NUMBER DESCRIPTION DEPT REV CODE CPT CODE UNIT PRICE

Document Sample
NUMBER DESCRIPTION DEPT REV CODE CPT CODE UNIT PRICE Powered By Docstoc
					                                                REV    CPT   UNIT      ROOM
  NUMBER              DESCRIPTION      DEPT    CODE   CODE   PRICE     PRICE
12427      R&B 2HTU ICU                0      201               0.00    8748.00
14050      R&B 4FE-CCU                 0      210               0.00    8747.99
14241      R&B 4FE-ICU                 0      201               0.00    8748.00
14308      R&B 4FE-ICU                 0      201               0.00    8748.00
22426      R&B 2HTU CCU                0      211               0.00    8747.98
24059      R&B 4FE-CCU                 0      211               0.00    8747.98
32003      R&B 2FM-MS TELEMETRY        0      214               0.00    4211.99
32425      R&B 2HTU INTERMEDIATE ICU   0      206               0.00    4212.00
32466      R&B PEDS-INTERMEDIATE ICU   0      206               0.00    4212.00
34009      R&B 4FM-INTERM/CCU          0      214               0.00    4211.99
34058      R&B 4FE-CCU/INTERMIDIATE    0      214               0.00    4211.99
34249      R&B 4FE-INTERM/ICU          0      206               0.00    4212.00
34306      R&B 4FE-INTERM/ICU          0      206               0.00    4212.00
42218      R&B 2FE-MED/SURG PVT        0      121               0.00    3132.00
42465      R&B 2FN-PEDS PVT            0      113               0.00    3131.98
43000      R&B 3FM-MED/SURG PVT        0      121               0.00    3132.00
43026      R&B 3FM - PEDS PVT          0      113               0.00    3131.98
43216      R&B 3FE-OBS/PVT             0      112               0.00    3131.99
43471      R&B 3FE-LABOR/DELV PVT      0      112               0.00    3131.99
44008      R&B 4FM-MED/SUR PVT         0      121               0.00    3132.00
44057      R&B 4FE-CCU M/S PVT         0      121               0.00    3132.00
52001      R&B 2FM-MED/SUR SEMI-PVT    0      121               0.00    3132.00
52217      R&B 2FE-MED/SUR SEM-PVT     0      121               0.00    3132.00
52423      R&B 2HTU MED/SUR SEMI-PVT   0      121               0.00    3132.00
52464      R&B 2FN-PEDS SEMI/PVT       0      123               0.00    3131.96
52480      R&B 2FN PEDS (MED/SUR)S-P   0      121               0.00    3132.00
53009      R&B 3FM-MED/SUR SEMI-PVT    0      121               0.00    3132.00
53215      R&B 3FE-OB SEMI/PVT         0      122               0.00    3131.97
53470      R&B 3FE LAB/DELIV OB S/PV   0      122               0.00    3131.97
54007      R&B 4FM-MED/SUR SEM-PVT     0      121               0.00    3132.00
54056      R&B 4FE-CCU M/S SEMI-PVT    0      121               0.00    3132.00
54247      R&B 4FE-ICU M/S SEMI-PVT    0      121               0.00    3132.00
54304      R&B 4FE-ICU M/S SEMI-PVT    0      121               0.00    3132.00
62463      R&B 2FN-PEDS WARD           0      153               0.00    3131.95
63024      R&B 3FM - PEDS WARD         0      153               0.00    3131.95
63404      R&B 2FM-NSY WARD            0      153               0.00    3131.95
63420      R&B 3FM-SPCN WARD           0      153               0.00    3131.95
73411      R&B 3FM-ICNN                0      174               0.00    8208.00
83402      R&B 3FM-NURSERY / SPCN      0      173               0.00    4212.00
83410      R&B 3FM-INTRM/CARE NEONT    0      173               0.00    4212.00
83428      R&B 3FM-INTRM/CARE NEONT    0      173               0.00    4212.00
83436      R&B 3FM-CONT/CARE NSY LII   0      172               0.00    3132.00
92460      R&B 2FN NEWBORN             0      171               0.00    1620.00
93401      R&B 3FM-NEWBORN NSY         0      171               0.00    1620.00
100016     VAGINAL DELIVERY NORMAL     1      722            2592.00       0.00
100065     GEN ANESTHESIA 1/2HR        1      370             355.00       0.00
100099     SPINAL ANESTHESIA           1      370             424.00       0.00
100115     EPIDURAL ANESTHES           1      370             424.00       0.00
100123     NORMAL C-SECT DELIVERY      1      360            4860.00       0.00
100149     MAJOR SURG 1/2 HR           1      360            1323.00       0.00
100255     RECOVERY RM 1/2HR           1      710             372.00       0.00
100263     EMERGENCY C-SECT DELIVERY   1      360            5400.00       0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
100271    FETAL MONITORING P/DAY      1   920     59050   1062.00       0.00
100289    KREISSELMAN-S/U             1   410             1088.00       0.00
100297    D&C                         1   360     59812   3690.00       0.00
100305    PREGNANCY - LIMITED         1   402     76815    858.00       0.00
100313    VAGINAL DELIVERY HI-RISK    1   722             4009.00       0.00
100321    LACTATION VISIT INPATIENT   1   729                0.00       0.00
100339    DIABETIC VISIT INPATIENT    1   942                0.00       0.00
200022    OB EVALUATION AND MNGT      2   510     99215    891.00       0.00
200030    OXYTOCIN CHALLENGE TEST     2   920     59020    820.00       0.00
200048    NON STRESS TEST             2   920     59025   1089.00       0.00
200055    FETAL BIOPHYSICAL PROFILE   2   402     76818   1187.00       0.00
200063    PLACENTA LOCALIZATION       2   402     76815    858.00       0.00
200071    PREGNANCY - LIMITED         2   402     76815    858.00       0.00
200105    CONTRACTION STRESS TEST     2   510              615.00       0.00
200113    REMOVE CERCLAGE SUTURE      2   361     59871   3695.00       0.00
200121    OBF KSR =<37 WEEK R/O LBR   2   099                0.00       0.00
200329    HYDRATION IV INFUSION INI   2   260     90760    267.00       0.00
200337    THER/PRO/DIAG IV INF INIT   2   260     90765    267.00       0.00
200345    HYDRATE IV INFUSON ADD-ON   2   260     90761    249.00       0.00
200352    THER/PRO/DX IV INF ADD-ON   2   260     90766    249.00       0.00
200360    THER/PROPH/DIAG INJ SC/IM   2   940     90772    267.00       0.00
200378    TH/PR/DX INJ SC/IM EA ADD   2   940     90772    223.00       0.00
200386    TH/PR/DX INJ IV PUSH INIT   2   940     90774    267.00       0.00
200402    TPDX IV PUSH NEW SUB INIT   2   940     90775    223.00       0.00
200428    TH/PR/DX IV PUSH EA ADD     2   940     90776    223.00       0.00
250027    FETAL MONITORING P/HOUR     2   720     59050     44.00       0.00
250100    OBSV CARE S/DAY OBS L1      2   762     99234   1034.00       0.00
250118    OBSV CARE S/DAY OBS L2      2   762     99235   2067.00       0.00
250126    OBSV CARE S/DAY OBS L3      2   762     99236   3132.00       0.00
250134    OBSV CARE OVRNT OBS L1      2   762     99218   1034.00       0.00
250142    OBSV CARE OVRNT OBS L2      2   762     99219   2067.00       0.00
250159    OBSV CARE OVRNT OBS L3      2   762     99220   3132.00       0.00
250167    OBSERVATION PER HOUR - OB   2   762              130.00       0.00
250175    OBSERVTN DIRECT ADMT - OB   2   762               86.00       0.00
300020    POC-TTL BILIRUBIN TRNSCT    3   301     88400     30.00       0.00
300103    ICNN TRANSP/TEAM 1 HR       3   239              228.00       0.00
300129    ICNN TRANSP/TEAM RETURN 1   3   239              228.00       0.00
301002    LATE DISCHARGE ORDER ICNN   3   224                0.00    8208.00
301028    LATE DISCHARGE ORDER SCN    3   224                0.00    4211.98
301044    LATE DISCH/ORDER CCN 3FM    3   172                0.00    3132.00
500108    LATE DISCHARGE ORDER ICU    5   224                0.00    8748.00
500801    CARDIOVERSION (ICU)         5   480     92960   1182.00       0.00
600106    LATE DISCHARGE ORDER CCU    6   224                0.00    8748.00
600809    CARDIOVERSION (CCU)         6   480     92960   1182.00       0.00
700104    LATE DISCHARGE ORDER NSY    7   224                0.00    1620.00
900266    OBSERVATION PER HOUR        9   762              176.00       0.00
900274    OBSERVATION DIRECT ADMIT    9   762              108.00       0.00
900415    OBSV CARE S/DAY PEDS L1     9   762     99234   1404.00       0.00
900423    OBSV CARE S/DAY PEDS L2     9   762     99235   2808.00       0.00
900431    OBSV CARE S/DAY PEDS L3     9   762     99236   4212.00       0.00
900449    OBSV CARE OVRNT PEDS L1     9   762     99218   1404.00       0.00
900456    OBSV CARE OVRNT PEDS L2     9   762     99219   2808.00       0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
900464    OBSV CARE OVRNT PEDS L3     9    762    99220   4212.00      0.00
900514    OBSV CARE S/DAY 2E L1       9    762    99234   1404.00      0.00
900522    OBSV CARE S/DAY 2E L2       9    762    99235   2808.00      0.00
900530    OBSV CARE S/DAY 2E L3       9    762    99236   4212.00      0.00
900548    OBSV CARE OVRNT 2E L1       9    762    99218   1404.00      0.00
900555    OBSV CARE OVRNT 2E L2       9    762    99219   2808.00      0.00
900563    OBSV CARE OVRNT 2E L3       9    762    99220   4212.00      0.00
900613    OBSV CARE S/DAY 2M L1       9    762    99234   1404.00      0.00
900621    OBSV CARE S/DAY 2M L2       9    762    99235   2808.00      0.00
900639    OBSV CARE S/DAY 2M L3       9    762    99236   4212.00      0.00
900647    OBSV CARE OVRNT 2M L1       9    762    99218   1404.00      0.00
900654    OBSV CARE OVRNT 2M L2       9    762    99219   2808.00      0.00
900662    OBSV CARE OVRNT 2M L3       9    762    99220   4212.00      0.00
900712    OBSV CARE S/DAY 3M L1       9    762    99234   1404.00      0.00
900720    OBSV CARE S/DAY 3M L2       9    762    99235   2808.00      0.00
900738    OBSV CARE S/DAY 3M L3       9    762    99236   4212.00      0.00
900746    OBSV CARE OVRNT 3M L1       9    762    99218   1404.00      0.00
900753    OBSV CARE OVRNT 3M L2       9    762    99219   2808.00      0.00
900761    OBSV CARE OVRNT 3M L3       9    762    99220   4212.00      0.00
900811    OBSV CARE S/DAY 4M L1       9    762    99234   1404.00      0.00
900829    OBSV CARE S/DAY 4M L2       9    762    99235   2808.00      0.00
900837    OBSV CARE S/DAY 4M L3       9    762    99236   4212.00      0.00
900845    OBSV CARE OVRNT 4M L1       9    762    99218   1404.00      0.00
900852    OBSV CARE OVRNT 4M L2       9    762    99219   2808.00      0.00
900860    OBSV CARE OVRNT 4M L3       9    762    99220   4212.00      0.00
1000017   CIRCUMCISION GLOBAL FEE     10   510             233.34      0.00
1000041   HEARING SCREEN INITIAL IP   10   471    92585    223.00      0.00
1000108   HISTORY & PHYSICAL PHYS     10   510    99242    215.00      0.00
1000124   COMPREHENSIVE CHART RVW     10   510    99358    160.00      0.00
1000215   MINOR SURGICAL PROCEDURE    10   361    MULTI    540.00      0.00
1000223   PARENT CNFR 30 MIN/SOC WK   10   510    99366     72.00      0.00
1000231   NURSE SPECIALIST 30 MIN     10   510    99366    191.00      0.00
1000249   CENTER CONFERENCE 30 MIN    10   510    99366    109.00      0.00
1000256   COORDINATOR FEE             10   510    99366    215.00      0.00
1000264   COORDINATOR ALLIED PROF     10   510    99366    215.00      0.00
1000405   HEARING SCREEN FOLLW/U OP   10   471    92585    223.00      0.00
1000413   HEARING SCREEN OP           10   471    92585    223.00      0.00
1050020   BLOOD ADMINISTRATION        10   391    36430    891.00      0.00
1060086   PSY DIAG: TEST ADM 1HR/BN   10   510    96110    172.00      0.00
1060094   PSY DIAG: TEST ADM 2HR/BN   10   510    96110    345.00      0.00
1060102   PSY DIAG:TEST ADM 3HR/BYL   10   510    96111    517.00      0.00
1060110   PSY DIAG:TEST ADM 4 HR/BY   10   510    96111    689.00      0.00
1060128   PSY DIAG:TEST ADM 5HR/BYL   10   510    96111    859.00      0.00
1060136   PSY DIAG:TEST ADM 6HR/BYL   10   510    96111   1031.00      0.00
1060144   PSY DIAG:TEST ADM 15MIN/B   10   510    96111    211.00      0.00
1060169   PSY DIAG:TEST SCRNG 1HR/B   10   510    96110    172.00      0.00
1060177   PSY DIAG:TEST SCRNG 2HR/B   10   510    96111    345.00      0.00
1060185   PSY DIAG:TEST SCRNG 15MIN   10   510    96111    211.00      0.00
1060201   PSY DIAG:WRITTEN RPT 1 HR   10   510    96110    172.00      0.00
1060219   PSY DIAG: WRITTEN RPT 2HR   10   510    96111    345.00      0.00
1060227   PSY DIAG:WRITTEN RPT 15 M   10   510    96111    211.00      0.00
1300110   SSS NEW PT COMPR 60MIN      13   942    99205    584.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
1300128   SSC EST PT COMPR 40MIN      13   942    99215    487.00       0.00
1300136   SSC EST PT DETAIL 25MIN     13   942    99214    384.00       0.00
1300144   SSC EST PT EXPN 15MIN       13   942    99213    312.00       0.00
1300151   SSC EST PT FOCUS 10MIN      13   942    99212    297.00       0.00
1300235   SOC WRKR NW PT EXP EA 15M   13   942             223.00       0.00
1300243   SOC WRKR F/U EA 15MN-3HRS   13   942             223.00       0.00
1300268   SSC INI HLTH ED ASSES 30M   13   942             223.00       0.00
1300276   SSC HLTH ED F/U DEVLP 15M   13   942             111.00       0.00
1300284   SSC ANTPTM HLTH ED FU 15M   13   942             111.00       0.00
1300292   SSC PSTPTM HLTH ED FU 15M   13   942             111.00       0.00
1300318   SSC CONSULT DETAILD 25MIN   13   942    99213    384.00       0.00
1300334   SSC CONSLT DETAILD 45 MIN   13   942    99204    487.00       0.00
1300359   SSC CONSLT COMPR 60MIN      13   942    99205    668.00       0.00
1300375   SSC INIT COMPR NUTR MGMT    13   942    99205    856.00       0.00
1300383   SSC ORIENT HLTH ED EA 15M   13   942             111.00       0.00
1300391   SOC WRKR NW PT 30MIN        13   942    99203    446.00       0.00
1300409   SSC PERINATAL EDUC EA 15M   13   942             111.00       0.00
1300417   SOC WRKR NW PT 30MIN        13   942             446.00       0.00
1300425   SSC INIT NUTR ASSESS 30M    13   942             223.00       0.00
1300433   SOC WRKR F/U 30MIN          13   942    99213    446.00       0.00
1300441   SSC F/UP NUTRIT EA 15M      13   942             111.00       0.00
1300458   SSC PSTPTM NUTR/ASSES 15M   13   942    97803    111.00       0.00
1300466   SSC ANTE F/U INDIV EA 15M   13   942             111.00       0.00
1300482   SSC PSTPTM NUTR/ASSES 15M   13   942             111.00       0.00
1600022   INITIAL TX.,COOLING MEASU   16   510    16000    373.00       0.00
1600030   DRSG &/OR DEBRIDEMENT - S   16   510    16020    355.00       0.00
1600048   DRSG &/OR DEBRIDEMENT - M   16   510    16025    422.00       0.00
1600055   DRSG &/OR DEBRIDEMENT - L   16   510    16030    484.00       0.00
1600063   WHIRLPOOL                   16   510    97022    295.00       0.00
1600071   RE-CHECK                    16   510    99212    182.00       0.00
1900109   LATE DISCHARGE ORDER PEDS   19   224               0.00    3132.00
2000065   SKULL LIMTED                20   320    70250    499.00       0.00
2000073   SKULL COMPLETE              20   320    70260   1089.00       0.00
2000099   FACIAL BONES LIMITED        20   320    70140    526.00       0.00
2000107   FACIAL BONES COMPLETE       20   320    70150    991.00       0.00
2000123   NASAL BONES                 20   320    70160    526.00       0.00
2000164   MANDIBLE LIMIT              20   320    70100    561.00       0.00
2000172   MANDIBLE COMP               20   320    70110    979.00       0.00
2000180   EYE FOR FB                  20   320    70030    809.00       0.00
2000198   ORBITS                      20   320    70200    979.00       0.00
2000206   OPTIC FORAMINA              20   320    70190    552.00       0.00
2000214   TEMPOROMANDIBULAR JOINTS    20   320    70330    937.00       0.00
2000222   SINUSES LIMIT               20   320    70210    408.00       0.00
2000230   SINUSE COMP.                20   320    70220    735.00       0.00
2000248   MAXILLA                     20   320    70150   1031.00       0.00
2000263   SOFT TISS NECK              20   320    70360    450.00       0.00
2000297   SPINE SINGLE VIEW           20   320    72020    340.00       0.00
2000305   CERVICAL SPINE LIMIT        20   320    72040    548.00       0.00
2000313   CERVICAL SPINE COMPLETE     20   320    72050    869.00       0.00
2000321   CERVICAL SPINE FLEX & E     20   320    72052   1182.00       0.00
2000339   THORACIC SPINE              20   320    72070    560.00       0.00
2000347   THORACOLUMBAR SPINE         20   320    72080    588.00       0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
2000354   SCOLIOSIS SERIES            20   320    72090    653.00      0.00
2000362   LUMBOSACRAL LIMITED         20   320    72100    594.00      0.00
2000370   LUMBOSACRAL COMPLETE        20   320    72110   1042.00      0.00
2000388   LUMBOSACRAL BENDING VIEW    20   320    72120    701.00      0.00
2000396   PELVIS 1 VIEW               20   320    72170    385.00      0.00
2000404   PELVIS 3 VIEWS              20   320    72190    548.00      0.00
2000412   SACROILIAC JOINTS           20   320    72202    667.00      0.00
2000420   SACRUM                      20   320    72220    579.00      0.00
2000438   COCCYX                      20   320    72220    579.00      0.00
2000446   SACRUM & COCCYX             20   320    72220    679.00      0.00
2000453   STERNUM                     20   320    71120    506.00      0.00
2000461   STERNO/CLAVICULAR JOINTS    20   320    71130    549.00      0.00
2000487   RIBS BILATERAL              20   320    71110    915.00      0.00
2000537   ACROMIOCLAVICULAR JOINTS    20   320    73050    530.00      0.00
2000693   HIP BILATERAL COMPLETE      20   320    73520    754.00      0.00
2000701   HIPS & PELVIS INFANT        20   320    73540    364.00      0.00
2000842   CHEST PORT 1 VIEW           20   324    71010    417.00      0.00
2000859   CHEST PORT 2 VIEW           20   324    71020    588.00      0.00
2000867   ABD PORT 1 VIEW             20   320    74000    474.00      0.00
2000875   ABD PORT 2 VIEW             20   320    74010    578.00      0.00
2000883   CHILD FB                    20   320    76010    255.00      0.00
2000891   CHEST 1 VIEW                20   324    71010    315.00      0.00
2000909   CHEST 2 VIEW                20   324    71020    486.00      0.00
2000917   CHEST 3 VIEW                20   324    71021    502.00      0.00
2000941   ABDOMEN 1 VIEW              20   320    74000    371.00      0.00
2000958   ABDOMEN 2 VIEW              20   320    74010    475.00      0.00
2000966   ABDOMEN 3 VIEW              20   320    74020    502.00      0.00
2001048   CHOLANG POST-OPERATIVE      20   320    74305   1337.00      0.00
2001063   CHOLANGIOGRAPHY OPERATIVE   20   320    74300   1907.00      0.00
2001071   PERCUTANEOUS CHOLANGIOGRP   20   320    74320   4560.00      0.00
2001097   UROGRAM IVP                 20   320    74410   1613.00      0.00
2001105   INF IVP-TOMOS               20   320    74415   1847.00      0.00
2001113   IVP W TOMO OR INF           20   320    74400   1510.00      0.00
2001121   URO RETROGRADE              20   320    74420   1533.00      0.00
2001147   CYSTOGRAM                   20   320    74430   1231.00      0.00
2001154   PERCUT TRANSHEP BIL DRNGE   20   320    75980   7860.00      0.00
2001162   URETHRO CYST RETRO VOIDNG   20   320    74455   1645.00      0.00
2001170   URETHRO CYST RETROGRADE     20   320    74450   1133.00      0.00
2001188   TOMOGRAM INDEP              20   320    76100   1518.00      0.00
2001196   TOMOGRAM W/ROUTINE          20   320    76100    882.00      0.00
2001204   PORTABLE SET UP             20   320    Q0092    102.00      0.00
2001220   NEPHRO GRAM IN OR           20   320    74000    576.00      0.00
2001238   URETERAL STENT PLACEMENT    20   320    74480   1551.00      0.00
2001246   NEPHROSTOMY RIGHT           20   320    74475   3312.00      0.00
2001279   ESOPHAGUS                   20   320    74220   1038.00      0.00
2001287   UPPER GI                    20   320    74247   1381.00      0.00
2001295   UPPER GI LIMIT              20   320    74246   1399.00      0.00
2001303   UPPER GI/SMALL BOWEL        20   320    74249   1907.00      0.00
2001311   SMALL BOWEL XRAY            20   320    74250   1424.00      0.00
2001329   BARIUM ENEMA                20   320    74270   1249.00      0.00
2001337   BARIUM ENEMA AIR CONTRAST   20   320    74280   1770.00      0.00
2001378   FLUORO, UP TO 1 HOUR        20   320    76000   1062.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
2001386   FLUOROSCOPY > 1 HR          20   320    76001   1424.00      0.00
2001394   ENTEROCLYSIS                20   320    74251   3040.00      0.00
2001410   BARIUM SWALLOW W/THERAPIS   20   320    74230   1188.00      0.00
2001469   DUPLICATION RADIOLGY FILM   20   320    76499     16.00      0.00
2001527   INSERT PICC AGE 5 />        20   323    36569   3351.00      0.00
2001535   REPLACE PICC LINE COMPLET   20   323    36584   3351.00      0.00
2001543   INJ W/FLUOR, EVAL CVAD      20   323    36598    216.00      0.00
2001550   EXTREMITY ANGIO - UNIL      20   323    75710   2921.00      0.00
2001568   UNIL CERE INT CAROT ANGIO   20   323    75665   2921.00      0.00
2001576   BONE AGE STUDIES            20   320    77072    517.00      0.00
2001584   BONE SURVEY COMPLETE        20   320    77075   1457.00      0.00
2001592   INFANT BONE SURVEY          20   320    77076   1391.00      0.00
2001600   BONE LENGTH STUDIES         20   320    77073   1295.00      0.00
2001618   FLUORO FOR SPINE INJECT     20   320    77003   1296.00      0.00
2001626   PERC VERTEBROPLASTY FLUOR   20   320    72291   1296.00      0.00
2001634   FLUORO FOR BIOPSY           20   320    77002   1296.00      0.00
2001642   MAMMO NEEDLE LOCAL LEFT     20   320    77032   1061.00      0.00
2001659   MAMMO NEEDLE LOCAL RIGHT    20   320    77032   1061.00      0.00
2001683   PERC PEG TUBE PLACEMENT     20   323    43246   2478.00      0.00
2001691   INS N-TNLD CV CTH AGE 5/>   20   323    36556   3351.00      0.00
2001709   ENDO CATH - PANCR DUCT      20   320    74329   1237.00      0.00
2002228   FOOT LIMITED LEFT           20   320    73620    364.00      0.00
2002236   FOOT COMPLETE LEFT          20   320    73630    457.00      0.00
2002244   FEMUR LEFT                  20   320    73550    456.00      0.00
2002251   ELBOW LEFT LIMITED          20   320    73070    373.00      0.00
2002269   CLAVICLE LEFT               20   320    73000    493.00      0.00
2002277   ANKLE COMPLETE LEFT         20   320    73610    454.00      0.00
2002285   ANKLE LIMITED LEFT          20   320    73600    397.00      0.00
2002293   FOREARM LEFT                20   320    73090    397.00      0.00
2002301   HAND LIMITED LEFT           20   320    73120    397.00      0.00
2002319   HAND COMPLETE LEFT          20   320    73130    459.00      0.00
2002327   HEEL LEFT                   20   320    73650    325.00      0.00
2002335   HIP COMPLETE LEFT           20   320    73510    591.00      0.00
2002343   HIP OPERATIVE LEFT          20   320    73530   1822.00      0.00
2002350   HIP LIMITED LEFT            20   320    73500    391.00      0.00
2002368   FINGERS LEFT                20   320    73140    287.00      0.00
2002376   HUMERUS LEFT                20   320    73060    318.00      0.00
2002384   KNEE & PATELLA LEFT         20   320    73564    653.00      0.00
2002392   KNEE COMPLETE RIGHT         20   320    73562    402.00      0.00
2002400   KNEE COMPLETE LEFT          20   320    73562    402.00      0.00
2002418   KNEE LIMITED LEFT           20   320    73560    362.00      0.00
2002426   NAVICULAR SERIES LEFT       20   320    73110    456.00      0.00
2002434   NEPHROSTOGRAM LEFT          20   320    74425   1533.00      0.00
2002442   NEPHROSTOMY LEFT            20   320    74475   3312.00      0.00
2002459   RIBS LEFT                   20   320    71100    615.00      0.00
2002467   SCAPULA LEFT                20   320    73010    549.00      0.00
2002475   SHOULDER COMPLETE LEFT      20   320    73030    509.00      0.00
2002483   SHOULDER LIMITED LEFT       20   320    73020    362.00      0.00
2002491   TIBIA & FIBULA LEFT         20   320    73590    410.00      0.00
2002509   TOES LEFT                   20   320    73660    270.00      0.00
2002517   WRIST COMPLETE LEFT         20   320    73110    462.00      0.00
2002525   WRIST LIMITED LEFT          20   320    73100    392.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
2002541   ELBOW RIGHT COMPLETE        20   320    73080    462.00      0.00
2002558   ELBOW LEFT COMPLETE         20   320    73080    462.00      0.00
2002566   URETERAL STENT PLACMNT/LT   20   320    74480   1550.00      0.00
2002574   URETERAL STENT PLACMT/RT    20   320    74480   1550.00      0.00
2002608   RIBS RIGHT                  20   320    71100    615.00      0.00
2002616   SCAPULA RIGHT               20   320    73010    549.00      0.00
2002624   SHOULDER LIMITED RIGHT      20   320    73020    362.00      0.00
2002632   SHOULDER COMPLETE RIGHT     20   320    73030    509.00      0.00
2002640   HUMERUS RIGHT               20   320    73060    318.00      0.00
2002657   ELBOW RIGHT LIMITED         20   320    73070    373.00      0.00
2002665   FOREARM RIGHT               20   320    73090    397.00      0.00
2002673   WRIST LIMITED RIGHT         20   320    73100    392.00      0.00
2002681   WRIST COMPLETE RIGHT        20   320    73110    462.00      0.00
2002699   NAVICULAR SERIES RIGHT      20   320    73110    456.00      0.00
2002707   HAND COMPLETE RIGHT         20   320    73130    459.00      0.00
2002715   HAND LIMITED RIGHT          20   320    73120    397.00      0.00
2002723   FINGERS RIGHT               20   320    73140    287.00      0.00
2002731   HIP LIMITED RIGHT           20   320    73500    391.00      0.00
2002749   HIP COMPLETE RIGHT          20   320    73510    591.00      0.00
2002756   FEMUR RIGHT                 20   320    73550    456.00      0.00
2002764   KNEE LIMITED RIGHT          20   320    73560    362.00      0.00
2002772   KNEE & PATELLA RIGHT        20   320    73564    653.00      0.00
2002780   TIBIA & FIBULA RIGHT        20   320    73590    410.00      0.00
2002798   ANKLE LIMITED RIGHT         20   320    73600    397.00      0.00
2002806   ANKLE COMPLETE RIGHT        20   320    73610    454.00      0.00
2002814   FOOT LIMITED RIGHT          20   320    73620    364.00      0.00
2002822   FOOT COMPLETE RIGHT         20   320    73630    457.00      0.00
2002830   HEEL RIGHT                  20   320    73650    325.00      0.00
2002848   HIP OPERATIVE RIGHT         20   320    73530   1822.00      0.00
2002855   NEPHROSTOGRAM RIGHT         20   320    74425   1533.00      0.00
2002863   CLAVICLE RIGHT              20   320    73000    493.00      0.00
2002871   TOES RIGHT                  20   320    73660    270.00      0.00
2002897   NEPHROSTOMY TUBE CHANGE     20   320    75984   1025.00      0.00
2002905   ASPIRATION OF MAJOR JOINT   20   323    20610   1025.00      0.00
2002913   PERCUT TRANSHEP CATH INTR   20   323    47510   6804.00      0.00
2003028   INS PACEMKR FLUORO & XRAY   20   320    71090   1663.00      0.00
2079903   OTHER RADIOLOGY SERVICES    20   320               0.00      0.00
2080067   SINUS FISTULA               20   323    76080   1022.00      0.00
2080075   HYSTEROSALPINGOGRAPHY       20   320    74740   1035.00      0.00
2080091   ERCP                        20   320    74330   1237.00      0.00
2080133   SURGICAL SPECIMEN MAMM      20   320    76098    169.00      0.00
2080158   MYELOGRAM CERVICAL          20   320    72240   1868.00      0.00
2080166   MYELOGRAM THORACIC          20   320    72255   2538.00      0.00
2080299   VENOGRAM EXTREMITY RT       20   320    75820   4406.00      0.00
2080307   VENOGRAM EXTREMITY BILAT    20   320    75822   4461.00      0.00
2080471   INFERIOR VENA CAVA          20   323    75825   6957.00      0.00
2080497   MYELOGRAM LUMBAR            20   320    72265   1481.00      0.00
2080505   MYELOGRAM 2 OR > REGIONS    20   320    72270   2410.00      0.00
2080562   ABSCESS DRAINAGE            20   320    75989   2516.00      0.00
2080570   ANGIO EXISTING CATH         20   323    75898   1286.00      0.00
2080588   INS TUNLD CV CATH AGE 5/>   20   323    36558   7406.00      0.00
2080687   ARTHRO SHOULDER             20   322    73040    983.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
2080737   ARTHRO HIP                  20   322    73525   1069.00      0.00
2080802   VENOGRAM EXTREMITY LEFT     20   320    75820   4406.00      0.00
2080885   AV SHUNT EXTREMITY LT       20   320    75790   5462.00      0.00
2080893   AV SHUNT EXTREMITY RT       20   320    75790   5462.00      0.00
2080901   THROMBOLYSIS PERIPHERAL R   20   320    75896   8220.00      0.00
2081222   INS TNLD CVAD W PORT        20   323    36561   9379.00      0.00
2081248   REMOVE TNLD CV CATH         20   323    36589   1739.00      0.00
2081263   SPINAL PUNCTURE             20   361    62270    852.00      0.00
2081305   REM TNLD CVAD W PORT/PUMP   20   323    36590   3351.00      0.00
2085009   RADIOLOGY SURG/COMPONENT    20   361    MULTI   1025.00      0.00
2200020   ABDOMEN COMPLETE            22   402    76700   1399.00      0.00
2200038   ABDOMEN LIMITED             22   402    76705    838.00      0.00
2200046   LIVER SONOGRAM              22   402    76705    968.00      0.00
2200053   GALL BLADDER SONOGRAM       22   402    76705    838.00      0.00
2200061   KIDNEY SONOGRAM             22   402    76770    968.00      0.00
2200095   AORTA SONOGRAM              22   402    76770    968.00      0.00
2200111   CHEST                       22   402    76604    968.00      0.00
2200129   URINARY BLADDER             22   402    76856    973.00      0.00
2200137   PREGNANCY - LIMITED         22   402    76815    857.00      0.00
2200145   PREGNANCY - COMPLETE        22   402    76805    939.00      0.00
2200178   PREGNANCY - MULTIPLE        22   402    76810   1259.00      0.00
2200202   PELVIC                      22   402    76856    946.00      0.00
2200244   BREAST UNILATERAL           22   402    76645    358.00      0.00
2200251   SCROTUM (TESTICLES)         22   402    76870    968.00      0.00
2200269   THYROID/NECK MASS           22   402    76536    968.00      0.00
2200277   INTRALUMINAL PROSTATE       22   402    76872   1448.00      0.00
2200285   NEONATAL HEAD               22   402    76506   1019.00      0.00
2200319   BREAST COMP BILATERAL       22   402    76645    505.00      0.00
2200327   ARTERIAL VASC-DUP BILAT     22   921    93925   1360.00      0.00
2200335   NON-OB TRANSVAG US          22   402    76830    811.00      0.00
2200343   EXTREMITY - NON VASCULAR    22   402    76880    968.00      0.00
2200350   FETAL BIOPHYSICAL PROFILE   22   402    76818   1132.00      0.00
2200384   GUIDANCE FOR THORACENTESI   22   402    76942    367.00      0.00
2200392   GUIDANCE FOR PARACENTESIS   22   402    76942    367.00      0.00
2200400   GUIDANCE FOR BIOPSY         22   402    76942    367.00      0.00
2200426   GUIDANCE FOR CYST/ASPIR     22   402    76942    367.00      0.00
2200434   GUIDANCE FOR AMNIOCENTESI   22   402    76946    367.00      0.00
2200483   CAROTID IMAGING BILATERAL   22   921    93880   1296.00      0.00
2200491   AORTA LLEO FEM              22   921    93925    881.00      0.00
2200517   PVL SEGMENTAL PRESSURES     22   921    93923   1846.00      0.00
2200525   ANKLE-BRACHIAL INDEX (ABI   22   921    93922    936.00      0.00
2200533   PSEUDOANEURYSM COMPRESSIO   22   402    76936   1942.00      0.00
2200541   PVL PENILE BRACHIAL INDIC   22   921    93980   1727.00      0.00
2200558   SAPHENOUS VEIN MAPPING UN   22   921    93971    964.00      0.00
2200566   SAPHENOUS VEIN MAPPING BI   22   921    93970   1432.00      0.00
2200574   PVL THORACIC OUTLET         22   921    93923   1846.00      0.00
2200582   PVL RAYNAUDS SYNDROME       22   921    93923   1846.00      0.00
2200590   PVL PPG PHOTOPLETHYSMOGR    22   921    93923   1846.00      0.00
2200608   ARTERIAL VASC-DUPLEX UNIT   22   921    93926   1136.00      0.00
2200640   VENOUS DUPLEX BILAT         22   921    93970   1432.00      0.00
2200657   VENOUS DUPLEX UNILAT        22   921    93971    964.00      0.00
2200665   PORTABLE SET UP             22   921    Q0092    102.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
2200673   HEMODIALYSIS ACCESS         22   921    93990    787.00      0.00
2200681   SPINAL CANAL                22   402    76800   1025.00      0.00
2200715   VEIN MAPPING UPPER EXT BI   22   921    93970   1432.00      0.00
2200756   VEIN MAPPING UPPER EX UNI   22   921    93971    964.00      0.00
2200772   US GUIDE VASCULAR ACCESS    22   402    76937     93.00      0.00
2200798   TRANSVAGINAL OB US          22   402    76817    811.00      0.00
2200814   US GUIDE INTRAOPERATIVE     22   402    76998   1846.00      0.00
2200848   NEONATAL HIP                22   402    76885   1025.00      0.00
2200863   APPENDIX                    22   402    76705    838.00      0.00
2200921   PERITONEOCENTESIS ABD       22   360    49080   1025.00      0.00
2201002   ULTRASOUND SURG/COMPONENT   22   361    MULTI   1025.00      0.00
2300028   INCOMPLETE LIMITED EXAM     23   351    76380   1752.00      0.00
2300051   HEAD W/O CONTRAST           23   351    70450   2934.00      0.00
2300069   HEAD W/CONTRAST             23   351    70460   3208.00      0.00
2300077   HEAD DBL STUDY              23   351    70470   4305.00      0.00
2300085   ORBIT W/O CONTRAST          23   351    70480   2934.00      0.00
2300176   EAR W/O CONTRAST            23   351    70480   3089.00      0.00
2300200   FACIAL W/O CONTRAST         23   351    70486   3089.00      0.00
2300218   FACIAL W/CONTRAST           23   351    70487   3377.00      0.00
2300234   MAXILLA FACIAL W/O CONTRS   23   351    70486   3089.00      0.00
2300242   MAXILLA FACIAL W/CONTRAST   23   351    70487   3377.00      0.00
2300267   INTERNAL AUDITORY CANAL     23   351    70480   3089.00      0.00
2300283   MAXILLA FACIAL LMT          23   351    76380   1752.00      0.00
2300291   MASTOID                     23   351    70480   2934.00      0.00
2300309   TEMPORAL MANDIBULAR JTS     23   351    70486   2934.00      0.00
2300317   NASOPHARYNX W/O CONTRAST    23   351    70486   2934.00      0.00
2300325   NASOPHARYNX W/CONTRAST      23   351    70487   3208.00      0.00
2300366   EXTREM UP W/O CONTRAST      23   352    73200   2502.00      0.00
2300374   EXTREM UP W/CO              23   352    73201   3010.00      0.00
2300390   EXTREM LOW W/O CONTRAST     23   352    73700   2502.00      0.00
2300408   EXTREM LOW W/CONTRAST       23   352    73701   2860.00      0.00
2300465   ABSCESS DRAINAGE            23   352    75989   4341.00      0.00
2300523   DUPLICATION CAT SCAN FILM   23   350    76497     16.00      0.00
2300549   CHEST W/O CONTRAST          23   352    71250   3208.00      0.00
2300556   CHEST W/CONTRAST            23   352    71260   3567.00      0.00
2300598   ABDOMEN W/O CONTRAST        23   352    74150   3208.00      0.00
2300606   ABD W/CONTRAST              23   352    74160   3564.00      0.00
2300622   PELVIS W/O CONTRAST         23   352    72192   3208.00      0.00
2300630   PELVIS W/CONTRAST           23   352    72193   3564.00      0.00
2300663   GUIDANCE BIOPSY             23   352    77012   4119.00      0.00
2300671   CHEST ANGIO R/O PE          23   352    71260   3567.00      0.00
2300689   GUIDANCE FOR CYST ASP       23   352    77012   4119.00      0.00
2300697   GUIDANCE FOR TUBE PLACEMT   23   352    77012   4119.00      0.00
2300705   GUIDANCE CHEST TUBE PLACE   23   352    77012   4119.00      0.00
2300713   CTA ABD W & WO CONTRAST     23   352    74175   4305.00      0.00
2300721   CT ABD W AND WO CONTRAST    23   352    74170   4305.00      0.00
2300762   CERVICAL W/O CONTRAST       23   352    72125   4305.00      0.00
2300770   CERVICAL W/CONTRAST         23   352    72126   4951.00      0.00
2300788   THORACIC W/O CONTRAST       23   352    72128   5162.00      0.00
2300796   THORACIC W/CONTRAST         23   352    72129   6111.00      0.00
2300804   LUMBAR W/O CONTRAST         23   352    72131   5162.00      0.00
2300812   LUMBAR W/CONTRAST           23   352    72132   5805.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
2300820   NECK W/O CONTRAST           23   352    70490   2934.00      0.00
2300838   NECK W/CONTRAST             23   352    70491   3208.00      0.00
2300861   KIDNEY STONE STUDY          23   352    74150   3208.00      0.00
2301034   PELVIS LIMITED              23   350    76380   1752.00      0.00
2301042   ABDOMEN LIMITED             23   350    76380   1752.00      0.00
2301059   CHEST LIMITED               23   350    76380   1752.00      0.00
2301067   3D RENDER W/O POSTPROCESS   23   350    76376   1350.00      0.00
2301075   3D RENDER WITH POSTPROCES   23   350    76377   1573.00      0.00
2301505   CT SURGICAL COMPONENT       23   361    MULTI   1025.00      0.00
2400026   THYROID UPTAKE & SCAN       24   341    78007    945.00      0.00
2400034   THY IMAGING ONLY            24   341    78010    745.00      0.00
2400059   THYROID METS; WHOLE BODY    24   341    78018   2448.00      0.00
2400067   PARATHYROID IMAGING         24   341    78070   1897.00      0.00
2400075   BONE MARROW MULTIPLE        24   341    78103   2618.00      0.00
2400083   LIV/SPL VASC FLOW           24   341    78216   1788.00      0.00
2400091   GALLBLADDER                 24   341    78223   2742.00      0.00
2400109   GASTRIC EMPTYING            24   341    78264   2853.00      0.00
2400133   BONE IMAGING MUL.           24   341    78305   2182.00      0.00
2400141   BONE IM WHOLE BOD           24   341    78306   2289.00      0.00
2400158   BONE 3-PHASE                24   341    78315   2784.00      0.00
2400166   BONE SPECT                  24   341    78320   1444.00      0.00
2400174   GATED W/EF, REF, VV         24   341    78472   2710.00      0.00
2400182   PUL PERF IMA PART           24   341    78580   1802.00      0.00
2400190   AEROSOL VENT. MUL.          24   341    78587   1386.00      0.00
2400208   BRAIN SPECT                 24   341    78607   1803.00      0.00
2400216   RENOGRAM W/FLOW             24   341    78707   2658.00      0.00
2400224   RENAL W/DRUG INTERVENTION   24   341    78708   4554.00      0.00
2400232   TUMOR LOC ISO MUL           24   341    78801   2657.00      0.00
2400240   TUMOR LOC ISO WHO           24   341    78802   2837.00      0.00
2400257   STRESS MYOCAR/PERF W/WO R   24   341    78465   4099.00      0.00
2400265   REST MYOCARDIAL PERF ONLY   24   341    78464   2147.00      0.00
2400273   GATED WALL MOTION           24   341    78478    414.00      0.00
2400307   HYP THYR - INIT RX          24   342    79005    375.00      0.00
2400315   INDIUM WBC                  24   341    78806   4320.00      0.00
2400323   GI BLEED                    24   341    78278   2604.00      0.00
2400331   TESTICULAR                  24   341    78761   1539.00      0.00
2400349   NM ISOT RX IV THERAPY       24   342    79101   1143.00      0.00
2400356   GATED LVEF                  24   341    78480    443.00      0.00
2400364   SPINAL PUNCTURE LUMB DIAG   24   361    62270    852.00      0.00
2400372   SENTINEL NODE INJECTION     24   361    38792    268.00      0.00
2400380   RAD SOURCE HANDLING         24   342    77790    917.00      0.00
2400406   CISTERNOGRAM                24   341    78630   4013.00      0.00
2400448   CYSTOGRAM                   24   341    78740   1803.00      0.00
2400455   TUMOR LOCALIZATION-SPECT    24   341    78803   2961.00      0.00
2400463   THROMBOSIS IMAG/BILATERAL   24   341    78456   1148.00      0.00
2400471   MECKELS                     24   341    78290   1539.00      0.00
2400604   LYMPH GLAND IMAGING         24   341    78195   3205.00      0.00
2400620   PERFUSION/VENT LUNG SCAN    24   341    78588   3188.00      0.00
2400661   I-131 RX / THYROID CANCER   24   342    79005   1188.00      0.00
2490027   ISOT TC 99M MDP             24   343    A9503    343.00      0.00
2490076   ISOT TC99M PERTEC PER MCI   24   343    A9512     27.00      0.00
2490175   ISOT TC 99M MYOVIEW         24   343    A9502    984.00      0.00
                                            REV     CPT     UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE     PRICE     PRICE
2490209   ISOT TL 201 1 MCI           24   343    A9505      328.00       0.00
2490225   ISOT TC 99M CERETEC         24   343    A9521     2238.00       0.00
2490274   ISOT IN-111 DTPA 0.5 MCI    24   343    A9548     1933.00       0.00
2490290   ISOT OCTREOTIDE PER DOSE    24   343    A9572     4320.00       0.00
2490308   ISOT I-123 DX ISOTP 1 MCI   24   343    A9509      622.00       0.00
2490316   ISOT IN-111 WBC PER DOSE    24   343    A9570     1944.00       0.00
2490324   ISOT CERETEC WBC PER DOSE   24   343    A9569     1944.00       0.00
2490449   ISOT TC 99M ACUTECT         24   343    A9504     2459.00       0.00
2490456   ISOT TC 99M NEOTECT         24   343    A9536     2623.00       0.00
2490498   ISOT TC 99M CARDIOLITE      24   343    A9500      984.00       0.00
2490514   ISOT I-131 RX PER MCI       24   344    A9517       66.00       0.00
2490548   ISOT I 123 THYR PER 100UC   24   343    A9516      223.00       0.00
2490555   ISOT TC 99M DISOFENIN       24   343    A9510      498.00       0.00
2490621   ISOT I-131 DX PER MCI       24   343    A9528     1171.00       0.00
2490696   ISOT I-131 MIBG PER 500 U   24   343    A9508     3564.00       0.00
2490720   ISOT TC99M SC PER DOSE      24   343    A9541      394.00       0.00
2490746   ISOT TC99M DTPA PER DOSE    24   343    A9539      395.00       0.00
2490761   ISOT TC99M CHOLETEC DOSE    24   343    A9537      648.00       0.00
2490803   ISOT TC99M DMSA PER DOSE    24   343    A9551     4443.00       0.00
2490829   ISOT GA67 PER MCI           24   343    A9556      114.00       0.00
2490845   ISOT TC99M MAA PER DOSE     24   343    A9540     1296.00       0.00
2490860   ISOT TC99M MAG3 PER DOSE    24   343    A9562     4212.00       0.00
2490886   ISOT TC99M RBC PER DOSE     24   343    A9560     1944.00       0.00
2500015   POC-GLUCOSE BLD MON DVICE   25   300    82962       66.00       0.00
2500023   POC-GLUCOSE BLD DVICE ADD   25   300    8296291     66.00       0.00
2500031   POC-ACT CARTRIDGE           25   305    85347       62.00       0.00
2500049   POC-RP-CALCIUM; IONIZED     25   301    82330      144.00       0.00
2500056   POC-RP-HBG METHMGLBN QUAN   25   301    83050       77.00       0.00
2500064   POC-RP-CRBN MONOXIDE QUAN   25   301    82375      130.00       0.00
2500072   POC-RP-CHLORIDE; BLOOD      25   301    82435       49.00       0.00
2500080   POC-RP-BLOOD GAS; PH ONLY   25   301    82800       86.00       0.00
2500098   POC-RP-BLDGAS=>2 WO O2SAT   25   301    82803      204.00       0.00
2500106   POC-RP-BLDGAS=>2 & O2 SAT   25   301    82805      300.00       0.00
2500114   POC-RP-BLDGAS O2 SAT ONLY   25   301    82810       92.00       0.00
2500122   POC-RP-HEMGLBN-O2 AFINITY   25   301    82820      106.00       0.00
2500130   POC-RP-GLUCOSE QUAN BLOOD   25   301    82947       42.00       0.00
2500148   POC-RP-SODIUM; SERUM        25   301    84295       51.00       0.00
2500155   POC-RP-HEMGLOBN BLD COUNT   25   305    85018       25.00       0.00
2500163   POC-SPECIFIC GRAVITY        25   301    81002       27.00       0.00
2500171   POC-APTT CARTRIDGE          25   305    85730       64.00       0.00
2500189   POC-PT CARTRIDGE            25   305    85610       42.00       0.00
2500197   POC-URINE LABSTIX 5 TEST    25   301    81002       27.00       0.00
2500205   POC-URINE MULTISTIX 10      25   301    81002       27.00       0.00
2500213   POC-AMNIOTEST               25   301    83986       38.00       0.00
2500221   POC-FERN TEST               25   300    Q0114       76.00       0.00
2500239   POC-OCCULT BLOOD            25   301    82272       34.00       0.00
2500247   POC-RP-POTASSIUM SERUM      25   301    84132       49.00       0.00
2600104   LATE DISCH/ORDER MED/SUR    26   224                 0.00    4211.98
2600203   LATE DISCH/ORDER MED/SUR    26   224                 0.00    3132.00
2700102   LATE DISCHARGE ORDER OB     27   224                 0.00    3132.00
2800100   LATE DISCH/ORDER MED/SUR    28   224                 0.00    3132.00
2900108   LATE DISCH/ORDER MED/SUR    29   224                 0.00    3132.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
2900207   LATE DISCH/ORDER MED/SUR    29   224               0.00    4211.98
3000346   C: NBN COLLECTION CARD      30   300               1.00       0.00
3000387   SPECIMEN TNSFR; PT NOT MD   30   300    99001      0.00       0.00
3000395   SPECIMEN TNSFR; PT NOT MD   30   300    99001     52.00       0.00
3100054   HEMATOCRIT                  31   305    85014     87.00       0.00
3100088   CBC & AUTO WBC DIFF         31   305    85025    141.00       0.00
3100096   CBC ONLY                    31   305    85027    131.00       0.00
3100104   RETICULOCYTE COUNT          31   305    85045    139.00       0.00
3100112   BONE MARROW PREP            31   310    85097     83.00       0.00
3100138   FDP                         31   305    85362    155.00       0.00
3100146   FIBRINOGEN                  31   305    85385    211.00       0.00
3100153   FETAL ROSETTE TEST          31   305    85461    160.00       0.00
3100187   RPR CORD BLOOD              31   302    86592     99.00       0.00
3100195   PLATELET COUNT              31   305    85049     90.00       0.00
3100211   PROTHROMBIN TIME            31   305    85610    144.00       0.00
3100229   PT MIXTURE STUDY            31   305    85611    164.00       0.00
3100237   ESR WESTERGREN              31   305    85652    144.00       0.00
3100245   SICKLE CELL SCREEN          31   305    85660    140.00       0.00
3100260   PTT                         31   305    85730    175.00       0.00
3100278   PTT MIXTURE STUDY           31   305    85732    185.00       0.00
3100294   ANTIBODY ABSORPTION         31   305    86978    174.00       0.00
3100302   ANTIBODY ELUTION            31   305    86860    174.00       0.00
3100310   ANTIBODY TITER RBC          31   305    86886    273.00       0.00
3100328   ANTIBODY ID STD RBC         31   305    86870    407.00       0.00
3100336   ANTIBODY ID SEL RBC         31   305    86870    343.00       0.00
3100344   COOMBS DIRECT POLY          31   305    86880    160.00       0.00
3100351   ANTIBODY SCREEN RBC         31   300    86850    275.00       0.00
3100369   CROSSMATCH IS/UNIT          31   305    86920    199.00       0.00
3100377   RH(D) ISG/DOSE              31   250    J2790    204.00       0.00
3100385   RH(D) ISG/MIC DOSE          31   636    J2788    117.00       0.00
3100393   TRANS RXN WORKUP            31   305    86880    152.00       0.00
3100401   SYRINGE ALIQUOT             31   305    86985    187.00       0.00
3100419   BLOOD TYPING ABO            31   300    86900    161.00       0.00
3100427   ANTIGEN RBC                 31   305    86905    146.00       0.00
3100435   FFP THAW/UNIT               31   305    86927    100.00       0.00
3100443   CRYO THAW/UNIT              31   305    86927    100.00       0.00
3100450   NON-CROSSMATCH SETUP        31   305    86999    125.00       0.00
3100476   PREWARMED TECHNIQUE         31   305    86850    213.00       0.00
3100484   BLOOD TYPING RH             31   300    86901     74.00       0.00
3100492   POOLING COMPONENTS          31   305    86965     47.00       0.00
3100500   SPLITTING COMPONENT         31   305    86985    187.00       0.00
3100518   ANTIGEN RBC COOMBS          31   305    86905    157.00       0.00
3100526   CROSSMATCH CBS/UNIT         31   305    86922    157.00       0.00
3100534   CRYOFIBRINOGEN              31   300    82585     92.00       0.00
3100542   CRYOGLOBULIN                31   300    82595     92.00       0.00
3100559   PERINATAL RAPID HIV         31   302    86701     84.00       0.00
3100567   KLEIHAUER TEST              31   300    85460    245.00       0.00
3100583   RUBELLA ANTIBODY IGG        31   300    86762    133.00       0.00
3100609   PLT AGG (IN VITRO) EA AGT   31   305    85576    105.00       0.00
3100617   PLT FUNCTION PLAVIX         31   305    85576    105.00       0.00
3100625   BLEEDING MANAGEMENT         31   305    85002    105.00       0.00
3100633   PLT FUNCTION ASPRIN         31   305    85576    105.00       0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
3100641   TZANCK SMEAR                31   311    88160     81.00      0.00
3100658   HEM: PERIPH BLD SMR         31   310    85060     81.00      0.00
3100666   PREWARM XM                  31   300    86850    371.00      0.00
3100674   PREWARM ANTIBODY SCREEN     31   300    86850    489.00      0.00
3100690   SMEAR, EOSINOPHILS          31   300    89190     74.00      0.00
3100708   ASO TITER                   31   300    86060    152.00      0.00
3100716   RHEUMATOID FACTOR           31   300    86430    152.00      0.00
3100724   COLD AGGLUTININS            31   300    86157    194.00      0.00
3100732   HETEROPHILE ANTIBODY        31   300    86308    133.00      0.00
3100740   RPR                         31   300    86592    109.00      0.00
3100757   HEMOGLOBIN                  31   305    85018     71.00      0.00
3100765   PACKED CELL VOLUME          31   305    85013     60.00      0.00
3100773   WET MOUNT NON CX-VAG        31   306    87210    104.00      0.00
3100781   WET MOUNT SPERM ID          31   300    89321    109.00      0.00
3100799   CRYSTALS EXAM FLUID         31   300    89060    133.00      0.00
3100807   HEMATOCRIT FLUID            31   305    85013     60.00      0.00
3100815   CRYSTALS EXAM SYNOV         31   300    89060    133.00      0.00
3100823   CELL COUNT CSF              31   300    89051    174.00      0.00
3100831   CELL COUNT SYNOV            31   300    89051    174.00      0.00
3100849   CELL COUNT FLUID            31   300    89051    174.00      0.00
3100856   COOMBS DIRECT IGG           31   305    86880    171.00      0.00
3100864   COOMBS DIRECT CORD          31   305    86880    160.00      0.00
3100872   COOMBS DIRECT C3BD          31   305    86880    160.00      0.00
3100880   COOMBS INDIRECT             31   305    86885    265.00      0.00
3100898   SICKLE CELL SCREEN UNIT     31   305    85660    140.00      0.00
3100906   SMEAR WBC DIFF              31   305    85007     75.00      0.00
3100914   SMEAR SCAN ONLY             31   305    85008     56.00      0.00
3100922   SMEAR WBC DIFF BUFFY        31   305    85009     71.00      0.00
3100930   CBC AUTO & AUTO DIFF        31   305    85025    141.00      0.00
3100948   CBC AUTO & MAN DIFF         31   305    85027    131.00      0.00
3100955   OCMED RAPID HIV AB          31   302    86701     84.00      0.00
3100963   PLT PH ORD NOT TRANSFUSED   31   390    P9035    670.00      0.00
3100971   FFP ORD NOT TRANSFUSED      31   390    P9017     79.00      0.00
3100989   CRYO ORD NOT TRANSFUSED     31   390    P9012     79.00      0.00
3100997   ALIQ ORD NOT TRANSFUSED     31   300    86985    187.00      0.00
3101003   CR ABO TYPE                 31   305    86900    161.00      0.00
3101011   CR ANTIBODY SCREEN          31   305    86850    275.00      0.00
3101029   CR ANTIBODY ID SEL          31   305    86870    343.00      0.00
3101037   CR ANTIBODY ID STD          31   305    86870    407.00      0.00
3101045   CR ANTIBODY TITER           31   305    86886    273.00      0.00
3101052   CR ANTIGEN RBC CBS          31   305    86905    157.00      0.00
3101060   CR ANTIGEN RBC              31   305    86905    146.00      0.00
3101078   CR COOMBS DIRCT C3BD        31   305    86880    160.00      0.00
3101086   CR CROSSMAT CBS/UNIT        31   305    86922    157.00      0.00
3101094   CR COOMBS DIRCT IGG         31   305    86880    171.00      0.00
3101102   CR COOMBS DIRCT POLY        31   305    86880    160.00      0.00
3101128   CR FETAL ROSE TEST          31   305    85461    160.00      0.00
3101136   CR KLEIHAUER TEST           31   305    85460    245.00      0.00
3101151   CR LEUKODEP FILTER          31   305              70.00      0.00
3101169   CR SICKLE CELL TEST         31   305    85660    140.00      0.00
3101177   CR RH TYPE                  31   305    86901     74.00      0.00
3101185   D-DIMER - QUAN              31   305    85379    240.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
3200029   CONCENTRATION ANY           32   306    87015     56.00      0.00
3200045   CUL MISC                    32   306    87070    179.00      0.00
3200060   CUL STOOL                   32   306    87045    273.00      0.00
3200078   CUL THROAT                  32   306    87070    179.00      0.00
3200086   CUL PEDS BLOOD              32   306    87040    224.00      0.00
3200094   CUL BLOOD                   32   306    87040    224.00      0.00
3200110   CUL ANAEROBIC               32   306    87075    255.00      0.00
3200128   CUL ENVIRONMENTAL           32   306    87081      0.00      0.00
3200144   CUL URINE                   32   306    87088    214.00      0.00
3200151   SMR WET MOUNT CX-VAG        32   306    87210    104.00      0.00
3200169   STREP SCREEN                32   306    87430    192.00      0.00
3200177   CUL FUNGUS                  32   306    87102    228.00      0.00
3200185   CUL FUNGUS SKIN             32   306    87101    239.00      0.00
3200193   CUL FUNGUS BLOOD            32   306    87103    239.00      0.00
3200201   CUL AFB                     32   306    87116    228.00      0.00
3200219   LISTERIA TYPE               32   306    87147    113.00      0.00
3200243   O&P SMR/CONC/ID             32   306    87177    173.00      0.00
3200250   ARTHROPOD-INSECT ID         32   306    87168     60.00      0.00
3200268   SENS KB EACH                32   306    87181     42.00      0.00
3200276   SENS KB PANEL               32   306    87184    188.00      0.00
3200284   SENS MIC PANEL              32   306    87186    261.00      0.00
3200300   SMR GRAM STAIN              32   306    87205     90.00      0.00
3200318   SMR AFB                     32   306    87206    109.00      0.00
3200326   SMR MALARIAL                32   306    87207    173.00      0.00
3200334   SMR CRYPTOSPORIDIUM         32   306    87207    173.00      0.00
3200342   SMR PINWORM PREP            32   306    87172     98.00      0.00
3200359   SMR KOH                     32   306    87220    104.00      0.00
3200375   ROTAVIRUS AG                32   306    87425    219.00      0.00
3200391   OCCULT BLOOD FECAL          32   306    82270     64.00      0.00
3200409   RSV ANTIGEN                 32   306    87420    160.00      0.00
3200417   HAEMOPHILUS TYPE            32   306    87147    113.00      0.00
3200425   SMR GRAM STAIN              32   306    87205     90.00      0.00
3200433   SMR AFB                     32   306    87206    109.00      0.00
3200441   SMR FUNGUS                  32   306    87205     90.00      0.00
3200458   TISSUE GRINDING             32   306    87176     56.00      0.00
3200466   STREP LATEX A CUL TYP STA   32   306    87147    113.00      0.00
3200474   STREP LATEX B CUL TYP STA   32   306    87147    113.00      0.00
3200482   STREP LATEX C CUL TYP STA   32   306    87147    113.00      0.00
3200490   STREP LATEX F CUL TYP STA   32   306    87147    113.00      0.00
3200516   CL DIFFICILE TOXINS         32   306    87324    178.00      0.00
3200524   STREP LANCEFIELD A          32   306    87430     51.00      0.00
3200532   STREP LANCEFIELD B          32   302    86403     51.00      0.00
3200540   STREP LANCEFIELD C          32   302    86403     51.00      0.00
3200557   STREP LANCEFIELD F          32   302    86403     51.00      0.00
3200565   STREP LANCEFIELD G          32   302    86403     51.00      0.00
3200573   STREP LATEX G CUL TYP STA   32   306    87147    113.00      0.00
3200581   SPUTUM SCREEN SPSCR         32   306    87205     90.00      0.00
3200599   ID AEROBIC IDACR            32   306    87077    109.00      0.00
3200607   CUL ABCESS                  32   306    87070    179.00      0.00
3200615   CUL NEEDLE ASPIRATE         32   306    87070    179.00      0.00
3200623   CUL BURN                    32   306    87070    179.00      0.00
3200631   CUL CATHETER TIP            32   306    87070    179.00      0.00
                                       REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION   DEPT CODE    CODE   PRICE     PRICE
3200649   CUL CSF                32   306    87070    179.00      0.00
3200656   CUL DECUBITUS          32   306    87070    179.00      0.00
3200664   CUL DRAINAGE           32   306    87070    179.00      0.00
3200672   CUL EAR - EYE          32   306    87070    179.00      0.00
3200680   CUL STERILE FLUID      32   306    87070    179.00      0.00
3200698   CUL GONORRHEAE         32   306    87081    133.00      0.00
3200706   CUL UROGENITAL         32   306    87070    179.00      0.00
3200714   CUL INCISION           32   306    87070    179.00      0.00
3200722   CUL IV SITE            32   306    87070    179.00      0.00
3200730   CUL MRSA               32   306    87070    179.00      0.00
3200748   CUL NEWBORN EYE        32   306    87070    179.00      0.00
3200755   CUL RESPIRATORY        32   306    87070    179.00      0.00
3200763   CUL TISSUE             32   306    87070    179.00      0.00
3200771   CUL TXN RXN            32   306    87070    179.00      0.00
3200789   CUL VRE                32   306    87070    179.00      0.00
3200805   SMR FUNGUS             32   306    87205     90.00      0.00
3200813   SMR ISOSPORA           32   306    87206    109.00      0.00
3200821   SMR WBC                32   306    87205     90.00      0.00
3200839   E COLI 0157 ANTIGEN    32   306    87335    120.00      0.00
3200847   NEISSERIA TYPE         32   306    87147    113.00      0.00
3200854   SALMON O D TYPE        32   306    87147    113.00      0.00
3200862   SALMON O A-I/VI TYPE   32   306    87147    113.00      0.00
3200870   SHIGELLA GR B TYPE     32   306    87147    113.00      0.00
3200888   SHIGELLA GR D TYPE     32   306    87147    113.00      0.00
3200896   CUL ID GNR             32   306    87077    109.00      0.00
3200904   CUL ID GNC             32   306    87077    109.00      0.00
3200912   CUL ID GPR             32   306    87077    109.00      0.00
3200920   CUL ID YEAST           32   306    87106    109.00      0.00
3200938   CUL ID STAPH           32   306    87077    109.00      0.00
3200946   CUL ID STREP           32   306    87077    109.00      0.00
3200953   CUL ID PSEUDOMONAS     32   306    87077    109.00      0.00
3200961   CUL ID HAEMOPHILUS     32   306    87077    109.00      0.00
3200979   CUL ID MORAXELLA       32   306    87077    109.00      0.00
3200987   CUL ID GARDNERELLA     32   306    87077    109.00      0.00
3200995   CUL ID ENTEROCOCCUS    32   306    87077    109.00      0.00
3201001   CUL ID E COLI          32   306    87077    109.00      0.00
3201019   CUL ID GROUP B STREP   32   306    87077    109.00      0.00
3201027   CUL ID S AUREUS        32   306    87077    109.00      0.00
3201035   CUL ID NON-S AUR (2)   32   306    87077    109.00      0.00
3201043   CUL ID SALMONELLA      32   306    87077    109.00      0.00
3201050   CUL ID SHIGELLA        32   306    87077    109.00      0.00
3201068   CUL ID YERSINIA        32   306    87077    109.00      0.00
3201076   CUL ID CAMPYLOBACTER   32   306    87077    109.00      0.00
3201084   CUL ID VIBRIO          32   306    87077    109.00      0.00
3201092   CUL ID E COLI 0157     32   306    87077    109.00      0.00
3201100   CUL ID GROUP A STREP   32   306    87077    109.00      0.00
3201118   ANA ID GNR             32   306    87076     98.00      0.00
3201126   ANA ID GPC             32   306    87076     98.00      0.00
3201134   ANA ID GNC             32   306    87076     98.00      0.00
3201142   ANA ID GPR             32   306    87076     98.00      0.00
3201159   ANA ID C DIFF          32   306    87076     98.00      0.00
3201167   BLD ID GNR             32   306    87077    109.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
3201175   BLD ID GNC                  32   306    87077    109.00      0.00
3201183   BLD ID GPR                  32   306    87077    109.00      0.00
3201191   BLD ID YEAST                32   306    87106    109.00      0.00
3201209   BLD ID STAPH                32   306    87077    109.00      0.00
3201217   BLD ID STREP                32   306    87077    109.00      0.00
3201225   BLD ID ENTEROCOCCUS         32   306    87077    109.00      0.00
3201233   BLD ID PSEUDOMONAS          32   306    87077    109.00      0.00
3201241   BLD ID HAEMOPHILUS          32   306    87077    109.00      0.00
3201258   BLD ID MORAXELLA            32   306    87077    109.00      0.00
3201266   BLD ID GARDNERELLA          32   306    87077    109.00      0.00
3201324   BLD ID GNR (2)              32   306    87077    109.00      0.00
3201332   BLD ID STAPH (2)            32   306    87077    109.00      0.00
3201340   BLD ID STREP (2)            32   306    87077    109.00      0.00
3201357   CUL ID ENTEROCOC (2)        32   306    87077    109.00      0.00
3201365   CUL ID GNC (2)              32   306    87077    109.00      0.00
3201373   CUL ID GNR (2)              32   306    87077    109.00      0.00
3201381   CUL ID GNR (3)              32   306    87077    109.00      0.00
3201399   CUL ID GNR (4)              32   306    87077    109.00      0.00
3201407   CUL ID GNR (5)              32   306    87077    109.00      0.00
3201415   CUL ID GPR (2)              32   306    87077    109.00      0.00
3201423   CUL ID HAEMOPHIL (2)        32   306    87077    109.00      0.00
3201431   CUL ID PSEUDOMON (2)        32   306    87077    109.00      0.00
3201449   CUL ID S AUREUS (2)         32   306    87077    109.00      0.00
3201456   CUL ID STAPH (2)            32   306    87077    109.00      0.00
3201464   CUL ID STAPH (3)            32   306    87077    109.00      0.00
3201472   CUL ID STREP (2)            32   306    87077    109.00      0.00
3201480   CUL ID STREP (3)            32   306    87077    109.00      0.00
3201498   CUL ID NON-S AUR (2)        32   306    87077    109.00      0.00
3201506   CUL ID BRP B STREP          32   306    87081    133.00      0.00
3201514   ID ANAEROBIC IDAN           32   306    87076     98.00      0.00
3201522   E.COLI 0157 EC0157          32   306    87147    113.00      0.00
3201530   WOUND CULT SUPERF CUWDS     32   306    87070    179.00      0.00
3201548   WOUND CULT DEEP CUWDD       32   306    87070    179.00      0.00
3201555   LEGIONELLA UA AG            32   306    87449    151.00      0.00
3201563   LEGIONELLA UA AG            32   306    87449    151.00      0.00
3201571   INFLUENZA A                 32   306    87804     79.00      0.00
3201589   INFLUENZA B                 32   306    87804     79.00      0.00
3201597   OCCULT BLD FHG, QUAL, 1-3   32   300    82274     43.00      0.00
3201605   GRP B STREP SCREEN BY PCR   32   306    87653    196.16      0.00
3201613   ENTEROVIRUS QUAL BY PCR     32   306    87498    196.16      0.00
3201621   MRSA BY PCR                 32   306    87641      0.00      0.00
3300019   ELECTROLYTE PANEL           33   301    80051    224.00      0.00
3300027   METABOLIC BASE PANEL        33   301    80048    271.00      0.00
3300035   METABOLIC COMP PANEL        33   301    80053    335.00      0.00
3300043   HEP FUNC PANEL              33   301    80076    259.00      0.00
3300050   RENAL FUNC PANEL            33   301    80069    295.00      0.00
3300068   CREATININE W/GFR            33   301    82565    144.00      0.00
3300076   OSMOLALITY FLUID            33   301    83930    149.00      0.00
3300084   2 HR GLUC TOLERANCE TEST    33   301    82951    339.00      0.00
3300092   VANCOMYCIN TROUGH           33   301    80202    261.00      0.00
3300142   GLUCOSE GEST SCREEN 50GMS   33   301    82950    181.00      0.00
3300159   VOLUME URINE COLLECT        33   301    81050     31.00      0.00
                                        REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION    DEPT CODE    CODE   PRICE     PRICE
3300167   LIPID PANEL             33   301    80061    306.00      0.00
3300183   UBG URINE QUAL          33   301    84578     53.00      0.00
3300191   CARBAMAZEPINE TOTAL     33   301    80156    238.00      0.00
3300209   VALPROIC ACID           33   301    80164    238.00      0.00
3300225   UA AUTO & MICRO         33   301    81001    104.00      0.00
3300233   UA REFLEX MICRO         33   301    81001    104.00      0.00
3300241   UA REAGENT STRIP AUTO   33   301    81003     91.00      0.00
3300258   UA MICROSCOPIC          33   301    81015     14.00      0.00
3300266   HCG URINE QUAL          33   301    81025    153.00      0.00
3300274   VOLUME TIMED URINE      33   301    81050     31.00      0.00
3300290   ACETAMINOPHEN           33   301    82003    246.00      0.00
3300308   KETONES SERUM           33   301    82009     66.00      0.00
3300316   KETONES URINE           33   301    81002     66.00      0.00
3300332   ALBUMIN                 33   301    82040    109.00      0.00
3300340   ETHANOL                 33   301    82055    269.00      0.00
3300357   THEOPHYLLINE            33   301    80198    241.00      0.00
3300365   AMMONIA                 33   301    82140    209.00      0.00
3300373   AMYLASE SERUM           33   301    82150    210.00      0.00
3300381   AMYLASE 24HR URINE      33   301    82150    200.00      0.00
3300399   PHENOBARBITAL           33   301    80184    238.00      0.00
3300407   CHLORIDE CSF            33   301    82438    116.00      0.00
3300431   CALCIUM TOTAL           33   301    82310    159.00      0.00
3300456   CALCIUM 24HR URINE      33   301    82340    151.00      0.00
3300464   CO2 TOTAL               33   301    82374    116.00      0.00
3300472   CHLORIDE                33   301    82435    123.00      0.00
3300480   CHLORIDE 24HR URINE     33   301    82436    200.00      0.00
3300498   CHLORIDE FLUID          33   301    82438    116.00      0.00
3300506   CHOLESTEROL TOTAL       33   301    82465    154.00      0.00
3300514   CK TOTAL                33   301    82550    192.00      0.00
3300522   CK-MB FRACTION          33   301    82553    228.00      0.00
3300530   CREATININE              33   301    82565    144.00      0.00
3300548   CREATININE URINE        33   301    82570    140.00      0.00
3300555   CREATININE CLEAR        33   301    82575    267.00      0.00
3300563   DIGOXIN                 33   301    80162    295.00      0.00
3300571   PHENYTOIN TOTAL         33   301    80185    254.00      0.00
3300605   UA DRUG SCREEN QUAL     33   301    80100    283.00      0.00
3300613   GENTAMICIN TROUGH       33   301    80170    249.00      0.00
3300621   PH                      33   301    82800    134.00      0.00
3300639   ARTERIAL GASES          33   301    82805    503.00      0.00
3300647   REDUCING SUBS FECES     33   301    81002     66.00      0.00
3300654   GLUCOSE                 33   301    82947    170.00      0.00
3300662   GTT 2-HR ADD 3          33   301    82952     76.00      0.00
3300670   GTT 2-HR ADD 6          33   301    82952     76.00      0.00
3300688   GTT 2-HR ADD 4          33   301    82952     76.00      0.00
3300696   GTT 2-HR 3-SPEC         33   301    82951    339.00      0.00
3300704   GTT 2-HR ADD 5          33   301    82952     76.00      0.00
3300712   GLUCOSE 1HR PPD         33   301    82950    127.00      0.00
3300720   GGT                     33   301    82977    165.00      0.00
3300738   HCG SERUM QUAL          33   301    84703    153.00      0.00
3300753   FERRITIN                33   301    82728    254.00      0.00
3300761   BLOOD URINE             33   301    81001     53.00      0.00
3300779   HORMONE TSH             33   301    84443    264.00      0.00
                                        REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION    DEPT CODE    CODE   PRICE     PRICE
3300787   IRON TOTAL              33   301    83540    176.00      0.00
3300795   TIBC                    33   301    83550    217.00      0.00
3300803   LACTIC ACID             33   301    83605    164.00      0.00
3300811   LD TOTAL                33   301    83615    165.00      0.00
3300837   LD FLUID                33   301    83615    165.00      0.00
3300852   PHOSPHATIDLY GLY        33   301    84081    306.00      0.00
3300860   HDL CHOLESTEROL         33   301    83718    202.00      0.00
3300878   MAGNESIUM TOTAL         33   301    83735    200.00      0.00
3300894   MYOGLOBIN               33   301    83874    186.00      0.00
3300902   OSMOLALITY              33   301    83930    149.00      0.00
3300910   OSMOLALITY URINE        33   301    83935    142.00      0.00
3300928   PH FLUID                33   301    83986     50.00      0.00
3300936   ALKALINE PHOSPHATASE    33   301    84075    152.00      0.00
3300944   PHOSPHORUS              33   301    84100    158.00      0.00
3300951   PHOSPHORUS 24HR URINE   33   301    84105    140.00      0.00
3300977   POTASSIUM               33   301    84132    150.00      0.00
3300985   POTASSIUM 24HR URINE    33   301    84133    200.00      0.00
3300993   PREALBUMIN              33   300    84134    165.00      0.00
3301009   PROTEIN TOTAL           33   301    84155    114.00      0.00
3301017   PROTEIN URINE QUAL      33   301    81002     66.00      0.00
3301025   PROTEIN TOTAL FLUID     33   301    84155    114.00      0.00
3301033   PROTEIN TOTAL CSF       33   301    84155    120.00      0.00
3301041   QUINIDINE               33   301    80194    238.00      0.00
3301058   SODIUM                  33   301    84295    150.00      0.00
3301066   SODIUM 24HR URINE       33   301    84300    150.00      0.00
3301074   SP GR FLUID             33   301    84315     50.00      0.00
3301082   THYROXINE FREE          33   301    84439    157.00      0.00
3301090   TOBRAMYCIN TROUGH       33   301    80200    251.00      0.00
3301108   AST                     33   301    84450    163.00      0.00
3301116   ALT                     33   301    84460    211.00      0.00
3301124   TRIGLYCERIDES           33   301    84478    163.00      0.00
3301132   TROPONIN, QUAN          33   301    84484    228.00      0.00
3301140   UREA NITROGEN           33   301    84520    144.00      0.00
3301157   UREA NIT 24HR URINE     33   301    84540    200.00      0.00
3301165   UREA CLEARANCE          33   301    84545    267.00      0.00
3301173   URIC ACID               33   301    84550    156.00      0.00
3301181   URIC ACID 24HR FLUID    33   301    84560    200.00      0.00
3301207   CRP                     33   302    86140    133.00      0.00
3301215   URIC ACID FLUID         33   301    84560    147.00      0.00
3301223   PSA TOTAL               33   301    84153    241.00      0.00
3301231   CEA                     33   301    82378    241.00      0.00
3301249   VITAMIN B-12            33   301    82607    215.00      0.00
3301256   FOLIC ACID              33   301    82746    215.00      0.00
3301264   PROCAINAMIDE/NAPA       33   301    80192    251.00      0.00
3301272   HCG B-SUBUNIT QUANT     33   301    84702    241.00      0.00
3301405   BILIRUBIN TOTAL         33   301    82247    108.00      0.00
3301413   BILIRUBIN DIRECT        33   301    82248     97.00      0.00
3301421   GLUCOSE 2HR PPD         33   301    82950    134.00      0.00
3301439   AMYLASE 2HR URINE       33   301    82150    200.00      0.00
3301447   SODIUM URINE            33   301    84300    150.00      0.00
3301454   CHLORIDE URINE          33   301    82436    140.00      0.00
3301462   POTASSIUM URINE         33   301    84133    150.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
3301470   UREA NITROGEN URINE         33   301    84540    140.00      0.00
3301488   ALBUMIN FLUID               33   301    82042    103.00      0.00
3301496   AMYLASE FLUIS               33   301    82150    210.00      0.00
3301504   CALCIUM FLUID               33   301    82310    159.00      0.00
3301512   CHOLESTEROL FLUID           33   301    82465    154.00      0.00
3301520   CREATININ 24HR URINE        33   301    82570    200.00      0.00
3301538   CREATININE FLUID            33   301    82570    154.00      0.00
3301546   POTASSIUM FLUID             33   301    84132    150.00      0.00
3301553   SODIUM FLUID                33   301    84302    147.00      0.00
3301561   UREA NITROGEN FLUID         33   301    84520    144.00      0.00
3301579   VANCOMYCIN PEAK             33   301    80202    261.00      0.00
3301587   VANCOMYCIN RANDOM           33   301    80202    261.00      0.00
3301595   TOBRAMYCIN PEAK             33   301    80200    251.00      0.00
3301603   TOBRAMYCIN RANDOM           33   301    80200    251.00      0.00
3301611   GENTAMICIN RANDOM           33   301    80170    251.00      0.00
3301629   GENTAMICIN PEAK             33   301    80170    251.00      0.00
3301637   REDUCING SUBS URINE         33   301    81002     66.00      0.00
3301645   PROTEIN TOTAL URINE         33   301    84155    120.00      0.00
3301652   PROTEIN 24HR URINE          33   301    84155    200.00      0.00
3301660   GLUCOSE CSF                 33   301    82945    134.00      0.00
3301678   GLUCOSE FLUID               33   301    82945    134.00      0.00
3301686   GLUCOSE URINE               33   301    82945    134.00      0.00
3301694   GLUCOSE 24HR URINE          33   301    82945    134.00      0.00
3301702   HORMONE TSH REFLEX          33   301    84443    264.00      0.00
3301710   OCMED CHEM PANEL 8          33   301              14.00      0.00
3301728   OCMED CHEM PANEL A          33   301              67.00      0.00
3301736   OCMED CHEM PANEL 16         33   301              36.00      0.00
3301744   OCMED EXEC PANEL B          33   301              62.00      0.00
3301751   OCMED EXEC PANEL C          33   301              62.00      0.00
3301769   SP GR URINE                 33   301    81002     66.00      0.00
3301777   LIPASE                      33   301    83690    210.00      0.00
3301876   MAGNESIUM 24HR URINE        33   301    83735    200.00      0.00
3301884   LD CSF                      33   301    83615    165.00      0.00
3301892   MICROALBUMIN RANDOM         33   301    82043    147.00      0.00
3301900   LDL CHOLESTEROL             33   301    83721    202.00      0.00
3301918   FETAL FIBRONECTIN           33   301    82731    410.00      0.00
3301926   CRP HIGH SENSITIVITY        33   302    86141    174.00      0.00
3301934   SALICYLATE                  33   301    80196    211.00      0.00
3301942   TRANSFERRIN                 33   301    84466    228.00      0.00
3301959   HEMOGLOBIN GLYCO            33   301    83036    222.00      0.00
3301967   NATRIURETIC PEPTIDE         33   301    83880    316.00      0.00
3301975   CHLAMYDIA URINE             33   300    87491     24.00      0.00
3301983   SODIUM URINE FRAC EX        33   301    84300     38.00      0.00
3302007   CR UA REAGENT AUTO          33   301    81003     91.00      0.00
3410016   A: PROTEIN S TOTAL          34   300    85306     22.00      0.00
3410024   A: 17KETOSTEROIDS, FRACT    34   301    83593     41.36      0.00
3410032   A: CREATININE UA 17KETOST   34   301    82570      8.39      0.00
3410040   A: 17HYDROXYCORTICOSTEROI   34   301    83491     38.90      0.00
3410057   A: ACE                      34   300    82164     12.00      0.00
3410065   A: AFP                      34   300    82105     10.25      0.00
3410073   A: ALA URINE                34   300    82135     43.56      0.00
3410081   A: ALDOLASE BLOOD           34   300    82085      8.50      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
3410099   A: ALDOSTERONE BLOOD        34   300    82088     15.00      0.00
3410107   A: ALDOSTERONE URINE        34   300    82088     16.95      0.00
3410123   A: AMEBIASIS AB             34   300    86753     16.15      0.00
3410149   A: AMPHETAMINE GCMS         34   300    80102     22.50      0.00
3410156   A: ANTI-THROMBIN III        34   300    85301     15.00      0.00
3410164   A: ANTIBODY DNA DS          34   300    86225     11.50      0.00
3410172   A: ANTIBODY MITCHND         34   300    86256     11.45      0.00
3410180   A: ANTIBODY NEUTRO          34   300    86255     50.70      0.00
3410198   A: ANTIBODY NUCLEAR         34   300    86038      8.00      0.00
3410206   A: ANTIBODY SM MUSC         34   300    86255     11.00      0.00
3410214   A: ASPERGILLIS AB           34   300    86606     13.50      0.00
3410222   A: ANTITRIPSIN              34   300    82103     12.25      0.00
3410230   A: CREATININE UA 17HYDROX   34   301    82570     10.53      0.00
3410248   A: ALKALINE PHOS, ISOENZY   34   301    84080     11.88      0.00
3410255   A: ALKALINE PHOS, TOTAL     34   301    84075      6.12      0.00
3410263   A: AMPHET/METH CONFIRM UA   34   301    82145     22.50      0.00
3410271   A: FLUOR AB SCRN EA AB      34   302    86255     11.45      0.00
3410289   A: ANTI-NEUTRPHL CYTO ABS   34   302    86021     54.30      0.00
3410297   A: ACTIN SMOOTH MCL ABIGG   34   301    83516     11.00      0.00
3410305   A: BARBITURATES GC/MS       34   300    82542     60.20      0.00
3410313   A: BENZODIAZEPN GC/MS       34   300    80102     64.45      0.00
3410321   A: BARBITRTES QT GC/MS,UA   34   301    82205     36.75      0.00
3410339   A: BENZODIAZEPNES CONF UA   34   301    80101     14.38      0.00
3410347   A: CANBNOIDS CONF UA GCMC   34   301    82542     45.10      0.00
3410354   A: CD4, T CELL COUNT        34   302    86361     22.50      0.00
3410362   A: CHLAMYDIA, TRACHOMATIS   34   306    87110     43.20      0.00
3410370   A: CHLAMYDIA, TRACHOMATIS   34   306    87140      5.30      0.00
3410388   A: CHROMOSOME ANALY BLOOD   34   311    88262    122.00      0.00
3410396   A: CHROMOSOME, TISSUE CUL   34   311    88230    140.30      0.00
3410404   A: CANCER AG 125            34   300    86304      9.65      0.00
3410412   A: CANCER AG 27.29          34   300    86300     14.60      0.00
3410420   A: CANNABIS GC/MS           34   300    80102     45.10      0.00
3410438   A: CARDIOLIPIN AB           34   300    86147     17.50      0.00
3410446   A: CATECHOL PLS FRAC        34   300    82384     19.20      0.00
3410453   A: CATECHOL URN FRAC        34   300    82384     19.30      0.00
3410461   A: CEA                      34   300    82378     17.25      0.00
3410479   A: CERULOPLASMIN            34   300    82390     16.45      0.00
3410487   A: CHLAMYDIA AG             34   300    87490     10.79      0.00
3410503   A: CMV AB-IGG               34   300    86644     15.00      0.00
3410511   A: COCAINE GC/MS            34   300    80102     64.45      0.00
3410537   A: COCCI AB-COMP FIX        34   300    86171     26.50      0.00
3410545   A: COCCI AB-ID              34   300    86331      9.50      0.00
3410552   A: COMPLEMENT CH50          34   300    86162     15.50      0.00
3410560   A: COMPLEMENT C3C           34   300    86160     10.00      0.00
3410578   A: COMPLEMENT C4            34   300    86160     10.00      0.00
3410586   A: COPPER BLOOD             34   300    82525     14.55      0.00
3410594   A: CORTISOL TOTAL           34   300    82533     13.00      0.00
3410602   A: CRYOGLOBULIN             34   300    82595     14.00      0.00
3410636   A: CULTURE VIRUS            34   300    87252     36.60      0.00
3410644   A: CHROMOSOME, INTERPRETA   34   311    88291     42.70      0.00
3410651   A: COCAINE CONF GC/MS, UA   34   301    82520     36.75      0.00
3410669   A: COCCI AB, COMPLEMENT F   34   302    86635     13.25      0.00
                                            REV     CPT   UNIT     ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE    PRICE
3410677   A: COCCI AB, IMMUNODIFFUS   34   302    86635     9.50      0.00
3410685   A: CYTOMEGALOVIRUS CULTUR   34   306    87252    37.06      0.00
3410693   A: CYTOMEGALOVIRUS CLT RA   34   306    87254     6.54      0.00
3410701   A: EBV AB PNL, CAPSID IGG   34   302    86665     9.25      0.00
3410719   A: EBV AB PNL, CAPSID IGM   34   302    86665     9.25      0.00
3410727   A: EBV AB PANEL, EBNA IGG   34   302    86664     9.25      0.00
3410735   A: HEAVY METAL BLOOD, ARS   34   301    82175    15.00      0.00
3410743   A: HEAVY METAL BLOOD, MER   34   301    83825    13.88      0.00
3410750   A: HEAVY METAL BLOOD, LEA   34   301    83655     8.62      0.00
3410768   A: HEAVY METAL COMP UA, A   34   301    82175    19.19      0.00
3410776   A: HEAVY METAL COMP UA, L   34   301    83655    19.19      0.00
3410784   A: HEAVY METAL COMP UA, M   34   301    83825    19.19      0.00
3410792   A: HEAVY METAL COMP UA, C   34   301    82300    19.19      0.00
3410800   A: DHEA-S HORMONE           34   300    82627    16.00      0.00
3410818   A: DRUG SCREEN MECO         34   300    80101    38.00      0.00
3410859   A: ESTRADIOL (E2)           34   300    82670    17.25      0.00
3410867   A: HEAVY METAL COMP UA,CO   34   301    83018    19.19      0.00
3410875   A: HEAVY METAL COMP UA,TI   34   301    83018    19.19      0.00
3410883   A: HEAVY METAL COMP UA,CR   34   301    82570    19.16      0.00
3410891   A: HEMGLBINPATHY EVAL,RBC   34   305    85041     1.50      0.00
3410909   A: FACTOR IX                34   300    85250    72.00      0.00
3410917   A: FACTOR V                 34   300    85220    26.50      0.00
3410925   A: FACTOR VIII              34   300    85240    26.70      0.00
3410933   A: FACTOR VIII AG           34   300    85246    33.50      0.00
3410958   A: FEBRILE AGGLUTININ       34   300    86000    52.50      0.00
3410966   A: FOLIC ACID RBC           34   300    82747    10.00      0.00
3410974   A: FOLIC ACID               34   300    82746    14.52      0.00
3410982   F: SMEAR AFB PH             34   306    87206    22.65      0.00
3410990   F: CULTURE AFB PH           34   306    87116    42.94      0.00
3411006   A: G-6-PD QUANT             34   300    82955    25.75      0.00
3411014   A: GASTRIN                  34   300    82941    16.25      0.00
3411022   A: HAPTOGLOBIN              34   300    83010    13.00      0.00
3411030   A: HEMGLBINPATHY EVAL,HGB   34   305    85018     1.50      0.00
3411048   A: HEMGLBINPATHY EVAL,HCT   34   305    85014     1.50      0.00
3411055   A: HEMGLBINPATHY EVAL,CHR   34   301    83021    10.50      0.00
3411063   A: HEP ABC ACUTE PNL, HCV   34   302    86803     8.89      0.00
3411071   A: HEP ABC ACUTE PNL, HAV   34   302    86709     5.68      0.00
3411089   A: HEP ABC ACUTE PNL, HBC   34   302    86705     6.17      0.00
3411097   A: HEP ABC ACUTE PNL,HBSA   34   306    87340     3.95      0.00
3411113   A: HEMOGLOBIN GLYCO         34   300    83036     9.09      0.00
3411121   A: HEP A AB-IGM             34   300    86709     5.56      0.00
3411147   A: HEP B CORE AB            34   300    86704     9.75      0.00
3411154   A: HEP B E AG               34   300    87350    11.75      0.00
3411162   A: HEP B SURF AB            34   300    86706    26.18      0.00
3411188   A: HEP B SURF AG            34   300    87340     4.00      0.00
3411196   A: HEP C RIBA               34   300    86804    69.50      0.00
3411204   A: AB IMMUNOASSAY           34   300    86701    15.50      0.00
3411220   A: HORMONE ACTH             34   300    82024    20.25      0.00
3411238   A: HORMONE FSH              34   300    83001     7.00      0.00
3411246   A: HORMONE GROWTH           34   300    83003    10.25      0.00
3411253   A: HORMONE LH               34   300    83002    10.00      0.00
3411261   A: HORMONE PROLACTIN        34   300    84146    10.00      0.00
                                            REV     CPT   UNIT     ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE    PRICE
3411279   A: HSV CULTURE              34   300    87252    25.00      0.00
3411287   A: HSV I&II ABS-IGG         34   300    86695    34.15      0.00
3411329   A: HEPATITIS C AB, EIA      34   302    86803     8.87      0.00
3411337   A: HERPES SIMP VIRUS CULT   34   306    87255    25.00      0.00
3411345   A: HSV TYPE 1&2 DNA, PCR    34   306    87529    34.15      0.00
3411352   A: IGE TOTAL, SERUM         34   301    82785    14.00      0.00
3411360   A: IMMUNOFIXATION, SERUM    34   302    86334    30.78      0.00
3411378   A: IMMUNOFIXATION, IGA      34   301    82784     8.55      0.00
3411386   A: IMMUNOFIXATION, IGG      34   301    82784     9.12      0.00
3411394   A: IMMUNOFIXATION, IGM      34   301    82784     8.55      0.00
3411402   A: IG G/A/M QT              34   300    82784    27.00      0.00
3411410   A: IGA                      34   300    82784    10.80      0.00
3411428   A: IGE                      34   300    82784    14.00      0.00
3411436   A: IGM                      34   300    82784    10.80      0.00
3411451   A: INSULIN                  34   300    83525    10.50      0.00
3411469   A: LUPUS ANTICOAG EVAL PT   34   305    85730    16.88      0.00
3411477   A: LIDOCAINE                34   300    80176    89.70      0.00
3411485   A: LUPUS ANTICOAG EVAL DR   34   305    85613    16.87      0.00
3411493   A:FUNGUS CULTURE            34   306    87102     8.33      0.00
3411527   A: LEAD, BLOOD              34   300    83655    15.60      0.00
3411535   A: LEGIONELLA AB            34   300    86713    11.45      0.00
3411568   A: LIME DISEASE AB          34   300    86618    58.95      0.00
3411576   A: OVA & PARASITES, CONCE   34   306    87177     7.75      0.00
3411584   A: OVA & PARASITES, STAIN   34   306    87209     7.75      0.00
3411592   A: PCP CONF URINE, GCMS     34   301    83992    45.00      0.00
3411600   A: METANEPHRINES            34   300    83835    29.80      0.00
3411618   A: MYCOPLASMA AB            34   300    86738    12.45      0.00
3411634   A: MYOGLOBIN URINE          34   300    83874    15.00      0.00
3411642   A: EP PROTEIN SERUM, FRAC   34   301    84165    11.53      0.00
3411659   A: EP PROTEIN SERUM, TOTA   34   301    84155     4.14      0.00
3411667   A: EP PROTEIN URINE, FRAC   34   301    84166     8.78      0.00
3411675   A: EP PROTEIN URINE, TOTA   34   301    84156     2.82      0.00
3411683   A: EP PROTEIN URINE, CREA   34   301    82570     4.07      0.00
3411691   A: PTH, INTACT              34   301    83970    19.04      0.00
3411709   A: OLIGOCLONAL BANDS        34   300    83916    49.78      0.00
3411717   A: OPIATES CONFIRM URINE    34   300    80102    48.75      0.00
3411725   A: PTH, CALCIUM             34   301    82310     3.36      0.00
3411733   A: T-LYMPH SUBSETS, T CEL   34   302    86359     8.34      0.00
3411741   A: T-LYMPH SUBSETS, B CEL   34   302    86355     8.34      0.00
3411758   A: T-LYMPH SUBSETS, CD4/C   34   302    86360    10.22      0.00
3411766   A: PCP GC/MS                34   300    80102    60.20      0.00
3411774   A: PHOS ACID (PAP)          34   300    84066    10.00      0.00
3411808   A: PP, RBC                  34   300    84202    15.65      0.00
3411824   A: PROGESTERONE             34   300    84144    10.00      0.00
3411832   A: PROTEIN C ASSAY          34   300    85303    19.75      0.00
3411840   A: PROTEIN EP CSF           34   300    84166    14.50      0.00
3411857   A: PROTEIN EP FLUID         34   300    84166    39.12      0.00
3411881   A: PSA TOTAL                34   300    84153    10.40      0.00
3411899   A: PTH C-TERMINAL           34   300    83970    46.35      0.00
3411907   A: Q FEVER AB               34   300    86638    23.00      0.00
3411915   A: TORCH IGG, CMV           34   302    86644     5.58      0.00
3411923   A: TORCH IGG, HSV TYPE 1    34   302    86695     5.59      0.00
                                            REV     CPT   UNIT     ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE    PRICE
3411931   A: TORCH IGG, HSV TYPE 2    34   302    86696     5.59      0.00
3411964   A: RUBELLA IGM              34   300    86762     9.45      0.00
3411972   A: RUBEOLA IGG              34   300    86765     8.00      0.00
3411998   B: AFB CULTURE AND SMEAR    34   306    87116    25.00      0.00
3412004   A: STONE ANALYSIS           34   300    82365    13.00      0.00
3412012   A: TORCH IGG, RUBELLA       34   302    86762     5.58      0.00
3412020   A: T CELL CD4 COUNT         34   311    88182    26.90      0.00
3412046   A: TESTOSTERONE             34   300    84403    13.75      0.00
3412079   A: TOXOPLASMA IGM           34   300    86778    17.50      0.00
3412087   A: TRANSFERRIN              34   300    84466    20.81      0.00
3412095   A: T3 TOTAL                 34   300    84480     8.00      0.00
3412103   A: TORCH IGG, TOXOPLASMA    34   302    86777     5.58      0.00
3412111   A: TORCH IGG, TOXO IGM      34   302    86778     5.58      0.00
3412129   A: TORCH IGM AB, CMV        34   302    86645     6.70      0.00
3412137   A: TORCH IGM AB, HSV TYP1   34   302    86695     6.70      0.00
3412145   A: TORCH IGM AB, HSV TYP2   34   302    86696    11.15      0.00
3412152   A: VDRL CSF                 34   300    86593     8.50      0.00
3412160   A: VITAMIN B-12             34   300    82607    14.37      0.00
3412186   A: VZV IGG                  34   300    86787     8.50      0.00
3412202   A: TORCH IGM AB, RUBELLA    34   302    86762     6.70      0.00
3412210   A: TORCH IGM AB, TOXOPLAS   34   302    86777     6.70      0.00
3412228   A: TORCH IGM AB, TOXO IGM   34   302    86778     6.70      0.00
3412236   A: VDRL, CSF                34   302    86592     8.50      0.00
3412244   A: VMA, URINE               34   301    84585    11.81      0.00
3412251   A: WESTERN BLOT             34   300    86689    43.88      0.00
3412269   A: VMA, URINE CREATININE    34   301    82570     3.94      0.00
3412277   A: CANCER ANTIGEN 19-9      34   302    86301    14.15      0.00
3412285   A: C-PEPTIDE                34   301    84681    12.75      0.00
3412293   A: ERYTHROPOIETIN           34   301    82668    15.50      0.00
3412301   A: ZINC                     34   300    84630    35.50      0.00
3412319   A: GIARDIA ANTIGEN          34   306    87329    22.00      0.00
3412327   A: GLOMERULAR BASE AB       34   301    83520    75.98      0.00
3412335   A: H. PYLORI ANTIGEN        34   306    87338    20.25      0.00
3412343   A: HOMOCYSTEINE             34   301    83090    20.00      0.00
3412376   A: 5-HIAA URINE             34   300    83497    15.60      0.00
3412400   A: ASO TITER                34   300    86060     6.50      0.00
3412418   A: RHEUMATOID FACTOR        34   300    86431     5.50      0.00
3412426   A: COLD AGGILLUTININGS      34   300    86157    16.00      0.00
3412434   A: CHLAMYDIA URINE          34   300    87491    17.95      0.00
3412442   A: OC URINE                 34   300    87591    17.95      0.00
3412459   A: LEGIONELLA URINARY AG    34   306    87449    21.75      0.00
3412467   A: LIPOPROTEIN(A)           34   301    83695    25.00      0.00
3412475   A: LIVER-KIDNEY MICROSOME   34   302    86376    15.00      0.00
3412483   A: T3 FREE                  34   301    84481    14.50      0.00
3412491   A: TSI                      34   301    84445    57.20      0.00
3412509   B: CYCLOSPORINE             34   300    80158    30.00      0.00
3412517   A: VITAMIN B1               34   301    84425    19.50      0.00
3412525   A: IGG                      34   300    82784    10.80      0.00
3412533   A: VITAMIN D,1,25-DIHYDRO   34   301    82652    26.50      0.00
3412541   B: LIDOCAINE                34   300    80176    23.00      0.00
3412558   A: VITAMIN D,25-HYDROXY     34   301    82306    26.50      0.00
3412566   B: LITHIUM                  34   300    80178    12.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
3412574   B: CALCIUM,IONIZED          34   301    82330     15.00      0.00
3412582   B: PRIMIDONE                34   300    80188     33.00      0.00
3412590   B: AFB SMEAR                34   306    87206     12.00      0.00
3412608   B: NAPA/PROCAINAMIDE        34   300    80192     33.00      0.00
3412616   A: PHOSPHOLIPID NEUTR.      34   305    85597     31.60      0.00
3412624   B: PSEUDO CHE               34   300    82480     15.00      0.00
3412632   A: HIV RNA QUANT, PCR       34   306    87536     86.00      0.00
3412673   A: CA 15-3                  34   302    86300     21.00      0.00
3412699   B: CRYPTOCOCCUS ANTIGEN     34   302    86403     17.50      0.00
3412707   F: CUL AFB BLOOD            34   300    87116     21.97      0.00
3412715   F: SENS AFB PANEL (6)       34   300    87190    119.28      0.00
3412723   F: MHA-TP                   34   300    86781      8.22      0.00
3412731   F: RPR QUAL                 34   300    86592      8.89      0.00
3412749   F: RPR QUANT                34   300    86593      8.89      0.00
3412756   F: TP-PA                    34   300    86781     26.90      0.00
3412806   MISC BATTERY                34   300               0.00      0.00
3412830   A: H PYLORI ABS-IGG         34   300    86677     20.25      0.00
3412848   A: MICROALBUMIN             34   300    82043      8.87      0.00
3412855   F: SENS AFB EACH            34   306    87190     18.24      0.00
3412863   A: FERRITIN                 34   300    82728     15.14      0.00
3412871   A: PRIMIDONE                34   300    80188     44.63      0.00
3412889   B: TOBRAMYCIN PEAK          34   300    80200     23.00      0.00
3412897   B: TOBRAMYCIN RANDOM        34   300    80200     23.00      0.00
3412905   B: TOBRAMYCIN TROUGH        34   300    80200     23.00      0.00
3412913   B: QUINIDINE                34   300    80194     23.00      0.00
3412921   A: ANTIBODY NUCLEAR TITER   34   300    86039      8.00      0.00
3412939   B: CARBAMAZEPINE            34   300    80156     23.00      0.00
3412947   A: HEP C RNA QUANT          34   300    87522    147.50      0.00
3412954   A: HEP C RNA QUAL           34   300    87521     99.00      0.00
3412962   A: HEP C AB REFLEX          34   300    86803      8.87      0.00
3412970   A: HEP C RIBA               34   300    86804     75.25      0.00
3412988   A: DRVVT 1:1 MIX            34   305    85613     22.50      0.00
3412996   A: 17-OHPROGESTERONE        34   301    83498     59.93      0.00
3413010   C: NBN SCREEN-HGB QT        34   301    83021     14.50      0.00
3413028   C: NBN SCREEN-TRANSFERASE   34   301    82776     14.50      0.00
3413036   C: NBN SCREEN-QT MS/MS      34   301    83789     14.75      0.00
3413044   C: NBN SCREEN-THYROID STM   34   301    84443     14.50      0.00
3413051   C: NBN SCREEN-BIOTINIDASE   34   301    82261     14.50      0.00
3413077   C: NBN SCREEN-IMMUNOREACT   34   301    83516     14.50      0.00
3413085   A: WEST NILE IGM, CSF       34   302    86788     29.67      0.00
3413093   C: NBN SCREEN-17 OHP        34   301    83498     14.50      0.00
3413101   A: MITOCHONDRIAL TITER      34   302    86256     14.00      0.00
3413119   A: CARDIOLIPIN AB IGA       34   302    86147     27.83      0.00
3413127   A: CARDIOLIPIN AB IGG       34   302    86147     27.83      0.00
3413135   A: CARDIOLIPIN AB IGM       34   302    86147     27.83      0.00
3413143   A: HSV TYPE                 34   306    87140     34.15      0.00
3413150   A: HEXOGONAL PHASE NEUT     34   305    85597     42.00      0.00
3413168   A: Q FEVER 1 LGG TITER      34   302    86638     13.50      0.00
3413176   A: Q FEVER 2 LGG TITER      34   302    86638     13.50      0.00
3413184   A: Q FEVER 1 LGM TITER      34   302    86638     15.60      0.00
3413192   A: Q FEVER 2 LGM TITER      34   302    86638     15.60      0.00
3413200   A: LYME DISEASE BY WB       34   302    86617    107.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
3413218   A: CALCITONIN               34   301    82308     70.10      0.00
3413226   A: CYANIDE                  34   301    82600     45.99      0.00
3413234   A: COXSACKIE A ANTIBODY     34   302    86658     51.00      0.00
3413242   A: COXSACKIE B ANIBODY      34   302    86658     26.55      0.00
3413259   A: ANDROSTENEDIONE          34   301    82157     51.43      0.00
3413267   A: METHOTREXATE             34   301    80299     35.61      0.00
3413275   A: HANTAVIRUS ANTIBODY      34   302    86790     60.00      0.00
3413283   A: T3 UPTAKE                34   301    84479      4.00      0.00
3413291   A: CGC-C. TRACHOMATIS RNA   34   306    87491     27.50      0.00
3413309   A: CGC-N. GONORRHOEAE RNA   34   306    87591     27.50      0.00
3413317   A: TESTOSTERONE, TOTAL      34   301    84403     44.78      0.00
3413325   A: TESTOSTERONE, FREE       34   301    84402     44.77      0.00
3413333   A: INFLUENZA B VIRUS        34   306    87275      7.75      0.00
3413341   A: INFLUENZA A VIRUS        34   306    87276      7.75      0.00
3413358   A: PSA, TOTAL               34   301    84153     12.00      0.00
3413366   A: PSA, FREE                34   301    84154     12.00      0.00
3413374   A: TOXOPLASMA IGG           34   302    86777     12.25      0.00
3413382   A: TOXPLASMA IGM            34   302    86778     12.25      0.00
3413390   A: AMIKACIN                 34   301    80150     28.75      0.00
3413408   A: BETA-2 MICROGLOBULIN     34   301    82232     12.50      0.00
3413416   A: CADMIUM, BLOOD           34   301    82300     22.80      0.00
3413424   A: CARNITINE FREE & TOTAL   34   301    82379     31.00      0.00
3413432   A: CHLAMYDIA TRACH DFA      34   306    87270     37.50      0.00
3413440   A: CHLAMYDIA DNA, URINE     34   306    87491     45.00      0.00
3413457   A: N.GONORRHOEAE DNA PRO    34   306    87590     10.79      0.00
3413465   A: HEP INDUCED PLATE AB     34   302    86022     66.35      0.00
3413473   A: HERPES SIMP VIRUS, DFA   34   306    87299     13.10      0.00
3413481   A: INFLUENZA ABS, IGG/IGM   34   302    86710     15.50      0.00
3413499   A: INSULIN ANTIBODY         34   302    86337    114.58      0.00
3413507   A: LAMOTRIGINE              34   301    80299     20.75      0.00
3413515   A: LEGIONELLA CULTURE       34   306    87081     59.50      0.00
3413523   A: METHYLMALONIC ACID       34   301    83921     75.98      0.00
3413531   A: MYCO/UREAPLASMA CU       34   306    87109     23.40      0.00
3413549   A: PARAINFLUNZA VIRUS DFA   34   306    87279     97.97      0.00
3413556   A: PROINSULIN               34   301    84206     91.50      0.00
3413564   A: PTH-RELATED PROTEIN      34   301    83519     45.00      0.00
3413572   A: SULFONYLUREA             34   301    82492     70.00      0.00
3413598   A: THYROGLOBULIN AB         34   302    86800      9.25      0.00
3413606   A: THYROID PEROXIDASE AB    34   302    86376     11.75      0.00
3413614   A: WEST NILE IGM, SERUM     34   302    86788     28.00      0.00
3413622   A: AEROBIC BACT ID          34   306    87077     45.00      0.00
3413630   A: LEVETIRACETAM            34   301    80299     32.63      0.00
3413648   A: HSV IGM AB               34   302    86694     55.50      0.00
3413655   A: HSV IGM TITER            34   302    86694     41.00      0.00
3413663   A: SIN NOMBRE VIRUS IGG     34   302    86790     99.00      0.00
3413671   A: SIN NOMBRE VIRUS IGM     34   302    86790     72.00      0.00
3413689   U: COCCI AB, CF             34   302    86171     40.00      0.00
3413697   U: COCCI AB, ID             34   302    86631     34.00      0.00
3413705   B: AMYLASE                  34   301    82150     10.50      0.00
3413713   B: LIPASE                   34   301    83690     12.00      0.00
3413721   B: RETIC                    34   305    85044      7.00      0.00
3413739   B: TACROLIMUS               34   301    80197     39.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER             DESCRIPTION       DEPT CODE    CODE   PRICE     PRICE
3500022   FFP PP/3 CMV PF-DBB         35   390    P9017     45.00      0.00
3500071   WB PROC FEE-DBB             35   390    P9010    236.00      0.00
3500089   PRBC PROC FEE-DBB           35   390    P9021    214.00      0.00
3500113   CRYO PROC FEE-DBB           35   390    P9012     73.00      0.00
3500121   WB CMV PROC FEE-DBB         35   390    P9010    174.60      0.00
3500170   PLT ESIS PF-DBB             35   390    P9034    620.00      0.00
3500204   FFP PROC FEE-DBB            35   390    P9017     73.00      0.00
3500220   PLT PROC FEE-DBB            35   390    P9019     75.00      0.00
3500238   PRBC LP PROC FEE-DBB        35   390    P9016    224.00      0.00
3500287   PRBC LV PROC FEE-DBB        35   390    P9021    136.00      0.00
3500303   FFP PP CMV PF-DBB           35   390    P9017    142.00      0.00
3500345   DESIGNATION FEE-DBB         35   390              50.00      0.00
3500352   FFP SPECIAL-DBB             35   390               0.00      0.00
3500360   AUTO PF (FC L/M)-DBB        35   390    P9021    335.00      0.00
3500386   BLOOD UNIT-OTHER            35   390               0.00      0.00
3500436   E: HLA MATCH/UNIT-DBB       35   300    86813    185.00      0.00
3500451   FFP CRYOPOOR PF-DBB         35   390    P9044     73.00      0.00
3500477   PLT ESIS LP PF-DBB          35   390    P9035    620.00      0.00
3500485   STERILE DOCK FEE-DBB        35   270    99070     30.00      0.00
3500493   E: SATELLITES PP 4          35   270    99070     60.00      0.00
3500501   E: SATELLITES PP 8          35   270    99070     80.00      0.00
3500535   DRAW CLOT & HOLD            35   300    36415     80.00      0.00
3500543   CR DRAW CLOT & HOLD         35   300    36415     80.00      0.00
3510013   E: OVERTIME/HALF HOUR       35   399    86999     70.00      0.00
3510021   E: CMV UNIT TESTING         35   300    86644     37.00      0.00
3510039   E: IRRADIATION/UNIT         35   300    86945     65.00      0.00
3510047   E: SCREENED UNIT/AG         35   300    86903     50.00      0.00
3510054   E: ANTIBODY ID PANEL        35   300    86870    150.00      0.00
3510062   E: ANTIBODY ID AUTO         35   300    86978    150.00      0.00
3510070   E: OUT-AREA SURCHARGE       35   399               0.00      0.00
3510088   E: CROSS AHG/UNIT           35   300    86922     85.00      0.00
3510096   E: UNIT COST DIFF           35   380               0.00      0.00
3510104   E: ADD PROC, REFER          35   399               0.00      0.00
3510120   E: PREWARM TECHNIQUE        35   300    86850     75.00      0.00
3510138   E: SPECI TNSFR; PT NOT MD   35   300    99001     35.00      0.00
3510146   E: ANTIBODY ID ALLO         35   300    86978    200.00      0.00
3510153   E: ANTIBODY ID EXTRA        35   300    86870     50.00      0.00
3510161   E: ABO TESTING              35   300    86900     25.00      0.00
3510179   E: TX RXN EVALUATION        35   399             300.00      0.00
3510187   E: ANTIBODY TITER           35   300    86886    120.00      0.00
3510195   E: ANTIBODY ELUTION         35   300    86860    125.00      0.00
3510203   E: EXT PHENOTYPE/AG         35   300    86903     50.00      0.00
3510211   E: HTLA NEUTRALIZE          35   300    86977    100.00      0.00
3510229   E: WNV RNA                  35   306    87798      9.20      0.00
3510237   E: DELIVERY CODE            35   399    86999     15.00      0.00
3510245   E: ASAP/STAT WORKUPDBB      35   399    86999    100.00      0.00
3510252   E: RH PHENOTYPING           35   305    86906     25.00      0.00
3510260   E:ABO                       35   305    86900     20.00      0.00
3510278   E:RH                        35   305    86901     20.00      0.00
3510286   E: DAT                      35   305    86880     25.00      0.00
3510518   E:CR ABO TESTING            35   300    86900     25.00      0.00
3510526   E:CR ANTIBODY ELUT          35   300    86860    125.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
3510534   E:CR ANTIBODY TITER         35   300    86886    120.00      0.00
3510542   E:CR ANTIBODY ID AL         35   300    86978    200.00      0.00
3510559   E:CR ANTIBODY ID PN         35   300    86870    150.00      0.00
3510567   E:CR SCREEN UNIT/AG         35   300    86903     50.00      0.00
3510575   E:CR ANTIBODY ID AU         35   300    86978    150.00      0.00
3510583   E:CR CMV UNIT TESTING       35   300    86644     37.00      0.00
3510591   E:CR CROSS AHG/UNIT         35   300    86922     85.00      0.00
3510609   E:CR EXT PHENOTYPE/AG       35   300    86903     50.00      0.00
3510617   E:CR ANTIBODY ID EX         35   300    86870     50.00      0.00
3510625   E:CR HLA MATCH/UNIT         35   300    86813    185.00      0.00
3510633   E:CR HTLA NEUTRAL           35   300    86977    100.00      0.00
3510641   E:CR IRRADIATE/UNIT         35   300    86945     60.00      0.00
3510666   E:CR PWRM TECHNIQUE         35   300    86850     75.00      0.00
3510674   E:CR SATELLITES PP4         35   270    99070     60.00      0.00
3510682   E:CR SATELLITES PP8         35   270    99070     80.00      0.00
3510690   E:CR STER DOCK FEE          35   270    99070     30.00      0.00
3510708   E:CR TX RXN EVAL            35   399             300.00      0.00
3510716   E:CR WNV                    35   399    87798      9.20      0.00
3600038   K: MARROW: ASP ST+INT       36   310    85097    187.20      0.00
3600079   K: MARROW: IRON ST          36   305    85536    112.70      0.00
3600632   K: UNLISTED SURG PATH       36   310    88399      0.00      0.00
3600640   SPECIMEN TNSFR; PT NOT MD   36   300    99001     72.05      0.00
3600707   SPECIMEN TNSFR; PT NOT MD   36   300    99001      0.00      0.00
3650009   K:LEVEL I:GRS               36   310    88300     69.35      0.00
3650025   K:LEVEL II: GRS+MIC         36   310    88302    162.30      0.00
3650041   K:LEVEL III: GRS+MIC        36   310    88304    172.15      0.00
3650066   K:LEVEL IV: GRS+MIC         36   310    88305    214.50      0.00
3650082   K: MARROW: BX INT           36   310    88305     93.50      0.00
3650108   K: MARROW: BX ST+INT        36   310    88305    149.75      0.00
3650124   K:LEVEL V: GRS+MIC          36   310    88307    275.65      0.00
3650140   K:LEVEL VI: GRS+MIC         36   310    88309    370.35      0.00
3650165   K:DECALCIFICATION           36   310    88311     29.75      0.00
3650181   K:ACID FAST/AFB             36   310    88312     74.85      0.00
3650207   K:GIEMSA/H PYLORI           36   310    88312     74.85      0.00
3650223   K:GMS/FUNGUS                36   310    88312     74.85      0.00
3650249   K:GMS/PCP                   36   310    88312     74.85      0.00
3650264   K:GRAM/MICROORGANISMS       36   310    88312     74.85      0.00
3650280   K:PAS/FUNGUS                36   310    88312     74.85      0.00
3650306   K:SPEC STAINS: GRP 1        36   310    88312     90.15      0.00
3650322   K:ALB-MPS                   36   310    88313     79.10      0.00
3650348   K:ALB-PAS/MPS               36   310    88313     79.10      0.00
3650363   K:CONGO RED/AMYLOID         36   310    88313     79.10      0.00
3650389   K:G&S/RETICULUM             36   310    88313     79.10      0.00
3650405   K:MUCICARMINE/MUCIN         36   310    88313     79.10      0.00
3650421   K:PAS/GLYCOGEN              36   310    88313     79.10      0.00
3650447   K:PRUSSIAN BLUE/IRON        36   310    88313     79.10      0.00
3650462   K:SPEC STAINS: GRP 2        36   310    88313     90.15      0.00
3650488   K:TRICHROME/COLLAGEN        36   310    88313     79.10      0.00
3650504   K:VERHOEFF/ELASTIN          36   310    88313     79.10      0.00
3650520   K:CONS: FS FIRST SPEC       36   310    88331    142.25      0.00
3650546   K:CONS: FS ADD SPECS        36   310    88332      0.00      0.00
3800018   ECG 12LD NEWBORN            38   730    93000    356.00      0.00
                                            REV     CPT     UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE     PRICE     PRICE
3800026   ECG 12LD ADULT              38   730    93000      356.00      0.00
3800034   ECG 12LD PEDIATRIC          38   730    93000      356.00      0.00
3800042   ECG RHYTHM TRACE            38   730    93041      356.00      0.00
3800059   ECG 12LD WITH MAGNET        38   730    93000      370.00      0.00
3900040   CARDIAC STRESS TEST         39   482    93017     1730.00      0.00
4000501   EEG HV/PHOTIC STIM          40   740    95819      746.00      0.00
4000543   EEG CEREBRAL DEATH EVAL     40   740    95824      547.00      0.00
4000568   EEG ASLEEP ONLY             40   740    95822      704.00      0.00
4000584   EEG EXTENDED <1HR           40   740    95812     1075.00      0.00
4000600   EEG EXTENDED >1HR           40   740    95813     1075.00      0.00
4000626   EEG AWAKE/DROWSY HV/PHOTC   40   740    95816      746.00      0.00
4000634   EEG AWAKE/DROWSY INTERUPT   40   740    9581652    559.00      0.00
4100087   POC-URINE PREGNANCY         41   300    81025       83.00      0.00
4100236   THORACENTESIS               41   450    32421     1034.00      0.00
4100244   TRIAGE (TRACKING ONLY)      41   450                 0.00      0.00
4100251   MINOR BURN CARE             41   450    MULTI      165.00      0.00
4100269   CHEST TUBE INSERTION        41   450    32551     1034.00      0.00
4100905   ER VISIT - LEVEL 1          41   450    99281      486.00      0.00
4100921   ER VISIT - LEVEL 2          41   450    99282      625.00      0.00
4100947   ER VISIT - LEVEL 3          41   450    99283      984.00      0.00
4100962   ER VISIT - LEVEL 4          41   450    99284     1458.00      0.00
4100988   ER VISIT - LEVEL 5          41   450    99285     2192.00      0.00
4101119   IMMUNIZATION ADM 1 VACCI    41   450    90471      112.00      0.00
4101143   BLOOD ADMINISTRATION        41   391    36430     1655.00      0.00
4101168   INTRAOSSEUS PLACEMENT       41   450    36680      471.00      0.00
4101184   PEDIATRIC CATHERIZATION     41   450    51702      743.00      0.00
4101200   CUTDOWN                     41   450    36625      495.00      0.00
4101226   CENTRAL LINE/DIALYSIS CAT   41   450    MULTI     1533.00      0.00
4101325   TRACHEOSTOMY INSERTION      41   450    31603     3534.00      0.00
4101341   CRICOTHYROTOMY              41   450    31605     3534.00      0.00
4101408   THROMBOLYTIC THERAPY        41   450    92977      471.00      0.00
4101424   PACEMAKER EXTERNAL PROC     41   450    92953     1280.00      0.00
4101440   CARDIOVERSION               41   450    92960     1280.00      0.00
4101465   CPR                         41   450    92950     1280.00      0.00
4101523   EWALD INSERTION/LAVAGE      41   450    91105      396.00      0.00
4101622   FEMCATH INSERTION           41   450    51701      264.00      0.00
4101648   FOLEY INSERTION             41   450    51702      248.00      0.00
4101705   EAR IRRIGATION              41   450    69210      295.00      0.00
4101820   EPISTAXSIS SIMPLE           41   450    30901      627.00      0.00
4101846   EPISTAXSIS COMPLEX          41   450    30903      872.00      0.00
4101903   SPLINT SHORT ARM PROC       41   450    MULTI      494.00      0.00
4101929   SPLINT LONG ARM PROC        41   450    MULTI      494.00      0.00
4101945   SPLINT SHORT LEG PROC       41   450    MULTI      309.00      0.00
4101960   SPLINT LONG LEG PROC        41   450    MULTI      309.00      0.00
4102109   LUMBAR PUNCTURE ADULT       41   450    62270      852.00      0.00
4102125   LUMBAR PUNCTURE PED         41   450    62270      852.00      0.00
4102240   GT REPLACEMENT              41   450    43760      670.00      0.00
4102349   FB REMOVAL EAR              41   450    69200      477.00      0.00
4102364   ET INSERT/MAINT             41   450    31500     1280.00      0.00
4102448   NG IRRIGATION               41   450    91105      396.00      0.00
4102463   FOLEY IRRIGATION            41   450    51700      883.00      0.00
4102489   POC-GLUCOSE BLD MON DVICE   41   300    82962       66.00      0.00
                                            REV     CPT     UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE     PRICE      PRICE
4102505   POC-GLUCOSE BLD DVICE ADD   41   300    8296291      66.00      0.00
4102521   D&C                         41   450    59812      3690.00      0.00
4102547   VISUAL ACUITY               41   450    99173       165.00      0.00
4102562   CRITICAL CARE               41   450    99291      5198.00      0.00
4102604   FB REMOVAL NOSE             41   450    30300       477.00      0.00
4102687   FINGER SPLINT PROCEDURE     41   450    MULTI       494.00      0.00
4102703   SUTURE/STAPLING PROCEDURE   41   450    MULTI       690.00      0.00
4102711   DERMABOND PROCEDURE         41   450    MULTI       690.00      0.00
4102760   I&D                         41   450    10060       568.00      0.00
4102786   I&D WITH PACKING            41   450    10061       679.00      0.00
4102802   KNEE IMMOBILIZER PROC       41   450    MULTI       309.00      0.00
4102828   SHOULDER IMMOBILIZER PROC   41   450    MULTI       494.00      0.00
4102844   CLAVICLE STRAP PROCEDURE    41   450    MULTI       494.00      0.00
4102869   CAST REMOVAL                41   450    MULTI       309.00      0.00
4102885   EXTREMITY REDUCT LOCAL      41   450    MULTI       616.00      0.00
4102901   EXTREMITY REDUC CONSC/SED   41   450    MULTI      3128.00      0.00
4102927   ED DELIVERY/STABILIZATION   41   450    59409      3179.00      0.00
4102943   NEWBORN RESUSCITATION       41   450    99440      1280.00      0.00
4103024   FB REMOVAL EXTREMITY        41   450    MULTI       477.00      0.00
4103040   REMOVAL OF NAIL BED         41   450    MULTI       165.00      0.00
4103065   FB REMOVAL EYE              41   450    MULTI       380.00      0.00
4103081   EXTREMITY REDUCT SIMPLE     41   450    MULTI       207.00      0.00
4103206   PACEMAKER PERCUT PROC       41   450    33210     24028.00      0.00
4103214   MISC ED PROCEDURE-INTERME   41   450    MULTI       972.00      0.00
4103222   DEBRIDEMENT PROC WOUND      41   450    MULTI       165.00      0.00
4103230   MISC ED PROCEDURE-COMPLEX   41   450    MULTI      2160.00      0.00
4103248   DEBRIDEMENT PROC BURN       41   450    MULTI       243.00      0.00
4103255   TH/PR/DX IV PUSH EA ADD     41   940    90776       223.00      0.00
4103263   MISC ED PROCEDURE-SIMPLE    41   450    MULTI       324.00      0.00
4103271   HYDRATION IV INFUSION INI   41   260    90760       267.00      0.00
4103289   THER/PRO/DIAG IV INF INIT   41   260    90765       267.00      0.00
4103297   HYDRATE IV INFUSON ADD-ON   41   260    90761       249.00      0.00
4103305   THER/PRO/DX IV INF ADD-ON   41   260    90766       249.00      0.00
4103313   THER/PROPH/DIAG INJ SC/IM   41   940    90772       267.00      0.00
4103321   TH/PR/DX INJ SC/IM EA ADD   41   940    90772       223.00      0.00
4103339   T/P/D INJ IV PUSH INIT      41   940    90774       267.00      0.00
4103354   THER/PROPH/DIAG INJ SC/IM   41   450    90772       267.00      0.00
4103370   TH/PR/DX INJ SC/IM EA ADD   41   450    90772       223.00      0.00
4103388   MOD CS BY SAME PHYS <5YRS   41   370    99143       495.00      0.00
4103396   MOD CS BY SAME PHYS 5+YRS   41   370    99144       495.00      0.00
4103404   MOD CS BY SAME PHY ADD-ON   41   370    99145       248.00      0.00
4103412   MOD CS DIFF PHYS < 5 YRS    41   370    99148       495.00      0.00
4103420   MOD CS DIFF PHYS 5 YRS +    41   370    99149       495.00      0.00
4103438   MOD CS DIFF PHYS ADD-ON     41   370    99150       248.00      0.00
4103446   TPDX IV PUSH NEW SUB INIT   41   940    90775       223.00      0.00
4103461   I&D PILONID CYS; SMPL       41   450    10080       450.00      0.00
4103479   I&D PILONID CYST; CPLX      41   450    10081      3699.00      0.00
4103487   INC & REM FB, SQ; SMPL      41   450    10120       450.00      0.00
4103495   INC & REM FB, SQ; COMPL     41   450    10121      5152.00      0.00
4103503   I&D HEMATOMA                41   450    10140      3699.00      0.00
4103511   PUNCT ASP-ABSC,HEMAT,CYST   41   450    10160       450.00      0.00
4103529   I&D, CPLX, POSTOP WND INF   41   450    10180      5863.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
4103537   DEBR EXZ/INF SKIN; 10% BS   41   450    11000    254.00      0.00
4103545   DEBR EXZ/INF SKIN ADD 10%   41   450    11001    254.00      0.00
4103552   DEBR W OPEN FX; SKIN & SQ   41   450    11010   1377.00      0.00
4103560   DEB O FX; SKIN-TO MUSCLE    41   450    11011   1377.00      0.00
4103578   DEBR O FX; SKIN - TO BONE   41   450    11012   1377.00      0.00
4103586   DEBRIDE; SKIN, PT           41   450    11040    467.00      0.00
4103594   DEBRIDE; SKIN, FT           41   450    11041    467.00      0.00
4103602   DEBRIDE; SKIN TO SQ TISSU   41   450    11042    851.00      0.00
4103610   DEBRIDE; SKIN TO MUSCLE     41   450    11043    851.00      0.00
4103628   DEBRIDE; SKIN TO BONE       41   450    11044   2202.00      0.00
4103636   REM SKIN TAGS; TO 15        41   450    11200    254.00      0.00
4103644   EXC TR-EXT B9+MARG 0.5<CM   41   450    11400   1377.00      0.00
4103651   EXC B9 LES T/A/L 0.6-1 CM   41   450    11401   1384.00      0.00
4103669   EXC B9 LES T/A/L 1.1-2 CM   41   450    11402   1384.00      0.00
4103677   EXC B9 LES T/A/L 2.1-3 CM   41   450    11403   2792.00      0.00
4103685   EXC B9 LES T/A/L 3.1-4 CM   41   450    11404   5176.00      0.00
4103693   EXC B9 LES T/A/L >4.0 CM    41   450    11406   5176.00      0.00
4103701   EXC B9 S/N/EX/G 0.5<CM      41   450    11420   2792.00      0.00
4103719   EXC B9 S/N/EX/G 0.6-1 CM    41   450    11421   2792.00      0.00
4103727   EXC B9 S/N/EX/G 1.1-2 CM    41   450    11422   2792.00      0.00
4103735   EXC B9 S/N/EX/G 2.1-3 CM    41   450    11423   5176.00      0.00
4103743   EXC B9 S/N/EX/G 3.1-4 CM    41   450    11424   5176.00      0.00
4103750   EXC B9 S/N/EX/G >4.0 CM     41   450    11426   6755.00      0.00
4103768   EXC FACE-MM B9+MG 0.5<CM    41   450    11440   1377.00      0.00
4103776   EXC FACE-MM B9+MG 0.6-1CM   41   450    11441   1377.00      0.00
4103784   EXC FACE-MM B9+MG 1.1-2CM   41   450    11442   2779.00      0.00
4103792   EXC FACE-MM B9+MG 2.1-3CM   41   450    11443   2779.00      0.00
4103800   EXC FACE-MM B9+MG 3.1-4CM   41   450    11444   2779.00      0.00
4103818   EXC FACE-MM B9+MG > 4 CM    41   450    11446   6755.00      0.00
4103826   TRIM ND NAILS               41   450    11719    254.00      0.00
4103834   DEBRIDE NAIL(S); 1-5        41   450    11720    254.00      0.00
4103842   DEBRIDE NAIL(S); 6/>        41   450    11721    254.00      0.00
4103859   SPL AVULSE NP; SGL          41   450    11730    254.00      0.00
4103867   SPL AVULSE NP; EA ADDTL     41   450    11732    254.00      0.00
4103875   EVAC SU HEMATOMA            41   450    11740     95.00      0.00
4103883   REMOVAL OF NAIL BED         41   450    11750   1377.00      0.00
4103891   REM NAIL BED/FINGER TIP     41   450    11752   6755.00      0.00
4103909   REPAIR NAIL BED             41   450    11760    674.00      0.00
4103917   WEDGE EXC NAIL FOLD         41   450    11765    467.00      0.00
4103925   SREP S/N/A/G/TR/E 2.5<CM    41   450    12001    409.00      0.00
4103933   SRP S/N/A/G/T/E 2.6-7.5CM   41   450    12002    409.00      0.00
4103941   SR S/N/A/G/T/E 7.6-12.5CM   41   450    12004    409.00      0.00
4103958   SR S/N/A/G/T/E 12.6-20CM    41   450    12005    409.00      0.00
4103966   SR S/N/A/G/T/E 20.1-30CM    41   450    12006    409.00      0.00
4103974   SREP S/N/A/G/TR/E; > 30CM   41   450    12007    409.00      0.00
4103982   SREP F/E/N/L/MM; 2.5CM/<    41   450    12011    409.00      0.00
4103990   SREP F/E/N/L/MM; 2.6-5 CM   41   450    12013    409.00      0.00
4104006   SREP F/E/N/L/MM 5.1-7.5CM   41   450    12014    409.00      0.00
4104014   SRP F/E/N/L/MM 7.6-12.5CM   41   450    12015    409.00      0.00
4104022   SREP F/E/N/L/MM 12.6-20CM   41   450    12016    409.00      0.00
4104030   SREP F/E/N/L/MM 20.1-30CM   41   450    12017    409.00      0.00
4104048   SREP F/E/N/L/MM; > 30.0CM   41   450    12018    409.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
4104055   TX S WND DEHISC; SMPL       41   450    12020   1448.00      0.00
4104063   TX S WND DEHIS; W PACK      41   450    12021   1448.00      0.00
4104071   INT REP S/A/T/EX; 2.5<CM    41   450    12031    674.00      0.00
4104089   IN REP S/A/T/EX 2.6-7.5CM   41   450    12032    674.00      0.00
4104097   IN RP S/A/T/EX 7.6-12.5CM   41   450    12034    674.00      0.00
4104105   IN REP S/A/T/EX 12.6-20CM   41   450    12035    674.00      0.00
4104113   IN REP S/A/T/EX 20.1-30CM   41   450    12036    674.00      0.00
4104121   INT REP S/A/T/EX > 30.0CM   41   450    12037    674.00      0.00
4104139   INT REP N/H/F/G; 2.5<CM     41   450    12041    674.00      0.00
4104147   INT REP N/H/F/G 2.6-7.5CM   41   450    12042    674.00      0.00
4104154   IN REP N/H/F/G 7.6-12.5CM   41   450    12044    674.00      0.00
4104162   INT REP N/H/F/G 12.6-20CM   41   450    12045    674.00      0.00
4104170   INT REP N/H/F/G 20.1-30CM   41   450    12046    674.00      0.00
4104188   INT REP N/H/F/G; > 30.0CM   41   450    12047    674.00      0.00
4104196   IN REP F/E/N/L/MM 2.5<CM    41   450    12051    674.00      0.00
4104204   IN REP F/E/N/L/MM 2.6-5CM   41   450    12052    674.00      0.00
4104212   IN RP F/E/N/L/M 5.1-7.5CM   41   450    12053    674.00      0.00
4104220   IN R F/E/N/L/M 7.6-12.5CM   41   450    12054    674.00      0.00
4104238   IN RP F/E/N/L/M 12.6-20CM   41   450    12055    674.00      0.00
4104246   IN RP F/E/N/L/M 20.1-30CM   41   450    12056    674.00      0.00
4104253   IN RP F/E/N/L/MM > 30.0CM   41   450    12057    674.00      0.00
4104261   C REP TRUNK; 1.1-2.5CM      41   450    13100   1448.00      0.00
4104279   CREP TRUNK; 2.6-7.5CM       41   450    13101   1448.00      0.00
4104287   C REP TRUNK EA ADDL 5< CM   41   450    13102   1448.00      0.00
4104295   C REP S/A/L; 1.1-2.5CM      41   450    13120    674.00      0.00
4104303   CREP S/A/L; 2.6-7.5CM       41   450    13121   1448.00      0.00
4104311   C REP S/A/L; EA ADD 5 <CM   41   450    13122    674.00      0.00
4104329   CREP F/G/H/F; 1-2.5CM       41   450    13131   1448.00      0.00
4104337   CREP F/G/H/F; 2.6-7.5CM     41   450    13132   1448.00      0.00
4104345   C RP H/A/G/EX EA ADD 5<CM   41   450    13133   1448.00      0.00
4104352   CPLX REP E/N/E/L; 1.0<CM    41   450    13150   1448.00      0.00
4104360   CREP E/N/E/L; 1.1-2.5CM     41   450    13151   1448.00      0.00
4104378   CREP E/N/E/L; 2.6-7.5CM     41   450    13152   1448.00      0.00
4104386   C REP E/N/E/L EA ADD 5<CM   41   450    13153    674.00      0.00
4104394   INIT TX, 1ST DEGR BURN      41   450    16000    254.00      0.00
4104402   DRESS/DEBR P-THK BURN, SM   41   450    16020    467.00      0.00
4104410   DRESS/DEBR P-THK BURN MED   41   450    16025    851.00      0.00
4104428   DRESS/DEBR P-THK BURN, LG   41   450    16030    851.00      0.00
4104436   ESCHAROTOMY; INIT INC       41   450    16035    851.00      0.00
4104444   ESCHAROTOMY; ADD INCISION   41   360    16036    333.00      0.00
4104451   PUNCT ASP BRST CYST-INITL   41   450    19000   1385.00      0.00
4104469   INC ST ABSC; SUPERF         41   450    20000    450.00      0.00
4104477   INC ST ABSC; DEEP           41   450    20005   6806.00      0.00
4104485   EXPL P WND; NECK            41   450    20100   3083.00      0.00
4104493   EXPL P WND; CHEST           41   450    20101   6466.00      0.00
4104501   EXPL P WND; ABD/FLANK       41   450    20102   6466.00      0.00
4104519   EXPL P WND; EXTREM          41   450    20103   3083.00      0.00
4104527   REM FB MUSCLE; SMPL         41   450    20520   1377.00      0.00
4104535   REM FB MUSCLE; DEEP         41   450    20525   6755.00      0.00
4104543   INJ SGL TNDN SHTH OR LIGA   41   450    20550    743.00      0.00
4104550   INJ TENDON ORIGIN/INSERT    41   450    20551    743.00      0.00
4104568   TPI(S) - 1/2 MUSCLE(S)      41   450    20552    743.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
4104576   TPI(S) - 3/> MUSCLE(S)      41   450    20553    743.00      0.00
4104584   DRAIN/INJECT SM JNT/BURSA   41   450    20600    743.00      0.00
4104592   DRAIN/INJ INTRM JNT/BURSA   41   450    20605    743.00      0.00
4104600   DRAIN/INJ MAJOR JNT/BURSA   41   450    20610    743.00      0.00
4104618   CL TX NSL BNE FX WO MANIP   41   450    21310    800.00      0.00
4104626   CL TX NSL BNE FX WO STBLZ   41   450    21315    800.00      0.00
4104634   CL TX NSL BNE FX W/ STBLZ   41   450    21320   5225.00      0.00
4104642   CL TX ORB FX NBO WO MANIP   41   450    21400   2383.00      0.00
4104659   CL TX MNDBLR FX; WO MANIP   41   450    21450    800.00      0.00
4104667   CL TX TMJ DISLCTION INITL   41   450    21480    800.00      0.00
4104675   CL TX RIB FX, UNCOMPL, EA   41   450    21800    566.00      0.00
4104683   CL TX STERNUM FX            41   450    21820    566.00      0.00
4104691   CL TX VRTBRL PROCES FX(S)   41   450    22305    566.00      0.00
4104709   I & D SHLDR; DEEP ABSC      41   450    23030   5862.00      0.00
4104717   REM FB SHOULDER; SQ         41   450    23330   2779.00      0.00
4104725   CL TX CLVCLR FX; WO MANIP   41   450    23500    566.00      0.00
4104733   CL TX CLVCLR FX; W/ MANIP   41   450    23505    566.00      0.00
4104741   CL TX SCLAV DISLOC WO MAN   41   450    23520    566.00      0.00
4104758   CL TX SCLAV DISLOC W MAN    41   450    23525    566.00      0.00
4104766   CL TX ACLAV DISLOC WO MAN   41   450    23540    566.00      0.00
4104774   CL TX ACLAV DISLOC W MAN    41   450    23545    566.00      0.00
4104782   CL TX SCAPULR FX WO MANIP   41   450    23570    566.00      0.00
4104790   CL TX SCAPULAR FX W MANIP   41   450    23575    566.00      0.00
4104808   CL TX PRX HUMRL FX WO MAN   41   450    23600    566.00      0.00
4104816   CL TX PRX HUMRL FX W MAN    41   450    23605    566.00      0.00
4104824   CL TX GR TBRSTY FX WO MAN   41   450    23620    566.00      0.00
4104832   CL TX GR TBRSTY FX W/ MAN   41   450    23625    566.00      0.00
4104840   CL TX SHLDR W/MAN WO ANES   41   450    23650    566.00      0.00
4104857   CL TX SHLDR & FX GT W MAN   41   450    23665    566.00      0.00
4104865   DEEP I&D - UA/ELBOW         41   450    23930   5862.00      0.00
4104873   INF BURSA I&D - UA/ELBOW    41   450    23931   5862.00      0.00
4104881   REM FB UP ARM/ELBOW; SQ     41   450    24200   1377.00      0.00
4104899   REM FB DEEP U/ARM/ELBOW     41   450    24201   5152.00      0.00
4104907   CL TX HUMERUS FX WO MANIP   41   450    24500    566.00      0.00
4104915   CL TX HUMERUS FX W MANIP    41   450    24505    566.00      0.00
4104923   CL TX SC/T HMRS FX WO MAN   41   450    24530    566.00      0.00
4104931   CL TX SC/TX HMRS FX W MAN   41   450    24535    566.00      0.00
4104949   CL TX EC HUMRUS FX WO MAN   41   450    24560    566.00      0.00
4104956   CL TX EC HUMERUS FX W MAN   41   450    24565    566.00      0.00
4104964   CL TX C HUMERUS FX WO MAN   41   450    24576    566.00      0.00
4104972   CL TX C HUMERUS FX W MAN    41   450    24577    566.00      0.00
4104980   RX CL ELBOW DISL WO ANES    41   450    24600    566.00      0.00
4104998   CL TX MONTEG ELB FX W MAN   41   450    24620    566.00      0.00
4105003   CL TX NURSMAID ELBW W MAN   41   450    24640    566.00      0.00
4105011   CL TX RDL HD/NK FX WO MAN   41   450    24650    566.00      0.00
4105029   CL TX RDL HD/NK FX W MAN    41   450    24655    566.00      0.00
4105037   TREAT ULNAR FRACTURE        41   450    24670    566.00      0.00
4105045   TREAT ULNAR FRACTURE        41   450    24675    566.00      0.00
4105052   REP TENDN/MSCL FARM WRIST   41   450    25260   9341.00      0.00
4105060   REP T/M EXTNSR FA/W 1 EA    41   450    25270   9341.00      0.00
4105078   CL TX RDAL SHFT FX WO MAN   41   450    25500    566.00      0.00
4105086   CL TX RDAL SHFT FX W MAN    41   450    25505    566.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
4105094   CL TX ULNR SHFT FX WO MAN   41   450    25530    566.00      0.00
4105102   CL TX ULNR SHFT FX W MAN    41   450    25535    566.00      0.00
4105110   CL TX RDL/ULNR FX WO MAN    41   450    25560    566.00      0.00
4105128   CL TX RDL/ULNR FX W MAN     41   450    25565    566.00      0.00
4105136   TX FRACTURE RADIUS/ULNA     41   450    25600    566.00      0.00
4105144   TX FRACTURE RADIUS/ULNA     41   450    25605    566.00      0.00
4105151   CL TX CRPL SCPH FX WO MAN   41   450    25622    566.00      0.00
4105169   CL TX CRPL SCPH FX W MAN    41   450    25624    566.00      0.00
4105177   CL TX CARP B FX WO MANIP    41   450    25630    566.00      0.00
4105185   CL TX CRPL BN FX W MAN EA   41   450    25635    566.00      0.00
4105193   CL TX OF ULNAR STYLOID FX   41   450    25650    566.00      0.00
4105201   CL TX CRPL DISLOC W MANIP   41   450    25660    566.00      0.00
4105219   CL TX TR-SC FX DISL W MAN   41   450    25680    566.00      0.00
4105227   DRAIN FINGER ABSC; SIMPLE   41   450    26010    450.00      0.00
4105235   DRAIN FINGER ABSC; CMPLX    41   450    26011   3699.00      0.00
4105243   REP FING/HND TENDON, EA     41   450    26350   8419.00      0.00
4105250   FLEX TENDON REP ZONE 2 EA   41   450    26356   8419.00      0.00
4105268   REP ET HAND WO FG EA TNDN   41   450    26410   5268.00      0.00
4105276   EXTENSOR TENDON REPAIR EA   41   450    26418   5268.00      0.00
4105284   CL TX M FX S WO MAN EA BN   41   450    26600    566.00      0.00
4105292   CL TX MC FX, SGL; W MANIP   41   450    26605    566.00      0.00
4105300   CL TX CMC DISL THMB W MAN   41   450    26641    566.00      0.00
4105318   CL TX FX DISL THMB W MAN    41   450    26645    566.00      0.00
4105326   CL TX CMC DISL W M, EA      41   450    26670    566.00      0.00
4105334   CL TX MCP DISL SGL W MAN    41   450    26700    566.00      0.00
4105342   CL TX PHAL SHFT FX WO MAN   41   450    26720    566.00      0.00
4105359   CL TX PHAL SHFT FX W MAN    41   450    26725    566.00      0.00
4105367   CL TX ART FX M JNT WO MAN   41   450    26740    566.00      0.00
4105375   CL TX ART FX M JNT W MAN    41   450    26742    566.00      0.00
4105383   CL TX D PH FX F/TH WO MAN   41   450    26750    566.00      0.00
4105391   CL TX D PH FX F/TH W MAN    41   450    26755    566.00      0.00
4105409   CL TX IP D W MAN WO ANES    41   450    26770    566.00      0.00
4105417   REM FB, PELVIS OR HIP; SQ   41   450    27086   2779.00      0.00
4105425   REM FB PELVIS OR HIP DEEP   41   450    27087   6806.00      0.00
4105433   CL TX PELV RNG FX WO MAN    41   450    27193    566.00      0.00
4105441   CL TX COCCYGEAL FX          41   450    27200    566.00      0.00
4105458   CL TX ACETABL X(S) WO MAN   41   450    27220    566.00      0.00
4105466   CL TX PROX FEM FX WO MAN    41   450    27230    566.00      0.00
4105474   CL TX FMRL FX P NCK W MAN   41   450    27232   1803.00      0.00
4105482   TX THIGH FRACTURE WO MAN    41   450    27238    566.00      0.00
4105490   TX THIGH FRACTURE W MAN     41   450    27240   1803.00      0.00
4105508   CL TX GT TRCNTR FX WO MAN   41   450    27246    566.00      0.00
4105516   C TX TRMA HIP DISL WO ANE   41   450    27250    566.00      0.00
4105524   TX SP HIP DISL WO MAN/ANE   41   450    27256    566.00      0.00
4105532   CL TX POST HIP DISL WO AN   41   450    27265    566.00      0.00
4105540   CLTX THIGH FX               41   450    27267    566.00      0.00
4105557   CLTX THIGH FX W/MNPJ        41   360    27268   2098.00      0.00
4105565   DEEP I&D, THIGH/KNEE        41   450    27301   5862.00      0.00
4105573   REM FB DEEP THIGH OR KNEE   41   450    27372   6755.00      0.00
4105581   CL TX FMRL SHFT FX WO MAN   41   450    27500    566.00      0.00
4105599   CL TX FMRL SHFT FX W MAN    41   450    27502    566.00      0.00
4105607   CL TX D FEM FX WO MANIP     41   450    27508    566.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
4105615   CL TX FMUR FX/EPIPHYS SEP   41   450    27510    566.00      0.00
4105623   CL TX PATELLAR FX, WO MAN   41   450    27520    566.00      0.00
4105631   CL TX PRX TBIAL FX WO MAN   41   450    27530    566.00      0.00
4105649   CL TX KNEE DISL; WO ANES    41   450    27550    566.00      0.00
4105656   CL TX PATELR DISL WO ANES   41   450    27560    566.00      0.00
4105664   I&D LG/ANK DEEP ABSC/HEMA   41   450    27603   5862.00      0.00
4105672   I&D LEG/ANKL INFCTD BURSA   41   450    27604   6806.00      0.00
4105680   CL TX TIB SHFT FX WO MAN    41   450    27750    566.00      0.00
4105698   CL TX TIB SHFT FX W MAN     41   450    27752    566.00      0.00
4105706   CLTX MEDIAL ANKLE FX        41   450    27760    566.00      0.00
4105714   CL TX MED/ANKL FX W MAN     41   450    27762    566.00      0.00
4105722   CL TX POST ANKLE FX         41   450    27767    566.00      0.00
4105730   CL TX POS/ANKL FX W MAN     41   450    27768    566.00      0.00
4105748   CL TX PRX FB/SFT FX WO MN   41   450    27780    566.00      0.00
4105755   CL TX PRX FB/SFT FX W MAN   41   450    27781    566.00      0.00
4105763   CL TX DISTL FIB FX WO MAN   41   450    27786    566.00      0.00
4105771   CL TX DISTL FIB FX W MAN    41   450    27788    566.00      0.00
4105789   TX OF ANKLE FX WO MAN       41   450    27808    566.00      0.00
4105797   TX OF ANKLE FX W MAN        41   450    27810    566.00      0.00
4105805   CL TX TRML ANKL FX WO MAN   41   450    27816    566.00      0.00
4105813   CL TX TRML ANKL FX W MAN    41   450    27818    566.00      0.00
4105821   CL TX ANK DISLOCT WO ANES   41   450    27840    566.00      0.00
4105839   REM FB, FOOT; SQ            41   450    28190   1377.00      0.00
4105847   REM FB; FOOT DEEP           41   450    28192   5152.00      0.00
4105854   REM FB; FOOT DEEP COMPLEX   41   450    28193   2779.00      0.00
4105862   REPR FOOT FLEX TENDON, EA   41   450    28200   6665.00      0.00
4105870   REPR FOOT EXTNSR TNDN, EA   41   450    28208   6665.00      0.00
4105888   CL TX CALCANEAL FX WO MAN   41   450    28400    566.00      0.00
4105896   CL TX CALCANEAL FX W MAN    41   450    28405    566.00      0.00
4105904   CL TX TALUS FX; WO MANIP    41   450    28430    566.00      0.00
4105912   CL TX TALUS FX; W MANIP     41   450    28435    566.00      0.00
4105920   TX TARSAL BONE FX WO MAN    41   450    28450    566.00      0.00
4105938   TX TARSAL BONE FX W MAN     41   450    28455    566.00      0.00
4105946   CL TX METATARSL FX WO MAN   41   450    28470    566.00      0.00
4105953   CL TX METATARSL FX W MAN    41   450    28475    566.00      0.00
4105961   CL TX FX GT PHALXS WO MAN   41   450    28490    566.00      0.00
4105979   CL TX FX GT PHALXS W MAN    41   450    28495    566.00      0.00
4105987   CL TX FX PHLX/PHLG WO MAN   41   450    28510    566.00      0.00
4105995   CL TX FX PHLX/PHLG W MAN    41   450    28515    566.00      0.00
4106001   CL TX TRSL BN DIS WO ANES   41   450    28540    566.00      0.00
4106019   C TX TLTRSL JNT DIS WO AN   41   450    28570    566.00      0.00
4106027   CL TX TMT JNT DIS WO ANES   41   450    28600    566.00      0.00
4106035   CL TX MTP JNT DIS WO ANES   41   450    28630    566.00      0.00
4106043   CL TX IP JNT DISL WO ANES   41   450    28660    566.00      0.00
4106050   APPLY SHOULDER SPICA        41   450    29055    657.00      0.00
4106068   APPLY PLASTER VELPEAU       41   450    29058    350.00      0.00
4106076   APPLY LONG ARM CAST         41   450    29065    657.00      0.00
4106084   APPLY SHORT ARM CAST        41   450    29075    657.00      0.00
4106092   APPLY GAUNTLET CAST         41   450    29085    350.00      0.00
4106100   APPLY LONG ARM SPLINT       41   450    29105    350.00      0.00
4106118   APP SHRT ARM SPLNT STATIC   41   450    29125    350.00      0.00
4106126   APP SHRT ARM SPLNT DYNAM    41   450    29126    350.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
4106134   APPLY FINGER SPLNT STATIC   41   450    29130    350.00      0.00
4106142   APPLY FINGER SPLNT DYNAM    41   450    29131    350.00      0.00
4106159   STRAPPING; THORAX           41   450    29200    350.00      0.00
4106167   STRAPPING; LOW BACK         41   450    29220    350.00      0.00
4106175   STRAPPING; SHOULDER         41   450    29240    350.00      0.00
4106183   STRAPPING; ELBOW OR WRIST   41   450    29260    350.00      0.00
4106191   STRAPPING; HAND OR FINGER   41   450    29280    350.00      0.00
4106209   APPLY LONG LEG CAST         41   450    29345    657.00      0.00
4106217   APPLY SHRT LEG CAST         41   450    29405    657.00      0.00
4106225   APPLY WLKR SHORT LEG CAST   41   450    29425    657.00      0.00
4106233   APP PATELR TNDN BRNG CAST   41   450    29435    657.00      0.00
4106241   ADD WALKER TO OLD CAST      41   450    29440    350.00      0.00
4106258   APP CLBFT CST LNG/SHT LEG   41   450    29450    350.00      0.00
4106266   APPLY LONG LEG SPLINT       41   450    29505    350.00      0.00
4106274   APPLY SHORT LEG SPLINT      41   450    29515    350.00      0.00
4106282   HIP STRAPPING               41   450    29520    350.00      0.00
4106290   KNEE STRAPPING              41   450    29530    350.00      0.00
4106308   STRAP ANKLE OR FOOT         41   450    29540    350.00      0.00
4106316   STRAPPING OF TOES           41   450    29550    350.00      0.00
4106324   UNNA BOOT STRAPPING         41   450    29580    350.00      0.00
4106332   DENIS-BROWNE SPLINT STRAP   41   450    29590    350.00      0.00
4106340   REM GAUNTLET BT/BODY CAST   41   450    29700    350.00      0.00
4106357   REMOVE FULL ARM/LEG CAST    41   450    29705    350.00      0.00
4106365   REM SHOULDER OR HIP SPICA   41   450    29710    657.00      0.00
4106373   WINDOWING OF CAST           41   450    29730    350.00      0.00
4106381   WEDGING OF CAST-NOT CLBFT   41   450    29740    350.00      0.00
4106399   UNL PROC CAST/STRAPPING     41   450    29799    350.00      0.00
4106407   CNTRL POST EPISTAX, INIT    41   450    30905    360.00      0.00
4106415   CTRL POST EPISTAX, SQ       41   450    30906    360.00      0.00
4106423   TRCH TUBE CHG B4 FIS TRCT   41   450    31502    428.00      0.00
4106431   LARYNGOSCOPY, IND; DIAG     41   450    31505    263.00      0.00
4106449   LRYNGSCPY IND W REM OF FB   41   450    31511    516.00      0.00
4106456   LARYNGOSCOPY, FLEX; DIAG    41   450    31575    516.00      0.00
4106464   LARYNGOSCPY FLEX W REM FB   41   450    31577   1278.00      0.00
4106472   THORACTMY MAJ W CARD MASG   41   450    32160   2515.00      0.00
4106480   THORACENTESIS FOR ASPIRAT   41   450    32421   1665.00      0.00
4106498   THORACNTESIS W/TUBE INSRT   41   450    32422   1665.00      0.00
4106506   INSERTION OF CHEST TUBE     41   450    32551   1665.00      0.00
4106514   PERICARDIOCENTESIS; INITL   41   450    33010   1665.00      0.00
4106522   PERICARDIOCENTESIS; SUBSQ   41   450    33011   1665.00      0.00
4106530   BL DRAW < 3 YRS FEM/JUGLR   41   450    36400     75.00      0.00
4106548   BL DRAW < 3 YRS SCLP VEIN   41   450    36405     80.00      0.00
4106555   BL DRAW < 3 YRS OTHR VEIN   41   450    36406    106.00      0.00
4106563   VENIPUNCTURE AGE 3 >YRS     41   450    36410     49.00      0.00
4106571   ROUTINE VENIPUNCTURE        41   450    36415     14.00      0.00
4106589   VEIN ACCESS CUTDWN < 1 YR   41   450    36420     69.00      0.00
4106597   VENIPUNCTURE CUTDWN 1>YRS   41   450    36425     69.00      0.00
4106605   BLOOD PUSH TRANSF < 2 YRS   41   450    36440   1087.00      0.00
4106613   INS N-TNLD CV CTH <5 YRS    41   450    36555   3491.00      0.00
4106621   INS N-TNLD CV CTH AGE 5/>   41   450    36556   3491.00      0.00
4106639   DRAW BLOOD OFF VAD          41   450    36591    182.00      0.00
4106647   COLLECT BLOOD FROM PICC     41   450    36592    122.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
4106654   DECLOT VASCULAR DEVICE      41   450    36593     794.00      0.00
4106662   ART PUNCTURE BLOOD FOR DX   41   450    36600      69.00      0.00
4106670   ARTERIAL CATH/CANN PERCUT   41   450    36620     189.00      0.00
4106688   UMBIL CATH, NB FOR DX/TX    41   360    36660     142.00      0.00
4106696   THRMBLYSIS CEREB / IV INF   41   450    37195     794.00      0.00
4106704   REP LIP FT VERMILION ONLY   41   450    40650    2383.00      0.00
4106712   REP LIP FT 1/2 < VERT HGT   41   450    40652    2383.00      0.00
4106720   RP LIP FT >1/2 VT HT CPLX   41   450    40654    2383.00      0.00
4106738   DR ABS CYST HEMA-MTH SMPL   41   450    40800     450.00      0.00
4106746   DR ABS CYST HEMA-MTH CPLX   41   450    40801    2383.00      0.00
4106753   REM FB EMBED MTH/VST SMPL   41   450    40804     202.00      0.00
4106761   REM FB EMBED MTH/VST CPLX   41   450    40805    2383.00      0.00
4106779   CL LAC MOUTH VESTI 2.5<CM   41   450    40830     800.00      0.00
4106787   CL LAC MOUTH VESTI >2.5CM   41   450    40831    2383.00      0.00
4106795   I&D ABSC/CYS TNG FOM LING   41   450    41000    5225.00      0.00
4106803   I&D ABSC/CYS TNG FOM SUPR   41   450    41005     800.00      0.00
4106811   RP LAC FOM-2/3 ANT 2.5<CM   41   450    41250     800.00      0.00
4106829   RP LAC PST 1/3 TNG 2.5<CM   41   450    41251     800.00      0.00
4106837   RP LAC T/FOM > 2.6CM CPLX   41   450    41252    2383.00      0.00
4106845   DR ABS CYS HEMA DNTLVOLAR   41   450    41800     450.00      0.00
4106852   DR ABS PALATE, UVULA        41   450    42000     800.00      0.00
4106860   REP PALATE LAC UP TO 2 CM   41   450    42180     800.00      0.00
4106878   REP PALATE LAC OVER 2 CM    41   450    42182   12761.00      0.00
4106886   DR ABSCESS; PAROTID, SMPL   41   450    42300    5225.00      0.00
4106894   DR ABSCESS; PAROTID, CPLX   41   450    42305    5225.00      0.00
4106902   DR ABSCES SUBMAX EXTERNAL   41   450    42310     800.00      0.00
4106910   I&D ABSCES PERITONSILLAR    41   450    42700     800.00      0.00
4106928   REM FB, PHARYNX             41   450    42809     202.00      0.00
4106936   CTRL OROPHAR HEMORRH SMPL   41   450    42960     360.00      0.00
4106944   ESOPHGOGASTRIC TAMP W/BAL   41   360    43460     414.00      0.00
4106951   REPOSTION GASTROSTMY TUBE   41   450    43761    2721.00      0.00
4106969   I&D PERIRECTAL/ISCHAL ABS   41   450    46040    7279.00      0.00
4106977   I&D; PERIANAL ABSCESS       41   450    46050    3492.00      0.00
4106985   INCS THROMB HEMORID, EXT    41   450    46083     642.00      0.00
4106993   BANDING OF HEMORRHOIDS      41   450    46221    1534.00      0.00
4107009   EXCISE EXT THROMB HEMORID   41   450    46320    7279.00      0.00
4107017   ANOSCOPY; DX                41   450    46600     202.00      0.00
4107025   ANOSCOPY; W REM FB          41   450    46608    2785.00      0.00
4107033   PERITONEOCENTESIS INITIAL   41   450    49080    1665.00      0.00
4107041   PERITONEOCENTESIS; SUBSEQ   41   450    49081    1665.00      0.00
4107058   DRAIN BLADDER BY NEEDLE     41   450    51100     642.00      0.00
4107066   DR BLADDER BY TROCAR/CATH   41   450    51101     331.00      0.00
4107074   DRAIN BL W/CATH INSERTION   41   450    51102    6189.00      0.00
4107082   INS BLADDER CATH, COMPLEX   41   450    51703     331.00      0.00
4107090   CHNG CYSTOSTOMY TUBE SMPL   41   450    51705     642.00      0.00
4107108   IRIG CORPORA CAVE PRIAPSM   41   450    54220     642.00      0.00
4107116   I&D EPIDYMS SCROTAL SPACE   41   450    54700    7144.00      0.00
4107124   DR SCROTAL WALL ABSCESS     41   450    55100    3699.00      0.00
4107132   REM FB IN SCROTUM           41   450    55120    7144.00      0.00
4107140   I&D VULVA/PERINEAL ABSCES   41   450    56405     883.00      0.00
4107157   I&D BARTHOLIN'S GLAND ABS   41   450    56420     433.00      0.00
4107165   COLPOCENTESIS               41   450    57020    1945.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
4107173   FIT OR INSERT PESSARY       41   450    57160    433.00      0.00
4107181   INS PACK NON-OB VAG HEMOR   41   450    57180    433.00      0.00
4107199   COLPORRHAPHY                41   450    57200   6087.00      0.00
4107207   D&C DIAG OR THERAP NOT OB   41   450    58120   6087.00      0.00
4107215   REMOVE IUD                  41   450    58301    433.00      0.00
4107223   CURETTAGE, POSTPARTUM       41   450    59160   6087.00      0.00
4107231   DELIVERY OF PLACENTA        41   450    59414   6087.00      0.00
4107249   CESAREAN DELIVERY ONLY      41   450    59514   2451.00      0.00
4107256   INJ ANES TRIGEMINAL NERVE   41   450    64400    743.00      0.00
4107264   INJ ANES OTH PERI NRV/BR    41   450    64450   1311.00      0.00
4107272   REM FB CONJUNCTIVA SPRFCL   41   450    65205    278.00      0.00
4107280   REM FB CONJUNCTIVA EMBED    41   450    65210    278.00      0.00
4107298   REM FB CRNL WO SLIT LAMP    41   450    65220    278.00      0.00
4107306   REM FB CRNL W SLIT LAMP     41   450    65222    278.00      0.00
4107314   I&D EYELID ABSCESS          41   450    67700    929.00      0.00
4107322   REM FB EYELID EMBEDDED      41   450    67938    697.00      0.00
4107330   DR ABS/HEMA EXT EAR SMPL    41   450    69000    450.00      0.00
4107348   US EXAM, CHEST              41   402    76604    306.00      0.00
4107355   US EXAM, ABDOM, COMPLETE    41   402    76700    483.00      0.00
4107363   US EXAM OF ABDOM LIMITED    41   402    76705    483.00      0.00
4107371   US EXAM ABDO BK WALL COMP   41   402    76770    483.00      0.00
4107389   OB US < 14 WKS SNGL FETUS   41   402    76801    483.00      0.00
4107397   OB US < 14 WKS ADDL FETUS   41   402    76802    306.00      0.00
4107405   OB US, LIMITED STUDY        41   402    76815    306.00      0.00
4107413   TRANSVAGINAL OB US          41   402    76817    306.00      0.00
4107421   NON-OB TRANSVAG US          41   402    76830    483.00      0.00
4107439   US EXAM, PELVIC, LIMITED    41   402    76857    306.00      0.00
4107447   US EXAM, EXTREMITY          41   402    76880    483.00      0.00
4107454   POC-OCCULT BLD OTHR SRCES   41   301    82271     34.00      0.00
4107462   POC-OCLT BLD FCS 1-3 TSTS   41   301    82272     34.00      0.00
4107470   IMMUN ADM EA ADDL VACCINE   41   450    90472     81.00      0.00
4107488   TX/PROPH/DG AD SEQ IV INF   41   450    90767    126.00      0.00
4107496   THER/DIAG CONCURRENT INF    41   450    90768     89.00      0.00
4107504   CARDIOVERSION ELEC INTRNL   41   730    92961   1744.00      0.00
4107512   12 LEAD EKG; TRACING ONLY   41   730    93005    125.00      0.00
4107520   1-3 LEAD EKG TRACING ONLY   41   730    93041    125.00      0.00
4107538   BRONCHOSPASM PRE/POST BD    41   460    94060    296.00      0.00
4107546   AIRWAY INHALATON TREATMNT   41   412    94640    124.00      0.00
4107553   PULSE OX, MULTIPLE          41   460    94761    153.00      0.00
4107561   ANAL COLPSPY CHILD SUSPCT   41   450    99170     42.00      0.00
4107579   CRITICAL CARE EA ADD 30MN   41   450    99292    265.00      0.00
4107587   SMOKING CESS 3-10 MIN       41   942    99406     53.00      0.00
4107595   SMOKING CESS > 10 MIN       41   942    99407     53.00      0.00
4107603   AUDIT/DAST, 15-30 MIN       41   450    99408     75.00      0.00
4107611   DR ABS/HEMA EXT EAR CPLX    41   450    69005   5862.00      0.00
4110060   PULSE OXIMETER              41   460    94760    152.80      0.00
4300315   RECOVERY 30 MINUTES         43   710             307.00      0.00
4300323   MISC ENDO/SPA PROCEDURE     43   750    91299    675.00      0.00
4300380   ENDO TRNSTNL CARE-TR <6HR   43   750               0.00      0.00
4300398   THER/PROPH/DIAG INJ SC/IM   43   940    90772    267.00      0.00
4300406   RECOVERY < 6HRS LV 1        43   710             965.00      0.00
4300414   RECOVERY > 6HRS LV 2        43   710            1931.00      0.00
                                            REV     CPT     UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE     PRICE      PRICE
4300422   GI SERVICE MINIMAL          43   750                783.00      0.00
4300430   ENDOSCOPIC SURGERY ASSIST   43   360                783.00      0.00
4300448   ENDOSCOPIC TEE ASSIST       43   483                783.00      0.00
4300455   ENDO TRNSTNL CARE-TR >6HR   43   750                  0.00      0.00
4301008   GI SERVICE 60 MIN           43   750               3131.00      0.00
4301107   BRONCHOSCOPY SRV 60 MIN     43   361               3131.00      0.00
4301123   GI PROC EACH ADD'L 30 MIN   43   750               1565.00      0.00
4301321   BLOOD ADMINISTRATION        43   391    36430      1485.00      0.00
4301990   DSCHRG LOUNGE 30MIN STATS   43   260                  0.00      0.00
4302204   POC-CLO TEST                43   306    87077        96.00      0.00
4302303   SPINAL PUNCTURE LUMBAR DX   43   361    62270       852.00      0.00
4302345   THER/PRO/DIAG IV INF INIT   43   260    90765       267.00      0.00
4302360   THER/PRO/DG IV INF ADD-ON   43   260    90766       249.00      0.00
4302386   PHERESIS/DIALYSIS TRACKIN   43   750                  0.00      0.00
4500054   ROUTINE VENIPUNCTURE        45   300    36415        43.00      0.00
4500062   SPECIMEN BANK               45   300    36415        43.00      0.00
4500070   C: NBN SCREEN SERVICE       45   300    36416         6.00      0.00
4600037   BI CER INT CRTIDS ANG INI   46   323    75671      7303.00      0.00
4600052   ABDOMINAL AORTOGRAM INIT    46   323    75625      8139.00      0.00
4600078   ANGI SEL VISCERL VES INIT   46   323    75726      9601.00      0.00
4600094   AB AORTGRM W BI RUNOF INI   46   323    75630      9133.00      0.00
4600136   VENOGRAM EXTRMTY UNILATRL   46   320    75820      4646.00      0.00
4600144   VENOGRAM EXTRMTY BILATRL    46   320    75822      4592.00      0.00
4600185   VENOGRAM SVC-SRLGRHY INIT   46   320    75827      7413.00      0.00
4600193   VENOGM SVC-SRLGRHY EA ADD   46   320    7582776    7413.00      0.00
4600201   UNIL SEL RENAL VENOGRM      46   320    75831      4917.00      0.00
4600219   IV US CORONARY VES INIT     46   480    92978      3996.00      0.00
4600250   TC RETRIEVAL OF IV FB       46   320    75961      7477.00      0.00
4600276   PERC PLCMNT IVC FILTER      46   320    75940      4648.00      0.00
4600300   VENOGRAM IVC-SRLGRHY INIT   46   320    75825      7413.00      0.00
4600318   VENOGM IVC-SRLGRHY EA ADD   46   320    7582576    7413.00      0.00
4600326   INS URETERL CATH/STENT      46   320    74480      3796.00      0.00
4600342   S&I INJ PLM/BPG/CORO ANGI   46   481    93556      3707.00      0.00
4600359   S&I-INJ VT OR AT ANGIOGR    46   481    93555      3129.00      0.00
4600367   INJ - CORONARY ANGIOGRAM    46   481    93545      2850.00      0.00
4600375   INJ SEL LV/LA ANGI W CATH   46   481    93543      2850.00      0.00
4600383   INJ FOR AORTOGRAM W CATH    46   481    93544      2848.00      0.00
4600391   INJ VENOUS BPG PATENCY      46   481    93540      2850.00      0.00
4600409   THOR AORTOGRM W SRIAL INI   46   323    75605      8389.00      0.00
4600433   INS PACEMKR FLUORO & XRAY   46   320    71090      1663.00      0.00
4600441   CORONARY PTCBA CIRC         46   480    92982LC   16050.00      0.00
4600474   LHC RETRO PERCUTANEOUS      46   481    93510     10126.00      0.00
4600482   RIGHT HEART CATH            46   481    93501     10126.00      0.00
4600490   COMB RHC & RETROGR LHC      46   481    93526     11525.00      0.00
4600565   IABP INSERTION              46   481    33967      5885.00      0.00
4600573   CORONARY STENT RCA          46   480    92980RC   16671.00      0.00
4600581   CORON STENT ADD VES RCA     46   480    92981RC    9014.00      0.00
4600615   DILATE FOR STRICTURE/OBST   46   320    74360     12124.00      0.00
4600623   THRMBCTMY AVF DIAL GRAFT    46   323    36831      4438.00      0.00
4600664   PTCA SINGLE VESSEL RCA      46   480    92995RC   17902.00      0.00
4600730   CYST/INS INDWL URTR STENT   46   323    52332      6679.00      0.00
4600748   CARDIOVERSION               46   480    92960      1182.00      0.00
                                            REV     CPT     UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE     PRICE      PRICE
4600755   AORTIC ARCH ANGIOGRAM       46   323    75650      5843.00      0.00
4600763   BIL CERV-COMM CARTID ANGI   46   323    75680      5843.00      0.00
4600771   VERT/CERV/INTRACRAN ANGIO   46   323    75685      5843.00      0.00
4600789   ANGI SEL EA ADD VSCRL VES   46   323    75774      2489.00      0.00
4600797   EXTRMTY ART BIL ANGI INIT   46   323    75716      5843.00      0.00
4600862   EXTRM ART BIL ANGI EA ADD   46   323    7571676    5843.00      0.00
4600870   US GUIDE VASCULAR ACCESS    46   402    76937        93.00      0.00
4600888   PLCMNT DRUG ELUT STNT SGL   46   481    G0290     16671.00      0.00
4600896   PLC DRUG EL STNT-E AD VES   46   481    G0291     10260.00      0.00
4600904   AB AORTGRM-BI RUNOF EA AD   46   323    7563076    9133.00      0.00
4600912   BI CER INT CTID ANG EA AD   46   323    7567176    7303.00      0.00
4600920   PULM UNIL SEL ANG EA ADD    46   323    7574176    6926.00      0.00
4600938   REM TNLD CVAD W PORT/PUMP   46   323    36590      3351.00      0.00
4600946   INS N-TNLD CV CTH AGE 5/>   46   323    36556      3351.00      0.00
4600953   INS TNLD CVAD W PORT RT     46   323    36561RT    9379.00      0.00
4600961   INS TNLD CVAD W PORT LT     46   323    36561LT    9379.00      0.00
4600979   INTUBATION ENDOTRACH EMER   46   323    31500       703.00      0.00
4600987   DECORTICATION PLM PARTIAL   46   323    32225      4801.00      0.00
4600995   INS/REPO LDS SC W INS PG    46   481    33249     10800.00      0.00
4601001   CORONARY PTCBA LAD          46   480    92982LD   16050.00      0.00
4601019   CORONARY PTCBA RCA          46   480    92982RC   16050.00      0.00
4601027   CORONARY STENT LAD          46   480    92980LD   16671.00      0.00
4601035   CORONARY STENT CIRC         46   480    92980LC   16671.00      0.00
4601043   CORON STENT ADD VES CIRC    46   480    92981LC    9014.00      0.00
4601050   CORON STENT ADD VES LAD     46   480    92981LD    9014.00      0.00
4601068   PTCA SINGLE VESSEL CIRC     46   480    92995LC   17902.00      0.00
4601076   PTCA SINGLE VESSEL LAD      46   480    92995LD   17902.00      0.00
4601084   PTA BRACHCEPHLC ARTERIES    46   323    35475      6047.00      0.00
4601092   THRMBCTY ART/VEN GRFT-W R   46   323    35876      5224.00      0.00
4601100   SEL CATH PL ART ADD THR/B   46   323    36218      1895.00      0.00
4601118   REVISE AV FISTULA - GRAFT   46   323    36832      5224.00      0.00
4601126   OPEN REV AVF W THROMBECT    46   323    36833      5224.00      0.00
4601134   PERC NON CRNRY STENT INIT   46   323    37205      9491.00      0.00
4601142   PERC NON CNRY STENT EA AD   46   323    37206      9491.00      0.00
4601159   INS/REPO LDS DC W INS PG    46   481    33249     10800.00      0.00
4601167   CABG VEIN ONLY-3 COR VEIN   46   481    33512     10988.00      0.00
4601175   CABG VEN/ART GRFTS-2 VEN    46   481    33518      1447.00      0.00
4601183   CABG/VLV >1 MTH AFT INIT    46   481    33530      1741.00      0.00
4601191   CABG ART'L GRFT(S) 1 ART    46   481    33533     10337.00      0.00
4601209   UNLISTED CARDIAC SURGERY    46   481    33999      1150.00      0.00
4601217   BYPS GRFT W VEIN FEM-POP    46   323    35556      7043.00      0.00
4601225   TRANSFUS BLOOD-BLOOD COMP   46   391    36430       594.00      0.00
4601233   ARTERIAL PUNCT BLOOD - DX   46   323    36600       196.00      0.00
4601241   CREATE AVF N-AUTOGEN GRFT   46   323    36830      3831.00      0.00
4601258   CHNG IV CATH AT THROMB TX   46   323    37209      3780.00      0.00
4601266   IVC FILTER PLACEMENT        46   323    37620      3530.00      0.00
4601274   INJ ART CONDUIT PATENCY     46   481    93539       118.00      0.00
4601282   PTCBA EA ADD VESSEL CIRC    46   480    92984LC    9014.00      0.00
4601290   PTCBA EA ADD VESSEL LAD     46   480    92984LD    9014.00      0.00
4601308   PTCBA EA ADD VESSEL RCA     46   480    92984RC    9014.00      0.00
4601316   ART OCCLUSIVE DVICE PLCMT   46   481    G0269       338.00      0.00
4601324   POC-OXY HGB                 46   301    82810        60.00      0.00
                                            REV     CPT     UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE     PRICE      PRICE
4601332   POC-TOTAL HGB               46   305    85018        60.00      0.00
4601340   INS/REPL TEMP PACER SC      46   481    33210     10530.00      0.00
4601357   INS/REPL TEMP PACER DC      46   481    33211     10530.00      0.00
4601365   INS/REPL PERM PACER AV      46   481    33208     16200.00      0.00
4601373   REPOSTION PACING-DEFIB LD   46   481    33215     10260.00      0.00
4601381   PERC DRN-INJ RENAL PELVIS   46   323    50392      5317.00      0.00
4601399   BIL CERV-COM CART ANG ADD   46   323    7568076    5843.00      0.00
4601407   REM SC/DC ICD LD-TV EXTCT   46   481    33244     10260.00      0.00
4601415   REVISE SKIN POCKET PACER    46   481    33222      6383.00      0.00
4601423   REVISE SKIN POCKET DEFIB    46   481    33223      6383.00      0.00
4601431   FLUOROGUIDE VEIN DEVICE     46   320    77001      2207.00      0.00
4601449   TC PERM OCC-EMB PERC TUMR   46   323    61626     12798.00      0.00
4601456   PERC DRAIN/STNT PLC URETR   46   323    50393      5726.00      0.00
4601464   PERC TRNSCTH RETRVL OF FB   46   323    37203      4838.00      0.00
4601472   PERC BILARY DRAIN INT-EXT   46   323    47511      6048.00      0.00
4601480   PERC BIL DR CATH INT-EXT    46   320    75982      2169.00      0.00
4601498   INJ PROC EXTREM VENOGRAM    46   323    36005       205.00      0.00
4601506   TBA OPEN BRACHIO TRNK/BR    46   323    35458     12910.00      0.00
4601514   INS TV ELCT SC PACER/AICD   46   481    33216      9888.00      0.00
4602017   EXTMTY ART UNI ANG RT INI   46   323    75710RT    7854.00      0.00
4602025   EXTMTY ART UNI ANG LT INI   46   323    75710LT    7854.00      0.00
4602033   EXTY ART UNI ANG RT EA AD   46   323    7571076    7854.00      0.00
4602041   EXTY ART UNI ANG LT EA AD   46   323    7571076    7854.00      0.00
4602058   TRANSCATHETER BIOPSY RT     46   320    75970      4648.00      0.00
4602066   TRANSCATHETER BIOPSY LT     46   320    75970      4648.00      0.00
4602074   TRANSCATH EMBOLIZ TX RT     46   320    75894     10098.00      0.00
4602082   TRANSCATH EMBOLIZ TX LT     46   320    75894     10098.00      0.00
4602090   PULM UNIL SEL ANG RT INIT   46   323    75741RT    6926.00      0.00
4602108   PULM UNIL SEL ANG LT INIT   46   323    75741LT    6926.00      0.00
4602132   UNIL SEL RENAL VENOGRM RT   46   320    75831      4917.00      0.00
4602140   UNIL SEL RENAL VENOGRM LT   46   320    75831      4917.00      0.00
4602157   TRANSCATH INFUSION TX RT    46   320    75896      8727.00      0.00
4602165   TRANSCATH INFUSION TX LT    46   320    75896      8727.00      0.00
4602199   TC NONCARD STNT EA VES RT   46   320    75960     16050.00      0.00
4602207   TC NONCARD STNT EA VES LT   46   320    75960     16050.00      0.00
4602231   INS URETERL CATH/STENT RT   46   320    74480RT    3796.00      0.00
4602249   INS URETERL CATH/STENT LT   46   320    74480LT    3796.00      0.00
4602256   NEPHROSTOMY TUBE INS RT     46   320    74475RT    3614.00      0.00
4602264   NEPHROSTOMY TUBE INS LT     46   320    74475LT    3614.00      0.00
4602272   A-V SHUNT ANGIOGRAM RT      46   323    75790      5854.00      0.00
4602280   A-V SHUNT ANGIOGRAM LT      46   323    75790      5854.00      0.00
4602298   TL ATHCTOMY PERIPH ART RT   46   320    75992RT   17902.00      0.00
4602306   TL ATHCTOMY PERIPH ART LT   46   320    75992LT   17902.00      0.00
4602314   INSERT TUNLD CV CATH RT     46   323    36558RT    7406.00      0.00
4602322   INSERT TUNLD CV CATH LT     46   323    36558LT    7406.00      0.00
4602355   TL ATH EA ADD PERI ART RT   46   320    75993RT    5376.00      0.00
4602363   TL ATH EA ADD PERI ART LT   46   320    75993LT    5376.00      0.00
4602371   TC NONCARD STNT RT EA ADD   46   320    7596076    5376.00      0.00
4602389   TC NONCARD STNT LT EA ADD   46   320    7596076    5376.00      0.00
4602397   REMOVE TNLD CV CATH         46   323    36589      1739.00      0.00
4602405   TLBA PERIPHRAL ARTERY RT    46   320    75962RT   15640.00      0.00
4602413   TLBA PERIPH ART RT EA ADD   46   320    75964RT    5376.00      0.00
                                            REV     CPT     UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE     PRICE      PRICE
4602421   TLBA PERIPHRAL ARTERY LT    46   320    75962LT   15640.00      0.00
4602439   TLBA PERIPH ART LT EA ADD   46   320    75964LT    5376.00      0.00
4602447   VENOUS TLBA RIGHT INIT      46   320    75978     15640.00      0.00
4602454   VENOUS TLBA RIGHT EA ADD    46   320    7597876    5376.00      0.00
4602462   VENOUS TLBA LEFT INIT       46   320    75978     15640.00      0.00
4602470   VENOUS TLBA LEFT EA ADD     46   320    7597876    5376.00      0.00
4602488   EXISTNG CATH ANGIO-FOL-UP   46   320    75898      1286.00      0.00
4602496   KIDNEY ANGIOGRAM - UNIL     46   323    75722      5843.00      0.00
4602504   PTA VENOUS                  46   323    35476      4320.00      0.00
4602520   INTRO NEEDLE OR CATH VEIN   46   323    36000      1066.00      0.00
4602538   PTH BILIRY DRAIN-CONT MON   46   320    75980      8727.00      0.00
4602546   INTR CTH SUP/INF VENA CAV   46   481    36010      1895.00      0.00
4602553   KIDNEY ANGIOGRAM - BILAT    46   323    75724      6926.00      0.00
4602561   SEL CATH PLACE VENOUS SYS   46   323    36011      1895.00      0.00
4602579   DILATE NPHRSTMY TRCT PERC   46   323    50395      5317.00      0.00
4602587   CREATE AV DIALYSIS SHUNT    46   323    36145      1895.00      0.00
4602595   TPA PERC; RENAL/OTHR VISC   46   323    35490      7993.00      0.00
4602603   INS TUNLD CV CATH AGE 5/>   46   323    36558      7406.00      0.00
4602611   TPA, PERC; AORTIC           46   323    35491      7993.00      0.00
4602629   INSERT PICC AGE 5 />        46   323    36569      3351.00      0.00
4602637   TPA, PERC; ILIAC            46   323    35492      7993.00      0.00
4602652   TPA, PERC FEM-POP - RIGHT   46   323    35493RT    7993.00      0.00
4602660   PTA TIBIOPERONEAL TRUNK     46   323    35470      4320.00      0.00
4602678   TPA, PERC FEM-POP - LEFT    46   323    35493LT    7993.00      0.00
4602686   PTA RENAL/VISCERAL ARTER    46   323    35471      4320.00      0.00
4602694   TPA, PERC BR/TRNK/BRNCH     46   323    35494      7993.00      0.00
4602702   PTA AORTIC                  46   481    35472      4320.00      0.00
4602710   TPA PERC TIBIO TRNK         46   323    35495      7993.00      0.00
4602728   PTA ILIAC                   46   323    35473      4320.00      0.00
4602736   VEN CATH SEL ORG BLD SAMP   46   323    36500       483.00      0.00
4602744   PTA FEMORAL POPLITEAL       46   323    35474      4320.00      0.00
4602751   PULM BILAT SEL ANGIO        46   323    75743      9601.00      0.00
4602769   INT CTH RT HRT/MN PLM ART   46   481    36013      1895.00      0.00
4602777   TLBA RENAL OTH VISCRL ART   46   320    75966      5376.00      0.00
4602785   SEL CATH PLACE LT/RT PULM   46   323    36014      1895.00      0.00
4602793   INJ PROC CCATH PULM ANGIO   46   481    93541       162.00      0.00
4602801   INT NDL/CTH CARTD/VTB ART   46   323    36100      1895.00      0.00
4602819   INS LEAD PACE-DEFIB, DUAL   46   481    33217     10679.00      0.00
4602827   INT NDL/CTH RTRG BRAC ART   46   323    36120      1895.00      0.00
4602843   INT NDL/CTH EXTREMITY ART   46   323    36140      1895.00      0.00
4602868   INTRO CATHETER AORTA        46   323    36200      1895.00      0.00
4602876   PRIM ART MECH THROMBCTOMY   46   323    37184     11340.00      0.00
4602884   SEL CATH PL ART 1 THOR/BR   46   323    36215      1895.00      0.00
4602900   SEL CATH PL ART 2 THOR/BR   46   323    36216      1895.00      0.00
4602926   SEL CATH PL ART 3 THOR/BR   46   323    36217      1895.00      0.00
4602942   SEL CATH PL ART 1 AB/LO-X   46   323    36245      1895.00      0.00
4602967   SEL CATH PL ART 2 AB/LO-X   46   323    36246      1895.00      0.00
4602983   SEL CATH PL ART 3 AB/LO-X   46   323    36247      1895.00      0.00
4603015   NEPH/PYLOSTOMY TUBE CHNGE   46   323    50398      3614.00      0.00
4603080   RECOVERY ROOM CATH LAB      46   710                965.00      0.00
4603122   UNIL CERV CAROTID ANGIO     46   323    75676      3650.00      0.00
4603197   THOR AORTOGRM W SRIAL ADD   46   323    7560576    8389.00      0.00
                                            REV     CPT     UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE     PRICE      PRICE
4603213   ABDOMINAL AORTGRAM EA ADD   46   323    7562576    8139.00      0.00
4603239   ABDOMEN SELECTIVE 2 RUNS    46   323    7572676   11947.00      0.00
4603502   ILIAC ANGIO W CARD CATH     46   320    G0278      1286.00      0.00
4603510   POSTOP PERC BD STONE REM    46   320    74327      2048.00      0.00
4603528   REM BILI STONE VIA T-TUBE   46   323    47630      4077.00      0.00
4603536   SQ REM SC/DC ICD GENERATR   46   481    33241     10260.00      0.00
4604146   RENAL ANGIO W CARD CATH     46   320    G0275      1286.00      0.00
4604161   CHG PERC TUBE OR DR CATH    46   320    75984      3614.00      0.00
4604187   INTRAVASCULAR CATH EXCHG    46   320    75900      3614.00      0.00
4604195   REPLACE TUNNELED CV CATH    46   323    36581      7406.00      0.00
4604229   INS SWAN GANZ BEDSIDE       46   481    93503      4304.00      0.00
4604237   ART CATH FOR ANGIO WO LHC   46   481    93508     10126.00      0.00
4604302   PERC AVF THROMBECT GRAFT    46   323    36870      5765.00      0.00
4606042   AAI PACER INSERTION         46   481    33206     16200.00      0.00
4606067   VVI PACER INSERTION         46   481    33207     16200.00      0.00
4606166   LV PACING LEAD ADD-ON       46   481    33225     13500.00      0.00
4606174   REPOSITION L VENTRIC LEAD   46   481    33226     10665.00      0.00
4606182   INS/RPL PG ONLY SGL CHAM    46   481    33212     16200.00      0.00
4606208   INS/RPL PG ONLY DUAL CHAM   46   481    33213     16200.00      0.00
4606224   REMOVE PPM PLS GEN          46   481    33233     10260.00      0.00
4606240   EVAL INT IMP/REP LEADS      46   480    93640      3375.00      0.00
4606257   EVAL INT IMP/RP LDS & GEN   46   480    93641      3375.00      0.00
4606273   INSRT SC ICD GENERATOR      46   481    33240     10800.00      0.00
4606281   INSRT DC ICD GENERATOR      46   481    33240     10800.00      0.00
4606307   PACER SINGLE LEAD REMOVAL   46   481    33234     10530.00      0.00
4606315   PACER DUAL LEAD REMOVAL     46   481    33235     10800.00      0.00
4606323   REPLACE NON-TUNLD CV CATH   46   323    36580      3351.00      0.00
4700035   IPPB SUBSEQUENT             47   412    9464076     781.00      0.00
4700043   OXIMETER SPOT CHECK         47   460    94760       127.00      0.00
4700068   HHN/SVN SUBSEQUENT          47   412    9464076     623.00      0.00
4700076   PERCUSSION 4POSITION SUBQ   47   410    94668       351.00      0.00
4700100   SUCTION NT                  47   410    31720       182.00      0.00
4700118   EXTUBATE                    47   410    94799       244.00      0.00
4700126   PULSE OXIMETRY W/EXERCISE   47   460    94761       332.00      0.00
4700134   INTUBATION                  47   410    31500       363.00      0.00
4700142   CONT P-OX SYSTEM CHECK      47   460    94762       127.00      0.00
4700183   CARDIOVERSION               47   480    92960       470.00      0.00
4700191   TRANSPORT CRITICAL PT       47   419    94799       711.00      0.00
4700241   IPPB INITIAL                47   412    94640       781.00      0.00
4700258   USN INITIAL                 47   412    94640       761.00      0.00
4700266   CONT PULSE OX S/U           47   410    94762       645.00      0.00
4700290   PERCUSSION 3POSITION INIT   47   410    94667       351.00      0.00
4700332   RESP RESUSCITAT / BAGGING   47   410    94799      1719.00      0.00
4700407   ICN/PED EX TRANS 1ST 2HRS   47   419               2406.00      0.00
4700415   BRONCHOSCOPY-ASSIT/THER     47   410    31622      1719.00      0.00
4700431   NEWBORN RESUSCITATION       47   410    99440      1719.00      0.00
4700449   DELIVERY ATTENDANCE 15MIN   47   410    99436       243.00      0.00
4700456   BEDSIDE SPIROMETRY          47   460    94010       232.00      0.00
4700464   VENT MGMT INPAT INIT DAY    47   410    94002      4939.00      0.00
4700472   VENT MGMT INPAT SUBQ DAY    47   410    94003      3479.00      0.00
4700480   ABG, CALCULATED SAT.        47   301    82803       562.00      0.00
4700498   ABG, MEASURED SATURTN INI   47   301    82805       812.00      0.00
                                            REV     CPT     UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE     PRICE     PRICE
4700506   ABG, PH ONLY                47   301    82800      289.00      0.00
4700514   USN SUBSEQUENT              47   412    9464076    761.00      0.00
4700522   CARBOXYHEMOGLOBIN INITIAL   47   301    82375      297.00      0.00
4700530   DELIVERY ATTEND EXT 30MIN   47   410    99436      482.00      0.00
4700548   ICN/PED EXT TRAN EA AD HR   47   419              1203.00      0.00
4700555   PPV NWBRN-NOT RESUSC INIT   47   410    94640      277.00      0.00
4700563   SURFACTANT ADMIN            47   460    94610      920.00      0.00
4700589   FORCED VITAL CAPACITY/FVC   47   410    94150      167.00      0.00
4700597   HHN/SVN INITIAL             47   412    94640      623.00      0.00
4700605   CPAP/BIPAP DAILY            47   410    94660      614.00      0.00
4700621   MDI/DPI ADMIN INIT          47   412    94640      373.00      0.00
4700654   SPUTUM SPEC. COLLECTION     47   300    89220      197.00      0.00
4700662   ARTERIAL PUNCTURE           47   300    36600      211.00      0.00
4700670   OP EVAL FOR PULSE OXIMTRY   47   410    99211      332.00      0.00
4700696   PPV NWBORN (NOT RESUSC)SB   47   410    9464076    198.00      0.00
4700704   MDI/DPI ADMIN SUBQ          47   412    9464076    373.00      0.00
4700746   EXP PRESS VALVE SUBQ        47   410    94668      233.00      0.00
4700753   HHN W VENT INITIAL          47   412    94640      574.00      0.00
4700761   BAN AEROECLIPSE INITIAL     47   412    94640      526.00      0.00
4700779   BAN AEROECLIPSE SUBQ        47   412    9464076    526.00      0.00
4700787   MDI/DPI W VENT INITIAL      47   412    94640      372.00      0.00
4700795   CONT BLAND AERO SETUP       47   412    94640      549.00      0.00
4700860   HHN W VENT SUBQ             47   412    9464076    574.00      0.00
4700878   MDI/DPI W VENT SUBQ         47   412    9464076    372.00      0.00
4700886   CONT BLAND AERO CHECK       47   412    9464076    310.00      0.00
4700894   CONT NEB 1ST HOUR           47   412    94644     1077.00      0.00
4700902   INHALATION TX LEV 1 INIT    47   412    94640      599.00      0.00
4700910   CONT NEB EA ADDL HOUR       47   412    94645      511.00      0.00
4700928   INHALATION TX LV 2 INITL    47   412    94640      673.00      0.00
4700936   MDI/DPI INSTRUCTION         47   410    94664      572.00      0.00
4700944   INHALATION TX LV 3 INITL    47   412    94640      748.00      0.00
4700951   PERCUSSION 4POSITION INIT   47   410    94667      542.00      0.00
4700969   INHALATION TX LV 4 INITL    47   412    94640      822.00      0.00
4700977   EXP PRESS VALVE INIT        47   410    94667      305.00      0.00
4700985   INHALATION TX LV 1 SUBSQ    47   412    9464076    599.00      0.00
4700993   PERCUSSION 4POSITION SUBQ   47   410    94668      542.00      0.00
4701009   INHALATION TX LV 2 SUBS     47   412    9464076    673.00      0.00
4701017   LUNG RECRUIT MANEUVER/TR    47   410                 0.00      0.00
4701025   INHALATION TX LV 3 SUBSQ    47   412    9464076    748.00      0.00
4701033   VENT PRONE POSITION/TR      47   410                 0.00      0.00
4701041   INHALATION TX LV 4 SUBSQ    47   412    9464076    822.00      0.00
4701058   VENT ST PRESS/VOL LOOP/TR   47   410                 0.00      0.00
4701066   ABG CALC SAT EA ADD'L       47   301    8280391    562.00      0.00
4701074   MDI W/LUNG FUNC MEAS INIT   47   412    94640      767.00      0.00
4701082   ABG MEAS SAT EA ADD'L       47   301    8280591    812.00      0.00
4701090   MDI W/LUNG FUNC MEAS SUBQ   47   412    9464076    767.00      0.00
4701108   CARBOXYHEMOGLOBIN EA ADD'   47   301    8237591    205.00      0.00
4701116   CODE BLUE / CPR             47   410    92950     5400.00      0.00
4701132   HYPERTONIC SPUTUM IND INI   47   412    94640      781.00      0.00
4701140   HYPERTONIC SPUTUM IND SUB   47   412    9464076    781.00      0.00
4701363   ARTERIAL PUNCTURE EA ADDL   47   300    3660059    211.00      0.00
4701389   CO2, EXPIRED GAS BY IR      47   460    94770      217.00      0.00
                                            REV     CPT     UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE     PRICE     PRICE
4701405   CO2, EXPIRED GAS BY IR      47   460    9477076    109.00      0.00
4708004   RCP TIME 15 MIN             47   410                 0.00      0.00
4708103   INIT PT ASSESS/TR           47   410                 0.00      0.00
4708129   SUB PT ASSESS/TR            47   410                 0.00      0.00
4708145   TRACH TUBE CHANGE/TR        47   410                 0.00      0.00
4708160   TRACH TUBE CARE/TR          47   410                 0.00      0.00
4708186   ETT RETAPE POSITIONING/TR   47   410                 0.00      0.00
4708202   MONITOR CUFF PRESSURE/TR    47   410                 0.00      0.00
4708228   PLCMT OF NASAL AIRWAY/TR    47   410                 0.00      0.00
4708244   PLCMTREMOV SPEECH VALV/TR   47   410                 0.00      0.00
4708269   ET SUCTIONING/TR            47   410                 0.00      0.00
4708285   PLACE CHANGE INLINE SX/TR   47   410                 0.00      0.00
4708301   IN/LINE ET SUCTIONING/TR    47   410                 0.00      0.00
4708327   INCENTIVE SPIROMETRY/TR     47   410                 0.00      0.00
4708343   CONT AERO EQUIP CHANGE/TR   47   410                 0.00      0.00
4708368   OXYGEN SETUP/TR             47   410                 0.00      0.00
4708384   OXYGEN ASSESSMENT/TR        47   410                 0.00      0.00
4708400   OXYGEN EQUIP CHANGE/TR      47   410                 0.00      0.00
4708426   PTSYS ASSESNIV NON EMR/TR   47   410                 0.00      0.00
4708442   SETTING ADJ NIV NON EMRTR   47   410                 0.00      0.00
4708467   PTSYS ASSESS NIV EMER/TR    47   410                 0.00      0.00
4708483   SETTING ADJ NIV EMER/TR     47   410                 0.00      0.00
4708509   NIV EQUIP CHANGE/TR         47   410                 0.00      0.00
4708525   PTVENT ASSESSMENT/TR        47   410                 0.00      0.00
4708541   VENT SETTING ADJUST/TR      47   410                 0.00      0.00
4708566   VENT EQUIP CHANGE/TR        47   410                 0.00      0.00
4708582   VENT CIRCUIT CHANGE/TR      47   410                 0.00      0.00
4800124   FLOW VOLUME LOOP            48   460    94375      343.00      0.00
4800207   MULTPL 02 SAT'S             48   460    94761      436.00      0.00
4800231   ABG, SATUR ONLY             48   301    82810      199.00      0.00
4800249   ABG, CALC. SAT.             48   301    82803      387.00      0.00
4800256   ABG, MEAS. SAT.             48   301    82805      559.00      0.00
4800504   MDI W/LUNG FUNC MEAS INIT   48   412    94640      767.00      0.00
4800512   MDI W/LUNG FUNC MEAS SUBQ   48   412    9464076    767.00      0.00
4800603   CARBOXYHEMOGLOBIN INITIAL   48   301    82375      297.00      0.00
4800611   CARBOXYHEMOGLOBIN EA ADDL   48   301    8237591    205.00      0.00
4800637   HHN/SVN INITIAL             48   410    94640      623.00      0.00
4800645   HHN/SVN SUBSEQUENT          48   410    9464076    623.00      0.00
4800652   MAX VOLUNTARY VENT/ONLY     48   460    94200      332.00      0.00
4801080   SPIROMETRY                  48   460    94010      647.00      0.00
4801106   SPIROMETRY/BR0NCH W/O INT   48   460    94060      945.00      0.00
4801122   FRC                         48   460    94240      282.00      0.00
4801148   S B DLCO                    48   460    94720      312.00      0.00
4801205   BEDSIDE SPIROMETRY          48   460    94010      232.00      0.00
4801247   ARTERIAL PUNCTURE           48   300    36600      196.00      0.00
4801585   ABG CALC SAT EA ADD'L       48   300    8280391    562.00      0.00
4801601   ABG MEAS SAT EA ADD'L       48   300    8280591    812.00      0.00
4801809   ARTERIAL PUNCTURE EA ADDL   48   300    3660091    196.00      0.00
4808002   RCP TIME 15 MIN             48   410                 0.00      0.00
4900072   TEE PROBE PLACEMENT ONLY    49   483    93313     2411.00      0.00
4900080   TEE 2ND ACQUISITION         49   483    93313      756.00      0.00
4900205   STRESS ECHO EKG W/MD SUPV   49   483    93017     1375.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
4900304   STRESS/EXERCISE ECHOCARD    49   483    93350   2182.00      0.00
4900320   ECHOCARDIO M/MODE/2D        49   483    93307   1076.00      0.00
4900346   DOPPLER ECHO; COMPLETE      49   483    93320    307.00      0.00
4900361   TRANSESOPHAGEAL ECHO        49   483    93312   2410.00      0.00
4900387   COLOR MAPPING               49   483    93325    307.00      0.00
4900403   FOLLOW UP ECHOCARDIOGRAPH   49   483    93308    538.00      0.00
4900429   TTE CONG ABN; COMPLETE      49   483    93303   1114.00      0.00
4900445   TTE CONG ABN LIMITED/F-UP   49   483    93304    608.00      0.00
4900460   DOPPLER ECHO LMITED/ F-UP   49   483    93321    304.00      0.00
5000138   ADAPTER IV BOTTLES SCREW    50   272              12.00      0.00
5000427   SUTURE SURGITIC CHROMIC     50   272              49.00      0.00
5000526   ELECTRODE LEEP BALL 5.5CM   50   272              77.00      0.00
5000773   DRAIN CHEST SYS MULTI PUR   50   272             134.00      0.00
5000781   TRAY PREP E-Z W/STK & GLO   50   272              19.00      0.00
5000807   CATH SCT 14FR 22.2IN CLS    50   272              44.00      0.00
5000997   TRAY AMNIOCENTESIS          50   272              44.00      0.00
5001003   TRAY GENERAL BASIC BX       50   272              33.00      0.00
5001276   VACUUM TND TCH ULTRA CUP    50   272              80.00      0.00
5001532   CRUTCHES ADULT MED ADJ      50   271    E0114     35.00      0.00
5001540   CRUTCHES ADULT TALL ADJ     50   271    E0114     35.00      0.00
5001557   CRUTCHES YOUTH ADJ          50   271    E0114     47.00      0.00
5001797   TUBING NITRO-SET            50   272              47.00      0.00
5002464   PROBE BIPOLAR 10 FR         50   272            1037.00      0.00
5002563   KIT MATERNITY               50   271             105.00      0.00
5002589   PATCH HERNIA SM OVAL 8X12   50   278    C1781   2211.50      0.00
5002597   IMPLANT PATCH/HERN OV 11X   50   278    C1781   2622.50      0.00
5002605   KIT BREAST PUMP HYGIENIKI   50   271             111.00      0.00
5003058   CANES WOOD                  50   271    E0100     18.00      0.00
5003660   TRANDUCER KIT DOUBLE        50   272              65.00      0.00
5003835   TUBE FEEDING WEIGHTED 12F   50   272              71.00      0.00
5003843   TUBE FEEDING WEIGHTED 8FR   50   272              65.00      0.00
5004643   DRAPE SURG W/TWL 17 5/8X1   50   272              21.00      0.00
5004932   CATH THORACIC ANGLED 28FR   50   272              59.00      0.00
5004940   CATH THORACIC ANGLED 32FR   50   272              59.00      0.00
5004957   CATH THORACIC ANGLED 36FR   50   272              59.00      0.00
5004981   CATH THORACIC STRAIGHT 20   50   272              53.00      0.00
5005004   CATH THORACIC STRAIGHT 28   50   272              53.00      0.00
5005012   CATH THORACIC STRAIGHT 32   50   272              53.00      0.00
5005020   CATH THORACIC STRAIGHT 36   50   272              53.00      0.00
5005038   CATH THORACIC STRAIGHT 40   50   272              49.00      0.00
5005327   ELECTRODE LEEP 1.5X0.5      50   272             126.00      0.00
5005467   ELECTRODE RADIUS 2.0X1.0    50   272              77.00      0.00
5005509   ELECTRODE LEEP 1.5X0.7      50   272              82.00      0.00
5005673   NEEDLE 15GX3/8-1 7/8"STER   50   272              50.00      0.00
5005699   NEEDLE BONE MARROW/ASPIR    50   272              61.00      0.00
5005707   NEEDLE TRU CUT BI 14GX4 1   50   272              48.00      0.00
5005715   NEEDLE TRU CUT BI 14GX6"    50   272              55.00      0.00
5005731   TRAY ADULT LUMBAR PUNCTUR   50   272              55.00      0.00
5005749   TRAY CONT EPIDURAL 18G TO   50   272              81.00      0.00
5005756   TRAY DISP MYELOGRAM         50   272              50.00      0.00
5005764   TRAY JAMSHIDI BONE MARROW   50   272              90.00      0.00
5005772   TRAY JAMSHIDI BONE MARROW   50   272              71.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5005798   TRAY PED LUMBAR PUNCTURE    50   272              55.00      0.00
5005806   TRAY THORACENTESIS CATH     50   272              82.00      0.00
5005814   TRAY THORACENTESIS W/ASP    50   272              77.00      0.00
5006317   PAD HYPER/HYPOTHERMIA       50   271              56.00      0.00
5007257   ADAPTER PORTEX SWIVEL FIB   50   272               9.00      0.00
5007356   LINER SPENCO BOOT           50   271             152.00      0.00
5007364   BOOT SPENCO                 50   274    L9900    205.75      0.00
5007398   COLLAR STIFFNECK SMALL      50   274    L0140     39.00      0.00
5007711   MASK LARYNG LMA AIRWA SZ4   50   272              37.00      0.00
5007992   DILATOR FILIFORM TIP 4FR    50   272             116.00      0.00
5008024   CATH BILIARY DRAINAGE 10F   50   272    C1729    295.00      0.00
5008297   TRAY CATH BONANNO STRL      50   272    C1751    227.00      0.00
5008602   LIGACLIP APPLIER 20/20 ME   50   272             577.00      0.00
5008800   SPONGE SURG 2X4 ABS HEMOS   50   272             166.00      0.00
5008818   SPONGE SURG 4X8 ABS HEMOS   50   272             166.00      0.00
5008826   SPONGE SURG 2X3 ABS HEMOS   50   272              91.00      0.00
5008842   TRAY URINE METER W/FOLEY    50   272             107.00      0.00
5009147   TUBE BRONCH SZ 35 LEFT      50   272             288.00      0.00
5009154   TUBE BRONCH SZ 37 LEFT      50   272             288.00      0.00
5009162   TUBE BRONCH SZ 39 LEFT      50   272             288.00      0.00
5009188   TUBE BRONCH SZ 35 RIGHT     50   272             314.00      0.00
5009220   TRAY OPEN HEART SUPPLY PA   50   272            2913.00      0.00
5009287   DRAPE IOBAN C-ARM ANTIMIC   50   272              76.00      0.00
5009444   LIGACLIP MULTIPLE CLIP MS   50   272             590.00      0.00
5009469   STAPLER PREM TA MF 30 V-3   50   272             381.00      0.00
5009477   LOADING UNIT PREM TA MF 3   50   272             168.00      0.00
5009485   STAPLER PREM TA MF 30 3.5   50   272             331.00      0.00
5009493   LOADING UNIT PREM TA MF 3   50   272             152.00      0.00
5009501   STAPLER PREM TA MF 30 4.8   50   272             331.00      0.00
5009519   LOADING UNIT PREM TA MF 3   50   272             152.00      0.00
5009527   STAPLER PREM TA MF 60 3.5   50   272             343.00      0.00
5009535   LOADING UNIT PREM TA 60 3   50   272             171.00      0.00
5009543   STAPLER PREM MF TA 60-4.8   50   272             343.00      0.00
5009550   LOADING UNIT 60-4.8 MF      50   272             171.00      0.00
5009568   STAPLER PREM TA MF 90 3.5   50   272             362.00      0.00
5009584   STAPLER PREM TA MF 90 4.8   50   272             362.00      0.00
5009618   STAPLER TA ROTICULATOR 30   50   272            1810.00      0.00
5009626   STAPLER TA ROTICULATOR 55   50   272             760.00      0.00
5009634   STAPLER TA ROTICULATOR 55   50   272             760.00      0.00
5009642   STAPLER PREMIUM CEEA 25 D   50   272            1037.00      0.00
5009675   PURSESTRING 65 INSTR DISP   50   278             679.75      0.00
5009683   STAPLER MF GIA 60 3.8 BLU   50   272             363.00      0.00
5009691   LOADING UNIT MF GIA 60 3.   50   272             196.00      0.00
5009709   STAPLER MF GIA 80 3.8       50   272             549.00      0.00
5009717   LOADING UNIT MF GIA 80 3.   50   272             286.00      0.00
5009725   STAPLER PREM SURGI W/TIA    50   272             248.00      0.00
5009733   STAPLER PREM SURGI W/TIA    50   272             248.00      0.00
5009741   STAPLER PREM SURGI W/TIA    50   272             210.00      0.00
5009758   TROCAR VERSAPORT RADIO 5M   50   272             170.00      0.00
5009774   TROCAR VERSAPORT RADIO 5-   50   272             202.00      0.00
5009782   TROCAR VERSAPORT RADIO 5-   50   272             202.00      0.00
5009790   SURGIPORT LONG 10MM SS SL   50   272             222.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
5009816   TROCAR VERSAPORT BLUNT 5-   50   272             242.00      0.00
5009865   TROCAR THORACOPORT 5.5MM    50   272              63.00      0.00
5009873   TROCAR THORACOPORT 10.5MM   50   272              79.00      0.00
5009881   THORACOPORT 11.5MM TROCAR   50   272              63.00      0.00
5009907   SURGINEEDLE 120MM           50   272              62.00      0.00
5009915   SURGINEEDLE 150MM           50   272              62.00      0.00
5009923   INSTRUMENT DISP CLOSE AUT   50   272              97.00      0.00
5009931   CLAMP ENDO LUNG 12MM        50   272             309.00      0.00
5009949   INSTRUMT DISP CLIP APP ML   50   272             379.00      0.00
5009964   SHEATH INTRODUCER VENOUS    50   272    C1766     66.00      0.00
5009998   SHEARS LAB DISP 5MM         50   272             256.00      0.00
5010004   INSTRUMENT DISP GRASP II    50   272             321.00      0.00
5010012   INSTR DISP DISSECT 5MM      50   272             264.00      0.00
5010020   INSTRUMENT DISP CLINCH II   50   272             309.00      0.00
5010038   INSTRUMENT DISP BABCOCK     50   272             304.00      0.00
5010046   INSTR DISP ENDOPADDLE 12M   50   272             552.00      0.00
5010053   DEVICE LASE DEL ENDST 5MM   50   272             268.00      0.00
5010079   SHEARS 5MM SHORT            50   272             275.00      0.00
5010095   STAPLER POWERED LDS 15W D   50   272             644.00      0.00
5010111   STAPLER CONCORD SKIN 50W    50   272              60.00      0.00
5010137   SUCTION SURGIWAND II 5MM    50   272             144.00      0.00
5013867   USCI GT1 FLPY 180CM J TIP   50   272             581.00      0.00
5014766   GUIDEWIRE CHOICE PT         50   272    C1769    374.00      0.00
5014881   BALLOON UT SDS 9X4X75       50   272    C1725    758.00      0.00
5014931   BALLOON UT SDS 5X2X75       50   272    C1725    758.00      0.00
5014949   BALLOON UT SDS 5X4X75       50   272    C1725    758.00      0.00
5014998   BALLOON UT SDS 7X2X75       50   272    C1725   1001.00      0.00
5015078   SLEEVE SCD THIGH LENGTH M   50   271             191.00      0.00
5015094   BLADE MANDIBULAR OS         50   272             464.00      0.00
5015128   CATH JAVID CAROTID          50   272    C1751    394.00      0.00
5015243   TUBE VENT MODIFD T-TUBE     50   272              84.00      0.00
5015250   CATH BALLOON DILATION       50   272    C1725   1217.00      0.00
5015268   VENT SUMP LV W/SENTINEL E   50   272              79.00      0.00
5015276   INTRO SHEATH 10CM 8.5FR     50   272    C1894    202.00      0.00
5015375   KIT ARTERIAL LINE 20G 6"    50   272              70.00      0.00
5015383   KIT ARTERIAL LINE 18G 6"    50   272              70.00      0.00
5015391   KIT ARTERIAL LINE 20G 3"    50   272              68.00      0.00
5015409   KIT ARTERIAL LINE 18G 3"    50   272              68.00      0.00
5015565   TRAY TRACHEOTOMY C.S.       50   272             798.00      0.00
5015573   TRAY SUTURE C.S.            50   272             208.00      0.00
5015599   TOTE CV LINE INSERTION      50   272             317.00      0.00
5015664   TRAY PERC.SHEATH INTRO.AK   50   272    C1766    149.00      0.00
5015797   CATH IV ANGIO #3828125      50   272    C1751     37.00      0.00
5015938   SET LOCAL C.S.              50   272             187.00      0.00
5015961   BASIN COMPRESS PROCESSED    50   271              44.00      0.00
5016043   STRIP STERI 1/4 X 4" SKIN   50   272              15.00      0.00
5016084   CIRCUIT VENTILATOR ADULT    50   272              60.00      0.00
5016472   KNIFE MYRINGOTOMY           50   272              44.00      0.00
5016613   EXTRACTOR 3 LUMEN           50   272             498.00      0.00
5016670   SENSOR DIGITAL D25R ADULT   50   272              25.00      0.00
5016712   BLADE HALL OSCILLATOR       50   272              79.00      0.00
5016746   CATH 6FR JL4.0              50   272    C1887     43.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
5016787   CATH 6FR CARDMULTI STRA     50   272    C1887    122.00      0.00
5016803   CATH PIGTAIL 4FR 65CM       50   272              68.00      0.00
5016811   CATH VERTEBRAL 4FR          50   272              68.00      0.00
5016829   CATH 5FR VERTEBRAL          50   272              60.00      0.00
5016969   TUBE TRACH SIZE 6           50   272             155.00      0.00
5016985   TUBE TRACH SINGLE CANNUAL   50   272             119.00      0.00
5017009   PADS ADULT STAT             50   272              85.00      0.00
5017207   KIT GASTRIC LAVAGE          50   272              77.00      0.00
5017223   GUIDEWIRE STRAIGHT 145CM    50   272    C1769     25.00      0.00
5017249   SENSOR DIGITAL I20R INFNT   50   272              28.00      0.00
5017280   MESH TRELEX NATURAL POLY    50   278    C1781    620.75      0.00
5017314   RESERVOIR CARDIOTOMY        50   272             149.00      0.00
5017405   DRAIN BLAKE ROUND 19F       50   272              66.00      0.00
5017413   DRAIN BLAKE ROUND 10F       50   272              66.00      0.00
5017447   SYRINGE HEALON .4% SODIUM   50   272             134.00      0.00
5017462   SYRINGE VISCOAT SODIUM HY   50   250             258.00      0.00
5017470   CATH THROMBECTOMY AVD 4F    50   272    C1757    234.00      0.00
5017678   RESERVOIR 400C JACKSON PR   50   272              60.00      0.00
5017686   KNIFE ACL GRAFT 12MM        50   272             254.00      0.00
5017710   EVACUATOR 400CC 3/16" PVC   50   272              39.00      0.00
5017728   BLADE SURG OSCILLATOR DIS   50   272              79.00      0.00
5017819   TUBE SUCTION 6FR            50   272              58.00      0.00
5017827   ADAPTER STOPCOCK ANTEGRDE   50   272             156.00      0.00
5017835   SET PERFUSION MULTIPLE      50   272              70.00      0.00
5017868   CATH GUIDE JL4              50   272    C1887    245.00      0.00
5017900   SPLINT KNEE 24"             50   274    L1830     53.50      0.00
5017918   SPLINT KNEE 19"             50   274    L1830     46.50      0.00
5017942   COLLAR CERVICAL UNIVERSAL   50   274    L0210     39.00      0.00
5017959   SHOE WOMEN POST OP SZ MED   50   274    L3260     15.25      0.00
5017967   SHOE WOMEN POST OP SZ LAR   50   274    L3260     15.25      0.00
5017991   SPLINT WRIST UNIVERSAL      50   274    L3908     64.00      0.00
5018049   TUBING STERILE 3/8X3/32X7   50   272              52.00      0.00
5018056   BRAT PAK 250CC              50   272             277.00      0.00
5018064   ASSEMBLY BRAT PERFUSION     50   272              71.00      0.00
5018072   KIT LAP CHOLE               50   272            1056.00      0.00
5018080   KIT LAP CHOLE A             50   272            1923.00      0.00
5018106   TRAY CARDIAC CATH           50   272             412.00      0.00
5018114   TRAY DIALYSIS DLC600TEC     50   272             303.00      0.00
5018122   BAG RESUSCITATION ADULT     50   271              36.00      0.00
5018189   ORTHOSIS ANKLE SML          50   274    L1902    202.00      0.00
5018197   ORTHOSIS ANKLE LG           50   274    L1902    202.00      0.00
5018205   SHUNT CAROTD ENDRT EXT3X4   50   272            1136.00      0.00
5018213   SHUNT CARTD ENDA EX 3.5X5   50   272            1136.00      0.00
5018247   KIT WOUND DEBRIDEMENT W/F   50   272             112.00      0.00
5018320   PULLEY OVER DOOR ECONOMY    50   271              46.00      0.00
5018528   TUBE BRONCH 41 LEFT         50   272             288.00      0.00
5018585   POUCH ENDO CATCH 10MM       50   272             378.00      0.00
5018593   STAPLER PREM SURGI W/TIA    50   272             210.00      0.00
5018692   INSERT FOGARTY 33MM         50   272              88.00      0.00
5018700   CATH FOGARTY EMBOLECTMY 3   50   272    C1757    129.00      0.00
5018841   CANNULA FEMORAL VENOUS 21   50   272             484.00      0.00
5018858   CANNULA RETROGRADE RCSP     50   272             305.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5018874   PAD INSULATION CARDIAC SH   50   272               98.00      0.00
5018965   SYRINGE HEALON .85% SODIU   50   250              199.00      0.00
5019153   TRAY ANGIOGRAPHY            50   272              226.00      0.00
5019187   FELT TEFLN PATCH 1X6"STRL   50   278    C1768     290.50      0.00
5019195   GRAFT SAUVAGE VASCULAR 1"   50   278    C1768     528.00      0.00
5019203   STENT URETERAL POLAR 7X26   50   278    C2617    1425.50      0.00
5019252   SENSOR DIGITAL N25R NEONT   50   272               26.00      0.00
5019310   BLADE ARTHRO ABR NBLASTER   50   272              252.00      0.00
5019336   CANNULA ARTHROSCOPY 4.5     50   272               63.00      0.00
5019344   BAG INFUSION 3000CC         50   272              166.00      0.00
5019369   STENT SENTINOL 10X41X75     50   278    C1876   10560.00      0.00
5019435   INTRODUCER VASCULAR 9F      50   272    C1766     177.00      0.00
5019443   KIT TURBOSONIC PHACO 30     50   272              380.00      0.00
5019468   CATH BALLOON DILATION       50   272    C1725    1217.00      0.00
5019492   RETRACTOR STONE FLAT WIRE   50   272              818.00      0.00
5019757   SUTURE SURGIT POLISORB 21   50   272               73.00      0.00
5020029   KNIFE ROCKING T             50   272               70.00      0.00
5020078   TRAY MULTILUMEN AK25703     50   272              278.00      0.00
5020151   LIGATOR 7 BAND SPEEDBAND    50   272             1187.00      0.00
5020193   EVACUATOR 100CC BULB        50   272               21.00      0.00
5020201   DERMACARRIER 1.5 TO 1       50   272               73.00      0.00
5020573   SLEEVES SCD STERILE THIGH   50   272              161.00      0.00
5020623   SPLINT ANKLE FIG 8 LARGE    50   274    L1901      56.00      0.00
5020631   SPLINT ANKLE FIG 8 MED      50   274    L1901      56.00      0.00
5020649   BELT RIB MENS UNIVERSAL     50   274    L0210      40.25      0.00
5020656   BELT RIB WOMEN UNIVERSAL    50   274    L0210      40.25      0.00
5020672   SHOE POST OP MENS SZ MEDI   50   274    L3260      15.25      0.00
5020706   WRIST UNN-BRACE NEOPRENE    50   274    L3909      86.00      0.00
5020714   BRACE THUMB BLACK NEOPREM   50   274    L3909      94.50      0.00
5020870   SUTURE LASSO 90             50   272              478.00      0.00
5020961   KIT BLOWER/MISTER           50   272              208.00      0.00
5020987   DILATOR FILIFORM TIP 5FR    50   272              289.00      0.00
5021001   ELECTRODE VAPOR 90 DEGR/H   50   272              743.00      0.00
5021423   VALVE HEMO MERIT            50   272               47.00      0.00
5021472   GUIDEWIRE RDRUNR 018        50   272    C1769     507.00      0.00
5021480   GUIDEWIRE J 80CM            50   272    C1769      47.00      0.00
5021506   GUIDEWIRE ROADRUNNER        50   272    C1769     111.00      0.00
5021514   CATH 6FR CARDMULTI ANG      50   272    C1887     122.00      0.00
5021571   TIP IM FOUR ORIFICES        50   272               54.00      0.00
5021647   GUIDEWIRE SUP STIF ST       50   272    C1769     113.00      0.00
5021746   SUTURE BRIDGE RETENTION     50   272               54.00      0.00
5022140   DRAPE SLUSH & WARMING       50   272              159.00      0.00
5022256   BAG INFUSION 500CC          50   272               53.00      0.00
5022298   SHIELD CORNEAL 12HR         50   272               83.00      0.00
5022306   SHEARS LCS 5MM KNIFE DOWN   50   272             1361.00      0.00
5022314   BLADE ARTHRO FULL RADIUS    50   272              247.00      0.00
5022322   BLADE ARTHRO INCISOR 4.5M   50   272              247.00      0.00
5022330   BLADE ARTHRO FULL RADIUS    50   272              247.00      0.00
5022694   GLOVE RADIATION RESISTANT   50   271              174.00      0.00
5022959   CUFF BP ADLT GREY CRITIKO   50   271               44.00      0.00
5022975   TROCAR OPTICAL VISIPORT 5   50   272              231.00      0.00
5023015   TRAY MULTI LUMEN M2720HK    50   272              151.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
5023098   SLEEVE SCD THIGH MED V      50   271              60.00      0.00
5023130   CATH THROMBECTOMY 4F 40CM   50   272    C1757    234.00      0.00
5023155   PUNCH AORTIC 5MM            50   272             124.00      0.00
5023171   CABLE SURGCAL DISP.         50   272              87.00      0.00
5023197   CANNULA ARTHROSCOPY 7.0     50   272              63.00      0.00
5023205   CATH ATRIAL VEIN 18FR       50   272    C1751    104.00      0.00
5023387   CATH DRAINAGE 8FR           50   272    C1729    303.00      0.00
5023395   CATH PIGTAIL 8FR            50   272             320.00      0.00
5023403   CATH DRAINAGE 10FR          50   272    C1729    303.00      0.00
5023544   CATH 5FR HEADHUNTER 1       50   272              60.00      0.00
5023551   CATH 5FR 90CM PIG 90CM      50   272              60.00      0.00
5023577   SHEATH 8FR FLEX             50   272    C1766    193.00      0.00
5023700   GUIDEWIRE FLOPPY 300CM      50   272    C1769    332.00      0.00
5023742   SPLINT WRIST & THUMB RIGH   50   274    L3906    115.25      0.00
5024476   TRAY TWO LUMEN AK12122H     50   272             312.00      0.00
5024518   TRAY PERICARDIOCENTIS       50   272             588.00      0.00
5024542   NEEDLE POTTS COURNA.CATH    50   272              53.00      0.00
5024609   TUBE TRACH SINGLE CANNULA   50   272             122.00      0.00
5024757   CATH SWAN GANZ 831HF7.5     50   272    C1887    191.00      0.00
5024872   CIRCUIT PEDI SS SURGERY     50   272               6.00      0.00
5024898   KIT PEG SAFETY 20FR PUSH    50   272             540.00      0.00
5024930   SLEEVES SCD KNEE LENGTH     50   271             124.00      0.00
5025135   CATH BALLOON LIGHTWAVE 30   50   272    C1725   3019.00      0.00
5025150   CANNULA CORONARY OSTIA P    50   272             124.00      0.00
5025168   FILTER BLOOD TRANSFER       50   272              53.00      0.00
5025176   HOOD STERI SHIELD SYSTEM    50   272              85.00      0.00
5025184   BAG RESUSCITATION PEDS      50   271              39.00      0.00
5025333   TRAY LACERATION SUTURE      50   272              19.00      0.00
5025358   TRAY LACERATION             50   272              24.00      0.00
5025416   PILLOW ABDUCTION MED        50   271              75.00      0.00
5025622   CATH CHOLANGIOGRAPHY 4F     50   272    C1887    117.00      0.00
5025648   CATH FOGARTY EMBOLECTM 4F   50   272    C1757    129.00      0.00
5025655   CATH FOGARTY EMBOLECTM 5F   50   272    C1757    129.00      0.00
5025689   GLOVE RADIATION RESISTANT   50   272             208.00      0.00
5025754   PACK INTRA-COMPART SYSTEM   50   272             239.00      0.00
5025945   VALVE 3                     50   272              66.00      0.00
5025952   VALVE 4                     50   272              70.00      0.00
5025960   DEVICE INFLATION            50   272             386.00      0.00
5025978   DEVICE INFLATION BASIX      50   272             151.00      0.00
5025986   VALVE HEMO DBL              50   272              79.00      0.00
5026000   TRAY EPIDURAL SINGLE SHOT   50   272              64.00      0.00
5026026   SUCTION SURGIWAND II SPT    50   272             136.00      0.00
5026158   TUBE GASTROE MIS SIL/28FR   50   272             161.00      0.00
5026638   SHEET DURALASTIC STRL 030   50   272              93.00      0.00
5026646   SHEET DURALASTIC STRL 020   50   272             107.00      0.00
5026794   CANNULA INTER DISPOSABLE    50   272              34.00      0.00
5026828   PUNCH AORTIC 4MM            50   272             124.00      0.00
5026836   TRAY DIALYSIS DLC800TEC     50   272             303.00      0.00
5026844   KIT PICC 4FR                50   272    C1751    375.00      0.00
5027008   INSERTS FOGARTY 61MM        50   272              90.00      0.00
5027024   WRAP KNEE ARTHROSCOPY       50   271             137.00      0.00
5027032   WRAP SHOULDER ARTHROSCOPY   50   271             224.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5027065   BOOT TRACTION UNIVERSAL B   50   274    L9900     53.75      0.00
5027081   CATH CENTRAL VENOUS MULTI   50   272    C1751    278.00      0.00
5027099   FABRIC CARDIOVSCULAR 1X3"   50   278    C1768   1077.00      0.00
5027131   VALVE TALKING PASSY MUIR    50   272             241.00      0.00
5027180   BLADE SURG SAW DISP NEXGE   50   272             272.00      0.00
5027255   CATH BROVIAC 6.6F SURECUF   50   272    C1751    515.00      0.00
5027297   INTRODUCER VASCULAR 10F     50   272    C1766    253.00      0.00
5027313   BALLOON MAVERICK 1.5 20     50   272    C1725    970.00      0.00
5027321   BALLOON MAVERICK 2.0 20     50   272    C1725    970.00      0.00
5027339   BALLOON MAVERICK 2.5 20     50   272    C1725    970.00      0.00
5027347   BALLOON MAVERICK 3.0 20     50   272    C1725    970.00      0.00
5027354   BALLOON MAVERICK 3.5 20     50   272    C1725    970.00      0.00
5027362   BALLOON MAVERICK 4.0 20     50   272    C1725    970.00      0.00
5027628   SPLINT TENNIS ELBOW SZ ME   50   274    L3700     94.50      0.00
5027636   SPLINT TENNIS ELBOW SZ LA   50   274    L3700     94.50      0.00
5027768   ORTHOSIS ANKLE XLG          50   274    L1902    202.00      0.00
5027776   ORTHOSIS ANKLE MED          50   274    L1902    202.00      0.00
5027818   CATH CONE TIP 5FR           50   272    C1758     48.00      0.00
5028063   CATH EMBOLECTOMY 2FR.       50   272    C1757    451.00      0.00
5028154   TUBE GASTROSTOMY 22FR       50   272              60.00      0.00
5028600   PROBE LACRIMAL SIL 11.7CM   50   272             195.00      0.00
5028618   GUIDEWIRE ANGLED            50   272    C1769    152.00      0.00
5028626   LINE PRESSURE 48"           50   272              10.00      0.00
5028642   GUIDEWIRE BALANCE           50   272    C1769    332.00      0.00
5028659   GUIDEWIRE STEX              50   272    C1769     65.00      0.00
5028667   GUIDEWIRE BENS              50   272    C1769     65.00      0.00
5028691   CATH 7FR AL1                50   272    C1887     52.00      0.00
5028717   CATH 6FR RCB                50   272    C1887     43.00      0.00
5028725   CATH ANGLED PIG MALL        50   272    C1887     43.00      0.00
5028741   TUBE TRACH SINGLE CANNULA   50   272             122.00      0.00
5028758   TUBE TRACH SINGLE CANNULA   50   272             122.00      0.00
5028766   TUBE TRACH SINGLE CANN SZ   50   272             122.00      0.00
5028782   TUBE TRACH LOW PRESSURE S   50   272             155.00      0.00
5028857   CUFF BP ADULT LG 2-TUBE     50   271              46.00      0.00
5028865   CATH THERMOD PACEPORT 7.5   50   272    C1751    249.00      0.00
5028923   CATH TROCAR 20FR            50   272              80.00      0.00
5028964   TRAY PERMCATH DUAL LUMEN    50   272    C1751    728.00      0.00
5029020   DRAIN SUMP TRIPLE ABRAMSO   50   272              90.00      0.00
5029186   ELECTRODE RADIUS 1.0 X 1.   50   272              82.00      0.00
5029194   ELECTRODE RADIUS 2.0 X 0.   50   272              77.00      0.00
5029210   TOURNIQUET STERILE 8"       50   272              65.00      0.00
5029269   CEMENT BONE MIXER           50   272             243.00      0.00
5029350   KIT NOSE STOP               50   272             147.00      0.00
5029376   TRAY DIFFICULT CATH         50   272    C1751    723.00      0.00
5029384   DRAIN SUCTION TRU CLOSE     50   272              79.00      0.00
5029517   TRAY MULTI LUMEM AK22123    50   272             534.00      0.00
5029533   RETAINER FISH VISCERA       50   272             123.00      0.00
5029905   TUBE GASTROSTOMY 16FR.      50   272              60.00      0.00
5029913   TUBE GASTROSTOMY 18FR.      50   272              60.00      0.00
5029921   TUBE GASTROSTOMY 20FR.      50   272              60.00      0.00
5029939   TUBE TRACH FENESTRATED SZ   50   272             173.00      0.00
5029947   SHOE POST OP MENS SZ LARG   50   274    L3260     15.25      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
5029954   SHOE POST OP MENS SZ. SMA   50   274    L3260     15.25      0.00
5030010   TUBE TRACH FENES CUFFED     50   272             168.00      0.00
5030036   TUBE TRACH FENES CUFFLES    50   272             152.00      0.00
5030085   STRIPPER VIEN               50   272              86.00      0.00
5030325   TUBE TRACH CUFFLESS FENES   50   272             193.00      0.00
5030358   SUTURE ANCHOR CRKSCRW 5MM   50   272            1177.00      0.00
5030366   DRAPE MICRO W/TUBE          50   272              33.00      0.00
5030382   CEMENT BONE SIMPLEX         50   272             334.00      0.00
5030408   SPLINT ANKLE FIG 8 SMALL    50   274    L1901     56.00      0.00
5030473   SHOE WOMEN POST OP SZ SMA   50   274    L3260     15.25      0.00
5030705   CATH PIG 4FR 90CM           50   272              68.00      0.00
5030713   CATH HOOK 0.8 4FR           50   272              68.00      0.00
5030952   TOURNIQUET STERILE 12"      50   272              76.00      0.00
5030960   TOURNIQUET STERILE 18"      50   272              84.00      0.00
5030978   TOURNIQUET STERILE 24"      50   272              94.00      0.00
5030986   TOURNIQUET STERILE 30"      50   272             100.00      0.00
5030994   TOURNIQUET STERILE 34"      50   272             108.00      0.00
5031000   TOURNIQUET STERILE 42"      50   272             112.00      0.00
5031166   BLADE MICRO OSC SAW DISP    50   272              31.00      0.00
5031174   BLADE SURGERY SAW DISP 26   50   272              78.00      0.00
5031182   BLADE SURGERY SAW DISP 17   50   272              78.00      0.00
5031190   BLADE SURG SAW DISP BRAZO   50   272             163.00      0.00
5031240   ELECTRODE PACING INTRA 10   50   272    C1730    463.00      0.00
5031273   ELECTRODE KNIFE COLLNS      50   272             374.00      0.00
5031299   ELECTRODE ROLLER LOOP 28F   50   272             310.00      0.00
5031307   LOOP CUTTING 24FR           50   272             258.00      0.00
5031513   BURR DIAMOND OSTEON 162     50   272             346.00      0.00
5031687   BRACE ANKLE (SCOTT) LG.     50   274    L1902     99.50      0.00
5031695   BRACE ANKLE (SCOTT) X-LG    50   274    L1902     68.25      0.00
5031745   TUBE TRACH FENES CUFFED S   50   272             168.00      0.00
5031752   TUBE TRACH FENES CUFFED S   50   272             168.00      0.00
5031794   CATH GUIDE WISE FL4         50   272    C1887    266.00      0.00
5031802   CATH GUIDE WISE FL4SH       50   272    C1887    266.00      0.00
5032073   LOOP CUTTING 22F            50   272             187.00      0.00
5032206   STENT URETERAL POLAR 7X28   50   278    C2617   1425.50      0.00
5032313   MESH DEXON 7"X9"            50   278    C1781    775.00      0.00
5032453   SLING ROLYAN H/ARM II LM    50   271             168.00      0.00
5032511   STENT SINGLE J DIVERSION    50   278    C2625   2112.00      0.00
5032776   TRAY CATH UMBIL VESSEL 3.   50   272    C1751    241.00      0.00
5032784   TRAY CATH UMBIL VESSEL 5.   50   272    C1751    390.00      0.00
5032818   CATH 6FR JL5.0              50   272    C1887     43.00      0.00
5032826   CATH 6FR AR1                50   272    C1887     43.00      0.00
5032834   CATH 6FR LCB                50   272    C1887     43.00      0.00
5032842   CATH 6FR IMA                50   272    C1887     43.00      0.00
5032859   CATH 5FR SIMMONS 2          50   272              60.00      0.00
5032867   GUIDEWIRE SUPER STIF J      50   272    C1769    170.00      0.00
5033048   MINI VIBRATORS              50   271              49.00      0.00
5033097   KNEE NEO WRAP JUMBO         50   274    L1825    290.00      0.00
5033303   CATH 5FR COBRA 1            50   272              60.00      0.00
5033360   LITHOTRIPER DISP 31MM       50   272            1528.00      0.00
5033402   LITHOTRIPER DISP 22MM       50   272            1468.00      0.00
5033535   PACK CATARACT               50   272             576.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
5033600   CURRETTE SPATULA RING       50   272             129.00      0.00
5033766   TUBE TRACH REINFORCED CUF   50   272              34.00      0.00
5033980   CATH MP A2 6FR              50   272    C1887     43.00      0.00
5034012   GUIDEWIRE FLOPPY EXSU .01   50   272    C1769    332.00      0.00
5034087   KIT DBL LUMEN CVC 7FR       50   272    C1751    243.00      0.00
5034269   LEAD WIRES EKG SET/5 UNST   50   271              86.00      0.00
5034343   PROBE IRIGATING OCUTOME     50   272             687.00      0.00
5034467   TRAY HEMODIALYSIS DUEL LU   50   272             439.00      0.00
5034491   BAG INFUSION 1000 CC        50   272              53.00      0.00
5034517   SENSOR MYOCARDIAL TEMP      50   272              68.00      0.00
5034541   HEMOSTAT FIBRILLAR 1"X2"    50   272             193.00      0.00
5034673   SLEEVE SCD KNEE LNGTH V     50   271              55.00      0.00
5034681   CATH URINARY ICN NSY 3.5F   50   272              97.00      0.00
5034699   CATH URINARY ICN NSY 6.5F   50   272              51.00      0.00
5035126   NEEDLE FLEXITIP (000199)    50   272             164.00      0.00
5035134   NEEDLE FLEXITIP (000138)    50   272             133.00      0.00
5035191   SUTURE PDS 2-0 STP10 27"    50   272             110.00      0.00
5035324   SLIPPER COMPRESSION REGUL   50   271             274.00      0.00
5035332   SENSOR OXIMETER NEO/TODD    50   272              60.00      0.00
5035365   SLIPPER COMPRESSION LARGE   50   271             137.00      0.00
5035381   CATH THERM S TIP 604244     50   272    C1751    194.00      0.00
5035407   CATH MONITOR WEDGE 6 FR     50   272    C1751    156.00      0.00
5035431   BALLOON MAVERICK 3.5 9      50   272    C1725    970.00      0.00
5035498   BRACE KNEE PATELLA SZ XLA   50   274    L1800    263.50      0.00
5035688   NEEDLE BIOP HAWKINS 3 20G   50   272              91.00      0.00
5035738   HEMOCONCENTRATOR UNKLE PH   50   272             291.00      0.00
5035852   BALLOON 3 LUMEN RETRIEVAL   50   272    C1725    498.00      0.00
5036116   GUIDEWIRE BABY J            50   272    C1769     44.00      0.00
5036132   CATH COBRA 1 4FR            50   272              68.00      0.00
5036140   CATH 5FR HOOK 0.8           50   272              60.00      0.00
5036157   CATH HOOK 1.0 4FR           50   272              68.00      0.00
5036173   BALLOON UT SDS 5X4X120      50   272    C1725   1141.00      0.00
5036405   NEEDLE ELECTRODE EMG CHAN   50   272             100.00      0.00
5036413   NEEDLE ELECTRODE EMG CHAN   50   272             100.00      0.00
5036553   KNIFE ACL GRAFT 10MM        50   272             254.00      0.00
5036637   STAPLER PREMIUM PLUS CEEA   50   272            1037.00      0.00
5036652   CATH 5FR PIG 65CM           50   272              60.00      0.00
5036660   SHEATH 6FR FLEX             50   272    C1894     99.00      0.00
5037064   CATH 6FR PROGRESSIVE RT     50   272              57.00      0.00
5037122   SPLINT WRIST SML RIGHT      50   274    L3906     36.50      0.00
5037130   BRACE KNEE PATELLA SZ XXL   50   274    L1800    263.50      0.00
5037155   BANDAGE UNA BOOT            50   272              22.00      0.00
5037346   SPONGE STICK KITTNER ENDO   50   272              70.00      0.00
5037353   INJECTOR HUMI               50   272             116.00      0.00
5037411   SPLINT NASAL OVERSZ REUTE   50   272              94.00      0.00
5037429   PACK NASAL SINUS            50   272              58.00      0.00
5037437   CANNULA STRGHT VENOUS 34F   50   272             102.00      0.00
5037445   TRACTION KIT SHOULDER UPP   50   271             139.00      0.00
5037460   PACK SINUS KENNEDY SLIM     50   272              62.00      0.00
5037544   SAC PLEATMAN FOR LAP        50   272             110.00      0.00
5037577   SUCTION DEVICE PUDDLEVAC    50   271              83.00      0.00
5037627   MANIPULATOR KRONNER         50   272             114.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5037742   CATH CHOLE OPERATIVE 4.5F   50   272    C1887    127.00      0.00
5037759   CATH INTR PERITL 9F PI93    50   272    C1751     91.00      0.00
5037981   BALLOON UT SDS 10X2X75      50   272    C1725    758.00      0.00
5037999   CATH 6FR FR 4.0             50   272    C1887     43.00      0.00
5038138   SUTURE GORE TEX CV6 TT-13   50   272              77.00      0.00
5038542   BRUSH CYTOLOGY 1604         50   272             154.00      0.00
5038583   RETRIEVER SUTURE ACUFEX     50   272             146.00      0.00
5038856   ADAPTER UROLOK              50   272              70.00      0.00
5038872   DRAPE TUR PERINEAL          50   272              58.00      0.00
5038914   LOOP RESECT CUTTING 24F     50   272             258.00      0.00
5039383   NEEDLE BIOP HAWKINS 20GX1   50   272              91.00      0.00
5039821   CATH WHISTLE TIP 4FR        50   272    C1758     48.00      0.00
5039847   CATH WHISTLE TIP 5FR        50   272    C1758     48.00      0.00
5039862   CATH WHISTLE TIP 6FR        50   272    C1758     39.00      0.00
5039870   CATH CONE TIP 6FR           50   272    C1758     39.00      0.00
5039920   RETRIEVER STONE GEMINI 4W   50   272             858.00      0.00
5039946   RETRIEVER SEGURA BASKET 4   50   272             706.00      0.00
5039995   BALLOON MAVERICK 2.5 9      50   272    C1725    970.00      0.00
5040340   STENT URETERAL POLAR 6X22   50   278    C2617   1425.50      0.00
5040357   STENT URETERAL POLAR 6X24   50   278    C2617   1425.50      0.00
5040381   STENT URETERAL POLAR 7X24   50   278    C2617   1425.50      0.00
5040399   GUIDEWIRE PTPE COATED 035   50   272    C1769     58.00      0.00
5040415   GUIDEWIRE ANGL 150CMX.035   50   272    C1769    170.00      0.00
5040514   FORCEP GRASPING TRICEP 3P   50   272             826.00      0.00
5040530   PROBE LITHOTRIPTOR 1.9F     50   272             831.00      0.00
5040548   PROBE LITHOTRIPTOR 3F       50   272             778.00      0.00
5040555   PROBE LITHOTRIPTOR 5FR      50   272             552.00      0.00
5040563   PROBE LITHOTRIPTOR 9F       50   272             727.00      0.00
5040571   FELT TEFLON 6X6" MESH       50   278    C1768    994.50      0.00
5040589   FABRIC SAUVAGE VASCU 4X4"   50   278    C1768    818.50      0.00
5040779   BREAST PUMP KIT HOLLISTER   50   272             114.00      0.00
5040811   CANNULA VENOUS MC2          50   272             121.00      0.00
5040878   SPLINT BRIDGEMASTER NASAL   50   272             108.00      0.00
5040985   PACK ORTHOARTS MAJOR        50   272             153.00      0.00
5041454   BRUSH CYTOLOGY #1601        50   272              57.00      0.00
5041520   CATH MULTIPURP              50   272             119.00      0.00
5041652   KIT D&C SUCTION SETUP       50   272              96.00      0.00
5041900   TUBE ENDO DUAL UNIVENT 6.   50   272             581.00      0.00
5041918   TUBE ENDO DUAL UNIVENT 7.   50   272             581.00      0.00
5041926   TUBE ENDO DUAL UNIVENT 7.   50   272             581.00      0.00
5041934   TUBE ENDO DUAL UNIVENT 8.   50   272             581.00      0.00
5041975   CATH LEONARD 10F SURECUFF   50   272    C1751    644.00      0.00
5041983   CATH PORTA 8.FR SINGL/LUM   50   272    C1751    949.00      0.00
5042007   CATH HICKMAN ROUND 12.0F    50   272    C1751    424.00      0.00
5042049   INSERT SURG CLAMP 86MM      50   272              63.00      0.00
5042064   CANNULA SAPHENOUS VEIN      50   272              14.00      0.00
5042429   CATH IRRIGATING FOGARTY 4   50   272             103.00      0.00
5042452   CATH ADHERANT CLOT 5/8      50   272    C1757    778.00      0.00
5042460   CATH ADHERANT CLOT 6/10     50   272    C1757    778.00      0.00
5042536   SUCTION VITALVUE SYSTEM 7   50   272             363.00      0.00
5042544   SUCTION VITALVUE SYSTEM 7   50   272             385.00      0.00
5042551   SHEET BILATERAL LIMB        50   272              70.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5042635   CANNULA ARTERIAL 20F        50   272               68.00      0.00
5042775   TUBE GASTROS MIC SILICON    50   272              166.00      0.00
5042841   LOCATOR NERVE VERI STIM     50   272              152.00      0.00
5042973   TUBE LASER CUFFED 5.5       50   272              249.00      0.00
5042999   TUBE REINFORCED CUFF 6.0    50   272               34.00      0.00
5043005   TUBE REINFORCED CUFF 8.0    50   272               34.00      0.00
5043013   MASK LARYNG LMA AIRWA SZ2   50   272               29.00      0.00
5043062   PUNCH VASCULAR GOOSEN 4.8   50   272              139.00      0.00
5043112   PROBE DILATOR PARSONNETT    50   272              280.00      0.00
5043120   PROBE DILATOR PARSONNETT    50   272              280.00      0.00
5043179   GLOVE CUT RESISTANT SZ ME   50   272              204.00      0.00
5043187   GLOVE CUT RESISTANT SZ LG   50   272              204.00      0.00
5043195   GLOVE CUT RESISTANT SZ XL   50   272              204.00      0.00
5043211   GUIDEWIRE STRGHT TIP        50   272    C1769     170.00      0.00
5043245   KIT ORTHOSORB ABSORB PIN    50   278             5940.00      0.00
5043310   CANNULA ARTHROSCOPY 5.5     50   272               63.00      0.00
5043419   BLADE ARTHRO RAZOR CUT 4.   50   272              245.00      0.00
5043427   CATH FOGARTY BIL PROBE 5F   50   272    C1725     129.00      0.00
5043492   MESH MARLEX PERFIC PLUG     50   278    C1781    1949.25      0.00
5043534   PROSTHESIS MALLEABLE 3.25   50   278    L8613    2773.75      0.00
5043617   SUTURE ANCHOR GII MINI      50   272             1181.00      0.00
5043625   KIT FINGER TRAP SM          50   272              108.00      0.00
5043633   KIT FINGER TRAP MED         50   272              108.00      0.00
5043641   KIT FINGER TRAP LG          50   272              108.00      0.00
5043864   BINDER ABD ELAS UNIV LTXF   50   274    L0625      50.25      0.00
5043872   BINDER ABD ELASTIC XL       50   274    L0625      43.75      0.00
5043948   INTRODUCER MINIPORT 2MM     50   272              171.00      0.00
5044227   PACK C-SECTION CUSTOM       50   272              372.00      0.00
5044334   KIT DIRECT DRAW PLASMA SE   50   272              454.00      0.00
5044383   CANNULA AORTIC ROOT         50   272               59.00      0.00
5044482   BRACE NEOPRENE ELBOW UNIV   50   274    L3700      86.50      0.00
5044805   BINDER ABD ELASTIC XXL      50   274    L0625      58.25      0.00
5045273   GUIDEWIRE PLAT PLUS ST      50   272    C1769     374.00      0.00
5045588   CATH ATLANTIS 6FR US        50   272    C1753    2220.00      0.00
5045604   TUBE BRONCH SZ 37 RIGHT     50   272              314.00      0.00
5045638   SUTURE MERSILENE 3/16X12"   50   272              262.00      0.00
5045687   MASK LARYNG/LMA AIRWY SZ5   50   272               35.00      0.00
5045760   FILTER LEUKODEP DLVR LAB    50   272               70.00      0.00
5045786   STENT SENTINOL 8X42X75      50   278    C1876   10560.00      0.00
5045851   SUTURE SURG STEEL 4-0 V-2   50   272               72.00      0.00
5046040   LIGACLIP MCS SMALL 20/20    50   272              673.00      0.00
5046255   TRAY DIALYSIS MCDLTSLI5 S   50   272              457.00      0.00
5046263   TRAY DIALYSIS MCDLTSL20 S   50   272              457.00      0.00
5046388   CATH URETH/FOLLWR 14 FR     50   272              214.00      0.00
5046396   CATH URETH/FOLLWR 8 FR      50   272              214.00      0.00
5046693   CANNULA FLEXARCH STRGHT 2   50   272               72.00      0.00
5046776   SUTURE TI-CRON 2-0 CV316    50   272              507.00      0.00
5046859   BRACE KNEE PATELLA SZ LAR   50   274    L1800     263.50      0.00
5046867   BRACE KNEE PATELLA SZ MED   50   274    L1800     263.50      0.00
5046982   SPLINT WRIST AND THUMB LG   50   274    L3906      88.00      0.00
5047055   DRAPE IOBAN SZ 90CMX85CM    50   272               45.00      0.00
5047378   CATH 6FR JL3.5              50   272    C1887      43.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5047394   BALLOON MAVERICK 4.0 9      50   272    C1725    970.00      0.00
5047436   BALLOON MAVERICK 3.0 12     50   272    C1725    970.00      0.00
5047907   BLADE ARTHRO STONE CUT 4.   50   272             252.00      0.00
5047915   BLADE ARTHRO STONE CUT 5.   50   272             252.00      0.00
5048210   GUIDEWIRE IRONMAN           50   272    C1769    415.00      0.00
5048228   BALLOON MAVERICK 2.0 12     50   272    C1725    970.00      0.00
5048236   GUIDEWIRE FLOPPY .018       50   272    C1769    384.00      0.00
5048244   KIT CARPAL LIG.TUNNEL REL   50   272             690.00      0.00
5048269   CATH URETH/FOLLWR 10 FR     50   272             214.00      0.00
5048830   CUTTER 3.5MM AGGRESSIVE I   50   272             370.00      0.00
5048848   CUTTER 4.0MM AGGRESSIVE I   50   272             396.00      0.00
5048855   CASSETTE DISP HUMMER2       50   271             137.00      0.00
5048863   DRAIN BLAKE 15F R HUBLESS   50   272              71.00      0.00
5048871   BRACE ANKLE (SCOTT) MED     50   274    L1902     73.50      0.00
5048897   CATH 5FR FL4                50   272    C1887     43.00      0.00
5048905   CATH 5FR FR4                50   272    C1887     43.00      0.00
5048913   CATH 5FR PIGTAIL            50   272    C1887     43.00      0.00
5049036   BALLOON UT SDS 4X4X75       50   272    C1725    758.00      0.00
5049044   CATH PIGTAIL 6FR            50   272              43.00      0.00
5049119   BLADE INCISOR ORBIT 4.5MM   50   272             326.00      0.00
5049135   BLADE INCISOR 5.5MM         50   272             247.00      0.00
5049143   BLADE SYNOVATOR 5.5MM       50   272             247.00      0.00
5049150   BLADE INCISOR PLUS 4.5MM    50   272             245.00      0.00
5049192   BLADE STONE CUTTER 4.0MM    50   272             252.00      0.00
5049226   SET PUMP TUBE               50   272             235.00      0.00
5049937   BALLOON MAVERICK 3.0 9      50   272    C1725    970.00      0.00
5049994   PACK ANTERIOR CERVICAL      50   272             372.00      0.00
5050414   SET INSUFFLATION (AIR)      50   272             104.00      0.00
5050422   PAC VISUAL IMPLATATION Y-   50   272             731.00      0.00
5050612   CATH 6FR JR 5.0             50   272    C1887     43.00      0.00
5050620   CATH 6FR AL1                50   272    C1887     43.00      0.00
5051453   CATH PORTA XPORT 6.FR 1LU   50   272    C1788   1416.00      0.00
5051487   DEVICE CLOS SYS PERCLO 6F   50   278    C1760   2068.00      0.00
5052170   CATH GUIDE JR4.5 ST         50   272    C1887    245.00      0.00
5052196   PATCH HEMASHIELD 2X6"       50   278    C1768   2685.25      0.00
5052774   PROBE V/PACING              50   272             478.00      0.00
5052980   BLADE SYNOVATOR ORBIT 4.5   50   272             326.00      0.00
5053582   DRAIN BLAKE ROUND 15FR      50   272              63.00      0.00
5054036   CATH 6FR JL 6.0             50   272    C1887     43.00      0.00
5054192   CATH SWAN NECK LEFT         50   272    C1751    745.00      0.00
5054788   HEMOSTAT NU-KNIT 6X9"       50   272             427.00      0.00
5054796   TUBE GASTROSTOMY 24FR       50   272              60.00      0.00
5054929   CATH TURBOTRACKER           50   272    C1887   1636.00      0.00
5054937   COIL INTRAVASCULAR DIAMON   50   278             716.00      0.00
5054945   COIL INTRAVASCULAR DIAMON   50   278             695.25      0.00
5055041   CANNULA ARTERIAL FEM W/LL   50   272             461.00      0.00
5055355   BALLOON UT SDS 8X4X135      50   272    C1725    758.00      0.00
5055363   CATH 5FR FR 3.5             50   272    C1887     43.00      0.00
5055397   CATH 5FR FL 3.5             50   272    C1887     43.00      0.00
5055405   CATH 5FR FL 5               50   272    C1887     43.00      0.00
5055439   CATH 5FR AL1                50   272    C1887     43.00      0.00
5055447   CATH 5FR IM                 50   272    C1887     43.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5055561   INSTR DISP ENDOCLIP 5MM     50   272              726.00      0.00
5055835   PROBE HEMOSTASIS BIPOLAR    50   272             1037.00      0.00
5055850   STENT SENTINOL 8X60X75      50   278    C1876   10560.00      0.00
5055975   GUIDEWIRE GLIDE J           50   272    C1769     152.00      0.00
5055983   BALLOON UT SDS 8X2X75       50   272    C1725    1081.00      0.00
5055991   BALLOON MAVERICK 2.5 12     50   272    C1725     970.00      0.00
5056213   SET INTRODUCER POSI STICK   50   272              316.00      0.00
5056221   DRAPE MICRO FOR ZEISS MD    50   272               94.00      0.00
5056247   LOOP RESECTOSCOP CUTG 24F   50   272              305.00      0.00
5056320   GUIDEWIRE CHOICE PT EXSU    50   272    C1769     376.00      0.00
5056338   GUIDEWIRE LLT               50   272    C1769      55.00      0.00
5056684   SUTURE STEEL #5 B-P 18"     50   272             3230.00      0.00
5056734   BALLOON MAVERICK 2.0 15     50   272    C1725     970.00      0.00
5056759   GUIDEWIRE BENTSON EX        50   272    C1769      72.00      0.00
5056932   NEEDLE BIOPSY 18GA 15CM     50   272              183.00      0.00
5057005   BLADE MINI ARTHRO FULL #3   50   272              247.00      0.00
5057013   BLADE MINI ARTHRO FULL #3   50   272              245.00      0.00
5057260   SET INTRODUCER STENT 10     50   272    C1894     398.00      0.00
5057302   PAD DEFIB ELECTRO STRL ST   50   272              159.00      0.00
5057328   QUICKANCHOR GII EASY ANCH   50   278              841.25      0.00
5057427   BLADE MANDIBULAR OS 11.5    50   272              607.00      0.00
5057435   BLADE RECIPROCATING 27.0    50   272              302.00      0.00
5058128   CATH GLIDE 5FR ANGL 100CM   50   272    C1887     270.00      0.00
5058136   CATH SIMMONS 1 4FR          50   272               87.00      0.00
5058144   CATH 5FR HOOK 1.0           50   272               60.00      0.00
5058409   CARTRIDGE BOWL PRESSURIZR   50   272              430.00      0.00
5059068   SET CATH H/S 5FR            50   272              102.00      0.00
5059779   CATH 6FR AL2                50   272    C1887      43.00      0.00
5059829   KIT PICC 5FR                50   272    C1751     464.00      0.00
5059985   REAMER CANN COR W/COLLPIN   50   272              818.00      0.00
5059993   REAMER CANN COR W/COLLPIN   50   272              818.00      0.00
5060009   KIT TRTREX TRANSTIBIAL AC   50   272              602.00      0.00
5060017   SCREW CANN/INTERF 7X20MM    50   278    C1713    1012.00      0.00
5060025   SCREW CANN INTERF 7X25MM    50   278    C1713    1012.00      0.00
5060033   SCREW CANN INTERF 8X20MM    50   278    C1713    1012.00      0.00
5060041   SCREW CANN INTERF 8X25MM    50   278    C1713    1012.00      0.00
5060066   SCREW CANN INTERF 9X25MM    50   278    C1713    1012.00      0.00
5060173   SET MINI LIFE SET DIALYSI   50   272              179.00      0.00
5060561   SUTURE ANCHOR CORKSCREW 5   50   272              747.00      0.00
5060579   PUSHER KNOT 6TH FINGER      50   272              332.00      0.00
5060595   CANNULA TWIST IN CLEAR 8.   50   272              104.00      0.00
5060603   SUTURE LASSO                50   272              478.00      0.00
5060967   OXYMIZER PEDANT             50   272               55.00      0.00
5061148   CIRCUIT HOOD                50   272               56.00      0.00
5061155   BAG HYPRNFLTN 1/2L NOMASK   50   272               46.00      0.00
5061288   CATH UMB DOUBLE LUMEN 3.5   50   272    C1751     114.00      0.00
5061817   MASK BI PAP SM              50   271               63.00      0.00
5061825   MASK BIPAP NASAL MED/LGW/   50   271               63.00      0.00
5062179   SET COLON DECOMPRESSION     50   272              374.00      0.00
5062328   TRAY ARTHROGRAM DBL SNGL    50   272              151.00      0.00
5062427   BLADE SAW 1"                50   272              573.00      0.00
5062526   INSTRUMENT ENDO GIA II 1    50   272              415.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5062534   LOAD UNIT ENDO GIA II 45-   50   272              367.00      0.00
5062542   LOAD UNIT ENDO GIA II 30-   50   272              367.00      0.00
5062559   LOAD UNIT ENDO GIA II 30-   50   272              367.00      0.00
5062567   LOAD UNIT ENDO GIA II 45-   50   272              367.00      0.00
5062633   BALLOON UT SDS 6X4X120      50   272    C1725    1081.00      0.00
5063003   PROBE HOOKED KNIFE CURVED   50   272              493.00      0.00
5063227   STENT SENTINOL 7X59X75      50   278    C1876   10560.00      0.00
5063359   MASK LARYNG LMA SZ3 DISP    50   272               56.00      0.00
5063367   MASK LARYNG LMA SZ4 DISP    50   272               56.00      0.00
5063490   ULTRATOME DLWG 30MM STD T   50   272              743.00      0.00
5063730   KIT POST OPEN HEART         50   272               83.00      0.00
5063763   CATH IV ANGIO 16GAX1 1/4"   50   272    C1751      11.00      0.00
5064092   STENT VISION 3.0 12         50   278    C1876   10956.00      0.00
5064233   GUIDEWIRE BMW 175CM         50   272    C1769     332.00      0.00
5064241   GUIDEWIRE BMW 300CM         50   272    C1769     332.00      0.00
5064340   BALLOON UT SDS 5X2X135      50   272    C1725     758.00      0.00
5064357   BALLOON UT SDS 6X2X135      50   272    C1725     758.00      0.00
5064464   LOAD UNIT ENDO GIA II 30-   50   272              860.00      0.00
5064472   LOAD UNIT ENDO GIA II 60-   50   272              958.00      0.00
5064480   LOAD UNIT ENDO GIA II 60-   50   272              958.00      0.00
5064613   FORCEP LG CAP W/NEEDLE      50   272              259.00      0.00
5064621   FORCEP LG CAP W/O NEEDLE    50   272              286.00      0.00
5064639   FORCEP LG CAP W/NEEDLE 24   50   272              259.00      0.00
5064787   BLADE SHARP HOOK 10CM       50   272              436.00      0.00
5064811   CATH 5FR PIG ANG            50   272    C1887      43.00      0.00
5064910   BALL GREEN PHYSIO GYMNIC    50   271               35.00      0.00
5064936   SUTURE ETHIBOND 2-0 STP-1   50   272              116.00      0.00
5064993   SET PNEUMO THORAX           50   272              419.00      0.00
5065297   GUIDEWIRE STRAIGHT .020     50   272    C1769     497.00      0.00
5065685   SHEATH SUPER 7FR MT         50   272    C1766      73.00      0.00
5065933   SHEATH SUPER 6FR MT         50   272    C1766      71.00      0.00
5066113   BINDERS ABDOMINAL LARGE     50   274    L0625     308.00      0.00
5066758   CANNULA SOFT TIP CORONARY   50   272               94.00      0.00
5066782   BALLOON UT SDS 4X4X120      50   272    C1725    1141.00      0.00
5066790   GUIDEWIRE SUPER STIF J 26   50   272    C1769     178.00      0.00
5066865   STENT SENTINOL 9X21X75      50   278    C1876   10560.00      0.00
5067087   SYSTEM INFLATION            50   272              162.00      0.00
5067236   PACK ARTHROSCOPY KNEE       50   272              371.00      0.00
5067244   PACK ACL                    50   272              914.00      0.00
5067251   PACK SHOULDER ARTHROSCOPY   50   272              328.00      0.00
5067269   PACK LAPAROSCOPY            50   272              679.00      0.00
5067392   KIT TOTAL HIP REPLACEMENT   50   272              303.00      0.00
5067715   CATH 6FR JR3.5              50   272    C1887      43.00      0.00
5067723   CATH SIMMONS 2 4FR          50   272               68.00      0.00
5067806   BRACE COMFRT/ELBOW SUPP L   50   274    L3701      54.25      0.00
5067996   GUIDEWIRE JAG               50   272    C1769     602.00      0.00
5068283   CATH DRAINAGE 14FR          50   272    C1729     307.00      0.00
5068572   BLADE CUTTLER AGGRESSIVE    50   272              396.00      0.00
5068606   BAG DRAINAGE                50   271               55.00      0.00
5068754   BLADES DERMATOME ZIMMER     50   272              112.00      0.00
5068770   MESHERCARRIER SKIN GRAFT    50   272               97.00      0.00
5069240   PROBE GOLD INJECTION 10FR   50   272             1317.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5069265   IMMOBILIZER SHOULDER LG     50   274    L3651     19.75      0.00
5069323   NEEDLE BIOPSY ASAP 15GA 1   50   272             183.00      0.00
5069331   DRESSING ADHESIVE INTERCE   50   272             796.00      0.00
5069406   BALLOON DIALATOR 8-10MM     50   272    C1726    929.00      0.00
5069471   PROBE GOLD INJECTION 7FR    50   272            1317.00      0.00
5069489   PROBE GOLD DIRECT 10FR      50   272             685.00      0.00
5069919   CATH GUIDE WISE Q4          50   272    C1887    266.00      0.00
5069950   BAG RESUSCITATION NEONT/D   50   271              67.00      0.00
5070248   CATH BALL DILATOR 12-15MM   50   272    C1726    929.00      0.00
5070255   BALLOON DIALATOR 12-15CM    50   272    C1726    937.00      0.00
5070495   PACK TOTAL KNEE             50   272             631.00      0.00
5070503   PACK TOTAL HIP              50   272             821.00      0.00
5070545   BRUSH CYTOLOGY RX           50   272             453.00      0.00
5070842   CATH COBRA 2 4FR            50   272              87.00      0.00
5071295   STAPLER PROTACK 5MM W/FAS   50   272            1596.00      0.00
5071303   BALLOON DIALATOR 18-20MM    50   272    C1726    937.00      0.00
5071311   BALLOON DIALATOR 15-18MM    50   272    C1726    957.00      0.00
5071519   ELECTRODE SIDE EFFECT 3.5   50   272             768.00      0.00
5072079   BINDER ABDOMINAL XXXLG      50   274    L0625    308.00      0.00
5072087   BINDER ABDOMINAL XLG        50   274    L0625    308.00      0.00
5072194   BALLOON DIALATOR 6-8MM      50   272    C1726    798.00      0.00
5072269   CATH BILIARY DRAINAGE       50   272    C1729    295.00      0.00
5072285   KIT CATH FIXATION 8FR       50   272              52.00      0.00
5072293   CATH NEPHRO                 50   272    C1729    303.00      0.00
5072327   CATH 6FR AR2                50   272    C1887     43.00      0.00
5072715   STENT BILLIARY 10F 7CM      50   278    C2617    176.50      0.00
5072830   GUIDEWIRE ROSEN             50   272              48.00      0.00
5072897   MESH SURGIPRO MONOFIL 1X4   50   278    C1781    721.50      0.00
5072905   MESH SURGIPRO MONOFIL 3X5   50   278    C1781    994.50      0.00
5072921   MESH SURGIPRO MONOFIL 14X   50   278    C1781   1042.25      0.00
5073184   PILLOW ABD ULTRSLING II L   50   271             224.00      0.00
5073226   SNARE OVAL STANDARD CAPTI   50   272    C1773     66.00      0.00
5073234   SNARE OVAL MICRO CAPTIFLE   50   272    C1773     66.00      0.00
5073242   SNARE OVAL MINI CAPTIFLEX   50   272    C1773     66.00      0.00
5073788   SHEATH BANANA PEEL          50   272             212.00      0.00
5073978   IMPLANT HERNIA SM CIRCLE    50   278    C1781   2591.50      0.00
5074026   PILLOW POSTURE NECK ROYLA   50   271              68.00      0.00
5074398   SHEET DURALASTIC STRL 010   50   272             107.00      0.00
5074711   FEEDER HABERMAN             50   272              52.00      0.00
5074992   BALLOON UT SDS 7X4X75       50   272    C1725    758.00      0.00
5075031   SHUNT INTRACORONARY 1.5MM   50   272             311.00      0.00
5075049   SHUNT CTS FLO COIL 2.0      50   272             311.00      0.00
5075056   SHUNT INTRACORONARY 2.25    50   272             311.00      0.00
5075064   SHUNT INTRACORONARY 2.5     50   272             311.00      0.00
5075072   SHUNT INTRACORONARY 3.0     50   272             311.00      0.00
5075155   MASK LARYNG LMA AIRWA 2.5   50   272              32.00      0.00
5075296   BALLOON UT SDS 6X4X75       50   272    C1725    758.00      0.00
5075395   SHUNT INTRACORONARY 1.75    50   272             311.00      0.00
5075932   GRIP POWER HAND             50   271              71.00      0.00
5076054   DEVICE CLOSURE 6FR ANGIOS   50   278    C1760    912.25      0.00
5076419   LOAD UNIT ENDO GIA II 4.5   50   272             367.00      0.00
5076427   STAPLER PREMIUM CEEA 28 D   50   272            1037.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5076476   SUCTION SURGIWAND II 5MM    50   272              136.00      0.00
5076583   CATH GUIDE RWY 6FR JL4      50   272    C1887     266.00      0.00
5076591   CATH GUIDE RWY 6FR JL3.5    50   272    C1887     266.00      0.00
5076609   CATH GUIDE RWY 6FR AL1      50   272    C1887     266.00      0.00
5076617   CATH GUIDE RUNWAY 6F AL2    50   272    C1887     266.00      0.00
5076625   CATH GUIDE RUNWAY 6F HS     50   272    C1887     313.00      0.00
5076633   CATH GUIDE RWY 6FR JR4      50   272    C1887     266.00      0.00
5076641   CATH 6FR KIMNY              50   272    C1887      43.00      0.00
5076658   CATH GUIDE RWY 6FR KIMNY    50   272    C1887     266.00      0.00
5076674   CATH GUIDE RUNWAY 6FR MP    50   272    C1887     266.00      0.00
5076914   STENT BILIARY RX 10CM 7FR   50   278    C2625    1012.00      0.00
5076922   STENT BILIARY RX 12CM 7FR   50   278    C2625    1012.00      0.00
5076948   STENT BILIARY RX 7CM 10FR   50   278    C2625    1012.00      0.00
5076963   STENT BILIARY RX 5CM 10FR   50   278    C2625    1012.00      0.00
5077136   BLADE MINI RECIPROCATING    50   272              302.00      0.00
5077144   PROBE BILATOR PARSONNETT    50   272              280.00      0.00
5077151   PROBE BILATOR PARSONNETT    50   272              280.00      0.00
5077276   TRAY PERICARDIOCENTESIS     50   272              574.00      0.00
5077284   VALVE 1                     50   272               60.00      0.00
5077300   TUBE TRACH CUFFLESS SZ 8    50   272              168.00      0.00
5077318   TUBE TRACH CUFFLESS SZ 10   50   272              152.00      0.00
5077342   TUBE TRACH CUFFLESS SZ 8    50   272              147.00      0.00
5077474   KNIFE MINI CARPAL TUNNEL    50   272              432.00      0.00
5077573   SUTURE RETRIEVER SMALL      50   272              195.00      0.00
5077581   SUTURE RETRIEVER MEDIUM     50   272              195.00      0.00
5077599   SUTURE RETRIEVER LARGE      50   272              195.00      0.00
5077615   BALLOON UT SDS 6X2X75       50   272    C1725     758.00      0.00
5077656   SPONGE TONSIL X-RAY STRG.   50   272               10.00      0.00
5077847   SUTURE ETHIBOND 2-0 V-5 3   50   272              724.00      0.00
5078217   BAG BLOOD WARMING STD FLW   50   272               41.00      0.00
5078308   KIT FEMORAL PREP            50   272              473.00      0.00
5078340   BALLOON UT SDS 8X4X75       50   272    C1725     758.00      0.00
5078357   BALLOON MAVERICK 1.5 9      50   272    C1725     970.00      0.00
5078639   BALLOON MAVERICK 3.5 12     50   272    C1725     970.00      0.00
5078647   CATH 5FR SIM 1              50   272               68.00      0.00
5078720   SET INTRODUCER MICRO PUN.   50   272    C1894     127.00      0.00
5078738   SET INTRODUCER MICRO PUN    50   272              204.00      0.00
5078837   SUTURE NUROLON 4-0 TF 8-1   50   272              111.00      0.00
5078928   CUP MUSHROOM EXTRACTOR      50   272               81.00      0.00
5079041   MESH GRAFT DUAL 20X30       50   278    C1781   14880.75      0.00
5079074   MESH GRAFT 10 X 15 DUAL     50   278    C1781    4056.75      0.00
5079207   INTRODUCER VASCULAR 7FR     50   272    C1892     177.00      0.00
5079231   BRACE WRIST D RING LG       50   274    L3763      55.50      0.00
5079397   DRAPE BI-LVL SURG TBL LRG   50   272              130.00      0.00
5079462   SHEATH NEEDLE TLA           50   272              106.00      0.00
5080270   SPRING FINGER EXT. ASST.    50   271               59.00      0.00
5080692   BLADE RD IRRIGATED BUR      50   272              396.00      0.00
5080742   CLIP LIGATING & MARKING S   50   272               15.00      0.00
5080759   CLIP LIGATING & MARKING M   50   272               17.00      0.00
5080767   CLIP LIGATING & MARKING L   50   272               34.00      0.00
5081252   BALLOON UT SDS 10X4X75      50   272    C1725     758.00      0.00
5081609   STENT LIBERTE 4.0 32        50   278    C1876    8360.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5081617   STENT LIBERTE 3.0 16        50   278    C1876    8360.00      0.00
5081658   STENT LIBERTE 4.0 24        50   278    C1876    8360.00      0.00
5081674   STENT EXPRESS 2 3.0 24      50   278    C1876    8360.00      0.00
5081690   STENT LIBERTE 4.0 16        50   278    C1876    8360.00      0.00
5081708   STENT EXPRESS 2 3.5 16      50   278    C1876    8360.00      0.00
5082011   SYSTEM NEPHROSTOMY CATH     50   272    C1729     686.00      0.00
5082029   SYSTEM BILIARY CATHETER     50   272    C1729     686.00      0.00
5082110   ADHESIVE SKIN INDERMAL      50   272               86.00      0.00
5082128   SUTURE TI-CRON 5-0 CV-11    50   272              181.00      0.00
5082219   MESH GRAPH DUAL 8.0X12.X1   50   278    C1781    4056.75      0.00
5082664   STENT VISION 4.0 18         50   278    C1876   10956.00      0.00
5082904   BALLOON MAVERICK 2.0 9      50   272    C1725     970.00      0.00
5083035   BALLOON UT SDS 4X2X75       50   272    C1725     758.00      0.00
5083472   CATH AORTIC ROOT 9FR        50   272               93.00      0.00
5083571   GUIDEWIRE GLIDE STRAIGHT    50   272    C1769     152.00      0.00
5083647   CANNULA TWIST 6X7           50   272              104.00      0.00
5083654   CANNULA TWIST 6MMX9MM       50   272              104.00      0.00
5083704   NEEDLE BIOPSY ASAP 18X21C   50   272              183.00      0.00
5083712   NEEDLE BIOPSY ASAP 18X10C   50   272              183.00      0.00
5084587   STENT LIBERTE 3.5 8         50   278    C1876    8360.00      0.00
5085642   CATH GUIDE RUNWAY 6FR IM    50   272    C1887     266.00      0.00
5085667   CATH GUIDE RWY 6FR JL4.5    50   272    C1887     266.00      0.00
5085675   CATH GUIDE RUNWAY 6FR AR1   50   272    C1887     266.00      0.00
5085683   CATH GUIDE RWY 6FR IM85     50   272    C1887     313.00      0.00
5085691   CATH GUIDE RWY 6FR AR2      50   272    C1887     266.00      0.00
5085709   CATH GUIDE RWY 6FR JL5      50   272    C1887     266.00      0.00
5085717   CATH GUIDE RWY 6FR JR5      50   272    C1887     266.00      0.00
5085865   CATH GUIDE MACH1 7FR FR4    50   272    C1887     266.00      0.00
5085907   CATH GUIDE MACH1 7FR AL1    50   272    C1887     266.00      0.00
5086137   GUIDEWIRE SHINOBI 300CM     50   272    C1769     415.00      0.00
5086152   CATH 5FR COBRA 2            50   272               60.00      0.00
5086236   CATH 5FR AR2                50   272    C1887      43.00      0.00
5086244   CATH 5FR RCB                50   272    C1887      43.00      0.00
5086251   CATH 5FR LCB                50   272    C1887      43.00      0.00
5086269   CATH 5FR MP2                50   272    C1887      43.00      0.00
5086764   GUIDEWIRE JAG STRAIGHT      50   272    C1769     621.00      0.00
5086921   SHEATH 6FR UP & OV          50   272    C1894     235.00      0.00
5086939   SHEATH 7FR UP & OV          50   272    C1894     249.00      0.00
5086947   BLADE OSCILLATING 1/2" UN   50   272              536.00      0.00
5086954   CATH HICKMAN 9.6 SURECUFF   50   272    C1751     519.00      0.00
5087960   CATH PIGTAIL MINI 10FR      50   272    C1729     307.00      0.00
5088042   HEMO VALVE/TORQUE           50   272               87.00      0.00
5088141   CATH GUIDE RUNWAY 6FR Q4    50   272    C1887     266.00      0.00
5088166   CATH GUIDE RUNWAY 6FR LCB   50   272    C1887     266.00      0.00
5088174   CATH GUIDE RUNWAY 6F RCB    50   272    C1887     266.00      0.00
5088190   CATH GUIDE 6FR AR1          50   272    C1887     187.00      0.00
5088208   CATH URINARY ICN NSY 5.0F   50   272               21.00      0.00
5088455   CATH GUIDE RWY 6FR JR3.5    50   272    C1887     266.00      0.00
5088703   SHEETING GEL SILICONE       50   271              103.00      0.00
5088778   SHEARS ULTRA AUTO SONIC 5   50   272             1171.00      0.00
5088885   CATH VITEK 5FR              50   272    C1887      64.00      0.00
5089644   STENT SENTINOL 8X60X135     50   278    C1876   10560.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
5089669   KIT TRANSDUCE COVER ULTRS   50   272              52.00      0.00
5089842   TRAY PROC GROSHONG 5.0 FR   50   272             498.00      0.00
5090840   HARNESS STERNUM SUPPRT RG   50   274    L0210    307.50      0.00
5090857   HARNESS STERNUM SUPPRT LG   50   274    L0210    307.50      0.00
5090931   SHEATH FLEX 7FR 24CM        50   272    C1894    193.00      0.00
5091376   BLADE STONE CUTTR 4.0MM V   50   272              90.00      0.00
5091426   SUCTION SURGIWAND II 5MMV   50   272             106.00      0.00
5091541   ELECTRODE VAPOR 90 DEGR V   50   272             224.00      0.00
5091822   BLADE PADGETT HOOD 252 V    50   272              24.00      0.00
5091848   BLADE ARTH/STONE CUT 4.0V   50   272              90.00      0.00
5091855   BLADE ARTH/STONE CUT 5.5V   50   272              90.00      0.00
5091871   BLADE INCISOR 5.5MM V       50   272              90.00      0.00
5091897   BLADE INCISOR PLUS 4.5MM    50   272              90.00      0.00
5091905   BLADE INCISOR PLUS 5.5MMV   50   272             108.00      0.00
5091954   FORCEP LG CAP W/NDL 240CV   50   272              58.00      0.00
5091962   FORCEP LG CAP W/O NDL 240   50   272              58.00      0.00
5091970   FORCEP LG CAP W/NDL 160CM   50   272              58.00      0.00
5092028   BLADE ARTH/ABR NBLAST 5.5   50   272              90.00      0.00
5092051   BLADE ARTH/FULL RADIUS 4.   50   272              90.00      0.00
5092119   BLADE MINI ART/FULL 3410V   50   272              74.00      0.00
5092259   BLADE RD IRRIGATED BUR V    50   272              91.00      0.00
5092549   BALLOON NC RANGR 4.0 15MV   50   272    C1725   1162.00      0.00
5092572   BALLOON Q RANGER 2.5 20 V   50   272    C1725   1162.00      0.00
5092754   SHEARS LAB DISP 5MM         50   272             105.00      0.00
5092770   LIGACLIP MCS SMALL 20/20    50   272              91.00      0.00
5092929   CATH THERMO 6FR             50   272    C1751    192.00      0.00
5093018   SLIPPER COMPRESSION REG V   50   271             108.00      0.00
5093570   CATH 5FR WILLIAMS RIGHT     50   272    C1887     43.00      0.00
5093711   ENDO BABCOCK LAP DISP       50   272             105.00      0.00
5093729   INSTR DISP DISSECT 5MM V    50   272             105.00      0.00
5093927   STAPLER PREM SURG W.TIA 9   50   272              83.00      0.00
5094040   TOURNIQUET STERILE 8"       50   272              41.00      0.00
5094362   DEVICE INFLAT/MONARCH 25    50   272              95.00      0.00
5094388   SUCTION SURGIWAND II 5MM    50   272              60.00      0.00
5094636   ELECTRODE ROUND 3" 900 S    50   272              38.00      0.00
5095559   PROBE ABLATOR 60 DEGREE     50   272             552.00      0.00
5095708   BLADE ARTHRO FULL RAD 5.5   50   272              90.00      0.00
5095716   BLADE ARTHRO INCISOR 4.5M   50   272              90.00      0.00
5096110   DRAIN BLAKE 10F RD HUBLES   50   272              63.00      0.00
5096177   TRAY PIE GROSHONG 4F INTR   50   272    C1751    403.00      0.00
5096185   INTRODUCER MICRO/RAD 4.5    50   272    C1894    158.00      0.00
5096367   DEVICE PERCUSSION LOW FLW   50   271             162.00      0.00
5096375   DEVICE PERCUSSION HI/FLOW   50   271             162.00      0.00
5096458   INSTR VASC GOOSEN PUNCH     50   272             150.00      0.00
5096813   STENT URETERAL POLAR 6X26   50   278    C2617   1425.50      0.00
5096862   WIRE TEMP PACING            50   272             256.00      0.00
5096946   TROCAR VERSAPORT SLEEVE 5   50   272              82.00      0.00
5096953   TROCAR VERSAPORT RADIO 5M   50   272             154.00      0.00
5097019   DEVICE LASER DEL ENDSTAT    50   272             116.00      0.00
5097134   CATH STONE BASKET 2X4       50   272    C1769   1389.00      0.00
5097449   GRAFT MESH LARGE            50   278    C1781   2595.75      0.00
5097456   ROD 3.0 GUIDE STR BALL TP   50   272             417.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5097480   GRAFT MESH EXTENDED         50   278    C1781    2751.50      0.00
5097498   STENT BILIARY CLSO10-5      50   278    C2617     446.75      0.00
5097589   TUBING INTELIJET PUMP V     50   272               83.00      0.00
5098157   SUTURE/ETHBND 3-0 SH 30"V   50   272                4.00      0.00
5098439   TROCAR VRSPT RADIO 5-12MV   50   272              166.00      0.00
5098579   MASK CPAP FULL FACE-SMALL   50   271               95.00      0.00
5098587   SLIPPER COMPRESSION LG V    50   271              108.00      0.00
5098595   MASK CPAP FULL FACE-MED     50   271               95.00      0.00
5098603   MASK CPAP FULL FACE-LARGE   50   271               95.00      0.00
5098629   DRAPE MICROSCOPE 4862CL     50   272               48.00      0.00
5098884   CATH GUIDE 6FR JL3.5SH      50   272    C1887     270.00      0.00
5100151   STENT SENTINOL 5X80X135     51   278    C1876   10560.00      0.00
5100169   STENT SENTINOL 10X21X75     51   278    C2625   10560.00      0.00
5100250   DRAPE IOBAN C-ARM ATIM 2V   51   272               44.00      0.00
5100284   STENT EXPRESS 2 2.5 8       51   278    C1876    8360.00      0.00
5100318   STENT LIBERTE 3.0 12        51   278    C1876    8360.00      0.00
5100326   STENT LIBERTE 3.0 20        51   278    C1876    8360.00      0.00
5100334   STENT LIBERTE 3.5 12        51   278    C1876    8360.00      0.00
5100359   STENT LIBERTE 4.0 12        51   278    C1876    8360.00      0.00
5100367   STENT LIBERTE 4.0 20        51   278    C1876    8360.00      0.00
5100391   SEALS SCOPE WARMER DISP     51   272               18.00      0.00
5100805   DRAIN BLAKE 19F R HUBLESS   51   272               71.00      0.00
5100813   BLADE GRAFT HARVST SAW #8   51   272              538.00      0.00
5100862   BLADE GRAFT HARVST SAW#11   51   272              463.00      0.00
5100870   HALTER HEAD UNIVERSAL       51   272               85.00      0.00
5100953   GLOVE EDEMA L SMALL         51   271               18.00      0.00
5101159   PROBE ABLATOR 90 DEGREE     51   272              659.00      0.00
5101167   COIL INTRAVASCLR 6 40 2.4   51   278              484.00      0.00
5101175   COIL INTRAVASCLR 6 40 2.6   51   278              396.00      0.00
5101183   COIL INTRAVASCLR 7 40 2.3   51   278              396.00      0.00
5101209   COIL INTRAVASCLR 4 30 2.9   51   278              484.00      0.00
5101233   SUTURE GUIDE GABBAY-FRATE   51   272              236.00      0.00
5101258   BALLOON XXL 12X4X75         51   272    C1725    1134.00      0.00
5101423   INSTRUMENT PUNCH GOOSEN 4   51   272              153.00      0.00
5101498   DRAPE MICRO                 51   272               58.00      0.00
5101522   HOOD O2 DISPOS W/DIFFUSER   51   271               44.00      0.00
5101647   BLANKET CARDIAC - STERILE   51   272              120.00      0.00
5101910   COTTON ROLL 6X9 STERILE     51   272               25.00      0.00
5101936   SLEEVES SCD THIGH V         51   271               50.00      0.00
5101944   INSTRUMENT DSP GRASP II V   51   272              424.00      0.00
5101951   SUCTION/IRRIGATOR           51   272              377.00      0.00
5102033   SUTURE PRLN 6-0 BV-1 24"V   51   272                4.00      0.00
5102058   ELECTRODE LEEP BALL 12CMV   51   272               39.00      0.00
5102082   CATH GUIDE RY 6FR JR3.5SH   51   272    C1887     266.00      0.00
5102090   CATH GUIDE RWY 6FR JL4SH    51   272    C1887     266.00      0.00
5102116   CATH GUIDE RWY 6FR JR4SH    51   272    C1887     266.00      0.00
5102124   CATH GUIDE RUNWAY 6F Q4SH   51   272    C1887     313.00      0.00
5102132   CATH GUIDE RWY 6FR MPSH     51   272    C1887     313.00      0.00
5102140   CATH GUIDE RWY 6FR HSSH     51   272    C1887     313.00      0.00
5102280   SUTURE SILK 0 CT-1 30" V    51   272                4.00      0.00
5102421   GUIDEWIRE STIFF ANGLE       51   272    C1769     231.00      0.00
5102488   STENT SENTINOL 7X39X135     51   278    C2625   10560.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5103080   CATH PICC LINE 4 FR 50CM    51   272    C1751     205.00      0.00
5103114   CANNULA RETRO/CARDIOPLEG    51   272              409.00      0.00
5103221   KIT TRTREX TRANSTIBL ACLV   51   272              270.00      0.00
5103262   SUTURE TICRON 2-0 Y-31      51   272              228.00      0.00
5103452   TOTE INTUBATION             51   272              400.00      0.00
5103486   SHEATH SUPER 10FR           51   272    C1766      71.00      0.00
5103494   SHEATH SUPER 10FR 25CM      51   272    C1766     158.00      0.00
5103502   SHEATH SUPER 11FR           51   272    C1766      71.00      0.00
5103510   SHEATH SUPER 11FR 25CM      51   272    C1766     158.00      0.00
5103643   NEEDLE BIOP SYS 18GA 10CM   51   272              183.00      0.00
5103650   NEEDLE BIOP SYS 18GA 15CM   51   272              183.00      0.00
5103775   SENSOR DIGITAL I20 INFANT   51   272               51.00      0.00
5103783   SENSOR DIGITAL D20 PEDIE    51   272               39.00      0.00
5103791   SENSOR DIGITAL D25 ADULT    51   272               39.00      0.00
5103809   SENSOR DIGITAL N25 NEONAT   51   272               51.00      0.00
5103817   BARS TEETH ARCH/BANDS STR   51   272               73.00      0.00
5103841   SUTURE CAPIO 48"            51   272               69.00      0.00
5103858   DEVICE CAPIO SUTURE CAPT    51   272             1321.00      0.00
5104187   CATH PACING 5FR CURVE       51   275              396.50      0.00
5104237   CABLE SURGICAL DISP 4042    51   272              124.00      0.00
5104336   ELECTRODE SUCTION VAPOR90   51   272              818.00      0.00
5104385   GUIDEWIRE 038"STIFF 3CM T   51   272    C1769      58.00      0.00
5104393   CATH URET OPEN END 6FR      51   272    C1758      52.00      0.00
5104401   INFLATOR LEVEEN 10CC        51   272              223.00      0.00
5105093   SHEATH 6FR COBRA            51   272              272.00      0.00
5105101   FILTER OPTEASE VENA CAVA    51   278    C1880   13156.00      0.00
5105259   CATH DRAINAGE PIGTAIL MIN   51   272    C1729      66.00      0.00
5105382   GUIDEWIRE GRAPHIX PT        51   272    C1769     374.00      0.00
5105515   BALLOON MAVERICK 4.0 12     51   272    C1725     970.00      0.00
5105523   BALLOON MAVERICK 3.5 15     51   272    C1725     970.00      0.00
5105531   BALLOON MAVERICK 4.0 15     51   272    C1725     970.00      0.00
5105549   BALLOON MAVERICK 3.0 15     51   272    C1725     970.00      0.00
5105556   BALLOON MAVERICK 2.5 15     51   272    C1725     970.00      0.00
5105606   PACK VASCULAR               51   272              330.00      0.00
5105622   NEEDLE BX SP/CUT DSP 16X1   51   272              145.00      0.00
5105663   VEIN HARVESTER SAPHLITE     51   272             1297.00      0.00
5105747   DEVICE BONE TUNNEL CUFF L   51   272             1297.00      0.00
5106034   BALLOON CUTNG CORO 2.0 10   51   272    C1725    3701.00      0.00
5106042   BALLOON CUTNG CORO 2.5 10   51   272    C1725    3701.00      0.00
5106059   BALLOON CUTNG CORO2.25 10   51   272    C1725    3701.00      0.00
5106067   BALLOON CUTNG CORO 2.5 15   51   272    C1725    3701.00      0.00
5106075   BALLOON CUTNG CORO2.75 10   51   272    C1725    3701.00      0.00
5106083   BALLOON CUTNG CORO2.75 15   51   272    C1725    3701.00      0.00
5106091   BALLOON CUTNG CORO 3.0 10   51   272    C1725    3701.00      0.00
5106109   BALLOON CUTNG CORO 3.0 15   51   272    C1725    3701.00      0.00
5106117   BALLOON CUTNG CORO 3.5 15   51   272    C1725    3701.00      0.00
5106125   BALLOON CUTNG CORO3.25 10   51   272    C1725    3701.00      0.00
5106133   BALLOON CUTNG CORO3.25 15   51   272    C1725    3701.00      0.00
5106141   BALLOON CUTNG CORO 3.5 10   51   272    C1725    3701.00      0.00
5106158   BALLOON CUTNG CORO3.75 10   51   272    C1725    3701.00      0.00
5106166   BALLOON CUTNG CORO3.75 15   51   272    C1725    3701.00      0.00
5106174   BALLOON CUTNG CORO 4.0 10   51   272    C1725    3701.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5106182   BALLOON CUTNG CORO 4.0 15   51   272    C1725    3701.00      0.00
5106315   STENT URETERAL 8FR 22"      51   278    C2617    1054.00      0.00
5106653   CATH GUIDE 6FR EBU 3.5      51   272    C1887     778.00      0.00
5106760   CATH GUIDE RWY 6FR AL1SH    51   272    C1887     266.00      0.00
5106802   BAG TRU CLOSE W/EMPTY PRT   51   272              104.00      0.00
5106810   NEEDLE SPINAL SPRTT 6"22G   51   272               57.00      0.00
5106828   NEEDLE EPIDURAL T WNG 6"    51   272              105.00      0.00
5106869   CATH GUIDE RUNWAY 6F ART4   51   272    C1887     266.00      0.00
5106877   CATH GUIDE RWY 6FR ART4SH   51   272    C1887     313.00      0.00
5106943   INSTRUM/DISP CLP APP M/LV   51   272              166.00      0.00
5107081   ELECTRODE COAGULATION TIS   51   272              572.00      0.00
5107362   BALLOON MAVERICK 2.0 30     51   272    C1725     970.00      0.00
5107370   BALLOON MAVERICK 2.5 30     51   272    C1725     970.00      0.00
5107388   BALLOON MAVERICK 3.0 30     51   272    C1725     970.00      0.00
5107396   BALLOON MAVERICK 3.5 30     51   272    C1725     970.00      0.00
5107404   BALLOON MAVERICK 4.0 30     51   272    C1725     970.00      0.00
5107412   STENT PROTEGE 7X40X80 6FR   51   278    C1876   11440.00      0.00
5107438   STENT PROTEGE 8X40X80 6FR   51   278    C1876   11440.00      0.00
5107446   STENT PROTEGE 8X60X80 6FR   51   278    C1876   11440.00      0.00
5107594   BALL EXERCISE 29" BLUE      51   271              104.00      0.00
5107834   NEEDLE SPINAL ULTRS 22G6"   51   272              105.00      0.00
5107867   STENT LIBERTE 3.5 24        51   278    C1876    8360.00      0.00
5108154   KIT QUICK PRESSURE MONITR   51   272              322.00      0.00
5108188   STENT EXP MONO 6.0 14       51   278    C1876   10560.00      0.00
5108204   WIRE V 18 200               51   272    C1769     390.00      0.00
5108303   HEMO DISC SQUARE            51   272               18.00      0.00
5108329   GUIDEWIRE RADIAL .018       51   272    C1769     163.00      0.00
5108352   STENT EXP MONO 5.0 15       51   278    C1876   10560.00      0.00
5108360   STENT EXP MONO 4.0 19       51   278    C1876   10560.00      0.00
5108386   STENT EXP MONO 6.0 18       51   278    C1876   10560.00      0.00
5108394   STENT EXP MONO 7.0 15       51   278    C1876   10560.00      0.00
5108428   HEMOSTAT NU KNIT 1"X3 1/2   51   272              122.00      0.00
5108436   MASSAGER WAND RECHARGEABL   51   272              149.00      0.00
5108444   STENT EXP MONO 5.0 19       51   278    C1876   10560.00      0.00
5108469   BALLOON UT SDS 7X4X50       51   272    C1725     758.00      0.00
5108477   BALLOON UT SDS 8X4X50       51   272    C1725     758.00      0.00
5109483   CATH GUIDE BRITE 6FR LCB    51   272    C1725     270.00      0.00
5109491   CATH GUIDE BRITE 6FR XB4    51   272    C1725     270.00      0.00
5109517   CATH GUIDE BRITE 6FR ALI    51   272    C1725     270.00      0.00
5109525   CATH GUIDE BRITE 6FR AL2    51   272    C1725     270.00      0.00
5109533   CATH GUIDE BRITE 6FR JL5    51   272    C1725     270.00      0.00
5109541   CATH GUIDE BRITE 6F ALISH   51   272    C1725     270.00      0.00
5109715   GUIDEWIRE STRAIGHT .020 V   51   272    C1769     125.00      0.00
5109731   TROCAR NEEDLE 146 STEP      51   272               87.00      0.00
5109749   TROCAR CANNULA 10MM STEP    51   272              293.00      0.00
5109756   CANNULA & DILATOR 3/BX      51   272              210.00      0.00
5109764   TROCAR CANNULA 12MM STEP    51   272              449.00      0.00
5109806   STAPLER PRIM CEEA 25 DSPV   51   272              478.00      0.00
5109830   CATH GUIDE BRITE 6F JL4SH   51   272    C1725     270.00      0.00
5109848   CATH GUIDE BRITE 6F JR4SH   51   272    C1725     270.00      0.00
5109855   CATH GUIDE BRITE 6FR JR4    51   272    C1725     270.00      0.00
5109863   CATH GUIDE BRITE 6FR JL4    51   272    C1725     270.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
5109889   CATH GUIDE BRITE 6FR IM     51   272    C1725    270.00      0.00
5109897   CATH GUIDE BRITE 6FR IMSH   51   272    C1725    270.00      0.00
5109905   CATH GUIDE BRITE 6F XB3.5   51   272    C1725    270.00      0.00
5109962   BALLOON UT SDS 6X4X50       51   272    C1725    758.00      0.00
5110077   KNIFE COLD HALF SINGLE      51   272             465.00      0.00
5110176   KNIFE COLD                  51   272             385.00      0.00
5110192   SPLINT PIL-O ELBOW SUPPRT   51   274    L3700    237.25      0.00
5110200   SET AXIUS XPOSE STABILIZE   51   272            2708.00      0.00
5110242   HEMO BAND RADSTAT LONG      51   272             112.00      0.00
5110259   CANNULA AND DILATOR 11MM    51   272             230.00      0.00
5110291   STABILIZER SYSTEM           51   272            4266.00      0.00
5110325   KNIFE RESECTOSCOPE 24F TU   51   272             328.00      0.00
5110333   LOOP RESECTOSCOPE 27FR      51   272             305.00      0.00
5110341   ROLLERBALL 3MM              51   272             328.00      0.00
5110358   ELECTRODE POWERBALL         51   272             610.00      0.00
5110390   MASK LARENG LMA FLEX SZ2    51   272              60.00      0.00
5110473   STOCKING STUMP 4"           51   274    L8420    153.00      0.00
5110598   SUTURE ENDOSURGERY 5MM SY   51   272            1306.00      0.00
5110606   SUTURE ETHIBND EXCL OEEN6   51   272             158.00      0.00
5111257   CATH INLINE 5FR             51   272              60.00      0.00
5111265   CATH INLINE 6FR             51   272              54.00      0.00
5111273   CATH INLINE 8FR             51   272              54.00      0.00
5111299   LOOP RESECTION CUTTNG 24F   51   272             305.00      0.00
5111349   SET INTRODUCER 6FR 13CMRD   51   272    C1894    191.00      0.00
5111356   CATH GUIDE BRITE 6F JR3.5   51   272    C1725    270.00      0.00
5111380   CATH GUIDE BRITE 6F JL3.5   51   272    C1725    270.00      0.00
5111398   GUIDEWIRE FORTE W/MARKRS    51   272    C1769    374.00      0.00
5111422   SUTURE FIBER WIRE 2 38"     51   272              64.00      0.00
5111497   CATH SERVANTA               51   272              56.00      0.00
5111760   MASK LARYNG LMA SZ5 DISP    51   272              56.00      0.00
5111877   RESERVOIR 400C JCKS/PRT V   51   272              20.00      0.00
5111893   SURGINEEDLE 120MM V         51   272              29.00      0.00
5111935   BALLOON DILATR 240CM12/15   51   272    C1726    380.00      0.00
5112263   FORCEPS BIPOLAR CUTTNG 5M   51   272            1273.00      0.00
5112271   FORCEPS BIPOLAR CUTTNG 10   51   272            1193.00      0.00
5112362   CIRCUIT CPAP INF 4C HEATR   51   271             100.00      0.00
5112396   STYLET DLYS QNTN            51   272             751.00      0.00
5112404   SPLINT NASAL DENVER SM/ME   51   271             162.00      0.00
5112412   SPLINT NASAL DENVER LG      51   271             162.00      0.00
5112552   CUP CURRETTE                51   272             137.00      0.00
5112578   HANDPC SFT PALLETTE DL ND   51   272            1232.00      0.00
5112644   CATH GUIDE RWY 6FR FL2SH    51   272    C1887    313.00      0.00
5112735   CATH STRAIGHT 6FR 40CM      51   272    C1751     82.00      0.00
5113279   EZ PAP WITH MOUTHPIECE      51   271              60.00      0.00
5113287   GENERATOR FLOW INFNT CPAP   51   272             190.00      0.00
5113360   SET RIGHT HEART ASSIST      51   272            3876.00      0.00
5114202   RETRIEVER SEGURA BKT 3.0    51   272             858.00      0.00
5114210   INFLATOR ENCORE OR CYSTO    51   272             353.00      0.00
5114228   CATH DUAL LUMEN URET 10FR   51   272    C1758    205.00      0.00
5114236   RETRACTOR STONE ZERO TIP    51   272             897.00      0.00
5114269   GUIDEWIRE SENSOR 035X3CM    51   272    C1769    157.00      0.00
5114277   DILATOR CO-AXIAL 8/10       51   272             150.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5114319   STENT URETERL POLARIS5X22   51   278    C2617    1320.00      0.00
5114327   STENT URETERAL POLARS5X24   51   278    C2617    1320.00      0.00
5114335   STENT URETERAL POLARS5X26   51   278    C2617    1425.50      0.00
5114392   PAD DISP KNEE TRIANGLE      51   272               75.00      0.00
5114400   ADAPTER TROCAR PORT 5MM     51   272              124.00      0.00
5114467   CATH ANGIO KUMPE ACCESS     51   272               72.00      0.00
5114665   CARD TEST HTT               51   271              197.00      0.00
5114749   GUIDEWIRE ST .021           51   272    C1769      69.00      0.00
5114897   INSTRUMENT SCALPEL HARMNC   51   272             1429.00      0.00
5115175   MESH COMPOSIX 7"X9"         51   278    C1781   10252.00      0.00
5115183   MESH COMPOSIX 8"X10"        51   278    C1781   13173.50      0.00
5115191   MESH KUGEL HERNIA 11X14 P   51   278    C1781    7488.75      0.00
5115217   MESH PERFIX PLUG MED        51   278    C1781    1931.50      0.00
5115225   MESH PERFIC PLUG SM         51   278    C1781    1821.50      0.00
5115241   MILK BREAST                 51   270               13.00      0.00
5115357   FORTIFIER HUMAN MILK SMLC   51   270                4.00      0.00
5115423   KIT DRESSING VAC TRAC MED   51   272              129.00      0.00
5115431   KIT DRESSING VAC TRAC LG    51   272              156.00      0.00
5115449   KIT DRESSING VAC TRAC SM    51   272              102.00      0.00
5115456   KIT CANISTER VAC STSW ISO   51   272              144.00      0.00
5115472   PAD TRAC                    51   272               73.00      0.00
5115480   AUTO TOME RX30MM            51   272             1109.00      0.00
5115498   AUTO TOME RX 20MM           51   272             1109.00      0.00
5115506   SPHINCTEROTOME RX20MM       51   272              754.00      0.00
5115522   SPHINCTEROTOME NEEDLKNF X   51   272              754.00      0.00
5115530   BASKET RETRVAL TRAPZD 2X4   51   272             1113.00      0.00
5115548   BASKET RETRVL TRAP 2.5X4C   51   272             1113.00      0.00
5115555   GUIDEWIRE JAGTAIL 035       51   272    C1769     356.00      0.00
5115563   GUIDEWIRE JAGWIRE 035       51   272    C1769     559.00      0.00
5115571   CANNULA TAPERED RAPID EXC   51   272              270.00      0.00
5115589   CANNULA TAPERED RAPD EX/X   51   272              320.00      0.00
5115613   GUIDEWIRE JF .038" X 70CM   51   272    C1769     375.00      0.00
5115621   STAPLER PREM/PLS CEEA 31V   51   272              436.00      0.00
5115647   DILATOR SHEATH 16FR         51   272    C1892     375.00      0.00
5115654   CATH DIALYSIS 19CM          51   272    C1750     375.00      0.00
5115662   CATH DIALYSIS 28CM          51   272    C1750     375.00      0.00
5115670   CATH DIALYSIS 23CM          51   272    C1750     375.00      0.00
5115696   TUBE FEEDING PED 12FR 5CC   51   272              161.00      0.00
5115704   NEEDLE INSUL STIMPLX 21GX   51   272               45.00      0.00
5115720   CATH COMP 12FR #2951        51   272    C1751     221.00      0.00
5115738   GUIDEWIRE COMP 0.035 J ST   51   272    C1769     221.00      0.00
5115761   KIT ORTHO PAT PROCESSING    51   272             2249.00      0.00
5115779   SPLINT ELBOW KNEE SOFT M    51   274    L3999      86.25      0.00
5115803   PATCH HERNIA COMPOSX SM O   51   278    C1781    5073.25      0.00
5115811   PATCH HERNIA COMPOSX SM C   51   278    C1781    4158.00      0.00
5115829   PATCH HERNIA COMPOSX LG C   51   278    C1781    5764.00      0.00
5116140   TUBE TRACH SIZE 8 PERC      51   272              174.00      0.00
5116298   GLOVE EDEMA LARGE RT        51   271               19.00      0.00
5116330   STENT LIBERTE 4.0 28        51   278    C1876    8360.00      0.00
5116355   KIT BLOWER/MISTER           51   272              249.00      0.00
5116462   BALLOON OPENSAIL 2.0 10     51   272    C1725     997.00      0.00
5116470   BALLOON OPENSAIL 2.5 10     51   272    C1725     997.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5116488   BALLOON OPENSAIL 3.0 10     51   272    C1725     997.00      0.00
5116538   BALLOON OPENSAIL 3.0 15     51   272    C1725     997.00      0.00
5116546   BALLOON OPENSAIL 3.5 15     51   272    C1725     997.00      0.00
5116595   INSTRUMENT ENDOGIA VERSFR   51   272              415.00      0.00
5116611   DRESSING SINUSTENT DRWSTR   51   272               67.00      0.00
5116710   TRAY LUMBAR PUNCT C ADULT   51   272               50.00      0.00
5116892   FILTER VENA CAVA TULIP JG   51   278    C1880    8910.00      0.00
5116918   STENT SMART 8X60X80         51   278    C1876   14476.00      0.00
5116926   STENT SMART 7X40X80         51   278    C1876   14476.00      0.00
5116967   STENT SMART 9X60X80         51   278    C1876   14476.00      0.00
5117098   CATH 6FR 3DRC               51   272    C1887      45.00      0.00
5117106   BALLOON CONQUEST 12X4X75    51   272    C1725     880.00      0.00
5117312   MASK LARYNGEAL LMA FLX .5   51   272               42.00      0.00
5117411   TRAP FINGER XL STRL DBL     51   272              108.00      0.00
5117510   SHEARS LCS 5MM KNIFE DWNV   51   272              664.00      0.00
5117932   CATH 12FR TRIP LUM #11792   51   272    C1752     221.00      0.00
5117957   GW J ST .035X70CM #11792    51   272    C1769     221.00      0.00
5118013   BAG REPLACEMENT WASTE       51   272               49.00      0.00
5118252   STENT EXPRESS 2 2.75 8      51   278    C1876    8360.00      0.00
5118278   STENT LIBERTE 4.5 28        51   278    C1876    8360.00      0.00
5118286   STENT LIBERTE 4.5 32        51   278    C1876    8360.00      0.00
5118310   STENT LIBERTE 5.0 32        51   278    C1876    8360.00      0.00
5118369   STENT LIBERTE 2.75 20       51   278    C1876    8360.00      0.00
5118377   STENT EXPRESS 2 2.25 12     51   278    C1876    8360.00      0.00
5118476   CANNULA NONVENT CONCT 20F   51   272              164.00      0.00
5118492   HEEL LIFT DISP 99200        51   274    L9900     109.25      0.00
5118542   LINE POST OP                51   272               48.00      0.00
5118963   INSERT RETRACT SUT HOLD     51   272              208.00      0.00
5119029   TRAY PARACENTESIS           51   272              216.00      0.00
5119268   KIT PAT WILSON FRAME        51   271              127.00      0.00
5119276   SCALPEL HARMONIC CURV SHR   51   272             1361.00      0.00
5119391   CATH 5FR PIGTAIL 20 BAND    51   272              373.00      0.00
5119458   TUBE TRACH REPL PERFIT #7   51   272              528.00      0.00
5119482   PIN DISTRACTION 16MM        51   272              214.00      0.00
5119490   SLEEVE SCD THIGH LARGE      51   271              229.00      0.00
5119516   PRESSURIZER FEMORAL SM      51   272               69.00      0.00
5119607   DVC CAPIO SUTUR CAPTURE V   51   272             1015.00      0.00
5119664   DRESSING AQUACEL SILV 4X4   51   272               45.00      0.00
5119680   CATH GUIDE BRITE 6FR RCBS   51   272    C1725     270.00      0.00
5119698   CATH GUIDE BRITE 6FR ARI    51   272    C1725     270.00      0.00
5119706   CATH GUIDE BRITE 6FR AR2    51   272    C1725     270.00      0.00
5119763   SET SPLIT BACK PAD SM       51   272              727.00      0.00
5119771   SET SPLIT BACK PAD MED      51   272              727.00      0.00
5119938   PACKS STEINMAN DRILL        51   272              917.00      0.00
5119946   STENT EXPRESS LD 6X20X75    51   278    C1876   11396.00      0.00
5119953   STENT EXPRESS LD 6X40X75    51   278    C1876   12276.00      0.00
5119961   STENT EXPRESS LD 7X20X75    51   278    C1876   11396.00      0.00
5119979   STENT EXPRESS LD 7X40X75    51   278    C1876   12276.00      0.00
5119995   STENT EXPRESS LD 8X40X75    51   278    C1876   12276.00      0.00
5120001   STENT EXPRESS LD 9X40X75    51   278    C1876   12276.00      0.00
5120019   STENT EXPRESS LD 10X40X75   51   278    C1876   12276.00      0.00
5120076   SEALANT HEMO MATRIX FLOSL   51   272              664.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5120191   PACK CYSTO                  51   272              185.00      0.00
5120209   PACK ENT                    51   272              170.00      0.00
5120217   PACK D AND C                51   272              121.00      0.00
5120225   PACK EXTREMITY              51   272              243.00      0.00
5120233   PACK VAG HYST               51   272              216.00      0.00
5120241   PACK BASIC                  51   272              152.00      0.00
5120258   PACK LAPAROTOMY             51   272              210.00      0.00
5120423   CATH GUIDE BRITE 6FRXBLAD   51   272    C1725     270.00      0.00
5120431   CATH GUIDE BRITE 6FR JL6    51   272    C1725     270.00      0.00
5120449   STENT EXPRESS LD 8X30X75    51   278    C1876   12276.00      0.00
5120456   STENT EXPRESS LD 7X30X75    51   278    C1876   12276.00      0.00
5120480   STENT EXPRESS LD 9X30X75    51   278    C1876   11396.00      0.00
5120530   STENT EXPRESS LD 10X10X75   51   278    C1876   11396.00      0.00
5120548   STENT EXPRESS LD 8X60X75    51   278    C1876   13156.00      0.00
5120555   STENT EXPRESS LD 6X30X75    51   278    C1876   12276.00      0.00
5120563   STENT EXPRESS LD 7X30X135   51   278    C1876   12276.00      0.00
5120605   STENT EXPRESS LD 7X60X75    51   278    C1876   13156.00      0.00
5120639   STENT EXPRESS LD 6X30X135   51   278    C1876   12276.00      0.00
5120647   STAPLER TR DST 45 3.5       51   272              900.00      0.00
5120654   LOAD UNIT TA DST 45 3.5     51   272              235.00      0.00
5120688   TRAY PICC NEO 2.8           51   272              238.00      0.00
5120837   STAPLER TA DST 45 4.8       51   272              900.00      0.00
5120886   BALLOON CONQUEST 6X4X50     51   272    C1725    1057.00      0.00
5120894   BALLOON CONQUEST 7X4X50     51   272    C1725    1057.00      0.00
5120902   BALLOON CONQUEST 8X4X50     51   272    C1725     880.00      0.00
5120928   CATH GUIDE RWY 6FR CLS4     51   272    C1887     266.00      0.00
5120936   CATH GUIDE RWY 6FR AR2SH    51   272    C1887     266.00      0.00
5120944   CATH GUIDE RWY 6FR VL4      51   272    C1887     266.00      0.00
5120951   CATH GUIDE RWY 6FR VL4SH    51   272    C1887     266.00      0.00
5120969   ELASTIC STAYS 5MM           51   272              183.00      0.00
5121140   KIT OXYGNTR TUBE PK TRX2    51   272             4289.00      0.00
5121199   BALLOON QMAV 2.0 8          51   272    C1725    1496.00      0.00
5121207   BALLOON QMAV 2.5 8          51   272    C1725    1047.00      0.00
5121215   BALLOON QMAV 2.0 12         51   272    C1725    1047.00      0.00
5121223   BALLOON QMAV 2.5 15         51   272    C1725    1047.00      0.00
5121231   BALLOON QMAV 3.0 15         51   272    C1725    1047.00      0.00
5121249   BALLOON QMAV 4.0 15         51   272    C1725    1047.00      0.00
5121256   INTRODUCER RAABE 6FR 55CM   51   272    C1894     214.00      0.00
5121314   BALLOON QMAV 3.0 8          51   272    C1725    1047.00      0.00
5121322   BALLOON QMAV 3.5 8          51   272    C1725    1047.00      0.00
5121330   BALLOON QMAV 4.0 8          51   272    C1725    1047.00      0.00
5121348   BALLOON QMAV 2.5 12         51   272    C1725    1047.00      0.00
5121355   BALLOON QMAV 3.0 12         51   272    C1725    1047.00      0.00
5121363   BALLOON QMAV 3.5 12         51   272    C1725    1047.00      0.00
5121371   BALLOON QMAV 4.0 12         51   272    C1725    1047.00      0.00
5121389   BALLOON QMAV 2.0 15         51   272    C1725    1047.00      0.00
5121397   BALLOON QMAV 3.5 15         51   272    C1725    2383.00      0.00
5121439   BALLOON QMAV 3.5 20         51   272    C1725    2383.00      0.00
5121447   BALLOON QMAV 4.0 20         51   272    C1725    2383.00      0.00
5121504   SPLNT ORTH THMB RSTC LT M   51   274              158.00      0.00
5121520   CATH 5FR SLIP VERT          51   272    C1887     145.00      0.00
5121553   COIL TORNADO 3/2/18         51   278    C1877     697.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5121629   STENT ASPIRE 10X5X100       51   278    C2625   17160.00      0.00
5121678   PATCH HERNIA LARGE OVAL     51   278    C1781    9495.25      0.00
5121694   ELECTRODE SIDE EFFECT 3.5   51   272              224.00      0.00
5121751   BRACE ANK/FT WLKR HI SM     51   274    L4386     258.25      0.00
5121769   BRACE ANK/FT WLKR HI MED    51   274    L4386     277.25      0.00
5121777   BRACE ANK/FT WLKR HI LG     51   274    L4386     277.25      0.00
5121785   STABILIZER VEGA PATELLA S   51   274    L1815     545.25      0.00
5121793   STABILIZER VEGA PATELLA M   51   274    L1815     545.25      0.00
5121801   STABILIZER VEGA PATELLA L   51   274    L1815     545.25      0.00
5121819   STABILIZER VEGA PATELL XL   51   274    L1815     545.25      0.00
5121827   STABILIZER VEGA PATEL XXL   51   274    L1815     545.25      0.00
5121876   INTRODUCER HEMOSTATC L 7F   51   272    C1894     270.00      0.00
5121884   INTRODUCER HEMOSTATC L 9F   51   272    C1894     351.00      0.00
5121900   SPLINT THUMB SUEDE 7 1/2"   51   274    L3913      61.25      0.00
5121926   SPLINT FOOT ANKLE RT SM     51   274    L4398     256.25      0.00
5121934   SPLINT FOOT ANKLE RT MED    51   274    L4398     258.75      0.00
5121942   SPLINT FOOT ANKLE RT LG     51   274    L4398     376.50      0.00
5122023   KIT RAINOUT REDUCTION       51   270               53.00      0.00
5122049   SCREW DELTA 9MM             51   278    C1713    1707.25      0.00
5122056   SCREW DELTA 10MM            51   278    C1713    1707.25      0.00
5122064   SCREW DELTA 11MM            51   278    C1713    1707.25      0.00
5122080   SCREW BIO 7MM               51   278    C1713    1249.50      0.00
5122098   SCREW BIO 8MM               51   278    C1713    1249.50      0.00
5122106   SCREW BIO 9MM               51   278    C1713    1249.50      0.00
5122114   SCREW BIO 10MM              51   278    C1713    1249.50      0.00
5122122   SCREW BIO CORKSCREW 5.0MM   51   278    C1713    2244.00      0.00
5122270   SPLINT ULNAR DEVIAT RT ME   51   271    A4570     213.00      0.00
5122312   MONITOR DISCOGRAM           51   272              478.00      0.00
5122320   SET NEEDLE DISCOG DOCKING   51   272               83.00      0.00
5122338   KIT NEEDLE SET DISCOGRAM    51   272               44.00      0.00
5122528   FILTER WIRE 300CM           51   272             5045.00      0.00
5122700   KIT TISSEEL SEALANT 2ML     51   272              781.00      0.00
5122734   KIT TISSEEL SEALANT 5ML     51   272             1901.00      0.00
5122742   SET SPRAY TISSEEL           51   272              166.00      0.00
5122759   COSEAL PREMIX 4ML           51   272             1855.00      0.00
5122767   SHEATH 6FR AN L2            51   272    C1893     272.00      0.00
5122783   KIT PAT CARE JACKSON TABL   51   272              153.00      0.00
5122791   MASK NASAL SIL INFNT SM     51   272               72.00      0.00
5122809   MASK NASAL SIL INFNT LG     51   272               72.00      0.00
5122841   NEEDLE BIOPSY BONE OSTEOS   51   272              192.00      0.00
5122858   HANDPIECE TURBOVAC WAND90   51   272              742.00      0.00
5123450   SUTURE FIBERWIRE 2 C-13 3   51   272               64.00      0.00
5123492   MASK LMA FASTRACH SZ 3      51   272              107.00      0.00
5123591   CATH GUIDE BRITE 6FR XBLA   51   272    C1725     270.00      0.00
5124060   BLADE GRAFT HARVEST SAW#6   51   272              538.00      0.00
5124078   BLADE GRAFT HARVEST SAW#7   51   272              538.00      0.00
5124110   CATH 5FR CARDMULTI ANG      51   272    C1887     122.00      0.00
5124128   CATH 5FR CARDMULTI STRA     51   272    C1887     137.00      0.00
5124292   SCREW IMPLANT 5.5MM BIO T   51   278    C1713    1892.00      0.00
5124318   SCREW IMPLANT 7MM BIO TNO   51   278    C1713    1980.00      0.00
5124326   SCREW IMPLANT 8MM BIO TNO   51   278    C1713    1716.00      0.00
5124334   SCREW IMPLANT 9MM BIO TNO   51   278    C1713    1980.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5124359   LOAD UNIT ENDO GIAII 30 3   51   272              138.00      0.00
5124698   STENT URET POLARIS 6X28     51   278    C2617     622.75      0.00
5124987   TUBE TRACHEOSTOMY BVN 9.0   51   272    A7521     725.00      0.00
5125109   STENT SMART 10X60X80        51   278    C1876   14476.00      0.00
5125141   CATH 4FR CARD MULTI ANG     51   272    C1887     174.00      0.00
5125158   CATH 4FR PIG ANG            51   272    C1887      58.00      0.00
5125166   CATH 4FR JR4                51   272    C1887      58.00      0.00
5125174   CATH 4FR JL4                51   272    C1887      58.00      0.00
5125208   BALLOON CUTNG CORO 2.0 15   51   272    C1725    3701.00      0.00
5125216   BALLOON CUTNG CORO 3.0 6    51   272    C1725    3701.00      0.00
5125224   BALLOON CUTNG CORO 3.5 6    51   272    C1725    3701.00      0.00
5125232   BALLOON CUTNG CORO 4.0 6    51   272    C1725    3701.00      0.00
5125240   BALLOON CUTNG CORO 2.5 6    51   272    C1725    3701.00      0.00
5125257   BALLOON CUTNG CORO 2.0 6    51   272    C1725    3701.00      0.00
5125265   BALLOON CUTNG CORO 2.75 6   51   272    C1725    3701.00      0.00
5125273   BALLOON CUTNG CORO 2.25 6   51   272    C1725    3701.00      0.00
5125281   BALLOON CUTNG CORO2.25 15   51   272    C1725    3701.00      0.00
5125299   BALLOON CUTNG CORO 3.75 6   51   272    C1725    3701.00      0.00
5125307   BALLOON CUTNG CORO 3.25 6   51   272    C1725    3701.00      0.00
5125372   SYRINGE CORD BLOOD DRAWIN   51   272               56.00      0.00
5125422   SUTURE FASTAK FIBERW 2.8M   51   272              623.00      0.00
5125497   CATH AIRWAY EXCHANGE 7MM    51   272              150.00      0.00
5125562   NEEDLE SMART                51   272              353.00      0.00
5125695   PADS DEFIB RADIOLUCENT      51   271              192.00      0.00
5125927   ELECTRODE 2X2               51   271                2.00      0.00
5125935   ELECTRODE ROUND 2 3/4"      51   272               21.00      0.00
5126040   CEMENT SIMPLEX W/TOBRAMYC   51   272             1895.00      0.00
5126115   NEEDLE SHEATH NEOPIC 2.8    51   272               97.00      0.00
5126123   NEEDLE SHEATH NEOPIC 1.9    51   272               97.00      0.00
5126180   CATH GUIDE OPTIMA 6FR JL4   51   272    C1887     187.00      0.00
5126206   CATH GUIDE OPTIMA 6FR JL4   51   272    C1887     187.00      0.00
5126305   CATH GUIDE OPTIMA 6FR SHA   51   272    C1887     187.00      0.00
5126321   CATH GUIDE OPTIMA 6FR JR5   51   272    C1887     187.00      0.00
5126339   CATH GUIDE OPTIMA 6FR ALI   51   272    C1887     187.00      0.00
5126354   CATH GUIDE OPTIMA 6FR AL2   51   272    C1887     187.00      0.00
5126388   CATH GUIDE OPTIMA 6FR ARI   51   272    C1887     187.00      0.00
5126420   CATH GUIDE OPTIMA 6FR LCB   51   272    C1887     187.00      0.00
5126438   CATH GUIDE OPTIMA 6FR LCB   51   272    C1887     187.00      0.00
5126453   CATH GUIDE OPTIMA 6FR HS    51   272    C1887     187.00      0.00
5126461   CATH GUIDE OPTIMA 6FR HSS   51   272    C1887     187.00      0.00
5126479   CATH GUIDE OPTIMA 6FR IM    51   272    C1887     187.00      0.00
5126495   CATH GUIDE OPTIMA 6FR MP    51   272    C1887     187.00      0.00
5126768   HANDLE IMPLANT MAGNUM/KNT   51   278             3520.00      0.00
5126776   CONNECTOR MAGNUM NEEDL/GR   51   272              519.00      0.00
5126792   SUTURE CARTRIDGE GREEN      51   272              602.00      0.00
5126818   SUTURE BIO ANCHOR#2 FIBRW   51   272              977.00      0.00
5126826   TUBE SUCTION MINI           51   272              137.00      0.00
5126859   CATH GUIDE VIKING 7F JLH    51   272    C1887     187.00      0.00
5126958   SHUNT INTRACORONARY 1.25M   51   272              311.00      0.00
5127048   CATH GUIDE VIKING 8FR JL4   51   272    C1887     187.00      0.00
5127113   STENT TAXUS 2.5 8           51   278    C1874   25960.00      0.00
5127121   STENT TAXUS 2.5 12          51   278    C1874   25960.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5127139   STENT TAXUS 2.5 16          51   278    C1874   25960.00      0.00
5127147   STENT TAXUS 2.5 20          51   278    C1874   25960.00      0.00
5127154   STENT TAXUS 2.5 24          51   278    C1874   25960.00      0.00
5127162   STENT TAXUS 2.75 8          51   278    C1874   25960.00      0.00
5127170   STENT TAXUS 2.75 12         51   278    C1874   25960.00      0.00
5127188   STENT TAXUS 2.75 16         51   278    C1874   25960.00      0.00
5127196   STENT TAXUS 2.75 20         51   278    C1874   25960.00      0.00
5127204   STENT TAXUS 2.75 24         51   278    C1874   25960.00      0.00
5127212   STENT TAXUS 2.75 28         51   278    C1874   25960.00      0.00
5127220   STENT TAXUS 2.75 32         51   278    C1874   25960.00      0.00
5127238   STENT TAXUS 3.0 8           51   278    C1874   25960.00      0.00
5127246   STENT TAXUS 3.0 12          51   278    C1874   25960.00      0.00
5127253   STENT TAXUS 3.0 16          51   278    C1874   25960.00      0.00
5127261   STENT TAXUS 3.0 20          51   278    C1874   25960.00      0.00
5127279   STENT TAXUS 3.0 24          51   278    C1874   25960.00      0.00
5127287   STENT TAXUS 3.0 28          51   278    C1874   25960.00      0.00
5127295   STENT TAXUS 3.0 32          51   278    C1874   25960.00      0.00
5127303   STENT TAXUS 3.5 8           51   278    C1874   25960.00      0.00
5127311   STENT TAXUS 3.5 12          51   278    C1874   25960.00      0.00
5127329   STENT TAXUS 3.5 16          51   278    C1874   25960.00      0.00
5127337   STENT TAXUS 3.5 20          51   278    C1874   25960.00      0.00
5127345   STENT TAXUS 3.5 24          51   278    C1874   25960.00      0.00
5127352   STENT TAXUS 3.5 28          51   278    C1874   25960.00      0.00
5127360   STENT TAXUS 3.5 32          51   278    C1874   25960.00      0.00
5127394   BLADE MANDIBULAR UNDERM D   51   272              262.00      0.00
5127402   BLADE MANDIBULAR RECIPROC   51   272              302.00      0.00
5127428   BLADE MINI MANDIBLR 16.OM   51   272              302.00      0.00
5127477   CATH 4FR ARI                51   272    C1887      58.00      0.00
5127501   CATH 4FR IM                 51   272    C1887      58.00      0.00
5127519   CATH 4FR MP2                51   272    C1887      58.00      0.00
5127527   CATH 4FR ALI                51   272    C1887      58.00      0.00
5127535   CATH 4FR JL3.5              51   272    C1887      58.00      0.00
5127592   ELECTRODE RADIUS 2.5X1.0    51   272               80.00      0.00
5127758   BLADE SAGITTAL .97 THICK    51   272              203.00      0.00
5127766   BLADE SAGITTAL 1.27 THICK   51   272              203.00      0.00
5127774   BLADE RECIPRORATING 70.0M   51   272              185.00      0.00
5127808   SENSOR FOREHEAD PULSE OXI   51   272               83.00      0.00
5127873   CATH 4FR JL5                51   272    C1887      58.00      0.00
5127881   TUBING INTEGRATED           51   272              374.00      0.00
5128038   BLADE SAGITTAL 18.0         51   272              203.00      0.00
5128046   BLADE SAGITTAL 25.0 MM      51   272              203.00      0.00
5128137   BLADE SAGITTAL W/10MM STP   51   272              154.00      0.00
5128145   BLADE LONG MEDIUM           51   272              178.00      0.00
5128152   BLADE SAGITTAL W/80MM STP   51   272              154.00      0.00
5128160   BLADE SAGITTAL W/120MM ST   51   272              154.00      0.00
5128178   FORCEP RADIAL JAW BIOPSY    51   272              270.00      0.00
5128442   CATH SILVERHAWK SS+ 2.6CM   51   272    C1714   11668.00      0.00
5128459   CATH SILVERHAWK LX 9.0CM    51   272    C1714   11668.00      0.00
5128467   BALLOON QMAV 5.0 8          51   272    C1725    1047.00      0.00
5128475   BALLOON QMAV 5.0 12         51   272    C1725    1047.00      0.00
5128491   BALLOON QMAV 5.0 20         51   272    C1725    1047.00      0.00
5128673   TRAY CATH CAVITY DRAINAGE   51   272              424.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5128681   STENT WAVEMAX 5X17X75       51   278    C1876   11000.00      0.00
5128699   STENT WAVEMAX 6X12X75       51   278    C1876   11000.00      0.00
5128707   STENT WAVEMAX 6X38X75       51   278    C1876   11000.00      0.00
5128715   STENT WAVEMAX 8X17X75       51   278    C1876   11000.00      0.00
5128723   STENT WAVEMAX 6X28X75       51   278    C1876   11000.00      0.00
5128731   STENT WAVEMAX 6X17X75       51   278    C1876   11000.00      0.00
5129036   NEEDLE NITINO SUTURNG LP    51   272              415.00      0.00
5129044   NEEDLE JAMSHIDI DISP 11GX   51   272              113.00      0.00
5129051   SHEATH GUIDE RENAL6FR STR   51   272    C1894     311.00      0.00
5129069   STENT WAVEMAX 5X38X75       51   278    C1876   11000.00      0.00
5129085   CATH PORTA XPORT 8FR 1 LU   51   272    C1751    1416.00      0.00
5129267   FORCEP RADIAL JAW BIOPSY    51   272               58.00      0.00
5129978   CEMENT BONE 40 GRAM         51   272              359.00      0.00
5129986   CEMENT BONE SMART SET MV    51   272              346.00      0.00
5129994   DILATOR CANNULA MINST7/8    51   272              275.00      0.00
5130109   NEEDLE BASE PLATE 18G       51   272               14.00      0.00
5130117   SNARE GOOSENECK 2MM 200CM   51   272    C1773    2415.00      0.00
5130125   SNARE GOOSENECK 4MM 200CM   51   272    C1773    2415.00      0.00
5130133   SNARE GOOSENECK 7MM 200CM   51   272    C1773    2415.00      0.00
5130281   EXTRACTOR RX TRVL 9.0 12.   51   272              673.00      0.00
5130299   EXTRACTOR RX RTVL 12. 15.   51   272              673.00      0.00
5130489   SNARE GOOSENECK AMPLTZ 20   51   272    C1773    1097.00      0.00
5130497   SNARE GOOSENECK AMPLTZ 30   51   272    C1773    1097.00      0.00
5130505   CATH PERITONEAL 2 CUFF62C   51   272    C1750     297.00      0.00
5130513   BAG BLOOD WARMER HG/FLOW    51   272              110.00      0.00
5130844   STENT WAVEMAX 5X28X75       51   278    C1876   11000.00      0.00
5130851   STENT WAVEMAX 10X28X75      51   278    C1876   11000.00      0.00
5130877   STENT WAVEMAX 10X38X75      51   278    C1876   11000.00      0.00
5130885   STENT WAVEMAX 12X38X75      51   278    C1876   11000.00      0.00
5130893   BALLOON FOX 12X20X75        51   272    C1725     758.00      0.00
5130901   BALLOON FOX 12X40X135       51   272    C1725     758.00      0.00
5130919   BALLOON FOX 12X60X75        51   272    C1725     758.00      0.00
5130943   MASK LARYNGEAL LMA SZ2 DS   51   272               59.00      0.00
5130950   MASK LARYNGEAL LMA SZ2.5D   51   272               59.00      0.00
5130976   SPLINT ULNAR DEVIATION WF   51   271    A4570     273.00      0.00
5130984   CATH GUIDE RY 6FR JL3.5ST   51   272    C1887     266.00      0.00
5130992   CATH GUIDE RY 6FR JL3.5SH   51   272    C1887     266.00      0.00
5131008   CATH GUIDE RWY 6FR JL6      51   272    C1887     266.00      0.00
5131016   CATH GUIDE RUNWAY 6FR ARI   51   272    C1887     266.00      0.00
5131024   CATH GUIDE RY 6FR ART 3.5   51   272    C1887     313.00      0.00
5131032   CATH GUIDE RY 6FR A 3.5ST   51   272    C1887     313.00      0.00
5131040   CATH GUIDE RWY 6FR Q 3.5    51   272    C1887     266.00      0.00
5131057   CATH GUIDE RY 6FR Q 3.5ST   51   272    C1887     266.00      0.00
5131065   CATH GUIDE RY 6FR KIMNYSH   51   272    C1887     313.00      0.00
5131156   FILTER ULPA OPTIMUM SMOKE   51   272              408.00      0.00
5131164   ATTACHMENT SMOKE EVAC OPT   51   272               54.00      0.00
5131198   CATH X SIZER 4.5 135        51   272    C1757    5454.00      0.00
5131206   CATH X SIZER 5.5 135        51   272    C1757    5454.00      0.00
5131214   GUIDEWIRE AQ ANGLED         51   272    C1769     187.00      0.00
5131222   GUIDEWIRE AQ ANGLED EXCH    51   272    C1769     228.00      0.00
5131230   GUIDEWIRE AQ STIFF ANGLED   51   272    C1769     237.00      0.00
5131248   GUIDEWIRE AQ STIFF ANG/EX   51   272    C1769     291.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5131255   BALLOON CUTTING PERIP 5X2   51   272    C1725    3117.00      0.00
5131263   BALLOON CUTTING PERIP 6X2   51   272    C1725    3117.00      0.00
5131271   BALLOON CUTTNG PERIP 7X2X   51   272    C1725    3117.00      0.00
5131289   BALLOON CUTTNG PERIP 8X2X   51   272    C1725    3117.00      0.00
5131297   CATH GUIDE PERIP MACH1 6L   51   272    C1887     332.00      0.00
5131305   CATH GUIDE PERIP MACH1 6R   51   272    C1887     332.00      0.00
5131313   CATH GUIDE PERIP MACH1 7L   51   272    C1887     332.00      0.00
5131321   CATH GUIDE PERIP MACH1 7R   51   272    C1887     332.00      0.00
5131362   ELECTRODE RADIUS 1.0X.7V    51   272               23.00      0.00
5131370   ELECTRODE RADIUW 1.0X1.0V   51   272               23.00      0.00
5131388   ELECTRODE RADIUS 2.OX1.0V   51   272               23.00      0.00
5131396   SET OPCABMULTI VESSEL V     51   272              910.00      0.00
5131404   SET AXIUS STABILZR DP/BLV   51   272              910.00      0.00
5131412   PROBE LITHOTRIPTOR 3F V     51   272              174.00      0.00
5131503   TUBE FEEDING JEJUNAL 8.5F   51   272              519.00      0.00
5131552   MASK LARYNGEAL LMA AIRWAY   51   272               50.00      0.00
5131560   ELECTRODE STANDARD DISP     51   272              764.00      0.00
5131586   INTRODUCER W/BXNDL 196/10   51   272              171.00      0.00
5131651   BALLOON OPENSAIL 1.5 10     51   272    C1725     997.00      0.00
5131669   CATH GUIDE RWY CLS3.5SH     51   272    C1887     266.00      0.00
5131677   CATH GUIDE RWY CLS4SH       51   272    C1887     266.00      0.00
5131685   CATH GUIDE RWY 6FR WR       51   272    C1887     266.00      0.00
5131693   CATH GUIDE RWY 6FR WRSH     51   272    C1887     266.00      0.00
5131701   CATH GUIDE RWY 6FR JL3      51   272    C1887     266.00      0.00
5131719   CATH GUIDE RWY 6FR AL.75    51   272    C1887     266.00      0.00
5131735   DEVICE RETRIEVAL ROTH NET   51   272    C1773     311.00      0.00
5131743   GUIDEWIRE IQ W/O MARKERS    51   272    C1769     374.00      0.00
5131750   CATH GUIDE RWY 6FR LCBSH    51   272    C1887     266.00      0.00
5131768   CATH GUIDE RUNWY 6F RCBSH   51   272    C1887     266.00      0.00
5131776   CATH GUIDE RWY 6FR AL1.5    51   272    C1887     266.00      0.00
5131784   CATH GUIDE RWY 6FR CLS4.5   51   272    C1887     266.00      0.00
5131792   CATH GUIDE RWY 6FR ART4.5   51   272    C1887     266.00      0.00
5131800   CATH GUIDE RWY 6FR Q4.5     51   272    C1887     266.00      0.00
5131818   CATH GUIDE RWY 6FR JR3      51   272    C1887     266.00      0.00
5131826   CATH GUIDE RWY 6FR CLS3.5   51   272    C1887     266.00      0.00
5131834   CATH GUIDE MACH1 7F LCBSH   51   272    C1887     266.00      0.00
5131842   CATH GUIDE MACH1 7FR RCB    51   272    C1887     266.00      0.00
5131859   CATH GUIDE MACH1 7F RCBSH   51   272    C1887     266.00      0.00
5131883   CATH GUIDE OPTIMA 6F GL3.   51   272    C1887     187.00      0.00
5131891   CATH GUIDE OPTIMA 6FGL3.5   51   272    C1887     187.00      0.00
5131909   CATH GUIDE OPTIMA 6FR GL4   51   272    C1887     187.00      0.00
5131917   CATH GUIDE OPTIMA 6FGL4SH   51   272    C1887     187.00      0.00
5131925   CATH GUIDE OPTIMA 6F JL4S   51   272    C1887     170.00      0.00
5131990   STENT PROTEGE 7X20X80 6FR   51   278    C1876   11440.00      0.00
5132147   BALLOON STRLG MRL 4X15X80   51   272    C1725    1197.00      0.00
5132154   BALLOON STRLG MRL 4X20X80   51   272    C1725    1197.00      0.00
5132162   BALLOON STRLG MRL 5X15X80   51   272    C1725    1197.00      0.00
5132170   BALLOON STRLG MRL 5X20X80   51   272    C1725    1197.00      0.00
5132188   BALLOON STRLG MRL 6X15X80   51   272    C1725    1197.00      0.00
5132196   BALLOON STRLG MRL 6X20X80   51   272    C1725    1197.00      0.00
5132204   BALLOON STRLG MRL 7X15X80   51   272    C1725    1197.00      0.00
5132212   BALLOON STRLG MRL 7X20X80   51   272    C1725    1197.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5132220   BALLOON POLAR 4X20X120      51   272    C1725    2337.00      0.00
5132238   BALLOON POLAR 4X40X120      51   272    C1725    2337.00      0.00
5132246   BALLOON POLAR 4X60X120      51   272    C1725    2337.00      0.00
5132253   BALLOON POLAR 5X60X120      51   272    C1725    2337.00      0.00
5132261   BALLOON POLAR 6X60X120      51   272    C1725    2337.00      0.00
5132279   BALLOON POLAR 7X60X120      51   272    C1725    2337.00      0.00
5132311   CARTRIDGE NITROUS OXIDE     51   271             1994.00      0.00
5132345   STENT XCEED 6X8X120         51   278    C1876   12760.00      0.00
5132352   STENT WAVEMAX 7X38X75       51   278    C1876   11000.00      0.00
5132360   CATH 4FR JL6                51   272    C1887      58.00      0.00
5132378   CATH 4FR AL2                51   272    C1887      58.00      0.00
5132386   CATH 4FR AL3                51   272    C1887      58.00      0.00
5132394   CATH 4FR AR2                51   272    C1887      58.00      0.00
5132469   INTRODUCER TRACH TUBE L5F   51   272              208.00      0.00
5132527   CATH MOTARJEME 4FR 65CM     51   272               74.00      0.00
5132535   ADAPTR CRCT RT DL HTR WRE   51   271              431.00      0.00
5132543   CATH GUIDE PERIPH MACH 16   51   272    C1887     332.00      0.00
5132550   PUMP FEMOSTOP               51   271              519.00      0.00
5132568   DEVICE FEMOSTOP PLUS        51   272              309.00      0.00
5132584   STENT WAVEMAX 8X38X75       51   278    C1876   11000.00      0.00
5132618   PINS DISTRACTION 14MM       51   272              214.00      0.00
5132782   TRAY DIALYS CHRON 19CM      51   272             1237.00      0.00
5132790   TRAY DIALYSIS CHRONIC 28C   51   272             1237.00      0.00
5132808   TRAY DIALYSIS CHRONIC 23C   51   272             1237.00      0.00
5133004   FORCEP POT BIOPSY SING/U    51   272              270.00      0.00
5133020   DEVICE FEMOSTOP HD          51   272              318.00      0.00
5133038   PAD ARTIC UNIVERSAL SMALL   51   272              660.00      0.00
5133053   TRAY DIALYSIS 37CM METAL    51   272             1235.00      0.00
5133061   VALVE SHEATH FLOW GUARD/P   51   272              124.00      0.00
5133079   TRAY DIALYSIS 50CM          51   272             1746.00      0.00
5133186   GUIDEWIRE ASAHI PROWATER    51   272    C1769     374.00      0.00
5133194   GUIDEWIRE ASAHI GRAND SLM   51   272    C1769     270.00      0.00
5133202   GUIDEWIRE ASAHI MIRCLEBR3   51   272    C1769     478.00      0.00
5133210   GUIDEWIRE ASAHI MIRCLBR4.   51   272    C1769     478.00      0.00
5133228   GUIDEWIRE ASAHI MIRCLBR 6   51   272    C1769     478.00      0.00
5133236   CATH GUIDE BRITE 6FR RB     51   272    C1725     270.00      0.00
5133285   CATH GUIDE BRITE 6F 3DRCS   51   272    C1725     270.00      0.00
5133293   CATH GUIDE BRITE 6F MPSH    51   272    C1725     270.00      0.00
5133301   CATH GUIDE BRITE 6F MP      51   272    C1725     270.00      0.00
5133319   CATH GUIDE BRITE 6F ARISH   51   272    C1725     270.00      0.00
5133327   CATH GUIDE BRITE 6F XB4SH   51   272    C1725     270.00      0.00
5133335   CATH GUIDE BRITE 6F HS      51   272    C1725     270.00      0.00
5133343   CATH GUIDE BRITE HSSH       51   272    C1887     270.00      0.00
5133350   CATH GUIDE BRITE 6F ZBC4    51   272    C1725     270.00      0.00
5133368   CATH GUIDE BRITE 6F 3DRC    51   272    C1725     270.00      0.00
5133376   CATH GUIDE BRITE 6F XBC3.   51   272    C1725     270.00      0.00
5133384   CATH GUIDE BRITE 6F XBRCA   51   272    C1887     270.00      0.00
5133392   CATH GUIDE BRITE 6F IMVBI   51   272    C1725     270.00      0.00
5133400   CATH GUIDE BRITE 6F JL4.5   51   272    C1725     270.00      0.00
5133418   CNN NSL 7FT OTE CRV TIP C   51   271               50.00      0.00
5133442   STENT WAVEMAX 8X28X75       51   278    C1876   11000.00      0.00
5133459   STENT WAVEMAX 7X28X75       51   278    C1876   11000.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5133657   APPLIER MENISCAL DSP R/LK   51   272              453.00      0.00
5133665   SUTURE MENISCAL REP PLA#0   51   272              727.00      0.00
5133673   SUTURE MENISCL REP PLA#27   51   272              727.00      0.00
5133681   SUTURE MENISCL REP PLA#12   51   272              727.00      0.00
5133699   CATH PICC 1.9FR             51   272    C1751     145.00      0.00
5133707   KIT CATHETER PICC 1.9FR     51   272              133.00      0.00
5133715   INTRODUCER PICC 1.9FR       51   272              182.00      0.00
5133731   DEVICE ULTRASOUND SLED      51   272              145.00      0.00
5133764   SHEATH GUIDE 7FR MP         51   272    C1894     540.00      0.00
5133871   CATH 5FR FLUSH 90CM         51   272    C1887      89.00      0.00
5133889   CATH 4FR 30RC               51   272    C1887      58.00      0.00
5133897   CATH 4FR LCB                51   272    C1887      58.00      0.00
5133905   CATH 4FR RCB                51   272    C1887      58.00      0.00
5133913   CIRCUIT BIPAP HEATED ADLT   51   272              124.00      0.00
5134226   FORCEP BOT BIOPSY S/U V     51   272               73.00      0.00
5134259   STENT XPERT 6X40X120        51   278    C1876   15840.00      0.00
5134267   STENT XPERT 6X60X120        51   278    C1876   15840.00      0.00
5134275   STENT XPERT 6X60X80         51   278    C1876   15840.00      0.00
5134283   STENT XPERT 6X40X80         51   278    C1876   15840.00      0.00
5134358   INSTRUMENT FRCP LIGASURE    51   272              997.00      0.00
5134366   BRACE ANK/FT WLKR HI XLG    51   274    L4386     389.75      0.00
5134374   BRACE ANK/FT WLKR HI XSM    51   274    L4386     362.75      0.00
5134440   SPLINT WRIST THMB LEFT LG   51   274    L3984     158.25      0.00
5134457   SPLINT WRIST THMB LEFT MD   51   274    L3984     158.25      0.00
5134465   SPLINT WRIST THUMB RT MED   51   274    L3984     158.25      0.00
5134473   SPLINT WRIST THMB LEFT SM   51   274    L3984     158.25      0.00
5134481   SPLINT WRIST THUMB RT SM    51   274    L3984     158.25      0.00
5134499   SPLINT WRIST THMB LFT XLG   51   274    L3984     158.25      0.00
5134507   SPLINT WRIST THUMB RT XLG   51   274    L3984     158.25      0.00
5134515   SPLINT WRIST THUMB RT XSM   51   274    L3984     163.25      0.00
5134523   SPLINT WRIST THUMB RT XXL   51   274    L3984     163.25      0.00
5134531   SPLINT WRIST THUMB RT LG    51   274    L3984     158.25      0.00
5134549   SPLINT WRIST THMB LFT XSM   51   274    L3984     163.25      0.00
5134556   MASK NASAL SIL INFNT MED    51   272               72.00      0.00
5134572   NEEDLE JAMSHIDI 8GA 4"      51   272              113.00      0.00
5134580   NEEDLE JAMSHIDI 13GA 2"     51   272               62.00      0.00
5134598   NEEDLE JAMSHIDI 13G 3 1/2   51   272              113.00      0.00
5134630   TRAY EPIDURAL 25GA OB       51   272              130.00      0.00
5134648   TRAY SPINAL 27GA OB         51   272              136.00      0.00
5134739   SUTURE FASTAKE ANCHOR W/H   51   272              747.00      0.00
5134861   BURR EGG                    51   272              262.00      0.00
5134879   BURR PEAR                   51   272              262.00      0.00
5134887   BURR ROUND FAST CUTTING     51   272              232.00      0.00
5134903   BURR FASTCUTTING 7.1MM RD   51   272              232.00      0.00
5134911   BLADE DRILL WIRE PASS       51   272              279.00      0.00
5134945   TIP BONE CLEANING           51   272               54.00      0.00
5134952   BRUSH FEMORAL               51   272               54.00      0.00
5134960   BLADE LARGE THIN SAFEDGE    51   272              218.00      0.00
5134978   BLADE RECIPROCATING LG33.   51   272              302.00      0.00
5134994   PROBE DILATOR PARSONNETT    51   272               83.00      0.00
5135009   PROBE HOOK ULTRASNC DEV V   51   272              268.00      0.00
5135017   TROCAR CANNULEA 10MM STPV   51   272              122.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5135108   STENT EXP MONO 6.0 18/50    51   278    C1876   10560.00      0.00
5135330   KIT EMERGENCY CRICO/TRCHD   51   272              473.00      0.00
5135348   MASK LARING FASTRAC LM4 U   51   272             2054.00      0.00
5135355   MASK LARING FASTRAC LMA5U   51   272             2054.00      0.00
5135363   MASK LARING PROSEAL LMA4U   51   272             1017.00      0.00
5135371   MASK LARYNG PROSEAL LMA5U   51   272             1017.00      0.00
5135389   TRAY COMBI TUBE 41FR        51   272              289.00      0.00
5135397   TRAY COMBI TUBE 37FR        51   272              289.00      0.00
5135405   PATCH ACTION                51   272               36.00      0.00
5135413   STABILIZER ACROBAT VACM/S   51   272             4266.00      0.00
5135421   KIT CATH PREMICATH 27GA S   51   272              222.00      0.00
5135496   PROBE ABLATION MICROW FLX   51   272            10713.00      0.00
5135504   CATH EPIDURAL 21GX24"       51   272    C1751     262.00      0.00
5135512   PROBE ABLATION MICRW FL10   51   272            16557.00      0.00
5135553   APPLICATOR TIP DUAL C 20G   51   272               76.00      0.00
5135561   TIP DUAL SPRAY PLATELT GL   51   272               76.00      0.00
5135579   APPLICATOR RATIO PLATLT G   51   272               87.00      0.00
5135603   SYSTEM INJ RAPID REFILL     51   272               91.00      0.00
5135652   NEEDLE EPIDURAL STRGT 18G   51   272               62.00      0.00
5135660   NEEDLE EPIDURAL STR 18GX3   51   272               60.00      0.00
5135744   DRESSING ACTICOAT ABSRB4X   51   272              201.00      0.00
5135769   DRAPE MICROSCOPE DISP       51   272              216.00      0.00
5135793   SEAL HEARTSTRING PRX 4.3M   51   272             1795.00      0.00
5135801   DEVICE HEARTSTRING PRX SL   51   272             1516.00      0.00
5135827   CIRCUIT HEATED HIGHFLOW I   51   271              153.00      0.00
5135850   BAG COLLECTOR FLUID STERL   51   272              103.00      0.00
5135876   COVER C ARM DISP            51   271               66.00      0.00
5135900   INSTR VESSEL SEALING 20CM   51   272             1467.00      0.00
5136064   LEAD EXTRACTION SYSTEM 5    51   272            29140.00      0.00
5136080   CANNULA WITH TROCAR         51   272              104.00      0.00
5136106   DEVICE LEAD CLIPPER         51   272              195.00      0.00
5136114   DILATOR SHEATH SS SZ A      51   272              739.00      0.00
5136122   INTRODUCER PEEL AWAY 14FR   51   272              252.00      0.00
5136130   INTRODUCER PEEL AWAY 12FR   51   272              252.00      0.00
5136148   DILATOR SHEATH 11.5FR       51   272              436.00      0.00
5136155   INTRODUCER PEEL AWAY 9FR    51   272              252.00      0.00
5136163   INTRODUCER PEEL AWAY 10FR   51   272              252.00      0.00
5136171   INTRODUCER PEEL AWAY 7FR    51   272              252.00      0.00
5136189   SHEATH CURVED FEMORL 16FR   51   272    C1894    1364.00      0.00
5136197   SHEATH CURVED FEMRL 12FR    51   272    C1894     569.00      0.00
5136205   SNARE 20MM W/12FR ST SHEA   51   272    C1773    1655.00      0.00
5136213   SNARE 20MM                  51   272    C1773    2579.00      0.00
5136221   SNARE 13MM W/12F ST SHEAT   51   272    C1773    1655.00      0.00
5136239   SNARE 13MM                  51   272    C1773    2579.00      0.00
5136247   DILATOR SHEATH SS SZ C      51   272              739.00      0.00
5136254   DILATOR SHEATH SS SZ B      51   272              739.00      0.00
5136262   DILATOR SHEATH 10FR         51   272              436.00      0.00
5136270   DILATOR SHEATH TEF SET C    51   272              490.00      0.00
5136288   DILATOR SHEATH TEF SET C    51   272              436.00      0.00
5136296   DILATOR SHEATH 8.5FR EXLG   51   272              490.00      0.00
5136304   DILATOR SHEATH TEF S/B EX   51   272              490.00      0.00
5136312   DILATOR SHEATH 8.5FR        51   272              436.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5136320   DILATOR SHEATH TEF SET B    51   272             436.00      0.00
5136338   DILATOR SHEATH 13FR EXLON   51   272             490.00      0.00
5136346   DILATOR SHEATH 7FR EXLONG   51   272             490.00      0.00
5136353   DILATOR SHEATH 13FR         51   272             436.00      0.00
5136361   DILATOR SHEATH 7FR          51   272             436.00      0.00
5136379   DEVICE LOCKNG STYLT .016    51   272    C1773   1572.00      0.00
5136387   DILATOR SHEATH 11.5 EXLNG   51   272             490.00      0.00
5136395   DILATOR SHEATH 10FR EXLNG   51   272             490.00      0.00
5136403   DEVICE PIN VISE             51   272             228.00      0.00
5136411   GUIDEWIRE STYLET            51   272    C1769    145.00      0.00
5136437   DEVICE SOF GRIP HEMOSTAT    51   272             199.00      0.00
5136445   DEVICE COIL EXPANDER        51   272             208.00      0.00
5136601   PACK PACEMAKER              51   272             181.00      0.00
5136627   CATH EXTRACTION PRON        51   272    C1757   1975.00      0.00
5136635   SET INTRODUCER MICROPUN 5   51   272    C1894    120.00      0.00
5136668   TRAY CATH PIC 2 LUMEN 5FR   51   272    C1751    196.00      0.00
5136734   CATH 4FR JOG MULTI ANG      51   272    C1887    118.00      0.00
5136742   CATH 4FR JOG JL3.5          51   272    C1887     40.00      0.00
5136759   CATH 4FR JOG JL4            51   272    C1887     40.00      0.00
5136767   CATH 4FR JOG JL5            51   272    C1887     40.00      0.00
5136775   CATH 4FR JOG JR3.5          51   272    C1887     40.00      0.00
5136783   CATH 4FR JOG JR4            51   272    C1887     40.00      0.00
5136791   CATH 4FR JOG JR5            51   272    C1887     40.00      0.00
5136809   CATH 4FR JOG PROGRESSV RT   51   272    C1887     40.00      0.00
5136817   CATH 4FR JOG PIG ANG        51   272    C1887     40.00      0.00
5136825   CATH 4FR JOG ALI            51   272    C1887     40.00      0.00
5136833   CATH 4FR JOG AL2            51   272    C1887     40.00      0.00
5136841   CATH 4FR JOG ARI            51   272    C1887     40.00      0.00
5136858   CATH 4FR JOG AR2            51   272    C1887     40.00      0.00
5136866   CATH 4FR JAG IMA            51   272    C1887     40.00      0.00
5136874   CATH 4FR JOG RCB            51   272    C1887     40.00      0.00
5136882   CATH 4FR JOG LCB            51   272    C1887     40.00      0.00
5136890   CATH 4FR JOG MPA2           51   272    C1887     40.00      0.00
5136908   CANNULA 100MM CURV 20G 10   51   272             133.00      0.00
5136916   CANNULA 150MM CURVED 20G    51   272             172.00      0.00
5136924   ELECTRODE PAD SELF ADHESV   51   272              88.00      0.00
5136932   CATH 4FR JOG PIG ST         51   272    C1887     37.00      0.00
5136973   NASAL CPAP ADULT SMALL      51   271             104.00      0.00
5136981   MASK CPAP NASAL ADULT MED   51   271              64.00      0.00
5136999   MASK CPAP NASAL ADULT LG    51   271              64.00      0.00
5137005   NASAL CPAP ADULT XLARGE     51   271             104.00      0.00
5137088   CATH GUIDE BRITE 6F XBRCA   51   272    C1887    270.00      0.00
5137096   NEEDLE ACTIVE TIP CURV5.0   51   272             110.00      0.00
5137104   NEEDLE ACTIVE TIP STRG4.0   51   272             110.00      0.00
5137120   GUIDEWIRE SENSOR .038 STR   51   272    C1769    195.00      0.00
5137138   GUIDEWIRE .025 STRAIGHT     51   272    C1769    170.00      0.00
5137146   GUIDEWIRE SUPERSTIFF .35A   51   272    C1769    266.00      0.00
5137153   GUIDEWIRE SUPERSTIFF .035   51   272    C1769    266.00      0.00
5137187   BANDAGES TRANSELAST CLASS   51   271    A6448      2.00      0.00
5137195   BANDAGES KIDNEY F/RUBB SM   51   271    A5126      9.00      0.00
5137203   BANDAGES KIDNEY F/RUBB LG   51   271    A5126     16.00      0.00
5137245   TRAY THORA/PARACENTESIS     51   272             235.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5137336   FORCEP GRASPING 2.6FX90CM   51   272              878.00      0.00
5137344   FORCEP GRASPING 3.2FX90CM   51   272              878.00      0.00
5137351   RETRIEVER STONE 3FX90CM     51   272              826.00      0.00
5137369   RETRIEVER STONE BSKT NITI   51   272              897.00      0.00
5137385   DRESSING VAC ATS WHITE LG   51   272              166.00      0.00
5137401   SLEEVE SCD STERILE THGH L   51   272              161.00      0.00
5137419   SLEEVE SCD KNEE LENGTH      51   271              124.00      0.00
5137427   SLEEVE SCD THIGH MEDIUM     51   271              191.00      0.00
5137435   SLEEVE SCD THIGH LARGE      51   271              229.00      0.00
5137476   KIT NERVE BLOCK 22GA X 8"   51   272               60.00      0.00
5137484   KIT NERVE BLOCK 25GA X 6"   51   272               56.00      0.00
5137492   STENT XCEED 6X40X120        51   278    C1876   12760.00      0.00
5137500   STENT XCEED 7X80X120        51   278    C1876   12760.00      0.00
5137518   STENT XCEED 7X40X120        51   278    C1876   12760.00      0.00
5137526   CATH 6FR PIG DUAL LUMEN     51   272    C1887     536.00      0.00
5137732   SLEEVE TROCAR 5MM           51   272               98.00      0.00
5137740   BLADE LNG RECIP SHRT 33.5   51   272              326.00      0.00
5137757   BLADE SHRT TAPRD LNG 27.0   51   272              288.00      0.00
5137765   BLADE LG TR ACRS CUT RASP   51   272              541.00      0.00
5137773   BLADE SAFDGE LG/SHRT 23.0   51   272              326.00      0.00
5137781   BLADE MINI RECP SHRT 27.0   51   272              288.00      0.00
5137799   BLADE MINI RECP SHRT 14.5   51   272              326.00      0.00
5137807   BLADE CORE INTRA ORL 12.0   51   272              413.00      0.00
5137815   BLADE CORE INTRA ORAL 7.0   51   272              413.00      0.00
5137831   BLADE AGGRESIVE 4.0 SINUS   51   272              396.00      0.00
5137856   STENT XCEED 6X60X120        51   278    C1876   12760.00      0.00
5137864   STENT XCEED 7X60X120        51   278    C1876   12760.00      0.00
5137872   BALLOON FOX 4X40X135        51   272    C1725     758.00      0.00
5137880   BALLOON FOX 5X40X135        51   272    C1725     758.00      0.00
5137898   BALLOON FOX 6X40X135        51   272    C1725     758.00      0.00
5137914   CATH GUIDE BRITE XB4        51   272    C1887     270.00      0.00
5138375   STENT LIBERTE 3.0 8         51   278    C1876    8360.00      0.00
5138383   STENT LIBERTE 2.75 8        51   278    C1876    8360.00      0.00
5138474   CATH STONE BASKET 1.5X3     51   272             1175.00      0.00
5138482   SHEATH 12FR 30CM            51   272    C1894     276.00      0.00
5138490   SHEATH 14FR 30CM            51   272    C1894     276.00      0.00
5138508   CATH DRAINAGE 12FR 25CM     51   272    C1729     285.00      0.00
5138516   CATH DRAINAGE 14FR 25CM     51   272    C1729     285.00      0.00
5138524   CATH STONE BASKET 1.8X2.5   51   272             1575.00      0.00
5138532   ELECTRODES VALUTRADE        51   271                4.00      0.00
5138540   CANNULA 410 CU 20GA 7.5MM   51   272              133.00      0.00
5138557   SET ESPOCAN SPIRAL EPIDUR   51   272               73.00      0.00
5138631   BRACE BACK PROLIGN SM       51   274    L0628     910.75      0.00
5138649   BRACE BACK PROLIGN MED      51   274    L0628     910.75      0.00
5138656   BRACE BACK PROLIGN LG       51   274    L0628     910.75      0.00
5138664   BRACE BACK PROLIGN XL       51   274    L0628     910.75      0.00
5138672   BRACE BACK PROLIGN XXL      51   274    L0628     910.75      0.00
5138680   CATH DRAIN SUPRPUBIC ROBV   51   272    C2627     122.00      0.00
5138698   INSTRUMENT FRCP LIGASUREV   51   272              816.00      0.00
5138706   LOOPS RESECT CUT 24FRV      51   272              313.00      0.00
5138722   STENT LIBERTE 3.5 16        51   278    C1876    8360.00      0.00
5138789   STENT LIBERTE 4.5 12        51   278    C1876    8360.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5138797   SET FILTERLINE H ADLT/PED   51   271               51.00      0.00
5138805   SET FILTERLINE INFANT/NEO   51   271               51.00      0.00
5138961   SENSOR OXYCLIQ NEONATAL     51   272               35.00      0.00
5138995   INTRODUCER PEEL AWAY 16FR   51   272    C1892     199.00      0.00
5139001   INTRODUCER PEEL AWAY 20FR   51   272    C1892     160.00      0.00
5139019   INTRODUCER PEEL AWAY 22FR   51   272    C1892     160.00      0.00
5139043   CATH GUIDE BRI 6FR XB 4.5   51   272    C1887     270.00      0.00
5139050   CATH GUIDE BRITE 6FR AL3    51   272    C1887     270.00      0.00
5139068   CATH GUI BRI 6F XBLAD 4.5   51   272    C1887     270.00      0.00
5139076   SPLINT NGHT DORSAL PF-MED   51   274    L1930     138.50      0.00
5139084   SPLINT NGHT DORSAL PF-LG    51   274    L1930     316.75      0.00
5139092   PAD CPM KNEE DANNIGER 400   51   271               47.00      0.00
5139100   CABLE CATH LAB DISP PCMKR   51   272              124.00      0.00
5139118   STENT LIBERTE 2.75 12       51   278    C1876    8360.00      0.00
5139126   STENT LIBERTE 2.75 16       51   278    C1876    8360.00      0.00
5139134   STENT LIBERTE 3.5 20        51   278    C1876    8360.00      0.00
5139142   STENT LIBERTE 4.0 8         51   278    C1876    8360.00      0.00
5139159   STENT LIBERTE 4.5 16        51   278    C1876    8360.00      0.00
5139167   STENT LIBERTE 5.0 12        51   278    C1876    8360.00      0.00
5139175   STENT LIBERTE 5.0 16        51   278    C1876    8360.00      0.00
5139258   KIT PLNTR FACI NIGHT MED    51   274    L1930     768.50      0.00
5139266   KIT PLNTR FACI NIGHT LG     51   274    L1930     768.50      0.00
5139274   CUP HEEL SILICONE MED       51   271               97.00      0.00
5139282   CUP HEEL SILICONE MED       51   271               97.00      0.00
5139290   STRAP FOOT CONTROL          51   271              127.00      0.00
5139308   HOOKS ELAS STAY 12MM BLNT   51   272              183.00      0.00
5139332   SENSOR DIGI OXICLIQ ADULT   51   272               29.00      0.00
5139340   SENSOR DIGI OXICLIQ INFNT   51   272               35.00      0.00
5139357   SENSOR DIGI OXICLIQ PEDS    51   272               29.00      0.00
5139464   STENT EXPRESS LD 5X17X75    51   278    C1876   11396.00      0.00
5139472   GUIDEWIRE ANGLED 260CM      51   272    C1769     225.00      0.00
5139506   IMMOBILIZER SHOULDER UNIV   51   274    L3650      96.75      0.00
5139514   COLLAR CERVICAL ADJUSTABL   51   274    L0172     321.50      0.00
5139522   SPLINT ACROMIO CLAVICULAR   51   274    L3670     180.75      0.00
5139555   SPLINT WRST & THMB LT XXL   51   274    L3908     163.25      0.00
5139563   PAD II SHOULDER SMALL       51   274    L3660     396.75      0.00
5139571   PAD II SHOULDER MEDIUM      51   274    L3660     396.75      0.00
5139589   PAD II SHOULDER LARGE       51   274    L3660     396.75      0.00
5139597   SPLINT TENNIS ELBOW XSML    51   274    L3701      84.25      0.00
5139605   SPLINT TENNIS ELBOW SML     51   274    L3701      84.25      0.00
5139613   SPLINT TENNIS ELBOW MED     51   274    L3701      84.25      0.00
5139621   SPLINT TENNIS ELBOW LG      51   274    L3701      84.25      0.00
5139639   SPLINT TENNIS ELBOW XL      51   274    L3701      84.25      0.00
5139647   SPLINT TENNIS ELBOW XXL     51   274    L3701      84.25      0.00
5139654   SPLINT TENNIS ELBOW UNIV    51   274    L3701      58.00      0.00
5139662   SPLINTSRITE SMALL           51   274    L4386     524.25      0.00
5139670   SPLINTSRITE MEDIUM          51   274    L4386     524.25      0.00
5139688   SPLINTSRITE LARGE           51   274    L4386     524.25      0.00
5139696   SPLINTSRITE XLARGE          51   274    L4386     524.25      0.00
5139704   BRACE ANK/FT WLKR LO SML    51   274    L4386     261.50      0.00
5139712   BRACE ANK/FT WLKR LO MED    51   274    L4386     261.50      0.00
5139720   BRACE ANK/FT WLKR LO LG     51   274    L4386     261.50      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5139779   STENT EXP MONO 4.0 15       51   278    C1876   10560.00      0.00
5139845   BRACE ANK/FT WKR WRAP SM    51   274    L4386     258.25      0.00
5139852   BRACE ANK/FT WKR WRAP MED   51   274    L4386     258.25      0.00
5139860   BRACE ANK/FT WKR WRAP LG    51   274    L4386     258.25      0.00
5139936   STENT LIBERTE 2.75 24       51   278    C1876    8360.00      0.00
5139944   STENT LIBERTE 2.75 28       51   278    C1876    8360.00      0.00
5139951   STENT LIBERTE 2.75 32       51   278    C1876    8360.00      0.00
5139969   STENT LIBERTE 3.0 24        51   278    C1876    8360.00      0.00
5139977   STENT LIBERTE 3.0 28        51   278    C1876    8360.00      0.00
5139985   STENT LIBERTE 3.0 32        51   278    C1876    8360.00      0.00
5139993   STENT LIBERTE 3.5 28        51   278    C1876    8360.00      0.00
5140009   STENT LIBERTE 3.5 32        51   278    C1876    8360.00      0.00
5140017   STENT LIBERTE 4.5 20        51   278    C1876    8360.00      0.00
5140025   STENT LIBERTE 4.5 24        51   278    C1876    8360.00      0.00
5140033   STENT LIBERTE 5.0 20        51   278    C1876    8360.00      0.00
5140041   STENT LIBERTE 5.0 24        51   278    C1876    8360.00      0.00
5140058   STENT LIBERTE 5.0 28        51   278    C1876    8360.00      0.00
5140074   GUIDEWIRE .018              51   272    C1769     252.00      0.00
5140082   CATH BALL OCCLUDER OCCLUS   51   272    C2628     322.00      0.00
5140090   WIRE SENSOR STRAIGHT .035   51   272    C1769     195.00      0.00
5140108   WIRE SENSOR ANGLED .035     51   272    C1769     195.00      0.00
5140116   GUIDEWIRE .025              51   272    C1769     266.00      0.00
5140124   CATH NEHP MALECOT 20FR      51   272    C1729     320.00      0.00
5140132   CATH NEPH RNTRY MLCT 20FR   51   272    C1729     332.00      0.00
5140140   CATH NEPH MALECOT 16FR      51   272    C1729     332.00      0.00
5140157   CATCHER ULTRASOUND STONE    51   272              291.00      0.00
5140165   CATH BERN TIP ACCESS        51   272               83.00      0.00
5140173   KIT PUNCTURE MARDIS II      51   272              311.00      0.00
5140181   SHEATH RENAL CLEAR          51   272              241.00      0.00
5140199   CATH BALL NEPHROMAX         51   272    C1726    1097.00      0.00
5140207   DILATOR AMPLATZ & SHEATH    51   272             1017.00      0.00
5140215   PROBE US 3.8MM 300X330      51   272             2114.00      0.00
5140223   NEEDLE PERC ACCESS 18G      51   272              154.00      0.00
5140231   PROBE PNEUMATIC 497MM       51   272              897.00      0.00
5140249   PROBE US 3.8MM 400X3MM      51   272             2114.00      0.00
5140256   PROBE PNEUMATIC 570MM       51   272              897.00      0.00
5140264   ELECTRODE NEUROLINE CUP     51   271               37.00      0.00
5140371   KIT FECAL MGT SYSTEM        51   271             1197.00      0.00
5140397   SUTURE CAP POL MONO OTC36   51   272              102.00      0.00
5140405   TUBE FEEDING WEIGHTED 6FR   51   272               55.00      0.00
5140413   SET SUCTION INTROPERATIVE   51   272               79.00      0.00
5140447   TUBE ENDOTRACH CHNGR STRL   51   272               57.00      0.00
5140462   CATH PICC DUAL LUMEN 5FR    51   272    C1751     205.00      0.00
5140470   STENT EXP MONO 6.0 14 150   51   278    C1876   10560.00      0.00
5140488   CATH BALL STRLING 7X2X135   51   272    C1725    1855.00      0.00
5140603   KIT PICC 3FR                51   272    C1751     286.00      0.00
5140629   INST DISC LAP HND ACC DEV   51   272             2023.00      0.00
5140637   INSTR DISC LAP MED SLEEVE   51   272             2023.00      0.00
5140835   KIT SHOULDER SUSPENSION     51   272              285.00      0.00
5140843   WAND ENT ULTRA 45           51   272              727.00      0.00
5140850   WAND ENT ULTRA              51   272              831.00      0.00
5140868   PROBE ABLATION SUCT 60DEG   51   272              756.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5140884   WAND EVAC 70 EXTRA LONG     51   272              789.00      0.00
5140967   SUTURE ENDO POLY 4-0 ES-9   51   272              165.00      0.00
5140975   HANDPIECE HARMON ACE 23CM   51   272             1476.00      0.00
5140983   HANDPIECE HARMON ACE 36CM   51   272             1675.00      0.00
5141007   FIBER LASER HO 270UM DISP   51   272             1596.00      0.00
5141015   FIBER LASER HO 400UM DISP   51   272             1596.00      0.00
5141023   SET HTA PROCEDURE           51   272             3311.00      0.00
5141031   KIT ABLATION ENDOMETRIAL    51   272             3876.00      0.00
5141056   SPLINT NASAL SEPTAL DOYLE   51   272              108.00      0.00
5141239   DILATOR NOTTINGHAM URETER   51   272              569.00      0.00
5141270   CEMENT BONE RADIOPAQ VERT   51   272             2043.00      0.00
5141288   CEMENT BONE DELIVE VETERB   51   272             2094.00      0.00
5141296   KIT PREP CEMENT BONE VETE   51   272              374.00      0.00
5141304   HANDL STYLET CEM BONE VET   51   272              478.00      0.00
5141312   LOAD UN ROTIC ENDO 45-3.5   51   272              652.00      0.00
5141320   LOAD UN ROTIC ENDO 60-3.5   51   272             1160.00      0.00
5141338   LOAD UN ROTIC ENDO 45-2.5   51   272              652.00      0.00
5141346   LOAD UN ROTIC ENDO 30-3.5   51   272              571.00      0.00
5141353   LOAD UN ROTIC ENDO 60-2.5   51   272             1160.00      0.00
5141361   TUBING CUSTOM OXY TRILLIU   51   272             1177.00      0.00
5141379   CATH NEPH LOCK LOOP 12F     51   272    C1729     374.00      0.00
5141387   CATH NEPH LOCK LOOP 14F     51   272    C1729     374.00      0.00
5141403   KIT APPL FALOPE RING BAND   51   272              646.00      0.00
5141411   KIT FALOPE RING BAND        51   272              201.00      0.00
5141429   STENT NEPHURETER 8FR 24CM   51   278    C2617    1038.50      0.00
5141437   KIT NDL AXIAL BX VERTEBRO   51   272              374.00      0.00
5141478   TRAY INFLAT BONE TAMP KYP   51   272            14005.00      0.00
5141486   DEVICE BONE BIOPSY KYPHON   51   272              540.00      0.00
5141494   CEMENT BONE & MIXER KYPHO   51   272              789.00      0.00
5141502   INTRODUCER DILATOR PEEL S   51   272              166.00      0.00
5141510   FILTER G2 VENA CAVA         51   278    C1880   12276.00      0.00
5141528   DEVICE HEMOSTASIS V+PAD     51   272              270.00      0.00
5141585   SUCTION WAND 45 INTG CABL   51   272              890.00      0.00
5141593   SUTURE BIOCRKSCRW ANC 5.0   51   272             1077.00      0.00
5141601   SUTURE CRKSCRW ANCH 6.5MM   51   272              810.00      0.00
5141619   MONITOR PRB PEDIC NEU JJB   51   272             4947.00      0.00
5141627   BLANKET PED UNERBDY 550LG   51   272               62.00      0.00
5141635   BLANKET PED UNDRBDY 555SM   51   272               57.00      0.00
5141726   STENT NEPHRO 8FR 22CM       51   278    C2617    1038.50      0.00
5141734   STENT EXPRESS LD 5X17X135   51   278    C1876   11396.00      0.00
5141742   STENT EXPRESS LD 5X27X75    51   278    C1876   12276.00      0.00
5141759   STENT EXPRESS LD 5X27X135   51   278    C1876   12276.00      0.00
5141767   STENT EXPRESS LD 5X37X75    51   278    C1876   12276.00      0.00
5141825   POUCH ENDO CATCH 15MM       51   272              541.00      0.00
5141882   SUTURE FASTAK FIBERW 2.4M   51   272              685.00      0.00
5141890   TIPS BILICAL CALIBRATION    51   272               23.00      0.00
5141908   DEVICE CLOS SYS STAR 6FR    51   278    C1760    1804.00      0.00
5141916   TUBE IMA FLX/SPIRAL SZ 6    51   272              278.00      0.00
5142021   STENT GFT FLUENCY 6X40X80   51   278    C1874   19316.00      0.00
5142039   STENT GFT FLUENCY 6X60X80   51   278    C1874   21076.00      0.00
5142047   STENT GFT FLUENCY 7X40X80   51   278    C1874   19316.00      0.00
5142054   STENT GFT FLUENCY 7X60X80   51   278    C1874   21076.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5142062   BALLOON CONQUEST 6X4X75     51   272    C1725    878.00      0.00
5142070   CATH GUIDE MACH1 JL3.5SH    51   272    C1887    266.00      0.00
5142088   CATH GUIDE MACH1 JL4SH      51   272    C1887    266.00      0.00
5142096   CATH GUIDE MACH1 JL5        51   272    C1887    266.00      0.00
5142104   CATH GUIDE MACH1 JL5SH      51   272    C1887    266.00      0.00
5142112   CATH GUIDE MACH1 JR4        51   272    C1887    266.00      0.00
5142120   CATH GUIDE MACH1 JR4SH      51   272    C1887    266.00      0.00
5142138   CATH DBL L 11.5FR #4625     51   272    C1752    228.00      0.00
5142161   GW JF .035X70 CM #4625      51   272    C1769    228.00      0.00
5142179   CATH DBL L 11.5FR #4626     51   272    C1752    228.00      0.00
5142187   GW JF .035X70 CM #4626      51   272    C1769    228.00      0.00
5142195   CATH DUAL L 11.5FR #3446    51   272    C1752    220.00      0.00
5142203   GW J ST .038" X 70CM        51   272    C1769    220.00      0.00
5142211   DRESSING MATRX WOUND 7X10   51   272             340.00      0.00
5142229   CATH GUIDE MACH1 JL4        51   272    C1887    266.00      0.00
5142237   CATH GUIDE MACH1 JL 3.5     51   272    C1887    266.00      0.00
5142245   CATH GUIDE MACH1 AR1        51   272    C1887    266.00      0.00
5142252   CATH GUIDE MACH1 AR1 SH     51   272    C1887    266.00      0.00
5142260   CATH GUIDE MACH1 AL1        51   272    C1887    266.00      0.00
5142310   BRACE ANKLE LACE UP SM      51   274    L1902    211.00      0.00
5142328   BRACE ANKLE LACE UP MED     51   274    L1902    211.00      0.00
5142336   BRACE ANKLE LACE UP LG      51   274    L1902    211.00      0.00
5142344   BRACE ANKLE LACE UP XLG     51   274    L1902    211.00      0.00
5142351   BRACE ANKLE VELCRO C STIR   51   274    L1906    181.50      0.00
5142435   BALLOON VOYAGER 1.5 12      51   272    C1725    957.00      0.00
5142443   BALLOON VOYAGER 1.5 15      51   272    C1725    957.00      0.00
5142450   BALLOON VOYAGER 2.0 8       51   272    C1725    957.00      0.00
5142468   BALLOON VOYAGER 2.0 12      51   272    C1725    957.00      0.00
5142476   BALLOON VOYAGER 2.0 15      51   272    C1725    957.00      0.00
5142484   BALLOON VOYAGER 2.0 20      51   272    C1725    957.00      0.00
5142492   BALLOON VOYAGER 2.5 8       51   272    C1725    957.00      0.00
5142500   BALLOON VOYAGER 2.5 12      51   272    C1725    957.00      0.00
5142518   BALLOON VOYAGER 2.5 15      51   272    C1725    957.00      0.00
5142526   BALLOON VOYAGER 2.5 20      51   272    C1725    957.00      0.00
5142534   BALLOON VOYAGER 3.0 8       51   272    C1725    957.00      0.00
5142542   BALLOON VOYAGER 3.0 12      51   272    C1725    957.00      0.00
5142559   BALLOON VOYAGER 3.0 15      51   272    C1725    957.00      0.00
5142567   BALLOON VOYAGER 3.0 20      51   272    C1725    957.00      0.00
5142575   BALLOON VOYAGER 3.5 8       51   272    C1725    957.00      0.00
5142583   BALLOON VOYAGER 3.5 12      51   272    C1725    957.00      0.00
5142591   BALLOON VOYAGER 3.5 15      51   272    C1725    957.00      0.00
5142609   BALLOON VOYAGER 3.5 20      51   272    C1725    957.00      0.00
5142617   STENT MINI VISION 2.0 8     51   278    C1876   9240.00      0.00
5142625   STENT MINI VISION 2.0 12    51   278    C1876   9240.00      0.00
5142633   STENT MINI VISION 2.0 15    51   278    C1876   9240.00      0.00
5142641   STENT MINI VISION 2.0 23    51   278    C1876   9240.00      0.00
5142658   STENT MINI VISION 2.25 8    51   278    C1876   9240.00      0.00
5142666   STENT MINI VISION 2.25 12   51   278    C1876   9240.00      0.00
5142674   STENT MINI VISION 2.25 15   51   278    C1876   9240.00      0.00
5142682   STENT MINI VISION 2.25 18   51   278    C1876   9240.00      0.00
5142690   STENT MINI VISION 2.25 23   51   278    C1876   9240.00      0.00
5142708   STENT MINI VISION 2.5 8     51   278    C1876   9240.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5142716   STENT MINI VISION 2.5 12    51   278    C1876   9240.00      0.00
5142724   STENT MINI VISION 2.5 15    51   278    C1876   9240.00      0.00
5142732   STENT MINI VISION 2.5 18    51   278    C1876   9240.00      0.00
5142740   STENT MINI VISION 2.5 23    51   278    C1876   9240.00      0.00
5142757   STENT MINI VISION 2.0 18    51   278    C1876   9240.00      0.00
5142765   KIT PLATELET SEPARATOR      51   272             727.00      0.00
5142807   PATCH HRNIA MSH SM 4.3CM    51   278    C1781   3876.50      0.00
5142815   PATCH HRNIA MSH MED 6.4CM   51   278    C1781   4633.25      0.00
5142823   TIP APPLICTR DUAL CANNULA   51   272              76.00      0.00
5142831   CUFF SM ADLT VNYL CRITIKO   51   271              16.00      0.00
5142849   CUFF ADULT VNYL CRITIKON    51   271              17.00      0.00
5142856   CUFF CHILD VNYL CRITIKON    51   271              15.00      0.00
5142864   CUFF LG ADLT VNYL CRITIKO   51   271              18.00      0.00
5142872   CUFF ADLT THIGH VNYL CRIT   51   271              21.00      0.00
5142898   INTRDUCR W/BXNDL 20GX20CM   51   272             236.00      0.00
5142963   CNN NSL O2 THRP NEO         51   271              50.00      0.00
5143029   SUTURE POLYSORB 3-0 48"     51   272             102.00      0.00
5143037   HOOK ELASTIC STAY SHRP BL   51   272             183.00      0.00
5143078   TUBE LMA FLEX SPIRAL 7.5    51   272             278.00      0.00
5143094   CATH 5FR MOTARJEME          51   272              60.00      0.00
5143219   SUPPORT LUMB SAC CRISCROS   51   274    L0628    162.75      0.00
5143227   SPLINT ANKLE FIG 8 XL       51   274    L1901     56.00      0.00
5143235   BRACE ANKLE LACE UP XXL     51   274    L1902    202.75      0.00
5143243   BRACE KNEE HYPERCNTRL SM    51   274    L1810    372.25      0.00
5143250   BRACE KNEE HYPERCNTRL MED   51   274    L1810    372.25      0.00
5143268   BRACE KNEE HYPERCNTRL LG    51   274    L1810    372.25      0.00
5143276   BRACE KNEE HYPERCNTRL XL    51   274    L1810    372.25      0.00
5143284   BRACE KNEE HYPERCNTRL XXL   51   274    L1810    372.25      0.00
5143292   STABILIZR PATELLA RT XXLG   51   274    L1825    256.75      0.00
5143300   STABILIZER PATELLA RT XL    51   274    L1825    256.75      0.00
5143318   STABILIZER PATELLA RT LG    51   274    L1825    256.75      0.00
5143326   STABILIZER PATELLA RT MED   51   274    L1825    256.75      0.00
5143334   STABILIZER PATELLA RT SM    51   274    L1825    256.75      0.00
5143342   STABILIZR PATELLA LT XXLG   51   274    L1825    256.75      0.00
5143359   STABILIZER PATELLA LT XLG   51   274    L1825    256.75      0.00
5143367   STABILIZER PATELLA LT LG    51   274    L1825    256.75      0.00
5143375   STABILIZER PATELLA LT MED   51   274    L1825    256.75      0.00
5143383   STABILIZER PATELLA LT SM    51   274    L1825    256.75      0.00
5143433   DRAPE MICROSCOPE 48X118"    51   272              79.00      0.00
5143441   SPLINT WRIST BL 8" LT XSM   51   274    L3908     79.75      0.00
5143458   SPLINT WRIST BL 8" LT SM    51   274    L3908     79.75      0.00
5143466   SPLINT WRIST RIGHT MED      51   274    L3908     87.50      0.00
5143474   SPLINT WRIST BL 8" LT XLG   51   274    L3908     79.75      0.00
5143482   SPLINT WRIST BL 8" RT SM    51   274    L3908     79.75      0.00
5143540   CATH PICC DUAL LUMEN 21G    51   272    C1751    351.00      0.00
5143557   SPLINT WRIST BL 8" RT MED   51   274    L3908     79.75      0.00
5143565   SPLINT WRIST BL 8" LT LG    51   274    L3908     79.75      0.00
5143573   SPLINT WRIST BL 8" RT XLG   51   274    L3908     79.75      0.00
5143581   SPLINT WRIST BL 8" RT LG    51   274    L3908     79.75      0.00
5143599   SPLINT WRIST BL 8" RT MED   51   274    L3908     79.75      0.00
5143623   SEALER DIVIDER LIGASURE V   51   272            1695.00      0.00
5143631   HNDSWTCH ATLS LIGSUR 20CM   51   272            1817.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
5143649   HNDSWTCH ATLS LIGSUR 37CM   51   272             1817.00      0.00
5143698   RETRACTOR BLUE SHARPHOOKS   51   272              365.00      0.00
5143847   FORTIFIER HUMAN MILK ENFA   51   270                4.00      0.00
5143854   STENT NEPHROURTRL 8F 26CM   51   278    C2617    1065.00      0.00
5143862   INTRO SHEATH 10CM 9FR       51   272    C1894     243.00      0.00
5143888   BLADE ARTH BONE CUT 3.5MM   51   272              478.00      0.00
5144050   CATH SILVERHAWK MS 6.0CM    51   272    C1714   11668.00      0.00
5144068   CATH SILVERHAWK SX 4.3CM    51   272    C1714   11668.00      0.00
5144076   CATH SILVERHAWK ES 2.2CM    51   272    C1714   11668.00      0.00
5144100   DRAPE WITH CUTOUT           51   272              133.00      0.00
5144118   BALLOON UT SDS 4X6X75       51   272    C1725     789.00      0.00
5144126   BALLOON UT SDS 5X6X75       51   272    C1725     789.00      0.00
5144134   STENT GRAFT FLNCY 8X40X80   51   278    C1875   19316.00      0.00
5144142   STENT GRFT FLNCY 10X60X80   51   278    C1875   19316.00      0.00
5144175   HOOD INFANT O2 W/DIFF-LG    51   271               49.00      0.00
5144217   CATH TWIN PASS              51   272    C1725    1177.00      0.00
5144225   GW CHOICE PT XS 128CM       51   272    C1769     374.00      0.00
5144308   CATH CV PRO-LINE 6FR        51   272    C1751    1117.00      0.00
5144324   CATH GLIDE 5FR ANGLD 65CM   51   272    C1887     270.00      0.00
5144332   SHEATH GUIDE 6FR MP         51   272    C1894     540.00      0.00
5144399   CATH SILVERHAWK LS 6.0CM    51   272    C1714   11668.00      0.00
5144407   SHEATH PINNACLE 4FR         51   272    C1894      64.00      0.00
5144415   SHEATH PINNACLE 5FR         51   272    C1894      46.00      0.00
5144423   SHEATH PINNACLE 6FR         51   272    C1894      46.00      0.00
5144431   SHEATH PINNACLE 7FR         51   272    C1894      46.00      0.00
5144449   SHEATH PINNACLE 8FR         51   272    C1894      46.00      0.00
5144456   GW STIFF ANGLED 260CM       51   272    C1769     254.00      0.00
5144464   SHEATH PINNACLE 10FR        51   272    C1894      46.00      0.00
5144472   SHEATH PINNACLE 11FR        51   272    C1894      46.00      0.00
5144480   SHEATH PINNACLE 9FR         51   272    C1894      46.00      0.00
5144530   SHEATH PINNACLE 8FR 25CM    51   272    C1894     153.00      0.00
5144548   SHEATH PINNACLE 7FR 25CM    51   272    C1894     153.00      0.00
5144555   SHEATH PINNACLE 6FR 25CM    51   272    C1894     153.00      0.00
5144605   TRAY CIRCUMCISION DISPOSA   51   272               83.00      0.00
5144613   STENT 6MMX24MM 135CM .014   51   278    C1876   13156.00      0.00
5144639   CATH SUCT 14FR 54CM CLSD    51   272               75.00      0.00
5144647   CATH SUCT 14F 30.5CM CLSD   51   272               75.00      0.00
5144654   CATH GLIDE 4FR ANGLD 65CM   51   272    C1887     251.00      0.00
5144662   CATH GLIDE MACH 1 7FR HS    51   272    C1887     266.00      0.00
5144670   CATH GLIDE MACH 1 7FR Q4    51   272    C1887     266.00      0.00
5144688   CATH GLIDE 4FR ANGL 100CM   51   272    C1887     251.00      0.00
5144696   BALLOON SYM 2X4X135         51   272    C1725    3371.00      0.00
5144704   BALLOON SYM 2X10X135        51   272    C1725    3371.00      0.00
5144712   BALLOON SYM 2X2X135         51   272    C1725    3371.00      0.00
5144787   MASK LARYNG LMA SZ1.5 DIS   51   272               48.00      0.00
5144936   CATH DRAINAGE 14.0 30CM     51   272    C1729     244.00      0.00
5144944   GUIDEWIRE .038 100CM        51   272    C1769     244.00      0.00
5144969   SET SUTURE CAPE ANCHOR      51   272              220.00      0.00
5144977   KNIFE RESECTSCPE 24F TUIP   51   272              328.00      0.00
5145008   INTRODUCER RAABE 8FR 55CM   51   272    C1894     214.00      0.00
5145016   BALLOON UT SDS 6X6X75       51   272    C1725     789.00      0.00
5145032   INTRODUCER SUPRA FOLY 16F   51   272               68.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5145040   CATH URET 6EYE RD TIP 20F   51   272               71.00      0.00
5145057   CATH URET 6EYE RD TIP 22F   51   272               71.00      0.00
5145065   CATH URET 6EYE RD TIP 24F   51   272               71.00      0.00
5145172   STAPLER SKIN SUBCUTANEOUS   51   272              174.00      0.00
5145180   STOCKING STUMP 6"           51   274    L8420     153.00      0.00
5145206   TRAY PROCE XTRA LVL VERTE   51   272             1496.00      0.00
5145214   CANNULA STRT 11GUAGEX12CM   51   272              270.00      0.00
5145222   CANNULA STRT 13GUAGEX12CM   51   272              270.00      0.00
5145255   FILTER REINFUSION           51   272               58.00      0.00
5145263   BALLOON PROFILER 7X4X75     51   272    C1725    1111.00      0.00
5145271   BALLOON PROFILER 8X4X75     51   272    C1725    1111.00      0.00
5145289   STRAP TENNIS ELBOW UNIV     51   274    L3701      37.25      0.00
5145305   CATH RINSPIRATION           51   272    C1757    5045.00      0.00
5145321   HANDPIECE HARM ACE 23CM V   51   272             1476.00      0.00
5145446   SET RETRV VENA CAVA FILTR   51   272    C1773    1033.00      0.00
5145479   FOAM RUBBER KOMPREX LF      51   271               97.00      0.00
5145552   CATH UNI-FUSE 5FX135CMX10   51   272    C1751     768.00      0.00
5145560   CATH OMNI FLUSH 4FR 65CM    51   272               79.00      0.00
5145578   BALLOON PROFILER 5X6X75     51   272    C1725    1111.00      0.00
5145586   CATH UNI-FUSE 5FX135CMX20   51   272    C1751     768.00      0.00
5145602   SET BLOOD WARMER LEVEL 1    51   272              266.00      0.00
5145693   STPLR CNTOUR CRVD CUT GRE   51   272             1581.00      0.00
5145701   STPLR CNTOUR CRVD CUT BLU   51   272             1581.00      0.00
5145719   RELOAD CNTOUR CUT STPL ST   51   272              818.00      0.00
5145727   RELOAD CNTOUR CUT STPL TH   51   272              818.00      0.00
5145784   STENT SMART 8X80X80         51   278    C1876   14476.00      0.00
5145842   CATH PRONTO V3 EXTRACTION   51   272    C1757    1975.00      0.00
5145891   CATH SILVERHAWK EXL 6.0CM   51   272    C1714   11668.00      0.00
5145966   STENT VIABAHN 5X5           51   278    C1874   20944.00      0.00
5145974   STENT VIABAHN 5X15          51   278    C1874   28908.00      0.00
5145982   STENT VIABAHN 7X15          51   278    C1874   28028.00      0.00
5145990   STENT VIABAHN 8X5           51   278    C1874   20064.00      0.00
5146014   CATH FOLEY 6.5FR SILICONE   51   272              623.00      0.00
5146030   SLING SNOOPY 6"X12" SMALL   51   274    L3651     107.00      0.00
5146121   SENSOR FLOW INFANT          51   271               95.00      0.00
5146139   SENSOR FLOW ADULT           51   271               95.00      0.00
5146212   SHEATH URETERL ACCESS 12F   51   272    C1894     529.00      0.00
5146220   GW SUPER STIF ST 260CM      51   272    C1769     178.00      0.00
5146246   PNEUMO TACH W/O CONCTR IN   51   271               83.00      0.00
5146329   BALL STRL MONRL 3X20X135    51   272    C1725    1197.00      0.00
5146337   BALL STRL MONO 3.5X20X135   51   272    C1725    1197.00      0.00
5146360   EXERCISER THUMB OPPOCISER   51   271               52.00      0.00
5146378   SHEATH DEST 6FR ST90        51   272    C1894     623.00      0.00
5146436   KIT ORAL CARE               51   271               86.00      0.00
5146535   DRESSING VAC ATS WHITE LG   51   272               82.00      0.00
5146543   TRAY PICC 1.9FR             51   272    C1751     203.00      0.00
5146550   CATH BERN TIP 40CM          51   272    C1758      83.00      0.00
5153002   STENT VIABAHN 5X10X120      51   278    C1874   25573.00      0.00
5153010   STENT VIABAHN 6X10X120      51   278    C1874   25573.00      0.00
5153028   STENT VIABAHN 7X10X120      51   278    C1874   25573.00      0.00
5153036   INTRO SHTH MICRO SET 4FR    51   272    C1894     124.00      0.00
5153044   STENT VIABAHN 6X15X120      51   278    C1874   29630.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5153051   INTRO SHTH MICRO SET 5FR    51   272    C1894     124.00      0.00
5153069   INTRO SHTH MICRO SET 6FR    51   272    C1894     124.00      0.00
5153127   KIT SEAL CAP W/FL ACC RET   51   272            20942.00      0.00
5153135   BLADE ARTHRO FL RAD 2.5MM   51   272              208.00      0.00
5153143   BLADE ARTHRO RESECT 3.5MM   51   272              208.00      0.00
5153150   BLADE ARTHRO FL RAD 3.5MM   51   272              208.00      0.00
5153168   BLADE ARTHRO RESECT 4.0MM   51   272              208.00      0.00
5153176   BLADE ARTHRO RESECT 5.0MM   51   272              208.00      0.00
5153184   BLADE ARTHRO RESECT 5.5MM   51   272              208.00      0.00
5153192   BLADE ARTHRO AGGRES 2.5MM   51   272              208.00      0.00
5153200   BLADE ARTHRO AGGR ANG 4.0   51   272              208.00      0.00
5153218   BLADE ARTHRO AGGRES 5.0MM   51   272              208.00      0.00
5153226   BLADE ARTHRO ABRA BUR 3.0   51   272              208.00      0.00
5153234   BLADE ARTHRO RESC ANG 5.0   51   272              208.00      0.00
5153242   BLADE ARTHRO BRL BUR 4.0M   51   272              208.00      0.00
5153259   BLADE ARTHRO BRL BUR 5.5M   51   272              208.00      0.00
5153267   BLADE ARTHRO RND BUR 4.0M   51   272              208.00      0.00
5153275   BLADE ARTHRO TOMCAT 4.0MM   51   272              208.00      0.00
5153283   BLADE ARTHRO TOMCAT 5.0MM   51   272              208.00      0.00
5153291   BLADE ARTHRO TOMCAT 5.5MM   51   272              208.00      0.00
5153341   PROBE COAG SERFAS 90S       51   272              129.00      0.00
5153358   PROBE COAG HOOK RF          51   272              129.00      0.00
5153424   EXERCISER OPPOCISER THUMB   51   271               52.00      0.00
5153440   MASK CPAP NASAL LG          51   271               61.00      0.00
5153457   MASK CPAP NASAL MD          51   271               61.00      0.00
5153481   STENT COR 12MM 3.0 VISION   51   278    C1876    9240.00      0.00
5153499   STENT COR 18MM 3.0 VISION   51   278    C1876    9240.00      0.00
5153507   STENT COR 12MM 3.5 VISION   51   278    C1876    9240.00      0.00
5153515   STENT COR 18MM 3.5 VISION   51   278    C1876    9240.00      0.00
5153523   STENT COR 12MM 4.0 VISION   51   278    C1876    9240.00      0.00
5153531   STENT COR 18MM 4.0 VISION   51   278    C1876    9240.00      0.00
5153556   STENT COR 8MM 2.5 ENDEVR    51   278    C1876   20680.00      0.00
5153564   STENT COR 12MM 2.5 ENDEVR   51   278    C1876   20680.00      0.00
5153572   STENT COR 14MM 2.5 ENDEVR   51   278    C1876   20680.00      0.00
5153580   STENT COR 18MM 2.5 ENDEVR   51   278    C1876   20680.00      0.00
5153598   STENT COR 24MM 2.5 ENDEVR   51   278    C1876   20680.00      0.00
5153606   STENT COR 30MM 2.5 ENDEVR   51   278    C1876   20680.00      0.00
5153614   STENT COR 9MM 3.0 ENDEVR    51   278    C1876   20680.00      0.00
5153622   STENT COR 12MM 3.0 ENDEVR   51   278    C1876   20680.00      0.00
5153630   STENT COR 15MM 3.0 ENDEVR   51   278    C1876   20680.00      0.00
5153648   STENT COR 12MM 3.0 ENDEVR   51   278    C1876   20680.00      0.00
5153655   STENT COR 24MM 3.0 ENDEVR   51   278    C1876   20680.00      0.00
5153663   STENT COR 30MM 3.0 ENDEVR   51   278    C1876   20680.00      0.00
5153671   STENT COR 9MM 3.5 ENDEVR    51   278    C1876   20680.00      0.00
5153689   STENT COR 12MM 3.5 ENDEVR   51   278    C1876   20680.00      0.00
5153697   STENT COR 15MM 3.5 ENDEVR   51   278    C1876   20680.00      0.00
5153705   STENT COR 18MM 3.5 ENDEVR   51   278    C1876   20680.00      0.00
5153713   STENT COR 24MM 3.5 ENDEVR   51   278    C1876   20680.00      0.00
5153721   STENT COR 30MM 3.5 ENDEVR   51   278    C1876   20680.00      0.00
5153762   BELT SEROLA SI UF XLG       51   271               89.00      0.00
5153796   NDL IMP SEED 18GX20CM 5PE   51   278    C2641     414.00      0.00
5153804   IMPL SEED PD-103            51   278    C2641     343.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
5153812   IMPL SEEDS CARTDGE PD-103   51   278    C2641    397.00      0.00
5153820   IMPL SEED PD-103 READYLNK   51   278    C2640    440.00      0.00
5153838   IMPL SEEDS PD-103 SRCELNK   51   278    C2640    458.00      0.00
5153846   IMPL SEEDS I-125 SRCELINK   51   278    C2638    282.00      0.00
5153853   IMPL SEED I-125 READYLINK   51   278    C2638    264.00      0.00
5153861   IMPL SEEDS I-125 LOOSE      51   278    C2639    106.00      0.00
5153879   IMPL SEEDS CARTRDGE I-125   51   278    C2639    132.00      0.00
5153887   NDL IMPL SEEDS I-125        51   278    C2639    185.00      0.00
5153911   BRCE ORT STD SM CLF RT 10   51   274    L1971    629.00      0.00
5153929   BRACE ORTH STD SM ANK LFT   51   274    L1971    629.00      0.00
5153937   BRACE ORTH STD MED ANK RT   51   274    L1971    629.00      0.00
5153945   BRACE ORTH STD MED ANK LT   51   274    L1971    629.00      0.00
5153952   BRACE ORTH STD LG ANK RT    51   274    L1971    629.00      0.00
5153960   BRACE ORTH STD LG ANK LFT   51   274    L1971    629.00      0.00
5153994   CANN DRI LOK 8.0X90MM       51   272             149.00      0.00
5154000   CANN DRI LOK 5.0X75MM       51   272             149.00      0.00
5154018   CANN DRI LOK 6.5X75MM       51   272             149.00      0.00
5154034   APPLICATOR FLUSEAL ENDO     51   272             212.00      0.00
5154042   SENSOR FLOW ADULT           51   271              60.00      0.00
5154067   SUT 5 CTX 12IN MERSILENE    51   272             291.00      0.00
5154133   NEB FLO MST CT 72IN ADMSK   51   271              56.00      0.00
5155353   PROBE COAG SERFAS CONTOUR   51   272             129.00      0.00
5155361   PROBE COAG SERFAS 90S-MAX   51   272             129.00      0.00
5155379   PROBE COAG SERFAS 50S       51   272             129.00      0.00
5500111   LENS ANTERIOR CHAMBER IOL   55   276    V2630      0.00      0.00
5500137   LENS IRIS SUPPORTED IOL     55   276    V2631      0.00      0.00
5500145   LENS POSTERIOR CHAMBR IOL   55   276    V2632      0.00      0.00
5500152   LENS IOL (NEW TECHNOLOGY)   55   276    C1780      0.00      0.00
5500160   MISC COLGEN IMPL URIN TCT   55   278    L8603      0.00      0.00
5500178   MISC CON TIS NON-HU C1763   55   278    C1763      0.00      0.00
5500194   MISC ANCHR SCRW TIS C1713   55   278    C1713      0.00      0.00
5500343   TRAY AMNIOCENTESIS          55   272             132.00      0.00
5500350   TRAY ASPIRATING             55   272              98.00      0.00
5500368   TRAY BONE MARROW            55   272              98.00      0.00
5500376   TRAY CHEMOTHERAPY           55   272              41.00      0.00
5500384   TRAY CHEST TUBE INSERTION   55   272             561.00      0.00
5500392   TRAY CULDOCENTESIS          55   272              74.00      0.00
5500400   TRAY CUTDOWN                55   272             554.00      0.00
5500418   SET D&C - UCC               55   272             231.00      0.00
5500426   LENS IOL PRSBOPIA AD COST   55   276    V2788      0.00      0.00
5500434   TRAY TRACTION TONGS G/W     55   272             195.00      0.00
5500442   TRAY HYSTEROSALPINGOGRAM    55   272             131.00      0.00
5500459   TRAY HYSTRSLPINGGRM-DR.AL   55   272             131.00      0.00
5500467   TRAY INCISION & DRAINAGE    55   272              98.00      0.00
5500475   TRAY MASTOID                55   272              74.00      0.00
5500483   TRAY NOSE BLEED             55   272              98.00      0.00
5500491   TRAY OPEN CHEST EMERGENCY   55   272            1228.00      0.00
5500509   TRAY PARACENTESIS           55   272              82.00      0.00
5500517   TRAY PELVIC                 55   272              74.00      0.00
5500525   TRAY RENAL BIOPSY           55   272             107.00      0.00
5500533   TRAY SIGMOIDOSCOPE/PRCTCP   55   272             139.00      0.00
5500541   TRAY SMR                    55   272              98.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
5500558   TRAY STAPEDECTOMY           55   272              74.00      0.00
5500566   TRAY SUTURE LINE            55   272             316.00      0.00
5500574   TRAY SUTURE - SMALL         55   272             325.00      0.00
5500582   TRAY SUTURE - LARGE         55   272             326.00      0.00
5500590   TRAY THORACENTESIS          55   272             135.00      0.00
5500608   TRAY TRACHEOTOMY            55   272             554.00      0.00
5500616   TROCAR SP NEEDLE W/OBTURT   55   272              74.00      0.00
5500624   TRAY TYMPANOPLSTY           55   272              74.00      0.00
5500632   SET LOCAL - CS              55   272             292.00      0.00
5500640   SET CHEST TUBE REMOVAL      55   272             130.00      0.00
5500657   SET LOCAL NOSE BLEED        55   272             293.00      0.00
5500665   CART ISOLATION              55   272              82.00      0.00
5500673   CART CRASH                  55   272             574.00      0.00
5500681   BRONCHOSCOPE                55   272             574.00      0.00
5500699   CAST/ARM ABOVE ELBOW        55   271             246.00      0.00
5500707   CAST/ARM BELOW ELBOW        55   271             164.00      0.00
5500715   CAST/BODY ADULT             55   271             492.00      0.00
5500723   CAST/BODY CHILD             55   271             450.00      0.00
5500731   CAST/LEG LONG               55   271             410.00      0.00
5500749   CAST/LEG SHORT              55   271             350.00      0.00
5500756   CAST/SPLINT ARM P           55   271             150.00      0.00
5500764   CAST/SPLINT LEG P           55   271             300.00      0.00
5500772   TRAY PERICARDIOCENTIS       55   272             820.00      0.00
5500780   TRAY PERICARDIAL DRAIN      55   272             107.00      0.00
5500798   STEINMAN PIN ON TRAY        55   278             292.25      0.00
5500806   TRAY TONSIL HEMORRHAGE      55   272              82.00      0.00
5500889   MISC IMPLANTS NOS           55   278               0.00      0.00
5500897   L3675 VEST TYP SHLDR REST   55   274    L3675      0.00      0.00
5500939   TRAY UMBILICAL              55   272             559.00      0.00
5500947   TRAY RESUSCITATION          55   272             224.00      0.00
5500970   STAINLESS STEEL WIRE        55   278             135.66      0.00
5500988   L3764 EWHO W/JOINT(S) CF    55   274    L3764      0.00      0.00
5500996   LENS IOL ASTIGMTS AD COST   55   276    V2787      0.00      0.00
5501010   L5688 BK WAIST BELT WEB     55   274    L5688      0.00      0.00
5501036   OTIS KNEE                   55   272            1500.00      0.00
5501077   L1906 AFO MULTIGM SUPR PF   55   274    L1906      0.00      0.00
5501093   L0999 ADD SPNL ORTH NOS     55   274    L0999      0.00      0.00
5501119   L3649 ORTHO SHOE MOD NOS    55   274    L3649      0.00      0.00
5501382   MISC SOFT TISS/MESH C1781   55   278    C1781      0.00      0.00
5501390   MISC VASCULAR GRAFT C1768   55   278    C1768      0.00      0.00
5501416   COCHLEAR IMPLANT SYSTEM     55   278    L8614      0.00      0.00
5501424   MISC JOINT DEVICE IMPLANT   55   278    C1776      0.00      0.00
5501440   PROSORBA SUPPLIES           55   272            5096.00      0.00
5501457   L0859 MRI COMPATIBLE SYST   55   274    L0859      0.00      0.00
5501465   L3980 ORTHOSIS HUMERO FX    55   274    L3980      0.00      0.00
5501473   L3995 ORTHOSIS HUMERO FX    55   274    L3995      0.00      0.00
5501481   L3660 SQ FIG-8 ABDCT CANV   55   274    L3660      0.00      0.00
5501499   L0210 THORACIC RIB BELT     55   274    L0210      0.00      0.00
5501515   L0180 MULTI POST CERV COL   55   274    L0180      0.00      0.00
5501523   L2182 DROP KNEE JOINT       55   274    L2182      0.00      0.00
5501531   L1815 PRFB KO W CNDYL PAD   55   274    L1815      0.00      0.00
5501549   L2850 FEM LNGT INTERF/SCK   55   274    L2850      0.00      0.00
                                            REV     CPT   UNIT     ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE    PRICE
5501556   L2530 NON-MLDED TGH LACER   55   274    L2530     0.00      0.00
5501564   L2340 CUSTOM FABR PRE/TIB   55   274    L2340     0.00      0.00
5501572   L2620 HVY DUTY PELVIC HIP   55   274    L2620     0.00      0.00
5501580   L2350 CUSTOM FABRC PTB/SC   55   274    L2350     0.00      0.00
5501598   L2126 THEMOPLST KAFO FR/P   55   274    L2126     0.00      0.00
5501606   L1970 CUSTOM FABRICATES A   55   274    L1970     0.00      0.00
5501622   L8430 MULTI PLY AB/KNEE S   55   274    L8430     0.00      0.00
5501630   L5668 MOLDED DISTAL CUSHN   55   274    L5668     0.00      0.00
5501648   L1800 ORTH ELAST/KNEE W/S   55   274    L1800     0.00      0.00
5501663   L3999 ORTHOSES UNDER SLEE   55   274    L3999     0.00      0.00
5501671   L3807 ORTHOSIS WRST/HND/F   55   274    L3807     0.00      0.00
5501689   L0984 PROTECT BODY SOCK     55   274    L0984     0.00      0.00
5501697   L2134 ORTHOTIC SEMI/RGD F   55   274    L2134     0.00      0.00
5501705   L3260 AMBL SURGICAL BOOT    55   274    L3260     0.00      0.00
5501721   L0627 LO SAG RIGID PNL PF   55   274    L0627     0.00      0.00
5501739   L0637 LSO SAG-CRNL PNL PF   55   274    L0637     0.00      0.00
5501747   L2184 LIM MOT ADJ KNEE JT   55   274    L2184     0.00      0.00
5501754   L0450 TLSO FLEX/SHLDR STR   55   274    L0450     0.00      0.00
5501762   L1230 TLSO MILWAUKEE ADD    55   274    L1230     0.00      0.00
5501770   L1990 DBL UPRHT METAL AFO   55   274    L1990     0.00      0.00
5501788   L2220 DBL ACTION ANK JNT    55   274    L2220     0.00      0.00
5501796   L2265 LONG TONGUE STIRRUP   55   274    L2265     0.00      0.00
5501804   L4398 FT DROP SPLNT RECUM   55   274    L4398     0.00      0.00
5501812   L0458 PREFAB TLSO TO XIPH   55   274    L0458     0.00      0.00
5501820   L0625 LO FLX L1 TO BLW L5   55   274    L0625     0.00      0.00
5501838   L1040 LUMB/RIB PAD CTLSO    55   274    L1040     0.00      0.00
5501846   L1200 TLSO                  55   274    L1200     0.00      0.00
5501853   L1820 KO W PADS & JNTS      55   274    L1820     0.00      0.00
5501861   L0456 TLSO FLEX/RIGID PNL   55   274    L0456     0.00      0.00
5501879   L5540 PREP BK PTB LAM SKT   55   274    L5540     0.00      0.00
5501887   L5655 SOCKET INSRT BLW KN   55   274    L5655     0.00      0.00
5501895   L5673 SKT INSRT W/LOCK ME   55   274    L5673     0.00      0.00
5501903   L5972 FLEXIBLE KEEL FOOT    55   274    L5972     0.00      0.00
5501911   L5910 ENDO BLW KN ALIGNBL   55   274    L5910     0.00      0.00
5501929   L5940 ENDO BK ULTRA-LIGHT   55   274    L5940     0.00      0.00
5501937   L0630 LSO FLEX ELAS RIGID   55   274    L0630     0.00      0.00
5501945   L0639 LSO CSTM AP/LAT CNT   55   274    L0639     0.00      0.00
5501952   L2760 LWEXT EXTNSN PER BR   55   274    L2760     0.00      0.00
5502018   CORNEAL TISSUE PROCESSING   55   278    V2785     0.00      0.00
5502026   L0621 SACRO FLEX SURG SUP   55   274    L0621     0.00      0.00
5502042   L1830 CANVAS KO IMMOB PRE   55   274    L1830     0.00      0.00
5502059   L0628 LO FLX WO RGD ST PR   55   274    L0628     0.00      0.00
5502067   L3650 SO PRE FIG 8 RSTRAN   55   274    L3650     0.00      0.00
5551007   MISC STERILE SUPPLIES       55   272              0.00      0.00
5551015   MISC NON-STERILE SUPPL      55   271              0.00      0.00
5551023   MISC GEN NEUSTM IM RCH BA   55   278    C1820     0.00      0.00
5551031   MISC PENILE PROSTH INFLAT   55   278    C1813     0.00      0.00
5551056   MISC PENILE PROS NON-INFL   55   278    C2622     0.00      0.00
5551080   MISC PROS IMPLANTS NOS      55   278    L8699     0.00      0.00
5551122   MISC PACEMAKER DUAL CHAMB   55   275    C1785     0.00      0.00
5551148   MISC PACEMAKER SNGL/CHAMB   55   275    C1786     0.00      0.00
5551189   MISC BREAST IMPLANT C1789   55   278    C1789     0.00      0.00
                                            REV     CPT   UNIT     ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE    PRICE
5551197   MISC BLADDER SLNG FX/W SM   55   278    C1771     0.00      0.00
5551205   MISC HUMAN TISSUE IMPLANT   55   278    C1762     0.00      0.00
5551221   MISC LEAD DEFIBR ENDOC SC   55   275    C1777     0.00      0.00
5551247   MISC CARDIVT/DEFIB OTH/T    55   275    C1882     0.00      0.00
5551262   MISC LEAD DEFIB OTH/T EN    55   275    C1896     0.00      0.00
5551288   MISC LEAD PACEMK/DEFIB C    55   275    C1899     0.00      0.00
5551296   MISC LEAD LT VENT COR SYS   55   275    C1900     0.00      0.00
5551320   MISC DEBIBRILLT DUAL/CHMB   55   275    C1721     0.00      0.00
5551346   MISC DEFIBRILLT SGL/CHAMB   55   275    C1722     0.00      0.00
5551361   MISC DEFIBRILLT NOT SGL/D   55   275    C1882     0.00      0.00
5551379   MISC LEAD DEFIBR ENDO D/C   55   275    C1895     0.00      0.00
5551387   MISC LEAD PACEMK TRN VDD    55   275    C1779     0.00      0.00
5551395   MISC PACEMK S/CHAMB N-RR    55   275    C2620     0.00      0.00
5551411   L0174 CERVICAL COLLAR S/R   55   274    L0174     0.00      0.00
5551429   L4396 STATIC AFO INCL SFT   55   274    L4396     0.00      0.00
5551437   L0810 CERV HALO INCORP JK   55   274    L0810     0.00      0.00
5551445   L1832 KO ADJ KNEE JT RG S   55   274    L1832     0.00      0.00
5551452   L0120 CERV FLX NONADJ FM    55   274    L0120     0.00      0.00
5551478   L8440 PROSTH SHRINKR B/KN   55   274    L8440     0.00      0.00
5551486   L5460 IMMED PST SUR N/WGT   55   274    L5460     0.00      0.00
5551510   L3670 SO ACRM CLV CANVS W   55   274    L3670     0.00      0.00
5551528   L8460 PROSTH SHRNK ABV/KN   55   274    L8460     0.00      0.00
5551536   L1686 HO ABDUC CNTRL HIP    55   274    L1686     0.00      0.00
5551544   L4360 PNEUMTC WLKNG SPLNT   55   274    L4360     0.00      0.00
5551551   L0172 CERV COLLAR SRGD FM   55   274    L0172     0.00      0.00
5551569   L2624 ADD TO LWR EXTRM PV   55   274    L2624     0.00      0.00
5551585   L3908 WHO WRIST EXT CNTRL   55   274    L3908     0.00      0.00
5551593   L1930 AFO CUSTOM FIT PLST   55   274    L1930     0.00      0.00
5551601   L5400 POSTOP DRSS&CASTNG    55   274    L5400     0.00      0.00
5551627   L1960 ORTHOSIS AFO P/ANKL   55   274    L1960     0.00      0.00
5551635   L2275 PLAST/MOD LW EXT PD   55   274    L2275     0.00      0.00
5551643   L2820 SOFT INTERF BLW KNE   55   274    L2820     0.00      0.00
5551650   L5530 BELOW KNEE PROSTH     55   274    L5530     0.00      0.00
5551668   L5620 TEST SOCKET BLW/KNE   55   274    L5620     0.00      0.00
5551676   L5637 BELOW KNEE TOT/CONT   55   274    L5637     0.00      0.00
5551684   L5666 BELOW KNEE CUFF/SUS   55   274    L5666     0.00      0.00
5551692   L8420 PROSTH SOCK MULTI/P   55   274    L8420     0.00      0.00
5551700   L1940 AFO MOLD PAT/PLASTC   55   274    L1940     0.00      0.00
5551718   L2770 LOWER EXT ORTH P/BR   55   274    L2770     0.00      0.00
5551726   L2270 VARUS/VALGUS STRP P   55   274    L2270     0.00      0.00
5551734   L4205 ORTHO DVC REPAIR      55   274    L4205     0.00      0.00
5551742   L4210 REPLACE PLATE/SCRWH   55   274    L4210     0.00      0.00
5551759   L0140 CERVICAL SEMI-RIGID   55   274    L0140     0.00      0.00
5551767   L4350 PNEUMATIC ANKL/C SP   55   274    L4350     0.00      0.00
5551791   L5450 POST OP APP N-WGTBR   55   274    L5450     0.00      0.00
5551809   L2136 FEM CAST RGD PREF/I   55   274    L2136     0.00      0.00
5551817   L2180 PLST SHOE INC W/KNE   55   274    L2180     0.00      0.00
5551825   L2186 KNEE/JT ADJUST/MOTN   55   274    L2186     0.00      0.00
5551833   L2188 QUADRILATERAL BRIM    55   274    L2188     0.00      0.00
5551841   L2850 FEMORAL LENGHT SOCK   55   274    L2850     0.00      0.00
5551858   L2830 THIGH SECTN/INTERF    55   274    L2830     0.00      0.00
5551866   L0486 TLSO 2 SHELLS RIG/S   55   274    L0486     0.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
5551882   L2200 JOINTS                55   274    L2200       0.00      0.00
5551890   L2999 NEOPRENE HIGH SLEEV   55   274    L2999       0.00      0.00
5551908   L3982 RADIUS/ULNR FRCT OR   55   274    L3982       0.00      0.00
5551916   L5690 PADD/CSTM WAIST BLT   55   274    L5690       0.00      0.00
5551924   L1680 HIP/ABD ORTH W/H JT   55   274    L1680       0.00      0.00
5551932   L0472 TLSO ANT FRAME HYPX   55   274    L0472       0.00      0.00
5551940   L2128 KAFO FX ORTHOSIS C/   55   274    L2128       0.00      0.00
5551957   L8010 MASTECTOMY SLEEVE     55   274    L8010       0.00      0.00
5551973   L2132 HIP FAX ORTHOSIS      55   274    L2132       0.00      0.00
5551981   L4386 WALKING SPLINT O/SH   55   274    L4386       0.00      0.00
5552005   MISC LEAD PACEMK NOT TRAN   55   275    C1898       0.00      0.00
5552013   L3225 MAN'S OXF SHOE W BR   55   274    L3225       0.00      0.00
5552021   MISC PACEMK DL CHAMBER NR   55   275    C2619       0.00      0.00
5552047   MISC PACEMAKER ADAPTER      55   275    C1883       0.00      0.00
5552062   MISC INTRO/SHEATH FIX P/A   55   272    C1892       0.00      0.00
5552088   MISC INTRO/SHEATH FIX N/P   55   272    C1893       0.00      0.00
5552104   MISC INTRO/SHEATH FIX N/L   55   272    C1894       0.00      0.00
5552120   MISC INTR/SHEATH STEERB N   55   272    C1766       0.00      0.00
5552146   MISC GUIDE WIRE             55   272    C1769       0.00      0.00
5552161   MISC CLOSURE DEVICE VASCL   55   278    C1760       0.00      0.00
5552187   MISC CATH EP <=19 ELECTRO   55   272    C1730       0.00      0.00
5552203   MISC CATH EP >=20 ELECTRO   55   272    C1731       0.00      0.00
5552229   MISC CATH EP NOT COOL TIP   55   272    C1733       0.00      0.00
5552245   MISC PACEMK NOT SNGL OR D   55   275    C2621       0.00      0.00
5552260   MISC CATH GUIDING C1887     55   272    C1887       0.00      0.00
5552286   MISC EVENT REC CARDIA IMP   55   278    C1764       0.00      0.00
5552302   L0460 TLSO 2 SHELL LINER    55   274    L0460       0.00      0.00
5552328   L2860 TORSION MECH/ADJUST   55   274    L2860       0.00      0.00
5552344   L1499 PADS REPL PHIL COLL   55   274    L1499       0.00      0.00
6100143   LITHOTRIPSY UNILATERAL      61   790    MULTI   21447.00      0.00
6100150   LITHOTRIPSY BILATERAL       61   790    MULTI   25715.00      0.00
6100168   URETEROSCOPE                61   360             1914.00      0.00
6100176   CYST W REM FB/STNT URETH    61   360    52310    2160.00      0.00
6100184   EP EVAL INT IMPLANT/REPL    61   480    93640    3375.00      0.00
6100192   EP EVAL INT IMPL/REPL TST   61   480    93641    3375.00      0.00
6100200   KTP LASER EQUIP RENTAL      61   369                0.00      0.00
6100218   HOLMIUM LASER EQUIP RENTA   61   369                0.00      0.00
6100226   POC-URINE PREGNANCY         61   301    81025      83.00      0.00
6100234   MISC LITHOTRIPSY RENTAL     61   790                0.00      0.00
6100242   MOD CS BY SAME PHYS 5YRS+   61   370    99144     495.00      0.00
6100259   MOD CS BY SAME PHY ADD-ON   61   370    99145     248.00      0.00
6100309   US PLCMNT RAD TX FIELDS     61   402    76950     345.00      0.00
6100317   BRACHYTX ISODSE PLN CMPLX   61   333    77328    1684.00      0.00
6100325   US INTRSTL RADIO ELE APPL   61   402    76965    1437.00      0.00
6100333   RAD TX SIMULATION CMPLX     61   333    77290    1676.00      0.00
6100341   RAD TX DOSE PLAN            61   333    77300     665.00      0.00
6100358   RAD TX DEVICES SIMPLE       61   333    77332    1232.00      0.00
6100366   RAD TX PHYSICS CONSULT      61   333    77370     665.00      0.00
6100374   SPECIAL RAD TX PROCEDURE    61   333    77470    2475.00      0.00
6100382   INTRSTL RAD SRCE AP CMPLX   61   342    77778    7733.00      0.00
6100390   INJECTION FOR CYSTOGRAM     61   360    51600    1541.00      0.00
6100408   CYSTO W REM FB/STNT SMPL    61   360    52310    7656.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
6100416   TRANSPERI NEEDL PLC PROST   61   360    55875   15394.00      0.00
6101000   SURGERY MINUTE LV1          61   360               83.00      0.00
6101026   SURGERY MINUTE LV2          61   360              138.00      0.00
6101042   SURGERY MINUTE LV3          61   360              194.00      0.00
6101067   SURGERY MINUTE LV1 (AH)     61   360              101.00      0.00
6101075   SURGERY MINUTE LV2 (AH)     61   360              176.00      0.00
6101083   SURGERY MINUTE LV3 (AH)     61   360              250.00      0.00
6101653   LITHOCLAST EQUIP RENTAL     61   790                0.00      0.00
6101661   LITHOTRIPSY EQUIP RENTAL    61   790              750.00      0.00
6106470   CYST/INS INDWL URTR STENT   61   360    52332    2160.00      0.00
6200109   OPEN HEART SUR/MINUTE LV3   62   360              194.00      0.00
6200125   TRANSESOPHAGEAL TEE         62   483    93318    2673.00      0.00
6300206   RECOVERY RM MINUTE LV1      63   710               12.00      0.00
6300214   RECOVERY RM MINUTE LV2      63   710               23.00      0.00
6300222   RECOVERY RM MINUTE LVFLR    63   710                2.00      0.00
6300313   THER/PRO/DIAG IV INF INIT   63   260    90765     267.00      0.00
6300339   THER/PRO/DX IV INF ADD-ON   63   260    90766     249.00      0.00
6300347   THER/PROPH/DIAG INJ SC/IM   63   940    90772     267.00      0.00
6300354   TH/PR/DX INJ SC/IM EA ADD   63   940    90772     223.00      0.00
6300362   TH/PR/DX INJ IV PUSH INIT   63   940    90774     267.00      0.00
6300388   TPDX IV PUSH NEW SUB INIT   63   940    90775     223.00      0.00
6300404   TH/PR/DX IV PUSH EA ADD     63   940    90776     223.00      0.00
6400071   SPINAL ANESTHESIA           64   370              633.00      0.00
6400089   LOCAL TRAY                  64   272              430.00      0.00
6400097   BRACH BK                    64   370              633.00      0.00
6400105   INF BK                      64   370              633.00      0.00
6400147   SS ANES GEN/ATTND MINUTE    64   370               18.00      0.00
6400204   ANESTHESIA GEN/ATTND MIN    64   370               18.00      0.00
6500060   SPINAL ANESTHESIA           65   370              633.00      0.00
6500078   LOCAL TRAY                  65   272              430.00      0.00
6500086   INF BK                      65   370              633.00      0.00
6500334   MOD CS BY SAME PHYS 5YRS+   65   370    99144     495.00      0.00
6500342   MOD CS BY SAME PHY ADD-ON   65   370    99145     248.00      0.00
6500409   US PLCMNT RAD TX FIELDS     65   402    76950     345.00      0.00
6500417   BRACHYTX ISODSE PLN CMPLX   65   333    77328    1684.00      0.00
6500425   US INTRSTL RADIO ELE APPL   65   402    76965    1437.00      0.00
6500433   RAD TX SIMULATION CMPLX     65   333    77290    1676.00      0.00
6500441   RAD TX DOSE PLAN            65   333    77300     665.00      0.00
6500458   RAD TX DEVICES SIMPLE       65   333    77332    1232.00      0.00
6500466   RAD TX PHYSICS CONSULT      65   333    77370     665.00      0.00
6500474   SPECIAL RAD TX PROCEDURE    65   333    77470    2475.00      0.00
6500482   INTRSTL RAD SRCE AP CMPLX   65   342    77778    7733.00      0.00
6500490   INJECTION FOR CYSTOGRAM     65   360    51600    1541.00      0.00
6500508   CYSTO W REM FB/STNT SMPL    65   360    52310    7656.00      0.00
6500516   TRANSPERI NEEDL PLC PROST   65   360    55875   15394.00      0.00
6501001   SURGERY MINUTE LV1          65   360               70.00      0.00
6501027   SURGERY MINUTE LV2          65   360              126.00      0.00
6501506   RECOVERY RM MINUTE LV1      65   710                9.00      0.00
6501522   RECOVERY RM MINUTE LV2      65   710               18.00      0.00
6501704   ANESTHESIA GEN/ATTND MIN    65   370               18.00      0.00
6502033   THER/PRO/DIAG IV INF INIT   65   260    90765     267.00      0.00
6502074   THER/PRO/DX IV INF ADD-ON   65   260    90766     249.00      0.00
                                            REV     CPT     UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE     PRICE      PRICE
6502090   THER/PROPH/DIAG INJ SC/IM   65   940    90772       267.00      0.00
6502116   TH/PR/DX INJ IV PUSH INIT   65   940    90774       267.00      0.00
6502157   TH/PR/DX INJ SC/IM EA ADD   65   940    90772       223.00      0.00
6502165   TPDX IV PUSH NEW SUB INIT   65   940    90775       223.00      0.00
6502173   LITHOTRIPSY UNILATERAL      65   790    MULTI     21447.00      0.00
6502181   LITHOTRIPSY BILATERAL       65   790    MULTI     25715.00      0.00
6502199   LITHOTRIPSY EQUIP RENTAL    65   790                750.00      0.00
6502215   CYST/INS INDWL URTR STENT   65   360    52332      2160.00      0.00
6502223   CYST W REM FB/STNT URETH    65   360    52310      2160.00      0.00
6502231   TH/PR/DX IV PUSH EA ADD     65   940    90776       223.00      0.00
6605000   DISCOGRAM CERV/THOR INIT    66   320    72285      2629.00      0.00
6605026   DISCOGRAM CERV/THR EA ADD   66   320    7228576    2629.00      0.00
6605042   DISCOGRAM LUMBAR INITIAL    66   320    72295      2629.00      0.00
6605067   DISCOGRAM LUMBAR EA ADD     66   320    7229576    2629.00      0.00
6605091   FLUORO FOR SPINE INJECT     66   320    77003       471.00      0.00
6605117   NEEDLE LOCALIZATION XRAY    66   320    77002       593.00      0.00
6605125   DISCOGRAM INJ CRV/TH INIT   66   361    62291      1134.00      0.00
6605141   DISCGRAM INJ CV/TH EA ADD   66   361    6229176    1134.00      0.00
6605166   DISCOGRAM INJ LUMBAR INIT   66   361    62290      1127.00      0.00
6605182   DISCOGRAM INJ LUMB EA ADD   66   361    6229076    1127.00      0.00
6605208   EPID INJ CERV/THOR W/SED    66   361    62310      4014.00      0.00
6605224   EPID INJ CERV/THR W/O SED   66   361    62310      4014.00      0.00
6605240   EPID INJ LUMB/SAC W/SED     66   361    62311      4014.00      0.00
6605265   EPID INJ LUMB/SAC W/O SED   66   361    62311      4014.00      0.00
6605281   EPID INJ BLOOD/CLOT PATCH   66   361    62273      2331.00      0.00
6605307   INJ STELLATE GANGL W/SED    66   361    64510      4014.00      0.00
6605323   INJ STELATE GANGL W/O SED   66   361    64510      4014.00      0.00
6605349   INJ FCTS CR/TH S/LV W/SED   66   361    64470      4014.00      0.00
6605364   INJ FCTS CR/TH S/L WO SED   66   361    64470      4014.00      0.00
6605372   INJ TNSF EP CV SG LV WSED   66   361    64479      4014.00      0.00
6605380   INJ FCTS CR/TH EA ADD LVL   66   361    64472      2331.00      0.00
6605398   IN TNSF EP CV SG LV WOSED   66   361    64479      4014.00      0.00
6605406   INJ FCTS LM/SC S/LV W/SED   66   361    64475      4014.00      0.00
6605414   INJ TRNSF EPI CV EA AD LV   66   361    64480      2331.00      0.00
6605422   INJ FCTS L/SC S/LV WO SED   66   361    64475      4014.00      0.00
6605430   INJ TNSF EP LS SG LV WSED   66   361    64483      4014.00      0.00
6605448   INJ FCTS LM/SAC EA ADD LV   66   361    64476      1321.00      0.00
6605455   IN TNSF EP LS SG LV WOSED   66   361    64483      4014.00      0.00
6605463   PRHRL NRV BRNCH BLK W/SED   66   361    64450      2331.00      0.00
6605471   INJ TRNSF EPI LS EA AD LV   66   361    64484      2331.00      0.00
6605489   PRHL NRV BRNCH BLK WO SED   66   361    64450      1457.00      0.00
6605505   SYMPTH NRV INJ LUMB W/SED   66   361    64520      2509.00      0.00
6605521   SYMPT NRV INJ LUMB WO SED   66   361    64520      2509.00      0.00
6605547   INTCSTL NRV BLK SGL W/SED   66   361    64420      1457.00      0.00
6605562   INTCSTL NV BLK SGL WO SED   66   361    64420      1457.00      0.00
6605588   ITCSTL NV MLT RG BL W/SED   66   361    64421      1457.00      0.00
6605604   ITCSTL NV MT RG BL WO SED   66   361    64421      1457.00      0.00
6605620   INTARTCLR S/H/K INJ W/SED   66   361    20610      1321.00      0.00
6605646   INTRTCLR S/H/K INJ WO SED   66   361    20610      1321.00      0.00
6605703   NRV BLK CERV PLEXUS W/SED   66   361    64413      1457.00      0.00
6605729   NRV BLK CRV PLXUS W/O SED   66   361    64413      1457.00      0.00
6605745   NRV BLK GTR/OCCIPTL W/SED   66   361    64405      2331.00      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
6605760   NRV BLK GTR/OCPTL W/O SED   66   361    64405    2331.00      0.00
6605786   SACROILIAC JNT INJ W/SED    66   361    27096    4014.00      0.00
6605802   SACROILAC JNT INJ W/O SED   66   361    27096    4014.00      0.00
6605828   NV DST NER AG ILNGL W/SED   66   361    64622    8242.00      0.00
6605844   NV DST NR AG ILNGL WO SED   66   361    64622    8242.00      0.00
6605869   NV DST NR AG LM LV1 W/SED   66   361    64622    8242.00      0.00
6605885   NV DST NR AG LM L1 WO SED   66   361    64622    8242.00      0.00
6605901   NV DST NR AG LUMB ADD LVL   66   361    64623    4014.00      0.00
6605927   NV DST NR AG CV LV1 W/SED   66   361    64626    5152.00      0.00
6605943   NV DST NR AG CV L1 WO SED   66   361    64626    5152.00      0.00
6605968   NV DST NR AG CERV ADD LVL   66   361    64627    1321.00      0.00
6605984   NPLSTY DCMPRS DISK W/SED    66   361    62287   11830.00      0.00
6606008   NPLSTY DCMPRS DSK W/O SED   66   361    62287   11830.00      0.00
6606016   INJ SGL TENDON W/SED        66   361    20551     825.00      0.00
6606024   TPTS 1-2 MUSCLE(S) W/SED    66   361    20552     825.00      0.00
6606032   INJ SGL TENDON W/O SED      66   361    20551     825.00      0.00
6606040   TPTS 1-2 MUSCLE(S) WO SED   66   361    20552     825.00      0.00
6606065   TPTS 3/> MUSCLE(S) W/SED    66   361    20553     825.00      0.00
6606081   TPTS 3/> MUSCLE(S) WO SED   66   361    20553     825.00      0.00
6606107   RECOVERY PAIN MGMT LV1      66   710                9.00      0.00
6606123   RECOVERY PAIN MGMT LV2      66   710               18.00      0.00
6606149   TH/PR/DX INJ IV PUSH INIT   66   940    90774     267.00      0.00
6606164   THER/PRO/DIAG IV INF INIT   66   260    90765     267.00      0.00
6606180   MOD CS BY SAME PHYS 5YRS+   66   370    99144     495.00      0.00
6606206   THER/PRO/DIAG INJ, SC/IM    66   940    90772     267.00      0.00
6606222   MOD CS BY SAME PHY ADD-ON   66   370    99145     248.00      0.00
6606248   TPDX IV PUSH NEW SUB INIT   66   940    90775     223.00      0.00
6606271   TH/PR/DX IV PUSH EA ADD     66   940    90776     223.00      0.00
6606289   HYDRATION IV INFUSION INI   66   260    90760     267.00      0.00
6606305   SPINAL LUMB PUNCT W/SED     66   361    62270    1457.00      0.00
6606321   SPINAL LUMB PUNCT W/O SED   66   361    62270    1457.00      0.00
6606339   PIRIFORMIS-MSK PROC W/SED   66   361    20999    7563.00      0.00
6606347   PIRIFORMIS-GN MSK W/O SED   66   361    20999    7563.00      0.00
7900038   LIDOCAINE/D5W 2GM/500ML P   79   250    J2001     122.01      0.00
7900046   SOD CHLORIDE 0.45% INJ 10   79   250    J7030      75.22      0.00
7900053   SOD CHLORIDE 0.45% INJ 50   79   250    J7040      73.28      0.00
7900095   SOD CHLORIDE 0.9% INJ 100   79   250    J7030      72.03      0.00
7900111   SOD CHLORIDE 0.9% INJ 250   79   250    J7050      71.42      0.00
7900129   SOD CHLORIDE 0.9% INJ 500   79   250    J7040      71.00      0.00
7900178   SODIUM CHLORIDE 0.9% IRRI   79   250               75.22      0.00
7900202   AMINOSYN 10% INJ 500MLS     79   250              509.60      0.00
7900228   DEXTROSE 10%/NACL 0.9% IN   79   250               98.85      0.00
7900236   D10W INJ 250MLS             79   250               74.62      0.00
7900244   DEXTROSE 10% INJ 500MLS     79   250               74.42      0.00
7900269   HEPARIN/D5W 12,500 UNITS/   79   250    J1644      92.37      0.00
7900277   LIPOSYN II 20% INJ 500MLS   79   250              551.66      0.00
7900285   DEXTROSE 20% INJ 500MLS     79   250               81.27      0.00
7900293   MANNITOL 20% INJ 250MLS     79   250    J2150     124.79      0.00
7900350   MAGNESIUM SULF 40MG/ML 10   79   250    J3475     100.87      0.00
7900376   D5W INJ 100MLS              79   250    J7060      77.09      0.00
7900400   D5W INJ 50MLS               79   250    J7060      77.09      0.00
7900426   D5W ADV 100MLS              79   250    J7060      75.28      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7900442   D5W ADV 50ML                79   250    J7060     22.87      0.00
7900459   D5LR INJ 1000MLS            79   250              75.60      0.00
7900475   D5W/RINGER'S INJ 1000MLS    79   250              76.97      0.00
7900483   D5W/NACL 0.225% INJ 1000M   79   250    J7042     71.95      0.00
7900491   D5W/NACL 0.225% INJ 250ML   79   250    J7042     71.00      0.00
7900509   D5W/NACL 0.225% INJ 500ML   79   250    J7042     71.00      0.00
7900517   D5W/NACL 0.3% INJ 500MLS    79   250    J7042     71.38      0.00
7900525   D5W/NACL 0.45% INJ 1000ML   79   250    J7042     72.64      0.00
7900533   D5W/NACL 0.45% INJ 250MLS   79   250    J7042     71.00      0.00
7900541   D5W/NACL 0.45% INJ 500MLS   79   250    J7042     71.57      0.00
7900558   D5W/0.9NS 20MEQ KCL 1000M   79   250              86.11      0.00
7900566   D5W/NACL 0.9% INJ 1000MLS   79   250    J7042     72.64      0.00
7900574   D5W/NACL 0.9% INJ 500MLS    79   250    J7042     72.14      0.00
7900624   DEXTROSE 50% INJ 500MLS     79   250              89.37      0.00
7900632   NITROGLYCERIN 50MG/D5W 25   79   250             102.97      0.00
7900723   ACETAMINOPHEN 100MG/ML IN   79   250              37.27      0.00
7900731   ACETAMINOPHEN CHLD 160/5M   79   250              26.55      0.00
7900756   ACETAMINOPHEN 120MG SUPP    79   250              11.24      0.00
7900764   ACETAMINOPHEN 325MG SUPP    79   250              11.44      0.00
7900772   ACETAMINOPHEN 650MG SUPP    79   250              11.77      0.00
7900780   ACETAMINOPHEN 325MG TAB (   79   250               8.46      0.00
7900798   APAP/CODEINE 300-15MG TAB   79   250              11.97      0.00
7900814   APAP/CODEINE 300-60MG TAB   79   250              14.01      0.00
7900822   APAP/CODEINE 300-30MG TAB   79   250              12.41      0.00
7900830   AcetaZOLAMIDE 250MG TAB (   79   250              10.87      0.00
7900848   AcetaZOLAMIDE 500MG INJ     79   250    J1120    266.62      0.00
7900855   AcetaZOLAMIDE 500MG CAP(D   79   250              37.81      0.00
7900897   ACETYLCHOLINE 20MG SOLN (   79   250             394.93      0.00
7900905   ACETYLCYSTEINE 20% (MUCOM   79   250    J7608     47.92      0.00
7900913   ACTIDOSE/SORBITOL 50GM/24   79   250             135.00      0.00
7900921   ACYCLOVIR 200MG CAP (ZOVI   79   250              15.18      0.00
7900947   ACYCLOVIR 800MG TAB (ZOVI   79   250              39.64      0.00
7900996   ALBUTEIN 25% INJ 100MLS     79   250    P9047    866.92      0.00
7901002   ALBUTEIN 25% INJ 50MLS      79   250    P9047    438.29      0.00
7901010   ALBUTEIN 5% INJ 250MLS (    79   250    P9041    230.65      0.00
7901028   ALBUTEIN 5% INJ 500MLS (A   79   250    P9041    451.63      0.00
7901036   PLASBUMIN-5 5% INJ 50MLS    79   250    P9041    180.74      0.00
7901044   ALBUTEROL 2MG TAB (PROVEN   79   250              10.00      0.00
7901051   ALBUTEROL 90MCG INH (VENT   79   250             175.25      0.00
7901093   ALBUTEROL 2MG/5ML SYRUP (   79   250              12.85      0.00
7901119   ALFENTANIL 500MCG/ML INJ    79   250              70.33      0.00
7901143   ALLOPURINOL 100MG TAB (ZY   79   250               9.26      0.00
7901150   ALLOPURINOL 300MG TAB (ZY   79   250              13.15      0.00
7901176   AlPRAZolam 0.5MG TAB (XAN   79   250              13.61      0.00
7901184   AlPRAZolam 0.25MG TAB (XA   79   250              12.51      0.00
7901192   ALPROSTADIL 500MCG INJ      79   250    J0270    230.93      0.00
7901283   GAVISCON FOAM TAB           79   250               8.22      0.00
7901291   GENATON SUSP 360ML (GAVIS   79   250               9.77      0.00
7901341   AMANTADINE 100MG CAP (SYM   79   250              12.10      0.00
7901366   AMIKACIN 500MG/2ML INJ (A   79   250    J0278     41.06      0.00
7901374   AMILORIDE 5MG TAB (MIDAMO   79   250              12.81      0.00
7901390   AMINOCAPROIC ACID 500MG T   79   250              31.59      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7901408   AMINOCAPROIC ACID 250MG/M   79   250              30.12      0.00
7901432   AMINOPHYLLINE 25MG/ML INJ   79   250    J0280     16.42      0.00
7901481   AMITRIPTYLINE 10MG TAB (E   79   250               8.93      0.00
7901499   AMITRIPTYLINE 25MG TAB (E   79   250              11.26      0.00
7901507   AMLODIPINE 5MG TAB (NORVA   79   250              10.57      0.00
7901515   AMMONIA AROMATIC 0.33ML I   79   250              10.44      0.00
7901556   AMOX/CLAV 125MG/5ML SUSP    79   250              13.14      0.00
7901564   AMOX/CLAV 250MG/5ML SUSP    79   250              16.28      0.00
7901614   AMOXICILLIN 125MG/5ML SUS   79   250              10.86      0.00
7901622   AMOXICILLIN 250MG/5ML SUS   79   250              10.03      0.00
7901630   AMOXICILLIN 250MG CAP (TR   79   250               9.56      0.00
7901648   AMOXICILLIN 500MG CAP (TR   79   250              11.29      0.00
7901655   AMOX/CLAV 250MG/125MG TAB   79   250              40.43      0.00
7901663   AMOX/CLAV 500MG/125MG TAB   79   250              40.95      0.00
7901689   AMPICILLIN/SULBACTAM 1.5G   79   250    J0295     56.94      0.00
7901697   AMPICILLIN/SULBACTAM 3GM    79   250    J0295     99.60      0.00
7901713   AMPHOTERICIN B 50MG INJ (   79   250    J0285    149.56      0.00
7901739   AMPICILLIN 500MG CAP (PRI   79   250              10.44      0.00
7901754   AMPICILLIN 1GM INJ (PRINC   79   250    J0290     58.97      0.00
7901770   AMPICILLIN 250MG INJ (PRI   79   250    J0290     33.48      0.00
7901804   AMPICILLIN 500MG INJ        79   250    J0290     43.19      0.00
7901812   PRINCIPEN 125MG/5ML SUSP    79   250              10.02      0.00
7901820   PRINCIPEN 250MG/5ML SUSP    79   250              10.23      0.00
7901838   AMPICILLIN 250MG CAP (PRI   79   250               9.25      0.00
7901895   ANTICOAG CITRATE DEXTROSE   79   250             162.06      0.00
7901911   AURODEX OTIC SOLN 15ML (A   79   250              29.83      0.00
7901929   ANTIVENIN LATRODECTUS KIT   79   250             194.67      0.00
7901945   AQUAPHOR OINTMENT 396GM     79   250              85.61      0.00
7901978   CECON 90MG/ML SOLN 50ML     79   250             143.85      0.00
7901994   VITAMIN C 500MG TAB (ASCO   79   250               8.07      0.00
7902018   ASPIRIN 81MG CHEW TAB       79   250               8.28      0.00
7902034   ASPIRIN 325MG EC TAB (ECO   79   250               8.06      0.00
7902042   ASPIRIN 300MG SUPPOSITORY   79   250              13.20      0.00
7902059   ASPIRIN 600MG SUPPOSITORY   79   250              13.29      0.00
7902067   ASPIRIN 325MG TAB           79   250               7.88      0.00
7902075   ASPIRIN/ANTACID TAB (ASCR   79   250               8.02      0.00
7902083   ASA/CODEINE 325-30MG TAB    79   250              12.36      0.00
7902109   ATENOLOL 50MG TAB (TENORM   79   250              14.34      0.00
7902141   ATRACURIUM 10MG/ML INJ 10   79   250              59.63      0.00
7902158   ATROPINE SULF 1% OP OINT    79   250              42.77      0.00
7902174   ATROPINE SULF 0.4MG/ML IN   79   250    J0460     13.00      0.00
7902182   ATROPINE SULF 0.05MG/ML I   79   250    J0460     54.99      0.00
7902190   ATROPINE SULF 0.1MG/ML IN   79   250    J0460     39.34      0.00
7902240   AZATHIOPRINE 50MG TAB (IM   79   250    J7500     13.99      0.00
7902273   BAC/POLY/NEO/HC OP OINT 3   79   250             102.91      0.00
7902281   BACITRACIN 50000U INJ       79   250             122.72      0.00
7902299   BACITRACIN ZINC 500U/GM O   79   250              31.58      0.00
7902307   BACITRACIN OP OINTMENT 3.   79   250              45.81      0.00
7902323   BACLOFEN 10MG TAB (LIORES   79   250              13.07      0.00
7902349   BECLOMETHASONE NS SPR (BE   79   250             599.99      0.00
7902398   BENAZEPRIL 5MG TAB (LOTEN   79   250              15.54      0.00
7902406   BENAZEPRIL 20MG TAB (LOTE   79   250              15.66      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7902414   BENZO/TETRA/BUTAME ORAL (   79   250             252.12      0.00
7902422   HURRICAINE 20% AER 60GM     79   250             175.20      0.00
7902430   DERMOPLAST 20% AER          79   250              40.62      0.00
7902448   BENZONATATE 100MG CAP (TE   79   250              13.37      0.00
7902471   BENZTROPINE 1MG/ML INJ (C   79   250    J0515    247.82      0.00
7902489   BENZTROPINE 0.5MG TAB (CO   79   250               9.14      0.00
7902497   BENZTROPINE 2MG TAB (COGE   79   250               9.84      0.00
7902505   BETAMETHASONE VAL 0.1% CR   79   250              44.27      0.00
7902513   BETAMETHASONE SOLUSPA 6MG   79   250    J0702    223.45      0.00
7902521   BETAMETHASONE AUG 0.05% O   79   250             178.28      0.00
7902539   BETAMETHASONE VAL 0.1% OI   79   250              45.70      0.00
7902588   BETHANECHOL 10MG TAB (URE   79   250              18.92      0.00
7902596   BETHANECHOL 25MG TAB (URE   79   250              21.13      0.00
7902604   BISACODYL 10MG SUPP (DULC   79   250               8.91      0.00
7902612   BISACODYL 5MG EC TAB (DUL   79   250               7.93      0.00
7902653   FLEET PREP #1 KIT           79   250              45.41      0.00
7902679   BROMOCRIPTIN 2.5MG TAB (P   79   250              24.22      0.00
7902703   BUMETANIDE 1MG TAB (BUMEX   79   250              10.66      0.00
7902711   BUMETANIDE 0.25MG/ML INJ    79   250              20.51      0.00
7902737   BUPIVACAINE/EPI .25% INJ    79   250              31.74      0.00
7902745   BUPI-MPF/EPI 0.5% (SENSOR   79   250              29.17      0.00
7902760   BUPIVACAINE 0.25% INJ 10M   79   250              23.08      0.00
7902794   BUPIVACAINE 0.5% INJ 30ML   79   250              25.65      0.00
7902810   BuPROPion 75MG TAB (WELLB   79   250              13.11      0.00
7902828   BusPIRone 5MG TAB (BUSPAR   79   250              13.49      0.00
7902836   BUSULFAN 2MG TAB (MYLERAN   79   250    J8510     34.54      0.00
7902844   BUTALBITAL/ASPIRIN/CAFFEI   79   250              14.33      0.00
7902869   BUTALBITAL/APAP/CAFFEINE    79   250              14.49      0.00
7902885   ASA/CAFF/BUTALBITAL/COD (   79   250              20.17      0.00
7902893   BUTORPHANOL 2MG/ML INJ 1M   79   250    J0595     40.21      0.00
7902901   CALAMINE LOTION 120ML       79   250              19.65      0.00
7902919   CALAMINE/PRAMOX LOTION 18   79   250              32.11      0.00
7902935   CALCITRIOL 0.25MCG CAP (R   79   250              16.76      0.00
7902950   CALCIUM CARB 500MG CHW TA   79   250              11.21      0.00
7902976   CALCIUM CHL 10% INJ 10ML    79   250              23.94      0.00
7902984   CALCIUM CHLORIDE 10% INJ    79   250              40.01      0.00
7902992   CALCIUM GLUCONATE 10% INJ   79   250    J0610     20.03      0.00
7903008   CALCIUM GLUCONATE 500MG T   79   250               9.43      0.00
7903024   OYSTER SHELL-CALCIUM W/D    79   250               8.14      0.00
7903040   CAPTOPRIL 25MG TAB (CAPOT   79   250              13.49      0.00
7903065   CARBASTAT 0.01% OP SOL (M   79   250             184.53      0.00
7903073   CARBACHOL 1.5% OP SOLN 15   79   250             258.05      0.00
7903081   CARBACHOL 3% OP SOLN 15ML   79   250             293.74      0.00
7903099   CARBAMAZEPINE 100MG/5ML S   79   250              10.19      0.00
7903115   CARBAMAZEPINE 200MG TAB (   79   250              11.05      0.00
7903123   CARBAMIDE PEROXIDE OTIC S   79   250              28.54      0.00
7903131   CARBIDOPA/LEVO 10-100MG T   79   250              16.28      0.00
7903149   CARBIDOPA/LEVO 25-100MG T   79   250              17.66      0.00
7903156   CARBIDOPA/LEVO 25-250MG T   79   250              19.84      0.00
7903164   CARBIDOPA/LEVO ER 50-200M   79   250              20.81      0.00
7903214   CARBOPROST 250MCG INJ (HE   79   250             378.32      0.00
7903263   CEFACLOR 250MG CAP (CECLO   79   250              22.70      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7903271   CEFACLOR 125MG/5ML SUSP 7   79   250              11.10      0.00
7903289   CEFACLOR 250MG/5ML SUSP 7   79   250              12.53      0.00
7903297   CEFADROXIL 500MG CAP        79   250              36.18      0.00
7903339   CEFAZOLIN 1GM INJ (ANCEF)   79   250    J0690     44.43      0.00
7903347   CEFAZOLIN 1GM INJ (KEFZOL   79   250    J0690     30.59      0.00
7903370   CEFOTAXIME 1GM INJ (CLAFO   79   250    J0698     43.43      0.00
7903396   CEFOTAXIME 2GM INJ (CLAFO   79   250    J0698     49.56      0.00
7903438   CEFOXITIN 1GM INJ (MEFOXI   79   250    J0694     73.79      0.00
7903453   CEFOXITIN 2GM INJ (MEFOXI   79   250    J0694    166.41      0.00
7903479   CEFTAZIDIME 1GM INJ (FORT   79   250    J0713     65.69      0.00
7903503   CEFTAZIDIME 2GM ADV (FORT   79   250    J0713    107.09      0.00
7903529   CEFTIZOXIME 1GM INJ (CEFI   79   250    J0715     74.70      0.00
7903578   CEFUROXIME 250MG TAB (CEF   79   250    J0697     39.62      0.00
7903586   CEFUROXIME 1.5GM ADV (ZIN   79   250    J0697     89.26      0.00
7903594   CEFUROXIME 750MG INJ (ZIN   79   250    J0697     48.26      0.00
7903651   CEPHALEXIN 250MG CAP (KEF   79   250              20.51      0.00
7903669   CEPHALEXIN 500MG CAP (KEF   79   250              34.07      0.00
7903677   CEPACOL LOZENGE             79   250              11.07      0.00
7903693   CHLORAL HYDRATE 500MG/5ML   79   250              17.28      0.00
7903768   CHLORDIAZEPOXIDE 10MG CAP   79   250              11.35      0.00
7903776   CHLORDIAZEPOXIDE 25MG CAP   79   250              11.43      0.00
7903784   CHLORDIAZEPOXIDE 5MG CAP    79   250               9.02      0.00
7903818   CHLOROPROCAINE 1% INJ (NE   79   250    J2400    138.43      0.00
7903826   CHLOROPROCAINE-MPF 2% INJ   79   250    J2400     50.63      0.00
7903834   CHLOROPROCAINE-MPF 3% INJ   79   250    J2400     58.13      0.00
7903842   CHLOROTHIAZIDE 250MG/5ML    79   250              10.12      0.00
7903909   CHLORPHENIRAMINE 2MG/5ML    79   250              10.72      0.00
7903917   CHLORPHENIRAMINE 4MG TAB    79   250               8.03      0.00
7903958   ChlorproMAZINE 25MG/ML IN   79   250    J3230     62.63      0.00
7903974   ChlorproMAZINE 25MG TAB (   79   250    Q0172      9.70      0.00
7903982   ChlorproPAMIDE 100MG TAB    79   250              10.15      0.00
7904006   ChlorproPAMIDE 250MG TAB    79   250              12.83      0.00
7904014   CHLORTHALIDONE 25MG TAB     79   250               9.34      0.00
7904055   CHLORZOXAZONE 500MG TAB (   79   250              11.32      0.00
7904063   CHOLESTYRAMINE 4GM POWD     79   250              35.30      0.00
7904071   CHOLINE MAG TRISAL 750MG    79   250              13.10      0.00
7904089   CIMETIDINE 200MG TAB (TAG   79   250               8.82      0.00
7904105   CIMETIDINE 150MG/ML INJ 2   79   250              37.16      0.00
7904121   CIMETIDINE 300MG TAB        79   250              15.37      0.00
7904162   CIPROFLOXACIN 10MG/ML INJ   79   250    J0744    159.41      0.00
7904170   CIPROFLOXACIN 0.3% OP SOL   79   250             152.59      0.00
7904188   CIPROFLOXACIN 250MG TAB (   79   250              42.63      0.00
7904196   CIPROFLOXACIN 500MG TAB (   79   250              38.34      0.00
7904204   CIPROFLOXACIN 750MG TAB (   79   250              39.93      0.00
7904212   CISPLATIN AQ 50MG INJ (PL   79   250    J9062    206.32      0.00
7904220   MAGNESIUM CITRATE SOLN 30   79   250              18.34      0.00
7904238   CLARITHROMYCIN 500MG TAB    79   250              45.17      0.00
7904261   CLINDAMYCIN 600MG INJ (CL   79   250              43.05      0.00
7904279   CLINDAMYCIN 600MG INJ (CL   79   250              42.28      0.00
7904287   CLINDAMYCIN 75MG/5ML SUSP   79   250              29.04      0.00
7904295   CLINDAMYCIN 150MG CAP (CL   79   250              16.31      0.00
7904329   ClonAZEPAM 1MG TAB (KLONO   79   250              14.44      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7904345   ClonIDINE 0.1MG/24HR PATC   79   250             158.60      0.00
7904352   ClonIDINE 0.2MG/24HR PATC   79   250             261.86      0.00
7904360   ClonIDINE 0.3MG/24HR PATC   79   250             242.97      0.00
7904378   ClonIDINE 0.1MG TAB (CATA   79   250               9.35      0.00
7904386   ClonIDINE 0.2MG TAB (CATA   79   250              10.02      0.00
7904410   CLORAZEPATE DIP 3.75MG TA   79   250              17.33      0.00
7904428   CLOTRIMAZOLE 10MG TROCHE    79   250              18.43      0.00
7904444   CLOTRIMAZOLE 1% VAG CREAM   79   250              41.07      0.00
7904469   CLOTRIMAZOLE/BETAMET DIPR   79   250             144.25      0.00
7904519   CODEINE PHOS 30MG/2ML INJ   79   250    J0745     30.40      0.00
7904535   CODEINE SULF 30MG TAB       79   250              13.60      0.00
7904543   COLCHICINE 0.6MG TAB        79   250              10.09      0.00
7904550   COLCHICINE 1MG/2ML INJ 2M   79   250    J0760     53.92      0.00
7904568   COLESTID 5GM POWD           79   250             237.85      0.00
7904584   COLLODION FLEXIBLE 100ML    79   250             213.69      0.00
7904600   CONJ,ESTROGENS 0.3MG TAB    79   250              20.04      0.00
7904626   CONJ,ESTROGENS 0.9MG TAB    79   250              20.04      0.00
7904659   CONJ,ESTROGEN 25MG INJ (P   79   250    J1410    356.22      0.00
7904667   CONJ,ESTROGENS 0.625MG TA   79   250              20.04      0.00
7904675   CONJ,ESTROGENS 1.25MG TAB   79   250              20.04      0.00
7904683   CONJ,ESTROGEN 0.625MG CRE   79   250             409.30      0.00
7904691   CONRAY 60% INJ 50ML         79   250    Q9964     95.89      0.00
7904774   CYANOCOBALAMIN 1000MCG/1M   79   250    J3420     19.18      0.00
7904790   CYCLOBENZAPRINE 10MG TAB    79   250              17.94      0.00
7904808   CYCLOPENTOLATE 1% OPHTH S   79   250              40.21      0.00
7904816   CYCLOPENTOLATE HCL OP 2%    79   250             136.37      0.00
7904824   CYCLOPEN 0.2%/PHENYLEP 1%   79   250             111.02      0.00
7904832   CYCLOPHOSPHAMIDE 50MG TAB   79   250    J8530     39.09      0.00
7904857   CYCLOPHOSPHAMIDE 1GM INJ    79   250    J9096    239.15      0.00
7904865   CYCLOPHOSPHAMIDE 500MG IN   79   250    J9095    164.98      0.00
7904873   CycloSPORINE 50MG/ML 5ML    79   250    J7516    165.26      0.00
7904899   CYPROHEPTADINE 4MG TAB      79   250              10.80      0.00
7904907   CYSTO CONRAY II 17.2% 250   79   250    Q9959    141.11      0.00
7904915   CYTARABINE 100MG INJ (CYT   79   250    J9100     43.24      0.00
7904949   DACARBAZINE 200MG INJ (DT   79   250    J9140    209.14      0.00
7904964   DANAZOL 100MG CAP (DANOCR   79   250              29.35      0.00
7904972   DANTROLENE SODIUM 25MG CA   79   250              15.69      0.00
7904980   DANTROLENE 20MG INJ (DANT   79   250             431.81      0.00
7904998   DAPSONE 100MG TAB           79   250               9.18      0.00
7905003   DAUNOrubicin 20MG INJ       79   250    J9150    296.94      0.00
7905029   DEFEROXAMINE 500MG INJ (D   79   250    J0895    116.06      0.00
7905037   DEMECLOCYCLINE 150MG TAB    79   250              68.26      0.00
7905078   DESIPRAMINE 25MG TAB (NOR   79   250              11.27      0.00
7905086   DESMOPRESSIN 4MCG/ML INJ    79   250    J2597    562.88      0.00
7905094   DESMOPRESSIN 0.01% SOL (D   79   250             504.43      0.00
7905102   DESOXIMETASONE 0.25% CREA   79   250             259.93      0.00
7905110   NEO/POLY/DEX 0.1% OP OINT   79   250              55.34      0.00
7905128   NEO/POLY/DEX 0.1% OP SUSP   79   250              55.35      0.00
7905136   DEXAMETHASONE 0.5MG TAB (   79   250    J8540      8.99      0.00
7905144   DEXAMETHASON 0.5MG/5ML EL   79   250    J8540      9.38      0.00
7905151   DEXAMETHASONE 0.75MG TAB    79   250    J8540     10.07      0.00
7905219   DEXAMETHASONE 0.1% OP SUS   79   250             271.98      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7905243   DEXAMETHASONE 4MG TAB (DE   79   250    J8540     12.28      0.00
7905268   DEXPANTHENOL 250MG/ML INJ   79   250              40.58      0.00
7905276   DEXTRAN 40 LMW 10% 500ML    79   250    J7100    210.71      0.00
7905284   DEXTRAN 70 HMW 32% 100ML    79   250    J7110     34.69      0.00
7905318   GLUTOSE 40% GEL 15GM        79   250              41.32      0.00
7905334   DEXTROSE 50% SYRINGE 50ML   79   250              39.15      0.00
7905391   DIAZEPAM 5MG/ML INJ 2ML (   79   250    J3360     46.57      0.00
7905409   DIAZEPAM 10MG TAB (VALIUM   79   250              10.79      0.00
7905417   DIAZEPAM 2MG TAB (VALIUM)   79   250               9.40      0.00
7905425   DIAZEPAM 5MG TAB (VALIUM)   79   250              10.00      0.00
7905433   DIDUCAINE 1% OINTMENT 30G   79   250              36.22      0.00
7905441   DICLOFENAC 25MG EC TAB (V   79   250              15.08      0.00
7905490   DICYCLOMINE 10MG CAP (BE    79   250               9.58      0.00
7905508   DICYCLOMINE 10MG/ML INJ (   79   250    J0500    144.91      0.00
7905516   DIDANOSINE 100MG CHW TAB    79   250              27.01      0.00
7905573   DIGOXIN 0.125MG TAB (LANO   79   250              10.58      0.00
7905615   DIGOXIN 0.25MG/ML INJ 2ML   79   250    J1160     19.37      0.00
7905656   DIGOXIN 0.25MG TAB (LANOX   79   250              10.58      0.00
7905664   DIHYDROERGOTAMINE 1MG/ML    79   250    J1110    209.52      0.00
7905698   DILTIAZEM 60MG TAB (CARD    79   250              12.90      0.00
7905706   DILTIAZEM CD 120MG CAP (C   79   250              16.65      0.00
7905714   DILTIAZEM CD 180MG CAP (C   79   250              18.49      0.00
7905722   DILTIAZEM CD 240MG CAP (C   79   250              17.37      0.00
7905730   DILTIAZEM CD 300MG CAP (C   79   250              27.59      0.00
7905771   DILTIAZEM 30MG TAB (CARDI   79   250              10.97      0.00
7905821   DINOPROSTONE (PROSTIN E2)   79   250            4254.26      0.00
7905862   DIPHENHYDRAMINE 25MG CAP    79   250    Q0163      4.65      0.00
7905888   DiphenhydrAMINE 50MG/1ML    79   250    J1200     17.47      0.00
7905912   DiphenhydrAMINE 50MG CAP    79   250    Q0163      8.58      0.00
7905926   ISOSORB DIN 5MG TAB (ISOR   79   250               8.69      0.00
7905938   DIPHENOXYLATE/ATROPINE 2.   79   250              10.70      0.00
7905946   DIPHENOXYLATE/ATROPINE 2.   79   250              11.19      0.00
7905953   DIPIVEFRIN 0.1% OP SOLN 5   79   250              89.95      0.00
7905979   DIPYRIDAMOLE 25MG TAB (P    79   250              10.52      0.00
7905995   DISOPYRAMIDE 150MG SA CAP   79   250              18.69      0.00
7906001   DISOPYRAMIDE 100MG CAP (N   79   250              12.84      0.00
7906019   DISOPYRAMIDE 150MG CAP (N   79   250              13.79      0.00
7906035   DIVALPROEX 250MG E TAB (D   79   250              23.38      0.00
7906043   DOBUTamine 250MG/20ML INJ   79   250    J1250     62.56      0.00
7906050   DOCUSATE CALCIUM 240MG CA   79   250               8.62      0.00
7906076   DOCUSATE SOD 100MG CAP (C   79   250               8.46      0.00
7906126   DOXAPRAM 20MG/ML INJ (DOP   79   250             209.69      0.00
7906134   DOXAZOSIN 2MG TAB (CARDUR   79   250              15.03      0.00
7906167   DOXEPIN HCL 10MG CAP (SIN   79   250              10.02      0.00
7906175   DOXEPIN HCL 25MG CAP (SIN   79   250              10.82      0.00
7906183   DOXOrubicin 2MG/ML INJ 5M   79   250    J9000    152.76      0.00
7906191   DOXOrubicin 2MG/ML INJ 25   79   250    J9000    331.42      0.00
7906225   DOXYCYCLINE HYCLATE 100MG   79   250              93.89      0.00
7906233   DOXYCYCLINE 100MG CAP (VI   79   250              18.09      0.00
7906290   ECHOTHIOPHATE 0.125% OP S   79   250             315.46      0.00
7906316   CALCIUM DISOD 200MG/ML IN   79   250    J0600    239.97      0.00
7906332   EVAC EMPTY CONTAINER 1000   79   250              16.96      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7906340   EVAC EMPTY CONTAINER GLAS   79   250              15.81      0.00
7906357   EVAC EMPTY CONTAINER 500M   79   250              16.53      0.00
7906365   ENALAPRIL 10MG TAB (VASOT   79   250              16.62      0.00
7906381   ENALAPRIL 5MG TAB (VASOTE   79   250              15.65      0.00
7906449   EPHEDrine SULF 50MG/ML IN   79   250              21.08      0.00
7906456   EPINEPHrine 1MG/ML INJ 1M   79   250    J0170     21.08      0.00
7906464   EPINEPHrine 0.1MG/ML SYR    79   250    J0170     28.88      0.00
7906530   ERGOCALCIFEROL ORAL DROP    79   250              19.32      0.00
7906589   ERGOLOID MESYLATES 1MG TA   79   250              31.21      0.00
7906597   CAFERGOT 2/100 SUPP         79   250    J1330     45.50      0.00
7906621   ERYTHROMYCIN 200MG/5ML SU   79   250              15.74      0.00
7906647   ERYTHROMYCIN 400MG/5ML SU   79   250              13.09      0.00
7906654   ERYTHROMYCIN 1000MG INJ (   79   250    J1364    109.12      0.00
7906662   ERYTHROMYCIN 1000MG ADV (   79   250    J1364    109.12      0.00
7906670   ERYTHROMYCIN LAC 500MG AD   79   250    J1364     61.13      0.00
7906696   ERYTHROMYCIN BASE 250MG T   79   250               8.74      0.00
7906704   EES/SULFISOX 200-600 SUSP   79   250              15.74      0.00
7906712   ESMOLOL 10MG/ML INJ (BREV   79   250              27.16      0.00
7906720   ESMOLOL 250MG/ML INJ (BRE   79   250              88.22      0.00
7906738   ESTRADIOL 1MG TAB (ESTRAC   79   250              10.03      0.00
7906746   ESTRADIOL 0.05MG PATCH (C   79   250              63.73      0.00
7906753   ESTRADIOL 0.1MG PATCH (CL   79   250              63.73      0.00
7906761   ESTRADIOL 40MG/ML INJ (DE   79   250    J0970    235.67      0.00
7906787   ESTROPIPATE 0.75 TAB (OGE   79   250              10.70      0.00
7906795   ETHACRYNIC ACID 50MG INJ    79   250             462.10      0.00
7906811   ETHAMBUTOL 100MG TAB (MYA   79   250              12.06      0.00
7906837   ETHAMBUTOL 400MG TAB (MYA   79   250              21.25      0.00
7906878   ETIDRONATE 200MG TAB (DID   79   250              34.17      0.00
7906894   ETODOLAC 300MG CAP (LODIN   79   250              18.40      0.00
7906928   ETOPOSIDE 20MG/ML INJ (VE   79   250    J9182    413.50      0.00
7906944   FAMOTIDINE 20MG TAB (PEPC   79   250              22.11      0.00
7906969   FAMOTIDINE 20MG/2ML INJ (   79   250              21.84      0.00
7906977   FELODIPINE 5MG CR TAB (PL   79   250              19.05      0.00
7906993   FENTANYL CIT 250MCG/5ML I   79   250    J3010     14.14      0.00
7907009   FENTANYL 25MCG/HR PATCH (   79   250              92.08      0.00
7907017   FENTANYL 50MCG/HR PATCH (   79   250             160.32      0.00
7907025   FENTANYL 75MCG/HR PATCH (   79   250             239.47      0.00
7907066   FERROUS GLUCONATE 300MG T   79   250               8.29      0.00
7907074   FERROUS SULFATE 220MG/5ML   79   250              10.13      0.00
7907108   FERROUS SULFATE 325MG TAB   79   250               8.07      0.00
7907124   FILGRASTIM 300MCG/ML INJ    79   250    J1440    991.46      0.00
7907132   FINASTERIDE 5MG TAB (PROS   79   250              31.37      0.00
7907157   FLECAINIDE 50MG TAB (TAMB   79   250              20.80      0.00
7907181   FLUCONAZOLE 100MG TAB (DI   79   250              57.54      0.00
7907215   FLUDROCORTISONE 0.1MG TAB   79   250              13.24      0.00
7907249   FLUNISOLIDE 0.025% SPR (N   79   250             275.12      0.00
7907264   FLUOCINOLONE 0.025% CREAM   79   250              32.88      0.00
7907272   FLUOCINOLONE 0.025% OINT    79   250              41.63      0.00
7907280   FLUOCINOLONE 0.01% SOLN 6   79   250              72.47      0.00
7907298   FLUOCINONIDE 0.05% CREAM    79   250              89.03      0.00
7907348   FLUOROMETHOLONE 0.1% OP S   79   250              67.05      0.00
7907355   FLUOROURACIL 50MG/ML INJ    79   250    J9190     77.10      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7907363   FLUOXETINE 20MG CAP (PROZ   79   250              27.87      0.00
7907389   FLUPHENAZINE 1MG TAB (PRO   79   250              12.30      0.00
7907397   FLUPHENAZ DEC 25MG/ML INJ   79   250    J2680    152.42      0.00
7907413   FLUPHENAZINE 25MG/10ML IN   79   250    J2680     56.17      0.00
7907454   FLURAZEPAM 15MG CAP (DALM   79   250               9.79      0.00
7907470   FLURBIPROFEN 0.03% OP SOL   79   250              59.51      0.00
7907504   FOLIC ACID 5MG/ML INJ 10M   79   250              26.60      0.00
7907512   FOLIC ACID 1MG TAB (FOLAT   79   250              10.31      0.00
7907538   FOSINOPRIL 10MG TAB (MONO   79   250              16.61      0.00
7907546   FOSINOPRIL 20MG TAB (MONO   79   250              16.61      0.00
7907579   FUROSEMIDE 100MG/10ML INJ   79   250    J1940     14.69      0.00
7907587   FUROSEMIDE 40MG/4ML INJ (   79   250    J1940     14.46      0.00
7907603   FUROSEMIDE 10MG/ML SOLN 6   79   250              10.98      0.00
7907611   FUROSEMIDE 20MG TAB (LASI   79   250               8.68      0.00
7907629   FUROSEMIDE 40MG TAB (LASI   79   250               8.83      0.00
7907652   GELFOAM 2CMX6CMX7CM (GELF   79   250              64.29      0.00
7907660   GELFOAM 8X12.5X10M (SURGI   79   250             281.89      0.00
7907678   GELFOAM 8CMX6.25CM (GELFO   79   250             192.16      0.00
7907686   GELFILM OP FILM ABSORBABL   79   250             253.57      0.00
7907694   GEMFIBROZIL 600MG TAB (LO   79   250              15.87      0.00
7907702   GENTAMICIN 0.1% CREAM 15G   79   250              37.97      0.00
7907710   GENTAMICIN 10MG/ML INJ 2M   79   250    J1580     47.62      0.00
7907728   GENTAMICIN 40MG/ML INJ 2M   79   250    J1580     16.04      0.00
7907736   GENTAMICIN 0.3% OP OINT 3   79   250             121.98      0.00
7907744   GENTAMICIN 0.3% OP SOLN 5   79   250              63.91      0.00
7907769   GliPIzide 10MG TAB (GLUCO   79   250              13.00      0.00
7907777   GliPIzide 5MG TAB (GLUCOT   79   250              10.32      0.00
7907785   CALCIUM GLUBIONATE 1.8GM/   79   250               7.95      0.00
7907793   GLUCAGON 1MG KIT            79   250    J1610    343.04      0.00
7907892   GLYburide 2.5MG TAB (MICR   79   250               9.88      0.00
7907900   GLYburide 5MG TAB (MICRON   79   250              11.56      0.00
7907918   GLYCERIN 1.5GM PEDIATRIC    79   250               9.18      0.00
7907926   GLYCERIN 3GM ADULT SUPP     79   250               9.23      0.00
7907934   GLYCOPYRROLATE 2MG TAB (R   79   250              24.29      0.00
7908072   GUANABENZ 4MG TAB (WYTANS   79   250              15.01      0.00
7908098   GUANFACINE 1MG TAB (TENEX   79   250              14.19      0.00
7908130   HALOPERIDOL 2MG/ML CONC L   79   250    J1630     12.35      0.00
7908205   HEMORRHOIDAL SUPP (ANUSOL   79   250               9.65      0.00
7908213   HYDROCORTISONE AC 25MG SU   79   250              14.30      0.00
7908221   HEPARIN SOD 1,000 UNITS/M   79   250    J1644     71.48      0.00
7908239   HEPARIN SOD 1,000 UNITS/M   79   250    J1644     14.60      0.00
7908247   HEPARIN SOD 10,000 UNITS/   79   250    J1644     45.35      0.00
7908262   HEPARIN LOCK 100 UNITS/ML   79   250    J1642     13.94      0.00
7908304   HEPATITIS B IMMUNE GLOBUL   79   250    90371   2724.29      0.00
7908338   HETASTARCH 6%/NACL PREMIX   79   250             193.58      0.00
7908353   HEXACHLOROPHENE 3% LIQ (P   79   250             155.50      0.00
7908411   HydrALAZINE 20MG/ML INJ (   79   250    J0360    116.73      0.00
7908429   HydrALAZINE 10MG TAB        79   250               9.21      0.00
7908437   HydrALAZINE 25MG TAB (APR   79   250              10.25      0.00
7908445   HydrALAZINE 50MG TAB (APR   79   250              10.90      0.00
7908478   HYDROCHLOROTHIAZIDE 25MG    79   250               8.68      0.00
7908486   HYDROCHLOROTHIAZIDE 50MG    79   250               8.89      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7908551   TUSSIONEX SUSPENSION        79   250              31.40      0.00
7908585   HYDROCORTISONE 10MG TAB (   79   250              10.68      0.00
7908601   HYDROCORTISONE 0.5% CREAM   79   250              29.79      0.00
7908619   HYDROCORTISONE 1% CREAM 2   79   250              32.54      0.00
7908635   HYDROCORTISONE 100MG INJ    79   250    J1720     39.05      0.00
7908643   HYDROCORTISONE 250MG INJ    79   250    J1720     48.72      0.00
7908650   HYDROCORTISONE 500MG INJ    79   250    J1720     96.23      0.00
7908676   HYDROCORTISONE 0.5% OINTM   79   250              26.44      0.00
7908684   HYDROCORTISONE 1% OINTMEN   79   250              37.97      0.00
7908692   HYDROCORTISONE 100MG ENEM   79   250              79.78      0.00
7908700   HYDROmorphone 2MG/ML INJ    79   250    J1170     20.13      0.00
7908718   HYDROmorphone 4MG/1ML INJ   79   250    J1170     18.71      0.00
7908726   HYDROmorphone 2MG TAB (D    79   250              12.78      0.00
7908734   HYDROmorphone 4MG TAB (DI   79   250              14.80      0.00
7908742   HYDROXYCHLOROQUINE 200MG    79   250              16.93      0.00
7908767   HYDROXYUREA 500MG CAP (HY   79   250              17.28      0.00
7908775   HydrOXYzine HCL 10MG TAB    79   250              12.30      0.00
7908809   HydrOXYzine HCL 10MG/5ML    79   250              11.58      0.00
7908825   HydrOXYzine PAMOATE 25MG    79   250    Q0177      9.83      0.00
7908833   IBUPROFEN (MOTRIN) 100MG/   79   250              55.12      0.00
7908874   IBUPROFEN 800MG TAB (MOTR   79   250              10.60      0.00
7908882   IBUPROFEN 200MG TAB (ADVI   79   250               8.07      0.00
7908890   IBUPROFEN 400MG TAB (MOT    79   250               9.19      0.00
7908908   IBUPROFEN 600MG TAB (MOTR   79   250               9.87      0.00
7908924   IDARUBICIN 5MG/5ML INJ (I   79   250    J9211   1758.42      0.00
7908965   PRIMAXIN IV 500MG ADV       79   250    J0743    251.83      0.00
7908973   IMIPRAMINE HCL 10MG TAB (   79   250              10.82      0.00
7908981   IMIPRAMINE HCL 25MG TAB (   79   250              14.20      0.00
7909054   INDAPAMIDE 2.5MG TAB (LOZ   79   250              14.04      0.00
7909062   INDIGO CARMINE 8MG/ML INJ   79   250              61.06      0.00
7909096   INDOMETHACIN 1MG INJ (IND   79   250            2559.99      0.00
7909104   INDOMETHACIN 75MG ER CAP    79   250              26.62      0.00
7909112   INDOMETHACIN 25MG CAP (IN   79   250              10.61      0.00
7909120   INDOMETHACIN 50MG CAP (IN   79   250              12.72      0.00
7909153   NPH INSULIN INJ (NOVOLIN    79   250    J1815     40.50      0.00
7909161   70/30 NPH/REG INSULIN INJ   79   250    J1815     40.50      0.00
7909179   REG INSULIN (NOVOLIN R)     79   250    J1815     40.50      0.00
7909252   SUMMERS EVE 0.3% SOLN       79   250              19.90      0.00
7909260   POVIDONE-IODINE 10% OINT    79   250              31.83      0.00
7909286   POVIDONE-IODINE 10% OINT    79   250              10.50      0.00
7909294   IODINE STRONG SOLN 480ML    79   250             217.39      0.00
7909351   FERROUS SULFATE 15MG/0.6M   79   250              10.08      0.00
7909377   ISONIAZID 100MG TAB (INH)   79   250               8.30      0.00
7909393   ISONIAZID 50MG/5ML SYP 47   79   250              14.33      0.00
7909401   ISONIAZID 300MG TAB (INH)   79   250               8.70      0.00
7909443   ISOPROTERENOL 0.2MG/ML AM   79   250              64.20      0.00
7909476   ISOSORBIDE MONO 20MG TAB    79   250              13.23      0.00
7909492   ISOSORBIDE DIN 5MG SL TAB   79   250               9.13      0.00
7909500   ISOSORB DIN 40MG ER TAB (   79   250              13.99      0.00
7909518   ISOSORBIDE DINITRATE 10MG   79   250               8.94      0.00
7909575   K-PHOS NEUTRAL TAB          79   250               9.31      0.00
7909583   K-Y GEL 113.5GM             79   250              30.59      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7909591   KANAMYCIN 1GM/3ML INJ (KA   79   250    J1840    113.16      0.00
7909625   KETAMINE 100MG/ML INJ 5ML   79   250              80.83      0.00
7909633   KETOCONAZOLE 2% CREAM (NI   79   250             103.59      0.00
7909641   KETOCONAZOLE 200MG TAB (N   79   250              31.60      0.00
7909682   KETOROLAC 10MG TAB (TORAD   79   250              14.63      0.00
7909732   LABETALOL 200MG TAB (NORM   79   250              12.74      0.00
7909740   LABETALOL 5MG/ML INJ (TRA   79   250              10.84      0.00
7909757   LABETALOL 100MG TAB (TRAN   79   250              11.22      0.00
7909773   LACTATED RINGERS INJ 1000   79   250    J7120     72.41      0.00
7909781   LACTATED RINGERS INJ 500M   79   250    J7120     73.09      0.00
7909849   LEUCOVORIN CAL 5MG TAB (L   79   250              32.29      0.00
7909872   LEVOBUNOLOL 0.5% OP SOLN    79   250             104.68      0.00
7909898   LEVOTHYROXINE 25MCG TAB (   79   250               9.36      0.00
7909914   LEVOTHYROXINE 75MCG TAB (   79   250               9.82      0.00
7909963   LEVOTHYROXIN 500MCG INJ (   79   250              81.04      0.00
7909971   LEVOTHYROXINE 50MCG TAB (   79   250               9.61      0.00
7909989   LEVOTHYROXINE 125MCG TAB    79   250              10.27      0.00
7909997   LEVOTHYROXINE 150MCG TAB    79   250              10.36      0.00
7910003   LEVOTHYROXINE 100MCG TAB    79   250              10.45      0.00
7910011   LEVOTHYROXINE 200MCG TAB    79   250              14.46      0.00
7910029   LIDOCAINE 4% SOLN 50ML      79   250              61.97      0.00
7910037   LIDOCAINE-MPF 4% INJ (XYL   79   250    J2001     54.55      0.00
7910045   LIDOCAINE 0.5% INJ 50ML     79   250    J2001     28.12      0.00
7910052   LIDOCAINE 1% MDV INJ 20ML   79   250    J2001     12.71      0.00
7910094   LIDOCAINE 2% INJ 20ML MDV   79   250    J2001     12.80      0.00
7910128   LIDOCAINE 2% GEL (XYLOCAI   79   250             131.00      0.00
7910144   LIDOCAINE 5% OINT 35.4GM    79   250              96.30      0.00
7910169   LIDOCAINE 2% VISC SOLN 10   79   250              10.97      0.00
7910177   LIDOCAINE/EPI 0.5% INJ 50   79   250    J2001     32.21      0.00
7910185   LIDOCAINE/EPI 1% INJ 20ML   79   250    J2001     20.13      0.00
7910219   LIDOCAINE/EPI 2% INJ 20ML   79   250    J2001     22.79      0.00
7910268   BLISTEX LIP BALM MIS 0.15   79   250              11.36      0.00
7910276   LISINOPRIL 5MG TAB (PRINI   79   250              14.96      0.00
7910284   LISINOPRIL 10MG TAB (PRIN   79   250              14.74      0.00
7910300   LITHIUM CARBONATE 300MG T   79   250               9.52      0.00
7910318   LITHIUM CITRATE 8MEQ/5ML    79   250              10.73      0.00
7910383   LOPERAMIDE 1MG/5ML LIQ 12   79   250              11.44      0.00
7910409   LOPERAMIDE 2MG CAP (IMODI   79   250              12.90      0.00
7910425   LORazepam 2MG/ML INJ (ATI   79   250    J2060     16.80      0.00
7910433   LORazepam 1MG TAB (ATIVAN   79   250              14.45      0.00
7910441   LOVASTATIN 20MG TAB (MEVA   79   250              17.15      0.00
7910516   MAGNESIUM CHLORIDE 64MG T   79   250               8.47      0.00
7910557   MANNITOL 25% INJ 50ML       79   250    J2150     16.97      0.00
7910581   MD-GASTROVIEW SOLN 1ML      79   250    Q9963     11.63      0.00
7910599   MEBENDAZOLE 100MG CHW TAB   79   250              37.94      0.00
7910623   MECLIZINE 25MG TAB (ANTIV   79   250               8.89      0.00
7910664   MEDIUM CHAIN TRIGLYCERIDE   79   250               8.04      0.00
7910672   MedroxyPROGESTERone 10MG    79   250              11.11      0.00
7910680   MedroxyPROGESTERone 2.5MG   79   250               9.83      0.00
7910698   MedroxyPROGESTERone 5MG T   79   250              10.98      0.00
7910706   MEDROXYPROGESTERONE 400MG   79   250    J1051    687.56      0.00
7910722   MEGESTROL AC 40MG TAB (ME   79   250              17.96      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7910748   BANALG-HS LINIMENT LIQ 60   79   250              37.67      0.00
7910755   MEPERIDINE 100MG/ML INJ (   79   250    J2175     20.32      0.00
7910763   MEPERIDINE 25MG/ML INJ (D   79   250    J2175     20.23      0.00
7910771   MEPERIDINE 50MG/ML INJ (D   79   250    J2175     20.80      0.00
7910789   MEPERIDINE 75MG/ML SYR (D   79   250    J2175     20.13      0.00
7910797   MEPERIDINE 300MG/30ML PCA   79   250    J2175     77.04      0.00
7910813   MEPERIDINE 50MG TAB (DEME   79   250              14.95      0.00
7910839   MEPIVACAINE-MPF 1% INJ (P   79   250    J0670     42.26      0.00
7910847   MEPIVACAINE-MPF 2% INJ (P   79   250    J0670     63.57      0.00
7910870   MERCAPTOPURINE 50MG TAB (   79   250              38.70      0.00
7910904   METAPROTERENOL 10MG/5ML S   79   250              12.19      0.00
7910920   METAPROTERENOL 65MCG INH    79   250             277.46      0.00
7910946   METAPROTERENOL 0.6% NEB 2   79   250    J7669     16.92      0.00
7910961   METHADONE 5MG/5ML ORAL SO   79   250              10.25      0.00
7910979   METHADONE 5MG TAB (DOLOPH   79   250              12.59      0.00
7910987   METHAZOLAMIDE 50MG TAB (N   79   250              13.03      0.00
7910995   METHIMAZOLE 10MG TAB (TAP   79   250              13.40      0.00
7911019   METHOCARBAMOL 100MG/ML IN   79   250    J2800    209.23      0.00
7911027   METHOCARBAMOL 500MG TAB (   79   250              10.80      0.00
7911043   METHOTREXATE 2.5MG TAB      79   250    J8610     37.47      0.00
7911076   METHOTREXATE 25MG/ML INJ    79   250    J9260    112.30      0.00
7911092   METHYLDOPA 250MG TAB (ALD   79   250              10.35      0.00
7911142   METHYLDOPATE 250MG/5ML IN   79   250    J0210    152.42      0.00
7911159   METHYLENE BLUE 1% INJ 1ML   79   250    A9535     54.28      0.00
7911167   METHYLERGONOVINE 0.2MG/ML   79   250    J2210     48.16      0.00
7911175   METHYLERGONOVINE 0.2MG TA   79   250              16.86      0.00
7911183   METHYLPHENIDATE 5MG TAB (   79   250              12.21      0.00
7911191   METHYLPHENIDATE 20MG ER T   79   250              18.18      0.00
7911209   MethylPREDNISolone 125MG    79   250    J2930     41.21      0.00
7911217   MethylPREDNISolone 1000MG   79   250    J2930    188.90      0.00
7911225   MethylPREDNISolone 40MG I   79   250    J2920     35.74      0.00
7911233   MethylPREDNISolone 500MG    79   250    J2930    102.45      0.00
7911258   MethylPREDNISolone 40MG I   79   250    J1030     51.06      0.00
7911266   MethylPREDNISolone 80MG I   79   250    J1040     77.84      0.00
7911274   MethylPREDNISolone 4MG TA   79   250    J7509     12.16      0.00
7911316   METOCLOPRAMIDE 10MG/2ML I   79   250    J2765     14.61      0.00
7911332   METOCLOPRAMIDE 10MG TAB (   79   250              10.28      0.00
7911357   METOLAZONE 5MG TAB (ZAROX   79   250              20.38      0.00
7911365   METOLAZONE 2.5MG TAB (ZAR   79   250              18.84      0.00
7911399   METOPROLOL 5MG/5ML INJ (L   79   250              28.69      0.00
7911407   METOPROLOL 100MG TAB (LOP   79   250              13.57      0.00
7911415   METOPROLOL 50MG TAB (LOPR   79   250              11.89      0.00
7911431   MetRONIDAZOLE/NACL 500MG    79   250              63.22      0.00
7911449   MetRONIDAZOLE 250MG TAB (   79   250              10.86      0.00
7911530   MIDRIN CAP                  79   250              13.93      0.00
7911555   MILRINONE 20MG/20ML INJ (   79   250    J2260     90.32      0.00
7911571   MINERAL OIL (MURI-LUBE) 1   79   250              62.84      0.00
7911589   MINERAL OIL 30ML            79   250              14.46      0.00
7911605   MISOPROSTOL 100MCG TAB (C   79   250              13.83      0.00
7911613   MITOMYCIN 5MG INJ (MUTAMY   79   250    J9280    564.78      0.00
7911662   MORICIZINE 200MG TAB (ETH   79   250              17.69      0.00
7911670   MORICIZINE 300MG TAB (ETH   79   250              21.33      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7911688   MORphine SULFATE 10MG/ML    79   250    J2270     19.37      0.00
7911696   MORphine PF 1MG/ML INJ (D   79   250    J2275     32.59      0.00
7911704   MORphine SULFATE 15MG/ML    79   250    J2270     18.80      0.00
7911712   MORphine SULFATE 15MG/ML    79   250    J2270     12.04      0.00
7911753   MORphine SUL 10MG/5ML SOL   79   250              10.25      0.00
7911761   MORphine 20MG/ML SOLUTION   79   250              14.39      0.00
7911779   MORphine 30MG CR TAB (ORA   79   250              22.59      0.00
7911787   MORRHUATE SOD 5% INJ        79   250             343.04      0.00
7911803   VITAMIN B COMPLEX CAP       79   250               7.90      0.00
7911837   MULTIVITAMINS W/ MINERALS   79   250               7.97      0.00
7911845   MULTIVITAMIN THERAPEUTIC    79   250               8.36      0.00
7911852   POLY-VI-FLOR/FE .25MG/ML    79   250              10.58      0.00
7911902   POLY-VIT DROP (MULTIVITAM   79   250              10.42      0.00
7911910   THERA-PLUS LIQ 120ML (THE   79   250              11.03      0.00
7911951   NABUMETONE 500MG TAB (REL   79   250              17.41      0.00
7911969   NADOLOL 40MG TAB (CORGARD   79   250              15.79      0.00
7912009   NAFCILLIN 1GM INJ           79   250              74.40      0.00
7912025   NAFCILLIN 2GM INJ           79   250             160.37      0.00
7912041   NALBUPHINE 20MG/ML INJ 1M   79   250    J2300     37.16      0.00
7912066   NALOXONE 0.4MG/ML INJ 1ML   79   250    J2310     43.63      0.00
7912082   NALOXONE 1MG/ML SYR 2ML (   79   250    J2310    130.65      0.00
7912090   NALTREXONE 50MG TAB (REVI   79   250              40.09      0.00
7912124   AK-CON 0.1% OPHTH SOLN 15   79   250              50.38      0.00
7912207   NEOMYCIN SULF POWD (NEO-R   79   250              66.05      0.00
7912215   NEOMYCIN 500MG TAB          79   250              22.58      0.00
7912231   NEOSTIGMINE 1MG/ML INJ 10   79   250    J2710     23.84      0.00
7912272   NIACIN 500MG SA CAP         79   250               8.15      0.00
7912280   NIACIN 50MG TAB             79   250               7.72      0.00
7912348   NICOTINE TD 14MG/24HR PAT   79   250              24.47      0.00
7912355   NICOTINE TD 21MG/24HR PAT   79   250              24.47      0.00
7912363   NICOTINE 7MG/24HR PATCH     79   250              24.47      0.00
7912389   NIFEdipine 10MG CAP (PROC   79   250              13.97      0.00
7912421   NIMODIPINE 30MG CAP (NIMO   79   250              62.26      0.00
7912439   NITROFURANTOIN MAC 100MG    79   250              25.47      0.00
7912462   NITROFURANTOIN MAC 50MG C   79   250              17.22      0.00
7912470   NITROGLYCERIN 5MG/ML INJ    79   250              49.64      0.00
7912546   NITROGLYCERIN 2.5MG CAP (   79   250               9.18      0.00
7912579   NITROGLYCERIN SR 6.5MG CA   79   250               9.03      0.00
7912611   NORMOSOL-R PH 7.4 INJ 100   79   250             440.81      0.00
7912637   NORTRIPTYLINE 10MG CAP (P   79   250              10.91      0.00
7912645   NORTRIPTYLINE 25MG CAP (P   79   250              14.27      0.00
7912652   NTG 0.1MG/HR PATCH (2.5M    79   250              19.58      0.00
7912660   NTG 0.2MG/HR PATCH (5MG/2   79   250              19.86      0.00
7912678   NTG 0.3MG/HR PATCH (7.5MG   79   250              34.26      0.00
7912686   NTG 0.4MG/HR PATCH (10MG/   79   250              21.61      0.00
7912694   NTG 0.6MG/HR PATCH (15MG    79   250              23.05      0.00
7912710   NYSTATIN 100,000 UNITS CR   79   250              39.73      0.00
7912728   NYSTATIN 100,000 UNITS OI   79   250              32.50      0.00
7912744   NYSTOP 100000U POWD 15GM    79   250             166.46      0.00
7912769   NYSTATIN 100,000 UNITS VA   79   250             252.84      0.00
7912777   NYSTATIN/TRIAMCINOLONE CR   79   250              42.46      0.00
7912785   NYSTATIN/TRIAMCINOLONE OI   79   250              42.46      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7912835   OFLOXACIN 200MG TAB (FLOX   79   250              39.70      0.00
7912843   OLSALAZINE 250MG CAP (DIP   79   250              24.25      0.00
7912868   OMEPRAZOLE 20MG CR CAP (P   79   250              37.23      0.00
7912959   ONE TOUCH LOW CONTROL TES   79   250    A4256     22.50      0.00
7912975   OPHTHALMIC IRRIGATION (BS   79   250              46.55      0.00
7913064   SUSPENDING LIQ 1ML          79   250               9.94      0.00
7913130   OXYBUTYNIN 5MG TAB (DITRO   79   250              12.27      0.00
7913155   OxyCODONE/ACETAM 5-325MG    79   250              12.17      0.00
7913189   ASA 325MG/OxyCODONE 4.5MG   79   250              18.32      0.00
7913197   OXYMETAZOLINE 0.05% NASAL   79   250              25.27      0.00
7913221   OXYTOCIN 10UNITS/ML INJ (   79   250    J2590     45.34      0.00
7913239   PACLITAXEL 30MG/5ML INJ (   79   250    J9265    195.58      0.00
7913247   PAMIDRONATE 30MG INJ (ARE   79   250    J2430    295.17      0.00
7913254   PANCREASE EC CAP 4500 UNI   79   250              10.56      0.00
7913270   PAPAVERINE 30MG/ML INJ 10   79   250    J2440     45.35      0.00
7913304   PAROXETINE 20MG TAB (PAXI   79   250              29.90      0.00
7913387   GOLYTELY SOLN 4000MLS       79   250             114.95      0.00
7913403   PEN G BENZ CR 1.2MILL UNI   79   250    J0540    241.21      0.00
7913429   PEN G BENZ LA 1.2MMU INJ.   79   250    J0570    203.52      0.00
7913437   PEN G BENZ LA 600K UNITS    79   250    J0560    177.42      0.00
7913460   PEN G POT 20MMU INJ (PFIZ   79   250    J2540    125.75      0.00
7913478   PEN G POT 5MMU INJ (PFIZE   79   250    J2540     49.25      0.00
7913502   PEN G PROCAINE 600MU (WYC   79   250    J2510     91.20      0.00
7913510   PENICILLAMINE 250MG CAP (   79   250              40.28      0.00
7913536   PENICILLN VK 250MG TAB      79   250               9.34      0.00
7913551   PENICILLN VK 500MG TAB      79   250              10.59      0.00
7913619   PENTAZOCIN/NALOXONE 50-0.   79   250              16.19      0.00
7913676   PENTOXIFYLLINE 400MG C TA   79   250              12.62      0.00
7913692   PERMETHRIN 1% SOLN (NIX)    79   250              46.68      0.00
7913718   PERPHENAZINE 2MG TAB (TRI   79   250    Q0175     14.62      0.00
7913767   PETROLATUM GEL 28.4GM       79   250              19.58      0.00
7913775   DURATEARS OP OINTMENT 3.5   79   250              39.19      0.00
7913783   PHENAPHTHAZINE PAPER (NIT   79   250             218.25      0.00
7913791   PHENAZOPYRIDINE 100MG TAB   79   250              11.42      0.00
7913809   PHENAZOPYRIDINE 200MG TAB   79   250              14.69      0.00
7913825   BELLADONNA/PHENOBARB 16MG   79   250              18.91      0.00
7913841   DONNATAL TAB                79   250               8.21      0.00
7913866   PHENOBARBITAL 100MG TAB     79   250              10.19      0.00
7913874   PHENOBARBITAL 15MG TAB      79   250               9.94      0.00
7913908   PHENOBARBITAL 130MG/1ML I   79   250    J2560     43.91      0.00
7913916   PHENOBARBITAL 65MG/ML INJ   79   250    J2560     22.60      0.00
7913924   PHENOBARBITAL 30MG TAB      79   250              10.16      0.00
7913932   PHENOBARBITAL 60MG TAB      79   250              10.10      0.00
7913940   PHENOL 90% LIQ 1ML          79   250              10.43      0.00
7913957   PHENTOLAMINE MESYLAT INJ    79   250    J2760    266.84      0.00
7913973   PHENYLEPHRINE 10MG/ML INJ   79   250    J2370     16.13      0.00
7913981   NOSE DROPS EX-STR SOLN (N   79   250              31.45      0.00
7914005   PHENYLEPHRINE 0.5% NS SPR   79   250              36.22      0.00
7914013   PHENYLEPHRINE 0.25% NS SP   79   250              36.22      0.00
7914088   PHENYTOIN 50MG CHW TAB (D   79   250              11.88      0.00
7914096   PHENYTOIN 250MG/5ML INJ (   79   250    J1165     24.64      0.00
7914104   PHENYTOIN 30MG CAP (DILAN   79   250              10.36      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7914112   PHENYTOIN 125MG/5ML SUSP    79   250               9.94      0.00
7914120   PHENYTOIN 100MG CAP (DILA   79   250              10.19      0.00
7914138   PHOSPHORATED CARB SOLN (E   79   250               9.88      0.00
7914146   PHYSOSTIGMINE 1MG/ML INJ    79   250              46.65      0.00
7914153   PHYTONADIONE 5MG TAB (MEP   79   250              23.25      0.00
7914161   PHYTONADIONE 10MG/ML INJ    79   250    J3430     72.05      0.00
7914203   PILOCARPINE 0.5% OP SOLN    79   250              47.46      0.00
7914211   PILOCARPINE 1% OP SOLN 15   79   250              62.20      0.00
7914229   PILOCARPINE 2% OP SOLN 15   79   250              76.99      0.00
7914237   PILOCARPINE 3% OP SOL 15M   79   250              70.65      0.00
7914245   PILOCARPINE 4% OP SOLN 15   79   250              73.33      0.00
7914252   PILOCARPINE 6% OP SOLN 15   79   250              85.04      0.00
7914351   PIROXICAM 10MG CAP (FELDE   79   250              18.59      0.00
7914385   PNEUMOCOCCAL 25MCG/0.5ML    79   250    90732    239.47      0.00
7914401   BACITRACIN/POLYMYXIN OINT   79   250              58.86      0.00
7914419   BACITRACIN/POLYMYXIN OP O   79   250             156.41      0.00
7914427   BAC/NEO/POLY OINT 30GM (    79   250              33.86      0.00
7914435   NEO/POLY/BACI OP OINT 3.5   79   250              64.08      0.00
7914443   BAC/NEO/POLY OINTMETN 1GM   79   250              10.47      0.00
7914450   CORTISPORIN OINTMENT 15GM   79   250             277.43      0.00
7914468   NEO/POLY/GRAM OPHTH SOLN    79   250             181.14      0.00
7914476   CORTISPORIN OP SUSP 7.5ML   79   250             256.93      0.00
7914484   FIBER 625MG TAB (FIBER CO   79   250               8.44      0.00
7914518   NEO/POLY/HC OTIC SUSP 10M   79   250             185.53      0.00
7914526   POTASSIUM ACETATE 2MEQ/ML   79   250              14.52      0.00
7914591   POTASSIUM CHLORIDE 2MEQ/M   79   250    J3480     14.08      0.00
7914625   SSKI 1GM/ML SOL 30L         79   250              78.76      0.00
7914633   POTASSIUM PHOSPHAT 3MM/ML   79   250              10.32      0.00
7914658   PRAMOXINE NS 1% AER (PROC   79   250             234.07      0.00
7914666   PRAMOXINE-HC 1% AER (PROC   79   250             259.98      0.00
7914674   PRAVASTATIN 10MG TAB (PRA   79   250              31.91      0.00
7914716   PRAZOSIN HCL 1MG CAP (MIN   79   250               9.79      0.00
7914724   SODIUM BICARB 8.4% ABBOJE   79   250              36.00      0.00
7914740   PrednisoLONE 5MG/5ML SYP    79   250    J7510     17.51      0.00
7914757   PrednisoLONE 0.12% OP SUS   79   250             151.16      0.00
7914765   PrednisoLONE 1% OP SUSP 5   79   250              81.61      0.00
7914823   PredniSONE 10MG TAB (DELT   79   250    J7506      8.57      0.00
7914831   PredniSONE 1MG TAB (DELTA   79   250    J7506      9.33      0.00
7914849   PredniSONE 20MG TAB (DELT   79   250    J7506      8.88      0.00
7914856   PredniSONE 5MG TAB (DELTA   79   250    J7510      8.47      0.00
7914864   PrimiDONE 250MG TAB (Myso   79   250              14.78      0.00
7914872   PrimiDONE 50MG TAB (MysoL   79   250              13.60      0.00
7914880   PROBENECID 500MG TAB (BEN   79   250              15.03      0.00
7914906   PROBENECID/COLCHICINE 500   79   250              13.97      0.00
7914930   PROCAINAMIDE 100MG/ML INJ   79   250    J2690     51.92      0.00
7914948   PROCAINAMIDE 500MG/ML INJ   79   250    J2690     51.92      0.00
7914971   PROCAINAMIDE 750MG SA TAB   79   250              13.32      0.00
7915069   PROCHLORPERAZINE 5MG TAB    79   250    Q0164     12.22      0.00
7915119   PROCHLORPERAZINE 25MG SUP   79   250              32.91      0.00
7915135   PROCHLORPERAZINE 10MG TAB   79   250    Q0165     14.56      0.00
7915192   PROMETHAZINE 50MG/1ML INJ   79   250    J2550     27.24      0.00
7915200   PROMETHAZINE 6.25MG/5ML P   79   250              11.45      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7915218   PROMETHAZINE 12.5MG SUPP    79   250              37.25      0.00
7915226   PROMETHAZINE 25MG SUPP (P   79   250              41.69      0.00
7915242   PROMETHAZINE 25MG TAB (PH   79   250              11.56      0.00
7915259   PROMETHAZINE VC SYRUP (PH   79   250              12.88      0.00
7915283   PROMETHAZINE DM SYRUP (PH   79   250               9.89      0.00
7915291   PROPAFENONE 150MG TAB (RY   79   250              20.37      0.00
7915309   PROPARACAINE 0.5% OP SOLN   79   250              73.90      0.00
7915325   PROPOFOL 1% 50ML INJ (DIP   79   250              77.10      0.00
7915333   PROPOXYPHENE HCL 65MG CAP   79   250              10.39      0.00
7915366   PROPOXYPHENE/APAP 100-650   79   250              11.63      0.00
7915416   PROPRANOLOL 1MG/ML INJ (I   79   250    J1800     70.33      0.00
7915432   PROPRANOLOL 60MG LA CAP (   79   250              20.23      0.00
7915473   PROPRANOLOL 10MG TAB (IND   79   250               9.63      0.00
7915481   PROPRANOLOL 40MG TAB (IND   79   250              10.67      0.00
7915499   INDERIDE 40/25 TAB          79   250              20.32      0.00
7915507   INDERIDE 80/25 TAB          79   250              23.43      0.00
7915523   PROTAMINE 10MG/ML INJ 25M   79   250    J2720    123.75      0.00
7915531   PROTAMINE 10MG/ML INJ 5ML   79   250    J2720     47.71      0.00
7915549   PROTRIPTYLINE 10MG TAB (V   79   250              33.48      0.00
7915564   GUAIFEN/PSEUDO/COD LIQ      79   250              11.19      0.00
7915598   PSEUDOEPHEDRINE 30MG TAB    79   250               8.06      0.00
7915606   KONSYL-ORANGE 3.4GM UD PA   79   250               9.61      0.00
7915622   PYRAZINAMIDE 500MG TAB      79   250              16.65      0.00
7915630   PYRIDOSTIGMINE 60MG TAB (   79   250              12.12      0.00
7915655   PYRIDOXINE 100MG/1ML INJ    79   250    J3415     73.83      0.00
7915671   PYRIDOXINE 50MG TAB (VITA   79   250               7.85      0.00
7915697   quiniDINE SULFATE 200MG T   79   250               9.08      0.00
7915721   quiniDINE GLUC 80MG/ML IN   79   250             137.91      0.00
7915747   quiniDINE GL 324MG CR TAB   79   250              17.97      0.00
7915804   RAMIPRIL 2.5MG CAP (ALTAC   79   250              22.83      0.00
7915820   RANITIDINE 15MG/ML SYRUP    79   250              15.30      0.00
7915853   RANITIDINE 150MG TAB (ZAN   79   250              31.93      0.00
7915937   RIFAMPIN 300MG CAP (RIFAD   79   250              22.58      0.00
7915945   RINGERS INJ 1000MLS         79   250    J7120     75.00      0.00
7915952   RUBELLA VACCINE (MERUVAX)   79   250    90706    145.28      0.00
7915986   SCOPOLAMINE 0.4MG/ML INJ    79   250              41.78      0.00
7915994   SCOPOLAMINE 0.25% OP SOL    79   250             160.64      0.00
7916000   SCOPOLAMINE 1.5MG/72HR PA   79   250              65.16      0.00
7916034   SENNA LAX 8.6MG TAB (AKA    79   250               8.12      0.00
7916042   SERTRALINE 50MG TAB (ZOLO   79   250              10.61      0.00
7916059   SILVER NITRATE APPLICATOR   79   250              11.87      0.00
7916083   SSD 1% CREAM 400GM          79   250             209.93      0.00
7916091   SSD 1% CREAM 50GM           79   250              56.83      0.00
7916109   SIMITHICONE 40MG/0.6ML DR   79   250              36.97      0.00
7916117   SIMETHICONE 80MG CHW TAB    79   250               8.92      0.00
7916141   SODIUM ACETATE 2MEQ/ML IN   79   250               9.94      0.00
7916166   SODIUM BICARB 8.4% ABBOJE   79   250              47.14      0.00
7916182   SODIUM BICARB 4.2% INJ AB   79   250              35.54      0.00
7916190   SODIUM BICARB 650MG TAB     79   250               8.06      0.00
7916208   SOD CHLORIDE 0.9% NEB 5ML   79   250              10.77      0.00
7916216   SODIUM CHLORIDE 1GM TAB     79   250               7.97      0.00
7916232   SOD CHLORIDE 4MEQ/ML(23.4   79   250    J7130     20.61      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7916265   BICITRA SOLN 30ML           79   250              14.28      0.00
7916273   NITROPRUSSIDE 25MG/ML INJ   79   250              86.24      0.00
7916281   SOD PHOSPHAT 3MM/ML INJ 1   79   250              10.10      0.00
7916307   SOD POLYSTYRENE/SORBITAL    79   250              42.46      0.00
7916315   SOD POLYSTYRENE SULF 30GM   79   250             121.98      0.00
7916323   SOD POLYST SULF POWD 454G   79   250             504.96      0.00
7916372   SORBITOL 70% SOLUTION 480   79   250               9.78      0.00
7916380   SOTALOL 80MG TAB (BETAPAC   79   250              25.42      0.00
7916414   SPIRONOLACTONE 25MG TAB (   79   250              11.70      0.00
7916448   EYE WASH SOLN 118ML         79   250              38.20      0.00
7916471   STERILE WATER IRRIG SOLN    79   250              75.98      0.00
7916497   STERILE WATER IRRIG SOLN    79   250              72.26      0.00
7916505   STERILE EMPTY 30ML VIAL     79   250               9.33      0.00
7916554   SUCCINYLCHOLINE 20MG/ML I   79   250    J0330     31.73      0.00
7916570   SUCRALFATE 1GM TAB (CARAF   79   250              13.41      0.00
7916596   SUFENTANIL 50MCG/ML INJ 2   79   250              61.57      0.00
7916612   SULFACET/PRED 10%/0.23% O   79   250             111.53      0.00
7916638   SULFACETAMIDE 10% OP SOLN   79   250              34.78      0.00
7916679   SULFASALAZINE 500MG TAB (   79   250               9.40      0.00
7916737   SULINDAC 150MG TAB (CLINO   79   250              15.25      0.00
7916745   SULINDAC 200MG TAB (CLINO   79   250              16.73      0.00
7916752   SUMATRIPTAN 6MG/0.5ML INJ   79   250    J3030    361.05      0.00
7916786   TAMOXIFEN 10MG TAB (NOLVA   79   250              25.58      0.00
7916794   AKWA TEARS OP SOLN 15ML     79   250              34.96      0.00
7916802   TEMAZEPAM 15MG CAP (RESTO   79   250              12.99      0.00
7916810   TERAZOSIN 1MG CAP (HYTRIN   79   250              18.55      0.00
7916828   TERAZOSIN 2MG CAP (HYTRIN   79   250              19.76      0.00
7916869   TERBUTALINE 1MG/ML INJ (B   79   250    J3105     42.96      0.00
7916877   TERBUTALINE 2.5MG TAB (BR   79   250              10.85      0.00
7916885   TERBUTALINE 5MG TAB (BRET   79   250              12.29      0.00
7916927   TETANUS IMMUNE GLOBULIN(H   79   250    J1670    600.01      0.00
7916950   TETRACAINE 2% SOLN (PONTO   79   250             118.15      0.00
7916976   TETRACYCLINE 250MG CAP (S   79   250               8.18      0.00
7917016   TETRAHYDROZOLINE 0.05% OP   79   250              28.69      0.00
7917024   THEOPHYLLINE 80MG/15ML EL   79   250              32.60      0.00
7917032   THEOPHYLLINE 300MG CR CAP   79   250              16.12      0.00
7917040   THEOPHYLLINE 100MG CR CAP   79   250              12.22      0.00
7917149   THIAMINE HCL 100MG/ML INJ   79   250    J3411     80.68      0.00
7917198   THIOPENTAL 500MG INJ (PEN   79   250             133.22      0.00
7917248   THIORIDAZINE 100MG TAB (M   79   250              12.77      0.00
7917255   THIORIDAZINE 10MG TAB (ME   79   250              10.16      0.00
7917263   THIORIDAZINE 25MG TAB (ME   79   250              11.22      0.00
7917289   THIOTHIXENE 1MG CAP (NAVA   79   250               9.36      0.00
7917297   THIOTHIXENE 5MG CAP (NAVA   79   250              11.17      0.00
7917305   THROMBIN-JMI 20000U KIT     79   250            1425.08      0.00
7917339   THYROID 30MG TAB (ARMOUR    79   250               9.57      0.00
7917370   THYROID 60MG TAB (ARMOUR    79   250               9.70      0.00
7917404   TICLOPIDINE 250MG TAB (TI   79   250              26.15      0.00
7917438   TIMOLOL MAL 0.5% OPHTH SO   79   250             106.74      0.00
7917446   TOBRAMYCIN 0.3% OP OINT (   79   250             278.04      0.00
7917453   TOBRAMYCIN 40MG/ML INJ 2M   79   250    J3260     47.41      0.00
7917461   TOBRAMYCIN 0.3% OP SOLN 5   79   250              95.32      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7917479   TOBRAMYCIN/DEXAMETHASONE    79   250             362.09      0.00
7917487   TOBRA/DEXAMET OP SUSP.(TO   79   250             241.67      0.00
7917511   TOLAZamide 100MG TAB (TOL   79   250              10.37      0.00
7917529   TOLAZamide 250MG TAB (TOL   79   250              13.41      0.00
7917552   TOLBUTamide 500MG TAB (O    79   250               9.77      0.00
7917594   TOLNAFTATE 1% POWDER 45GM   79   250              37.75      0.00
7917602   TOLNAFTATE 1% SOLN 10ML     79   250              44.67      0.00
7917610   TPN ELECTROLYTES            79   250             436.93      0.00
7917636   EMPTY CONTAINER 3000ML PL   79   250              20.80      0.00
7917644   EMPTY CONTAINER 4000ML PL   79   250              22.34      0.00
7917651   TRACE ELEMENTS INJ 1ML      79   250              38.20      0.00
7917677   TraZODONE 150MG TAB (DESY   79   250              18.74      0.00
7917735   TRIAMCINOLONE INH 20GM (A   79   250    J7683    567.56      0.00
7917743   TRIAMCINOLONE 10MG/ML INJ   79   250    J3301     74.19      0.00
7917750   TRIAMCINOLONE 40MG/1ML IN   79   250    J3301     59.63      0.00
7917768   TRIAMCINOLONE 40MG/ML INJ   79   250    J3301    262.42      0.00
7917800   TRIAMTERENE 50MG CAP (DYR   79   250              16.90      0.00
7917834   TRIAMTERENE/HCTZ 75-50MG    79   250              14.51      0.00
7917867   TRIFLUOPERAZINE 2MG TAB (   79   250              14.29      0.00
7917917   TRIHEXYPHENIDYL 2MG TAB (   79   250               8.95      0.00
7917925   TRIHEXYPHENIDYL 5MG TAB (   79   250              10.32      0.00
7917966   TRIMETHOBENZAMIDE 200MG/2   79   250    J3250     31.73      0.00
7917974   TRIMETHOBENZAMIDE 100MG S   79   250              14.64      0.00
7917982   TRIMETHOBENZAMIDE 200MG S   79   250              17.14      0.00
7917990   TRIMETHOPRIM 100MG TAB (P   79   250              12.76      0.00
7918014   TRIMETHOPRIM POLYMYX OP S   79   250             109.59      0.00
7918048   SULFAMETH/TRIMETHOPR INJ    79   250              41.53      0.00
7918055   SULFATRIM SUSPENSION 100M   79   250              10.63      0.00
7918063   SMZ/TMP DS 800-160 TAB (B   79   250              18.70      0.00
7918105   TRIPROLIDINE/PSE 1.25/30    79   250              10.71      0.00
7918113   TRIPROLIDINE/PSEUDO 2.5/6   79   250               7.90      0.00
7918139   TROPICAMIDE 0.5% OP SOLN    79   250             100.74      0.00
7918162   TUBERCULIN TEST 5U/0.1ML    79   250              35.89      0.00
7918196   PHENYLEPH/ANTIPY/B-CAINE    79   250              70.39      0.00
7918238   URSODIOL 300MG CAP (ACTIG   79   250              27.17      0.00
7918253   VALPROIC ACID 250MG/5ML S   79   250              10.46      0.00
7918261   VALPROIC ACID 250MG CAP (   79   250              13.60      0.00
7918279   VANCOMYCIN 1000MG INJ       79   250    J3370     62.13      0.00
7918287   VANCOMYCIN 500MG INJ        79   250    J3370     45.43      0.00
7918295   VANCOMYCIN 500MG ADV        79   250    J3370     44.67      0.00
7918337   VASOPRESSIN 20U/ML INJ 1M   79   250              40.50      0.00
7918345   VECURONIUM 10MG INJ (NORC   79   250              38.20      0.00
7918360   VERAPAMIL 2.5MG/ML INJ 2M   79   250              20.41      0.00
7918378   VERAPAMIL 120MG TAB (CALA   79   250              11.83      0.00
7918386   VERAPAMIL SR 180MG TAB (C   79   250              18.84      0.00
7918394   VERAPAMIL SR 240MG TAB (    79   250              16.83      0.00
7918410   VERAPAMIL 80MG TAB (CALAN   79   250              11.89      0.00
7918428   VITAMIN B W/C TAB (TOTAL    79   250               7.90      0.00
7918444   VinBLAStine 10MG INJ (VEL   79   250    J9360    142.77      0.00
7918451   VinCRIStine 1MG/1ML INJ (   79   250    J9370    181.65      0.00
7918485   VITAMIN A D OINTMENT 5GM    79   250              13.47      0.00
7918493   BETA CAROTENE 25000IU CAP   79   250               7.71      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7918501   AQUASOL A 50000/ML INJ      79   250             165.58      0.00
7918519   VITAMIN E 200IU CAP         79   250               7.83      0.00
7918535   VITAMIN E 50IU/ML DROP 12   79   250              29.23      0.00
7918543   WARFARIN 2.5MG TAB (COUMA   79   250              15.50      0.00
7918550   WARFARIN 2MG TAB (COUMADI   79   250              15.26      0.00
7918568   WARFARIN 7.5MG TAB (COUMA   79   250              18.60      0.00
7918626   ZIDOVUDINE 100MG CAP (RET   79   250              22.92      0.00
7918634   ZINC OXIDE 20% OINTMETN 4   79   250              81.60      0.00
7918642   ZINC OXIDE 20% OINTMENT 6   79   250              28.99      0.00
7918659   DIAPER RASH 40% OINTMENT    79   250              38.28      0.00
7918675   ZINC SULFATE 220MG CAP      79   250               8.47      0.00
7918709   D5W INJ 1000MLS             79   250    J7070     72.03      0.00
7918758   NEUTRA-PHOS POW             79   250              10.51      0.00
7918816   ANTIBIOTIC MONITORING FEE   79   250             250.00      0.00
7918857   CALCIUM GLUCONATE POWD 50   79   250               9.98      0.00
7918949   LIQUOR 30ML                 79   250               9.67      0.00
7918956   MORTAR GLASS 20Z            79   250               8.10      0.00
7918972   SODIUM CHL 0.65% NS SPRAY   79   250              25.65      0.00
7918980   PESTLE GLASS 2OZ            79   250               8.10      0.00
7919046   COCAINE HCL 10% SOL 4ML     79   250             255.25      0.00
7919137   MORphine 100MG CR TAB (MS   79   250              47.00      0.00
7919145   DILTIAZEM 5MG/ML INJ 5ML    79   250              28.69      0.00
7919152   QUINAPRIL 10MG TAB (ACCUP   79   250              16.86      0.00
7919194   ACETIC ACID GLACIAL SOL 5   79   250             126.55      0.00
7919251   MICONAZOLE 2% CREAM (MONI   79   250              53.80      0.00
7919293   OFLOXACIN 300MG TAB (FLOX   79   250              45.81      0.00
7919335   TERAZOSIN 5MG CAP (HYTRIN   79   250              18.55      0.00
7919343   SIMPLE SYRUP 480ML          79   250               9.85      0.00
7919384   DOBUTamine/D5W 250MG/250M   79   250    J1250     70.48      0.00
7919400   DEXTROSE 70% INJ 2000MLS    79   250             136.70      0.00
7919426   AMINOSYN II 10% INJ 2000M   79   250             638.96      0.00
7919434   DIPYRIDAMOLE 5MG/ML INJ (   79   250    J1245     88.18      0.00
7919442   CLARITHROMYCIN 250MG TAB    79   250              45.17      0.00
7919459   VITAMIN E 400IU CAP         79   250               8.40      0.00
7919467   ISRADIPINE 2.5MG CAP (DYN   79   250              18.00      0.00
7919483   MESALAMINE 400MG EC TAB (   79   250              19.08      0.00
7919517   ONDANSETRON 4MG/2ML INJ (   79   250    J2405     34.40      0.00
7919541   ACTIDOSE-AQ 50GM/240ML LI   79   250             135.00      0.00
7919574   ISOSORBIDE 60MG ER TAB (I   79   250              17.92      0.00
7919616   SLOW FE 160MG CR TAB        79   250               9.40      0.00
7919624   ROCURONIUM 10MG/ML INJ (Z   79   250             123.08      0.00
7919665   THEOPHYLLINE 400MG CR TAB   79   250              18.79      0.00
7919723   IPRATROPIUM 0.02% INHAL S   79   250    J7644     17.60      0.00
7919731   NATALCARE PLUS TAB (PRENA   79   250               8.92      0.00
7919772   RIFAMPIN 600MG INJ (RIFAD   79   250             562.12      0.00
7919798   WARFARIN 10MG TAB (COUMAD   79   250              19.01      0.00
7919806   ALLERGY 2% CREAM 30GM (BE   79   250              27.85      0.00
7919814   LIDOCAINE-MPF 2% INJ (XYL   79   250    J2001     32.16      0.00
7919830   TRIAMTERENE/HCTZ 37.5-25    79   250              10.14      0.00
7919848   CycloSPORINE 100MG CAP (S   79   250    J7502     45.57      0.00
7919855   CHLORAMBUCIL 2MG TAB (LEU   79   250    J8600     30.91      0.00
7919863   MEGESTROL 40MG/ML SUSP (M   79   250              14.23      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7919871   THEOPHYLLINE 200MG CR CAP   79   250              14.50      0.00
7919897   HOMATROPINE 5% OP SOLN 5M   79   250             182.74      0.00
7919905   OPTIPRANOLOL 0.3% OP SOLN   79   250             104.51      0.00
7919913   RAMIPRIL 5MG CAP (ALTACE)   79   250              23.06      0.00
7919921   PHYTONADIONE 1MG/0.5ML SY   79   250    J3430     40.00      0.00
7919939   WARFARIN 1MG TAB (COUMADI   79   250              14.94      0.00
7919947   ASPIRIN 81MG EC TAB         79   250               8.01      0.00
7919970   POTASSIUM CHL 20MEQ TAB (   79   250              12.25      0.00
7919988   WARFARIN 5MG TAB (COUMADI   79   250              15.84      0.00
7920028   ERYTHROMYCIN BS 500MG TAB   79   250               9.72      0.00
7920085   EPINEPHrine 30MG/30ML INJ   79   250    J0170     61.06      0.00
7920150   FAMCICLOVIR 500MG TAB (FA   79   250              65.44      0.00
7920226   LEVOBUNOLOL 0.25% OP SOL    79   250             100.00      0.00
7920242   GLYburide MICRONIZED 3MG    79   250              12.42      0.00
7920267   ABCIXIMAB 2MG/ML INJ (REO   79   250    J0130   2760.64      0.00
7920283   PROPOFOL 1% 20ML INJ (DIP   79   250              34.40      0.00
7920291   ALBUTEROL 4MG ER TAB (VOS   79   250              18.23      0.00
7920317   GliPIzide XL 5MG TAB (GLU   79   250              10.65      0.00
7920333   CycloSPORINE 25MG CAP (SA   79   250    J7515     19.43      0.00
7920358   HEPARIN/NACL 1,000 UNITS/   79   250    J1644     41.44      0.00
7920366   CALCIUM CARB 1250MG/5ML S   79   250               9.85      0.00
7920374   THROMBIN-JMI 5000U SOL      79   250             351.46      0.00
7920390   TOBRAMYCIN 1.2GM POWDER I   79   250    J3260    909.78      0.00
7920424   HYOSCYAMINE 0.125MG SL TA   79   250              10.39      0.00
7920440   ORAJEL 7.5% GEL 9.5GM (B    79   250              41.72      0.00
7920456   VARICELLA VACC INJ (VARIV   79   250    90716    288.20      0.00
7920457   ROWASA 4GM/60ML ENEMA UNI   79   250             102.46      0.00
7920481   OPCON-A OP SOL 15ML         79   250              40.78      0.00
7920499   NEDOCROMIL INH (TILADE) 1   79   250             419.20      0.00
7920507   VENLAFAXINE 75MG TAB (EFF   79   250              24.18      0.00
7920515   MetFORMIN 850MG TAB (GLUC   79   250              17.62      0.00
7920523   MetFORMIN 500MG TAB (GLUC   79   250              13.48      0.00
7920531   HEPATITIS B 5MCG/0.5ML IN   79   250    90744    174.17      0.00
7920549   ITRACONAZOLE 100MG CAP (S   79   250              60.68      0.00
7920572   DINOPROSTONE 10MG VAG (CE   79   250            1026.17      0.00
7920606   LEVOTHROID 112MCG TAB (SY   79   250               9.83      0.00
7920614   METHYLENE BLUE 1% INJ 10M   79   250              67.76      0.00
7920622   LEVOCARNITIN 200MG/ML INJ   79   250    J1955    238.07      0.00
7920648   AZITHROMYCIN 1GM POWD (ZI   79   250    Q0144    147.56      0.00
7920655   SODIUM BENZOATE POWDER 50   79   250              91.77      0.00
7920671   LOSARTAN 25MG TAB (COZAAR   79   250              22.37      0.00
7920697   SEVOFLURANE INHALATION 25   79   250              71.59      0.00
7920721   FAMOTIDINE 40MG/5ML SUSP    79   250              28.52      0.00
7920739   PHENYLEPHRINE 10MG/ML INJ   79   250    J2370     98.74      0.00
7920762   CALCITONIN 200IU/ML INJ (   79   250    J0630    239.79      0.00
7920796   ACARBOSE 50MG TAB (PRECOS   79   250              16.25      0.00
7920804   PILOCARPINE 4% OP GEL (PI   79   250             224.93      0.00
7920812   MetRONIDAZOLE 0.75% TOPIC   79   250             280.75      0.00
7920838   LORATADINE 10MG TAB (CLAR   79   250              13.64      0.00
7920846   METOPROLOL XL 50MG TAB (T   79   250              15.64      0.00
7920879   PROPANTHELINE 15MG TAB      79   250              12.02      0.00
7920895   CISATRACURIUM BESY. 2MG/M   79   250             146.29      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7920903   ISOFLURANE INHALATION SOL   79   250              16.71      0.00
7920937   CHLORHEXIDINE 0.12% SOLN    79   250              69.62      0.00
7920945   CLARITHROMYCIN 250MG/5ML    79   250              16.48      0.00
7920960   ALPRACLONIDINE 0.5% OP SO   79   250             351.84      0.00
7920978   ALENDRONATE 10MG TAB (FOS   79   250              32.30      0.00
7920994   RISPERIDONE 1MG TAB (RISP   79   250              36.43      0.00
7921034   ULTRASOUND GEL              79   250               8.10      0.00
7921042   DEXAMETHASONE PHOSPHA POW   79   250    J1100    493.15      0.00
7921075   PROCAINAMIDE 1000MG ER TA   79   250              23.80      0.00
7921083   ALCOHOL ABSOLUTE 480ML      79   250               7.50      0.00
7921133   TraMADOL 50MG TAB (ULTRAM   79   250              14.48      0.00
7921141   METHADONE 10MG TAB (DOLOP   79   250              12.99      0.00
7921158   GABAPENTIN 400MG CAP (NEU   79   250              19.85      0.00
7921166   IBUTILIDE 0.1MG/ML INJ (C   79   250    J1742   1804.59      0.00
7921174   BUPIVACAINE MPF 0.5% INJ    79   250              62.63      0.00
7921190   FLUVOXAMINE 50MG TAB (LUV   79   250              27.14      0.00
7921216   ZOLPIDEM 5MG TAB (AMBIEN)   79   250              42.90      0.00
7921265   MORphine 15MG CR TAB (ORA   79   250              16.47      0.00
7921281   MYCOPHENOLATE 250MG CAP (   79   250    J7517     38.64      0.00
7921307   ETHYL CHLOR AER 103.5ML     79   250             107.08      0.00
7921349   SODIUM CHLORIDE 3% NEB 15   79   250              15.75      0.00
7921372   VENLAFAXINE 37.5MG TAB (E   79   250              22.78      0.00
7921380   AMINOSYN-HF 8% SOLN 500ML   79   250    B4176    780.27      0.00
7921406   FLUOXETINE 20MG/5ML LIQ (   79   250              38.94      0.00
7921414   ENALAPRIL 20MG TAB (VASOT   79   250              20.45      0.00
7921596   CycloSPORINE 100MG CAP MO   79   250    J7502     38.94      0.00
7921604   MOEXIPRIL 15MG TAB (UNIVA   79   250              21.08      0.00
7921620   FOSPHENYTOIN 50MG/ML INJ    79   250    Q2009    161.59      0.00
7921638   POTASSIUM CHL 20MEQ/100ML   79   250    J3480     81.94      0.00
7921646   INS LISPRO 100 UNITS/ML I   79   250    J1815    395.92      0.00
7921661   AMANTADINE 50MG/5ML SYRUP   79   250              10.84      0.00
7921679   CEFTIZOXIME 1GM ADV (CEFI   79   250    J0715     86.41      0.00
7921687   ANASTROZOLE 1MG TAB (ARIM   79   250              70.37      0.00
7921695   CEFTIZOXIME 2GM ADV (CEFI   79   250    J0715    141.93      0.00
7921703   ZAFIRLUKAST 20MG TAB (ACC   79   250              20.65      0.00
7921729   TraZODONE 100MG TAB (DESY   79   250              13.52      0.00
7921786   LAMIVUDINE 150MG TAB (EPI   79   250              45.91      0.00
7921802   LAMOTRIGINE 100MG TAB (LA   79   250              37.70      0.00
7921810   MESALAMINE 250MG C CAP (P   79   250              13.92      0.00
7921836   CARBAMIDE PEROXIDE 10% SO   79   250              20.12      0.00
7921844   MESNA 1GM INJ (MESNEX) 10   79   250    J9209    514.26      0.00
7921869   LIDOCAINE 2% GEL (XYLOCAI   79   250              54.21      0.00
7921877   CHILDREN'S SUDAFED 15MG/5   79   250              36.40      0.00
7921885   IMPACT 1.5 LIQ 250ML        79   250              83.21      0.00
7921893   ISOSOURC HN LIQ 1000MLS     79   250              96.91      0.00
7921927   BACITRACIN/POLYMYXIN OINT   79   250              12.64      0.00
7921935   PYRIDOSTIGMINE 180MG TAB    79   250              21.48      0.00
7921943   MOLINDONE 10MG TAB (MOBAN   79   250              23.58      0.00
7921976   DESMOPRESSIN 4MCG/ML INJ    79   250    J2597     92.57      0.00
7922032   FENTANYL 100MCG PATCH (DU   79   250             213.17      0.00
7922040   MAGNESIUM OXIDE 400MG TAB   79   250               8.96      0.00
7922081   LATANOPROST 0.005% OP (XA   79   250             296.22      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7922099   BICALUTAMIDE 50MG TAB (CA   79   250             111.43      0.00
7922115   OFLOXACIN 0.3% OP SOLN (O   79   250             247.83      0.00
7922123   M.V.I. ADULT INJ 10ML       79   250              43.35      0.00
7922149   LEUCOVORIN 100MG INJ        79   250    J0640     40.11      0.00
7922172   OYSTER-CAL 500MG TAB (OSC   79   250               8.38      0.00
7922198   AMOX/CLAV 875MG/125MG TAB   79   250              37.78      0.00
7922248   TIMOLOL GEL 0.5% OP SOLN    79   250             114.16      0.00
7922255   INDINAVIR 400MG CAP (CRIX   79   250              31.69      0.00
7922263   REMIFENTANIL INJ 1MG (ULT   79   250              95.02      0.00
7922271   ATORVASTATIN 10MG TAB (LI   79   250              31.80      0.00
7922289   MAGNESIUM SULF 50% INJ 10   79   250    J3475     16.80      0.00
7922305   VALPROATE 100MG/ML INJ (D   79   250              80.53      0.00
7922313   BOTOX 100U INJ              79   250    J0585   2509.98      0.00
7922354   DICLOFENAC 0.1% OP SOL (V   79   250             265.30      0.00
7922362   CARVEDILOL 3.125MG TAB (C   79   250              23.79      0.00
7922370   COMBIVENT INH 14.7GM        79   250             439.09      0.00
7922396   ZIAC 5/6.25MG TAB           79   250              30.81      0.00
7922404   CARTEOLOL OP SOLN 1% 5ML    79   250             121.81      0.00
7922420   CHLOROTHIAZIDE 500MG TAB    79   250              27.72      0.00
7922446   KETOROLAC 0.5% OP SOL (AC   79   250             219.52      0.00
7922461   MedroxyPROGESTERone 150MG   79   250    J1055    273.75      0.00
7922479   ENULOSE 10GM/15 SYP 473ML   79   250              18.44      0.00
7922487   ZOSYN 3.375GM INJ.          79   250    J2543    126.81      0.00
7922495   DONEPEZIL 5MG TAB (ARICEP   79   250              45.46      0.00
7922503   LANSOPRAZOLE 15MG DR CAP    79   250    J1956     41.53      0.00
7922529   PRAMIPEXOLE 0.25MG TAB (M   79   250              26.57      0.00
7922545   LEVOFLOXACIN 500MG TAB (L   79   250              84.45      0.00
7922552   TROPICAMIDE 1% OP SOL (MY   79   250             107.13      0.00
7922560   FLUTICASONE 0.05% SPR (FL   79   250             296.41      0.00
7922685   OMEPRAZOLE 10MG CR CAP (P   79   250              35.71      0.00
7922735   VALSARTAN 80MG TAB (DIOVA   79   250              25.52      0.00
7922743   GEMCITABINE 200MG INJ (GE   79   250    J9201    699.58      0.00
7922750   GEMCITABINE 1GM INJ (GEMZ   79   250    J9201   3200.85      0.00
7922776   OLANZAPINE 5MG TAB (ZYPRE   79   250              59.26      0.00
7922826   PETROLATUM GEL 5GM          79   250              10.62      0.00
7922834   MINERAL OIL 480ML           79   250               9.74      0.00
7922891   RIFAMPIN 150MG CAP (RIFAD   79   250              24.85      0.00
7922982   BuPROPion 150MG SR TAB (W   79   250              29.68      0.00
7923055   LEVOFLOX/DEX 500MG PREMIX   79   250    J1956    270.33      0.00
7923063   SOD HYPOCHLORITE SOLN 5.2   79   250               8.48      0.00
7923071   LEVOCARNITINE 330MG TAB (   79   250              14.10      0.00
7923089   CLOBETASOL 0.05% OINT (TE   79   250             244.67      0.00
7923097   CLOBETASOL 0.05% CREAM 30   79   250             214.42      0.00
7923105   DEXAMETHASONE PHOS 4MG/ML   79   250    J1100     20.17      0.00
7923154   DOLASETRON 12.5MG/0.625ML   79   250    J1260    121.15      0.00
7923162   LANSOPRAZOLE 30MG DR CAP    79   250              41.53      0.00
7923188   CYANOCOBALAMIN 500MCG TAB   79   250               7.83      0.00
7923212   MONTELUKAST 10MG TAB (SIN   79   250              38.39      0.00
7923261   NOREPINEPHRINE 1MG/ML INJ   79   250              42.50      0.00
7923287   MUPIROCIN 2% CREAM (BACTR   79   250             276.38      0.00
7923311   ZIAC 2.5/6.2MG TAB          79   250              30.81      0.00
7923337   RANITIDINE 25MG/ML INJ (Z   79   250    J2780     40.04      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7923352   TOLTERODINE 2MG TAB (DETR   79   250              26.98      0.00
7923410   EURAX 10% CREAM 60GM        79   250             102.68      0.00
7923477   BISOPROLOL FUM 5MG TAB (Z   79   250              16.84      0.00
7923485   ZOSYN 4.5GM VIAL            79   250    J2543    158.03      0.00
7923493   FLEET PHOS SODA-FL SOLN 4   79   250              34.40      0.00
7923501   FLEET ENEMA 133ML           79   250              17.28      0.00
7923519   ENOXAPARIN 80MG/0.8ML INJ   79   250    J1650    269.75      0.00
7923535   CEFEPIME 1GM INJ (MAXIPIM   79   250    J0692    125.77      0.00
7923543   PYRIDOSTIGMINE 60MG/5ML S   79   250              10.93      0.00
7923584   VITAMIN A D OINTMENT 454G   79   250              74.75      0.00
7923626   LEUPROLIDE 3.75MG INJ (LU   79   250    J1950   2678.30      0.00
7923642   OXAZEPAM 15MG CAP (SERAX)   79   250              15.81      0.00
7923659   SALSALATE 500MG TAB (DISA   79   250              10.09      0.00
7923683   TACROLIMUS 1MG CAP (PROGR   79   250    J7507     43.81      0.00
7923691   GLIMEPIRIDE 2MG TAB (AMAR   79   250              12.52      0.00
7923709   RALOXIFENE 60MG TAB (EVIS   79   250              36.02      0.00
7923733   SODIUM THIOSULFATE CRYSTA   79   250             107.08      0.00
7923758   POTASSIUM CHL 8MEQ TAB (K   79   250               9.22      0.00
7923766   POTASSIUM CITRATE 540MG T   79   250              10.73      0.00
7923774   RIMEXOLONE 1% OP SUSP (VE   79   250             220.25      0.00
7923790   IRBESARTAN 150MG TAB (AVA   79   250              24.39      0.00
7923816   TOLTERODINE 1MG TAB (DETR   79   250              26.49      0.00
7923824   CARVEDILOL 25MG TAB (CORE   79   250              23.79      0.00
7923832   MINOXIDIL 2.5MG TAB (LONI   79   250              20.46      0.00
7923857   LEVOCARNITINE 100MG/ML SO   79   250    J1955     11.53      0.00
7923873   MIRTAZAPINE 15MG TAB (REM   79   250              28.22      0.00
7923899   EPTIFIBATIDE 20MG/10ML IN   79   250    J1327    456.43      0.00
7923907   EPTIFIBATIDE 75MG/100ML(I   79   250    J1327   1407.90      0.00
7924004   OLOPATADINE 0.1% OP SOLN    79   250             373.52      0.00
7924012   SIMVASTATIN 40MG TAB (ZOC   79   250              41.07      0.00
7924038   CANDESARTAN 8MG TAB (ATA    79   250              23.59      0.00
7924053   HEPATITIS A VACC (HAVRIX)   79   250    90632    297.99      0.00
7924079   CELECOXIB 100MG CAP (CELE   79   250              26.98      0.00
7924087   CELECOXIB 200MG CAP (CELE   79   250              39.41      0.00
7924095   SIMVASTATIN 10MG TAB (ZOC   79   250              28.78      0.00
7924103   CLOPIDOGREL 75MG TAB (PLA   79   250              37.16      0.00
7924145   DESFLURANE INHALATION 240   79   250              69.03      0.00
7924236   DESONIDE 0.05% OINT 15GM    79   250              98.00      0.00
7924293   PrednisoLONE 15MG/5ML SYR   79   250    J7510     30.39      0.00
7924301   FENOLDOPAM 10MG/ML INJ (C   79   250             384.72      0.00
7924319   ISOXSUPRINE 10MG TAB (VAS   79   250              14.89      0.00
7924335   TOPIRAMATE 25MG CAP (TOPA   79   250              28.60      0.00
7924343   LAMOTRIGINE 25MG TAB (LAM   79   250              42.73      0.00
7924350   BuPROPion 100MG TAB (WELL   79   250              14.94      0.00
7924400   GABAPENTIN 100MG CAP (NEU   79   250              11.75      0.00
7924426   CEFPODOXIME 200MG TAB (VA   79   250              46.10      0.00
7924434   NAPROXEN 250MG TAB          79   250              13.65      0.00
7924475   GABAPENTIN 300MG CAP (NEU   79   250              17.82      0.00
7924483   ISOSORBIDE MONO 30MG ER T   79   250              17.66      0.00
7924491   MISOPROSTOL 200MCG TAB (C   79   250              16.68      0.00
7924533   TAMSULOSIN 0.4MG CAP (FLO   79   250              31.42      0.00
7924541   LAMISIL ATHLT FOOT 1% CRE   79   250              58.14      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7924616   SUMATRIPTAN 25MG TAB (IMI   79   250             164.40      0.00
7924624   DICLOFENAC 75MG TAB (VOLT   79   250              28.00      0.00
7924665   LEVOTHYROXINE 88MCG TAB (   79   250               9.86      0.00
7924855   TELMISARTAN 40MG TAB (MIC   79   250              20.66      0.00
7924863   FLUCONAZOLE 40MG/ML SUSP    79   250             116.33      0.00
7924897   COSOPT 2-.5% OP SOLN 5ML    79   250             238.96      0.00
7924947   TERAZOL 3 0.8% VAG CREAM    79   250             137.39      0.00
7924954   MIDODRINE 2.5MG TAB (PROA   79   250              16.75      0.00
7924988   HYZAAR 50-12.5MG TAB        79   250              22.37      0.00
7924996   AMITRIPTYLINE 100MG TAB (   79   250              16.02      0.00
7925027   FLUCONAZOLE 10MG/ML SUSP    79   250              38.87      0.00
7925068   ALUM HYDROXIDE 320MG/5ML    79   250               9.81      0.00
7925084   PIOGLITAZONE 30MG TAB (AC   79   250              48.86      0.00
7925092   CILOSTAZOL 100MG TAB (PLE   79   250              21.44      0.00
7925118   BROMETANE DX SYP 473ML      79   250              10.30      0.00
7925134   CITALOPRAM 20MG TAB (CELE   79   250              26.18      0.00
7925142   MOMETASONE NASAL SPRAY (N   79   250             375.65      0.00
7925159   ANAGRELIDE 0.5MG CAP (AGR   79   250              40.85      0.00
7925167   CEFUROXIME 250MG/5ML SUSP   79   250              39.04      0.00
7925209   COLESTIPOL 1GM TAB (COLES   79   250              12.56      0.00
7925225   PARICALCITOL 5MCG/1ML INJ   79   250    J2501    176.40      0.00
7925233   DEXAMETHASONE 4MG/ML INJ    79   250    J1100     64.98      0.00
7925258   CAFFEINE CITRATE 20MG/ML    79   250    J0706    198.84      0.00
7925308   ENOXAPARIN 60MG/0.6ML INJ   79   250    J1650    204.73      0.00
7925316   ENOXAPARIN 40MG/0.4ML INJ   79   250    J1650     87.53      0.00
7925324   ROSIGLITAZONE 4MG TAB (AV   79   250              37.39      0.00
7925332   IRINOTECAN 20MG/ML INJ (C   79   250    J9206   2996.74      0.00
7925365   KETOCONAZOLE 2% SHAMPOO (   79   250    J1956    168.12      0.00
7925373   AMPHOTERICIN B LIPID COMP   79   250    J0287    924.07      0.00
7925399   MOXIFLOXACIN 400MG TAB (A   79   250              63.61      0.00
7925407   MUPIROCIN NASAL 2% OINT (   79   250              59.56      0.00
7925472   CYANIDE ANTIDOTE KIT        79   250            1055.74      0.00
7925498   ALTEPLASE 50MG INJ (ACTI    79   250    J2997   7966.47      0.00
7925506   FINGER STICK BLOOD SUGAR    79   250               8.10      0.00
7925530   ZOSYN 2.25GM INJ.           79   250    J2543     87.75      0.00
7925548   GATIFLOXACIN 10MG/ML INJ    79   250    J1590    226.87      0.00
7925571   MANNITOL 20% INJ 500MLS     79   250    J2150    124.38      0.00
7925597   CHOLINE MAG 500MG TRIS TA   79   250              11.07      0.00
7925605   BECLOMETHASONE 80MCG AER    79   250    J7622    365.54      0.00
7925621   ENOXAPARIN 100MG/1ML INJ    79   250    J1650    334.77      0.00
7925647   QUETIAPINE 25MG TAB (SERO   79   250              27.18      0.00
7925654   PRAZOSIN HCL 2MG CAP (MIN   79   250              10.46      0.00
7925696   AGGRENOX 25-200MG CAP       79   250              28.79      0.00
7925704   DIABETIC TUSSIN DM LIQ 11   79   250              10.08      0.00
7925712   PANTOPRAZOLE 40MG TAB (PR   79   250              42.15      0.00
7925720   COMBIVIR TAB                79   250              61.44      0.00
7925738   IMOVAX RABIES 2.5IU/ML IN   79   250    90676    778.64      0.00
7925746   REPAGLINIDE 0.5MG TAB (PR   79   250              20.34      0.00
7925753   LINEZOLID 600MG/300ML INJ   79   250    J2020    433.91      0.00
7925811   RABEPRAZOLE 20MG TAB (ACI   79   250              41.53      0.00
7925837   TOPIRAMATE 25MG TAB (TOPA   79   250              25.96      0.00
7925878   REPAGLINIDE 2MG TAB (PRAN   79   250              20.34      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7925936   ALENDRONATE 70MG TAB (FOS   79   250             124.53      0.00
7925951   HALOPERIDOL 5MG TAB (HALD   79   250              13.49      0.00
7925977   PANTOPRAZOLE 40MG INJ (PR   79   250    C9113     95.32      0.00
7926009   OPREVEKIN 5MG INJ (NEUMEG   79   250    J2355   1175.53      0.00
7926025   VENLAFAXINE 25MG TAB (EFF   79   250              22.34      0.00
7926058   QUETIAPINE 100MG TAB (SER   79   250              41.24      0.00
7926991   OTHER PHARMACY SERVICE      79   250               0.00      0.00
7927007   ESTRATEST TAB (1.25/2.5)    79   250              20.75      0.00
7927057   MetRONIDAZOLE 0.75% VAG.    79   250             202.15      0.00
7927114   CLOTRIMAZOLE/BETAMET DIPR   79   250             222.26      0.00
7927155   OXCARBAZEPINE 300MG TAB (   79   250              33.48      0.00
7927163   METHENAMINE 1GM TAB (MAND   79   250              11.59      0.00
7927254   RISPERIDONE 0.25MG TAB (R   79   250              40.54      0.00
7927551   BUDESONIDE .25MG/2ML RESP   79   250    J7626     43.96      0.00
7927601   BUDESONIDE 0.5MG/2ML RESP   79   250    J7626     50.03      0.00
7927650   CIMETIDINE 150MG/ML INJ 8   79   250              47.72      0.00
7927700   MILK OF MAGNESIA SUSP 30M   79   250              12.94      0.00
7927809   PILOCARPINE 5MG TAB (SALA   79   250              19.13      0.00
7927908   PRAMIPEXOLE 0.125MG TAB (   79   250              26.36      0.00
7928005   TERCONAZOLE 80MG SUPP (TE   79   250             287.00      0.00
7928021   VENLAFAXINE XR 75MG CAP (   79   250              41.21      0.00
7928039   OYSTER SHELL 500 CALC + D   79   250               8.30      0.00
7928054   VITRON-C/IRON W/C 200MG T   79   250               8.76      0.00
7928062   AMINOPHYLLINE 100MG TAB     79   250               8.15      0.00
7928088   OXYBUTYNIN XL 5MG TAB (DI   79   250              32.55      0.00
7928104   NEPHROCAPS CAP              79   250              11.93      0.00
7928112   GUAIFENESIN 7.5/5ML SYP (   79   250              11.22      0.00
7928120   NIACIN 250MG TAB            79   250               7.84      0.00
7928146   B O 16-A SUPPRETTES         79   250              51.06      0.00
7928195   VENLAFAXINE XR 37.5MG CAP   79   250              37.59      0.00
7928203   PATIENTS OWN MED            79   250               5.00      0.00
7928229   RIVASTIGMINE 1.5MG CAP (E   79   250              36.96      0.00
7928310   CALMOSEPTINE OINTMENT 113   79   250              45.61      0.00
7928336   GUAIFEN/PSEUDO 600MG/120M   79   250              11.60      0.00
7928369   WHISKEY 30ML                79   250               9.67      0.00
7928377   COLESEVELAM 625MG TAB (WE   79   250              16.59      0.00
7928385   PERPHENAZINE 16MG TAB (TR   79   250    Q0176     21.58      0.00
7928393   VERAPAMIL SR 120MG TAB (C   79   250              14.69      0.00
7928435   HELIDAC MIS                 79   250              40.70      0.00
7928443   OxyCODONE 20MG CR TAB (Ox   79   250              37.86      0.00
7928450   HYOSCYAMINE 0.375MG ER TA   79   250              12.59      0.00
7928492   SPIRONOLACTONE 50MG TAB (   79   250              14.26      0.00
7928500   ATACAND HCT 16-12.5MG TAB   79   250              29.26      0.00
7928518   LEVETIRACETAM 500MG TAB (   79   250              28.88      0.00
7928534   POLY-VI-SOL/IRON DROPS 50   79   250               8.26      0.00
7928542   ZIAC 10/6.25MG TAB          79   250              30.81      0.00
7928567   PHENOBARBITAL 20MG/5ML EL   79   250              13.02      0.00
7928575   DIPHTHERIA/TETANUS/PERTUS   79   250             156.02      0.00
7928583   SEVELAMER 800MG TAB (RENA   79   250              23.77      0.00
7928591   BECLOMETHASONE 40MCG AER    79   250    J7622    291.63      0.00
7928609   BuPROPion SR 100MG TAB (W   79   250              20.39      0.00
7928617   FELODIPINE 2.5MG ER TAB (   79   250              19.05      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
7928633   GliPIzide XL 2.5MG TAB (G   79   250               10.65      0.00
7928666   LEVOTHROID 137MCG TAB (SY   79   250                9.10      0.00
7928690   THEOPHYLLINE 300MG TR TAB   79   250                9.92      0.00
7928708   THEOPHYLLINE 200MG ER TAB   79   250               10.33      0.00
7928716   TENECTEPLASE 50MG KIT (TN   79   250    J3100   11125.26      0.00
7928732   CARISOPRODOL 350MG TAB (S   79   250               12.12      0.00
7928757   CALCIUM CITRATE 950MG TAB   79   250                8.01      0.00
7928765   CLINDAMYCIN 1% LOT (CLEOC   79   250              267.30      0.00
7928773   NATEGLINIDE 120MG TAB (ST   79   250               20.49      0.00
7928799   ESOMEPRAZOLE 40MG CAP (NE   79   250               40.93      0.00
7928815   BACITRACIN ZINC 500U/GM O   79   250               11.19      0.00
7928823   ZOLPIDEM 10MG TAB (AMBIEN   79   250               42.90      0.00
7928831   ENTACAPONE 200MG TAB (COM   79   250               30.64      0.00
7928849   LEUPROLIDE 7.5MG INJ (LUP   79   250    J1950    3177.41      0.00
7928898   ESOMEPRAZOLE 20MG CAP (N    79   250               40.94      0.00
7928922   ADVAIR DISKUS 100/50 #28    79   250              438.29      0.00
7928930   CLOTRIMAZOLE 1% AF CREAM    79   250               57.00      0.00
7928963   HEPARIN SOD 1,000 UNITS/M   79   250    J1644      76.90      0.00
7928989   RACEPINEPHRINE 2.25% INH    79   250               14.42      0.00
7928997   ENOXAPARIN 120MG/0.8ML IN   79   250    J1650     399.92      0.00
7929003   AMMONIUM LACT 12% LOT 225   79   250              113.82      0.00
7929011   ERTAPENEM 1GM INJ (INVANZ   79   250              258.75      0.00
7929045   HydrOXYzine 25MG/1ML INJ    79   250    J3410      15.28      0.00
7929052   HydrOXYzine 50MG/ML INJ 2   79   250    J3410      19.46      0.00
7929078   MOXIFLOXACIN 400MG INJ (A   79   250              259.48      0.00
7929086   OxyCODONE 10MG CR TAB (Ox   79   250               24.41      0.00
7929128   LINEZOLID 100MG/5ML SUSP    79   250               31.71      0.00
7929151   ADVAIR DISKUS 500/50 #28    79   250              771.25      0.00
7929169   KETOROLAC 15MG/1ML INJ (T   79   250    J1885      23.93      0.00
7929185   KETOROLAC 60MG/2ML INJ (T   79   250    J1885      25.65      0.00
7929193   KETOROLAC 30MG/1ML INJ (T   79   250    J1885      23.21      0.00
7929201   THIAMINE HCL 100MG TAB (V   79   250                7.75      0.00
7929219   POTASSIUM CHL 10% SF LIQ    79   250               12.67      0.00
7929227   PROGESTERONE 50MG/ML INJ    79   250    J2675     228.82      0.00
7929235   PROMETHAZINE 25MG/1ML INJ   79   250    J2550      17.88      0.00
7929250   STREPTOMYCIN 1GM (1000 MG   79   250    J3000      93.32      0.00
7929268   MORphine SULF 2MG/ML INJ    79   250    J2270      18.42      0.00
7929292   MetRONIDAZOLE 500MG TAB (   79   250               13.09      0.00
7929300   HEPARIN SOD 1,000 UNITS/M   79   250    J1644      35.92      0.00
7929334   CycloSPORINE 25MG CAP MOD   79   250    J7515      18.02      0.00
7929342   NITROGLYCERIN 2% OINT (NI   79   250               15.20      0.00
7929359   PHENYTOIN 100MG/4ML SUSP    79   250               19.68      0.00
7929367   SOD POLYSTYRENE 15GM/60ML   79   250               59.06      0.00
7929383   GUAIFENESIN 100MG/5ML SYP   79   250               14.16      0.00
7929391   LIDOCAINE 2% VISC SOLN 20   79   250               19.27      0.00
7929409   GUAIFENESIN DM SYP (ROBI    79   250               13.11      0.00
7929425   LACTULOSE 20GM/30ML UD SY   79   250               32.34      0.00
7929433   LIOTHYRONINE 5MCG TAB (CY   79   250               13.59      0.00
7929441   ACETYLCYSTEINE 20% (MUCOM   79   250    J7608      47.14      0.00
7929581   BUTALBITAL/APAP/CAF/CODE    79   250               21.00      0.00
7929599   GUAIFENESIN W/COD SYRUP 1   79   250               14.22      0.00
7929615   PROMETHAZINE/COD 6.25/10    79   250               18.06      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7929623   HYDROCODONE/APAP 7.5MG/50   79   250              39.15      0.00
7929656   LANSINOH 7GM OINT           79   250              25.21      0.00
7929672   DOCUSATE SOD 100MG/10ML L   79   250              13.35      0.00
7929680   METOCLOPRAMIDE 10MG/10ML    79   250              14.28      0.00
7929698   SUCRALFATE 1GM/10ML UD SU   79   250              31.07      0.00
7929706   HYDROCORTISONE 2.5% CREAM   79   250             152.32      0.00
7929748   VALPROIC ACID 250MG/5ML S   79   250              26.10      0.00
7929755   PRAZOSIN HCL 5MG CAP (MIN   79   250              12.53      0.00
7929763   LOPERAMIDE 2MG/10ML LIQ 1   79   250              20.08      0.00
7929813   ALENDRONATE 35MG TAB (FOS   79   250             124.54      0.00
7929839   MESALAMINE 500MG SUPP (CA   79   250              35.65      0.00
7929847   CARVEDILOL 12.5MG TAB (CO   79   250              23.79      0.00
7929854   CARVEDILOL 6.25MG TAB (CO   79   250              23.79      0.00
7929904   SIMVASTATIN 20MG TAB (ZOC   79   250              45.00      0.00
7929912   ISOSULFAN 1% INJ (LYMPHAZ   79   250             594.30      0.00
7929920   APAP/CODEINE ELIXIR 5ML (   79   250              15.13      0.00
7929938   ROPINIROLE 0.25MG TAB (RE   79   250              28.74      0.00
7929946   LORazepam 2MG/ML INJ (ATI   79   250    J2060     60.42      0.00
7929961   LIDOCAINE/D5W 2GM/250ML P   79   250    J2001    101.01      0.00
7929987   BUMETANIDE 0.25MG/ML INJ    79   250              34.88      0.00
7930001   OPIUM 10% TINCTURE          79   250              16.85      0.00
7930043   HYDROCODONE/APAP 10-325MG   79   250              18.04      0.00
7930068   DiphenhydrAMINE 12.5MG/5M   79   250              13.83      0.00
7930076   AZTREONAM 1GM INJ (AZACTA   79   250             217.58      0.00
7930084   AZTREONAM 2GM INJ (AZACTA   79   250             286.61      0.00
7930092   HALOPERIDOL 1MG TAB (HALD   79   250              10.23      0.00
7930100   CEFAZOLIN 10GM INJ (ANCEF   79   250    J0690     27.93      0.00
7930118   CEPHALEXIN 125MG/5ML SUSP   79   250              12.66      0.00
7930126   CEPHALEXIN 250MG/5ML SUSP   79   250              15.66      0.00
7930134   NITROFURANTOIN 25MG/5ML S   79   250              47.52      0.00
7930159   ENOXAPARIN 30MG/0.3ML INJ   79   250    J1650     53.48      0.00
7930183   ERYTHROMYCIN DR 250MG CAP   79   250               9.61      0.00
7930191   POTASSIUM CHL 8MEQ ER TAB   79   250               9.22      0.00
7930209   BENAZEPRIL 10MG TAB (LOTE   79   250              14.80      0.00
7930225   AMOX/CLAV 200MG/5ML SUSP(   79   250              12.42      0.00
7934250   TIZANIDINE 4MG TAB (ZANAF   79   250              18.70      0.00
7934268   ATENOLOL 25MG TAB (TENORM   79   250              13.65      0.00
7934276   TOPIRAMATE 100MG TAB (TOP   79   250              45.20      0.00
7934326   MELOXICAM 7.5MG TAB (MOBI   79   250              31.40      0.00
7934359   AMOX/CLAV 400MG/5ML SUSP(   79   250              14.91      0.00
7934383   IMATINIB 100MG CAP (GLEEV   79   250             203.12      0.00
7934391   CARBAMAZEPINE 100MG CHW T   79   250               9.85      0.00
7934409   BIMATOPROST 0.03% SOL (LU   79   250             314.05      0.00
7934425   IFOSFAMIDE 1GM INJ (IFEX)   79   250    J9208    350.70      0.00
7934433   DESIPRAMINE 10MG TAB (NOR   79   250              10.58      0.00
7934441   PROPOFOL 1% 100ML INJ (DI   79   250             144.59      0.00
7934466   MONTELUKAST 4MG CHW TAB (   79   250              38.39      0.00
7934482   LISINOPRIL 20MG TAB (ZEST   79   250              15.25      0.00
7934516   VINORELBINE 10MG/ML INJ (   79   250    J9390   2351.25      0.00
7934524   RISEDRONATE 5MG TAB (ACTO   79   250              33.72      0.00
7934557   TRAVOPROST 0.004% SOL (TR   79   250             312.56      0.00
7934581   HALOPERIDOL LAC 5MG/ML IN   79   250    J1630     20.13      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
7934607   RITUXIMAB 100MG INJ (RITU   79   250    J9310    2516.68      0.00
7934615   ULTRAM/ACET 37.5MG/325MG    79   250               16.13      0.00
7934623   DROTRECOGIN 20MG INJ (XIG   79   250             5242.32      0.00
7934631   TOBRAMYCIN 300MG/5ML NEB    79   250    J7682     301.53      0.00
7934656   GLYCOPYRROLATE 1MG TAB (R   79   250               17.55      0.00
7934664   CLARITHROMYCIN 500MG XL T   79   250               43.37      0.00
7934706   MODAFINIL 200MG TAB (PROV   79   250               68.94      0.00
7934714   LOTEPREDNOL 0.5% SUSP (LO   79   250              213.08      0.00
7934789   RIZATRIPTAN 10MG TAB (MAX   79   250              144.25      0.00
7934797   DIVALPROEX SPRINKLE 125MG   79   250               15.31      0.00
7934813   ESTROGEN (MENEST) 0.625MG   79   250               14.26      0.00
7934839   FLUVASTATIN XL 80MG TAB (   79   250               35.39      0.00
7934854   METOPROLOL XL 25MG TAB (T   79   250               15.64      0.00
7934862   LEUPROLIDE ACETATE 30MG I   79   250    J1950   12422.19      0.00
7934870   MIRTAZAPINE 30MG TAB (REM   79   250               28.83      0.00
7934888   LIOTHYRONINE 25MCG TAB (C   79   250               15.49      0.00
7934904   LINEZOLID 600MG TAB (ZYVO   79   250              338.64      0.00
7934920   DESMOPRESSIN 0.01% NASAL    79   250              555.64      0.00
7934946   TOLTERODINE LA 2MG CAP (D   79   250               41.26      0.00
7934953   LETROZOLE 2.5MG TAB (FEMA   79   250               75.03      0.00
7934961   IODOSORB GEL CADEXOMER IO   79   250              235.28      0.00
7934987   POTASSIUM CHL 10% SF LIQ    79   250               12.90      0.00
7935000   HUMALOG MIX 75/25 SUSP      79   250    J1815     395.92      0.00
7935026   CASPOFUNGIN ACETATE 50MG    79   250    J0637    1618.02      0.00
7935042   DIVALPROEX 125MG EC TAB (   79   250               15.14      0.00
7935059   ZOLMITRIPTAN 2.5MG TAB (Z   79   250              135.20      0.00
7935075   CAPTOPRIL 12.5MG TAB (CAP   79   250               13.09      0.00
7935109   BETADINE 5% SPRAY 90GM      79   250               58.32      0.00
7935125   HEPARIN SOD 5,000 UNITS/M   79   250    J1644      37.92      0.00
7935133   VALCYCLOVIR 500MG TAB (VA   79   250               47.66      0.00
7935141   TACROLIMUS 0.1% OINT (PRO   79   250              385.45      0.00
7935166   CUROSURF 240MG/3ML SUSP     79   250             2862.92      0.00
7935174   CUROSURF 120MG/1.5ML SUS    79   250             1468.17      0.00
7935182   ClomiPRAMINE 50MG CAP (AN   79   250               16.21      0.00
7935190   LITHIUM CR 450MG TAB (ESK   79   250               12.13      0.00
7935208   POLY-VI-FLOR 0.25MG DROP    79   250               10.50      0.00
7935216   QUINAPRIL 5MG TAB (ACCUPR   79   250               16.86      0.00
7935232   INS GLARGINE 100 UNITS/ML   79   250    J1815     374.32      0.00
7935240   ADVAIR DISKUS 250/50 #28    79   250              438.29      0.00
7935257   LEVOFLOXACIN 250MG TAB (L   79   250               74.72      0.00
7935273   TERBINAFINE 250MG TAB (LA   79   250               98.72      0.00
7935281   RECOMBIVA-HB 10MCG/M PF I   79   250              203.89      0.00
7935299   LEVOFLOX/DEX 250MG PREMIX   79   250    J1956     140.02      0.00
7935331   TraZODONE 50MG TAB (DESYR   79   250               10.78      0.00
7935372   MULTITRACE-4 PED INJ 3ML    79   250               47.72      0.00
7935380   OXAZEPAM 10MG CAP (SERAX)   79   250               14.10      0.00
7935398   PROMETHAZINE 50MG SUPP (P   79   250               46.81      0.00
7935406   IMIPENEM AND CILASTATIN 5   79   250    J0743     242.71      0.00
7935414   DROPERIDOL 2.5MG/ML INJ 2   79   250    J1790      39.90      0.00
7935547   GATIFLOXACIN 200MG TAB (T   79   250               68.46      0.00
7935554   NITROGLYCERIN 0.4MG SL TA   79   250               42.28      0.00
7935570   RIZATRIPTAN 5MG TAB (MAXA   79   250              144.25      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
7935588   LEVOTHYROXINE 175MCG TAB    79   250               10.39      0.00
7935596   CIPROFLOXACIN OTIC SUSP (   79   250              438.06      0.00
7935604   MetFORMIN 1000MG TAB (GLU   79   250               19.75      0.00
7935612   MICONAZOLE 2% CREAM 28.4G   79   250               31.95      0.00
7935646   SUMATRIPTAN 50MG TAB (IMI   79   250              153.31      0.00
7935653   RESERPINE 0.1MG TAB         79   250               11.96      0.00
7935661   ILEX SKIN PROTECT PST       79   250               42.15      0.00
7935679   PHENYTOIN 100MG/2ML INJ (   79   250    J1165      16.69      0.00
7935703   PROPYLTHIOURACIL 50MG TAB   79   250                8.75      0.00
7935729   MAALOX PLUS X-STR SUS 30M   79   250               13.72      0.00
7935760   ZIPRASIDONE HCL 40MG CAPS   79   250               45.08      0.00
7935778   MetFORMIN XR 500MG TAB (G   79   250               13.35      0.00
7935786   MORphine 60MG CR TAB (ORA   79   250               34.88      0.00
7935802   DICLOXACILLIN 250MG CAP (   79   250               12.58      0.00
7935828   TENOFOVIR 300MG TAB (VIRE   79   250              138.94      0.00
7935836   MIGLITOL 25MG TAB (GLYSE    79   250               14.85      0.00
7935919   ACETIC ACID .25% IRRIG SO   79   250               43.60      0.00
7935927   EPINEPHrine 1:1000 SOL 30   79   250              155.10      0.00
7935968   AVITENE 35X35MM PAD         79   250              117.38      0.00
7935976   PENICILLIN VK 250MG/5ML S   79   250                7.93      0.00
7936008   CALCIUM LACTATE 650MG TAB   79   250                7.79      0.00
7936032   COLY-MYCIN-S OTIC SUS       79   250              277.52      0.00
7936172   SODIUM BICARBONATE POWDER   79   250                7.81      0.00
7936198   ACYCLOVIR 5% OINT (ZOVIRA   79   250              589.93      0.00
7936222   BISMATROL 262MG CHEWABLE    79   250               36.09      0.00
7936248   ClonAZEPAM 0.5MG TAB (KLO   79   250               13.68      0.00
7936388   GRANULEX SPRAY 56.7GM       79   250               94.06      0.00
7936404   IODINE 2% MILD TINCTURE     79   250               80.92      0.00
7936412   IPECAC SYRUP 30ML           79   250               26.58      0.00
7936560   ETODOLAC 400MG TAB (LODIN   79   250               18.72      0.00
7936578   IRINOTECAN 40MG/2ML INJ (   79   250    J9206    1243.27      0.00
7936586   ALTEPLASE (CATHFLO) 2MG I   79   250              369.56      0.00
7936610   DIP/TET PEDIATRIC INJ 0.5   79   250              231.13      0.00
7936628   PAROXETINE (PAXIL) 10MG T   79   250               28.97      0.00
7936651   HYOSCYAMINE 0.125MG/5ML E   79   250               18.35      0.00
7936669   SUMATRIPTAN (IMITREX) 5MG   79   250              232.99      0.00
7936677   FLUORESCEIN SODIUM STRIPS   79   250               10.75      0.00
7936685   TEARS RENEWED OP SOL (AQU   79   250               47.26      0.00
7936693   FACTOR VIII (KOGENATE) 50   79   250    J7190    3393.15      0.00
7936719   TRI-VIT/FLUORIDE 0.25MG D   79   250               10.96      0.00
7936727   PAROXETINE CR 12.5MG TAB    79   250               36.48      0.00
7936743   L.E.T. SOLUTION 3ML         79   250               58.95      0.00
7936750   NEDOCROMIL (ALOCRIL) 2% O   79   250              364.49      0.00
7936768   DRONABINOL 2.5MG CAP (MAR   79   250               50.42      0.00
7936826   DOCUSATE SOD 250MG CAP      79   250                8.26      0.00
7936834   OXALIPLATIN (ELOXATIN) 50   79   250    J9263     519.94      0.00
7936842   ETOMIDATE 2MG/ML INJ (AMI   79   250               19.04      0.00
7936859   HYDROCERIN CREAM 454GM      79   250               67.40      0.00
7936867   ALCOHOL 98% INJ 5ML (DEHY   79   250              273.75      0.00
7936875   ZETIA (EZETIMIBE) 10MG TA   79   250               34.41      0.00
7936891   NYSTATIN 500,000U/5ML SUS   79   250               15.97      0.00
7936917   RITUXIMAB 500MG INJ (RITU   79   250    J9310   12285.91      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7936925   NASACORT AQ 55MCG/SPRAY N   79   250             382.47      0.00
7936958   ISONIAZID (NYDRAZID) 100M   79   250             958.36      0.00
7936966   FML S.O.P. 0.1% OP OIN      79   250             215.28      0.00
7936982   ERYTHROMYCIN OP OIN 3.5GM   79   250              40.27      0.00
7936990   IRON SUCROSE (VENOFER) 20   79   250    J1756    271.79      0.00
7937006   ATROPINE SUL 0.4MG/ML 20M   79   250    J0460     25.16      0.00
7937014   GENTAMICIN/NACL 80MG/100M   79   250    J1580     92.37      0.00
7937022   MAGNESIUM S04 50% 2ML INJ   79   250    J3475     12.03      0.00
7937048   JEVITY 1.5 CAL LIQ 1000ML   79   250              44.50      0.00
7937063   GLUCOSE 5GM TAB             79   250              11.66      0.00
7937089   JEVITY 1.5 CAL LIQ 240ML    79   250              30.24      0.00
7937097   ROPIVACAINE HCL 2MG/ML 0.   79   250    J2795     51.80      0.00
7937105   ROPIVACAINE HCL 5MG/ML 0.   79   250    J2795     98.57      0.00
7937121   NOVOLOG INS ASPART 100 UN   79   250    J1815    393.74      0.00
7937139   CEFDINIR (OMNICEF) 300MG    79   250              36.76      0.00
7937154   PNEUMOCOCCAL VACCINE (INF   79   250    90669    336.65      0.00
7937162   AKWA TEARS OP OIN 3.5 GM    79   250              37.08      0.00
7937170   PIOGLITAZONE 15MG TAB (AC   79   250              43.57      0.00
7937188   FLUOCINONIDE 0.05% SOLN (   79   250             165.38      0.00
7937196   DiphenhydrAMINE 25MG CAP    79   250               8.51      0.00
7937212   TRIAMCINOLONE 0.5% OINT 1   79   250              42.78      0.00
7937238   DAKIN'S SOLN (FULL STR) 0   79   250              53.57      0.00
7937246   DAKIN'S SOLN (HALF STR) 0   79   250              53.57      0.00
7937253   CEFTIBUTEN 90MG/5ML SUSP    79   250              39.27      0.00
7937261   VORICONAZOLE 200MG INJ (V   79   250    J3465    571.08      0.00
7937279   THYROLAR-1 60MG TAB         79   250              13.58      0.00
7937287   MUPIROCIN 2% OINT (BACTRO   79   250             265.76      0.00
7937295   NUTRADERM THERAPEUTIC LOT   79   250              53.46      0.00
7937311   LOSARTAN 50MG TAB (COZAAR   79   250              24.33      0.00
7937337   FORMULATION R OINT. 30GM    79   250              36.40      0.00
7937345   ClomiPRAMINE 25MG CAP (AN   79   250              14.00      0.00
7937378   AMLODIPINE 10MG TAB (NORV   79   250              25.62      0.00
7937386   ESCITALOPRAM 10MG TAB (LE   79   250              32.26      0.00
7937394   PEN G BENZATHINE 2.4 MMU    79   250    J0580    404.71      0.00
7937428   KENALOG-40 40MG/ML INJ 5M   79   250    J3301    261.14      0.00
7937436   DDAVP 0.1MG TAB (DESMOPRE   79   250              30.54      0.00
7937444   COMPOUNDED MEDICATION       79   250               7.56      0.00
7937451   ARGATROBAN 100MG/ML INJ 2   79   250            5064.15      0.00
7937469   LAMIVUDINE 100MG TAB (EPI   79   250              74.91      0.00
7937477   TRIAZOLAM 0.125MG TAB (HA   79   250              12.43      0.00
7937485   TPN, ADULT (PER 1000ML)     79   250             789.40      0.00
7937493   TPN, NEONATE (PER 100ML)    79   250             694.15      0.00
7937501   CEFDINIR 125MG/5ML SUSP (   79   250              43.38      0.00
7937519   BETAMETHASONE AUG 0.05% C   79   250             224.25      0.00
7937527   TACROLIMUS 0.5MG CAP (PRO   79   250    J7507     25.68      0.00
7937535   DIVALPROEX ER 500MG TAB (   79   250              32.79      0.00
7937550   AMIODARONE 50MG/ML INJ 18   79   250    J0282     93.21      0.00
7937584   EMP PCA VIAL 30ML MIS       79   250              59.39      0.00
7937592   LEFLUNOMIDE 10MG TAB (ARA   79   250             101.23      0.00
7937600   ATORVASTATIN 20MG TAB (LI   79   250              43.87      0.00
7937618   ATORVASTATIN 40MG TAB (LI   79   250              43.87      0.00
7937626   DROTRECOGIN ALFA 5MG INJ    79   250            1315.72      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
7937642   VORICONAZOLE 200MG TAB (V   79   250              268.14      0.00
7937667   TERAZOL 7 0.4% CREAM 45 G   79   250              240.24      0.00
7937675   BREVIBLOC HCL 2500MG/250M   79   250              549.77      0.00
7937683   POLIOVIRUS VACCINE INACTI   79   250    90713     169.19      0.00
7937691   HAEMOPHILUS B CONJUGATE V   79   250    90749     173.26      0.00
7937709   CEFEPIME HCL 2GM INJ (MAX   79   250    J0692     268.75      0.00
7937717   PEDIARIX 0.5ML INJ          79   250    90749     340.80      0.00
7937733   ASCORBIC ACID 500MG/ML IN   79   250              107.79      0.00
7937758   CEFTRIAXONE 100MG/ML SYR    79   250    J0696     235.42      0.00
7937782   HYDROCERIN MOISTURIZING C   79   250               36.39      0.00
7937790   LR 1L + PITOCIN 15 UNITS    79   250              104.73      0.00
7937808   DUTASTERIDE 0.5MG CAPULES   79   250               35.02      0.00
7937816   DISTILLED VINEGAR 1 ML      79   250                7.58      0.00
7937824   OXYTOCIN 10UNITS/ML INJ 1   79   250    J2590      43.23      0.00
7937832   LIDOCAINE 5% PATCH (LIDOD   79   250               49.40      0.00
7937840   CALCIUM GLUCONATE 10% INJ   79   250               32.48      0.00
7937857   CYANOCOBALAMIN 100MCG TAB   79   250                7.73      0.00
7937865   MULTITRACE-4 CONC INJ 10    79   250               17.02      0.00
7937881   CASPOFUNGIN ACETATE 70MG    79   250    J0637    1615.91      0.00
7937899   LANSOPRAZOLE 15MG SOLUTAB   79   250               45.16      0.00
7937907   LANSOPRAZOLE 30MG SOLUTAB   79   250               45.16      0.00
7937915   BETAXOLOL 0.5% OPHTH. SOL   79   250              185.71      0.00
7937923   METOPROLOL 25MG TAB (LOPR   79   250                9.40      0.00
7937931   ZIPRASIDONE HCL 60MG CAPS   79   250               53.09      0.00
7937956   DOLASETRON INJ 100MG/5ML    79   250    J1260     285.92      0.00
7937964   ROSUVASTATIN 20MG TAB (CR   79   250               36.34      0.00
7937972   CYTARABINE 100MG/ML INJ (   79   250    J9110     129.12      0.00
7937980   EDROPHONIUM CL 10MG/ML IN   79   250               68.94      0.00
7937998   TIOTROPIUM BR 18MCG CAP (   79   250              248.46      0.00
7938004   MEMANTINE 10MG TAB (NAMEN   79   250               30.96      0.00
7938020   ESTRADIOL 0.075MG/DAY PAT   79   250               63.73      0.00
7938038   M-M-R II LIVE INJ           79   250    90707     227.07      0.00
7938079   PREVACID I.V 30MG INJ       79   250              170.01      0.00
7938087   LIDOCAINE 4% PF SOLN 5ML    79   250               25.15      0.00
7938095   INSULIN ASPART 70/30 10ML   79   250    J1815     393.74      0.00
7938137   LEVOFLOXACIN 750MG TAB (L   79   250              150.72      0.00
7938145   LEVOFLOX/D5W 750MG PREMIX   79   250    J1956     238.40      0.00
7938152   PEMETREXED 500MG INJ (ALI   79   250    J9305   10947.02      0.00
7938178   POTASSIUM CHLORIDE 2MEQ/M   79   250    J3480      12.60      0.00
7938186   HALOPERIDOL DECAN 100MG/M   79   250    J1631      82.86      0.00
7938194   MD-GASTROVIEW UD SOLN 5ML   79   250    Q9963      17.36      0.00
7938202   ROPINIROLE 4MG TAB (REQUI   79   250               29.53      0.00
7938210   CINACALCET 30MG TAB (SENS   79   250               79.00      0.00
7938228   SIROLIMUS 1MG TAB (RAPAMU   79   250               57.57      0.00
7938244   MYCOPHENOLATE 500MG INJ (   79   250              201.97      0.00
7938251   TACROLIMUS 5MG/ML INJ (PR   79   250    J7525     658.21      0.00
7938269   FENTANYL CIT 100MCG/2ML I   79   250    J3010      11.21      0.00
7938277   MORphine SULFATE 4MG/ML I   79   250    J2270      16.50      0.00
7938285   WARFARIN 4MG TAB (COUMADI   79   250               15.56      0.00
7938293   WARFARIN 3MG TAB (COUMADI   79   250               15.53      0.00
7938301   ROPINIROLE 1MG TAB (REQUI   79   250               28.74      0.00
7938319   WARFARIN 6MG TAB (COUMADI   79   250               18.23      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7938327   DIOVAN HCT 80MG/12.5MG TA   79   250              26.88      0.00
7938335   ACETAMINOPHEN 500MG TAB (   79   250               8.16      0.00
7938343   ORAJEL 10% GEL 5.3GM (REG   79   250              34.65      0.00
7938350   PROMETHAZINE VC/CODEINE S   79   250              11.94      0.00
7938368   CARBAMAZEPINE XR 100MG TA   79   250              11.16      0.00
7938376   BUPIVACAINE 0.25% INJ 30M   79   250              25.73      0.00
7938384   AEROCHAMBER PLUS MASK (SM   79   250              98.92      0.00
7938392   RANITIDINE IN NS 1MG/ML O   79   250              22.74      0.00
7938400   ENALAPRILAT 25 MCG/ML ORA   79   250              32.89      0.00
7938418   AMLODIPINE ORAL SUSP 1MG/   79   250              29.48      0.00
7938426   MetRONIDAZOLE 50MG/ML SUS   79   250              20.84      0.00
7938434   SPIRONOLACTONE 4MG/ML ORA   79   250              13.51      0.00
7938442   URSODIOL 25MG/ML SUSP       79   250              34.25      0.00
7938459   SPIRONOL/HCTZ 5MG/ML ORAL   79   250              36.53      0.00
7938475   FOLIC ACID 50MCG/ML SUSP    79   250              16.44      0.00
7938483   HYDROCHLOROT 5MG/ML SUSP    79   250              22.99      0.00
7938491   MORphine ORAL SOLN 0.4MG/   79   250              12.83      0.00
7938509   CAPTOPRIL 1MG/ML SOLN       79   250              21.53      0.00
7938517   LORAZEPAM 0.5MG/ML ORAL S   79   250              39.56      0.00
7938525   VANCOMYCIN 50MG/ML SOLN     79   250              25.00      0.00
7938533   INSULIN REG 1 UNIT/ML INJ   79   250    J1815     35.68      0.00
7938566   EPLERENONE 25MG TAB (INSP   79   250              42.24      0.00
7938582   LEVOFLOXACIN 500MG INJ (L   79   250    J1956    270.33      0.00
7938590   OMEPRAZOLE 2MG/ML SUSPENS   79   250               6.44      0.00
7938608   ARIPIPRAZOLE 10MG TAB (AB   79   250              90.85      0.00
7938616   CycloSPORINE OPHTH. 0.05%   79   250              38.76      0.00
7938624   LANTHANUM CARBONATE 250MG   79   250              17.05      0.00
7938632   HYALURONIDASE 150UNIT/ML    79   250    J3470    177.14      0.00
7938640   LIDO/EPI PF 1.5% 5ML INJ    79   250              31.05      0.00
7938657   TESTOSTERONE TRANSDERMAL    79   250              58.08      0.00
7938665   HYDROCORTISONE IV 1MG/ML    79   250              24.72      0.00
7938673   TIAGABINE 2MG TAB (GABITR   79   250              38.00      0.00
7938681   DOXEPIN HCL 5% CREAM (ZON   79   250             291.48      0.00
7938699   METOCLOPRAMIDE 1MG/1ML OR   79   250               9.11      0.00
7938707   LIDOCAINE 5% IN DEXTROSE    79   250              28.10      0.00
7938715   ABREVA 10% CREAM 2.0GM      79   250              89.15      0.00
7938723   RIFAMPIN 10MG/ML ORAL SUS   79   250              24.65      0.00
7938731   FLOVENT HFA 110MCG INHALA   79   250             511.98      0.00
7938749   FLOVENT HFA 44MCG INHALAT   79   250             382.69      0.00
7938756   FLOVENT HFA 220MCG INHALA   79   250             787.77      0.00
7938764   COLLAGENASE OINTMENT 15GM   79   250             292.37      0.00
7938772   LICE TREATMENT MAXIUM STR   79   250              36.68      0.00
7938798   MAGNESIUM SULFATE POWDER    79   250              18.89      0.00
7938806   HUMATE-P 2000UNIT INJ (F    79   250    J7190   9584.40      0.00
7938814   CIPROFLOXACIN HCL 0.3%OP.   79   250             301.88      0.00
7938822   FENOFIBRATE 48MG TAB (Tri   79   250              18.07      0.00
7938848   ACETADOTE 200MG/ML INJ. 3   79   250             617.39      0.00
7938855   RISEDRONATE SODIUM 35MG T   79   250             145.01      0.00
7938863   NITROBID 2% OINTMENT 60GM   79   250             102.11      0.00
7938871   DOLASETRON 100MG TAB (ANZ   79   250             310.14      0.00
7938889   MOXIFLOXACIN HCL 0.5% OP.   79   250             272.12      0.00
7938921   FENT(1MCG/ML)/BUPI 1/8(0.   79   250              75.92      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7938939   FENT(2MCG/ML)/BUPI(1/16)/   79   250              84.66      0.00
7938947   LAMINARIA JAPONICA CERVIC   79   250              70.37      0.00
7938954   LEVETIRACETAM 100MG/ML OR   79   250              12.80      0.00
7938962   ALBUTEROL 0.042% NEB 3ML    79   250    J7603     20.19      0.00
7938970   DAPTOMYCIN 500MG INJ. (CU   79   250             891.82      0.00
7938988   ZOVIA 1/35E TAB             79   250             178.16      0.00
7939002   KALETRA ORAL SOLN (LOPINA   79   250              85.80      0.00
7939010   MONONINE 1000UNIT INJ (F    79   250    J7194   4770.06      0.00
7939036   OYST-CAL-D 500MG TAB (OS-   79   250               8.30      0.00
7939044   BENICAR 20MG TAB            79   250              23.44      0.00
7939051   INFLIXIMAB 100MG INJ (REM   79   250    J1745   2882.20      0.00
7939077   UREA 40% CREAM 85.1 GM      79   250             249.12      0.00
7939085   SALMETEROL 50MCG INHALATI   79   250             749.52      0.00
7939093   DIGOXIN ELIXIR 0.05MG/ML    79   250              11.84      0.00
7939101   VITAMIN E 3000IU CREAM 2    79   250              36.40      0.00
7939127   TRIMETHOBENZAMIDE 300MG C   79   250              16.10      0.00
7939135   LUBRISOFT UNSCENTED LOTIO   79   250              38.91      0.00
7939143   ENOXAPARIN 20MG/ML INJ (L   79   250             211.82      0.00
7939150   PALIVIZUMAB 50MG INJ. (SY   79   250            8089.56      0.00
7939168   BECAPLERMIN 0.01% GEL (RE   79   250            2354.83      0.00
7939176   LIDOCAINE/PRILOCAINE 2.5%   79   250              53.22      0.00
7939192   GENTIAN VIOLET 1% TOPICAL   79   250              34.80      0.00
7939218   CLEOCIN VAGINAL CREAM 2%    79   250             273.61      0.00
7939226   FLUOCINONIDE 0.05% OINTME   79   250             200.12      0.00
7939234   DERMA-SMOOTHE/FS OIL(Fluo   79   250             239.59      0.00
7939242   DESONIDE 0.05% OINTMENT 6   79   250             236.81      0.00
7939259   DIASTAT 2.5MG RECTAL GEL    79   250            1127.81      0.00
7939267   ISOSOR DIN. 20MG/HYDRALA    79   250              24.68      0.00
7939275   ARIPIPRAZOLE 5MG TAB (ABI   79   250              90.85      0.00
7939283   BROMAXEFED DM RF SYRUP (R   79   250              15.68      0.00
7939291   HEPATITIS B INJ. (Nabi-HB   79   250             707.41      0.00
7939309   PREGABALIN 75MG CAPSULE (   79   250              28.12      0.00
7939341   SALIVART ORAL MOISTURIZER   79   250              53.60      0.00
7939358   TUBERCULIN PPD 5TU/0.1ML    79   250              26.64      0.00
7939374   ZOLEDRONIC ACID INJ. 4MG/   79   250    J3487   4027.60      0.00
7939408   TETANUS TOXOID ADSORBED P   79   250    90703    209.68      0.00
7939416   MENOMUNE A/C/Y/W 135 INJ    79   250             462.51      0.00
7939457   IMMUNE GLOBULIN 6GM INJ.    79   250    J1566   2316.42      0.00
7939465   IMMUNE GLOBULIN 12GM INJ.   79   250    J1566   4625.28      0.00
7939473   DOPamine/D5W 400MG/250ML    79   250    J1265    104.45      0.00
7939481   DOPamine 200MG/5ML INJ.     79   250    J1265     24.20      0.00
7939499   DOPamine 800MG/5ML INJ.     79   250    J1265     54.02      0.00
7939507   ACYCLOVIR SODIUM 500MG/10   79   250    J0133     21.82      0.00
7939515   ACYCLOVIR NA 5MG/ML INJ.    79   250    J0133     39.75      0.00
7939572   FOMEPIZOLE 1GM/ML INJ (A    79   250    J1451   5006.28      0.00
7939580   DIGOXIN IMMUNE FAB (DIGIF   79   250    J1162   2293.56      0.00
7939598   APROTININ 10,000KIU/200ML   79   250    J0365   2385.11      0.00
7939606   APROTININ 10,000KIU/100ML   79   250    J0365   1301.16      0.00
7939622   NESIRITIDE 1.5MG INJ (NA    79   250    J2325   2372.73      0.00
7939630   IRON DEXTRAN 50MG/ML INJ    79   250    J1752    222.85      0.00
7939655   ADENOSINE 6MG/2ML INJ (AD   79   250    J0150     72.51      0.00
7939663   ADENOSINE 3MG/ML INJ 30ML   79   250    J0152   1021.97      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
7939671   HEPATITIS B SYRINGE 0.5ML   79   250    90371    322.60      0.00
7939747   CALCIUM ACETATE 667MG GEL   79   250              14.23      0.00
7939754   BACTERIOSTATIC WATER INJ    79   250              12.41      0.00
7939762   SOD CHLORIDE 0.9% INJ 10M   79   250              11.45      0.00
7939770   STERIL WATER FOR INJ 10ML   79   250              11.65      0.00
7939788   SOD CHLORIDE 0.9% BACTERI   79   250              12.79      0.00
7939812   STERIL WATER FOR INJ 1000   79   250              25.74      0.00
7939820   SOD CHLORIDE 0.9% INJ 100   79   250              24.68      0.00
7939838   SOD CHLORIDE 0.9% INJ 50M   79   250              23.61      0.00
7939846   SOD CHLORIDE 0.45% INJ 50   79   250              28.77      0.00
7939853   STERIL WATER FOR INJ 250M   79   250              45.61      0.00
7939861   STERIL WATER FOR INJ 2000   79   250              48.78      0.00
7939879   SOD CHLORIDE 0.9% INJ 50M   79   250              26.96      0.00
7939895   INDOMETHACIN 25MG/5ML SUS   79   250               9.18      0.00
7939903   GATIFLOXACIN 0.3% OPHTH S   79   250             220.14      0.00
7939911   VANCOMYCIN HCL 125MG CAP    79   250             117.99      0.00
7939929   CAFFEINE/SOD BENZOATE 500   79   250              71.79      0.00
7939945   PENTOSAN POLYSUL SOD 100M   79   250              33.93      0.00
7939952   ETOPOSIDE 20MG/ML INJ (VE   79   250    J9181     50.38      0.00
7939960   PLEGISOL SOLUTION 1000ML    79   250             225.60      0.00
7939978   CLOZAPINE 200MG TAB (CLOZ   79   250              44.74      0.00
7939986   NALMEFENE HCL 100MCG/ML (   79   250              42.85      0.00
7939994   STROMECTOL 3MG TAB          79   250              38.62      0.00
7940018   D5W INJ 500ML BAG           79   250    J7060     19.16      0.00
7940026   LIDOCAINE-MPF/EPI 2% INJ    79   250    J2001    101.08      0.00
7940034   AEROCHAMBER SPACER          79   250              58.72      0.00
7940042   HEPARIN LOCK 10UNT/ML INJ   79   250              11.55      0.00
7940059   SENNA/DSS 8.6-50MG TAB (S   79   250               8.97      0.00
7940067   TARCEVA 100MG TAB           79   250             481.31      0.00
7940075   DOXOrubicin 2MG/ML INJ 10   79   250    J9000    164.58      0.00
7940109   NITROLINGUAL PUMPSPRAY 4.   79   250             378.65      0.00
7940117   NITROLINGUAL PUMPSPRAY (P   79   250             121.06      0.00
7940125   GENGRAF 25MG CAP (CYCLOSP   79   250              18.03      0.00
7940133   DIMETHYL SULFOXIDE IRRIGA   79   250    J1212    364.74      0.00
7940141   SALIVA SUBSTITUTE SOLUTIO   79   250              44.24      0.00
7940158   PILOCARPINE 1% OP SOLN 2M   79   250              38.60      0.00
7940166   OWN MED IV PREPARATION FE   79   250              55.00      0.00
7940174   MORPHINE SULFATE 10MG/5ML   79   250              13.39      0.00
7940182   PREGABALIN 100MG CAPSULE    79   250              26.25      0.00
7940190   DULOXETINE 20MG CAPSULE (   79   250              39.32      0.00
7940208   CALCITRIOL 1MCG/ML INJ 1M   79   250    J0636     43.24      0.00
7940216   LoxaPINE 25MG CAP (LOXITA   79   250              22.20      0.00
7940224   SOD CHLORIDE 0.9% INJ 100   79   250             107.43      0.00
7940232   ALAVERT ALLERGY-SINUS TAB   79   250              11.84      0.00
7940240   NEURONTIN 250MG/5ML SOLUT   79   250               9.85      0.00
7940257   CETIRIZINE HCL 5MG CHEWAB   79   250              28.67      0.00
7940265   PRE-ADMINISTRATION IVIG F   79   250    G0332    333.92      0.00
7940273   TRIAMCINOLONE 0.5% CREAM    79   250              36.90      0.00
7940281   SODIUM BICARB 8.4% INJ 50   79   250              16.70      0.00
7940299   DEXTROSE 50% VIAL 50MLS     79   250              23.84      0.00
7940307   PANCURONIUM 1MG/ML INJ 10   79   250              21.86      0.00
7940315   DULOXETINE 30MG CAPSULE (   79   250              43.17      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7940323   DEXTROSE 5% INJ 250ML       79   250    J7060     71.48      0.00
7940349   ACYCLOVIR 200MG/5ML SUSP    79   250              20.74      0.00
7940356   MAALOX PLUS SUSPENSION 35   79   250               9.26      0.00
7940364   DOMEBORO PACKETS POWDER     79   250              13.10      0.00
7940372   CROTALIDAE POLYVALENT IMM   79   250            5997.08      0.00
7940380   BUPIVACAINE 0.75% INJ 10M   79   250              27.26      0.00
7940398   BUPIVACAINE HCL IN DEXTRO   79   250              45.23      0.00
7940406   COSYNTROPIN 0.25MG INJ. (   79   250    J0835   1022.73      0.00
7940414   DIPHENHYDRAMINE 12.5MG/5M   79   250               8.22      0.00
7940422   ENALAPRILAT 1.25MG/ML INJ   79   250              36.09      0.00
7940430   ERYTHROMYCIN OP OIN 1GM     79   250              39.29      0.00
7940448   FLUOCINOLONE ACET 0.01% C   79   250              43.55      0.00
7940455   FLUOCINONIDE 0.05% OINTME   79   250             128.89      0.00
7940463   HYDROCODONE/HOMATROPIN SY   79   250              11.07      0.00
7940471   HydrOXYzine HCL 25MG TAB    79   250              14.55      0.00
7940505   LIDOCAINE 1% INJ PF 30ML    79   250    J2001     14.61      0.00
7940513   LIDOCAINE 100MG/5ML SYRIN   79   250    J2001     35.33      0.00
7940521   LIDOCAINE-MPF/EPI 1% INJ    79   250    J2001     82.35      0.00
7940539   LIDOCAINE-MPF/EPI 1.5% IN   79   250    J2001     91.52      0.00
7940547   XYLOCAINE/EPI 2% ST/PK IN   79   250    J2001     98.97      0.00
7940554   MAGNESIUM 30MG TAB (MAG G   79   250               7.92      0.00
7940562   MORphine SUL 30MG/30ML PC   79   250    J2270     70.79      0.00
7940570   M.V.I PEDIATRIC INJ 10ML    79   250             362.09      0.00
7940596   ZOFRAN ODT 8MG TAB (ZOFRA   79   250    Q0179    219.58      0.00
7940612   CALCIUM CARBONATE 648MG T   79   250               7.67      0.00
7940620   PENICILLIN GK 5MMU INJ (P   79   250    J2540     47.14      0.00
7940638   PENTAZOCINE LACTATE INJ 3   79   250    J3070     72.62      0.00
7940646   PERMETHRIN 5% CREAM 60GM    79   250             174.57      0.00
7940653   PHENOBARBITAL 20MG/5M ELX   79   250              10.96      0.00
7940679   PILOCARPINE 2% OP SOL 2ML   79   250              38.60      0.00
7940687   POTASSIUM CHLORIDE 10MEQ    79   250              10.66      0.00
7940695   PROCHLORPERAZINE 5MG/ML I   79   250    J0780     36.09      0.00
7940703   PROPRANOLOL HCL ER 80MG C   79   250              21.97      0.00
7940711   SELEGILINE 5MG CAPSULE (E   79   250              25.07      0.00
7940729   DEPO-TESTOSTERONE 200MG/M   79   250             139.91      0.00
7940737   TETANUS/DIPHTHERIA TOXOID   79   250    90718    144.14      0.00
7940745   THEOPHYLLINE 100MG ER TAB   79   250               9.31      0.00
7940752   TIMOLOL MAL 0.25% OPHTH.    79   250              93.21      0.00
7940760   TRIAMCINOLON 0.025% CREAM   79   250              30.39      0.00
7940778   TRIAMCINOLONE 0.1% CREAM    79   250              45.35      0.00
7940786   TRIAMCINOLON 0.025% OINT.   79   250              34.95      0.00
7940794   TRIAMCINOLON 0.1% OINT. 1   79   250              28.48      0.00
7940802   AZITHROMYCIN 250MG TAB (Z   79   250              51.95      0.00
7940810   LOXAPINE 5MG CAP (LOXITA    79   250              15.12      0.00
7940836   MEN-PHOR LOTION 222ML       79   250              43.62      0.00
7940844   SOD CHLORIDE 3% INJ 500ML   79   250             120.89      0.00
7940851   MUCINEX 600MG E TAB (SAME   79   250              10.76      0.00
7940877   NIFEdipine 30MG ER TAB (P   79   250              17.63      0.00
7940885   AZITHROMYCIN 200MG/5ML SU   79   250              38.89      0.00
7940893   SEVELAMER 400MG TAB (RENA   79   250              15.66      0.00
7940901   CAFFEINE CITRATE 20MG/ML    79   250             250.30      0.00
7940919   ECONAZOLE CREAM 1% 30GM (   79   250             186.28      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE      PRICE
7940927   AEROCHAMBER PLUS MASK (ME   79   250               29.70      0.00
7940935   FLUOXETINE 10MG CAP (PROZ   79   250               25.96      0.00
7940943   FORADIL AEROLIZ CAP         79   250              210.89      0.00
7940950   CLINDAMYCIN 900MG INJ (CL   79   250               52.66      0.00
7940968   GUAIFENESIN 100MG/5ML SYR   79   250                8.18      0.00
7940976   FENOFIBRATE 145MG TAB (TR   79   250               39.09      0.00
7940984   BRIMONIDINE 0.2% OPHTH. S   79   250              196.10      0.00
7940992   HEP FLUSH 10 UNITS/ML 10M   79   250    J1642      37.05      0.00
7941008   CLINDAMYCIN 300MG INJ (CL   79   250               39.82      0.00
7941016   ZOFRAN ODT 4MG TAB (ZOFRA   79   250    Q0179     134.85      0.00
7941024   AMPICILLIN 2GM INJ ADV (P   79   250    J0290     158.24      0.00
7941057   TEMAZEPAM (RESTORIL) 7.5M   79   250               52.13      0.00
7941065   INSULIN REG SLIDING SCALE   79   250    J1815      40.50      0.00
7941073   MAALOX SUSPENSION           79   250                9.32      0.00
7941081   PENTOBARBITAL INJ. 50MG/M   79   250    J2515      75.49      0.00
7941099   NoVoSeven 4800MCG INJ-Coa   79   250            31280.04      0.00
7941107   SOD CHLORIDE 5% OPHTH SOL   79   250               76.70      0.00
7941115   CYTARABINE 1000MG INJ (C    79   250    J9110     143.17      0.00
7941123   ETH-OxyDOSE 20MG/ML CONC.   79   250               24.85      0.00
7941131   HYDROmorphone 50MG/5ML IN   79   250    J1170      74.82      0.00
7941149   UROXATRAL 10MG TAB          79   250               31.15      0.00
7941156   HYDROCHLOROTHIAZIDE 12.5M   79   250               11.02      0.00
7941164   CAPSAICIN 0.075% CREAM 60   79   250              161.44      0.00
7941172   ZIDOVUDINE 10MG/ML INJ 20   79   250              169.14      0.00
7941180   SCLEROSOL INTRAPLEURAL AE   79   250              388.55      0.00
7941206   RIFAXIMIN 200MG TAB (XIFA   79   250               42.90      0.00
7941214   PREGABALIN 50MG CAPSULE (   79   250               26.25      0.00
7941222   LOVASTATIN 40MG TAB (MEVA   79   250               24.34      0.00
7941230   LYMPHOCYTE IMMUNE GLOBULI   79   250    J7504    2136.61      0.00
7941248   LOVASTATIN 10MG TAB (MEVA   79   250               12.93      0.00
7941255   METHADOSE 10MG/ML CONC. (   79   250                8.35      0.00
7941263   MOLINDONE HCL 50MG TAB (M   79   250               39.49      0.00
7941271   COSOPT 2-0.5% OP SOLN 10M   79   250              526.67      0.00
7941289   PEPPERMINT SPIRIT SOLUTIO   79   250               36.16      0.00
7941297   CAMPHOR SPIRITS SOLUTION    79   250               30.46      0.00
7941305   OXYBUTYNIN TRANSDERMAL SY   79   250               99.73      0.00
7941313   MEXILETINE 150MG CAP (MEX   79   250               14.44      0.00
7941321   MEROPENEM 1GM INJ (MERREM   79   250    J2185     300.05      0.00
7941339   SOD CHLORIDE 0.9% NEB 3ML   79   250                8.51      0.00
7941347   NADOLOL 20MG TAB (CORGARD   79   250               14.59      0.00
7941354   OCTREOTIDE 50MCG/ML INJ (   79   250    J2354      71.37      0.00
7941362   OCTREOTIDE 100MCG/ML INJ    79   250    J2354      98.92      0.00
7941370   OCTREOTIDE 500MCG/ML INJ    79   250    J2354     293.31      0.00
7941388   FLUCONAZOLE/D5W 200MG/100   79   250    J1450     202.12      0.00
7941396   FLUCONAZOLE/D5W 400MG/200   79   250    J1450     201.73      0.00
7941404   AZITHROMYCIN 500MG INJ (Z   79   250    J0456     178.50      0.00
7941412   AMPICILLIN/SULBACTAM 1.5G   79   250    J0295      42.56      0.00
7941420   AMPICILLIN/SULBACTAM 3GM    79   250    J0295      97.49      0.00
7941438   CEFTRIAXONE 250MG INJ (RO   79   250    J0696      92.25      0.00
7941446   CEFTRIAXONE 500MG INJ (RO   79   250    J0696     161.06      0.00
7941453   CEFTRIAXONE 1GM INJ ADV (   79   250    J0696      54.81      0.00
7941461   CEFTRIAXONE 1GM INJ (ROCE   79   250    J0696     270.22      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7941479   CEFTRIAXONE 2GM ADV INJ (   79   250    J0696     92.29      0.00
7941487   AMIODARONE 50MG/ML INJ 3M   79   250    J0282     26.58      0.00
7941495   CHLOROTHIAZIDE 500MG INJ    79   250    J1205    864.46      0.00
7941503   AMIODARONE 200MG TAB (COR   79   250              34.42      0.00
7941511   FLUMAZENIL 0.1MG/ML INJ (   79   250             125.35      0.00
7941529   PANAFIL SE EMULSION 34ML    79   250             342.84      0.00
7941537   ACCUZYME SE EMULSION 34M    79   250             215.39      0.00
7941552   XENADERM OINTMENT 30GM      79   250             225.50      0.00
7941560   NeoProfen 10MG/ML SOLN IN   79   250            2424.53      0.00
7941578   MIDAZOLAM 1MG/ML INJ (VER   79   250    J2250     35.05      0.00
7941586   MIDAZOLAM 2MG/ML SYRUP (V   79   250    J2250     38.89      0.00
7941594   MIDAZOLAM (VERSED) 50MG/1   79   250    J2250     89.85      0.00
7941602   MIDAZOLAM 1MG/ML INJ 2ML    79   250    J2250     13.17      0.00
7941628   GENGRAF 100MG CAP (CYCLOS   79   250              38.94      0.00
7941636   LEVOTHYROXINE 25MCG/ML OR   79   250              28.26      0.00
7941644   TRYPSIN COMPLEX OINTMENT    79   250             254.40      0.00
7941651   MESNA 400MG TAB (MESNEX)    79   250             360.93      0.00
7941677   CIPROFLOXACIN 10MG/ML INJ   79   250    J0744     38.95      0.00
7941685   DAKIN'S SOLN (QUARTER STR   79   250              53.57      0.00
7941693   TRIFLURIDINE 1% OP.SOLN (   79   250             531.28      0.00
7941701   STOMAHESIVE POWDER          79   250               9.56      0.00
7941719   VITAMIN D 400UNIT TABLET    79   250               7.72      0.00
7941727   CYTRA-3 SYRUP (POLYCITRA    79   250               7.83      0.00
7941735   PRAMLINTIDE ACETATE 0.6MG   79   250             513.10      0.00
7941743   RANOLAZINE 500MG TAB (RAN   79   250              35.78      0.00
7941750   AMINOSYN-PF 7% INJ 500ML    79   250             271.01      0.00
7941768   AMOXICILLIN 50MG/ML DROP    79   250               8.39      0.00
7941776   BUDESONIDE 32MCG NASAL SP   79   250             393.16      0.00
7941784   CROMOLYN SOD 5.2MG/ACT SP   79   250              81.21      0.00
7941792   CARBOXYMETHYLCELLULOSE (R   79   250              66.14      0.00
7941800   CONRAY 60% INJ 100ML        79   250    Q9964    187.78      0.00
7941818   FENOFIBRATE 200MG CAP (LO   79   250              29.13      0.00
7941826   METHYLPREDNISOLONE 1MG/ML   79   250              34.00      0.00
7941834   ATROPINE SUL 1% OP SOLUTI   79   250              30.39      0.00
7941859   STERILE TALC 5GM FOR SUSP   79   250             333.52      0.00
7941867   ZIPRASIDONE HCL 20MG CAPS   79   250              45.08      0.00
7941875   NORETHINDRONE ACETATE 5MG   79   250              24.66      0.00
7941883   RETEPLASE HALF-KIT INJ (R   79   250            5332.40      0.00
7941891   ATRIPLA TAB                 79   250             217.52      0.00
7941917   CALCIUM GLUCONATE 650MG T   79   250               7.69      0.00
7941925   FLORANEX CHEWABLE TABLET    79   250               8.73      0.00
7941958   AZELASTINE NASAL 137MCG S   79   250             370.55      0.00
7941974   LIDOCAINE 1% INJ 1ML (FOR   79   250    J2001      9.82      0.00
7941982   TRIAMCINOLONE 40MG/ML INJ   79   250    J3301     47.55      0.00
7941990   DORZOLAMIDE HCL OPHTH. SO   79   250             292.56      0.00
7942006   DEXTROSE 5% INJ 500ML BAG   79   250    J7060     71.00      0.00
7942014   ALBENDAZOLE 200MG TAB (AL   79   250              20.08      0.00
7942022   ONDANSETRON 4MG/2ML SYRIN   79   250    J2405     22.51      0.00
7942030   TIGECYCLINE 50MG INJ. (TY   79   250    J3243    316.80      0.00
7942048   SALINE FLUSH 0.9% INJ 5ML   79   250              15.18      0.00
7942055   SALINE FLUSH 0.9% INJ 2.5   79   250              14.61      0.00
7942063   MD-GASTROVIEW SOLN 120ML    79   250    Q9963    186.33      0.00
                                            REV     CPT   UNIT       ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE      PRICE
7942071   METHYL SALICYLATE NF (WIN   79   250               41.18      0.00
7942089   CANDIDA ALBICANS SKIN TES   79   250               12.27      0.00
7942097   PROPRANOLOL 20MG/5ML ORAL   79   250               10.28      0.00
7942105   PARICALCITOL 1MCG CAP       79   250               55.44      0.00
7942113   TROPICAMIDE 1% OP SOLN (M   79   250               47.72      0.00
7942121   SIMVASTATIN 80MG TAB (ZOC   79   250               45.00      0.00
7942139   EFAVIRENZ 600MG TAB (SUST   79   250              122.32      0.00
7942147   FLUOROURACIL 5% CREAM (Ef   79   250              990.32      0.00
7942154   OSELTAMIVIR 75MG CAP (TAM   79   250               60.39      0.00
7942162   ISOSORBIDE DINITRATE 20MG   79   250                9.26      0.00
7942170   FLUCYTOSINE ORAL LIQUID 1   79   250               73.65      0.00
7942188   QUADRIVALENT HUMAN PAPILL   79   250    90649     584.02      0.00
7942212   HEPATITIS A VAC 25U/0.5ML   79   250    90633     221.07      0.00
7942220   CALCITONIN NASAL SPRAY 20   79   250              383.01      0.00
7942238   DEXAMETHASONE PHOS 10MG/M   79   250    J1100      32.40      0.00
7942246   HYDROCORT/IODOQUINOL CREA   79   250              225.69      0.00
7942253   HYDRALAZINE 1MG/ML ORAL S   79   250               13.01      0.00
7942261   FERRIC SUBSULFATE (ASTRIN   79   250               85.04      0.00
7942279   LEVALBUTEROL HFA AER (XO    79   250              218.00      0.00
7942287   GRISEOFULVIN 250MG TAB (G   79   250               27.50      0.00
7942295   LACTULOSE 10GM/15ML SOLN    79   250               18.47      0.00
7942303   D5W/LR 20MEQ KCL 1000ML P   79   250               86.49      0.00
7942329   0.9% NS WITH 20MEQ KCL 10   79   250               83.21      0.00
7942337   D5W/NS WITH 40MEQ KCL 100   79   250               87.25      0.00
7942345   D5W/0.45NS 20MEQ KCL 1000   79   250               77.89      0.00
7942352   LANTHANUM CARBONATE 500MG   79   250               38.32      0.00
7942360   MAGNESIUM SULF 2 GRAMS/50   79   250    J3475     103.51      0.00
7942378   GLATIRAMER ACETATE 20MG/M   79   250              309.21      0.00
7942386   HYDROCORTISONE 1MG/ML ORA   79   250               16.43      0.00
7942394   SOD CHLORIDE 0.9% INJ MIN   79   250              142.19      0.00
7942402   TORSEMIDE 10MG TAB (DEMAD   79   250               13.27      0.00
7942410   BEVACIZUMAB 25MG/ML INJ (   79   250    J9035   10551.75      0.00
7942428   BEVACIZUMAB 25MG/ML INJ (   79   250    J9035    2693.62      0.00
7942451   CARBOPLATIN 150MG/15ML IN   79   250    J9045     260.39      0.00
7942477   GLYCOPYRROLATE 100MCG/ML    79   250               37.00      0.00
7942485   SOTALOL AF 80MG TAB (BETA   79   250               27.05      0.00
7942493   PRAZIQUANTEL 600MG TAB (B   79   250               86.14      0.00
7942501   FONDAPARINUX 2.5MG/0.5ML    79   250    J1652     209.40      0.00
7942519   CycloSPORINE MODIFIED 100   79   250    J7502      43.87      0.00
7942535   EXACTACAIN AEROSOL (CETA    79   250              232.55      0.00
7942543   QUInine SULFATE 324MG CAP   79   250               43.18      0.00
7942568   RIFABUTIN 150MG CAP (MYCO   79   250               70.81      0.00
7942576   BRINZOLAMIDE 1% OPTH SUSP   79   250              354.97      0.00
7942584   CARBOPLATIN 450MG/45ML IN   79   250    J9045     398.29      0.00
7942592   CARBOPLATIN 50MG INJ (PAR   79   250    J9045     155.21      0.00
7942600   CASTOR OIL 60ML             79   250               28.76      0.00
7942618   SORE THROAT CHERRY SPRAY    79   250               28.54      0.00
7942626   SITAGlipTIN PHOSPHATE 50M   79   250               45.72      0.00
7942634   CARbaMAZEPINE ER 400MG TA   79   250               21.95      0.00
7942642   D5W/0.45NS 30MEQ KCL 1000   79   250               80.32      0.00
7942659   MYCOPHENOLATE 360MG TAB (   79   250               44.65      0.00
7942667   ATOVAQUONE 750MG/5ML SUSP   79   250              131.63      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7942675   INFLUENZA VIRUS VACCINE 2   79   250    90658    115.27      0.00
7942683   EPOETIN 3,000 UNITS/ML IN   79   250    Q4081    290.82      0.00
7942691   EPOETIN 4,000 UNITS/ML IN   79   250    Q4081    259.79      0.00
7942709   EPOETIN 2,000 UNITS/ML IN   79   250    Q4081    197.10      0.00
7942717   EPOETIN 10,000 UNITS/ML I   79   250    Q4081    634.98      0.00
7942725   EPOETIN 20,000 UNITS/ML I   79   250    Q4081   1260.30      0.00
7942733   EPOETIN 40,000 UNITS/ML I   79   250    Q4081   2510.93      0.00
7942741   FLUDROCORTISONE 0.02MG/ML   79   250              20.00      0.00
7942758   ALPHANINE 1000 IU INJ (FA   79   250    J7194   5648.47      0.00
7942766   INTERFERON BETA-1 A 30MCG   79   250    Q3025   1061.58      0.00
7942774   PENICILLIN VK 125MG/5ML S   79   250              10.00      0.00
7942782   BISMATROL 524MG/30ML SUSP   79   250              12.04      0.00
7942790   BROMALINE 1-15MG/5ML SOLN   79   250               9.84      0.00
7942808   HYDROmorphone 6MG/30ML PC   79   250    J1170    104.00      0.00
7942816   CAFFEINE CITRATE 10MG/ML    79   250              65.50      0.00
7942824   HYDROCODONE/APAP 5MG-325M   79   250              13.79      0.00
7942832   HYDROCODONE/APAP 7.5MG-32   79   250              14.37      0.00
7942840   SOD CHLORIDE 4MEQ/ML(23.4   79   250    J7130     38.20      0.00
7942857   LIQUITEARS SOLN (LIQUIFI    79   250              38.51      0.00
7942865   GALANTAMINE 8MG TAB (RAZA   79   250              33.46      0.00
7942873   LEVORA-28 0.15/30 TAB (LE   79   250              15.96      0.00
7942881   THYROTROPIN ALFA 1.1 MG (   79   250    J3240   4364.97      0.00
7942899   ERYTHROMYCIN LAC 500MG IN   79   250    J1364    129.63      0.00
7942907   DacliZUMAB 25MG/5ML INJ (   79   250    J7513   2161.48      0.00
7942915   AK-DILATE 2.5% OP SOLN (M   79   250              40.87      0.00
7942923   FOSAMAX + D 70-2800 TAB     79   250             137.54      0.00
7942931   BUDESONIDE 180MCG INH (PU   79   250             532.36      0.00
7942949   PNEUMONIA VAC ADMIN FEE     79   250    90471    103.76      0.00
7942956   INFLUENZA VAC ADMIN FEE     79   250    90471    103.76      0.00
7942964   HEPATITIS B VAC ADMIN FEE   79   250    90471    103.76      0.00
7942972   STAVUDINE 20MG CAP (ZERIT   79   250              47.75      0.00
7942980   RITONAVIR 100MG CAP (NORV   79   250              68.74      0.00
7942998   SAQUINAVIR MESYLATE 200MG   79   250              32.57      0.00
7943004   GLYCERIN LIQUID             79   250               9.88      0.00
7943020   NYSTATIN 100,000 UNITS/ML   79   250              19.00      0.00
7943038   TETRACAINE 0.5% OPHTH SOL   79   250              44.29      0.00
7943046   TOLNAFTATE 1% CREAM 30GM    79   250              26.71      0.00
7943053   PACLITAXEL 100MG/16.7ML I   79   250    J9265    345.71      0.00
7943061   GLYCOPYRROLATE 0.2MG/ML I   79   250              20.61      0.00
7943079   MORPHINE SULF 20MG/ML SOL   79   250              24.32      0.00
7943087   NAFCILLIN 1GM ADV INJ       79   250              87.36      0.00
7943095   AMPICILLIN 1GM ADV INJ (P   79   250    J0290     87.36      0.00
7943103   SOD CHLORIDE 0.9% INJ 100   79   250              75.57      0.00
7943111   HEPARIN LOCK 10UNIT/ML 3M   79   250    J1642     33.03      0.00
7943129   MYCOPHENOLATE 200MG/ML SU   79   250              38.40      0.00
7943137   ALBUTEROL 0.5% NEB 0.5ML    79   250    J7603     13.09      0.00
7943145   LEVALBUTEROL 1.25MG/0.5ML   79   250    J7603     23.79      0.00
7943152   ALBUTEROL 0.083% NEB 3ML    79   250    J7603     15.75      0.00
7943160   VISIPAQUE 320MG/ML INJ 10   79   250    Q9967    499.44      0.00
7943178   OMNIPAQUE 240MG/ML INJ 10   79   250    Q9966    217.02      0.00
7943186   IMMUNE GLOBULIN INTRAVENO   79   250    J1561    437.64      0.00
7943194   OMNIPAQUE 300MG/ML INJ 10   79   250    Q9967    429.59      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE   PRICE     PRICE
7943202   OMNIPAQUE 300MG/ML INJ 50   79   250    Q9967    223.97      0.00
7943210   OMNIPAQUE 350MG/ML INJ 10   79   250    Q9967    476.28      0.00
7943228   OMNIPAQUE 350MG/ML INJ 50   79   250    Q9967    243.07      0.00
7943236   VISIPAQUE 320MG/ML INJ 15   79   250    Q9967    685.81      0.00
7943244   OMNIPAQUE 180MG/ML INJ 10   79   250    Q9965    200.38      0.00
7943251   OMNIPAQUE 240MG/ML INJ 50   79   250    Q9966    270.31      0.00
7943269   OMNIPAQUE 240MG/ML INJ 1M   79   250    Q9966     40.74      0.00
7943277   SITAGlipTIN PHOSPHATE 100   79   250              45.72      0.00
7943285   IMMUNE GLOBULIN 5% 10GM (   79   250    J1568   4901.45      0.00
7943293   MITOMYCIN 20MG INJ (MUTAM   79   250    J9290    421.91      0.00
7943301   GANCICLOVIR 500MG INJ (CY   79   250    J1570    313.95      0.00
7943319   BOUDREAUX BUTT PST 16% 12   79   250              41.07      0.00
7943327   STERIL WATER INJ 10ML       79   250              63.49      0.00
7943335   VALGANCICLOVIR HCL 450MG    79   250             252.20      0.00
7943343   CLOPIDOGREL 300MG TAB (PL   79   250             125.99      0.00
7943350   DECITABINE 50MG INJ (DACO   79   250    J0894   6086.43      0.00
7943368   DORNASE ALFA 1MG/ML SOL 2   79   250    J7639    266.52      0.00
7943376   LEVALBUTEROL 1.25MG/3ML N   79   250    J7615     35.81      0.00
7943384   TROMETHAMINE 30MEQ/100ML    79   250             953.89      0.00
7943392   PROCRIT 40,000 UNITS/ML     79   250    J0885   2510.93      0.00
7943400   PROCRIT 20,000 UNITS/ML     79   250    J0885   1260.30      0.00
7943418   PROCRIT 10,000 UNITS/ML     79   250    J0885    634.98      0.00
7943426   PROCRIT 2000 UNITS/ML INJ   79   250    J0885    197.10      0.00
7943434   PROCRIT 4000 UNITS/ML INJ   79   250    J0885    259.79      0.00
7943442   PROCRIT 3000 UNITS/ML INJ   79   250    J0885    290.82      0.00
7943459   LABETALOL 5MG/ML INJ 4ML    79   250              45.90      0.00
7943467   BETAXOLOL HCL 0.25% OP SU   79   250             423.55      0.00
7943475   DIVALPROEX ER 250MG (DEPA   79   250              21.96      0.00
7943483   HYDROCOD/IBUPROF 7.5-200    79   250              19.23      0.00
7943491   D5W/0.45NS 40MEQ KCL 1000   79   250              80.32      0.00
7943509   CIPROFLOXACN 400MG PREMIX   79   250    J0744     88.45      0.00
7943517   CIPROFLOXACN 200MG PREMIX   79   250    J0744     78.80      0.00
7943525   HEPARIN LOCK 1UNIT/ML 3ML   79   250    J1642     14.90      0.00
7943541   ETHACRYNIC ACID 25MG TAB    79   250              16.47      0.00
7943558   POLYETHYLENE GLYCOL 3350    79   250              38.39      0.00
7943566   MEGESTROL ACE 40MG/ML SUS   79   250              65.22      0.00
7943574   CYCLOPHOSPHAMIDE 25MG TAB   79   250    J8530     23.02      0.00
7943582   DIGOXIN 0.05/ML SOL UD      79   250              14.81      0.00
7943657   HEPARIN LOCK PF 10UNIT/ML   79   250    J1642     36.00      0.00
7943673   FOSCARNET 24MG/ML INJ 250   79   250    J1455    323.23      0.00
7943707   ALBUTEROL 5 MG/ML 20 ML N   79   250    J7602    103.88      0.00
7943715   SOD CHL 0.9% NEB SOL 15ML   79   250              11.87      0.00
7943731   PANAFIL OINTMENT 30GM       79   250              31.99      0.00
8000010   HEMODIALYSIS                80   800    90935   5458.00      0.00
8000028   PERITONEAL DIALYSIS         80   800    90945   5458.00      0.00
8000044   CLARK HEMOPERF CARTRG XLG   80   800    90997   3030.00      0.00
8100018   PLASMA PHERESIS             81   940    36514   4410.00      0.00
8700015   WORK TOLERANCE TESTING      87   420    97660     70.00      0.00
8700064   CARDIAC REHAB WO CONT ECG   87   420    93797     88.00      0.00
8700080   ADVANCED ERGO TESTING       87   420    97660     65.00      0.00
8700106   PHYSICAL AGILITY TEST II    87   420    97660     49.00      0.00
8700122   ASSES/EVAL BRIEF INIT       87   420              83.00      0.00
                                            REV     CPT   UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
8700130   ASSES/EVAL LIMITED INITIL   87   420             125.00      0.00
8700148   ASSES/EVAL INTERM/INITIAL   87   420             162.00      0.00
8700155   ASSES/EVAL LIMIT/ESTAB      87   420              80.00      0.00
8700163   ASSES/EVAL INTERM/ESTB      87   420             106.00      0.00
8700189   GAIT TRAINING 15MIN         87   420    97116     85.00      0.00
8700221   CPM SET-UP                  87   420    97110     96.00      0.00
8700239   CPM FOLLOW UP               87   420    97110     77.00      0.00
8700247   THERAPEUTIC EX INIT 30MIN   87   420             112.00      0.00
8700254   KINETIC ACT ADD 15MIN       87   420              50.00      0.00
8700270   ELEC STIM MAN INIT 30MIN    87   420              79.00      0.00
8700288   ORTHOTIC TRAIN INIT 30MIN   87   420             135.00      0.00
8700296   ORTHOTIC TRAIN ADD 15MIN    87   420              60.00      0.00
8700304   PROSTHETIC TRAIN ADD 15MN   87   420              69.00      0.00
8700338   ADL TRAIN INIT 30MIN        87   420             112.00      0.00
8700346   WORK CONDITION INIT 2HR     87   420    97545    162.00      0.00
8700353   WORK CONDITIONING ADD 1HR   87   420    97546     80.00      0.00
8700361   ADL TRAIN ADD 15MIN         87   420              50.00      0.00
8700379   ASSES/EVAL COMP INIT        87   420             296.00      0.00
8700395   ULTRASOUND INIT 30MIN       87   420              71.00      0.00
8700403   ELECTRICAL STIM UNATTEND    87   420    97014     62.00      0.00
8700411   MASSAGE INITIAL 30MIN       87   420              75.00      0.00
8700429   MECHANICAL TRACTION         87   420    97012     62.00      0.00
8700437   MANUAL TRACTION INIT 30MN   87   420              69.00      0.00
8700445   JOINT MOBILIZATION          87   420              73.00      0.00
8700452   IONTOPHERESIS INIT 30MN     87   420             102.00      0.00
8700460   APPLY TENS UNIT             87   420    64550     61.00      0.00
8700478   CONTRAST BATHS INIT 30MIN   87   420              69.00      0.00
8700494   WHRLPOOL SML/PULSE LAVAGE   87   420    97022     62.00      0.00
8700536   GAIT TRAINING INIT 30MIN    87   420              91.00      0.00
8700544   KINETIC ACT INIT 30MIN      87   420             112.00      0.00
8700551   WORK CAPACITY MEAS FCE I4   87   420    97670    988.00      0.00
8700577   JOB SITE ANALYSIS 1HR       87   420    97680    169.00      0.00
8700585   WORK CAPACTY MEAS FCE II8   87   420    97670    988.00      0.00
8700593   LIFTING ASSESSMENT          87   420    97660     81.00      0.00
8700601   PHYSICAL AGILITY TEST III   87   420    97660     65.00      0.00
8700619   WORK CAPTY MEAS FCE III12   87   420    97670    988.00      0.00
8700627   POST OFFER EMPLOY TEST      87   420    97620     97.00      0.00
8700635   PHYS PERF TEST INIT 30MIN   87   420             137.00      0.00
8700643   PHYS PERF TEST ADD 15MIN    87   420              69.00      0.00
8700650   ADL/ORTHOTIC/PROSTHETC CK   87   420             152.00      0.00
8700668   ADL/ORT/PROS CK ADD 15MIN   87   420              77.00      0.00
8700684   BIODEX TEST                 87   420    97752     81.00      0.00
8700866   GROUP THERAPY               87   420    97150     60.00      0.00
8700908   PROSTHETIC TRAIN INIT 30M   87   420             152.00      0.00
8700924   COMM/WRK RE-INTEGR 15MIN    87   420    97537     94.00      0.00
8700932   PHYS PERFORM TEST 15MIN     87   420    97750    103.00      0.00
8701013   JOBST PUMP                  87   420    97016     62.00      0.00
8701104   PT EVALUATION               87   420    97001    207.00      0.00
8701112   PT RE-EVALUATION            87   420    97002    104.00      0.00
8701120   JOBSITE ANALYSIS 2HR        87   420    97680    338.00      0.00
8701138   JOB SITE ANALYSIS 4HR       87   420    97680    675.00      0.00
8701179   MSCL TEST EXTREM OR TRUNK   87   420    95831     98.00      0.00
                                            REV     CPT     UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE     PRICE     PRICE
8701187   MUSCLE TEST HAND            87   420    95832       83.00      0.00
8701195   MSCL TEST TOT BODY W HAND   87   420    95834      163.00      0.00
8701203   ROM EA EXTREM TRNK NT HND   87   420    95851       70.00      0.00
8701211   WLCHR MGT PROP TRAIN 15MN   87   420    97542       77.00      0.00
8701245   MANUAL THERAPY EA 15MIN     87   420    97140       73.00      0.00
8701328   STRAPPING LOW BACK          87   420    29220      155.00      0.00
8701336   STRAPPING SHOULDER          87   420    29240      168.00      0.00
8701369   STRAPPING HIP               87   420    29520      149.00      0.00
8701377   STRAPPING KNEE              87   420    29530      146.00      0.00
8701385   STRAPPING ANKLE             87   420    29540      102.00      0.00
8701401   ASSES/EVAL EXTEND/INIT      87   420               235.00      0.00
8701419   ASSES/EVAL EXTEND/ESTB      87   420               150.00      0.00
8701427   ASSES/EVAL COMPR/ESTB       87   420               225.00      0.00
8701542   NEURO MUSCL RE-ED INI 30M   87   420               112.00      0.00
8701559   ACTIVE WOUNDCARE <20CM      87   420    97597      134.00      0.00
8701666   ACTIVE WOUNDCARE >20CM      87   420    97598      171.00      0.00
8702045   NON WND ELECT STIM          87   420    G0283       49.00      0.00
8702102   EXTREMITY TEST INIT 30MIN   87   420               108.00      0.00
8702128   EXTREMITY TEST ADD 15MIN    87   420                60.00      0.00
8702144   MSCL TEST DURING EXERCISE   87   420               231.00      0.00
8702169   FUNCTIONAL ACT INIT 30MIN   87   420               112.00      0.00
8702185   PHYS MED TX ADD 15MIN       87   420                46.00      0.00
8702201   MYOF RLSE SFT TISS MOBIL    87   420               121.00      0.00
8702227   SFT TISS MOBIL INIT 30MIN   87   420               112.00      0.00
8702243   INDIVIDUAL INSTRUCTION      87   420               112.00      0.00
8702268   FABRICATION OF ORTHOTICS    87   420               112.00      0.00
8702284   GROUP EX < 5 PT INIT 30MN   87   420                56.00      0.00
8702300   GROUP EX < 5 PT ADD 15MIN   87   420                25.00      0.00
8702326   ELECTRICAL STIM MAN 15MIN   87   420    97032       44.00      0.00
8702342   IONTOPHORESIS 15MIN         87   420    97033       56.00      0.00
8702367   CONTRAST BATH 15MIN         87   420    97034       38.00      0.00
8702383   ULTRASOUND/PHONO 15MIN      87   420    97035       41.00      0.00
8702409   THERAPEUTIC EXRCISE 15MIN   87   420    97110       77.00      0.00
8702425   NEUROMUSCULAR RE-ED 15MIN   87   420    97112       81.00      0.00
8702441   MASSAGE 15MIN               87   420    97124       77.00      0.00
8702508   THERAPEUTIC ACT 15MIN       87   420    97530       81.00      0.00
8702524   SELFCARE MGMT TRAIN 15MIN   87   420    97535       82.00      0.00
8702540   PATIENT ED ORG GRP INSTR    87   420    97650       73.00      0.00
8702565   TAPING                      87   420                73.00      0.00
8702581   PT EVAL - INITIAL 30 MIN    87   420               207.00      0.00
8702607   PT EVAL - ADD 15 MIN        87   420               104.00      0.00
8702623   PHYS THER TX INIT 30MIN     87   420               122.00      0.00
8702649   PHYS THER TX ADD 15MIN      87   420                61.00      0.00
8702664   ADL/ORTHOTIC/PROSTHETC CK   87   420    97762      152.00      0.00
8702680   ORTHOTIC FIT / TRAIN 15MN   87   420    97760       84.00      0.00
8702706   PROSTHETIC TRAINING 15MIN   87   420    97761       77.00      0.00
8702904   PT VISIT TRACKING           87   420                 0.00      0.00
8708000   NEUROMSCLR RE-ED 15MIN-59   87   420    9711259     81.00      0.00
8708026   PT RE EVAL-59               87   420    9700259    104.00      0.00
8708042   APPLY TENS UNIT-59          87   420    6455059     61.00      0.00
8708067   PHYS PERFRM TEST 15MIN-59   87   420    9775059    103.00      0.00
8708083   THERAPEUTIC ACT 15MIN-59    87   420    9753059     81.00      0.00
                                            REV     CPT     UNIT      ROOM
 NUMBER           DESCRIPTION         DEPT CODE    CODE     PRICE     PRICE
8708091   ROM EA EXT TRNK NT HND-59   87   420    9585159     70.00      0.00
8708109   THERPUTC EXRCISE 15MIN-59   87   420    9711059     77.00      0.00
8708125   ELECTR STIM - MEDICARE-59   87   420    G028359     49.00      0.00
8708141   GAIT TRAINING 15MIN-59      87   420    9711659     85.00      0.00
8708166   MASSAGE 15MIN-59            87   420    9712459     77.00      0.00
8708182   ELECTR STIM UNATTENDED-59   87   420    9701459     49.00      0.00
8708224   MANUAL THERAPY EA 15MN-59   87   420    9714059     73.00      0.00
8708364   SELFCR MGMT TRAIN 15MN-59   87   420    9753559     82.00      0.00
8800013   SPEECH THERAPY TREATMENT    88   440    92507      205.00      0.00
8800021   SPEECH THERAPY EVALUATION   88   444    92506      205.00      0.00
8800039   SPEECH THERAPY MDF BARIUM   88   444    92611      205.00      0.00
8800047   SPEECH TREATMENT OF SWALL   88   440    92526      154.00      0.00
8800054   SPEECH EVALUATION OF SWAL   88   444    92610      205.00      0.00
8900011   ASSES/EVAL COMPR/INIT       89   430               296.00      0.00
8900029   THERAPEUTIC EX INIT 30MIN   89   430               112.00      0.00
8900037   ADL TRAIN INIT 30MIN        89   430               112.00      0.00
8900045   ADL TRAIN ADD 15MIN         89   430                50.00      0.00
8900110   ULTRASOUND INIT 30MIN       89   430                71.00      0.00
8900128   ELECTRICAL STIM UNATTEND    89   430    97014       62.00      0.00
8900144   MASSAGE INITIAL 30MIN       89   430                75.00      0.00
8900151   CONTRAST BATHS INIT 30MIN   89   430                69.00      0.00
8900169   WHIRLPOOL SMALL             89   430    97022       62.00      0.00
8900177   IONTOPHERESIS INIT 30MIN    89   430               102.00      0.00
8900185   PARAFIN BATH                89   430    97018       62.00      0.00
8900193   ASSES/EVAL BRIEF INIT       89   430                83.00      0.00
8900201   ASSES/EVAL LIMIT/INIT       89   430               125.00      0.00
8900219   ASSES/EVAL INTERM/INIT      89   430               162.00      0.00
8900227   ASSES/EVAL LIMIT/ESTB       89   430                80.00      0.00
8900235   ORTHOTIC TRAIN INIT 30MIN   89   430               135.00      0.00
8900243   ORTHOTIC TRAIN ADD 15MIN    89   430                60.00      0.00
8900250   MANUAL THERAPY EA 15MIN     89   430    97140       73.00      0.00
8900268   KINETIC ACT INIT 30MIN      89   430               112.00      0.00
8900276   KINETIC ACT ADD 15MIN       89   430                50.00      0.00
8900284   NEURO MUSCL RE-ED INI 30M   89   430               112.00      0.00
8900300   JOINT MOBILIZATION          89   430                73.00      0.00
8900326   ELEC STIM MAN INIT 30MIN    89   430                79.00      0.00
8900409   PHYS PERF TEST INIT 30MIN   89   430               137.00      0.00
8900417   PHYS PERF TEST ADD 15MIN    89   430                69.00      0.00
8900425   ADL/ORTHOTIC/PROSTHETC CK   89   430               152.00      0.00
8900433   ADL/ORT/PROS CK ADD 15MIN   89   430                77.00      0.00
8900508   JOBST PUMP                  89   430    97016       62.00      0.00
8900607   OT EVALUATION INITIAL       89   430    97003      207.00      0.00
8900615   OT RE-EVALUATION            89   430    97004      104.00      0.00
8900748   MUSCLE TEST HAND            89   430    95832       83.00      0.00
8900755   APP SHORT ARM STATIC SPLN   89   430    29125      182.00      0.00
8900763   APP FINGER SPLINT STATIC    89   430    29130      182.00      0.00
8900771   APP SHORT ARM SPLINT DYNM   89   430    29126      228.00      0.00
8900789   APP LONG ARM SPLINT         89   430    29105      228.00      0.00
8900797   APP FINGER SPLINT DYNAMIC   89   430    29131      228.00      0.00
8900813   WLCHR MGT PROP TRAIN 15MN   89   430    97542       77.00      0.00
8900821   COMM WORK REINTEGRAT 15MN   89   430    97537       94.00      0.00
8900839   COG SKILL TRAIN 15MIN       89   430    97532       84.00      0.00
                                            REV     CPT     UNIT      ROOM
 NUMBER            DESCRIPTION        DEPT CODE    CODE     PRICE     PRICE
8900912   STRAPPING SHOULDER          89   430    29240      168.00      0.00
8900920   STRAPPING ELBOW/WRIST       89   430    29260      182.00      0.00
8900938   STRAPPING HANDS/FINGER      89   430    29280      182.00      0.00
8900953   ASSES/EVAL EXTEND/INIT      89   430               235.00      0.00
8900961   ASSES/EVAL INTERM/ESTB      89   430               106.00      0.00
8900979   ASSES/EVAL EXTEND/ESTB      89   430               150.00      0.00
8901068   SENSORY INTEGRATION 15MIN   89   430    97533       90.00      0.00
8901084   APPLY TENS UNIT             89   430    64550       61.00      0.00
8901100   OT RE-EVALUATION-59         89   430    9700459    104.00      0.00
8901142   PHYS PERFRM TEST 15MIN-59   89   430    9775059    103.00      0.00
8901167   PARAFFIN BATH-59            89   430    9701859     26.00      0.00
8901183   MANUAL THERAPY EA 15MN-59   89   430    9714059     73.00      0.00
8901191   APPLY TENS UNIT-59          89   430    6455059     61.00      0.00
8901225   THERPUTC EXRCISE 15MIN-59   89   430    9711059     77.00      0.00
8901241   NEUROMSCLR RE-ED 15MIN-59   89   430    9711259     81.00      0.00
8901266   MASSAGE 15MIN-59            89   430    9712459     77.00      0.00
8901282   SOFT TISSUE MOB/SCAR MSG    89   430    9714059     74.00      0.00
8901308   THERAPEUTIC ACT 15MIN-59    89   430    9753059     81.00      0.00
8901340   SELFCR MGMT TRAIN 15MN-59   89   430    9753559     82.00      0.00
8901407   GROUP THERAPY               89   430    97150       60.00      0.00
8901449   PHYS PERFORM TEST 15MIN     89   430    97750      103.00      0.00
8901464   ACTIVE WOUNDCARE <20CM      89   430    97597      134.00      0.00
8901480   ACTIVE WOUNDCARE >20CM      89   430    97598      171.00      0.00
8901506   ROM EA EXT TRNK NT HND-59   89   430    9585159     70.00      0.00
8901522   ROM MEASURE & REP HAND-59   89   430    9585259     50.00      0.00
8901548   ELECTR STIM - MEDICARE-59   89   430    G028359     49.00      0.00
8901563   ELECTR STIM UNATTENDED-59   89   430    9701459     49.00      0.00
8902041   NON WND ELECT STIM          89   430    G0283       49.00      0.00
8902108   EXTREMITY TEST INIT 30MIN   89   430               108.00      0.00
8902124   EXTREMITY TEST ADD 15MIN    89   430                48.00      0.00
8902140   MSCL TEST DURING EXERCISE   89   430               231.00      0.00
8902165   MSCL TEST EXTREM OR TRUNK   89   430    95831       98.00      0.00
8902181   MSCL TEST TOT BODY W HAND   89   430    95834      163.00      0.00
8902207   ROM EA EXTREM TRNK NT HND   89   430    95851       70.00      0.00
8902223   ROM MEASURE & REP HAND      89   430    95852       50.00      0.00
8902249   FUNCTIONAL ACT INIT 30MIN   89   430               112.00      0.00
8902264   PHYS MED TX ADD 15MIN       89   430                46.00      0.00
8902280   MYOF RLSE SFT TISS MOBIL    89   430               121.00      0.00
8902306   SFT TISS MOBIL INIT 30MIN   89   430               112.00      0.00
8902322   INDIVIDUAL INSTRUCTION      89   430               112.00      0.00
8902348   FABRICATION OF ORTHOTICS    89   430               112.00      0.00
8902363   GROUP EX < 5 PT INIT 30MN   89   430                56.00      0.00
8902389   GROUP EX < 5 PT ADD 15MIN   89   430                25.00      0.00
8902405   ELECTRICAL STIM MAN 15MIN   89   430    97032       44.00      0.00
8902421   IONTOPHORESIS 15MIN         89   430    97033       56.00      0.00
8902447   CONTRAST BATH 15MIN         89   430    97034       38.00      0.00
8902462   ULTRASOUND/PHONO 15MIN      89   430    97035       41.00      0.00
8902488   THERAPEUTIC EXRCISE 15MIN   89   430    97110       77.00      0.00
8902504   NEUROMUSCULAR RE-ED 15MIN   89   430    97112       81.00      0.00
8902520   MASSAGE 15MIN               89   430    97124       77.00      0.00
8902561   THERAPEUTIC ACT 15MIN       89   430    97530       81.00      0.00
8902587   SELFCARE MGMT TRAIN 15MIN   89   430    97535       82.00      0.00
                                             REV     CPT   UNIT      ROOM
 NUMBER             DESCRIPTION        DEPT CODE    CODE   PRICE     PRICE
8902603   TAPING                       89   430              73.00      0.00
8902629   OT EVAL - INIT 30 MIN        89   430             207.00      0.00
8902645   OT EVAL - ADD 15MIN W RPT    89   430             104.00      0.00
8902660   OT TREATMENT - INIT 30MIN    89   430             122.00      0.00
8902686   OT TREATMENT - ADD 15MIN     89   430              61.00      0.00
8902702   ORTHOTIC FIT / TRAIN 15MN    89   430    97760     84.00      0.00
8902900   OT VISIT TRACKING            89   430               0.00      0.00
          Comparative Pricing Charge   20