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Summary - Office of Statewide Health Planning and Development

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					Hospital Name: Sierra Nevada Memorial Hospital
OSHPD Facility No: 106291023
Effective Date of Charges: June 1, 2007

             Facility            INITIAL         CHANGE   FINAL      FINAL %
5015 Sierra Nevada           $295,223,649 $25,349,813 $320,573,462     8.6%
Hospital Name: Sierra Nevada Memorial Hospital
OSHPD Facility No: 106291023
Effective Date of Charges: June 1, 2007
                                                 Rates as of
SNMH Complete Chargemaster                       July 1, 2007
   CDM                 DESCRIPTION                   PRICE
  40100083 OB US LIMITED FETUS(S)                $      210.50
  40105729 MITY VAC DISPOSABLE                   $      426.00
  40106230 SET BLOOD WARMING                     $      155.25
  40109853 MONITOR FETAL INT ELECTRODE           $      143.25
  40109861 MONITOR FETAL INT CATH                $      556.50
  40120149 RECOVERY BASIC, INITIAL HR            $      252.50
  40120271 NONSTRESS TEST 30 MIN                 $      202.00
  40120278 CONTRACTION STRESS TEST 1 HR          $      403.75
  40120285 OXYTOCIN CHALLENGE TEST 2 HR          $      388.00
  40120292 OB ASSESSMENT PER HR                  $      162.00
  40120296 LABOR, OVER 6 HOURS                   $    1,729.50
  40120299 DELIVERY BASIC                        $    2,189.50
  40120306 OUT OF HOSPITAL DELIVERY              $      699.50
  40120313 NB HEARING SCREEN IN-PT INITIA        $      102.50
  40120320 NB HEARING SCREEN O-PT INITIAL        $      102.50
  40120327 NB HEARING TEST RE-SCREEN             $      102.50
  40120334 SPECIAL PROCEDURE CHARGE              $       59.50
  40120341 TREATMENT ROOM                        $       59.50
  40120348 OB ASSESSMENT FIRST HR                $      389.25
  40120355 LD VERSION                            $      334.75
  40120362 INJ TX/DX/PROPH SUBQ/IM               $       43.25
  40120369 LD ANTEPARTUM MONITORING              $      318.00
  40120397 EPIDURAL TRAY                         $      325.50
  40123076 LABOR ASSESS AND OBS DAILY            $      899.50
  40130560 TRAY SPINAL S17345/S17566             $      206.25
  40131246 TRAY PARACERVICAL/PUDENDAL            $      164.25
  40200507 PACU INPT PROCEDURE ROOM 30MIN        $    1,134.25
  40210420 EPIDURAL PROCEDURE MAIN SURN          $    1,492.75
  40210427 CARDIOVERSION IV RM CHGE INPT         $    1,129.50
  40250000 SURGERY LEVEL 1 1ST 30MIN             $    1,848.25
  40250007 SURGERY LEVEL 1 ADD 15MIN             $      646.50
  40250014 SURGERY LEVEL 2 1ST 30MIN             $    2,401.25
  40250021 SURGERY LEVEL 2 ADD 15MIN             $      840.75
  40250028 SURGERY LEVEL 3 1ST 30MIN             $    3,121.25
  40250035 SURGERY LEVEL 3 ADD 15MIN             $    1,092.50
  40250042 SURGERY LEVEL 4 1ST 30MIN             $    4,057.25
  40250049 SURGERY LEVEL 4 ADD 15MIN             $    1,420.25
  40250056 SURGERY LEVEL 5 1ST 30MIN             $    5,274.00
  40250063 SURGERY LEVEL 5 ADD 15MIN             $    1,845.75
  40270022 SURGERY LEVEL 1 1ST 30MIN             $    2,389.75
  40270029 SURGERY LEVEL 1 ADD 15MIN             $      836.25
  40270050 PACU STANDARD 1ST 30MIN               $      585.50
  40270057 PACU STANDARD ADDL 15MIN              $      204.75
  40270064 PACU COMPLEX 1ST 30MIN                $      761.50
  40270071 PACU COMPLEX ADDL 15MIN               $      267.00
  40300996 GEN ANESTH SUPPLY PANEL CHARGE        $      506.00
  40301038 T & A SUPPLY PANEL                    $      338.25
  40301097 LAPOROSCOPY PANEL                     $    2,973.75
  40301429 LITHOTRIPSY ESWL UNI                  $   13,681.50
  40301437 LITHOTRIPSY ESWL BIL                  $   21,625.75
  40301444 LITHOTRIPSY ESWL UNI                  $   13,681.50
  40301450 LITHOTRIPSY ESWL BIL                  $   21,625.75
  40301550 COSMETIC SURG 1.0 HR                  $    1,105.25
40301556   COSMETIC SURG 1.5 HRS            $   1,445.50
40301562   COSMETIC SURG 2.0 HRS            $   1,700.25
40301568   COSMETIC SURG 2.5 HRS            $   2,210.50
40301574   COSMETIC SURG 3.0 HRS            $   2,550.25
40301580   COSMETIC SURG>3 HRS EA ADD HR    $     850.25
40301587   COSMETIC SURGERY 1.25 HR         $   1,275.25
40301594   COSMETIC SURGERY 1.75 HR         $   1,573.00
40301603   COSMETIC SURGERY 2.25 HR         $   1,955.25
40301610   COSMETIC SURGERY 2.75 HR         $   2,380.50
40301617   COSMETIC SURGERY EA ADD 15 MIN   $     212.75
40301624   COSMETIC SURGERY 0.25 HR         $     281.00
40301631   COSMETIC SURGERY 0.50 HR         $     552.75
40301638   COSMETIC SURGERY 0.75 HR         $     833.75
40310364   EPIDURAL PROCEDURE OPS           $   1,275.25
40310371   CARDIOVERSION IV RM OUTPT        $   1,139.00
40310378   CARDIOVERT ELECTR RM CHRG OUPT   $     964.75
40420000   ANESTH STANDARD 1ST 30MIN        $     207.00
40420007   ANESTH STANDARD ADDL 15M         $      73.00
40420014   ANESTH MAC/REG 1ST 30MIN         $     159.00
40420021   ANESTH MAC/REG ADDL 15MIN        $      56.00
40420028   LOCAL ANESTHESIA                 $     110.00
40420035   MODERATE SEDAT <5 1ST 30M        $     120.00
40420042   MODERAT SEDAT =>5 1ST 30M        $     120.00
40420049   MODERATE SEDAT ADD 15MIN         $      60.00
40502069   IV NS 0.9% W/ 20MEQ KCL 1000ML   $     129.50
40503567   MANNITOL 20% 500ML PM BAG        $     137.50
40517629   IV D51/2NS W/20MEQ KCL 1000ML    $     129.50
40517790   IV D5NS W/20MEQ KCL 1000ML       $     129.50
40530008   IV NACL 0.45% W/20KCL/1000ML     $     129.50
40531634   POTASSIUM INFUSION LITER         $     108.75
40560021   DEXTROSE 5% IN WATER 1000ML      $     129.50
40560039   DEXTROSE 5% IN WATER 500ML       $     129.50
40560047   DEXTROSE 5% IN WATER 250ML       $     129.50
40560054   DEXTROSE 5% IN WATER 50ML        $     129.50
40560062   DEXTROSE 5% IN WATER 50ML        $     129.50
40560070   IV SODIUM CHLORIDE 0.9% 1000ML   $     129.50
40560088   IV SODIUM CHLORIDE 0.9% 500ML    $     129.50
40560096   IV SODIUM CHLORIDE 0.9% 250ML    $     129.50
40560104   IV SODIUM CHLORIDE 0.9% 100ML    $     129.50
40560112   IV SODIUM CHLORIDE 0.9% 50ML     $     129.50
40560120   DEXTROSE 5% NACL 0.9% 1000ML     $     129.50
40560146   DEXTROSE 5% NACL 0.45% 1000ML    $     129.50
40560153   DEXTROSE 5% NACL 0.45% 500ML     $     129.50
40560161   DEXTROSE 5% NACL 0.225% 1000ML   $     129.50
40560187   IV SODIUM CHLORIDE.45% 1000ML    $     129.50
40560195   DEXTROSE 5% IN LR 1000ML         $     129.50
40560203   DEXTROSE 5% IN LR 500ML          $     129.50
40560211   LACTATED RINGERS 1000ML          $     129.50
40560229   LACTATED RINGERS 500ML           $     129.50
40560237   IV RINGERS 1000CC                $     129.50
40560328   DEXTROSE 10% IN WATER 500ML      $     129.50
40600017   CULT SCRN SINGLE ORG             $      90.00
40600025   CULT STOOL SALM/SHIG             $     424.50
40600041   CULT UR W/COLONY CNT             $     250.50
40600058   PINWORM EXAM                     $     136.50
40600082   SMEAR GRAM/GEIMSA                $     158.00
40600124   MIC                              $     204.25
40600132   TISSUE EXAM FOR FUNGI            $     136.50
40600157   CULT BLOOD                       $     380.00
40600173   CULTURE UR                   $    55.50
40600181   CULTURE ANAEROBIC            $   291.00
40600199   CULTURE BACT                 $   357.75
40600223   CULT SCR STREP               $    90.00
40600264   INDIA INK PREP (SMEAR)       $   158.00
40600272   SMEAR WET MOUNT              $   158.00
40600314   CULTURE ANAEROBIC            $   512.25
40600322   CULT ANAEROB GENITAL         $   271.25
40600363   MIC/ID/STAPH                 $   204.25
40600371   CULT ANAEROB GENITAL         $   241.50
40600389   CULT ENVIRONMENTAL NC        $    43.25
40600397   VENIPUNCTURE OP              $    34.25
40600439   CULT SCREEN VRE              $   488.00
40600447   CULT SCRN SINGLE ORG         $    90.00
40600454   CULT AEROBIC OTHER QN        $   357.75
40610024   ASO TITER                    $    28.00
40610032   COLD AGGLUTININ SCRN         $   201.75
40610040   MONO TEST SCRN               $   164.75
40610057   RHEUMATOID FACTOR QN         $   176.00
40610065   SYPHIL VDRL/RPR QL           $   158.00
40610073   SKIN TEST COCCIDIO           $   179.75
40610081   SKIN TEST TB INTRADRM        $   179.75
40610099   PREG URINE VISUAL            $   196.25
40610115   HISTOPLASMOSIS SKIN TST      $   142.25
40610123   SKIN TEST EA                 $   176.00
40610131   PANEL MENINGITIS             $   640.00
40610149   IMMUNOASSAY STREP A          $    82.00
40610156   HCG PREG QL                  $   233.00
40610164   PHOSPHATIDYLGLYCEROL         $   534.75
40610180   PART AGG SCRN E COLI/NI      $   122.00
40610198   SKIN TEST CANDIDA            $   142.25
40610214   PART AGG AB STREP B          $   122.00
40610242   INFLUENZA AB                 $   156.50
40610263   RUBELLA AB                   $   182.75
40610271   H PYLORI AB                  $   201.00
40610289   EIA QL MULTI AG              $   224.00
40610305   HIV-1/HIV-2 AB SINGLE        $   331.25
40610313   EIA QL C DIFF TOX AG         $   224.00
40610321   LYME DISEASE AB              $   391.75
40610328   RAPID HIV 1&2 SINGLE ASSAY   $   198.50
40620007   UA AUTO W/O MICRO            $   102.25
40620015   UA AUTO W/MICRO              $   141.50
40620023   UA MICRO ONLY                $    77.75
40620049   OCC BLD FEC QL 3 SPEC        $    69.75
40630006   ACETONE/KETONES QN           $   158.00
40630022   ALBUMIN SERUM                $   158.00
40630030   PHOSPHATASE ALKALINE         $   158.00
40630055   AMMONIA                      $   273.75
40630063   AMYLASE                      $   226.75
40630071   BILIRUBIN TOTAL              $    57.00
40630097   ALCOHOL                      $   240.75
40630105   UREA NITROGEN BLOOD          $   158.00
40630113   CALCIUM TOTAL                $   158.00
40630121   CPK TOTAL                    $   216.00
40630139   CREATININE BLOOD             $   164.75
40630147   CREATININE CLEARANCE         $   291.00
40630196   GENTAMICIN TROUGH            $   313.50
40630204   GLUCOSE BLOOD                $   164.75
40630212   GLUCOSE POST DOSE            $   176.00
40630279   LACTATE DEHYDRO (LDH)   $     216.00
40630287   LIDOCAINE               $     313.50
40630295   LIPASE                  $     123.00
40630303   MAGNESIUM               $     176.00
40630311   PHOSPHORUS              $     176.00
40630337   PROTEIN TOTAL           $     158.00
40630352   PROTEIN TOTAL OTHER     $     179.75
40630378   SALICYLATE              $     201.75
40630386   AST/SGOT                $     176.00
40630394   ALT/SGPT                $     176.00
40630402   SPEC GRAV NON URINE     $     136.50
40630410   THEOPHYLLINE            $     313.50
40630428   TOBRAMYCIN PEAK         $     313.50
40630436   URIC ACID BLOOD         $     176.00
40630501   OSMOLALITY BLOOD        $     224.00
40630519   PHENYTOIN TOTAL         $     313.50
40630527   ACETAMINOPHEN           $     313.50
40630543   DIGOXIN                 $     313.50
40630550   CHOLESTEROL TOTAL       $     158.00
40630568   IRON                    $     224.00
40630576   TRIGLYCERIDES           $     194.75
40630584   LACTATE/LACTIC ACID     $     224.00
40630592   COMP METABOLIC PANEL    $     626.75
40630618   CPK MB ONLY             $     534.75
40630626   CARBAMAZEPINE TOTAL     $     316.00
40630634   BASIC METABOLIC PANEL   $     427.00
40630675   LIPID PANEL             $     235.00
40630683   CREATININE UR 24HR      $     164.75
40630691   THYROID HORMONE UPTKE   $      98.50
40630709   BILIRUBIN DIRECT        $     148.75
40630717   GLUCOSE BLOOD           $     113.00
40630725   OSMOLALITY URINE        $     224.00
40630733   GENTAMICIN PEAK         $     313.50
40630741   AMYLASE UR RAN          $     226.75
40630758   MUCIN CLOT SYNOVIAL     $     125.00
40630766   VISCOSITY               $      34.25
40630782   GLUCOSE                 $     164.75
40630790   CREATININE UR RAN       $     164.75
40630808   SODIUM UR RAN           $     141.50
40630816   POTASSIUM UR RAN        $     158.00
40630824   PROTEIN UR RAN          $     158.00
40630832   SODIUM UR 24HR          $     141.50
40630840   PROTEIN UR 24HR         $     158.00
40630857   AMYLASE FLD             $     226.75
40630865   LDH FLD                 $     216.00
40630873   HEMOGLOBIN FETAL QL     $     147.00
40630899   CHLORIDE OTHER          $     164.75
40630907   PROTEIN TOTAL OTHER     $     116.25
40630923   ELECTROLYTE PANEL       $     327.75
40630949   BILIRUBIN NEONATAL      $     240.75
40630956   24 HR URINE POTASSIUM   $     147.00
40630972   GLUCOSE BODY FLUID      $     154.00
40630980   DRUG SCRN UR SGL 1ST    $     505.75
40630987   GENERAL HEALTH PANEL    $   1,029.00
40631020   IRON BINDING CAPACITY   $     208.00
40631038   HEMOGLOBIN A1C          $     194.00
40631046   HEPATIC FUNC PANEL      $     338.00
40631053   THYROXINE FREE          $     273.75
40631061   PHENOBARBITAL           $     313.50
40631079   GGT/GGTP                 $    97.75
40631087   CARCINOEMBRYONIC AG      $   372.25
40631095   FERRITIN                 $   265.50
40631103   FOLLICLE STIM HORMONE    $   310.00
40631111   CHLORIDE UR 24HR         $   141.50
40631129   PREALBUMIN               $   247.75
40631137   BILIRUBIN DIRECT         $    50.75
40631145   TRIIODOTHYRONINE TOT     $   300.50
40631178   CREATININE FLD           $   164.75
40631186   ESTRADIOL                $   671.75
40631210   CHOLESTEROL HDL          $   177.00
40631228   LITHIUM                  $   193.50
40631236   THYROXINE TOTAL          $   174.00
40631244   THYROID STIM HORMONE     $   287.25
40631251   HCG QN                   $   227.50
40631269   ASSAY OF PSA TOTAL       $   288.00
40631277   DIPROPYL/VALPROIC ACID   $   271.25
40631285   PANEL GLUCOSE TOL 2      $   258.50
40631301   PROLACTIN                $   294.00
40631319   LUTEINIZING HORMONE      $   294.00
40631327   FOLIC ACID SERUM         $   294.00
40631335   VITAMIN B-12             $   294.00
40631343   GTT 3HR 1ST 3 SPEC       $   179.50
40631350   TRANSFERRIN              $   293.75
40631351   GTT 3HR EA ADD           $   120.50
40631359   GTT 4HR 1ST 3 SPEC       $   179.50
40631367   GTT 4HR EA ADD           $   179.75
40631368   MYOGLOBIN                $   296.50
40631375   GTT 5HR 1ST 3 SPEC       $   179.50
40631376   TROPONIN QN              $   227.00
40631383   GTT 5HR EA ADD           $   239.25
40631391   GTT 6HR 1ST 3 SPEC       $   179.50
40631392   RENAL FUNCTION PANEL     $   511.00
40631399   GTT 6HR EA ADD           $   297.75
40631400   PSA SCRN                 $   366.75
40631418   PSA FREE                 $   402.00
40631425   C-REACTIVE PROTEIN       $    58.25
40631439   LACTOSE TOL 3 SPEC       $    92.00
40631446   LACTOSE ADD SPECIMEN     $    92.00
40631460   FETAL FIBRONECTIN        $   597.25
40631467   B TYPE BNP               $   578.25
40631474   CHOLEST LDL DIR MEAS     $   163.25
40631481   CRP HIGH SENSITIVITY     $   221.00
40631495   CORTISOL AM PM DRAW      $   194.75
40631501   VANCOMYCIN               $   313.50
40640013   BLEEDING TIME            $   334.75
40640039   FIBRINOGEN ACTIVITY      $   243.25
40640047   D-DIMER QN               $   224.00
40640054   PROTHROMBIN TIME         $   173.50
40640062   PARTIAL THROMBO TIME     $   223.25
40640069   PLATELET AGG EA AGENT    $   264.50
40650004   BLOOD GAS PH PCO2 PO2    $   417.25
40650012   CARBON DIOXIDE           $   158.00
40650020   SODIUM OTHER             $   141.50
40650038   POTASSIUM                $   158.00
40650046   CHLORIDES BLOOD          $   164.75
40650061   BLOOD GAS PH             $   216.00
40650079   BLOOD GAS PH PCO2 PO2    $   417.25
40650087   BLOOD GAS PH PCO2 PO2    $   417.25
40650103   CHLORIDE UR RAN                  $   107.25
40650137   CARBON MONOXIDE QN               $   297.50
40650144   CALCIUM IONIZED                  $   199.75
40660052   CROSSMATCH IMMED SPIN            $   436.00
40660060   COOMBS DIRECT                    $   164.75
40660078   RBC AB SCR                       $   181.25
40660159   PI RH(D) T&H                     $   126.25
40660167   ABO                              $   126.25
40660175   RBC AB SCR                       $   126.25
40660183   ABO                              $   103.25
40660191   PI RH(D) TYPE & RH               $   103.25
40660199   RH (D)                           $    95.25
40660207   RBC AB SCR                       $    95.25
40660215   HEM/AGG AUTO SCRN EA             $    95.25
40670010   CELL CT FLUID W/DIFF             $   300.50
40670044   CBC W/AUTO DIFF                  $   273.75
40670051   BUFFY COAT MAN DIFF              $   237.50
40670069   HEMATOCRIT SPUN                  $   164.75
40670077   CBC AUTO W/O DIFF                $   201.75
40670093   RBC WBC OR PLT MANL              $   148.25
40670101   RETICULOCYTE AUTO                $   216.00
40670119   SED RATE RBC NON AUTO            $   158.00
40670176   SMEAR WBC STOOL                  $   158.00
40670184   SEMEN ANALYS W/O HUHN            $    80.00
40670192   CRYSTAL ID LT MICROSC            $   276.00
40670200   HGB F KLEIHAUER-BETKE            $   123.50
40680092   ALUMINUM SERUM/QUEST             $    21.15
40680231   PI GRAM STAIN SMEAR FLUORSCENT   $    82.50
40680233   ALDOLASE/QUEST                   $     7.50
40680238   PI CONCENTRATION INFECT AGENT    $    82.50
40680241   ALPHA 1 ANTITRYP W PHENO/QUEST   $    30.18
40680282   ANA/HCCL                         $    50.00
40680290   ANTI DNA/HCCL                    $   116.00
40680308   ANTIMITROCHRONDIAL/HCCL          $   116.00
40680324   ANTISMOOTH MUSCLE/QUEST          $     9.85
40680340   CALCIUM 24 URINE/HCCL            $    58.25
40680399   COMPLEMENT C3/HCCL               $   115.50
40680407   CORTISOL/HCCL                    $   111.00
40680423   CRYOGLOBULIN/QUEST               $    17.50
40680480   ESTRIOL/QUEST                    $    28.89
40680522   FUNGUS CULTURE/HCCL              $    81.00
40680548   GASTRIN/QUEST                    $    13.89
40680555   GLUCOSE 6 P04/HCCL               $    58.50
40680571   HAPTOGLOBIN/HCCL                 $   121.00
40680605   HEMOGLOBIN ELECTRO/HCCL          $    62.00
40680613   HEMOSIDERIN/QUEST                $     6.97
40680654   IMMUNO ELECTRO/HCCL              $   215.00
40680670   INSULIN/HCCL                     $   110.00
40680682   MALARIA PREP/HCCL                $    38.50
40680689   CA 15-3/HCCL                     $   126.50
40680703   ANTI SSA/HCCL                    $    78.75
40680710   ANTI SSB/HCCL                    $   157.50
40680717   ANTI SMITH/HCCL                  $   157.50
40680724   ANTI RNP/HCCL                    $   157.50
40680731   ANTI J01/HCCL                    $   157.50
40680738   ANTI SCL 70/HCCL                 $   157.50
40680795   METANEPHRINES/QUEST              $    25.74
40680811   OVA & PARASITES/HCCL             $    85.75
40680852   SPE/HCCL                         $   103.50
40680902   TESTOSTERONE/HCCL                $   165.75
40680969   VMA/QUEST                        $    22.51
40681009   ACID PTASE/QUEST                 $     9.75
40681025   PROGESTERONE/HCCL                $   200.75
40681041   TOXOPLASMOSIS ANTIBODY/QUEST     $    15.15
40681058   CMV/IGG/QUEST                    $    10.25
40681066   COMPLEMENT C4/HCCL               $   115.50
40681074   CAROTENE/HCCL                    $    12.88
40681090   HSV CULTURE/HCCL                 $   233.50
40681108   LEAD BLOOD/HCCL                  $    58.25
40681116   HUMAN GROWTH HORMONE/HCCL        $   200.00
40681132   IGE BY RIA/HCCL                  $   158.50
40681165   CATECHOLAMINES FRACT URINE/QUE   $    18.48
40681173   CATECHOLAMINE FRACT PLASMA/QUE   $    27.02
40681207   ALPHA FETOPROTEIN/HCCL           $   159.00
40681237   PTH RELATED PROTEIN/QUEST        $   105.00
40681249   COPPER SERUM/QUEST               $     7.89
40681256   HLA B27/QUEST                    $    18.82
40681264   NORPACE/QUEST                    $    20.96
40681298   CH 50/QUEST                      $    10.63
40681330   NORTRIPTYLINE/QUEST              $    15.25
40681363   RESP SYNCYTIAL VIRUS/HCCL        $    89.50
40681371   HEP B SURFACE AG/HCCL            $    99.50
40681389   FLECAINIDE/QUEST                 $    19.26
40681413   ROTAVIRUS/HCCL                   $    89.50
40681421   DHEA-S/HCCL                      $   214.00
40681439   HEP B SURFACE AB/HCCL            $   103.50
40681447   CERULOPLASMIN/HCCL               $   103.50
40681454   GIARDIA EIA/HCCL                 $    89.50
40681470   HEPATITIS C/HCCL                 $   137.50
40681482   PI HEP C GENOTYPE SEP/QUEST      $    26.84
40681484   PI HEP C GENTYP SEP/QUEST X2     $    37.50
40681488   DNA PROBECHLTRACH(PANEL)/HCCL    $    97.00
40681500   PI HEP C GENOTYPING AMPLIF/BRL   $    70.00
40681506   PI HEP C GENOTYPING REVERS/QST   $    26.80
40681516   PI HEPC GENTYP INTRP/QUEST X2    $    37.50
40681518   PI HEP C GENOTYPE INTERP/QUEST   $    26.80
40681520   CRYPTOCOCCAL LA/HCCL             $    98.00
40681546   CHOLINESTERASE/HCCL              $    50.75
40681559   BORRELIA DNA PCR/QUEST           $   181.80
40681579   AGGLUTININS BRUCELLA/QUEST       $     7.44
40681586   PREGNENOLONE/QUEST               $    79.96
40681595   ANTITHYROID THYROGLOBULIN/HCCL   $   153.00
40681603   24 HR URINE ARSENIC/QUEST        $    17.68
40681645   THYROID PEROXIDE/HCCL            $    73.00
40681652   ANTI-DNASE B/QUEST               $    15.51
40681694   ANTIBODY ID/HCCL                 $   162.50
40681702   ANTI-CENTROMERE ANTIBODY/QUEST   $    72.72
40681710   AMIKACIN PEAK/QUEST              $    14.52
40681728   AMIKACIN TROUGH/QUEST            $    14.52
40681736   AMIKACIN RANDOM/QUEST            $    14.52
40681744   ZINC PROTOPORPHYRINS/QUEST       $    57.50
40681751   VDRL CSF/QUEST                   $    17.20
40681769   VITAMIN A/QUEST                  $    15.71
40681777   ZINC SERUM/QUEST                 $    12.12
40681801   VARICELLA ZOSTER IGG/HCCL        $   124.00
40681843   RUBEOLA IMMUNITY SCREEN/HCCL     $   124.00
40681884   RBC FRAGILITY /MAYO              $    77.16
40681918   F TULARENSIS AGGLUTININ/QUEST    $    13.04
40681959   MYOGLOBIN QL URINE/QUEST         $    13.35
40681975   MERCURY BLOOD/QUEST              $    17.70
40681983   24 HR URINE MERCURY/QUEST        $    19.34
40681991   LEUKOCYTE ALK PHOSPHATE/QUEST    $    10.91
40682007   MARIJUANA QL URINE/HCCL          $    29.00
40682031   24 HR URINE LEAD/QUEST           $    14.63
40682056   IGG/HCCL                         $    86.00
40682072   IGM/HCCL                         $    63.00
40682080   HEPATITIS BE ANTIGEN/QUEST       $     9.34
40682098   IGA/HCCL                         $    63.00
40682106   HEP B CORE AB TOTAL/HCCL         $   116.00
40682122   HEPATITIS BE ANTIBODY/QUEST      $     9.34
40682130   HEMOGLOBIN A2 QUANT/HCCL         $   173.75
40682148   HEPATITIS A VIRUS IGM /HCCL      $   108.25
40682155   HEPATITIS B CORE AB IGM/HCCL     $   113.25
40682163   RBC FOLATE/HCCL                  $   479.75
40682171   FRUCTOSAMINE/QUEST               $     6.42
40682189   FTA ABS/QUEST                    $     8.62
40682197   VONWILLEBRANT MULTIMERIC/QUEST   $    68.88
40682205   FACTOR IX/ COAG CENTER/QUEST     $    48.18
40682213   FECAL FAT QUAL/QUEST             $    16.16
40682221   DIAZEPAM/QUEST                   $    14.36
40682247   EXTRACTABLE NUCLEAR AG/HCCL      $   157.57
40682262   DXYLOSE TOLERANCE/QUEST          $    12.76
40682270   DESIPRAMINE/QUEST                $    17.46
40682288   CYCLOSPORIN/HCCL                 $   173.75
40682296   CRYPTOSPORIDIUM/HCCL             $    52.25
40682353   PRENATAL (PANEL W/ HBSAG)        $    98.75
40682411   24 HR UR IMMUNOELECTRPHOR/HCCL   $   215.00
40682478   DNA PROBE GC/HCCL                $   112.75
40682486   DNA PROBE CHLAMYD IATRACH/HCCL   $   112.75
40682494   HEPATITIS ACUTE WITH C/HCCL      $   359.00
40682536   RUBEOLA IGG & IGM/QUEST          $    47.36
40682635   MYCOPLASMA UREA CULTURE/QUEST    $    21.60
40682641   MYCOPLASMA CULT PNEUMONIAE/QUE   $    23.23
40682643   PERTUSSIS PCR/QUEST              $   206.78
40682650   VIRAL CULTURE /QUEST             $    27.21
40682652   PI FLOWCYTOMETRY/READ 9-15       $   118.18
40682657   PI FLOWCYTOMETRY/TC 1 MARKER     $   118.18
40682665   PI FLOWCYTOMETRY/TC ADD-ON       $   118.19
40682676   LEGIONELLA CULTURE/HCCL          $    63.75
40682692   NON-NIDA/HCCL                    $    38.50
40682718   ANTITHROMBIN III/QUEST           $    15.09
40682817   VON WILLEBRANDS A9/QUEST         $    99.00
40682858   TOTAL ESTROGENS SERUM/QUEST      $    22.98
40682866   PNUEMOCYSTIS DFA/QUEST           $    68.68
40682874   ANTICARDIOLIPIN ANTIBODY/HCCL    $   244.75
40682880   PI PNEUMOCYSTIS CARINII /QUEST   $    34.00
40682882   24 HR URINE URIC ACID/HCCL       $    45.75
40682887   PI PNEUMOCYSTIS CONCENTRAT/QUE   $    34.00
40682932   SCHLICTER TEST/HCCL              $   144.50
40682940   NATURAL KILLER CELLS/QUEST       $    66.66
40682973   ZARONTIN/QUEST                   $    12.73
40683013   24 HR UR PROTEIN ELECTRO/HCCL    $   103.50
40683104   24 HR URINE UREA NIT/HCCL        $    45.75
40683112   SUGAR WATER TEST/QUEST           $    24.24
40683120   THYROID STIMULATING IMMUNO/QUE   $    64.34
40683145   DEXAMETHASONE/QUEST              $    56.96
40683146   PROTEIN S IMMUNO COAC CTR/QUES   $    40.40
40683161   SJOGRENS PRECIPITINS/HCCL        $   315.00
40683179   PROTEIN C ANTIGEN/QUEST          $    30.00
40683187   PROTEIN ELECTTRO RAN URINE/HCC   $   103.50
40683195   PROTEIN S FUNCTION/QUEST         $    28.79
40683229   PROTEIN C FUNCT/QUEST            $    31.85
40683237   PARVOVIRUS AB/LC/QUEST           $    25.00
40683245   24 HR URINE PHOSPHORUS/HCCL      $    50.00
40683278   MYCOPLASMA TITER/QUEST           $    21.08
40683286   OSTEOCALCIN/QUEST                $    32.08
40683336   HALDOL/QUEST                     $    21.15
40683351   APOLIPOPROTEIN A1 & B/QUEST      $    11.53
40683369   BORDETELLA PERTUSSIS AB/QUEST    $    40.09
40683377   CALCIUM RANDOM URINE/HCCL        $    49.75
40683473   TISSUE TRANSGLUTAMINASE/QUEST    $    33.33
40683518   ANTI-DNA (SS)/QUEST              $    24.55
40683526   ANTI-SPERM ANTIBODIES/QUEST      $    93.01
40683534   APOLIPOPROTEIN A1/QUEST          $     5.77
40683542   APOLIPOPROTEIN B/QUEST           $     5.76
40683575   C1Q COMPLEMENT/QUEST             $    16.76
40683617   CLOMIPRAMINE/QUEST               $    55.05
40683682   HISTOPLASMA ANTIBODIES/QUEST     $    39.53
40683690   INTERLEUKIN 2/QUEST              $   115.90
40683724   24 HR MAGNESIUM/HCCL             $    32.25
40683732   PLATELET AB INDIRECT/COAG CENT   $    40.40
40683765   TETANUS ANTITOXOID AB/QUEST      $    25.28
40683781   FREE T3/HCCL                     $   163.00
40683815   GABAPENTIN/QUEST                 $    20.05
40683831   METHYLMALONIC ACID/QUEST         $    35.00
40683856   FK506/HCCL                       $   132.25
40683864   COLLAGEN X-LINK N-TELO PNL/QUE   $    27.68
40683872   REVERSE T3/QUEST                 $    19.80
40683914   HOMOCYSTEINE SERUM/HCCL          $   278.50
40683930   COPPER LIVER TISSUE /MAYO        $    86.20
40683948   VIP/QUEST                        $    35.89
40683955   GLIADIN ANTIBODIES/QUEST         $    28.28
40684017   BUPROPION (WELLBUTRIN)/QUEST     $    89.88
40684059   HELICOBACTER IGM/QUEST           $    15.80
40684066   NICKEL PLASMA /NATIONAL MED      $    66.00
40684108   TICK ID/QUEST                    $    33.68
40684158   CLOZARIL/QUEST                   $    19.00
40684166   LEGIONELLA AG GURINE/QUEST       $    16.00
40684204   HIV-1 RNA QUANT/QUEST            $    91.91
40684239   CARNITINE&METABOLIC/QUEST        $    53.13
40684255   HEP C PCR/QUEST                  $    90.99
40684298   PROCAINAMIDE/HCCL                $   161.25
40684301   FACTOR V/QUEST                   $    48.18
40684328   FACTOR X ACTIVITY CLOTTING       $    29.00
40684336   IRON LIVER TISSUE /MAYO          $    92.55
40684344   FACTOR XI/QUEST                  $    44.64
40684352   FACTOR XII/QUEST                 $    48.18
40684387   II-DEOXYCORTISOL CMPD/QUEST      $    34.81
40684409   IGFBP-3/QUEST                    $    33.25
40684425   HEP B DNA PCR/QUEST              $   165.00
40684441   FACTOR II/QUEST                  $   115.14
40684468   FACTOR VII/QUEST                 $    29.00
40684476   FACTOR VIII/QUEST                $    44.64
40684514   LYMES WB/QUEST                   $    19.06
40684565   LAMOTRIGINE/QUEST                $    19.03
40684573   LIPOPROTEIN (A)/HCCL             $   135.75
40684581   17-OH PREGNENOLONE/QUEST         $    39.00
40684611   ESTRONE/QUEST                    $    26.92
40684638   HOMOCYSTINE, URINE/QUEST         $   105.00
40684646   BETA 2 GLYCOPROTEIN/HCCL         $   297.00
40684654   CALCULUS ANALYSIS QN/QUEST       $    18.38
40684689   ULTRASENS HIV RNA/QUEST          $    91.91
40684713   TOPIRAMATE/QUEST                 $    40.00
40684794   PI EBNA NUC ANTIG/NRL            $    38.50
40684808   PI VCA/NRL                       $    38.50
40684816   PI CMV/ICG/QUEST                 $    11.06
40684824   PI CMV IGM/QUEST                 $    11.06
40684905   PI (HBC AB) IGG/IGM/NRL          $    21.42
40684913   PI (HBS AB)/NRL                  $    21.42
40684921   PI (HBS AG)/NRL                  $    21.41
40684973   PI B CELLS TOTAL COUNT           $    16.00
40684980   PI T CELL TTL COUNT/QUEST        $    15.99
40684987   PI NK CELLS TOTAL COUNT          $    15.99
40685081   PI DNA ACID ANTI/SNL             $    65.00
40685103   PI ANA ANTIBODIES/HCCL           $    65.00
40685110   PI ANTIGEN COMPLIMENT EA         $    65.00
40685117   PI EXTRACTABLE NUCLEAR AB        $    65.00
40685278   PI FLUORES ANTIB/QUEST           $    48.61
40685286   PI FLUORCES TITER/NRL            $    46.20
40685413   PI HERPES SIMP TYPE I/QUEST      $     7.03
40685421   PI HERPES SIMP TYPE 1/QUEST      $     7.50
40685428   PI/ HSV AB IGG                   $     7.02
40685442   GAMMAGLOBULIN -IgA/IgD/IgG/IgM   $     3.50
40685448   PI ALBUMIN SERUM                 $     3.50
40685456   PI GLUCOSE QUANTITVE             $     3.50
40685464   PI GLYCATED PROTEIN              $     3.50
40685472   PI/ GAMMABLOBULIN                $     3.50
40685480   PI IMMUNE COMPLEX                $     3.50
40685499   PI SUB PLASM/COAG CNTR           $    41.73
40685502   PI THROMBIN /COAG CNTR           $    41.73
40685510   PI RUSS V VEN/COAG CNT           $    41.73
40685529   PI PRO TIME/COAG CNTR            $    41.73
40685533   NUCLEAR ENZYMATIC/SLI            $    20.00
40685537   PI PLATELET N/COAG CNT           $    41.73
40685545   NUCLEAR MOLECULAR ISO OR EXTRT   $    20.00
40685561   PANEL NUCLEAR SEPERRATION/SLI    $    20.00
40685588   NUCLEIC ACID PROBE/SLI           $    20.00
40685618   NUCLEAR MOLECUL INTERP/RPT/SLI   $    19.85
40685690   PI VIRUS NOT OTHERWISE SPECIFI   $    13.06
40685698   PI/ RUBELLA                      $    13.06
40685706   PI/ TOXOPLASMA                   $    13.07
40685714   PI/CYTOMEGALOVIRUS (CMV)         $    13.07
40685722   PI/TOXOPLASMA IGM                $    13.07
40685730   PI/ CMV (IGM)                    $    13.07
40685738   PI/HERPES SIMPLEX TYPE 1         $    13.07
40685746   PI/HERPES SIMPLEX N/S            $    13.07
40685754   PI/ANTINUCLEAR ANTIBODIES ANA    $     1.75
40685762   PI/ANTITHYROID MICROSOMAL        $     1.75
40685770   PI/COMPLEMENT ANTIGEN            $     3.50
40685778   PI/ DNA ACID ANTIBODY            $     1.75
40685786   PI/EXTRACT NUCLEAR ANTI          $     8.75
40685794   PI/RHEUMATOID FACTOR (RH)        $     1.75
40685802   PI/FOURESCENT ANTIBODY           $    10.50
40685880   PI/PROTEIN                       $     6.24
40685888   IgG SERUM                        $    48.80
40685896   PI/ALBUMIN SERUM                 $    12.51
40685904   IgG CSF                          $    48.80
40685912   PI/MYELIN BASIC PROTEIN, CSP     $     6.24
40685919   ALBUMIN SERUM                    $    48.80
40685926   ALBUMEN CSF                      $    48.80
40685933   OLIGOCLONAL BANDING CSF          $    48.80
40685936   PI/PROTEIN TOTAL                 $    18.76
40685944   PI/ ELEC FRACT & QUANT           $     9.38
40685952   PI/GAMMAGLOBULIN                 $    28.10
40685960   PI/NEPHELOMETRY                  $    18.76
40686014   A-PTT PI (LUPUS)                 $    57.75
40686021   DRVVT PI (LUPUS)                 $    92.00
40686028   C1 ESTERASE INHIB/FUNCTL QUEST   $    25.12
40686034   LATEX IGE /QUEST                 $     7.07
40686047   ANTIBODY CHLAMYDIA IgM PI        $    15.02
40686054   ANTIBODY CHLAMYDIA PI            $    15.01
40686056   PI/BLOOD TYPING ABO              $    35.04
40686068   STACHYBOTRYS IgE PI QUEST        $    41.13
40686075   STACHYBOTRYS IgG PI QUEST        $    41.13
40686082   STACHYBOTRYS ANALYTE PI/QUEST    $    41.14
40686095   CHROMOSOME LYMPH-ANAL PI QUEST   $    99.66
40686096   PI/EB VIRUS (VCA)                $    94.25
40686102   CHROMOSOME ANAL COUNT PI QUEST   $    99.66
40686104   PI/EBNA NUCLEAR ANTIGEN          $    94.25
40686109   CHROMOSOME ANAL CYTOGEN PI QST   $    99.68
40686112   PI/EB VIRUS EARLY ANTIGEN (EA)   $    94.25
40686160   PI/HYDROXYPROLINE; FREE          $    33.75
40686168   PI/HYDROXYPROLINE; TOTAL         $    33.75
40686176   PI/TT3; TOTAL                    $    44.00
40686192   PI/NOT OTHERWISE SPECIFIED       $     1.75
40686272   PI/INFECTIOUS AGENT CONCENT      $     5.00
40686280   PI/ OVA AND PARASITES            $     5.00
40686288   PI/BARBITURATES NOT ELSEWHR SP   $     9.90
40686296   PI/PRIMIDONE ASSAY               $     5.64
40686368   PI LD & LDH                      $     6.94
40686376   PI ISOENZYMES; SEPARAT & QUANT   $     6.94
40686416   PI/MERCURY QUANTITATIVE          $     2.00
40686424   PI/CREATININE OTHER SOURCE       $     2.00
40686432   PI/MICROALBUMIN                  $    45.45
40686439   PI HER-2 FISH DNA PROBE          $    32.40
40686440   PI CREATININE                    $    45.45
40686446   PI HER 2 FISH ANALYSIS           $    32.40
40686448   PI/PROTEIN; TOTAL                $     4.00
40686453   PI HER 2 FISH CYTOGEN REPORT     $    32.40
40686456   PI/ELECTROPHORETIC FACT & QUAN   $     4.00
40686460   HER 2 FISH CYTOGEN REPORT        $    34.19
40686496   PI/CALCIUM; TOTAL                $   198.50
40686504   PI/PARATHYROID HORMONE           $   171.12
40686512   PI/HEPATITIS B SURFACE ANTIGEN   $     6.06
40686520   PI/IgM ANTIBODY                  $     6.06
40686528   PI/IgM ANTIBODY                  $     7.58
40686536   PI/HEPATITIS C ANTIBODY          $     6.06
40686544   PI/HEMOGLOBIN ELECTROPHORESIS    $     8.32
40686552   PI/SICKLING OF RBC, REDUCTION    $     8.33
40686560   PI/PROTOZOA NOT ELSEWHERE SPEC   $    11.75
40686568   PI/GEL DIFFUSION QUALITATIVE     $    30.60
40686576   PI/ASPERGILLUS                   $    30.61
40686583   PI/ HYPERSENS PNEUMONITIS        $    25.56
40686584   PI/ANTIBODY ACTINOMYCES          $    23.50
40686592   PI/PROTEIN; TOTAL                $     3.33
40686600   PI/GAMMAGLOBULIN                 $     9.99
40686608   PI/ELECTROPHORETIC FACTIONATIO   $     3.33
40686616   PI/IMMUNOELECTROPHORESIS SERUM   $     3.35
40686624   PI/OTHER SOURCE                  $    17.00
40686632   PI/COLLAGEN CROSS LINKS          $    17.00
40686688   PI/PHOSPHATASE ALKALINE          $     7.58
40686696   PI/ISOENZYMES                    $     7.57
40686720   PI/MICROSOMAL ANTIBODIES         $    70.75
40686728   PI/THYROGLOBULIN ANTIBODIES      $    70.00
40686736   PI/FLOW CYTOMETRY                $    57.57
40686744   PI/HEMOGRAM                      $    57.57
40686752   PI/CPK CREATINE KINASE           $     7.01
40686760   PI/CPK ISOENZYMES                $     7.00
40686768   PI/FACTOR VIII (AHG) ONE STAGE   $    96.08
40686776   PI/FACTOR VIII RELATED ANTIGEN   $    96.08
40686784   PI/FACT VIII, VW FACT;RISTO CO   $    96.09
40686792   PI/TOXOPLASMA                    $     3.92
40686800   PI/TOXOPLASMA IgM                $     3.91
40686807   PI CULT PATH ORGANISMS SCREEN    $    26.25
40686808   BISMUTH/QUEST                    $    40.09
40686814   PI SMEAR STAIN                   $    26.25
40686816   TIN /NATIONAL MED                $   100.00
40686821   PI ENZYME ACTIVITY ELECTROPHOR   $    12.61
40686824   BABESIA (PANEL)/QUEST            $    72.72
40686828   PI AMYLASE                       $    12.60
40686830   QUINIDINE/HCCL                   $    75.00
40686835   PI MOLECULAR DIAG ISO/EXTRACT    $    29.12
40686846   PI NUCL ACID EXTRAC C15/VIROLG   $    80.00
40686849   PI MOLECULAR DIAG SEPARATION     $    29.12
40686852   PI NUC ENZYM DIGEST C15/VIROLG   $    80.00
40686856   PI MOLECULAR DIAG NUCLEIC PROB   $    29.12
40686858   PI NUCL ACID SEPAR C15/VIROLG    $    80.00
40686863   PI MOLECULAR DIAG INTRP&REPORT   $    29.13
40686864   PI NUCL ACID AMPL C15/VIROLG     $    80.00
40686870   PI REVERS TRANSCRPT C15/VIROLG   $    80.00
40686876   PI TISSUE CULTURE C15/VIROLG     $    80.00
40686882   PI TISS CULT ADDL C15/VIROLG     $    80.00
40686888   PI NUCL ACID INTERP C1/VIROLG    $    80.00
40686895   PHENOTYPE DNA HIV W/CLT ADD      $    80.00
40686944   PNEUMOCOCCAL AB(12-PANEL)QUEST   $    69.00
40686986   HLA ABC TISSUE TYPE/UCLA         $   340.00
40686993   WORM ID/HCCL                     $    21.00
40687007   PI MOLECULAR DIAG ISOLATION      $    37.03
40687014   PI MOLECULAR DIAG AMPLIF         $    37.03
40687021   PI MOLECULAR DIAG SEPARATIN      $    37.03
40687028   PI MOLECULAR DIAG REVERSE        $    37.03
40687035   PI MOLECULAR DIAG NUCLEAR PROB   $    37.03
40687042   PI MOLECULAR DIAG NUCLEOTIDASE   $    37.05
40687049   PANEL HER-2 (FISH)/QUEST         $    97.20
40687056   CD4 CELLS ABSOLUTE/QUEST         $    25.25
40687063   CREATINE/QUEST                   $    25.73
40687070   PI/FEBRILE AG/SALMONELLA/QUEST   $    53.33
40687077   MOLECULAR NUCLEIC AMPLI 2 SEQ    $    31.76
40687079   PI/FEBRILE AG/BACTERIUM/QUEST    $    53.33
40687086   PI/AFEBRILE AG/BRUCELLA/QUEST    $    53.34
40687093   PI/CHLAYMYDIA CULTURE/QUEST      $     8.27
40687100   PI/CHLAMYDIA CLTR/IM-FLR/QUEST   $     8.27
40687107   PI/24 URINE ARSENIC/QUEST        $    17.21
40687114   PI/24 HR URINE LEAD/QUEST        $    17.21
40687121   PI/24 HR URINE MERCURY/QUEST     $    17.22
40687128   PI/AMPLIFICATION N-ACID /QUEST   $    29.13
40687135   PI/DOT SOT BLOT PRODUCT./QUEST   $    29.13
40687142   PI CELIAC/FLORO-ANTIBODY/QUEST   $    61.61
40687149   PI/CELIAC/IMMUNOASSAY/QUEST'     $    61.61
40687156   PI/HSV IGG & IGM/QUEST           $     8.07
40687163   ANAEROBIC ID/HCCL                $    52.25
40687170   AEROBIC ID/HCCL                  $    23.25
40687177   HIV 1 RNA QN PCR EXPAND/QUEST    $   114.89
40687184   HEP C RNA by bDNA/QUEST          $   111.87
40687194   HEPTIMAX ULTRA SENSE.HCV/QUES    $   264.50
40687201   CA125/HCCL                       $   272.50
40687222   PI DNA ISOL/EXTRAC               $    93.60
40687229   PI DNA PROBE                     $    93.60
40687236   PI DNA REACTION                  $    93.60
40687243   PI DNA DOT\SLOT\BLOT             $    93.60
40687250   PI DNA INTERP/REPORT             $    93.60
40687264   PI DNA ISOL/EXTRAC               $    94.75
40687271   PI DNA ENZYMATIC                 $    94.75
40687278   PI DNA PROBE                     $    94.75
40687285   PI DNA SCAN                      $    94.75
40687292   PI DNA INTERP/REPORT             $    94.75
40687306   PI ANALYTE ASSAY MULTI STEP      $    18.46
40687313   PI IMMUNOASSAY ANALYTE QUANTIT   $    18.47
40687320   PI GAMMAGLOBULIN                 $    18.46
40687327   CMV IGM/HCCL                     $   141.24
40687334   CA-19-9 HCCL                     $   174.42
40687341   ERYTHROPIETIN /HCCL              $   157.56
40687348   DIHYDROTESTOSTERONE /QUEST       $    29.34
40687355   CITRULLINE PEPTIDE ANITBDY /QS   $    42.00
40687369   MOLECULAR DX ISOLATION/EXTRACT   $    31.31
40687376   MOLECULAR DX NUCLEIC ACID PRBE   $    31.31
40687383   MOLECULAR DX AMPLIF NUCLEIC      $    31.31
40687390   MOLECULAR DX INTERP & REPORT     $    31.31
40687397   EPIDERMAL GROWTH FACT RCPT/QST   $   130.30
40687405   MOLECULAR DX NUCLEIC AMPLI       $    31.31
40687419   VITAMIN D 25 HYDROXY/HCCL        $   440.00
40687426   INSULIN GROWTH FACTOR/HCCL       $   250.00
40687433   HEPARIN INDUCED PLT AB/QUEST     $   110.48
40688004   HUMAN CALCIVIRUS /UNVER IOWA     $   125.00
40688011   OXYCODONE /QUEST                 $    52.92
40688018   SIROLIMUS /QUEST                 $    65.00
40688025   24HR URINE COPPER /QUEST         $    12.00
40688032   C1Q COMPLEMENT /QUEST            $    35.25
40688039   METHADONE /QUEST                 $    71.71
40688046   W NILE VIRUS IgG/IgM/QUEST       $    55.95
40688053   EOSIN CATIONIC PROTEIN /QUEST    $    72.97
40688060   10-HYDROXYCARBAZEPINE /QUEST     $    37.00
40688067   WEST NILE VIRUS CSF /QUEST       $    55.95
40688074   H PYLORI ANTIGEN /HCCL           $   222.00
40688088   TISSUE CULTURE BONE MARROW       $    68.02
40688095   CHROMOSOME ANALYSIS 20-25        $    68.02
40689002   CHROMOSOME KARYOTYPE STUDY       $    68.02
40689009   CYTO/MOLECULAR REPORT            $    68.03
40689016   MUMPS IgG/HCCL                   $    63.25
40690026   ACTH/PLASMA/QUEST                $    24.31
40690034   ALDOSTERONE SERUM/QUEST          $    26.07
40690067   CALCITONIN/QUEST                 $    20.20
40690141   FECES LIPID/QUEST                $    35.84
40690281   RENIN/QUEST                      $    21.00
40690364   CA 27.29/QUEST                   $    12.03
40690372   CORTISOL URINARY FREE/QUEST      $    13.64
40690380   CANDIDA ANTIBODY/QUEST           $    21.45
40690398   C-PEPTIDE/HCCL                   $   200.25
40690414   COXSACKIE B/QUEST                $    32.85
40690430   CHLORPROMAZINE(THORAZINE)/QUES   $    22.08
40690463   CHORAZEPATE/QUEST                $    14.60
40690471   DHEA/QUEST                       $    18.75
40690497   DIGITOXIN /NATIONAL MED          $    37.00
40690505   SELENIUM/QUEST                   $    29.00
40690513   DOXEPIN/QUEST                    $    17.46
40690596   INTRINSIC FACTOR BLOCK AB/QUES   $    60.85
40690612   5-NUCLEOTIDASE/MAYO              $    62.61
40690638   LSD URINE/QUEST                  $    87.22
40690661   METHOTREXATE/QUEST               $    48.45
40690687   17A- HYDROXYPROGESTERONE/QUEST   $    18.18
40690695   MEXILETINE/QUEST                 $    51.01
40690703   INFLUENZA AB/QUEST               $    25.00
40690711   INSULIN AB/QUEST                 $     8.71
40690729   BETA 2 MICRO SERUM/HCCL          $   155.75
40690745   ANTI-NEUTROPHIL CYTO AB/QUEST    $    58.70
40690794   TEICHOIC ACID/QUEST              $    14.36
40690802   THIORIDAZINE/QUEST               $    69.38
40690828   TRIMIPRAMINE/QUEST               $    51.36
40690836   VITAMIN E/QUEST                  $    15.71
40690844   LYSOZYME/QUEST                   $    22.26
40690851   ANTI-HCV RIBA/QUEST              $    65.65
40690869   MUMPS IGG AB/QUEST               $    11.87
40690943   VITAMIN C/QUEST                  $    10.36
40690976   HPV/QUEST                        $    69.00
40690992   PYRUVIC ACID/QUEST               $    17.23
40691016   SEROTONIN BLOOD/QUEST            $    37.60
40691040   TRAZODONE/QUEST                  $    35.86
40691073   VITAMIN B1/QUEST                 $    22.40
40691081   VITAMIN B6/QUEST                 $    15.23
40691099   VITAMIN D 25 HYDROXY/QUEST       $    21.71
40691107   VITAMIN D1, 25 HYDROXY/QUEST     $    27.20
40691131   ASPERGILLUS/QUEST                $    17.56
40691149   ARSENIC BLOOD/QUEST              $    17.68
40691156   MYELIN BASIC PROTEIN/QUEST       $    15.15
40691172   MANGANESE/QUEST                  $    44.44
40691180   CHROMIUM/QUEST                   $    41.41
40691198   HTLV/QUEST                       $    27.00
40691214   AMOEBA ANTIBODY/QUEST            $    70.00
40691230   ANTIPLATELET ANTIBODIES/QUEST    $    40.40
40691248   FLUOXETINE/QUEST                 $    28.79
40691255   ADENOVIRUS ANTIBODY/QUEST        $    14.36
40691263   ANTIGLOMERULAR MEMBRANE/QUEST    $    51.01
40691271   ANDROSTENEDIONE/QUEST            $    20.60
40691297   ACETYLCHOLINE RECEPTOR AB/QUES   $    27.96
40691313   BLASTOMYCES/QUEST                $    21.37
40691321   ANGIOTENSIN CONVERT ENZY/QUEST   $    11.62
40691339   ALPHA 1 ANTITRYPSIN PHENO/QUES   $    10.00
40691347   AMIODARONE/QUEST                 $    19.19
40691370   IMMUNE COMPLEX (RAJI)/QUEST      $    59.00
40691388   CADMIUM/QUEST                    $    17.30
40691404   CLONAZEPAM/QUEST                 $    16.06
40691412   ANTI-HISTONE AB/QUEST            $    25.65
40691420   COCCIDIOIDES AB/UCDAVIS          $    32.00
40691446   CITRATE 24HR URINE/QUEST         $    22.93
40691479   HOUSE CALL OVER 7 MILES          $    19.00
40691495   DRAWING FEE                      $    10.00
40691503   RBC MG/QUEST                     $    18.69
40691552   NEWBORN SCREENING TEST           $   101.75
40691578   COLLECTION FEE DRUG SCREEN       $    20.00
40691594   COLLCTN FEE LONG BEACH GENETIC   $    30.00
40694084   PI/GAMMAGLOBULIN                 $    27.50
40694092   PI/IMMUNOGLOBULIN SUBCLASSES     $    27.50
40694108   PI/TOTAL TESTOSTERONE            $   162.50
40694116   PI/THYROGLOBULIN ANTIBODY        $     9.79
40694124   PI/THYROGLOBULIN                 $     9.79
40694131   5 HIAA/QUEST                     $    10.10
40694138   17 HYDROXYCORT/QUEST             $    30.71
40694145   17 KETOSTEROIDS/QUEST            $    30.65
40694152   PORPHOBILINOGEN QN/QUEST         $    19.00
40694166   IMIPRAMINE/QUEST                 $    16.92
40694173   AMITRIPTYLINE/QUEST              $    15.66
40694180   OXALATES/QUEST                   $    17.33
40694187   PORPHOBILINOGEN QN/QUEST         $    19.00
40694243   ALDOSTERONE URINE/QUEST          $    35.89
40694250   CYSTINE QN/QUEST                 $    48.45
40694257   DELTA AMINOLV ACID/QUEST         $    27.50
40694264   HOMOVANILLIC ACID/QUEST          $    75.60
40694320   PI PORPHYRINS QUANT & FRACT      $    20.10
40694327   PI PORPHOBILINOGEN QUANT         $    20.05
40694348   PI MOLECULAR DIAGN ISOLATION     $    26.80
40694350   PI MOLCULAR DIAGN ISLTION X2     $    37.50
40694355   PI MOLECULAR DIAGN AMPLIFICAT    $    26.80
40694357   PI MOLCULR DIAGN AMPLFCAT X2     $    37.50
40694362   PI MOLECULAR DIAGN MUTATION      $    26.80
40694364   PI MOLECULAR DIAGN MUTATION X2   $    37.50
40694383   PI PHENOBARBITOL ASSAY           $     5.65
40694418   PI/HSV IGG & IGM/QUEST           $     8.07
40694425   PI/HSV IGG & IGGM/QUEST          $     8.08
40694432   PI HEP B ANTIBODY TOTAL          $     6.06
40694439   PI HEP Be ANTIBODY               $     6.06
40694453   PI CD4 CD8 COUNT                 $    15.99
40694460   PI VIRUS TISSSUE CULT INNOCUL    $     8.49
40694467   PI INFECT AGENT ANTIGEN NOS      $     8.49
40694481   PI MICROALBUMIN URINE QUANT      $    45.45
40694488   PI CREATININE OTHER SOURCE       $    45.45
40694495   PI DIPTHERIA ANTIBODY            $    28.25
40694502   PI TETANUS ANTIBODY              $    28.25
40694509   PI HYDROYPROLINE TOTAL           $    35.89
40694516   PI HYDROXYPROLINE FREE           $    35.89
40694530   PI VIRUS ANTIBODY NEC            $     7.50
40694537   PI NONINFECT ANTIBODY SCRN EA    $    54.95
40694544   PI IMMUNOASSAY NOS               $    54.95
40694565   PI AMINO ACIDS SNGL QUANT        $     5.73
40694607   PI NON ENDOCRINE RECEPTOR ASSY   $    48.61
40694614   PI HORMONE BINDING GLOBULIN      $   162.50
40694621   HIV 1/QUEST                      $    19.38
40694628   HIV 2/QUEST                      $    84.18
40694642   CHROMOGRANIN A/QUEST             $    95.00
40694677   VENIPUNCTURE IP                  $    20.00
40694705   COURIER SERVICE (NEV-COUNTY)     $    85.00
40694712   ASSAY NEPHELOMETRY NOT SPEC      $   127.00
40694719   IMMUNFIX E-PHORSIS/URINE/CSF     $   127.00
40694726   PROTEIN E-PHORESIS SERUM         $   127.00
40694733   ASSAY OF GAMMAGLOBULIN IGM       $   127.00
40694740   VENIPUNCTURE OFF SITE            $    20.00
40755000   GROSS ONLY LEVEL I               $    36.25
40755008   GROSS & MICRO LVL II             $    36.25
40755016   GROSS & MICRO LVL III            $    60.50
40755024   GROSS & MICRO LVL IV             $    73.50
40755032   GROSS & MICRO LEVEL V            $   110.75
40755040   GROSS & MICRO LVL VI             $   156.50
40755048   DECALCIFICATION                  $    36.25
40755056   SPECIAL STAIN I                  $    60.50
40755064   STAIN GROUP II                   $    36.25
40755080   CONSULT PATH REQ PREP            $    60.50
40755096   CONSULT PATH SURGERY             $    60.50
40755104   FROZEN SECT FIRST BLOCK          $    68.25
40755112   FROZN SECT EA ADDL               $    60.50
40755120   IMMUNOCYTO EA AB                 $   104.75
40755234   TECH FEE CYTOPATH/SMEARS W/INT   $    60.50
40755242   TECH FEE CYTOPATH/FILTER W/INT   $    60.50
40755250   TECH FEE CYTOPATH/SMEAR&FILTER   $    66.00
40755258   TECH FEE CYTOPATH/CONCENTRATIO   $    75.75
40755266   TECH FEE CYTOPATH/NON GYN        $    36.25
40755274   CYTO OTHER W/PREP                $    60.50
40755282   SMEAR W/PREP                     $    60.50
40755298   FNA SPEC ADEQUACY                $    89.50
40755306   FNA SPEC ADEQUACY                $    60.50
40755314   FNA INTERPRETATION               $    60.50
40800290   BELT RIB                         $   108.75
40800340   CHEST DRAINAGE DEVICE            $   248.00
40800845   CATH BONANNO                     $   533.00
40800860   CATH COUDE                       $   114.00
40800951   CATH FOLEY 3 WAY                 $   110.50
40801314   HEMOVAC                          $   143.75
40801389   CRUTCH ADULT                     $   108.75
40801942   IMMOBILIZER SHOULDER             $   119.75
40802015   LEAD PACEMAKER BIPOLAR CORDIS    $   779.00
40802247   NEEDLE BIOPSY                    $   121.50
40802254   NEEDLE MICROVASIVE BIOPSY        $   394.25
40803302   SHIELD FULLER                    $   123.25
40803385   SLING AND SWATHE                 $   134.54
40803799   IMMOBILIZER KNEE S-M-L-XL        $   114.21
40804409   TUBE LAVACUATOR                  $   157.00
40804516   TUBE TRACHEOSTOMY SHILEY         $   585.00
40804763   PILLOW ABDUCTION CHARNLEY        $   189.75
40804821   SPLINT WRIST COCKUP              $   146.00
40805588   CATH SWAN GANZ                   $   437.50
40805653   COLO F LED KIT (HOLLISTER PCH)   $   336.75
40805729   MITY VAC DISPOSABLE              $   171.00
40806032   TRAY URINE METER CATH 16         $   145.00
40806164   CARDIAC DEFIB-MONITOR PADS       $   176.50
40806230   SET BLOOD WARMING                $   143.75
40806263   PCA - INFUSION SET               $   170.00
40807097   TUBE ENDO ORAL PAE               $   132.50
40807568   INTRODUCERS                      $   322.50
40807816   CATH HICKMAN SINGLE LUMEN        $   533.00
40807840   HUMI MANIPULATOR                 $   537.50
40807915   SHUNT JAVID CAROTID              $   515.25
40807964   HICKMAN DOUBLE LUMEN            $     459.00
40808459   DRAIN STRYKER WOUND             $     112.75
40808533   PACK HIP                        $     292.00
40808558   BANDAGE ESMARK 6                $     157.00
40808574   CEMENT ORTHO 1/2 BATCH          $     181.25
40808590   CEM. CANCEL. PRESSURIZER        $     334.00
40808608   CEM. STRT. FEM. NOZZLE          $      94.50
40809259   SCREWS MINI FRAGMENT            $     153.00
40809267   SCREWS SM FRAGMENT              $     158.50
40809275   SCREWS REG CORTICAL             $      92.50
40809283   SCREWS REG CANCELLOUS           $     307.75
40809291   SCREWS MALLEOLAR                $     212.00
40809317   PLATES REG DCP NARROW           $     774.00
40809333   PLATES SM FRAG DCP (3.5)        $   3,552.25
40809341   PLATES 1/3 TUBULAR (3.5)        $     586.75
40809366   PLATES TUBULAR (2.7)            $     365.00
40809390   WASHERS STAINLESS STEEL         $     204.50
40809416   SCREWS ACE CANNULATED           $   1,247.25
40809424   SCREWS DHS LAG                  $     876.00
40809432   PLATES DHS COMPRESSION          $   1,413.50
40809515   KNEE BRACE MED DESIGN           $   1,084.25
40809622   FIBERGLASS ROLLS 3              $      85.25
40809630   FIBERGLASS ROLLS 4              $     112.75
40809648   FIBERGLASS ROLLS 5              $     164.25
40809663   DRAPE ISOLATION IOBAN           $     278.25
40809671   CUTTING LOOP                    $     399.50
40809689   BLADE DERMATOME-PADGETT DISP.   $     146.00
40810026   TROCAR K S CATH                 $     316.25
40810372   KIT ARTERIAL                    $     138.75
40810414   KIT PRESSURE MONITORING         $     112.75
40810760   AS STAPLER ROTICULATOR          $     995.00
40810828   ARTHROSCOPY PACK                $     927.00
40810885   BRONCHO-CATHETER                $     394.25
40810935   BILIARY ASPIRATION              $   1,183.75
40810968   TROCAR/AM 5-8-11-12MM B&NB      $     435.75
40811016   NEEDLE- PORTA-CATH IV           $      94.50
40811099   GASTROSTOMY BUTTON              $   1,496.25
40811131   CATH WORD GLAND                 $     281.25
40820215   PLEURA GARD                     $     621.25
40820348   TRAY PAC(CATH INTRODUCER)       $     243.50
40820397   EPIDURAL TRAY                   $     325.50
40820512   TRAY THORACENTESIS              $     357.50
40820769   TRAY NERVE BLOCK                $     947.00
40820991   MONITOR- COMPARTMENT PRESS      $     141.25
40821155   BASIN SET MINOR                 $     132.75
40821262   SPLINT FIBERGLASS 3 X 12        $     186.00
40821270   SPLINT FIBERGLASS 4 X 15        $     243.50
40821288   SPLINT FIBERGLASS 4 X 30        $     239.25
40830560   TRAY SPINAL                     $     206.25
40831238   COSET                           $     248.00
40831303   FILTER PALL                     $      99.50
40831436   E.C. ACESSOR KIT                $   3,098.50
40831444   NEEDLE VERRES VS#140000         $     211.75
40831477   TROCAR-BLUNT HASSAN #C0178      $     168.00
40831501   LIGACLIP-AM M/L                 $     357.50
40831519   ENDO BABCOCK                    $     620.25
40831543   ENDO SHEARS                     $     313.50
40831550   STAPLER ETS ATB35-ATW35         $   1,940.00
40831568   DLU PROXIMATE TR/TCR/TCT        $     680.00
40831576   DLU TA 30 55 & 90                $     717.00
40831626   BAG RESUSCITATION DISPOSAL       $     220.75
40851418   REINFUSER W/DRAIN DISPOSABLE     $     748.25
40851467   PACK TOFFLE SINUS                $     248.00
40851475   SHUNT VASCO-FLO                  $     628.50
40851483   SUPPORT- MAMMARY                 $     605.25
40851525   DRAPE ENDO-VIDEO                 $     153.00
40851533   SCREW KUROSAKA ACL               $   1,443.00
40851574   MULTILUMEN CVP KIT               $     334.00
40851657   BLANKET- BAIR HUGGER             $      98.00
40851731   SCD SLEEVE                       $     506.00
40851871   ART LINE PRESSURE KIT            $     272.00
40851889   TRAY QUINTON CATH 11.5           $   1,125.50
40851962   BLADDER EVACUATOR UROVAC DISP    $     135.75
40860484   TRACH TUBE PORTEX (SGL CUFF)     $     203.00
40860534   RETRIEVER SUTURE                 $     285.50
40860575   TUBE ET LARYNGOFLEX              $     894.00
40860583   TOURNIQUET ARM DISP              $     275.25
40860708   PORTACATH VENOUS ACCESD          $   2,169.50
40870087   CATH CHOLANGIOGRAM               $     276.25
40870111   FOGARTY CATH EMBOLECTOMY         $     394.25
40870129   CATH FILIFORM                    $     303.25
40870152   MALLECOTT/MUSHROOM CATH          $     193.25
40870178   TUBE T                           $     139.75
40870186   CATH URETERAL                    $     101.50
40870202   CEMENT- ORTHO SIMPL              $     654.00
40870228   COTTON ROLL                      $     141.25
40870277   DRAIN- JACKSON RES.              $     114.00
40870285   JACKSON PRATT DRAIN              $     119.75
40870343   BIOPSY FORCEPS (DISPOSABLE)      $     186.50
40870442   LEGGINGS TRANSVERSE              $     153.00
40870483   FALLOPIAN RING                   $     399.50
40870582   HEMOCLIPS LG/MED                 $      95.00
40870608   MESH MARLEX                      $     857.00
40870616   CEM. HI-VAC MIX BOWL             $     649.75
40870798   PIN STEINMAN                     $     141.25
40870848   INTRA OCULAR LENS                $     517.50
40870854   INTRAOCULAR LENS ARRAY POST CH   $     683.50
40870905   SAW GIGLI DISPOSABLE             $     127.50
40870996   AS SURGICLIP 11 5 13 0           $     553.50
40871002   AS STAPLER GIA REG & MULTIFIRE   $   2,802.25
40871010   AS STAPLER CEEA 25 28 31         $   2,736.50
40871036   STAPLER SKIN                     $      97.75
40871101   NERVE STIMULATOR DISP.           $     327.50
40871127   SUCTION LECTROVAC                $     105.50
40871150   SUTURE TYPE B                    $     382.00
40871408   PACK- BASIC                      $     164.25
40871432   PACK ORTHO                       $     441.75
40871457   PACK- PERI-GYN                   $     199.00
40871499   STOCKINETTE TUBULAR              $     101.50
40871812   FEMORAL SURGICAL WICK            $     250.50
40871861   C-SECTION PACK                   $     842.00
40871887   PACK EXTREMITY                   $     331.00
40871895   LAPROSCOPY PACK                  $     362.25
40871986   FOGARTY BILIARY BALLOON PROBE    $     691.25
40871994   FOGARTY BILIARY IRRIGATOR        $     283.50
40872026   TRAY PEG 20FT                    $   1,248.25
40872109   DYONICS BLADE                    $   1,064.50
40872117   BASIN SET CUSTOM                 $     159.25
40872141   DILATOR- BALLOON- ESOPHAGEAL     $   1,283.25
40872158   OSTOMY IRRIGATION KIT            $     617.50
40872190   SHOULDER ABDUCTION SUPPORT       $     531.25
40872257   SURGICEL 2 X14                   $     318.25
40872281   NEEDLE SCLEROSING                $     555.25
40872307   IMMOBILIZER- UNIVERSAL KNEE      $     498.25
40872380   ESOPHAGEAL STEH W/PROBE          $     116.50
40872471   DERMA CARRIER                    $     123.25
40872919   POLYP SNARE                      $     143.75
40872927   KIT CHOLANGIOGRAPHY              $     203.00
40873065   MESH MARLEX 1X4                  $     528.25
40873099   PACK PHAKO                       $     520.25
40873206   SURGILAV TUBING SET ST           $     355.75
40873289   DHS- DCS COMPR. SCREW            $     130.50
40873693   MARLEX PRE-FIX PLUG              $   1,248.25
40873735   J&J ABSORBABLE PIN               $   1,086.50
40873800   MENTOR ASEPTIC FILL KIT          $     608.00
40874246   XR WIRE INTERVENTIONAL B         $     581.50
40874618   BRUSH CYTOLOGY 3FR               $     959.50
40874659   CATH UROMAX                      $   1,747.25
40874675   LEVEEN SYRINGE INFLATOR          $     602.50
40874683   ELECTRODE BUGBEE 5 FR            $     602.50
40874691   ELECTRODE VAPORTRODE/VAPORTOME   $     930.67
40874717   ELECTROHYDR LITHOTRIPTOR PROBE   $   1,477.50
40874725   BASKET - GEMINI/ZEROTIP          $   1,622.75
40874741   EXTRACTOR SEGURA/TRICEP          $   1,338.25
40874758   MALACUSO STENT REMOVAL FORCEPS   $     380.75
40874766   ERCP CANNULA                     $     478.00
40874774   ERCP GLIDEWIRE                   $     798.75
40874790   ERCP PUSHING CATHETER            $     217.00
40874808   ERCP STENT INTRODUCER SET        $     491.25
40874816   ERCP SPHINCTEROTOME/NEEDLE KNI   $     813.00
40874824   CATHETER ERCP BILIARY DILATION   $     433.75
40874832   ERCP BILIARY BALLON DIL. CATH    $   1,496.25
40874840   ERCP BILIARY STENT               $     332.25
40874865   ERCP RETRIEVAL BALLOON           $     857.75
40874873   ERCP STONE EXTRACTION BASKET     $   1,469.00
40874881   ERCP CYTOLOGY BRUSH              $     666.25
40874915   POLYP SNARE & NET COMBO          $     489.25
40874923   POLYP TRAP                       $     104.50
40874931   HEMOSTASIS PROBE 7-10 FR         $   1,271.00
40874949   HEMOSTASIS/INJ. PROBE 10FR       $   1,751.50
40874956   MARLEX MESH KEYHOLE              $     657.25
40875029   AGEE WRIST JACK IMPLANT          $   7,591.25
40875052   MICRO DEBRIDER BLADE             $     964.75
40875094   ENDOCATCH                        $     768.00
40875128   DRAIN BLAKE 15FR DISPOSABLE      $     229.25
40875169   MV GUIDE/GLIDEWIRE               $     380.75
40875177   GUIDEWIRE SURGITEK               $     186.50
40875193   BURR MICRO MILL 19MM             $     986.50
40875219   PULSAVAC FAN SPRAY KIT DISP      $     227.00
40875235   RETRACTOR TRIANGLE FAN           $   1,149.00
40875243   ANCHOR GII QUICK ANCHOR(MITEK)   $   1,622.75
40875268   ENDOSTITCH                       $   1,462.75
40875276   LAP/ARTHRO HYDROFLEX TUBING      $     602.50
40875284   LEGGINGS FOR NEW STIRRUPS        $     212.00
40875292   MICRO MILL DRAPE                 $     180.75
40875300   MINI-PORT INTRODUCER             $     482.00
40875326   ANCHOR RC/MITEK PANALOK          $   1,789.50
40875359   NEEDLE PRO BLOCK                 $     104.50
40875391   VEIN STRIPPER DISPOSIBLE         $     206.25
40875417   THORACORPORT 10.5                $     435.50
40875441   DLU ENDOSTITCH                   $     238.00
40875458   SCALPEL ACE HARMONIC #ACE36      $   2,948.40
40875474   FOLEY CATH SILASTIC              $     195.75
40875482   GASTROSTOMY TUBE MIC             $     539.75
40875490   MV STIFF SHAFT GUIDE/GLIDEWIRE   $     595.00
40875573   TRIPOLAR CUTTING FORCEP 5/10MM   $   1,983.00
40875778   SOLUSET TODDLER/ADOLESCENT       $     174.50
40875866   ESOPHAG BAND MICROVASIVE 5/8     $   2,408.75
40876034   DILATOR- BALLOON PYLORIC         $     990.75
40876050   DILATOR- BALLOON CRE             $   1,852.50
40876122   MESH BARD COMPOSIX 8X10          $   7,229.75
40876138   MESH BARD COMPOSIX 6X8           $   4,820.25
40876146   MESH BARD COMPOSIX 3X6           $   1,643.75
40876154   MESH BARD COMPOSIX 2X4           $   1,627.75
40876186   STRAP, ANKLE NEX-GEN             $     195.75
40876194   SPLINT AQUAPLAST NASAL           $      93.75
40876202   BLADE, PATELLA REAMING           $     663.75
40876234   CEMENT- PALACOS                  $     713.75
40876250   CORD, DAC                        $     197.00
40876262   PADDLE, ENDO 10MM                $   1,103.50
40876280   IRRI-FLO SYSTEM                  $     386.50
40876286   ET LASER GUARD                   $     400.25
40876292   TUBING, LEVEL 1                  $     350.75
40876320   NEEDLE, BRACHY                   $     105.50
40876326   TRAY, QUINTON CATH 13.5          $   1,229.00
40876338   CABLE SYSTEM, DALL-MILES         $   2,478.25
40876344   NEEDLE, MORGAN STERN             $     774.00
40876350   CATHETER URETERAL-DL             $     448.25
40876356   STENT URO E-P RETRO 24/26 CM     $     988.25
40876370   ELECTRODE, VAPR (SIDE & END)     $   1,162.75
40876376   BIS SENSOR                       $     228.00
40876382   ARGON GI PROBE                   $   1,601.75
40876388   DIAMOND VIEW LIGHT F/U PANEL     $     547.00
40876394   INTERCEED ADHESIVE BARRIER       $   1,060.75
40876400   UNIVENT TUBE                     $   1,147.75
40876406   TROCAR/OBTURATOR, ORANGE #4215   $     367.25
40876412   TROCAR BLUNT TIP 10MM            $   1,302.25
40876418   DILATOR BALLOON PDBS             $   1,004.25
40876424   FASTNER PROTACK 5MM              $   3,786.00
40876436   PROBE ULTRASONIC LITHOTRIPSY     $   1,099.00
40876442   CPAP SYSTEM #85006               $     241.25
40876448   CATHETER, GROSHONG 7FR SL        $   1,672.50
40876454   MESH 3D MAX MED & LG             $     935.00
40876466   MESH PROLENE PHM 6X6             $     483.00
40876472   HANDPIECE ABC #130321            $     492.25
40876538   TUBING AQUASENS #25360           $     857.50
40876544   CATHETER AIRWAY EXCHANGE 14/19   $     278.75
40876550   IMPLANT RAPID LOC MENISCAL       $     925.75
40876562   ENDOCLOSE                        $     213.75
40877752   GREENLIGHT LASER FIBER DISP      $   3,920.00
40877808   WALLSTENT 7.5 FR 68 & 80 MM      $   6,023.50
40877816   NEEDLE SPROTTE STAND 22G-24G     $     134.75
40877823   LIGASURE ELECT LS2111 LS3111     $   1,164.25
40877830   TUBING, NORMOFLO IR#600          $     467.50
40877854   PERC NEPH SET 20FR (#410-102)    $     446.25
40877894   VNUS CLOSURE CATHETERS 6FT/8FT   $   6,967.00
40877901   VNUSCLOSURE PACK CPP-1           $      772.75
40877908   BENTSON GUIDE WIRE #49-145       $      130.50
40877935   CLEARVACGOLD SUCTION TUBING      $      116.00
40877942   TVT TENSION DEVICE #810041 A&B   $    3,819.25
40877949   LEMAITRE VALVULOTOME             $    2,833.75
40877971   CANNULA THRDED/NON-THRD 11MM     $      104.25
40877978   NEEDLE VERRES-AM 120/150MM       $      113.00
40877985   BARUIM SULFATE 6MG               $      447.00
40877992   AEM ENCISION SCIZZORS & SHEATH   $      591.75
40877999   INLET CLOSURE DEVICE CTI-512N    $      858.00
40878006   AEM/ENCISION SPATULA/J-HOOK      $      260.50
40878013   CATHETER BARD/HEMOGLIDE          $    1,386.00
40878020   LIGACLIP LARGE DISP ER-420       $      549.00
40878027   TROCAR VERSA-STEP 5 & 11MM       $      932.50
40878034   DILATOR VERSA-STEP               $      302.50
40878041   VERSA-STEP EXPANDABLE SLEEVE     $      400.50
40878056   NOVASURE DISP OBLATION KIT       $    5,700.00
40878070   STAPLER RELOAD DLN GIA 50        $    1,720.00
40878077   STAPLER ETS #6TB45               $    2,632.50
40878084   STAPLER RELOAD DLU 6R45B         $      848.00
40878098   SCALPEL ACE HARMONIC #14SHORT    $    2,597.40
40878105   CANUFLOW                         $      148.00
40878112   DEPUY DISP SURGICAL HOOD         $      214.50
40878119   INSTRATEK TITAIUM SCREWS         $      671.00
40878154   ZIMMER ORTHOPAT CELLSAVER        $      572.00
40880326   BLADE, MICRO SAW                 $      566.75
40880342   SET UP SAW BLADE                 $      236.75
40883359   ENDO PEANUTS                     $      106.50
40883730   SLING SYSTEM MONARCH+            $    5,970.00
40883737   SLING MONARCH SUB FACIAL         $    5,671.00
40884136   EXPRESS OSTEO INTRODUCER SYSTE   $   18,566.00
40884143   10-2 FRACTURE                    $   12,497.50
40884150   15-3 OSTEO INTRODUCER SYSTEM     $   19,048.25
40884157   20-3 OSTEO INTRODUCER SYSTEM     $   19,218.00
40884164   KYPHON MIXER & CEMENT            $    1,365.00
40884206   AEM DISPOSABLE CORD              $      106.00
40884353   GELPORT ASS DEVICE 120MM         $    3,736.25
40892727   MENISECTOMY ELECTRODE            $      587.50
40892750   BLADE, AGEE CARPAL               $    1,430.00
40900045   SIMUL AIDED FIELD SIMPLE         $      743.50
40900047   SIMUL AIDED FIELD INTER          $    1,156.50
40900055   SIMUL AIDED FIELD COMPLEX        $    1,363.00
40900063   BASIC RAD DOSIM CALC PLAN        $      289.50
40900101   TELETX ISODOSE PLAN SIMP         $      397.00
40900128   TELETX ISODOSE PLAN INTER        $      495.75
40900136   TELETX ISODOSE PLAN CPLX         $      578.50
40900144   SPECIAL TELETX PORT PLAN         $      842.75
40900152   SPECIAL RAD DOSIMETRY TLD        $      107.75
40900160   TX DEVICE DESIGN SIMPLE          $      281.25
40900179   TX DEVICE DESIGN INTERMED        $      397.00
40900187   TX DEVICE DESIGN COMPLEX         $      694.25
40900195   CONTINUING PHYSICS CONSLT        $      702.50
40900209   SPEC MED RAD PHYS CONSULT        $      785.00
40900225   RAD TX SIMPLE 6-10 MEV           $      578.50
40900306   RAD TX COMPLEX 6-10 MEV          $      908.75
40900330   THERAPEUT RAD PORT FILMS         $       83.00
40900470   SPECIAL TX PROCEDURE             $    2,064.75
40900616   VISIT LEVEL 1 NEW PT             $      128.25
40900632   RAD TX INTERMED 6-10MEV          $      743.50
40900640   RAD TX COMPLEX 11-19 MEV         $     991.25
40900648   RAD TX INTERMED 11-19MV          $     826.00
40900656   RAD TX SIMPLE 11-19 MEV          $     661.00
40900664   SIMUL AIDED FIELD 3D             $   6,194.00
40900680   BRACHY ISO PLAN COMPLEX          $   1,032.75
40900688   INTERSTITIAL COMPLEX             $   1,156.50
40900705   SUPRV HANDL LOAD RADIOELE        $     107.75
40900710   BRACHYTHPY SRC IODINE 125        $     183.75
40900719   US TRANSREC PROSTATE VOL         $     578.50
40900726   IGRT                             $     181.50
40900871   CT GUIDED THERAPY PLACEMT        $     721.00
40900878   RO TRAY INTERVENTIONAL MINOR     $     116.50
40900885   RAD TX COMPLEX 20+ MEV           $   1,073.75
40900892   IMRT TREATMENT PLAN              $   2,289.75
40900899   IMRT PER SESSION                 $   1,236.25
40901000   BRACHY ISO PLAN SIMPLE           $     455.25
40901007   BRACHY ISO PLAN INTERMED         $     744.00
40901014   INTERSTITIAL SIMPLE              $   1,465.75
40901021   INTERSTITIAL INTERMED            $   1,097.50
40901028   VISIT LEVEL 1 NEW W PROC         $     128.25
40901035   VISIT LEVEL 2 NEW PT             $     138.00
40901042   VISIT LEVEL 2 NEW W PROC         $     138.00
40901049   VISIT LEVEL 3 NEW PT             $     147.50
40901056   VISIT LEVEL 3 NEW W PROC         $     147.50
40901063   VISIT LEVEL 4 NEW PT             $     214.75
40901070   VISIT LEVEL 4 NEW W PROC         $     214.75
40901077   VISIT LEVEL 5 NEW PT             $     281.75
40901085   VISIT LEVEL 5 NEW W PROC         $     281.75
40901092   VISIT LEVEL 1 EST PT             $     115.25
40901099   VISIT LEVEL 1 EST W PROC         $     115.25
40901106   VISIT LEVEL 2 EST PT             $     124.00
40901113   VISIT LEVEL 2 EST W PROC         $     124.00
40901120   VISIT LEVEL 3 EST PT             $     132.75
40901127   VISIT LEVEL 3 EST W PROC         $     132.75
40901135   VISIT LEVEL 4 EST PT             $     193.00
40901142   VISIT LEVEL 4 EST W PROC         $     193.00
40901149   VISIT LEVEL 5 EST PT             $     253.25
40901156   VISIT LEVEL 5 EST W PROC         $     253.25
40901163   XR FLUORO < 1 HR                 $     588.25
40901170   LARYNGOSCPY FLEX F/O DIAG        $     189.25
41000013   AUTOADSORPTION                   $      80.00
41000019   CMV NEG PED 120 ML               $     137.00
41000056   CROSSMATCH PER UNIT              $     100.00
41000068   CMV NEG PED 80 ML                $      91.00
41000076   FRESH FROZEN PLASMA              $      75.00
41000084   RH IMMUME GLOBULIN               $      96.75
41000118   CRYOPRECIPITATES                 $      75.00
41000183   AUTOLOGOUS BLOOD UNIT MEDICARE   $     320.00
41000191   MPT PLATELET PHERESIS            $     670.00
41000197   ANTI-CMV                         $      40.00
41000258   PLATELET CROSSMATCH              $     150.00
41000308   PHENOTYPED UNITS 1 ANTIGEN       $      60.00
41000332   ADSORPTION                       $      85.00
41000340   ANTIBODY I.D.                    $     230.00
41000357   RED CELL PANEL ADDITIONAL        $     100.00
41000365   ENZYME PANEL                     $     100.00
41000399   WASHED RBC                       $     320.00
41000415   IRRADIATION/B/BANK               $      50.00
41000423   HLA MATCHING CLASS 1             $     250.00
41000431   EXTENDED RH PHENOTYPE            $     125.00
41090002   RED BLOOD CELLS LEUKO REDUCED    $     248.00
41090010   WHOLE BLOOD                      $     257.00
41090017   PER ANTIGEN PER UNIT CONFIRMED   $      60.00
41090024   PER ANTIGEN PER UNIT HIST SCRN   $      50.00
41090031   PER UNIT PRE SELECT DNRS W/PT    $      50.00
41090038   PHENOTYPED UNIT RARE ANTIGEN     $     300.00
41090045   CHLOROQUINE ZAP OR AET           $     100.00
41090059   BLOOD BANK ELUTION               $     175.00
41090073   RED CELL TYPE EA NON ABO/RH-D    $      25.00
41090080   RED CELL ANTIBODY SCREEN         $      90.00
41100009   EKG 12 LEAD (CARDIOLOGY)         $     248.50
41100016   EKG 12 LEAD BY RT SUBS SAME MD   $     248.50
41100017   EKG RHYTHM WITH 3-LEADS          $     226.00
41100023   EKG 12 LEAD SUBS DIFF MD         $     248.50
41100025   CV STRESS TEST W/ TRACING ONLY   $     655.50
41100030   EKG 12 LEAD SUBS SAME MD         $     248.50
41100033   EEG                              $     630.75
41100037   EKG 12 LEAD BY RT SUBS DIFF MD   $     248.50
41100041   EEG SLEEP                        $     586.75
41100080   HOLTER MONITOR-HOOKUP & RECORD   $     287.00
41100086   HOLT MONITOR-SCAN&REPORT ONLY    $     287.00
41100256   DOPPLER ECHO WAVE & DISPLAY      $     159.25
41100785   KING OF HEARTS ARRHY RECORDING   $     155.25
41100792   KING OF HEARTS ARRHY ANALYSIS    $     155.25
41101015   2D ECHOCARDIOGRAM LIMITED        $     517.75
41101030   CONGENITAL ECHO COMPLETE         $   1,203.75
41101031   DOPPLER ECHOCARDIOGRAM COLORF1   $     159.25
41101049   PERI CARDOA EFFISOPM (M MODE)    $     213.50
41101056   COMPLETE ECHOCARDIOGRAM/MMODE    $   1,203.75
41101098   ECHOCARDIOGRAM STRESS            $     650.00
41101105   EKG BY RESP.THERAPY              $     248.50
41101117   TILT TABLE TEST                  $   1,274.50
41200340   CHEST DRAINAGE DEVICE            $     248.00
41204383   FEEDING TUBE                     $      61.25
41204565   HEIMLICH CHEST VALVE             $     177.00
41210414   KIT PRESSURE MONITORING          $     112.75
41220280   TRAY BIOPSY BONE MARROW          $     344.50
41231029   GALLIUM GA-67 DX PER MCI         $     132.00
41231036   I-123 NA IO DX 100UCi/CAP        $       6.00
41231043   PENTETATE DX UP TO 25MCI         $   4,231.75
41231050   IN111 OXYQUINOL DX/0.5MCI        $   2,527.75
41231057   NM SM153 LEXIDRONAM 50MCI        $   7,721.75
41231078   MERTIATIDE DX TO 15MCI           $     652.25
41231085   LABELED RBC DX TO 30MCI          $     543.50
41231092   SULFUR COLLOD DX TO 20MCI        $     225.75
41231099   I-131 NA IOD THER CAP/MCI        $     225.75
41231667   TRAY PER-Q-CATH                  $     930.75
41231758   TRAY PARACENTESIS                $     610.00
41262188   STENT BILIARYW/DEL SYS 9X40X75   $   5,830.00
41270285   JACKSON PRATT DRAIN              $     119.75
41270393   BX DEVICE MAMMOTOME 11 GA        $   1,590.25
41273436   CATH FILTR SET GUNTHR TULIP      $   3,808.00
41273917   BIOPSY GUN(ASAP)                 $     212.00
41273925   DRAINAGE POUCH                   $     161.75
41274089   TRAY INTERVENTIONAL MINOR        $     111.75
41274097   TRAY INTERVENTIONAL-MAJOR        $     380.75
41274105   TRAY ENTEROCYLSIS                $     330.50
41274113   NEEDLE BIOPSY A                  $     125.75
41274139   CATHETER-INTERVENTIONAL A        $     175.00
41274162   CATHETER-ANGIOPLASTY A           $   1,595.50
41274170   CATHETER-ANGIOPLASTY B           $   3,292.00
41274196   CATHETER-ANGIOPLASTY B           $     587.50
41274204   XR CATHETER-DRAINAGE B           $     978.50
41274220   DRAINAGE SET                     $     918.75
41274303   SHEATH-INTERVENTIONAL A          $     175.00
41274345   PNEUMOTHORAX SET                 $     100.00
41274378   CATHETER-HYSTERO                 $     368.50
41274386   INTRODUCER SET                   $     478.00
41274410   INDEFLATOR                       $     405.00
41274650   CATHETER- THROMBECTOMY- ARROW    $     442.00
41275775   CATH BIL FLEXIMA W PIGTAIL       $     978.50
41276282   CATH SECURING DEVICE             $     103.75
41276448   CATH GROSHONG 7 FR SL            $   1,672.50
41283225   XR UNIFUSE INFUSN PTTRN 5x9x3    $     806.50
41283260   CATH CUTTING BALLOON 6x2x50      $   4,800.00
41283267   CONTROL WIRE V-18                $     523.75
41283352   XR STENT EXPRESS BILIARY         $   4,569.00
41283366   CATH ANGLE GLIDE 4FR/5FR         $     324.25
41283415   XR CATH EMBOLECTOMY 5FR x40CM    $     412.75
41283436   XR CATH FILTR SET GUNTHR TULIP   $   3,808.00
41283786   CATH PERIPHERAL GUIDE 6F LIMA    $     981.00
41283793   CATH PERIPHERAL DILATION         $   3,600.00
41283800   CATH PERIPHERAL INFLATION UNIT   $   5,700.00
41283807   CATH INFL NITROUS OXIDE CARTDG   $     390.00
41284227   CATH RDC GUIDE 6FR               $     887.25
41293209   SESTAMIBI DX TO 40MCI            $     770.00
41293225   EXAMETAZIME DX TO 25MCI          $   3,623.50
41293296   MACROAG ALBUM DX TO 10MCI        $     212.00
41293303   DISOFENIN DX UP TO 15MCI         $     365.00
41293310   MEDRONATE DX UP TO 30MCI         $      33.00
41293317   PENTETATE DX UP TO 25MCI         $     147.75
41293324   RP DEFINITY (PERFLUTREN) 2ML     $     723.25
41293331   IN111 PENTETREOTID DX/MCI        $   3,326.45
41302233   MA MAMMO DX DIG WO CAD RT        $     256.25
41302241   MA MAMMO DX DIG WO CAD BI        $     382.75
41302530   MA MAMMO SCREEN DIG BIL          $     388.75
41302536   MA MAMMO SCREEN DIG BIL          $     388.75
41302746   MA STEREOTACTIC LOC EA RT        $   1,942.75
41302761   MA MAMMO PLACE NDL EA RT         $     994.75
41302811   MA SURGICAL SPECIMEN EA          $     142.50
41302829   MA MAMMARY DUCTO SNGL RT         $     351.25
41302852   US BREAST RT                     $     274.00
41302860   US GUIDED NEEDL PLACEMENT        $     813.00
41302868   US GUIDED NEEDL PLACEMENT        $     813.00
41302876   IR LEVEL 1 60 MINS               $     742.75
41302892   IR LEVEL II 60 MINS              $     928.25
41302908   IR LEVEL III 60 MINS             $   1,237.25
41302940   MA MAMMO DX DIG WO CAD LT        $     256.25
41302956   MA MAMMARY DUCTO SNGL LT         $     351.25
41302964   MA MAMMO PLACE NDL EA LT         $     994.75
41302972   MA STEREOTACTIC LOC EA LT        $   1,942.75
41302980   US GUIDED NEEDL PLACEMENT        $     813.00
41302988   US BREAST LT                     $     274.00
41302995   US BREASTS BIL                   $     519.25
41302996   US GUIDED NEEDL PLACEMENT        $     813.00
41303003   MA DIGITALIZ COMPTR SCRN         $      64.50
41303010   MA DIGITALIZ COMPTR DIAG         $      64.50
41303053   MA STEREOTACTIC LOC EA UN   $     139.25
41303067   MA DIGITALIZ COMPTR SCRN    $      64.50
41303074   MA MAMMO DX DIG WO CAD BI   $     382.75
41303081   MA MAMMO SCREEN DIG BIL     $     388.75
41303088   MA MAMMO DX DIG WO CAD UN   $     256.25
41400003   XR AC JTS W/WO WTS BIL      $     372.50
41400011   XR CLAVICLE COMPLETE RT     $     326.75
41400029   XR ELBOW 3+ VIEWS RT        $     411.00
41400037   XR ELBOW 2 VIEWS RT         $     292.00
41400045   XR FINGER(S) 2+ VIEWS RT    $     296.00
41400052   XR FOREARM 2 VIEWS RT       $     282.00
41400060   XR HAND 3+ VIEWS RT         $     407.75
41400067   XR HAND 3+ VIEWS BIL        $     814.00
41400074   XR HAND 2 VIEWS BIL         $     524.75
41400078   XR HAND 2 VIEWS RT          $     263.50
41400086   XR HUMERUS 2+ VIEWS RT      $     357.00
41400094   XR SCAPULA COMPLETE RT      $     368.00
41400102   XR ARTHROGRAM SHOULDER RT   $   1,027.50
41400128   XR SHOULDER 2+ VIEWS RT     $     391.25
41400136   XR SHOULDER 1 VIEW RT       $     253.50
41400144   XR WRIST 3+ VIEWS RT        $     398.50
41400151   XR WRIST 2 VIEWS RT         $     268.25
41400158   IR UROGRAM ANTEGRADE UNI    $     717.00
41400169   XR ANKLE 3+ VIEWS RT        $     419.00
41400177   XR ANKLE 2 VIEWS RT         $     296.00
41400185   XR FEMUR 1 VIEW RT          $     370.25
41400193   XR FOOT 3+ VIEWS RT         $     411.00
41400201   XR FOOT 2 VIEWS RT          $     263.50
41400250   XR PELV&HIP INFANT/CHLD2+   $     336.50
41400268   XR HIP 2+ VIEWS RT          $     299.00
41400284   XR ARTHROGRAM KNEE RT       $   1,027.50
41400300   XR KNEE 4+ VIEWS RT         $     411.00
41400318   XR KNEE 1 OR 2 VIEWS RT     $     333.50
41400326   XR CALCANEUS 2+ VIEWS RT    $     268.25
41400334   XR TIBIA & FIBULA 1VW RT    $     279.50
41400342   XR TOE(S) 2+ VIEWS RT       $     277.00
41400359   XR ABDOMEN 1 VIEW (AP)      $     268.25
41400367   XR ABDOMEN AP/DECUB/ERECT   $     357.00
41400375   XR ABD AP DECUB UPR+CHEST   $     387.50
41400383   XR COLON BE W AIR CON       $     704.00
41400391   XR COLON BE W OR WO KUB     $     704.00
41400425   XR CHOLANGIO/PANC INTRAOP   $     525.50
41400433   XR CHOLE THRU EXIST CATH    $     633.00
41400474   XR ESOPHAGUS                $     417.00
41400490   XR SMALL BOWEL              $     675.50
41400508   XR UGI WO KUB               $     658.00
41400516   XR UGI W SMALL INTESTINE    $     929.50
41400532   XR EYE FOREIGN BODY RT      $     370.25
41400557   XR FACIAL BONES 3+ VIEWS    $     638.50
41400565   XR FACIAL BONES <3 VIEWS    $     473.75
41400599   XR MANDIBLE 4+ VIEWS        $     757.50
41400607   XR MANDIBLE <4 VIEWS        $     368.00
41400631   XR NASAL BONES 3+ VIEWS     $     407.75
41400656   XR NECK SOFT TISSUE         $     270.50
41400672   XR ORBITS 4+ VIEWS          $     515.00
41400680   XR OPTIC FORAMINA           $     337.50
41400698   XR SINUSES 3+ VIEWS         $     521.00
41400714   XR SALIVARY GLAND CALCULU   $     282.00
41400730   XR SKULL 4+ VIEWS           $     767.50
41400748   XR SKULL <4 VIEWS           $     381.50
41400771   XR TMJ OPEN/CLOSED BIL      $     497.25
41400797   XR SINUSES <3 VIEWS         $     242.25
41400821   XR CHEST 1 VIEW             $     210.00
41400839   XR CHEST 2 VIEWS            $     333.50
41400841   XR RIBS W/CHEST 4+ VW BIL   $     655.00
41400843   XR RIBS W CHEST 3+ VWS RT   $     637.50
41400845   XR RIBS W CHEST 3+ VWS LT   $     637.50
41400847   XR CHEST 2 VWS W APIC LOR   $     381.50
41400854   XR CHEST 4+ VIEWS           $     436.50
41400862   XR CHEST 2 VIEWS W FLUORO   $     478.25
41400870   XR RIBS 3 VIEWS BIL         $     476.00
41400888   XR RIBS 2 VIEWS RT          $     458.75
41400896   XR STERNOCLAVIC JT(S) 3+    $     359.50
41400904   XR STERNUM 2+ VIEWS         $     400.50
41400912   XR C SPINE CMP +FLEX/EXT    $     849.50
41400920   XR CERVICAL SPINE 2-3 VW    $     442.00
41400938   XR LUMBAR SPINE 4+ VIEWS    $     755.75
41400946   XR LUMBAR SPINE 2 OR 3 VW   $     440.50
41400953   XR MYELOGRAM LUMBAR         $   1,646.50
41400961   XR MYELOGRAM 2 OR>REGIONS   $   1,959.00
41400987   XR PELVIS 1 OR 2 VIEWS      $     249.00
41401001   XR PELVIS CMPL 3+ VIEWS     $     540.50
41401027   XR HIPS 2+ W PELVIS BIL     $     540.50
41401035   XR SACROILIAC JT 3+ VWS     $     372.50
41401043   XR SACRUM & COCCYX 2+ VWS   $     256.25
41401050   XR SCOLIOSIS SUP & STAND    $     302.75
41401076   XR THORACIC SPINE 3 VIEWS   $     391.25
41401084   XR THORACOLUMB SPINE 2 VW   $     339.00
41401100   XR UROGRAM RETROGRADE       $     433.50
41401118   IR CYSTOURETHROGR RETRO     $     978.50
41401126   IR CYSTOURETHROGRAM VOID    $     590.25
41401134   XR UROGRM INFUS DRP/BOLUS   $   1,098.00
41401142   XR UROGRM DRP/BOLUS W/TOM   $   1,615.50
41401175   IR HYSTEROSALPINGOGRAM      $     761.50
41401191   XR BONE AGE STUDIES         $     265.00
41401209   XR BONE LENGTH STUDIES      $     370.25
41401217   XR BONE SURVEY LIMITED      $     618.50
41401225   XR BONE SURVEY INFANT       $     336.50
41401241   IR SINUS TRACT/FIST/ABSC    $     704.00
41401316   XR TOMOGRAM SINGLE PLANE    $     313.50
41401498   IR CYSTOGRAM 3+ VIEWS       $     522.50
41401859   XR FLUORO 2-3 HOURS         $   1,232.25
41401866   XR FLUORO 3-4 HOURS         $   1,478.25
41401873   XR FLUORO 4-5 HOURS         $   1,724.50
41402207   XR SM BOWEL ENTEROCLYSIS    $     929.50
41402231   MA MAMMO DIAG RT            $     230.75
41402314   MA MAMMO PLACE NDL EA RT    $     991.25
41402355   IR FLUOR GUID NDL BX/ASP/   $     791.50
41402470   MA SURGICAL SPECIMEN EA     $     142.50
41402488   XR MYELOGRAM CERVICAL       $   1,378.00
41402520   XR SWALLOW FUNCT CINE/VID   $     480.75
41402538   MA MAMMO SCREENING BIL      $     188.00
41402546   XR HIP 1 VIEW RT            $     251.50
41403023   XR ARTHROGRAM WRIST RT      $   1,027.50
41403031   XR ARTHROGRAM ELBOW RT      $   1,027.50
41403049   XR ARTHROGRAM HIP RT        $   1,027.50
41403056   XR ARTHROGRAM ANKLE RT      $   1,027.50
41403254   IR UROGRAM ANTEGRADE UNI    $     717.00
41403270   IR LEVEL III 60 MINS        $   1,232.25
41403277   IR LEVEL III 90 MINS        $   1,847.50
41403284   IR LEVEL III 120 MINS       $   2,463.50
41403291   IR LEVEL III 150 MINS       $   3,078.00
41403296   IR LEVEL I 60 MINS          $     740.00
41403298   IR LEVEL III 180 MINS       $   3,694.00
41403303   IR LEVEL I 90 MINS          $   1,109.50
41403310   IR LEVEL I 120 MINS         $   1,343.75
41403312   IR LEVEL II 60 MINS         $     924.75
41403317   IR LEVEL I 150 MINS         $   1,526.75
41403319   IR LEVEL II 90 MINS         $   1,293.75
41403326   IR LEVEL II 120 MINS        $   1,512.00
41403333   IR LEVEL II 150 MINS        $   2,032.25
41403381   IR VENOGRAM EXTREMITY UNI   $     644.25
41403403   XR VENOGRAM EXTREMITY BIL   $   1,141.50
41403462   IR LEVEL III 60 MINS        $   1,232.25
41403469   IR LEVEL III 90 MINS        $   1,847.50
41403476   IR LEVEL III 120 MINS       $   2,463.50
41403483   IR LEVEL III 150 MINS       $   3,078.00
41403969   XR BILE STONE REM POSTOP    $   1,190.50
41404337   XR ENDO BILIARY DUCT CATH   $   1,203.50
41404345   IR ANGIO EXTREMITY UNI      $   1,649.50
41404353   XR CLAVICLE COMPLETE LT     $     326.75
41404361   XR ELBOW 3+ VIEWS LT        $     411.00
41404369   XR ELBOW 2 VIEWS LT         $     292.00
41404377   XR FOREARM 2 VIEWS LT       $     282.00
41404385   XR HAND 3+ VIEWS LT         $     407.75
41404393   XR HAND 2 VIEWS LT          $     263.50
41404401   XR HUMERUS 2+ VIEWS LT      $     357.00
41404409   XR SCAPULA COMPLETE LT      $     368.00
41404417   XR ARTHROGRAM SHOULDER LT   $   1,027.50
41404425   XR SHOULDER 2+ VIEWS LT     $     391.25
41404433   XR SHOULDER 1 VIEW LT       $     253.50
41404441   XR WRIST 3+ VIEWS LT        $     398.50
41404449   XR WRIST 2 VIEWS LT         $     268.25
41404457   XR ANKLE 3+ VIEWS LT        $     419.00
41404465   XR ANKLE 2 VIEWS LT         $     296.00
41404473   XR FEMUR 1 VIEW LT          $     370.25
41404481   XR FOOT 3+ VIEWS LT         $     411.00
41404489   XR FOOT 2 VIEWS LT          $     263.50
41404497   XR HIP 2+ VIEWS LT          $     299.00
41404505   XR ARTHROGRAM KNEE LT       $   1,027.50
41404513   XR KNEE 4+ VIEWS LT         $     411.00
41404521   XR KNEE 1 OR 2 VIEWS LT     $     333.50
41404529   XR CALCANEUS 2+ VIEWS LT    $     268.25
41404537   XR TIBIA & FIBULA 1VW LT    $     279.50
41404545   XR EYE FOREIGN BODY LT      $     336.50
41404553   XR MANDIBLE <4 VIEWS        $     368.00
41404561   XR ORBITS 4+ VIEWS          $     515.00
41404569   XR ORBITS 4+ VIEWS          $     643.25
41404577   XR OPTIC FORAMINA           $     337.50
41404593   IR ARTHROGRAM WRIST LT      $   1,027.50
41404601   XR ARTHROGRAM ELBOW LT      $   1,027.50
41404609   XR ARTHROGRAM HIP LT        $   1,027.50
41404617   XR ARTHROGRAM ANKLE LT      $   1,027.50
41404625   XR FINGER(S) 2+ VIEWS RT    $     296.00
41404633   XR FINGER(S) 2+ VIEWS RT    $     296.00
41404641   XR FINGER(S) 2+ VIEWS UNI   $     296.00
41404649   XR FINGER(S) 2+ VIEWS RT    $     296.00
41404657   XR FINGER(S) 2+ VIEWS LT    $     296.00
41404665   XR FINGER(S) 2+ VIEWS LT    $     296.00
41404673   XR FINGER(S) 2+ VIEWS LT    $     296.00
41404681   XR FINGER(S) 2+ VIEWS LT    $     296.00
41404689   XR FINGER(S) 2+ VIEWS LT    $     296.00
41404697   XR TOE(S) 2+ VIEWS RT       $     277.00
41404705   XR TOE(S) 2+ VIEWS RT       $     277.00
41404713   XR TOE(S) 2+ VIEWS RT       $     277.00
41404721   XR TOE(S) 2+ VIEWS RT       $     277.00
41404729   XR TOE(S) 2+ VIEWS LT       $     277.00
41404737   XR TOE(S) 2+ VIEWS LT       $     277.00
41404745   XR TOE(S) 2+ VIEWS LT       $     277.00
41404753   XR TOE(S) 2+ VIEWS LT       $     277.00
41404761   XR TOE(S) 2+ VIEWS LT       $     277.00
41404769   XR HIP 1 VIEW LT            $     251.50
41404777   XR RIBS 2 VIEWS LT          $     458.75
41404841   LUMBAR PUNCTURE DIAGNOSTC   $     430.00
41404849   XR BONE DENSITY(DXA)AXAL    $     344.50
41404856   XR CHEST 1 VIEW             $     256.25
41404864   XR FLUORO < 1 HR            $     641.75
41404872   MA MAMMO DIAG LT            $     230.75
41404880   MA MAMMO DIAG BIL           $     259.00
41404904   XR FLUORO < 1 HR            $     641.75
41404952   XR CHEST SPECIAL VIEWS      $     171.50
41404958   XR CERVICAL SPINE 4+ VIEW   $     749.00
41404964   XR L SPINE CMPL W BEND VW   $     468.50
41404970   XR L SPINE BEND ONLY 4+ V   $     440.50
41404976   XR UPP EXTRM INFANT 2+ LT   $     282.00
41404982   XR UPP EXTRM INFANT 2+ RT   $     282.00
41404988   XR KNEE 3 VIEWS LT          $     376.00
41404994   XR KNEE 3 VIEWS RT          $     376.00
41405000   XR KNEE AP STANDING BIL     $     286.25
41405006   XR LOW EXTRM INFANT 2+ LT   $     282.00
41405012   XR LOW EXTRM INFANT 2+ RT   $     282.00
41405024   XR UGI W AIR CON WO KUB     $     626.50
41405030   XR UGI W AIR CON+SM BOWEL   $     884.25
41405042   XR CHOLAN INTRAOP ADD SET   $     164.75
41405048   XR BONE SURVEY COMPLETE     $     906.00
41405054   XR ENDO PANCREAS DUCT CTH   $   1,203.50
41405060   XR ENDO ERCP                $   1,203.50
41405066   IR ANGIO EXTREMITY LT       $     647.75
41405072   IR ANGIO EXTREMITY RT       $     647.75
41405078   XR ANGIO EXTREMITY LT       $     647.75
41405084   XR ANGIO EXTREMITY RT       $     647.75
41420010   IR LEVEL I 60 MINS          $     740.00
41420060   XR URETER CATH/STENT PLC    $   1,060.00
41420078   XR CHOLE PERC TRANSHEP      $     662.50
41420086   IR RENAL PERC CTH INS UNI   $   1,060.00
41420094   IR AORTOGRAM THORAC W SER   $   2,063.50
41420110   IR AORTOGRAM ABD W SERIAL   $   2,212.50
41420128   IR AORTOGRM ABD W ILIOFEM   $   2,269.00
41420144   IR ANGIO CERVICOCER ARCH    $   2,271.00
41420152   IR ANGIO CAROTD CEREB UNI   $   2,246.00
41420160   IR ANGIO CAROTD CEREB BIL   $   2,282.25
41420186   IR ANGIO CAROTD CERV BIL    $   2,282.25
41420202   IR ANGIO EXTREMITY BIL      $   2,253.50
41420210   XR ANGIO RENAL W FLUSH UN   $   2,212.50
41420228   IR ANGIO RENAL W FLUSH BI   $   2,282.25
41420236   IR ANGIO VISC WO OR W FLS   $   2,212.50
41420252   IR ANGIO PULMONARY BIL      $   2,282.25
41420260   IR ANGIO AV SHUNT           $   2,063.50
41420267   IR ANGIO BRACHIAL RETRO     $   2,202.75
41420278   IR SHUNTOGRAM NONVASCULAR   $     572.00
41420302   IR TRNSCTH ANG EXIST CATH   $     786.75
41420328   IR TRANSCATH THRPY EMBOLZ   $   3,500.25
41420336   IR PTA PERIPHERAL ARTERY    $   3,044.50
41420344   IR PTA RENAL/VISCERAL       $   3,044.50
41420352   IR PTA PERIPH ART EA ADD    $   1,180.00
41420378   IR ANGIO EA ADD VESSEL      $   1,427.75
41420386   XR VENACAVAGRAM INFERIOR    $   2,063.50
41420394   IR VENACAVAGRAM SUPERIOR    $   2,063.50
41420410   XR VENOGRAM RENAL UNI       $   2,063.50
41420436   IR PTA VENOUS               $   3,044.50
41420444   IR IVC FILTER PLACEMENT     $   2,212.50
41420502   XR BILIARY DRAIN TRANSHEP   $   2,246.00
41420510   IR TUBE/CATH CHANGE W CON   $     837.50
41420528   IR FLUOR GUIDE CATH DRAIN   $   2,062.50
41420544   IR GASTRO TUBE PERC PLACE   $     779.00
41420552   IR BILE DUCT DIL WWO STNT   $   2,517.00
41420560   XR NEPHRO/URET/URTHRA DIL   $     780.50
41420578   IR TRANSCTH THERPY INFUS    $   3,329.75
41420602   IR STENT(S) PLC NON COR     $   2,536.25
41420610   IR BILIARY DRN CATH/STENT   $   2,536.25
41420617   XR STENT(S) PLC NON COR     $   3,098.25
41420660   XR ANGIO VERTEBRAL UNI      $   2,246.00
41420702   IR ANGIO PELVIC             $   2,536.25
41420815   XR TREATMENT ROOM 30 MIN    $     125.00
41420822   XR TREATMENT ROOM 60 MIN    $     249.75
41460031   MR ORB/FAC/NECK WO CON      $   2,861.50
41460049   MR BRAIN WO CON             $   2,554.75
41460064   MR BRAIN W CON              $   3,225.50
41460098   MR CHEST WO CON             $   3,234.00
41460122   MR C SPINE WO CON           $   2,887.25
41460148   MR UPP EXTREM JNT WO RT     $   2,310.00
41460189   MR LOW EXTREM JNT WO RT     $   2,310.00
41460213   MR ABDOMEN WO CON           $   3,972.00
41460304   MR TMJ UNI                  $   2,887.25
41460318   MR BRAIN WO&W CON           $   3,815.50
41460320   MR C SPINE W CON            $   3,801.50
41460338   MR C SPINE WO&W CON         $   3,972.00
41460346   MR T SPINE WO CON           $   2,887.25
41460353   MR T SPINE W CON            $   3,801.50
41460361   MR T SPINE WO&W CON         $   3,972.00
41460375   MR UPP EXTREM JNT W RT      $   2,201.00
41460379   MR L SPINE WO CON           $   2,887.25
41460387   MR L SPINE W CON            $   3,801.50
41460395   MR L SPINE WO&W CON         $   3,972.00
41460400   MR PELVIS WO CON            $   3,060.75
41460411   MR UPP EXTREM WO CON RT     $   2,310.00
41460429   MR LOW EXTREM WO CON RT     $   2,310.00
41460452   MR BREAST W CON BIL         $   2,887.25
41460478   MR ANGIO CHEST WO CON       $   3,063.50
41460497   MR ANGIO PELVIS W CON       $   2,397.75
41460510   MR ANGIO LOW EXTREM WO BI   $   2,887.25
41460528   MR ANGIO ABDOMEN W CON      $   3,063.50
41460536   MR UPP EXTREM JNT WO LT     $   2,310.00
41460544   MR LOW EXTREM JNT WO LT     $   2,310.00
41460552   MR UPP EXTREM WO CON LT     $   2,310.00
41460560   MR LOW EXTREM WO CON LT     $   2,310.00
41460582   MR C SPINE WO CON           $   2,887.25
41460588   MR ANGIO HEAD WO CON        $   3,063.50
41460589   MR T SPINE WO CON           $   2,887.25
41460592   MR ANGIO HEAD W CON         $   3,703.00
41460596   MR L SPINE WO CON           $   2,887.25
41460623   MR BRAIN WO CON             $   2,887.25
41460630   MR ANGIO HEAD WO CON        $   3,063.50
41460631   MR ABDOMEN WO&W CON         $   5,125.50
41460638   MR PELVIS WO&W CON          $   5,125.50
41460645   MR ANGIO NECK WO CON        $   3,063.50
41460650   MR ANGIO NECK WO&W CON      $   4,599.00
41460657   MR ABDOMEN WO&W CON         $   5,125.50
41460692   MR CHEST WO&W CON           $   5,125.50
41460706   MR LOW EXTREM JNT W LT      $   2,797.25
41460713   MR LOW EXTREM JNT WO&W LT   $   5,116.75
41460727   MR LOW EXTREM WO&W CON LT   $   5,116.75
41460734   MR LOW EXTREM JNT W RT      $   2,797.25
41460748   MR LOW EXTREM W CON RT      $   2,795.00
41460755   MR LOW EXTREM WO&W CON RT   $   5,116.75
41460783   MR UPP EXTREM JNT W LT      $   2,310.00
41460797   MR UPP EXTREM WO&W CON LT   $   5,116.75
41460804   MR UPP EXTREM JNT W RT      $   2,310.00
41460811   MR UPP EXTREM JNT WO&W RT   $   5,116.75
41460825   MR UPP EXTREM WO&W CON RT   $   5,116.75
41460832   MR ORB/FAC/NECK W CON       $   2,797.25
41460839   MR ORB/FAC/NECK WO&W CON    $   5,116.75
41460845   MR PELVIS WO&W CON          $   5,125.50
41460852   MR 3D W SEPARATE WKSTATN    $     379.50
41460859   MR ABDOMEN WO CON           $   3,972.00
41460866   IR PERIPHERL ART ATHERECT   $   2,964.00
41470000   INJ TX/DX/PRO IVPUSH INIT   $      72.00
41470035   INF IV HYDRAT INIT 1ST HR   $     180.00
41470049   INF IV HYDRAT EA ADD HR     $      36.00
41470070   INF TX/DX/PRO INIT 1ST HR   $     180.00
41490557   IR LEVEL II 60 MINS         $     768.00
41490616   XR BONE DENSITY(DXA)APEND   $     151.00
41490623   XR FLUORO NDL LOCAL SPINE   $     986.25
41490630   XR FLUORO NDL LOCAL SPINE   $   1,232.25
41490637   XR FLUORO NDL LOCAL SPINE   $   1,539.00
41490687   XR FB LOCAL NOSE TO RECTM   $     357.00
41490702   XR SIALOGRAM UNI            $     504.50
41490709   IR FLUOR VERTEBROPLT/AUGM   $     596.50
41490716   IR FLUORO CVAD PLACEMENT    $     618.00
41490723   IR AORTOGRAM THOR WO SER    $     988.50
41490730   IR PTA VENOUS               $   1,847.25
41490737   XR DISKOGRM LUMBAR SPINE    $     653.50
41490744   XR FLUORO PACEMAKER INSRT   $     986.25
41490751   IR INTRVAS US NONCOR INIT   $     773.00
41490765   IR ENVAS REP INFRAREN AAA   $   2,352.50
41490814   IR ENDOVAS REPR ILIAC ART   $   3,044.50
41500000   CT HEAD WO CON              $   1,935.50
41500018   CT HEAD W CON               $   2,372.75
41500026   CT HEAD WO&W CON            $   3,436.25
41500182   CT CHEST WO CON             $   1,133.50
41500240   CT ABDOMEN WO CON           $   2,259.25
41500257   CT ABDOMEN W CON            $   2,754.25
41500265   CT ABDOMEN WO&W CON         $   3,847.75
41500455   CT MAXILLOFACIAL WO CON     $   1,935.50
41500463   CT MAXILLOFACIAL W CON      $   2,430.00
41500471   CT MAXILLOFACIAL WO&W CON   $   3,436.25
41500489   CT SOFT TISSUE NECK WO      $   1,658.50
41500497   CT SOFT TISSUE NECK W CON   $   2,153.50
41500505   CT SOFT TISSUE NECK WO&W    $   2,645.75
41500513   CT CHEST WO CON             $   2,531.00
41500521   CT CHEST W CON              $   3,247.25
41500539   CT CHEST WO&W CON           $   4,654.75
41500679   CT PELVIS WO CON            $   1,745.25
41500687   CT PELVIS W CON             $   2,240.25
41500695   CT PELVIS WO&W CON          $   2,735.50
41500703   CT UPP EXTREM WO CON RT     $   1,363.75
41500711   CT UPP EXTREM W CON RT      $   2,065.75
41500729   CT UPP EXTREM WO&W RT       $   2,469.25
41500737   CT LOW EXTREMITY WO RT      $   1,363.75
41500745   CT LOW EXTREMITY W RT       $   2,065.75
41500752   CT LOW EXTREMITY WO&W RT    $   2,469.25
41500760   CT CERVICAL SPINE WO CON    $   2,476.25
41500778   CT CERVICAL SPINE W CON     $   2,971.25
41500786   CT THORACIC SPINE WO CON    $   2,202.25
41500794   CT THORACIC SPINE W CON     $   2,697.50
41500802   CT LUMBAR SPINE WO CON      $   2,151.25
41500810   CT LUMBAR SPINE W CON       $   2,645.75
41500919   CT GUIDED NEEDLE PLACEMNT   $   1,976.75
41500968   CT 3D W SEPARATE WKSTATN    $     594.50
41501000   CT ANGIO HEAD WO&W CON      $   3,555.75
41501007   CT ANGIO NECK WO&W CON      $   4,453.00
41501014   CT ANGIO CHEST WO&W CON     $   3,359.25
41501021   CT ANGIO PELVIS WO&W CON    $   3,359.25
41501028   CT ANGIO UPP EXTR WO&W UN   $   2,031.50
41501035   CT ANGIO LOW EXTR WO&W UN   $   2,031.50
41501042   CT ANGIO ABDOMEN WO&W CON   $   3,359.25
41501049   CT ANGIO AORT WO&W RUNOFF   $   4,006.75
41501164   CT CERVICAL SPINE WO&W      $   3,875.00
41501172   CT THORACIC SPINE WO&W      $   3,035.25
41501180   CT LUMBAR SPINE WO&W CON    $   3,875.00
41501222   CT CHEST W CON LTD          $   1,133.50
41501305   CT GUIDE CATH DRAIN         $   1,976.75
41501313   CT GUIDED NEEDLE PLACEMNT   $   2,180.75
41501339   CT MAXILLOFACIAL WO LTD     $     814.25
41501768   IR LEVEL I 60 MINS          $     776.75
41501775   IR LEVEL I 90 MINS          $   1,164.50
41501784   IR LEVEL III 60 MINS        $   1,293.00
41501791   IR LEVEL III 90 MINS        $   1,939.25
41501800   IR LEVEL II 60 MINS         $     970.25
41501826   CT ORBIT/SEL/FOS/EAR WO     $   1,935.50
41501834   CT ORBIT/SEL/FOS/EAR W      $   2,430.00
41501842   CT ORBIT/SEL/FOS/EAR WO&W   $   3,436.25
41501850   CT UPP EXTREM WO CON LT     $   1,363.75
41501858   CT UPP EXTREM W CON LT      $   2,065.75
41501866   CT UPP EXTREM WO&W LT       $   2,244.75
41501874   CT LOW EXTREMITY WO LT      $   1,363.75
41501882   CT LOW EXTREMITY W LT       $   2,065.75
41501890   CT LOW EXTREMITY WO&W LT    $   2,469.25
41501925   CT ABDOMEN WO CON           $   2,178.00
41501932   CT PELVIS WO CON            $   2,178.00
41501939   CT CHEST WO CON             $   2,178.00
41501953   CT CHEST WO CON             $   2,395.25
41501960   CT ABDOMEN WO CON           $   2,178.00
41501974   CT SOFT TISSUE NECK WO      $   2,095.50
41502030   CT PELVIS W CON             $   2,412.00
41502044   CT CHEST W CON              $   2,745.75
41502051   CT ABDOMEN W CON            $   2,745.75
41502065   CT SOFT TISSUE NECK W CON   $   2,444.50
41502121   CT PELVIS WO&W CON          $   3,281.75
41502135   CT CHEST WO&W CON           $   3,786.75
41502142   CT ABDOMEN WO&W CON         $   3,786.75
41502156   CT SOFT TISSUE NECK WO&W    $   3,186.00
41502187   CT 3D W SEPARATE WKSTATN    $     379.50
41600016   NM BONE MULTIPLE            $   1,751.00
41600024   NM BONE WHOLE BODY          $   1,826.00
41600065   NM BRAIN COMPLETE W FLOW    $   1,954.25
41600073   NM CARD BLOOD POOL SNGL     $   1,841.50
41600092   NM CEREBROSPINAL FLW VENT   $   1,106.50
41600099   NM CSF FLOW CISTERNOGRAM    $   2,663.50
41600115   NM KIDNEY SCAN W FLOW       $   1,610.75
41600131   NM LIVER & SPLEEN           $   1,396.50
41600198   NM PUL PERF PARTICULATE     $   1,505.50
41600255   NM THYROID UPTAKE SINGLE    $     731.75
41600263   NM THYROID UPTAKE MULTI     $     817.25
41600271   NM THYROID SCAN W UP MULT   $   1,190.75
41600560   NM KIDNEY W FLOW & FUNC     $   1,922.25
41600586   NM TUMOR LOCALIZE MULTI     $   1,949.25
41600602   NM HEPATOBILIARY DUCTS      $   1,248.50
41600610   NM MYOCARD PERF PLNR SNGL   $   2,040.25
41600628   NM GASTROINTEST BL LOSS     $   1,978.50
41600651   NM LIVER SPECT              $   1,610.75
41600669   NM BONE SPECT               $   2,040.50
41600677   NM MYOCAR PERF SPECT SNGL   $   1,231.75
41600685   NM MYOCAR PERF SPECT MULT   $   2,222.00
41600693   NM MYOCARD INFARCT SPECT    $     810.75
41601030   NM BONE 3 PHASE             $   1,922.25
41601071   NM GASTRIC EMPTYING         $   1,916.25
41601097   NM PUL VENT AERO MULTI PR   $   1,505.50
41601105   NM RADIOPHARM THRPY ORAL    $     829.25
41601147   INFUS/INSTIL RADIOELEMNT    $     248.50
41601170   NM PARATHYROID              $   1,919.25
41601188   NM GASTRIC EMPTYING         $   2,414.00
41601279   NM TUMOR LOCAL WB SNG DAY   $   2,743.50
41601329   NM TUMOR LOCALIZE SPECT     $   2,255.00
41601378   NM INFLAM PROCESS LOC LTD   $   2,141.25
41601410   NM INFLAM PROCES LOC SPEC   $   1,643.75
41601428   NM INFLAM PROCESS LOC WB    $   3,234.50
41601568   NM KIDNEY W FLW&FUN SNG W   $   1,457.50
41601632   NM CSF SHUNT EVALUATION     $   1,321.75
41601640   NM CARD BLD POOL 1ST PASS   $   1,050.75
41601654   NM LYMPH SYSTEM             $   2,579.75
41601661   NM CCK                      $     179.00
41601668   NM KID W FLO/FN MULT WO&W   $   1,457.50
41650011   US SOFT TISS HEAD & NECK    $     571.75
41650029   US GUIDED NEEDL PLACEMENT   $     271.50
41650037   US ABDOMEN COMPLETE         $   1,026.25
41650045   US ABDOMEN LIMITED          $     714.00
41650078   US RETROPERITONEAL COMPL    $     681.75
41650102   US RETROPERITONEAL COMPL    $     600.25
41650110   US RETROPERITONEAL COMPL    $     510.75
41650128   US PELVIS NON OB            $     681.75
41650177   US PELVIS NON OB            $     760.50
41650193   US GUIDED NEEDL PLACEMENT   $     850.00
41650201   US BREAST RT                $     286.75
41650208   US CHEST                    $     286.75
41650292   US PREG FOLLOWUP/EA GEST    $     567.25
41650318   US DPLX EXTRACRAN BIL-CMP   $   1,060.25
41650417   US ENCEPHALOGRAM            $     750.75
41650425   US PELVIS NON OB LTD F/U    $     560.50
41650458   US SCROTUM                  $     580.50
41650466   US TRANSVAGINAL             $     733.00
41650508   US PREG+DETL EA ADDL GEST   $     567.25
41650524   US V DPLX AB/PEL/RET CMP    $   1,060.25
41650532   US FETAL BIOPH PROF W NST   $     567.25
41650540   US GUIDED NEEDL PLACEMENT   $     765.50
41650557   US GUIDED AMNIOCENTESIS     $     527.00
41650565   US V DPLX AO/IVC/GRFT CMP   $   1,060.25
41650573   US V DPLX VENOUS EXT RT     $     746.50
41650607   US HIPS INFANT DYNAMIC      $     488.50
41650615   US PREG 1 OR >FETUSES LTD   $     567.25
41650656   IR LEVEL I 60 MINS          $     776.75
41650663   IR LEVEL I 90 MINS          $   1,164.50
41650670   IR LEVEL I 120 MINS         $   1,410.25
41650672   IR LEVEL II 60 MINS         $     970.25
41650679   IR LEVEL II 90 MINS         $   1,358.00
41650686   IR LEVEL II 120 MINS        $   1,745.50
41650698   IR LEVEL III 60 MINS        $   1,293.00
41650770   US SONOHYSTEROGRAM          $   1,185.50
41650778   US GUIDED NEEDL PLACEMENT   $     850.00
41650786   US BREAST LT                $     286.75
41650802   US V DPLX VENOUS EXT LT     $     746.50
41650810   US V DPLX VENOUS EXT RT     $     746.50
41650818   US V DPLX VENOUS EXT LT     $     746.50
41650826   US V DPLX VENOUS EXT BIL    $   1,490.50
41650834   US V DPLX VENOUS EXT BIL    $   1,490.50
41650841   US GUIDED NEEDL PLACEMENT   $   1,164.50
41650842   MA MAMMO PLACE NDL EA LT    $     991.25
41650848   US GUIDED NEEDL PLACEMENT   $   1,164.50
41650850   MA MAMMO PLACE NDL EA RT    $     991.25
41650858   US EXTREMITY NON VAS RT     $     746.50
41650865   US EXTREMITY NON VAS LT     $     746.50
41650873   US EXTREMITY NON VAS LT     $     746.50
41650881   US V DPLX ART LOW EXT BIL   $   1,255.75
41650889   US V DPLX ART LOW EXT RT    $     849.00
41650897   US V DPLX ART LOW EXT LT    $     849.00
41650905   US V DPLX ART UP EXT BIL    $   1,344.75
41650913   US V DPLX ART UP EXT RT     $     891.75
41650921   US V DPLX ART UP EXT LT     $     891.75
41650928   US DPLX EXTRACRAN UNI-LTD   $     537.75
41650935   US DPLX EXTRACRAN LT-LTD    $     537.75
41650942   US DPLX EXTRACRAN RT-LTD    $     537.75
41660595   US PELVIS NON OB            $   1,001.75
41660609   NM THERAPY CONSULTATION     $     280.50
41660658   NM PUL PERF PARTICULATE     $   1,332.50
41660665   NM PUL VENT AERO MULTI PR   $   1,332.50
41660672   US PREG<14WK SNGL1ST GEST   $     404.25
41660686   US PREG TRANSVAGINAL        $     404.25
41660699   US PREG=>14WK SNG 1ST GES   $     404.25
41660713   US PREG+DETL SNGL1ST GEST   $     778.00
41660727   US GUIDE INTRAOP 0-1 HOUR   $     557.50
41660734   US GUIDE INTRAOP 1-2 HOUR   $   1,207.00
41660741   US EXTREMITY NON VAS BIL         $   1,492.25
41660748   US EXTREMITY NON VAS BIL         $   1,492.25
41660755   US SPINAL CANAL & CONTENT        $     571.75
41660776   US GUIDED VASCULAR ACCESS        $     118.50
41700097   TOBRAMYCIN 1.2 GM INJ            $     870.00
41700113   GUANFACINE 1MG TAB               $      15.25
41700139   DOPAMINE 400MG/5ML INJ           $      89.25
41700220   CEFUROXIME 1.5 GM INJ            $     112.50
41700279   CARBAMIDE (GLYOXIDE) 60MLBOT     $      45.25
41700287   NIACIN 50MG TAB                  $      10.50
41700311   CEFOTETAN 1GM INJ                $     110.00
41701087   VINCRISTINE 2MG/2ML INJ          $     229.18
41701095   CHLORAL HYDRATE 500MG CAP        $      11.00
41701129   RUBELLA VACCINE INJ              $     125.75
41701145   LIDOCAINE W/EPI 1% 30ML INJ      $      76.00
41701166   ALDESLEUKIN 22MU/INJ             $   1,836.00
41701178   ATROPINE 1% 1ML EYE DROPS        $      19.50
41701210   ATORVASTATIN 20MG TAB            $      25.50
41701350   INTERFERON ALFA-2A 3MU/ML INJ    $     163.00
41701376   POLY/NEOM/BACI (NEOSPORIN)15GM   $      32.25
41701434   AMPICILLIN/SULBACTA 1.5MG ADV    $      97.00
41701467   STREPTOKINASE 1.5MU INJ          $   1,796.25
41701475   PLACEBO ORAL                     $      11.00
41701483   PLACEBO INJECTIONS               $      55.25
41701509   PYRIDOXINE (B6) 50MG TAB         $      10.50
41701517   DICLOFENAC 25MG TAB              $      12.50
41701590   LIDOCAINE PF 0.5% 50ML INJ       $     109.25
41701681   FLUOCINONIDE 0.05% 15GM          $      95.50
41701756   THIAMINE 100MG TAB               $      10.75
41701970   POTASSIUM CHLORIDE 20MG TAB      $      13.50
41702002   MESALAMINE 60ML RECTAL ENEMA     $      60.00
41702036   CHARCOAL W/SORBITOL 240MLBOT     $      61.00
41702044   ERTHROMYCIN 333MG TAB            $      12.25
41702382   POT/SOD CITRATE(POLYCITRA)30ML   $      12.50
41702408   DIPHENOXYLA/ATROP(LOMOTIL)60ML   $      39.00
41702416   SORBITOL 60MLBOT                 $      26.25
41702580   CITRIC ACID/SOD CITRATE 120ML    $      38.25
41702614   PHENYTOIN 125MG/5ML 60MLBOT      $      51.25
41702788   AMINOCAPROIC ACID 5GM/20ML 250   $      69.75
41702796   G.I. COCKTAIL                    $      77.00
41702838   K Y 45GM JELLY                   $      27.75
41702846   NIMODIPINE 30MG CAP              $      21.00
41702853   DINOPROSTONE 5MG/15ML VAG SYR    $     398.25
41702861   NICARDIPINE 30MG CAP             $      11.00
41702879   NICARDIPINE 20MG CAP             $      13.00
41702885   NORCO 10MG/325MG TAB             $      15.00
41702903   LISINOPRIL 5MG TAB               $      15.25
41702937   BUTALBITAL/APC (FLORICET) TAB    $      14.00
41702986   ASTEMIZOLE 10MG TAB              $      19.50
41702994   PROPAFENONE 150MG TAB            $      19.50
41703000   BROMOCRIPTINE 2.5MG TAB          $      21.75
41703034   DIPHENHYDRAMINE 25MG/10ML UDC    $      14.50
41703059   HYOSCYAMINE 0.125MG TAB          $      13.50
41703075   ALPROSTADIL(PED) 500MCG/ML INJ   $     377.50
41703091   WARFARIN 1MG TAB                 $      13.75
41703125   ADENOSINE 6MG/2ML INJ            $     164.00
41703133   SELEGILINE 5MG TAB               $      20.75
41703141   PRAMOXINE 1% 15GM RECTAL FOAM    $      46.25
41703158   FLUCONAZOLE 200MG/100ML NS       $     504.75
41703174   CAPSAICIN 0.025% 45GM            $      35.75
41703190   FLUOXETINE 20MG CAP              $      23.25
41703232   MUPIROCIN 2% 15GM                $      89.00
41703349   SCOPOLAMINE 0.4MG/ML INJ         $      78.75
41703380   MITOMYCIN 5MG/ML INJ             $     524.25
41703406   FILGRASTIN 300 MCG/ML INJ        $     458.25
41703414   FENTANYL 25MCG PATCH             $      57.00
41703422   FENTANYL 50MCG PATCH             $      89.50
41703430   FENTANYL 75MCG PATCH             $     106.00
41703448   FENTANYL 100MCG PATCH            $     118.50
41703505   IBUPROFEN 100MG/5ML 120MLBOT     $      39.50
41703521   CHLOROTHIAZIDE 500MG INJ         $     101.75
41703562   VERAPAMIL SR 180MG TAB           $      19.50
41703588   NICOTINE TRANSDERMAL 7MG PATCH   $      26.00
41703596   NICOTINE TRANSDERMA 14MG PATCH   $      26.00
41703604   NICOTINE TRANSDERMA 21MG PATCH   $      23.75
41703612   FLUMAZENIL 0.5MG/5ML INJ         $     103.00
41703620   BUSPIRONE 10MG TAB               $      17.50
41703646   TICLOPINDINE 250MG TAB           $      20.25
41703661   MINOXIDIL 2.5MG TAB              $      13.00
41703695   ACYCLOVIR 200MG/5ML 60MLBOT      $      91.50
41703703   PHENYLEPHRINE 2.5%2ML EYE DROP   $      33.50
41703711   MAGIC MOUTHWASH 240ML            $      38.25
41703729   ZALCITABINE 0.750 MG TABLET      $      16.00
41703745   DEXTROSE 10% 5ML INJ             $      65.75
41703752   DICLOFENAC 0.1% 5ML EYE DROPS    $      73.75
41703760   SUCRALFATE 1GM/10ML 60MLBOT      $      39.50
41703778   PILOCARPINE 5MG TAB              $      12.25
41703794   ZIDOVUDINE 200 MG/20ML VIAL      $      93.00
41703802   ZIDOVUDINE 50MG/5ML 60MLBOT      $      44.25
41703810   ISOFLURANE 100 ML INH            $     352.25
41703828   IFOSFAMIDE 3GM INJ               $     493.75
41703836   MESNA 1 GM/10 ML INJ             $     459.40
41703844   ALKA SELTZER 2-TAB PACK          $      10.00
41703851   SILVER SULFADIAZINE 1% 20GM      $      38.00
41703885   MESNA 200 MG/2ML AMPULE          $      77.75
41703893   SODIUM BICARBONATE 648 MG TAB    $      10.75
41703919   METHOXAMINE 20 MG/1 ML INJ       $     147.50
41703927   RISPERIDONE 1 MG TAB             $      23.25
41703935   BUPIVACAINE DEXTROSE 2 MG INJ    $      86.00
41703943   DANAZOL 200 MG CAP               $      16.00
41703950   NYST/LIDO,MAAL MOUTHWASH 180ML   $      34.50
41703976   HYDROMORPHONE 50MG/5ML INJ       $     123.00
41703984   HYDROCORTISONE 20MG TAB          $      10.75
41703992   LEVOTHYROXINE 75 MCG TAB         $      12.25
41704008   METAPROTERENOL 10 MG/5 ML DOSE   $      12.25
41704032   NIACIN 250 MG CAP                $      11.00
41704040   SODIU THIOSULFATE 1GM/10ML INJ   $      77.00
41704065   HAEMOPHILUS B CONJ VACC 0.5 ML   $     103.75
41704107   LEUPROLIDE 7.5 MG INJ            $   1,683.75
41704156   ZAFIRLUKAST 20MG TABLET          $      16.25
41704172   HYOSCYAMINE 0.5MG/ML INJ         $     122.75
41704180   DORZOLAMIDE 2% 5ML EYE DROPS     $      86.25
41704198   METHOTREXATE 2.5 MG TAB          $      27.00
41704206   INSULIN REGULAR 100U/1ML DOSE    $      73.50
41704214   CISATRACURIUM 20MG/10ML INJ      $     131.50
41704222   FOSPHENYTOIN 100 MG/2ML INJ      $     137.50
41704230   CYCLOSPORINE 25MG CAP            $      17.50
41704255   PANCURONIUM 1MG/ML 10ML INJ      $      83.25
41704263   ANESTHETIC/DYCL(CEPACOL) 120ML   $    29.75
41704271   ATORVASTATIN 10MG TAB            $    19.75
41704297   THEOPHYLLINE EX 400MG TAB        $    15.50
41704305   NAPHAZOLINE 0.1% 15ML EYE DROP   $    70.50
41704321   TRIHEXYPHENIDYL 5MG TAB          $    11.50
41704339   ROBITUSSIN CODEINE 10ML DOSE     $    12.50
41704347   VENLAFAXINE 25MG TABLET          $    17.25
41704354   ORABASE 5GM OINTMENT             $    29.00
41704396   IPRA/ALBUT(COMBIVENT) 14GM INH   $   144.50
41704404   AMINO ACID 10% 500ML             $   106.00
41704412   ZOSYN 2.25GM VIAL                $   104.00
41704420   RIFAMPIN 600 MG INJ              $   396.25
41704545   ZOSYN 3.375GM VIAL               $   121.25
41704578   FERROUS SULFATE 325MG TAB        $    10.50
41704586   MULTISTIX BOX                    $    27.00
41704594   CAPSAICIN 0.075% 30GM            $    52.25
41704602   DOPAMINE 800MG/5ML INJ           $    95.25
41704610   EPINEPHRINE 1MG/ML INJ           $    95.25
41704628   ERYTHROMYCIN 1GM INJ             $    94.00
41704644   ALUMINUM HYDROXIDE 475MG CAP     $    11.25
41704651   CROMOLYN 8.1GM INH - PER TX      $     4.25
41704669   ERYTHROMYCIN 500 MG INJ          $    84.00
41704677   FLUCONAZOLE 100MG TAB            $    37.75
41704685   HALOPERIDOL 2MG/ML 60ML BOT      $   129.00
41704701   PRED/SULF (VASOCIDIN) 5ML EYED   $    67.25
41704719   TEMAZEPAM 7.5MG CAP              $    11.00
41704735   TRIFLURIDINE 7.5ML EYE DROP      $   245.00
41704842   DEXTROSE 5% 250ML EXCEL BAG      $    95.00
41704859   DEXTROSE 5% NS 0.9% 500 ML       $    75.25
41704917   LEVOFLOXACIN 500MG TAB           $    42.75
41704925   LEVOFLOXACIN 500MG/100ML D5      $   177.25
41704933   INDIA INK TATTOO 100ML           $    32.50
41704941   HYDROMORPHONE 3MG SUPP           $    17.50
41704958   DEXTROSE 5% NACL 0.225% 500ML    $    75.25
41704974   DEXTROSE 5% 50ML*MINI BAG PLUS   $    75.25
41705005   PETROLATUM(VASOLINE) 5GM PKG     $    10.75
41705013   STERILE WATER 250 ML             $    92.50
41705021   HEPARIN 1000 U/ML 10ML INJ.      $    74.50
41705054   HYDROC/APAP(LORCET)10/650MG TB   $    12.25
41705062   HEPARIN 1000U/500ML PM BAG       $    84.00
41705070   OCTREOTIDE 200MG/ML INJ          $   499.00
41705088   LEVOFLOXACIN 250ML/50ML D5       $   139.50
41705120   ATENOLOL 5MG/10ML INJ            $    96.50
41705146   HEPATITIS A (IMM GLOB) 2ML       $   376.75
41705153   LOSARTAN 25MG TAB                $    17.75
41705203   SILVER NITRATE APPLICATOR BOX    $    35.50
41705211   MULTIVITAMIN CONC 5ML INJ        $    90.50
41705229   STERILE WATER 240ML              $    75.25
41705260   BRIMONIDINE 5 ML EYE DROPS       $   110.50
41705278   NALMEFENE 100 MCG/ML INJ         $    87.00
41705286   LATANOPROST 2.5 ML EYE DROPS     $   138.50
41705294   PHENOBARBITAL 20 MG/5ML 60M BO   $    24.00
41705302   BUPROPION SR 100MG TAB           $    19.25
41705328   DIVALPROEX E.C. 500MG TAB        $    19.50
41710005   SILVER SULFADIAZINE 1% 50 GM     $    48.25
41710013   SILVER SULFADIAZINE 1% 400GM     $   105.50
41710138   HYALURONATE 0.5ML SYRINGE        $   218.25
41710187   COLLAGEN ABS(HELISTAT) 3X4 PAD   $   149.00
41710229   CEFAZOLIN 1GM/50ML PREMIX        $    83.00
41710252   CEFTAZIDIME 1GM INJ              $     116.25
41710260   CEFTAZIDIME 2GM INJ              $     139.50
41710286   CEFTRIAXONE 1GM INJ              $     179.50
41710302   CEFTRIAXONE 2GM INJ              $     279.50
41710369   CLINDAMYCIN 300MG/2ML INJ        $      86.00
41710419   DOXORUBICIN 10MG/5ML VIAL        $     170.50
41710427   DOXYCYCLINE 100MG INJ            $     130.00
41710526   FAT EMULSION 20% 250ML PREMIX    $      86.25
41710542   FLUOROURACIL 500MG/10ML INJ      $     136.75
41710559   FLOUROMETHOLONE 0.1% 10ML EYED   $      56.00
41710575   GENTAMICIN 80MG/2ML INJ          $      73.25
41710591   HETASTARCH 6% 500ML INJ          $     184.00
41710617   IMIPENEM/CILASTATIN 500MG INJ    $     146.75
41710633   MECHLORETHAMINE 10MG INJ         $      79.75
41710674   METRONIDAZOLE 500MG/100ML BAG    $      94.50
41710724   NAFCILLIN 1GM VIAL               $      80.75
41710765   NAFCILLIN 2GM VIAL               $      87.00
41710773   PENICILLIN G 5MU INJ             $      78.50
41710781   PENICILLIN G 20MU INJ            $     129.00
41710963   VANCOMYCIN 500MG INJ             $      96.25
41711003   ACYCLOVIR 500MG INJ              $     177.25
41711011   ALBUMIN 25% 100ML BOT            $     456.00
41711045   AMIKACIN SULFATE 500MG/2ML INJ   $      93.00
41711052   AMINOPHYLLINE 250MG/10ML INJ     $      73.00
41711060   AMINOPHYLLINE 500MG/20ML INJ     $      73.50
41711086   AMPICILLIN 1GM INJ               $      78.75
41711094   AMPICILLIN 250 MG INJ            $      76.75
41711102   AMPICILLIN 125MG INJ             $      72.75
41711136   AMPICILLIN 500MG INJ             $      77.75
41711144   AMPICILLIN 2GM INJ               $      87.50
41711185   BLEOMYCIN SULFATE 15 UNIT INJ    $     601.00
41711201   DANAPAROID 750 V/0.6ML AMPULE    $     342.00
41711342   QUINAPRIL 5MG TABLET             $      16.00
41711359   DINOPROSTONE E2(CERVIOIL)10MG    $     482.00
41711367   ENALAPRIL 1.25MG/ML INJ          $     122.75
41711375   DIVALPROEX E.C. 125MG TAB        $      13.00
41711417   GLIPIZINE XL 5MG TABLETS         $      12.25
41711425   MORPHINE 4MG/ML INJ              $      73.50
41711441   DONEPEZIL 5MG TAB                $      26.00
41711449   LOTRISONE CREAM 45GM TUBE        $     131.50
41711457   KETOROLAC 30MG/ML INJ            $      83.75
41711481   KETOROLAC 60MG/2ML INJ           $      87.25
41711489   MEDROXYPROGESTERONE 150MG/ML I   $     179.25
41711497   EPINEPHRINE 5MG/ML 5ML MDV       $     164.25
41711505   GOSERELIN IMPLANT 10.8MG INJ     $   3,109.25
41711521   ORABASE-B 6GM TUBE               $      30.25
41711537   LAMOTRIGINE 100MG TAB            $      22.25
41711545   TOPIRAMATE 25MG TAB              $      17.75
41711561   RITUXIMAB 100 MG INJ             $     978.00
41711585   BUPROPION 75MG TABLET            $      15.25
41711593   NTG SPRAY UD-AMBULANCE           $      18.50
41711601   TOPIRAMATE 100MG TAB             $      25.25
41711609   GEMCITABINE 1 GM INJ             $     493.98
41711633   AZITHROMYCIN 250MG TAB           $      34.50
41711641   CLOPIDOGREL BISULFATE 75MG TAB   $      26.75
41711649   HH ATROVENT/PROVENTIL            $      21.75
41711665   CLINAMYCIN 300MG CAP             $      27.00
41711683   OPIUM TINCTURE 1ML DOSE          $      13.00
41711691   TERBINAFINE 1% 30GM TUBE         $     147.00
41711707   HOMATROPINE 5% 5ML EYE DROPS     $      53.25
41711715   MEDROXYPROGESTERONE 5MG TAB      $      15.00
41711723   OLANZAPINE 5MG TAB               $      30.25
41711731   DOLASETRON 12.5MG INJ            $      82.50
41711747   LITHIUM CARBONATE CR 450MG TAB   $      13.00
41711755   EDETATE DISODIUM 3GM INJ         $     273.75
41711763   ENOXAPARIN 40MG/0.4ML INJ        $      98.00
41711779   TAMSULOSIN 0.4 MG CAP            $      18.00
41711797   INFLIXIMAB 100 MG INJ            $   1,387.50
41711805   CARVEDILOL 3.125MG TABLET        $      18.50
41711813   STERILE WATER 10ML INJ           $      12.25
41711821   AZITHROMYCIN 500MG/VIAL          $     135.75
41711829   LANSOPRAZOLE 30MG CAP            $      28.75
41720004   ACETAZOLAMIDE 500MG INJ          $     138.50
41720061   ATROPINE 1MG/10ML INJ            $     110.25
41720095   ATROPINE 0.4MG/ML INJ            $      70.00
41720103   ATROPINE 1MG/1ML INJ             $      71.75
41720129   BACITRACIN 50000U INJ            $      86.00
41720152   BENZTROPINE 2MG/2ML INJ          $      95.50
41720160   BETAMETHAS/PHOS/ACE 6MG/ML INJ   $      87.75
41720178   BETHANECHOL 5MG/1ML INJ          $      87.50
41720228   BUPIVACAINE 0.5% 30ML INJ        $      97.50
41720244   BUPIVACAINE 0.25% 30ML INJ       $      88.50
41720251   BUPIVACAINE 0.75% 30ML INJ       $      90.25
41720269   BUPIVACAINE/EPI 0.5% 30ML INJ    $      95.50
41720277   BUPIVACAINE/EPI 0.75% 30ML INJ   $      96.50
41720285   BUPIVACAINE/EPI 0.25% 30ML INJ   $      94.00
41720301   BUTORPHANOL 2MG/1ML INJ          $      97.50
41720335   CALCIUM CHLORIDE 10%/10ML INJ    $     107.75
41720343   CALCIUM GLUC 0.47MEQ/ML 10ML     $      73.50
41720350   CARMUSTINE 100MG/3ML INJ         $     378.50
41720368   CHLORDIAZEPOXIDE 100ML INJ       $     134.25
41720384   CHLORPROMAZINE 50MG/2ML INJ      $      87.75
41720426   CODEINE 60MG/ML INJ              $      83.25
41720434   CODEINE 30MG/ML INJ              $      62.75
41720483   CYANOCOBALAMIN/B12 1MG/ML INJ    $      72.25
41720517   CYCLOPHOSPHAMIDE 500MG INJ       $     178.20
41720533   CYCLOPHOSPHAMIDE 100 MG INJ      $      38.50
41720558   CYTARABINE 100MG INJ             $     233.50
41720566   CYTARABINE 500MG INJ             $     157.25
41720582   DACTINOMYCIN 0.5MG/3ML INJ       $      82.00
41720590   DAUNORUBICIN 20MG/10ML INJ       $     468.50
41720608   DEFEROXAMINE MESYLAT 500MG INJ   $      78.00
41720640   DEXAMETHASONE 4MG/ML INJ         $      75.75
41720665   DEXTROSE 50% 25GM/50ML SYRINGE   $      85.75
41720673   DEXTROSE 50% IN WATER INJ        $      75.00
41720707   DIAZEPAM 10MG/2ML SYRINGE        $      79.25
41720749   DICYCLOMINE 10MG/2ML INJ         $     127.00
41720764   DIGOXIN 0.5MG/2ML INJ            $      78.25
41720772   DIGOXIN 0.1MG/ML INJ             $      65.75
41720780   DIHYDROERGOTAMINE 1MG/ML INJ     $     178.25
41720798   DRAMAMINE 50MG/ML INJ            $      61.50
41720822   DIPHENHYDRAMINE 50MG/ML INJ      $      75.25
41720848   DIPHTHERIA/TET/PERTU 0.5ML INJ   $     146.25
41720855   DIPHTHERIA TETANUS 0.5ML INJ     $      86.25
41720871   DOPAMINE 200MG/5ML INJ           $      80.00
41720905   DOXAPRAM 20MG/ML INJ             $     275.25
41720913   DROPERIDOL 5MG/2ML INJ           $      87.75
41720947   EDROPHONIUM 10MG/ML 10ML INJ     $     103.75
41720996   EPINEPHRINE 10MG/10ML SYRINGE    $    87.25
41721002   EPINEPHRINE 0.3ML INJECTION      $    82.00
41721010   EPINEPHRINE 1MG/ML INJ           $    95.25
41721036   ESMOLOL 2.5GM/10ML INJ           $   294.75
41721051   ESTRADIOL CYPIONATE 5ML/ML INJ   $    27.00
41721085   ESTROGENIC SUBST 25MG/5ML INJ    $   209.00
41721093   ETHACRYNATE 50MG INJ             $   100.00
41721119   ETOPOSIDE 100 MG/5 ML INJ        $   188.50
41721127   FENTANYL STERIL 100MCG/2ML INJ   $    77.75
41721135   FENTANYL 250MCG/5ML INJ          $    84.50
41721176   FUROSEMIDE 100MG/10ML INJ        $    78.50
41721184   FUROSEMIDE 20MG/2ML INJ          $    73.50
41721234   GLYCOPYRROLATE 0.2MG/1ML INJ     $    73.75
41721242   GLYCOPYRROLATE 0.2ML/ML 20ML     $    79.00
41721267   HALOPERIDOL 5MG/1 ML INJ         $   101.00
41721275   HEPARIN 5000 UNITS/ML VIAL       $    73.75
41721283   HEPARIN 1000 UNITS/ML VIAL       $    74.50
41721309   HEPARIN 100 UNITS/ML VIAL        $    61.50
41721317   HEPARIN LOCK FLUSH 10 UNITS/ML   $    73.25
41721333   HEPARIN 20,000 UNITS/ML VIAL     $    88.25
41721341   HEPARIN 10000 UNITS/ML VIAL      $    77.00
41721374   HYALURONIDASE 150U/ML INJ        $    82.75
41721390   HYDROCORTISONE 250MG/2ML INJ     $    82.00
41721408   HYDROCORTISONE 100MG/2ML INJ     $    78.00
41721416   HYDROMORPHONE 4MG/ML INJ         $    75.00
41721424   HYDROXYZINE 50MG/ML INJ          $    73.50
41721465   INDIGOTINDISULFONATE 5ML INJ     $    98.00
41721572   IRON DEXTRAN 100MG/2ML INJ       $   162.25
41721580   ISOPROTERENOL 1MG/5ML INJ        $   202.75
41721622   KETAMINE HCL 500MG/5ML INJ       $   281.50
41721630   LABETALOL 5MG/ML 20ML INJ        $    89.00
41721648   LEUCOVORIN CALCIUM 50MG INJ      $   138.25
41721671   LIDOCAINE 1% 20ML INJ            $    71.00
41721689   LIDOCAINE 1% 50MG/5ML SYRINGE    $   101.50
41721697   LIDOCAINE PF 2% 20ML INJ         $   112.00
41721713   LIDOCAINE 1.5% 20ML INJ          $   114.75
41721747   LIDOCAINE 2% 100MG/5ML SYRINGE   $    84.75
41721762   LIDOCAINE W/EPI 1.5% 30ML        $   101.25
41721770   LIDOCAINE EPI 2% 30ML INJ        $    78.75
41721788   LIDOCAINE W/EPI 2% 20ML INJ      $    76.75
41721796   LIDOCAINE EPI 1:100000 1% 20ML   $    82.00
41721804   LIDOCAINE 2% 20ML INJ            $    71.00
41721820   LIDOCAINE 1% 50ML INJ            $    88.50
41721853   LIDOCAINE 0.5% 50ML INJ          $    85.50
41721887   LIDOCAINE W/DEXTR 1.5% 2ML INJ   $    73.75
41721895   LIDOCAINE W/EPI 0.5% 50ML INJ    $    88.50
41721911   MAGNESIUM SULFATE 1GM/2ML INJ    $    75.25
41721952   MEPERIDINE 50MG/ML INJ           $    73.75
41721960   MEPERIDINE 25MG/ML INJ           $    73.75
41721978   MEPERIDINE 100MG/ML INJ          $    74.00
41721986   MEPIVACAINE PF 2% 20ML INJ       $   109.50
41721994   MEPIVACAINE 1% 30ML INJ          $    95.00
41722018   METARAMINOL BITART 10ML/ML INJ   $    82.75
41722026   METHADONE 10MG/ML INJ            $    73.00
41722034   METHOCARBAMOL 500MG TAB          $    10.75
41722067   METHYLDOPA 250MG/5ML INJ         $   103.00
41722075   METHYLENE BLUE 10MG/ML INJ       $    91.75
41722083   METHYLERGONOVINE 0.2MG/1ML INJ   $    87.25
41722091   METHYL/AC(DEPO-MEDROL) 40MG/ML   $    95.00
41722109   METHYLPREDNISOLONE 80MG/ML       $      95.00
41722117   METHYLPREDNISOLONE 40MG/ML INJ   $      78.50
41722125   METHYLPREDNISOLONE 500MG/8ML     $     103.00
41722133   METHYLPREDNISOLONE 125MG/2ML     $      82.75
41722141   METOCLOPRAMIDE 10MG/2ML INJ      $      78.75
41722182   METOPROLOL 5MG/5ML INJ           $      83.00
41722208   MORPHINE SULFATE 10MG            $     108.75
41722240   NALBUPHINE 20MG/ML INJ           $      78.75
41722265   NALOXONE 0.4MG/ML INJ            $      82.75
41722273   NALOXONE 2MG/2ML INJ             $      89.00
41722281   NALOXONE 0.4MG/ML SYRINGE        $      85.75
41722307   NALOXONE 0.04MG/2ML INJ          $      77.75
41722349   NEOSTIGMINE 1MG/ML 10ML INJ      $      73.25
41722356   NITROGLYCERIN 50MG/10ML INJ      $     117.25
41722372   NOREPINEPHRINE 4MG/4ML INJ       $     104.50
41722398   OXYTOCIN 10U/ML INJ              $      73.75
41722406   PANCURONIUM 4MG/2ML INJ          $      77.75
41722414   PENICIL G/BENZAT/PROC 0.6MU/ML   $      70.50
41722422   PENICILL G/BENZATHINE 0.6MU/ML   $      98.00
41722430   PENICILL G/BENZATHIN 2.4MU/4ML   $     131.00
41722455   PENICILL G/BENZATHIN 1.2MU/2ML   $     119.50
41722463   PENICILLIN G PROC 1.2MU/2ML TU   $     109.50
41722471   PENICILLIN G PROC 2.4MU/4ML TU   $      90.25
41722505   PENTOBARBITAL 100MG/2ML INJ      $      34.50
41722513   PHENOBARBITAL 65MG/ML INJ        $      77.00
41722521   PHENOBARBITAL 130MG/ML INJ       $      77.00
41722539   PHENTOLAMINE MESYLA 5MG/ML INJ   $     155.50
41722547   PHENYLEPHRINE 1% 10MG/ML INJ     $      73.00
41722554   PHENYTOIN 100MG/2ML INJ          $      85.00
41722570   PHENYTOIN 250/5ML INJ            $      88.00
41722588   PHYSOSTIGMINE 2MG/2ML INJ        $     104.75
41722596   PHYTONADIONE 1MG/0.5ML SYRINGE   $      80.00
41722604   PHYTONADIONE 10MG/1ML INJ        $      85.75
41722620   POLYMYXIN B 0.5MU INJ            $      38.50
41722638   POTASSIUM ACE 2MEQ/ML 20ML INJ   $      16.75
41722661   POTASSIUM CHLOR 20 MEQ INJ       $      74.00
41722679   POTASSIUM CHLOR 40 MEQ INJ       $      75.00
41722687   POTASSIUM PHOS 4.4MEQ/ML 15ML    $      76.00
41722711   PROCHLORPERAZINE 10MG/2ML INJ    $      92.25
41722729   PROGESTERONE 50MG/ML 10ML INJ    $     186.00
41722752   PROMETHAZINE 25MG/ML INJ         $      78.75
41722760   PROPRANOLOL 1MG/ML INJ           $     129.00
41722778   PROTAMINE 50MG/5ML INJ           $      90.75
41722794   PRALIDOXIME 1GM INJ              $     118.00
41722802   PYRIDOSTIGMINE 5MG/ML 2ML INJ    $      79.75
41722810   PYRIDOXINE 100MG/ML 10ML INJ     $      18.25
41722828   PROMETHAZINE 50MG/ML INJ         $      81.25
41722885   SINCALIDE 5MCG INJ               $     154.75
41722893   SODIUM ACETAT 2MEQ/ML 20ML INJ   $      13.75
41722919   SODIUM BICARB 50 MEG/50ML SYR    $     129.50
41722927   SODIUM BICARB 5 MEG/10ML SYR     $     111.50
41722935   SODIUM CHLORIDE 0.9% 10ML INJ    $      13.00
41722943   SOD CHLORIDE 4MEQ/ML 30ML INJ    $      76.00
41722968   SOD PHOSPHATE 4MEQ/ML 15ML INJ   $      75.50
41722976   SODIUM TETRADECYL 3% 2ML INJ     $     132.50
41722984   SPECTINOMYCIN 2GM INJ            $      92.00
41722992   STREPTOKINASE 0.75MU INJ         $   1,120.00
41723024   SUCCINYLCHOLINE 1000MG INJ       $     117.75
41723032   SUCCINYLCHOLINE 200MG/10ML INJ   $      74.00
41723040   SUFENTANIL CITRA 50MCG/ML 2ML    $   101.25
41723057   TERBUTALINE 1MG/ML INJ           $   146.25
41723073   TESTOSTERONE CYPI 200MG/ML INJ   $   129.00
41723099   TETANUS IMMUNE GLOBUL 250U SYR   $   144.25
41723107   TETANUS TOXOID ABSOR 0.5ML INJ   $    83.25
41723123   THIAMINE 100MG/1ML INJ           $    78.75
41723131   THIOPENTAL 500MG/20ML SYRINGE    $    85.00
41723149   THROMBIN TOPICAL 5000 UNIT INJ   $   138.75
41723156   TRACE METAL 1ML INJ              $    21.00
41723172   TRIAMCINOLONE 40MG/ML INJ        $    91.00
41723206   TRIMETHOBENZAMID 200MG/2ML INJ   $    65.75
41723214   TUBERCULLIN (PPD) 5 UNITS/5CC    $   133.75
41723222   TUBOCURARINE 30MG/10ML INJ       $    92.00
41723248   VASOPRESSIN 20U/ML INJ           $    98.50
41723263   VECURONIUM 10MG INJ              $   103.75
41723271   VERAPAMIL 5MG/2ML INJ            $    74.00
41723313   MULTIVITAMIN (MVI-12) 10ML INJ   $    96.75
41723370   BISMUTH SUBSA(PEPTO BISM)120ML   $    27.25
41723388   MULTIVITAMIN (THERAGRAN) 120ML   $    33.50
41723404   GUAIF/CODEINE(ROBITUSSIN)120ML   $    33.25
41723412   GUAIFE/PSEUD(ROBITUSSIN) 120ML   $    25.25
41723420   GUAIFENES/DM (ROBITUSSIN)120ML   $    31.00
41723446   GUAIFENESIN 120ML                $    26.75
41723453   PROMETHZAINE/CODEINE 120MLBOT    $    23.25
41723479   PROMETHAZINE/VC 120MLBOT         $    33.50
41723503   MAG/CARB/ALGIN (GAVISCON)180ML   $    19.75
41723511   KAOLIN/PECTIN(KAOPECTATE)120ML   $    27.25
41723552   METOCLOPRAMIDE 5MG/5ML 60MLBOT   $    27.50
41723560   DOBUTAMINE 250MG/20CC INJ        $    99.25
41723594   PROCAINAMIDE 100MG/ML 10ML INJ   $    57.50
41723602   PROCAINAMIDE 500MG/ML 2ML INJ    $   110.25
41723693   AMOXICILLIN 250MG/5ML 100MLBOT   $    48.25
41724139   HYDR0CO 5/ACET 500(LORTAB) TAB   $    14.00
41724147   HYDROC/ACET(LORTAB)7.5-500 TAB   $    14.00
41730011   ACETIC ACID 15ML EAR DROPS       $   195.00
41730029   ACETIC ACID/HC 10ML EAR DROPS    $   132.25
41730037   ACETYLCHOLINE CL 2ML EYE DROPS   $   105.75
41730045   ACETYLCYSTEINE 20% 30ML BOTTLE   $   115.75
41730052   ACETYLCYSTEINE 20% 10ML BOTTLE   $    42.00
41730060   ACETYLCYSTEINE 20% 4ML (PER TX   $    29.50
41730078   ACYCLOVIR 15GM OINTMENT          $   258.75
41730128   AMOXICILLIN 125MG/5ML 150MLBOT   $    35.00
41730136   AMOX/POT CLAVU 250MG/5ML 150ML   $   189.75
41730144   AMOX/POT CLAVU 125MG/5ML 150ML   $   121.25
41730169   AMPICILLIN 125MG/5ML 100MLBOT    $    37.00
41730177   ATROPINE 1% 5CC EYE DROPS        $    77.75
41730185   BACITRACIN 3.5GM EYE OINTMENT    $    33.00
41730193   BALANCED SALT SOL 15ML EYEDROP   $    37.75
41730201   BALANCED SALT SOLUTION 500ML     $    91.75
41730243   BENZOC/ANTIP(AURALGAN)10ML EAR   $    63.75
41730250   BETAMETHASO/DIPROPI 0.05% 15GM   $    91.50
41730334   BETAMETHASO/VALERATE 0.1% 15GM   $    38.00
41730367   CARBOCHOL 0.1% 1.5ML EYE DROPS   $    86.25
41730375   CEFACLOR 250MG/5ML 75MLBOT       $    90.50
41730383   CEFACLOR 125ML/5ML 75MLBOT       $    69.00
41730417   CHLORAMPHENICOL 3.5GM EYE OINT   $    62.75
41730425   CHLORAMPHENICOL 15ML EYE DROPS   $    82.00
41730466   CICLOPIROX OLAMINE 30GM TUBE     $    90.00
41730474   CLOTRIMAZOLE 1% 15GM             $    70.75
41730482   CLOTRIMAZOLE 100MG/7 VAG TAB     $    75.25
41730490   CLOTRIMAZOLE 45GM VAG CREAM      $    70.50
41730508   CLOTRIMAZOLE 1% 10ML L0TION      $    64.50
41730516   CLOTRIMAZ/BETAM(LOTRISONE)15GM   $    82.00
41730573   POLY/NEOMY/HC(CORTISPORIN)15GM   $    69.00
41730615   CROTAMITON 60GM CREAM            $    38.00
41730631   CYCLOPENTOLATE 0.5% 5CC TOP      $    58.00
41730656   DESOXIMETASONE 0.05% 15GM        $    62.75
41730664   DEXA/NEO/PO(MAXITROL)3.5GM EYE   $    44.25
41730672   DEXA/NEO/PO(MAXITROL) 5CC EYE    $    44.25
41730722   DIBUCAINE 30GM RECTAL OINT       $    35.00
41730730   DICLOXACILLIN 62.5MG/5ML 100ML   $    47.75
41730789   DYCLONINE 0.5% 30ML INJ          $    73.75
41730797   EPINEPHRINE 1% 15ML EYE DROP     $    90.25
41730805   EPINEPHRINE 0.5% 15ML EYE DROP   $    66.25
41730813   ERYTHROMYCIN 3.5GM EYE OINT      $    35.50
41730821   ERYTHROMYCIN 400MG/5ML 100ML     $    61.50
41730839   ERYTHROMYCIN 200MG/5ML 100ML     $    37.75
41730854   ERYTHR/SULF(PEDIAZOLE)100MLBOT   $    75.75
41730870   ESTROGENIC SUBS 45GM VAG CREAM   $   152.00
41730896   ETHYL CHLORIDE 120ML SPRAY       $    80.25
41730920   FLUOCINOLONE .025% 15GM          $    30.75
41730946   FLUOCINOLONE .01% 15GM CREAM     $    39.00
41730961   FLUOCINONIDE 0.05% 15GM          $    63.75
41731019   FUROSEMIDE 10MG/ML 60MLBOT       $    19.75
41731027   FUROSEMIDE 40MG/4ML INJ          $    76.00
41731035   GENTAMICIN 0.03% 5ML EYE DROP    $    49.50
41731050   GENTAMYCIN 0.3% 3.5GM EYE OINT   $    71.75
41731076   HALOPERIDOL 2MG/ML 15MLBOT       $    53.25
41731084   HEMORRHOIDAL 30GM RECTAL OINT    $    33.75
41731092   HEXACHLOROPHENE 150MLBOT         $    78.25
41731118   HYDROCORTISONE 1% 30GM CREAM     $    32.25
41731126   HYDROCORTISONE 2.5% 30GM CREAM   $    45.75
41731134   HYDROCORTISONE 1% 30GM OINT      $    33.50
41731142   PREPARATION-H 30GM RECTAL CREA   $    36.00
41731191   HYOSCYAMINE 0.125MG/ML 15MLBOT   $    65.75
41731266   IPRATROPIUM 14GM INHALER         $   139.00
41731324   LIDOCAINE 2% 30GM JELLY          $    83.25
41731332   LIDOCAINE 5% 35GM CREAM          $    34.50
41731399   METAPROTERENOL 14GM INH-PER TX   $     4.25
41731407   MICONAZOLE 45MG VAGINAL CREAM    $    57.50
41731423   MICONAZOLE 100MG VAG SUPP #7     $    27.00
41731449   MORPHINE(ROXINOL) 20MG/ML DOSE   $    13.50
41731480   NAPHAZOLINE.012% 15ML EYE DROP   $    82.00
41731506   PO/NEO/BAC(NEOSPORIN)3.5GM EYE   $    34.50
41731514   POLY/NEO/BA(NEOSPORIN)10ML EYE   $    45.50
41731555   NITROGLYCERIN 1 INCH (DOSE)      $    11.50
41731563   NITROGLYCERIN 14.5GM SPRAY       $    71.00
41731571   NITROGLYCERIN 0.3MG BOT          $    11.00
41731589   NITROGLYCERIN 0.6MG BOT          $    18.25
41731597   NITROGLYCERIN 0.4MG TAB          $    20.00
41731605   NYSTATIN 100000U/ML 60MLBOT      $    71.50
41731639   NYSTATIN 15GM POWDER             $    94.00
41731696   PEG ELECTROLYTE (COLYTE) 1 GAL   $    82.75
41731712   PENICILLIN VK 125MG/5ML 200ML    $    33.25
41731720   PENICILLIN VK 250MG/5ML 200ML    $    34.75
41731761   PHYSOSTIGMINE 3.5GM EYE OINT     $    47.75
41731779   PILOCARPINE 0.5% 15ML EYE DROP   $    43.75
41731787   PILOCARPINE 3% 15ML EYE DROP     $    46.25
41731795   PILOCARPINE 1% 15ML EYE DROP     $    92.25
41731803   PILOCARPINE 6% 15ML EYE DROP     $    48.25
41731811   PILOCARPINE 2% 5ML EYE DROP      $    47.75
41731829   PILOCARPINE 4% 5ML EYE DROP      $    49.50
41731837   PILOCA/EPI(ALCON)15CC EYE DROP   $    55.25
41731860   POTASSIUM IODIDE 30MLBOT         $    48.75
41731902   PREDNISOLONE 1% 5ML EYE DROP     $    75.50
41732017   SOD CHLO(0CEAN)45ML NOSE SPRAY   $    29.50
41732033   SULFANILAMIDE 120GM VAG CREAM    $   134.25
41732058   SULFACETAMIDE 10%15ML EYE DROP   $    46.00
41732066   SULFACETAMIDE 10%3.5GM EYEOINT   $    32.00
41732124   TETRA/BENZ/BU (CETACAINE) 56GM   $   131.00
41732140   TIMOLOL 0.25% 5ML EYE DROP       $    68.75
41732157   TIMOLOL 0.5% 5ML EYE DROP        $    78.00
41732165   TOBRAMYCIN 0.3% 5ML EYE DROP     $    76.75
41732181   TRIAMCINOLONE 0.1% 80GM CREAM    $    31.50
41732215   TRIAMCINOLONE 0.1% 60ML BOT      $    38.75
41732223   TRIAMCINOLONE 0.5% 15GM CREAM    $    35.50
41732231   TRIAMCINOLONE 63GM CAN           $    65.75
41732264   TRIPLE SULFA 78 GM TUBE          $    48.50
41732280   TROPICAMIDE 0.5% 15ML EYEDROP    $    98.50
41732298   TROPICAMIDE 1% 15ML EYEDROP      $   118.75
41732306   TOBRAMYCIN 80MG/2ML INJ          $    92.50
41732314   VIDARABINE 3.5 GM EYE OINT       $    55.25
41740002   ACEBUTOLOL 200MG CAP             $    16.00
41740028   ACETAMINOPHEN 500MG TAB          $     9.75
41740036   ACETMINOPHEN 160MG/5ML 120ML     $    38.50
41740044   ACETAMINOPHEN 325MG TAB          $     9.25
41740051   ACETAMINOPHEN 120MG SUPP         $    12.25
41740069   ACETAMINOPHEN 325MG SUPP         $    12.50
41740093   ACETAMINOPHEN/CODEINE 60MG TAB   $    14.50
41740101   ACETAMINOPHEN/CODEINE 30MG TAB   $    12.25
41740135   ACETAZOLAMIDE 250MG TAB          $    10.75
41740168   ACYCLOVIR 200MG CAPSULE          $    18.50
41740176   ALBUTEROL 5MG/ML 20ML (PER TX)   $    13.25
41740184   ALBUTEROL 4MG TAB                $    15.25
41740200   ALBUTEROL 2MG TAB                $    12.00
41740218   ALBUTEROL 2.5MG/3ML INH PILLOW   $    18.00
41740226   ALG/SOD BIC/MAG(GAVISCON-2)TAB   $    10.25
41740234   ALLOPURINOL 100MG TAB            $     9.75
41740242   ALLOPURINOL 300MG TAB            $    10.50
41740267   ALPRAZOLAM 0.25MG TAB            $    15.00
41740275   ALPRAZOLAM 1MG TAB               $    19.00
41740283   ALU,MAG,HYDR,SIME (MYLANTA)TAB   $    10.50
41740317   ALUMINIUM HYDROXIDE 12OZ         $    19.25
41740333   AMANTADINE HCL 100MG CAP         $    12.25
41740341   AMILORIDE HCL 5MG TAB            $    13.00
41740432   AMITRIPTYLINE 10MG TAB           $    11.00
41740440   AMITRIPTYLINE 25MG TAB           $    12.00
41740507   AMITRIPTYLINE 50MG TAB           $    13.25
41740556   AMOXICILLIN 250MG CAPSULE        $    11.25
41740564   AMOXICILLIN 500MG CAP            $    12.50
41740614   AMOX/POT CLAVU 250MG TAB         $    21.50
41740648   AMPICILLIN 500MG CAPSULE         $    11.00
41740655   AMPICILLIN 250MG CAPSULE         $    10.75
41740721   ASPIRIN 325MG TAB                $    10.75
41740747   ASPIRIN 300MG SUPP               $    12.00
41740754   ASPIRIN 600MG SUPP               $    12.00
41740812   ASPIRIN/COD (EMPIRIN) 30MG TAB   $    10.75
41740838   ATENOLOL 50MG TAB                $   15.25
41740846   ATROPINE 1% 3.5GM EYE DROPS      $   29.00
41740853   AZATHIOPRINE 50 MG TAB           $   15.50
41740861   ACETAMINOPHEN CHEW 80MG TAB      $    9.75
41740879   BACLOFEN 10 MG TAB               $   12.00
41740903   BELLADONNA PB (DONNATAL) TAB     $   11.00
41740911   BELLADONNA PB (DONNATAL) 10ML    $   20.50
41740937   BENZONATATE 100MG CAP            $   15.50
41740952   BENZTROPINE MESTLATE 1MG TAB     $   11.25
41740978   BETHANECHOL 25MG TAB             $   13.75
41741018   BISACODYL 5MG TAB                $   10.75
41741075   BUMETANIDE 1MG TAB               $   12.50
41741083   BUSULFAN 2MG TAB                 $   19.50
41741141   CALCITRIOL 0.25MCG CAP           $   17.00
41741158   CALCIUM (OSCAL) 500MG TAB        $   10.50
41741166   CAPTOPRIL 25 MG TAB              $   16.75
41741174   CAPTOPRIL 12.5MG UD TAB          $   13.75
41741182   CARBAMAZEPINE 200MG TAB          $   12.00
41741240   CARISOPRODOL 350MG TAB           $   13.25
41741273   CASACARA SAGRADA AROM 5ML UDC    $   11.00
41741307   CEFACLOR 250MG CAP               $   19.75
41741331   CEPHALEXIN 50O MG CAP            $   16.25
41741356   CEPHALEXIN 250MG CAP             $   13.25
41741380   CETYLPYRIDINU/ALCO(CEPACOL)LOZ   $   11.00
41741414   CHLORAMBUCIL 2MG TAB             $   19.75
41741430   CHLORDIAZEPOXIDE 10MG CAP        $   11.25
41741448   CHLORDIAZEPOXIDE 25MG TAB        $   10.75
41741455   CHLORDIAZEPOXIDE 5MG CAP         $   11.00
41741463   CHLORDIAZEPOX/CLID(LIBRAX) CAP   $   18.25
41741505   CHLOROTHIAZIDE 500MG TAB         $   11.50
41741547   CHLORPHENIRAMINE MALEA 4MG TAB   $   10.50
41741554   CHLORPROMAZINE 25MG TAB          $   11.50
41741562   CHLORPROMAZINE 10MG TAB          $   12.00
41741638   CHLORPROPAMIDE 100MG TAB         $   12.00
41741695   CHLORZOXAZONE 500MG TAB          $   12.50
41741786   CLINDAMYCIN 150MG CAP            $   20.75
41741794   CLONAZEPAM 0.5MG TAB             $   13.75
41741810   CLONIDINE-TTS 0.2MG PATCH        $   82.50
41741828   CLONIDINE 0.1MG TAB              $   11.25
41741885   COLCHICINE 0.6MG TAB             $   11.00
41741927   CROMOLYN SOD 20MG/2ML INH        $   11.00
41741943   CYCLOBENZAPRINE 10MG TAB         $   14.75
41741950   CYCLOPHOSPHAMIDE 50 MG TAB       $   15.00
41741968   CYPROHEPTADINE 4MG TAB           $   11.00
41741984   DESIPRAMINE 25MG TAB             $   12.25
41741992   DEXAMETHASONE 0.5MG TAB          $   11.00
41742008   DEXAMETHASONE 1.5MG TAB          $   11.50
41742065   DEXAMETHASONE 4MG TAB            $   13.25
41742081   DEXBROMPHE/PSEUD(DRIXORAL) TAB   $   11.00
41742107   DIAZEPAM 5MG TAB                 $   12.00
41742156   DIAZEPAM 2MG TAB                 $   11.25
41742164   DICLOXACILLIN 250MG TAB          $   12.25
41742206   DICYCLOMINE 20MG TAB             $   11.50
41742263   DIGOXIN 0.1MG CAP                $   11.00
41742271   DIGOXIN 0.125MG TAB              $   12.00
41742289   DIGOXIN 0.25MG TAB               $   12.00
41742305   DIGOXIN 0.05MG/ML 60MLBOT        $   52.00
41742313   DILTIAZEM 30MG TAB               $   13.00
41742321   DILTIAZEM 60MG TAB               $   14.50
41742347   DIPHENHYDRAMINE 25 MG CAP        $    10.50
41742354   DIPHENYDRAMINE 50 MG CAP         $    10.75
41742453   DIPHENOXYLA/ATROP(LOMOTIL) TAB   $    13.75
41742495   DIPYRIDAMOLE 25MG TAB            $    11.25
41742560   DIVALPROEX SOD 250MG TAB         $    15.50
41742578   DOCUSATE CALCIUM 240MG TAB       $    10.75
41742586   DOCUSATE SOD 250MG TAB           $    10.50
41742594   DOCUSATE SOD 100MG TAB           $    10.75
41742610   DOCUSATE/CASANTHRA(DOXIDAN)CAP   $    10.50
41742636   DOXEPIN 25MG CAP                 $    11.00
41742651   DOXEPIN 10MG CAP                 $    11.50
41742685   DOXYCYCLINE 100MG CAP            $    12.00
41742735   ENALAPRIL 5MG TAB                $    15.50
41742750   EPHEDRINE SULFATE 25MG CAP       $    11.00
41742768   ERGOCALCIFEROL 50000U CAP        $    11.00
41742784   ERGOLOID MESYLATE 1MG TAB        $    13.75
41742818   ERGOTAMINE/CAFF (CAFERGOT) TAB   $    12.25
41742875   ERYTHROMYCIN BASE 250MG TAB      $    11.50
41742909   ERYTHROMYCIN BASE 500MG TAB      $    12.50
41742917   ERYTHROMYCIN BASE EC 333MG TAB   $    12.25
41742958   ESTRADIOL TRANS 0.05MG PATCH     $    29.50
41742974   ESTROGENIC SUBST 0.625MG TAB     $    14.75
41742982   ESTROGENIC SUBST 0.3MG TAB       $    13.75
41742990   ESTROGENIC SUBST 1.25MG TAB      $    16.75
41743022   ESTROPIPATE 0.625MG TAB          $    14.50
41743030   ETHACRYNATE 25MG TAB             $    11.00
41743048   ETHAMBUTOL 400MG TAB             $    11.00
41743063   ETHINYL ESTRADIOL 0.2 MG TAB     $     8.50
41743097   FLAVOXATE 100MG TAB              $    17.50
41743113   FLUDROCORTISONE 0.1MG TAB        $    14.50
41743139   FLUORESCEIN 100MG/ML INJ         $    94.00
41743154   FLUPHENAZINE 1MG TAB             $    12.50
41743188   FOLIC ACID 1MG TAB               $    11.00
41743196   FUROSEMIDE 80MG TAB              $    12.50
41743204   FUROSEMIDE 40MG TAB              $    11.00
41743212   FUROSEMIDE 20MG TAB              $    11.00
41743220   GLIPIZIDE 5MG TAB                $    11.50
41743238   GLUCAGON 1MG/1ML INJ             $   229.75
41743246   GLYBURIDE 5MG TAB                $    14.00
41743253   GLYCERIN ADULT RECTAL SUPP       $    11.25
41743261   GLYCERIN CHILDREN RECTAL SUPP    $    11.50
41743279   GLYCOPYRROLATE 1MG TAB           $    13.50
41743295   GUAI/PHENY/DM(ROBITUSSIN)120ML   $    16.00
41743329   GUAIFENESIN 10ML ORAL DOSE       $    12.25
41743428   HALOPERIDOL 1MG TAB              $    11.00
41743436   HALOPERIDOL 5MG TAB              $    12.25
41743444   HALOTHANE 250ML BOT              $    96.25
41743477   HEMORRHODIAL RECTAL SUPP         $    12.25
41743485   HEMORRHOIDAL HC RECTAL SUPP      $    13.75
41743519   HYDRALAZINE 10MG TAB             $    10.75
41743527   HYDRALAZINE 25MG TAB             $    11.00
41743550   HYDROCHLOROTHIZAIDE 25MG TAB     $    10.75
41743592   HYDRO/ASP 5-500(LORTAB+ASA)TAB   $    11.00
41743600   HYDROC/HOMATR(HYCODAN)5ML DOSE   $    10.75
41743626   HYDROCORTISONE 60ML RECTAL ENE   $    46.00
41743642   HYDROMORPHONE 2MG TAB            $    12.50
41743659   HYDROMORPHONE 4MG TAB            $    13.50
41743667   HYDROXYCHLOROQUINE 200MG TAB     $    18.50
41743675   HYDROXYUREA 500MG CAP            $    16.25
41743683   HYDROXYZINE 25 MG TAB            $   10.75
41743691   HYDROXYZINE 10MG TAB             $   10.75
41743709   HYDROXYZINE 50 MG TAB            $   11.00
41743725   IBUPROFEN 600MG TAB              $   12.00
41743741   IBUPROFEN 800MG TAB              $   12.00
41743766   IMIPRAMINE 10MG TAB              $   10.50
41743774   IMIPRAMINE 25MG TAB              $   14.00
41743790   INDAPAMIDE 2.5MG TAB             $   15.50
41743808   INDOMETHACIN 25MG CAP            $   12.25
41743832   IPECAC SYRUP 30ML UDC            $   18.25
41743865   ISOMETH/DICHLO/APA(MIDRIN) CAP   $   11.00
41743873   ISONIAZID 100MG TAB              $   11.00
41743881   ISONIAZID 300MG TAB              $   11.00
41743915   ISOSORBIDE DINITRATE 10MG TAB    $   12.00
41743923   ISOSORBIDE DINITRATE 20MG TAB    $   13.25
41743972   KETOCONAZOLE 200MG TAB           $   23.75
41743980   LABETALOL 200MG TAB              $   13.00
41744004   LACTOBACILLUS ACIDOPHI 1GM PKG   $   12.25
41744020   LEUCOVORIN CALCIUM 5MG TAB       $   22.50
41744053   LEVOTHYROXINE 200MCG TAB         $   12.25
41744061   LEVOTHYROXINE 50MCG TAB          $   11.25
41744079   LEVOTHYROXINE 150MCG TAB         $   11.50
41744087   LEVOTHYROXINE 100MCG TAB         $   11.50
41744095   LIDOCAINE VISCOUS 2% 20ML UDC    $   16.25
41744103   LIDOCAINE 4% 50ML LOTION         $   41.25
41744137   LITHIUM CARBONATE 300MG CAP      $   11.25
41744145   LOPERAMIDE 2MG CAP               $   14.50
41744178   LORAZEPAM 0.5MG TAB              $   13.50
41744186   LORAZEPAM 1MG TAB                $   11.00
41744194   MAGNESIUM OXIDE 250MG TAB        $   10.50
41744277   MEDROXYPROGESTERONE 2.5MG TAB    $   11.25
41744293   MEGESTROL ACETATE 40MG TAB       $   16.00
41744301   MELPHALAN 2MG TAB                $   12.25
41744319   MENTHOL/PHENOL (CEPASTAT) LOZ    $   11.00
41744350   MEPROBAMATE 400MG TAB            $   10.75
41744426   METAPROTERENOL 10MG TAB          $   11.00
41744459   METHADONE 5MG/5ML DOSE           $   11.50
41744483   METHOCARBAMOL 1GM/10ML INJ       $   12.25
41744541   METHYLDOPA 250MG TAB             $   10.75
41744574   METHYLERGONOVINE 0.2MG TAB       $   13.75
41744582   METHYLPHENIDATE 10MG TAB         $   12.25
41744608   METHYLPREDNISOLONE 4MG TAB       $   13.00
41744632   METOCLOPRAMIDE 10MG TAB          $   15.00
41744657   METOLAZONE 2.5MG TAB             $   16.25
41744665   METOPROLOL 50MG TAB              $   14.50
41744681   METRONIDAZOLE 250 MG TAB         $   13.00
41744699   MEXILETINE 200MG CAPSULE         $   14.50
41744715   MIDAZOLAM 10MG/2ML INJ           $   93.00
41744749   MILK OF MAGNESIA 10ML UDC        $   12.00
41744756   MINERAL OIL (MURI-LUB) 30ML      $   19.50
41744764   MINOXIDIL 10MG TAB               $   13.00
41744772   MORPHINE SR (MSCONT) 30MG TAB    $   18.50
41744780   NADOLOL 40MG TAB                 $   17.25
41744798   NAPROXEN 250MG TAB               $   15.25
41744814   NEOMYCIN 500MG TAB               $   19.75
41744822   POLY/NEO/BACI(NEOSPORIN)1GMPKG   $   11.00
41744848   NICOTINE POLACRILEX 2MG GUM      $   11.00
41744855   NIFEDIPINE 10MG CAP              $   12.50
41744871   NITROFURANTOIN 50MG CAP          $    6.25
41744913   NITROGLYCERIN 10MG/24HRS PATCH   $   20.25
41744921   NITROGLYCERIN 15MG/24HRS PATCH   $   17.25
41744939   NITROGLYCERIN 5MG/24HRS PATCH    $   19.50
41744947   NITROCLYCERIN 2.5MG/24HR PATCH   $   19.25
41744962   NITROGLYCERIN SR 2.5MG CAP       $   10.75
41744970   NITROGLYCERIN SR 6.5MG CAP       $   11.00
41745001   NORTRIPTYLINE 25MG CAP           $   14.00
41745027   NYSTATIN 0.5MU TAB               $   13.50
41745043   OPIUM/BELLADONNA (B&O) SUPP      $   23.25
41745076   GUAIFENESIN 200MG TAB            $   11.00
41745159   OXYBUTYNIN 5MG TAB               $   12.25
41745167   OXYCODONE/APAP (PERCOCET) TAB    $   11.50
41745241   PENICILLAMINE 250MG CAP          $   15.50
41745282   PENICILLIN VK 250MG TAB          $   10.75
41745290   PENICILLIN VK 500MG TAB          $   11.00
41745357   PENTOXIFYLLINE 400MG TAB         $   14.00
41745415   PHENAZOPYRIDINE 200MG TAB        $   14.00
41745423   PHENAZOPYRIDINE 100MG TAB        $   12.25
41745431   PHENOBARBITAL 20MG/5ML DOSE      $   13.75
41745456   PHENOBARBITAL 30MG TAB           $   10.75
41745498   PHENOBARBITAL 100MG TAB          $   10.75
41745506   PHENOBARBITAL 60MG TAB           $   10.75
41745530   PHENOLPHTALEIN (EXLAX) TAB       $   11.00
41745613   PHENYTOIN 50MG TAB               $   12.00
41745647   PHENYTOIN 100MG CAP              $   12.00
41745654   PHYTONADIONE 5MG TAB             $   13.25
41745662   PILOCARPINE 1% 1ML EYE DROP      $   19.50
41745670   PINDOLOL 5MG TAB                 $   12.25
41745746   POTASSIUM CHLOR 10MEQ CAP        $   12.00
41745753   POTASSIUM CHLOR 8MEQ CAP         $   12.00
41745761   POTASSIUM CHL 20MEQ/15ML UDC     $   14.50
41745811   PROZOSIN 1MG CAP                 $   11.50
41745829   PRAZOSIN 5MG TAB                 $   13.25
41745852   PREDNISONE 10MG TAB              $   10.50
41745860   PREDNISONE 1MG TAB               $   11.00
41745878   PREDNISONE 5MG TAB               $   10.75
41745886   PREDNISONE 20MG TAB              $   10.75
41745902   PRIMIDONE 250MG TAB              $   18.25
41745910   PRIMIDONE 50MG TAB               $   12.50
41745928   PROBENECID 0.5GM TAB             $   12.00
41745951   PROCAINAMIDE 250MG TAB           $   11.00
41746058   PROCHLORPERAZINE 10 MG TAB       $   15.25
41746066   PROCHLORPERAZINE 25MG RECT SUP   $   25.25
41746090   PROMETHAZINE 25MG TAB            $   13.00
41746108   PROMETHAZINE 50MG RECTAL SUP     $   30.75
41746116   PROMETHAZINE 25MG RECTAL SUP     $   26.50
41746124   PROMETHAZINE 12.5MG RECTAL SUP   $   13.75
41746199   PROPOXYPHENE 65MG TAB            $   10.75
41746207   PROPO/APAP100-650(DARVOCET)TAB   $   14.50
41746223   PROPRANOLOL LA 80MG TAB          $   16.75
41746272   PROPRANOLOL 20MG TAB             $   11.50
41746280   PROPYLTHIOURACIL 50MG TAB        $   10.50
41746322   PSEUDOEPHEDRINE 30MG TAB         $   10.75
41746330   PSY/HYDROP/MUCI(METAMUCIL)1PKG   $   11.50
41746348   PYRIDOSTIGMINE 60MG TAB          $   13.50
41746389   QUINIDINE SULFATE 300MG TAB      $   11.00
41746397   QUINIDINE SULFATE 200MG TAB      $   11.00
41746405   QUINIDINE SULFATE SR 300MG TAB   $   11.00
41746439   RIFAMPIN 300MG CAP               $   19.50
41746462   SCOPOLAMINE HBR PATCH TAB        $      24.75
41746470   SENNA LAXATIVE TAB               $      10.50
41746504   SIMETHICONE 80MG TAB             $      11.00
41746546   SODIUM CITRATE 30ML UDC          $      12.50
41746553   SODIUM FLUORIDE 2.2MG TAB        $      11.00
41746561   HYALURONATE SODIUM 10MG/ML SYR   $     388.00
41746595   SPIRONOLACTONE 25MG TAB          $      12.25
41746603   SPIRONOL/HCTZ(ALDACTAZIDE) TAB   $      10.25
41746611   SUCRALFATE 1GM TAB               $      15.25
41746686   TMP/SMX 160-800 (SEPTRA DS)TAB   $      13.25
41746702   SULFASALAZINE 0.5GM TAB          $      10.75
41746710   SULFINPYRAZONE 100MG TAB         $      11.00
41746785   SULINDAC 200MG TAB               $      15.25
41746793   TAMOXIFEN 10MG TAB               $      18.25
41746801   TERBUTALINE 2.5MG TAB            $      12.00
41746819   TERBUTALINE 5MG TAB              $      13.00
41746850   TETRACAINE 0.5% 1ML EYE DROP     $      19.50
41746876   TETRACYCLINE 250MG TAB           $      10.75
41746959   THEOPHYLLINE SR 200MG TAB        $      12.25
41747015   THEOPHYLLINE SR 300MG TAB        $      13.00
41747080   THIORIDAZINE 25MG TAB            $      11.00
41747098   THIORIDAZINE 10MG TAB            $      11.00
41747114   THIOTHIXENE 5MG CAP              $      11.00
41747171   THYROID 60MG TAB                 $      12.00
41747205   TIMOLOL 10MG TAB                 $       9.00
41747247   TOLAZAMIDE 100MG TAB             $      10.75
41747262   TOLBUTAMIDE 0.5GM TAB            $      11.00
41747304   TRAZODONE 50MG TAB               $      12.25
41747312   TRIAMTERENE 50MG CAP             $      14.75
41747320   TRIAMTE/HCTZ 50-25(DYAZIDE)CAP   $      14.50
41747346   TRIAZOLAM 0.25MG TAB             $      17.00
41747411   TRIHEXYPHENIDYL 2MG TAB          $      11.00
41747445   TRIMETHOBENZAMIDE 250MG CAP      $      12.00
41747460   TRIMETHOPRIM 100MG TAB           $      11.25
41747486   TRIPROLIE/PSEUDOEP(ACTIFED)TAB   $      10.75
41747494   VALPROIC ACID 250MG CAP          $      11.00
41747510   VANCOMYCIN HCL 1GM LIQ           $      98.50
41747528   VERAPAMIL 80MG TAB               $      13.75
41747551   TOCOPHEROL 400 IU CAP            $      10.75
41747569   STUART 1+1 PRENATAL VITAMI TAB   $      11.00
41747577   WARFARIN 2.5MG TAB               $      14.00
41747585   WARFARIN 7.5MG TAB               $      15.50
41747593   WARFARIN 2MG TAB                 $      13.75
41747601   WARFARIN 10MG TAB                $      15.50
41747619   WARFARIN 5MG TAB                 $      14.00
41747742   GELFOAM SPONGE 100-10MM          $     116.00
41747841   LIDOCAINE 160MG/4ML INJ          $      40.25
41747999   MEPIVACAINE PF 1.5% 30ML INJ     $     104.25
41748146   HYDRALAZINE 20MG/ML INJ          $      96.75
41748195   ASPIRIN 125MG RECTAL SUPP        $      11.25
41748294   ANTIVENIM (BLACK WIDOW) 2.5ML    $     149.25
41748310   REGIONAL ANESTHETIC AGENT        $     274.25
41748369   LOCAL ANESTHETIC AGENT           $      41.75
41748393   PROCHLORPERAZINE 5MG RECTA SUP   $      13.75
41748492   LIDOCAINE 2GM/500ML PM BAG       $     104.50
41748518   MECLIZINE 25MG TAB               $      11.00
41748567   MECLIZINE 12.5MG TAB             $      11.00
41748583   GELFOAM SPONGE 12-7MM            $      38.75
41748633   ANTIVENIM(RATTLESNAKE)10ML INJ   $   2,386.75
41748690   CYCLOPENTOLATE 1% 2ML EYE DROP   $    36.00
41748716   CARBAMIDE(DEBROX) 15ML EARDROP   $    29.00
41748732   DOPAMINE 800MG/500ML PM BAG      $   125.25
41748757   A & D 5GM OINT PKG               $    10.00
41748856   DANTROLENE 20MG INJ              $   256.50
41748880   IODINE (LUGOLS SOLUTION) 480ML   $    16.75
41748914   MANNITOL 12.5GM/50ML INJ         $    77.00
41750001   ACETAMINIPHEN 80 MG/0.8ML 15ML   $    39.00
41750050   OXYMETAZOLINE 15ML NOSE SPRAY    $    27.25
41750100   SIMETHICONE 40MG/0.6ML 30MLBOT   $    53.25
41750118   TRIETH/POLY(CERUMENEX)12ML EAR   $    91.75
41750142   ANALGESIC BALM 3 OZ OINTMENT     $    19.75
41750159   BENZOCAINE 2OZ SPRAY             $    21.50
41750167   CALCIUM CARB (TUMS) TABLET       $     8.19
41750175   MAGNESIUM CITRATE 10 OZ BOTTLE   $    10.50
41750209   PHENYLEPHRINE.25%15MLNOSESPRAY   $    40.25
41750233   PHENYLEPHRINE.5%15ML NOSESPRAY   $    34.50
41750258   PHENYLEPHRINE 10% 5ML EYE DROP   $    55.25
41750282   SELENIUM SULFIDE 120ML SHAMPOO   $    45.25
41750308   SOD PHOSPHAT(PHOSPHO SODA)45ML   $    13.75
41750324   TRYPSIN/BALSAM/CAST 4OZ SPRAY    $    28.75
41750332   LUBRICANT OCULAR 3.5GM EYE OIN   $    49.50
41750381   TOBRAM/DEXAM(TOBADEX)3.5GM EYE   $   104.25
41750399   TOBRAMY/DEXAM(TOBADEX) 5ML EYE   $    90.75
41750415   NIFEDIPINE XL 30MG TAB           $    18.25
41750423   SODIUM CHLORIDE 3% 500ML BAG     $    92.50
41750431   EPINEPHRINE 1MG/ML 30MG INJ      $    99.25
41750449   COLCHICINE 1MG/2ML INJ           $    94.25
41750456   RACEPINEHRINE 15ML INH           $    78.75
41750480   PERMETHRIN 5% 60GM               $    99.50
41750498   PILOCARPINE 2% 1ML EYE DROP      $    12.25
41750506   DEXTRAM-70 100ML INJ             $   144.00
41750514   LACTULOSE 10GM/15ML 240MLBOT     $    66.00
41750555   METOCLOPRAMIDE 150MG/30ML INJ    $   147.00
41750563   CEFIXIME 100MG/5ML 50MLBOT       $   115.25
41750662   ISRADIPINE 2.5 MG CAP            $    16.75
41750670   DIDANOSINE 100 MG TAB            $    11.50
41750688   HIVID 0.375MG TAB                $    12.25
41750696   DILTIAZEM CD 300 MG CAP          $    22.75
41750704   FINASTERIDE 5MG TAB              $    20.75
41750712   PYRIMETHAMINE 25 MG TAB          $    14.50
41750720   DIPENTUM 250 MG CAP              $    11.00
41750746   SALINE FLUSH 10 ML               $    56.00
41750761   ACETAMINOPHEN 650 MG RECT SUPP   $    12.75
41750787   ALBUTEROL 2 MG/5ML 60MLBOT       $    39.50
41750803   AMINOCAPROIC ACID250MG/ML 60ML   $   167.50
41750852   AMPICILLIN SULBACTAM 3GM INJ     $   118.50
41750860   ZIDOVUDINE 100 MG CAP            $    11.00
41750936   BROMPHENI/PHENY(DIMETAPP)120ML   $    27.00
41750951   CALAMINE LOTION 120MLBOT         $    27.00
41750969   CALCIUM GLUC 0.47MEQ/ML 50ML     $    82.25
41750993   CEFUROXIME 500 MG TAB            $    41.75
41751017   PREDN/SULF (CETAPRED)3.5GM EYE   $    49.50
41751033   CHLOROPROCAINE-PF 3% 30 ML INJ   $   167.25
41751041   CHLOROPROCAINE 1% 30 ML INJ      $   138.00
41751066   CLOTRIMAZOLE CREAM 1% 45GM       $    35.75
41751074   CORTISPORIN 3.5GM EYE OINT       $    54.00
41751082   CORTISPORIN 7.5ML EYE DROP       $    94.75
41751090   CORTISPORIN 10ML EAR SOLUTION    $    44.00
41751108   CORTISPORIN 10ML EAR SUSPENSIO   $    90.00
41751116   COSYNTROPIN 0.25MG INJ           $   131.00
41751124   NEDOCROMIL 16.2GM INH (PER TX)   $     4.25
41751132   DESMOPRESSIN (DDAVP) 4MCG/1ML    $   135.00
41751140   DEXTRANOMER 4GM GRANULES         $    17.50
41751157   DEMECLOCYCLINE 300 MG TAB        $    18.25
41751165   TESTOSTERONE/ESTRADIO 10ML INJ   $    66.75
41751173   DEXAMETHASONE 0.5MG/5ML 100ML    $    46.25
41751181   DICYCLOMINE 10MG/5ML 60MLBOT     $    44.25
41751215   DILTIAZEM SR 60 MG CAP           $    15.25
41751223   DILTIAZEM SR 90 MG CAP           $    14.50
41751231   DIPHENHYDRAMINE 25MG/10ML 120M   $    27.00
41751249   DISOPYRAMIDE CR 100MG CAP        $    11.00
41751256   DISOPYRAMIDE CR 150MG CAP        $    16.75
41751348   ESTRADIOL VALERATE 20MG/ML 5ML   $   124.25
41751355   FERROUS SULFATE 220MG/5ML 60ML   $    22.50
41751363   FLECAINIDE ACETATE 100MG TAB     $    22.25
41751389   FOLIC ACID 5MG/ML 5ML INJ        $    75.25
41751413   HYDROXYZINE 10MG/5ML 60MLBOT     $    26.50
41751421   IODINATED GLYCER 60MG/5ML 60ML   $    41.75
41751447   LEUCOVORIN CALCIUM 350 MG INJ    $   129.25
41751454   LINDANE SHAMPOO 120MLBOT         $    40.25
41751462   LINDANE LOTION 120MLBOT          $    50.50
41751488   METAPROTERENOL 10MG/5ML 60ML     $    21.00
41751546   MIDAZOLAM 1MG/ML 10ML INJ        $    93.00
41751553   MINERAL OIL 10MLBOT              $    12.00
41751579   MORPHINE PF 1OMG/10ML INJ        $   107.00
41751587   MORPHINE PF 1MG/2ML INJ          $    99.75
41751595   MORPHINE PF 5MG/10ML INJ         $    66.75
41751603   MORPHINE 10MG/ML INJ             $    73.75
41751611   MORPHINE 10MG/10ML SYRINGE       $    95.25
41751629   MORPHINE 15MG/ML INJ             $    78.00
41751645   MORPHINE 8MG/ML INJ              $    60.00
41751710   POLY/TRIM(POLYTRIM)10MLEYEDROP   $    88.00
41751736   PROMETHAZINE/DM 120MLBOT         $    29.50
41751744   PROMETHAZINE/VC/CODEI 120MLBOT   $    33.50
41751769   PREDNISOLONE 15MG/5ML 60MLBOT    $    85.50
41751777   PROCHLORPERAZINE 5MG/5ML 120ML   $    58.25
41751785   PROPOFOL 500MG/50ML INJ          $   151.00
41751793   PROPOFOL 200MG/20ML INJ          $   112.00
41751801   PSUEDOEPHEDRINE 30MG/5ML 120ML   $    18.25
41751819   PYRIDOSTIGMINE 60MG/5ML 60MLBO   $    21.50
41751827   RANITIDINE 15MG/ML 60MLBOT       $    61.50
41751843   TMP/SMX 40-200 (SEPTRA) 100ML    $    59.50
41751850   CARBI/LEVO(SINEMET)10-100MGTAB   $    14.50
41751868   CARBI/LEVO(SINEMET) 25-100 TAB   $    15.00
41751876   CARBI/LEVO(SINEMET) 25-250 TAB   $    16.25
41751892   SOD POLYSTYRENE 15GM 60MLBOT     $    38.00
41751900   SOD POLYSTYRENE 30G/120ML ENEM   $    73.25
41751926   TERCONAZOLE-7 45GM VAG CREAM     $    64.25
41751934   THIORIDAZINE 30MG/ML 60MLBOT     $    57.00
41751942   TOBRAMYCIN 0.3% 3.5GM EYE OINT   $    99.50
41751975   VALPORIC ACID 250MG/5ML 60MLBO   $    81.50
41751983   PRED/SULF (CETAPRED) 5ML EYE     $    77.00
41752015   DESMOPRESSIN 2.5ML NASAL SOL     $   376.75
41752023   CARBAMAZEPINE 100MG/5ML 60ML     $    35.50
41752056   PHENERGAN CODEINE 5ML DOSE       $    13.00
41752064   DRONABINOL 2.5MG CAP             $    25.25
41752072   GUAI/COD/PSEU(ROBITUSSIN)120ML   $    28.75
41752114   TRANYLCYPROMINE 10MG TAB         $      11.00
41752122   BENAZEPRIL 10MG TAB              $      15.25
41752130   MORPHINE SR (MSCONT) 15MG TAB    $      15.25
41752148   TERAZOSIN 2MG TAB                $      19.25
41752163   NABUMETONE 500MG TAB             $      17.50
41752189   CAMP/PHEN/MENT (CAMP PHENIQUE)   $      19.50
41752205   RABIES VAC(IMOVAX) 2.5U/ML SYR   $     415.75
41752247   LIDOCAINE PF 1% 5OMG/5ML INJ     $      79.00
41752254   MESALAMINE 400MG TAB             $      15.00
41752270   BACTERIOSTATIC H2O 30ML INJ      $      13.00
41752288   BACTERIOSTATIC NS 0.9% 30ML      $      13.00
41752296   GELFILM 25-50MM                  $      99.25
41752312   CYCLOP/PHE(CYCLOMYDRIL 2ML EYE   $      24.00
41752320   HALOPERIDOL 2MG/ML 120MLBOT      $     134.00
41752338   FLUOXETINE 20MG/5ML 60MLBOT      $     178.25
41752346   MICONAZOLE 3OZ SPRAY             $      40.25
41752379   CHLORHEXIDINE 480MLBOT           $      56.75
41752387   OCTREOTIDE ACETA 100MCG/ML INJ   $     131.50
41752395   LEVOTHRYOXINE 112MCG TAB         $      12.50
41752437   SOD HYPOCHLORITE(DAKINS)1500ML   $      41.00
41752445   SODIUM POLYSTYRENE SULF 500ML    $     136.75
41752478   SUMATRIPTAN SUCC 6MG/0.5ML INJ   $     199.50
41752494   DILTIAZEM 50MG/10ML INJ          $     101.25
41752510   LOCAL ANESTHETIC AGENT           $     109.50
41752668   LOCAL ANESTHESIA AGENT           $     124.00
41760000   COCAINE 4% 4MLBOT                $      63.00
41760018   COCAINE 10% 4MLBOT               $      83.75
41760083   MPT INJ                          $      73.00
41760141   ALBUMIN 25% 50MLBOT              $     259.50
41760174   LIDOCAINE (ANESTACON) 15MLBOT    $      28.75
41760190   ASPIRIN 80MG TAB                 $      10.50
41760216   BACITRACIN 30 GM OINT            $      27.75
41760224   BISACODYL 10MG RECTAL SUPP       $      10.75
41760240   CHOLESTYRAMINE 9GM PKG           $      21.00
41760265   CIPROFLOXACIN 250 MG TAB         $      29.75
41760281   CLOTRIMAZOLE TROCHE 10MG TAB     $      17.75
41760505   DIAG/BLOOD GLUCOSE(DEXTROSTIX)   $      15.50
41760570   DIAG/URIN/PROTEIN (COMBISTIX)    $      27.00
41760588   DIAG/GLUCOSE URINE/KETONE BOX    $      25.25
41760646   FAMOTIDINE 20MG TAB              $      18.00
41760661   FERROUS GLUCONATE 3OOMG TAB      $      10.50
41760687   FLURBIPROFEN .03%2.5ML EYEDROP   $      53.25
41760877   THIOTEPA 15 MG INJ               $     416.51
41760885   PROMETHAZINE 6.25MG/5ML 120ML    $      30.25
41760976   TEMAZEPAM 15MG CAP               $      13.50
41761016   ALTEPLASE (TPA)100MG/100ML INJ   $   6,176.25
41761024   TRIMENTHOBENZAMIDE 200MG SUPP    $      13.25
41761032   TRIMETHOBENZAMIDE 100MG SUPP     $      13.00
41761123   PROPARACAINE 15ML EYE DROP       $      64.75
41761156   POL B/BACI(POLYSPORIN)30GMOINT   $      34.75
41761172   CEFTRIAXONE 500MG INJ            $     143.00
41761180   ARTIFICIAL TEARS 15ML EYE DROP   $      51.75
41761206   CLINDAMYCIN-T (CLEOCIN) 60ML     $      64.25
41761230   ERYTHROMYCIN 125MG/5ML 60MLBOT   $      34.00
41761248   ERYTHROMYCIN 250MG/5ML 60ML      $      45.75
41761271   CARBOPROST TROME 250MCG/ML INJ   $     192.75
41761297   PANCRELIPASE (PANCREASE) CAP     $      12.25
41761370   ENALAPRIL 10MG TAB               $      16.00
41761396   VITB/C/ZINC 600MG STRESS TAB     $      10.75
41761446   NYSTATIN 15GM CREAM              $      29.75
41761461   NYSTATIN 15GM OINT               $      29.75
41761487   TRIAM/ACETO/NYST (MYCOLOG)15GM   $      35.75
41761495   TRIAM/ACET/NYST (MYCOLOG) 15GM   $      35.75
41761529   TERAZOSIN 1MG CAP                $      19.25
41761636   NYSTATIN 10000U VAGINAL TABS     $      41.75
41761669   ALUM,MAGN,HYDROX (MAALOX) 30ML   $      12.25
41761693   CEFTRIAXONE 250MG INJ            $     122.25
41761750   BARIUM ENEMA PREP 1 KIT          $      31.75
41761784   LIDOC 5% W/GLUC 7.5% MPF 2ML     $     129.00
41761826   HYDROCORTISONE 0.5% 30GM         $      27.75
41761859   NITROGYLCERIN 7.5MG/24HR PATCH   $      20.25
41761875   KERI LOTION 6.5MLBOT             $      19.50
41761883   MEPERIDINE 75MG/ML INJ           $      73.75
41761891   IBUPROFEN 200MG TAB              $      10.50
41761925   SECOBARBITAL 100MG CAP           $      14.00
41761941   MIDAZOLAM 2MG/2ML INJ            $      78.25
41761958   AMPHOTERCIN B 50MG INJ           $     101.25
41762006   ATRACURIUM 100MG/10ML INJ        $     117.25
41762022   CALCIUM CHL 100MG/ML 10ML INJ    $      73.00
41762055   LOVASTATIN 20MG TAB              $      20.75
41762063   VINBLASTINE 10MG INJ             $     220.39
41762071   ANTISEPTIC (HIBICLENS) 120ML     $      36.50
41762089   TRIAMCINOLONE.025% 15GM CREAM    $      26.00
41762188   POVIDONE IODINE 85GM VAG GEL     $      88.25
41762196   POVIDONE IODINE 28GM OINT        $      26.50
41762204   POVIDONE IOD(BETADINE)30ML VAG   $      28.75
41762212   ANTISEPTIC (CHLORASEPTIC) 6OZ    $      34.75
41762303   AMOXICILLIN CHEWABLE 250MG TAB   $      11.00
41762337   GLUCOSE 5GM TAB                  $      11.00
41762352   ETOMIDATE(AMIDATE)40MG/20MLINJ   $     138.75
41762378   INDOMETHACIN 50MG RECTAL SUPP    $      19.25
41762451   CLONIDINE-TTS 0.1MG PATCH        $      53.25
41762469   NITROGLYCERIN 50MG/250ML PMBOT   $      91.75
41762485   MEASLES/MUMPS/RUBELLA VACCINE    $     125.50
41762543   EUCERINE 60GM CREAM              $      27.75
41762592   A&D/ZINC OXIDE 28GM TUBE         $      26.00
41762600   POVIDONE (BETADINE).89GM PKG     $      10.75
41762626   MULTIVITAMIN W/MINERALS TAB      $      10.75
41762709   NITROPRUSSIDE 50MG INJ           $      78.25
41762733   QUININE SULFATE 325MG CAP        $      11.00
41762741   ASCORBIC ACID (VIT C) 500MG      $      10.75
41762758   PROCHLORPERAZINE 5MG TAB         $      13.00
41762766   DILTIAZEM 90MG TAB               $      16.00
41762840   DINOPROSTON E2 20MG VAG SUPP     $   1,341.50
41763046   TOLNAFTATE 15GM TUBE             $      11.00
41763053   ASTRINGENTS (DOMEBORO) PKG       $      19.50
41763061   LORAZEPAM 2MG/ML INJ             $      83.00
41763079   HYDROMORPHONE 2MG/ML INJ         $      74.50
41764143   LIDOCAINE W/EPI 1% 5ML INJ       $      79.00
41764150   VERAPAMIL SR 240MG TAB           $      19.25
41764200   FERROUS SULFAT 15MG/0.6ML 60ML   $      36.75
41764242   CLINDAMYCIN 600MG/4ML INJ        $      86.00
41764267   CLINDAMYCIN 900MG/6ML ADV        $     102.25
41764317   CEFUROXIME 750MG INJ             $      91.00
41764341   CEFOTAXIME 1GM INJ               $     103.50
41764358   NAFCILLIN 500MG INJ              $     105.75
41764390   PENICILLIN G 1MU INJ             $      82.00
41764432   CENTRAL FLUSH PER PROTOCOL       $      10.25
41764440   TRIAMTE/HCTZ 75-50 (MAXIDE)TAB   $    14.75
41764473   METHADONE 10MG TAB               $    11.00
41764499   AMIODARONE 200MG TAB             $    24.25
41764515   CALCITONIN 400IU/2ML INJ         $   169.00
41764580   TETRAHYDRAZOLINE 15ML EYE DROP   $    36.00
41764598   THEOPHYLLINE 80MG/15ML 60MLBOT   $    40.25
41764655   VANCOMYCIN 1GM INJ               $    89.00
41764697   DANTROLENE 25MG TAB              $    21.00
41764705   DIPIVEFRIN 0.1% 5ML EYE DROPS    $    53.25
41764721   DIPTHERIA/TETANU PED 0.5ML INJ   $    86.25
41764747   DOXACURIUM 1MG/ML 5ML INJ        $   260.25
41764754   EPHEDRINE SULFATE 50MG/ML INJ    $    74.00
41764796   ETIDRONATE DISODIUM 200MG TAB    $    22.75
41764804   GLUCOSE PASTE TUBE               $    19.50
41764812   HEMORRHOIDAL HC 30GM RECTAL CR   $   110.25
41764846   LEVOTHYROXINE 125MG TAB          $    11.50
41764861   PHOSPHORUS (NEUTRA-PHOS) PKG     $    12.25
41764887   BULK FIBER LAX (FIBERCON) TAB    $    10.75
41764903   GEMFIBROZIL 600MG TAB            $    18.00
41764929   HYOSCYAMINE 0.375MG CAP          $    13.50
41764937   CEFIXIME 400MG TAB               $    37.00
41764960   URSODIOL CAP 300MG CAP           $    24.00
41765025   ASPIRIN EC 325MG TAB             $    10.50
41765033   ATROPINE PED 0.5MG/5ML INJ       $    86.00
41765066   CARBOPLATIN 50 MG INJ            $   193.00
41765074   CEFOTETAN 2GM INJ                $   134.25
41765082   CHARCOAL W/AQUA 240MLBOT         $    36.25
41765090   CISPLATIN AQ 50 MG/50 ML INJ     $   214.75
41765108   CIPROFLOXACIN 400MG/200ML BAG    $   199.00
41765116   CIPROFLOXACIN 500MG TAB          $    29.00
41765165   LISINOPRIL 10MG TAB              $    15.50
41765173   MAGNESIUM SULF 4.06MEQ/ML 50ML   $    38.50
41765199   MICONAZOLE 30GM CREAM            $    31.50
41765215   MORPHINE 2MG/ML INJ              $    73.50
41765231   NALOXONE 2MG/2ML SYRINGE         $   141.50
41765249   NORTRIPTYLINE 10MG CAP           $    15.00
41765272   PHENYLEPRINE 1%15ML NOSE SPRAY   $    34.50
41765298   PRAMOXINE HC 10GM RECTAL CREAM   $    66.75
41765306   PREDNISONE 0.12% 5ML EYE DROP    $    46.25
41765330   DILTIAZEM CD 180MG CAP           $    18.25
41765348   DILTIAZEM CR 240MG CAP           $    20.00
41765363   OPS GEN INDUCTION/MAIN 1.25 HR   $   483.75
41765421   KETORALAC 10MG TAB               $    15.25
41765439   DIDANOSIDE 100MG TAB             $    11.00
41765462   ERYTHROMYCIN 400MG TAB           $    11.50
41765470   BENZOCAINE (DERMOPLAST) SPRAY    $    19.75
41765579   ETHANOLAMINE OLEATE 2ML INJ      $   143.25
41765587   CARBI/LEVO(SINEMET) 50-200 TAB   $    18.00
41765603   LIDOCAINE PF 1% 30ML INJ         $   101.75
41765611   PENICILLIN G PROC 0.6MU/ML TUB   $    66.75
41765629   PENICI G/BENZA/PROCA 1.2MU/2ML   $   108.00
41765637   FLUOCINONIDE 0.05% 30GM          $    69.50
41765645   TRIAMCINOLONE 0.1% 15GM CREAM    $    29.50
41765652   TRIAMCINOLONE .1% 15 GM OINT     $    29.50
41765678   ALUM,MAGN,HYDROX (MAALOX) 5OZ    $    19.25
41765686   IBUPROFEN 100MG/5ML DOSE         $    12.00
41765702   SODIUM BICARBONATE 2.5MEQ/5ML    $    82.50
41765710   CLONIDINE-TTS 0.3MG PATCH        $    87.25
41765728   DILTIAZEM CD 120MG CAP           $    17.25
41765744   ACETYCYSTEINE 20% 3ML (PER TX)   $    32.00
41765751   MAGNESIUM CHLORIDE 64MG TAB      $    11.00
41765769   CHLORPROMAZINE 100MG SUPP        $    29.75
41765835   CEPHALEXIN 250MG/5ML 100MLBOT    $    59.50
41765843   CEPHALEXIN 125MG/5ML 100MLBOT    $    47.50
41765850   SERTRALINE 50MG TAB              $    20.50
41765868   ESTRADIOL 2MG TAB                $    14.75
41765876   FLUDARABINE 50 MG INJ            $   946.82
41765900   CLARITHROMYCIN 500MG TAB         $    27.25
41765926   TRIMPRAMINE MALEATE 25MG CAP     $    13.75
41765934   KETOCONAZOLE 2% 30GM CREAM       $   106.00
41765967   LOPERAMIDE A-D 1MG/5ML 120ML     $    41.25
41765975   ALCOHOL ABSOLUTE 200PROOF500ML   $    39.25
41765983   PERPHENAZINE 2MG TAB             $    13.75
41765991   OXYBUTYNIN 5MG/5ML 60MLBOT       $    38.50
41766007   MASTISOL LIQUID ADHESIVE 15ML    $    66.75
41766015   DIPHENHYDRAMINE 30GM CREAM       $    31.75
41766049   GANCICLOVIR 500MG INJ            $   256.77
41766056   METHOTREXATE PF 50 MG/2ML INJ    $   241.00
41766064   EXCEDRIN TAB                     $    10.75
41766106   PRAVASTATIN 20MG TAB             $    22.50
41766114   EPOETIN ALPHA 10000 U/ML INJ     $   357.00
41766148   BIPERIDEN 2MG TAB                $    12.50
41766189   RABIES IMMUN GLOB 300U/2ML INJ   $   424.00
41766197   FLUTAMIDE 125MG CAP              $    12.25
41766205   DIGOXIN IMMUNE FAB 40 ML INJ     $   931.75
41766221   ACETAMINOPH/CODEINE 12.5ML UDC   $    12.25
41766288   BETAXOLOL-S 0.25% 5ML EYE DROP   $   103.50
41766296   CALADRYL LOTION 90MLBOT          $    26.25
41766312   PAROXETINE 20MG TAB              $    22.25
41766320   FOSCARNET 6000MG/250ML PM BAG    $   342.75
41766338   LEVOTHYROXINE 88MCG TAB          $    12.25
41766353   LIDO IV KIT                      $    89.25
41766361   SMX DESENSITIZATION              $   289.25
41766395   PACLITAXEL 30MG/5ML INJ          $   252.25
41766403   ETOPOSIDE 50 MG CAP              $   150.92
41766411   ANTISEPTIC (BAG BALM) 30 GM      $    27.00
41766460   VINCRISTINE 1MG INJ              $   248.75
41766478   TMP 80/SMX 400 10ML(SEPTRA)INJ   $    91.50
41766486   LIOTHYRONINE 25MCG TAB           $    13.50
41766502   PHENOLPHTHALEIN (CORRECTOL)TAB   $    11.00
41766510   MORPHINE 1000MG/20ML INJ         $   295.25
41766536   LIDOCAINE VISCOUS 100MLBOT       $    29.25
41766544   MEGESTROL 40MG/ML 60MLBOT        $   117.25
41766569   SOTALOL 80MG TAB                 $    21.50
41766577   LACTASE (LACTAID) CAPLET         $    30.00
41766593   RIMANTADINE 100MG TAB            $    19.25
41766601   DOBUTAMINE 500MG/250ML PM BAG    $   144.50
41766635   CAMP/PHEN/MENT (BLISTEX).35OZ    $    20.00
41766643   LEVOBUNOLOL 0.5% 5ML EYE DROP    $    81.25
41766650   TMP 40MG/SMX 200MG 5ML DOSE      $    11.00
41766668   ONDANSETRON 8 MG TAB             $    92.25
41766759   MORPHINE SR (MSCONT) 100MG TAB   $    31.50
41766767   SODIUM BICARB 84MG/ML 50ML INJ   $    95.50
41766775   ASPARAGINASE 10000IU INJ         $   211.00
41766783   TETRACAINE 20MG/2ML INJ          $    71.00
41766791   ASCORBIC ACID 25000MG/50ML       $   109.25
41766825   NICARDIPINE SR 30MG CAP          $    11.00
41766833   NICARDIPINE SR 45MG CAP          $    11.00
41766841   RAMIPRIL 2.5MG CAP               $    16.25
41766858   EDROPHONIUM 1ML INJ              $    87.75
41766866   PSEUDOEPHEDRINE 30 MG/5ML DOSE   $    11.00
41766882   ALBUTEROL 2 MG/5ML ORAL DOSE     $    12.00
41766890   PREDNISOLONE 15MG/5 ML DOSE      $    19.25
41766908   TERCONAZOLE 80MG VAGINAL SUP     $    39.50
41766924   ENOXAPARIN 30MG/0.3ML SYRINGE    $    62.75
41766932   FOSINOPRIL 20MG TAB              $    16.00
41766957   NITROGLYCERIN 0.3 MG TAB         $    10.50
41766965   NITROGLYCERIN 0.4 MG TAB         $    11.25
41766973   NITROGLYGERIN 0.6 MG TAB         $    11.00
41766981   NITROGLYGERIN 0.15 MG TAB        $    10.50
41766999   RSI KIT                          $   178.25
41767005   PREPARATION-H RECTAL SUP         $    12.50
41767013   MONSELS SOLUTION 60ML BOTTLE     $    41.25
41767021   SALMETEROL 6.5GM INH (PER TX)    $    14.50
41767039   IPRATROPIUM 0.5MG/2.5ML INH      $    18.25
41767047   ONE TOUCH SOL HIGH CONT BOX      $   179.25
41767054   ONE TOUCH SOL LOW CONT BOX       $   179.25
41767062   ONE TOUCH STRIPS (FSBS)          $    13.75
41767088   ONDANSETRON 2 MG/ML 20ML INJ     $    62.28
41767096   ONDANSETRON 4 MG/2ML INJ         $    66.64
41767138   OFLOXACIN 0.3% 5ML EYE DROP      $   119.00
41767146   FLUOXETINE 10MG CAP              $    23.00
41767153   AMLODIPINE 5MG TABLET            $    17.25
41767187   NITROGLYCERIN 1 INCH (DOSE)      $    11.25
41767195   OVRAL TAB                        $    20.25
41767211   CIPROFLOXACIN 5ML EYE DROPS      $   126.00
41767229   MAGNESIUM SULFATE 5GM/10ML INJ   $    76.00
41767237   PAMIDRONATE 30MG INJ             $   673.00
41767252   ZOLPIDEM 5MG TABLET              $    27.53
41767278   PINDOLOL 10MG TAB                $    11.00
41767294   STUART PRENATAL VITAMIN TAB      $    11.25
41767302   APRACLONIDINE 5ML EYE DROPS      $   110.50
41767310   FELODIPINE 5MG TAB               $    15.50
41767336   LIQUOR 30ML DOSE                 $    12.25
41767351   LORATADINE 10MG TAB              $    23.00
41767369   BUMETANIDE 1MG/4ML INJ           $    76.75
41767385   DEXAMETHASONE 10MG/ML INJ        $    78.50
41767419   GABAPENTIN 300MG CAP             $    17.50
41767435   GLYBURIDE 3MG TAB                $    14.75
41767443   ROCURONIUM 10 MG/ML INJ          $    82.50
41767468   METHYPREDNISOLONE 32MG TAB       $    12.25
41767484   FLUVASTATIN 20MG CAP             $    19.25
41767534   GABAPENTIN 100MG CAP             $    13.25
41767575   ACETAZOLAMIDE 500MG CAPSULE      $    18.50
41767591   EMLA 5GM CREAM                   $    47.50
41767609   CALCIPOTRIENE .005% 100GM OINT   $   368.25
41767625   AMPICILLIN 250MG/5ML 100MLBOT    $    44.00
41767641   METHIMAZOLE 10MG TAB             $    14.50
41767658   PROCAINE HYDROCHLORIDE 2ML INJ   $    75.25
41767666   UNDECYLEN/ZINC(DESENEX) POWDER   $    31.00
41767674   QUINAPRIL 10MG TAB               $    16.00
41767682   HYDROCOD/ACET(LORTAB) 5MG/10ML   $    19.75
41767708   PROPAFOL 1000MG/100ML INJ        $   262.00
41767757   VENLAFAXINE 37.5 MG TABLET       $    17.50
41767765   CLOBETASOL 0.05% 30GM TUBE       $   118.00
41767781   FAMCICLOVIR 500 MG TAB           $    38.25
41767815   ATROPINE 8 MG/20 ML INJ          $    78.50
41767823   DESOXIMETASONE 0.25% 15GM        $      58.25
41767849   CALCIUM + VIT D 500 MG TAB       $      10.75
41767856   OXYCODONE 5MG TAB                $      12.25
41767872   HEP HIC FLUSH NEONANTAL 10U/ML   $      62.75
41767880   LACTIC ACID LOTION 120ML         $      38.50
41767898   NEFAZODONE 100MG TAB             $      16.25
41767922   SODIUM CHLORIDE 1000MG TAB       $      11.00
41767930   NAPH/ANTA2(VASOCON-A)15ML EYED   $      61.50
41767948   ACETIC ACID 0.25% IRR 250ML      $     104.25
41767955   SEVOFLURANE 250ML INH            $     858.25
41767963   HYDROCO/ACET(LORTAB)5MG(URC)#6   $      14.00
41767971   TYLENOL CODEINE 30MG URC #6      $      12.50
41767989   AMOXICILLIN 250MG URC #3         $      11.25
41768011   ZINC SULFATE 220 MG CAP          $      10.50
41768037   COLYTE POWDER 2 TBSP PKG         $      10.75
41768045   PROCARBAZINE 50MG TAB            $      11.00
41768052   BETHANECHOL 10 MG TAB            $      11.00
41768060   BISMUTH SUBSA(PEPTO BISMOL)TAB   $      10.75
41768078   LIDOCAINE 2% 5ML JELLY           $      36.75
41768086   IV FLUSH                         $      10.25
41768094   INSULIN CHARGE                   $     148.00
41768136   METOPROLOL XL 50MG TAB           $      15.50
41768169   DEXTROS 25% 2.5GM/10ML SYRINGE   $      90.00
41768177   ALENDRONATE 10 MG TABLET         $      22.25
41768185   CHLORTHALIDONE 25MG TAB          $      10.50
41768193   HYOSCYAMINE SL 0.125MG TABLET    $      11.00
41768219   PIROXICAM 10MG CAP               $      11.00
41768235   CLARITHROMYCIN 125MG/5ML 50ML    $      87.25
41768268   PERGOLIDE MESYLATE 0.05MG TAB    $      16.00
41768276   STERILE WATER 50ML INJ           $      76.00
41768292   METFORMIN 500 MG TAB             $      14.00
41768300   DOME PASTE 10YD BOX              $      68.50
41768342   LET GEL 3ML TOPICAL              $      18.50
41768359   CALCITONIN 2ML NOSE SPRAY        $     115.25
41768367   ACARBOSE 50 MG TAB               $      13.25
41768375   MAGNESIUM 40GM/1000ML PM BAG     $      94.25
41768383   DOXAZOSIN 1 MG TABLET            $      16.00
41768409   CEFUROXIME 125MG/5ML 100MLBOT    $     107.75
41768417   TACRINE 10MG CAP                 $      11.00
41768425   ITRACONAZOLE 100MG CAP           $      17.50
41768433   ETODOLAC 400MG TAB               $      17.75
41768441   METFORMIN 850MG TAB              $      16.75
41768466   ANASTROZOLE 1 MG TAB             $      34.50
41768474   DAPSONE 100 MG TAB               $      11.25
41768482   SIMVASTATIN 10MG TAB             $      20.50
41768490   M0RPHINE 15MG/ML 20ML INJ        $      63.50
41768508   METHYLPREDNISOLONE 1000MG/16ML   $     137.25
41768516   TRAMADOL HCL 50 MG TAB           $      15.50
41768524   BENZOIN TINC SPRAY 210ML CAN     $      36.75
41768532   CIDOFOVIR 375MG/5ML INJ          $   1,983.75
41768565   HHN TERBUTALINE                  $      11.00
41768581   HHN CROMOLYN                     $      10.25
41768599   HHN ISOPROTERENOL                $      11.00
41768607   HHN EPINEPHRINE                  $      11.00
41768615   HHN ACETYLCYSTEINE               $      10.25
41768623   HHN ALBUTEROL                    $      10.25
41768631   HHN BITOLTEROL                   $      11.00
41768649   HHN IPATROPIUM                   $      10.25
41768664   OXYCODONE CR 20 MG TAB           $      21.00
41768672   POTASSIUM CHL 10MG/100ML BAG     $      79.75
41768698   OXYCODONE CR 10 MG TAB           $      16.75
41768706   ISOSORIBDE MONONITRAT 30MG TAB   $      18.50
41768714   INDINAVIR SULFATE 400MG CAPS     $      14.50
41768722   PROPRANOLOL-LA 60MG CAP          $      16.25
41768748   DIMETHYL SULFOXIDE 50ML INJ      $     239.25
41768755   POTASSIUM CHL 10 MEQ/50ML BAG    $      80.00
41768763   PROCAINAMIDE EX 500MG TAB        $      13.75
41768771   ESMOLOL 100MG/10ML INJ           $     140.00
41768789   LITHIUM CITR 300MG/5ML 60MLBOT   $      31.00
41768805   IBUTILIDE 1MG/10ML INJ           $     649.25
41768862   FAMOTIDINE 10MG/ML               $      78.25
41768888   IRINOTECAN 100 MG/5ML INJ        $   1,750.75
41768896   AMOX/POT CLAVU 875MG TAB         $      28.75
41768904   AMOX/POT CLAVU 500MG TAB         $      27.25
41768938   GENTAMYCIN 80MG/50ML NS          $      87.75
41768946   LAMIVUDINE 150 MG TABLET         $      16.00
41768953   FAMOTIDINE 20MG/2ML INJ          $      88.00
41768977   CEFAZOLIN 10GM INJ               $     138.00
41768985   PERGOLIDE 0.25MG TAB             $      15.50
41768993   CARTEOLOL 1% ML EYE DROPS        $      83.75
41769001   MELATONIN 3MG TAB                $      10.75
41769009   CALCIUM ACE 667MG TAB            $      11.25
41769017   VITAMIN D 400IU CAP              $      10.50
41769025   MONTELUKAST 10 MG TABLET         $      22.50
41769049   MIDAZOLAM 10MG/5ML DOSE          $      30.00
41769057   PRAMIPEXOLE 0.125MG TAB          $      14.75
41769105   GENTAMICIN 40MG/ML 20 ML INJ     $      69.25
41769113   PRAMIPEXOL 1MG TAB               $      19.25
41769121   DOXORUBICIN 20 MG/10ML INJ       $   2,508.71
41769129   ENOXAPARIN 80MG/0.8ML INJ        $     182.75
41769137   AZITHROMYCIN 200MG/5ML 30ML LI   $      97.75
41769145   VALPROATE 500MG/5ML INJ          $     109.25
41769153   IPRATROPIUM NASAL SPRAY.03% 30   $     111.00
41769161   MYCOPHENOLATE MOFETIL 500MG/20   $     381.50
41769169   VALACYCLOVIR 500MG TAB           $      26.25
41769177   FEXOFENADINE 60MG CAP            $      15.50
41769185   CELEBREX 100MG CAP               $      18.25
41769193   SUMATRIPTAN 50MG TAB             $      67.25
41769201   FIORINAL CODEINE CAP             $      13.75
41769209   OCTREOTIDE 1000MCG/ML 5ML MDV    $     475.50
41769217   BUPROPION SR 150MG TAB           $      18.00
41769225   ENOXAPARIN 100MG/10ML INJ        $     222.00
41769233   VINORELBINE 10MG/ML INJ          $     254.14
41769241   LEVOFLOXACIN 250MG TAB           $      38.25
41769249   VENLAFAXINE XR 37.5MG CAP        $      20.25
41769257   ATENOLOL 25MG TAB                $      14.00
41769265   VENLAFAXINE XR 75MG CAP          $      21.50
41769273   CALCITONIN 100IU/0.5ML INJ       $     101.75
41769289   ARTHROTEC-50 TAB                 $      18.50
41769305   AMIODARONE 150MG/3ML INJ         $     289.75
41769313   PILOCARPINE 4% 5GM EYE GEL       $      66.75
41769321   CEFOXITIN 1GM INJ                $     107.75
41769345   HYALURONATE 14MG/ML .85ML SYR    $     315.00
41769353   OMEGA-3 500MG CAPSULE            $      10.50
41769361   DEMEROL DRIP(PCA) 500 MG/50 ML   $     225.00
41769369   ALTEPLASE 50MG/50ML INJ          $   3,275.50
41769377   DILAUDID DRIP (PCA) 20MG/100ML   $     442.25
41769385   MORPHINE DRIP (PCA)100MG/100ML   $     228.00
41769393   ACETAMINOPHEN 650MG/20.3ML UDC   $      13.25
41769401   FERROUS SULFATE 300MG/5ML UDC    $       8.25
41769409   METOCLOPRAMIDE 5MG/5ML UDC       $      11.50
41769417   SODIUM CHLORIDE 0.9% 3ML UDINH   $      11.00
41769425   RALOXIFENE 60MG TAB              $      20.75
41769433   CERTRIZINE 10MG TAB              $      18.25
41769449   DOXAZOSIN 4MG TAB                $      16.00
41769455   MISOPROSTOL 25 MCG TAB           $      16.75
41769461   BERACTANT 8ML VIAL               $   1,852.50
41769467   NEUPOGEN 480 MCG/ML INJ          $     515.00
41769473   GOSERELIN IMPLANT 3.6MG INJ      $   1,082.50
41769479   TOLTERODINE 2MG TAB              $      19.25
41769485   TORSEMIDE 10 MG TAB              $      13.25
41769491   ISOSULFAN BLUE 50MG/5ML INJ      $     229.75
41769497   ALTEPLASE 1MG/1ML INJ            $     137.00
41769503   PREMPRO 0.625MG/2.5MG TAB        $      17.00
41769509   MISOPROSTOL VAG GEL100MCG/20ML   $     118.50
41769515   MISOPROSTOL VAG GEL 50MCG/10ML   $     116.00
41769521   PYRIDIUM PLUS 150 MG TABS        $      16.75
41769527   LANSOPRAZOLE 15MG CAP            $      28.75
41769533   KETOROLAC 0.5% 3ML EYE DROPS     $      93.25
41769539   DIPYRIDAMOLE 5 MG/ML INJ         $     379.75
41769545   HEPATITIS-B VACC RECOM/PEDIATR   $     140.50
41769551   ZINC CHLORIDE (TPN)              $      55.50
41769563   LANCETS FINGER STIX (FSBS)       $      11.00
41777320   LACTOBACILLUS ACIDOPHILUS TAB    $      11.00
41777350   ENOXAPARIN 60MG/0.6ML INJ        $     141.25
41777356   GUAIFENESIN LA 600MG CAP         $      11.25
41777362   ROSIGLITAZONE 4MG TAB            $      21.00
41777368   HYDROCORTISONE 5MG TAB           $      11.25
41777374   ENOXAPARIN 30MG/0.3ML AMP        $      82.75
41777380   LIDOCAINE 2% 10ML JELLY          $      34.50
41777386   PAPAIN-UREA DEBRIDING OINTMENT   $     136.50
41777392   ENOXAPARIN 70MG/0.7ML SYRINGE    $     140.00
41777398   ENOXAPARIN 90MG/0.9ML SYRINGE    $     190.00
41777404   EPOETIN 40000U/ML INJ            $     990.75
41777410   CITALOPRAM 20MG TAB              $      20.25
41777422   ROFECOXIB 25MG TAB               $      21.50
41777428   MIRTAZAPINE 15MG TAB             $      22.25
41777446   IPRATROPIUM 14 GM INH (PYXIS)    $     141.25
41777452   VALSARTAN 80MG CAP               $      17.00
41777458   ISOSULFAN BLUE 1% 10MG/ML INJ    $     241.50
41777464   INSULIN REGULAR 100U/ML PYXIS    $      59.76
41777470   INSULIN NPH 100U/ML PYXIS DOSE   $      67.76
41777476   INS NOVOLIN 70/30 100U/ML PYX    $      59.76
41777482   INSULIN HUMALOG 100U/ML PYXIS    $      59.20
41777488   INSULIN LENTE 100U/ML PYXIS      $      59.76
41777494   ESTRADIOL 1MG TAB                $      11.50
41777500   IMMUNE GLOBULIN 5GM              $   1,271.50
41777506   HAEMOPHILUS B CONJUGATE 0.5ML    $      89.25
41777512   DEXTROSE 10%-H2O 500ML/WITH RX   $      92.50
41777518   DEXTROSE 5% IN WATER 50 ML       $      92.50
41777524   DEXTROSE 5% 100ML                $      92.50
41777530   DEXTROSE 5% 250ML BAG            $      92.50
41777536   DEXTROSE 5% 500ML                $      92.50
41777542   DEXTROSE 5% 1000ML               $      92.50
41777548   MORPHINE 1000MG/40ML INJ         $     247.75
41777554   DEXTROSE 5%-LR 500ML/WITH RX     $      92.50
41777560   DEXTROSE 5% LR 1000ML            $     113.50
41777572   DEXTROSE 5% NACL 0.45% .5L/RX    $      92.50
41777578   DEXTROSE 5% NACL 0.45% 1000ML    $      92.50
41777584   DEXTROSE 5% NACL 0.9% 1L/RX      $      92.50
41777590   SODIUM CHLOR 0.45% 1000ML        $      92.50
41777596   SODIUM CHLOR 0.9% 100ML          $      92.50
41777602   SODIUM CHLORIDE 0.9% 1000ML      $      92.50
41777608   SODIUM CHLOR 0.9% 1000ML         $      92.50
41777614   SODIUM CHLOR 0.9% 500ML          $      92.50
41777620   SODIUM CHLORIDE 0.9% 50ML        $      92.50
41777626   SODIUM CHLOR .9% IRRIG .5L/RX    $      92.50
41777632   IRRIGATION LR 3000ML/WITH RX     $      95.00
41777638   IRRIGATION NACL .9% 1500ML/RX    $      95.00
41777644   IRRIGATION NACL .9% 3000ML/RX    $      95.00
41777650   IRRIGATION SW 1500ML/WITH RX     $      95.00
41777656   IRRIGATION SW 3000ML/WITH RX     $      95.00
41777662   IRRIGATION SW 500ML/WITH RX      $      95.00
41777668   LACTATED RINGERS 500ML/WITH RX   $      92.50
41777674   LACTATED RINGERS 1000ML/RX       $      92.50
41777680   QUETIAPINE 25MG TAB              $      17.75
41777686   LEVOTHYROXINE 200MCG/2ML INJ     $     155.50
41777700   LAMOTRIGINE 25MG TAB             $      12.25
41777706   PSEUDOEPHREDRINE 60 MG TAB       $       8.50
41777712   NISOLDIPINE 10MG TAB             $      16.00
41777730   DIPYRIDAMOLE 200MG/ASA25MG CAP   $      19.75
41777736   RAPACURONIUM 100MG/5ML           $      81.50
41777742   TRASTUZUMAB 440 MG INJ           $   7,434.30
41777748   NALOXONE 0.4MG/ML 10ML VIAL      $      87.00
41777754   CARBACHOL 1.5% 15ML EYE DROPS    $      82.75
41777760   ALBUTEROL 5MG/ML 20ML BOTTLE     $      69.50
41777767   RID (LICE SHAMPOO) 60 ML         $      31.75
41777773   LORAZEPAM 40MG/10ML INJ          $     158.50
41777779   RISPERIDONE 0.25MG TAB           $      22.50
41777785   RISPERIDONE 30MG/30ML LIQUID     $     273.75
41777803   CERIVASTATIN 0.2MG TAB           $      17.50
41777809   BOTOX 100 U INJ                  $   1,193.25
41777815   TIZANIDINE 4 MG TAB              $      17.75
41777833   BENZOYL PEROXIDE WASH 10% BOTT   $     106.75
41777839   BETA CAROTENE 25,000 IU CAPS     $      10.75
41777845   TOPOTECAN 4 MG INJ               $   2,679.28
41777851   PSEUDOEPHEDRINE ER 120 MG TAB    $      11.50
41777862   DOCETAXEL 20 MG/0.5ML VIAL       $   1,114.31
41777868   LINEZOLID 200 MG 100 ML/BOTTLE   $      76.75
41777900   EPOETIN ALFA 4000 UNIT/ML INJ    $     207.50
41777914   HEPARIN 25000 UNITS/500 ML       $     103.75
41777935   OXYCODONE 80 MG TAB              $      40.25
41777942   CIPROFLOXACIN 200 MG/100ML BAG   $     146.25
41777949   MIRTAZAPINE 45 MG TAB            $      22.75
41777956   PCA POUCH                        $      10.25
41777963   FLUTICASONE 110MCG INHALER       $     266.00
41777984   HEP A VAC 720 u/0.5 ML INJ       $     202.25
41777991   LIDOCAINE ANESTHETIC 4% 5 GM     $      47.75
41777998   TIROFIBAN 12.5 MG/50 ML INJ      $   1,347.25
41778005   ANAGRELIDE 0.5 MG CAP            $      29.75
41778012   ISOPROTERENOL 0.2 MG/10 ML INJ   $      76.50
41778019   TENECTEPLASE 50 MG VIAL          $   6,176.25
41778033   GLIMEPIRIDE 2 MG TAB             $      13.00
41778040   LANSOPRAZOLE 15MG/5ML 50 ML LQ   $      37.00
41778047   DOCUSATE SODIUM 100MG/25ML UDC   $      13.25
41778054   PIOGLITAZONE 15 MG TAB           $      23.25
41778061   IMMUNE GLOBULIN 10GM INJ         $   2,640.50
41778068   MAALOX PLUS 30 ML UDC            $      12.25
41778082   SUFENTANIL 250 MCG/5 ML INJ      $     197.00
41778089   SUFENTANIL 100 MCG/2 ML INJ      $      79.25
41778096   METRONIDAZOLE 500 MG TAB         $      14.00
41778103   ALFENTANIL 2500 MG/5 ML INJ      $     109.00
41778110   BENAZEPRIL 40 MG TAB             $      15.25
41778117   QUINAPRIL 20 MG TAB              $      16.00
41778124   SIMVASTATIN 20 MG TAB            $      26.00
41778131   ROFECOXIB 12.5 MG TAB            $      21.50
41778159   FENTANYL 100 MCG/ML CARPUJET     $      75.25
41778166   METHYLPHENIDATE 5 MG TAB         $      11.50
41778173   OXYBUTYNIN XL 5 MG TAB           $      21.75
41778180   CLINDAMYCIN 75MG/5ML 100 ML BT   $      50.25
41778187   WARFARIN 3MG TAB                 $      14.00
41778194   LOSARTAN 50 MG TAB               $      16.75
41778208   SODIUM CHLORIDE 0.9%/10ML SYR    $      24.00
41778243   INSULIN 70-30                    $     148.00
41778250   INSULIN LISPRO                   $     111.00
41778257   INSULIN HUMAN LENTE              $     147.50
41778264   INSULIN HUMAN NPH                $     147.50
41778271   INSULIN HUMAN REGULAR            $     147.50
41778278   INSULIN HUMAN ULTRALENTE         $     147.50
41778285   INSULIN PORK NPH                 $     174.00
41778292   INSULIN PORK REGULAR             $     174.00
41778299   DEXTROSE 30% (TPN)               $     593.25
41778313   DEXTROSE 5% (PPN)                $      92.50
41778320   HHN CONTINUOUS                   $      11.00
41778327   IMMUNE GLOBULIN 5GM/50ML INJ     $   1,310.50
41778334   PANTOPRAZOLE 40MG/10ML INJ       $     137.00
41778341   NS 1000 ML                       $      98.00
41778362   FOLIC ACID (TPN)                 $      89.25
41778369   BETANIETHASONE 0.05% 60 ML       $      76.50
41778376   MONTELUKAST 1OMG TAB             $      22.50
41778383   INSULIN REGULAR (TPN)            $      44.25
41778390   HEP DIAL 500 I INJ               $      56.00
41778397   MULTIVITAMINS (TPN)              $      34.50
41778404   MIVACUIUM 20MG/10ML VIAL         $     129.00
41778411   FENTANYL 400MCG LOZGENGE         $      43.25
41778425   RISEDRONATE 5MG TAB              $      19.75
41778432   THIAMINE (TPN)                   $     104.25
41778439   FLUTICASONE 44MCG INHALER        $     136.25
41778446   MICONAZOLE 200MG/3 VAG SUPP      $      51.00
41778453   FLUTICASONE 7.9GM INHALER        $     126.50
41778460   ROFECOXIB 12.5MG/ML 150ML BOTT   $     252.50
41778481   DEXTROSE 5% 100ML MINI BAG PLU   $      92.50
41778488   METAPROTERENOL 14 GM INHALER     $      51.00
41778502   EPOETIN 20,000 UNITS/ML INJ      $     645.25
41778509   BRINZOLAMIDE 1% 5ML EYEDROPS     $      96.50
41778516   FAMOTIDINE TPN                   $      53.00
41778530   KCL 10mEq in D5.2NS 500ML        $     202.75
41778537   LEVALBUTEROL 0.63MG/3ML INH      $      20.25
41778544   VICOPROFEN TAB                   $      10.75
41778558   FELODIPINE 2.5MG TAB             $      15.50
41778565   MENINGOCOCC VACC ACYW-135 INJ    $     168.50
41778572   BENAZEPRIL 5 MG TAB              $      15.25
41778579   CANDESARTAN 8 MG TAB             $      17.25
41778586   BICULATAMIDE 50 MG TAB           $      55.00
41778593   MORPHINE PF 500MG/20ML INJ       $     430.75
41778607   MORPHINE 10 MG/ML INJ            $      73.00
41778614   KCL 10mEq in D5.5NS 1000ML       $     202.75
41778621   KCL 20mEq in D5 1000ML           $     202.75
41778628   IRINOTECAN 20MG/ML INJ           $     344.00
41778635   MAFENIDE 56.7 GM CREAM           $      90.50
41778649   KCL 20mEq in D5.2NS 1000ML       $     202.75
41778656   TERAZOSIN 5 MG CAP               $      19.25
41778663   MAGNESIUM 12.5% 8 ML INJ         $      93.25
41778670   NATEGLINIDE 120MG TAB            $      15.50
41778677   VINBLASTINE 1 MG INJ             $     132.75
41778684   KCL 20mEq in D5LR 1000ML         $     202.75
41778691   KCL 20mEq in D5NS 1000ML         $     202.75
41778698   KCL 20mEq in NS 1000ML           $     202.75
41778705   KCL 30mEq in D5 1000ML           $     213.50
41778712   KCL 30mEq in D5.2NS 1000ML       $     202.75
41778719   KCL 30mEq in D5.5NS 1000ML       $     202.75
41778726   KCL 40mEq in D5.2NS 1000ML       $     202.75
41778733   KCL 40mEq in D5.5NS 1000ML       $     202.75
41778740   KCL 40mEq in D5LR 1000ML         $     213.50
41778747   KCL 40mEq in D5NS 1000ML         $     202.75
41778754   KCL 40mEq in NS 1000ML           $     101.25
41778775   GLUTAMINE 106M/0.52 OZ PKG       $      11.50
41778782   GLUCOSAMINE/CHONDROITIN TABLET   $      13.50
41778789   CYANOCOBALAMIN 500 MCG TAB       $      10.50
41778810   LISINOPRIL 20MG TAB              $      16.00
41778824   MEPERIDINE 1500 MG/30 ML INJ     $      74.00
41778831   TIMOLOL XE 0.5% OPHT GEL         $      83.75
41778836   BENZOCAINE 20% 3.75 GM GEL       $      35.75
41778843   PERGOLIDE MESYLATE 1 MG TAB      $      27.75
41778850   CIPRO 500 MG/5 ML 100 ML BOT     $     261.00
41778857   FAMOTIDINE 8 MG/ML 50 ML BOT     $     109.50
41778864   IFOSFAMIDE 1 GM INJ              $     295.14
41778871   NIACIN 500 MG TAB                $      10.50
41778878   PHENASEPTIC THROAT SPRAY 180ML   $      26.25
41778899   DEXTROSE 10% 1000 ML BAG         $      92.50
41778906   GELUSIL TAB                      $       8.50
41778913   MAALOX TAB                       $       8.50
41778920   MISOPROSTOL 100 MCG TAB          $      16.75
41778927   DEXTROSE 5% NS 0.225% 1000ML     $      92.50
41778934   DOCUSATE SODIUM 50MG/5ML 60ML    $      29.00
41778941   RX COMPOUNDING FEE               $      64.25
41778948   ANTIVENIN CROTALIDAE 1GM/1VIAL   $   2,386.75
41778976   MULTIVITAMIN (PPN)               $      75.50
41778990   DERMABOND 0.5 ML ADHESIVE        $      71.75
41779004   POTASSIUM 10MEQ/5ML INJ          $      72.00
41779011   POTASSIUM 30MEQ/15ML INJ         $      73.25
41779039   MAGNESIUM 1 GM/100 ML PM BAG     $      93.00
41779046   HHN MORPHINE                     $      82.00
41779053   DEXTROSE 10% SALINE 0.9% LITRE   $      92.50
41779060   COMBIVENT 14.7GM INH (PER TX)    $      33.50
41779088   TOLTERODINE LA 4 MG CAP          $      22.50
41779095   PHYTONADIONE 10MG/1ML INJ        $      85.75
41779109   CEFOTAXIME 2GM INJ               $     188.50
41779116   HEPATITIS-A ADULT VAC 1440U/ML   $     213.75
41779123   OLANZAPINE 2.5MG TABLET          $      27.25
41779130   BUSPIRONE 5MG TABLET             $      14.50
41779137   MESALAMINE CR 250 MG CAP         $      13.25
41779144   GELFILM 125-20                   $     633.50
41779151   LEUCOVORIN 500 MG INJ            $     137.00
41779158   FENOFIBRATE 54MG TAB             $      15.00
41779165   ALTEPLASE (TPA) 2MG INJ.         $     231.75
41779172   REMIFENTANIL 2MG/5ML INJ.        $      51.75
41779186   SINEMET CR 25-100 TABLET         $      15.25
41779193   FEXOFENADINE 180MG TAB           $      20.00
41779207   INSULIN GLARGINE 100U/ML INJ     $     184.25
41779214   NIACIN ER 500MG TAB              $      15.00
41779221   ZOLMITRIPTAN 2.5MG TAB           $      61.25
41779228   CARVEDILOL 25MG TAB              $      18.50
41779235   ALENDRONATE 70 MG TAB            $      86.75
41779242   DOCETAXEL 80MG/2ML INJ           $   4,093.00
41779256   CILOSTAZOL 100MG TAB             $      18.50
41779263   PHOSPHORUS 250 MG TAB            $      11.00
41779270   KETOROLAC 0.4ML EYE DROP         $      97.75
41779277   SODIUM CHLORIDE 0.9% 3ML SYRNG   $      12.00
41779284   RIVASTIGMINE TARTRATE 1.5MGCAP   $      20.25
41779298   DALTEPARIN 5,000 UNITS INJ.      $     138.25
41779305   DALTEPARIN 5,500 UNIT INJ.       $     138.00
41779312   DALTEPARIN 6,000 UNITS INJ.      $     144.00
41779319   DALTEPARIN 6,500 UNITS INJ.      $     150.25
41779326   DALTEPARIN 7,000 UNITS INJ.      $     156.25
41779333   DALTEPARIN 7,500 UNITS INJ.      $     162.75
41779340   DALTEPARIN 8,000 UNITS INJ.      $     169.00
41779354   DALTEPARIN 8,500 UNITS INJ.      $     175.00
41779361   DALTEPARIN 9,000 UNITS INJ.      $     181.25
41779368   DALTEPARIN 10,000 UNITS INJ.     $     178.25
41779375   DALTEPARIN 11,000 UNITS INJ.     $     189.50
41779382   DALTEPARIN 12,000 UNITS INJ.     $     200.00
41779389   DALTEPARIN 13,000 UNITS INJ.     $     211.00
41779396   DALTEPARIN 14,000 UNITS INJ.     $     222.00
41779403   DALTEPARIN 15,000 UNITS INJ.     $     232.75
41779410   DALTEPARIN 16,000 UNITS INJ.     $     243.50
41779417   DALTEPARIN 17,000 UNITS INJ.     $     254.75
41779424   DALTEPARIN 18,000 UNITS INJ.     $     265.50
41779431   OCTREOTIDE 50MCG/ML INJ.         $     101.25
41779438   GROSHONG PICC FLUSH /PROTOCOL    $      10.25
41779445   PENTOBARBITAL 50MG/ML 20ML MDV   $      69.50
41779452   OSELTAMIVIR 75 MG CAP            $      15.00
41779459   CIPROFLOXACIN 5ML EYE-DROP PXY   $     148.00
41779501   NON-FORMULARY UNIT DOSE NFBB     $      21.00
41779508   NON FORMULARY UNIT DOSE NFARB    $      20.00
41779515   NON FORMULARY UNIT DOSE NFAS     $      21.00
41779522   NON FORMULARY UNIT DOSE NFS      $      21.00
41779529   NON FORMULARY UNIT DOSE NFAN     $      21.00
41779536   PARICALCITOL 5MEQ/ML INJ.        $      81.00
41779543   EPTIFIBATIDE 20MG/10ML INJ       $     215.00
41779550   EPTIFIBRATE 75MG/100ML INJ       $     506.75
41779557   DALTEPARIN 2,500 UNITS INJ       $     110.00
41779564   DALTEPARIN 20,OOO UNIT INJ       $     178.25
41779571   OFLOXACIN 0.3% 1ML               $      18.50
41779578   COSOPT 5ML EYE DROP              $     134.25
41779585   ASPIRIN EC 162MG TAB             $      10.50
41779599   ESTRATEST 1.25MG/2.5MG TAB       $      18.50
41779606   SPIRONOLACTONE 100MG TAB         $      17.00
41779613   METFORMIN XR 500MG TAB           $      13.75
41779620   TRIAMCINOLONE .1% 80GM CREAM     $      24.50
41779627   TRIAMCINOLONE .1% 454 GM CREAM   $      90.00
41779634   CEFOTAXIME 500MG INJ             $      92.25
41779641   DARBEPOETIN ALFA/ALBU.60MCG/ML   $     714.50
41779649   ALBUTEROL 17GM INHALER           $     117.25
41779663   HALLS COUGH DROPS                $      10.50
41779670   TOLCAPONE 200MG TABLET           $      20.25
41779677   TOLCAPONE 100MG TABLET           $       9.25
41779684   IMMUNE-GLOBULIN 1.5% 2ML VIAL    $      62.00
41779691   CELECOXIB 200 MG CAP             $      21.50
41779699   BUDESONIDE 0.25MG/2ML INHPILOW   $      29.00
41779706   BUDESONIDE 0.5MG/2ML INHPILLOW   $      29.00
41779713   ATOVAQUONE 750MG/5ML 60ML        $     356.25
41779727   DOCUSATE 50MG/5ML 60ML BOTTLE    $      29.00
41779734   METRONIDAZOLE .75% 78GM VAGCRM   $     135.75
41779741   GALANTAMINE 4MG TAB              $      20.00
41779749   VECURONIUM 20MG/10ML INJ         $     140.50
41779756   ZOLEDRONIC ACID 4MG/5ML INJ      $   2,125.25
41779763   NON FORMULARY                    $      40.00
41779770   NON FORMULARY                    $      45.00
41779777   NON FORMULARY                    $      50.00
41779784   NON FORMULARY                    $      49.50
41779791   NON FORMULARY                    $      90.00
41779798   NON FORMULARY                    $     110.00
41779805   NON FORMULARY                    $     130.00
41779812   LIOTHYRONINE 5MCG TAB            $      13.00
41779819   ANTIVENIN-RATTLESNAKE 1GM VIAL   $   2,386.75
41779826   DARBEPOETIN ALFA/ALB 200MCG/ML   $   2,220.00
41779833   HYALURONATE 10MG/ML .85ML SYR    $     298.00
41779840   INTERFERON 5MU/0.5ML 2.5ML MDV   $     183.25
41779847   WARFARIN 4MG TAB                 $      14.00
41779854   LIDOCAINE 5% PATCH               $      38.25
41779861   GLIPIZIDE XL 2.5MG TAB           $      12.25
41779868   QUETIAPINE FUMARATE 100MG TAB    $      21.75
41779882   IMMUNE GLOBULIN 6GM              $     534.75
41779889   KCL 20mEq in D5.5NS 1000ML       $     202.75
41779896   MITOXANTRONE 2MG/ML INJ          $   4,147.25
41779910   FLUTICASONE PROP. 50MCG/16GM     $     159.25
41779917   ALBUTEROL ER 4MG TAB             $      15.00
41779920   DAPTOMYCIN 500MG VIAL            $     257.00
41779924   LINEZOLID 600MG TAB              $     138.75
41779931   RISPERIDONE 0.5MG TAB            $      22.75
41779938   AMIODARONE 400MG TAB             $      33.00
41779952   MESALT 4X4 PATCH                 $      12.25
41779959   TEGASEROD MALEATE 6MG TAB        $      13.75
41779966   LOXAPINE 10MG CAP                $      16.25
41779973   TIAGABINE 4MG TAB                $      12.50
41779980   ALBUTEROL 5MG/ML 20ML INH SOL    $      73.25
41779987   CARBOXY METHYLCELLULOSE 75GM     $      47.25
41779994   STERILE WATER 100ML INJ          $      80.75
41780001   CYANIDE ANTIDOTE KIT             $     428.00
41780008   FLUCONAZOLE 150MG TAB            $      54.00
41780015   MIDODRINE 5MG TAB                $      20.25
41780029   IRBESARTAN 150MG TAB             $      17.50
41780036   IRBESARTAN 300MG TAB             $      19.25
41780043   LEVALBUTEROL 1.25MG/3ML INH      $      20.25
41780050   VISCOAT 0.75ML OPHT. SYR         $     390.75
41780057   HEPATITIS B IMM GLOB 1560U/5ML   $   1,600.00
41780064   INSULIN ASPART                   $     193.50
41780071   MORPHINE 60MG/ML 20ML            $      73.00
41780078   INDOCYANINE GREEN 2MG EYE SOL    $     187.75
41780085   OXALIPLATIN 100MG\20ML VIAL      $   5,491.91
41780092   TRIAMTERENE 50MG/HCTZ 25MG       $      14.50
41780099   CAPECITABINE 500MG TAB           $      51.25
41780106   SALMETEROL 50MCG INH-PER TX      $      14.50
41780113   SIMVASTATIN 80MG TAB             $      28.50
41780120   SIMVASTATIN 40MG TAB             $      28.50
41780134   ALBUTEROL 2.5MG/0.5ML INH        $      14.00
41780141   RACEPINEPHRNE 2.25%/.05ML INH    $      18.00
41780155   CANDESARTAN 16M TAB              $      17.25
41780162   METHYLPREDNISOLONE 100MG/MLINJ   $      82.75
41780169   KCL 10mEq in D5.5NS 500ML        $     113.00
41780176   EPIRUBICIN 50MG/25ML INJ         $   3,421.00
41780183   AMIFOSTINE 500MG INJ             $   1,097.50
41780190   CARBOPLATIN 150MG INJ            $   1,173.00
41780197   CARBOPLATIN 450MG INJ            $     547.00
41780204   PAROXETINE CR 12.5MG TAB         $      24.75
41780211   OXYCODONE 5MG/5ML ORAL DOSE      $      12.25
41780218   NON FORMULARY                    $      60.00
41780225   DALTEPARIN 4,000 UNITS INJ       $     152.75
41780232   POLYETHYLENE GLYCO.ELECT.17GM    $      10.50
41780239   SECRETIN 16MCG INJ               $     972.75
41780246   SENNA PLUS TAB                   $      10.75
41780253   OXCARBAZEPINE 150MG TAB          $      15.25
41780260   LIDOCAINE PF 2% 20MG/ML 10ML     $      78.25
41780267   INTERFERON ALFA-2B 50MU/ML INJ   $   1,757.50
41780274   KCL 20mEq in NS.45 1000ML        $     213.50
41780281   SERTRALINE 100MG TABLET          $      20.75
41780288   OXCARBAZEPINE 300MG TAB          $      18.25
41780295   TRANDOLAPRIL 1MG TAB             $      13.50
41780302   VANCO MIX 0.1ML EYE SYRINGE      $     165.25
41780344   GI COCKTAIL 200ML BOTTLE         $     146.00
41780351   RIZATRIPTAN BENZOATE 10MG TAB    $      66.25
41780358   INSULIN CHARGE                   $     111.00
41780365   SALMETEROL 50MCG DISKUS          $     141.50
41780372   CEFPROZIL 125MG/5ML 50ML         $      85.75
41780386   LETROZOLE 2.5MG TABLET           $      41.08
41780414   CARVEDILOL 6.25MG TABLET         $      19.25
41780428   OLMESARTAN MEDOXOMIL 20MG TAB    $      16.75
41780435   RAMPRIL 10MG CAPSULE             $      16.75
41780442   ADVAIR 250-50MCG DISKUS          $     239.50
41780470   IRON DEXTRAN 50MG/ML VIAL        $      70.50
41780477   IRON SUCROSE 20MG/ML 5ML VIAL    $     158.00
41780485   DROTRECOGIN ALFA 20 MG INJ       $   2,308.00
41780492   MEROPENEM 1GM VIAL               $     175.00
41780499   TOLAZAMIDE 500MG TABLET          $      12.50
41780506   LEPIRUDIN 50 MG INJ              $     364.50
41780513   MERCAPTOPURINE 50MG TABLET       $      26.25
41780520   PAPAVERINE 30MG/ML 10ML VIAL     $      68.00
41780527   BACITRACIN 15GM OINTMENT         $      27.50
41780534   ETHYL ALCOHOL/D5W 1000ML         $     319.50
41780548   METOPROLOL 25MG TAB              $      18.25
41780559   NS MINI BAG PLUS 100ML BAG       $      75.25
41780566   NS MINI BAG PLUS 50ML            $      75.25
41780573   MIDAZOLAM 100MG/100ML DRIP       $     412.25
41780580   LORAZEPAM 40MG/500ML DRIP        $     462.00
41780587   PROMETRIUM 100MG CAPSULE         $      15.00
41780601   PAROXETINE CR 25MG TAB           $      22.00
41780608   TROPICAMIDE 1% 2ML EYE DROPS     $      34.75
41780615   HYDROMORPHINE 250MG INJ.         $     268.00
41780622   VERAPAMIL SR 120MG CAPSULE       $      16.00
41780629   PIOGLATAZONE 45MG TAB            $      29.75
41780636   MIRTAZAPINE 30MG TAB             $      21.00
41780643   ESCITALOPRAM OXALATE 10MG TAB    $      19.25
41780650   GLIPIZIDE 10MG TAB               $      11.50
41780657   GUAIFENESIN 5ML ORAL LIQUID      $      12.00
41780664   EZETIMIBE 10MG TAB               $      20.50
41780671   BUPIVACAINE EPI 0.5% 10ML        $      85.25
41780678   ENALAPRIL 2.5MG TAB              $      12.75
41780685   BENAZEPRIL 20MG TAB              $      13.75
41780692   LEVOFLOXACIN 750MG TAB           $      57.75
41780699   TETRACAINE 0.5% 15ML EYE DROPS   $      33.50
41780713   LEVONORGESTREL 0.75MG/2TAB PKG   $      77.75
41780720   ATENOLOL 100MG TAB               $      15.50
41780727   BICITRA 30ML DOSE                $      11.75
41780734   IMMUNE GLOBULIN 10ML             $     308.00
41780741   IMMUNE GLOBULIN 12 GM BOTTLE     $   1,038.25
41780748   LORAZEPAM 20MG/10ML INJ          $     110.00
41780783   LEVOFLOXACIN 750MG/150ML D5      $     262.75
41780790   HEPATITIS B IMMUN-GLOB 1ML SYR   $     347.00
41780797   VALSARTAN 160MG TABLET           $      17.00
41780811   HYDROMORPH 1MG/ML INJ            $      14.75
41780818   GEMCITABINE 1GM VIAL             $   1,985.94
41780825   TIOTROPIUM 18MCG HANDIHALER      $     126.00
41780832   PANTOPRAZOLE 40MG TAB            $      27.75
41780839   SALIVERT 73.9 ORAL SPRAY         $      18.00
41780846   CLINDAMYCIN 300MG/50ML DEXTROS   $     158.25
41780853   ALBUTEROL 2.5MG/3ML PYXIS        $      18.00
41780860   SODIUM FERRIC GLCNT 6.25MG/5ML   $     160.75
41780867   CLINDAMYCIN 600MG/50ML DEXTROS   $     170.25
41780874   CLINDAMYCIN 900MG/50ML DEXTROS   $     178.25
41780881   LACTULOSE 20GM/30ML ORAL DOSE    $      23.00
41780888   CEFOXITIN 2GM INJ                $     143.25
41780895   PANTOPRAZOLE 20MG TABLET         $      27.75
41780902   DILTIAZEM 125MG/25ML VIAL        $      72.00
41780909   VENLAFAXINE XR 150MG CAP         $      26.75
41780916   POTASSIUM PHOS 22MEQ/NS 250ML    $     224.00
41780923   COENZYME Q10 50MG CAP            $      10.50
41780930   POTASSIUM PHS 14.7MEQ/NS 100ML   $     224.00
41780944   LEVETIRACETAM 250MG TAB          $      19.50
41780986   METHOTREXATE PF 1GM VIAL         $     175.75
41780993   METHOTREXATE 20MG VIAL           $      59.00
41781000   DARVOCET TABS 6 PKG TAKE HOME    $      13.00
41781007   GLYBURIDE 1.25MG TAB             $      10.25
41781014   ADVAIR 100/50 RT DISKUS          $     258.75
41781021   ESMOLOL 2500MG/250ML PM          $     330.25
41781028   CYANOCOBALAMIN 1000 MCG TAB      $      11.50
41781035   DALTEPARIN 9500U/0.95ML INJ      $     186.25
41781042   RISEDRONATE 35MG TAB             $      86.75
41781049   AZITHROMYCIN 500MG TAB           $      79.00
41781063   GATIFLOXACIN 0.3% 5ML EYE DROP   $     161.50
41781070   OCUVITE TAB                      $      11.25
41781098   DOLASETRON 100MG TAB             $     214.00
41781105   MEMANTINE 5MG TAB                $      20.25
41781112   ESCITALOPRAM OXALATE 20MG TAB    $       9.00
41781119   MISOPROSTOL 50MCG TAB            $       9.00
41781126   ESTRADIOL .025MG TRNSDML PTCH    $      39.75
41781133   NESIRITIDE 1.5MG VIAL            $   1,220.25
41781140   HYDROMORPHONE ER 16MG CAP        $      45.25
41781151   PALONOSETRON 0.25MG/5ML INJ      $     782.50
41781154   QUINIDINE GLUCONATE 80MG/ML      $      63.65
41781161   ENTACAPONE 200MG TAB             $       8.00
41781168   TOLTERODINE LA 2MG CAP           $      22.25
41781182   ACETYLCYSTEINE 6GM/30ML INJ      $     319.85
41781189   ADVAIR 500/50MCG RT DISKUS       $     408.50
41781203   ERLOTINIB 150MG TAB              $     241.00
41781210   AMLODIPINE 10MG TAB              $      18.00
41781217   CEFUROXIME AX 250MG TAB          $      26.40
41781224   RITUXIMAB 500MG 50ML VIAL        $   6,769.34
41781231   TETRACAINE 0.5% 2ML EYE DROPS    $      32.73
41781238   ASPIRIN EC 81MG TABLET           $       8.50
41781245   DOXORUBICIN 50MG/25ML VIAL       $     254.83
41781252   FENOFIBRATE 145MG TABLET         $      23.33
41781259   NEPHROCAPS (STRESS VITAMINS)     $       9.68
41781294   DEXAMETHASONE 1MG TAB            $       9.63
41781350   PYRIDOSTIGMINE 180MG TAB         $      10.06
41781357   ZONISAMIDE 50MG CAPSULE          $      13.86
41781364   ZONISAMIDE 100MG CAPSULE         $      18.25
41781371   METAPROLOL XL 25MG TABLET        $      12.51
41781378   PROPRANOLOL 10MG TABLET          $       9.06
41781385   CARVEDILOL 12.5MG TAB            $      16.44
41781392   BETAMETHASNE VLRT 0.1% 15G ONT   $      43.03
41781399   BETAMETHASNE VLRT 0.1% 15G CRM   $      43.03
41783206   CYCLOPHOSPHAMIDE 1000MG INJ      $     814.12
41783213   ISRADIPINE 5MG TAB               $      12.80
41783220   KETOCONAZOLE 15GM TOPICAL CRM    $      74.21
41783227   AZACITIDINE 100MG VIAL           $   1,358.22
41783234   CISPLATIN 100MG/100ML VIAL       $     271.00
41783241   CYTARABINE 2000MG VIAL           $     241.00
41783248   FLUOROURACIL 5000MG/100ML VIAL   $     126.69
41783255   LEUCOVORIN 200MG VIAL            $     101.00
41783262   LEUCOVORIN 100MG VIAL            $     153.50
41783269   OXALIPLATIN 50MG VIAL            $   2,132.87
41783276   OXALIPLATIN 100MG VIAL           $   5,233.24
41783283   PACLITAXEL 100MG/16.7ML VIAL     $     496.00
41783290   PACLITAXEL 300MG/50ML VIAL       $   1,171.00
41783297   METHOTREXATE PF 1000MG/40ML VI   $     250.00
41783304   DOXORUBICN LIPO 50MG/25ML VIAL   $   6,089.80
41783311   IMMUNE GLOBULIN 10GM BOTTLE      $   2,422.00
41783318   PORACTANT ALFA 120MG/1.5ML       $     694.82
41783325   DEXTROSE 5% ALCOHOL 1000ML BAG   $      92.50
41783332   METRONIDAZOLE 500MG/100ML IV     $     102.02
41783339   KCL 10 mEq in D5.2NS 500ML       $      92.50
41783346   DEXTROSE 5% NS 0.45% 500ML BAG   $      92.50
41783353   ACID MANTLE 4OZ CREAM            $      56.42
41783360   BAG BALM 30GM TOPICAL OINTMENT   $      28.89
41783367   DENTEMP (DENTAL FILLING) 2GM     $      26.00
41783374   ESTRADIOL 0.075MG PATCH          $      44.50
41783388   MYCOLOG II 30GM TOPICAL CREAM    $      40.47
41783395   PAROXETINE 10MG TAB              $      19.21
41783402   TRIXAICIN 60GM TOPICAL CREAM     $      30.07
41783409   DULOXETINE 30MG CAP              $      23.92
41783416   DULOXETINE 20MG CAP              $      22.20
41783423   CAFFEINE/SOD.BENZOATE 500MG/2M   $      89.75
41783430   HYDROCHLOROTHIAZIDE 12.5MG TAB   $      10.16
41783451   PRIMAQUINE 26.3MG TAB            $      13.18
41783458   ANTI/BENO(AURODEX)15ML EARDROP   $      14.95
41783465   RIFAMPIN 150MG CAP               $       9.87
41783472   HYDROCHLOROTHIAZIDE 6.25MG TAB   $       8.48
41783479   SOTALOL 20MG TAB                 $       8.12
41783486   FENTANYL 200MCG/100ML DRIP       $      88.94
41783493   FLUOROMETHOLONE 0.1% 5ML DROPS   $      78.85
41783500   PORACTANT ALFA 240MG/3ML VIAL    $   1,306.61
41783507   DIMERCAPROL 3ML AMP              $     223.64
41783514   METHYLPREDNISOLONE 2GM           $     144.48
41783521   HALOPERIDOL -DECANOATE 50MG/ML   $     275.14
41783528   AMMONIA INHALANT                 $       9.68
41783535   AMYL NITRATE INHALANT            $      10.98
41783542   MEGESTROL 10MG TAB               $       8.00
41783549   CASPOFUNGIN 70MG/10ML VIAL       $   1,092.57
41783556   CASPOFUNGIN 50MG/10ML VIAL       $     859.09
41783563   MAGNESIUM SULF 2GM/100ML PM IV   $     133.52
41783570   MAGNESIUM SULF 3GM/100ML PM IV   $     133.52
41783577   POTASSIUM+LIDO 20MEQ 250ML BAG   $     198.44
41783584   POTASSIUM+LIDO 40MEQ 500ML BAG   $     197.04
41783591   OXYTOCIN+LACT.RINGRS 10UN/LITR   $     127.24
41783598   LIDOCAINE W/EPI 1% 50ML          $      75.00
41783605   HEPARIN 1000 UNITS/ML 10ML VIA   $      56.00
41783612   METOCLOPRAMIDE 2.5MG TAB         $       8.00
41783619   IBUPROFEN 50MG TABLET            $       8.00
41783626   GLYBURIDE 2.5MG TAB              $       9.49
41783633   LEVOTHYROXINE 25MCG TAB          $       9.15
41783640   BACLOFEN TAB 20MG TAB            $      15.25
41783647   RAMIPRIL 1.25MG CAP              $      17.58
41783654   LIMIVUDINE 300MG TAB             $      28.84
41783696   LIDOCAINE 1GM/250ML PM IV BAG    $      75.00
41783703   AUGMENTIN ES 600MG/5ML 75ML      $     154.90
41783710   VORICONAZOLE 200MG TAB           $     124.04
41783717   VORICONAZOLE 200MG/10ML VIAL     $     291.29
41783724   ESTROGEN.3MG/MEDROXY 2.5MG TAB   $      15.73
41783738   CHLOROPROCAINE 2%/30ML VIAL      $      27.36
41783745   VALSARTAN 40MG TAB               $      16.06
41783752   AUGMENTIN XR 1000MG TAB          $      21.82
41783759   NON FORMULARY                    $      55.00
41783766   NON FORMULARY                    $      65.00
41783773   NON FORMULARY                    $      70.00
41783780   NON FORMULARY                    $      75.00
41783787   NON FORMULARY                    $      80.00
41783794   NON FORMULARY                    $     100.00
41783801   NON FORMULARY                    $     155.00
41783808   NON FORMULARY                    $     180.00
41783809   AQUAPHOR (EUCERIN) 396GM OINT    $      62.83
41783815   NON FORMULARY                    $     205.00
41783822   NON FORMULARY                    $     230.00
41783829   DIAZEPAM 20MG RECTAL GEL SYRNG   $     392.00
41783836   OXYTOCIN 100UNITS/10ML VIAL      $     148.64
41783843   PEGFILGRASTIM 6MG/0.6ML VIAL     $   6,722.56
41783850   OXYCODONE 20MG/ML ORAL LIQUID    $      13.52
41783857   HYDRO 5MG/APAP 325MG(NORCO)TAB   $      10.59
41783864   HYDRO 7.5MG/APAP 325MG(NORCO)    $      10.98
41783878   SENNA SYRUP 237ML BOTTLE         $      18.55
41783885   CALCIPOTRIENE .005% 120GM OINT   $     769.97
41783892   TRIAMCINOLONE 0.1% 454GM OINT    $     102.28
41783899   KCL 10mEq in D5.5NS 1000ML       $     202.75
41783906   HYDROC/IODOQ(VYTONE)1% 30GM CR   $      30.95
41783913   NON FORMULARY                    $     300.00
41783920   MULTI VIT + MINERALS (CENTRUM)   $       8.48
41783927   NON FORMULARY                    $     400.00
41783934   NON FORMULARY                    $     500.00
41783941   NON-FORMULARY                    $     600.00
41783948   NON-FORMULARY                    $     700.00
41783955   NON-FORMULARY                    $     800.00
41783962   NON-FORMULARY                    $     900.00
41783969   NON-FORMULARY                    $   1,000.00
41783976   DESIPRAMINE 10MG TABLET          $       9.92
41783983   ESTRATEST HS TABLET              $      18.50
41783990   FLUCYTOSINE 500MG CAPSULE        $      45.87
41783997   MODAFINAL 200MG TABLET           $      40.33
41784004   ALFUZOSIN 10MG TAB               $      18.37
41784011   MULTIVITAMIN PLUS ZINC TAB       $       9.63
41784018   NEVIRAPINE 200MG TAB             $      35.76
41784025   PREGABALIN 50MG CAPSULE          $      16.65
41784032   RESERPINE 0.1MG TAB              $       9.54
41784039   RITONAVIR 100MG CAP              $      46.59
41784046   ROPINIROLE 0.25MG TAB            $      16.86
41784053   ROPINIROLE 2MG TAB               $      16.86
41784067   TEGASEROD HYDROGEN MALEATE 2MG   $      22.15
41784074   BUPROPION XL 150MG TAB           $      24.88
41784081   CARBAMAZEPINE 200MG 10ML ORAL    $      17.45
41784095   BACITRACIN 0.9GM TOPICAL OINTM   $       8.62
41784102   CEREFOLIN (WITH NAC) TABLET      $      14.00
41784109   OLMESARTAN 5MG TABLET            $      16.40
41784116   NADOLOL 10MG TABLET              $      13.18
41784130   CHLORPROMAZINE 25MG SUPP         $      24.51
41784137   DISOPYRAMIDE 100MG CAPSULE       $      13.66
41784200   SEVELAMAR 800MG TABLET           $      16.11
41784207   LANTHANUM CARBONATE 250MG TAB    $      13.71
41784214   PYRAZINAMIDE 500MG TABLET        $      13.76
41784221   EFAVIRENZ 600MG TABLET           $      14.67
41784228   EMTR 200MG/TENOF 300MG TAB       $      99.92
41784235   ZIPRASIDONE 20MG CAP             $      27.69
41784242   CELESTONE 6MG/ML INJ             $      30.54
41784249   CALCITONIN 50 UNITS/0.25ML SYR   $      52.14
41784256   CALCITONIN 100 UNITS/0.5ML SYR   $      96.27
41784263   CLADRIBINE 10MG/10ML VIAL        $   1,323.50
41784270   BUDESONIDE EC 3MG CAP            $      27.07
41784284   COSOPT 10ML EYE DROPS            $     291.34
41784291   DAPTACEL ADULT 0.5ML VACCINE     $     115.38
41784298   DALTEPARIN 25000IU/2.5ML SYR     $     388.55
41784305   DESFLURANE 240ML INHALATION      $     395.40
41784312   HEPARIN SODIUM 5000U 0.5ML INJ   $      12.99
41784319   VARICELLA PF VACCINE             $     465.51
41784326   EXUBERA 3MG POWDER INHALATION    $     458.00
41784340   LUBIPROSTONE 24MCG CAP           $      20.77
41784354   CONIVAPTAN 20MG/4ML AMPULE       $     823.81
41784361   TRANDOLAPRIL 1MG TAB             $      14.29
41784368   ARIPIPRAZOLE 15MG TAB            $      54.12
41784375   DALTEPARIN 19000IU/1.9ML SYR     $     308.74
41784382   DALTEPARIN 21000IU/2.1ML SYR     $     335.34
41784389   DALTEPARIN 22000IU/2.2ML SYR     $     348.66
41784396   DALTEPARIN 23000IU/2.3ML SYR     $     361.96
41784403   DALTEPARIN 24000IU/2.4ML SYR     $     375.25
41784410   DPT/PERTUSIS/TETANUS 0.5ML VAC   $      72.01
41784500   ADACEL 0.5ML VACCINE             $     115.38
41784507   INDAPAMIDE 1.25MG TAB            $      11.98
41784514   INSULIN NOVOLOG 100UN/1ML DOSE   $      59.36
41784521   TRANDOLAPRIL 2MG TAB             $      14.43
41784528   METOCLOPRAMIDE 5MG TAB           $       9.92
41784535   ZOSYN 4.5GM VIAL                 $     111.92
41784542   NATALIZUMAB 300MG/15ML VIAL      $   5,381.02
41784549   INSULIN HUMAN NPH 100UN/ML 3ML   $      72.77
41784556   INSULIN HUMAN REG 100UN/ML 3ML   $      72.77
41784563   INSULIN REG/NPH 70/30 100U/ML    $      72.77
41784570   INSULIN ASPART 100UNITS/ML 3ML   $     116.86
41784577   TOBRAMYCIN/NACL 0.2% 300MG/5ML   $     187.26
41784584   DORNASE ALFA 2.5ML INH           $     143.86
41784591   CAFFEINE 200MG TABLET            $       8.72
41784598   LORAZEPAM 2MG (1ML) ORAL DOSE    $      15.44
41784605   LORAZEPAM 2MG/30ML BOTTLE        $     154.84
41784619   ALBUTEROL CFE/FRE 6.7GM INHALR   $     146.83
41784626   DUTASTERIDE 0.5MG CAP            $      22.03
41784633   LIDOCAINE PF W/EPI 2% 30ML       $     129.71
41784640   LEVOFLOXACIN 2MG/ML60ML BOTTLE   $     147.43
41784647   CEFOXITIN 2GM 50ML/D5W PB        $     111.18
41784654   CEFOXITIN 1GM/50ML PREMIX BAG    $      94.25
41784661   CEFTRIAXONE 2GM/50ML DEXTROSE    $     209.27
41784668   CEFTRIAXONE 1GM/DEXTROSE 50ML    $     137.97
41784675   CEFAZOLIN 1GM/50ML PB            $     105.35
41784689   CETUXIMAB 100MG INJ              $   1,226.00
41784696   LIDOCAINE PF W/EPI 2% 30ML       $      66.97
41784731   HALOPERIDOL 2MG/ML 5ML ORAL DS   $      20.56
41784752   ALBUTEROL CFE/FRE 6.7GM INH      $     146.83
41784759   BUDESONIDE EC 3MG CAPSULE        $      27.87
41784773   PREGABALIN 25MG CAP              $      17.20
41784843   KCL 20mEq in D5.2NS 500ML        $      92.50
41784850   LORAZEPAM TAKEHOME 6PACK PYXIS   $      18.17
41784857   METHOTREXATE 100MG/4ML VIAL      $     271.00
41784864   LANTHANUM 500MG TAB              $      18.46
41784871   SODIUM CHLORIDE 0.225% 500ML     $      62.80
41784878   MICONAZOLE 2% 85G TPCL POWDER    $      41.34
41784885   GLUCOSAMINE 500MG/CHONDR 400MG   $       9.78
41784892   GENTAMICIN 20MG/2ML VIAL         $      60.96
41784906   DONEPEZIL 10MG TAB               $      30.14
41784913   FONDAPARINUX 7.5MG/0.6ML SYRNG   $     297.92
41810067   MANIPULAT CHEST WALL INIT        $     268.75
41810074   MANIPULAT CHEST WALL SUB         $      83.50
41810482   MAXIMUM BREATHING CAP MVV        $     172.50
41811129   CO2 EXPIRED GAS INFRARED         $     571.25
41811377   CPR                              $     644.50
41811442   ARTERIAL PUNCTURE                $      61.75
41811466   VENT INIT DAY INVASIVE           $   1,316.25
41811514   INTUBATION ET EMERGENCY          $     148.00
41831071   METER PEAK FLOW                  $     307.75
41831287   AEROCHAMBER PEDS                 $     270.50
41831626   BAG RESUSCITATION DISPOSAL       $     220.75
41840000   BLAND AERO TX INIT EA DAY        $     257.50
41840007   BLAND AERO TX SUBS               $     257.50
41840014   INH TX INITIAL EA DAY            $     257.50
41840021   INH TX EA SUBSEQ TX/DAY          $     172.50
41840028   VENT SUBSEQ DAY NON-INVAS        $     895.25
41840035   CPAP/BIPAP INITIAT & MGMT        $     751.00
41840042   DEMO/EVAL INHALATION TX          $     108.75
41840056   PULSE OX MULTI W EXERCISE        $     257.50
41840063   PULSE OX CONTIN OVERNIGHT        $     257.50
41840127   SPIROMETRY                       $     170.25
41840176   BRNCHSPASM EVAL PRE/POST         $     162.75
41840183   AIRWAY CLOSE VOL SNG BRTH        $     110.50
41840190   PULM STRESS TEST COMPLEX        $      441.25
41840197   PULM STRESS TEST SIMPLE         $      162.75
41840204   THORACIC GAS VOLUME             $      110.50
41840210   BLAND AERO TX INIT EA DAY       $      257.50
41840217   BLAND AERO TX SUBS              $      257.50
41840224   INH TX INITIAL EA DAY           $      257.50
41840231   INH TX INITIAL EA DAY           $      172.50
41840259   VITAL CAPACITY TOTAL            $      170.25
41840266   ARTERIAL PUNCTURE               $       61.75
41840287   PULSE OX SINGLE DETERMIN        $      177.50
41840309   ARTERIAL PUNCTURE               $       61.75
41840316   ARTERIAL PUNCTURE               $       61.75
41840323   INH TX INITIAL EA DAY           $      257.50
41840330   RESP FLOW VOLUME LOOP           $      179.50
41840337   PULSE OX SINGLE DETERMIN        $      177.50
41840344   PULSE OX CONTIN OVERNIGHT       $      257.50
41840528   CPAP/BIPAP INITIAT & MGMT       $      375.75
41840542   VENT INIT DAY NON-INVAS         $    1,316.25
41840563   VENT SUBSEQ DAY INVASIVE        $      895.25
41840577   VENT SUBSEQ DAY INVASIVE        $      895.25
41840584   VENT SUBSEQ DAY NON-INVAS       $      895.25
41850042   PULSE OX CONTIN OVERNIGHT       $      257.50
41850105   PULSE OX MULTI W EXERCISE       $      257.50
41860369   IRRIGATION STERILE WATER 3L     $      108.75
41860377   IRRIGATION STERILE WATER 1.5L   $      108.75
41860781   BIPAP NASAL MASK                $      261.25
41875508   BIPAP MASK                      $      276.25
41875722   RESUSCITATION BAG I/P           $      248.00
41876358   HEATED VENTILATOR CIRCUIT       $       84.50
41880136   CONTINOUS NEBULIZER             $       61.25
41890039   RESP FLOW VOLUME LOOP           $      179.50
41890047   FUNCT RESIDUAL CAP/VOL          $      162.75
41890054   CARB MONO DIFFUS CAPACITY       $      203.00
41890181   PULSE OX SINGLE DETERMIN        $      177.50
41890188   AIRWAY RESISTANCE               $      576.50
41890206   TRACH TUBE CHG NO FISTULA       $      204.00
41890582   DEMO/EVAL INHALATION TX         $      502.00
41890589   DEMO/EVAL INHALATION TX         $      502.00
41900102   RIGHT HEART CATH                $    6,888.00
41900110   LEFT HEART CATH PERC            $   10,730.75
41900144   ANGIO INJ CRNRY W CRD CTH       $      868.75
41900152   ANGIO INJ LV/LA W CRD CTH       $      449.00
41900160   ANGIO INJ AORTA W CRD CTH       $      443.25
41900178   ANGIO INJ PULM W CRD CTH        $      590.00
41900186   ANGIO INJ RV/RA W CRD CTH       $      592.75
41900194   ANGIO INJ CRNRY BYPS GRFT       $      725.25
41900202   ANGIO INJ ART CONDUIT IMA       $      725.25
41900228   ANGIO ATR/VEN W CARD CTH        $    2,346.75
41900236   ANGIO PUL/AO/COR/GF W CTH       $    3,578.00
41900244   CL FLUORO < 1 HR                $      739.25
41900252   INSERT IAB DEVICE PERC          $    3,550.25
41900260   PACEMKER INS TEMP SNGL          $    3,115.00
41900278   CARDIOVERSION EXT               $    1,139.75
41900286   LEFT HEART CATH CUTDOWN         $    2,953.25
41900302   PERICARDIOCENTES INITIAL        $    2,690.50
41900402   RIGHT & LEFT HEART CATH         $   18,357.25
41900415   PACER INSERT 1.0 HR             $    2,474.25
41900422   PACER INSERT 1.5 HR             $    3,711.25
41900429   PACER INSERT 2.0 HR             $    4,947.75
41900430   TILT TABLE EVALUATION          $   1,465.50
41900437   PACER INSERT 2.5 HR            $   6,184.25
41900442   SWAN GANZ INSERTION            $     118.00
41900443   PACER INSERT 3.0 HR            $   7,421.25
41900450   PACER INSERT 3.5 HR            $   8,660.00
41900474   PACER INSERT 1.25 HR           $   3,092.75
41900481   PACER INSERT 1.75 HR           $   4,329.75
41900488   PACER INSERT 2.25 HR           $   5,566.75
41900495   PACER INSERT 2.75 HR           $   6,329.25
41900777   CL FLUORO PACEMAKER INSRT      $     859.25
41900826   ANALY DUAL PACE W REPROG       $      93.00
41907568   INTRODUCERS                    $     322.50
41909754   ELECTRODE FAST PATCH           $     208.25
41920348   TRAY PAC(CATH INTRODUCER)      $     243.50
41921155   BASIN SET MINOR                $     362.25
41940010   CORONARY CATHETER              $     218.75
41940028   PIGTAIL CATHETER               $     218.75
41940036   THERMODILUTION CATHETER        $     737.00
41940052   CL STERILE DISP TRAY           $   1,212.00
41940060   INTRODUCER SHEATH              $     246.00
41940094   MYLER SHEATH                   $     531.25
41940110   TERUMO GLIDE WIRE              $     328.50
41940352   IABP BALLOON 40 CC             $   5,329.75
41941028   HIGH PRESSURE TUBING           $     125.75
41941744   CL WIRE STIFF                  $     258.50
41951954   FEMOSTOP COMPRESSION           $     639.00
41971150   SUTURE TYPE B                  $     382.00
41971408   PACK BASIC                     $     164.25
41974139   XR CATHETER-INTERVENTIONAL A   $     175.00
41974162   CATHETER-ANGIOPLASTY A         $   1,595.50
41974410   INDEFLATOR                     $     405.00
42000164   PT EVALUATION 45               $     182.25
42000166   PT PHYS PRF TEST EA 15         $      61.75
42000190   PT NEUROMSCL RE-ED EA 15       $      61.75
42000208   PT IONTOPHORESIS EA 15         $      61.75
42000224   PT CONTRAST BATH EA 15         $      61.75
42000287   PT MANUAL THERAPY EA 15        $      61.75
42000314   PT INFRARED THERAPY            $      61.75
42010017   PT ULTRASOUND EA 15            $      61.75
42010029   PT EVALUATION 15               $      60.75
42010041   PT TRACTION MECHANICAL         $      61.75
42010058   PT E-STIM ATTEND EA 15         $      61.75
42010064   PT E-STIM UNATTENDED OTHR      $      61.75
42020016   PT GAIT TRAINING EA 15         $      61.75
42020023   PT SELF CARE/HOME EA 15        $      61.75
42020040   PT EXERCISE THR EA 15          $      61.75
42020046   PT THR ACTIVITY EA 15          $      61.75
42020060   PT ORTHOTIC FIT/TRN EA 15      $      42.00
42050087   PT EVALUATION 30               $     121.25
42050095   PT EVALUATION 60               $     242.50
42050103   PT RE-EVALUATION 15            $      61.75
42050111   PT RE-EVALUATION 30            $     123.00
42080178   OT EVALUATION 15               $      60.75
42080184   OT EVALUATION 30               $     120.50
42080192   OT EVALUATION 45               $     180.50
42080200   OT EVALUATION 60               $     240.75
42080289   OT EXERCISE THR EA 15          $      60.75
42080290   OT E-STIM UNATTENDED OTHR      $      60.75
42080364   OT MANUAL THERAPY EA 15        $      60.75
42080366   OT ULTRASOUND EA 15         $    60.75
42080432   OT IONTOPHORESIS EA 15      $    60.75
42080523   OT PARAFFIN BATH THERAPY    $    60.75
42080536   OT ORTHOTIC FIT/TRN EA 15   $    36.75
42080555   OT DEBR SL>20CM WO ANE 15   $   213.00
42080563   PT DEBR SL>20CM WO ANE 15   $   213.00
42080577   PT DEBR SL<20CM WO ANE 15   $   142.25
42080591   PT THERAPY GROUP 45         $   122.00
42080602   OT RE-EVALUATION 30         $   121.50
42080608   OT SELF CARE/HOME EA 15     $    60.75
42080610   OT RE-EVALUATION 15         $    60.75
42080653   OT DEBR SL<20CM WO ANE 15   $   141.00
42080660   PT WC BRIEF ASSESS/EVAL     $    60.75
42080667   PT WC LTD AS/EVAL NEW PAT   $    60.75
42080674   PT WC INT AS/EVAL NEW PAT   $   120.50
42080681   PT WC EXT AS/EVAL NEW PAT   $    98.75
42080688   PT WC COMP AS/EVL NEW PAT   $   130.75
42080702   PT WC INT AS/EVAL EST PAT   $   121.50
42080709   PT WC EXT AS/EVAL EST PAT   $   121.50
42080716   PT WC COMP AS/EVL EST PAT   $    98.75
42080730   PT WC E-STIM UNATTENDED     $    34.25
42080744   PT WC WHIRLPOOL             $    80.25
42080751   PT WC EXERCISE THR INI 30   $   121.50
42080758   PT WC NEUROMSCL ED INI 30   $   121.50
42080765   PT WC FUNC ACTVTY INI 30    $   121.50
42080772   PT WC GAIT TRAIN INI 30     $   123.25
42080779   PT WC IONTOPHORES INI 30    $   121.50
42080786   PT WC TRACTN MANL INI 30    $   121.50
42080793   PT WC MASSAGE INI 30        $    68.00
42080800   PT WC CONTRST BATH INI 30   $    29.00
42080807   PT WC ULTRASOUND INI 30     $   121.50
42080814   PT WC MYOFSCL RL/SFT TIS    $    60.75
42080821   PT WC ORTHOTIC TRN INI 30   $    56.50
42080828   PT WC PROSTHC TRN INI 30    $    73.00
42080835   PT WC THR ACTIVITY INI 30   $    80.75
42080842   PT WC TRAINING ADL INI 30   $    60.75
42080856   PT WC TX JOINT MOBILIZATN   $    60.75
42080863   PT WC TREATMENT TAPING      $    60.75
42080870   PT WC TX SOFT TISS INI 30   $    60.75
42080877   PT WC GRP EX<5PTS INI 30    $    81.00
42080884   PT WC GRP EX<5PTS ADD 15    $    40.50
42080891   PT WC GROUP ED 2-5PTS 1HR   $   162.00
42080906   PT WC JOB SITE VIST/ASMNT   $   121.50
42080913   PT WC FUNC CAP MEASURMENT   $   121.50
42080920   PT WC WORK TOLERANCE TEST   $   121.50
42080934   PT WC TX INDV INST INI 30   $    60.75
42081000   OT WC BRIEF ASSESS/EVAL     $    60.75
42081007   OT WC LTD AS/EVAL NEW PAT   $    60.75
42081014   OT WC INT AS/EVAL NEW PAT   $   120.50
42081021   OT WC EXT AS/EVAL NEW PAT   $    98.75
42081028   OT WC COMP AS/EVL NEW PAT   $   130.75
42081035   OT WC LTD AS/EVAL EST PAT   $    60.75
42081042   OT WC INT AS/EVAL EST PAT   $   121.50
42081049   OT WC EXT AS/EVAL EST PAT   $   121.50
42081056   OT WC COMP AS/EVL EST PAT   $    98.75
42081070   OT WC E-STIM UNATTENDED     $    61.75
42081077   OT WC PARAFFIN BATH THR     $    60.75
42081084   OT WC WHIRLPOOL             $    80.25
42081091   OT WC EXERCISE THR INI 30   $   121.50
42081099   OT WC NEUROMSCL ED INI 30   $   121.50
42081106   OT WC FUNC ACTVTY INI 30    $   121.50
42081120   OT WC IONTOPHORES INI 30    $   121.50
42081134   OT WC MASSAGE INI 30        $    68.00
42081141   OT WC CONTRST BATH INI 30   $    29.00
42081148   OT WC ULTRASOUND INI 30     $   121.50
42081155   OT WC MYOFSCL RL/SFT TIS    $    60.75
42081162   OT WC ORTHOTIC TRN INI 30   $    56.50
42081169   OT WC PROSTHC TRN INI 30    $    73.00
42081176   OT WC THR ACTIVITY INI 30   $    80.75
42081183   OT WC TRAINING ADL INI 30   $    60.75
42081190   OT WC TX FAB ORTH INI 30    $    73.25
42081197   OT WC TX JOINT MOBILIZATN   $    60.75
42081204   OT WC TREATMENT TAPING      $    60.75
42081211   OT WC TX SOFT TISS INI 30   $    60.75
42081218   OT WC GRP EX<5PTS INI 30    $    80.75
42081225   OT WC GRP EX<5PTS ADD 15    $    40.50
42081232   OT WC GROUP ED 2-5PTS 1HR   $   162.00
42081246   OT WC JOB SITE VIST/ASMNT   $   121.50
42081253   OT WC FUNC CAP MEASURMENT   $   121.50
42081260   OT WC WORK TOLERANCE TEST   $   121.50
42081267   OT WC WORK HARDNNG INI 2H   $   359.50
42081295   PT PROSTHETIC TRN EA 15     $    37.50
42081302   OT PROSTHETIC TRN EA 15     $    37.50
42081316   PT WC LTD AS/EVAL EST PAT   $    60.75
42082035   ST TREATMENT SPEECH 15      $    61.75
42082049   PT MC EVALUATION INI 30     $   123.25
42082056   OT MC EVALUATION INI 30     $   123.25
42100001   ST COM/WORK REINT EA 15     $    62.50
42100007   OT THR ACTIVITY EA 15       $    60.75
42100131   ST EVAL SWALLOWING 60       $   245.00
42100149   ST TREATMENT SWALLOW 15     $    55.75
42100151   OT NEUROMSCL RE-ED EA 15    $    60.75
42100198   ST DVL COGNT SKILL EA 15    $    62.50
42100303   ST EVALUATION SPEECH 60     $   245.00
42100317   ST TREATMENT SPEECH 30      $   123.25
42100327   ST TREATMENT GROUP 45       $   121.50
42100334   ST ASSESS APHASIA PER HR    $   183.75
42100341   ST TEST NEUROBEHAVL         $   183.75
42100348   ST EVAL VOICE PROSTHETIC    $   120.00
42100350   PT THERAPY GROUP 15         $    40.50
42100362   PT THERAPY GROUP 30         $    81.00
42100369   PT THERAPY GROUP 60         $   162.00
42100376   OT THERAPY GROUP 15         $    40.50
42100383   OT THERAPY GROUP 30         $    81.00
42100390   OT THERAPY GROUP 45         $   121.50
42100397   OT THERAPY GROUP 60         $   162.00
42100404   ST TREATMENT GROUP 15       $    40.50
42100411   ST TREATMENT GROUP 30       $    81.00
42100418   ST TREATMENT GROUP 45       $   121.50
42100425   ST TREATMENT GROUP 60       $   162.00
42100432   OT COM/WORK REINT EA 15     $    60.75
42100439   PT COM/WORK REINT EA 15     $    61.75
42100446   OT DVL COGNT SKILL EA 15    $    60.75
42100453   OT SENSORY TECH EA 15       $    60.75
42100460   PT WHEELCHAIR TRN EA 15     $    61.75
42100467   OT WHEELCHAIR TRN EA 15     $    60.75
42100482   OT E-STIM ATTEND EA 15      $    61.75
42110000   PT RE-EVALUATION 45         $   184.75
42110007   PT RE-EVALUATION 60         $   246.25
42110014   PT BIOFEEDBACK 15           $    61.75
42110021   PT BIOFEEDBACK 30           $   123.25
42110028   PT BIOFEEDBACK 45           $   184.75
42110035   PT DEBR SL<20CM WO ANE 30   $   203.25
42110042   PT DEBR SL<20CM WO ANE 45   $   261.50
42110049   PT DEBR SL<20CM WO ANE 60   $   319.75
42110056   PT DEBR SL>20CM WO ANE 30   $   290.75
42110063   PT DEBR SL>20CM WO ANE 45   $   349.00
42110070   PT DEBR SL>20CM WO ANE 60   $   406.25
42110077   PT E-STIM UNATTENDED ULCR   $   123.25
42110084   PT ORTH/PROSTH CK EA 15     $    49.75
42110091   PT SENSORY TECH EA 15       $    61.75
42110203   PT MC EVALUATION ADD 15     $    61.75
42110210   PT MC RE-EVAL INI 30        $   123.25
42110217   PT MC RE-EVAL ADD 15        $    61.75
42110224   PT MC CASE CONSULT W RPT    $    49.75
42110238   PT MC COM/WK REINT INI 30   $   123.25
42110245   PT MC COM/WK REINT ADD 15   $    61.75
42110252   PT MC CONFERENCE INI 30     $    99.50
42110259   PT MC CONFERENCE ADD 15     $    49.75
42110266   PT MC CONTRST BATH INI 30   $    58.50
42110273   PT MC CONTRST BATH ADD 15   $    29.25
42110280   PT MC DEBR WO ANES INI 30   $   203.25
42110287   PT MC DEBR WO ANES ADD 15   $    58.50
42110294   PT MC DVL COGNT INI 30      $   123.25
42110301   PT MC DVL COGNT ADD 15      $    61.75
42110308   PT MC E-STIM ATTND INI 30   $   123.25
42110315   PT MC E-STIM ATTND ADD 15   $    61.75
42110322   PT MC E-STIM UNATT INI 30   $   123.25
42110329   PT MC E-STIM UNATT ADD 15   $    61.75
42110336   PT MC EXERCISE THR INI 30   $   123.25
42110343   PT MC EXERCISE THR ADD 15   $    61.75
42110350   PT MC GAIT TRAIN INI 30     $   123.25
42110357   PT MC GAIT TRAIN ADD 15     $    61.75
42110364   PT MC INFRARED THR INI 30   $   123.25
42110371   PT MC INFRARED THR ADD 15   $    61.75
42110378   PT MC IONTOPHORES INI 30    $   123.25
42110385   PT MC IONTOPHORES ADD 15    $    61.75
42110392   PT MC MANUAL THR INI 30     $   123.25
42110399   PT MC MANUAL THR ADD 15     $    61.75
42110406   PT MC MASSAGE INI 30        $    70.25
42110413   PT MC NEUROMSCL ED INI 30   $   123.25
42110420   PT MC NEUROMSCL ED ADD 15   $    61.75
42110427   PT MC ORTH/PROS CK INI 30   $    99.50
42110434   PT MC ORTH/PROS CK ADD 15   $    49.75
42110441   PT MC ORTH FIT/TRN INI 30   $    83.25
42110448   PT MC ORTH FIT/TRN ADD 15   $    42.25
42110455   PT MC PROSTHTC TRN INI 30   $    83.25
42110462   PT MC PROSTHTC TRN ADD 15   $    42.25
42110469   PT MC SLF CARE/HME INI 30   $   123.25
42110476   PT MC SLF CARE/HME ADD 15   $    61.75
42110483   PT MC SENSORY TECH INI 30   $   123.25
42110490   PT MC SENSORY TECH ADD 15   $    61.75
42110497   PT MC THR ACTVTY INI 30     $   123.25
42110504   PT MC THR ACTIVITY ADD 15   $    61.75
42110511   PT MC ULTRASOUND INI 30     $   123.25
42110518   PT MC ULTRASOUND ADD 15     $    61.75
42110525   PT MC WHEELCHR TRN INI 30   $   123.25
42110532   PT MC WHEELCHR TRN ADD 15   $    61.75
42110539   PT MC WHRLPL THR INI 30     $    53.00
42110546   PT MC WHRLPL THR ADD 15     $    27.00
42110553   PT MC THERAPY COMBO INI30   $   123.25
42110560   PT MC THERAPY COMBO ADD15   $    61.75
42110602   PT WC BIOFEEDBACK 15        $    61.75
42110609   PT WC BIOFEEDBACK 30        $   123.25
42110616   PT WC BIOFEEDBACK 45        $   184.75
42110623   PT WC CONTRST BATH ADD 15   $    29.25
42110630   PT WC E-STIM MNL INI 30     $   123.25
42110637   PT WC E-STIM MNL ADD 15     $    61.75
42110644   PT WC EXERCISE THR ADD 15   $    61.75
42110651   PT WC GAIT TRAIN ADD 15     $    61.75
42110665   PT WC IONTOPHORES ADD 15    $    61.75
42110672   PT WC MANIPULATION          $    61.75
42110679   PT WC MANIPLN EA ADD AREA   $    61.75
42110686   PT WC ORTHOTIC TRN ADD 15   $    42.25
42110693   PT WC PHYS PRF TST INI 30   $   123.25
42110700   PT WC PHYS PRF TST ADD 15   $    61.75
42110707   PT WC PROSTHC TRN ADD 15    $    42.25
42110714   PT WC THR ACTIVITY ADD 15   $    61.75
42110721   PT WC TRACTN MANL ADD 15    $    61.75
42110728   PT WC TRAINING ADL ADD 15   $    61.75
42110735   PT WC TX INDV INST ADD 15   $    61.75
42110742   PT WC TX SOFT TISS ADD 15   $    61.75
42110749   PT WC WORK HARDNNG INI 2H   $   359.75
42110756   PT WC WORK HARDNNG ADD HR   $   180.50
42116658   PT WC INFRARED THERAPY      $    61.75
42116665   PT DEBRIDE NONSL W/O ANES   $   319.75
42116672   PT DEBRIDE NONSL W/O ANES   $   240.00
42116679   PT DEBRIDE NONSL W/O ANES   $   160.00
42116686   PT DEBRIDE NONSL W/O ANES   $    80.00
42120000   OT EVAL SWALLOWING 15       $   232.25
42120007   OT EVAL SWALLOWING 30       $   261.50
42120014   OT EVAL SWALLOWING 45       $   290.75
42120021   OT EVAL SWALLOWING 60       $   319.75
42120028   OT EVAL SWAL VID/FLR 30     $   261.50
42120035   OT EVAL SWAL VID/FLR 45     $   290.75
42120042   OT EVAL SWAL VID/FLR 60     $   319.75
42120049   OT CONTRAST BATH EA 15      $    29.25
42120056   OT DEBR SL<20CM WO ANE 30   $   203.25
42120064   OT DEBR SL<20CM WO ANE 45   $   261.50
42120071   OT DEBR SL<20CM WO ANE 60   $   319.75
42120078   OT DEBR SL>20CM WO ANE 30   $   290.75
42120085   OT DEBR SL>20CM WO ANE 45   $   349.00
42120092   OT DEBR SL>20CM WO ANE 60   $   406.25
42120099   OT DVLPMENTAL TEST LIM      $   245.25
42120106   OT DVLPMENTAL TEST EXT      $   245.25
42120113   OT ORAL FUNCTION THERAPY    $    76.75
42120120   OT ORTH/PROSTH CK EA 15     $    49.75
42120127   OT TEST NEUROBEHAVL EA HR   $   197.75
42125000   OT APP SPLNT SHRT ARM STC   $   108.00
42125007   OT APP SPLNT SHRT ARM DYN   $   133.00
42125014   OT APP SPLINT FINGER STC    $    71.50
42125021   OT APP SPLINT FINGER DYN    $    82.25
42125028   OT STRAP ELBOW OR WRIST     $    94.00
42125035   OT STRAP HAND OR FINGER     $    89.75
42125042   OT APPLICATION CAST/SPLNT   $   133.00
42130000   OT MC EVALUATION ADD 15     $    61.75
42130007   OT MC RE-EVAL INI 30        $   123.25
42130014   OT MC RE-EVAL ADD 15        $    61.75
42130021   OT MC PHYS PRF TST INI 30   $   123.25
42130028   OT MC PHYS PRF TST ADD 15   $    61.75
42130035   OT MC CONFERENCE INI 30     $    99.50
42130042   OT MC CONFERENCE ADD 15     $    49.75
42130056   OT MC EVAL SWAL ADD 15      $    61.75
42130063   OT MC EVAL SWAL VID INI30   $   123.25
42130070   OT MC EVAL SWAL VID ADD15   $    61.75
42130077   OT MC COM/WK REINT INI 30   $   123.25
42130084   OT MC COM/WK REINT ADD 15   $    61.75
42130105   OT MC CONTRST BATH INI 30   $    58.50
42130112   OT MC DEBR WO ANES INI 30   $   203.25
42130119   OT MC DEBR WO ANES ADD 15   $    58.50
42130126   OT MC DVL COGNT INI 30      $   123.25
42130133   OT MC DVL COGNT ADD 15      $    61.75
42130140   OT MC E-STIM ATTND INI 30   $   123.25
42130148   OT MC E-STIM ATTND ADD 15   $    61.75
42130154   OT MC E-STIM UNATT INI 30   $   123.25
42130161   OT MC E-STIM UNATT ADD 15   $    61.75
42130168   OT MC EXERCISE THR INI 30   $   123.25
42130175   OT MC EXERCISE THR ADD 15   $    61.75
42130182   OT MC FAB SPLINT INI 30     $    99.50
42130189   OT MC FAB SPLINT ADD 15     $    49.75
42130196   OT MC IONTOPHORES INI 30    $   123.25
42130203   OT MC IONTOPHORES ADD 15    $    61.75
42130210   OT MC MANUAL THR INI 30     $   123.25
42130217   OT MC MANUAL THR ADD 15     $    61.75
42130224   OT MC NEUROMSCL ED INI 30   $   123.25
42130231   OT MC NEUROMSCL ED ADD 15   $    61.75
42130238   OT MC ORTH/PROS CK INI 30   $    99.50
42130245   OT MC ORTH/PROS CK ADD 15   $    49.75
42130252   OT MC ORTH FIT/TRN INI 30   $    83.25
42130259   OT MC ORTH FIT/TRN ADD 15   $    42.25
42130266   OT MC PARAFFIN THR INI 30   $   123.25
42130273   OT MC PARAFFIN THR ADD 15   $    61.75
42130280   OT MC PROSTHTC TRN INI 30   $    83.25
42130287   OT MC PROSTHTC TRN ADD 15   $    42.25
42130294   OT MC SLF CARE/HME INI 30   $   123.25
42130301   OT MC SLF CARE/HME ADD 15   $    61.75
42130308   OT MC SENSORY TECH INI 30   $   123.25
42130315   OT MC SENSORY TECH ADD 15   $    61.75
42130322   OT MC THR ACTIVITY INI 30   $   123.25
42130329   OT MC THR ACTIVITY ADD 15   $    61.75
42130336   OT MC TST DVLPMNTL INI 30   $   122.25
42130343   OT MC TST DVLPMNTL ADD 15   $    61.75
42130350   OT MC TST NEUROBVL INI 30   $    99.50
42130357   OT MC TST NEUROBVL ADD 15   $    49.75
42130364   OT MC ULTRASOUND INI 30     $   123.25
42130371   OT MC ULTRASOUND ADD 15     $    29.25
42130378   OT MC WHEELCHR TRN INI 30   $   123.25
42130385   OT MC WHEELCHR TRN ADD 15   $    61.75
42130392   OT MC WHRLPL THR INI 30     $    53.00
42130399   OT MC WHRLPL THR ADD 15     $    27.00
42140000   OT WC E-STIM MNL INI 30     $   123.25
42140007   OT WC E-STIM MNL ADD 15     $    61.75
42140014   OT WC EXERCISE THR ADD 15   $    61.75
42140021   OT WC FUNC ACTVTY ADD 15    $    61.75
42140028   OT WC GAIT TRAIN ADD 15     $    61.75
42140035   OT WC IONTOPHORES ADD 15    $    61.75
42140042   OT WC MANIPULATION          $    61.75
42140049   OT WC MANIPLN EA ADD AREA   $    61.75
42140056   OT WC OR/PRS/ADL CK INI30   $    99.50
42140070   OT WC ORTHOTIC TRN ADD 15   $    42.25
42140077   OT WC PHYS PRF TST INI 30   $   123.25
42140084   OT WC PHYS PRF TST ADD 15   $    61.75
42140091   OT WC PROSTHC TRN ADD 15    $    42.25
42140098   OT WC THR ACTIVITY ADD 15   $    61.75
42140105   OT WC TRAINING ADL ADD 15   $    61.75
42140112   OT WC TX INDV INST INI 30   $   123.25
42140119   OT WC TX INDV INST ADD 15   $    61.75
42140126   OT WC TX FAB ORTH ADD 15    $    36.75
42140133   OT WC TX SOFT TISS ADD 15   $    61.75
42140140   OT WC WORK HARDNNG ADD HR   $   180.50
42140196   OT DEBRIDE NONSL W/O ANES   $   319.75
42140203   OT DEBRIDE NONSL W/O ANES   $   240.00
42140210   OT DEBRIDE NONSL W/O ANES   $   160.00
42140217   OT DEBRIDE NONSL W/O ANES   $    80.00
42150000   ST EVALUATION SPEECH 15     $   117.75
42150007   ST EVALUATION SPEECH 45     $   184.75
42150014   ST EVAL SWALLOWING 15       $   232.25
42150021   ST EVAL SWALLOWING 30       $   261.50
42150027   ST EVAL SWALLOWING 45       $   290.75
42150034   ST EVAL SWAL VID/FLR 30     $   261.50
42150041   ST EVAL SWAL VID/FLR 45     $   290.75
42150048   ST EVAL SWAL VID/FLR 60     $   319.75
42150055   ST EVAL NON-SPCH COMM DVC   $   238.75
42150062   ST EVAL COMM DVC INI 60     $   238.75
42150069   ST TREATMENT SPEECH 45      $   184.75
42150076   ST TREATMENT SPEECH 60      $   246.25
42150083   ST TREATMENT SWALLOW 30     $   111.25
42150090   ST TREATMENT SWALLOW 45     $   167.50
42150097   ST TREATMENT SWALLOW 60     $   222.50
42150104   ST TX NON-SPCH COMM DVC     $   123.25
42150111   ST MOD/TRN VOICE PROS 15    $   106.00
42150118   ST MOD/TRN VOICE PROS 30    $   211.75
42150125   ST MOD/TRN VOICE PROS 45    $   316.50
42150132   ST MOD/TRN VOICE PROS 60    $   422.50
42150139   ST DVLPMENTAL TEST LIM      $   245.25
42150146   ST DVLPMENTAL TEST EXT      $   245.25
42150153   ST SELF CARE/HOME EA 15     $    61.75
42150160   ST EVALUATION SPEECH 30     $   151.25
42200381   PT SACROLUMBAR SUPPORT      $   188.00
42201389   PT CRUTCH ADULT             $   108.75
42205133   PT SHOE POST OP             $    88.00
42211172   PT THERAPUTTY               $    70.50
42292903   PT EQU ARM STRAPPING        $   126.50
42292910   PT EQU LEG STRAPPING        $   348.25
42293158   PT EQU GYM BALL 53CM        $    24.00
42293207   PT EDEMA GLOVES             $     7.00
42293280   PT LUMBAR CORSET            $    31.00
42300184   ER EVIDENTIARY EXAM         $   850.00
42300192   ER EVIDENTIARY EXAM         $   550.00
42300290   RIB BELT                    $   108.75
42300860   CATH COUDE                  $   114.00
42301389   CRUTCH ALUMINUM             $   108.75
42301821   SPLINT, COCK-UP             $   146.00
42301942   IMMOBILIZER SHOULDER        $   119.75
42303385   SLING SWATHE                     $     134.50
42303740   SPLINT CLAVICAL MCLEOD           $     123.25
42304409   TUBE LAVACUATOR                  $     157.00
42304516   TUBE TRACHEOSTOMY SHILEY         $     585.00
42304821   SPLINT WRIST COCKUP              $     146.00
42305471   PROBE THERMIA DISPOSABLE         $     119.75
42305505   TRAY TRICATHETER                 $     377.75
42306016   TRAY, URINE METER CATH-16/18     $     145.00
42306230   SET BLOOD WARMING                $     143.75
42306255   HEART PACING- EXTERNAL           $     467.25
42308343   KIT GASTRIC LAVAGE               $     371.50
42308632   TROCAR CHEST TUBE                $     158.50
42309630   FIBERGLASS ROLLS 4               $     112.75
42309648   FIBERGLASS ROLLS 5               $     164.25
42309754   ELECTRODE FAST PATCH             $     208.25
42309796   EYE IRRIGATION DEVICE (MORGAN)   $     300.25
42310026   TROCAR K S CATH                  $     316.25
42311016   NEEDLE PRT A CATH                $      94.50
42311131   CATHETER WORD GLAND              $     281.25
42317289   ER CRITIC CARE ADD 30MIN         $     499.25
42317303   ER CRITIC CARE ADD 30MIN         $     998.25
42320215   PLEURA GARD                      $     621.25
42320348   TRAY PAC (CATH INTRODUCER)       $     243.50
42320454   LUMBAR PUNCTURE TRAY-ADULT       $     218.75
42320462   LUMBAR PUNCTURE TRAY-PED         $     184.25
42320504   SUTURE TRAY DISPOSABLE           $     256.50
42320512   TRAY, THORACENTESIS              $     357.50
42320520   TRAY TRACHEOTOMY                 $     239.25
42320744   SUTURE PACK MAJOR                $     261.25
42321098   AIRCAST                          $     191.25
42321262   SPLINT FIBERGLASS 3 X 12         $     186.00
42321270   SPLINT FIBERGLASS 4 X 15         $     243.50
42321346   CATH EPISTAT                     $     493.00
42321494   CAUTERY LOOP                     $     121.75
42331071   PEAK FLOW METER                  $     307.75
42331758   TRAY PARACENTESIS                $     610.00
42331790   NASAL PACK                       $      90.50
42351657   BLANKET- BAIR HUGGER             $      98.00
42360419   IRRIGATION SODIUM CHLORIDE 3L    $     108.75
42360443   IRRIGATING NACL .9% 500CC        $     108.75
42370129   CATH FILIFORM                    $     303.25
42370798   PIN STEINMAN                     $     141.25
42371036   SKIN STAPLER 25                  $      97.75
42371127   SUCTION LECTROVAC                $     105.50
42372257   SURGICEL 2X14                    $     236.75
42373206   SURGILAV TUBING SET ST           $     355.75
42373214   MULTIOIFACE TIP ST               $     226.25
42375482   GASTROSTOMY TUBE, MIC            $     539.75
42376040   OXISENSOR D25 ADULT              $     104.25
42382066   PANEL CATHERIZATION DIFFICULT    $     303.25
42399007   ER LEVEL 2                       $     293.00
42399014   ER LEVEL 3                       $     476.25
42399021   ER LEVEL 4                       $     952.00
42399028   ER LEVEL 5                       $   1,464.25
42399042   ER LEVEL 1                       $     146.75
42399281   ER LEVEL 1 W/PROCEDURE           $     146.75
42399282   ER LEVEL 2 W/PROCEDURE           $     293.00
42399283   ER LEVEL 3 W/PROCEDURE           $     476.25
42399284   ER LEVEL 4 W/PROCEDURE           $     952.00
42399285   ER LEVEL 5 W/PROCEDURE      $   1,464.25
42399291   ER CRITICAL CARE 30-74MIN   $   2,196.25
42399292   ER CRITIC CARE ADD 30MIN    $   1,098.25
42399299   ER CRIT CARE 30-74 W/PROC   $   2,196.25
42399306   ER CRITIC CARE ADD 30MIN    $   1,098.25
42410021   ASP FINE NDL W/O IMAGING    $      90.75
42410038   INF IV TX/DX PUMP PROLONG   $     302.50
42410060   I&D ABSCESS SIMPLE          $      65.25
42410061   I&D ABSCESS COMPLEX         $     136.25
42410080   I&D CYST PILONIDAL SIMPLE   $      65.25
42410081   I&D CYST PILONIDAL CPLX     $     104.00
42410120   I&R FB SUBQ SIMPLE          $      84.50
42410121   I&R FB SUBQ COMPLEX         $     194.75
42410140   I&D HEMATOMA/SEROMA/FLUID   $      65.25
42410160   ASP ABSC/HEMA/CYST/BULLA    $      52.25
42410180   I&D WOUND POSTOP COMPLEX    $     220.75
42411000   DEBR SKIN 10% SURFACE       $      45.50
42411010   DEBR/REM FB SKIN/SUBQ       $     525.25
42411011   DEBR/REM FB SKIN/MUSCLE     $     473.50
42411012   DEBR/REM FB SKIN/MUS/BONE   $     648.25
42411040   DEBR SKIN PART THICKNESS    $      65.25
42411041   DEBR SKIN FULL THICKNESS    $      97.75
42411042   DEBR SKIN/SUBQ TISSUE       $     143.00
42411043   DEBR SKIN/SUBQ/MUSCLE       $     253.00
42411044   DEBR SKIN/MUSCLE/BONE       $     337.25
42411400   EXC BENIGN LES T/A/L<0.5    $      71.50
42411420   EXC BENIGN LESION <0.5CM    $      78.25
42411720   DEBRIDE NAIL UP TO 5        $      32.75
42411730   AVULSION NAIL PLATE SNGLE   $      65.25
42411732   AVULSION NAIL PLAT EA ADD   $      45.50
42411740   EVAC HEMATOMA SUBUNGAL      $      39.25
42411750   EXC NAIL & MATRIX           $     214.00
42411752   EXC NAIL MATRIX REM PHAL    $     317.75
42411760   REPAIR NAIL BED             $     207.75
42411765   EXC SKIN NAIL FOLD          $      58.75
42412001   LR SMPL TRNK/NECK <=2.5     $      84.50
42412002   LR SMPL TRNK/NECK 2.6-7.5   $     117.00
42412004   LR SMPL TRN/NECK 7.6-12.5   $     136.25
42412005   LR SMPL TRNK/NECK 12.6-20   $     156.00
42412006   LR SMPL TRNK/NECK 20.1-30   $     168.75
42412007   LR SMPL TRNK/NECK >30       $     168.75
42412011   LR SMPL FACE/EAR <=2.5      $      90.75
42412013   LR SMPL FACE/EAR 2.6-5      $     110.75
42412014   LR SMPL FACE/EAR 5.1-7.5    $     130.00
42412015   LR SMPL FACE/EAR 7.6-12.5   $     149.50
42412016   LR SMPL FACE/EAR 12.6-20    $     175.25
42412017   LR SMPL FACE/EAR 20.1-30    $     201.50
42412018   LR SMPL FACE/EAR >30        $     227.00
42412020   CLOSE SMPL WOUND DEHISC     $     104.00
42412031   LR INT SCLP/TRNK <=2.5      $     117.00
42412032   LR INT SCLP/TRNK 2.6-7.5    $     143.00
42412034   LR INT SCLP/TRNK 7.5-12.5   $     168.75
42412035   LR INT SCLP/TRNK 12.6-20    $     188.50
42412036   LR INT SCLP/TRNK 20.1-30    $     220.75
42412037   LR INT SCLP/TRNK >30        $     253.00
42412041   LR INT NK/HND/FT <=2.5      $     142.00
42412042   LR INT NK/HND/FT 2.6-7.5    $     143.00
42412044   LR INT NK/HND/FT 7.6-12.5   $     175.25
42412045   LR INT NK/HND/FT 12.6-20    $     207.75
42412046   LR INT NK/HND/FT 20.1-30         $   240.25
42412047   LR INT NK/HND/FT >30             $   272.25
42412051   LR INT FACE/EAR <=2.5            $   149.50
42412052   LR INT FACE/EAR 2.6-5            $   156.00
42412053   LR INT FACE/EAR 5.1-7.5          $   194.75
42412054   LR INT FACE/EAR 7.6-12.5         $   233.75
42412055   LR INT FACE/EAR 12.6-20          $   272.25
42412056   LR INT FACE/EAR 20.1-30          $   311.50
42412057   LR INT FACE/EAR >30              $   350.25
42413100   LR CPLX TRUNK 1.1-2.5            $    65.25
42413101   LR CPLX TRUNK 2.6-7.5            $   175.25
42413102   LR CPLX TRUNK ADD <=5            $    97.75
42413120   LR CPLX SC/ARM/LG 1.1-2.5        $   143.00
42413121   LR CPLX SC/ARM/LG 2.6-7.5        $   240.25
42413122   LR CPLX SC/ARM/LG ADD <=5        $    97.75
42413131   LR CPLX HD/HND/FT 1.1-2.5        $   188.50
42413132   LR CPLX HD/HND/FT 2.6-7.5        $   317.75
42413133   LR CPLX HD/HND/FT ADD <=5        $   117.00
42413150   LR CPLX EYE/N/EAR <=1.0          $   143.00
42413151   LR CPLX EYE/N/EAR 1.1-2.5        $   240.25
42413152   LR CPLX EYE/N/EAR 2.6-7.5        $   402.25
42413153   LR CPLX EYE/N/EAR ADD <=5        $   149.50
42413160   CLOSE WOUND LATE COMPLEX         $   272.25
42416000   TX BURN 1ST DEG INITIAL          $    32.75
42416020   DRESS/DEBR BURN SMALL            $    39.25
42416025   DRESS/DEBR BURN MEDIUM           $    65.25
42416030   DRESS/DEBR BURN LARGE            $   130.00
42417250   CHEMICAL CAUTERIZ TISSUE         $    52.25
42419000   BREAST CYST PUNC ASPIRATE        $    78.00
42419020   I&D BREAST ABSCESS DEEP          $   253.00
42420103   EXPLORE WOUND EXTREMITY          $   434.50
42420520   REM FB MUSC/TENDON SMPL          $   143.00
42420550   INJ TENDON LIGAMENT              $    74.75
42420551   INJ TENDON ORGIN/INSERT          $    39.25
42420552   INJ TRIGGER PT 1-2 MUSCL         $    39.25
42420600   ARTHROCENT SM JT/BURSA           $    26.25
42420605   ARTHROCENT INT JT/BURSA          $    32.75
42420610   ARTHROCENT JT MAJOR              $    39.25
42420670   REM IMPLANT DEVICE SUPERFICIAL   $   130.00
42421310   TX FX BONE NASAL CLSD WO         $    71.50
42421315   TX FX NASAL WO STABILIZ          $   130.00
42421450   TX FX MANDIB CLOSED              $    78.25
42421451   TX FX MANDIB W/MANIP             $   518.75
42421453   TX FX MANDIB FIX CLOSED          $   564.25
42421480   TX DSLC JAW CLOSED               $   181.50
42421800   TX FX RIB CLSD EACH              $    78.25
42421925   BIOPSY SOFT TISSUE OF BACK       $   214.00
42423330   REMOVAL FB SHOULDER SUBQ         $   564.25
42423500   TX FX CLAVICLE CLOSED            $   188.50
42423505   TX FX CLAVICLE W/MAN CLSD        $   227.00
42423520   TX DSLC STERNOCLAV CLOSED        $   168.75
42423525   TX DSLC S-CLAV W/MAN CLSD        $   156.00
42423540   TX DSLC ACROMIOCLAV CLSD         $   110.75
42423545   TX DSLC A-CLAV W/MAN CLSD        $   168.75
42423570   TX FX SCAPULA CLOSED             $   104.00
42423575   TX FX SCAPULA W/MAN CLSD         $   181.50
42423600   TX FX HUMER PROX CLOSED          $   130.00
42423605   TX FX HUM PROX W/MAN CLSD        $   324.25
42423620   TX FX HUMER GR TUBER CLSD        $    84.50
42423625   TX FX HUM G-T W/MAN CLSD    $   168.75
42423650   TX DSLC SHLDR W/MAN CLSD    $   227.00
42423655   TX DSLC SHOULDER W ANES     $   304.75
42423665   TX DSLC/FX G-T W/MAN CLSD   $   194.75
42423675   TX DLSC SHLDR W/MAN CLSD    $   292.00
42423930   I&D ARM ELB/DEEP ABS HEM    $   207.75
42423931   DRAINAGE ARM BURSA          $   194.50
42424200   REM FB ARM/ELBOW SUBQ       $   123.25
42424500   TX FX HUMER SHAFT CLOSED    $    84.50
42424505   TX FX HUM SHFT W/MAN CLSD   $   408.50
42424530   TX FX HUM SUPR/TRAN CLSD    $   162.25
42424535   TX FX HUM S-T W/MAN CLSD    $   343.75
42424560   TX FX HUMER EPICOND CLSD    $   143.00
42424565   TX FX HUM EPIC W/MAN CLSD   $   259.50
42424576   TX FX HUMER CLOSED          $    90.75
42424577   TX FX HUMER W/MAN CLOSED    $   285.50
42424600   TX DSLC ELBOW CLOSED        $   214.00
42424605   TX DISLC ELBOW CLS W/ANES   $   227.00
42424640   TX ELBOW CHILD W/MAN CLSD   $   168.75
42424650   TX FX RADIAL HD/NCK CLSD    $   168.75
42424655   TX FX RAD HD/NK W/MAN CLD   $   227.00
42424670   TX FX ULNA PROX CLOSED      $   143.00
42425270   RPR FOREARM TN/MUS EXTNSR   $   368.50
42425500   TX FX RADIAL SHAFT CLOSED   $   188.50
42425505   TX FX RAD SHFT W/MAN CLSD   $   279.25
42425515   TX FX RADIUS/ULNA OPEN      $   590.00
42425530   TX FX ULNA CLOSED           $   279.25
42425535   TX FX ULNA W/MAN CLOSED     $   259.75
42425560   TX FX RADIUS/ULNA CLOSED    $   207.75
42425565   TX FX RAD/ULNA W/MAN CLSD   $   499.25
42425600   TX FX DISTAL RADIAL CLSD    $   253.00
42425605   TX FX DIST RAD W/MAN CLSD   $   292.00
42425622   TX FX NAVICULAR CLOSED      $   253.00
42425624   TX FX NAVICULR W/MAN CLSD   $   259.50
42425630   TX FX CARPAL CLOSED         $   253.00
42425635   TX FX CARPAL W/MAN CLOSED   $   298.50
42425650   TX FX ULNAR STYLOID CLSD    $   376.25
42425660   TX DSLC CARPAL W/MAN CLSD   $   194.75
42425675   TX DSLC RADULN W/MAN CLSD   $   259.50
42425690   TX DSLC LUNATE W/MAN CLSD   $   331.00
42426010   DRN ABSC FINGER SIMPLE      $    65.25
42426011   DRN ABSC FINGER COMPLEX     $   253.00
42426350   RPR FLEXOR HAND TENDON EA   $   518.75
42426410   REPAIR HAND EXTENSOR        $   389.25
42426418   REPAIR FINGER EXTENSOR      $   324.25
42426591   RPR MUSCLES HAND            $   777.75
42426600   TX FX METACARPAL CLOSED     $   130.00
42426605   TX FX METACARP W/MAN CLSD   $   214.00
42426607   TX FX METACARPAL FIX CLSD   $   356.75
42426641   TX DSLC THUMB W/MAN CLSD    $   143.00
42426670   TX DSLC HAND W/MAN CLSD     $   117.00
42426700   TX DSLC MP W/MAN CLOSED     $   149.50
42426720   TX FX PHALANX CLOSED        $   110.75
42426725   TX FX PHALANX W/MAN CLSD    $   175.25
42426740   TX FX JT M-P/I-P CLOSED     $   181.50
42426742   TX FX JT MP/IP W/MAN CLSD   $   298.50
42426750   TX FX PHALANX DIST CLOSED   $    58.75
42426755   TX FX PHAL DIS W/MAN CLSD   $    84.50
42426770   TX DSLC JT I-P W/MAN CLSD   $    84.50
42426951   AMPUTATE FINGER/THUMB        $     408.50
42427086   REM FB PELVIS/HIP SUBQ       $     104.00
42427250   TX DSLC HIP TRAUMA CLSD      $     253.00
42427252   TX DSL HIP TRAUMA W AN CL    $     311.25
42427257   TX DSLC HIP TRAUMA CLSD      $   1,011.00
42427265   TX DSLHIP POST ARTHRO CL     $     259.50
42427266   TX DSL HIP ARTHRO W AN CL    $     357.00
42427370   KNEE ARTHROGRAPHY INJ PROC   $      45.50
42427500   TX FX FEMORAL SHAFT CLSD     $     525.25
42427502   TX FX FEM SHFT W/MAN CLSD    $     486.25
42427520   TX FX PATELLAR CLOSED        $     220.75
42427530   TX FX TIBIAL PROX CLSD       $     194.75
42427550   TX DSLC KNEE CLOSED          $     168.75
42427560   TX DSLC PATELLAR CLOSED      $     194.75
42427750   TX FX TIBIAL SHAFT CLOSED    $     363.00
42427752   TX FX TIB SHFT W/MAN CLSD    $     453.75
42427760   TX FX ANKLE MALL CLOSED      $     175.25
42427762   TX FX ANK MALL W/MAN CLSD    $     227.00
42427780   TX FX FIB SHFT PROX CLSD     $     130.00
42427781   TX FX FIB SHFT W/MAN CLSD    $     194.75
42427786   TX FX ANKLE DIST CLOSED      $     194.75
42427788   TX FX ANK DIST W/MAN CLSD    $     259.50
42427808   TX FX ANKLE BIMALL CLOSED    $     194.75
42427810   TX FX ANK BIML W/MAN CLSD    $     324.25
42427818   TX FX ANK TRIM W/MAN CLSD    $     421.75
42427840   TX DISLC ANKLE CLOSED        $     149.50
42428190   REMOVAL FB FOOT SUBQ         $     110.75
42428400   TX FX CALCANEAL CLOSED       $     168.75
42428470   TX FX METATARSAL CLOSED      $     188.50
42428475   TX FX METACARP W/MAN CLSD    $     181.50
42428490   TX FX GR TOE CLOSED          $      78.25
42428495   TX FX GR TOE W/MAN CLOSED    $      84.50
42428510   TX FX PHAL WO MANIP CLSD     $      52.25
42428515   TX FX PHAL W MANIP CLSD      $      90.75
42428630   TX DSLC JT METATARSO CLSD    $     149.50
42428660   TX DSLC JT INTERPHAL CLSD    $     104.00
42429065   APPLY CAST LONG ARM          $      52.25
42429075   APPLY CAST SHORT ARM         $      39.25
42429085   APPLY CAST HAND/FOREARM      $      39.25
42429105   APPLY SPLINT LONG ARM        $      39.25
42429125   APPLY SPLINT SHRT ARM STC    $      32.75
42429126   APPLY SPLINT SHRT ARM DYN    $      84.50
42429130   APPLY SPLINT FINGER STC      $      32.75
42429131   APPLY SPLINT FINGER DYN      $      84.50
42429240   STRAPPING SHOULDER           $      39.25
42429345   APPLY CAST LONG LEG          $      71.50
42429405   APPLY CAST SHORT LEG         $      52.25
42429425   APPLY CAST SHORT LEG WALK    $      65.25
42429505   APPLY SPLINT LONG LEG        $      45.50
42429515   APPLY SPLINT SHORT LEG       $      39.25
42429550   STRAPPING TOES               $      20.00
42429705   REMOV/BIVALV CAST ARM/LEG    $      26.25
42430300   REMOVAL FB NASAL             $      84.50
42430901   CNTRL NOSEBLEED ANTR SMPL    $      65.25
42430903   CNTRL NOSEBLEED ANTR CPLX    $      97.75
42430905   CNTRL NOSEBLEED POST INIT    $     188.50
42430906   CNTRL NOSEBLEED POST SUBS    $     149.50
42431500   INTUBATION ENDOTRACHEAL      $      97.75
42431502   TRACH TUBE CHG NO FISTUL     $      65.25
42431505   LARYNGOSCOPY DIAG                $      65.00
42431525   LARYNGOSCOPY DIRECT DIAG         $     272.25
42431530   LARYNGOSCOPY W/FB REMOVAL        $     272.25
42431575   LARYNGOSCPY FLEX F/O DIAG        $     117.00
42431603   TRACHEOSTOMY EMERG TRANS         $     298.50
42431605   TRACHEOSTOMY EMERG CRICO         $     298.50
42432000   THORACENTESIS                    $     130.00
42432002   THORACENTESIS INSRT TUBE         $     162.25
42432020   THORACOSTOMY TUBE                $     162.25
42432960   PNEUMOTHORAX THERAPEUTIC         $      78.25
42433010   PERICARDIOCENTES INITIAL         $     143.00
42433210   INSERT TEMP CARD ELECTROD        $     253.00
42435190   RPR BLOOD VESSEL LESION          $   1,425.75
42435207   REPAIR BLOOD VESS LESION         $   1,496.75
42435226   RPR BLD VESSL LOW EXTREM         $   1,050.25
42436011   CATH PLACE VEN 1ST SELECT        $     194.50
42436420   VENIPUNCT CUTDOWN < AGE 1        $      65.25
42436425   VENIPUNCT CUTDOWN > AGE 1        $      52.25
42436430   TRANSFUS BLOOD/BLOOD COMP        $      26.25
42436556   INSERT NONTUN CV CATH >5         $      78.25
42436561   INS TUNNEL CVAD W PORT>5         $     214.00
42436569   INS PICC WO PORT/PUMP>5YR        $      58.75
42436625   ARTERIAL CATH/CANN CUTDWN        $      97.75
42436680   PLACE NDL INTRAOSSO INFUS        $      71.50
42440650   RPR LIP FULL THICK               $     253.00
42440800   DRN ABSC/CYST MOUTH SMPL         $      65.25
42440830   CLOSE LAC MOUTH <2.5CM           $      65.00
42440831   CLOSE LAC MOUTH >2.5CM           $     103.75
42441000   I&D INTRAORAL LINGUAL            $      65.00
42441008   DRN MOUTH LESION                 $      65.00
42441250   LR MOUTH/TONGUE <2.5CM           $      90.75
42441251   LR MOUTH/TONGUE POSTERIOR        $     130.00
42441252   LR MOUTH/TONGUE >2.6CM           $     253.00
42441800   DRN ABSC DENTOALVEOLAR           $      78.25
42441874   RPR TOOTH SOCKET                 $     188.25
42442182   LR PALATE >2CM                   $     194.75
42442700   I&D ABSC PERITONSILLAR           $     110.75
42442809   REMOVAL FB PHARYNX               $      84.50
42442999   THROAT SURGERY PROCEDURE         $     218.50
42443215   ESOPHAGOSCOPY FB REMOVAL         $     272.25
42443752   PLACE NG/OG TUBE PHY SKIL        $      65.25
42443760   CHANGE GASTROSTOMY TUBE          $      52.25
42445005   I&D ABSC RECTUM SUBMUCOSL        $     156.00
42445300   PROCTOSIGMOID RIGID              $      45.50
42445330   SIGMOIDOSCOPY FLEX               $      84.50
42446040   I&D ABSC ISCHIO/PERIRECTL        $     194.75
42446050   I&D ABSC PERIANAL SUPERFC        $      65.25
42446060   INC RECTAL ABSCESS               $     551.00
42446083   INC HEMORRHOID EXTERNAL          $      65.25
42446221   HEMORRHOIDECTOMY SIMPLE          $     110.75
42446320   ENUCLEA/EXCIS EXT HEMORHD        $     104.00
42446600   ANOSCOPY DIAG                    $      45.50
42449080   PERITONEOCENTES INITIAL          $      97.75
42449505   RPR INI INGUNL HERNIA >5         $     635.25
42449560   RPR VENTRAL HERNIA INIT REDUCE   $     855.25
42449900   ABDOMINAL WALL REPAIR            $     479.75
42451010   BLADDER ASP W INS SUPRAP         $     142.75
42451700   IRRIG/LAV/INSTL BLADDER          $      20.00
42451701   INSERT CATH BLADDER              $      19.75
42451702   INSERT CATH BLADDER SMPL        $      20.00
42451705   CHG CYSTOSTOMY TUBE SMPL        $      45.50
42454700   DRAINAGE OF SCROTUM             $      90.75
42456405   I&D ABSC VULVA/PERINEAL         $     168.75
42456420   I&D ABSC GLAND BARTHOLIN        $      84.50
42457020   COLPOCENTESIS                   $      52.25
42457180   TREAT VAG HEMORR NON OB         $     104.00
42457200   REPAIR LACERATION VAGINA        $     505.75
42457500   BIOPSY CERVIX                   $      52.00
42457510   CAUTERIZATION OF CERVIX         $      52.00
42458301   REMOVE UTERINE DEVICE INT       $      32.75
42459409   VAGINAL DELIVERY                $     680.75
42459414   DELIVERY OF PLACENTA            $     162.25
42459812   TX INCOMPLETE MISCARRIAGE       $     337.25
42462270   LUMBAR PUNCTURE DIAGNOSTC       $     130.00
42462273   EPIDURAL BLOOD PATCH            $      65.25
42464402   INJ ANES NERVE FACIAL           $     117.00
42464413   CERVICAL PLEXUS INJ             $      78.00
42464450   INJ ANES NERVE PERIPHERAL       $      39.25
42465205   REM FB CONJUCTIV SUPERFIC       $      45.50
42465210   REM FB CONJUCTIV EMBEDDED       $      52.25
42465220   REM FB CORNEAL WO SLT LMP       $      52.25
42465222   REM FB CORNEAL W/SLT LMP        $      78.25
42467700   BLEPHARO DRN ABSC EYELID        $     130.00
42467938   REMOVAL FB EYELID EMBEDED       $      58.75
42469000   DRN ABS/HEMA EXT EAR SMPL       $      84.50
42469020   DRN ABSC EXT AUD CANAL          $     130.00
42469200   REM FB EXT AUD CANAL            $      52.25
42469210   REMOVE CERUMEN IMPACTED         $      39.25
42490471   ADMIN OTHER IMMUN VAC ONE       $       7.00
42490760   INF IV HYDRAT INIT 1ST HR       $     165.00
42490761   INF IV HYDRAT EA ADD HR         $      33.00
42490765   INF TX/DX/PRO INIT 1ST HR       $     165.00
42490766   INF TX/DX/PRO EA ADD HR         $      33.00
42490767   INF TX/DX/PRO SEQ 1ST HR        $      33.00
42490768   INF TX/DX CONCURRENT            $     256.50
42490772   INJ TX/DX/PROPH SUBQ/IM         $      33.00
42490773   INJ TX/DX/PRO INTRA-ARTER       $      66.00
42490774   INJ TX/DX/PRO IVPUSH INIT       $      66.00
42490775   INJ TX/DX/PRO IV PUSH SEQ       $      66.00
42490802   ADMIN INFLUENZA VACCINE         $       7.00
42490809   ADMIN PNEUMO VACCINE            $       7.00
42490816   ADMIN HEP B VACCINE             $       7.00
42491105   GASTRIC INTUB/LAVAGE TMT        $     531.75
42492950   EMERG ROOM CPR                  $   2,397.75
42492960   CARDIOVERSION EXT               $     366.25
42492977   THROMBOLYSIS CORONARY IV        $     293.00
42493005   EKG 12 LEAD (EME-DEPT)          $     140.00
42493012   EKG 12 LEAD (EME-DEPT) REPEAT   $     140.00
42497597   DEBR SELCT SESSION <=20CM       $      97.75
42497602   DEBR NON-SELECTIV SESSION       $      47.50
42499195   PHLEBOTOMY THERAPEUT            $     324.25
42500003   XR AC JTS W/WO WTS BIL          $     341.50
42500011   XR CLAVICLE COMPLETE RT         $     299.50
42500029   XR ELBOW 3+ VIEWS RT            $     376.75
42500037   XR ELBOW 2 VIEWS RT             $     267.75
42500045   XR FINGER(S) 2+ VIEWS RT        $     271.25
42500052   XR FOREARM 2 VIEWS RT           $     258.50
42500060   XR HAND 3+ VIEWS RT             $     373.75
42500067   XR HAND 3+ VIEWS BIL        $   746.25
42500074   XR HAND 2 VIEWS BIL         $   481.00
42500078   XR HAND 2 VIEWS RT          $   241.50
42500086   XR HUMERUS 2+ VIEWS RT      $   327.25
42500094   XR SCAPULA COMPLETE RT      $   337.25
42500102   XR ARTHROGRAM SHOULDER RT   $   942.00
42500128   XR SHOULDER 2+ VIEWS RT     $   358.75
42500136   XR SHOULDER 1 VIEW RT       $   232.50
42500144   XR WRIST 3+ VIEWS RT        $   365.25
42500151   XR WRIST 2 VIEWS RT         $   246.00
42500158   IR UROGRAM ANTEGRADE UNI    $   657.25
42500169   XR ANKLE 3+ VIEWS RT        $   384.00
42500177   XR ANKLE 2 VIEWS RT         $   271.25
42500185   XR FEMUR 1 VIEW RT          $   339.50
42500193   XR FOOT 3+ VIEWS RT         $   376.75
42500201   XR FOOT 2 VIEWS RT          $   241.50
42500250   XR PELV&HIP INFANT/CHLD2+   $   308.50
42500268   XR HIP 2+ VIEWS RT          $   274.00
42500284   XR ARTHROGRAM KNEE RT       $   942.00
42500300   XR KNEE 4+ VIEWS RT         $   376.75
42500318   XR KNEE 1 OR 2 VIEWS RT     $   305.75
42500326   XR CALCANEUS 2+ VIEWS RT    $   246.00
42500334   XR TIBIA & FIBULA 1VW RT    $   256.25
42500342   XR TOE(S) 2+ VIEWS RT       $   254.00
42500359   XR ABDOMEN 1 VIEW (AP)      $   246.00
42500367   XR ABDOMEN AP/DECUB/ERECT   $   327.25
42500375   XR ABD AP DECUB UPR+CHEST   $   355.25
42500383   XR COLON BE W AIR CON       $   645.25
42500391   XR COLON BE W OR WO KUB     $   645.25
42500425   XR CHOLANGIO/PANC INTRAOP   $   481.75
42500433   XR CHOLE THRU EXIST CATH    $   580.25
42500474   XR ESOPHAGUS                $   382.25
42500490   XR SMALL BOWEL              $   619.25
42500508   XR UGI WO KUB               $   603.25
42500516   XR UGI W SMALL INTESTINE    $   852.00
42500532   XR EYE FOREIGN BODY RT      $   339.50
42500557   XR FACIAL BONES 3+ VIEWS    $   585.25
42500565   XR FACIAL BONES <3 VIEWS    $   434.25
42500599   XR MANDIBLE 4+ VIEWS        $   694.50
42500607   XR MANDIBLE <4 VIEWS        $   337.25
42500631   XR NASAL BONES 3+ VIEWS     $   373.75
42500656   XR NECK SOFT TISSUE         $   248.00
42500672   XR ORBITS 4+ VIEWS          $   472.00
42500680   XR OPTIC FORAMINA           $   309.50
42500698   XR SINUSES 3+ VIEWS         $   477.50
42500714   XR SALIVARY GLAND CALCULU   $   258.50
42500730   XR SKULL 4+ VIEWS           $   703.50
42500748   XR SKULL <4 VIEWS           $   349.75
42500771   XR TMJ OPEN/CLOSED BIL      $   455.75
42500797   XR SINUSES <3 VIEWS         $   222.00
42500821   XR CHEST 1 VIEW             $   192.50
42500839   XR CHEST 2 VIEWS            $   305.75
42500841   XR RIBS W/CHEST 4+ VW BIL   $   600.50
42500843   XR RIBS W CHEST 3+ VWS RT   $   584.50
42500845   XR RIBS W CHEST 3+ VWS LT   $   584.50
42500847   XR CHEST 2 VWS W APIC LOR   $   349.00
42500854   XR CHEST 4+ VIEWS           $   400.25
42500862   XR CHEST 2 VIEWS W FLUORO   $   438.50
42500870   XR RIBS 3 VIEWS BIL         $   436.25
42500888   XR RIBS 2 VIEWS RT          $     420.50
42500896   XR STERNOCLAVIC JT(S) 3+    $     329.50
42500904   XR STERNUM 2+ VIEWS         $     367.25
42500912   XR C SPINE CMP +FLEX/EXT    $     778.75
42500920   XR CERVICAL SPINE 2-3 VW    $     405.25
42500938   XR LUMBAR SPINE 4+ VIEWS    $     692.75
42500946   XR LUMBAR SPINE 2 OR 3 VW   $     403.75
42500953   XR MYELOGRAM LUMBAR         $   1,509.25
42500961   XR MYELOGRAM 2 OR>REGIONS   $   1,795.75
42500987   XR PELVIS 1 OR 2 VIEWS      $     228.25
42501001   XR PELVIS CMPL 3+ VIEWS     $     495.50
42501027   XR HIPS 2+ W PELVIS BIL     $     495.50
42501035   XR SACROILIAC JT 3+ VWS     $     341.50
42501043   XR SACRUM & COCCYX 2+ VWS   $     235.00
42501050   XR SCOLIOSIS SUP & STAND    $     277.50
42501076   XR THORACIC SPINE 3 VIEWS   $     358.75
42501084   XR THORACOLUMB SPINE 2 VW   $     310.75
42501100   XR UROGRAM RETROGRADE       $     397.50
42501118   IR CYSTOURETHROGR RETRO     $     897.00
42501126   IR CYSTOURETHROGRAM VOID    $     541.00
42501134   XR UROGRM INFUS DRP/BOLUS   $   1,006.50
42501142   XR UROGRM DRP/BOLUS W/TOM   $   1,481.00
42501175   IR HYSTEROSALPINGOGRAM      $     698.00
42501191   XR BONE AGE STUDIES         $     243.00
42501209   XR BONE LENGTH STUDIES      $     339.50
42501217   XR BONE SURVEY LIMITED      $     567.00
42501225   XR BONE SURVEY INFANT       $     308.50
42501241   IR SINUS TRACT/FIST/ABSC    $     645.25
42501308   XR TOMOGRAM SINGLE PLANE    $     692.75
42501316   XR TOMOGRAM SINGLE PLANE    $     287.50
42501498   IR CYSTOGRAM 3+ VIEWS       $     479.00
42501859   XR FLUORO 2-3 HOURS         $   1,129.50
42501866   XR FLUORO 3-4 HOURS         $   1,355.00
42501873   XR FLUORO 4-5 HOURS         $   1,580.75
42502207   XR SM BOWEL ENTEROCLYSIS    $     852.00
42502231   MA MAMMO DIAG RT            $     211.50
42502314   MA MAMMO PLACE NDL EA RT    $     908.75
42502355   IR FLUOR GUID NDL BX/ASP/   $     725.50
42502470   MA SURGICAL SPECIMEN EA     $     130.75
42502488   XR MYELOGRAM CERVICAL       $   1,263.25
42502520   XR SWALLOW FUNCT CINE/VID   $     440.75
42502538   MA MAMMO SCREENING BIL      $     172.25
42502546   XR HIP 1 VIEW RT            $     230.50
42503023   XR ARTHROGRAM WRIST RT      $     942.00
42503031   XR ARTHROGRAM ELBOW RT      $     942.00
42503049   XR ARTHROGRAM HIP RT        $     942.00
42503056   XR ARTHROGRAM ANKLE RT      $     942.00
42503254   IR UROGRAM ANTEGRADE UNI    $     657.25
42503381   IR VENOGRAM EXTREMITY UNI   $     590.50
42503403   XR VENOGRAM EXTREMITY BIL   $   1,046.50
42503969   XR BILE STONE REM POSTOP    $   1,091.25
42504337   XR ENDO BILIARY DUCT CATH   $   1,103.25
42504345   IR ANGIO EXTREMITY UNI      $   1,512.00
42504353   XR CLAVICLE COMPLETE LT     $     299.50
42504361   XR ELBOW 3+ VIEWS LT        $     376.75
42504369   XR ELBOW 2 VIEWS LT         $     267.75
42504377   XR ELBOW 2 VIEWS LT         $     258.50
42504385   XR HAND 3+ VIEWS LT         $     373.75
42504393   XR HAND 2 VIEWS LT          $     241.50
42504401   XR HUMERUS 2+ VIEWS LT      $   327.25
42504409   XR SCAPULA COMPLETE LT      $   337.25
42504417   XR ARTHROGRAM SHOULDER LT   $   942.00
42504425   XR SHOULDER 2+ VIEWS LT     $   358.75
42504433   XR SHOULDER 1 VIEW LT       $   232.50
42504441   XR WRIST 3+ VIEWS LT        $   365.25
42504449   XR WRIST 2 VIEWS LT         $   246.00
42504457   XR ANKLE 3+ VIEWS LT        $   384.00
42504465   XR ANKLE 2 VIEWS LT         $   271.25
42504473   XR FEMUR 1 VIEW LT          $   339.50
42504481   XR FOOT 3+ VIEWS LT         $   376.75
42504489   XR FOOT 2 VIEWS LT          $   241.50
42504497   XR HIP 2+ VIEWS LT          $   274.00
42504505   XR ARTHROGRAM KNEE LT       $   942.00
42504513   XR KNEE 4+ VIEWS LT         $   376.75
42504521   XR KNEE 1 OR 2 VIEWS LT     $   305.75
42504529   XR CALCANEUS 2+ VIEWS LT    $   246.00
42504537   XR TIBIA & FIBULA 1VW LT    $   256.25
42504545   XR EYE FOREIGN BODY LT      $   308.50
42504553   XR MANDIBLE <4 VIEWS        $   337.25
42504561   XR ORBITS 4+ VIEWS          $   472.00
42504569   XR ORBITS 4+ VIEWS          $   589.75
42504577   XR OPTIC FORAMINA           $   309.50
42504593   IR ARTHROGRAM WRIST LT      $   942.00
42504601   XR ARTHROGRAM ELBOW LT      $   942.00
42504609   XR ARTHROGRAM HIP LT        $   942.00
42504625   XR FINGER(S) 2+ VIEWS RT    $   271.25
42504633   XR FINGER(S) 2+ VIEWS RT    $   271.25
42504641   XR FINGER(S) 2+ VIEWS UNI   $   271.25
42504649   XR FINGER(S) 2+ VIEWS RT    $   271.25
42504657   XR FINGER(S) 2+ VIEWS LT    $   271.25
42504665   XR FINGER(S) 2+ VIEWS LT    $   271.25
42504673   XR FINGER(S) 2+ VIEWS LT    $   271.25
42504681   XR FINGER(S) 2+ VIEWS LT    $   271.25
42504689   XR FINGER(S) 2+ VIEWS LT    $   271.25
42504697   XR TOE(S) 2+ VIEWS RT       $   254.00
42504705   XR TOE(S) 2+ VIEWS RT       $   254.00
42504713   XR TOE(S) 2+ VIEWS RT       $   254.00
42504721   XR TOE(S) 2+ VIEWS RT       $   254.00
42504729   XR TOE(S) 2+ VIEWS LT       $   254.00
42504737   XR TOE(S) 2+ VIEWS LT       $   254.00
42504745   XR TOE(S) 2+ VIEWS LT       $   254.00
42504753   XR TOE(S) 2+ VIEWS LT       $   254.00
42504761   XR TOE(S) 2+ VIEWS LT       $   254.00
42504769   XR HIP 1 VIEW LT            $   230.50
42504777   XR RIBS 2 VIEWS LT          $   420.50
42504849   XR BONE DENSITY(DXA)AXAL    $   315.75
42504856   XR CHEST 1 VIEW             $   235.00
42504864   XR FLUORO < 1 HR            $   588.25
42504872   MA MAMMO DIAG LT            $   211.50
42504880   MA MAMMO DIAG BIL           $   237.50
42504904   XR FLUORO < 1 HR            $   588.25
42504952   XR CHEST SPECIAL VIEWS      $   157.25
42504958   XR CERVICAL SPINE 4+ VIEW   $   686.50
42504964   XR L SPINE CMPL W BEND VW   $   429.50
42504970   XR L SPINE BEND ONLY 4+ V   $   403.75
42504976   XR UPP EXTRM INFANT 2+ LT   $   258.50
42504982   XR UPP EXTRM INFANT 2+ RT   $   258.50
42504988   XR KNEE 3 VIEWS LT          $   344.75
42504994   XR KNEE 3 VIEWS RT          $     344.75
42505000   XR KNEE AP STANDING BIL     $     262.50
42505006   XR LOW EXTRM INFANT 2+ LT   $     258.50
42505012   XR LOW EXTRM INFANT 2+ RT   $     258.50
42505024   XR UGI W AIR CON WO KUB     $     574.25
42505030   XR UGI W AIR CON+SM BOWEL   $     810.50
42505048   XR BONE SURVEY COMPLETE     $     830.50
42505054   XR ENDO PANCREAS DUCT CTH   $   1,103.25
42505060   XR ENDO ERCP                $   1,103.25
42505066   IR ANGIO EXTREMITY LT       $     593.75
42505072   IR ANGIO EXTREMITY RT       $     593.75
42505078   XR ANGIO EXTREMITY LT       $     593.75
42505084   XR ANGIO EXTREMITY RT       $     593.75
42520060   XR URETER CATH/STENT PLC    $     971.75
42520078   XR CHOLE PERC TRANSHEP      $     607.25
42520210   XR ANGIO RENAL W FLUSH UN   $   2,028.25
42520386   XR VENACAVAGRAM INFERIOR    $   1,891.50
42520410   XR VENOGRAM RENAL UNI       $   1,891.50
42520502   XR BILIARY DRAIN TRANSHEP   $   2,058.75
42520560   XR NEPHRO/URET/URTHRA DIL   $     715.50
42520617   XR STENT(S) PLC NON COR     $   2,840.00
42520660   XR ANGIO VERTEBRAL UNI      $   2,058.75
42560031   MR ORB/FAC &/OR NECK WO     $   2,861.50
42560049   MR BRAIN WO CON             $   2,554.75
42560064   MR BRAIN W CON              $   3,225.50
42560098   MR CHEST WO CON             $   3,234.00
42560122   MR C SPINE WO CON           $   2,887.25
42560148   MR UPP EXTREM JNT WO RT     $   2,310.00
42560189   MR LOW EXTREM JNT WO RT     $   2,310.00
42560213   MR ABDOMEN WO CON           $   3,972.00
42560304   MR TMJ UNI                  $   2,887.25
42560318   MR BRAIN WO&W CON           $   3,815.00
42560320   MR C SPINE W CON            $   3,801.50
42560338   MR C SPINE WO&W CON         $   3,972.00
42560346   MR T SPINE WO CON           $   2,887.25
42560353   MR T SPINE W CON            $   3,801.50
42560361   MR T SPINE WO&W CON         $   3,972.00
42560379   MR L SPINE WO CON           $   2,887.25
42560387   MR L SPINE W CON            $   3,801.50
42560395   MR L SPINE WO&W CON         $   3,972.00
42560400   MR PELVIS WO CON            $   3,060.75
42560411   MR UPP EXTREM WO CON RT     $   2,310.00
42560429   MR LOW EXTREM WO CON RT     $   2,310.00
42560452   MR BREAST W CON BIL         $   2,887.25
42560478   MR ANGIO CHEST WO CON       $   3,063.50
42560497   MR ANGIO PELVIS W CON       $   2,397.75
42560510   MR ANGIO LOW EXTREM WO BI   $   2,887.25
42560528   MR ANGIO ABDOMEN W CON      $   3,063.50
42560536   MR UPP EXTREM JNT WO LT     $   2,310.00
42560544   MR LOW EXTREM JNT WO LT     $   2,310.00
42560552   MR UPP EXTREM WO CON LT     $   2,310.00
42560560   MR LOW EXTREM WO CON LT     $   2,310.00
42560582   MR C SPINE WO CON           $   2,887.25
42560588   MR ANGIO HEAD WO CON        $   3,063.50
42560589   MR T SPINE WO CON           $   2,887.25
42560592   MR ANGIO HEAD W CON         $   3,703.00
42560596   MR L SPINE WO CON           $   2,887.25
42560623   MR BRAIN WO CON             $   2,887.25
42560630   MR ANGIO HEAD WO CON        $   3,063.50
42560631   MR ABDOMEN WO&W CON         $   5,125.50
42560638   MR PELVIS WO&W CON          $   5,125.50
42560645   MR ANGIO NECK WO CON        $   3,063.50
42560650   MR ANGIO NECK WO&W CON      $   4,599.00
42560657   MR ABDOMEN WO&W CON         $   5,125.50
42560692   MR CHEST WO&W CON           $   5,125.50
42560706   MR LOW EXTREM JNT W LT      $   2,797.25
42560713   MR LOW EXTREM JNT WO&W LT   $   5,116.75
42560727   MR LOW EXTREM WO&W CON LT   $   5,116.75
42560734   MR LOW EXTREM JNT W RT      $   2,797.25
42560748   MR LOW EXTREM W CON RT      $   2,795.00
42560755   MR LOW EXTREM WO&W CON RT   $   5,116.75
42560783   MR UPP EXTREM JNT W LT      $   2,310.00
42560797   MR UPP EXTREM WO&W CON LT   $   5,116.75
42560804   MR UPP EXTREM JNT W RT      $   2,310.00
42560806   MR BREAST WO&W CON UNI      $   2,193.50
42560811   MR UPP EXTREM JNT WO&W RT   $   5,116.75
42560818   MR BREAST WO&W CON BIL      $   3,186.75
42560825   MR GUIDED NDL BX/ASP/INJ    $   2,062.00
42560832   MR ORB/FAC/NECK W CON       $   2,797.25
42560839   MR ORB/FAC &/OR NECK WO&W   $   5,116.75
42560845   MR PELVIS WO&W CON          $   5,125.50
42560852   MR 3D W SEPARATE WKSTATN    $     379.50
42560859   MR ABDOMEN WO CON           $   3,972.00
42590616   XR BONE DENSITY(DXA)APEND   $     138.50
42590623   XR FLUORO NDL LOCAL SPINE   $     904.00
42590630   XR FLUORO 1-2 HOURS         $   1,129.50
42590637   XR FLUORO NDL LOCAL SPINE   $   1,410.75
42590687   XR FB LOCAL NOSE TO RECTM   $     327.25
42590702   XR SIALOGRAM UNI            $     462.50
42590716   IR FLUORO CVAD PLACEMENT    $     566.50
42590737   XR DISKOGRM LUMBAR SPINE    $     599.00
42600000   CT HEAD WO CON              $   1,935.50
42600018   CT HEAD W CON               $   2,372.75
42600026   CT HEAD WO&W CON            $   3,436.25
42600182   CT CHEST WO CON LTD         $   1,133.50
42600240   CT ABDOMEN WO CON           $   2,259.25
42600257   CT ABDOMEN W CON            $   2,754.25
42600265   CT ABDOMEN WO&W CON         $   3,847.75
42600455   CT MAXILLOFACIAL WO CON     $   1,935.50
42600463   CT MAXILLOFACIAL W CON      $   2,430.00
42600471   CT MAXILLOFACIAL WO&W CON   $   3,436.25
42600489   CT SOFT TISSUE NECK WO      $   1,658.50
42600497   CT SOFT TISSUE NECK W CON   $   2,153.50
42600505   CT SOFT TISSUE NECK WO&W    $   2,645.75
42600513   CT CHEST WO CON             $   2,531.00
42600521   CT CHEST W CON              $   3,247.25
42600539   CT CHEST WO&W CON           $   4,654.75
42600679   CT PELVIS WO CON            $   1,745.25
42600687   CT PELVIS W CON             $   2,240.25
42600695   CT PELVIS WO&W CON          $   2,735.50
42600703   CT UPP EXTREM WO CON RT     $   1,363.75
42600711   CT UPP EXTREM W CON RT      $   2,065.75
42600729   CT UPP EXTREM WO&W RT       $   2,469.25
42600737   CT LOW EXTREMITY WO RT      $   1,363.75
42600745   CT LOW EXTREMITY W RT       $   2,065.75
42600752   CT LOW EXTREMITY WO&W RT    $   2,469.25
42600760   CT CERVICAL SPINE WO CON    $   2,476.25
42600778   CT CERVICAL SPINE W CON     $   2,971.25
42600786   CT THORACIC SPINE WO CON         $   2,202.25
42600794   CT THORACIC SPINE W CON          $   2,697.50
42600802   CT LUMBAR SPINE WO CON           $   2,151.25
42600810   CT LUMBAR SPINE W CON            $   2,645.75
42600919   CT GUIDED NEEDLE PLACEMNT        $   1,976.75
42600968   CT 3D W SEPARATE WKSTATN         $     594.50
42601000   CT ANGIO HEAD WO&W CON           $   3,555.75
42601007   CT ANGIO NECK WO&W CON           $   4,453.00
42601014   CT ANGIO CHEST WO&W CON          $   3,359.25
42601021   CT ANGIO PELVIS WO&W CON         $   3,359.25
42601028   CT ANGIO UPP EXTR WO&W UN        $   2,031.50
42601035   CT ANGIO LOW EXTR WO&W UN        $   2,031.50
42601042   CT ANGIO ABDOMEN WO&W CON        $   3,359.25
42601049   CT ANGIO AORT WO&W RUNOFF        $   4,006.75
42601164   CT CERVICAL SPINE WO&W           $   3,875.00
42601172   CT THORACIC SPINE WO&W           $   3,035.25
42601180   CT LUMBAR SPINE WO&W CON         $   3,875.00
42601222   CT CHEST W CON LTD               $   1,133.50
42601339   CT MAXILLOFACIAL WO LTD          $     814.25
42601826   CT ORBIT/SEL/FOS/EAR WO          $   1,935.50
42601834   CT ORBIT/SEL/FOS/EAR W           $   2,430.00
42601842   CT ORBIT/SEL/FOS/EAR WO&W        $   3,436.25
42601850   CT UPP EXTREM WO CON LT          $   1,363.75
42601858   CT UPP EXTREM W CON LT           $   2,065.75
42601866   CT UPP EXTREM W0&W LT            $   2,244.75
42601874   CT LOW EXTREMITY WO LT           $   1,363.75
42601882   CT LOW EXTREMITY W LT            $   2,065.75
42601890   CT LOW EXTREMITY WO&W LT         $   2,469.25
42601925   CT ABDOMEN WO CON                $   2,178.00
42601932   CT PELVIS WO CON                 $   2,178.00
42601939   CT CHEST WO CON                  $   2,178.00
42601953   CT CHEST WO CON                  $   2,395.25
42601960   CT ABDOMEN WO CON                $   2,178.00
42601974   CT SOFT TISSUE NECK WO           $   2,095.50
42602030   CT PELVIS W CON                  $   2,412.00
42602044   CT CHEST W CON                   $   2,745.75
42602051   CT ABDOMEN W CON                 $   2,745.75
42602065   CT SOFT TISSUE NECK W CON        $   2,444.50
42602121   CT PELVIS WO&W CON               $   3,281.75
42602135   CT CHEST WO&W CON                $   3,786.75
42602142   CT ABDOMEN WO&W CON              $   3,786.75
42602156   CT SOFT TISSUE NECK WO&W         $   3,186.00
42700013   CARDIAC EXER SESSION W EKG       $     154.00
42800058   PR SELF CARE/MANAGEMENT 15 MIN   $      56.25
42800064   PR THERP EXER INDIV 15 MIN       $      56.25
42800070   PR THERP EXER GROUP 15 MIN       $      56.25
42800084   PR EVALUATION 1HR                $     134.25
42950011   US SOFT TISS HEAD & NECK         $     571.75
42950029   US GUIDED NEEDL PLACEMENT        $     271.50
42950037   US ABDOMEN COMPLETE              $   1,026.25
42950045   US ABDOMEN LIMITED               $     714.00
42950078   US RETROPERITONEAL COMPL         $     681.75
42950102   US RETROPERITONEAL COMPL         $     600.25
42950128   US PELVIS NON OB                 $     681.75
42950177   US PELVIS NON OB                 $     760.50
42950193   US GUIDED NEEDL PLACEMENT        $     850.00
42950201   US BREAST RT                     $     286.75
42950208   US CHEST                         $     286.75
42950292   US PREG FOLLOWUP/EA GEST         $     567.25
42950318   US DPLX EXTRACRAN BIL-CMP    $   1,060.25
42950417   US ENCEPHALOGRAM             $     750.75
42950425   US PELVIS NON OB LTD F/U     $     560.50
42950458   US SCROTUM                   $     580.50
42950466   US TRANSVAGINAL              $     733.00
42950508   US PREG+DETL EA ADDL GEST    $     567.25
42950524   US V DPLX AB/PEL/RET CMP     $   1,060.25
42950532   US FETAL BIOPH PROF W NST    $     567.25
42950565   US V DPLX AO/IVC/GRFT CMP    $   1,060.25
42950573   US V DPLX VENOUS EXT RT      $     746.50
42950607   US HIPS INFANT DYNAMIC       $     488.50
42950770   US SONOHYSTEROGRAM           $   1,185.50
42950786   US BREAST LT                 $     286.75
42950802   US V DPLX VENOUS EXT LT      $     746.50
42950810   US V DPLX VENOUS EXT RT      $     746.50
42950818   US V DPLX VENOUS EXT LT      $     746.50
42950826   US V DPLX VENOUS EXT BIL     $   1,490.50
42950834   US V DPLX VENOUS EXT BIL     $   1,490.50
42950858   US EXTREMITY NON VAS RT      $     746.50
42950865   US EXTREMITY NON VAS LT      $     746.50
42950873   US EXTREMITY NON VAS LT      $     746.50
42950881   US V DPLX ART LOW EXT BIL    $   1,255.75
42950889   US V DPLX ART LOW EXT RT     $     849.00
42950897   US V DPLX ART LOW EXT LT     $     849.00
42950905   US V DPLX ART UP EXT BIL     $   1,344.75
42950913   US V DPLX ART UP EXT RT      $     891.75
42950921   US V DPLX ART UP EXT LT      $     891.75
42950928   US DPLX EXTRACRAN UNI-LTD    $     537.75
42950935   US DPLX EXTRACRAN LT-LTD     $     537.75
42950942   US DPLX EXTRACRAN RT-LTD     $     537.75
42960557   US GUIDED AMNIOCENTESIS      $     527.00
42960595   US PELVIS NON OB             $   1,001.75
42960672   US PREG<14WK SNGL1ST GEST    $     404.25
42960686   US PREG TRANSVAGINAL         $     404.25
42960699   US PREG=>14WK SNG 1ST GES    $     404.25
42960713   US PREG+DETL SNGL1ST GEST    $     778.00
42960741   US EXTREMITY NON VAS BIL     $   1,492.25
42960748   US EXTREMITY NON VAS BIL     $   1,492.25
42960755   US SPINAL CANAL & CONTENT    $     571.75
43000340   CHEST DRAINAGE DEVICE        $     248.00
43001314   HEMOVAC                      $     143.75
43005505   TRAY TRICATHETER             $     377.75
43005588   CATH SWAN GANZ TD            $     437.50
43006164   CARDIAC DEFIB-MONITOR PADS   $     322.50
43006347   BED ALARM SENSOR MAT DISP    $     172.50
43009515   BRACE KNEE MED DESIGN        $   1,479.25
43010026   CATH TROCAR K S              $     316.25
43010323   KIT BREAST PUMP DISPOSABLE   $     272.00
43010372   KIT ARTERIAL                 $     138.75
43020215   PLUERA GARD                  $     621.25
43020280   TRAY BIOPSY BONE MARROW      $     344.50
43020348   TRAY PAC(CATH INTRODUCER)    $     243.50
43020512   TRAY THORACENTESIS           $     357.50
43020520   TRAY TRACHEOTOMY             $     239.25
43031246   TRAY PARACERVICAL/PUDENDAL   $     164.25
43031667   TRAY PER-Q-CATH              $     930.75
43031758   TRAY PARACENTESIS            $     610.00
43040036   CATH THERMODILUTION          $     737.00
43051731   SCD SLEEVE                   $     506.00
43051871   ART LINE PRESSURE KIT           $     272.00
43051889   TRAY QUINTON CATH 11.5          $   1,125.50
43073206   TUBING SURGILAV SET ST          $     355.75
43075219   TRAY PULSAVAC W/FAN KIT         $     227.00
43075482   GASTROSTOMY TUBE MIC            $     539.75
43076090   TRACH KIT PER-FIT PERC          $   2,982.75
43076292   TUBING RAPID INFUSER            $     350.75
43077592   TROCAR KIT SZ 20                $     282.25
43077830   TUBING NORMOFLO #IR-600         $     467.50
43083758   TUBE GASTNY MICRO 24FR          $     271.50
43083891   DRESSING AQUA CELL HG 6X6       $     213.50
43090007   DRESSING BLACK MED-FOAM         $     234.25
43090014   CANISTER FOR WOUND-VAC          $     261.25
43090105   HEMOVAC SNYDER ORTHPAT          $     203.75
43200340   CHEST DRAINAGE DEVICE           $     248.00
43201314   HEMOVAC                         $     143.75
43205505   TRAY TRICATHETER                $     377.75
43205588   CATH SWAN GANZ TD               $     437.50
43206164   CARDIAC DEFIB-MONITOR PADS      $     322.50
43206347   BED ALARM SENSOR MAT DISP       $     172.50
43209515   BRACE KNEE MED DESIGN           $   1,479.25
43210026   CATH TROCAR K S                 $     316.25
43210323   KIT BREAST PUMP DISPOSABLE      $     272.00
43210372   KIT ARTERIAL                    $     138.75
43220215   PLEURA GARD                     $     621.25
43220280   TRAY BIOPSY BONE MARROW         $     344.50
43220348   TRAY PAC(CATH INTRODUCER)       $     243.50
43220454   LUMBAR PUNC TRAY- ADULT         $     218.75
43220512   TRAY THORACENTESIS              $     357.50
43220520   TRAY TRACHEOTOMY                $     239.25
43231246   TRAY PARACERVICAL/PUDENDAL      $     164.25
43231667   TRAY PER-Q-CATH                 $     930.75
43231758   TRAY PARACENTESIS               $     610.00
43240036   CATH THERMODILUTION             $     737.00
43251731   SCD SLEEVE                      $     506.00
43251871   ART LINE PRESSURE KIT           $     272.00
43251889   TRAY QUINTON CATH 11.5          $   1,125.50
43273206   TUBING SURGILAV SET ST          $     355.75
43275219   TRAY PULSAVAC W/FAN KIT         $     227.00
43275482   GASTROSTOMY TUBE MIC            $     539.75
43276090   TRACH KIT PER-FIT PERC          $   2,982.75
43276292   TUBING RAPID INFUSER            $     350.75
43277592   TROCAR KIT SZ 20                $     282.25
43277830   TUBING NORMOFLO #IR-600         $     467.50
43283758   TUBE GASTNY MICRO 24FR          $     271.50
43283891   DRESSING AQUA CELL HG 6X6       $     213.50
43290007   DRESSING BLACK MED-FOAM         $     234.25
43290014   CANISTER FOR WOUND-VAC          $     261.25
43290105   HEMOVAC SNYDER ORTHPAT          $     203.75
43400340   CHEST DRAINAGE DEVICE           $     248.00
43401314   HEMOVAC                         $     143.75
43402015   LEAD PACEMAKER BIPOLAR CORDIS   $     779.00
43405505   TRAY TRICATHETER                $     377.75
43405588   CATH SWAN GANZ TD               $     437.50
43406164   CARDIAC DEFIB-MONITOR PADS      $     322.50
43406347   BED ALARM SENSOR MAT DISP       $     172.50
43409515   BRACE KNEE MED DESIGN           $   1,479.25
43410026   CATH TROCAR K S                 $     316.25
43410323   KIT BREAST PUMP DISPOSABLE      $     272.00
43410372   KIT ARTERIAL                   $     138.75
43410505   THORACENTESIS SET TRAY         $     227.50
43411032   PERICARDIOCENTESIS KIT         $   1,197.00
43411347   THOROCOTOMY SET                $     258.50
43420215   PLEURA GARD                    $     621.25
43420280   TRAY BIOPSY BONE MARROW        $     344.50
43420348   TRAY PAC(CATH INTRODUCER)      $     243.50
43420454   LUMBAR PUNC TRAY- ADULT        $     218.75
43420462   LUMBAR PUNC TRAY- PED          $     184.25
43420512   TRAY THORACENTESIS             $     357.50
43420520   TRAY TRACHEOTOMY               $     239.25
43431246   TRAY PARACERVICAL/PUDENDAL     $     164.25
43431626   BAG RESUSCITATION DISPOSAL     $     220.75
43431667   TRAY PER-Q-CATH                $     930.75
43431758   TRAY PARACENTESIS              $     610.00
43431816   AIRWAY COMBITUBE               $     531.25
43440036   CATH THERMODULITION            $     737.00
43451731   SCD SLEEVE                     $     506.00
43451806   PROBE CHANDLER                 $   1,296.25
43451814   CATH THERMO PACE PORT          $     792.25
43451863   CATH PRESS KIT                 $     285.25
43451871   ART LINE PRESSURE KIT          $     272.00
43451889   TRAY QUINTON CATH 11.5         $   1,125.50
43460484   TRACH TUBE PORTEX (SGL CUFF)   $     203.00
43473206   TUBING SURGILAV SET ST         $     355.75
43475219   TRAY PULSAVAC W/FAN KIT        $     227.00
43475482   GASTROSTOMY TUBE MIC           $     539.75
43476047   OXISENSOR N25 NEONATAL/ADULT   $     135.75
43476090   TRACH KIT PER-FIT PERC         $   2,982.75
43476292   TUBING RAPID INFUSER           $     350.75
43476544   CATH AIRWAY EXCHANGE 14/19     $     278.75
43477592   TROCAR KIT SZ 20               $     282.25
43477830   TUBING NORMOFLO #IR-600        $     467.50
43483758   TUBE GASTNY MICRO 24FR         $     271.50
43483891   DRESSING AQUA CELL HG 6X6      $     213.50
43484367   TRACH KIT PEDIATRIC 3.5        $   1,232.50
43490007   DRESSING BLACK MED-FOAM        $     234.25
43490014   CANISTER FOR WOUND-VAC         $     261.25
43490105   HEMOVAC SNYDER ORTHPAT         $     203.75
43500340   CHEST DRAINAGE DEVICE          $     248.00
43501314   HEMOVAC                        $     143.75
43505505   TRAY TRICATHETER               $     377.75
43505588   CATH SWAN GANZ TD              $     437.50
43506164   CARDIAC DEFIB-MONITOR PADS     $     322.50
43506347   BED ALARM SENSOR MAT DISP      $     172.50
43509515   BRACE KNEE MED DESIGN          $   1,479.25
43510026   CATH TROCAR K S                $     316.25
43510323   KIT BREAST PUMP DISPOSABLE     $     272.00
43510372   KIT ARTERIAL                   $     138.75
43520215   PLEURA GARD                    $     621.25
43520280   TRAY BIOPSY BONE MARROW        $     344.50
43520348   TRAY PAC(CATH INTRODUCER)      $     243.50
43520512   TRAY THORACENTESIS             $     357.50
43520520   TRAY TRACHEOTOMY               $     239.25
43531246   TRAY PARACERVICAL/PUDENDAL     $     164.25
43531667   TRAY PER-Q-CATH                $     930.75
43531758   TRAY PARACENTESIS              $     610.00
43540036   CATH THERMODILUTION            $     737.00
43551731   SCD SLEEVE                     $     506.00
43551871   ART LINE PRESSURE KIT          $     272.00
43551889   TRAY QUINTON CATH 11.5         $   1,125.50
43573206   TUBING SURGILAV SET ST         $     355.75
43575219   TRAY PULSAVAC W/FAN KIT        $     227.00
43575482   GASTROSTOMY TUBE MIC           $     539.75
43576047   OXISENSOR N25 NEONATAL/ADULT   $     135.75
43576090   TRACH KIT PER-FIT PERC         $   2,982.75
43576292   TUBING RAPID INFUSER           $     350.75
43577592   TROCAR KIT SZ 20               $     282.25
43577830   TUBING NORMOFLO #IR-600        $     467.50
43583758   TUBE GASTNY MICRO 24FR         $     271.50
43583891   DRESSING AQUA CELL HG 6X6      $     213.50
43590007   DRESSING BLACK MED-FOAM        $     234.25
43590014   CANISTER FOR WOUND-VAC         $     261.25
43590105   HEMOVAC SNYDER ORTHPAT         $     203.75
43600340   CHEST DRAINAGE DEVICE          $     248.00
43601314   HEMOVAC                        $     143.75
43605505   TRAY TRICATHETER               $     377.75
43605588   CATH SWAN GANZ TD              $     437.50
43606164   CARDIAC DEFIB-MONITOR PADS     $     322.50
43606347   BED ALARM SENSOR MAT DISP      $     172.50
43609515   BRACE KNEE MED DESIGN          $   1,479.25
43610026   CATH TROCAR K S                $     316.25
43610323   KIT BREAST PUMP DISPOSABLE     $     272.00
43610372   KIT ARTERIAL                   $     138.75
43620215   PLEURA GARD                    $     621.25
43620280   TRAY BIOPSY BONE MARROW        $     344.50
43620348   TRAY PAC(CATH INTRODUCER)      $     243.50
43620512   TRAY THORACENTESIS             $     357.50
43620520   TRAY TRACHEOTOMY               $     239.25
43631246   TRAY PARACERVICAL/PUDENDAL     $     164.25
43631667   TRAY PER-Q-CATH                $     930.75
43631758   TRAY PARACENTESIS              $     610.00
43640036   CATH THERMODILUTION            $     737.00
43651731   SCD SLEEVE                     $     506.00
43651871   ART LINE PRESSURE KIT          $     272.00
43651889   TRAY QUINTON CATH 11.5         $   1,125.50
43673206   TUBING SURGILAV SET ST         $     355.75
43675219   TRAY PULSAVAC W/FAN KIT        $     227.00
43675482   GASTROSTOMY TUBE MIC           $     539.75
43676047   OXISENSOR N25 NEONATAL/ADULT   $     135.75
43676090   TRACH KIT PER-FIT PERC         $   2,982.75
43676292   TUBING RAPID INFUSER           $     350.75
43677592   TROCAR KIT SZ 20               $     282.25
43677830   TUBING NORMOFLO #IR-600        $     467.50
43683758   TUBE GASTNY MICRO 24FR         $     271.50
43683891   DRESSING AQUA CELL HG 6X6      $     213.50
43690007   DRESSING BLACK MED-FOAM        $     234.25
43690014   CANISTER FOR WOUND-VAC         $     261.25
43690105   HEMOVAC SNYDER ORTHPAT         $     203.75
43700340   CHEST DRAINAGE DEVICE          $     248.00
43701314   HEMOVAC                        $     143.75
43705505   TRAY TRICATHETER               $     377.75
43705588   CATH SWAN GANZ TD              $     437.50
43706164   CARDIAC DEFIB-MONITOR PADS     $     322.50
43706347   BED ALARM SENSOR MAT DISP      $     172.50
43709515   BRACE KNEE MED DESIGN          $   1,479.25
43710026   CATH TROCAR K S                $     316.25
43710323   KIT BREAST PUMP DISPOSABLE     $     272.00
43720215   PLEURA GARD                    $     621.25
43720280   TRAY BIOPSY BONE MARROW        $     344.50
43720348   TRAY PAC(CATH INTRODUCER)      $     243.50
43720512   TRAY THORACENTESIS             $     357.50
43720520   TRAY TRACHEOTOMY               $     239.25
43731246   TRAY PARACERVICAL/PUDENDAL     $     164.25
43731667   TRAY PER-Q-CATH                $     930.75
43731758   TRAY PARACENTESIS              $     610.00
43740036   CATH THERMODILUTION            $     737.00
43751731   SCD SLEEVE                     $     506.00
43751871   ART LINE PRESSURE KIT          $     272.00
43751889   TRAY QUINTON CATH 11.5         $   1,125.50
43773206   TUBING SURGILAV SET ST         $     355.75
43775219   TRAY PULSAVAC W/FAN KIT        $     227.00
43775482   GASTROSTOMY TUBE MIC           $     539.75
43776047   OXISENSOR N25 NEONATAL/ADULT   $     135.75
43776090   TRACH KIT PER-FIT PERC         $   2,982.75
43776292   TUBING RAPID INFUSER           $     350.75
43777592   TROCAR KIT SZ 20               $     282.25
43777830   TUBING NORMOFLO #IR-600        $     467.50
43783758   TUBE GASTNY MICRO 24FR         $     271.50
43783891   DRESSING AQUA CELL HG 6X6      $     213.50
43790007   DRESSING BLACK MED-FOAM        $     234.25
43790014   CANISTER FOR WOUND-VAC         $     261.25
43790105   HEMOVAC SNYDER ORTHPAT         $     203.75
43800340   CHEST DRAINAGE DEVICE          $     248.00
43801314   HEMOVAC                        $     143.75
43805505   TRAY TRICATHETER               $     377.75
43805588   CATH SWAN GANZ TD              $     437.50
43806164   CARDIAC DEFIB-MONITOR PADS     $     322.50
43806347   BED ALARM SENSOR MAT DISP      $     172.50
43809515   BRACE KNEE MED DESIGN          $   1,479.25
43810026   CATH TROCAR K S                $     316.25
43810323   KIT BREAST PUMP DISPOSABLE     $     272.00
43810372   KIT ARTERIAL                   $     138.75
43820215   PLEURA GARD                    $     621.25
43820280   TRAY BIOPSY BONE MARROW        $     344.50
43820348   TRAY PAC(CATH INTRODUCER)      $     243.50
43820512   TRAY THORACENTESIS             $     357.50
43820520   TRAY TRACHEOTOMY               $     239.25
43831246   TRAY PARACERVICAL/PUDENDAL     $     164.25
43831667   TRAY PER-Q-CATH                $     930.75
43831758   TRAY PARACENTESIS              $     610.00
43840036   CATH THERMODILUTION            $     737.00
43851731   SCD SLEEVE                     $     506.00
43851871   ART LINE PRESSURE KIT          $     272.00
43851889   TRAY QUINTON CATH 11.5         $   1,125.50
43873206   TUBING SURGILAV SET ST         $     355.75
43875219   TRAY PULSAVAC W/FAN KIT        $     227.00
43875482   GASTROSTOMY TUBE MIC           $     539.75
43876047   OXISENSOR N25 NEONATAL/ADULT   $     135.75
43876090   TRACH KIT PER-FIT PERC         $   2,982.75
43876292   TUBING RAPID INFUSER           $     350.75
43877592   TROCAR KIT SZ 20               $     282.25
43877830   TUBING NORMOFLO #IR-600        $     467.50
43883758   TUBE GASTNY MICRO 24FR         $     271.50
43883891   DRESSING AQUA CELL HG 6X6      $     213.50
43890007   DRESSING BLACK MED-FOAM        $     234.25
43890014   CANISTER FOR WOUND-VAC         $     261.25
43890105   HEMOVAC SNYDER ORTHPAT           $     203.75
43900340   CHEST DRAINAGE DEVICE            $     248.00
43905505   TRAY TRICATHETER                 $     377.75
43905588   CATH SWAN GANZ TD                $     437.50
43906164   CARDIAC DEFIB-MONITOR PADS       $     322.50
43906347   BED ALARM SENSOR MAT DISP        $     172.50
43909515   BRACE KNEE MED DESIGN            $   1,479.25
43910026   CATH TROCAR K S                  $     316.25
43910323   KIT BREAST PUMP DISPOSABLE       $     272.00
43920215   PLEURA GARD                      $     621.25
43920280   TRAY BIOPSY BONE MARROW          $     344.50
43920322   CIRCUMCISION TRAY                $     189.75
43920348   TRAY PAC(CATH INTRODUCER)        $     243.50
43920462   LUMBAR PUNC TRAY PED             $     184.25
43920512   TRAY THORACENTESIS               $     357.50
43920520   TRAY TRACHEOTOMY                 $     239.25
43920538   TRAY UMBILICAL ARTERY            $     488.25
43931667   TRAY PER-Q-CATH                  $     930.75
43931758   TRAY PARACENTESIS                $     610.00
43940036   CATH THERMODILUTION              $     737.00
43951731   SCD SLEEVE                       $     506.00
43951871   ART LINE PRESSURE KIT            $     272.00
43951889   TRAY QUINTON CATH 11.5           $   1,125.50
43973206   TUBING SURGILAV SET ST           $     355.75
43975219   TRAY PULSAVAC W/FAN KIT          $     227.00
43975482   GASTROSTOMY TUBE MIC             $     539.75
43976090   TRACH KIT PER-FIT PERC           $   2,982.75
43976292   TUBING RAPID INFUSER             $     350.75
43976442   CPAP DISP SYSTEM                 $     241.25
43977592   TROCAR KIT SZ 20                 $     282.25
43977830   TUBING NORMOFLO #IR-600          $     467.50
43983758   TUBE GASTNY MICRO 24FR           $     271.50
43983891   DRESSING AQUA CELL HG 6X6        $     213.50
43990014   CANISTER FOR WOUND-VAC           $     261.25
43990105   HEMOVAC SNYDER ORTHPAT           $     203.75
44100070   HEMODIALYSIS                     $     493.75
44100077   HEMOPERFUSION                    $     522.50
44100084   PERITONEAL DIALYSIS              $     348.50
44100091   APHERESIS                        $     923.25
63700079   INJ TX/DX/PROPH SUBQ/IM          $      30.00
63700086   INJ TX/DX/PRO IVPUSH INIT        $      60.00
63700093   INJ TX/DX/PRO IV PUSH SEQ        $      60.00
63700500   OBS CARE 2-N DISCHARGE DAY       $      32.00
63800001   ATC CHEMO IV 1.0 HR              $     261.00
63800008   ATC CHEMO IV 1.5 HR              $     391.00
63800016   ATC CHEMO IV 2.0 HR              $     520.75
63800024   ATC CHEMO IV 2.5 HR              $     650.25
63800032   ATC CHEMO IV 3.0 HR              $     780.00
63800038   ATC CHEMO IV 3.5 HR              $     909.75
63800045   ATC CHEMO IV 4.0 HR              $   1,040.00
63800052   ATC BLOOD ADM 1.5 HR             $     391.00
63800059   ATC BLOOD ADM 2.0 HR             $     520.75
63800066   ATC BLOOD ADM 2.5 HR             $     650.25
63800073   ATC BLOOD ADM 3.0 HR             $     780.00
63800081   ATC BLOOD ADM 3.5 HR             $     909.75
63800088   ATC BLOOD ADM 4.0 HR             $   1,040.00
63800095   ATC IV THERAPY 1.0 HR            $     261.00
63800540   ATC AMB PROC MAJOR 30 MIN(360)   $     131.00
63800547   ATC AMB PROC MAJOR 1.0 HR(360)   $     261.00
63800555   ATC AMB PROC MAJOR 1.5 HR(360)   $     391.00
63800563   ATC AMB PROC MAJOR 2.0 HR(360)   $     520.75
63800571   ATC AMB PROC MAJOR 2.5 HR(360)   $     650.25
63800578   ATC AMB PROC MAJOR 3.0 HR(360)   $     780.00
63800585   ATC AMB PROC MAJOR 3.5 HR(360)   $     909.75
63800592   ATC AMB PROC MAJOR 4.0 HR(360)   $   1,040.00
63800606   ATC YAG LASER                    $   1,282.00
63800607   ATC CHEMO INJ 30 MIN             $     131.00
63800613   ATC EPO <10,000 U 30 MIN         $     131.00
63800614   ATC CHEMO INJ 1.0 HR             $     261.00
63800620   ATC EPO <10,000 U 1.0 HR         $     261.00
63800621   ATC CHEMO INJ 1.5 HR             $     391.00
63800627   ATC EPO<10,000 U 1.5 HR          $     391.00
63800634   ATC EPO 10,000U OR >INI 30 MIN   $     131.00
63800636   ATC BLOOD ADM 1.0 HR             $     261.00
63800642   ATC EPO 10,000 U OR > 1.0 HR     $     261.00
63800644   ATC TREATMENT RM 1.0 HR          $     261.00
63800645   ATC EPO 10,000 U OR > 1.5 HR     $     391.00
63800646   ATC EPO 10,000 U OR > 2.0 HR     $     520.75
63800652   ATC TREATMENT RM 1.5 HR          $     391.00
63800659   ATC TREATMENT RM 2.0 HR          $     520.75
63800701   ATC IV INFUSION 1.0 HR           $     261.00
63800708   ATC IV INFUSION 1.5 HR           $     391.00
63800715   ATC IV INFUSION 2.0 HR           $     520.75
63800722   ATC IV INFUSION 2.5 HR           $     650.25
63800729   ATC IV INFUSION 3.0 HR           $     780.00
63800736   ATC IV INFUSION 3.5 HR           $     909.75
63800743   ATC IV INFUSION 4.0 HR           $   1,040.00
63800748   ATC IV INFUSION 30 MIN           $     131.00
63800750   ATC TREATMENT RM 30 MIN          $     131.00
63800764   ATC CHEMO IV 4.5 HR              $   1,170.00
63800771   ATC CHEMO IV 5.0 HR              $   1,299.25
63800778   ATC CHEMO IV 5.5 HR              $   1,429.25
63800785   ATC CHEMO IV 6.0 HR              $   1,559.25
63800792   ATC BLOOD ADM 4.5 HR             $   1,170.00
63800799   ATC BLOOD ADM 5.0 HR             $   1,299.25
63800806   ATC BLOOD ADM 5.5 HR             $   1,429.25
63800813   ATC BLOOD ADM 6.0 HR             $   1,559.25
63800820   ATC BLOOD ADM 6.5 HR             $   1,689.25
63800827   ATC BLOOD ADM 7.0 HR             $   1,818.50
63800834   ATC BLOOD ADM 7.5 HR             $   1,948.50
63800841   ATC BLOOD ADM 8.0 HR             $   2,078.25
63800848   ATC AMB PROC MAJOR 4.5 HR(360)   $   1,170.00
63800855   ATC AMB PROC MAJOR 5.0 HR(360)   $   1,299.25
63800862   ATC AMB PROC MAJOR 5.5 HR(360)   $   1,429.25
63800869   ATC AMB PROC MAJOR 6.0 HR(360)   $   1,559.25
63800878   ATC AMB PROC MAJOR 6.5 HR(360)   $   1,689.25
63800885   ATC AMB PROC MAJOR 7.0 HR(360)   $   1,818.50
63800896   ATC AMB PROC MAJOR 7.5 HR(360)   $   1,948.50
63800899   ATC AMB PROC MAJOR 8.0 HR(360)   $   2,078.25
63800900   ATC CHEMO IV 7.5 HR              $   1,948.50
63800907   ATC CHEMO IV 9.5 HR              $   2,471.00
63800914   ATC CHEMO IV 8.5 HR              $   2,210.25
63800921   ATC CHEMO IV 9.0 HR              $   2,341.00
63800927   ATC CHEMO IV 10.5 HR             $   2,728.25
63800960   ATC CHEMO IV 8.0 HR              $   2,078.25
63800990   ATC CHEMO IV 6.5 HR              $   1,689.25
63800997   ATC CHEMO IV 7.0 HR              $   1,818.50
63801003   ATC IV INFUSION 15 MIN           $      65.75
63801011   ATC IV INFUSION 4.5 HR          $   1,170.00
63801018   ATC IV INFUSION 5.0 HR          $   1,299.25
63801025   ATC IV INFUSION 5.5 HR          $   1,429.25
63801032   ATC IV INFUSION 6.0 HR          $   1,559.25
63801039   ATC IV INFUSION 6.5 HR          $   1,689.25
63801046   ATC IV INFUSION 7.0 HR          $   1,818.50
63801053   ATC IV INFUSION 7.5 HR          $   1,948.50
63801060   ATC IV INFUSION 8.0 HR          $   2,078.25
63801067   ATC IV INFUSION 0.5 HR          $     131.00
63801074   ATC TREATMENT RM 6.0 HR         $   1,560.50
63801083   ATC TREATMENT RM 3.0 HR         $     781.75
63801132   ATC BLOOD ADM 8.5 HR            $   2,208.50
63801139   ATC BLOOD ADM 9.0 HR            $   2,338.00
63801146   ATC BLOOD ADM 9.5 HR            $   2,468.00
63801153   ATC BLOOD ADM 10.0 HR           $   2,597.75
63801160   ATC CHEMO IV 11.5 HR            $   2,995.50
63801167   ATC CHEMO IV 10.0 HR            $   2,600.75
63801174   ATC CHEMO IV 11.0 HR            $   2,861.00
63801181   ATC IV INFUSION 45 MIN          $     196.00
63801188   ATC TREATMENT RM 15 MIN         $      65.75
63801202   ATC TREATMENT RM 45 MIN         $     196.00
63801209   ATC TREATMENT RM 4.0 HR         $   1,041.25
63801216   ATC IV INFUSION 1.75 HR         $     456.00
63801223   ATC IV INFUSION 1.25 HR         $     325.75
63801230   ATC TREATMENT RM 2.5 HR         $     651.50
63802224   ATC IV INFUSION 9.5 HR          $   2,475.25
63803000   SURGERY LEVEL 1 1ST 30MIN       $     130.00
63803007   SURGERY LEVEL 1 ADD 15MIN       $      46.00
63803014   SURGERY LEVEL 2 1ST 30MIN       $     169.25
63803021   SURGERY LEVEL 2 ADD 15MIN       $      58.75
63803035   TRANSFUS BLOOD/BLOOD COMP       $   1,575.50
63904516   TUBE TRACHEOSTOMY SHILEY        $     585.00
63904565   VALVE HEIMLICH -CHEST           $     177.00
63905505   TRAY TRICATHETER                $     377.75
63906263   PCA INFUSION SET                $     170.00
63908459   STRYKER WOUND DRAIN             $     112.75
63910026   TROCAR K S CATH                 $     316.25
63910505   THORACENTESIS SET TRAY          $     227.50
63911016   NEEDLE- PORTA-CATH IV           $      94.50
63913794   CATH KIT DUAL LUMIN 5FR X 55    $   1,296.75
63920215   PLEURA GARD                     $     621.25
63920280   TRAY BIOPSY BONE MARROW         $     344.50
63920348   TRAY PAC(CATH INTRODUCER)       $     243.50
63920454   LUMBAR PUNC TRAY- ADULT         $     218.75
63920462   LUMBAR PUNC TRAY- PED           $     184.25
63920512   TRAY THORACENTESIS              $     357.50
63920744   SUTURE PACK MAJOR               $     261.25
63931303   FILTER PALL                     $      99.50
63931667   TRAY PER-Q-CATH                 $     930.75
63931709   DRESSING CHANGE TRAY PERQCATH   $      84.00
63931758   TRAY PARACENTESIS               $     610.00
63951889   TRAY QUINTON CATH 11.5          $   1,125.50
63973206   SURGILAV TUBING SET ST          $     355.75
63973214   MULTIOIFACE TIP ST              $     226.25
63973925   DRAINAGE POUCH                  $     161.75
63975482   GASTROSTOMY TUBE, MIC           $     539.75
63975842   INTRASITE GEL                   $      96.50
63976448   CATH GROSHONG 7FR SL            $   1,672.50
63977025   TUBE TRACH SHILEY 8             $     276.75
63983084   SIMPLUSE VERICARE KIT          $     311.00
63983197   PNEUMOTHORAX KIT               $     608.50
63983317   INTRODUCER MICRO CRBA 5 FR     $     214.50
63983891   DRESSING AQUACELL HG 6X6       $     213.50
63983905   DRESSING PRISMA                $     108.25
63984017   DRESSING VIGILONE 13 X 24      $     198.00
63984024   DRESSING VIGILONE 6X6 OR 6X8   $     386.75
63984374   INTRODUCER MICRO 4.5 FR        $   1,599.00
63984381   LAVAGE PULSE VERICARE          $     283.50
63990035   PROFORE WRAP                   $      99.75
63990042   HYALOFILL-F DRESSING           $     156.75
64000003   XR AC JTS W/WO WTS BIL         $     341.50
64000011   XR CLAVICAL. RIGHT             $     299.50
64000029   XR ELBOW COMPLETE. RIGHT       $     376.75
64000037   XR ELBOW 2 VIEWS RT            $     267.75
64000045   XR FINGER(S) 2+ VIEWS RT       $     271.25
64000052   XR FOREARM 2 VIEWS RT          $     258.50
64000060   XR HAND 3+ VIEWS RT            $     373.75
64000078   XR HAND 2 VIEWS RT             $     241.50
64000086   XR HUMERUS 2+ VIEWS RT         $     327.25
64000094   XR SCAPULA. RIGHT              $     337.25
64000128   XR SHOULDER 2+ VIEWS RT        $     358.75
64000136   XR SHOULDER 1 VIEW RT          $     232.50
64000144   XR WRIST 3+ VIEWS RT           $     365.25
64000151   XR WRIST 2 VIEWS RT            $     246.00
64000169   XR ANKLE 3+ VIEWS RT           $     384.00
64000177   XR ANKLE 2 VIEWS RT            $     271.25
64000185   XR FEMUR 1 VIEW RT             $     339.50
64000193   XR FOOT 3+ VIEWS RT            $     376.75
64000201   XR FOOT 2 VIEWS RT             $     241.50
64000250   XR PELV&HIP INFANT/CHILD2+     $     308.50
64000268   XR HIP 2+ VIEWS RT             $     274.00
64000300   XR KNEE 4+ VIEWS RT            $     376.75
64000318   XR KNEE 1 OR 2 VIEWS RT        $     305.75
64000326   XR CALCANEUS 2+ VIEWS RT       $     246.00
64000334   XR TIBIA & FIBULA 1 VW RT      $     256.25
64000342   XR TOE(S) 2+ VIEWS RT          $     254.00
64000359   XR ABDOMEN 1 VIEW (AP)         $     246.00
64000367   XR ABDOMEN AP/DECUB/ERECT      $     327.25
64000375   XR ABD AP DECUB UPR+CHEST      $     355.25
64000656   XR NECK FOR SOFT TISSUES       $     248.00
64000821   XR CHEST (1 VIEW)              $     192.50
64000839   XR CHEST 2 VIEW                $     305.75
64000847   XR CHEST 2VWS W APIC LOR       $     349.75
64000854   XR CHEST 4+ VIEWS              $     400.25
64000870   XR RIBS 3 VIEWS BIL            $     436.25
64000888   XR RIBS. RIGHT                 $     420.50
64000896   XR STERNOCLAVIC JT(S) 3+       $     329.50
64000904   XR STERNUM 2+ VIEWS            $     367.25
64000912   XR C SPINE CMP +FLEX/EXT       $     778.75
64000920   XR CERVICAL SPINE 2-3 VW       $     405.25
64000938   XR LUMBAR SPINE 4+ VIEWS       $     692.75
64000946   XR LUMBAR SPINE 2 OR 3 VW      $     403.75
64000987   XR PELVIS 1 OR 2 VIEWS         $     228.25
64001001   XR PELVIS CMPL 3+ VIEWS        $     495.50
64001027   XR HIPS 2+ W PELVIS BIL        $     495.50
64001035   XR SACROILIAC JT 3+ VWS        $     341.50
64001043   XR SACRUM & COCCYX 2+ VWS      $     235.00
64001050   XR SCOLIOSIS SUP & STAND       $     277.50
64001068   XR SPINE ENTIRE AP & LAT       $   627.00
64001076   XR THORACIC SPINE 3 VIEWS      $   358.75
64001084   XR THORACOLUMB SPINE 2 VW      $   310.75
64001191   XR BONE AGE STUDIES            $   243.00
64001209   XR BONE LENGTH STUDIES         $   339.50
64001217   XR BONE SURVEY LIMITED         $   623.75
64001225   XR BONE SURVEY INFANT          $   308.50
64002546   XR HIP 1 VIEW RT               $   230.50
64004353   XR CLAVICAL. LEFT              $   299.50
64004361   XR ELBOW COMPLETE. LEFT        $   376.75
64004369   XR ELBOW 2 VIEWS LT            $   267.75
64004377   XR FOREARM 2 VIEWS LT          $   258.50
64004385   XR HAND 3+ VIEWS LT            $   373.75
64004393   XR HAND 2 VIEWS LT             $   241.50
64004401   XR HUMERUS 2+ VIEWS LT         $   327.25
64004409   XR SCAPULA COMPLETE LT         $   337.25
64004425   XR SHOULDER 2+ VIEWS LT        $   358.75
64004433   XR SHOULDER 1 VIEW LT          $   232.50
64004441   XR WRIST 3+ VIEWS LT           $   365.25
64004449   XR WRIST 2 VIEWS LT            $   246.00
64004457   XR ANKLE 3+ VIEWS LT           $   384.00
64004465   XR ANKLE 2 VIEWS LT            $   271.25
64004473   XR FEMUR 1 VIEW LT             $   339.50
64004481   XR FOOT 3+ VIEWS LT            $   376.75
64004489   XR FOOT 2 VIEWS LT             $   241.50
64004497   XR HIP 2+ VIEWS LT             $   274.00
64004513   XR KNEE 4+ VIEWS LT            $   376.75
64004521   XR KNEE 1 OR 2 VIEWS LT        $   305.75
64004529   XR CALCANEUS 2+ VIEWS LT       $   246.00
64004537   XR TIBIA & FIBULA 1 VW LT      $   256.25
64004625   XR FINGER(S) 2+ VIEWS RT       $   271.25
64004633   XR FINGER(S) 2+ VIEWS RT       $   271.25
64004641   XR FINGER(S) 2+ VIEWS UNI      $   271.25
64004649   XR FINGER(S) 2 VIEWS RT        $   271.25
64004657   XR FINGER(S) 2 VIEWS LT        $   271.25
64004665   XR FINGER(S) 2 VIEWS LT        $   271.25
64004673   XR FINGER(S) 2 VIEWS LT        $   271.25
64004681   XR FINGER(S) 2 VIEWS LT        $   271.25
64004689   XR FINGER(S) 2 VIEWS LT        $   271.25
64004697   XR TOE(S) 2+ VIEWS RT          $   254.00
64004705   XR TOE(S) 2+ VIEWS RT          $   254.00
64004713   XR TOE(S) 2+ VIEWS RT          $   254.00
64004721   XR FOOT. RIGHT (FIFTH DIGIT)   $   254.00
64004729   XR TOE(S) 2+ VIEWS LT          $   254.00
64004737   XR TOE(S) 2+ VIEWS LT          $   254.00
64004745   XR TOE(S) 2+ VIEWS LT          $   254.00
64004753   XR TOE(S) 2+ VIEWS LT          $   254.00
64004761   XR TOE(S) 2+ VIEWS LT          $   254.00
64004769   XR HIP 1 VIEW LT               $   230.50
64004777   XR RIBS 2 VIEWS LT             $   420.50
64004952   XR CHEST SPECIAL VIEWS         $   157.25
64004958   XR CERVICAL SPINE 4+ VIEWS     $   686.50
64004964   XR L-SPINE CMPL W BEND VW      $   429.50
64004970   XR L-SPINE BEND ONLY 4+ V      $   403.75
64004976   XR UPP EXTRM INFANT +2 LT      $   258.50
64004982   XR UPP EXTRM INFANT 2+ RT      $   258.50
64004988   XR KNEE 3 VIEWS LT             $   344.75
64004994   XR KNEE 3 VIEWS RT             $   344.75
64005000   XR KNEE AP STANDING BIL        $   262.50
64005006   XR LOW EXTRM INFANT 2+ LT        $     258.50
64005012   XR LOW EXTRM INFANT 2+ RT        $     258.50
64005018   XR ABD AP + OBLIQ+ CONE          $     327.25
64005048   XR BONE SURVEY. COMPLETE         $     830.50
64100421   BLOOD ADM 1-SOUTH 2.0 HRS        $     575.75
64100428   BLOOD ADM 1-SOUTH 2.5 HRS        $     719.50
64100435   BLOOD ADM 1-SOUTH 3.0 HRS        $     863.25
64100442   BLOOD ADM 1-SOUTH 3.5 HRS        $   1,007.00
64100449   BLOOD ADM 1-SOUTH 4.0 HRS        $   1,150.75
64100456   BLOOD ADM 1-SOUTH 4.5 HRS        $   1,294.50
64100463   BLOOD ADM 1-SOUTH 5.0 HRS        $   1,438.50
64100470   BLOOD ADM 1-SOUTH 5.5 HRS        $   1,582.00
64100477   BLOOD ADM 1-SOUTH 6.0 HRS        $   1,726.00
64100484   BLOOD ADM 1-SOUTH 6.5 HRS        $   1,869.50
64100491   BLOOD ADM 1-SOUTH 7.0 HRS        $   2,013.50
64100498   BLOOD ADM 1-SOUTH 7.5 HRS        $   2,157.25
64100505   BLOOD ADM 1-SOUTH >8.0 HRS       $   2,301.00
64100512   BLOOD ADM 2 SOUTH 3.0 HRS        $     863.25
64100519   BLOOD ADM 2 SOUTH 3.5 HRS        $   1,007.00
64100526   BLOOD ADM 2 SOUTH 4.0 HRS        $   1,150.75
64100533   BLOOD ADM 2 SOUTH 4.5 HRS        $   1,294.50
64100540   BLOOD ADM 2 SOUTH 5.0 HRS        $   1,438.50
64100547   BLOOD ADM 2 SOUTH 5.5 HRS        $   1,582.00
64100554   BLOOD ADM 2 SOUTH 6.0 HRS        $   1,726.00
64100561   BLOOD ADM 2 SOUTH 6.5 HRS        $   1,869.50
64100568   BLOOD ADM 2 SOUTH 7.0 HRS        $   2,013.50
64100575   BLOOD ADM 2 SOUTH 7.5 HRS        $   2,157.25
64100582   BLOOD ADM 2 SOUTH >8.0 HRS       $   2,301.00
64100589   BLOOD ADM 2-NORTH 2.0 HRS        $     575.75
64100596   BLOOD ADM 2-NORTH 3.0 HRS        $     863.25
64100603   BLOOD ADM 2-NORTH 3.5 HRS        $   1,007.00
64100610   BLOOD ADM 2-NORTH 4.0 HRS        $   1,150.75
64100617   BLOOD ADM 2-NORTH 4.5 HRS        $   1,294.50
64100624   BLOOD ADM 2-NORTH 5.0 HRS        $   1,438.50
64100631   BLOOD ADM 2-NORTH 5.5 HRS        $   1,582.00
64100638   BLOOD ADM 2-NORTH 6.0 HRS        $   1,726.00
64100645   BLOOD ADM 2-NORTH 6.5 HRS        $   1,869.50
64100652   BLOOD ADM 2-NORTH 7.0 HRS        $   2,013.50
64100659   BLOOD ADM 2-NORTH 7.5 HRS        $   2,157.25
64100666   BLOOD ADM 2-NORTH >8.0 HRS       $   2,301.00
64100673   BLOOD ADM ICCU 1.0               $     288.25
64100680   BLOOD ADM ICCU 1.5 HRS           $     431.75
64100687   BLOOD ADM ICCU 2.0 HRS           $     575.75
64100694   BLOOD ADM ICCU 7.0 HOURS         $   2,013.50
64100701   CHEMOTHERAPY IV 1-SOUTH 2.0 HR   $     529.00
64100708   CHEMOTHERAPY IV 1-SOUTH 2.5 HR   $     660.75
64100715   CHEMOTHERAPY IV 1-SOUTH 3.0 HR   $     793.00
64100722   CHEMOTHERAPY IV 1-SOUTH 3.5 HR   $     924.75
64100729   CHEMOTHERAPY IV 1-SOUTH 4.0 HR   $   1,057.25
64100736   CHEMOTHERAPY IV 1-SOUTH 4.5 HR   $   1,189.25
64100743   CHEMOTHERAPY IV 1-SOUTH 5.0 HR   $   1,321.00
64100750   CHEMOTHERAPY IV 1-SOUTH 5.5 HR   $   1,453.00
64100757   CHEMOTHERAPY IV 1-SOUTH 6.0 HR   $   1,585.25
64100764   CHEMOTHERAPY IV 1-SOUTH 6.5 HR   $   1,717.00
64100771   CHEMOTHERAPY IV 1-SOUTH 7.0 HR   $   1,849.00
64100778   CHEMOTHERAPY IV 1-SOUTH 7.5 HR   $   1,981.00
64100785   CHEMOTHERAPY IV 1-SOUTH 8.0 HR   $   2,113.25
64100792   CHEMOTHERAPY IV 2-NORTH 3.0 HR   $     793.00
64100799   CHEMOTHERAPY IV 2-NORTH 3.5 HR   $     924.75
64100806   CHEMOTHERAPY IV 2-NORTH 4.0 HR   $   1,057.25
64100813   CHEMOTHERAPY IV 2-NORTH 4.5 HR   $   1,189.25
64100820   CHEMOTHERAPY IV 2-NORTH 5.0 HR   $   1,321.00
64100827   CHEMOTHERAPY IV 2-NORTH 5.5 HR   $   1,453.00
64100834   CHEMOTHERAPY IV 2-NORTH 6.0 HR   $   1,585.25
64100841   CHEMOTHERAPY IV 2-NORTH 6.5 HR   $   1,717.00
64100844   CHEMOTHERAPY IV 2-SOUTH 1.0 HR   $     264.50
64100848   CHEMOTHERAPY IV 2-NORTH 7.0 HR   $   1,849.00
64100855   CHEMOTHERAPY IV 2-NORTH 7.5 HR   $   1,981.00
64100862   CHEMOTHERAPY IV 2-NORTH 8.0 HR   $   2,113.25
64100869   CHEMOTHERAPY IV 2-SOUTH 3.0 HR   $     793.00
64100876   CHEMOTHERAPY IV 2-SOUTH 3.5 HR   $     924.75
64100883   CHEMOTHERAPY IV 2-SOUTH 4.0 HR   $   1,057.25
64100890   CHEMOTHERAPY IV 2-SOUTH 4.5 HR   $   1,189.25
64100897   CHEMOTHERAPY IV 2-SOUTH 5.0 HR   $   1,321.00
64100904   CHEMOTHERAPY IV 2-SOUTH 5.5 HR   $   1,453.00
64100911   CHEMOTHERAPY IV 2-SOUTH 6.0 HR   $   1,585.25
64100918   CHEMOTHERAPY IV 2-SOUTH 6.5 HR   $   1,717.00
64100925   CHEMOTHERAPY IV 2-SOUTH 7.0 HR   $   1,849.00
64100932   CHEMOTHERAPY IV 2-SOUTH 7.5 HR   $   1,981.00
64100939   CHEMOTHERAPY IV 2-SOUTH 8.0 HR   $   2,113.25
64101247   BLOOD ADM 2-NORTH 1.0 HR         $     232.25
64101317   INF IV HYDRAT INIT 1ST HR        $     150.00
64101324   INF IV HYDRAT EA ADD HR          $      30.00
64101331   DIRECT ADMIT FOR OBSV            $     268.25
64101338   OBSERVATION PER HOUR             $      65.75
64101345   BLOOD ADM EAST WING 1.0 HR       $     232.25
64101352   BLOOD ADM EAST WING 2.0 HRS      $     575.25
64101359   BLOOD ADM EAST WING 2.5 HRS      $     719.25
64101366   BLOOD ADM EAST WING 3.0 HRS      $     862.75
64101373   BLOOD ADM EAST WING 3.5 HRS      $   1,006.75
64101380   BLOOD ADM EAST WING 4.0 HRS      $   1,150.25
64101387   BLOOD ADM EAST WING 4.5 HRS      $   1,294.25
64101394   BLOOD ADM EAST WING 5.0 HRS      $   1,437.75
64101401   BLOOD ADM EAST WING 5.5 HRS      $   1,581.75
64101408   BLOOD ADM EAST WING 6.0 HRS      $   1,725.50
64101415   BLOOD ADM EAST WING 6.5 HRS      $   1,869.25
64101422   BLOOD ADM EAST WING 7.0 HRS      $   2,013.00
64101429   BLOOD ADM EAST WING 7.5 HRS      $   2,157.00
64101436   BLOOD ADM EAST WING 8.0 HRS      $   2,300.50
68000298   GUARD'S BREAKFAST                $       7.25
68000306   GUARD'S LUNCH / DINNER           $       9.50
80000011   BLS-E SH/SCENE-HOSP              $     441.00
80000029   BLS-NE SH/SCENE-HOSP             $     382.25
80010218   ALS NOTX/NO TRANSPORT            $     647.00
80010242   BLS-E RH/RESIDENCE-HOSP          $     441.00
80010259   BLS-E EH/ECF-HOSP                $     441.00
80010267   BLS-E HH/HOSP-HOSP               $     441.00
80010275   BLS-E SI/SCENE-SITE              $     441.00
80010283   BLS-E PH/MD OFFICE-HOSP          $     441.00
80010291   BLS-NE RH/RES-HOSP               $     382.25
80010309   BLS-NE EH/ECF-HOSP               $     382.25
80010317   BLS-NE HH/HOSP-HOSP              $     382.25
80010325   BLS-NE HR/HOSP-RES               $     382.25
80010333   BLS-NE ER/ECF-RESIDENCE          $     382.25
80010341   BLS-NE RE/RES-ECF                $     382.25
80010358   BLS-NE HE/HOSP-ECF               $     382.25
80010366   BLS-NE PH/MD OFFICE-HOSP         $     382.25
80010374   BLS-NE EP/ECF-MD OFFICE          $     382.25
80010390   BLS-E NH/SNF-HOSP                $   441.00
80010398   BLS-NE NH/SNF-HOSP               $   382.50
80010406   BLS-NE NR/SNF-RES                $   382.25
80010414   BLS-NE RN/RES-SNF                $   382.25
80010422   BLS-NE HN/HOSP-SNF               $   382.25
80010430   BLS-NE NP/SNF-MD OFFICE          $   382.25
80010438   BLS-NE RP/RES-MD OFFICE          $   382.25
80010446   BLS-NE PR/MD OFFICE-RES          $   382.25
80010454   BLS-NE PE/MD OFFICE-ECF          $   382.25
80010462   BLS-NE PN/MD OFFICE-SNF          $   382.25
80010469   BLS-NE PN/MD OFF-MD OFF          $   382.25
80010478   BLS-NE JH/DIALYSIS-HOSP          $   382.25
80010484   BLS-NE PN/MD OFF-MD OFF MILEAG   $    13.25
80020406   ALS1-NE HD/HOSP-DIAG TX          $   647.00
80020414   ALS1-NE DH/DIAG TX-HOSP          $   647.00
80020422   BLS-NE DH/DIAG TX-HOSP           $   382.25
80020450   BLS-NE HD/HOSP-DIAG TX           $   382.25
80020458   BLS-NE HJ/HOSP-DIALYSIS          $   382.25
80020466   BLS-NE IN/SITE-SNF               $   382.25
80020472   CRIT CARE SCT HH/HOSP-HOSP       $   764.50
80020479   ALS SH/SCENE-HOSP MILEAGE        $    13.25
80020486   BLS-E SH/SCENE-HOSP MILEAGE      $    13.25
80020493   BLS-NE SH/SCENE-HOSP MILEAGE     $    13.25
80020500   ALS RH/RES-HOSP MILEAGE          $    13.25
80020507   ALS EH/ECF-HOSP MILEAGE          $    13.25
80020514   ALS HH/HOSP-HOSP MILEAGE         $    13.25
80020521   ALS PH/MD OFFICE-HOSP MILEAGE    $    13.25
80020528   ALS SI/SCENE-SITE MILEAGE        $    13.25
80020535   BLS-E RH/RES-HOSP MILEAGE        $    13.25
80020542   BLS-E EH/ECF-HOSP MILEAGE        $    13.25
80020549   BLS-E HH/HOSP-HOSP MILEAGE       $    13.25
80020556   BLS-E SI/SCENE-SITE MILEAGE      $    13.25
80020563   BLS-E PH/MD OFFICE-HOSP MILEAG   $    13.25
80020570   BLS-NE RH/RES-HOSP MILEAGE       $    13.25
80020577   BLS-NE EH/ECF-HOSP MILEAGE       $    13.25
80020584   BLS-NE HH/HOSP-HOSP MILEAGE      $    13.25
80020661   BLS-NE HR/HOSP-RES MILEAGE       $    13.25
80020668   BLS-NE ER/ECF-RESIDENCE MILEAG   $    13.25
80020675   BLS-NE RE/RES-ECF MILEAGE        $    13.25
80020682   BLS-NE HE/HOSP-ECF MILEAGE       $    13.25
80020689   BLS-NE PH/MD OFFICE-HOSP MILEA   $    13.25
80020696   BLS-NE EP/ECF-MD OFFICE MILEAG   $    13.25
80020703   ALS NH/SNF-HOSP MILEAGE          $    13.25
80020710   BLS-E NH/SNF-HOSP MILEAGE        $    13.25
80020717   BLS-NE NH/SNF-HOSP MILEAGE       $    13.25
80020724   BLS-NE NR/SNF-RES MILEAGE        $    13.25
80020731   BLS-NE RN/RES-SNF MILEAGE        $    13.25
80020738   BLS-NE HN/HOSP-SNF MILEAGE       $    13.25
80020745   BLS-NE NP/SNF-MD OFFICE MILEAG   $    13.25
80020752   BLS-NE RP/RES-MD OFFICE MILEAG   $    13.25
80020759   BLS-NE PR/MD OFFICE-RES MILEAG   $    13.25
80020766   BLS-NE PE/MD OFFICE-ECF MILEAG   $    13.25
80020773   BLS-NE PN/MD OFFICE-SNF MILEAG   $    13.25
80020780   BLS-NE JH/DIALYSIS-HOSP MILEAG   $    13.25
80020787   ALS1-NE HD/HOSP-DIAG TX MILEAG   $    13.25
80020794   ALS1-NE DH/DIAG TX-HOSP MILEAG   $    13.25
80020801   BLS-NE DH/DIAG TX-HOSP MILEAGE   $    13.25
80020808   BLS-NE HD/HOSP-DIAG TX MILEAGE   $    13.25
80020815   BLS-NE HJ/ HOSP-DIALYSIS MILEA   $    13.25
80020822   BLS-NE IN/SITE-SNF MILEAGE       $    13.25
80020829   CRIT CARE SCT HH/HOSP-HOSP MIL   $    13.25
80020836   ALS1-NE SH/SCENE-HOSP            $   647.00
80020843   ALS1-NE SH/SCENE-HOSP MILEAGE    $    13.25
80020850   ALS1-E SH/SCENE-HOSP             $   647.00
80020857   ALS1-E SH/SCENE-HOSP MILEAGE     $    13.25
80020864   ALS1-NE RH/RES-HOSP              $   647.00
80020871   ALS1-NE RH/RES-HOSP MILEAGE      $    13.25
80020878   ALS1-E RH/RES-HOSP               $   647.00
80020885   ALS1-E RH/RES-HOSP MILEAGE       $    13.25
80020892   ALS1-NE EH/ECF-HOSP              $   647.00
80020899   ALS1-NE EH/ECF-HOSP MILEAGE      $    13.25
80020906   ALS1-E EH/ECF-HOSP               $   647.00
80020913   ALS1-E EH/ECF-HOSP MILEAGE       $    13.25
80020920   ALS1-NE HH/HOSP-HOSP             $   647.00
80020927   ALS1-NE HH/HOSP-HOSP MILEAGE     $    13.25
80020934   ALS1-E HH/HOSP-HOSP              $   647.00
80020941   ALS1-E HH/HOSP-HOSP MILEAGE      $    13.25
80020948   ALS1-NE PH/OFFICE-HOSP           $   647.00
80020955   ALS1-NE PH/OFFICE-HOSP MILEAGE   $    13.25
80020962   ALS1-E PH/OFFICE-HOSP            $   647.00
80020969   ALS1-E PH/OFFICE-HOSP MILEAGE    $    13.25
80020976   ALS1-NE SI/SCENE-SITE            $   647.00
80020983   ALS1-NE SI/SCENE-SITE MILEAGE    $    13.25
80020990   ALS1-E SI/SCENE-SITE             $   647.00
80020997   ALS1-E SI/SCENE-SITE MILEAGE     $    13.25
80021004   ALS1-NE NH/SNF-HOSP              $   647.00
80021011   ALS1-NE NH/SNF-HOSP MILEAGE      $    13.25
80021018   ALS1-E NH/SNF-HOSP               $   647.00
80021025   ALS1-E NH/SNF-HOSP MILEAGE       $    13.25
80021039   ALS2 SH/SCENE-HOSP               $   647.00
80021043   ALS2 SH/SCENE-HOSP MILEAGE       $    13.25
80021046   ALS2 RH/RES-HOSP                 $   647.00
80021053   ALS2 RH/RES-HOSP MILEAGE         $    13.25
80021060   ALS2 EH/ECF-HOSP                 $   647.00
80021067   ALS2 EH/ECF-HOSP MILEAGE         $    13.25
80021088   ALS2 PH/MD OFICE-HOSP            $   647.00
80021095   ALS2 PH/MD OFFICE-HOSP MILEAGE   $    13.25
80021102   ALS2 SI/SCENE-SITE               $   647.00
80021109   ALS2 SI/SCENE-SITE MILEAGE       $    13.25
80021116   ALS2 NH/SNF-HOSP                 $   647.00
80021123   ALS2 NH/SNF-HOSP MILEAGE         $    13.25
80021130   ALS1-NE NJ/SNF-DIALYSIS          $   647.00
80021137   ALS1-NE JN/DIALYSIS-SNF          $   647.00
80021144   ALS1-NE NJ/SNF-DIALYSIS MILEAG   $    13.25
80021151   ALS1-NE JN/DIALYSIS-SNF MILEAG   $    13.25
80021158   BLS-NE-NJ/SNF-DIALYSIS           $   382.25
80021165   BLS-NE JN/DIALYSIS-SNF           $   382.25
80021172   BLS-NE NJ/SNF-DIALYSIS MILEAGE   $    13.25
80021179   BLS-NE JN/DIALYSIS-SNF MILEAGE   $    13.25
80021186   ALS NO TRANSPORT MILEAGE         $    13.25
80021194   BLS-NE NN/TCU-SNF                $   382.25
80021202   BLS-NE NN/TCU-SNF MILEAGE        $    13.25
80021210   BLS-NE NE/TCU-ECF                $   382.25
80021218   BLS-NE NE/TCU-ECF MILEAGE        $    13.25
80021226   BLS-NE NR/TCU-RES                $   382.25
80021234   BLS-NE NR/TCU-RES MILEAGE        $    13.25
80021242   BLS-NE NH/TCU-HOSP               $   382.25
80021250   BLS-NE NH/TCU-HOSP MILEAGE       $    13.25
80021258   BLS-NE NJ/TCU-DIALYSIS           $     382.25
80021266   BLS-NE NJ/TCU-DIALYSIS MILEAGE   $      13.25
80021274   BLS-NE JN/DIALYSIS-TCU           $     382.25
80021282   BLS-NE JN/DIALYSIS-TCU MILEAGE   $      13.25
80021290   BLS-NE ND/TCU-DIAG               $     382.25
80021298   BLS-NE ND/TCU-DIAG MILEAGE       $      13.25
80021306   BLS-NE DN/DIAG-TCU               $     382.25
80021312   BLS-NE DN/DIAG-TCU MILEAGE       $      13.25
80021319   BLS-NE HI/HOSP-SITE              $     382.25
80021326   BLS-NE HI/HOSP-SITE MILEAGE      $      13.25
80021333   BLS-NE ES/ECF-SNF                $     382.25
80021340   BLS-NE ES/ECF-SNF MILEAGE        $      13.25
80021347   BLS-NE HP/HOSP-MD OFFICE         $     382.25
80021354   BLS-NE HP/HOSP-MD OFF MILEAGE    $      13.25
80021361   BLS-NE NN/SNF-SNF                $     382.25
80021375   BLS-NE NN/SNF-SNF MILEAGE        $      13.25
80021382   BLS-NE RR/RES-RES                $     382.25
80021389   BLS-NE RR/RES-RES MILEAGE        $      13.25
80021396   BLS-E HP/HOSP-MD OFFICE          $     441.00
80021403   BLS-E HP/HOSP-MD OFFICE MILEAG   $      13.25
80021417   CPR NO TRANSPORT                 $     441.00
80021424   ALS1-E JH/DIALYSIS-HOSP          $     647.00
80021431   ALS1-E JH/DIALYSIS-HOSP MILEAG   $      13.25
80021438   ALS1-E HP/HOSP-MD OFFICE         $     647.00
80021445   ALS1-E HP/HOSP-MD OFF MILEAGE    $      13.25
80100001   NEW PATIENT COMPREHENSIVE        $      82.00
80100019   CLIENT ORIENTATION EA 15         $      13.25
80100035   PF VAGINAL DELIVERY/DAHLE MD     $   1,318.00
80100043   PF C-SECTION/DAHLE,MD            $   2,262.50
80100050   PF INITIAL OBSTETRICAL VISIT     $     183.00
80100068   INI NUTRITION ASSMT FIRST 30     $      25.50
80100084   PF D & C/ DAHLE,MD               $   1,227.75
80100092   PF ECTOPIC PREGNANCY/DAHLE MD    $   1,227.75
80100100   INI OFF-VISIT WITHIN 16 WK LMP   $     265.00
80100118   INI NUTRITION ASSMT ADDL 15      $      13.25
80100134   PF AMNIOCENTESIS/DAHLE,MD        $     663.50
80100142   PF OCT INTERPRETATION/DAHLE,MD   $     172.50
80100159   ANTEPARTUM OFFICE VISIT          $      88.00
80100167   F/U ANTEPARTUM NUTRITION ASSMT   $      13.25
80100183   PF NST INTERPRETATION/DAHLE MD   $     172.50
80100191   PF CST INTERPRETATION/DAHLE MD   $     172.50
80100209   PRE-OP VISIT                     $      56.00
80100217   F/U NUTRITIONAL GROUP            $       5.00
80100233   PF INITIAL HOSP DAY/DAHLE MD     $     123.25
80100241   PF SUBSEQ HOSP CARE/DAHLE MD     $      82.00
80100258   POST OP VISIT                    $      56.00
80100266   POST-PARTUM NUTRITIONAL ASSMT    $      13.25
80100274   ULTRASOUND REPORT ONLY           $      74.00
80100282   PF DISCHARGE DAY/DAHLE MD        $      41.25
80100290   PF VAGINAL DELIVERY/LEON MD      $   1,318.00
80100308   POSTPARTUM VISIT                 $      88.00
80100316   INITIAL ASSMT/CARE PLAN 30       $      25.50
80100332   PF C-SECTION/LEON MD             $   2,262.50
80100340   PF D & C/ LEON MD                $   1,227.75
80100357   TREATMENT ROOM                   $      41.25
80100365   INI. ASSMT/CARE PLAN ADDL 15     $      13.25
80100381   PF ECTOPIC PREGNANCY/LEON MD     $   1,227.75
80100399   PF AMNIOCENTESIS/LEON MD         $     172.50
80100407   ANTERPARTUM VISIT 10TH & SBSQT   $     164.00
80100415   F/U ANTEPARTUM ASSMT/TX/INTVNT   $      13.25
80100431   PF OCT INTERPRETATION/LEON MD    $     172.50
80100449   PF NST INTERPRETAT /LEON MD      $     172.50
80100456   OFFICE VISIT NEW PATIENT         $     112.25
80100480   PF CST INTERPRETATION/LEON MD    $     172.50
80100506   OFFICE VISIT ESTAB PT.           $      69.75
80100514   POSTPARTUM ASSMT/INTVNT/C-PLAN   $      13.25
80100530   PF SUBSEQ HOSP CARE/LEON MD      $      82.00
80100548   PF DISCHARGE DAY/LEON MD         $      41.25
80100555   GLUCOMETER BLOOD SUGAR           $      13.25
80100563   INI.HEALTH-EDU ASSMT 30          $      25.50
80100605   WET MOUNT                        $      26.00
80100613   INI.HEALTH-EDU ASSMT/ADD 15      $      13.25
80100621   TCA TREATMENT                    $      58.00
80100628   URINALYSIS DIP TEST              $       2.83
80100654   PREG URINE VISUAL                $     110.50
80100662   F/U ANTEPARTUM HLTH-EDU ASSMT    $      13.25
80100704   NON-STRESS TEST                  $     172.50
80100712   F/U ANTEPARTUM HLTH-ED GRP/15    $       5.00
80100753   RHOGAM-RHO D IMM GLOB HUMAN      $     131.50
80100761   PF PERINATAL EDUC INDIVID./15    $      13.25
80100803   PRENATAL VITAMINS 300 DAY SPLY   $      60.00
80100811   PERINATAL EDUC GROUP/15          $       5.00
80100860   POST-PARTUM ASSMT/TX/INTERVENT   $      13.25
80100951   INI COMPREHENSIVE CARE PLAN      $     200.75
80100985   PF VAGINAL DELIVERY/GODDARD MD   $   1,318.00
80100993   PF C-SECTION/GODDARD MD          $   2,262.50
80101025   PF D & C/GODDARD MD              $   1,227.75
80101033   PF ECTOPIC PREGNANCY/GODDARD     $   1,227.75
80101041   PF AMNIOCENTESIS/GODDARD MD      $     172.50
80101058   PF OCT INTERPRETATION/GODDARD    $     172.50
80101066   PF NST INTERPRETATION/GODDARD    $     172.50
80101074   PF CST INTERPRETATION/GODDARD    $     172.50
80101082   PF INITIAL HOSP DAY/GODDARD      $     123.25
80101090   PF SUBSEQ HOSP CARE/GODDARD      $      82.00
80101108   PF DISCHARGE DAY/GODDARD         $      41.25
80101116   PF C-SECTION ASSIST/DAHLE        $     246.00
80101124   PF C-SECTION ASSIST/MICHELIN     $     246.00
80101132   PF C-SECTIO ASSIST/LEON          $     246.00
80101157   PF C-SECTION ASSIST/GODDARD      $     246.00
80101173   PF C-SECTION ASSIST/MISC         $     246.00
80101215   PF LIMITED U.S./DAHLE            $     147.50
80101231   PF LIMITED U.S./LEON             $     147.50
80101256   PF LIMITED U.S./GODDARD          $     147.50
80101264   PF COMPLETE U.S./DAHLE           $     181.75
80101280   PF COMPLETE U.S/LEON MD          $     181.75
80101306   PF COMPLETE U.S./GODDARD MD      $     181.75
80101330   PF INITIAL HOSP DAY/LEON MD      $     123.25
80101397   PF TUBAL LIGATION/ DAHLE MD      $     601.00
80101405   PF TUBAL LIGATION/ LEON MD       $     601.00
80101439   PF TUBAL LIGATION/GODDARD MD     $     601.00
80101603   PF VAGINAL DELIVERY/MALVEHY MD   $   1,318.00
80101611   PF C-SECTION/MALVEHY MD          $   2,262.50
80101619   PF D & C/MALVEHY MD              $   1,227.75
80101627   PF ECTOPIC PREGNANCY/MALVEHY     $   1,227.75
80101635   PF AMNIOCENTESIS/MALVEHY MD      $     663.50
80101643   PF OCT INTERPRETATION/MALVEHY    $     172.50
80101651   PF NST INTERPRETATION/MALVEHY    $     172.50
80101659   PF CST INTERPRETATION/MALVEHY    $     172.50
 80101667   PF INTIAL HOSP DAY/MALVEHY MD    $     123.25
 80101675   PF SUBSEQ HOSP CARE/MALVEHY MD   $      82.00
 80101683   PF DISCHARGE DAY/MALVEHY MD      $      41.25
 80101691   PF C-SECTION ASSIST/MALVEHY MD   $     246.00
 80101699   PF LIMITED U.S./MALVEHY MD       $     147.50
 80101707   PF TUBAL LIGATION/MALVEHY MD     $     601.00
 80101721   DEPO PROVERA (MHC) 150 MG INJ    $     179.00
 80101728   PF VAGINAL DELIVERY/RETHERFORD   $   1,318.00
 80101735   PF C-SECTION/RETHERFORD MD       $   2,262.50
 80101742   PF D & C/RETHERFORD MD           $   1,227.75
 80101749   PF ECTOPIC PREGNCY/RETHERFORD    $   1,227.75
 80101756   PF AMNIOCENTESIS/RETHERFORD MD   $     663.50
 80101763   PF OCT INTERPRET./RETHERFORD     $     172.50
 80101770   PF NST INTERPRET./RETHERFORD     $     172.50
 80101777   PF CST INTERPRET./RETHERFORD     $     172.50
 80101784   PF INITIAL HOSP DAY/RETHERFORD   $     123.25
 80101791   PF SUBSEQ HOSP CARE/RETHERFORD   $      82.00
 80101798   PF DISCHARGE DAY/RETHERFORD MD   $      41.25
 80101805   PF LIMITED U.S./RETHERFORD MD    $     147.50
 80101812   PF COMPLETE U.S./RETHERFORD MD   $     181.75
 80101819   PF TUBAL LIGATION/ RETHERFORD    $     601.00
 80101826   PF C-SECTION ASSIST/RETHERFORD   $     246.00
 99060006   ONE SOUTH MED SURG               $   1,571.00
 99060014   ONE SOUTH PEDIATRIC              $   1,571.00
 99060022   2 NORTH MED SURG                 $   1,571.00
 99060030   2 NORTH PEDIATRIC                $   1,571.00
 99060046   2 SOUTH MED SURG                 $   1,571.00
 99060054   2 SOUTH PEDIATRICS               $   1,571.00
 99060062   ICU                              $   3,549.00
 99060070   ICU GENERAL DUTY                 $   1,571.00
 99060096   ICU PEDIATRICS                   $   3,549.00
 99060107   MED SURG EAST WING PEDIATRICS    $   1,571.00
 99060114   MEDICAL SURGICAL EAST WING       $   1,571.00
 99060122   NURSERY                          $   1,328.00
 99060130   NURSERY PEDIATRICS               $   1,571.00
 99060147   TRANSITIONAL CARE                $   1,241.00
 99060170   OB                               $   1,571.00
 99060177   NURSERY SP CARE/BORDER           $   1,571.00
 99060519   LABOR AND DELIVERY ROOM          $   1,571.00
 99060642   MED SURG CONCENTRATED CARE       $   2,964.00
 99060650   MED SURG CONCENTRATE CARE PEDS   $   2,964.00
 99060974   2 SOUTH MED SURG W/TELEMETRY     $   2,421.00
405158999   IV SOLUTION 0.9% SOD CHL 150ML   $     129.50
405159055   IV SOLUTION 5% DEXTROSE 500ML    $     129.50
405159056   IV SOLUTION 5% DEXTROSE 250ML    $     129.50
405159961   IV SOLUTION 5% DEXTROSE 100ML    $     129.50
405162142   IV SOLUTION 0.9% SOD CHL 100ML   $     129.50
405192366   IV SOLUTION 5% DEXTROSE 1000ML   $     129.50
405192368   IV SOLUTION 10% DEXTROSE 500ML   $     129.50
405192370   IV SOLUTION D5%-0.9% NS 1000ML   $     129.50
405192372   IV SOLUTION 5%D-0.45% NS 1000M   $     129.50
405192375   IV SOLUTION 5%D-.20% NS 1000ML   $     129.50
405192380   NS 45%-D 5%-POT CHL 0.15% 1000   $     129.50
405192385   NS 0.9%-D5%-POT CHL 0.15% 1000   $     129.50
405192390   IV SOLUTION L-R 1000ML           $     129.50
405192391   IV SOLUTION L-R 5% DEXT 1000ML   $     129.50
405192393   IV SOLUTION 0.9% SOD CHL 1000M   $     129.50
405192394   IV SOLUTION 0.9% SOD CHL 500ML   $     129.50
405192395   IV SOLUTION 0.9% SOD CHL 250ML   $     129.50
405192396   IV SOLUTION 0.45% SOD CHL 1000   $     129.50
405192423   IV SOLUTION 5% DEXTROSE 50ML     $     129.50
405192557   IV SOLUTION L-R 500ML            $     129.50
405192640   NS 0.9%-0.15% POT CHL 1000ML     $     129.50
405192650   IV SOLUTION D5%-0.45% NS 500ML   $     129.50
408106638   SLING SHOULDER ULTRA 2           $     415.75
408106972   BRUSH INTRA MEDULLARY #14        $     100.25
408108626   MESH MARLEX 6X6                  $     360.50
408110369   PLATE TIB PROX 4H 4.5M           $   6,725.75
408116205   ENDO GIA 12MM UNIVERSAL          $   1,881.00
408120499   TUBE TRACH SHILEY 10LPC          $     454.50
408121935   MESH 3D MAX RT & LT              $   1,443.00
408127397   STAPLER 3.5MM 6035S              $   2,049.00
408132476   NEEDLE COLORADO 3CM              $     265.25
408138774   STAPLER RELOAD 45MM 2.5          $   2,046.25
408139784   STAPLER RELOAD 60MM 3.5          $   2,250.50
408139785   STAPLER RELOAD 60MM 2.5          $   2,604.00
408141306   SUTURE ANCHOR CORKSCREW 5.5MM    $   2,301.00
408149334   SCREW LOCKING SZ 16MM            $     850.25
408149989   CATH SWAN GANZ 7.5FR 110CM 5LM   $     501.25
408151149   SCREW CANNULA LOCK 5.0 X 75MM    $   1,388.50
408152313   PLATE LCPM 6M 3.5 X 77           $   2,215.25
408152332   PLATE 1/2 TUBULAR LCP 5 HOLE     $   1,178.00
408152730   PROBE PACING SWAN GANZ           $   1,148.75
408156762   SCREW CANNULA LOCK 5.0 X 70MM    $   1,388.50
408170907   POLYP RETRIEVAL NET ROTH         $     608.50
408177618   SCREW CANNULA LOCK 5.0 X 30MM    $   1,388.50
408177755   SCREW LOCKING 4 X 46MM           $     990.75
408177756   SCREW LOCKING 4 X 42MM           $     990.75
408184185   SCALPEL ACE HARMONIC CRVD 23P    $   2,597.50
408189202   BASKET NITRONOL 4 WIRE 10MM      $   1,410.25
408190844   PERAGGE TRANS-OPT SYSTEM         $   8,453.50
408190887   WOUND RETRACTOR MED              $     195.00
408194761   WOUND RETRACTOR SM               $     195.00
408205213   RETRIEVAL SYSTEM MANARCH         $     516.75
408205303   FORCEP GYRUS 5MM DISP.           $   2,878.00
408214853   PLATE TIBIAL 3.5MM 6 HOLE LT     $   7,213.50
408215023   PLATE PROX LOCK 3.5 X 196M       $   7,992.50
408216910   FORCEP GYRUS 10MM DISP           $   2,722.00
408216972   PLATE PROX 5H 3.5 X 142M         $   7,134.00
408219704   CANNULA 18GA X 145CM             $     189.00
408220051   PLATE TIBIAL 3.5MM 6 HOLE RT     $   7,213.50
408220913   CENTRAL LINE INSERTION KIT       $     217.00
408223140   PLATE TIBIAL 3.5MM 8 HOLE RT     $   7,287.50
408223852   PLATE PROX 12H 3.5 X 268M        $   8,273.50
408223854   PLATE PROX 6 HOLE 3.5X160MM      $   7,420.00
408223983   GELPORT ACCESS DEVICE 120MM      $   3,795.00
408224123   PLATE TIBIAL 3.5MM 4 HOLE RT     $   7,213.50
408224124   PLATE TIBIAL 3.5MM 4 HOLE LT     $   7,213.50
408224125   PLATE TIBIAL 3.5MM 8 HOLE LT     $   7,287.50
408224126   PLATE TIBIAL 3.5MM 10 HOLE RT    $   7,361.75
408224128   PLATE TIBIAL 3.5MM 10 HOLE LT    $   7,361.75
408224129   PLATE TIBIAL 3.5MM 12 HOLE RT    $   7,441.25
408224138   PLATE TIBIAL 3.5MM 12 HOLE LT    $   7,441.25
408224139   PLATE TIBIAL 3.5MM 14 HOLE RT    $   7,536.75
408224140   PLATE TIBIAL 3.5MM 14 HOLE LT    $   7,536.75
408226153   SCREW CANNULA 70 X 80MM          $   2,059.25
408226158   SCREW CANNULA LOCK 5.0 X 75MM    $   1,388.50
408226195   SCREW CANNULA LOCK 5.0 X 8MM     $   1,388.50
408226229   SCREW CANNULA LOCK 5.0 X 35MM    $   1,388.50
408226233   SCREW LOCKING 5 X 45MM           $     990.75
408226835   GRAFT MINI MINK INJECTION        $   3,880.00
408231369   SPLINT DENVER SERIES 5000 MINI   $     320.00
408231370   SPLINT DENVER SER 5000 LARGE     $     320.00
408231371   SPLINT DENVER SERIES 5000 MED    $     320.00
408231372   SPLINT DENVER SERIES 4000        $     217.00
408233439   PLATE MED TIBIAL DISTAL 3.5MM    $   5,880.00
409148896   BOLUS MATERIAL 30 X 30 X 0.5CM   $     624.00
412107396   BIOPSY HANDPIECE 9G x 12CM       $   1,950.00
412107410   BIOPSY HANDPIECE 12G x 12CM      $   1,950.00
412142622   BIOPSY HANDPIECE 9G x 9CM        $   1,950.00
412163893   INTRODUCER SHEATH ANSEL FLEXOR   $     516.50
412198096   INTRODUCER SHEATH 7FRX0.38X10    $      94.25
412198098   INTRODUCER SHEATH 6FRX0.38X10    $      94.25
412200749   CATH RENAL ANGIO 7.5             $   2,644.25
412211429   CATH BALLOON SYNERGY 3x2x75      $   1,365.00
412217079   INTRODUCER SET 7FR X 30CM        $     312.50
412221383   BIOPSY SITE IDENTIFIER 13-09     $     585.00
412221384   BIOPSY SITE IDENTIFIER 13-12     $     585.00
412230285   BIOPSY SYS EX-CORE 18GA          $     468.00
423120499   TUBE TRACH SHILEY 10LPC          $     454.50
430220913   CENTRAL LINE INSERTION KIT       $     217.00
432220913   CENTRAL LINE INSERTION KIT       $     217.00
434220913   CENTRAL LINE INSERTION KIT       $     217.00
435220913   CENTRAL LINE INSERTION KIT       $     217.00
436220913   CENTRAL LINE INSERTION KIT       $     217.00
437220913   CENTRAL LINE INSERTION KIT       $     217.00
438220913   CENTRAL LINE INSERTION KIT       $     217.00
639120499   TUBE TRACH SHILEY 10LPC          $     454.50
                                    AB 1045 - List of 25 Common
                                   Outpatient Procedures for 2007
Hospital Name: Sierra Nevada Memorial Hospital
OSHPD Facility No: 106291023
Effective Date of Charges: June 1, 2007

In response to requests from hospitals and the public, OSHPD has developed this form to assist hospitals in
collecting and submitting the average charge for 25 common outpatient procedures performed by hospitals, as
required by AB 1045 (Chapter 532, Statutes of 2005). In developing this form, OSHPD compiled the outpatient
procedures reported by hospitals in 2006, analyzed 2005 hospital ambulatory surgery data collected by OSHPD,
and compared outpatient data obtained from CMS and DHS. Use of the OSHPD form is voluntary, but highly
encouraged, as it allows hospitals to report and the public to compare uniform information regarding common
outpatient procedures.
Evaluation & Management Services (CPT Codes 99201-99499)                    2007 CPT Code       Average Charge
  Emergency Room Visit, Level 2 (low to moderate severity)                       99282                    $293.00
  Emergency Room Visit, Level 3 (moderate severity)                              99283                    $476.25
  Emergency Room Visit, Level 4 (high severity)                                  99284                    $952.00
  Outpatient Visit, established patient, 15 minutes                              99213       n/a
Laboratory & Pathology Services (CPT Codes 80048-89356)                     2007 CPT Code       Average Charge
  Basic Metabolic Panel                                                          80048                     $68.75
  Blood Gas Analysis, including 02 saturation                                    82805       n/a
  Complete Blood Count, automated                                                85027                     $46.00
  Complete Blood Count, with differential WBC, automated                         85025                     $67.75
  Comprehensive Metabolic Panel                                                  80053                     $93.75
  Creatine Kinase (CK), (CPK), Total                                             82550                     $50.25
  Lipid Panel                                                                    80061                     $87.75
  Partial Thromboplastin Time                                                    85730                     $55.50
  Prothrombin Time                                                               85610                     $50.25
  Thyroid Stimulating Hormone                                                    84443                    $123.25
  Troponin, Quantitative                                                         84484                     $85.25
  Urinalysis, without microscopy                                            81002 or 81003                 $39.75
  Urinalysis, with microscopy                                               81000 or 81001                 $50.25
Radiology Services (CPT Codes 70010-79999)                                  2007 CPT Code       Average Charge
  CT Scan, Abdomen, with contrast                                                74160                  $2,754.25
  CT Scan, Head or Brain, without contrast                                       70450                  $1,935.50
  CT Scan, Pelvis, with contrast                                                 72193                  $2,240.25
  Mammography, Screening, Bilateral                                              77056                    $237.50
  MRI, Head or Brain, without contrast, followed by contrast                     70553                  $3,815.50
  Ultrasound, Abdomen, Complete                                                  76700                  $1,026.25
  Ultrasound, OB, 14 weeks or more, transabdominal                               76805                    $404.25
  X-Ray, Lower Back, four views                                                  72110                    $692.75
  X-Ray, Chest, two views                                                        71020                    $305.75
Medicine Services (CPT Codes 90281-99602)                                   2007 CPT Code       Average Charge
  Cardiac Catheterization, Left Heart, percutaneous                              93510
  Echocardiography, complete                                                     93307
  Electrocardiogram, routine, with interpretation and report                     93000       n/a
  Inhalation Treatment, pressurized or nonpressurized                            94640                    $257.50
  Physical Therapy, Evaluation                                                   97001                    $121.25
  Physical Therapy, Gait Training                                                97116                     $61.75
  Physical Therapy, Therapeutic Exercise                                         97110                     $61.75
     Office of Statewide Health Planning and Development                                AB 1045 (May 2007)
                                       AB 1045 - List of 25 Common
                                      Outpatient Procedures for 2007
Hospital Name: Sierra Nevada Memorial Hospital
OSHPD Facility No: 106291023
Effective Date of Charges: June 1, 2007

Surgery Services (CPT Codes 10021-69990)                                        2007 CPT Code        Average Charge
 Arthroscopy, Knee, with meniscectomy (medial or lateral)                           29881
 Arthroscopy, Shoulder, with partial acromioplasty                                  29826
 Carpal Tunnel Surgery                                                              64721
 Cataract Removal with Insertion of Intraocular Lens, 1 Stage                       66984
 Colonoscopy, diagnostic                                                            45378
 Colonoscopy, with biopsy                                                           45380
 Colonoscopy, with lesion removal, by snare technique                               45385
 Discission, secondary membranous cataract, laser surgery                           66821
 Endoscopy, Upper GI, with biopsy                                                   43239
 Endoscopy, Upper GI, diagnostic                                                    43235
 Excision, Breast Lesion                                                            19120
 Hernia Repair, Inguinal, 5 years and older                                         49505
 Injection, Diagnostic or Therapeutic substance, epidural                           62311
 Injection, Anesthetic or Steroid, transforaminal epidural                          64483
 Laparoscopic Cholecystectomy                                                       47562
 Tympanostomy (insert ventilating tube, general anesthesia)                         69436
 Tonsillectomy with Adenoidectomy, less than 12 years old                           42820

                                                                                2007 CPT Code
Other Common Outpatient Procedures (list as needed)                                                  Average Charge




  Count of Reported Procedures (minimum 25 required)
Instructions for Completing AB 1045 Common Outpatient Procedure Form
1. Enter Hospital Name and OSHPD Facility Number. Revise Effective Date of Charges, if necessary.
2. Enter Average Charge for at least 25 commonly performed outpatient procedures. For Evaluation & Management
   Services, do not include related ancillary charges. For all other procedures, include related ancillary charges.
   NOTE: The CPT codes are included on this form to help identify the listed procedures based on the principal
  procedure appearing on the patient's medical record. The average charge for all related services and procedures
   (e.g., supplies, drugs, lab, use of operating room, etc.) should be included in the average charge for that procedure.
3. Do not change procedure descriptions or CPT code references. Use "Other Common Outpatient Procedures"
   (rows 62-71) if you are unable to select procedures from list.
4. Submit completed form as Excel (.xls) file, along with chargemaster and percent change in gross revenue
   calculation, by e-mail to chargemaster@oshpd.ca.gov or by standard mail on CD.


      Office of Statewide Health Planning and Development                                       AB 1045 (May 2007)

				
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