Morrill County Community Hospital
The FY19 IPPS Final Rule from CMS states that effective Jan. 1, 2019, hospitals are required to make available a list of their current standard charges via the internet in a machine-readable format and to update this information at least annually, or more often as appropriate. Morrill County Community Hospital is therefore posting our basic charge master to become compliant with the new regulation. Please note that these prices are subject to change without notice and do not represent a complete picture of the charges incurred during a visit or stay in our facility.
If you are contemplating having a procedure done at MCCH and would like to know the estimated cost to you, please contact our office staff at 308-262-1616.
CPT © 2018 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Applicable FARS/DFARS Restrictions Apply to Government Use. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or disperse medical services. The AMA assumes no liability for data contained or not contained herein.
Charge Code Description Proc Code Rate Effective Date 01/01/2019
AMB ALS SCT A0434 2130.00
AMB ALS1 EMERGENT A0427 1245.00
AMB ALS1 A0426 785.00
AMB ALS2 A0433 1800.00
AMB BLS EMERGENT A0429 925.00
AMB BLS NON EMERGENT A0428 655.00
AMBULANCE LOADED MILE A0425 22.00
AMBULANCE LOADED MILE NON-COV A0888 1.01
CARDIAC REHAB EVALUATION 93797 297.00
CARDIAC REHAB W/MONITOR 93798 205.00
CHEST WALL MANIPULATION 94667 199.00
CR PHASE III 2 DAY/WK/MO 32.00
CR PHASE III 3 DAYS/WK/MO 48.00
CR PHASE III COUPLE/MO 50.00
EVALUATE PT USE OF INHALER 94664 195.00
OTHER TX PROC IMPROVE RESP FUNCTION G0238 64.00
PULM REHAB INCL EXER 1 HR PER SESSION G0424 215.00
PULMONARY STRESS TEST 94618 485.00
SPIROMETER - VOLUME LOOP 94375 290.00
SPIROMETRY PRE-POST MED 94060 686.00
SPIROMETRY TEST 94010 320.00
TX PROC IMPR RESP FUNCTION >2 INDIVIDUAL G0239 59.00
TX PROC STRENGTH RESPITORY MUSCLE 15 MIN G0237 71.00
APPENDECTOMY 44950 2.00
2% CHLORHEXIDINE GLUCONATE CLOTHS A6250 9.35
4 FACET INTRO NDL 11/13G 100.45
ABDOMINAL BINDER XXL 65.00
ABDOMINAL BINDER, UNIV. 65.00
ADHESIVE FELT 1/16" /4" 6.85
ADHESIVE FELT 1/4" /4" 12.90
ADULT DIAPER TAN LARGE 4.60
AIRWAY BERMAN 2.50
AIRWAY NASOPHARYNGEAL 26.50
AIRWAYS CHILD 9.95
ALCOHOL STICKS 3/PKG20/BX 3.05
ALLDRESS 4X4 43.90
ALLDRESS 6X6 48.20
ALLERGY TRAY 28X1/2 1CC 40.25
AMBU TUBE CHECK 52.95
ANES AGENT SUPPLIES 0.00
ANES BREATH/CIRCUIT 45.80
ANES BREATHNG CIRCUIT PED 45.80
ANKLE BRACE W/STRAP 94.75
ANKLE BRACE W/STRAP MED 94.75
ANKLE BRACE W/STRAP SMALL 94.75
ANKLE BRACE W/STRAP XLG 94.75
ANKLE BRACE W/STRAP XSM 94.75
ANKLE HONEYCOMB RIGHT 76.90
ANKLE HONEYCOMB STIRRUP 76.90
ANOSCOPE CVR W/OBURATR 6.90
ANOSCOPE DISP 19.95
ANTI REFLUX FILTER 53.25
ANTI-EMBOLISM STOCKING 362.55
APEX S/D HALF PIN 20 THR 2X45 412.50
APPLIC. COTTON TIP 6" 2'S 1.50
APPLICAT.COTTON TIP 6"100 0.10
APPLICATOR,PROTOSCOP 18" 1.50
ARCH SUPPORT 195.75
ARM ALUM SPLINT ADULT 95.40
ARM ALUM SPLINT PEDI 95.40
ARM COLLES SPLINT 95.40
ARM COLLES SPLINT 9105 95.40
ARM SLING A4565 8.35
ARM SLING AND SWATHE A4565 166.95
ARM SLING CHILD A4565 72.35
ARM SLING MEDIUM A4565 8.35
ARM SLING SMALL A4565 8.35
ARM SLING W/PAD & STRAP A4565 19.65
ARM SLING W/STRP/PAD LG A4565 19.65
ARM SLING W/STRP/PAD MED A4565 19.65
ARM SLING W/STRP/PAD SM A4565 19.65
ARM SLING W/STRP/PAD XLG A4565 19.65
ARM SLING X-LARGE A4565 8.35
ARM SLING X-SMALL A4565 8.35
ARM SPLINT ALUM ADULT 95.40
ARM SPLINT ALUM PEDI 95.40
ARM SPLINT COLLES 95.40
ASEPTO STERILE 8.90
AUTOPLEX W/VERTAPLEX 1662.50
BAG AMBU DISP 328.00
BAG ENEMA 12.60
BAG,URIMETER/16 FOLEY CAT 198.90
BAG,WIDE DRAIN Y ASSBLY 29.05
BANDAGE 3X5YD NONST 5.85
BANDAGE ABD 5X9 1.80
BANDAGE ACE 5.30
BANDAGE ACE 3" 5.30
BANDAGE ACE 4" 5.30
BANDAGE ACE 6x4.5 YDS 5.30
BANDAGE ACE STERILE 7.25
BANDAGE COBAN 1" 9.20
BANDAGE COBAN 2" 19.10
BANDAGE COBAN 3" 6.75
BANDAGE COBAN 3" STERILE 9.55
BANDAGE COBAN 4" 8.45
BANDAGE COBAN 4" STERILE 11.95
BANDAGE COFLEX 2" STERILE 9.20
BANDAGE CONFORMING 1 STRL 2.00
BANDAGE CONFORMING 2 STRL 5.85
BANDAGE CONFORMING 3 STRL 7.70
BANDAGE CONFORMING 4 STRL 9.35
BANDAGE CONFORMING 6 STRL 15.70
BANDAGE KLING 2" NONSTER 4.40
BANDAGE KLING NONST 4" 7.60
BANDAGE PLASTER 3X3 24.10
BANDAGE TELFA 3X4 3.25
BANDAGE TUBULAR #2 1X150 144.80
BANDAGE TUBULAR /YARD 5.50
BANDAGE, DOME PASTE #4 144.95
BANDAGE, PLAST.3X15X-FAST 3.70
BANDAGE, PLAST.4X15 X-FST 4.20
BANDAGE, PLASTER 2X3 17.40
BANDAGE,ELASTOPLAST 3 52.55
BANDAGE,PLASTER 4X5 30.30
BANDAGE,PLASTER 6X5 41.95
BANDAID 1X3 WOVEN 19.70
BANDAID EX-LG 100/BX 1.25
BANDAID FINGERTIP 1.00
BANDAID KNUCKLE 0.85
BEAVER MINI BLADE 99070 22.35
BENDABLE FORK 65.00
BENDABLE SOUP SPOON 65.00
BENZOIN COMPOUND TX 1.95
BETADINE SOAK 8.90
BI POLAR 28FR LOOP 660.00
BILE BAG 9 OZ SMALL 23.00
BILE DRAINAGE POUCH SET 163.20
BINOCULAR MICROSCOPY 92504 67.45
BIOPSY CUTTING NEEDLE 18G 39.00
BIOPSY FORCEPS 638.85
BIOPSY FORCEPS EGD 638.85
BIOPSY NEEDLE QUICK CORE 202.90
BIOPSY NET 736.70
BIOPSY PUNCH 15.70
BIOPSY US NEEDLE GUIDE 49.40
BIPOLAR 24-26 FR LOOP 3861.60
BIPOLAR COAG ELECTRODE 745.25
BIPOLAR CUTTING LOOP 24/26FR 743.25
BIS MONITORING SYSTEM 281.85
BLADE ELECTRODE 26.25
BLOOD ADM 1 UNIT 219.50
BLOOD ALCOHOL 62.70
BLOOD SET-UP 190.10
BOWL 32 OZ GRADUATE 6.00
CAMERA & TV 44.70
CAMERA COVER 85.00
CANNISTER WITH GEL 500 ML 5 PACK A7000 147.85
CANNULA CURETTE 4MM FLEX 184.75
CANNULA CURETTE 6MM FLEX 184.75
CANNULATED COUNTERSINK 99070 500.00
CARBON CONNECTING ROD 3MM X 90MM 338.25
CAST PADDING 2" STERILE 5.75
CAST PADDING 2X4 NONSTRL 3.65
CAST PADDING 3" STERILE 6.80
CAST PADDING 3" STERILE 8.10
CAST PADDING 3X4 NONSTRL 5.00
CAST PADDING 4X4 NONSTRL 6.30
CAST PADDING 6"X4 NONSTRL 9.55
CAST WEDGE 12.30
CATH & GLOVE 14FR 7.75
CATH & GLOVE 6FR 7.20
CATH & GLOVE 8FR 7.05
CATH BILIARY BALLON #5 702.10
CATH BILIARY BALLON #6 702.10
CATH FEMALE 14FR X 6 2.85
CATH FILEY 12 X 5CC--30CC 59.40
CATH FOLEY 10 X 3CC 96.90
CATH FOLEY 12 X 30CC 59.40
CATH FOLEY 14 X 5CC 22.85
CATH FOLEY 16 X 30CC 57.30
CATH FOLEY 16 X 5CC 22.85
CATH FOLEY 18 X 30CC 60.30
CATH FOLEY 18 X 5CC 49.95
CATH FOLEY 20 X 30CC 16.50
CATH FOLEY 20 X 5CC 22.35
CATH FOLEY 22 X 30CC 16.50
CATH FOLEY 22 X 5CC 22.35
CATH FOLEY 22FR 5CC 27.35
CATH FOLEY 24 X 30CC 60.30
CATH FOLEY 24 X 5 SILASTI 150.05
CATH FOLEY 24 X 5CC 52.70
CATH FOLEY 26FR 10 CC 67.60
CATH FOLEY 8 X 3CC 96.90
CATH FOLEY SIL 20FR 5CC 27.35
CATH FOLEY SIL 5CC 24 FR 16.30
CATH INTRO PERC 6FR SHEATH KIT 116.90
CATH KIT FEMALE 43.30
CATH MALE EXTERNAL MED 12.25
CATH MALE EXTERNAL STD. 12.25
CATH PLAIN 51.95
CATH PLUG 6.65
CATH STABILIZTN DEVICE 17.39
CATH STYLET 140.25
CATH STYLET COUNCILL 151.75
CATH SUPRAPUBIC INTRODUCE 248.40
CATH THORACIC 12FR 78.65
CATH THORACIC 16FR 91.25
CATH THORACIC 20FR 63.75
CATH THORACIC 24FR 63.05
CATH THORACIC 28FR 63.05
CATH THORACIC 32FR 51.00
CATH THORACIC 36FR 51.00
CATH THORACIC 8FR 195.20
CATH TRAY URETHRAL 14FR 29.00
CATH TRAY W/O CATH 24.55
CATH URETHRAL MALE VINYL 2.00
CATH YUEH PIGTAIL 81.20
CATH/GLOVE 10FR 7.05
CATHETER CONDOM 6.45
CATHETER EMLEOLECTOMY 508.60
CATHETER LEG STRAP ADJ 27.30
CATHETER SUCTION 5.30
CATHETER TRAY FOLEY 16FR 136.60
CATHETER URETERAL OPEN TIP 6FR C1758 121.75
CATHETER URETHRAL 12FR RD 47.25
CATHETER URETHRAL 14FR RD 47.25
CAUTERY CORD 51.35
CAUTERY HI-TEMP FINE TIP 115.65
CAUTERY PAD 115.65
CAUTERY PAD 44.70
CAUTERY PENCIL HAND 44.75
CAUTERY PENCIL TEFLON 44.75
CAUTERY SUCTION 114.15
CAUTERY TIP CLEANER 3.45
CAUTERY, EXTENDED BLADE 53.35
CENTRAL LINE DRSG CHANGE KIT 64.05
CENTRAL PICC LINE CAPS 23.75
CERVICAL ROLL 77.80
CERVICAL ROLL ORIG MCKENZ 77.80
CHEMO KIT 56.65
CHEMO SAFETY BOX 141.50
CHEST PERCUSSION THERAPY 68.85
CHEST PROCUSSION 7X 63.00
CHEST TUBE TRAY 168.00
CHIBA NEEDLE 34.00
CHLORAPREP W/TINT APPLIC 28.25
CHOLANGIOCATH KIT 374.30
CHOLANGIOGRAPHY SET W/CTH 274.90
CIRCUIT BREATH PEDIATRIC 78.85
CIRCUIT, BREATHIN ANES 45.80
CLAMP POUCH 22.25
CLAVICAL SPLINT 102.70
CLIPPER BLADE RAZOR 15.00
CLOSED IV CATH SYSTEM 22GA X 1 21.00
CO2 DECTECTOR 119.50
CODE BLUE EASI-LAV-ADULT 750.45
CODE BLUE EASI-LAV-PEDIAT 750.45
COLD STERILE STRIPS-1 BTL 389.85
COLD/HOT GEL PACK 3.65
COLLAR BUTTON TUBE TEFLON 105.30
COLLAR CERVI FOAM 4" 65.60
COLLAR CERVI INFANT 114.30
COLLAR CERVI MED 255.65
COLLAR CERVI PEDIATRIC 34.00
COLLAR CERVI PHILA LG 317.10
COLLAR CERVI PHILA MED 317.10
COLLAR CERVI PHILA SM 317.10
COLLAR CERVI SM 255.65
COLLAR CERVICAL 2" UNIV 65.60
COLLAR CERVICAL 3" UNIV 65.60
COLLAR SERPENTINE COLLAR 94.65
COLLAR STIFF NECK ADULT 40.00
COLLAR STIFF NECK BABY 40.00
COLLAR STIFF NECK NO NECK 40.00
COLLAR STIFF NECK PED. 40.00
COLLECTOR CLEAN CATCH 9.75
COLONOSCOPE-RENT 268.60
COLOS OSTOMY BELT 68.85
COLOS OSTOMY SYSTEM 1-1/2 34.40
COLOS OSTOMY SYSTEM 2-1/4 47.50
COLOS POUCH 2-1/4 36.40
COLOS POUCH 2-3/4 36.40
COLOS POUCH CLAMP 21.05
COLOS STOMA POUCH 1-1/4" 36.40
COMB 0.25
COMFORT BATH 36.00
COMFORT HAIR 25.30
COMPRESSOR SCREW SWINGBAR 5.20
CONCAVE REAMER 437.50
CONE TIP CATHETER 8FR 59.45
CONNECTOR GROSHONG REP 143.50
CONTROL SYRINGE 13.10
CONVEX REAMER 437.50
CORD CLAMP 11.30
COTTON BALL PREPTIC MED 17.20
COTTON BALLS LG 18.95
COVERS, MAYO TABLE 18.35
CPAP HUMIDIFIER RENTAL 583.55
CPAP KIT FLEXFIT 1089.75
CPAP TUBING 404.45
CRESCENTIC BLADE 15MM CUT EDGE 332.50
CRICOTHYROTOMY KIT 430.20
CROSTELLA BALLOON 99070 525.00
CROUP TENT 62.70
CT TRIPAK 54.60
CUFF BLOOD PRESSURE DISP 10.00
CURRETTE ADENOID 356.55
CYSTO PACK 36.70
CYSTO SET W/LG BORE CLAMP 23.25
CYSTOSCOPY IRRIGATION SET 29.20
CYTOLOGY BRUSH 691.75
DEBRIDEMENT PUMP PER DAY 321.85
DEFIB PADS 429.15
DEFIBULATOR/CARDIOVERSION 214.85
DEFLUX METAL NEEDLE 3.7FR X 23G 202.50
DEFOGGER 40.30
DENTAL INSTRUMENT TRAY 407.00
DENTAL MACHINE 134.25
DENTURE CUPS 3.35
DERMABOND PEN .7ML 99070 71.50
DERMABOND SKIN ADHESIVE 85.65
DESTINATION SHEATH 6FR 500.00
DIAPER ADULT LG 4.60
DIAPER PAMPERS INFANT 2.60
DIAPERS,MEDIUM 16-24 LBS. 2.85
DIGITAL PAD L/XLG SILOPAD 30.10
DIGITAL PAD S/M SILOPAD 24.95
DILATOR ESOPHAGEAL 26.55
DISP PATIENT SLING A4565 117.75
DISP. EAR CURRETTE 50/BX 8.05
DISP. FACE TENT 11.00
DISSECTOR 5MM 716.45
DISSECTORS, KITTNER BLUNT 13.75
DRAIN ABCESS SET 14FR 355.00
DRAIN BAG 31.25
DRAIN BAG LEG LARGE 63.05
DRAIN CATH 18FR 284.60
DRAIN CATH 8.5/25 277.00
DRAIN J-PRATT FLAT SILICO 149.65
DRAIN J-VAC CLOSED WND 42.70
DRAIN JACKSON PRATT 100 CC 37.25
DRAIN JACKSON PRATT 400 CC 45.00
DRAIN JACKSON-PRATT 204.65
DRAIN PENROSE 6.45
DRAIN PENROSE 1 X 36 21.40
DRAIN PENROSE 1/2 X 12 4.55
DRAIN PENROSE 1/4 X 18 5.20
DRAIN POUCH SET BILIARY 32.20
DRAIN UNIT PLEUR VAC ADUL 563.60
DRAIN UNIT PLEUR VAC INFA 663.50
DRAIN URINE 2000CC 58.25
DRAPE C-ARM 16.60
DRAPE HAND SURGICAL 66.40
DRAPE IMPERVIOUS SPLIT 90715 16.35
DRAPE STERILE 18 X 26 7.20
DRAPE-BASIC 155.10
DRAPE-GOWN 43.70
DRAPE-LAP 226.05
DRAPE-PERI-GYN 154.10
DRESSING ACTICOAT 5 X 5 132.75
DRESSING ADAPTIC 3 X 16 5.00
DRESSING ADAPTIC 3 X 4.25 9.15
DRESSING ADAPTIC 3X3 3.00
DRESSING ALLDRESS 51.95
DRESSING AQUACEL SILVER 135.45
DRESSING CLR ACRYLIC 4X5 35.20
DRESSING CLR ACRYLIC 5X6 61.00
DRESSING DERMAGRAN 4X4 49.75
DRESSING DUODERM CGF 4X4 22.10
DRESSING HYPAR GEL 92.75
DRESSING MESALT 53.15
DRESSING NON-ADHERING 3X8 19.15
DRESSING NONADHERENT 3X4 1.05
DRESSING OPSITE 4 X 5 1/2 13.85
DRESSING OPSITE 6X6.5CM 4.10
DRESSING OPSITE 8 X 4 18.20
DRESSING RAY-TEC 4X4 10/B 9.55
DRESSING SPONGE 2X2 2EA/P 0.50
DRESSING TEGAD/SLV AGMESH 29.65
DRESSING TEGADERM 2 X 2 2.80
DRESSING TEGADERM 2 X 3/4 1.95
DRESSING TEGADERM 4 X 4 7.90
DRESSING TEGADERM 8 X 12 22.30
DRESSING TELFA 2X3 100/BX 1.45
DRESSING TELFA 4X3 1.45
DRESSING TELFA 4X8 ISLAND 12.60
DRESSING TELFA 6 X 3 1.95
DRESSING TENDERSORB(ABD) 1.80
DRESSING TRANSP 2X3 100/B 4.10
DRESSING VASELINE 1/2X72 20.20
DRESSING VASELINE 1X8 7.75
DRESSING VASELINE 3X9 13.85
DRESSING XEROFORM 1X8 9.45
DRESSING XEROFORM 5X9 14.60
DROPPER CLINICAL 2.40
DRSG ALLEVYN 3X3 12.80
DRSG AQUACEL 4X4 33.60
DRSG COMPRESSION COFLEX 2 LAYER A6454 42.95
DRSG MEDIFLEX 4X4 BORDER 15.25
DRSG MEPILEX AG FOAM 4X4 30.00
DRSG OPTICELL GEL FIBER 4.25 X 4.25 A6197 15.95
DRSG OPTIFOAM NON-ADH 4X4 19.35
DRSG SILVASORB 4X4 A6243 60.85
DUODERM CGF 6X6 10/BOX 156.10
DURAPREP SOL & REMOVER 30.90
EDEMA GLOVE 74.35
EGIA UNIV HANDLE STAPLER 598.20
ELBOW BRACE HINGED RIGHT 208.00
ELBOW HINGED BRACE LEFT 208.00
ELBOW SUPPORT 53.35
ELECRODES PACING 595.00
EMPTY EVACUATED CONTAINER 69.45
ENDO GIA 45 MM 3.5 BLUE RELOAD 510.00
ENDO GIA 45MM RELOAD PURPLE 2142.30
ENDO GIA 60MM MEDIUM PURPLE 2540.10
ENDO GIA 60MM RELOAD TAN 2652.90
ENDO GOA 45MM WHITE RELOAD 510.00
ENDO PROCEDURE KIT 56.00
ENDO RETREIVAL SYSTEM 5MM 365.00
ENDO SPONGE MIC=MED INNOV 28.35
ENDOCLIP GUN 1745.55
ENDOLOOP 196.00
ENDOMETRIAL PIPELLE CURRETTE 28.15
ENDOMETRIAL SUC CURETTE 82.10
ENDOPATH 5MM SCISSORS 204.65
ENDOPOUCH 739.75
ENDOSCOPIC MARKER 5 ML SYRINGE 112.50
ENDOSCOPY SNARE 396.00
ENDOSTITCH APPLIER 1300.00
ENDOTRACH STYLET 10FR 44CM 8.15
ENDOTRACH TUBE/STYLET UNCUFFED 2.5MM 10.95
ENDOTRACH TUBE/STYLET UNCUFFED 3.0MM 10.95
ENDOTRACH TUBE/STYLET UNCUFFED 3.5MM 10.95
ENDOTRACHEAL TUBE HOLDER ADULT 18.95
ENDOTRACHEAL TUBE HOLDER PEDIATRIC 18.95
ENDS CATCH 727.85
ENEMA ADM. SET 12.60
ENZYME SOLUTION 709.50
EQUALIZER WALKER 93.25
EQUIPMENT RENTAL 0.00
EVACUATED DRAINAGE BOTTLE PLASTIC 1000ML 40.25
EXERCISE PULLEY 33.00
EXTENSION SET HIGH FLOW 6.10
EXUDERM LP/THIN HDROCOLD DRSG 4X4 A6234 8.35
EYE METAL SHIELD 9.45
EYE PATCH BLACK 11.70
EYE TRAY 60.40
FECAL MANAGEMENT COLL BAG 37.00
FECAL MANAGEMENT SYSTEM 806.65
FEMALE CATH KIT 47.20
FETAL HEART MONITOR 102.50
FIBRIN SEALANT TISSEEL 4 ML 431.80
FILIFORM COUDE TIP 232.90
FILTER LEUKOCYTE TCXL-12 134.50
FILTER SET W/SWIVEL INSUF 116.00
FILTERPALL PXL 12 1074.90
FILTERS, BREATH (PALL) 48.45
FILTERS, BREATHING-HUMID 48.45
FINGER DRESSING (COTTON) 28.65
FINGER SPLINT AL/FM 18x1 7.70
FINGER SPLINT AL/FM 3/4" 7.05
FINGER SPLINT AL/FM18X1/2 6.10
FINGER SPLINT BOUTONNIERE 20.70
FINGER SPLINT, 4 PRONG 3" 22.15
FINGER SPLINT,FOLDOVER LG 26.50
FINGER SPLINT,FOLDOVER ME 26.50
FINGER SPLINT,GUTTER ALUM 29.40
FINGER SPLINT,THIMB.1-1/2 35.70
FINGER SPLINT,THIMBLE 1" 22.15
FINGER STAX SPLINT 13.50
FINGER TRAP SINGLE MEDIUM 101.25
FLANGE 1 3/4" 123.15
FLANGE 4" 493.75
FLANGE WAFER 2-1/4 49.95
FLUID WARMING TUBING 18ML 39.75
FOAM BLOCKS FOR PHYS THER 14.70
FOLEY CATH TRAY SILICONE 16FR 10 ML 162.85
FOLLOWER WOVEN 295.75
FOOD GUARD LARGE PLASTIC 61.00
FOOT PADS 115.70
FOOT PILLOW 244.60
GAIT BELT W/BUCKLE 60" 56.40
GASTRIC BRUSH 133.60
GASTROCULT 35.85
GASTROSTOMY TUBE 186.75
GEL AQUASONIC 100 5LTR 237.75
GELFILM 125CM 725.60
GELFOAM 100 321.35
GIA 30 3.5/2.5 RELOAD 1593.00
GIA 30 3.5/2/5 GUN 1926.10
GLASSES 8OZ 25/PKG 18.10
GLIDECATH C1725 240.00
GLIDECATH 4FR STRAIGHT 260.00
GLIDESCOPE TRACH TUBE 15.75
GLIDESCOPE VL STAT 178.50
GLIDEWIRE .035" 450.00
GLIDEWIRE 260 CM ANGLED 175.00
GLIDEWIRE ANGLED C1769 560.00
GLIDEWIRE STRAIGHT STIFF C1769 270.00
GLUCOMETER SUPPLY PER DAY 42.00
GOGGLES 24.05
GOODE T-GROMMET VENT TUBE 1370.75
GRIPPER 70.05
GROSHNG TRIPLE LUMEN TRAY 3965.30
GROSHONG CATH #7710802 1230.50
GROUND ELECTRODE 2 POLYHE 51.50
GROUND-IT-ELECTRODE 51.75
HAND DRILL 10G 233.35
HAND STITCHER 1394.20
HANDSWITCH LCD STERILE 516.50
HEEL/ELBOW PROTECTOR 44.90
HEELBO X-LG 56.35
HEIMLICH CHEST DRAIN VALV 198.70
HEMOCLIP LARGE LT400 147.85
HEMOCLIP MEDIUM LT200 75.80
HIBCLENS 4 OZ 29.95
HIBICLENS PKT 3.90
HINGED ADJUSTABLE UNIV KNEE BRACE 282.00
HUMID VENT 48.45
HUMIDIFIER AQUAPAK STRL 19.30
HYDROGEL GZE SKINTEGRITY 4X4 A6231 8.85
HYDROGEN PEROXIDE 6.15
HYPERGEL PACKET .5 OZ 93.50
HYPERTHERMIA K PAD HEAT THERAPY 149.00
HYPOFIX DRESS RETEN SHEET 107.90
INFLATION DEVICE 99070 192.50
INFLATION DEVICE DISPOSABLE 192.50
INJECTION NEEDLE 22 G TRANSURETHRAL 382.50
INSTRUMENT KIT 1300.25
INSUFLOW SYNERGY PORT 5MM 267.00
INSULATED NEEDLE W/EXT SET 51.85
INTERVENTIONAL SPINE INFLATOR 99070 243.75
INTRAOCULAR LENS 1119.20
INTRODUCER SHEATH 6FR 120.00
INVALID RING 38.55
IRRIGATION BAG 2-1/2 47.15
ISOLATION SUPPLY DAILY 50.00
ISOMED REFILL FLUSH 294.05
IV 1.2 MICRON FILTER EXT 11.15
IV ARM BOARD DISPOSABLE 38.25
IV ARMBOARD CHILD 44.60
IV ARMBOARD INFANT 40.65
IV BLOOD Y-TYPE PLUMSET 52.90
IV BLOOD-TYPE W/PUMP 26.05
IV BURETTE PLUMSET 150ML 67.25
IV CAP M/F STERILE 2.95
IV CATH GROSHONG TRIPLE L 1789.10
IV CATH INTERLINK Y TYPE 61.00
IV CATH INTRACATH 19GX8 60.45
IV CATH JELCO 14X2 1/4 15.85
IV CATH JELCO 16X2-1/4 15.85
IV CATH JELCO 18X1-3/4 15.85
IV CATH STABILIZR STATLOK 30.75
IV CATHALON 24X3/4 17.20
IV CV CATH KIT 2-LUMEN 531.00
IV CV MULTILUMEN CATH KIT 84.95
IV EXT W/CLAVE 7" 8.80
IV EXTENSION SET 20 S1015 7.85
IV FILTER SET 22.50
IV HEMODIALYSIS KIT TWO-L 1016.55
IV HEPLOCK ADAPTOR CLAVE 8.80
IV INFUSOR BAG 500CC 78.40
IV INSYTE 8.85
IV INTRACATH 17X12 39.70
IV INTRACATH 22X8 56.50
IV KIT PERC INTROD. 8.5FR 430.20
IV PALL BLOOD FILTER 54.20
IV PICC PLUS STABILIZER 24.50
IV PIGGYBACK MICRO 20.45
IV PLUG, ADAPTER-MALE 5.30
IV PRIMARY PIGGBACK MACRO 17.75
IV PRIMARY PLUMSET 38.40
IV PUMP DAILY 34.75
IV PUMP INITIAL SET-UP E0779 204.85
IV SET EXTENSION SET 30 8.70
IV SET NON-VENTED VENOSET 10.95
IV SET SOLUSET 100 34.40
IV SET SURGICAL VENOSET 60.40
IV SET-UP 110.60
IV SUBCLAV JUG 14G X 12 287.25
IV SUBCLAV JUG 16 X 30 301.70
IV VENOSET SECONDARY-DS 5.35
JACKSON PRATT RESEVOIR BULB 68.25
K WIRE PIN COVERS 9.15
KANGAROO POUCH 69.85
KIT, LTA 45.50
KLEENEX 1.95
KNEE IMMOBILIZER 91.00
KNEE SPLINT 24" 329.15
KNEE STABILIZER L1830 66.00
KNEE SUPPORT HINGED 79.00
KNEE SUPPORT OPEN PATELLA 154.95
KNEE SUPPORT SLEEVE 24.45
KNEE WRAP AROUND SUPPORT 216.90
KNIFE BLADE 3.35
KNIFE BLADES #12 8.55
KNIFE BLADES #15 3.35
KUMAR SURG CATHETER 120.00
KWIK KIT 53.65
KWIK KIT MINI PLUS 69.55
KY JELLY 2 OZ 6.75
KY JELLY 4OZ 11.45
KY JELLY 5GM 4.20
KY LUBRICANT 2.7GM 1.00
KYPHO NDL KIT 1983.50
LAPAROSCOPIC CAUTERY CORD 51.50
LAPAROSCOPIC ELECTRODE 80.00
LAPAROSCOPIC HANDSWITCH 124.00
LAPAROSCOPIC PACK 120.75
LAPAROSCOPIC SHRT SCISSOR 1379.80
LASER VAPORIZATION UNIT 3445.40
LAVACUATOR, STOMACH 131.45
LEGGING XLG STERILE 14.15
LEGGINGS (SURGICAL) 12.75
LIGACLIP APPLIER 405.30
LIGACLIP LG 85.10
LIGACLIP MED 85.10
LIGACLIP SM 85.10
LIMB HOLDER 58.45
LMA SIZE 1 PEDIATRIC 40.75
LMA SIZE 2 46.75
LMA SIZE 4 46.75
LONG MEDIUM AGRESSIVE BLADE 31 X 9 139.70
LOTION 4 OZ 5.85
LTA KIT 45.50
LUKENS TUBE 35.00
LUMBAR ROLL 181.55
LUMBAR SUPPORT SM/MED/LG 263.10
MANOMETER CVP 18G 57.30
MARKER, SURGICAL 13.75
MARLEX MESH 10X14 190 BOX 1348.90
MASK D-FILT 12' TUBING 126.65
MASK ISOLATION 50/BOX 75.20
MASK NEBULIZER PED DRAGON 12.80
MASK NON-REBREATHER 18.90
MASK RESPIRATOR (TB) 6.65
MASK, DISPOSABLE 6.65
MASK, FLUID SHIELD 13.25
MASK, SURGICAL 1.80
MASK-AEROSOL DISP W/O TB 5.70
MATTRESS EGGCARTON 64.25
MAYO STAND 18.95
MEDI-FLOW LENS TUBING 190.50
MEDIRONIC ISO REFILL KIT 171.80
MEDIUM BLADE 18.5 X 9.0 MM 139.70
MEPILEX FOAM BORDER DRSG 4X4 12.90
MICRO INTRO KIT/NEEDLE 131.25
MICRO MULTI-PIN CLAMP 1695.50
MICRO NUT DRIVER 1123.50
MICRO ROD TO ROD CLAMP 3/3 1670.50
MILLIPORE FILTER 91.35
MIRROR LARYNGEAL 210.15
MISCELLANEOUS SUPPLY 0.00
MOLE SKIN 5.00
MONITOR BP OP PROCEDURE 78.90
MONITOR CVP INVASIVE 214.85
MONITOR DYNAMAP 134.25
MOUTH GUARD BITE BLOCK 16.65
MRI TRIPAK 139.70
MUCOSAL ATOM DEV (MAD300) 37.60
MYRINGOTOMY BLADE 50.65
NASAL SPLINT 222.05
NASAL SPLINT ALUMAFOAM 40.30
NASAL TAMPON PACK 131.00
NASOPHARYGNEAL AIRWAY 26.50
NAVICROSS CATH 700.00
NAVICROSS SUPPORT CATH 90CM ANGLED 99070 402.50
NDL 23 X 1 0.25
NDL BIOPSY TRU-CUT 6" 182.80
NDL BLUNT 8.70
NDL HUBER INF 20X.75 49.92
NDL HUBER INF 20X1 49.92
NDL HYPO SPINAL 22 X 3.5 14.60
NDL IV 20X1-1/4 ABBOCATHT 49.20
NDL IV BUTTERFLY 19X7/8 26.05
NDL IV BUTTERFLY 21 26.05
NDL IV BUTTERFLY 23 GA 27.40
NDL SPINAL 18GX3.5 14.60
NDL SPINAL 20X3.5 14.60
NDL SPINAL 22G X 3.5 14.60
NDL SPINAL 24GS 90MM W/INTRODUCER 40.15
NDL TUOHY 22G X 4.25 39.25
NDL TUOHY EPIDURAL 20X3.5 17.00
NEEDLE BOX 1 QUART 17.80
NEEDLE BOX CONT 8 QT 40.30
NEEDLE COUNTER MAGNETIC 8.80
NEEDLE INSUFFLATION 262.40
NEEDLE MAT 36.45
NIPPLE AND NUT DISPOSE 50 4.10
NITREX WIRE 270.00
NITRIX WIRE C1769 270.00
NORMLGEL .5 OZ TUBE 46.20
NUGAUZE 1" PLAIN 49.20
NUGAUZE 1/2 IODO 49.20
NUGAUZE 1/2 PLAIN 43.40
NUGAUZE 1/4 PLAIN 43.60
NUGAUZE 2" IODOFOOORM 78.20
NUGAUZE 2" PLAIN 66.15
O2 CPAP DISPOSABLE MASK 217.75
O2 SENSOR NEONATE 227.00
O2 SENSOR PEDI 174.65
O2 SENSOR, ADULT 174.65
O2 SENSOR, INFANT 227.00
OLYMPUS SNARE DISP. CAUTE 112.75
OPSITE 4 X 4 3/4 11.30
ORTHO FELT 1 X 3 STERILE 6.25
ORTHO GLASS CASTING 2 X 12 17.30
ORTHO GLASS CASTING 3 X 12 20.75
ORTHO GLASS CASTING 4 X 30 42.55
ORTHO GLASS CASTING 5 X 30 52.95
ORTHO GLASS CASTING 6 X 30 47.95
ORTHO OFF LOADING SHOE 177.80
OSTOMY BELT 65.30
OTHO GLASS CASTING 3 X 35 48.20
OTW PTA BALLOON CATHETER .035" 525.00
OXYGEN CANNULA EAR WRAP 4.50
OXYGEN CANNULA PEDIATRIC 12.40
OXYGEN FACE TENTS 11.00
OXYGEN GREEN O2 ADAPTERS 212.30
OXYGEN NEBULIZER MIST W/T A7003 11.45
OXYGEN RE-BREATHER VENTUR 26.70
OXYGEN SWIVEL TUBE CONNEC 22.75
OXYGEN TENT 235.65
PACING CATHETER 1090.00
PACK BASIC V 155.10
PACK C-SECTION CUSTOM 1415.80
PACK LAPAROTOMY 61.75
PACK LEGGINGS 10.80
PACK OB DELIVERY III 209.70
PACK ORTHO VI EXTREMITY 264.95
PACK PERI-GYN 154.10
PACK SHEET 26.95
PAD OVAL EYE 1.80
PADDING, CAST 3 X 4 13.55
PADDING, CAST 4 X 4 17.80
PADDING, CAST 6 X 4 26.70
PADS INCONTINENCE 1.90
PASTE, PREMIUM 125.50
PATTIES CODMAN SG 1/2 X 2 94.25
PCA PUMP 142.05
PCA TUBING SET MINI-BORE 69.45
PEAK FLOW METER POCKET 115.60
PEAKFLOW MOUTH PIECE 4.40
PEDIFOAM SLEEVES 6" 3.85
PEG GASTRSTOMY KIT 513.45
PESSARY 195.00
PHISOHEX 100.25
PICC LINE KIT DOUBLE LUMEN 437.20
PICC LINE KIT SINGLE LUMEN 382.50
PINNACLE ACCESS SYSTEM 6FR 240.00
PINNACLE INTRODUCER SHEATH C1894 120.00
PLASTER (J) SPLINT 2" PER 4.40
PLASTER (J) SPLINT 3" PER 3.40
PLASTER (J) SPLINT 4" PER 3.85
PLASTER (J) SPLINT 5" PER 4.95
PLASTER SPLINT 3 X 15 2.15
PLEATMAN SAC 338.70
PNEUMOFIX NEEDLE 145.50
POLY-MEM DRESSING 335.45
POLYMEM 3 X 3 33.85
POLYMEM 4 X 4 18.05
POLYMEN 6.5 X 7 139.70
POLYP TRAP 23.25
PORT DRESSING 10.15
PORTA-CATH NEEDLE 93.65
POUCH 1 3/4" 19.70
POUCH 4" 44.50
POUCH PACK VIS U ALL 8X13 321.05
POUCH PACKAGE VISUALL 4X8 110.75
POUCHPAK VIS U ALL 3.5X25 72.45
PRISMA MATRIX DRESSING 4.34 SQ INCH 37.60
PROLENE MESH 423.30
PROTECTIVE HINGED KNEE BRACE 151.00
PULL-UPS TODDLER 3.70
PUNCH BIOPSY 2MM MM0320 26.80
PUNCH BIOPSY 3MM MM0320 21.50
PUNCH BIOPSY 4MM MM0321 26.80
PUNCH BIOPSY 5MM MM0321 26.80
PUTTY EXERCISE PKG BL/GRN 55.90
PUTTY EXERCISE RED 40.15
PUTTY EXERCISE YELLOW 40.15
QUIK PREPDX ELECT 50/BX 13.85
RAPID INFUSION SET 71.30
RAPID RHINO NASAL PACKING 9CM 254.45
RECHARGEABLE BATTERY 3.5 61.95
REDUCER 5MM 135.85
RESPIRATORY ASST DEVICE 828.55
RESTON PADS 30.40
RESTRAINT, VEST 188.55
RESTRAINT, WAIST 131.65
RESUSCITATION MODULE PED 885.25
RETRACTOR ELASTIC STAYS 5MM 199.35
RETRACTOR RINGS 199.35
RHYTHM STRIP 42.20
RIB BELT UNIV 29.50
RIB BELT XXL 37.90
ROYAL FLUSH CATH 330.00
RUNTHROUGH NS WIRE 240.00
SACROILIAC BELT-S/M/L/XL 170.40
SALINE WOUND WASH 7OZ 29.45
SCD PUMP/STOCKINGS 246.25
SCOTCHCAST (F) CASTING 2" 14.60
SCOTCHCAST (F) CASTING 3" 18.65
SCOTCHCAST (F) CASTING 4" 24.35
SCOTCHCAST (F) CASTING 5" 87.85
SCOTCHCAST W/SPLINT.SYS4" 205.15
SCOTCHPLAST 3" BLUE 106.40
SHOE DARCO LG 78.20
SHOE DARCO MED 78.20
SHOE DARCO PEDIATRIC 102.70
SHOE ORTHO FEMALE 129.40
SHOE ORTHO MALE SM 126.35
SHOE POST OP VNL (CAST) 102.70
SHORT MEDIUM BLADE 18.5 X 9.0 99070 166.20
SHORT NARROW BLADE 11.5 X 5.5 139.70
SHORT NARROW BLADE 15.0 X 7.0 99070 166.20
SHORT NARROW BLADE 15.0 X 7.0MM 139.70
SHOULDER IMMOBIL VELPEAU 49.30
SHOULDER IMMOBILIZER UNIV 219.15
SILVERCELL DRSG NON ADHSV 4x4 30.25
SKIN BARRIER FILM 5.00
SKIN PREP 50/BX 6.65
SKINTEGRITY HYDROGEL 1 OZ 22.30
SLING AND SWATHE A4565 165.00
SMITH & NEPHEW COLD PACK 203.05
SOD CHL IRRIGATION 1000ML J0561 11.95
SOD CHL IRRIGATION 250 ML 6.95
SOD CHL IRRIGATION 500 ML 11.30
SODASORB 97.55
SPADE DRILL 437.50
SPEED BRACE WITH STRAP 277.55
SPHERE INFLATION DEVICE 296.00
SPINAL NEEDLE 22G X 7 16.50
SPLINT SAMS 72.95
SPONGE - SURGICAL PATTIES 101.80
SPONGE PACK 4X4 12 PLY200 77.15
SPONGES-KITTNER 13.75
STAND ASSIST DISP PATIENT SLING E0621 147.90
STAPLE REMOVER 32.50
STAPLER ROYAL 35 117.55
STAPLER SKIN DISPOSABLE 23.30
STERI STRIPS 1/4 X 1-1/2 15.30
STERI-STRIP 1 X 5 36.75
STERI-STRIP 1/2 X 4 16.00
STERI-STRIP 1/4 X 3 6.65
STERI-STRIP 1/4 X 4 16.00
STERILE SLEEVE TOURNQUET 22.50
STOCKINETTE IMPER STRL 8" 29.70
STOCKINETTE IMPER STRL 9" 44.70
STOCKINETTE TUB PER FOOT 2.10
STOCKING TED KNEE HIGH 24.10
STOCKING TED THIGH HIGH 40.20
STOPCOCK K-751 3-WAY 16.55
STOPCOCK LL 3-WAY 13.95
STRAIGHT COLD KNIFE STR 560.00
STRAIGHT TIP NITINOL WIRE 0.038X150 152.15
STRAINER KIDNEY 10.30
STRAPPING TAPE 26.80
STRESS TEST QUICK PREP EL 11.45
STRT SHANK DRILL BIT 247.00
STYLET INTUB 14FR 5-10MM 13.95
STYLET,INTUBATING #14 106.35
STYLET,INTUBATING #6 106.35
SUBCLAVIN SK. SCRUB 17.85
SUCTION COAGULATOR 10FR 53.35
SUCTION POOLE 51.40
SUCTION TUBE ATTACHMENT 40.60
SUCTION TUBING 5MM X 18" 3.15
SUREPRESS ABSORBANT PADDING 4X3.2 8.85
SUREPRESS HI COMPRESSION BNDG 4X3.2 68.25
SURGICAL HAND PACK 193.45
SURGICEL 2X3 196.30
SURGIFOAM GELATIN SPONGE 2CM X 6CM X 7MM 56.40
SURGISEAL STYLUS 54.00
SUSPENSORY EX.LG. 97.95
SUSPENSORY LG. 78.95
SUSPENSORY SCROTAL SUPPORT 63.25
SUTR CTD VICRYL 5.0 ETHVCP493H 118.50
SUTURE 0 VICRYL PLUS CP-1 24.15
SUTURE 2-0 CHROMIC 95 11981 25.05
SUTURE 3-0 CHROMIC 7/96 26.80
SUTURE 3-0 CHROMIC 95 BB- 25.40
SUTURE 3-0 PROLENE 95 65.35
SUTURE 3-0 SILK BB-0037 129.30
SUTURE 3-0 VICRYL 95BB002 29.55
SUTURE 3-0 VICRYL PLS PS2 45.55
SUTURE 4-0 CABLE WHITE 23.60
SUTURE 4-0 ETHIBOND MID 41.60
SUTURE 4-0 ETHILON PS-2 36.40
SUTURE 4-0 MONOCRYL ETHY426H 137.10
SUTURE 4-0 PROLENE PS2 18.75
SUTURE 4-0 PROLENE SL5690 72.40
SUTURE 4-0 SURGI-PRO 43.80
SUTURE 5-0 VICRYL PS-3 85.45
SUTURE 6-0 CLEAR MONO 74.35
SUTURE 6-0 PROLENE96BB-76 65.95
SUTURE 6-0 SILK 20.95
SUTURE 6-0 SILK 11/86BB34 16.00
SUTURE 7-0 PROLENE 95 187.30
SUTURE AUTO SUT. GIA 1156.20
SUTURE AUTO SUT. SM-35W 251.30
SUTURE AUTO SUT. TA-55 1236.80
SUTURE CHROMIC 0 BB-0044 26.80
SUTURE CHROMIC 0 GC812 16.70
SUTURE CHROMIC 1 22.50
SUTURE CHROMIC 2-0 GC811 44.10
SUTURE CHROMIC 2-0 GI G12 16.90
SUTURE CHROMIC 3-0 BB-53 25.50
SUTURE CHROMIC 5-0 64.20
SUTURE CHROMIC GUT 4-0 P3 85.20
SUTURE CLIP AUTO (DISP) 70.65
SUTURE CTD VICRYL 3/0 96.60
SUTURE ENDOSTITCH SILK 423.75
SUTURE ETHIBOND BB-0015 212.40
SUTURE ETHILON 4-0 BB-067 54.80
SUTURE ETHILON 4-0 PS 2 77.40
SUTURE GRASPER 218.10
SUTURE GRASPER 201.32
SUTURE MISC. 1-0 PROLENE 22.45
SUTURE MISC. 2-0 PROLENE 22.45
SUTURE MONOCRYL 4-0 78.25
SUTURE MONOCRYL 5-0 P-3 89.15
SUTURE MONOSOF 4-0 41.75
SUTURE NOVAFIL 6-0 DX16 100.20
SUTURE NUROLON 0 267.80
SUTURE PDS 1 GC 341 36.25
SUTURE PDS II 5-0 P-3 97.00
SUTURE PDS II 2-0 CT-1 9.75
SUTURE PDS II PRECISION PNT 4.0 CLR MONO 103.30
SUTURE PDS II TAPER PNT 4.0 VIO MONO 61.50
SUTURE PLAIN 3-1 2322 5.85
SUTURE PLAIN GUT 00 16.00
SUTURE PLAIN GUT 5-0 P3 90.75
SUTURE PLIABILIZED 4/0 18" P-3 80.45
SUTURE POLYSRB 3-0 SL5640 34.75
SUTURE PROLENE 2-0 CT2 48.35
SUTURE PROLENE 3-0 17.70
SUTURE PROLENE 5-0 P-3 47.05
SUTURE PROLENE 5-0 PS-3 93.45
SUTURE PROLENE 6-0 P-3 48.00
SUTURE REMOVAL KIT 23.95
SUTURE SILK 0 (678G) 22.55
SUTURE SILK 2-0 (685H) 21.70
SUTURE SILK 2-0 12/BX 153.75
SUTURE SILK 2-0 GI 012 153.75
SUTURE SILK 3-0 BB-37 135.95
SUTURE SILK 3-0 TIES SA-6 26.65
SUTURE SILK 4-0 BB-0029 28.50
SUTURE SILK 4-0 BB-0038 138.55
SUTURE SILK 4-0 TIES SA-6 11750 27.05
SUTURE SUPRAMID 4-0 29.20
SUTURE VICRYL 0 UND REEL 44.25
SUTURE VICRYL 2-0 10/95 27.35
SUTURE VICRYL 2-0 RL BB21 31.90
SUTURE VICRYL 3-0 3/96 29.35
SUTURE VICRYL 3-0 PS-2 78.30
SUTURE VICRYL 4-0 PS2 42.95
SUTURE VICRYL CTD 4-0 RB1 21.30
SWAB VAG/REC 8" 0.90
SWIVEL ADAPTOR 617.15
SYRINGE WOUND IRRIGATION 68.40
T-TUBE 16FR 31.15
TABLE BACK PAPER 19.25
TAPE ADHESIVE CLOTH 2" 17.20
TAPE ADHESIVE, CLOTH 1" 8.70
TAPE DURAPORE 1/2" SILK 3.85
TAPE DURAPORE 3" SILK 23.50
TAPE DUROPORE 2" SILK 17.85
TAPE ELASTOPLAST 1" 4.90
TAPE KIT 292.65
TAPE MEDIPORE 2" ROLL 39.15
TAPE MEDIPORE 3" ROLL 21.65
TAPE MEDIPORE 4" ROLL 78.35
TAPE MICROPORE 1" PAPER 6.15
TAPE MICROPORE 1/2" PAPER 2.65
TAPE MICROPORE 2" PAPER 12.25
TAPE SILICONE KIND REMOVE 4.85
TAPE TRANSPORE 1" ADHESIV 10.65
TAPE TRANSPORE 1/2" ADHES 5.20
TEGASORB 4 X 4 69.05
TENNIS ELBOW SUPPORT/GEL 53.55
TENS UNIT PURCHASE 675.80
TENS UNIT RENTAL/WEEK 42.20
THD DISPOSABLE KIT 750.75
THERA CAIN 420.10
THERABAND 8.90
THERABOND 3D CONTACT DRSG 4X4 A4649 69.90
THERAPUTTY - RED 22.30
THERAPUTTY - YELLOW 22.30
THORACIC VENT PROC TRAY 2088.15
THUMB SPICA 85.30
TIELLE DRSG SILICONE 4X4 A6212 9.45
TIP SPATULA LAPROSCOPIC 332.10
TIPOLISHER 6.95
TOE COMBS POLYFOAM 6.40
TOOTHETTE 20 PER BAG 17003 36.75
TOPICAL SKIN ADHESIVE 57.00
TORQUE DEVICE TD 01 99070 34.00
TOURNIQUET 102.95
TRACH TUBE ADULT #8 275.95
TRACH TUBE PEDI SZ 3.0 233.95
TRACH TUBE PEDI SZ 4 272.95
TRACHEOSTOMY CARE TRAY 9.85
TRAP SPECIMEN A/P 19.95
TRAY EPIDURAL 18 X 5 J1750 87.90
TRAY HYPERAL 20/CS 45.05
TRAY IRRIGATION BULB 20.45
TRAY IRRIGATION PISTON 16.55
TRAY LP 20 X 3-1/2 ADULT 219.50
TRAY LP 22GA X 1-1/2 PED 309.35
TRAY PARACERVICAL/PUDENDA 154.45
TRAY PREP 47.45
TRAY SPINAL TRAY 46.25
TRAY T & A 665.10
TRAY THORACENT/PARACENTES 10060 160.05
TRAY VAGINAL PREP E-Z 78.90
TRAY, GEN. PREP E-Z 51.50
TRAY-LACERATION 88.00
TRAY-SMALL INSTRUMENT 47.90
TROCAR 12MM 492.55
TROCAR 5MM 441.15
TROCAR SITE CLOSURE 1315.20
TUBE ETT 7.85
TUBE FEEDING 10FR 21.70
TUBE FEEDING 5FRXX15 7.55
TUBE FEEDING 8FRX15 7.55
TUBE GAUZE PER FOOT 3.20
TUBE RECTAL TUBE #24 46.00
TUBE SALEM SUMP 55.30
TUBE, ENDOTRACHEAL 32.40
TUBING CORRUGATED/100FT 113.30
TUBING CYSTO 9.95
TUBING DISPO.INSULFLATION 117.00
TUBING SUCTION 3/16X10' 10.05
TUBING-MAXIFLEX 12.75
TVS TUBING W/SPIKE 112.50
TWO LUMEN JUGULAR 7FR 505.70
U-BAG PEDIATRIC 12.15
UNDERPADS BLUE 5/PKG 10.65
UNDERWEAR PROTECTIVE ADLT 3.20
UNNA BOOT PRIMER 3" 80.80
UNNA BOOT PRIMER 4" 25.65
URINARY LEG BAG EXTENSION TUBING 7.45
US VASCULAR ACCESS KIT/ PIV 80.85
UTERINE SUC CURRETTE 82.10
UTERINE SUC. CURETTE 10 140.45
UTERINE SUC. CURETTE 8 191.70
VAC SENSATRAC GRANUFOAM DRSG MEDIUM A6550 175.00
VAC ULTA VERALINK 5 PACK A6550 192.50
VAC VERAFLO CLEANSE MED 5 PACK A6550 379.50
VAC VERAFLOW DRSG MEDIUM A6550 363.00
VAG. ROLL STERILE 48.25
VAGINAL PACKING GAUZE 2 X 72 44.70
VASCULAR INTRO SET-DISP. 392.35
VENOM RF CANNULA 174.40
VENT TUBE T-GAMMET SILICO 317.95
VERTEPORT CEMENT 10G 211.25
VESSEL LOOPS 13.85
VISCO HEEL CRADLES 104.75
VOLDYNE 5000ML 62.95
VOLUMETRIC FLOW METER 58.50
WARMING BLANKET/GOWN 23.40
WASH CLOTH PREMOISTENED 58.00
WATER STERILE 500 CC IRR 10.60
WATER STERILE/IRR 250ML 7.60
WATER STERILE/IRRIG 1500 17.05
WATER STERILE/IRRIG. 1000 20.10
WIRE AMPLATZ 35/80 152.25
WIRE,SNARE SZ 8 BENT ENDS 4.85
WRAP STERILIZATION 18X18 1234.25
WRAP STERILIZATION 24X24 1068.20
WRAP STERILIZATION 54X54 755.80
WRAP SURGICAL 30X30 950.05
WRAP SURGICAL 45X45 1170.35
WRIST BRACE CHILD LT 167.00
WRIST BRACE CHILD RT 167.00
WRIST BRACE COCKUP 10" 69.00
WRIST BRACE LT MED 167.00
WRIST BRACE PED LT 169.70
WRIST ET F'ARM SPL. LT/LG 167.00
WRIST ET FOREARM BRACE 205.70
WRIST SPLINT 8" 50.00
WRIST/FOREARM SPLINT RTSM 169.55
CT ABDOMEN PELVIS W CONT 74177 4090.00
CT ABDOMEN PELVIS W/WO 74178 4636.00
CT ANGIO RUNOFF 75635 3416.50
CT ANGIOGRAPHY ABDOMEN 74175 2994.50
CT ANGIOGRAPHY CAROTID 70498 2840.50
CT ANGIOGRAPHY CHEST 71275 3035.50
CT ANGIOGRAPHY PELVIC 72191 2952.00
CT GUIDE TISSUE ABLATION 1916.00
CT ORBIT SELLA/POST FOSSA/EAR W/O CONTR 70480 1885.00
CT ORBIT SELLA/POST FOSSA/EAR W/O W/CONT 70482 2322.00
CT-3D RENDER W/O POSTPROC 76376 437.00
CT-ABDOMEM PELVIS WO CONT 74176 3247.00
CT-ABDOMEN W/O CONTRAST 74150 2200.00
CT-ABDOMEN W/W/O CONTRAST 74170 3258.00
CT-ABDOMEN WITH CONTRAST 74160 2573.00
CT-ANGIO CIRCLE OF WILLIS 70496 2785.00
CT-CERVICAL SPINE W/CONTR 72126 2505.50
CT-CERVICAL SPINE W/O CON 72125 2339.00
CT-CHEST W/O CONTRAST 71250 2058.50
CT-CHEST W/WO CONTRAST 71270 2813.00
CT-CHEST WITH CONTRAST 71260 2529.00
CT-CTA ABD/PELVIS W/CONTR 74174 4734.00
CT-FACIAL/SINUS W/O CONT 70486 1866.00
CT-FACIAL/SINUS WITH CONT 70487 2086.50
CT-GUIDED NEEDLE BIOPSY 77012 2272.50
CT-HEAD W/O CONTRAST 70450 1988.00
CT-HEAD W/W/O CONTRAST 70470 2311.50
CT-HEAD WITH CONTRAST 70460 2148.00
CT-LIMITED/LOCALIZED FU 76380 1309.00
CT-LOW EXTREMITY W/CON RT 73701 2144.50
CT-LOW EXTREMITY W/CONT L 73701 2144.50
CT-LOW EXTREMITY W/O CN L 73700 1997.50
CT-LOW EXTREMITY W/O CN R 73700 1997.50
CT-LUMBAR W/O CONTRAST 72131 2174.50
CT-LUMBAR WITH CONTRAST 72132 2514.00
CT-NECK W/O CONTRAST 70490 2144.50
CT-NECK W/WO CONTRAST 70492 2456.50
CT-NECK WITH CONTRAST 70491 2423.00
CT-ORBIT/EAR/IAC WITH CON 70481 2592.00
CT-ORBIT/SELLA/IAC W/O CO 70480 2166.50
CT-PELVIS W/O CONTRAST 72192 2130.00
CT-PELVIS W/W/O CONTRAST 72194 2590.00
CT-PELVIS WITH CONTRAST 72193 2395.00
CT-THORACIC SPINE WITH CO 72129 2474.50
CT-THORACIC SPINE WO CONT 72128 2374.00
CT-UP EXTREMITY W/CON LT 73201 2027.50
CT-UP EXTREMITY W/CONT RT 73201 2027.50
CT-UP EXTREMITY W/O CO LT 73200 1972.00
CT-UP EXTREMITY W/O CO RT 73200 1972.00
MYELOGRAPHY LOWER SPINE 72265 1826.50
CARDIAC RHYTHYM STRIP 93041 275.50
ECG 93005 345.00
ECHO W/DOPPLER COMPLETE 93306 2102.50
ECHOCARDIOGRAM 93307 1954.00
ELECTROMYELOGRAM 95810 3672.50
ELECTROMYELOGRAM W/CPAP 95811 4139.00
HOLTER MONITOR 93225 525.50
REMOTE 30 DAY ECG HOOK UP 93270 282.00
STRESS TEST 93017 1049.00
BLOOD TRANSFUSION SERVICE 36430 80.00
CHEMOTHERAPY ADM Q0084 105.00
EMERGENCY ROOM LEVEL I 99281 190.00
EMERGENCY ROOM LEVEL II 99282 303.00
EMERGENCY ROOM LEVEL III 99283 510.00
EMERGENCY ROOM LEVEL IV 99284 688.00
EMERGENCY ROOM LEVEL V 99285 1155.00
EMERGENCY-TRAUMA 99291 1877.00
ER NO CHARGE VISIT 99281 0.00
ER-INTRAOSSEOUS IV 36680 695.00
ER-OTHER FACILITY 99282 0.00
HYDRATE IV INFUSION ADD HR 96361 97.00
HYDRATION IV INFUSION 1HR 96360 352.00
INFUSION THERAPY ADD'L HR 96366 125.00
INFUSION TX CHEMO 1ST HR 96413 933.00
INFUSION TX CHEMO ADDL HR 96415 185.00
IV INFUSION THER 1ST HOUR 96365 425.00
TREATMENT RM LEVEL II 701.00
TREATMENT ROOM LEVEL 1 94.00
MENINGITIS VACCINATION 117.00
RABIES/TYPHOID VACCINAT'N 583.00
Care in assisted livin Q5002 0.01
Care prov in patient home Q5001 0.01
Care provided, NOS Q5009 0.01
HH AIDE VISIT G0156 90.00
HH LPN ASSESS/EVAL G0494 195.00
HH LPN TRAIN/EDUCATION G0496 195.00
HH LPN VISIT G0300 195.00
HH MILEAGE 0.55
HH NO CHARGE VISIT 0.00
HH NO CHARGE VISIT 0.00
HH OCC THERAPY EVAL G0152 272.00
HH OCC THERAPY VISIT G0152 272.00
HH PHYS THERPAY VISIT G0151 272.00
HH PT ASSISTANT G0151 272.00
HH PT EVAL G0151 272.00
HH SKILLED NURSE VISIT G0299 206.00
HH SN ASSESS/EVAL G0493 206.00
HH SN NEGOTIATED RATE 200.00
HH SN PRN VISIT G0299 206.00
HH SN TRAIN/EDUCATION G0495 206.00
HH SPEECH EVAL G0153 272.00
HH SPEECH THERAPY VISIT G0153 272.00
ABSORBATACK FIXATION DEVICE 5MM C1781 1200.40
AZUR COIL EMBOLIZATION SYSTEM C1884 525.00
BILIARY STENT SYSTEM 10 X 60 C1876 785.75
GUIDE WIRE C1769 105.00
HAMMER TOE IMPLANT C1713 1861.50
K-WIRE 4 X .028 C1713 15.80
K-WIRE DOUBLE ENDED 6" C1713 60.00
K-WIRE TR PTS 4 X .035 C1713 15.80
K-WIRE TR PTS 4 X .045 C1713 15.80
MALE SLING SYSTEM C1771 8995.00
METALLIC URETERAL STENT FR6.0 X 24CM C2625 1720.00
MINI ARC BLADDER SLING C1781 2705.00
MINI QUICK ANCHOR C1713 824.25
PARAMOUNT MINI GPS STENT C1876 1870.00
POWER PORT C1788 603.75
SCREW- HEXALOBE LAG C1713 410.00
STAR CLOSE SYSTEM C1760 612.50
STARCLOSE DEVICE C1760 275.00
SURGIMESH 11X16CM WN C1781 743.75
SURGIMESH PLUG C1781 855.00
SURGIMESH TINDRA CK C1781 1146.25
SURGIMESH TINTRA 1522/XB C1781 3095.00
SYNTHETIC MESH VAGINAL SUPPORT SYSTEM C1763 3577.00
T-PLATE C1713 1295.00
TIGER SCREW C1713 437.50
URETERAL STENT 6FR C2625 313.50
VENA CAVA FILTER C1880 1400.00
25-HYDROXY VITAMIN D 82306 169.20
5-HYDROXYINDOLEACETIC ACI 83497 120.00
ABG 82803 223.90
ABSOLUTE CD4 & CD8 COUNT 86360 148.90
ACETAMINOPHEN 80329 203.50
ACETAMINOPHEN-URINE 80329 94.20
ACETYLCHOLINESTERASE 82482 128.50
ACID FAST (TB) STAIN 87206 45.00
ACUTE HEPATITIS PANEL 80074 697.50
ADRENOCORTICOTROPIC HORMO 82024 241.00
AFTER HOURS DRAWING FEE 46.40
AGENT NOS ASSAY W/OPTIC 87899 100.70
AGGLUTININS FEBRILE EACH ANTIGEN 86000 190.50
ALBUMIN 82040 51.40
ALCOHOL WHOLE BLOOD 80320 188.00
ALDOLASE 82085 93.20
ALDOSTERONE SERUM 82088 274.20
ALDOSTERONE URINE 36415 274.20
ALK PHOSPHATASE FRACTION 84080 217.40
ALKALINE PHOSPHATASE 84075 52.50
ALLERGEN SPECIFIC IGG QUAN 86001 98.00
ALLERGENS 86003 50.25
ALLERGENS PANEL 86003 50.25
ALPHA 1 ANTITRYPSIN 82103 175.30
ALPHA FETOPROTEIN TUMOR M 82105 151.00
ALPHA-1-ANTITRYPSIN PHENOTYPE 82104 238.00
ALT(SGPT) 84460 61.10
AMIKACIN 80150 168.10
AMINOLEVULINIC ACID DELTA 82135 133.00
AMITRIPTYLINE 80335 98.60
AMMONIA 82140 158.50
AMP PATIENT NUCLEIC ACID 83901 109.50
AMPHETAMINE CONFIRM URINE 82145 187.50
AMYLASE RANDOM URINE 62.10
AMYLASE, SERUM 82150 82.00
ANA PLASMA PHACOCYTOPHILIUM 86666 46.55
ANAEROBE IDENTIFICATION 87076 279.50
ANDENOVIRUS ANTIBODY 86603 196.70
ANDROSTENEDIONE 82157 256.60
ANGIOTENSIN CONVERT ENZYM 82164 166.00
ANITBODY CANDIDA 86628 83.70
ANTI THYROIDGLOBULIN 86800 112.00
ANTI-CENTROMER ANTIBODY 86255 247.30
ANTI-DNASE B ANTIBODY 86215 106.80
ANTI-DOUBLE STRANDED DNA 86225 130.40
ANTI-INSULIN AB IGA 86337 251.90
ANTI-JO 1 ABS 86235 143.20
ANTI-MULLERIAN HORMONE 83516 208.10
ANTI-SMITH ANTIBODY 86235 143.20
ANTI-THYROID MICROSOMAL 86376 179.90
ANTIBODY ASPERGILLUS 86606 187.50
ANTIBODY BACTERIUM NOS 86609 28.50
ANTIBODY COCCIDIOIDES 86635 110.30
ANTIBODY ID LISS PANEL 86870 240.00
ANTIBODY ID PEG PANEL 86870 240.00
ANTIBODY SCREENING 86850 102.50
ANTIBODY SHIGELLA 86771 235.60
ANTIEXTRACTABLE NUC ANTIG 86235 143.20
ANTIFUNGAL SER ITRACONAZO 80299 357.80
ANTIMITOCHONDRIAL TITER 86256 270.00
ANTINUCLEAR ANTIBODY 86038 130.70
ANTINUCLEAR ANTIBODY ANA 86039 75.80
ANTISMOOTH MUSCLE TITER 86256 256.80
ANTITHROMBIN III 85300 226.00
APLIFICATION NEUCLIC ACID 83898 358.70
APOE GENOTYPING ELECTROPH 83894 160.40
APOE GENOTYPING ISOLATION 83891 101.20
ARTERIAL PUNCTURE 36600 97.40
ASO QUANTITATIVE 86060 100.70
ASPERGILLUS FUMIGATUS IGG 86606 192.80
ASSAY NEPHELOMETRY NOT SP 83883 376.80
ASSAY OF CALPROTECTIN FECAL 83993 355.00
ASSAY OF COPPER 82525 167.00
ASSAY OF ESTRONE 82679 223.90
ASSAY OF SELENIUM 84255 258.90
ASSAY OF THYROID ACTIVITY 84442 153.00
AST (SGOT) 84450 64.30
B CELLS-TOTAL COUNT 86355 183.10
BABESIA MICROTI IGG IGM 86753 222.80
BABESIA MICROTTI 86753 43.50
BACTERIAL ANTIGENS 86403 166.00
BACTERIUM ANTIBODY 86609 293.60
BASEMENT MEMBRANE 86255 235.60
BENZODIAZEPINS URINE SCRN 80303 90.00
BETA 2 MICROGLOBULIN SERM 82232 174.60
BILE ACIDS FRACTION & TOT 83789 401.70
BILIRUBIN - NEONATAL 82247 67.50
BILIRUBIN DIRECT 82248 51.75
BILIRUBIN TOTAL 82247 59.25
BK VIRUS DNA BY PCR QUANT 87799 621.30
BLD SMEAR MANUAL DIFF 85007 48.20
BLEEDING TIME 85002 85.70
BLOOD ABO GROUP 86900 62.00
BLOOD GASES BY OXIMETRY 94760 70.70
BLOOD TYPE RH 86901 67.50
BLOOD/UNIT AG TYPING 86905 171.40
BODY FLUID ALBUMIN 82042 58.90
BODY FLUID AMYLASE 82150 102.50
BODY FLUID CRYSTAL ID 89060 78.20
BODY FLUID PROTEIN 84155 58.90
BODY FLUID SPECIFIC GRAVI 84315 35.00
BRAIN NATURETIC PEPTID 83880 260.30
BREATH ALCOHOL 94760 73.00
BUN 84520 53.60
C PEPTIDE 84681 111.40
C-DIFF CONFORMATION 87324 167.10
C-DIFFICILE ANITGEN 87449 236.00
C-DIFFICILE TOXIN B 87324 162.00
C-REACTIVE PROTEIN 86140 101.80
C1 ESTERASE INHIB ANTIGEN 83520 334.20
CA - 125 86304 186.40
CA 15-3 86300 179.90
CADMIUM ASSAY 82300 126.40
CALCITONIN 82308 173.60
CALCIUM 82310 65.30
CALCIUM 24 HR URINE 82340 66.00
CALCULUS (STONE) ASSAY 82365 151.20
CANCER ANTIGEN CA 19-9 86301 139.30
CANCER ANTIGEN CA 27-29 86316 128.50
CANDIDA ANTIBODY IGA 86628 170.60
CANDIDA ANTIBODY IGG 86628 170.60
CANDIDA ANTIBODY IGM 86628 170.60
CANDIDA IGG IGM IGA 83874 199.20
CARBAMAZEPINE TEGRETOL 80156 129.00
CARBON MONOXIDE 82375 159.70
CARDIOLIPIN IGA 86147 114.60
CARDIOLIPIN IGG 86147 114.60
CARDIOLIPIN IGM 86147 114.60
CATECHOLAMINES-PLASMA 82384 241.00
CBC W/AUTOMATED DIFF 85025 114.60
CEA 82378 148.90
CELL CT W/DIFF BODY FLUID 89051 126.80
CELL SUSRFACE AB IGG 86255 235.60
CENTROMERE IGG AB 83516 198.20
CERULOPLASMIN 82390 115.60
CHLAMYDIA ANTIBODY X 3 86631 198.20
CHLAMYDIA DNA PROBE 87490 110.30
CHLAMYDIA IGG & IGM 83874 199.20
CHLAMYDIA IGM ANTIBODY X3 86632 370.60
CHLAMYDIA PSITTACI IGG-GM 86631 198.20
CHLORIDE 82435 56.40
CHOLESTEROL 82465 58.80
CHROM ADD'L HIGH RESOLUT 88289 155.80
CHROM ANAL KARYOTYPE STDY 88280 276.10
CHROMOGENIC SUBSTRATE ASSAY 85130 206.00
CHROMOSOME AD'L KARYOTYPE 88280 276.10
CHROMOSOME ANL 2 KARYOTYP 88262 483.10
CHROMOSOME TEST #5834 88271 155.30
CHROMOTOGRAPHY QUANT MULT 82492 381.20
CITRATE URINE (24 HR) 82507 238.90
CK 82550 101.00
CK-MB 82553 202.50
CLOSTRIDIAM DIFFICULE 87324 251.70
CLOT FACTOR XIII FIBRIN 85291 75.80
CLOT TO HOLD 36415 26.80
CLOTTING FUNCT ACTIVITY 85397 179.00
CLTR FUNGUS SKN HAIR NAIL 87101 158.50
CMV ANTIBODY 86644 171.10
CMV ANTIBODY IGM 86645 340.60
CNS DNA/RNA AMP PROBE MULTIPLE 12-25 87483 510.40
COLD AGGLUTININS 145.60
COMPLEMENT C2 86160 171.40
COMPLEMENT C3 86160 171.40
COMPLEMENT C4 86160 171.40
COMPLEMENT CH50 228.40
CONSULT REPORT REQUIRING PREP J SLIDES 88323 84.00
CORTISOL 82533 217.00
CORTISOL FREE 82530 184.30
COTOPATH FLD BRUSH SM/FIL 88107 150.50
COTOPATH FLUID FILTER MET 88106 150.50
COXSACKIE VIRUS B ABS 86658 413.40
CREATINE URINE 82570 72.80
CREATININE 82565 58.55
CREATININE CLEARANCE 82575 99.00
CREATININE RANDOM URINE 82570 108.40
CROSSMATCH & PROCESS/UNIT 86920 294.60
CRP HIGH SENSITIVITY 86141 213.50
CRYOGLOBULIN 82595 110.80
CRYOPRECIPITATE PER UNIT P9012 771.30
CRYPTOSPORID STAIN 87206 99.90
CRYPTOSPORIDIUM PARVUM AG 87328 117.00
CSF ALBUMIN 83883 358.90
CSF ANTIBODIES 82784 132.90
CULTURE ABSCESS 87070 107.00
CULTURE ANAEROBIC 87075 114.90
CULTURE BACTERIA OTHER 87070 58.20
CULTURE BACTERIA SCREEN 87081 80.50
CULTURE BLOOD 87040 195.00
CULTURE BODY FLUID 87070 58.20
CULTURE CATHETER TIP 87070 58.20
CULTURE CHLAMYDIA 87110 219.20
CULTURE CSF/BACTERIAL 87070 58.20
CULTURE DRAINAGE 87070 107.00
CULTURE EAR 87070 107.00
CULTURE EYE 87070 58.20
CULTURE FUNG. EXCPT BLOOD 87102 158.50
CULTURE FUNGUS (BLOOD) 87103 294.70
CULTURE GENITAL COMPLETE 87070 107.00
CULTURE JOINT 87070 58.20
CULTURE MYCOBACTERIUM TB 87116 170.00
CULTURE PERITONEAL FLUID 87070 107.00
CULTURE RESPIRATORY 87070 107.00
CULTURE STOOL 87045 107.00
CULTURE STOOL ADD PTHGNS 87046 62.00
CULTURE STREP SCR/GENITAL 87081 80.50
CULTURE THROAT 87070 96.00
CULTURE URINE W/COLONY CT 87088 80.00
CULTURE VIRAL 87252 249.10
CULTURE VRE SCREEN 87081 80.50
CULTURE WOUND 87070 107.00
CYCLIC CITRULLINATED PEPT 83516 198.20
CYCLOSPORA STAIN 87206 99.90
CYCLOSPORINE 80158 245.40
CYTOGENETICS REPORT 88291 236.50
CYTOMEG DNA QUANT 87497 358.40
CYTOPATH CONCENTRATE TECH 88108 148.90
CYTOPATH FLD CONCENTRATE 88108 148.90
CYTOPATH FLD WASH SM/FIL 88107 150.50
CYTOPATH FLUID CENTRIFUG 150.50
CYTOPATH SMEAR EXT STUDY 88162 133.40
CYTOPATH SMEAR NON-GYN 88112 238.30
CYTOPATH SMEAR SCREEN/INT 88160 100.70
CYTOPLASMIC NEUTROPHOILIC 86255 235.60
CYTP CERV/VAG THIN LAYER PREP MNL SCREEN 88142 111.30
D-DIMER 85380 161.30
DECALCIFICATION PROCEDURE 88311 102.80
DEHYDROEPIANDROSTERONE 82626 216.50
DEOXYCORTISAL 82634 323.70
DETECT AGENT NOS DNA AMP 87798 229.20
DETECT AGNT MULT DNA AMPL 87801 305.90
DHEA SULFATE 82627 221.80
DIGOXIN LEVEL 80162 142.40
DILANTIN PHENYTOIN 80185 154.30
DIRECT COOMBS C3D 86880 74.00
DIRECT COOMBS IGG 86880 74.00
DIRECT COOMBS POLY 86880 74.00
DNA/RNA INFLUENZA 1ST 2 TYPES 87502 131.00
DNS DOUBLE STRANDED ABS 86225 124.10
DOT AFTER HOUR FEE 50.50
DOT/SLOT BLOT PRODUCTION 83893 109.50
DRUG ASSAY CLOZAPINE 80159 233.00
DRUG SCREEN NAME & SSN 31.10
DRUG SCREEN QUANT GABAPENTIN 80171 156.00
DRUG SCREEN QUANTITATIVE GABAPENTIN 80171 479.00
DRUG SCREEN TLC 80303 272.10
DRUG SCREEN X 9 80307 289.20
DRUG TEST PRSMV CHEMISTRY ANALYZERS 80307 94.50
DRUG TEST QUAL INSTRUMENT 80306 362.00
E COLI 0157 HEMORRHAGIC 87335 48.20
E.DISPAR AG 87337 155.30
E.HISTORLYTICA AG 87336 155.30
EBV IGG AB TO EARLY AB 86663 159.80
EHRLICHIA CHAFFEENSIS IGG 86666 198.20
ELECTROLYTE PANEL 80051 112.50
ELECTRON MICROSCOPY DIAGNOSTIC 88348 650.20
ENCEPHALITIS ANTIBODY 86654 349.10
ENCEPHALITIS ANTIBODY 86651 349.10
ENCEPHALITIS ANTIBODY 86652 349.10
ENDOMYSIAL IGA AUTOANTIBO 86256 270.00
ENTEROHEMORRHAGIC E COLI 87081 84.70
ENTEROVIRUS PROBE&REVRS TRNS 87498 180.00
ENZYMATIC DIGESTION 83892 88.90
EOSINOPHILS URINE 88344 311.10
EPSTEIN BARR EBV-EA,ICG 86663 160.70
EPSTEIN BARR NUCLEAR ABS 86664 160.70
EPSTEIN BARR VCA IGG 86665 160.70
EPSTEIN BARR VCA IGM 86665 160.70
ERYTHROCYTE SEDIMENT RATE 85651 56.80
ERYTHROPOIETIN 82668 241.00
ESTRADIOL 82670 186.40
ESTROGEN 82672 282.80
F2 PROTHROMBIN G20210A 81240 321.50
F5 LEIDEN VARIANT 81241 242.00
FACTOR II ACTIVITY 85210 263.50
FACTOR II GENE MUT/MOLEC 83890 236.30
FACTOR II GENE MUT/NUCLEI 83898 358.70
FACTOR II MUTATION 83896 49.40
FACTOR II MUTATION 83912 134.50
FACTOR IX ACTIVITY 85250 289.40
FACTOR V LEIDEN DX 83896 49.40
FACTOR VII 85230 281.70
FACTOR XI ACTIVITY 85270 278.50
FAP-MOLECULE GEL ELECTRO 83894 160.40
FAP-MOLECULE NUCLEIC AMPL 83898 358.70
FECAL FAT STAIN 82715 53.60
FECAL FATS 82710 258.10
FECAL WBC ANTIGEN 83630 102.40
FERRITIN 82728 134.10
FFP-FRESH FROZEN PLASMA 86927 38.50
FIBRENOGEN 85384 154.80
FIBRINOGEN TEST 85366 95.20
FLOW CYTOMETRY 86359 120.40
FLOW CYTOMETRY (X17) 88180 69.60
FNA 88170 105.00
FNA EVALUATION 88172 140.30
FNS INTERPRETATION/REPORT 88173 182.90
FOB II IMMUNOASSAY 82274 46.00
FOLATE 82746 129.00
FOLLICLE STIMULAT HORMONE 83001 160.70
FREE INSULIN 83527 151.70
FTA-ABS 86781 183.10
G6PD ENZYME 82955 236.20
GAMMA-GT 82977 65.30
GASTRIN 82941 316.00
Gastrointestinal pathogen 87507 706.50
GC DNA PROBE 87590 92.30
GENERAL HEALTH PANEL 80050 331.00
GENTAMYCIN 80170 198.20
GIARDIA ANTIBODY BY IFA 86674 235.30
GIARDIA LAMBLIA AG 87329 126.00
GIARDIA/CRYPTO IMMUNO 87328 158.50
GLIADIN IGA ANTIBODY 83520 163.00
GLIADIN IGG ANTIBODY 83520 163.00
GLUCOSE 82947 56.30
GLUCOSE CSF 82945 96.70
GLUCOSE TOL.TST(OGTT)3SPC 82951 365.40
GLUCOSE TOL.TST(OGTT)ADDL 82952 68.75
GLUCOSE-ONE TOUCH 82948 49.20
GLYCOHEMOGLOBIN 83036 92.30
GLYCOPROTEIN ANTIBODY 86146 153.60
GRAM STAIN SMEAR 87205 55.00
GROWTH HORMONE 83003 134.90
H PYLORI IGA QUANTITATIVE 86677 164.10
H PYLORI IGG A M RAPID 87339 87.90
H PYLORI IGM 86677 161.00
H PYLORI QUANT IGG 86677 186.40
H PYLORI STOOL ANTIGEN 87338 270.30
H PYLORI UREASE ACTIVITY 87339 110.10
HANTAVIRUS IGG 86790 265.30
HANTAVIRUS IGM 86790 265.30
HAPTOGLOBIN 83010 139.50
HCG QUANTITATIVE 84702 131.90
HCV GENOTYPING 87902 819.50
HCV RNA DET/QUANT BY PCR 87522 494.40
HDL 83718 86.30
HEAVY METAL ARSENIC 82175 205.70
HEAVY METAL LEAD 83655 104.80
HEAVY METAL MERCURY 83825 211.30
HEMATOCRIT 85014 37.40
HEMOGLOBIN 85018 39.80
HEMOGRAM 85027 81.25
HEP C GENOTYPE DNA 87902 781.70
HEP C NUCLEIC ACID AMPL'N 83898 376.80
HEP C RNA PCR QUALITATIVE 718.60
HEPARIN ASSAY 85520 231.00
HEPATIC FUNCTION PANEL 80076 140.50
HEPATITIS A IGG & IGM ANT 86708 167.30
HEPATITIS A IGM ANTIBODY 86709 124.00
HEPATITIS B ANTIGEN 87350 114.10
HEPATITIS B CORE ANTIBODY 86704 137.20
HEPATITIS B CORE IGM ANTI 86705 143.70
HEPATITIS B DNA QUANT PCR 87517 631.80
HEPATITIS B SURFACE ANTIB 86706 136.90
HEPATITIS B SURFACE ANTIG 87340 106.50
HEPATITIS B VIRUS DETECTR 87516 432.60
HEPATITIS BE ANTIBODY 86707 137.80
HEPATITIS BE ANTIGEN 87350 114.10
HEPATITIS C ANTIBODY G0472 149.60
HEPATITIS C ANTIBODY RIBA 86804 669.40
HERPES SIMPLEX 1 & 2 IGM 86694 136.60
HERPES SIMPLEX 1 1GB AB 86695 136.60
HERPES SIMPLEX 1 DNA 87529 453.10
HERPES SIMPLEX 2 1GB AB 86696 136.60
HERPES SIMPLEX 2 DNA 87529 160.80
HERPES SIMPLEX TISSUE CUL 87252 261.50
HERPES TISSUE CULT ADD'L 87253 151.10
HFE HEMOCHROMATOSIS GENE ANAL COMMON 81256 432.00
HIA A&B PHENOTYPE 86813 923.10
HISTONE IGG AB 86235 404.90
HIV-1 ANTIBODY 86701 105.70
HLA TYPING DR/DQ 86816 361.60
HLA-B27 86812 315.00
HOMOCYSTEINE 82131 347.50
HPGDE DNA EXTRACTION 83891 386.00
HPV HIGH RISK THIN PREP 87624 170.50
HPV HIGH RISK TYPES 87624 205.10
HPV TYPES 16 AND 18 ONLY 87625 111.00
HTLV-I/II AB CONFIRM SERM 86689 457.70
HUMAN HERPES VIRUS-6 PCR 87532 287.80
HYDROXYCORTICOSTERIODS 17 83491 582.20
IADNA RESP PROBE 3-5 TARGETS 87631 185.00
IADNA STREPTOCOCCUS GRP A AMPLIFIED PROB 87651 103.00
ID BACTERIA ISOLATE 87077 104.50
ID FUNGUS 87107 151.20
ID MANUAL 87077 104.50
ID ONLY BACTERIA 87077 80.00
ID ONLY URINE ORGANISM 87077 104.50
ID ROUTINE 87077 80.00
ID URINE ISOLATE 87077 80.00
IFE KAPPA LIGHT CHAINS 83883 376.80
IFE LAMDBA LIGHT CHAINS 83883 376.80
IGA SERUM 82784 106.80
IGE 82785 142.00
IGF BINDING PROTEIN-3 82397 664.40
IGG SERUM 82784 106.80
IGG SUBCLASSES 1-2-3 OR 4 82787 78.30
IGM SERUM 82784 106.80
IMIPRAMINE ASSAY 80174 299.90
IMMUNOASSAY NONANTIBODY 83516 17.00
IMMUNOASSAY QUANT NOS NON 83520 173.00
IMMUNOCYTOCHEMISTRY 88342 209.00
IMMUNOFIXATION 86334 376.80
IMMUNOFIXATION IFE KAPPA 83883 376.80
IMMUNOFIXATION IFE LAMBDA 83883 376.80
IMMUNOFIXATION URINE 86335 376.80
IMMUNOFIXJ ELECTROPHORESIS 86335 63.40
IMMUNOFLUORESCENSE PER SPEC 1ST ANTB 88346 242.85
IMMUNOFLUORESCENSE PER SPEC ADDL ANTB 88350 209.85
INF AGENT DET NUCLEIC ACID CLOSTRIDIUM 87493 143.25
INFECTIOUS AGENT DNA/RNA INFLUENZA 87502 131.00
INFLUENZA A & B ANTIGEN 87400 117.00
INFLUENZA VIRUS ANTIBODY 86710 399.60
INSULIN-SERUM 83525 130.00
INTERPHASE ANALYZ 100/300 88275 348.10
INTERPRETATION & REPORT 83912 141.30
INTRINSIC FACTOR ANTIBODIES 86340 177.25
IONIZED CALCIUM 82330 130.50
IRON 83540 73.00
IRON BINDING TOTAL 83550 78.00
JAK2 GENE ANALYSIS 81270 490.00
KETONE BODIES SERUM QUANTITATIVE 82010 95.35
LACTIC ACID LACTATE 83605 121.25
LDH 83615 77.60
LDH BODY FLUID 83615 77.60
LDH ISOENZYMES 83625 154.10
LEAD BLOOD 83655 80.00
LEGAL DRAWING FEE 81.00
LEUCOCYTES (STOOL) 87210 127.60
LEUKEMIA LYMPH PHENO ADDL 88185 352.70
LEUKEMIA LYMPH PHENOTYPE 88184 387.50
LEVETIRACETAM (KEPPRA) 80177 234.00
LIPASE 83690 96.00
LIPID PROFILE 80061 124.00
LIPOPROTEIN A 83695 156.30
LITHIUM 80178 156.40
LUPUS ANTICOAGULANT 85613 133.00
LUTEINIZING HORMONE 83002 159.80
LUTEINIZING RELEASING FACTOR 83727 424.60
LYME ANTIBODY 86618 235.00
LYME DISEASE PCR 87476 564.10
LYME DISEASE SEROLOGY 86618 172.00
LYME DISEASE WESTERN BLOT 86617 331.80
LYMPH CHORIOMENINGITIS 86727 118.10
MACRO EXAM ARTHROPOD 87168 65.70
MAGNESIUM 83735 80.10
MALATONIN 83519 446.50
MANUAL ID 87077 104.50
METABOLIC PANEL 80048 147.80
METANEPHRINES PLASMA 83835 610.60
METHYLMALONIC ACID 83921 317.00
MICROALBUMIN/RANDOM 82043 106.80
MICROSOMAL ANTIBODY EACH 86376 127.00
MITOCHONDRIAL ANTIBODIES 83516 208.10
MOLECULAR DIAG AMP PT 83900 208.70
MOLECULAR DIAGNOSTICS ISO 83890 248.20
MOLECULAR EXTRACTION 83890 248.20
MOLECULAR GEL ELECTROPHOR 83894 168.40
MOLECULAR INTERPRETATION 83912 141.30
MOLECULAR ISOLATION/EXTRA 83890 248.20
MOLECULAR ISOLATION/EXTRA 83891 106.30
MOLECULAR MUTATION SCAN 83903 143.00
MOLECULAR PATH PROC LEVEL 4 81403 692.15
MOLECULAR SEPARATION 83894 168.40
MONOCLONAL PROTEIN URINE 84166 63.40
MONOSPOT 86308 76.00
MOPATH PROCEDURE LEVEL 9 81408 340.00
MORPHINE LEVEL (SERUM) 80348 254.00
MPO ANCA IMMUNASSY NONANT 83516 187.30
MTHFR GENE ANALYSIS 81291 220.20
MTHRF MOLECULAR DIAG AMP 83900 208.70
MTHRF MOLECULAR ISOLATION 83890 248.20
MTHRF NUCLEIC ACID PROBE 83896 51.90
MULTIORGAN PANEL 80053 195.70
MUMPS IGG ANTIBODY 86735 135.00
MUMPS IGM ANTIBODY 86735 135.00
MYCOPLASMA IGG AB 86738 114.70
MYCOPLASMA IGM AB 86738 114.70
MYCOPLASMA PNEUM IGM IFA 86738 283.50
MYELOPEROXIDASE ANTIBODIE 83520 334.60
MYOGLOBIN SERUM 83874 209.20
NEISSERIA GONORRHEAE ANTI 86171 210.30
NH CULTURES DONE AT MCCH 57.30
NH-CULTURE AEROBIC 87077 78.80
NH-CULTURE BACTERIAL OTH 87070 115.60
NICOTINE/METABOLITE SERUM 80323 218.20
NK CELLS TOTAL COUNT 86357 129.30
NMP 22 86386 112.50
NOROVIRUS EIA STOOL 87449 421.60
NRNP IGG AUTOANTIBODIES 86235 143.20
NTX TELOPEPTIDE URINE 82523 295.70
NUCLEIC ACID PROBE 83896 51.90
NUCLEIC ACID SIGNAL AMPLI 83908 54.30
OCCULT BLOOD OTHER SOURCE 82271 222.70
OLIGOCLONAL BANDS 83916 181.30
OPIATES CONFIRM URINE 80348 254.20
OSMOLALITY SERUM 83930 84.00
OSMOLALITY URINE 83935 87.00
OVA & PARASITES 87177 102.30
OXALATE 24 HR URINE 83945 185.00
PAN ANCA 86021 366.90
PARATHYROID HORMONE INTAC 83970 220.00
PARVOVIRUS B19 IGG 86747 219.90
PARVOVIRUS B19 IGM 86747 219.90
PATERNITY SCREEN 45.00
PH 83986 92.20
PH BODY FLUID 82800 91.10
PHENOBARBITAL 80184 164.20
PHENYTOIN FREE 80185 161.90
PHILADELPHIA CHROMOSOME 88237 1061.70
PHOSPHATIDY/SERINE ABS 86148 100.60
PHOSPHORUS 84100 64.40
PHOSPHORUS URINE 84105 121.50
PINWORM OVA 87172 105.30
PLASMA FROZEN W/I 8 HRS P9017 221.60
PLATELET ANTIBODY 86022 625.90
PLATELET COUNT 85049 57.25
PLATELET I 86999 294.60
PLATELET PHERESIS LEUKORD P9035 1208.80
PLATELETS LEUKOREDUCE/IRR P9033 331.80
PLATELETS LEUKOREDUCED EA P9031 205.80
POOLING BLOOD PRODUCTS 86965 84.30
PORPHOBILINOGEN (PBG) 84110 254.20
PORPHYRINS URINE QANTITATION FRACTION 84120 175.00
POTASSIUM 84132 53.90
PR3 ANCA IMUNASSY NONANTI 83516 187.30
PREALBUMIN 84134 116.50
PREGNANCY TEST SERUM-QUAN 84703 154.10
PREGNANCY TEST-SERUM 84703 125.00
PREGNANCY TEST-URINE 81025 80.30
PREGNENOLONE 84140 246.70
PROCALCITONIN (PCT) 84145 193.00
PROGESTERONE 84144 150.90
PROGESTERONE ASSAY 83498 327.10
PROLACTIN 84146 169.50
PROSTATE SPECIFIC ANTIGEN 84152 109.90
PROSTATIC ACID PHOSPHATAS 84066 163.00
PROTEIN C ACTIVATED RESIS 85307 265.40
PROTEIN C AG 85302 189.94
PROTEIN C FUNCTIONAL 85303 275.50
PROTEIN CSF 84155 61.80
PROTEIN ELECTROPHORESIS 84165 127.00
PROTEIN S FREE 85306 265.40
PROTEIN S FUNCTIONAL 85306 265.40
PROTEIN S TOTAL 85305 324.60
PROTEIN SERUM 84155 88.40
PROTEIN URINE 24 HR 84156 88.40
PROTEIN URINE RANDOM 84156 66.00
PROTEIN, TOTAL 84155 59.90
PROTEINASE 3 ANTIBODIES 83520 318.70
PROTIME 85610 57.90
PROTOPORPHYRIN RBC QUANT 84202 311.70
PSA (SCREENING) G0103 127.50
PSA-FREE 84154 139.00
PTT 85730 92.10
QUANTITATIVE ASSAY DRUG 80329 237.00
RAPID STREP A 87430 92.10
RBC LEUKOREDUCE/IRRADIATE P9040 646.60
RBC LEUKOREDUCED PER UNIT P9016 448.00
RBC SICKLE CELL TEST 85660 112.50
RENAL FUNCTION PANEL 80069 237.15
RENIN 84244 482.00
RESP VIRUS 12-25 TARGETS 87633 674.00
RESPIRATORY SYNCYTIAL VIR 87420 150.50
RESTOCETIN COFACTOR 85245 353.20
RESTORIL/TEMAZEPAM LEVEL 80346 196.70
RETICULIN IGA AUTOANTIBOD 86256 269.70
RETICULOCYTE COUNT 85045 77.50
REVERSE T3 84482 229.00
REVERSE TRANSCRIPTION 83902 140.00
RHEUMATOID FACTOR 86431 79.00
RIA NONANTIBODY 83519 286.50
RIBOFLAVIN (VIT B-2) 84252 283.50
RIBOSOME P IGG AB 83520 334.60
RICKETTSIA 86757 272.20
RNP IGG ANTIBODY 86235 142.80
ROCKY MOUNTAIN FEVER IGG 86757 272.20
ROCKY MOUNTAIN FEVER IGM 86757 272.20
ROTOVIRUS (ROTOV) 87425 202.50
RPR 86592 65.90
RUBELLA 86762 137.20
RUBELLA IGM ANTIBODIES 86762 137.20
RUBEOLA IGG ANTIBODY 86765 144.50
RUBEOLA IGM ANTIBODY 86765 144.50
SALICYLATE 80329 211.00
SCL-70 IGG AUTOANTIBODIES 86235 143.20
SEMEN EXAM-FOR PRESENCE 89321 76.00
SENSITIVITY 87184 133.80
SENSITIVITY VITEK 87186 103.00
SEROTONIN 84260 307.70
SERUM ADH 84588 149.60
SEX HORMONE GLOBULIN 84270 208.10
SHIGA TOXIN A/B 87899 74.00
SJOGREN'S ANTI SS-A 86235 143.20
SJOGREN'S ANTI SS-B 86235 143.20
SMEAR SPECIAL STAIN 87207 96.80
SMOOTH MUSCLE ANTIBODIES 86255 226.00
SODIUM 84295 59.30
SODIUM 24 HR URINE 84300 65.80
SODIUM RANDOM URINE A9579 18.00
SPECIAL STAIN GROUP I 88312 115.00
SPECIAL STAIN GROUP II 88313 221.60
SPECIAL STAIN ID ENZYME 88319 403.20
SPECIFIC GRAVITY 81099 47.80
SPECIMEN CONCENTRATION 87015 45.30
SPECTROPHOTOMETRY 84311 318.10
ST LOUIS EQUINE ENC IGG 86653 366.60
ST LOUIS EQUINE ENC IGM 86653 366.60
STONE ANALYSIS (KIDNEY) 82365 158.80
STOOL CULTR AEROBIC BACT EA 87046 200.40
STREP PNEUMO-SEROTYPES 86317 210.90
SULFATE URINE 84392 175.20
SURG PATH LEVEL I 88300 118.00
SURG PATH LEVEL II 88302 225.00
SURG PATH LEVEL III 88304 184.00
SURG PATH LEVEL IV 88305 227.00
SURG PATH LEVEL IV ADDL 88305 227.00
SURG PATH LEVEL V 88307 450.90
SURG PATH LEVEL VI 88309 360.00
T CELLS TOTAL COUNT 86359 126.40
T3 FREE 84481 188.90
T3 TOTAL 84480 121.00
T3 UPTAKE 84479 120.30
T4 84436 80.50
T4 FREE 84439 97.50
TB TEST CELL IMMUN MEASUR 86480 251.52
TESTOSTERONE FREE 84402 162.00
TESTOSTERONE TOTAL 84403 163.90
THC CONFIRMATION URINE 80375 329.10
THEOPHYLLINE 80198 147.30
THROMBIN TIME 85670 89.30
THROMBIN TIME 85670 89.30
THYROGLOBULIN 84432 143.00
THYROID STIMULATING IMMGL 84445 440.50
TIAGABINE 80299 285.70
TIAGABINE QUANT DRUG SCREEN 80199 171.00
TIS TRANSGLUTAMINASE IGA 83516 208.10
TIS TRNSGLUTAMINAS IGA/IG 83516 272.80
TISSUE CULT NON-NEOPLASTI 88230 648.90
TISSUE EXAM FOR FUNGI 87220 121.40
TOBRAMYCIN PEAK/TROUGH 80200 171.00
TOXOCARA LGG AB 86682 187.80
TOXOPLASMA IGG AB 86777 168.60
TOXOPLASMA IGM AB 86778 160.80
TOXOPLASMA LGG AB 86317 371.20
TREPONEMA PALLIDUM 86780 164.00
TRICHROME STAIN 87209 80.00
TRIGLYCERIDES 84478 61.30
TRILEPTAL LEVEL 80183 357.70
TROPONIN 84484 236.20
TSH 84443 114.60
TSH RECEPTOR AB 83519 446.50
U1 RNP 86235 143.20
UNLISTED CHEMISTRY PROCEDURE 84999 21.50
UREA 24 HR URINE 84540 52.50
UREA RANDOM URINE 84540 52.50
URIC ACID 84550 64.90
URIC ACID URINE 84560 61.80
URINALYSIS, COMPLETE 81001 55.70
URINALYSIS, MICROSCO ONLY 81015 24.00
URINALYSIS, W/O MICROSCOP 81002 39.40
URINE 24 CORTISOL 82530 210.40
URINE 24 HR CATECHOLAMINE 82384 264.60
URINE 24 HR METANEPHRINES 83835 258.10
URINE 24 HR SHIAA 83497 192.30
URINE 24 HR VMA 84585 204.70
URINE CHLORIDE 82436 137.80
URINE DRUG SCRN MRO & TST 79.10
URINE LEAD 83655 127.70
URINE MERCURY 83825 152.10
URINE POTASSIUM 84133 65.80
VALPROIC ACID 80164 143.00
VANCOMYCIN, PEAK/TROUGH 80202 160.00
VARACELLA-ZOSTER IGM AB 86787 154.70
VARICELLA (HERPES 1) CULT 87274 209.10
VARICELLA (HERPES 2) CULT 87273 335.00
VARICELLA ZOSTER IGG 86787 154.70
VARICELLA ZOSTER VIRAL 87290 211.40
VARICELLA ZOSTER VIRUS 87798 476.20
VDRL-CEREBRAL SPINAL FLD 86592 85.00
VENIPUNCTURE 36415 31.00
VENIPUNCTURE X 2 36415 61.80
VENIPUNCTURE X 3 36415 92.80
VENIPUNCTURE X 4 36415 123.70
VENIPUNCTURE X 5 36415 154.70
VITAMIN B-1 THIAMINE 84425 382.40
VITAMIN B-12 82607 155.50
VITAMIN B-6 84207 98.60
VITAMIN B6 LEVEL 84207 153.70
VITAMIN D-1 25 DEHYDROXY 82652 308.00
VITAMIN K 84597 743.50
VITEK ID YEAST 87106 146.30
VW ANTIGEN 179.00
VW FACTOR VIII ACTIVITY 85240 285.70
VW MULTIMERS 85247 603.80
WBC 85048 64.40
WEST NILE VIRUS AB IGM 86788 151.80
WEST NILE VIRUS ANTIBODY 86789 151.80
WEST NILE VIRUS IGG 86790 151.80
WEST NILE VIRUS IGM 86790 151.80
WET MOUNT SALINE/IN 87210 55.00
YEAST SUSCEPTIBILITY 87186 269.00
ZINC SERUM 84630 77.10
ZONIZAMIDE 80339 340.60
MRI ANGIO LOW EXT WW LT 73725 4177.00
MRI ANGIO UP EXT WW LT 73225 2927.50
MRI LOW EXT NJNT W/CO LT 73719 2829.00
MRI LOW EXT NON JOINT LT 73718 2684.50
MRI-ABDOMEN W&W/O CONTRAS 74183 3586.50
MRI-ABDOMEN W/CONTRAST 74182 3202.50
MRI-ABDOMEN W/O CONTRAST 74181 3065.50
MRI-ANGIO LWR EXT WW RT 73725 4177.00
MRI-ANGIO UP EXT WWO RT 73225 2927.50
MRI-ANGIOGRAPH ABD W/WO 74185 3475.50
MRI-ANGIOGRAPH CHEST W/WO 71555 4775.50
MRI-ANGIOGRAPH NECK W&W/O 70549 3414.00
MRI-ANGIOGRAPH NECK W/CON 70548 3194.00
MRI-ANGIOGRAPH NECK WO CO 70547 3491.00
MRI-ANGIOGRAPH PELVIS WWO 72198 3282.50
MRI-ANGIOGRAPH SPINAL 72159 3948.50
MRI-ANGIOGRAPHY HEAD W/CO 70545 3237.00
MRI-ANGIOGRAPHY HEAD W/O 70544 3202.50
MRI-ANGRIOGRAPH HEAD W&WO 70546 3609.00
MRI-BRAIN W&W/O CONTRAST 70553 3620.00
MRI-BRAIN W/CONTRAST 70552 3377.50
MRI-BRAIN W/O CONTRAST 70551 3216.00
MRI-CERVICAL SPINE W&W/O 72156 4316.50
MRI-CERVICAL SPINE W/CONT 72142 3151.50
MRI-CERVICAL SPINE W/O CO 72141 2924.00
MRI-CHEST W&W/O CONTRAST 71552 4480.00
MRI-CHEST W/CONTRAST 71551 3670.00
MRI-CHEST W/O CONTRAST 71550 3635.00
MRI-FACE NECK OR ORBITS 70540 3370.00
MRI-FACE/NECK W/&W/O CONT 70543 3971.00
MRI-FACE/NECK/ORBITS W/CO 70542 3935.50
MRI-LOW EXT NJNT W/CO RT 73719 2829.00
MRI-LOW EXT NON JOINT RT 73718 2684.50
MRI-LUMBAR SPINE W&W/O CO 72158 4316.50
MRI-LUMBAR SPINE W/CONTRA 72149 3079.00
MRI-LUMBAR SPINE W/O CONT 72148 3258.00
MRI-LWR EXT JNT W/0 CN LT 73721 2551.00
MRI-LWR EXT JNT W/CON LT 73722 3022.00
MRI-LWR EXT JNT W/O CN RT 73721 2551.00
MRI-LWR EXT JNT W/WO LT 73723 3475.50
MRI-LWR EXT JOINT W&WO RT 73723 3475.50
MRI-LWR EXT JOINT W/CN RT 73722 3022.00
MRI-LWR EXT NJNT W&WO RT 73720 2924.00
MRI-LWR EXT NJNT W/WO C L 73720 2924.00
MRI-PARTIAL STUDY 76498 4480.00
MRI-PELVIS W&W/O CONTRAST 72197 4316.50
MRI-PELVIS W/CONTRAST 72196 3147.00
MRI-PELVIS W/O CONTRAST 72195 2996.50
MRI-SB-BRAIN EXT W/WO CON 70553 8337.00
MRI-SB-CERVICAL SPINE W/C 72142 7451.00
MRI-THORACIC SPINE 72146 3463.00
MRI-THORACIC SPINE W&W/O 72157 4316.50
MRI-THORACIC SPINE W/CONT 72147 3803.00
MRI-TMJ 70336 3279.50
MRI-UP EXT JNT W&W/O CN L 73223 3397.50
MRI-UP EXT JNT W/CON LT 73222 2573.00
MRI-UP EXT JNT W/O CN LT 73221 2350.50
MRI-UP EXT JOINT W&W/O RT 73223 3397.50
MRI-UP EXT JOINT W/CON RT 73222 2573.00
MRI-UP EXT JOINT W/O C RT 73221 2350.50
MRI-UP EXT NJNT LT 73218 2451.00
MRI-UP EXT NJNT W&WO RT 73220 2933.50
MRI-UP EXT NJNT W/CON LT 73219 2668.00
MRI-UP EXT NJNT W/CON RT 73219 2668.00
MRI-UP EXT NJNT W/WO C LT 73220 2933.50
MRI-UP EXT NON JOINT RT 73218 2451.00
NM - MYOCARDIAL IMAGE SPECT SINGLE 78451 3478.00
NM LIVER SPLEEN VASCULAR FLO 78216 3071.00
NM-BONE IMAGING SPECT 78320 2666.00
NM-BONE 3 PHASE TECHNIQUE 78315 1920.50
NM-BONE IMAGING WHOLE BOD 78306 1805.00
NM-BONE JOINT IMAGING LTD 78300 1233.00
NM-BONE JOINT MULT AREAS 78305 1715.50
NM-BOWEL IMAGING MECKEL'S 78290 1204.00
NM-CARDIAC BLOOD POOL MUG 78472 2511.50
NM-GASTRIC EMPTYING STUDY 78264 1840.50
NM-GASTROINTESTINAL BLOOD 78278 1846.00
NM-HEPATODUCTAL SYS W/CCK 78227 2230.50
NM-KIDNEY IMAGING SNG W/P 78708 2251.00
NM-LIVER SPLEEN IM STATIC 78215 2809.50
NM-LIVER SPLEEN SPECT 78205 2050.50
NM-LYMPHATICS/LYMPH NODES 78195 1882.00
NM-MYOCARDIAL IMAGE SPECT 78452 4185.50
NM-MYOCARDIAL PYP QAL&QAT 78466 1749.00
NM-MYOCARDIAL SPECT SINGL 78464 2183.00
NM-PARATHYROID IMAGING 78070 1434.50
NM-PULMONARY PERFUSION 78580 1434.50
NM-PULMONARY VENTILATION 78579 1911.50
NM-RENAL F&F W/O PHARMACY 78707 1831.50
NM-RENAL IMAGING SPECT 78710 2276.00
NM-RENAL IMAGING STATIC 78700 1806.50
NM-RENAL W/F&F MULTI W/RX 78709 1796.00
NM-TESTICULAR W/VASCULAR 78761 1582.50
NM-THYROID IMAGING UPTAKE 78006 844.00
NM-THYROID IMAGNG W/BLD F 78013 844.00
NM-THYROID UPTAKE MULTI 78007 1412.50
NM-TUMOR LOCALIZATION LTD 78800 2016.50
NM-TUMOR LOCALIZATION MUL 78801 2255.50
NM-URETHRAL REFLUX STUDY 78740 2408.00
NM-VENTILATION/PERF LUNG 78582 2565.00
BCG TREATMENT ROOM 51720 475.00
DEBRIDEMENT MUSCLE FASCIA 20 SQ CM 11043 590.00
DEBRIDEMENT MUSCLE FASCIA EA ADDL 20 CM 11046 250.00
DEBRIDEMENT OPEN WOUND 20 SQ CM 97597 220.00
DEBRIDEMENT OPEN WOUND EACH ADD'L 20 SQ 97598 105.00
DEBRIDEMENT SUBCUTANEOUS TISS EA ADDL 20 11045 110.00
DEBRIDEMENT SUBCUTANIOUS TISS 20 SQ CM 11042 230.00
LEAVE OF ABSENCE 0.00
NEG PRESSURE WOUND TX NON DME <50 SQ CM 97607 246.00
NEG PRESSURE WOUND TX NON DME > 50 SQ CM 97608 305.00
OBSERVATION 1 HOUR 1095.00
OBSERVATION 24+ HRS 53.13
OBSERVATION UP TO 10 HRS 126.50
OBSERVATION UP TO 11 HRS 115.91
OBSERVATION UP TO 12 HRS 106.25
OBSERVATION UP TO 13 HRS 98.08
OBSERVATION UP TO 14 HRS 91.07
OBSERVATION UP TO 15 HRS 85.00
OBSERVATION UP TO 16 HRS 79.69
OBSERVATION UP TO 17 HRS 75.00
OBSERVATION UP TO 18 HRS 70.83
OBSERVATION UP TO 19 HRS 67.11
OBSERVATION UP TO 2 HOURS 557.50
OBSERVATION UP TO 20 HRS 63.75
OBSERVATION UP TO 21 HRS 60.71
OBSERVATION UP TO 22 HRS 57.95
OBSERVATION UP TO 23 HRS 55.43
OBSERVATION UP TO 3 HOURS 378.33
OBSERVATION UP TO 4 HOURS 288.75
OBSERVATION UP TO 5 HOURS 235.00
OBSERVATION UP TO 6 HOURS 199.17
OBSERVATION UP TO 7 HRS 173.57
OBSERVATION UP TO 8 HRS 154.38
OBSERVATION UP TO 9 HRS 139.44
PICC LINE INSERTION 36569 1258.00
PICC LINE REPLACEMENT 36584 995.00
PRIVATE ROOM 1295.00
PROGRESSIVE/INTERMEDIATE CARE 1890.00
REMOVE DEVITAL TISSUE W/O ANES 97602 167.00
SEMI PRIVATE ISOLATION ROOM 1375.00
SEMI PRIVATE ROOM 1275.00
OT ATTENDED ELEC. STIM. 97032 71.50
OT CONSULTATION 1 HOUR 60.00
OT CONSULTATION 15 MIN 15.00
OT DEBRIDEMENT @15 MIN. 97139 63.00
OT EVAL HIGH COMPLEX 60 MIN 97167 172.00
OT EVAL LOW COMPLEX 30 MIN 97165 172.00
OT EVAL MOD COMPLEX 45 MIN 97166 172.00
OT HAND/KINETIC ACT@15MIN 97530 75.00
OT MANUAL THERAPY 97140 85.00
OT MASSAGE 97124 75.00
OT NEUROMUSC. RE-ED @15MN 97112 75.00
OT ORTHOTICS,INIT. @15MIN 97760 91.00
OT PARAFFIN BATH 97018 64.00
OT RE-EVAL EST PLAN CARE 97168 102.00
OT SCHOOL MILEAGE 6001 0.58
OT SELF CARE @15 MIN. 97535 82.00
OT STERILE DRESS APP@15MN 97139 63.00
OT THERAPEUTIC EXER@15MIN 97110 90.00
OT TRAVEL TIME 15 MINUTES 15.00
OT ULTRASOUND 97035 63.00
OT UNATTENDED ELEC. STIM. G0283 75.00
OT WHIRLPOOL 97022 124.50
OT WHIRLPOOL, STERILE 97022 124.50
OT- MILEAGE 0.55
OT-CONSULTATION 15 MIN 12.50
OT-INFINITY CONSULT 15MIN 16.25
OT-INFINITY MILEAGE 0.50
OT-IONTOPHORESIS 15 MIN 97033 97.00
OT-ORTHOTIC FIT & TRAIN 97760 91.00
OT-SCHOOL TRAVEL 4006 11.50
OT-SCHOOL TRTMT 15 MIN 4006 11.50
OT-SIDNEY CONSULT 15 MIN 15.00
OT-THERAPEUTIC ACTVTY @15 97530 83.00
OT-WHEELCHAIR MNGMT 15 MN 97542 60.00
OT-WORK HARDENING 15 MIN 97545 140.00
EXTENDED FLOOR RECOVERY HOUR 213.00
PACU PHASE II 625.00
PACU-PHASE I (MINUTE) 10.45
ELEC. STIM, ATTENDED@15MN 97032 65.00
ELECTRIC STIMULATION THERAPY G0283 60.00
EXERCISE,THERAPEUTIC-15MN 97110 90.00
GAIT TRAINING, @15 MIN. 97116 80.00
IONTOPHORESIS @ 15MIN 97033 97.00
JOBST COMPRESSION 97016 60.50
JOINT MOBILIZATION 97140 85.00
MANUAL THERAPY 1/> REGIONS 97140 85.00
MASSAGE 97124 75.00
MASSAGE/MYOFASCIAL 97250 75.00
NEG PRESS WOUND THERAPY DME <= 50 SQ CM 97605 240.00
NEG WOUND PRESS THERAPY DME > 50 SQ CM 97606 299.00
NEUROMUSCULAR REEDUCATION 97112 83.00
NH-PT ASST /15 MIN 13.75
ORTHOTIC TRAINING @30 MIN 97500 94.00
PARAFFIN BATH 64.00
PROSTHETIC TRAINING @30MN 97761 82.50
PT CONSULTATION 1 HOUR 60.00
PT CONSULTATION 15 MIN 12.50
PT CONSULTATION 15 MIN 15.00
PT CONSULTATION/HR 50.00
PT DRY NEEDLING 97799 75.00
PT EVAL HIGH COMPLEX 45 MIN 97163 156.00
PT EVAL LOW COMPLEX 20 MIN 97161 156.00
PT EVAL MOD COMPLEX 30 MIN 97162 156.00
PT MILEAGE 0.50
PT TRAVEL TIME 15 MINUTES 15.00
PT-IONTOPHORESIS 15 MIN 97033 97.00
PT-RE-EVALUATION EST PLAN CARE 97164 94.00
REMOVAL DEVITALIZED TISSUE @15 MIN. 97602 190.00
TRACTION-CERVICAL/PELVIC 97012 65.00
ULTRASOUND 97035 75.00
UNNA BOOT APPLICATION 29580 170.00
UNNA BOOT APPLICATION BILATERAL 29580 180.00
WHIRLPOOL, REG. C-TUB 121.00
WHIRLPOOL, REG. HI/LO 121.00
WHIRLPOOL, STERILE C-TUB 97022 124.50
WHIRLPOOL, STERILE HI/LO 97022 124.50
WORK HARDENING 97545 140.00
WORK HARDENING ADDTL HOUR 97546 70.00
ABDOMEN 1 VW 74018 349.00
ABDOMEN 2 VW 74019 465.00
ABDOMEN 3 VW 74022 580.50
ANGIOGRAPHY EXTREMITY 75710 1350.00
ANKLE (AP & LAT) LEFT 73600 265.00
ANKLE (AP & LAT) RT 73600 265.00
ANKLE 3V OR 4V LEFT 73610 343.00
ANKLE 3V OR 4V RT 73610 343.00
BONE AGE STUDIES 77072 226.00
BONE DENSITY SCAN 77080 605.50
BONE SCAN 78306 1783.00
CERVICAL SPINE 3-VIEW 72040 355.50
CERVICAL SPINE, AP & LAT 72040 345.00
CERVICAL SPINE-COMPLETE 72050 476.00
CHEST (PA ONLY) 71045 274.50
CHEST 2 VIEWS 71046 368.50
CHEST,PA,LAT,&BOTH OBLIQU 71022 409.00
CHEST-SPECIAL VIEW 71035 439.50
CHILD ABUSE 904.00
CHOLANGIOGRAPHY(OPERATIVE 74300 586.00
CLAVICLE 2V LEFT 73000 264.50
CLAVICLE 2V RT 73000 264.50
COCCYX, MINIMUM 2V 72220 336.50
CONTRST X-RAY URINARY TRA 74420 748.00
CONTRST X-RAY URINARY TRA 74400 859.50
CYSTOGRAPHY 74430 572.50
ELBOW 2V LT 73070 289.00
ELBOW 2V RT 73070 289.00
ELBOW COMPLETE LT 73080 286.00
ELBOW-COMPLETE RT 73080 286.00
EYE ORBIT 70200 423.50
EYE-FORIEGN BODY 70030 254.00
FACIAL BONES-MINIMUM 3V 70150 530.00
FEMUR 2V LT 73552 338.50
FEMUR 2V RT 73552 338.50
FINGER-MINIMUM 2V LT 73140 245.50
FINGER-MINIMUM 2V RT 73140 245.50
FLUORO EXAM <1 HOUR 76000 656.50
FLUORO EXAM >1 HOUR 76001 1219.50
FLUORO NO CHARGE NEEDLE GUIDE 77002 0.00
FLUOROGUIDE FOR SPINE INJ 77003 627.00
FLUOROGUIDE FOR VEIN DEVI 77001 833.00
FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT 77002 627.00
FOOT AP & LATERAL LT 73620 254.00
FOOT AP & LATERAL RT 73620 254.00
FOOT MIMIMIUM 3V LT 73630 331.50
FOOT MINIMUM 3V RT 73630 331.50
FOREARM AP & LAT LT 73090 302.00
FOREARM AP & LAT RT 73090 302.00
GI TRACT UPR W/SM INTEST W/MULT SERIES 74245 935.00
HAND 2V LT 73120 243.50
HAND 2V RT 73120 243.50
HAND-MINIMUM 3V LT 73130 331.50
HAND-MINIMUM 3V RT 73130 331.50
HIP UNILATERAL 1V LT 73501 266.00
HIP UNILATERAL COMP LT 73502 343.00
HIP-BILATERAL 2V EA HIP 73521 511.50
HIP-UNILATERAL 1V RT 73501 266.00
HIP-UNILATERAL COMP RT 73502 343.00
HUMERUS MINIMUM 2V LT 73060 333.50
HUMERUS-MINIMUM 2V RT 73060 333.50
HYPAQUE Q9951 46.00
KNEE AP & LAT RT 73560 270.00
KNEE AP & LATERAL LT 73560 270.00
KNEE COMPLETE LT 73562 415.00
KNEE COMPLETE W/PATELLA L 73564 409.00
KNEE-COMPL W/PATELLA RT 73564 409.00
KNEE-COMPLETE RT 73562 415.00
KNEES BOTH STANDING AP 73565 229.50
L SPINE BEND VIEWS 72120 481.50
L SPINE COMPL W/BEND VIEW 72114 421.00
LUMBAR SPINE AP & LAT 72100 410.00
LUMBAR SPINE-COMPLETE 72110 441.00
MAMMOGRAM SCREENING ONLY 77057 258.00
MANDIBLE-MINIMUM 4V 70110 522.00
MRI-PULSE OXIMETER 169.00
NASAL BONES-MINIMUM 3V 70160 409.00
NG TUBE PLACEMENT 74340 575.50
NM-VENTILATION/PERFUSION 78582 3153.50
NO CANCELLATION FEE 138.00
OMNISCAN 20ML 537.00
OS CALSUS MINIMUM 2V LT 73650 229.50
OS CALSUS-MINIMUM 2V RT 73650 229.50
PELVIS-AP ONLY 72170 281.00
PERCU PLACE-G-TUBE 74350 575.50
POST T-TUBE CHOLANGIOGRAM 74305 586.00
RAD TEMPOROMANDIBLE JT UNILATERAL 70328 522.00
RADIOGRAPHIC PROCEDURE 76499 644.50
RIBS BILATERAL 3V LT 71110 414.00
RIBS UNILATERAL 2V LT 71100 316.00
RIBS-BILATERAL 3V 71110 456.50
RIBS-UNILATERAL 2V RT 71100 316.00
SACROILIAC JOINTS <3 VIEWS 72200 342.00
SCAPULA COMPLETE LT 73010 279.75
SCAPULA-COMPLETE RT 73010 486.50
SCOLIOSIS-ERECT & SUPINE 72090 452.50
SCOLIOSIS-ERECT ONLY 2 VIEW 72082 313.00
SHOULDER 1V LT 73020 212.00
SHOULDER 1V RT 73020 212.00
SHOULDER AC BILATERAL LT 73050 349.00
SHOULDER MINIMUM 2V LT 73030 311.00
SHOULDER(AC)-BILATERAL 73050 272.75
SHOULDER-MINIMUM 2V RT 73030 311.00
SINUSES-LESS THAN 3V 70210 289.00
SINUSES-MINIMUM 3V 70220 444.00
SKELETAL SERIES COMPLETE 77075 964.50
SKULL-LESS THAN 4V 70250 319.00
SKULL-MINIMUM 4V 70260 593.00
SOFT TISSUE NECK 70360 312.00
SPINE SINGLE VIEW 72020 282.00
STERNOCLAVIC JT 3/>VWS 71130 384.50
STERNUM-MINIMUM 2V 71120 395.50
THORACIC SPINE 3 VIEWS 72072 512.50
THORACIC SPINE-1V 72070 383.50
THORACIC SPINE-AP & LAT 72070 421.00
TIBIA AP & LAT LT 73590 317.00
TIBIA-AP & LAT RT 73590 317.00
TOE MINIMUM 2V LT 73660 225.00
TOE-MINIMUM 2V RT 73660 225.00
UGI/AIR CONTRAST - SB 74249 3796.50
UNLISTED XRAY 76499 0.50
UPPER GI TRACT W/CONTRAST 74247 632.00
URETHROCYSTOGRAPHY RETROGRADE 74450 632.50
US-DOPPLER-EXT VIEWS 93965 656.00
US-DOPPLER-LOW EXTREMITY 93925 1087.50
VENOGRAPHY EXTREMITY UNILATERAL 75820 675.00
WRIST AP & LAT LT 73100 256.00
WRIST MINIMUM 3V LT 73110 331.50
WRIST-AP & LAT RT 73100 256.00
WRIST-MINIMUM 3V RT 73110 331.50
X-RAY NOSE TO RECTUM 76010 283.00
OXYGEN 1 HOUR 13.50
OXYGEN DAILY 324.00
** PATCH/ PASTE REMOVAL * 0.00
*** REMINDER *** 25.00
ABATACEPT FOR IV SOLN [25 2272.05
ABATACEPT SUBCUTANEOUS IN 1772.90
ACETAMIN/ COD LIQ [120-12 4.00
ACETAMIN/ COD TAB [30 MG] 25.00
ACETAMINOPHEN 80 MG TAB 2.00
ACETAMINOPHEN ADULT SUP 6 4.00
ACETAMINOPHEN CHILD SUP [ 4.00
ACETAMINOPHEN DRP [80 MG/ 2.00
ACETAMINOPHEN IV SOLN [10 70.80
ACETAMINOPHEN IV SOLN 10 90.00
ACETAMINOPHEN LIQ [160 MG 4.00
ACETAMINOPHEN SUSP 160 MG 2.00
ACETAMINOPHEN TAB [325 MG 2.00
ACETAMINOPHEN TAB [500 MG 2.00
ACETYLCYSTEINE SOL 20% 100.05
ACIDOPHILUS CAP 1.00
ACYCLOVIR CAP [200 MG] 6.15
ACYCLOVIR INJ [500 MG] 55.05
ACYCLOVIR TAB [400 MG] 25.00
ADALIMUMAB INJ KIT 40 MG/ 4322.85
ADENOSINE INJ [6 MG/2ML] 86.50
ALBUMIN 25gm/100ml 90.00
ALBUMIN, HUMAN INJ 25% 57.25
ALBUTEROL MDI 180.30
ALBUTEROL NEB [2.5 MG/3ML J8499 20.00
ALCOHOL ABSOLUTE INJ [98% 157.25
ALLOPURINOL TAB [100 MG] 5.00
ALLOPURINOL TAB [300 MG] 5.00
ALPRAZOLAM TAB [0.5 MG] 8.00
ALTEPLASE FOR INJ [100 MG 20547.70
AMANTADINE CAP [100 MG] 8.20
AMIKACIN INJ [500 MG/2ML] 59.90
AMINOPHYLLINE INJ [25 MG/ 90.00
AMINOPHYLLINE INJ [500 MG 55.75
Amiodarone 150MG/3ML 124.36
AMIODARONE HCL IN DEXTROS 166.70
AMIODARONE INJ [150 MG/3M 60.20
AMIODARONE TAB [200 MG] 23.85
AMITRIPTYLINE TAB [25 MG] 5.00
AMLODIPINE TAB [5 MG] 6.95
AMOX/CLAV POT TAB [250/12 25.95
AMOXICIL/ POT CLAV SUS [2 217.50
AMOXICIL/ POT CLAV SUS [6 249.10
AMOXICIL/ POT CLAV SUS [6 260.75
AMOXICIL/ POT CLAV TAB [2 17.75
AMOXICIL/ POT CLAV TAB [5 173.65
AMOXICIL/ POT CLAV TAB [8 19.60
AMOXICILLIN CAP [250 MG] 5.00
AMOXICILLIN CAP [500 MG] 5.00
AMOXICILLIN SUS [125 MG/5 25.00
AMOXICILLIN SUS [125 MG/5 4.00
AMOXICILLIN SUS [250 MG/5 4.00
AMOXICILLIN SUS [400 MG/5 4.00
AMOXICILLIN SUS [400 MG/5 4.00
AMPICILLIN INJ [1 GM] 71.65
AMPICILLIN/ SULB INJ [1.5 61.15
AMPICILLIN/ SULB INJ [3 G 64.20
ANTIPY/ BENZO/ PE DRP ** 7.50
ANTIPY/BENZO DRO OTIC SOL 25.00
apridia solostar pen 100u/ml 100.00
ARTIFICIAL TEARS DRP ** 25.00
Asclera Intravenous Solution 1 % 882.50
ASPIRIN CHEW TAB [81 MG] 2.00
ASPIRIN EC TAB [325 MG] 2.00
ASPIRIN EC TAB [81 MG] 2.00
ASPIRIN TAB [325 MG] 2.00
ATENOLOL TAB [50 MG] 5.00
ATORVASTATIN TAB [10 MG] 5.00
ATORVASTATIN TAB [40 MG] 32.65
Atropine 1% OPTH 98.50
ATROPINE INJ [0.4 MG/0.5M 56.80
ATROPINE INJ [1 MG/ML] 61.90
ATROPINE INJ SYR [0.25 MG 58.50
ATROPINE INJ SYR [1 MG/10 59.80
Avodart Oral Capsule 0.5 MG 18.66
AZELASTINE 0.05% DRP ** 60.05
AZELASTINE SPRAY ** 25.00
AZITHROMYCIN INJ [500 MG] 55.05
AZITHROMYCIN SUS [100 MG/5ML] Q0144 104.65
AZITHROMYCIN SUS [200/5M]L 104.65
AZITHROMYCIN TAB [250 MG] 22.20
AZTREONAM INJ [1 GM] 139.20
BACITRA TOP OIN [500U/GM] 25.00
Bacitracin 50,000 units for injection 119.80
BACLOFEN TAB 10 MG 5.00
BAL PERU/ TRYP/ CAS OIL O 25.00
BAL PERU/ TRYP/ CAS OIL S 25.00
BAL PERU/ TRYP/ CAS OIL S 25.00
BAL PERU/TRYP/CAS OIL OIN 166.80
BCG LIVE INTRAVESICAL FOR 512.00
BECLOMETHASONE NAS SPR 33.00
BELLADONNA/PB ELX [60 ML 27.95
BENAZEPRIL TAB [10 MG] 5.00
BENZOC/ TETRA/ BUTAM SPR 7.50
BENZOCAINE/ BENZE OIN ** 13.70
BENZOCAINE/ MENTHOL LOZ 2.00
BENZOIN COMP TINC SWB 25.00
BENZONATATE CAP [100 MG] 5.00
BENZTROPINE TAB [1 MG] 25.00
BETA CAR/ VIT A /C/E/MIN 25.00
BETAMETH DIP 0.05% CRM * 25.00
BETAMETH DIP 0.05% LOT * 25.00
BETAMETH DIP 0.05% OIN * 25.00
BETAMETH VAL 0.1% CRM [15 25.00
BETAMETH VAL 0.1% CRM [45 25.00
BETAMETH VAL 0.1% LOT [60 25.00
BETAMETH VAL 0.1% OIN [15 25.00
BETAMETH VAL 0.1% OIN [45 25.00
BETHANECHOL TAB [10 MG] 25.00
BETHANECHOL TAB [25 MG] 25.00
BISACODYL SUPP [10 MG] 4.00
BISACODYL TAB [5 MG] 2.00
BISMUTH SUBSAL LIQ [262 M 4.00
BISOPROL/ HCTZ TAB [5-6. 25.00
BISOPROL/ HCTZ TAB [10-6. 25.00
BISOPROL/ HCTZ TAB [2.5-6 25.00
BISOPROLOL TAB [5MG] 25.00
Boniva Intravenous Solution 3 MG/3ML 1316.93
BOTOX DS 2OO UNITS/VIAL 3317.52
Botox Injection Solution Reconstituted 1 901.50
BRINZOLAMIDE OPHTH SUSP 1 372.85
BUDESONIDE INHALATION [0. 24.75
BUDESONIDE MDI [90 MCG] 436.50
BUDESONIDE-FORMOTEROL FUM 90.50
BUDESONIDE-FORMOTEROL FUM 119.50
BUMETANIDE INJ [0.25 MG/M 55.40
BUMETANIDE TAB [1 MG] 5.50
BUPIVACAINE 0.5% INJ 58.80
BUPIVACAINE INJ 0.5% W/ E 55.35
BUPIVACAINE PRESERVATIVE 55.25
Bupivacaine-Epinephrine 0.25%-1:200000 41.91
BUPROPION SR TAB [150 MG] 25.00
CA POLYCARBOPHIL TAB [500 2.00
CALAMINE/ ZINC OX OIN ** 25.00
Calcitonin (Salmon) Nasal Solution 200 U 73.72
CALCITONIN INJ [400 UNT/2 2682.95
CALCITONIN SPR [200 U/DOS 83.45
CALCITRIOL CAP [0.25 MCG] 25.00
CALCIUM ACET CAP [667 MG] 25.00
CALCIUM CARB & MINS TAB [ 25.00
CALCIUM CARB & VIT D TAB 2.00
CALCIUM CARB CHEW TAB 500MG 5.00
CALCIUM CARB TAB [750 MG] 2.00
CALCIUM CARB/ VIT D TAB [ 2.00
CALCIUM CARB/ VIT D TAB [ 2.00
CALCIUM CARBONATE-VITAMIN 2.00
CALCIUM CL 10% INJ [10 ML 55.60
CALCIUM GLUC 10% INJ [10 55.65
CALCIUM/MAGNESIUM/ZINC 2.00
CAPTOPRIL TAB [25 MG] 25.00
CAPTOPRIL TAB [50 MG] 25.00
CARBAMAZEPINE ER TAB [100 MG] 5.00
CARBAMAZEPINE TAB [200 MG 5.00
CARBAMIDE PEROXIDE 6.5% O 2.00
CARBIDOPA/ LEVO CR TAB [5 25.00
CARBIDOPA/ LEVO TAB [10-1 25.00
CARBIDOPA/ LEVO TAB [25-1 5.00
Cardene IV Intravenous Solution 463.28
CARVEDILOL CR CAP [20 MG] 26.45
CARVEDILOL CR CAP [40 MG] 26.45
CARVEDILOL TAB [12.5 MG] 25.00
CARVEDILOL TAB [25 MG] 7.80
CARVEDILOL TAB [3.125 MG] 8.45
CARVEDILOL TAB [6.25 MG] 25.00
CATHFLO ACTIVASE 2MG 75.00
CEFADROXIL CAP [500 MG] 14.40
CEFAZOLIN INJ [1GM] 57.65
CeFAZolin Sodium-Dextrose Premix 65.75
CEFDINIR CAP [300 MG] 15.35
CEFDINIR SUS 250/5ML 315.10
CEFDINIR SUSP [125 MG/5ML 4.00
CEFOTAXIME INJ [1 GM] 63.60
CEFOXITIN IIV SOLN PB BAG 67.75
CEFPODOXIME TAB [200 MG] 28.50
CEFPROZIL SUS [125 MG/5ML 4.00
CEFPROZIL SUS [250 MG/5ML 117.30
CEFPROZIL TAB [250 MG] 25.00
CEFTAZIDIME INJ [1 GM] 59.75
CEFTAZIDIME INJ [500 MG] 62.15
CEFTRIAXONE INJ [1 GM] 184.00
CEFTRIAXONE INJ [1 GM] AD 59.70
CEFTRIAXONE INJ [2 GM] 64.50
CEFTRIAXONE INJ [250 MG] 59.30
CEFTRIAXONE INJ [500 MG] 107.55
CEFTRIAXONE INJ [750 MG] 61.40
CEFUROXIME INJ [750 MG] 61.40
Cefuroxime Sodium Injection Solution Rec 109.52
CEFUROXIME SUSP [250 MG/5 7.60
CEFUROXIME TAB [250 MG] 17.60
CEFUROXIME TAB [500 MG] 28.05
CELECOXIB CAP [100 MG] 27.65
CEPHALEXIN CAP [250 MG] 5.00
CEPHALEXIN CAP [500 MG] 5.50
CEPHALEXIN SUS [125/5ML-1 71.25
CEPHALEXIN SUS [250 MG/5M 86.25
CETIRIZINE LIQ [1MG/1ML - 1.00
CETIRIZINE TAB [10 MG] 7.50
CHARCOAL ACTIVATED LIQ [2 4.00
CHARCOAL/ SORBITOL SUS [2 4.00
CHLORDIAZEPOXIDE CAP [25 25.00
CHLORDIAZEPOXIDE CAP [5 M 25.00
CHLORHEX/ ISOPRP ALC LIQ 25.00
CHLORHEXIDINE LIQ 0.12% 4.00
CHLORPROMAZINE INJ [25 MG 92.20
CHLORPROMAZINE TAB [25 M 25.00
CHLORPROMAZINE TAB [100 M 25.00
CHOLESTYRAMINE PKT [4 GM] 20.45
CILOSTAZOL TAB [100 MG] 25.00
CIM 35.05
CIMETIDINE TAB 300 MG 25.00
Cimzia Injectable 200 mg/ml 11162.32
CIPROFLOXACIN TAB [250MG] 15.00
CIPROFLOXACIN TAB [500 MG 18.55
CIPROFLOXACIN/ D5W PREMIX 57.10
CIPROFLOXACIN/ DEX DRP 72.80
CIPROFLOXACIN/ HC DRP 65.65
CITALOPRAM TAB [10 MG] 5.00
CITALOPRAM TAB [20 MG] 10.80
CLARITHROMYCIN SUSP [250 4.30
CLARITHROMYCIN TAB [250 MG] 5.00
CLARITHROMYCIN TAB [500 M 26.05
CLEVIPREX 540.00
CLINDAMYCIN 1% SOL ** 25.00
CLINDAMYCIN CAP [150 MG] 4.60
CLINDAMYCIN INJ [600 MG/4 55.90
Clinimix E 5/15 Parental Nutrition 388.95
CLONAZEPAM TAB [0.5 MG] 25.00
CLONAZEPAM TAB [1 MG] 25.00
CLONIDINE PAT [0.1 MG/24H 99.50
CLONIDINE PAT [0.2 MG/24H 167.50
CLONIDINE TAB [0.1 MG] 5.00
CLONIDINE TAB [0.2 MG] 25.00
CLOPIDOGREL TAB [75 MG] 23.20
CLOTRIMAZ/ BETAMETH CRM [ 25.00
CLOTRIMAZOLE 1% CRM ** 25.00
CLOTRIMAZOLE THROAT LOZENGE 10 MG 5.75
clozapine 100 mg 10.00
COLCHICINE TAB [0.6 MG] 19.65
COLLAGENASE OIN [30 GM] 27.10
Combivent Respimat Inhalation 718.52
creon 12,000 capsule 11.00
Crofab 1 GM 8611.20
CROMOLYN NAS SPR ** 25.00
CYCLOBENZAPRINE TAB [10 M 25.00
CYCLOPENTOLATE 1% EYE DROPS 10.00
CYCLOSPORINE DRP 26.40
CYPROHEPTADINE TAB [4 MG 5.00
D5 0.225NS 1000ML (D51/4NS) 100.00
D51/2NACLW/20MEQ KCL1000ML PREMIX 186.50
DANTROLENE INJ [20 MG] 277.00
DAPTOMYCIN FOR IV SOLN 50 811.20
daykin's 0.5% 20.00
Deflux Injection Prefilled Syringe 50-15 6100.40
DEMECLOCYCLINE TAB [150 M 29.45
DENOSUMAB INJ [60 MG/ML] 2496.85
Depakote(divalproex) 250 25.00
DESLORATADINE TAB [5 MG] 21.50
DEX 5%/ 0.45% SOD CL [100 186.50
DEX 5%/ 0.45% SOD CL [500 186.50
DEX 5%/ 0.9% SOD CL [1000 186.50
DEX 5%/ LACT RING [1000 M 186.50
DEXAMETH PHO SOL 0.1% OP 91.50
DEXAMETHASONE INJ [4 MG/M 56.85
Dexamethasone Intensol Oral Concentrate 10.00
DEXAMETHASONE SOD PHOSPHA J1100 60.05
DEXAMETHASONE SODIUM PHOS 56.60
DEXAMETHASONE TAB [4 MG] 5.00
DEXTROSE 10% [1000ML] 186.50
DEXTROSE 10% [500 ML] 25.00
DEXTROSE 25% INJ SYR [10 55.85
DEXTROSE 40% GEL 4.00
DEXTROSE 5% [100 ML] 25.00
DEXTROSE 5% [100 ML] + 25.00
DEXTROSE 5% [1000 ML] 186.50
DEXTROSE 5% [250 ML] 25.00
DEXTROSE 5% [50 ML] 25.00
DEXTROSE 5% [50 ML] + 90.00
DEXTROSE 5% 500 ML 186.50
DEXTROSE 50% INJ SYR [50 55.10
DIAZEPAM CON LIQ 5 MG/5 4.00
DIAZEPAM INJ SYR [10 MG/2 75.60
DIAZEPAM RECT APP [2.5 M 844.80
DIAZEPAM RECT APP [10 MG] 1002.15
DIAZEPAM TAB [5 MG] 25.00
DICLOFENAC PATCH 29.50
DICLOFENAC TAB [50 MG] 25.00
DICLOFENAC TAB [75 MG] 25.00
DICYCLOMINE CAP [10 MG] 5.00
DICYCLOMINE INJ [20 MG/2M 136.90
DICYCLOMINE TAB [20 MG] 25.00
DIGOXIN INJ [0.25 MG/ML] 58.30
DIGOXIN TAB [0.125 MG] 5.00
DIGOXIN TAB [0.25 MG] 5.00
Dilaudid Injection Solution 1 MG/ML 56.35
DILTIAZEM 125MG/25ML INJ 10.00
DILTIAZEM 30 MG TAB 5.00
DILTIAZEM 50MG/10MG INJ 10.00
DILTIAZEM CD CAP [120 MG] 25.00
DILTIAZEM CD CAP [180 MG] 25.00
DILTIAZEM CD CAP [240 MG] 25.00
DILTIAZEM CD CAP [300 MG] 25.00
DILTIAZEM HCL ADV [100 M 66.55
DILTIAZEM INJ [25 MG/5 ML 55.55
DILTIAZEM TAB [90 MG] 25.00
DIMENHYDRINATE INJ [50 MG 64.30
DIMENHYDRINATE TAB [50 MG 1.00
DIMETHYL SULFOXIDE SOLN 5 1705.70
DIPHEN/ LID/ MYL SUS [120 25.00
DIPHEN/ LID/ MYL/ NYST SU 25.00
DIPHENHYDRAMINE CAP [25 M 2.00
DIPHENHYDRAMINE CRM 4.00
DIPHENHYDRAMINE HCL GEL 2 1.00
DIPHENHYDRAMINE INJ [50 M 56.00
DIPHENHYDRAMINE LIQ [12.5 2.00
DIVALPROEX CAP [125 MG] 25.00
DM/ PE/ CPM LIQ [15-5-2 M 4.00
DOBUTAMINE INJ [12.5 MG/M 55.30
DOBUTAMINE INJ [2 MG/ML I 194.15
DOCUSATE CAP [100 MG] 5.00
DOCUSATE CAP [240 MG] 2.00
DOCUSATE SYR [50 MG/5ML - 7.40
DONEPEZIL TAB [5 MG] 27.80
DONEPEZIL TAB [10 MG] 45.80
DONNATAL/ XYL/ MALX SUS 18.65
DOPAMINE/ D5W PREMIX [400 194.15
DORZOLAMIDE 2% DRP ** 26.70
DORZOLMD/ TIMLOL DRP ** 42.95
DOXAZOSIN TAB [2 MG] 25.00
DOXAZOSIN TAB [4 MG] 5.00
DOXAZOSIN TAB [8 MG] 25.00
Doxepin HCl Oral Capsule 10 MG 10.00
Doxy 100 IV Reconstitued Inj 70.04
DOXYCYCLINE CAP [100 MG] 25.55
DROPERIDOL INJ [2.5 MG/ML 56.25
DULOXETINE CAP [20 MG] 5.00
DULOXETINE CAP [30 MG] 28.75
DULOXETINE CAP [60 MG] 25.20
DUTASTERIDE CAP [0.5 MG] 25.50
DYPHYL/ GUAIF LIQ [100-10 4.00
DYPHYL/ GUAIF TAB [200-30 3.35
EFFEXOR XR 75 MG CAP 32.30
Eliquis (apixaban) 25.00
eliquis 2.5mg 15.00
Eliquis Oral Tablet 5 mg 25.19
EMOLLIENT LOT ** 25.00
EMOLLIENT OIN ** 25.00
EMOLLIENT OIN ** 25.00
EMOLLIENT/ SKIN CLEANSER 16.65
ENALAPRIL MALEATE TAB [5 25.00
ENALAPRIL TAB [10 MG] 57.05
ENALAPRILAT INJ [1.25 MG/ 57.05
ENOXAPARIN INJ SYR [100 M 298.05
ENOXAPARIN INJ SYR [30 MG 297.70
ENOXAPARIN INJ SYR [40 MG 297.70
ENOXAPARIN INJ SYR [60 MG 298.05
ENOXAPARIN INJ SYR [80 MG 298.05
EPHEDRINE INJ [50 MG/ML] 76.25
EPINEPHRINE INJ [1 MG/ML 64.00
EPINEPHRINE INJ [1MG/ML] 57.55
EPINEPHRINE INJ SYR [1 MG 55.60
EPOETIN ALFA INJ [10000 U 669.30
EPOETIN ALFA INJ [20000 U 2500.88
EPOETIN ALFA INJ [3000 UN 240.95
EPOETIN ALFA INJ [4000 UN 267.75
ERYTHRO/ SULF SUS [200-60 4.00
ERYTHROMYCIN EYE OIN ** 17.20
ERYTHROMYCIN INJ [500 MG] 187.15
ERYTHROMYCIN TAB [250 MG] 25.00
ERYTHROMYCIN TAB [500 MG] 25.00
ESCITALOPRAM TAB [10 MG] 26.95
ESCITALOPRAM TAB [20 MG] 27.25
ETANERCEPT INJ [50 MG/ML] 2230.25
ETHYL CHLORIDE SPR 25.00
Etomidate Solution 40 mg / 20 ml 67.12
EXENATIDE INJ PEN [10 MCG 301.00
EXENATIDE INJ PEN [5 MCG] 1067.75
EZETIMIBE TAB [10 MG] 25.85
FAMOTIDINE IN NACL 0.9% I 55.09
FAMOTIDINE TAB [20 MG] 25.00
Fasenra Subcutaneous Solution Prefilled 6177.74
FAT EMULSION 20% INJ [100 75.00
FELODIPINE TAB [5 MG] 6.05
FENOFIBRATE TAB (48MG) 25.00
FENOFIBRATE TAB [145 MG] 27.70
FENTANYL CITRATE INJ [0.0 56.85
FENTANYL INJ [250 MCG/5 M 56.95
FENTANYL PAT [100 MCG/HR] 170.25
FENTANYL PAT [25 MCG/HR] 53.50
FENTANYL PAT [50 MCG/HR] 89.25
FENTANYL PAT [75 MCG/HR] 130.75
FENTANYL PATCH 12 MCG/HR 12.00
FENTANYL TD PATCH 72HR [1 86.20
FERRIC GLUC INJ [62.5 MG/ 152.65
FERROUS FUM TAB [324 MG] 25.00
FERROUS FUMARATE TAB [324 25.00
FERROUS SULF LIQ [220 MG/ 4.00
FERROUS SULF TAB [325 MG] 25.00
FEXOFEN/ PSEUDO TAB [60-1 7.50
FEXOFENADINE TAB [60 MG] 4.20
FEXOFENADINE TAB [180 MG] 25.00
FINGER STICK BLOOD SUGAR 0.00
FIRST AID TREATMENT ** 18.90
FISH OIL CAP [1000 MG] 5.00
FLAVOXATE TAB [100 MG] 7.15
FLEET PHOS SOL 2.00
Florajen 3 Probiotic 5.00
FLUCONAZOLE TAB [150 MG] 48.80
FLUCONAZOLE/ SOD CL PREMI 55.15
Fludrocortisone Acetate Tablet 0.1 mg 31.80
FLUMAZENIL INJ [0.5 MG/5 62.80
FLUNISOLIDE NAS SPR ** 33.00
Fluorescein OPTH strips 1.00
FLUOXETINE CAP [20 MG] 25.00
FLUOXETINE SOL [20 MG/5ML 4.00
FLUSH HEP-LOCK [100 UNT/M 56.10
FLUSH SOD CL 0.9% 1.00
FLUTICAS/ SALMET MDI [100 409.87
FLUTICAS/ SALMET MDI [250 409.87
FLUTICAS/ SALMET MDI [500 630.20
FLUTICASONE MDI [44 MCG] 52.25
FLUTICASONE MDI [220 MCG] 96.00
FLUTICASONE NAS SPR ** 33.00
FOLIC ACID INJ [1 MG/0.2 59.20
FOLIC ACID TAB [1 MG] 25.00
FOLIC ACID TAB [800 MCG] 1.00
FUROSEMIDE INJ [100 MG/10 58.90
FUROSEMIDE INJ [20 MG/2ML 56.65
FUROSEMIDE INJ [40 MG/4ML 59.25
FUROSEMIDE TAB [20 MG] 25.00
FUROSEMIDE TAB [40 MG] 25.00
FUROSEMIDE TAB [80 MG] 25.00
GABAPENTIN CAP [100 MG] 25.00
GABAPENTIN CAP [300 MG] 25.00
GABAPENTIN CAP [400 MG] 25.00
GamaSTAN S/D Intramuscular Injectable 867.10
Gamunex-C 12102.58
GARLIC CAP [300 MG] 2.00
GEMFIBROZIL TAB [600 MG] 25.00
GENTAMICIN PREMIX [1.6 M 25.00
GENTAMICIN 0.1% CRM 25.00
GENTAMICIN 0.1% OIN ** 25.00
GENTAMICIN 0.3% EYE DRP 25.00
GENTAMICIN 0.3% EYE OIN 14.25
GENTAMICIN INJ [40MG/ML] 56.95
Geodon Intramuscular Solution Reconstitu 148.80
GLIMEPIRIDE TAB [2 MG] 25.00
GLIPIZIDE ER TAB [2.5 MG 25.00
GLIPIZIDE ER TAB [10 MG] 25.00
GLIPIZIDE TAB [10 MG] 3.00
GLIPIZIDE TAB [5 MG] 5.00
GLUCAGON EMERG KIT [1 MG] 588.15
GLUCAGON HCL (RDNA) FOR I 514.80
GLUCOS/ CHONDR COMPLX CAP 25.00
GLUCOSAMINE CAP [500 MG] 3.00
GLYBUR/ METFOR TAB [2.5-5 25.00
GLYBURIDE TAB [5 MG] 25.00
GLYBURIDE TAB 2.5 MG 25.00
GLYCERIN SUP ADULT 1.60
GLYCERIN SUP CHILD 1.55
GLYCOPYRROLATE INJ [0.2 M 56.95
GLYCOPYRROLATE TAB [1 MG] 25.00
GOLIMUMAB IV SOLN [50 MG/ 995.60
GUAIFEN/ CARBETA LIQ [60M 30.70
GUAIFEN/ COD SYR [100-10 25.00
GUAIFEN/ DM LIQ [100-10 M 4.00
GUAIFEN/ DM TAB [600-30 M 2.00
GUAIFENESIN LIQUID UD (20 2.00
GUAIFENESIN SYR [100 MG/5 4.00
GUAIFENESIN TAB [400 MG] 3.00
GUAIFENESIN TAB [600 MG] 2.00
HALOPERIDOL INJ [5 MG/ML] 62.20
HALOPERIDOL TAB [1 MG] 25.00
HALOPERIDOL TAB [5 MG] 25.00
HEPARIN INJ [10,000 UNT/M 59.80
HEPARIN INJ [1000 UNT/ML] 59.85
HEPARIN INJ [5,000 UNT/ML 56.10
HEPARIN LOCK FLUSH INJ [5 55.15
HEPARIN SODIUM [50 UNIT/M 55.05
HEPATITIS A VACCINE 10.00
Hepatitis B immune globulin 618.51
HYDRALAZINE HCL INJ [20 M 60.30
HYDRALAZINE HCL TAB [25 M 25.00
HYDRALAZINE TAB [10 MG] 25.00
HYDROCHLOROTHIAZIDE CAP 12.5 mg 5.00
HYDROCHLOROTHIAZIDE TAB [ 5.00
HYDROCOD/ ACET LIQ [7.5-5 25.00
HYDROCOD/ ACET TAB [10-50 25.00
HYDROCOD/ ACET TAB [5-500 25.00
HYDROCOD/ ACET TAB [7.5-5 25.00
HYDROCOD/ ACET TAB [7.5-6 25.00
HYDROCODONE-ACETAMINOPHEN 25.00
HYDROCODONE-IBUPROFEN TAB 25.00
HYDROCORTISONE 0.1% CRM 201.70
HYDROCORTISONE 0.5% CRM 25.00
HYDROCORTISONE 1% CRM ** 12.40
HYDROCORTISONE 2.5% CRM 4.00
HYDROCORTISONE INJ [100 M 59.85
HYDROCORTISONE SUPP [25 M 67.95
HYDROCORTISONE TAB [10 MG 25.00
HYDROGEN PEROXIDE 3% SOL 4.00
HYDROmorphone HCl Oral Tablet 2 MG 5.00
HYDROMORPHONE INJ [2 MG/M 56.35
HYDROMORPHONE INJ [4 MG/M 25.00
HYDROQUINONE 4% CRM 25.00
HYDROXYCHLOROQUINE TAB [2 25.00
HYDROXYUREA CAP [500 MG] 25.00
HYDROXYZINE HCL TAB [10 M 25.00
HYDROXYZINE HCL TAB [25 M 25.00
HYDROXYZINE INJ [50 MG/ML 59.15
HYDROXYZINE LIQ [10 MG/5M 4.00
HYDROXYZINE PAM CAP [25 M 25.00
HYDROXYZINE PAM CAP [50 M 25.00
HYLAN INTRA-ARTICULAR INJ 871.21
IBANDRONATE TAB [150 MG] 367.35
IBUPROFEN LIQ [200 MG/10M 2.00
IBUPROFEN TAB [200 MG] 2.00
IBUPROFEN TAB [400 MG] 25.00
IBUPROFEN TAB [600 MG] 25.00
IBUPROFEN TAB [800 MG] 25.00
IMIPENEM-CILASTATIN IV SO 88.15
IMIPENEM-CILASTATIN IV SO 162.90
Imipramine HCl Oral Tablet 25 MG 10.50
IMMUNE GLOBULIN (HUMAN) I 50.25
Inderal LA Oral Capsule Ext Rel 80 mg 25.00
INDOMETHACIN 50 MG CAP 10.00
INDOMETHACIN CAP [25 MG] 25.00
Injectafer Intravenous Solution 750 MG/1 1876.83
INS- ASP/ASP PROT 70/30 I 81.00
INS- ASPART INS 78.25
INS- GLARGINE INJ 95.50
INS- LISPRO INJ 78.00
INS- NPH HUMAN INJ 42.25
INS- NPH/REG HUM 70/30 IN 42.25
INS- NPL/INS LISP 50/50 I 80.75
INS- NPL/INS LISP 75/25 I 80.75
INS- REG HUMAN INJ 42.25
INS- REG HUMAN INJ 25.00
INTERFERON BETA 1A INJ [3 3397.95
INVANZ ADV VIL 1 GM 233.95
Invega Sustenna Intramuscular Suspension 3754.80
Invega Sustenna Intramuscular Suspension 5681.03
IPRATROPIUM MDI ** 77.50
IRBESARTAN TAB [300 MG] 25.00
IRON POLYSAC CAP [150 MG] 25.00
IRR- SOD CL 0.9% [1000 ML 27.00
IRR- SOD CL 0.9% [500 ML] 25.00
IRR- STERILE WATER [1000 25.70
IRR- STERILE WATER [500 M 25.00
ISONIAZID TAB [300 MG] 25.00
ISOPROTERENOL INJ [0.2 MG 66.65
ISOSORBIDE MONO ER TAB [3 A9270 5.35
ISOSORBIDE MONO ER TAB [6 5.45
ISOSORBIDE MONO TAB [20 M 25.00
ISOSORBIDE TAB [10 MG] 25.00
ISOSORBIDE TAB [20 MG] 25.00
ISOSORBIDE TAB [40 MG] 25.00
ISOSORBIDE/ HYDRAL TAB [2 25.00
ISRADIPINE TAB [5 MG] 25.00
IVPB CEFOXITIN 1GM 13.40
IVPB Esmolol Premix 586.20
Kcentra Intravenous Kit 500 UNIT 2150.55
Keppra 100MG/ML 10.00
KEPPRA 500 MG 6.92
KETAMINE HCL INJ [50 MG/M 55.75
KETAMINE INJ [100 MG/ML] 25.00
KETOCONAZOLE 2% CRM ** 25.00
KETOCONAZOLE 2% SHM ** 25.00
KETOCONAZOLE TAB [200 MG] 25.00
KETOROLAC DRP 0.5% ** 104.55
KETOROLAC INJ [30 MG/ML] 56.90
KETOROLAC INJ [60 MG/2ML] 58.75
KETOROLAC TAB [10 MG] 25.00
KETOTIFEN DROPS ** 7.05
L ACID/ L PAR/ STRP/ BIF 25.00
L-METHYLFOL/ MCOBAL/ ACYS 25.00
LABETALOL INJ [100 MG/20M 55.15
LABETALOL TAB [200 MG] 25.00
LABETALOL TAB [300 MG] 25.00
Labetalolo Carpuject 178.59
LACTASE TAB 2.00
LACTATED RINGERS [1000 ML 122.00
LACTULOSE LIQ [10 GM/15ML 32.40
LAMIVU/ ZIDOVU TAB [150-3 57.95
LAMOTRIGINE TAB [100 MG] 29.45
LANSOPRAZOLE CAP [30 MG] 25.70
LANSOPRAZOLE PKT [30 MG] 17.40
LANSOPRAZOLE SOLUTAB [15 17.20
LANSOPRAZOLE SOLUTAB [30 38.70
LATANOPROST DRP ** 157.20
LEUPROLIDE ACETATE (3 MON 3329.10
LEUPROLIDE ACETATE (6 MON 6658.20
LEVETIRACETAM INJ 328.30
LEVETIRACETAM INJ 500 MG/ 66.25
LEVETIRACETAM PREMIX 500mg/100ml 150.00
LEVETIRACETAM TAB [250 MG 26.20
LEVOBUNOLOL 0.5% DRP ** 37.10
LEVOFLOXACIN INJ [500 MG] 175.30
LEVOFLOXACIN INJ [750 MG] 174.50
LEVOFLOXACIN TAB [250 MG] 57.75
LEVOFLOXACIN TAB [500 MG] 30.00
LEVOFLOXACIN TAB [750 MG] 108.40
LEVOFLOXACIN/ D5W PREMIX 175.30
LEVOFLOXACIN/ D5W PREMIX 174.50
LEVOTHYROXINE INJ [200 MC 72.00
LEVOTHYROXINE SODIUM TAB 3.00
LEVOTHYROXINE TAB [100 MC 25.00
LEVOTHYROXINE TAB [112 MC 25.00
LEVOTHYROXINE TAB [125 MC 25.00
LEVOTHYROXINE TAB [150 MC 25.00
LEVOTHYROXINE TAB [175 MC 25.00
LEVOTHYROXINE TAB [200 MC 25.00
LEVOTHYROXINE TAB [25 MCG 25.00
LEVOTHYROXINE TAB [50 MCG 25.00
LEVOTHYROXINE TAB [75 MCG 25.00
LEVOTHYROXINE TAB [88 MCG 25.00
LIDOCAINE LOCAL PRESERVA 55.85
LIDOCAINE 1% INJ 57.00
LIDOCAINE 1GM/ D5W PREMIX 25.00
LIDOCAINE 2% INJ 55.10
LIDOCAINE 2% JEL [20 MG/M 25.00
LIDOCAINE 2% TOPICAL JELLY 10.00
LIDOCAINE 2% VISCOUS [100 4.00
Lidocaine 4% Patch 5.00
LIDOCAINE 4% TOPICAL SOLUTION 10.00
LIDOCAINE 5% PATCH 31.25
LIDOCAINE HCL LOCAL (PF) 2% 5ML 55.70
LIDOCAINE INJ 2% W/ EPINE 55.80
LIDOCAINE INJ SYR [100 MG 55.70
Lidocaine Viscouse Unit Dose 4.00
LIDOCAINE-PRILOCAINE CREA 25.00
LIDOCAINE/ EPI 1% INJ 55.15
LIDOCAINE/ EPI 2% INJ 55.80
LINACLOTIDE 145 MCG CAP 13.50
LINCOMYCIN INJ [600 MG/2M 66.75
Linezolid 600 MG Tablet 6.74
LISINOPRIL TAB [5 MG] 25.00
LISINOPRIL TAB [10 MG] 25.00
LISINOPRIL TAB [20 MG] 25.00
LISINOPRIL TAB [40 MG] 25.00
LISINOPRIL/ HCTZ TAB [20- 25.00
LISINOPRIL/ HCTZ TAB [20- 25.00
LOPERAMIDE CAP [2 MG] 25.00
LOPERAMIDE LIQ [120 ML] * 4.00
LORATADINE TAB [10 MG] 2.15
LORAZEPAM INJ [2 MG/ML] 55.90
LORAZEPAM TAB [0.5 MG] 25.00
LORAZEPAM TAB [1 MG] 18.99
LOSARTAN TAB [50 MG] 9.20
LOSARTAN/ HCTZ TAB [100-2 25.20
LOSARTAN/ HCTZ TAB [50-12 25.00
LOVASTATIN TAB [20 MG] 25.00
LOVASTATIN/ NIACIN TAB [2 12.90
LUBIPROSTONE TAB [24 MCG] 26.00
Lupron Depot (1-Month) Intramuscular Kit 1833.99
LUTEIN CAP [20 MG] 3.00
Lyrica Oral Capsule 100 MG 25.00
Lyrica Oral Capsule 150 MG 25.00
Lyrica Oral Capsule 25 MG 25.00
Lyrica Oral Capsule 75 MG 25.00
MAG 64 64MG TAB 2.00
MAG HYD/ AL HYD/ SIM SUS 4.00
MAG HYD/ AL HYD/ SIM SUS A9270 4.00
MAGNES HYDROX/ CASCARA [3 1.50
MAGNESIUM CITRATE SOL 4.75
MAGNESIUM HYDROX SUS [400 2.00
MAGNESIUM HYDROX TAB [325 1.00
MAGNESIUM OXIDE TAB [400 3.00
MAGNESIUM SULF INJ [1 GM/ 55.75
MAGNESIUM SULFATE INJ 50% 61.95
MAGNESIUM SULFATE INJ PRE 25.00
MAGNESIUM SULFATE IVPB [1GM/100ML] 50.00
MAGNESIUM TAB [84 MG] 25.00
MANNITOL 20% PREMIX INJ [ 25.00
MANNITOL 25% INJ [50 ML] 55.05
MAPROTILINE TAB [50 MG] 25.00
Marcaine/Epinephrine 0.25-1:200,000% 56.25
Marcaine/Epinephrine 0.5% 55.10
MECLIZINE TAB [25 MG] 25.00
MEDROXYPROGESTERONE INJ [ 241.20
MEDROXYPROGESTERONE TAB [ 25.00
MEDROXYPROGESTONE TAB [10 25.00
MEGESTROL ES SUS [625 MG/ 20.00
MEGESTROL SUS [40 MG/ML - 4.00
MEGESTROL TAB [40 MG] 25.00
MELOXICAM TAB [7.5 MG] 25.00
MEMANTINE TAB [10 MG] 25.80
MENTHOL/ CAMPHOR LOT ** 2.00
MEPERIDINE INJ [100 MG/ML 25.30
MEPERIDINE INJ [25 MG/ML] 25.45
MEPERIDINE INJ [50 MG/ML] 25.65
MEPERIDINE INJ [75 MG/ML] 25.30
MEPERIDINE TAB [50 MG] 25.00
MEPIVACAINE 2% MPF INJ [2 55.45
MERCAPTOPURINE TAB [50 MG 25.00
MESALAMINE TAB [400 MG] 25.00
METAXALONE TAB [800 MG] 26.15
METFORMIN TAB [1000 MG] 25.00
METFORMIN TAB [500 MG] 5.00
Methadone HCL Oral Conc 10 mg/ml 10.00
Methadone HCl Oral Tablet 5 MG 12.75
METHIMAZOLE TAB [10 MG] 25.00
METHOCARBAMOL INJ [100 MG 59.20
METHOCARBAMOL TAB [500 MG 25.00
METHOCARBAMOL TAB [750 MG 25.00
METHOTREXATE TAB [2.5 MG] 26.25
METHYLDOPA TAB [250 MG] 3.00
METHYLDOPA/ HCTZ TAB [250 25.00
METHYLENE BLUE 1% INJ 62.50
METHYLPREDNISOLONE INJ [1 68.50
METHYLPREDNISOLONE INJ [4 63.45
METHYLPREDNISOLONE INJ [4 59.20
METHYLPREDNISOLONE INJ [8 69.00
METHYLPREDNISOLONE SOD SU 118.60
METHYLPREDNISOLONE TAB [4 25.00
METOCLOPRAMIDE INJ [5 MG/ 55.70
METOCLOPRAMIDE LIQ [5 MG/ 4.00
METOCLOPRAMIDE TAB [10 MG 25.00
METOLAZONE TAB [2.5 MG] 25.00
METOLAZONE TAB [5 MG] 25.00
METOPROLOL INJ [5 MG/5ML] 57.40
METOPROLOL SUCC ER TAB [ 25.00
METOPROLOL SUCC ER TAB [ 25.00
METOPROLOL SUCC ER TAB [5 25.00
METOPROLOL TAR TAB [100 M 25.00
METOPROLOL TAR TAB [25 MG 25.00
METOPROLOL TAR TAB [50 MG 25.00
METRONIDAZOLE 0.75% CRM 41.85
METRONIDAZOLE 0.75% GEL 25.00
METRONIDAZOLE TAB [250 MG 25.00
METRONIDAZOLE TAB [500 MG 25.00
METRONIDAZOLE/ SOD CL PRE 57.20
MEXILETINE CAP [150 MG] 25.00
MICONAZOLE 2% CRM ** 12.80
MICONAZOLE 2% OIN ** 213.35
MIDAZOLAM INJ [1 MG/1 ML- 55.30
MIDAZOLAM INJ 1MG/ ML 57.05
Midodrine HCl Oral Tablet 5 MG 5.80
MIDODRINE TAB [5 MG] 25.00
MINERAL OIL [30ML] ** 1.00
MINERAL OIL ENEMA 1.00
MINERAL OIL LIGHT TOPICAL 25ML 10.00
MINERAL OIL SUSP [120 ML 12.00
MINOCYCLINE CAP [50 MG] 5.10
MINOXIDIL TAB [10 MG] 25.00
MINOXIDIL TAB [2.5 MG] 25.00
MIRTAZAPINE TAB [30 MG] 25.00
MISOPROSTOL TAB [100 MCG] 25.00
MOEXIPRIL TAB [15 MG] 25.00
MOEXIPRIL TAB [7.5 MG] 25.00
MOEXIPRIL/ HCTZ TAB [15-1 5.35
MOEXIPRIL/ HCTZ TAB [15-2 25.00
MOMETASONE 0.1% CRM ** 25.00
MOMETASONE 0.1% OIN ** 25.00
MOMETASONE NAS SPR ** 44.50
MONTELUKAST TAB [10 MG] 25.55
MORPHINE INJ [10 MG/ML] 57.20
MORPHINE INJ [15 MG/ML MD 25.00
MORPHINE INJ [2 MG/ML] 25.00
MORPHINE INJ [4 MG/ML] 25.00
MORPHINE SOLN [2 MG/5ML] 10.30
MORPHINE SOLN [20 MG/1ML] 25.00
MORPHINE SULFATE TAB ER [ 25.00
MOXIFLOXACIN 0.5% DRP ** 126.50
MOXIFLOXACIN TAB [400 MG] 90.75
MOXIFLOXACIN/ NACL PREMIX 55.25
MTH/M BL/HYO/P SAL/NAH2PO 25.00
MULTIVIT/ FE TAB 2.00
MULTIVIT/ FE/ MIN LIQ [60 1.00
MULTIVITAMIN INJ 56.10
MULTIVITAMIN LIQ [60ML] 11.40
MULTIVITAMIN TAB 1.00
MUPIROCIN CRM 2% ** 26.15
MUPIROCIN OIN 2% 25.00
Myrbetriq Oral Tablet Extended Release 2 20.97
NABUMETONE TAB [500 MG] 25.00
NADOLOL TAB [20 MG] 25.00
NAFCILLIN SODIUM INJ [2 G 108.00
NALBUPHINE INJ [10 MG/ML] 59.00
NALOXONE HCL INJ [1 MG/ML 158.40
NALOXONE INJ [0.4 MG/ML] 59.15
NAPHAZOLINE/ PHEN DRP ** 2.00
NAPROXEN TAB [220 MG] 2.00
NAPROXEN TAB [375 MG] 25.00
NAPROXEN TAB [500 MG] 25.00
NAPROXEN TAB [550 MG] 25.00
NARATRIPTAN TAB [2.5 MG] 120.10
NATALIZUMAB INJ 20 MG/ML 8928.00
NATEGLINIDE TAB 120 MG 25.00
NEBIVOLOL TAB 5 MG 25.00
NEO/ BAC/ POLY OIN 7.50
NEO/ BAC/ POLY OIN [EYE] 56.95
NEO/ BAC/ POLY OIN [PKT] 2.00
NEO/ BAC/ POLY/ HC OIN [E 65.10
NEO/ POLY/ GRAM DRP [EYE] 25.00
NEO/ POLY/ HC DRP [EYE] 66.05
NEO/ POLY/ HC DRP SOL [EA 7.75
NEO/ POLY/ HC DRP SUS [EA 25.00
NEO/BAC/POLY/DEX OIN (EYE 31.50
NEO/POLY/HC CREAM 29.50
NEOMYCIN TAB [500 MG] 5.50
Neostigmine 10MG/10ML 293.25
NEOSTIGMINE INJ [1.00 MG/ 68.20
NF BusPIRone HCl Oral Tablet 15 MG 5.50
NF Casodex Tablet 50 mg 25.00
NIACIN TAB [100 MG] 2.00
NIACIN TAB [500 MG] 3.00
NICOTINE PAT [14 MG/24HR] 10.25
NICOTINE PAT [21 MG/24HR] 10.25
NIFEDIPINE CAP [10 MG] 25.00
NIFEDIPINE ER TAB [30 MG] 25.00
NIFEDIPINE ER TAB [60 MG] 25.00
NISOLDIPINE TAB [10 MG] 9.10
NISOLDIPINE TAB [17 MG] 55.60
NISOLDIPINE TAB [20 MG] 29.80
NITROFURANTOIN CAP [100 M 25.00
NITROFURANTOIN CAP [50 MG 25.00
NITROGLYCERIN 2% OIN [PKT 25.00
NITROGLYCERIN PAT [10 MG] 7.50
NITROGLYCERIN PAT [2.5 MG 7.50
NITROGLYCERIN PAT [5 MG] 6.75
NITROGLYCERIN TAB [0.4 MG 25.00
NITROGLYCERIN/ D5W PREMIX 94.35
NITROPRUSSIDE INJ [25 MG/ 114.60
NON FORMULARY DRUG 0.00
NOREPINEPHRINE INJ [1 MG/ 59.55
NORETH/ ETH EST TAB [1 - 25.00
NORTRIPTYLINE CAP [25 MG] 25.00
Nubain 10MG/ML 35.00
NYSTATIN CRM [100,000 UNT 25.00
NYSTATIN OIN [100,000 UNT 25.00
NYSTATIN PWD [100,000 UNT 25.00
NYSTATIN SUS [100,000 UNT 4.00
NYSTATIN/ TRIAM CRM [30 G 25.35
Ocrevus Intravenous Solution 300 MG/10ML 44850.00
OFLOXACIN 0.3% DRP [EAR] 7.50
OFLOXACIN 0.3% DRP [EYE] 28.45
OLANZAPINE TAB [5 MG] 51.40
OLMESARTAN TAB [20 MG] 25.00
OLOPATADINE 0.1% DRP [EYE 104.80
OLOPATADINE 0.2% DRP [EYE 175.20
OMALIZUMAB FOR INJ [150 M 2359.90
OMEGA-3-ACID CAP [1 GM] 5.85
OMEPRAZOLE CAP [20 MG] 25.00
ONDANSETRON INJ [2 MG/ML] 56.15
ONDANSETRON OD TAB [4 MG] 69.35
ONDANSETRON TAB [4 MG] 71.85
OPHTHALMIC IRRIGATION SO 2.00
Ora Blend Flavor Supspension 5.00
ORPHENADRINE CITRATE INJ 90.00
ORPHENADRINE TAB [100 MG] 25.00
OSELTAMIVIR CAP [30 MG] 42.65
OSELTAMIVIR PHOSPHATE CAP 46.50
OSELTAMIVIR SUSP [15 MG/M 46.50
OXYBUTYNIN CHL ER TAB 5 M 25.00
Oxybutynin Tab ER 5 MG 12.77
oxycodone 5mg 5.00
OXYCODONE CR 40MG TAB 25.00
OXYCODONE TAB [5MG] 25.00
OXYCODONE TAB CR [10 MG] 25.00
OXYCODONE/ ACET TAB [5-32 10.50
OXYMETAZOLINE 0.05% SPR 25.20
oxymorphone 40mg 15.00
OXYTOCIN INJ [10 UNT/ML] 57.05
PACKED RED BLOOD CELLS 0.00
Pamidronate inj 92.68
PANCRELIPASE CAP 6.40
PANTOPRAZOLE INJ [40 MG] 61.00
PANTOPRAZOLE TAB [40 MG] 28.45
PAPAIN/UREA OIN ** 351.40
PAREGORIC LIQ [2 MG/5ML] 25.00
PARICALCITOL CAP [1 MCG] 47.40
PAROXETINE TAB [12.5 MG] 25.00
PAROXETINE TAB [20 MG] 25.00
PEGS ELECTROLYTE SOL 140.25
PEN G BENZ/ PEN G PROC IN 166.75
PENICILLIN G BENZ (600 MU 181.20
PENICILLIN G BENZ INJ [1. 156.90
PENICILLIN G POT INJ [5 M 67.00
PENICILLIN G PROC INJ [60 111.10
PENICILLIN V K TAB [250 M 25.00
PENICILLIN V K TAB [500 M 25.00
PENTOXIFYLLINE TAB [400 M 25.00
PERINDOPRIL TAB [2 MG] 9.20
PERINDOPRIL TAB [4 MG] 25.00
PERINDOPRIL TAB [8 MG] 25.00
PERMETHRIN 5% CRM ** 189.00
Permethrin External Cream 5 % 59.16
PERPHENAZINE TAB [4 MG] 25.00
PETROLATUM WHITE OINT PKT 1.00
PHARMACOKINETIC CONSULT 0.25
PHENAZOPYRIDINE TAB [100 25.00
PHENOBARBITAL INJ [130 MG 103.70
PHENOBARBITAL LIQ [60 MG/ 25.00
PHENOBARBITAL TAB [32.4 M 25.00
PHENOL LOZ 2.00
PHENOL SPR BTL ** 28.00
PHENTOLAMINE INJ [5 MG] 450.00
PHENYEPHRINE 0.5% NASAL SPRAY 10.00
PHENYLEPHRINE 1% SPR [NAS 25.00
PHENYLEPHRINE 10% [EYE] 25.00
PHENYLEPHRINE 10MG/1ML 57.60
PHENYLTOLOX/ ACET TAB [60 3.00
PHENYTOIN CAP [100 MG] 25.00
PHENYTOIN CHEW TAB [50 MG 25.00
PHENYTOIN SOD INJ [50 MG/ 57.00
PHENYTOIN SUS [100 MG/4ML 4.00
PHNYL/ BPM SUS [10-6 MG/5 119.05
PHNYL/ CPHR/ MTHSCP TAB 3.00
PHNYL/ CPM/ METHSCP TAB 3.00
PHNYL/ MO/ SHLVO/ PET OIN 25.00
PHOSPHR AC/ DEX/ FRUC SOL 2.00
PHYSOSTIGMINE INJ [1 MG/M 57.45
PHYTONADIONE INJ [10 MG/M 140.25
PHYTONADIONE TAB [VIT K] 69.25
PILOCARPINE 1% [EYE] ** 26.20
PILOCARPINE 2% [EYE] ** 26.35
PILOCARPINE 4% [EYE] ** 25.00
PIOGLITAZONE TAB [15 MG] 25.00
PIOGLITAZONE TAB [30 MG] 55.35
PIOGLITAZONE TAB [45 MG] 60.05
PIPERACILLIN/ TAZO INJ [2 63.20
PIPERACILLIN/ TAZO INJ [3 67.25
PIROXICAM CAP [20 MG] 25.00
PODOPHYLLUM RESIN 25% ** 28.20
POLYETHYLENE GLYC [119GM] 2.30
Polymyxin B Sulfate/Trim Opth Solution 13.75
POLYMYXIN/ TMP DRP [EYE] 25.00
POT CL/ D51/2NACL PREMIX 186.50
POT CL/ NACL 0.9% PREMIX 186.50
POT CL/ NACL 0.9% PREMIX 186.50
POTASSIUM BICARB TAB [25 25.00
POTASSIUM CHL ER CAP [10 25.30
POTASSIUM CHLORIDE INJ [2 55.03
Potassium Citrate ER 10 mEq 12.00
POTASSIUM CL LIQ [20 MEQ/ 59.12
POTASSIUM CL TAB [10 MEQ] 25.00
POTASSIUM CL TAB [20 MEQ] 25.00
POTASSIUM CL TAB [8 MEQ] 25.00
POTASSIUM PHOS TAB [500 M 25.00
POVIDONE-IODINE 10% OIN 25.00
PRALIDOXIME INJ [1 GM] 260.10
PRAMIPEXOLE TAB [0.125 MG 25.75
PRAMLINTIDE INJ [0.6MG/ML 184.90
PRAMOXINE HCL/ HC 1% CRM 25.00
PRAMOXINE/ CALAMINE LOT 25.00
PRAMOXINE/ CHLOR/ HC DRP 7.50
PRAMOXINE/ HC ** 203.05
PRAVASTATIN TAB [20 MG] 25.00
PRAVASTATIN TAB [40 MG] 25.00
PREDNISOLONE 1% DRP [EYE] 38.75
PREDNISOLONE LIQ [15 MG/5 42.75
PREDNISOLONE LIQ [15 MG/5 J7510 56.25
PREDNISOLONE LIQ [5 MG/5M 4.00
PREDNISONE TAB [10 MG] 25.00
PREDNISONE TAB [20 MG] 25.00
PREDNISONE TAB [5 MG] 25.00
PREGABALIN CAP [25 MG] 15.80
PRENAT VIT/ FE/ FA TAB [6 3.00
Prevnar 13 648.30
Primidone 250 mg TAB 5.00
PRIMIDONE TAB [50 MG] 25.00
PROCAINAMIDE CAP [250 MG] 3.00
PROCAINAMIDE INJ [100 MG/ 61.60
PROCHLORPERAZINE INJ [5 M J0780 88.80
PROCHLORPERAZINE TAB [5 M 25.00
PROMETHAZINE 12.5MG TABLET 10.00
PROMETHAZINE INJ [25 MG/M 56.60
PROMETHAZINE INJ [50 MG/M 57.25
PROMETHAZINE LIQ [6.25 MG 4.00
PROMETHAZINE SUP (12.5 MG 15.60
PROMETHAZINE SUP [25 MG] 17.80
PROMETHAZINE TAB [25 MG] 25.00
PROMETHAZINE W/ CODEINE S 25.00
PROPOFOL DRIP 57.60
PROPOFOL INJ [10 MG/ML] 55.35
PROPRANOLOL HCL INJ [1 MG 65.00
PROPRANOLOL LA CAP [60 MG 25.00
PROPRANOLOL TAB [10 MG] 25.00
PROPRANOLOL TAB [20 MG] 25.00
PROPRANOLOL TAB [40 MG] 25.00
PROPYLTHIOURACIL TAB [50 25.00
PROTAMINE SULF INJ [250MG 56.70
Protonix 40MG INJ 75.00
PSEUDOEPHEDRINE TAB [60 M 1.00
PSYLLIUM 4.00
PT- HYDROCOLLOID BDG 22.50
PT- HYDROCOLLOID BDG XTHN 27.00
PT- SILVER DRESSING 173.75
PT- SILVER DRSNG 25.50
PYRIL/ CPM/ PE TAB [25-4- 25.00
QUETIAPINE TAB [100 MG] 28.00
QUETIAPINE TAB [25 MG] 25.00
QUINAPRIL TAB [10 MG] 6.30
QUINAPRIL TAB [20 MG] 6.30
QUINIDINE GLUC TAB [324 M 5.50
QUINIDINE SULF TAB [200 M 25.00
QUININE SULFATE CAP [324 27.90
QUINUPRIS/ DALFOPRIS INJ 883.65
RABEPRAZOLE TAB [20 MG] 49.00
RABIES IMMUNE GLOBULIN (H 900.30
RABIES VIRUS VACCINE, HDC 887.05
RALOXIFENE TAB [60 MG] 27.95
RAMELTEON TAB [8 MG] 29.25
RAMIPRIL CAP [2.5 MG] 7.85
RAMIPRIL CAP [5 MG] 9.90
RANITIDINE TAB [150 MG] 6.25
RANITIDINE/ NACL PREMIX [ 55.15
RANOLAZINE TAB [500 MG] 16.15
REGADENOSON INJ [0.4 MG 673.55
Reglan 10MG/10ML 62.30
Relistor Subcutaneous Solution 12 MG/0.6 375.00
REMIFENTANIL 1MG 173.80
REPAGLINIDE TAB [0.5 MG] 25.15
REPAGLINIDE TAB [2 MG] 25.15
Repatha Subcutaneous Solution Prefilled 825.00
RESERPINE TAB [0.25 MG] 25.00
RETAPAMULIN 1% OIN [10GM] 219.60
RETAPAMULIN 1% OIN [5GM] 28.65
RIMANTADINE TAB [100 MG] 25.00
RIMEXOLONE 1% DRP [EYE] 41.30
RISEDRONATE TAB [35 MG] 99.30
RISPERIDONE INJ [25 MG] 1024.15
RISPERIDONE INJ [37.5 MG] 1536.30
RISPERIDONE TAB [0.25 MG] 27.70
RISPERIDONE TAB [1 MG] 25.00
RIVAROXABAN TAB [10 MG] 34.40
RIVAROXABAN TAB [15 MG] 28.65
RIVASTIGMINE CAP [1.5 MG] 25.70
RIVASTIGMINE CAP [3 MG] 25.70
RIVASTIGMINE PAT [4.6 MG] 45.25
RIVASTIGMINE PAT [9.5 MG] 45.25
RIZATRIPTAN TAB [5 MG] 117.40
ROCURONIUM INJ [10 MG/ML] 56.05
ROPINIROLE TAB [0.25 MG] 25.00
ROPINIROLE TAB [0.5 MG] 25.00
ROPINIROLE TAB [1 MG] 25.00
ROSIGLIT/ METFORM TAB [4/ 25.00
ROSIGLITAZONE TAB [4 MG] 25.00
ROSUVASTATIN TAB [10 MG] 27.30
RT- ACETYLCYSTEINE INJ 10 20.00
RT- ALBUTEROL/ IPRATROPIU 20.00
RT- BUDESONIDE NEB [0.5 M J7626 20.00
RT- CROMOLYN SOD [10 MG/M 20.00
RT- FORMOTEROL NEB [20 MC 20.00
RT- IPRATROPIUM NEB 0.02% 20.00
RT- LEVALBUTEROL NEB [1.2 J7612 20.00
RT- METAPROTERENOL NEB 0. 20.00
RT- RACEPINEPHRINE NEB 2. 20.00
RT- SOD CHLORIDE 0.9% NEB 20.00
RT- TERBUTALINE INJ [1MG/ 20.00
RT-ARFORMOTEROL NEB (15MC 20.00
SALINE CLEANSER SOL ** 16.95
SALINE NASAL GEL 20 SWABS 1.00
SALMETEROL MDI ** 33.00
SCOPOLAMINE PAT [1.5 MG] 70.50
SCOPOLAMINE TAB [2.5 MG] 25.00
SELEGILINE TAB [5 MG] 25.00
SELENIUM SULF 2.5% SHM * 34.20
SELENIUM TAB [200 MCG] 2.00
SELENIUM TAB [50 MCG] 2.00
SENNA/ DOC SOD TAB 2.00
SENNOSIDES-DOCUSATE SODIU 2.00
SERTRALINE TAB [50 MG] 25.00
SERTRALINE TAB [100 MG] 25.00
SILVER NITRATE STK 25.00
SILVER SULFADIAZINE 1% CR 25.00
SILVER SULFADIAZINE 1% CR 25.00
SILVER SULFADIAZINE CREAM 25.00
SILVER SULFADIAZINE CREAM 7.50
SIMETHICONE DRP [40 MG/0. 2.00
SIMETHICONE TAB [80 MG] 1.00
SIMVASTATIN TAB [10 MG] 25.00
SIMVASTATIN TAB [20 MG] 25.00
SIMVASTATIN TAB [40 MG] 25.00
SITAGLIPTIN TAB [100 MG] 39.75
SKIN CLEANSER/ EMOLLIENT 25.00
SOD BICARB INJ SYR [10 ME 68.30
SOD BICARB INJ SYR [50 ME 62.45
SOD BICARB TAB [650 MG] 25.00
SOD CHL 3000ML 186.50
SOD CHLOR 0.65% SPR ** 25.00
SOD CHLOR 0.9% INJ [30ML] 55.05
SOD CHLOR 23.4% INJ 55.10
SOD CHLOR 5% DRP ** 25.00
SOD CHLOR TAB [1 GM] 25.00
SOD CHLORIDE INJ 0.9% [10 55.85
SOD CHLORIDE INJ 0.9% [25 122.00
SOD CL 0.45% [1000 ML] 122.00
SOD CL 0.9% [100 ML] 122.00
SOD CL 0.9% [100 ML] ADV 186.50
SOD CL 0.9% [1000 ML] 122.00
SOD CL 0.9% [250 ML] 186.50
SOD CL 0.9% [25ML] 25.00
SOD CL 0.9% [50 ML] 93.60
SOD CL 0.9% [500 ML] 186.50
SOD CL 3% HYPERTONIC [50 186.50
SOD PHOS MB/ SOD PHOS DB 55.15
SOD PHOS MB/ SOD PHOS ENE 2.00
SOD PHOS/ POT PHOS PKT 4.00
SOD POLY SULF SUS [15 GM/ 35.00
SODIUL CHLO 0.9% 50ML ADV 10.00
SODIUM CHLOR 0.9% 250ML ADV 10.00
SODIUM CHLORIDE INJ 0.9% 57.15
SODIUM CHLORIDE NEB 10.00
SODIUM TETRADECYL SULFATE 150.00
SOLIFENACIN TAB [10 MG] 28.85
SOTALOL TAB [80 MG] 25.00
SPIRONOLAC/ HCTZ TAB [25- 25.00
SPIRONOLACTONE TAB [25 MG 25.00
SPIRONOLACTONE TAB [50 MG 25.00
STERILE H20 IRR 3000 ML 186.50
STERILE WATER (+NACL) 186.50
STERILE WATER FOR INJ 20ML 10.00
Sterile Water for Irrigation 1000 ML 65.76
SUCCINYLCHOLINE INJ [20 M 55.40
SUCRALFATE SUS [1 GM/10ML 4.00
SUCRALFATE TAB [1 GM] 5.00
sugammadex 200mg/2ml 47.44
Sulfa-Trimeth Solu 800-160 mg/10mL 35.04
SULFAMETH/ TMP DS TAB [80 5.80
SULFAMETH/ TMP INJ [400-8 56.15
SULFAMETH/ TMP SUS [200-4 43.50
SULINDAC TAB [200 MG] 25.00
SUMATRIPTAN INJ [6 MG/0.5 306.25
Suprane Inhalation Solution 33.00
SYRPALTA LIQ FLAVOR 4.00
TACROLIMUS 0.1% OIN ** 28.50
Tamoxifen Citrate Oral Tablet 10 MG 5.00
TAMOXIFEN TAB [10 MG] 25.00
TAMOXIFEN TAB [20 MG] 25.00
TAMSULOSIN CAP [0.4 MG] 25.00
TAMSULOSIN HCL CAP [0.4 M 16.85
Tazicef Injection Solution IM 59.75
TEA TREE OIL ** 2.00
TELMISARTAN TAB [40 MG] 25.90
TEMAZEPAM CAP [15 MG] 25.00
TENECTEPLASE INJ [50 MG] 9437.20
TERAZOSIN CAP [1 MG] 3.00
TERAZOSIN CAP [5 MG] 25.00
TERBINAFINE 1% CRM ** 24.45
TERBINAFINE TAB [250 MG] 45.80
TERBUTALINE INJ [1 MG/ML] 59.80
TERBUTALINE TAB [2.5 MG] 25.00
TERCONAZOLE 0.8% VAG CRM 25.00
TERIPARATIDE INJ [20 MCG/ 2251.35
TESTOSTERONE 1% GEL [5 GM 22.80
TESTOSTERONE CYP INJ [100 25.95
TESTOSTERONE CYP INJ [200 85.90
TET/DIPH/PERTUS INJ 0.5 M 175.60
TETRACAINE DRP 0.5% [EYE] 12.50
TETRACAINE HCL OPHTH SOLN 7.50
TETRACYCLINE CAP [250 MG] 25.00
TETRACYCLINE CAP [500 MG] 25.00
TETRAHYDROZNE 0.05% PED D 21.50
THEOPHYLLINE TAB [100 MG] 25.00
THEOPHYLLINE TAB [200 MG] 3.00
Thiamine Oral Tablet 100 mg 6.50
THIORIDAZINE TAB [10 MG] 25.00
THIORIDAZINE TAB [25 MG] 25.00
THIOTHIXENE CAP [2 MG] 25.00
THYROID *ARMOUR TAB [120 25.00
THYROID *ARMOUR TAB [30 M 25.00
THYROID TAB [65 MG] 3.00
TIAGABINE TAB [4 MG] 27.45
TICARCILLIN/ CLAV INJ [3. 64.00
TICLOPIDINE TAB [250 MG] 25.00
TIGECYCLINE INJ [50 MG] 220.50
TIMOLOL TAB [10 MG] 25.00
TIOTROPIUM MDI ** 60.50
TIZANIDINE TAB [4 MG] 25.00
TOBRAMYCIN 0.3% DRP [EYE] 17.00
TOBRAMYCIN INJ [80 MG/2ML 55.70
TOBRAMYCIN/ DEX DRP [EYE] 95.95
TOBRAMYCIN/ DEX OIN [EYE] 162.55
TOCILIZUMAB INJ PFS [162M 2341.90
TOLNAFTATE 1% CRM ** 25.00
TOLNAFTATE 1% PWD ** 25.00
TOLTERODINE LA CAP [4 MG] 29.05
TOLTERODINE TAB [2 MG] 25.40
TOPIRAMATE TAB [25 MG] 25.00
TOPIRAMATE TAB [100 MG] 26.20
TOPIRAMATE TAB [200MG] 27.30
TORSEMIDE INJ [10 MG/ML] 63.80
TORSEMIDE TAB [20 MG] 25.00
Toujeo Insulin Pen 300 units/ml 88.18
TRAMADOL ER TAB [100 MG] 25.00
TRAMADOL TAB [50 MG] 25.00
TRANDOL/ VERAP TAB [4-24 25.00
TRANDOLAPRIL TAB [2 MG] 25.00
TRANDOLAPRIL TAB [4 MG] 25.00
TRANEXAMIC ACID 250.00
TRAVOPROST DRP [EYE] ** 110.10
TRAZODONE TAB [100 MG] 25.00
TRAZODONE TAB [150 MG] 25.00
TRAZODONE TAB [50 MG] 25.00
TRETINOIN 0.025% CRM ** 25.00
TRIAMCINOLONE 0.025% CRM 25.00
TRIAMCINOLONE 0.1% CRM [3 25.00
TRIAMCINOLONE 0.1% CRM [8 25.00
TRIAMCINOLONE 0.1% OIN [1 25.00
TRIAMCINOLONE 0.1% PSTE [ 56.45
TRIAMCINOLONE 0.5% OIN [1 25.00
TRIAMCINOLONE ACETONIDE I 65.30
TRIAMCINOLONE INH ** 33.00
TRIAMCINOLONE MDI ** 384.00
TRIAMCINOLONE VL [40 MG/M 65.30
TRIAMTER/ HCTZ CAP [37.5- 5.00
TRIAMTER/ HCTZ TAB [75-50 25.00
TRIHEXYPHENIDYL TAB [2 MG 25.00
TRIMETHOPRIM TAB [100 MG] 25.00
TRIPROLIDINE LIQ [1.25MG/ 27.45
TROPICAMIDE 1% DRP [EYE] 7.50
TROSPIUM TAB [20 MG] 25.00
TUBE FEEDING BOLUS 0.00
TUBE FEEDING CONTINUOUS 0.00
TUBE FEEDING FLUSH 0.00
TUBE FEEDING START 0.00
TUBE FEEDING STOP 0.00
TUBERCULIN PPD INJ [5 TU/ 169.20
TUBERCULIN PPD INJ 5 UNIT 169.20
UBIDECARENONE CAP [50 MG] 3.00
Uloric 40 mg Tab 36.97
VAC- H1N1 INFLUENZA VIRUS 3.00
VAC- HEPATITIS B INJ [20 60.10
VAC- HUMAN PAPILLOMAVIRUS 883.10
VAC- INFLUENZA VIRUS INJ 101.50
VAC- PNEUMOCOCCAL 23 INJ 434.30
VAC- TETAN/ DIPH/ PERT IN 90715 253.45
VAC- TETANUS DIPH TOX ADU 150.50
VALACYCLOVIR TAB [1 GM] 18.60
VALACYCLOVIR TAB [500 MG] 28.05
VALPROIC ACID CAP [250 MG 3.20
VALPROIC ACID LIQ [250 MG 4.00
VALSARTAN TAB [80 MG] 25.00
VALSARTAN TAB [160 MG] 25.00
VALSARTAN/ HCTZ TAB [80-1 25.00
VANCO 500MG ADV 10.00
VANCO ORAL SOLUTION KIT 178.00
VANCOMYCIN INJ [1 GM] 63.80
VANCOMYCIN INJ [750MG] 60.45
Vancomycin Oral Solution 50mg/ml 178.00
VARENICLINE TAB [0.5 MG] 25.00
VARENICLINE TAB [1 MG] 25.00
VASOPRESSIN INJ [20 UNT/M 60.20
VECURONIUM INJ [10 MG] 27.20
Venlafaxine HCl ER Oral Capsule Extended 5.00
VENLAFAXINE TAB [75 MG] 8.75
Venofer Intravenous Solution 20 MG/ML 131.84
Venofer Intravenous Solution 20 MG/ML 120.00
VERAPAMIL INJ [2.5 MG/ML] 62.30
VERAPAMIL SR CAP [120 MG] 5.00
VERAPAMIL SR TAB [180 MG] 25.00
VERAPAMIL SR TAB [240 MG] 25.00
VERAPAMIL TAB [80 MG] 25.00
VIT- B COM/ C/ FE,FA/MIN 25.00
VIT- B COMPLEX 1.00
VIT- B-1 INJ [100 MG/ML] 65.70
VIT- B-1 TAB [100 MG] 25.00
VIT- B-12 INJ [1000 MCG/M 55.50
VIT- B-12 INJ [1000 MCG/M 67.00
VIT- B-12 TAB [100 MCG] 1.00
VIT- B-12 TAB [500 MCG] 1.00
VIT- B-12/ B-6/ FA TAB 25.00
VIT- B-12/ B-6/ FA TAB [0 25.00
VIT- B-12/ B-6/ L-MFOLATE 25.00
VIT- B-12/ C/ FE/ IFC CAP 25.00
VIT- B-6 TAB [100 MG] 1.00
VIT- B-6 TAB [50 MG] 1.00
VIT- B6, B12, FOLIC ACID 25.00
VIT- C TAB [500 MG] 1.00
VIT- D CAP [1000 UNT] 25.00
VIT- D CAP [50,000 UNT] 25.00
VIT- E CAP [1000 UNT] 1.00
VIT- E CAP [400 UNT] 1.00
VIT- K INJ [10 MG/ML] 150.80
Voltaren gel (diclofenac) 59.00
WARFARIN TAB [1 MG] 8.25
WARFARIN TAB (7.5MG) 12.35
WARFARIN TAB [10 MG] 5.00
WARFARIN TAB [2 MG] 8.60
WARFARIN TAB [2.5 MG] 8.90
WARFARIN TAB [3 MG] 8.90
WARFARIN TAB [4 MG] 8.95
WARFARIN TAB [5 MG] 9.25
WATER BACT INJ 55.05
WATER STERILE INJ 55.10
Wellbutrin XL Oral Tablet Extended Relea 5.00
Xanax 0.25 MG 71.00
Zarxio 300 MG INJ 1521.63
Zenpep Oral Capsule DR 15000 Units 5.00
ZINC OXIDE 20% OIN ** 25.00
ZINC OXIDE PASTE [120 GM] 19.50
ZINC OXIDE PASTE [60 GM] 25.00
ZINC SULFATE CAP [220 MG] 2.00
ZINC TAB [50 MG] 2.00
ZIPRASIDONE CAP [20 MG] 45.15
Ziprasidone HCl Oral Capsule 40 MG 12.50
ZIPRASIDONE INJ [20 MG] 125.70
ZOLEDRONIC ACID INJ [5 MG 68.05
ZOLPIDEM TAB [5 MG] 25.00
ZOMETA 4MG/5ML VIAL 1612.10
ZONISAMIDE CAP [25 MG] 25.00
ZOSYN 4.5 GM IV 126.40
Zyvox 600mg/300ml 300.00
Zyvox Intravenous Solution 2 MG/ML 87.92
GASTROGRAFIN 1 CC Q9967 2.50
ISOVUE-370 100ML Q9967 108.00
ISOVUE-370 75ML Q9967 108.00
ISOVUE-M 200 10ML VIAL Q9966 130.50
NM-99M TC A9512 652.00
NM-99M TC04 TECHNETIUM A9512 635.50
NM-CARDIOLITE A9500 1107.00
NM-DTPA A9567 962.00
NM-I 123 IDODINE A9516 1064.50
NM-I 131 IODINE A9530 995.50
NM-KINEVAC A4641 439.50
NM-MAA A9540 905.00
NM-MDP A9503 742.00
NM-PYP A9514 705.50
NM-TC-99M OXIDRONATE DX TO 30 MCI A9561 742.00
NM-Tc99m CHOLETEC A9537 816.50
NM-Tc99m labeled rbc A9560 1420.00
NM-Tc99m MERTIATIDE A9562 967.00
NM-Tc99m SULFUR COLLOID A9541 759.50
OMNIPAQUE 240MG 10ML VIAL Q9967 191.50
OMNIPAQUE 300 50 ML Q9967 132.00
PROHANCE 20ML A9576 287.00
VISIPAQUE PER ML Q9966 4.00
NON SNF - PRIVATE PAY 400.00
SNF - SEMI-PRIVATE ROOM 640.00
COLONOSCOPE 2260.00
CYSTO W/SIMPLE REMOVAL STENT/FORIEGN BDY 52310 2555.00
CYSTOSCOPE 52000 1900.00
ENDOVENOUS CHEM ADHESIVE 1ST VEIN 36482 5500.00
ENDOVENOUS CHEM ADHESIVE SBSQ VEIN 36483 5500.00
ENDOVENOUS LASER TX 36478 5325.00
GASTROSCOPE 2260.00
NO CHARGE VISIT 0.00
SP CLNC PROC SPIDER VEINS 36471 250.00
SP CLNC TR ADD LEVEL III 225.00
SP CLNC TR ADD LEVEL IV 585.00
SP CLNC TR RM LEVEL III 637.25
SP CLNC TR RM LEVEL IV 1677.65
SPEC CLINIC PROCEDURE RM 140.30
SPEC CLNC TR RM LEVEL II 425.00
SPECIALTLY CLINIC LEVEL 1 NEW PATIENT 99201 40.00
SPECIALTY CLINIC LEVEL 1 EST PATIENT 99211 40.00
SPECIALTY CLINIC LEVEL 2 EST PATIENT 99212 45.00
SPECIALTY CLINIC LEVEL 2 NEW PATIENT 99202 45.00
SPECIALTY CLINIC LEVEL 3 EST PATIENT 99213 55.00
SPECIALTY CLINIC LEVEL 3 NEW PATIENT 99203 55.00
SPECIALTY CLINIC LEVEL 4 EST PATIENT 99214 65.00
SPECIALTY CLINIC LEVEL 4 NEW PATIENT 99204 65.00
SPECIALTY CLINIC LEVEL 5 EST PATIENT 99215 90.00
SPECIALTY CLINIC LEVEL 5 NEW PATIENT 99205 90.00
TRANSLAMINAR LUMBAR/SACRAL 62323 1267.35
SPEECH TX CONSULT 15 MIN 12.50
SPEECH TX MILEAGE 0.50
ST - TRAVEL TIME/15 MIN 12.50
ST-AUDIOMETRIC SCREENING 92551 97.00
ST-EVAL @ 30 MIN. 92523 284.00
ST-EVAL @ 45 MIN. 92523 284.00
ST-EVAL @ 60 MIN. 92523 284.00
ST-TREATMENT @ 30 MIN. 92507 245.00
ST-TREATMENT @ 45 MIN. 92507 141.00
ST-TREATMENT @ 60 MIN. 92507 245.00
BIOPSY OF PROSTATE 55700 870.00
CAUTERIZE GRANULATION 17250 250.00
CHEST TUBE INSERTION 441.00
COLONOSCOPE 2260.00
CYSTO/DVIU 52276 2750.00
CYSTO/URETHRAL DILATION 52281 2450.00
CYSTOSCOPY\STENT REMOVAL 52310 2555.00
DILATION ESOPHAGUS/ BOUGI 2782.00
ENDOVENOUS CHEM ADHESIVE 1ST VEIN 36482 5500.00
ENDOVENOUS CHEM ADHESIVE SBSQ VEIN 36483 5500.00
ENDOVENOUS LASER TX 36478 5325.00
FEEDING TUBE INSERTION 255.00
FLEX SIGMOIDOSCOPY 1775.00
GASTROSCOPE 2260.00
IV CUTDOWN 278.00
IVR PROCEDURE ROOM 3450.00
OR CATARACT SURGERY 950.00
OR DENTAL SURGERY 622.00
OR-ANAL SPINKLER RELEASE 308.00
OR-BIOPSY 308.00
OR-BREAST BIOPSY 308.00
OR-CIRCUMCISION GEN ANES 308.00
OR-CIRCUMCISION W/ANEST 475.00
OR-D & C 622.00
OR-EXCISION LES/CYST W/SE 622.00
OR-HEMMORRHOID BANDING 183.00
OR-LITHOTRIPSY 50590 9750.00
OR-LIVER BIOPSY 308.00
OR-PROCTOSCOPE 308.00
OR-SIMPLE PROCEDURE 270.00
OR-UREASE BIOPSY 293.00
OR-URETHAL DILATION 622.00
OR-VAGINAL/UTERINE BIOPSY 622.00
PARACENTHESIS 219.00
PROC RM LEVEL III ADD'L 585.00
PROC RM LEVEL IV ADD'L 605.00
PROCEDURE RM LEVEL II ADD 225.00
PROCEDURE ROOM LEVEL 1 140.30
PROCEDURE ROOM LEVEL II 637.25
PROCEDURE ROOM LEVEL III 1677.65
PROCEDURE ROOM LEVEL IV 1725.00
RHIZOTOMY ADD'L LEVEL 1225.00
SB-US NDL THORACENTESIS 32555 1952.00
SPINAL TAP 365.00
SUBCLAVIAN INSERTION 255.00
SURG MAJ ADD'L 15 MIN. 890.00
SURG MAJ ADD'L MINUTE 45.75
SURG MIN ADD'L MINUTE 27.50
SURG MINOR 1ST 30 MIN 1285.00
SURG MINOR ADD'L 15 MIN 495.00
SURG MINOR ORTHO 1ST 30 M 1830.00
SURG MINOR ORTHO ADD 15 M 580.00
SURG.MAJOR - 1ST 15 MIN. 1580.00
TENDONECTOMY 148.00
THORANCENTESIS 32554 219.00
TOURNIQUET CUFF 95.65
VASECTOMY 55250 475.00
BREAST SONOGRAM 76645 498.00
EYE MEASURING 76519 234.50
OB US LIMITED FETUS(S) 76815 489.50
PELVIC US-NON-OBSTETRIC 76856 741.00
US - BREAST(S) 76645 498.00
US - URINE CAPACITY MEAS 51798 182.00
US >14 WKS SINGLE FETUS 76805 878.00
US 1ST TRIMESTER 76801 878.00
US ABDOMINAL AORTA STUDY AAA 76706 499.50
US CAROTID DOPPLER 93880 1374.50
US EXAM ABDO AORTA 76775 599.50
US EXAM ABDO RENAL 76775 599.50
US EXTREMITY NONVASCULAR 76882 581.50
US FETAL BIOPHY PROF W/O 76819 499.50
US GUIDE VASCULAR ACCESS 76937 601.50
US NO CHARGE UNILAT VEINS 93971 0.00
US TRANSRECTAL 76872 637.00
US-ABDOM BACK WALL LMTD 76775 614.00
US-ABDOMENAL COMPLETE 76700 769.00
US-ABDOMENAL LIMITED 76705 697.50
US-ARTERIAL EXT BILATERAL 93923 941.00
US-ARTERIAL EXT UNILATERL 93922 667.50
US-ARTERIAL RENAL DOPPLER 93975 953.50
US-ASPIRATION GUIDANCE 76948 836.50
US-EXTREMITY DUPLEX BILAT 93970 1209.00
US-EXTREMITY UNILATERAL 93971 941.00
US-GROIN 76938 676.00
US-NEEDLE PLACE GUIDANCE 76942 836.50
US-PELVIC LIMITED 76857 452.50
US-POSTERIOR COSTOPHRENIC 76705 696.50
US-RETROPERITONEAL COMPL 76770 768.00
US-SCROTAL 76870 594.00
US-SFT TISSUE HEAD & NECK 76536 558.00
US-TRANSVAGINAL 76830 726.50
US-UNLISTED PROCEDURE 76999 585.00