CDM Item Number Revenue Code Service ID Service Mod1 Service Mod2 Service Mod3 Service Mod4 DRG

ervice Mod4 DRG Qualifier DRG Code Service Description Gross Charge Discounted Cash Price
1002160 164 ISOLATION 67.65 47.36
1007204 762 G0378 LEVEL 1 OBSERVATION EACH ADDL HR 52.10 36.47
1007205 762 G0378 LEVEL 2 OBSERVATION EACH ADDL HR 75.97 53.18
1007206 762 OBSERV SUBSEQUENT DATE SEVERE 57.25 40.08
1007210 762 G0378 LEVEL 1 OBSERVATION FIRST HR 271.33 189.93
1007211 762 G0378 LEVEL 2 OBSERVATION FIRST HR 352.73 246.91
1007213 710 PHASE II RECOVERY FIRST 1/2 HR 540.33 378.23
1007214 710 PHASE II RECOVERY ADDL 1/2 HR 302.72 211.90
1007215 480 92960 EXTERNAL ELECTRICAL CARDIOVERSION 1,655.90 1,159.13
1007216 480 92953 TEMPORARY TRANSCUTANEOUS PACING 1,697.30 1,188.11
1007217 300 36415 ROUTINE VENIPUNCTURE 115.91 81.14
1007224 391 36430 TRANSFUSION BLOOD PRODUCTS 1,237.75 866.43
1007225 260 96360 HYDRATION IV INFUSION INIT 31-60 MINS 424.31 297.02
1007226 260 96361 HYDRATE IV INFUSION ADD-ON 222.52 155.76
1007227 260 96365 THER/PROPH/DIAG IV INF INIT =<1 HR 613.96 429.77
1007228 260 96366 THER/PROPH/DIAG IV INF ADDON 216.25 151.38
1007230 260 96375 IV PUSH, SEQUENTIAL, NEW DRUG 179.68 125.78
1007232 761 90715 TCTANUS/DIPTH TOX-ADULT-IM/JET INJ 45.00 31.50
1007235 762 G0379 DIRECT REFERRAL FOR OBSERVATION SVCS 1,746.72 1,222.70
1007401 260 96372 INJECTION SC/IM 153.74 107.62
1007402 260 96374 IV PUSH, INITIAL 327.57 229.30
1007403 260 96376 IV PUSH, SEQUENTIAL, SAME DRUG+30 MIN 179.68 125.78
1007500 480 92950 CARDIOPULMONARY RESUSCITATION 800.70 560.49
1007501 300 82272 HEMOCCULT 17.05 11.94
1007502 761 51702 FOLEY CATHETER INSERTION 323.25 226.28
1007503 761 51701 STRAIGHT CATHETERIZATION 331.33 231.93
1007504 300 82948 CAPILLARY BLOOD GLUCOSE 27.95 19.57
1007505 761 36593 DECLOTTING BY THROMBOLYTIC AGENT 726.02 508.21
1007506 761 36591 COLLECTION OF BLOOD FROM VENOUS ACC 331.33 231.93
1007507 771 90471 IMMUNIZATION ADMIN 1 VACCINE 153.74 107.62
1007508 260 96367 TX/PROPH/DG ADDL SEQ IV INF 216.25 151.38
1007510 771 90472 IMMUNIZATION ADMIN EA ADDL 90.82 63.57
1008100 762 99218 OBSERVATION LOW IDPA 1 - 6.5 HOURS 401.50 281.05
1008101 762 99218 OBSERVATION LOW IDPA 6.51-12.5 HOURS 629.00 440.30
1008102 762 99218 OBSERVATION LOW IDPA 12.5-23 HOURS 1,027.00 718.90
1080004 335 96409 CHEMO ADMINISTRATION INTRAVENOUS PUSH 148.75 104.13
1080010 391 36430 TRANSFUSION BLD/BLD COMPONENTS 716.00 501.20
1080041 335 96413 CHEMO THERAPY ADMIN IV SINGLE DRUG 353.75 247.63
1090000 761 99211 OP VISIT, EST PT, LEVEL 1 202.37 141.66
1090001 510 99212 OP VISIT, EST PT, LEVEL 2 228.50 159.95
1090002 510 99213 OP VISIT, EST PT, LEVEL 3 228.50 159.95
1090003 510 99214 OP VISIT, EST PT, LEVEL 4 297.25 208.08
1090004 510 99215 OP VISIT, EST PT, LEVEL 5 376.00 263.20
1090050 510 51700 BLADDER INSTILLATION 353.75 247.63
1090100 510 90718 ADULT TETANUS TOXOID 83.25 58.28
1090101 510 96372 THER/PROPH/DIAG INJ SC/IM 153.74 107.62
1090102 260 96360 HYDRATION IV INFUSION INIT 31-60 MINS 424.31 297.02
1090103 260 96361 HYDRATE IV INFUSION ADD-ON 222.52 155.76
1090104 260 96365 THER/PROPH/DIAG IV INF INIT =<1 HR 613.96 429.77
1090105 260 96366 THER/PROPH/DIAG IV INF ADDON 216.25 151.38
1090106 260 96374 THER/PROPH/DIAG INJ IV PUSH 327.57 229.30
1090107 510 96376 TX/PRO/DX INJ SAME DRUG ADDON 125.62 87.93
1090108 260 96375 IV PUSH, SEQUENTIAL, NEW DRUG 145.77 102.04
1090109 771 90471 IMMUNIZATION ADMIN 1 VACCINE 153.74 107.62
1090110 510 36591 BLOOD COLLECTION/IMPLANTABLE DEVICE 331.33 231.93
1090111 510 36593 IMPLANTED DEVICE DECLOTTING 726.02 508.21
1090112 300 82962 CAPILLARY BLOOD GLUCOSE 27.95 19.57
1090114 510 51702 FOLEY CATHETER INSERTION 323.25 226.28
1090115 300 82272 OCCULT BLOOD,FECES,SINGLE-DIAGNOSTIC 17.06 11.94
1090118 260 96368 IV INFUSION, CONCURRENT 134.90 94.43
1090119 260 96523 IRRIGATION VAD/PORT FLUSH 203.28 142.30
1090120 260 96367 IV INFUSION, SEQUENTIAL NEW 216.25 151.38
1090121 771 90472 IMMUNIZATION ADMINISTRATION EA ADDL 90.82 63.57
1090122 761 G0463 Hosp OP Clinic Visit - MC 203.62 142.53
1090123 260 M0243 COVID MEDICATION INFUSION 617.40 432.18
1600485 71 STOCKINETTE 3 28.33 19.83
1601933 71 UROLOCK II ADAPTOR PT CHARGE 58.71 41.10
1604426 272 OR CHARGE INJECTION NEEDLE 23G 0.4 MM 173.43 121.40
1605241 272 BLADE DERMABLADE BIOPSY (PT CHG) 20.00 14.00
1606201 272 SENSOR OXYGEN ADULT/CHILD OXIMAX MAX-N 45.06 31.54
1607878 71 PT C HANDPIECE INTERPULSE W/HIGH FLOW TI 117.96 82.57
1608113 272 TUBE NASOJEJUNOSTOMY 10FR 140CM 93.86 65.70
1610167 278 C1713 MINI-MONSTER CANNULATED SHORT THREADED S 1,137.50 796.25
2000900 270 ATTENDS-NH 5.89 4.12
2000901 270 ATTENDS-ECF 3.59 2.51
2002000 440 AMBULATION TRAINING PER 10 MIN 5.75 4.03
2002002 440 BED MOBILITY PRACTICE PER 10 MIN 5.75 4.03
2002004 440 BATHING EXERCISES PER 10 MIN 5.75 4.03
2002006 440 CANE EXERCISES PER 10 MIN 5.75 4.03
2002008 440 DRESSING EXERCISES PER 10 MIN 5.75 4.03
2002010 440 ENDURANCE TRAINING PER 10 MIN 5.75 4.03
2002012 440 GROOMING EXERCISES PER 10 MIN 5.75 4.03
2002014 440 TRANSFER TRAINING PER 10 MIN 5.75 4.03
2002016 440 HOT PACK TREATMENTS PER 10 MIN 5.75 4.03
2002018 440 ICE PACK TREATMENTS PER 10 MIN 5.75 4.03
2002020 440 LOWER EXTREMITY EXERCISES PER 10 MIN 5.75 4.03
2002022 440 MAT EXERCISES PER 10 MIN 5.75 4.03
2002024 440 RANGE OF MOTION EXERCISES PER 10 MIN 5.75 4.03
2002026 440 SPLINTING PROCEDURES PER 10 MIN 5.75 4.03
2002028 440 TOILETING EXERCISES PER 10 MIN 5.75 4.03
2002030 440 UPPPER EXTREMITY EXERCISES PER 10 MIN 5.75 4.03
2005000 440 ADULT DAY CARE SERVICES PER HOUR 9.25 6.48
2005001 440 ADULT DAY CARE MEAL 4.75 3.33
2006002 270 ATTEND WIPES-NH 2.31 1.62
2006003 270 ATTEND WIPES-ECF 2.31 1.62
2006504 440 92507 SPEECH THERAPY PER 45 MIN 188.25 131.78
2007390 732 TELEMETRY-N H DAILY 211.75 148.23
2008183 129 NH RM & BD @ $100 A DAY 119.92 83.94
2008184 129 NH RM & BD @ $137.50 157.85 110.50
2008185 129 NH RM & BD @ $120 A DAY 143.76 100.63
2008186 129 NH RM & BD @ $125 A DAY 162.97 114.08
2008188 129 NH RM & BD @ $135 A DAY 161.95 113.37
2008189 129 NH RM & BD @ $130 A DAY 133.25 93.28
2008190 129 NH RM & BED @ $140 A DAY 180.91 126.64
2008191 129 NH RM & BD @ $150 A DAY 153.75 107.63
2008192 129 NH RM & BD @ $80 A DAY 104.29 73.00
2008193 129 NH RM & BD @ $67 A DAY 87.64 61.35
2008194 129 NH RM & BD @ $260 A DAY 260.00 182.00
2008195 129 NH RM & BD @ $160 A DAY 164.00 114.80
2008198 129 NH RM & BD @ $155 A DAY 201.41 140.99
2008200 129 NH RM & BED @ $145 A DAY 148.63 104.04
2008212 129 NH RM & BD @ $175 A DAY 179.38 125.57
2008214 129 NH RM & BD @ $185 A DAY 189.63 132.74
 2009000 270 K PUMP 35.88 25.12
3001010 360 20610 ARTHROCENTESIS MAJOR JT/BURSA 127.00 88.90
3001011 762 99220GF INITIAL OBSERVATION CARE HIGH 240.75 168.53
3001012 987 99223GF INITIAL HOSPITAL CARE HIGH 245.25 171.68
3001013 762 99219GF INITIAL OBSERVATION CARE MODERATE 170.75 119.53
3001014 987 99238GF HOSPITAL DISCHARGE MANAGEMENT <30 MIN 131.25 91.88
3001015 987 99232GF SUBSEQUENT HOSP E&M W/2 COMPONENTS 87.50 61.25
3001016 987 99222GF INITIAL HOSP E&M W/3 COMPONENTS 183.75 128.63
3001017 960 99315GF NUR FAC DISCHARGE DAY MANAGMT<30MIN 74.50 52.15
3001018 360 49561AS REPAIR INCIS/VENT HERNIA; INCAR/STRANG 2,801.50 1,961.05
3001019 360 49568AS IMPLANTATION OF MESH 656.75 459.73
3001020 987 19301AS MASTECTOMY PARTIAL 2,101.25 1,470.88
3001025 360 49505AS REPAIR INITIAL INGUINAL HERNIA 2,407.75 1,685.43
3001026 302 86580 TB INTRADERMAL TEST 10.50 7.35
3002005 960 99348GF HOME VISIT LOW COMPLEXITY ESTAB PT. 97.75 68.43
3002006 960 99201GF OFFICE VISIT NEW FOCUSED 52.50 36.75
3002007 960 99202GF OFFICE VISIT NEW EXPANDED 78.75 55.13
3002008 960 99203GF OFFICE VISIT NEW DETAILED 122.50 85.75
3002009 960 99204GF OFFICE VISIT NEW COMPREHENSIVE 175.00 122.50
3002010 960 99205GF OFFICE VISIT NEW COMPLEX 240.75 168.53
3002020 761 29580 STRAPPING; UNNA BOOT 87.50 61.25
3002021 360 1110026 BX SKIN/SUBQ TISS(SEP PRO); 1 LES 128.75 90.13
3002022 360 17110 DESTRCT WARTS/MOLLUSCUM TO 14 LES 109.50 76.65
3002023 360 11200 REMOVAL OF SKIN TAGS; UP TO 15 240.75 168.53
3002024 360 69210 REMOV IMPACTED CERUMEN (SEP PRO) 65.75 46.03
3002025 360 20552 TRIGGER POINT INJECTION ONE/TWO MUSCLES 87.50 61.25
3002026 360 10060 I&D ABCESS; SIMPL/SNGL 192.50 134.75
3002027 360 10140 I&D HEMATOMA/SEROMA/FLUID COLLEC 219.00 153.30
3002028 360 56405 I&D ABSCESS; PERINEUM 262.75 183.93
3002100 510 97597 SELECT DEBRIDEMENT 20 CM OR LESS 197.00 137.90
3002101 510 30901GF CONTROL NASAL HEMORR ANT SIMP 269.50 188.65
4000492 636 Tc99mm Ceretec 632.75 442.93
4001233 150 AUTO ALERT 20.00 14.00
4200300 320 7356050 XR BILATERAL KNEE 420.47 294.33
4780303 250 RIFAXIMIN 200MG TAB (XIFAXAN) 16.87 11.81
4780304 250 METHAZOLAMIDE 50MG 4.00 2.80
10001700 360 REMOVAL OF SKIN TAGS UP TO 15 855.25 598.68
10001701 360 EXCISION OF NEVUS SINGLE OR MULTIPLE >5 855.25 598.68
10001702 360 EXCISION OF LESION SINGLE OR MULTIPLE L5 855.25 598.68
10001703 360 SIMPLE WOUND DEBRIDEMENT CLEAN 855.25 598.68
10001704 360 SONO GUIDED ASPIRATION BIOPSY 855.25 598.68
10001705 360 SIMPLE WOUND EXPLORATION 855.25 598.68
10001706 360 SMPL WOUND EXPLOR W/ RMVL FOREIGN BD 855.25 598.68
10001707 360 EXCISION SINGLE NAIL MATRIX FNG TOE 1,644.50 1,151.15
10001708 360 EXCISION OF NEVUS MULTIPLE >4 1,644.50 1,151.15
10001709 360 EXCISION OF LESION MULTIPLE >4 1,644.50 1,151.15
10001710 360 INCISION DRAINAGE ABSCESS OR WOUND 1,644.50 1,151.15
10001711 360 WOUND DEBRIDEMENT CONTAMINATION 1,644.50 1,151.15
10001712 360 55250 VASECTOMY 5,976.34 4,183.44
10001713 360 SCLEROTHERAPY SPIDER VEINS 1,644.50 1,151.15
10001714 761 SPECIAL PROCEDURE FIRST 30 MIN. 157.25 110.08
10001715 761 SPECIAL PROCEDURE EACH ADDITIONAL 15 78.75 55.13
10002001 360 CARDIO VASCULAR LEVEL 1 156.00 109.20
10002002 360 CARDIO VASCULAR LEVEL 2 144.58 101.21
10002003 360 CARDIO VASCULAR LEVEL 3 163.96 114.77
10002004 360 CARDIO VASCULAR LEVEL 4 175.36 122.75
10002005 360 CARDIO VASCULAR LEVEL 5 181.95 127.37
10002006 360 CARDIO VASCULAR LEVEL 1 UNSCHEDULED 108.25 75.78
10002007 360 CARDIO VASCULAR LEVEL 2 UNSCHEDULED 106.75 74.73
10002008 360 CARDIO VASCULAR LEVEL 3 UNSCHEDULED 126.50 88.55
10002009 360 CARDIO VASCULAR LEVEL 4 UNSCHEDULED 129.50 90.65
10002010 360 CARDIO VASCULAR LEVEL 5 UNSCHEDULED 126.75 88.73
10002011 360 ENDOCRINE LEVEL 1 141.83 99.28
10002012 360 ENDOCRINE LEVEL 2 143.22 100.25
10002013 360 ENDOCRINE LEVEL 3 161.18 112.83
10002014 360 ENDOCRINE LEVEL 4 175.36 122.75
10002015 360 ENDOCRINE LEVEL 5 181.95 127.37
10002016 360 ENDOCRINE LEVEL 1 UNSCHEDULED 108.25 75.78
10002017 360 ENDOCRINE LEVEL 2 UNSCHEDULED 106.75 74.73
10002018 360 ENDOCRINE LEVEL 3 UNSCHEDULED 126.50 88.55
10002019 360 ENDOCRINE LEVEL 4 UNSCHEDULED 129.50 90.65
10002020 360 ENDOCRINE LEVEL 5 UNSCHEDULED 126.75 88.73
10002021 360 GASTROINTESTINAL LEVEL 1 143.22 100.25
10002022 360 GASTROINTESTINAL LEVEL 2 143.22 100.25
10002023 360 GASTROINTESTINAL LEVEL 3 161.18 112.83
10002024 360 GASTROINTESTINAL LEVEL 4 172.61 120.83
10002025 360 GASTROINTESTINAL LEVEL 5 179.19 125.43
10002026 360 GASTROINTESTINAL LEVEL 1 UNSCHEDULED 105.75 74.03
10002027 360 GASTROINTESTINAL LEVEL 2 UNSCHEDULED 104.50 73.15
10002028 360 GASTROINTESTINAL LEVEL 3 UNSCHEDULED 126.50 88.55
10002029 360 GASTROINTESTINAL LEVEL 4 UNSCHEDULED 129.50 90.65
10002030 360 GASTROINTESTINAL LEVEL 5 UNSCHEDULED 125.00 87.50
10002031 360 GYNECOLOGICAL LEVEL 1 141.83 99.28
10002032 360 GYNECOLOGICAL LEVEL 2 143.21 100.25
10002033 360 GYNECOLOGICAL LEVEL 3 161.18 112.83
10002034 360 GYNECOLOGICAL LEVEL 4 172.61 120.83
10002035 360 GYNECOLOGICAL LEVEL 5 179.19 125.43
10002036 360 GYNECOLOGICAL LEVEL 1 UNSCHEDULED 109.00 76.30
10002037 360 GYNECOLOGICAL LEVEL 2 UNSCHEDULED 107.50 75.25
10002038 360 GYNECOLOGICAL LEVEL 3 UNSCHEDULED 126.50 88.55
10002039 360 GYNECOLOGICAL LEVEL 4 UNSCHEDULED 129.50 90.65
10002040 360 GYNECOLOGICAL LEVEL 5 UNSCHEDULED 125.00 87.50
10002041 360 URINARY LEVEL 1 167.14 117.00
10002042 360 URINARY LEVEL 2 173.11 121.18
10002043 360 URINARY LEVEL 3 179.08 125.36
10002044 360 URINARY LEVEL 4 187.43 131.20
10002045 360 URINARY LEVEL 5 194.59 136.21
10002046 360 URINARY LEVEL 1 UNSCHEDULED 108.25 75.78
10002047 360 URINARY LEVEL 2 UNSCHEDULED 106.75 74.73
10002048 360 URINARY LEVEL 3 UNSCHEDULED 126.50 88.55
10002049 360 URINARY LEVEL 4 UNSCHEDULED 129.50 90.65
10002050 360 URINARY LEVEL 5 UNSCHEDULED 127.75 89.43
10002051 360 INTEGUMENTARY LEVEL 1 141.83 99.28
10002052 360 INTEGUMENTARY LEVEL 2 143.22 100.25
10002053 360 INTEGUMENTARY LEVEL 3 161.18 112.83
10002054 360 INTEGUMENTARY LEVEL 4 172.61 120.83
10002055 360 INTEGUMENTARY LEVEL 5 179.19 125.43
10002056 360 INTEGUMENTARY LEVEL 1 UNSCHEDULED 109.50 76.65
10002057 360 INTEGUMENTARY LEVEL 2 UNSCHEDULED 108.00 75.60
10002058 360 INTEGUMENTARY LEVEL 3 UNSCHEDULED 126.50 88.55
10002059 360 INTEGUMENTARY LEVEL 4 UNSCHEDULED 129.50 90.65
10002060 360 INTEGUMENTARY LEVEL 5 UNSCHEDULED 125.00 87.50
10002061 360 NEUROLOGICAL LEVEL 1 142.52 99.76
10002062 360 NEUROLOGICAL LEVEL 2 143.89 100.72
10002063 360 NEUROLOGICAL LEVEL 3 162.24 113.57
10002064 360 NEUROLOGICAL LEVEL 4 172.61 120.83
10002065 360 NEUROLOGICAL LEVEL 5 179.19 125.43
10002066 360 NEUROLOGICAL LEVEL 1 UNSCHEDULED 108.25 75.78
10002067 360 NEUROLOGICAL LEVEL 2 UNSCHEDULED 106.75 74.73
10002068 360 NEUROLOGICAL LEVEL 3 UNSCHEDULED 126.50 88.55
10002069 360 NEUROLOGICAL LEVEL 4 UNSCHEDULED 129.50 90.65
10002070 360 NEUROLOGICAL LEVEL 5 UNSCHEDULED 125.00 87.50
10002071 360 RESPIRATORY LEVEL 1 141.83 99.28
10002072 360 RESPIRATORY LEVEL 2 143.22 100.25
10002073 360 RESPIRATORY LEVEL 3 161.18 112.83
10002074 360 RESPIRATORY LEVEL 4 171.22 119.85
10002075 360 RESPIRATORY LEVEL 5 185.76 130.03
10002076 360 RESPIRATORY LEVEL 1 UNSCHEDULED 107.75 75.43
10002077 360 RESPIRATORY LEVEL 2 UNSCHEDULED 106.75 74.73
10002078 360 RESPIRATORY LEVEL 3 UNSCHEDULED 126.50 88.55
10002079 360 RESPIRATORY LEVEL 4 UNSCHEDULED 129.50 90.65
10002080 360 RESPIRATORY LEVEL 5 UNSCHEDULED 126.50 88.55
10002081 360 SKELETAL LEVEL 1 SCHEDULED 102.50 71.75
10002082 360 SKELETAL LEVEL 2 SCHEDULED 103.50 72.45
10002083 360 SKELETAL LEVEL 3 SCHEDULED 116.50 81.55
10002084 360 SKELETAL LEVEL 4 179.88 125.92
10002085 360 SKELETAL LEVEL 5 194.75 136.33
10002086 360 SKELETAL LEVEL 1 148.74 104.12
10002087 360 SKELETAL LEVEL 2 150.47 105.33
10002088 360 SKELETAL LEVEL 3 175.02 122.51
10002089 360 SKELETAL LEVEL 4 UNSCHEDULED 129.50 90.65
10002090 360 SKELETAL LEVEL 5 UNSCHEDULED 125.25 87.68
10002091 360 CANCEL LEVEL 1 PRIOR TO ANESTHESIA 51.25 35.88
10002092 360 CANCEL LEVEL 2 PRIOR TO ANESTHESIA 51.75 36.23
10002093 360 CANCEL LEVEL 3 PRIOR TO ANESTHESIA 58.50 40.95
10002094 360 CANCEL LEVEL 4 PRIOR TO ANESTHESIA 62.50 43.75
10002095 360 CANCEL LEVEL 5 PRIOR TO ANESTHESIA 61.75 43.23
10002096 360 CANCEL LEVEL 1 AFTER ANESTH INDUCT 70.25 49.18
10002097 360 CANCEL LEVEL 2 AFTER ANESTH INDUCT 69.50 48.65
10002098 360 CANCEL LEVEL 3 AFTER ANESTH INDUCT 126.50 88.55
10002099 360 CANCEL LEVEL 4 AFTER ANESTH INDUCT 129.50 90.65
10002100 360 CANCEL LEVEL 5 AFTER ANESTH INDUCT 81.00 56.70
10002101 360 BRONCHOSCOPY 5,235.80 3,665.06
10002102 360 UPPER GI ENDOSCOPY 3,653.41 2,557.39
10002103 360 MODERATE SEDATION TOTAL MINUTES 19.50 13.65
10002105 710 PACU PHASE 1 55.01 38.51
10002106 710 ASD PHASE 2 16.60 11.62
10002107 360 EDG COLONOSCOPY W/ DILAT 6,317.21 4,422.05
10002108 360 COLONOSCOPY 3,653.41 2,557.39
10002109 360 EDG COLONOSCOPY 4,612.12 3,228.48
10002110 360 DX. SINGLE ENDOSCOPY W / WO BX. 3,083.95 2,158.77
10002111 360 MULTIPLE ENDOSCOPIES W/WO BIOPSY 3,700.87 2,590.61
10002112 360 THERAPEUTIC SINGLE ENDO PLUS MINOR 4,317.79 3,022.45
10002113 360 ERCP 9,123.36 6,386.35
10002114 360 SPINE LEVEL 1 158.66 111.06
10002115 360 SPINE LEVEL 2 160.50 112.35
10002116 360 SPINE LEVEL 3 186.70 130.69
10002117 360 SPINE LEVEL 4 191.86 134.30
10002118 360 SPINE LEVEL 5 239.72 167.80
10002119 360 69990 OPERATING MICROSCOPE ADD ON 4,051.30 2,835.91
10002120 360 69990 OPERATING MICROSCOPE ADD ON 4,051.30 2,835.91
10002121 360 PAIN CLINIC LEVEL 2 BILAT 4,809.82 3,366.87
10002122 360 PODIATRY LEVEL 1 120.20 84.14
10002123 360 PODIATRY LEVEL 2 121.59 85.11
10002124 360 PODIATRY LEVEL 3 141.44 99.01
10002125 360 PODIATRY LEVEL 4 145.36 101.75
10002126 360 PODIATRY LEVEL 5 157.38 110.17
10002999 360 MINOR PROCEDURE RAD 2,760.22 1,932.15
10003000 360 MINOR PROCEDURE 2,840.27 1,988.19
10003001 360 PAIN CLINIC PROCEDURE 2,491.22 1,743.85
10003002 360 PAIN CLINIC LEVEL 2 3,206.55 2,244.59
10003003 360 BEDSIDE PROCEDURE 2,164.51 1,515.16
10003004 750 91110 PILLCAM PLACEMENT 2,840.38 1,988.27
10003005 761 99211 ASD NURSING SERVICE 202.37 141.66
10003015 360 CT GUIDED MINOR PROCEDURE 4,916.30 3,441.41
10003100 360 ACL RECONSTRUCTION 20,116.00 14,081.20
10003101 360 KNEE ARTHROSCOPY 9,889.57 6,922.70
10003102 360 ORIF DISTAL EXTREMITY 10,281.50 7,197.05
10003103 360 ORIF HIP 12,797.75 8,958.43
10003104 360 ORIF PATELLA 13,601.25 9,520.88
10003105 360 QUADRICEP TENDON REPAIR 11,821.25 8,274.88
10003106 360 ROTATOR CUFF REPAIR 20,414.89 14,290.42
10003107 360 SHOULDER ARTHROSCOPY 19,922.78 13,945.95
10003108 360 SHOULDER DECOMPRESSION DIS CLAVICAL 17,721.81 12,405.27
10003109 360 SHOULDER RESURFACE/ARTHROPLASTY 17,784.00 12,448.80
10003110 360 TOPAZ TENOTOMY 11,036.19 7,725.33
10003111 360 TOTAL KNEE REPLACEMENT 17,639.75 12,347.83
10003112 360 TOTAL HIP REPLACEMENT 15,779.50 11,045.65
10003113 360 ARTHRODESIS 8,860.41 6,202.29
10003114 360 BUNIONECTOMY 10,936.03 7,655.22
10003151 360 CYSTOSCOPY 8,580.06 6,006.04
10003152 360 LITHOTRIPSY 17,993.10 12,595.17
10003153 360 51700 BLADDER INSTILLATION 353.75 247.63
10003154 360 ESWL Rental 6,077.75 4,254.43
10003155 360 52441 CYSTO INSERTION TRANSPROSTATIC IMPLANT S 5,823.63 4,076.54
10003156 360 52442 ADDL TRANSPROSTATIC IMPLANT 1,535.32 1,074.72
10003157 360 C9739 CYSTO W/ INSERT 1 TO 3 IMPLANTS MC 14,920.45 10,444.32
10003158 360 C9740 CYSTO W/ INSERT TRANSPROSTATIC IMPLANT 4 28,190.76 19,733.53
10003160 360 CYSTOSCOPY W/ URETEROSCOPY 15,422.94 10,796.06
10003161 278 C1880 INFERIOR VENA CAVA FILTER 9,633.44 6,743.41
10003162 360 MEDIPORT PLACEMENT 10,596.80 7,417.76
10003163 360 LAPAROSCOPIC CHOLECYSTECTOMY 17,841.25 12,488.88
10003164 360 LAPAROSCOPIC NISSEN FUNDOPLICATION 25,326.91 17,728.84
10003165 360 LAPAROSCOPIC NISSEN CHOLECYSTECTOMY 25,326.91 17,728.84
10003166 360 PACEMAKER PLACEMENT 18,059.82 12,641.87
10003167 360 LAP PARAESOPHAG HERN REPAIR 31,122.62 21,785.83
10003168 360 UMBILICAL HERNIA REPAIR 10,906.77 7,634.74
10003170 360 CYSTO W/ LITHOTRIPSY 15,436.70 10,805.69
10004046 360 OR LEVEL 5 1HR 30 MINUTES 8,820.25 6,174.18
10004057 360 SCHEDULED CASE 110.25 77.18
10004058 360 UNSCHEDULED CASE (NOT ON CALL) 220.75 154.53
10004059 360 DISCONTINUED PROCEDURE LEVEL I 55.00 38.50
10004060 360 DISCONTINUED PROCEDURE LEVEL II 110.25 77.18
10004061 360 DISCONTINUED PROCEDURE LEVEL III 165.50 115.85
10004062 360 DISCONTINUED PROCEDURE LEVEL IV 220.75 154.53
10004063 360 DISCONTINUED PROCEDURE LEVEL V 275.75 193.03
10005617 480 51798 US PV RESIDUAL URINE BLDR SCAN 198.39 138.87
10006007 710 RECOVERY RM PHASE I FIRST 1/2 HOUR 736.75 515.73
10006015 710 99205 RECOVERY ROOM PHASE 1 ADDITIONAL 1/2 HR 484.00 338.80
10006016 360 EACH ADDITIONAL 15 MIN PACU I 375.25 262.68
10006017 360 EACH ADDITIONAL 15MIN PACU II 259.25 181.48
10006018 360 EXTEND RECOVERY >6 HOURS PACU II 6,223.50 4,356.45
10006019 360 PACU PHASE I AND PHASE II 2,452.50 1,716.75
10006020 360 ASD W ADDITIONAL DX SERVICES 129.50 90.65
10006743 360 45999 ENEMA 285.50 199.85
10006972 360 36425 VENIPUNCTURE CUTDOWN 17.25 12.08
10006973 360 36556 CENTRAL VENOUS CATHETER 869.00 608.30
10006974 360 36600 WITHDRAWAL OF ARTERIAL BLOOD 17.25 12.08
10006975 360 36593 DECLOTTING BY THROMBOLYTIC AGENT 192.50 134.75
10006976 360 36430 BLOOD TRANSFUSION 263.50 184.45
10006977 360 82948 GLUCOSE BLOOD REAGENT STRIP 4.50 3.15
10006988 360 96374 IV PUSH MEDICATION INITIAL 118.50 82.95
10006989 360 96372 IM INJ ANTIBIOTIC 122.50 85.75
10006991 360 96375 IV PUSH MEDICATION EACH SUBSEQUENT 122.50 85.75
10007010 920 91035 BRAVO PH MONITORING 1,747.61 1,223.33
10007011 360 ADDITIONAL 15MIN. LEVEL 2 490.75 343.53
10007012 360 ADDITIONAL 15MIN. LEVEL 1 478.75 335.13
10007013 360 OR LEVEL 1 30 MIN 957.25 670.08
10007014 360 OR LEVEL 2 TWO HOURS 3,557.00 2,489.90
10007015 360 OR LEVEL 1 ONE HOUR 1,849.50 1,294.65
10007016 360 OR LEVEL 1 ONE 1/2 HOUR 2,774.25 1,941.98
10007017 360 OR LEVEL 2 30 MINUTES 1,423.25 996.28
10007018 360 OR LEVEL 2 ONE HOUR 2,208.25 1,545.78
10007019 360 OR LEVEL 2 ONE 1/2 HOURS 2,945.00 2,061.50
10007020 360 OR LEVEL 3 30 MINUTES 2,208.25 1,545.78
10007021 360 ADDITIONAL 15 MIN. LEVEL 3 552.25 386.58
10007022 360 OR LEVEL 3 ONE HOUR 2,945.00 2,061.50
10007039 360 ADDITIONAL 15MIN. LEVEL 4 809.75 566.83
10007040 360 OR LEVEL 4 0.5HR 2,626.50 1,838.55
10007041 360 OR LEVEL 5 30 MINUTES 6,402.25 4,481.58
10007042 360 OR LEVEL 4 1HOUR 4,785.75 3,350.03
10007043 360 OR LEVEL 5 1HOUR 8,098.00 5,668.60
10007044 360 OR LEVEL 3 1HR 30 MIN 3,681.50 2,577.05
10007045 360 OR LEVEL 4 1HR 30 MIN 5,690.50 3,983.35
10007048 360 OR LEVEL 3 2 HOURS 4,418.25 3,092.78
10007049 360 OR LEVEL 4 2 HOURS 6,995.25 4,896.68
10007050 360 ADDITIONAL 15 MIN LEVEL 5 1,251.75 876.23
10007051 360 OR LEVEL 5 2 HOURS 11,043.25 7,730.28
10007052 360 OR LEVEL 3 2HR 30 MIN 4,979.00 3,485.30
10007053 360 OR LEVEL 4 2 HR 30 MIN 8,098.00 5,668.60
10007055 360 OR LEVEL 5 2.5 HOURS 12,516.25 8,761.38
10007056 360 OR LEVEL 3 3 HOURS 5,690.50 3,983.35
10007057 360 OR LEVEL 4 3 HOURS 8,892.50 6,224.75
10007058 360 OR LEVEL 5 3 HOURS 13,987.75 9,791.43
10007059 360 OR LEVEL 3 4 HOURS 7,114.00 4,979.80
10007060 360 OR LEVEL 4 4 HOURS 9,959.25 6,971.48
10007061 360 OR LEVEL 5 4 HOURS 14,938.25 10,456.78
10007062 360 OR LEVEL 4 5 HOURS 11,026.25 7,718.38
10007063 360 OR LEVEL 5 5 HOURS 16,360.25 11,452.18
10007064 360 OR LEVEL 4 6 HOURS 12,093.00 8,465.10
10007065 360 OR LEVEL 5 6 HOURS 17,783.50 12,448.45
10007066 360 OR LEVEL 5 7 HOURS 19,205.75 13,444.03
10007067 360 OR LEVEL 5 8 HOURS 20,628.75 14,440.13
10007068 360 OR LEVEL 5 9 HOURS 22,051.00 15,435.70
10007069 360 OR LEVEL 5 10HOURS 23,474.25 16,431.98
10007070 360 EACH ADDITIONAL 15 MIN PAC U 1 375.25 262.68
10007072 710 RECOVERY RM FIRST 1/2 HOUR PHASE 2 501.00 350.70
10007073 710 RECOVERY RM PHASE 2 EA ADD 30MIN 284.25 198.98
10007074 360 EACH ADDITIONAL 15 MIN PACU II 259.25 181.48
10007075 360 EXTENDED RECOVERY >6 HOURS PAC U II 6,223.50 4,356.45
10007076 360 PACU PHASE 1 AND PHASE II 2,452.50 1,716.75
10007077 710 ASD W ADDITIONAL DX SERVICES 129.50 90.65
10007086 360 96365 INFUSION THER OTHER THAN CHEMO 362.50 253.75
10008013 360 51701 CATH URETHRA; SIMPL 106.50 74.55
10008014 360 82948 GLUCOSE BLOOD REAGENT STRIP 25.00 17.50
10008015 360 G0107 COLORECTAL SCRN; HI RISK IND 18.50 12.95
10008020 360 51702 INSERTION TEMP INDWELLING CATH SIMP 106.50 74.55
10008021 360 50590 LITHOTRIPSY UNILATERAL 12,332.09 8,632.46
10008022 360 5059050 LITHOTRIPSY BILAT 18,528.93 12,970.25
10008023 750 91010 ESOPHAGEAL MANOMETRY 1,755.04 1,228.53
10008024 360 50590 ARTHROSCOPY 11,323.03 7,926.12
10008025 750 91034 RESTECH GASTROESOPH REFLUX W NASAL PH 1,755.04 1,228.53
10008050 360 FLEXIBLE SIGMOIDOSCOPY 2,547.47 1,783.23
10008051 360 LAP GASTROESOPH SPHINC AUG 25,326.91 17,728.84
10008052 360 46930 DESTRUCTION INTERNAL HEMORRHOID THERMAL 3,628.94 2,540.26
10008053 360 HOLMIUM LASER 2,998.25 2,098.78
10008054 360 GREENLIGHT LASER 5,942.48 4,159.74
10008055 360 200 MICRON FIBER 1,205.49 843.84
10008099 360 EWSL UNILAT LITHOTRIPS RENTAL 5,328.00 3,729.60
10008100 360 43280 LAP NISSEN 31,122.62 21,785.83
10008101 360 43775 LAP SLEEVE GASTRECTOMY 15,353.19 10,747.23
10008102 360 64488 TAP BLOCK BILAT 2,276.51 1,593.56
10008103 360 64415 NJX AA&/STRD BRACH PLEXUS 2,873.81 2,011.67
10008104 360 LAP APPENDECTOMY 11,121.96 7,785.37
10008105 360 CARPAL TUNNEL - Non ORTHO 6,128.79 4,290.15
10008106 360 INGUINAL HERNIA REPAIR 10,808.51 7,565.96
10008107 360 LESION REMOVAL 1-5 LESIONS 4,821.18 3,374.83
10008108 360 LESION REMOVAL 6-10 LESIONA 9,642.37 6,749.66
10008109 360 LAP REPAIR VENTRAL, UMBILICAL, AND/OR EP 17,208.41 12,045.89
10009001 274 SUPPLIES/DEVICES 1,061.00 742.70
10074500 279 GAMMA PROBE RENTAL 3,100.00 2,170.00
12000001 963 812 ANES LWR INTST SCR COLSC 159.79 111.85
12000002 963 731 ANES UPR GI NDSC PX NOS 159.79 111.85
12000003 963 811 ANES LWR INTST NDSC NOS 159.79 111.85
12000004 963 790 ANESTH SURG UPPER ABDOMEN 159.79 111.85
12000005 963 1810 ANESTH LOWER ARM SURGERY 159.79 111.85
12000006 963 400 ANESTH SKIN EXT/PER/ATRUNK 159.79 111.85
12000007 963 830 ANESTH REPAIR OF HERNIA LOWER NOS 159.79 111.85
12000008 963 1214 ANESTH HIP ARTHROPLASTY 159.79 111.85
12000010 963 1402 ANESTH KNEE ARTHROPLASTY 131.55 92.09
12000011 963 1610 ANESTH SURGERY OF SHOULDER 131.55 92.09
12000012 963 813 ANES UPR LWR GI NDSC PX 131.55 92.09
12000013 963 1920 ANESTH CATHETERIZE HEART 131.55 92.09
12000014 964 1920 ANESTH CATHETERIZED HEART 131.55 92.09
12000015 964 812 ANES LWR INTST SCR COLSC 131.55 92.09
12000016 964 1916 ANESTH DX ARTERIOGRAPHY 131.55 92.09
12000017 963 1916 ANESTH DX ARTERIOGRAPHY 131.55 92.09
12000018 964 731 ANES UPR GI NDSC PX NOS 131.55 92.09
12000019 963 1926 ANES TX INTERV RAD HRT/CRAN 131.55 92.09
12000020 964 1926 ANES TX INTERV RAD HRT/CRAN 131.55 92.09
12000021 964 811 ANES LWR INTST NDSC NOS 131.55 92.09
12000022 963 532 ANESTH VASCULAR ACCESS 131.55 92.09
12000023 964 532 ANESTH VASCULAR ACCESS 131.55 92.09
12000024 964 790 ANESTH SURG UPPER ABDOMEN 131.55 92.09
12000025 963 1922 ANESTH CAT OR MRI SCAN 131.55 92.09
12000026 964 1922 ANESTH CAT OR MRI SCANN 131.55 92.09
12000027 964 1810 ANESTH LOWER ARM SURGERY 131.55 92.09
12000028 964 813 ANES UPR LWR GI NDSC PX 131.55 92.09
12000029 964 400 ANESTH SKIN EXT/PER/ATRUNK 131.55 92.09
12000030 963 1951 ANESTH BURN LESS 4 PERCENT 131.55 92.09
12000031 964 1951 ANESTH BURN LESS 4 PERCENT 131.55 92.09
12000032 963 1952 ANESTH BURN 4-9 PERCENT 131.55 92.09
12000033 964 1952 ANESTH BURN 4-9 PERCENT 131.55 92.09
12000034 963 1953 ANESTH BURN EACH 9 PERCENT 131.55 92.09
12000035 964 1953 ANESTH BURN EACH 9 PERCENT 131.55 92.09
12000036 964 99100 SPECIAL ANESTHESIA SERVICE <1 OR >70 YRS 131.55 92.09
12000037 963 1200 ANESTH HIP JOINT PROCEDURE 131.55 92.09
12000038 964 1200 ANESTH HIP JOINT PROCEDURE 131.55 92.09
12000039 963 520 ANESTH CHEST PROCEDURE 131.55 92.09
12000040 964 520 ANESTH CHEST PROCEDURE 131.55 92.09
12000041 963 902 ANESTH ANORECTAL SURGERY 131.55 92.09
12000042 964 902 ANESTH ANORECTAL SURGERY 131.55 92.09
12000043 963 1270 ANESTH THIGH ARTERIES SURG 131.55 92.09
12000044 964 1270 ANESTH THIGH ARTERIES SURG 131.55 92.09
12000045 963 320 ANESTH NECK ORGAN 1YR/> 131.55 92.09
12000046 964 320 ANESTH NECK ORGAN 1YR/> 131.55 92.09
12000047 964 1214 ANESTH HIP ARTHROPLASTY 131.55 92.09
12000048 963 1480 ANESTH LOWER LEG BONE SURG 131.55 92.09
12000049 964 1480 ANESTH LOWER LEG BONE SURG 131.55 92.09
12000050 963 1250 ANESTH UPPER LEG SURGERY 131.55 92.09
12000051 964 1250 ANESTH UPPER LEG SURGERY 131.55 92.09
12000052 963 1440 ANESTH KENN ARTERIES SURG 131.55 92.09
12000053 964 1440 ANESTH KNEE SRTERIES SURG 131.55 92.09
12000054 963 846 ANESTH HYSTERECTOMY 131.55 92.09
12000055 964 846 ANESTH HYSTERECTOMY 131.55 92.09
12000056 963 904 ANESTH PERINEAL SURGERY 131.55 92.09
12000057 964 904 ANESTH PERINEAL SURGERY 131.55 92.09
12000058 963 300 ANESTH HEAD/NECK/PTRUNK 131.55 92.09
12000059 964 300 ANESTH HEAD/NECK/PTRUNK 131.55 92.09
12000060 963 752 ANESTH REPAIR OF HERNIA 131.55 92.09
12000061 964 752 ANESTH REPAIR OF HERNIA 131.55 92.09
12000062 963 524 ANESTH CHEST DRAINAGE 131.55 92.09
12000063 964 524 ANESTH CHEST DRAINAGE 131.55 92.09
12000064 963 1520 ANESTH LOWER LEG VEIN SURG NOS 131.55 92.09
12000065 964 1520 ANESTH LOWER LEG WEIN SURG NOS 131.55 92.09
12000066 963 702 ANESTH FOR LIVER BIOPSY 131.55 92.09
12000067 964 702 ANESTH FOR LIVER BIOPSY 131.55 92.09
12000068 963 1630 ANESTH SURGERY OF SHOULDER NOS 131.55 92.09
12000069 964 1630 ANESTH SURGERY OF SHOULDER NOS 131.55 92.09
12000070 963 1260 ANESTH UPPER LEG VEINS SURG 131.55 92.09
12000071 964 1260 ANESTH UPPER LEG VEINS SURG 131.55 92.09
12000072 963 1420 ANESTH KNEE JOINT CASTING 131.55 92.09
12000073 964 1420 ANESTH KNEE JOINT CASTING 131.55 92.09
12000074 963 730 ANESTH ABDOMINAL WALL SURG UPPER POST 131.55 92.09
12000075 964 730 ANESTH ADBOMINAL WALL SURG UPPER POST 131.55 92.09
12000076 963 1472 ANESTH ACHILLES TENDON SURG 131.55 92.09
12000077 964 1472 ANESTH ACHILLES TENDON SURG 131.55 92.09
12000078 963 100 ANESTH SALIVARY GLAND 131.55 92.09
12000079 964 100 ANESTH SALIVARY GLAND 131.55 92.09
12000080 963 1992 ANESTH N BLOCK/INJ PRONE 131.55 92.09
12000081 964 1992 ANESTH N BLOCK/INJ PRONE 131.55 92.09
12000082 963 700 ANESTH ABDO WALL SURG UPPER ANT NOS 159.79 111.85
12000083 964 700 ANESTH ABDO WALL SURG UPPER ANT NOS 131.55 92.09
12000084 964 830 ANESTH REPAIR OF HERNIA LOWER NOS 131.55 92.09
12000085 963 560 ANESTH HEART SURG W/O PUMP 159.79 111.85
12000086 964 560 ANESTH HEART SURG W/O PUMP 131.55 92.09
12000087 963 770 ANESTH BLOOD VESSEL REPAIR 159.79 111.85
12000088 964 770 ANESTH BLOOD VESSEL REPAIR 131.55 92.09
12000089 963 350 ANESTH NECK VESSEL SURGERY NOS 159.79 111.85
12000090 964 350 ANESTH NECK VESSEL SURGERY NOS 131.55 92.09
12000091 963 1470 ANESTH LOWER LEG SURGERY NOS 131.55 92.09
12000092 964 1470 ANESTH LOWER LEG SURGERY NOS 131.55 92.09
12000093 963 62322 NJX INTERLAMINAR LMBR/SAC 829.85 580.90
12000094 963 500 ANESTH ESOPHAGEAL SURGERY 131.55 92.09
12000095 964 500 ANESTH ESOPHAGEAL SURGERY 131.55 92.09
12000096 963 940 ANESTH VAGINAL PROCEDURES 131.55 92.09
12000097 964 940 ANESTH VAGINAL PROCEDURES 131.55 92.09
12000098 963 600 ANESTH CERV SPINE CORD SURGERY 131.55 92.09
12000099 964 600 ANESTH CERV SPINE CORD SURGERY 131.55 92.09
12000100 963 604 ANESTH SITTING PROCEDURE 131.55 92.09
12000101 964 604 ANESTH SITTING PROCEDURE 131.55 92.09
12000102 963 1936 ANESTH PERC IMG TX SP PROC 131.55 92.09
12000103 964 1936 ANESTH PERC IMG TX SP PROC 131.55 92.09
12000104 963 1210 ANESTH HIP JOINT SURGERY 131.55 92.09
12000105 964 1210 ANESTH HIP JOINT SURGERY 131.55 92.09
12000106 963 1230 ANESTH SURGERY OF FEMUR 131.55 92.09
12000107 964 1230 ANESTH SURGERY OF FEMUR 131.55 92.09
12000108 964 1402 ANESTH KNEE ARTHROPLASTY 131.55 92.09
12000109 963 830 ANESTH REPAIR OF HERNIA LOWER NOS 131.55 92.09
12000110 963 902 ANESTH ANORECTAL SURGERY 131.55 92.09
12000111 963 812 ANES LWR INTST SCR COLSC 131.55 92.09
12000112 963 811 ANES LWR INTST NDSC NOS 131.55 92.09
12000113 963 731 ANES UPR GI NDSC PX NOS 131.55 92.09
12000114 963 790 ANESTH SURG UPPER ABDOMEN 131.55 92.09
12000115 963 1810 ANESTH LOWER ARM SURGERY 131.55 92.09
12000116 963 400 ANESTH SKIN EXT/PER/ATRUNK 131.55 92.09
12000117 963 1214 ANESTH HIP ARTHROPLASTY 131.55 92.09
12000118 963 99100 SPECIAL ANESTHESIA SERVICE <1 OR >70 YRS 131.55 92.09
12000119 963 1402 ANESTH KNEE ARTHROPLASTY 131.55 92.09
12000120 963 1610 ANESTH SURGERY OF SHOULDER 131.55 92.09
12000121 963 813 ANES UPR LWR GI NDSC PX 131.55 92.09
12000122 963 1920 ANESTH CATHETERIZE HEART 131.55 92.09
12000123 963 910 ANESTH BLADDER SURGERY 131.55 92.09
12000124 964 910 ANESTH BLADDER SURGERY 131.55 92.09
12000125 963 910 ANESTH BLADDER SURGERY 131.55 92.09
12000126 963 670 ANESTH EXT SPINE CORD SURGERY 131.55 92.09
12000127 963 670 ANESTH EXT SPINE CORD SURGERY 131.55 92.09
12000128 964 670 ANESTH EXT SPINE CORD SURGERY 131.55 92.09
12000129 963 320 ANESTH NECK ORGAN 1YR/> 131.55 92.09
12000130 963 404 ANESTH SURGERY OF BREAST RADICAL 131.55 92.09
12000131 963 404 ANESTH SURGERY OF BREAST RADICAL 131.55 92.09
12000132 964 404 ANESTH SURGERY OF BREAST RADICAL 131.55 92.09
12000133 963 1916 ANESTH DX ARTERIOGRAPHY 131.55 92.09
12000134 963 862 ANESTH KIDNEY/URETER SURG 131.55 92.09
12000135 963 862 ANESTH KIDNEY/URETER SURG 131.55 92.09
12000136 964 862 ANESTH KIDNEY/URETER SURG 131.55 92.09
12000137 963 1926 ANES TX INTERV RAD HRT/CRAN 131.55 92.09
12000138 963 1400 ANESTH KNEE JOINT SURGERY 131.55 92.09
12000139 963 1400 ANESTH KNEE JOINT SURGERY 131.55 92.09
12000140 964 1400 ANESTH KNEE JOINT SURGERY 131.55 92.09
12000141 963 532 ANESTH VASCULAR ACCESS 131.55 92.09
12000142 963 802 ANESTH FAT LAYER REMOVAL 131.55 92.09
12000143 963 802 ANESTH FAT LAYER REMOVAL 131.55 92.09
12000144 964 802 ANESTH FAT LAYER REMOVAL 131.55 92.09
12000145 963 1922 ANESTH CAT OR MRI SCAN 131.55 92.09
12000146 963 27096 SIJ ANESTH/SETROID INJ 981.11 686.78
12000147 963 1951 ANESTH BURN LESS 4 PERCENT 131.55 92.09
12000148 963 840 ANESTH SURG LOWER ABDOMEN 131.55 92.09
12000149 963 840 ANESTH SURG LOWER ABDOMENT 131.55 92.09
12000150 964 840 ANESTH SURG LOWER ABDOMEN 131.55 92.09
12000151 963 1820 ANESTH LOWER ARM PROCEDURE 131.55 92.09
12000152 963 1820 ANESTH LOWER ARM PROCEDURE 131.55 92.09
12000153 964 1820 ANESTH LOWER ARM PROCEDURE 131.55 92.09
12000154 963 540 ANESTH CHEST SURGERY 131.55 92.09
12000155 963 540 ANESTH CHEST SURGERY 131.55 92.09
12000156 964 540 ANESTH CHEST SURGERY 131.55 92.09
12000157 963 1952 ANESTH BURN 4-9 PERCENT 131.55 92.09
12000158 963 1112 ANESTH BONE ASPIRATE/BX 131.55 92.09
12000159 963 1112 ANESTH CHEST SURGERY 131.55 92.09
12000160 963 1953 ANESTH BURN EACH 9 PERCENT 131.55 92.09
12000161 964 1112 ANESTH BONE ASPIRATE/BX 131.55 92.09
12000162 964 140 ANESTH PROCEDURES ON EYE 131.55 92.09
12000163 963 140 ANESTH PROCEDURES ON EYE 131.55 92.09
12000164 963 140 ANESTH PROCEDURE ON EYE 131.55 92.09
12000165 963 1200 ANESTH HIP JOINT PROCEDURE 131.55 92.09
12000166 964 1844 ANESTH VASCULAR SHUNT SURG 131.55 92.09
12000167 963 1844 ANESTH VASCULAR SHUNT SURG 131.55 92.09
12000168 963 1844 ANESTH VASCULAR SHUNT SURG 131.55 92.09
12000169 963 520 ANESTH CHEST PROCEDURE 131.55 92.09
12000170 963 1270 ANESTH THIGH ARTERIES SURG 131.55 92.09
12000171 963 1480 ANESTH LOWER LEG BONE SURG 131.55 92.09
12000172 963 1250 ANESTH UPPER LEG SURGERY 131.55 92.09
12000173 963 1440 ANESTH KENN ARTERIES SURG 131.55 92.09
12000174 963 846 ANESTH HYSTERECTOMY 131.55 92.09
12000175 963 904 ANESTH PERINEAL SURGERY 131.55 92.09
12000176 963 300 ANESTH HEAD/NECK/PTRUNK 131.55 92.09
12000177 963 752 ANESTH REPAIR OF HERNIA 131.55 92.09
12000178 963 524 ANESTH CHEST DRAINAGE 131.55 92.09
12000179 963 1520 ANESTH LOWER LEG VEIN SURG NOS 131.55 92.09
12000180 963 702 ANESTH FOR LIVER BIOPSY 131.55 92.09
12000181 963 1630 ANESTH SURGERY OF SHOULDER NOS 131.55 92.09
12000182 963 62320 NJX INTERLAMINAR CRV/THRC 733.04 513.13
12000183 963 1260 ANESTH UPPER LEG VEINS SURG 131.55 92.09
12000184 964 62322 NJX INTERLAMINAR LMBR/SAC 840.61 588.43
12000185 963 62323 NJX INTERLAMINAR LMBR/SAC 931.33 651.93
12000186 964 1620 ANESTH SHOULDER PROCEDURE 131.55 92.09
12000187 963 1620 ANESTH SHOULDER PROCEDURE 131.55 92.09
12000188 963 1620 ANESTH SHOULDER PROCEDURE 131.55 92.09
12000189 963 1420 ANESTH KNEE JOINT CASTING 131.55 92.09
12000190 963 730 ANESTH ABDOMINAL WALL SURG UPPER POST 131.55 92.09
12000191 963 600 ANESTH CERV SPINE CORD SURGERY 131.55 92.09
12000192 963 1230 ANESTH SURGERY OF FEMUR 131.55 92.09
12000193 963 1472 ANESTH ACHILLES TENDON SURG 131.55 92.09
12000194 963 100 ANESTH SALIVARY GLAND 131.55 92.09
12000195 963 800 ANESTH ABDO WALL SURG LOWER ANT NOS 131.55 92.09
12000196 964 800 ANESTH ABDO WALL SURG LOWER ANT NOS 131.55 92.09
12000197 963 800 ANESTH ABDO WALL SURG LOWER ANT NOS 131.55 92.09
12000198 963 1992 ANESTH N BLOCK/INJ PRONE 131.55 92.09
12000199 963 700 ANESTH ABDO WALL SURG UPPER ANT NOS 131.55 92.09
12000200 963 1924 ANES THER INTERVEN RAD ART 131.55 92.09
12000201 964 1924 ANES THER INTERVEN RAD ART 131.55 92.09
12000202 963 1924 ANES THER INTERVEN RAD ART 131.55 92.09
12000203 963 560 ANESTH HEART SURG W/O PUMP 131.55 92.09
12000204 963 770 ANESTH BLOOD VESSEL REPAIR 131.55 92.09
12000205 963 1320 ANESTH KNEE AREA SURGERY 131.55 92.09
12000206 964 1320 ANESTH KNEE AREA SURGERY 131.55 92.09
12000207 963 1320 ANESTH KNEE AREA SURGERY 131.55 92.09
12000208 963 350 ANESTH NECK VESSEL SURGERY NOS 131.55 92.09
12000209 963 1470 ANESTH LOWER LEG SURGERY NOS 131.55 92.09
12000210 963 832 ANESTH REPAIR OF HERNIA V&A 131.55 92.09
12000211 964 832 ANESTH REPAIR OF HERNIA V&A 131.55 92.09
12000212 963 832 ANESTH REPAIR OF HERNIA V&A 131.55 92.09
12000213 963 500 ANESTH ESOPHAGEAL SURGERY 131.55 92.09
12000214 963 940 ANESTH VAGINAL PROCEDURES 131.55 92.09
12000215 963 604 ANESTH SITTING PROCEDURE 131.55 92.09
12000216 963 1936 ANESTH PERC IMG TX SP PROC 131.55 92.09
12000217 963 1210 ANESTH HIP JOINT SURGERY 131.55 92.09
12000218 963 630 ANESTH LUMBAR SPINE CORD DURGERY 131.55 92.09
12000219 964 630 ANESTH LUMBAR SPINE CORD SURGERY 131.55 92.09
12000220 963 630 ANESTH LUMBAR SPINE CORD SURGERY 131.55 92.09
12000221 963 1274 ANESTH FEMORAL EMBOLECTOMY 131.55 92.09
12000222 964 1274 ANESTH FEMORAL EMBOLECTOMY 131.55 92.09
12000223 963 1274 ANESTH FEMORAL EMBOLECTOMY 131.55 92.09
12000224 964 1932 ANES TX INTERV RAD TH VEIN 131.55 92.09
12000225 963 1932 ANES TX INTERV RAD TH VEIN 131.55 92.09
12000226 963 1932 ANES TX INTERV RAD TH VEIN 131.55 92.09
12000227 963 914 ANESTH REMOVAL OF PROSTATE RESECTION 131.55 92.09
12000228 963 914 ANESTH REMOVAL OF PROSTATE RESECTION 131.55 92.09
12000229 964 914 ANESTH REMOVAL OF PROSTATE RESECTION 131.55 92.09
12000300 963 528 ANES MEDIASCPY & DX THORSCPY 131.55 92.09
12000301 963 528 ANES MEDIASCPY & DX THORSCPY 131.55 92.09
12000302 964 528 ANES MEDIASCPY & DX THORSCPY 131.55 92.09
12000303 963 64421 NJX AA&/STRD NTRCOST NRV EA 671.97 470.38
12000304 963 64488 TAP BLOCK BI INJECTION 841.25 588.88
12000305 964 921 ANESTH VASECTOMY 131.55 92.09
12000306 963 921 ANESTH VASECTOMY 131.55 92.09
12000307 963 921 ANESTH VASECTOMY 131.55 92.09
12000308 964 912 ANESTH BLADDER TUMOR SURG 131.55 92.09
12000309 963 912 ANESTH BLADDER TUMOR SURG 131.55 92.09
12000310 963 912 ANESTH BLADDER TUMOR SURG 131.55 92.09
12000311 963 1392 ANESTH KNEE AREA SURGERY UPPER 131.55 92.09
12000312 964 1392 ANESTH KNEE AREA SURGERY UPPER 131.55 92.09
12000313 963 1392 ANESTH KNEE AREA SURGERY UPPER 131.55 92.09
12000314 964 99140 ANES COMPLICJ EMER COND 131.55 92.09
12000315 964 920 ANESTH GENITALIA SURGERY 131.55 92.09
12000316 964 918 TRANSURETHRAL PROCEDURE 131.55 92.09
12000317 964 541 ANESTH THORACOTOMY W 1 LUNG VENT 131.55 92.09
12000318 964 1638 ANESTH SHOULDER REPLACEMENT 131.55 92.09
12000319 964 1830 ANESTH LOWER ARM SURGERY NOS 131.55 92.09
12000320 964 797 ANESTH SURGERY FOR OBESITY 131.55 92.09
12000321 964 1462 ANESTH LOWER LEG PROCEDURE 131.55 92.09
12000322 964 1710 ANESTH ELBOW AREA SURGERY 131.55 92.09
12000323 964 522 ANESTH CHEST LINING BIOPSY 131.55 92.09
12000324 964 620 ANESTH SPINE CORD SURGERY 131.55 92.09
12000325 964 1656 ANESTH ARM-LEG VESSEL SURG 131.55 92.09
12000326 964 880 ANESTH ABDOMEN VESSEL SURG 131.55 92.09
12000327 964 1991 ANESTH NERVE BLOCK/INJ 131.55 92.09
12000328 964 926 ANESTH REMOVAL OF TESTIS INGUINAL 131.55 92.09
12000329 964 860 ANESTH SURGERY OF ABDOMEN 131.55 92.09
12000330 964 1232 ANESTH AMPUTATION OF FEMUR 131.55 92.09
12000331 964 1380 ANESTH CLOSED PROCEDURE KNEE JOINT 131.55 92.09
12000332 964 1120 ANESTH PROCEDURE ON BONY PELVIS 131.55 92.09
12000333 964 1610 ANESTH SURGERY OF SHOULDER 131.55 92.09
12000334 964 870 ANESTH BLOADDER STONE SURG 131.55 92.09
12000335 964 214 ANESTH SKULL DRAINAGE 131.55 92.09
12000336 964 1740 ANESTH UPPER ARM SURGERY 131.55 92.09
12000337 964 873 ANESTH KIDNEY STONE DESTRUCT 131.55 92.09
12000338 964 750 ANESTH REPAIR OF HERNIA 131.55 92.09
12000339 964 1360 ANESTH KNEE AREA SURGERY 131.55 92.09
12000340 964 794 ANESTH PANCREAS REMOVAL 131.55 92.09
12000341 964 566 ANESTH BABG WO PUMP 131.55 92.09
12000342 964 1940 ANESTH FOR PERCUT IMAGE-GUIDE DESTRUCTIO 131.55 92.09
12000343 964 1942 ANESTH FOR PERCUT IMAGE-GUIDE NEUROMODUL 131.55 92.09
12000344 964 530 ANESTH FOR PERM TRANS PACEMAKER INSERT 131.55 92.09
12000345 964 1925 ANESTH FOR THERAPEUTIC INTERV RADIOLOGIC 131.55 92.09
12000346 964 920 ANESTH FOR PROCEDURES ON MALE GENITALIA 131.55 92.09
12000347 964 352 ANESTH FOR PROC ON MAJ NECK VESS SIMP LI 131.55 92.09
12005058 370 ANES SUPPLIES 1ST HOUR 758.50 530.95
12005060 370 ANESTHESIA FIRST 15 MINS 1,000.69 700.48
12005061 370 ANESTHESIA EACH ADDITIONAL MINUTE 66.74 46.72
12005074 370 ANES EQ&SUPP ADD 15 MIN 129.50 90.65
14000005 451 29405 APPLIC SHORT LEG CAST 267.75 187.43
14000006 456 29405 APPLIC SHORT LEG CAST 267.75 187.43
14000007 450 28192 REMOV FB FT; SUBQ 669.50 468.65
14000008 451 28192 REMOV FB FT; SUBQ 669.50 468.65
14000009 456 28192 REMOV FB FT; SUBQ 669.50 468.65
14000010 450 37799 UNLISTED VASCULAR PROCEDURE 0.01 0.01
14000013 450 96375 IV PUSH, SEQUENTIAL, NEW DRUG 145.77 102.04
14000014 450 96372 INJECTION SC/IM 153.74 107.62
14000015 450 96360 HYDRATION IV,INITIAL,31MIN TO 1HR 424.31 297.02
14000016 450 96361 HYDRATION IV, ADDL HR 222.52 155.76
14000017 450 96365 IV INFUSION, INITIAL, UP TO 1 HR 613.96 429.77
14000018 450 96366 IV INFUSION, ADDL HR 216.25 151.38
14000019 450 96374 IV PUSH, INITIAL 327.98 229.59
14000020 450 96376 IV PUSH, SEQUENTIAL, SAME DRUG 179.68 125.78
14000021 450 96368 IV INFUSION, CONCURRENT 134.90 94.43
14000022 456 96372 INJECTION SC/IM 118.50 82.95
14000023 451 SQ IM THERA OR PROPH DRUG 118.50 82.95
14000024 456 IV INFUSION 1ST HOUR 379.50 265.65
14000025 451 IV INFUSION 1ST HOUR 379.50 265.65
14000026 456 96361 IV INFUSION HYDRATION EACH ADDTL HR 204.00 142.80
14000027 451 IV INFUSION HYDRATION EACH ADDTL HR 204.00 142.80
14000029 300 INTERDERMAL TUBERCULIN 17.75 12.43
14000030 456 IV INFUSION PROPH 1ST HOUR 379.50 265.65
14000031 451 IV INFUSION PROPH 1ST HOUR 379.50 265.65
14000032 456 IV INFUSION PROPH ADDTL HOUR 204.00 142.80
14000033 451 IV INFUSION PROPH ADDTL HOUR 204.00 142.80
14000034 456 96374 IV PUSH, INITIAL 169.50 118.65
14000035 260 96374 IV PUSH INITIAL DRUG 169.50 118.65
14000036 456 IV PUSH, SEQUENTIAL, SAME DRUG 169.50 118.65
14000037 451 IV PUSH EACH SEQ DRUG 169.50 118.65
14000038 456 96375 IV PUSH, SEQUENTIAL, NEW DRUG 118.50 82.95
14000039 260 96375 IV PUSH, SEQUENTIAL, NEW DRUG 118.50 82.95
14000040 450 96367 IV INFUSION, SEQUENT, UP TO 1 HR 216.25 151.38
14000045 451 96367 IV INFUSION, SEQUENTIAL NEW 204.00 142.80
14000047 456 96367 IV INFUSION, SEQUENTIAL NEW 204.00 142.80
14000050 456 11760 REPR NAIL BED 297.50 208.25
14000051 450 42310 DRNG ABSCESS SUBMAXIL SUBLING ORAL 640.53 448.37
14000052 450 43760 CHANEGASTROSTOMYTUBEPERCUTNOIMAGIN 481.23 336.86
14000053 450 51705 CYSTOSTOMY TUBE CHANGE 765.89 536.12
14000054 761 15271 APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1 5,560.43 3,892.30
14000055 761 15272 APP SKN SUB GRFT T/A/L AREA/100SQ CM EA 1,322.37 925.66
14000056 761 15273 SKIN SUB GRFT T/ARM/LG CHILD 10,201.91 7,141.34
14000057 761 15274 APP SKN SUB GRFT T/A/L AREA>=100SCM ADL 2,305.47 1,613.83
14000058 761 15275 SUB GRFT F/S/N/H/F/G/M/D<100SQ CM 1ST 25 5,721.68 4,005.18
14000059 761 15276 SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADD 1,725.63 1,207.94
14000060 451 40831 CLO LACERATIONMOUTH;OVER 2.5CM/COMPLEX 643.75 450.63
14000061 456 40831 CLOLACERATIONMOUTH;OVER2.5CM/COMPLEX 643.75 450.63
14000062 450 40831 CLO LAC ERATIONMOUTH;OVER 2.5/COMPLEX 643.75 450.63
14000064 761 15278 SKN SUB GRFT F/N/H/F/G CH ADD 2,906.93 2,034.85
14000065 450 17250 CHEMICAL CAUTERIZATION 428.18 299.73
14000066 761 15277 SUB GRFT F/S/N/H/F/G/M/D>=100SCM 1STSQ C 5,560.43 3,892.30
14000067 761 11042 DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM 1,154.74 808.32
14000068 761 11045 DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ 634.91 444.44
14000069 761 97602 RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANE 630.56 441.39
14000070 510 97605 NEGATIVE PRESSURE WOUND THERAPY DME <= 5 630.56 441.39
14000071 761 97606 NEGATIVE PRESSURE WOUND THERAPY DME <= 5 1,154.75 808.33
14000080 450 46060 INCISION & DRAIN OF A PERIRECTAL ABSCESS 314.50 220.15
14000090 450 11000 DEBR EXZ INF SKIN 10% BS 1,606.31 1,124.42
14000091 450 16030 DRS&/DBRDMT PRTL-THKNS BURNS 1 1,063.31 744.32
14000100 450 35207 REPAIR BLOOD VESSEL HAND OR FINGER 314.50 220.15
14000101 450 35226 REPAIR BLOOD VESSEL LOWER EXTREMITY 337.25 236.08
14000105 450 26989 SURG PROCED NOS FINGER HAND 381.50 267.05
14000106 450 26765 OPEN REDUCTION DISSTAL PHALANGEAL FX 1,011.25 707.88
14000500 451 DECLOTTING BY THROMBOLYTIC AGENT 68.50 47.95
14000501 451 INSERTION TEMPORARY INDWELLING BLADDER 133.25 93.28
14000502 451 NB RESUSCITATION 549.75 384.83
14000503 456 NB RESUSCITATION 549.75 384.83
14000504 456 INSERTION TEMPORARY INDWELLING BLADDER 133.25 93.28
14000505 450 51703 INSERT TEMP BLADDER CATH/COMPLCAT 173.00 121.10
14000506 451 51703 INSERT TEMP BLADDER CATH/COMPLCATED 173.00 121.10
14000507 456 51703 INSERT TEMP BLADDER CATH/COMPLCATED 173.00 121.10
14000550 456 11042 DEBRID; SKIN & SUBQ TISS 560.75 392.53
14000551 456 29505 APPLIC LONG LEG SPLINT 230.50 161.35
14000552 456 29515 APPLIC SHORT LEG SPLINT 230.50 161.35
14000553 456 6520526 REMOV FB EXT EYE; CONJUNC SUPERF 322.50 225.75
14000601 450 10061 I&D ABSCESS:COMPLIC/MX 829.50 580.65
14000602 450 56405 I&D ABSCESS; PERINEUM 1,002.05 701.44
14000603 450 54700 INCISION & DRAINAGE OF EPIDIDYMIS 805.50 563.85
14000604 450 56420 I&D ABSCESS BARHOLINS GLAND 392.79 274.95
14000605 450 26412 REP ET HAND; W FG EA TENDON 9,611.51 6,728.06
14001186 300 36415 ROUTINE VENIPUNCTURE 115.91 81.14
14003010 450 36591 COLLECT BLOOD, COMPL IMPLANT VAD 331.33 231.93
14003011 456 VENOUS ACCESS DEVICE BLOOD COLL 120.00 84.00
14003012 451 VENOUS ACCESS DEVICE BLOOD COLL 120.00 84.00
14003043 450 11406 EXC BEN LES TRUNK; OVER 4.0 CM 794.75 556.33
14003044 450 11420 EXC BEN LES SCALP; 0.5 CM/LESS 3,339.48 2,337.64
14003178 450 45300 PROCTOSIG RIGID W/W/O COLLECT 346.00 242.20
14003186 450 45330 EMER RM SIGMOIDOSCOP 346.00 242.20
14003187 450 36550 DECLOTTING BY THROMBOLYTIC AGENT 523.25 366.28
14003188 456 DECLOTTING BY THROMBOLYTIC AGENT 523.25 366.28
14003189 451 DECLOTTING BY THROMBOLYTIC AGENT 523.25 366.28
14003270 450 26433 REPAIR OF EXTENSOR TENDON DISTAL INSERT. 1,625.75 1,138.03
14003284 450 20552 INJ TRIGGER POINT 1/2 MUSCL 818.94 573.26
14003285 450 20553 TRIGGER POINT INJ. THREE OR MORE MUSCLES 289.50 202.65
14003287 450 11730 AVULS OF NAIL PLATE PART OR COMPL SIMPLE 417.73 292.41
14004000 456 1205226 LAYER CLO FACE/LIPS 2.6-5.0CM 314.50 220.15
14005999 450 46040 I&D RECTAL ABCESS 2,747.25 1,923.08
14006000 450 10060 I&D ABCESS; SIMPL/SNGL 428.18 299.73
14006001 761 10021 FNA BX W/O IMG GDN 1ST LES 1,118.92 783.24
14006002 450 10080 I & D PILONIDAL CYST: SIMPL 243.50 170.45
14006004 450 10120 INCS & REMOV FB SUBQ TISS; SIMPL 799.61 559.73
14006005 450 10121 INCS & REMOV SUBQ TISS; COMPLIC 794.75 556.33
14006006 450 10140 I&D HEMATOMA/SEROMA/FLUID COLLEC 448.50 313.95
14006007 450 10160 PUNCT ASPIR ABSCES/HEMAT/BULL/CYST 810.67 567.47
14006008 450 10022 FINE NEEDLE ASPIRATION W/GUIDANCE 487.00 340.90
14006009 456 10060 I&D ABCESS; SIMPL/SNGL 296.75 207.73
14006010 456 10120 INCS & REMOV FB SUBQ TISS; SIMPL 243.50 170.45
14006011 450 11010 DEBRID W/REMOV MAT;SKIN & SUBQ 1,522.00 1,065.40
14006012 450 11011 DEBRID W/REMOV MAT;SKIN-SBQ-MUSC 1,522.00 1,065.40
14006013 450 11012 DEBRID W/REM MAT;SKIN-MUSC-BONE 1,522.00 1,065.40
14006014 450 97597 RMVL DEVITAL TIS 20CM< 307.75 215.43
14006015 450 97598 RMVL DEVITAL TIS ADDL 20CM 273.00 191.10
14006016 450 11042 DEBRID; SKIN & SUBQ TISS 560.75 392.53
14006017 450 11043 DEBRID; SKIN-SUBQ TISS-MUSCL 431.50 302.05
14006018 450 11044 DEBRID; SKIN-SUBQ TISS-MUSCL-BONE 1,518.00 1,062.60
14006019 450 11055 PARING/CUTTING BEN LES; 1LES 217.00 151.90
14006020 450 11056 PARING//CUTTING BENLES;2-4 LES 217.00 151.90
14006021 450 11057 PARING/CUTTING BEN LES ;> 4 LES 217.00 151.90
14006022 450 11100 BX SKIN/SUBQ TISS(SEP PRO); 1 LES 122.25 85.58
14006023 450 11101 BX SKIN/SUBQ TIS (SEP PRO); EA ADD 115.50 80.85
14006024 456 1016026 PUNCTASPIR ABSCES/HEMAT/BULL/CYST 243.50 170.45
14006025 450 11201 REMOVE SKIN TAGS;EA ADD 10 LES 217.00 151.90
14006026 450 11300 SHAVING 1 LES TRUNK; 0.5CM/LESS 110.50 77.35
14006027 450 11301 SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM 118.50 82.95
14006028 450 11302 SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM 182.75 127.93
14006029 450 11303 SHAVING 1 LES TRUNK; OVER 2.0 CM 217.00 151.90
14006030 450 11305 SHAVING 1 LES SCALP; 0.5CM/LESS 118.50 82.95
14006031 450 11306 SHAVING 1 LES SCALP; 0.6 TO 1.0 CM 118.50 82.95
14006032 450 11307 SHAVING 1 LES SCALP;1.1 TO 2.0 CM 182.75 127.93
14006033 450 11308 SHAVING 1 LES SCALP; OVER 2.0 CM 229.00 160.30
14006034 450 11310 SHAVING 1 LES FACE;0.5CM/LESS 118.50 82.95
14006035 450 11311 SHAVING 1 LES FACE; 0.6 TO 1.0 CM 118.50 82.95
14006036 450 11312 SHAVING 1 LES FACE;1 TO 2.0 CM 217.00 151.90
14006037 450 11313 SHAVING 1 LES FACE; OVER 2.0 CM 431.50 302.05
14006038 450 11400 EXC BEN LES TRUNK;0.5 CM/LESS 488.25 341.78
14006039 450 11401 EXC BEN LES TRUNK; 0.6 TO 1.0 CM 488.25 341.78
14006040 450 11402 EXC TR-EXT B9+MARG 1.1-2 CM 2,150.86 1,505.60
14006041 450 11403 EXC BEN LES TRUNK; 2.1 TO 3.0 CM 794.75 556.33
14006042 450 11404 EXC BEN LES TRUNK; 3.1 TO 4.0 CM 794.75 556.33
14006045 450 11421 EXC BEN LES SCALP 0.6 TO 1.0CM0 488.25 341.78
14006046 450 11422 EXC BEN LES SCALP; 1.1 TO 2.0 CM 488.25 341.78
14006047 450 11423 EXC BEN LES SCALP; 2.1 TO 3.0 CM 794.75 556.33
14006049 450 11426 EXC BEN LES SCALP; OVER 4.0 CM 1,522.00 1,065.40
14006050 450 11440 EXC BEN LES FACE; 0.5 CM/LESS 488.25 341.78
14006051 450 11441 EXC BEN LES FACE; 0.6 TO 1.Q CM 488.25 341.78
14006052 450 11442 EXC BEN LES FACE; 1.1 TO 2.0 CM 502.50 351.75
14006053 450 11443 EXC BEN LES FACE; 2.1 TO 3.0 CM 794.75 556.33
14006054 450 11444 EXC BEN FACE; 3.1 TO 4.0 CM 794.75 556.33
14006055 450 11446 EXC BEN LES FACE; OVER 4.0 CM 1,522.00 1,065.40
14006074 450 11719 TRIM NONDYSTROPHIC NAILS-ANY NUMBER 91.00 63.70
14006075 450 11720 DEBRID NAIL(S) ANY METHOD(S);1 TO 5 91.00 63.70
14006076 450 11721 DEBRID NAIL(S) ANY METHOD(S); 6/MORE 91.00 63.70
14006078 450 11732 AVULSION PLATE PART/COMPLT SIMPL; EA 167.00 116.90
14006079 450 11740 EVACUATION SUBUNGUAL HEMATOMA 198.15 138.71
14006080 450 11750 EXC NAIL/MATRIX PART/COMPLT PERM 829.50 580.65
14006081 450 11752 EXC NAIL/MATRIX PERM;AMPUT DISTAL 1,522.00 1,065.40
14006082 450 11755 BX NAIL UNIT ANY METHD(SEP PRO) 488.25 341.78
14006083 450 11760 REPR NAIL BED 1,646.46 1,152.52
14006084 456 11750 EXC NAIL/MATRIX PART/COMPLT PERM 488.25 341.78
14006085 456 10160 PUNCTASPIR ABSCES/HEMAT/BULL/CYST 243.50 170.45
14006090 456 12001 SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA 278.75 195.13
14006091 450 12001 SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS 417.73 292.41
14006092 450 12002 SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM 417.73 292.41
14006093 450 12004 SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM 417.73 292.41
14006094 450 12005 SREP S/N/A/G/TR/E; 12.6-20.0CM 1,107.42 775.19
14006095 456 12002 SIMPL REPR SCLP 297.50 208.25
14006097 450 12011 SIMPL REPR FACE/MUCOUS; 2.5/LESS 417.73 292.41
14006098 450 12013 SR FCE/EAR/EYE/INSE/LIP 2.6-5 417.73 292.41
14006099 450 12014 SIMPL REPR FACE/MUCOUS 5.1-7.5CM 417.73 292.41
14006100 456 12011 SIMPL REPR FACE/MUCOUS; 2.5/LESS IDPA 297.50 208.25
14006101 450 12015 SIMPL REPR FACE/MUCOUS 7.60-12.50CM 417.73 292.41
14006104 450 12020 TX SUPERF WOUND DEHISCENCE;SIMPL 314.50 220.15
14006105 450 12021 TX SUPERF WOUND DEHISCENCE; W/PACK 298.50 208.95
14006106 450 12031 LAYER CLO SCLP/TRUNK; 2.5 CM/LESS 1,037.38 726.17
14006107 450 12032 LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM 799.62 559.73
14006108 450 12034 LAYER CLO SCLP/TRUNK; 7.6 TP 12.5 1,037.38 726.17
14006110 450 12035 INTMD WND REPAIR S/A/T/EXT 1,091.64 764.15
14006111 450 12006 SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM 246.00 172.20
14006113 450 12042 INTMD WND REPAIR N-HF/GENIT 799.62 559.73
14006118 450 12051 LAYER CLO FACE/LIPS; 2.5CM/LESS 799.62 559.73
14006119 450 12052 INTMD WND REPAIR FACE/MM 2.6-5.0 CM 1,037.38 726.17
14006120 450 12053 LAYER CLO FACE/LIPS; 5.1 TO 7.5CM 314.50 220.15
14006121 450 12054 INTMD WND REPAIR FACE/MM 7.6-12.5 CM 1,107.42 775.19
14006128 450 13120 REPR COMPLX SCLP /EXTREM;1.1-2.5CM 484.00 338.80
14006129 450 13121 REPR COMPLX SCLP/EXTREM; 2.6-7.5CM 1,606.31 1,124.42
14006130 450 13122 C REP S/A/L; EA ADD 5 CM/< 534.39 374.07
14006131 450 13131 REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5 1,519.70 1,063.79
14006132 450 13132 REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM 1,605.63 1,123.94
14006157 450 15931 EXC SACRAL PRESS ULCER W/PRIM SUTUR 1,522.00 1,065.40
14006161 450 15999 UNLISTED PROC EXC PRESS ULCER 1,522.00 1,065.40
14006162 450 16000 INT TX 1ST DEGREE BURN W/LOCAL TX 217.00 151.90
14006165 450 16020 DSG/DEBRID INIT/SUBSQT; WO ANES SM 428.18 299.73
14006170 450 16025 DSG/DEBRID INIT/SUBSQT; WO ANES MED 193.50 135.45
14006173 450 17000 DESTRCT-ANY METHD-BEN LES; W/ANE;1 72.25 50.58
14006174 450 17003 DESTRCT-ANY METHD-BEN LES 2-14, EA 68.50 47.95
14006175 450 17004 DESTRCT-ANY METHD-BEN LES 15/>LESS 352.50 246.75
14006176 450 17110 DESTRCT WARTS/MOLLUSCUM TO 14 LES 72.25 50.58
14006177 450 17111 DESTRCT WARTS/MOLLUSCUM;15/>LES 331.75 232.23
14006180 456 16020 DSG/DEBRID INIT/SUBSQT; WO ANES SM 217.00 151.90
14006198 450 19000 PUNCT ASPIRAT CYST BREAST 225.00 157.50
14006199 450 19001 PUNCT ASPIR CYST BREAST; EA AD CYST 225.00 157.50
14006208 450 10060 INC SOFT TISSUE ABSC;SPRFCL 259.25 181.48
14006210 450 20100 ESPLOR PENETR WOND (SEP PRO) NECK 256.75 179.73
14006211 450 20102 EXPLOR WOUND (SEP PRO);ABD/FLNK/BK 1,476.00 1,033.20
14006212 450 20103 EXPLO PENTR WOUND (SEP PRO); EXTREM 2,081.62 1,457.13
14006221 450 20520 REMOV FB MUSCL/TENDON; SIMPL 488.25 341.78
14006223 450 20550 INJ TENDON SHEATH/LIG/TRIG PT/CYST 257.75 180.43
14006224 450 20600 ARTHROCENTESIS/ASPRIN/ING; SMJT 257.75 180.43
14006225 450 20605 ARTHROCENTESIS/ASPRI/INJ; INTERM JT 793.27 555.29
14006226 450 20610 ARTHROCENTESIS MAJOR JT/BURSA 793.27 555.29
14006227 450 20615 ASPIRAT & INJ TX BONE CYST 238.25 166.78
14006229 450 21300 CLO TX SKULL FX WO OR 1,464.25 1,024.98
14006230 450 21310 CLO TX NASAL BONE FX WO MANIP 1,464.25 1,024.98
14006231 450 21315 CLO TX NASAL BONE FX; WO STABILIZAT 1,464.25 1,024.98
14006232 450 21320 CLO TX NASAL BONE FX; W/STABILAZAT 1,464.25 1,024.98
14006236 450 20610 ARTHROCENTESIS MAJOR JT/BURSA 257.75 180.43
14006237 450 21450 CLO TX MANDIB FX; WO MANIP 218.25 152.78
14006238 450 21451 CLO TX MANDIB FX; W/MANIP 1,518.00 1,062.60
14006239 450 21480 CLO TX TM DISLOC; INIT/SUBSQT 206.75 144.73
14006240 450 21485 CLO TX TM DISLOC; COMPLIC INIT/SUBS 1,464.25 1,024.98
14006241 450 21493 CLO TX HYOID FX; WO MANIP 631.50 442.05
14006242 450 21494 CLO TX HYOID FX; W/MANIP 669.75 468.83
14006244 450 21499 UNLISTED MS PROC HEAD 1,464.25 1,024.98
14006245 450 21501 I&D DEEP ABSCESS SOFT TISS NECK 749.75 524.83
14006247 450 21550 BX SOFT TISS NECK/THORAZ 488.25 341.78
14006250 450 21800 CLO TX RIB FX UNCOMP EA 200.00 140.00
14006251 450 21820 CLO TX STERNUM FX 213.00 149.10
14006252 450 21899 UNLISTED PROC NEC/THORAZ 631.50 442.05
14006253 450 21920 BX SOFT TISS BACK/FLANK; SUPERF 794.75 556.33
14006254 450 21930 EXC TUMOR SOFT TISS BACK/FLANK 1,522.00 1,065.40
14006255 450 22305 CLO TX VERTEBRAL PROCESS FX 213.00 149.10
14006256 450 22310 CLO TX VERT BODY FX WO MINIP-W/CAST 213.00 149.10
14006265 450 23330 REMOVE FB SHOULDER; SUBQ 488.25 341.78
14006266 450 23500 CLO TX CLAV FX; WO MANIP 213.00 149.10
14006268 450 23520 CLO TX STERNOCLAV DISLOC; W/O MANIP 213.00 149.10
14006269 450 23525 CLO TX STERNOCLAV DISLOC; W/MANIP 213.00 149.10
14006270 450 23540 CLO TX ACROMIOCLAV DISLOC; WO MINIP 213.00 149.10
14006271 450 23545 CLO TX ACROMIOCLAV DISLOC; W/ MINIP 213.00 149.10
14006272 450 23570 CLO TX SCAPULAR FX; WO MANIP 213.00 149.10
14006273 450 23575 CLO TX SCAP FX; W/MANIP W/WO TRACT 213.00 149.10
14006274 450 23600 CLO TX PROX HUMERAL FX; WO MANIP 280.50 196.35
14006275 450 23605 CLO TX PROX HUMER FX; W/MANIP 280.50 196.35
14006276 450 23620 CLO TX GR HUMERAL TUBER FX; WO 280.50 196.35
14006277 450 23625 CLO TX GR HUMERAL TUBER FX; W/MANIP 280.50 196.35
14006278 450 23650 CLO TX SHLDR DISLOC W/MANIP;WO ANES 610.93 427.65
14006281 450 23675 CLO TX SHLDR DISLOC W/FX W/MAN 280.50 196.35
14006287 450 24065 BX SOFT TISS UP ARM/ELBOW; SUPERF 794.75 556.33
14006289 450 24075 EXC TUMOR UPPER ARM/ELBOW; SUBSQ 1,277.25 894.08
14006291 450 24200 REMOV FB UPPER ARM/ELBOW; SUBSQ 488.25 341.78
14006299 450 24500 CLO TX HUMERAL SHAFT FX; WO MANIP 280.50 196.35
14006300 450 24505 CLO TX HUMERAL FX; W/MANIP W/WO TRA 280.50 196.35
14006301 450 24530 CLO TX SUPRACONDYL HUMER FX; W/O MAN 280.50 196.35
14006302 450 24535 CLO TX SYOERCONDYL HUMER FX;W/MAN 280.50 196.35
14006303 450 24560 CLO TX HUMER EPICOND FX; WO MANIP 280.50 196.35
14006305 450 24576 CLO TX HUMERAL CONDYL FX; WO MANIP 280.50 196.35
14006306 450 24577 CLO TX HUMERAL CONDYL FX; W MAN 280.50 196.35
14006307 450 24600 TX CLO ELBOW DISLOC; WO ANES 280.50 196.35
14006308 450 24605 TX CLOSED ELBOW DISLOC WITH ANESTHESIA 3,404.00 2,382.80
14006310 450 24640 CL TX NURSEMAID ELBOW W MANIP 780.90 546.63
14006311 450 24650 CLO TX RADIAL HEAD/NECK FX; WO MANIP 280.50 196.35
14006312 450 24655 CLO TX RADIAL HEAD/NECK FX; W/MANIP 280.50 196.35
14006313 450 24670 CLO RX ULNAR FX PROX END; WO MANIP 280.50 196.35
14006314 450 24675 CLO TX ULNAR FX PROX END; W/MANIP 280.50 196.35
14006321 450 25065 BX SOFT TISS FOREARM/WRIST; SUPERF 794.75 556.33
14006323 450 25075 EXC TUMOR FOREARM/WRIST AREA; SUBQ 794.75 556.33
14006332 450 25500 CLO TX RADIAL SHAFT FX; WO MANIP 280.50 196.35
14006333 450 25505 CLO TX RADIAL SHAFT FX; W/MANIP 280.50 196.35
14006334 450 25520 CLO TX RADIAL FX W/DISLOC RAD/ULNA 280.50 196.35
14006335 450 25530 CLO TX ULNAR SHAFT FX WO MANIP 280.50 196.35
14006336 450 25535 CLO TX ULNAR SHAFT FX W/MANIP 280.50 196.35
14006337 450 25560 CLO TX RAD & ULNA SHAFT FX; WO MANIP 280.50 196.35
14006338 450 25565 CL TX RADIAL & ULNA FX W MANIP 4,809.21 3,366.45
14006339 450 25600 CLO TX DIST RAD FX; WO MANIP 372.75 260.93
14006340 450 25605 CLOSED TREATMENT DISRAL RADIAL FRACTURE 4,421.96 3,095.37
14006341 450 25622 CLO TX CARPAL SCAPHOID FX; WO MANIP 280.50 196.35
14006342 450 25624 CLO TX CARPAL SCAPHOID FX; W/MANIP 280.50 196.35
14006343 450 25630 CLO TX CARPAL BONE FX; WO MANIP EA 280.50 196.35
14006344 450 25635 CLO TX CARPAL BONE FX; W/MANIP EA 280.50 196.35
14006345 450 25650 CLO TX ULNAR STYLOID FX 280.50 196.35
14006346 450 25660 CLO TX RADIOCARPAL DISLOC W/MANIP 280.50 196.35
14006347 450 25675 CLO TX RADIOULNAR DISLOC W/MANIP 280.50 196.35
14006348 450 25680 CLO TX TRANS-SCAPHOPERILUNAR W/MANI 280.50 196.35
14006349 450 25690 CLO TX LUNATE DISLOC W/MANIP 280.50 196.35
14006351 450 26010 DRAINAGE FINGER ABSCESS; SIMPL 277.24 194.07
14006359 450 26600 CLO TX METACARP FX 1; WO MANIP 372.75 260.93
14006360 450 26605 CLO TX METACARP FX 1; W/MANIP EA 280.50 196.35
14006361 450 26607 CLO TX METACARPAL FX W/MANIP W/FIXA 280.50 196.35
14006363 450 26641 CLO TX CARPOMETA DISLOC THUMB W/MAN 280.50 196.35
14006364 450 26645 CLO TX CARPOMETACAR FX THUMB W/MAN 280.50 196.35
14006366 450 26670 CLO TX DISLOC-NOT THUMB; WO ANES 280.50 196.35
14006369 450 26700 CLO TX MCP DISLOC-1W/MANIP-WO ANES 213.00 149.10
14006371 450 26720 CLO TX PHALANGEAL FX; WO MANIP EA 213.00 149.10
14006372 450 26725 CLO TX PHALANGEAL FX; W/WO TRACT 213.00 149.10
14006373 450 26755 CL TX D PHAL FX FGRR/THMB; W MANIP 726.14 508.30
14006379 450 26770 CLO TX IP JT DISLOC W/WMANIP; WO ANES 626.21 438.35
14006380 450 57180 INTRO VAGINAL PACKING NON OB 380.01 266.01
14006390 450 27086 REMOV FB PELVIS/HIP; SUBQ TISS 488.25 341.78
14006392 450 27193 CLO TX PELVIC RING FX; WO MANIP 280.50 196.35
14006394 450 27220 CLO TX ACETABULUM FX; WO/ MANIP 280.50 196.35
14006395 450 27230 CLO TX FEM FX PROX END NECK; WO MAN 280.50 196.35
14006397 450 27246 CLO TX GREATER TROCH FX WO MANIP 280.50 196.35
14006398 450 27250 CLO TX HIP DISLOC TRAUMA; WO ANES 280.50 196.35
14006400 450 27258 TX SPON HIP DISLOC; WO ANES/MANIP 280.50 196.35
14006404 450 24565 CLO HUMER EPICOND FX; W/MANIP 280.50 196.35
14006409 450 27500 CLO TX FEMORAL SHAFT FX WO MANIP 280.50 196.35
14006410 450 27501 CLO TX SUPRACONDYL FEM FX WO MANIP 280.50 196.35
14006411 450 27520 CLO TX PATELLAR FX WO MANIP 280.50 196.35
14006412 450 27530 CLO TX TIBIAL FX PROX;WO MANIP 280.50 196.35
14006413 450 27532 CLO TX TIB FX; W/WO MANIP W/TRACT 280.50 196.35
14006414 450 27538 CLO TX FX KNEE W/WO MANIP 280.50 196.35
14006415 450 27550 CLO TX KNEE DISLOC; WO ANES 280.50 196.35
14006417 450 27560 CLO TX PATELLAR DISLOC; WO ANES 726.13 508.29
14006424 450 27603 I&D LEG/ANK; DEEP ABSCESS/HEMATOMA 796.00 557.20
14006426 450 27613 BX SOFT TISS LEG/ANK AREA; SUPERF 794.75 556.33
14006430 450 27750 CLO TX TIBIAL SHAFT FX; WO MANIP 280.50 196.35
14006431 450 27752 CLO TX TIB FX; W/MANIP W/WO TRACT 280.50 196.35
14006432 450 27760 CLO TX MEDIAL MALLEOLUS FX; WO MANI 280.50 196.35
14006433 450 27762 CLO TX MED MALLEOLUS FX; W/MANIP 280.50 196.35
14006435 450 27780 CLO TX PROX FIB/SHAFT FX; WO MANIP 280.50 196.35
14006436 450 27781 CLO TX PROX FIB/SHAFT FX; W MANIP 280.50 196.35
14006437 450 27786 CLO TX DISTAL FIBULAR FX; WO MANIP 280.50 196.35
14006438 450 27788 CLO TX DISTAL FIBULAR FX; W/MANIP 280.50 196.35
14006439 450 27788 CLO TX BIMALLEOLAR ANK FX; WO MANIP 280.50 196.35
14006440 450 27810 CLO TX BIMALLEOLAR ANK FX; W/MANIP 280.50 196.35
14006441 450 27816 CLO TX TRIMALLEOLAR ANK FX; WO MANIP 280.50 196.35
14006442 450 27818 CLO TX TRIMALLEOLAR ANK FX; W/MANIP 4,423.85 3,096.70
14006443 450 27824 CLO TX FX ARTICUL-DIST TIB; WO ANES 280.50 196.35
14006444 450 27825 CLO TX FX DIST TIB; W/TRACT/ANES 280.50 196.35
14006445 450 27830 CLO TX PROX TIB-FIB JT DISL; WO ANES 280.50 196.35
14006447 450 27840 CLO TX ANK DISLOC; WO ANES 280.50 196.35
14006459 450 28190 REMOV FB FT; SUBQ 488.25 341.78
14006462 450 28400 CLO TX CALCAN FX; WO MANIP 280.50 196.35
14006463 450 28405 CLO TX CALCAN FX; W/MANIP 280.50 196.35
14006464 450 28430 CLO TX TALUS FX; WO MANIP 280.50 196.35
14006465 450 28435 CLO TX TALUS FX; W/MANIP 280.50 196.35
14006466 450 28450 TX TARSAL BONE FX; WO MANIP EA 280.50 196.35
14006467 450 28470 CLO TX METATARSAL FX; WO MANIP EA. 280.50 196.35
14006468 450 28475 CLO TX METATARSAL FX; W/MANIP EA 280.50 196.35
14006471 450 28490 CLO TX FX GRT TOE PHALANX; WO MANIP 213.00 149.10
14006472 450 28495 CL TX FX GT PHALANX(S); W MANIP 726.13 508.29
14006475 450 28510 CLO TX FX PHALNX NOT GR TOE; WO/MAN 213.00 149.10
14006476 450 28515 CLO TX FX PHALNX NOT GR TOE; W/MANI 213.00 149.10
14006478 450 28530 CLSD TX SESAMOID FX 280.50 196.35
14006480 450 28540 CLO TX TARSAL BONE DISLOC; WO ANES 280.50 196.35
14006484 450 28570 CLO TX TALOTARS JT DISLO; WO ANES 280.50 196.35
14006488 450 28600 CLO TX TARSOMETAT JT DISLOC; WO ANES 280.50 196.35
14006492 450 28630 CLO TX METARSOPHAL JT DISL; WO ANES 213.00 149.10
14006496 450 28660 CLO TX IP JT DISLOC; WO ANES 213.00 149.10
14006500 450 29065 APPLY LONG ARM CAST 845.31 591.72
14006501 450 29075 APPLIC; ELBOW TO FINGER 755.39 528.77
14006502 450 29085 APPLIC; HAND & LOWER FOREARM 230.50 161.35
14006503 450 29105 APPLIC; LONG ARM SPLINT 454.59 318.21
14006504 450 29125 APPLIC; SHORT ARM SPLINT; STATOC 331.33 231.93
14006505 456 29125 APPLIC; SHORT ARM SPLINT; STATOC 230.50 161.35
14006506 450 29130 APPLY FINGER SPLINT; STATIC 199.14 139.40
14006507 450 29240 STRAPPING; SHOULDER 379.34 265.54
14006508 450 29345 APPLIC LONG LEG CAST 755.39 528.77
14006509 456 29105 APPLIC; LONG ARM SPLINT 225.00 157.50
14006510 450 29358 APPLIC LONG LEG CAST BRACE 225.00 157.50
14006512 450 29425 APPLIC SHORT LEG CAST 862.22 603.55
14006513 450 29425 APPLIC SHORT LEG CAST; WALKING/AMB 225.00 157.50
14006514 456 APPLIC FINGER SPLINT; STATIC 213.00 149.10
14006515 451 APPLIC; SHORT ARM SPLINT; STATOC 230.50 161.35
14006516 450 29445 APPLIC RIGID TOT CONTACT LEG CAST 225.00 157.50
14006517 451 APPLIC SHORT LEG SPLINT 230.50 161.35
14006518 450 29505 APPLIC LONG LEG SPLINT 443.67 310.57
14006519 450 29515 APPLIC SHORT LEG SPLINT 433.29 303.30
14006520 450 29580 STRAPPING; UNNA BOOT 132.75 92.93
14006521 450 29705 REMOV/BIVALV; FULL ARM/LEG CAST 755.39 528.77
14006522 450 29710 REMOV/BIVALV; SHOULDER/HIP SPICA 140.75 98.53
14006523 450 29715 REMOV/BIVALV; TURNBUCKLE JACKET 140.75 98.53
14006524 450 29730 WINDOWING CAST 132.75 92.93
14006525 450 29740 WEDGING CAST 140.75 98.53
14006533 450 30300 REMOV FB INTRANASAL; RIGHT 394.72 276.30
14006537 450 30905 CNTRL POST EPISTAX INIT 374.21 261.95
14006539 450 31500 INTUBATION ENDOTRACHEAL EMER PROC 643.50 450.45
14006540 450 31502 TRACHEOT TUBE CHANGE BEFOR FISTULA 288.25 201.78
14006541 450 31505 LARYNGOSCOPY INDIREC; DX (SEP PROC) 154.00 107.80
14006542 450 31510 LARYNGOSCOPY INDIRECT; W/BX 1,658.75 1,161.13
14006543 450 30901 CONTROL NASAL HEMORR ANT SIMP 354.58 248.21
14006544 450 31512 LARYNGOSCOPY INDIRECT; W/REMOV LES 1,658.75 1,161.13
14006547 450 31520 LARYNGOSCP DIR W/WO TREACHEO DX NB 164.50 115.15
14006550 450 31575 LARYNGOSCOPY FLEX FIBEROPTIC; DX 72.25 50.58
14006552 450 31577 LARYNGOSCPY FIBEROPTIC; W/REMOV FB 501.25 350.88
14006556 450 31603 TRACHEOSTOMY EMER PROC; TRANSTRACH 1,518.00 1,062.60
14006558 450 31605 TRACH EMER PROC; CRICOTHYROID MEMBR 1,518.00 1,062.60
14006570 450 32421 THORACENTESIS-ASPIR-INT/SUBSQT 444.75 311.33
14006571 450 32422 THORACENTESIS W/INSRT TUBE (SEP PROC) 444.75 311.33
14006572 450 32421 THORACENTESIS 1,096.75 767.73
14006573 450 32551 TUBE THORACOSTOMY (SEP PROC) 469.75 328.83
14006579 450 33210 INSRT/REPLC TEMP 1 ELECT (SEP PROC) 791.75 554.23
14006580 450 33211 INSRT/REPLC TEMP ELECTROD (SEP PROS) 791.75 554.23
14006586 450 36420 VENIPUNCT CUTDOWN; < 1YR 659.00 461.30
14006587 450 36425 VENIPUNCT CUTDOWN; AGE 1/OVER 659.00 461.30
14006588 391 36430 BLOOD TRANSFUSION, COMPONENTS 716.00 501.20
14006589 456 BLOOD PRODUCT TRANSFUSION 716.00 501.20
14006590 451 BLOOD PRODUCT TRANSFUSION 716.00 501.20
14006595 450 36556 INS CENTRAL VENOUS ACCESS >5 659.00 461.30
14006596 761 36556 PLCMT CENT VENOUS CATH; PERQ <5YR 2,300.00 1,610.00
14006603 450 38300 DRAINAGE LYMPH NODE ABSCESS;SIMPL 749.75 524.83
14006605 450 38505 BX/EXC LYMPH NODE; BY NEEDLE SUPERF 660.50 462.35
14006608 450 40490 BX LIP 631.50 442.05
14006610 450 40800 DRAIN ABSCESS VESTIBULE MOUTH;SIMPL 206.75 144.73
14006611 450 40804 REMOV EMBEDDED FB MOUTH; SIMPL 218.25 152.78
14006613 450 40808 BX VESTIBULE MOUTH 206.75 144.73
14006614 450 40830 CLO LACERATION MOUTH; 2.5 CM/LESS 218.25 152.78
14006618 450 41005 INTRAORAL I&D ABSCESS; SUBLINGUAL 218.25 152.78
14006622 450 41015 EXTRAORAL I&D ABSCESS; SUBLINGUAL 631.50 442.05
14006639 450 41800 DRAIN ABSCESS DENTOALVEOLAR STRUCT 206.75 144.73
14006659 450 42960 CONTROL OROPHARYNG HEMORR; SIMPL 285.50 199.85
14006660 450 42970 CONTROL NASOPHARYNG HEMORR; SIMPL 285.50 199.85
14006671 451 97598 RMVL DEVITAL TIS ADDL 20CM 273.00 191.10
14006672 456 97598 RMVL DEVITAL TIS ADDL 20CM 273.00 191.10
14006673 451 97597 RMVL DEVITAL TIS 20CM< 307.75 215.43
14006674 456 97597 RMVL DEVITAL TIS 20CM< 307.75 215.43
14006708 450 45005 I&D SUBMUCOSAL ABSCESS RECTUM 302.50 211.75
14006713 450 45300 PROCTOSIG RIGID W/W/O COLLECT 229.00 160.30
14006714 450 45303 PROCSIGMOSCOPY RIGID; W/DILAT 346.00 242.20
14006715 450 45305 PROCSIGMOSCOPY RIGID; W/BX 1/MX 346.00 242.20
14006720 450 45317 PROCSIGMOIDOS RIGID;W/CONTROL BLD 366.00 256.20
14006747 450 46050 I&D PERIANAL ABSCESS SUPERF 2,300.75 1,610.53
14006750 450 46083 INCS THROMBOSED HEMORRHOID EXT 834.06 583.84
14006755 450 46221 HEMORRHOIDECTOMY BY SIMPL LIG 285.50 199.85
14006764 450 46320 ENUCLEATION EXT THROBOTIC HEMORRHO 302.50 211.75
14006765 450 46500 INJ SCLEROSING SOLUTION HEMORRHOIDS 285.50 199.85
14006791 450 49080 PERITONEOCENTESIS;INIT 444.75 311.33
14006803 450 53600 DILAT URETHRAL STRICT-MALE; INIT 280.50 196.35
14006806 450 53620 DILAT URETHRAL FILLIFORM-MALE; INIT 475.00 332.50
14006824 450 55100 DRAINAGE SCROTAL WALL ABSCESS 749.75 524.83
14006833 450 59409 VAG DELIV ONLY 1,447.00 1,012.90
14006834 450 59414 DELIV PLACENTA (SEPART PROC) 1,364.25 954.98
14006846 450 62270 SPINAL PUNCT LUMBAR DX 1,798.06 1,258.64
14006869 450 62311 LUMBA SACRAL (CAUDAL) 1,255.00 878.50
14006870 450 64450 INJ ANES AGENT; OTHER PERIPHERAL 1,843.01 1,290.11
14006871 450 62310 CERVICAL INJECTION 297.50 208.25
14006884 450 65205 REMOV FB EXT EYE; CONJUNC SUPERF 351.79 246.25
14006885 450 65210 REMOV FB EXT EYE; CONJUNC EMBEDDED 322.50 225.75
14006886 450 65220 REMOV FB EXT EYE;CORNEAL WO LAMP 382.39 267.67
14006888 450 67700 BLEPHAROTOMY DRAIN ABSCESS EYELID 361.75 253.23
14006889 450 67810 BX EYELID 361.75 253.23
14006890 450 67938 REMOV EMBEDDED FB EYELID 975.63 682.94
14006891 450 30906 CTRL POST EPISTAX SQ 734.38 514.07
14006894 450 68810 PROBE NASOLACRIM DUCT W/WO IRRIG.G 342.00 239.40
14006895 450 68899 UNLISTED PROC LACRIMAL SYST 322.50 225.75
14006896 450 69000 DRAIN EXT EAR ABSCESS; SIMPL 2,063.92 1,444.74
14006897 450 69020 DRAIN EXT AUDITORY CANAL ABSCESS 243.50 170.45
14006898 450 69100 BX EXT EAR 488.25 341.78
14006899 981 69000 DRAIN EXT EAR ABSCESS; SIMPL 546.45 382.52
14006900 450 69110 EXC EXT EAR; PART SIMPL REPR 794.75 556.33
14006903 450 69210 REMOV IMPACTED CERUMEN (SEP PRO) 127.75 89.43
14006909 450 43752 NG TUBE PLACEMENT W/FLUORO 465.75 326.03
14006920 456 IMMUN ADMIN, ONE VACCINE 83.25 58.28
14006921 451 IMMUN ADMIN, ONE VACCINE 83.25 58.28
14006922 771 90471 IMMUN ADMIN, ONE VACCINE 153.74 107.62
14006923 771 G0009 ADMIN PNEUMONIA VACCINE- MC 153.74 107.62
14006927 771 90472 IMMUNIZATION ADMIN EA ADDL 90.82 63.57
14006977 636 90732 PNEUMOCOCCAL POLYSACCH VAC-ADULT 25.00 17.50
14006978 450 90733 MENINGOCOCCAL POLYSACCH VAC-SUBSQ 226.00 158.20
14006979 450 90735 JAPANESE ENCEPHALITIS VAC-SUBQ USE 226.00 158.20
14006981 636 90746 HEPATITIS B VAC ADULT DOSE-IM USE 44.50 31.15
14006984 636 90748 HEP B/HEMOPHILUS INFLU B VAC-IM USE 851.25 595.88
14006995 920 92326 REPLAC CONTACT LENS 65.75 46.03
14006997 450 92950 CARDIOPULMONARY RESUSCITATION 800.70 560.49
14007000 450 92953 TEMPORARY TRANSCUTANEOUS PACING 1,697.30 1,188.11
14007001 450 92960 CARDIOVERSION ELECTIVE, EXTERN 1,655.90 1,159.13
14007002 480 92961 CARDIOVERS ELEC-CONVER ARRHY; INT 1,149.00 804.30
14007003 761 46040 I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX 3,629.33 2,540.53
14007005 730 93005 ECG-ROUTINE 12 LEAD TRACING ONLY 47.50 33.25
14007007 730 93041 RHYTHM ECG 1-3 LEADS; TRACING ONLY 82.00 57.40
14007062 450 99281 ER VISIT, LEVEL 1 215.48 150.84
14007063 450 99282 ER VISIT, LEVEL 2 397.91 278.54
14007064 450 9928325 ER VISIT, LEVEL 3 712.15 498.51
14007066 450 9928425 ER VISIT, LEVEL 4 1,188.21 831.75
14007067 450 9928525 ER VISIT, LEVEL 5 1,766.15 1,236.31
14007068 450 99291 CRITICAL CARE, 1ST 30-74 MIN 2,362.04 1,653.43
14007069 450 99465 NB RESUSCITATION 549.75 384.83
14007070 450 99292 CRITICAL CARE, ADDL 30 MIN 1,149.96 804.97
14007073 300 82272 COLORECTAL SCRN; HI RISK IND 346.00 242.20
14007074 300 82272 OCCULT BLOOD, FECES, SINGLE-DIAGNOSTIC 17.06 11.94
14007089 331 96542 CHEMO BY BOTH INFUSION AND O 353.75 247.63
14008001 450 12041 INTMD WND REPAIR N-HF/GENIT 931.04 651.73
14008002 450 36410 VENIPUNCT> 3YR W/MD SKILL (SEP PRO) 43.50 30.45
14008004 300 86580 TB INTERDERMAL TEST 46.15 32.31
14008006 450 92977 THROMBOLYSIS CORONARY; IV INFUSION 726.02 508.21
14008011 451 CATH URETHRA; SIMPLE 133.25 93.28
14008013 450 51701 CATH URETHRA; SIMPL 331.33 231.93
14008014 300 82962 GLUCOSE,QUANT,BLD REAGENT STRP 27.95 19.57
14008017 450 27256 TX SPON HIP DISLOC; WO ANES/MANIP 165.75 116.03
14008019 450 51702 INSERTION TEMPORARY INDWELLING BLADDER 323.25 226.28
14008020 450 51701 INSERTION NONINDWELLING BLADDER CATH 106.50 74.55
14008025 451 99281 ER VISIT, LEVEL 1 IDPA 168.25 117.78
14008026 456 99282 ER VISIT, LEVEL 2 IDPA 277.00 193.90
14008027 456 99283 ER VISIT, LEVEL 3 IDPA 437.50 306.25
14008028 450 9928425 ER VISIT, LEVEL 4 IDPA 703.75 492.63
14008029 450 99285 ER VISIT, LEVEL 5 IDPA 1,044.50 731.15
14008030 450 64402 INJ ANESTHETIC AGENT FACIAL NERVE 934.54 654.18
14008031 450 69209 REMOVE IMPACTED EAR WAX UNI 198.24 138.77
14008032 450 51798 US PV RESIDUAL URINE BLDR SCAN 203.35 142.35
14008035 450 29131 APPLICATION OF FINGER SPLINT: DYNAMIC 199.14 139.40
14008036 450 29435 APPY PATELLAR TENDON BEARING CAST 839.26 587.48
14008102 762 99218 OBSERVATION LOW IDPA 12.51-23 HRS. 313.50 219.45
14009004 981 99291 ER PHYSICIAN CRITICAL CARE 1ST HOUR 994.00 695.80
14010000 960 10021 FINE NEEDLE ASPIRATION W/O GUIDANCE 502.37 351.66
14010001 450 1002226 FINE NEEDLE ASPIRATION W/GUIDANCE 280.25 196.18
14010002 981 10060 I&D ABCESS; SIMPL/SNGL 398.67 279.07
14010003 981 10061 I&D ABSCESS:COMPLIC/MX 781.55 547.09
14010004 450 1008026 I & D PILONIDAL CYST: SIMPL 257.50 180.25
14010005 450 1008126 I&D PILONIDAL CYST; COMPLIC 772.50 540.75
14010006 981 10120 INCS & REMOV FB SUBQ TISS; SIMPL 439.60 307.72
14010007 450 1012126 INCS & REMOV SUBQ TISS; COMPLIC 695.25 486.68
14010008 450 1014026 I&D HEMATOMA/SEROMA/FLUID COLLEC 257.50 180.25
14010009 981 10160 PUNCT ASPIR ABSCES/HEMAT/BULL/CYST 388.19 271.73
14010010 450 1101026 DEBRID W/REMOV MAT;SKIN & SUBQ 566.50 396.55
14010011 450 1101126 DEBRID W/REMOV MAT;SKIN-SBQ-MUSC 669.50 468.65
14010012 450 1101226 DEBRID W/REM MAT;SKIN-MUSC-BONE 772.50 540.75
14010013 450 1104126 DEBRID; SKIN FULL THICK 128.75 90.13
14010014 450 1104226 DEBRID; SKIN & SUBQ TISS 386.25 270.38
14010015 450 1104326 DEBRID; SKIN-SUBQ TISS-MUSCL 695.25 486.68
14010016 450 1104426 DEBRID; SKIN-SUBQ TISS-MUSCL-BONE 978.50 684.95
14010017 450 1105526 PARING/CUTTING BEN LES; 1LES 77.25 54.08
14010018 450 1110026 BX SKIN/SUBQ TISS(SEP PRO); 1 LES 151.50 106.05
14010019 450 1110126 BX SKIN/SUBQ TIS (SEP PRO); EA ADD 51.50 36.05
14010020 450 1120126 REMOVE SKIN TAGS;EA ADD 10 LES 77.25 54.08
14010021 450 1130026 SHAVING 1 LES TRUNK; 0.5CM/LESS 103.00 72.10
14010022 450 1130126 SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM 128.75 90.13
14010023 450 1130226 SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM 149.25 104.48
14010024 450 1130326 SHAVING 1 LES TRUNK; OVER 2.0 CM 180.25 126.18
14010025 450 1130626 SHAVING 1 LES SCALP; 0.6 TO 1.0 CM 134.00 93.80
14010026 450 1130726 SHAVING 1 LES SCALP;1.1 TO 2.0 CM 159.75 111.83
14010027 450 1130826 SHAVING 1 LES SCALP; OVER 2.0 CM 180.25 126.18
14010028 450 1131026 SHAVING 1 LES FACE;0.5CM/LESS 128.75 90.13
14010029 450 1131126 SHAVING 1 LES FACE; 0.6 TO 1.0 CM 149.25 104.48
14010030 450 1131326 SHAVING 1 LES FACE; OVER 2.0 CM 216.25 151.38
14010031 450 1140026 EXC BEN LES TRUNK;0.5 CM/LESS 170.00 119.00
14010032 450 1140126 EXC BEN LES TRUNK; 0.6 TO 1.0 CM 206.00 144.20
14010033 981 11402 EXC TR-EXT B9+MARG 1.1-2 CM 389.65 272.76
14010034 450 1140326 EXC BEN LES TRUNK; 2.1 TO 3.0 CM 334.75 234.33
14010035 450 1140426 EXC BEN LES TRUNK; 3.1 TO 4.0 CM 437.75 306.43
14010036 450 1140626 EXC BEN LES TRUNK; OVER 4.0 CM 643.75 450.63
14010037 981 11420 EXC BEN LES SCALP; 0.5 CM/LESS 370.88 259.62
14010038 450 1142126 EXC BEN LES SCALP 0.6 TO 1.0CM0 221.50 155.05
14010039 450 1142226 EXC BEN LES SCALP; 1.1 TO 2.0 CM 298.75 209.13
14010040 450 1142326 EXC BEN LES SCALP; 2.1 TO 3.0 CM 396.50 277.55
14010041 450 1142626 EXC BEN LES SCALP; OVER 4.0 CM 559.25 391.48
14010042 450 1144026 EXC BEN LES FACE; 0.5 CM/LESS 216.25 151.38
14010043 450 1144126 EXC BEN LES FACE; 0.6 TO 1.Q CM 309.00 216.30
14010044 450 1144226 EXC BEN LES FACE; 1.1 TO 2.0 CM 386.25 270.38
14010045 450 1144326 EXC BEN LES FACE; 2.1 TO 3.0 CM 453.25 317.28
14010046 450 1144426 EXC BEN FACE; 3.1 TO 4.0 CM 515.00 360.50
14010047 450 1144626 EXC BEN LES FACE; OVER 4.0 CM 618.00 432.60
14010048 450 1164026 EXC MALIG LES FACE; 0.5 CM/LESS 309.00 216.30
14010049 450 1171926 TRIM NONDYSTROPHIC NAILS-ANY NUMBER 36.00 25.20
14010050 450 1172026 DEBRID NAIL(S) ANY METHOD(S);1 TO 5 113.25 79.28
14010051 981 11730 AVULS OF NAIL PLATE PART OR COMPL SIMPLE 146.17 102.32
14010052 450 1173226 AVULSION PLATE PART/COMPLT SIMPL; EA 72.00 50.40
14010053 981 11740 EVACUATION SUBUNGUAL HEMATOMA 101.75 71.23
14010054 981 11750 EXC NAIL/MATRIX PART/COMPLT PERM 829.50 580.65
14010055 450 1175226 EXC NAIL/MATRIX PERM;AMPUT DISTAL 515.00 360.50
14010056 450 1175526 BX NAIL UNIT ANY METHD(SEP PRO) 195.75 137.03
14010057 981 11760 REPR NAIL BED 545.63 381.94
14010058 450 1177226 EXC PILONIDAL CYST/SINUS;COMPLIC 2,472.00 1,730.40
14010059 456 1200126 SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA 249.25 174.48
14010060 981 12002 SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM 365.15 255.61
14010061 981 12004 SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM 460.61 322.43
14010062 981 12005 SIMPL REPR SCLP/TRUNK; 12.6-20.0CM 861.42 602.99
14010063 450 1200626 SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM 520.25 364.18
14010064 981 12011 SIMPL REPR FACE/MUCOUS; 2.5/LESS 297.79 208.45
14010065 981 12013 SR FCE/EAR/EYE/INSE/LIP 2.6-5 365.15 255.61
14010066 981 12014 SIMPL REPR FACE/MUCOUS 5.1-7.5CM 718.85 503.20
14010067 450 1202026 TX SUPERF WOUND DEHISCENCE;SIMPL 350.25 245.18
14010068 450 1202126 TX SUPERF WOUND DEHISCENCE; W/PACK 412.00 288.40
14010069 981 12031 LAYER CLO SCLP/TRUNK; 2.5 CM/LESS 635.95 445.17
14010070 981 12032 LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM 786.48 550.54
14010071 981 12034 LAYER CLO SCLP/TRUNK; 7.6 TP 12.5 992.65 694.86
14010072 981 12035 LAYER CLO UNSPECIF 773.88 541.72
14010073 981 12041 INTMD WND REPAIR N-HF/GENIT 742.86 520.00
14010074 981 12042 LAYER CLO NECK/FT/GENIT; 2.6-7.5 795.21 556.65
14010075 981 12051 LAYER CLO FACE/LIPS; 2.5CM/LESS 831.21 581.85
14010076 450 1205226 LAYER CLO FACE/LIPS; 2.6 TO 5.0CM 489.25 342.48
14010077 450 1205326 LAYER CLO FACE/LIPS; 5.1 TO 7.5CM 535.50 374.85
14010078 981 12054 LAYER CLO FACE/LIPS; 7.6 TO 12.5CM 1,055.66 738.96
14010079 450 1312026 REPR COMPLX SCLP /EXTREM;1.1-2.5CM 437.75 306.43
14010080 981 13121 REPR COMPLX SCLP/EXTREM; 2.6-7.5CM 1,220.62 854.43
14010081 981 13122 C REP S/A/L; EA ADD 5 CM/< 363.56 254.49
14010082 981 13131 REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5 1,033.02 723.11
14010083 981 13132 REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM 1,515.15 1,060.61
14010084 450 1313326 REPR CMPLX-FAC/HAND/FT; EA ADD 5CM 463.50 324.45
14010085 450 1315126 REPR COMPLX LIDS/LIPS; 1.1-2.5CM 803.50 562.45
14010086 450 1540026 APPLIC XENOGFT SKIN; 100 SQ CM/LESS 772.50 540.75
14010087 450 1593126 EXC SACRAL PRESS ULCER W/PRIM SUTUR 1,699.50 1,189.65
14010088 450 1600026 INT TX 1ST DEGREE BURN W/LOCAL TX 61.75 43.23
14010089 981 16020 DSG/DEBRID INIT/SUBSQT; WO ANES SM 277.28 194.10
14010090 450 1602526 DSG/DEBRID INIT/SUBSQT; WO ANES MED 231.75 162.23
14010091 981 16030 DRS&/DBRDMT PRTL-THKNS BURNS 1 694.33 486.03
14010092 450 1700026 DESTRCT-ANY METHD-BEN LES; W/ANE;1 128.75 90.13
14010093 450 1700326 DESTRCT-ANY METHD-BEN LES 2-14, EA 31.00 21.70
14010094 450 1711026 DESTRCT WARTS/MOLLUSCUM TO 14 LES 128.75 90.13
14010095 450 1711126 DESTRCT WARTS/MOLLUSCUM;15/>LES 170.00 119.00
14010096 450 1900026 PUNCT ASPIRAT CYST BREAST 154.50 108.15
14010097 450 1900126 PUNCT ASPIR CYST BREAST; EA AD CYST 77.25 54.08
14010098 450 1910026 BX BREAST; NEEDLE CORE(SEP PROC) 386.25 270.38
14010099 450 2010226 EXPLOR WOUND (SEP PRO);ABD/FLNK/BK 1,236.00 865.20
14010100 981 20103 EXPLO PENTR WOUND (SEP PRO); EXTREM 4,099.63 2,869.74
14010101 450 2052026 REMOV FB MUSCL/TENDON; SIMPL 355.25 248.68
14010102 450 2055026 INJ TENDON SHEATH/LIG/TRIG PT/CYST 103.00 72.10
14010103 981 20552 INJ TRIGGER POINT 1/2 MUSCL 236.70 165.69
14010104 450 2055326 TRIGGER POINT INJ. THREE OR MORE MUSCLES 154.50 108.15
14010105 981 20605 ARTHROCENTESIS/ASPRI/INJ; INTERM JT 238.88 167.22
14010106 981 20610 ARTHROCENTESIS MAJOR JT/BURSA 304.35 213.05
14010107 450 2061526 ASPIRAT & INJ TX BONE CYST 334.75 234.33
14010108 450 2150126 I&D DEEP ABSCESS SOFT TISS NECK 901.25 630.88
14010109 450 2155026 BX SOFT TISS NECK/THORAZ 437.75 306.43
14010110 450 2180026 CLO TX RIB FX UNCOMP EA 200.75 140.53
14010111 450 2182026 CLO TX STERNUM FX 453.25 317.28
14010112 450 2192026 BX SOFT TISS BACK/FLANK; SUPERF 412.00 288.40
14010113 450 2193026 EXC TUMOR SOFT TISS BACK/FLANK 1,370.00 959.00
14010114 450 2350026 CLO TX CLAV FX; WO MANIP 453.25 317.28
14010115 450 2354026 CLO TX ACROMIOCLAV DISLOC; WO MINIP 515.00 360.50
14010116 450 2357026 CLO TX SCAPULAR FX; WO MANIP 540.75 378.53
14010117 450 2360026 CLO TX PROX HUMERAL FX; WO MANIP 690.00 483.00
14010118 981 23650 CLO TX SHLDR DISLOC W/MANIP;WO ANES 617.95 432.57
14010119 450 2406526 BX SOFT TISS UP ARM/ELBOW; SUPERF 231.75 162.23
14010120 450 2407526 EXC TUMOR UPPER ARM/ELBOW; SUBSQ 679.75 475.83
14010121 450 2450026 CLO TX HUMERAL SHAFT FX; WO MANIP 762.25 533.58
14010122 450 2453026 CLO TX SUPRACONDYL HUMER FX; W/O MAN 762.25 533.58
14010123 450 2457626 CLO TX HUMERAL CONDYL FX; WO MANIP 618.00 432.60
14010124 450 2460026 TX CLO ELBOW DISLOC; WO ANES 679.75 475.83
14010125 981 2460526 TX CLOSED ELBOW DISLOC WITH ANESTHESIA 1,184.50 829.15
14010126 981 24640 CL TX NURSEMAID ELBOW W MANIP 533.34 373.34
14010127 450 2465026 CLO TX RADIAL HEAD/NECK FX; WO MANIP 576.75 403.73
14010128 450 2467026 CLO RX ULNAR FX PROX END; WO MANIP 721.00 504.70
14010129 450 2507526 EXC TUMOR FOREARM/WRIST AREA; SUBQ 1,143.25 800.28
14010130 450 2550026 CLO TX RADIAL SHAFT FX; WO MANIP 592.25 414.58
14010131 450 2550526 CLO TX RADIAL SHAFT FX; W/MANIP 1,143.25 800.28
14010132 450 2553026 CLO TX ULNAR SHAFT FX WO MANIP 592.25 414.58
14010133 450 2556026 CLO TX RAD & ULNA SHAFT FX; WO MANIP 643.75 450.63
14010134 981 25565 CL TX RADIAL & ULNA FX W MANIP 4,809.21 3,366.45
14010135 450 2560026 CLO TX DIST RAD FX; WO MANIP 717.00 501.90
14010136 981 25605 CLOSED TREATMENT DISRAL RADIAL FRACTURE 2,148.96 1,504.27
14010137 450 2562226 CLO TX CARPAL SCAPHOID FX; WO MANIP 721.00 504.70
14010138 450 2563026 CLO TX CARPAL BONE FX; WO MANIP EA 643.75 450.63
14010139 450 26010 DRAINAGE FINGER ABSCESS; SIMPL 253.45 177.42
14010140 450 2601126 DRAINAGE FINGER ABSCESS; COMPLIC 731.25 511.88
14010141 450 2641026 REPAIR, EXTENSOR TENDON, HAND 1,771.50 1,240.05
14010142 981 26418 ER REPAIR EXT. TENDON FINGER PRI/SEC 2,947.28 2,063.10
14010143 450 2643326 REPAIR OF EXTENSOR TENDON DISTAL INSERT. 1,545.00 1,081.50
14010144 450 2660026 CLO TX METACARP FX 1; WO MANIP 489.25 342.48
14010145 450 2660526 CLO TX METACARP FX 1; W/MANIP EA 633.50 443.45
14010146 450 2664126 CLO TX CARPOMETA DISLOC THUMB W/MAN 659.25 461.48
14010147 450 2664526 CLO TX CARPOMETACAR FX THUMB W/MAN 906.50 634.55
14010148 450 2670026 CLO TX MCP DISLOC-1W/MANIP-WO ANES 489.25 342.48
14010149 450 2672026 CLO TX PHALANGEAL FX; WO MANIP EA 365.75 256.03
14010150 450 2672526 CLO TX PHALANGEAL FX; W/WO TRACT 633.50 443.45
14010151 450 2676526 OPEN REDUCTION DISSTAL PHALANGEAL FX 1,225.75 858.03
14010152 981 26770 CLO TX IP JT DISLOC W/WMANIP; WO ANES 1,072.25 750.58
14010153 450 2750026 CLO TX FEMORAL SHAFT FX WO MANIP 1,261.75 883.23
14010154 450 2753026 CLO TX TIBIAL FX PROX;WO MANIP 829.25 580.48
14010155 981 27560 CLO TX PATELLAR DISLOC; WO ANES 1,445.69 1,011.98
14010156 450 2760326 I&D LEG/ANK; DEEP ABSCESS/HEMATOMA 1,004.25 702.98
14010157 450 2775026 CLO TX TIBIAL SHAFT FX; WO MANIP 767.25 537.08
14010158 450 2775226 CLO TX TIB FX; W/MANIP W/WO TRACT 1,493.50 1,045.45
14010159 450 2776026 CLO TX MEDIAL MALLEOLUS FX; WO MANI 721.00 504.70
14010160 450 2776226 CLO TX MED MALLEOLUS FX; W/MANIP 556.25 389.38
14010161 450 2778626 CLO TX DISTAL FIBULAR FX; WO MANIP 643.75 450.63
14010162 450 2778826 CLO TX DISTAL FIBULAR FX; W/MANIP 1,133.00 793.10
14010163 981 27818 CLO TX TRIMALLEOLAR ANK FX; W/MANIP 2,273.08 1,591.16
14010164 450 2782526 CLO TX FX DIST TIB; W/TRACT/ANES 1,606.75 1,124.73
14010165 450 2784026 CLO TX ANK DISLOC; WO ANES 767.25 537.08
14010166 450 2819026 REMOV FB FT; SUBQ 772.50 540.75
14010167 450 2840026 CLO TX CALCAN FX; WO MANIP 633.50 443.45
14010168 450 2845026 TX TARSAL BONE FX; WO MANIP EA 515.00 360.50
14010169 450 2847026 CLO TX METATARSAL FX; WO MANIP EA. 473.75 331.63
14010170 450 2847526 CLO TX METATARSAL FX; W/MANIP EA 654.00 457.80
14010171 450 2849026 CLO TX FX GRT TOE PHALANX; WO MANIP 267.75 187.43
14010172 450 2851026 CLO TX FX PHALNX NOT GR TOE; WO/MAN 257.50 180.25
14010173 450 2851526 CLO TX FX PHALNX NOT GR TOE; W/MANI 329.50 230.65
14010174 450 2860026 CLO TX TARSOMETAT JT DISLOC; WO ANES 437.75 306.43
14010175 981 29065 APPLY LONG ARM CAST 613.31 429.32
14010176 981 29075 APPLIC; ELBOW TO FINGER 383.50 268.45
14010177 450 2908526 APPLIC; HAND & LOWER FOREARM 154.50 108.15
14010178 981 29105 APPLIC; LONG ARM SPLINT 411.46 288.02
14010179 981 29125 APPLIC; SHORT ARM SPLINT; STATOC 259.12 181.38
14010180 981 29130 APPLY FINGER SPLINT; STATIC 155.66 108.96
14010181 981 29240 STRAPPING; SHOULDER 120.22 84.15
14010182 981 29345 APPLIC LONG LEG CAST 575.81 403.07
14010183 981 29405 APPLIC SHORT LEG CAST 381.27 266.89
14010184 450 2942526 APPLIC SHORT LEG CAST; WALKING/AMB 267.75 187.43
14010185 450 2944526 APPLIC RIGID TOT CONTACT LEG CAST 484.00 338.80
14010186 981 29505 APPLIC LONG LEG SPLINT 373.06 261.14
14010187 981 29515 APPLIC SHORT LEG SPLINT 317.54 222.28
14010188 450 2958026 STRAPPING; UNNA BOOT 103.00 72.10
14010189 981 29705 REMOV/BIVALV; FULL ARM/LEG CAST 330.95 231.67
14010190 450 2973026 WINDOWING CAST 73.25 51.28
14010191 450 2974026 WEDGING CAST 128.75 90.13
14010192 450 3030026 REMOV FB INTRANASAL; RIGHT 149.25 104.48
14010193 981 30901 CONTRL NASAL HEMORR-ANT-SIMPL 401.41 280.99
14010194 981 30905 CNTRL POST EPISTAX INIT 558.77 391.14
14010195 981 31500 INTUBATION ENDOTRACHEAL EMER PROC 752.47 526.73
14010196 450 3150226 TRACHEOT TUBE CHANGE BEFOR FISTULA 314.25 219.98
14010197 450 3150526 LARYNGOSCOPY INDIREC; DX (SEP PROC) 237.00 165.90
14010198 450 3151026 LARYNGOSCOPY INDIRECT; W/BX 654.00 457.80
14010199 450 3157526 LARYNGOSCOPY FLEX FIBEROPTIC; DX 319.25 223.48
14010200 450 3160326 TRACHEOSTOMY EMER PROC; TRANSTRACH 1,076.25 753.38
14010201 450 3160526 TRACH EMER PROC; CRICOTHYROID MEMBR 947.50 663.25
14010202 450 3242126 THORACENTESIS 772.50 540.75
14010203 450 3321026 INSRT/REPLC TEMP 1 ELECT (SEP PROC) 772.50 540.75
14010204 450 3522626 REPAIR BLOOD VESSEL LOWER EXTREMITY 2,662.50 1,863.75
14010205 450 3641026 VENIPUNCT> 3YR W/MD SKILL (SEP PRO) 77.25 54.08
14010206 450 3642526 VENIPUNCT CUTDOWN; AGE 1/OVER 164.75 115.33
14010207 450 3655626 INS CENTRAL VENOUS ACCESS >5 378.00 264.60
14010208 450 3660026 ART PUNCT WITHDRAWAL BLD DX; 113.25 79.28
14010209 981 36620 ART CATH-SAMPL (SEP PRO); PERG 346.60 242.62
14010210 450 3830026 DRAINAGE LYMPH NODE ABSCESS;SIMPL 298.75 209.13
14010211 450 3850526 BX/EXC LYMPH NODE; BY NEEDLE SUPERF 473.75 331.63
14010212 450 4049026 BX LIP 185.50 129.85
14010213 450 4080826 BX VESTIBULE MOUTH 267.75 187.43
14010214 450 4375226 NG TUBE PLACEMENT W/FLUORO 180.25 126.18
14010215 450 4500526 I&D SUBMUCOSAL ABSCESS RECTUM 489.25 342.48
14010216 450 4530026 PROCTOSIG RIGID W/W/O COLLECT 257.50 180.25
14010217 450 4530326 PROCSIGMOSCOPY RIGID; W/DILAT 283.25 198.28
14010218 450 4530526 PROCSIGMOSCOPY RIGID; W/BX 1/MX 334.75 234.33
14010219 450 4533026 EMER RM SIGMOIDOSCOP 437.75 306.43
14010220 450 4604026 I&D RECTAL ABCESS 1,287.50 901.25
14010221 450 4605026 I&D PERIANAL ABSCESS SUPERF 391.50 274.05
14010222 450 4606026 INCISION & DRAIN OF A PERIRECTAL ABSCESS 2,034.25 1,423.98
14010223 981 46083 INCS THROMBOSED HEMORRHOID EXT 807.25 565.08
14010224 450 4622126 HEMORRHOIDECTOMY BY SIMPL LIG 231.75 162.23
14010225 450 4632026 ENUCLEATION EXT THROBOTIC HEMORRHO 293.50 205.45
14010226 450 4693526 DESTRCT HEMORRHOIDS ANY METHOD:EXT 525.25 367.68
14010227 450 4908026 PERITONEOCENTESIS;INIT 772.50 540.75
14010228 450 5170026 BLADDER IRRIGA SIMPL LAVAGE 164.75 115.33
14010229 450 5170126 CATH URETHRA; SIMPLE 92.75 64.93
14010230 981 51702 INSERTION TEMPORARY INDWELLING BLADDER 283.61 198.53
14010231 981 51705 CYSTOSTOMY TUBE CHANGE 370.88 259.62
14010232 450 5360026 DILAT URETHRAL STRICT-MALE; INIT 207.00 144.90
14010233 450 5362026 DILAT URETHRAL FILLIFORM-MALE; INIT 267.75 187.43
14010234 450 5470026 INCISION & DRAINAGE OF EPIDIDYMIS 463.50 324.45
14010235 450 5510026 DRAINAGE SCROTAL WALL ABSCESS 237.00 165.90
14010236 981 56405 I&D ABSCESS; PERINEUM 468.47 327.93
14010237 450 6010026 BX THYROID PERCUT CORE NEEDLE 314.25 219.98
14010238 981 62270 SPINAL PUNCT LUMBAR DX 595.59 416.91
14010239 981 64450 INJ ANES AGENT; OTHER PERIPHERAL 294.05 205.84
14010240 981 65205 REMOV FB EXT EYE; CONJUNC SUPERF 177.30 124.11
14010241 450 6521026 REMOV FB EXT EYE; CONJUNC EMBEDDED 164.75 115.33
14010242 981 65220 REMOV FB EXT EYE;CORNEAL WO LAMP 176.98 123.89
14010243 450 6781026 BX EYELID 283.25 198.28
14010244 450 6910026 BX EXT EAR 293.50 205.45
14010245 450 6911026 EXC EXT EAR; PART SIMPL REPR 1,179.25 825.48
14010246 981 69200 REM FB EXT AUDITORY CANAL; WO ANESTH 354.43 248.10
14010247 450 6921026 REMOV IMPACTED CERUMEN (SEP PRO) 77.25 54.08
14010248 450 4375326 GASTRIC INTUB & ASPIR/LAVAGE-TX 425.50 297.85
14010249 480 9296026 CARDIOVERSION ELECTIVE, EXTERN 370.75 259.53
14010250 981 5642026 I&D ABSCESS BARHOLINS GLAND 274.56 192.19
14010251 981 2781026 CLO TX BIMALLEOLAR ANK FX; W/MANIP 1,271.04 889.73
14010252 981 67938 REMOVE EMBEDDED FB EYLID 939.19 657.43
14010255 456 1201126 SIMPL REPR FACE;2.5/LESS 273.00 191.10
14010256 981 12015 SIMPL REPR FACE/MUCOUS 7.60-12.50 cm 904.30 633.01
14010260 981 12052 INTMD WND REPAIR FACE/MM 2.6-5.0 CM 886.83 620.78
14010261 450 1016026 PUNCTASPIR ABSCES/HEMAT/BULL/CYST 154.50 108.15
14010262 981 12001 SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS 271.89 190.32
14010263 450 4083126 CLOLACERATIONMOUTH;OVER 2.5CM/COMPLEX 643.75 450.63
14010265 450 4231026 DRNG ABCESS SUBMAXIL SUBLING ORAL 310.00 217.00
14010266 450 4376026 CHANGEASTROSTOMYTUBEPERCUTNDIMAGIN 250.00 175.00
14010267 981 17250 CHEMICAL CAUTERIZATION PRO FEE 154.59 108.21
14010270 450 97597 RMVL DEVITAL TIS 20CM< 307.75 215.43
14010271 450 97598 RMVL DEVITAL TIS ADDL 20CM 273.00 191.10
14010300 450 5170326 INSERT TEMP BLADDER CATH/COMPLCAT 180.25 126.18
14010301 451 5170326 INSERT TEMP BLADDER CATH/COMPLCATED 180.25 126.18
14010302 456 5170326 INSERT TEMP BLADDER CATH/COMPLCATED 180.25 126.18
14010303 450 2819226 REMOV FB FT; SUBQ 669.50 468.65
14010304 981 26755 CL TX D PHAL FX FGRR/THMB; W MANIP 1,217.61 852.33
14010305 981 11000 DEBR EXZ INF SKIN 10% BS 167.98 117.59
14010306 981 28495 CL TX FX GT PHALANX(S); W MANIP 689.85 482.90
14010307 450 26418 ER REPAIR EXT. TENDON FINGER PRI/SEC 8,860.40 6,202.28
14010308 981 26412 REP ET HAND; W FG EA TENDON 3,064.68 2,145.28
14010311 981 29435 APPY PATELLAR TENDON BEARING CAST 468.06 327.64
14010312 981 30906 CTRL POST EPISTAX SQ 810.07 567.05
14015100 260 96365 INFUSION THERAPY EXCEPT CHEMO 1ST HOUR 134.25 93.98
14016639 450 4180026 DRAIN ABSCESS DENTOALVEOLAR STRUCT 288.50 201.95
14016640 981 64402 INJ ANESTHETIC AGENT FACIAL NERVE 397.05 277.94
14016641 981 27265 CL TX POST HIIP DISLOC WO ANESTH 981.07 686.75
14016642 981 29131 APPLICATION OF FINGER SPLING: DYNAMIC 282.44 197.71
14016643 981 29280 STRAPPING HAND/FINGER 139.21 97.45
14016644 981 23655 CL TX SHLDR DISL W MANIP W ANESTH 1,185.16 829.61
14020001 451 1002226 FINE NEEDLE ASPIRATION W/GUIDANCE 280.25 196.18
14020002 451 1006026 I&D ABCESS; SIMPL/SNGL 226.50 158.55
14020003 451 1006126 I&D ABSCESS:COMPLIC/MX 741.50 519.05
14020004 451 1008026 I & D PILONIDAL CYST: SIMPL 257.50 180.25
14020005 451 1008126 I&D PILONIDAL CYST; COMPLIC 772.50 540.75
14020006 451 1012026 INCS & REMOV FB SUBQ TISS; SIMPL 283.25 198.28
14020007 451 1012126 INCS & REMOV SUBQ TISS; COMPLIC 695.25 486.68
14020008 451 1014026 I&D HEMATOMA/SEROMA/FLUID COLLEC 257.50 180.25
14020009 451 1016026 PUNCT ASPIR ABSCES/HEMAT/BULL/CYST 154.50 108.15
14020010 451 1101026 DEBRID W/REMOV MAT;SKIN & SUBQ 566.50 396.55
14020011 451 1101126 DEBRID W/REMOV MAT;SKIN-SBQ-MUSC 669.50 468.65
14020012 451 1101226 DEBRID W/REM MAT;SKIN-MUSC-BONE 772.50 540.75
14020013 451 1104126 DEBRID; SKIN FULL THICK 128.75 90.13
14020014 451 1104226 DEBRID; SKIN & SUBQ TISS 386.25 270.38
14020015 451 1104326 DEBRID; SKIN-SUBQ TISS-MUSCL 695.25 486.68
14020016 451 1104426 DEBRID; SKIN-SUBQ TISS-MUSCL-BONE 978.50 684.95
14020017 451 1105526 PARING/CUTTING BEN LES; 1LES 77.25 54.08
14020018 451 1110026 BX SKIN/SUBQ TISS(SEP PRO); 1 LES 151.50 106.05
14020019 451 1110126 BX SKIN/SUBQ TIS (SEP PRO); EA ADD 51.50 36.05
14020020 451 1120126 REMOVE SKIN TAGS;EA ADD 10 LES 77.25 54.08
14020021 451 1130026 SHAVING 1 LES TRUNK; 0.5CM/LESS 103.00 72.10
14020022 451 1130126 SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM 128.75 90.13
14020023 451 1130226 SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM 149.25 104.48
14020024 451 1130326 SHAVING 1 LES TRUNK; OVER 2.0 CM 180.25 126.18
14020025 451 1130626 SHAVING 1 LES SCALP; 0.6 TO 1.0 CM 134.00 93.80
14020026 451 1130726 SHAVING 1 LES SCALP;1.1 TO 2.0 CM 159.75 111.83
14020027 451 1130826 SHAVING 1 LES SCALP; OVER 2.0 CM 180.25 126.18
14020028 451 1131026 SHAVING 1 LES FACE;0.5CM/LESS 128.75 90.13
14020029 451 1131126 SHAVING 1 LES FACE; 0.6 TO 1.0 CM 149.25 104.48
14020030 451 1131326 SHAVING 1 LES FACE; OVER 2.0 CM 216.25 151.38
14020031 451 1140026 EXC BEN LES TRUNK;0.5 CM/LESS 170.00 119.00
14020032 451 1140126 EXC BEN LES TRUNK; 0.6 TO 1.0 CM 206.00 144.20
14020033 451 1140226 EXC BEN LES TRUNK; 1.1 TO 2.0 CM 262.75 183.93
14020034 451 1140326 EXC BEN LES TRUNK; 2.1 TO 3.0 CM 334.75 234.33
14020035 451 1140426 EXC BEN LES TRUNK; 3.1 TO 4.0 CM 437.75 306.43
14020036 451 1140626 EXC BEN LES TRUNK; OVER 4.0 CM 643.75 450.63
14020037 451 1142026 EXC BEN LES SCALP; 0.5 CM/LESS 190.50 133.35
14020038 451 1142126 EXC BEN LES SCALP 0.6 TO 1.0CM0 221.50 155.05
14020039 451 1142226 EXC BEN LES SCALP; 1.1 TO 2.0 CM 298.75 209.13
14020040 451 1142326 EXC BEN LES SCALP; 2.1 TO 3.0 CM 396.50 277.55
14020041 451 1142626 EXC BEN LES SCALP; OVER 4.0 CM 559.25 391.48
14020042 451 1144026 EXC BEN LES FACE; 0.5 CM/LESS 216.25 151.38
14020043 451 1144126 EXC BEN LES FACE; 0.6 TO 1.Q CM 309.00 216.30
14020044 451 1144226 EXC BEN LES FACE; 1.1 TO 2.0 CM 386.25 270.38
14020045 451 1144326 EXC BEN LES FACE; 2.1 TO 3.0 CM 453.25 317.28
14020046 451 1144426 EXC BEN FACE; 3.1 TO 4.0 CM 515.00 360.50
14020047 451 1144626 EXC BEN LES FACE; OVER 4.0 CM 618.00 432.60
14020048 451 1164026 EXC MALIG LES FACE; 0.5 CM/LESS 309.00 216.30
14020049 451 1171926 TRIM NONDYSTROPHIC NAILS-ANY NUMBER 36.00 25.20
14020050 451 1172026 DEBRID NAIL(S) ANY METHOD(S);1 TO 5 113.25 79.28
14020051 451 1173026 AVULS OF NAIL PLATE PART OR COMPL SIMPLE 283.25 198.28
14020052 451 1173226 AVULSION PLATE PART/COMPLT SIMPL; EA 72.00 50.40
14020053 451 1174026 EVACUATION SUBUNGUAL HEMATOMA 87.50 61.25
14020054 451 1175026 EXC NAIL/MATRIX PART/COMPLT PERM 463.50 324.45
14020055 451 1175226 EXC NAIL/MATRIX PERM;AMPUT DISTAL 515.00 360.50
14020056 451 1175526 BX NAIL UNIT ANY METHD(SEP PRO) 195.75 137.03
14020057 451 1176026 REPR NAIL BED 360.50 252.35
14020058 451 1177226 EXC PILONIDAL CYST/SINUS;COMPLIC 2,472.00 1,730.40
14020059 451 1200126 SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA 249.25 174.48
14020060 451 1200226 SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM 334.75 234.33
14020061 451 1200426 SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM 422.25 295.58
14020062 451 1200526 SIMPL REPR SCLP/TRUNK; 12.6-20.0CM 499.50 349.65
14020063 451 1200626 SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM 520.25 364.18
14020064 451 1201126 SIMPL REPR FACE/MUCOUS; 2.5/LESS 273.00 191.10
14020065 451 1201326 SR FCE/EAR/EYE/INSE/LIP 2.6-5 334.75 234.33
14020066 451 1201426 SIMPL REPR FACE/MUCOUS 5.1-7.5CM 360.50 252.35
14020067 451 1202026 TX SUPERF WOUND DEHISCENCE;SIMPL 350.25 245.18
14020068 451 1202126 TX SUPERF WOUND DEHISCENCE; W/PACK 412.00 288.40
14020069 451 1203126 LAYER CLO SCLP/TRUNK; 2.5 CM/LESS 288.50 201.95
14020070 451 1203226 LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM 473.75 331.63
14020071 451 1203426 LAYER CLO SCLP/TRUNK; 7.6 TP 12.5 499.50 349.65
14020072 451 1203526 LAYER CLO UNSPECIF 566.50 396.55
14020073 451 1204126 INTMD WND REPAIR N-HF/GENIT 334.75 234.33
14020074 451 1204226 LAYER CLO NECK/FT/GENIT; 2.6-7.5 437.75 306.43
14020075 451 1205126 LAYER CLO FACE/LIPS; 2.5CM/LESS 437.75 306.43
14020076 451 1205226 LAYER CLO FACE/LIPS; 2.6 TO 5.0CM 489.25 342.48
14020077 451 1205326 LAYER CLO FACE/LIPS; 5.1 TO 7.5CM 535.50 374.85
14020078 451 1205426 LAYER CLO FACE/LIPS; 7.6 TO 12.5CM 721.00 504.70
14020079 451 1312026 REPR COMPLX SCLP /EXTREM;1.1-2.5CM 437.75 306.43
14020080 451 1312126 REPR COMPLX SCLP/EXTREM; 2.6-7.5CM 690.00 483.00
14020081 451 1312226 REBR CMPLX-SCLP/ARM/LEG; EA AD 5CM 185.50 129.85
14020082 451 1313126 REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5 566.50 396.55
14020083 451 1313226 REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM 901.25 630.88
14020084 450 13133 REPR CMPLX-FAC/HAND/FT; EA ADD 5CM 463.50 324.45
14020085 451 1315126 REPR COMPLX LIDS/LIPS; 1.1-2.5CM 803.50 562.45
14020086 451 1540026 APPLIC XENOGFT SKIN; 100 SQ CM/LESS 772.50 540.75
14020087 451 1593126 EXC SACRAL PRESS ULCER W/PRIM SUTUR 1,699.50 1,189.65
14020088 451 1600026 INT TX 1ST DEGREE BURN W/LOCAL TX 61.75 43.23
14020089 451 1602026 DSG/DEBRID INIT/SUBSQT; WO ANES SM 113.25 79.28
14020090 451 1602526 DSG/DEBRID INIT/SUBSQT; WO ANES MED 231.75 162.23
14020091 451 1603026 DSG/DEBRID INT/SUBSQT; WO ANES LG 340.00 238.00
14020092 451 1700026 DESTRCT-ANY METHD-BEN LES; W/ANE;1 128.75 90.13
14020093 451 1700326 DESTRCT-ANY METHD-BEN LES 2-14, EA 31.00 21.70
14020094 451 1711026 DESTRCT WARTS/MOLLUSCUM TO 14 LES 128.75 90.13
14020095 451 1711126 DESTRCT WARTS/MOLLUSCUM;15/>LES 170.00 119.00
14020096 451 1900026 PUNCT ASPIRAT CYST BREAST 154.50 108.15
14020097 451 1900126 PUNCT ASPIR CYST BREAST; EA AD CYST 77.25 54.08
14020098 451 1910026 BX BREAST; NEEDLE CORE(SEP PROC) 386.25 270.38
14020099 451 2010226 EXPLOR WOUND (SEP PRO);ABD/FLNK/BK 1,236.00 865.20
14020100 451 2010326 EXPLO PENTR WOUND (SEP PRO); EXTREM 1,339.00 937.30
14020101 451 2052026 REMOV FB MUSCL/TENDON; SIMPL 355.25 248.68
14020102 451 2055026 INJ TENDON SHEATH/LIG/TRIG PT/CYST 103.00 72.10
14020103 451 2055226 TRIGGER POINT INJECTION ONE/TWO MUSCLES 103.00 72.10
14020104 451 2055326 TRIGGER POINT INJ. THREE OR MORE MUSCLES 154.50 108.15
14020105 451 2060526 ARTHROCENTESIS/ASPRI/INJ; INTERM JT 103.00 72.10
14020106 451 2061026 ARTHROCENTESIS MAJOR JT/BURSA 149.25 104.48
14020107 451 2061526 ASPIRAT & INJ TX BONE CYST 334.75 234.33
14020108 451 2150126 I&D DEEP ABSCESS SOFT TISS NECK 901.25 630.88
14020109 451 2155026 BX SOFT TISS NECK/THORAZ 437.75 306.43
14020110 451 2180026 CLO TX RIB FX UNCOMP EA 200.75 140.53
14020111 451 2182026 CLO TX STERNUM FX 453.25 317.28
14020112 451 2192026 BX SOFT TISS BACK/FLANK; SUPERF 412.00 288.40
14020113 451 2193026 EXC TUMOR SOFT TISS BACK/FLANK 1,370.00 959.00
14020114 451 2350026 CLO TX CLAV FX; WO MANIP 453.25 317.28
14020115 451 2354026 CLO TX ACROMIOCLAV DISLOC; WO MINIP 515.00 360.50
14020116 451 2357026 CLO TX SCAPULAR FX; WO MANIP 540.75 378.53
14020117 451 2360026 CLO TX PROX HUMERAL FX; WO MANIP 690.00 483.00
14020118 451 2365026 CLO TX SHLDR DISLOC W/MANIP;WO ANES 566.50 396.55
14020119 451 2406526 BX SOFT TISS UP ARM/ELBOW; SUPERF 231.75 162.23
14020120 451 2407526 EXC TUMOR UPPER ARM/ELBOW; SUBSQ 679.75 475.83
14020121 451 2450026 CLO TX HUMERAL SHAFT FX; WO MANIP 762.25 533.58
14020122 451 2453026 CLO TX SUPRACONDYL HUMER FX; W/O MAN 762.25 533.58
14020123 451 2457626 CLO TX HUMERAL CONDYL FX; WO MANIP 618.00 432.60
14020124 451 2460026 TX CLO ELBOW DISLOC; WO ANES 679.75 475.83
14020125 451 2460526 TX CLOSED ELBOW DISLOC WITH ANESTHESIA 1,184.50 829.15
14020126 451 2464026 CLO TX RADIAL HEAD SUBLUXA CHILD 273.00 191.10
14020127 451 2465026 CLO TX RADIAL HEAD/NECK FX; WO MANIP 576.75 403.73
14020128 451 2467026 CLO RX ULNAR FX PROX END; WO MANIP 721.00 504.70
14020129 451 2507526 EXC TUMOR FOREARM/WRIST AREA; SUBQ 1,143.25 800.28
14020130 451 2550026 CLO TX RADIAL SHAFT FX; WO MANIP 592.25 414.58
14020131 451 2550526 CLO TX RADIAL SHAFT FX; W/MANIP 1,143.25 800.28
14020132 451 2553026 CLO TX ULNAR SHAFT FX WO MANIP 592.25 414.58
14020133 451 2556026 CLO TX RAD & ULNA SHAFT FX; WO MANIP 643.75 450.63
14020134 451 2556526 CLO TX RAD & ULNA SHAFT FX; W/MANIP 1,287.50 901.25
14020135 451 2560026 CLO TX DIST RAD FX; WO MANIP 717.00 501.90
14020136 451 2560526 CLOSED TREATMENT DISRAL RADIAL FRACTURE 1,251.50 876.05
14020137 451 2562226 CLO TX CARPAL SCAPHOID FX; WO MANIP 721.00 504.70
14020138 451 2563026 CLO TX CARPAL BONE FX; WO MANIP EA 643.75 450.63
14020139 451 2601026 DRAINAGE FINGER ABSCESS; SIMPL 237.00 165.90
14020140 451 2601126 DRAINAGE FINGER ABSCESS; COMPLIC 731.25 511.88
14020141 451 2641026 REPAIR, EXTENSOR TENDON, HAND 1,771.50 1,240.05
14020142 451 2641826 ER REPAIR EXT. TENDON FINGER PRI/SEC 1,462.50 1,023.75
14020143 451 2643326 REPAIR OF EXTENSOR TENDON DISTAL INSERT. 1,545.00 1,081.50
14020144 451 2660026 CLO TX METACARP FX 1; WO MANIP 489.25 342.48
14020145 451 2660526 CLO TX METACARP FX 1; W/MANIP EA 633.50 443.45
14020146 451 2664126 CLO TX CARPOMETA DISLOC THUMB W/MAN 659.25 461.48
14020147 451 2664526 CLO TX CARPOMETACAR FX THUMB W/MAN 906.50 634.55
14020148 451 2670026 CLO TX MCP DISLOC-1W/MANIP-WO ANES 489.25 342.48
14020149 451 2672026 CLO TX PHALANGEAL FX; WO MANIP EA 365.75 256.03
14020150 451 2672526 CLO TX PHALANGEAL FX; W/WO TRACT 633.50 443.45
14020151 451 2676526 OPEN REDUCTION DISSTAL PHALANGEAL FX 1,225.75 858.03
14020152 451 2677026 CLO TX IP JT DISLOC W/WMANIP; WO ANES 489.25 342.48
14020153 451 2750026 CLO TX FEMORAL SHAFT FX WO MANIP 1,261.75 883.23
14020154 451 2753026 CLO TX TIBIAL FX PROX;WO MANIP 829.25 580.48
14020155 451 2756026 CLO TX PATELLAR DISLOC; WO ANES 453.25 317.28
14020156 451 2760326 I&D LEG/ANK; DEEP ABSCESS/HEMATOMA 1,004.25 702.98
14020157 451 2775026 CLO TX TIBIAL SHAFT FX; WO MANIP 767.25 537.08
14020158 451 2775226 CLO TX TIB FX; W/MANIP W/WO TRACT 1,493.50 1,045.45
14020159 451 2776026 CLO TX MEDIAL MALLEOLUS FX; WO MANI 721.00 504.70
14020160 451 2776226 CLO TX MED MALLEOLUS FX; W/MANIP 556.25 389.38
14020161 451 2778626 CLO TX DISTAL FIBULAR FX; WO MANIP 643.75 450.63
14020162 451 2778826 CLO TX DISTAL FIBULAR FX; W/MANIP 1,133.00 793.10
14020163 451 2781826 CLO TX TRIMALLEOLAR ANK FX; W/MANIP 1,406.00 984.20
14020164 451 2782526 CLO TX FX DIST TIB; W/TRACT/ANES 1,606.75 1,124.73
14020165 451 2784026 CLO TX ANK DISLOC; WO ANES 767.25 537.08
14020166 451 2819026 REMOV FB FT; SUBQ 772.50 540.75
14020167 451 2840026 CLO TX CALCAN FX; WO MANIP 633.50 443.45
14020168 451 2845026 TX TARSAL BONE FX; WO MANIP EA 515.00 360.50
14020169 451 2847026 CLO TX METATARSAL FX; WO MANIP EA. 473.75 331.63
14020170 451 2847526 CLO TX METATARSAL FX; W/MANIP EA 654.00 457.80
14020171 451 2849026 CLO TX FX GRT TOE PHALANX; WO MANIP 267.75 187.43
14020172 451 2851026 CLO TX FX PHALNX NOT GR TOE; WO/MAN 257.50 180.25
14020173 451 2851526 CLO TX FX PHALNX NOT GR TOE; W/MANI 329.50 230.65
14020174 451 2860026 CLO TX TARSOMETAT JT DISLOC; WO ANES 437.75 306.43
14020175 451 2906526 APPLIC; SHOULDER TO HAND 273.00 191.10
14020176 451 2907526 APPLIC; ELBOW TO FINGER 221.50 155.05
14020177 451 2908526 APPLIC; HAND & LOWER FOREARM 154.50 108.15
14020178 451 2910526 APPLIC; LONG ARM SPLINT 231.75 162.23
14020179 451 2912526 APPLIC; SHORT ARM SPLINT; STATOC 231.75 162.23
14020180 451 2913026 APPLIC FINGER SPLINT; STATIC 77.25 54.08
14020181 451 2924026 APPLIC SLING SHOULDER 77.25 54.08
14020182 451 2934526 APPLIC LONG LEG CAST 273.00 191.10
14020183 451 2940526 APPLIC SHORT LEG CAST 283.25 198.28
14020184 451 2942526 APPLIC SHORT LEG CAST; WALKING/AMB 267.75 187.43
14020185 451 2944526 APPLIC RIGID TOT CONTACT LEG CAST 484.00 338.80
14020186 451 2950526 APPLIC LONG LEG SPLINT 190.50 133.35
14020187 451 2951526 APPLIC SHORT LEG SPLINT 123.50 86.45
14020188 451 2958026 STRAPPING; UNNA BOOT 103.00 72.10
14020189 451 2970526 REMOV/BIVALV; FULL ARM/LEG CAST 92.75 64.93
14020190 451 2973026 WINDOWING CAST 73.25 51.28
14020191 451 2974026 WEDGING CAST 128.75 90.13
14020192 981 30300 REMOV FB INTRANASAL; RIGHT 585.54 409.88
14020193 451 3090126 CONTRL NASAL HEMORR-ANT-SIMPL 190.50 133.35
14020194 451 3090526 CONTRL NASAL HEMORR-POST W/PACKING 509.75 356.83
14020195 451 3150026 INTUBATION ENDOTRACHEAL EMER PROC 412.00 288.40
14020196 451 3150226 TRACHEOT TUBE CHANGE BEFOR FISTULA 314.25 219.98
14020197 451 3150526 LARYNGOSCOPY INDIREC; DX (SEP PROC) 237.00 165.90
14020198 451 3151026 LARYNGOSCOPY INDIRECT; W/BX 654.00 457.80
14020199 451 3157526 LARYNGOSCOPY FLEX FIBEROPTIC; DX 319.25 223.48
14020200 451 3160326 TRACHEOSTOMY EMER PROC; TRANSTRACH 1,076.25 753.38
14020201 451 3160526 TRACH EMER PROC; CRICOTHYROID MEMBR 947.50 663.25
14020202 451 3242126 THORACENTESIS 772.50 540.75
14020203 451 3321026 INSRT/REPLC TEMP 1 ELECT (SEP PROC) 772.50 540.75
14020204 451 3522626 REPAIR BLOOD VESSEL LOWER EXTREMITY 2,662.50 1,863.75
14020205 451 3641026 VENIPUNCT> 3YR W/MD SKILL (SEP PRO) 77.25 54.08
14020206 451 3642526 VENIPUNCT CUTDOWN; AGE 1/OVER 164.75 115.33
14020207 451 3655626 INS CENTRAL VENOUS ACCESS >5 378.00 264.60
14020208 451 3660026 ART PUNCT WITHDRAWAL BLD DX; 113.25 79.28
14020209 451 3662026 ART CATH-SAMPL (SEP PRO); PERG 310.00 217.00
14020210 451 3830026 DRAINAGE LYMPH NODE ABSCESS;SIMPL 298.75 209.13
14020211 451 3850526 BX/EXC LYMPH NODE; BY NEEDLE SUPERF 473.75 331.63
14020212 451 4049026 BX LIP 185.50 129.85
14020213 451 4080826 BX VESTIBULE MOUTH 267.75 187.43
14020214 451 4375226 NG TUBE PLACEMENT W/FLUORO 180.25 126.18
14020215 451 4500526 I&D SUBMUCOSAL ABSCESS RECTUM 489.25 342.48
14020216 451 4530026 PROCTOSIG RIGID W/W/O COLLECT 257.50 180.25
14020217 451 4530326 PROCSIGMOSCOPY RIGID; W/DILAT 283.25 198.28
14020218 451 4530526 PROCSIGMOSCOPY RIGID; W/BX 1/MX 334.75 234.33
14020219 451 4533026 EMER RM SIGMOIDOSCOP 437.75 306.43
14020220 451 4604026 I&D RECTAL ABCESS 1,287.50 901.25
14020221 451 4605026 I&D PERIANAL ABSCESS SUPERF 391.50 274.05
14020222 451 4606026 INCISION & DRAIN OF A PERIRECTAL ABSCESS 2,034.25 1,423.98
14020223 451 4608326 INCS THROMBOSED HEMORRHOID EXT 257.50 180.25
14020224 451 4622126 HEMORRHOIDECTOMY BY SIMPL LIG 231.75 162.23
14020225 451 4632026 ENUCLEATION EXT THROBOTIC HEMORRHO 293.50 205.45
14020226 451 4693526 DESTRCT HEMORRHOIDS ANY METHOD:EXT 525.25 367.68
14020227 451 4908026 PERITONEOCENTESIS;INIT 772.50 540.75
14020228 451 5170026 BLADDER IRRIGA SIMPL LAVAGE 164.75 115.33
14020229 981 51701 INSERT BLADDER CATHETER 207.30 145.11
14020230 451 5170226 INSERTION TEMPORARY INDWELLING BLADDER 134.00 93.80
14020231 451 5170526 CYSTOSTOMY TUBE CHANGE 350.25 245.18
14020232 451 5360026 DILAT URETHRAL STRICT-MALE; INIT 207.00 144.90
14020233 451 5362026 DILAT URETHRAL FILLIFORM-MALE; INIT 267.75 187.43
14020234 451 5470026 INCISION & DRAINAGE OF EPIDIDYMIS 463.50 324.45
14020235 451 5510026 DRAINAGE SCROTAL WALL ABSCESS 237.00 165.90
14020236 451 5640526 I&D ABSCESS; PERINEUM 309.00 216.30
14020237 451 6010026 BX THYROID PERCUT CORE NEEDLE 314.25 219.98
14020238 451 6227026 SPINAL PUNCT LUMBAR DX 334.75 234.33
14020239 451 6445026 INJ ANES AGENT; OTHER PERIPHERAL 314.25 219.98
14020240 451 6520526 REMOV FB EXT EYE; CONJUNC SUPERF 144.25 100.98
14020241 451 6521026 REMOV FB EXT EYE; CONJUNC EMBEDDED 164.75 115.33
14020242 451 6522026 REMOV FB EXT EYE;CORNEAL WO LAMP 200.75 140.53
14020243 451 6781026 BX EYELID 283.25 198.28
14020244 451 6910026 BX EXT EAR 293.50 205.45
14020245 451 6911026 EXC EXT EAR; PART SIMPL REPR 1,179.25 825.48
14020246 450 69200 REM FB EXT AUDITORY CANAL; WO ANESTH 381.65 267.16
14020247 451 6921026 REMOV IMPACTED CERUMEN (SEP PRO) 77.25 54.08
14020248 451 4375326 GASTRIC INTUB & ASPIR/LAVAGE-TX 425.50 297.85
14020249 450 27265 CL TX POST HIP DISLOC WO ANESTH 765.58 535.91
14020250 450 29280 STRAPPING HAND/FINGER 114.42 80.09
14020251 450 23655 CL TX SHLDR DISL W MANIP W ANESTH 4,746.53 3,322.57
14020252 450 29260 STRAPPING ELBOW OR WRIST 120.81 84.57
14020253 981 29260 STRAPPING ELBOW OR WRIST 130.24 91.17
14020260 451 1205226 LAYER CLO FACE/LIPS 2.6 TO 5.0CM 489.25 342.48
14020261 451 1016026 PUNCTASPIR ABSCES/HEMAT/BULL/CYST 154.50 108.15
14020262 451 1002126 FINE NEEDLE ASPIRATION W/O GUIDANCE 252.25 176.58
14020263 451 4083126 CLOLACERATIONMOUTH;OVER 2.5CM/COMPLEX 643.75 450.63
14020264 451 2819226 REMOV FB FT; SUBQ 669.50 468.65
14020265 451 97597 RMVL DEVITAL TIS 20CM< 307.75 215.43
14020266 451 97598 RMVL DEVITAL TIS ADDL 20CM 273.00 191.10
14026639 451 4180026 DRAIN ABSCESS DENTOALVEOLAR STRUCT 288.50 201.95
14030000 456 1002126 FINE NEEDLE ASPIRATION W/O GUIDANCE 252.25 176.58
14030001 456 1002226 FINE NEEDLE ASPIRATION W/GUIDANCE 280.25 196.18
14030002 456 1006026 I&D ABCESS; SIMPL/SNGL 226.50 158.55
14030003 456 1006126 I&D ABSCESS:COMPLIC/MX 741.50 519.05
14030004 456 1008026 I & D PILONIDAL CYST: SIMPL 257.50 180.25
14030005 456 1008126 I&D PILONIDAL CYST; COMPLIC 772.50 540.75
14030006 456 1012026 INCS & REMOV FB SUBQ TISS; SIMPL 283.25 198.28
14030007 456 1012126 INCS & REMOV SUBQ TISS; COMPLIC 695.25 486.68
14030008 456 1014026 I&D HEMATOMA/SEROMA/FLUID COLLEC 257.50 180.25
14030009 456 1016026 PUNCT ASPIR ABSCES/HEMAT/BULL/CYST 154.50 108.15
14030010 456 1101026 DEBRID W/REMOV MAT;SKIN & SUBQ 566.50 396.55
14030011 456 1101126 DEBRID W/REMOV MAT;SKIN-SBQ-MUSC 669.50 468.65
14030012 456 1101226 DEBRID W/REM MAT;SKIN-MUSC-BONE 772.50 540.75
14030013 456 1104126 DEBRID; SKIN FULL THICK 128.75 90.13
14030014 456 1104226 DEBRID; SKIN & SUBQ TISS 386.25 270.38
14030015 456 1104326 DEBRID; SKIN-SUBQ TISS-MUSCL 695.25 486.68
14030016 456 1104426 DEBRID; SKIN-SUBQ TISS-MUSCL-BONE 978.50 684.95
14030017 456 1105526 PARING/CUTTING BEN LES; 1LES 77.25 54.08
14030018 456 1110026 BX SKIN/SUBQ TISS(SEP PRO); 1 LES 151.50 106.05
14030019 456 1110126 BX SKIN/SUBQ TIS (SEP PRO); EA ADD 51.50 36.05
14030020 456 1120126 REMOVE SKIN TAGS;EA ADD 10 LES 77.25 54.08
14030021 456 1130026 SHAVING 1 LES TRUNK; 0.5CM/LESS 103.00 72.10
14030022 456 1130126 SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM 128.75 90.13
14030023 456 1130226 SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM 149.25 104.48
14030024 456 1130326 SHAVING 1 LES TRUNK; OVER 2.0 CM 180.25 126.18
14030025 456 1130626 SHAVING 1 LES SCALP; 0.6 TO 1.0 CM 134.00 93.80
14030026 456 1130726 SHAVING 1 LES SCALP;1.1 TO 2.0 CM 159.75 111.83
14030027 456 1130826 SHAVING 1 LES SCALP; OVER 2.0 CM 180.25 126.18
14030028 456 1131026 SHAVING 1 LES FACE;0.5CM/LESS 128.75 90.13
14030029 456 1131126 SHAVING 1 LES FACE; 0.6 TO 1.0 CM 149.25 104.48
14030030 456 1131326 SHAVING 1 LES FACE; OVER 2.0 CM 216.25 151.38
14030031 456 1140026 EXC BEN LES TRUNK;0.5 CM/LESS 170.00 119.00
14030032 456 1140126 EXC BEN LES TRUNK; 0.6 TO 1.0 CM 206.00 144.20
14030033 450 1140226 EXC BEN LES TRUNK; 1.1 TO 2.0 CM 262.75 183.93
14030034 456 1140326 EXC BEN LES TRUNK; 2.1 TO 3.0 CM 334.75 234.33
14030035 456 1140426 EXC BEN LES TRUNK; 3.1 TO 4.0 CM 437.75 306.43
14030036 456 1140626 EXC BEN LES TRUNK; OVER 4.0 CM 643.75 450.63
14030037 456 1142026 EXC BEN LES SCALP; 0.5 CM/LESS 190.50 133.35
14030038 456 1142126 EXC BEN LES SCALP 0.6 TO 1.0CM0 221.50 155.05
14030039 456 1142226 EXC BEN LES SCALP; 1.1 TO 2.0 CM 298.75 209.13
14030040 456 1142326 EXC BEN LES SCALP; 2.1 TO 3.0 CM 396.50 277.55
14030041 456 1142626 EXC BEN LES SCALP; OVER 4.0 CM 559.25 391.48
14030042 456 1144026 EXC BEN LES FACE; 0.5 CM/LESS 216.25 151.38
14030043 456 1144126 EXC BEN LES FACE; 0.6 TO 1.Q CM 309.00 216.30
14030044 456 1144226 EXC BEN LES FACE; 1.1 TO 2.0 CM 386.25 270.38
14030045 456 1144326 EXC BEN LES FACE; 2.1 TO 3.0 CM 453.25 317.28
14030046 456 1144426 EXC BEN FACE; 3.1 TO 4.0 CM 515.00 360.50
14030047 456 1144626 EXC BEN LES FACE; OVER 4.0 CM 618.00 432.60
14030048 456 1164026 EXC MALIG LES FACE; 0.5 CM/LESS 309.00 216.30
14030049 456 1171926 TRIM NONDYSTROPHIC NAILS-ANY NUMBER 36.00 25.20
14030050 456 1172026 DEBRID NAIL(S) ANY METHOD(S);1 TO 5 113.25 79.28
14030051 456 1173026 AVULS OF NAIL PLATE PART OR COMPL SIMPLE 283.25 198.28
14030052 456 1173226 AVULSION PLATE PART/COMPLT SIMPL; EA 72.00 50.40
14030053 456 1174026 EVACUATION SUBUNGUAL HEMATOMA 87.50 61.25
14030054 456 1175026 EXC NAIL/MATRIX PART/COMPLT PERM 463.50 324.45
14030055 456 1175226 EXC NAIL/MATRIX PERM;AMPUT DISTAL 515.00 360.50
14030056 456 1175526 BX NAIL UNIT ANY METHD(SEP PRO) 195.75 137.03
14030057 456 1176026 REPR NAIL BED 360.50 252.35
14030058 456 1177226 EXC PILONIDAL CYST/SINUS;COMPLIC 2,472.00 1,730.40
14030060 456 1200226 SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM 334.75 234.33
14030061 456 1200426 SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM 422.25 295.58
14030062 456 1200526 SIMPL REPR SCLP/TRUNK; 12.6-20.0CM 499.50 349.65
14030063 456 1200626 SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM 520.25 364.18
14030064 456 1201126 SIMPL REPR FACE/MUCOUS; 2.5/LESS 273.00 191.10
14030065 456 1201326 SR FCE/EAR/EYE/INSE/LIP 2.6-5 334.75 234.33
14030066 456 1201426 SIMPL REPR FACE/MUCOUS 5.1-7.5CM 360.50 252.35
14030067 456 1202026 TX SUPERF WOUND DEHISCENCE;SIMPL 350.25 245.18
14030068 456 1202126 TX SUPERF WOUND DEHISCENCE; W/PACK 412.00 288.40
14030069 456 1203126 LAYER CLO SCLP/TRUNK; 2.5 CM/LESS 288.50 201.95
14030070 456 1203226 LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM 473.75 331.63
14030071 456 1203426 LAYER CLO SCLP/TRUNK; 7.6 TP 12.5 499.50 349.65
14030072 456 1203526 LAYER CLO UNSPECIF 566.50 396.55
14030073 456 1204126 INTMD WND REPAIR N-HF/GENIT 334.75 234.33
14030074 456 1204226 LAYER CLO NECK/FT/GENIT; 2.6-7.5 437.75 306.43
14030075 456 1205126 LAYER CLO FACE/LIPS; 2.5CM/LESS 437.75 306.43
14030076 456 1205226 LAYER CLO FACE/LIPS; 2.6 TO 5.0CM 489.25 342.48
14030077 456 1205326 LAYER CLO FACE/LIPS; 5.1 TO 7.5CM 535.50 374.85
14030078 456 1205426 LAYER CLO FACE/LIPS; 7.6 TO 12.5CM 721.00 504.70
14030079 456 1312026 REPR COMPLX SCLP /EXTREM;1.1-2.5CM 437.75 306.43
14030080 456 1312126 REPR COMPLX SCLP/EXTREM; 2.6-7.5CM 690.00 483.00
14030081 456 1312226 REBR CMPLX-SCLP/ARM/LEG; EA AD 5CM 185.50 129.85
14030082 456 1313126 REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5 566.50 396.55
14030083 456 1313226 REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM 901.25 630.88
14030084 456 1313326 REPR CMPLX-FAC/HAND/FT; EA ADD 5CM 463.50 324.45
14030085 456 1315126 REPR COMPLX LIDS/LIPS; 1.1-2.5CM 803.50 562.45
14030086 456 1540026 APPLIC XENOGFT SKIN; 100 SQ CM/LESS 772.50 540.75
14030087 456 1593126 EXC SACRAL PRESS ULCER W/PRIM SUTUR 1,699.50 1,189.65
14030088 456 1600026 INT TX 1ST DEGREE BURN W/LOCAL TX 61.75 43.23
14030089 456 1602026 DSG/DEBRID INIT/SUBSQT; WO ANES SM 113.25 79.28
14030090 456 1602526 DSG/DEBRID INIT/SUBSQT; WO ANES MED 231.75 162.23
14030091 456 1603026 DSG/DEBRID INT/SUBSQT; WO ANES LG 340.00 238.00
14030092 456 1700026 DESTRCT-ANY METHD-BEN LES; W/ANE;1 128.75 90.13
14030093 456 1700326 DESTRCT-ANY METHD-BEN LES 2-14, EA 31.00 21.70
14030094 456 1711026 DESTRCT WARTS/MOLLUSCUM TO 14 LES 128.75 90.13
14030095 456 1711126 DESTRCT WARTS/MOLLUSCUM;15/>LES 170.00 119.00
14030096 456 1900026 PUNCT ASPIRAT CYST BREAST 154.50 108.15
14030097 456 1900126 PUNCT ASPIR CYST BREAST; EA AD CYST 77.25 54.08
14030098 456 1910026 BX BREAST; NEEDLE CORE(SEP PROC) 386.25 270.38
14030099 456 2010226 EXPLOR WOUND (SEP PRO);ABD/FLNK/BK 1,236.00 865.20
14030100 456 2010326 EXPLO PENTR WOUND (SEP PRO); EXTREM 1,339.00 937.30
14030101 456 2052026 REMOV FB MUSCL/TENDON; SIMPL 355.25 248.68
14030102 456 2055026 INJ TENDON SHEATH/LIG/TRIG PT/CYST 103.00 72.10
14030103 456 2055226 TRIGGER POINT INJECTION ONE/TWO MUSCLES 103.00 72.10
14030104 456 2055326 TRIGGER POINT INJ. THREE OR MORE MUSCLES 154.50 108.15
14030105 456 2060526 ARTHROCENTESIS/ASPRI/INJ; INTERM JT 103.00 72.10
14030106 456 2061026 ARTHROCENTESIS MAJOR JT/BURSA 149.25 104.48
14030107 456 2061526 ASPIRAT & INJ TX BONE CYST 334.75 234.33
14030108 456 2150126 I&D DEEP ABSCESS SOFT TISS NECK 901.25 630.88
14030109 456 2155026 BX SOFT TISS NECK/THORAZ 437.75 306.43
14030110 456 2180026 CLO TX RIB FX UNCOMP EA 200.75 140.53
14030111 456 2182026 CLO TX STERNUM FX 453.25 317.28
14030112 456 2192026 BX SOFT TISS BACK/FLANK; SUPERF 412.00 288.40
14030113 456 2193026 EXC TUMOR SOFT TISS BACK/FLANK 1,370.00 959.00
14030114 456 2350026 CLO TX CLAV FX; WO MANIP 453.25 317.28
14030115 456 2354026 CLO TX ACROMIOCLAV DISLOC; WO MINIP 515.00 360.50
14030116 456 2357026 CLO TX SCAPULAR FX; WO MANIP 540.75 378.53
14030117 456 2360026 CLO TX PROX HUMERAL FX; WO MANIP 690.00 483.00
14030118 456 2365026 CLO TX SHLDR DISLOC W/MANIP;WO ANES 566.50 396.55
14030119 456 2406526 BX SOFT TISS UP ARM/ELBOW; SUPERF 231.75 162.23
14030120 456 2407526 EXC TUMOR UPPER ARM/ELBOW; SUBSQ 679.75 475.83
14030121 456 2450026 CLO TX HUMERAL SHAFT FX; WO MANIP 762.25 533.58
14030122 456 2453026 CLO TX SUPRACONDYL HUMER FX; W/O MAN 762.25 533.58
14030123 456 2457626 CLO TX HUMERAL CONDYL FX; WO MANIP 618.00 432.60
14030124 456 2460026 TX CLO ELBOW DISLOC; WO ANES 679.75 475.83
14030125 456 2460526 TX CLOSED ELBOW DISLOC WITH ANESTHESIA 1,184.50 829.15
14030126 456 2464026 CLO TX RADIAL HEAD SUBLUXA CHILD 273.00 191.10
14030127 456 2465026 CLO TX RADIAL HEAD/NECK FX; WO MANIP 576.75 403.73
14030128 456 2467026 CLO RX ULNAR FX PROX END; WO MANIP 721.00 504.70
14030129 456 2507526 EXC TUMOR FOREARM/WRIST AREA; SUBQ 1,143.25 800.28
14030130 456 2550026 CLO TX RADIAL SHAFT FX; WO MANIP 592.25 414.58
14030131 456 2550526 CLO TX RADIAL SHAFT FX; W/MANIP 1,143.25 800.28
14030132 456 2553026 CLO TX ULNAR SHAFT FX WO MANIP 592.25 414.58
14030133 456 2556026 CLO TX RAD & ULNA SHAFT FX; WO MANIP 643.75 450.63
14030134 456 2556526 CLO TX RAD & ULNA SHAFT FX; W/MANIP 1,287.50 901.25
14030135 456 2560026 CLO TX DIST RAD FX; WO MANIP 717.00 501.90
14030136 456 2560526 CLOSED TREATMENT DISRAL RADIAL FRACTURE 1,251.50 876.05
14030137 456 2562226 CLO TX CARPAL SCAPHOID FX; WO MANIP 721.00 504.70
14030138 456 2563026 CLO TX CARPAL BONE FX; WO MANIP EA 643.75 450.63
14030139 456 2601026 DRAINAGE FINGER ABSCESS; SIMPL 237.00 165.90
14030140 456 2601126 DRAINAGE FINGER ABSCESS; COMPLIC 731.25 511.88
14030141 456 2641026 REPAIR, EXTENSOR TENDON, HAND 1,771.50 1,240.05
14030142 456 2641826 ER REPAIR EXT. TENDON FINGER PRI/SEC 1,462.50 1,023.75
14030143 456 2643326 REPAIR OF EXTENSOR TENDON DISTAL INSERT. 1,545.00 1,081.50
14030144 456 2660026 CLO TX METACARP FX 1; WO MANIP 489.25 342.48
14030145 456 2660526 CLO TX METACARP FX 1; W/MANIP EA 633.50 443.45
14030146 456 2664126 CLO TX CARPOMETA DISLOC THUMB W/MAN 659.25 461.48
14030147 456 2664526 CLO TX CARPOMETACAR FX THUMB W/MAN 906.50 634.55
14030148 456 2670026 CLO TX MCP DISLOC-1W/MANIP-WO ANES 489.25 342.48
14030149 456 2672026 CLO TX PHALANGEAL FX; WO MANIP EA 365.75 256.03
14030150 456 2672526 CLO TX PHALANGEAL FX; W/WO TRACT 633.50 443.45
14030151 456 2676526 OPEN REDUCTION DISSTAL PHALANGEAL FX 1,225.75 858.03
14030152 456 2677026 CLO TX IP JT DISLOC W/WMANIP; WO ANES 489.25 342.48
14030153 456 2750026 CLO TX FEMORAL SHAFT FX WO MANIP 1,261.75 883.23
14030154 456 2753026 CLO TX TIBIAL FX PROX;WO MANIP 829.25 580.48
14030155 456 2756026 CLO TX PATELLAR DISLOC; WO ANES 453.25 317.28
14030156 456 2760326 I&D LEG/ANK; DEEP ABSCESS/HEMATOMA 1,004.25 702.98
14030157 456 2775026 CLO TX TIBIAL SHAFT FX; WO MANIP 767.25 537.08
14030158 456 2775226 CLO TX TIB FX; W/MANIP W/WO TRACT 1,493.50 1,045.45
14030159 456 2776026 CLO TX MEDIAL MALLEOLUS FX; WO MANI 721.00 504.70
14030160 456 2776226 CLO TX MED MALLEOLUS FX; W/MANIP 556.25 389.38
14030161 456 2778626 CLO TX DISTAL FIBULAR FX; WO MANIP 643.75 450.63
14030162 456 2778826 CLO TX DISTAL FIBULAR FX; W/MANIP 1,133.00 793.10
14030163 456 2781826 CLO TX TRIMALLEOLAR ANK FX; W/MANIP 1,406.00 984.20
14030164 456 2782526 CLO TX FX DIST TIB; W/TRACT/ANES 1,606.75 1,124.73
14030165 456 2784026 CLO TX ANK DISLOC; WO ANES 767.25 537.08
14030166 456 2819026 REMOV FB FT; SUBQ 772.50 540.75
14030167 456 2840026 CLO TX CALCAN FX; WO MANIP 633.50 443.45
14030168 456 2845026 TX TARSAL BONE FX; WO MANIP EA 515.00 360.50
14030169 456 2847026 CLO TX METATARSAL FX; WO MANIP EA. 473.75 331.63
14030170 456 2847526 CLO TX METATARSAL FX; W/MANIP EA 654.00 457.80
14030171 456 2849026 CLO TX FX GRT TOE PHALANX; WO MANIP 267.75 187.43
14030172 456 2851026 CLO TX FX PHALNX NOT GR TOE; WO/MAN 257.50 180.25
14030173 456 2851526 CLO TX FX PHALNX NOT GR TOE; W/MANI 329.50 230.65
14030174 456 2860026 CLO TX TARSOMETAT JT DISLOC; WO ANES 437.75 306.43
14030175 456 2906526 APPLIC; SHOULDER TO HAND 273.00 191.10
14030176 456 2907526 APPLIC; ELBOW TO FINGER 221.50 155.05
14030177 456 2908526 APPLIC; HAND & LOWER FOREARM 154.50 108.15
14030178 456 2910526 APPLIC; LONG ARM SPLINT 231.75 162.23
14030179 456 2912526 APPLIC; SHORT ARM SPLINT; STATOC 231.75 162.23
14030180 456 2913026 APPLIC FINGER SPLINT; STATIC 77.25 54.08
14030181 456 2924026 APPLIC SLING SHOULDER 77.25 54.08
14030182 456 2934526 APPLIC LONG LEG CAST 273.00 191.10
14030183 456 2940526 APPLIC SHORT LEG CAST 283.25 198.28
14030184 456 2942526 APPLIC SHORT LEG CAST; WALKING/AMB 267.75 187.43
14030185 456 2944526 APPLIC RIGID TOT CONTACT LEG CAST 484.00 338.80
14030186 456 2950526 APPLIC LONG LEG SPLINT 190.50 133.35
14030187 456 2951526 APPLIC SHORT LEG SPLINT 123.50 86.45
14030188 456 2958026 STRAPPING; UNNA BOOT 103.00 72.10
14030189 456 2970526 REMOV/BIVALV; FULL ARM/LEG CAST 92.75 64.93
14030190 456 2973026 WINDOWING CAST 73.25 51.28
14030191 456 2974026 WEDGING CAST 128.75 90.13
14030192 456 3030026 REMOV FB INTRANASAL; RIGHT 149.25 104.48
14030193 456 3090126 CONTRL NASAL HEMORR-ANT-SIMPL 190.50 133.35
14030194 456 3090526 CONTRL NASAL HEMORR-POST W/PACKING 509.75 356.83
14030195 456 3150026 INTUBATION ENDOTRACHEAL EMER PROC 412.00 288.40
14030196 456 3150226 TRACHEOT TUBE CHANGE BEFOR FISTULA 314.25 219.98
14030197 456 3150526 LARYNGOSCOPY INDIREC; DX (SEP PROC) 237.00 165.90
14030198 456 3151026 LARYNGOSCOPY INDIRECT; W/BX 654.00 457.80
14030199 456 3157526 LARYNGOSCOPY FLEX FIBEROPTIC; DX 319.25 223.48
14030200 456 3160326 TRACHEOSTOMY EMER PROC; TRANSTRACH 1,076.25 753.38
14030201 456 3160526 TRACH EMER PROC; CRICOTHYROID MEMBR 947.50 663.25
14030202 456 3242126 THORACENTESIS 772.50 540.75
14030203 456 3321026 INSRT/REPLC TEMP 1 ELECT (SEP PROC) 772.50 540.75
14030204 456 3522626 REPAIR BLOOD VESSEL LOWER EXTREMITY 2,662.50 1,863.75
14030205 456 3641026 VENIPUNCT> 3YR W/MD SKILL (SEP PRO) 77.25 54.08
14030206 456 3642526 VENIPUNCT CUTDOWN; AGE 1/OVER 164.75 115.33
14030207 456 3655626 INS CENTRAL VENOUS ACCESS >5 378.00 264.60
14030208 456 3660026 ART PUNCT WITHDRAWAL BLD DX; 113.25 79.28
14030209 456 3662026 ART CATH-SAMPL (SEP PRO); PERG 310.00 217.00
14030210 456 3830026 DRAINAGE LYMPH NODE ABSCESS;SIMPL 298.75 209.13
14030211 456 3850526 BX/EXC LYMPH NODE; BY NEEDLE SUPERF 473.75 331.63
14030212 456 4049026 BX LIP 185.50 129.85
14030213 456 4080826 BX VESTIBULE MOUTH 267.75 187.43
14030214 456 4375226 NG TUBE PLACEMENT W/FLUORO 180.25 126.18
14030215 456 4500526 I&D SUBMUCOSAL ABSCESS RECTUM 489.25 342.48
14030216 456 4530026 PROCTOSIG RIGID W/W/O COLLECT 257.50 180.25
14030217 456 4530326 PROCSIGMOSCOPY RIGID; W/DILAT 283.25 198.28
14030218 456 4530526 PROCSIGMOSCOPY RIGID; W/BX 1/MX 334.75 234.33
14030219 456 4533026 EMER RM SIGMOIDOSCOP 437.75 306.43
14030220 456 4604026 I&D RECTAL ABCESS 1,287.50 901.25
14030221 456 4605026 I&D PERIANAL ABSCESS SUPERF 391.50 274.05
14030222 456 4606026 INCISION & DRAIN OF A PERIRECTAL ABSCESS 2,034.25 1,423.98
14030223 456 4608326 INCS THROMBOSED HEMORRHOID EXT 257.50 180.25
14030224 456 4622126 HEMORRHOIDECTOMY BY SIMPL LIG 231.75 162.23
14030225 456 4632026 ENUCLEATION EXT THROBOTIC HEMORRHO 293.50 205.45
14030226 456 4693526 DESTRCT HEMORRHOIDS ANY METHOD:EXT 525.25 367.68
14030227 456 4908026 PERITONEOCENTESIS;INIT 772.50 540.75
14030228 456 5170026 BLADDER IRRIGA SIMPL LAVAGE 164.75 115.33
14030230 456 5170226 INSERTION TEMPORARY INDWELLING BLADDER 134.00 93.80
14030231 456 5170526 CYSTOSTOMY TUBE CHANGE 350.25 245.18
14030232 456 5360026 DILAT URETHRAL STRICT-MALE; INIT 207.00 144.90
14030233 456 5362026 DILAT URETHRAL FILLIFORM-MALE; INIT 267.75 187.43
14030234 456 5470026 INCISION & DRAINAGE OF EPIDIDYMIS 463.50 324.45
14030235 456 5510026 DRAINAGE SCROTAL WALL ABSCESS 237.00 165.90
14030236 456 5640526 I&D ABSCESS; PERINEUM 309.00 216.30
14030237 456 6010026 BX THYROID PERCUT CORE NEEDLE 314.25 219.98
14030238 456 6227026 SPINAL PUNCT LUMBAR DX 334.75 234.33
14030239 456 6445026 INJ ANES AGENT; OTHER PERIPHERAL 314.25 219.98
14030241 456 6521026 REMOV FB EXT EYE; CONJUNC EMBEDDED 164.75 115.33
14030242 456 6522026 REMOV FB EXT EYE;CORNEAL WO LAMP 200.75 140.53
14030243 456 6781026 BX EYELID 283.25 198.28
14030244 456 6910026 BX EXT EAR 293.50 205.45
14030245 456 6911026 EXC EXT EAR; PART SIMPL REPR 1,179.25 825.48
14030246 456 6920026 REMOV FB-EXT AUDIT CANAL; WO ANES, RIGHT 216.25 151.38
14030247 456 6921026 REMOV IMPACTED CERUMEN (SEP PRO) 77.25 54.08
14030248 456 4375326 GASTRIC INTUB & ASPIR/LAVAGE-TX 425.50 297.85
14030249 456 4083126 CLOLACERATIONMOUTH;OVER 2.5CM/COMPLEX 643.75 450.63
14030250 456 2819226 REMOV FB FT; SUBQ 669.50 468.65
14030251 456 97598 RMVL DEVITAL TIS ADDL 20CM 273.00 191.10
14030252 456 97597 RMVL DEVITAL TIS 20CM< 307.75 215.43
14030255 456 1602026 DSG/DEBRID INIT/SUBSQT; WO ANES SM 113.25 79.28
14036639 456 4180026 DRAIN ABSCESS DENTOALVEOLAR STRUCT 288.50 201.95
14099281 981 99281 ER PHYSICIAN LEVEL 1 185.05 129.54
14099282 981 99282 ER PHYSICIAN LEVEL 2 259.12 181.38
14099283 981 99283 ER PHYSICIAN LEVEL 3 382.39 267.67
14099284 981 99284 ER PHYSICIAN LEVEL 4 547.87 383.51
14099285 981 99285 ER PHYSICIAN LEVEL 5 815.37 570.76
14099292 981 99292 ER PHYSICIAN CRITICAL CARE ADDL 30 MINS 457.75 320.43
15001075 636 J7325 SYNVISC ONE INJ 4,170.77 2,919.54
15002001 983 99201 OFFICE/OP VISIT NEW I 83.75 58.63
15002002 983 99202 OFFICE/OP VISIT NEW II 138.87 97.21
15002003 983 99203 OFFICE/OP VISIT NEW III 202.48 141.74
15002004 983 99204 OFFICE/OP VISIT NEW IV 303.18 212.23
15002005 983 99212 OFFICE/OP VISIT EST I 88.02 61.61
15002006 983 99213 OFFICE/OP VISIT EST II 132.56 92.79
15002007 983 99214 OFFICE/OP VISIT EST III 194.50 136.15
15002008 983 99215 OFFICE/OP VISIT EST IV 275.99 193.19
15002009 983 99241 OFFICE CONSULTATION I 138.00 96.60
15002010 983 99242 OFFICE CONSULTATION II 207.54 145.28
15002011 983 99243 OFFICE CONSULTATION III 279.25 195.48
15002012 983 99244 OFFICE CONSULTATION IV 388.99 272.29
15003001 983 20526 CARPAL TUNNEL TX INJ 287.93 201.55
15003002 983 20550 INJ SGL TENDON SHTH OR LIGAMENT 201.42 140.99
15003003 983 20550 INJ TENDON ORIGIN/INSERTION 201.42 140.99
15003004 983 20600 DRAIN/INJ SMALL JOINT/BURSA W/O US 183.39 128.37
15003005 983 20605 DRAIN/INJ INTER JOINT/BURSA W/O US 207.78 145.45
15003006 983 20610 DRAIN/INJ MAJOR JOINT/BURSA W/O US 265.02 185.51
15003007 983 20612 ASPIRATE/INJ 229.26 160.48
15003008 983 64455 N BLOCK INJ PLANTAR DIGIT 168.42 117.89
15003009 636 J3590 SKIN SUBSTITUTE NOS- AMNIOFIX 2,683.41 1,878.39
15003010 636 J7325 SYNVISC SYRINGE 3 x 16mg/2mL PER MG 78.81 55.17
15003011 636 J7323 EUFLEXXA INJ PER DOSE 1,034.06 723.84
15003012 636 J7323 EUFLEXXA INJ PER DOSE 1,126.18 788.33
15004001 983 29065 APPLICATION LONG ARM CAST 387.90 271.53
15004002 983 29075 APPLICATION OF FOREARM CAST 334.66 234.26
15004003 983 29085 APPLY HAND/WRIST CAST 352.04 246.43
15004004 983 29086 APPLY FINGER CAST 234.69 164.28
15004005 983 29345 APPLICATION OF LONG LEG CAST 486.79 340.75
15004006 983 29405 APPLY SHORT LEG CAST 321.62 225.13
15004007 983 29425 APPLY WLKR SHORT LEG CAST 348.79 244.15
15004008 983 29105 APPLY LONG ARM SPLINT 358.58 251.01
15004009 983 29125 APPLY FOREARM SPLINT 266.21 186.35
15004010 983 29130 APPLICATION OF FINGER SPLINT 154.77 108.34
15004011 983 29515 APPLICATION OF LOWER LEG SPLINT 268.38 187.87
15004012 360 HIP IM ROD OR PINNING 22,086.49 15,460.54
15101001 975 27125 PARTIAL HIP REPL, PROSTHESIS 4,314.50 3,020.15
15101002 975 27130 TOTAL HIP ARTHROPL 5,918.41 4,142.89
15101003 975 27132 CONV TO TOTAL HIP ARTHROPL 7,038.91 4,927.24
15101004 975 27134 REVISE TOTAL HIP ARTHROPL, BOTH COMP 8,148.81 5,704.17
15101005 975 27137 REVISE TOTAL HIP ARTHROPL, ACETABUL 6,271.41 4,389.99
15101006 975 27138 REVISE TOTAL HIP ARTHROPL, FEMORAL 6,438.90 4,507.23
15101007 975 27445 ARTHROPL KNEE, CONTRAINED PROSTH 5,929.01 4,150.31
15101008 975 27446 ARTHROPL KNEE C&P, MEDIAL LAT 5,108.50 3,575.95
15101009 975 27447 TOT KNEE ARTHROPLASTY 6,664.70 4,665.29
15101010 975 27486 REVISE/REPLACE KNEE JOINT 1 COMPONENT 6,066.81 4,246.77
15101011 975 27487 REVISE/REPLACE KNEE JOINT TIB&FIB COMPON 8,051.28 5,635.90
15101012 975 25608 TREAT FX RAD INTRA-ARTICUL; 2 FRAGS 3,167.38 2,217.17
15101013 975 25000 INSC EXTENSOR TENDON SHEATH 1,614.66 1,130.26
15101014 975 27130AS TOTAL HIP ARTHROPL-PA ASSIST 5,918.41 4,142.89
15101015 975 27447AS TOT KNEE ARTHROPLASTY-PA ASST 6,476.87 4,533.81
15101016 975 64450 INJ ANESTH; OTHR PERPHERAL NRV/BRANCH 244.48 171.14
15101017 975 24685 OPEN TX ULNAR FRACTURE PROXIMAL END 2,817.49 1,972.24
15101018 975 24685AS OPEN TREATMENT ULNAR FRACTURE PA ASSIST 2,817.49 1,972.24
15101019 975 64447 INJ ANESTHETIC AGENT FEMORAL 888.82 622.17
15101020 360 ORTHOPEDICS I 120.20 84.14
15101021 360 ORTHOPEDICS II 121.59 85.11
15101022 360 ORTHOPEDICS III 141.44 99.01
15101023 360 ORTHOPEDICS IV 145.36 101.75
15101024 360 ORTHOPEDICS V 157.38 110.17
15101025 975 27245 TREAT INTER PR SUBTRCHNTRIC FEM FX 1 5,997.91 4,198.54
15101026 975 27245AS TREAT INTER PR SUBTRCHNTRIC FEM FX 1-PA 5,997.91 4,198.54
15101027 975 29880 ARTHRS KNEE W/MENISCECTOMY MED 4,278.47 2,994.93
15101028 360 ORTHOPEDICS MINOR PROCEDURE 2,295.15 1,606.61
15101029 975 23130 ACROMIOPL/ACROMIONECT PARTIAL 2,293.76 1,605.63
15101030 975 23412 REPAIR ROTATOR CUFF; CHRONIC 3,833.45 2,683.42
15101031 975 23130AS ACROMIOPL/ACROMIONECT PARTIAL-ASST 2,461.84 1,723.29
15101032 975 23412AS REPAIR ROTATOR CUFF; CHRONIC-ASST 3,833.45 2,683.42
15101033 975 29881 KNEE ARTHROPLASTY SURG W/ MENISCECTOMY 3,521.57 2,465.10
15101034 975 26123 FASCT PRTL PALMAR 1 DGT PROX IPHA 4,199.62 2,939.73
15101035 975 26125 FASCT PRTL PALMAR ADDL DGT PROX IPHA 1,621.18 1,134.83
15101036 975 27570 MANIPULATE KNEE JNT UNDER ANESTH 834.49 584.14
15101037 975 64721 NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL 2,040.64 1,428.45
15101038 975 27236 BIPOLAR HIP REPLACEMENT 5,378.82 3,765.17
15101039 975 27236AS BIPOLAR HIP REPLACEMENT-ASST 5,378.82 3,765.17
15101040 975 25609 TREAT FX RADIAL 3 + FRAG 4,161.60 2,913.12
15101041 975 25609AS TREAT FX RADIAL 3 + FRAG 4,044.31 2,831.02
15101042 975 64718 NEUROPLASTY ULNAR NERVE AT ELBOW 2,577.05 1,803.94
15101043 975 24105 EXCISE OLECRANON BURSA 1,564.68 1,095.28
15101044 975 27332 ARTHROT KNEE W MENISC MED OR LAT 2,991.34 2,093.94
15101045 975 27792 OPEN TX DISTAL FIBULAR FRACT LAT MALLEOL 2,764.68 1,935.28
15101046 975 27766 OPEN TREATMENT MEDIAL MALLEOLUS 2,715.36 1,900.75
15101047 975 27792AS OPEN TX DISTAL FIBULAR FRACT LAT MALLEOL 2,764.68 1,935.28
15101048 975 27766AS OPEN TREATMENT MEDIAL MALLEOLUS 2,715.36 1,900.75
15101049 975 29807 ARTHROSCOPY SHOULDER SURGICAL REPAIR OF 4,489.74 3,142.82
15101051 975 29827 ARTHROSCOPY SHOULDER SURGICAL WITH ROTAT 4,642.08 3,249.46
15101052 975 27132AS CONV TO TOTAL HIP ARTHROPL 7,038.91 4,927.24
15101053 975 29875 ARTHROSCOPY KNEE SYNOVECTOMY L 2,760.99 1,932.69
15101054 975 29879 ARTHROSCOPY KNEE; ABRAS ARTHROPL 3,336.87 2,335.81
15101055 975 26160 EXC TNDN SHTH LES HND/FING 2,305.71 1,614.00
15101056 975 26055 TENDON SHEATH INCISION 2,288.33 1,601.83
15101057 975 23420 RECONSTRUCTION ROTATOR CUFF AV 3,814.98 2,670.49
15101058 975 23420AS RECONSTRUCTION ROTATOR CUFF AV 3,814.98 2,670.49
15101059 975 23410 OPEN REPAIR ROTATOR CUFF 3,499.87 2,449.91
15101060 975 23410AS OPEN REPAIR ROTATOR CUFF 3,499.87 2,449.91
15101061 975 25608AS TREAT FX RAD INTRA-ARTICUL; 2 FRAGS 3,074.53 2,152.17
15101062 975 25607 TREAT FX RAD EXTRA-ARTICUL 8,453.57 5,917.50
15101063 975 25607AS TREAT FX RAD EXTRA-ARTICUL 8,453.57 5,917.50
15101064 975 11424 EXCBLES S/N/EX G 3.1-4.0 CM 2,680.59 1,876.41
15101065 975 29879AS ARTHROSCOPY KNEE; ABRAS ARTHROPL 3,336.87 2,335.81
15101066 975 29881AS KNEE ARTHROSCOPY/SURGERY 3,609.61 2,526.73
15101067 975 27814 OPEN TX BIMALLEOLAR ANKLE FX 9,928.15 6,949.71
15101068 975 26735 OPEN TX PHALANG SHAFT FRACT PROX/MIDDLE 5,595.37 3,916.76
15101069 975 26765 OPEN TX DISTAL PHALANG FRACT EA 4,117.31 2,882.12
15101070 975 26410 REP ET HAND WO FG EA TENDON 3,038.07 2,126.65
15101071 975 11760 REPAIR NAIL BED 1,049.23 734.46
15101072 975 27814AS OPEN TX BIMALLEOLAR ANKLE FX 9,928.15 6,949.71
15101073 975 27829 TREAT LOWER LEG JOINT 2,892.21 2,024.55
15101074 975 10140 I&D HEMATOMA/FLUID 1,012.01 708.41
15101075 975 11042 DEB SUBQ TISSUE 20 SQ CM 745.69 521.98
15101076 975 24359 REPAIR ELBOW DEB/ATTCH OPEN 4,343.83 3,040.68
15101077 975 27266 CL TX POSTOP HIP DISLOC W ANESTH 2,438.41 1,706.89
15101078 975 27235 PERC FIX FEM PROX NK FX 3,116.99 2,181.89
15101079 975 27266AS CL TX POSTOP HIP DISLOC W ANESTH 2,438.41 1,706.89
15101080 975 29880AS ARTHRS KNEE W/MENISCECTOMY MED 4,385.43 3,069.80
15101081 975 26727 PERC SK FIX UNST PHAL SHFT FX PR/MID PH 1,443.44 1,010.41
15101082 975 25111 EXC 1' WRITS GANGLION 1,027.23 719.06
15101083 636 J7325 SYNVISC OR SYNVISC-ONE 1 MG 116.40 81.48
15101084 975 20680 REM IMPL DEEP 1,450.10 1,015.07
15101085 975 20551 INJ TENDON ORIGIN/INSERT 132.49 92.74
15101086 975 27760 CL TX MEDIAL ANKLE FX 945.03 661.52
15101087 975 11044 DEB BONE 20 SQ CM 731.89 512.32
15101088 975 23600 CL TX PROX HUMERAL FX WO MANIP 960.08 672.06
15101089 975 27758 TREATMENT OF TIBIA FRACTURE 2,864.45 2,005.12
15101090 975 27758AS TREATMENT OF TIBIA FRACTURE 2,864.45 2,005.12
15101091 975 25622 CL TX CARPAL SCAPHOID FX WO MANIP 855.96 599.17
15101092 975 27259 OP TX SP HIP DISLOC W FEM SHORTEN 4,900.27 3,430.19
15101093 975 25600 CLTX DSTL RADIAL FX/SPIPHYSL SEP WO MNP 867.53 607.27
15101094 975 26750 CL TX D PHAL FX FGR/THMB WO MANIP 593.07 415.15
15101095 975 27333 ARTHROT KNEE W MENISC; MED & LAT 2,194.60 1,536.22
15101096 975 27524 OP TX PATEL FX W IF &/REP 2,559.49 1,791.64
15101097 975 27524AS OP TX PATEL FX W IF &/REP 2,559.49 1,791.64
15101098 983 2060050 DRAIN/INJ SMALL JOINT/BURSA W/O US BILAT 281.93 197.35
15101099 983 2060550 DRAIN/INJ INTER JOINT/BURSA W/O US BILAT 319.49 223.64
15101100 975 12020 TX S WND DEHISC; SMPL 564.28 395.00
15101101 975 24516 TX HUMERUS SH FX W IMPANT 2,819.27 1,973.49
15101102 975 27506 OP TX FEM SFT FX W INS IM IMPL 4,115.54 2,880.88
15101103 975 29876 KNEE ARTHROSCOPY/SURGERY 2+ COMPART 2,365.74 1,656.02
15101104 360 TOT KNEE ARTHROPLASTY 41,827.41 29,279.19
15101105 360 BIPOLAR OR TOT HIP REPLACEMENT 41,827.41 29,279.19
15101106 360 KNEE ARTHROSCOPY 10,058.99 7,041.29
15101107 360 ORTHO CARPAL TUNNEL 6,128.79 4,290.15
15101108 360 TOT SHOULDER 43,027.27 30,119.09
15101110 360 ROTATOR CUFF REPAIR & OTHER PROC 21,890.83 15,323.58
15101111 360 NEUROPLASTY; ULNAR NERVE TRANSPOSITION-O 6,128.81 4,290.17
15101112 360 KNEE MANIPULATION 4,728.00 3,309.60
15101113 360 WRIST ORIF 21,919.94 15,343.96
15102000 983 2061050 DRAIN/INJ MAJOR JOINT/BURSA W/O US BILAT 396.05 277.24
15102001 983 20552 INJ TRIGGER POINT 1/2 MUSCL 235.79 165.05
15102002 983 29540 STRAPPING ANKLE AND/OR FOOT 77.00 53.90
16000001 271 DNU BAG OSTOMY 1 3/4 DRAINABLE0 21.00 14.70
16000002 270 A4389 BAG OSTOMY 1 3/4 DRAINABLE 21.09 14.76
16000003 272 SUTURE PROLENE 4-0 PC-5 ETH 8631G 21.09 14.76
16000004 272 SUTURE ETHILON 4-0 PC-5 ETH 1894G 21.09 14.76
16000006 272 SUTURE ETHILON 5-0 PC-3 ETH 1965G 21.09 14.76
16000007 272 SUTURE ETHILON 6-0 PC-1 21.09 14.76
16000008 272 SUTURE CHROMIC 5-0 P-3 ETH 687G 21.09 14.76
16000009 272 DASH IT HALLOW DIRECT ACESS 1,338.14 936.70
16000010 272 SUTURE PROLENE 6-0 BV-1 30 ETH 8709H 61.53 43.07
16000011 272 FROVA INTUBATING INTRODUCER 8F 330.29 231.20
16000012 272 RAPI-FIT FROVA INTUBATING INTRODUCER 14F 317.09 221.96
16000013 272 RAPID-FIT FROVA INTUBATING INTRODUCER 14 268.61 188.03
16000014 272 RETOGRADE INTUBATION SET 11F 553.61 387.53
16000015 272 RETROGRADE INTUBATION SET REPLACEMENT WI 198.26 138.78
16000016 272 SUTURE GORTEX 2-0 CV-2 2N08A 77.49 54.24
16000017 272 SUTURE VICRYL 4-0 RB-1 ETH J214H 21.09 14.76
16000018 258 SHIELD EYE WITH GARTER 21.09 14.76
16000019 272 SUTURE VICRYL 3-0 TIES ETH J110T 27.06 18.94
16000020 272 SOFT TIPPED AIRWAY EXCHANGE CATHETER 11F 217.72 152.40
16000022 272 SUTURE CHROMIC 3-0 SH ETH G122H 22.38 15.67
16000023 272 SUTURE MONOCRYL 4-0 PS-2 ETH Y426H 20.00 14.00
16000025 272 ENK OXYGEN FLOW MODULATOR SET 6F 480.33 336.23
16000027 272 SUTURE SILK 2-0 18 TIE ETH A185H 21.09 14.76
16000033 272 SUTURE RETENTION BRIDGES ETH RSB5 36.20 25.34
16000035 272 SUTURE PROLENE 4-0 RB-1 ETH 8557H 28.88 20.22
16000036 272 A4344 CATH SILICONE 16FR 5CC 23.09 16.16
16000037 272 SUTURE PROLENE 5-0 C-1 ETH 8720H 50.56 35.39
16000038 272 A4344 CATH SILICONE 18FR 5CC 21.09 14.76
16000041 272 A4344 CATH SILICONE 24FR 5CC 21.09 14.76
16000042 272 SUTURE PROLENE 5-0 P-3 ETH 8698G 20.00 14.00
16000044 272 A4344 *CATH SILICONE 28FR 5CC 21.09 14.76
16000047 272 SUTURE SILK 2-0 K-S ETH 623H 21.09 14.76
16000048 272 SUTURE ETHILON 6-0 C-2 ETH 667G 21.09 14.76
16000049 272 SUTURE ETHILON 2-0 ETH 664G 21.09 14.76
16000050 272 SUTURE ETHILON 3-0 FS-1 ETH 663H 21.09 14.76
16000051 272 SUTURE ETHILON 4-0 FS-2 ETH 662G 21.09 14.76
16000052 272 SUTURE ETHILON 6-0 PS-3 ETH 1665G 21.09 14.76
16000053 272 SUTURE ETHILON 4-0 FS-2 ETH 662H 20.00 14.00
16000055 272 SUTURE PROLENE #1 TP-1 LOOPED ETH D9487 164.23 114.96
16000056 272 SUTURE PROLENE MONO BLUE 1.60 TP-1 ETH 8 21.09 14.76
16000057 272 SUTURE PDS #1 TP-1 LOOPED ETH Z880G 21.09 14.76
16000058 272 SUTURE PROLENE 0 SH ETH 8834H 21.09 14.76
16000059 272 A4415 DNU BAG BLUE 2 3/4 (70MM)FLANGE 26.50 18.55
16000060 272 A4425 DNU BAG POUCH BLUE 2 3/4 (70MM)FLANGE 21.00 14.70
16000061 270 A4371 POWDER PREMIUM (OSTOMY CARE) 21.09 14.76
16000062 271 A4385 DNU RINGS BARRIER INSIDE DIA 1 3/16 25.00 17.50
16000063 272 SUTURE SILK 3-0 18 TIES ETH A-184H 21.41 14.99
16000064 272 SUTURE SILK 3-0 30 TIES ETH A304H 21.09 14.76
16000065 272 A4385 DNU STRIPS BARRIER SZ/60 GRAMS 31.00 21.70
16000072 272 SUTURE SILK 2-0 FS ETH 685-G 21.09 14.76
16000074 272 SUTURE ETHILON 3-0 FS-1 ETH 663G 21.09 14.76
16000077 272 SUTURE PROLENE #1 CT-X ETH 8455-H 21.09 14.76
16000078 272 SUTURE PROLENE 0 V-34 ETH 8444H 21.09 14.76
16000079 272 SUTURE PROLENE 3-0 FS-2 ETH 8665G 20.00 14.00
16000080 272 SUTURE PROLENE 7-0 P-6 ETH 8648G 21.09 14.76
16000084 272 SUTURE SILK 2-0 SH 30 ETH K833H 20.00 14.00
16000085 272 A4338 *BRAVO CAPSULE DELIVERY SYSTEM 1,018.54 712.98
16000086 272 PATENCY CAPSULE 129.74 90.82
16000087 272 A4338 *BRAVO CAPSULE DELVRY STM NON CALIBR NEW 1,048.05 733.64
16000090 272 *CATH MALECOT 26FR 108.58 76.01
16000091 272 SUTURE PDS #1 TP-1 ETH Z879G 21.09 14.76
16000092 272 SUTURE PDS 4-0 RB-1 ETH Z304H 21.09 14.76
16000093 272 SUTURE PDS 0 CT-2 ETH Z334H 20.00 14.00
16000095 272 SUTURE PDS 2-0 CT-1 ETH Z339H 21.09 14.76
16000096 272 SUTURE PDS 3-0 SH ETH Z316H 20.00 14.00
16000097 272 SUTURE PDS 2-0 SH ETH Z317H 21.09 14.76
16000101 272 SUTURE PDS 5-0 II P-3 ETH Z493G 25.29 17.70
16000102 272 DNU GASKET OSTOMY LOOP KARAYA 21.00 14.70
16000107 272 SUTURE CHROMIC 2-0 CT-3 ETH 893H 21.09 14.76
16000108 272 SUTURE PROLENE 6-0 P-1 ETH 8697G 62.19 43.53
16000109 272 SUTURE CHROMIC 3-0 RB-1 ETHU204H 21.09 14.76
16000119 272 SUTURE SILK 2-0 SH CR/8 ETH C012D 30.22 21.15
16000120 272 SUTURE SILK 3-0 SH CR/8 ETH C013D 29.35 20.55
16000121 272 SUTURE SILK 3-0 SH 30 CR/8 ETH C017T 33.50 23.45
16000122 272 SUTURE SILK 4-0 30 TIES ETH SA83H 21.09 14.76
16000123 272 SUTURE VICRYL 2-0 CT1 CR8 J839D 28.50 19.95
16000125 272 SUTURE SILK 4-0 30 TIES ETH A303H 21.09 14.76
16000126 272 SUTURE MONOCRYL 3-0 PS-1 ETH Y936H 21.09 14.76
16000127 272 SUTURE MONOCRYL 2-0 ETH Y945H 21.09 14.76
16000128 272 SUTURE MONOCRYL 3-0 PS-2 ETH Y497G 21.09 14.76
16000139 272 CATH FOGARTY BILRY 5F 355.85 249.10
16000152 272 SHEATH 23CM BRITE TI 164.50 115.15
16000153 272 CATH 7.5FR TAUT CHOLANGOGRAM 157.33 110.13
16000155 272 STETHOSCOPE ESOPHAGEAL 18FR 20.00 14.00
16000156 272 GELPORT LAPAROSCOPIC SYSTEM 2,164.50 1,515.15
16000162 272 CATH THORACIC 16FR 32.13 22.49
16000163 272 CATH THORACIC 20FR 47.92 33.54
16000173 272 BRUSH CYTOLOGY DISPOSABLE 141.06 98.74
16000175 272 NEEDLE INTRAOSSEOUS 15G 25MM 40KGS 479.76 335.83
16000176 272 NEEDLE INTRAOSSEOUS 15G 15MM 3-39KGS 476.96 333.87
16000177 272 NEEDLE INTRAOSSEOUS 15G 45MM BARIATRIC 476.96 333.87
16000178 272 EZ-STABILIZER 77.83 54.48
16000180 278 C1768 GRAFT BIFURCATED 16 X 1,467.68 1,027.38
16000181 278 C1768 GRAFT AAA BIFURCATED MAIN BODY 25,257.67 17,680.37
16000182 278 C1768 GRAFT AAA ILIAC LEG GRAFT 9,215.63 6,450.94
16000183 278 C1768 GRAFT AAA ILIAC LEG GRAFT 9,215.63 6,450.94
16000185 278 GRAFT 1,843.90 1,290.73
16000186 278 C1768 GRAFT HEMASHIELD GOLD 20MMX10MMXL40CM 3,122.08 2,185.46
16000187 278 C1768 GRAFT HEMASHIELD GOLD 22MMX11MMXL40CM 2,730.56 1,911.39
16000189 272 SUTURE VICRYL 4-0 TF ETH J434H 21.09 14.76
16000191 272 DRESSING HYDROFERA BLUE W/FILM 4X4 27.10 18.97
16000192 272 WIPE INSTRUMENT-MENTR 20.00 14.00
16000193 271 MEDIHONEY 1.5OZ TUBE 50.30 35.21
16000194 272 A6262 MEDIFIL PARTICLES COLLAGEN 1GR 79.96 55.97
16000195 278 C1781 MESH FLAT SHEET 6X6 176.16 123.31
16000196 278 C1781 PHASIX PLUG AND PATCH 574.43 402.10
16000197 278 C1781 PROLENE HERNIA SYSTEM MESH 1,757.79 1,230.45
16000198 278 C1781 PHASIX MESH 3x4 6,979.99 4,885.99
16000199 272 SUTURE ETHILON 5-0 P-3 ETH 698-G 20.00 14.00
16000200 278 C1757 CATH FOGARTY ART EMB 4FR 80 LATEX FREE 190.01 133.01
16000201 278 C1757 CATH FOGARTY ART EMB 3 FR LATEX FREE 191.02 133.71
16000202 278 C1757 CATH ART EMB 3 FR 187.80 131.46
16000203 278 C1757 CATH ANGIOGRAPHIC 4FR BERN 65CM 58.84 41.19
16000204 278 C1757 CATH ART EMB 4FR 80 187.80 131.46
16000205 278 C1781 PHASIX MESH 4x6 9,352.16 6,546.51
16000206 278 C1757 CATH ART EMBOLECTOMY 5FR 187.73 131.41
16000207 278 C1781 MESH PROLENE 3.0 X 6. 384.29 269.00
16000208 278 C1781 MESH PROLENE 12 X 12 400.88 280.62
16000209 278 C1781 MESH OVAL 4X6 1,218.75 853.13
16000210 278 C1781 PHASIX MESH 6X8 15,359.39 10,751.57
16000211 272 DRESSING AQUACEL AG 4 X 5 30.26 21.18
16000212 278 C1768 GRAFT PTFE BIFURCATED 18X9X40 3,386.35 2,370.45
16000213 278 C1768 GRAFT PTFE BIFURCATED 20X10X40 1,713.88 1,199.72
16000214 278 C1781 PHASIX MESH 8x10 25,940.31 18,158.22
16000215 278 C1768 GRAFT THIN WALL 8MMX60CM 4,242.61 2,969.83
16000216 272 T-ANCHORS HERNIA SET 210.11 147.08
16000217 278 C1781 *MESH PROLENE 3.0 X 6.0 PROLITE 238.93 167.25
16000218 278 C1781 SURGIMESH XB 5,631.78 3,942.25
16000219 278 C1757 CATH ART EMB 190.01 133.01
16000220 278 C1768 GRAFT VASC 6MM 40CM 2,518.94 1,763.26
16000222 278 C1768 GRAFT VASC 4MM-7MM THIN-WALLED 5,816.09 4,071.26
16000223 278 C1768 GRAFT RINGED 6 X 90 4,665.84 3,266.09
16000224 278 KII FIOS FIRST ENTRY 11MM X 150M 210.81 147.57
16000225 278 C1781 PHASIX MESH 10x12 50,242.28 35,169.60
16000226 278 C1768 GRAFT VASC 14MMX7MM 40 CM 3,119.66 2,183.76
16000227 278 C1768 GRAFT VASC 12MMX6MM 40 CM 2,450.67 1,715.47
16000228 278 C1768 GRAFT HEMASHIELD GOLD 18X9X40 1,864.80 1,305.36
16000229 278 C1768 GRAFT HEMASHIELD GOLD 2,730.56 1,911.39
16000230 278 C1781 PHASIX MESH 15CMX20CM 26,384.02 18,468.81
16000231 278 C1768 GRAFT RINGED 6 X 40 2,665.87 1,866.11
16000235 278 C1768 GRAFT VASC 8MM 80CM 5,334.83 3,734.38
16000237 278 C1768 GRAFT VASC 6-4.5X80CM DISTAFLOW 8,277.01 5,793.91
16000238 278 C1768 GRAFT VASC 6MMX80CM FLEX SM W/STAND 6,607.95 4,625.57
16000240 278 C1768 GRAFT THIN WALL 6MMX60CM PTFE 4,242.61 2,969.83
16000241 278 C1768 GRAFT DERMAL & EPIDERMAL TISSUE 6,655.73 4,659.01
16000242 278 C1768 VASCULAR GRAFT 35 CM 4,911.60 3,438.12
16000245 278 C1768 DERMIS AXIS 6X8 CM 5,836.57 4,085.60
16000248 278 C1768 VASCULAR GRAFT 4,546.38 3,182.47
16000251 278 C1768 GRAFT VASC 6MMX40CM 3,583.86 2,508.70
16000252 278 C1768 GRAFT VASC 8MMX80CM 6,826.40 4,778.48
16000253 278 C1768 GRAFT VASC 6MMX80CM 8,055.15 5,638.61
16000254 278 C1768 GRAFT VASC 8MMX80CM 8,140.48 5,698.34
16000255 278 C1768 GRAFT VASC 4MMX7MMTAPEREDX45CM 4,106.08 2,874.26
16000271 278 C1768 GRAFT VASC 8MM-100CM THIN-WALLED 5,396.27 3,777.39
16000272 278 C1768 GRAFT 4.5MM-6.5MMX70CM THIN WALLED 2,925.11 2,047.58
16000273 278 C1874 STENT GUIDE LEMAITRE 199.30 139.51
16000274 278 C1768 GRAFT VASC 8MM-58CM THIN-WALLED 2,787.35 1,951.15
16000275 278 C1768 GRAFT VASC 8MM-42CM THIN-WALLED 2,018.43 1,412.90
16000278 271 STOCKING DONNER 125.00 87.50
16000279 272 STAPLER ROTCUL55-4.8 940.98 658.69
16000280 272 *STAPLER ROTCUL55-4.8 761.02 532.71
16000287 272 PAPILLOTOME COTTON DOUBLE LUMEN 548.50 383.95
16000294 278 C1769 GUIDE WIRE 7.5 35-480 354.97 248.48
16000313 272 NEEDLE SPINAL 20GX3.54MONO 20.00 14.00
16000322 272 SUTURE DEXON PRE-1 ETH 9532-215-0 30.66 21.46
16000333 272 SUTURE SILK 3-0 PS-1 ETH 1684G 21.09 14.76
16000436 271 NEBULIZER VORTRAN PERCUSSIVE 344.20 240.94
16000437 270 EXERCISER VOLUMETRIC 4000ML 21.09 14.76
16000443 272 *AQUA-PACK 21.09 14.76
16000444 272 AQUA-PACK 1000 ML 20.00 14.00
16000450 272 LINE PRESSURE MONITOR 21.09 14.76
16000456 272 SUTURE PDS 0 CT-1 ETH Z346H 21.09 14.76
16000472 272 CATHETER -PTA DILATATION 710.75 497.53
16000473 272 S-CURVE URETHRAL DILATOR SET W/ AQ HYDRO 960.95 672.67
16000474 278 C1769 GUIDE WIRE PC ROADRUNNER 204.87 143.41
16000475 272 CYSTIC DUCT INTRODUCER 328.40 229.88
16000476 272 S-CURVE URETHRAL DILATOR 22 FR 167.40 117.18
16000477 272 SUTURE VICRYL 2-0 SH ETH J417H 21.09 14.76
16000478 278 C1769 GUIDE WIRE ROADRUNNER .018 300CM 563.18 394.23
16000485 278 GRAFT PRE SHAPED 3,160.95 2,212.67
16000489 278 C1768 GRAFT STRAIGHT 6MMX60CM REMV RING THIN W 4,000.27 2,800.19
16000490 278 C1768 GRAFT STRAIGHT 8MMX80CM PTFE REM RING TH 4,495.18 3,146.63
16000493 278 C1768 GRAFT DISTA FLOW SM CUFF 80CMX6M 6,607.95 4,625.57
16000530 278 C1874 STENT ICAST 8MMX38MMX80CM 8,574.62 6,002.23
16000531 278 C1874 STENT ICAST 6MMX59MMX80CM 9,240.61 6,468.43
16000532 278 C1874 STENT ICAST 10MMX38MMX80CM 8,574.62 6,002.23
16000533 278 C1874 STENT TACSHIELD 3X6 1,631.68 1,142.18
16000534 278 C1874 STENT TACSHIELD 4X6 1,764.87 1,235.41
16000535 278 C1874 STENT TACSHIELD 5X5 1,764.87 1,235.41
16000536 278 C1874 STENT TACSHIELD 6X8 2,843.78 1,990.65
16000537 278 C1874 STENT TACSHIELD 8X10 4,645.28 3,251.70
16000538 278 C1874 STENT TACSHIELD 8X12 5,094.82 3,566.37
16000540 272 US CBL EXTNS DISPOSABLE 99.90 69.93
16000541 272 WRENCH KIT ASSEM-BLY KIT 151.36 105.95
16000553 272 VALVE-HEIMLICH 134.06 93.84
16000554 272 SUTURE VICRYL 5-0 TF ETH J433H 21.09 14.76
16000590 278 C1757 CATH ART EMB 7.5 FR 341.32 238.92
16000600 272 *CATH MUSHROOM 32FR 35.73 25.01
16000611 272 CATH BRONCHO 41FR L 223.75 156.63
16000612 272 CATH BRONCHO 39F LEF 223.75 156.63
16000615 272 CATH BRONCHO 39FR RIG 183.69 128.58
16000617 272 CATH BRONCHO 37FR RIGH 183.69 128.58
16000618 272 CATH BRONCHO 37FR LEF 322.98 226.09
16000630 278 C1757 CATH HEMO 20FR 30CC 20.50 14.35
16000631 272 CATH SILICONE 20FR 5CC 37.11 25.98
16000640 278 C1757 *CATH HEMO 22FR 30CC 20.50 14.35
16000641 272 *CATH SILICONE 22FR 5CC RETENTION 21.09 14.76
16000645 272 SUTURE ETHILON 5-0 PC-5 ETH 1895G 22.87 16.01
16000650 272 *CATH SILICONE 24FR 5CC RETENTION 21.09 14.76
16000651 278 C1757 *CATH HEMO 24FR 30CC 20.50 14.35
16000652 272 CATH THORACIC 24FR 34.51 24.16
16000653 272 CATH THORACIC STRAIGHT 28FR 23.27 16.29
16000660 272 CATH THORACIC 36FR 21.66 15.16
16000665 272 CATH THORACIC 32FR 38.44 26.91
16000666 272 CATH THORACIC 36FR RIGHT ANGLE 78.87 55.21
16000668 278 C1725 CATH SPIROFLEX 4F 135CM 5,311.27 3,717.89
16000669 278 C1725 CATH SPIROFLEX 5F 135CM 5,311.27 3,717.89
16000670 278 C1725 CATH SPIROFLEX 6F 120CM 6,426.80 4,498.76
16000671 278 C1725 CATH SPIROFLEX 6F 90CM 7,758.78 5,431.15
16000672 278 C1725 CATH SPIROFLEX 6F 50CM 2,996.95 2,097.87
16000690 272 A4330 CATH COUNCIL 20FR 5CC TIP 52.84 36.99
16000691 272 *CATH 16FR 5CC LATEX 56.78 39.75
16000692 272 *CATH 18FR 5CC LATEX 56.78 39.75
16000693 272 C1758 CATH, DUAL LUMEN URETHERAL 405.33 283.73
16000694 278 C1894 DILATOR 8/10 SHEATH SET 287.88 201.52
16000695 272 CATH COUNCIL 22FR 5CC 56.69 39.68
16000696 272 A4330 CATH COUNCIL TIP 16FR 5CC 84.10 58.87
16000697 272 A4330 CATH COUNCIL TIP 18FR 5CC 84.10 58.87
16000698 272 A4330 CATH COUNCIL TIP 20FR 5CC 84.10 58.87
16000699 272 C1894 DILATOR NAVIGATION 12/14FR 673.83 471.68
16000704 272 CATH FLEXIMA APD J TIP 8X20 329.97 230.98
16000705 272 CATH ALL PURPOSE 10FR 21.09 14.76
16000706 271 DRAIN KIT PLEURX CATH 2,978.33 2,084.83
16000707 272 BRUSH CYTOLOGY 3.0/85 62.03 43.42
16000708 271 PLEURX PERITONEAL CATH KIT 2,019.54 1,413.68
16000709 271 PLEURX PERITONEAL CATHETER STARTER KIT 2,978.33 2,084.83
16000710 272 CATH ALL PURPOSE 16FR 20.00 14.00
16000711 272 CATH RED RUBBER COUDE TIP 16 FR 20.00 14.00
16000712 272 CATH ALL PURPOSE 20FR 21.09 14.76
16000713 271 PLEURX DRAINAGE SYSTEM 1000ML 207.22 145.05
16000714 272 TUBE GASTRONOMY 16FR 20CC 331.34 231.94
16000716 272 MOSS G-TUBE PEG KIT 18FR 1,799.26 1,259.48
16000717 272 MOSS TUBE GASTROSTOMY 18FR 1,264.38 885.07
16000718 272 TUBE GASTRONOMY 18FR 20CC 331.34 231.94
16000719 272 TUBE GASTRONOMY 22FR 20CC 193.25 135.28
16000720 272 TUBE GASTROSTOMY 20FR 20CC 238.83 167.18
16000721 272 MEASURING STOMA DEVICE 20.83 14.58
16000722 272 TRAY INTRODUCER 9 FR 155.93 109.15
16000723 272 KIT BUTTON REPLACEMENT 18FR 984.71 689.30
16000724 272 KIT BUTTON REPLACEMENT 18FR X 2.4CM 1,302.24 911.57
16000726 272 KIT BUTTON REPLACEMENT 18FR 393.36 275.35
16000727 272 KIT BUTTON REPLACEMENT 28FR X 2 1,548.89 1,084.22
16000728 272 KIT BUTTON REPLACEMENT 28 1,303.02 912.11
16000729 272 KIT BUTTON REPLACEMENT 28 1,194.13 835.89
16000730 272 KIT BUTTON REPLACEMENT 24 1,548.89 1,084.22
16000731 272 KIT BUTTON REPLACEMENT 24FR 1,095.79 767.05
16000732 272 KIT BUTTON REPLACEMENT 24 940.88 658.62
16000734 272 KIT BUTTON REPLACEMENT 24 892.90 625.03
16000735 278 C1768 GRAFT BIFURCATED 16/ 3,198.16 2,238.71
16000736 278 C1768 GRAFT BIFURCATED 18/9/ 2,662.29 1,863.60
16000737 270 EXERCISER VOLUMETRIC 2500ML 20.00 14.00
16000738 278 C1768 GRAFT HEMOSHIELD GOLD TUBE 16MMX30CM 1,911.39 1,337.97
16000740 278 C1768 GRAFT SURGISIS BIODESIGN 20X20 23,346.28 16,342.40
16000742 278 C1768 GRAFT SURGISIS BIODESIGN 20X30 32,101.13 22,470.79
16000745 272 RETAINER FISC (FISH) 117.22 82.05
16000746 272 A4344 *CATH SILICONE 12FR 5CC 21.09 14.76
16000750 272 RETAINER GLASSMAN JUMBO 177.30 124.11
16000751 272 DEFOGGER FRED 66.46 46.52
16000752 272 SET BLOOD/FLUID WARMI 42.98 30.09
16000753 272 CATH SILICONE 22FR 5CC 31.57 22.10
16000756 272 CLEARIFY VISUALIZATION SYSTEM 170.01 119.01
16000765 272 A4344 *CATH SILICONE 24FR 5CC 23.44 16.41
16000770 272 CATH SILICONE 26FR 5CC RETENTION 21.09 14.76
16000780 272 SYSTEM CD-SET BAXTER 124.50 87.15
16000791 272 *CATH SILICONE 14FR 30CC 21.09 14.76
16000796 272 CATH SILICONE 16FR 30CC 21.79 15.25
16000798 278 C1752 CATH HEMO 16FR 30CC 20.50 14.35
16000800 272 A4338 *CATH SILICONE 18FR 30CC 21.09 14.76
16000801 278 C1768 GRAFT VASC VENAFLO II 6MMX40CM STRAI 2,174.21 1,521.95
16000802 272 A4344 CATHETER 6FR FOLEY PEDIATRIC 96.09 67.26
16000803 272 A4344 CATHETER 8FR FOLEY PEDIATRIC 24.78 17.35
16000804 272 CATHETER - AINTREE INTUBATION 195.10 136.57
16000805 272 *SPECI-CATH KIT FEMALE 21.09 14.76
16000806 272 CATH SILICONE 20FR 30CC 21.79 15.25
16000808 272 CATH SILICONE 20FR 30CC 2WAY 21.09 14.76
16000810 272 *CATH SILICONE 22FR 30CC 27.45 19.22
16000812 272 DNU CATH SILICONE 24FR 30CC 58.00 40.60
16000815 272 *CATH SILICONE 26FR 30CC 27.89 19.52
16000816 278 C1768 GRAFT THIN WALLED REMOVABLE RINGS 4,314.29 3,020.00
16000817 272 CATH SILICONE 28FR 5CC RETENTION 21.09 14.76
16000818 278 C1768 GRAFT RINGED 10 X 80 4,693.22 3,285.25
16000819 278 C1768 GRAFT STRETCH 6MMX40CM 1,720.25 1,204.18
16000823 278 C1768 GRAFT VASC 6 X 10 5,495.25 3,846.68
16000830 272 A4344 CATH SILICONE 10FR 3CC M/L PEDIATRIC 33.46 23.42
16000833 278 C1768 GRAFT BI-FURCATED 16X8 3,122.08 2,185.46
16000836 278 C1768 GRAFT STRAIGHT 8MMX80 3,341.52 2,339.06
16000837 278 C1768 GRAFT VASC 6MMX40CM 3,310.80 2,317.56
16000838 278 MESH ATRIUM CQUR 15X20CM 2,552.48 1,786.74
16000843 278 C1781 MESH PATCH DUAL 20X30 7,543.17 5,280.22
16000844 278 C1781 MESH PATCH DUAL 15X19 4,010.51 2,807.36
16000846 278 C1781 MESH PATCH DUAL10X15 2,160.56 1,512.39
16000847 278 C1781 MESH PATCH SOFT TISSUE 15X 5,928.72 4,150.10
16000848 278 C1768 GRAFT BIFURCATED KNITTED 12MMX6MM 2,167.38 1,517.17
16000849 278 C1768 GRAFT VASC PROPATEN 6MMX80CM 8,055.15 5,638.61
16000850 278 C1768 GRAFT VASC PROPATEN 6MMX50CM 5,324.59 3,727.21
16000851 278 C1768 GRAFT VASC PROPATEN 8MMX50CM 5,324.59 3,727.21
16000852 272 A4346 CATH 3WAY 18FR 5CC IRRIGATION 40.74 28.52
16000853 272 A4340 *CATH 3WAY 16FR 5CC IRRIGATION 36.28 25.40
16000855 272 A4346 CATH 3WAY 22FR 30CC IRRIGATION 38.40 26.88
16000857 272 C1769 WIRE - K 366.00 256.20
16000858 278 FIXION PF NAIL 2,730.75 1,911.53
16000859 278 FIXION PF PEG 795.75 557.03
16000860 272 A4346 CATH 3WAY 24FR 30CC 46.04 32.23
16000865 272 A4346 CATH 3WAY 26FR 30CC IRRIGATION 36.36 25.45
16000867 272 CATH ANGIO 4FR-.035-100CM-JB2 53.30 37.31
16000868 272 CATH ANGIO 4FR-.035-100CM-H1 53.30 37.31
16000870 272 CATH URETHRAL 14F BAX 21.09 14.76
16000871 272 TROCAR ARGYLE 16FR 21.09 14.76
16000872 272 TROCAR ARGYLE 20FR 131.94 92.36
16000876 272 TRAY CATHETER 16 FR LF 28.33 19.83
16000877 272 CATH 8FR CONE TIP URETERAL 72.90 51.03
16000878 272 TRAY CATHETER W/D FDL 21.09 14.76
16000879 272 CATH 5FR CONE TIP URETERAL 71.08 49.76
16000882 272 CATH ANGIO 4FR-.035-100CM 60.55 42.39
16000883 278 C1781 MESH SOFT TISUE 10 X 2,058.16 1,440.71
16000884 272 CATH ANGIO 14G 5.25 54.09 37.86
16000888 272 PRO PORT SYSTEM 983.42 688.39
16000889 278 PORT TITANIUM IMPLATED W/CATH 2,328.58 1,630.01
16000890 272 TRAY URETHRAL 14FR D 20.00 14.00
16000895 272 SET NEPHROSTOMY ULTRATHANE 745.14 521.60
16000896 272 PERCUTANEOUS NEPHROSTOMY SET 762.14 533.50
16000897 272 SET NEPHROSTOMY ULTRATHANE 8.5FR 780.67 546.47
16000900 272 CATH NEPHROSTOMY 10FR PERCUFLEX 440.49 308.34
16000946 272 SUTURE VICRYL #1 CT-1 ETH J947H 21.09 14.76
16000969 278 C1894 DILATOR NAVAGATION HD 12/14 FR 673.83 471.68
16000975 271 SM SLEEVE COMPRESSION 105.38 73.77
16000976 271 MED SLEEVE COMPRESSION 66.03 46.22
16000977 271 LG SLEEVE COMPRESSION 177.73 124.41
16000978 271 SLEEVE SCD EXTRA LARGE BARIATRIC 198.82 139.17
16000979 271 SLEEVE SCD MEDIUM KNEE 150.75 105.53
16000999 636 *EPIFIX 2.0X3.0 635.20 444.64
16001001 272 SNARE 4FR AMPLTZ 10/ 860.49 602.34
16001010 272 CATH PERCUTANEOUS 10F 30CM 215.41 150.79
16001012 272 CATH PERCUTANEOUS 12FR 189.74 132.82
16001023 272 SET TRIPLE PRESSURE TRANSDUCER 224.59 157.21
16001024 272 TRANSDUCER KIT PRESSURE MONITOR 204.59 143.21
16001032 272 SALIVARY DUCT CATHETER 333.66 233.56
16001040 278 SLING TRANSVAGINAL MID-URETHRAL SYSTEM 3,125.84 2,188.09
16001041 278 C2631 T.V.T URINARY 2,952.42 2,066.69
16001042 278 C2631 TVT ADVANTAGE SYSTEM 4,783.33 3,348.33
16001044 278 SLING SYSTEM MID URETHRAL 4,355.11 3,048.58
16001045 278 RETRIVAL DEPLOYMENT DEVICE 1,021.64 715.15
16001073 272 FLEX POINT ELECTRODE UNIV ROLLERBLL 415.85 291.10
16001074 272 *ELECTRODE UNIV ROLLERBLL 481.03 336.72
16001075 272 ELECTRODE COLLINS KNIFE 22/24 FR 243.40 170.38
16001120 272 SHUNT 6 INCH CAROTID ARTERY 131.61 92.13
16001125 278 C1760 VASOSEAL ES 767.97 537.58
16001199 272 HET BIPOLAR FORCEPS 1,981.35 1,386.95
16001200 272 FORCEP ORANGE BIOPSY W/NEED 40.31 28.22
16001201 272 BIOPSY RADIAL JAW HOT 151.36 105.95
16001203 272 STAPLER CURVED 29MM 1,152.59 806.81
16001204 272 STAPLER DISP MULTIFIER 27.02 18.91
16001205 272 STAPLER 35W 26.63 18.64
16001206 272 STAPLER 21 MM CURVED 1,229.54 860.68
16001207 272 STAPLER 35W 3M ORTH 35.56 24.89
16001208 272 STAPLER LINEAR 30 V T 262.08 183.46
16001209 272 LINEAR CUTTER 55MM 245.70 171.99
16001210 272 SHEARS 5 MM CURVED HARMONIC 1,258.46 880.92
16001214 272 HEMOCLIP 25 MED ENDOSCOPIC GRN 21.09 14.76
16001215 272 HEMOCLIP INSTINCT EMDPSCOPIC 632.19 442.53
16001216 272 CLIP HEMOLOK WECK LARGE 99.95 69.97
16001217 272 ***STAPLER 33 MM CURVED 737.23 516.06
16001218 272 MICROFX OCD UNIVERSAL DRILL 1,975.60 1,382.92
16001219 272 HEMOSPRAY 5,145.35 3,601.75
16001220 272 STAPLER CURVED 25MM 737.26 516.08
16001221 272 STAPLER ECS 21 MM ENDOSCOPIC 1,306.14 914.30
16001222 272 STAPLER PROXIMATE LINEAR TX30G 377.52 264.26
16001224 272 STAPLER RELOAD 60MM WHITE 5,268.05 3,687.64
16001225 272 LINEAR CUTTER 75 MM 356.98 249.89
16001226 272 STAPLER PROXIMATE LINEAR RELOAD 140.11 98.08
16001227 272 RELOAD LINEAR CUTTER 75MM 195.63 136.94
16001228 272 STAPLER PROXIMATE LINEAR RELOAD 30MM 167.40 117.18
16001231 272 SCALPEL HARMONIC HAND HELD 36CM 1,138.50 796.95
16001232 272 DNU SCALPEL HARMONIC HAND HELD 14CM 785.00 549.50
16001233 272 CUTTER 4.0MM TOMCAT 215.39 150.77
16001234 272 CUTTER ANGLED AGGRESSIVE 5.0MM 174.62 122.23
16001235 272 BUR 5.5MM ROUND 12 FLUTE - HOLLOW 227.42 159.19
16001236 272 BUR 4.0MM BARREL 12 FLUTE HOLLOW 203.74 142.62
16001237 272 BUR 5.5MM BARREL 12 FLUTE HOLLOW 227.42 159.19
16001238 272 CUTTER 4.0 AGGRESSIVE PLUS 202.82 141.97
16001239 272 CUTTER 4.0MM RESECTOR 200.27 140.19
16001240 272 SERFAS ENERGY SUPER 90-S 622.25 435.58
16001241 272 PROBE 3.5MM HOOK SERFAS ENERGY 468.57 328.00
16001242 272 *TUBE SET FLOSTEADY 191.85 134.30
16001243 272 SCALPEL HARMONIC HAND HELD 36CM 1,322.52 925.76
16001244 272 TUBING INSUFFLATION HYSTEROSCOPIC CROSS/ 218.31 152.82
16001245 272 TUBING INSUFFLATION ARTHROSCOPIC INFLOW 236.28 165.40
16001250 272 SERFAS ENERGY 90-S CRUISE 565.38 395.77
16001251 272 RESECTOR SHAVER BLADE F-SERIES-5.5MM 225.74 158.02
16001280 278 C1768 GRAFT VASC 22 1,484.74 1,039.32
16001281 278 C1768 GRAFT VASC 26 1,621.27 1,134.89
16001300 272 DRAIN SILICONE 10FR 26.59 18.61
16001303 272 DRAIN SILICONE 7MM FLAT 21.09 14.76
16001304 272 DRAIN JACKSON PRATT 10MM FLAT 21.09 14.76
16001307 272 RESERVOIR 100ML JACK/ 20.00 14.00
16001309 272 DRAIN SILICONE 15FR 28.15 19.71
16001312 272 DRAIN JACKSON PRATT 19FR 26.33 18.43
16001316 272 SURGICEL FIBRILLAR 2 X4 284.52 199.16
16001317 278 C1874 6X24 URETERAL STENT 368.23 257.76
16001318 278 C1874 6X26 URETERAL STENT 368.23 257.76
16001319 278 C1874 6X28 URETERAL STENT 368.23 257.76
16001322 272 TB-0009OF SET 1,317.07 921.95
16001323 272 *DRAIN T 10FR BARD 29.41 20.59
16001324 272 *HANDPIECE THUNDERBEAT 20CM 1,668.29 1,167.80
16001325 272 HANDPIECE THUNDERBEAT 35CM 3,050.28 2,135.20
16001326 272 DRAIN T 12FR BARD 29.41 20.59
16001327 272 *DRAIN T 14FR 57.08 39.96
16001328 272 *DRAIN T 16FR 1001B 32.04 22.43
16001329 272 *DRAIN T 18 FR 52.06 36.44
16001330 272 *DRAIN DEAVER T-TUBE 20 FR 29.41 20.59
16001347 272 SNARE POLYPECTOMY X-SMALL 65.17 45.62
16001348 272 SNARE POLYPECTOMY LARGE 51.89 36.32
16001355 272 SUTURE 6-0 VICRYL PS-3 21.09 14.76
16001380 272 A7521 TUBE TRACH 4 216.35 151.45
16001381 272 A7521 TUBE TRACH FENESTRATED 4 218.78 153.15
16001382 272 A7521 TUBE TRACH 6 LPC 211.41 147.99
16001383 272 A7521 TUBE TRACH FENESTRATED 6 218.49 152.94
16001384 272 TUBE TRACH 8 216.41 151.49
16001385 272 TUBE TRACH FENESTRATED 8 214.33 150.03
16001386 272 A7521 TUBE TRACH CUFFED 8 210.11 147.08
16001387 272 A7521 TUBE TRACH 10 221.12 154.78
16001388 272 A7521 TUBE TRACH 10 FEN 209.16 146.41
16001389 272 *TUBE SHILEY 8 DIC FENESTRATED 21.09 14.76
16001390 272 A7521 TUBE TRACH 8 DCT DISPOSABLE 193.73 135.61
16001391 272 A7521 TUBE TRACH 8 FEN DISPOSABLE 177.72 124.40
16001392 272 TUBE TRACH 6 SHILEY DISPOSABLE 208.92 146.24
16001393 272 A7520 TUBE TRACH 4 SHILEY CUFFLESS 205.92 144.14
16001394 272 A7520 TUBE TRACH 6 SHILEY CUFFLESS 139.75 97.83
16001395 272 A7520 TUBE TRACH 4 SHILEY FEN CUFFLESS 175.99 123.19
16001396 272 A7520 TUBE TRACH 6 SHILEY FEN CUFFLESS 198.44 138.91
16001397 272 A7520 TUBE TRACH 7 SHILEY W/ CUFF 190.00 133.00
16001398 272 A7520 TUBE TRACH 6.5 SHILEY W/ CUFF 190.00 133.00
16001400 272 SET EXTENSION LUER LOCK 76CM 4.0ML. 21.09 14.76
16001401 272 DNU SET LIPID FILTER 1.2 MICRON LUER LCK 21.00 14.70
16001402 278 C1781 MESH DEXON 25X15CM 902.32 631.62
16001403 278 C1781 MESH DEXON 20X10CM 876.00 613.20
16001405 278 C1788 PORT, 19MM, STRAIGHT, 80MM 972.74 680.92
16001406 278 POWERPORT DUO MRI IMPLANTABLE 9.5 CF 2,001.94 1,401.36
16001407 272 PRO PORT SYSTEM SINGLE LUMEN 1.6MM 8.5FR 944.78 661.35
16001408 278 C1788 PRO PORT SYSTEM LOW PROFILE 1.6MM 8.5FR 972.74 680.92
16001409 278 C1781 MESH VICRYL KNITTED 12 X12 4,233.55 2,963.49
16001410 278 C1781 MESH VICRYL WOV 12 X12 3,101.37 2,170.96
16001411 272 PORT MARS 19X60MM STRAIGHT DISPOSABLE 699.60 489.72
16001412 272 PORT MARS 19X40MM STRAIGHT DISPOSABLE 699.60 489.72
16001413 278 PORT MARS 19X70MM STRAIGHT DISPOSABLE 800.79 560.55
16001414 278 PORT MARS 19X40MM STRAIGHT DISPOSABLE 699.60 489.72
16001415 278 PORT MARS 19X90MM STRAIGHT DISPOSABLE 800.79 560.55
16001416 278 PORT MARS 19X 120MM STRAIGHT DISPOSABLE 941.28 658.90
16001417 278 PORT MARS 19X100MM STRAIGHT DISPOSABLE 941.28 658.90
16001418 278 PORT MARS 19X110MM STRAIGHT DISPOSABLE 941.28 658.90
16001428 272 LIGATOR 253.22 177.25
16001429 278 C1874 STENT WALLFLEX ESOPHAGEAL 23MMX125MM 9,265.58 6,485.91
16001430 278 C1874 STENT POLYFLEX 18X90 6,992.89 4,895.02
16001431 278 C1874 STENT POLYFLEX 18X120 6,992.89 4,895.02
16001432 278 C1874 STENT POLYFLEX ESOPHAGEAL 16X20X90 6,160.41 4,312.29
16001433 278 C1874 STENT POLYFLEX ESOPHAGEAL 18X23X120 6,160.41 4,312.29
16001434 278 C1874 STENT POLYFLEX 21X120 6,992.89 4,895.02
16001435 278 C1874 STENT WALLFLEX ESOPHAGEAL 8,408.12 5,885.68
16001436 278 C1781 MESH MARLEX 10 X 14 628.03 439.62
16001437 278 C1874 STENT WALLFLEX COLONIC 8,741.12 6,118.78
16001438 278 L8600 BREAST PROSTHESIS IMPLANTABLE 3,071.87 2,150.31
16001439 278 C1781 MESH MYCRO 6CM X 12CM 457.37 320.16
16001440 278 C1874 STENT WALLFLEX ESOPHAGEAL 23X155MM 8,915.94 6,241.16
16001441 278 C1874 STENT WALLFLEX ESOPHAGEAL 18MM X 153MM 7,727.57 5,409.30
16001442 278 C1874 WALLFLEX EXOPHAGEAL PARTIALLY COVERED 23 7,727.57 5,409.30
16001443 272 A7520 TUBE TRACH 6 SHILEY CUFFED FENESTRATED D 170.09 119.06
16001444 272 A7520 TUBE TRACH 6 SHILEY XL CUFFED 265.66 185.96
16001445 272 A7520 TUBE TRACH 8 XL SHILEY CUFFED 265.66 185.96
16001446 272 A7520 TUBE TRACH 5 SHILEY XL CUFFLED 265.66 185.96
16001453 272 SIZER 68HP 500CC 194.59 136.21
16001476 272 TUNNELER INSRT HICKMA 177.89 124.52
16001477 272 FLEX PORT 20 MM 203.60 142.52
16001478 271 SET PRIMARY GRAVITY WITH 2 PORTS 21.09 14.76
16001479 272 FLEXPATH 15 MM 484.06 338.84
16001481 271 SET SOLUSET 21.09 14.76
16001483 272 CATH LUMEN 4FR 3 347.71 243.40
16001484 272 CATH LUMEN 3FR 3 347.71 243.40
16001485 272 CATH LUMEN 5FR 3 347.71 243.40
16001490 278 SECURFIT STEM 19,257.29 13,480.10
16001491 272 TRIDENT SHELL 7,189.44 5,032.61
16001492 272 TRIDENT LINER 6,135.78 4,295.05
16001494 271 SET BLOOD Y-TYPE B2 I 21.09 14.76
16001520 271 SET OMNI-FLOW WITH 2 PORTS 98.00 68.60
16001570 278 C1874 STENT BALLOON CORINT 7MM/15MM 3,812.79 2,668.95
16001587 272 WINGED INFUSION SET 20G X 0.1 21.09 14.76
16001590 272 ADAPTER FIBER OPTIC S 41.08 28.76
16001600 278 C1769 GUIDE WIRE PLATINUM PLUS 508.56 355.99
16001605 271 SET BLOOD PUMP 43.55 30.49
16001607 271 DNU SET BLOOD PUMP 41.50 29.05
16001608 278 C TAPER 36 MM HEAD 4,242.71 2,969.90
16001700 272 SET PNEUMOTHORAX LANDERS 398.84 279.19
16001705 271 SET NITRO 40IN 21.00 14.70
16001715 271 SET ANESTHESIA PUMP 30.05 21.04
16001721 271 SET BLOOD Y-TYPE 90 21.09 14.76
16001743 278 PROSTHESIS 20MM X 10MM 1,787.69 1,251.38
16001784 272 CATH AIR EX C-CAE19 214.60 150.22
16001786 272 CATH AIR EXCHANGE 214.60 150.22
16001801 272 KIT ARTERIAL LINE 63.57 44.50
16001802 272 CATH BRITE TIP 6FR-.070-90CM 297.50 208.25
16001806 272 C1751 CATH LUMEN MULTI KIT 180.40 126.28
16001807 272 CATH SET-CNTRL VEIN 61.18 42.83
16001808 272 CATH KIT RADIAL ART 69.19 48.43
16001810 272 *LOOP CUTTING 24 FR 220.32 154.22
16001815 272 *NEEDLE EPIDURAL TUOHY 17GA 76.93 53.85
16001816 272 NEEDLE TUOHY EPID 60.10 42.07
16001817 272 NEEDLE-TUOHY EPID 21.75 15.23
16001819 272 *STIMUCATH CONT NERVE BLK SET 17GX4CM 227.90 159.53
16001820 272 STIMUCATH CONT NERVE BLCK SET 17GX8CM 207.09 144.96
16001825 272 NEEDLE NERVE BLOCK PROBLO 41.08 28.76
16001827 272 SET PNEUMOTHORAX TPT 337.17 236.02
16001838 272 TUBE EXTENSION 8 30.63 21.44
16001844 71 TUBE NASOJEJUNOSTOMY 10FR 140CM 93.85 65.70
16001848 271 TUBING PCA MINI BORE 21.09 14.76
16001850 272 DRAINAGE UNIT THORA SEAL 203.10 142.17
16001851 272 COLLECTION UNIT 130.60 91.42
16001853 271 SET NITROGLYCERIN 107 28.75 20.13
16001856 258 SOLUTION POTASSIUM CHLORIDE 34.06 23.84
16001860 272 PLUG ANAL FISTULA 3,319.01 2,323.31
16001863 272 SENSOR BIS XP QUATRO 93.73 65.61
16001872 271 SET CO 2 TUBING 45.10 31.57
16001873 271 SET CO 2 TUBING STRYKER HIGH FLOW 180.14 126.10
16001875 258 J7042 SOLUTION DEXTROSE BAG 5% 100ML 20.58 14.41
16001876 258 J7042 SOLUTION DEXTROSE 5% ADVANTAGE 20.58 14.41
16001879 258 SOLUTION POTASSIUM CHLORIDE 1000ML 27.76 19.43
16001880 258 J7042 SOLUTION DEXTROSE 5% 250ML 20.58 14.41
16001882 258 J7042 SOLUTION DEXTROSE 10% (BAG) 1000ML 42.65 29.86
16001883 258 J7042 SOLUTION DEXTROSE 10% 20.58 14.41
16001885 258 J7042 SOLUTION DEXTROSE 5% 500ML 20.58 14.41
16001888 272 *SET INFUSION WING 20GA 34.20 23.94
16001890 258 SOLUTION DEXTROSE 5% 1000ML 23.21 16.25
16001891 272 SET ANESTHESIA 1.5ML 20.00 14.00
16001895 258 J7042 SOLUTION DEXTROSE 5% SOD CHLORIDE .225 20.58 14.41
16001899 258 J7042 SOLUTION DEXTROSE 5% SOD CHLORIDE .45 20.58 14.41
16001900 258 SOLUTION DEXTROSE 5% SOD CHLORIDE .45 23.08 16.16
16001905 258 SOLUTION DEXTROSE 5% SOD CHLORIDE .9% 24.94 17.46
16001910 258 SOLUTION DEXTROSE 5% LAC/RINGER 21.09 14.76
16001915 258 SOLUTION DEXTROSE 5% LAC/RINGER 20.79 14.55
16001920 258 SOLUTION LACTATED RINGERS 21.09 14.76
16001921 258 J7042 SOLUTION SODIUM CHLORIDE 3% 24.30 17.01
16001925 258 J7120 LACTATED RINGERS 1000 ML 22.10 15.47
16001929 272 CLEARSIGHT FINGER CUFF LARGE 1,229.28 860.50
16001930 272 CLEARSIGHT FINGER CUFF MEDIUM 1,229.28 860.50
16001931 272 CLEARSIGHT FINGER CUFF SMALL 1,229.28 860.50
16001932 272 FLOTRAC SENSOR 1,229.28 860.50
16001933 636 Q4186 DRESSING EPIFIX 3X3 CM 669.96 468.97
16001934 258 SOLUTION SODIUM CHLORIDE .9% 100ML 20.00 14.00
16001935 258 SOLUTION SODIUM CHLORIDE .9% 50ML 22.07 15.45
16001936 258 SOLUTION SOD CHLORIDE .9% 250ML 21.09 14.76
16001937 258 SOLUTION SODIUM CHLORIDE .9% AS 22.29 15.60
16001938 272 SUTURE TRICON 2 BLUE 30 T-56/HGS-21 25.98 18.19
16001940 636 Q4186 *EPIFIX 2.0X2.0 CM 908.36 635.85
16001941 258 SOLUTION SOD CLORIDE 0.9% 500ML BAG 24.35 17.05
16001945 258 SODIUM CHLORIDE .9% 1000ML BAG 21.09 14.76
16001950 258 SOLUTION SODIUM CHLORIDE .9% IR 500ML BT 22.97 16.08
16001955 258 SODIUM CHLORIDE .9% 1000ML 23.29 16.30
16001956 258 SOLUTION SODIUM CL BAG .9% IRG 3000ML 31.69 22.18
16001957 258 SOLUTION SODIUM CHLORIDE .9% 1500ML 21.09 14.76
16001960 636 *EPIFIX 2.0X4.0 CM 575.99 403.19
16001962 258 J7060 WATER STERILE 500ML 21.68 15.18
16001965 258 WATER STERILE 1000ML 20.00 14.00
16001966 258 SOLUTION WATER STERILE 3000ML 39.17 27.42
16001967 258 SOLUTION WATER STERILE BAG 1000ML 20.00 14.00
16001968 258 SOLUTION WATER STERILE 1500ML BOTTLE 20.00 14.00
16001972 258 SOLUTION GLYCINE 3000 51.97 36.38
16001992 258 J7042 DNU SOLUTION LACTATED RINGERS 20.58 14.41
16002020 272 NEEDLE NERVE BLOCK 28.37 19.86
16002024 278 OCCLUDER VASCULAR 1.0 190.27 133.19
16002025 278 C1766 OCCLUDER VASCULAR 1.5 251.99 176.39
16002026 278 OCCLUDER VASCULAR 2.0 244.44 171.11
16002027 278 OCCLUDER VASCULAR 2.5 244.44 171.11
16002035 258 SOLUTION MANITOL 20% 70.14 49.10
16002045 258 SOLUTION SODIUM CHLORIDE .45% 1000ML 21.09 14.76
16002046 258 SOLUTION SODIUM CHLORIDE .45% 250ML 21.09 14.76
16002047 258 SOLUTION SODIUM CHLORIDE .45% 500ML 21.09 14.76
16002058 258 SOLUTION PREMIX POTASSIUM CHL 1000ML 26.52 18.56
16002085 272 SET MANIFOLD EXT CAT 25CM 37.23 26.06
16002100 272 TUBE BLAKEMORE 20FR 1,113.25 779.28
16002103 278 SHUNT-DENVR VENS-SRG 3,859.89 2,701.92
16002152 272 *SUTURE TAPE 18 UMBILICAL SEE NOTES 21.09 14.76
16002170 271 VASCU-GUARD W/APEX PROCESSING 720.65 504.46
16002178 272 LG LIGACLIP 21.09 14.76
16002180 272 LS100 LIGACLIP 21.09 14.76
16002185 272 LIGACLIP HORIZON 21.09 14.76
16002211 272 DRESSING AQUACEL AG 4 X 13.5 151.71 106.20
16002222 272 SUTURE ETHILON #2 LR ETH 490T 21.09 14.76
16002232 271 KIT EDLICH GAS LAVGE 27.98 19.59
16002300 272 A4340 CATH COUDE 18FR 5CC 36.63 25.64
16002301 272 A4340 CATH COUDE 2-WAY 16FR 5CC 34.00 23.80
16002302 272 A4340 CATH COUDE 20FR 5CC 36.65 25.66
16002310 272 *CATH COUDE 22FR 30CC 3 WAY 81.34 56.94
16002315 272 *CATH COUDE 24FR 30CC 3 WAY 81.34 56.94
16002320 272 A4340 *CATH COUDE 12FR SILICONE 61.58 43.11
16002325 272 *CATH COUDE 14FR SILICONE 61.58 43.11
16002345 272 SHEATH INTRODUCER CP- 99.46 69.62
16002346 272 SHEATH INTRODUCER CL- 181.62 127.13
16002391 272 STAPLER TA90 4.8/D 1,142.81 799.97
16002400 272 RELOAD TA 90 4.8 182.87 128.01
16002401 272 RELOAD TA 90 3.5 178.42 124.89
16002402 278 C1874 STENT PALMAZ UNMOUNTED XL 40C 5,444.47 3,811.13
16002403 278 C1874 STENT PALMAZ UNMOUNTED XL 50C 5,827.41 4,079.19
16002420 272 CATH PIGTAIL 5FR W/M 131.90 92.33
16002547 272 CATH SUPER TORQUE VERTEBRAL 5FR 64.64 45.25
16002581 272 STAPLER TA55 3.5 245.15 171.61
16002582 272 STAPLER TA55/408D 389.85 272.90
16002585 272 RELOAD UNIT 4.8 TA55 153.13 107.19
16002616 272 RELOAD UNIT TA55 3.5 211.27 147.89
16002618 272 SET VASCULAR DIALATOR 203.17 142.22
16002619 272 6FR 20CM VASCULAR DIALATOR 78.79 55.15
16002620 272 8FR 20CM VASCULAR DIALATOR 78.79 55.15
16002621 272 *10FR 20CM VASCULAR DIALATOR 78.79 55.15
16002622 272 *12FR 20CM VASCULAR DIALATOR 78.79 55.15
16002623 272 *14FR 20CM VASCULAR DIALATOR 78.79 55.15
16002704 272 NEEDLE STIMULATOR 21G X 1.5 (40MM) 40.43 28.30
16002705 272 NEEDLE STIMULATOR 21G X 3 1/8 (80MM) 43.02 30.11
16002706 272 *NEEDLE STIMULATOR 21G X 2 (50MM) 40.43 28.30
16002707 272 21G 4 ECHOSTIM ECHOGENIC INSULATED NEE 50.80 35.56
16002708 272 *21G 6 ECHOBLOCK ECHOGENIC NON-INSULTE 43.02 30.11
16002709 272 *20G 6 ECHOBLOCK PTC30 ECHOGENIC NON-IN 34.37 24.06
16002710 272 22G 2 ECHOBLOCK PTC ECHOGENIC NEEDLE 28.11 19.68
16002711 272 17G 6 ECHOTUOHY EPIDURAL NEEDLES 51.23 35.86
16002712 272 18G 8 TUOHY NEEDLES 46.91 32.84
16002713 272 22G 6 TUOHY NEEDLES 46.91 32.84
16002714 272 Y22G 3.5 TUOHY NEEDLES 38.70 27.09
16002715 272 *22G 6 ECHOBLOCK PTC30 ECHOGENIC NON-IN 34.37 24.06
16002716 272 20G 8 ECHOBLOCK PTC30 ECHOGENIC NON-IN 34.37 24.06
16002717 272 *22G 8 ECHOBLOCK PTC30 ECHGENIC NON-INS 34.37 24.06
16002784 272 COLD SNARE EXACTO 2.4MM 230CM 102.50 71.75
16002785 272 SNARE 15MM 120MM 1,159.01 811.31
16002786 272 SNARE STANDARD 9-15DX120CML CATH 1,071.21 749.85
16002807 272 FELT PTFE TEFLON 319.62 223.73
16002850 278 C1874 STENT PALMAZ 5FR X 80CM 3,812.79 2,668.95
16002960 272 *ADHESIVE DERMABOND 87.66 61.36
16002961 272 EXOFUSION SKIN CLOSURE SYSTEM 22CM 206.19 144.33
16002962 272 EXOFUSION SKIN CLOSURE SYSTEM 30 CM 226.44 158.51
16002963 272 EXOFIN SURGICAL SKIN ADHESIVE 1ML 49.73 34.81
16002965 272 ADHESIVE SURE&CLOSE WOUND CLOSURE SYS 81.82 57.27
16002970 272 ADHESIVE BIO-GLUE 2,757.06 1,929.94
16002971 272 SURGICAL SEALANT 4ML COSEAL 2,109.45 1,476.62
16002972 272 C1713 HEMOSTATIC MATRIX FLOSEAL 5ML 770.30 539.21
16002973 272 TACHOSIL SEALANT PATCH 2,283.56 1,598.49
16002974 272 *DURASEAL EXACT 5ML 4,414.11 3,089.88
16002975 272 DURAGEN SECURE 3X3 3,505.61 2,453.93
16002976 272 *DURASEAL 8CM APPLICATOR 873.83 611.68
16002977 272 ENDOSCOPIC APPLICATOR FLOSEAL 242.10 169.47
16002978 272 FIBRIN SEALANT 4ML TISSEEL 875.62 612.93
16002979 272 ENDOSCOPIC APPLICATOR TISSEEL SPRAY SET 474.35 332.05
16003003 271 BAG OSTOMY 2 DRAINABLE 21.09 14.76
16003005 271 BAG OSTOMY 3 DRAINABLE 21.09 14.76
16003006 271 DNU BAG OSTOMY 1 3/4 DRAINABLE 21.00 14.70
16003010 272 SUTURE HI-FI 1X40 104.43 73.10
16003011 272 SUTURE HI-FI 1X40 2 QTY TELFLEX 177.30 124.11
16003014 272 SUTURE VICRYL 3-0 SH ETH J415H 21.09 14.76
16003015 272 DNU SUTURE CAPIO NONABSORBABLE 146.67 102.67
16003016 272 SUTURE SILK 2-0 CT-1 ETH 423H 21.09 14.76
16003017 272 SUTURE MONOCRYL 5-0 PS-2 ETH Y495G 21.09 14.76
16003018 272 SUTURE VICRYL 3-0 SH 18 J864D 38.34 26.84
16003019 278 TUBE CONNECTOR SHUNT 199.50 139.65
16003020 272 SUTURE CAPIO ABSORBABLE 146.67 102.67
16003021 272 CATH VENOUS SHUNT 222.75 155.93
16003023 272 SUTURE PROLENE 7-0 BV-1 30 ETH 8703H 62.19 43.53
16003024 272 SUTURE PROLENE 2-0 SH 48 ETH 8533H 21.09 14.76
16003025 272 SUTURE PROLENE 3-0 SH 48 ETH 8534H 29.80 20.86
16003026 272 SUTURE SILK 2-0 SH 30 ETH C016D 47.74 33.42
16003027 272 SUTURE SILK 2-0 CT-1 ETH C022D 35.19 24.63
16003028 272 SUTURE SILK 3-0 REEL ETH LA-54-G 21.09 14.76
16003029 272 SUTURE SILK 2-0 REEL ETH LA55G 21.09 14.76
16003030 272 SUTURE SILK 2-0 30 TIES ETH SA-85H 20.00 14.00
16003032 272 SUTURE CHROMIC #1 CT-1 ETH 925H 22.62 15.83
16003033 272 DNU SUTURE MONOCRYL 4-0 P-3 ETH Y494G 31.50 22.05
16003034 272 SUTURE MONOCRYL 5-0 P-3 ETH Y493G 20.64 14.45
16003035 272 DNU SUTURE MONOCRYL 3-0 PS-2 ETH Y497G 31.50 22.05
16003036 272 SUTURE STAINLESS STEEL M682G 80.00 56.00
16003037 272 SUTURE VICRYL 3-0 SH ETH J416H 21.09 14.76
16003038 272 SUTURE VICRYL 5-0 P-3 ETH J493G 21.09 14.76
16003039 272 SUTURE VICRYL 2-0 CT-1 ETH J945H 21.09 14.76
16003040 272 SUTURE VICRYL 2-0 UR-5 ETH J375H 21.09 14.76
16003041 272 SUTURE VICRYL 4-0 TIES ETH J643H 21.09 14.76
16003042 272 SUTURE VICRYL 0 CT-1 ETH J946H 21.09 14.76
16003043 272 SUTURE ETHILON 7-0 P-6 18 ETH 1647G 21.98 15.39
16003044 272 SUTURE ETHILON P-3 ETH699G 21.09 14.76
16003045 272 SUTURE PLAIN 6-0 (FAST ACTING)ETH 1916G 34.29 24.00
16003046 272 SUTURE ETHIBOND #2 LR ETH X496T 23.87 16.71
16003047 272 SUTURE PROLENE 4-0 PS-2 ETH 8682G 21.09 14.76
16003048 272 SUTURE PDS 6-0 II P-1 ETH Z489G 23.78 16.65
16003049 272 SUTURE PROLENE 2-0 SH 36 ETH 8523H 29.60 20.72
16003050 272 SUTURE VICRYL ETH J232 21.09 14.76
16003051 272 SUTURE SILK 6-0 P-3 ETH 1639G 21.09 14.76
16003052 272 SUTURE SILK 4-0 SH ETH K831H 21.09 14.76
16003053 272 SUTURE VICRYL 0 CT-1 ETH J346H 21.09 14.76
16003054 272 SUTURE VICRYL 0 UR-5 ETH J376H 21.09 14.76
16003055 272 SUTURE VICRYL 0 8-18 J740D 38.17 26.72
16003056 272 SUTURE VICRYL 4-0 PS-2 ETH J496H 21.09 14.76
16003057 272 SUTURE PLAIN 3-0 CT' ETH 842H 21.09 14.76
16003058 272 SUTURE CHROMIC 4-0 SH ETH G121H 21.09 14.76
16003059 272 SUTURE CHROMIC 0 CT' ETH 924H 21.09 14.76
16003060 272 SUTURE CHROMIC 2-0 CT' ETH 923H 21.09 14.76
16003061 272 SUTURE PROLENE 6-0 BV-1 ETH 8805H 109.10 76.37
16003062 272 SUTURE MERSILENE 2-0 SH ETH R833H 21.09 14.76
16003063 272 SUTURE ETHIBOND 1 EXCEL OS-4 ETH X518H 21.09 14.76
16003064 272 SUTURE GZM 7-776 TEVDEK II 2 C-2 21.09 14.76
16003065 272 SUTURE MONOCRYL 4-0 PC-3 ETH Y845G 20.00 14.00
16003066 272 SUTURE VICRYL 1 CTX ETH J977H 21.09 14.76
16003067 272 DNU SUTURE ETH J549H 24.25 16.98
16003068 272 SUTURE ETHIBOND 0 CT-1 ETH X424H 21.09 14.76
16003069 272 SUTURE ETHIBOND 4-0 X871H 21.09 14.76
16003070 272 A4338 *CATH SILICONE 14FR 5CC 21.09 14.76
16003071 272 DNU ENDO STITCH W/SURG 2-0 GRN 48 ES-9 194.00 135.80
16003072 272 DNU ENDO STITCH 10MM SUTURING DEVICE 503.75 352.63
16003073 272 DNU PROTACK 5 MM 982.50 687.75
16003074 272 SUTURE TI-CON COATED BRAIDED 5 46.53 32.57
16003075 272 SUTURE ETHIBOND EXCEL X833H 21.09 14.76
16003076 272 SUTURE ETHIBOND 0 V-34 X444H 21.09 14.76
16003077 272 SUTURE ETHIBOND 0 OS-2 CX74T 35.72 25.00
16003078 272 SUTURE VICRYL 70CM CP-2 J870H 21.09 14.76
16003079 272 SUTURE ETHIBOND 0 CX45D 68.09 47.66
16003080 272 SUTURE VICRYL 2-0 ETH J269H 21.09 14.76
16003081 272 SUTURE VICRYL CT-1 J260H 21.09 14.76
16003082 636 J7326 GEL-ONE PER DOSE 1,918.88 1,343.22
16003100 272 SUTURE SILK 0 30 TIES ETH SA86G 0 21.09 14.76
16003101 272 SUTURE SILK 3-0 FS-1 ETH 684H 21.09 14.76
16003102 272 SUTURE SILK 3-0 K-S ETH 622H 21.09 14.76
16003103 272 SUTURE SILK 4-0 KS ETH 621H 21.09 14.76
16003104 272 SUTURE SILK 5-0 FS-2 ETH 682G 21.09 14.76
16003105 272 SUTURE SILK 5-0 P-3 ETH 640G 21.09 14.76
16003106 272 SUTURE SILK 6-0 C-3 ETH 711G 21.09 14.76
16003107 272 SUTURE SILK 0 CT-1 ETH 424H 21.09 14.76
16003108 272 SUTURE SILK 3-0 SH 30 ETH K832H 21.09 14.76
16003109 272 SUTURE VICRYL 0 TIES ETH J616H 21.09 14.76
16003110 272 SUTURE VICRYL 4-0 P-3 ETH J494H 21.09 14.76
16003111 272 SUTURE VICRYL 2-0 UR-6 ETH J602H 21.09 14.76
16003112 272 SUTURE PROLENE 2-0 KS ETH 8623H 21.09 14.76
16003113 272 SUTURE PROLENE 2-0 FS-1 ETH 8685H 21.09 14.76
16003114 272 SUTURE PROLENE 3-0 KS ETH 8622H 21.09 14.76
16003115 272 SUTURE PROLENE 4-0 KS ETH 8621H 21.09 14.76
16003116 272 SUTURE PROLENE 4-0 FS-2 ETH 8683G 20.00 14.00
16003117 272 SUTURE PROLENE 5-0 FS-2 ETH 8661G 21.09 14.76
16003118 272 SUTURE PROLENE 5-0 PS-5 ETH 8655G 21.09 14.76
16003119 272 SUTURE PROLENE #1 CT-1 ETH 8425H 21.09 14.76
16003120 272 SUTURE PROLENE 0 MO-7 CR/8 ETH C841G 73.95 51.77
16003121 272 SUTURE PROLENE 3-0 SH 36 ETH 8522H 21.09 14.76
16003122 272 SUTURE PROLENE 3-0 V-7 ETH 8976H 27.41 19.19
16003123 272 SUTURE PROLENE 4-0 SH 36 ETH 8521H 21.09 14.76
16003124 272 SUTURE PROLENE 5-0 BV-1 ETH 9702H 109.63 76.74
16003125 272 SUTURE PDS 4-0 SH ETH 9706H 34.00 23.80
16003126 272 SUTURE PDS 4-0 II FS-1 ETH Z441H 21.09 14.76
16003127 272 SUTURE PDS #1 CT-1 ETH Z347H 21.09 14.76
16003128 272 SUTURE PDS 4-0 SH ETH Z315H 21.09 14.76
16003129 272 SUTURE CHROMIC #1 TIES ETH S115H 21.09 14.76
16003130 272 SUTURE CHROMIC 0 TIES ETH S114H 20.00 14.00
16003131 272 SUTURE CHROMIC #2 TP-1 ETH GL31G 21.09 14.76
16003132 272 SUTURE CHROMIC #1 TP-1 ETH GL30G 21.09 14.76
16003133 272 SUTURE CHROMIC 0 BP-1 ETH 47T 23.87 16.71
16003134 272 SUTURE CHROMIC 2-0 SH ETH G123H 21.09 14.76
16003135 272 SUTURE CHROMIC 3-0 CT-3 ETH 892H 21.09 14.76
16003136 272 SUTURE CHROMIC 4-0 RB-1 ETH U203H 21.09 14.76
16003137 272 SUTURE PLAIN 2-0 CT-1 ETH 843H 21.09 14.76
16003138 272 SUTURE ETHILON 2-0 FS ETH 664H 21.09 14.76
16003139 272 SUTURE ETHILON 5-0 FS-2 ETH 661G 21.09 14.76
16003140 272 SUTURE ETHILON 6-0 FS-3 DNR 48.48 33.94
16003141 272 SUTURE CHROMIC 2-0 SH ETH 883H 21.09 14.76
16003142 272 *SUTURE TAPE 36 UMBILICAL SEE NOTES 21.09 14.76
16003143 272 SUTURE CHROMIC 3-0 CT-2 ETH 882H 21.09 14.76
16003144 272 SUTURE SURGICAL STEEL #7 CCS ETH M655G 79.31 55.52
16003145 272 SUTURE SURGICAL STEEL #5 CCS ETH M653G 75.59 52.91
16003146 272 SUTURE GORE 3N10B 3-0 GORTEX CV3 90.21 63.15
16003147 272 SUTURE GORE 4N02A 4-0 GORTEX CV4 118.56 82.99
16003148 272 SUTURE GORE 5N02A 5-0 GORTEX CV5 117.10 81.97
16003149 272 SUTURE PROLENE #2 MS/3 ETH 3846T 51.07 35.75
16003150 272 SUTURE SILK 4-0 FS-2 ETH 683G 21.09 14.76
16003151 272 SUTURE GORE 6M02A 6-0 GORTEX CV6 121.43 85.00
16003152 272 SUTURE 3-0 VICRYL CT-1 J258H 21.09 14.76
16003153 272 SUTURE 5-0 NUROLON 21.09 14.76
16003154 272 SUTURE 6-0 NUROLON 23.18 16.23
16003155 272 SUTURE 4-0 PDS II PS-2 NEEDLE 18 27.11 18.98
16003156 272 SUTURE 2-0 VICRYL CDT-2 NEEDLE 2 21.09 14.76
16003157 272 SUTURE 5-0 PDS RB-1 NEEDLE 21.09 14.76
16003158 272 SUTURE ETHICON ENDOLOOPS 125.75 88.03
16003159 272 SUTURE EHTIBOND EXCEL 1 CT 20.58 14.41
16003160 272 SUTURE EHTBOND EXCEL 5CCS 63.20 44.24
16003161 272 SUTURE VICRYL 27 38.81 27.17
16003162 272 PACK SHOULDER SPLIT 142.56 99.79
16003199 272 SUTURE BONE WAX 21.09 14.76
16003664 272 C1751 CATH GROSHONG SINGLE LUMEN 7FR 1,781.52 1,247.06
16003665 272 CATH GROSHONG DUAL LUMEN 9.5FR 1,148.64 804.05
16004000 272 MASK LMA DISPOSABLE SZ 3 158.92 111.24
16004001 272 MASK LMA DISPOSABLE SZ 4 DNU 95.13 66.59
16004002 272 *MASK LMA DISPOSABLE SZ 5 95.13 66.59
16004063 272 PACK ORTHO UPPER EXTREMITY 76.06 53.24
16004064 272 PACK ORTHO LOWER EXTREMITY 163.13 114.19
16004065 272 PACK CYSTO 24.09 16.86
16004066 272 CYSTOSCOPE DISPOSABLE SCOPE 782.55 547.79
16004067 272 HEMOSTASIS VALVE LARGE BORE 52.48 36.74
16004068 272 PACK ORTHO MAJOR 78.32 54.82
16004082 272 PACK ORTHOARTS HIP W/ POCKET 195.24 136.67
16004084 272 PACK BASIC II W/ UTILITY COVER 21.09 14.76
16004085 272 PACK KNEE ARTHROSCOPY/FLUID CONTROL 207.84 145.49
16004086 272 PACK UNIVERSAL 65.76 46.03
16004087 272 PACK SHOULDER ARTHROSCOPY ORTHOARTS 206.41 144.49
16004088 272 PACK UNIVERSAL SPLIT SURGICAL AURORA 54.16 37.91
16004090 272 PACK OB III 49.56 34.69
16004092 272 PACK EENT I 40.91 28.64
16004093 272 PACK LAP 111 34.65 24.26
16004102 272 CATH PERCUTANEOUS 14 FR 215.41 150.79
16004166 272 C1769 CATH BENTSON WIRE .035X180 CM TSFB 35 34.85 24.40
16004207 272 TUBE ENDOTRACHEAL 8.5 32.27 22.59
16004209 272 TUBE NASOPHARYNGEAL 28 49.60 34.72
16004210 272 TUBE COMBITUBE 41FR. 256.79 179.75
16004211 272 TUBE TRACH MLT 6.0 43.33 30.33
16004212 272 TUBE TRACH MLT 4.0 27.92 19.54
16004213 272 TUBE TRACH ORAL RAE CUFFED 6.5 21.09 14.76
16004214 272 TUBE NASOPHARYNGEAL 2 22.75 15.93
16004217 272 TUBE NASAL RAE-FLEX 7.0 24.00 16.80
16004218 272 TUBE NASAL RAE-FLEX 7.5 21.09 14.76
16004219 272 TUBE TRACH ORAL RAE FLEX CUFFED 7.5 21.09 14.76
16004220 272 TUBE NASOPHARYNGEAL 2 24.78 17.35
16004221 272 TUBE TRACH ORAL RAE FLEX CUFFED 8.0 21.09 14.76
16004222 272 TUBE TRACH CUFFED 4.5 21.09 14.76
16004271 272 TUBE NASAL RAE NR W/O CUFF 4.0 21.09 14.76
16004272 272 TUBE NASAL RAE NR W/O CUFF 4.5 21.09 14.76
16004273 272 TUBE NASAL RAE NR W/O CUFF 5.0 21.09 14.76
16004274 272 TUBE NASAL RAE NR W/O CUFF 5.5 21.09 14.76
16004275 272 TUBE NASAL RAE R E W/ CUFF 3.5 98.51 68.96
16004276 272 TUBE NASAL RAE R E W/ CUFF 4.0 92.89 65.02
16004277 272 TUBE NASAL RAE R E W/ CUFF 4.5 93.24 65.27
16004278 272 TUBE NASAL RAE R E W/ CUFF 5.0 98.53 68.97
16004297 272 NEEDLE BIOPSY TRU-CUT 56.00 39.20
16004299 272 BIOPSY NEEDLE CO-AX INTRODUCER 15G X11.8 77.83 54.48
16004310 272 NEEDLE TIP SINGLE USE 234.03 163.82
16004315 272 ADHESIVE MASTISOL LIQUID 2/3 CC VIAL 20.00 14.00
16004383 272 TLAB TRANSJUGULAR LIVER BIOPSY KIT 1,843.90 1,290.73
16004384 272 *AMPLATZER VASCULAR PLUG II 22MM 2,922.13 2,045.49
16004385 272 NEEDLE CHIBA COAXIAL SET 14CM 161.08 112.76
16004387 272 CATH 4 FR SIM1 NON-HYDROPHILLIC 168.65 118.06
16004389 272 CATH 4 FR BERENSTEIN 65 CM 72.65 50.86
16004390 272 NEEDLE COAXIAL INTRO 19X10 80.99 56.69
16004391 272 NEEDLE COAXIAL INTRO 19X15 80.99 56.69
16004392 272 BIOPSY DEVICE 18G X 15CM 215.12 150.58
16004393 272 BIOPSY NEEDLE CO-AX INTRO 17G X 11.8CM 77.83 54.48
16004394 272 PUNCH BIOPSY 2MM 20.00 14.00
16004395 272 PUNCH BIOPSY 1MM 20.00 14.00
16004396 272 PUNCH BIOPSY 3MM 21.09 14.76
16004397 272 *TRAY BONE MARROW BIOPSY MONOJECT 204.69 143.28
16004398 272 TRAY BONE MARROW BIOPSY JAMSHIDI 79.08 55.36
16004399 272 COAXIAL SETS WITH CHIBA NEEDLE 14CM 160.22 112.15
16004400 272 PLUG FISTULA ANAL 3,968.76 2,778.13
16004401 272 *AMPLATZER VASCULAR PLUG II 20MM 2,922.13 2,045.49
16004402 272 *AMPLATZER VASCULAR PLUG II 14MM 2,922.13 2,045.49
16004403 272 *NEEDLE BIOPSY 20GX3.5 44.55 31.19
16004404 272 BIOPSY DEVICE 16G X 15CM 215.12 150.58
16004405 272 *BIOPSY TEMNO EVOL 20X20 198.92 139.24
16004406 272 BIOPSY ACHIEVE 20X15 117.57 82.30
16004407 272 PUNCH AORTIC CLEANCUT 3.5MM 80.17 56.12
16004408 272 PUNCH AORTIC CLEANCUT 5.0MM 94.44 66.11
16004409 272 *AMPLATZER VASCULAR PLUG II 10MM 2,922.13 2,045.49
16004410 272 *AMPLATZER VASCULAR PLUG II 12MM 2,922.13 2,045.49
16004411 272 *AMPLATZER VASCULAR PLUG II 16MM 2,922.13 2,045.49
16004412 272 AMPLATZER VASCULAR PLUG 4 4MM 3,336.57 2,335.60
16004413 272 *AMPLATZER VASCULAR PLUG 4 6MM 3,336.57 2,335.60
16004414 272 AMPLATZER VASCULAR PLUG 4 8MM 3,336.57 2,335.60
16004415 272 CATH W/GLOVE 14 SCTN 21.09 14.76
16004420 272 CATH SUCTION #10 21.09 14.76
16004421 272 A4624 CATH SUCTION 6 FR 21.09 14.76
16004422 272 CATH 4 FR JB 1 TEMP OPEN END 69.03 48.32
16004435 272 CATH ALL PURPOSE 14FR 31.17 21.82
16004440 272 CATH VERSI 18FR 21.09 14.76
16004444 272 A4340 CATH COUDE 14FR 10CC - 5CC PACKAGE 39.66 27.76
16004445 272 CATH MALECOT 22FR 108.54 75.98
16004450 272 CATH MALECOT 24FR 82.61 57.83
16004451 272 C1729 CATH MALECOT 24FR LATEX FREE 167.44 117.21
16004453 272 TUBE ET REINFORCED NO CUFF 2.5 127.44 89.21
16004454 272 TUBE ET REINFORCED NO CUFF 3.0 127.44 89.21
16004455 272 TUBE ET REINFORCED NO CUFF 3.5 123.72 86.60
16004456 272 TUBE ET REINFORCED NO CUFF 4.0 127.44 89.21
16004457 272 TUBE ET REINFORCED NO CUFF 4.5 125.15 87.61
16004460 272 *CATH MALECOT 28FR 108.58 76.01
16004461 272 *CATH MALECOT 30FR 108.58 76.01
16004462 272 *CATH MUSHROOM 20FR 75.12 52.58
16004463 272 *CATH MUSHROOM 22FR 75.12 52.58
16004464 272 ORAL RAE TUBE W/ CUFF 8.0 96.48 67.54
16004465 272 NASAL RAE TUBE W/CUFF 8.0 96.48 67.54
16004466 272 TUBE ET REINFORCED W/CUFF 6.0 162.00 113.40
16004467 272 *TUBE ET REINFORCED W/CUFF 6.5 106.12 74.28
16004470 272 CATH BAKER JEJUNOSTOMY 16 F 1,219.85 853.90
16004471 272 KIT GASTROJEJUNOSTOMY SET 1,423.20 996.24
16004472 272 CATH GASTROJEJUNOSTOMY REPLAC CATH 303.25 212.28
16004474 272 DNU BAG OSTOMY 1 1/2 DRAINABLE 21.00 14.70
16004476 272 CAUTERY TIP SURGICAL 46.32 32.42
16004477 278 A4648 MARKER BREAST BIOPSY 17G. 10CM ULTRA CLI 245.08 171.56
16004478 272 TIP SCISSOR METZENBAUM 224.30 157.01
16004482 272 BAG OSTOMY 1 1/2 DRAINABLE 21.09 14.76
16004486 272 DNU BAG OSTOMY 1 SEALED 21.00 14.70
16004487 272 DNU BAG OSTOMY 1 1/4 SEALED 0 21.00 14.70
16004488 272 DNU BAG OSTOMY 1 1/2 SEALED 21.00 14.70
16004489 272 DNU BAG OSTOMY 1 3/4 SEALED 21.00 14.70
16004490 272 DNU BAG OSTOMY 3 SEALED 21.00 14.70
16004491 272 BAG OSTOMY 1/4 DRAINABLE 21.09 14.76
16004494 271 BAG COLOSTOMY FLANGE 2 3/4 70MM 21.09 14.76
16004497 270 A4405 PASTE KARAYA 7910 22.62 15.83
16004498 271 FLANGE FLEX 2.25 INCH 107.37 75.16
16004504 272 DNU BAG OSTOMY 2 1/2 DRAINABLE 21.00 14.70
16004505 272 BAG OSTOMY 2 DRAINABLE 21.09 14.76
16004506 271 DNU FLANGE CLOSED END 83.25 58.28
16004507 272 BAG UROSTOMY 1 21.00 14.70
16004508 272 DNU DRAIN TUBE UROSTOMY 38.25 26.78
16004510 272 DNU BAG OSTOMY 2 1/2 SEALED 21.00 14.70
16004511 272 A4365 DNU BAG OSTOMY 3 DEODORIZER FILTER 21.00 14.70
16004512 272 DNU BAG OSTOMY 1 1/8 DRAINABLE 21.00 14.70
16004513 272 A4365 DNU BAG OSTOMY 64MM (2 1/2 ) 21.00 14.70
16004516 272 A4421 DNU DRAIN STOMA IRRIGATOR 23.75 16.63
16004517 271 FLANGE FLEXWARE 2 3/4X 2 1/4 21.09 14.76
16004518 272 A4421 DNU KIT STOMA IRRIGATOR 21.00 14.70
16004519 272 BARRIER POST OP CUT TO FIT 35.50 24.85
16004520 272 A6154 BARRIER POST OP CUT TO FIT 54.43 38.10
16004521 272 DNU BAG OSTOMY 2 SEALED 21.00 14.70
16004523 272 A4338 DX-PH PROBE 439.02 307.31
16004524 271 BARRIER SKIN 4X4 21.09 14.76
16004526 272 DNU OSTOMY LOOP STARTER SET 3 1/2 25.00 17.50
16004527 272 DNU OSTOMY LOOP DRAINABLE 21.00 14.70
16004529 271 POUCH CLOSED W/FILTER 1 3/16 21.00 14.70
16004538 271 POUCH POST OP 21.00 14.70
16004547 272 *DRESSING EZ DERM (MEDISKIN) 223.87 156.71
16004549 272 THERASKIN 2X3 4,143.75 2,900.63
16004550 272 DRESSING EZ DERM 3X4 (MEDISKIN) 206.31 144.42
16004556 272 TUBE ENDOTRACHEAL 6.0 21.09 14.76
16004606 272 DNU TUBE ET ORAL RAE NO CUFF 3.0 21.00 14.70
16004607 272 TUBE ET ORAL RAE NO CUFF 3.5 21.09 14.76
16004608 272 TUBE ET ORAL RAE NO CUFF 4.0 21.00 14.70
16004609 272 TUBE ET NO CUFF 2.5 21.09 14.76
16004610 272 TUBE ET NO CUFF 3.0 21.09 14.76
16004611 272 TUBE ET NO CUFF 3.5 21.09 14.76
16004612 272 TUBE ET NO CUFF 4.5 21.09 14.76
16004615 272 SET T-U-R Y TYPE IR 41.79 29.25
16004616 272 36 ARGYLE SALEM SUMP TUBE 10FR 21.09 14.76
16004662 278 SYSTEM FILTER G2 FOR PERMANENT PLACEMENT 2,770.50 1,939.35
16004663 278 C1880 KIT TRAPEASE INTRODUCER 2,780.03 1,946.02
16004664 272 CATH SAVVY BALLOON 3X6X80 668.50 467.95
16004665 272 CATH SAVVY BALLOON 3X10X80 668.50 467.95
16004704 272 *NEEDLE BIOPSY 18GA X 73.51 51.46
16004705 272 MAXCORE BIOPSY 18GX25CM 158.31 110.82
16004706 272 *ENDO GIA II 60-4.8 559.70 391.79
16004707 272 *ENDO GIA PURPLE 60MM MED/THICK RELOAD 1,558.07 1,090.65
16004708 272 *ENDO GIA BLCK 60MM ARTICULATING EXTRA-T 1,898.14 1,328.70
16004709 272 NEEDLE KOPANS BREAST 20G/9CM 101.90 71.33
16004710 272 NEEDLE BREAST KOPANS 20GA/9CM 75.35 52.75
16004716 272 CAUTERY PENCIL DISP 24.30 17.01
16004718 272 *STAPLER ENDO GIA UNIVERSAL 1,166.83 816.78
16004719 272 *DNU RELOAD ENDO GIA ROTICULATING 60-4.8 867.66 607.36
16004720 272 *DNU RELOAD ENDO GIA ROTICULATING 60-3.5 1,608.37 1,125.86
16004724 272 TUBE ET 7.5MM 21.09 14.76
16004727 272 TUBE NASAL RAE W/CUFF 6.0 94.97 66.48
16004728 272 TUBE NASAL RAE W/CUFF 6.5 98.51 68.96
16004729 272 TUBE NASAL RAE W/CUFF 7.0 97.51 68.26
16004741 272 TUBE TRACH LARYNGOFLEX SZ 8 266.84 186.79
16004742 272 TUBE TRACH LARYNGOFLEX SZ 9 271.78 190.25
16004743 272 TUBE TRACH LARYNGOFLEX SZ 10 271.78 190.25
16004744 272 *TUBE TRACH LARYNGOFLEX SZ 7 299.62 209.73
16004753 272 DNU TUBE TRACH 4.5FR 8646 21.00 14.70
16004756 272 TUBE ENDOTRACHEAL 6.5 21.09 14.76
16004757 272 TUBE ENDOTRACHEAL 7.0 21.09 14.76
16004758 272 TUBE ENDOTRACHEAL 7.5MM 21.09 14.76
16004759 272 TUBE ENDOTRACHEAL 8.0MM 21.09 14.76
16004761 272 TUBE ENDOTRACHEAL 9.0MM 21.09 14.76
16004762 272 TUBE ENDOTRACHEAL 9.5MM 21.09 14.76
16004763 272 TUBE TRACH 7.5 HI-LO CUFFED 20.00 14.00
16004764 272 TUBE TRACH 7.0 HI-LO CUFFED 21.09 14.76
16004765 272 TUBE TRACH 8.0 HI-LO CUFFED 21.09 14.76
16004767 272 TUBE TRACH ORAL RAE CUFFED 5.5 21.09 14.76
16004770 272 DNU TUBE TRACH CUFFED 5.0 21.00 14.70
16004771 272 TUBE TRACH ORAL RAE CUFFED 6.0 21.09 14.76
16004773 272 TUBE TRACH CUFFED 8.0 38.83 27.18
16004774 272 TUBE TRACH CUFFED 8.5 38.79 27.15
16004778 272 TUBE TRACH CUFFED 27.16 19.01
16004781 272 TUBE NASAL RAE R E W/ CUFF 7.5 98.50 68.95
16004782 272 *TUBE NASAL RAE R E W/ CUFF 8 95.74 67.02
16004786 272 TUBE TRACH ORAL RAE CUFFED 5.5 21.09 14.76
16004787 272 TUBE TRACH ORAL RAE CUFFED 5.0 21.09 14.76
16004788 272 TUBE TRACH ORAL RAE CUFFED 6.0 21.09 14.76
16004789 272 TUBE TRACH ORAL RAE CUFFED 4.5 21.09 14.76
16004796 272 TUBE TRACH MLT 5.0 38.83 27.18
16004801 278 C1887 CATH VISTA BRIGHT TIP 6FX55CM H-STICK 279.25 195.48
16004802 278 C1887 CATH VISTA BRITE TIP 6F INTERNAL MAMMARY 678.20 474.74
16004805 272 CATH VISTA BRIGHT TIP 6FX55CM RDC(1) 262.75 183.93
16004807 272 TUBE TRACH ORAL RAE CUFFED 7.0 21.09 14.76
16004838 272 TUBE NASAL RAE R E W/ CUFF 5.5 102.41 71.69
16004885 272 CATH BAKER JEJUNSOTOMY 16FR 108 LONG 15C 692.00 484.40
16004900 272 *SHOULDER SUSPENSION KIT 340.96 238.67
16004917 272 C1725 TUBE ET NO CUFF 4.0 20.00 14.00
16004919 272 TUBE ET W/CUFF 5.0 21.09 14.76
16004930 272 SET CYSTO IRRIGATION 39.78 27.85
16004985 272 TUBE LEVINE 14FR 21.00 14.70
16004990 274 B4082 TUBE NG LEVINE 16FR ARGY 21.09 14.76
16004999 272 TUBE SALEM SUMP 18FR 57.89 40.52
16005000 274 B4082 TUBE LEVINE 18FR 21.09 14.76
16005001 272 TUBE SALEM SUMP 16FR 57.89 40.52
16005002 272 TUBE SALEM SUMP 14FR 21.09 14.76
16005003 272 TUBE SALEM SUMP 12FR 21.09 14.76
16005004 278 C1894 DRYSEAL SHEATH DSL1628 915.74 641.02
16005005 278 C1874 EXCLUDER RLT261418 36,629.45 25,640.62
16005006 278 C1874 EXCLUDER PLC181400 15,018.07 10,512.65
16005007 278 C1894 DRYSEAL SHEATH DSL1828 1,098.88 769.22
16005008 278 C1725 Q50 PLUS STENT GRAFT BALLOON CATH 1,615.03 1,130.52
16005009 278 C1894 DRYSEAL SHEATH DSL1228 915.74 641.02
16005010 278 C1874 EXCLUDER RLT281418 36,629.45 25,640.62
16005011 272 SHEATH 5FR BRITE TIP 151.36 105.95
16005012 278 C1887 8 FR DESTINATION SHEATH 458.87 321.21
16005014 272 SHEATH 456.58 319.61
16005015 272 SHEATH 456.58 319.61
16005016 272 SHEATH INTRODUCER 6FR SHUTTLE 828.88 580.22
16005017 272 SHEATH DESTINATION 90CM 579.51 405.66
16005018 258 HEMOSTATIC ABSORBABLE PARTICLES 477.65 334.36
16005019 272 SHEATH DESTINATION 45CM 502.23 351.56
16005020 278 C1768 GRAFT MAIN BODY 27,189.04 19,032.33
16005021 278 C1768 GRAFT LEG CONTROL 12,553.91 8,787.74
16005022 272 DNU ENDO RETRACT 5MM 347.78 243.45
16005023 272 ENDO RETRACT 10MM 761.12 532.78
16005024 272 GRASPER ROTICULATOR 5MM 928.84 650.19
16005025 272 RELOADS ENDO STAPLER ETHICON 204.68 143.28
16005026 272 SILS DISSECTOR 5MM 1,131.62 792.13
16005027 272 SHEATH DESTINATION RDC RENAL CATH 6FR 45 502.23 351.56
16005028 272 MARGINMARKER WITH CLIPS 592.22 414.55
16005029 272 SHEATH DESTINATION RDC RENAL 5FR 45CM 502.23 351.56
16005030 272 ENDOPATH 5MM GRASPER 144.13 100.89
16005032 272 *CATH EPIDURAL 52.24 36.57
16005034 272 TROCAR THORACIC 12MM 257.01 179.91
16005035 278 C1874 EXCLUDER RLT231218 35,098.20 24,568.74
16005036 278 C1874 EXCLUDER PLC141200 14,335.65 10,034.96
16005037 278 C1874 EXCLUDER PLL161207 10,069.92 7,048.94
16005038 278 C1894 DRYSEAL SHEATH DSF1233 1,471.86 1,030.30
16005039 278 C1894 DRYSEAL SHEATH DSF1633 1,415.25 990.68
16005040 272 C1725 CATH OCCULDER OCCULSION MOLDING MOB37 1,655.01 1,158.51
16005041 278 C1874 EXCLUDER PLL161407 10,572.75 7,400.93
16005048 272 TRAY PONSKY PULL PEG 208.61 146.03
16005070 278 TISSUE EXPANDERS 4,829.25 3,380.48
16005130 272 LIGASURE EXACT DISSECTOR 2,190.58 1,533.41
16005131 272 DNU CLIP APPLIER 10MM EN 250.50 175.35
16005132 272 LIGASURE IMPACT 2,390.42 1,673.29
16005133 272 LIGASURE SMALL JAW 1,582.68 1,107.88
16005134 272 LIGASURE BLUNT TIP 5 MM 1,896.57 1,327.60
16005135 272 DNU CLIP APPLIER LIGAMAX 5 419.25 293.48
16005136 272 PENCIL FORCE TRIVERSE BOVIE 172.97 121.08
16005137 272 LIGASURE ATLAS 10MM 37CM HAND SWITCHING 1,633.24 1,143.27
16005138 272 LIGASURE CURVED MARYLAND 5MM 23CM 2,184.47 1,529.13
16005139 272 LIGASURE CURVED MARYLAND 5MM 37CM 1,970.21 1,379.15
16005140 272 VISIPORT PLUS OPTICAL TROCAR 5-12MM 501.22 350.85
16005150 272 *L-HOOK ELECTRODE 33CM 192.86 135.00
16005151 272 *L-HOOK ELECTRODE 45CM 180.44 126.31
16005154 272 CATH BERENSTEIN II .038 X 100 CM 52.02 36.41
16005155 272 MEGADYNE EZ CLEAN BLADE ELECTRODES 4 20.25 14.18
16005156 272 SCISSOR 5MMX35CM 164.32 115.02
16005157 272 BAG SPECIMEN RETRIEVAL SYSTEM 263.41 184.39
16005158 272 TROCAR BALLOON 12X100MM 90.20 63.14
16005159 272 TROCAR 5X100 OPT SEP SYS 73.80 51.66
16005160 272 SLEEVE CANN/SEAL 28.11 19.68
16005161 272 DNU SLEEVE ADV FIX CANN/SEAL 31.25 21.88
16005162 272 *TROCAR 11x100 THR OPT SEP SYS 118.92 83.24
16005163 272 SLEEVE 11X100MM THR CAN/SEAL 59.46 41.62
16005164 272 DNU SLEEVE 11X100MM ADVFIX CAN/SEAL 72.50 50.75
16005165 272 TROCAR 15X150 NON BLADED 205.41 143.79
16005166 272 DNU TROCAR 15X100 NON BLADED 200.50 140.35
16005167 271 CAUTERY PENCIL 51.89 36.32
16005168 272 BLADE ELECTRODE 21.09 14.76
16005169 272 MEGADYNE NEEDLE ELECTRODE 2.75 43.42 30.39
16005170 272 E-Z CLEAN BLADE ELECTRODE 6 21.09 14.76
16005171 272 DNU BALLOON 5MM ORIGIN PORT 72.00 50.40
16005172 272 *CLIP APPLIER 5MM 368.77 258.14
16005173 272 *CLIP APPLIER 10MM 245.86 172.10
16005174 272 KII FIOS FIRST ENTRY 11MM X 150M 138.38 96.87
16005175 272 KII FIOS FIRST ENTRY 5MM X 150MM 71.35 49.95
16005176 272 *KII SLEEVE 5 X 150 32.43 22.70
16005177 272 KII SLEEVE 11 X 150 54.05 37.84
16005178 272 TROCAR 15X100MM OPTICAL ACCESS 209.73 146.81
16005179 272 TROCAR 5X100MM OPTIC ACCESS 77.90 54.53
16005180 272 CLIP APPLIER AUTO ENDO 5MM 456.58 319.61
16005181 272 TROCAR 5x100 NO BALLOON 75.67 52.97
16005182 272 TROCAR 5x150 77.90 54.53
16005183 272 TROCAR SLEEVE 5 X 100MM 34.59 24.21
16005184 272 ACCESS NEEDLE STEP INSUFFLATION 152.10 106.47
16005185 272 NEEDLE, SURGINEEDLE 150MM LONG PNEUMOPER 72.48 50.74
16005186 272 SPECIMEN RETRIEVAL SYSTEM 3X6 185.83 130.08
16005187 272 ENDOSCOPIC PEANUT DEVICE 5MM 207.45 145.22
16005188 272 TROCAR OPTIC PORT 11x100MM 118.90 83.23
16005189 272 OPTICAL PORT SLEEVE 11 X 100 58.43 40.90
16005190 272 CLIP APPLIER 5MM ENDOCLIP III 1,454.92 1,018.44
16005191 272 CLIP APPLIER 10MM ENDOCLIP II 1,114.58 780.21
16005192 272 DRAIN ROUND WOUND W/ TROCAR 10FR 31.69 22.18
16005193 272 12X150 KII OPTICAL ACCESS SYSTEM 125.40 87.78
16005194 272 C1725 CATH OCCULDER OCCULISION 26FRX100CM 822.51 575.76
16005195 272 C1725 CATH OCCULDER OCCULSION 34FRX100CM 822.51 575.76
16005196 272 LINEAR RELOAD 60MM GREEN 534.72 374.30
16005198 272 REINFORCEMENT ECHELON 60MM 735.48 514.84
16005199 272 PUSH-BUTTON SMOKE EVAC PENCIL, COATED 94.30 66.01
16005200 272 CATH ART EMB 2FR 274.37 192.06
16005204 272 TRAY SPINAL PENCIL PO W/O LIDOCAINE 74.54 52.18
16005205 272 TRAY LUMBAR PUNCTURE PED 90.73 63.51
16005206 272 RELOAD LINEAR CUTTER 55MM 153.75 107.63
16005207 272 TRAY EPIDURAL PAINPAK 74.01 51.81
16005208 272 TRAY SPINAL PENCIL LIDOCAINE 62.48 43.74
16005209 272 *TRAY CONTINOUS EPIDURAL 86.06 60.24
16005210 272 TRAY LUMBAR PUNCTURE 79.87 55.91
16005211 272 TRAY CONTINOUS CONTINUOUS EPIDURAL TRAY 94.13 65.89
16005213 272 TRAY THORACENTISIS 138.70 97.09
16005217 272 *TRAY NERVE BLOCK CONT STIM 469.67 328.77
16005218 272 TRAY SPINAL NEEDLE PEACAN 75.89 53.12
16005219 272 SET NERVE BLOCK CONT TUOHY 123.68 86.58
16005220 272 SET NERVE BLOCK CONT TUOHY 108.67 76.07
16005221 272 TRAY NERVE BLOCK CONT STIM 317.14 222.00
16005222 272 SET NERVE BLOCK CONT TUOHY 108.71 76.10
16005238 272 SHEATH SUPER R/O 8FR 11CM 155.68 108.98
16005256 272 TIPLESS STONE EXTRACTOR 1,176.60 823.62
16005257 272 EXTRACTOR EBL 8.5-20 621.65 435.16
16005258 272 EXTRACTOR STONE EBL 511.02 357.71
16005259 272 WIRE BASKET MWB-2X4 1,450.53 1,015.37
16005260 272 BASKET MEMORY POLYP RETRIEVER 7FR 609.18 426.43
16005285 272 BLADE BEAVER 3M 21.09 14.76
16005286 272 BLADE BEAVER 5MM 21.09 14.76
16005388 272 STYLET INTUBATING 14FR 20.00 14.00
16005389 272 STYLET INTUBATING 10FR 21.09 14.76
16005390 272 BASKET RETRIEVER ZERO TIP 1,251.23 875.86
16005391 272 BASKET STONE RETRACTOR TIPLESS 1.5FR 1,018.34 712.84
16005392 272 BASKET STONE SKYLITE TIPLESS 1.9FR 822.38 575.67
16005393 272 STAPLER ETHELON POWERED 340MM 1,120.02 784.01
16005394 272 STAPLER ETHELON POWERED 440MM 1,122.92 786.04
16005395 272 LINEAR RELOAD 60MM BLUE 534.72 374.30
16005397 272 LINEAR RELOAD 60MM BLACK 534.72 374.30
16005401 272 ULTRABLATOR 30 DEGREE, THREE RIB 285.12 199.58
16005402 272 ULTRABLATOR 90 DEGREE, THREE RIB 285.12 199.58
16005403 272 BAG OSTOMY 2 1/2 DRAINABLE 21.09 14.76
16005422 278 C1874 STENT 4.8FRX24CM URET 695.96 487.17
16005423 278 C1874 STENT [Link] 26 CM URET 695.96 487.17
16005426 278 C1874 STENT 7FR X 26CM URETERAL SOFT 492.37 344.66
16005427 278 C1874 STENT 7FR X 24CM URETERAL SOFT 492.37 344.66
16005428 272 CATH 18FR X 4CM URETERAL BALLOON 1,608.24 1,125.77
16005429 278 C1874 STENT CAROTID 6MMX30MM 7,325.89 5,128.12
16005430 278 C1874 STENT CAROTID 6MMX20MM 7,325.89 5,128.12
16005431 278 C1874 STENT CAROTID 7MMX20MM 7,325.89 5,128.12
16005505 272 PAPILLOTOME HUIBRESGS 846.43 592.50
16005512 272 ENDOPATH PROBE SHAFT 76.76 53.73
16005513 272 *SHAFT EPS 04 142.72 99.90
16005514 272 SUCTION IRRIGATOR HANDPIECE - ENDOPATH 146.07 102.25
16005515 272 HOOK ENDOPATH ELECTRODE 76.76 53.73
16005516 272 EPIX SUCTION IRRIGATOR SYSTEM W/5MM PROB 236.43 165.50
16005517 272 TUBE NASOPHARYNGEAL 32 24.80 17.36
16005519 272 TUBE NASOPHARYNGEAL 30 24.78 17.35
16005520 272 DNU TRAY THORACOSTOMY 59.50 41.65
16005530 272 VALVE TRACH/VENT SWALLOWING 235.49 164.84
16005591 272 URINEMETER DRAIN BAG 2000 CC 27.68 19.38
16005606 272 PACK ANGIO (CUSTOM) 228.01 159.61
16005740 272 SET MANOMETER W/STOPC 21.09 14.76
16005798 272 COIL EMBOLIZATION 5 X 188.75 132.13
16005816 272 TUBE TRACH 3.0 CUFFED 22.70 15.89
16005819 272 TUBE TRACH 5.0 UNCUFFED 21.00 14.70
16005820 272 TUBE ORAL RAE CUFFED 4.0 21.09 14.76
16005821 272 TUBE TRACH 2.5 UNCUFFED 112.13 78.49
16005823 272 TUBE TRACH 4.0 UNCUFFED 68.55 47.99
16005841 272 PH PROBE PAC-50015M 181.62 127.13
16005842 272 TUBE ET MICROCUFF PED 3.5MM 38.88 27.22
16005843 272 TUBE ET MICROCUFF PED 4.0MM 82.68 57.88
16005844 272 TUBE ET MICROCUFF PED 4.5MM 47.44 33.21
16005846 272 TUBE ET MICROCUFF PED 5.0MM 47.44 33.21
16005887 272 TUBE TRACH 4.0 UNCUFFED 21.09 14.76
16005888 272 TUBE TRACH 4.0 CUFFED 21.09 14.76
16005894 275 C1899 LEADWIRE 4470 3,163.45 2,214.42
16005895 275 C1899 LEADWIRE 4457 3,163.45 2,214.42
16005899 275 C1785 AUTOMATIC ICD IMPLANT 58,274.13 40,791.89
16005900 275 C1896 LEADWIRE 0148-141619 ICD 23,309.65 16,316.76
16006050 272 INTRODUCER HEMOSTASIS 6FR 12CM 36.11 25.28
16006051 272 INTRODUCER HEMOSTASIS 6FR 5CM 43.24 30.27
16006053 272 NEEDLE ASPERATION 21G 13MM 242.32 169.62
16006054 272 NEEDLE ASPERATION 21G W/PORT 13MM 272.93 191.05
16006055 272 NEEDLE ASPIRATION NA2 SMOOTHSHOT 21G 272.93 191.05
16006056 272 NEEDLE SPINAL 18 X 3 1/2 21.09 14.76
16006057 272 NEEDLE 22 X 3/4 NON-C 50.76 35.53
16006060 272 TUBE UNIVENT ENDO 6.5 628.68 440.08
16006061 272 *TUBE UNIVENT 6.0 628.68 440.08
16006062 272 TUBE UNIVENT ENDO 7.5MM 628.68 440.08
16006063 272 TUBE UNIVENT ENDO 7.0MM 628.68 440.08
16006064 272 TUBE UNIVENT ENDO 8.5 628.68 440.08
16006065 272 TUBE UNIVENT ENDO 8.0 628.68 440.08
16006066 272 NEEDLE SPINAL 22 X 3.5 20.00 14.00
16006068 272 DNU NEEDLE SPINAL 22 X 5 21.00 14.70
16006073 272 NEEDLE RIGHT ANGLE 20 30.75 21.53
16006074 272 NEEDLE 20 X 3/4 NDN-C 24.30 17.01
16006076 272 NEEDLE 22 X 1 NON-COR 52.32 36.62
16006078 272 NEEDLE 19 X 1.5 NON-CORING RT 21.09 14.76
16006079 272 NEEDLE 19 X 3/4 NDN-C 23.22 16.25
16006080 278 C1769 GUIDE WIRE STEERABLE 466.19 326.33
16006081 272 CANNULA 100MM 20G 182.19 127.53
16006082 272 GROUNDING PAD RFA 105.47 73.83
16006100 272 ALEXIS WOUND PROTECTOR/RETRACTOR X-LARG 312.59 218.81
16006101 272 ALEXIS WOUND PROTECTOR/RETRACTOR XX-LARG 474.14 331.90
16006102 272 ALEXIS WOUND PROTECTOR/RETRACTOR LARGE 256.40 179.48
16006103 272 ALEXIS WOUND PROTECTOR/RETRACTOR MEDIU 173.16 121.21
16006120 278 C1874 DNU STENT SMART 6X20CM 5,162.75 3,613.93
16006121 278 C1874 STENT SMART 14X40 4,706.72 3,294.70
16006122 278 C1874 STENT SMART 14X60 4,706.72 3,294.70
16006201 272 DNU SENSOR OXISENSOR II N-25 45.06 31.54
16006202 272 SYRINGE EPIDURAL 7CC 21.09 14.76
16006203 272 LIGACLIP ALLPORT M/L 1,948.22 1,363.75
16006204 272 UROSTOMY POST OP 3/4 30.25 21.18
16006205 272 BLADE BEAVER MINI 21.09 14.76
16006402 272 CATH ULTRA 5FR/120CM 948.30 663.81
16006411 278 C1874 SHEATH 6FR 11C BRIGHT 130.09 91.06
16006438 272 DNU CATH 5X2X120 ULTRA DI 631.25 441.88
16006610 272 *CATH BRONCHO 41FR RIGHT 397.93 278.55
16006820 270 NEEDLE SPINAL 22 X 8 INCH 64.87 45.41
16006821 272 *NEEDLE SPINAL 25G 3 1/2 21.09 14.76
16006822 272 NEEDLE SPINAL 20G X6IN LONG LENGTH WITH 21.09 14.76
16006823 272 NEEDLE SPINAL 18G X 6IN LONG LENGTH 25.17 17.62
16006826 272 NEEDLE SPINAL 22X5 31.64 22.15
16006827 272 NEEDLE SPINAL 20X5 31.64 22.15
16006828 272 NEEDLE SPINAL TOUHY 20X5G 45.36 31.75
16006829 272 NEEDLE SPINAL TOUHY 22X5G 45.36 31.75
16007000 272 BASKET STONE 2.4 FR GEMINI 3 WIRE 1,045.74 732.02
16007010 272 SHEATH 7FR BRIGHT TIP 5.5CM 110.87 77.61
16007011 272 SHEATH 7FR BRIGHT TI 137.21 96.05
16007112 272 C1887 CATH PIGTAIL 4FR 110CM 49.20 34.44
16007114 272 C1887 CATH PIGTAIL 4FR 65CM 49.20 34.44
16007115 272 C1887 ACCU-VU PIGTAIL 4FX70CM 949.65 664.76
16007147 278 C1769 GUIDE WIRE 300CM X 035 STORQ 275.22 192.65
16007197 272 WIRE INFUSION KATZEN 705.95 494.17
16007204 278 C1874 STENT WALL 20 X 40 CM 3,979.29 2,785.50
16007207 272 *CATH SELECTIVE C2X.035X65CM 60.55 42.39
16007210 278 C1874 VIABAHN ENDOPROSTHESIS 10,822.34 7,575.64
16007211 278 C1874 VIABAHN BALLOON EXPANDABLE ENDOPROSTHESI 10,838.99 7,587.29
16007212 278 C1874 VIABAHN VBX BALLOON EXPANDABLE ENDOPROST 11,108.71 7,776.10
16007213 272 CATH GLIDE TERUMO 4FR 65 LONG 242.00 169.40
16007214 272 CATH GLIDE TERUMO 120CM 242.00 169.40
16007215 278 C1874 VIABAHN VBX BALLOON EXPANDABLE ENDOPROST 11,108.71 7,776.10
16007216 278 C1874 VIABAHN VBX BALLOON EXPANDABLE ENDOPROST 11,108.71 7,776.10
16007217 278 C1874 VIABAHN ENDOPROSTHESIS 23,166.46 16,216.52
16007218 278 C1874 VIABAHN ENDOPROSTHESIS 11,851.47 8,296.03
16007219 278 C1874 VIABAHN VBX BALLOON EXPANDABLE ENDOPROST 11,385.27 7,969.69
16007220 278 C1874 VIABAHN ENDOPROSTHESIS 11,388.60 7,972.02
16007221 278 C1874 VIABAHN ENDOPROSTHESIS 13,153.50 9,207.45
16007223 278 C1874 VIABAHN ENDOPROSTHESIS 21,911.40 15,337.98
16007224 278 C1874 VIABAHN SX ENDO HEPARIN 18 RO 6MMX15CM 6 13,206.78 9,244.75
16007225 278 C1874 VIABAHN BX BALLOON ENDO 7FR 135CM CATH H 11,088.90 7,762.23
16007226 278 C1874 VIABAHN BX BALLOON ENDO 7FR 135CM CATH H 11,088.90 7,762.23
16007227 278 C1874 VIABAHN BX BALLOON EXP ENDO 7X79MM 7FR 11,866.21 8,306.35
16007229 270 ACAPELLA DM BLUE W/T GHPC MED FLOW 171.06 119.74
16007233 272 SHEATH 6FR BRITE TIP 23CM 147.16 103.01
16007234 272 SHEATH 7FR BRITE TIP 150.45 105.32
16007235 272 SHEATH 7FR BRITE TIP 23CM .97MM 167.79 117.45
16007236 272 SHEATH 7FR X 11CM BRITE TIP 136.53 95.57
16007237 272 SHEATH 8FR X 35CM BRITE TIP 149.36 104.55
16007238 272 SHEATH 9FR X 23CM BRITE TIP 151.18 105.83
16007239 272 SHEATH 10FR X 11CM BRITE TIP 136.53 95.57
16007240 272 SHEATH 9FR X 35CM BRITE TIP 245.57 171.90
16007241 272 SHEATH 6FR BRITE TIP 5.5CM 110.87 77.61
16007250 272 SHEATH SUPER 9FR 95.44 66.81
16007252 272 SHEATH SUPER 10FR 37.52 26.26
16007280 278 C1874 STENT PALMAZ 7FR X 80 CM CORINTHIAN 3,916.02 2,741.21
16007285 272 *CATH BLUE MAX 5.8 FR 909.66 636.76
16007290 272 CATHETER STERLING MONORAIL BALLOON DILAT 749.75 524.83
16007291 272 CATH TRANSIT MICRO 3MMX135CM 1,141.46 799.02
16007296 272 CATH GLIDE 4FR 100CM NON-TAPER ANGLE 274.73 192.31
16007297 272 CATH GLIDE 4FR 65CM 251.12 175.78
16007298 272 WIRE MAGIC TORQUE 247.22 173.05
16007299 278 C1769 GUIDE WIRE AMPLATE 201.72 141.20
16007300 278 C1874 STENT SMART 10X20X120 4,944.98 3,461.49
16007301 278 C1874 DNU STENT SMART 12X30X80 4,706.89 3,294.82
16007302 278 C1874 STENT SMART 14X40X80 4,706.72 3,294.70
16007303 272 CATH DILATION PTA PRO 8MMX4CMX80CM 744.58 521.21
16007304 272 CATH PIGTAIL 4FR 65CM 421.46 295.02
16007305 272 CATH PIGTAIL 4FR 100CM 151.36 105.95
16007306 272 CATH PIGTAIL 5FR 65CM 439.02 307.31
16007307 272 C1725 CATHETER CENTESIS ONE STEP 6FR 133.20 93.24
16007310 278 C1725 CATH GUIDE 6FR 90CM PV MACH 1 200.90 140.63
16007312 278 C1725 CATH GUIDE RUNWAY MP2 532.79 372.95
16007313 278 C1725 CATH GUIDE RUNWAY JR4 532.79 372.95
16007321 272 CATH VIPER SMALL VESSEL BA 1,418.92 993.24
16007325 272 KIT BIO PREP 1,053.64 737.55
16007326 272 BONE CEMENT MIXING AND DELIVERY SYSTEM C 423.21 296.25
16007327 272 CLEARMIX SINGLE DOUBLE MIX 386.28 270.40
16007328 278 C1874 STENT EPIC 10X20 x 75CM SELF EXPANDING 3,995.94 2,797.16
16007329 278 C1874 STENT EPIC 12X60X75CM SELF EXPANDING VA 3,995.94 2,797.16
16007330 278 C1874 STENT EPIC 6X30 SELF EXPANDING VASCULAR 3,995.94 2,797.16
16007331 278 C1874 STENT EPIC 6X60 SELF EXPANDING VASCULAR 3,995.94 2,797.16
16007332 278 C1874 STENT EPIC 8X30 SELF EXPANDING VASCULAR 3,995.94 2,797.16
16007333 278 C1874 STENT EPIC 8X40 SELF EXPANDING VASCULAR 3,995.94 2,797.16
16007334 278 C1874 STENT EPIC 8X60 SELF EXPANDING VASCULAR 3,995.94 2,797.16
16007335 278 C1874 STENT EPIC 10X40 SELF EXPANDING VASCULAR 3,995.94 2,797.16
16007336 278 C1874 STENT EPIC 10X60 SELF EXPANDING VASCULAR 3,995.94 2,797.16
16007337 278 C1874 STENT EPIC 10X40X120 VASCULAR 3,995.94 2,797.16
16007338 278 C1874 STENT EPIC 10X20X120 SELF EXPANDING VASC 3,995.94 2,797.16
16007339 278 C1769 GUIDE WIRE V-14 300CM 716.96 501.87
16007340 278 C1769 GUIDE WIRE V-18 300CM 338.66 237.06
16007348 272 *CATH PIGTAIL 5FR 80.00 56.00
16007349 272 *CATH PIGTAIL 5FR 90CM 66.16 46.31
16007350 278 C1769 GUIDE WIRE TSFNB-38-1 38.74 27.12
16007400 272 COIL TORNADO 3MM 2MM 374.75 262.33
16007401 272 COIL TORNADO 4MM 2MM 374.75 262.33
16007402 272 COIL TORNADO 5MM 2MM 374.75 262.33
16007403 272 COIL TORNADO 6MM 2MM 374.75 262.33
16007406 278 C1874 STENT SMART 8X20 4,944.98 3,461.49
16007410 278 C1874 STENT WALL 10FR 20X60 230 CM 5,439.48 3,807.64
16007411 278 C1874 STENT WALL 10FR 22X60 230 CM 5,439.48 3,807.64
16007412 278 C1874 STENT WALL 10FR 20X60 230 CM 5,439.48 3,807.64
16007413 278 C1874 STENT WALL 10FR 22X60 135 CM 5,439.48 3,807.64
16007420 272 PASSER (PUNCTURE CLOSURE DEVICE 184.99 129.49
16007446 272 GUIDE WIRE AX 21 480 237.00 165.90
16007447 278 C1874 STENT BEV WL 7.5 10X42X75 3,579.70 2,505.79
16007448 278 C1769 GUIDE WIRE ANPLATZ STIFF 195.84 137.09
16007460 278 C1874 STENT WALL B10687110 3,579.70 2,505.79
16007470 278 C1874 STENT WALL B8607110 3,579.70 2,505.79
16007498 272 CATH TNT PER GD15-87 315.25 220.68
16007501 272 CATH POWER FLEX 80 CM 743.71 520.60
16007506 272 CATH BRONCHO 35FR LEFT 223.76 156.63
16007508 272 CATH COOK 159683 164.28 115.00
16007509 272 CATH 5FR-100CM-.035-STRAIGHT 60.55 42.39
16007512 272 SHEATH FLO CHECK 4FR X 12CM 30.71 21.50
16007515 272 CATH STRAIGHT P5.0B-38-65-M-NS-0 CUST4-6 115.63 80.94
16007530 272 CATH STRAIGHT .035 4FR 100 CM 131.80 92.26
16007532 272 CATH TORCON ADV/5FR 78.91 55.24
16007541 272 WIRE KIRCHNER .045 29.18 20.43
16007543 272 WIRE KIRCHNER .9MM LENGTH 9 STYLE 7 21.09 14.76
16007549 272 CATH TRIGUIDE 7FR 347.71 243.40
16007557 272 NEEDLE C-SDIN 15.5 G 3CM 445.62 311.93
16007558 272 NEEDLE INTRA CDIN 14G 3CM 221.69 155.18
16007559 272 NEEDLE C-DIN 16G 3CM 188.25 131.78
16007565 272 CATH PIGTAIL 4FR X 125CM INFINITY 145.95 102.17
16007566 272 CATH STRAIGHT 5.0 93.44 65.41
16007567 272 CATH STRAIGHT 4FR 75.67 52.97
16007568 272 WIRE INFUSION KATZEN 670.83 469.58
16007588 272 CATH STRAIGHT 4FR 125CM 75.67 52.97
16007597 278 C1725 BALLON DILATATION CATH XXL 7F 12MM X 2C 954.19 667.93
16007598 278 C1725 *BALLOON DILATATION CATH XXL 7FR 14MM X 954.19 667.93
16007600 278 C1769 GUIDE WIRE 180CM PLATINUM 411.29 287.90
16007601 278 C1874 STENT 24MMX3.5MM 6,626.60 4,638.62
16007602 278 C1874 STENT PROMUS PREMIER 4.00MM X 12MM 6,992.89 4,895.02
16007603 272 CATH HI-FLOW 4FR 110CM 80.00 56.00
16007604 278 C1725 CATH DILATION 2.5MMX10CMX135CM 1,135.01 794.51
16007605 278 C1725 CATH DILATION 3.0MMX10CMX135CM 1,135.01 794.51
16007607 278 C1725 CATH POLAR 2.5MMX100CMX135CM 2,996.95 2,097.87
16007609 272 CATH BALLOON STERLING 5MMX12CMX80CM 834.28 584.00
16007612 272 C1769 GUIDE WIRE LT 46 602 305.06 213.54
16007613 278 C1769 GUIDE WIRE M 46-254 246.79 172.75
16007614 272 CATH PIGTAIL COOK 5057 65.73 46.01
16007615 272 C1769 TORQUE DEVICE 7017 DNU 69.75 48.83
16007616 278 C1769 GUIDE WIRE CRAGG FX46-214 737.25 516.08
16007617 272 SHUTTLE SL 6FR 90CM 528.06 369.64
16007618 272 SHUTTLE SL 7FR 90CM 528.06 369.64
16007619 272 CATH SLIP 5FR 100CM HI 218.88 153.22
16007620 272 CATH SLIP 5FR 100CM JB1 218.88 153.22
16007621 272 CATH SLIP 5FR 100CM JB2 218.88 153.22
16007622 278 C1874 STENT ICAST 8X59X80 9,407.11 6,584.98
16007623 278 C1874 STENT URETHERAL SOFT 6X26 679.31 475.52
16007624 278 C1874 STENT URETHERAL SOFT 6X24 695.96 487.17
16007625 278 C1874 STENT URETHERAL SOFT 4.87FRX22CM 679.31 475.52
16007626 278 C1874 STENT COLONIC 4CM 31FR 3,740.40 2,618.28
16007627 278 C1874 STENT COLONIC 6CM 31FR 3,901.90 2,731.33
16007628 278 C1874 STENT COLONIC 10CM 31FR 4,696.49 3,287.54
16007629 278 C1874 STENT URETHERAL SOFT 6X22-30 708.62 496.03
16007630 272 C1725 CATH BALLOON STERLING 6MMX40CMX135QCM 1,126.19 788.33
16007631 272 C1725 CATH PTA BALLOON DILATION 4MMX40CMX146CM 994.65 696.26
16007632 278 C1769 GUIDE MPA 1 598 942 399.59 279.71
16007633 278 C1874 STENT PERCUFLEX 8FRX30CM 639.02 447.31
16007635 272 CATH 4FR 100CM .035 IMAGER II SELECTIVE 60.55 42.39
16007636 272 CATH 4FR 65CM .035 IMAGER II SELECTIVE 60.55 42.39
16007637 278 C1874 STENT EXPRESS RENAL 5X15 90CM 4,134.29 2,894.00
16007638 272 GATEWAY ADVANTAGE Y-ADAPTER 165.20 115.64
16007639 272 C1725 COYOTE ES MONORAIL 3X20X114 1,176.80 823.76
16007640 278 C1769 GUIDE WIRE 9316 74.58 52.21
16007641 278 C1769 GUIDE WIRE ANGIOGUARD EMBOLI 5,827.41 4,079.19
16007642 272 C1725 ULTRAVERSE 5X40X130 632.70 442.89
16007643 272 C1725 STERLING OVER THE WIRE BALLOON 1,126.19 788.33
16007644 272 C1725 STERLING OVER THE WIRE BALLOON 6X20X135 1,126.19 788.33
16007645 278 STENT ESOPHAGEAL W/DUA 12CM 9,075.47 6,352.83
16007646 278 C1725 SYMMETRY BALLOON DILATION CATH 2.5MMX100 1,075.59 752.91
16007647 278 C1874 STENT URETHERAL SOFT PERCUFLEX CONTOUR V 708.62 496.03
16007650 278 C1769 GUIDE WIRE 9911 65.64 45.95
16007651 272 CATH STRAIGHT 4FRX65CMX.035 0 SIDE HOLES 108.11 75.68
16007652 272 CATH STRAIGHT 4FRX100CMX.035 0 SIDE HOLE 90.81 63.57
16007653 272 CATH STRAIGHT 4FRX65CM 82.17 57.52
16007654 278 C1769 GUIDE WIRE AMPLATZ EMERALD .035X180CM 188.69 132.08
16007655 278 C1769 GUIDE WIRE STRAIGHT CATH EXCHANGE 59.45 41.62
16007656 278 C1769 GUIDE WIRE AMPLATZ EMERALD 172.20 120.54
16007657 272 CATH STRAIGHT 4FRX65CM 82.17 57.52
16007658 278 C1769 GUIDE MPA1 586 842 366.29 256.40
16007659 278 C1769 GUIDE SON 1 586 880 366.29 256.40
16007660 272 SHEATH 5FR CHECK-FLO 78.66 55.06
16007661 278 C1769 GUIDE WIRE TM 480 A 500.66 350.46
16007662 278 C1769 GUIDE WIRE TM 260 A 283.05 198.14
16007663 272 IMPRESS KA2 CATHETER 4F 65CM 166.79 116.75
16007664 272 9FR 35CM FLEXOR CHECK FLO INTRODUCER SET 568.98 398.29
16007665 272 MULITPORT ADAPTER 151.36 105.95
16007666 272 DNU ADAPTER HEMOSTASIS VALVE 27.50 19.25
16007667 272 NEEDLE W/SELDINGER SHIELD ONE WALL 21.09 14.76
16007669 272 C1769 GUIDE WIRE ROSEN 260 111.36 77.95
16007671 272 C1769 GUIDE WIRE STIFF D.035 L260 STRAIGHT 108.40 75.88
16007672 272 GUIDE WIRE STIFF D.035 L180 STRAIGHT 210.29 147.20
16007673 278 C1769 GUIDE WIRE PLAT PLUS 313.89 219.72
16007674 278 C1769 GUIDE WIRE 46-601 288.05 201.64
16007675 278 C1769 GUIDE WIRE 68029 71.75 50.23
16007677 278 C1769 GUIDE WIRE 55601 62.52 43.76
16007678 278 C1769 GUIDE WIRE PLATINUM PLUS 300CM .014 394.50 276.15
16007679 278 C1769 GUIDE WIRE AMPLATZ STIFF 46 51A 193.52 135.46
16007680 272 CATH PIGTAIL 4FR 100 CM 169.72 118.80
16007681 272 *CATH PIGTAIL 5FR 76.75 53.73
16007683 272 CATH DILATION 6MMX4CMX80CM 614.63 430.24
16007684 272 C1725 CATH BALLOON STERLING 3.0MMX60MM 150CM 791.00 553.70
16007686 272 CATH 156894 (CUSTOM) 65.73 46.01
16007688 272 SHEATH 8FR/25CM 15-64 149.19 104.43
16007691 272 *CATH PIGTAIL 5FR 86.26 60.38
16007692 272 CATH STRAIGHT 4FR .035X80CM 124.32 87.02
16007698 272 CATH TUNNEL 14.5FR RT 28CM 1,211.70 848.19
16007699 272 CATH TUNNEL 14.5FR RT 32CM 1,211.70 848.19
16007700 272 CATH BALLOON DILATORS 30DX90CMX10CMX.03 2,160.03 1,512.02
16007702 272 CATH STRAIGHT 5.0 69.19 48.43
16007703 272 *CATH PERMCATH 19CM, 36CM OVERALL 779.74 545.82
16007705 272 CATH SPY G 4 FR .038-100CM-JR 3.5 43.24 30.27
16007706 272 CATH SPY G 4 FR .038-100CM-JL 3.5 43.24 30.27
16007707 272 CATH PERMCATH 23CM, 40CM OVERALL 800.07 560.05
16007708 272 CATH SPY G 4 FR .038-100CM-JR 5 66.95 46.87
16007709 272 SET MICROPUNCTURE 4.0 99.84 69.89
16007710 272 CATH PERMCATH 40CM 598.09 418.66
16007711 272 CATH SPY G 4 FR .038-100CM-JL 5 108.11 75.68
16007716 272 CATH ULTRA THIN DIAM 4X80CM 744.58 521.21
16007717 272 CATH 5FR SIM-1 SIDEWINDER 64.64 45.25
16007719 272 CATH OCCLUSION BALLOON 2,078.50 1,454.95
16007720 272 CATH SIMMONS II 65.73 46.01
16007721 272 CATH DRAINAGE FLEXIMA APD/10/20 329.97 230.98
16007722 272 CATH DRAINAGE FLEXIMA APD/12/25 329.97 230.98
16007723 272 C1729 CATH DRAINAGE 18 FR LOOP TYPE W/O STYLET 385.95 270.17
16007724 272 CATH DRAINAGE 16 FR LOOP W/O STYLET 290.25 203.18
16007726 272 CATH POLY RADPICC LINE 166.97 116.88
16007727 272 CATH DRAINAGE FLEXIMA 14FR 329.97 230.98
16007728 272 CATH POWERPICC 345.31 241.72
16007731 272 CATH SUPRAPUBIC INTRODUCER 82.17 57.52
16007734 272 MICROPUNCTURE WIRE 80.36 56.25
16007738 278 C1725 CATH BALLOON DIAMOND ULTRA 7X4X75 582.74 407.92
16007743 272 GUIDEWIRE SHEATH FLO CHECK 4FR X 11CM 21.00 14.70
16007744 272 CATH PIGTAIL 5FR 100CM 60.55 42.39
16007748 272 CATH C2 4FR 73.51 51.46
16007751 272 CATH COBRA II 65CM 4FR 80.00 56.00
16007752 272 CATH COBRA 2 AT 100 4FR 69.03 48.32
16007759 278 C1725 CATH BALLOON 5FRX110CM FLOW ASSISTED 717.58 502.31
16007763 272 CATH SOFT-VU 4FR 80CM 128.54 89.98
16007764 272 *CATH 5FR SOFT-VU 148.76 104.13
16007765 272 C1729 *CATH BILIARY DRAINAGE 8.5FR 469.52 328.66
16007767 272 CATH RUTNER 8F CONE TIPPED 68.84 48.19
16007768 272 CATH OPEN ENDED URETE 59.88 41.92
16007769 272 C1725 CATH BALLOON 5MMX4CMX8CM 1,126.19 788.33
16007770 272 CATH THRUWAY 190CMX0.14 452.31 316.62
16007771 272 CATH ULTRA THIN DIAMOND 7MMX2CMX75CM 614.63 430.24
16007772 272 C1725 CATH BALLOON MUSTANG 7X40X75CM 599.39 419.57
16007775 272 ADAPTER INTUBATED FOR CAPONE CO2 SENSOR 41.86 29.30
16007776 272 ADAPTER NON INTUBATED W/O2 SEATING CAPON 39.05 27.34
16007777 272 CATH THRUWAY 300CMX0.14 470.39 329.27
16007780 272 SET MICROPUNCTURE MPIS 98.20 68.74
16007781 278 C2625 FANELLI BILIARY STENT SET 2,097.87 1,468.51
16007782 272 DILATOR NOTTINGHAM 754.07 527.85
16007784 272 DILATOR VESSEL 27.11 18.98
16007786 272 DIALATOR VESSEL 26146 22.62 15.83
16007788 272 DILATOR 48-153 21.09 14.76
16007789 272 SET DIALATOR 50-314 333.66 233.56
16007790 272 C1726 CATH ACHALASIA BALLOON DILATOR 30MM 2,047.92 1,433.54
16007791 272 C1726 CATH ACHALASIA BALLOON DILATOR 35MM 2,099.12 1,469.38
16007792 272 WIRE INFUSION 46-192 705.95 494.17
16007793 272 CATH ACHALASIA BALLOON DILATOR 40MM 2,159.99 1,511.99
16007794 272 WIRE INFUSION KATZEN 705.95 494.17
16007795 272 C1726 BALLOON ESOPHAGEAL FIXED WIRE 5865 692.19 484.53
16007796 272 *CATH POLY RADPICC DUAL LINE 225.24 157.67
16007798 272 DILATOR VESSEL COOK 55.62 38.93
16007799 272 DILATOR JCD 8.0-38-20 37.74 26.42
16007800 272 DILATOR JCD 8.0-38-20 65.35 45.75
16007801 272 COON 14 FR DILATOR 65.35 45.75
16007803 272 SHEATH W/UNI-VALVE 10 78.91 55.24
16007805 272 C1725 CATH BALLOON MUSTANG 8X40X75 532.80 372.96
16007807 272 SHEATH 9FR X 10CM PINNACLE 151.36 105.95
16007808 272 SUTURE SILK 4-0 18 TIES ETH A183H 21.09 14.76
16007809 272 C1725 *CATH BALLOON MUSTANG 8X40X135 599.39 419.57
16007810 272 SYRINGE INJECTION MEDRAD 38.91 27.24
16007811 272 WAND TURBINATE REFLEX-45 614.63 430.24
16007812 272 WAND EVAC-XTRA TONSIL/ADENOID 614.63 430.24
16007813 272 SHEATH 9FR X 11CM INTERVENTIONAL 151.36 105.95
16007814 272 WIRE SUPER STIFF .035X75CM 139.46 97.62
16007815 272 SYRINGE INJECTION 200 21.09 14.76
16007816 272 5 FR DILATOR (CUSTOM) 34.15 23.91
16007817 272 COON 7 FR DILATOR (CUSTOM) 75.85 53.10
16007818 272 COON 6 FR DILATOR 20CM .038 65.35 45.75
16007822 272 C1725 CATH BALLOON MUSTANG 8X30X75 599.39 419.57
16007823 272 COON 10 FR DILATOR 65.35 45.75
16007824 272 CATH BALLOON CODA 10FR 100CM 860.50 602.35
16007825 278 C1725 CATH BALLOON CODA 9FR 120CM 1,475.17 1,032.62
16007826 272 COON 12 FR DILATOR 65.34 45.74
16007829 272 CATH SUPER TORQUE 5FR/J 80.00 56.00
16007830 272 TORQUE VISE 27.80 19.46
16007831 278 C1874 STENT INTRO SYSTEM 10-7 410.22 287.15
16007832 272 C1769 GUIDE WIRE - STRAIGHT TIP 0.35 150CM 160.51 112.36
16007833 278 C1769 GLIDE WIRE 46 154 195.61 136.93
16007834 278 C1769 GLIDE WIRE 46-152 174.14 121.90
16007835 278 C1874 STENT INTRO SYSTEM 10-5 586.07 410.25
16007837 272 CATH GLO TIP ERCP 196.75 137.73
16007840 272 SHEATH INTRODUCER 7 F 84.33 59.03
16007841 272 CATH MICRO 3FR 150CM L HI-FLOW 1,317.07 921.95
16007842 272 SHEATH INTRODUCER 15-712-1 84.33 59.03
16007843 272 INTRODUCER SHEATH 15-731 149.19 104.43
16007844 272 SHEATH PINNACLE 15-73 149.19 104.43
16007845 272 INTRODUCER COUDE TIP 15X70CM 34.04 23.83
16007846 278 C1887 CATH MICRO INFUSION 2.9DX150LX5 649.34 454.54
16007847 278 C1887 CATH MICRO INFUSION 2.9DX150LX10 649.34 454.54
16007848 272 PAINPUMP BLOCK AID REUSABLE 1,192.73 834.91
16007849 272 PAINPUMP 2 400ML 736.32 515.42
16007850 278 DNU STENT URETERAL 6FR X 22-30CM 340.00 238.00
16007853 272 SHEATH SUPER 15-735B 153.68 107.58
16007855 272 PERITONEAL DIALYSIS CATH UNIVERSAL TENCK 187.79 131.45
16007856 272 GUIDEWIRE THRUWAY 300CM 49-297 470.39 329.27
16007857 272 CHRONIC CATHETER ACCESSORY 16FR 166.92 116.84
16007858 272 CATH PERITONEAL DIALYSIS TENCKHOFF 47CM 192.33 134.63
16007859 272 WIRE GUIDE EXTRA STIFF LUNDERQUIST 358.24 250.77
16007860 272 TWISTER PLUS 22LD ROTATABLE RETRIEVAL DE 245.86 172.10
16007861 278 C1769 CATH TNT GUIDEWIRE TR 337.91 236.54
16007862 272 TWISTER PLUS 26LD ROTATABLE RETREVAL DEV 245.86 172.10
16007863 272 RETRIEVER SUTURE BLUE LASSO 170.81 119.57
16007865 272 RETRIEVER SUTURE 10.1 947.16 663.01
16007867 272 RETRIEVER ROTH NET FOOD BOLUS PLATINUM 368.77 258.14
16007871 272 *CATH SYMMETRY 1,134.43 794.10
16007874 272 CATH STRAIGHT 5 FR .038X70CM 104.87 73.41
16007875 272 CATH STRAIGHT 5 FR .038X100CM 104.87 73.41
16007876 272 CATH WIRE 5 FR .035X260CM 259.25 181.48
16007877 272 KIT BLOOD CONSERVATION 1/4 WOUND DRAIN 434.63 304.24
16007878 278 C1725 CATH BALLOON DIL 10X40 MUSTANG 599.39 419.57
16007879 272 HYDROPHILIC WIRE GUIDE HIWIRE 302.05 211.44
16007880 278 C1725 CATH BALLOON DILATION STERLING 4x20x135 1,126.19 788.33
16007881 278 C1725 CATH BALLOON 5X2X80 STERLING 1,126.19 788.33
16007882 278 C1725 CATH MUSTANG 9X40X135 6FR 616.78 431.75
16007883 278 C1725 CATH BALLOON 4X40X145 COYOTE 1,126.19 788.33
16007884 278 C1769 GUIDE WIRE ROADRUNNER .035 260CM 339.65 237.76
16007885 278 C1725 CATH BALLOON 3X40X145 COYOTE 1,126.19 788.33
16007886 278 C1769 GUIDE WIRE 197303 30.75 21.53
16007887 272 4FR WOVEN FILIFORM SPIRAL TIP 251.68 176.18
16007888 272 PERI-STRIPS DRY 708.40 495.88
16007889 272 5F WOVEN FILIFORMS SPIRAL TIP 251.68 176.18
16007890 272 6F WOVEN FILIFORMS SPIRAL TIP 251.68 176.18
16007891 272 8FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007892 272 10FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007893 272 12FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007894 272 14FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007895 272 VASC RET FORC 191687 1,056.11 739.28
16007896 272 16FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007897 272 18FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007898 272 20FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007900 272 CATH PIGTAIL 7FR 65.73 46.01
16007901 272 22FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007902 272 COIL EMBOLIZATION 188.75 132.13
16007903 272 COIL EMBOLIZATION 188.75 132.13
16007904 272 COIL EMBOLIZATION MWC 188.75 132.13
16007905 272 COIL EMBOLIZATION 194.59 136.21
16007906 272 COIL EMBOLIZATION 959 194.59 136.21
16007907 272 COIL EMBOLIZATION 390 188.75 132.13
16007908 272 COIL EMBOLIZATION 5 X 188.75 132.13
16007909 272 COIL EMBOLIZATION 5 X 188.75 132.13
16007910 272 HUMIDIFIER PRE-FILLED 20.00 14.00
16007911 272 COIL EMBOLIZATION MWC 231.80 162.26
16007912 272 SHEATH 14 FR X 30 CM 175.67 122.97
16007913 272 SHEATH 10 FR 90 CM DA 316.10 221.27
16007914 272 SHEATH 12FR X 75CM 40 351.22 245.85
16007915 272 24FR WOVEN PHILLIPS FOLLOWER 377.69 264.38
16007917 272 SHEATH 7FR LONG 501-6 185.34 129.74
16007918 272 SET COPE LOOP NEPRROSTOMY 598.90 419.23
16007919 271 HIGH FLOW MULTI 8FR 5 82.17 57.52
16007921 272 WIRE SENSOR DUAL FLEX PTFE 268.26 187.78
16007922 272 PACK TUR LINGERMAN 236.93 165.85
16007925 278 C1725 CATH BALLOON COYOTE ES 3X40X146 1,176.82 823.77
16007927 272 COIL EMBOLIZATION 38- 231.80 162.26
16007928 272 DNU SHEATH INTRO 10FR 501 87.00 60.90
16007931 272 CATH SUCTION IN LINE ENDOTRACHEAL KIT 64.50 45.15
16007932 272 COIL EMBOLIZATION MReye 35-2-3 313.19 219.23
16007933 272 COIL EMBOLIZATION MReye 35-3-3 333.66 233.56
16007934 272 COIL EMBOLIZATION MReye 35-3-4 313.19 219.23
16007935 272 COIL EMBOLIZATION MReye 35-3-5 428.50 299.95
16007936 278 C1874 STENT WALL 22X35 3,844.76 2,691.33
16007937 278 C1874 STENT WALL 20X40 3,844.76 2,691.33
16007938 272 CATH SUCTION IN LINE ENDOTRACH REPLACEM 24.86 17.40
16007939 272 SHEATH 11FR 10CM 84.33 59.03
16007940 272 CATH SUCTION ENDOTRACH 14 FR 35.60 24.92
16007942 272 CATH SYMMETRY 4X2 135 1,197.13 837.99
16007943 272 SHEATH 5FR ULTIMUM HEMOSTASIS INTRODUCER 36.11 25.28
16007944 272 CATH SYMMETRY 3X4X135 1,197.13 837.99
16007946 272 *CATH SYMMETRY 2 X 2 X 1,366.23 956.36
16007947 272 CATH SYMMETRY 3X2X135 1,197.13 837.99
16007948 272 CATH SYMMETRY BALLOON 3X100 685.50 479.85
16007949 272 CATH SYMMETRY 5X 1,134.43 794.10
16007955 278 C1769 GUIDE WIRE .035 X 180 234.39 164.07
16007956 278 C1769 GUIDE WIRE .035 X 260 STRAIGHT TIP 189.88 132.92
16007959 272 CATH POWER FLEX 8 X 3 743.71 520.60
16007965 272 SENSOR OXYGEN ADULT NELLCOR OXIMAX 61.00 42.70
16007969 272 SHEATH UTLTIMUM 5 FR X 23 CM 77.83 54.48
16007982 278 C1874 STENT WALL 6X45X75 3,759.51 2,631.66
16007983 272 CATH SYMMETRY 2X4X135 1,197.13 837.99
16007985 272 C1769 GUIDE WIRE RLPC ROAD RUNNER 279.89 195.92
16007988 272 CATH SPY G 4 FR .038-100CM-3DRC 34.24 23.97
16007989 272 CATH SPY GLASS 4 FR .038-100CM-JL4 34.24 23.97
16007990 278 C1874 STENT PALMZ BAL EXP 2,730.56 1,911.39
16007992 272 *CATH PLTFRM 6FR 4MA1 351.22 245.85
16007994 272 DNU CATH SYMMETRY 6X4X90 712.75 498.93
16007995 272 *CATH PLTFM 6FR 4MC 351.22 245.85
16007996 278 C1874 STENT PRLOAD P3008M 3,379.90 2,365.93
16007997 278 C1874 STENT PALMAZ 8MM2908 3,379.90 2,365.93
16007999 278 C1874 STENT PALMZ EXP BALL 2,730.56 1,911.39
16008000 278 Q4196 PURAPLY AM 2X2 COMMERCIAL 4SQ CM 2,634.18 1,843.93
16008005 272 BREAST IMPLANT SIZER CONTOUR PROFILE SAL 175.67 122.97
16008006 278 CONTOUR PROFILE SALINE MAMMARY SIZERS 194.59 136.21
16008007 278 CONTOUR PROFILE SALINE MAMMARY IMPLANT 2,897.55 2,028.29
16008011 278 CONTOUR PROFILE SALINE MAMMARY IMPLANT 2,107.31 1,475.12
16008012 278 CONTOUR PROFILE SALINE MAMMARY IMPLANT 4,214.62 2,950.23
16008015 272 SHEATH STRAIGHT 6FR X 45CM 491.01 343.71
16008016 272 SHEATH ANGLED 6FR X 45CM 483.98 338.79
16008017 272 SHEATH STRAIGHT 7FR X 45CM 483.98 338.79
16008018 272 SHEATH ANGLED 7FR X 45CM 483.98 338.79
16008020 272 SHEATH ACCESS 13/15x36CM 710.71 497.50
16008021 272 SHEATH ACCESS 11/13X36CM 710.71 497.50
16008022 272 SINGLE ACTION PUMP 1-WAY CHECK VALVE 268.37 187.86
16008036 271 SENSOR FLOW 21.00 14.70
16008044 272 C1725 CATH BALLOON MUSTANG 9X40X75 599.39 419.57
16008047 272 C1725 CATH BALLOON COYOTE 2X20X142 1,126.19 788.33
16008049 272 C1725 *CATH BALLOON COYOTE 3X20X143 1,126.19 788.33
16008055 272 TROCAR 10/12MM ETHICON 261.17 182.82
16008062 370 CIRCUIT ANESTHESIA PED 2 LITER BAG 25.68 17.98
16008063 370 CIRCUIT ANESTHESIA 28.59 20.01
16008065 270 CIRCUIT JACKSON-REES MODIFIED PED 76.97 53.88
16008068 272 STOPCOCK 3-WAY 21.09 14.76
16008070 270 CIRCUIT JACKSON-REES 2 LITER 49.73 34.81
16008071 272 DNU MANIFOLD HI-FLO STOPCOCK 21.09 14.76
16008073 272 SET ULTRA EXTENSION 36 21.09 14.76
16008076 272 *MANIFOLD TWO PORT 21.09 14.76
16008077 272 MANIFOLD THREE PORT 21.09 14.76
16008078 272 STOPCOCK FOUR GANG 21.85 15.30
16008079 271 CIRCUIT VENT W/MR290 SINGLE LIMB HEATED 109.43 76.60
16008080 270 A4615 OPTIFLOW NASAL CANNULA SMALL 100.68 70.48
16008081 270 A4615 OPTIFLOW NASAL CANNULA MEDIUM 95.82 67.07
16008082 272 GRASPER REPOSABLE 38CM 233.10 163.17
16008083 270 A4615 OPTIFLOW PLUS CANNULA LARGE 95.82 67.07
16008084 272 DISPOSABLE 5MM BABCOCK 755.88 529.12
16008085 272 GRASPER 10MM BABCOCK 176.38 123.47
16008086 272 DNU GRASPER BABCOCK SINGLE ACTION 1,336.25 935.38
16008087 272 DNU GRASPER BABCOCK DOUBLE ACTION 1,336.25 935.38
16008097 272 DNU DUET TRS 45-4.8 1,224.00 856.80
16008098 272 DNU DUET TRS 60-4.8 1,048.75 734.13
16008099 272 CATH SPYGLASS JR 3.5 47.57 33.30
16008100 272 *NEEDLE DISPOSABLE PROBLOC INSULATED 67.19 47.03
16008105 272 *NEEDLE HAKKA BLOCK BEVEL 152MM25G 30.05 21.04
16008107 272 NEEDLE ATRAUMATIC SPROTTE SPINAL 22G31/2 43.02 30.11
16008108 272 NEEDLE ATRAUMATIC SPROTTE SPINAL 22G 6 51.03 35.72
16008109 272 NEEDLE ATRAUMATIC SPROTTE SPINAL 25G31/2 43.02 30.11
16008110 272 *NEEDLE HAKKO TUOHY 6 17G 46.91 32.84
16008111 272 NEEDLE HAKKO TUOHY 3 1/2 17G 71.13 49.79
16008112 272 *NEEDLE HAKKO TUOHY 6 22G 32.43 22.70
16008113 272 *NEEDLE HAKKO TUOHY 6 25G 31.34 21.94
16008114 272 NEEDLE HAKKO TWIN-BUEL SPINAL 20G 3 1/2 21.09 14.76
16008115 272 *NEEDLE HAKKO TWIN-BUEL SPINAL 25G 3 1/2 21.09 14.76
16008116 272 *NEEDLE HAKKO ECHOGENIC 7 22G 34.37 24.06
16008117 272 *NEEDLE HAKKO ECHOGENIC 6 25G 34.37 24.06
16008118 272 *NEEDLE HAKKO ECHOGENIC 4 25G 30.05 21.04
16008119 272 NEEDLE REG SPROTTE + MAGNI HUB 25G 3 1/2 43.02 30.11
16008121 272 NEEDLE REG SPROTE + MAGNI HUB 25G 5 43.02 30.11
16008122 272 SET TIP DEFLECT EBDOBRONCHIA BLOCKER 623.76 436.63
16008123 272 SET BLOCKER 5.0 623.76 436.63
16008124 272 SET BLOCKER 7.0 623.76 436.63
16008125 272 SET BLOCKER 9.0 78CM 623.76 436.63
16008126 272 SET BLOCKER ELCIP 9.0 571.51 400.06
16008130 272 *NEEDLE ECHOBLOCK MSK 22G X 2 (50MM) 36.11 25.28
16008131 272 *NEEDLE ECHOBLOCK MSK 22G X 3 1/8 80MM 36.11 25.28
16008132 272 NEEDLE ECHOBLOCK NON-INS 21G X 2 (50MM) 36.11 25.28
16008133 272 *NEEDLE MLE PTC LUER 22G X 2 3/8 28.11 19.68
16008134 272 *NEEDLE MLE PTC LUER 22G X 3 1/2 30.05 21.04
16008135 272 NEEDLE TUOHY MLE 17G X 3 1/2 43.02 30.11
16008136 272 *NEEDLE TUOHY MLE 18G X 3 1/2 43.02 30.11
16008400 278 C1874 STENT MEMOTHERM 8 X 40 3,369.91 2,358.94
16008401 278 C1874 STENT ACCULINK 6-80X30 190CM 7,492.39 5,244.67
16008402 278 FILTER ACCUNET 190CM 5,443.88 3,810.72
16008403 278 C1725 CATH BALLOON 95-15 748.57 524.00
16008404 272 CATH BALLOON 89-15 690.00 483.00
16008405 272 CATH KUMAR CHOLANGIOGRAPHY 145.95 102.17
16008406 272 CATH CHOLANGIOGRAM 5FR 189.67 132.77
16008408 278 C1874 STENT SMART 8X40 4,978.28 3,484.80
16008410 272 *CATH T-TUBE 12FR 29.41 20.59
16008412 272 CATH T-TUBE 16FR 28.63 20.04
16008430 278 C1874 DNU STENT SMART 10X40 5,477.77 3,834.44
16008456 272 DRAIN HEMOVAC 400 ML 36.73 25.71
16008457 272 PVC ROUND DRAIN 30.67 21.47
16008458 272 PERFORATED 400CC PVC WOUND DRAIN 34.28 24.00
16008502 278 C1725 CATH POLAR 3X100X135X0.014 2,996.95 2,097.87
16008503 278 C1725 CATH POLAR 4X40X135X0.014 2,663.96 1,864.77
16008504 278 C1725 CATH POLAR 6X40X135X0.014 2,663.96 1,864.77
16008505 278 C1725 CATH POLAR 2.5X40X135X0.014 2,663.96 1,864.77
16008506 278 C1725 CATH POLAR 2,663.96 1,864.77
16008518 278 C1876 STENT SMART 7X80X40 4,706.89 3,294.82
16008519 278 C1876 CATH GUID BRI TIP MP-A-1 100CM 6FR .070 372.95 261.07
16008520 278 C1876 STENT SMART 6X2X80 4,445.48 3,111.84
16008521 278 C1876 STENT SMART 6X2X135 4,445.48 3,111.84
16008522 278 C1876 STENT SMART 7X2X80 4,445.48 3,111.84
16008523 278 C1876 STENT SMART 7X2X135 4,944.98 3,461.49
16008524 278 C1876 STENT SMART 8X2X80 4,445.48 3,111.84
16008525 278 C1876 STENT SMART 8X2X135 4,944.98 3,461.49
16008526 278 C1876 STENT SMART 6X4X80 4,928.33 3,449.83
16008527 278 C1876 STENT SMART 6X4X135 4,928.33 3,449.83
16008528 278 C1876 STENT SMART 7X4X80 4,928.33 3,449.83
16008529 278 C1876 STENT SMART 7X4X135 4,928.33 3,449.83
16008530 278 C1876 STENT SMART 8X4X80 4,928.33 3,449.83
16008531 278 C1876 STENT SMART 8X4X135 5,477.77 3,834.44
16008532 278 C1876 STENT SMART 6X6X80 4,928.33 3,449.83
16008533 278 C1876 DNU STENT SMART 6X6X135 6,326.90 4,428.83
16008534 278 C1876 STENT SMART 7X6X80 4,928.33 3,449.83
16008535 278 C1876 STENT SMART 7X60MM 6FR 5,477.77 3,834.44
16008536 278 C1876 STENT SMART 8X6X80 4,928.33 3,449.83
16008537 278 C1876 STENT SMART 8X6X135 4,928.33 3,449.83
16008600 278 99070 IMPLANT GEL-FILLED BREAST 1,737.75 1,216.43
16008601 278 99070 IMPLANT GEL-FILLED BREAST 1,737.75 1,216.43
16008602 278 99070 IMPLANT GEL-FILLED BREAST 1,737.75 1,216.43
16008610 272 SIZIER SALINE 194.59 136.21
16008814 272 SUTURE PROLENE 0 CT-1 ETH C821G 78.28 54.80
16008816 274 BRACE KNEE SMALL 159.75 111.83
16008817 274 BRACE KNEE MEDIUM 159.75 111.83
16008818 274 BRACE KNEE LARGE 159.75 111.83
16008819 270 BRACE KNEEX-LARGE 159.75 111.83
16008823 274 STRAPS PATELLA TENDON SMALL 46.50 32.55
16008824 274 STRAPS PATELLA TENDON MEDIUM 46.50 32.55
16008825 274 STRAPS PATELLA TENDON LARGE 46.50 32.55
16008826 274 KNEE SUPPORT X-SMALL 49.75 34.83
16008827 274 KNEE SUPPORT SMALL 49.75 34.83
16008828 274 KNEE SUPPORT MEDIUM 49.75 34.83
16008829 271 SLEEVE THIGH SMALL 63.50 44.45
16008830 271 SLEEVE THIGH MEDIUM 63.50 44.45
16008831 274 NEOPRENE ELBOW 44.50 31.15
16008891 271 MASK LMA UNIQUE SZ 3 41.24 28.87
16008892 271 MASK LMA UNIQUE SZ 4 30.41 21.29
16008893 271 MASK LMA UNIQUE SZ 5 30.41 21.29
16008920 272 SYRINGE INFLATION ENCORE 26 94.30 66.01
16008921 278 C1874 STENT POLYFLEX 21X90 6,992.89 4,895.02
16008922 272 WIRE HYDRA JAG .035X260CM STRAIGHT TIP 735.81 515.07
16008923 272 C1769 JAGWIRE .038IN X 260CM 512.81 358.97
16008924 272 C1769 JAGWIRE .035IN X 450CM 728.33 509.83
16008925 272 C1769 JAGWIRE .035IN X 450CM 1,106.13 774.29
16008991 272 DRAIN SET-END NSL BILY 593.56 415.49
16008993 272 CATH GLO-TIP ANGLED ERCP 280.98 196.69
16009000 271 SET NITROGLYCERIN 107 22.79 15.95
16009001 271 SET BLOOD PUMP SMARTSITE 29.67 20.77
16009002 271 TUBING PCA MINI BORE ALARIS 21.09 14.76
16009003 271 SET BLOOD Y-TYPE GRAVITY SMARTSITE 21.00 14.70
16009004 271 SET PRIMARY GRAVITY WITH 2 PORTS 21.09 14.76
16009005 271 SET INFUSION EPIDURAL MICROBORE 21.00 14.70
16009006 271 SET INFUSION 4 PORT SMARTSITE 21.79 15.25
16009007 271 SET INFUSION SHORT 2 PIECE 21.00 14.70
16009009 272 CLOSURE FAST PREM PCK MIS 7F07 4,109.25 2,876.48
16009010 272 INFILTRATION TUBING SET 64.87 45.41
16009011 272 MICRO INTRODUCER 131.90 92.33
16009012 272 BURR FLUTED 3MM MATCHSTICK 927.22 649.05
16009013 272 BURR 6.4MM CYLINDRICAL CARBIDE 878.05 614.64
16009014 272 BURR 3.2MM FLUTED CARBIDE SIDE CUTTER 835.90 585.13
16009015 272 SPINE DRILL TIP 632.70 442.89
16009040 272 CLIP FIXING DEVICE DISPOSABLE 298.54 208.98
16009050 272 SUTURE CAPTURING DEVICE CAPIO CL 2,214.00 1,549.80
16009080 272 CATH 7FR ULTRA THINK DIAMOND 614.63 430.24
16009100 278 C2625 STENT TRANSHEPATIC BILIARY 5X15 4,581.18 3,206.83
16009101 272 DISP TOURNIQUET CUFF 18X3 78.97 55.28
16009102 272 DISP TOURNIQUET 24X4 87.74 61.42
16009103 272 DISP TOURNIQUET CUFF 34X4 101.07 70.75
16009104 272 *ABSORBABLE FIXATION SYSTEM 2,423.41 1,696.39
16009105 278 C2625 STENT TRANSHEPATIC BILIARY 5X12 4,811.78 3,368.25
16009106 272 CLARIVEIN IC 65CM 2,282.95 1,598.07
16009107 270 CAPNOLINE SMART H PLUS ADULT W/02 73.47 51.43
16009108 272 SORBAFIX FIXATION DEVICE LAPAROSCOPIC 2,721.94 1,905.36
16009109 272 CLARIVEIN IC 85CM 2,282.95 1,598.07
16009110 278 C2625 STENT TRANSHEPATIC BILIARY 7X29 4,478.78 3,135.15
16009115 278 C2625 STENT TRANSHEPATIC BILIARY 8X29 4,254.85 2,978.40
16009120 278 C2625 STENT TRANSHEPATIC BILIARY 7X39 4,413.01 3,089.11
16009125 278 C2625 STENT TRANSHEPATIC BILIARY 8X39 4,413.01 3,089.11
16009130 278 C1887 CATH GUIDE 55CM 6F 184.15 128.91
16009136 272 CATH BERENSTEIN 4 FR X 125 CM 122.60 85.82
16009137 272 CATH CROSS OVER TEMPO 5F 65 CM 0 SIDE 95.13 66.59
16009138 272 CATH BERENSTEIN 4 FR X 150 CM 209.79 146.85
16009139 272 CATH INFUSION 4FR 135X5 CM 956.01 669.21
16009141 272 CATH BERENSTEIN 4 FR X 65 CM 54.85 38.40
16009142 272 CATH INFUSION 4FR 135X10 CM 956.01 669.21
16009145 278 C2625 STENT TRANSHEPATIC BILIARY 6X12 4,581.18 3,206.83
16009150 278 C2625 STENT TRANSHEPATIC BILIARY 6X15 4,581.18 3,206.83
16009155 278 C2625 STENT TRANSHEPATIC BILIARY 5X18 4,811.78 3,368.25
16009160 278 C2625 STENT TRANSHEPATIC BILIARY 6X18 4,581.18 3,206.83
16009165 278 C2625 STENT TRANSHEPATIC BILIARY 6X23 4,634.46 3,244.12
16009170 278 C2625 STENT BLUE 5MMX18MMX80CM 4,438.82 3,107.17
16009175 278 C2625 STENT BLUE 5MMX24MMX80CM 4,634.62 3,244.23
16009180 278 C2625 STENT RENAL BILIARY 5X15X90 4,134.30 2,894.01
16009185 278 C2625 STENT RENAL BILIARY 5X19X90 4,134.30 2,894.01
16009190 278 C2625 STENT RENAL BILIARY 6X14X90 4,134.30 2,894.01
16009195 278 C2625 STENT RENAL BILIARY 6X18X90 2,497.50 1,748.25
16009200 278 C2625 STENT RENAL BILIARY 4X19X90 4,134.30 2,894.01
16009220 272 TUBE MINNESOTA 18FR 2,247.09 1,572.96
16009221 278 L8699 REFLUX MANAGEMENT SYSTEM SIZE 13 18,314.72 12,820.30
16009222 278 L8699 REFLUX MANAGEMENT SYSTEM SIZE 14 18,314.72 12,820.30
16009223 278 L8699 REFLUX MANAGEMENT SYSTEM SIZE 15 18,314.72 12,820.30
16009224 278 L8699 REFLUX MANAGEMENT SYSTEM SIZE 16 18,314.72 12,820.30
16009225 278 L8699 REFLUX MANAGEMENT SYSTEM SIZE 17 18,772.59 13,140.81
16009226 272 REFLUX SIZING TOOL 499.50 349.65
16009300 278 C2625 STENT TRUNK IPSILATERIAL LEG 24,301.98 17,011.39
16009305 278 C1874 STENT CONTRALATERAL LEG 12MM X 14CM 11,218.60 7,853.02
16009310 272 SHEATH INTRODUCER 18FR X 30CM 421.46 295.02
16009311 272 SHEATH INTRODUCER 12FR X 30CM 263.41 184.39
16009585 278 C1768 GRAFT AORTIC HEMASHIE 16X30 2,034.94 1,424.46
16009586 278 C1768 GRAFT WALL ENDOPROSTHEIS 6,493.40 4,545.38
16009587 278 C1768 GRAFT WALL ENDOPROSTHEIS 8MM X 30MM 6,655.73 4,659.01
16009588 278 C1768 GRAFT WALL ENDOPROSTHEIS 8MM X 70MM 7,492.39 5,244.67
16009590 278 C1768 GRAFT AORTIC HEMASHIE 18X30 1,864.77 1,305.34
16009591 278 C1768 GRAFT SURGISIS BIODESIGN 9X14 2,659.86 1,861.90
16009595 278 C1768 GRAFT HEMASHIELD 20X3 1,481.83 1,037.28
16009600 278 C1768 GRAFT BIFURCATED 14 X 7 2,167.80 1,517.46
16009610 278 C1768 GRAFT BIFURCATED 18 3,287.39 2,301.17
16009735 272 A4344 CATH SILICONE 16FR 5CC LF 21.09 14.76
16009737 271 KIT MENISECTOMY BASIC 175.67 122.97
16009999 278 C1887 CATH BRITE TIP 6FR-.070-55CM-MPA-1 184.15 128.91
16100000 272 SUTURE ANCHOR 4.5 GROSS FT. 807.81 565.47
16100001 278 C1713 TROCHANTERIC NAIL KIT 180 TI GAMMA 3 3,696.24 2,587.37
16100002 278 C1713 LAG SCREW TI GAMMA 3 1,398.58 979.01
16100003 278 C1713 LOCKING SCREW FULLY THREADED 580.24 406.17
16100004 278 C1769 K-WIRE 333.00 233.10
16100005 278 C1769 GUIDE WIRE BALL TIPPED STERILE 582.74 407.92
16100006 278 C1769 GUIDE WIRE PARTIALLY THREADED 86.10 60.27
16100007 278 C1725 ULTRAVERSE 035 7.0MM X 150MM 316.35 221.45
16100008 278 C1725 ULTRAVERSE 035 4.0MMX80MM 316.35 221.45
16100009 278 C1768 GRAFT 10/10 BTB 11,987.82 8,391.47
16100010 278 C1713 PLATE LCP VOLAR DISTAL RADIUS 4H RIGHT 2,467.49 1,727.24
16100011 278 C1713 SCREW 2.4 LOCKING SLF-TPNG 14MM RECESS 346.31 242.42
16100012 278 C1713 SCREW 2.4 LOCKING SLF-TPNG 22MM RECESS 346.31 242.42
16100013 278 C1713 SCREW 2.4 LOCKING SLF-TPNG 24MM RECESS 346.31 242.42
16100014 278 C1713 SCREW 2.4 CORTEX SLF-TPNG 14MM RECESS 198.85 139.20
16100015 278 C1713 SCREW LAG 2.4MM X 16MM X 2 499.49 349.64
16100016 278 C1725 ULTRAVERSE 035 4.0MMX60MM 316.35 221.45
16100017 278 C1725 LUTONIX 035 DCB 5F 4,162.44 2,913.71
16100018 278 C1713 SCREW 3.5 X 10MM LOCKING CORTICAL SC 283.05 198.14
16100019 278 C1713 SCREW 3.5 X 8MM LOCKING CORTICAL SC 283.05 198.14
16100020 278 C1713 SCREW 2.3X20MM THREADED LOCKING 290.13 203.09
16100021 278 C1713 SCREW 3.5X12.0 MM CORTICAL SCREW 112.50 78.75
16100022 278 C1713 SCREW 3.5 X 12MM LOCKING CORTICAL SC 283.05 198.14
16100023 278 C1713 SCREW 2.3X24MM THREADED LOCKING 283.05 198.14
16100024 278 C1713 SCREW 2.3X22MM THREADED LOCKING 283.05 198.14
16100025 278 C1713 SCREW 3.5 X 16MM CORTICAL 112.50 78.75
16100026 278 C1713 SCREW 3.5 X 18MM CORTICAL 249.75 174.83
16100027 278 C1713 SCREW 3.5 X 14MM CORTICAL 112.50 78.75
16100028 278 C1713 SCREW SUPER REVO SUTURE ANCHOR KIT 716.77 501.74
16100029 278 C1725 ULTRAVERSE 03550 MM X 60MMX130CM 316.35 221.45
16100030 278 C1713 SCREW 2.7 CORTEX 16MM 140.42 98.29
16100031 278 C1713 SCREW 2.4 CORTEX 20MM 366.29 256.40
16100032 278 C1713 SCREW 2.4 CORTEX 24MM 366.29 256.40
16100033 278 C1713 SCREW 2.4 CORTEX 26MM 366.29 256.40
16100034 278 C1713 SCREW 2.4 CORTEX 28MM 366.29 256.40
16100035 278 C1713 SCREW 2.4 LOCKING 18MM 366.29 256.40
16100036 278 C1713 SCREW 2.7 CORTEX 14MM 140.42 98.29
16100037 278 C1713 SCREW 3.5 LOCKING 36MM 392.93 275.05
16100038 278 C1713 SCREW3.5 LOCKING 50MM 392.93 275.05
16100039 278 C1713 SCREW 3.5 CORTEX 30MM 94.30 66.01
16100040 278 C1725 LUTONIX 035 5.0MM X 60MM 4,162.44 2,913.71
16100041 278 C1713 SCREW LAG VHS W/COMP SCREW 935.72 655.00
16100042 278 C1713 SCREW 3.5 CORTEX12MM 103.52 72.46
16100043 278 C1713 SCREW 4.0 CORTEX16MM 90.20 63.14
16100044 278 C1713 SCREW 4.0 CORTEX18MM 88.25 61.78
16100045 278 C1713 SCREW 4.0 CORTEX20MM 86.10 60.27
16100046 278 C1713 SCREW LAG VHS W/COMP SCREW 1,102.21 771.55
16100047 278 C1713 SCREW LAG VHS W/COMP SCREW 1,102.21 771.55
16100048 278 C1713 SCREW 4.0 CORTEX18MM 90.20 63.14
16100049 278 C1725 LUTONIX 035 4.0MM X 60MM 4,162.44 2,913.71
16100050 278 C1713 FIXATION PINS SET OF 3 832.49 582.74
16100051 278 C1725 ULTRAVERSE 035 5.0MMX40MM 325.52 227.86
16100052 278 C1725 ULTRAVERSE 035 6.0MM X 40MM 325.52 227.86
16100053 278 C1725 LUTONIX 035 6.0MM X 100MM 5,535.15 3,874.61
16100054 278 C1725 LUTONIX 035 5.0MM X 40MM 5,535.15 3,874.61
16100055 278 KIT RADIUS DISTAL 8,780.46 6,146.32
16100056 272 C1725 ULTRAVERSE 035 6.0MM X 80MM 325.52 227.86
16100057 278 C1725 LUTONIX 035 6.0MM X 60MM 4,162.44 2,913.71
16100058 278 KIT RADIUS DISTAL 8,780.46 6,146.32
16100059 278 C1725 LUTONIX 035 7.0MM X 60MM 4,162.44 2,913.71
16100060 278 C1713 SCREW PROPEL 9X30MM I/F 333.00 233.10
16100061 278 C1713 SCREW CANNULATED 2.4 10MM 749.24 524.47
16100062 278 C1713 SCREW CANNULATED 2.4 16MM 749.24 524.47
16100063 278 C1713 SCREW CANNULATED 2.4 15MM 749.24 524.47
16100064 278 C1713 SCREW CANNULATED 2.4 14MM 767.97 537.58
16100065 278 C1713 GUARDSMAN FEM IFS 9X30MM 341.32 238.92
16100066 278 C1713 SUTURE ANCHOR TITANIUM 4.0MM 853.30 597.31
16100067 278 C1725 LUTONIX 035 5.0MM X 60MM 4,283.15 2,998.21
16100068 278 C1781 BIO A TISSUE REINFORCEMENT 8X8 1,367.20 957.04
16100069 278 C1725 ULTRAVERSE 035 4.0MMX40MM 325.52 227.86
16100070 278 CONGRUENT TRIBIAL INSERT 1/2 14MM RT 5,113.74 3,579.62
16100071 278 CONGRUENT TRIBIAL INSERT 1/2 12MM RT 3,972.27 2,780.59
16100072 278 CONGRUENT TIBIAL INSERT 3,972.27 2,780.59
16100073 278 CONGRUENT TIBIAL INSERT SIZE 5/6 12MM RT 4,460.48 3,122.34
16100074 278 C1725 LUTONIX 035 5.0MMX100MM 4,162.44 2,913.71
16100075 278 C1725 LUTONIX 035 5.0MM X 150MM 4,994.93 3,496.45
16100076 278 C1725 LUTONIX 035 5F 4,162.44 2,913.71
16100077 278 C1725 LUTONIX 035 DCB 5F 4,162.44 2,913.71
16100078 278 C1781 BIO A TISSUE REINFORCEMENT 10X30 6,730.83 4,711.58
16100079 278 C1781 BIO A TISSUE REINFORCEMENT 20X30 12,642.68 8,849.88
16100080 278 C1725 ULTRAVERSE 035 4.0MMX100MM 316.35 221.45
16100081 278 C1725 ULTRAVERSE 035 5.0 MM X 100MM 316.35 221.45
16100082 278 C1725 LUTONIX035DCB5F 4,994.93 3,496.45
16100083 278 BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT 8,938.50 6,256.95
16100084 278 BASEPLATE CCM STEM TIBIAL SIZE 3 LEFT 8,766.41 6,136.49
16100085 278 C1725 LUTONIX035DCB5F 4,162.44 2,913.71
16100086 278 C1713 SCREW FEMORAL 8MM X 25MM 341.32 238.92
16100087 278 C1713 SCREW PROPEL TIBIAL 341.32 238.92
16100088 278 C1725 ULTRAVERSE 035 7.0MM X 40MM 316.35 221.45
16100089 278 C1725 LUTONIX 035 5.0MM X 40MM 130CM 4,162.44 2,913.71
16100090 278 PIN GUIDE 2.5MM 312.59 218.81
16100091 278 POST TAPER HEMICAP 15.6MM 2,528.77 1,770.14
16100092 278 ARTICULAR HEMICAP 52MMX48MM 17,806.76 12,464.73
16100093 278 ANCHOR SUTURE TITANIUM 5.5 MM 1,000.98 700.69
16100094 278 SCREW 6.5X40MM EXTENDED TAB 6,017.78 4,212.45
16100095 278 ANCHOR SUTURE PEEK 5.5MM 1,362.73 953.91
16100096 278 ROD 6X40MM 1,196.24 837.37
16100097 278 SET SCREW 868.64 608.05
16100098 278 SCREW 6.5X35MM EXTENDED TAB 6,017.78 4,212.45
16100099 278 GUIDE WIRE 482.92 338.04
16100100 278 C1713 PLATE NARROW VOLAR DISTAL RADIOUS RT 2,730.56 1,911.39
16100101 278 C1713 PLATE NARROW VOLAR DISTAL RADIUS RT 2,730.56 1,911.39
16100102 278 C1713 PLATE DISTAL RADIUS RT STANDARD 2,730.56 1,911.39
16100103 278 C1713 PLATE DISTAL RADIUS FIBULA LT 4H 86MM 2,269.78 1,588.85
16100104 272 JASHIDI NEEDLE 570.72 399.50
16100105 278 ARTICULATING CAGE 11X30X9 11,414.59 7,990.21
16100106 278 ARTICULATING CAGE 11X30X10 11,414.59 7,990.21
16100107 278 SCREW 6.5X40MM EXTENDED TAB 6,017.78 4,212.45
16100108 272 JASHIDI NEEDLE 570.72 399.50
16100109 278 C1769 GUIDE WIRE 469.31 328.52
16100110 278 SCREW 6.5X45 TIGER MIS 6,017.78 4,212.45
16100111 278 SCREW 6.5X40 TIGER MIS 6,017.78 4,212.45
16100112 278 SET SCREW 868.64 608.05
16100113 278 ROD MIS 5.5X45MM 1,196.24 837.37
16100114 278 ARTICULATING CAGE 30X11X11 11,414.59 7,990.21
16100115 278 SCREW 6.5X50MM EXTENDED TAB 6,017.78 4,212.45
16100116 278 SCREW 6.5X45MM EXTENDED TAB 6,017.78 4,212.45
16100117 278 GUIDE WIRE 482.92 338.04
16100118 272 OSTEO-SITE NEEDLE BIOPSY BONE 1,352.19 946.53
16100119 278 C1713 COTTON WEDGE 7MM 8,277.01 5,793.91
16100120 278 C1713 EVANS WEDGE 10MM 9,471.63 6,630.14
16100121 272 C1713 DRILL 2.0X110MM SOLID MEASURING AO 1,058.09 740.66
16100122 278 C1713 K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 2. 168.10 117.67
16100123 278 C1713 OLIVE WIRE SMOOTH 1.4MM 580.24 406.17
16100124 278 C1713 R3CON LOCKING PLATE SCREW 2.7X18 1,058.09 740.66
16100125 278 C1713 R3CON NON-LOCKING PLATE SCREW 2.7X12MM 819.17 573.42
16100126 278 C1713 R3CON NON-LOCKING PLATE SCREQ 2.7X14MM 819.17 573.42
16100127 278 C1713 HEVANS PLATE MEDOIUM LEFT 20MM 7,509.04 5,256.33
16100128 278 C1713 DRILL 4.6X220MM CANNULATED 3/16 SQ CONN 1,279.95 895.97
16100129 278 C1713 K-WIRE SINGLE TROCAR TIP SMOOTH W/ FLOUR 511.98 358.39
16100130 278 C1713 MONSTER CANNULATED MEDIUM THREAD SCREW H 4,420.10 3,094.07
16100131 278 C1713 MONSTER CANNULATED MEDIUM THREADED SCREW 4,420.10 3,094.07
16100132 278 C1725 LUTONIX 035 4MM X 40MM 130CM 4,162.44 2,913.71
16100133 278 C1713 3.5MM CORTICAL SCREW SELF-TAP SMALL HEX 103.11 72.18
16100134 278 C1713 CRUSHED CANCELLOUS CHIPS 15CC 1-4MM 1,952.35 1,366.65
16100135 278 C1769 GUIDE WIRE 469.31 328.52
16100136 278 C1713 DRILL 2.4X140MM SOLID MEASURING LONG AO 1,058.09 740.66
16100137 278 C1725 ULTRAVERSE 035 5.0 MM X 150MM 316.35 221.45
16100138 278 C1713 MTP PLATE SHORT-SHORT LEFT 2-HOLE DISTAL 8,072.21 5,650.55
16100139 278 C1713 K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1. 176.50 123.55
16100140 278 C1713 R3CON LOCKING PLATE SCREW 3.5X20MM 1,126.35 788.45
16100141 278 C1713 R3CON LOCKING PLATE SCREW 3.5X20MM 1,126.35 788.45
16100142 278 C1713 R3CON NON-LOCKING PLATE SCREW 3.5X14MM 819.17 573.42
16100143 278 C1713 R3CON NON-LOCKING PLATE SCREW 3.5X16MM 819.17 573.42
16100144 278 C1713 R3CON NON-LOCKING PLATE SCREW 3.5X20MM 819.17 573.42
16100145 278 C1713 MINI-MONSTER CANNULATED SHORT THREAD SCR 1,416.48 991.54
16100146 278 C1713 COUNTERSINK 3.5MM HEADLESS 1,058.09 740.66
16100147 278 C1713 DRILL 2.3X120MM CANNULATED AO 1,058.09 740.66
16100148 278 C1713 K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1. 176.50 123.55
16100149 278 PIN 33MM HEADED 386.34 270.44
16100150 278 PIN 449.56 314.69
16100151 278 PIN TENSION BAND 70CM 403.89 282.72
16100152 278 C1725 LUTONIX 035 5X80 4,162.44 2,913.71
16100153 278 C1725 LUTONIX 035 5X80 4,162.44 2,913.71
16100154 278 C1725 LUTONIX 035 4X60 5F 4,162.44 2,913.71
16100155 278 C1725 LUTONIX 035 4X80 5F 4,162.44 2,913.71
16100156 278 C1725 ULTRAVERSE 035 6.0MM X 100MM 316.35 221.45
16100157 278 C1725 ULTRAVERSE 035 7.0MM X 100MM 316.35 221.45
16100158 278 C1725 ULTRAVERSE 035 7.0MM X 80MM 316.35 221.45
16100159 278 C1725 ULTRAVERSE 035 7.0MM X 150MM 316.35 221.45
16100160 278 HEAD RESURFACING 50X16 19,053.58 13,337.51
16100161 278 C1725 ULTRAVERSE 035 6.0MM X 120MM 316.35 221.45
16100162 278 C1725 ULTRAVERSE 035 6.0MM X 60MM 316.35 221.45
16100163 278 C1725 ULTRAVERSE 035 5.0MM X 120MM 316.35 221.45
16100164 278 C1725 ULTRAVERSE 035 5.0MM X 80MM 316.35 221.45
16100165 278 C1725 ULTRAVERSE 035 4.0MM X 150MM 316.35 221.45
16100166 278 C1725 ULTRAVERSE 035 4.0MM X 120MM 316.35 221.45
16100167 278 C1713 MINI-MONSTER CANNULATED SHORT THREADED S 1,194.62 836.23
16100168 278 C1713 R3CON NON-LOCKING PLATE SCREW 2.7X16MM 819.17 573.42
16100169 278 C1713 R3CON NON-LOCKING PLATE SCREW 2.7X15MM 819.17 573.42
16100170 278 C1713 R3CON LOCKING PLATE SCREW 2.7X15MM 1,126.35 788.45
16100171 278 C1713 R3CON LOCKING PLATE SCREW 2.7X12MM 1,126.35 788.45
16100172 278 C1713 MTP PLATE 0 DEGREE LONG RIGHT 8,072.21 5,650.55
16100173 278 C1713 MTP SPIN GUARD FEMALE REAMER 19MM 2,218.58 1,553.01
16100174 278 C1762 MTP DISC 19X5MM 12,543.51 8,780.46
16100175 278 C1781 MESH XL 10X14 6,126.69 4,288.68
16100176 278 C1781 MESH XL 8X12 4,693.15 3,285.21
16100177 278 C1781 MESH OVAL 6X9IN 3,020.69 2,114.48
16100178 278 C1781 MESH RECTANGLE 4X6IN 1,279.95 895.97
16100179 278 C1781 MESH SQUARE 5X5IN 1,416.48 991.54
16100180 278 C1781 MESH HERNIA 4,095.84 2,867.09
16100181 278 C1781 MESH HERNIA 2,559.90 1,791.93
16100182 278 C1781 MESH HERNIA 1,757.79 1,230.45
16100183 278 C1781 MESH HERNIA 1,928.46 1,349.92
16100184 278 C1781 MESH HERNIA 2,832.96 1,983.07
16100185 278 C1781 MESH 2,480.54 1,736.38
16100186 278 C1781 MESH VENTRALIGHT ST ECHO 4.5 3,988.32 2,791.82
16100187 278 C1781 MESH VENTRALIGHT ST WITH ECHO 6 4,758.00 3,330.60
16100188 278 C1781 MESH VENTRALIGHT ST WITH ECHO 10x15CM 13,925.85 9,748.10
16100189 278 C1781 MESH VENTRALIGHT ST WITH ECHO 15CM CIRCL 3,018.47 2,112.93
16100190 278 C1781 MESH HERNIA C-QUR 25CM X 35 CM 5,542.06 3,879.44
16100191 278 C1781 MESH VENTRALIGHT ST WITH ECHO 10X13 EL 11,937.15 8,356.01
16100192 278 C1781 MESH VENTRALIGHT ST WITH ECHO 8X10 EL 5,707.29 3,995.10
16100193 278 C1781 MESH VENTRALIGHT ST WITH ECHO 20CM CIRCL 8,167.78 5,717.45
16100194 278 C1781 MESH SURGICAL ABSORBABLE PATCH 4INW X 5I 2,158.74 1,511.12
16100195 278 C1781 MESH SURGICAL PARTIALLY ABSORBABLE PATCH 4,758.00 3,330.60
16100196 278 C1781 MESH VENTRIO ST HERNIA PATCH 15.5CMX25.7 8,711.51 6,098.06
16100197 278 C1781 MESH VENTRALIGHT ST WITH ECHO 6X8 3,788.08 2,651.66
16100198 278 C1781 MESH VENTRIO ST HERNIA PATCH 3X3 2,414.15 1,689.91
16100199 278 C1713 XEMPLIFI DBM GEL 5 CC 3,413.25 2,389.28
16100200 278 PLATLET RICH PLASMA 2,704.38 1,893.07
16100201 278 SET SCREW 702.44 491.71
16100202 278 VOYAGER 7.5X45 4,390.23 3,073.16
16100203 278 ELEVATE 28X7 16,156.03 11,309.22
16100204 278 VOYAGER 6.5X45 4,390.23 3,073.16
16100205 278 C1776 PERC ROD 45MM 2,414.21 1,689.95
16100207 278 NEEDLE TROCAR PAK 502.23 351.56
16100208 278 NEEDLE BEVELED PAK 502.23 351.56
16100209 278 BAYONEXES KNIFE 1,372.38 960.67
16100210 278 C1781 MESH HERNIA C-QUR 20CM X 30 CM 4,245.31 2,971.72
16100211 272 GUIDE WIRE 266.05 186.24
16100212 278 ELEVATE 9X28MM 16,156.03 11,309.22
16100213 278 40MM ECLIF PLATE 3,775.65 2,642.96
16100214 278 VOYAGER 7.5X50 4,390.23 3,073.16
16100215 278 C1781 MESH HERNIA C-QUR 10CM X 15CM 1,157.81 810.47
16100216 278 PERC ROD 30MM 2,546.33 1,782.43
16100217 278 4.0X14MM FIXED SCREW 1,324.99 927.49
16100218 278 4.0X14MM VARIABLE SCREW 1,324.99 927.49
16100219 278 10X14X11 CORNERSTONE PSR 3,161.02 2,212.71
16100220 278 OPTEFORM 5CC 5,812.67 4,068.87
16100221 278 OPTEFORM 10CC 9,711.18 6,797.83
16100222 278 C1889 6X14X11 CORNERSTONE PSR 3,071.93 2,150.35
16100223 278 XEMPLIFI DBM PUTTY 10 CC 6,146.41 4,302.49
16100224 278 RISE SPACER 8X22MM 7-13MM 20,195.35 14,136.75
16100225 278 SHEATH INTRODUCER 6F 203.25 142.28
16100226 278 C1713 CREO AMP 6.5X40MM MODULAR CANNULATED SCR 2,047.95 1,433.57
16100227 278 C1713 CREO AMP 6.5X45MM MODULAR CANNULATED SCR 2,047.95 1,433.57
16100228 278 C1776 CREO MIS LOCKING CAP 499.50 349.65
16100229 278 C1713 CREO MIS MODULAR POLYAXIAL TULIP 10MM RE 2,047.95 1,433.57
16100230 278 C1713 ANCHOR 5.5MM BONE 1,348.21 943.75
16100231 272 DRILL 4.5 MM 878.05 614.64
16100232 272 DRILL 3.5 MM 878.05 614.64
16100233 278 C1713 CREO MIS 5.5MM CURVED ROD TITANIUM ALLOY 1,317.09 921.96
16100234 278 C1713 CREO MIS 5.5MM CURVED ROD, TITANIUM ALLO 1,248.75 874.13
16100235 272 1.6MM K-WIRE 500MM BLUNT TIP 499.50 349.65
16100236 272 L8699 1.6MM NITINOL K-WIRE, 500MM, BLUNT TIP 511.99 358.39
16100237 278 RISE SPACER, 10X26MM, 8-15MM, 10DEGREE 20,195.35 14,136.75
16100238 278 C1713 XEMPLIFI DBM GEL 1CC 853.31 597.32
16100239 278 L8699 XTEND ANTERIOR CERVICAL PLATE 1-LEVEL 12 3,413.25 2,389.28
16100240 278 C1713 SCREW LAG VHS W/COMP SCREW 1,064.91 745.44
16100241 278 C1713 SCREW FEMORAL INTERF. 8MMX20MM,3.5MM 341.32 238.92
16100242 278 C1713 SCREW FEMORAL INTERF. 9MMX25MM,3.5MM 341.32 238.92
16100243 278 XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D 790.25 553.18
16100244 278 L8699 XTEND ANTERIOR CERVICAL PLATE 2-LEVEL 26 3,413.25 2,389.28
16100245 278 XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D 790.25 553.18
16100246 278 XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D 790.25 553.18
16100247 278 C1713 AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 14MM 1,959.21 1,371.45
16100248 278 C1713 SCREW CANNULATED COMPRESSION S.S 12MM 1,744.92 1,221.44
16100249 278 C1713 K-WIRE SINGLE TROCAR POINT 166.50 116.55
16100250 278 C1713 SCREW 2.7MM 13MM 239.76 167.83
16100251 278 C1713 PLATE VARI-ANGLE 4 HOLE 1,440.37 1,008.26
16100252 278 C1713 SCREW LAG W/COMP 12.7MM X 70MM 596.00 417.20
16100253 278 C1713 SCREW CORTIAL SCREW 4.5SS 113.47 79.43
16100254 278 TIBIAL INSERT SIZE 4 15MM 7,270.21 5,089.15
16100255 278 C1713 PIN THREADED TIP GD 2.5MM X 9 174.14 121.90
16100256 278 C1713 PLATE KEYLESS 4 HOLE 1,621.27 1,134.89
16100257 278 C1713 SCREW LAG W/COMP 959.11 671.38
16100258 278 C1713 SCREW CORTIAL SCREW 4.5SS 113.47 79.43
16100259 278 C1713 SCREW CORTIAL SCREW 4.5SS 134.48 94.14
16100260 278 C1713 PLATE 4 HOLE 8 HOLE HEAD 2,867.09 2,006.96
16100261 278 C1713 PLATE 5 HOLE 2,952.42 2,066.69
16100262 278 C1713 PLATE 3 HOLE 3.5 LCP 5,000.34 3,500.24
16100263 278 C1713 PLATE 6 HOLE VHS VARI-ANGLE 1,621.27 1,134.89
16100264 278 C1713 PLATE 4 HOLE VHS VARI-ANGLE 1,911.39 1,337.97
16100265 278 C1713 PLATE 7 HOLE 3.5 LCP 648.51 453.96
16100266 278 C1713 PLATE 2 HOLE 56MM 1,911.39 1,337.97
16100267 278 TIBIAL INSERT 7,551.18 5,285.83
16100268 278 TIBIAL INSERT 4,908.28 3,435.80
16100269 278 TIBIAL INSERT 7,621.43 5,335.00
16100270 278 PLATE STANDARD TUBE135MM DIA.,4 HOLE 1,521.30 1,064.91
16100271 278 SCREW- 44MM 90.73 63.51
16100272 278 SCREW - 46MM 90.73 63.51
16100273 278 SCREW - 90MM 965.12 675.58
16100274 278 SCREW COMPRESSION 1 206.18 144.33
16100275 278 C1713 SCREW 2.2MM 14MM 432.28 302.60
16100276 278 C1713 SCREW LOCKING 2.7MM 13MM 411.19 287.83
16100277 278 C1713 SCREW LOCKING 2.7MM 15MM 411.19 287.83
16100278 278 C1713 3.5MM ULS ONE-THIRD TUBULAR PLT 8H, 107M 620.18 434.13
16100279 278 C1713 3.5MM ULS ONE-THIRD TUBULAR PLT 10H, 133 632.80 442.96
16100280 278 PLATE 10MM 46MM RIB 3,143.41 2,200.39
16100281 272 SCREW RIB 10MM 333.66 233.56
16100282 272 DRILL BIT 2.2MM 349.51 244.66
16100283 278 C1713 SCREW 2.4 LOCKING 2.7MM 20MM 432.28 302.60
16100284 278 C1713 SCREW 2.4 LOCKING 2.7MM 18MM 399.60 279.72
16100285 278 C1713 SCREW 2.4 LOCKING 2.7MM 16MM 399.60 279.72
16100286 278 C1713 SCREW 2.4 LOCKING 2.7MM 12MM 399.60 279.72
16100287 278 C1713 SCREW 2.7MM 16MM 246.71 172.70
16100288 278 C1713 SCREW 2.7MM 14MM 246.71 172.70
16100289 278 C1713 SCREW 2.7MM 12MM 239.76 167.83
16100290 272 TOPAZ MICRO DEDRIDER 1,274.92 892.44
16100291 278 C1713 DVR CROSSLOCK PLATE LEFT 2,977.02 2,083.91
16100292 278 C1713 LP NON LOCK 2.7MM X 10MM 217.60 152.32
16100293 278 C1713 DVR CROSSLOCK PLATE RIGHT 2,977.02 2,083.91
16100294 278 DNU PATELLA 2,507.70 1,755.39
16100295 278 TIBIAL INSERT 7,621.43 5,335.00
16100296 278 STEM FLUTED EXTENSION 4,225.68 2,957.98
16100297 278 TIBIAL AUG. BLK 5,566.81 3,896.77
16100298 278 TIBIAL INSERT CR SLOPE 5,275.83 3,693.08
16100299 278 TIBIAL INSERT CR SLOPE 7,919.98 5,543.99
16100300 278 ACETABULAR CUP 19,906.31 13,934.42
16100301 278 SUMMIT STEW SIZE 2 HI-OFF SET 21,142.10 14,799.47
16100302 272 SLEEVE ADAPTOR T2 1,422.44 995.71
16100303 278 STEM EXTENSION 6,251.68 4,376.18
16100304 272 DRILL BIT QUICK RELEASE 730.54 511.38
16100305 278 TIBIAL INSERT CR SLOPE 4,869.99 3,408.99
16100306 278 C1713 LP NON LOCK 2.7MMX 18MM 217.60 152.32
16100307 278 C1713 SCREW LOCKING 2.7MM 14MM 399.60 279.72
16100308 278 C1713 DVR LOCK NARROW MINI L 3,664.23 2,564.96
16100309 278 C1713 LOCK SCREW SQUARE 2.7MMX14MM 432.28 302.60
16100310 278 FEMORAL UNI INPLANT 8,014.94 5,610.46
16100311 278 C1713 DVR LOCK NARROW L 3,664.23 2,564.96
16100312 278 C1713 SCREW LOCKING 2.7MM 8MM 432.28 302.60
16100313 278 C1769 GUIDE WIRE .91MMX80MM SS 197.52 138.26
16100314 278 C1713 CREO AMP 6.5X35MM MODULAR CANNULATED SCR 2,047.95 1,433.57
16100315 278 ADAPTOR TAPER SLEEVE 1,422.44 995.71
16100316 278 PUTTY 1CC 709.47 496.63
16100317 278 C1713 15MM 4.0 VARIABLE SCREW/MEDTRONIC 1,287.65 901.36
16100318 278 PLATE 35MM 21LV ATLANTIS 3,775.65 2,642.96
16100319 272 TICRON 2 BLUE 30 T-56/HGS-21 935.24 654.67
16100320 278 HIP STEM TAPERED W/POROCOAT 21,142.10 14,799.47
16100321 278 C1713 CREO MIS 5.5X50mm CURVED ROD TITANIUM AL 1,248.75 874.13
16100322 278 C1713 5X14X11 CORNERSTONE PSR 3,161.02 2,212.71
16100323 278 C1713 PLATE 19MM 3,424.43 2,397.10
16100324 278 C1713 4X15MM SCREW 1,324.99 927.49
16100325 278 C1762 TISSUE SPINAL GRAFT 709.47 496.63
16100326 278 C1889 RISE SPACER, 10X26MM, 7-14MM 19,626.19 13,738.33
16100327 278 C1889 RISE SPACER 10X30MM 8-15MM 10 DEGREE 19,626.19 13,738.33
16100328 272 OVERTUBEGUARDUS 8.6-10.0 25CM 668.18 467.73
16100330 272 TIP SUCTION ORTHO 103.78 72.65
16100331 278 C1713 PERI SCREW 3.55X16MM 162.09 113.46
16100332 278 C1713 3.5 MM CANNULATED SCREW 663.52 464.46
16100333 278 C1713 PERI SCREW 3.5X MM X 26 W/ 2.7 MM 162.09 113.46
16100334 278 C1713 DISTAL LATERAL FIBULA LOCKING PLATE 2,366.71 1,656.70
16100335 278 C1713 2.7MM CORTICAL SCREW 16MM 97.33 68.13
16100336 278 C1713 2.7MM CORTICAL SCREW 18MM 97.33 68.13
16100337 278 C1713 DISTAL LATERAL FIBULA LOCKING PLATE 4H 8 2,308.99 1,616.29
16100338 272 SCREW FORTE CANCELLOUS 4.0MMX10MM FULL T 239.62 167.73
16100339 278 C1713 SCREW 3.5 CORTEX 14MM 111.37 77.96
16100340 278 C1713 SCREW 3.5 CORTEX 16MM 108.65 76.06
16100341 278 C1713 SCREW 3.5 CORTEX 18MM 111.37 77.96
16100342 278 C1713 SCREW EXT. STEM 238.10 166.67
16100343 272 2.7MM STANDARD DRILL 481.87 337.31
16100344 278 C1713 TAO Q-C FOR 3.5MM SCREWS 110MM 321.04 224.73
16100345 278 C1713 SCREW FORTE CANCELLOUS 4.0MMX14MM FULL T 227.19 159.03
16100346 278 C1713 DISTAL LATERAL FIBULA LOCKING PLATE 6H 1 2,469.52 1,728.66
16100347 278 C1713 CREO AMP 6.5X50MM MODULAR CANNULATED SCR 1,998.00 1,398.60
16100349 278 C1713 SCREW FORTE CANCELLOUS 4.0MMX16MM FULL T 227.19 159.03
16100350 278 TRAY TIBIAL TRAPEZOID 13,030.19 9,121.13
16100351 272 TRAY TIBIAL TRAPEZOID 9,033.51 6,323.46
16100352 272 TRAY TIBIAL TRAP 9,033.51 6,323.46
16100353 278 TIBIAL INSERT 6,919.00 4,843.30
16100354 272 TRAY TIBIAL TRAP 12,187.27 8,531.09
16100355 278 TIBIAL INSERT CR SLOPE 7,270.21 5,089.15
16100356 278 TRAY TIBIAL TRAPEZOID 13,030.19 9,121.13
16100357 272 TRAY TIBIAL TRAPEZOID 13,557.02 9,489.91
16100358 278 TIBIAL INSERT SIZE 4 15MM 8,116.65 5,681.66
16100359 278 C1713 4.0 MM CANNULATED SCREW 1/3 THD 48MM 708.58 496.01
16100360 278 TIBIAL INSERT SIZE 4 9MM 4,644.52 3,251.16
16100361 278 TIBIAL INSERT SIZE 3 11MM SLOPE 7,270.21 5,089.15
16100362 278 TIBIAL INSERT SIZE 3 13MM SLOPE 7,270.21 5,089.15
16100363 278 C1713 4.0MM CANNULATED SCREW 1/3 THD 4MM 674.70 472.29
16100364 278 C1889 35MM ECLIF PLATE 3,669.24 2,568.47
16100365 278 C1713 4.0 X 15MM FIXED SCREW 1,256.24 879.37
16100366 278 C1713 CREO AMP 7.5X40MM CANNULATED SCREW 1,998.00 1,398.60
16100367 278 C1713 CREO AMP 7.5X45MM CANNULATED SCREW 1,998.00 1,398.60
16100368 278 C1713 CREO AMP 7.5x55mm MOD CANNULATED SCREW 1,980.00 1,386.00
16100370 278 FEMORAL POROUS SIZE 4 LEFT 14,425.76 10,098.03
16100371 278 FEMORAL HEAD 28MM +10 4,326.13 3,028.29
16100372 278 FEMORAL POROUS 14,074.19 9,851.93
16100373 278 C1713 QCKFIX SCREW, TI, CANC, PT, 3.0X28MM 499.50 349.65
16100374 278 C1713 QCKFIX SCREW, TI, CANC, PT, 3.0X30MM 499.50 349.65
16100375 272 A4649 THD GDWIRE W TRCR TIP, .45 W/LASER 86.49 60.54
16100376 272 A4649 COUNTERSINK, 3.0MM, CANNULATED 614.64 430.25
16100377 278 FEMORAL POROUS 21,652.60 15,156.82
16100378 278 C1713 PLATE 19MM ZEVO 3,246.75 2,272.73
16100379 278 C1713 3.15X15MM FIXED SCREW 1,256.24 879.37
16100380 278 HEAD RESURFACING 50X19 22,948.59 16,064.01
16100381 272 CLIP OTSC SYSTEM SET 12/6GC 165CM 2,068.70 1,448.09
16100382 272 CLIP OTSC SYSTEM SET 12/6T 220CM 1,945.78 1,362.05
16100383 272 CLIP OTSC SYSTEM SET 11/6T 165CM 1,538.36 1,076.85
16100384 278 ANCHOR OTSC 165CM 1,548.89 1,084.22
16100385 278 C1781 MESH VENTRALIGHT ST 30.5X35.6CM 9,927.40 6,949.18
16100386 278 C1781 MESH VENTRALIGHT 4.5X11.4CM 1,541.96 1,079.37
16100390 278 C1776 FEMORAL HEAD 1,356.96 949.87
16100391 278 C1713 PEDICLE ACCESSS KIT 1,665.00 1,165.50
16100392 278 C1781 MESH OVAL 6X9IN 2,059.04 1,441.33
16100393 278 C1713 CREO MIS 5.5MM CURVED ROD 75MM 1,248.75 874.13
16100394 278 C1889 SABLE SPACER 10 X 26 6-12MM 8 DEGREE 20,812.50 14,568.75
16100395 278 C1725 ULTRAVERSE 130 3X40MM 749.25 524.48
16100396 278 C1725 ULTRAVERSE 130CM 6X40MM 632.00 442.40
16100399 278 C1725 ULTRAVERSE 130 4X40MM 632.70 442.89
16100400 278 C1713 PLATE 3-HOLE DVR 2,653.97 1,857.78
16100401 278 L8699 CERVICAL CAGE CIF 6 DEG -07 9,973.20 6,981.24
16100402 278 L8699 CERVICAL CAGE CIF 6 DEG -08 9,973.20 6,981.24
16100403 278 L8699 CERVICAL PLATE 10MM 8,533.00 5,973.10
16100404 278 L8699 CERVICAL PLATE 14 MM 8,324.88 5,827.42
16100405 278 C1769 K-WIRE 1.6 65.60 45.92
16100406 278 C1769 K-WIRE 539.45 377.62
16100407 272 DRILL BIT 12MM 702.44 491.71
16100408 278 SCREW SELF DRILLING 4.0X14MM 1,404.87 983.41
16100409 360 20930 BONE GRAFT I FACTOR 2.5CC 5,200.00 3,640.00
16100410 278 SCREW SELF DRILLING 4.0X12MM 1,404.87 983.41
16100411 278 C1713 DISTRACTION PIN 12MM 832.49 582.74
16100412 278 L8699 CERVICAL PLATE 1,535.94 1,075.16
16100413 278 CERVICAL 3.5MM SELF DRILLING SCREW, 12MM 1,141.46 799.02
16100414 278 CERVICAL 3.5MM SELF DRILLING SCREW, 14MM 1,141.46 799.02
16100415 278 C1713 SCREW MULTI DIRECTIONAL 24MM 492.83 344.98
16100416 278 C1713 SCREW 2.5 LOCKING 24MM 266.40 186.48
16100417 278 C1713 SCREW 3.5 LOCKING 12MM 266.40 186.48
16100418 278 CERVICAL 4.0MM SELF DRILLING SCREW, 12MM 1,141.46 799.02
16100419 278 L8699 TESERA SC CAGE, 16MMX13.5MMX6MM, 7 16,383.35 11,468.35
16100420 272 INSERTS MULTI 2.0 231.80 162.26
16100421 278 L8699 CERVICAL CAGE CIF, 6 DEG, -06 9,973.20 6,981.24
16100422 278 L8699 1-LEVEL, 12MM CERVICAL PLATE 8,324.88 5,827.42
16100423 278 C1713 DISTRACTION PIN 14MM 853.30 597.31
16100424 278 C1713 7MM 4 HOLE ANTERIOR PLATE 8,324.88 5,827.42
16100425 278 C1713 7MM LOCKING COVER 832.49 582.74
16100426 278 C1713 3.5MM VARIABLE SCREW SELF DRILLING 14MM 1,365.28 955.70
16100427 272 DRILL, 12MM 702.44 491.71
16100428 278 C1713 INTERBODY, 16X14X7MM 7 DEGREE STERILE 9,973.20 6,981.24
16100429 278 L8699 MOBI-C CERVICAL DISC PROSTHESIS 15X 15 14,851.80 10,396.26
16100430 272 CANNULATED DRILL Q-C 2,005.59 1,403.91
16100431 278 PIN GUIDE 1.6MM X 9IN PARTIAL THREAD 288.01 201.61
16100432 278 WASHER 3. AND 4.0 SCREW 159.83 111.88
16100433 278 SCREW CANNULATED 4.0X60MM 1/2 THREAD 656.15 459.31
16100434 272 CANNULATED DRILL Q-C 4.5MM 1,901.56 1,331.09
16100435 278 C1713 6.5MM CANNULATED SCREW 16MM THD 80MM 825.31 577.72
16100436 278 C1713 6.5MM CANNULATED SCREW 16MM THD 85MM 805.18 563.63
16100437 272 3.2MM X 9IN PARTIAL THD TROCAR TIP GDE P 325.75 228.03
16100438 272 1.6MM X 6IN SMOOTH TROCARTIP GDE PIN, 5/ 208.48 145.94
16100439 278 C1713 6.5MM CANNULATED SCREW 16MM THD 70MM 805.18 563.63
16100440 278 CABLE CERCLAGE 1.8MMX22 GRIP 1,300.94 910.66
16100441 278 CABLE CERCLAGE 1.8MMX635MM COCR 1,308.86 916.20
16100442 278 GTR 5 HOLE EXTENDED W/4 CABLES 14,206.60 9,944.62
16100443 278 C1713 6.5MM CANNULATED SCREW 16MM THD 75MM 805.18 563.63
16100445 278 WIRE K 2.0X150MM 269.34 188.54
16100450 272 SUTURE ORTHOCORD 103.04 72.13
16100451 278 ANCHOR HEALIX 4.5MM 1,197.65 838.36
16100452 278 C1713 DISTRACTION PIN 14MM 239.86 167.90
16100453 278 L8699 MOBI-C CERVICAL DISC PROSTHESIS 17X17 15,282.50 10,697.75
16100470 272 CARBOJET TUBE 544.38 381.07
16100480 278 SCREW- 40MM 90.73 63.51
16100481 278 FEMORAL FIXATION 4 HOLE 135 DEGREE 1,521.30 1,064.91
16100482 278 SCREW LAG 70MM 12.7 MM 965.12 675.58
16100483 272 GUIDE WIRE 3.2X230MM 585.00 409.50
16100484 272 IMPACTOR HEAD 498.73 349.11
16100485 278 SCREW COMPRESSION 1/2 IN 241.75 169.23
16100486 278 SCREW- 42MM 90.73 63.51
16100487 278 C1713 DVR LOCK NARROW R 3,063.35 2,144.35
16100488 278 C1713 SCREW 2.7MM 15MM 246.71 172.70
16100500 272 SHEATH 18FR 439.02 307.31
16100501 272 SHEATH 12FR 277.47 194.23
16100502 278 C1768 GRAFT 25,903.68 18,132.58
16100503 278 C1768 GRAFT - LINE EXTENDER 10,572.59 7,400.81
16100504 278 GRAFT 10 10 12,643.86 8,850.70
16100520 278 FEMUR POROUS 21,652.60 15,156.82
16100521 272 TRAY TIBIAL TRAP 13,557.02 9,489.91
16100522 278 TIBIAL INSERT CR SLOPE 7,919.98 5,543.99
16100523 272 C1713 DNU DRILL BIT 1,277.25 894.08
16100524 278 PROXIMAL TIBIAL SPACER 5,759.98 4,031.99
16100525 278 C1713 CREO MIS 5.5MM 80MM CURVED ROD TITANIUM 1,248.75 874.13
16100530 278 SCREW 4.0MM - 40 MM LENGTH 491.70 344.19
16100531 278 SCREW 4.0MM - 44 MM LENGTH 491.70 344.19
16100532 278 SCREW 4.0MM - 48 MM LENGTH 491.70 344.19
16100533 278 SCREW 4.0MM - 50 MM LENGTH 491.70 344.19
16100534 278 C1713 BONE SCREW 6.5x35 236.46 165.52
16100535 272 K-WIRE .35X6 DBL TRO 6PK NS 301.52 211.06
16100536 272 K-WIRE .045X6 DBL TRO 6PK NS 301.52 211.06
16100537 278 C1713 Z NAIL 5.0X30 CORT SCREW FA 691.46 484.02
16100538 278 C1776 CONTINUUM MULTI-HOLE SHELL 64 OO 8,909.61 6,236.73
16100539 278 C1776 CONTINUUM MULTI-HOLE SHELL 62NN 8,909.61 6,236.73
16100540 278 SCREW LOCKING CAP NCB 720.00 504.00
16100541 278 SCREW 5.0 CANCELLOUS 65MM 667.32 467.12
16100542 278 SCREW 5.0 CANCELLOUS 80MM 667.32 467.12
16100543 278 SCREW 5.0 CANCELLOUS 85MM 667.32 467.12
16100544 278 SCREW NCB 5.0,L. 34MM 790.24 553.17
16100545 278 C1713 Z NAIL 5.0X32.5 CORT SCREW 708.75 496.13
16100546 272 NCB DRILL BIT 4.3MM,L. 195MM 540.87 378.61
16100547 278 C1713 Z NAIL 5.0X27.5 CORT SCREW 691.46 484.02
16100548 271 CALIBRATED DRILL 4.3MM LONG 382.78 267.95
16100549 278 C1776 CONTINUUM LONGEVITY NEUTRAL LINER, II 32 3,172.31 2,220.62
16100550 278 C1713 PLATE TIBIA NCB PROXIMAL 2,708.44 1,895.91
16100551 278 C1713 PERI SCREW 3.5MMX10MM W2.7MM HEAD 158.14 110.70
16100552 278 C1713 PERI SCREW 3.5MM X 12MM W/2.7 HEAD 158.14 110.70
16100553 278 C1713 PERI SCREW 3.5MM X 12MM W/2.7 HEAD 158.14 110.70
16100554 278 C1713 PERI SCREW 3.5MM X 24MM W/2.7 HEAD 158.14 110.70
16100555 278 BONE SCREW 6.5 X 30MM 513.66 359.56
16100556 278 C1713 PERI SCREW 3.5MM X 40MM W/2.7 HEAD 158.14 110.70
16100557 278 C1713 LOCKING SCREW 3.5MM X 20MM W/2.7 HEAD 358.10 250.67
16100558 278 FEMORAL STEM SZ 11, 145MM 19,699.30 13,789.51
16100559 278 C1713 BONE SCREW 233.10 163.17
16100560 272 NCB QC 3.3MM X 195MM 597.07 417.95
16100561 272 2.5MM QC 180MM BIT 449.56 314.69
16100562 278 GUIDE WIRE NCB-PH 86.50 60.55
16100563 278 FEMORAL STEM SZ 14, 160MM 18,263.34 12,784.34
16100564 278 FEMORAL HEAD 36MM O.D. 4,280.48 2,996.34
16100565 278 CROWN CUP 2, 36MM I.D. 6,311.39 4,417.97
16100566 278 DRILL BIT 20MM 4.5 NOVATION 242.34 169.64
16100567 278 C1713 BONE SCREW 6.5 X 20 236.46 165.52
16100568 278 CUP CLUSTER-HOLE SHELL 7,533.63 5,273.54
16100569 278 CUP CROWN CLUSTER-HOLE 7,331.33 5,131.93
16100570 278 DISTAL VOTAR RADIAL LOCKING PLATE 2,828.54 1,979.98
16100571 278 PERIARTICULAR LOCKING PEG 220.89 154.62
16100572 278 PERIARTICULAR LOCKING SCREW 2.4MMX20MM 366.92 256.84
16100573 278 PERIARTICULAR LOCKING SCREW 2.4MMX22MM 366.92 256.84
16100574 278 PERIARTICULAR LOCKING SCREW 2.4MMX14MM 292.10 204.47
16100575 272 BIT 1.8MM 1,018.54 712.98
16100576 278 K-WIRES 1.6MMX150MM 269.34 188.54
16100577 278 DISTAL VOTAR RADIAL LOCKING PLATE 2,963.93 2,074.75
16100578 278 PERIARTICULAR LOCKING SCREW 2.4MMX18MM 366.92 256.84
16100579 278 PERIARTICULAR LOCKING SCREW 2.4MMX16MM 292.10 204.47
16100580 278 C1713 SCREW CORTICAL 2.7X22MM 86.78 60.75
16100581 278 C1713 SCREW CORTICAL 2.7X14MM 84.66 59.26
16100582 278 DISTAL VOTAR RADIAL LOCKING PLATE 2,828.54 1,979.98
16100583 278 K-WIRES TROCAR POINT 1.25MM X 150MM 269.34 188.54
16100584 278 ELEMENT STEM 18,183.96 12,728.77
16100585 272 DRILL BIT Q-C 2.5MM DIA 110MM 259.31 181.52
16100586 278 FEMORAL HEAD 36MM O.D. 6,315.61 4,420.93
16100587 278 PERIARTICULAR LOCKING SCREW 2.4MMX12MM 292.10 204.47
16100588 278 PERIARTICULAR LOCKING SCREW 2.4MMX18MM 292.10 204.47
16100589 278 PERIARTICULAR LOCKING SCREW 2.4MMX22MM 292.10 204.47
16100590 278 C1713 PERIARTICULAR CORTICAL SCREW 16MMX3.5MM 158.14 110.70
16100591 278 LOCKING SCREW 362.59 253.81
16100592 272 2.0 STANDARD DRILL QC 175MM LONG 2,604.67 1,823.27
16100593 272 2.0 STANDARD DRILL QC 100MM LONG 234.84 164.39
16100594 272 2.5 STANDARD DRILL QC 110MM LONG 234.84 164.39
16100595 272 K-WIRE 269.34 188.54
16100596 272 PLATE PERIARTICULAR DISTAL LATERAL FIBUL 2,590.13 1,813.09
16100597 272 SCREW FORTE CANCELLOUS 4.0MMX18MM 239.62 167.73
16100598 272 SCREW FORTE CANCELLOUS 4.0MMX20MM 203.81 142.67
16100599 272 SCREW FORTE CANCELLOUS 4.0MMX22MM 203.81 142.67
16100600 278 C1769 GUIDE WIRE 1.6 147.60 103.32
16100601 278 DRILL BIT 30MM 4.5 242.34 169.64
16100602 278 C1776 CONTINUUM LONGEVITY NEUTRAL LINER, JJ 32 3,172.31 2,220.62
16100603 278 C1776 CONTINUUM MULTI-HOLE SHELL 7,326.00 5,128.20
16100604 278 C1776 CONTINUUM LONGEVITY NEUTRAL LINER, HH 32 3,172.31 2,220.62
16100605 278 PERI SCREW 3.5MM X 24MM W/2.7MM HEAD SEL 157.88 110.52
16100606 278 ELEMENT STEM 19,699.30 13,789.51
16100607 278 FEMORAL HEAD BIOLOX 8,298.59 5,809.01
16100608 278 CROWN CUP NOVATION 7,331.33 5,131.93
16100609 278 CROWN CUP NOVATION LINER 6,837.33 4,786.13
16100610 272 CANNULATED DRILL TRINKLE END 1,706.93 1,194.85
16100611 272 GUIDE PIN 2.4MMX9IN PARTIAL THREAD TRO 435.69 304.98
16100612 272 WASHER FOR 4.5MM SCREW 159.83 111.88
16100613 272 CANNULATED SCREW 4.5MMX70MM 1/3 THREAD 704.48 493.14
16100614 272 GUIDE PIN 1.6MM X 9IN PARTIAL THREAD TIP 414.43 290.10
16100615 272 WASHER FOR 5.5 THRU 7.5 SCREWS 159.83 111.88
16100616 272 GUIDE PIN 3.2MM X 12IN PARTIAL THRD TIP 435.50 304.85
16100617 278 C1776 FEMORAL COMPONENT SIZE E 13,919.19 9,743.43
16100618 278 SCREW CANNULATED 4.0MMX46MM 1/2 THREAD 656.15 459.31
16100619 278 C1776 CONTINUUM MULTI-HOLE SHELL 56 KK 7,326.00 5,128.20
16100620 278 SCREW CANNULATED 6.5MMX80MMX16MM THREAD 794.29 556.00
16100621 278 SCREW CANNULATED 6.5MMX85MMX16MM THREAD 794.29 556.00
16100622 278 SCREW CANNULATED 6.5MMX100MMX16MM THREAD 794.29 556.00
16100623 278 C1776 FEMORAL COMPONENT SIZE G 6,752.07 4,726.45
16100624 278 C1776 LEGACY KNEE POSTERIOR STABILIZED SIZE G 3,008.60 2,106.02
16100625 278 C1776 STEMMED TIBIAL COMPONENT PRECOAT SIZE 7 3,252.36 2,276.65
16100626 278 C1776 LPS-FLEX GSF OPTION FEMORAL, SIZE C-LT 6,752.07 4,726.45
16100627 278 C1713 Z NAIL 10.5X110 LAG SCREW 1,974.37 1,382.06
16100628 278 C1776 CONTINUUM LONGEVITY NEUTRAL LINER, KK 32 3,172.31 2,220.62
16100629 278 C1776 LEGACY KNEE POSTERIOR STABILIZED SIZE EF 3,954.31 2,768.02
16100630 278 C1713 SCREW CANNULATED 4.5 40MM 665.99 466.19
16100631 278 C1713 SCREW CANNULATED 4.5 52MM 852.47 596.73
16100632 278 WASHER 10 MM 123.24 86.27
16100633 278 C1713 SCREW CANNULATED 7.3MM 100MM 852.47 596.73
16100634 278 C1713 SCREW CANNULATED 7.3MM 115MM 873.78 611.65
16100635 278 C1713 SCREW CANNULATED7.3 95MM 852.47 596.73
16100636 278 C1713 SCREW CANNULATED 4.5 52MM 774.80 542.36
16100637 278 C1776 FEMORAL COMPONENT SIZE E-LT 6,752.07 4,726.45
16100638 278 C1776 ALL-POLY PATELLA 38MM 1,920.85 1,344.60
16100639 272 PATELLA REAMER BLADE SIZE 46 494.51 346.16
16100640 278 C1776 FEMORAL COMPONENT SIZE D LEFT 11,388.62 7,972.03
16100641 278 C1776 FEMORAL HEAD 32MM-3.5 2,056.24 1,439.37
16100642 278 C1776 VERSYS FM MC CLR 15X160MM STD NECK 12,021.12 8,414.78
16100643 278 C1713 PERIARTICULAR LOCKING SCREW 2.4MMX14MM 370.42 259.29
16100644 278 C1713 PERI LOCKING SCREW 3.5MMX16MM 370.42 259.29
16100645 278 C1713 SCREW CANNULATED 3.5MMX50MM 1/2 THREAD 647.34 453.14
16100646 272 GUIDE PIN 1.6MM X 6IN PARTIAL THREAD TIP 325.75 228.03
16100647 272 DRILL BIT Q-C 3.5MM DIA 110MM 273.50 191.45
16100648 278 C1776 FEMORAL HEAD 32MM+0 1,356.95 949.87
16100649 278 C1776 VERSYS 6 INCH BEADED FC 14X160MM STD NEC 8,305.49 5,813.84
16100650 272 SUTURE PASS THROUGH 167.21 117.05
16100651 272 SUTURE PASS THROUGH 167.21 117.05
16100652 272 SUTURE PASS THROUGH 167.21 117.05
16100653 278 C1776 CONTINUUM LONGEVITY NEUTRAL LINER, NN 32 3,172.31 2,220.62
16100654 278 C1776 VERSYS 6 INCH BEADED FC 15X160MM STD BOD 8,305.49 5,813.84
16100655 278 C1776 CONTINUUM LONGEVITY NEUTRAL LINER, OO 32 3,172.31 2,220.62
16100656 278 C1776 NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF 3,008.60 2,106.02
16100657 278 C1776 CONTINUUM LONGEVITY NEUTRAL LINER II 36X 3,172.32 2,220.62
16100658 278 C1776 CONTINUUM CLUSTER-HOLE SHELL 52 II 5,282.33 3,697.63
16100659 278 C1713 Z NAIL 5.0X100 LAG SREW 1,926.21 1,348.35
16100660 272 PASSER TWO PIN 774.45 542.12
16100661 278 C1776 CONTINUUM MULTI-HOLE SHELL 52 II 8,909.61 6,236.73
16100662 278 C1776 NEXGEN LPS-FLEX OPTION FEMORAL SIZE G-LT 6,752.07 4,726.45
16100663 278 C1776 MODULAR HEAD 32MM+3MM NECK 1,356.95 949.87
16100664 278 C1713 Z NAIL 10.5X105 LAG SCREW 1,926.21 1,348.35
16100665 278 Z NAIL CPM 11.5MMX21.5CM 130R 5,599.97 3,919.98
16100666 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X 3,172.31 2,220.62
16100667 272 GDE PIN 3.2MM X 12IN PARTIAL THD TROCAR 308.69 216.08
16100668 278 C1776 CONTINUUM CLUSTER-HOLE SHELL 50 HH 8,909.61 6,236.73
16100669 272 SCREW FORTE CANCELLOUS 4.0MMX22MM FULL T 239.62 167.73
16100670 272 ACL KIT CAYENNE 1,756.08 1,229.26
16100671 278 SCREW 9 MM X 25MM 1,387.31 971.12
16100672 278 SCREW 8 MM X 25MM 1,387.31 971.12
16100673 272 BLADE CONMED 280.27 196.19
16100674 272 KNIFE ACL GRAFT DEPUY 545.79 382.05
16100675 278 SCREW 8 MM X 25MM 1,387.31 971.12
16100676 278 C1776 NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF 3,008.60 2,106.02
16100677 278 C1713 PERI SCREW 3.5MM X 20MM W/2.7MM HEAD SEL 158.14 110.70
16100678 272 6.5MM CANNULATED SCREW 16MM THD 100MM 803.20 562.24
16100679 278 C1776 CONTINUUM MULTI-HOLE SHELL 48 GG 8,909.61 6,236.73
16100680 278 SCREW SPEED 1,229.26 860.48
16100681 272 PATELLA REAMER BLADE SIZE 51 494.51 346.16
16100682 278 C1713 6.5MM CANNULATED SCREW 16MM THD 105MM 803.19 562.23
16100683 278 C1713 6.5MM CANNULATED SCREW 16MM THD 110MM 803.19 562.23
16100685 278 WIRE MAGNUM 108.11 75.68
16100686 278 DISTAL LATERAL FIBULA RADIAL LOCKING 10H 2,995.38 2,096.77
16100687 278 PIN GUIDE 1.6MM X 6IN PARTIAL THREAD 325.59 227.91
16100688 278 C1713 4.0MM CANNULATED SCREW 1/3 THD 46MM 688.11 481.68
16100689 272 DRILL HAND FREE 4.3MM 152.5MM 377.70 264.39
16100690 278 C1713 Z NAIL 5.0X40 CORT SCREW FA 691.46 484.02
16100691 278 C1713 Z NAIL 5.0X42.5 CORT SCREW 708.75 496.13
16100692 278 C1713 Z NAIL CPM 11.5MMX36CM 7,976.58 5,583.61
16100693 272 DRILL HAND FREE 3.3MM 664.20 464.94
16100694 272 DRILL CALIB HUM AFFIXUS 1,770.17 1,239.12
16100695 272 C1713 AFFIXUS HUM BALL NOSE GW ST 1,398.60 979.02
16100696 272 C1769 WIRE AIRSCH W/TROCAR 2.5MM 172.20 120.54
16100697 272 C1713 SCREW BLUNT TIP AFFIXUS 4X56MM 745.92 522.14
16100698 272 C1713 SCREW BONE ANN CORT 4X30MM 722.61 505.83
16100699 272 C1713 NAIL PROXIMAL HUMERUS RT LONG AFFIXUS 8. 7,272.72 5,090.90
16100700 278 CEMEX GENTA 1,896.57 1,327.60
16100701 278 PASTE BONE 10 CC 7,375.57 5,162.90
16100702 278 PASTE BONE OPTECURE 4,636.08 3,245.26
16100703 278 C1713 5CC BEAT-BSM KIT 4,745.80 3,322.06
16100704 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER LL 36M 2,997.00 2,097.90
16100705 278 FEMORAL STEM SZ 16, 170MM 19,699.30 13,789.51
16100706 278 C1776 MODULAR HEAD 36MM +3MM NECK 2,692.14 1,884.50
16100707 278 C1713 Z NAIL 10.5X85 LAG SCREW 1,926.24 1,348.37
16100710 278 LOFT PFJ SIZE 3 20,089.67 14,062.77
16100711 278 C1776 BIPOLAR LINER 42/43 OD X 22MM ID 738.51 516.96
16100712 278 C1713 6.5MM CANNULATED SCREW 16MM THD 95MM 803.20 562.24
16100713 278 C1713 6.5MM CANNULATED SCREW 16MM THD 115MM 803.20 562.24
16100714 278 C1776 BIPOLAR SHEL 43MM OD 1,098.68 769.08
16100715 278 C1776 ARCOS 1PC 9.5X175MM BRCH BODY STD 10,988.83 7,692.18
16100716 278 C1776 22.2MM DIA COCR MOD HD - 5 NK 1,355.64 948.95
16100719 275 C1785 PACEMAKER LV GENERATOR 14,984.77 10,489.34
16100720 275 C1785 PACEMAKER DUAL CHAMBER WITHOUT LEADS 18,314.72 12,820.30
16100721 275 C1785 PACEMAKER DUAL CHAMBER 13,652.80 9,556.96
16100725 278 PACEMAKER LEAD 2,472.00 1,730.40
16100726 278 PACEMAKER LEAD 2,472.00 1,730.40
16100744 278 FEMORAL HEAD 4,193.55 2,935.49
16100745 278 DNU PEG PETELLA 2,196.00 1,537.20
16100746 278 PETELLA POLY 41 MM 2,025.97 1,418.18
16100749 278 PEG PETELLA 23 MM 2,935.84 2,055.09
16100750 278 DNU PEG PETELLA 23 MM 5,170.50 3,619.35
16100751 278 CONGRUENT TIBIAL INSERT 5,113.74 3,579.62
16100752 278 BASEPLATE CCM STEM TIBIAL SIZE 3 RIGHT 8,766.41 6,136.49
16100753 278 FEMORAL COMPONENT SIZE 4 RIGHT 14,607.16 10,225.01
16100754 272 BLADE LINVATEC/HALL 60X13X1.27 386.34 270.44
16100756 278 FEMORAL COMPONENT RLP POROUS SIZE 4 13,005.60 9,103.92
16100757 278 FEMORAL COMPONENT RLP POROUS SIZE 5 14,136.54 9,895.58
16100758 278 BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT 7,804.07 5,462.85
16100759 278 CONGRUENT TRIBIAL INSERT 3/4 10MM RT 3,972.27 2,780.59
16100760 278 FEMORAL COMPONENT RLP POROUS SIZE 3 13,005.60 9,103.92
16100761 278 FEMORAL COMPONENT POROUS SIZE 3 LEFT 14,607.16 10,225.01
16100762 278 CONGRUENT TRIBIAL INSERT 5,113.74 3,579.62
16100763 278 FEMORAL COMPONENT SIZE 3 14,136.54 9,895.58
16100764 278 CONGRUENT TRIBIAL INSERT 4,460.48 3,122.34
16100765 278 BASEPLATE CCM STEM TIBIAL SIZE 2 RIGHT 8,938.50 6,256.95
16100766 278 BASEPLATE CCM STEM TIBIAL SIZE 1 RIGHT 7,804.07 5,462.85
16100767 278 BASEPLATE CCM TIBIAL 2 LEFT 7,804.07 5,462.85
16100768 278 BASEPLATE CCM STEM TIBIAL SIZE 5 LEFT 7,804.07 5,462.85
16100769 278 BASEPLATE CCM TIBIAL 4 LEFT 7,804.07 5,462.85
16100770 278 STEM P SERIES 21,599.91 15,119.94
16100771 278 FEMORAL HEAD 3,995.11 2,796.58
16100772 278 BIPOLAR 5,882.91 4,118.04
16100773 278 CONGRUENT TRIBIAL INSERT 1/2 14MM RT 4,460.48 3,122.34
16100774 278 FEMORAL HEAD 5,443.88 3,810.72
16100775 278 FEMORAL COMPONENT RLP POROUS SIZE 2 RT 14,607.16 10,225.01
16100776 278 BIPOLAR COMPONENT 28X55 4,903.71 3,432.60
16100777 278 BIPOLAR 6,497.54 4,548.28
16100778 278 BIPOLAR 4,903.71 3,432.60
16100779 278 BIPOLAR 6,848.75 4,794.13
16100780 272 PRP KIT PROCEDURE 452.50 316.75
16100781 272 KIT APPLICATOR 737.56 516.29
16100782 278 CONGRUENT TRIBIAL INSERT 3/4 10MM LT 3,972.27 2,780.59
16100783 278 BIPOLAR 7,375.57 5,162.90
16100784 278 BIPOLAR 6,848.75 4,794.13
16100785 278 STEM P SERIES 27,395.02 19,176.51
16100786 278 STEM P SERIES 27,395.02 19,176.51
16100787 278 FEMORAL HEAD 4,326.13 3,028.29
16100788 278 BIPOLAR 4,903.71 3,432.60
16100789 278 BIPOLAR COMPONENT 4,903.71 3,432.60
16100790 278 FEMORAL COMPONENT RLP POROUS COCR 6 17,827.84 12,479.49
16100791 278 BASEPLATE CCM STEM TIBIAL SIZE 6 LEFT 8,766.41 6,136.49
16100792 278 CONGRUENT TRIBIAL INSERT 5/16 10MM LEFT 4,460.48 3,122.34
16100793 278 BASEPLATE CCM STEM TIBIAL SIZE 6 RIGHT 8,766.41 6,136.49
16100794 278 FEMORAL COMPONENT RLP POROUS SIZE 6 RT 17,827.84 12,479.49
16100795 278 ELEMENT STEM 19,699.30 13,789.51
16100796 278 TIBIAL INSERT CR SLOPE 5,147.98 3,603.59
16100800 278 FEMUR POROUS SIZE 4 13,005.60 9,103.92
16100801 278 STEM P SERIES 26,692.58 18,684.81
16100802 278 STEM P SERIES 25,287.71 17,701.40
16100803 278 STEM P SERIES 25,287.71 17,701.40
16100804 278 STEM P SERIES 27,395.02 19,176.51
16100806 278 STEM P SERIES 26,692.58 18,684.81
16100809 278 ELEMENT STEM 28,097.45 19,668.22
16100810 278 FEMORAL POROUS 20,809.67 14,566.77
16100811 278 TRAY TIBIAL TRAP 13,030.19 9,121.13
16100812 278 TIBIAL INSERT 7,270.21 5,089.15
16100814 278 C1776 NEXGEN LPS 5-6 12 MM 3,008.61 2,106.03
16100815 278 C1776 NEXGEN LPS FEMORAL SIZE E RT 6,752.07 4,726.45
16100816 278 C1776 NEXGEN LPS FEMORAL SIZE F RT 6,752.07 4,726.45
16100817 278 C1776 NEXGEN LPS FLEX FEMORAL SIZE F LT 6,752.07 4,726.45
16100818 278 C1776 NEXGEN LPS 5-6 17 MM 2,936.38 2,055.47
16100820 278 DURAT DEG INS 5,001.35 3,500.95
16100821 278 C1713 BONE SCREW 6.5 X 25 SELF TAP 236.46 165.52
16100822 278 C1776 M/L TAPER KINECTIV STEM SIZE 15 6,515.71 4,561.00
16100823 278 C1776 PSN FEM PS CMT CCR STD SZ7 L 6,752.17 4,726.52
16100824 278 C1776 PSN TIB STM 5 DEG SIZE F L 3,008.66 2,106.06
16100825 278 C1776 ARCOS 16X175MM BRCH BODY STD 10,989.00 7,692.30
16100826 278 C1776 PSN TIB STM 5 DEG SIZE F R 2,997.00 2,097.90
16100830 278 BASEPLATE CCM STEM TIBIAL SIZE 4 LEFT 7,804.07 5,462.85
16100831 278 BASEPLATE CCM STEM TIBIAL SIZE 5 RIGHT 7,804.07 5,462.85
16100834 278 FEMORAL POROUS SIZE 3 LEFT 14,425.76 10,098.03
16100835 278 C1713 PERI SCREW 3.5MM X 22MM W/2.7MM HEAD SEL 158.14 110.70
16100836 278 C1713 SCREW FORTE CANCELLOUS 4.0MMX20MM FULL T 227.21 159.05
16100837 278 C1713 LOCKING SCREW 3.5 x 14MM 1,452.87 1,017.01
16100838 278 C1713 LOCKING SCREW 3.5 X 16MM 1,452.87 1,017.01
16100839 278 C1713 LOCKING SCREW 3.5MM X 20MM 1,452.87 1,017.01
16100840 278 C1713 LOCKING SCREW 3.5 X 22MM 1,452.87 1,017.01
16100841 278 C1713 TEMP FIXATION PIN 1.1MM SMALL 489.51 342.66
16100842 278 C1713 DRILL BIT 2.5 X 60MM 1,165.50 815.85
16100843 278 C1713 K-WIRE 1.1 X 150MM BLUNT 113.91 79.74
16100844 278 C1713 MTP PLATE RIGHT 12,239.71 8,567.80
16100845 278 C1713 SCREW LAG 3.5 X 32MM 1,648.18 1,153.73
16100850 278 CONGRUENT TRIBIAL INSERT 3/4 14MM LEFT 4,460.48 3,122.34
16100851 278 CONGRUENT TRIBIAL INSERT 5/16 12MM LEFT 3,972.27 2,780.59
16100852 278 C1776 LEGACY KNEE POSTERIOR STABILIZED SIZE E 3,008.60 2,106.02
16100853 278 BASEPLATE CCM TIBIAL COCR 4 LEFT 7,804.07 5,462.85
16100854 278 FEMORAL COMPONENT RLP POROUS COCR 5 13,005.60 9,103.92
16100855 278 PEG PETELLA 26 MM 4,232.17 2,962.52
16100856 278 TIBIAL INSERT PCL SIZE 3/4 10MM 3,972.27 2,780.59
16100857 278 BASEPLATE CCM TIBIAL COCR 3 LEFT 8,766.41 6,136.49
16100858 278 FEMORAL POROUS SZ 5 RIGHT 21,652.60 15,156.82
16100859 278 TRAY TIBIAL TRAP SZ 5F/5T 13,557.02 9,489.91
16100860 278 TIBIAL INSERT SIZE 5 15MM 6,919.00 4,843.30
16100861 278 FEMORAL POROUS SZ 4 RIGHT 13,316.08 9,321.26
16100862 278 PEG PETELLA 4,232.17 2,962.52
16100863 278 PEG PATELLA 4,407.79 3,085.45
16100864 278 FEMORAL STEM SZ 15, 165MM 18,183.96 12,728.77
16100865 278 BIPOLAR COMPONENT 4,794.12 3,355.88
16100866 278 C1776 PROLONG HIGHLY CROSSLINKED POLYETHYLENE 1,920.85 1,344.60
16100867 278 C1776 LEGACY KNEE POSTERIOR STABILIZED 3,008.60 2,106.02
16100868 278 C1776 TAPER STEM PLUG NEXGEN 1,586.15 1,110.31
16100869 278 C1776 LEGACY KNE POSTERIOR STABILIZED 6,752.07 4,726.45
16100870 278 C1713 PALACOS R+G 1X40 SINGLE BONE CEMENT 982.34 687.64
16100871 272 PATELLA REAMING BLADE SIZE 41 494.51 346.16
16100872 278 C1776 STEMMED TIBIAL COMPONENT PRECOAT SIZE 5 3,252.36 2,276.65
16100873 278 C1776 LEGACY KNEE POSTERIOR STABILIZED SIZE E 3,008.60 2,106.02
16100874 278 C1776 STEMMED TIBIAL COMPONENT PRECOAT SIZE 4 3,252.36 2,276.65
16100875 278 C1776 ALL-POLY PATELLA 32MM 1,920.85 1,344.60
16100876 278 C1776 LEGACY KNEE POSTERIOR STABILIZED SIZE C 3,008.60 2,106.02
16100877 278 C1776 LEGACY KNE POSTERIOR STABILIZED SIZE D 6,752.07 4,726.45
16100878 278 C1776 NEXGEN PROLONG ALLPOLY PATELLA, 29MM 1,920.85 1,344.60
16100879 272 PATELLA REAMER BLADE SIZE 38 494.51 346.16
16100880 278 C1776 LEGACY KNE POSTERIOR STABILIZED SIZE R-L 6,752.07 4,726.45
16100881 278 C1776 NEXGEN PRECOAT STEMTIBIAL PLATE SZ 4 3,252.36 2,276.65
16100882 278 C1776 LEGACY KNEE POSTERIOR STABILIZED SZ CD 3,954.31 2,768.02
16100883 278 C1776 LEGACY KNE POSTERIOR STABILIZED SIZE D-L 6,752.07 4,726.45
16100884 278 C1776 STEMMED TIBIAL COMPONENT PRECOAT SIZE 6 3,252.36 2,276.65
16100885 272 PATELLA REAMER BLADE SIZE 35 349.25 244.48
16100886 278 C1713 REFOBACIN BONE CEMENT R 1X40 US 599.40 419.58
16100887 278 C1776 NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD 3,008.60 2,106.02
16100888 278 C1713 HEADLESS TROCAR DRILL PIN75MM 855.81 599.07
16100899 278 C1776 NEXGEN LPS FLEX FIXED PROLONG ART SUR EF 3,008.60 2,106.02
16100900 278 CUP MAGNUM 580DX521D 19,366.16 13,556.31
16100901 278 CUP MAGNUM PF 480DX42ID 20,433.87 14,303.71
16100902 278 C1776 NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 3 3,252.36 2,276.65
16100903 278 CUP MAGNUM PF 500DX44ID 21,557.77 15,090.44
16100904 278 C1776 NEXGEN LPS FLEX FIXED PROLONG ART SUR CD 3,008.60 2,106.02
16100905 278 CUP MAGNUM 620DX561D M2A 19,366.16 13,556.31
16100906 278 CUP MAGNUM 50ODX48ID 20,117.77 14,082.44
16100907 278 MAGNUM PF CUP 50ODX46ID 21,557.77 15,090.44
16100908 278 CUP MAGNUM 54ODX48ID 20,433.87 14,303.71
16100909 278 ACT ARTIC HD ARCOM XL 28X46MM 9,616.00 6,731.20
16100910 278 ACT ARTIC HD ARCOM XL 28X44MM 9,616.00 6,731.20
16100911 278 M2A MAGNUM PF CUP 50ODX44ID 21,557.77 15,090.44
16100912 278 ACT ARTIC HD ARCOM XL 28X50MM 9,616.00 6,731.20
16100913 278 CUP MAGNUS 56ODX50ID 21,557.77 15,090.44
16100914 278 C1776 NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD 3,008.60 2,106.02
16100915 278 C1776 NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 2 4,745.18 3,321.63
16100916 278 C1776 NEXGEN LPS FLEX FIXED PSIZE CD 12MM 3,862.33 2,703.63
16100917 278 C1776 NEXGEN LPS FLEX FIXED PROLONG ART SUR GH 3,008.60 2,106.02
16100918 278 C1776 NEXGEN LPS FLEX FIXED PROLONG ART SUR GH 3,008.60 2,106.02
16100919 278 C1776 NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD 3,008.60 2,106.02
16100920 278 MAGNUM 12/14 TPR 52-60 STD 2,037.06 1,425.94
16100921 278 MAGNUM 12/14 TPR 52-60 +9 2,037.06 1,425.94
16100922 278 C1776 ARCOS 13X175M BRCH BODY STD 10,988.83 7,692.18
16100923 278 C1776 ARCOS 12X175MM BRCH BODY STD 10,988.83 7,692.18
16100924 278 C1776 NEXGEN LPS FLEX FIXED PROLONG ART SUR GH 3,008.60 2,106.02
16100925 278 C1776 NEXGEN LPS FLEX FIXED PROLONG ART SUR EF 3,008.60 2,106.02
16100926 278 C1776 ACROS 1PC 14X175MM BRCH BODY STD 10,988.83 7,692.18
16100927 278 28MM MOD HD STD NECK TP1 TAPER 1,355.64 948.95
16100928 278 C1713 PSN 2.5MM FEMALE SCREW 25MM 466.20 326.34
16100929 278 C1776 PSN FEM PS CMT CCR NRW SIZE 5 L 5,827.50 4,079.25
16100930 278 CER BIOLOXD OPTION HD 28MM 10,164.26 7,114.98
16100931 278 CER OPTION 12/14 TPR SLEEVE +4 1,176.58 823.61
16100932 278 C1776 PSN ASF PS 16MM VE L 3-5 CD 3,008.60 2,106.02
16100933 278 C1776 PSN TIB STM 5 DEG SIZE D L 2,997.00 2,097.90
16100934 278 C1776 ALL POLY PAT VE 32MM DIA 1,920.85 1,344.60
16100935 278 C1776 ARCOS 11X175MM BRCH BODY STD 10,988.83 7,692.18
16100936 278 C1776 PSN FEM PS CMT CCR STD SZ8 L 6,752.17 4,726.52
16100937 278 C1776 PSN ASF PS 10MM VE L 6-9 GH 2,830.50 1,981.35
16100938 278 C1776 PSN TIB STM 5 DEG SZ G L 2,997.00 2,097.90
16100939 278 C1776 ALL POLY PAT VE 38 MM DIA 1,920.87 1,344.61
16100940 278 MAGNUM MOD HD SZ 52MM 7,347.49 5,143.24
16100941 278 MAGNUM MOD HD SZ 56MM 7,347.49 5,143.24
16100942 278 CUP MAGNUM M2A 12/14 TPR 42-50+3 2,149.46 1,504.62
16100943 278 MAGUM M2A MOD HD SZ 48MM 7,754.89 5,428.42
16100944 278 C1776 PSN FEM PS CMT CCR STD SZ10 L 5,827.50 4,079.25
16100945 278 C1776 PSN ASF PS 12MM VE L 10-12 GH 2,830.50 1,981.35
16100946 278 C1776 ALL POLY PAT VE 41 MM DIA 1,415.25 990.68
16100947 278 C1776 BIOLOX DELTA FEM HEAD, 32MM, +0MM 2,414.25 1,689.98
16100948 278 C1776 PSN FEM PS CMT CRR NRW SZ9 R 5,827.50 4,079.25
16100949 278 C1776 PSN TIB STM 5 DEG SZ E R 3,252.41 2,276.69
16100950 278 ACT ARTIC E1 28MM ID X 42MM OD 9,809.52 6,866.66
16100951 278 C1776 PSN ASF PS 10MM VE R 6-9 EF 3,008.65 2,106.06
16100952 278 C1776 ALL POLY PAT VE 35 MM DIA 1,415.25 990.68
16100953 278 C1776 PSN FEM PS CMT CRR NRW SZ8 R 6,752.07 4,726.45
16100954 278 C1776 PSN ASF PS 16MM VE L 6-9 CD 3,008.60 2,106.02
16100955 278 C1776 PSN ASF PS 11MM VE R 6-9 EF 3,008.65 2,106.06
16100956 278 C1776 PSN FEM PS CMT CCR NRW SIZE 6 R 6,752.17 4,726.52
16100957 278 C1776 M/L TAPER KINECTIV STEM SIZE 12.5 6,515.71 4,561.00
16100958 278 C1776 PSN FEM PS CMT CCR STD SZ10 R 5,827.50 4,079.25
16100959 278 C1776 PSN ASF PS 10MM VE L 10-12 GH 3,008.65 2,106.06
16100960 278 C1776 PSN FEM PS CMT CCR STD SZ11 R 6,752.17 4,726.52
16100961 278 C1776 PSN ASF PS 10MM VE R 10-12 GH 2,830.50 1,981.35
16100962 278 C1776 PSN ASF PS 10MM VE L 6-9 EF 3,008.65 2,106.06
16100963 278 C1776 BF HUMERAL HEAD 15MMX46MM 4,372.48 3,060.74
16100964 278 C1776 TM HUMERAL STEM 48 DEG 11MMX130MM 11,183.20 7,828.24
16100965 278 C1776 PSN FEM PS CMT CCR STD SZ9 R 6,752.17 4,726.52
16100966 278 C1776 PSN TIB STM 5 DEG SZ G R 2,997.00 2,097.90
16100967 278 C1776 PSN ASF PS 11MM VE R 6-9 GH 3,008.65 2,106.06
16100968 278 C1776 PSN ASF PS 10MM VE L 10-12 GH 3,008.65 2,106.06
16100969 278 C1776 PSN ASF PS 12MM VE R 10-12 GH 3,008.66 2,106.06
16100970 278 PSN FEM PS CMT CCR STD SZ12 R 6,752.17 4,726.52
16100971 278 PSN ASF PS 11MM VE R 10-12 GH 3,008.65 2,106.06
16100972 278 C1776 ALL POLY PAT VE 38 MM DIA 1,415.25 990.68
16100975 278 C1776 PSN FEM PS CMT CCR STD SZ11 L 5,827.50 4,079.25
16100976 278 C1776 PSN FEM PS CMT CCR STD SZ7 L 5,827.50 4,079.25
16100977 278 C1776 PSN ASF PS 12MM VE L 6-9 EF 2,830.50 1,981.35
16100978 278 C1776 PSN ASF PS 10MM VE R 6-9 GH 3,008.65 2,106.06
16100979 278 C1713 GEMINUS VOLAR DISTAL RADIUS 3,593.07 2,515.15
16100980 278 C1713 SMOOTH PEG LOCKING 2.00X16MM 369.27 258.49
16100981 278 C1713 SMOOTH PEG LOCKING 2.0X18MM 369.27 258.49
16100982 278 C1713 SMOOTH PEG LOCKING 2.7X22MM 396.27 277.39
16100983 278 C1713 HIGH COMPRESSION LOCKING PEG 2.7X22MM 426.24 298.37
16100984 278 C1713 SCREW CORTICAL LOCKING 3.5X10MM 392.94 275.06
16100985 278 C1713 SCREW CORTICAL LOCKING 3.5X12MM 392.94 275.06
16100986 278 C1713 SCREW CORTICAL NON LOCKING 3.5X10MM 386.28 270.40
16100987 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X 2,997.00 2,097.90
16100988 278 C1776 32MM MOD HEAD COCR +6mm NECK 1,355.62 948.93
16100989 278 C1776 ARCOS 12X175MM BRCH BODY HI 10,988.83 7,692.18
16100990 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER, KK 32 3,172.31 2,220.62
16100991 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER II 32X 3,172.31 2,220.62
16100992 278 C1776 PSN FEM PS CMT CCR NRW SZ7 R 6,752.17 4,726.52
16100993 278 C1776 PSN ASF PS 12MM VE L 6-9 EF 3,008.65 2,106.06
16100994 278 CABLE GRIP SYS,4X40MM 1,992.60 1,394.82
16100995 278 CABLE GRIP SYS W/TWO CRIMP 4X35MM 1,992.60 1,394.82
16100996 278 C1776 PSN ASF PS 14MM VE L 10-12 GH 3,008.65 2,106.06
16100997 272 *PATELLA REAMER BLADE SIZE 41 368.36 257.85
16100998 278 C1776 PSN TIB STM 5 DEG SIZE E L 3,252.36 2,276.65
16100999 636 Q4186 DRESSING EPIFIX 2X3 634.43 444.10
16101000 278 C1713 PIN GUIDE 3.2 MM 639.35 447.55
16101001 278 C1713 SCREW LAG 85MM 937.92 656.54
16101002 278 C1713 SCREW 4.7 X 25.4 MM 195.48 136.84
16101003 278 SCREW 4.5 X 44MM 140.38 98.27
16101004 278 SCREW 4.5 X 38MM 140.38 98.27
16101005 278 SCREW 2.4 X 16MM CANNOLATED 544.38 381.07
16101006 278 C1889 AFB1115-AVAFLEXBALLOON 11G 15MM 8,576.42 6,003.49
16101007 278 C1713 AUTOPLEX W/VERTAPLEX HV 3,466.26 2,426.38
16101008 272 IVAS 11G BIOPSY 292.54 204.78
16101009 278 C1889 CURETTE 11G 1,968.80 1,378.16
16101010 278 C1889 11G IVAS ACCESS CANNULA 250.17 175.12
16101011 278 C1889 11G 20MM AVAFLEX KIT 8,576.42 6,003.49
16101012 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER GG 32X 3,172.31 2,220.62
16101014 278 C1776 PSN ASF PS 10MM VE L 10-11 EF 3,008.65 2,106.06
16101015 278 C1776 PSN TIB STM 5 DEG SIZE F L 2,997.00 2,097.90
16101016 278 C1776 PSN ASF PS 14MM VE L 6-9 EF 2,830.50 1,981.35
16101017 278 C1776 PSN TIB STM 5 DEG SZ E L 2,997.00 2,097.90
16101018 278 C1776 PSN ASF PS 14MM VE R 6-9 EF 3,008.65 2,106.06
16101020 278 C1776 CER BIOLOXD OPTION HD 32MM 3,473.36 2,431.35
16101021 278 C1889 CER OPTION TYPE 1 TPR SLEEVE +3 945.89 662.12
16101022 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER, JJ 3 3,172.31 2,220.62
16101023 278 C1776 CER BIOLOXD OPTION HD 36MM 3,473.36 2,431.35
16101024 278 C1889 CER OPTION TYPE 1 TPR SLEEVE +6 945.89 662.12
16101025 272 COMP RVS 2.7 MM DIA DRL 772.35 540.65
16101026 278 C1713 COMP REV SHLDR 9 IN STEINMANN 530.20 371.14
16101027 272 COMP RVS 3.2 MM DRL 563.50 394.45
16101028 278 C1776 COMP RVS 25MM BSPLT HA+ADPTR 5,744.25 4,020.98
16101029 278 C1713 HMRL BEARING 36 MM + 3 VITE 6,127.20 4,289.04
16101030 278 C1776 HMRL TRAY +3 STD 5,296.20 3,707.34
16101031 278 C1713 COMP NLK SCR 3.5HEX 4.75X25 ST 484.69 339.28
16101032 278 C1713 COMP NLK SCR 3.5HEX 4.75X20 ST 471.03 329.72
16101033 278 C1776 COMP RVRS SHLDR GLNSP STD 36MM 4,583.91 3,208.74
16101034 278 C1713 COMP RVS CNTRL 6.5X25MM ST/RST 463.37 324.36
16101035 278 C1713 AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 15MM 1,984.68 1,389.28
16101036 278 C1713 CANNULATED COMPRESSION SCREW W/ S.S. 1,651.68 1,156.18
16101037 278 C1713 AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 17MM 1,984.68 1,389.28
16101038 278 C1713 AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 16MM 2,042.24 1,429.57
16101039 272 A4649 COUNTERSINK 2.0 - 2.5MM CANNULATED 1,798.95 1,259.27
16101040 272 MRI STERILE SHORT OSTEOTOME BLADE 12MM 383.78 268.65
16101041 278 C1713 COMP RV SHLDR GD AND BN R 3,906.29 2,734.40
16101042 278 C1713 COMP LK SCR 3.5 HEX 4.75X20 ST 484.69 339.28
16101043 278 C1776 COMP PRIMARY STEM 9MM MINI 13,570.42 9,499.29
16101044 278 C1713 HMRL BEARING 36MM STD VITE 6,304.89 4,413.42
16101045 278 C1713 COMP LK SCR 3.5 HEX 4.75X30 ST 484.69 339.28
16101046 278 C1776 PSN ASF PS 13MM VE R 10-12 EF 3,095.90 2,167.13
16101047 278 C1889 CER OPTION TYPE 1 TPR SLEEVE 0MM 973.32 681.32
16101048 278 C1776 PSN ASF PS 16MM VE R 10-12 GH 3,008.65 2,106.06
16101049 278 C1776 PSN FEM CR POR CCR STD SZ8 R 10,722.60 7,505.82
16101100 278 C1713 PLATE 135 DEGREE 3 HOLE 1,442.37 1,009.66
16101101 278 C1713 SCREW CORTICAL NON LOCKING 3.5X12MM 386.28 270.40
16101102 278 C1769 K-WIRE 1.6X127MM 143.50 100.45
16101103 278 C1713 DRILL SOLID SIDE CUTTING 2X40MM 459.54 321.68
16101104 278 C1713 DRILL SOLID SIDE CUTTING 2.5X40MM 469.53 328.67
16101105 278 C1713 DRIVER PEG TORQUE 462.87 324.01
16101200 278 NITINOL SPEED 18X18X15MM 5,250.72 3,675.50
16101201 272 GUIDE 1,387.31 971.12
16101223 278 C1713 XEMPLIFI DBM PUTTY 5 CC 3,426.57 2,398.60
16101224 278 C1713 CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY 1,317.09 921.96
16101225 278 C1713 CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY 1,248.75 874.13
16101226 278 C1713 CREO MIS 5.5X40MM CURVED ROD TITANIUM AL 1,279.97 895.98
16101227 278 C1713 CREO AMP 6.5X45MM MODULAR CANNULATED SCR 1,998.00 1,398.60
16101228 278 SUSTAIN RADIOLUCENT SPACER 8X22 8MM 20,195.35 14,136.75
16101229 278 C1713 CREO MIS MODULAR POLYAXIAL TULIP 30MM RE 1,998.00 1,398.60
16101230 278 C1889 COLONIAL ACDF SPACER 12X14 7DEGREE 7MM 3,330.00 2,331.00
16101231 278 XEMPLIFI DBM PUTTY 3 CC 2,370.75 1,659.53
16101232 278 C1889 COLONIAL ACDF SPACER 12X14 7DEGREE 6MM 3,426.57 2,398.60
16101233 278 C1889 COLONIAL ACDF SPACER 12X14 7DEGREE 10MM 3,395.70 2,376.99
16101234 278 C1713 BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI 749.25 524.48
16101235 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL 3,300.00 2,310.00
16101236 278 C1713 XEMPLIFI DBM PUTTY 1 CC 832.50 582.75
16101237 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL 3,300.00 2,310.00
16101238 278 C1713 BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI 749.25 524.48
16101239 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL 3,300.00 2,310.00
16101240 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL 3,300.00 2,310.00
16101241 278 C1713 DISTRACTION PIN 12MM 171.33 119.93
16101242 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL 3,395.70 2,376.99
16101243 278 C1713 DISTRACTION PIN 14MM 171.33 119.93
16101244 278 C1713 BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI 770.98 539.69
16101245 278 C1889 COLONIAL ACDF SPACER 12X14 0DEGREE 6MM 3,395.70 2,376.99
16101246 278 C1889 COLONIAL ACDF SPACER 12X14 7DEGREE 5MM 3,395.70 2,376.99
16101247 278 C1889 COLONIAL ACDF SPACER 12X14 0 DEGREE 5MM 3,426.57 2,398.60
16101248 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 3-LEVEL 3,426.57 2,398.60
16101933 278 C1776 PSN TIB STM 5 DEG SIZE D R 3,252.36 2,276.65
16101940 636 Q4186 EPIFIX 2.0x2.0 CM 820.43 574.30
16101945 278 C1776 PSN FEM PS CMT CRR NRW SZ6 L 5,827.50 4,079.25
16101946 278 C1776 PSN FEM PS CMT CRR NRW SZ5 R 5,827.50 4,079.25
16101948 278 C1776 PSN FEM PS CMT CRR NRW SZ6 R 6,752.07 4,726.45
16101949 278 C1776 PSN MC VE ASF R 10MM 8-11 GH 3,008.66 2,106.06
16101951 278 C1776 PSN ASF PS 12MM VE R 6-9 CD 3,008.65 2,106.06
16101952 278 C1776 PSN ASF PS 10MM VE R 6-9 CD 3,008.65 2,106.06
16101953 278 C1776 JOINT DEVICE (IMPLANTABLE) 3,008.65 2,106.06
16101954 278 C1776 PSN ASF PS 11MM VE L 3-5 CD 3,008.65 2,106.06
16101955 636 Q4186 EPIFIX 5.0X6.0 CM 669.86 468.90
16101956 636 Q4186 EPIFIX 4.0X4.0 CM 653.51 457.46
16101957 636 Q4186 EPIFIX 3.0 X 4.0 CM CONSIGN 0.01 0.01
16101958 636 Q4186 DRESSING EPIFIX 18MM DISC 2,614.86 1,830.40
16101960 636 Q4186 EPIFIX 2.0x4.0 CM 592.69 414.88
16101961 278 C1776 PSN FEM PS CMT CRR NRW SZ7 R 6,947.88 4,863.52
16101962 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL 3,395.70 2,376.99
16101963 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL 3,395.70 2,376.99
16101972 278 C1776 PSN ASF PS 13MM VE R 6-9 CD 3,008.66 2,106.06
16101973 272 6.5MM CANNULATED SCREW 16MM THD 90MM 803.20 562.24
16101974 272 FLUID COLLECTION BAG 59.78 41.85
16102000 272 DRILL BIT 3.2 179.19 125.43
16102001 272 TIP IMPACTOR 1,735.03 1,214.52
16102002 272 TAP LAG SCREW 3,863.39 2,704.37
16102003 278 DRILL BIT 1.7 986.92 690.84
16102004 278 HUMERAL STEM 8,309.82 5,816.87
16102005 278 HUMERAL HEAD 6,323.69 4,426.58
16102006 278 REPLICATOR PLATE TORQUE SCREW DRIVER 5,216.47 3,651.53
16102010 278 HUMERAL STEM 11,168.74 7,818.12
16102011 278 HUMERAL ADAPTER TRAY 7,693.44 5,385.41
16102012 278 GLENOID PLATE 6,392.17 4,474.52
16102013 278 GLENOSPHERE 8,534.60 5,974.22
16102014 278 HUMERAL LINER 4,864.37 3,405.06
16102015 278 TORQUE DEFINING SCREW 1,061.55 743.09
16102016 272 DRILL BITS 1,278.43 894.90
16102017 278 GLENOSPHERE LOCKING SCREW 490.82 343.57
16102018 278 COMPRESSION SCREW/LOCKING CAP KIT 702.44 491.71
16102019 278 COMPRESSION SCREW/LOCKING CAP KIT 702.44 491.71
16102020 278 COMPRESSION SCREW/LOCKING CAP KIT 702.44 491.71
16102021 278 COMPRESSION SCREW/LOCKING CAP KIT 490.82 343.57
16102022 278 COMPRESSION SCREW/LOCKING CAP KIT 490.82 343.57
16102023 278 COMPRESSION SCREW/LOCKING CAP KIT 490.82 343.57
16102025 278 HUMERAL STEM 7,761.92 5,433.34
16102026 278 GLENOSPHERE 5,935.59 4,154.91
16102027 278 HUMERAL LINER 3,378.72 2,365.10
16102028 278 C1713 3.5MM CORTICAL SCREW SELF-TAP SMALL HEX 103.11 72.18
16102029 278 C1713 3.5MM ULS T-PLT 4H HEAD 6H SHAFT 85MM 1,397.63 978.34
16102030 278 C1713 5CC BETA-BSM KIT 4,745.80 3,322.06
16103000 278 VENOUS OUTFLOW COMPONENT 8,095.58 5,666.91
16103001 278 ARTERIAL GRAFT COMPONENT 3,547.30 2,483.11
16103002 278 ACCESSORY COMPONENT KIT 1,791.21 1,253.85
16103012 272 VIATRAC 14 PLUS 4X20, 135CM 1,036.10 725.27
16103013 278 C1884 EMBOSHIELD NAV PROTECT SYSTEM 5,644.27 3,950.99
16103014 278 STENT XACT 8-6X30 8,587.28 6,011.10
16103015 272 VIATRAC 14 PLUS 4X30, 135CM 1,036.10 725.27
16103016 272 VIATRAC 14 PLUS 6X30, 135CM 1,036.10 725.27
16103017 278 STENT XACT 10-8MMX40MM 8,587.28 6,011.10
16103018 272 VIATRAC 14 PLUS 5X30, 135CM 1,036.10 725.27
16107600 278 GUIDE WIRE .035X4 P/T 86.50 60.55
16107601 278 CROWN CUP CLUSTER HOLE SHELL 7,942.26 5,559.58
16107602 278 CROWN CUP GXL LINER 6,837.33 4,786.13
16107603 278 FEMORAL STEM ELEMENT 19,699.30 13,789.51
16107604 278 FEMORAL HEAD COCR 28MM DIA 3MM NK 1,355.64 948.95
16107605 278 FEMORAL HEAD COCR 4,634.33 3,244.03
16107606 278 FEMORAL HEAD COCR 4,634.33 3,244.03
16108000 636 Q4101 APLIGRAPH PER SQ CM 4,653.63 3,257.54
16108001 278 C1713 BB-TAK 166.56 116.59
16108002 278 C1713 BB-TAK, THREADED 283.05 198.14
16108003 278 C1713 LO-PRO SCRW,TI,3.0MMX 14MMCORT 366.29 256.40
16108004 278 C1713 LO-PRO SCRW,TI,3.0MMX 16MMCORT 366.29 256.40
16108005 278 C1713 LO-PRO SCRW,TI,3.0MMX 18MMCORT 366.29 256.40
16108006 272 CANNULATED DRILL BIT, 2.0MM (AO) 189.18 132.43
16108007 278 C1713 LO-PRO SCRW,TI,3X 28MMCANN,PT THD 409.58 286.71
16108008 278 C1769 GUIDEWIRE, .045 X5.91 28.70 20.09
16108009 272 C1713 LO-PRO LOCK SCRW,TI3.0MMX 14MM 459.53 321.67
16108010 278 C1713 LO-PRO LOCK SCRW,TI,3.0MMX 16M 366.29 256.40
16108011 278 C1769 .062 GUIDE WIRE WITH TROCAR TIP 61.50 43.05
16108012 272 DRILL BIT, 2.0MM (AO) 298.54 208.98
16108013 278 C1713 LO-PRO MTP PLT TM CONTRD,SHT,L,TI 2,663.96 1,864.77
16108014 278 C1713 SPEEDBRG IMP SYS W/BIO-COMP SWVLK 5,794.11 4,055.88
16108015 272 A4649 CANNULATED DRILL 3.5MM 614.63 430.24
16108016 272 A4649 BONE TAP 4.5MM CANNULATED 614.63 430.24
16108017 272 A4649 BONE TAP 5.5MM CANNULATED 614.63 430.24
16108018 272 A4649 BONE TAP 6.0MM 614.63 430.24
16108019 272 A4649 GUIDEWIRE W/TRCR TIP 2MMX200MM 614.63 430.24
16108020 278 C1713 LO-PRO SCRW,TI,5.5MMX45MM 2,647.31 1,853.12
16108021 278 C1713 LO-PRO SCREW TI 3.0MMX20CORT 366.29 256.40
16108022 278 C1713 LO-PRO SCRW,TI,3.0MMX 22MMCORT 366.29 256.40
16108023 278 C1713 3.0X12MM VAL SCREW TI 466.19 326.33
16108024 278 C1713 3.0X14MM VAL SCREW TI 466.19 326.33
16108025 278 C1713 3.0X20MM VAL SCREW TI 466.19 326.33
16108026 278 C1713 LO-PRO MTP PLATE STR, LONG TI 2,663.96 1,864.77
16108027 278 C1713 PHALANGEAL REAMER 22MM 1,498.48 1,048.94
16108028 278 C1713 METATARSAL REAMER 22MM 1,498.48 1,048.94
16108029 278 DECELLULARIZED DERMIS 31,883.59 22,318.51
16108030 278 C1713 SPEEDBRG IMP SYS W/BIO-COMP SWVLK 6,519.31 4,563.52
16108031 278 C1713 FHL IMPLANT SYSTEM 6.25 MM 4,978.35 3,484.85
16108032 278 C1713 TENO SCREW KIT DISP. 649.35 454.55
16108033 278 C1713 COMPR FT SCREW MINI 3.5 X 32MM 1,165.50 815.85
16108034 278 C1713 COMPR FT SCREW MINI 3.5 X 34MM 1,165.50 815.85
16108035 272 A4649 G-WIRE W/TRCR TIP .45 W/ LASER LINE 63.28 44.30
16108036 272 DRILL BIT2.7MM CMP FT CALIBRATED 668.18 467.73
16108037 272 A4649 DRILL PROFILE MINI CMP FT 513.99 359.79
16108038 272 DRL BIT 5.0MM CANN 599.65 419.76
16108039 278 C1713 COMPR FT SCRE XL 7 X 55MM 2,314.35 1,620.05
16108040 278 C1713 COMPR FT SCREW XL 7 X 60MM 2,314.35 1,620.05
16108041 272 A4649 GUIDEWIRE W/TRCR TIP 2.4MMX9.25 63.28 44.30
16108042 272 A4649 GUIDEWIRE W/TRCR TIP 2.4MMX9.25 126.57 88.60
16108100 278 MAIN PUMP TUBING 214.33 150.03
16108101 272 MULTIFIRE SCORPION NEEDLE 597.07 417.95
16108102 272 SUTURE ANCH BIOCOMP SWI-VELOCK C CLD 4.7 1,404.87 983.41
16108103 278 C1713 CANNULA TWIST-IN NOTCHED 108.11 75.68
16108104 272 FIBERLINK 175.67 122.97
16108105 278 BONE CUTTER 4.0MMX13CM 231.80 162.26
16108106 272 FIBERTAPE 175.61 122.93
16108107 278 C1713 SYNDESMOSIS TIGHTROPE XP IMPLANT STAINLE 4,978.35 3,484.85
16108109 272 FIBERWIRE #2 BLU 38 W/2 STR DP NDL 190.27 133.19
16108110 278 TORPEDO 4.0MMX13CM 354.73 248.31
16108111 272 TAPERES CRVD NDL 26MM 1/2 CIRCLEX/LOOP 77.90 54.53
16108112 272 PUNCH, DISP CRKSCREW SWVLK ANCHS 263.41 184.39
16108113 272 DBL LOADED 4.75MM BIO-COMP SWVLK 1,464.61 1,025.23
16108114 272 BIO-COMP SWIVELOCK C, FT, 4.75X19.1MM 1,650.75 1,155.53
16108115 272 BIO-COMP, SWIVELOCK C, TT, 4.75X19.1MM 1,650.75 1,155.53
16108116 278 C1713 IMPLANT SYS, BIOC ACHILLES SPEEEDB W JUM 6,643.35 4,650.35
16108117 278 C1713 IMPLANT SYS, BIOC ACHILLES SPEEDB W/JUMP 2,044.88 1,431.42
16108118 278 L8699 UROLIFT UL400 DELIVERY DEVICE & IMPLANT 3,246.75 2,272.73
16109000 272 ABIATOR LIGHTWAVE SUCTION 337.50 236.25
16109009 278 C1713 3.2MM THREAD PIN, 508MM 444.51 311.16
16109010 272 CODA SHAVER 4.2MM 149.01 104.31
16109011 278 SCREW COMPRESSION LAG 206.18 144.33
16109012 278 FEMORAL NAIL 5,599.97 3,919.98
16109013 278 C1713 LAG SCREW 80MM 2,316.25 1,621.38
16109014 272 GUIDE WIRE TEAR DROP 705.00 493.50
16109015 272 GUIDE PIN 3.2MM 913.17 639.22
16109016 278 SCREW LAG 80MM 12.7 MM 965.12 675.58
16109017 278 FEMORAL FIXATION 3 HOLE 135 DEGREE 1,521.30 1,064.91
16109018 278 SCREW CORTICAL 4.5MM 40MM 67.93 47.55
16109019 278 C1713 3MMx100CM TEARDROP GD 580.34 406.24
16109020 272 TUBE SET 24K 161.00 112.70
16109021 272 TUBE SET 24K 33.25 23.28
16109022 278 Z NAIL 10.5X95 LAG SCREW 75MM 1,926.24 1,348.37
16109023 278 C1776 FEMORAL NAIL 10MMX21.5CM 130 R 5,309.41 3,716.59
16109024 278 C1776 BIPOLAR LINER 53/54/55MM OD X 28MM ID 738.51 516.96
16109025 278 C1776 BIPOLAR SHELL 55MM OD 1,739.89 1,217.92
16109026 278 C1713 Z NAIL CPM 10MMX21.5CM 130L 5,309.49 3,716.64
16109027 278 C1713 BALL TIP GUIDE WIRE 3.0MMX100CM 419.84 293.89
16109028 278 LAG SCREW 10.5X90 Z NAIL 2,031.63 1,422.14
16109029 272 C1769 BALL NOSE GUIDE WIRE 80CM 600.06 420.04
16109030 278 C1713 PIN 2.0MM 333.40 233.38
16109031 272 C1769 BALL NOSE GUIDE WIRE 100CM 491.51 344.06
16109090 278 C1776 VERSYS 6 INCH BEADED FC 11X160MM STD NEC 8,305.49 5,813.84
16109091 278 C1776 M/L TAPER KINECTIV STEM SIZE 10 6,515.71 4,561.00
16109092 278 C1776 12/14 COCR FEMORAL HEAD 32MM + 0 1,356.98 949.89
16109093 278 C1776 CONTINUUM MULTI-HOLE SHELL 50 HH 8,909.75 6,236.83
16109094 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER HH 32x 3,172.36 2,220.65
16109099 278 C1776 BIPOLAR SHEL 47MM OD 1,098.68 769.08
16109100 278 C1776 MODULAR NECK 12/14 NECK TAPER 1,232.10 862.47
16109101 278 C1776 MODULAR NECK 12/14 TAPER 2,364.69 1,655.28
16109102 278 C1776 MODULAR NEX C 12/14 NECK TAPER 2,364.69 1,655.28
16109103 278 C1776 BIPOLAR LINER 47/48/49MM OD X 28MM ID 738.51 516.96
16109104 278 C1776 BIPOLAR SHELL 48MM OD 1,098.70 769.09
16109105 278 C1776 VERSYS PRESS FIT LD/FX SZ 11X120MM 4,428.83 3,100.18
16109106 278 C1776 12/14 COCE FEMORAL HEAD 28MM 1,356.95 949.87
16109107 278 C1776 MODULAR NECK E 12/14 TAPER 12,021.12 8,414.78
16109108 278 C1776 BIPOLAR SHELL 49MM OD 1,098.68 769.08
16109109 278 C1776 VERSYS FM MC CLR 13X140MM STD NECK 12,021.12 8,414.78
16109110 278 HIP PROSTHESIS TAPER 7.5 6,872.18 4,810.53
16109111 278 C1776 HIP PROSTHESIS TAPER ML 6,909.75 4,836.83
16109112 278 HIP PROSTHESIS TAPER 6 12,678.98 8,875.29
16109113 278 C1776 HIP PROSTHESIS TAPER SZ 12.5 6,515.61 4,560.93
16109114 278 C1776 MODULAR NEX G 12/14 NECK TAPER 1,232.10 862.47
16109115 278 C1776 CONTINUUM LONGEVITY NEUTRAL LINER, MM 32 3,172.31 2,220.62
16109116 278 C1776 CONTINUUM MULTI-HOLE SHELL 58LL 7,326.00 5,128.20
16109117 278 C1776 VERSYS FM MC CLR 12X140MM STD NECK 12,021.12 8,414.78
16109118 278 C1776 MODULAR NEX B 12/14 NECK TAPER 1,232.10 862.47
16109119 278 C1776 HIP PROSTHESIS TAPER SZ 16.25 6,515.61 4,560.93
16109120 278 HEAD METASUL LDH 44 CODE J TAPER 18/20 6,508.44 4,555.91
16109121 278 HEAD METASUL LDH 50 CODE P TAPER 18/20 7,231.59 5,062.11
16109122 278 C1776 VERSYS ADVOCATE CEMENTED STEM 11X120 STA 5,271.40 3,689.98
16109123 278 C1713 VERSYS DISTAL CENTRALIZER 11MM 236.46 165.52
16109124 278 C1776 12/14 COCR FEMORAL HEAD 36MM +7.0 2,692.10 1,884.47
16109125 278 C1713 HIVAC 7 SINGLE/DOUBLE SINGLE 887.43 621.20
16109126 278 C1776 BIPOLAR SHELL 53MM OD 1,098.68 769.08
16109127 278 C1776 VERSYS PRESS FIT LD/FX SZ 15X140MM 2,990.43 2,093.30
16109128 278 C1776 HIP PROSTHESIS TAPER SZ 11 6,909.75 4,836.83
16109129 278 C1776 32MM MOD HEAD COCR STD NECK 1,355.62 948.93
16109130 278 ACETABULAR METASUL DUROM 50/044 CODE J 15,046.19 10,532.33
16109131 278 ACETABULAR METASUL DUROM 56/050 CODE J 16,717.98 11,702.59
16109132 278 ACETABULAR COMPONENT STD 28MM 8,429.24 5,900.47
16109133 278 ACETABULAR COMPONENT ELEV RM 28MM 8,429.24 5,900.47
16109134 278 FEMORAL HEAD 28MM 4,074.13 2,851.89
16109135 278 C1776 M/L TAPER KINECTIV STEM SIZE 9 6,909.75 4,836.83
16109136 272 DISPOSABLE FLEXDRILL 15M 482.85 338.00
16109137 278 C1776 MODULAR NEX R NECK TAPER 2,364.69 1,655.28
16109138 272 MODULAR DRILL BIT 3.2X30 420.40 294.28
16109140 278 HEAD ADAPTER METASUL TAPER 12/14-18/20 695.41 486.79
16109141 272 HIP PACK 878.05 614.64
16109145 278 C1776 M/L TAPER KINECTIV STEM SIZE 13.5 6,515.71 4,561.00
16109194 278 C1776 PSN ASF PS 10MM VE L 3-5 CD 3,008.65 2,106.06
16109195 278 C1776 PSN FEM PS CMT CCR NRW SZ4 L 5,827.50 4,079.25
16109196 278 C1776 PSN FEM PS CMT CCR NRW SIZE 5 R 6,752.17 4,726.52
16109197 278 C1776 PSN ASF PS 10MM VE R 3-5 CD 3,008.65 2,106.06
16109198 278 C1776 PSN TIB STM 5 DEG SIZE D R 3,252.41 2,276.69
16109199 272 4 INCH INSERTION NEEDLE 470.29 329.20
16109200 272 CABLE & SLEEVE SET 1.6MM 1,503.21 1,052.25
16109201 278 C1897 LEAD, NEUROSTIM TEST KIT 6,660.00 4,662.00
16109202 272 NEUROSTIM PATIENT TRIAL KIT 293.11 205.18
16109203 272 NEUROSTIM OR CABLE AND EXT 20.58 14.41
16109204 272 NEUROSTIM ENHANCED KIT W/T STYLET CAP 402.97 282.08
16109205 278 C1713 AFFIXUS HUMERAL PROX HUMEROUS LEFT LONG 7,272.72 5,090.90
16109206 278 C1713 SCREW BLUNT TIP AFFIXUS BLUNT TIP SCREW 739.20 517.44
16109207 278 C1713 ANN CORT BONE SCREW 4X24MM 716.10 501.27
16109208 278 C1713 LO-PRO LOCK SCREW SS 2.7 X 16MM 382.95 268.07
16109209 278 C1713 LO PRO LOCK SCRW SS 2.7X18MM 379.50 265.65
16109210 272 C1769 G-WIRE W/TRCT TIP .078X5.91 IN(2MMX150MM 33.00 23.10
16109211 278 C1713 LO PRO SCRW TM SS 3.5 X 14MMCORT 143.50 100.45
16109212 278 C1713 LO PRO SCRW TM SS 3.5X16MMCORT 115.50 80.85
16109213 278 C1713 LO PRO SCRW TM SS 3.5X24MMCORT 115.50 80.85
16109214 278 C1713 LOP PRO SCRW TM SS 3.5X50MMCORT 115.50 80.85
16109215 278 C1713 LO PRO SCRW TM SS 3.5X55MMCORT 115.50 80.85
16109216 278 C1713 LOW PROF SCRW SS 4.0X50MMCAN LNG THD 544.50 381.15
16109217 272 DRILL BIT 3.5 MM 263.07 184.15
16109218 272 DRILL BIT Q-C 2.6MM DRILL BIT CANNULATED 594.25 415.98
16109219 272 2.0MM DRILL BIT CALIBRATED 316.35 221.45
16109220 272 2.5MM DRILL BIT 288.63 202.04
16109221 272 2.5 MM DRILL BIT CALIBRATED 283.05 198.14
16109222 272 C1769 GUIDE WIRE TROCAR TIP 1.35MM 66.00 46.20
16109224 278 C1713 LOCK DISTAL FIBULA PLT SS RT 8H 2,623.50 1,836.45
16109225 278 C1776 COMP PRIMARY STEM 7MM MINI 13,184.97 9,229.48
16109228 278 C1713 Z NAIL10.5X120 LAG SCREW 1,926.24 1,348.37
16109229 278 C1713 Z NAIL 5.0 X 35 CORT SCREW FA 691.47 484.03
16109230 278 C1713 CANNULA, TWIST-IN 85.66 59.96
16109231 272 SCOPE DISPOSABLE URETEROSCOPE 4,995.00 3,496.50
16109232 272 PROSTATE BX UROLOGY 1,199.30 839.51
16109233 272 PATHOLOGY KIT UROLOGY 88.60 62.02
16109234 278 C1820 16 CONTACT IMPLANTABLE PULSE GENERATOR K 70,244.68 49,171.28
16109235 272 35CM LONG TUNNELING TOOL 653.83 457.68
16109236 272 PRECESION PASSING ELEVATOR 197.74 138.42
16109237 278 C1776 M/L TAPER KINECTIV STEM SIZE 15 6,704.67 4,693.27
16109238 278 C1776 BIOLOX DELTA FEM HEAD, 36MM, +0MM 2,414.25 1,689.98
16109239 278 C1776 CONTINUUM VIVACIT-E NEUTRAL LINER LL 36X 2,997.00 2,097.90
16109240 272 C1725 STERLING BALLON 3X40X150 632.70 442.89
16109241 272 C1725 STERLING BALLON 4X40X135 632.70 442.89
16109242 278 C1889 SABLE SPACER, 10X22,6-12 MM, 8 DEG. 20,812.50 14,568.75
16109243 278 C1874 VIABAHN BX BALLON EXP ENDO/6MMX39MM 7FR8 10,512.81 7,358.97
16109245 278 C1889 SABLE SPACER 10X26, 7-14MM, 15 DEGREE 20,812.50 14,568.75
16109246 278 C1889 SABLE SPACER 10X26, 9-16 MM, 8 DEGREE 20,812.50 14,568.75
16109247 278 C1776 PSN TIB STM 5 DEG SZ H L 3,252.41 2,276.69
16109248 278 C1713 CABLE READY PIN ASSY 4MMX 40MM 1,889.21 1,322.45
16109249 278 C1776 PSN ASF PS 14MM VE R 10-12 GH 3,008.65 2,106.06
16109250 278 C1776 PSN FEM PS CMT CCR NRW SZ6 L 6,752.17 4,726.52
16109251 278 C1776 ARCOS 15X175MM BRCH BODY STD 10,988.00 7,691.60
16109252 271 RF CALIBRATED DRILL 4.3MM 679.12 475.38
16109253 271 RF CALIBRATED DRILL 4.9MM 1,457.04 1,019.93
16109254 278 C1713 Z NAIL 6.0X40 CANC SCREW FA 716.18 501.33
16109255 278 C1889 SABLE SPACER 10X26, 7-14MM, 15 DEGREE 20,812.50 14,568.75
16109256 278 C1713 Z NAIL 6.0X70 CANC SCREW FA 716.18 501.33
16109257 278 C1713 Z NAIL 6.0X85 CANC SCREW FA 716.18 501.33
16109258 278 C1776 Z NAIL RF 11.5MMX20CM UNIV 7,532.06 5,272.44
16109259 278 C1713 NCB CORT SCREW 5.0X 14MM SELF TAPPING 580.35 406.25
16109260 278 C1776 PSN FEM PS CMT CCR NRW SZ9 L 6,752.17 4,726.52
16109261 278 C1776 PSN ASF PS 13MM VE L 6-9 EF 2,830.50 1,981.35
16109262 278 C1776 BIOLOAR SHELL 44MM OD 1,098.70 769.09
16109263 278 C1776 BIPOLAR LINER 44/45/46MM OD X 28MM ID 738.53 516.97
16109264 278 C1776 PSN FEM PS CMT CRR NRW SZ8 L 5,827.50 4,079.25
16109265 278 C1874 STENT EXPRESS LD ILIAC BIL OTW 5MMX17MM 3,837.99 2,686.59
16109266 278 C1776 PSN FEM PS CMT CCR STD SZ9 L 5,827.50 4,079.25
16109267 278 C1776 PSN ASF PS 12MM VE R 6-9 GH 2,830.50 1,981.35
16109268 278 C1889 INDEPENDENCE MIS SPACER, 24X30MM 15DEG 26,640.00 18,648.00
16109269 278 C1713 LUMBAR ANCHOR, 25MM 1,665.00 1,165.50
16109270 278 C1776 PSN ASF PS 12MM VE L 6-9 GH 2,830.50 1,981.35
16109271 278 C1776 PSN ASF PS 12MM VE L 3-5 CD 2,830.50 1,981.35
16109272 272 INSULATED EXTENSION BLADE HEX6 23.66 16.56
16109273 272 COATED STRAIGHT LAP ELECTORDE 36CM 144.69 101.28
16109274 272 PACK SPINE CUSTOM 525.71 368.00
16109275 272 PACK MINOR SETUP TRAY 150.59 105.41
16109276 278 C1713 LOCKING SCREW 2.7 X 10MM 1,461.87 1,023.31
16109277 278 C1713 LOCKING SCREW 2.7X12MM 1,461.87 1,023.31
16109278 278 C1713 DRILL BIT 2.5 X 30MM 1,165.50 815.85
16109279 278 C1713 K-WIRE 1.4X150MM BLUNT/TROCAR 179.82 125.87
16109280 278 C1713 MTP PLATE LEFT 12,311.01 8,617.71
16109281 278 C1713 SCREW LAG 3.5 X 18MM 1,658.34 1,160.84
16109282 278 C1713 LO-PRO LOCK SCREW SS 2.7X18MM 382.95 268.07
16109283 278 C1713 CACELLOUS SCREW 3.0 X 18MM 143.50 100.45
16109284 278 C1713 LO PRO SCRW TM SS 3.5 X 18MMCORT 143.50 100.45
16109285 278 C1713 LO PRO SCRW TM SS 3.5 X 26MMCORT 143.50 100.45
16109286 278 C1713 5 HOLE LOCKING DISTAL FIB PLATE R 2,414.25 1,689.98
16109287 278 C1713 DISTRACTION PIN 12MM 233.10 163.17
16109288 278 C1889 AFB1115-AVAFLEXBALLOON 10G 15MM 8,576.42 6,003.49
16109289 278 C1889 NIKO SPACER 14X16, 3.5/3.5 DEG, 21MM 13,320.00 9,324.00
16109290 272 2-0 FW BLUE W/TPR 3/8CIR NEEDLE 90.20 63.14
16109291 272 DUAL-FLEX GUIDEWIRE .035 X150CM, ANGLED 141.43 99.00
16109292 278 C1776 PSN TIB STM 5 DEG SIZE C R 2,997.00 2,097.90
16109293 278 C1776 PSN ASF PS 16MM VE R 3-5 CD 2,830.50 1,981.35
16109294 275 C1785 ASSURITY PACEMAKER MRI 14,652.00 10,256.40
16109295 272 US STR POUCH ASSY, LEAD CAP 149.85 104.90
16109296 278 L8699 RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL 3,300.00 2,310.00
16109297 278 C1776 PSN ASF PS 12MM VE R 10-11 EF 2,830.50 1,981.35
16109298 272 SPEEDIE CATH MALE 14FX14 20.00 14.00
16109299 272 SPEEDIE CATH MALE 16 FRX14 20.00 14.00
16109300 278 L8699 MOBI-C CERVICAL DISC PROSTHESIS 13 X 15 14,851.80 10,396.26
16109301 272 DYNJS0164 MINOR SET UP PACK 146.18 102.33
16109302 272 1200 PSI TUBING 29.52 20.66
16109303 272 SURSEAL ENDOSCOPIC VALVE 51.25 35.88
16109304 278 C1776 PSN MC VE ASF PS L 13MM VE 10-12 GH 2,830.50 1,981.35
16109305 278 C1889 HEDRON P SPACER 10X26, 8MM 8 DEG 14,152.50 9,906.75
16109306 278 C1776 PSN ASF PS 11MM VE L 3-5 EF 2,830.50 1,981.35
16109307 272 ANNULOTOMY KNIFE 1,665.00 1,165.50
16109308 278 C1889 INDEPENDENCE MIS SPACER, 24X30MM 15DEG 1 26,640.00 18,648.00
16109309 272 K-WIRES 499.50 349.65
16109310 272 BIPOLAR FORCEPS [Link] 2,664.00 1,864.80
16109311 278 C1713 ILLUMINATION SYSTEM 3,330.00 2,331.00
16109312 278 C1889 RISE SPACER, 18X50MM, 7-14MM, 3-15 DEGRE 26,640.00 18,648.00
16109313 272 .35 SIMMONS 1 CATH 4 FR. 65CM 49.20 34.44
16109314 278 C1776 PSN MC VE ASF L 16MM 6-9 GH 2,830.50 1,981.35
16109315 272 MINIONE BUTTON 24FR SIZE 2.5 CM 399.60 279.72
16109316 272 MINIONE BUTTON 24FR SIZE 3.0CM 399.60 279.72
16109317 272 MINIONE BUTTON 24FR SIZE 3.5CM 399.60 279.72
16109318 278 C1889 SABLE SPACER, 10X30,6-12 MM, 8 DEG. 20,812.50 14,568.75
16109319 278 C1889 ELSA SPACER 20 X 55MM, 8-17MM, 5-20 DEG. 34,798.50 24,358.95
16109320 278 C1713 SELF DRILLING SCREW, VARIABLE ANGLE 5.5M 2,497.50 1,748.25
16109321 272 K-WIRES, THREADED, BLUNT 499.50 349.65
16109322 278 C1725 LUTONIX 018 4X80 4F 4,162.44 2,913.71
16109323 272 C1725 STERLING BALLON 3X20X150 1,126.21 788.35
16109324 278 C1713 3.5MM SCREW HEX 732.60 512.82
16109325 278 C1776 PSN ASF PS 13MM VE R 10-12 GH 2,830.50 1,981.35
16109326 272 SINGLE USE GRASPING FORCEPS 235.36 164.75
16109327 278 C1713 CANNULATED COMPRESSION SCREW W/ S.S. 14M 1,744.92 1,221.44
16109328 278 C1713 LOW PROFILE SCREW TI 4.5X24MM 249.75 174.83
16109329 278 C1713 LOW PROFILE SCREW TI 4.5X26MM 249.75 174.83
16109330 278 C1713 ANKLE FUSION PLATE, ANT TT, RIGHT 6,909.75 4,836.83
16109331 278 C1713 LOW PROFILE SCREW TI 4.5X34MM 249.75 174.83
16109332 278 C1713 LOW PROFILE SCREW TI 4.5X46MM 249.75 174.83
16109333 278 C1713 LOW PROFILE SCREW TI 4.5X50MM 249.75 174.83
16109334 278 C1713 LOW PROFILE SCREW TI 4.5X55MM 249.75 174.83
16109335 278 C1713 LOW PROFILE SCREW TI 4.5X30MM 649.35 454.55
16109336 278 C1713 LOW PROFILE SCREW TI 5.5X50MM 249.75 174.83
16109337 272 PRFL DRL, 7.0MM CMPR FT 666.00 466.20
16109338 272 A4649 .062X7 LONG, GUIDEWIRE 133.20 93.24
16109339 278 C1713 LARGE BB-TAK, THREADED 499.50 349.65
16109340 272 CALIBRATED DRILL BIT, 3.0MM, LONG 649.35 454.55
16109341 272 SOLID DRILL BIT, 5.5MM LONG 499.50 349.65
16109342 272 1.65MM K-WIRE 600MM BLUNT THREAD 499.50 349.65
16109343 272 UMBILICAL CORD TAPE 2 X30 21.85 15.30
16109344 278 C1713 FIBERGRAFT BG PUTTY XXS 1CC 715.95 501.17
16109345 278 L8699 SKY 2 LEVEL PLTE 28MM T1 2,497.50 1,748.25
16109346 272 SKY VARIABLE S-D SCREW 16MM T1 399.60 279.72
16109347 278 C1713 DISTRACTOR PIN 12MM 164.00 114.80
16109348 278 L8699 ACIS-STERILE LORDOTIC/STANDARD-5MM HT 2,997.00 2,097.90
16109349 278 L8699 ACIS STERILE LORDOTIC/STANDARD-6MM HT 2,997.00 2,097.90
16109350 278 L8699 ACIS STERILE LORDOTIC/STANDARD-7MM HT 2,997.00 2,097.90
16109351 278 C1713 FIBERGRAFT BG PUTTY XXS 2CC 1,365.30 955.71
16109352 278 L8699 SKY 1 LEVEL PLTE 12MM T1 2,247.75 1,573.43
16109353 272 SKY VARIABLE S-D SCREW 18MM T1 399.60 279.72
16109354 272 SKY VARIABLE S-D SCREW 16MM T1(52016) 399.60 279.72
16109355 278 C1713 CONF INTRO NEEDLE, 11G 6 529.47 370.63
16109356 272 1.6 MM KIRSCHER WIRE BLNT TIP 480MM 166.50 116.55
16109357 278 C1713 5.0 MM TI CAN MTRZ PLYAX 45MM SCREW 3,113.55 2,179.49
16109358 278 C1713 7.0 MM T1 CAN MTRX PLYAX SCRW 45MM 3,113.55 2,179.49
16109359 278 C1713 FIBERGRAFT BG PUTTY GPD M 6CC 4,279.05 2,995.34
16109360 272 200 MM FIBERGRAFT GPS CANNULA 599.40 419.58
16109361 278 C1776 VIPER 2 LORDOTIC ROD 40MM 799.20 559.44
16109362 278 C1776 X-PAC 10X28MM LORDOTIC 17,898.75 12,529.13
16109363 278 C1776 MATRIX LOCKING CAP W/O SADDLE 183.15 128.21
16111884 272 CATH ANGIO 14G 5.25 52.57 36.80
16476100 270 DNU SYRINGE 10 ML SOD CHLORIDE INJECTION 6.25 4.38
17000001 360 2ND ADDL LEVEL SPINE INJ 933.05 653.14
17000002 360 3RD ADDL LEVEL SPINE INJ 933.05 653.14
17000003 360 6463550 BILAT RF ABLATION LUMBAR OR SACRAL 9,195.24 6,436.67
17000004 360 64636 ADD'L LEVEL RF ABLATION LUMBAR SACRAL 3,065.07 2,145.55
17000005 360 6463650 BILAT ADD'L LEVEL RF ABLATION LUMBAR OR 4,597.61 3,218.33
18010001 920 NEUROMONITORING SERVICES ANS 2,334.62 1,634.23
18010002 360 22869 INSJ STABLJ DEV W/O DCMPRN 70,389.31 49,272.52
18010003 360 63650 NEUROMONITORING SERVICES PERC IMPL NS EL 21,811.47 15,268.03
18010004 360 63685 INC/REPL SPINE NSTIM PG/RCVR 101,736.41 71,215.49
18010005 360 63655 LAMINECT IMPL NS ELECTRODES; EPIDURAL PE 71,559.93 50,091.95
18010006 360 64624 GENICULAR RF ABLAT 6,130.15 4,291.11
18010007 360 64635 LUMBAR OR SACRAL RF ABLAT 6,130.15 4,291.11
18010008 360 64633 CERV OR THORACIC RF ABLAT 6,131.19 4,291.83
18010009 360 64510 BLOCK- STELLATE GANGLION 2,873.82 2,011.67
18010010 360 63042 LAMINECTOMY SINGLE LUMBAR 21,887.30 15,321.11
18010011 360 22551 NECK SPINE FUSE & REMOV BEL C2 43,029.93 30,120.95
18010012 360 22612 LUMBAR SPINE FUSION 43,029.93 30,120.95
18010013 360 22513 KYPHOPLASTY; PERQ VERTEBRAL AUGMENTATION 21,273.90 14,891.73
18010014 360 22558 LUMBAR SPINE FUSION 43,151.69 30,206.18
18010015 360 22634 SPINE FUSION EXTRA SEGMENT 8,525.26 5,967.68
18010016 360 63048 REMOVE SPINAL LAMINA ADD-ON 8,484.10 5,938.87
18010017 360 22853 INSJ BIOMECHANICAL DEVICE 5,950.71 4,165.50
18010018 360 22842 INSERT SPINE FIXATION DEVICE 10,766.43 7,536.50
18010020 360 ADDL LEVEL NECK SPINE FUSION 5,659.50 3,961.65
18010021 360 20930 SP BONE ALGRFT MORSEL ADD ON 6,163.95 4,314.77
18010022 360 20931 SP BONE ALGRFT STRUCT ADD ON 8,690.93 6,083.65
18010023 360 20936 SP BONE AGRFT LOCAL ADD ON 3,191.80 2,234.26
18010024 360 22015 I&D ABSCESS P-SPINE l/s/ls 6,503.79 4,552.65
18010025 360 22514 PERQ VERTEBRAL AUGMENTATION 21,919.93 15,343.95
18010026 360 22515 PERQ VERTEBRAUL AUGMENTATION 21,919.93 15,343.95
18010027 360 22552 ADDL NECK SPINE FUSION 5,655.38 3,958.77
18010028 360 22554 NECK SPINE FUSION 43,151.79 30,206.25
18010029 360 22585 ADDL SPINAL FUSION 4,923.58 3,446.51
18010030 360 22600 NECK SPINE FUSION 12,997.79 9,098.45
18010031 360 22610 THORAX SPINE FUSION 6,275.04 4,392.53
18010032 360 22614 SPINE FUSION EXTRA SEGMENT 3,488.61 2,442.03
18010033 360 22633 LUMBAR SPINE FUSION COMBINED 43,151.78 30,206.25
18010034 360 22840 INSERT SPINE FIXATION DEVICE 2,579.09 1,805.36
18010035 360 22845 INSERT SPINE FIXATION DEVICE 5,790.18 4,053.13
18010036 360 22846 INSERT SPINE FIXATION DEVICE 8,583.51 6,008.46
18010037 360 22854 INSJ BIOMECHANICAL DEVICE 5,849.34 4,094.54
18010038 360 22856 CERV ARTIFIC DISKECTOMY 56,584.19 39,608.93
18010039 360 63030 LOW BACK DISK SURGERY 21,919.94 15,343.96
18010040 360 63035 SPINAL DISK SURGERY ADD ON 11,192.95 7,835.07
18010041 360 63045 REMOVE SPINE LAMINA 1 CRVL 21,919.94 15,343.96
18010042 360 REMOVE SPINE LAMINA 1 THRC 21,919.94 15,343.96
18010043 360 63047 REMOVE SPINE LAMINA 1 LMBR 21,919.94 15,343.96
18010044 360 63081 REMOVE VERT BODY DCMPRN CRVL 6,673.15 4,671.21
18010045 360 63082 REMOVE VERTEBRAL BODY ADD-ON 6,673.15 4,671.21
18010046 360 63266 EXCISE INTRSPINL LESION THRC 21,919.94 15,343.96
18010047 360 63267 EXCISE INTRSPINL LESION LMBR 21,919.94 15,343.96
18010048 360 63276 BX/EXC XDRL SPINE LESN THRC 39,453.56 27,617.49
18010049 360 63295 REPAIR LAMINECTOMY DEFECT 4,589.28 3,212.50
18010050 360 63662 REMOVE SPINE ELTRD PLATE 7,497.81 5,248.47
18010051 360 63685 INSRT/REDO SPINE N GENERATOR 103,012.97 72,109.08
18010052 360 63688 REVISE/REMOVE NEURORECEIVER 11,464.38 8,025.07
18010053 360 22015 I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LU 8,720.77 6,104.54
18010054 360 63056 DECOMPRESS SPINAL CORD LMBR 21,938.45 15,356.92
18010055 360 NEURO CARPAL TUNNEL 6,128.79 4,290.15
18020600 983 20600 DRAIN/INJ SM JNT/BURSA 193.00 135.10
18020602 519 96372 ADMIN INJ SC/IM 172.80 120.96
18020603 983 20552 INJ TRIG PT 1/2 MSCL 750.75 525.53
18020604 983 20553 INJ TRIG PT > 3 MSCL 750.75 525.53
18020605 983 20605 DRAIN/INJ INT JNT/BURSA 219.00 153.30
18020610 983 20610 DRAIN/INJ MAJ JNT/BURSA 279.00 195.30
18020611 983 0232T PRP NJX 5,669.30 3,968.51
18020612 983 J9250 METHOTREXATE 5mg 49.56 34.69
18020613 983 J7327 MONOVISC INJ PER DOSE 2,819.01 1,973.31
18020614 983 J0897 DENOSUMAG INJ PROLIA 1 mg 58.00 40.60
18099201 983 99201 NEW PATIENT SIMPLE 10 MIN 89.00 62.30
18099202 983 99202 NEW PATIENT LMT 20 MIN 146.00 102.20
18099203 983 99203 NEW PATIENT LOW 30 MIN 213.00 149.10
18099204 983 99204 NEW PATIENT MOD 45 MIN 319.00 223.30
18099205 983 99205 NEW PATIENT COMP 60 MIN 410.00 287.00
18099211 983 99211 EST PATIENT SIMPLE 50.00 35.00
18099212 983 99212 EST PATIENT LMT 10 MIN 89.00 62.30
18099213 983 99213 EST PATIENT LOW 15 MIN 134.00 93.80
18099214 983 99214 EST PATIENT MOD 25 MIN 197.00 137.90
18099215 983 99214 EST PATIENT COMP 40 MIN 279.00 195.30
18099241 960 99241 OP CONSULT LEVEL 1 142.00 99.40
18099242 960 99242 OP CONSULT LEVEL 2 214.00 149.80
18099243 960 99243 OP CONSULT LEVEL 3 288.00 201.60
18099244 960 99244 OFFICE CONSULTATION 402.00 281.40
18099245 960 99245 OP CONSULT LEVEL 5 503.00 352.10
18099354 960 99354 PRO LONG SERV 1ST HOUR 206.00 144.20
18099355 960 99355 PRO LONG SERV EACH ADD 30 177.00 123.90
18099358 960 99358 EXT SERV 1ST HOUR 209.00 146.30
18099359 960 99359 EXT SERV EA ADDL 30 MIN 147.00 102.90
18100054 360 NEUROPLASTY; ULNAR NERVE TRANSPOSITION- 6,128.81 4,290.17
19001001 360 76872 TRANSRECTAL ULTRASOUND 370.26 259.18
19001002 360 PROSTATE BIOPSY 6,089.40 4,262.58
19001003 360 URO ULTRASOUND RENTAL - 1 PT 1,998.00 1,398.60
19001004 360 TRANSRECTAL PROBE RENTAL - 1 PT 999.00 699.30
19001005 360 URO ULTRASOUND RENTAL- 2 PT 999.00 699.30
19001006 360 URO ULTRASOUND RENTAL- 3 PT 666.00 466.20
19001007 360 URO ULTRASOUND RENTAL- 4 PTS 499.50 349.65
19001008 360 TRANSRECTAL PROBE RENTAL- 2 PT 499.50 349.65
19001009 360 TRANSRECTAL PROBE RENTAL- 3 PTS 333.00 233.10
19001010 360 TRANSRECTAL PROBE RENTAL- 4 PTS 249.75 174.83
19001011 360 HOLMIUM MSTRPULSE HF 2,580.75 1,806.53
19001012 360 HOLMIUM MP 200 FIBER 1,032.50 722.75
19001013 360 HOLMIUM LOW WATT 1,665.00 1,165.50
19001014 360 HOLMIUM 200 FORTEC FIBER 732.60 512.82
19001015 360 HOLMIUM HIGH WATT LASER 1,831.50 1,282.05
20001000 983 10120 INC & REM FB SQ; SMPL 411.06 287.74
20001001 983 11200 REM SKIN TAGS; = 15 LESIONS 233.58 163.51
20001002 983 20610 DRAIN/INJ MAJOR JOINT/BURSA W/O US 284.58 199.21
20001003 983 29260 STRAPPING; ELBOW OR WRIST 136.68 95.68
20001004 510 69209 REMOVE IMPACTED EAR WAX UNI 153.00 107.10
20001005 983 69210 REMOVE IMPACTED EAR WAX UNI 130.56 91.39
20001006 983 81002 N-AUTOM URINALYS WO MICRO 13.26 9.28
20001007 983 86580 SKIN TEST; TB ID 29.58 20.71
20001008 771 90471 IMMUNIZATION ADMIN 1 VACCINE 43.86 30.70
20001009 771 90472 IMMUNIZATION ADM; EA ADDTL VACCINE 26.52 18.56
20001010 983 90633 HEPA VACC PED/ADOL 2 DOSE IM 74.46 52.12
20001011 983 90647 HIB PRP-OMP VACC 3 DOSE IM 57.12 39.98
20001012 983 9064726 HIB PRP-OMP VACC 3 DOSE IM 26.00 18.20
20001013 983 90648 HIB PRP-T VACCINE 4 DOSE IM 57.12 39.98
20001014 983 9064826 HIB PRP-T VACCINE 4 DOSE IM 26.00 18.20
20001015 983 90653 IIV ADJUVANT VACCINE IM 31.62 22.13
20001016 983 90658 IIV3 VACCINE SPLT 0.5 ML IM 31.62 22.13
20001017 983 90670 PCV13 VACCINE IM 232.56 162.79
20001018 983 90681 RV1 VACC 2 DOSE LIVE ORAL 187.68 131.38
20001019 983 90700 DTAP VACCINE < 7 YRS IM 60.18 42.13
20001020 983 90707 SQ MMR VACCINE 98.94 69.26
20001021 983 90713 POLIOVIRUS IPV SC/IM 62.22 43.55
20001022 983 90715 TDAP VACCINE >7 IM 83.64 58.55
20001023 983 90716 VAR VACCINE LIVE SUBQ 160.14 112.10
20001024 983 90723 DTAP-HEP B-IPV VACCINE IM 139.74 97.82
20001025 983 90732 PPSV23 VACC 2 YRS+ SUBQ/IM 111.18 77.83
20001026 983 90733 MPSV4 VACCINE SUBQ 186.66 130.66
20001027 983 90734 MCV4 MENACWY VACCINE IM 191.76 134.23
20001028 918 96110 DEVELOPMENTAL SCREEN W/SCORE 28.56 19.99
20001029 960 99024 POST-OP FOLLOW-UP VISIT 68.34 47.84
20001030 983 99080 SPECIAL REPORTS 36.72 25.70
20001031 983 99203 OFFICE/OUTPATIENT VISIT NEW 30 MIN 217.26 152.08
20001032 983 99204 OFFICE/OUTPATIENT VISIT NEW 45 MIN 325.38 227.77
20001033 983 99205 OFFICE/OUTPATIENT VISIT NEW 60 MIN + 418.20 292.74
20001034 983 99211 OFFICE/OUTPATIENT VISIT EST 5 MIN 51.00 35.70
20001035 983 99212 OFFICE/OUTPATIENT VISIT EST 10 MIN 90.78 63.55
20001036 983 99213 OFFICE/OUTPATIENT VISIT EST 15 MIN 136.68 95.68
20001037 983 99214 OFFICE/OUTPATIENT VISIT EST 25 MIN 200.94 140.66
20001038 983 99217 OBSERVATION CARE DISCHARGE 191.76 134.23
20001039 983 99220 INITIAL OBSERVATION CARE 70 MIN 452.88 317.02
20001040 983 99222 INITIAL HOSPITAL CARE 50 MIN 302.94 212.06
20001041 983 99233 SUBSEQUENT HOSPITAL CARE 35 MIN 240.72 168.50
20001042 983 99238 HOSP DC DAY MANAGEMENT; 30 MIN/< (MD) 173.40 121.38
20001043 983 99305 NURSING FACILITY CARE INIT 35 MIN 234.60 164.22
20001044 983 99307 NURSING FAC CARE SUBSEQ 10 MIN 83.64 58.55
20001045 983 99308 NURSING FAC CARE SUBSEQ 15 MIN 124.44 87.11
20001046 983 99309 NURSING FAC CARE SUBSEQ 25 MIN 162.18 113.53
20001047 983 99315 SNF DISCHARGE DAY; 30 MINUTES 138.72 97.10
20001048 515 99381 INIT PM E/M NEW PAT INF <1 YR 196.86 137.80
20001049 515 99382 INIT PM E/M NEW PAT 1-4 YRS 209.10 146.37
20001050 515 99383 PREV VISIT NEW AGE 5-11 211.14 147.80
20001051 515 99384 PREV VISIT NEW AGE 12-17 233.58 163.51
20001052 770 99385 PREV VISIT NEW AGE 18-39 281.86 197.30
20001053 510 99386 PREV VISIT NEW AGE 40-64 297.84 208.49
20001054 510 99387 INIT PM E/M NEW PAT 65+ YRS 303.96 212.77
20001055 515 99391 PER PM REEVAL EST PAT INF <1 YR 171.36 119.95
20001056 515 99392 PREV VISIT EST AGE 1-4 181.56 127.09
20001057 515 99393 PREV VISIT EST AGE 5-11 183.60 128.52
20001058 515 99394 PREV VISIT EST AGE 12-17 200.94 140.66
20001059 770 99395 PREV VISIT EST AGE 18-39 242.06 169.44
20001060 770 99396 REV VISIT EST AGE 40-64 245.82 172.07
20001061 770 99397 PER PM REEVAL EST PAT 65+ YR 260.10 182.07
20001062 983 INFLUENZA IA W DO 51.00 35.70
20001063 983 87880QW STREP A ASSAY W/OPTIC 51.00 35.70
20001064 771 G0008 ADMIN FLU VIRUS VACCINE 36.49 25.54
20001065 771 G0009 ADMIN PNEUMONIA VACCINE 38.98 27.29
20001066 983 G0101 CA SCRNING PELV & BRST EXAM 93.51 65.46
20001067 983 G0402 INIT PREVENTIVE EXAM, NEW BENEFICIARY 275.61 192.93
20001068 983 G0438 PPPS INITIAL VISIT 312.22 218.55
20001069 983 G0439 PPPS SUBSEQ VISIT 224.75 157.33
20001070 983 J2920 METHYLPREDNISOLONE INJ TO 40 MG 17.37 12.16
20001071 983 Q0091 OBTAINING SCREEN PAP SMEAR 79.39 55.57
20001072 983 Q2037 FLUVIRIN VACC 3 YRS & > IM 31.30 21.91
20001073 510 99201 OFFICE/OUTPATIENT VISIT NEW 90.78 63.55
20001074 510 99202 OFFICE/OUTPATIENT VISIT NEW 148.92 104.24
20001075 419 94640 AIRWAY INHALATION TREATMENT 73.44 51.41
20001076 983 85018QW HEMACUE 44.88 31.42
20001077 305 85014 HEMATOCRIT 16.07 11.25
20001078 983 17110 DESTRUCTION B9 LESIONS 1-14 298.00 208.60
20001080 983 99211 NURSIN SERVICE 40.00 28.00
20006500 440 92507 SPEECH THERAPY PER 15 MIN 154.50 108.15
20006502 440 92507 SPEECH THERAPY PER 30 MIN 168.50 117.95
20006506 440 92507 SPEECH THERAPY PER 1 HOUR 201.25 140.88
20009000 270 K PUMP 35.88 25.12
28000005 900 90791 INITIAL EVALUATION/ASSESSMENT 265.25 185.68
28000010 915 90853 GROUP THERAPY 233.25 163.28
28000015 914 90833 INDIVIDUAL THERAPY 45MIN. 254.75 178.33
28000020 914 90837 INDIVIDUAL THERAPY 60 MIN. 328.75 230.13
28000025 914 90832 INDIVIDUAL THERAPY 30 MIN. 132.50 92.75
28000030 916 90846 FAMILY THERAPY WO/PATIENT 1 HR 259.75 181.83
28000035 916 90847 FAMILY THERAPY W/PATIENT 1 HR 281.25 196.88
28000040 914 90833 INDIVIDUAL THERAPY W/E&M 30 MIN 132.50 92.75
29001001 920 95806 HOME SLEEP TEST 1,096.33 767.43
29001002 920 95810 POLYSOMNOGRAPHY WO PAP 6,985.27 4,889.69
29001003 920 95811 POLYSOMNOGRAPHY W PAP 6,985.27 4,889.69
30000100 450 31500 INTUBATION HOSPITAL 718.03 502.62
30000149 460 94060 SPIROMETRY P & P 895.71 627.00
30000160 460 94070 BR PROV W/METHACHOLINE 534.00 373.80
30000165 460 94620TC BR PROV W EXERCISE 534.00 373.80
30000214 410 94002 VENT INIT DAY MANAGEMENT 2,072.39 1,450.67
30001194 482 93017 EKG STRESS TEST 895.71 627.00
30001195 730 93041 EKG RHYTHM STRIP 206.48 144.54
30001200 730 93005 EKG 12 LEAD 209.94 146.96
30001201 482 93017 DOBUTAMINE STRESS TEST EKG ONLY 895.71 627.00
30002210 410 94644 CONT NEB ([Link]) 693.94 485.76
30002235 410 94645 CONT NEB (SUB HR) 693.94 485.76
30002645 410 94664 DEMO/EVAL TX OP 687.67 481.37
30004770 460 94770 END TIDAL CO2 MONITORING 918.12 642.68
30007088 271 OXYGEN PER HOUR 14.83 10.38
30007091 480 92950 CODE ATTENDENT HOSP 640.75 448.53
30007094 450 92950 CODE ATTENDANT ER 640.75 448.53
30007370 731 93225 HOLTER MONITOR HOOKUP ONLY 367.46 257.22
30007371 731 93225 HOLTER HOOKUP 24 - 48 HOURS 383.60 268.52
30007372 731 93242 HOLTER HOOKUP 3 - 7 DAYS 115.96 81.17
30007373 731 93246 HOLTER HOOKUP 8-15 DAYS 190.73 133.51
30008012 410 94640 NEB/MDI INITIAL 693.94 485.76
30008110 300 89220 SPUTUM INDUCT 0.9% SALINE 518.63 363.04
30008128 460 94150 VITAL CAPACITY ONLY 540.77 378.54
30008136 460 94760 PULSE OX 51.72 36.20
30008169 410 94664 DEMONSTRATION & EVALUATION OF TX 687.67 481.37
30008193 410 94667 CPT INITIAL 391.09 273.76
30008201 460 94010 SPIROMTRY PRE ONLY 503.00 352.10
30008235 410 94640 NEB/MDI SUB 693.94 485.76
30008243 410 94668 CPT SUBSEQUENT 391.09 273.76
30008256 460 94729 LUNG DIFFUSION 263.80 184.66
30008257 410 94660 BIPAP CPAP MANAGEMENT 687.67 481.37
30008284 300 36600 ARTERIAL PUNCTURE 384.43 269.10
30008286 460 94727 FUNCTIONAL RESIDUAL CAPACITY 503.00 352.10
30008293 460 94750 PULMONARY COMPLNC STDY 503.00 352.10
30008326 460 94150 Vital Capacity, Total 488.82 342.17
30008334 460 94375 FV LOOP ONLY 918.12 642.68
30008335 410 94640 MDI INITIAL 248.25 173.78
30008336 412 9464076 MDI SUBS 72.25 50.58
30008367 460 94761 PULSE OX MULTIPLE DETERMINATIONS 139.77 97.84
30008420 410 94002 NIPPV INIT 2,072.39 1,450.67
30008422 410 94003 NIPPV SUBS 1,699.86 1,189.90
30008516 410 31720 NASOTRACHEAL SX 687.67 481.37
30008571 450 31500 INTUBATION/ASSIST (ED) 698.95 489.27
30008573 450 31500 INTUBATION/ASSIST EMERG 718.03 502.62
30008600 412 94640 INTERMITTANT POSSITIVE PRESSURE 97.25 68.08
30008605 412 9464076 IPPB SUBS RX 72.25 50.58
30008606 460 94726 IGV PLETHYSMOGRAPHY 918.12 642.68
30008701 270 OXYGEN PER DAY 228.09 159.66
30008705 410 94003 VENT SUBS DAY MANAGEMENT 1,699.86 1,189.90
30008706 460 94200 MAX VOL VENT-ONLY 387.56 271.29
30009015 460 94360 DNU RAW VENT 185.50 129.85
30009025 460 94680 GAS ANALYSIS 503.00 352.10
30009026 460 94762 PULSE OX OVERNIGHT STUDY 503.00 352.10
30009028 730 9300576 EKG 12 LEAD SUBSEQUENT 209.94 146.96
30009029 460 94618 PULSE OX 6 MINUTE WALK TEST includes HR, 382.94 268.06
30009030 942 99406 SMOKING CESSATION 112.24 78.57
30009032 731 93270 EKG KING OF HEARTS EVENT MONITOR 217.50 152.25
31000010 434 97165GO OT EVAL LOW COMPLEX 20 MIN 361.85 253.30
31000011 434 97166GO OT EVAL MOD COMPLEX 30 MIN 419.98 293.99
31000012 434 97167GO OT EVAL HIGH COMPLEX 45 MINS 480.24 336.17
31000050 444 92506GN * DO NOT USE 323.75 226.63
31000051 444 92521GN ST EVALUATION FLUENCY 589.94 412.96
31000052 444 92522GN ST EVALUATION SOUND PRODUCTION 589.94 412.96
31000053 444 92523GN ST EVALUATION SOUND PROD/COMPREHENSION 589.94 412.96
31000054 444 92524GN ST ANALYSIS VOICE RESONANCE 589.94 412.96
31000055 440 97127GN ST COGNITIVE SKILL DEVELOPMENT 87.28 61.10
31000192 424 97161GP PT EVAL LOW COMPLEX 20 MIN 357.32 250.12
31000193 424 97162GP PT EVAL MOD COMPLEX 30 MIN 420.02 294.01
31000194 424 97163GP PT EVAL HIGH COMPLEX 45 MIN 489.62 342.73
31001000 434 97003GO OT OCCUPATIONAL THERAPY EVALUATION 198.75 139.13
31001001 434 97168GO OT RE-EVAL EST PLAN CARE 225.06 157.54
31001010 430 97110GO GO OT THERAPEUTIC EXERCISE,15 MINUTES 161.71 113.20
31001020 430 97530GO OT THERAPEUTIC ACTIVITIES, 15 MINUTES 142.18 99.53
31003150 430 97112GO OT NEUROMUSC RE-EDUCATION 15 MIN. 161.71 113.20
31003160 430 97761GO GO OT PROSTHETIC TRAINING, 15 MIN. 78.50 54.95
31003170 430 97535GO OT SELF CARE/HOME MGMT TRN 15 MIN. 142.00 99.40
31003175 420 97605GP NEGATIVE PRESS WOUND TX 50 CM OR GREATER 237.25 166.08
31003176 420 97606GP NEGATIVE PRESSURE TX GREATER THAN 50 CM 237.25 166.08
31004011 420 97016GP GP PT VASOPNEUMATIC DEVICES 50.00 35.00
31004036 420 97032GP PT TENS, ELEC STIM MANUAL, 15 MINUTES 164.64 115.25
31004063 420 97598 SELECT DEBRIDEMENT GREATER THAN 20 CM 611.04 427.73
31004064 420 97597 SELECT DEBRIDEMENT 20 CM OR LESS 680.49 476.34
31004068 420 29220 GP PT STRAPPING-LOW BACK 110.50 77.35
31004070 420 29240 GP PT STRAPPING-SHOULDER 203.28 142.30
31004071 420 29530 GP PT TAPING- KNEE 198.32 138.82
31004072 420 64550 GP PT TENS APPLICATION 83.64 58.55
31004077 420 97110GP PT THERAPEUTIC EXERCISE, 15 MINS. 161.71 113.20
31004078 420 97113GP PT AQUATIC THERAPY, 15 MINS 180.86 126.60
31004087 420 97112GP PT NEUROMUSC, 15 MINS. 161.71 113.20
31004101 420 97116GP PT GAIT TRAINING, 15 MINUTES 156.92 109.84
31004127 420 97022GP PT WHIRLPOOL 223.30 156.31
31004155 420 97761GO PT PROSTHETIC TRAINING, 15 MIN 72.25 50.58
31004170 424 97164GP GP PT RE EVALUATION 226.29 158.40
31004184 420 97012GP GP PT MECHANICAL TRACTION 170.40 119.28
31004186 420 97763GP PT CHECKOUT ORTH/PROST USE, 15MIN 160.68 112.48
31004187 430 97762GO OT CHECKOUT ORTH/PROST USE 15MIN 81.25 56.88
31004192 424 97001GP GP PT EVALUATION 225.00 157.50
31004218 420 97535GP PT SELF CARE/HOME MGMT TRN 15 MIN 142.00 99.40
31004242 420 97035GP GP PT ULTRASOUND, 15 MINUTES 171.91 120.34
31004266 420 97530GP PT THERAPEUTIC ACTIVITY, 15 MINUTES 142.18 99.53
31004267 420 97033GP PT IONTOPHORESIS, 15 MINUTES 234.42 164.09
31004330 429 G0283GP GP ELECTRICAL STIMULATION (UNATTENDED) 124.16 86.91
31004350 918 96120 NEUROPSYCHOLOGICAL TESTING ADMIN W/COMP 27.50 19.25
31004351 918 96125 STANDARDIZED COGNITIVE ASSESSMENT 398.32 278.82
31004360 420 97750GP PHYSICAL PERFORMANCE TESTING, 15 MINUTES 71.89 50.32
31004370 420 95992GP CANALITH REPOSITIONING, UNTIMED 312.20 218.54
31005010 440 92507GN GN ST TREAT SPEECH LANG VOICE, INDIV I 369.15 258.41
31005012 440 92507GN GN ST TREAT SPEECH LANG VOICE, INDIV II 390.25 273.18
31005014 440 92507GN GN ST TREAT SPEECH LANG VOICE, INDIV III 421.89 295.32
31005016 440 92507GN GN ST TREAT SPEECH LANG VOICE, INDIV IV 390.25 273.18
31005020 444 92611GN GN ST VIDEO SWALLOWING EVAL 776.13 543.29
31005024 440 96105GN GN ST ASPHAGIA ASSESS W/REPORT PER HR 431.72 302.20
31005026 444 92610GN ST SWALLOW EVALUATION 795.54 556.88
31005028 440 92526GN GN ST TX OF SWALLOW/ORAL DYSFUNCTION 407.00 284.90
31005032 440 92526GN GN ST DYSPHAGIA TREATMENT 407.00 284.90
31007000 420 G8978CHGP MOBILITY CURRENT STATUS 0.01 0.01
31007001 420 G8978CIGP MOBILITY CURRENT STATUS 0.01 0.01
31007002 420 G8978CJGP MOBILITY CURRENT STATUS 0.01 0.01
31007003 420 G8978CKGP MOBILITY CURRENT STATUS 0.01 0.01
31007004 420 G8978CLGP MOBILITY CURRENT STATUS 0.01 0.01
31007005 420 G8978CMGP MOBILITY CURRENT STATUS 0.01 0.01
31007006 420 G8978CNGP MOBILITY CURRENT STATUS 0.01 0.01
31007010 420 G8979CHGP MOBILITY GOAL 0.01 0.01
31007011 420 G8979CIGP MOBILITY GOAL 0.01 0.01
31007012 420 G8979CJGP MOBILITY GOAL 0.01 0.01
31007013 420 G8979CKGP MOBILITY GOAL 0.01 0.01
31007014 420 G8979CLGP MOBILITY GOAL 0.01 0.01
31007015 420 G8979CMGP MOBILITY GOAL 0.01 0.01
31007016 420 G8979CNGP MOBILITY GOAL 0.01 0.01
31007020 420 G8980CHGP MOBILITY DISCHARGE 0.01 0.01
31007021 420 G8980CIGP MOBILITY DISCHARGE 0.01 0.01
31007022 420 G8980CJGP MOBILITY DISCHARGE 0.01 0.01
31007023 420 G8980CKGP MOBILITY DISCHARGE 0.01 0.01
31007024 420 G8980CLGP MOBILITY DISCHARGE 0.01 0.01
31007025 420 G8980CMGP MOBILITY DISCHARGE 0.01 0.01
31007026 420 G8980CNGP MOBILITY DISCHARGE 0.01 0.01
31007030 420 G8978CHGP MOBILITY CURRENT STATUS I 0.01 0.01
31007031 420 G8978CIGP MOBILITY CURRENT STATUS II 0.01 0.01
31007032 420 G8978CJGP MOBILITY CURRENT STATUS III 0.01 0.01
31007033 420 G8978CKGP MOBILITY CURRENT STATUS IV 0.01 0.01
31007034 420 G8978CLGP MOBILITY CURRENT STATUS V 0.01 0.01
31007035 420 G8978CMGP MOBILITY CURRENT STATUS VI 0.01 0.01
31007036 420 G8978CNGP MOBILITY CURRENT STATUS VII 0.01 0.01
31007037 420 G8979CHGP MOBILITY GOAL I 0.01 0.01
31007038 420 G8979CIGP MOBILITY GOAL II 0.01 0.01
31007039 420 G8979CJGP MOBILITY GOAL III 0.01 0.01
31007040 420 G8979CKGP MOBILITY GOAL IV 0.01 0.01
31007041 420 G8979CLGP MOBILITY GOAL V 0.01 0.01
31007042 420 G8979CMGP MOBILITY GOAL VI 0.01 0.01
31007043 420 G8979CNGP MOBILITY GOAL VII 0.01 0.01
31007044 420 G8980CHGP MOBILITY DISCHARGE I 0.01 0.01
31007045 420 G8980CIGP MOBILITY DISCHARGE II 0.01 0.01
31007046 420 G8980CJGP MOBILITY DISCHARGE III 0.01 0.01
31007047 420 G8980CKGP MOBILITY DISCHARGE IV 0.01 0.01
31007048 420 G8980CLGP MOBILITY DISCHARGE V 0.01 0.01
31007049 420 G8980CMGP MOBILITY DISCHARGE VI 0.01 0.01
31007050 420 G8980CNGP MOBILITY DISCHARGE VII 0.01 0.01
31007051 420 G8981CHGP CHANGING BODY POSITION CURRENT I 0.01 0.01
31007052 420 G8981CIGP CHANGING BODY POSITION CURRENT II 0.01 0.01
31007053 420 G8981CJGP CHANGING BODY POSITION CURRENT III 0.01 0.01
31007054 420 G8981CKGP CHANGING BODY POSITION CURRENT IV 0.01 0.01
31007055 420 G8981CLGP CHANGING BODY POSITION CURRENT V 0.01 0.01
31007056 420 G8981CMGP CHANGING BODY POSITION CURRENT VI 0.01 0.01
31007057 420 G8981CNGP CHANGING BODY POSITION CURRENT VII 0.01 0.01
31007058 420 G8982CHGP CHANGING BODY POSITION GOAL I 0.01 0.01
31007059 420 G8982CIGP CHANGING BODY POSITION GOAL II 0.01 0.01
31007060 420 G8982CJGP CHANGING BODY POSITION GOAL III 0.01 0.01
31007061 420 G8982CKGP CHANGING BODY POSITION GOAL IV 0.01 0.01
31007062 420 G8982CLGP CHANGING BODY POSITION GOAL V 0.01 0.01
31007063 420 G8982CMGP CHANGING BODY POSITION GOAL VI 0.01 0.01
31007064 420 G8982CNGP CHANGING BODY POSITION GOAL VII 0.01 0.01
31007065 420 G8983CHGP CHANGING BODY POSITION DISCHARGE I 0.01 0.01
31007066 420 G8983CIGP CHANGING BODY POSITION DISCHARGE II 0.01 0.01
31007067 420 G8983CJGP CHANGING BODY POSITION DISCHARGE III 0.01 0.01
31007068 420 G8983CKGP CHANGING BODY POSITION DISCHARGE IV 0.01 0.01
31007069 420 G8983CLGP CHANGING BODY POSITION DISCHARGE V 0.01 0.01
31007070 420 G8983CMGP CHANGING BODY POSITION DISCHARGE VI 0.01 0.01
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31007074 420 G8984CJGP CARRYING MOVING OBJECTS CURRENT III 0.01 0.01
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31007078 420 G8984CNGP CARRYING MOVING OBJECTS CURRENT VII 0.01 0.01
31007079 420 G8985CHGP CARRYING MOVING OBJECTS GOAL I 0.01 0.01
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31007082 420 G8985CKGP CARRYING MOVING OBJECTS GOAL IV 0.01 0.01
31007083 420 G8985CLGP CARRYING MOVING OBJECTS GOAL V 0.01 0.01
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31007197 430 G8983CNGO CHANGING BODY POSITION DISCHARGE VII 0.01 0.01
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31007219 430 G8987CHGO SELF CARE CURRENT I 0.01 0.01
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31007421 440 G8999CHGN MOTOR SPEECH (CURRENT) I 0.01 0.01
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31007428 440 G9186CHGN MOTOR SPEECH (GOAL) I 0.01 0.01
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31007481 440 G9164CLGN LANG EXPRESS (DC) V 0.01 0.01
31007482 440 G9164CMGN LANG EXPRESS (DC) VI 0.01 0.01
31007483 440 G9164CNGN LANG EXPRESS (DC) VII 0.01 0.01
31007484 440 G9165CHGN ATTEN (CURRENT) I 0.01 0.01
31007485 440 G9165CIGN ATTEN (CURRENT) II 0.01 0.01
31007486 440 G9165CJGN ATTEN (CURRENT) III 0.01 0.01
31007487 440 G9165CKGN ATTEN (CURRENT) IV 0.01 0.01
31007488 440 G9165CLGN ATTEN (CURRENT) V 0.01 0.01
31007489 440 G9165CMGN ATTEN (CURRENT) VI 0.01 0.01
31007490 440 G9165CNGN ATTEN (CURRENT) VII 0.01 0.01
31007491 440 G9166CHGN ATTEN (GOAL) I 0.01 0.01
31007492 440 G9166CIGN ATTEN (GOAL) II 0.01 0.01
31007493 440 G9166CJGN ATTEN (GOAL) III 0.01 0.01
31007494 440 G9166CKGN ATTEN (GOAL) IV 0.01 0.01
31007495 440 G9166CLGN ATTEN (GOAL) V 0.01 0.01
31007496 440 G9166CMGN ATTEN (GOAL) VI 0.01 0.01
31007497 440 G9166CNGN ATTEN (GOAL) VII 0.01 0.01
31007498 440 G9167CHGN ATTEN (DC) I 0.01 0.01
31007499 440 G9167CIGN ATTEN (DC) II 0.01 0.01
31007500 440 G9167CJGN ATTEN (DC) III 0.01 0.01
31007501 440 G9167CKGN ATTEN (DC) IV 0.01 0.01
31007502 440 G9167CLGN ATTEN (DC) V 0.01 0.01
31007503 440 G9167CMGN ATTEN (DC) VI 0.01 0.01
31007504 440 G9167CNGN ATTEN (DC) VII 0.01 0.01
31007505 440 G9168CHGN MEMORY (CURRENT) I 0.01 0.01
31007506 440 G9168CIGN MEMORY (CURRENT) II 0.01 0.01
31007507 440 G9168CJGN MEMORY (CURRENT) III 0.01 0.01
31007508 440 G9168CKGN MEMORY (CURRENT) IV 0.01 0.01
31007509 440 G9168CLGN MEMORY (CURRENT) V 0.01 0.01
31007510 440 G9168CMGN MEMORY (CURRENT) VI 0.01 0.01
31007511 440 G9168CNGN MEMORY (CURRENT) VII 0.01 0.01
31007512 440 G9169CHGN MEMORY (GOAL) I 0.01 0.01
31007513 440 G9169CIGN MEMORY (GOAL) II 0.01 0.01
31007514 440 G9169CJGN MEMORY (GOAL) III 0.01 0.01
31007515 440 G9169CKGN MEMORY (GOAL) IV 0.01 0.01
31007516 440 G9169CLGN MEMORY (GOAL) V 0.01 0.01
31007517 440 G9169CMGN MEMORY (GOAL) VI 0.01 0.01
31007518 440 G9169CNGN MEMORY (GOAL) VII 0.01 0.01
31007519 440 G9170CHGN MEMORY (DC) I 0.01 0.01
31007520 440 G9170CIGN MEMORY (DC) II 0.01 0.01
31007521 440 G9170CJGN MEMORY (DC) III 0.01 0.01
31007522 440 G9170CKGN MEMORY (DC) IV 0.01 0.01
31007523 440 G9170CLGN MEMORY (DC) V 0.01 0.01
31007524 440 G9170CMGN MEMORY (DC) VI 0.01 0.01
31007525 440 G9170CNGN MEMORY (DC) VII 0.01 0.01
31007526 440 G9171CHGN VOICE (CURRENT) I 0.01 0.01
31007527 440 G9171CIGN VOICE (CURRENT) II 0.01 0.01
31007528 440 G9171CJGN VOICE (CURRENT) III 0.01 0.01
31007529 440 G9171CKGN VOICE (CURRENT) IV 0.01 0.01
31007530 440 G9171CLGN VOICE (CURRENT) V 0.01 0.01
31007531 440 G9171CMGN VOICE (CURRENT) VI 0.01 0.01
31007532 440 G9171CNGN VOICE (CURRENT) VII 0.01 0.01
31007533 440 G9172CHGN VOICE (GOAL) I 0.01 0.01
31007534 440 G9172CIGN VOICE (GOAL) II 0.01 0.01
31007535 440 G9172CJGN VOICE (GOAL) III 0.01 0.01
31007536 440 G9172CKGN VOICE (GOAL) IV 0.01 0.01
31007537 440 G9172CLGN VOICE (GOAL) V 0.01 0.01
31007538 440 G9172CMGN VOICE (GOAL) VI 0.01 0.01
31007539 440 G9172CNGN VOICE (GOAL) VII 0.01 0.01
31007540 440 G9173CHGN VOICE (DC) I 0.01 0.01
31007541 440 G9173CIGN VOICE (DC) II 0.01 0.01
31007542 440 G9173CJGN VOICE (DC) III 0.01 0.01
31007543 440 G9173CKGN VOICE (DC) IV 0.01 0.01
31007544 440 G9173CLGN VOICE (DC) V 0.01 0.01
31007545 440 G9173CMGN VOICE (DC) VI 0.01 0.01
31007546 440 G9173CNGN VOICE (DC) VII 0.01 0.01
31007547 440 G9174CHGN SPEECH LANG (CURRENT) I 0.01 0.01
31007548 440 G9174CIGN SPEECH LANG (CURRENT) II 0.01 0.01
31007549 440 G9174CJGN SPEECH LANG (CURRENT) III 0.01 0.01
31007550 440 G9174CKGN SPEECH LANG (CURRENT) IV 0.01 0.01
31007551 440 G9174CLGN SPEECH LANG (CURRENT) V 0.01 0.01
31007552 440 G9174CMGN SPEECH LANG (CURRENT) VI 0.01 0.01
31007553 440 G9174CNGN SPEECH LANG (CURRENT) VII 0.01 0.01
31007554 440 G9175CHGN SPEECH LANG (GOAL) I 0.01 0.01
31007555 440 G9175CIGN SPEECH LANG (GOAL) II 0.01 0.01
31007556 440 G9175CJGN SPEECH LANG (GOAL) III 0.01 0.01
31007557 440 G9175CKGN SPEECH LANG (GOAL) IV 0.01 0.01
31007558 440 G9175CLGN SPEECH LANG (GOAL) V 0.01 0.01
31007559 440 G9175CMGN SPEECH LANG (GOAL) VI 0.01 0.01
31007560 440 G9175CNGN SPEECH LANG (GOAL) VII 0.01 0.01
31007561 440 G9176CHGN SPEECH LANG (DC) I 0.01 0.01
31007562 440 G9176CIGN SPEECH LANG (DC) II 0.01 0.01
31007563 440 G9176CJGN SPEECH LANG (DC) III 0.01 0.01
31007564 440 G9176CKGN SPEECH LANG (DC) IV 0.01 0.01
31007565 440 G9176CLGN SPEECH LANG (DC) V 0.01 0.01
31007566 440 G9176CMGN SPEECH LANG (DC) VI 0.01 0.01
31007567 440 G9176CNGN SPEECH LANG (DC) VII 0.01 0.01
31009605 420 97140 GP PT MYOFACIAL RELEASE 178.28 124.80
31009607 420 97140GP PT MANUAL THERAPY,15 MINUTES 178.28 124.80
31009608 440 97129 THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTE 174.70 122.29
31009609 440 97130 THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MI 168.23 117.76
32000001 943 93798 CARDIAC REHAB PHASE 2 W ECG MONITOR 115.50 80.85
33001000 420 97140 MM MANUAL THERAPY,15 MINUTES 93.86 65.70
33002000 420 97124 MM MASSAGETHERAPY 82.42 57.69
34001000 948 G0424 PULMONARY REHAB 1 HR SESSION FOR COPD DX 200.57 140.40
34002000 948 G0238 PULMONARY REHAB 15 MIN SESSION FOR NON C 117.40 82.18
34003000 948 G0239 PULMONARY REHAB GROUP SESSION FOR NON CO 115.95 81.17
34004000 948 94625 pulmonary rehabilitation; without contin 189.31 132.52
34005000 948 94626 outpatient pulmonary rehabilitation; wit 189.31 132.52
35000002 943 93798 CARDIAC REHAB PHASE 2 W ECG MONITOR 377.61 264.33
39000010 610 74185 MMRA Abdomen w/wo contrast 2,681.22 1,876.85
39000011 610 73222 MMRI U EXTR; ANY JOINT W CONTRAST 3,774.67 2,642.27
39001224 615 70544 MMRA BRAIN WITHOUT CONTRAST 3,102.69 2,171.88
39001225 615 70546 MMRA BRAIN WITH CONTRAST 3,572.43 2,500.70
39001226 615 70547 MMRA NECK WO CONTRAST 3,102.69 2,171.88
39001233 612 72147 MMRI THORACIC SPINE W/CONTRAST 3,683.70 2,578.59
39001234 612 72149 MMRI LUMBAR SPINE WITH CONTRAST 3,792.78 2,654.95
39001235 612 72142 MMRI CERVICAL SPINE WITH CONTRAST 3,792.78 2,654.95
39008503 611 70551 MMRI BRAIN W/O CONTRAST 3,027.02 2,118.91
39008504 611 70553 MMRI BRAIN WITH AND WITHOUT CONTRAST 3,899.68 2,729.78
39008506 610 76393 MMRI LOCALIZIN BIOPSY 942.00 659.40
39008509 614 70540 MMRI ORBIT / FACE / NECK W/O CONTRAST 3,353.15 2,347.21
39008539 612 72141 MMRI CERVICAL SPINE W/O CONTRAST 3,328.55 2,329.99
39008542 612 72146 MMRI THORACIC SPINE W/O CONTRAST 3,328.55 2,329.99
39008545 612 72148 MMRI LUMBAR SPINE W/O CONTRAST 3,328.55 2,329.99
39008551 614 71550 MMRI CHEST W/O CONTRAST 2,590.34 1,813.24
39008554 614 74181 MMRI ABDOMEN W/O CONTRAST 3,576.21 2,503.35
39008560 611 70544 MMRI HEAD & / OR NECK 2,273.25 1,591.28
39008581 614 72195 MMRI PELVIS W/O CONTRAST 3,576.21 2,503.35
39008584 610 76499 MMRI SPECIFY 2,032.50 1,422.75
39008585 610 73221RT MMRI ELBOW JT RIGHT W/O CONTRAST 3,479.49 2,435.64
39008586 610 73221LT MMRI ELBOW LEFT - W/O CONTRAST 3,479.49 2,435.64
39008587 610 73221RT MMRI SHOULDER JT RIGHT W/O CONTRAST 3,354.55 2,348.19
39008588 610 73221LT MMRI SHOULDER JT LEFT W/O CONTRAST 3,354.55 2,348.19
39008590 610 71550 MMRI GREAT VESSELS 3,980.40 2,786.28
39008591 614 73218LT MMRI UPPER EXTREMITY LEFT - W/O CONTRAST 3,367.68 2,357.38
39008593 610 73218RT MMRI UPPER EXTREMITY RT W/O CONTRAST 3,367.68 2,357.38
39008595 610 73219RT MMRI UPPER EXTREMITY RIGHT W/CONTRAST 3,814.91 2,670.44
39008596 610 75552 MMRI CARDIAC 2,073.00 1,451.10
39008597 614 73219LT MMRI UPPER EXTREMITY LEFT - W/CONTRAST 3,814.91 2,670.44
39008612 614 73721RT MMRI KNEE RIGHT - W/O CONTRAST 3,354.55 2,348.19
39008613 614 73721LT MMRI KNEE LEFT - W/O CONTRAST 3,354.55 2,348.19
39008616 610 73721LT MMRI HIP JT LEFT - WITHOUT CONTRAST 3,354.55 2,348.19
39008617 610 73721RT MMRI HIP JT RIGHT W/O CONTRAST 3,354.55 2,348.19
39008618 610 73222LT MMRI SHOULDER LT W/CONTRAST 3,814.91 2,670.44
39008619 610 73222RT MMRI SHOULDER JT RIGHT W/CONTRAST 3,815.77 2,671.04
39008620 614 73718RT MMRI LOWER EXT RIGHT W/O CONTRAST 3,354.55 2,348.19
39008621 614 73719RT MMRI LOWER EXT RIGHT WITH CONTRAST 3,814.91 2,670.44
39008622 614 73720RT MMRI LOWER EXT RIGHT WO/W CONTRAST 4,150.34 2,905.24
39008624 614 73718LT MMRI LOWER EXT LEFT - WITHOUT CONTRAST 3,354.55 2,348.19
39008625 614 73719LT MMRI LOWER EXT LEFT - WITH CONTRAST 3,814.91 2,670.44
39008627 614 73720LT MMRI LOWER EXT LEFT WO / W CONTRAST 4,150.34 2,905.24
39008640 610 MMRI TESLASCAN 529.00 370.30
39008644 611 70553 MMRI BRAIN /+CONT 2,602.96 1,822.07
39008647 636 A9579 MMRI CONTRAST MEDIA 283.99 198.79
39008648 636 A9579 MMRI CONTRAST GADOLINIUM 12.02 8.41
39008650 611 70552 MMRI BRAIN W/CONTRAST GADOLINIUM 3,572.43 2,500.70
39008659 614 70542 MMRI ORBIT/FACE/NECK WITH CONTRAST 3,707.69 2,595.38
39008660 614 70540 MMRI ORBIT/FACE/NECK W/O 3,353.15 2,347.21
39008661 614 70543 MMRI ORBIT / FACE / NECK WO / W CONTRAST 4,034.94 2,824.46
39008704 612 72156 MMRI CERVICAL SPINE WO / W CONTRAST 4,120.02 2,884.01
39008710 612 72157 MMRI THORACIC SPINE WO/W CONTRAST 4,010.94 2,807.66
39008716 612 72158 MMRI LUMBAR WO/W CONTRAST 4,120.02 2,884.01
39008718 614 71551 MMRI CHEST WITH CONTRAST 3,149.39 2,204.57
39008728 614 71552 MMRI CHEST WO / W CONTRAST 3,484.80 2,439.36
39008734 610 74183 MMRI ABDOMEN WO/W CONTRAST 3,924.76 2,747.33
39008736 614 74182 MMRI ABDOMEN WITH CONTRAST 4,084.30 2,859.01
39008774 614 72196 MMRI PELVIS WITH CONTRAST 4,023.44 2,816.41
39008776 614 72197 MMRI PELVIS WO / W CONTRAST 4,358.86 3,051.20
39008779 610 76499 MMRI SPECIFY F/U 1,016.75 711.73
39008785 610 73223RT MMRI SHOULDER JT RIGHT WO/W CONTRAST 4,151.18 2,905.83
39008786 610 73223LT MMRI SHOULDER JT LEFT WO/W CONTRAST 4,151.18 2,905.83
39008787 610 73223RT MMRI ELBOW JT RIGHT WO/W CONTRAST 3,814.91 2,670.44
39008788 610 73223LT MMRI ELBOW JT LEFT WO/W CONTRAST 3,814.91 2,670.44
39008791 610 71550 MMRI GREAT VESSELS WO / W CONTRAST 4,651.24 3,255.87
39008797 610 75553 MMRI CARDIAC W/CONT 2,573.00 1,801.10
39008806 614 73220RT MMRI UPPER EXTREMITY RIGHT WO/W CONTRAST 4,150.34 2,905.24
39008807 610 73220LT MMRI UPPER EXTREMITY LEFT WO/W CONTRAST 4,150.34 2,905.24
39008829 614 73723LT MMRI KNEE LEFT WO / W CONTRAST 4,150.34 2,905.24
39008830 614 73723RT MMRI KNEE RIGHT WO / W CONTRAST 4,150.34 2,905.24
39008831 614 73722RT MMRI KNEE RIGHT W/CONTRAST 3,721.87 2,605.31
39008832 614 73722LT MMRI KNEE LEFT W/CONTRAST 3,721.87 2,605.31
39008834 610 73723RT MMRI HIP JT RIGHT WO/W CONTRAST 4,150.34 2,905.24
39008835 610 73723LT MMRI HIP JT LEFT WO/W CONTRAST 4,150.34 2,905.24
39008836 610 73722RT MMRI HIP JT RIGHT W/CONTRAST 3,721.87 2,605.31
39008837 610 73722LT MMRI HIP JT LEFT W/CONTRAST 1,666.23 1,166.36
40000011 301 80048 BASIC METABOLIC PANEL POINT OF CARE 123.12 86.18
40000012 301 80053 COMP METABOLIC PANEL POINT OF CARE 178.08 124.66
40000013 301 82150 AMYLASE POINT OF CARE 205.15 143.61
40000014 301 82550 CK POINT OF CARE 80.47 56.33
40000015 300 85025 BACK UP CBC 61.08 42.76
40000016 301 82553 CK-MB POINT OF CARE 110.72 77.50
40000017 301 84484 TROPONIN POINT OF CARE 167.29 117.10
40000018 301 83874 MYOGLOBIN POINT OF CARE 151.42 105.99
40000026 300 87077 ORG ID REF LAB 68.72 48.10
40000035 301 84550 URIC ACID POINT OF CARE 55.70 38.99
40000055 301 80051 ELECTROLYTE PANEL 77.46 54.22
40000071 301 80076 HEPATIC PANEL 124.50 87.15
40000072 300 85025 EMPLOYEE CBC 174.70 122.29
40000073 300 81003 EMPLOYEE URINALYSIS 5.45 3.82
40000074 301 80305 EMPLOYEE NICOTINE SCREEN 3.93 2.75
40000075 300 80323 EMPLOYEE NICOTINE CONFIRM 21.15 14.81
40000076 300 86762 EMPLOYEE RUBELLA 9.90 6.93
40000077 300 86765 EMPLOYEE RUBEOLA 20.32 14.22
40000078 300 86735 EMPLOYEE MUMPS 13.88 9.72
40000079 300 86787 EMPLOYEE VARICELLA 12.74 8.92
40000080 300 86706 EMPLOYEE HEP B AB 240.35 168.25
40000081 300 86480 EMPLOYEE QUANTIFERON TB 59.99 41.99
40000082 301 80320 EMPLOYEE ALCOHOL 20.72 14.50
40000083 300 87389 EMPLOYEE HIV 1/2 18.96 13.27
40000084 300 87340 EMPLOYEE HEP B AG 12.50 8.75
40000085 300 86803 EMPLOYEE HEP C AB 13.57 9.50
40000121 301 82040 ALBUMIN SERUM 46.90 32.83
40000122 301 82040 ALBUMIN REFERRED 11.65 8.16
40000125 301 82042 ALBUMIN URINE, OR OTHER SOURCES 19.61 13.73
40000126 301 83018 COBALT BLOOD 48.88 34.22
40000127 301 82495 CHROMIUM SERUM 34.91 24.44
40000128 301 83018 IODINE URINE 539.96 377.97
40000129 301 82175 ARSENIC FRACTIONATED 265.89 186.12
40000130 301 82175 ARSENIC - QUANTITATIVE 97.35 68.15
40000131 301 82190 ATOMIC ABSORPTION SPECT. EA ANALYTE 459.50 321.65
40000132 301 82300 CADMIUM - BLOOD 109.08 76.36
40000133 301 82108 ALUMINUM - SERUM 84.25 58.98
40000135 300 86735 MUMPS AB IGM 87.55 61.29
40000136 302 86747 B-19 PARVOVIRUS IGG 59.82 41.87
40000137 302 86747 B-19 PARVOVIRUS IGM 59.82 41.87
40000145 301 83695 LIPOPROTEIN (LITTLE A) 64.09 44.86
40000147 301 82150 AMYLASE SERUM 205.15 143.61
40000150 301 82150 AMYLASE BODY FLUID 91.06 63.74
40000151 301 83690 LIPASE-BODY FLUID 100.58 70.41
40000152 300 C9803 SPEC COLL SNF/LAB COVID-19 94.35 66.05
40000153 300 G2023 SPECIMEN COLLECT COVID-19 86.94 60.86
40000154 301 84520 UREA NITROGEN SERUM 46.90 32.83
40000155 300 86612 BLASTOMYCES AB-BY ID 58.90 41.23
40000159 301 84540 RENAL FAILURE INDICIES 5 18.50 12.95
40000160 301 84540 UREA NITROGEN URINE 62.47 43.73
40000161 301 84540 UREA NITROGEN 24 HR URINE 62.47 43.73
40000162 301 82150 AMYLASE URINE 205.15 143.61
40000165 301 82164 ANGIOTENSIN I - CONVERTING ENZYME (ACE) 78.81 55.17
40000168 301 82374 TCO2 BICARBONATE 33.88 23.72
40000170 301 82247 BILIRUBIN TOTAL 46.90 32.83
40000171 300 U0003 SARS-COV-2 COVID-19 AMP PRB HIGH THROUGH 315.01 220.51
40000188 301 82248 BILIRUBIN DIRECT 47.52 33.26
40000196 301 82310 CALCIUM-SERUM 46.90 32.83
40000220 301 82465 CHOLESTEROL TOTAL 46.90 32.83
40000238 301 82550 CK SERUM 80.47 56.33
40000239 301 82550 REFERRED CK 80.47 56.33
40000246 301 82565 CREATININE-SERUM 53.36 37.35
40000249 301 82570 CREATININE-BODY FLUI 56.75 39.73
40000250 301 82570 CREATININE-URINE 56.75 39.73
40000251 301 82570 CREATININE 24 HR URINE 56.75 39.73
40000252 301 82570 RENAL FAILURE INDICIES 4 18.50 12.95
40000253 301 82575 CREATININE CLEARANCE 102.27 71.59
40000279 301 82947 GLUCOSE 44.47 31.13
40000287 301 82950 GLUCOSE PRANDIAL 38.25 26.78
40000288 301 82945 RENAL FAILURE INDICIES 3 18.50 12.95
40000289 301 82945 GLUCOSE URINE 46.90 32.83
40000290 301 82945 GLUCOSE 24 HR URINE 20.18 14.13
40000291 301 82945 GLUCOSE BODY FLUID 46.90 32.83
40000295 301 82951 GLUCOSE TLRNCE (1ST 3 SPEC.) 124.90 87.43
40000303 301 82952 GLUCOSE TOL SR HOUR 4 20.18 14.13
40000304 301 82952 GLUCOSE TOL SR HOUR 5 20.18 14.13
40000335 301 83605 LACTIC ACID, ARTERIAL 117.31 82.12
40000336 301 83605 LACTIC ACID, VENOUS 94.61 66.23
40000337 301 83615 LDH SERUM 62.47 43.73
40000338 301 83615 LDH BODY FLUID 62.47 43.73
40000339 300 83630 LACTOFERIN STOOL 93.26 65.28
40000340 300 87254 VIRAL SMEAR, SHELL VIAL 173.18 121.23
40000344 301 84105 PHOSPHORUS URINE 107.24 75.07
40000345 301 84100 PHOSPHORUS SERUM 46.90 32.83
40000346 301 84105 PHOPHORUS 24 HR URINE 48.70 34.09
40000350 301 84133 POTASSIUM URINE 51.74 36.22
40000351 301 84133 POTASSIUM 24 HR URINE 51.74 36.22
40000352 301 84132 POTASSIUM BLOOD 49.76 34.83
40000353 301 84132 FULL ARTERIAL PROFILE 3 18.50 12.95
40000354 301 84134 PREALBUMIN 86.18 60.33
40000355 301 84132 POTASSIUM BLOOD GAS 49.76 34.83
40000360 300 82157 ANDROSTENDIONE 130.25 91.18
40000367 300 85549 LYSOZYME, SERUM OR BODY FLUID 59.00 41.30
40000373 301 83930 OSMOLALITY SERUM MEASURED 29.46 20.62
40000374 301 83935 OSMOLALITY URINE MEASURED 42.55 29.79
40000375 301 83986 PH BODY FLUID 55.90 39.13
40000394 301 84450 AST SERUM 46.90 32.83
40000402 301 84460 ALT SERUM 46.90 32.83
40000405 301 82671 ESTROGEN SERUM FRACTION 200.98 140.69
40000410 301 82977 GAMMA GT 47.45 33.22
40000427 301 84295 FULL ARTERIAL PROFILE 2 43.00 30.10
40000428 301 84295 SODIUM BLOOD 46.90 32.83
40000429 301 84302 SODIUM BF 46.90 32.83
40000430 301 84295 SODIUM BLOOD GAS 46.90 32.83
40000433 300 86162 COMPLEMENT TOTAL (CH50) 103.35 72.35
40000436 301 84155 PROTEIN TOTAL 95.30 66.71
40000437 301 84155 TOTAL PROTEIN REF LAB 44.47 31.13
40000444 301 84550 URIC ACID SERUM 55.70 38.99
40000446 301 84560 URIC ACID BF/URINE 47.02 32.91
40000447 301 84560 URIC ACID 24 HR URINE 47.02 32.91
40000469 300 85002 BLEEDING TIME 111.18 77.83
40000470 300 87449 BETA-D-GLYCAN 456.86 319.80
40000481 310 81403 JAK2 EXON 12 1,151.90 806.33
40000483 310 81401 TPMT GENETICS 1,120.27 784.19
40000484 310 81403 KRAS VAREXON 376.34 263.44
40000485 310 81275 KRAS GENE ANALYSIS 376.34 263.44
40000486 310 81256 HEMOCHROMATOSIS HFE 3 MUTATIONS 270.60 189.42
40000487 310 81479 IBD SGI DIAGNOSTIC 88.13 61.69
40000488 310 81291 MTHFR 270.38 189.27
40000489 310 81240 PROTHROMBIN GENE MUTATION 288.38 201.87
40000490 310 81241 FACTOR V LEIDEN I 244.34 171.04
40000491 310 81270 JAK 2 GENE ANALYSIS 409.05 286.34
40000492 311 88271 CYTOGENETICS DNA PROBE FISH MDS 287.01 200.91
40000493 311 88271 MOLECULAR CYTOGENETICS DNA PROBE 291.95 204.37
40000494 310 88368 INSITU HYBRID MORPHOMETRIC MANUAL 777.21 544.05
40000495 300 85244 FACTOR VIII RELATED AG 142.07 99.45
40000496 311 88273 MOLECULAR CYTOGENETICS FISH 10-30 168.54 117.98
40000497 310 88364 INSITU HYBRID MORPHOMETRIC AUTO 395.15 276.61
40000498 310 88381 MICRODISSECTION NAMUAL 65.44 45.81
40000499 310 88368 ALK MORPHOMETRIC ANALYSIS 742.42 519.69
40000500 310 81235 EGFR GENE ANALYSIS 613.59 429.51
40000501 310 81301 MSI ANALYSIS 501.77 351.24
40000502 300 83516 DGP IGG 67.35 47.15
40000503 310 81206 BCR ABL BY PCR 1,231.19 861.83
40000504 310 81162 BRCA 1 AND 2 6,026.77 4,218.74
40000505 301 82668 ERYTHROPOIETIN 112.09 78.46
40000506 311 88271 MOLECULAR CYTO DNA PROBE-MAYO 1,923.48 1,346.44
40000507 311 88271 CYTO DNA PROBE BALLF 512.66 358.86
40000508 311 G0476 HPV DNA IGH RISK TYPES 115.56 80.89
40000510 310 88363 ARCHIVAL TISSUE MOLECULAR 42.55 29.79
40000511 311 88271 FISH PLASMA CELL MAYO 779.93 545.95
40000512 311 85246 VON WILLIBRAND FACTOR COLLAGEN BINDING A 560.39 392.27
40000513 301 83516 GBM GLOM BASEMENT MEMBRANE 19.04 13.33
40000514 311 88271 MISC MOL CYTO DNA PROBE 69.51 48.66
40000519 300 89190 EOSINOPHIL COUNT NASAL 50.44 35.31
40000520 300 81015 EOSINOPHILS URINE 10.36 7.25
40000521 300 81015 URINE MICROSCOPIC 14.47 10.13
40000526 300 85520 HEPARIN ANTI-XA 73.36 51.35
40000527 300 85384 FIBRINOGEN 121.63 85.14
40000528 305 85397 FACTOR VWF GPIBM 330.19 231.13
40000535 300 85014 HEMATOCRIT X 17.18 12.03
40000543 300 85018 HEMOGLOBIN X 34.94 24.46
40000544 300 83051 HEMOGLOBIN - PLASMA 99.27 69.49
40000545 300 85018 HEMOGLOBIN BLOOD GAS 34.94 24.46
40000584 300 85048 WBC X 25.91 18.14
40000586 300 85540 LEUK ALKA PHOS(LAP) 52.50 36.75
40000600 300 85049 PLATELET COUNT X 29.18 20.43
40000603 300 85032 PLATELET COUNT-MAN 68.83 48.18
40000604 305 85032 WBC COUNT MANUAL 46.25 32.38
40000606 390 P9059 PLASMA FROZEN WITHIN 24 HOURS 251.78 176.25
40000610 301 84244 RENIN LEVEL 110.44 77.31
40000611 300 84238 SOLUBLE TRANSFERRIN RECEPTOR 80.44 56.31
40000617 305 85597 HEXAGONAL PHASE PHOSPHOLIPID 72.54 50.78
40000618 300 85610 PT(PROTHROMBIN TIME) 52.94 37.06
40000619 300 85670 THROMBIN TIME 54.81 38.37
40000620 300 85613 DILUTE RUSSELL VIPER VENOM TIME 91.91 64.34
40000621 300 85611 PT MIXING STUDY 18.82 13.17
40000626 300 85730 PTT PARTL THRMBPLSTN 85.77 60.04
40000627 300 85307 APC RESISTANCE PROFILE 106.08 74.26
40000628 300 85732 APTT MIXING STUDY 30.82 21.57
40000629 300 85810 VISCOSITY 71.97 50.38
40000634 300 85045 RETICULOCYTE COUNT 99.27 69.49
40000638 300 86430 RA FACTOR-FLUID 70.94 49.66
40000640 302 86235 SCL-70 AB 20.92 14.64
40000642 300 85652 SED RATE ESR 51.88 36.32
40000645 300 89325 SPERM ANTIBODIES 286.75 200.73
40000659 300 85660 SICKLE CELL SCREEN 17.05 11.94
40000660 301 83516 ANTI PM/SCL-100 319.06 223.34
40000665 300 86593 RPR QUANT 64.63 45.24
40000667 300 86592 RPR QUAL 48.54 33.98
40000669 300 87420 RSV 67.35 47.15
40000675 300 86308 MONO TEST 73.06 51.14
40000676 300 86308 HETEROPHILE ANTIBODY 27.00 18.90
40000683 300 83883 ASO TITER 234.00 163.80
40000695 300 86332 RAJI CELL ASSAY 131.50 92.05
40000698 300 86000 FEBRILE AGGLUTININS 31.50 22.05
40000699 300 86003 RAST TEST (ALLERGEN) 31.13 21.79
40000700 300 86331 IMMUNODI FUSION 14.25 9.98
40000701 302 86003 GALACTOSE ALPHA ALLERGEN 80.95 56.67
40000702 300 86003 ALLERGEN PENICILLIN 80.95 56.67
40000703 300 86003 ALLERGEN APPLE 80.95 56.67
40000704 300 86003 ALLERGENS BRAZIL NUT 80.95 56.67
40000705 300 86003 ALLERGENS PISTACHIO 31.13 21.79
40000712 390 P9016 RBC LEUKOCYTES REDUCED 653.52 457.46
40000713 390 P9040 RBC LEUKOREDUCED IRRADIATED 948.80 664.16
40000715 300 86431 RA TITER QUANT 76.07 53.25
40000717 300 86430 RA FACTOR QUAL 70.94 49.66
40000720 301 82482 RBC CHOLINESTERASE 72.25 50.58
40000725 300 86157 COLD AGGLUTININS 66.00 46.20
40000726 301 82525 COPPER SERUM 67.35 47.15
40000727 301 84255 SELENIUM 108.77 76.14
40000728 301 82525 COPPER URINE 141.81 99.27
40000790 300 81002 URINE DIPSTICK 23.75 16.63
40000810 300 86735 MUMPS ANTIBODY IGG 41.19 28.83
40000816 301 84703 PREG TEST(UCG)UR 106.94 74.86
40000820 301 84703 PREG TEST (HCG) SER 106.94 74.86
40000824 300 81003 URINALYSIS C/S IF INDICATED 40.08 28.06
40000832 300 81050 URINE VOLUME 22.91 16.04
40000840 300 87172 PINWORMS TAPE TEST 54.54 38.18
40000841 306 87169 PARASITE MACROSCOPIC 27.16 19.01
40000850 390 P9035 PLATELETS, PHERESIS 1,986.75 1,390.73
40000857 300 87329 GIARDIA AG 85.36 59.75
40000860 301 84600 METHANOL BLOOD 56.25 39.38
40000861 301 83921 METHYLMALONIC ACID 176.18 123.33
40000865 301 82270 BLD OCCULT - COLORECTAL SCREENING 18.50 12.95
40000866 301 82271 BLD OCCULT - OTHER SOURCES THAN FEC 18.50 12.95
40000867 301 82272 BLD OCCULT - FECES NONSCREENING 18.50 12.95
40000868 300 82274QW QW BLD OCCULT FECAL IMMUNO CHEMICAL 113.29 79.30
40000869 300 82274 BLD OCCULT FECAL IMMUNO DIAGNOSTIC 74.12 51.88
40000872 300 87209 TRICHROME STAIN 91.63 64.14
40000873 306 87205 GRAM STAIN 60.35 42.25
40000874 300 87270 CHLAMYDIA TRACH OMATIS DFA 89.45 62.62
40000875 300 87177 OVA & PARASITE SMEAR-DIRECT 53.45 37.42
40000876 300 87272 FLUORESCENT TECHNIQUE CRYPTOSPORIDM 45.50 31.85
40000884 300 86255 FLUORES NONINFECT AGENT AB;EA 101.25 70.88
40000885 300 86256 FLUORES NONINFECT AGENT TITER 101.25 70.88
40000886 300 86255 SMOOTH MUSCLE AB, IGG 55.66 38.96
40000887 300 86256 SMOOTH MUSCLE TITER 57.54 40.28
40000888 300 86255 RETUCULIN AB IGA 94.62 66.23
40000889 302 86255 AGNA 1 219.80 153.86
40000890 302 86255 AMPHIPHYSIN 219.80 153.86
40000891 302 86255 ANNA 1 219.80 153.86
40000892 302 86255 ANNA 2 219.80 153.86
40000893 302 86255 ANNA 3 219.80 153.86
40000894 302 86255 CRMP 5 IGG 219.80 153.86
40000895 302 86255 PCA 1 219.80 153.86
40000896 302 86255 PCA 2 219.80 153.86
40000897 302 86255 PCA TR 219.80 153.86
40000898 302 86255 ENDOMYSIAL AB 173.72 121.60
40000900 301 80154 VALIUM (DIAZEPAM) 96.00 67.20
40000914 306 87185 SENSI ENZYME DIRECT 9.56 6.69
40000915 300 87184 SENSITIVITY ORGANISM 1 85.88 60.12
40000916 300 87186 REF SUSCEPTIBILITY 78.81 55.17
40000917 300 87184 SENSITIVITY ORGANISM 2 72.25 50.58
40000918 300 87184 SENSITIVITY ORGANISM 3 72.25 50.58
40000919 300 87184 SENSITIVITY ORGANISM 4 72.25 50.58
40000920 306 87186 SUSCEPT SLOW GROWER 737.40 516.18
40000923 300 87081 CULTURE-STREP ONLY 80.84 56.59
40000931 306 87186 SUSCEPTIBILITY 1 78.81 55.17
40000932 306 87186 SUSCEPTIBILITY 2 96.56 67.59
40000933 306 87186 SUSCEPTIBILITY 3 72.25 50.58
40000934 306 87186 SUSCEPTIBILITY 4 72.25 50.58
40000935 306 87181 SENSITIVITY REFERRED 53.26 37.28
40000955 301 82232 BETA-2-MICRGLBLN SER 86.18 60.33
40000956 300 87880 STREP A ANTIGEN 68.83 48.18
40000964 300 87070 CULTURE-EXUDATE/WND 118.59 83.01
40000980 300 87070 CULTURE-TISSUE 118.59 83.01
40000995 300 87075 CULTURE-ANAEROBIC 140.83 98.58
40000998 300 87040 CULTURE BLOOD 1 166.77 116.74
40000999 300 87040 CULTURE BLOOD 2 113.18 79.23
40001004 300 87081 CULTURE-GC 38.25 26.78
40001005 300 87070 CULTURE-BRONC WASH 118.59 83.01
40001006 306 87081 CULTURE-MRSA PRE OP 98.18 68.73
40001007 300 87081 CULTURE MRSA SURVEILLANCE 80.84 56.59
40001008 300 87081 CULTURE - LEGIONELLA 84.56 59.19
40001009 300 87081 CULTURE VRE 80.84 56.59
40001010 300 86927 FROZEN COMPONENT THAWING 742.42 519.69
40001012 300 87070 CULTURE UROGENITAL 118.59 83.01
40001013 300 87081 CULTURE VRE SCREEN 80.84 56.59
40001038 300 87070 CULTURE-SPUTUM 118.59 83.01
40001046 300 87070 CULTURE-SPINAL FLUID 118.59 83.01
40001053 300 87070 CULTURE-EAR 118.59 83.01
40001061 300 87070 CULTURE-EYE 118.59 83.01
40001079 306 87086 CULTURE-URINE 92.12 64.48
40001087 300 87070 CULTURE-THROAT 118.59 83.01
40001095 300 87070 CULTURE-NOSE 118.59 83.01
40001107 301 80048 BASIC MET PANEL 123.12 86.18
40001111 300 83516 ANTI-GBM PANEL (GBM ELISA) 182.75 127.93
40001112 301 80053 COMP MET PANEL 178.08 124.66
40001113 300 83516 IM. ASSAY NOT INFECTIOUS AG OR AB 61.41 42.99
40001114 301 83520 RNA POLYMERASE III IGG 141.81 99.27
40001115 300 83516 GLUTAMIC ACID DECARBOXYIASE AB 91.63 64.14
40001116 301 83516 HISTONE AB 70.90 49.63
40001141 301 83586 17 KETOSTEROIDS (TOTAL) 83.25 58.28
40001142 301 83498 17 HYDROXYPROGESTERONE 94.75 66.33
40001185 300 36416 BLOOD DRAW - CAPILLARY 17.18 12.03
40001186 300 36415 BLOOD DRAWING 16.70 11.69
40001187 72 COLLECTION FEE 31.04 21.73
40001212 750 43756 MELTZER-LYONS TEST 46.25 32.38
40001238 301 82553 CK-MB 138.71 97.10
40001239 301 82552 CK ISOENZYMES 74.45 52.12
40001276 300 86738 MYCOPLASMA PN IgG 52.92 37.04
40001278 301 83874 MYOGLOBIN-SERUM 151.42 105.99
40001279 301 80192 PROCAINMIDE & NAPA 88.00 61.60
40001280 301 80188 PRIMIDONE-MYSOLINE 88.00 61.60
40001285 300 89320 SEMEN ANALYSIS 76.25 53.38
40001293 940 99195 PHLEBOTOMY THERAPEUTIC 323.25 226.28
40001304 306 87799 EBV QUANT PCR 301.33 210.93
40001305 300 86663 EBV ABS-EA 51.81 36.27
40001306 300 86790 HANTA VIRUS IgG 94.75 66.33
40001307 300 86789 WEST NILE VIRUS ABS 194.17 135.92
40001308 300 86790 HTLV I/II ANTIBODIES 39.28 27.50
40001309 302 86790 PARAINFLUENZA IGG 48.25 33.78
40001319 300 86922 CROSSMATCH AHG 99.00 69.30
40001320 300 86920 CROSSMATCH UNIT 2 365.23 255.66
40001321 300 86920 CROSSMATCH UNIT 3 69.75 48.83
40001322 300 86920 CROSSMATCH UNIT 4 69.75 48.83
40001323 300 86920 CROSSMATCH UNIT 5 69.75 48.83
40001324 300 86920 CROSSMATCH UNIT 6 69.75 48.83
40001325 300 86920 CROSSMATCH 365.23 255.66
40001326 300 86920 CROSSMATCH UNIT 12 69.75 48.83
40001327 300 86901 BLD TYPG RH ONLY 105.11 73.58
40001328 300 86920 CROSSMATCH UNIT 7 69.75 48.83
40001329 300 86920 CROSSMATCH UNIT 8 69.75 48.83
40001330 300 86921 CROSSMATCH 37C 84.25 58.98
40001331 300 86920 CROSSMATCH UNIT 9 69.75 48.83
40001332 300 86920 CROSSMATCH UNIT 10 69.75 48.83
40001333 300 86920 CROSSMATCH UNIT 11 69.75 48.83
40001335 300 86850 ANTIBODY SCREEN 169.28 118.50
40001336 300 86971 RBC ENZYME TREATMENT 141.81 99.27
40001337 300 86805 PLATELET CROSSMATCH MACE 1 237.52 166.26
40001338 300 86922 PLATELET CROSSMATCH MACE 2 373.06 261.14
40001343 300 86880 DIRECT COOMBS TEST 106.35 74.45
40001345 300 86682 ECHINOCOCCUS AB 87.00 60.90
40001426 301 82088 ALDOSTERNE URINE 132.81 92.97
40001427 301 84075 ALKALINE PHOSPHATASE 46.90 32.83
40001434 301 84080 ALK PHOS ISOS 121.76 85.23
40001440 300 86651 ARBOVIRUS PANEL California 51.25 35.88
40001445 306 86340 INTRINSIC FACTOR BLOCK ANTIBODY 136.00 95.20
40001475 301 82803 ARTERIAL BLD GAS EPOC 248.82 174.17
40001478 300 87149 TB IDENTIFICATION 124.90 87.43
40001479 300 87077 BACTERIAL ID 1 68.72 48.10
40001480 300 87077 REF BACTERIAL ID(MULTI-STEP) 132.36 92.65
40001481 300 87077 BACTERIAL ID 2 68.72 48.10
40001482 300 87077 BACTERIAL ID 3 63.00 44.10
40001483 300 87077 BACTERIAL ID 4 63.00 44.10
40001484 306 87076 ANAEROBIC BACT ID 20.53 14.37
40001486 306 83516 PARIETAL CELL AB IGG 190.00 133.00
40001491 300 87102 CULTURE-FUNGUS 53.45 37.42
40001492 306 87107 FUNGUS MOLD ID 139.03 97.32
40001493 306 87107 FUNGUS ID PANEL 212.02 148.41
40001494 306 87153 ID DNA/RNA SEQUENCING 427.16 299.01
40001495 300 86606 ASPERGUILLUS AB TITER 111.68 78.18
40001500 301 84620 D-XYLOSE 123.75 86.63
40001509 301 84443 TSH 139.77 97.84
40001510 301 84445 THYROID STIMULATING IMMUNOGLOBULIN 204.26 142.98
40001511 301 83520 THYROTROPIN REC AB 96.53 67.57
40001517 301 82384 CATECHLMNS/FRACT URINE 121.34 84.94
40001518 301 82384 CATECHLMNS/PLASMA 121.34 84.94
40001525 300 86038 ANA SCREEN 109.27 76.49
40001526 300 86039 ANA TITER 92.97 65.08
40001528 301 83050 METHEMOGLOBIN QUANT 20.18 14.13
40001530 300 86255 ANCA IgG 153.54 107.48
40001531 300 86256 ANCA TITER 61.64 43.15
40001533 301 83835 METANEPHRINE 24 HR UR 89.17 62.42
40001535 300 86644 CMV AB IGG 89.32 62.52
40001538 300 86645 AB CMV IGM 91.91 64.34
40001539 306 87015 CONCENTRATION AFB 36.26 25.38
40001540 306 87206 ACID FAST STAIN 29.18 20.43
40001541 306 87116 CULTURE-AFB 240.36 168.25
40001542 301 82135 AMINOLEVULINIC ACID URINE 91.75 64.23
40001543 301 84120 PORPHYRINS, URINE 106.01 74.21
40001544 301 84110 PORPHOBILINOGEN URINE 76.35 53.45
40001545 301 87799 BK VIRUS PCR PLASMA 675.02 472.51
40001546 301 80193 LEFLUNOMODE 509.36 356.55
40001565 301 82105 ALPHAFETOPROT MATRNL 89.17 62.42
40001566 301 82088 ALDOSTERNE SERUM 132.81 92.97
40001570 301 82103 ALPHA 1 ANTITRYPSIN 74.73 52.31
40001571 301 82104 ALPHA 1 ANTITRYPSIN - PHENOTYPE 178.08 124.66
40001572 301 82103 STOOL ALPHA 1 ANTITRYPSIN 74.73 52.31
40001573 301 82107 ALPHA FETOPROTEIN L3 269.17 188.42
40001574 301 82105 ALPHA FETOPROT TM 89.17 62.42
40001575 300 86753 AMOEBIC AB TITER 185.50 129.85
40001576 301 80299 INTRACONAZOLE 122.99 86.09
40001577 301 80299 AMIODARONE 76.25 53.38
40001580 300 86612 BLASTOMYCES AB-BY CF 85.50 59.85
40001610 300 86787 VARICELLA ZOSTER IGG 40.08 28.06
40001611 300 86787 VARICELLA ZOSTER IGM 40.08 28.06
40001615 300 86695 HERPES SIMPLX IGM TYPE I 87.00 60.90
40001617 300 86695 HERP SIMPLX IGG I AND 2 74.73 52.31
40001618 300 86696 HSV 2 GLYCOPROTEIN G AB IGG 177.80 124.46
40001619 302 86694 HERPES SIMPLX IGM TYPES 1 AND 2 69.51 48.66
40001624 300 86592 VDRL 37.36 26.15
40001626 301 82800 PH VENOUS BLOOD 55.90 39.13
40001657 301 84066 PRSTTC ACD PHOS 70.36 49.25
40001680 301 84166 ELCTRPHRSS URINE PROTEIN 67.35 47.15
40001681 301 84165 ELCTRPHRSS-PROTEIN SERU 102.70 71.89
40001682 301 83883 FREE LIGHT CHAINS SERUM 234.00 163.80
40001683 301 83883 FREE LIGHT CHAINS K/L SERUM 119.65 83.76
40001684 300 83883 FREE LITE CHAINS - KAPPA URINE 119.65 83.76
40001685 300 83883 FREE LITE CHAINS LAMBDA URINE 119.65 83.76
40001686 301 84166 ELECTROPHORESIS URINE RANDOM 67.35 47.15
40001707 301 84234 FROZ PROG RECEPTOR 258.53 180.97
40001713 301 82672 ESTRGN-TOTL SER/UR 288.25 201.78
40001715 301 82533 CORTISOL BLOOD (TOTAL) 86.18 60.33
40001716 301 82530 FREE CORTISOL SERUM 83.18 58.23
40001717 301 82533 CORTISOL SALIVA 141.81 99.27
40001764 300 87491 CHLAMYDIA BY LCR 120.54 84.38
40001770 300 86635 COCCIDIOIDES AB BY CF 80.44 56.31
40001771 300 86658 COXSACKIE A VIRUS AB A7 46.25 32.38
40001772 301 83690 LIPASE-SERUM 100.58 70.41
40001773 300 86658 COXSACKIE B VIRUS AB B1 44.50 31.15
40001775 301 80061 LIPID PROFILE 125.63 87.94
40001776 301 80050 GENERAL HEALTH PANEL 372.51 260.76
40001798 301 80178 LITHIUM 79.70 55.79
40001800 300 83788 MASS SPECTROMETRY ANALYTE 174.00 121.80
40001804 301 83825 MERCURY QUANTITATIVE 101.98 71.39
40001805 301 83789 IODINE SPOT URINE 141.81 99.27
40001830 301 83036 GLYCOHEMOGLOBIN 92.12 64.48
40001845 301 83003 HUMAN GROWTH HORMONE 86.18 60.33
40001855 301 83700 ELCTRPHRSS LIPO 342.00 239.40
40001863 301 84155 PROTEIN 24 HR URINE 23.75 16.63
40001870 301 84202 FREE ERYTHRCT PROTOPORPH 79.00 55.30
40001871 301 82746 FOLIC ACID 82.63 57.84
40001888 301 84482 T3 REVERSE 69.81 48.87
40001889 301 84480 T3 (TRIIODOTHYRONINE) 110.44 77.31
40001890 300 86698 HISTOPLASMA AB (ID) 55.90 39.13
40001891 300 87385 HISTOPLASMA AG URINE 174.53 122.17
40001892 300 87385 HISTOPLASMA AG SERUM 174.53 122.17
40001900 312 88347 IMMUNO FLUORESCENT Ab INDIRECT 139.00 97.30
40001921 300 86376 THYROID PEROXIDASE AB 95.18 66.63
40001922 300 86376 MICROSOME LIV/KID AB 76.47 53.53
40001947 301 80170 GENTAMYCIN RANDOM 113.45 79.42
40001948 301 80170 GENTAMYCIN THROUGH 171.53 120.07
40001949 301 80170 GENTAMYCIN PEAK 113.45 79.42
40001950 300 83525 INSULIN 2 HOUR 91.50 64.05
40001951 300 83520 LEPTIN 149.99 104.99
40001952 300 86710 INFLUENZA A AB IgG 117.53 82.27
40001953 300 83520 TRYPTASE 75.60 52.92
40001954 300 83525 INSULIN SERUM 99.80 69.86
40001955 301 83527 FREE INSULIN (TOTAL ) 48.54 33.98
40001956 301 83835 FREE PLASMA METANEPHRINES 302.43 211.70
40001957 302 86340 INTRINSIC FACTOR 82.08 57.46
40001958 300 83150 HOMOVANILLIC ACID 91.00 63.70
40001960 300 86337 INSULIN ABS 218.25 152.78
40001961 300 83519 ACETYCHOLINE RECEPTOR BINDING AB 248.16 173.71
40001962 300 83519 ACETYCHOLINE RECEPTOR BLOCKING AB 111.81 78.27
40001963 300 83520 MANNOSE BINDING LECTIN 182.16 127.51
40001964 302 83520 CYTOKINES 87.00 60.90
40001965 300 83519 VOLTAGE GATED CALCIUM CHANNEL 249.96 174.97
40001966 300 83519 ACETYCHOLINE REC MODULATING AB 222.01 155.41
40001967 300 83520 ANTI MULLERIAN HORMONE 229.07 160.35
40001968 300 83519 MUSK AUTOANTIBODY 1,917.22 1,342.05
40001969 300 83519 ACHR GANG NEURON AB 248.16 173.71
40001970 300 83519 NEURONAL VGKC AUTO AB 248.16 173.71
40001971 301 83520 STRIATIONAL AB 237.52 166.26
40001996 301 80184 PHENOBARBITOL 119.65 83.76
40002002 301 80156 TEGRETOL (CARBAM) 140.83 98.58
40002003 301 80157 CARBAMAZEPINE FREE 86.29 60.40
40002009 301 80186 DILANTIN, FREE 105.99 74.19
40002010 301 80185 DILANTIN 137.65 96.36
40002011 301 80195 SIROLIMUS 148.24 103.77
40002012 301 80197 TACROLIMUS(FK 506) 235.34 164.74
40002043 301 80307 TOX SCREEN URINE 115.63 80.94
40002045 301 80101 DRUG SCREEN EACH ANALYTE 11.00 7.70
40002048 300 86777 TOXOPLASMOSIS ABS IgG 87.98 61.59
40002049 300 86317 TETANUS AB 74.73 52.31
40002050 300 86317 DIPHTHERIA AB 74.73 52.31
40002051 300 86317 PNEUMOCOCCAL AB 8.48 5.94
40002069 301 83497 5 HIAA SEROTONIN 57.27 40.09
40002070 301 83498 17 HYDROXYPROGESTERONE 70.97 49.68
40002085 301 84585 VMA 24 HR URINE 118.27 82.79
40002119 300 87252 CULTURE - VIRAL 112.61 78.83
40002120 300 87253 VIRUS ISOLATION 61.00 42.70
40002127 300 83540 IRON 52.36 36.65
40002135 300 87624 HPV DNA 166.36 116.45
40002186 301 84630 ZINC 64.63 45.24
40002187 301 84630 ZINC RBC 325.06 227.54
40002210 301 82379 CARNITINE QUATITATIVE 112.00 78.40
40002218 301 82378 CEA 170.47 119.33
40002250 301 82677 ESTRIOL 79.35 55.55
40002251 301 82670 ESTRADIOL 87.55 61.29
40002253 302 86336 INHIBIN-MATERNAL SERUM 89.45 62.62
40002254 301 83520 INHIBIN B 248.98 174.29
40002283 301 84156 PROTEIN URINE 59.99 41.99
40002284 301 84157 PROTEIN, CSF 58.30 40.81
40002285 301 84157 PROTEIN BODY FLUID 46.90 32.83
40002287 301 82043 MICROALBUMIN URINE 81.82 57.27
40002288 301 82043 MICROALBUMIN , QUANTITATIVE 46.25 32.38
40002291 300 89050 CELL COUNT BODY FL 94.24 65.97
40002293 301 82390 CERULOPLASMIN 91.91 64.34
40002294 301 82397 IGF BINDING PROTEINS 51.50 36.05
40002295 301 82397 VASCULAR ENDOTHELIAL GROWTH FACTOR 218.17 152.72
40002320 300 80158 CYCLOSPORINE 153.54 107.48
40002323 300 87337 E HISTOLYTICA AG DETCTN 61.75 43.23
40002337 300 86972 RBC PRETREATMENT DENSITY GRADIENT 159.54 111.68
40002338 300 86970 RBC CHEMICAL TREATMENT 108.16 75.71
40002339 300 86978 ADSORPTION 75.82 53.07
40002340 300 86860 ELUTION, ANTIBODY 354.94 248.46
40002341 300 86870 ANTIBODY ID 248.16 173.71
40002342 302 86146 B2 GLYCOPROTEIN 1 AB - IGG 25.45 17.82
40002343 300 86147 CARDIOLIPIN AB-IgG 106.35 74.45
40002344 300 86148 PHOSPHATIDYLSERINE AB - IGG 84.25 58.98
40002358 300 85025 CBC-AUTOMATED DIFFERENTIAL 91.32 63.92
40002359 300 85007 MANUAL DIFFERENTIAL 21.54 15.08
40002360 300 85027 HEMOGRAM 57.27 40.09
40002362 302 86235 SMITH ANTIBODY IGG 20.81 14.57
40002363 302 86235 RNP AB 24.08 16.86
40002365 300 85230 FACTOR 7 ASSAY 142.07 99.45
40002366 302 86235 SSA ANTIBODIES IGG 20.81 14.57
40002367 302 86235 SSB ABS IGG 20.81 14.57
40002369 302 86235 JO-1 ANTIBODY, IGG 21.02 14.71
40002370 300 85240 FACT VIII ASSAY 93.26 65.28
40002371 300 85210 FACTOR II ASSAY 89.72 62.80
40002372 302 86235 CHROMATIN 22.91 16.04
40002373 302 86235 SM/RNP AB 20.81 14.57
40002374 305 85130 ANTI XA 244.62 171.23
40002376 300 85220 FACTOR 5 ASSAY 142.07 99.45
40002385 300 86710 INFLUENZA B ANTIBODY IGG 71.71 50.20
40002440 301 84439 T4 FREE 121.63 85.14
40002441 301 84439 DIALYSIS FREE T4 92.17 64.52
40002523 301 80162 DIGOXIN 131.30 91.91
40002525 300 83986 STOOL PH 20.18 14.13
40002526 300 83993 CALPROTECTIN FECAL 572.68 400.88
40002531 301 80198 THEOPHYLLINE 136.19 95.33
40002535 301 84425 THIAMINE (VIT B1) 148.24 103.77
40002536 301 84591 NIACIN 301.33 210.93
40002549 300 81001 URINALYSIS/MICROSCOPIC CS IF INDICATED 61.24 42.87
40002553 301 83874 MYOGLOBIN-URINE 65.75 46.03
40002556 300 86900 BLOOD TYPING ABO ONLY 198.32 138.82
40002562 300 87591 NEIS GONOR BY LCR 120.54 84.38
40002563 306 87581 MYCOPLASMA PNEUMO PCR 107.71 75.40
40002564 306 87532 HERPES VIRUS6 PCR 260.68 182.48
40002565 306 87556 M TUBERCULOSIS PCR 503.96 352.77
40002580 301 84478 TRIGLYCERIDES 56.12 39.28
40002584 300 86689 WESTERN BLOT 162.25 113.58
40002595 301 84484 TROPONIN 167.29 117.10
40002655 301 80307 TOX-DAV5 NONDOT 135.25 94.68
40002660 301 80307 TOX DAU DOT 135.25 94.68
40002661 301 80307 HMC NEW EMPLOYEE DRUG SCREEN 13.35 9.35
40002664 301 83916 OLIGOCLONAL BANDS 39.50 27.65
40002671 301 80307 TOX-DAU 7 78.81 55.17
40002713 300 87210 WET MOUNT/KOH PREP 50.44 35.31
40002739 301 84436 T4 TOTAL 82.08 57.46
40002762 301 82728 FERRITIN 124.94 87.46
40002770 301 84153 PSA SCREENING 141.26 98.88
40002775 301 84154 FREE AND TOTAL PSA 121.76 85.23
40002776 302 86316 PRO 2 PSA 131.74 92.22
40002788 300 87324 DNU C DIFF TOXIN A & B 140.25 98.18
40002789 300 87230 DNU C DIFFICILE CYTOTOXIN ASSAY 84.50 59.15
40002804 301 82943 GLUCAGON 106.08 74.26
40002820 301 80194 QUINIDINE 79.00 55.30
40002838 301 82085 ALDOLASE 57.27 40.09
40002846 301 82140 AMMONIA 78.81 55.17
40002847 300 82139 AMINO ACID PLASMA QT 6 OR MORE 128.50 89.95
40002853 300 86701 ELISA 66.00 46.20
40002854 300 86703 HIV 1/2 AB 53.50 37.45
40002855 306 87389 HIV 1/2 ANTIGEN ANTIBODY 116.28 81.40
40002857 310 81373 HLAB27 108.95 76.27
40002859 301 83090 HOMOCYSTEINE 158.83 111.18
40002860 301 83088 HISTAMINE URINE 80.00 56.00
40002887 301 83001 FSH 135.53 94.87
40002906 300 87046 CULTURE-E COLI 0157 61.41 42.99
40002907 306 87015 CONCENTRATION STEC 22.10 15.47
40002908 306 87427 SHIGA TOXIN 1 71.10 49.77
40002909 306 87427 SHIGA TOXIN 2 71.10 49.77
40002910 300 87045 CULTURE-SALMONELLA/SHIGELLA 111.18 77.83
40002911 301 83020 ELCTRPHRSS HGB 191.17 133.82
40002912 301 83021 CHROMATOGRAPHY, HGB 52.25 36.58
40002929 300 86713 LEGIONELLA AB SCREEN 96.00 67.20
40002942 300 87801 LEGIONELLA PCR 319.15 223.41
40002943 300 87801 CT/GC AMPLIFIED DETECTION 110.44 77.31
40002944 300 87801 B PERTUSSIS PCR 266.83 186.78
40002945 300 87110 CULTURE CHLAMYDIA 127.63 89.34
40002946 300 87804 INFLUENZA A/B ANTIGEN 109.08 76.36
40002947 300 86632 CHLAMYDIA AB PANEL-IGM(C. TRACOMATIS) 52.50 36.75
40002948 300 87899 CAMPYLOBACTER ANTIGEN 82.06 57.44
40002950 301 82507 CITRATE URINE 109.08 76.36
40002951 301 84402 FREE TESTOSTERONE-FEMALE 99.27 69.49
40002952 301 84403 TESTOSTERONE TOTAL 154.89 108.42
40002955 301 84270 SEX HORMONE BINDING GLOBULIN 79.91 55.94
40002956 300 89321 SEMEN POST VAS 58.17 40.72
40002960 301 83002 LEUTENIZ HRMN(LH) 104.72 73.30
40002961 301 83727 GONADOTROPIN RELEASING HORMONE 599.50 419.65
40002978 301 80202 VANCOMYCIN TROUGH 300.18 210.13
40002979 301 80202 VANCOMYCIN PEAK 219.18 153.43
40002980 301 84586 VASO INTESTNL POLYPEPTD 195.89 137.12
40002986 301 84702 BHCG-QUANT 82.08 57.46
40002989 301 84702 BHCG TUMOR MARKER 82.08 57.46
40002994 301 82077 ALCOHOL ETOH 86.18 60.33
40002995 301 80320 CHAIN OF CUSTODY URINE ALCOHOL 40.37 28.26
40002997 301 83655 LEAD LEVEL 74.12 51.88
40003012 301 83010 HAPTOGLOBIN 77.44 54.21
40003014 300 87070 CULTURE-BODY FLUID 118.59 83.01
40003018 300 87046 CULTURE-CAMPYLOBACTR 90.01 63.01
40003059 301 80150 AMIKACIN 65.75 46.03
40003061 301 80335 AMITRIPTYLINE LEVL 90.82 63.57
40003062 301 80335 NORTRIPTYLINE 59.09 41.36
40003091 300 86803 HEP C AB 84.81 59.37
40003092 300 87902 HEP C GENOTYPE 482.68 337.88
40003101 300 86692 HEP DELTA ANTIBODY 134.25 93.98
40003109 300 86708 HEP A AB TOTAL 69.75 48.83
40003110 302 86708 HEP A IGG 70.90 49.63
40003111 302 86709 HEP A IGM 40.08 28.06
40003117 300 86704 HEP B CORE AB TOTAL 82.08 57.46
40003118 300 86705 HEPATITIS B CORE AB - IGM 104.02 72.81
40003125 301 83970 PTH-PARTHYRD HRMN 240.35 168.25
40003130 300 86022 HEPARIN IND PLTLT AB 257.25 180.08
40003140 301 82784 IMMUNOGLOBULIN G 60.26 42.18
40003141 301 82787 IGG SUBCLASS 1 43.00 30.10
40003142 301 82787 IGG SUBCLASS 2 43.00 30.10
40003143 301 82787 IGG SUBCLASS 3 43.00 30.10
40003144 301 82787 IGG SUBCLASS 4 43.00 30.10
40003155 301 82784 IMMUNOGLOBULIN A 60.26 42.18
40003156 301 82784 IMMUNOGLOBULIN D 88.42 61.89
40003160 300 86334 ELCTRPHRSS-IMMUNO 157.77 110.44
40003162 300 86335 IMMUNOELPHSIS-NOT BLOOD 176.82 123.77
40003163 302 86003 ALLERGENS ADULT FOOD 22.40 15.68
40003164 301 82785 IMMUNOGLOBULIN E 87.55 61.29
40003166 301 82784 IMMUNOGLOBULIN M 60.26 42.18
40003167 301 80174 IMIPRAMINE 83.25 58.28
40003168 301 82785 ALLERGENS UPPER RESP 40.94 28.66
40003169 300 86335 IFE URINE QUALITATIVE 122.17 85.52
40003170 300 86003 ALLERGENS COMMON FOOD 22.40 15.68
40003172 301 82785 ALLERGENS FOOD PROFILE 40.94 28.66
40003173 301 82785 ALLERGENS CHILDHOOD MARCH PROFILE 40.94 28.66
40003174 300 87425 ROTAVIRUS 86.18 60.33
40003185 300 86677 H PYLORI ANTIBODY 111.27 77.89
40003186 300 87338 H PYLORI AG FECES 182.16 127.51
40003187 300 86677 H PYLORI IGM 399.96 279.97
40003208 301 82308 CALCITONIN 131.98 92.39
40003210 300 86300 CA 27-29 157.77 110.44
40003216 300 86304 CA-125 161.05 112.74
40003220 300 86300 CA-15-3 157.77 110.44
40003224 302 86225 DS DNA 17.73 12.41
40003240 301 84144 PROGESTERONE 129.18 90.43
40003241 301 84140 PREGNENOLONE 62.00 43.40
40003244 301 83070 HEMOSIDERIN-URINE QUAL 43.50 30.45
40003250 300 86753 ENTAM HISTLYT AB 92.00 64.40
40003265 301 82375 CARBON MONOXIDE 25.91 18.14
40003281 300 86141 C-REACTIVE PROTEIN HS 108.15 75.71
40003285 301 83718 HDL-CHOL DIRECT 55.90 39.13
40003300 300 86671 SACCHAROMYCES CERVISIAE AB IGG 81.75 57.23
40003301 300 86671 SACCHAROMYCES CERVISIAE AB IGA 81.75 57.23
40003315 300 86762 RUBELLA 34.63 24.24
40003316 300 86765 RUBEOLA IGM 70.36 49.25
40003317 300 86765 RUBEOLA 70.36 49.25
40003318 301 80179 SALICYLATE 66.00 46.20
40003319 300 80323 NICOTINE URINE 105.71 74.00
40003320 301 80323 NICOTINE SERUM 124.09 86.86
40003340 300 86160 C3 COMPLEMENT 74.73 52.31
40003341 300 86200 CYCLIC CITR PEPTIDE AB IGG 123.81 86.67
40003342 300 86161 COMPLEMENT COMPONENT 1 FUNCTIONAL 201.52 141.06
40003343 300 86160 COMPLEMENT 2 112.09 78.46
40003344 300 86160 COMPLEMENT 4 77.44 54.21
40003345 301 83520 C1 ESTERASE INHIBITOR FUNCTIONAL 177.26 124.08
40003346 301 83883 C1 ESTERASE INHIBITOR LEVEL 234.00 163.80
40003347 302 86160 C1Q COMPLEMENT 124.09 86.86
40003372 300 85300 ANTITHROMBIN III 141.89 99.32
40003373 305 85301 ANTITHROMBIN 3 ANTIGEN 100.36 70.25
40003398 300 86301 CA-19-9 150.36 105.25
40003406 300 86706 HEP B SUR AB 70.36 49.25
40003407 300 86706 HEP B SURFACE AB QUANT 100.18 70.13
40003448 301 80200 TOBRAMYCIN 144.00 100.80
40003449 300 87449 LEGIONELLA ANTIGEN 99.27 69.49
40003450 306 87449 BLASTOMYCES ANTIGEN 386.41 270.49
40003451 306 87899 STREP PNEUMO AG 117.03 81.92
40003455 301 82941 GASTRIN 91.91 64.34
40003463 301 82607 VITAMIN B12 127.06 88.94
40003505 301 82380 CAROTENE 65.75 46.03
40003524 301 82805 ABG WITH MEASURED SO2 165.27 115.69
40003547 302 86780 SYPHILIS IGG 20.31 14.22
40003604 302 86325 BENCE-JONES SCREEN 61.75 43.23
40003612 300 87324 C DIFF ANTIGEN 46.25 32.38
40003613 300 87305 ASPERGILLUS ANTIGEN 146.61 102.63
40003646 301 83945 OXALATE 70.36 49.25
40003701 300 86615 BORDATELLA PERTUSSIS IGG 53.75 37.63
40003702 300 86615 BORDATELLA PERTUSSIS IGM 53.75 37.63
40003703 300 86618 LYME DISEASE AB 110.44 77.31
40003704 300 86615 B PERTUSSIS IGA 53.75 37.63
40003705 300 86617 LYME DISEASE WESTERN BLOT 132.54 92.78
40003706 300 86611 B HENSLAE CAT SCRATCH IGG AND IGM 39.28 27.50
40003707 300 86611 BARTONELLA HENSLAE CAT SCRATCH IGM 39.28 27.50
40003708 300 86615 B PERTUSSIS IGG 62.83 43.98
40003709 300 86615 B PERTUSSIS IGM 62.83 43.98
40003710 300 86615 B PERTUSSIS IGA 62.83 43.98
40003711 300 87340 HEP B SUR AG 67.35 47.15
40003712 300 87341 CONFIRMATION HEP B S AG 208.28 145.80
40003774 300 85302 PROTEIN C ANTIGEN 115.50 80.85
40003775 300 85303 PROTEIN C FUNCTIONAL 142.07 99.45
40003776 300 85305 PROTEIN S TOTAL 115.50 80.85
40003777 300 85306 PROTEIN S FUNCTIONAL 142.07 99.45
40003778 301 84146 PROLACTIN 107.99 75.59
40003779 301 84145 PROCALCITONIN 354.51 248.16
40003800 301 82491 FLUCYTOSINE 112.00 78.40
40003802 301 80171 GABAPENTIN 91.00 63.70
40003803 301 82491 CHROMATOG - QUANT IMURAN 330.00 231.00
40003804 301 82480 CHOLINESTERASE SERUM 24.75 17.33
40003805 301 82482 CHILINESTERASE RBC 51.75 36.23
40003806 301 82542 6 MMPN 139.89 97.92
40003807 301 82542 6 TGN 192.27 134.59
40003842 300 84206 PROINSULIN 64.15 44.91
40003843 301 84260 SEROTONIN 159.26 111.48
40003844 300 80299 CRYSTODIGIN (DIGITOXIN) 100.00 70.00
40003845 301 84202 ZINC PROTOPROPHYRIN 45.02 31.51
40003873 301 83873 MYELIN BASIC-CSF 84.25 58.98
40003884 300 86720 LEPTOSPIRA AB 83.25 58.28
40003885 301 83491 17HYDROCORTSTRD 100.00 70.00
40003893 301 82340 CALCIUM 24HR URINE 66.00 46.20
40003943 301 84481 FREE T3 112.09 78.46
40003992 300 87077 CLO-TEST 91.91 64.34
40003993 301 83014 H PYLORI DRUG ADMINISTRATION 25.09 17.56
40003994 301 83013 H PYLORI BREATH TEST 138.26 96.78
40004001 310 81479 IBD SGI DIAGNOSTIC 96.13 67.29
40004002 300 86140 C REACTIVE PROTEIN 49.08 34.36
40004003 300 83520 PROMETHEUS ASCA IGG 40.90 28.63
40004004 300 83520 PROMETHEUS ASCA IGA 40.90 28.63
40004005 300 81479 PROMETHEUS IGA 40.90 28.63
40004006 300 83520 PROMETHEUS ANTI OMPC IGA 40.90 28.63
40004007 300 83520 PROMETHEUS ANTI CBIR1 40.90 28.63
40004008 300 83520 PROMETHEUS FLAZ 32.73 22.91
40004009 300 83520 PROMETHEUS FLAX 32.73 22.91
40004010 300 82397 PROMETHEUS VEGF 32.73 22.91
40004011 301 82397 PROMETHEUS ICAM 32.73 22.91
40004012 301 82397 PROMETHEUS VCAM 32.73 22.91
40004013 301 82397 PROMETHEUS SAA 32.73 22.91
40004014 312 88346 PROMETHEUS PANCA 397.05 277.94
40004015 312 88350 PROMETHEUS DNASE SENSITIVITY 397.05 277.94
40004018 310 81450 ONCOHEME NGS 6,256.17 4,379.32
40004019 300 81511 QUAD 1 MARKER 135.90 95.13
40004065 301 84681 C-PEPTIDE 104.72 73.30
40004081 301 80164 VALPROIC ACID DEPAKENE 138.44 96.91
40004131 300 85378 D-DIMER SEMI-QUANT 65.75 46.03
40004132 300 85379 D-DIMER QUANTITATIVE 155.12 108.58
40004133 300 85362 FIBRIN SPLIT PRODUCTS 38.66 27.06
40004179 301 82523 N-TELOPEPTIDE, URINE 99.50 69.65
40004180 301 82530 CORTISOL - URINE (FREE) 83.18 58.23
40004198 300 86707 HEP BE AB 104.89 73.42
40004199 300 87350 HEP BE AG 60.26 42.18
40004206 300 87350 HEP BE AG 69.75 48.83
40004207 301 84207 VITAMIN B 6 134.98 94.49
40004213 301 83735 MAGNESIUM URINE 76.24 53.37
40004214 301 83735 MAGNESIUM SERUM 76.24 53.37
40004215 301 83735 MAGNESIUM 24 HR URINE 34.36 24.05
40004216 300 87207 MALARIA SMEAR 42.25 29.58
40004217 300 86757 TYPHUS AB IGG 50.00 35.00
40004218 300 86638 Q FEVER AB 87.00 60.90
40004219 300 86757 ROCKY MTN IGG 91.91 64.34
40004221 300 86622 BRUCELLA AB 58.00 40.60
40004223 300 86668 FRANCISELLA AB 76.25 53.38
40004247 301 84300 RENAL FAILURE INDICIES 2 18.50 12.95
40004248 301 84300 SODIUM URINE 59.29 41.50
40004249 301 84300 SODIUM 24 HR URINE 59.29 41.50
40004250 301 84307 SOMATOSTATIN 212.00 148.40
40004251 300 84305 SOMATOMEDIN C 102.54 71.78
40004255 301 84252 VITAMIN B 2 176.25 123.38
40004260 300 81002 SPECIFIC GRAV URINE 25.00 17.50
40004261 301 82542 PTH RELATED PEPTIDE 179.00 125.30
40004262 300 81002 URINE PH 20.35 14.25
40004265 301 84315 SPECFC GRAV BODY FL 27.27 19.09
40004268 300 85335 FACTOR INHIBITOR TEST 155.54 108.88
40004271 300 85300 LUPUS INHIBITOR 141.89 99.32
40004280 301 82436 CHLORIDE-URINE 54.53 38.17
40004281 301 82436 CHLORIDE 24 HR URINE 91.38 63.97
40004285 301 82435 CHLORIDE-SERUM 32.83 22.98
40004287 301 82438 CHLORIDE-BODY FLUID 20.18 14.13
40004289 310 88264 ANALYZE 20 - 25 CELLS CHROMOSOME 373.06 261.14
40004290 310 88262 CHROMOSOME ANALYSIS 206.75 144.73
40004291 300 89051 CELL COUNT/DIF BDYFL 103.66 72.56
40004293 301 82480 CHOLINESTERASE SERUM 54.00 37.80
40004295 301 82595 CRYOGLOBULIN QUAL/SEMI-QUANT 41.00 28.70
40004297 300 86641 CRYPTOCOCCUS AB 100.00 70.00
40004298 390 P9012 CRYOPRECIPITATE PER UNIT 235.64 164.95
40004299 300 87328 CRYPTOSPORIDIUM AG 85.36 59.75
40004300 301 84022 THIORIDAZINE(MELLARIL) 79.00 55.30
40004313 301 80182 NORTRIPTYLINE 68.50 47.95
40004326 301 82180 VITAMIN C 60.26 42.18
40004327 301 82306 VITAMIN D 25 HYDROXY 185.29 129.70
40004328 301 82652 VITAMIN D 125 94.08 65.86
40004329 300 84446 VITAMIN E 73.08 51.16
40004330 300 84590 VITAMIN A (RETINOL) 85.12 59.58
40004331 300 84597 VITAMIN K1 160.62 112.43
40004332 301 82172 APOLIPOPROTEIN B 78.27 54.79
40004333 301 80327 5 A DIHYDROTESTOSTERONE 110.64 77.45
40004334 301 84588 VASOPRESSIN ADH 152.45 106.72
40004335 301 82657 DIHYDRODAMINE 667.24 467.07
40004339 301 83721 LDL-CHOL DIRECT 55.90 39.13
40004340 301 82656 ELASTASE STOOL 254.37 178.06
40004354 301 80176 LIDOCAINE 79.00 55.30
40004370 301 84432 THYROGLOBULIN 86.18 60.33
40004538 301 80069 RENAL PANEL 137.23 96.06
40004628 300 85732 APTT CIRCULATING INHIBITOR 30.82 21.57
40004832 300 87556 M TB DIRECT DETECT 417.25 292.08
40004968 301 82627 DHEA SULFATE 112.09 78.46
40004969 301 82626 DHEA 49.91 34.94
40004970 301 80160 DESIPRAMINE 79.00 55.30
40004971 300 82010 BETA HYDROXYBUTYRATE 98.18 68.73
40004972 301 80160 CLOZAPINE 48.06 33.64
40004990 301 82330 CALCIUM-IONIZED 97.35 68.15
40004991 301 82330 FULL ARTERIAL PROFILE 5 59.25 41.48
40005013 301 84060 ACID PHOSPHATASE TOTAL 43.50 30.45
40005020 300 83516 TISSUE TRANSGLUATMINASE IGG 66.00 46.20
40005021 300 83520 IMMASSAY QUANT BY RADPHARM 88.50 61.95
40005022 300 83516 TISSUE TRANGLUTAMINASE IGA 66.00 46.20
40005023 300 86255 MITOCHONDRIAL AB, IGG 64.14 44.90
40005024 300 83516 GLIADIN AB IGA 66.00 46.20
40005025 300 83516 GLIADIN AB IGG 66.00 46.20
40005027 300 83516 DGP IGA 67.35 47.15
40005028 302 86235 RIBOSOME P ANTIBODY IGG 22.79 15.95
40005029 300 83516 MYELIN ASSOC GLYCOPROTEIN AB IGM 76.58 53.61
40005030 302 86235 CENTROMERE AB 21.63 15.14
40005031 300 86256 ANTIMITOCHONDRIAL ABS 34.34 24.04
40005056 300 80180 MYCOPHENOLIC ACID 97.09 67.96
40005057 300 80299 CLOMIPRAMINE LEVEL 77.75 54.43
40005058 301 80177 KEPPRA (LEVETIRACETAM) 145.90 102.13
40005059 301 80201 TOPIRAMATE (TOPAMAX) 122.17 85.52
40005060 301 80183 OXCARBAZEPINE (TRILEPTAL) 99.80 69.86
40005061 301 80175 LAMOTRIGINE 73.36 51.35
40005062 301 80339 LACOSAMIDE (VIMPAT) 477.23 334.06
40005063 301 80339 CLOBAZAM 289.27 202.49
40005100 310 81406 RET PROTO ONCOGENE 4,258.44 2,980.91
40005132 300 82955 GLUCOSE 6 PHOSPHATE DEHYDROGENAS E 52.00 36.40
40005135 300 89125 URINE FAT 43.50 30.45
40005138 300 82952 GLUCOSE TOL UR ADDHR 10.50 7.35
40005139 301 82705 FECAL FAT QUALITATIVE 47.45 33.22
40005140 301 82710 FECAL FAT (QUANT) 109.63 76.74
40005143 300 89055 FECAL WBC 55.66 38.96
40005144 301 84126 STOOL-24 HR PROTOPORPHYR 276.25 193.38
40005145 301 84302 FECAL SODIUM 24.50 17.15
40005146 301 84133 FECAL POTASSIUM 24.25 16.98
40005147 301 82438 FECAL CHLORIDE 24.25 16.98
40005161 300 86618 LYME AB CSF 101.25 70.88
40005229 301 84466 TIBC / TRANSFERRIN 102.70 71.89
40005237 301 80143 ACETMNPHEN (TYLENOL) 101.98 71.39
40005238 301 82009 ACETONE 29.18 20.43
40005240 301 82017 ACYICARNITINE QUANTITATIVE 319.50 223.65
40005242 301 82024 ACTH HORMONE 182.16 127.51
40005245 301 80400 ACTH STIMULATION 292.24 204.57
40005251 301 82747 RBC FOLATE 99.27 69.49
40005252 301 82340 CALCIUM UR QUANT 20.18 14.13
40005294 300 87081 CULTURE PERTUSS 190.75 133.53
40005435 301 80154 CLONAZEPAM/BENZO 79.00 55.30
40005601 306 87507 GASTRO PATHOGENS 1,042.70 729.89
40005602 306 87498 ENTEROVIRUS PCR PLASMA 208.54 145.98
40005606 306 87505 GI PARASITE PANEL 780.00 546.00
40005609 306 87497 CMV QUANTITATIVE PCR 343.60 240.52
40005610 306 87651 STREP GRP A MOLECULAR 128.12 89.68
40005611 306 87493 C DIFFICILE TOXIC GENE 189.53 132.67
40005612 306 87517 HEPATITIS B VIRAL DNA 334.34 234.04
40005613 300 86804 HEPATITIS C RIBA 227.97 159.58
40005614 300 87496 CMV BY PCR 166.00 116.20
40005615 300 87522 HEPATITIS C RNA PCR QUA 387.81 271.47
40005616 300 87799 BK VIRUS URINE 505.60 353.92
40005617 300 87529 HERPES SIMPLEX BY PCR 283.61 198.53
40005618 301 80074 HEPATITIS PANEL ACUTE 348.36 243.85
40005619 300 87798 JC VIRUS 462.50 323.75
40005620 306 87521 HEP C RNA QUALITATIVE 240.00 168.00
40005621 306 87798 B. PERTUSSIS/PARAPERTUSIS PCR 290.24 203.17
40005622 300 87798 NOROVIRUS 1 PCR 344.59 241.21
40005623 300 87798 NOROVIRUS 2 PCR 344.59 241.21
40005624 306 87799 JC POLYOMA VIRUS PCR 1,068.31 747.82
40005625 306 87480 CANDIDA NA PROBE 49.93 34.95
40005626 306 87510 GARDNERELLA PROBE 49.93 34.95
40005627 306 87660 TRICH VAG PROBE 49.93 34.95
40005628 300 87529 HSV PCR NON CSF 188.25 131.78
40005629 300 87529 HSV PCR NON CSF CHARGE ONLY 189.35 132.55
40005630 306 87798 ZIKA VIRUS BY PCR 779.93 545.95
40005631 302 86790 ZIKA IGM 531.77 372.24
40005632 306 87486 CHLAM PNEUMO PROBE 107.71 75.40
40005633 306 87633 RESP VIRUS 12-25 TARGETS 107.71 75.40
40005946 300 86713 LEGIONELLA IGM AB 78.81 55.17
40006646 300 84479 T3 UPTAKE 44.73 31.31
40006903 300 86902 RBC ANTIGEN SCREEN/UNIT 146.07 102.25
40006904 300 86905 RBC ANTIGEN SCREEN/PATIENT 146.07 102.25
40006905 300 86902 RBC ANTIGEN TIER 4 393.80 275.66
40006906 300 86904 BLD TYPE-SERUM 114.35 80.05
40006907 300 0001U RBC MOLECULAR TYPE 715.99 501.19
40007050 300 85250 FACTOR IX ASSAY 142.07 99.45
40007051 300 85270 FACTOR XI ASSAY 145.62 101.93
40007052 300 85280 FACTOR XII ASSAY 145.90 102.13
40007053 300 85260 FACTOR X ASSAY 146.17 102.32
40007054 300 85290 FACTOR XIII 57.73 40.41
40007055 310 88360 TISSUE IHC ERA/PRA 742.42 519.69
40007056 310 88361 BREAST RECEPTOR 248.16 173.71
40007057 310 88365 TISSUE INSITU HYBRID 362.31 253.62
40007058 310 88365 TISSUE INSITU HYBRID MAYO 1,391.13 973.79
40007063 310 88331 FRZ SECTION 362.31 253.62
40007064 310 88332 FROZEN SECTION (EA ADDN) 113.62 79.53
40007065 310 88300 GROSS EXAM 108.16 75.71
40007069 311 88173 CYTOLOGY FINE NEEDLE ASPIRATE 242.22 169.55
40007070 310 88321 CONSULTATION MAYO CLINIC 580.81 406.57
40007071 310 88329 PATH CONSULT 336.94 235.86
40007072 310 88323 MAYO CONSULT SLIDEPREP 580.81 406.57
40007073 310 88325 MAYO COMP CONSULT 580.81 406.57
40007075 312 88348TC ELECTRON MICROSCOPY 647.50 453.25
40007095 300 82360 STONE ANALYSIS (CHEMICAL) 71.00 49.70
40007096 300 82365 STONE ANALYSIS ( INFRARED SPEC ) 108.74 76.12
40007100 310 88311 DECALCIFICATION 70.36 49.25
40007101 312 88312 SPECIAL STAINS GRP I 176.68 123.68
40007102 312 88313 SPECIAL STAIN GROUP II (OTHER) 171.53 120.07
40007103 312 88313 MAYO SPEC STN II 298.60 209.02
40007123 310 88312 FUNGAL STAIN 176.68 123.68
40007125 312 88342 IMMUNOCYTOCHEM FIRST AB 141.81 99.27
40007126 310 88342 IMMUNOCYTOCHEM FIRST G 83.34 58.34
40007127 310 IMMUNOCYTOCHEM EACH ADD AB G 83.34 58.34
40007128 310 88341 IMMUNOCYTOCHEM EACH ADDITIONAL AB 90.91 63.64
40007129 312 88344 IMMUNO PER SPEC;MULIPLEX AB 141.81 99.27
40007203 310 88108 CYTOLOGY NONGYN 142.20 99.54
40007206 310 88161 CYTO NGYN SPUTUM 109.06 76.34
40007207 310 88112 CELLULAR ENHANCEMENT 196.61 137.63
40007210 311 88175 PAP AUTO REVIEW 116.72 81.70
40007211 311 88143 PAP SMEAR MANUAL 97.25 68.08
40007212 311 88142 PAP SMEAR ROUTINE 106.08 74.26
40007213 311 88141 PAP PATH REVIEW 28.90 20.23
40007214 311 G0145 PAP SMEAR LOW/HI 103.09 72.16
40007215 311 88174 PAP AUTO VERIFY 246.71 172.70
40007216 311 G0143 PAP SMEAR MANUAL SCREEN & RESCREEN 106.08 74.26
40007217 311 G0144 PAP SMEAR LOW RISK FP R AND V 106.08 74.26
40007219 311 G0124 PAP SMEAR THIN LAYER PHYSICIAN ITRP 106.08 74.26
40007220 311 88148 PAP SMEAR DIAGNOSITIC 118.58 83.01
40007246 300 86406 CRYPTOCOCCAL TITER 65.00 45.50
40007247 300 86480 TB QUANTIFERON 194.97 136.48
40007248 300 86406 STREPTOCOCCUS TITER 65.00 45.50
40007318 301 83880 BRAIN NATRIURETIC PEPTIDE 239.47 167.63
40007345 300 86403 CRYPTOCOCCAL AG-CSF 74.73 52.31
40007346 300 86403 CRYPTOCOCCAL AG-SERUM 74.73 52.31
40007348 300 86403 STREPTOCOCCUS SCREEN SERUM 68.50 47.95
40007474 310 88302 LEVEL 2 GROSS MICRO 150.36 105.25
40007475 310 88304 LEVEL 3 GROSS MICRO 190.43 133.30
40007476 310 88305 LEVEL 4 GROSS MICRO 258.36 180.85
40007477 310 88307 LEVEL 5 GROSS MICRO 496.60 347.62
40007478 310 88309 LEVEL 6 GROSS MICRO 705.99 494.19
40007500 310 88300 SP LV1 GROSS 73.75 51.63
40007523 310 88239 TISSUE CX NEOPLASTIC 2,841.45 1,989.02
40007524 310 88237 BONE MARROW, TISSUE CULTURE 481.36 336.95
40007525 310 88104 CYTOLOGY NGYN BRUSHING 156.71 109.70
40007526 311 88160 CYTOPATHOLOGY OTHER THAN GYN 130.25 91.18
40007527 310 88237 BONE MARROW, MSMART 6,535.22 4,574.65
40007531 311 88172 FNA-BX IMM EVAL 74.25 51.98
40007533 300 89060 BODY FLUID CRYSTALS 78.36 54.85
40007537 300 86022 PLATELET AB (INDIRECT) 341.42 238.99
40007538 311 88182 PLSMA CELL 1ST MARKER BM 362.31 253.62
40007539 311 88184 FLOW CYTOMETRY FIRST MARKER 211.77 148.24
40007540 311 88185 FLOW CYTOMETRY EACH ADD MARKER 71.71 50.20
40007541 300 86360 CD4 AND CD8, ABSOLUTE COUNT 78.17 54.72
40007542 300 86361 CD4 COUNT 75.26 52.68
40007544 302 86356 MONONUCLEAR CELL AG QUANT 88.25 61.78
40007545 300 86355 B CELLS TOTAL 96.27 67.39
40007546 300 86357 NATURAL KILLER CELLS 96.27 67.39
40007547 300 86359 T CELLS TOTAL 96.27 67.39
40007548 300 86352 NEUTROPHIL OXIDATIVE BURST 296.70 207.69
40007549 302 86352 CHRONIC URTICARIA INDEX 277.89 194.52
40007550 300 80299 ADALIMUMAB ACTIVITY 892.41 624.69
40007551 300 82397 ADALIMUMAB ANTIBODY 695.82 487.07
40007553 311 88187 FLOWCYTO INT 2-8 MARK 96.22 67.35
40007554 311 88182 FLOWCYTO CELL CYCLE DNA 127.84 89.49
40007555 311 88184 PLSMA CELL 1ST SURF MARK BM 742.42 519.69
40007561 302 86353 LYMPHOCYTE TRANSFORMATION 87.00 60.90
40007562 302 86341 ISLET AG 2 AB 770.01 539.01
40007563 302 86341 GAD ANTIBODY 90.65 63.46
40007600 302 86316 CHROMOGRANIN A 177.52 124.26
40007601 301 83951 DES GAMMA CARBOXY PROTHROMBIN 254.43 178.10
40007602 300 87118 ID MALDI-TOF MASS SPEC AFB 312.75 218.93
40007603 301 82397 PTH RELATED PEPTIDE 102.45 71.72
40007604 300 81596 FIBROTEST-ACTITEST 489.19 342.43
40007605 300 80161 Carbamazepine-10,11-Epoxide 59.53 41.67
40007606 300 82642 DIHYDROTESTOSTERONE, SERUM 107.52 75.26
40007607 300 87635 SARS-CoV-2 PCR 179.28 125.50
40007608 300 86341 ZINC TRANSPORTER 8 ANTIBODY 524.13 366.89
40007609 300 86769 SARS COV-2 IGG 68.83 48.18
40007610 300 87635 SARS-CoV-2 PCR (HMC) 179.28 125.50
40007611 300 87641 MRSA SCREEN MOLECULAR 158.83 111.18
40007612 300 87426 SARS RAPID ANTIGEN 134.52 94.16
40007613 300 0241U RESP 4PLEX PANEL 237.61 166.33
40007614 319 88291 CYTOGEN/MOLECULAR INTERP/REPORT 102.90 72.03
40007615 300 87640 PRE OP Staph PCR 313.37 219.36
40007616 300 0077U M PROTEIN MALDI 821.27 574.89
40007617 300 83520 LAMBDA FREE LIGHT CHAINS 653.23 457.26
40007618 300 83520 KAPPA FREE LIGHT CHAINS 653.23 457.26
40008113 310 85097 BM ASP INTERP 842.09 589.46
40009232 300 82131 HOMOCYSTINE URINE 156.53 109.57
40009233 300 82131 PHOSPHOETHANOLAMINE URINE 640.75 448.53
40009234 301 82136 CYSTINE URINE 237.45 166.22
40009236 302 86235 NUCLEAR ANTIGEN ANTIBODY 90.79 63.55
40009237 300 84305 IGF-1, LC/MS, S 52.87 37.01
40010493 311 88274 INTERPHASE INSITU HYBRIDIZATION 106.35 74.45
40010494 311 88275 IN SITU HYBRID 100 TO 300 CELLS 179.70 125.79
40021111 300 86255 ANTI-GBM PANEL (GBM IGA) 177.50 124.25
40021276 300 86738 MYCOPLASMA PN IgM 69.54 48.68
40021305 300 86664 EBV ABS-EBNA 57.27 40.09
40021306 300 86790 HANTA VIRUS IgM 92.00 64.40
40021307 300 86788 WEST NILE VIRUS IGM 188.44 131.91
40021434 301 84075 ALK PHOS ISOS (TOTAL) 46.90 32.83
40021440 300 86652 ARBOVIRUS PANEL Eastern Equine 49.75 34.83
40021615 300 86696 HERPES SIMPLX IGM TYPE II 48.50 33.95
40021617 300 86696 HERPES SIMPLEX IgG TYPE II 66.81 46.77
40021707 300 84233 FROZ EST RECEPTOR 250.89 175.62
40021771 300 86658 COXSACKIE A VIRUS AB A9 45.00 31.50
40021773 300 86658 COXSACKIE B VIRUS AB B2 43.25 30.28
40021952 300 86710 INFLUENZA A AB IgM 117.53 82.27
40021955 301 83527 FREE INSULIN 52.90 37.03
40022048 300 86778 TOXOPLASMOSIS ABS IgM 72.29 50.60
40022342 302 86146 B2 GLYCOPROTEIN 1 AB IGA 25.45 17.82
40022343 300 86147 CARDIOLIPIN AB-IgM 106.35 74.45
40022344 300 86148 PHOSPHATIDYLSERINE AB IGM 81.75 57.23
40022370 300 85245 FACT VIII (RISTCTN) 120.81 84.57
40022385 300 86710 INFLVENZA B ANTIBODY IGM 117.53 82.27
40022770 301 84153 PSA - DIAGNOSTIC 141.26 98.88
40022771 301 84153 PSA - REFERRED 141.26 98.88
40022775 301 G0257 UNSCHED DIALYSIS ESRD PT HOS 0.01 0.01
40022947 300 86632 CHLAMYDIA AB PANEL-IGM(C. PNEUMONIA) 51.00 35.70
40024217 300 86757 TYPHUS AB IGM 48.50 33.95
40024219 300 86757 ROCKY MTN IgM 89.17 62.42
40024290 310 88230 CHROMOSOME AN/TISSUE CULTURE 200.75 140.53
40024370 300 86800 THYROGLOBULIN ANTIBODY 62.73 43.91
40027212 311 88142 PAP SMEAR DIAGNOSTIC 94.50 66.15
40031111 300 86255 ANTI-GBM PANEL (GBM IGG) 177.50 124.25
40031305 300 86665 EBV ABS-VCA IgG 66.81 46.77
40031440 300 86653 ARBOVIRUS PANEL St. Louis 49.75 34.83
40031771 300 86658 COXSACKIE A VIRUS AB A10 45.00 31.50
40031773 300 86658 COXSACKIE B VIRUS AB B3 43.25 30.28
40032342 302 86146 B2 GLYCOPROTEIN 1 AB IGM 25.45 17.82
40032343 300 86147 CARDIOLIPIN AB - IGA 106.35 74.45
40032344 300 86148 PHOSPHATIDYLSERINE AB IGA 81.75 57.23
40032370 300 85246 FACT VIII vWF/Ag 98.18 68.73
40032947 300 86632 CHLAMYDIA AB PANEL-IGM(C. PSITTACI) 51.00 35.70
40041305 300 86665 EBV ABS-VCA IgM 66.81 46.77
40041306 300 G0499 HEPB SCREEN HIGH RISK INDIV MEDICARE 160.41 112.29
40041307 300 86305 HUMAN EPIDIDYMIS PROTEIN 4 374.30 262.01
40041308 310 88314 HISTOCHEMICAL STAINS ADD-ON 149.72 104.80
40041309 310 88319 ENZYME HISTOCHEMISTRY 203.20 142.24
40041310 310 88189 FLOW CYTOMETRY INTERPRETATION 16/> MARKE 299.17 209.42
40041311 310 88188 FLOW CYTOMETRY INTERP 9-15 MARKERS 228.26 159.78
40041312 301 82135 AMINOLEVULINIC ACID DELTA 213.67 149.57
40041313 301 84110 PORPHOBILINOGEN URINE; QUAN 94.07 65.85
40041440 300 86654 ARBOVIRUS PANEL Western Equine 49.75 34.83
40041771 300 86658 COXSACKIE A VIRUS AB A16 45.00 31.50
40041773 300 86658 COXSACKIE B VIRUS AB B4 43.25 30.28
40042370 300 85247 FACTOR 8 VWF MULTIMERIC 280.75 196.53
40044295 301 82595 CRYOGLOBULIN QUANT 43.37 30.36
40051773 300 86658 COXSACKIE B VIRUS AB B5 43.25 30.28
40061773 300 86658 COXSACKIE B VIRUS AB B6 43.25 30.28
42000017 341 78499 NM AORTOGRAM 1,179.30 825.51
42000020 341 78800 NM LABEL WHITE BLOOD CELL SCAN 3,929.68 2,750.78
42000025 341 78104 NM BONE MARROW 1,341.71 939.20
42000030 341 78315 NM BONE SCAN 3 PHASE 1,199.90 839.93
42000031 341 78803 NM BONE/JOINT SPECT 1,963.48 1,374.44
42000033 341 78306 NM BONE TOTAL 1,308.98 916.29
42000034 320 72080 XR spine, thoracolum junc 2VW+ 381.00 266.70
42000035 320 72081 XR Spine; 1 VW Scoliotic exam 392.05 274.44
42000036 320 72082 XR spine; 2 or 3 VW scoliotic exam 452.82 316.97
42000037 320 72083 XR spine; 4 or 5 VW scoliotic exxam 697.58 488.31
42000038 320 72084 XR spine; min 6VW scoliotic exam 697.58 488.31
42000039 320 73501 XR hip; unilat 1VW 392.05 274.44
42000040 320 73502 XR hip; unilat 2-3VWS 392.05 274.44
42000041 320 73503 XR hip; unilat, min 4VW 440.06 308.04
42000042 320 73521 XR hip; bilat, 2VW 440.06 308.04
42000043 320 73522 XR hip; bilat, 3-4VW 440.06 308.04
42000044 320 73523 XR hip; bilat, min 5 VW 677.92 474.54
42000045 320 73551 XR femur 1VW 392.05 274.44
42000046 320 73552 XR femur min 2 VW 392.05 274.44
42000058 341 78290 NM BOWEL (MECKELS) STUDY 2,012.56 1,408.79
42000060 340 78800 NM MIRALUMA 1,179.30 825.51
42000066 341 78605 NM BRAIN(STATIC) 1,564.69 1,095.28
42000082 341 78699 NM DYNAMIC BRAIN 1,606.69 1,124.68
42000090 341 78472 NM CARDC BLD PL 1,472.60 1,030.82
42000093 341 78452 MYOCARDIAL SPECT MULTIPLE STUDIES STRESS 4,197.74 2,938.42
42000094 341 78451 NM MYOCARD SPECT 2 DAY PROTOCOL 4,197.47 2,938.23
42000108 341 78466 NM CRDC MYOCARD I 1,299.71 909.80
42000116 341 78630 NM CISTERNOGRAM 1,646.85 1,152.80
42000165 341 78300 NM JOINT LMTD AREA 1,179.30 825.51
42000173 341 78305 NM JOINT MLTP AREA 1,190.63 833.44
42000181 341 78201 NM LIVER 1,503.83 1,052.68
42000199 341 78215 NM LIVER & SPLEEN 1,839.26 1,287.48
42000200 360 50200 INTRO PROC-KDN BX 908.25 635.78
42000207 341 78226 NM HEPATOBILIARY HIDA SCAN WO CCK 1,588.23 1,111.76
42000209 341 78227 NM HEPATOBILLIARY HIDA SCAN WITH CCK 1,636.22 1,145.35
42000223 341 78580 NM LUNG PRFSN STDY 1,308.98 916.29
42000231 341 78579 NM LUNG VENTILATION 1,179.30 825.51
42000248 341 78580 NM LUNG PERFUSION 1,200.00 840.00
42000249 341 78582 NM LUNG VENT & PERF. (VQ) 531.77 372.24
42000250 341 78598 NM LUNG QUANTITATIVE 1,564.69 1,095.28
42000253 341 78267 NM UREA BREATH TEST C-14; ACQUISITION 752.66 526.86
42000254 341 78268 NM UREA BREATH TEST C-14; ANALYSIS 376.34 263.44
42000256 341 78473 NM MUGA SCAN 1,624.24 1,136.97
42000272 341 78700 NM RENAL 1,439.88 1,007.92
42000280 341 78701 NM RENL W/ARTFLW 1,598.05 1,118.64
42000281 250 A9698 SITZ MARK NON-RAD CONTRAST MATERIALNOC 90.48 63.34
42000289 343 A9512 NM TECHNETIUM PERTECHNETATE 112.08 78.46
42000290 343 A9562 NM RENAL DOSE (TC MAG3) 431.87 302.31
42000291 343 A9537 NM HEPATOBILIARY DOSE-CHO 182.81 127.97
42000292 343 A9539 NM LUNG VENTIL DOSE(DTPA) <=25.00 mci 476.93 333.85
42000294 343 A9560 NM MUGA DOSE (PYP) 144.23 100.96
42000295 343 A9500 NM CARDIOLITE DOSE (TC) 617.40 432.18
42000296 343 A9503 NM BONE DOSE (TCMDP) 114.90 80.43
42000300 343 A9540 NM TCMAA-1 LUNG PERFUSION <=10.00 mci 476.93 333.85
42000301 341 78480 NM EJECTION FRACTION-MYOC 1,065.25 745.68
42000302 341 78464 NM MYOCARD PERFUSION-SING 1,475.50 1,032.85
42000303 341 78453 NM MYOCARDIO-WALL MOTION 1,564.69 1,095.28
42000304 340 78708 NM RENAL W/PHARMACY 1,564.69 1,095.28
42000308 343 A9541 NM Tc99m Sulfur Colloid 559.61 391.73
42000314 341 78185 NM SPLEEN W/FLOW 1,179.30 825.51
42000322 340 78013 NM THYROID 1,296.98 907.89
42000324 341 78070 NM PARATHYROID IMAGING 1,179.30 825.51
42000330 340 78012 NM THYROID UPTAKE 1,179.30 825.51
42000345 341 78018 NM THYROID MET SCAN-WHOLE BODY 1,515.15 1,060.61
42000348 340 78014 NM THYROID UPTAKE&SCN 1,179.30 825.51
42000360 341 78645 NM SHUNT EVALUATION 1,179.30 825.51
42000362 341 78761 NM TESTICULAR IMAGING W/VASCULAR FLOW 1,216.77 851.74
42000371 341 78458 NM VENOGRAM 1,179.30 825.51
42000389 341 78445 NM VENOGRAM/LUNG 1,302.98 912.09
42000390 341 78740 NM VOIDING CYSTO 1,179.30 825.51
42000421 341 NM ANY ADD FLOW STDY 403.75 282.63
42000429 341 78195 NM LYMPHOSCINTIGRAPY 2,256.64 1,579.65
42000439 341 NM CHRG ON CALL 377.75 264.43
42000447 341 NM CHRG CONCUR ON CAL 213.00 149.10
42000454 341 78230 NM PAROTID 1,208.78 846.15
42000462 340 78262 NM GASTRIC REFLUX STUDY 1,208.78 846.15
42000470 341 78278 NM GI BLEED LOC 1,208.78 846.15
42000488 341 78264 NM GASTRIC EMPTYING STUDY 1,183.55 828.49
42000490 341 78802 NM Absesses/Infec whole body 3,929.68 2,750.78
42000491 341 78399 NM UNLISTED NUCLEAR MEDICINE STUDY 1,000.00 700.00
42001000 402 76998 US GUIDE INTRAOP 767.85 537.50
42001007 402 76870 SONO SCROTUM 558.09 390.66
42001016 402 76880RT SONO KNEE RIGHT 263.25 184.28
42001017 402 76880LT SONO KNEE LEFT 263.25 184.28
42001035 402 76942 SONO GUIDED NEEDLE PLACEMENT 544.46 381.12
42001056 402 76705 SONO LLQ RLQ 558.09 390.66
42001064 402 76856 SONO PELVIC 558.09 390.66
42001106 402 76815 SONO PREGNCY FTL AGE LIMITED 558.09 390.66
42001114 402 76857 SONO POST VOID RESIDUAL 558.09 390.66
42001122 402 76770 SONO RETROPEROTINEAL 558.09 390.66
42001130 402 76775 SONO ABDOMINAL AORTA 558.09 390.66
42001148 402 76705 SONO SPLEEN 558.09 390.66
42001155 402 76705 SONO PANCREAS 558.09 390.66
42001163 402 76775 SONO KIDNEYS BILATERAL 558.09 390.66
42001164 402 76775RT SONO KIDNEY RIGHT 542.36 379.65
42001165 402 76775LT SONO KIDNEY LEFT 542.36 379.65
42001171 402 76705 SONO GALL BLADDR 558.09 390.66
42001189 402 76705 SONO LIVER 558.09 390.66
42001197 402 76700 SONO ABDOMEN COMPLETE 558.09 390.66
42001205 402 76705 SONO ABDMEN LMTD 558.09 390.66
42001213 402 76536 SONO THYROID 558.09 390.66
42001215 402 76536 SONO PAROTID 558.09 390.66
42001220 402 76830 SONO TRANSVAGINAL 558.09 390.66
42001221 402 76882 SONO EXTREMITY BILATERAL (NON VASC) 275.00 192.50
42001222 402 76882 SONO EXTREMITY (NON VASCULAR) 544.46 381.12
42001223 402 76882 SONO EXTREMITY LEFT (NON-VASC) 275.00 192.50
42001239 402 7653650 SONO NECK BILATERAL 542.36 379.65
42001240 402 76536RT SONO NECK RIGHT 542.36 379.65
42001241 402 76536LT SONO NECK LEFT 542.36 379.65
42001247 402 76536 SONO SOFT TISSUE H+N 558.09 390.66
42001300 402 76604 SONO CHEST 558.09 390.66
42001304 402 76641RT SONO BREAST RIGHT COMPLETE 767.85 537.50
42001305 402 76641LT SONO BREAST LEFT COMPLETE 767.85 537.50
42001308 402 76642RT SONO BREAST RIGHT 558.09 390.66
42001309 402 76642LT SONO BREAST LEFT LIMITED 558.09 390.66
42001310 402 76970 US FOLLOW UP STUDY 217.52 152.26
42002003 320 73630LT XR FOOT LEFT 288.43 201.90
42002005 320 73630RT XR FOOT RIGHT 288.43 201.90
42002010 320 73620 XR FOOT 2 VIEW 288.43 201.90
42002040 320 72040 XR C SPINE AP LAT 327.24 229.07
42002046 320 73610RT XR ANKLE RT 3V 357.78 250.45
42002047 320 73610LT XR ANKLE LT 3V 357.21 250.05
42002054 320 73590RT XR LOWER LEG RIGHT 384.06 268.84
42002055 320 73590LT XR LOWER LEG LEFT 384.06 268.84
42002070 320 73564RT XR KNEE COMPLETE 336.00 235.20
42002071 320 73564LT XR KNEE COMPLETE 336.00 235.20
42002075 320 73565 XR KNEE STDG AP BILT 288.44 201.91
42002087 320 73564LT XR KNEE 4V+ LEFT 409.64 286.75
42002088 320 73564RT XR KNEE 4V+ RIGHT 409.64 286.75
42002095 320 73560LT XR KNEE 1/2 VIEWS LEFT 288.44 201.91
42002096 320 73560RT XR KNEE 1/2 VIEWS RIGHT 288.44 201.91
42002097 320 73562LT XR KNEE 3V LT 371.84 260.29
42002098 320 73562RT XR KNEE 3V RT 371.84 260.29
42002100 320 7356050 XR KNEE BILATERAL 432.66 302.86
42002103 320 73550LT XR FEMUR 2 VWS LEFT 231.75 162.23
42002104 320 73550RT XR FEMUR 2VWS RIGHT 231.75 162.23
42002105 320 73660TALT XR TOE LEFT GREAT TOE 288.43 201.90
42002115 320 73660T9 XR TOE RIGHT 5TH 288.43 201.90
42002153 320 73510RT XR HIP COMPLETE RIGHT 333.25 233.28
42002154 320 73510LT XR HIP COMPLETE LEFT 333.25 233.28
42002179 320 72170 XR PELVIS 1/2 VWS 405.07 283.55
42002180 320 73540 XR PEL HIP INFANT 209.50 146.65
42002186 320 77075 XR SKELETAL SURVEY 971.51 680.06
42002187 320 77072 XR BONE AGE 365.88 256.12
42002195 320 71130 XR STRNO CLVCLR JN 306.26 214.38
42002205 320 73660T1 XR TOE LEFT 2ND 288.43 201.90
42002208 320 73130 XR HAND MIN 3 VWS 229.77 160.84
42002209 320 73130LT XR HAND MIN 3 VWS LT 288.44 201.91
42002210 320 73120LT XR HAND 2 VIEW LEFT 409.64 286.75
42002211 320 73130RT XR HAND 3 VWS RT 288.44 201.91
42002212 320 73140FA XR FINGER LEFT THUMB 288.44 201.91
42002213 320 73120RT XR HAND 2 VIEW RIGHT 409.64 286.75
42002214 320 73140F1 XR FINGER-2ND DIGIT LEFT 288.44 201.91
42002215 320 73140F2 XR FINGER-3RD DIGIT LEFT 288.44 201.91
42002216 320 73140F3 XR FINGER-4TH DIGIT LEFT 288.44 201.91
42002217 320 73140F4 XR FINGER-5TH DIGIT LEFT 288.44 201.91
42002218 320 73140F5 XR FINGER RIGHT THUMB 288.44 201.91
42002219 320 73140F6 XR FINGER-2ND DIGIT RIGHT 288.44 201.91
42002221 320 73140F7 XR FINGER-3RD DIGIT RIGHT 288.44 201.91
42002222 320 73140F8 XR FINGER-4TH DIGIT RIGHT 288.44 201.91
42002223 320 73140F9 XR FINGER-5TH DIGIT RIGHT 288.44 201.91
42002228 320 73110LT XR WRIST LEFT 288.43 201.90
42002229 320 73110RT XR WRIST RIGHT 288.43 201.90
42002237 320 73090RT XR FOREARM RIGHT 313.62 219.53
42002239 320 73090LT XR FOREARM LEFT 313.62 219.53
42002252 320 73060RT XR HUMERUS RIGHT 384.06 268.84
42002253 320 73060LT XR HUMERUS LEFT 384.06 268.84
42002260 320 73010RT XR SCAPULA COMPLETE RT 405.07 283.55
42002261 320 73010LT XR SCAPULA COMPLETE LT 405.07 283.55
42002262 320 7301050 XR SCAPULA COMPLETE BIL 457.86 320.50
42002277 320 73000LT XR CLAVICLE COMPLETE LT 312.40 218.68
42002278 320 73000RT XR CLAVICLE COMPLETE RT 312.40 218.68
42002279 320 73020LT XR SHOULDER LEFT 1 VIEW 288.43 201.90
42002280 320 73020RT XR SHOULDER RIGHT 1 VIEW 288.43 201.90
42002284 320 73030LT XR SHOULDER COMPLETE LT 300.21 210.15
42002285 320 7303050 XR SHOULDER COMPLETE BILATERAL 457.86 320.50
42002286 320 73030RT XR SHOULDER COMPLETE RT 301.32 210.92
42002288 320 7300050 XR CLAVICLE BILATERAL 468.58 328.01
42002289 320 73060 X-RAY EXAM OF HUMERUS 2+ VIEWS 576.10 403.27
42002290 320 7307050 XR ELBOW 2v BILATERAL 434.81 304.37
42002291 320 7308050 XR ELBOW 3v BILATERAL 587.00 410.90
42002292 320 7309050 XR FOREARM BILATERAL 470.44 329.31
42002293 320 7311050 XR WRIST BILATERAL 344.65 241.26
42002294 320 7312050 XR HAND BILATERAL 365.88 256.12
42002295 320 7351050 XR HIP BILATERAL 499.88 349.92
42002296 320 7355050 XR FEMUR BILATERAL 347.62 243.33
42002297 320 7359050 XR LOWER LEG BILATERAL 576.10 403.27
42002298 320 7361050 XR ANKLE BILATERAL 521.15 364.81
42002299 320 7363050 XR FOOT BILATERAL 405.78 284.05
42002300 320 73050 XR AC JOINTS BILATERAL 412.57 288.80
42002305 320 73660T2 XR TOE LEFT 3RD 288.43 201.90
42002310 320 70360 XR NECK SOFT TISSE 290.15 203.11
42002328 320 72010 XR SPINE ENTIRE 879.00 615.30
42002330 320 72070 XR TSPINE 2VWS 409.64 286.75
42002344 320 72200 XR SACRO ILIAC JNT 405.07 283.55
42002351 320 72220 XR COCCYX & SACRUM 313.91 219.74
42002369 320 72220 XR SACRUM COCCYX 782.44 547.71
42002377 320 72110 XR LMBR SPNE MN 4VWS 518.24 362.77
42002378 320 72265 LUMBAR MYELOGRAM 2,400.53 1,680.37
42002379 320 72020 XR SPINE 1 VIEW 233.68 163.58
42002380 320 72114 XR LSPINE COMPLETE 559.61 391.73
42002381 320 72120 XR LUMBAR FLEXION EXTENSION 2V 395.19 276.63
42002385 320 72100 XR LUMBAR SPN 2/3 VIEW 409.64 286.75
42002393 320 72072 XR TSPINE 3 VWS 409.64 286.75
42002405 320 73660T3 XR TOE LEFT 4TH 288.43 201.90
42002427 320 72050 XR C SPINE 4/5 VWS 435.79 305.05
42002428 320 72052 XR C SPINE COMPLETE 376.09 263.26
42002435 320 72040 XR C SPINE 2/3 VWS 365.88 256.12
42002436 320 72240 XR CERVICAL MYELOGRAM 2,400.53 1,680.37
42002442 320 73070 XR ELBOW LT 2 VIEWS 289.87 202.91
42002443 320 73070 XR ELBOW RT 2 VIEW 289.87 202.91
42002445 320 73080RT XR ELBOW RIGHT 3 VIEW 391.33 273.93
42002446 320 73080LT XR ELBOW LEFT 3 VIEW 391.33 273.93
42002450 320 73650RT XR CALCANEUS RIGHT (HEEL) 288.43 201.90
42002451 320 73650LT XR CALCANEUS LEFT (HEEL) 288.43 201.90
42002473 320 73592LT XR LOWER EXT. INFANT LEFT 289.87 202.91
42002474 320 73592RT XR LOWER EXT. INFANT RIGHT 289.87 202.91
42002478 320 76010 XR BABYGRAM 199.50 139.65
42002492 320 71120 XR STERNUM 311.95 218.37
42002500 320 71111 XR RIBS BILATERAL MIN 4 VWS 424.31 297.02
42002505 320 73660T4 XR TOE LEFT 5TH 288.43 201.90
42002518 320 71101RT XR RIBS/CHEST RIGHT MIN 3VWS 409.64 286.75
42002519 320 71101LT XR RIBS/CHEST LEFT MIN 3 VWS 409.64 286.75
42002534 324 71030 XR CHEST COMPLETE 258.00 180.60
42002542 324 71046 XR CHEST 2 PA LAT 216.91 151.84
42002555 324 71045 XR CHEST 1 VIEW 251.57 176.10
42002559 324 71045 XR CHEST PORTABLE 1 VIEW AP 245.44 171.81
42002560 324 71035 XR CHEST SPECIAL VIEWS 218.50 152.95
42002561 324 71047 XR CHEST2 VWS FRONT LAT W/ LORDOTIC 394.58 276.21
42002565 324 71048 XR CHEST 4+ VWS 394.58 276.21
42002567 320 72069 XR SCOLIOSIS SURVY 223.50 156.45
42002575 320 70150 XR FACIAL BONES COMPLETE 409.64 286.75
42002605 320 73660T5RT XR TOE RIGHT GREAT TOE 288.43 201.90
42002617 320 70160 XR NASAL BONES COMPLETE 290.15 203.11
42002625 320 70200 XR ORBITS 365.88 256.12
42002633 320 70220 XR SINUSES COMPLETE 368.69 258.08
42002674 320 70330 XR TMJ BIL 231.75 162.23
42002682 320 70328 XR TMJ UNI 201.75 141.23
42002705 320 73660T6 XR TOE RIGHT 2ND 288.43 201.90
42002708 320 70110 XR MANDIBLE COMPLETE 365.88 256.12
42002716 320 70140 XR ZYGOMATIC ARCH <3VWS 259.50 181.65
42002724 320 70190 XR OPTC FRMNA RHSE 316.00 221.20
42002740 320 70250 XR SKULL LESS THAN 4 VIEWS 376.09 263.26
42002757 320 70260 XR SKULL COMPLETE 409.64 286.75
42002770 320 74245 XR UGI/SM BOWEL NO CONTRAST 680.56 476.39
42002773 320 74270 X-RAY XM COLON 1CNTRST STD 815.65 570.96
42002800 324 71023 CHEST SINGLE VIEW W FLUOROSCOPY 327.24 229.07
42002801 324 71034 CHEST COMPLETE WITH FLUOROSCOPY 327.24 229.07
42002802 320 73530 HIP XRAY INTRAOPERATIVE 523.50 366.45
42002805 320 73660T7 XR TOE RIGHT 3RD 288.43 201.90
42002807 320 74240 XR UGI/SM BOWEL 697.58 488.31
42002808 320 75989 ANG ABSCESS DRAINAGE /FLURO US CT GUIDED 463.18 324.23
42002809 320 76000 FL FLUORO TIME 60 MINUTES 823.57 576.50
42002810 320 76000 FL BRONCOSCOPY/ERCP 734.20 513.94
42002811 320 77001 FLUOROGUIDE FOR VEIN DEVICE 550.86 385.60
42002812 320 77003 FLURO GUIDANCE NEEDLE LOCALIZATION 309.00 216.30
42002815 320 74240 XR UGI 649.33 454.53
42002817 320 77002 NEEDLE LOCALIZATION BY XRAY 625.04 437.53
42002818 320 77001 FLVORO GUIDED MEDIPORT/VENOUS ACCES 359.00 251.30
42002819 320 77003 FLUOROGUIDE FOR SPINE INJECT 625.04 437.53
42002823 320 74220 X-RAY XM ESOPHAGUS 1CNTRST 658.56 460.99
42002856 320 74455 XR CYSTOGRAM VDNG 1,380.04 966.03
42002858 320 74251 X-RAY XM SM INT 2CNTRST STD 886.08 620.26
42002864 320 74430 XR CYSTOGRAM 1,346.38 942.47
42002865 360 51600 INJECTION CYSTOGRAM 235.34 164.74
42002870 320 74450 XR URETHROGRAM RETROGRADE 697.58 488.31
42002871 320 74420 UROGRAPHY RETOGRADE 1,380.04 966.03
42002872 320 74450 XR RETROGRADE OR 774.25 541.98
42002873 360 51610 INJECTION RETRO URETHVCYSTGRAM 241.23 168.86
42002890 320 74480 INTRODUCTION URETHAL CATHETER1STENT 1,436.50 1,005.55
42002891 320 74485 DILATION URETHRA - URETERS NEPHROSTOM 6,246.38 4,372.47
42002898 320 74400 XR IVP 720.89 504.62
42002905 320 73660T8 XR TOE RIGHT 4TH 288.43 201.90
42002914 320 74305 XR CHOLANGIOGRAM T TUBE 569.60 398.72
42002915 360 47505 XR INJECTION T-TUBE CHOLANGIOGRAM 309.50 216.65
42002916 360 47500 XR INJECTION PERQ CHOLANGIOGRAM 309.50 216.65
42002917 360 47630 XR EXTRACT BILE STONE PERA 509.50 356.65
42002918 320 74301 XR CHOLANGIOGRAM ADDITIONAL INTRAOP 659.23 461.46
42002930 320 74300 XR CHOLANGIOGRAM INTRAOP 878.11 614.68
42002931 320 74301 ANG ADDITIONAL SET CHOLANGIOGRAPHY 327.75 229.43
42002932 320 74320 XR CHOLANGIOGRAPHY,PERCUTANEOUS 589.00 412.30
42002934 320 74327 XR BILIARY STONE REMOVAL 768.00 537.60
42002935 320 74360 INTRALUMINAL DILATION ESOPHOGUS 558.23 390.76
42002936 320 74340 INTRO GI TUBE WITH FLUORO OR FILM 310.07 217.05
42002937 320 49440 ANG PERCUTANEOUS PLACEMENT GASTRO TUBE 3,953.56 2,767.49
42002938 320 74355 ANG PERCUT PLACEMENT ENTERCLYSIS TUBE 439.33 307.53
42002989 320 74022 XR ACUTE ABD SERIES 446.12 312.28
42002997 320 74019 XR ABDOMEN 2 VIEWS 405.07 283.55
42002998 320 74021 XR ABDOMEN 3+ VIEWS 423.76 296.63
42003000 320 74241 XR UGI W KUB NO CONTRAST 445.33 311.73
42003003 320 74018 XR ABDOMEN 1 VIEW KUB 335.43 234.80
42003051 401 77051 MAMMO DIAGNOSTIC MAMMO 96.00 67.20
42003052 401 77055RT MAMMO DIAGNOSTIC RIGHT MAMMOGRAPHY 96.00 67.20
42003053 401 77065LT MAMMO DIGITAL DIAGNOSTICE LEFT WITH CAD 314.46 220.12
42003054 403 G0202 MAMMO SCREEN BILATERAL INCL CAD 371.25 259.88
42003055 401 77065LT MAMMO DIGITAL DIAGNOSTIC LEFT 314.46 220.12
42003056 401 77065RT RT MAMMO DIGITAL DIAGNOSTIC RIGHTWITH CAD 281.25 196.88
42003057 401 77066 MAMMO DIGITAL DIAGNOSTIC BILATERAL 458.98 321.29
42003058 401 MAMMMO BILATERAL 151.25 105.88
42003059 401 77065RT MAMMO DIGITAL DIAGNOSTIC RIGHT 314.46 220.12
42003060 401 G0279 MAMMO DIAG TOMOSYNTHESIS 110.58 77.41
42003061 403 77063 MAMMO TOMO BILATERAL 110.58 77.41
42003062 403 77067 MAMMO DIG SCR BILAT INCLUD CAD 334.17 233.92
42003075 401 77056 MAMMO DIAGNOSTIC BILATERAL MAMMOGRAPHY 151.25 105.88
42003100 490 19291 MAMMO PREOP WIRE PLACEMENT ADDITIONAL 260.25 182.18
42003160 320 73092 XR PED UPPER EXT BIL 405.07 283.55
42003177 320 74290 XR CHOLECYSTOGRAPHY ORAL 697.58 488.31
42003179 320 74291 XR DELAYED GB 377.50 264.25
42003185 320 72069 XR SPINE STNDMG AP 299.00 209.30
42003201 320 74250 XR SMALL X-RAY XM SM INT 1CNTRST STD 658.46 460.92
42003219 320 76080 XR FISTULOGRAM 1,698.02 1,188.61
42003227 320 74280 XR FLURO BARIUM ENEMA AIR X-RAY XM COLON 1,397.89 978.52
42003240 360 32405 INTRO PROC-LUNG BX 593.25 415.28
42003663 401 19281 MAMMO NEEDLE LOCALIZATION RIGHT BREAST 442.25 309.58
42003664 320 77032LT MAMMO NEEDLE LOCALIZATION LEFT BREAST 442.25 309.58
42003665 360 19283 MAMMO STEREOTACTIC NEEDLE LOC RIGHT BRST 1,562.08 1,093.46
42003666 360 19284 MAMMO STEREOTACTIC NEEDLE LOC LEFT BRST 1,026.00 718.20
42003667 360 19081 MAMMO BREAST STEREO UNILAT + WIRE 3,061.44 2,143.01
42003668 360 1908150 MAMMO STEREO BIOPSY BILAT + WIRE 3,061.44 2,143.01
42003669 360 19082 MAMMO BREAST STERO UNILAT AD LESIONS 1,026.00 718.20
42003670 360 19282 MAMMO BREAST NEEDLE LOC EACH ADD'L 442.25 309.58
42003672 320 76098 MAMMO SURGICAL SPECIMEN 1,740.47 1,218.33
42003705 490 19290 MAMMO PREOP WIRE PLACEMENT INITIAL 578.75 405.13
42003710 320 20501 XR INJ PROC 9 SISTUL 238.00 166.60
42003715 360 51610 INJ PROC-RETROG 163.25 114.28
42003720 360 51600 INJ PROC-CYSTO 108.00 75.60
42003800 360 50390 KIDNEY CYST ASPR 513.00 359.10
42003805 360 32555 LUNG CYST ASPRI 1,711.71 1,198.20
42003810 360 49406 ANG RETRO PERI CYST ASP 5,139.19 3,597.43
42003815 360 19001 INTRO CYST ASP-BRST 342.00 239.40
42003820 360 19000 INTRO CYST ASP-BRST 342.00 239.40
42004415 921 93875 OCULA PLETHYSMOGPHY 356.75 249.73
42005001 320 77086 DXA BONE DENSITY VERT FX ASS 178.02 124.61
42005002 450 20604 ARTHROCENTESIS/ASPRI/INJ; SML JT US 633.39 443.37
42005003 450 20606 ARTHROCENTESIS/ASPRI/INJ; INTJT US 633.39 443.37
42005004 450 20611 ARTHROCENTESIS/ASPRI/INJ; MAJ JT US 633.39 443.37
42005005 450 62302 Myelography Lumbar Injection Cervical 1,842.12 1,289.48
42005006 450 62303 Myelography Lumbar Injection Thoracic 1,842.12 1,289.48
42005007 450 62304 Myelography Lumbar Injection Lumbrosacr 1,842.12 1,289.48
42005008 450 62305 Myelography Lumbar Injection- 2 or more 1,842.12 1,289.48
42006000 320 77080 DNU DXA BONE DENSITY AXIAL 365.88 256.12
42006001 320 77081 DXA BONE DENSITY / PERIPHERAL 220.94 154.66
42006002 320 77082 DXA BONE DENSITY INCL VERT FX 178.02 124.61
42006003 320 77080 DXA BONE DENSITY AXIAL 365.88 256.12
42006500 320 76496 ANG UNLISTED FLURO PROCEDURE 317.82 222.47
42007000 360 47000 INTRO PROC-LIV BX 530.25 371.18
42007500 636 A9579JW MMRI CONTRAST GADOL WASTE 12.02 8.41
42007600 404 OUTSIDE PET SCAN EXAM 8,825.00 6,177.50
42007999 320 71035 XR CHEST ONE VIEW SPECIAL 197.60 138.32
42008015 320 76001 FLUORO GUIDE > 1 hours 1,139.51 797.66
42008324 320 74230 X-RAY XM SWLNG FUNCJ C+ 642.50 449.75
42009010 360 49010 INTRO PROC RETROP BX 3,174.50 2,222.15
42009100 360 19100 INTRO PROC-BRST BX 3,422.97 2,396.08
42009101 360 19083 BX BREAST 1st LES US GUID 4,384.01 3,068.81
42009102 341 A9516 IODINE I-123 SOD IODIDE PER 100 UCI TO 9 365.81 256.07
42009103 320 77077 XR JOINT SURVEY SINGLE VIEW 2+ JOINTS 400.82 280.57
42009104 320 74221 X-RAY XM ESOPHAGUS 2CNTRST 658.56 460.99
42009105 320 74248 X-RAY SM INT F-THRU STD 397.07 277.95
42009106 402 7664150 SONO BREAST BILATERAL 767.85 537.50
43004850 360 35476 ANG PTA ARTERIAL ANASTOMOSIS AVF 12,069.00 8,448.30
43005000 636 Q9967 CONTRAST ISOVUE 300 0.84 0.59
43005001 636 Q9967JW CONTRAST ISOVUE 300 WASTE 0.82 0.57
43005537 323 75625 ANG ABDOMINAL AORTOGRPHY 9,771.36 6,839.95
43005539 321 75665 ANG UNILAT CAROTID & CEREB 2,890.25 2,023.18
43005541 321 75676 ANG UNILAT CERVCL CAROTD 1,165.50 815.85
43005542 321 75680 ANG CERVICAL CAROTID ANGIO BICATERAL 2,890.25 2,023.18
43005545 323 75605 ANG THORACTIC AORTOGRAPHY 16,205.89 11,344.12
43005553 323 75630 ANG ABDM AORTGRPHY W ROFF 9,771.36 6,839.95
43005555 321 75685 ANG VERTEBRAL ANGIOGRPHY 2,537.75 1,776.43
43005561 323 75741 ANG PULMONARY ANGIO UNIL 9,771.36 6,839.95
43005569 321 75650 ANG CERVICO CEREBRL ANGI 2,890.25 2,023.18
43005577 321 75671 ANG BILAT CAROTID CEREBR 3,005.75 2,104.03
43005580 320 75889 ANG HEPATIC VENOGRAM 9,771.36 6,839.95
43005585 320 75825 ANG INFERIOR VENACAVGRPH 9,771.36 6,839.95
43005593 320 75827 ANG SUPERIOR VENACAVOGRP 2,367.91 1,657.54
43005595 321 75743 ANG PULMONARY ANGIO BILAT 6,659.46 4,661.62
43005601 360 36251 ANG SELECTIVE UNILATERAL RENAL 9,638.68 6,747.08
43005602 360 36253 SUPER SELECTIVE RENAL UNILATERAL 16,205.89 11,344.12
43005606 360 36254 SUPER SELECTIVE RENAL BILATERAL 9,771.36 6,839.95
43005607 360 36252 ANG SELECTIV RENAL BILAT 15,353.19 10,747.23
43005608 321 G0275 ANG RENAL ANGIO W/CORONARY ANGIO 1,248.50 873.95
43005609 360 37191 ANG GREENFIELD FILTER 2,041.25 1,428.88
43005615 321 75893 ANG RENAL VEIN RENIN 665.75 466.03
43005617 320 75962 ANG PTA EXTREMITY ANGIOPLASTY 12,069.15 8,448.41
43005618 360 37224 ANG PTA FEM-POP 16,279.90 11,395.93
43005625 320 75964 ANG PTA EACH ADDITIONAL EXTREMITY VESSE 6,916.05 4,841.24
43005633 321 75660 ANG UNILAT CAROTID 1,248.50 873.95
43005635 321 75962 ANG PTA BRACHIOCEPHALIC 2,890.25 2,023.18
43005640 323 75716 ANG EXTREMITY BILATERAL ANGIOGRAPHY 9,771.36 6,839.95
43005641 323 75710 ANG EXTREMITY UNILATER ANGIO 9,771.36 6,839.95
43005642 321 G0278 ANG ILIAL/FEMORAL W CORONARY ANGIO 1,248.50 873.95
43005647 323 75726 ANG SELECTIVE VISCERAL 9,771.36 6,839.95
43005649 321 75960 ANG STENT INTRAVASCULAR 12,069.24 8,448.47
43005651 323 75774 ANG ADD SELECTIVE VESSEL ADD ON 7,445.86 5,212.10
43005657 320 75966 ANG RENAL PTA 13,832.07 9,682.45
43005658 320 75968 ANG PTA EACH ADDITIONAL REUAL/VISCOART 6,916.05 4,841.24
43005660 360 37201 ANG TRANSCATHETER THERAPY THROMBOLYSIS 1,578.50 1,104.95
43005661 360 37236 ANG TRANSCATHETER PERCUTANEOUS STENT 34,936.71 24,455.70
43005662 360 37206 ANG TRANSCATHETER PERCUTANEOUS STENT AD 13,230.00 9,261.00
43005663 360 37241 ANG EMBOLIZATION OR OCCLUSION VEIN 35,810.13 25,067.09
43005673 320 75894 ANG TRANSCATHETER EMBOLIZATION 25,103.59 17,572.51
43005675 320 75820 ANG VENOGRPHY EXT UNILAT 2,367.91 1,657.54
43005676 360 36500 ANG VENOUS SAMPLE COLLECTION 2,148.03 1,503.62
43005677 320 75822 ANG VENOGRPHY EXTR BILAT 5,751.27 4,025.89
43005678 320 75831 ANG RENAL VENOGRAPHY - UNILATERAL 9,771.36 6,839.95
43005679 320 75833 ANG RENAL VENOGRPHY BIL 9,771.36 6,839.95
43005680 320 75893 ANG VENOUS SAMPLING 16,205.89 11,344.12
43005681 320 75896 ANG TRANSCATH INFUSION 3,469.50 2,428.65
43005683 323 75736 ANG PELVIC SELECTIVE 9,771.36 6,839.95
43005685 323 75710 ANG EXTREMITY UNILATERAL 9,771.36 6,839.95
43005687 320 75898 ANG ANGIOGRAM EXISNG CATH 5,895.05 4,126.54
43005689 481 93555 ANGIMAGING S&I CARDIAL CATH. VENT. ATRIA 1,636.75 1,145.73
43005691 481 93556 ANG IMAGING S&I CORONARY ANGIO 1,352.50 946.75
43005693 481 93508 ANG CORONARY ANGIO W/O LH CATH 2,561.25 1,792.88
43005695 481 93545 ANG SELECTIVE CORONARY ANGIO 1,210.25 847.18
43005697 481 93539 ANG SELECTIVE ARTERIAL CONDUIT 1,352.50 946.75
43005699 481 93540 ANG SELECTIVE VENOUS CONDUIT 1,352.50 946.75
43005701 481 93544 ANG AORTOGRAM 924.75 647.33
43005703 481 93510 ANG LEFT HEART CATH 2,561.25 1,792.88
43005705 481 93543 ANG SELECT. LEFT VENTRICULAR OR ARTERIAL 924.75 647.33
43005707 481 93454 ANG CATHETER IN CORONARY ARTERY ANGIO 10,299.97 7,209.98
43005708 481 93455 ANG ANGIO BYPASS GRAFT 10,299.97 7,209.98
43005709 481 93452 ANG LEFT HEART CATH WITH VENTRICLE 10,299.97 7,209.98
43005710 481 93451 ANG RIGHT HEART CATH WITH 02 10,299.97 7,209.98
43005711 481 93458 ANG NATIVE CORONARY ANGIL W/L+ HEART 10,299.97 7,209.98
43005712 481 93459 ANG NATIVE CORONARY AND BYPASS GRAFT 10,299.97 7,209.98
43005713 481 93567 ANG SUPRAVALVULAR AORTOGRAPHY 7,948.56 5,563.99
43005714 481 93503 ANG SWAN-GUNZ CATHETERIZATION 5,895.05 4,126.54
43005800 360 37220 ANG PTA ILIAL ARTERY 17,467.19 12,227.03
43005801 360 37221 ANG PTA/STENT ILIAL ARTERY 34,936.71 24,455.70
43005802 360 37222 ANG PTA ADDITIONAL ILIAC ARTERY 12,069.15 8,448.41
43005803 360 37224 ANG PTA FEMORAL-POPLITEAL ARTERY 17,467.19 12,227.03
43005804 360 37223 ANG PTA AND STENT ADDITIONAL ILIAC 19,572.61 13,700.83
43005805 360 37226 ANG PTA FEMORAL-POPLITEAL W/STENT 34,936.71 24,455.70
43005806 360 37228 ANG PTA TIBIAL ARTERY 34,936.71 24,455.70
43005807 360 37230 ANG PTA STENT TIBIAL ARTERY 56,203.38 39,342.37
43005808 360 37232 ANG ADDITIONAL PTA TIBIAL ARTERY 12,069.15 8,448.41
43005809 360 37234 ANG ADDITIONAL PTA W/STENT TIBIAL 19,665.96 13,766.17
43005810 360 36147 ANG AV FISTULA DIRECT STICK 2,803.16 1,962.21
43005811 360 36148 ANG AV FISTULA INTERVENTION 2,148.03 1,503.62
43005812 360 37215 ANG CAROTID STENT W/ PROTECTION 28,329.05 19,830.34
43005813 360 37216 ANG CAROTID STENT W/OUT PROTECTION 28,329.05 19,830.34
43005814 360 37236 ANG ART STENT NON-LWR ETRMTY IST 22,799.25 15,959.48
43005815 360 75791 ANG AVF RIGHT FEMORAL ACCESS 2,170.77 1,519.54
43005816 360 36200 ANG CATHETER AORTA FEMORAL ACCESS 7,445.86 5,212.10
43005817 360 36120 ANG CATHETER AORTA AXILLARY ACCESS 6,659.46 4,661.62
43005818 360 36140 ANG CATHETER EXTREMITY ARTERY 7,445.86 5,212.10
43005819 360 36215 ANG ARTERIAL SELECTIVE 1ST ORDER 7,754.73 5,428.31
43005820 360 35471 ANG PTA RENAL ARTERY 14,924.49 10,447.14
43005821 360 36216 ANG ARTERIAL SELECTIVE 2ND ORDER 11,880.31 8,316.22
43005822 360 36217 ANG ARTERIAL SELECTIVE 3RD ORDER 11,880.31 8,316.22
43005823 360 36218 ANG ARTERIAL ADDITIONAL 2ND OR 3RD 11,880.31 8,316.22
43005824 360 36245 ANG ABDOMEN 1ST ORDER 11,880.31 8,316.22
43005825 360 36246 ANG ABDOMEN 2ND ORDER 11,880.31 8,316.22
43005826 360 36247 ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER 11,880.31 8,316.22
43005827 360 36248 ANG ADDITIONAL 1,2,3 ORDER, EACH 11,545.49 8,081.84
43005828 360 36010 ANG VENA CAVA VENOGRAPHY 3,956.51 2,769.56
43005829 360 36011 ANG CATHETER VEIN 1ST ORDER 3,942.65 2,759.86
43005830 360 36012 ANG CATHETER VEIN 2ND ORDER 4,790.77 3,353.54
43005831 360 36013 ANG CATHETER RV OR MAIN PA 2,642.36 1,849.65
43005832 360 36014 ANG SELECT RT OR LT PULMONARY ART 3,972.24 2,780.57
43005833 360 36015 ANG CATHETER SEGMENTAL PULMONARY A 4,069.92 2,848.94
43005834 360 36598 ANG INJECTION EXISTING CATHETER 1,226.40 858.48
43005835 360 36593 ANG CYSIS CLOTTED CATHETER/DEVICE 1,201.44 841.01
43005836 360 37191 ANG VENA LAVA FILTER PLACEMENT 16,205.78 11,344.05
43005838 360 75978 ANG PTA VENOUS (AVF) 7,303.82 5,112.67
43005840 360 37202 ANG INFUSION NON THROWOLSIS 3,469.50 2,428.65
43005841 360 37242 ANG EMBOLIZATION OCCLUSION ARTERY 35,810.13 25,067.09
43005843 360 35476 ANG VEIN PTA SURGICAL 12,069.15 8,448.41
43005844 360 37237 ANG ART STENT NON-LWR EXTMTY ADDITIONAL 11,026.03 7,718.22
43005845 360 37238 ANG STENT PLACEMENT VEIN INITIAL 34,674.87 24,272.41
43005846 360 37239 ANG STENT VEIN EACH ADDITIONAL 14,529.70 10,170.79
43005847 360 37246 ANG PTA AORTA , RENAL OR MESENTERIC 16,216.62 11,351.63
43005848 360 37241 ANG EMBOLIZATION VEIN 34,674.87 24,272.41
43005849 360 37244 ANG EMBOLIZATION HEMMORRHAGE A OR V 35,810.13 25,067.09
43005850 360 35476 ANG PTA ARTERIAL ANASTOMOSIS AVF 12,069.00 8,448.30
43005851 360 35476 ANG PTA VENOUS ANASTOMOSIS AVP 14,924.49 10,447.14
43005899 360 36002 INJECTION PX PRQ TX EXTREMITY PSEUDOANEU 1,892.52 1,324.76
43005900 360 36221 ANG THORACIC AORTA WITH CAROTID AN 9,771.36 6,839.95
43005901 360 36222 ANG CCA SELECTIVE WITH CAROTID ANG 9,771.36 6,839.95
43005902 360 36223 ANG CCA SELECTIVE WITH CEREBRAL 16,205.89 11,344.12
43005903 360 36224 ANG ICA SELECTIVE 16,205.89 11,344.12
43005904 360 36225 ANG SUBCLAVIAN/INNOMIWATE W VERT 9,771.36 6,839.95
43005905 360 36226 ANG VERTEBRAL ARTERY SELECTIVE 16,205.89 11,344.12
43005906 360 36227 ANG ECA SELECTIVE ADD ON 13,404.93 9,383.45
43005907 360 36228 ANG ICA/VERTEBRAL BRANCH SELECTIVE 10,480.81 7,336.57
43005908 360 37213 ANG CATHETER EXCHANGE ART/VEIN 8,166.32 5,716.42
43005909 360 37211 ANG ARTERIAL INFUSION LYSIS INITIAL 16,611.03 11,627.72
43005910 360 37212 ANG VENOUS INFUSION LYSIS INITIAL 10,015.65 7,010.96
43005911 360 37214 ANG CESSATION OF THROMBOLYSIS 8,166.32 5,716.42
43005912 360 37217 ANG STENT PLACEMENT RETRO CCA/INNOM 4,577.44 3,204.21
43005913 360 37218 ANG STENT PLACEMENT ANTE CCA/IMMOM 4,577.44 3,204.21
43005914 321 36903 ANG INTRO CATH DIALYSIS CIRCUIT 34,936.71 24,455.70
43005915 321 36901 ANG AVF/GRAFT DIAGNOSTIC ANGIO 5,687.80 3,981.46
43005916 321 36902 ANG PTA AVF/GRAFT 17,467.19 12,227.03
43005917 360 36473 ENDOVENOUSE MCHNCHEM 1ST VEIN 9,771.36 6,839.95
43005918 360 36474 ENDOVENOUS MCHNCHEM ADD ON 4,387.78 3,071.45
43005919 360 37248 ANG PTA VEIN, INITIAL OR SAME 15,375.21 10,762.65
43005920 360 3622250 ANG CCA SELECTIVE WITH CAROTID ANG BILAT 15,023.47 10,516.43
43005921 481 93454 ANG CATHETER IN CORONARY ARTERY ANGIO BI 15,449.95 10,814.97
43005999 360 3622350 ANG BILAT CCA SELECTIVE W/ CEREBRAL 24,308.84 17,016.19
43006000 322 73040 SHOULDER ARTHROGRAM 875.50 612.85
43006001 360 23350 INJECTION PROCEDURE SHOULDER ARTHR 724.57 507.20
43006010 360 25246 INJECTION PROCEDURE FOR WRIST ARTHOGRAPH 493.05 345.14
43006011 360 G0278 ILIAC ART ANGIO CARDIAC CATH 2,008.39 1,405.87
43006012 360 37221 BILAT ANG PTA/STENT ILIAC ARTERY 52,404.69 36,683.28
43006013 360 34812 OPEN FEM ART EXPOSURE 20,137.53 14,096.27
43006014 360 34707 EVASC RPR ILIO ILIAC ENDOGRAFT 25,056.15 17,539.31
43006090 360 3622650 ANG VERTEBRAL ARTERY SELECTIVE 24,308.84 17,016.19
43009999 360 3624750 ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER BI 17,820.29 12,474.20
44000001 350 76376 CT 3D RECONSTRUCTION 1,414.68 990.28
44000003 350 74263 CT VIRTUAL COLONOSCOPY SCREENING 559.05 391.34
44000004 350 75571 CT CORONARY CALCIUM SCORING SCREEN 110.69 77.48
44000005 350 CT VC/CCS COMBO SCREENING 626.25 438.38
44000006 350 74261 CT VIRTUAL COLONOSCOPY DIAGNOSTIC 559.05 391.34
44000063 350 77078 CT BONE MINERAL DENSITY 302.50 211.75
44003201 350 73201 CT UPPER EXT WITH CONT 2,701.58 1,891.11
44003417 350 70488 CT MAXILLOFACIAL WO/W IV CONTRAST 2,986.78 2,090.75
44003420 350 70486 CT MAXILLOFACIAL W/O IV CONTRAST 1,210.61 847.43
44003425 351 70450 CT HEAD W/O IV CONTRAST 2,219.26 1,553.48
44003433 351 70460 CT HEAD WITH IV CONTRAST 2,590.68 1,813.48
44003441 351 70470 CT HEAD W/WO IV CONTRAST 2,917.94 2,042.56
44003466 350 70481 CT IAC ORB SELLA WITH IV CONTRAST 1,282.50 897.75
44003482 350 70490 CT NECK W/O IV CONTRAST 2,282.29 1,597.60
44003490 350 70491 CT NECK WITH IV CONTRAST 2,663.01 1,864.11
44003500 350 73706RT CTA LOWER EXTREMITY ANGIO RIGHT 1,728.00 1,209.60
44003501 350 73706LT CTA LOWER EXTREMITY ANGIO LEFT 1,728.00 1,209.60
44003503 350 74174 CTA ABDOMEN PELVIS 4,035.18 2,824.63
44003504 350 73206RT CTA UPPER EXTRENITY ANGIO RIGHT 1,728.00 1,209.60
44003505 350 73206LT CTA UPPER EXTRENITY ANGIO LEFT 1,728.00 1,209.60
44003507 350 7370650 CTA LOWER EXTREMITY ANGIO BILATERAL 2,128.00 1,489.60
44003508 350 70492 CT NECK WO/W IV CONTRAST 2,998.43 2,098.90
44003509 350 7320650 CTA UPPER EXTRENITY ANGIO BILATERAL 2,128.00 1,489.60
44003510 350 72191 CTA PELVIS ANGIOGRAPHY 3,476.14 2,433.30
44003511 350 75635 CTA AORTO-ILIAC RUNOFF 5,153.26 3,607.28
44003512 350 74175 CTA ABDOMEN ANGIOGRAPHY 3,476.14 2,433.30
44003513 350 70496 CTA HEAD ANGIOGRAPHY 2,917.08 2,041.96
44003514 350 70498 CTA NECK ANGIOGRAPHY 3,476.14 2,433.30
44003515 350 71275 CTA CHEST ANGIOGRAPHY 3,476.14 2,433.30
44003516 350 71250 CT CHEST W/O IV CONTRAST 2,429.05 1,700.34
44003517 350 71250 CT DX POST LOW DOSE LUNG SCREEN 2,429.05 1,700.34
44003518 350 75574 CTA HRT W/ 3D IMAGE 3,490.67 2,443.47
44003524 350 71260 CT CHEST WITH IV CONTRAST 2,805.28 1,963.70
44003532 350 71270 CT CHEST W/WO IV CONTRAST 3,140.71 2,198.50
44003535 350 76375 CT RECONSTRUCTION 665.75 466.03
44003540 350 72192 CT PELVIS W/O IV CONTRAST 2,429.05 1,700.34
44003557 350 72193 CT PELVIS WITH IV CONTRAST 2,736.86 1,915.80
44003565 350 72194 CT PELVIS W/WO IV CONTRAST 3,141.56 2,199.09
44003573 350 74150 CT ABDOMEN W/O IV CONTRAST 2,429.05 1,700.34
44003581 350 74160 CT ABDOMEN WITH IV CONTRAST 2,736.86 1,915.80
44003582 350 74176 CT ABD PELVIS WO IV CONTRAST 3,699.75 2,589.83
44003583 350 74177 CT ABD PELVIS WITH IV CONTRAST 4,146.99 2,902.89
44003584 350 74178 CT ABD PELVIS W/WO IV CONTRAST 4,482.42 3,137.69
44003599 350 74170 CT ABDOMEN W/WO IV CONTRAST 3,140.71 2,198.50
44003607 350 72125 CT C SPINE W/O IV CONTRAST 2,462.31 1,723.62
44003609 350 72126 CT CERV SPINE W CONTR 2,575.75 1,803.03
44003611 350 72127 CT CERV SPINE W & WO CONTR 2,575.75 1,803.03
44003620 350 72128 CT T SPINE W/O IV/IT CONTRAST 2,429.05 1,700.34
44003622 350 72129 CT THORACIC SPINE W CONTR 2,575.75 1,803.03
44003623 350 72131 CT L SPINE W/O IV/IT CONTRAST 2,429.05 1,700.34
44003624 350 72130 CT THORACIC SPINE W & WO CONTR 2,575.75 1,803.03
44003625 350 72132 CT L SPINE W CONTRAST 1,232.72 862.90
44003627 350 72133 CT LS W & WO CONTRAST 2,575.75 1,803.03
44003680 350 75989 CT GUIDED FOR DRAIN PLACEMENT 2,499.33 1,749.53
44003700 350 77012 CT GUIDANCE FOR NEEDLE PLACEMENT 2,558.19 1,790.73
44003701 350 77012 CT GUIDED NEEDLE PLACEMENT BX ASP 2,379.08 1,665.36
44003722 350 70480 CT IAC ORB SELLA W/O IV CONTRAST 1,960.31 1,372.22
44003730 350 70482 CT IAC WO/W IV CONTRAST 1,497.00 1,047.90
44003748 350 73200 CT UPP EXT W/O IV CONTRAST 2,321.71 1,625.20
44003750 350 70487 CT MAXILLOFACIAL WITH IV CONTRAST 2,651.34 1,855.94
44003755 350 73202 CT EXTRMTS BTH UPPER W/WO IV CONTRAST 1,546.32 1,082.42
44003761 350 73700RT CT LOWER EXT W/O IV CONT RIGHT 2,321.71 1,625.20
44003762 350 73700LT CT LOWER EXT W/O IV CONTRAST LEFT 2,321.71 1,625.20
44003763 350 7370050 CT LOWER EXT W/O IV CONTRAST BILATERAL 2,410.60 1,687.42
44003765 350 7370150 CT LOWER EXT WITH IV CONTRAST BILATERAL 1,442.89 1,010.02
44003766 350 73701RT CT LOWER EXT WITH IV CONTRAST RIGHT 2,701.29 1,890.90
44003767 350 73701LT CT LOWER EXT WITH IV CONTRAST LEFT 2,701.29 1,890.90
44003771 350 7370250 CT LOWER EXT WO/W IV CONTRAST BILTERAL 2,737.36 1,916.15
44003772 350 73702RT CT LOWER EXT WO/W IV CONTRAST RIGHT 2,801.93 1,961.35
44003773 350 73702LT CT LOWER EXT WO/W IV CONTRAST LEFT 2,801.93 1,961.35
44003774 350 74261 CT COLONOGRAPHY DX 2,224.89 1,557.42
44003775 350 74263 CT COLONOGRAPHY SCRN 2,713.28 1,899.30
44004230 320 72265 CT LUMAR MYELOGRAM 2,396.53 1,677.57
45000004 510 G0389TC VL AAA MEDICAL SCREEN 150.75 105.53
45001166 402 76775 SONO BLADDER SCAN 544.46 381.12
45004118 921 93922 VL ANKLE/BRACHIAL INDEX (ABI/TBI) 959.04 671.33
45004126 921 93923 VL SEGMENTAL ARTERY PRESSURES 959.04 671.33
45004127 921 93923TC VL PBI WITH ABI/TBI 569.50 398.65
45004130 921 93923 VL TOE PRESSURES 959.04 671.33
45004131 921 93923 VL FINGER PRESSURES 959.04 671.33
45004134 921 93924 VL ABI WITH EXERCISE 945.73 662.01
45004167 921 93923 VL THORACIC OUTLET EVAL 636.76 445.73
45004175 921 93880TC VL CAROTID DUPLEX BILATERAL 1,321.45 925.02
45004176 921 0126T VL IMT MEASUREMENT CAROTID ARTERY 132.50 92.75
45004182 921 93882 VL CAROTID DUPLEX LIMITED 615.05 430.54
45004183 921 93882RT VL CAROTID DUPLEX RIGHT 700.27 490.19
45004184 921 93882 VL CAROTID DUPLEX LIMITED 702.99 492.09
45004185 921 93882 TC VL TEMPORAL ARTERY DUPLEX 702.99 492.09
45004217 921 93930 VL ARTERIAL DUPLEX ARM BILATERAL 1,326.61 928.63
45004218 921 93930TC VL BYPASS GRAFT DUPLEX ARM BILATERAL 857.75 600.43
45004219 921 93931TCRT VL BYPASS GRAFT RIGHT ARM 571.00 399.70
45004220 921 93931RT VL ARTERIAL DUPLEX RIGHT ARM 959.04 671.33
45004221 921 93931TCLT VL BYPASS GRAFT LEFT ARM 571.00 399.70
45004222 921 93931LT VL ARTERIAL DUPLEX LEFT ARM 959.04 671.33
45004225 921 93925 VL ARTERIAL DUPLEX LEG BILATERAL 1,326.61 928.63
45004230 921 93926RT VL ARTERIAL DUPLEX RIGHT LEG 959.04 671.33
45004231 921 93926LT VL ARTERIAL DUPLEX LEFT LEG 959.04 671.33
45004233 921 93975 VL MESENTERIC ART DPLX 1,326.61 928.63
45004235 921 93976TC VL MESENTERIC ART DPLX LTD 796.00 557.20
45004241 921 93975 VL RENAL ARTERY DUPLEX COMPLETE 1,326.61 928.63
45004242 921 93975 VL ABDOMINAL VENOUS DUPLEX 1,326.61 928.63
45004243 921 93975TC VL PELVIC SCROTAL DUPLEX 1,186.50 830.55
45004245 921 93976 VL RENAL ARTERY DUPLEX LIMITED 890.00 623.00
45004246 921 93976TCLT VL RENAL ARTERY DUPLEX LEFT 796.00 557.20
45004314 921 93980 VL AA ILIAC DUPLEX COMPLETE 577.50 404.25
45004316 921 93978TC VL AA ILIAC DUPLEX 1,321.45 925.02
45004317 921 93978 VL RENAL BYPASS GRAFT DUPLEX 967.99 677.59
45004318 921 93978TC VL VENA CAVA DUPLEX 865.75 606.03
45004319 921 93978TCLT VL RENAL BYPASS GRAFT DUPLEX LEFT 865.75 606.03
45004320 921 93979 VL AA ILIAC DUPLEX LTD 967.99 677.59
45004321 921 93979TCLT VL AA LEFT ILIAC DUPLEX LTD 577.50 404.25
45004340 921 93925TC VL BYPASS GRAFT LEG BILATERAL 831.25 581.88
45004345 921 93926RT VL BYPASS GRAFT RIGHT LEG 959.04 671.33
45004346 921 93926LT VL BYPASS GRAFT LEFT LEG 959.04 671.33
45004357 921 93970 VL DEEP VEIN DUPLEX BIL. LEG 1,044.41 731.09
45004365 921 93971RT VL DEEP VEIN DUPLEX RIGHT LEG 829.46 580.62
45004366 921 93971LT VL DEEP VEIN DUPLEX LEFT LEG 829.46 580.62
45004368 921 93970 VL DEEP VEIN DUPLEX BIL. ARM 1,044.41 731.09
45004369 921 93971RT VL DEEP VEIN DUPLEX RIGHT ARM 829.46 580.62
45004370 921 93971LT VL DEEP VEIN DUPLEX LEFT ARM 829.46 580.62
45004371 921 93970 VL VENOUS REFLUX DUPLEX 1,519.98 1,063.99
45004373 921 93970 VL VEIN MAPPING COMPLETE 1,048.49 733.94
45004374 921 93971 VL VEIN MAPPING LIMITED 558.09 390.66
45004375 921 93971TCLT VL VEIN MAPPING LEFT LEG 415.75 291.03
45004376 921 93970TC VL VEIN MAPPING BILATERAL ARM 642.00 449.40
45004377 921 93971TCRT VL VEIN MAPPING RIGHT ARM 415.75 291.03
45004378 921 93971TCLT VL VEIN MAPPING LEFT ARM 744.75 521.33
45004399 921 93965 VL VENOUS REFLUX EVALUATION 421.69 295.18
45004400 921 93990 VL DIALYSIS ACCESS DUPLEX 832.70 582.89
45004401 402 76937 VL US GUIDED VASCULAR ACCESS 272.71 190.90
45004402 921 G0365 VL DIALYSIS GRAFT PRE OP VESSEL MAPPING 1,222.33 855.63
45004999 921 VL VIDEO OR CD COPY OF PATIENT EXAM 15.75 11.03
45008990 480 93312 ECHO TEE IMAGING 2,476.82 1,733.77
45009024 480 93320TC ECHO DOPPLER STUDY OF HEART COMPLETE 444.75 311.33
45009032 480 93325 ECHO DOPPLER COLOR FLOW MAPPING ADD ON 471.47 330.03
45009082 480 93321TC ECHO DOPPLER OF HEART LIMITED STUDY 444.75 311.33
45009220 480 93308 ECHO 2-D ECHOCARDIOGRAM LIMITED STUDY 695.92 487.14
45009320 480 93307 ECHO 2-D IMAGE ONLY 585.75 410.03
45009323 480 93303TC ECHO LIMITED STUDY CONGENITAL DEFECT 452.75 316.93
45009324 480 93306 ECHO 2-D ECHOCARDIOGRAM COMPLETE STUDY 1,514.56 1,060.19
45009325 480 93350 ECHO DOBUTAMINE STRESS ECHOCARDIOGRAM 1,477.62 1,034.33
45009326 250 TC ECHO INJECTION DOBUTAMINE PER 250MG 51.25 35.88
45009327 482 93016 ECHO STRESS ECHO PHYSICIAN SUPERVISION 89.25 62.48
45009328 636 TC ECHO INJECTION OF OPTISON CONTRAST 595.75 417.03
45009329 480 93350 ECHO TREADMILL STRESS ECHOCARDIOGRAM 1,477.62 1,034.33
45009330 480 C8929 ECHO TTE w/ or w/o FOL w/ cont doppler 2,328.85 1,630.20
45009331 480 C8924 ECHO 2D TTE W/ OR W/O FOL W/ CONT F/U 1,501.44 1,051.01
45009332 480 C8925 ECHO 2D TEE W/ OR W/O FOL W/ CONT INTERP 2,328.85 1,630.20
45009333 480 C8928 ECHO TTE W/ OR W/O FOL W/ CONT STRESS 2,328.85 1,630.20
45009334 480 C8930 ECHO TTE W/ OR W/O CONTR CONT ECG 2,328.85 1,630.20
45009335 254 Q9957 DEFINITY INJ, PERFLUTREN LIPID MICROSPHE 605.23 423.66
45009336 921 93985 DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL 1,011.55 708.09
45009337 921 93986 DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL 486.96 340.87
45009345 490 51798 US PV RESIDUAL URINE BLDR SCAN 198.39 138.87
46008644 611 70553 MRI BRAIN /+CONT 2,602.96 1,822.07
46008647 636 A9579 MRI CONTRAST MEDIA 283.99 198.79
46008648 636 A9579 MRI CONTRAST GADOLINIUM 12.02 8.41
46008649 615 70549 MMRA NECK WO W/ CONTRAST 3,572.43 2,500.70
46008650 350 71271 CT Thorax Lung Cancer Screening 493.27 345.29
46008651 350 71250 HIGH RESOLUTION CT CHEST 2,429.05 1,700.34
46008652 610 C8901 MMRA ABDOMEN WO CONTRAST 3,072.86 2,151.00
46008653 350 71250 DIAGNOSTIC CHEST LDLS 2,429.05 1,700.34
46008655 320 73600LT XR ANKLE LT 1-2V 347.14 243.00
46008656 320 73600RT XR ANKLE RT 1-2V 347.70 243.39
47000005 258 HETASTARCH 6% 500ML INJ (HESPAN) 196.62 137.63
47000006 250 BENZONATATE 100MG CAP (TESSALON) 6.91 4.84
47000007 250 CLARITIN D 5MG/120MG TAB 12 HOUR 7.26 5.08
47000010 250 CENTRUM SILVER TAB 7.26 5.08
47000012 250 CYCLOPENTOLATE OPTH SOL 1% 5ML (CYCLOGYL 77.15 54.01
47000014 637 FAMCICLOVIR 500MG TAB (FAMVIR) 31.81 22.27
47000015 250 PHENOBARBITAL 60MG/ML 2ML INJ 35.45 24.82
47000016 637 HYOSCYAMINE 0.375MG TAB (LEVBID) 7.26 5.08
47000017 636 J2795 ROPIVACAINE 1% 10MG/ML 10ML INJ (NAROPIN 31.81 22.27
47000018 637 GUAIFENESIN DM 20mg/200MG 10ML(ROBITUSSI 6.31 4.42
47000021 637 A9270GY QUINAPRIL 20MG TAB (ACCUPRIL) 6.25 4.38
47000022 250 TRACE ELEMENTS INJ 5ML 110.95 77.67
47000023 637 A9270GY TRIAM/HCTZ 50/25MG CAP (DYAZIDE) 6.75 4.73
47000024 250 ESTRADIOL 0.5MG TAB (ESTRACE) 7.26 5.08
47000026 250 CIMETIDINE 800MG TAB (TEGAMET) 13.65 9.56
47000027 637 LISINOPRIL 10MG TAB (ZESTRIL) 6.91 4.84
47000030 637 SPIRONOLACTONE/HCTZ 25/25MG TAB (ALDACTA 7.85 5.50
47000031 637 SPIRONOLACTONE 25MG TAB (ALDACTONE) 6.91 4.84
47000035 636 J8600 GY MELPHALAN 2MG TAB (ALKERAN) 11.62 8.13
47000036 250 ENOXAPARIN SQ 150MG/ML (LOVENOX) 346.33 242.43
47000041 637 AMITRIPTYLINE 25MG TAB (ELAVIL) 7.26 5.08
47000043 637 SODIUM CHLORIDE 1000MG TAB 7.85 5.50
47000044 250 AMPICILLIN 500MG CAP 7.85 5.50
47000047 637 ALUMINUM HYDROXIDE 320MG/5ML GEL 120ML 20.33 14.23
47000049 637 CEFADROXIL 500MG CAP (DURICEF) 19.36 13.55
47000051 636 J0285 AMPHOTERICIN INJ 50MG 120.86 84.60
47000052 250 ACETOHEXAMIDE 500MG TAB (DYMELOR) 7.47 5.23
47000055 637 SERTRALINE 50MG TAB (ZOLOFT) 11.06 7.74
47000056 250 NITROPRUSSIDE 50MG/2ML INJ (NITROPRESS) 5,495.06 3,846.54
47000059 250 FLEXALL GEL 13.25 9.28
47000062 636 J9000 ADRIAMYCIN INJ 10MG/5ML 113.66 79.56
47000078 250 NYSTATIN SUSP 100MU/ML 60ML 45.04 31.53
47000090 250 CIPRODEX OTIC SUSP 7.5ML 767.91 537.54
47000091 250 LANSOPRAZOLE 30MG SOLUTAB (PREVACID) 53.37 37.36
47000135 637 A9270GY LEVOTHYROXINE 0.2MG TAB (SYNTHROID) 6.75 4.73
47000138 258 S0072 AMIKIN INJ 1GM/4ML 322.50 225.75
47000143 636 J9370 VINCRISTINE (VINCASAR PFS) 48.95 34.27
47000144 636 J9070 CYCLOPHOSPHAMIDE 2 GRM SDV (CYTOXAN) 4,831.77 3,382.24
47000145 636 J2469 PALONOSETRON 0.25MG/5ML (ALOXI) 2,177.33 1,524.13
47000146 636 J2505 PEGFILGASTRIM (NEULASTA) 20,552.18 14,386.53
47000147 250 WARFARIN 2.5MG TAB (COUMADIN) 6.68 4.68
47000148 250 A9270GY NITROGLYCERIN 0.3MG/HR PATCH (NITRO-DUR) 18.50 12.95
47000151 636 J0696 CEFTRIAXONE INJ 500MG (ROCEPHIN) 103.16 72.21
47000160 250 HYPOTEARS OPTH OINT 41.00 28.70
47000169 250 NEO/POLY/HC OTIC SUSP(CORTISPORIN OTIC) 468.02 327.61
47000177 637 NABUMETONE 500MG TAB (RELAFEN) 6.91 4.84
47000178 250 WARFARIN 10MG TAB (COUMADIN) 7.47 5.23
47000194 250 DIVALPROEX DR 250MG TAB (DEPAKOTE) 7.26 5.08
47000201 637 BENAZEPRIL 10MG TAB(LOTENSIN) 7.47 5.23
47000203 250 POLYETHYLENEGLYCOL PWD (COLYTE) 22.95 16.07
47000241 250 RU TUSS TAB 7.85 5.50
47000244 637 VERAPAMIL SR 180MG TAB (ISOPTIN SR) 11.02 7.71
47000277 250 LITHIUM CARBONATE CR 300MG TAB (LITHOBID 6.75 4.73
47000285 636 J3010 FENTANYL 500MCG/10ML INJ (SUBLIMAZE) 27.90 19.53
47000320 637 SULFASALAZINE DR 500MG TAB (SULFAZINE) 7.85 5.50
47000334 250 DOXEPIN HCL 100MG CAP (SINEQUAN) 7.85 5.50
47000335 250 IBUPROFEN 600MG TAB (MOTRIN) 7.26 5.08
47000350 250 ISONIAZID 300MG TAB (NIAZID) 6.75 4.73
47000377 250 MAGNESIUM SULFATE SYR INJ 50% 10ML 73.80 51.66
47000384 250 STERILE WATER INJ 10ML 16.87 11.81
47000426 250 FLUMAZENIL 0.5MG/5ML INJ (ROMAZICON) 47.64 33.35
47000433 637 ECONAZOLE CRM 1% 15GM (SPECTAZOLE) 125.23 87.66
47000441 250 CARB/LEVO 25/250MG TAB (SINEMET) 7.85 5.50
47000458 250 SILVER SULFADIAZINE 1%CREAM 50GM (SILVAD 69.15 48.41
47000466 250 SOD CHLORIDE 250ML ADV 26.50 18.55
47000474 250 SOD CHLORIDE 3% 500ML 125.51 87.86
47000490 637 A9270GY AMANTADINE 100MG CAP(SYMMETREL) 28.94 20.26
47000495 258 AMINO ACID 10% INJ (AMINOSYN) 270.78 189.55
47000496 258 LIPOSYN II 20% 500ML INJ 284.01 198.81
47000497 258 D 70W 70% 500ML 112.27 78.59
47000498 258 D10W 10% 1000ML IV FLUID 37.89 26.52
47000500 250 A & D OINT 60GM 24.40 17.08
47000501 636 J1644 HEPARIN SOD/0.45%NS 25,000U/250ML PREMIX 61.02 42.71
47000503 636 J7060 D5W 5% 100ML IV FLUID 35.15 24.61
47000505 258 DEXTROSE INJ 5% 250ML 30.80 21.56
47000506 636 J7060 D5W 5% 500ML IV FLUID 30.80 21.56
47000509 636 J7042 D5W/0.45% NS 1000ML IV FLUID 36.61 25.63
47000510 258 D5W/0.9%NS 1000ML IV FLUID 34.84 24.39
47000512 258 D5W/LR 1000ML IV FLUID 40.66 28.46
47000514 258 LACTATED RINGER 1000ML IV FLUID 36.51 25.56
47000515 258 NACL 0.45% 1000ML IV FLUID 33.74 23.62
47000518 636 J1442 FILGRASTIM 300MCG/ML INJ (NEUPOGEN) 802.53 561.77
47000519 258 NACL 0.9% 100ML IV FLUID 30.42 21.29
47000520 258 J7050 NACL 0.9% IV 250ML IV FLUID 43.58 30.51
47000521 258 NACL 0.9% 100ML IV MINI BAG 45.50 31.85
47000522 636 J7040 NACL 0.9% IV 500ML IV FLUID 30.80 21.56
47000523 258 J7030 NACL 0.9% 1000ML IV FLUID 32.25 22.58
47000525 258 STERILE WATER IRRIG 500ML 39.27 27.49
47000527 250 ACETIC ACID SOL 0.25% 134.22 93.95
47000531 258 D 50W 50% 500ML 90.43 63.30
47000532 250 SELENIUM SUL SHAMPOO 2.5% 118ML 33.74 23.62
47000534 258 SODIUM CHLOR SOL 0.9% 1000ML 91.81 64.27
47000535 250 SODIUM CHLORIDE 100MEQ/40ML INJ 35.15 24.61
47000536 250 SELENIUM AC INJ 40MCG/ML 10ML 35.15 24.61
47000537 250 POTASSIUM PHOSPHATE 3MM/ML 15ML INJ 206.40 144.48
47000538 250 SODIUM ACETATE 2MEQ/ML 50ML 35.45 24.82
47000542 250 POTASSIUM ACETATE 40MEQ/20ML 20ML INJ 33.46 23.42
47000543 636 J2780 RANITIDINE 150MG/6ML INJ (ZANTAC) 43.58 30.51
47000544 250 CHLORHEXIDINE GLUCONATE 4% 120ML SOL (HI 33.74 23.62
47000545 637 FINASTERIDE 5MG TAB (PROSCAR) 12.20 8.54
47000548 636 J3411 THIAMINE HCL 200MG/2ML INJ 50.85 35.60
47000549 250 SUCRALFATE 1GM/10ML 120ML SUSP 53.75 37.63
47000550 258 SODIUM CHLORIDE SOL 0.9% 3000ML 36.61 25.63
47000552 636 J7042 D5W/0.225% NS 1000ML IV FLUID 36.61 25.63
47000554 636 J7040 D5W 5% 1000ML IV FLUID 33.41 23.39
47000561 250 EUCERIN 120GM CRM 35.45 24.82
47000562 637 MEGESTROL ORAL SUSP 40MG/ML 240ML (MEGAC 258.59 181.01
47000563 636 J1580 GENTAMICIN 80MG/2ML INJ 35.15 24.61
47000564 250 ETOMIDATE 2MG/ML 20ML INJ (AMIDATE) 137.17 96.02
47000566 636 J2597 DESMOPRESSIN 4MCG/ML 10ML MDV INJ (DDAVP 824.27 576.99
47000567 250 DESMOPRESSIN 0.01% NASAL SPRAY (DDAVP) 584.59 409.21
47000568 637 INTRACONAZOLE 10 MG/ML 120ML ORAL SUSP 1,197.62 838.33
47000569 250 METHOTREXATE INJ 50MG/2ML 30.50 21.35
47000573 637 PSEUDOEPHEDRINE 30MG TAB (SUDAFED) 7.47 5.23
47000575 250 HYDROCORTISONE 25MG SUPPS (ANUSOL) 7.85 5.50
47000578 636 J2543 PIPERACILLIN/TAZOBACTAM 3GM/.375GM INJ 73.65 51.56
47000579 250 NACL 0.9% 20ML INJ 8.29 5.80
47000580 250 ETHYL CHLOR AER 56.94 39.86
47000586 250 ESMOLOL 100MG/10ML INJ (BREVIBLOC) 86.00 60.20
47000587 250 MORPHINE 1MG/ML 2ML AMP (ASTRAMORPH) 53.74 37.62
47000588 637 LEVOTHYROXINE 0.075MG TAB (SYNTHROID) 7.26 5.08
47000593 636 J2001 LIDOCAINE 2000MG/250ML PREMIX (XYLOCAINE 103.72 72.60
47000594 250 MYCOLOG 30GR CRM (NYSTATIN/TRIAMCIN) 164.09 114.86
47000595 250 GAVISCON SUSP 30.50 21.35
47000596 637 A9270GY SIMVASTATIN 10MG TAB (ZOCOR) 11.25 7.88
47000601 250 DEXTROSE 50% SYRINGE 25GM/50ML 94.42 66.09
47000604 250 XYLOCAINE HCL INJ 4% 41.25 28.88
47000605 250 ALBUMIN 25% 50ML (PLASBUMIN) 981.46 687.02
47000606 250 CHARCOAL AQUA ACTIDOSE 50GM 27.60 19.32
47000612 637 LEVOTHYROXINE 0.05MG TAB (SYNTHROID) 7.26 5.08
47000614 250 ROCURONIUM 100MG/10ML INJ 175.49 122.84
47000617 250 ALFENTANIL INJ 500MCG/ML (ALFENTA) 34.25 23.98
47000618 250 DAKINS FULL STR 1000ML 33.74 23.62
47000621 250 KETOCONAZOLE 2% 15GM CRM (NIZORAL) 85.71 60.00
47000623 636 J2930 SOLU MDRL INJ 250MG 122.23 85.56
47000624 250 LIDOCAINE/PRILOCAINE 2.5-2.5% CRM 5GM 42.64 29.85
47000628 250 GENTAMICIN OPTH SOL 0.3% 5ML (GENTAK) 82.47 57.73
47000631 250 SODIUM BICARB 8.4 % INJ 50ML VIAL 60.48 42.34
47000632 250 BENZOCAINE SPRY 0.5ML (HURRICAINE) 169.21 118.45
47000633 250 ALUMINUM SULF & CALC ACETATE 2%(DOMBERO) 39.80 27.86
47000635 637 TRIMOX SUSP: 250/5ML 80ML 33.74 23.62
47000636 637 A9270GY AMOXICILLIN/CAVULANATE 125MG/5ML 75ML SU 119.75 83.83
47000637 250 CECLOR SUSP 250/5ML 152.82 106.97
47000638 250 ALBUTEROL 2MG/5ML 5ML SYRUP 41.54 29.08
47000639 250 SSD CRM 1% 271.95 190.37
47000641 250 CORTISONE 25MG TAB (CORTONE) 7.47 5.23
47000643 637 PROPRANOLOL 10MG TAB (INDERAL) 7.85 5.50
47000644 250 VASOPRESSIN 20U/1ML INJ (PITRESSIN) 35.15 24.61
47000645 250 BUTALBITAL/ASA/CAFFEINE CAP (FIORINAL) 6.75 4.73
47000646 250 BUPIVACAINE SPINAL 0.75% 2ML AMP (MARCAI 33.41 23.39
47000647 637 LITHIUM CARBONATE CAP 300MG 6.91 4.84
47000653 637 CALCIUM ACETATE 667MG CAP (PHOSLO) 7.22 5.05
47000654 250 NACL 0.9% IV 50ML IV FLUID 23.22 16.25
47000655 250 NOVOCAIN INJ 10% 30.50 21.35
47000658 250 THIOPENTAL 500MG INJ (PENTOTHAL) 84.07 58.85
47000659 250 LIDOCAINE/PRILOCAINE 2.5%/2.5% 5GM TUBE 42.71 29.90
47000662 250 ARTIFICIAL TEARS OPHTH SOLN 20.33 14.23
47000663 250 SODIUM BICARB 8.4% PEDIATRIC ABBOJECT 35.45 24.82
47000664 250 J0690 CEFAZOLIN SODIUM INJ 1GM 38.25 26.78
47000667 250 GARAMYCIN OINT 0.1% 15GM 27.60 19.32
47000668 250 SILVER NITRATE STICK 7.26 5.08
47000671 636 S0039 SMZ TMP 400-80/5 10ML INJ (BACTRIM) 44.45 31.12
47000673 250 DURAGESIC SYSTEM 100MCG 162.12 113.48
47000675 636 J2400 CHLOROPROCAINE MPF 2% INJ (NESACAINE) 56.69 39.68
47000676 250 SUCCINYLCHOLINE 20MG/ML 10ML INJ (ANECTI 163.71 114.60
47000677 636 S0028 FAMOTIDINE 20MG/2ML INJ 6.75 4.73
47000678 250 DILTIAZEM INJ 25MG/5ML 62.46 43.72
47000680 250 SODIUM BICARB 8.4% ABBOJECT 50ML 35.45 24.82
47000687 636 J0256 PROLASTIN INJ 1000MG 767.61 537.33
47000688 250 NACL 0.9% 250ML ADV 42.31 29.62
47000689 636 J7060 D5W 5% 250ML IV FLUID 43.58 30.51
47000690 637 ALLOPURINOL 100MG TAB (ZYLOPRIM) 6.91 4.84
47000692 250 BACIT/POLYM OPTH OINT (POLYSPORIN) 101.11 70.78
47000698 250 DOXEPIN HCL 75MG CAP (SINEQUAN) 7.85 5.50
47000701 250 VALPROIC ACID 250MG/5ML SYRUP (DEPAKENE) 91.81 64.27
47000702 250 LEVOTHYROXINE 0.15MG TAB (SYNTHROID) 7.85 5.50
47000703 250 NEOSTIGMINE 10MG/10ML INJ(PROSTIGMIN) 545.29 381.70
47000705 637 SOTALOL 80MG TAB (BETAPACE) 12.20 8.54
47000707 250 ETHACRYNIC ACID 50MG INJ (EDECRIN) 81.75 57.23
47000710 637 CARB/LEVO CR 50/200MG TAB (SINEMET) 9.29 6.50
47000711 637 CARB/LEVO CR 25/100MG TAB (SINEMET) 7.26 5.08
47000713 250 MAGNESIUM SU INJ 50% 35.45 24.82
47000717 250 CAPSAICIN 0.025% CRM 35.45 24.82
47000718 637 LIOTHYRONINE 25MCG TAB 7.85 5.50
47000720 250 INDIGO CARMINE 5ML INJ 972.25 680.58
47000721 250 CENTRUM LIQ 39.80 27.86
47000725 250 RACEMIC EPINEPHRINE INH SOLN 2.25% 0.5ML 56.94 39.86
47000727 637 PAROXETINE 20MG TAB (PAXIL) 10.51 7.36
47000728 250 MINERAL OIL USP 160Z 35.45 24.82
47000732 637 NITROGLYCERIN 2%OINT 30GM TUBE (NITROB 110.68 77.48
47000733 250 POTASSIUM 20 MEQ/15ML ELIXER 97.11 67.98
47000734 637 ZOLPIDEM 5MG TAB (AMBIEN) 8.29 5.80
47000736 250 SODIUM ACETATE 40MEQ/20ML INJ 35.15 24.61
47000737 636 J2405 ONDANSETRON 4MG/2ML INJ (ZOFRAN) 31.66 22.16
47000741 250 STERILE WATER 20ML INJ 29.32 20.52
47000746 637 DILTIAZEM CD 120MG CAP (CARDIZEM) 6.91 4.84
47000757 636 J3430 PHYTONADIONE 10MG/ML INJ (VITAMIN K) 279.46 195.62
47000759 250 BUMETANIDE 2.5MG/10ML INJ(BUMEX) 20.33 14.23
47000760 636 J2930 METHYLPREDNISOLONE 2GM INJ (SOLU-MEDROL) 247.23 173.06
47000761 637 METFORMIN 500MG TAB (GLUCOPHAGE) 6.91 4.84
47000763 250 SMZ/TMP 200MG/40MG/5ML SUSP (SEPTRA) 52.50 36.75
47000765 636 J3535 IPRATROPIUM BROM HFA 18MCG INHALER(ATROV 339.64 237.75
47000766 250 IMIPRAMINE HCL 10MG TAB (TOFRANIL) 7.26 5.08
47000767 636 J1644 HEPARIN 5,000units/ML INJ 35.45 24.82
47000769 250 J7644 IPRATROPIUM BROM U/D NEB (ATROVENT) 11.06 7.74
47000770 250 DILTIAZEM INJ 50MG/10ML 97.62 68.33
47000773 637 OXYMETAZOLINE 0.05% NASAL SPRAY(AFRIN) 27.90 19.53
47000774 250 SIMETHICONE 40MG/0.6ML DROP (GAS-X) 35.45 24.82
47000775 250 J7613 ALBUTEROL SULF NEB SOL 0.083% 3ML 11.09 7.76
47000776 636 J0744 CIPROFLOXACIN 400MG/200ML IVPB(CIPRO) 122.32 85.62
47000780 250 ESTERIFIED ESTROGENS & METHYLTESTOSTERON 7.85 5.50
47000781 250 CHLOROPROCAINE MPF 3% INJ (NESACAINE) 107.45 75.22
47000786 258 NALOXONE HCL INJ 0.4MG/ 30.50 21.35
47000787 250 VENLAFAXINE XR 37.5MG TAB (EFFEXOR) 7.85 5.50
47000788 250 BACITRACIN OINT 30GM TUBE 20.33 14.23
47000789 250 PHENYLEPHRINE PED DROP (NEO-SYNEPHRINE) 27.60 19.32
47000790 637 ASPIRIN EC 81MG TAB 6.43 4.50
47000802 250 ULTRAM TAB 50MG 7.47 5.23
47000803 250 DIPRIVAN INJ 10MG/ML 88.62 62.03
47000814 250 SODIUM POLYSTYRENE 15GM/60ML SUSP (KAYEX 80.18 56.13
47000816 250 SODIUM POLYSTYRENE 15GM/60ML (KAYEXALATE 102.77 71.94
47000817 343 A9569 TECHNETIUM Tc 99 EXAMETAZIME DOSE 448.89 314.22
47000818 250 HYDROXYCHLOROQUINE 200MG TAB (PLAQUENIL) 7.47 5.23
47000819 343 A9505 THALLIUM TI 201 THALLOUS CHLORIDE 448.89 314.22
47000825 637 TERAZOSIN 2MG CAP (HYTRIN) 8.85 6.20
47000828 636 J0696 CEFTRIAXONE 1000MG INJ (ROCEPHIN) 213.60 149.52
47000830 637 NYSTATIN OINT 100MU/GM 30GM TUBE 27.60 19.32
47000831 637 TERAZOSIN 5MG CAP (HYTRIN) 8.85 6.20
47000833 637 RISPERDONE 1MG TAB (RISPERDAL) 12.44 8.71
47000834 637 HYDROCORTISONE 2.5% 30GM CRM (CORTIZONE) 43.58 30.51
47000838 250 FLUPHENAZINE HCL TAB 5MG 6.75 4.73
47000840 250 FLUPHENAZINE HCL 1MG TAB (PROLIXIN) 6.75 4.73
47000842 250 J7611 ALBUTEROL SOL 0.5%-20ML BOTTLE 62.46 43.72
47000843 636 J2001 LEVOTHYROXINE SOD INJ 0.1MG (SYNTHROID) 426.80 298.76
47000844 637 ITRACONAZOLE 100MG CAP (SPORANOX) 35.45 24.82
47000846 250 CONTIGEN SKIN TEST SYR 166.77 116.74
47000849 250 ALENDRONATE 10MG TAB (FOSAMAX) 10.23 7.16
47000853 636 J9000 DOXORUBICIN 50MG VIAL (ADRIAMYCIN) 548.94 384.26
47000855 278 CONTIGEN IMPLANT SYR 1,695.32 1,186.72
47000856 250 AMMONIUM LACTATE LOT 12% (LAC-HYDRIN) 68.85 48.20
47000860 636 J0630 CALCITONIN SALMON 200IU/ML 2ML INJ 177.54 124.28
47000862 636 J0713 CEFTAZIDIME 1000MG INJ (FORTAZ) 59.56 41.69
47000863 637 RANITIDINE 150MG TAB (ZANTAC) 8.72 6.10
47000864 637 A9270GY RANITIDINE 300MG (ZANTAC) TAB 15.25 10.68
47000867 637 A9270GY MESALAMINE 400MG TAB (ASACOL) 6.75 4.73
47000868 637 GABAPENTIN 100MG CAP (NEURONTIN) 6.91 4.84
47000869 637 CYCLOSPORINE 25MG CAP (SANDIMMUNE) 8.85 6.20
47000872 250 FLUOXETINE 10MG CAP 11.62 8.13
47000877 250 FAMCICLOVIR 250MG TAB (FAMVIR) 16.32 11.42
47000878 250 SUMATRIPTAN 50MG TAB (IMITREX) 74.96 52.47
47000881 637 ISOSORBIDE MONONITRATE ER 60MG TAB(IMDUR 7.26 5.08
47000882 250 CISTRACURIUM 2MG/ML INJ (NIMBEX) 87.44 61.21
47000883 250 METHACHOLINE 100MG PWD (PROVOCHOLINE) 269.35 188.55
47000884 637 ANASTRAZOLE 1MG TAB (ARIMIDEX) 31.81 22.27
47000886 250 GLIPIZIDE XL 5MG TAB (GLUCOTROL XL) 6.91 4.84
47000888 250 CHROMAGEN FORTE CAP 7.85 5.50
47000890 636 J2175 DEMEROL CARPUJECT 100MG 35.45 24.82
47000893 636 J3535 FLUTICASONE HFA 220MCG MDI (FLOVENT) 2,171.31 1,519.92
47000895 250 FLUTICASONE HFA 110MCG MDI (FLOVENT) 1,397.91 978.54
47000898 636 J2060 LORAZEPAM 2MG/1ML INJ (ATIVAN) 51.13 35.79
47000899 250 IONAMIN CAP 15MG 1.25 0.88
47000901 250 FLUTICASONE HFA 44MCG MDI (FLOVENT) 196.25 137.38
47000905 636 S0020 BUPIVACAINE 0.75% 30ML INJ (MARCAINE) 44.45 31.12
47000906 637 CETIRIZINE 10MG TAB (ZYRTEC) 8.85 6.20
47000907 250 BACITRACIN INJ 50,000 UNITS 61.88 43.32
47000909 250 DNAZOL100MG CAP (DANOCRINE) 9.25 6.48
47000911 250 MORPHINE SULFATE CR 15MG TAB (MS CONTIN) 7.85 5.50
47000913 250 AMINOACID 8% INJ (HEPATAMINE) 545.93 382.15
47000917 636 J0585 BOTOX INJ 200 UNITS 1,983.64 1,388.55
47000922 636 J1815 INSULIN LISPRO 100U/ML 3ML VIAL INJ (HUM 221.24 154.87
47000923 636 J7509 METHYLPREDNISOLONE 4MG TAB (MEDROL) 7.47 5.23
47000924 637 AMOXICILLIN/CLAVULANATE 875/125MG TAB 22.95 16.07
47000925 250 PHENOBARBITAL 40MG/10ML U/D ELIXIR 35.15 24.61
47000926 250 CONGO RED AMPULE 27.60 19.32
47000930 636 J1245 DIPYRIDAMOLE 50MG/10ML SDV (PERSANTINE) 54.34 38.04
47000933 637 LATANOPROST EYE DROP 0.005% 2.5ML (XALAT 178.97 125.28
47000934 637 LORATIDINE/PSEUDOEPHEDRINE 10MG/240MG TA 13.65 9.56
47000945 250 REMIFENTANIL 2MG INJ (ULTIVA) 103.42 72.39
47000947 250 REMIFENTANIL 1MG/3ML INJ (ULTIVA) 256.43 179.50
47000948 250 MELATONIN 3MG TAB 7.47 5.23
47000949 250 CAFF/NA BENZ INJ 500MG 33.74 23.62
47000951 637 VITAMIN E 400U CAP 7.85 5.50
47000952 637 ACARBOSE 25MG TAB (PRECOSE) 7.47 5.23
47000955 250 HYDROCORTISONE CRM (ANUSOL-HC) 140.61 98.43
47000959 250 BRIMONIDINE OPHTH SOL (ALPHAGAN) 119.42 83.59
47000960 636 J1645 DALTEPARIN 2500U/0.2ML INJ 72.64 50.85
47000961 250 SSD CRE 1% 400 GRAM 135.96 95.17
47000962 636 J1645 DALTEPARIN 5000U/0.2ML INJ 197.74 138.42
47000965 636 Q0144 AZITHROMYCIN 200MG/5ML 15ML SUSP 143.57 100.50
47000971 636 J0461 ATROPINE SULF 0.4MG/ML INJ 33.41 23.39
47000972 637 MULTI VITAMIN TAB 7.26 5.08
47000976 636 J3030 SUMATRIPTAN 6MG/0.5ML INJ (IMITREX) 376.10 263.27
47000977 250 SYNTHROID TAB 175MCG 7.85 5.50
47000980 636 J0153 ADENOSINE 6MG/2ML INJ (ADENOCARD) 54.34 38.04
47000981 637 WARFARIN 3MG TAB (COUMADIN) 6.91 4.84
47000982 636 J1742 IBUTILIDE INJ 1MG/10ML INJ (CORVERT) 934.10 653.87
47000984 637 METFORMIN 850MG TAB (GLUCOPHAGE) 6.91 4.84
47000986 637 LEVOFLOXACIN 500MG TAB (LEVAQUIN) 46.78 32.75
47000990 250 FLUCONAZOLE 50MG/5ML SUSP (DIFLUCAN) 152.82 106.97
47000991 250 FLUCONAZOLE 200MG/5ML SUSP (DIFLUCAN) 553.19 387.23
47000995 250 SULFACETAMIDE 10% OPHTH SOLN (BLEPH-10) 262.30 183.61
47000997 636 J2310 NALOXONE HCL 0.4MG/ML INJ (NARCAN) 88.32 61.82
47000999 637 PANCRELIPASE 12,000 UNIT CAP 7.85 5.50
47001000 250 CLONAZEPAM TAB 1MG 6.75 4.73
47001001 250 DISOPYRAMIDE PHOS CAP 150MG 6.75 4.73
47001004 250 DIBUCAINE 1% OINT (NUPERCAINAL) 26.45 18.52
47001009 637 ORPHENADRINE 100MG TAB (NORFLEX) 8.85 6.20
47001010 250 QUINIDEX EXTENTAB 300MG 6.75 4.73
47001012 637 PROPRANOLOL LA 60MG CAP (INDERAL LA) 9.11 6.38
47001013 250 POTASSIUM CAP 10MEQ 6.75 4.73
47001016 250 VALSARTAN 80MG TAB (DIOVAN) 6.75 4.73
47001017 637 BUPROPION SR 150MG TAB (WELLBUTRIN SR) 7.47 5.23
47001018 636 ALBUMIN INJ 25GM/100ML 731.25 511.88
47001019 250 LEVOBUNOLOL OPTH SOL 0.5% (BETAGAN) 83.97 58.78
47001025 637 MAGNESIUM OXIDE 400MG TAB (MAG OX) 7.26 5.08
47001026 250 SUMATRIPTAN 100MG TAB (IMITREX) 116.85 81.80
47001027 250 TROLAMINE (ASPERCREME) 27.60 19.32
47001032 250 CROMOLYN SODIUM 20MG NEB (GASTROCROM) 10.50 7.35
47001033 250 DOCUSATE SODIUM 60MG/15ML SYRUP (DSS) 30.50 21.35
47001034 250 NEO/POLY/DEX SUSP 0.1% 42.71 29.90
47001035 250 SSD CREAM 1% 50 GRAM 39.80 27.86
47001036 636 J0282 AMIODARONE 150MG/3ML (50MG/ML)(CORDARONE 67.99 47.59
47001038 636 J2250 MIDAZOLAM 5MG/5ML VIAL (VERSED) 47.94 33.56
47001039 250 DURICEF CAP 500MG 10.23 7.16
47001041 637 GLYBURIDE 3MG (DIABETA) 7.47 5.23
47001042 636 J9070 CYCLOPHPSPHAMIDE INJ 100MG (CYTOXAN) 29.32 20.52
47001044 258 JOBST THIGH HIGH LARGE B 337.90 236.53
47001045 250 TETRACYCLINE SUSP 125MG 30.50 21.35
47001048 250 ACETYLCYSTINE 20% 30ML ORAL SOL(MUCO 41.48 29.04
47001049 637 TERBINAFINE 250MG TAB (LAMISIL) 34.84 24.39
47001050 637 TORSEMIDE 20MG TAB (DEMADEX) 7.26 5.08
47001051 636 J9000 DOXORUBICIN 10MG VIAL (ADRIAMYCIN) 240.03 168.02
47001056 250 RANITIDINE HCL TAB 300MG 13.25 9.28
47001058 250 LIDOCAINE 1% W/EPI 20ML (XYLOCAINE) 35.15 24.61
47001059 636 J2001 LIDOCAINE MPF 2% 10ML POLYAMP (XYLO) 35.15 24.61
47001060 250 ALUMINUM HYDROXIDE 600MG/5ML SUSP (AMPHO 30.50 21.35
47001061 636 J2795 ROPIVACAINE 1% 10MG/ML 20ML INJ (NAROPIN 120.53 84.37
47001062 250 HYDROXYZINE HCL 50MG TAB (ATARAX) 7.85 5.50
47001069 637 PRAMOXINE & HYDROCORTISONE 1% 10GM AEROS 157.77 110.44
47001071 637 CARVEDILOL 6.25MG TAB (COREG) 8.72 6.10
47001072 637 TOBRAMYCIN & DEXAMETHASONE 3.5GM OINT 134.22 93.95
47001075 637 MECLIZINE HCL 25MG TAB (ANTIVERT) 7.26 5.08
47001077 637 METOPROLOL XL SUCC 50MG (TOPROL XL) 6.91 4.84
47001078 250 KETAMINE 50MG/ML INJ 10ML (KETALAR) 86.00 60.20
47001085 636 J3370 VANCOMYCIN 1000MG INJ (VANCOCIN) 77.29 54.10
47001088 637 CARBAMAZEPINE ER 200MG TAB (TEGRETOL) 18.89 13.22
47001090 250 DAKINS 1/2 STR 0.25% 473ML 47.57 33.30
47001095 637 BICALUTAMIDE 50MG TAB (CASODEX) 56.69 39.68
47001098 637 RALOXIFENE 60MG TAB 32.44 22.71
47001101 250 STERILE TALC PACKET 181.89 127.32
47001104 637 CLOPIDOGREL 75MG TAB (PLAVIX) 15.21 10.65
47001106 637 OLOPATADINE OPHTH 0.1% 5ML (PATANOL) 250.74 175.52
47001107 637 MIRTAZAPINE 15MG TAB 11.06 7.74
47001108 250 FLUTICASONE NASAL SPRAY 0.05% (FLONASE) 212.39 148.67
47001110 637 A9270GY MINOCYCLINE 100MG CAP (MINOCIN) 8.75 6.13
47001114 250 LEVOFLOXACIN 25MG/ML 20ML (LEVAQUIN) 247.26 173.08
47001115 636 J1956 LEVOFLOXACIN 500MG/100ML IVPB PREMIX 189.43 132.60
47001117 637 HYDROCORTISONE 25MG SUPPS (ANUCORT HC) 105.29 73.70
47001118 250 SSD CREAM 1% 50GM 23.75 16.63
47001119 636 90389 TETANUS TOX PF SDV VIAL 108.08 75.66
47001122 637 CARBAMAZEPINE XR 400MG TAB (TEGRETOL XR) 7.47 5.23
47001123 636 S0157 BECAPLERMIN GEL 0.01% 15GM (REGRANEX) 1,988.77 1,392.14
47001126 636 J3010 FENTANYL 100MCG/2ML INJ (SUBLIMAZE) 33.41 23.39
47001128 637 A9270GY TOLTERODINE 2 MG TAB (DETROL) 6.25 4.38
47001129 250 NACL 0.9% 10ML SALINE LOCK/ FLUSH 6.91 4.84
47001132 250 NEO/POLY/DEX EYE DROP 5ML 30.97 21.68
47001133 637 HYDRALAZINE 25MG TAB 7.85 5.50
47001135 250 MORRHUATE SOD INJ 5% 30ML VIAL 234.18 163.93
47001143 637 LEVOTHYROXINE 0.112MG TAB (SYNTHROID) 7.85 5.50
47001145 250 MONTELUKAST 10MG TAB 11.06 7.74
47001151 250 ANTIPYRINE/BENZOCAINE OTIC SOLN(AURALGAN 27.01 18.91
47001158 637 ASPIRIN 325MG TAB 6.95 4.87
47001160 250 PENTOSAN POLYSULFATE SODIUM 100MG CAP 9.29 6.50
47001165 250 DOXAZOSIN 4MG TAB (CARDURA) 7.47 5.23
47001173 637 AMOXICILLIN 250MG/5ML 80ML SUSP 38.00 26.60
47001177 250 HYDROCORTISONE 30MG SUPP (PROCTOCORT) 7.85 5.50
47001181 636 J1642 HEP-LOCK INJ 100U/ML 30ML 33.41 23.39
47001191 250 GAS-X EX ST LIQ 50MG/5ML 23.75 16.63
47001192 637 OLANZAPINE 5MG TAB (ZYPREXA) 94.45 66.12
47001193 250 RIZATRIPTAN MLT 10MG TAB (MAXALT) 101.39 70.97
47001197 250 REMERON TAB 30MG 11.62 8.13
47001198 637 BUDESONIDE 180MCG (PULMICORT &FLEXIHALER 402.11 281.48
47001199 637 J7517 GY MYCOPHENOLATE 500MG TAB (CELLCEPT) 24.50 17.15
47001200 637 GLYBURIDE 2.5MG TAB (DIABETA) 7.26 5.08
47001216 637 HYDROXYZINE HCL 25MG TAB (ATARAX) 7.26 5.08
47001219 250 BELLADONNA&OPIUM 16A 16.2MG/60MG SUPP 233.23 163.26
47001221 250 CYANOCOBALAMIN INJ 1000 17.15 12.01
47001224 250 LORAZEPAM TAB 0.5MG 7.85 5.50
47001232 637 LORAZEPAM 1MG TAB (ATIVAN) 7.26 5.08
47001252 250 ESMOLOL 250MG/ML INJ (BREVIBLOC) 429.42 300.59
47001257 637 AMOXICILLIN/CLAVULANATE 500/125MG TAB 20.33 14.23
47001290 250 HYDROCORTISONE 250MG/2ML INJ (SOLU-CORT 80.85 56.60
47001308 250 BUTORPHANOL 2MG/ML INJ (STADOL) 39.80 27.86
47001324 250 HYDROCORTISONE 100MG/2ML INJ (SOLU-CORTE 81.98 57.39
47001326 250 BACITRACIN OINT 500U/G 27.90 19.53
47001349 637 TERBUTALINE 2.5MG TAB (BRETHINE) 7.85 5.50
47001356 250 BRETHINE TAB 5MG (TERBUTALINE) 7.85 5.50
47001357 636 J2930 METHYLPREDNISOLONE 500MG/4ML INJ 217.70 152.39
47001359 250 SODIUM CITRATE/CITRIC ACID 120ML (BICITR 20.33 14.23
47001373 250 POTASSIUM IODIDE SOLUTION 1000MG/ML 56.94 39.86
47001380 637 BUMETANIDE 1MG TAB (BUMEX) 9.20 6.44
47001398 250 BUMETANIDE 0.5MG TAB (BUMEX) 7.85 5.50
47001400 637 DONEPEZIL 10MG TAB (ARICEPT) 20.47 14.33
47001405 637 A9270GY TRIAM/HCTZ 37.5/25MG TAB (MAXIDE) 6.75 4.73
47001406 637 BUSPIRONE 5MG TAB (BUSPAR) 7.47 5.23
47001407 637 PRAMIPEXOLE 0.125MG TAB (MIRAPEX) 7.85 5.50
47001433 636 J0558 BICILLIN CR INJ 600000 UNITS 58.11 40.68
47001438 636 J1162 DIGIBIND INJ 38MG 1,614.00 1,129.80
47001471 637 CAPTOPRIL 25MG TAB (CAPOTEN) 13.00 9.10
47001474 637 AMPICILLIN 250MG CAP 7.26 5.08
47001486 250 DIPYRIDAMOLE 75MG TAB (PERSANTINE) 6.75 4.73
47001489 250 SUCRALFATE 1000MG TAB (CARAFATE) 7.47 5.23
47001497 637 DILTIAZEM HCL 30MG TAB (CARDIZEM) 7.26 5.08
47001505 250 DILTIAZEM HCL 60MG TAB (CARDIZEM) 7.85 5.50
47001508 250 HYDROCORTISONE OINT (ANUSOL HC) 27.60 19.32
47001555 250 SILVER SULFADIAZINE 1% CREAM 400GM(SILVA 149.64 104.75
47001596 250 MULTIVITAMIN 10ML INJ 296.45 207.52
47001597 250 LEVOTHYROXINE 0.125MG TAB (SYNTHROID) 7.26 5.08
47001602 250 J7614 LEVALBUTEROL 0.63MG NEB (XOPENEX) 31.15 21.81
47001607 250 IPRATROPIUM/ALBUTEROL INHALER (COMBIVENT 2,378.97 1,665.28
47001610 250 CARVEDILOL 3.125MG TAB (COREG) 9.29 6.50
47001614 636 J2355 OPRELVEKIN 5MG INJ (NEUMEGA) 1,113.07 779.15
47001615 250 DIPHENHYDRAMINE 1% CRM (BENADRYL) 27.60 19.32
47001617 250 AYR SALINE GEL NASAL 23.75 16.63
47001620 250 SCLEROSOL AEROSOL (STERILE TALC) 642.11 449.48
47001625 637 PAROXETINE 10MG TAB (PAXIL) 11.62 8.13
47001628 637 SODIUM BICARB 650MG TAB 5.81 4.07
47001629 637 TAMULOSIN 0.4MG CAP (FLOMAX) 19.57 13.70
47001638 636 Q0161 CHLORPROMAZINE HCL 25MG TAB (THORAZINE 7.85 5.50
47001649 636 J3105 TERBUTALINE 1MG/ML 1ML INJ (BRETHINE) 35.45 24.82
47001650 637 LORATADINE 10MG TAB (CLARITIN) 11.06 7.74
47001661 637 CLINDAMYCIN HCL 150MG CAP (CLEOCIN) 7.85 5.50
47001687 250 SULINDAC 200MG TAB (CLINORIL) 7.47 5.23
47001695 637 BENZTROPINE MESYLATE 1MG TAB (COGENTIN) 7.85 5.50
47001702 637 CLARITHROMYCIN 500MG TAB (BIAXIN) 27.55 19.29
47001728 250 BETOPTIC OPTH SOL 0.5% 5ML 115.04 80.53
47001730 637 BETAMETHASONE S OPTH 0.25% 5ML SUSP 156.03 109.22
47001737 250 COLCHICINE 0.6MG TAB (COLCRYS) 51.84 36.29
47001750 250 CARBAMAZEPINE 100MG CHEW TAB (TEGRETOL) 6.91 4.84
47001754 250 BISMUTH SUSP 8OZ (KAOPECTATE) 35.15 24.61
47001772 637 OXYBUTYNIN 5MG TAB (DITROPAN) 6.91 4.84
47001786 636 Q0164 PROCHLORPERAZINE 10MG TAB (COMPAZINE) 7.63 5.34
47001787 250 THEOCLEAR LA 260 CAPS 2 7.85 5.50
47001789 250 MUPIROCIN OINT 2% 22 GM (BACTROBAN) 183.34 128.34
47001802 250 NADOLOL 40MG TAB (CORGARD) 17.57 12.30
47001805 250 FLUDROCORTISONE 0.1MG TAB (FLORINEF) 7.85 5.50
47001826 250 LIDOCAINE INJ 1% 50ML MDV (XYLOCAINE) 29.35 20.55
47001828 250 COUMADIN TAB 2.5MG 7.26 5.08
47001836 637 WARFARIN 2MG TAB (COUMADIN) 6.91 4.84
47001838 250 WARFARIN 4MG TAB 7.47 5.23
47001854 250 AMOXICILLIN/CLAVULANATE 250MG TAB (AUGME 10.23 7.16
47001855 250 CEFAZOLIN 1GM INJ ADV (KEFZOL) 42.13 29.49
47001888 637 DILTIAZEM CD 180MG CAP (CARDIZEM) 6.91 4.84
47001925 637 MAGNESIUM ALUM 30ML U/D SUSP (MAALOX) 19.66 13.76
47001948 637 NIFEDIPINE 10MG CAP (PROCARDIA) 6.91 4.84
47001966 636 J0133 ACYCLOVIR 500MG INJ (ZOVIRAX) 231.50 162.05
47001968 637 TRAZODONE 50MG TAB (DESERYL) 7.47 5.23
47001970 250 DAPSONE 25MG TAB 6.64 4.65
47001971 637 RIFAMPIN 300MG TAB 8.68 6.08
47001974 636 J1940 FUROSEMIDE 40MG/4ML INJ (LASIX) 50.26 35.18
47001976 636 J8540 DEXAMETHASONE 4MG TAB 6.91 4.84
47001977 250 DOXAPRAM 20MG/ML 20ML (DOPRAM) 384.12 268.88
47001978 637 CEPHALEXIN 125MG/5ML SUSP (KEFLEX) 39.80 27.86
47001979 637 AZITHROMYCIN 250MG TAB-PACK (Z-PAK) 208.02 145.61
47001980 250 PHYSOSTIGMINE 1MG/1ML 19.76 13.83
47001992 637 GLYBURIDE 5MG TAB (DIABETA) 6.91 4.84
47002009 250 TOBRAMYCIN 80MG/2ML INJ 47.50 33.25
47002019 250 BUPRENORPHINE 0.324MG/ML INJ (BUPRENEX) 35.45 24.82
47002023 250 ISOSORBIDE MONO 20MG 7.47 5.23
47002040 250 DICLOXACILLIN 500MG CAP 7.47 5.23
47002055 250 TETANUS TOX PED VACCINE 89.78 62.85
47002057 637 DIGOXIN 0.25MG TAB (LANOXIN) 11.33 7.93
47002065 250 DIGOXIN 0.125MG TAB (LANOXIN) 13.37 9.36
47002075 636 J2805 SINCALIDE 5MCG INJ (KINEVAC) 522.04 365.43
47002091 637 GEMFIBROZIL 600MG TAB (LOPID) 9.95 6.97
47002099 637 PHENYTOIN 100MG CAP (DILANTIN) 7.26 5.08
47002108 250 SCOPOLAMINE SCOP DISC (TRANSDERM SCOP) 37.19 26.03
47002126 250 CAPTOPRIL 12.5MG TAB (CAPOTEN) 7.26 5.08
47002139 636 J1160 DIGOXIN 0.50MG/2ML INJ (LANOXIN) 70.95 49.67
47002170 637 ASPIRIN 600MG SUPP 7.47 5.23
47002183 637 BUSPIRONE 10MG TAB (BUSPAR) 7.47 5.23
47002188 637 ASPIRIN 300MG SUPP 7.47 5.23
47002191 250 CEPHALEXIN 500MG CAP (KEFLEX) 8.85 6.20
47002204 636 J0290 AMPICILLIN 1000 MG INJ 43.58 30.51
47002207 637 ACETAMINOPHEN 325MG SUPP (TYLENOL) 7.26 5.08
47002208 637 CLONAZEPAM 0.5MG TAB (KLONOPIN) 7.26 5.08
47002212 636 J0290 AMPICILLIN 2000MG INJ 42.13 29.49
47002217 637 CIPROFLOXACIN 500MG TAB (CIPRO) 20.33 14.23
47002223 636 J3250 TRIMETHOBENZAMIDE 200MG/2ML INJ (TIGAN) 35.15 24.61
47002232 250 CHLORPROMAZINE 100MG TAB (THORAZINE) 7.85 5.50
47002238 636 J0280 AMINOPHYLLINE INJ 25MG/ML 10ML 63.41 44.39
47002246 636 J1200 DIPHENHYDRAMINE 50MG/ML INJ (BENADRYL) 33.41 23.39
47002248 637 TRIAM/HCTZ 37.5/25MG CAP (DYAZIDE) 7.26 5.08
47002271 637 ASPIRIN EC 325MG TAB 6.95 4.87
47002289 250 ERYTHROMYCIN 400MG FILMTABS (E.E.S.) 7.47 5.23
47002324 637 CARISOPRODOL 350MG TAB (SOMA) 7.47 5.23
47002329 250 CLINDAMYCIN 600MG/4ML 4ML INJ (CLEOCIN) 54.20 37.94
47002355 637 GUAIFENESIN W/CODEINE 5ML U/D ELIXIR (T 5.80 4.06
47002360 636 J3301 TRIAMCINOLONE 40MG/ML 5ML MDV (KENALOG) 173.94 121.76
47002397 250 THROMBIN TOPICAL 5000 IU 383.00 268.10
47002420 250 ERYTHROMYCIN 250MG TAB (ERY-TAB) 71.13 49.79
47002422 637 TRIAMCINOLONE 0.025% 80 GM CRM (KENALOG) 51.84 36.29
47002453 250 ESTRADIOL 1MG TAB (ESTRACE) 7.47 5.23
47002477 637 SALINE ENEMA (FLEET) 7.26 5.08
47002487 637 FERROUS SULFATE 325 MG TAB 7.26 5.08
47002493 250 ERYTHROMYCIN 500MG ADV (ERYTHROCIN) 45.00 31.50
47002496 250 CHLORPROMAZINE 50MG TAB (THORAZINE) 7.85 5.50
47002501 636 J1364 ERYTHROMYCIN 1000MG INJ (ERITHROCIN) 93.27 65.29
47002511 250 BUTALBITAL/ASPIRIN/CAFFEINE TAB 6.75 4.73
47002514 636 J3301 TRIAMCINOLONE 40MG/1ML INJ (KENALOG) 49.69 34.78
47002527 250 POTASSIUM CHLORIDE 40MEQ/20ML INJ 35.15 24.61
47002530 637 CLONIDINE TTS-3 PATCH (CATAPRES) 103.16 72.21
47002535 250 POTASSIUM CHLORIDE 10MEQ/5ML INJ 33.41 23.39
47002537 637 CYCLOBENZAPRINE 10MG TAB (FLEXERIL) 6.91 4.84
47002545 250 FOLIC ACID 1MG TAB 7.26 5.08
47002549 250 FOLIC ACID INJ 5MG/ML 59.56 41.69
47002571 250 LACTULOSE 10GM/15ML U/D CUP 10.74 7.52
47002576 250 LINCOMYCIN 300MG/ML INJ (LINCOCIN) 130.38 91.27
47002595 250 POLYCARBOPHIL 500MG TAB (FIBERCON) 7.47 5.23
47002602 637 HALOPERIDOL 5MG TAB 7.26 5.08
47002610 637 HALOPERIDOL 1MG TAB 7.26 5.08
47002626 636 J0694 CEFOXITIN 1000MG VIAL (MEFOXIN) 54.34 38.04
47002628 250 HALOPERIDOL 0.5MG TAB (HALDOL) 7.85 5.50
47002637 636 J3230 CHLORPROMAZINE 25MG/1ML INJ (THORAZIN 38.36 26.85
47002642 636 Q0161 CHLORPROMAZINE 25MG TAB 35.62 24.93
47002644 250 HALOPERIDOL TABS 2MG 6.75 4.73
47002667 637 CITRATE OF MAG 300ML LIQ 9.03 6.32
47002675 250 MINERAL OIL 472ML BOTTLE 30.53 21.37
47002683 250 MYLANTA SUSP 14.75 10.33
47002701 637 HYDROXYUREA 500MG CAP (HYDREA) 7.85 5.50
47002709 250 MILK OF MAG SUSP 30 ML 10.36 7.25
47002725 250 NUPERCAINAL 1% OINT 60 GM TUBE 26.45 18.52
47002728 637 HYDROCODONE & CHLORPHENIRAMINE 5ML SUSP 33.41 23.39
47002758 250 HEXACHLOROPHENE 3% LIQ SOAP(PHISOHEX) 65.67 45.97
47002766 637 GUAIFENESIN 200MG/10ML (ROBITUSSIN) 6.63 4.64
47002784 637 LOPERAMIDE HCL 2MG CAP (IMODIUM) 8.92 6.24
47002790 636 J2920 METHYLPREDNISOLONE 40MG/1ML INJ (SOLU-ME 35.15 24.61
47002793 637 ACETAMINOPHEN SUPP 650MG (TYLENOL) 7.26 5.08
47002808 636 J2930 METHYLPREDNISOLONE 1000 MG/8ML INJ 301.59 211.11
47002816 636 J2930 METHYLPREDNISOLONE 125 MG/2ML INJ 34.29 24.00
47002818 637 PROPRANOLOL LA 80MG CAP (INDERAL LA) 7.85 5.50
47002832 636 J0595 STADOL INJ 2MG/ML 41.25 28.88
47002834 637 PROPRANOLOL 40MG TAB (INDERAL) 7.85 5.50
47002835 636 J2354 OCTREOTICLE 0.05MG (SANDOSTATIN) 38.72 27.10
47002843 637 CLONIDINE HCL 0.1MG TAB 7.26 5.08
47002847 637 CLONIDINE HCL 0.2MG TAB 7.26 5.08
47002865 636 J3360 DIAZEPAM 10MG/2ML INJ (VALIUM) 160.10 112.07
47002883 250 INDOMETHACIN 50MG CAP (INDOCIN) 6.75 4.73
47002891 250 INDOMETHACIN 25MG CAP (INDOCIN) 6.91 4.84
47002894 250 CARA KLENZ WOUND CLEANSE 76.41 53.49
47002899 636 J2270 MORPHINE SULFATE 2MG/ML INJ 33.46 23.42
47002902 250 COUMADIN TABS 7.5MG 7.26 5.08
47002910 250 NEO/POLY/HC OTIC SOLN (CORTISPORIN) 70.90 49.63
47002925 636 J2001 LIDOCAINE 2GM PREMIX (XYLOCAINE) 109.25 76.48
47002927 636 J2001 LIDOCAINE 2% 5ML VIAL 33.41 23.39
47002931 636 J3480 D5W/0.45%NS + 20MEQ KCL 1000ML IV FLUID 81.05 56.74
47002933 637 VERAPAMIL HCL 120MG TAB (CALAN) 7.26 5.08
47002934 637 TOBRAMYCIN & DEXAMETHASONE OPTH 2.5ML 267.88 187.52
47002976 250 LIDOCAINE 2% 50ML INJ (XYLOCAINE) 35.45 24.82
47002982 250 ISOSORBIDE DINITRATE 20MG TAB (ISORDIL) 7.47 5.23
47003006 250 ISOSORBIDE DIN 10MG (ISORDIL TITRADOSE) 6.91 4.84
47003014 637 A9270GY POTASSIUM CHLORIDE 20 MEQ TAB (K-DUR) 6.25 4.38
47003071 637 CEPHALEXIN 250MG CAP (KEFLEX) 6.91 4.84
47003090 250 NEO/POLY/HC OTIC SUSP (CORTISPORIN) 125.51 87.86
47003099 636 J1940 FUROSEMIDE 100MG/10ML INJ (LASIX) 33.41 23.39
47003116 250 HYDROCORTISONE 100MG/60ML (CORTENEMA) 110.57 77.40
47003121 637 FUROSEMIDE 40MG TAB (LASIX) 7.26 5.08
47003139 637 FUROSEMIDE 20MG TAB (LASIX) 7.26 5.08
47003147 637 FUROSEMIDE 80MG TAB (LASIX) 7.26 5.08
47003154 637 A9270GY CHLORAMBUCIL 2MG TAB (LEUKERAN) 6.75 4.73
47003155 637 BETHANECHOL 25MG TAB (URECHOLINE) 6.91 4.84
47003162 250 LEVOTHROID TABS 25MCG 7.85 5.50
47003170 250 LEVOTHROID TABS 150MCG 7.85 5.50
47003172 636 J2001 LIDOCAINE 1% 2ML INJ MPF (XYLOCAINE) 33.41 23.39
47003188 250 LEVOTHROID TABS 200MCG 6.75 4.73
47003197 250 AZTREONAM INJ 1000MG (AZACTAM) 186.17 130.32
47003204 250 LEVOTHROID TABS 100MCG 7.85 5.50
47003212 250 LEVOTHROID TABS 50MCG 7.85 5.50
47003214 636 J2001 LIDOCAINE 1% 20ML INJ (XYLOCAINE) 33.41 23.39
47003221 637 LEVOTHYROXINE 0.1MG TAB (SYNTHROID) 7.26 5.08
47003231 250 CALCIUM CHLORIDE 10ML INJ 26.83 18.78
47003238 637 CHLORDIAZEPOXIDE 25MG CAP (LIBRIUM) 7.26 5.08
47003248 637 CHLORDIAZEPOXIDE 10MG CAP (LIBRIUM) 7.85 5.50
47003253 637 DIPHENOXYLATE/ATROPINE TAB (LOMOTIL) 7.26 5.08
47003263 250 INDAPAMIDE 2.5MG TAB (LOZOL) 6.75 4.73
47003272 250 CALCIUM GLUCONATE 10% 50ML INJ 33.46 23.42
47003279 637 HYOSCYAMINE 0.125MG SL TAB 7.26 5.08
47003295 637 METOPROLOL TART 50MG TAB (LOPRESSOR) 6.91 4.84
47003321 250 NOREPINEPHRINE BITART 4MG/4ML INJ (LE 55.21 38.65
47003329 637 NITROFURANTOIN 100MG CAP (MACROBID) 7.47 5.23
47003345 637 NITROFURANTOIN 50MG CAP (MACRODANTIN) 6.91 4.84
47003370 250 CHLORDIAZEPOXIDE 5MG CAP (LIBRIUM) 7.85 5.50
47003371 637 AMOXICILLIN 875MG TAB 7.47 5.23
47003373 250 LEFLUNOMIDE 20MG TAB (ARAVA) 38.25 26.78
47003375 636 J3490 GLYCOPYRROLATE 0.4MG/2ML INJ (ROBINUL) 133.66 93.56
47003381 250 CHLOROTHIAZIDE 500MG TAB (DIURIL) 7.85 5.50
47003384 636 J3246 TIROFIBAN 12.5 MG/250ML PREMIX (AGGRASTA 2,070.12 1,449.08
47003387 250 DEXTROSE 5% 100 CC BAG 27.60 19.32
47003388 636 J1750 IRON DEXTRAN 100MG/2ML INJ (INFED) 178.97 125.28
47003389 250 CERUMENEX DROP 97.91 68.54
47003393 250 ESTRATEST TAB 6.75 4.73
47003396 637 CELECOXIB 100MG CAP (CELEBREX) 10.74 7.52
47003397 250 CELECOXIB 200MG CAP (CELEBREX) 32.60 22.82
47003399 250 CYCLOSPORINE 50MG/ML 5ML INJ (SANDIMMUNE 129.42 90.59
47003400 637 LEVOTHYROXINE SOD 0.088MG 7.85 5.50
47003401 637 CITALOPRAM 20MG TAB (CELEXA) 10.23 7.16
47003405 637 METRONIDAZOLE 0.75% TOPICAL GEL 148.46 103.92
47003406 636 J0702 BETAMETHASONE AF 0.05% CRM (DIPROLENE) 328.61 230.03
47003407 250 BAC/NEO/POLY OPHTH OINT 3.5GM OINT(NEOSP 72.34 50.64
47003412 636 J1940 FUROSEMIDE 20MG INJ (LASIX) 33.41 23.39
47003416 637 APRACLONIDINE OPTH SOL 0.5% 5ML (IOPIDIN 212.39 148.67
47003417 637 CALCITONIN NASAL SPRAY 3.7ML (MIACALCIN) 133.07 93.15
47003418 637 GY DORZOLAMIDE/TIMOLOL EYE DROP (COSOPT) 209.48 146.64
47003462 636 J8498 PROCHLORPERAZINE 25MG SUPPS 15.98 11.19
47003485 637 PSYLLIUM PKT (METAMUCIL) 7.26 5.08
47003502 250 ENALAPRILAT 1.25MG/ML SDV (VASOTEC) 67.99 47.59
47003503 637 OMEPRAZOLE 20MG CAP (PRILOSEC) 7.47 5.23
47003512 636 J1020 METHYLPREDNISOLONE 80MG/ML INJ (DEPO-MED 46.74 32.72
47003514 636 J1030 METHYLPREDNISOLONE ACE 40MG/ML INJ (DEPO 56.13 39.29
47003527 637 A9270GY POTASSIUM CHLORIDE 10MEQ CAP (MICRO-K) 6.25 4.38
47003536 250 DOXYCYCLINE 200MG INJ (DOXY-200) 144.08 100.86
47003584 637 A9270GY MINOCYCLINE 100MG CAP (MINOCIN) 9.25 6.48
47003587 636 J2175 MEPERIDINE HCL 100MG INJ (DEMEROL) 33.41 23.39
47003593 250 TRIFLURIDINE OPTH SOL 1% (VIROPTIC) 279.80 195.86
47003600 250 FENTANYL 25MCG/HR PATCH (DURAGESIC) 94.38 66.07
47003603 250 MEPERIDINE HCL INJ 25MG 35.45 24.82
47003611 636 J2175 MEPERIDINE HCL 50MG INJ (DEMEROL) 33.41 23.39
47003637 250 MEPERIDINE HCL INJ 75MG 30.50 21.35
47003661 250 MORPHINE SULFATE CR 30MG TAB (MS CONTIN) 10.18 7.13
47003677 637 BACLOFEN 10MG TAB 7.85 5.50
47003717 637 SIMETHICONE 80MG CHEW TAB 6.91 4.84
47003742 636 J2250 MIDAZOLAM 2MG/2ML VIAL (VERSED) 33.41 23.39
47003757 250 SODIUM PHOSPHATE 45MMOL/15ML INJ 78.59 55.01
47003760 636 J3370 VANCOMYCIN INJ 500MG 53.74 37.62
47003766 637 NAPROXEN 500MG TAB (NAPROSYN) 7.47 5.23
47003768 250 NYSTOP 60GM TOPICAL PWD (MYCOSTATIN) 412.28 288.60
47003809 636 J3420 CYANOCOBALAMIN 1000MCG INJ (VIT B12) 55.69 38.98
47003816 637 NEOMYCIN SULF 500MG TAB 7.26 5.08
47003857 637 NITROGLYCERIN 0.4MG/HR PATCH (NITRO-DUR) 13.07 9.15
47003865 250 FENTANYL 50MCG/HR PATCH (DURAGESIC) 107.79 75.45
47003882 250 VEPESID INJ 20MG/ML 620.60 434.42
47003884 636 Q0163 DIPHENHYDRAMINE 12.5MG/5ML ELIXIR (BENAD 33.74 23.62
47003892 250 CARBAMIDE PEROXIDE 6.5% EARWAX REMOVAL 20.33 14.23
47003917 250 LACRALUBE OPHTH OINT 3.5GM TUBE 27.01 18.91
47003923 637 A9270GY TAMOXIFEN 10MG TAB (NOLVADEX) 8.00 5.60
47003940 636 J3370 VANCOMYCIN 500MG INJ (VANCOCIN) 44.45 31.12
47003949 250 NORMODYNE TABS 100MG 6.75 4.73
47003973 250 ACETIC ACID 2% W/ HYDROCORTISONE 15ML 42.71 29.90
47003980 250 DESIPRAMINE HCL 75MG TAB (NORPRAMIN) 6.75 4.73
47004004 637 GUAIFENSIN 200MG TAB (ORGANIDIN) 7.47 5.23
47004014 250 BUPIVACAINE 0.25% W/ EPI 10ML VIAL 20.33 14.23
47004048 250 NEO/POLY/DEX OPHTH SUSP(MAXITROL SUSP) 92.32 64.62
47004053 637 CALCIUM W/VITAMIN D 250/125MG TAB 7.85 5.50
47004079 637 CALCIUM 500+D TAB (OS-CAL+D) 7.26 5.08
47004089 258 DEXTRAN 40 10%-NACL 0.9% 500ML 129.42 90.59
47004095 637 WARFARIN 4MG TAB (COUMADIN) 6.91 4.84
47004105 636 J7509 METHYLPREDNISOLONE 4MG DOSEPAK (MEDROL 56.69 39.68
47004137 637 PENICILLIN V POTASSIUM 250MG TAB(PEN-VK) 7.47 5.23
47004145 637 PENICILLIN V POTASSIUM 500MG TAB (PEN-VK 7.47 5.23
47004194 250 DIPYRIDAMOLE 25MG TAB (PERSANTINE) 7.26 5.08
47004202 250 DIPYRIDAMOLE 50MG TAB (PERSANTINE) 7.85 5.50
47004221 637 BELLADON/PHENOBARB 5ML LIQ (DONNATAL) 43.41 30.39
47004228 250 PROMETHAZINE 12.5MG SUPPS (PHENERGAN) 15.39 10.77
47004251 637 PHENOBARBITAL 32.4 MG TAB 7.85 5.50
47004277 636 J7512 PREDNISONE 20MG TAB 7.26 5.08
47004279 636 J2270 MORPHINE SULFATE PCA 30MG/30ML 73.56 51.49
47004285 637 PREDNISONE 10MG TAB 7.26 5.08
47004287 636 J2175 MEPERIDINE PCA 300MG (DEMEROL) 83.09 58.16
47004293 637 PREDNISONE 5MG TAB 7.26 5.08
47004312 636 J0461 ATROPINE 0.5 MG 5ML SYR 29.35 20.55
47004319 637 NITROGLYCERIN 0.4MG (1/150 GR) #25 (NIT 26.45 18.52
47004327 637 CONJUGATED ESTROGENS 0.625MG TAB (PREMAR 7.26 5.08
47004335 637 CONJUGATED ESTROGENS 0.3MG TAB (PREMARIN 7.85 5.50
47004338 250 EYE WASH 120ML SOL (PURIFIED WATER) 26.27 18.39
47004345 637 METHADONE HCL 10MG TAB (DOLOPHINE) 7.85 5.50
47004351 637 VITAMIN C 500MG TAB (ASCORBIC ACID) 6.91 4.84
47004353 636 90714 TETANUS/DIPH VACC (DECAVAC) 97.91 68.54
47004384 636 J2370 PHENYLEPHRINE 10MG/1ML INJ (NEO) 39.23 27.46
47004401 637 BETHANECHOL 10MG TAB (URECHOLINE) 7.47 5.23
47004435 636 J0295 AMPICILLIN & SULBACTAM 1500MG INJ(UNASYN 43.58 30.51
47004445 636 J1165 PHENYTOIN INJ 50MG/ML 5ML VIAL (DILANTIN 35.15 24.61
47004447 250 PHENYTOIN 125MG/5ML 237ML SUSP (DILANTIN 158.53 110.97
47004467 637 PHENAZOPYRIDINE 100MG TAB (PYRIDIUM) 6.91 4.84
47004484 637 VERAPAMIL HCL 80MG TAB (CALAN) 7.26 5.08
47004501 637 METRONIDAZOLE 250MG TAB (FLAGYL) 7.26 5.08
47004509 637 CHOLESTYRAMINE PWD PKT (QUESTRAN) 15.68 10.98
47004520 637 TRAMADOL 50MG TAB (ULTRAM) 6.91 4.84
47004542 637 TOBRAMYCIN OPTH 0.3% 5ML SOL 158.05 110.64
47004544 637 BISACODYL SUPP 10MG 6.91 4.84
47004574 637 A9270GY QUININE 324MG CAP (QUALAQUIN) 6.25 4.38
47004583 636 J0295 AMPICILLIN & SULBACTAM 3000MG INJ(UNASYN 75.14 52.60
47004590 637 METOCLOPRAMIDE 10MG TAB (REGLAN) 7.26 5.08
47004601 636 J2270 MORPHINE 10MG/10ML AMP (ASTRAMORPH) 75.50 52.85
47004616 637 TEMAZEPAM 15MG CAP (RESTORIL) 6.91 4.84
47004617 250 J7611 ALBUTEROL SOL 0.5%-0.5ML DOSE 4.06 2.84
47004625 637 ACETAMINOPHEN 120MG SUPP (TYLENOL) 7.85 5.50
47004627 250 ERTHROMYCIN 200MG/5ML SUSP (E.E.S.) 1,287.98 901.59
47004640 250 RITALIN TABS 10MG 7.47 5.23
47004643 250 ERYTHROMYCIN 500MG INJ (ERYTHROCIN) 422.11 295.48
47004657 637 METHYLPHENIDATE 5MG TAB (RITALIN) 7.97 5.58
47004690 250 DAKINS 1/4 STR 0.125% 473ML 33.74 23.62
47004717 636 J2310 NARCAN INJ 0.4MG/ML 35.45 24.82
47004731 250 ROCALTROL CAPS 0.25MCG 7.85 5.50
47004732 250 EPHEDRINE SULFATE INJ 50MG 263.81 184.67
47004734 250 EPINEPHRINE 1MG/ML AMP 81.35 56.95
47004741 250 TUBERSOL INJ 5TU/0.1ML 17.15 12.01
47004757 637 TRIAMCINOLONE 0.1% 15GM CRM (KENALOG) 27.90 19.53
47004780 637 SULFAMETHOXAZOLE/TMP DS 800/160MG TAB 7.26 5.08
47004781 636 J1885 KETORALAC 30MG/1ML INJ (TORADOL) 45.63 31.94
47004783 250 KETOROLAC 60MG/2ML 2ML VIAL (TORADOL) 47.94 33.56
47004816 250 BUPIVACAINE 0.5% W/ EPI 30ML VIAL (MARCA 33.41 23.39
47004822 637 CARB/LEVO 10/100MG TAB (SINEMET) 7.26 5.08
47004830 637 CARB/LEVO 25/100MG TAB (SINEMET) 7.85 5.50
47004855 250 DOXEPIN HCL 50MG CAP (SINEQUAN) 7.85 5.50
47004863 250 DOXEPIN HCL 10MG CAP (SINEQUAN) 7.85 5.50
47004864 250 VERAPAMIL HCL 5MG/2ML INJ 162.71 113.90
47004871 250 DOXEPIN HCL 25MG CAP (SINEQUAN) 7.26 5.08
47004874 250 NATURE'S TEAR DROPS 23.75 16.63
47004875 637 A9270GY FOSINOPRIL 10MG TAB (MONOPRIL) 6.25 4.38
47004880 637 ISOSORBIDE MONONITRATE 20MG TAB (ISMO) 7.47 5.23
47004898 250 KETOROLAC 10MG TAB (TORADOL) 6.25 4.38
47004921 637 POTASSIUM CHLORIDE 8MEQ TAB (KLOR-CON) 7.26 5.08
47004963 637 CLONIDINE TTS -2 PATCH (CATAPRES) 106.34 74.44
47004971 637 LABETALOL 100MG TAB (TRANDATE) 6.91 4.84
47005011 250 BUPIVACAINE 0.25% 10ML INJ (MARCAINE) 33.41 23.39
47005012 250 MAGNESIUM SULFATE 50% ORAL LIQ 60ML 35.15 24.61
47005020 250 EPINEPH 1:10000 INJ ABBOJECT 58.40 40.88
47005076 637 ATENOLOL 50MG TAB (TENORMIN) 6.91 4.84
47005079 636 J1250 DOBUTAMINE 250MG/20ML INJ 28.76 20.13
47005084 637 TETRACYCLINE HCL 250MG CAP 7.26 5.08
47005102 250 MINERAL OIL LIGHT 10ML (MURI-LUBE) 73.89 51.72
47005118 250 THEOPHYLLINE CR 300MG TAB (THEO-DUR) 7.26 5.08
47005126 250 THEOPHYLLINE ER 400MG TAB (THEO-DUR) 7.26 5.08
47005127 636 J2001 LIDOCAINE 0.5% 50ML VIAL (XYLOCAINE) 64.96 45.47
47005135 636 J2001 LIDOCAINE 1% 5ML INJ MPF (XYLOCAINE) 33.41 23.39
47005143 250 LIDOCAINE 0.5% W/EPI 50ML (XYLOCAINE MPF 33.41 23.39
47005150 250 XYLO 1%EPI 1:100000 INJ 35.45 24.82
47005152 637 AMITRIPTYLINE 10MG TAB (ELAVIL) 7.26 5.08
47005159 637 MULTI VIT W/ MINERAL TAB 7.26 5.08
47005167 637 THIAMINE 100MG TAB (VITAMIN B1) 55.50 38.85
47005178 636 J1265 DOPAMINE 400MG/250ML PREMIX 151.27 105.89
47005235 250 TRIP ANTIBIOTIC OPHTH OI 20.04 14.03
47005258 250 IMIPRAMINE HCL 25MG TAB (TOFRANIL) 6.75 4.73
47005260 250 J2704 PROPOFOL 10MG/ML 20ML INJ 31.08 21.76
47005285 637 CEPHALEXIN 250MG/5ML 100ML SUSP (KELFEX) 73.21 51.25
47005300 636 J2150 MANNITOL 25% 50ML VIAL (ARIDOL) 101.20 70.84
47005320 250 XYLOCAINE INJ 1% 50CC 35.45 24.82
47005333 250 LIDOCAINE 2% W/EPI SDV 10ML (XYLOCAINE M 35.45 24.82
47005383 250 CLOTRIMAZOLE 10MG LOZENGE (MYCELEX) 7.47 5.23
47005417 250 NEO/POLY/DEX OPHTH OINT(MAXITROL OINT) 35.45 24.82
47005440 250 LIDOCAINE TOPICAL 4% 50ML SOL (XYLOCAIN 300.49 210.34
47005442 637 CIPROFLOXACIN 250MG TAB (CIPRO) 15.98 11.19
47005456 637 ACETAMINOPHEN XS 500MG CAPLET (TYLENOL X 6.76 4.73
47005464 637 ACETAMINOPHEN W/CODEINE #3 TAB 7.26 5.08
47005465 250 LIDOCAINE W/EPI INJ 1.5% 5ML (XYLOCAINE) 25.45 17.82
47005466 250 NEO/POLY/GRAM OPHTH SOLN (NEOSPORIN) 287.93 201.55
47005480 637 ACETAMINOPHEN 325MG TAB (TYLENOL) 7.30 5.11
47005481 250 LIDOCAINE JELLY 2% 30ML (XYLOCAINE) 567.92 397.54
47005485 636 J2001 LIDOCAINE 2% 20MG/ML 5ML SYR (XYLOCAINE) 64.20 44.94
47005524 250 AMOXICILLIN 500MG CAP 7.47 5.23
47005530 637 DIAZEPAM 5MG TAB (VALIUM) 7.26 5.08
47005532 637 BUPROPION 100MG TAB (WELLBUTRIN) 7.47 5.23
47005533 637 WARFARIN 5MG TAB (COUMADIN) 6.91 4.84
47005555 250 DIAZEPAM 2MG TAB (VALIUM) 7.85 5.50
47005560 250 NITROLINGUAL 0.4MG SPRAY (NITROSTAT) 76.41 53.49
47005574 637 AMIODARONE 200MG TAB (PACERONE) 17.72 12.40
47005589 637 ENALAPRIL 10MG TAB (VASOTEC) 6.91 4.84
47005597 637 ENALAPRIL 5MG TAB (VASOTEC) 6.91 4.84
47005608 636 Q0163 DIPHENHYDRAMINE 25MG CAP(BENADRYL) 6.91 4.84
47005639 637 A9270GY HYDROCODONE/APAP TAB 5/500MG (VICODIN) 6.25 4.38
47005670 250 HYDROXYZINE PAM 50MG CAP (VISTARIL) 7.85 5.50
47005688 250 HYDROXYZINE PAM 100MG CAP (VISTARIL) 6.75 4.73
47005696 250 NICOTINE PATCH 21MG/DAY 26.45 18.52
47005698 250 NICOTINE PATCH 14MG/DAY 27.60 19.32
47005731 637 BELLADONNA /PHENOBARB TAB (DONNATAL) 7.85 5.50
47005757 250 Nitroglycerin/D5W : 50MG/250ML PREMIX 96.17 67.32
47005772 250 FERROUS SULFATE 220MG ELIXIR 35.15 24.61
47005779 637 ALPRAZOLAM 0.5MG TAB (XANAX) 7.26 5.08
47005815 636 J3010 FENTANYL 250MCG/5ML INJ (SUBLIMAZE) 33.41 23.39
47005822 250 FML OPHTH SUSP 0.1% 95.01 66.51
47005830 636 90724 INFLUENZA VIRUS VACCINE (FLUZONE) 28.75 20.13
47005842 637 TRIPLE ANTIBIOTIC OINT PKT (NEOSPORIN) 6.75 4.73
47005961 250 CEPHALEXIN SUSP 250MG/5ML 62.76 43.93
47005987 250 NYSTATIN CREAM 30GM 27.90 19.53
47005988 250 CEFACLOR 125MG/5ML 75ML SUSP 74.96 52.47
47006028 250 BUTALBITAL/ACETAMINOPHEN/CAFFEINE TAB 7.85 5.50
47006069 250 CEFUROXIME 250MG TAB (CEFTIN) 18.30 12.81
47006085 636 J8540 DEXAMETHASONE 2MG TAB 7.47 5.23
47006092 250 DESIPRAMINE HCL 25MG TAB (NORPRAMIN) 6.75 4.73
47006126 250 ORPHENADRINE 60MG/2ML 2ML INJ (NORFLEX) 109.51 76.66
47006142 250 IRON COMPLEX 150MG CAP (FERREX) 6.91 4.84
47006143 250 CECLOR SUSP 125MG/5ML 83.97 58.78
47006150 636 J0744 CIPROFLOXACIN INJ 400MG/40ML (CIPRO) 30.22 21.15
47006168 636 J0834 COSYNTROPIN 0.25MG INJ (CORTROSYN) 549.95 384.97
47006258 636 Q9968 METHYLENE BLUE 0.5% 10ML 1,872.09 1,310.46
47006275 637 ALLOPURINOL 300MG TAB (ZYLOPRIM) 6.91 4.84
47006283 250 EUCERIN 40Z CRM 39.93 27.95
47006317 636 J9190 FLUOROURACIL 500MG/10ML INJ (ADRUCIL) 33.46 23.42
47006343 636 J9070 CYCLOPHOSPHAMIDE 1000MG INJ (CYTOXAN) 3,002.33 2,101.63
47006356 636 J2780 ZANTAC INJ 25MG/ML 35.45 24.82
47006365 250 DURAGESIC SYSTEM 75MCG 149.91 104.94
47006381 636 J1790 DROPERIDOL INJ 2.5MG/ML 2ML AMP 33.41 23.39
47006432 250 ALCOHOL DEHYDRATED 1ML AMP INJ 51.00 35.70
47006469 637 AMLODIPINE 10MG TAB 11.06 7.74
47006471 637 AMLODIPINE 5 MG TAB 6.91 4.84
47006473 637 LISINOPRIL 20MG TAB (ZESTRIL) 7.47 5.23
47006480 637 CALCIUM 500MG TAB (OSCAL) 6.91 4.84
47006497 250 METOLAZONE 5 MG TAB (ZAROXOLYN) 14.65 10.26
47006498 250 BUPIVACAINE 0.5% INJ 10ML (MARCAINE) 35.15 24.61
47006510 250 J0133 ACYCLOVIR INJ 500MG 144.75 101.33
47006549 250 D 50W 50% VIAL 50ML 33.46 23.42
47006562 636 Q0144 AZITHROMYCIN 250MG TAB (ZITHROMAX) 33.41 23.39
47006564 637 BISACODYL 5MG EC TAB (DULCOLAX) 6.91 4.84
47006580 250 ERYTHROMYCIN 250MG CAP (ERY-TAB) 26.69 18.68
47006597 636 J8610 METHOTREXATE 2.5MG TAB 15.21 10.65
47006639 637 SALINE NASAL SPRAY (OCEAN) 16.28 11.40
47006648 637 CLONIDINE TTS -1 PATCH (CATAPRES) 46.78 32.75
47006713 636 J1100 DEXAMETHASONE 4MG/ML 5ML INJ SDV 33.50 23.45
47006721 250 MEPIVACAINE 1% 20ML INJ (CARBOCAINE) 75.78 53.05
47006739 636 J0702 BETAMETHASONE 6MG/ML 5ML INJ (CELESTONE) 115.05 80.54
47006747 637 DICYCLOMINE 10MG CAP (BENTYL) 7.85 5.50
47006806 250 DILTIAZEM 300MG CAP (CARDIZEM CD) 13.00 9.10
47006812 637 DILTIAZEM ER 90MG CAP (CARDIZEM) 7.85 5.50
47006814 637 DOXAZOSIN 1MG TAB (CARDURA) 6.91 4.84
47006836 250 DOXYCYCLINE 100MG INJ (VIBRAMYCIN) 129.86 90.90
47006838 250 DOCUSATE SODIUM 100MG CAP (COLACE) 7.26 5.08
47006860 250 VECURONIUM 10MG INJ (NORCURON) 104.81 73.37
47006886 250 LABETALOL 100MG/20ML INJ (TRANDATE) 69.72 48.80
47006944 636 J2300 NALBUPHINE 10MG/ML 1ML INJ (NUBAIN) 136.56 95.59
47006960 637 DOCUSATE CALCIUM 240MG CAP (SURFAK) 6.91 4.84
47006970 250 PROSIGHT TAB (OCUVITE) I CAPS 7.26 5.08
47007083 250 GAVISCON SUSP 30.50 21.35
47007109 250 GLIPIZIDE 10MG TAB (GLUCOTROL) 6.91 4.84
47007125 250 GENTAMYCIN OPTH SOL 38.36 26.85
47007133 637 POLYETHYLENE GLYCOL-ELECTROLYTE SOL (GOL 81.35 56.95
47007208 250 GRANULEX AEROSOL 4OZ 97.91 68.54
47007232 250 GLYCERIN ADULT SUPP 7.85 5.50
47007234 636 J1610 GLUCAGON 1MG HYPOKIT INJ (GLUCAGEN) 310.01 217.01
47007272 637 METRONIDAZOLE 500MG TAB (FLAGYL) 7.85 5.50
47007281 250 GENTAMICIN SULFATE CRM 27.60 19.32
47007299 250 GENTAMICIN SULFATE 0.1%OINT 15GM 229.55 160.69
47007315 250 GENTAMICIN OPHTH OINT 3.5GM(GENTAK) 91.41 63.99
47007322 636 J2270 MORPHINE SULFATE 10MG/ML INJ 31.81 22.27
47007349 250 GLIPIZIDE 5MG TAB (GLUCOTROL) 7.72 5.40
47007350 250 DIAZOXIDE 15MG/ML 20ML INJ (HYPERSTAT) 524.72 367.30
47007355 637 A9270GY TRIAM/HCTZ 75/50MG TAB (MAXIDE) 6.75 4.73
47007413 250 TETRACAINE 0.5% EYE DROP 154.80 108.36
47007414 250 ERYTHROMYCIN EC 333MG (ERY-TAB) 6.75 4.73
47007430 637 IBUPROFEN 200MG TAB (MOTRIN) 1.44 1.01
47007447 636 J9217 LUPRON DEPOT INJ 7.5MG 2,308.75 1,616.13
47007505 250 CHLORPHENIRAMINE MAL 4MG TAB (CHLORPHEN) 7.85 5.50
47007565 250 DILTIAZEM 240MG CAP (CARDIZEM CD) 10.23 7.16
47007588 636 J1100 DEXAMETHASONE SOD PHOS 10MG/ML 1ML INJ 33.74 23.62
47007629 636 J2354 OCTREOTIDE 100MCG/ML INJ (SANDOSTATIN) 76.05 53.24
47007637 636 90732 PNEUMOVAX 23 INJ 0.5ML 586.82 410.77
47007646 637 CEFUROXIME 500MG TAB (CEFTIN) 35.15 24.61
47007648 250 CEFOXITIN 500MG TAB 33.41 23.39
47007650 250 CEFPROZIL 250MG/5ML SUSP 50ML (CEFZIL) 147.31 103.12
47007654 250 CEFOXITIN 250MG TAB (CEFZIL) 17.15 12.01
47007677 250 FAMOTIDINE 20MG TAB (PEPCID) 7.26 5.08
47007680 250 LIDOCAINE VISCOUS 2% 100ML (XYLOCAINE) 58.41 40.89
47007711 250 DICLOXACILLIN 250MG CAP 7.47 5.23
47007751 637 FLUOXETINE 20MG CAP 12.44 8.71
47007760 250 BACITRACIN OPHTH OINT 3.5GM TUBE 332.09 232.46
47007769 250 PENICILLIN V POTASSIUM 250MG/5ML SUSP (P 35.45 24.82
47007785 250 PENICILLIN G SODIUM 5MU INJ 195.53 136.87
47007919 250 CORTISPORIN OPTH OINT 134.22 93.95
47007943 250 ERYTHROMYCIN OPHTH OINT 0.5% (ILOTYCIN) 26.45 18.52
47007992 250 DOXYCYCLINE 100MG CAP (VIBRAMYCIN) 24.61 17.23
47008023 300 86580 TUBERSOL 5TU/0.1ML INJ 46.29 32.40
47008030 636 J1450 FLUCONAZOLE PREMIX 200MG (DIFLUCAN) 364.35 255.05
47008032 637 FLUCONAZOLE 100MG TAB (DIFLUCAN) 40.99 28.69
47008034 250 FLUCONAZOLE 200MG TAB (DIFLUCAN) 61.02 42.71
47008106 636 J1410 CONJUGATED ESTROGENS 25MG INJ (PREMARIN) 1,685.60 1,179.92
47008130 637 CONJUGATED ESTROGENS 0.625MG/GM 42.5GM C 210.93 147.65
47008263 636 Q0177 HYDROXYZINE PAM 25MG CAP (VISTARIL) 6.91 4.84
47008270 636 J3535 ALBUTEROL HFA 90MCG (VENTOLIN HFA) 149.91 104.94
47008346 636 J2590 OXYTOCIN 10U/1ML INJ (PITOCIN) 35.45 24.82
47008347 636 J1630 HALOPERIDOL LACT 5MG/1ML INJ 35.15 24.61
47008361 250 VASOPRESSIN INJ 10U/0.5 35.45 24.82
47008368 636 J0360 HYDRALAZINE HCL 20MG/ML INJ 84.26 58.98
47008370 250 HYDROXYZINE HCL 50MG/1ML INJ (VISTARIL) 115.81 81.07
47008387 637 PREDNISONE OPTH 1% 5ML SUSP (PRED-FORTE) 85.71 60.00
47008388 250 HYDROCORTISONE 2.5% OINT (CORTIZONE) 27.60 19.32
47008404 636 J1644 HEPARIN 10,000units/ML INJ 38.36 26.85
47008429 250 IMIPENEM & CILASTATIN 500MG ADV INJ (PRI 134.00 93.80
47008486 250 PROMETHAZINE 25MG SUPP (PHENERGAN) 17.72 12.40
47008487 250 J1642 HEPARIN LOCK 500UNIT/5ML FLUSH 35.15 24.61
47008495 637 HYDROCORTISONE 1% CRM (CORTIZONE) 27.60 19.32
47008536 250 PAPAVERINE HCL 60MG/2ML 2ML INJ 219.15 153.41
47008602 637 HYDROCHLOROTHIAZIDE 25MG TAB 6.91 4.84
47008643 250 PAREGORIC LIQUID 5ML 14.65 10.26
47008668 636 J2720 PROTAMINE SULFATE 50MG/5ML INJ 54.61 38.23
47008676 250 PREDNISONE 1MG TAB 7.26 5.08
47008693 637 IBUPROFEN 800MG TAB (MOTRIN) 7.26 5.08
47008726 637 NITROGLYCERIN 0.2MG/HR PATCH (NITRO-DUR) 13.07 9.15
47008759 636 J0743 IMIPENEM/CILASTATIN 500MG INJ (PRIMAXIN) 141.28 98.90
47008866 637 PROPYLTHIOURACIL 50MG TAB 7.47 5.23
47008889 250 FERROGEL FORTE CAP 7.85 5.50
47008891 636 J0886 EPOETIN ALPHA 10MU/ML INJ (W/ DIALYSIS) 496.25 347.38
47009011 250 NICOTINE PATCH 7MG/DAY 23.75 16.63
47009014 250 HYPOTEARS OPTH SOL 25.00 17.50
47009099 636 J1644 HEPARIN 1,000units/ML 1ML INJ 42.71 29.90
47009118 636 J1644 HEPARIN SODIUM INJ( 1MU/ 35.45 24.82
47009121 250 HYDROMET 5ML DOSE (HYCODAN) 6.08 4.26
47009122 636 J0780 PROCHLORPERAZINE 10MG/2ML INJ (COMPAZINE 95.46 66.82
47009142 250 PROCARDIA XL 90 MG 13.00 9.10
47009146 250 PHENOBARB SOD INJ 130MG 35.45 24.82
47009161 637 NIFEDIPINE XL 30 MG TAB (PROCARDIA XL) 6.91 4.84
47009162 636 J1670 TETANUS INJ 250U (BAY-TET) 536.63 375.64
47009179 637 AMOXICILLIN 250MG CAP 6.91 4.84
47009394 636 J7500 AZATHIOPRINE 50MG TAB (IMURAN) 7.47 5.23
47009410 250 ISOPROTERENOL HCL INJ 0 54.00 37.80
47009415 250 ISUPREL HCL INJ 0.2MG/M 80.25 56.18
47009435 636 J2765 METOCLOPRAMIDE 10MG/2ML INJ (REGLAN) 35.15 24.61
47009436 250 ISOPROTERENOL 1MG/5ML AMP (ISUPREL) 1,217.78 852.45
47009480 250 REFRESH PM LUB OPTH 39.80 27.86
47009500 637 LEVOTHYROXINE 0.025MG TAB (SYNTHROID) 7.26 5.08
47009526 636 J0696 CEFTRIAXONE 1000MG ADV VIAL (ROCEPHIN) 41.84 29.29
47009634 637 ASPIRIN 81MG CHEW TAB 6.95 4.87
47009717 637 WARFARIN 1MG TAB (COUMADIN) 6.91 4.84
47009724 636 S0017 AMINOCAPROIC ACID 250MG/ML 20ML INJ (AMI 65.96 46.17
47009766 637 VERAPAMIL SR 240MG TAB (ISOPTIN SR) 11.23 7.86
47009774 636 J1800 PROPRANOLOL 1MG/1ML INJ (INDERAL) 35.45 24.82
47009881 637 IBUPROFEN 400 MG TAB 7.26 5.08
47009949 250 IPECAC SYRUP 1.4MG/ML 6.25 4.38
47009964 250 ISOSORBIDE DIN 40MG TAB (ISORDIL TITRADO 6.75 4.73
47009989 250 POLYMYXIN B/TRIMETHOPRIM OPHTH DROPS 39.51 27.66
47009994 250 AMPICILLIN & SULBACTAM 1.5GM ADV INJ 37.50 26.25
47009995 250 AMPICILLIN & SULBACTAM 3GM ADV INJ (UNAS 65.25 45.68
47009996 636 J3475 MAGNESIUM SULFATE 1000MG/2ML INJ 59.56 41.69
47009998 636 J1644 HEPARIN INJ 1000U/ML 30ML 35.15 24.61
47080002 258 SOD BICARB INJ:50MEQ 50ML 35.45 24.82
47080015 637 MELATONIN 5MG TAB 6.64 4.65
47080016 637 TIMOLOL 0.5% OPTH SOLN 5 ML 73.10 51.17
47080017 636 IV TEMPLATE 395.14 276.60
47080018 636 J2780 RANITIDINE 50MG/2ML IV (ZANTAC) 35.45 24.82
47080019 637 CARBAMAZEPINE 200MG TAB (TEGRETOL) 6.91 4.84
47080020 636 J9201 GEMCITABINE 1GM VIAL (GEMZAR) 1,897.00 1,327.90
47080027 636 P9047 ALBUMIN 25% (12.5GM/50ML) INJ 502.06 351.44
47080031 636 J9070 CYCLOPHOSPHAMIDE 500MG INJ (CYTOXAN) 116.42 81.49
47080032 636 J9000 DOXORUBICIN 20MG VIAL (ADRIAMYCIN) 339.05 237.34
47080033 250 CIPRO HC EAR DROP 10ML BOTTLE 313.20 219.24
47080036 637 OXYCODONE SR 20MG TAB (OXYCONTIN) 11.62 8.13
47080038 636 J1442 FILGRASTIM 480MCG/0.8 ML INJ (NEUPOGEN) 2,821.72 1,975.20
47080039 636 J2993 RETEPLASE 10 UNIT HALFKIT (RETAVASE) 4,546.14 3,182.30
47080040 636 J1327 EPTIFIBATIDE 2MG/ML 100ML VIAL (INTEG 2,086.68 1,460.68
47080041 250 J2353 OCTREOTIDE LAR DEP 30MG (SANDOSTATIN) 6,971.75 4,880.23
47080043 250 OSMOLITE 8OZ LIQ 8.75 6.13
47080045 636 J3010 FENTANYL 1000MCG/20ML INJ (SUBLIMAZE) 144.11 100.88
47080046 637 TIZANIDINE 4MG TAB (ZANAFLEX) 6.91 4.84
47080048 636 J7192 FACTOR 8 REC. 1127 U/VIAL 7,359.77 5,151.84
47080049 250 LETROZOLE 2.5MG TAB (FEMARA) 30.50 21.35
47080050 250 CALCIUM CHLORIDE 10% INJ 1000MG/10ML 112.78 78.95
47080051 636 Q9968 LYMPHAZURIN 1% INJ 5ML(ISOSULFAN BLUE) 5,474.19 3,831.93
47080052 250 DILTIAZEM INJ 125MG/25ML 113.31 79.32
47080054 637 CILOSTAZOL 100MG TAB (PLETAL) 8.85 6.20
47080055 637 TOPIRAMATE 25MG TAB (TOPAMAX) 10.23 7.16
47080057 637 LEVOTHYROXINE 0.137MCG TAB (SYNTHROID) 6.39 4.47
47080058 250 J1573 HEP B IMM GLOB 5ML 2,690.00 1,883.00
47080059 636 90746 HEP B VAC RECOMB 20MCG/ML 1ML INJ 302.54 211.78
47080060 637 A9270GY PRAVASTATIN TAB: 20MG (PRAVACHOL) 11.75 8.23
47080063 637 HYDROCORTISONE 2.5% CRM (RECTAL USE) 101.69 71.18
47080068 250 VITAMIN A 50MG/ML 2ML VIAL (AQUASOL) 98.72 69.10
47080069 637 LIOTHYRONINE 5MCG TAB 6.39 4.47
47080071 637 CALCIUM CARBONATE 500MG TAB (TUMS) 1.38 0.97
47080072 636 J8530 CYCLOPHOSPHAMIDE 25MG TAB (CYTOXAN) 6.08 4.26
47080073 637 METOPROLOL XL SUCC 100MG (TOPROL XL) 6.91 4.84
47080074 636 J2820 SARGRAMOSTIM 500MCG VIAL (LEUKINE) 1,176.00 823.20
47080076 636 J7131 NACL 3% 500ML HYPERTONIC SALINE IVF 31.96 22.37
47080080 250 PHENOL 10ML TOPICAL 31.81 22.27
47080081 636 J2325 NESIRITIDE 1.5MG INJ (NATRECOR) 2,168.38 1,517.87
47080082 636 J1644 HEPARIN 10,000units/10ML INJ 31.96 22.37
47080083 637 MOXIFLOXACIN 400MG TAB (AVELOX) 126.42 88.49
47080087 637 ZIPRASIDONE 20MG CAP (GEODON) 39.15 27.41
47080088 250 PANCURONIUM 10MG/5ML AMP 59.56 41.69
47080089 637 LINEZOLID 600MG TAB (ZYVOX) 297.23 208.06
47080090 636 J2020 Linezolid PREMIX 600MG/300ML IVPB (ZYV 454.12 317.88
47080091 250 J2770 QUINUPRISTIN & DALFOPRISTIN 500MG VIAL 363.00 254.10
47080092 637 TRAMADOL/APAP 37.5/325MG TAB (ULTRACET) 4.06 2.84
47080094 250 BALSALAZIDE 750MG TAB (COLAZAL) 6.08 4.26
47080096 250 EPINEPH 1:1000 30MG/30ML INJ 37.77 26.44
47080097 637 ACETAMINOPHEN ELIXIR 5ML DOSE 4.06 2.84
47080098 636 Q0162 ONDANSETRON ODT 4MG TAB (ZOFRAN ODT) 107.45 75.22
47080100 250 FOLBEE TAB (FOLTX) 6.09 4.26
47080101 636 J0886 EPOETIN ALPHA 20000 U (W/ DIALYSIS) (PRO 977.25 684.08
47080102 250 PODOPHYLLUM RESIN (PODOCON-25) 212.39 148.67
47080103 637 PRAMIPEXOLE 0.25MG TAB (MIRAPEX) 7.85 5.50
47080106 250 VANICREAM 16OZ JAR 48.46 33.92
47080107 637 TOLTERODINE ER 4MG CAP (DETROL) 15.98 11.19
47080108 637 PSEUDOEPHEDRINE 120MG 12 HR TAB (SUDAFED 4.15 2.91
47080109 636 J1071 DEPOTESTOSTERONE CYP 200MG INJ 1ML 105.77 74.04
47080110 636 J0690 CEFAZOLIN 1000MG INJ (ANCEF) 35.95 25.17
47080112 637 ZINC SULFATE 220MG CAP (EQUIV 50MG) 6.39 4.47
47080114 636 Q0169 PROMETHAZINE 25MG TAB (PHENERGAN) 6.08 4.26
47080116 637 SALINE NASAL GEL AYR 16.28 11.40
47080117 637 A9270GY NEPHRO-VITE TAB 5.75 4.03
47080118 637 ENSURE HIGH PROTEIN SUPPLEMENT 240ML 10.50 7.35
47080119 250 HALOPERIDOL 2MG/ML SOL (HALDOL) 157.77 110.44
47080120 637 OLANZAPINE 10MG TAB (ZYPREXA) 45.90 32.13
47080121 250 COCAINE 4% SOL 160.50 112.35
47080125 636 Q0173 TRIMETHOBENZAMIDE 300MG CAP (TIGAN) 6.91 4.84
47080126 637 PRIMIDONE 50MG TAB (MYSOLINE) 6.31 4.42
47080127 636 J1100 DEXAMETHASONE 10MG INJ SDV 35.95 25.17
47080129 636 J2997 ALTEPLASE 2MG (CATHFLO ACTIVASE) 312.77 218.94
47080131 250 LUGOL'S SOLUTION 68.85 48.20
47080132 636 J3489 ZOLEDRONIC ACID 4MG INJ (ZOMETA) 3,960.12 2,772.08
47080133 636 90648 HIB VACCINE (W/TET) 124.93 87.45
47080135 637 A9270GY SIMVASTATIN 40MG TAB (ZOCOR) 18.75 13.13
47080137 250 DESMOPRESSIN 4MCG/ML 1ML AMP (DDAVP) 113.39 79.37
47080138 636 J7131 NACL 7% 5ML NEB 9.29 6.50
47080139 637 FLORANEX TAB 30.80 21.56
47080140 250 DOCUSATE SODIUM 10MG/ML LIQ 120ML 15.98 11.19
47080141 250 CALCIUM GLUCONATE 1000MG/10ML 167.86 117.50
47080142 250 BOOST DIABETIC SUPPLEMENT 11.50 8.05
47080143 636 J1260 DOLASETRON 12.5MG INJ (ANZEMET) 71.46 50.02
47080144 250 EMPTY IV CONTAINER 250ML 18.80 13.16
47080145 250 MULTIVITAMIN LIQ (CENTAMIN) 25.00 17.50
47080146 250 PERUVIAN BALSAM 65.75 46.03
47080147 250 FENTANYL 100MCG/HR PATCH (DURAGESIC) 201.06 140.74
47080148 250 FENTANYL 75MCG/HR PATCH (DURAGESIC) 196.69 137.68
47080149 250 CHARCOAL ACTIDOSE WITH SORBITOL (80Z) 89.48 62.64
47080150 250 EMPTY STERILIZED VIAL 30ML 4.15 2.91
47080151 250 GLIMEPIRIDE 4MG TAB (AMARYL) 5.80 4.06
47080152 250 EPINEPHRINE 0.3MG/0.3ML AUTO PEN 1,074.72 752.30
47080153 637 LIDOCAINE VISCOUS 15ML U/D (XYLOCAINE) 7.26 5.08
47080154 636 J0878 DAPTOMYCIN 500MG VIAL (CUBICIN) 567.73 397.41
47080155 637 VANCOMYCIN 250MG (VANCOCIN) 70.60 49.42
47080156 250 ESMOLOL 2500MG/250ML PREMIX (BREVIBLOC) 2,608.97 1,826.28
47080157 250 J7614 LEVALBUTEROL 1.25MG NEB (XOPENEX) 13.07 9.15
47080158 250 CHLORHEXIDINE ORAL RINSE (PERIDEX) 42.43 29.70
47080160 637 GALANTAMINE 4MG TAB (RAZADYNE) 12.44 8.71
47080161 636 J1335 ERTAPENEM 1000MG INJ (INVANZ) 653.05 457.14
47080162 637 ALENDRONATE 70MG WEEKLY TAB (FOSAMAX) 84.63 59.24
47080163 637 GABAPENTIN 300MG CAP (NEURONTIN) 6.91 4.84
47080164 637 TIOTROPIUM HANDIHALER (SPIRIVA) 488.48 341.94
47080165 250 VANICREAM 4OZ TUBE 18.30 12.81
47080166 637 QUETIAPINE 25MG TAB (SEROQUEL) 8.29 5.80
47080167 636 90658 INFLUENZA ADULT VACCINE 76.19 53.33
47080168 637 HYDROCORTISONE 2.5% LOT 115.05 80.54
47080169 637 ACYCLOVIR 400MG TAB (ZOVIRAX) 7.85 5.50
47080170 636 J0735 CLONIDINE 100MCG/ML 10ML VIAL (DURACLON) 265.76 186.03
47080171 637 A9270GY TOPIRAMATE 100MG TAB(TOPAMAX) 18.00 12.60
47080172 637 A9270GY KETOCONAZOLE 200MG (TAB) 12.50 8.75
47080174 637 AMOXICILLIN/CLAVULANATE 400MG SUSP (AUGM 316.41 221.49
47080175 636 J3490 METOPROLOL 5MG/5ML INJ (LOPRESSOR) 29.64 20.75
47080176 250 CULTURELLE W/LACTOBACILLUS CAP 5.25 3.68
47080177 637 A9270GY MODAFINIL100MG TAB (PROVIGIL) 18.75 13.13
47080179 636 J1815 INSULIN GLARGINE PEN (LANTUS SOLOSTAR 451.63 316.14
47080180 250 DIPHTHERIA/TETANUS TOX PEDIATRIC 55.21 38.65
47080181 250 VALPROATE SODIUM 500MG/5ML INJ 34.28 24.00
47080182 636 J1450 Fluconazole/PREMIX IVPB: 200MG/100ML 99.09 69.36
47080185 637 A9270GY TRIPLE ANTIBIOTIC OINT 1LB JAR (NEOSPORI 198.00 138.60
47080187 637 OXYBUTYNIN XL 5MG TAB (DITROPAN XL) 19.08 13.36
47080189 250 SUCRALFATE 1000MG/10ML (CARAFATE) 56.59 39.61
47080190 250 LIDOCAINE 5% PATCH (LIDODERM) 41.25 28.88
47080193 250 DEXMEDETOMIDINE 200MCG/2ML INJ 330.93 231.65
47080194 637 OXYCODONE CR 10MG TAB (OXYCONTIN) 8.29 5.80
47080195 637 OXYCODONE 5MG CAP (ROXICODONE) 6.91 4.84
47080197 637 VITAMIN A 10,000U CAP 4.06 2.84
47080198 637 POTASSIUM CHLORIDE 10MEQ TAB (KLOR CON) 7.26 5.08
47080199 636 J0461 ATROPINE 1MG/10ML INJ ABBOJECT 70.02 49.01
47080200 637 ENSURE 10.50 7.35
47080201 250 DOCUSATE SODIUM 50MG/5ML LIQ (DSS) 22.75 15.93
47080203 250 DANTROLENE 50MG CAP (DANTRIUM) 7.74 5.42
47080205 250 MULTIVITAMIN LIQUID 240ML 25.44 17.81
47080206 637 MICONAZOLE 2% 30GM CRM (LOTRIMIN AF) 55.78 39.05
47080209 637 POLYETHYLENE GLYCOL 3350 17GM PKT (MIRAL 13.96 9.77
47080211 637 VANCOMYCIN 125MG CAP (VANCOCIN) 134.61 94.23
47080212 250 A9180 PERMETHRIN 1% CRM RINSE 31.00 21.70
47080214 250 PHENYLEPHRINE 0.25% NASAL SPRAY (NEO-SYN 15.39 10.77
47080215 250 LOLLIPOPS FENTANYL (ACTIQ) 65.00 45.50
47080216 637 ACETAMINOPHEN W/CODEINE ORAL SOLN 5ML 2.61 1.83
47080218 637 TRAVOPROST 0.004% EYE DROP 2.5ML (TRAVAT 406.47 284.53
47080220 636 J1750 IRON DEXTRAN COMPLEX 50MG/ML 1ML SDV (DE 147.31 103.12
47080221 250 TOLTERODINE 2MG CAP (DETROL) 14.93 10.45
47080222 250 PREGABALIN 25MG CAP (LYRICA) 37.30 26.11
47080223 637 GUAIFENESIN 600MG TAB (MUCINEX) 6.91 4.84
47080224 637 PENTOXIFYLLINE 400MG TAB ER (TRENTAL) 7.26 5.08
47080225 250 BUPIVACAINE 0.5% 30ML INJ (MARCAINE) 28.48 19.94
47080226 250 PREGABALIN 150MG CAP (LYRICA) 9.95 6.97
47080227 250 METRONIDAZOLE 500MG/100ML IVPB PREMIX 36.61 25.63
47080228 250 CINNAMON 1000MG CAP 6.91 4.84
47080229 636 J1956 LEVOFLOXACIN 750MG/150ML IVPB PREMIX 247.26 173.08
47080230 637 SLOW FE IRON 7.26 5.08
47080232 250 CHLORASEPTIC MUCOUS MEMBRANE SPRAY 1.4% 18.89 13.22
47080233 250 MEPHYTON 5MG TAB (VITAMIN K) 118.97 83.28
47080234 250 BOOST LIQ 240 ML CAN 10.50 7.35
47080236 637 EZETIMIBE 10MG TAB (ZETIA) 32.63 22.84
47080237 636 J3486 ZIPRASIDONE 20MG/ML IM INJ (GEODON) 54.34 38.04
47080238 637 BISMUTH 262MG CHEWABLE TAB 1.38 0.97
47080239 637 HYDRALAZINE HCL 10MG TAB 6.98 4.89
47080240 637 CALCITRIOL 0.5MCG CAP (ROCALTROL) 9.59 6.71
47080241 637 TRIPLE ANTIBIOTIC OINT 30GM TUBE (NEOSPO 13.37 9.36
47080242 250 ESTRIDIOL VAG CRM 42.5GM TUBE (ESTRACE) 223.71 156.60
47080243 636 J9190 FLUOROURACIL 1 GM VIAL (50MG/1ML; 20ML) 30.70 21.49
47080245 250 SENNA 8.6MG TAB (SENOKOT) 6.98 4.89
47080246 250 DULOXETINE 30MG CAP (CYMBALTA) 34.07 23.85
47080247 250 WARFARIN 5MG INJ (COUMADIN) 86.84 60.79
47080248 636 J1652 FONDAPARINUX 2.5MG/0.5ML INJ (ARIXTRA) 173.15 121.21
47080249 637 MORPHINE SULFATE CONC 20MG/ML 30ML 78.44 54.91
47080250 637 FENOFIBRATE 145MG TAB (TRICOR) 15.21 10.65
47080251 637 FLUTICASONE & SALMETEROL 100/50 INHALER 235.05 164.54
47080252 637 ZINC OXIDE 454GM OINT TUB 62.46 43.72
47080253 637 FLUTICASONE & SALMETEROL 250/50 DISKUS 665.74 466.02
47080255 250 BUMETANIDE 2MG TAB (BUMEX) 6.98 4.89
47080256 250 INSULIN ASPART PREFILLED PEN (NOVOLOG) 623.49 436.44
47080257 636 J1815 INSULIN ASPART PROTAMINE/ASPART 70/30 PE 593.44 415.41
47080258 636 J1815 INSULIN DETEMIR PREFILLED PEN (LEVEMIR) 490.82 343.57
47080259 637 CALCITRIOL 0.25 MCG LIQ CAP (ROCALTROL) 7.26 5.08
47080260 250 ESOMEPRAZOLE 40MG INJ (NEXIUM) 237.07 165.95
47080261 250 STERILE WATER FOR INJECTION 1000 ML 5.54 3.88
47080262 637 AMOX/CLAVULANATE 200MG/28.5MG 50ML 71.91 50.34
47080264 637 PEDIALYTE 237ML BOTTLE 20.93 14.65
47080265 637 FLUTICASONE & SALMETEROL 500/50 DISKUS 1,085.05 759.54
47080266 250 J2353 OCTREOTIDE LAR DEPOT 20MG (SANDOSTATIN) 13,088.50 9,161.95
47080267 636 J0885 EPOETIN ALPHA 20,000U (PROCRIT) 2,603.84 1,822.69
47080268 636 J0885 EPOETIN ALPHA 10,000 U (PROCRIT) 1,702.80 1,191.96
47080269 637 A9270GY LITHIUM CARBONATE TAB ER 450MG 6.25 4.38
47080270 250 CLOTRIMAZOLE 1% 30GM CRM (LOTRIMIN) 29.35 20.55
47080271 250 B TOTAL LIQ 30 ML DROPPER BOTTLE 31.25 21.88
47080272 636 J2280 MOXIFLOXACIN 400MG/250ML PREMIX IVPB (AV 140.91 98.64
47080273 637 ACETAMINOPHEN 160MG/5ML U/D CUPS (TYLENO 6.95 4.87
47080274 637 QUETIAPINE 100MG TAB (SEROQUEL) 15.76 11.03
47080275 250 RIVASTIGIMINE 3MG CAP (EXELON) 13.55 9.49
47080276 250 RIVASTIGMINE 1.5MG CAP (EXELON) 14.24 9.97
47080277 637 MEMANTINE 5MG TAB (NAMENDA) 10.78 7.55
47080278 250 MENOMUNE-A/C/Y/W-135 INJ 0.05MG 625.71 438.00
47080280 637 A9270GY IRBESARTAN 150MG TAB (AVAPRO) 6.25 4.38
47080282 250 PREGABALIN 50MG CAP (LYRICA) 42.39 29.67
47080283 636 J3475 MEGESTROL 20MG TAB (MEGACE) 7.26 5.08
47080285 637 CARBOXYMETHYLCELLULOSE OPHTH DROP 15ML 32.25 22.58
47080286 637 PREGABALIN 75MG CAP (LYRICA) 30.68 21.48
47080287 637 RANOLAZINE 500MG TAB (RANEXA) 10.51 7.36
47080289 636 J0583 BIVALIRUDIN 250MG INJ (ANGIOMAX) 1,988.35 1,391.85
47080290 637 SOLIFENACIN 5MG TAB (VESICARE) 39.15 27.41
47080291 637 DICLOFENAC&MISOPROSTOL 50MG TAB (ARTHROT 9.41 6.59
47080292 250 J2260 MILRINONE 20MG/100ML PREMIX (PRIMACOR) 82.00 57.40
47080293 637 PIOGLITAZONE 30MG TAB (ACTOS) 26.83 18.78
47080294 250 JUZO COMPRESSION STOCKINGS 90.94 63.66
47080295 250 CEPASTAT LOZENGE 13.37 9.36
47080296 250 GLIPIZIDE XL 2.5MG TAB (GLUCOTROL XL) 6.98 4.89
47080297 250 VARENICLINE 0.5MG TAB(1 CARD OF 11 TABS) 65.75 46.03
47080298 250 VARENICLINE 1MG TAB (1 CARD OF 28 TAB) 174.25 121.98
47080299 637 HYDROCODONE/APAP 7.5/325MG 15 ML ELIXIR 14.93 10.45
47080301 637 A9270GY TELMISARTAN 80MG TAB (MYCARDIS) 8.25 5.78
47080302 250 HYDROMORPHONE 2MG TAB (DILAUDID) 6.98 4.89
47080303 250 RIFAXIMIN 200MG TAB (XIFAXIN) 70.55 49.39
47080305 637 OXYCODONE/APAP 5/325MG TAB (PERCOCET) 11.68 8.18
47080307 637 OSELTAMIVIR 75MG CAP (TAMIFLU) 71.86 50.30
47080308 250 DEMECLOCYCLINE 150MG TAB 47.04 32.93
47080309 250 FIBERSOURCE (TUBE FEED) 10.50 7.35
47080310 250 BOOST HIGH PROTEIN 10.50 7.35
47080311 637 A9270GY FOSINOPRIL 20 MG TAB (MONOPRIL) 6.50 4.55
47080312 637 LEVETIRACETAM 500MG TAB (KEPPRA) 15.39 10.77
47080313 637 IBUPROFEN 100MG/5ML U/D CUP 6.98 4.89
47080314 636 J2997 ALTEPLASE 100MG INJ (ACTIVASE) 46,726.74 32,708.72
47080315 636 J2274 MORPHINE 0.5MG/ML 10 ML VIAL (DURAMORPH) 476.76 333.73
47080316 637 MISOPROSTOL 200MCG TAB (CYTOTEC) 6.98 4.89
47080317 636 J3010 FENTANYL 2500MCG/50ML INJ (SUBLIMAZE) 34.00 23.80
47080318 250 AMMONIA INHALANTS 7.85 5.50
47080319 250 AMMONIUM LACTATE 12% CRM (LAC-HYDRIN) 54.34 38.04
47080320 250 CYANIDE ANTIDOTE KIT 738.50 516.95
47080321 250 CLIDINIUM/CPZ 5MG/2.5MG CAP (LIBRAX) 6.98 4.89
47080322 250 COLLODION FLEXIBLE 5 ML 445.57 311.90
47080323 250 HEPATITIS A VACCINE INACTIVATED (HAVRIX) 305.64 213.95
47080325 636 J1610 GLUCAGON 1MG INJ (GLUCAGEN) 911.05 637.74
47080326 250 GLUCOSE TAB 7.26 5.08
47080327 636 J1720 HYDROCORTISONE 500MG/4ML INJ (SOLU-CORTE 61.59 43.11
47080328 636 J0153 ADENOSINE 90MG/30ML VIAL (ADENOCARD) 977.11 683.98
47080329 636 J3489 ZOLEDRONIC ACID 5MG/100ML PREMIX (RECLAS 4,669.25 3,268.48
47080330 636 J2001 LIDOCAINE 0.5% 50 ML MDV (XYLOCAINE) 29.35 20.55
47080332 250 LIDOCAINE-MPF 2% VIAL 5ML (XYLOCAINE-MPF 27.93 19.55
47080333 250 NEO/POLY/BACT OPHTH OINT (NESPORIN OPHTH 25.57 17.90
47080334 637 MOMETASONE FUROATE 0.1% 15GM CRM (ELOCON 109.25 76.48
47080335 637 LUBIPROSTONE 24MCG CAP (AMITIZA) 16.28 11.40
47080336 637 HYDROCODONE/APAP TAB 10/325 MG (NORCO) 7.19 5.03
47080338 250 SEVOFLURANE INHALATION ANESTHETIC (ULTAN 930.90 651.63
47080339 250 VASELINE 2.5OZ TUBE 8.13 5.69
47080440 250 ETOMIDATE 20MG/10ML AMP (AMIDATE) 95.59 66.91
47080441 637 PROBIOTIC CAP 7.26 5.08
47080442 250 FENTANYL 12 MCG/HR PATCH (DURAGESIC) 94.37 66.06
47080443 637 A9270GY TACROLIMUS 1MG CAP (PROGRAF) 17.50 12.25
47080444 637 DICLOFENAC 1% 100GM TOPICAL GEL (VOLTAR 268.23 187.76
47080445 637 ASPIRIN & DIPYRIDAMOL 200MG CAP (AGGRENO 10.78 7.55
47080446 637 OXCARBAZEPINE 150MG TAB (TRILEPTAL) 6.91 4.84
47080447 637 A9270GY METHIMAZOLE 10 MG TAB (TAPAZOLE) 6.00 4.20
47080448 250 MAGIC MOUTHWASH 120 ML 322.50 225.75
47080451 250 J0287 ABELCET B LIPOSOMAL 100MG VIAL 794.50 556.15
47080452 637 URSODIOL 300MG CAP (ACTIGALL) 9.41 6.59
47080453 636 J1570 GANCICLOVIR 500MG INJ (CYTOVENE) 257.13 179.99
47080454 637 CYCLOSPORINE 25MG MICRO (NEORAL) 7.47 5.23
47080456 250 VENLAFAXINE XR 75MG CAP (EFFEXOR) 17.14 12.00
47080457 637 A9270GY MINOXIDIL 10MG TAB (LONITEN) 6.25 4.38
47080458 250 DIVALPROEX ER 250MG TAB (DEPAKOTE) 7.26 5.08
47080459 636 J0456 AZITHROMYCIN 500MG INJ (ZITHROMAX) 79.32 55.52
47080461 250 PEPTINEX 240 ML ORAL FEED 43.50 30.45
47080463 250 J2185 MEROPENEM 1GM IV (MERREM) 261.50 183.05
47080464 250 IMMUNE GLOBULIN 5GM VIAL (GAMMAGARD S/D) 1,711.89 1,198.32
47080465 637 VIT D 50,000IU CAP (ERGOCALCIFEROL) 7.26 5.08
47080466 250 ESCITALOPAM 10 MG TAB (LEXAPRO) 11.90 8.33
47080467 250 NAFCILLIN 2000MG INJ 72.75 50.93
47080468 250 OXACILLIN 2GM ADV INJ 87.25 61.08
47080469 250 CHLORTHALIDONE 50MG TAB (THALITONE) 6.91 4.84
47080470 637 PYRIDOXINE B6 25MG 7.85 5.50
47080471 250 HALFLYTELY BOWEL PREP W/BISAC TAB 222.56 155.79
47080473 250 PROPOFOL 500MG/50ML INJ 96.75 67.73
47080474 637 VITAMIN B-12 500MCG TAB 6.63 4.64
47080475 636 J2270 MORPHINE SULFATE 4MG/ML INJ 29.86 20.90
47080476 636 J7510 PREDNISOLONE 15MG/5ML ELIXIR (PEDIAPRED) 6.91 4.84
47080477 250 METRONIDAZOLE 20MG/ML SUSP 12.78 8.95
47080478 637 VITAMIN D3 1000U (25MCG) TAB 7.26 5.08
47080479 636 J1815 INSULIN GLARGINE 100U/ML 10 ML VIAL (LA 393.24 275.27
47080480 637 ROPINIROLE 0.5MG TAB (REQUIP) 7.26 5.08
47080481 637 NULYTELY 4000ML BOWEL PREP 102.32 71.62
47080482 250 DULOXETINE 20MG CAP (CYMBALTA) 15.49 10.84
47080484 250 ENTACAPONE 200MG TAB (COMTAN) 13.00 9.10
47080485 250 FISH OIL 500MG CAP 6.95 4.87
47080486 637 METFORMIN ER 500MG TAB (GLUCOPHAGE XR) 7.26 5.08
47080487 636 S0074 CEFOTETAN 1000MG VIAL (CEFOTAN) 54.61 38.23
47080488 637 VENLAFAXINE 75MG TAB (EFFEXOR) 9.68 6.78
47080490 637 BUDESONIDE & FORMOTEROL 160/4.5 INHALER 1,532.49 1,072.74
47080500 637 HEMORRHOIDAL GEL (PREPARATION H) 16.28 11.40
47080502 636 Q0163 DIPHENHYDRAMINE 12.5MG/5ML ORAL SYR 6.08 4.26
47080503 250 J2680 FLUPHENAZINE DECANOATE 25MG/ML INJ 165.00 115.50
47080504 637 GLYCERIN PEDIATRIC SUPPS 1.44 1.01
47080505 250 CHLORHEXIDINE GLUCONATE 4% SCRUB 8 OZ 25.27 17.69
47080506 250 CHLORHEXIDINE GLUCONATE 4% SCRUB 32 OZ 50.55 35.39
47080507 636 J1885 KETOROLAC 15MG/1ML INJ (TORADOL) 29.86 20.90
47080508 637 BETAXOLOL 0.5% OPTH SUSP (BETOPTIC) 149.91 104.94
47080510 637 PULMOCARE 240ML TUBE FEEDING 8.50 5.95
47080512 250 J7620 IPRATROPIUM/ALBUTEROL 3ML NEB (DUONEB) 10.27 7.19
47080513 636 J1644 HEPARIN 10,000U/ML 5 ML INJ 72.34 50.64
47080514 637 A9270GY MIDODRINE 5MG TAB 11.63 8.14
47080515 250 J2310 NALOXONE 2MG/2ML SYR (NARCAN) 180.15 126.11
47080516 637 LAMOTRIGINE 100MG TAB (LAMICTAL) 9.41 6.59
47080517 636 J1756 IRON SUCROSE 100MG/5ML INJ (VENOFER) 283.80 198.66
47080518 637 VITAMIN D3 400U TAB 1.16 0.81
47080519 250 LET SOLUTION 24.40 17.08
47080520 250 LIDOCAINE 2% W/EPI 10ML VIAL (XYLOCAINE 17.15 12.01
47080521 637 HALLS SF COUGH DROP 6.09 4.26
47080522 637 DEXTROMETHORPHAN COUGH SYRUP 3 OZ (DELSY 42.13 29.49
47080523 637 METOPROLOL TART 25MG TAB (LOPRESSOR) 6.91 4.84
47080524 637 ESOMEPRAZOLE 40MG TAB (NEXIUM) 24.06 16.84
47080525 636 Q0161 CHLORPROMAZINE 10MG TAB (THORAZINE) 7.26 5.08
47080526 636 J2997 ALTEPLASE 2MG (CATHFLO ACTIVASE) 789.78 552.85
47080527 637 VALACYCLOVIR 1000MG TAB (VALTREX) 45.90 32.13
47080528 637 OSMOPREP TAB 11.25 7.88
47080529 637 A9270GY HYDROCODONE/APAP TAB 10/650MG (LORCET) 6.00 4.20
47080530 637 ACETAMINOPHEN 325MG/10.15ML ELIXIR (TYLE 6.98 4.89
47080531 637 CARB/LEVO/ENTAC 100MG TAB (STALEVO) 16.32 11.42
47080532 637 IRBESARTAN/HYDROCHLOROTHIAZIDE 300/25MG 17.25 12.08
47080533 637 PRESERVISION W/ LUTEIN SOFTGEL 6.39 4.47
47080534 637 A9270GY NADOLOL 80MG TAB (CORGARD) 6.00 4.20
47080536 636 90653 INFLUENZA HIGH DOSE VACCINE 141.79 99.25
47080537 637 ROPINIROLE 1MG TAB (REQUIP) 6.64 4.65
47080538 637 CHLORTHALIDONE 25MG TAB (THALITONE) 6.91 4.84
47080539 636 J0885 EPOETIN ALPHA 40,000 U (PROCRIT) 4,517.45 3,162.22
47080541 637 DNU METOPROLOL XL TAB: 25MG (TOPROL) 6.64 4.65
47080542 637 NYSTATIN 100MU/ML SUSP 5ML U/D CUP 12.87 9.01
47080543 637 MUPIROCIN 15 GM CRM (BACTROBAN) 280.37 196.26
47080552 250 CRANBERRY TABLETS 450MG 6.95 4.87
47080559 636 J0131 ACETAMINOPHEN PREMIX IVPB: 1000MG/100ML 264.25 184.98
47080560 636 J1642 HEPARIN 100 U /ML 5ML SYR 18.02 12.61
47080562 637 ARIPIPRAZOLE 5MG TAB (ABILIFY) 148.76 104.13
47080563 250 MEPIVICAINE 2% 20ML INJ (CARBOCAINE) 31.81 22.27
47080564 637 SPIRONOLACTONE 50MG TAB (ALDACTONE) 6.64 4.65
47080566 636 J2916 FERRIC GLUCONATE 62.5 MG/5ML VIAL (FERRL 188.27 131.79
47080567 637 HYDROCODONE/APAP TAB 5/325MG (NORCO) 11.68 8.18
47080568 250 ACETYLCYSTEINE 10% 30ML VIAL (MUCOMYST) 79.50 55.65
47080569 250 J1572 FLEBOGAMMA 10GM/100ML 1,086.00 760.20
47080570 250 J1572 FLEBOGAMMA 20GM/400ML 2,171.75 1,520.23
47080572 250 NF-MELOXICAM ORAL TABLET 7.5MG 11.63 8.14
47080573 250 ALCOHOL DEHYDRATED 5ML AMP INJ 208.52 145.96
47080575 637 DUTASTERIDE 0.5 MG CAP (AVODART) 18.25 12.78
47080576 637 ERYTHROMYCIN 400MG/5ML SUSP (E.E.S) 122.76 85.93
47080577 636 J1165 PHENYTOIN 100MG/2ML INJ (DILANTIN) 30.22 21.15
47080579 636 J3475 MAGNESIUM SULFATE 5000MG/10ML INJ 96.75 67.73
47080580 250 MULTITRACE-4 MDV 10ML 94.03 65.82
47080581 250 J1170 HYDROMORPHONE 10MG/ML SDV (DILAUDID HP) 26.00 18.20
47080582 637 CARVEDILOL 12.5 MG TAB (COREG) 9.95 6.97
47080583 637 DIALYVITE RENAL MVI TAB 9.29 6.50
47080584 637 DABIGATRAN 150 MG CAP (PRADAXA) 20.47 14.33
47080586 637 BIMATOPROST 0.03% OPHTH 2.5ML (LUMIGAN) 477.37 334.16
47080587 637 POTASSIUM CITRATE TAB 10MEQ (UROCIT K) 7.55 5.29
47080588 250 POLIDOCANOL 1% 2ML INJ (ASCLERA) 387.44 271.21
47080589 250 INTRALIPID 20% 500ML 284.01 198.81
47080590 636 J1815 INSULIN REGULAR 100 U/ML 10 ML VIAL (HUM 335.17 234.62
47080591 637 METHAZOLAMIDE 25MG TAB (NEPTAZANE) 6.64 4.65
47080592 637 VENLAFAXINE XR 150MG CAP (EFFEXOR XR) 24.06 16.84
47080593 636 J1170 HYDROMORPHONE PCA 0.2MG/ML (DILAUDID PCA 86.28 60.40
47080594 250 NACL 0.9% BACTERIOSTATIC 20ML VIAL 28.76 20.13
47080595 637 NUTRIHEP (HEPATIC FORM) SUPP 250ML 76.05 53.24
47080596 250 PREFILLED SYR 0.5ML TDaP (ADACEL) 216.46 151.52
47080597 636 J0132 ACETYLCYSTEINE 6000MG/30ML INJ 1,032.60 722.82
47080598 637 VASOLEX 60GM OINT 269.92 188.94
47080599 636 Q0162 ONDANSETRON ODT 8MG TAB (ZOFRAN ODT) 178.97 125.28
47080600 636 J1652 FONDAPARINUX 5MG/0.4ML INJ (ARIXTRA) 587.48 411.24
47080601 636 J1652 FONDAPARINUX 7.5MG/0.6ML INJ (ARIXTRA) 587.48 411.24
47080602 250 LEVOTHRYOXINE 100MCG INJ 487.62 341.33
47080603 637 VITAMIN A & D OINT 56.7GM TUBE 10.74 7.52
47080604 250 NACL 0.45% 250ML IV FLUID 28.76 20.13
47080605 637 ATORVASTATIN 40MG TAB (LIPITOR) 25.99 18.19
47080606 637 ATORVASTATIN 10MG TAB (LIPITOR) 17.98 12.59
47080607 637 NEOSTIGMINE 15MG TAB (PROSTIGMIN) 8.85 6.20
47080608 637 VITAMIN B-12 250 MCG TAB 7.03 4.92
47080609 636 J1741 IBUPROFEN 800MG/200ML IVPB (CALDOLOR) 121.15 84.81
47080610 637 GY HYDROCORTISONE 5MG TAB (CORTEF) 6.68 4.68
47080611 637 SEVELAMER HCL 800MG TAB (RENAGEL) 16.56 11.59
47080612 637 RIVAROXABAN 10MG (XARELTO) 84.71 59.30
47080613 250 ENOXAPARIN SQ 40MG/0.4ML (LOVENOX) 155.43 108.80
47080614 637 DIVALPROEX ER 500MG TAB 22.26 15.58
47080615 250 J1950 LUPRON DEPOT 22.5MG 3 MONTH KIT 9,679.75 6,775.83
47080616 636 J1815 INSULIN DETEMIR 10ML VIAL (LEVEMIR) 622.50 435.75
47080620 637 MELOXICAM 7.5MG TAB (MOBIC) 15.11 10.58
47080621 637 TRIMETHOPRIM 100MG TAB (PRIMSOL) 6.64 4.65
47080622 636 J1580 GENTAMICIN 40MG/ML 20ML VIAL 112.96 79.07
47080623 637 CARBOXYMETHYLCELLULOSE EYE OINT 3.5GM 40.68 28.48
47080624 250 ENOXAPARIN SQ 30MG/0.3ML (LOVENOX) 129.58 90.71
47080626 343 A9562 NM RENAL DOSE (TC MAG3) 1,700.26 1,190.18
47080627 343 A9537 NM HEPATOBILIARY DOSE- CHO 205.66 143.96
47080629 637 ROFLUMILAST 500MG TAB (DALIRESP) 31.53 22.07
47080630 343 A9560 NM MUGA DOSE (PYP) 149.91 104.94
47080631 343 A9500 NM CARDIOLITE DOSE (TC) 332.00 232.40
47080632 343 A9503 NM BONE DOSE (TCMDP) 123.65 86.56
47080635 343 A9520 NM TC99 FILTERED 836.76 585.73
47080636 343 A9521 NM Tc99m CERETEC 2,154.67 1,508.27
47080637 637 SYSTANE BALANCE EYE DROP 10ML 39.82 27.87
47080638 637 DARIFENACIN 7.5MG TAB (ENABLEX) 23.82 16.67
47080639 250 RIFAMPIN 600MG VIAL (RIFADIN) 355.35 248.75
47080640 250 J9280 MITOMYCIN 40MG VIAL 5,662.56 3,963.79
47080641 250 MITOMYCIN 5MG VIAL 210.50 147.35
47080642 637 RAMIPRIL 10MG CAP (ALTACE) 6.00 4.20
47080644 250 ENOXAPARIN SQ 100MG/ML (LOVENOX) 316.11 221.28
47080645 637 CORICIDIN HBP COUGH & CONGESTION 6.98 4.89
47080646 343 A9516 NM IODINE 123 326.56 228.59
47080647 636 J9357 VALRUBICIN 800MG/20ML (VALSTAR) 21,593.65 15,115.56
47080649 343 A9567 TECHNETIUM Tc 99 PENTELATE DIAGNOSTIC 448.89 314.22
47080650 250 A9270GY ACETAZOLAMIDE 250MG TAB (DIAMOX) 5.75 4.03
47080651 250 A9270GY HYDROCODONE/IBUPROFEN 7.5MG/200MG (VICOP 6.25 4.38
47080652 636 J0883 ARGATROBAN 125MG/125ML PREMIX 3,396.17 2,377.32
47080653 250 ACYCLOVIR 5% 15GM OINT (ZOVIRAX) 652.56 456.79
47080654 636 J2795 ROPIVACAINE 1% 20ML INJ (NAROPIN) 58.08 40.66
47080655 636 J1650 ENOXAPARIN SQ 60MG/0.6ML (LOVENOX) 138.30 96.81
47080656 636 J0278 AMIKACIN 1000MG/4ML INJ 130.14 91.10
47080658 250 NF-VIIBRYD ORAL TABLET 10MG 20.97 14.68
47080659 250 NIACIN ER 500MG TAB 25.38 17.77
47080660 250 NF- FELODIPINE TABLET ER 5MG 8.54 5.98
47080661 250 NF-LOSARTAN POTASSIUM ORAL TABLET 100MG 24.33 17.03
47080662 250 NF-CLONAZEPAM ORAL TABLET 1MG 7.52 5.26
47080663 250 NF-LOSARTAN POTASSIUM ORAL TABLET 100MG 20.96 14.67
47080664 250 NF-MECLICOT TAB 12.5MG 0.06 0.04
47080665 250 NF-MECLIZINE HCL ORAL TABLET 12.5MG 3.29 2.30
47080666 250 NF-BIOBRANE GLOVES 986.16 690.31
47080667 250 NF-CORDRAN SP TOPICAL CREAM 0.05% 9.12 6.38
47080668 250 NF-MEMANTINE HCL TAB 10MG 20.89 14.62
47080669 250 NF-NEO AC ORAL SYRUP 10MG-30MG-15MG/5ML 0.79 0.55
47080670 250 NF-JANUVIA ORAL TABLET 100MG 34.10 23.87
47080671 343 A9512 NM Tc99m Pertechnetate Dose 115.33 80.73
47080674 636 J9267 PACLITAXEL 6MG/ML INJ 590.56 413.39
47080675 636 J9045 CARBOPLATIN 150 MG/15ML INJ 672.55 470.79
47080677 636 J2785 REGADENOSON 0.4MG/5ML INJ 1,355.34 948.74
47080678 250 NF-CHERATUSSIN AC SYR 10MG-100MG/5ML 0.06 0.04
47080679 250 NF-FEXOFENADINE HCL ORAL TABLET 180MG 30.38 21.27
47080680 636 J1170 HYDROMORPHONE 1MG/ML INJ 27.10 18.97
47080681 250 NF-LEVOTHYROXINE IV PWD FOR SOLN 100MCG 306.81 214.77
47080682 250 NF-ATACAND HCT TAB 16MG-12.5MG 13.59 9.51
47080683 250 NF-RISPERDAL ORAL TABLET 0.5MG 21.23 14.86
47080684 250 NF-LYRICA CAP 100MG 16.24 11.37
47080685 250 NF-LOSARTAN POTASSIUM ORAL TABLET 100MG 12.33 8.63
47080686 250 NF-ISOSORBIDE DINITRATE ORAL TABLET 30MG 5.57 3.90
47080687 250 NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30 2.96 2.07
47080688 250 NF-PROTONIX ORAL TABLET 40MG 20.24 14.17
47080689 250 NF-ATORVASTATIN CALCIUM ORAL TAB 20MG 24.30 17.01
47080690 250 NF-PANTOPRAZOLE SODIUM ORAL TAB EC 40MG 26.05 18.24
47080691 250 NF-RABEPRAZOLE SODIUM TAB EC 20MG 41.06 28.74
47080692 250 NF-CRESTOR TAB 10MG 26.99 18.89
47080693 250 NF-ZESTRIL TABLET 10MG 6.22 4.35
47080694 250 NF-ESCITALOPRAM ORAL TABLET 10MG 1.04 0.73
47080695 250 NF-ESCITALOPRAM ORAL TABLET 20MG 18.04 12.63
47080696 250 NF-CITALOPRAM HBR ORAL TAB 40MG 1.46 1.02
47080697 250 NF-LISINOPRIL ORAL TABLET 10MG 4.55 3.19
47080698 250 NF-LISINOPRIL ORAL TABLET 40MG 6.90 4.83
47080699 250 NF-MELOXICAM ORAL TAB 15MG 22.39 15.67
47080700 250 NF-TRAZODONE HCL ORAL TABLET 100MG 3.41 2.39
47080701 636 J1250 DOBUTAMINE 250MG/250ML PREMIX 79.09 55.36
47080702 250 NF-LEVOTHYROXINE ORAL TABLET 0.2MG 2.95 2.07
47080703 250 NF-MELATONIN 3MG 0.16 0.11
47080704 250 NF-LABETALOL HCL ORAL TABLET 200MG 3.52 2.46
47080705 250 NF-CLONAZEPAM DISINTEGRATING TAB 1MG 6.55 4.59
47080706 250 NF-DOXAZOSIN MESYLATE ORAL TABLET 8MG 4.80 3.36
47080707 250 NF-TERAZOSIN HCL CAP 2MG 7.46 5.22
47080709 636 J2550 PROMETHAZINE 25MG/ML 1ML INJ (PHENERGAN 28.48 19.94
47080710 250 NF-NIFEDIPINE ER TABLET 90MG 26.41 18.49
47080711 636 J3360 DIAZEPAM 5 MG/ML 10 ML INJ 88.12 61.68
47080712 636 90715 TETANUS TOX/DIPHTH/PERTUS INJ (ADACEL) 258.54 180.98
47080713 250 NF-DEMECLOCYCLINE HCL TAB 300MG 79.34 55.54
47080714 250 NF-DEMECLOCYCLINE HCL ORAL TABLET 300MG 89.01 62.31
47080715 250 NF-BETAINE HYDROCHLORIDE POWDER 0.10 0.07
47080716 250 PROPARACAINE 0.5% OPHTH DROP 203.99 142.79
47080717 250 TERAZOSIN 1 MG CAP (HYTRIN) 15.98 11.19
47080718 250 NF-TERAZOSIN HCL CAP 2MG 7.46 5.22
47080719 250 NF-PRADAXA ORAL CAPSULE 75MG 19.36 13.55
47080720 250 NF-ICAPS ORIGINAL ORAL TABLET 0.72 0.50
47080721 250 TROPICAMIDE 1% OPHTH SOLN 2ML 46.49 32.54
47080722 250 NF-VOTRIENT TAB 200MG 286.82 200.77
47080723 250 NF-PRILOSEC CAP DR 40MG 43.29 30.30
47080724 250 NF-FERREX 150 FORTE CAP 25MCG-1MG-150MG 1.28 0.90
47080725 250 NF-MELOXICAM ORAL TABLET 15MG 19.38 13.57
47080726 250 NF-PROCARDIA XL TABLET 60MG 14.32 10.02
47080727 250 NF-EFFIENT ORAL TABLET 10MG 44.04 30.83
47080728 250 NF-FEOSOL ORAL TABLET 45MG 0.98 0.69
47080729 250 NF-MEPROBAMATE ORAL TABLET 200MG 6.19 4.33
47080730 250 NF-AMITRIPTYLINE HCL ORAL TABLET 100MG 6.13 4.29
47080731 250 NF-PRAZOSIN HCL CAP 1MG 2.22 1.55
47080732 250 NF-LISINOPRIL ORAL TABLET 10MG 3.16 2.21
47080733 250 NF-LISINOPRIL ORAL TABLET 40MG 6.16 4.31
47080734 250 NF-XARELTO TAB 20MG 41.00 28.70
47080735 250 NF-NIFEDIPINE EXTENDED RELEASE TABLET 90 14.08 9.86
47080736 250 NF-CALCIUM CITRATE + D TABLET 0.37 0.26
47080737 250 NF-ENALAPRIL MALEATE ORAL TABLET 2.5MG 3.15 2.21
47080738 250 NF-OYSCO D TABLET 250MG-125IU 0.04 0.03
47080739 250 NF-OXAPROZIN ORAL TABLET 600MG 6.79 4.75
47080740 250 NF-PANTOPRAZOLE SODIUM ORAL TAB EC 40MG 45.68 31.98
47080741 250 NF-FELODIPINE TAB ER 10MG 14.75 10.33
47080742 250 NF-OMEGA-3 CAPSULE 0.31 0.22
47080743 250 NF-ACYCLOVIR CAP 200MG 5.96 4.17
47080744 636 J0133 ACYCLOVIR 1000MG/20ML INJ 156.19 109.33
47080746 258 CLINIMIX 5/20 1000 ML 218.49 152.94
47080749 636 C9290 BUPIVICAINE LIPOSOM 1.3% 20ML (EXPAREL) 2,004.88 1,403.42
47080750 258 CLINIMIX 5/20 2000 ML 397.31 278.12
47080751 250 NF-ATENOLOL TAB 100MG 4.87 3.41
47080752 250 NF-ZYRTEC ORAL TABLET 10MG 11.00 7.70
47080754 250 NF-ABILIFY TAB 10MG 101.67 71.17
47080755 250 NF-VIMOVO TAB DR 20MG-500MG 9.27 6.49
47080756 250 NF-VERAPAMIL HCL CAP ER 120MG 6.74 4.72
47080757 250 NF-RIFAXIMIN TAB 550MG 109.29 76.50
47080758 250 NF-ACETAMINOPHEN CAP 650MG 0.98 0.69
47080759 250 NF-LOSARTAN POTASSIUM ORAL TABLET 25MG 1.19 0.83
47080760 250 NF-XARELTO ORAL TABLET 20MG 41.00 28.70
47080761 250 DONEPEZIL 5MG TAB (ARICEPT) 34.46 24.12
47080762 250 NF-AVALIDE ORAL TABLET 150MG-12.5MG 19.18 13.43
47080763 250 NF-ACTONEL TAB 35MG 187.10 130.97
47080764 250 NF-RIFAXIMIN TAB 550MG 116.95 81.87
47080765 250 NF-SPIRONOLACTONE ORAL TABLET 100MG 6.22 4.35
47080766 250 NF-METOCLOPRAMIDE HCL ORAL TABLET 5MG 2.48 1.74
47080767 250 DOCETAXEL 20MG/2ML INJ 926.78 648.75
47080768 250 NF-JANUVIA ORAL TABLET 100MG 43.53 30.47
47080769 637 SODIUM CITRATE & CITRIC ACID 15 ML SOLN 6.63 4.64
47080770 637 SULFASALAZINE 500 MG TAB (AZULFADINE) 6.31 4.42
47080771 250 NF-STALEVO 200 TAB 50MG-200MG-200MG 23.37 16.36
47080772 250 NF-OMEPRAZOLE CAP DR 40MG 3.22 2.25
47080773 250 NF-NASONEX SPRAY 0.05MG/INH 697.31 488.12
47080774 250 NF-LOSARTAN-HCTZ ORAL TABLET 100MG-25MG 15.85 11.10
47080775 250 NF-LOSARTAN POTASSIUM ORAL TABLET 100MG 12.33 8.63
47080776 250 NF-RAPAFLO CAP 8MG 24.95 17.47
47080777 250 GY LIDOCAINE 2% TOPICAL 5 ML SYRINGE 32.07 22.45
47080778 637 SILODOSIN 8MG CAP (RAPAFLO) 24.95 17.47
47080779 250 NF-LUMIGAN OPHTH SOLN 0.01% 202.21 141.55
47080780 250 NF-PRAVACHOL ORAL TABLET 20MG 20.36 14.25
47080781 250 NF-LISINOPRIL AND HCTZ TABLET 20MG-25MG 5.64 3.95
47080782 250 NF-CARBAMAZEPINE CAP ER 200MG 1.73 1.21
47080783 250 NF-CARBAMAZEPINE CAP ER 200MG 20.33 14.23
47080784 250 NF-CARBAMAZEPINE ORAL TAB ER 400MG 13.01 9.11
47080785 250 NF-DIOVAN TAB 320MG 26.97 18.88
47080786 250 NF-HYDRALAZINE HCL ORAL TABLET 100MG 4.70 3.29
47080787 250 NF-AMLODIPINE BESYLATE ORAL TABLET 10MG 11.14 7.80
47080788 250 NF-PLAVIX TAB 75MG 34.22 23.95
47080789 250 NF-ATENOLOL ORAL TABLET 100MG 11.08 7.76
47080790 250 NF-METFORMIN HCL ORAL TABLET 1000MG 20.64 14.45
47080791 250 NF-RANITIDINE HCL CAPSULE 300MG 12.74 8.92
47080792 250 NF-FLUDROCORTISONE ACETATE ORAL TAB 0.1M 8.07 5.65
47080793 250 NF-DYAZIDE CAPSULE 3.04 2.13
47080794 250 NF-POTASSIUM CHLORIDE CAP ER 10MEQ 9.45 6.62
47080795 250 NF-PREDNISONE ORAL TABLET 10MG 1.57 1.10
47080796 250 NF-GLYBURIDE TAB 5MG 3.26 2.28
47080797 250 NF-HYDRALAZINE HCL ORAL TABLET 50MG 2.21 1.55
47080798 250 NF-PAROXETINE HCL ORAL TABLET 10MG 11.77 8.24
47080799 250 NF-OMEPRAZOLE CAP DR 20MG 24.74 17.32
47080800 250 NF-LOSARTAN K AND HCTZ TABLET 100MG-25MG 15.85 11.10
47080801 250 NF-AMLODIPINE & BENAZEPRIL HCL 5MG-10MG 12.58 8.81
47080802 250 NF-AMLODIPINE BESYLATE ORAL TABLET 5MG 7.66 5.36
47080803 250 NF-LEVOTHYROXINE ORAL TABLET 0.1MG 1.97 1.38
47080804 250 NF-GABAPENTIN ORAL TABLET 600MG 11.17 7.82
47080805 250 NF-TRAMADOL HCL TAB 50MG 7.74 5.42
47080806 250 NF-SPIRIVA INH/NEB CAP 18MCG 41.48 29.04
47080807 250 NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG 128.81 90.17
47080809 250 NF-REMERON TAB 30MG 22.97 16.08
47080810 250 NF-CARBAMAZEPINE CAP ER 300MG 20.33 14.23
47080811 637 BAG BALM OINTMENT 37.94 26.56
47080812 250 NF-QUETIAPINE FUMARATE ORAL TABLET 100MG 3.35 2.35
47080813 250 NF-QUETIAPINE FUMARATE ORAL TABLET 50MG 29.06 20.34
47080814 250 NF-SERTRALINE HCL TAB 50MG 13.10 9.17
47080815 250 NF-METHADONE HCL TAB 5MG 1.14 0.80
47080816 250 NF-GABAPENTIN CAP 400MG 9.47 6.63
47080817 250 NF-ASACOL HD TAB DR 800MG 20.26 14.18
47080818 250 NF-PREDNISOLONE ACETATE INJ SUSP 25MG/1M 1.68 1.18
47080819 250 NF-PREDNISOLONE ACETATE OPHTH SUSP 1% 10.55 7.39
47080820 250 NF-JANUVIA ORAL TABLET 100MG 43.53 30.47
47080821 250 NF-IMDUR TAB ER 30MG 9.57 6.70
47080822 250 NF-GLIMEPIRIDE ORAL TABLET 1MG 1.78 1.25
47080823 250 NF-LISINOPRIL AND HCTZ TABLET 10MG-12.5M 5.16 3.61
47080824 250 NF-LOSARTAN POTASSIUM ORAL TABLET 100MG 13.63 9.54
47080825 250 NF-PINDOLOL TABLET 10MG 6.25 4.38
47080826 250 NF-TRILIPIX CAP DR 135MG 30.99 21.69
47080827 250 NF-BUDESONIDE CAP DR 3MG 65.85 46.10
47080828 250 NF-WELCHOL ORAL TABLET 625MG 8.71 6.10
47080829 250 NF-COMBIGAN OPHTH SOLN 0.2%-0.5% 104.62 73.23
47080830 250 NF-LUMIGAN OPHTH SOLN 0.01% 233.62 163.53
47080831 250 NF-HYDROCODONE & HOMATROPINE SYR 5-1.5/5 1.83 1.28
47080832 250 NF-POLY VITAMIN LIQUID 0.60 0.42
47080833 250 NF-POLYETHYLENE GLYCOL 300 SOLUTION 2.32 1.62
47080834 250 NF-PRADAXA CAP 75MG 22.15 15.51
47080835 250 NF-ETODOLAC ORAL TABLET 400MG 7.52 5.26
47080836 250 NF-NITRO-DUR TD PATCH ER 0.1MG/1HR 18.76 13.13
47080837 250 NF-TEGRETOL-XR ORAL TAB ER 400MG 14.86 10.40
47080838 250 NF-BUPROPION HCL SR ORAL TABLET ER 200MG 17.81 12.47
47080839 250 NF-NORCO TAB 325MG-7.5MG 12.88 9.02
47080840 250 NF-METOLAZONE ORAL TABLET 5MG 7.20 5.04
47080841 250 NF-ATORVASTATIN CALCIUM ORAL TAB 20MG 22.28 15.60
47080842 250 NF-12 HOUR DECONGESTANT ORAL TAB ER 120M 1.90 1.33
47080843 250 NF-BISMUTH METALLICUM TABLET 0.57 0.40
47080844 250 CALCIUM GLUCONATE 500MG TAB 6.31 4.42
47080845 250 NF-LEVOTHYROXINE SODIUM ORAL TABLET 175M 4.37 3.06
47080846 250 NF-PRAVACHOL ORAL TABLET 40MG 29.77 20.84
47080847 250 NF-ORGAN-1 NR TAB 200MG 0.88 0.62
47080848 250 NF-MELOXICAM ORAL TABLET 15MG 21.43 15.00
47080849 250 NF-VITAMIN D ORAL CAPSULE 5000IU 0.55 0.39
47080850 250 SUPREP BOWEL PREP KIT 562.07 393.45
47080851 250 BOWEL PREP KIT 16 OZ 399.75 279.83
47080852 250 VITAMIN D 50,000IU CAP (ERGOCALIFEROL) 6.63 4.64
47080854 250 VITAMIN D3 5000U CAP 6.63 4.64
47080855 250 CALCIUM CITRATE 250 MG TAB 6.31 4.42
47080856 250 NF-DESMOPRESSIN ACETATE ORAL TABLET 0.2M 17.47 12.23
47080857 250 NF-EPLERENONE ORAL TABLET 25MG 16.41 11.49
47080858 250 HEPLOCK 10,000units/10ML SYRINGE 18.89 13.22
47080859 250 DESMOPRESSIN ACETATE 0.1MG TAB 14.04 9.83
47080861 250 NF-EPLERENONE ORAL TABLET 25MG 18.15 12.71
47080862 250 NF-ZIPRASIDONE HCL CAP 40MG 55.00 38.50
47080863 250 NF-PROCARBAZINE HCL CAP 50MG 3.23 2.26
47080864 250 HYDROMORPHONE 1MG/ML SOLN 8 ML 576.00 403.20
47080865 250 NF-AMLODIPINE BESYLATE ORAL TABLET 2.5MG 8.05 5.64
47080866 250 NF-LABETALOL HCL ORAL TABLET 200MG 4.54 3.18
47080867 250 NF-LISINOPRIL ORAL TABLET 40MG 9.44 6.61
47080868 250 NAPROXEN ORAL TABLET 220MG 6.31 4.42
47080869 250 NF-METFORMIN HCL ORAL TABLET 1000MG 8.77 6.14
47080870 250 NF-FEOSOL ORAL TABLET 45MG 0.62 0.43
47080871 250 NF-JANUVIA ORAL TABLET 50MG 45.71 32.00
47080872 250 NF-ENABLEX TAB ER 7.5MG 40.32 28.22
47080873 250 FIBERCON TAB 625MG 7.47 5.23
47080874 250 NF-FLUVASTATIN ORAL CAPSULE 20MG 20.16 14.11
47080875 250 NF-FERREX 150 CAPSULE 150MG 1.21 0.85
47080876 250 NF-OMEPRAZOLE CAP DR 40MG 27.61 19.33
47080877 250 NF-FLOVENT HFA INH/NEB AER PWD 0.22MG/1A 123.95 86.77
47080878 250 NF-SEREVENT DISKUS DISK 0.046MG/ACT 11.35 7.95
47080879 250 NF-MIRAPEX ORAL TABLET 1.5MG 10.35 7.25
47080880 250 NF-LISINOPRIL ORAL TABLET 5MG 2.12 1.48
47080881 250 NF-NIFEDIPINE ORAL TAB ER 60MG 10.44 7.31
47080882 250 NF-PROTONIX ORAL TABLET 40MG 20.24 14.17
47080883 250 NF-CYMBALTA CAP DR 30MG 20.89 14.62
47080884 250 PRASUGREL 10MG TAB (EFFIENT) 43.97 30.78
47080885 250 NF-LOVASTATIN ORAL TABLET 40MG 17.43 12.20
47080886 250 NF-TIMOLOL MALEATE OPHTH SOLN 0.25% 11.25 7.88
47080887 637 FENOFIBRATE 160MG TAB (TRICOR) 31.55 22.09
47080888 250 J7626 BUDESONIDE NEB 0.5MG/2ML(PULMICORT) 68.22 47.75
47080889 250 NF-PROBENECID TAB 500MG 5.58 3.91
47080890 250 NF-HYDROXYZINE HCL ORAL TABLET 10MG 2.90 2.03
47080891 250 NF-HYDROCODONE AND APAP TAB 7.5MG-325MG 2.88 2.02
47080892 250 NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG 4.05 2.84
47080893 250 NF-SIMVASTATIN ORAL TABLET 20MG 0.38 0.27
47080894 250 NF-K-DUR TAB ER 20MEQ 5.00 3.50
47080895 636 J1953 LEVETIRACETAM 1000MG IVPB PREMIX 254.40 178.08
47080896 250 NF-LISINOPRIL ORAL TABLET 2.5MG 3.00 2.10
47080898 636 J1953 LEVETIRACETAM 500MG/5ML 5ML INJ 166.12 116.28
47080899 637 HYDROCODONE/APAP TAB 7.5/325MG(NORCO) 6.98 4.89
47080900 636 Q0138 FERUMOXYTOL 510MG/17ML INJ(FERAHEME) 2,857.84 2,000.49
47080902 250 NF-GLIMEPIRIDE ORAL TABLET 2MG 3.90 2.73
47080903 250 GLIMEPERIDE 2MG TAB (AMARYL) 6.75 4.73
47080904 250 NF-SIMVASTATIN ORAL TABLET 20MG 21.77 15.24
47080905 250 NF-POTASSIUM CHLORIDE ORAL TAB ER 20MEQ 4.62 3.23
47080906 637 SITAGLIPTIN 50MG TAB (JANUVIA) 88.45 61.92
47080907 250 NF-METOLAZONE ORAL TABLET 5MG 6.67 4.67
47080908 250 NF-POTASSIUM CHLORIDE ORAL TAB ER 20MEQ 13.51 9.46
47080909 250 NF-DEXTROSE INJECTION 10% 0.01 0.01
47080910 636 J1953 LEVETIRACETAM 500MG PREMIX (KEPPRA) 152.60 106.82
47080911 250 LEVETIRACETAM 100MG/ML ORAL SOLN 120ML 399.75 279.83
47080912 250 NF-TEMAZEPAM CAP 15MG 1.51 1.06
47080913 250 NF-TEMAZEPAM CAP 7.5MG 38.13 26.69
47080915 250 NF-MORPHINE SULFATE IR ORAL TABLET 15MG 1.76 1.23
47080917 636 J0282 AMIODARONE 450MG/9ML (50MG/ML)CORDARONE 40.96 28.67
47080922 636 J1953 LEVETIRACETAM 500MG/5ML 5ML INJ 40.71 28.50
47080926 637 ATORVASTATIN 20MG TAB (LIPITOR) 24.67 17.27
47080935 250 NF-LEVAQUIN ORAL TABLET 750MG 97.11 67.98
47080937 250 NF-KETOROLAC TROMETHAMINE OPHTH SOLN 0.5 85.02 59.51
47080939 250 NF-KAYEXALATE PWD FOR SUSP 5.95 4.17
47080942 250 NF-PRAZOSIN HCL CAP 2MG 4.23 2.96
47080944 637 NEPHRO-VITE TAB 6.68 4.68
47080945 250 POTASSIUM CHLORIDE/NS IVPB: 20MEQ/100ML 28.48 19.94
47080946 250 NF-CITALOPRAM ORAL TABLET 20MG 8.44 5.91
47080947 637 A9270GY NEPHRO-VITE TAB 5.75 4.03
47080948 250 J7608 ACETYLCYSTEINE 20% INH RESP SOLN 4ML(MUC 70.74 49.52
47080952 250 NF-LISINOPRIL AND HCTZ TABLET 12.5MG-20M 5.58 3.91
47080953 637 NITROGLYCERIN 2% OINT 1 GM PKT(NITROBID) 14.59 10.21
47080954 250 TICAGRELOR 90MG TAB (BRILINTA) 22.40 15.68
47080956 636 Q0138 FERUMOXYTOL INJ 510MG/17ML 2,557.40 1,790.18
47080957 250 NF-CILOSTAZOL ORAL TABLET 50MG 8.08 5.66
47080958 250 NF-ALBUTEROL ORAL TABLET 4MG 2.51 1.76
47080959 250 NF-RAMIPRIL CAP 10MG 12.93 9.05
47080960 250 NF-CRESTOR TAB 20MG 16.87 11.81
47080961 250 NF-ISOSORBIDE DINITRATE ORAL TABLET 10MG 4.57 3.20
47080969 250 NF-GALANTAMINE HBR ORAL CAP ER 8MG 28.38 19.87
47080970 250 NF-LISINOPRIL ORAL TABLET 40MG 2.25 1.58
47080971 250 NF-METOCLOPRAMIDE HCL ORAL TABLET 10MG 2.32 1.62
47080972 250 NF-METOCLOPRAMIDE HCL ORAL TABLET 5MG 2.48 1.74
47080973 250 NF-JANUVIA ORAL TABLET 100MG 50.09 35.06
47080974 73 NF-ACEBUTOLOL HYDROCHLORIDE CAP 400MG 5.78 4.05
47080975 250 TROPICAMIDE OPHTH SOLN 1% 2ML 40.00 28.00
47080976 250 NF-TIMOLOL MALEATE OPHTH SOLN 0.25% 5.31 3.72
47080977 250 NF-ALLOPURINOL ORAL TABLET 300MG 2.90 2.03
47080978 250 NF-TIMOPTIC IN OCUDOSE OPHTH SOLUTION 0. 25.16 17.61
47080979 250 NF-ALPHAGAN P OPHTH SOLN 0.1% 101.50 71.05
47080980 250 NF-DORZOLAMIDE HCL OPHTH SOLN 2% 31.03 21.72
47080981 250 NF-HYDREA CAPSULE 500MG 5.58 3.91
47080982 250 NF-CELEXA TAB 20MG 19.99 13.99
47080984 250 CLARITHROMYCIN ORAL SUSP 250MG/5ML 50ML 247.82 173.47
47080985 250 NF-PROBENECID AND COLCHICINE 500MG-0.5MG 76.37 53.46
47080986 250 NF-LITHIUM CARBONATE CAP 600MG 1.73 1.21
47080987 73 NF-TIMOLOL MALEATE OPHTH SOLN 0.5% 13.60 9.52
47080988 250 NF-TIMOLOL MALEATE OPHTH SOLN 0.5% 13.31 9.32
47080989 250 NF-JALYN ORAL CAPSULE 0.5MG-0.4MG 26.30 18.41
47080990 250 NF-SIMVASTATIN ORAL TABLET 10MG 2.40 1.68
47080991 250 APIXABAN 2.5MG TABLET 44.20 30.94
47080992 250 NF-TRIAMTERENE AND HCTZ TABLET 75MG-50MG 5.17 3.62
47080993 250 NF-ZONISAMIDE CAP 25MG 27.78 19.45
47080994 250 NF-ZONISAMIDE CAP 50MG 4.85 3.40
47080995 250 NF-Zonisamide Oral Capsule 50MG 3.31 2.32
47080996 250 NF-FEOSOL ORAL TABLET 65MG 0.30 0.21
47080997 250 NF-CALCIUM 600/VITAMIN D CAPSULE 0.27 0.19
47080998 250 NF-AFINITOR ORAL TABLET 10MG 1,643.56 1,150.49
47080999 250 NF-EXEMESTANE ORAL TABLET 25MG 80.93 56.65
47081000 250 NF-Brimonidine Tartrate Ophth Soln 0.2% 16.28 11.40
47081001 250 NF-Dorzolamide Hydrochloride and Timolol 49.00 34.30
47081002 73 NF-Levaquin Oral Tablet 750MG 87.00 60.90
47081003 250 NF-DORZOLAMIDE HCL-TIMOLOL 22.3MG-6.8MG/ 57.00 39.90
47081004 250 NF-PLAQUENIL TAB 200MG 22.69 15.88
47081005 250 NF-ARAVA ORAL TABLET 20MG 87.06 60.94
47081006 250 NF-VITAMIN B COMPLEX ORAL TABLET 0.44 0.31
47081008 250 NF-GLUCOS-AMINE ORAL CAPSULE 500MG 0.68 0.48
47081009 250 NF-DOPamine HCl Injection 160MG/ML 6.98 4.89
47081010 250 NF-RISPERDAL CONSTA IM PWD FOR SUSP ER 5 3,593.35 2,515.35
47081011 250 NF-NAMENDA XR ORAL CAPSULE ER 21MG 55.21 38.65
47081012 250 NF-QUETIAPINE FUMARATE ORAL TABLET 300MG 75.06 52.54
47081013 250 NF-ENEMA RECTAL LIQUID 0.02 0.01
47081014 250 NF-ARMOUR THYROID ORAL TABLET 90MG 1.69 1.18
47081015 250 NF-Pravastatin Sodium Oral Tablet 20MG 13.00 9.10
47081016 250 NF-SYSTANE BALANCE OPHTH SOLN 0.6% 4.85 3.40
47081017 250 NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.2% 15.84 11.09
47081018 250 NF-ELOCON CREAM 0.1% 11.77 8.24
47081019 250 NF-VITAMIN B COMPLEX CAPSULE 0.41 0.29
47081020 250 NF- FELODIPINE TABLET ER 5MG 7.79 5.45
47081021 250 NF-SYNTHROID ORAL TABLET 0.075MG 2.97 2.08
47081022 250 NF-SYNTHROID ORAL TABLET 0.1MG 3.05 2.14
47081023 250 NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI 0.05 0.04
47081024 250 NF-MEPROBAMATE TAB 200MG 0.08 0.06
47081025 250 NF-MEPROBAMATE ORAL TABLET 200MG 30.42 21.29
47081026 250 BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI 14.79 10.35
47081027 250 NF-CANDESARTAN CILEXETIL ORAL TABLET 32M 20.80 14.56
47081028 250 NF-LIBRAX CAPSULE 154.49 108.14
47081029 250 NF-FENOFIBRATE ORAL TABLET 145MG 20.60 14.42
47081030 250 NF-TIMOLOL MALEATE OPHTH SOLN 0.5% 207.08 144.96
47081031 73 NF- POTASSIUM BROMIDE CRYSTAL 0.19 0.13
47081032 250 NF- ALTAVERA TAB 30MCG-0.15MG-NA 4.42 3.09
47081033 250 NF-TIMOLOL MALEATE OPHTH GEL DROP 0.5% 152.58 106.81
47081034 250 NF-Omeprazole Delayed-Release Capsule 40 39.51 27.66
47081035 250 NF-BUDESONIDE CAP DR 3MG 87.61 61.33
47081036 250 NF-15% AMINO ACIDS INTRAVENOUS SOLUTION 0.11 0.08
47081037 250 NF-METHIMAZOLE ORAL TABLET 5MG 7.50 5.25
47081038 250 NF-CHLORDIAZ/CLIDINIUM ORAL CAP 5MG-2.5M 4.39 3.07
47081039 250 NF-DUREZOL OPHTH EMUL 0.05% 119.60 83.72
47081040 250 LITHIUM CARBONATE CAP 300MG 6.31 4.42
47081041 250 NF-VASERETIC ORAL TABLET 10MG-25MG 62.72 43.90
47081042 250 NF-METHYLPHENIDATE ER ORAL TAB ER 20MG 8.04 5.63
47081043 250 NF-SIMBRINZA OPHTH SUSP 0.2%-1% 77.33 54.13
47081044 250 NF-SYSTANE OPHTH SOLUTION 2.72 1.90
47081046 250 NF-Brimonidine Tartrate Ophth Soln 0.15% 97.62 68.33
47081047 250 NF-Pravastatin Sodium Oral Tablet 20MG 3.48 2.44
47081048 250 NF-BETIMOL OPHTH SOLN 0.25% 16.37 11.46
47081049 250 NF-FLAXSEED OIL CAPSULE 1000MG 0.29 0.20
47081050 250 NF-NITRO-DUR TRANSDERM PATCH ER 0.6MG/1H 27.52 19.26
47081051 250 NF-MIRTAZAPINE ORAL TABLET 30MG 5.70 3.99
47081053 250 NF-GEODON CAP 40MG 29.02 20.31
47081054 250 NF-ATIVAN TAB 0.5MG 6.42 4.49
47081055 250 NF-DILAUDID ORAL TABLET 4MG 3.09 2.16
47081056 250 NF-DILAUDID ORAL TABLET 4MG 9.62 6.73
47081057 250 NF-BALSALAZIDE DISODIUM CAP 750MG 11.67 8.17
47081058 250 NF-ALPHAGAN P OPHTH SOLN 0.15% 87.20 61.04
47081059 250 NF-CURASOL HYDROGEL SATURATED 22.36 15.65
47081060 250 NF-SIMVASTATIN ORAL TABLET 40MG 19.49 13.64
47081061 250 NF-RAMIPRIL ORAL CAPSULE 2.5MG 21.97 15.38
47081062 250 NF-CELEXA TAB 20MG 27.78 19.45
47081063 250 NF-CELEXA TAB 20MG 13.78 9.65
47081064 250 NF-DEXILANT CAP DR 60MG 37.57 26.30
47081065 636 J0878 DAPTOMYCIN 500MG IV 2,485.16 1,739.61
47081067 250 NF-ANDROGEL GEL 1% 55.08 38.56
47081068 250 NF-ROBAXIN-750 ORAL TABLET 750MG 49.46 34.62
47081069 250 NF-RENVELA ORAL TABLET 800MG 24.80 17.36
47081070 250 NF-MYCOPHENOLATE MOFETIL ORAL TABLET 500 36.88 25.82
47081071 250 NF-MYCOPHENOLATE MOFETIL CAP 250MG 37.93 26.55
47081072 250 NF-PROGRAF CAP 1MG 23.13 16.19
47081073 636 J1439 INJECTAFER IV SOLN 750MG/15ML 4,904.38 3,433.07
47081074 250 NF-ENALAPRIL MALEATE ORAL TABLET 10MG 0.70 0.49
47081075 250 NF-ENALAPRIL-HYDROCHLOROTHIAZIDE TAB 10M 8.05 5.64
47081076 250 NF-ARICEPT TAB 23MG 72.85 51.00
47081077 250 NF-CRESTOR TAB 5MG 23.76 16.63
47081079 250 NF-METHIMAZOLE ORAL TABLET 5MG 1.97 1.38
47081080 250 NF-OCTREOTIDE ACETATE INJ SOLN 500MCG/1M 195.25 136.68
47081081 250 NF-1ST TIER UNIFINE PENTIPS NEEDLE DEVIC 0.89 0.62
47081082 250 NF-PREVACID CAP DR 30MG 100.96 70.67
47081083 250 NF-TROSPIUM CHLORIDE ORAL TABLET 20MG 12.55 8.79
47081084 250 NF-METHYLCELLULOSE 1500 CPS POWDER 5.93 4.15
47081085 250 NF-CO Q-10 LIQUID CAPSULE 100MG 2.04 1.43
47081088 250 NF-VITAMIN B-12 SUBLINGUAL TABLET 1000MC 0.59 0.41
47081089 250 NF-CLONIDINE HCL TAB 0.3MG 2.19 1.53
47081090 250 NF-METOPROLOL TARTRATE 100MG TAB 4.03 2.82
47081091 250 NF-PHOSPHA 250 NEUTRAL ORAL TABLET 2.36 1.65
47081092 250 NF-NEXAVAR ORAL TABLET 200MG 219.78 153.85
47081093 250 NF-XIFAXAN ORAL TABLET 550MG 148.78 104.15
47081094 250 NF-OXYCODONE HCL ORAL TABLET 20MG 5.12 3.58
47081095 250 NF-B-100 COMPLEX TABLET 0.44 0.31
47081096 250 NF-CYTOMEL ORAL TABLET 5MCG 4.68 3.28
47081097 250 NF-SYNTHROID ORAL TABLET 75MCG 5.36 3.75
47081098 250 NF-ALPRAZOLAM TAB 0.25MG 3.23 2.26
47081099 250 NF-RAMIPRIL CAP 10MG 12.01 8.41
47081100 250 NF-ALLEGRA ALLERGY ORAL TABLET 180MG 2.77 1.94
47081101 250 NF-BENAZEPRIL HCL ORAL TABLET 20MG 4.88 3.42
47081102 250 ESZOPICLONE 1MG TAB 19.66 13.76
47081103 250 NF-VENLAFAXINE HCL CAP ER 150MG 28.93 20.25
47081104 250 NF-ALPRAZOLAM TAB 0.25MG 3.23 2.26
47081105 250 NF-AMITIZA ORAL LIQUID FILLED CAPSULE 8M 29.24 20.47
47081106 250 NF-CARDIZEM LA TAB EXTENDED RELEASE 360M 20.64 14.45
47081107 636 IV TEMPLATE 664.76 465.33
47081108 250 SODIUM TETRADECYL 1% INJ 2ML 217.93 152.55
47081109 250 SODIUM PHOSPHATE 15MMOL/5ML INJ 108.42 75.89
47081110 636 TIGECYCLINE 50MG/10ML INJ 664.76 465.33
47081111 250 NF-HYDROCHLOROTHIAZIDE ORAL TABLET 50MG 1.00 0.70
47081112 250 NF-FISH OIL LIQ CAP 1,000MG 0.29 0.20
47081113 250 NF-AUBAGIO TAB 14MG 962.98 674.09
47081114 250 NF-BENAZEPRIL HCL ORAL TABLET 40MG 4.69 3.28
47081115 250 NF-SIMVASTATIN ORAL TABLET 80MG 21.77 15.24
47081116 250 NF-BENAZEPRIL HCL ORAL TABLET 40MG 5.61 3.93
47081117 250 NF-PRESERVISION ORAL LIQUID CAPSULE 1.23 0.86
47081118 250 NF-LINZESS CAP 290MCG 51.53 36.07
47081119 250 NF-OXYCODONE HCL CAP 5MG 8.55 5.99
47081120 250 NF-OXYCODONE HCL ORAL TABLET 30MG 8.98 6.29
47081121 250 NF-BONIVA ORAL TABLET 150MG 885.84 620.09
47081122 250 NF-NITROGLYCERIN SL SPRAY 0.4MG/1SPRAY 313.19 219.23
47081123 250 NF-MORPHINE SULFATE CAP ER 30MG 27.00 18.90
47081124 250 NF-TARCEVA TAB 150MG 1,187.41 831.19
47081125 250 COLESTIPOL 1000mg TAB (COLESTID) 7.48 5.24
47081126 250 ZADITOR OPHTH SOLN 0.025% 56.67 39.67
47081127 250 NF-ZADITOR OPHTH SOLN 0.025% 10.88 7.62
47081128 250 NF-MICRO-K CAP ER 10MEQ 3.65 2.56
47081129 250 NF-MICRO-K CAPSULE 10MEQ 3.65 2.56
47081130 250 NF-PATADAY OPHTH SOLN 0.2% 353.00 247.10
47081131 250 NF-UCERIS ORAL EXTENDED RELEASE TABLET 9 272.85 191.00
47081132 250 NF-GLUCOSAMINE & CHONDR TAB 500MG-400MG 5.73 4.01
47081133 250 NF-MULTAQ ORAL TABLET 400MG 41.59 29.11
47081134 250 NF-VIACTIV CHEWABLE TABLET 0.72 0.50
47081135 250 NF-ALLEGRA ALLERGY ORAL TABLET 180MG 2.42 1.69
47081136 250 NF-UCERIS ORAL EXTENDED RELEASE TABLET 9 272.85 191.00
47081137 250 NF-ERYTHROCIN STEARATE FILMTAB TAB 250MG 1.87 1.31
47081138 250 NF-SPIRONOLACTONE ORAL TAB 50MG 3.60 2.52
47081139 250 NF-SIMVASTATIN ORAL TABLET 20MG 21.77 15.24
47081141 250 NF-FENOFIBRATE ORAL TABLET 54MG 9.15 6.41
47081142 250 NF-ALBUTEROL INH/NEB SOLUTION 0.042% 7.10 4.97
47081143 250 NF-PNEUMOCOCCAL 13-VALENT VACCINE, DIPHT 1,747.45 1,223.22
47081144 250 NF-NEXIUM CAP DR 40MG 55.31 38.72
47081145 636 90670 PNEUMOCCAL VACCINE 13 914.10 639.87
47081146 250 J2150 MANNITOL 20% 500 ML 101.20 70.84
47081147 250 NF-TORADOL TABLET 10MG 8.05 5.64
47081148 636 90586 BCG INJ 770.72 539.50
47081149 250 NF-PIOGLITAZONE ORAL TABLET 15MG 30.99 21.69
47081150 250 NF-VENLAFAXINE HYDROCHLORIDE CAP ER 150M 2.40 1.68
47081151 250 NF-ABILIFY TAB 30MG 223.25 156.28
47081152 250 NF-ATORVASTATIN CALCIUM ORAL TAB 80MG 47.69 33.38
47081153 250 NF-QUETIAPINE FUMARATE ORAL TABLET 50MG 29.06 20.34
47081154 250 NF-WELLBUTRIN XL 24 HR TAB ER 150MG 34.45 24.12
47081155 250 NF-CYMBALTA CAP DR 60MG 45.43 31.80
47081156 250 CARB/LEVO ER TAB 50MG-200MG 8.40 5.88
47081157 250 NF-CARB/LEVO TAB ER 50-200M 8.83 6.18
47081158 250 NF-SYSTANE ULTRA OPHTHALMIC SOLN 0.4%-0. 62.76 43.93
47081159 250 NF-MOBIC ORAL TABLET 15MG 18.10 12.67
47081160 250 NF-TESTOSTERONE CYPIONATE IM OIL 200MG/1 296.72 207.70
47081161 250 NF-CANDESARTAN CILEXETIL & HCTZ 16-12.5 16.36 11.45
47081162 250 NF-CANDESARTAN CILEXETIL TAB 16MG 17.17 12.02
47081163 250 NF-FLECAINIDE ACETATE TABLET 50MG 8.94 6.26
47081164 250 NF-ATACAND ORAL TABLET 8MG 5.31 3.72
47081165 250 NF-GILOTRIF ORAL TABLET 40MG 1,145.73 802.01
47081166 250 NF-GENTEAL OPHTHALMIC SOLUTION 0.2% 2.50 1.75
47081167 250 NF-ATENOLOL ORAL TABLET 100MG 12.28 8.60
47081168 250 NF-ATENOLOL ORAL TABLET 25MG 3.62 2.53
47081169 250 NF-VALSARTAN ORAL TABLET 320MG 27.98 19.59
47081170 250 NF-NITRO-DUR TRANSDERM PATCH ER 0.3MG/1H 27.62 19.33
47081171 250 TESTOSTERONE 200MG/ML INJ 133.09 93.16
47081172 250 NF-BIOTIN ORAL TABLET 1000MCG 0.20 0.14
47081173 250 NF-AMOXICILLIN TABLET 875MG 3.86 2.70
47081174 250 NF-NAMENDA XR CAP ER 28MG 59.91 41.94
47081175 250 NF-NUEDEXTA CAP 20MG-10MG 63.04 44.13
47081176 250 NF-MIACALCIN NASAL SPRAY 200IU/ACT 134.17 93.92
47081177 250 NF-ESTRACE VAGINAL CREAM 0.1MG/1GM 31.51 22.06
47081179 250 NF-HUMULIN N INJECTION 100U/ML 67.28 47.10
47081180 250 NF-RisperDAL Tablet 0.5MG 42.99 30.09
47081181 250 NF-hydrALAZINE HCl Oral Tablet 25 2.32 1.62
47081182 250 NF-Zofran Tablet 8MG 195.80 137.06
47081183 250 NF-TIMOLOL MALEATE OPHTH SOLN 0.5% 17.83 12.48
47081187 250 SUGAMMADEX 200MG/2ML INJ (BRIDION) 595.57 416.90
47081188 250 NF-SENSIPAR ORAL TABLET 60MG 226.61 158.63
47081189 250 NF-CoQ10 In Oil Liquid Capsule 100MG-30I 1.16 0.81
47081190 250 NF-HYDROMORPHONE HCL ORAL TABLET 2MG 1.89 1.32
47081191 250 NF-TEARS NATURALE II OPHTH SOLUTION 3.22 2.25
47081192 250 NF-OMEPRAZOLE CAP DR 10MG 17.20 12.04
47081193 250 NF- KETOROLAC TROMETHAMINE 30MG/1ML 3.00 2.10
47081194 250 NF-FUROSEMIDE INJ SOLN 10MG/1ML 5.77 4.04
47081196 250 NF-RIVASTIGMINE TARTRATE CAP 6MG 30.43 21.30
47081197 250 NF-DILAUDID ORAL TABLET 4MG 7.18 5.03
47081198 250 HUMALOG MIX 75/25 INJECTION 137.01 95.91
47081199 250 NF-HUMALOG MIX 75/25 SUBQ SUSP 75U-25U/1 70.59 49.41
47081200 250 SULFAMETH/TMP SUSP 800/160/20ML 22.96 16.07
47081201 250 TRANEXAMIC ACID 1000MG/10ML INJ 290.55 203.39
47081202 250 NF-SIMVASTATIN ORAL TABLET 10MG 12.41 8.69
47081203 250 NF-DICLOFENAC SODIUM ORAL TAB EC 50MG 5.89 4.12
47081204 250 NF-DICLOFENAC SODIUM ORAL TAB ER 100MG 35.21 24.65
47081205 250 NF-HUMALOG MIX 75/25 INJECTION 128.75 90.13
47081206 250 NF-SANCTURA XR CAP ER 60MG 28.73 20.11
47081207 250 NF-ATIVAN INJ SOLN 2MG/1ML 7.70 5.39
47081208 250 NF-LEVSIN SL TAB 0.125MG 4.49 3.14
47081209 250 NF-Calcitonin-Salmon Nasal Spray 200IU/1 128.00 89.60
47081210 250 NF-Calcitonin-Salmon Nasal Spray 200IU/1 128.00 89.60
47081211 250 NF-LEVSIN SL TAB 0.125MG 4.49 3.14
47081212 250 NF-DIOVAN HCT ORAL TABLET 160MG-12.5MG 31.69 22.18
47081213 250 NF-DIOVAN HCT ORAL TABLET 320MG-25MG 55.63 38.94
47081214 250 NF-CARVEDILOL ORAL TABLET 25MG 8.62 6.03
47081215 250 NF-ENALAPRIL MALEATE ORAL TABLET 20MG 11.14 7.80
47081216 250 NF-NICOTINE TD PATCH ER 14MG/24HR 9.91 6.94
47081217 250 NF-FEXOFENADINE HCL ORAL TABLET 180MG 1.21 0.85
47081218 250 NF-LEVOTHYROXINE SODIUM ORAL TABLET 137M 7.85 5.50
47081219 250 NF-AMBIEN CR EXTENDED-RELEASE TABLET 6.2 38.05 26.64
47081220 250 NF-ALTAVERA ORAL TABLET 0.15MG-30MCG 5.13 3.59
47081221 250 NF-LEVOBUNOLOL HCL OPHTH SOLN 0.5% 14.91 10.44
47081222 250 NF-BYSTOLIC TAB 20MG 18.08 12.66
47081223 250 NF-BYSTOLIC ORAL TABLET 5MG 17.80 12.46
47081224 250 NF-ZIAC ORAL TABLET 2.5MG-6.25MG 6.31 4.42
47081225 250 NF-LATANOPROST OPHTH SOLN 0.005% 213.65 149.56
47081226 250 NF-LATANOPROST OPHTH SOLN 0.005% 213.65 149.56
47081227 250 NF-Rocaltrol Liquid Filled Capsule 0.5MC 11.63 8.14
47081228 250 NF-Metadate CD Capsule ER 20MG 11.63 8.14
47081229 637 NOZIN NASAL SANITIZER AMP 9.49 6.64
47081230 637 NOZIN NASAL SANITIZER 12ML 87.94 61.56
47081231 250 NF-HYDROXYZINE HCL ORAL TAB 10MG 3.75 2.63
47081232 250 NF-HYDROXYZINE HCL ORAL TABLET 10MG 4.16 2.91
47081233 250 NF-LOTREL CAP 5MG-20MG 25.45 17.82
47081234 250 NF-CRESTOR ORAL TABLET 40MG 24.54 17.18
47081235 250 NF-Citalopram Oral Tablet 20MG 11.06 7.74
47081236 250 NF-LITHIUM CARBONATE ORAL TAB ER 450MG 2.15 1.51
47081237 250 NF-CELEXA TAB 10MG 34.80 24.36
47081238 250 NF-DALIRESP ORAL TABLET 500MCG 54.88 38.42
47081239 250 NF-CITRUCEL FIBER ORAL PWD FOR SUSP 2GM 0.16 0.11
47081240 250 NF-MORPHINE SULFATE TAB IR 30MG 3.22 2.25
47081241 250 NF-DICLOFENAC SODIUM OPHTH SOLN 0.1% 16.28 11.40
47081242 250 PANTOPRAZOLE 40MG INJ (PROTONIX) 39.51 27.66
47081243 250 NF-JAKAFI ORAL TABLET 15MG 936.80 655.76
47081244 250 NF-WELLBUTRIN TAB 100MG 17.27 12.09
47081247 250 NF-Tekturna Oral Tablet 150MG 15.00 10.50
47081248 250 NF-Tekturna Oral Tablet 300MG 33.19 23.23
47081249 250 NF-Gabapentin Oral Capsule 100MG 3.00 2.10
47081250 250 NF-Gabapentin Oral Capsule 100MG 2.00 1.40
47081251 250 NF-Meclizine HCl Oral Tablet 25MG 3.00 2.10
47081252 250 NF-Amitriptyline HCl Oral Tablet 25MG 2.00 1.40
47081254 250 NF-ALPRAZolam Oral Tablet 0.25MG 2.00 1.40
47081255 250 NF-HYDROcodone-Acetaminophen 5-325MG 3.00 2.10
47081256 250 NF-TRAVATAN Z OPHTH SOLN 0.004% 334.49 234.14
47081258 250 NF-LITHIUM CARBONATE CAP 150MG 0.56 0.39
47081259 250 NF-ARMOUR THYROID TABLET 60MG 3.23 2.26
47081260 250 NF-EYE VITAMINS AND MINERALS ORAL TABLET 0.21 0.15
47081262 250 NF-PINDOLOL ORAL TABLET 10MG 6.63 4.64
47081264 250 NF-OXYCODONE HCL-ACETAMINOPHEN ORAL TABL 16.49 11.54
47081265 250 NF-Sanctura XR Oral Cap ER 60MG 24.00 16.80
47081266 250 NF-LAMICTAL XR EXTENDED RELEASE TAB 200M 121.39 84.97
47081267 250 NF-CHROMIUM ORAL TABLET 200MCG 0.12 0.08
47081268 250 NF-FLAXSEED OIL CAPSULE 1300MG 0.41 0.29
47081269 250 NF-FEMARA TAB 2.5MG 130.54 91.38
47081270 250 NF-ABILIFY ORAL TABLET 2MG 157.86 110.50
47081271 250 NF-BENICAR ORAL TABLET 40MG 42.95 30.07
47081273 636 CEFUROXIME INJ PWD FOR SOLN 750MG 24.00 16.80
47081274 250 NF-FLORAJEN3 ORAL CAPSULE 2.32 1.62
47081275 250 EDRPHONIUM INJ SOLUTION 10MG/1ML-15ML 446.28 312.40
47081276 250 NF-PYRIDOSTIGMINE BROMIDE TAB 60MG 3.71 2.60
47081277 250 NF-MICARDIS HCT TAB 40MG-12.5MG 33.05 23.14
47081278 250 NF-MICARDIS ORAL TABLET 40MG 9.47 6.63
47081279 250 NF-PRAVASTATIN SODIUM ORAL TABLET 10MG 14.94 10.46
47081280 250 NF-FISH OIL CONCENTRATE CAPSULE 0.45 0.32
47081282 250 NF-Pataday Ophthalmic Solution 0.2% 352.13 246.49
47081283 250 NF-SENNA PLUS ORAL TABLET 50MG-8.6MG 0.59 0.41
47081284 250 NF-HYDROMORPHONE HCL ORAL TABLET 4MG 2.85 2.00
47081286 250 NF-RISPERDAL CONSTA IM PWD FOR SUSP ER 2 2,214.63 1,550.24
47081287 250 NF-HEPARIN SODIUM INJ SOLN 2,500U/1ML 3.69 2.58
47081288 250 NF-OMEGA 3 CAPSULE 1000MG 0.31 0.22
47081289 250 NF-SERTRALINE HCL ORAL TABLET 100MG 10.18 7.13
47081290 250 NF-LATUDA ORAL TABLET 120MG 243.55 170.49
47081291 250 NF-LEFLUNOMIDE ORAL TABLET 20MG 19.85 13.90
47081292 250 NF-EFFEXOR XR ORAL CAP ER 37.5MG 20.81 14.57
47081293 250 NF-SIMBRINZA OPHTH SUSP 0.2%-1% 91.91 64.34
47081294 250 NF-ZOCOR ORAL TABLET 20MG 28.44 19.91
47081296 250 ATROPINE SULF EYE DROPS 1% 5ML 271.39 189.97
47081297 250 NF-ZOCOR ORAL TABLET 10MG 23.15 16.21
47081298 250 NF-REVATIO TAB 20MG 193.21 135.25
47081299 250 NF-RENVELA ORAL TABLET 800MG 29.96 20.97
47081300 250 NF-CLOBETASOL PROPIONATE CREAM 0.05% 39.73 27.81
47081301 250 NF-TERCONAZOLE VAG CRM 0.4% 4.45 3.12
47081302 250 NF-FELODIPINE EXTENDED-RELEASE TABLET 10 12.62 8.83
47081303 250 NF-URSODIOL TAB 500MG 21.03 14.72
47081304 250 NF-RIFAXIMIN TAB 200MG 51.49 36.04
47081305 250 NF-XIFAXAN ORAL TABLET 550MG 118.62 83.03
47081306 250 NF-LOVASTATIN ORAL TABLET 20MG 7.19 5.03
47081307 250 NF-SIMVASTATIN ORAL TABLET 20MG 19.68 13.78
47081308 250 NF-URSODIOL ORAL TABLET 500MG 21.03 14.72
47081309 250 NF-XIFAXAN ORAL TABLET 550MG 162.16 113.51
47081310 250 NF-ISONIAZID ORAL TABLET 300MG 3.71 2.60
47081311 250 NF-PYRIDOXINE HCL TABLET 50MG 0.48 0.34
47081312 250 NF-CITRACAL + D TABLET 0.68 0.48
47081313 250 NF-VITAMIN D ORAL CAPSULE 5000IU 0.55 0.39
47081315 250 NF-DIFICID ORAL TABLET 200MG 926.42 648.49
47081316 250 NF-THEOPHYLLINE 12 HR TAB ER 300MG 3.15 2.21
47081317 250 NF-FOSINOPRIL SODIUM ORAL TABLET 10MG 5.54 3.88
47081318 250 NF-VALSARTAN ORAL TABLET 40MG 17.95 12.57
47081319 250 NF-LOSARTAN POTASSIUM ORAL TABLET 50MG 10.71 7.50
47081320 250 ASCLERA 1% INJ 2ML 133.30 93.31
47081321 250 NF-CELEXA TAB 20MG 40.12 28.08
47081322 250 NF-PRAVASTATIN SODIUM ORAL TABLET 40MG 15.36 10.75
47081323 250 NF-MOMETASONE FUROATE NASAL SPRAY 0.05MG 57.15 40.01
47081324 250 NF-PANCREAZE CAP DR 10850U-2600U-6200U 3.50 2.45
47081325 250 NF-XIFAXAN ORAL TABLET 550MG 171.73 120.21
47081326 250 NF-ADVATE INTRAVENOUS PWD FOR SOLN 1IU 8.47 5.93
47081327 250 NF-ADVATE INTRAVENOUS PWD FOR SOLN 1IU 8.07 5.65
47081328 250 NF-RESTASIS MULTIDOSE OPHTH EMUL 0.05% 432.82 302.97
47081329 250 NF-IRON 100 PLUS ORAL TABLET 5.36 3.75
47081330 250 NF-VESICARE ORAL TABLET 10MG 51.12 35.78
47081332 250 NF-METHADONE HCL ORAL TABLET 10MG 0.70 0.49
47081333 250 NF-AMITRIPTYLINE HCL ORAL TABLET 100MG 11.80 8.26
47081334 250 MEGESTEROL ORAL SUSP 400MG/10ML 19.46 13.62
47081335 250 NF-XIFAXAN ORAL TABLET 550MG 171.73 120.21
47081336 250 NF-URSODIOL ORAL TABLET 500MG 24.75 17.33
47081337 250 NF-PATADAY OPHTH SOLN 0.2% 353.00 247.10
47081338 250 NF-SIMVASTATIN ORAL TABLET 20MG 21.77 15.24
47081339 250 NF-DICLOFENAC SODIUM DR TABLET 75MG 8.12 5.68
47081340 250 NF-ENTRESTO TAB 49MG-51MG 37.62 26.33
47081341 250 NF-ENTRESTO TAB 24MG-26MG 37.62 26.33
47081342 250 NF-PRAVASTATIN SODIUM ORAL TABLET 80MG 22.30 15.61
47081343 250 NF-WELLBUTRIN SR 12 HR TAB ER 100MG 32.76 22.93
47081344 250 NF-ZANTAC 300 TABLET 300MG 58.14 40.70
47081345 250 NF-HYZAAR ORAL TABLET 100MG-25MG 21.48 15.04
47081346 250 NF-HYDRALAZINE HCL ORAL TAB 50MG 5.57 3.90
47081347 250 NF-PROVERA ORAL TABLET 2.5MG 6.48 4.54
47081348 250 NF-MYRBETRIQ ORAL TABLET 50MG 57.24 40.07
47081349 250 NF-CYPROHEPTADINE HCL ORAL TABLET 4MG 2.95 2.07
47081350 250 NF-ESTERIFIED ESTROGENS-METHYLTESTOSTERO 3.74 2.62
47081351 250 NF-CO Q-10 CAPSULE 10MG 1.82 1.27
47081352 250 NF-EFUDEX CREAM 5% 50.77 35.54
47081353 250 NF-TRIAMCINOLONE OIN 0.1% 0.31 0.22
47081354 250 NF-PROBIOTIC DIGESTIVE CARE CAP 20 BILLI 2.48 1.74
47081355 250 NF-PROBIOTIC DIGESTIVE CARE ORAL TAB 10M 2.83 1.98
47081356 250 NF-OYSCO 500 + D ORAL TABLET 500MG-200IU 0.06 0.04
47081357 250 NF-VITAMIN C TABLET 100MG 0.08 0.06
47081359 250 HYDROXYZINE 50 MG/ ML IM 37.80 26.46
47081360 250 NF-Morphine Sulfate Oral Cap ER 20MG 20.00 14.00
47081361 250 NF-Morphine Sulfate Oral Tab ER 15MG 5.81 4.07
47081362 250 NF-ARAVA ORAL TABLET 20MG 79.84 55.89
47081363 250 NF-NITROGLYCERIN SUBLINGUAL TABLET 0.3MG 2.18 1.53
47081364 250 NF-ASTEPRO NASAL SPRAY 205.5MCG/1ACT 28.77 20.14
47081365 250 NF-PREMARIN VAGINAL CREAM 0.625MG/1GM 64.24 44.97
47081366 250 NF-CHOLECALCIFEROL TAB 1000IU 0.87 0.61
47081367 250 NF-FLORAJEN3 ORAL CAPSULE 2.13 1.49
47081368 250 NF-DIOVAN HCT ORAL TABLET 320MG-12.5MG 58.78 41.15
47081369 250 NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M 19.57 13.70
47081370 250 NF-METROGEL TOPICAL GEL 1% 31.37 21.96
47081371 250 NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY 0.55 0.39
47081372 250 NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY 0.55 0.39
47081373 250 NF-PRAVACHOL ORAL TABLET 20MG 20.36 14.25
47081374 250 ASCORBIC ACID INJ SOLN 500MG/1ML 504.79 353.35
47081375 250 NF-TRULICITY SUBQ SOLN 0.75MG/0.5ML 1,746.06 1,222.24
47081376 250 NF-JARDIANCE ORAL TABLET 25MG 76.20 53.34
47081377 250 NF-TIGAN CAP 300MG 20.12 14.08
47081378 250 NF-CYTOMEL ORAL TABLET 5MCG 4.68 3.28
47081379 250 NF-FAMOTIDINE INJECTION 10MG/ML 2.86 2.00
47081380 250 NF-FAMOTIDINE INJECTION 10MG/ML 1.42 0.99
47081381 250 NF-CLOBETASOL PROPIONATE CREAM 0.05% 39.73 27.81
47081382 250 NF-BETAMETHASONE DIP CREAM 0.05% 11.76 8.23
47081383 250 NF-AMERGE TAB 2.5MG 315.61 220.93
47081384 250 NF-IBUPROFEN ORAL TABLET 200MG 5.33 3.73
47081385 250 NF-LEVOTHYROXINE ORAL TABLET 200MCG 2.95 2.07
47081386 250 NF-CELEXA TAB 40MG 41.26 28.88
47081387 250 NF-AMLODIPINE & BENAZEPRIL HCL 5MG-20MG 13.28 9.30
47081388 250 NF-MORPHINE SULFATE CAP ER 30MG 26.40 18.48
47081389 250 MIVACURIUM 20MG/10 ML INJ 143.44 100.41
47081390 250 NF-CARDIZEM CD 24 HR CAP ER 240MG 203.96 142.77
47081391 250 NF-ADVAIR HFA 115/21 INH AER 115MCG-21MC 144.56 101.19
47081392 250 NF-BROVANA INH SOLN 15MCG/2ML 40.50 28.35
47081393 250 NF-INSPRA ORAL TABLET 50MG 50.54 35.38
47081394 250 NF-VICOPROFEN TABLET 17.03 11.92
47081395 250 NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 2 1.76 1.23
47081396 250 NF-ELIMITE TOPICAL CREAM 5% 495.00 346.50
47081397 250 NF-BUDESONIDE INH/NEB SUSP 0.25MG/2ML 20.92 14.64
47081398 250 NF-CRANBERRY CONCENTRATE CAPSULE 500MG 0.32 0.22
47081399 250 NF-TRIAMCINOLONE ACETONIDE NASAL SPRAY 5 33.04 23.13
47081400 250 NF-CALCIUM 600 TAB 600MG 0.10 0.07
47081401 250 NF-Cyclobenzaprine HCl Oral Tablet 5MG 6.00 4.20
47081403 250 NF-BENAZEPRIL HCL ORAL TABLET 10MG 1.14 0.80
47081404 250 NF-ONGLYZA ORAL TABLET 5MG 44.21 30.95
47081405 250 NF-ENALAPRIL/HCTZ 10MG-25MG TABLET 5.67 3.97
47081406 250 NF-LEFLUNOMIDE ORAL TABLET 20MG 72.67 50.87
47081407 250 NF-ICAPS AREDS ORAL LIQUID FILLED CAPSUL 1.07 0.75
47081408 250 NF-PHENDIMETRAZINE ORAL CAP ER 105MG 4.80 3.36
47081409 250 NF-GLUCOSAMINE & CHONDROITIN 500MG-400MG 3.73 2.61
47081410 250 NF-IRON 100 WITH VITAMIN C ORAL TABLET 0.94 0.66
47081411 250 NF-MAG 200 ORAL TABLET 150MG-200MG 0.30 0.21
47081412 250 NF-OMEGA-3 OIL LIQUID FILLED CAPSULE 100 0.40 0.28
47081413 250 NF-VITAMIN B COMPLEX TAB 0.08 0.06
47081414 250 NF-BRILINTA ORAL TABLET 60MG 29.47 20.63
47081415 250 NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG 12.48 8.74
47081416 250 NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG 9.73 6.81
47081417 250 NF-CILOSTAZOL ORAL TABLET 50MG 7.30 5.11
47081419 250 NF-PRESERVISION AREDS LIQUID FILLED CAPS 1.04 0.73
47081420 250 NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M 0.78 0.55
47081421 250 NF-CRESTOR ORAL TABLET 10MG 24.64 17.25
47081423 250 NF-SYSTANE BALANCE OPHTH SOLN 0.6% 4.18 2.93
47081424 250 NF-PREDNISOLONE ACETATE OPHTH SUSP 1% 43.23 30.26
47081425 250 NF-TRAVATAN Z OPHTH SOLN 0.004% 175.33 122.73
47081426 250 NF-LIALDA ORAL DELAYED-RELEASE TABLET 1. 52.22 36.55
47081427 250 NF-GLUCOSAMINE & CHONDR CAP 500MG-400MG 2.56 1.79
47081428 250 NF-CARTIA XT ORAL 24 HR CAP ER 120MG 4.79 3.35
47081429 250 NF-PRESERVISION AREDS ORAL LIQUID CAPSUL 1.06 0.74
47081430 250 NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M 75.38 52.77
47081431 250 NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M 75.38 52.77
47081432 250 NF-CILOSTAZOL ORAL TABLET 50MG 7.30 5.11
47081433 250 NF-CRESTOR ORAL TABLET 5MG 46.17 32.32
47081434 250 NF-TRAVOPROST OPHTH SOLN 0.004% 314.29 220.00
47081435 250 NF-Budesonide Delayed Release Capsule 3M 75.00 52.50
47081436 250 NF-LOVASTATIN ORAL TABLET 20MG 12.21 8.55
47081437 250 NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15% 136.52 95.56
47081438 250 NF-CYTOMEL TABLET 25MCG 4.73 3.31
47081439 250 NF-VITAMIN B COMPLEX INJ SOLN 8.00 5.60
47081440 250 NF-ERYTHROMYCIN ORAL TABLET 500MG 4.73 3.31
47081441 250 NF-GABITRIL TABLET 16MG 63.49 44.44
47081442 250 NF-HYDROXYZINE HCL IM SOLN 50MG/1ML 1.50 1.05
47081443 250 NF-FELODIPINE EXTENDED RELEASE TAB 10MG 12.01 8.41
47081444 250 NF-CITALOPRAM HBR ORAL TAB 40MG 1.50 1.05
47081445 250 NF-CYANOCOBALAMIN INJ SOLN 1000MCG/1ML 21.75 15.23
47081446 250 NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML 6,968.17 4,877.72
47081447 250 NF-TRICOR ORAL TABLET 145MG 24.94 17.46
47081448 250 NF-SOTALOL HCL ORAL TABLET 160MG 17.10 11.97
47081449 250 NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML 6,968.17 4,877.72
47081450 250 NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG 8.60 6.02
47081452 636 J0885 EPOETIN ALPHA 2000 UNITS (PROCRIT) 260.40 182.28
47081453 250 NF-INSPRA ORAL TABLET 50MG 50.00 35.00
47081454 250 NF-VITAMIN D ORAL TABLET 2000IU 0.15 0.11
47081455 250 NF-1ST TIER UNIFINE PENTIPS PLUS DEVICE 1.11 0.78
47081456 250 NF-BACTRIM DS ORAL TABLET 800MG-160MG 9.63 6.74
47081457 250 NF-VISTARIL CAPSULE 50MG 14.38 10.07
47081458 250 NF-DALIRESP ORAL TABLET 500MCG 47.95 33.57
47081459 250 NF-MORPHINE SULFATE IR ORAL TABLET 15MG 1.65 1.16
47081460 250 NF-PRO-BIOTIC BLEND ORAL CAPSULE 0.18 0.13
47081461 250 NF-NICODERM CQ TD PATCH ER 14MG/24HR 8.97 6.28
47081462 250 NF-NIACIN ORAL TABLET 500MG 0.11 0.08
47081463 250 NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG 17.31 12.12
47081464 250 NF-PRESERVISION AREDS 2 ORAL LIQ CAP 0.93 0.65
47081465 250 NF-CRANBERRY FRUIT CAPSULE 425MG 0.24 0.17
47081466 250 NF-CRAN-PLUS ORAL CAPSULE 0.67 0.47
47081467 250 NF-SIMVASTATIN ORAL TABLET 20MG 21.77 15.24
47081468 250 NF-CILOSTAZOL TAB 50MG 7.30 5.11
47081469 250 NF-CYCLOPENTOLATE HCL OPHTH SOLN 0.5% 20.51 14.36
47081470 250 NF-CYCLOPENTOLATE HCL OPHTH SOLN 1% 10.80 7.56
47081471 250 NF-ALPHAGAN P OPTHAMALIC SOLUTION 0.1% 148.79 104.15
47081472 250 NF-LATANOPROST OPHTH SOLN 0.005% 60.50 42.35
47081473 250 NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML 6.38 4.47
47081474 250 NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML 66.10 46.27
47081477 250 NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML 27.44 19.21
47081478 250 NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML 27.44 19.21
47081479 250 NF-JUBLIA TOPICAL APPLICATION SOLUTION 1 798.85 559.20
47081480 250 NF-METFORMIN HCL ORAL TABLET 850MG 4.79 3.35
47081481 250 NF-AMILORIDE HCL ORAL TABLET 5MG 7.34 5.14
47081482 250 NF-AMILORIDE HCL ORAL TABLET 5MG 7.34 5.14
47081483 250 NF-CEFAZOLIN NA-NACL IV SOLN 2GM-0.9% 2.28 1.60
47081484 250 NF-SACCHARIN CALCIUM POWDER 11.02 7.71
47081485 250 NF-SIMVASTATIN ORAL TABLET 40MG 19.57 13.70
47081486 250 NF-EVISTA TAB 60MG 24.85 17.40
47081487 250 NF-GABAPENTIN CAP 100MG 3.04 2.13
47081488 250 NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG 137.39 96.17
47081490 250 CEFEPIME 1 GM VIAL 32.43 22.70
47081491 636 TNKASE IV POWDER FOR SOLUTION 50MG 34,706.98 24,294.89
47081493 250 SOTALOL 150MG/10ML INJ 7,332.51 5,132.76
47081494 250 NF-PAROXETINE HCL ORAL TABLET 40MG 2.12 1.48
47081495 636 PROCAINAMIDE 1000MG/10ML INJ 441.08 308.76
47081496 250 NF-ADVAIR DISKUS 500/50 DISK 27.06 18.94
47081497 636 IV TEMPLATE 18,685.53 13,079.87
47081498 636 J1170 HYDROMORPHONE 0.5MG/0.5ML INJ (DILAUDID) 25.21 17.65
47081499 250 NF-OSELTAMIVIR PHOSPHATE PWD FOR SUSP 6M 11.82 8.27
47081500 250 NF-RAMIPRIL CAP 10MG 14.54 10.18
47081501 250 NF-FEOSOL ORAL TABLET 45MG 0.64 0.45
47081502 250 NF-FEOSOL ORAL TABLET 65MG 0.25 0.18
47081503 250 NF-AFINITOR ORAL TABLET 5MG 2,334.47 1,634.13
47081504 250 NF-DEXAMETHASONE ELIX 0.5MG/5ML 1.16 0.81
47081505 250 NF-FEOSOL ORAL TABLET 45MG 0.62 0.43
47081506 250 NF-CHLORDIAZEPOXIDE CAP 10MG 2.55 1.79
47081507 250 NF-LACTASE TABLET 0.56 0.39
47081508 250 NF-THEO-24 24 HR CAP ER 100MG 9.44 6.61
47081509 250 NF-AMILORIDE HCL ORAL TABLET 5MG 7.93 5.55
47081510 250 NF-BONIVA ORAL TABLET 150MG 621.68 435.18
47081511 250 NF-IBANDRONATE SODIUM ORAL TABLET 150MG 599.91 419.94
47081512 250 NF-TAMIFLU PWD FOR SUSP 6MG/1ML 10.43 7.30
47081513 250 NF-ZINC ACETATE CAP 25MG 6.72 4.70
47081514 250 NF-OCUVITE TABLET 0.39 0.27
47081515 250 NF-LISINOPRIL ORAL TABLET 40MG 6.34 4.44
47081516 250 NF-PULMICORT FLEXHALER INH/NEB 180MCG/1A 1,123.51 786.46
47081517 250 NF-BUDESONIDE INH/NEB PWD 180MCG/1ACT 1,123.51 786.46
47081518 250 NF-MEDIHONEY TOPICAL GEL 80% 1.41 0.99
47081519 250 NF-PAPAYA ENZYME TABLET 14.96 10.47
47081520 250 NF-ARGININE ORAL CAPSULE 600MG 0.37 0.26
47081521 250 NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI 0.05 0.04
47081522 250 NF-MARINOL LIQ CAP 5MG 112.24 78.57
47081523 250 NF-GLYNASE PRES-TAB ORAL TABLET 3MG 11.39 7.97
47081525 250 NF-ALEVE ARTHRITIS TAB 220MG 0.32 0.22
47081526 250 NF-ALEVE CAP 220MG 0.70 0.49
47081527 250 NF-SAM-E 400 ORAL TABLET EC 400MG 5.60 3.92
47081528 250 NF-NYSTATIN/TRIAMCINOLONE ACETONID OINTM 22.99 16.09
47081529 250 NF-FENOFIBRATE AVPAK ORAL TABLET 48MG 7.84 5.49
47081530 250 POTASSIUM PHOSPHATE ORIGINAL TAB 500MG 2.11 1.48
47081531 250 NF-MODAFINIL AVPAK ORAL TABLET 200MG 145.50 101.85
47081532 250 NF-FOSINOPRIL SODIUM ORAL TABLET 40MG 5.14 3.60
47081533 250 NF-NEXIUM 24HR CAP DR 20MG 2.77 1.94
47081534 250 NF-BISOPROLOL FUMARATE TAB 5MG 16.07 11.25
47081535 250 NF-CALTRATE 600 TAB 600MG 0.57 0.40
47081536 250 NF-AFINITOR TAB 10MG 2,565.43 1,795.80
47081537 250 NF-EXEMESTANE ORAL TABLET 25MG 83.28 58.30
47081538 250 NF-EXEMESTANE ORAL TABLET 25MG 83.28 58.30
47081539 250 NF-VITAMIN D ORAL TABLET 1000IU 0.11 0.08
47081540 250 NF-COENZYME Q10 LIQ CAP 100MG 2.09 1.46
47081541 250 NF-NIFEDIPINE AVPAK TAB ER 60MG 9.02 6.31
47081542 250 NF-VITAMIN B-12 ORAL SOLUTION 1000MCG/ML 0.51 0.36
47081543 250 NF-SAXAGLIPTIN HYDROCHLORIDE TAB 5MG 51.13 35.79
47081544 250 NF-PERFOROMIST INH SOLN 20MCG/2ML 42.04 29.43
47081545 250 NF-CARBOXYMETHYLCELLULOSE SODIUM-GLYCERI 5.19 3.63
47081546 250 NF-ALPRAZOLAM DISINTEGRATING TAB 2MG 17.15 12.01
47081547 250 NF-PROTONIX TAB EC 40MG 25.83 18.08
47081548 250 NF-QUINAPRIL HCL TAB 40MG 16.33 11.43
47081549 250 NF-BENAZEPRIL HCL-HCTZ TAB 10MG-12.5MG 8.94 6.26
47081550 250 NF-LOTENSIN HCT ORAL TABLET 10MG-12.5MG 11.54 8.08
47081551 250 NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML 28.38 19.87
47081553 250 NF-TRIAMCINOLONE ACETONIDE CREAM 0.025% 0.43 0.30
47081554 250 NF-TIMOLOL MALEATE OPHTH GEL DROP 0.25% 171.45 120.02
47081555 250 NF-TRADJENTA TAB 5MG 67.75 47.43
47081556 250 NF-TIMOLOL MALEATE OPHTH GEL DROP 0.5% 50.60 35.42
47081557 250 NF-MICROLIPID OIL 0.08 0.06
47081558 250 NF-LEUPROLIDE ACETATE IM 3 MONTH PWD FOR 22,715.33 15,900.73
47081559 250 NF-CHLORASEPTIC MUCOUS MEMBRANE LONZENGE 0.70 0.49
47081560 250 NF-1ST TIER UNILET COMFORTOUCH LANCET 0.19 0.13
47081561 250 NF-COMBIGAN OPHTH SOLN 0.2%-0.5% 167.12 116.98
47081562 250 NF-CO Q-10 CAPSULE 50MG 1.53 1.07
47081563 250 NF-HYDROCORTISONE ACETATE CRM 2.5% 42.00 29.40
47081564 250 NF-ATOVAQUONE SUSP 750MG/5ML 9.97 6.98
47081565 250 NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML 28.38 19.87
47081566 250 NF-DULERA INH AER PWD 5MCG-100MCG/ACT 124.28 87.00
47081567 637 NF-JARDIANCE ORAL TABLET 25MG 76.55 53.59
47081568 250 NF-NICOTINE TD PATCH ER 7MG/24HR 17.53 12.27
47081569 250 NF-BETASERON SUBQ KIT 0.3MG 1,294.11 905.88
47081570 250 NF-BENAZEPRIL HCL ORAL TABLET 10MG 5.23 3.66
47081571 250 NF-BENICAR ORAL TABLET 5MG 28.20 19.74
47081572 250 NF-CYTOMEL TABLET 0.025MG 4.90 3.43
47081573 250 NF-CYTOMEL TABLET 25MCG 5.11 3.58
47081574 250 NF-VELTASSA POWDERFORSUSPENSION 8.4GM/1P 216.60 151.62
47081575 250 NF-CINNAMON ORAL CAPSULE 500MG 0.21 0.15
47081576 250 NF-SELENIUM TABLET 100MCG 0.06 0.04
47081577 250 NF-PROCTOCORT RECTAL CREAM 1% 7.46 5.22
47081579 250 NF-GAS-X ULTRA STRENGTH LIQ CAP 180MG 1.23 0.86
47081580 250 NF-SINUS PRESSURE&CONGESTION RELIEF PE 1 0.89 0.62
47081581 250 NF-MYLANTA SUSPENSION 0.06 0.04
47081582 250 NF-JARDIANCE ORAL TABLET 10MG 76.55 53.59
47081583 250 NF-TRAVOPROST OPHTH SOLN 0.004% 326.88 228.82
47081584 250 NF-TRAVATAN Z OPHTH SOLN 0.004% 353.39 247.37
47081585 250 NF-CREON ORAL DELAYED RELEASE CAPSULE 15.20 10.64
47081586 250 NF-VALSARTAN AND HYDROCHLOROTHIAZIDE TAB 18.50 12.95
47081587 250 NF-DAPTOMYCIN IV PWD FOR SOLN 350MG 1,368.16 957.71
47081588 250 NF-ENTOCORT EC CAP DR 3MG 71.20 49.84
47081589 250 NF-VITAMIN A CAPSULE 25,000IU 0.42 0.29
47081590 250 NF-BIOTIN ORAL CAPSULE 2500MCG 0.40 0.28
47081591 250 NF-JANUMET ORAL TABLET 50MG-1000MG 19.47 13.63
47081592 250 NF-BIMATOPROST OPHTH SOLN 0.01% 373.38 261.37
47081593 250 NF-ALPHAGAN P OPHTH SOLN 0.1% 151.61 106.13
47081594 250 NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC 24.35 17.05
47081595 250 NF-AMILORIDE HCL TAB 5MG 5.58 3.91
47081596 250 NF-VITA-BEE WITH C ORAL TABLET 0.19 0.13
47081597 250 NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125 8.96 6.27
47081598 250 NF-CELEXA TAB 40MG 28.24 19.77
47081599 250 NF-HYDROXYZINE PAMOATE CAP 50MG 2.47 1.73
47081600 250 NF-ALPHAGAN P OPHTH SOLN 0.1% 151.54 106.08
47081601 250 NF-RAMIPRIL CAP 10MG 15.45 10.82
47081602 250 NF-SEREVENT DISKUS INH PWD 50MCG/1ACTUAT 32.54 22.78
47081603 250 NF-TELMISARTAN ORAL TABLET 80MG 19.85 13.90
47081604 250 NF-TRELEGY ELLIPTA INH PWD 45.84 32.09
47081605 250 NF-TOBI INH/NEB SOLN 300MG/5ML 135.98 95.19
47081606 250 NF-COLESTIPOL HCL TAB 1GM 5.35 3.75
47081607 250 NF-PROVIGIL ORAL TABLET 200MG 213.07 149.15
47081608 250 NF-AMANTADINE HCL LIQ CAP 100MG 5.59 3.91
47081609 250 NF-MODAFINIL ORAL TABLET 100MG 90.63 63.44
47081610 250 NF-MODAFINIL ORAL TABLET 200MG 137.21 96.05
47081611 250 NF-VITAMIN A CAPSULE 8000IU 0.11 0.08
47081612 250 NF-FARXIGA ORAL TABLET 5MG 51.38 35.97
47081613 250 NF-BROVANA INH SOLN 15MCG/2ML 41.98 29.39
47081614 250 NF-TIMOLOL MALEATE OPHTH SOLN 0.5% 5.19 3.63
47081616 250 NF-SYNJARDY XR ORAL TAB ER 12.5MG-1000MG 40.21 28.15
47081621 250 NF-CELEXA TABLET 20MG 19.69 13.78
47081622 637 KAYEXALATE PWDR 756.77 529.74
47081623 250 NF-MILK THISTLE CAPSULE 150MG 0.91 0.64
47081624 250 NF-GARLIC CAPSULE 500MG 0.31 0.22
47081625 250 NF-TRIHEXYPHENIDYL HCL TAB 2MG 0.79 0.55
47081627 250 NF-QVAR REDIHALER INH AEROSOL LIQ 0.04MG 82.88 58.02
47081629 250 NF-METFORMIN HCL ORAL TABLET 850MG 5.19 3.63
47081630 250 NF-BELBUCA BUCCAL FILM 600MCG 54.87 38.41
47081631 250 NF-MIRTAZAPINE DISINTEGRATING TAB 15MG 10.02 7.01
47081632 250 NF-TRANEXAMIC ACID ORAL TABLET 650MG 22.55 15.79
47081633 250 NF-RANITIDINE HCL ORAL SYRUP 15MG/1ML 3.20 2.24
47081634 250 NF-ESTRADIOL TRANSDERMAL SYS 0.1MG/24HR 49.09 34.36
47081635 250 NF-SODIUM CHLORIDE 0.02 0.01
47081636 250 NF-ACEBUTOLOL HCL CAP 200MG 4.35 3.05
47081637 250 NF-SELEGILINE HCL CAP 5MG 11.68 8.18
47081638 250 NF-NORGESTIMATE AND ETHINYL ESTRADIOL 6.07 4.25
47081639 250 NF-PYRIDOXINE TAB 100MG 0.22 0.15
47081640 250 NF-VITAMIN B COMPLEX TAB 2.28 1.60
47081642 250 SODIUM CHLORIDE 7% (RESP) 4ML 16.48 11.54
47081644 250 NF-MACULAR HEALTH FORMULA ORAL CAPSULE 3.06 2.14
47081645 250 NF-DORZOLAMIDE HCL OPHTH SOLN 2% 29.14 20.40
47081646 250 NF-LUMIGAN OPHTH SOLN 0.01% 373.23 261.26
47081647 250 NF-NIACIN ORAL TABLET 100MG 0.14 0.10
47081648 250 NF-OCTREOTIDE ACETATE INJ SOLN 1,000MCG/ 681.08 476.76
47081649 250 NF-MORPHINE SULFATE IR ORAL TABLET 15MG 1.71 1.20
47081650 250 NF-PEDVAXHIB IM SOLN 7.5MCG/0.5ML 270.97 189.68
47081651 250 NF-VITAMIN K TABLET 0.1MG 0.17 0.12
47081652 250 NF-LINZESS CAP 145MCG 66.96 46.87
47081653 250 NF-MYRBETRIQ ORAL TABLET 50MG 58.05 40.64
47081656 250 NF-ALLEGRA-D 12 HOUR ORAL TAB ER 60MG-12 3.69 2.58
47081657 250 NF-CEFTRIAXONE INJ PWD FOR SOLN 2GM 365.64 255.95
47081658 250 NF-OXYCODONE HCL ORAL TAB 15MG 8.19 5.73
47081660 250 NF-TRANEXAMIC ACID ORAL TABLET 650MG 32.04 22.43
47081661 250 NF-PROTONIX ORAL ENTERIC-COATED TABLET 4 33.16 23.21
47081663 250 NF-TAGRISSO TAB 80MG 2,406.45 1,684.52
47081664 250 NF-DIGESTIVE ENZYMES TABLET 0.39 0.27
47081666 250 NF-GABAPENTIN AVPAK ORAL TABLET 800MG 11.96 8.37
47081667 250 NF-ZANTAC 150 TAB 150MG 17.89 12.52
47081668 250 NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG 6.75 4.73
47081669 250 NF-ATROVENT HFA INH ORAL/NEB SOLN 17MCG 144.55 101.19
47081670 250 NF-BUTALB/APAP/CAFF TABLET 50MG-325MG-40 8.02 5.61
47081671 250 NF-MORPHINE SULFATE 24 HR CAP ER 45MG 36.74 25.72
47081672 250 NF-MUCINEX DM TAB ER 2.40 1.68
47081673 250 NF-LEXAPRO ORAL TABLET 10MG 17.20 12.04
47081674 250 NF-XTANDI LIQ CAP 40MG 448.86 314.20
47081675 250 NF-METOPROLOL SUCCINATE CAP ER 25MG 6.96 4.87
47081676 250 NF-METOPROLOL SUCCINATE ER TAB ER 25MG 4.21 2.95
47081677 250 NF-RIVASTIGMINE TD PATCH ER 9.5MG/24HR 43.73 30.61
47081678 250 NF-REFRESH OPHTH SOLUTION 1.49 1.04
47081680 250 NF-PAPAYA ENZYME TABLET 14.96 10.47
47081681 250 NF-FOLBEE-PLUS CZ TAB 3.06 2.14
47081682 250 NF-FOLIC ACID ORAL TABLET 0.8MG 0.05 0.04
47081683 250 NF-PRILOSEC CAP DR 20MG 27.48 19.24
47081684 250 NF-PROGESTERONE IM OIL 50MG/1ML 16.25 11.38
47081685 250 NF-VIVELLE-DOT TD PATCH ER 0.0375MG/24HR 78.65 55.06
47081686 250 NF-PROGESTERONE LIQ CAP 100MG 11.29 7.90
47081687 250 NF-DAPTOMYCIN IV PWD FOR SOLN 500MG 2,200.37 1,540.26
47081688 250 NF-DAPTOMYCIN IV PWD FOR SOLN 500MG 2,200.33 1,540.23
47081689 250 NF-MICONAZOLE POWDER 159.60 111.72
47081690 250 NF-MICONAZOLE POWDER 181.62 127.13
47081691 250 NF-ENTRESTO ORAL TABLET 49MG-51MG 40.07 28.05
47081692 250 NF-WELLBUTRIN XL TABLET ER 300MG 37.86 26.50
47081693 250 NF-ARMOUR THYROID TABLET 30MG 3.41 2.39
47081694 250 NF-GABAPENTIN SUSP 25MG/1ML 5.62 3.93
47081695 250 NF-GABAPENTIN ORAL SOLUTION 250MG/5ML 1.37 0.96
47081696 250 NF-GABAPENTIN AVPAK ORAL TABLET 600MG 9.81 6.87
47081697 250 NF-JANUVIA ORAL TABLET 100MG 70.73 49.51
47081698 250 NF-OXCARBAZEPINE ORAL TABLET 300MG 10.87 7.61
47081699 250 NF-PIOGLITAZONE HCL ORAL TABLET 45MG 50.23 35.16
47081700 250 NF-LISINOPRIL ORAL TABLET 10MG 4.09 2.86
47081701 250 NF-LISINOPRIL ORAL TABLET 10MG 0.93 0.65
47081702 250 NF-AMARYL TAB 4MG 20.07 14.05
47081703 250 NF-ZYPREXA TABLET 7.5MG 81.70 57.19
47081704 250 NF-GUAIFENESIN ORAL TABLET 400MG 12.28 8.60
47081705 250 NF-ANASTROZOLE ORAL TABLET 1MG 53.21 37.25
47081706 250 NF-VENLAFAXINE HCL AVPAK TAB 75MG 8.73 6.11
47081707 250 NF-OXYBUTYNIN CHLORIDE ORAL TAB ER 10MG 14.22 9.95
47081708 250 NF-CONCERTA TAB ER 36MG 29.39 20.57
47081709 250 NF-NITROSTAT TABLET 0.3MG 0.45 0.32
47081710 250 NF-OPDIVO INTRAVENOUS SOLUTION 10MG/1ML 1,401.80 981.26
47081711 250 NF-BEVESPI AEROSPHERE INH 4.8MCG-9MCG/1A 177.18 124.03
47081712 250 NF-KETOCONAZOLE CREAM 2% 9.80 6.86
47081713 250 NF-HOMEOPATHIC CHEW TAB 1.18 0.83
47081714 250 NF-PROLENSA OPHTH SOLN 0.07% 461.27 322.89
47081715 250 NF-MURO-128 OPHTH OINTMENT 5% 107.50 75.25
47081716 250 BALOXAVIR 40 MG TAB 398.22 278.75
47081717 250 NF-ANORO ELLIPTA INH PWD 62.5MCG-25MCG/1 35.43 24.80
47081718 250 NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M 0.67 0.47
47081719 250 NF-CEFOTAXIME INJECTION PWD FOR SOLN 1GM 28.11 19.68
47081720 636 J3101 KCENTRA 500 UNITS 6,028.41 4,219.89
47081721 250 NF-CHLORTHALIDONE ORAL TABLET 25MG 9.46 6.62
47081722 250 NF-LO LOESTRIN FE ORAL TAB 26.07 18.25
47081723 250 NF-VITAMIN B12 ORAL TABLET 500MCG 0.23 0.16
47081724 250 NF-VITAMIN B12 ORAL TABLET 1000MCG 0.38 0.27
47081726 250 NF-TERAZOSIN HCL CAP 10MG 6.94 4.86
47081727 250 NF-CARDIZEM ORAL TABLET 60MG 49.59 34.71
47081728 250 NF-LIPITOR ORAL TABLET 20MG 19.31 13.52
47081729 250 NF-SPRINTEC TABLET 10.22 7.15
47081730 250 NF-ARICEPT ORAL TABLET 10MG 40.93 28.65
47081731 250 NF-NAMENDA TAB 10MG 36.61 25.63
47081733 250 NF-ACTOS ORAL TABLET 45MG 106.04 74.23
47081734 250 NF-DULOXETINE CAPSULE DELAYED RELEASE 60 30.19 21.13
47081735 250 NF-HYDROCHLOROTHIAZIDE CAP 12.5MG 1.83 1.28
47081736 250 NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 1MG 34.68 24.28
47081737 250 NF-FEXOFENADINE HCL ORAL TAB 180MG 2.78 1.95
47081738 250 NF-PULMICORT FLEX INH/NEB PWD 180MCG/1AC 812.43 568.70
47081739 250 NF-ESOMEPRAZOLE MAGNESIUM CAP DR 40MG 43.40 30.38
47081740 250 NF-LETROZOLE ORAL TABLET 2.5MG 78.34 54.84
47081741 250 NF-PRANDIN TAB 2MG 5.95 4.17
47081742 250 NF-JANUVIA ORAL TABLET 100MG 36.03 25.22
47081743 250 NF-PRESERVISION AREDS ORAL LIQUID CAPSUL 1.15 0.81
47081744 250 NF-PRESERVISION AREDS 2 LIQ CAP 0.93 0.65
47081745 250 NF-PRESERVISION AREDS 2 LIQ CAP 0.93 0.65
47081746 250 NF-PRANDIN TAB 2MG 5.78 4.05
47081747 250 NF-TURMERIC ORAL TABLET 1053MG 1.48 1.04
47081749 250 NF-COQ10 ORAL CAPSULE, LIQUID FILLED 200 1.83 1.28
47081750 250 NF-LEVOCARNITINE CAP 300MG 1.13 0.79
47081751 250 NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML 112.90 79.03
47081752 250 NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML 112.90 79.03
47081753 250 NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML 112.90 79.03
47081754 250 NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML 112.90 79.03
47081755 250 NF-AUGMENTIN XR ORAL TABLET ER 1000MG 21.78 15.25
47081756 250 NF-PRAZOSIN HCL CAP 2MG 5.09 3.56
47081757 250 NF-OFLOXACIN OPHTH SOLN 0.3% 48.45 33.92
47081760 250 NF-TOUJEO SUBCUTANEOUS SOLUTION 300U/1ML 414.63 290.24
47081761 250 NF-ZOLOFT TAB 100MG 13.28 9.30
47081762 250 NF-SOTALOL HCL AF ORAL TABLET 160MG 53.79 37.65
47081763 250 NF-CYMBALTA CAP DR 20MG 22.21 15.55
47081764 250 NF-ESTRADIOL TRANSDERMAL SYS 0.05MG/24HR 45.34 31.74
47081765 250 NF-TRIAZOLAM ORAL TABLET 0.25MG 3.78 2.65
47081766 637 NF-TYLENOL PM ES SYR 500MG-25MG/15ML 0.10 0.07
47081767 250 NF-TYLENOL PM EXTRA STRENGTH TABLET 0.45 0.32
47081768 250 NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1 9.83 6.88
47081769 250 NF-INCRUSE ELLIPTA INH PWD 62.5MCG/1ACT 48.51 33.96
47081770 250 NF-JANUVIA ORAL TABLET 50MG 88.45 61.92
47081771 250 NF-VYVANSE CAP 70MG 29.53 20.67
47081772 250 NF-ADDERALL TAB 30MG 33.77 23.64
47081773 250 NF-PALIPERIDONE ORAL TABLET, ER 6MG 122.11 85.48
47081774 250 NF-LACTASE ENZYME ORAL TABLET 3000U 0.29 0.20
47081775 250 NF-SYSTANE OPHTH SOLUTION 2.34 1.64
47081776 250 NF-OMEGA-3 KRILL OIL CAPSULE LIQUID FILL 1.15 0.81
47081777 250 NF-CAPTOPRIL ORAL TABLET 100MG 15.23 10.66
47081778 250 NF-WELLBUTRIN ORAL TABLET 100MG 7.44 5.21
47081779 250 NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC 14.03 9.82
47081780 250 NF-PROPAFENONE HCL CAP ER 425MG 32.60 22.82
47081781 250 NF-ACARBOSE ORAL TABLET 25MG 3.64 2.55
47081782 250 NF-ACARBOSE ORAL TABLET 25MG 3.64 2.55
47081783 250 NF-GLIPIZIDE ORAL TAB ER 10MG 3.22 2.25
47081785 250 NF-MYRBETRIQ ORAL TABLET 25MG 61.49 43.04
47081786 250 NF-ASMANEX TWIST INH/NEB POWDER 220MCG/A 739.36 517.55
47081787 250 NF-CANNABIDIOL SOLN 100MG/1ML 59.28 41.50
47081788 637 OSELTAMIVIR 30MG CAP (TAMIFLU) 60.97 42.68
47081789 637 NF-HYOSCYAMINE SULFATE DISINTEG TAB 0.12 2.28 1.60
47081791 250 NF-CO-Q-10 ORAL LIQUID CAPSULE 100MG 0.89 0.62
47081792 250 NF-JOINT BOOST ORAL TABLET 0.21 0.15
47081793 250 NF-ACCUPRIL ORAL TABLET 40MG 7.92 5.54
47081794 250 NF-SIMVASTATIN ORAL TABLET 20MG 19.57 13.70
47081795 637 NF-BACTRIM DS ORAL TABLET 800MG-160MG 12.48 8.74
47081796 250 NF-RAPAFLO CAP 8MG 41.84 29.29
47081797 250 NF-TRESIBA SUBQ SOLN 100U/1ML 162.70 113.89
47081798 250 NF-BYSTOLIC ORAL TABLET 10MG 22.92 16.04
47081799 250 NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC 28.10 19.67
47081800 250 NF-CREON 24,000 UNITS CAP 31.78 22.25
47081801 250 NF-TRANDOLAPRIL ORAL TABLET 4MG 4.60 3.22
47081802 250 NF-HALCION ORAL TABLET 0.25MG 26.84 18.79
47081803 250 NF-JANUVIA ORAL TABLET 100MG 75.74 53.02
47081804 250 NF-FLECTOR PATCH ER 1.3% 50.65 35.46
47081805 250 NF-BUPROPION HCL ORAL TABLET 75MG 3.18 2.23
47081806 250 NF-IBRANCE CAP 125MG 2,845.57 1,991.90
47081807 250 NF-LIPITOR TAB 80MG 75.27 52.69
47081808 401 NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI 0.04 0.03
47081809 250 NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI 0.06 0.04
47081810 250 NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG 146.79 102.75
47081811 250 NF-PROVENTIL HFA INH SUSP 0.09MG/1ACT 50.98 35.69
47081812 250 NF-COMBIVENT INH AER PWD 103MCG-18MCG/1 91.82 64.27
47081813 250 NF-VENTOLIN HFA INH SUSP 0.09MG/1ACT 12.26 8.58
47081814 250 NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1 168.11 117.68
47081815 250 NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1 153.98 107.79
47081816 250 NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1 106.39 74.47
47081817 250 NF-COMBIVENT INH AER PWD 103MCG-18MCG/1 91.82 64.27
47081818 250 NF-COMBIVENT INH AER PWD 103MCG-18MCG/1 91.82 64.27
47081819 250 NF-PROPAFENONE HCL CAP ER 425MG 40.00 28.00
47081820 250 NF-DILTIAZEM HCL CAPSULE 90MG 14.50 10.15
47081821 250 NF-MEMANTINE HCL ORAL TABLET 10MG 24.41 17.09
47081822 250 ALBUTEROL HFA INH SUSP 0.09MG/1ACT 12.50 8.75
47081823 250 IPRATROP/ALB RESP INH 100MCG-20MCG/ACT 20.50 14.35
47081824 250 NF-HYZAAR ORAL TABLET 50MG-12.5MG 8.19 5.73
47081825 250 NF-DONEPEZIL HCL ORAL TABLET 10MG 31.15 21.81
47081826 250 NF-VITAMIN E TABLET 100IU 0.24 0.17
47081827 250 INDOCYANINE GREEN INJ 25MG 520.50 364.35
47081828 250 NF-K-PHOS ORIGINAL TAB 500MG 2.22 1.55
47081829 250 NF-VIRT-GARD TAB 1MG-2.2MG-25MG 2.00 1.40
47081830 250 HALOPERIDOL DECAN 50MG/ML INJ 122.55 85.79
47081831 250 RAPID INTUBATION KIT 154.80 108.36
47081832 250 NF-FLECTOR PATCH ER 1.3% 101.62 71.13
47081833 637 NF-PROTONIX ORAL ENTERIC-COATED TABLET 4 33.16 23.21
47081834 637 NF-MORPHINE SULFATE CAP ER 20MG 20.92 14.64
47081835 250 NF-MORPHINE SULFATE CAP ER 20MG 21.43 15.00
47081836 250 NF-TIMOLOL MALEATE OPHTH GFS 0.5% 73.75 51.63
47081837 250 NF-DOXEPIN HCL CAP 10MG 0.81 0.57
47081838 250 NF-PROTEGRA ANTIOXIDANT CAPSULE 0.42 0.29
47081839 250 NF-GERITOL COMPLETE ORAL TABLET 0.36 0.25
47081841 250 NF-ZINC ACETATE CAP 50MG 13.87 9.71
47081842 637 NF-ALTAVERA ORAL TABLET 0.15MG-30MCG 4.42 3.09
47081843 250 NF-PREDNISOLONE ACETATE OPHTH SUSP 0.12% 8.71 6.10
47081844 250 NF-ENTRESTO ORAL TABLET 24MG-26MG 43.58 30.51
47081845 250 NF-EFFEXOR XR EXTENDED RELEASE CAPSULE 7 29.84 20.89
47081846 250 NF-DILANTIN CAP ER 100MG 2.62 1.83
47081848 250 NF-FELODIPINE EXTENDED RELEASE TABLET 10 10.86 7.60
47081849 250 NF-CARTIA XT ORAL 24 HR CAP ER 240MG 8.20 5.74
47081850 637 NF-JANUVIA ORAL TABLET 100MG 75.74 53.02
47081851 250 NF-BICALUTAMIDE ORAL TABLET 50MG 65.86 46.10
47081852 250 NF-FELODIPINE ORAL TAB ER 10MG 10.86 7.60
47081853 250 NF-SUMATRIPTAN SUCCINATE ORAL TABLET 25M 108.21 75.75
47081854 637 NF-MAGNESIUM OXIDE ORAL TABLET 400MG 0.36 0.25
47081855 250 NF-CINACALCET HCL ORAL TABLET 30MG 123.63 86.54
47081856 250 NF-MYRBETRIQ ORAL TABLET 50MG 64.81 45.37
47081857 250 NF-QUINAPRIL HCL TAB 10MG 15.10 10.57
47081858 250 NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30 6.71 4.70
47081859 250 NF-LOTRIMIN AF TOPICAL POWDER 2% 0.28 0.20
47081860 250 NF-NORTRIPTYLINE HCL AVPAK CAP 10MG 2.26 1.58
47081861 250 NF-FELODIPINE EXTENDED RELEASE TABLET 5M 6.04 4.23
47081862 636 J2430 PAMIDRONATE INJ 30MG/10ML 139.32 97.52
47081863 250 NF-LABETALOL HCL ORAL TABLET 300MG 4.08 2.86
47081865 250 NF-VENLAFAXINE HCL CAP ER 150MG 81.04 56.73
47081866 250 NF-VENLAFAXINE HCL ORAL TABLET 100MG 11.84 8.29
47081867 250 NF-ETHAMBUTOL HCL TAB 400MG 10.70 7.49
47081868 250 NF-RIFABUTIN CAP 150MG 18.60 13.02
47081869 250 NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI 0.05 0.04
47081870 250 NF-VITAL AF 1.2 CAL SUSP 0.13 0.09
47081871 250 NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG 16.68 11.68
47081872 250 NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG 16.68 11.68
47081873 250 NF-FENOFIBRATE AVPAK ORAL TABLET 145MG 20.53 14.37
47081874 250 NF-LEVOCETIRIZINE DIHCL ORAL TABLET 5MG 12.31 8.62
47081875 250 NF-OXYMETAZOLINE HCL NASAL SPRAY 0.05% 1.41 0.99
47081876 250 NF-ELIQUIS TAB 5MG 37.67 26.37
47081877 250 NF-TIMOLOL MALEATE OPHTH SOLN 0.5% 15.35 10.75
47081878 250 NF-SILODOSIN CAP 4MG 35.85 25.10
47081879 250 NF-CLARINEX ORAL TABLET 5MG 35.04 24.53
47081880 250 NF-COQ10 ORAL CAPSULE 100MG 0.56 0.39
47081881 250 NF-ENALAPRIL MALEATE ORAL TABLET 2.5MG 5.83 4.08
47081882 250 NF-CELEXA TAB 20MG 45.41 31.79
47081883 250 NF-ZOCOR ORAL TABLET 40MG 38.69 27.08
47081884 250 NF-LEVOTHYROXINE SODIUM ORAL TABLET 175M 3.22 2.25
47081885 250 NF-EFFEXOR-XR CAP ER 150MG 44.29 31.00
47081886 250 NF-ZOLMITRIPTAN DISINTEGRATING TAB 5MG 620.93 434.65
47081887 250 NF-ZOLMITRIPTAN ORAL TABLET 5MG 224.16 156.91
47081888 637 NF-CELEBREX CAP 200MG 29.84 20.89
47081889 250 NF-KRILL OIL ORAL LIQUID CAPSULE 500MG 0.96 0.67
47081890 250 NF-LOSARTAN AND HYDROCHLOROTHIAZIDE 100- 13.63 9.54
47081891 121 NF-1ST BASE CREAM 55.16 38.61
47081892 637 NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML 4.61 3.23
47081893 637 NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML 4.20 2.94
47081894 637 NF-POTASSIUM CHLOR/NACL INJ 2MEQ/100ML-0 0.02 0.01
47081895 250 GABAPENTIN SOLN 250MG/5ML 34.00 23.80
47081896 250 ROCURONIUM 50MG/5ML INJ 45.15 31.61
47081897 250 NF-ZINC SULFATE CAP 220MG 0.48 0.34
47081900 250 NF-FOLIC ACID AVPAK ORAL TABLET 0.4MG 1.10 0.77
47081901 250 NF-SYSTANE OPHTHALMIC OINTMENT 3%-94% 10.01 7.01
47081902 250 NF-CRANBERRY ORAL TABLET 450MG 0.14 0.10
47081903 250 NF-B COMPLEX TABLET 0.09 0.06
47081904 250 NF-GLIPIZIDE ER ORAL TAB ER 2.5MG 3.78 2.65
47081905 250 NF-CARTIA XT 24 HR CAP 180MG 6.66 4.66
47081906 250 NF-LUTEIN LIQUID FILLED CAPSULE 20MG 1.29 0.90
47081907 250 NF-PRESERVISION LUTEIN ORAL LIQUID CAPSU 0.76 0.53
47081908 250 NF-XOPENEX HFA INH/NEB AER PWD 0.045MG/1 21.84 15.29
47081909 250 NF-HALDOL DECANOATE IM OIL 50MG/1ML 417.95 292.57
47081910 250 CREON 12,000 UNITS CAP 19.15 13.41
47081911 250 NF-CRESTOR TAB 20MG 21.48 15.04
47081912 636 J3490 SEPTRA 800MG/160MG 10 CC IV 35.86 25.10
47081913 250 NF-PREDNISONE ORAL TABLET 2.5MG 0.66 0.46
47081914 250 NF-RABEPRAZOLE SODIUM ORAL TAB EC 20MG 45.79 32.05
47081915 250 NF-IRON ORAL TABLET 65MG 0.35 0.25
47081916 250 NF-VITAMIN D3 LIQUID FILLED CAPSULE 25MC 0.15 0.11
47081917 250 NF-SIMVASTATIN ORAL TABLET 10MG 11.28 7.90
47081918 250 NF-DILAUDID ORAL SOLUTION 1MG/1ML 4.84 3.39
47081919 250 NF-FLUOROMETHOLONE OPHTH SUSP 0.1% 68.20 47.74
47081920 250 NF-FLUOROMETHOLONE OPHTH SUSP 0.1% 68.20 47.74
47081921 250 NF-FISH OIL ORAL LIQ CAP 1200MG 0.22 0.15
47081922 250 NF-ALEVE ORAL TABLET 220MG 0.51 0.36
47081923 250 NF-ALEVE ORAL TABLET 220MG 0.41 0.29
47081924 250 NF-FOLIC ACID ORAL TABLET 0.4MG 0.04 0.03
47081926 250 NF-CRESTOR ORAL TABLET 20MG 44.25 30.98
47081927 121 NF-OMEGA 3-6-9 ORAL LIQUID FILLED CAPSUL 0.59 0.41
47081928 250 NF-OMEGA 3-6-9 ORAL LIQUID FILLED CAPSUL 0.53 0.37
47081929 250 NF-CANDESARTAN CILEXETIL ORAL TABLET 8MG 12.69 8.88
47081930 250 NF-TURMERIC ORAL CAPSULE 500MG 0.54 0.38
47081931 250 NF-RETAINE PM OPHTHALMIC OINTMENT 8.64 6.05
47081932 250 NF-RETAINE CMC OPHTHALMIC SOLUTION 0.5% 1.43 1.00
47081933 250 NF-CITALOPRAM HBR TABLET 40MG 9.78 6.85
47081934 250 NF-TYLENOL 8 HOUR TAB ER 650MG 0.46 0.32
47081935 250 NF-TYLENOL ARTHRITIS ORAL TABLET 650MG 0.31 0.22
47081936 250 NF-RYBELSUS ORAL TABLET 7MG 130.88 91.62
47081937 250 NF-ONDANSETRON ORAL TABLET 8MG 166.13 116.29
47081938 121 NF-OLMESARTAN MEDOXOMIL ORAL TABLET 20MG 27.65 19.36
47081939 250 NF-OLMESARTAN MEDOXOMIL ORAL TABLET 40MG 38.43 26.90
47081940 250 NF-METOPROLOL TARTRATE ORAL TABLET 100MG 4.26 2.98
47081941 250 NF-FLUVASTATIN SODIUM ORAL TAB ER 80MG 35.05 24.54
47081942 250 NF-ADVANCED EYE HEALTH LIQ CAP 1.07 0.75
47081943 250 NF-D-MANNOSE ORAL CAPSULE 300MG 0.70 0.49
47081944 250 NF-VITAMIN C ORAL TABLET 1000MG 0.31 0.22
47081945 250 NF-IPRATROPIUM BROMIDE NASAL SPRAY 0.03% 14.89 10.42
47081947 250 NF-VIMPAT ORAL TABLET 100MG 74.71 52.30
47081948 636 MINOCYCLINE 100MG INJ 1,068.64 748.05
47081949 636 Q0244 REGEN-COV 600MG/10ML INJ 0.01 0.01
47081950 250 NF-MORPHINE SULFATE CAP ER 60MG 46.57 32.60
47081951 250 NF-INSULIN LISPRO KWIKPEN SUBQ SOLN 100U 84.86 59.40
47081952 250 NF-FOLIC ACID ORAL TABLET 0.8MG 6.75 4.73
47081953 250 NF-BUPROPION SR ORAL TAB ER 100MG 6.75 4.73
47081954 121 NF-LACTATED RINGER'S SOLUTION-POTASSIUM 0.06 0.04
47081955 250 NF-ICAPS AREDS ORAL TABLET 0.48 0.34
47081956 250 NF-EPLERENONE TAB 25MG 60.22 42.15
47081957 121 NF-ETODOLAC CAP 200MG 5.75 4.03
47081958 250 NF-LODINE ORAL TABLET 400MG 86.88 60.82
47081959 250 NF-STIOLTO RESPIMAT INH 2.5-2.5MCG/1ACT 526.06 368.24
47081960 250 NF-MAGNESIUM OXIDE TABLET 250MG 0.08 0.06
47081961 250 NF-BENGAY GREASELESS CREAM 10%-15% 0.28 0.20
47081962 250 NF-ROPINIROLE HCL TAB 0.5MG 10.02 7.01
47081963 250 NF-IRON ORAL TABLET 27MG 0.10 0.07
47081964 250 NF-DIVALPROEX SODIUM ORAL TAB DR 500MG 13.00 9.10
47081965 250 NF-PRAVASTATIN ORAL TABLET 20MG 13.07 9.15
47081966 250 NF-DOXYLAMINE SUCC-PYRIDOXINE HCL TAB DR 31.28 21.90
47081967 250 NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1 9.83 6.88
47081968 637 TIMOLOL 0.5% OPTH SOLN 5 ML 73.10 51.17
47081969 250 NF-SOTALOL HCL ORAL TABLET 80MG 10.25 7.18
47081970 250 NF-FOSINOPRIL ORAL TABLET 40MG 3.28 2.30
47081971 250 NF-GABAPENTIN CAP 400MG 35.36 24.75
47081972 250 NF-NIFEDIPINE ER TABLET 60MG 16.20 11.34
47081973 250 NF-MELATONIN ORAL TABLET 10MG 0.59 0.41
47081974 250 NF-ROSUVASTATIN CALCIUM CAP 5MG 14.64 10.25
47081975 250 NF-CRESTOR TAB 5MG 22.46 15.72
47081977 250 NF-DETROL LA CAP ER 4MG 58.69 41.08
47081978 250 NF-MOVE FREE OMEGA JOINT PLUS LIQ CAP 3.10 2.17
47081979 250 NF-SUPER B COMPLEX W/C CAPSULE 0.20 0.14
47081980 250 NF-LEVOTHYROXINE SODIUM LIQ CAPSULE 137M 20.30 14.21
47081981 250 NF-LEXAPRO TAB 5MG 58.07 40.65
47081982 250 NF-HYDROCHLOROTHIAZIDE CAP 12.5MG 1.70 1.19
47081983 637 IVERMECTIN 3MG TAB 21.37 14.96
47081984 637 BUDESONIDE 160MCG/FORMOTEROL 4.5MCG/ACT 21.72 15.20
47081985 250 NF-FARXIGA ORAL TABLET 10MG 49.93 34.95
47081986 250 NF-NOVOLIN N INJECTION 100U/ML 66.10 46.27
47081987 250 NF-NOVOLIN R INJECTION 100U/ML 66.10 46.27
47081989 637 NF-HUMULIN N (NPH) INJECTION 100U/ML 71.38 49.97
47081990 637 NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML 6.38 4.47
47081991 250 NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML 6.38 4.47
47081992 250 NF-NOVOLIN R INJ SOLN 100U/1ML 66.10 46.27
47081993 637 NF-DEXTROSE & NACL W/KCL IJ 5%-0.45%-0.0 0.02 0.01
47081994 250 NF-KETOROLAC TROMETHAMINE TAB 10MG 8.63 6.04
47081995 250 NF-SUDAFED ORAL TABLET 30MG 0.97 0.68
47081996 250 NF-CELEXA TAB 20MG 17.13 11.99
47081997 250 NF-BREZTRI AEROSPHERE INH AER LIQ 264.85 185.40
47081998 250 NF-RIZATRIPTAN BENZOATE DIS TAB 10MG 261.68 183.18
47081999 250 NF-LORAZEPAM INTENSOL CONCENTRATE 2MG/ML 6.40 4.48
47082000 250 NF-FLECAINIDE ACETATE ORAL TABLET 50MG 8.08 5.66
47082001 250 NF-TRAVATAN Z OPHTH SOLN 0.004% 196.99 137.89
47082002 250 NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG 9.73 6.81
47082003 250 NF-CITALOPRAM HYDROBROMIDE ORAL TAB 20MG 10.14 7.10
47082004 250 NF-MAXALT ORAL TABLET 10MG 143.05 100.14
47082005 250 NF-HUMALOG KWIKPEN SUBQ SOLN 100U/1ML 169.73 118.81
47082006 250 NF-MAXALT-MLT DISINTEGRATING TAB 10MG 175.54 122.88
47082007 250 NF-TORSEMIDE ORAL TABLET 5MG 2.54 1.78
47082008 250 NF-VALSARTAN ORAL TABLET 160MG 20.85 14.60
47082009 250 NF-EPLERENONE ORAL TABLET 50MG 16.66 11.66
47082010 250 NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML 3.53 2.47
47082011 250 FLUORESCEIN 500MG/5ML INJ 248.82 174.17
47082012 250 NF-PREVAGEN ORAL CAP 10MG-50MCG 3.80 2.66
47082014 250 NF-AMITRIPTYLINE HCL ORAL TABLET 100MG 10.16 7.11
47082015 250 NF-NORTRIPTYLINE CAPSULE 10MG 1.95 1.37
47082016 637 APIXABAN 5MG TABLET 42.92 30.04
47082017 637 TIMOLOL 0.5% OPTH SOLN 5 ML 73.10 51.17
47082018 250 NF-DESITIN ORIGINAL TOPICAL OINTMENT 40% 0.14 0.10
47082019 250 NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG 3.22 2.25
47082020 250 NF-MINOCYCLINE HCL CAP 100MG 13.59 9.51
47082021 250 NF-HYDROCHLOROTHIAZIDE ORAL TABLET 50MG 0.96 0.67
47082022 250 NF-COLESTIPOL ORAL TABLET 1GM 6.80 4.76
47082023 250 NF-COLESTIPOL HCL TAB 1GM 4.95 3.47
47082024 250 NF-LOVASTATIN ORAL TABLET 10MG 5.38 3.77
47082025 250 NF-AMIODARONE HCL ORAL TABLET 100MG 29.72 20.80
47082026 250 NF-MINOCYCLINE HCL 24.08 16.86
47082027 637 FLUVOXAMINE MALEATE 50MG TABLET 11.07 7.75
47082028 250 NF-CARBAMAZEPINE CAP ER 300MG 2.59 1.81
47082030 250 NF-QUINAPRIL HCL TAB 10MG 23.36 16.35
47082031 250 NF-CHLOROTHIAZIDE SOD IV PWD FOR SOLN 0. 1,428.96 1,000.27
47082032 250 NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M 16.85 11.80
47082033 250 NF-FIBERCON ORAL TABLET 625MG 0.42 0.29
47082034 250 NF-CHLOROTHIAZIDE IV POWDER FOR SOLN 0.5 1,428.96 1,000.27
47082035 250 NF-NALTREXONE HCL ORAL TABLET 50MG 10.94 7.66
47082036 250 NF-KLONOPIN TABLET 1MG 13.97 9.78
47082038 250 REMDESIVIR 100MG INJ (VEKLURY) 2,683.20 1,878.24
47082040 250 NF-FLUVOXAMINE MALEATE TAB 50MG 10.29 7.20
47082041 250 NF-FLUVOXAMINE MALEATE CAP ER 100MG 40.73 28.51
47082042 250 NF-ADVAIR DISKUS 100/50 DISK 25.36 17.75
47082043 250 NF-FEXOFENADINE HCL/PSEUDOEPHEDRINE HCL 26.10 18.27
47082044 637 VITAMIN C 1000 MG TAB (ASCORBIC ACID) 6.75 4.73
47082045 250 NF-FLUVOXAMINE MALEATE TAB 50MG 10.29 7.20
47082046 250 NF-VITAMIN E CAPSULE 1000IU 0.32 0.22
47082047 250 NF-FEBUXOSTAT ORAL TABLET 40MG 49.51 34.66
47082048 250 NF-NASACORT ALLERGY 24HR NASAL SPRAY 55M 6.46 4.52
47082049 250 NF-JANUMET XR ORAL TAB ER 1000MG-100MG 79.49 55.64
47082050 250 NF-PRIMIDONE ORAL TABLET 250MG 4.20 2.94
47082052 636 NACL 0.9% + 40 MEQ KCL 1000 ML IV FLUID 52.05 36.44
47082054 250 NF-NAMZARIC CAP ER 7MG-10MG 81.61 57.13
47082055 250 NF-DOXYCYCLINE CAP 50MG 5.80 4.06
47082056 636 J0696 CEFTRIAXONE 2000MG INJ (ROCEPHIN) 392.62 274.83
47082059 250 NF-MAYZENT ORAL TABLET 2MG 1,289.24 902.47
47082060 250 NF-DALFAMPRIDINE ORAL TAB ER 10MG 189.48 132.64
47082061 250 NF-DILTIAZEM 24 HR CAP ER 240MG 7.79 5.45
47082062 250 NF-QUINAPRIL HCL/HCTZ ORAL TAB 20MG-25MG 4.89 3.42
47082065 250 NF-ROSUVASTATIN CALCIUM AVPAK TABLET 10M 5.49 3.84
47082068 250 NF-ETOMIDATE INTRAVENOUS SOLUTION 2MG/1M 3.75 2.63
47082069 250 NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML 4.20 2.94
47082070 250 NF-ROCURONIUM BROMIDE IV SOLN 10MG/1ML 4.20 2.94
47082071 250 NF-NEPRO WITH CARB STEADY ORAL SUSP 0.06 0.04
47082072 250 NF-MORPHINE SULFATE CAP ER 60MG 44.82 31.37
47082073 250 NF-MORPHINE SULFATE CAP ER 30MG 22.72 15.90
47082074 250 NF-EUTHYROX ORAL TABLET 75MCG 2.19 1.53
47082076 250 NF-ALTACE ORAL CAPSULE 10MG 4.82 3.37
47082077 250 NF-TRIAMTERENE AND HCTZ TABLET 37.5MG-25 1.57 1.10
47082078 250 NF-MORPHINE SULFATE CAP ER 60MG 45.44 31.81
47082079 250 NF-MORPHINE SULFATE IR ORAL TABLET 30MG 7.30 5.11
47082081 250 NF-LANSOPRAZOLE PWD FOR SUSP 3MG/1ML 1.84 1.29
47082082 250 LIDOCAINE JELLY 2% 5ML (XYLOCAINE) 36.12 25.28
47082083 250 NF-SIMVASTATIN ORAL TABLET 40MG 19.57 13.70
47082084 250 NF-PANTOPRAZOLE 20MG TABLET 15.94 11.16
47082085 250 NF-TRIAMCINOLONE ACETONIDE CREAM 0.1% 0.27 0.19
47082088 250 NF-SUBOXONE SL FILM 8MG-2MG 43.12 30.18
47082089 250 NF-PROCTOSOL-HC RECTAL CREAM 2.5% 3.52 2.46
47082091 250 NF-TRULICITY SUBQ SOLN 1.5MG/0.5ML 2,127.74 1,489.42
47082093 250 NF-I-VITE LUTEIN ORAL TABLET 0.31 0.22
47082094 250 NF-MYLANTA TONIGHT ORAL SUSPENSION 0.07 0.05
47082095 250 NF-ALPHAGAN P OPHTH SOLN 0.15% 189.52 132.66
47082096 250 NF-CARTIA XT ORAL 24 HR CAP ER 120MG 4.89 3.42
47082099 250 NF-ROSUVASTATIN CALCIUM CAP 10MG 14.64 10.25
47082100 250 NF-ADVAIR HFA 230/21 INH AER 230MCG-21MC 194.73 136.31
47082101 250 NF-LORAZEPAM ORAL TABLET 1MG 3.63 2.54
47082102 636 KCENTRA 548 IU 7,681.82 5,377.27
47082103 250 NF-ROSUVASTATIN CALCIUM ORAL TABLET 20MG 34.45 24.12
47082104 250 NF-POTASSIUM CHLORIDE IV SOLN 30MEQ/100M 0.13 0.09
47082106 250 NF-SODIUM CHLORIDE 0.02 0.01
47082107 250 NF-ANTIBIOTIC OINTMENT 0.63 0.44
47082108 250 NF-ZOSYN IV SOLUTION 4GM-0.5GM/100ML 1.22 0.85
47082110 636 PIPERACILLIN/TAZOBACTAM 4GM/.5GM INJ 30.96 21.67
47082113 250 NF-FOSINOPRIL SODIUM ORAL TABLET 20MG 4.76 3.33
47082114 250 NF-8HR ARTHRITIS PAIN RELIEF TABER 650MG 0.30 0.21
47082116 250 NF-VISION HEALTH ORAL LIQUID CAPSULE 0.63 0.44
47082118 250 NF-NEXIUM 24HR ORAL TABLET DR 20MG 3.71 2.60
47082119 250 NF-VIT B COMPLEX AND IRON-VIT B COMPLEX 10.29 7.20
47082120 250 NF-VIT. B COMPLEX AND MINERAL-VIT. B COM 29.78 20.85
47082121 250 NF-FLAX SEED OIL CAPSULE 1000MG 0.32 0.22
47086654 637 LOSARTAN 50MG TAB (COZAAR) 10.23 7.16
47086662 637 NEPRO 240 ML SUPPLEMENT 16.50 11.55
53000001 771 G0008 ADMIN OF FLU VIRUS VACCINE 10.25 7.18
53000002 636 90656 ADULT FLU PREFILLED SYRINGE 10.50 7.35
53000003 636 90655 PEDIATRIC PREFILLED SYRINGE 13.50 9.45
53000004 636 90662 INFLUENZA VIRUS VACCINE 65+ 26.75 18.73
53001000 510 99211 O/P CLINCI VISIT LEVEL I 59.75 41.83
58008919 942 97802 MNT INDIVIDUAL ASSESSMENT 69.96 48.97
58008921 942 97803 MNT INDIVIDUAL FOLLOW-UP 62.54 43.78
58008923 942 97804 MNT GROUP ASSESSMENT 36.57 25.60
58008924 942 G0270 MNT INDIVIDUAL REASSESSMENT CHANGE COND 59.00 41.30
58009814 942 CAL COUNT 11.50 8.05
58009815 270 EXCHANGE LIST FOR WEIGHT MANAGEMENT 5.25 3.68
58009817 270 EXCHANGE LIST FOR MEAL PLANNING 6.50 4.55
58009818 270 FIRST STEP IN DIABETES MEAL PLANNING 2.50 1.75
60009815 510 EXCHANGE LIST FOR WEIGHT MANAGEMENT 5.00 3.50
60009817 510 EXCHANGE LIST FOR MEAL PLANNING 6.00 4.20