 14GM 10.4710 637 $ - 471010230 METARAMINOL 10MG/ML INJ 10.4710 250 $ - 471010235 METFORMIN 500MG TAB 10.4710 637 $ - 471010236 METFORMIN 850MG TAB 10.4710 637 $ - 471010240 METHACHOLINE 100MG POWDER 10.4710 250 $ - 471010250 METHADONE 10MG INJ 10.4710 636 $ 95.50 471010260 METHADONE 10MG TAB 10.4710 637 $ - 471010270 METHADONE 5MG TAB 10.4710 637 $ - 471010275 METHAZOLAMIDE 50MG TAB 10.4710 637 $ - 471010280 METHENAMINE 1G TAB 10.4710 637 $ - 471010290 METHENAMINE 500MG TAB 10.4710 637 $ - 471010295 METHIMAZOLE 5MG TAB 10.4710 637 $ - 471010300 METHOCARBAMOL 100MG/ML INJ 10.4710 250 $ - 471010310 METHOCARBAMOL 500MG TAB 10.4710 637 $ - 471010320 METHOCARBAMOL 750MG TAB 10.4710 637 $ - 471010330 MEHTOHEXITAL 100MG SYRINGE 10.4710 636 $ - 471010340 METHOTREXATE 100MG INJ 10.4710 636 $ - 471010350 METHOTREXATE 2.5MG TAB 10.4710 636 $ - 471010360 METHOTREXATE 200MG INJ 10.4710 636 $ - 471010365 METHOTREXATE 20MG INJ 10.4710 636 $ - 471010380 INJ 10.4710 636 $ - 471010385 METHOTREXATE 1GM INJ 10.4710 636 $ - 471010400 METHYCLOTHIAZIDE 5MG TAB 10.4710 637 $ - 471010420 METHYLCELLULOSE PKT 10.4710 637 $ - 471010430 METHYLDOPA 250MG INJ 10.4710 250 $ - 471010440 METHYLDOPA 250MG TAB 10.4710 637 $ - 471010470 METHYLDOPA 500MG TAB 10.4710 637 $ - 471010500 METHYLENE BLUE 10ML INJ 10.4710 636 $ - 471010510 METHYLENE BLUE 1ML INJ 10.4710 636 $ - 471010535 METHYLPHENIDATE 20MG TAB 10.4710 637 $ - 471010540 METHYLPHENIDATE 10MG TAB 10.4710 637 $ - 471010550 METHYLPHENIDATE 5MG TAB 10.4710 637 $ - 471010560 METHYLPRED ACET 40MG INJ 10.4710 636 $ - 471010570 METHYLPRED ACET 80MG INJ 10.4710 636 $ 93.50 471010580 METHYLPRED SUCC 1000MG INJ 10.4710 250 $ - 471010590 METHYLPRED SUCC 125MG INJ 10.4710 636 $ 45.00 471010600 METHYLPRED SUCC 40MG INJ 10.4710 636 $ 45.00 471010610 METHYLPRED SUCC 500MG INJ 10.4710 250 $ - 471010620 METHYLPREDNISOLONE 4MG TAB 10.4710 637 $ - 471010625 METHYLTESTOSTERONE 10MG TAB 10.4710 637 $ - 471010630 METHYSERGIDE 2MG TAB 10.4710 637 $ - 471010640 METOCLOPRAMIDE 20MG INJ 10.4710 636 $ 41.50 471010650 METOCLOPRAMIDE 10MG TAB 10.4710 637 $ 7.00 471010680 METOCLOPRAMIDE 5MG/5ML SYR 10.4710 637 $ - 471010700 METOLAZONE 10MG TAB 10.4710 637 $ - 471010710 METOLAZONE 2.5MG TAB 10.4710 637 $ - 471010720 METOLAZONE 5MG TAB 10.4710 637 $ - 471010730 METOPROLOL 100MG TAB 10.4710 637 $ - 471010740 METOPROLOL 50MG TAB 10.4710 637 $ 9.00 471010744 METOPROLOL XL 50MG TAB 10.4710 637 $ - 471010745 METOPROLOL XL 100MG TAB 10.4710 637 $ - 471010746 METOPROLOL XL 200MG TAB 10.4710 637 $ - 471010750 METOPROLOL 5MG/5ML INJ 10.4710 250 $ - 471010760 METRONIDAZOLE 250MG TAB 10.4710 637 $ - 471010765 METRONIDAZOLE GEL 45GM 10.4710 637 $ - 471010770 METRONIDAZOLE 500MG INJ 10.4710 250 $ - 471010780 METRONIDAZOLE 500MG/NS 100 ML 10.4710 250 $ - 471010790 METRONIDAZOLE 500MG TAB 10.4710 637 $ - 471010800 METYRAPONE 250MG CAP 10.4710 637 $ - 471010815 MEXILETINE 150MG CAP 10.4710 637 $ - 471010820 MEXILETINE 200MG CAP 10.4710 637 $ - 471010830 MEXILETINE 250MG CAP 10.4710 637 $ - 471010880 MICONAZOLE 100MG VAG SUPP 10.4710 637 $ - 471010900 MICONAZOLE 200MG VAG SUPP 10.4710 637 $ - 471010910 MICONAZOLE CRM 30GM 10.4710 637 $ - 471010930 MICONAZOLE CRM 45GM 10.4710 637 $ - 471010970 MIDAZOLAM 25MG/5ML INJ 10.4710 636 $ - 471010980 MIDAZOLAM 2MG/2ML INJ 10.4710 636 $ - 471010990 MIDAZOLAM 50MG/10ML INJ 10.4710 636 $ - 471011000 MIDAZOLAM 5MG/5ML INJ 10.4710 636 $ - 471011010 MIDAZOLAM 5MG/ML INJ 10.4710 636 $ 45.50 471011015 MIDRIN CAP 10.4710 637 $ - 471011020 MILK OF MAGNESIA 10ML SUSP 10.4710 637 $ 8.00 471011025 MILK OF MAGNESIA TAB 325MG 10.4710 637 $ - 471011040 MINERAL OIL STERILE 10ML 10.4710 250 $ - 471011050 MINERAL OIL STERILE 10ML 10.4710 250 $ - 471011065 MINOCYCLINE 50MG CAP 10.4710 637 $ - 471011067 MINOCYCLINE 100MG CAP 10.4710 637 $ - 471011070 MINOXIDIL 2.5MG TAB 10.4710 637 $ - 471011075 MINOXIDIL 10MG TAB 10.4710 637 $ - 471011100 MITOMYCIN 5MG INJ 10.4710 636 $ - 471011113 MIVACURIUM 20MG INJ 10.4710 250 $ - 471011118 MOMETASONE 0.1% CRM 15GM 10.4710 637 $ - 471011120 MORPHINE 10MG INJ 10.4710 636 $ 34.50 471011170 MORPHINE 300MG/20ML INJ 10.4710 250 $ - 471011190 MORPHINE 4MG INJ 10.4710 636 $ - 471011220 MORPHINE CR 30MG TAB 10.4710 637 $ - 471011225 MORPHINE CR 15GM TAB 10.4710 637 $ - 471011230 MORPHINE CR 60MG TAB 10.4710 637 $ - 471011240 MORPHINE CR 100MG TAB 10.4710 637 $ - 471011260 MORPHINE MIX 2MG/ML 1ML LIQ 10.4710 637 $ - 471011267 MORPHINE 20MG/ML SOLN 10.4710 637 $ - 471011270 MORPHINE PCA 1MG/ML INJ 30ML 10.4710 250 $ - 471011275 MORPHINE PCA 5MG/ML INJ 30ML 10.4710 250 $ - 471011280 MORPHINE PF 10MG/10ML INJ 10.4710 636 $ - 471011310 MORPHINE PF 5MG/10ML INJ 10.4710 636 $ - 471011315 MORPHINE PF 200MG/20ML IN 10.4710 636 $ - 471011318 MORPHINE 500MG/20ML INJ 10.4710 636 $ - 471011319 MORPHINE FOR INHAL 10MG/ML SOL 10.4710 250 $ - 471011340 MULTIVITAMIN INJ 5ML 10.4710 250 $ - 471011360 MULTIVITAMIN PED INJ 10.4710 250 $ - 471011400 MULTIVITAMIN/MINERAL TAB 10.4710 637 $ - 471011415 MUMPS SKIN TEST 40UNIT/ML 10.4710 250 $ - 471011427 NABUMETONE 500MG TAB 10.4710 637 $ - 471011430 NACL 0.9% IRRIGATION 1000 ML 10.4710 250 $ - 471011460 NADOLOL 40MG TAB 10.4710 637 $ - 471011475 NAFCILLIN 500MG INJ 10.4710 250 $ - 471011480 NAFCILLIN 1GM INJ 10.4710 250 $ - 471011510 NAFCILLIN 2GM INJ 10.4710 250 $ - 471011540 NALBUPHINE 10MG INJ 10.4710 636 $ 41.50 471011590 NALOXONE 0.4MG/ML INJ 10.4710 250 $ 41.50 471011593 NALOXONE 2MG SYRG 10.4710 636 $ - 471011615 NAPHAZOLINE .1% O.S. 15ML 10.4710 637 $ - 471011617 NAPHAZOLINE/ANTAZ O.S. 15ML 10.4710 637 $ - 471011620 NAPHAZOLIN PHEN O.S. 15ML 10.4710 250 $ - 471011630 NAPROXEN 250MG TAB 10.4710 637 $ - 471011675 NEDOCROMIL ORAL INH 16.2GM 10.4710 637 $ - 471011676 NEFAZODONE 150MG TAB 10.4710 637 $ - 471011677 NEFAZODONE 100MG TAB 10.4710 637 $ - 471011690 NEOMYCIN 500MG TAB 10.4710 637 $ - 471011710 NEOSPORIN OINT 15GM 10.4710 637 $ - 471011720 NEOSPORIN OINT PKT 10.4710 637 $ 7.00 471011730 NEOSPORIN OO 3.5GM 10.4710 637 $ - 471011745 NEOSPORIN GU IRRIGANT 10.4710 250 $ - 471011750 NEOSTIGMINE 1/1000 INJ 1MG/ML 10.4710 636 $ - 471011760 NEOSTIGMINE 1/2000 INJ .5MG/ML 10.4710 250 $ - 471011775 NEUTRA PHOS PKT 10.4710 637 $ - 471011785 NEUTRA PHOS K PKT 10.4710 637 $ - 471011790 NIACIN 100MG TAB 10.4710 637 $ - 471011799 PHARMACY ITEM TO FACILITY 10.4710 250 $ - 471011830 NICARDIPINE 20MG CAP 10.4710 637 $ - 471011840 NICARDIPINE 30MG CAP 10.4710 637 $ - 471011850 NICOTINE 2MG GUM 10.4710 637 $ - 471011855 NICOTINE 7MG/DAY PATCH 10.4710 637 $ - 471011856 NICOTINE 14MG/DAY PATCH 10.4710 637 $ - 471011857 NICOTINE 21MG/DAY PATCH 10.4710 637 $ - 471011860 NIFEDIPINE 10MG CAP 10.4710 637 $ 10.50 471011880 NIFEDIPINE XL 30MG TAB 10.4710 637 $ - 471011890 NIFEDIPINE XL 60MG TAB 10.4710 637 $ - 471011897 ZYPREXA ZYDIS 5MG TAB 10.4710 637 $ - 471011900 NIMODIPINE 30MG CAP 10.4710 637 $ - 471011920 NITROFURANTOIN 100MG CAP 10.4710 637 $ - 471011930 NITROFURANTOIN 25MG/5ML 10.4710 637 $ - 471011960 NITROGLYCERIN 0.4MG PATCH 10.4710 637 $ - 471011965 NITROGLYCERIN 0.3MG PATCH 10.4710 637 $ - 471011980 NITROGLYCERIN 0.1MG PATCH 10.4710 637 $ - 471011990 NITROGLYCERIN 50MG INJ 10.4710 250 $ - 471012000 NITROGLYCERIN 0.2MG PATCH 10.4710 637 $ - 471012030 NITROGLYCERIN OINT 30GM 10.4710 637 $ - 471012040 NITROGLYCERIN OINT UD 1 INCH 10.4710 637 $ - 471012060 NITROGLYCERIN 0.4MG TABLET 10.4710 637 $ 5.00 471012065 NITROGLYCERIN 0.6MG 10.4710 637 $ - 471012070 NITROGLYCERIN SPRY 14.4GM 10.4710 637 $ - 471012080 NITROGLYCERIN SR 2.5MG CA 10.4710 637 $ - 471012090 NITROGLYCERIN SR 6.5MG CA 10.4710 637 $ - 471012100 NITROGLYCERIN SR 9MG CAP 10.4710 637 $ - 471012110 NITROPRUSSIDE 50MG INJ 10.4710 250 $ - 471012120 NOREPINEPHRINE 4MG INJ 10.4710 250 $ - 471012130 NORTRIPTYLINE 10MG CAP 10.4710 637 $ - 471012140 NORTRIPTYLINE 25MG CAP 10.4710 637 $ - 471012190 NYSTATIN 500,000U TAB 10.4710 637 $ - 471012200 NYSTATIN CRM 15GM 10.4710 637 $ - 471012210 NYSTATIN OINT 15GM 10.4710 637 $ - 471012220 NYSTATIN SUSP 500MU/5ML 60ML 10.4710 637 $ - 471012230 NYSTATIN PWD 15GM 10.4710 637 $ - 471012240 NYSTATIN VAGINAL TAB 100MU 10.4710 637 $ - 471012250 NYSTATIN/TRIA CRM 15GM 10.4710 637 $ - 471012260 NYSTATIN/TRIAM OINT 15GM 10.4710 637 $ - 471012270 NASAL MOISTURIZING SPRY 45ML 10.4710 637 $ - 471012274 OCTREOTIDE 0.05MG/ML 10.4710 636 $ - 471012275 OCTREOTIDE 0.1MG/ML INJ 10.4710 636 $ - 471012276 OCTREOTIDE 200MCG INJ 10.4710 636 $ - 471012277 OCTREOTIDE ACET 0.5MG INJ 10.4710 636 $ - 471012278 OFLOXACIN O.S. 5ML 10.4710 637 $ - 471012285 OLSALAZINE 250MG CAP 10.4710 637 $ - 471012289 OMEPRAZOLE 10MG CAP 10.4710 637 $ - 471012290 OMEPRAZOLE 20MG CAP 10.4710 637 $ - 471012291 ONDANSETRON 32MG/DSW 50ML 10.4710 636 $ - 471012292 ONDANSETRON 8MG TAB 10.4710 637 $ 110.50 471012293 ONDANSETRON 2MG/ML INJ 10.4710 636 $ - 471012294 ONDANSETRON 4MG INJ 10.4710 636 $ - 471012295 ORAL PROTECTIVE PASTE 5GM 10.4710 637 $ - 471012296 ONDANSETRON 4MG TABLET 10.4710 250 $ - 471012297 ONDANSETRON 2MG/ML 20ML INJ 10.4710 636 $ - 471012305 ORTHOCLONE 5MG INJ 10.4710 636 $ - 471012325 OXAPROZIN 600MG TAB 10.4710 637 $ - 471012380 OXTRIPHYLLINE SA 400MG TA 10.4710 637 $ - 471012410 OXYBUTYNIN 5MG TAB 10.4710 637 $ - 471012420 OXYBUTYNIN 5MG/5ML SYRUP 10.4710 637 $ - 471012425 OXYCHLOROSENE 2GM POWDER 10.4710 250 $ - 471012430 OXYCODONE/ACETAMINOPHEN TAB 10.4710 637 $ 12.00 471012440 OXYCODONE/ASPIRIN TAB 10.4710 637 $ - 471012460 OXYMETAZOLONE SPRY 15ML 10.4710 637 $ 12.00 471012470 OXYTOCIN 10U INJ 10.4710 250 $ 75.00 471012476 PACLITAXEL 30MG INJ 10.4710 636 $ - 471012477 PAMIDRONATE 30MG INJ 10.4710 636 $ - 471012480 PANCREASE CAP 10.4710 637 $ - 471012485 PANCREASE MT-4 CAP 10.4710 637 $ - 471012490 PANCREASE MT-16 CAP 10.4710 637 $ - 471012504 PANCURONIUM 4MG/2ML INJECTION 10.4710 250 $ - 471012520 PAPAVERINE 150MG CAP 10.4710 637 $ - 471012530 PAPAVERINE 60MG INJ 10.4710 636 $ - 471012540 PAREGORIC LIQ 0.4MG/ML 10.4710 637 $ - 471012545 PAROXETINE 20MG TAB 10.4710 637 $ - 471012570 PEN G/BENZATHINE 1200MU INJ 10.4710 636 $ 51.00 471012575 PEN G/BENZATHINE 2400MU INJ 10.4710 636 $ - 471012580 PEN G/BENZATHINE 600MU INJ 10.4710 636 $ - 471012590 PEN G/PROCAINE 1.2MU INJ 10.4710 636 $ 119.00 471012610 PROCAINE PEN G 600,000U INJ 10.4710 636 $ - 471012620 PEN G/PROCAINE/BENZ 1200MU INJ 10.4710 636 $ - 471012640 BICILLIN CR 1200MU/2ML INJ 10.4710 636 $ 56.00 471012650 PENICILLAMINE 125MG CAP 10.4710 637 $ - 471012660 PENICILLAMINE 250MG CAP 10.4710 637 $ - 471012680 PENICILLIN 250MG/5ML 100ML 10.4710 637 $ - 471012690 PENICILLIN G 1,000,000U INJ 10.4710 636 $ - 471012697 PENICILLIN G 5,000,000U INJ 10.4710 636 $ - 471012710 PENICILLIN VK 250MG TAB 10.4710 637 $ - 471012720 PENICILLIN VK 500MG TAB 10.4710 637 $ - 471012750 PENTAMIDINE 300MG INJ 10.4710 250 $ - 471012780 PENTAZOCINE-NX TAB 10.4710 637 $ - 471012840 PENTOBARBITAL 50MG/ML INJ 10.4710 250 $ - 471012850 PENTOXIFYLLINE 400MG TAB 10.4710 637 $ - 471012860 PEPTO BISMOL 26MG/15ML SUSP 10.4710 637 $ - 471012863 PERDIEM GRANS 250GM 10.4710 250 $ - 471012865 PERFUSION PRIME SOL 1000ML 10.4710 250 $ - 471012868 PERGOLIDE 0.25MG TAB 10.4710 637 $ - 471012869 PERGOLIDE 0.05MG TAB 10.4710 637 $ - 471012870 PERGOLIDE 1MG TAB 10.4710 637 $ - 471012875 PERMETHRIN 5% CRM 60GM 10.4710 637 $ - 471012876 PERPHENAZINE 2MG TAB 10.4710 636 $ - 471012890 PHENAZOPYRIDINE 100MG TAB 10.4710 637 $ - 471012900 PHENAZOPYRIDINE 200MG TAB 10.4710 637 $ - 471012905 PHENELZINE 15MG TAB 10.4710 637 $ - 471012910 PHENOBARBITAL 100MG TAB 10.4710 637 $ - 471012920 PHENOBARBITAL 130MG/INJ 10.4710 250 $ - 471012930 PHENOBARBITAL 15MG TAB 10.4710 637 $ - 471012950 PHENOBARBITAL 30MG TAB 10.4710 637 $ - 471012970 PHENOBARBITAL 60MG TAB 10.4710 637 $ - 471012990 PHENOBARBITAL 65MG INJ 10.4710 250 $ - 471012999 PERPHENAZINE 4MG TAB 10.4710 637 $ - 471013010 PHENOXYBENZAMINE 10MG CAP 10.4710 637 $ - 471013020 PHENTOLAMINE 5MG INJ 10.4710 250 $ - 471013035 PHENOL LIQUIFIED 10.4710 250 $ - 471013040 PHENYLEPHRINE 1% 15ML 10.4710 637 $ - 471013050 PHENYLEPHRINE 10% OS 5ML 10.4710 250 $ - 471013055 PHENYLEPHRINE 10% O.S. UD 1ML 10.4710 250 $ - 471013060 PHENYLEPHRINE 10MG INJ 10.4710 636 $ - 471013070 PHENYLEPHRINE 2.5% OS 15ML 10.4710 250 $ - 471013075 PHENYLEPHRINE .25% SPRY 15ML 10.4710 637 $ - 471013076 PHENYLEPHRINE .5% SPRY 15ML 10.4710 637 $ - 471013080 PHENYTOIN 100MG CAP 10.4710 637 $ - 471013090 PHENYTOIN 100MG INJ 10.4710 250 $ - 471013100 PHENYTOIN 125MG/5ML SUSP 10.4710 637 $ - 471013110 PHENYTOIN 250MG/5ML INJ 10.4710 250 $ - 471013120 PHENYTOIN 30MG CAP 10.4710 637 $ - 471013140 PHENYTOIN 50MG TAB CHEW 10.4710 637 $ - 471013165 PHOSPHO SODA 3OZ 10.4710 637 $ - 471013170 PHYSOSTIGMINE 2MG INJ 10.4710 250 $ - 471013180 PILOCARPINE 0.25% OS 15ML 10.4710 637 $ - 471013190 PILOCARPINE 0.5% OS 15ML 10.4710 637 $ - 471013200 PILOCARPINE 1% OS 15ML 10.4710 637 $ - 471013210 PILOCARPINE 2% OS 15ML 10.4710 637 $ - 471013220 PILOCARPINE 3% OS 15ML 10.4710 637 $ - 471013230 PILOCARPINE 4% HS GEL 4GM 10.4710 637 $ - 471013240 PILOCARPINE 4% OS 15ML 10.4710 637 $ - 471013260 PILOCARPINE 6% OS 15ML 10.4710 637 $ - 471013270 PILOCARPINE 8% OS 15ML 10.4710 637 $ - 471013280 PINDOLOL 10MG TAB 10.4710 637 $ - 471013290 PINDOLOL 5MG TAB 10.4710 637 $ - 471013294 PIPERACIL/TAZO 3.375GM INJ 10.4710 636 $ 112.05 471013330 PIROXICAM 10MG CAP 10.4710 637 $ - 471013340 PIROXICAM 20MG CAP 10.4710 637 $ - 471013380 PNEUMOCOCCAL VACCINE INJ 0.5ML 10.4710 636 $ 20.50 471013384 POLIO INJ VACC. 0.5ML 10.4710 250 $ 35.00 471013390 POLYCITRA SYRUP110MG/ML 10.4710 637 $ - 471013400 POLYCITRA K SYRUP 220MG/ML 10.4710 637 $ - 471013420 POLYMYXIN B 500,000U VIAL 10.4710 250 $ - 471013430 POLYSTYRENE PWD 4TSP/15GM 10.4710 637 $ - 471013435 POLYSTYR SULF SUS 15GM UD 60ML 10.4710 637 $ - 471013445 POLYTRIM OPTH SOL 10ML 10.4710 637 $ - 471013460 POTASSIUM ACET INJ 2MEQ/ML 10.4710 250 $ - 471013470 POTASSIUM CHLOR 10MEQ CAP 10.4710 637 $ - 471013480 POTASSIUM CHLOR 20MEQ INJ 10.4710 250 $ - 471013490 POTASSIUM CHLOR 30MEQ INJ 10.4710 636 $ - 471013500 POTASSIUM CHLOR 40MEQ INJ 10.4710 250 $ - 471013520 POTASSIUM CHLOR 8MEQ TAB 10.4710 637 $ - 471013530 POTASSIUM PHOS INJ 10.4710 250 $ - 471013540 POTASSIUM PHOS NEUTRAL TAB 10.4710 637 $ - 471013550 POTASSIUM PHOS TAB 10.4710 637 $ - 471013555 POTASSIUM IODIDE 30ML 10.4710 637 $ - 471013570 POVIDONE IOD OINT 30GM 10.4710 637 $ - 471013580 POVIDONE IODINE OINT PKT 10.4710 637 $ - 471013590 POVIDONE IOD CLEANSE 120ML 10.4710 637 $ - 471013600 POVIDONE IOD SHAMPOO 120ML 10.4710 637 $ - 471013610 POVIDONE IOD SOLN 120ML 10.4710 637 $ 15.50 471013615 POVIDONE IOD 5% O.S. 50ML 10.4710 250 $ - 471013620 PRALIDOXIME 1GM INJ 10.4710 250 $ - 471013625 PRAMOXINE HC CRM 30GM 10.4710 637 $ - 471013630 PRAMOXINE FOAM 15GM 10.4710 637 $ - 471013633 PRAVASTATIN 10MG TAB 10.4710 637 $ - 471013634 PRAVASTATIN 20MG TAB 10.4710 637 $ - 471013635 PRAZEPAM 5MG CAP 10.4710 250 $ - 471013640 PRAZOSIN 1MG CAP 10.4710 637 $ - 471013650 PRAZOSIN 2MG CAP 10.4710 637 $ - 471013660 PRAZOSIN 5MG CAP 10.4710 637 $ - 471013670 PREDNISONE 1MG/1ML 30ML ELIX 10.4710 637 $ - 471013675 PREDNISOLONE 15MG/5ML SYRUP 10.4710 637 $ - 471013680 PREDNISOLONE 0.12% OS 5ML 10.4710 637 $ - 471013690 PREDNISOLONE 1% O.S. 5ML 10.4710 637 $ - 471013700 PREDNISOLONE PHOS 05 5ML 10.4710 250 $ - 471013705 PREDNISONE 1MG TAB 10.4710 637 $ - 471013710 PREDNISONE 10MG TAB 10.4710 637 $ 4.00 471013720 PREDNISONE 2.5MG TAB 10.4710 637 $ - 471013730 PREDNISONE 20MG TAB 10.4710 637 $ - 471013740 PREDNISONE 50MG TAB 10.4710 637 $ - 471013750 PREDNISONE 5MG TAB 10.4710 637 $ - 471013760 PREDNISOLONE 5MG/5ML SYRUP 10.4710 637 $ - 471013770 PREDNISONE 5MG/ML 30ML 10.4710 637 $ - 471013780 PREGESTIMIL PWD 454GM 10.4710 637 $ - 471013785 PREPARATION H 27GM 10.4710 637 $ - 471013786 PREPARATION H SUPP 10.4710 637 $ - 471013790 PRIMIDONE 250MG TAB 10.4710 637 $ - 471013800 PRIMIDONE 250MG/5ML 60LM 10.4710 637 $ - 471013810 PRIMIDONE 50MG TAB 10.4710 637 $ - 471013820 PROBENECID 500MG TAB 10.4710 637 $ - 471013830 PROBUCOL 250MG TAB 10.4710 250 $ - 471013840 PROCAINAMIDE 1GM INJ 10.4710 636 $ - 471013850 PROCAINAMIDE 250MG CAP 10.4710 637 $ - 471013860 PROCAINAMIDE 375MG CAP 10.4710 250 $ - 471013870 PROCAINAMIDE 500MG CAP 10.4710 637 $ - 471013890 PROCAINAMIDE SR 250MG TAB 10.4710 250 $ - 471013900 PROCAINAMIDE SR 500MG TAB 10.4710 637 $ - 471013910 PROCAINAMIDE SR 750MG TAB 10.4710 637 $ - 471013911 PROCANBID 1000MG TAB 10.4710 637 $ - 471013912 PROCANBID 500MG TABLET 10.4710 637 $ - 471013920 PROCAINE 1% 30ML SDV 10.4710 250 $ - 471013930 PROCAINE 2% 30ML SDV 10.4710 250 $ - 471013940 PROCARBAZINE 50MG CAP 10.4710 637 $ - 471013950 PROCHLORPERAZINE 10MG INJ 10.4710 636 $ 88.00 471013955 PROCHLORPERAZINE 10MG CAP 10.4710 250 $ - 471013960 PROCHOLORPERAZINE 10MG TAB 10.4710 637 $ 17.50 471013980 PROCHLORPERAZ 2.5MG SUPP 10.4710 637 $ - 471013990 PROCHLORPERAZ 25MG SUPP 10.4710 637 $ 22.50 471014010 PROCHLORPERAZINE 5MG SUPP 10.4710 637 $ - 471014020 PROCHLORPERAZINE 5MG TAB 10.4710 636 $ 11.00 471014040 PROMETHAZINE 12.5 MG SUPP 10.4710 637 $ 30.50 471014050 PROMETHAZINE 25MG INJ 10.4710 636 $ 45.00 471014060 PROMETHAZINE 25MG SUPP 10.4710 637 $ 30.00 471014070 PROMETHAZINE 25MG TAB 10.4710 637 $ 8.50 471014080 PROMETHAZINE 50MG INJ 10.4710 636 $ 45.00 471014090 PROMETHAZINE 50MG SUPP 10.4710 637 $ - 471014100 PROMETHAZINE DM SYRUP 10.4710 637 $ - 471014120 PROMETHAZINE SYRUP 1.25MG/ML 10.4710 637 $ - 471014130 PROMETHAZINE VC SYRUP 10.4710 637 $ - 471014165 PROPAFENONE 150MG TAB 10.4710 637 $ - 471014167 PROPOFOL 200MG INJ 10.4710 250 $ - 471014170 PROPANTHELINE 15MG TAB 10.4710 637 $ - 471014180 PROPARACAINE OS 15ML 10.4710 637 $ 57.00 471014200 PROPOXYPHENE 65MG CAP 10.4710 637 $ - 471014230 PROPOXYPHENE/APAP 100MG TAB 10.4710 637 $ - 471014240 PROPOXYPHENE/APAP 50MG TAB 10.4710 637 $ - 471014250 PROPOXYPHENE/ASA 65MG CAP 10.4710 637 $ - 471014260 PROPRANOLOL 10MG TAB 10.4710 637 $ - 471014270 PROPRANOLOL 1MG INJ 10.4710 250 $ - 471014280 PROPRANOLOL 20MG TAB 10.4710 637 $ - 471014290 PROPRANOLOL 40MG TAB 10.4710 637 $ - 471014300 PROPRANOLOL 60MG TAB 10.4710 637 $ - 471014310 PROPRANOLOL 80MG TAB 10.4710 637 $ - 471014320 PROPRANOLOL LA 120MG CAP 10.4710 637 $ - 471014330 PROPRANOLOL LA 60MG CAP 10.4710 637 $ - 471014340 PROPRANOLOL LA 80MG CAP 10.4710 637 $ - 471014345 PROPYLTHIOURACIL 50MG TAB 10.4710 637 $ - 471014350 PROTAMINE 250MG INJ 10.4710 250 $ - 471014360 PROTAMINE 50MG INJ 10.4710 250 $ - 471014380 PROTRIPTYLINE 5MG TAB 10.4710 637 $ - 471014390 PSEUDOEPHED 30MG TAB 10.4710 637 $ - 471014450 PSYLLIUM SUGAR FREE PKT 10.4710 637 $ - 471014470 PYRANTEL 250MG/5ML SYRUP 10.4710 637 $ - 471014475 PYRAZINAMIDE 500MG TAB 10.4710 637 $ - 471014480 PYRIDOSTIG 10MG INJ 10.4710 250 $ - 471014490 PYRIDOSTIG 180MG LA TAB 10.4710 637 $ - 471014500 PYRIDOSTIG 60MG TAB 10.4710 637 $ - 471014510 PYRIDOSTIGMINE 60MG/5ML SYRUP 10.4710 637 $ - 471014520 PYRIDOXINE 100MG INJ 10.4710 250 $ - 471014530 PYRIDOXINE 100MG TAB 10.4710 637 $ - 471014540 PYRIDOXINE 50MG TAB 10.4710 637 $ - 471014550 PYRIMETHAMINE 25MG TAB 10.4710 637 $ - 471014553 QUINAPRIL 5MG TAB 10.4710 637 $ - 471014554 QUINAPRIL 10MG TAB 10.4710 637 $ - 471014560 QUINIDINE GLUC 324MG TAB 10.4710 637 $ - 471014570 QUINIDINE GLUC 80MG INJ 10.4710 250 $ - 471014635 QUININE 325MG CAP 10.4710 637 $ - 471014640 RABIES IMMUNE GLOB 300U/2ML 10.4710 250 $ 332.50 471014645 RABIES IMMUNEGLOB 150U/ML 10ML 10.4710 636 $ - 471014660 EPINEPHRINE RACE INH SOL 15ML 10.4710 637 $ - 471014663 RAMIPRIL 2.5 CAP 10.4710 637 $ - 471014690 RESERPINE 0.1MG TAB 10.4710 250 $ - 471014700 RESERPINE 0.25MG TAB 10.4710 637 $ - 471014715 RIFABUTIN 150MG CAP 10.4710 637 $ - 471014720 RIFAMPIN 150MG CAP 10.4710 637 $ - 471014730 RIFAMPIN 300MG CAP 10.4710 637 $ - 471014735 RIFAMPIN 600MG INJ 10.4710 250 $ - 471014737 RIMANTADINE SYRUP 10MG/ML 10.4710 637 $ - 471014738 RIMANTADINE 100MG TABLET 10.4710 637 $ - 471014740 RIOPAN SUSP 540MG/5ML 10.4710 637 $ - 471014745 RIOPAN PLUS SUSP 360ML 10.4710 637 $ - 471014755 RISPERIDONE 1MG TAB 10.4710 637 $ - 471014765 ROCURONIUM 100MG INJ 10.4710 250 $ - 471014770 ROLAIDS TAB 550MG CHEW 10.4710 637 $ - 471014780 RUBELLA VACCINE 10.4710 250 $ - 471014800 SALINE LOCK MAINTENANCE FEE 10.4710 250 $ - 471014810 SALSALATE 500MG TAB 10.4710 637 $ - 471014815 SALSALATE 750MG TAB 10.4710 637 $ - 471014817 SARGRAMOSTIM 500MCG INJ 10.4710 636 $ - 471014830 SCOPOLAMINE 1.5MG PATCH 10.4710 637 $ - 471014840 SCOPOLOMINE 0.4MG/ML INJ 10.4710 250 $ - 471014850 SECOBARBITAL 100MG CAP 10.4710 637 $ - 471014870 SELEGILINE 5MG TAB 10.4710 637 $ - 471014875 SELENIUM 1% SHAMPOO 210ML 10.4710 637 $ - 471014880 SELENIUM 2.5% SOL 120ML 10.4710 637 $ - 471014890 SELENIUM 400MCG/10ML INJ 10.4710 250 $ - 471014895 SENOKOT GRANS 60GM 10.4710 637 $ - 471014900 SENOKOT TAB 10.4710 637 $ - 471014905 SENOKOT SYRUP 60ML 10.4710 637 $ - 471014910 SENOKOT-S TAB 10.4710 637 $ - 471014922 SERTRALINE 50MG TAB 10.4710 637 $ - 471014925 SILVER NITRATE APPLICATOR 10.4710 637 $ - 471014928 SILVER SULFADIAZINE CR 25GM 10.4710 637 $ - 471014930 SILVER SULFADIAZ CRM 50GM 10.4710 637 $ 19.00 471014940 SILVER SULFADIAZINE 400 GM 10.4710 637 $ - 471014970 SIMETHICONE 80MG TAB 10.4710 637 $ - 471014980 SIMETHICONE DROPS 30ML 10.4710 637 $ - 471014985 SIMVASTATIN 10MG TAB 10.4710 637 $ - 471014990 SINCALIDE 5MCG INJ 10.4710 636 $ - 471015010 SODIUM ACET INJ 10.4710 250 $ - 471015020 SODIUM BICARB 50MEQ INJ 10.4710 250 $ - 471015030 SODIUM BICARB 50MEQ SYRG 10.4710 250 $ 45.00 471015040 SODIUM BICARB 5MEQ SYRG 10.4710 250 $ - 471015050 SODIUM BICARB 650MG TAB 10.4710 637 $ - 471015060 SODIUM CHLOR 100MEQ/40ML 10.4710 250 $ - 471015065 SODIUM CHLOR 120MEQ/30ML 10.4710 250 $ - 471015070 SODIUM CHLOR 1GM TAB 10.4710 637 $ - 471015100 SODIUM CHLOR BACT 30ML 10.4710 250 $ - 471015110 SODIUM CHLOR INJ 50ML 10.4710 250 $ - 471015120 SODIUM CHLOR 10ML SDV 10.4710 250 $ - 471015123 SODIUM CHLOR 2 O.S. 15ML 10.4710 637 $ - 471015125 SODIUM CHLOR 5% OS 15ML 10.4710 637 $ - 471015130 SODIUM CITRATE SOL 30ML 10.4710 250 $ - 471015140 SODIUM FLUORIDE 2.2MG TAB 10.4710 637 $ - 471015150 FLUORIDE SODIUM DROPS 30ML 10.4710 637 $ - 471015160 SOD HYALURONATE .55ML OPHT INJ 10.4710 250 $ - 471015165 SOD HYAL AMVISC PLUS .8ML 10.4710 250 $ - 471015170 SODIUM PHOS INJ 15MMO/5ML 10.4710 250 $ - 471015175 SODIUM TETRADECYL 1% INJ 10.4710 250 $ - 471015180 SODIUM TETRADECYL 3% INJ 10.4710 250 $ - 471015183 SODIUM THIOSULF 50MG INJ 10.4710 250 $ - 471015184 SODIUM THIOSULFATE 1GM INJ 10.4710 250 $ - 471015185 SORBITOL SOLUTION 480ML 10.4710 637 $ - 471015186 SOTALOL 80MG TAB 10.4710 637 $ - 471015200 SPIRITUS FRUMENTI SOLN 10.4710 637 $ - 471015210 SPIRONOLACTONE 100MG TAB 10.4710 637 $ - 471015220 SPIRONOLACTONE 25MG TAB 10.4710 637 $ - 471015280 STREPTOKINASE 250,000U 10.4710 636 $ - 471015330 SUCCINYLCHOLINE 200MG/10MLINJ 10.4710 636 $ 45.00 471015340 SUCRALFATE 1000MG TAB 10.4710 637 $ - 471015350 SUFENTANIL 5ML INJ 250MCG 10.4710 250 $ - 471015355 SUFENTANIL 1ML INJ 50MCG 10.4710 250 $ - 471015360 SULFACETAMIDE 10% 00 3.5GM 10.4710 637 $ - 471015370 SULFACETAMIDE 10% O.S. 15ML 10.4710 637 $ - 471015390 SULFADIAZINE 500MG TAB 10.4710 637 $ - 471015400 SULFAMETHOX/TRIMETH DS TAB 10.4710 637 $ - 471015410 SULFAMETH/TRIMETH 80MG/5ML INJ 10.4710 250 $ - 471015420 SULFAMETH/TRIMETH SUSPENSION 10.4710 637 $ - 471015430 SULFAMETH/TRIMETH TAB 10.4710 637 $ - 471015440 SULFANILAMIDE VAG CRM 113GM 10.4710 637 $ - 471015450 SULFANILAMIDE VAG SUPP 10.4710 637 $ - 471015460 SULFASALAZINE 500MG TAB 10.4710 637 $ - 471015500 SULFISOXAZOLE 500MG TAB 10.4710 637 $ - 471015520 SULINDAC 150MG TAB 10.4710 637 $ - 471015530 SULINDAC 200MG TAB 10.4710 637 $ - 471015533 SUMATRIPTAN 25MG TAB 10.4710 637 $ - 471015534 SUMATRIPTAN 6MG INJ 10.4710 636 $ 330.00 471015570 SYNTHETIC SALIVA 75GM SPRAY 10.4710 637 $ - 471015580 TAMOXIFEN 10MG TAB 10.4710 637 $ - 471015590 TED HOSE KNEE LARGE/LONG 10.4710 250 $ - 471015600 TED HOSE KNEE LARGE/REG 10.4710 250 $ - 471015610 TED HOSE KNEE MED/LONG 10.4710 250 $ - 471015620 TED HOSE KNEE MED/REG 10.4710 250 $ - 471015625 TED HOSE THIGH SMALL/SHORT 10.4710 250 $ - 471015630 TED HOSE KNEE SMALL/LONG 10.4710 250 $ - 471015640 TED HOSE KNEE SMALL/REG 10.4710 250 $ - 471015650 TED HOSE KNEE X-LARGE/LONG 10.4710 250 $ - 471015660 TED HOSE KNEE X-LARGE/REG 10.4710 250 $ - 471015670 TED HOSE THIGH LARGE/LONG 10.4710 250 $ - 471015680 TED HOSE THIGH LARGE/REGU 10.4710 250 $ - 471015690 TED HOSE THIGH LARGE/SHORT 10.4710 250 $ - 471015700 TED HOSE THIGH MED/LONG 10.4710 250 $ - 471015710 TED HOSE THIGH MED/REGULAR 10.4710 250 $ - 471015720 TED HOSE THIGH MED/SHORT 10.4710 250 $ - 471015730 TED HOSE THIGH SMALL/LONG 10.4710 250 $ - 471015740 TED HOSE THIGH SMALL/REGU 10.4710 250 $ - 471015760 TEMAZEPAM 15MG CAP 10.4710 637 $ - 471015770 TEMAZEPAM 30MG CAP 10.4710 637 $ - 471015780 TERAZOSIN 1MG TAB 10.4710 637 $ - 471015785 TERAZOSIN 5MG TAB 10.4710 637 $ - 471015790 TERBUTALINE 1MG INJ 10.4710 636 $ - 471015801 TERBUTALINE 1MG/ML INH SOLN HH 10.4710 637 $ - 471015810 TERBUTALINE 2.5MG TAB 10.4710 637 $ - 471015820 TERBUTALINE 5MG TAB 10.4710 637 $ - 471015840 TERCONAZOLE 0.4% CRM 45GM 10.4710 637 $ - 471015843 TERCONAZOLE 0.8% CRM 20GM 10.4710 637 $ - 471015845 TERCONAZOLE 80MG SUPP 10.4710 637 $ - 471015875 TESTOST CYPION. 200MG/ML INJ 10.4710 250 $ - 471015890 TETANUS IMMUNE GLOB. 250 UNIT 10.4710 636 $ 249.50 471015900 TETANUS TOXOID 0.5ML 10.4710 636 $ - 471015910 TETRACAINE OPTH SOL UD 2ML 10.4710 250 $ - 471015915 TETRACAINE 2% SOL 30ML 10.4710 250 $ - 471015940 TETRACYCLINE 250MG CAP 10.4710 637 $ - 471015960 TETRACYCLINE 500MG CAP 10.4710 637 $ - 471015985 TETRAHYDROZOLINE OPHTH 15ML 10.4710 637 $ - 471015990 THEOPHYLLIN 80MG/15ML ELIX 10.4710 637 $ - 471016050 THEOPHYLLINE SR 100MG TAB 10.4710 637 $ - 471016080 THEOPHYLLINE SR 200MG TAB 10.4710 637 $ - 471016110 THEOPHYLLINE SR 300MG TAB 10.4710 637 $ - 471016120 THEOPHYLLINE SR 450MG TAB 10.4710 637 $ - 471016150 THEOPHYLLINE-24 100MG CAP 10.4710 637 $ - 471016160 THEOPHYLLINE-24 200MG CAP 10.4710 637 $ - 471016170 THEOPHYLLINE-24 300MG CAP 10.4710 637 $ - 471016190 THEOPHYLLINE-TPHYL 400MG 10.4710 637 $ - 471016195 THIABENDAZOLE 500MG CHEW 10.4710 637 $ - 471016200 THIAMINE 100MG TAB 10.4710 637 $ - 471016210 THIAMINE 100MG INJ 10.4710 250 $ - 471016220 THIAMINE 50MG TAB 10.4710 637 $ - 471016230 THIETHYLPERAZINE 10MG INJ 10.4710 636 $ - 471016260 THIOGUANINE 40MG TAB 10.4710 637 $ - 471016270 THIOPENTAL 500MG INJ 10.4710 636 $ - 471016280 THIORIDAZINE 10MG TAB 10.4710 637 $ - 471016290 THIORIDAZINE 25MG TAB 10.4710 637 $ - 471016325 THIOTHIXENE 2MG CAP 10.4710 637 $ - 471016327 THIOTHIXENE 5MG CAP 10.4710 637 $ - 471016345 THROMBIN 10,000U TOP MU KIT 10.4710 250 $ - 471016350 THROMBIN 5,000U TOP MU POWDER 10.4710 250 $ - 471016410 THYROID 30MG TAB (1/2GR) 10.4710 250 $ - 471016420 THYROID 60MG TAB (1GR) 10.4710 637 $ - 471016440 TICARCILLIN/CLAVULAN 3.1G INJ 10.4710 250 $ - 471016450 TICLOPIDINE 250MG TAB 10.4710 637 $ - 471016460 TIMOLOL 0.25% OS 5ML 10.4710 637 $ - 471016470 TIMOLOL 0.5% OS 5ML 10.4710 637 $ - 471016480 TIMOLOL 10MG TAB 10.4710 637 $ - 471016490 TIMOLOL 20MG TAB 10.4710 637 $ - 471016500 TIMOLOL 5MG TAB 10.4710 637 $ - 471016510 TOBRAMYCIN 0.3% 00 3.5GM 10.4710 637 $ - 471016520 TOBRAMYCIN 0.3% O.S. 5ML 10.4710 637 $ - 471016530 TOBRAMYCIN 1.2GM VIAL 10.4710 636 $ - 471016540 TOBRAMYCIN INJ 40MG/ML 10.4710 636 $ - 471016550 TOBRAMYCIN 20MG/2ML INJ 10.4710 636 $ - 471016560 TOBRAMYCIN 80MG/2ML INH 10.4710 636 $ - 471016569 TOBRAMYCIN 80MG INJ 10.4710 636 $ - 471016570 TOBRA/DEX OPTH SOL 5ML 10.4710 637 $ - 471016575 TOBRA/DEX OPTH OINT 3.5GM 10.4710 637 $ - 471016580 TOCAINIDE 400MG TAB 10.4710 637 $ - 471016600 TOLAZAMIDE 100MG TAB 10.4710 637 $ - 471016610 TOLAZAMIDE 250MG TAB 10.4710 637 $ - 471016620 TOLAZOLINE 100MG INJ 10.4710 250 $ - 471016640 TOLBUTAMIDE 500MG TAB 10.4710 637 $ - 471016645 TOLMETIN 200MG TAB 10.4710 637 $ - 471016667 TPN ELECTROLYTES III 20ML 10.4710 250 $ - 471016669 TORSEMIDE INJ 20MG 10.4710 250 $ - 471016670 TRACE ELEMENTS INJ 10.4710 250 $ - 471016671 TORSEMIDE 5MG TAB 10.4710 637 $ - 471016672 TORSEMIDE 10MG TAB 10.4710 637 $ - 471016673 TORSEMIDE 20MG TAB 10.4710 637 $ - 471016674 TRAMADOL TAB 50 MG 10.4710 637 $ - 471016675 TRANEXAMIC ACID 500MG TAB 10.4710 637 $ - 471016680 TRAZODONE 100MG TAB 10.4710 637 $ - 471016700 TRAZODONE 50MG TAB 10.4710 637 $ - 471016710 TRIAMCINOLONE 0.025% CR 15GM 10.4710 637 $ - 471016720 TRIAMCINOLONE 0.1% CR 15GM 10.4710 637 $ - 471016725 TRIAMCINOLONE 0.1% OINT 15GM 10.4710 637 $ - 471016730 TRIAMCINOLONE 0.5% CR 15GM 10.4710 637 $ - 471016740 TRIAMCINOLONE 0.5% OINT 15GM 10.4710 637 $ - 471016750 TRIAMCINOLONE ACET 10MG/ML INJ 10.4710 250 $ - 471016760 TRIAMCINOLONE ACET 40MG/ML INJ 10.4710 636 $ 76.50 471016770 TRIAMCINOLONE DENTAL PASTE 5GM 10.4710 637 $ - 471016780 TRIAMCINOLONE SPRAY 63GM 10.4710 637 $ - 471016790 TRIAMCINOLONE DIAC 40MG/ML INJ 10.4710 250 $ - 471016795 TRIAMCINONLONE NASALINH 16.5GM 10.4710 637 $ - 471016800 TRIAMCINOLONE ORAL INHALE 20GM 10.4710 637 $ - 471016810 TRIAMTERENE 50MG CAP 10.4710 637 $ - 471016820 TRIAZOLAM 0.25MG TAB 10.4710 637 $ - 471016825 TRIFLURIDINE 1% OPHTH 7ML 10.4710 637 $ - 471016830 TRIFLUOPERAZINE 1MG TAB 10.4710 637 $ - 471016840 TRIFLUOPERAZINE 5MG TAB 10.4710 250 $ - 471016850 TRIHEXYPHENIDYL 2MG TAB 10.4710 637 $ - 471016860 TRIHEXYPHENIDYL 5MG TABLET 10.4710 637 $ - 471016890 TRIMETHOBENZAMIDE 100MG CAP 10.4710 637 $ - 471016900 TRIMETHOBENZAMIDE 100MG SUPP 10.4710 637 $ 19.50 471016910 TRIMETHOBENZAMIDE 200MG INJ 10.4710 250 $ - 471016920 TRIMETHOBENZAMIDE 200MG SUPP 10.4710 637 $ 22.50 471016930 TRIMETHOBENZAMIDE 250MG CAP 10.4710 636 $ - 471016985 TRISALICYLATE 500MG TAB 10.4710 637 $ - 471016987 TRISALICYLATE 750MG TAB 10.4710 637 $ - 471016990 TROPICAMIDE 0.5% 0PHTH 15ML 10.4710 637 $ - 471016992 TROPICAMIDE 1% OPHTH 15ML 10.4710 637 $ - 471016995 TUBERCULIN SKIN TEST 10.4710 250 $ 11.50 471017017 TYPHOID ORAL VACC #4 10.4710 637 $ 20.50 471017030 URISED TAB 10.4710 637 $ - 471017060 URSODIOL 300MG CAP 10.4710 637 $ - 471017070 VALPROIC ACID 250MG CAP 10.4710 637 $ - 471017090 VANCOMYCIN 1GM INJ 10.4710 636 $ - 471017095 VANCOMYCIN 125MG CAP 10.4710 637 $ - 471017100 VANCOMYCIN 250MG CAP 10.4710 637 $ - 471017120 VANCOMYCIN 500MG INJ 10.4710 636 $ - 471017123 VARICELLA ZOSTER 125U INJ 10.4710 250 $ - 471017130 VASOPRESSIN 20U INJ 10.4710 250 $ - 471017150 VECURONIUM 10MG INJ 10.4710 250 $ - 471017153 VENLAFAXINE 25MG TAB 10.4710 637 $ - 471017155 VENLAFAXINE 37.5MG TAB 10.4710 637 $ - 471017160 VERAPAMIL 10MG INJ 10.4710 250 $ - 471017170 VERAPAMIL 120MG TAB 10.4710 637 $ - 471017180 VERAPAMIL 40MG TAB 10.4710 637 $ - 471017190 VERAPAMIL 5MG INJ 10.4710 250 $ - 471017200 VERAPAMIL 80MG TAB 10.4710 637 $ - 471017203 VERAPAMIL SR 120MG TAB 10.4710 637 $ - 471017205 VERAPAMIL SR 180MG TAB 10.4710 637 $ - 471017210 VERAPAMIL SR 240MG TAB 10.4710 637 $ - 471017215 VINBLASTINE 10MG INJ 10.4710 636 $ - 471017220 VINCRISTINE 1MG INJ 10.4710 636 $ - 471017230 VIOKASE TAB 10.4710 637 $ - 471017385 WARFARIN 1MG TAB 10.4710 637 $ - 471017390 WARFARIN 10MG TAB 10.4710 637 $ - 471017400 WARFARIN 2.5 MG TAB 10.4710 637 $ - 471017410 WARFARIN 2MG TAB 10.4710 637 $ - 471017420 WARFARIN 5MG TAB 10.4710 637 $ - 471017430 WARFARIN 7.5MG TAB 10.4710 637 $ - 471017460 ZIDOVUDINE 100MG CAP 10.4710 637 $ - 471017465 ZIDOVUDINE SYRUP 10MG/ML 10.4710 637 $ - 471017470 ZINC OXIDE OINT 30GM 10.4710 637 $ - 471017475 UNNA'S BOOT MEDICATED BANDAGE 10.4710 637 $ - 471017480 ZINC SULFATE INJ 1MG 10.4710 250 $ - 471017485 ZINC SULF 220MG CAP 10.4710 637 $ - 471017490 ZOLPIDEM 5MG TAB 10.4710 637 $ - 471017500 ZOLPIDEM 10MG TAB 10.4710 637 $ - 471022654 FLUOXETINE LA 90MG WEEKLY 10.4710 637 $ - 471026654 GAMUNEX 20GM VIAL 10.4710 636 $ - 471044566 CIMETIDINE ORAL 300MG/5ML 30ML 10.4710 637 $ - 471044887 ASTELIN NASAL SPRAY 30 ML 10.4710 637 $ - 471044987 GABAPENTIN ORAL SUSP 250MG/5ML 10.4710 637 $ - 471045777 TESTOSTERONE ENANTHATE 200MG 10.4710 636 $ - 471045873 SOMATROPIN INJ 1MG 10.4710 636 $ - 471045879 FLUVOXAMINE 50MG TAB 10.4710 637 $ - 471047899 DARBEPOETIN 40MCG/0.3ML INJ 10.4710 636 $ - 471055778 ATRACURIUM 50MG/5ML INJ 10.4710 250 $ - 471056874 ALUM HYDROX 600MG/5ML 360ML 10.4710 637 $ - 471060005 IV THERAPY 10.4710 250 $ - 471060010 5%DEXTROSE/0.225% NACL 1000ML 10.4710 250 $ - 471060011 5% DEXTROSE 1/4NS 1000ML C/S 10.4710 250 $ - 471060020 5% DEXTROSE 0.225% NACL 250ML 10.4710 250 $ - 471060030 5% DEXTROSE 0.225% NACL 500ML 10.4710 250 $ - 471060040 5% DESTROSE 0.45% NACL 1000 10.4710 250 $ - 471060041 5% DEXTROSE 1/2NS 1000ML C/S 10.4710 250 $ - 471060050 5% DEXTROSE 0.45% NACL 250 ML 10.4710 250 $ - 471060060 5% DEXTROSE 0.45% NACL 500 ML 10.4710 636 $ - 471060070 5% DEXTROSE 0.9% NACL 1000ML 10.4710 636 $ - 471060071 5% DEXTROSE NS 1000ML C/S 10.4710 250 $ - 471060080 5% DEXTROSE 0.9% NACL 250ML 10.4710 636 $ - 471060090 5% DEXTROSE 0.9% NACL 500ML 10.4710 636 $ - 471060100 5% DEXTROSE 1000ML 10.4710 636 $ - 471060101 5% DEXTROSE 1000ML C/S 10.4710 250 $ - 471060110 5% DEXTROSE 100ML 10.4710 636 $ - 471060120 5% DEXTROSE 150ML 10.4710 636 $ - 471060130 5% DEXTROSE 250ML 10.4710 636 $ - 471060140 5% DEXTROSE 25ML 10.4710 636 $ - 471060150 5% DEXTROSE 500ML 10.4710 636 $ - 471060160 5% DEXTROSE 50ML 10.4710 636 $ 65.40 471060170 5% DEXTROSE LACT RINGER 1000ML 10.4710 636 $ - 471060171 5% DEXTROSE/LR 1000ML C/S 10.4710 250 $ - 471060180 5% DEXTROSE LACT RINGER 500ML 10.4710 250 $ - 471060190 5% DEXTROSE NORMOSOL M 1000ML 10.4710 250 $ - 471060191 5% DEXT/NORMOSOL M 1000ML C/S 10.4710 250 $ - 471060200 5% DEXTROSE NORMOSOL M 500ML 10.4710 250 $ - 471060210 AMINO ACIDS 10% 500ML 10.4710 250 $ - 471060215 AMINO ACIDS 15% 500ML 10.4710 250 $ - 471060220 AMINO ACIDS 7% 500ML 10.4710 250 $ - 471060230 AMINO ACIDS 8.5% 500ML 10.4710 250 $ - 471060238 AMINO ACIDS HEPATIC 8% 500ML 10.4710 250 $ - 471060280 D51/2NS KCL 10MEQ 1000ML 10.4710 250 $ - 471060290 D51/2NS KCL 20MEQ 1000ML 10.4710 250 $ - 471060300 D51/2NS KCL 30MEQ 1000ML 10.4710 250 $ - 471060310 D51/2NS KCL 40MEQ 1000ML 10.4710 250 $ - 471060330 D51/4NS KCL 20MEQ 1000ML 10.4710 250 $ - 471060385 D-10-NS 1000ML 10.4710 250 $ - 471060386 DEXTROSE 10%/NS 1000ML C/S 10.4710 250 $ - 471060390 DEXTROSE 10% 1000ML 10.4710 250 $ - 471060391 DEXTROSE 10% 1000ML C/S 10.4710 250 $ - 471060400 DEXTROSE 10% 500ML 10.4710 250 $ - 471060410 DEXTROSE 20% 500ML 10.4710 250 $ - 471060420 DEXTROSE 30% 500ML 10.4710 250 $ - 471060425 DEXTROSE 40% 500ML 10.4710 250 $ - 471060430 DEXTROSE 50% 500ML 10.4710 250 $ - 471060450 DEXTROSE 70% 500ML 10.4710 250 $ - 471060460 DEXTROSE/LYTES 50% 500ML 10.4710 250 $ - 471060465 FAT EMULSION 10% 500ML 10.4710 250 $ - 471060466 FAT EMULSION 20% 500ML 10.4710 250 $ - 471060467 FAT EMULSION 20% 250ML 10.4710 250 $ - 471060480 LACTATED RINGERS 1000ML 10.4710 636 $ 90.00 471060481 LACTATED RINGERS 1000ML C/S 10.4710 250 $ - 471060490 LACTATED RINGERS 250ML 10.4710 636 $ - 471060500 LACTATED RINGERS 500ML 10.4710 636 $ - 471060510 LIDOCAINE 1GM/D5W 250ML 10.4710 250 $ - 471060520 LIDOCAINE 2GM/D5W 500ML 10.4710 636 $ - 471060525 MAGNESIUM SULF 40GM/1000ML H20 10.4710 250 $ - 471060530 NACL 0.45% 1000ML 10.4710 250 $ - 471060531 NACL 0.45% 1000ML C/S 10.4710 250 $ - 471060540 NACL 0.45% 500ML 10.4710 250 $ - 471060550 NACL 0.9% 1000ML 10.4710 636 $ 90.00 471060560 NACL 0.9% 100ML 10.4710 636 $ - 471060570 NACL 0.9% 150ML 10.4710 636 $ - 471060580 NACL 0.9% 250ML 10.4710 636 $ - 471060590 NACL 0.9% 25ML 10.4710 636 $ - 471060600 NACL 0.9% 500ML EXCEL 10.4710 636 $ 90.00 471060610 NACL 0.9% 50ML 10.4710 636 $ 65.40 471060634 POTASSIUM CHLOR 20MEQ/50ML INJ 10.4710 250 $ 45.00 471060635 POTASSIUM CHLOR 40MEQ/100ML 10.4710 250 $ - 471060636 SOL RINGERS INJ 1000ML 10.4710 250 $ - 471060640 STERILE WATER 1000ML INJ 10.4710 250 $ - 471066345 ACAMPROSATE 333MG TAB 10.4710 637 $ - 471066346 AZELASTINE 6ML EYE DROPS 10.4710 637 $ - 471073456 NITRO-DUR 0.6MG/HR PATCH 10.4710 637 $ - 471077456 MARIN SOLUTION PER ML 10.4710 637 $ - 471077555 BUPRENORPHONE/NALOXONE 8/2MG 10.4710 637 $ - 471077658 CORTICORELIN OVINE 100MCG VIAL 10.4710 636 $ - 471077775 EPIVIR ORAL SOLN 10MG/ML 30ML 10.4710 637 $ - 471077777 SINGULAIR 5MG CHEWABLE TABLET 10.4710 637 $ - 471077778 RID 10.4710 637 $ - 471077779 FLAGYL 50MG/ML SUSP 30ML 10.4710 637 $ - 471078995 ZYMAR EYE DROPS 10.4710 637 $ - 471082345 CEFDINIR SUSP 125MG/5ML 100ML 10.4710 637 $ - 471084444 MIDAZOLAM 10MG/5ML 10.4710 637 $ - 471084567 ABATACEPT 250MG/10ML 10.4710 636 $ - 471084568 BUDESONIDE 3MG CAP 10.4710 637 $ - 471086455 PROGRAF 0.5MG CAPSULE 10.4710 636 $ - 471086456 AVAPRO 75MG TABLET 10.4710 637 $ - 471086545 REQUIP 0.25MG TAB 10.4710 637 $ - 471086666 RIBOFLAVIN 100MG TAB 10.4710 637 $ - 471087455 EPROSARTAN 400MG TAB 10.4710 637 $ - 471087543 ESTINYL ESTRADIOL 91 TAB PACK 10.4710 637 $ - 471087699 THALOMID 50MG CAP 10.4710 637 $ - 471087765 FLURBIPROFEN OPTH SUSP 2.5ML 10.4710 637 $ - 471087954 CLOTIMAZOLE 2% CREAM 22GM 10.4710 637 $ - 471088000 INTERFERON ALFA-2B 10 MU 10.4710 636 $ - 471088111 CABERGOLINE 0.5 MG TAB 10.4710 637 $ - 471088123 CAFFEINE CITRATE INJ 60MG/3ML 10.4710 636 $ - 471088234 SILDANFIL 50 MG TABLET 10.4710 637 $ - 471088345 MORPHINE SULFATE SOLN 10MG/5ML 10.4710 637 $ - 471088346 DECITABINE 50MG VIAL 10.4710 636 $ - 471088347 IBANDRONATE SODIUM INJ 3MG/ML 10.4710 636 $ - 471088455 DAPTOMYCIN 500MG INJ 10.4710 636 $ - 471088456 BORTEZOMIB 3.5MG VIAL 10.4710 636 $ - 471088457 BENZOCAINE/PHENOL GEL 9GM 10.4710 637 $ - 471088645 INTERFERON ALFA-2B 50MU 10.4710 636 $ - 471088652 VARENICLINE 0.5MG TAB 10.4710 637 $ - 471088654 COLISTIMETHATE 150MG VIAL 10.4710 636 $ - 471088655 MD GASTROVIES 45ML 10.4710 255 $ - 471088656 E-Z-CAT 23GM PKT 10.4710 255 $ - 471088666 SECRETIN HUMAN SYNTHETIC 16MCG 10.4710 636 $ - 471088667 ROPIVACAINE INJ 200MG/20ML 10.4710 636 $ - 471088777 SUMATRIPTAN 5MG NASAL SPRAY 10.4710 637 $ - 471088779 NOVO SEVEN 2.4 MG 10.4710 636 $ - 471088844 CIDOFOVIR 375MG/5ML VIAL 10.4710 636 $ - 471088866 PROLIXIN DECANOATE 25MG/ML 5ML 10.4710 636 $ - 471088881 OXYTOCIN 20U/1000ML LR DRIP 10.4710 250 $ - 471088884 ACELLULAR PERTUSSIS/DT .5 >7yr 10.4710 637 $ - 471088885 ACELLULAR PERTUSSIS/DT .5 <7yr 10.4710 637 $ - 471088887 PAROMOMYCIN 250MG CAP 10.4710 637 $ - 471088888 MANNITOL 20% 500ML 10.4710 636 $ - 471088889 CYCLOSPORINE EYE GTTS 0.4ML 10.4710 636 $ - 471088898 CEFEPIME(MAXIPIME) 2GM INJ 10.4710 636 $ - 471088899 ARANESP 500MCG VIAL 1ML 10.4710 636 $ - 471088934 ELETRIPTAN 40MG (RELPAX) 10.4710 637 $ - 471088945 DUTASERIDE 0.5MG CAP 10.4710 637 $ - 471088946 ROPIVACAINE INJ 100MG/20ML 10.4710 636 $ - 471088990 CARNITOR 1000MG/10ML OS 10.4710 637 $ - 471088991 EMTRIVA 200MG CAP 10.4710 637 $ - 471088994 POSACONAZOLE SUSP 200MG / 5ML 10.4710 637 $ - 471088995 HEPATITIS B IMMUNE GLOBUL 1 ML 10.4710 636 $ 59.00 471088997 RISPERIDONE CONSTA 50MG/2ML 10.4710 636 $ - 471088998 RISPERIDONE CONSTA 37.5MG/2ML 10.4710 636 $ - 471088999 RISPERIDONE CONSTA 25MG/2ML 10.4710 636 $ - 471090875 OB PHARMACY KIT (PANEL) 10.4710 250 $ - 471090999 FACTOR Viii RECOMBINANT 555 IU 10.4710 636 $ - 471092365 DANAZOL 50MG CAP 10.4710 637 $ - 471094465 CEPHALEXIN 125MG/5ML 100ML 10.4710 637 $ - 471094567 ADALIMUMAB 40MG 0.8ML SYR 10.4710 636 $ - 471094573 LEVONORGESTREL 0.75MG TAB X2 10.4710 250 $ - 471095678 FOMEPIZOLE (ANTIZOL) 1500MG 10.4710 636 $ - 471096643 PEPCID 40MG/5ML SUSP 50ML 10.4710 637 $ - 471097343 FLEET ENEMA 133ML 10.4710 637 $ - 471097734 PREGABALIN 75MG CAPSULE 10.4710 637 $ - 471097854 ERIOTINIB 150MG TAB 10.4710 637 $ - 471097887 BUPRENORPHONE 8MG TAB 10.4710 637 $ - 471097888 BUPRENORPHONE/NALOXONE 2/0.5MG 10.4710 637 $ - 471098344 EPIRUBICIN 50MG INJ 10.4710 636 $ - 471098456 LORATIDINE SYRUP 5MG/5ML 10.4710 637 $ - 471098745 LANTHANUM CARBONATE 500MG TAB 10.4710 637 $ - 471098775 PREDNISONE 5MG/5ML 30ML - ORAL 10.4710 637 $ - 471098777 ZOFRAN ODT 8MG TAB 10.4710 636 $ - 471098844 PILOCARPINE .25% OPTH 15ML 10.4710 637 $ - 471098863 TOLNAFTATE 1% CREAM 30GM 10.4710 637 $ - 471098864 PREMPRO 0.45/1.5MG TABLET 10.4710 637 $ - 471098865 PREMPRO 0.3/1.5MG TABLET 10.4710 637 $ - 471098866 PREMPRO 0.625/2.5MG TABLET 10.4710 637 $ - 471099000 TACROLIMUS INJ 5MG/ML 10.4710 636 $ - 471099001 RANITIDINE INJ 150MG/6ML VIAL 10.4710 636 $ - 471099003 SODIUM CHLORIDE SOLUTION 10.4710 258 $ 11.00 471099123 ALFUZOSIN 10MG TAB 10.4710 637 $ - 471099124 RANITIDINE SYRUP 150MG/10ML 10.4710 637 $ - 471099224 SODIUM TETRADECYL SULF 3% 2ML 10.4710 637 $ - 471099250 DEFENSE AUDIT ADJUSTMENT 10.4710 250 $ - 471099334 SODIUM TETRADECYL SULF 1% 2ML 10.4710 637 $ - 471099445 TIGECYCLINE 50MG 10.4710 636 $ - 471099546 MEDIUM CHAIN TRYGLYCERIDE OIL 10.4710 637 $ - 471099554 DIPHENHYDRAMINE 50MG CAP 10.4710 637 $ 4.00 471099557 BUTORPHANOL 2MG/ML INJ 10.4710 636 $ 104.00 471099645 FONDAPARINUX SOD 7.5MG SYR.6ML 10.4710 636 $ - 471099654 ATRIPLA 600-200-300MG TAB 10.4710 637 $ - 471099661 DESOXIMETASONE CRM 0.25% 10.4710 637 $ - 471099662 COMBI-PATCH 0.05/0.14MG / DAY 10.4710 637 $ - 471099663 IMMUNE GLOBULIN IV 12GM POWDER 10.4710 636 $ - 471099664 IMMUNE GLOBULIN IV 6 GM POWDER 10.4710 636 $ - 471099665 IMMUNE GLOBULIN IV 3 GM POWDER 10.4710 636 $ - 471099666 TAMIFLU 12MG/ML ORAL SUSP 10.4710 637 $ - 471099675 TIROFIBAN 12.5GM/250ML 10.4710 636 $ - 471099778 POTASSIUM PHOSPHATE 473 ML 10.4710 636 $ - 471099844 PILOCARPINE .5% OPTH 15ML 10.4710 637 $ - 471099874 NATALIZUMAB 300MG INJ 10.4710 636 $ - 471099875 PREGABALIN 50MG CAPSULE 10.4710 637 $ - 471099876 DIMETAPP ELIXIR 30ML 10.4710 637 $ - 471099877 SUNITINIB 12.5MG CAP 10.4710 637 $ - 471099881 SILDENFIL 20 MG TABLET 10.4710 637 $ - 471099883 DENILEUKIN DIFETOX 150MCG 10.4710 636 $ - 471099884 OCTREOTIDE LAR (DEPO) 20MG INJ 10.4710 636 $ - 471099885 ACITRETIN 25MG CAPSULE 10.4710 637 $ - 471099887 DEXAMETHASONE .05% OPTH 3.5GM 10.4710 637 $ - 471099955 PILOCARPINE 6% OPTH 15ML 10.4710 637 $ - 471099977 RISPERDAL ORAL SOLN 30MG/30ML 10.4710 637 $ - 471099981 SILDENFIL 25 MG TABLET 10.4710 637 $ - 471099982 SULFINPYRAZONE 100MG TAB 10.4710 637 $ - 471099983 MITOXANTRONE 20MG INJ 10.4710 636 $ - 471099985 MITOXANTRONE 30MG INJ 10.4710 636 $ - 471099986 MITOXANTRONE 25MG INJ 10.4710 636 $ - 471099992 PILOCARPINE 3% OPTH 15ML 10.4710 637 $ - 471099994 ESTRADIOL DOT PATCH 0.025MG 10.4710 637 $ - 471100001 MT TEST CHARGES IV SOLUTIONS 10.4710 258 $ - 471100010 5% DEXTROSE 0.225% NACL 1000 10.4710 636 $ 89.00 471100040 5% DEXTROSE 0.45% NACL 1000 10.4710 636 $ 89.00 471100170 5% DEXTROSE LACT RINGER 1000 10.4710 636 $ 89.00 471100270 CPD SOL 500ML 10.4710 258 $ 81.00 471100272 D5 NACL 0.9% 1000 ML 10.4710 636 $ 89.00 471100280 D51/2 NS/10 KCL 1000 (PANEL) 10.4710 272 $ - 471100290 D5 1/2NS / 20 KCL 1000 (PANEL) 10.4710 272 $ - 471100300 D5 1/2 NS/30 KCL 1000 (PANEL) 10.4710 272 $ - 471100310 D5 1/2 NS/40 KCL 1000 (PANEL) 10.4710 272 $ - 471100315 D5LR / 20KCL 1000 (PANEL) 10.4710 272 $ - 471100330 D5 1/4 NS/20 KCL 1000 (PANEL) 10.4710 272 $ - 471100381 NS /20 KCL 1000 (PANEL) 10.4710 272 $ - 471100386 D5NS / 20KCL 1000 (PANEL) 10.4710 272 $ - 471100390 D5W 1000 ML 10.4710 636 $ 89.00 471100461 DEXTRAN 75 / 500 NS 10.4710 636 $ 168.00 471100462 DEXTRAN 70 IN WATER 10.4710 636 $ 155.00 471100463 DEXTRAN 40 IN WATER 10.4710 636 $ 168.00 471100464 DEXTRAN 40 / 500 NS 10.4710 636 $ 155.00 471100468 HEPARIN 25,000 UNITS 10.4710 636 $ 73.00 471100469 NS / HEPARIN 1,000/500 (PANEL) 10.4710 272 $ - 471100470 D5W 250/HEPARIN 25,000 (PANEL) 10.4710 272 $ - 471100471 HESPAN 500ML 10.4710 636 $ 363.00 471100480 LACTATED RINGERS 1000 ML 10.4710 636 $ 72.00 471100524 MANNITOL 25% 50 ML 10.4710 636 $ 112.00 471100530 NACL 0.45% 1000 ML 10.4710 636 $ 89.00 471100540 NACL 0.45% 500 ML 10.4710 636 $ 89.00 471100550 NACL 0.9% 1000 ML 10.4710 636 $ 89.00 471100580 NACL 0.9% 250 ML 10.4710 636 $ 89.00 471100600 NACL 0.9% 500 ML 10.4710 636 $ 89.00 471100710 KCL 10 MEQ 10.4710 636 $ 29.00 471100720 KCL 20 MEQ 10.4710 636 $ 29.00 471100730 KCL 30 MEQ 10.4710 636 $ 29.00 471100740 KCL 40 MEQ 10.4710 636 $ 29.00 471400005 PHARMACY 10.4714 250 $ - 471400017 POLYGAM S/D 5GM 10.4714 636 $ - 471400018 POLYGAM S/D 10GM 10.4714 636 $ - 471400547 STERILE WATER FOR INJ 20ML 10.4714 250 $ - 471400632 DOXIL 20MG VIAL 10.4714 636 $ - 471400661 NEUPOGEN 480MCG/1.6ML INJ 10.4714 636 $ - 471400737 FLUOROURACIL INJ(SYR)500MG 10.4714 636 $ 30.50 471400738 VINCRISTINE INJECTION 1MG/ML 10.4714 636 $ 90.00 471400752 RITUXAN 100MG INJ / 10ML 10.4714 636 $ 1,363.18 471400756 GEMZAR 200MG INJECTION 10.4714 636 $ - 471400969 MEDTRONIC PUMP KIT REFILL 10.4710 250 $ - 471400981 DIPRIVAN 1000MG/100ML 100ML 10.4714 250 $ - 471401182 TRASTUZMAB 440MG INJ / 20ML 10.4714 636 $ - 471401204 REMICADE 100MG AMPOULE 10.4714 636 $ - 471401224 CYANOCOBALAMIN 1000MCG INJ 1ML 10.4714 636 $ 34.50 471401248 TORADOL 30MG/ML 1ML VIAL 10.4714 636 $ - 471401527 LIORESAL INTRATHEC 1000MCG/5ML 10.4714 636 $ - 471401585 DEXAMETHASONE 10MG INJ 10.4714 636 $ 45.00 471401641 CARBOPLATIN INJECTION 150MG 10.4714 636 $ - 471401643 CYCLOPHOSPHAMIDE INJ 1GM 10.4714 636 $ 370.35 471401645 CYCLOPHOSPHAMIDE INJ 500MG 10.4714 636 $ 209.00 471401652 DOXORUBICIN INJ 50 MG/25ML 10.4714 636 $ 252.83 471401672 PACLITAXEL INJECTION 10.4714 636 $ - 471401851 ZOMETA 4MG INJECTION 10.4714 636 $ - 471401884 LEUCOVORIN 100MG VIAL 10.4714 636 $ 49.02 471401887 ARANESP 100MCG VIAL 1ML 10.4714 636 $ - 471401898 NEULASTA 6MG SYR 0.6ML 10.4714 636 $ - 471401903 OXALIPLATIN 50MG VIAL 10.4714 636 $ 3,088.70 471402028 GAMUNEX 10% 100ML 10.4714 636 $ - 471402164 DARBEPOETIN ALFA 150MCG/0.3ML 10.4714 636 $ - 471402165 DARBEPOETIN 60MCG/0.3ML INJ 10.4714 636 $ - 471402166 DABEPOETIN 200MCG/0.4ML 10.4714 636 $ - 471402167 DARBEPOETIN 300MCG/0.6ML 10.4714 636 $ - 471402310 CAFFEINE/SOD BENZOATE .5GM INJ 10.4714 250 $ - 471402640 CARBOPLATIN 50MG INJ 10.4714 636 $ 495.00 471403060 CEFTRIAXONE 1GM INJ 10.4714 636 $ 266.10 471405430 DIPHENHYDRAMINE 50MG INJ 10.4714 636 $ - 471406490 ESMOLOL 10MG/ML INJ 10ML 10.4714 250 $ - 471406695 ETOPOSIDE 100MG/5ML 10.4714 636 $ 380.25 471406800 FENTANYL 100MCG/2ML INJ 10.4714 636 $ - 471406905 FILGRASTIM 300MCG INJ 10.4714 636 $ - 471406985 FLUDARABINE 50MG INJ 10.4714 636 $ - 471407240 FUROSEMIDE 20MG INJ 10.4714 636 $ 34.50 471407485 GLYCOPYRROLATE 0.2MG/ML I 10.4714 250 $ - 471408020 HYDROCORT SUCC 100MG INJ 10.4714 636 $ - 471408090 HYDROMORPHONE 2MG INJ 10.4714 636 $ - 471409969 MEDTRONIC PUMP KIT REFILL 10.4714 250 $ - 471410590 METHYLPRED SUCC 125MG INJ 10.4714 636 $ 45.00 471411318 MORPHINE 500MG/20ML INJ 10.4714 636 $ - 471412294 ONDANSETRON 4MG INJ 10.4714 636 $ 106.50 471412297 ONDANSETRON 2MG/ML 20ML INJ 10.4714 636 $ 774.56 471413294 PIPERACIL/TAZO 3.375GM INJ 10.4714 636 $ 112.05 471414050 PROMETHAZINE 25MG INJ 10.4714 636 $ 45.00 471415330 SUCCINYLCHOLINE 200MG/10MLINJ 10.4714 636 $ 45.00 471416569 TOBRAMYCIN 80MG INJ 10.4714 636 $ 45.02 471417090 VANCOMYCIN 1GM INJ 10.4714 636 $ 97.55 471426654 GAMUNEX 20GM VIAL 10.4714 636 $ - 471460110 5% DEXTROSE 100ML 10.4714 636 $ - 471460120 5% DEXTROSE 150ML 10.4714 636 $ 65.40 471460130 5% DEXTROSE 250ML 10.4714 636 $ 90.00 471460150 5% DEXTROSE 500ML 10.4714 636 $ - 471460160 5% DEXTROSE 50ML 10.4714 636 $ 44.50 471460580 NACL 0.9% 250ML 10.4714 636 $ 90.00 471460590 NACL 0.9% 25ML 10.4714 636 $ 45.00 471460600 NACL 0.9% 500ML EXCEL 10.4714 636 $ 90.00 471460610 NACL 0.9% 50ML 10.4714 636 $ - 471488995 HEPATITIS B IMMUNE GLOBUL 1 ML 10.4714 636 $ 59.00 471499250 DEFENSE AUDIT ADJUSTMENT 10.4714 250 $ - 471500005 PHARMACY 10.4715 250 $ - 471500655 IMOVAX RABIES ID (PRE-EXPOSURE 10.4715 636 $ - 471500800 TAKE HOME PRESCRIPTION (EOC) 10.4715 253 $ - 471501248 TORADOL 30MG/ML 1ML VIAL 10.4715 636 $ 45.00 471501283 LIDOCAINE 1% 20ML VIAL 10.4715 250 $ - 471501295 LIDOCAINE 1% W/EPI 20ML 10.4715 250 $ 41.50 471501553 TETANUS/DIPHTHER TOX ADUL .5ML 10.4715 636 $ 20.00 471501622 ALFENTA 1000MCG/2ML 10.4715 250 $ - 471501758 LORAZEPAM 2MG/ML INJ 1ML 10.4715 636 $ 45.00 471501901 ZEMURON 50MG/5ML 10.4715 250 $ 100.00 471501990 BUPIVACAINE 0.25% SDV 10.4715 250 $ 66.00 471502119 SODIUM BICARB 4.2% 5ML 10.4715 250 $ - 471502130 BUPIVACAINE/EPI 0.5% SDV 10.4715 250 $ - 471502158 HYALURONIDASE 150UNITS/ML 10.4715 636 $ 150.00 471502310 CAFFEINE/SOD BENZOATE .5GM INJ 10.4715 250 $ - 471502790 CEFAZOLIN 1GM INJ 10.4715 636 $ 70.50 471505240 DIHYDROERGOTAMINE 1MG/ML 10.4715 636 $ - 471506800 FENTANYL 100MCG/2ML INJ 10.4715 636 $ 70.00 471507485 GLYCOPYRROLATE 0.2MG/ML I 10.4715 250 $ - 471509007 KETOROLAC 60MG INJ 10.4715 636 $ 88.00 471509300 LIDOCAINE 1% SDV STRL 30ML 10.4715 250 $ 34.50 471509490 LIDOCAINE/EPI 1% SDV 30ML 10.4715 250 $ - 471511750 NEOSTIGMINE 1/1000 INJ 1MG/ML 10.4715 636 $ 46.50 471514040 PROMETHAZINE 12.5 MG SUPP 10.4715 637 $ 30.50 471514080 PROMETHAZINE 50MG INJ 10.4715 636 $ - 471515030 SODIUM BICARB 50MEQ SYRG 10.4715 250 $ 45.00 471515065 SODIUM CHLOR 120MEQ/30ML 10.4715 250 $ 41.50 471515330 SUCCINYLCHOLINE 200MG/10MLINJ 10.4715 636 $ 45.00 471516760 TRIAMCINOLONE ACET 40MG/ML INJ 10.4715 636 $ 88.00 471516995 TUBERCULIN SKIN TEST 10.4715 250 $ 10.00 471599250 DEFENSE AUDIT ADJUSTMENT 10.4715 250 $ - 472000001 MT RT CHARGES - TESTING 10.4720 410 $ - 472000005 ISOLATION VISIT 10.4720 460 $ - 472000011 PDP ASSESSMENT-SUBSEQUENT 10.4720 460 $ - 472000012 PDP ASSESSMENT-INITIAL 10.4720 460 $ - 472000013 PRE-OP TEACHING 10.4720 460 $ - 472001580 TRACH CARE BY RT 10.4720 460 $ - 472002004 ARTERIAL PUNCTURE 10.4720 361 $ 59.00 472002216 SCOOP PROC SPC CARE 15 MIN 10.4720 272 $ 72.00 472002224 SCOOP OVER WIRE STRIPPING 10.4720 460 $ 214.00 472002232 SCOOP CLEANING/LEAP FROG 10.4720 460 $ 76.00 472002703 CONSCIOUS SEDATION 10.4720 460 $ - 472002729 TECH TRANSPORT 10.4720 460 $ 186.00 472003000 EKG TRACING ONLY 10.4720 730 $ 209.00 472003012 TRANSTELEPHONIC EVENT/MONITOR 10.4720 732 $ 1,311.00 472003231 HOLTER/24HR/SETUP/DISCONNECT 10.4720 731 $ 527.00 472005227 CAS/FAMILY CONFERENCE 10.4720 460 $ 175.00 472082375 CO-OXIMETRY 10.4720 301 $ 114.00 472082803 ABG (ARTERIAL BLOOD GAS) 10.4720 301 $ 302.00 472091017 INCENTIVE SPIROMETRY 10.4720 460 $ 307.00 472091018 NEBULIZED MEDICATION, INITIAL 10.4720 410 $ 136.00 472091019 NEB. MED. 10.4720 410 $ 136.00 472091021 BALLOON TAMPONADE 10.4720 272 $ 1,344.00 472091025 NEB. MED - CONTINUOUS 10.4720 410 $ 744.00 472091049 VENT TRANSPORT CT 10.4720 410 $ - 472091050 VENTILATOR 1ST DAY 10.4720 410 $ 2,766.00 472091055 VENTILATOR/SUBSEQUENT DAY 10.4720 410 $ 2,402.00 472091057 VENTILATOR-SETTINGS/CHANGES 10.4720 410 $ - 472091058 TUBING CHANGE-VENTILATOR 10.4720 272 $ - 472091059 VENT WEAN PER SHIFT 10.4720 460 $ - 472091060 VENTILATOR 4 HOUR CHECK 10.4720 410 $ - 472091090 BIPAP/CPAP PER HOUR 10.4720 410 $ 84.00 472091100 CPT 10.4720 410 $ 131.00 472091105 CHEST PT, COMPREHENSIVE/CF 10.4720 410 $ 388.00 472091115 CPT (CHEST PT) - INTIAL 10.4720 410 $ 249.00 472091117 IPV 10.4720 410 $ 388.00 472091120 INDUCE SPUTUM 10.4720 300 $ 218.00 472091121 RSV,NASAL ASPIRATION 10.4720 300 $ - 472091122 SPUTUM COLLECTION 10.4720 300 $ - 472091125 TRACHEOSTOMY - RCP ASSIST 10.4720 361 $ - 472091129 SPECIAL TECH ASSIST 10.4720 410 $ - 472091130 CODE 99 RCP ASST PER 1/4 HOUR 10.4720 480 $ 123.00 472091165 OLYMPIC TRACH. BUTTON - STERIL 10.4720 272 $ 821.00 472091175 BRONCHIAL BIOPSY NEEDLE - STER 10.4720 272 $ 516.00 472091180 BRONCHIAL BIOPSY FORCEP - STER 10.4720 272 $ 551.00 472091185 BRONCHIAL MICRO. BRUSH - STERI 10.4720 272 $ 281.00 472091189 EXTUBATE 10.4720 410 $ - 472091191 NT SUCTION 10.4720 410 $ - 472091194 CARDIOVERSION 10.4720 480 $ - 472091195 BRONCHIAL CYTOLOGY BRUSH -STER 10.4720 272 $ 165.00 472091201 OXYGEN 24 HOURS 10.4720 270 $ 686.00 472091210 OXYGEN 12 HOURS 10.4720 270 $ 344.00 472091211 OXYGEN PER HOUR 10.4720 270 $ 29.00 472091215 OXYGEN-MIN ADM. 10.4720 271 $ 87.00 472091221 MEDICAL AIR FULL DAY 10.4720 271 $ 612.00 472091222 MEDICAL AIR HALF DAY 10.4720 271 $ 308.00 472091225 MEDICAL AIR MINIMUM ADMIN 10.4720 271 $ 77.00 472091290 OXYGEN, SETUP-HIGH FLOW 10.4720 410 $ - 472091300 HEATED MIST 10.4720 410 $ 132.00 472091301 INTUBATION- RCP ASSIST 10.4720 410 $ - 472091305 HEATED MIST, DAILY SERVICE 10.4720 410 $ - 472091310 COOL MIST 10.4720 410 $ 132.00 472091315 COOL MIST, DAILY SERVICE 10.4720 410 $ - 472091400 MIST TENT 10.4720 410 $ 185.00 472091410 MIST TENT DAILY SERVICE 10.4720 410 $ - 472091411 TUBING CHANGE-CONT.MIST 10.4720 272 $ - 472091412 MIST SYSTEM CHECK 10.4720 410 $ - 472091420 HEATED HOOD 10.4720 460 $ 173.00 472091430 OXYGEN HOOD DAILY SERVICE 10.4720 410 $ - 472091445 MDI 10.4720 410 $ 74.00 472094010 SPIROMETRY/PRE-OP PFT/SCREEN 10.4720 460 $ 260.00 472094060 PRE & POST PFT 10.4720 460 $ 362.00 472094150 VITAL CAPACITY / NIF 10.4720 460 $ 94.00 472094160 PEAK FLOWRATE / FVC 10.4720 460 $ 94.00 472094400 BRAIN DEATH DETERMINATION 10.4720 460 $ 310.00 472094642 PENTAMIDINE AEROSOL TREATMENT 10.4720 410 $ 303.00 472094650 IPPB/INITAL TREATMENT 10.4720 410 $ 456.00 472094759 PULSE OXIMETRY, ROUTINE 10.4720 460 $ - 472094760 PULSE OXIMETRY 10.4720 460 $ 114.00 472094761 OXIMETRY, EPIDURAL SET-UP 10.4720 460 $ - 472094762 OVERNIGHT OXIMETRY 10.4720 460 $ 835.00 472096400 IPPB TREATMENT 10.4720 410 $ 157.00 472096499 MISCELLANEOUS RESPIRATORY ORDE 10.4720 410 $ - 472099190 BRONCHOSCOPY/DIAGNOSTIC- W/BIO 10.4720 360 $ 3,018.00 472099191 BRONCHOSCOPY W/TRANSBRONCH BIO 10.4720 360 $ 3,648.00 472099192 BRONCHOSCOPY W/NEEDLE BIOPSY 10.4720 360 $ 3,219.00 472099193 BRONCHOSCOPY/FOREIGN BODY REMO 10.4720 360 $ 4,217.00 472099194 BRONCHOSCOPY - LASER 10.4720 360 $ 4,903.00 472099195 BRONCHOSCOPY/THERAP./SUBSEQUEN 10.4720 360 $ 2,422.00 472099196 BRONCHOSCOPY/THERAPEUTIC/INITI 10.4720 360 $ 2,836.00 472099197 BRONCHOSCOPY/DIAGNOSTIC/NO BIO 10.4720 360 $ 2,692.00 472099198 BRONCHOSCOPY 10.4720 360 $ - 472099410 DEFENSE AUDIT ADJUSTMENT 10.4720 410 $ - 473000015 PROCEDURE ROOM 10.4720 761 $ 247.00 473002004 ARTERIAL PUNCTURE 10.4720 361 $ 62.00 473002319 ARTERIAL BLOOD - PH ONLY 10.4720 300 $ 123.00 473003000 EKG TRACING ONLY 10.4720 730 $ 218.00 473003012 TRANSTELEPHONIC EVENT/MONITOR 10.4720 732 $ 1,369.00 473003231 HOLTER/24HR/SETUP/DISCONNECT 10.4720 731 $ 549.00 473006506 ABG KIT 10.4720 270 $ 56.00 473009603 CO-OX 10.4720 300 $ 94.00 473082802 ABG - PUNCTURE - PANEL 10.4720 460 $ - 473082803 ARTERIAL BLOOD GASES (ABG'S) 10.4720 300 $ 302.00 473094001 SPIROMETRY - SIMPLE 10.4720 460 $ 258.00 473094004 PFT - PRE & POST BRONCHODILATO 10.4720 460 $ 362.00 473094007 FRC DETERMINATION 10.4720 460 $ 156.00 473094300 DIFFUSION 10.4720 460 $ 160.00 473094360 RESISTANCE TO AIR FLOW 10.4720 460 $ 250.00 473094606 COMPLETE PULMONARY FUNCTION TE 10.4720 460 $ - 473094620 PULMONARY EXERCISE EVAL. COMPL 10.4720 460 $ 1,456.00 473094625 LIMITED PULMONARY EXERCISE EVA 10.4720 460 $ 972.00 473094681 METABOLIC CART STUDY 10.4720 460 $ 743.00 473094699 PULM FUNCTION UNLISTED PROCEDU 10.4720 460 $ - 473094760 OXIMETRY, PULSE 10.4720 460 $ 114.00 473094761 OXIMETRY W/EXERCISE 10.4720 460 $ 506.00 473095070 INHALATION BRONCHIAL CHALLENGE 10.4720 924 $ 937.00 474000005 ACUTE HEMODIALYSIS TX 10.4740 800 $ 1,661.00 474000015 CAPD LINE CHANGE 10.4740 800 $ 129.00 474000030 THERAPEUTIC APHERESIS 10.4740 761 $ 2,022.00 474000031 CVVH DIALYSIS 10.4740 800 $ 2,381.00 474000040 CYCLING PERITONEAL DIALYSIS 10.4740 800 $ 810.00 474000045 PERITONEAL DAILY EXCHANGE 10.4740 800 $ 50.00 474000055 HEMOPERFUSION TREATMENT 10.4740 800 $ 2,453.00 474000060 CAPD SOLUTIONS 10.4740 270 $ 51.00 476000001 GI-MISC STERILE SUPPLY 10.4760 272 $ - 476000002 GI-MISC UNSTERILE SUPPLY 10.4760 271 $ - 476000003 GI-MISC IMPLANT 10.4760 278 $ - 476000010 TREATMENT ROOM 0-1 HR 10.4760 761 $ 231.00 476000020 TREATMENT ROOM 1-3 HR 10.4760 761 $ 462.00 476000034 AMBULATORY CARE 0-2HR 10.4760 710 $ 1,224.00 476000042 AMBULATORY CARE ADD 1/2HR 10.4760 710 $ 101.00 476000044 AMBULATORY CARE ADD 1 HR 10.4760 710 $ 202.00 476000220 IM INJECTION 10.4760 761 $ 101.00 476000227 IM INJECTION - ANTIBIOTIC 10.4760 761 $ 101.00 476000230 IV INJECTION 10.4760 761 $ 101.00 476000300 INFUSION THERAPY 0-1 HR 10.4760 260 $ 315.00 476000308 INFUSION HYDRATION 1ST HOUR 10.4760 260 $ 315.00 476000309 INFUSION THERAPY ADD'L HRS 10.4760 260 $ 190.00 476000310 INFUSION HYDRATION ADD'L HOUR 10.4760 260 $ 190.00 476001020 PASSPORT VISIT 0-30 MIN 10.4760 761 $ - 476001021 PASSPORT VISIT 31-60 MIN 10.4760 761 $ - 476002000 GI PROCEDURE 0<1 HR 10.4760 750 $ 2,401.00 476002010 GI PROCEDURE (MINUTES) 10.4760 750 $ 33.00 476006000 RAPID EXCHG LOCKING DEVICE 10.4760 272 $ 578.00 476006010 RAPID EXCHG XL CANNULA 10.4760 272 $ 708.00 476006020 STANDARD/TAPER CANNULAS 10.4760 272 $ 618.00 476006030 RAPID EXCHG JAGWIRE GUIDEWIRE 10.4760 272 $ 1,836.00 476006031 RAPID EXCHG JAGWIRE GUIDEWIRE 10.4760 272 $ 887.00 476006040 RAPID EXCHG EXT JAGWIRE GUIDEW 10.4760 272 $ 1,836.00 476006050 RAPID EXCHG JAGTAIL EXT GUIDEW 10.4760 272 $ 1,653.00 476006060 ULTRATOMES 10.4760 272 $ 1,775.00 476006070 EXTRACTOR RETRIEVAL BALLOONS 10.4760 272 $ 1,465.00 476006072 RAPID EXCHG TAPERTOME 10.4760 272 $ 1,541.00 476006080 RAPID EXCHG CYTOLOGY BRUSH 10.4760 272 $ 1,010.00 476006090 BILIARY STENTS 10.4760 278 $ 1,029.00 476006092 HURRICANE BALLOONS 10.4760 279 $ 1,846.00 476006094 BREEZE RX INFLATION DEVICE 10.4760 271 $ 525.00 476007000 02 NASAL CANNULA 10.4760 272 $ 37.00 476007001 ACCU CHECK STRIP/LANCET 10.4760 271 $ 15.00 476007010 CONTOUR ERCP CANNULAS 10.4760 271 $ 521.00 476007020 TANDEM XL ERCP CANNULAS 10.4760 271 $ 695.00 476007030 PATHFINDER GUIDEWIRE .018 10.4760 279 $ 1,158.00 476007031 SCHNEIDER SUPERSTIFF G-WIRE .0 10.4760 272 $ 959.00 476007040 JAGWIRE GUIDEWIRE 10.4760 279 $ 1,393.00 476007050 ZEBRA GUIDEWIRE 10.4760 279 $ 1,118.00 476007060 STONETOME SPHINCTEROTOME 10.4760 271 $ 2,703.00 476007070 ULTRATOME SPHINCTEROTOME 10.4760 271 $ 1,780.00 476007080 EXTRACTOR RETREVAL BALLOON 10.4760 271 $ 1,254.00 476007090 MAXFORCE BILI BALLOON CATH SYR 10.4760 279 $ 2,884.00 476007100 SEGURA BASKET, POSITRAP 10.4760 271 $ 2,011.00 476007110 SOLOPASS BILIARY STENT 10.4760 278 $ 1,279.00 476007120 PERCUFLEX BILIARY STENT 10.4760 278 $ 1,144.00 476007122 FLEXIMA BILIARY STENTS 10.4760 278 $ 922.00 476007130 MEMORY BASKET (WILSON) 10.4760 271 $ 2,411.00 476007140 LIHOTRIPTER, MECHANICAL 10.4760 272 $ 2,213.00 476007150 SAFETY PEG KIT 20FR (MICROVASI 10.4760 271 $ 1,116.00 476007160 PEG REPLACEMENT GT SECURE T (M 10.4760 272 $ 370.00 476007170 BUTTON REPLACMNT LOW PROFILE(M 10.4760 272 $ 887.00 476007180 MIRCOVASIVE PEJ 8.5 OR 12 10.4760 271 $ 1,091.00 476007190 KANGAROO FEEDING TUBE 12 FR 10.4760 271 $ 466.00 476007200 J FEEDING TUBE 12FR J LINE-SAN 10.4760 271 $ 720.00 476007210 J FEED'G TUBE 18FR STAYPUT-SAN 10.4760 271 $ 1,402.00 476007214 OLYMPUS QUICK CLIP - DISPOSABL 10.4760 271 $ 310.00 476007220 GASTRIC J FEED TUBE 18FR-MEDIN 10.4760 271 $ 579.00 476007230 GASTRIC J FEED TUBE 20-24FR-ME 10.4760 271 $ 871.00 476007240 FEEDING ADAPTER DUAL PORT 10.4760 271 $ 25.00 476007250 DECOMPRESSION TUBE FOR BUTTON 10.4760 271 $ 26.00 476007270 GOLD PROBE 10.4760 271 $ 1,968.00 476007280 GOLD PROBE INJECTION 10.4760 271 $ 2,757.00 476007282 ENTERYX INJ NEEDLE - ADD 10.4760 271 $ 667.00 476007290 SPEEDBAND SUPERVIEW LIGATOR 5 10.4760 271 $ 1,700.00 476007310 INTERJECT NEEDLE (MICROVASIVE) 10.4760 271 $ 442.00 476007320 RADIAL JAW 3BX FORCEPS COLD 10.4760 271 $ 362.00 476007330 RADIAL JAW 3 BX FORCEPS HOT 10.4760 271 $ 552.00 476007340 RADIAL JAW 3 BX FORCEPS MAX CA 10.4760 271 $ 511.00 476007350 SENSATION SHORT THROW SNARE 10.4760 271 $ 448.00 476007360 COMBO CATH CYTOLOGY BRUSH 10.4760 271 $ 1,036.00 476007370 FOREIGN BODY PROTECTOR HOOD 10.4760 271 $ 236.00 476007371 MULITBITE BIOSPY FORCEP 10.4760 272 $ 434.00 476007380 ALLIANCE INFLATION DEVICE 60 M 10.4760 271 $ 414.00 476007390 MAXIFORCE TTS DIL CATHETER 10.4760 279 $ 1,527.00 476007410 CRE TTS DIL CATHETER 10.4760 279 $ 2,151.00 476007415 ACHALASIA DILATOR 10.4760 279 $ 2,047.00 476007420 AMPLATZ STIFF GUIDEWIRE .038 10.4760 279 $ 1,410.00 476007430 ULTRAFLEX ESOPHAGEAL WALLSTENT 10.4760 279 $ 9,174.00 476007440 BILIARY WALLSTENT 10.4760 278 $ 7,821.00 476007442 BILIARY WALL STENT /C PERMALUM 10.4760 278 $ 5,830.00 476007450 BILIARY WALLSTENT 10X80 10.4760 278 $ 9,937.00 476007456 FUSION 5FR PUSH CATHETER 10.4760 279 $ 296.00 476007458 STENT PANCREATIC 10.4760 279 $ 231.00 476007460 REPLACEMENT FLEXISENSOR BANDAG 10.4760 271 $ 26.00 476007470 PEG CLEANING BRUSH 10.4760 272 $ 85.00 476007480 ALIEN RX 10.4760 272 $ 494.00 476007482 AUTOTOME RX 10.4760 272 $ 1,486.00 476007484 TRAPEZOID RX BASKETS 10.4760 272 $ 1,691.00 476007486 LOCKING DEVICE (OLYMPUS) 10.4760 272 $ 79.00 476007488 SPOT - COLON MARKER 10.4760 250 $ 143.00 476007490 HYDRA JAGUAR GUIDEWIRE 10.4760 272 $ 709.00 476007500 CLIP RESOLUTION (GI) 10.4760 278 $ 627.00 476007510 STENT ESOPHAGEAL 10.4760 278 $ 4,533.00 476007520 NEEDLE CARR-LOCKE 10.4760 272 $ 134.00 476007530 SUPER STIFF GUIDEWIRE 10.4760 272 $ 435.00 476007540 POLY LOOP (GI) 10.4760 279 $ 296.00 476007550 OVERTUBE (GI) 10.4760 279 $ 523.00 476010001 TRANS ESOPHA ECHOCARDIOGRAM 10.4760 483 $ 2,329.00 476010002 BONE MARROW BIOPSY 10.4760 361 $ 1,905.00 476010003 ACHALASIA DILATION 10.4760 750 $ 2,176.00 476010005 ESOPHOGEAL BALLOON DILATION 10.4760 750 $ 1,516.00 476010010 PERCUT LIVER BIOPSY 10.4760 750 $ 1,884.00 476010015 GASTRIC BALLOON DILATION 10.4760 750 $ 1,516.00 476010020 RECTAL DILATION 10.4760 750 $ 1,312.00 476010025 RECTAL BALLOON DILATION 10.4760 750 $ 1,516.00 476010030 SAVARY ESOPH DILATION 10.4760 750 $ 1,461.00 476010060 TRANSFUSION THERAPY 0-3 HR 10.4760 391 $ 700.00 476010061 TRANSFUSION THERAPY 3-6 HR 10.4760 391 $ 930.00 476010090 SMALL BOWEL BIOPSY 10.4760 750 $ 1,113.00 476010100 RN FIRST ASSIST-GI / MIN 10.4760 750 $ 1.72 476010200 CARDIOVERSION (GI) 10.4760 480 $ 1,965.00 476020005 ESOPHAGOSCOPY 10.4760 750 $ 1,575.00 476020020 ESOPHO W/BIOPSY 10.4760 750 $ 1,639.00 476020025 EGD/SCLERATHERAPY 10.4760 750 $ 3,115.00 476020030 EGD 10.4760 750 $ 2,590.00 476020035 EGD W/FOREIGN BODY REMOVAL 10.4760 750 $ 2,856.00 476020050 EGD W/BIOPSY 10.4760 750 $ 2,645.00 476020060 EGD W/HBX/POLYP 10.4760 750 $ 2,701.00 476020065 EGD FEEDING TUBE PLACEMENT 10.4760 750 $ 2,913.00 476020070 EGD W/ESOPH WALLSTENT PLACEMEN 10.4760 750 $ 3,289.00 476020072 EGD W / ENTERYX 10.4760 750 $ 10,029.00 476020080 ERCP 10.4760 750 $ 3,038.00 476020085 ERCP W/SPHINCTEROTOMY 10.4760 750 $ 3,937.00 476020095 ERCP W/BILIARY STENTING 10.4760 750 $ 4,088.00 476030000 ERCP W/BIOPSY 10.4760 750 $ 3,101.00 476030005 ERCP W/WALL STENT PLACEMENT 10.4760 750 $ 5,405.00 476030015 COLONOSCOPY 10.4760 750 $ 2,881.00 476030020 COLONOSCOPY W/BIOPSY 10.4760 750 $ 2,953.00 476030030 COLON W/HBX/POLYP 10.4760 750 $ 3,203.00 476030035 BLOCK 10.4760 750 $ 1,155.00 476030055 PROCTOSIGMOIDOSCOPY 10.4760 750 $ 1,067.00 476030060 SIGMOID W/BIOPSY 10.4760 750 $ 1,589.00 476030070 SIGMOID W/HBX/POLYP 10.4760 750 $ 1,579.00 476030080 SIGMOID EA ADDL POLYP 10.4760 750 $ 266.00 476030082 FLEXIBLE SIGMOIDOSCOPY 10.4760 750 $ 2,040.00 476030084 FLEXIBLE SIGMOID W/BIOPSY 10.4760 750 $ 2,101.00 476030085 HEATER PROBE 10.4760 271 $ 2,354.00 476030086 FLEX SIG W/HBX/POLYP 10.4760 750 $ 2,353.00 476030090 FULGERATION 10.4760 750 $ 510.00 476030095 PARACENTESIS 10.4760 361 $ 744.00 476030100 THORACENTESIS 10.4760 361 $ 744.00 476031015 COLONOSCOPY COMPLEX 10.4760 750 $ 3,684.00 476031020 COLONOSCOPY W/BIOPSY COMPLEX 10.4760 750 $ 3,747.00 476031030 COLON W/HBX/POLYP-COMPLEX 10.4760 750 $ 3,976.00 476031055 PROCTOSIGMOIDOSCOPY COMPLEX 10.4760 750 $ 1,645.00 476031060 SIGMOID W/BIOPSY COMPLEX 10.4760 750 $ 2,167.00 476031070 SIGMOID W/HBX/POLYP-COMPLEX 10.4760 750 $ 2,603.00 476031082 FLEXIBLE SIGMOIDSCOPY COMPLEX 10.4760 750 $ 3,067.00 476031084 FLEXIBLE SIGMOID W/BIOPSY COMP 10.4760 750 $ 2,680.00 476031086 FLEX SIG/HBX/POLYP-COMPLEX 10.4760 750 $ 2,931.00 476040001 PHOTO-ENDO VIDEO PRINT 10.4760 270 $ 62.00 476040010 ADDITIONAL POLYP 10.4760 750 $ 270.00 476041000 MICRO CRE WIREGUIDED BAL ALL S 10.4760 279 $ 2,026.00 476042000 US ENDO DISP RETRIEVAL NET 10.4760 272 $ 492.00 476050040 ATTEMPTED ENDOSCOPY 10.4760 750 $ 1,832.00 476050041 ATTEMPTED ENDOSCOPY-E 10.4760 750 $ 3,373.00 476050045 PERCUT ENDO-GASTROSTOMY 10.4760 750 $ 4,064.00 476050046 PEG AFTER HOURS 10.4760 750 $ 6,054.00 476050070 ESOPH DILATION 10.4760 750 $ 1,297.00 476060026 MICROVASIVE ROTATABLE SNARE 10.4760 272 $ 398.00 476060140 SUPP PH PROBE 10.4760 270 $ 243.00 476060150 BRAVO PH CAPSULE 10.4760 270 $ 752.00 476070000 ERCP W/BIOPSY-AFT HR 10.4760 750 $ 4,647.00 476070005 ERCP W/WALL STENT PLACEMT-E 10.4760 750 $ 6,946.00 476070025 EGD/SCLERATHERAPY-E 10.4760 750 $ 5,108.00 476070030 EGD-AFT HR 10.4760 750 $ 4,383.00 476070035 EGD W/FOREIGN BODY REMOVAL-E 10.4760 750 $ 4,846.00 476070050 EGD W/BIOPSY-AFT HR 10.4760 750 $ 4,433.00 476070060 EGD W/HBX/POLYP-AFT HR 10.4760 750 $ 4,691.00 476070065 EGD FEEDING TUBE PLACEMENT-E 10.4760 750 $ 4,458.00 476070080 ERCP-AFT HR 10.4760 750 $ 5,029.00 476070085 ERCP W/SPHINCTEROTOMY-E 10.4760 750 $ 5,929.00 476070095 ERCP W/BILIARY STENTING-E 10.4760 750 $ 6,078.00 476070100 MINOR SURG 1 10.4760 360 $ 1,062.00 476070151 PEG REPLACEMENT GT BALL (MICRO 10.4760 272 $ 274.00 476070152 MINI BUTTON SIZING DEVICE (MIC 10.4760 272 $ 87.00 476070153 PEG REPLACEMENT GT BALL - 24 F 10.4760 272 $ 296.00 476070200 MINOR SURG 2 10.4760 360 $ 2,227.00 476070204 PROBE - ERBE FIAPC 10.4760 272 $ 890.00 476070300 MINOR SURG 3 10.4760 360 $ 2,450.00 476071270 MOTILITY STUDY (GI) 10.4760 750 $ 2,482.00 476071280 24 HOUR PH STUDY 10.4760 750 $ 530.00 476072120 OLYMPUS SPRAY CATHETER 10.4760 271 $ 62.00 476080428 GROWTH HORMONE STIMULATION 10.4760 300 $ 231.00 476089100 BILIARY DRAINAGE-MIN 3 HRS 10.4760 750 $ 1,042.00 476089130 BASAL ANAL SINGLE SPEC 10.4760 750 $ 296.00 476089135 BASAL ANALYSIS 10.4760 750 $ 608.00 476089141 BASAL STIMULATED ANALYSIS 10.4760 750 $ 1,050.00 476090015 COLONOSCOPY-AFT HR 10.4760 750 $ 4,651.00 476090020 COLONOSCOPY W/BIOPSY-E 10.4760 750 $ 4,715.00 476090030 COLON W/HBX/POLYP-E 10.4760 750 $ 4,941.00 476090055 PROCTOSIGMOIDOSCOPY-E 10.4760 750 $ 3,359.00 476090060 SIMOID W/BIOPSY-E 10.4760 750 $ 3,131.00 476090070 SIGMOID W/HBX/POLYP-E 10.4760 750 $ 3,572.00 476090082 FLEXIBLE SIGMOIDOSCOPY-E 10.4760 750 $ 4,030.00 476090084 FLEXIBLE SIGMOID W/BIOPSY-E 10.4760 750 $ 3,646.00 476090086 FLEX SIG W/HBX/POLYP-E 10.4760 750 $ 3,897.00 476090785 IV INJECTION ADD'L SEQUENTIAL 10.4760 761 $ 101.00 476091030 BERNSTEIN TEST 10.4760 750 $ 646.00 476091050 CALCIUM INFUSION 10.4760 750 $ 1,270.00 476091055 GASTRIC CYTOLOGY 10.4760 750 $ 504.00 476091060 SALINE LOAD TEST 10.4760 750 $ 504.00 476091075 HOLLANDER TEST 10.4760 750 $ 1,148.00 476091295 TEST MEAL ZE 10.4760 750 $ 488.00 476091296 LACTOSE TOLERANCE 10.4760 750 $ 820.00 476091297 SECRETIN INFUSION TEST 10.4760 750 $ 504.00 476091298 SECRETIN W/DUODENAL INTUB 10.4760 750 $ 1,339.00 477000001 MT TEST CHARGES 10.4770 420 $ - 477000600 PT EVAL (NURSING REFERRAL *ONL 10.4770 420 $ - 477000740 EVALUATION 15 MIN 10.4770 420 $ 80.00 477000742 EVALUATION 30 MIN 10.4770 420 $ 160.00 477000744 EVALUATION 45 MIN 10.4770 420 $ 240.00 477000746 EVALUATION 60 MIN 10.4770 420 $ 320.00 477000760 CHANGE CONDITION/RE-EVAL (15) 10.4770 420 $ 62.00 477000780 HOT/COLD PACKS (15) 10.4770 420 $ - 477000800 MECHANICAL TRACTION UNATTENDED 10.4770 420 $ 35.00 477000820 ELECTRICAL STIM UNATTEND (15) 10.4770 420 $ 32.00 477000840 PARAFFIN-BATH (15) 10.4770 420 $ 33.00 477000860 WHIRLPOOL (15) 10.4770 420 $ 40.00 477000880 ELECTRICAL STIM ATTEND (15) 10.4770 420 $ 40.00 477000900 IONTOPHORESIS (15) 10.4770 420 $ 47.00 477000920 CONTRAST BATHS (15) 10.4770 420 $ 28.00 477000940 ULTRASOUND (15) 10.4770 420 $ 28.00 477000980 APPLICATION OF TENS UNIT (15) 10.4770 420 $ 141.00 477001000 THERAPEUTIC PROCEDURE 15MIN 10.4770 420 $ 57.00 477001020 NEUROMUSC RE-EDUCATION 15MIN 10.4770 420 $ 57.00 477001040 AQUATIC THER W/THER EXERC 15MI 10.4770 420 $ 65.00 477001060 GAIT TRAINING 15MIN 10.4770 420 $ 48.00 477001100 MANUAL THERAPY TECHNIQ (15) 10.4770 420 $ 85.00 477001120 THERAPEUTIC PROCEDURE GROUP 15 10.4770 420 $ 47.00 477001122 THERAPEUTIC PROCEDURE GROUP 30 10.4770 420 $ 94.00 477001124 THERAPEUTIC PROCEDURE GROUP 45 10.4770 420 $ 141.00 477001126 THERAPEUTIC PROCEDURE GROUP 60 10.4770 420 $ 188.00 477001140 ORTHOTICS FITTING/TRAIN (15) 10.4770 420 $ 57.00 477001160 PROSTHETIC TRAINING 15MIN 10.4770 420 $ 48.00 477001180 THERAPEUTIC ACTIVITIES 15MIN 10.4770 420 $ 62.00 477001200 SELF CARE/HOME MANAGEMENT 15MI 10.4770 420 $ 62.00 477001220 COMMUNITY/WORK REINTEGRAT 15MI 10.4770 420 $ 62.00 477001240 WHEELCHAIR MANAGE/TRAIN 15MIN 10.4770 420 $ 32.00 477001260 ORTHO/PROSTH CHECK EST PT 15MI 10.4770 420 $ 42.00 477001280 PHYS PERFORM TEST/MEASURE 15MI 10.4770 420 $ 39.00 477001300 PATIENT CARE CONFERENCE (15) 10.4770 420 $ - 477001320 FAMILY CONFERENCE (15) 10.4770 420 $ - 477001340 STAFF ASSIST (15) 10.4770 420 $ - 477002010 WC HOT/COLD PACKS 30 MIN 10.4770 420 $ - 477002020 WC TRACTION MECHANICAL 30 MIN 10.4770 420 $ 79.00 477002030 WC VASOPNEUMATIC DEVICES 30 MI 10.4770 420 $ 79.00 477002040 WC PARAFFIN 30 MIN 10.4770 420 $ 79.00 477002050 WC WHIRLPOOL 30 MIN 10.4770 420 $ 79.00 477002060 WC THER EX INITIAL 30 MIN 10.4770 420 $ 113.00 477002070 WC NEUROMUSCULAR REED 30 MIN 10.4770 420 $ 113.00 477002080 WC FUNCTIONAL ACTIVITIES 30 MI 10.4770 420 $ 113.00 477002090 WC GAIT TRAINING 30 MIN 10.4770 420 $ 113.00 477002100 WC ELECTRICAL STIM MANUAL 30 M 10.4770 420 $ 64.00 477002110 WC IONTOPHORESIS 30 MIN 10.4770 420 $ 95.00 477002120 WC TRACTION MANUAL 30 MIN 10.4770 420 $ 113.00 477002140 WC CONTRAST BATHS 30 MIN 10.4770 420 $ 55.00 477002150 WC ULTRASOUND (30) 10.4770 420 $ 57.00 477002152 WC TREAT ONE AREA ADD 15 MIN 10.4770 420 $ 47.00 477002160 WC POOL THERAPY W/THER EX 30 M 10.4770 420 $ 130.00 477002170 WC POOL THERAPY ADDL 15 MIN 10.4770 420 $ 64.00 477002171 WC MYOFASCIAL/SOFT TIS MOB 30 10.4770 420 $ 113.00 477002172 WC ORTHTIC TRAIN UPPR/LWR (30) 10.4770 420 $ 113.00 477002180 WC ORTHOTIC TRAIN EACH ADDL 15 10.4770 420 $ 57.00 477002190 WC PROSTHETIC TRAINING 30 MIN 10.4770 420 $ 98.00 477002200 WC PROSTH TRAIN EACH ADDL 15 M 10.4770 420 $ 48.00 477002210 WC TRAINING IN ADL 30 MIN 10.4770 420 $ 113.00 477002220 WC ADL TRAINING ADDITIONAL 15 10.4770 420 $ 57.00 477002230 WC SOFT TISSUE MOB 30 MIN 10.4770 420 $ 113.00 477002240 WC INDIVIDUAL INSTRUCTIONS 30 10.4770 420 $ 113.00 477002244 WC-ELECTRIC STIM-UNATTEND (30) 10.4770 420 $ 32.00 477002250 WC FABRICATION OR ORTHOTICS 30 10.4770 420 $ 113.00 477002260 WC JOINT MOBILIZATION 30 MIN 10.4770 420 $ 113.00 477002270 WC TAPING 30 MIN 10.4770 420 $ 59.00 477002280 WC FUNCT CAPACITY MEASURE 15 M 10.4770 420 $ 39.00 477002290 WC JOB SITE VISIT/ASSESS 1 HR 10.4770 420 $ 224.00 477002300 WC STAND TEST OF PHYS PERF 30 10.4770 420 $ 145.00 477002310 WC STAND TEST PERF ADD (15) 10.4770 420 $ 59.00 477002330 WC EXTREMITY TESTING 30 MIN 10.4770 420 $ 121.00 477002340 WC EXTREMITY TESTING ADDL 15 M 10.4770 420 $ 53.00 477002350 WC EVAL LIMITED 30 MIN 10.4770 420 $ 138.00 477002360 WC EVAL INTERMEDIATE 45 MIN 10.4770 420 $ 206.00 477002370 WC EVAL EXTENDED 1 HR 10.4770 420 $ 275.00 477002380 WC EVAL COMPREHENSIVE 1 1/2 HR 10.4770 420 $ 411.00 477002390 WC EVAL LIMITED ESTABLISHED 30 10.4770 420 $ 138.00 477002400 WC EVAL INTERMED ESTAB (45) 10.4770 420 $ 138.00 477002410 WC EVAL EXTENDED ESTAB (60) 10.4770 420 $ 138.00 477002420 WC EVAL COMPREHENSIVE EST 90 M 10.4770 420 $ 138.00 477002430 WC CHART NOTES (15) 10.4770 420 $ 13.00 477003020 VASOPNEUMATIC DEVICES 15 MIN 10.4770 420 $ 36.00 477003022 VASOPNEUMATIC DEVICES 30MIN 10.4770 420 $ 72.00 477004280 WC-PNEUMATIC PUMP 15 MIN 10.4770 420 $ 36.00 477004282 WC-PNEUMATIC PUMP 30 MIN 10.4770 420 $ 72.00 477007770 INFRARED 15 MIN 10.4770 420 $ 28.00 477007772 INFRARED 30 MIN 10.4770 420 $ 56.00 477007774 INFRARED 45 MIN 10.4770 420 $ 84.00 477007776 INFRARED 60 MIN 10.4770 420 $ 112.00 477031320 STAFF ASSIST 15 MIN 10.4770 420 $ - 477097001 INITIAL EVALUATION 15 MINUTES 10.4770 420 $ 80.00 477097010 HOT/COLD PACK 15 MIN 10.4770 420 $ 46.00 477097012 TRACTION-MECHANICAL 10.4770 420 $ 35.00 477097014 E-STIM (UNATTENDED 10.4770 420 $ 32.00 477097018 PARAFFIN BATH 10.4770 420 $ 33.00 477097033 IONTOPHORESIS-15 MIN 10.4770 420 $ 47.00 477097034 CONTRAST BATHS-15 MIN 10.4770 420 $ 28.00 477097035 ULTRASOUND-15 MIN 10.4770 420 $ 28.00 477097039 ICE MASSAGE-15 MIN 10.4770 420 $ 28.00 477097040 UNLISTED MODALITY 10.4770 420 $ 32.00 477097110 THERAPEUTIC EXERCISE-15 MIN 10.4770 420 $ 57.00 477097112 NEUROMUSCULAR RE-EDUCATION 15M 10.4770 420 $ 57.00 477097116 GAIT TRAINING 10.4770 420 $ 48.00 477097122 TRACTION-MANUAL 10.4770 420 $ 48.00 477097124 MASSAGE 10.4770 420 $ 42.00 477097139 UNLISTED PROCEDURE 10.4770 420 $ 48.00 477097140 CPM-DAILY USE 10.4770 420 $ 85.00 477097250 SOFT TISSUE MOBIL/MR 15 MIN 10.4770 420 $ 57.00 477097265 JOINT MOBILIZATION 10.4770 420 $ 57.00 477097504 ORTHOTICS FITTING/TRAINING 15M 10.4770 420 $ 57.00 477097520 PROSTHETIC TRAINING-15MIN 10.4770 420 $ 48.00 477097530 THERAPEUTIC ACTIVITIES-15 MIN 10.4770 420 $ 57.00 477097535 SELF-CARE TRAINING-15 MIN 10.4770 420 $ 45.00 477097542 WHEELCHAIR PROPULSION-15 MIN 10.4770 420 $ 32.00 477097703 ORTHO/PROSTH CHECKOUT-15 MIN 10.4770 420 $ 42.00 477097750 PT EVAL (MD ORDER) 10.4770 420 $ 72.00 477099070 MISCELLANEOUS SUPPLIES 10.4770 420 $ - 477099071 LUMBAR CUSHION 10.4770 272 $ 28.00 477099072 LUMBAR ROLL 10.4770 272 $ 12.00 477099073 REACHER 10.4770 272 $ 21.00 477099074 APPL. OF TENS UNIT 10.4770 420 $ 141.00 477099075 CPM PADS 10.4770 272 $ 99.00 477099420 DEFENSE AUDIT ADJUSTMENT 10.4770 420 $ - 477100001 GOLF INITIAL EVAL ONLY 10.4771 420 $ 99.00 477100004 GOLF 4 PACK VISIT 10.4771 420 $ 299.00 477100005 GOLF ADDITIONAL ESTAB VISIT 10.4771 420 $ 70.00 477100006 GOLF 6 PACK VISIT 10.4771 420 $ 399.00 477100012 GOLF 12 PACK VISIT 10.4771 420 $ 749.00 477100100 GOLF TREATMENT 15 MIN 10.4771 420 $ - 477101120 SINGLE MODALITY ADD'L 15 MIN 10.4770 420 $ 47.00 477101122 SINGLE MODALITY INIT'L 30 MIN 10.4770 420 $ 94.00 477101130 SINGLE PROCED ADD'L 15 MIN 10.4770 420 $ 47.00 477101132 SINGLE PROCED INIT'L 30 MIN 10.4770 420 $ 94.00 477101140 MODALITY/PROCED ADD'L 15 MIN 10.4770 420 $ 47.00 477101142 MODALITY/PROCED INIT'L 30 MIN 10.4770 420 $ 94.00 477101150 HUBBARD TANK ADD'L 15 MIN 10.4770 420 $ 47.00 477101152 HUBARD TANK INIT'L 30 MIN 10.4770 420 $ 150.00 477101160 HUBBARD/POOL/THER ADD'L 15 MIN 10.4770 420 $ 47.00 477101162 HUBARD/POOL/THER INIT'L 30 MIN 10.4770 420 $ 185.00 477101170 TESTS/MEASURMENTS ADD'L 15 MIN 10.4770 420 $ 94.00 477101172 TESTS/MEASUREMEN INIT'L 30 MIN 10.4770 420 $ 150.00 477101182 PRELIMINARY EVALUATION 10.4770 420 $ 150.00 477101190 CASE CONF ADD'L 15 MIN 10.4770 420 $ 47.00 477101192 CASE CONF INIT'L 30 MIN 1/MNTH 10.4770 420 $ 94.00 477400001 REC TX--EVALUATE AND TREAT 10.4770 990 $ - 477400015 REC MISCELLANOUS NOTIFICATION 10.4770 990 $ - 477401840 AQUATIC THERAPY (15) 10.4770 430 $ 58.00 477401842 AQUATIC THERAPY SE 10.4770 430 $ 58.00 477401860 THERAPEUTIC PROCEDURE GRP (15) 10.4770 430 $ 18.00 477401862 THERAPEUTIC PROCEDURE GROUP SE 10.4770 430 $ 18.00 477401880 THERAPY IND (15) 10.4770 430 $ 43.00 477401882 THERAPY IND SE 10.4770 430 $ 43.00 477401884 THERAPEUTIC PROCED GRP 105MIN 10.4770 430 $ 308.00 477401886 THERAPEUTIC PROCED GRP 120MIN 10.4770 430 $ 352.00 477401888 THERAPEUTIC PROCED GRP 135MIN 10.4770 430 $ 396.00 477401890 THERAPEUTIC PROCED GRP 150MIN 10.4770 430 $ 440.00 477401892 THERAPEUTIC PROCED GRP 165MIN 10.4770 430 $ 484.00 477401894 THERAPEUTIC PROCED GRP 180MIN 10.4770 430 $ 528.00 477401896 THERAPEUTIC PROCED GRP 195MIN 10.4770 430 $ 572.00 477401898 THERAPEUTIC PROCED GRP 210MIN 10.4770 430 $ 616.00 477401900 COMMUNITY WORK REINTEGRAT (15) 10.4770 430 $ 56.00 477401902 COMMUNITY WORK REINTEGRATION S 10.4770 430 $ 56.00 477409004 REC THER GROUP ACT 15 MIN 10.4770 430 $ 19.00 477409095 REC THER INIT ASSESSMENT 15MIN 10.4770 430 $ 51.00 477412339 ARTHO SWIM (15) 10.4770 430 $ 6.00 477415555 THERAPY IND 15 MIN 10.4770 430 $ 43.00 477415563 THERAPY GRP 15 MIN 10.4770 430 $ 18.00 477415571 CARE CONFERENCE 15 MIN 10.4770 430 $ - 477415600 FAMILY CONFERENCE 15 MIN 10.4770 430 $ - 478000100 STAFF ASSIST (15) 10.4770 440 $ - 478000600 NURSING SPEECH THERAPY REFERRA 10.4770 440 $ - 478001420 PATIENT CARE CONFERENCE (15) 10.4770 440 $ - 478001440 FAMILY CONFERENCE (15) 10.4770 440 $ - 478001460 EVAL OF SPEECH 15 MIN 10.4770 440 $ 67.00 478001462 EVAL OF SPEECH 30 MIN 10.4770 440 $ 134.00 478001464 EVAL OF SPEECH 45 MIN 10.4770 440 $ 201.00 478001466 EVAL OF SPEECH 60 MIN 10.4770 440 $ 268.00 478001480 TREATMENT OF SPEECH 15MIN 10.4770 440 $ 52.00 478001482 TREATMENT OF SPEECH 30MIN 10.4770 440 $ 104.00 478001484 TREATMENT OF SPEECH 45MIN 10.4770 440 $ 156.00 478001486 TREATMENT OF SPEECH 60MIN 10.4770 440 $ 208.00 478001488 TREATMENT OF SPEECH 75 MIN 10.4770 440 $ 260.00 478001490 TREATMENT OF SPEECH 90 MIN 10.4770 440 $ 312.00 478001500 GROUP TREAT SPCH,LANG,VOICE 15 10.4770 440 $ 40.00 478001502 GROUP TREAT SPCH,LANG,VOICE 30 10.4770 440 $ 80.00 478001504 GROUP TREAT SPCH,LANG,VOICE 45 10.4770 440 $ 120.00 478001506 GROUP TREAT SPCH,LANG,VOICE 60 10.4770 440 $ 160.00 478001507 GROUP TREAT SPCH,LANG,VOICE 75 10.4770 440 $ 200.00 478001508 GROUP TREAT SPCH,LANG,VOICE 90 10.4770 440 $ 240.00 478001520 LARYNGEAL FUNCTION STUDY 15 MI 10.4770 440 $ 67.00 478001522 LARYNGEAL FUNCTION STUDY 30 MI 10.4770 440 $ 134.00 478001524 LARYNGEAL FUNCTION STUDY 45 MI 10.4770 440 $ 201.00 478001526 LARYNGEAL FUNCTION STUDY 60 MI 10.4770 440 $ 268.00 478001540 EVAL SWALLOWING/ORAL FUNCT 15 10.4770 440 $ 67.00 478001542 EVAL SWALLOWING/ORAL FUNCT 30 10.4770 440 $ 134.00 478001544 EVAL SWALLOWING/ORAL FUNCT 45 10.4770 440 $ 201.00 478001546 EVAL SWALLOWING/ORAL FUNCT 60 10.4770 440 $ 268.00 478001560 TREAT SWALLOWING DYSFUNCT (15) 10.4770 440 $ 52.00 478001562 TREAT SWALLOWING DYSFUCNT 30 M 10.4770 440 $ 104.00 478001563 TREAT SWALLOWING DYSFUCNT 45 M 10.4770 440 $ 156.00 478001564 TREAT SWALLOWING DYSFUCNT 60 M 10.4770 440 $ 208.00 478001565 TREAT SWALLOWING DYSFUNCT 75 M 10.4770 440 $ 260.00 478001566 TREAT SWALLOWING DYSFUCNT 90 M 10.4770 440 $ 312.00 478001570 PURE TONE SCREEN 10.4770 440 $ 22.00 478092506 SPEECH/LANGUAGE EVALUATION 10.4770 440 $ 168.00 478092507 TREATMENT OF SP./LANG 10.4770 440 $ 91.00 478092525 SWALLOW EVALUATION 10.4770 440 $ 259.00 478092526 TREATMENT OF SWALLOW DYSFUNCTI 10.4770 440 $ 130.00 478092527 VIDEO-FLUOROSCOPIC STUDY 10.4770 440 $ 259.00 478101452 EVAL OF LANGUAGE 30 MIN 10.4770 440 $ 134.00 478101454 EVAL OF LANGUAGE 45 MIN 10.4770 440 $ 201.00 478101456 EVAL OF LANGUAGE 60 MIN 10.4770 440 $ 268.00 478101462 EVAL OF SPEECH 30 MIN 10.4770 440 $ 134.00 478101464 EVAL OF SPEECH 45 MIN 10.4770 440 $ 201.00 478101466 EVAL OF SPEECH 60 MIN 10.4770 440 $ 268.00 478101482 TREATMENT OF SPEECH 30MIN 10.4770 440 $ 104.00 478101486 TREATMENT OF SPEECH 60MIN 10.4770 440 $ 208.00 478101502 GROUP TREAT SPCH,LANG,VOICE 30 10.4770 440 $ 80.00 478101504 GROUP TREAT SPCH,LANG,VOICE 45 10.4770 440 $ 120.00 478101506 GROUP TREAT SPCH,LANG,VOICE 60 10.4770 440 $ 160.00 478101686 SPEECH GENERATING DEVICE 10.4770 440 $ 208.00 478192506 PRELIM EVALUATION 10.4770 440 $ 168.00 478700003 LAB COLLECTION 10.4876 510 $ 16.00 479000001 MT TEST CHARGES 10.4770 430 $ - 479000100 STAFF ASSIST (15) 10.4770 430 $ - 479000120 PATIENT CARE CONFERENCE (15) 10.4770 430 $ - 479000140 FAMILY CONFERENCE 10.4770 430 $ - 479000160 EVALUATION 15 MIN 10.4770 430 $ 74.00 479000162 EVALUATION 30 MIN SE 10.4770 430 $ 148.00 479000163 EVALUATION 30 MIN 10.4770 430 $ 148.00 479000164 EVALUATION 45 MIN 10.4770 430 $ 222.00 479000166 EVALUATION 60 MIN 10.4770 430 $ 296.00 479000180 CHANGE CONDITION/RE-EVAL (15) 10.4770 430 $ 57.00 479000182 RE-EVALUATION SE 10.4770 430 $ 57.00 479000200 HOT/COLD PACKS (15) 10.4770 430 $ - 479000202 HOT/COLD PACKS SE 10.4770 430 $ - 479000220 ELECTRICAL STIM UNATTEND (15) 10.4770 430 $ 29.00 479000222 ELECTRICAL STIMULATION UNATTEN 10.4770 430 $ 29.00 479000240 PARAFFIN BATH (15) 10.4770 430 $ 31.00 479000242 PARAFFIN BATCH SE 10.4770 430 $ 31.00 479000260 WHIRLPOOL (15) 10.4770 430 $ 36.00 479000262 WHIRLPOOL SE 10.4770 430 $ 36.00 479000280 ELECTRICAL STIM ATTEND (15) 10.4770 430 $ 36.00 479000282 ELECTRICAL STIMULATION ATTEND 10.4770 430 $ 36.00 479000300 IONTOPHORESIS (15) 10.4770 430 $ 44.00 479000302 IONTOPHORESIS SE 10.4770 430 $ 44.00 479000320 ULTRASOUND (15) 10.4770 430 $ 25.00 479000322 ULTRASOUND SE 10.4770 430 $ 25.00 479000340 CONTRAST BATHS (15) 10.4770 430 $ 25.00 479000342 CONTRAST BATHS SE 10.4770 430 $ 25.00 479000360 THERAPEUTIC PROCEDURE 15MIN 10.4770 430 $ 57.00 479000362 THERAPEUTIC PROCEDURE SE 10.4770 430 $ 57.00 479000380 NEUROMUSCULAR RE-EDUCATION 15M 10.4770 430 $ 52.00 479000382 NEUROMUSCULAR RE-ED MOVEMENT S 10.4770 430 $ 52.00 479000400 AQUATIC THER W/THERA EXERC 15M 10.4770 430 $ 59.00 479000402 AQUATIC THERAPY W/THERA EXER S 10.4770 430 $ 59.00 479000422 MASSAGE SE 10.4770 430 $ 25.00 479000440 MANUAL THERAPY TECHNIQ (15) 10.4770 430 $ 77.00 479000442 MANUAL THERAPY TECHNIQUES SE 10.4770 430 $ 77.00 479000460 THERAPEUTIC PROCEDURE GROUP 15 10.4770 430 $ 44.00 479000462 THERAPEUTIC PROCEDURE GROUP SE 10.4770 430 $ 44.00 479000463 THERAPEUTIC PROCEDURE GROUP 30 10.4770 430 $ 88.00 479000464 THERAPEUTIC PROCEDURE GROUP 45 10.4770 430 $ 132.00 479000465 THERAPEUTIC PROCEDURE GRP 75MI 10.4770 430 $ 220.00 479000466 THERAPEUTIC PROCEDURE GROUP 60 10.4770 430 $ 176.00 479000467 THERAPEUTIC PROCEDURE GRP 90MI 10.4770 430 $ 264.00 479000480 ORTHO FIT/TRAIN UP AND/OR LR E 10.4770 430 $ 52.00 479000482 ORTH FIT/TRAIN UP AND/OR LR EX 10.4770 430 $ 52.00 479000500 PROSTH TRAIN UPPER EXTR (15) 10.4770 430 $ 45.00 479000502 PROSTHETIC TRAINING UPPER EXTR 10.4770 430 $ 45.00 479000520 THERAPEUTIC ACTIVITIES 15MIN 10.4770 430 $ 52.00 479000522 THERAPEUT ACTIVITIES SE 10.4770 430 $ 52.00 479000540 SELF CARE/HOME MANAGEMENT 15MI 10.4770 430 $ 57.00 479000542 SELF CARE/HOME MNGMNT TRAIN 15 10.4770 430 $ 57.00 479000562 COMMUNITY/WORK REINTEGRT TRAIN 10.4770 430 $ 57.00 479000580 W/CHAIR PROPUL TRAIN (15) 10.4770 430 $ 29.00 479000582 WHEELCHAIR MANAGE PROPUL TRAIN 10.4770 430 $ 29.00 479000600 CHCK ORTHO/PROSTH USE-EST (15) 10.4770 430 $ 39.00 479000602 CHECKOUT ORTHO/PROSTH USE-EST 10.4770 430 $ 39.00 479000620 PHYS PERFORM TEST/MEASURE (15) 10.4770 430 $ 35.00 479000622 PHYSICAL PERFROM TEST/MEASURE 10.4770 430 $ 35.00 479000691 DRIVING RESPONSE EVAL 15 MIN 10.4770 430 $ 50.00 479000692 DRIVING RESPONSE EVAL 30 MIN 10.4770 430 $ 100.00 479000693 DRIVING RESPONSE EVAL 45 MIN 10.4770 430 $ 150.00 479002020 WC HOT/COLD PACKS 30 MIN 10.4770 430 $ - 479002040 WC VASOPNEUMATIC DEVICES 30 MI 10.4770 430 $ 73.00 479002050 WC PARAFFIN 30 MIN 10.4770 430 $ 73.00 479002060 WC WHIRLPOOL 30 MIN 10.4770 430 $ 73.00 479002070 WC THER EX INITIAL 30 MIN 10.4770 430 $ 105.00 479002080 WC NEUROMUSCULAR REED 30 MIN 10.4770 430 $ 105.00 479002090 WC FUNCTIONAL ACTIVITIES 30 MI 10.4770 430 $ 105.00 479002110 WC ELECTRICAL STIM MANUAL 30 M 10.4770 430 $ 58.00 479002120 WC IONTOPHORESIS 30 MIN 10.4770 430 $ 87.00 479002150 WC CONTRAST BATHS 30 MIN 10.4770 430 $ 51.00 479002160 WC ULTRASOUND 30 MIN 10.4770 430 $ 51.00 479002162 WC TREAT TO ONE AREA ADD 15 MI 10.4770 430 $ 52.00 479002170 WC POOL THERAPY W/THER EX 30 M 10.4770 430 $ 119.00 479002180 WC POOL THERAPY ADD'L 15 MIN 10.4770 430 $ 58.00 479002190 WC-ORTHOT TRN UPPR/LWR (30) 10.4770 430 $ 105.00 479002200 WC-ORTHO TRAIN EACH ADDL 15 MI 10.4770 430 $ 52.00 479002210 WC PROSTHETIC TRAINING 30 MIN 10.4770 430 $ 89.00 479002220 WC PROSTH TRAIN EACH ADDL 15 M 10.4770 430 $ 45.00 479002230 WC TRAINING IN ADL 30 MIN 10.4770 430 $ 105.00 479002240 WC ADL TRAINING ADDITIONAL 15 10.4770 430 $ 52.00 479002244 WC-ELECTRIC STIM-UNATEND (30) 10.4770 430 $ 29.00 479002250 WC SOFT TISSUE MOB 30 MIN 10.4770 430 $ 105.00 479002260 WC INDIVIDUALIZED INSTRUCT 30 10.4770 430 $ 105.00 479002270 WC FABRICATION OF ORTHOTICS 30 10.4770 430 $ 105.00 479002280 WC JOINT MOBILIZATION 30 MIN 10.4770 430 $ 105.00 479002290 WC TAPING 30 MIN 10.4770 430 $ 55.00 479002300 WC FUNCT CAPACITY MEASURE 15 M 10.4770 430 $ 35.00 479002310 WC JOB SITE VISIT/ASSESS 1 HR 10.4770 430 $ 206.00 479002320 WC STAND TESTS OF PHYS PERF 30 10.4770 430 $ 133.00 479002330 WC STAND TEST OF PHY PERF ADD 10.4770 430 $ 55.00 479002340 WC EVAL ADL ADDITIONAL 15 MIN 10.4770 430 $ 52.00 479002350 WC EXTREMITY TESTING 30 MIN 10.4770 430 $ 111.00 479002360 WC EXTREMITY TESTING ADDL 15 M 10.4770 430 $ 48.00 479002370 WC EVAL ADL 30 10.4770 430 $ 147.00 479002460 WC CHART NOTES (15) 10.4770 430 $ 12.00 479097110 THERAPEUTIC PROCEDURE-15 MIN 10.4770 430 $ 52.00 479097112 NEUROMUSCULAR RE-EDUC-15 MIN 10.4770 430 $ 52.00 479097139 UNLISTED THERAPEUTIC PROCEDURE 10.4770 430 $ 45.00 479097504 ORTHONICS FITTING/TRAIN-15 MIN 10.4770 430 $ 52.00 479097520 PROSTHETIC TRAINING-15 MIN 10.4770 430 $ 45.00 479097530 THERAPEUTIC ACTIVITIES 10.4770 430 $ 52.00 479097535 SELF-CARE TRAINING-15 MIN 10.4770 430 $ 41.00 479097542 WHEELCHAIR TRAINING-15 MIN 10.4770 430 $ 29.00 479097703 ORTHO/PROSTH CHECKOUT-15 MIN 10.4770 430 $ 39.00 479097750 CONSULT/EVALUATION-15 MIN 10.4770 430 $ 65.00 479099070 MISCELLANEOUS SUPPLIES 10.4770 430 $ - 479099071 REACHER 10.4770 272 $ 20.00 479099430 DEFENSE AUDIT ADJUSTMENT 10.4770 430 $ - 479100160 EVALUATION EACH ADD'L 15 MIN 10.4770 430 $ 74.00 479100162 EVALUATION INITIAL 30 MIN 10.4770 430 $ 148.00 479100170 CASE CONF ADD'L 15MIN 10.4770 430 $ 29.00 479100172 CASE CONF INIT 30MIN 1/MONTH 10.4770 430 $ 57.00 479100460 TREATMENT ADD'L 15 MIN 10.4770 430 $ 22.00 479100462 TREATMENT INIT'L 30 MIN 10.4770 430 $ 44.00 487800003 LAB-ANTIBODY RUBELLA IGM&IGG 10.4876 300 $ 44.08 487800004 LAB-VARICELLA 10.4876 300 $ 59.06 487800011 COMPASS COPHYA - NO CHARGE 10.4876 510 $ - 487800012 URINALYSIS - CONTRACT 10.4876 300 $ 18.09 487800054 SUP-STIFF NECK COLLAR 10.4876 271 $ 42.00 487800096 PEDOMETER 10.4876 271 $ 5.00 487800097 FITNESS EVENT 10.4876 510 $ 400.00 487800098 ON-SITE WELLNESS (15 MIN) 10.4876 983 $ 37.50 487800099 ON-SITE TECH (15MIN) 10.4876 510 $ 7.50 487800100 ML 100 MISSED APPT 10.4876 510 $ 52.00 487800101 ML 1010 FOLLOW-UP 10.4876 510 $ 50.00 487800102 ML 102 BASIC 10.4876 510 $ 50.00 487800103 ML 103 COMPLEX 10.4876 510 $ 50.00 487800104 ML 104 COMPREHENSIVE 10.4876 510 $ 50.00 487800140 PERCENT BODY FAT 10.4876 510 $ 21.00 487800150 FITNESS TESTING 30 MIN 10.4876 510 $ 55.00 487800151 FITNESS TESTING 15 MIN 10.4876 510 $ 27.50 487800152 ADVANCED ERGONOMICS 10.4876 510 $ 75.00 487800160 RANGE OF MOTION 10.4876 420 $ 66.00 487800210 MISCELLANEOUS SERVICE 10.4876 510 $ - 487800220 CONDITIONAL OFFER EXAM-1 10.4876 510 $ 141.00 487800225 CONDITIONAL OFFER EXAM-2 10.4876 510 $ 106.00 487800226 CONDITIONAL OFFER EXAM-3 10.4876 510 $ 110.00 487800227 CONDITIONAL OFFER EXAM-4 10.4876 510 $ 85.00 487800229 CONDITIONAL OFFER EXAM/PHYS 10.4876 510 $ 164.00 487800230 PHYSICAL EXAM-DMV 10.4876 510 $ 55.00 487800231 PHYSICAL EXAM-DMV ADD OTHR EXM 10.4876 510 $ 21.00 487800240 WELLNESS-PERSONAL WELLNESS PRO 10.4876 510 $ 192.00 487800245 CORPORATE WELLNESS PWP 10.4876 510 $ 202.00 487800250 WELLNESS-PERSONAL HLTH SCREEN 10.4876 510 $ 109.00 487800255 CORPORATE WELLNESS PHS 10.4876 510 $ 87.00 487800260 LAB EMC WELLNESS 10.4876 510 $ 50.00 487800270 LAB-WELLNESS 10.4876 300 $ 60.00 487800272 TOXICOLOGY-NICOTINE SERUM 10.4876 510 $ 74.00 487800273 TOXICOLOGY-ISOMER 10.4876 300 $ 169.00 487800274 TOXICOLOGY-NICOTINE URINE 10.4876 510 $ 74.00 487800275 TOXICOLOGY LAB FEE 10.4876 300 $ - 487800276 TOXICOLOGY MRO FEE 10.4876 300 $ - 487800279 TOXICOLOGY RAPID TEST 10.4876 300 $ 50.00 487800280 TOXICOLOGY-NON REGULATED 10.4876 300 $ 50.00 487800283 TOX.-EVIDENTIAL BREATH SCREEN 10.4876 300 $ 53.00 487800284 TOX-DOT MGMNT FEE 2 10.4876 510 $ 176.00 487800285 TOX.-NON REGULATED COLLECTION 10.4876 300 $ 21.00 487800286 TOXICOLOGY-REGULATED 10.4876 300 $ 53.00 487800287 TOXICOLOGY-REGULATED COLLECTIO 10.4876 300 $ 25.88 487800288 TOX-DOT MGMNT FEE 1 10.4876 510 $ 52.00 487800289 MISCELLANEOUS-WELLNESS 10.4876 500 $ - 487800290 WELLNESS-PERSONAL HLTH AWARENE 10.4876 510 $ 54.00 487800300 EDUCATION/PARTICIPANT-DOT 10.4876 510 $ 35.00 487800301 EDUCATION PARTICIPANT 10.4876 510 $ 10.00 487800302 EMC ANNUAL 10.4876 510 $ 53.00 487800303 EMC CONDITIONAL OFFER 10.4876 510 $ 75.00 487800304 PHYSICAL-MISCELLANEOUS 10.4876 510 $ - 487800305 PHYSICAL EXAM-HAZ MAT BASELINE 10.4876 510 $ 210.43 487800307 PHYSICAL EXAM-HAZ MAT ANNUAL 10.4876 510 $ 165.00 487800310 PHYSICAL EXAM-FAA 10.4876 510 $ 90.00 487800320 PHYSICAL EXAM BRIEF 10.4876 510 $ 65.00 487800330 PHYSICAL EXAM INTERMEDIATE 10.4876 510 $ 77.00 487800340 WELLNESS-PWP COE 10.4876 510 $ 198.00 487800350 WELLNESS - PWP ANNUAL 10.4876 510 $ 198.00 487800358 INJECTION-MISCELLANEOUS 10.4876 510 $ - 487800360 INJECTION-HEPATITIS B SERIES 10.4876 300 $ 220.00 487800365 INJECTION 10.4876 510 $ 10.40 487800370 INJECTION-HEPATITIS A 10.4876 300 $ 84.00 487800380 AUDIOMETRY SCREEN 10.4876 510 $ 18.09 487800381 AUDIO ON-SITE CHARGE 10.4876 510 $ 470.00 487800382 AUDIO ON-SITE VIDEO FEE 10.4876 510 $ 2.00 487800385 AUDIOMETRIC COMPUTER ANALYSIS- 10.4876 470 $ 32.00 487800388 VISION SCREENING 10.4876 510 $ 10.00 487800389 VISION - SPECIALIZED 10.4876 510 $ 25.00 487800390 PULMONARY FUNCTION SCREEN 10.4876 460 $ 21.00 487800400 FIT TO WORK EVALUATION 10.4876 510 $ 87.00 487800420 CARDIAC STRESS TEST - OCC HLTH 10.4876 482 $ 276.00 487800421 CARDIAC STRESS TEST - CONTRACT 10.4876 482 $ 153.00 487800422 STRESS ECHO - CONTRACT 10.4876 510 $ 515.00 487800423 TREADMILL - CONTRACT 10.4876 510 $ 276.00 487800430 ERGO JOB ANALYSIS 15 MIN 10.4876 510 $ 43.75 487800440 ERGO REPORT 15 MIN 10.4876 510 $ 43.75 487800450 ERGO WORKSITE EVAL - 15 MIN 10.4876 510 $ 37.50 487800453 ERGONOMIC EDUCATION 15 MIN 10.4876 510 $ 43.75 487800480 WELLNESS EDUCATION 10.4876 942 $ 150.00 487800481 WELLNESS EDUCATION 30 MIN 10.4876 510 $ 75.00 487800490 RESPIRATOR USE CERT - CONTRACT 10.4876 510 $ 50.00 487800492 RESPIRATOR USE CERTIFICATION 10.4876 942 $ 65.00 487800495 RESPIRATOR FIT TEST 10.4876 510 $ 35.00 487800499 MEDICAL REVIEW/SIGNATURE 10.4876 510 $ 11.00 487800500 SPECIALIST - CONTRACT 10.4876 510 $ - 487800501 BP - CONTRACT 10.4876 510 $ - 487800502 AUDIO - CONTRACT 10.4876 510 $ - 487800503 VISION - CONTRACT 10.4876 510 $ - 487800504 RESP FIT TEST - CONTRACT 10.4876 510 $ - 487800505 TOX - CONTRACT 10.4876 510 $ - 487800506 PFT - CONTRACT 10.4876 510 $ - 487800508 INJECTION - CONTRACT 10.4876 510 $ - 487800530 WC CHART NOTES PER PAGE 10.4876 983 $ 1.00 487800531 WC CHRT NOTES DUPLICATE / PAGE 10.4876 983 $ 1.00 487800541 OTHER OUTPATIENT VISIT 10.4876 983 $ 36.00 487800543 EDUCATION SERVICES 15 MIN 10.4876 510 $ 43.75 487800571 AUSA STANDARD TEST 10.4876 510 $ 195.00 487800572 AUSA STANDARD TEST WITH UE 10.4876 510 $ 295.00 487800573 AUSA CONTRACT ST 10.4876 510 $ 85.00 487800574 AUSA CONTRACT UE 10.4876 510 $ 40.00 487800575 AUSA - CONTRACT 10.4876 510 $ 95.00 487800599 WC MISSED APPOINTMENT 10.4876 983 $ - 487800600 FORMS PROCESSING FEE 10.4876 990 $ 15.00 487800899 LAB COLLECTION 10.4876 510 $ 16.00 487800991 TRAVEL - 15 MIN 10.4876 510 $ 28.75 487801040 XRAY-CHEST 1 VIEW/CONTRACT BID 10.4876 320 $ 64.00 487801042 XRAY-CHEST 3 VIEW/CONTRACT BID 10.4876 320 $ 92.00 487802010 WC HOT/COLD PACKS 30 MIN 10.4876 420 $ 49.00 487802030 WC VASOPNEUMATIC DEVICES 30 MI 10.4876 420 $ 72.00 487802040 WC PARAFFIN 30 MIN 10.4876 420 $ 49.00 487802060 WC THER EX INITIAL 30 MIN 10.4876 420 $ 120.00 487802070 WC NEUROMUSCULAR REED 30 MIN 10.4876 420 $ 120.00 487802080 WC FUNCTIONAL ACTIVITIES 30 MI 10.4876 420 $ 120.00 487802081 SUP-SHORT ARM CAST 10.4876 272 $ 43.00 487802085 SUP-SHORT LEG CAST 10.4876 271 $ 43.00 487802090 WC GAIT TRAINING 30 MIN 10.4876 420 $ 88.00 487802100 WC ELECTRICAL STIM MANUAL 30 M 10.4876 420 $ 58.00 487802110 WC IONTOPHORESIS 30 MIN 10.4876 420 $ 109.00 487802115 IONOTOPHERESIS ELECTRODES 10.4876 271 $ 11.00 487802120 WC TRACTION MANUAL 30 MIN 10.4876 420 $ 120.00 487802130 WC MASSAGE 30 MIN 10.4876 420 $ 50.00 487802140 WC CONTRAST BATHS 30 MIN 10.4876 420 $ 50.00 487802150 WC ULTRASOUND 10.4876 420 $ 51.00 487802152 WC TREAT ONE AREA ADD 15 MIN 10.4876 420 $ 51.00 487802170 WC ORTHOTIC TRAIN UPPER/LOWER 10.4876 420 $ 103.00 487802171 WC MYOFASC/SOFT TISSUE MOB 30 10.4876 420 $ 123.00 487802180 WC ORTHOTIC TRAIN EACH ADDL 15 10.4876 420 $ 51.00 487802190 WC PROSTHETIC TRAINING 30 MIN 10.4876 420 $ 117.00 487802200 WC PROSTHETIC TRAIN EACH ADDL 10.4876 420 $ 45.00 487802210 WC TRAINING IN ADL 30 MIN 10.4876 420 $ 103.00 487802220 WC ADL TRAINING ADDL 15 MIN 10.4876 420 $ 51.00 487802230 WC SOFT TISSUE MOB 30 MIN 10.4876 420 $ 120.00 487802240 WC INDIVIDUAL INSTRUCTIONS 30 10.4876 420 $ 120.00 487802244 WC-ELECTRICAL STIM (UNATTENDED 10.4876 420 $ 29.00 487802250 WC FABRICATION OF ORTHOTICS 30 10.4876 420 $ 120.00 487802260 WC JOINT MOBILIZATION 30 MIN 10.4876 420 $ 120.00 487802270 WC TAPING 30 MIN 10.4876 420 $ 54.00 487802280 WC FUNCTION CAPACITY MEASURE 1 10.4876 420 $ 35.00 487802290 WC JOB SITE VISIT/ASSESS 1 HR 10.4876 420 $ 203.00 487802300 WC STAND TESTS OF PHYS PERF 30 10.4876 420 $ 132.00 487802310 WC STAND TEST OF PHY PERF ADD 10.4876 420 $ 54.00 487802330 WC EXTREMITY TESTING 30 MIN 10.4876 420 $ 110.00 487802340 WC EXTREMITY TESTING ADDL 15 M 10.4876 420 $ 48.00 487802350 WC EVAL LIMITED 30 MIN 10.4876 420 $ 125.00 487802360 WC EVAL INTERMEDIATE 45 MIN 10.4876 420 $ 186.00 487802370 WC EVAL EXTENDED 1 HR 10.4876 420 $ 248.00 487802380 WC EVAL COMPREHENSIVE 1 1/2 HR 10.4876 420 $ 373.00 487802390 WC EVAL LIMTED ESTABLISHED 30 10.4876 420 $ 125.00 487802400 WC EVAL INTERMEDIATE EST 30 MI 10.4876 420 $ 125.00 487802410 WC EVAL EXTENDED ESTABLISHED 3 10.4876 420 $ 125.00 487802430 WC CHART NOTES 10.4876 420 $ 13.00 487802440 WC DUPLICATE REPORT 10.4876 420 $ 13.00 487802888 EKG TRACING ONLY 10.4876 480 $ 52.76 487803150 EVALUATION 15 MIN 10.4876 420 $ 73.00 487803160 REEVAL 10.4876 420 $ 56.00 487803170 HOT/COLD PACKS 10.4876 420 $ 42.00 487803190 ELECTRICAL STIMULATION UNATTEN 10.4876 420 $ 29.00 487803200 PARAFFIN BATH 10.4876 420 $ 31.00 487803220 ELECTRICAL STIMULATION ATTENDE 10.4876 420 $ 37.00 487803230 IONTOPHORESIS 10.4876 420 $ 43.00 487803240 CONTRAST BATHS 10.4876 420 $ 25.00 487803250 ULTRASOUND 10.4876 420 $ 25.00 487803260 ICE MASSAGE 10.4876 420 $ 25.00 487803270 APPLICATION OF TENS UNIT 10.4876 420 $ 128.00 487803280 THERAPEUTIC PROCEDURE 10.4876 420 $ 51.00 487803290 NEUROMUSCULAR RE-EDUCATION 10.4876 420 $ 53.00 487803310 GAIT TRAINING 10.4876 420 $ 45.00 487803320 MASSAGE 10.4876 420 $ 39.00 487803330 MANUAL THERAPY TECHNIQUES 10.4876 420 $ 77.00 487803340 THERAPEUTIC PROCEDURE GROUP 10.4876 420 $ 43.00 487803350 WC ORTHOTICS FITTING/TRAINING 10.4876 420 $ 51.00 487803360 WC PROSTHETIC TRAINING 10.4876 420 $ 45.00 487803370 THERAPEUTIC ACTIVITIES 10.4876 420 $ 56.00 487803380 SELF CARE/HOME MNGMENT 15 MIN 10.4876 420 $ 56.00 487803390 COMMUNITY/WORK REINTEGRATION 10.4876 420 $ 56.00 487803400 WHEELCHAIR MANAGE/PROPUL TRAIN 10.4876 420 $ 29.00 487803410 WC ORTHO/PROSTH CHECK EST PATI 10.4876 420 $ 39.00 487803420 PHYSICAL PERFORMANCE TEST/MEAS 10.4876 420 $ 65.00 487809901 BASIC EXAM W/INTERP 10.4876 983 $ 70.00 487809902 NEW PT.,EXPANDED PROB W/INTERP 10.4876 983 $ 85.00 487809903 NEW PT. INTERMED EXAM W/INTERP 10.4876 983 $ 112.00 487809904 NEW PT. EXTENDED EXAM W/INTERP 10.4876 983 $ 164.00 487809905 NEW PT COMP EXAM W/INTERP 10.4876 983 $ 217.00 487809911 ESTAB BRIEF EXAM W/INTERP 10.4876 983 $ 46.00 487809912 ESTAB PT/EXPANDED PROB W/INTER 10.4876 983 $ 67.00 487809913 EST. PT INTERMED EXAM W/INTERP 10.4876 983 $ 80.00 487809914 ESTAB PT EXTENDED EXAM W/INTER 10.4876 983 $ 108.00 487809915 EST. PT COMP EXAM W/INTERP 10.4876 983 $ 156.00 487809954 PROLONGED SERVICE W/INTERP 10.4876 983 $ 164.00 487810060 SIMPLE I&D 10.4876 983 $ 321.00 487810061 COMPLEX/MULTI I&D 10.4876 983 $ 331.00 487810065 SIMPLE I&D-TC 10.4876 361 $ 128.00 487810066 COMPLEX/MULTI I&D-TC 10.4876 361 $ 128.00 487810080 INCISION DRAINAGE PILONIDAL CY 10.4876 983 $ 256.00 487810085 INCISION DRAIN PILONIDAL CYST- 10.4876 361 $ 128.00 487810120 FOREIGN BODY REMOVAL SUB @ 10.4876 983 $ 260.00 487810125 FOREIGN BODY REMOVAL SUB Q-TC 10.4876 361 $ 128.00 487811000 DEBRIDMENT OF SKIN 10.4876 983 $ 191.00 487811005 DEBRIDMENT OF SKIN-TC 10.4876 361 $ 112.00 487811100 BIOPSY SKIN, SUBCUT 10.4876 983 $ 135.00 487811730 AVULSION OF NAIL 10.4876 983 $ 309.00 487811740 EVAC. SUBUNGUAL HEMATOMA 10.4876 983 $ 87.00 487811745 EVAC. SUBUNGUAL HEMATOMA-TC 10.4876 361 $ 47.00 487811750 EXC. INGROWN TOENAIL 10.4876 983 $ 310.00 487811755 EXC. INGROWN TOENAIL-TC 10.4876 361 $ 254.00 487812001 LACERATION SIMPLE TO 2.5CM 10.4876 983 $ 314.00 487812002 LACERATION SIMPLE 2.6-7.5 10.4876 983 $ 336.00 487812004 LACERATION SIMPLE 7.6-12.5CM 10.4876 983 $ 360.00 487812006 LACERATION SIMPLE TO 2.5CM-TC 10.4876 361 $ 156.00 487812009 LACERATION SIMPLE 7.6-12.5CM-T 10.4876 361 $ 156.00 487812011 LACERATION FACE TO 2.5CM 10.4876 983 $ 330.00 487812013 LACERATION FACE 2.6 TO 5.0CM 10.4876 983 $ 331.00 487812014 LACERATION FACE 5.1-7.5 10.4876 983 $ 362.00 487812015 LACERATION SIM. FACE 7.6-12.5 10.4876 983 $ 417.00 487812016 LACERATION FACE TO 2.5CM-TC 10.4876 361 $ 156.00 487812018 LACERATION FACE 2.6- TO 5.0CM- 10.4876 361 $ 156.00 487812019 LACERATION SIM. FACE 5.1-7.5-T 10.4876 361 $ 156.00 487812020 LACERATION SIM. FACE 7.6-12.5- 10.4876 361 $ 156.00 487812031 LACERATION INTERM. TO 2.5CM 10.4876 983 $ 349.00 487812032 LACERATION INTERM. 2.6-7.5CM 10.4876 983 $ 379.00 487812034 LAC. INTERM. 7.6-12.5CM 10.4876 983 $ 352.00 487812036 LACERATION INTERM. TO 2.5CM-TC 10.4876 361 $ 156.00 487812037 LACERATION INTERM. 2.6-7.5CM-T 10.4876 361 $ 156.00 487812039 LAC. INTER. 7.6-12.5CM-TC 10.4876 361 $ 156.00 487812041 LAC. INTERM. H/F TO 2.5CM 10.4876 983 $ 352.00 487812042 LAC. INTER. H/F 2.6 TO 7.5CM 10.4876 983 $ 397.00 487812046 LAC. INTERM. H/F TO 2.5CM-TC 10.4876 361 $ 156.00 487812047 LAC. INTERM. H/F 2.6 TO 7.5CM- 10.4876 361 $ 156.00 487812051 LAC. INTERM. FACE TO 2.5CM 10.4876 983 $ 373.00 487812052 LAC. INTERM. FACE 2.6-5.0CM 10.4876 983 $ 409.00 487812053 LAC. INTERM. FACE 5.1-7.5CM 10.4876 983 $ 167.00 487812054 LAC. INTERM. FACE 7.6-12.5CM 10.4876 983 $ 444.00 487812056 LAC. INTER. FACE TO 2.5CM-TC 10.4876 361 $ 156.00 487812057 LAC. INTERM. FACE 2.6-5.0CM-TC 10.4876 361 $ 156.00 487812058 LAC. INTERM. FACE 5.1-7.5CM-TC 10.4876 361 $ 156.00 487812059 LAC. INTERM. FACE 7.6-12.5CM-T 10.4876 361 $ 156.00 487816020 TREATMENT OF BURN, SMALL 10.4876 983 $ 301.00 487816024 TREATMENT OF BURN, SMALL-TC 10.4876 361 $ 112.00 487816025 TREATMENT BURN, MED 10.4876 983 $ 246.00 487816030 TREATMENT BURN,MED-TC 10.4876 361 $ 96.00 487817000 DESTRUCTION OF LESION, 1ST LES 10.4876 983 $ 87.00 487817003 DESTRUCTION EA. ADDITIONAL LES 10.4876 983 $ 56.00 487817005 DESTRUCTION OF LESION, 1ST-TC 10.4876 361 $ 35.00 487817008 DESTRUCTION EA. ADD LESION-TC 10.4876 361 $ 35.00 487819087 DUPLICATE REPORT 10.4876 983 $ 26.00 487820014 SUP-SHOULDER IMMOBILIZER 10.4876 271 $ 39.00 487820016 SUP-ORTHO GLASS/SPLINTING 10.4876 271 $ 15.00 487820039 SUP-ACROMIO/CLAVICULAR CANVAS 10.4876 271 $ 39.00 487820040 SUP-CERVICAL COLLAR 10.4876 271 $ 18.00 487820043 SUP-SLING 10.4876 271 $ 15.00 487820044 SUP-CRUTCHES 10.4876 271 $ 64.00 487820050 SUP-THUMB SPICA SPLINT 10.4876 271 $ 61.00 487820053 SUP-FINGER SPLINT 10.4876 271 $ 10.00 487820058 SUP-WALKER CAST SHOE 10.4876 271 $ 27.00 487820060 SUP-PATELLA STABILIZER 10.4876 271 $ 78.00 487820061 SUP-KNEE IMMOBILIZER 10.4876 271 $ 96.00 487820062 KNEE IMMOBILIZER-PED 10.4876 271 $ 42.00 487820065 SUP-AIR STIRRUP 10.4876 271 $ 85.00 487820068 SUP-ANKLE BRACE 10.4876 271 $ 51.00 487820070 SUP-MASON ALLEN SPLINT 10.4876 271 $ 37.00 487820168 SUP-RIB BELT 10.4876 271 $ 37.00 487820200 SUP-FOREARM/ELBOW BAND 10.4876 271 $ 29.00 487820250 SUP-LEWEN STERN SPLINT 10.4876 271 $ 40.00 487820260 SUP-WRIST SPLINT (LACING) 10.4876 271 $ 53.00 487820262 SUP-WRIST IMMOB/SUPPORT/NEOPRE 10.4876 271 $ 42.00 487820264 SUP-FOREARM SPLINT 10.4876 271 $ 18.00 487820270 SUP-TISSUE ADHESIVE 10.4876 510 $ 56.00 487820550 TRIGGER POINT INJECTION 10.4876 983 $ 232.00 487820555 TRIGGER POINT INJECTION-TC 10.4876 361 $ 135.00 487820605 ARTHROCENTESIS-INTERMEDIATE 10.4876 983 $ 355.00 487820610 ARTHROCENTESIS-MAJOR JOINT 10.4876 983 $ 235.00 487820611 ARTHROCENTESIS-INTERMEDIATE-TC 10.4876 361 $ 135.00 487820615 ARTHROCENTESIS-MAJOR JOINT-TC 10.4876 361 $ 135.00 487823500 CLAVICULAR FRACTURE W/O MAN 10.4876 983 $ 336.00 487823505 CLAVICULAR FRACTURE W/O MAN.-T 10.4876 361 $ 104.00 487823650 REDUCTION OF SHOULDER 10.4876 983 $ 436.00 487823655 REDUCTION OF SHOULDER-TC 10.4876 361 $ 104.00 487824640 REDUCT SUBLX RADIAL HEAD/CHILD 10.4876 983 $ 192.00 487824645 REDUCT SUBLX RADIAL HEAD/CHILD 10.4876 361 $ 74.00 487825500 TX RADIAL FRACTURE W/O MAN. 10.4876 983 $ 417.00 487825505 TX RADIAL FRACTURE W/O MAN.-TC 10.4876 361 $ 138.00 487825600 TX DISTAL RADIAL FRACTURE W/O 10.4876 983 $ 435.00 487825605 TX DISTAL RADIAL FRACT W/O MAN 10.4876 361 $ 138.00 487826600 HAND FRACTURES W/O MANIPULATIO 10.4876 983 $ 382.00 487826601 HAND FRACTURE W MANIPULATION 10.4876 983 $ 558.00 487826605 HAND FRACTURES W/O MANIP-TC 10.4876 361 $ 138.00 487826720 FINGER SHAFT FRACTURE 10.4876 983 $ 284.00 487826725 FINGER SHAFT FRACTURE-TC 10.4876 361 $ 104.00 487826726 FINGER SHAFT FRACTURE/TC 10.4876 361 $ 104.00 487826750 DIST FING FX W/O MAN 10.4876 983 $ 309.00 487827560 CLOSED TX PATELLA DISLOCATION 10.4876 983 $ 530.00 487827565 CLOSED TX PATELLA DISLOCATION- 10.4876 361 $ 138.00 487828400 CALCANEAL FRACTURE W/O MAN. 10.4876 983 $ 223.00 487828405 CALCANEAL FRACTURE W/O MAN.-TC 10.4876 361 $ 138.00 487828490 FRACTURE GREAT TOE 10.4876 983 $ 270.00 487828495 FX. GREAT TOE W/MANIPULATION 10.4876 983 $ 297.00 487828496 FRACTURE GREAT TOE-TC 10.4876 361 $ 104.00 487828500 FX. GREAT TOE W/MANIPULATION-T 10.4876 361 $ 104.00 487828510 TOE FRACTURE, EACH, W/O MAN. 10.4876 983 $ 269.00 487828514 TOE FRACTURE,EACH, W/O MAN.-TC 10.4876 361 $ 104.00 487828515 TOE FRACTURE W/MANIPULATON, EA 10.4876 983 $ 291.00 487828520 TOE FRACT W/MANIP. EA-TC 10.4876 361 $ 104.00 487829075 APPLICATON SHORT ARM CAST 10.4876 983 $ 204.00 487829080 APPLICATION SHORT ARM CAST-TC 10.4876 361 $ 111.00 487829085 APPLICATION HAND/LOW FOREARM 10.4876 983 $ 210.00 487829090 APPL HAND/LOW FORARM CAST-TC 10.4876 361 $ 111.00 487829105 APPLICATION LONG ARM SPLINT 10.4876 983 $ 205.00 487829110 APPLICATION LONG ARM SPLINT-TC 10.4876 361 $ 111.00 487829125 APPLICATION SHORT ARM SPLINT 10.4876 983 $ 188.00 487829129 APPLICATION SHORT ARM SPLINT-T 10.4876 361 $ 111.00 487829130 APPLICATION FINGER SPLINT 10.4876 983 $ 181.00 487829135 APPLICATION FINGER SPLINT-TC 10.4876 361 $ 111.00 487829405 APPLICATION SHORT LEG CAST 10.4876 983 $ 210.00 487829410 APPLICATION SHORT LEG CAST-TC 10.4876 361 $ 111.00 487829505 APPLICATION LONG LEG SPLINT 10.4876 983 $ 137.00 487829510 APPLICATION LONG LEG SPLINT-TC 10.4876 361 $ 70.00 487829515 APPLICATION SHORT LEG SPLINT 10.4876 983 $ 138.00 487829520 APPLICATION SHORT LEG SPLINT-T 10.4876 361 $ 70.00 487829700 CAST REMOVAL 10.4876 983 $ 131.00 487829705 CAST REMOVAL-TC 10.4876 361 $ 70.00 487830009 ACE WRAP 10.4876 271 $ 7.00 487830038 AERO CHAMBER 10.4876 271 $ 21.00 487830199 SUP-I.V. START KIT 10.4876 270 $ 7.00 487830255 SUP-PRN ADAPTER 10.4876 271 $ 4.00 487830260 SUP-T EXTENSION 10.4876 272 $ 4.00 487830300 FOREIGN BODY REMOVAL-NOSE 10.4876 983 $ 212.00 487830305 FOREIGN BODY REMOVAL-NOSE-TC 10.4876 361 $ 108.00 487830901 EPITAXIS-ANTERIOR 10.4876 983 $ 264.00 487830905 EPITAXIS-POSTERIOR 10.4876 983 $ 319.00 487830906 EPITAXIS-ANTERIOR-TC 10.4876 361 $ 141.00 487830910 EPITAXIS-POSTERIOR-TC 10.4876 361 $ 141.00 487832001 SIMPLE TO 2.5CM W/BLOCK 10.4876 983 $ 314.00 487832002 SIMPLE 2.6-7.5CM W/BLOCK 10.4876 983 $ 336.00 487832041 INTERM. H/F TO 2.5 W/BLOCK 10.4876 983 $ 362.00 487836415 BLOOD SPECIMEN COLLECTION 10.4876 300 $ - 487841001 SUP-PRIMARY TUBING 10.4876 272 $ 10.00 487841017 SUP-MICRODRIP TUBING 10.4876 272 $ 10.00 487846320 EXC. EXT. THROMBOTIC HEMORRHOI 10.4876 983 $ 111.00 487846325 EXC. THROMBOTIC HEMORRHOID-TC 10.4876 361 $ 150.00 487846600 ANOSCOPY 10.4876 983 $ 30.00 487846605 ANOSCOPY-TC 10.4876 361 $ - 487849930 BLEDSOE BOOT 10.4876 271 $ 130.00 487864450 DIGITAL BLOCK 10.4876 983 $ 359.00 487864455 DIGITAL BLOCK-TC 10.4876 361 $ 212.00 487865210 F.B. REMOVAL-SCLERAL/CONJUNCTI 10.4876 983 $ 279.00 487865215 R.B. REMOVAL-SCLERAL/CONJUNCT/ 10.4876 361 $ 168.00 487865220 FOREIGN BODY REM.-CORNEA 10.4876 983 $ 270.00 487865222 RMV FB CORNEAL W/SLIT LAMP 10.4876 983 $ 281.00 487865225 FOREIGN BODY REM.-CORNEA-TC 10.4876 361 $ 168.00 487865227 RMV FB CORNEAL W/SLIT LAMP-TC 10.4876 361 $ 168.00 487865435 RMV CORNEAL EPITHELIUM 10.4876 983 $ 599.00 487865440 RMV CORNEAL EPITHELIUM-TC 10.4876 361 $ 398.00 487869200 FOREIGN BODY REM.-EAR 10.4876 983 $ 154.00 487869205 FOREIGN BODY REM.-EAR-TC 10.4876 361 $ 66.00 487869210 RMV IMPACTED-CERUMEN 10.4876 983 $ 128.00 487869215 RMV IMPACTED-CERUMEN-TC 10.4876 361 $ 66.00 487870500 XRAY - CONTRACT SERVICE 10.4876 510 $ - 487870501 X-RAY LUMBAR SPINE - LIMITED 10.4876 320 $ 145.00 487871000 XRAY-ASBESTOS CHEST 1 VIEW 10.4876 320 $ 185.00 487871001 XRAY-ASBESTOS CHEST, 2 VIEW 10.4876 320 $ 195.00 487871002 XRAY-ASBESTOS, CHEST 2VW./OBLI 10.4876 320 $ 205.00 487871010 XRAY-CHEST, 1 VIEW 10.4876 320 $ 68.00 487871020 XRAY-CHEST, 2 VIEW 10.4876 320 $ 80.00 487871022 XRAY-CHEST, 2 VIEW/OBLIQUE 10.4876 320 $ 115.00 487879000 LAB-CONTRACT 10.4876 510 $ - 487880001 LAB-ENVIRONMENTAL EXP. MONITOR 10.4876 300 $ 599.00 487880002 LAB-HEPATITIS TITER 10.4876 300 $ 58.00 487880005 LAB-HIV 10.4876 300 $ 29.00 487880006 MUMPS TITER 10.4876 300 $ 109.00 487880007 MEASLES (RUBIOLA) TITER 10.4876 300 $ 60.00 487880010 LAB-PAP 10.4876 300 $ 45.00 487880100 LAB-SERUM TOXICOLOGY 10.4876 300 $ 35.00 487881002 URINALYSIS W/O MICRO 10.4876 300 $ 21.00 487881015 URINALYSIS WITH MICRO 10.4876 300 $ 24.00 487881025 PREGNANCY TEST-URINE 10.4876 300 $ 31.00 487882270 OCCULT BLOOD, FECES 10.4876 300 $ 17.00 487882480 LAB-CHOLINESTERASE 10.4876 300 $ 62.00 487882948 GLUCOSE 10.4876 300 $ 24.00 487883655 LAB-LEAD LEVEL 10.4876 300 $ 58.76 487884153 LAB-PSA 10.4876 300 $ 40.00 487884200 LAB-ZPP 10.4876 300 $ 80.00 487885013 SPUN MICRO HEMATROCRIT 10.4876 300 $ 21.00 487885018 HEMOGLOBIN 10.4876 300 $ 24.00 487886580 INJECTION-PPD 10.4876 510 $ 16.00 487886588 RAPID STREP 10.4876 300 $ 31.00 487887210 WET MOUNT 10.4876 300 $ 31.00 487887220 KOH PREP 10.4876 300 $ 31.00 487889203 E/M FIRST AID 10.4876 983 $ 90.00 487890718 INJECTION-DIP/TET 10.4876 510 $ 19.50 487890724 INJECTION-FLU 10.4876 510 $ 20.00 487890780 WC IV INFUSION FIRST HOUR 10.4876 260 $ 271.00 487890781 WC IV INFUSION ADD'L HRS 10.4876 260 $ 163.00 487890782 IM THERAPEUTIC INJECTION 10.4876 920 $ 18.00 487890784 IV INJECTION 10.4876 920 $ 31.00 487890788 IM/SQ ANTIBIOTIC INJECTION 10.4876 636 $ 18.00 487893000 EKG 12 LEAD RECORDING 10.4876 730 $ - 487893005 EKG WITH REPORT (EOH) 10.4876 730 $ 166.40 487894010 PULMONARY FUNCT. TEST 10.4876 460 $ 72.00 487894666 NEB MED TUBING 10.4876 272 $ 50.00 487894760 PULSE OXIMETRY 10.4876 983 $ 29.00 487897000 PT-MISC. PHYSICAL THERAPY SUPP 10.4876 420 $ 7.00 487897014 ELECTRICAL STIM/TENS 10.4876 420 $ 25.00 487897122 PT-MANUAL TRACTION 10.4876 420 $ 49.00 487897250 PT-SOFT TISSUE MOBILIZATION 10.4876 420 $ 51.00 487897265 PT-JOINT MOBILIZATION 10.4876 420 $ 39.00 487897670 WORK TOLERANCE TRAIN/MEAS / HR 10.4876 983 $ 104.00 487897799 MISC. PHYSICAL THERAPY SERVICE 10.4876 420 $ - 487898018 SPECIAL FRM/RPRT RQST BY INS 10.4876 983 $ 71.00 487899048 PHONE CALL 15 MIN EMPLY/AGNCY 10.4876 983 $ 26.00 487899049 MISSED APPOINTMENT 10.4876 510 $ 25.00 487899075 MEDICAL TESTIMONY 15 MIN 10.4876 983 $ 52.00 487899078 EDUCATIONAL SERVICES 10.4876 983 $ 52.00 487899080 SPECIAL REPORT 10.4876 983 $ 71.00 487899081 REQUIRED REPORT 10.4876 983 $ 22.00 487899082 MD FINAL DISCHARGE REPORT 10.4876 983 $ 22.00 487899086 WC SPECIAL REPORT 6 PAGE 10.4876 983 $ 156.00 487899087 SPECIAL REPORT 7 PAGE 10.4876 983 $ 187.00 487899201 BASIC EXAM 10.4876 983 $ 94.00 487899202 NEW PT., EXPANDED PROBLEM 10.4876 983 $ 115.00 487899203 NEW PT. INTERMEDIATE EXAM 10.4876 983 $ 149.00 487899204 NEW PT. EXTENDED EXAM 10.4876 983 $ 221.00 487899205 NEW PT COMPREHENSIVE EXAM 10.4876 983 $ 292.00 487899208 EXAM ROOM 10.4876 761 $ 61.00 487899211 ESTABLISHED BRIEF EXAM 10.4876 983 $ 89.00 487899212 ESTABLISHED PT/EXPANDED PROBLE 10.4876 983 $ 110.00 487899213 EST. PT INTERMEDIATE EXAM 10.4876 983 $ 145.00 487899214 ESTABLISHED PT EXTENDED EXAM 10.4876 983 $ 206.00 487899215 EST. PT COMPREHENSIVE EXAM 10.4876 983 $ 209.00 487899216 TREATMENT ROOM 10.4876 761 $ 31.00 487899245 COMPREHENSIVE CONSULTATION 10.4876 983 $ 259.00 487899354 PROLONGED SERVICE FIRST HOUR 10.4876 983 $ 150.00 487899357 PROLONGED NON FACE-TO-FACE SVC 10.4876 983 $ 135.00 487899358 PROLONGED SERVICE RECORD 15MIN 10.4876 983 $ 52.00 487899361 TEAM MEDICAL CONFERENCE 10.4876 983 $ 132.00 487899371 PHONE CALL-MD-SIMPLE 10.4876 983 $ 40.00 487899372 PHONE CALL-MD-INTERMEDIATE 10.4876 983 $ 55.00 487899373 PHONE CALL-MD-COMPREHENSIVE 10.4876 983 $ 70.00 487900001 PULM. REHAB. TO VISIT PATIENT 10.4879 943 $ - 487900005 CARDIAC REHAB IP VISIT 15 MIN 10.4879 943 $ - 487900006 SMOKING CESSATION-EMPLOYEE 10.4879 990 $ 64.00 487900007 SMOKING CESSATION-PUBLIC 10.4879 990 $ 64.00 487900010 CORONARY PREVENTION / INITIAL 10.4879 990 $ 51.00 487900015 CORONARY PREVENTION / MONTH 10.4879 990 $ 45.00 487900210 PULM REHAB THER PROC 15 MIN 10.4879 410 $ 51.00 487900220 PULM REHAB THER OTHER 15 MIN 10.4879 410 $ 51.00 487900230 PULM REHAB THER GROUP 15 MIN 10.4879 410 $ 31.00 487991019 NEBULIZED MEDICATION TREATMENT 10.4879 410 $ 53.00 487991100 POSTURAL DRAINAGE/PERCUSSION 10.4879 760 $ 48.00 487991300 PULM REHAB INITIAL ASSESSMENT 10.4879 419 $ 141.00 487991302 PULM REHAB LIMITED ASSESSMENT 10.4879 410 $ - 487991310 PULMONARY MAINTENANCE PER MONT 10.4879 419 $ 45.00 487992000 PULMONARY REHAB/THER 15 MIN 10.4879 419 $ 51.00 487992150 PULMONARY REHAB/TRAINING 15 MI 10.4879 419 $ 51.00 487992300 PERFORMANCE TEST/REPORT 15 MIN 10.4879 419 $ 53.00 487994699 PULSE OXIMETRY, MULIPLE 10.4879 460 $ 247.00 487997150 THER. PROCEDURE., GROUP, 15 MI 10.4879 419 $ 31.00 487997205 PHYSICAL THERAPY INSTR., 30 MI 10.4879 419 $ 36.00 487997530 THERAPEUTIC ACTIVITIES, 15 MIN 10.4879 419 $ 41.00 487997544 CARDIAC REHAB WITH TELEMETRY 10.4879 943 $ 111.00 487997590 CARDIAC REHAB W TELEMETRY 10.4879 943 $ 116.00 487997750 CONSULT/EVAL. W/REPORT, 15 MIN 10.4879 419 $ 51.50 487999754 CARDIAC MAINTENANCE PER MONTH 10.4879 943 $ 45.00 488007810 ACUPUNCTURE GROUP TREATMENT 10.4880 510 $ 20.00 488007811 ACUPUNCT GRP TRTMNT $0 10.4880 510 $ - 488007812 ACUPUNCT INPATIENT 1 HOUR - $0 10.4880 510 $ - 488078100 EMPLY-ACUPUNCTURE INITIAL 10.4880 510 $ 30.00 488078110 EMPLY-ACUPUNCTURE CONTINUED 10.4880 510 $ 10.00 488092110 EMPLY-ACUPUNCTURE NEW PT ASMNT 10.4880 510 $ 12.00 488097781 ACUPUNCTURE W ELECT STIM 10.4880 510 $ - 488097810 ACUPUNCTURE INITIAL 10.4880 510 $ 30.00 488097811 ACUPUNCTURE CONTINUED 10.4880 510 $ 20.00 488099211 ACUPUNCTURE NEW PT ASSESSMENT 10.4880 510 $ 15.00 644000901 INITIAL HOSP CARE LOW COMPLEX 10.3440 960 $ 176.00 644000902 INITIAL HOSP CARE MOD 50MIN 10.3440 960 $ 237.00 644000903 INITIAL HOSP CARE HIGH 70MIN 10.3440 960 $ 286.00 644000904 SUBSEQUENT HOSP CARE LOW 15MIN 10.3440 960 $ 94.00 644000905 SUBSEQUENT HOSP CARE MOD 25MIN 10.3440 960 $ 132.00 644000906 SUBSEQNT HOSP CARE HIGH 35MIN 10.3440 960 $ 176.00 644000907 HOSP DISCHARGE UP TO 30 MIN 10.3440 960 $ 110.00 644000908 INIT INPT CONSULT MINOR 20MIN 10.3440 960 $ 160.00 644000909 INIT INPT CONSULT LOW 40MIN 10.3440 960 $ 204.00 644000910 INIT INPT CONSULT MOD 55MIN 10.3440 960 $ 248.00 644000911 INIT INPT CNSLT MOD-HIGH 80MIN 10.3440 960 $ 314.00 644000912 INIT INPT CONSULT HIGH 110MIN 10.3440 960 $ 391.00
