PLEASE NOTE THESE CHARGES do not include fees from your surgeon or other professional services billed by the physician AND OTHER PROFESSIONAL PROVIDERS.
| Item # | Item Description | Charge |
| 311119 | 0.45% SALINE/KCL 20MEQ 1000ML | 160.00 |
| 310200 | 0.45% SALINE: 500ML | 80.00 |
| 310278 | 0.45% SALINE:1000ML | 95.00 |
| 380048 | 0.6 TO 1. BENIGN LESION; EXCEPT SKIN TAG | 418.00 |
| 380049 | 1.1 TO 2. BENIGN LESION; EXCEPT SKIN TAG | 465.00 |
| 16953 | 1.1 TO 2.5 CM | 562.00 |
| 171094 | 1.1 TO 2.5 CM | 625.00 |
| 171096 | 1.1 TO 2.5 CM | 650.00 |
| 16955 | 1.1 TO 2.5 CM | 694.00 |
| 16957 | 1.1 TO 2.5 CM | 694.00 |
| 171098 | 1.1 TO 2.5 CM | 850.00 |
| 171099 | 1.1 TO 2.5 CM | 1,000.00 |
| 16951 | 1.1 TO 2.5 CM | 1,542.00 |
| 170327 | 12.6 TO 20.0 CM | 371.70 |
| 170418 | 12.6 TO 20.0 CM | 371.70 |
| 16069 | 12.6 TO 20.0 CM | 410.00 |
| 171092 | 12.6 TO 20.0 CM | 990.00 |
| 16950 | 12.6 TO 20.0 CM | 1,187.00 |
| 171093 | 12.6 TO 20.0 CM | 1,242.00 |
| 171090 | 12.6 to 20.0CM | 371.70 |
| 16937 | 12.6 to 20.0CM | 427.00 |
| 16941 | 12.6 TO 20.0CM | 427.00 |
| 16945 | 12.6 TO 20.0CM | 920.00 |
| 798074 | 1-25-DIHYDROXY VITAMIN D | 193.00 |
| 791337 | 17-OH-PREGNENOLONE | 286.00 |
| 790812 | 17-OH-PROGESTERONE | 130.00 |
| 135011 | 1ST HOUR RECOVERY,A | 760.00 |
| 380050 | 2.1 TO 3. BENIGN LESION; EXCEPT SKIN TAG | 555.00 |
| 170350 | 2.6 TO 5.0 CM | 371.70 |
| 170467 | 2.6 TO 5.0 CM | 371.70 |
| 16905 | 2.6 TO 5.0 CM | 427.00 |
| 16947 | 2.6 TO 5.0 CM | 576.00 |
| 170485 | 2.6 TO 5.0 CM | 896.60 |
| 16956 | 2.6 TO 5.0 CM | 960.00 |
| 170301 | 2.6 TO 7.5 CM | 318.20 |
| 16055 | 2.6 TO 7.5 CM | 371.00 |
| 170442 | 2.6 TO 7.5 CM | 371.70 |
| 16939 | 2.6 to 7.5 CM | 427.00 |
| 170392 | 2.6 TO 7.5 CM | 431.80 |
| 16943 | 2.6 TO 7.5 CM | 532.00 |
| 16952 | 2.6 TO 7.5 CM | 693.00 |
| 171095 | 2.6 TO 7.5 CM | 725.00 |
| 16954 | 2.6 TO 7.5 CM | 750.00 |
| 171097 | 2.6 TO 7.5 CM | 850.00 |
| 16958 | 2.6 TO 7.5 CM | 960.00 |
| 171100 | 2.6 TO 7.5 CM | 1,265.00 |
| 331093 | 24HR URINE (CREATININE CLEARANCE) | 113.00 |
| 791276 | 25 HYDROXY VIT D (TOTAL) | 112.00 |
| 380051 | 3.1 TO 4 BENIGN LESION; EXCEPT SKIN TAG | 580.00 |
| 578612 | 4.0 CANNULATED 2.7 DRILL BIT | 1,435.00 |
| 578699 | 5.0 FEMORAL DRILL LONG GAMMA | 362.00 |
| 170368 | 5.1 TO 7.5 CM | 371.70 |
| 170475 | 5.1 TO 7.5 CM | 371.70 |
| 16935 | 5.1 to 7.5 CM | 427.00 |
| 16948 | 5.1 TO 7.5 CM | 696.00 |
| 798081 | 5-10 MTHFR MUTATION | 574.00 |
| 790961 | 5-HIAA (24HR URINE) | 90.00 |
| 170319 | 7.6 T0 12.5 CM | 334.20 |
| 16934 | 7.6 to 12.5 CM | 237.00 |
| 170376 | 7.6 TO 12.5 CM | 371.70 |
| 170483 | 7.6 TO 12.5 CM | 371.70 |
| 16940 | 7.6 to 12.5 CM | 427.00 |
| 170400 | 7.6 TO 12.5 CM | 465.15 |
| 16949 | 7.6 TO 12.5 CM | 864.00 |
| 171091 | 7.6 TO 12.5 CM | 990.00 |
| 16936 | 7.6 to 12.5CM | 427.00 |
| 16944 | 7.6 TO 12.5CM | 718.00 |
| 3000058 | A&D OINT. 60GM | 10.00 |
| 244022 | ABD 3+ VIEWS | 99.00 |
| 240017 | ABD SERIES W/PA CXR | 385.10 |
| 240548 | ABDOMEN 1 VIEW | 221.30 |
| 240555 | ABDOMEN 2 VIEWS | 279.80 |
| 23063 | ABDOMINAL DUPLEX | 584.10 |
| 23065 | ABDOMINAL LIMITED/UNILATERAL DUPLEX | 325.40 |
| 500865 | ABDOMINAL SUPPORT 12′ | 80.00 |
| 581208 | ABDOMINAL SUPPORT 9′ | 64.00 |
| 1403612 | ABDOMINOPERINEAL RES | 89.80 |
| 5571050 | ABDUCTION PILLOW/DEROYAL | 286.30 |
| 331960 | ABG (ARTERIAL BLD GASSES) | 210.00 |
| 1404976 | ABG DRAW | 52.40 |
| 241583 | ABI STUDY | 227.20 |
| 303289 | ABILIFY (ARIPiprazole)10MG TAB | 2.00 |
| 3077925 | ABILIFY MAINTENA 400MG SYRINGE | 4,000.40 |
| 303468 | ABILIFY(ARIPiprazole) 2MG TAB | 2.00 |
| 136576 | ABRASION ARTHROPLASTY | 2,000.00 |
| 939494 | ABRASION ARTHROSCOPY | 2,250.00 |
| 3078287 | ABRAXANE IV PWD FOR SUSP 100MG | 3,400.00 |
| 242353 | ABSCESS DRAINAGE (FL,US,OR CT) SI | 337.10 |
| 241245 | ABSCESS, FISTULA OR SINUS TRACT STUDY SI | 818.10 |
| 241246 | ABSCESS, FISTULA OR SINUS W/CONTRAST SI | 585.40 |
| 240365 | AC JOINTS BILATERAL | 191.90 |
| 517331 | ACAPELLA BLUE | 275.00 |
| 517349 | ACAPELLA GREEN | 208.00 |
| 18618 | ACAPELLA/PEP SUBS | 43.40 |
| 1405179 | ACC/CTRL VENOUS CIRC | 89.80 |
| 1415179 | ACC/CTRL VENOUS CON | 89.80 |
| 16463 | ACCU CHECK | 44.40 |
| 303288 | ACCUNEB (ALBUTEROL SULFATE) 1.25MG/3ML | 2.00 |
| 515182 | ACCUSTICK 21 GA 20CM DIAGNOS XR | 56.00 |
| 515186 | ACCUSTICK INTRODUCER SET W/RO MARKER XR | 455.00 |
| 790101 | ACE (ANGIOTENSION CONVERTING ENZYME) | 71.00 |
| 16985 | ACETABULUM NO MANIPULATION | 1,500.00 |
| 171124 | ACETABULUM NO MANIPULATION | 2,041.00 |
| 16986 | ACETABULUM W/ MANIPULATION | 3,044.00 |
| 171125 | ACETABULUM W/ MANIPULATION | 3,687.00 |
| 790367 | ACETAMINOPHEN | 222.00 |
| 3023191 | ACETAMINOPHEN SUSP 160MG/5ML 120ML | 11.15 |
| 303394 | acetaZOLAMIDE 500MG INJ. | 199.30 |
| 3019488 | ACETIC ACID .25% IRRIGATION 1000ML | 20.00 |
| 791549 | ACETYLCHOLINESTERASE ERYTHROCYTES | 63.00 |
| 3077834 | ACETYLCYSTEINE 200MG/ML (6G/30ML) INJ. | 456.85 |
| 790917 | ACH RECEPTOR BINDING AB (MUSCLE) | 244.00 |
| 1404396 | ACHILLES TENDON REPA | 89.80 |
| 790113 | AChR GANGLIONIC NEURONAL ANTIBODY | 75.00 |
| 798024 | ACID FAST CONCENTRATION | 27.00 |
| 791029 | ACID FAST SMEAR/STAIN | 17.00 |
| 640025 | ACLS HANDBOOK | 15.30 |
| 171102 | ACROM/CLAVICLE W/MANIPULATION | 1,457.00 |
| 16963 | ACROM/CLAVICLE W/MANIPULATION | 1,861.00 |
| 574711 | ACROMIONIZER 5.5EP-1 | 273.00 |
| 307799 | ACTEMRA (TOCILIZUMAB) 200MG INJ | 1,693.20 |
| 303610 | ACTEMRA (TOCILIZUMAB) 400MG INJ | 5,312.90 |
| 303749 | ACTEMRA (TOCILIZUMAB) 80MG/4ML SDV | 837.70 |
| 790600 | ACTH (ADRENOCORTICOTROPIC HORMONE) | 156.00 |
| 3077864 | ACTHIB 0.5ML VIAL | 103.30 |
| 5593304 | ACTION PATCH/IONTO PATCH | 128.10 |
| 303286 | ACTIVATED CHARCOAL 50GM (AQUA) | 27.30 |
| 3017698 | ACTIVATED CHARCOAL 50GM (SORBITAL) SUSP | 28.90 |
| 791238 | ACTIVATED PROT C RESIST V | 125.00 |
| 3030775 | ACTOS (PIOGLITAZONE) 15MG TAB | 2.00 |
| 3034000 | ACULAR (KETOROLAC) 0.5% 5ML | 15.00 |
| 3028299 | ACULAR 0.5% 5ML OPH SOLN | 39.30 |
| 380024 | ACUTE CARE DISCHARGE >30 MIN | 181.20 |
| 380143 | ACUTE CARE DISCHARGE >30 MIN | 196.00 |
| 3018589 | ACYCLOVIR 200MG CAP | 2.00 |
| 3024678 | ACYCLOVIR 800MG TAB | 2.00 |
| 303392 | ADACEL (DIPTH,PERTUSS,TET)VIAL | 179.30 |
| 330922 | ADALIMUMAB QUANT W/REFLEX TO AB | 774.00 |
| 307786 | ADDAMEL N CONENTRATE FOR INFUSION 10ML | 35.50 |
| 135029 | ADDITIONAL .5HR RECOVERY, B | 285.00 |
| 131174 | ADDITIONAL LEVELS; LUMBAR/SACRAL (ADD O | 500.00 |
| 131172 | ADDITL LEVELS; CERVICAL/THORACIC (ADD O | 500.00 |
| 3022979 | ADENOCARD 6MG/2ML INJ | 157.40 |
| 790985 | ADENOVIRUS (PCR) | 100.00 |
| 798000 | ADENOVIRUS ANTIBODY | 105.00 |
| 380163 | ADJACENT TISSUE TRSF;FOREHEAD;CHEEKS;CHI | 1,739.95 |
| 1403695 | ADRENALECTOMY | 89.80 |
| 3015049 | ADULT DT SYR(TET/DIPHTHERIA TOXOID) | 90.70 |
| 3030961 | ADVAIR DISKUS 100/50 14 DOSE | 115.40 |
| 3030958 | ADVAIR DISKUS 250/50 14 DOSE | 115.40 |
| 3030953 | ADVAIR DISKUS 500/50 14 DOSE | 115.40 |
| 791448 | AEROBIC BACTERIA ID (REF MAYO) | 126.00 |
| 3024892 | AEROCHAMBER HOLDING CHAMBER: | 45.60 |
| 3000165 | AFRIN NASAL SPRAY 30ML | 15.00 |
| 3030853 | AGGRENOX 200/25MG CAP | 2.00 |
| 581181 | AIR ANKLE STIRRUP UNVERSAL | 27.80 |
| 581179 | AIR CAST ANKLE RIGHT | 252.60 |
| 501047 | AIR TRAQ | 360.00 |
| 710004 | AIRTIME FEES | 30.50 |
| 18008 | AIRWAY INHALATION TREATMENT | 91.50 |
| 18007 | AIRWAY INITIAL TREATMENT, SUBS | 91.50 |
| 517571 | AIRWAY RETRIEVAL BASKET ZERO TIP | 794.00 |
| 517572 | AIRWAY RETRIEVAL BASKET ZERO TIP | 794.00 |
| 18569 | AIRWAY TX SUBS 1ST DRUG | 91.50 |
| 18571 | AIRWAY TX SUBS 2ND DRUG | 57.40 |
| 18572 | AIRWAY TX SUBS 3RD DRUG | 57.40 |
| 5501005 | AIRWAYS BERMAN 100MM | 3.50 |
| 5501002 | AIRWAYS BERMAN 60MM | 3.50 |
| 5501003 | AIRWAYS BERMAN 80MM | 3.50 |
| 5501004 | AIRWAYS BERMAN 90MM | 3.50 |
| 791019 | ALA (AMINOLEVULINIC ACID)(RANDOM URINE) | 70.00 |
| 790874 | ALA-DEHYDRATASE (ALA-D)(WHOLE BLOOD) | 280.00 |
| 330103 | ALBUMIN | 34.00 |
| 310468 | ALBUMIN(HUMAN)25% 50ML | 391.05 |
| 3025600 | ALCAINE (PROPARACAINE) 0.5% OPH 15ML | 10.00 |
| 330715 | ALCOHOL (ETOH) | 145.00 |
| 791043 | ALCOHOL (URINE) | 145.00 |
| 1311 | ALCOHOL SUBSTANCE ASSESSMENT | 400.00 |
| 1312 | ALCOHOL SUBSTANCE ASSESSMENT | 400.00 |
| 16126 | ALCOHOL SUBSTANCE ASSESSMENT | 400.00 |
| 16127 | ALCOHOL SUBSTANCE ASSESSMENT | 400.00 |
| 790204 | ALDOLASE | 55.00 |
| 3000231 | ALDOMET (METHYLDOPA) 250MG TAB | 2.00 |
| 790601 | ALDOSTERONE (SERUM) | 180.00 |
| 3078304 | ALIMTA IV POWDER FOR SOLUTION 100MG | 1,517.76 |
| 307789 | ALINIA (NITAZOXANIDE) 500MG TAB | 169.90 |
| 790375 | ALK PHOS TOTAL&ISOENZYMES | 60.00 |
| 330111 | ALK PHOSPHATASE | 60.00 |
| 303713 | ALKA-SELTZER GOLD (2) TABS | 2.00 |
| 596385 | ALLEVYN DRSG 3X33 | 45.20 |
| 3015031 | ALLOPURINOL (ZYLOPRIM) 100MG TAB | 2.00 |
| 3015023 | ALLOPURINOL (ZYLOPRIM) 300 MG TAB | 2.00 |
| 5596578 | ALOE VESTA 2N1 ANTIFUNGAL OINTMENT | 30.30 |
| 5596577 | ALOE VESTA 2N1 PROTECTIVE OINTMENT | 30.30 |
| 5596580 | ALOE VESTA 2N1 SKIN CONDITIONER | 65.70 |
| 5596575 | ALOE VESTA 3N1 CLEANSER FOAM | 67.10 |
| 3032544 | ALOXI (PALONOSETRON) 0.25MG/5ML INJ | 1,105.20 |
| 790703 | ALPHA-1-ANTITRYPSIN (PHENOTYPE) | 103.00 |
| 790026 | ALPHA-1-ANTITRYPSIN (TOTAL) | 103.00 |
| 791548 | ALPHA-1-MACROGLOBULIN | 508.00 |
| 790383 | ALPHA-FETOPROTEIN (AFP) (SERUM) | 98.00 |
| 791400 | ALPHA-GALACTOSIDASE (SERUM) | 1,054.00 |
| 3030261 | ALPHAGAN 0.15% OPHTH SOLN 5ML | 82.90 |
| 791264 | ALPHA-SUBUNIT PITUITARY TUMOR MARKER | 78.00 |
| 3018332 | ALPRAZolam 0.25MG TAB | 2.00 |
| 3014836 | ALPRAZolam TAB 0.5MG | 2.00 |
| 22170 | ALS EMERGENCY | 1,002.00 |
| 22204 | ALS MILEAGE | 23.50 |
| 22188 | ALS NON EMERGENCY | 633.00 |
| 330392 | ALT (SGPT) | 40.00 |
| 3031665 | ALTACE (RAMIPRIL) 1.25MG CAP | 2.00 |
| 3025626 | ALTACE (RAMIPRIL) 2.5MG CAP | 2.00 |
| 3019850 | ALTERNAGEL (ALUMINUM HYDOXIDE)120Z SUSP. | 10.00 |
| 790385 | ALUMINUM | 69.00 |
| 3031798 | AMARYL (GLIMEPIRIDE) 2MG TAB | 2.00 |
| 3026327 | AMBIEN (ZOLPIDEM) 5MG TAB | 2.00 |
| 515288 | AMBIT FENESTRATED CATH 3 19GAX 36 | 468.00 |
| 515290 | AMBIT PAIN FUSOR CATHETER | 263.00 |
| 515289 | AMBIT PAIN KIT/MEDIBAG & SHIPPER | 1,185.00 |
| 508447 | AMBU BAG ADULT DISP BVM | 43.00 |
| 509684 | AMBU BAG CHILD DISP | 124.00 |
| 514932 | AMBU BAG INFANT DISP | 61.00 |
| 3000405 | AMERICAINE AERO 57 GM | 10.00 |
| 3032554 | AMIDATE (ETOMIDATE) 2MG/ML : 20ML | 136.50 |
| 791327 | AMIKACIN (PEAK) | 90.00 |
| 791289 | AMIKACIN (RANDOM) | 90.00 |
| 791328 | AMIKACIN (TROUGH) | 90.00 |
| 3077976 | AMIKACIN SULFATE INJECTION 500MG/2ML | 47.20 |
| 790910 | AMINO ACIDS (QUANT)(PLASMA) | 100.00 |
| 798002 | AMIODARONE | 105.00 |
| 3025113 | AMIODARONE 200MG TAB | 2.00 |
| 303758 | AMIODARONE 150MG/100ML **PREMIXED** | 201.15 |
| 303759 | AMIODARONE 360MG/200ML **PREMIXED** | 151.25 |
| 3077814 | AMITIZA (LUBIPROSTONE) 8MCG GCP | 2.00 |
| 303372 | AMITIZA 24MCG CAPS | 2.00 |
| 3004647 | AMITRIPTYLINE 25MG TAB | 2.00 |
| 3025097 | amLODIPine 10MG TAB | 2.00 |
| 3025071 | amLODIPine 5MG TAB | 2.00 |
| 790862 | AMMONIA (NH3) | 151.00 |
| 3025592 | AMMONIA INHALANT | 2.00 |
| 1403604 | AMNIOCENTESIS | 89.80 |
| 570012 | AMNISURE | 314.00 |
| 3017565 | AMOXICILLIN 250MG CAP | 2.00 |
| 3015452 | AMOXICILLIN 875MG TABLET | 2.00 |
| 3019538 | AMOXICILLIN SUSP 400MG/5ML 50ML | 10.00 |
| 790124 | AMPAR-AB CBA | 75.00 |
| 3077852 | AMPHETAMINE MIXED 10MG TAB | 3.00 |
| 790117 | AMPHIPHYSIN ANTIBODY | 75.00 |
| 3009570 | AMPICILLIN VIAL :2GM | 101.45 |
| 3009554 | AMPICILLIN VIAL: 500MG | 29.40 |
| 3009562 | AMPICILLIN VIAL:1GM | 33.30 |
| 1404123 | AMPUTATION LEG | 89.80 |
| 137070 | AMPUTATION, FINGER, THUMB PRIMARY | 1,181.05 |
| 93081 | AMPUTATION, TOE METATARLSOPHALANGEAL | 1,100.00 |
| 131151 | AMPUTATION, TOE, METATARLSOPHALANGEAL JO | 2,000.00 |
| 330129 | AMYLASE | 62.00 |
| 791261 | ANA IFA (W/REFLEX) | 100.00 |
| 798030 | ANAEROBIC BACT SUSCEPTABILITY (REF MAYO) | 100.00 |
| 791461 | ANAEROBIC BACTERIAL ID (REF MAYO) | 178.00 |
| 791484 | ANAEROBIC BACTERIAL ID (REF) | 30.00 |
| 791462 | ANAEROBIC ID POS RODS & SE (REF MAYO) | 314.00 |
| 790206 | ANCA (C-ANCA & P-ANCA) | 78.00 |
| 798005 | ANCA SCREEN (W/REFLEX) | 78.00 |
| 310118 | ANCEF 1 GRAM/ NS 50ML: (PREMIXED BAG) | 61.85 |
| 310120 | ANCEF 2 GRAMS/NS 50ML:PREMIXED | 61.85 |
| 512086 | ANCHOR/SUTURE TAK ARTHREX | 975.00 |
| 3077831 | AndroGel (testosterone gel) 1.62% 60 DOS | 470.10 |
| 790878 | ANDROSTENEDIONE | 169.00 |
| 3023803 | ANERGY SCREEN: | 26.00 |
| 512788 | ANES CIRCUIT, ADULT FLEX CIRCUIT | 31.00 |
| 512789 | ANES CIRCUIT, PEDIATRIC FLEX CIRCUIT | 31.60 |
| 517061 | ANESTHESIA EPIDURAL SET GEMSTAR | 47.00 |
| 596091 | ANGIOCATH 12 GA X 3.00 | 104.00 |
| 596090 | ANGIOCATH 14 GA X 3.25 | 106.00 |
| 596089 | ANGIOCATH 16 GA X 3.25 | 97.00 |
| 596071 | ANGIOCATH 20 GA. 1.88 | 46.00 |
| 131188 | ANGIOGRAM; EXTREMITY | 435.00 |
| 1404412 | ANK/FOOT/LOW LEG OPE | 89.80 |
| 1504412 | ANK/FOOT/LOW LEG OPE | 89.80 |
| 137046 | ANKLE ARTHROSCOPY WITH DEPRIDEMENT | 874.80 |
| 240506 | ANKLE LEFT 2 VIEWS | 189.70 |
| 240514 | ANKLE LFT 3+ VIEWS | 245.90 |
| 507156 | ANKLE ORTHOSIS | 130.00 |
| 240507 | ANKLE RIGHT 2 VIEWS | 237.50 |
| 240515 | ANKLE RIGHT 3 VIEWS | 245.90 |
| 1404370 | ANKLE/ARTHROSCOPIC | 89.80 |
| 1404438 | ANKLE/TOTAL/REPLACEM | 89.80 |
| 134378 | ANORECTAL EXAM UNDER ANESTHESIA | 545.00 |
| 1403752 | ANORECTAL/PROCEDURE | 98.40 |
| 1503752 | ANORECTAL/PROCEDURE | 98.40 |
| 13111 | ANOSCOPY | 435.00 |
| 380148 | ANOSCOPY AND PROCTOSCOPY | 310.00 |
| 131164 | ANOSCOPY DIAGNOSTIC | 689.00 |
| 710008 | ANSWERING SERVICE | 135.00 |
| 137005 | ANTERIOR CERVICAL DISCECTOMY AND FUSION | 596.90 |
| 137004 | ANTERIOR CERVICAL DISCECTOMY AND FUSION | 774.80 |
| 137002 | ANTERIOR CERVICAL DISCECTOMY AND FUSION | 2,375.75 |
| 137003 | ANTERIOR CERVICAL DISCECTOMY AND FUSION | 2,903.55 |
| 13114 | ANTERIOR COLPORRHAPY | 1,517.00 |
| 1403976 | ANTERIOR/INTEGUMENTA | 98.40 |
| 790793 | ANTIBODY ELUTION (RBC), EACH ELUTION | 85.00 |
| 790417 | ANTIBODY IDENTIFICATION (EACH) | 84.00 |
| 790671 | ANTI-CCP | 59.00 |
| 791297 | ANTI-CENTROMERE AB (POS/NEG) | 397.00 |
| 790116 | ANTI-GLIAL NUCLEAR AB, TYPE 1 | 75.00 |
| 791306 | ANTIMULLERIAN HORMONE (AMH) | 441.00 |
| 790118 | ANTI-NEURONAL AB, TYPE 1 | 75.00 |
| 790119 | ANTI-NEURONAL AB, TYPE 2 | 75.00 |
| 790120 | ANTI-NEURONAL AB, TYPE 3 | 75.00 |
| 790835 | ANTI-SMITH SM | 130.00 |
| 798008 | ANTI-SMOOTH MUSCLE | 91.00 |
| 798009 | ANTITHROMBIN 3 (FUNCTIONAL) | 50.00 |
| 791314 | ANTITHROMBIN ANTIGEN | 84.00 |
| 303528 | ANUSOL (HYDROCORTISONE)1% 20G | 10.00 |
| 3016104 | ANUSOL HC (HYDROCORTISONE)2.5% CR | 10.00 |
| 3000645 | ANUSOL-HC SUPP: | 2.00 |
| 303412 | APIDRA(INSULIN GLULISINE) 100UNIT/ML | 39.80 |
| 136175 | APPENDECTOMY, LAPROSCOPIC | 2,000.00 |
| 136506 | APPENDECTOMY, OPEN | 2,000.00 |
| 136514 | APPENDECTOMY, OPEN +30 | 3,542.00 |
| 136522 | APPENDECTOMY, OPEN +60 | 5,084.00 |
| 16136 | APPLICATION CAST FIGURE OF EIGHT | 168.00 |
| 170504 | APPLICATION CAST FIGURE OF EIGHT | 251.00 |
| 137056 | APPLICATION OF MULTIPLANE PIN | 4,838.44 |
| 16138 | APPLY PLASTER VALPEAU | 330.00 |
| 170508 | APPLY PLASTER VALPEAU | 450.00 |
| 16600 | APPLY SHOULDER TO HAND | 230.00 |
| 170505 | APPLY SHOULDER TO HAND | 306.00 |
| 3019322 | APRESOLINE (hydrALAZINE) 10MG TAB | 2.00 |
| 3000686 | APRESOLINE (hydrALAZINE) 25MG TAB | 2.00 |
| 3000694 | APRESOLINE (HYDRALAZINE) 50MG TAB | 4.20 |
| 3000678 | APRESOLINE (hydrALAZINE)20MG/ML INJ | 88.55 |
| 515711 | AQUACEL 4X4 W/ SILVER | 46.00 |
| 515712 | AQUACEL AG DRESSING 2CM X 45 CM ROPE | 52.25 |
| 3000710 | AQUA-MEPHYTON(VIT.K) :10MG/ML 1ML INJ | 169.60 |
| 3000702 | AQUA-MEPHYTON(VIT.K):1MG/0.5ML | 29.40 |
| 303504 | ARANESP 100MCG (CHEMO INDUCED ANEMIA) | 1,875.60 |
| 303503 | ARANESP 100MCG (NON-CHEMO ANEMIA) | 1,875.60 |
| 303506 | ARANESP 200MCG (CHEMO INDUCED ANEMIA) | 3,751.20 |
| 303505 | ARANESP 200MCG (NON-CHEMO ANEMIA) | 3,751.20 |
| 303499 | ARANESP 25MCG (NON-CHEMO ANEMIA) | 521.20 |
| 303508 | ARANESP 300MCG (CHEMO INDUCED ANEMIA) | 5,625.00 |
| 303507 | ARANESP 300MCG (NON-CHEMO ANEMIA) | 5,626.00 |
| 303501 | ARANESP 40MCG (NON-CHEMO ANEMIA) | 750.30 |
| 303510 | ARANESP 500MCG (CHEMO INDUCED ANEMIA) | 9,377.90 |
| 303509 | ARANESP 500MCG (NON-CHEMO ANEMIA) | 9,377.90 |
| 3030535 | AREDIA (PAMIDRONATE): 30MG VIAL | 53.20 |
| 791445 | ARGININE VASOPRESSIN (PLASMA) | 148.00 |
| 3030741 | ARIMIDEX (ANASTROZOLE) 1MG TAB | 2.00 |
| 303487 | ARIXTRA (FONDAPARINUX NA) 2.5MG/0.5ML | 214.10 |
| 502036 | ARM SLING CHILD | 8.30 |
| 502044 | ARM SLING SMALL | 7.90 |
| 502069 | ARM SLING UNIVERSAL | 9.60 |
| 502070 | ARM SLING X-LARGE | 53.60 |
| 1404669 | ARM/ELB/NER/MUS/TEN | 89.80 |
| 1404651 | ARM/ELBOW/UP/INTEGU | 98.40 |
| 3013507 | ARMOUR THYROID TAB 30MG | 2.00 |
| 3013515 | ARMOUR THYROID TAB 60MG | 2.00 |
| 507548 | ARROW INTRODUCER KIT | 253.00 |
| 507555 | ARROW MULTILUMEN KIT | 342.50 |
| 790720 | ARSENIC | 107.00 |
| 1405040 | ARTERIAL CATHERIZATION OR CANNULATION | 98.40 |
| 1404313 | ARTERIOVENOUS/FISTUL | 89.80 |
| 1404172 | ARTERY/UPPER/LEG/BIP | 89.80 |
| 137059 | ARTHOSCOPY OF ANKLE DEPRI EXT | 2,275.00 |
| 241451 | ARTHROGRAPHY/SHOULDER | 724.40 |
| 13112 | ARTHROPLASTY LEFT TOTAL KNEE | 5,800.00 |
| 136597 | ARTHROPLASTY RIGHT TOTAL KNEE | 5,800.00 |
| 501919 | ARTHROSCOPY – ANKLE | 2,700.00 |
| 574098 | ARTHROSCOPY- ANKLE | 2,295.00 |
| 93076 | ARTHROSCOPY DEBRIDEMENT LIMITED | 1,967.00 |
| 501889 | ARTHROSCOPY- KNEE | 2,228.00 |
| 501893 | ARTHROSCOPY- KNEE TECHNICIAN DISCOUNT | 1,855.50 |
| 136563 | ARTHROSCOPY OF ANKLE DEPRI EXT | 2,000.00 |
| 501900 | ARTHROSCOPY SHAVER BLADES | 375.00 |
| 574095 | ARTHROSCOPY- SHOULDER | 1,620.00 |
| 501910 | ARTHROSCOPY- SHOULDER | 4,185.00 |
| 93074 | ARTHROSCOPY SHOULDER DIAGNOSTIC | 1,343.00 |
| 131144 | ARTHROSCOPY SHOULDER DIAGNOSTIC | 2,750.00 |
| 501901 | ARTHROSCOPY TUBING | 325.00 |
| 131162 | ARTHROSCOPY W/MENISECTOMY MEDIAL OR LATE | 2,000.00 |
| 137055 | ARTHROSCOPY, SHOULDER LIGAMENT RELEASE | 975.60 |
| 137053 | ARTHROSCOPY, SHOULDER, SURGICAL DECOMPRE | 814.80 |
| 93082 | ARTHROTOMY ELBOW INCLUD EXPLORATION | 1,580.00 |
| 131152 | ARTHROTOMY ELBOW INCLUD. EXPLORATION | 2,000.00 |
| 3017193 | ARZOL (SILVER NITRATE) STICK: | 2.00 |
| 3016138 | ASCORBIC ACID (VIT.C) 500MG TAB | 2.00 |
| 330076 | ASO TITER (ANTISTREPTOLOLYSIN O) | 61.00 |
| 3027705 | ASPERCREME 3OZ CR | 10.00 |
| 790753 | ASPERGILLUS (GALACTOMANNAN) AG | 196.00 |
| 791005 | ASPERGILLUS (IGE) FUMIGATUS | 25.00 |
| 791006 | ASPERGILLUS (IGE) NIGER | 144.00 |
| 790068 | ASPERGILLUS (IGG) FUMIGATUS | 92.00 |
| 16929 | ASPIR ABSCESS/HEMA COMP | 235.30 |
| 171085 | ASPIR ABSCESS/HEMA COMP | 707.24 |
| 16928 | ASPIR ABSCESS/HEMA SIMPLE | 235.30 |
| 171084 | ASPIR ABSCESS/HEMA SIMPLE | 707.24 |
| 509817 | ASPIRATION SET ENDO CYST | 714.00 |
| 3000801 | ASPIRIN 325MG TAB | 0.50 |
| 3001197 | ASPIRIN 81MG CHEWABLE TABLET | 0.50 |
| 3000819 | ASPIRIN EC 325MG TAB | 0.50 |
| 3030904 | ASPIRIN EC 81MG TAB | 0.50 |
| 3000876 | ASPIRIN SUPP(EMPIRIN) 300MG | 2.00 |
| 16399 | ASSESSMENT/EMTALA W/ PROVIDER | 15.00 |
| 330384 | AST (SGOT) | 34.00 |
| 3031707 | ATACAND (CANDESARTAN) 16MG TAB | 2.00 |
| 3000918 | ATARAX (hydrOXYzine) 10MG TAB | 2.00 |
| 3013085 | ATENOLOL 50MG TAB | 2.00 |
| 3028851 | ATENOLOL 25MG TAB | 2.00 |
| 500031 | ATHLETIC SUPPORTER XL | 43.00 |
| 303399 | ATIVAN (LORazepam) 0.5MG TAB | 2.00 |
| 3000975 | ATIVAN (LORazepam) 1MG TAB | 2.00 |
| 3000959 | ATIVAN (LORazepam) VIAL 2MG/ML 1ML | 29.40 |
| 513894 | ATOMIZER LMA MAD NASAL/ORAL W/3ML SYR. | 41.00 |
| 3029149 | ATROPINE DROPS(ISOPTO ATROPINE) 1% 5ML | 50.00 |
| 3001023 | ATROPINE SULFATE 0.4MG/ML 1ML INJ | 29.40 |
| 3023449 | ATROPINE SULFATE(0.1MG/ML)10ML SYRINGE | 55.90 |
| 3031042 | ATROVENT (IPRATROPIUM) 0.5MG/2.5ML NEB | 2.00 |
| 3019983 | ATROVENT (IPRATROPIUM) 12.9G INHALER | 169.20 |
| 3031013 | ATROVENT 0.06% NASAL SPRAY 15ML | 40.40 |
| 3031368 | AUGMENTIN (AMOX/CALV) 400MG/5ML 75ML SUS | 20.00 |
| 3024215 | AUGMENTIN (AMOX/CLAV) 500MG TAB | 2.00 |
| 3029073 | AUGMENTIN 875(AMOX-CLAV 875-125MG)TAB | 2.00 |
| 3031026 | AUGMENTIN ES-600MG/5ML 75ML | 15.00 |
| 3031151 | AUGMENTIN XR (AMOX/CLAV) 1000MG TAB | 2.00 |
| 578508 | AUSTIN MOORE HIP 50 | 3,105.00 |
| 514044 | AUSTIN MOORE HIP 52 | 2,649.00 |
| 514045 | AUSTIN MOORE HIP 54 | 3,188.00 |
| 137058 | AUTHROSCOPY KNEE REMOVAL OF FOREIGN BODY | 5,480.00 |
| 36082 | AUTO BLOOD | 306.70 |
| 791641 | AUTOLOGOUS TRANSPLANTATION | 314.00 |
| 3030915 | AVAPRO (IRBESARTAN) 150MG TAB | 2.00 |
| 3078288 | AVASTIN INTRAVENOUS SOL 25MG/1ML 100MG | 2,077.20 |
| 303336 | AVODART (DUTASTERIDE) 0.5MG CAP | 2.00 |
| 16018 | AVULSION OF NAIL PLATE | 160.00 |
| 171079 | AVULSION OF NAIL PLATE | 245.00 |
| 380149 | AVULSION OF TOENAIL | 245.00 |
| 574710 | AWL,TAPERED 3.8MM | 241.00 |
| 1404610 | AXILL/FEM/BYPAS/GRAF | 89.80 |
| 1404628 | AXILLA/SHOULDER/VEIN | 89.80 |
| 1404594 | AXILLARY/BRACH/ANEU | 89.80 |
| 3029503 | AYR NASAL GEL | 10.00 |
| 303686 | AYR SALINE BABY SPRAY/DROPS 30ML | 10.00 |
| 303536 | AYR SALINE NASAL SPRAY/DROPS 30ML | 10.00 |
| 303488 | AZACTAM (AZTREONAM) 1GM/50ML FROZEN | 128.10 |
| 303489 | AZACTAM (AZTREONAM) 2GM/50ML FROZEN | 231.90 |
| 3019769 | AZACTAM VIAL(AZTREONAM):1GM | 134.00 |
| 3019777 | AZACTAM VIAL(AZTREONAM):2GM | 279.60 |
| 303458 | AZOPT 1% (BRINZOLAMIDE) OPHTH SOLN | 140.30 |
| 3001106 | AZULFIDINE TAB(sulfASALAZINE) 500MG | 2.00 |
| 3009604 | B&0 SUPP(OPIUM 60MG W/BELLADONNA): | 30.00 |
| 330318 | B12 (COBALAMIN) | 160.00 |
| 514012 | BABCOCK 5MM | 145.50 |
| 3026087 | BACITRACIN OINTMENT 0.5oz 15gm | 15.00 |
| 3031121 | BACITRACIN 50,000 UNITS:VIAL | 53.55 |
| 516649 | BACK BRACE L/S SUPPORT | 476.00 |
| 331442 | BACTERIAL IDENTIFICATION (AEROBIC) | 70.00 |
| 3011907 | BACTRIM (SEPTRA) 30ML ORAL SUSP | 6.00 |
| 3011915 | BACTRIM (SEPTRA)ORAL SUSP: 10ML | 2.00 |
| 3001122 | BACTRIM DS TABLET (SULFAMET./TRIMETHOP): | 2.00 |
| 3025063 | BACTROBAN 22GM OINT | 15.00 |
| 3030937 | BAGBALM OINTMENT 8 OZ | 16.00 |
| 578548 | BAKER TWIN CUFF 20 FR | 475.00 |
| 515226 | BAKRI BALLOON OB | 370.00 |
| 515266 | BAKRI BALLOON OB | 700.00 |
| 501914 | BALL TIP PROBE | 500.00 |
| 502268 | BAND IT TENNIS ELBOW | 57.11 |
| 507522 | BANDAGE ROLL 4 X10 YD | 29.50 |
| 514067 | BANDAGE ROLL STRIP | 7.20 |
| 5448047 | BANDAGE TRIANGULAR -AMBULANCE | 511.30 |
| 798105 | BARTONELLA (PCR) | 300.00 |
| 578628 | BASIC LAPROTOMY PACK | 346.00 |
| 501915 | BAYONET KNIFE | 1,172.00 |
| 330087 | BB ANTIBODY SCREEN | 106.00 |
| 330061 | BB BLOOD TYPE (ABO) | 32.00 |
| 331036 | BB COLD AGGLUTININ SCREEN | 50.00 |
| 330055 | BB CROSSMATCH (PRBC) | 147.00 |
| 330038 | BB DIRECT COOMBS (DAT) | 46.00 |
| 791555 | BB FETAL BLEED SCREEN (ROSETTE) | 95.00 |
| 791046 | BB FETALDEX (KLEINHAUER-BETKE STAIN) | 80.00 |
| 331523 | BB RH TYPE | 66.00 |
| 36090 | BBB APHERESIS PLATELET | 994.00 |
| 791252 | BBB BLOOD TYPE DONOR UNIT (CHARGE) | 32.00 |
| 791022 | BBB CMV NEGATIVE UNIT (CHARGE) | 125.00 |
| 331531 | BBB CROSSMATCH 37 INCUBATE (EACH) | 34.00 |
| 330053 | BBB CROSSMATCH AHG (EACH) | 80.00 |
| 36033 | BBB FRESH FROZEN UNIT | 86.00 |
| 790203 | BBB IRRADIATION OF BLOOD UNIT (CHARGE) | 125.00 |
| 36074 | BBB LEUKO-DEP BLOOD UNIT (CHARGE) | 507.00 |
| 330056 | BBB REFERENCE LAB CROSSMATCH CHARGE | 147.00 |
| 791546 | BBB TRANSFUSION RX WORKUP (DAT) | 25.00 |
| 791361 | BCR/ABL1 (P190)(QUANT)(MINOR)(RT-PCR) | 1,156.00 |
| 790859 | BCR/ABL1 (P210)(QUANT)(MAJOR)(RT-PCR) | 1,218.00 |
| 790951 | BCR/ABL1 TRANS FISH (MAYO 922F) | 294.00 |
| 5493098 | BEARS RT | 13.70 |
| 3029313 | BENADRYL (diphenhydAMINE) 2% 28.3GM CR | 10.00 |
| 3001304 | BENADRYL CAP(diphenhydrAMINE)25MG | 2.00 |
| 3001312 | BENADRYL ELIX(diphenhydrAMINE)12.5mg/5ml | 2.00 |
| 3001254 | BENADRYL INJ(diphenhydrAMINE):50MG/1ML | 29.40 |
| 3031091 | BENICAR (OLMESARTAN) 20MG TAB | 2.00 |
| 3001387 | BENTYL (DICYCLOMINE) 10MG CAP | 2.00 |
| 3001346 | BENTYL AMP(DICYCLOMINE) 20MG/2ML | 168.30 |
| 3001460 | BENZOIN TINTURE OF CMPD 30ML | 10.00 |
| 514036 | BERKLEY COLLECTION SYSTEM | 171.00 |
| 514035 | BERKLEY CONNECTING HOSE 18 | 31.00 |
| 514033 | BERKLEY DISP COLL SET | 94.00 |
| 3077985 | BESIVANCE OPHTHALMIC SUSP 0.6% 5ML | 134.50 |
| 791397 | BETA LACTAMASE (ENZYME DETECTION) | 89.00 |
| 790602 | BETA-2 MICROGLOBULIN | 104.00 |
| 3001486 | BETADINE OINT 30GM | 10.00 |
| 3026293 | BETAGEN OPTH SOLN 0.5% 5ML | 25.00 |
| 790092 | BETA-HCG TUMOR MARKER (QUANT) | 116.00 |
| 790839 | BETA-HYDROXYBUTYRATE | 100.00 |
| 3030866 | BETAPACE (SOTALOL) 80MG TAB | 2.00 |
| 3020536 | BETOPTIC DROP 0.5% 5ml | 25.00 |
| 3032408 | BETOPTIC S(BETAXOLOL) 0.25% 10ML OPHTH | 287.70 |
| 3078124 | BEXSERO IM SUSPENSION 175MCG/0.5ML | 388.80 |
| 37303 | BH DIAGNOSTIC EVALUATION | 369.00 |
| 1404693 | BICEPS/TENDONESIS | 89.80 |
| 3001627 | BICILLIN L-A 1.2 MMU 2ML | 254.90 |
| 791044 | BILE ACIDS (TOTAL) | 68.00 |
| 506581 | BILE BAGS | 42.00 |
| 240575 | BILE DUCTS/PANCREAS ADD’L SET SI | 274.60 |
| 240571 | BILE DUCTS/PANCREAS SI | 284.40 |
| 240605 | BILE DUCTS/PANCREASE THRU CATHETER SI | 429.30 |
| 100017 | BILI LIGHT/ DAY | 59.80 |
| 330137 | BILIRUBIN (DIRECT) | 41.00 |
| 330145 | BILIRUBIN (TOTAL) | 66.00 |
| 137024 | BIMALLEOLAR ANKLE FRACTURE | 571.80 |
| 137025 | BIMALLEOLAR ANKLE FRACTURE | 867.10 |
| 137026 | BIMALLEOLAR ANKLE FRACTURE (OPEN) | 1,952.50 |
| 16071 | BIMALLEOLAR NO MANIPULATION | 972.00 |
| 171139 | BIMALLEOLAR NO MANIPULATION | 1,225.00 |
| 16072 | BIMALLEOLAR W/ MANIPULATION | 1,555.00 |
| 171140 | BIMALLEOLAR W/ MANIPULATION | 2,185.00 |
| 501817 | BIO PATCH BLUE | 38.00 |
| 515701 | BIOPSY BONE NEEDLE SET X-RAY | 1,171.00 |
| 131218 | BIOPSY BREAST OPEN INCISIONAL | 435.00 |
| 579082 | BIOPSY CELERO TITAN BIOPSY SIT MARKER | 388.00 |
| 579081 | BIOPSY CELERO INTRODUCER 12GA | 100.00 |
| 507333 | BIOPSY FORCEPS DISPOSABLE | 59.00 |
| 507334 | BIOPSY FOREIGN BODY GRASPER | 232.50 |
| 242304 | BIOPSY KIDNEY | 897.00 |
| 242296 | BIOPSY LIVER | 897.00 |
| 242312 | BIOPSY LUNG | 897.00 |
| 242305 | BIOPSY LYMPH NODE | 897.00 |
| 13010 | BIOPSY OF EXTERNAL EAR | 269.00 |
| 131128 | BIOPSY OF SKIN, SUBCU | 435.00 |
| 242320 | BIOPSY PANCREAS | 897.00 |
| 509006 | BIOPSY SET GREEN -X-RAY | 192.00 |
| 380165 | BIOPSY SKIN LESION | 235.75 |
| 579083 | BIOPSY SS VACUUM SPRING LOADED CORE | 735.00 |
| 1403265 | BIOPSY/CLAVICLE | 89.80 |
| 1503265 | BIOPSY/CLAVICLE | 89.80 |
| 1403091 | BIOPSY/SOFT/TISSUE | 89.80 |
| 1503091 | BIOPSY/SOFT/TISSUE | 89.80 |
| 18135 | BI-PAP/CPAP | 443.70 |
| 54251 | BIPOLAR CUT FORCEPS | 931.70 |
| 136035 | BI-POLAR HIP REPL D | 6,264.80 |
| 136043 | BI-POLAR HIP REPL E | 6,620.50 |
| 791253 | BK VIRUS PCR (QUANT) | 372.00 |
| 16014 | BLADDER IRRIGATION SIMPLE | 265.40 |
| 171076 | BLADDER IRRIGATION SIMPLE | 347.00 |
| 508787 | BLADE DISPOS NON-SHARPOINT CATARACT | 90.00 |
| 508198 | BLADE MINI/KNIFE OR | 110.00 |
| 508992 | BLAKEMORE TUBE 16FR | 1,114.00 |
| 798079 | BLASTOMYCES AB (IMMUNODIFFUSION)(SERUM) | 104.00 |
| 3024298 | BLEOMYCIN SULFATE(BLENOXANE) 15UNITS | 953.75 |
| 134394 | BLEPHARPLASTY | 1,090.00 |
| 1302 | BLOOD ADMINISTRATION 2 UNITS | 900.00 |
| 1303 | BLOOD ADMINISTRATION 3 UNITS | 1,100.00 |
| 1304 | BLOOD ADMINISTRATION 4 UNITS | 1,300.00 |
| 1305 | BLOOD ADMINISTRATION 5 UNITS | 1,500.00 |
| 1306 | BLOOD ADMINISTRATION 6 UNITS | 1,700.00 |
| 1307 | BLOOD ADMINISTRATION 7 UNITS | 1,900.00 |
| 1308 | BLOOD ADMINISTRATION 8 UNITS | 2,100.00 |
| 1301 | BLOOD ADMINISTRATION 1 UNIT | 700.00 |
| 1310 | BLOOD ADMINISTRATION 10 UNITS | 2,500.00 |
| 1309 | BLOOD ADMINISTRATION 9 UNITS | 2,300.00 |
| 514037 | BLOOD BAG SINGLE | 100.00 |
| 11130 | BLOOD COLLECTION IMPLANTED VAD | 74.90 |
| 11170 | BLOOD COLLECTION TUNNELED VAD | 74.90 |
| 509932 | BLOOD FLUID TUBING | 70.00 |
| 131148 | BLOOD PATCH | 435.00 |
| 1405054 | BLOOD PATCH | 701.10 |
| 509933 | BLOOD SOLUTION SET Y-TYPE PRESSURE PUMP | 37.00 |
| 3011071 | BLOXIVERZ(NEOSTIGMINE) 1mg/ml per | 17.20 |
| 22832 | BLS EMERGENCY | 843.00 |
| 22212 | BLS MILEAGE | 23.50 |
| 22840 | BLS NON EMERGENCY | 527.00 |
| 22205 | BLS NON TRANSPORT | 200.00 |
| 331997 | BNP (B-TYPE NAT. PEPTIDE) | 175.00 |
| 790747 | BODY FLUID AMYLASE | 93.00 |
| 798019 | BODY FLUID CELL COUNT W/DIFF | 29.00 |
| 790103 | BODY FLUID CHLORIDE | 10.00 |
| 790109 | BODY FLUID CREATININE | 25.00 |
| 790002 | BODY FLUID CRYSTALS | 23.00 |
| 790458 | BODY FLUID GLUCOSE | 14.00 |
| 790080 | BODY FLUID LDH | 30.00 |
| 790749 | BODY FLUID LIPASE | 39.00 |
| 790742 | BODY FLUID PH | 21.00 |
| 791274 | BODY FLUID PROTEIN | 28.00 |
| 790750 | BODY FLUID SPECIFIC GRAVITY | 30.00 |
| 790100 | BODY FLUID URIC ACID | 32.00 |
| 512283 | BODY FLUID WARMING CASSETTE | 50.00 |
| 510914 | BODY WARMING COVER FULL | 28.00 |
| 510915 | BODY WARMING COVER LOWER | 34.00 |
| 512282 | BODY WARMING COVER UPPER | 34.00 |
| 1404008 | BODY/CAST/OR/REVISION | 89.80 |
| 568086 | BONE 1/3 TUBULAR PLATE 10 H 121MM SMALL | 180.00 |
| 568072 | BONE 1/3 TUBULAR PLATE 2 H 25MM SMALL | 144.00 |
| 568073 | BONE 1/3 TUBULAR PLATE 3 H 37MM SMALL | 149.00 |
| 568075 | BONE 1/3 TUBULAR PLATE 4 H 49MM SMALL | 177.00 |
| 568077 | BONE 1/3 TUBULAR PLATE 5 H 61MM SMALL | 170.00 |
| 568079 | BONE 1/3 TUBULAR PLATE 6 H 73MM SMALL | 182.00 |
| 568081 | BONE 1/3 TUBULAR PLATE 7 H 85MM SMALL | 175.00 |
| 568083 | BONE 1/3 TUBULAR PLATE 8 H 97MM SMALL | 275.10 |
| 568074 | BONE 3.5MM CLOVERLEAF PLATE 3 HOLE 88MM | 457.00 |
| 568076 | BONE 3.5MM CLOVERLEAF PLATE 4 HOLE 104MM | 491.00 |
| 568085 | BONE 3.5MM COMPRESS PLATE 10 HOLE 121MM | 428.00 |
| 568078 | BONE 3.5MM COMPRESS PLATE 6 HOLE 73MM | 381.00 |
| 568080 | BONE 3.5MM COMPRESS PLATE 7 HOLE 85MM | 397.00 |
| 568082 | BONE 3.5MM COMPRESS PLATE 8 HOLE 97MM | 417.00 |
| 568084 | BONE 3.5MM COMPRESS PLATE 9 HOLE 109MM | 438.00 |
| 240704 | BONE AGE STUDIES | 350.00 |
| 790059 | BONE ALKALINE PHOSPHATASE | 165.00 |
| 509957 | BONE BRUSH | 63.00 |
| 515301 | BONE CALENDAR NAIL 3 HOLE | 1,222.00 |
| 515319 | BONE CALENDAR NAIL 4 HOLE | 1,065.00 |
| 515327 | BONE CALENDAR NAIL 6 HOLE | 1,152.00 |
| 515328 | BONE CALENDAR NAIL 8 HOLE | 1,123.00 |
| 578466 | BONE CANN SCREW 7X100LG | 492.00 |
| 578467 | BONE CANN SCREW 7X105LG | 315.00 |
| 578468 | BONE CANN SCREW 7X110LG | 492.00 |
| 578469 | BONE CANN SCREW 7X115LG | 492.00 |
| 578500 | BONE CANN SCREW 7X40LG | 492.00 |
| 578455 | BONE CANN SCREW 7X45LG | 303.00 |
| 578456 | BONE CANN SCREW 7X50LG | 369.00 |
| 578457 | BONE CANN SCREW 7X55LG | 756.00 |
| 578458 | BONE CANN SCREW 7X60LG | 492.00 |
| 578459 | BONE CANN SCREW 7X65LG | 505.00 |
| 578460 | BONE CANN SCREW 7X70LG | 473.00 |
| 578461 | BONE CANN SCREW 7X75LG | 451.00 |
| 578462 | BONE CANN SCREW 7X80LG | 451.00 |
| 578463 | BONE CANN SCREW 7X85LG | 322.00 |
| 578464 | BONE CANN SCREW 7X90LG | 473.00 |
| 578465 | BONE CANN SCREW 7X95LG | 497.00 |
| 509966 | BONE CEMENT REFOBACIN | 885.00 |
| 514052 | BONE COMP SCR 4.7X32MM2 | 155.00 |
| 568100 | BONE DISTAL LATERAL FIBULAR PLATE 6’4HOL | 1,000.00 |
| 568101 | BONE DISTAL LATERAL FIBULAR PLATE 6’4HOL | 1,294.00 |
| 568102 | BONE DISTAL LATERAL FIBULAR PLATE 6’6HOL | 1,352.00 |
| 568103 | BONE DISTAL LATERAL FIBULAR PLATE 6’6HOL | 1,535.00 |
| 515269 | BONE LAG SCREW 100MM | 750.00 |
| 515277 | BONE LAG SCREW 105MM | 597.00 |
| 515285 | BONE LAG SCREW 110MM | 317.00 |
| 515293 | BONE LAG SCREW 115MM | 317.00 |
| 515210 | BONE LAG SCREW 75MM | 317.00 |
| 515228 | BONE LAG SCREW 80MM | 693.00 |
| 515236 | BONE LAG SCREW 85MM | 901.00 |
| 515244 | BONE LAG SCREW 90MM | 693.00 |
| 515251 | BONE LAG SCREW 95MM | 597.00 |
| 509448 | BONE MAR DR. Q ILLINOIS 15GA ADJ. LENGTH | 49.00 |
| 791640 | BONE MARROW ASPIRATION | 364.00 |
| 93067 | BONE MARROW ASPIRATION | 437.00 |
| 790178 | BONE MARROW ASPIRATION/BIOPSY | 166.00 |
| 131329 | BONE MARROW BIOPSY AND ASPIRATIONS | 436.00 |
| 939394 | BONE MARROW BIOPSY AND ASPIRATIONS | 436.00 |
| 1403980 | BONE MARROW BIOPSY/ASPIRATION | 98.40 |
| 791660 | BONE MARROW BX | 481.00 |
| 509411 | BONE MARROW NEEDLE 16X1 5/16 | 334.00 |
| 509445 | BONE MARROW NEEDLE 18GA | 51.00 |
| 331326 | BONE MARROW SMEAR (INTERPRETATION) | 20.00 |
| 515609 | BONE PLATE CLOVER LEAF 3 HOLE | 426.00 |
| 515616 | BONE PLATE CLOVER LEAF 4 HOLE | 455.00 |
| 578389 | BONE PLATE COMPR BRD 10H | 370.00 |
| 578390 | BONE PLATE COMPR BRD 12H | 400.00 |
| 578391 | BONE PLATE COMPR BRD 14H | 400.00 |
| 510013 | BONE PLATE COMPR BRD 16H | 450.00 |
| 510021 | BONE PLATE COMPR BRD 18H | 490.00 |
| 578386 | BONE PLATE COMPR BRD 7H | 310.00 |
| 578378 | BONE PLATE COMPR NARR 12H | 275.00 |
| 578380 | BONE PLATE COMPR NARR 14H | 335.00 |
| 578381 | BONE PLATE COMPR NARR 15H | 375.00 |
| 578382 | BONE PLATE COMPR NARR 16H | 375.00 |
| 578383 | BONE PLATE COMPR NARR 18H | 384.00 |
| 572368 | BONE PLATE COMPR NARR 2H | 195.00 |
| 578402 | BONE PLATE SEMI-TUBE 10H | 135.00 |
| 578403 | BONE PLATE SEMI-TUBE 11H | 140.00 |
| 578404 | BONE PLATE SEMI-TUBE 12H | 145.00 |
| 578394 | BONE PLATE SEMI-TUBE 2H | 85.00 |
| 578395 | BONE PLATE SEMI-TUBE 3H | 90.00 |
| 578400 | BONE PLATE SEMI-TUBE 8H | 125.00 |
| 578401 | BONE PLATE SEMI-TUBE 9H | 133.00 |
| 578236 | BONE PLUG MEDIUM | 490.00 |
| 578235 | BONE POLY PLUG, 11MM | 248.00 |
| 589015 | BONE SCREW 6.5MM CANN 100MM x 16MM | 472.00 |
| 589031 | BONE SCREW 6.5MM CANN 100MM x 32MM | 472.00 |
| 589016 | BONE SCREW 6.5MM CANN 105MM x 16MM | 472.00 |
| 589032 | BONE SCREW 6.5MM CANN 105MM x 32MM | 472.00 |
| 589017 | BONE SCREW 6.5MM CANN 110MM x 16MM | 472.00 |
| 589033 | BONE SCREW 6.5MM CANN 110MM x 32MM | 472.00 |
| 589018 | BONE SCREW 6.5MM CANN 115MM x 16MM | 472.00 |
| 589034 | BONE SCREW 6.5MM CANN 115MM x 32MM | 472.00 |
| 589019 | BONE SCREW 6.5MM CANN 120MM x 16MM | 472.00 |
| 589035 | BONE SCREW 6.5MM CANN 120MM x 32MM | 472.00 |
| 589001 | BONE SCREW 6.5MM CANN 30MM x 16MM | 472.00 |
| 589002 | BONE SCREW 6.5MM CANN 35MM x 16MM | 472.00 |
| 589003 | BONE SCREW 6.5MM CANN 40MM x 16MM | 475.00 |
| 589004 | BONE SCREW 6.5MM CANN 45MM x 16MM | 472.00 |
| 589020 | BONE SCREW 6.5MM CANN 45MM x 32MM | 472.00 |
| 589005 | BONE SCREW 6.5MM CANN 50MM x 16MM | 472.00 |
| 589021 | BONE SCREW 6.5MM CANN 50MM x 32MM | 472.00 |
| 589006 | BONE SCREW 6.5MM CANN 55MM x 16MM | 472.00 |
| 589022 | BONE SCREW 6.5MM CANN 55MM x 32MM | 472.00 |
| 589007 | BONE SCREW 6.5MM CANN 60MM x 16MM | 472.00 |
| 589023 | BONE SCREW 6.5MM CANN 60MM x 32MM | 472.00 |
| 589008 | BONE SCREW 6.5MM CANN 65MM x 16MM | 472.00 |
| 589024 | BONE SCREW 6.5MM CANN 65MM x 32MM | 472.00 |
| 589009 | BONE SCREW 6.5MM CANN 70MM x 16MM | 673.00 |
| 589025 | BONE SCREW 6.5MM CANN 70MM x 32MM | 472.00 |
| 589010 | BONE SCREW 6.5MM CANN 75MM x 16MM | 673.00 |
| 589026 | BONE SCREW 6.5MM CANN 75MM x 32MM | 472.00 |
| 589011 | BONE SCREW 6.5MM CANN 80MM x 16MM | 673.00 |
| 589027 | BONE SCREW 6.5MM CANN 80MM x 32MM | 472.00 |
| 589012 | BONE SCREW 6.5MM CANN 85MM x 16MM | 673.00 |
| 589028 | BONE SCREW 6.5MM CANN 85MM x 32MM | 472.00 |
| 589013 | BONE SCREW 6.5MM CANN 90MM x 16MM | 673.00 |
| 589029 | BONE SCREW 6.5MM CANN 90MM x 32MM | 472.00 |
| 589014 | BONE SCREW 6.5MM CANN 95MM x 16MM | 673.00 |
| 589030 | BONE SCREW 6.5MM CANN 95MM x 32MM | 472.00 |
| 568033 | BONE SCREW CANC 4.0MM FULL 10MM SMALL | 111.00 |
| 568035 | BONE SCREW CANC 4.0MM FULL 12MM SMALL | 111.00 |
| 568037 | BONE SCREW CANC 4.0MM FULL 14MM SMALL | 111.00 |
| 568039 | BONE SCREW CANC 4.0MM FULL 16MM SMALL | 111.00 |
| 568041 | BONE SCREW CANC 4.0MM FULL 18MM SMALL | 52.00 |
| 568043 | BONE SCREW CANC 4.0MM FULL 20MM SMALL | 52.00 |
| 568045 | BONE SCREW CANC 4.0MM FULL 22MM SMALL | 52.00 |
| 568047 | BONE SCREW CANC 4.0MM FULL 24MM SMALL | 52.00 |
| 568049 | BONE SCREW CANC 4.0MM FULL 26MM SMALL | 52.00 |
| 568051 | BONE SCREW CANC 4.0MM FULL 28MM SMALL | 52.00 |
| 568053 | BONE SCREW CANC 4.0MM FULL 30MM SMALL | 52.00 |
| 568055 | BONE SCREW CANC 4.0MM FULL 32MM SMALL | 52.00 |
| 568056 | BONE SCREW CANC 4.0MM FULL 34MM SMALL | 52.00 |
| 568058 | BONE SCREW CANC 4.0MM FULL 36MM SMALL | 111.00 |
| 568059 | BONE SCREW CANC 4.0MM FULL 38MM SMALL | 52.00 |
| 568060 | BONE SCREW CANC 4.0MM FULL 40MM SMALL | 52.00 |
| 568062 | BONE SCREW CANC 4.0MM FULL 45MM SMALL | 52.00 |
| 568064 | BONE SCREW CANC 4.0MM FULL 50MM SMALL | 52.00 |
| 568066 | BONE SCREW CANC 4.0MM FULL 55MM SMALL | 91.00 |
| 568067 | BONE SCREW CANC 4.0MM FULL 60MM SMALL | 52.00 |
| 568034 | BONE SCREW CANC 4.0MM PART 10MM SMALL | 52.00 |
| 568036 | BONE SCREW CANC 4.0MM PART 12MM SMALL | 54.00 |
| 568038 | BONE SCREW CANC 4.0MM PART 14MM SMALL | 54.00 |
| 568040 | BONE SCREW CANC 4.0MM PART 16MM SMALL | 54.00 |
| 568042 | BONE SCREW CANC 4.0MM PART 18MM SMALL | 52.00 |
| 568044 | BONE SCREW CANC 4.0MM PART 20MM SMALL | 54.00 |
| 568046 | BONE SCREW CANC 4.0MM PART 22MM SMALL | 111.00 |
| 568048 | BONE SCREW CANC 4.0MM PART 24MM SMALL | 52.00 |
| 568050 | BONE SCREW CANC 4.0MM PART 26MM SMALL | 52.00 |
| 568052 | BONE SCREW CANC 4.0MM PART 28MM SMALL | 52.00 |
| 568054 | BONE SCREW CANC 4.0MM PART 30MM SMALL | 52.00 |
| 568057 | BONE SCREW CANC 4.0MM PART 35MM SMALL | 52.00 |
| 568061 | BONE SCREW CANC 4.0MM PART 40MM SMALL | 52.00 |
| 568063 | BONE SCREW CANC 4.0MM PART 45MM SMALL | 52.00 |
| 568065 | BONE SCREW CANC 4.0MM PART 50MM SMALL | 91.00 |
| 568092 | BONE SCREW CANC 4.0MM PART 60MM SMALL | 91.00 |
| 578252 | BONE SCREW CANCEL 4.0 10M | 25.00 |
| 578253 | BONE SCREW CANCEL 4.0 12M | 25.00 |
| 578254 | BONE SCREW CANCEL 4.0 14M | 25.00 |
| 578255 | BONE SCREW CANCEL 4.0 16M | 25.00 |
| 578256 | BONE SCREW CANCEL 4.0 18M | 27.00 |
| 578257 | BONE SCREW CANCEL 4.0 20M | 25.00 |
| 578258 | BONE SCREW CANCEL 4.0 22M | 25.00 |
| 578259 | BONE SCREW CANCEL 4.0 24M | 31.00 |
| 578298 | BONE SCREW CANCEL 4.0 26M | 25.00 |
| 578260 | BONE SCREW CANCEL 4.0 28M | 25.00 |
| 513504 | BONE SCREW CANCEL 4.0 30M | 25.00 |
| 578262 | BONE SCREW CANCEL 4.0 35M | 25.00 |
| 515632 | BONE SCREW CANCEL 4.0 40M | 25.00 |
| 578263 | BONE SCREW CANCEL 4.0 45M | 25.00 |
| 513710 | BONE SCREW CANCEL 4.0 50M | 25.00 |
| 578293 | BONE SCREW CANCEL 6.5 100 16MM | 50.00 |
| 578276 | BONE SCREW CANCEL 6.5 100 32MM | 50.00 |
| 578277 | BONE SCREW CANCEL 6.5 100 32MM | 50.00 |
| 578294 | BONE SCREW CANCEL 6.5 105 16MM | 50.00 |
| 515657 | BONE SCREW CANCEL 6.5 110 16MM | 50.00 |
| 578278 | BONE SCREW CANCEL 6.5 25 16MM | 50.00 |
| 578279 | BONE SCREW CANCEL 6.5 30 16MM | 50.00 |
| 578265 | BONE SCREW CANCEL 6.5 30 32MM | 50.00 |
| 578280 | BONE SCREW CANCEL 6.5 35 16MM | 50.00 |
| 578266 | BONE SCREW CANCEL 6.5 35 32MM | 50.00 |
| 578281 | BONE SCREW CANCEL 6.5 40 16MM | 50.00 |
| 514023 | BONE SCREW CANCEL 6.5 40 32MM | 50.00 |
| 578282 | BONE SCREW CANCEL 6.5 45 16MM | 50.00 |
| 514007 | BONE SCREW CANCEL 6.5 45 32MM | 50.00 |
| 578283 | BONE SCREW CANCEL 6.5 50 16MM | 50.00 |
| 578269 | BONE SCREW CANCEL 6.5 50 32MM | 50.00 |
| 578284 | BONE SCREW CANCEL 6.5 55 16MM | 50.00 |
| 578270 | BONE SCREW CANCEL 6.5 55 32MM | 50.00 |
| 578285 | BONE SCREW CANCEL 6.5 60 16MM | 50.00 |
| 578271 | BONE SCREW CANCEL 6.5 60 32MM | 50.00 |
| 578286 | BONE SCREW CANCEL 6.5 65 16MM | 50.00 |
| 578272 | BONE SCREW CANCEL 6.5 65 32MM | 50.00 |
| 578287 | BONE SCREW CANCEL 6.5 70 16MM | 50.00 |
| 578273 | BONE SCREW CANCEL 6.5 70 32MM | 50.00 |
| 578288 | BONE SCREW CANCEL 6.5 75 16MM | 50.00 |
| 578289 | BONE SCREW CANCEL 6.5 80 16MM | 50.00 |
| 578274 | BONE SCREW CANCEL 6.5 80 32MM | 51.00 |
| 578290 | BONE SCREW CANCEL 6.5 85 16MM | 50.00 |
| 578291 | BONE SCREW CANCEL 6.5 90 16MM | 186.00 |
| 578275 | BONE SCREW CANCEL 6.5 90 32MM | 50.00 |
| 578292 | BONE SCREW CANCEL 6.5 95 16MM | 50.00 |
| 589079 | BONE SCREW CANN 4.0MM 1/2 THREAD 10MM | 395.00 |
| 589080 | BONE SCREW CANN 4.0MM 1/2 THREAD 12MM | 395.00 |
| 589081 | BONE SCREW CANN 4.0MM 1/2 THREAD 14MM | 395.00 |
| 589061 | BONE SCREW CANN 4.0MM 1/2 THREAD 16MM | 395.00 |
| 589062 | BONE SCREW CANN 4.0MM 1/2 THREAD 18MM | 395.00 |
| 589063 | BONE SCREW CANN 4.0MM 1/2 THREAD 20MM | 395.00 |
| 589064 | BONE SCREW CANN 4.0MM 1/2 THREAD 22MM | 395.00 |
| 589065 | BONE SCREW CANN 4.0MM 1/2 THREAD 24MM | 395.00 |
| 589066 | BONE SCREW CANN 4.0MM 1/2 THREAD 26MM | 395.00 |
| 589067 | BONE SCREW CANN 4.0MM 1/2 THREAD 28MM | 395.00 |
| 589068 | BONE SCREW CANN 4.0MM 1/2 THREAD 30MM | 395.00 |
| 589069 | BONE SCREW CANN 4.0MM 1/2 THREAD 32MM | 395.00 |
| 589070 | BONE SCREW CANN 4.0MM 1/2 THREAD 34MM | 395.00 |
| 589072 | BONE SCREW CANN 4.0MM 1/2 THREAD 38MM | 563.00 |
| 589073 | BONE SCREW CANN 4.0MM 1/2 THREAD 40MM | 395.00 |
| 589074 | BONE SCREW CANN 4.0MM 1/2 THREAD 42MM | 395.00 |
| 589075 | BONE SCREW CANN 4.0MM 1/2 THREAD 44MM | 395.00 |
| 589076 | BONE SCREW CANN 4.0MM 1/2 THREAD 46MM | 563.00 |
| 589077 | BONE SCREW CANN 4.0MM 1/2 THREAD 48MM | 395.00 |
| 589078 | BONE SCREW CANN 4.0MM 1/2 THREAD 50MM | 563.00 |
| 589082 | BONE SCREW CANN 4.0MM 1/2 THREAD 55MM | 605.00 |
| 589084 | BONE SCREW CANN 4.0MM 1/2 THREAD 60MM | 563.00 |
| 589085 | BONE SCREW CANN 4.0MM 1/2 THREAD 65MM | 605.00 |
| 589096 | BONE SCREW CANN 4.0MM 1/2 THREAD 70MM | 605.00 |
| 589071 | BONE SCREW CANN 4.0MM 1/2 THREAD36MM | 395.00 |
| 589036 | BONE SCREW CANN 4.0MM 1/3 THREAD 10MM | 395.00 |
| 589037 | BONE SCREW CANN 4.0MM 1/3 THREAD 12MM | 395.00 |
| 589038 | BONE SCREW CANN 4.0MM 1/3 THREAD 14MM | 395.00 |
| 589039 | BONE SCREW CANN 4.0MM 1/3 THREAD 16MM | 395.00 |
| 589040 | BONE SCREW CANN 4.0MM 1/3 THREAD 18MM | 395.00 |
| 589041 | BONE SCREW CANN 4.0MM 1/3 THREAD 20MM | 395.00 |
| 589042 | BONE SCREW CANN 4.0MM 1/3 THREAD 22MM | 395.00 |
| 589043 | BONE SCREW CANN 4.0MM 1/3 THREAD 24MM | 395.00 |
| 589044 | BONE SCREW CANN 4.0MM 1/3 THREAD 26MM | 395.00 |
| 589045 | BONE SCREW CANN 4.0MM 1/3 THREAD 28MM | 395.00 |
| 589046 | BONE SCREW CANN 4.0MM 1/3 THREAD 30MM | 395.00 |
| 589047 | BONE SCREW CANN 4.0MM 1/3 THREAD 32MM | 395.00 |
| 589048 | BONE SCREW CANN 4.0MM 1/3 THREAD 34MM | 395.00 |
| 589049 | BONE SCREW CANN 4.0MM 1/3 THREAD 36MM | 395.00 |
| 589050 | BONE SCREW CANN 4.0MM 1/3 THREAD 38MM | 395.00 |
| 589051 | BONE SCREW CANN 4.0MM 1/3 THREAD 40MM | 395.00 |
| 589052 | BONE SCREW CANN 4.0MM 1/3 THREAD 42MM | 563.00 |
| 589083 | BONE SCREW CANN 4.0MM 1/3 THREAD 44MM | 395.00 |
| 589054 | BONE SCREW CANN 4.0MM 1/3 THREAD 46MM | 395.00 |
| 589055 | BONE SCREW CANN 4.0MM 1/3 THREAD 48MM | 395.00 |
| 589056 | BONE SCREW CANN 4.0MM 1/3 THREAD 50MM | 395.00 |
| 589057 | BONE SCREW CANN 4.0MM 1/3 THREAD 55MM | 395.00 |
| 589058 | BONE SCREW CANN 4.0MM 1/3 THREAD 60MM | 563.00 |
| 589059 | BONE SCREW CANN 4.0MM 1/3 THREAD 65MM | 395.00 |
| 589060 | BONE SCREW CANN 4.0MM 1/3 THREAD 70MM | 395.00 |
| 578326 | BONE SCREW CORITCAL 4.5 30MM | 12.00 |
| 578297 | BONE SCREW CORT 2.7MM 10M | 23.00 |
| 578299 | BONE SCREW CORT 2.7MM 14M | 23.00 |
| 578300 | BONE SCREW CORT 2.7MM 16M | 23.00 |
| 578301 | BONE SCREW CORT 2.7MM 18M | 23.00 |
| 578302 | BONE SCREW CORT 2.7MM 20M | 23.00 |
| 578303 | BONE SCREW CORT 2.7MM 22M | 23.00 |
| 578304 | BONE SCREW CORT 2.7MM 24M | 23.00 |
| 578295 | BONE SCREW CORT 2.7MM 6MM | 23.00 |
| 578296 | BONE SCREW CORT 2.7MM 8MM | 23.00 |
| 578305 | BONE SCREW CORT 3.5MM 10M | 111.00 |
| 578306 | BONE SCREW CORT 3.5MM 12M | 111.00 |
| 578307 | BONE SCREW CORT 3.5MM 14M | 22.00 |
| 578308 | BONE SCREW CORT 3.5MM 16M | 111.00 |
| 578224 | BONE SCREW CORT 3.5MM 18M | 111.00 |
| 578310 | BONE SCREW CORT 3.5MM 20M | 111.00 |
| 578311 | BONE SCREW CORT 3.5MM 22M | 22.00 |
| 578312 | BONE SCREW CORT 3.5MM 24M | 22.00 |
| 578313 | BONE SCREW CORT 3.5MM 26M | 22.00 |
| 578314 | BONE SCREW CORT 3.5MM 28M | 22.00 |
| 578315 | BONE SCREW CORT 3.5MM 32M | 22.00 |
| 578316 | BONE SCREW CORT 3.5MM 36M | 22.00 |
| 578317 | BONE SCREW CORT 3.5MM 40M | 22.00 |
| 568000 | BONE SCREW CORT 3.5MM S.T. 10MM SMALL | 138.00 |
| 568001 | BONE SCREW CORT 3.5MM S.T. 12MM SMALL | 138.00 |
| 568002 | BONE SCREW CORT 3.5MM S.T. 14MM SMALL | 138.00 |
| 568003 | BONE SCREW CORT 3.5MM S.T. 16MM SMALL | 138.00 |
| 568005 | BONE SCREW CORT 3.5MM S.T. 18MM SMALL | 138.00 |
| 568007 | BONE SCREW CORT 3.5MM S.T. 20MM SMALL | 128.00 |
| 568009 | BONE SCREW CORT 3.5MM S.T. 22MM SMALL | 130.00 |
| 568011 | BONE SCREW CORT 3.5MM S.T. 24MM SMALL | 62.00 |
| 568013 | BONE SCREW CORT 3.5MM S.T. 26MM SMALL | 128.00 |
| 568015 | BONE SCREW CORT 3.5MM S.T. 28MM SMALL | 130.00 |
| 568017 | BONE SCREW CORT 3.5MM S.T. 30MM SMALL | 130.00 |
| 568019 | BONE SCREW CORT 3.5MM S.T. 32MM SMALL | 62.00 |
| 568021 | BONE SCREW CORT 3.5MM S.T. 34MM SMALL | 62.00 |
| 568023 | BONE SCREW CORT 3.5MM S.T. 36MM SMALL | 138.00 |
| 568025 | BONE SCREW CORT 3.5MM S.T. 38MM SMALL | 62.00 |
| 568027 | BONE SCREW CORT 3.5MM S.T. 40MM SMALL | 138.00 |
| 568029 | BONE SCREW CORT 3.5MM S.T. 45MM SMALL | 130.00 |
| 568031 | BONE SCREW CORT 3.5MM S.T. 50MM SMALL | 138.00 |
| 568004 | BONE SCREW CORT 3.5MM SHAFT 16MM SMALL | 57.00 |
| 568006 | BONE SCREW CORT 3.5MM SHAFT 18MM SMALL | 57.00 |
| 568008 | BONE SCREW CORT 3.5MM SHAFT 20MM SMALL | 139.80 |
| 568010 | BONE SCREW CORT 3.5MM SHAFT 22MM SMALL | 57.00 |
| 568012 | BONE SCREW CORT 3.5MM SHAFT 24MM SMALL | 57.00 |
| 568014 | BONE SCREW CORT 3.5MM SHAFT 26MM SMALL | 57.00 |
| 568016 | BONE SCREW CORT 3.5MM SHAFT 28MM SMALL | 57.00 |
| 568018 | BONE SCREW CORT 3.5MM SHAFT 30MM SMALL | 57.00 |
| 568020 | BONE SCREW CORT 3.5MM SHAFT 32MM SMALL | 57.00 |
| 568022 | BONE SCREW CORT 3.5MM SHAFT 34MM SMALL | 57.00 |
| 568024 | BONE SCREW CORT 3.5MM SHAFT 36MM SMALL | 57.00 |
| 568026 | BONE SCREW CORT 3.5MM SHAFT 38MM SMALL | 57.00 |
| 568028 | BONE SCREW CORT 3.5MM SHAFT 40MM SMALL | 57.00 |
| 568030 | BONE SCREW CORT 3.5MM SHAFT 45MM SMALL | 57.00 |
| 568032 | BONE SCREW CORT 3.5MM SHAFT 50MM SMALL | 57.00 |
| 578225 | BONE SCREW CORTICAL 2.7MM | 23.00 |
| 578318 | BONE SCREW CORTICAL 4.5 14MM | 37.00 |
| 578319 | BONE SCREW CORTICAL 4.5 16MM | 10.00 |
| 578320 | BONE SCREW CORTICAL 4.5 18MM | 10.00 |
| 578321 | BONE SCREW CORTICAL 4.5 20MM | 38.00 |
| 578322 | BONE SCREW CORTICAL 4.5 22MM | 33.00 |
| 578323 | BONE SCREW CORTICAL 4.5 24MM | 33.00 |
| 578324 | BONE SCREW CORTICAL 4.5 26MM | 37.00 |
| 578325 | BONE SCREW CORTICAL 4.5 28MM | 37.00 |
| 578327 | BONE SCREW CORTICAL 4.5 32MM | 50.00 |
| 578328 | BONE SCREW CORTICAL 4.5 34MM | 50.00 |
| 515590 | BONE SCREW CORTICAL 4.5 34MM | 64.00 |
| 578329 | BONE SCREW CORTICAL 4.5 36MM | 70.00 |
| 578226 | BONE SCREW CORTICAL 4.5 38MM | 70.00 |
| 578331 | BONE SCREW CORTICAL 4.5 40MM | 70.00 |
| 578332 | BONE SCREW CORTICAL 4.5 42MM | 70.00 |
| 578333 | BONE SCREW CORTICAL 4.5 44MM | 70.00 |
| 578334 | BONE SCREW CORTICAL 4.5 46MM | 70.00 |
| 578335 | BONE SCREW CORTICAL 4.5 48MM | 37.00 |
| 515343 | BONE SCREW CORTICAL 4.5 50MM | 11.00 |
| 572336 | BONE SCREW CORTICAL 4.5 52MM | 37.00 |
| 578337 | BONE SCREW CORTICAL 4.5 54MM | 64.00 |
| 578338 | BONE SCREW CORTICAL 4.5 56MM | 37.00 |
| 578339 | BONE SCREW CORTICAL 4.5 58MM | 33.00 |
| 578340 | BONE SCREW CORTICAL 4.5 60MM | 33.00 |
| 578341 | BONE SCREW CORTICAL 4.5 64MM | 33.00 |
| 515350 | BONE SCREW CORTICAL 4.5 65MM | 70.00 |
| 578342 | BONE SCREW CORTICAL 4.5 70MM | 50.00 |
| 578242 | BONE SCREW MALLEOLAR 4.5 25MM | 50.00 |
| 578243 | BONE SCREW MALLEOLAR 4.5 30MM | 50.00 |
| 578244 | BONE SCREW MALLEOLAR 4.5 35M | 50.00 |
| 578245 | BONE SCREW MALLEOLAR 4.5 40MM | 50.00 |
| 578246 | BONE SCREW MALLEOLAR 4.5 45MM | 50.00 |
| 578247 | BONE SCREW MALLEOLAR 4.5 50MM | 50.00 |
| 578248 | BONE SCREW MALLEOLAR 4.5 55MM | 50.00 |
| 578249 | BONE SCREW MALLEOLAR 4.5 60MM | 50.00 |
| 578250 | BONE SCREW MALLEOLAR 4.5 65MM | 50.00 |
| 578251 | BONE SCREW MALLEOLAR 4.5 70MM | 50.00 |
| 504914 | BONE SCREW OSTEOTITE 70/20 | 391.00 |
| 504915 | BONE SCREW OSTEOTITE 80/35 | 391.00 |
| 515038 | BONE SMALL T-PLATE 3 HOLE | 171.00 |
| 515046 | BONE SMALL T-PLATE 4 HOLE | 218.00 |
| 515053 | BONE SMALL T-PLATE 5 HOLE | 340.00 |
| 515061 | BONE SPOON PLATE 5 HOLE | 397.00 |
| 515079 | BONE SPOON PLATE 6 HOLE | 426.00 |
| 241257 | BONE SURVEY COMPLETE | 503.20 |
| 241256 | BONE SURVEY LIMITED | 304.40 |
| 241258 | BONE SURVEY, INFANT | 314.90 |
| 568087 | BONE T-PLATE 3 H 50MM SMALL | 314.00 |
| 514965 | BONE T-PLATE 3 HOLE | 315.00 |
| 568090 | BONE T-PLATE 4 H 56MM SMALL | 325.00 |
| 514973 | BONE T-PLATE 4 HOLE | 353.00 |
| 514981 | BONE T-PLATE 5 HOLE | 379.00 |
| 514999 | BONE T-PLATE 6 HOLE | 415.00 |
| 568088 | BONE T-PLATE OBLIQUE 3 H 52MM SMALL | 328.00 |
| 568089 | BONE T-PLATE OBLIQUE 5 H 74MM SMALL | 355.00 |
| 568068 | BONE WASHER 2.7/3.5/4.0MM SCREW SMALL | 72.00 |
| 509948 | BONE WAX | 29.00 |
| 303366 | BONIVA (IBANDRONATE)150MG TAB | 2.00 |
| 1403992 | BONY/PELVIS | 89.80 |
| 303560 | BOOSTRIX (DIPH,PERTUSS(ACELL) TET 0.5ML | 163.10 |
| 790691 | BORDETELLA PERTUSSIS (PCR) | 347.00 |
| 3017763 | BORIC ACID POWDER 10GM | 10.00 |
| 137043 | BOTH MEDICAL AND LATERAL MENISCECTOMY | 969.60 |
| 514917 | BOVIE EXTENDER BLADES | 170.00 |
| 510153 | BOVIE EXTENDER ELECTRODE | 58.00 |
| 514918 | BOVIE EXTENSION LOOP | 58.00 |
| 578002 | BOVIE HANDLES | 30.00 |
| 578593 | BOVIE LOOP 15X12 | 75.00 |
| 578616 | BOVIE LOOP 20X12 | 75.00 |
| 514043 | BOVIE PAD PEDIATRIC | 28.00 |
| 791254 | BRCA1/BRCA2 USE KIT TEST-DONT ORDER THIS | 2,800.00 |
| 135532 | BREAST BIOPSY | 1,542.00 |
| 135540 | BREAST BIOPSY B | 2,123.00 |
| 135557 | BREAST BIOPSY C | 2,476.50 |
| 135565 | BREAST BIOPSY D | 2,831.00 |
| 244062 | BREAST BIOPSY W/ PLACEMENT OF | 1,787.00 |
| 515803 | BREAST MEDELA PUMP ELECTRIC | 514.00 |
| 517616 | BREAST PUMP ACCESSORY KIT MEDELA | 140.00 |
| 501616 | BREAST PUMP, DISP | 121.00 |
| 501617 | BREAST PUMP, KIT | 248.25 |
| 3016419 | BRETHINE (TERBUTALINE) 1MG/ML INJ | 86.50 |
| 3001718 | BRETHINE (TERBUTALINE) 5MG TAB | 2.00 |
| 3030983 | BREVIBLOC DRIP: 2500MG/250ML | 494.55 |
| 3078653 | BRIDION (sugammadex) 500MG/5ML 100MG/1ML | 422.82 |
| 3078671 | BRIDION INTRAVENOUS SOLUTION 200MG/2ML | 330.60 |
| 3078243 | BRILINTA ORAL TABLET 90MG | 19.80 |
| 134261 | BRONCH W/BIOPSY | 2,000.00 |
| 134253 | BRONCH W/BIOPSY A | 922.20 |
| 134279 | BRONCH W/BIOPSY C | 1,125.80 |
| 134287 | BRONCH W/BIOPSY D | 1,227.70 |
| 134295 | BRONCH W/LUNG BIOP A | 1,008.80 |
| 134303 | BRONCH W/LUNG BIOP B | 928.10 |
| 134311 | BRONCH W/LUNG BIOP C | 1,231.20 |
| 134329 | BRONCH W/LUNG BIOP D | 1,231.20 |
| 134337 | BRONCH W/REMOVAL A | 678.90 |
| 134345 | BRONCH W/REMOVAL B | 782.90 |
| 134352 | BRONCH W/REMOVAL C | 883.70 |
| 134360 | BRONCH W/REMOVAL D | 986.70 |
| 134212 | BRONCHOSCOPY A | 695.30 |
| 134220 | BRONCHOSCOPY B | 760.80 |
| 134238 | BRONCHOSCOPY C | 862.60 |
| 134246 | BRONCHOSCOPY D | 965.60 |
| 508468 | BROSELOW/BLUE/INTRAOSSEUS MODULE | 225.00 |
| 508465 | BROSELOW/BLUE/INTUBATION MODULE | 188.00 |
| 508466 | BROSELOW/BLUE/IV DELIVERY MODULE | 180.00 |
| 508467 | BROSELOW/BLUE/OXYGEN DELIVERY MODULE | 65.00 |
| 508477 | BROSELOW/GREEN/INTRAOSSEUS MODULE | 225.00 |
| 508474 | BROSELOW/GREEN/INTUBATION MODULE | 188.00 |
| 508475 | BROSELOW/GREEN/IV DELIVERY MODULE | 180.00 |
| 508476 | BROSELOW/GREEN/OXYGEN DELIVERY MODULE | 60.00 |
| 508473 | BROSELOW/ORANGE/INTRAOSSEUS MODULE | 225.00 |
| 508469 | BROSELOW/ORANGE/INTUBATION MODULE | 188.00 |
| 508471 | BROSELOW/ORANGE/IV DELIVERY MODULE | 180.00 |
| 508472 | BROSELOW/ORANGE/OXYGEN DELIVERY MODULE | 65.00 |
| 508451 | BROSELOW/PINK-RED/INTRAOSSEUS MODULE | 225.00 |
| 508448 | BROSELOW/PINK-RED/INTUBATION MODULE | 188.00 |
| 508449 | BROSELOW/PINK-RED/IV DELIVERY MODULE | 180.00 |
| 508450 | BROSELOW/PINK-RED/OXYGEN DELIVERY MODULE | 73.00 |
| 508456 | BROSELOW/PURPLE/INTRAOSSEUS MODULE | 225.00 |
| 508452 | BROSELOW/PURPLE/INTUBATION MODULE | 188.00 |
| 508453 | BROSELOW/PURPLE/IV DELIVERY MODULE | 180.00 |
| 508455 | BROSELOW/PURPLE/OXYGEN DELIVERY MODULE | 65.00 |
| 508464 | BROSELOW/WHITE/INTRAOSSEUS MODULE | 225.00 |
| 508461 | BROSELOW/WHITE/INTUBATION MODULE | 188.00 |
| 508462 | BROSELOW/WHITE/IV DELIVERY MODULE | 180.00 |
| 508463 | BROSELOW/WHITE/OXYGEN DELIVERY MODULE | 65.00 |
| 508460 | BROSELOW/YELLOW/INTRAOSSEUS MODULE | 225.00 |
| 508457 | BROSELOW/YELLOW/INTUBATION MODULE | 188.00 |
| 508458 | BROSELOW/YELLOW/IV DELIVERY MODULE | 180.00 |
| 508459 | BROSELOW/YELLOW/OXYGEN DELIVERY MODULE | 65.00 |
| 303433 | BROVANA (ARFORMOTEROL TART) 15MCG/2ML | 2.00 |
| 500881 | BUCKS BOOT | 59.00 |
| 3015650 | BUMEX (BUMETANIDE) 1MG TAB | 2.00 |
| 3022763 | BUMEX (BUMETANIDE) 1MG/4ML INJ | 29.40 |
| 3077820 | BUMEX (BUMETANIDE) 2.5MG/10ML | 35.50 |
| 330160 | BUN | 47.00 |
| 3101113 | BURETROL SOLUTION SET 150 ML | 14.10 |
| 16086 | BURN DRSG SMALL NO ANEST. | 208.00 |
| 170590 | BURN DRSG SMALL NO ANEST. | 208.00 |
| 170616 | BURN LARGE NO ANEST. | 361.40 |
| 16087 | BURN LARGE NO ANEST. | 469.00 |
| 16908 | BURN MED NO ANEST. | 306.00 |
| 170608 | BURN MED NO ANEST. | 306.00 |
| 517596 | BURN SHEET | 30.00 |
| 1403133 | BURR HOLES | 89.80 |
| 574093 | BURR OVAL 8 FLUTE 4.0MM X 13CM | 295.00 |
| 3020320 | BUSPAR (busPIRone) 5MG TAB | 2.00 |
| 303598 | BUTRANS(BUPRENORPHINE) 10MCG PATCH #4 HH | 221.60 |
| 303311 | BYETTA 10MCG /DOSE INJ | 411.10 |
| 1404602 | BYPASS/GRAFT | 89.80 |
| 303449 | BYSTOLIC (NEBIVOLOL) 5MG TAB | 2.00 |
| 790855 | C1 EST-INHIB ANTIGEN | 143.00 |
| 790856 | C1 EST-INHIB FUNCT ASSAY | 143.00 |
| 791249 | C1Q COMPLEMENT (SERUM) | 220.00 |
| 791250 | C3 COMPLEMENT (QUANT) | 36.00 |
| 790603 | C3 COMPLEMENT FUNCTIONAL | 163.00 |
| 790991 | C4 ACYLCARNITINE (QUANT URINE) | 152.00 |
| 791251 | C4 COMPLEMENT (QUANT)(SERUM) | 36.00 |
| 790604 | C4 COMPLEMENT FUNCTIONAL | 160.00 |
| 790605 | C5 COMPLEMENT ANTIGEN | 73.00 |
| 790992 | C5-DC ACYLCARNITINE (QUANT URINE) | 150.00 |
| 790993 | C5-OH ACYLCARNITINE (QUANT URINE) | 150.00 |
| 798012 | CA 125 | 65.00 |
| 790873 | CA 15-3 | 132.00 |
| 790674 | CA 19-9 | 80.00 |
| 790608 | CA 27-29 | 57.00 |
| 517877 | CABLE 6 HOLE PLATE | 1,479.00 |
| 517828 | CABLE STEEL 559 MM LONG | 1,145.00 |
| 790719 | CADMIUM | 112.00 |
| 303527 | CAFF SOD BENZ 500MG/ 2ML | 48.20 |
| 790838 | CAFFEINE (SERUM) | 136.00 |
| 3026814 | CALAMINE LOTION 177ML | 10.00 |
| 3001882 | CALAN (VERAPAMIL) 80MG TAB | 2.00 |
| 3026202 | CALAN SR (VERAPAMIL) 180MG TAB | 2.00 |
| 3021096 | CALAN SR (VERAPAMIL) 240MG TAB | 2.00 |
| 3001874 | CALAN VIAL(ISOPTIN,VERAPAMIL) 5MG/2ML | 29.40 |
| 790843 | CALCITONIN (SERUM) | 227.00 |
| 798013 | CALCIUM (24HR URINE) | 42.00 |
| 791311 | CALCIUM (RANDOM URINE) | 42.00 |
| 330178 | CALCIUM (TOTAL) | 40.00 |
| 3030861 | CALCIUM CARBONATE 500MG/5ML 30ML SUSP | 6.00 |
| 3001908 | CALCIUM CHLORIDE SYRINGE 1GM/10ML INJ | 61.35 |
| 3001924 | CALCIUM GLUCONATE 10% 10ML INJ | 29.40 |
| 798054 | CALCIUM IONIZED (SERUM) | 69.00 |
| 135953 | CALENDAR NAIL A | 3,932.40 |
| 135961 | CALENDAR NAIL B | 4,286.90 |
| 135979 | CALENDAR NAIL C | 4,642.70 |
| 135987 | CALENDAR NAIL D | 4,998.50 |
| 135995 | CALENDAR NAIL E | 5,353.10 |
| 80035 | CALORIE COUNT/DAY | 10.70 |
| 790732 | CALPROTECTIN (STOOL) | 620.00 |
| 508439 | CAM BOOT/WALKER LARGE | 220.00 |
| 508205 | CAM BOOT/WALKER PEDIATRIC-XS | 220.00 |
| 581206 | CAM BOOT/WALKER SMALL | 220.00 |
| 503531 | CAM BOOT/WALKER X-LARGE | 196.40 |
| 581207 | CAM WALKER | 220.00 |
| 3031147 | CAMPATH (ALEMTUZUMAB) 10mg | 1,622.70 |
| 303347 | CANCIDAS (CASPOFUNGIN)50MG | 984.75 |
| 331000 | CAPILLARY COLLECTION | 32.00 |
| 512949 | CAPNOLINE GUARDIAN BITE BLOCK MONTY | 80.00 |
| 512940 | CAPNOLINE ORAL/NASAL ADULT NON INTUB | 74.00 |
| 3018126 | CAPOTEN (CAPTOPRIL)12.5MG TAB | 2.00 |
| 70821 | CAR SEAT TEST AIRWAY 60 MIN | 142.87 |
| 70822 | CAR SEAT TEST AIRWAY EA ADD 30 MIN | 54.75 |
| 3019694 | CARAFATE (SUCRALFATE) 1G/10ML SUSP | 2.00 |
| 3002039 | CARAFATE (SUCRALFATE) 1GM TAB | 2.00 |
| 330756 | CARBON DIOXIDE (CO2) | 42.00 |
| 790336 | CARBON MONOXIDE (CARBOXYHEMOGLOBIN) | 50.00 |
| 3021666 | CARBOplatin(PARAPLATIN):50MG | 469.80 |
| 303540 | CARDENE (niCARdipine)40MG/ NS 200ML | 396.80 |
| 42013 | CARDIAC REHAB, MONITOR | 191.70 |
| 244018 | CARDIOLITE REST (8MCI) | 263.40 |
| 244020 | CARDIOLITE STRESS (33MCI) | 263.40 |
| 3025048 | CARDIZEM 25MG/5ML INJ | 29.40 |
| 3015940 | CARDIZEM (DILTIAZEM) 60MG TAB | 2.00 |
| 303574 | CARDIZEM (DILTIAZEM) VIAL: 50MG/10ML | 29.40 |
| 3029107 | CARDIZEM CD (DILTIAZEM) 300MG CAP | 2.00 |
| 3026178 | CARDIZEM CD(DILTIAZEM)120MG CAP | 2.00 |
| 3024728 | CARDIZEM CD(DILTIAZEM)180MG CAP | 2.00 |
| 3024736 | CARDIZEM CD(DILTIAZEM)240MG CAP | 2.00 |
| 3032567 | CARDIZEM(DILTIAZEM)ADVT VIAL: 100MG | 55.15 |
| 3025725 | CARDURA (DOXAZOSIN) 2MG TAB | 2.00 |
| 37159 | CARE COORDINATION | 28.00 |
| 37158 | CARE COORDINATION | 30.00 |
| 791246 | CARNITINE (SERUM) | 156.00 |
| 510252 | CAROTID ARTERY SHUNT | 130.00 |
| 23066 | CAROTID BILATERAL | 1,110.70 |
| 23067 | CAROTID LIMITED/UNILATERAL | 560.70 |
| 16978 | CARPAL NO MANIPULATION | 860.00 |
| 171117 | CARPAL NO MANIPULATION | 1,107.00 |
| 16979 | CARPAL W/ MANIPULATION | 1,275.00 |
| 171118 | CARPAL W/ MANIPULATION | 1,750.00 |
| 135854 | CARPAL TUNNEL B | 2,440.20 |
| 135862 | CARPAL TUNNEL C | 2,796.00 |
| 135870 | CARPAL TUNNEL D | 3,150.50 |
| 135847 | CARPAL TUNNEL OPEN | 2,000.00 |
| 790128 | CASPR2-IGG CBA | 75.00 |
| 16601 | CAST LOWER ARM | 197.00 |
| 170506 | CAST LOWER ARM | 227.00 |
| 502143 | CAST SHOE LGE | 63.00 |
| 502135 | CAST SHOE MED | 11.80 |
| 502127 | CAST SHOE SM | 17.70 |
| 502150 | CAST SHOE XLG | 66.00 |
| 512092 | CAST SHOE XSM | 18.10 |
| 505794 | CASTING SPLINT SYN 3 | 189.00 |
| 505793 | CASTING SPLINT SYN 4 | 229.00 |
| 3002088 | CASTOR OIL 60ML | 2.00 |
| 1404881 | CAT SCAN OR MRI | 89.80 |
| 3019371 | CATAPRES (cloNIDine) 0.1MG TAB | 2.00 |
| 3018969 | CATAPRES (cloNIDine) 0.2MG TAB | 2.00 |
| 3021187 | CATAPRES (cloNIDine) TTS-1 PATCH | 25.00 |
| 3025709 | CATAPRES (cloNIDine) TTS-2 PATCH | 36.50 |
| 516541 | CATARACT DYE/TRI-PAN | 296.60 |
| 137062 | CATARACT STENT | 4,502.00 |
| 514068 | CATARACT SURGICAL PACK | 1,258.20 |
| 135805 | CATARACTS | 1,542.00 |
| 135813 | CATARACTS B | 4,436.80 |
| 135821 | CATARACTS C | 4,762.00 |
| 135839 | CATARACTS D | 5,089.80 |
| 790474 | CATECHOLAMINE (24HR URINE) | 115.00 |
| 790944 | CATECHOLAMINE FRACTIONATION (PLASMA) | 110.00 |
| 515172 | CATH BREVI-KATH | 303.00 |
| 515171 | CATH CONQUEST BALLOON 6MM X 4CM 75 SHAFT | 1,170.00 |
| 518016 | CATH CONT IRRIG 18FR 30CC | 63.00 |
| 501442 | CATH CONT IRRIG 22FR 30CC | 63.00 |
| 518018 | CATH CONT IRRIG 24FR 30CC | 63.00 |
| 515190 | CATH COOK RADIOLOGY HNBR 5-0-38-40-P-NS | 94.00 |
| 515199 | CATH COOK RADIOLOGY PLIP 4.5-18.9 | 370.00 |
| 515187 | CATH COOK RADIOLOGY PLIP 5.5 INTRODUCER | 322.00 |
| 515198 | CATH COOK RADIOLOGY PLIP 7.0-18.9 | 370.00 |
| 515170 | CATH COOK RADIOLOGY PLIP 8 FR INTRODUCER | 350.00 |
| 515193 | CATH COOK RADIOLOGY TSCF 3.5-145-3 | 64.00 |
| 515192 | CATH COOK RADIOLOGY TSCF-3.5-80-3 | 59.00 |
| 518046 | CATH COUDE 12 FR | 18.00 |
| 518081 | CATH COUDE 14FR | 18.00 |
| 518045 | CATH COUDE 16 FR | 18.00 |
| 518024 | CATH COUDE 18 FR | 18.00 |
| 518038 | CATH COUDE 22 FR | 18.00 |
| 518077 | CATH COUDE W/BALL00N 14FR | 68.00 |
| 518073 | CATH COUDE W/BALLOON 12FR | 43.00 |
| 518078 | CATH COUDE W/BALLOON 16FR | 68.00 |
| 518079 | CATH COUDE W/BALLOON 18FR | 68.00 |
| 518059 | CATH COUDE W/BALLOON 20FR | 70.00 |
| 518080 | CATH COUDE W/BALLOON 22FR | 43.00 |
| 519020 | CATH COUDE W/BALLOON 24FR 30CC | 25.00 |
| 518006 | CATH FOLEY 12FR 5CC SILC | 41.00 |
| 518007 | CATH FOLEY 14FR 5CC SILC | 41.00 |
| 518009 | CATH FOLEY 16FR 5CC SILC | 41.00 |
| 518110 | CATH FOLEY 18FR 30CC | 47.00 |
| 518008 | CATH FOLEY 18FR 5CC SILC | 41.00 |
| 518010 | CATH FOLEY 20FR 5CC SILC | 41.00 |
| 518011 | CATH FOLEY 22FR 5CC SILC | 41.00 |
| 518003 | CATH FOLEY 24FR 30CC SILC | 47.00 |
| 518012 | CATH FOLEY 24FR 5CC SILC | 41.00 |
| 518004 | CATH FOLEY 28FR 30CC SILC | 20.00 |
| 518005 | CATH FOLEY 30FR 30CC SILC | 10.00 |
| 511506 | CATH FOLEY MUSHROOM 18FR | 83.00 |
| 511507 | CATH FOLEY MUSHROOM 20FR | 89.00 |
| 511508 | CATH FOLEY MUSHROOM 22FR | 71.25 |
| 514668 | CATH FOLEY MUSHROOM 24FR | 71.25 |
| 514022 | CATH FOLEY MUSHROOM 26FR | 71.25 |
| 514677 | CATH FOLEY MUSHROOM 28FR | 130.00 |
| 514676 | CATH FOLEY MUSHROOM 30FR | 104.00 |
| 514684 | CATH FOLEY MUSHROOM 32FR | 46.00 |
| 500303 | CATH FOLEY TRAY | 75.00 |
| 517406 | CATH PEDI 10 FR 2 WAY | 51.35 |
| 517398 | CATH PEDI 8FR 2 WAY | 18.00 |
| 500296 | CATH PUREWICK FEM EXTERNAL | 33.00 |
| 518066 | CATH RED ROBINSON 10 FR | 10.00 |
| 518104 | CATH RED ROBINSON 12FR | 10.00 |
| 518105 | CATH RED ROBINSON 14FR | 10.00 |
| 518067 | CATH RED ROBINSON 16 FR | 10.00 |
| 518049 | CATH RED ROBINSON 8 FR | 10.00 |
| 500305 | CATH SET H/S ELLIPTOSPHERE X-RAY | 140.00 |
| 516630 | CATH SUCTION 14FR CLOSED | 96.00 |
| 5501640 | CATH SUCTION 18 FR | 23.40 |
| 518064 | CATH THORACIC 28 FR 20 | 29.00 |
| 518054 | CATH THORACIC 32 FR 20 | 29.00 |
| 518065 | CATH THORACIC 36 FR 20 | 29.00 |
| 518027 | CATH TROCAR 10 FR 9 | 69.00 |
| 518028 | CATH TROCAR 12 FR 9 | 71.00 |
| 518116 | CATH TROCAR 16FR 10 | 71.00 |
| 570014 | CATH UMBILICAL 3.5 | 62.00 |
| 570015 | CATH UMBILICAL 5.0 | 62.00 |
| 570016 | CATH UMBILICAL KIT 3.5 | 270.00 |
| 570017 | CATH UMBILICAL KIT 5.0 | 270.00 |
| 500295 | CATH URETHRAL TRAY | 10.00 |
| 515185 | CATHETER 6FR.PIGTAIL 30CM X-RAY NAVARRE | 417.00 |
| 515184 | CATHETER 8J J-TIP 30CM X-RAY | 417.00 |
| 18637 | CATHETER ASPIRATION NT | 57.40 |
| 242060 | CATHETER FOR HYTEROGRAPHY | 229.60 |
| 594299 | CATHETER WORD/BARTHOLIN | 92.00 |
| 515167 | CATHETER10FR.PIGTAIL 30CM X-RAY NAVARRE | 375.00 |
| 3032532 | CATHFLO (ALTEPLASE) 2MG/2ML INJ | 449.20 |
| 503125 | CAUTERY STICK HI TEMP | 40.00 |
| 791330 | CBC | 90.00 |
| 790071 | CD4 T-CELL COUNT (FOR IMMUNE MONITORING) | 59.00 |
| 791263 | C-DIFF TOXIN (PCR) | 270.00 |
| 790300 | CEA (CARCINOEMBRYONIC ANTIGEN) | 38.00 |
| 3077963 | CEFepIME 1GM VIAL | 35.00 |
| 3020767 | CEFTIN (CEFUROXIME AXETIL) 250MG TAB | 2.00 |
| 3026418 | CEFZIL (CEFPROZIL) 250MG/5ML 50ML SUSP | 32.50 |
| 3031905 | CeleBREX (CELECOXIB) 100MG CAP | 2.00 |
| 3002252 | CELESTONE 12MG (2ML) INJ | 76.70 |
| 3002245 | CELESTONE INJ 6MG (1ML) INJ | 32.60 |
| 3002229 | CELESTONE SOLUSPAN VIAL(BETAMETHA) 5ML | 163.10 |
| 3031848 | CeleXA (CITALOPRAM) 20MG TAB | 2.00 |
| 790811 | CELIAC SEROLOGY CASCADE | 108.00 |
| 3032513 | CELLCEPT(MYCOPHENOLATE) 500MG TAB | 2.00 |
| 16911 | CENTRAL VEIN CATH | 589.00 |
| 171049 | CENTRAL VEIN CATH | 589.00 |
| 599035 | CENTRAL VENOUS SET 4.0 | 195.00 |
| 599036 | CENTRAL VENOUS SET 5.0 | 165.00 |
| 3002260 | CEPACOL LOZENGE: | 2.00 |
| 3002294 | CEPASTAT LOZENGE: | 2.00 |
| 515671 | CERCLAGE WIRE LOOPS | 99.00 |
| 790065 | CERULOPLASMIN (SERUM) | 205.00 |
| 500188 | CERV COLLAR FOAM LARGE | 21.00 |
| 500196 | CERV COLLAR FOAM MEDIUM | 14.00 |
| 500204 | CERV COLLAR FOAM SMALL | 23.10 |
| 581189 | CERV COLLAR PHILA LARGE | 39.90 |
| 581188 | CERV COLLAR PHILA MEDIUM | 39.90 |
| 581182 | CERV COLLAR PHILA PED | 229.80 |
| 581148 | CERV COLLAR PHILA SMALL | 229.70 |
| 509270 | CERV COLLAR STIFNECK ADJU | 59.00 |
| 509269 | CERV COLLAR STIFNECK PEDIATRIC | 50.00 |
| 240241 | CERVICAL >= 4 VIEWS | 294.90 |
| 240183 | CERVICAL 2 OR 3 VIEWS | 256.40 |
| 508496 | CERVICAL COLLAR FOAM SMALL XL | 23.10 |
| 241728 | CERVICAL FL EX OB | 373.40 |
| 1415180 | CERVICAL SPINE/CORD NOT OTHER SPECIFIED | 89.80 |
| 1403935 | CERVICAL/CERLAGE | 89.80 |
| 240258 | CERVICAL>=4V’s | 311.40 |
| 3029297 | CERVIDIL VAG INSERT 10MG | 242.50 |
| 1403653 | CESAREAN/HYSTERECTOMY | 89.80 |
| 1403646 | CESAREAN/SECTION | 98.40 |
| 3017102 | CETACAINE SPRAY 20GM | 48.90 |
| 16917 | CHANGE OF GASTROSTOMY TUBE | 600.00 |
| 171054 | CHANGE OF GASTROSTOMY TUBE | 600.00 |
| 303376 | CHANTIX (VARENICLINE) 1MG TAB | 2.00 |
| 515197 | CHECK FLOW INTRODUCER RCFN 5.0-18-7RA2.5 | 260.00 |
| 515200 | CHECK FLOW INTRODUCER RYCFW 5.5-35-6-CB | 235.70 |
| 515201 | CHECK FLOW INTRODUCER RYCFW 5.5-35-6-CR | 280.70 |
| 11120 | CHEMO EA SEQUENTIAL UP TO 1 HR | 163.90 |
| 11117 | CHEMO INFUSION EA ADD’L HR | 232.90 |
| 11116 | CHEMO INFUSION, INITIAL UP TO 1 HR | 375.70 |
| 11110 | CHEMO INJECTION, HORMONAL SQ IM | 125.30 |
| 11111 | CHEMO INJECTION, NON HORMONAL SQ IM | 125.30 |
| 11114 | CHEMO IV PUSH, EACH SEQUENTIAL | 253.20 |
| 11113 | CHEMO IV PUSH, INITIAL | 238.80 |
| 3078063 | CHEMO SET 111 CONTINUE-FLO SOLUTION | 80.00 |
| 240209 | CHEST 2 VIEWS | 279.80 |
| 240212 | CHEST 2 VIEWS + OBLIQUE | 361.70 |
| 244021 | CHEST 4+ VIEWS | 106.00 |
| 500211 | CHEST DRAIN ATRIUM | 255.40 |
| 241793 | CHEST LAT DECUB | 232.90 |
| 240191 | CHEST SINGLE VIEW, FRONTAL | 209.50 |
| 241785 | CHEST W/APICAL LORD 3 VIEW | 204.80 |
| 18551 | CHEST WALL MANIPULATION, SUBS | 57.40 |
| 18148 | CHEST WALL PERCUSSION | 69.20 |
| 791308 | CHLAMYDIA BY NUCLEIC ACID AMP(MISC SITE) | 138.00 |
| 3026822 | CHLORASEPTIC SPRAY | 10.00 |
| 3077851 | CHLORHEXIDINE 0.12% LIQ 473ML | 10.50 |
| 330202 | CHLORIDE | 52.00 |
| 331382 | CHLORIDE (24HR URINE) | 50.00 |
| 331374 | CHLORIDE (RANDOM URINE) | 50.00 |
| 3002369 | CHLOR-TRIMETON TAB 4MG | 2.00 |
| 517901 | CHOLANGIOGRAM UNIT 11 | 153.00 |
| 513678 | CHOLANGIOGRAM UNIT 7 | 152.00 |
| 330210 | CHOLESTEROL | 32.00 |
| 790967 | CHROMIUM (SERUM) | 467.00 |
| 791031 | CHROMOGRANIN (A) (SERUM) | 154.00 |
| 791453 | CHROMOSOME ANALYSIS (20-25 CELLS)(BM) | 618.00 |
| 80069 | CHRONIC CARE MANAGEMENT | 96.00 |
| 3024595 | CILOXAN OPTH SOLN 0.3% 5ML | 10.00 |
| 380145 | CIMINO FISTULA LEFT FOREARM | 1,720.00 |
| 307770 | CIMZIA (CERTOLIZUMAB PEGOL) LYO 400MG | 7,402.75 |
| 3021245 | CIPRO TAB (CIPROFLOXACIN) 500MG | 2.00 |
| 3077876 | CIPROFLOXACIN 0.2% OTIC SOL 0.25ML | 5.00 |
| 3018076 | CISplatin VIAL (PLATINOL) 10MG | 237.20 |
| 790057 | CITRATE (24HR URINE) | 130.00 |
| 3002583 | CITRATE OF MAGNESIA 300ML | 10.00 |
| 303291 | CITRUCEL FIBER CAPLETS | 2.00 |
| 790219 | CK ISOENZYMES | 171.00 |
| 330723 | CKMB | 129.00 |
| 514700 | CLAMP COVERS SILICONE | 27.00 |
| 3025410 | CLARITIN 10MG TAB | 2.00 |
| 3029537 | CLARITIN-D 12 HOUR TABLET | 2.00 |
| 1403257 | CLAVICLE | 75.00 |
| 240324 | CLAVICLE LEFT | 197.80 |
| 240325 | CLAVICLE RIGHT | 197.80 |
| 502739 | CLAVICLE SPLINT LARGE | 18.20 |
| 502721 | CLAVICLE SPLINT MEDIUM | 27.50 |
| 502713 | CLAVICLE SPLINT SMALL | 27.50 |
| 503174 | CLAVICLE SPLINT X-LARGE | 27.50 |
| 502010 | CLAVICLE SPLINT X-SMALL/CHILD | 18.20 |
| 3002625 | CLEOCIN (CLINDAMYCIN) 150MG CAP | 2.00 |
| 310125 | CLEOCIN 300MG/ D5W 50 ML | 73.30 |
| 310126 | CLEOCIN 600MG/ D5W 50 ML | 92.30 |
| 310127 | CLEOCIN 900MG/ D5W 50 ML | 102.00 |
| 74001 | CLINIC/AUDIOMETRY | 43.40 |
| 313474 | CLINIMIX 5/20% 2000ML **CENTRAL LINE** | 378.00 |
| 3078873 | CLINIMIX E 2.75/5 IV SOLUTION 1000ML | 148.25 |
| 313470 | CLINIMIX E 2.75/5% 2000ML | 378.00 |
| 3002666 | CLINORIL (SULINDAC) 200MG TAB | 2.00 |
| 517731 | CLIP APPLIER 5MM LIGAMAX | 555.00 |
| 791293 | CLOBAZAM (SERUM) | 244.00 |
| 790999 | CLOMIPRAMINE (SERUM) | 150.00 |
| 790883 | CLONAZEPAM (KLONOPIN) | 110.00 |
| 135955 | CLOSED METACARPAL FRACTURE WITH MANIPULA | 897.00 |
| 136621 | CLOSED REDUCTION SHOULDER | 1,542.00 |
| 380144 | CLOSED REDUCTION WITH CASTING | 1,256.25 |
| 137037 | CLOSED ROTATOR CUFF REPAIR | 1,867.00 |
| 380169 | CLOSED TREATMENT OF HIP DISLOCATION REQ | 1,767.55 |
| 380126 | CLOSED TX DISTAL RADIAL FX/EPIPHYSEAL SE | 546.50 |
| 1403315 | CLOSED/CHEST/SCOPES | 98.40 |
| 1503315 | CLOSED/CHEST/SCOPES | 98.40 |
| 131197 | CLOSURE OF GASTROSTOMY; SURGICAL | 435.00 |
| 790948 | CLOZAPINE (SERUM) | 150.00 |
| 3031073 | CLOZARIL (cloZAPine) 100MG TAB | 2.00 |
| 790032 | CMV (IGG) | 51.00 |
| 790031 | CMV (IGM) | 55.00 |
| 790976 | CMV QUANT (PCR) | 353.00 |
| 790968 | COBALT (SERUM) | 355.00 |
| 516821 | COBLATOR TONSIL EVAC 70 | 783.00 |
| 3018365 | COCAINE 4% 1ML TOP SOLN | 35.50 |
| 16984 | COCCYGEAL FX | 516.00 |
| 171123 | COCCYGEAL FX | 742.00 |
| 798031 | COENZYME Q10 (TOTAL) | 695.00 |
| 3002773 | COGENTIN (BENZTROPINE) 1MG TAB | 2.00 |
| 3002831 | COLACE(DOCUSATE)100MG/10ML SYRUP | 2.00 |
| 3078176 | COLAZAL (BALSALAZIDE) 750MG | 3.00 |
| 3024199 | COLCHICINE 0.6 MG TAB | 2.00 |
| 380156 | COLECTOMY PARTIAL WITH ANASTOMOSIS | 3,132.60 |
| 3031772 | COLESTID TABLET 1000 MG | 2.00 |
| 791237 | COLLAGEN/ADP ASSAY | 176.00 |
| 3024611 | COLLAGENASE 30GM OINT | 206.00 |
| 16090 | COLLECT BLOOD IMPLANT VEIN | 62.00 |
| 171060 | COLLECT BLOOD IMPLANT VEIN | 62.00 |
| 240019 | COLON | 584.10 |
| 240027 | COLON AIR | 701.10 |
| 380002 | COLON SCOPE REMOVAL OF LESION | 1,305.00 |
| 131183 | COLON SCREENING | 1,090.00 |
| 131189 | COLON SCREENING | 1,090.00 |
| 134410 | COLON SCREENING | 1,090.00 |
| 516861 | COLON STIENT 22X90 MM | 4,644.00 |
| 134493 | COLON W/BIOPSY | 1,090.00 |
| 134501 | COLON W/BIOPSY B | 905.80 |
| 134519 | COLON W/BIOPSY C | 894.20 |
| 134527 | COLON W/BIOPSY D | 1,090.80 |
| 134535 | COLON W/BLEEDING A | 785.30 |
| 134543 | COLON W/BLEEDING B | 887.20 |
| 134550 | COLON W/BLEEDING C | 990.20 |
| 134568 | COLON W/BLEEDING D | 1,094.30 |
| 134618 | COLON W/REM OBJ A | 779.40 |
| 134626 | COLON W/REM OBJ B | 963.20 |
| 134634 | COLON W/REM OBJ C | 965.60 |
| 134642 | COLON W/REM OBJ D | 1,166.90 |
| 134451 | COLON W/REMOVAL A | 710.40 |
| 134469 | COLON W/REMOVAL B | 801.70 |
| 134477 | COLON W/REMOVAL C | 986.70 |
| 134485 | COLON W/REMOVAL D | 1,090.80 |
| 13108 | COLON W/REMOVAL POLYP SNARE TECH | 1,405.00 |
| 134584 | COLON W/TUMOR B | 1,017.10 |
| 134592 | COLON W/TUMOR C | 1,129.40 |
| 134600 | COLON W/TUMOR D | 1,135.30 |
| 136639 | COLON/POLYPECT W/O A | 904.70 |
| 134980 | COLON/POLYPECT W/O A | 1,090.00 |
| 136647 | COLON/POLYPECT W/O B | 930.40 |
| 136654 | COLON/POLYPECT W/O C | 1,032.30 |
| 136670 | COLON/POLYPECT W/O D | 1,135.30 |
| 131117 | COLONOSCOPY W/CAUTERY | 1,090.00 |
| 380124 | COLONOSCOPY; FIBEROPTIC; BEYOND SPLENIC | 970.00 |
| 380168 | COLONOSCOPY; FIBEROPTIC; BEYOND SPLENIC | 1,063.75 |
| 380118 | COLONOSCOPY; FIBEROPTIC; BEYOND SPLENIC | 1,156.25 |
| 131168 | COLONSCOPE | 441.30 |
| 134428 | COLONSCOPY B | 962.10 |
| 134436 | COLONSCOPY C | 1,081.40 |
| 134444 | COLONSCOPY D | 1,039.30 |
| 514221 | COLORADO NEEDLE TIP | 470.00 |
| 1403901 | COLP/OTOMY/ECT/ORRHA | 89.80 |
| 131146 | COLPORRHAPHY, SUTURE OF INJURY VAGINA | 830.00 |
| 83017 | COLPOSCOPE RENT | 85.00 |
| 83133 | COLPOSCOPY BIOPSY CERVIX | 364.00 |
| 83134 | COLPOSCOPY BIOPSY CERVIX/ENDOCERVICAL | 400.00 |
| 135385 | COLPOSCOPY W/ BIOPSY OF CERVIX | 363.00 |
| 135384 | COLPOSCOPY W/ BIOPSY OF CERVIX AND ENDO | 389.00 |
| 303445 | COMBIGAN 0.2/0.5% SOL 10ML | 109.20 |
| 3077819 | COMBIVENT RESPIMAT 4GM INH SPRAY | 315.85 |
| 3002955 | COMPAZINE (PROCHLORPERAZINE) 5MG TAB | 2.00 |
| 3002922 | COMPAZINE(PROCHLORPERAZINE) 10MG/2ML INJ | 43.70 |
| 3002930 | COMPAZINE(PROCHLORPERAZINE) 25MG SUPP | 2.00 |
| 790104 | COMPLEMENT TOTAL (SERUM) | 106.00 |
| 170087 | COMPREHENSIVE | 836.40 |
| 16026 | COMPREHENSIVE | 1,285.00 |
| 380087 | COMPREHENSIVE/PER HR | 836.00 |
| 517885 | CONDYLAR PLATE 120MM | 705.00 |
| 517893 | CONDYLAR PLATE 150MM | 741.00 |
| 1405161 | CONT EPID LAB/CES | 98.40 |
| 18379 | CONTINUOUS OVERNIGHT STUDY | 338.30 |
| 517946 | CONTOUR BLUE RELOAD | 759.00 |
| 517949 | CONTOUR GREEN RELOAD | 759.00 |
| 517947 | CONTOUR STAPLER BLUE | 1,350.00 |
| 517948 | CONTOUR STAPLER GREEN | 1,350.00 |
| 242058 | CONTRAST XRAY SHOULDER | 716.80 |
| 16007 | CONTROL POSTERIOR NOSEBLEED | 259.10 |
| 171068 | CONTROL POSTERIOR NOSEBLEED | 562.00 |
| 16008 | CONTROL POSTERIOR NOSEBLEED SUB | 259.10 |
| 171069 | CONTROL POSTERIOR NOSEBLEED SUB | 570.00 |
| 3032525 | CONTROL-A-FLO SET | 78.15 |
| 515296 | COOK CATHETER FIXATION DEVICE | 44.00 |
| 515298 | COOK CHECK FLO INTRODUCER SET | 259.00 |
| 515299 | COOK DUCTOGRAM CANNULA | 208.00 |
| 515297 | COOK YUEH CENTESIS DISP CATH NEEDLE | 155.00 |
| 574094 | COOLCUT 90,ASP ABLATOR | 625.00 |
| 790064 | COPPER (24HR URINE) | 100.00 |
| 790704 | COPPER (SERUM) | 70.00 |
| 3030928 | CORDARONE 150MG/3ML VIAL | 29.40 |
| 3031152 | COREG (CARVEDILOL) 25MG TAB | 2.00 |
| 3030527 | COREG (CARVEDILOL) TAB: 3.125MG | 2.00 |
| 3003045 | CORGARD (NADOLOL) 40MG TAB | 2.00 |
| 93065 | CORRECTION HAMMER TOE | 1,300.00 |
| 3003086 | CORTENEMA 100MG/60ML ENEMA | 15.00 |
| 790821 | CORTISOL (AM) | 52.00 |
| 790994 | CORTISOL (BASELINE STIMULATION) | 52.00 |
| 790970 | CORTISOL (FREE)(24HR URINE) | 100.00 |
| 790870 | CORTISOL (FREE)(RANDOM URINE) | 100.00 |
| 798025 | CORTISOL (PM) | 52.00 |
| 790003 | CORTISOL (POST STIMULATION) | 52.00 |
| 790930 | CORTISOL (SALIVA) | 81.00 |
| 3003110 | CORTISPORIN OTIC SOLN 10ML | 25.00 |
| 3025519 | CORTROSYN VIAL 0.25MG/1ML | 445.10 |
| 3031127 | CORVERT (IBUTILIDE) 1MG INJ | 1,318.80 |
| 3030841 | COSOPT (DORZOLAMIDE/TIMOLOL) 10ML OPHTH | 29.70 |
| 791278 | COTININE (SERUM) | 20.00 |
| 3028471 | COUMADIN (WARFARIN) 1MG TAB | 2.00 |
| 3003144 | COUMADIN (WARFARIN) 2.5MG TAB | 2.00 |
| 3003128 | COUMADIN (WARFARIN) 2MG TAB | 2.00 |
| 3030279 | COUMADIN (WARFARIN) 3MG TAB | 2.00 |
| 3027713 | COUMADIN (WARFARIN) 4MG TAB | 2.00 |
| 3003169 | COUMADIN (WARFARIN) 5MG TAB | 2.00 |
| 3003151 | COUMADIN (WARFARIN) 7.5MG TAB | 2.00 |
| 37126 | COUPLE THERAPY – 1 SESSION | 109.30 |
| 37127 | COUPLE THERAPY – 6 SESSIONS | 546.50 |
| 37128 | COURT EVALUATION | 273.20 |
| 514902 | COVER KIT CIV-FLEX X-RAY | 38.00 |
| 3028976 | COZAAR (LOSARTAN) 25MG TAB | 2.00 |
| 3029271 | COZAAR (LOSARTAN) 50MG TAB | 2.00 |
| 516417 | CPAP FOR ENDOBRONCH TUBE MONTY | 195.00 |
| 512913 | CPAP MASK W/HEADGEAR SIZE LARGE | 133.00 |
| 512912 | CPAP MASK W/HEADGEAR SIZE MEDIUM | 133.00 |
| 512911 | CPAP MASK W/HEADGEAR SIZE SMALL | 133.00 |
| 512914 | CPAP WHISPER SWIVELL | 96.00 |
| 790038 | C-PEPTIDE | 102.00 |
| 330236 | CPK | 75.00 |
| 504906 | CPM KIT | 90.00 |
| 16027 | CPR | 646.80 |
| 171045 | CPR | 852.00 |
| 640030 | CPR CARDS ONLY | 6.50 |
| 508400 | CRADLE BOOT SPAN-AID | 82.00 |
| 3032620 | CRANBERRY TABLET | 2.00 |
| 330244 | CREATININE | 46.00 |
| 331408 | CREATININE (RANDOM URINE) | 66.00 |
| 83007 | CREIGHTON CARDIOLOGY BLDG/RENT | 1,569.50 |
| 3032560 | CRESTOR (ROSUVASTATIN) 10MG TAB | 2.00 |
| 599032 | CRICOTHYROTHMOY 3.5 | 509.00 |
| 599033 | CRICOTHYROTHMOY 6.0 | 509.00 |
| 170111 | CRITICAL CARE EA ADD 30 MIN | 225.00 |
| 16025 | CRITICAL CARE EA ADD 30 MIN | 333.00 |
| 170103 | CRITICAL CARE UP TO 74 MIN | 503.00 |
| 16035 | CRITICAL CARE UP TO 74 MIN | 666.00 |
| 790121 | CRMP-5-IGG | 75.00 |
| 798027 | CRP (C REACTIVE PROTEIN) | 100.00 |
| 790741 | CRP-HS (CARDIAC HIGH SENSITIVE) | 38.00 |
| 791051 | CRYOGLOBULIN (SERUM) | 65.00 |
| 135573 | C-SECTION A | 2,614.60 |
| 135581 | C-SECTION B | 2,969.10 |
| 135599 | C-SECTION C | 3,322.60 |
| 135607 | C-SECTION D | 3,677.10 |
| 135615 | C-SECTION E | 4,031.80 |
| 510211 | C-SECTION PACK | 257.00 |
| 135623 | C-SECTION W/TUBAL A | 2,632.10 |
| 135631 | C-SECTION W/TUBAL B | 2,986.70 |
| 135649 | C-SECTION W/TUBAL C | 3,342.50 |
| 135656 | C-SECTION W/TUBAL D | 3,698.30 |
| 135664 | C-SECTION W/TUBAL E | 4,052.90 |
| 790848 | CSF ALBUMIN | 27.00 |
| 790769 | CSF CELL COUNT | 31.00 |
| 790809 | CSF CRYPTOCOCCUS ANTIGEN | 368.00 |
| 791061 | CSF CULTURE | 87.00 |
| 790767 | CSF GLUCOSE | 100.00 |
| 791333 | CSF IMMUNOFIXATION ELECTROPHORESIS | 391.00 |
| 790808 | CSF LYME DISEASE SEROLOGY (W/REFLEX) | 170.00 |
| 790807 | CSF MYELIN BASIC PROTEIN | 153.00 |
| 790768 | CSF PROTEIN | 87.00 |
| 790748 | CSF PROTEIN ELECTROPHORESIS | 130.00 |
| 790805 | CSF VDRL | 22.00 |
| 240913 | CT ABD W & PELVIS WO CONT | 1,901.80 |
| 240918 | CT ABD W & PELVIS WO/W CONTRAST | 1,901.80 |
| 240911 | CT ABD W/CONT & PELVIS W/CONT | 1,503.90 |
| 240894 | CT ABD W/CONTRAST | 1,755.50 |
| 240910 | CT ABD W/O CONTRAST | 1,063.80 |
| 240912 | CT ABD W/WO CONT & PELVIS W/WO CONT | 1,901.80 |
| 240917 | CT ABD WO & PELVIS WO CONTRAST | 1,221.90 |
| 240916 | CT ABD WO & PELVIS W/ CONTRAST | 1,901.80 |
| 240914 | CT ABD WO & PELVIS WO/W | 1,901.80 |
| 240902 | CT ABD WO&W CONTRAST | 2,105.50 |
| 240920 | CT ABD WO/W & PELVIS W CONTRAST | 1,901.80 |
| 240919 | CT ABD WO/W & PELVIS WO CONTRAST | 1,901.80 |
| 240600 | CT ANGIO ABD ARTERIES | 2,269.30 |
| 240601 | CT ANGIO LOW EXT | 1,000.00 |
| 240915 | CT ANGIOGRAPHY ABD W/O&W CONTRAST | 2,339.60 |
| 242085 | CT ANGIOGRAPHY CHEST (NON-CORONARY) | 2,414.20 |
| 241120 | CT ANGIOGRAPHY HEAD | 2,265.80 |
| 242123 | CT ANGIOGRAPHY HEAD | 2,338.50 |
| 241121 | CT ANGIOGRAPHY NECK | 2,265.80 |
| 242395 | CT BONE DENSITY STUDY | 361.70 |
| 241405 | CT CERVICAL SPINE W/CONTRAST | 1,430.20 |
| 241439 | CT CERVICAL SPINE W/O CONTRAST | 1,180.80 |
| 242072 | CT CERVICAL SPINE WO&W CONTRAST | 1,787.10 |
| 240936 | CT CHEST W/CONTRAST | 1,403.20 |
| 242080 | CT CHEST W/WO CONTRAST | 1,508.60 |
| 240951 | CT CHEST WO CONTRAST | 1,169.20 |
| 241122 | CT COLONOGRAPHY, DIAGNOSTIC | 650.80 |
| 241123 | CT COLONOGRAPHY, SCREENING | 911.10 |
| 242190 | CT CYSTOGRAM – URETERAL REFLUX STUDY | 1,053.80 |
| 241579 | CT GUIDE (BX,ASP,INJ,LOC) SI | 1,956.80 |
| 240977 | CT HEAD/BRAIN W/CONTRAST | 1,169.20 |
| 240993 | CT HEAD/BRAIN W/O CONTRAST | 1,052.20 |
| 240985 | CT HEAD/BRAIN WO&W CONTRAST | 2,047.00 |
| 242096 | CT LIMITED F/U | 864.90 |
| 241009 | CT LOW EXT W/CONTRAST LEFT | 1,075.60 |
| 241005 | CT LOW EXT W/CONTRAST RIGHT | 1,075.60 |
| 241025 | CT LOW EXT W/O CONTRAST LEFT | 1,052.20 |
| 241004 | CT LOW EXT W/O CONTRAST RIGHT | 1,052.20 |
| 241017 | CT LOW EXT WO&W CONTRAST LEFT | 1,598.70 |
| 241003 | CT LOW EXT WO&W CONTRAST RIGHT | 1,598.70 |
| 242098 | CT LUMBAR SPINE W/CONTRAST | 1,245.30 |
| 241058 | CT LUMBAR SPINE W/O CONTRAST | 1,110.70 |
| 242106 | CT LUMBAR SPINE WO&W CONTRAST | 1,787.10 |
| 242361 | CT MAXILLO FACIAL WITHOUT CONTRAST | 1,122.30 |
| 242379 | CT MAXILLOFACIAL W/CONTRAST | 1,353.00 |
| 242387 | CT MAXILLOFACIAL WO&W CONTRAST | 1,502.70 |
| 241500 | CT MYELOGRAM LUMBAR | 536.20 |
| 242500 | CT MYELOGRAM LUMBAR SI | 1,424.80 |
| 241496 | CT NECK W/CONTRAST | 1,282.70 |
| 242122 | CT NECK W/O CONTRAST | 923.40 |
| 242114 | CT NECK WO&W CONTRAST | 1,720.50 |
| 242130 | CT ORBIT/EAR/FOSSA W/CONTRAST | 1,588.20 |
| 241595 | CT ORBIT/EAR/FOSSA W/O CONTRAST | 1,052.20 |
| 242148 | CT ORBIT/EAR/FOSSA W/O&W CONTRAST | 1,820.00 |
| 241413 | CT PELVIS W/CONTRAST | 1,368.10 |
| 241397 | CT PELVIS W/O CONTRAST | 1,192.60 |
| 241371 | CT PELVIS WO&W CONTRAST | 2,084.40 |
| 242254 | CT SINUS W/CONTRAST | 1,353.00 |
| 242270 | CT SINUS W/O CONTRAST | 1,122.30 |
| 242262 | CT SINUS WO&W CONTRAST | 1,502.70 |
| 242155 | CT THORACIC SPINE W/CONTRAST | 1,713.50 |
| 241546 | CT THORACIC SPINE W/O CONTRAST | 1,444.20 |
| 242163 | CT THORACIC SPINE WO&W CONTRAST | 1,787.10 |
| 242197 | CT UP EXT W/CONTRAST LEFT | 970.30 |
| 242191 | CT UP EXT W/CONTRAST RIGHT | 970.30 |
| 242171 | CT UP EXT W/O CONTRAST LEFT | 1,015.90 |
| 242192 | CT UP EXT W/O CONTRAST RIGHT | 1,015.90 |
| 242189 | CT UP EXT WO&W CONTRAST LEFT | 1,522.70 |
| 242193 | CT UP EXT WO&W CONTRAST RIGHT | 1,522.70 |
| 262405 | CTA RUNOFF | 1,650.00 |
| 3032612 | CUBICIN (DAPTOmycin):500MG VIAL | 880.90 |
| 131182 | CUBITAL TUNNEL RELEASE | 2,000.00 |
| 1403943 | CULDOSCOPY | 89.80 |
| 790847 | CULTURE AFB | 44.00 |
| 330863 | CULTURE BLOOD | 175.00 |
| 791224 | CULTURE BODY FLUID | 87.00 |
| 790485 | CULTURE FUNGUS BLOOD | 100.00 |
| 790482 | CULTURE FUNGUS OTHER SOURCE | 61.00 |
| 791227 | CULTURE GENITAL | 87.00 |
| 791891 | CULTURE GROUP B STREP (VAG/REC) | 115.00 |
| 330921 | CULTURE OTHER SOURCE | 87.00 |
| 791485 | CULTURE RESPIRTORY (REFERENCE LAB) | 35.00 |
| 330925 | CULTURE SPUTUM | 87.00 |
| 330889 | CULTURE STOOL | 105.00 |
| 330864 | CULTURE STREP A | 46.00 |
| 330897 | CULTURE THROAT/NOSE | 87.00 |
| 798029 | CULTURE TISSUE | 87.00 |
| 330905 | CULTURE URINE COLONY COUNT | 58.00 |
| 791440 | CULTURE URINE PRESUMPTIVE ID (EACH ISO) | 21.00 |
| 790020 | CULTURE VIRAL | 160.00 |
| 791323 | CULTURE VIRAL (NON RESPIRATORY) | 160.00 |
| 791226 | CULTURE WOUND | 87.00 |
| 3026392 | CYANOCOBALAMIN (VIT B12) 1000MCG/ML INJ | 29.40 |
| 3034002 | CYCLOPENTOLATE 1% OPHT SOL 2M | 15.00 |
| 303301 | CYCLOPHOSPHAMIDE (CYTOXAN)500MG IV | 645.40 |
| 791300 | CYCLOSPORA CONCENTRATION | 83.00 |
| 791032 | CYCLOSPORA STAIN (STOOL) | 83.00 |
| 790054 | CYCLOSPORIN (WHOLE BLOOD) | 113.00 |
| 3026442 | cycloSPORINE (NEORAL) 25MG TAB | 2.00 |
| 136076 | CYCTO C | 2,286.90 |
| 3032596 | CYMBALTA (DULoxetine) 30MG CAP | 2.00 |
| 303345 | CYMBALTA (DULoxetine)20MG CAP | 2.00 |
| 3078881 | CYRAMZA INTRAVENOUS SOLUTION 100MG/10ML | 2,696.60 |
| 3078880 | CYRAMZA INTRAVENOUS SOLUTION 500MG/50ML | 13,482.85 |
| 790056 | CYSTINURIA PROFILE (QUANT)(24HR URINE) | 282.00 |
| 240639 | CYSTO >=3 VIEWS SI | 415.80 |
| 136050 | CYSTO A | 1,576.50 |
| 136068 | CYSTO B | 1,931.10 |
| 136084 | CYSTO D | 2,641.40 |
| 241975 | CYSTO/VOIDING CYSTO(VCUG) | 946.00 |
| 303530 | CYSTOGRAFIN (DIATRIZOATE) 30% 300ML | 230.80 |
| 1403703 | CYSTOLITHOTOMY | 89.80 |
| 3029776 | CYTARABINE (CYTOSAR-U) 500MG | 168.95 |
| 303605 | CYTARABINE AQ 100MG/5ML VL | 29.40 |
| 791481 | CYTOGENETIC STUDY | 642.00 |
| 791468 | CYTOGENETICS & MOLEC INTERP AND REPORT | 226.00 |
| 791427 | CYTOGENOMIC MICROARRAY ANALYSIS (CGH) | 1,470.00 |
| 579042 | CYTOLOGY GASTRO BRUSH | 58.00 |
| 3003284 | CYTOMEL(LIOTHYRONINE)TAB 5MCG | 2.00 |
| 790670 | CYTOPATH (NON GYN) | 167.00 |
| 790794 | CYTOPATH CONCENTRATE | 32.00 |
| 3023647 | CYTOTEC (MISOPROSTOL) 100MCG TAB | 2.00 |
| 3077826 | CYTOTEC (MISOPROSTOL) 200MCG TAB | 2.00 |
| 3027424 | CYTRA-2(SODIUM CITRATE/CITRATEACID) | 3.00 |
| 135458 | D & C A | 1,576.50 |
| 135466 | D & C B | 1,931.10 |
| 135474 | D & C C | 2,286.90 |
| 135482 | D & C D | 2,641.40 |
| 135490 | D & C HYSTEROSCOPY A | 2,086.70 |
| 135508 | D & C HYSTEROSCOPY B | 2,440.20 |
| 135516 | D & C HYSTEROSCOPY C | 2,796.00 |
| 135524 | D & C HYSTEROSCOPY D | 3,150.50 |
| 331424 | D DIMER (QUANT) | 125.00 |
| 136399 | D&C HYSTER-LAP A | 6,167.70 |
| 136407 | D&C HYSTER-LAP B | 6,525.70 |
| 136415 | D&C HYSTER-LAP C | 6,880.30 |
| 136423 | D&C HYSTER-LAP D | 7,235.00 |
| 136431 | D&C HYSTER-LAP E | 7,589.50 |
| 136449 | D&C HYSTER-OPENLAP A | 6,229.70 |
| 136456 | D&C HYSTER-OPENLAP B | 6,584.20 |
| 136464 | D&C HYSTER-OPENLAP C | 6,940.10 |
| 136472 | D&C HYSTER-OPENLAP D | 7,294.60 |
| 136480 | D&C HYSTER-OPENLAP E | 7,649.20 |
| 136498 | D&C HYSTER-OPENLAP F | 8,003.90 |
| 131145 | D&C TREATMENT INCOMPLETE ABORTION | 2,000.00 |
| 311524 | D10NS:1000ML | 90.00 |
| 310633 | D10W :1000 ML | 95.00 |
| 3772118 | D10W: 250ML | 50.00 |
| 3032549 | D5 1/2NS + KCL 40 MEQ/:1000 ML | 160.00 |
| 310158 | D5 1/2NS/KCL 20MEQ 1000ML | 160.00 |
| 310246 | D5 1/4 500ML | 80.00 |
| 3032551 | D5 1/4NS + KCL 20 MEQ/:1000ML | 160.00 |
| 3078676 | D51/2NS/KCL 30MEQ 1000ML | 160.00 |
| 310237 | D51/2NS:1000ML | 95.00 |
| 311565 | D51/2NS:500ML | 74.90 |
| 3172111 | D51/2NS:500ML | 80.00 |
| 310245 | D51/4NS:1000ML | 95.00 |
| 310302 | D5LR:1000ML | 95.00 |
| 3032552 | D5NS + KCL 20 MEQ:1000ML | 160.00 |
| 3032616 | D5NS + KCL 40 MEQ:1000ML | 160.00 |
| 310211 | D5NS:1000ML | 95.00 |
| 313542 | D5W 250MLvisiv | 50.00 |
| 311124 | D5W 500ML VISIV | 80.00 |
| 310054 | D5W:1000ML | 95.00 |
| 310021 | D5W:100ML | 50.00 |
| 310039 | D5W:250ML | 50.00 |
| 310047 | D5W:500ML | 80.00 |
| 3030576 | DACARBAZINE(DTIC)INJ 200MG | 115.95 |
| 510435 | DACRON FLUFF-STERILE | 9.10 |
| 1405113 | DAILY HOSP MGMT OF EPIDURAL | 295.20 |
| 3019504 | DAKIN 0.25% SOLUTION | 20.00 |
| 303754 | DALIRESP (ROFLUMILAST) 500MCG TAB | 4.00 |
| 3078242 | DALVANCE IV POWDER FOR SOLUTION 500MG | 1,700.00 |
| 303603 | DANTRIUM (DANTROLENE SODIUM) 20MG VIAL | 338.30 |
| 3077833 | DAPSONE 100MG TAB | 2.00 |
| 303307 | DAPTACEL (DIPTH,PERTUS,TET PED) | 110.05 |
| 56050 | DAY CARE MEALS | 3.70 |
| 303692 | DDAVP 4MCG/ML (DESMOPRESSIN ACETATE) | 1,135.80 |
| 3031202 | DDAVP RHINAL 10MCG/0.1ML 5ML | 47.00 |
| 380162 | DEBRIDE INFECTED SKIN | 124.20 |
| 93062 | DEBRIDEMENT FOREIGN MATTER | 862.00 |
| 171088 | DEBRIDEMENT INFECTED SKIN | 124.20 |
| 16932 | DEBRIDEMENT INFECTED SKIN | 235.30 |
| 93061 | DEBRIDEMENT SKIN SUBCUTANEOUS | 1,315.00 |
| 131195 | DEBRIDEMENT SKIN,SUBCU,MUSCLE | 55.00 |
| 13109 | DEBRIDEMENT SKIN,SUBCU,MUSCLE | 85.00 |
| 131121 | DEBRIDEMENT SKIN/SUBCU/MUSCLE | 556.00 |
| 131123 | DEBRIDEMENT SUBCU TISSUE FIRST 20 SQ CM | 556.00 |
| 3003433 | DEBROX DROPS 15ML | 10.00 |
| 3030862 | DECADRON (DEXAMETHASONE) 1MG TAB | 2.00 |
| 3028505 | DECADRON (DEXAMETHASONE)0.1% OPH SOL 5ML | 15.00 |
| 3024066 | DECADRON (DEXAMETHASONE)10MG/ML 1ML INJ | 29.40 |
| 3003482 | DECADRON(DEXAMETHASONE) 4MG TAB | 2.00 |
| 3003458 | DECADRON(DEXAMETHASONE)SDV 4MG/ML 1ML | 29.40 |
| 791696 | DECALCITRATION PROCEDURE | 17.00 |
| 3078289 | DECITABINE IV SOLN 50MG VIAL | 2,621.50 |
| 16085 | DECLOT THROMBOLYTIC VEIN | 121.00 |
| 171061 | DECLOT THROMBOLYTIC VEIN | 121.00 |
| 11129 | DECLOTTING OF VAD | 298.50 |
| 93077 | DECOMPRESSION SUBACROMIAL SPACE | 1,551.00 |
| 137034 | DECOMPRESSIVE LAMINECTOMY | 2,240.55 |
| 1403372 | DECORTATION | 89.80 |
| 501301 | DECUBITI PAD BED SZ 33X72X2 | 75.00 |
| 501293 | DECUBITI PAD W/C 16X 18 X 3 | 76.00 |
| 534028 | DEFIB/PACER HEARTSTART ADULT | 96.00 |
| 534029 | DEFIB/PACER HEARTSTART PEDS | 103.00 |
| 3077816 | DEFINITY (PERFLUTREN LIPID)6.52MG/ML 2ML | 381.10 |
| 8015 | DELIVERY/LABOR ROOM | 1,884.30 |
| 3008093 | DEMEROL(MEPERIDINE) 50MG INJ | 35.60 |
| 3015429 | DEMEROL(MEPERIDINE)TABLET 50MG | 2.00 |
| 18241 | DEMONSTRATE PATIENT USE | 91.50 |
| 3031142 | DEPACON (VALPROATE) 100MG/ML 5ML INJ | 79.90 |
| 3003581 | DEPAKENE (VALPROIC) 250MG CAP | 2.00 |
| 3017656 | DEPAKOTE DR 250MG TAB | 2.00 |
| 3030030 | DEPAKOTE DR(DIVALPROEX) 125MG TAB | 4.25 |
| 3017748 | DEPAKOTE ER (DIVALPROEX) 500MG TAB | 2.00 |
| 11133 | DEPO PROVERA INJECTION | 45.90 |
| 3003649 | DEPO-MEDROL(methylPREDNISolone) 40MG/1ML | 34.80 |
| 3003656 | DEPO-MEDROL(methylPREDNIsolone) 80MG/1ML | 60.40 |
| 3021849 | DEPO-PROVERA(medroxyPROGESTERone) 150MG | 275.65 |
| 565027 | DERMABOND SKIN ADHESIVE | 109.00 |
| 565026 | DERMABOND SKIN MINI | 65.00 |
| 504588 | DERMAGRAN B 3 OZ TUBES | 51.00 |
| 3017623 | DESFERAL (DEFEROXAMINE) 2GM INJ | 190.44 |
| 3030733 | DESONIDE (DESOWEN) 0.05% 15GM CR | 25.00 |
| 131192 | DESTRUCTION PREMALIGNANT LESIONS, 1ST LE | 435.00 |
| 131193 | DESTRUCTION PREMALIGNANT LESIONS, 2-14 | 20.00 |
| 3003706 | DESYREL (traZODone) 50MG TAB | 2.50 |
| 170061 | DETAILED | 607.60 |
| 380061 | DETAILED | 608.00 |
| 16034 | DETAILED | 777.00 |
| 3031319 | DETROL (TOLTERODINE) 2MG TAB | 2.00 |
| 3032578 | DETROL LA (TOLTERODINE) 2MG CAP | 2.00 |
| 3030938 | DETROL LA (TOLTERODINE) 4MG CAP | 2.00 |
| 791284 | DEXAMETHASONE | 401.00 |
| 303616 | DEXILANT (DEXALANSOPRAZOLE) 60MG | 2.00 |
| 3003730 | DEXTROSE 50% INJ 50ML | 80.45 |
| 3028968 | DHE (DIHYDROERGOTAMINE) 45 1MG/ML INJ | 260.60 |
| 790877 | DHEA | 184.00 |
| 790030 | DHEA-SULFATE | 81.00 |
| 690005 | DIABETES GRP COUNSELING 30 MIN | 72.00 |
| 690006 | DIABETES GRP COUNSELING 60 MIN | 120.00 |
| 137039 | DIAGNOSTIC ARTHROSCOPY | 1,126.20 |
| 136548 | DIAGNOSTIC ARTHROSCOPY | 2,000.00 |
| 3003797 | DIAMOX(acetaZOLAMIDE) 250MG TAB | 2.00 |
| 3016591 | DIAPER RASH 2OZ OINT | 10.00 |
| 303398 | DIASTAT (DIAZEPAM)10MG RECTAL GEL | 811.80 |
| 3030882 | DIASTAT(DIAZEPAM)PED SYSTEM 2.5MG RECTAL | 684.30 |
| 56051 | DIETARY CONSULTATION/ELMWOOD | 37.50 |
| 56053 | DIETARY CONSULTATION/MAPLE HEIGHTS | 43.20 |
| 56054 | DIETARY CONSULTATION/POAKLAND HOSPITAL | 56.30 |
| 3022961 | DIFLUCAN (FLUCONAZOLE) 100MG TAB | 2.00 |
| 3027176 | DIFLUCAN 200MG/100ML BAG | 439.05 |
| 3077842 | DIFLUCAN(FLUCONAZOLE) 40MG/ML SUSP 35ML | 25.00 |
| 3031150 | DIGIFAB 40MG/VIAL INJ | 3,484.70 |
| 515120 | DIGIT WIDGET | 3,078.00 |
| 330814 | DIGOXIN | 96.00 |
| 3007137 | DIGOXIN 0.125MG TAB | 2.00 |
| 3007129 | DIGOXIN 0.25MG TAB | 2.00 |
| 790945 | DIHYDROTESTOSTERONE | 102.00 |
| 330251 | DILANTIN (PHENYTOIN) | 282.00 |
| 3003920 | DILANTIN (PHENYTOIN) 100MG CAP | 2.00 |
| 3017136 | DILANTIN (PHENYTOIN) 100MG/2ML INJ | 29.40 |
| 3026004 | DILANTIN (PHENYTOIN) 50MG CHEWABLE TAB | 2.00 |
| 3003961 | DILANTIN(PHENYTOIN) 125MG/5ML SUSP | 2.00 |
| 3003912 | DILANTIN(PHENYTOIN) 250MG/5ML INJ | 29.40 |
| 3003953 | DILANTIN(PHENYTOIN)SUSP 125MG/5ML:30ML | 12.00 |
| 3003995 | DILAUDID(HYDROmorphone) 2MG TAB | 2.00 |
| 791239 | DILUTE RUSSELLS VIPER VENOM TIME | 131.00 |
| 3030469 | DIOVAN (VALSARTAN) 80MG TAB | 2.00 |
| 3032539 | DIOVAN/HCT(VALSARTAN/HCTZ) 80/12.5MG TAB | 2.00 |
| 790069 | DIPHTHERIA TOXOID (IGG) ANTIBODY | 107.00 |
| 3024488 | DIPRIVAN 1% 10MG/ML 20 ML VIAL | 29.40 |
| 3016088 | DIPROSONE (BETAMETHASONE) 0.05% 15GM CRM | 10.00 |
| 3030776 | DIPROSONE (BETAMETHASONE) 0.05% 15GM OIN | 43.40 |
| 36058 | DIRECTED DONATION | 306.70 |
| 170498 | DISLOCATED ANKLE NO ANESTHESIA | 1,801.00 |
| 16129 | DISLOCATED ANKLE NO ANESTHESIA | 1,256.00 |
| 170499 | DISLOCATED ANKLE W/ ANESTHESIA | 2,155.00 |
| 16130 | DISLOCATED ANKLE W/ ANESTHESIA | 1,451.00 |
| 16079 | DISLOCATED HIP NO ANESTHESIA | 1,376.00 |
| 170487 | DISLOCATED HIP NO ANESTHESIA | 1,798.00 |
| 16082 | DISLOCATED HIP W/ ANESTHESIA | 2,115.00 |
| 170488 | DISLOCATED HIP W/ ANESTHESIA | 3,110.00 |
| 16131 | DISLOCATED INTERPHALANGEAL JOINT NO ANES | 855.00 |
| 170500 | DISLOCATED INTERPHALANGEAL JOINT NO ANES | 1,148.00 |
| 16132 | DISLOCATED INTERPHALANGEAL JOINT W/ ANES | 900.00 |
| 170501 | DISLOCATED INTERPHALANGEAL JOINT W/ ANES | 1,366.00 |
| 16077 | DISLOCATED KNEE NO ANESTHESIA | 1,181.00 |
| 171145 | DISLOCATED KNEE NO ANESTHESIA | 1,310.00 |
| 16078 | DISLOCATED KNEE W/ ANESTHESIA | 1,790.00 |
| 171146 | DISLOCATED KNEE W/ ANESTHESIA | 2,332.00 |
| 578609 | DISTAL FEMORAL DRILL 3.7 GAMMA | 596.00 |
| 16995 | DISTAL FEMORAL NO MANIPULATION | 1,500.00 |
| 171134 | DISTAL FEMORAL NO MANIPULATION | 1,952.00 |
| 16996 | DISTAL FEMORAL W/ MANIPULATION | 2,250.00 |
| 171135 | DISTAL FEMORAL W/ MANIPULATION | 3,234.00 |
| 16991 | DISTAL FIBULAR NO MANIPULATION | 891.00 |
| 171130 | DISTAL FIBULAR NO MANIPULATION | 1,101.00 |
| 16992 | DISTAL FIBULAR W/ MANIPULATION | 1,296.00 |
| 171131 | DISTAL FIBULAR W/ MANIPULATION | 1,788.00 |
| 16982 | DISTAL PHALANGE NO MANIPULATION | 560.00 |
| 171121 | DISTAL PHALANGE NO MANIPULATION | 713.00 |
| 16983 | DISTAL PHALANGE W/ MANIPULATION | 900.00 |
| 171122 | DISTAL PHALANGE W/ MANIPULATION | 1,239.00 |
| 16976 | DISTAL RADIAL OR EPIPHYSEAL SEP NO MAN | 900.00 |
| 171115 | DISTAL RADIAL OR EPIPHYSEAL SEP NO MAN | 1,119.00 |
| 131191 | DISTAL RADIAL OR EPIPHYSEAL SEP W/ MAN | 1,542.00 |
| 16977 | DISTAL RADIAL OR EPIPHYSEAL SEP W/ MAN | 1,721.00 |
| 171116 | DISTAL RADIAL OR EPIPHYSEAL SEP W/ MAN | 2,244.00 |
| 3004159 | DITROPAN (OXYBUTYNIN) 5MG TAB | 2.00 |
| 3030805 | DITROPAN XL (OXYBUTYNIN) 5MG TAB | 2.00 |
| 18016 | DLCO DIFFUSION -CO2/MEMBRANE DIFFUSE CAP | 191.50 |
| 791554 | DNA & RNA EXTRACT & HOLD | 225.00 |
| 791057 | DNA PROBE CHLAMYDIA | 138.00 |
| 791056 | DNA PROBE N.GONORRHOEAE | 138.00 |
| 3031024 | DOBUTREX (DOBUTamine) BAG: 500MG/250ML | 140.00 |
| 3004258 | DOBUTREX VIAL(DOBUTamine) 250MG/20ML | 70.90 |
| 3031301 | DOCEtaxel 20MG/2ml SDV | 1,610.00 |
| 3002856 | DOCUSATE(COLACE) 100MG CAP | 2.00 |
| 3004274 | DOMEBORO PACK | 2.00 |
| 303431 | DONEPEZIL 10MG TAB | 2.00 |
| 3030889 | DOPamine BAG: 400MG/D5W 250ML | 150.00 |
| 3004423 | DOPamine:800MG | 144.40 |
| 240266 | DORSAL SPINE 2V | 201.40 |
| 240270 | DORSAL SPINE 4 VIEWS | 310.20 |
| 240018 | DORSAL WITH SWIMMERS, 3 VIEW | 350.00 |
| 3077874 | DOTAREM 5 MMOL 10ML | 216.90 |
| 303400 | DOVONEX (CALCIPOTRIENE)0.005% CREAM 60G | 308.80 |
| 3000140 | DOXOrubicin (ADRIAMYCIN): 10MG 2MG/ML | 52.85 |
| 3030844 | DOXOrubicin LIPOSOME(DOXIL): 10MG 2MG/ML | 1,140.72 |
| 3014505 | DOXYCYCLINE (VIBRAMYCIN) 100MG CAP | 2.00 |
| 3024082 | DOXYCYCLINE 100MG/NS 250 ML | 159.40 |
| 544786 | DOYLE NASAL SEPTAL SPLINT | 286.00 |
| 506194 | DRAIN BAG 300 CC X-RAY | 143.00 |
| 517043 | DRAIN CATHETER 6FR. X-RAY | 420.00 |
| 517044 | DRAIN CATHETER APD LOOP 10/25 X-RAY | 514.00 |
| 16003 | DRAIN EXT EAR COM ABSCESS | 510.00 |
| 171067 | DRAIN EXT EAR COM ABSCESS | 510.00 |
| 16002 | DRAIN EXTERNAL EAR SIM ABSCESS | 387.00 |
| 171066 | DRAIN EXTERNAL EAR SIM ABSCESS | 387.00 |
| 509968 | DRAIN, ROUND W/ TROACR FOR KNEES | 65.00 |
| 517042 | DRAINAGE CATHETER SET X-RAY | 456.00 |
| 137040 | DRAINAGE OF INFECTION | 133.20 |
| 574771 | DRILL 4MM FOR 4.5MM ANCHOR SL | 498.00 |
| 578606 | DRILL BIT 5.0 PILOT TIP DISTAL | 373.00 |
| 568137 | DRILL BITS 4.5 | 1,435.00 |
| 568140 | DRILL BITS 2.5 QUICK CONNECT SMALL | 362.00 |
| 568141 | DRILL BITS 3.5 QUICK CONNECT SMALL | 362.00 |
| 3032595 | DRISDOL (ERGOCALCIFEROL) 50,000 UNIT CAP | 2.00 |
| 790610 | DS-DNA AB (DOUBLE STRANDED) | 49.00 |
| 80010 | DSME (MEDICAID) | 928.28 |
| 798104 | DU ANTIGEN | 26.00 |
| 518020 | DUAL SUMP SILICONE – OR ONLY | 70.00 |
| 3004480 | DULCOLAX (BISACODYL) 10MG SUPPOS | 2.00 |
| 3004498 | DULCOLAX (BISACODYL) 5MG TAB | 2.00 |
| 3031043 | DUONEB (ALBUTEROL/ATROVENT) SOL NEB | 2.00 |
| 3026590 | DURAGESIC (fentaNYL) 100MCG PATCH | 12.30 |
| 3026582 | DURAGESIC (fentaNYL) 75MCG PATCH | 9.20 |
| 303382 | DURAGESIC PATCH(fentaNYL) 12MCG | 18.90 |
| 3023662 | DURAGESIC PATCH(fentaNYL) 25MCG | 3.40 |
| 3023670 | DURAGESIC PATCH(fentaNYL) 50MCG | 6.10 |
| 303609 | DURAMORPH P/F 10MG/10ML AMP | 54.00 |
| 510500 | DVT LARGE UNIVERSAL | 153.00 |
| 510502 | DVT XL UNIVERSAL | 159.00 |
| 380160 | DX BRONCHOSCOPE/BRUSH | 731.30 |
| 1403407 | DX/THERAPEUTIC LUMAR PUNCTURE | 98.40 |
| 3004506 | DYAZIDE 37.5MG/25MG TAB | 2.00 |
| 131326 | EA ADDITIONAL LESION | 427.00 |
| 131328 | EA ADDITIONAL LESION | 1,160.00 |
| 11417 | EACH ADDITIONAL HOUR UP TO 8 | 37.50 |
| 170855 | EAR REV FOREIGN BODY | 170.50 |
| 509296 | EAR TUBES ARMSTRONG | 81.00 |
| 512951 | EASY CAP | 49.00 |
| 512952 | EASY CAP ADULT/PED PHILIPS | 49.00 |
| 513702 | EASY CAP PEDI 6 | 49.00 |
| 581160 | EASY WIPE TOILET AIDE | 87.00 |
| 23058 | ECHO LIMITED | 204.00 |
| 23057 | ECHOCARDIOGRAM | 884.10 |
| 23060 | ECHOCARDIOGRAM W/COLOR | 292.70 |
| 23108 | ECHOCARDIOGRAM W/DOPPLER & COLOR INCLUDE | 416.00 |
| 23055 | ECHOCARDIOGRAM W/DOPPLER & COLOR INCLUDE | 1,003.20 |
| 23109 | ECHOCARDIOGRAM WO COLOR | 205.85 |
| 594139 | ECS25A 25 STAPLER | 1,133.00 |
| 501587 | EDEMA WEAR STOCKING LARGE | 94.00 |
| 501586 | EDEMA WEAR STOCKING MEDIUM | 65.00 |
| 501585 | EDEMA WEAR STOCKING SMALL | 55.00 |
| 514054 | EEA 29 STAPLER | 1,115.00 |
| 514055 | EEA 33 STAPLER | 1,097.00 |
| 3026863 | EFFEXOR (VENLAFAXINE) 37.5MG TAB | 2.00 |
| 3031103 | EFFEXOR TAB (VENLAFAXINE) 25MG | 4.00 |
| 3030939 | EFFEXOR XR (VENLAFAXINE) 37.5MG CAP | 2.00 |
| 3031921 | EFFEXOR XR (VENLAFAXINE) 75MG CAP | 2.00 |
| 303561 | EFFIENT (PRASUGREL) 10MG TAB | 2.00 |
| 134659 | EGD DIAGNOSTIC | 1,090.00 |
| 380140 | EGD ESOPHAGUS BALLOON DILATION 30 MM OR | 606.25 |
| 380173 | EGD ESOPHAGUS BALLOON DILATION 30 MM OR | 770.00 |
| 134907 | EGD W/BALLOON<30 B | 896.60 |
| 134915 | EGD W/BALLOON<30 C | 956.20 |
| 134923 | EGD W/BALLOON<30 D | 1,058.10 |
| 134691 | EGD W/BIOPSY A | 944.60 |
| 134709 | EGD W/BIOPSY B | 1,164.50 |
| 134717 | EGD W/BIOPSY C | 1,163.40 |
| 134725 | EGD W/BIOPSY D | 1,207.80 |
| 134972 | EGD W/CONT BLEED A | 822.80 |
| 134998 | EGD W/CONT BLEED C | 1,027.60 |
| 135003 | EGD W/CONT BLEED D | 1,128.20 |
| 134774 | EGD W/DILATION A | 950.30 |
| 134782 | EGD W/DILATION B | 950.30 |
| 134683 | EGD W/DILATION BALLOON | 1,390.00 |
| 134790 | EGD W/DILATION C | 936.30 |
| 134808 | EGD W/DILATION D | 1,039.30 |
| 134675 | EGD W/DILATION GUIDEWIRE | 1,390.00 |
| 134733 | EGD W/INJECTION A | 1,096.70 |
| 134741 | EGD W/INJECTION B | 1,199.70 |
| 134758 | EGD W/INJECTION C | 1,302.60 |
| 134766 | EGD W/INJECTION D | 1,405.70 |
| 134816 | EGD W/PEG TUBE A | 950.30 |
| 134824 | EGD W/PEG TUBE B | 1,886.60 |
| 134832 | EGD W/PEG TUBE C | 1,803.60 |
| 134840 | EGD W/PEG TUBE D | 2,090.30 |
| 134857 | EGD W/REMOVAL OBJ A | 849.70 |
| 134931 | EGD W/REMOVAL OBJ A | 951.60 |
| 134865 | EGD W/REMOVAL OBJ B | 877.80 |
| 134949 | EGD W/REMOVAL OBJ B | 1,056.80 |
| 134873 | EGD W/REMOVAL OBJ C | 980.80 |
| 134956 | EGD W/REMOVAL OBJ C | 1,158.70 |
| 134881 | EGD W/REMOVAL OBJ D | 1,082.60 |
| 134964 | EGD W/REMOVAL OBJ D | 1,260.50 |
| 134667 | EGD WITH BIOPSY | 1,090.00 |
| 791476 | EGFR BY IHC, SCOPE IA | 224.00 |
| 242049 | EH XRAY-CHEST | 32.80 |
| 83056 | EKG | 58.00 |
| 23056 | EKG | 146.30 |
| 505096 | ELAS BAND 3 /STERILE | 20.00 |
| 791020 | ELASTASE PANCREATIC (SERUM) | 111.00 |
| 516507 | ELASTIC STAYS 4 5MM 2 FINGER | 210.00 |
| 516449 | ELASTIC STAYS 8 5MM | 295.00 |
| 3004639 | ELAVIL(AMITRIPTYLINE)100MG TAB | 2.00 |
| 3004613 | ELAVIL(AMITRIPTYLINE)TAB 10MG | 2.00 |
| 1404685 | ELB/SHOULDE/TENOPLAS | 89.80 |
| 1404677 | ELB/SHOULDER/TENOT/O | 89.80 |
| 1404701 | ELBO/HUMER/CLOSED/PR | 81.30 |
| 504911 | ELBOW FIXATOR | 12,196.00 |
| 240381 | ELBOW LEFT 2 VIEWS | 186.20 |
| 240399 | ELBOW LEFT 3 VIEWS | 232.90 |
| 170491 | ELBOW NO ANESTHESIA | 1,643.00 |
| 16118 | ELBOW NO ANESTHESIA | 1,147.00 |
| 240382 | ELBOW RIGHT 2 VIEWS | 186.20 |
| 240400 | ELBOW RIGHT 3 VIEWS | 232.90 |
| 16606 | ELBOW TO FINGER | 280.00 |
| 170509 | ELBOW TO FINGER | 287.00 |
| 170492 | ELBOW W/ ANESTHESIA | 1,790.00 |
| 16119 | ELBOW W/ ANESTHESIA | 1,360.00 |
| 1404719 | ELBOW/ARTHROSCOPIC | 89.80 |
| 1404727 | ELBOW/HUMERUS/OPEN | 89.80 |
| 1404776 | ELBOW/TOTAL/REPLACE | 89.80 |
| 3025121 | ELDEPRYL (SELEGILINE) 5MG TAB | 2.00 |
| 1403232 | ELECT/ARRHYT/CONVER | 89.80 |
| 501912 | ELECTRODE KIT | 1,337.00 |
| 331705 | ELECTROLYTE PANEL | 55.00 |
| 790734 | ELECTROLYTE PANEL (RANDOM URINE) | 55.00 |
| 303491 | ELIGARD (LEUPROLIDE ACETATE) 45MG INJ | 7,190.90 |
| 303571 | ELIGARD (LEUPROLIDE ACETATE) 7.5MG KIT | 1,198.50 |
| 303312 | ELIMITE (PERMETHRIN)5% CREAM 60GM | 106.10 |
| 3077815 | ELIQUIS (APIXABAN) 5MG TAB | 4.70 |
| 3078290 | ELLENCE INTRAVENOUS SOL 2MG/1ML 50MG VL | 121.40 |
| 83010 | EM EXTRA LAB TRIPS | 22.30 |
| 1404909 | EMBOLECTOMY | 89.80 |
| 303464 | EMEND (FOSAPREPITANT DIMEGLUMINE) 115MG/ | 749.30 |
| 303666 | EMEND (FOSAPREPITANT DIMEGLUMINE)150MG | 857.90 |
| 16907 | EMERG TRACHEOSTOMY | 726.00 |
| 171046 | EMERG TRACHEOSTOMY | 726.00 |
| 1404974 | EMERGENCY CONDITION | 192.00 |
| 3027309 | EMLA TOPICAL CRM 5 GM | 15.00 |
| 303338 | ENABLEX (DARIFENACIN) 7.5MG TAB | 2.00 |
| 303444 | ENALAPRILAT (VASOTEC) 2.5MG/2ML INJ | 29.40 |
| 514070 | ENDO 90MM LINEAR STAPLER | 1,068.00 |
| 514013 | ENDO BABCOCK ETHICON 10BB | 435.00 |
| 510542 | ENDO BLUNT TIP (KITNER) | 94.00 |
| 501079 | ENDO BOUGIE PEDIATRIC 10FR | 36.00 |
| 516390 | ENDO BRONCH TUBE 28FR LEFT | 447.00 |
| 516408 | ENDO BRONCH TUBE 28FR RIGHT | 325.00 |
| 516416 | ENDO BRONCH TUBE 35FR LEFT | 246.00 |
| 516424 | ENDO BRONCH TUBE 35FR RIGHT | 307.00 |
| 516432 | ENDO BRONCH TUBE 37FR LEFT | 447.00 |
| 516440 | ENDO BRONCH TUBE 37FR RIGHT | 358.00 |
| 516457 | ENDO BRONCH TUBE 39FR LEFT | 438.00 |
| 516465 | ENDO BRONCH TUBE 39FR RIGHT | 307.00 |
| 594247 | ENDO CLIP APPLIER, MED/LG COVIDIEN | 1,131.00 |
| 517968 | ENDO CLIP LG ETHICON ER420 | 346.00 |
| 517984 | ENDO DISSECTOR ETHICON 5DCD | 368.00 |
| 514062 | ENDO GIA ATS45 STAPLER | 990.00 |
| 510609 | ENDO GIA 35 STANDARD RELOAD | 373.00 |
| 514053 | ENDO GIA 35 VASCULAR STAPLER | 873.00 |
| 510625 | ENDO GIA 35V RELOAD | 373.00 |
| 514063 | ENDO GIA TR45W RELOAD | 495.00 |
| 514017 | ENDO GRASPER EPIX INLINE | 325.00 |
| 514020 | ENDO GRASPER ETHICON 5DSG . | 339.00 |
| 501078 | ENDO GUM ELASTIC BOUGIE 15FR | 36.00 |
| 516374 | ENDO PROXIMATE STAPLER TX30G | 520.00 |
| 510708 | ENDO RETRACTOR | 655.00 |
| 510716 | ENDO ROTICULATOR GRASP 174233 . | 824.00 |
| 517976 | ENDO SCISSORS ETHICON 5DCS | 394.00 |
| 514057 | ENDO STITCH 10 MM SUTURE DEVICE | 857.00 |
| 50100 | ENDO TUBE 6.5 CUFFED | 24.70 |
| 512955 | ENDO TUBE FASTENER ANCHOR FAST ER | 44.00 |
| 514080 | ENDO TUBE MALLINCKRODT 4.0 CUFFED | 22.50 |
| 514091 | ENDO TUBE MALLINCKRODT 5.5 CUFFED | 25.00 |
| 514097 | ENDO TUBE MALLINCKRODT 6.0 CUFFED | 91.00 |
| 5514095 | ENDO TUBE ORAL RAE UNCUFFED 4.0 | 51.50 |
| 510799 | ENDOCATCH | 270.00 |
| 83135 | ENDOCRINOLOGY TELEMEDICINE | 65.00 |
| 516242 | ENDOLOOP LIGATURE PDS II EZ10G OR | 252.00 |
| 510773 | ENDOLOOP LIGATURE SZ 0 EL10G OR | 247.00 |
| 131141 | ENDOMETRIAL ABLATION (THERMO) | 2,000.00 |
| 790558 | ENDOMYSIAL (IGA) ANTIBODY | 94.00 |
| 170871 | ENDOTRACH INTUBATION | 235.30 |
| 16906 | ENDOTRACH INTUBATION | 478.00 |
| 507003 | ENDOTRACHEAL TUBE HOLDER VENT/STRAP | 42.20 |
| 507002 | ENDOTRACHEAL TUBE HOLDER VENTILATOR | 49.00 |
| 3078449 | ENGERIX-B IM SUSPENSION 10MCG/0.5ML PED | 101.96 |
| 3027614 | ENSURE BOTTLE 240ML | 5.60 |
| 3077822 | ENSURE CLEAR 240ML | 6.50 |
| 511328 | ENT PACK | 54.00 |
| 3032602 | ENTEROBIOTIC S-IGC CAP(FLORAJEN3) | 2.00 |
| 790766 | ENTEROVIRUS (PCR)(PLASMA) | 307.00 |
| 3078730 | ENTYVIO INTRAVENOUS PWD FOR SOLN 300MG | 17,074.40 |
| 790958 | EOSINOPHILS (URINE) | 52.00 |
| 303593 | EOVIST (GADOXETATE DISODIUM) 10ML | 379.10 |
| 3004860 | ePHEDrine 50MG/ML 1ML VIAL | 29.40 |
| 3031070 | EPIDURAL CADD SET | 35.00 |
| 131165 | EPIDURAL CERVICAL/THORACIC | 668.00 |
| 15001 | EPIDURAL FLOOD-CERVICAL/THORACIC | 1,033.00 |
| 15000 | EPIDURAL FLOOD-CERVICAL/THORACIC | 1,036.70 |
| 15030 | EPIDURAL FLOOD-LUMBAR | 668.00 |
| 1405112 | EPIDURAL LAB/VAG DEL | 98.40 |
| 512819 | EPIDURAL NEEDLE 17GA X 4.5 | 36.00 |
| 512820 | EPIDURAL NEEDLE 17GA X 6 | 54.00 |
| 512811 | EPIDURAL TRAY | 98.00 |
| 512812 | EPIDURAL TRAY 20ga 3.5 (KIP) | 72.00 |
| 3004886 | EPINEPHrine 1:10,000 10ML 20 GAUGE | 65.35 |
| 3004894 | EPINEPHrine 1MG AMP | 29.40 |
| 3028257 | EPINEPHrine 30ML MDV INJ | 85.90 |
| 303518 | EPOGEN 10000 UNIT (CHEMO INDUCED ANEMIA | 382.80 |
| 303517 | EPOGEN 10000 UNIT (NON-CHEMO ANEMIA) | 382.80 |
| 303512 | EPOGEN 2000 UNIT (CHEMO INDUCED ANEMIA) | 121.30 |
| 303511 | EPOGEN 2000 UNIT (NON-CHEMO ANEMIA) | 121.30 |
| 303520 | EPOGEN 20000 UNIT (CHEMO INDUCED ANEMIA | 765.50 |
| 303519 | EPOGEN 20000 UNIT (NON-CHEMO ANEMIA) | 765.50 |
| 303514 | EPOGEN 3000 UNIT (CHEMO INDUCED ANEMIA) | 182.00 |
| 303513 | EPOGEN 3000 UNIT (NON-CHEMO ANEMIA) | 182.00 |
| 303516 | EPOGEN 4000 UNIT (CHEMO INDUCED ANEMIA) | 231.00 |
| 303515 | EPOGEN 4000 UNIT (NON-CHEMO ANEMIA) | 231.00 |
| 3017870 | EPSOM SALTS 454GM | 10.00 |
| 798034 | EPSTEIN BARR VIRUS (IGM) | 40.00 |
| 798033 | EPSTEIN-BARR VIRUS (IGG) | 40.00 |
| 790974 | EPSTEIN-BARR VIRUS (QUAL)(PCR) | 331.00 |
| 791262 | EPSTEIN-BARR VIRUS (QUANT)(PCR) | 330.00 |
| 16064 | ER AIRWAY INHALATION TREATMENT, INITIAL | 91.50 |
| 16065 | ER AIRWAY INHALATION TREATMENT, SUBS | 57.40 |
| 16066 | ER AIRWAY TREATMENT, SUBS 1ST DRUG | 57.40 |
| 16067 | ER AIRWAY TREATMENT, SUBS 2ND DRUG | 57.40 |
| 16068 | ER AIRWAY TREATMENT, SUBS 3RD DRUG | 57.40 |
| 16095 | ER BLOOD COLLECTION TUNNELED VAD | 72.80 |
| 16016 | ER EXCISION INGROWN NAIL | 365.00 |
| 16011 | ER FOLEY CATH COMPLICATED | 311.00 |
| 16520 | ER FOLEY PLACEMENT | 265.40 |
| 171073 | ER FOLEY PLACEMENT COMPLICATED | 265.40 |
| 171072 | ER FOLEY PLACEMENT SIMPLE | 265.40 |
| 16200 | ER INCENTIVE SPIROMETER PER DAY | 59.20 |
| 16044 | ER INFUSION EACH SEQUENTIAL UP TO 1 HR | 135.30 |
| 16001 | ER INFUSION THROMBOLYSIS ONLY | 192.00 |
| 16053 | ER INFUSION, CONCURRENT UP TO 1 HR | 89.90 |
| 16045 | ER INJECTION, SQ OR IM | 58.00 |
| 16070 | ER INJECTION, SQ OR IM, DEPO-PROVERA | 58.00 |
| 16038 | ER INTERMEDIATE | 430.60 |
| 16411 | ER IV HYDRATION EACH ADD’L HR | 112.50 |
| 16412 | ER IV HYDRATION, INITIAL UP TO 1 HR | 252.30 |
| 16413 | ER IV INF, EA INT OR EA SEQ, ADD’L HR | 112.50 |
| 16414 | ER IV INFUSION INITIAL, UP TO 1 HR | 252.30 |
| 16043 | ER IV PUSH EACH SEQUENTIAL | 111.50 |
| 16047 | ER IV PUSH INITIAL | 111.50 |
| 16036 | ER LEVEL V | 1,285.00 |
| 16037 | ER MAJOR | 777.00 |
| 16039 | ER MINOR | 260.00 |
| 16820 | ER PULSE OXIMETER MULTI | 115.90 |
| 16800 | ER PULSE OXIMETER SINGLE | 115.90 |
| 16081 | ER REFILL/MAINT PORTABLE PUMP | 264.80 |
| 16051 | ER SALINE LOCK WITH FLUSH/NO OTHER MEDS | 34.10 |
| 16510 | ER STRAIGHT CATH FOR RESIDUAL | 127.80 |
| 16500 | ER STRAIGHT CATH FOR SPECIMEN | 96.00 |
| 16280 | ER THERAPEUTIC PHLEBOTOMY | 138.30 |
| 16900 | ER TRAUMA ALERT ACTIVATION | 1,248.80 |
| 16050 | ER VACCINATION, EACH ADD’L | 29.20 |
| 16049 | ER VACCINATION, INITIAL | 65.50 |
| 16080 | ER VAD FLUSH | 73.90 |
| 16021 | ER VAGINAL DELIVERY | 2,083.00 |
| 171082 | ER VAGINAL DELIVERY | 2,640.00 |
| 3077812 | ERBITUX (CETUXIMAB) 100MG VL 50ML | 1,485.60 |
| 3037809 | ERBITUX (CETUXIMAB) 200MG VL 100ML | 2,476.00 |
| 3004548 | ERY-TAB(ERYTHROMYCIN) 333MG TAB | 2.00 |
| 3006147 | ERYTHROMYCIN OPTH OINT 3.5GM | 20.00 |
| 790612 | ERYTHROPOIETIN (EPO) | 99.00 |
| 791424 | ESBL CONFIRM SUSC-DISK METHOD PER PLATE | 30.00 |
| 511912 | ESMARK 4 | 42.00 |
| 511913 | ESMARK 6 | 61.00 |
| 515749 | ESOP DILATOR 12MM | 600.00 |
| 1403158 | ESOP/THY/LARY/TRACH | 98.40 |
| 1503158 | ESOP/THY/LARY/TRACH | 98.40 |
| 515764 | ESOPHAGEL CATH 18-19-20 DILATOR | 600.00 |
| 515731 | ESOPHAGEL DILATOR 10-12 MM | 609.00 |
| 515756 | ESOPHAGEL DILATOR 15MM | 600.00 |
| 1403307 | ESOPHAGUS | 89.80 |
| 240068 | ESOPHAGUS | 350.00 |
| 504533 | ESSURE KIT (DR.HAMBURGER)DR.KENNEDY | 4,154.00 |
| 93006 | ESTABLISHED PATIENT LEVEL 1 | 79.00 |
| 93007 | ESTABLISHED PATIENT LEVEL 2 | 112.00 |
| 93008 | ESTABLISHED PATIENT LEVEL 3 | 131.25 |
| 93009 | ESTABLISHED PATIENT LEVEL 4 | 196.25 |
| 93010 | ESTABLISHED PATIENT LEVEL 5 | 332.00 |
| 3030897 | ESTRACE (ESTRADIOL) 2MG TAB | 2.00 |
| 331014 | ESTRACE 0.01% VAG. CRM: 42.5GM | 164.90 |
| 790035 | ESTRADIOL (E2) | 100.00 |
| 3023035 | ESTRAdiol 0.05MG PATCH | 15.00 |
| 790540 | ESTRIOL UNCONJUGATED (E3) | 233.00 |
| 798101 | ESTROGENS (E1&E2) FRACTIONATED | 77.00 |
| 790743 | ESTRONE (E1) | 164.00 |
| 3031012 | ETOPOSIDE (VEPESID) : 10MG | 65.35 |
| 3015585 | EUCERIN (HYDROCERIN) CRM 4 OZ. | 10.00 |
| 532521 | EVAC BOTTLE (THORACENTESIS) | 50.00 |
| 3032521 | EVAC CONTAINER | 27.90 |
| 170277 | EVAC OF SUB HEMATOMA | 78.40 |
| 16017 | EVAC OF SUB HEMATOMA | 110.00 |
| 791303 | EVEROLIMUS | 816.00 |
| 3031111 | EVISTA (RALOXIFENE) 60MG TAB | 2.00 |
| 1403661 | EX/PERIT/LO/ABD/URIN | 89.80 |
| 83000 | EXAM ROOM EACH 1/2 DAY | 35.00 |
| 83001 | EXAM ROOM EACH FULL DAY | 50.00 |
| 574092 | EXCALIBUR 4.0 MM X 13CM | 295.00 |
| 3030845 | EXCEDRIN MIGRAINE (ASA/APAP/CAFF) TAB | 2.00 |
| 380150 | EXCISION BACK | 606.43 |
| 131198 | EXCISION BENIGN LESION 0.6 TO 1.0CM | 435.00 |
| 131160 | EXCISION BENIGN LESION 2.0 TO 3.0CM | 435.00 |
| 131196 | EXCISION BENIGN LESION OVER 4.1 | 435.00 |
| 380131 | EXCISION BENIGN LESIONS;FACE;EARS;EYES-0 | 417.50 |
| 380134 | EXCISION BENIGN LESIONS;TRUNK;ARMS;LEGS- | 368.75 |
| 137064 | EXCISION BIOPSY LIP | 224.00 |
| 137065 | EXCISION BIOPSY LIP | 224.00 |
| 131106 | EXCISION BREAST LESION W/PREOP RADIAL | 1,542.00 |
| 380139 | EXCISION FINGER OR TOE NAIL/NAIL MATRIX; | 553.75 |
| 93070 | EXCISION GANGLION;WRIST;PRIMARY | 1,005.00 |
| 380170 | EXCISION MALIG.LESIONS;FACE;EARS;EYES- 0 | 455.40 |
| 380133 | EXCISION MALIG.LESIONS;FACE;EARS;EYES- 1 | 671.25 |
| 131194 | EXCISION MALIG.LESIONS;FACE;EARS;EYES-0 | 435.00 |
| 131178 | EXCISION MALIG.LESIONS;FACE;EARS;EYES-0. | 435.00 |
| 380164 | EXCISION MALIG.LESIONS;FACE;EARS;EYES-0. | 541.65 |
| 131179 | EXCISION MALIG.LESIONS;TRUNKS, ARMS, LEG | 475.00 |
| 131158 | EXCISION MALIGNANT LESION 1.1 TO 2.0 CM | 435.00 |
| 131214 | EXCISION MALIGNANT LESION SCALP | 1,542.00 |
| 380135 | EXCISION MALIGNANT LESIONS; SCALP; NECK; | 839.00 |
| 131116 | EXCISION OF GANGLION CYST | 1,090.00 |
| 171078 | EXCISION OF NAIL AND NAIL MATRIX | 541.00 |
| 16024 | EXCISION OF NAIL OR NAIL MATRIX | 160.00 |
| 131204 | EXCISION OF SUBMANDIBULAR GLAND | 2,000.00 |
| 131185 | EXCISION OTHER BENIGN LESION 0.5 OR LESS | 435.00 |
| 131186 | EXCISION OTHER BENIGN LESION 0.5 OR LESS | 435.00 |
| 131129 | EXCISION OTHER BENIGN LESION 1.1 TO 2.0 | 435.00 |
| 131180 | EXCISION PILONIDAL CYST; EXTENSIVE | 2,000.00 |
| 131142 | EXCISION SKIN LESION; 2.1CM TO 3.0CM | 435.00 |
| 380022 | EXCISION TRUNK ARMS AND LEGS | 196.43 |
| 137067 | EXCISION TRUNK ARMS LEGS <.5CM | 365.00 |
| 131154 | EXCISION TRUNK BENIGN LESION 0.6 TO 1.0 | 435.00 |
| 131133 | EXCISION TRUNK BENIGN LESION 1.1 TO 2.0C | 435.00 |
| 131155 | EXCISION TRUNK BENIGN LESION 2.1 TO 3.0 | 435.00 |
| 131213 | EXCISION TUMOR SOFT TISSUE, PELVIS | 435.00 |
| 380047 | EXCISION; BENIGN LESION; EXCEPT SKIN TAG | 304.00 |
| 380130 | EXCISION; BENIGN LESION; EXCEPT SKIN TAG | 333.75 |
| 131200 | EXCISION; BENIGN LESION; EXCEPT SKIN TAG | 435.00 |
| 380128 | EXCISION; BENIGN LESION; EXCEPT SKIN TAG | 465.00 |
| 380122 | EXCISION; BENIGN LESION; EXCEPT SKIN TAG | 475.00 |
| 380123 | EXCISION; BENIGN LESION; EXCEPT SKIN TAG | 475.00 |
| 380129 | EXCISION; BENIGN LESION; EXCEPT SKIN TAG | 555.00 |
| 380121 | EXCISION;MALIGNANT LESION;FACE;EARS;EYEL | 803.75 |
| 131101 | EXCISIONAL BIOPSY, BREAST | 1,542.00 |
| 3030836 | EXELON (RIVASTIGMINE) 1.5MG CAP | 2.00 |
| 303475 | EXELON 4.6MG PATCH (RIVASTIGMINE) | 11.40 |
| 303432 | EXELON 9.5MG PATCH (RIVASTIGMINE) | 11.40 |
| 16042 | EXPAND LOW | 282.00 |
| 16364 | EXPAND MOD | 523.00 |
| 170038 | EXPANDED LOW | 265.40 |
| 380038 | EXPANDED LOW | 265.40 |
| 170046 | EXPANDED MODERATE | 430.60 |
| 380046 | EXPANDED MODERATE | 430.60 |
| 3078533 | EXPAREL INJECTION SUSP 266MG SDV 20ML | 765.45 |
| 3078528 | EXPAREL INJECTION SUSPENSION 133MG 10ML | 413.10 |
| 131156 | EXPLORATION WOUND ABDOMEN | 1,542.00 |
| 1403018 | EXT/MID/INN/EAR/BIOP | 89.80 |
| 1503018 | EXT/MID/INN/EAR/BIOP | 89.80 |
| 137009 | EXTERNAL FIXATION WRIST | 1,542.00 |
| 3019256 | EYE TRAY DRUG CHARGE: | 99.75 |
| 3030970 | EYE WASH 118ML | 10.00 |
| 508371 | EYE WASH MORGAN | 142.00 |
| 240093 | EYE, DETECTION OF FOREIGN BODY | 189.70 |
| 240094 | EYE, DETECTION OF FOREIGN BODY RIGHT | 155.00 |
| 1403042 | EYE/NOT/SPECIFIED | 89.80 |
| 595070 | EZ IO NEEDLE SET 15MM PEDIATRIC | 330.00 |
| 595071 | EZ IO NEEDLE SET 25MM ADULT | 394.00 |
| 595072 | EZ IO NEEDLE SET 45MM ADULT | 394.00 |
| 595073 | EZ IO STABILIZER | 90.00 |
| 510920 | EZ WAY SLING LARGE W/HEAD SUPPORT | 195.00 |
| 510921 | EZ WAY SLING X- LARGE W/HEAD SUPPORT | 199.00 |
| 690007 | FACE TO FACE COUNSELING 15 MIN | 68.00 |
| 1403117 | FACIAL BONES | 89.80 |
| 240092 | FACIAL BONES >= 3V’s | 350.00 |
| 240159 | FACIAL BONES< 3V | 209.50 |
| 790996 | FACTOR II ACTIVITY | 43.00 |
| 791315 | FACTOR V ACTIVITY ASSAY | 180.00 |
| 790764 | FACTOR V LEIDEN MUTATION | 577.00 |
| 790997 | FACTOR VII ACTIVITY | 137.00 |
| 790978 | FACTOR VIII ACT ASSAY COAGULATION | 200.00 |
| 790565 | FACTOR VIII ACTIVITY (INHIBITOR EVAL) | 200.00 |
| 790998 | FACTOR X ACTIVITY | 181.00 |
| 791313 | FACTOR XII ACTIVITY ASSAY | 181.00 |
| 791507 | FAMILIAL MUTATION TARGETED TESTING | 1,300.00 |
| 37302 | FAMILY SKILLS TRAINING CHILD 0-20 | 25.00 |
| 37180 | FAMILY THERAPY | 179.60 |
| 37198 | FAMILY THERAPY-50MIN | 168.70 |
| 37199 | FAMILY THERAPY-80MIN | 168.70 |
| 380062 | FASCIETOMY EA ADDITIONAL DIGIT | 1,052.00 |
| 3031088 | FASLODEX (FULVESTRANT) 25MG | 366.60 |
| 380141 | FASSCIECTOMY; PALMAR WITH OR WITHOUT Z-P | 2,092.50 |
| 16914 | FAST EXAM/ABDOMEN LIMITED | 408.20 |
| 3032520 | FAT EMULSION SET | 8.55 |
| 791037 | FATTY ACID PROFILE ESSENTIAL | 150.00 |
| 500526 | FEEDING TUBE 8 FR W/ STYLET | 76.00 |
| 790960 | FELBAMATE (FELBATOL) | 112.00 |
| 507596 | FEMORAL ARTERIAL RAD/CATH | 64.40 |
| 579038 | FEMORAL RESTRICTOR SET | 118.00 |
| 16993 | FEMORAL SHAFT NO MANIPULATION | 1,654.00 |
| 171132 | FEMORAL SHAFT NO MANIPULATION | 2,464.00 |
| 16994 | FEMORAL SHAFT W/ MANIPULATION | 2,445.00 |
| 171133 | FEMORAL SHAFT W/ MANIPULATION | 3,385.00 |
| 1404198 | FEMORAL/ART/EMOBLECT | 89.80 |
| 1404180 | FEMORAL/ARTERY/LIGAT | 89.80 |
| 244050 | FEMUR LEFT 1 VIEW | 85.00 |
| 244001 | FEMUR LEFT 2 VIEWS | 256.40 |
| 244051 | FEMUR RIGHT 1 VIEW | 85.00 |
| 240473 | FEMUR RIGHT 2 VIEWS | 256.40 |
| 1404107 | FEMUR/UPPER/CLOSED | 89.80 |
| 1504115 | FEMUR/UPPER/OPEN | 43.40 |
| 1404115 | FEMUR/UPPER/OPEN | 89.80 |
| 3078675 | FENtanyl 2mcg/ml/BUPIvacaine 0.125% Epid | 100.00 |
| 790581 | FERRITIN | 151.00 |
| 3020239 | FERRO SEQUELS TAB: | 2.00 |
| 3032325 | FERROUS GLUCONATE 324MG CAP | 2.00 |
| 3030873 | FERROUS SULFATE 220MG/5ML 30ML LIQ | 6.00 |
| 3017631 | FERROUS SULFATE 325MG TAB | 2.00 |
| 790614 | FETAL FIBRONECTIN | 390.00 |
| 16022 | FETAL MONITORING | 232.90 |
| 171083 | FETAL MONITORING | 232.90 |
| 3020544 | FIBERCON TAB | 2.00 |
| 790866 | FIBRIN DEGRADATION PRODUCTS (FDP) | 100.00 |
| 331309 | FIBRINOGEN | 69.00 |
| 505485 | FILSHIE CLIP | 343.00 |
| 3032522 | FILTER SET 0.2 | 41.60 |
| 3032523 | FILTER SET 1.2 | 51.15 |
| 131163 | FINE NEEDLE ASPIRATION; W/O IMAGING | 300.00 |
| 798041 | FINE-NEEDLE ASPIRATION INTERPERTATION | 81.00 |
| 241777 | FINGER LEFT >=2V. | 174.40 |
| 241778 | FINGER RIGHT >=2V. | 174.40 |
| 505865 | FINGER SPLINT PADDED | 4.60 |
| 16604 | FINGER SPLINT STATIC | 132.00 |
| 93032 | FINGER SPLINT STATIC | 132.00 |
| 170510 | FINGER SPLINT STATIC | 142.00 |
| 500549 | FINGER SPRING SPLINT | 38.70 |
| 3027879 | FIORICET (BUTALBI/CAFF/ACETA) TAB | 2.00 |
| 137035 | FIRST DORSAL COMPARTMENT RELEASE | 855.00 |
| 516960 | FISH GLASSMAN VISCERA RETAINER MEDIUM | 335.00 |
| 303467 | FISH OIL (OMEGA-3 FATTY ACIDS)1000MG C | 2.00 |
| 241967 | FISTULOGRAM | 896.60 |
| 3030875 | FLAGYL (metroNIDAZOLE) 500MG TAB | 2.00 |
| 3005198 | FLAGYL (metroNIDAZOLE) 500MG/100ML INJ | 116.80 |
| 790869 | FLECAINIDE (SERUM) | 123.00 |
| 501202 | FLEECE PAD | 30.00 |
| 3005214 | FLEXERIL (CYCLOBENZAPRINE) 10MG TAB | 2.00 |
| 3031061 | FLOMAX (TAMSULOSIN) 0.4MG CAP | 2.00 |
| 3028489 | FLONASE (FLUTICASONE) 0.5% 16GM SPRAY | 25.00 |
| 3005222 | FLORINEF(FLUDROCORTISONE) 0.1MG TAB | 2.00 |
| 510800 | FLOSEAL 5ML | 617.00 |
| 510801 | FLOSEAL ENDOSCOPIC APPLICATO | 315.00 |
| 93060 | FLOUROSCOPY 1ST HOUR | 16.25 |
| 3030170 | FLOVENT HFA 44MCG/ACT INHALER 10GM | 139.40 |
| 3029727 | FLOVENT HFA 110MCG/ACT INHALER 12GM | 186.60 |
| 791479 | FLOW CELL INTERP (16 OR MORE MARKERS) | 478.00 |
| 791480 | FLOW CELL INTERP (2-8 MARKERS) | 192.00 |
| 790923 | FLOW CYTOMETRY CD57,CD3,CD8 (BLOOD) | 111.00 |
| 790717 | FLOW CYTOMETRY CELL SURF (EACH ADD) | 63.00 |
| 791451 | FLOW CYTOMETRY CELL SURFACE (1ST MARKER) | 111.00 |
| 791478 | FLOW CYTOMETRY INTERP (9-15 MARKERS) | 480.00 |
| 3016302 | FLOXURIDINE (FUDR)INJ 500MG | 392.50 |
| 3015403 | FLU VACCINE (ADULT DOSE) INJ 0.5ML | 33.00 |
| 3032570 | FLU VACCINE (FLUZONE) INJ (6-35 MONTHS) | 35.20 |
| 3031392 | FLUDARABINE PHOS.VL(FLUDARA) 50MG INJ | 834.60 |
| 303492 | FLUMIST VACCINE NASAL SPRAY | 82.90 |
| 3015809 | FLUOR-I-STRIP: | 2.00 |
| 240697 | FLUORO GUIDE (BX,ASP,INJ,LOC) SI | 248.20 |
| 240317 | FLUORO GUIDE JOINT INJECTION | 559.30 |
| 240698 | FLUORO GUIDE VASCULAR ACCESS SI | 183.80 |
| 240696 | FLUORO UP TO 1HR SI | 314.90 |
| 15016 | FLUOROSCOPIC GUIDANCE | 351.90 |
| 137061 | FLUOROSCOPY | 239.00 |
| 3005248 | FLUOROURACIL:VL(ADRUCIL) 500MG/10ML | 29.40 |
| 83006 | FMC MONTHLY RENT | 9,298.00 |
| 83015 | FMC RENT FOR COMPUTER SERVICES | 375.00 |
| 3031068 | FML (FLUROMETHOLONE) 1% OPHTH SOLN 5ML | 15.00 |
| 518097 | FOGARTY EMBO CATH 2 FR NON-LATEX | 371.00 |
| 518098 | FOGARTY EMBO CATH 3 FR NON-LATEX | 440.00 |
| 518099 | FOGARTY EMBO CATH 4 FR NON-LATEX | 440.00 |
| 518094 | FOGARTY EMBO CATH 5 FR | 345.00 |
| 518101 | FOGARTY EMBO CATH 6 FR NON-LATEX | 440.00 |
| 518102 | FOGARTY EMBO CATH 7 FR NON-LATEX | 440.00 |
| 518090 | FOGARTY IRRIG CATH 4 FR | 300.00 |
| 518089 | FOGARTY IRRIG CATH 6 FR | 76.00 |
| 514908 | FOGARTY OCCLU CATH 14FR | 400.00 |
| 510898 | FOGARTY SOFTJAW INSERT SOFT33 | 98.00 |
| 514643 | FOGARTY SOFTJAW INSERT SOFT61 | 86.00 |
| 514650 | FOGARTY SOFTJAW INSERT SOFT86 | 89.00 |
| 518100 | FOGARY EMBO NON-LATEX CATH 5FR | 440.00 |
| 331258 | FOLATE | 22.00 |
| 790014 | FOLATE-RBC | 311.00 |
| 3019413 | FOLIC ACID 1MG INJ | 29.40 |
| 3005255 | FOLIC ACID 1MG TAB | 2.00 |
| 790989 | FOOD PANEL (IGE) (EACH) | 63.00 |
| 241223 | FOOT LEFT 2 VIEWS | 190.90 |
| 240522 | FOOT LEFT 3 VIEWS | 256.40 |
| 241224 | FOOT RIGHT 2 VIEWS | 190.90 |
| 240523 | FOOT RIGHT 3 VIEWS | 256.40 |
| 574772 | FOOTPRINT ULR 4.5 PK SUT SL | 1,040.00 |
| 1404925 | FOR/WIRST/HAND/VEINS | 89.80 |
| 1404891 | FOR/WRIST/HAND/ARTER | 75.00 |
| 1404941 | FOR/WRIST/HAND/CAST | 89.80 |
| 15007 | FORANIMAL – CERVICAL/THORACIC ADDTL | 503.00 |
| 15009 | FORANIMAL – LUMBAR/SACRAL ADDTL | 572.00 |
| 131173 | FORANIMAL LUMBAR/SACRAL | 800.00 |
| 578010 | FORCEP BIPOLAR W/ CORD | 204.00 |
| 517097 | FORCEP BIPOLAR W/MACRO JAW (DR.HAGEN) | 384.00 |
| 240407 | FOREARM LEFT 2 VIEWS | 209.50 |
| 240408 | FOREARM RIGHT 2 VIEWS | 209.50 |
| 1404834 | FOREARM/WRIST/HAND/INTEG | 98.40 |
| 131217 | FOREHEAD, CHEEK, CHIN, MOUTH, NECK, AXIL | 2,000.00 |
| 93058 | FOREIGN BODY REMOVAL COMPLICATED | 505.00 |
| 3026723 | FORTAZ (cefTAZidime) 1GM | 111.45 |
| 3028070 | FORTAZ(cefTAZidime) 2GM VIAL | 179.55 |
| 3029446 | FORTICAL(CALCITONIN) 200IU/SPRAY | 59.80 |
| 3030951 | FOSAMAX (ALENDRONATE) 70MG TAB | 2.00 |
| 3078536 | FOSPHENYTOIN SOD. 500MG PE/10ML | 185.00 |
| 170756 | FR/CL IP JT DISC W M | 362.80 |
| 18015 | FRC WASHOUT -PULM FUNCTION TEST BY GAS | 191.50 |
| 331598 | FRESH FROZEN PLASMA THAW (EACH UNIT) | 53.00 |
| 790078 | FROZEN SECTION (ADDITIONAL CHARGE) | 116.00 |
| 790060 | FROZEN SECTION/CONSULT DURING SURGERY | 186.00 |
| 791023 | FRUCTOSAMINE (SERUM) | 50.00 |
| 790599 | FSH (FOLLICLE-STIMULATING HORMONE) | 33.00 |
| 18729 | FULL SLEEP STUDY | 2,634.50 |
| 18730 | FULL SLEEP STUDY w/CPAP | 1,962.70 |
| 798070 | FUNGUS SMEAR/STAIN | 45.00 |
| 170757 | FX CARE – THIGH | 165.50 |
| 790125 | GABA-B-R AB CBA | 75.00 |
| 790091 | GABAPENTIN | 84.00 |
| 5488012 | GAIT TRANSFER BELT | 10.30 |
| 790980 | GAL-1-PHOS URDYLTRNS PHENOTYPING (RBC) | 219.00 |
| 798045 | GAL-1-PHOS URDYLTRNS(QUANT)(GALT) | 655.00 |
| 791312 | GALACTOSEMIA GENE ANALYSIS (14-MUTATION) | 1,200.00 |
| 240563 | GALL BLADDER | 298.50 |
| 3006014 | GAMAstan S/D 2ML Immune GLOBULIN (HUMAN) | 267.20 |
| 303438 | GAMMAGARD LIQUID (IMMUNE GLOB) 500MG | 164.05 |
| 3078684 | GAMUNEX-C INJECTION SOLUTION 500MG | 211.10 |
| 790772 | GANGLIOSIDE ANTOBODY PANEL | 64.00 |
| 3005479 | GARAMYCIN (GENTAMICIN) 0.3% OPH SOL 5ML | 10.00 |
| 3005487 | GARAMYCIN (GENTAMICIN) OPH OINT 3.5GM | 15.00 |
| 3077890 | GARDASIL 9 SDV 0.5ML | 394.50 |
| 171010 | GASTRIC INTUBATION | 116.40 |
| 16420 | GASTRIC INTUBATION | 173.10 |
| 501663 | GASTRIC LAVAGE 34 FR | 102.00 |
| 501665 | GASTRIC LAVAGE 34FR/RECTAL TUBE | 40.00 |
| 516887 | GASTRIC LAVAGE PEDIATRIC | 31.00 |
| 790616 | GASTRIN (SERUM) | 92.00 |
| 1404404 | GASTROCNEMIUS/RECESS | 89.80 |
| 3016344 | GAVISCON CHEWABLE TAB: | 2.00 |
| 508209 | GELFOAM SIZE 50 OR. ONLY | 240.00 |
| 515708 | GELOCAST/DOME 3 | 26.00 |
| 515709 | GELOCAST/DOME PASTE 4 DR. GARRED JR | 33.00 |
| 595028 | GELPOINT ADVANCED ACCESS PLATFORM | 1,425.00 |
| 303601 | GEMZAR (GEMCITABINE) VIAL:200MG | 432.40 |
| 145195 | GENERAL ANESTHESIA-A | 966.70 |
| 145203 | GENERAL ANESTHESIA-B | 1,173.90 |
| 145211 | GENERAL ANESTHESIA-C | 1,396.20 |
| 145229 | GENERAL ANESTHESIA-D | 1,609.30 |
| 145237 | GENERAL ANESTHESIA-E | 1,511.00 |
| 145245 | GENERAL ANESTHESIA-F | 1,690.00 |
| 145252 | GENERAL ANESTHESIA-G | 1,864.30 |
| 145260 | GENERAL ANESTHESIA-H | 2,465.90 |
| 145278 | GENERAL ANESTHESIA-I | 2,679.00 |
| 790376 | GENERAL HEALTH PANEL | 343.00 |
| 3005446 | GENTAMICIN (GARAMYCIN):10MG/ML 2ML *PED* | 29.40 |
| 791026 | GENTAMICIN (PEAK) | 118.00 |
| 330079 | GENTAMICIN (RANDOM) | 118.00 |
| 791028 | GENTAMICIN (TROUGH) | 118.00 |
| 3030886 | GENTAMICIN 100MG/ NS 50 ML | 82.85 |
| 310130 | GENTAMICIN 80 MG/ NS 50ML | 78.65 |
| 3005453 | GENTAMICIN:80MG/2ML | 29.75 |
| 307795 | GENTEAL EYE GEL 3.5ML | 10.00 |
| 3005545 | GENTIAN VIOLET 1% TOPICAL SOLN | 10.00 |
| 3030948 | GEODON (ZIPRASIDONE) 20MG CAP | 2.00 |
| 331978 | GGT (GAMMA-GLUTAMYLTRANSFERASE) | 22.00 |
| 3027341 | GI COCKTAIL(MAALOX,HYOSCYAM,LID.VIS)30ML | 2.00 |
| 517950 | GIA 55 RELOAD | 314.00 |
| 517943 | GIA 55 STAPLER, ETHICON TLC55 | 352.00 |
| 517960 | GIA 75 RELOAD EITHICON TCR75 | 446.00 |
| 517942 | GIA75 STAPLER, ETHICON TLC75 | 537.00 |
| 791269 | GLIADIN (IGA) ANTIBODY | 100.00 |
| 790082 | GLIADIN (IGG&IGA) ANTIBODY | 100.00 |
| 555111 | GLIDESCOPE BLADES LARGE #4 | 90.00 |
| 555112 | GLIDESCOPE BLADES SMALL #3 | 90.00 |
| 555113 | GLIDESCOPE GO SPECTRUM DVM S3 | 200.00 |
| 555117 | GLIDESCOPE GO SPECTRUM LOPRO S2 | 260.00 |
| 555114 | GLIDESCOPE GO SPECTRUM LOPRO S3 | 200.00 |
| 555116 | GLIDESCOPE GO SPECTRUM LOPRO S4 MONTY | 200.00 |
| 790865 | GLOMERULAR BASEMENT MEMBRANE (IGG) | 221.00 |
| 510955 | GLOW’N TELL TAPE | 297.00 |
| 790731 | GLU-6-PHOS (QUANT) DEHYDROGENASE (G6PD) | 116.00 |
| 3005578 | GLUCAGON 1MG/ML INJ | 459.40 |
| 3030105 | GLUCERNA 240ML | 7.55 |
| 3029131 | GLUCOPHAGE (metFORMIN) 500MG TAB | 2.00 |
| 3030780 | GLUCOPHAGE (metFORMIN) 850MG TAB | 2.00 |
| 3030941 | GLUCOPHAGE XR (metFORMIN) 500MG TAB | 2.00 |
| 3031009 | GLUCOSAMINE/CHONDROITIN TAB | 2.00 |
| 330277 | GLUCOSE | 45.00 |
| 330286 | GLUCOSE TT ADULT 2 HR | 123.00 |
| 791040 | GLUCOSE TT ADULT 3 HR | 123.00 |
| 791039 | GLUCOSE TT ADULT 5 HR | 123.00 |
| 331069 | GLUCOSE TT GESTATIONAL 1 HR | 53.00 |
| 330287 | GLUCOSE TT GESTATIONAL 3 HR | 123.00 |
| 330285 | GLUCOSE TT PEDS | 123.00 |
| 3021336 | GLUCOTROL (glipiZIDE) 5MG TAB | 2.00 |
| 3030913 | GLUCOTROL XL (glipiZIDE) 2.5MG TAB | 2.00 |
| 3027820 | GLUCOTROL XL (glipiZIDE) 5MG TAB | 2.00 |
| 790814 | GLUTAMIC ACID DECARBOXYLASE AB (GAD65) | 322.00 |
| 3030854 | GLUTOSE 15GM GEL | 2.00 |
| 3015254 | GLYCERIN PED SUPP: | 2.00 |
| 3015262 | GLYCERIN SUPP ADULT: | 2.00 |
| 310710 | GLYCINE IRRIGATION 3000ML | 89.80 |
| 790904 | GLYCOSOLATED HGB (A1C) | 97.00 |
| 517573 | GOLD INJECTION PROBE | 713.00 |
| 131201 | GONIOTOMY WITH KDB BLADE | 1,900.00 |
| 514347 | GORTEX 10CM X 15 CM GRAFT | 1,971.00 |
| 514348 | GORTEX 18CM X 24 CM GRAFT | 3,640.00 |
| 510912 | GOWN BEAR PAWS SIZE ADULT | 58.00 |
| 510913 | GOWN FLEX BEAR PAWS SIZE ADULT | 80.00 |
| 501916 | GRAFT PUTTY | 3,510.00 |
| 330020 | GRAM STAIN | 45.00 |
| 791232 | GRAM STAIN (REFERENCE LAB) | 45.00 |
| 790708 | GRANULOCYTE ANTIBODY | 90.00 |
| 690010 | GROUP 2 OR MORE 30 MIN | 16.00 |
| 37301 | GROUP SKILLS TRAINING CHILD 0-20 | 7.50 |
| 37222 | GROUP THERAPY | 81.20 |
| 790899 | GROWTH HORMONE (HGH) | 120.00 |
| 514901 | GUIDE MULTI-PRO 2000 STER X-RAY | 117.05 |
| 578611 | Guide Pin 1.6MM X 6 Smooth 4.0 Cann | 283.00 |
| 578608 | GUIDE PIN 3.2MM x 12 DRILL POINT | 130.00 |
| 578603 | GUIDE PIN 3.2MM x 12 PART THREADED | 431.00 |
| 578604 | GUIDE PIN 3.2MM X 9 PART THREADED | 431.00 |
| 578540 | GUIDE WIRE AMPLATZ -RADIOLOGY | 161.00 |
| 578530 | GUIDE WIRE M ANGLED | 301.00 |
| 578524 | GUIDE WIRE M STRAIGHT | 300.00 |
| 790207 | H PYLORI (BREATH TEST) | 204.00 |
| 790779 | H PYLORI ANTIGEN (STOOL) | 338.00 |
| 3005628 | HALDOL(HALOPERIDOL) 5MG/ML 1ML INJ | 47.85 |
| 3005669 | HALDOL(HALOPERIDOL)1MG TAB | 2.00 |
| 303691 | HALDOL(HALOPERIDOL)1MG TAB H.H. | 2.00 |
| 3005644 | HALDOL(HALOPERIDOL)5MG TAB | 2.00 |
| 3005610 | HALDOL(HALOPERIDOL)ORAL CONC 2MG/ML LIQ | 15.00 |
| 790015 | HALOPERIDOL | 267.00 |
| 3077893 | HALOPERIDOL DECANOATE INJ 50MG/ML | 108.10 |
| 241207 | HAND LEFT 2 VIEWS | 197.80 |
| 240431 | HAND LEFT 3 VIEWS | 232.90 |
| 241208 | HAND RIGHT 2 VIEWS | 197.80 |
| 240432 | HAND RIGHT 3 VIEWS | 232.90 |
| 517095 | HANDPIECE LAPARASCOPIC MORCELLEX | 1,688.00 |
| 790637 | HAPTOGLOBIN | 37.00 |
| 510734 | HARMONIC SCALPEL BLADE 36 CM | 1,446.00 |
| 3077862 | HAVRIX ADULT 1440 EL.U./ML | 218.40 |
| 331085 | HDL | 82.00 |
| 791422 | HDL (HDL2&HDL3) CHOLESTEROL SUBCLASSES | 252.00 |
| 509271 | HEAD IMMOBILIZER ADULT | 12.85 |
| 509272 | HEAD IMMOBILIZER CHILD | 64.80 |
| 509273 | HEAD IMMOBILIZER INFANT | 66.00 |
| 502271 | HEEL CUP RED STAR JUNIOR | 8.12 |
| 502270 | HEEL CUP RED STAR ADULT | 7.34 |
| 501472 | HEEL LIFT ADUST A LIFT SIZE LARGE | 32.00 |
| 501478 | HEEL LIFT ADUST A LIFT SIZE SMALL | 32.00 |
| 501486 | HEEL LIFT SMOOTH | 204.00 |
| 501483 | HEEL/ ELBOW PROTECTOR | 26.00 |
| 501488 | HEEL/ ELBOW PROTECTOR/W/FLEECE | 27.00 |
| 508926 | HEIMLIC CHEST DRAIN VALVE | 163.35 |
| 517570 | HELICAL BASKET 18 1.0 | 711.00 |
| 517581 | HELICAL BASKET SEGURA | 893.25 |
| 3026376 | HEMABATE 250 MCG INJ | 401.20 |
| 330509 | HEMATOCRIT | 35.00 |
| 380004 | HEMIARTHROPLASTY HIP | 2,869.00 |
| 790915 | HEMOCHROMATOSIS HFE GENE ANALYSIS | 466.00 |
| 330517 | HEMOGLOBIN | 35.00 |
| 16933 | HEMORRHOIDECTOMY, 2 OR MORE | 545.00 |
| 171089 | HEMORRHOIDECTOMY, 2 OR MORE | 950.00 |
| 131205 | HEMORRHOIDECTOMY, EXTERNAL, 2 OR MORE | 435.00 |
| 134386 | HEMORRHOIDECTOMY, INTERNAL | 545.00 |
| 508369 | HEMOVAC CLOSED WOUND SUCTION | 208.00 |
| 509975 | HEMOVAC FOR KNEE | 286.00 |
| 3028281 | HEPARIN 1000 UNITS/ML 2ML | 28.50 |
| 3005768 | HEPARIN 5000 UNITS/0.5ML CARPUJECT INJ | 29.40 |
| 791290 | HEPARIN ANTI-XA ASSAY | 195.00 |
| 303750 | HEPARIN LOCK FLUSH 10 UNITS/ML 5ML | 29.40 |
| 3019843 | HEPARIN LOCK FLUSH 100UNITS/ML 5ML | 29.40 |
| 303310 | HEPARIN SODIUM 2000 UNITS/1000ML | 100.00 |
| 3019330 | HEPARIN: 25,000 U/D5W 500ML DRIP | 100.00 |
| 790012 | HEPATITIS A (IGG) AB | 148.00 |
| 791365 | HEPATITIS A (IGM) AB | 148.00 |
| 791271 | HEPATITIS B (QUANT)(PCR) | 157.00 |
| 791331 | HEPATITIS B CORE (IGM) AB | 100.00 |
| 790914 | HEPATITIS B CORE (TOTAL) AB | 57.00 |
| 790796 | HEPATITIS B E-ANTIBODY | 53.00 |
| 790810 | HEPATITIS B E-ANTIGEN | 53.00 |
| 790946 | HEPATITIS B SURF (QUAL) AB | 37.00 |
| 790291 | HEPATITIS B SURF AG | 33.00 |
| 791273 | HEPATITIS B SURF(QUANT) AB | 37.00 |
| 790093 | HEPATITIS C (PCR) | 492.00 |
| 790990 | HEPATITIS C (QUANT)(RNA-PCR) | 492.00 |
| 798049 | HEPATITIS C ANTIBODY | 51.00 |
| 790815 | HEPATITIS C GENOTYPE (SERUM) | 645.00 |
| 791209 | HEPATITIS PANEL | 134.00 |
| 3029370 | HEP-B PED VACCINE 5MCG/0.5ML INJ | 139.15 |
| 790668 | HER2 SEMI-QUANT IHC STAIN | 243.00 |
| 3078429 | HERCEPTIN 150MG SDV 20ML | 3,999.00 |
| 380112 | HERNIA REPAIR | 2,378.00 |
| 135672 | HERNIA REPAIR A | 2,796.00 |
| 135680 | HERNIA REPAIR B | 3,150.50 |
| 135698 | HERNIA REPAIR C | 3,506.40 |
| 135706 | HERNIA REPAIR D | 3,862.10 |
| 135714 | HERNIA REPAIR E | 4,216.70 |
| 1403570 | HERNIA/LOWER/ABDOMEN | 82.40 |
| 1503570 | HERNIA/LOWER/ABDOMEN | 82.40 |
| 791488 | HERPES SIMPLEX VIRUS (IGM) AB (BY IFA) | 60.00 |
| 790690 | HERPES SIMPLEX VIRUS (PCR) | 194.00 |
| 303278 | HESPAN IV INFUSION BAG 500ML | 208.00 |
| 517810 | HEX BUTTON | 250.00 |
| 790716 | HGB S SCREEN (SICKLE CELL) | 178.00 |
| 241450 | HIP ARTHROGRAPHY SI | 780.30 |
| 244049 | HIP BILAT 2 VIEWS W/ TRAUMA PELVIS | 173.00 |
| 244042 | HIP BILAT W/PELVIS 2 VIEW | 122.00 |
| 244047 | HIP LEFT 2 VIEWS W/ TRAUMA PELVIS | 158.00 |
| 244043 | HIP LEFT 1 VIEW W/WO PELVIS | 91.00 |
| 244044 | HIP LEFT 2 VIEWS W/WO PELVIS | 126.00 |
| 136027 | HIP REPLACEMENT | 5,908.90 |
| 244045 | HIP RIGHT 1 VIEW W/WO PELVIS | 91.00 |
| 244048 | HIP RIGHT 2 VIEWS W/ TRAUMA PELVIS | 158.00 |
| 244046 | HIP RIGHT 2 VIEWS W/WO PELVIS | 126.00 |
| 1404065 | HIP/ARTHROSCOPIC | 75.00 |
| 1404057 | HIP/CLOSED | 81.30 |
| 1404081 | HIP/DISARTICULATION | 89.80 |
| 1404099 | HIP/TOTAL/OR/REVISION | 81.30 |
| 790707 | HISTAMINE | 90.00 |
| 791298 | HISTONES AUTO-ANTIBODY | 50.00 |
| 790931 | HISTOPLASMA ANTIGEN (SERUM) | 290.00 |
| 790775 | HISTOPLASMA ANTIGEN (URINE) | 269.00 |
| 790922 | HIV RNA (QUANT)(VIRAL LOAD) | 176.00 |
| 798050 | HIV-1/2 AG/AB COMBO (IN-HOUSE) | 175.00 |
| 790846 | HIV-1/2 AG/AB EVALUATION | 400.00 |
| 790105 | HLA-B27 | 175.00 |
| 23106 | HOLTER MON DR INT | 101.00 |
| 83049 | HOLTER MON HOOK UP | 205.00 |
| 23049 | HOLTER MON HOOK UP | 263.40 |
| 790667 | HOMOCYSTEINE (PLASMA) | 59.00 |
| 791482 | HOMOGENIZATION TISSUE FOR CULTURE | 31.00 |
| 380000 | HOSP VISIT 1ST DAY IP | 250.00 |
| 380003 | HOSP VISIT NEW IP 1ST | 370.00 |
| 93012 | HOSP VISIT SUBSEQ. LEVEL | 131.25 |
| 380013 | HOSPITAL DETAILED SUBSEQ LEVEL | 224.00 |
| 380012 | HOSPITAL EXPANDED SUBSEQ LEVEL | 133.00 |
| 380011 | HOSPITAL FOCUSED SUBSEQ LEVEL | 133.00 |
| 93053 | HOSPITAL OUTPATIENT CLINIC VISIT | 97.00 |
| 380031 | HOSPITAL SUB EXPANDED SNF LEVEL 2 | 125.00 |
| 380021 | HOSPITAL VISIT 1ST DAY LEVEL | 232.20 |
| 380015 | HOSPITAL VISIT DISCHARGE | 122.40 |
| 380016 | HOSPITAL VISIT DISCHARGE | 133.75 |
| 380017 | HOSPITAL VISIT DISCHARGE | 133.75 |
| 380014 | HOSPITAL VISIT DISCHARGE <30 MIN | 122.40 |
| 380008 | HOSPITAL VISIT SUBSEQ LEVEL | 71.25 |
| 380009 | HOSPITAL VISIT SUBSEQ LEVEL | 71.25 |
| 380010 | HOSPITAL VISIT SUBSEQ LEVEL | 132.50 |
| 380023 | HOSPITAL VISIT SUBSEQ LEVEL | 190.00 |
| 3031006 | HumaLOG 75/25 INSULIN 3ML PEN | 25.00 |
| 791277 | HUMAN ANTI-MOUSE ANTIBODY (HAMA) | 690.00 |
| 791013 | HUMAN EPIDIDYMIS PROTEIN 4 (HE4) | 520.00 |
| 790975 | HUMAN HERPES VIRUS-6 (PCR) | 79.00 |
| 503688 | HUMERAL FRACTURE BRACE MEDIUM | 152.42 |
| 503687 | HUMERAL FRACTURE BRACE LG | 152.42 |
| 503679 | HUMERAL FRACTURE BRACE SM | 152.42 |
| 240373 | HUMERUS LEFT 2 VIEWS | 232.90 |
| 16966 | HUMERUS NO MANIPULATION | 986.00 |
| 171105 | HUMERUS NO MANIPULATION | 1,200.00 |
| 240374 | HUMERUS RIGHT 2 VIEWS | 232.90 |
| 16967 | HUMERUS W/ MANIPULATION | 1,514.00 |
| 171106 | HUMERUS W/ MANIPULATION | 2,075.00 |
| 1404768 | HUMERUS/EXCIS/CYST/T | 89.80 |
| 1404743 | HUMERUS/NON/MALUNION | 89.80 |
| 1404735 | HUMERUS/OSTEOTOMY | 89.80 |
| 1404750 | HUMERUS/RAD/PROCEDUR | 89.80 |
| 514086 | HUMIDIFIER COOL MIST KAZ 1.2 GALLON | 120.00 |
| 3077881 | HUMIRA PEN (ADALIMUMAB) 40MG/0.8ML | 3,890.50 |
| 303567 | humuLIN 70/30 PFS 100 UNITS/ML 3ML | 20.00 |
| 303563 | humuLIN R (REG) INSULIN 100 UNIT/ML 3ML | 10.00 |
| 307772 | HYDRALAZINE 10MG TAB H.H. | 2.00 |
| 3015445 | HYDREA (HYDROXYUREA) 500MG CAP | 2.00 |
| 3005883 | HYDROCHLOROTHIAZIDE 25MG TAB | 2.00 |
| 3077889 | HYDROCODONE/ACET 7.5MG/325MG 15ML LIQUID | 4.50 |
| 3032585 | HYDROcodone/ACETAMINOPHEN 10/325 MG TAB | 2.00 |
| 303529 | HYDROCORTISONE 0.5% CR 30G | 10.00 |
| 303274 | HYDROCORTISONE 20MG TAB | 2.00 |
| 3005909 | HYDROGEN PEROXIDE 237ML | 10.00 |
| 3078073 | HYDROmorphone 0.2MG/ML (20MG/100ML) CADD | 100.00 |
| 3005941 | HYDROmorphone INJ 1MG/ML 1ML | 35.50 |
| 3077840 | HYDROMORPHONE:(10MG/ML) 10MG/1ML | 35.50 |
| 3005974 | HYGROTON (CHLORTHALIDONE) 50MG TAB | 2.00 |
| 3078690 | HYOSCYAMINE ORAL ELIXIR 0.125MG/5ML | 2.00 |
| 3078828 | HYPERRAB INJ SOLN 300IU/1ML | 1,725.30 |
| 136217 | HYSTER (ABD)W/WOBSO A | 2,889.60 |
| 136373 | HYSTER VAG W/WOBSO | 4,023.50 |
| 136332 | HYSTER VAG W/WOBSO A | 2,601.70 |
| 136340 | HYSTER VAG W/WOBSO B | 2,957.50 |
| 136357 | HYSTER VAG W/WOBSO C | 3,312.10 |
| 136365 | HYSTER VAG W/WOBSO D | 3,667.90 |
| 136381 | HYSTER VAG W/WOBSO F | 4,378.30 |
| 136225 | HYSTER(ABD)W/WOBSO B | 3,245.40 |
| 136233 | HYSTER(ABD)W/WOBSO C | 3,600.00 |
| 136241 | HYSTER(ABD)W/WOBSO D | 3,954.50 |
| 136258 | HYSTER(ABD)W/WOBSO E | 4,309.20 |
| 136266 | HYSTER(ABD)W/WOBSO F | 4,664.90 |
| 136274 | HYSTER(ABD)W/WOBSO G | 5,019.50 |
| 136282 | HYSTERECTOMY VAG A | 2,308.00 |
| 136290 | HYSTERECTOMY VAG B | 2,662.50 |
| 136308 | HYSTERECTOMY VAG C | 3,018.40 |
| 136316 | HYSTERECTOMY VAG D | 3,372.90 |
| 136324 | HYSTERECTOMY VAG E | 3,727.50 |
| 1403950 | HYSTEROSCOPY | 81.30 |
| 1503950 | HYSTEROSCOPY | 81.30 |
| 380171 | HYSTEROSCOPY DILATATION AND CUTETTAGE | 906.00 |
| 3026103 | HYTRIN (TERAZOSIN) 1MG CAP | 2.00 |
| 3026111 | HYTRIN (TERAZOSIN) 5MG CAP | 2.00 |
| 3029008 | HYZAAR (LOSARTAN/HCTZ) 50-12.5MG TAB | 2.00 |
| 131131 | I & D OF ABCESS; SIMPLE | 1,542.00 |
| 131216 | I & D OF HEMATOMA | 435.00 |
| 16903 | I & D PARONYCHIA | 265.00 |
| 170186 | I & D PARONYCHIA | 318.60 |
| 170187 | I & D PARONYCHIA | 318.60 |
| 16923 | I & D PARONYCHIA COMP | 265.00 |
| 131138 | I&D ABSCESS SCROTUM | 1,542.00 |
| 16927 | I&D OF HEMATOMA | 235.30 |
| 170210 | I&D OF HEMATOMA | 707.24 |
| 16930 | I&D PERIRECTAL ABSCESS | 235.30 |
| 171086 | I&D PERIRECTAL ABSCESS | 1,081.00 |
| 131187 | I&D PERIRECTAL ABSCESS | 1,542.00 |
| 16931 | I&D THROM HEMORRHOID | 235.30 |
| 171087 | I&D THROM HEMORRHOID | 1,081.00 |
| 170145 | I/D ABSCESS | 198.60 |
| 170988 | I/D BARTH GLAN ABS | 283.00 |
| 170921 | I/D PERIANAL ABSCESS | 1,081.00 |
| 3018084 | IBUPROFEN 200MG TABLET | 2.00 |
| 3077879 | IBUPROFREN 200MG TAB 50CT OP | 2.00 |
| 790613 | ID BY NUCLEIC ACID AMPLIFIED PROBE EACH | 47.00 |
| 791477 | ID BY NUCLEIC ACID DIRECT PROBE EACH | 372.00 |
| 791447 | ID BY NUCLEIC ACID SEQUENCING METHD EACH | 389.00 |
| 798051 | ID FUNGUS/YEAST (EACH) | 61.00 |
| 330923 | ID FUNGUS/YEAST (EACH) (MAYO) | 245.00 |
| 3032069 | IDArubicin (IDAMYCIN) 5MG VIAL | 1,365.00 |
| 3030831 | IFOSFAMIDE(IFEX) 1GM INJ | 602.30 |
| 3019033 | ILOTYCIN O/O(ERYTHROMYCIN BASE): | 20.00 |
| 93086 | IM HIP SCREW | 3,118.00 |
| 137021 | IM HIP SCREW | 3,118.00 |
| 3029867 | IMDUR (ISOSORBIDE MONONITRATE) 30MG TAB | 2.00 |
| 3025162 | IMITREX (SUMAtriptan) 6MG/0.5ML INJ | 350.90 |
| 3031065 | IMITREX(SUMATRIPTAN SUCC)50MG TAB | 2.00 |
| 331549 | IMMEDIATE SPIN BLOOD CROSSMATCH | 147.00 |
| 8016 | IMMUNIZATION ADMINISTRATION IM | 19.68 |
| 798052 | IMMUNOCYTOCHEM ANTIBODY INITIAL STAIN | 156.00 |
| 791265 | IMMUNOCYTOCHEM ANTIBODY STAIN EACH ADDT | 156.00 |
| 791415 | IMMUNOELECTROPHORESIS (URINE) | 162.00 |
| 790135 | IMMUNOFIXATION (24HR URINE) | 55.00 |
| 790723 | IMMUNOFIXATION ELECTROPHORESIS (SERUM) | 104.00 |
| 791267 | IMMUNOFLUORESCENCE BIOPSY INITIAL STAIN | 233.00 |
| 791449 | IMMUNOGLOBULIN (IGA) | 30.00 |
| 790067 | IMMUNOGLOBULIN (IGD) | 30.00 |
| 780057 | IMMUNOGLOBULIN (IGE) | 68.00 |
| 791423 | IMMUNOGLOBULIN (IGG) | 30.00 |
| 791431 | IMMUNOGLOBULIN (IGM) | 30.00 |
| 3023217 | IMOdium A-D(LOPERAMIDE)1mg/7.5ml 120ML | 5.00 |
| 3026434 | IMURAN (azaTHIOprine) 50MG TAB | 2.00 |
| 3017144 | INAPSINE(DROPERIDOL) 5MG/2ML INJ | 36.90 |
| 18188 | INCENTIVE SPIROMETER | 67.70 |
| 16926 | INCISION & REM FB COMPL | 235.30 |
| 170202 | INCISION & REM FB COMPL | 1,340.20 |
| 16925 | INCISION & REM FB SIMPLE | 235.30 |
| 170194 | INCISION & REM FB SIMPLE | 235.30 |
| 380158 | INCISION AND DRAINAGE OF ABSCESS-SIMPLE | 266.80 |
| 170160 | INCISION AND DRAINAGE OF PILONDIAL | 265.00 |
| 16924 | INCISION AND DRAINAGE OF PILONDIAL COMP | 265.00 |
| 135954 | INCISION DRAINAGE FOREARM WRIST | 549.60 |
| 96059 | INCISION DRAINAGE POST OP | 330.00 |
| 1403928 | INCOMPLETE/MISSED ABORTION | 89.80 |
| 37164 | IND THERAPY 30 MIN | 106.00 |
| 37172 | IND THERAPY 45 MIN | 175.60 |
| 37173 | IND THERAPY 60 MIN | 190.20 |
| 3006212 | INDERAL (PROPRANOLOL) 10MG TAB | 2.00 |
| 3026079 | INDERAL LA (PROPRANOLOL) 60MG CAP | 2.00 |
| 3019090 | INDERAL LA (PROPRANOLOL) 80MG CAP | 2.00 |
| 3006220 | INDERAL(PROPRANOLOL) 40MG TAB | 2.00 |
| 37299 | INDIVIDUAL BHIS CRISIS INTERVENTION | 25.00 |
| 37131 | INDIVIDUAL PHYCH 30M | 256.40 |
| 37149 | INDIVIDUAL PSYCH 50M | 418.60 |
| 37300 | INDIVIDUAL SKILLS TRAINING CHILD 0-20 | 25.00 |
| 3006261 | INDOCIN (INDOMETHACIN) 25MG CAP | 2.00 |
| 1403729 | INF/VENA/CAVA/LIGAT | 89.80 |
| 241751 | INFANT EXTREMITY UPPER >=2V. | 186.20 |
| 241769 | INFANT LEG 2 VIEWS | 151.00 |
| 507340 | INFLATION SYRINGE FOR BALLOON DIALATORS | 161.50 |
| 11128 | INFUSION EACH SEQUENTIAL UP TO 1 HR | 139.30 |
| 11140 | INFUSION, CONCURRENT UP TO 1 HR | 92.50 |
| 380172 | INGUINAL HERNIOGRAPHY AND MESH | 1,211.00 |
| 131102 | INGUINAL HERNIOGRAPHY AND MESH | 2,000.00 |
| 790837 | INHIBIN A TUMOR MARKER | 42.00 |
| 16300 | INIT. DRSG 1ST DEGREE | 103.10 |
| 170582 | INIT. DRSG 1ST DEGREE | 153.40 |
| 15012 | INITIAL EVALUATION | 180.00 |
| 131166 | INJ PARA VERT F JNT C/T 1 LEVEL | 687.00 |
| 15002 | INJ PARA VERT F JNT C/T 1 LEVEL | 1,221.00 |
| 15003 | INJ PARA VERT F JNT C/T 2 LEV | 612.00 |
| 131167 | INJ PARA VERT F JNT C/T 2 LEVEL | 368.00 |
| 15017 | INJ PARA VERT F JNT C/T 3+ LEVEL | 612.00 |
| 131169 | INJ PARA VERT F JNT C/T 3+ LEVELS | 357.00 |
| 131170 | INJ PARA VERT F JNT CL/S 3+ LEVELS | 357.00 |
| 131135 | INJ PARA VERT F JNT L/S 1 LEVEL | 435.00 |
| 15018 | INJ PARA VERT F JNT L/S 1 LEVEL | 1,221.00 |
| 131136 | INJ PARA VERT F JNT L/S 2 LEVEL | 435.00 |
| 15019 | INJ PARA VERT F JNT L/S 2 LEVEL | 612.00 |
| 15020 | INJ PARA VERT F JNT L/S 3 LEVEL | 612.00 |
| 131175 | INJ PARA VERT F JNT L/S 3+ LEVELS | 340.00 |
| 131137 | INJ SINGLE TENDON SHEATH LIGAMENT | 435.00 |
| 15011 | INJ SINGLE TENDON SHEATH LIGAMENT | 576.00 |
| 240699 | INJ W/FLUOR EVAL CV DEVICE | 136.40 |
| 170625 | INJ. TRIGGERPOINT 1 OR 2 MUSCLES | 95.00 |
| 16960 | INJ. TRIGGERPOINT 1 OR 2 MUSCLES | 122.00 |
| 93023 | INJECT ASPIR ARTHROCEN INTERMEDIATE JOIN | 198.00 |
| 93024 | INJECT ASPIR ARTHROCEN MAJOR JOINT OR BU | 234.00 |
| 93022 | INJECT ASPIR ARTHROCEN SMALL JOINT OR BU | 191.00 |
| 93054 | INJECT ENZYME PALMER FACIAL CORD | 489.00 |
| 93021 | INJECT SINGLE MULTIPLE TRIGGER POINTS | 225.00 |
| 3077846 | INJECTAFER (CARBOXYMALTOSE) 750MG 15ML | 1,931.85 |
| 83131 | INJECTION INTO EYE | 259.00 |
| 134576 | INJECTION LUMBAR REGION | 668.00 |
| 11123 | INJECTION, SQ OR IM | 59.80 |
| 93020 | INJECTS SINGLE MULTIPLE TRIGGER POINTS | 191.00 |
| 93019 | INJECTS SINGLE TENDON ORGIN INSERTION | 191.00 |
| 93018 | INJECTS SINGLE TENDON SHEATH OR LIGAMENT | 180.00 |
| 517090 | INLET CLOSE SURE PROCEDURE KIT | 405.00 |
| 380018 | INPATIENT CONSULT L3 | 210.00 |
| 93011 | INPATIENT CONSULT LEVEL 1 | 128.00 |
| 93013 | INPATIENT CONSULT LEVEL 3 | 247.00 |
| 93014 | INPATIENT CONSULT LEVEL 4 | 370.00 |
| 93015 | INPATIENT CONSULT LEVEL 5 | 503.00 |
| 93016 | INPATIENT CONSULT LEVEL 6 | 633.00 |
| 131140 | INSERT PICVAD CATH | 1,542.00 |
| 380120 | INSERT PICVAD CATH | 1,542.00 |
| 380006 | INSERTION CENTRAL CATHETER | 583.00 |
| 80941 | INSERTION CERVICAL DIALATOR | 185.00 |
| 380152 | INSERTION OF ATRIAL AND VENTRICULAR PACE | 1,244.30 |
| 83057 | INSERTION OF IUD DEVICE | 270.00 |
| 131127 | INSERTION PORT A CATH | 1,542.00 |
| 137051 | INSERTION, NON-BIODEGRADABLE DRUG D IMPL | 300.00 |
| 83039 | INSERTION, NON-BIODEGRADABLE DRUG DELIVE | 300.00 |
| 303664 | INSPRA (EPLERENONE) 25MG TAB | 2.00 |
| 511570 | INSULFLATION TUBING HEATED STRYKER NEW | 360.00 |
| 790860 | INSULIN (FREE) | 156.00 |
| 790025 | INSULIN (TOTAL) | 52.00 |
| 791054 | INSULIN ANTIBODIES | 176.00 |
| 3016492 | INSULIN DRIP:100UNITS/NS 100ML (REGULAR) | 75.00 |
| 790095 | INSULIN-LIKE GROWTH FACTOR 1 | 142.00 |
| 790863 | INSULIN-LIKE GROWTH FACTOR 3 (IGFBP-3) | 163.00 |
| 3031056 | INTEGRILIN 0.75MG/ML 100ML FOR INFUSION | 1,251.00 |
| 3031057 | INTEGRILIN 2MG/ML 10ML FOR BOLUS | 407.60 |
| 37125 | INTELLEGENCE TESTING | 210.60 |
| 137071 | INTERBODY DEVICE | 643.00 |
| 517096 | INTERCEED (TC7) ADHESION BARRIER | 781.00 |
| 514880 | INTERING GRAFT 7X60 | 3,286.00 |
| 514881 | INTERING GRAFT 8X60 | 3,286.00 |
| 330924 | INTERLEUKIN 6 (IL-6) | 299.00 |
| 16961 | INTERMEDIATE JOINT INJECTION | 144.00 |
| 170632 | INTERMEDIATE JOINT INJECTION | 195.80 |
| 380147 | INTERNAL HEMORRHOIDS | 677.50 |
| 791467 | INTERPHAS SITU HYBRID 100-300 CELLS FISH | 94.00 |
| 1403554 | INTEST/ENDOSCOPIC/PR | 98.40 |
| 1503554 | INTEST/ENDOSCOPIC/PR | 98.40 |
| 1403596 | INTR/LOWER/ABDOM/LAP | 98.40 |
| 1403547 | INTR/UPPER/ABDOM/LAP | 98.40 |
| 1403109 | INTRA/ORAL/T&A/DENTA | 98.40 |
| 1503109 | INTRA/ORAL/T&A/DENTA | 98.40 |
| 16019 | INTRAOSS NEEDLE/CATH PLACEMENT | 275.00 |
| 171080 | INTRAOSS NEEDLE/CATH PLACEMENT | 275.00 |
| 16909 | INTRAOSSEOUS INFUSION | 275.00 |
| 171047 | INTRAOSSEOUS INFUSION | 275.00 |
| 1404032 | INTRAPELVIC | 89.80 |
| 513660 | INTRAUTERINE CATH NEW MON | 150.00 |
| 330485 | INTRINSIC FACTOR BLOCKING AB | 117.00 |
| 171056 | INTRO NEEDLE/VEIN | 45.00 |
| 16919 | INTRO NEEDLE/VEIN | 75.00 |
| 303599 | INTRON A 10MM IU VL | 542.90 |
| 3025329 | INTRON A 1MMU/DOSE | 110.70 |
| 303600 | INTRON A 50 MM IU VL | 2,714.90 |
| 1403505 | INTRPERIT/UP/ABDOMEN | 98.40 |
| 1503505 | INTRPERIT/UP/ABDOMEN | 98.40 |
| 18063 | INTUBATION EMERGENCY | 385.10 |
| 1404975 | INTUBATION, EMERGENCY PROCEDURE | 351.20 |
| 303298 | INVanz 1GM VIAL | 295.50 |
| 303414 | INVEGA (PALIPERIDONE) 3MG TAB | 2.00 |
| 3078015 | INVOKANA ORAL TABLET 100MG | 17.00 |
| 3077843 | INVOKANA(CANAGLIFLOZIN) 300MG TAB | 2.00 |
| 511187 | IOBAN HIP DRAPE 6619 | 107.00 |
| 790880 | IODINE (SERUM) | 349.00 |
| 3029511 | IOPIDINE 0.5% OPHTH SOLN 5ML | 132.70 |
| 63012 | IOWA DEPART FOR THE BLIND | 9.20 |
| 170489 | IP JOINT W/MANIPULATION NO ANESTHESIA | 1,148.00 |
| 16083 | IP JOINT W/MANIPULATION NO ANESTHESIA | 855.00 |
| 170490 | IP JOINT W/MANIPULATION W/ ANESTHESIA | 1,366.00 |
| 16084 | IP JOINT W/MANIPULATION W/ANESTHESIA | 1,032.00 |
| 3031285 | IRINOTECAN (CAMPTOSAR): 100MG VIAL | 440.70 |
| 303721 | IRINOTECAN (CAMPTOSAR): 40MG VIAL | 115.50 |
| 790235 | IRON | 95.00 |
| 3027119 | IRON DEXTRAN 50MG/ML INJ | 178.40 |
| 511193 | IRRIVAC IRRIG/EVACULATOR STRYKER | 264.00 |
| 791228 | ISLET ANTIGEN 2 ANTIBODY | 333.00 |
| 791015 | ISLET CELL CYTOPLASMIC AB (IGG) | 203.00 |
| 3025766 | ISMO (ISOSORBIDE MONONITRATE) 20MG TAB | 2.00 |
| 509601 | ISOLATION -OTHER | 71.40 |
| 509171 | ISOLATION-RSV | 84.30 |
| 506482 | ISOLATION-VRE | 97.20 |
| 303606 | ISONIAZID 300MG TAB | 2.00 |
| 3006618 | ISORDIL(ISOSORBIDE DINITRATE) 20MG TAB | 2.00 |
| 303434 | ISOVUE-250 50ML | 208.35 |
| 303436 | ISOVUE-300 100ML | 408.00 |
| 303435 | ISOVUE-300 50ML | 216.55 |
| 3078117 | ISOVUE-370 INJECTION 76% 100ML | 340.20 |
| 3078109 | ISOVUE-370 INJECTION 76% 150ML | 470.65 |
| 303497 | ISOVUE-M 200 41% 10ML VIAL | 269.90 |
| 3032541 | ISOVUE-M 300 61% 15 ML | 298.80 |
| 331995 | I-STAT TROPONIN I | 160.00 |
| 599998 | IUD SKYLA | 1,347.00 |
| 599993 | IUD LILETTA | 250.00 |
| 599901 | IUD MIRENA | 906.00 |
| 599996 | IUD PARAGARD | 735.00 |
| 532519 | IV BLOOD Y-TYPE SET | 57.20 |
| 510113 | IV BURETROL SOLN SET | 22.00 |
| 531070 | IV CADD EPIDURAL EXTEN 90 surgery only | 35.00 |
| 511122 | IV CADD SET PCA EXT 68 med surg only | 35.00 |
| 531071 | IV CADD YELLOW STRIPE ADMIN 123 MONTY | 34.00 |
| 578063 | IV CHEMOSET 111 | 37.00 |
| 532532 | IV CONTINU-FLO SET/MICRODROP SET | 16.00 |
| 532520 | IV FAT IMMULSION | 13.00 |
| 532522 | IV FILTER SET 0.2 | 41.60 |
| 532523 | IV FILTER SET 1.2 | 51.15 |
| 11122 | IV HYDRATION EACH ADD’L HR | 115.90 |
| 11121 | IV HYDRATION, INITIAL UP TO 1 HR | 259.90 |
| 11127 | IV INFUSION EA INT OR EA SEQ, ADD’L HR | 115.90 |
| 11126 | IV INFUSION INITIAL, UP TO 1 HR | 259.90 |
| 578070 | IV PACLITAXEL SET-CHEMO | 80.00 |
| 510112 | IV PRIMARY VENOSET | 80.00 |
| 11125 | IV PUSH EACH SEQUENTIAL | 114.80 |
| 11124 | IV PUSH INITIAL | 114.80 |
| 16040 | IV PUSH SAME SUBSTANCE | 111.50 |
| 11150 | IV PUSH SAME SUBSTANCE | 114.80 |
| 532516 | IV SECONDARY VENOSET | 23.25 |
| 532518 | IV SET NITRO | 108.90 |
| 532524 | IV TUR/BLADDER Y-TYPE | 58.20 |
| 303617 | IVERMECTIN (STROMECTOL) 3MG TAB | 2.00 |
| 240621 | IVP INFUSION- NO DON’T USE!! | 560.70 |
| 241116 | IVP INFUSION W/TOMOGRAPHY- NO DON’T USE! | 595.80 |
| 240613 | IVP W/WO KUB, W/WO TOMOGRAPHY | 574.00 |
| 790952 | JAK2 V617F MUTATION (BLOOD)(MAYO# 88715) | 1,300.00 |
| 303388 | JANUVIA (sitaGLIPtin) 100MG TAB | 2.00 |
| 303389 | JANUVIA (sitaGLIPtin) 25MG TAB | 2.00 |
| 3024306 | JEVITY 1000ML | 45.80 |
| 303346 | JEVITY PLUS 1.2C 1000ML | 54.95 |
| 303572 | JEVITY RTH 1.5CAL LIQ 1000ML | 24.90 |
| 790107 | JO-1 AUTO ANTIBODY | 130.00 |
| 578020 | JP DRAIN FLAT 10MM | 197.00 |
| 578623 | JP DRAIN FLAT 7MM | 166.00 |
| 578622 | JP DRAIN ROUND 7FR 2ML | 50.00 |
| 578498 | JP DRAIN ROUND CHANNEL 15FR | 114.00 |
| 303303 | JUVEN PKT 23GM PWD | 2.00 |
| 3020858 | KAOPECTATE (BISMUTH SUBSALICYLATE) 240ML | 10.00 |
| 512144 | KATZ EXTRACTOR FOREIGN BODY REMOVAL ER | 362.00 |
| 3021120 | KAYEXOLATE (SODPOLYSTYRENE) 15GM/60ML | 2.00 |
| 3077859 | KCENTRA (PROTHROMBIN COMPLEX) 1158IU SDV | 4,487.10 |
| 3077858 | KCENTRA (PROTHROMBIN COMPLEX) 502IU SDV | 1,945.20 |
| 3016955 | KCL ADDED | 4.10 |
| 511599 | KDB KAHOOK DUAL BLADE | 1,185.00 |
| 3006857 | KEFLEX(CEPHALEXIN) 500MG CAP | 2.00 |
| 3006816 | KEFLEX(CEPHALEXIN)SUSP 250MG/5ML 100ML | 15.00 |
| 3006949 | KENALOG(TRIAMCINOLONE)ORABASE 0.1% 5GM | 65.30 |
| 790004 | KEPPRA (LEVETIRACETAM) | 222.00 |
| 3032619 | KEPPRA (levETIRAcetam) 500MG TAB | 2.00 |
| 303544 | KEPPRA (levETIRAcetam) VIAL 500MG | 178.65 |
| 3077813 | KEPPRA (levETIRAcetam)750MG ER TAB | 2.00 |
| 307798 | KEPPRA XR (levETIRAcetam) 500MG TAB | 2.00 |
| 3031822 | KETALAR (KETAMINE) 50MG/ML 10ML | 62.50 |
| 3077824 | KETAMINE HYDROCHLORIDE 25MG/0.5ML | 14.70 |
| 303720 | KETOCONAZOLE 2% SHAMPOO 120ML | 15.00 |
| 3078846 | KEYTRUDA INTRAVENOUS SOLUTION 100MG/4ML | 11,624.10 |
| 244000 | KINEVAC | 275.10 |
| 501039 | KING AIRWAY SIZE 0 | 153.00 |
| 501043 | KING AIRWAY SIZE 1 | 153.00 |
| 501044 | KING AIRWAY SIZE 2 | 153.00 |
| 501045 | KING AIRWAY SIZE 2 1/2 | 153.00 |
| 501040 | KING AIRWAY SIZE 3 | 150.00 |
| 501041 | KING AIRWAY SIZE 4 | 150.00 |
| 501042 | KING AIRWAY SIZE 5 | 150.00 |
| 791463 | KIRBY BAUER SUSC-DISK METHOD PER PLATE | 30.00 |
| 578230 | KIRSCH WIRE .035 D BAY | 37.00 |
| 578231 | KIRSCH WIRE .045 | 30.00 |
| 578233 | KIRSCH WIRE, .062 D BAY | 30.00 |
| 3019009 | klonoPIN (clonazePAM) 0.5MG TAB | 2.00 |
| 3025691 | klonoPIN (clonazePAM) 1MG TAB | 2.00 |
| 3006717 | K-LOR(POTASSIUM CHLORIDE)20 MEQ PACKET | 2.00 |
| 1404230 | KNEE ARTHROSCOPIC | 81.30 |
| 137022 | KNEE ARTHROSCOPY DEBRIDEMENT SHAVING | 1,162.20 |
| 131209 | KNEE ARTHROSCOPY DEBRIDEMENT SHAVING | 2,000.00 |
| 507155 | KNEE BR HINGED VELOCITY | 138.00 |
| 507150 | KNEE BR POST-OP T SCOPE SZ. REGULAR | 157.50 |
| 507151 | KNEE BR POST-OP T SCOPE SZ. XL | 149.50 |
| 502507 | KNEE BR POST-OP LG LONG | 29.20 |
| 507134 | KNEE BR POST-OP LG SHORT | 23.00 |
| 502499 | KNEE BR POST-OP MED LONG | 58.00 |
| 507142 | KNEE BR POST-OP MED SHORT | 38.90 |
| 502481 | KNEE BR POST-OP SM LONG | 27.00 |
| 507159 | KNEE BR POST-OP SM SHORT | 38.90 |
| 502515 | KNEE BR POST-OP XLG LONG | 29.20 |
| 507167 | KNEE BR POST-OP XL-SHORT | 23.00 |
| 240480 | KNEE LEFT 1 OR 2V. | 221.30 |
| 241215 | KNEE LEFT 3 VIEWS | 291.40 |
| 241217 | KNEE LEFT 4+ VIEWS | 316.90 |
| 240481 | KNEE RIGHT 1 OR 2V. | 232.30 |
| 241216 | KNEE RIGHT 3 VIEWS | 291.40 |
| 241218 | KNEE RIGHT 4+ VIEWS | 316.90 |
| 581185 | KNEE SLEEVE NEO OPEN LG | 35.20 |
| 581183 | KNEE SLEEVE NEO OPEN SM | 35.20 |
| 581186 | KNEE SLEVE OPEN X-LG | 31.80 |
| 581165 | KNEE SUPPORT LG | 61.40 |
| 581166 | KNEE SUPPORT XLG | 44.30 |
| 502503 | KNEE SUPPORT/CAGE/LARGE | 62.60 |
| 502502 | KNEE SUPPORT/CAGE/MEDIUM | 36.30 |
| 578620 | KNEE SURGICAL PACK TOTAL | 445.00 |
| 1404297 | KNEE/CAST/REM/REPAIR | 89.80 |
| 1404222 | KNEE/CLOSED | 89.80 |
| 1404289 | KNEE/DISARTICULATION | 89.80 |
| 1404263 | KNEE/JOINT/OPEN | 89.80 |
| 1404206 | KNEE/LOW/FEMUR/CLOSED | 89.80 |
| 1404214 | KNEE/LOW/FEMUR/OPEN | 89.80 |
| 1404040 | KNEE/NER/MUS/TEN/FAS | 89.80 |
| 1403968 | KNEE/OR/POP/INTEQUM | 98.40 |
| 1404321 | KNEE/POP/ARTERIES | 89.80 |
| 1404305 | KNEE/POP/VEINS | 89.80 |
| 241219 | KNEES STANDING AP BIL | 309.00 |
| 330947 | KOH SLIDE | 80.00 |
| 590007 | KOPAN NEEDLE #5 US | 164.00 |
| 514528 | KOPAN NEEDLE #7 US | 124.00 |
| 590008 | KOPAN NEEDLE #9 US | 124.00 |
| 303473 | K-PHOS NEUTRAL 250MG PKT | 2.00 |
| 3030806 | K-PHOS ORIGINAL 500MG TAB | 2.00 |
| 516689 | KUGEL HERNIA PATCH MEDIUM OVAL . | 967.00 |
| 516671 | KUGEL HERNIA PATCH SMALL OVAL . | 690.00 |
| 578600 | K-WIRE 9 .04 | 98.07 |
| 515660 | K-WIRE NON THREADED 4 .035 | 39.00 |
| 515661 | K-WIRE NON THREADED 4 .045 | 38.00 |
| 515662 | K-WIRE NON THREADED 4 .062 DOUBLE BAY | 37.00 |
| 515684 | K-WIRE NON THREADED 9 .045 | 221.00 |
| 515685 | K-WIRE NON THREADED 9 .062 | 40.00 |
| 515665 | K-WIRE THREADED 9 .035 | 86.00 |
| 515673 | K-WIRE THREADED 9 .045 | 90.00 |
| 515681 | K-WIRE THREADED 9 .062 | 86.00 |
| 568142 | K-WIRE TROCAR POINT 1.6MM 150MM SMALL | 45.00 |
| 501922 | KYPHOPAK BONE CEMENT | 693.00 |
| 501294 | KYPHOPAK BONE CEMENT XPEDEW/MIX | 1,107.00 |
| 501291 | KYPHOPAK FRACTTRAY 15/2 | 11,659.00 |
| 501920 | KYPHOPAK FRACTURE TRAY | 10,485.00 |
| 501923 | KYPHOPAK ONE STEP INTRODUCER SYSTEM | 11,659.00 |
| 137016 | KYPOHPLASTY ADDITIONAL LEVEL | 6,243.50 |
| 93066 | KYPOHPLASTY LUMBAR | 1,963.00 |
| 137015 | KYPOHPLASTY LUMBAR | 2,750.00 |
| 93068 | KYPOHPLASTY THORACIC | 1,963.00 |
| 137014 | KYPOHPLASTY THORACIC | 10,327.50 |
| 501295 | KYPOPAK BONE BIOPSY SZ 2 | 462.00 |
| 501921 | KYPOPAK BONE BIOPSY SZ 3 | 495.00 |
| 501292 | KYPOPAK MULTI TAP ADAPTER SZ 2 | 250.00 |
| 131124 | LAC REPAIR UP TO 2.5 CM | 556.00 |
| 1788831 | LAC/ 2.6 TO 5.0 CM | 68.00 |
| 513900 | LACERATION TRAY | 48.00 |
| 3019637 | LAC-HYDRIN CREAM 12% 140G | 10.00 |
| 3007061 | LACRI-LUBE S.O.P. OINT 3.5GMG | 15.00 |
| 331974 | LACTIC ACID | 86.00 |
| 3002567 | LACTULOSE SYRUP 20GRAMS/30ML | 2.00 |
| 578058 | LAG SCREW 2 3/4 | 371.00 |
| 578059 | LAG SCREW 3 | 362.00 |
| 578060 | LAG SCREW 3 1/2 | 385.00 |
| 578061 | LAG SCREW 4 | 385.00 |
| 303297 | LaMICtal (lamoTRIgine) 200MG TAB | 2.00 |
| 303448 | LaMICtal (lamoTRIgine) 25MG TAB | 3.00 |
| 303715 | LaMICtal XR 200MG | 2.00 |
| 3027440 | LamISIL (TERBINAFINE) 1% 12GM CREAM | 15.00 |
| 790746 | LAMOTRIGINE (LAMICTAL) | 104.00 |
| 3015817 | LANAPHILIC OINTMENT WITH UREA 10% | 15.00 |
| 3007087 | LANOXIN AMP(DIGOXIN)0.25MG/ML:2ML | 29.40 |
| 3078823 | LANSINOH HPA LANOLIN TOPICAL OINTMENT | 7.25 |
| 303323 | LANTUS SOLO 100U UNITS/ML 3ML | 53.20 |
| 136134 | LAP (DIAGNOSTIC) A | 4,790.20 |
| 136142 | LAP (DIAGNOSTIC) B | 5,144.80 |
| 136159 | LAP (DIAGNOSTIC) C | 5,499.40 |
| 136167 | LAP (DIAGNOSTIC) D | 5,853.90 |
| 136183 | LAP APPENDECTOMY +30 | 3,542.00 |
| 136191 | LAP APPENDECTOMY +60 | 5,084.00 |
| 135334 | LAP APPENDECTOMY A | 9,994.50 |
| 135342 | LAP APPENDECTOMY B | 10,350.30 |
| 135359 | LAP APPENDECTOMY C | 10,704.90 |
| 135367 | LAP APPENDECTOMY D | 11,059.50 |
| 135375 | LAP APPENDECTOMY E | 11,414.10 |
| 135383 | LAP APPENDECTOMY F | 11,768.70 |
| 135185 | LAP CHOL W/CH-CBDE A | 10,807.80 |
| 135193 | LAP CHOL W/CH-CBDE B | 11,163.70 |
| 135201 | LAP CHOL W/CH-CBDE C | 11,518.20 |
| 135219 | LAP CHOL W/CH-CBDE D | 11,872.90 |
| 135227 | LAP CHOL W/CH-CBDE E | 12,227.50 |
| 135235 | LAP CHOL W/CH-CBDE F | 12,583.20 |
| 135243 | LAP CHOL W/CH-CBDE G | 12,937.90 |
| 135110 | LAP CHOL W/OP CHOL A | 9,362.50 |
| 135128 | LAP CHOL W/OP CHOL B | 9,717.20 |
| 135136 | LAP CHOL W/OP CHOL C | 10,071.80 |
| 135144 | LAP CHOL W/OP CHOL D | 10,427.60 |
| 135151 | LAP CHOL W/OP CHOL E | 10,783.30 |
| 135169 | LAP CHOL W/OP CHOL F | 11,138.00 |
| 135177 | LAP CHOL W/OP CHOL G | 11,493.70 |
| 135086 | LAP CHOLE | 2,000.00 |
| 135094 | LAP CHOLE +30 | 3,542.00 |
| 135102 | LAP CHOLE +60 | 5,084.00 |
| 135060 | LAP CHOLE W/IOC +30 | 3,542.00 |
| 135078 | LAP CHOLE W/IOC +60 | 5,084.00 |
| 135052 | LAP CHOLY W/IOC | 2,000.00 |
| 136209 | LAP OPERATIVE D | 6,347.80 |
| 511326 | LAP PELVISCOPY PACK | 99.00 |
| 131105 | LAP REPAIR OF UMBILICAL HERNIA | 2,000.00 |
| 380166 | LAP VENT/ABD HERN PROC COMP | 2,163.15 |
| 135250 | LAP W/CH-CBDE OPEN A | 11,276.00 |
| 135268 | LAP W/CH-CBDE OPEN B | 11,631.80 |
| 135276 | LAP W/CH-CBDE OPEN C | 11,986.50 |
| 135284 | LAP W/CH-CBDE OPEN,D | 12,341.00 |
| 135292 | LAP W/CH-CBDE OPEN,E | 12,695.60 |
| 135300 | LAP W/CH-CBDE OPEN,F | 13,050.20 |
| 135318 | LAP W/CH-CBDE OPEN,G | 13,407.10 |
| 135326 | LAP W/CH-CBDE OPEN,H | 13,762.90 |
| 380155 | LAP; MOBIL SPLENIC FL ADD-ON | 441.60 |
| 380154 | LAPAROSCOPY; SURG; COLECTOMY; PARTIAL; W | 4,258.45 |
| 380119 | LAPAROSCOPY; SURGICAL; APPENDECTOMY | 1,521.25 |
| 380167 | LAPAROSCOPY; SURGICAL; REPAIR INITIAL IN | 995.90 |
| 131190 | LAPAROSCOPY; SURGICAL; REPAIR INITIAL IN | 1,342.00 |
| 380159 | LAPAROSCOPY;SURGICAL;COLECTOMY;TOTAL;ABD | 4,161.85 |
| 131104 | LAPROSCOPIC EXAM | 2,000.00 |
| 47563 | LAPROSCOPY CHOLECYSTECTOMY W/CHOLANGIOGR | 1,809.00 |
| 380005 | LAPROSCOPY HERNIA REPAIR | 1,885.00 |
| 134643 | LARYNGOSCOPY A | 422.60 |
| 134644 | LARYNGOSCOPY B | 456.50 |
| 134645 | LARYNGOSCOPY C | 469.40 |
| 134646 | LARYNGOSCOPY D | 470.50 |
| 16009 | LARYNGOSCOPY ONLY | 301.00 |
| 171070 | LARYNGOSCOPY ONLY | 400.00 |
| 16010 | LARYNGOSCOPY W/FB REMOVAL | 831.00 |
| 171071 | LARYNGOSCOPY W/FB REMOVAL | 975.00 |
| 131202 | LARYNGOSCOPY WITH BIOPSY | 1,242.00 |
| 3007228 | LASIX (FUROSEMIDE) 20MG TAB | 2.00 |
| 3007236 | LASIX (FUROSEMIDE) 40MG TAB | 2.00 |
| 3007210 | LASIX (FUROSEMIDE) 80MG TAB | 2.00 |
| 3007202 | LASIX INJ(FUROSEMIDE)10MG/ML 10ML | 29.40 |
| 3022623 | LASIX INJ(FUROSEMIDE)10MG/ML 2ML | 29.40 |
| 3007194 | LASIX INJ(FUROSEMIDE)10MG/ML 4ML | 46.00 |
| 3007178 | LASIX ORAL SOLN(FUROSEMIDE) 40MG/4ML | 2.00 |
| 3029966 | LATANOPROST(XALATAN) 0.005% OPHTH | 15.00 |
| 137048 | LATERAL BIMALLELAR ANKLE | 1,333.20 |
| 137047 | LATERAL MALLELAR ANKLE | 1,126.20 |
| 3077955 | LATUDA ORAL TABLET 80MG | 27.50 |
| 509676 | LAVAGE KIT TUM-E-VAC | 184.00 |
| 93063 | LAYER CLOS-12.6-20CM | 649.00 |
| 170486 | LAYER CLOS-ADDTL 5.0CM OR LESS | 896.60 |
| 330319 | LDH (SERUM) | 9.00 |
| 790227 | LDH ISOENZYMES | 85.00 |
| 790006 | LDL CHOLESTEROL DIRECT | 30.00 |
| 511342 | LDS 15 | 650.00 |
| 790623 | LEAD (BLOOD) | 65.00 |
| 790987 | LECITHIN/SPHINGOMYELIN (L/S RATIO) | 121.00 |
| 135722 | LEEP PROCEDURE, A | 1,749.70 |
| 135730 | LEEP PROCEDURE, B | 2,080.90 |
| 135748 | LEEP PROCEDURE, C | 2,435.50 |
| 501195 | LEG BAGS HOLLISTER | 36.00 |
| 1404362 | LEG/ANK/FOOT/LOW/CLO | 89.80 |
| 1404354 | LEG/ANK/FOOT/LOW/INT | 98.40 |
| 1404388 | LEG/ANK/FOOT/NE/MUS | 98.40 |
| 1404461 | LEG/EMBOLECTOMY | 89.80 |
| 1404453 | LEG/LOW/ART/INC/BYPAS | 89.80 |
| 1404479 | LEG/LOW/VEINS | 88.60 |
| 1404487 | LEG/LOW/VENO/THROME | 89.80 |
| 1404156 | LEG/NERV/MUSC/TEND/B | 89.80 |
| 1404149 | LEG/UPPER/INTEGUMENT | 98.40 |
| 330057 | LEGIONELLA ANTIGEN (URINE) | 125.00 |
| 790898 | LEGIONELLA ANTIBODY (SERUM) | 106.00 |
| 1403059 | LENS | 89.80 |
| 514069 | LENS IOL | 450.00 |
| 791286 | LEPTIN | 308.00 |
| 798032 | LEPTOSPIRA (IGM) | 322.00 |
| 1503920 | LESI | 98.40 |
| 3024041 | LEUCOVORIN 50MG | 29.40 |
| 790709 | LEUKOCYTE HISTAMINE RELEASE TEST | 90.00 |
| 3023316 | LEUPROLIDE (LUPRON) 7.5MG INJ | 3,623.00 |
| 3031343 | LEUPROLIDE (LUPRON) per 3.75 MG (DEPO) | 987.75 |
| 3030543 | LEVAQUIN (LEVOFLOXACIN) 250MG TAB | 2.00 |
| 3031962 | LEVAQUIN (LEVOFLOXACIN) 500MG TAB | 2.00 |
| 3031608 | LEVAQUIN 250MG/D5W 50ML INJ | 140.50 |
| 3031434 | LEVAQUIN 500MG/D5W 100ML INJ | 247.10 |
| 3032547 | LEVAQUIN 750MG/D5W 150ML INJ | 272.80 |
| 3016450 | LEVBID (HYOSCYAMINE ER) 0.375MG TAB | 2.00 |
| 511367 | LEVEEN SHUNT | 1,190.00 |
| 303337 | LEVEMIR (INSULIN DETEMIR) 100 UNITS/ML | 55.00 |
| 307797 | LEVETIRACETAM 100MG/ML SOL 30ML | 2.55 |
| 3025949 | LEVOPHED (NOREPINEPHRINE): 4MG/4ML AMP | 55.90 |
| 3007277 | LEVSIN (HYOSCYAMINE) 0.125MG TAB | 2.00 |
| 3031144 | LEXAPRO (ESCITALOPRAM) 10 MG TAB | 2.00 |
| 303552 | LEXAPRO (ESCITALOPRAM) 20MG TAB | 2.00 |
| 307773 | LEXAPRO (ESCITALOPRAM) 5 MG TAB HH | 2.00 |
| 790127 | LGI1-IGG CBC | 75.00 |
| 303597 | LIALDA (MESALAMINE) 1.2GM TAB | 2.00 |
| 3007343 | LIBRIUM (chlordiazePOXIDE) 5MG CAP | 2.00 |
| 3007368 | LIDOCAINE 2% SYR 100MG/5ML 5ML | 76.25 |
| 3024090 | LIDOCAINE 5% &DEXTROSE 7.5% 2 ML AMP | 50.40 |
| 3031011 | LIDOCAINE 5%/DEXT 7.5% 2ML | 50.40 |
| 3030990 | LIDOCAINE INFUSION: 2000MG/D5W 500ML | 122.65 |
| 303374 | LIDODERM 5% PATCH | 15.00 |
| 516248 | LIGASURE BLUNTTIP LAP SEAL/DIVIDER | 1,471.00 |
| 516241 | LIGASURE DOLPHIN TIP LAP SEAL/DIVIDER | 1,816.00 |
| 516243 | LIGASURE IMPACT | 2,183.00 |
| 516244 | LIGASURE SMALL JAW | 1,647.00 |
| 170020 | LIMITED | 156.80 |
| 16356 | LIMITED | 192.00 |
| 93071 | LIMITED SYNOVECTOMY | 1,910.00 |
| 136555 | LIMITED SYNOVECTOMY | 2,000.00 |
| 137041 | LIMITED SYNOVECTOMY | 2,000.00 |
| 3078018 | LINZESS ORAL CAPSULE 145MCG | 24.36 |
| 3077982 | LINZESS ORAL CAPSULE 290MCG | 10.15 |
| 3007475 | LIORESAL (BACLOFEN) 10MG TAB | 2.00 |
| 790995 | LIPASE | 116.00 |
| 331077 | LIPID PROFILE | 113.00 |
| 3030063 | LIPITOR (ATORVASTATIN) 10MG TAB | 2.00 |
| 303547 | LIPITOR (ATORVASTATIN) 40MG TAB | 2.00 |
| 303272 | LIPITOR(ATORVASTATIN) 20MG TAB | 2.00 |
| 790853 | LIPOPROTEIN (A) | 194.00 |
| 3110860 | LIPOSYN FAT EMULSION 20% 250ML | 185.05 |
| 3021278 | LISINOPRIL 10MG TAB | 2.00 |
| 303461 | LISINOPRIL 40MG TAB | 2.00 |
| 3030878 | LISINOPRIL 5MG TAB | 2.00 |
| 790201 | LITHIUM | 20.00 |
| 3030952 | LITHIUM CARBONATE 150 MG CAP | 2.00 |
| 511649 | LITHOTOMY PACKS | 42.00 |
| 331689 | LIVER PROFILE | 84.00 |
| 1403422 | LIVER/BX/PERCUTANEOUS | 89.80 |
| 790134 | LIVER/KIDNEY MICROSOME TYPE 1 AB | 72.00 |
| 3016013 | L-LYSINE 500MG TAB | 2.00 |
| 514905 | LOCK PIN MULTI-ANGLE X-RAY | 587.40 |
| 3023779 | LODINE (ETODOLAC) 200MG CAP | 2.00 |
| 3007541 | LOMOTIL (DIPHENOXYLATE&ATROPINE) TAB | 2.00 |
| 93033 | LONG ARM CAST | 362.00 |
| 93028 | LONG ARM SPLINT SHOULDER TO HAND | 230.00 |
| 16608 | LONG LEG CAST NWB | 368.00 |
| 93036 | LONG LEG CAST NWB | 368.00 |
| 16609 | LONG LEG CAST WALKER OR AMBULATORY TYPE | 406.00 |
| 93037 | LONG LEG CAST WALKER OR AMBULATORY TYPE | 406.00 |
| 16602 | LONG LEG SPLINT THIGH TO ANKLE OR TOE | 254.00 |
| 93030 | LONG LEG SPLINT THIGH TO ANKLE OR TOE | 254.00 |
| 170513 | LONG LEG SPLINT THIGH TO ANKLE OR TOE | 300.00 |
| 3006170 | LOPERAMIDE 2MG CAP | 2.00 |
| 3024744 | LOPID (GEMFIBROZIL) 600MG TAB | 2.00 |
| 3032593 | LOPRESSOR (METOPROLOL TA) 25MG TAB | 2.00 |
| 3007558 | LOPRESSOR (METOPROLOL TA) 50MG TAB | 2.00 |
| 3020080 | LOPRESSOR (METOPROLOL) 5MG/5ML AMP | 29.40 |
| 303676 | LORazepam INTENSOL 2MG/ML LIQ. 30ML | 137.10 |
| 303526 | LORCET (HYDROcodone/ACETAMIN)7.5/325MG | 2.00 |
| 303525 | LORCET (HYDROcodone/APAP) 5/325MG TAB | 2.00 |
| 3026335 | LOTENSIN (BENAZEPRIL) 10MG TAB | 2.00 |
| 3007582 | LOTRIMIN (CLOTRIMAZOLE) CREAM 15GM | 10.00 |
| 3020684 | LOTRISONE (CLOTRIM/BETAMETH) 15G CRM | 25.00 |
| 3030979 | LOVENOX (ENOXAPARIN) 100 MG/1ML SYRINGE | 345.80 |
| 303397 | LOVENOX (ENOXAPARIN) 150 MG/1ML SYRINGE | 518.60 |
| 3029941 | LOVENOX (ENOXAPARIN) 30 MG/0.3ML SYRINGE | 114.70 |
| 3030797 | LOVENOX (ENOXAPARIN) 40 MG/0.4ML SYRINGE | 152.90 |
| 3030798 | LOVENOX (ENOXAPARIN) 60 MG/0.6ML SYRINGE | 229.50 |
| 3030847 | LOVENOX (ENOXAPARIN) 80 MG/0.8ML SYRINGE | 272.70 |
| 241011 | LOW DOSE CT SCAN; FOR LUNG CANCER | 773.00 |
| 1403521 | LOW/ABD/WALL/ANTERIA | 81.30 |
| 1503521 | LOW/ABD/WALL/ANTERIA | 81.30 |
| 1404446 | LOW/LEG/CAST | 89.80 |
| 1403562 | LOW/POST/ABD/WALL | 89.80 |
| 303419 | LR (LACTATED RINGERS) 3000ML IRRIGATION | 70.00 |
| 310286 | LR (LACTATED RINGERS) 500ML | 80.00 |
| 310294 | LR(LACTATED RINGERS) 1000ML | 95.00 |
| 3030337 | LUBRIDERM 237 LOTION | 10.00 |
| 1403463 | LUMB/VENT/HERN/DEHIS | 89.80 |
| 1503463 | LUMB/VENT/HERN/DEHIS | 89.80 |
| 240282 | LUMBAR >= 4 Views | 314.90 |
| 240274 | LUMBAR 2 or 3 Views | 268.10 |
| 240283 | LUMBAR COMPLETE W/BENDING VIEWS | 385.10 |
| 137030 | LUMBAR DECOMPRESSION | 759.85 |
| 137031 | LUMBAR DECOMPRESSION | 2,375.75 |
| 137033 | LUMBAR DECOMPRESSION | 2,903.55 |
| 137032 | LUMBAR DECOMPRESSION | 3,160.95 |
| 137029 | LUMBAR DECOMPRESSION | 3,247.40 |
| 137063 | LUMBAR DISECTOMY | 14,189.00 |
| 137028 | LUMBAR DISKECTOMY | 3,247.40 |
| 16912 | LUMBAR PUNCTURE | 729.00 |
| 171050 | LUMBAR PUNCTURE | 729.00 |
| 1404977 | LUMBAR PUNCTURE – DIAGNOSTIC | 98.40 |
| 1415181 | LUMBAR REGION ANESTHESIA | 89.80 |
| 507506 | LUMBAR TRAY ADULT (SPINAL) | 93.00 |
| 507456 | LUMBAR TRAY PEDS (SPINAL) | 30.00 |
| 3078608 | LUPRON DEPOT 6 MONTH PWD FOR SUSP 45MG | 22,353.00 |
| 790649 | LUTEINIZING HORMONE (LH) | 66.00 |
| 3077847 | LUVOX (FLUVOXAMINE) 50MG TAB | 2.00 |
| 3030683 | LUVOX TAB(FLUVOXAMINE) 100MG | 2.00 |
| 790620 | LYME DISEASE SERUM (POS/NEG)(W/REFLEX) | 60.00 |
| 3031141 | LYMPHAZURIN 1% (ISOSULFANE BLUE) 5ML | 1,735.10 |
| 303285 | LYRICA (PREGABALIN) 50MG CAP | 2.00 |
| 99999 | LYRICA (PREGABALIN) 75MG | 8.90 |
| 313551 | LYRICA (PREGABALIN) 75MG | 8.90 |
| 303363 | LYRICA (PREGABALIN)25MG CAP | 2.00 |
| 790928 | LYSOZYME (MURAMIDASE) | 82.00 |
| 3007715 | MAALOX 30 ML | 2.00 |
| 3019736 | MAALOX SUSP. 355 ML | 10.00 |
| 3025907 | MACROBID (NITROFURANTOIN) 100MG CAP | 2.00 |
| 330239 | MACROPROLACTIN | 278.00 |
| 3018423 | MAG OXIDE 400MG TAB | 2.00 |
| 3030992 | MAG SULFATE 20GM/500ML INFUSION | 29.40 |
| 3030991 | MAG SULFATE 4GM/100ML | 29.40 |
| 3032382 | MAG SULFATE 50% 1GM/2ML INJ | 29.40 |
| 3029081 | MAGIC MOUTHWASH 240ML SUSP. | 35.00 |
| 331119 | MAGNESIUM | 75.00 |
| 791305 | MAGNESIUM (24HR URINE) | 75.00 |
| 307771 | MAGNESIUM SULFATE 1GM/D5W 100ML | 50.00 |
| 1403497 | MAJ/ABD/BLOOD/VESSEL | 81.30 |
| 1403711 | MAJ/LOW/ABD/VESSELS | 89.80 |
| 13102 | MAJOR 1ST HR OR | 2,000.00 |
| 13103 | MAJOR ADD 30 MIN OR | 750.00 |
| 16962 | MAJOR JOINT INJECTION | 192.00 |
| 170640 | MAJOR JOINT INJECTION | 559.30 |
| 1403174 | MAJOR/VESSEL/NECK | 89.80 |
| 3077845 | MAKENA DS (HYDROXYPORGEST) 250MG/ML | 1,825.00 |
| 790965 | MALARIA (PCR) | 100.00 |
| 790730 | MALARIAL SMEAR/STAIN | 115.00 |
| 1403836 | MALE/EXT/GENITALIA | 89.80 |
| 240075 | MANDIBLE < 4V’s | 237.70 |
| 240076 | MANDIBLE >= 4V’s | 291.40 |
| 791245 | MANGANESE | 156.00 |
| 310377 | MANNITOL 20% 500ML | 87.30 |
| 3018043 | MANNITOL 25% 50ML VIAL | 29.40 |
| 791292 | MANNOSE BINDING LECTIN | 423.00 |
| 507787 | MANOMETER PRESSURE TRAY | 16.00 |
| 3007863 | MARCAINE (BUPIVACAINE) 0.25% 10ML VIAL | 29.40 |
| 3007848 | MARCAINE (BUPIVACAINE) 0.25% 30ML VIAL | 29.40 |
| 3007830 | MARCAINE (BUPIVACAINE) 0.5% 10ML VIAL | 29.40 |
| 3019348 | MARCAINE (BUPIVACAINE) 0.5% 30ML VIAL | 29.40 |
| 3031016 | MARCAINE (BUPIVICAINE) 0.75% 10ML VIAL | 29.40 |
| 3020361 | MARCAINE 0.75%/DEXT. 8.25%: 2ML | 29.40 |
| 3030295 | MARCAINE W/EPI (BUPIVACAINE) 0.5% 30ML | 38.30 |
| 303602 | MARCAINE/EPI (BUPIVACAINE) 0.25% 50ML | 29.40 |
| 5512902 | MASK AEROSOL ADULT | 6.90 |
| 5512904 | MASK AEROSOL PEDI FISH FACE | 6.90 |
| 502125 | MASK LMA SUPREME 14 FR SIZE 3 | 62.00 |
| 502126 | MASK LMA SUPREME 14 FR SIZE 4 | 62.00 |
| 502128 | MASK LMA SUPREME 14 FR SIZE 5 | 62.00 |
| 502020 | MASK LMA SIZE 1.0 | 53.50 |
| 502021 | MASK LMA SIZE 1.5 | 58.00 |
| 502022 | MASK LMA SIZE 2.0 | 53.00 |
| 502023 | MASK LMA SIZE 2.5 | 53.50 |
| 502024 | MASK LMA SIZE 3.0 | 53.00 |
| 502025 | MASK LMA SIZE 4.0 | 53.00 |
| 502026 | MASK LMA SIZE 5.0 | 53.00 |
| 39143 | MASSAGE, 15 MIN | 71.40 |
| 240083 | MASTOIDS < 3V/SIDE | 176.80 |
| 240084 | MASTOIDS>= 3V/SIDE | 218.90 |
| 510916 | MATTRESS PORTA-WARM -OB ONLY | 213.00 |
| 20061 | MAX VOLUME VENTILATION | 59.80 |
| 511601 | MAXGRIP FORCEP 25 GA | 456.00 |
| 3030804 | MAXIPIME(CEFEPIME) 2GM INJ | 35.00 |
| 3025865 | MAXITROL OPHTH SUSP 5ML | 25.00 |
| 3007897 | MAXITROL OPTH OINT. 3.5GM | 25.00 |
| 18121 | MECHANICAL VENT INT | 567.20 |
| 3000595 | MECLIZINE 12.5MG ORAL TAB | 2.00 |
| 791106 | MECONIUM DRUGS OF ABUSE (9 PANEL) | 360.00 |
| 690009 | MED NUT REASSESS FACE TO FACE 15 MIN | 43.00 |
| 1403349 | MEDIASTINOSCOPY | 89.80 |
| 1403350 | MEDIASTINOSCOPY& DIAG THORACOSCOPY -VENT | 89.80 |
| 690008 | MEDICAL NUTRITION THERAPY 15 MIN | 43.00 |
| 37157 | MEDICATION MANAGEMENT | 139.00 |
| 37156 | MEDICATION MANAGEMENT | 189.30 |
| 3007970 | MEDROL (methylPREDNISolone) 4MG TAB | 2.00 |
| 3007962 | MEDROL(methylPREDNISolone) 4MG DOSEPAK | 25.00 |
| 3032626 | MEFOXIN (cefOXitin) 2GM | 86.50 |
| 3032625 | MEFOXIN (CEFOXITIN)1GM | 43.30 |
| 303462 | MEGACE (MEGESTROL) 40MG TAB | 2.00 |
| 3032457 | MEGACE (MEGESTROL) 40MG/ML:30ML SUSP | 69.15 |
| 3031022 | MELATONIN 5 MG TAB | 2.00 |
| 3008010 | MELLARIL (THIORIDAZINE) 100MG TAB | 2.00 |
| 37304 | MENTAL HEALTH ASSESSMENT, BY NON-PHYSICI | 190.20 |
| 3077873 | MENVEO (MENING A/C/Y/W-135/DIP) 0.5ML VL | 406.00 |
| 508208 | MEPILEX 4X4 AG | 46.00 |
| 508204 | MEPILEX BORDER SACRUM 7.2 X7.2 | 41.00 |
| 790721 | MERCURY (BLOOD) | 86.00 |
| 303661 | MERREM (MEROPENEM) 500MG/100ML | 155.03 |
| 303333 | MERREM (MEROPENEM): 1GM | 244.90 |
| 516695 | MESH ECHO POSITIONING 6X8 | 3,038.00 |
| 516694 | MESH ECHO POSITIONING SYSTEM 4X6 | 1,539.00 |
| 516691 | MESH KUGEL MODIFIED 7.5 CM SMALL CIRC | 495.00 |
| 516690 | MESH KUGEL MODIFIED OVAL 8CMX12.0CM | 675.00 |
| 578652 | MESH SURGIPRO 1 X 4 | 138.00 |
| 578653 | MESH SURGIPRO 3 X 5 | 263.00 |
| 516696 | MESH ULTRA PRO 12X12 | 1,400.00 |
| 516697 | MESH ULTRA PRO 6X6 | 847.00 |
| 516693 | MESH VENTRALEX PATCH ROUND 8CMX8CM | 1,555.00 |
| 3028220 | MESNA 200MG INJ | 224.95 |
| 331697 | METABOLIC BASIC PANEL | 69.00 |
| 331713 | METABOLIC COMPREHENSIVE PANEL | 93.00 |
| 16980 | METACARPAL NO MANIPULATION | 775.00 |
| 171119 | METACARPAL NO MANIPULATION | 974.00 |
| 16981 | METACARPAL W/ MANIPULATION | 901.00 |
| 171120 | METACARPAL W/ MANIPULATION | 1,186.00 |
| 3008150 | METAMUCIL PKT | 2.00 |
| 790209 | METANEPHRINES (24HR URINE) | 127.00 |
| 791009 | METANEPHRINES (RANDOM URINE) | 163.00 |
| 790728 | METANEPHRINES FRAC. FREE PLASMA | 80.00 |
| 137054 | METATARASAL OR TARSAL NONUNION/MALUNION | 1,368.60 |
| 16134 | METATARSALPHALANGES NO ANESTHESIA | 423.00 |
| 16135 | METATARSALPHALANGES W/ ANESTHESIA | 500.00 |
| 170502 | METATARSALPHANGES NO ANESTHESIA | 575.00 |
| 170503 | METATARSALPHANGES W/ ANESTHESIA | 873.00 |
| 798106 | METHADONE & METABOLITES | 557.00 |
| 303295 | METHADONE 10MG TAB | 2.00 |
| 3008200 | METHERGINE(METHYLERGONOVINE) 0.2MG/ML 1M | 29.40 |
| 3008218 | METHOTREXATE 2.5MG TAB | 2.00 |
| 3008234 | METHOTREXATE INJ: 50MG | 29.40 |
| 3008242 | METHYLENE BLUE SDV 1% 10ML | 434.90 |
| 790622 | METHYLMALONIC ACID (MMA)(SERUM) | 187.00 |
| 791010 | MEXILETINE | 70.00 |
| 3019678 | MEXILETINE 200MG | 2.00 |
| 37154 | MH LEVEL 1 | 108.20 |
| 517695 | MIC BUTTON KIT | 335.00 |
| 518132 | MIC GASTRO KIT 24FR | 305.00 |
| 517554 | MIC GASTRO TUBE 18FR | 200.00 |
| 517547 | MIC GASTRO TUBE 20FR | 200.00 |
| 517539 | MIC GASTRO TUBE 22FR | 183.00 |
| 518129 | MIC GASTRO TUBE 24FR | 183.00 |
| 518130 | MIC GASTRO TUBE 26FR | 200.00 |
| 516218 | MIC GASTRO TUBE 28FR | 195.00 |
| 518131 | MIC GASTRO TUBE 30FR | 200.00 |
| 3030783 | MICARDIS (TELMISARTAN) 40MG TAB | 2.00 |
| 137044 | MICRO FRACTURE | 1,143.00 |
| 790017 | MICROALBUMIN (QUANT)(RANDOM URINE) | 30.00 |
| 3017011 | MICRONASE (glyBURIDE) 5MG TAB | 2.00 |
| 515189 | MICROPUNCTURE SET | 145.00 |
| 303636 | MILK/MAGN LIQUID 16OZ H.H. | 10.00 |
| 517099 | MINERVA THERMAL ABLATION | 2,883.00 |
| 501902 | MINESCOTOMY ELECTRODE | 300.00 |
| 578595 | MINI MAY FULLY THREADED 40MM | 331.00 |
| 578592 | MINI MAY FULLY THREADED 55MM | 321.00 |
| 578591 | MINI MAY FULLY THREADED 60MM | 321.00 |
| 578590 | MINI MAY FULLY THREADED 65MM | 331.00 |
| 137038 | MINI OPEN ROTATOR CUFF REPAIR | 874.80 |
| 3008341 | MINIPRESS CAP(PRAZOSIN) 2MG | 2.00 |
| 508991 | MINNESOTA TUBE | 143.00 |
| 13100 | MINOR 1ST HR OR PROC | 1,542.00 |
| 13101 | MINOR ADD 30 MIN OR PROC | 555.00 |
| 513892 | MINOR PROCEDURE TRAY | 41.00 |
| 3031133 | MIRALAX 17GM POWDER PKT | 2.00 |
| 3032514 | MIRAPEX (PRAMIPEXOLE) 0.125MG TAB | 2.00 |
| 303476 | MIRAPEX (PRAMIPEXOLE) 1MG TAB | 2.00 |
| 93075 | MISC REVENUE MERRITT-OTHER | 400.00 |
| 3030826 | mitiXANtrone(NOVANTRONE)INJ 5MG | 901.25 |
| 790702 | MITOCHONDRIAL AB (M2) | 120.00 |
| 3008481 | mitoMYcin VIAL 5MG | 445.05 |
| 570019 | MITY VAC MYSTIC II PUMP W/ BELL CUP | 166.00 |
| 510963 | MIXING BOWL W/SPLAT DISP | 104.00 |
| 509969 | MIXING BOWL, QUICK VAC FOR KNEES | 397.00 |
| 791428 | MLH1 GENE; FULL SEQUENCE ANALYSIS | 624.00 |
| 261611 | MM BIOPSY SPECIMEN | 442.00 |
| 244058 | MM DIGITAL BILAT DIAGNOSTIC 2D MEDICARE | 391.00 |
| 2624007 | MM DIGITAL BILAT DIAGNOSTIC MEDICARE | 99.00 |
| 2624004 | MM DIGITAL BILAT DIAGNOSTIC PRIVATE | 319.00 |
| 2624005 | MM DIGITAL BILAT SCREENING MEDICARE | 99.00 |
| 2624002 | MM DIGITAL BILAT SCREENING PRIVATE | 319.00 |
| 262403 | MM DIGITAL DIAGNOSTIC 3D | 213.00 |
| 244059 | MM DIGITAL DIAGNOSTIC 3D MEDICARE | 227.00 |
| 244060 | MM DIGITAL DIAGNOSTIC 3D MEDICARE | 319.00 |
| 262409 | MM DIGITAL DIAGNOSTIC BILAT 2D PRIVATE | 319.00 |
| 262404 | MM DIGITAL DIAGNOSTIC BILAT 3D PRIVATE | 227.00 |
| 262407 | MM DIGITAL DIAGNOSTIC UNILAT 2D MEDICARE | 213.00 |
| 262406 | MM DIGITAL DIAGNOSTIC UNILAT 2D PRIVATE | 213.00 |
| 2624001 | MM DIGITAL SCREENING BILAT 2D MEDICARE | 319.00 |
| 262408 | MM DIGITAL SCREENING BILAT 2D PRIVATE | 319.00 |
| 244057 | MM DIGITAL SCREENING BILAT 3D MC/PR | 99.00 |
| 2624006 | MM DIGITAL UNI DIAGNOSTIC MEDICARE | 99.00 |
| 2624003 | MM DIGITAL UNI DIAGNOSTIC PRIVATE | 319.00 |
| 260050 | MM MAMMARY DUCT, MULTI SI | 411.90 |
| 260040 | MM MAMMORY DUCT, SINGLE SI | 411.90 |
| 260031 | MM NEEDLE GUIDE, EA LESION SI | 273.90 |
| 791471 | MMR IHC STAIN PMS2 (W/ADD REFLEX) | 120.00 |
| 3031140 | MMR-II (MEASLES,MUMPS,RUBELLA) 0.5ML INJ | 216.20 |
| 3030848 | MOBIC (MELOXICAM) 7.5MG TAB | 2.00 |
| 791456 | MOLD IDENTIFICATION | 64.00 |
| 791329 | MOLD PANEL | 93.00 |
| 791466 | MOLECULAR CYTO DNA PROBE (FISH) (EACH) | 80.00 |
| 303714 | MOM 30ML | 2.00 |
| 23130 | MON TX AND EVENT REC | 126.00 |
| 83130 | MON TX AND EVENT REC | 461.00 |
| 3022953 | MONISTAT 7 (MICONAZOLE) 100MG VAG SUPP | 2.00 |
| 3008390 | MONISTAT 7 VAG CRM(MICONAZOLE) 2% 45GM | 10.00 |
| 3023506 | MONISTAT DERM(MICONAZOLE)CRM 2% 15GM | 10.00 |
| 3026319 | MONOPRIL (FOSINOPRIL) 10MG TAB | 2.00 |
| 330608 | MONOTEST | 65.00 |
| 3077965 | MONUROL SUSPENSION 3GM | 210.60 |
| 791483 | MORPH ANALYSIS TUMOR IHC (MANUAL)(EACH) | 224.00 |
| 3078050 | MORPHINE 1MG/ML (100MG/100ML)CADD PCA | 100.00 |
| 3026913 | MORPHINE 20MG/1ML 30ML HH | 97.10 |
| 3029651 | MORPHINE 300MG (15MG/ML) 20ML | 43.90 |
| 3027887 | MORPHINE ER 100MG TAB | 2.00 |
| 3026947 | MORPHINE ER 15MG TAB | 2.00 |
| 307768 | MORPHINE ER 30MG TAB | 2.00 |
| 3025170 | MORPHINE ER 60MG TAB | 2.00 |
| 3077828 | MORPHINE SULFATE 10MG/0.5ML ORAL SOLN | 8.35 |
| 3008416 | MORPHINE SULFATE INJ 10MG | 40.55 |
| 3019702 | MORPHINE SULFATE INJ 2MG | 40.55 |
| 3019710 | MORPHINE SULFATE INJ 4MG | 40.55 |
| 3077966 | MORPHINE SULFATE: 250MG | 91.70 |
| 3027390 | MOTRIN (IBUPROFEN) 100MG/5ML UNIT DOSE | 2.00 |
| 3008465 | MOTRIN (IBUPROFEN) 400MG TABLET | 2.00 |
| 3008457 | MOTRIN (IBUPROFEN) 600MG TABLET | 2.00 |
| 3019298 | MOTRIN (IBUPROFEN) 800MG TABLET | 2.00 |
| 3026848 | MOTRIN SUS(MOTRIN,IBUPR 100MG/5ML 120M | 15.00 |
| 3078302 | MOVANTIK ORAL TABLET 25MG | 23.04 |
| 241671 | MRA ABD W/ OR W/O CONTRAST | 2,415.60 |
| 241669 | MRA BRAIN W/O&W CONTRAST | 2,442.50 |
| 241690 | MRA CHEST W/ OR W/O DYE | 2,415.60 |
| 241646 | MRA CHEST W/WO/WO | 1,988.00 |
| 241633 | MRA HEAD W/CONTRAST | 1,898.30 |
| 241636 | MRA HEAD W/O CONTRAST | 1,693.40 |
| 241628 | MRA HEAD W/WO | 2,169.80 |
| 241683 | MRA LOW EXT W/ OR W/O CONTRAST | 2,415.60 |
| 241638 | MRA NECK W/CONTRAST | 1,898.30 |
| 241637 | MRA NECK W/O CONTRAST | 1,693.40 |
| 241634 | MRA NECK W/O&W CONTRAST | 2,277.60 |
| 241658 | MRA PELVIS WO&W CONTRAST | 2,277.60 |
| 241656 | MRA SPINE WO&W CONTRAST | 2,442.50 |
| 241631 | MRA UP EXT WO&W CONTRAST | 2,415.60 |
| 241672 | MRI ABD W/CONTRAST | 2,050.50 |
| 241663 | MRI ABD W/O CONTRAST | 2,164.00 |
| 241673 | MRI ABD WO&W CONTRAST | 2,415.60 |
| 241666 | MRI BONE MARROW BLOOD SUPPLY | 2,571.20 |
| 241643 | MRI BRAIN W/CONTRAST | 2,145.20 |
| 241447 | MRI BRAIN W/O CONTRAST | 1,965.10 |
| 241644 | MRI BRAIN W/O&W CONTRAST | 3,275.80 |
| 241642 | MRI BRAIN W/P CONT. | 2,313.70 |
| 241667 | MRI BREAST UNILAT W&WO CONTRAST | 1,988.00 |
| 241668 | MRI BREAST W WO CONTRAST BILATERAL | 2,826.00 |
| 241648 | MRI CERVICAL SPINE W/CONTRAST | 1,932.20 |
| 241647 | MRI CERVICAL SPINE W/O CONTRAST | 1,965.10 |
| 241649 | MRI CERVICAL SPINE WO&W CONTRAST | 2,704.60 |
| 241635 | MRI CHEST W/CONTRAST | 1,968.60 |
| 241645 | MRI CHEST W/O CONTRAST | 1,503.90 |
| 241630 | MRI CHEST W/O&W CONTRAST | 2,415.60 |
| 241681 | MRI JOINT LOW EXT W/CONTRAST LEFT | 2,096.10 |
| 241685 | MRI JOINT LOW EXT W/CONTRAST RIGHT | 2,096.10 |
| 241662 | MRI JOINT LOW EXT W/O CONTRAST LEFT | 1,871.50 |
| 241686 | MRI JOINT LOW EXT W/O CONTRAST RIGHT | 1,871.50 |
| 241682 | MRI JOINT LOW EXT WO&W CONTRAST LEFT | 2,415.60 |
| 241687 | MRI JOINT LOW EXT WO&W CONTRAST RIGHT | 2,415.60 |
| 241677 | MRI JOINT UP EXT W/CONTRAST LEFT | 1,816.30 |
| 241688 | MRI JOINT UP EXT W/CONTRAST RIGHT | 1,816.30 |
| 241660 | MRI JOINT UP EXT W/O CONTRAST LEFT | 1,836.20 |
| 241689 | MRI JOINT UP EXT W/O CONTRAST RIGHT | 1,836.20 |
| 241684 | MRI JOINT UP EXT WO&W CONTRAST LEFT | 2,386.30 |
| 241691 | MRI JOINT UP EXT WO&W CONTRAST RIGHT | 2,386.30 |
| 241679 | MRI LOW EXT W/CONTRAST LEFT | 1,863.20 |
| 241692 | MRI LOW EXT W/CONTRAST RIGHT | 1,863.20 |
| 241680 | MRI LOW EXT W/O CONTRAST LEFT | 1,914.70 |
| 241693 | MRI LOW EXT W/O CONTRAST RIGHT | 1,914.70 |
| 241661 | MRI LOW EXT WO&W CONTRAST LEFT | 2,415.60 |
| 241694 | MRI LOW EXT WO&W CONTRAST RIGHT | 2,415.60 |
| 241654 | MRI LUMBAR SPINE W/CONTRAST | 1,932.20 |
| 241653 | MRI LUMBAR SPINE W/O CONTRAST | 1,834.00 |
| 241655 | MRI LUMBAR SPINE WO&W CONTRAST | 3,013.60 |
| 512959 | MRI NON MAGNETIC SMARTSET | 87.00 |
| 241641 | MRI ORBIT/FACE/NECK W/CONTRAST | 1,965.10 |
| 241640 | MRI ORBIT/FACE/NECK W/O CONTRAST | 1,864.30 |
| 241632 | MRI ORBT/FACE/NECK W/O&W CONTRAST | 2,313.70 |
| 241657 | MRI PELVIS W/CONTRAST | 1,968.60 |
| 241670 | MRI PELVIS W/O CONTRAST | 1,864.30 |
| 241674 | MRI PELVIS WO&W CONTRAST | 2,415.60 |
| 241651 | MRI THORACIC SPINE W/CONTRAST | 2,174.50 |
| 241650 | MRI THORACIC SPINE W/O CONTRAST | 1,834.00 |
| 241652 | MRI THORACIC SPINE WO&W CONTRAST | 2,657.90 |
| 241639 | MRI TMJ(TEMPROMANDIBULAR JOINT) | 1,726.30 |
| 262401 | MRI UNLISTED STUDY | 3,150.00 |
| 241676 | MRI UP EXT RT W/CONTRAST LEFT | 1,816.30 |
| 241695 | MRI UP EXT RT W/CONTRAST RIGHT | 1,816.30 |
| 241675 | MRI UP EXT RT W/O CONTRAST LEFT | 1,581.20 |
| 241696 | MRI UP EXT RT W/O CONTRAST RIGHT | 1,581.20 |
| 241659 | MRI UP EXT RT W/O&W CONTRAST LEFT | 2,415.60 |
| 241697 | MRI UP EXT RT W/O&W CONTRAST RIGHT | 2,415.60 |
| 791514 | MRSA SURVEILLANCE | 115.00 |
| 791291 | MSH2 FULL GENE ANALYSIS (PCR) | 1,930.00 |
| 3030911 | MSIR TAB 30MG | 2.00 |
| 307767 | MSIR TAB 30MG H.H. | 2.00 |
| 3019405 | MTE VIAL(TRACE ELEMENTS): | 31.40 |
| 3026988 | MUCINEX (guaiFENesin) 600MG TAB | 2.00 |
| 3020015 | MUCOMYST (ACETYLCYSTEINE) 20% 30ML VIAL | 58.90 |
| 798092 | MUCOPOLYSACCHARIDES QUANTITATTIVE | 93.00 |
| 3078137 | MULTAQ ORAL TABLET 400MG | 22.71 |
| 574701 | MULTIFIX S PEEK 5.5 MM | 1,347.00 |
| 517992 | MULTIPLE CLIP APPLIER ETHICON MCS20 | 325.00 |
| 514011 | MULTIPLE CLIP APPLIER MED ETHICON MCM20 | 326.00 |
| 18731 | MULTIPLE SLEEP LATENCY | 2,195.60 |
| 515948 | MULTIPOLAR BIPOLAR CUP 28 MM LINER | 1,140.00 |
| 515791 | MULTIPOLAR BIPOLAR CUP 44MM LINER | 1,140.00 |
| 515783 | MULTIPOLAR BIPOLAR CUP 44MM SHELL | 1,667.00 |
| 515784 | MULTIPOLAR BIPOLAR CUP 46MM SHELL | 1,447.00 |
| 515792 | MULTIPOLAR BIPOLAR CUP 47MM LINER | 900.00 |
| 515785 | MULTIPOLAR BIPOLAR CUP 48MM SHELL | 1,350.00 |
| 515703 | MULTIPOLAR BIPOLAR CUP 50MM LINER | 1,140.00 |
| 515782 | MULTIPOLAR BIPOLAR CUP 50MM SHELL | 1,667.00 |
| 515786 | MULTIPOLAR BIPOLAR CUP 52MM SHELL | 1,670.00 |
| 515789 | MULTIPOLAR BIPOLAR CUP 53MM LINER | 1,140.00 |
| 515787 | MULTIPOLAR BIPOLAR CUP 54MM SHELL | 1,447.00 |
| 515999 | MULTIPOLAR BIPOLAR CUP 55 MM SHELL | 1,667.00 |
| 515790 | MULTIPOLAR BIPOLAR CUP 57MM LINER | 1,069.00 |
| 515788 | MULTIPOLAR BIPOLAR CUP 57MM SHELL | 1,350.00 |
| 515795 | MULTIPOLAR BIPOLAR CUP SIZE 42 | 1,774.00 |
| 515796 | MULTIPOLAR BIPOLAR LINER 22 | 1,156.00 |
| 515797 | MULTIPOLAR BIPOLAR LINER 26 | 1,156.00 |
| 3013291 | MULTIVITAMIN ORAL TABLET | 2.00 |
| 3015148 | MULTIVITAMIN CONCENTRATE (MVC):10ML | 67.30 |
| 330609 | MUMPS VIRUS (IGG) | 45.00 |
| 330610 | MUMPS VIRUS (IGG)(EMPLOYEE HEALTH ONLY) | 45.00 |
| 791004 | MUMPS VIRUS (IGM) | 88.00 |
| 791321 | MUMPS VIRUS (RNA)(PCR) | 158.00 |
| 3031566 | MURO 128 2% 15ML OPHTH SOLN | 20.00 |
| 790940 | MUSK AUTO-AB (QUANT) | 450.00 |
| 3078393 | MYCAMINE INTRAVENOUS PWD FOR SOLN 100MG | 454.40 |
| 790016 | MYCO PNEUMONIA (IGG&IGM) | 179.00 |
| 790695 | MYCO TUBERCULOSIS (TB)(PCR) | 427.00 |
| 791336 | MYCOBACTERIUM CULTURE (ANY SOURCE) | 44.00 |
| 3031005 | MYCOLOG (NYSTATIN/TRIAMC)15GM CR | 104.00 |
| 791047 | MYCOPHENOLIC ACID | 148.00 |
| 3008523 | MYCOSTATIN CRM (NYSTATIN) 15GM | 15.00 |
| 790841 | MYCO-TB-QUANTIFERON | 165.00 |
| 3030974 | MYDRIACYL 1% 3ML | 55.15 |
| 3026186 | MYDRIACYL DROPS 1% 15ML | 15.00 |
| 790018 | MYELOPEROXIDASE (IGG) ANTIBODY | 144.00 |
| 3018902 | MYLICON 20MG/0.3ML DROPS | 2.00 |
| 3008648 | MYLICON 80MG TAB | 2.00 |
| 790736 | MYOGLOBIN (RANDOM URINE) | 311.00 |
| 798060 | MYOGLOBIN (SERUM) | 311.00 |
| 3077872 | MYRBETRIQ (MIRABEGRON) 25MG ER TAB | 12.00 |
| 136579 | MYRINGOTOMY UNDER GENERAL ANES | 2,000.00 |
| 3027010 | MYSOLINE (PRIMIDONE) 50MG TAB | 2.00 |
| 791309 | N.GONORRHOEA RNA (MISC SITE) | 138.00 |
| 3077827 | NABI-HB VL 1ML | 493.95 |
| 3031384 | NACL (SODIUM CHLORIDE) 1GM TAB | 2.00 |
| 3029305 | NAFCIL VIAL(NAFCILLIN NA) 1GM | 56.30 |
| 3025188 | NAFCIL VIAL(NAFCILLIN NA) 2GM | 143.80 |
| 3032555 | NAMENDA (MEMANTINE) 5MG TABLET | 2.00 |
| 3020007 | NAPROSYN (NAPROXEN) 500MG TAB | 2.00 |
| 3020304 | NARCAN (NALOXONE) 1MG/ML 2ML INJ | 78.40 |
| 3008754 | NARCAN (NALOXONE HCI) 0.4MG INJ | 34.00 |
| 3077892 | NAROPIN (ROPivacaine) 2MG/ML 200ML SDV | 283.00 |
| 3031010 | NAROPIN (ROPIVICAINE) 5MG/ML:30ML | 96.40 |
| 240100 | NASAL BONES >= 3Views | 256.40 |
| 512130 | NASAL CATHETER XOMED EPISTAT | 339.00 |
| 16006 | NASAL HEMOR COMPLEX | 259.10 |
| 171044 | NASAL HEMOR COMPLEX | 259.10 |
| 16005 | NASAL HEMOR SIMPLE | 254.60 |
| 171028 | NASAL HEMOR SIMPLE | 254.60 |
| 3018373 | NEBCIN (TOBRAMYCIN) 80MG/2ML INJ | 34.05 |
| 303688 | NEBUPENT 300MG INH VL 15ML | 350.00 |
| 240167 | NECK SOFT TISSUE | 291.40 |
| 501892 | NECK SURGERY INSTRUMENT | 10,993.00 |
| 579078 | NEEDLE BIOPSY 18 GA 10LX4L X-RAY | 275.00 |
| 579077 | NEEDLE BIOPSY 14 GA 10LX4L X-RAY | 275.00 |
| 1403166 | NEEDLE BX/THYROID | 89.80 |
| 509004 | NEEDLE CHIBA 10CM 20GA.-X-RAY | 55.00 |
| 509001 | NEEDLE CHIBA 10CM 22GA.-X-RAY | 55.00 |
| 509009 | NEEDLE CHIBA 15CM 18GA.-X-RAY | 55.00 |
| 509000 | NEEDLE CHIBA 15CM 20GA.-X-RAY | 58.00 |
| 509002 | NEEDLE CHIBA 15CM 22GA.-X-RAY | 55.00 |
| 509005 | NEEDLE CHIBA 15CM 23GA.-X-RAY | 46.00 |
| 509021 | NEEDLE CHIBA 18GA X 20 CM | 30.00 |
| 509003 | NEEDLE CHIBA 20CM 22GA.-X-RAY | 51.00 |
| 509022 | NEEDLE CHIBA 20GA X 20 CM | 30.00 |
| 509020 | NEEDLE CHIBA 22GA X 20 CM | 30.00 |
| 514090 | NEEDLE GUIDE INSERTS X-RAY | 117.00 |
| 514102 | NEEDLE GUIDE TRANS COVER PROSTATE | 72.00 |
| 514101 | NEEDLE GUIDE TRANSDUCER COVER | 31.00 |
| 131118 | NEEDLE GUIDE, EA LESION SI | 2,000.00 |
| 595012 | NEEDLE JAMISHIDI BIOPSY | 82.00 |
| 514355 | NEEDLE SCLEROTHERAPY DISP 230CM | 130.00 |
| 596092 | NEEDLE SPECIAL 12GA 4FR INTRODUCER | 80.00 |
| 596093 | NEEDLE SPECIAL 12GA 6FR INTRODUCER | 80.00 |
| 5595007 | NEEDLE SPINAL 18X3 1/2 | 29.60 |
| 5595010 | NEEDLE SPINAL 22GA X 1.50 | 29.60 |
| 5595009 | NEEDLE SPINAL 25 X 2 | 29.60 |
| 5595008 | NEEDLE SPINAL 25 X 31/2 | 29.60 |
| 596084 | NEEDLE STIMUPLEX NERVE BLOCK 22 GAX13/8 | 52.00 |
| 514727 | NEEDLE TEMNO BIOPSY # 20/20 | 222.00 |
| 514726 | NEEDLE TEMNO BIOPSY #15 GREEN | 222.00 |
| 592017 | NEEDLE TEMNO BIOPSY #15 ORANGE | 125.00 |
| 514725 | NEEDLE TEMNO BIOPSY 14GA 11CM | 109.00 |
| 514722 | NEEDLE TEMNO BIOPSY 14GA 6CM | 123.00 |
| 514719 | NEEDLE TEMNO BIOPSY 18GA 11CM | 122.50 |
| 514720 | NEEDLE TEMNO BIOPSY 18GA 6CM | 122.50 |
| 592024 | NEEDLE TEMNO BIOPSY 20 GA 11CM | 144.00 |
| 514721 | NEEDLE TEMNO BIOPSY 20GA 6CM | 200.00 |
| 508752 | NEEDLE VARESS 120MM | 71.40 |
| 508751 | NEEDLE VARESS 150MM | 219.00 |
| 5595014 | NEEDLE, SPINAL 20X3-1/2 DIAMOND | 29.60 |
| 5595023 | NEEDLE, SPINAL 20X3-1/2 QUINCKE | 29.60 |
| 5595025 | NEEDLE, SPINAL 22X31/2 | 29.60 |
| 5596052 | NEEDLE, SPINAL WHITACRE 27X3 1/2 | 29.60 |
| 596098 | NEEDLE,22GA COUDE 152MM ANEST. ONLY | 62.00 |
| 1403323 | NEEDLE/BX/PLEURA | 81.30 |
| 3019181 | NEOMYCIN 500MG TAB | 2.00 |
| 330673 | NEONATAL SCREEN (PKU) | 317.00 |
| 3009075 | NEOSPORIN OINT(NEO/POLY/BACIT) 0.9GM | 2.00 |
| 3009059 | NEOSPORIN OINT(NEO/POLY/BACIT) 30GM | 10.00 |
| 3009091 | NEOSPORIN OPH (NEOM/POLYB/GRAMI) 10ML | 51.40 |
| 3034003 | NEO-SYNEP (PHENYLEPHRINE) OPHT 2.5% 2ML | 15.00 |
| 3008945 | NEO-SYNEPH SPRAY(PHENYLEPHRINE) 0.5% 15M | 10.00 |
| 3008978 | NEO-SYNEPH SPRAY(PHENYLEPHRINE)0.25% 15M | 10.00 |
| 3028943 | NEO-SYNEPHRINE(PHENYLEPHRINE):10mg/1ML | 29.40 |
| 3032200 | NEPHROCAPS (VIT B,C,AND FOLIC ACID) | 2.00 |
| 3027028 | NEPTAZANE TAB(METHAZOLAMIDE) 50MG | 2.00 |
| 1404842 | NER/MUS/TEN/FASC/BUR | 81.30 |
| 16916 | NERVE BLOCK PERIPHERAL | 235.00 |
| 131181 | NERVE BLOCK PERIPHERAL | 235.00 |
| 171053 | NERVE BLOCK PERIPHERAL | 235.00 |
| 511598 | NERVE GUIDE 3MM (ID) X 2 CM (LENGTH) | 4,822.00 |
| 512324 | NERVE STIMULATOR | 206.00 |
| 3027671 | NESACAINE (CHLOROPROCAINE) 3% 20ML INJ | 107.55 |
| 3009109 | NESACAINE VIAL(CHLOROPROCAINE) 2% 20ML | 111.75 |
| 5416093 | NET DRSG. RETAINER SZ 2 | 3.50 |
| 5512128 | NET DRSG.RETAINER SZ 10 | 4.60 |
| 5417216 | NET DRSG.RETAINER SZ4 | 4.60 |
| 5512126 | NET DRSG.RETAINER SZ6 | 4.60 |
| 5512127 | NET DRSG.RETAINER SZ8 | 4.60 |
| 3031134 | NEULASTA (PEGFILGRASTIM) 6MG/0.6ML INJ | 11,391.10 |
| 3031533 | NEUMEGA SDV 5MG | 817.00 |
| 3025428 | NEUPOGEN (FILGRASTIM) 480MCG/1.6ML VIAL | 1,275.60 |
| 3024264 | NEUPOGEN SDV(FILGRASTIM) 300MCG/ML 1ML | 801.20 |
| 790800 | NEUROMYELITIS OPTICA (IGG)(SERUM) | 150.00 |
| 790114 | NEURONAL VGKC AUTOANTIBODY | 75.00 |
| 3030493 | NEURONTIN (GABAPENTIN) 100MG CAP | 2.00 |
| 3029859 | NEURONTIN (GABAPENTIN) 300MG CAP | 2.00 |
| 137020 | NEUROPLASTY/TRANSPOSITION; MEDIAN NERVE | 1,081.25 |
| 303472 | NEUTRA-PHOS-K PKT | 2.00 |
| 93001 | NEW PATIENT LEVEL 1 | 139.00 |
| 93002 | NEW PATIENT LEVEL 2 | 173.00 |
| 93003 | NEW PATIENT LEVEL 3 | 226.00 |
| 93004 | NEW PATIENT LEVEL 4 | 323.00 |
| 93005 | NEW PATIENT LEVEL 5 | 376.00 |
| 3030922 | NexIUM 40MG CAP (ESOMEPRAZOLE) | 2.00 |
| 303396 | NexIUM 40MG VIAL (ESOMEPRAZOLE)/NS 5ML | 121.40 |
| 599999 | NEXPLANON IMPLANT NON 340B | 1,197.00 |
| 3030981 | NIASPAN 500 MG CAP | 2.00 |
| 3029206 | NICORETTE GUM 2MG BOX 110 | 21.50 |
| 3030253 | NICOTINE 7MG/24HR PATCH | 2.10 |
| 790857 | NICOTINE & METABOLITES (SERUM) | 184.00 |
| 791222 | NICOTINE & METABOLITES (URINE) | 184.00 |
| 3025899 | NICOTINE 14MG/24HR PATCH | 2.10 |
| 3030790 | NICOTINE 21MG/24HR PATCH | 2.00 |
| 3026749 | NIFEREX FORTE 150MG CAP | 2.00 |
| 303532 | NIPENT (PENTOSTATIN) 10MG VIAL | 4,898.90 |
| 313600 | NITRO DRIP 25MG/250ML | 50.00 |
| 3009216 | NITRO-BID CAP(NITROGLYCERIN)2.5MG | 2.00 |
| 3009208 | NITRO-BID CAP(NITROGLYCERIN)6.5MG | 2.00 |
| 3025923 | NITRO-DUR 0.1MG/HR 2.5/24HR PATCH | 2.00 |
| 3017607 | NITRO-DUR 0.2MG/HR 5MG/24HR PATCH | 2.00 |
| 3009224 | NITRO-DUR 0.4MG/HR 10MG/24HR PATCH | 2.00 |
| 3018654 | NITRO-DUR 0.6MG/HR 15MG/24HR PATCH | 2.00 |
| 3017979 | NITROGLYCERIN FTV 50MG/10ML | 83.10 |
| 3017508 | NITROL (NITROGLYCERIN) 2% OINT 60GM | 25.00 |
| 3020056 | NITROPRESS(NITROPRUSSIDE NA):25MG/ML 2ML | 220.60 |
| 3009273 | NITROSTAT SUBL TABS(NITROGLYCERIN) 0.4MG | 15.00 |
| 3031046 | NIX 1% (PERMETHRIN LOT) 60ML | 25.00 |
| 3028018 | NIZORAL CRM (KETOCONAZOLE) 2% 30GM | 132.30 |
| 3019074 | NIZORAL(KETOCONAZOLE) 200 MG TAB | 2.00 |
| 243072 | NM BLOOD LOSS IMAGING | 888.30 |
| 243035 | NM BONE &/OR JOINT IMAGING 3 PHASE STUDY | 1,070.00 |
| 243032 | NM BONE &/OR JOINT IMAGING LIMITED AREA | 827.40 |
| 243028 | NM BONE &/OR JOINT IMAGING MULTIPLE AREA | 832.20 |
| 243024 | NM BONE &/OR JOINT IMAGING WHOLE BODY | 1,099.00 |
| 243040 | NM BONE IMAGING-SPECT(TOMOGRAPHIC) | 832.20 |
| 243071 | NM CARDIAC BLOOD POOL IMAGING | 1,022.50 |
| 243009 | NM GASTRIC EMPTYING STUDY | 1,449.20 |
| 243046 | NM HEPATOBILIARY SYSTEM IMAGING | 1,210.00 |
| 243047 | NM HEPATOBILIARY SYSTEM IMAGING W/RX | 1,354.00 |
| 243056 | NM INTESTINE IMAGING(MECKELS) | 724.40 |
| 243050 | NM KIDNEY IMAGING W/VASCULAR FLOW/FUNCTI | 1,086.90 |
| 243054 | NM KIDNEY IMAGING/MULTIPLE | 2,105.50 |
| 243005 | NM LIVER/SPLEEN IMAGING | 2,308.00 |
| 243002 | NM PARATHYROID IMAGING | 854.00 |
| 243012 | NM PULMONARY PERFUSION IMAGING,PARTICULA | 983.20 |
| 243003 | NM RENAL IMAGING | 863.80 |
| 243010 | NM THYROID IMAGING, MULTI UPTAKES | 741.40 |
| 243001 | NM THYROID NODULES IMAGING | 598.10 |
| 790126 | NMDA-R AB CBA | 75.00 |
| 596576 | NO STING BARRIER FILM | 27.00 |
| 3009323 | NOLVADEX (TAMOXIFEN) 10MG TAB | 2.00 |
| 22535 | NON COVERAGE MILEAGE | 10.70 |
| 3018480 | NORCURON (Vecuronium) 10MG VL | 29.40 |
| 3022755 | NORFLEX (ORPHENADRINE) 60MG/2 ML INJ | 86.70 |
| 731283 | NOROVIRUS (RNA-PCR) | 706.00 |
| 791017 | NOROVIRUS AG (EIA) | 377.00 |
| 3009398 | NORPRAMIN TAB(DESIPRAMINE) 25MG | 2.00 |
| 791552 | NORTRIPTYLINE (SERUM) | 298.00 |
| 3027325 | NORTRIPTYLINE 10MG CAP | 2.00 |
| 240800 | NOSE TO RECTUM 1 VIEW CHILD | 256.40 |
| 1403083 | NOSE/SINUSES/NOT/SPE | 89.80 |
| 3078405 | NOT OF FILE | 55.55 |
| 517970 | NOVASURE SURESOUND | 3,302.00 |
| 566088 | NOVII PATCH | 195.00 |
| 303321 | NovoLOG 70/30 FLEX PEN 100 UNITS/ML 3ML | 25.00 |
| 303322 | NovoLOG FLEX PEN 100UNITS/ML 3ML | 40.00 |
| 303562 | Nplate (romiPLOStim) 250MCG/0.5ML VIAL | 3,223.50 |
| 640050 | NRP TRAINING | 111.20 |
| 3111125 | NS + KCL 20MEQ 1000ML | 160.00 |
| 313442 | NS + OXYTOCIN 20 UNITS 1000ML PREMIX | 153.80 |
| 3032291 | NS 0.9% 2.5ML SYRINGE | 7.70 |
| 303287 | NS 0.9% 3ML FOR INHALATION | 2.00 |
| 310070 | NS 100 ML | 50.00 |
| 310104 | NS 1000ML | 95.00 |
| 3032712 | NS 1000ML/KCL 40MEQ | 170.00 |
| 311117 | NS 100ML ADV. | 50.00 |
| 311116 | NS 100ML MINIBAG | 65.00 |
| 310072 | NS 100ML SOL | 50.00 |
| 311623 | NS 10ML SYR | 8.40 |
| 310088 | NS 250ML | 50.00 |
| 313318 | NS 3% HYPERTONIC SALINE 500ML | 80.00 |
| 310096 | NS 500ML | 80.00 |
| 310062 | NS 50ML | 50.00 |
| 311115 | NS 50ML MINIBAG | 65.00 |
| 311118 | NS ADVANTAGE 250ML | 50.00 |
| 310526 | NS IRRIG:500ML | 25.00 |
| 311120 | NS IRRIGATION 1000ML | 43.00 |
| 3027135 | NS(SODIUM CHLOR) 30ML VIAL | 29.40 |
| 3020010 | NS(SODIUM CHLOR):20ML INJ | 28.50 |
| 511524 | N-TERFACE 4×4 | 23.50 |
| 3032518 | NTG IV SET | 108.80 |
| 790901 | NTX-TELOPEPTIDE (URINE) | 65.00 |
| 790112 | N-TYPE CALCIUM CHANNEL ANTIBODY | 75.00 |
| 70010 | NU ACCU CHECK | 45.70 |
| 70700 | NU ACCUCHECK | 45.70 |
| 8050 | NU CIRCUMCISION PROCEDURE | 1,836.80 |
| 70800 | NU PULSE OX/SINGLE | 115.90 |
| 3016500 | NUBAIN (NALBUPHINE) 10MG/ML INJ | 29.40 |
| 3031988 | NUBAIN (NALBUPHINE) 20MG/ML INJ | 29.40 |
| 3009455 | NUPERCAINAL (DIBUCAINE) OINT 30GM | 10.00 |
| 16120 | NURSE ELBOW W/MANIPULATION | 365.00 |
| 170493 | NURSE ELBOW W/MANIPULATION | 474.00 |
| 83004 | NURSE PER 1/2 DAY INTERVALS | 120.00 |
| 15015 | NURSE SEDATION | 336.50 |
| 5513010 | NURSING (NIPPLE ) SHIELD | 3.70 |
| 80009 | NURTITIONAL COUNSELING | 54.70 |
| 303756 | NUTRILYTE II SDV 20ML | 29.40 |
| 3008531 | NYSTATIN 5ML SUSP | 2.00 |
| 3027598 | NYSTOP (NYSTATIN TOPICAL POWDER)15 GM | 20.00 |
| 19123 | O2 EMERGENCY ROOM | 22.30 |
| 80700 | OB ACCUCHECK | 45.70 |
| 8080 | OB AMNIOINFUSION PROCEDURE | 448.30 |
| 512837 | OB DEL PACK | 65.00 |
| 80940 | OB FOLEY PLACEMENT | 150.90 |
| 80300 | OB INJECTION, SQ OR IM | 59.80 |
| 80150 | OB IV HYDRATION, EACH ADD’L HOUR | 115.90 |
| 80100 | OB IV HYDRATION, INITIAL UP TO 1 HR | 259.90 |
| 80570 | OB IV INFUSION CONCURRENT UP TO 1HR | 92.50 |
| 80550 | OB IV INFUSION EA INIT OR SEQ, ADD’L HR | 115.90 |
| 80500 | OB IV INFUSION INITIAL, UP TO 1 HR | 259.90 |
| 80521 | OB IV INFUSION THERAPEUTIC, ADD’L SEQ UP | 103.00 |
| 80430 | OB IV PUSH EACH SEQUENTIAL | 114.80 |
| 80400 | OB IV PUSH INITIAL | 114.80 |
| 80470 | OB IV PUSH SAME SUBSTANCE | 114.80 |
| 8064 | OB NON-STRESS TEST | 232.90 |
| 8181 | OB OBS >24 HR PER HR | 23.00 |
| 8162 | OB OBS 1ST HR LEVEL 2 | 380.00 |
| 8172 | OB OBS 2-24 HR LEVEL 2 | 40.00 |
| 8171 | OB OBS ADDITIONAL HR | 33.00 |
| 8182 | OB OBS PER HR >24 HR LEVEL 2 | 54.00 |
| 8163 | OB OBSERVATION FIRST HR | 341.00 |
| 80920 | OB STRAIGHT CATH RESIDUAL | 131.60 |
| 80900 | OB STRAIGHT CATH SPECIMEN | 98.80 |
| 10001 | OBS 1ST HR LEVEL 1 | 341.00 |
| 10011 | OBS 1ST HR LEVEL 2 | 380.00 |
| 10012 | OBS 2-24 HR LEVEL 2 | 40.00 |
| 10002 | OBS 2-24 LEVEL 1 | 33.00 |
| 10003 | OBS PER HR >24 HRS LEVEL 1 | 48.00 |
| 10013 | OBS PER HR >24 HRS LEVEL 2 | 54.00 |
| 380114 | OBSERVATION CARE | 247.50 |
| 380138 | OBSERVATION CARE | 338.75 |
| 380127 | OBSERVATION CARE DISCHARGE | 132.50 |
| 790909 | OBSTETRIC PANEL | 184.00 |
| 330684 | OCCULT BLOOD (OTHER) | 41.00 |
| 3018530 | OCEAN NASAL SPRAY(SALINE) | 10.00 |
| 303349 | OCUVITE LUTEIN CAP | 2.00 |
| 37165 | OFFICE/OUTPATIENT VISIT; EST | 80.00 |
| 380115 | OFFICE/OUTPATIENT VISIT; NEW | 300.00 |
| 3077857 | OFIRMEV (ACETAMINOPHEN) 1000MG/100ML VL | 136.30 |
| 514239 | OLCOTT TORQUE DEVICE | 58.00 |
| 790806 | OLIGOCLONAL BANDING | 100.00 |
| 380007 | OMENTECTOMY | 2,000.00 |
| 3030864 | OMNICEF (CEFDINIR) 125MG/5ML 60ML | 20.00 |
| 3030802 | OMNICEF (CEFDINIR) 300MG CAP | 2.00 |
| 303411 | OMNIPAQUE 240MG/ML 10ML | 241.80 |
| 1403471 | OMPHALOCELE | 89.80 |
| 11058 | ONC TREATMENT ROOM | 111.20 |
| 303611 | ONDANSETRON 4MG/5ML SOL 50ML HH | 14.06 |
| 137042 | ONE MINISCUS | 934.20 |
| 10700 | OP ACCUCHECK | 45.70 |
| 10850 | OP AIRWAY INHALATION TREATMENT, INITIAL | 91.50 |
| 10860 | OP AIRWAY INHALATION TREATMENT, SUBS | 91.50 |
| 10870 | OP AIRWAY TREATMENT SUBS 1ST DRUG | 91.50 |
| 10880 | OP AIRWAY TREATMENT SUBS 2ND DRUG | 91.50 |
| 10890 | OP AIRWAY TREATMENT SUBS 3RD DRUG | 91.50 |
| 10080 | OP BLOOD COLLECTION IMPLANTED VAD | 74.90 |
| 10085 | OP BLOOD COLLECTION TUNNELED VAD | 74.90 |
| 80061 | OP CONTINUOUS GLUCOSE MONITOR | 383.90 |
| 80051 | OP DIABETIC SELF MANAGEMENT F/U 15 MIN | 30.50 |
| 80008 | OP DM SELF MGMT PER 30 MIN | 34.00 |
| 10940 | OP FOLEY PLACEMENT | 150.90 |
| 80002 | OP GR MNT 30MIN | 12.90 |
| 80007 | OP GR MNT 30MIN | 12.90 |
| 80043 | OP GROUP DSME 1/2HR | 43.40 |
| 10200 | OP INCENTIVE SPIROMETER PER DAY | 67.70 |
| 80004 | OP IND INITIAL MNT 15MIN | 34.00 |
| 80005 | OP IND INITIAL MNT 15MIN | 34.00 |
| 80003 | OP IND MNT FOLLOW-UP 15MIN | 34.00 |
| 80006 | OP IND MNT FOLLOW-UP 15MIN | 34.00 |
| 80042 | OP INDIVIDUAL DSME 1/2 HR | 87.80 |
| 10020 | OP INJECTION, SQ OR IM | 59.80 |
| 10007 | OP IV HYDRATION, EACH ADD’L HOUR | 115.90 |
| 10006 | OP IV HYDRATION, INITIAL UP TO 1 HR | 252.30 |
| 10055 | OP IV INFUSION CONCURRENT UP TO 1HR | 92.50 |
| 10005 | OP IV INFUSION EA INIT OR SEQ, ADD’L HR | 112.50 |
| 10099 | OP IV INFUSION EACH SEQUENTIAL UP TO 1HR | 139.30 |
| 10009 | OP IV INFUSION, INITIAL UP TO 1 HR | 259.90 |
| 10004 | OP IV PUSH EACH SEQUENTIAL | 111.50 |
| 10008 | OP IV PUSH INITIAL | 114.80 |
| 10034 | OP IV PUSH SAME SUBSTANCE | 114.80 |
| 80027 | OP NUTR FOLLOW/UP | 20.00 |
| 10830 | OP PULSE OXIMETER/CONT OVERNIGHT | 338.30 |
| 10820 | OP PULSE OXIMETER/MULTI | 115.90 |
| 10800 | OP PULSE OXIMETER/SINGLE | 115.90 |
| 10900 | OP STRAIGHT CATH FOR SPECIMEN | 98.80 |
| 10920 | OP STRAIGHT CATH RESIDUAL | 131.60 |
| 10015 | OP VACCINATION, EA ADD’L AGENT | 30.10 |
| 10010 | OP VACCINATION, PRIMARY | 67.40 |
| 10070 | OP VAD FLUSH | 76.20 |
| 3078291 | OPDIVO INTRAVENOUS SOL 10MG/1ML 40MG | 2,808.40 |
| 93072 | OPEN CARPAL TUNNEL RELEASE | 1,423.00 |
| 93057 | OPEN TALOTARSAL JOINT DISLOCATION | 2,269.00 |
| 93079 | OPEN TREATMENT OF MEDIAL MALLEOUS FRACTU | 1,845.00 |
| 131149 | OPEN TREATMENT OF MEDIAL MALLEOUS FRACTU | 2,000.00 |
| 131150 | OPEN TREATMENT OF ULNAR FRACTURE | 2,000.00 |
| 93080 | OPEN TREATMENT OF ULNAR FRACTURE | 2,031.00 |
| 380142 | OPEN TX ANKLE DISLOC; W-W/O PERCUTANEOUS | 2,057.50 |
| 3030402 | OPIUM TINCTURE 1% 0.5ML | 2.00 |
| 1403075 | OPTHALOSCOPY | 89.80 |
| 136575 | OR ROOM MAJOR, I | 2,774.90 |
| 303425 | ORAJEL REG 10% (BENZOCAINE) 0.33OZ | 10.00 |
| 240118 | ORBITS >= 4V’s | 320.70 |
| 1403885 | ORCHIOPEXY/UNI/BILAT | 89.80 |
| 303329 | ORENCIA (ABATACEPT/MALTOSE) 250MG VIAL | 1,789.30 |
| 330246 | ORGANISM SPECIES SEROTYPE (EACH) | 15.00 |
| 137010 | ORIF HIP FRACTURE(INTERTROCHANTERIC HIP | 2,068.20 |
| 137011 | ORIF HIP FRACTURE(INTERTROCHANTERIC HIP | 2,128.80 |
| 135888 | ORIF OF EXTREMITY, A | 3,073.30 |
| 135896 | ORIF OF EXTREMITY, B | 3,416.20 |
| 135904 | ORIF OF EXTREMITY, C | 3,770.80 |
| 135912 | ORIF OF EXTREMITY, D | 4,126.50 |
| 135920 | ORIF OF EXTREMITY, E | 4,481.30 |
| 135938 | ORIF OF EXTREMITY, F | 4,836.90 |
| 135946 | ORIF OF EXTREMITY, G | 5,191.70 |
| 514213 | ORTHO PACK III | 106.00 |
| 511557 | ORTHO/NEURO PACK | 106.00 |
| 240530 | OS CALCIS LT >=2V’s | 162.80 |
| 240531 | OS CALCIS RT >=2V’s | 162.80 |
| 303315 | OSCAL D 500MG (CAL.CARBONATE/VIT D) TAB | 2.00 |
| 3009711 | OSCAL(CAL.CARB,OYSTER SHELL)500MG TAB | 2.00 |
| 594111 | OSCILLATING BLADE 5071-550 OR | 119.00 |
| 594112 | OSCILLATING BLADE 5071-551 OR | 119.00 |
| 790656 | OSMOLALITY (SERUM) | 18.00 |
| 790624 | OSMOLALITY (URINE) | 18.00 |
| 137050 | OSTECTOMY CALCANEUS | 3,355.46 |
| 380153 | OSTECTOMY, CALCANEUS | 1,383.45 |
| 93064 | OSTEOTOMY SHORTENING PHALANGES | 1,250.00 |
| 400142 | OT ADL TRAINING EA 15 MIN | 75.10 |
| 400167 | OT COGNITIVE SKILLS EA 15 MIN | 74.90 |
| 400159 | OT COMM/WORK REINTEGRATION EA 15 MIN | 74.90 |
| 400068 | OT CONTRAST BATH EA 15 MIN | 74.90 |
| 400152 | OT ELECTRICAL STIMULATION EA 15MIN | 71.40 |
| 400220 | OT ELECTRICAL STIM-UNATTENDED | 69.40 |
| 400533 | OT EVAL HIGH 60 MIN | 186.00 |
| 400531 | OT EVAL LOW 30 MIN | 186.00 |
| 400532 | OT EVAL MED 45 MIN | 186.00 |
| 400019 | OT EVALUATION | 186.20 |
| 400070 | OT IONTOPHORESIS EA 15 MIN | 112.40 |
| 400230 | OT MANUAL THERAPY EA 15 MIN | 74.90 |
| 400100 | OT MASSAGE EA 15 MIN | 74.90 |
| 400092 | OT NEUROMUSCULAR RE-EDUC EA 15 MIN | 74.90 |
| 40001 | OT OCCUPATIONAL THERAPY/NURSING HOME | 76.20 |
| 400126 | OT ORTHOTICS TRAINING EA 15 MIN | 79.80 |
| 400210 | OT PARAFFIN BATH | 74.90 |
| 400134 | OT PROSTHETIC TRAINING EA 15 MIN | 74.90 |
| 400027 | OT RE-EVAL | 186.20 |
| 400534 | OT RE-EVAL 30 MIN | 186.00 |
| 400061 | OT SENSORY INTEGRATIVE EA 15 MIN | 74.90 |
| 400051 | OT THERAPEUTIC ACTIVITY DIRECT EA 15MI | 75.00 |
| 400084 | OT THERAPY EXERCISE EA 15 MIN | 92.60 |
| 400185 | OT ULTRASOUND EA 15 MIN | 74.90 |
| 400187 | OT ULTRASOUND W/ES EA 15 MIN | 74.90 |
| 400170 | OT WHEEL CHAIR MANAGEMENT EA 15 MIN | 71.40 |
| 400050 | OT WHIRLPOOL | 74.90 |
| 400211 | OT WOUND CARE/DEBRIDE <=20CM | 163.70 |
| 400212 | OT WOUND CARE/DEBRIDE >=20CM | 163.70 |
| 137068 | OTHER PERIPHERAL NERVE OR BRANCH | 148.00 |
| 1403026 | OTOSCOPY | 89.80 |
| 511565 | OTT INSUFF TUBING | 40.00 |
| 380019 | OUTPATIENT DETAILED OBSERV LEVEL | 229.80 |
| 503489 | OUTRIGGER HAND SPLINT LARGE LEFT | 331.00 |
| 503490 | OUTRIGGER HAND SPLINT LARGE RIGHT | 466.00 |
| 578042 | OUTRIGGER HAND SPLINT MEDIUM/LEFT | 330.00 |
| 578041 | OUTRIGGER HAND SPLINT MEDIUM/RIGHT | 314.00 |
| 790829 | OXALATE (24HR URINE) | 142.00 |
| 3078303 | OXALIPLATIN IV SOLN 5MG/ML 100MG | 228.90 |
| 791296 | OXCARBAZEPINE METABOLITE (MHC) | 129.00 |
| 507001 | OXISENSOR NEONATAL/ADULT | 66.00 |
| 3078387 | oxyCODONE (ROXICODONE) IR 30MG TAB | 2.00 |
| 3031093 | oxyCODONE (ROXICODONE) IR 5MG TAB | 2.00 |
| 791301 | OXYCODONE METABOLITE(W/CONFIRM)(URINE) | 495.00 |
| 303690 | OXYCODONE/ACETAMIN 7.5MG/325MG TAB H.H. | 2.00 |
| 3003359 | oxyCONTIN (oxyCODONE) CR TAB 40MG | 2.00 |
| 303085 | oxyCONTIN (oxyCODONE) CR 10MG TAB | 2.00 |
| 19136 | OXYGEN 1 HR | 68.00 |
| 19065 | OXYGEN EACH ADD’L HOUR | 14.20 |
| 5513991 | OXYGEN MASK MED CONCENT | 13.70 |
| 19081 | OXYHOOD SET UP | 131.20 |
| 790115 | P/Q-TYPE CALCIUM CHANNEL ANTIBODY | 75.00 |
| 131161 | PACEMAKER GENERATOR REPLACEMENT DUAL LEA | 1,542.00 |
| 506805 | PACEMAKER TEMP LEAD | 2,633.00 |
| 511600 | PACEMAKER TERMINAL CAP STERILE | 344.40 |
| 504908 | PACEMAKER/CABLE EXTENSIONS * | 1,350.00 |
| 504891 | PACEMAKER/EXT DAILY | 144.40 |
| 504909 | PACEMAKER/INTERNAL * | 16,457.00 |
| 3078070 | PACLITAXEL SET | 80.00 |
| 710002 | PAGER RENTAL | 25.80 |
| 3030792 | PAMELOR (NORTRIPTYLINE) 25MG CAP | 2.00 |
| 791021 | PANCREATIC ELASTASE (STOOL) | 215.00 |
| 303581 | PANCREAZE (PANCRELIPASE) 10,500 UNITS | 2.00 |
| 3022854 | PANCREAZE CAP(PANCRELIPASE) 21,000 UNITS | 2.00 |
| 1403539 | PANNICULECTOMY | 89.80 |
| 790110 | PAP SMEAR CERVIX | 112.00 |
| 3019868 | PAPAVERINE 30MG/ML 10ML INJ | 29.40 |
| 16913 | PARACENTESIS W/ US | 731.00 |
| 171051 | PARACENTESIS W/ US | 731.00 |
| 790179 | PARASITE EXAMINATION | 15.00 |
| 791550 | PARASITE EXAMINATION | 20.00 |
| 330672 | PARATHYROID HORMONE INTACT (PTH) | 103.00 |
| 3031033 | PAREGORIC USP 30 ML LIQ | 25.00 |
| 791217 | PARIETAL CELL (IGG) ANTIBODY | 115.00 |
| 307774 | PARoxetine 20MG TAB HH | 2.00 |
| 131153 | PARTIAL EXCISION BONE | 750.00 |
| 93083 | PARTIAL EXCISION BONE | 1,848.00 |
| 131122 | PARTIAL EXCISION DISTAL PHALANX OF FINGE | 556.00 |
| 380151 | PARTIAL EXCISION OF BONE TALUS OR CALCAN | 1,713.75 |
| 18732 | PARTIAL SLEEP STUDY | 1,317.25 |
| 568093 | PARTIALLY THREADED GUIDE WIRE | 72.00 |
| 3030843 | PATANOL (OLOPATADINE) 0.1% 5ML OPHTH SOL | 154.70 |
| 171136 | PATELLA NO MANIPULATION | 1,137.00 |
| 16123 | PATELLA NO ANESTHESIA | 1,025.00 |
| 170496 | PATELLA NO ANESTHESIA | 1,420.00 |
| 16997 | PATELLA NO MANIPULATION | 892.00 |
| 16124 | PATELLA W/ ANESTHESIA | 1,200.00 |
| 170497 | PATELLA W/ ANESTHESIA | 1,660.00 |
| 790964 | PATERNITY TESTING (COLLECTION FEE) | 20.00 |
| 330075 | PATH CONSULT AND REPORT (MAYO) | 541.00 |
| 791670 | PATH CONSULT SURGERY | 151.00 |
| 3032591 | PAXIL (PARoxetine) 10MG/5ML 30 ML LIQUID | 6.00 |
| 3025147 | PAXIL (PARoxetine) 20MG TAB | 2.00 |
| 311122 | PCA CADD SET | 35.00 |
| 514059 | PDS II Z880G OR ONLY | 25.00 |
| 513637 | PEAK FLOW METER | 40.00 |
| 16020 | PEDS PLACEMENT CENTRAL VEIN CATH | 589.00 |
| 171081 | PEDS PLACEMENT CENTRAL VEIN CATH | 785.00 |
| 136092 | PEDS WORKUP, A | 1,576.50 |
| 136100 | PEDS WORKUP, B | 1,931.10 |
| 136118 | PEDS WORKUP, C | 2,286.90 |
| 136126 | PEDS WORKUP, D | 2,641.40 |
| 512530 | PEEP VALVE | 90.00 |
| 37160 | PEER SUPPORT | 164.10 |
| 37161 | PEER SUPPORT | 164.10 |
| 511581 | PEG TUBE | 545.00 |
| 511582 | PEG TUBE BRUSH | 34.00 |
| 16074 | PELVIC RING W/ MANIPULATION | 1,052.00 |
| 171142 | PELVIC RING W/ MANIPULATION | 2,000.00 |
| 16073 | PELVIC RING W/O MANIPULATION | 391.00 |
| 171141 | PELVIC RING W/O MANIPULATION | 646.00 |
| 1403638 | PELVIC/EXENTERATION | 89.80 |
| 240308 | PELVIS 1 OR 2 Vws | 209.50 |
| 240310 | PELVIS 3 VIEWS | 291.40 |
| 3009968 | PENICILLIN G:VIAL 5,000,000U | 162.15 |
| 3030196 | PENTASA (MESALAMINE) 500MG CAP | 2.00 |
| 303545 | PEPCID (FAMOTIDINE) 20MG/2ML VIAL | 29.40 |
| 3029222 | PEPCID (FAMOTIDINE)20MG TB: | 2.00 |
| 3026483 | PEPTO BISMOL LIQUID 240ML | 10.00 |
| 3030980 | PEPTO BISMOL TABLET | 2.00 |
| 3010073 | PERCOCET(oxyCODONE 5MG/APAP325MG) | 2.00 |
| 508365 | PERCUTANEOUS CATH FASTENER -RADIOLOGY | 137.00 |
| 137008 | PERCUTANEOUS PINNING HIP | 1,701.70 |
| 131184 | PERCUTANEOUS PINNING HIP | 2,000.00 |
| 137060 | PERCUTANEOUS SKELETAL FIX FILANGEAL | 1,748.00 |
| 137057 | PERCUTANEOUS SKELETAL FIX HUMERAL FRACTU | 7,128.71 |
| 131203 | PERCUTANEOUS SKELETAL FIX METACARPAL | 435.00 |
| 93056 | PERCUTANEOUS SKELETAL FIX METACARPAL | 884.00 |
| 3010164 | PERIACTIN (CYPROHEPTADINE) 4MG TAB | 2.00 |
| 16915 | PERICARDIOCENTESIS INITIAL | 392.00 |
| 171052 | PERICARDIOCENTESIS INITIAL | 392.00 |
| 1403786 | PERINEAL/PROSTATECTO | 89.80 |
| 3077871 | PERJETA (PERTUZUMAB) 420MG VIAL | 9,903.85 |
| 241068 | PET/CT FULL BODY | 4,883.80 |
| 241069 | PET/CT LIMTED | 4,883.80 |
| 241067 | PET/CT SKULL-THIGH | 4,883.80 |
| 18010 | PFT w/DILATOR | 318.80 |
| 18011 | PFT w/o DILATOR | 191.50 |
| 331880 | PH (WHOLE BLOOD) | 76.00 |
| 16965 | PHAL SHAFT FX NO MANIPULATION | 565.00 |
| 171104 | PHAL SHAFT FX NO MANIPULATION | 710.00 |
| 3010248 | PHAZYME ES (SIMETHICONE) 180MG CAP | 2.00 |
| 3010396 | PHENERGAN (PROMETHAZINE) 25MG SUPP | 2.00 |
| 3010271 | PHENERGAN (PROMETHAZINE) 25MG TAB | 2.00 |
| 3010339 | PHENERGAN (PROMETHAZINE)25MG/ML INJ | 29.40 |
| 3010370 | PHENERGAN (PROMETHAZINE)6.25MG/5ML SYRUP | 2.00 |
| 3010362 | PHENERGAN SYRUP(PROMETHAZINE) 30ML | 12.00 |
| 3010453 | PHENERGAN W/COD SYR(PROMETHAZINE) 30ML | 12.00 |
| 3010446 | PHENERGAN W/COD(PROMETHAZINE) 5ML SYRUP | 2.00 |
| 798061 | PHENOBARBITAL | 66.00 |
| 3010461 | PHENobarbital 20MG/5ML 5ML ELIXIR | 2.00 |
| 3010503 | PHENobarbital 32.4MG TAB | 2.00 |
| 3016633 | PHENobartital 130MG/1ML INJ | 133.70 |
| 1403331 | PHEUMOCENTESIS | 89.80 |
| 1404933 | PHLEBORRHAPY | 89.80 |
| 39130 | PHONONPHORESIS, 15MIN | 71.40 |
| 3031509 | PHOSLO (CALCIUM ACETATE) 667MG CAP | 2.00 |
| 790013 | PHOSPHATIDYLSERINE IGM | 105.00 |
| 790920 | PHOSPHOLIPID (IGA) CARDIO | 91.00 |
| 791067 | PHOSPHOLIPID (IGG) CARDIO | 91.00 |
| 791294 | PHOSPHOLIPID (IGM) CARDIO | 91.00 |
| 331986 | PHOSPHORUS | 61.00 |
| 790827 | PHOSPHORUS (RANDOM URINE) | 67.00 |
| 39009 | Physical Performance Testing | 111.60 |
| 11132 | PIC LINE REMOVAL W/O SUBQ PORT | 765.00 |
| 509431 | PICC 4.0 FR.GROSHONG TRAY | 329.00 |
| 509433 | PICC 5.0 FR.GROSHONG TRAY | 434.00 |
| 380117 | PICC W/O SUB PORT OR PUM AGE 5 YEARS OR | 623.75 |
| 3006501 | PILOCAR (PILOCARPINE) 2% OPHT SOLN 15ML | 88.20 |
| 3006477 | PILOCAR (PILOCARPINE) 1% OPH SOLN 15ML | 86.70 |
| 3006519 | PILOCAR SOL (PILOCARPINE) 4% 15ML | 92.90 |
| 574770 | PIN PASSING DRILL TIP 2.4 X 381 MM STRL | 372.00 |
| 790823 | PINWORM EXAM | 12.00 |
| 3010602 | PITOCIN VIAL (OXYTOCIN) 10U/ML 1ML | 29.40 |
| 16918 | PLACE NASO/ORO GASTRIC TUBE | 142.00 |
| 171055 | PLACE NASO/ORO GASTRIC TUBE | 142.00 |
| 131327 | PLACEMENT OF BREAST US GUIDE | 1,326.00 |
| 3027754 | PLAQUENIL (HYDROXYCHLOROQUINE) 200MG TAB | 2.00 |
| 791310 | PLASMA FREE HEMOGLOBIN | 49.00 |
| 501818 | PLASTER SPLINT 3 | 59.00 |
| 504826 | PLASTER SPLINT 4 | 83.00 |
| 505153 | PLASTER SPLINT 5 | 124.00 |
| 5412135 | PLASTER SPLINT UNIV 2 | 26.20 |
| 5412136 | PLASTER SPLINT UNIV 3 | 15.90 |
| 5412137 | PLASTER SPLINT UNIV 4 | 26.20 |
| 5412138 | PLASTER SPLINT UNIV 6 | 26.20 |
| 790210 | PLATELET AB SCREEN | 150.00 |
| 330566 | PLATELET COUNT | 54.00 |
| 790924 | PLATELET FUNCTION ASSAY | 176.00 |
| 3031079 | PLAVIX (CLOPIDOGREL) 75MG TAB | 2.00 |
| 37214 | PLAY THERAPY 50 MINUTES | 158.00 |
| 37206 | PLAY THERAPY-30 MIN | 105.40 |
| 511789 | PLEDGET TEFLON 4X4 FELT | 651.00 |
| 511771 | PLEDGET TEFLON 5 1/16 | 22.00 |
| 3026368 | PLENDIL (FELODIPINE) 5MG TAB | 2.00 |
| 3030801 | PLETAL (CILOSTAZOL) 100MG TAB | 2.00 |
| 1403380 | PLEURECTOMY | 89.80 |
| 3032481 | PLEURODESIS TALC SOLUTION | 330.20 |
| 790896 | PLT NEUTRALIZATION FOR LUPUS INHIBITOR | 21.00 |
| 1403398 | PLUM/RES/W/THORA/PLA | 89.80 |
| 511560 | PLUME-AWAY SMOKE EVACUATOR LAPROSCOPY | 108.00 |
| 3030519 | PNEUMOVAX 23 0.5ML SDV | 269.00 |
| 501883 | POLAR PAD UNIVERSAL W/ STAPS DJO | 107.00 |
| 3032618 | POLYCITRA (SYSTEMIC ALKALINZER)SYR 30 ML | 2.00 |
| 3031122 | POLYMYXIN B 500,000 UNITS INJ | 59.05 |
| 578619 | POLYPECTOMY SNARE,CAPTIFLEX | 186.00 |
| 3030851 | POLYTRIM (POLYMYXIN/TRIMETH) 10ML OPH | 20.00 |
| 1404347 | POP/EXC/GRAFT/ANEURY | 89.80 |
| 1404339 | POP/THROMBOENDARTER | 89.80 |
| 790625 | PORPHOBILINOGEN (QUANT)(RANDOM URINE) | 143.00 |
| 790648 | PORPHYRINS (QUANT)(RANDOM UA) | 70.00 |
| 798084 | PORPHYRINS TOTAL (PLASMA) | 78.00 |
| 135755 | PORT-A-CATH, A | 3,576.50 |
| 135763 | PORT-A-CATH, B | 3,905.40 |
| 135771 | PORT-A-CATH, C | 4,235.40 |
| 135789 | PORT-A-CATH, D | 4,593.50 |
| 135797 | PORT-A-CATH, E | 4,948.20 |
| 790132 | POST MORTEM ALCOHOL (BLOOD) | 35.00 |
| 790130 | POST MORTEM ALCOHOL (URINE) | 35.00 |
| 790131 | POST MORTEM ALCOHOL (VITREOUS FLUID) | 206.00 |
| 790129 | POST MORTEM DRUG SCREEN #12 | 508.00 |
| 502234 | POST OP SHOE MEN LARGE | 8.30 |
| 502235 | POST OP SHOE MEN X- LARGE | 12.30 |
| 502226 | POST OP SHOE MENS MEDIUM | 12.40 |
| 502218 | POST OP SHOE MENS SM | 12.30 |
| 502267 | POST OP SHOE WOMEN LARGE | 8.00 |
| 502259 | POST OP SHOE WOMEN MEDIUM | 12.60 |
| 502242 | POST OP SHOE WOMEN SMALL | 12.40 |
| 1403828 | POST/TUR/BLEEDING | 89.80 |
| 1403829 | POST/TUR/BLEEDING W/FRAG/REMOVAL UTRETRA | 89.80 |
| 1403984 | POSTERIOR/INTEGUMENT | 89.80 |
| 3027374 | POT PERMAGNATE 1000ML IRRIGATION | 70.90 |
| 3019421 | POT PHOSPHATE:VIAL 15ML | 29.40 |
| 331366 | POTASSIUM (24HR URINE) | 18.00 |
| 798056 | POTASSIUM (RANDOM URINE) | 18.00 |
| 330368 | POTASSIUM (SERUM) | 38.00 |
| 3027846 | POTASSIUM ACT:VIAL 40MEQ 20ML | 29.40 |
| 3027218 | POTASSIUM CHLOR 20MEQ/15ML LIQ | 2.00 |
| 3008267 | POTASSIUM CHLORIDE 10MEQ CAP | 2.00 |
| 3023555 | POTASSIUM CHLORIDE 20MEQ TAB | 2.00 |
| 3010685 | POTASSIUM CHLORIDE(KCL):2MEQ/ML IV | 4.10 |
| 303569 | POTASSIUM CITRATE 10MEQ TAB | 2.00 |
| 3030919 | POTASSIUM/SWI 100 ML:(ALIQUOTS) | 87.30 |
| 595021 | POWER PORT | 1,440.00 |
| 595020 | POWER PORT SAFETY NEEDLE | 49.00 |
| 42058 | PR GROUP | 91.50 |
| 42056 | PR OTHER 1:1 EA 15 MIN | 63.40 |
| 42070 | PR SMOKING CESSATION >10 MIN | 50.90 |
| 42075 | PR SMOKING CESSATION 3-10 MIN | 50.90 |
| 42054 | PR STRENGTH/ENDURANCE 1:1 EA 15 MIN | 77.30 |
| 303696 | PRADAXA (DABIGATRAN ) 150MG CAP | 2.00 |
| 303697 | PRADAXA (DABIGATRAN) 75MG CAP | 2.00 |
| 3025402 | PRAVACHOL TAB 20 MG | 2.00 |
| 3078175 | PRAXBIND INTRAVENOUS SOLUTION 2.5GM/50ML | 8,505.00 |
| 330104 | PREALBUMIN | 39.00 |
| 3030816 | PRECOSE (ACARBOSE) 50MG TAB | 2.00 |
| 3030976 | PRED FORTE 1% OPHTH SOLN 10ML | 15.00 |
| 3010750 | predniSONE 10MG TAB | 2.00 |
| 3030884 | predniSONE 1MG TAB | 2.00 |
| 3010768 | predniSONE 20MG TAB | 2.00 |
| 3010776 | predniSONE 5MG TAB | 2.00 |
| 331030 | PREGNANCY (SERUM +/-) | 69.00 |
| 332015 | PREGNANCY (URINE +/-) | 69.00 |
| 791175 | PREGNANCY BETA HCG (QUANT)(SERUM) | 210.00 |
| 791287 | PREGNENOLONE | 290.00 |
| 3031023 | PRELONE 15MG/5ML 5ML | 2.00 |
| 3010792 | PREMARIN (CONJ ESTROGEN) 25MG/5ML INJ | 419.90 |
| 3010818 | PREMARIN (CONJ. ESTROGENS) 0.625MG TAB | 2.00 |
| 3010826 | PREMARIN VAG CRM 42.5GM | 200.90 |
| 3027044 | PRENATAL VITAMIN TABLET | 2.00 |
| 514087 | PRESSURE MONITOR SET DISP | 524.50 |
| 514088 | PRESSURE MONITOR SLIT CATH | 347.00 |
| 507811 | PRESSURE TRANSDUCER | 66.00 |
| 3028190 | PREVACID (LANSOPRAZOLE)30MG CAP | 2.00 |
| 3028497 | PREVACID(LANSOPRAZOLE)15MG CAP | 2.50 |
| 690001 | PREVENTATIVE MEDICAL COUNSELING 15 MIN | 68.00 |
| 690003 | PREVENTATIVE MEDICAL COUNSELING 45 MIN | 200.00 |
| 690004 | PREVENTATIVE MEDICAL COUNSELING 60 MIN | 260.00 |
| 690002 | PREVENTATIVE MEDICINE COUNSELING 30 MIN | 64.00 |
| 3077868 | PREVNAR 13 PFS 0.5ML | 379.08 |
| 303459 | PRISTIQ (DESVENLAFAXINE) 50MG TAB | 2.00 |
| 791053 | PRO BNP | 130.00 |
| 303707 | PROAIR HFA 90 MCG INH 8.5GM | 72.00 |
| 3030784 | PROAMATINE (MIDODRINE) 5MG TAB | 2.00 |
| 3028260 | PROBENECID 500MG TAB | 2.00 |
| 3010990 | PROCAINAMIDE 1000MG/ML 10ML INJ | 246.80 |
| 791255 | PROCALCITONIN | 129.00 |
| 3010933 | PROCARDIA (NIFEdipine) 10MG CAP | 2.00 |
| 3022821 | PROCARDIA XL (NIFEdipine) 30MG TAB | 2.00 |
| 303521 | PROCRIT 40000 UNIT (NON-CHEMO ANEMIA) | 1,684.30 |
| 303522 | PROCRIT 40000 UNIT(CHEMO INDUCED ANEMIA | 1,684.30 |
| 3019611 | PROCTO FOAM HC AEROSOL 10GM | 74.10 |
| 791050 | PROGESTERONE | 74.00 |
| 303701 | PROGRAF 0.5MG CAPSULE | 2.00 |
| 303457 | PROHANCE (GADOTERIDOL) 15ML | 355.50 |
| 303456 | PROHANCE (GADOTERIDOL) 20ML | 438.90 |
| 790680 | PROLACTIN | 52.00 |
| 303543 | PROLASTIN-C 10MG INJ | 12.10 |
| 303665 | PROLIA (DENOSUMAB) 60MG PFS 1ML | 2,879.00 |
| 11118 | PROLONGED CHEMO INF VIA PUMP >8HR | 375.70 |
| 791441 | PROMETHEUS THIOPURINE METABOLITES | 801.00 |
| 3027515 | PROSCAR (FINASTERIDE) 5MG TAB | 2.00 |
| 3026491 | PROSTIN E2 (DINOPROSTONE) 20MG VAG SUPP | 1,468.40 |
| 517729 | PROTACK | 750.00 |
| 3011105 | PROTAMINE 250MG/25ML INJ | 89.15 |
| 791068 | PROTEIN (24HR URINE) | 75.00 |
| 331123 | PROTEIN (RANDOM URINE) | 75.00 |
| 790638 | PROTEIN C ACTIVITY | 45.00 |
| 798064 | PROTEIN ELECTROPHORESIS (24HR URINE) | 59.00 |
| 798062 | PROTEIN ELECTROPHORESIS (RANDOM URINE) | 59.00 |
| 790532 | PROTEIN ELECTROPHORESIS (SERUM) | 130.00 |
| 790106 | PROTEIN S ACTIVITY | 156.00 |
| 790639 | PROTEIN S AG FREE (W/REFLEX TOTAL) | 145.00 |
| 330376 | PROTEIN TOTAL (SERUM) | 39.00 |
| 790756 | PROTEIN TOTAL REFRACTOMETRY-ANY SOURCE | 63.00 |
| 791487 | PROTEINASE 3 AB (IGG) | 102.00 |
| 790826 | PROTHROMBIN G20210A MUTATION | 455.00 |
| 330475 | PROTIME (PT/INR) | 50.00 |
| 3032600 | PROTONIX (pantoprazole) 40mg TAB | 2.00 |
| 3030855 | PROVENTIL (ALBUTEROL) 2.5MG/3ML NEB | 2.00 |
| 303450 | PROVENTIL (ALBUTEROL) 5MG/ML 20ml MDV | 20.00 |
| 3077878 | PROVENTIL HFA 90MCG INH 6.7GM (OP/HH) | 75.35 |
| 3027358 | PROVERA (medroxyPROGESTERone) 2.5MG TAB | 2.00 |
| 16968 | PROX END ULNAR NO MANIPULATION | 822.00 |
| 171107 | PROX END ULNAR NO MANIPULATION | 1,072.00 |
| 16969 | PROX END ULNAR W/ MANIPULATION | 1,376.00 |
| 171108 | PROX END ULNAR W/ MANIPULATION | 1,980.00 |
| 16987 | PROXIMAL FEMEROL NO MANIPULATION | 1,100.00 |
| 171126 | PROXIMAL FEMEROL NO MANIPULATION | 1,745.00 |
| 16988 | PROXIMAL FEMEROL W/ MANIPULATION | 2,270.00 |
| 171127 | PROXIMAL FEMEROL W/ MANIPULATION | 3,358.00 |
| 16998 | PROXIMAL FIBULA NO MANIPULATION | 892.00 |
| 171137 | PROXIMAL FIBULA NO MANIPULATION | 1,021.00 |
| 16999 | PROXIMAL FIBULA W/ MANIPULATION | 1,309.00 |
| 171138 | PROXIMAL FIBULA W/ MANIPULATION | 1,782.00 |
| 3026772 | PROzac (FLUoxetine) 10MG CAP | 2.00 |
| 3022565 | PROzac (FLUoxetine) 20MG CAP | 2.00 |
| 791159 | PSA | 163.00 |
| 791160 | PSA (SCREENING) | 163.00 |
| 791357 | PSEUDOCHOLINESTERASE | 137.00 |
| 37123 | PSYCHIATRIC DIAG EVA | 328.90 |
| 37124 | PSYCHIATRIC DIAG EVA | 328.90 |
| 37167 | PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SE | 328.90 |
| 37166 | PSYCHOTHERAPY 30 W/EVAL | 135.00 |
| 39142 | PT ADL TRAINING 15 MIN | 74.90 |
| 39465 | PT ADL TRAINING EA 15MIN | 71.40 |
| 39210 | PT CANOLITH REPOSITIONING PER DAY | 106.20 |
| 39382 | PT ELECTRICAL STIMULATION EA 15MIN | 71.40 |
| 39144 | PT ELECTRICAL STIMULATION NON WOUND UNAT | 74.90 |
| 39151 | PT ELECTRICAL STIMULATION UNATTENDED | 74.90 |
| 39150 | PT ELECTRICAL STIMULATION UNATTENDED-WOU | 69.40 |
| 39692 | PT EVAL HIGH 45 MIN | 150.00 |
| 39690 | PT EVAL LOW 20 MIN | 150.00 |
| 39691 | PT EVAL MED 30 MIN | 150.00 |
| 39192 | PT EVALUATION | 148.80 |
| 39218 | PT EXERCISE EA 15MIN | 92.60 |
| 39226 | PT GAIT TRAINING EA 15MIN | 95.90 |
| 39614 | PT IONTOPHORESIS EA 15MIN | 107.20 |
| 39390 | PT MANUAL THERAPY EA 15 MIN | 95.50 |
| 790852 | PT MIX 1:1 SUBSTITUTION (EACH) | 103.00 |
| 39424 | PT NEUROMUSCULAR RE-EDUC EA 15 MIN | 86.60 |
| 39160 | PT NON-SELECTIVE WOUND DEBRIDEMENT | 102.80 |
| 39663 | PT ORTHOTICS TRAINING EA 15MI | 79.80 |
| 39168 | PT PARAFFIN BATH | 58.70 |
| 39200 | PT PHYSICAL PERFORMANCE TESTING EA 15MI | 102.70 |
| 39671 | PT PROSTHETIC TRAINING EA 15MI | 74.90 |
| 39693 | PT RE EVAL 20 MIN | 150.00 |
| 39655 | PT RE-EVALUATION | 149.80 |
| 39021 | PT TENS APPLICATION | 71.40 |
| 39622 | PT THERAPEUTIC ACTIVITY DIRECT EA 15MI | 75.00 |
| 39176 | PT TRACTION-MECHANICAL | 78.80 |
| 39127 | PT ULTRASOUND EA 15MIN | 79.90 |
| 39630 | PT ULTRASOUND W/ES EA 15 MIN | 79.90 |
| 39510 | PT UNNA BOOT APPLICATION | 126.50 |
| 39648 | PT VASOPNEUMATIC DEVICE | 58.90 |
| 39003 | PT VISIT MAPLE HEIGHTS | 58.00 |
| 39005 | PT VISIT PLEASANT VIEW | 69.20 |
| 39325 | PT WHIRLPOOL | 74.90 |
| 39333 | PT WOUND CARE/DEBRIDE <=20CM | 163.70 |
| 39335 | PT WOUND CARE/DEBRIDE >20CM | 193.80 |
| 39336 | PT WOUND VAC <=50CM | 113.60 |
| 39337 | PT WOUND VAC >50CM | 142.80 |
| 330448 | PTT | 53.00 |
| 791244 | PTT MIX 1:1 | 159.00 |
| 512817 | PUDENDAL LOCAL BLOCK SPINAL | 184.00 |
| 3031044 | PULMICORT (BUDESONIDE) 0.25MG/2ML NEB | 2.00 |
| 3031048 | PULMICORT (BUDESONIDE) 0.5MG/2ML NEB | 2.00 |
| 3020130 | PULMOCARE LIQUID 240ML | 10.05 |
| 507335 | PULMONARY BIOPSY FORCEP WITH NEEDLE | 159.00 |
| 18005 | PULMONARY STRESS TEST;6 MIN WALK | 191.50 |
| 18017 | PULMONARY STRESS TEST;6 MIN WALK | 191.50 |
| 18733 | PULMONARY STRESS TEST;6 MIN WALK | 191.50 |
| 507007 | PULSE OX LNCS DISP.SENSOR/MASIMO NEO/AD | 64.25 |
| 507006 | PULSE OX LNCS DISP.SENSOR/MASIMO NEO/AD | 66.00 |
| 18401 | PULSE OXIMETER | 115.90 |
| 18394 | PULSE OXIMETER CONTINUOUS | 115.90 |
| 93052 | PUNCTURE ASPIRATION OF ABCESS HEMATOMA | 666.30 |
| 790133 | PURKINJE CELL CYTOPLASMIC AB TYPE 1 | 75.00 |
| 790122 | PURKINJE CELL CYTOPLASMIC AB TYPE 2 | 75.00 |
| 790123 | PURKINJE CELL CYTOPLASMIC AB TYPE TR | 75.00 |
| 83011 | PV EXTRA LAB TRIPS | 18.80 |
| 303608 | PYRAZINAMIDE 500MG TAB | 2.00 |
| 3011139 | PYRIDIUM (PHENAZOPYRIDINE) 100MG TAB | 2.00 |
| 790685 | PYRIMIDINE 5′ NUCLEOTIDASE | 105.00 |
| 790726 | QUAD SCREEN MATERNAL | 350.00 |
| 3025006 | QUESTRAN LIGHT (CHOLESTYRAMINE) 4GM PKT | 2.00 |
| 511131 | QUICK USE CURRETTE | 103.00 |
| 3027366 | QUINAPRIL 10MG TAB | 2.00 |
| 509432 | QUINTON 36CM DIALYSIS CATH | 526.00 |
| 3031017 | QUIXIN (LEVOFLOXACIN) 0.5% 5ML OPTH SOLN | 36.90 |
| 791055 | RABIES ANTIBODY | 275.00 |
| 3032581 | RABIES IMMUNOGLOBULIN (HYERRAB) 2ML INJ | 1,446.50 |
| 3032582 | RABIES VACCINE (RABAVERT) 1ML | 721.30 |
| 3031045 | RACEMIC EPINEPHRINE 0.5ML FOR INHALATION | 2.00 |
| 1403216 | RAD/MODRAD MASTECTOM | 98.40 |
| 1403224 | RAD/MODRAD/MAST/NODE | 89.80 |
| 1403877 | RAD/ORCHIECTOMY/ABD | 89.80 |
| 1403869 | RAD/ORCHIECTOMY/ING | 89.80 |
| 1404131 | RAD/RES/UPPER/LEG | 89.80 |
| 1404875 | RAD/ULNA/WRI/HAND/OP | 98.40 |
| 1504875 | RAD/ULNA/WRI/HAND/OP | 98.40 |
| 1404867 | RAD/ULNA/WRIST/HAND/C | 89.80 |
| 507597 | RADIAL ARTERY CATH SET | 44.00 |
| 578625 | RADIAL JAW DISP SINGLE | 332.00 |
| 579043 | RADIAL JAW FORCEP BRONCH | 365.00 |
| 16970 | RADIAL SHAFT NO MANIPULATION | 700.00 |
| 171109 | RADIAL SHAFT NO MANIPULATION | 888.00 |
| 16971 | RADIAL SHAFT W/ MANIPULATION | 1,430.00 |
| 171110 | RADIAL SHAFT w/ MANIPULATION | 1,847.00 |
| 16974 | RADIAL/ULNAR NO MANIPULATION | 788.00 |
| 171113 | RADIAL/ULNAR NO MANIPULATION | 930.00 |
| 171114 | RADIAL/ULNAR W/ MANIPULATION | 1,980.00 |
| 16975 | RADIAL/ULNAR W/MANIPULATION | 1,518.00 |
| 1403299 | RADICAL PROC/CHEST | 89.80 |
| 1403620 | RADICAL/HYSTERECTOMY | 89.80 |
| 1403760 | RADICAL/PERINEAL/PRO | 89.80 |
| 574691 | RADIUS BONECUTTER 3.5 FULL | 319.00 |
| 303386 | RANEXA (RANOLAZINE) 500MG TAB | 2.00 |
| 790984 | RAPAMUNE (SIROLIMUS) | 124.00 |
| 303537 | RAPAMUNE (SIROLIMUS) 1MG TAB | 2.00 |
| 3032535 | RAPID FLO-BLOOD SET | 179.05 |
| 15013 | RE EVALUATION | 247.80 |
| 581154 | REACHER 26 | 31.00 |
| 581153 | REACHER 32′ | 37.00 |
| 303415 | RECLAST(ZOLEDRONIC/ACIDMANNITOL) 5MG | 3,189.40 |
| 3030931 | RECOMBIVAX HB ADULT 1ML VIAL | 216.10 |
| 1403208 | RECONSTRUCT/BREAST | 89.80 |
| 131325 | RECOVERY RM/ADD 15MN | 50.40 |
| 131134 | RECURRENT INGUINAL HERNIA + 90 | 4,250.00 |
| 131211 | REDUCTION NASAL TURBINATES | 435.00 |
| 16121 | REDUCTION OF SHOULDER | 1,323.00 |
| 170494 | REDUCTION OF SHOULDER | 1,942.00 |
| 791425 | REF ANTIGEN SCREENING DONOR UNIT (EACH) | 70.00 |
| 791450 | REF SUSCEPTIBILITY AEROBIC BACT (MIC) | 138.00 |
| 791475 | REFERENCE AG TYPE PT EACH NOT ABO/RH | 91.00 |
| 791063 | REFERENCE CAMPYLOBACTER ID | 70.00 |
| 11112 | REFILL/MAINT PORTABLE PUMP | 272.80 |
| 145187 | REGIONAL ANESETHESIA | 188.40 |
| 3011295 | REGITINE (PHENTOLAMINE) 5MG INJ | 437.40 |
| 3011303 | REGLAN (METOCLOPRAMIDE) 10MG TAB | 2.00 |
| 3021823 | REGLAN (METOCLOPRAMIDE) 5MG/5ML 30 ML | 12.00 |
| 3011329 | REGLAN (METOCLOPRAMIDE)10MG/2ML INJ | 29.40 |
| 3024884 | RELAFEN (NABUMETONE) 500MG TAB | 2.00 |
| 303669 | RELISTOR 12 MG VIAL | 226.10 |
| 3029743 | REMERON (MIRTAZAPINE) 15MG TAB | 2.00 |
| 3078292 | REMICADE POWDER FOR INJ 100MG | 3,259.90 |
| 16141 | REMOVAL CAST OF SHOULDER OR HIP | 300.00 |
| 170517 | REMOVAL CAST OF SHOULDER OR HIP | 472.00 |
| 16400 | REMOVAL EMBEDDED FB,MOUTH,SIMPLE | 243.00 |
| 170188 | REMOVAL EMBEDDED FB,MOUTH,SIMPLE | 443.00 |
| 137001 | REMOVAL EXTERNAL FIXATOR | 727.70 |
| 16092 | REMOVAL FB CONJ EMBEDDED | 202.40 |
| 171062 | REMOVAL FB CONJ EMBEDDED | 202.40 |
| 16088 | REMOVAL FB CONJ. SUPERFICIAL | 387.50 |
| 170830 | REMOVAL FB CONJ. SUPERFICIAL | 387.50 |
| 16091 | REMOVAL FB CORNEA W/O SLIT | 202.40 |
| 170848 | REMOVAL FB CORNEA W/O SLIT | 202.40 |
| 16093 | REMOVAL FB CORNEA W/SLIT | 202.40 |
| 171063 | REMOVAL FB CORNEA W/SLIT | 202.40 |
| 16440 | REMOVAL FB EAR | 253.00 |
| 171065 | REMOVAL FB EAR | 253.00 |
| 16450 | REMOVAL FB INTRANASAL | 453.00 |
| 171064 | REMOVAL FB INTRANASAL | 453.00 |
| 16140 | REMOVAL FULL ARM/LEG | 200.00 |
| 170516 | REMOVAL FULL ARM/LEG | 307.00 |
| 93051 | REMOVAL OF IMPLANT SUPERFICIAL | 1,170.00 |
| 93084 | REMOVAL OF IMPLANT; DEEP | 1,396.00 |
| 137052 | REMOVAL OF IMPLANT; DEEP, EG, BURIED PIN | 2,000.00 |
| 83058 | REMOVAL OF IUD DEVICE | 216.00 |
| 83059 | REMOVAL OF NON BIODEGRADABLE DRUG | 325.00 |
| 380137 | REMOVAL OF SKIN TAGS; ANY AREA; UP TO AN | 218.75 |
| 16139 | REMOVAL OR BIVALVING GAUNTLET,BOOT OR BO | 150.00 |
| 170515 | REMOVAL OR BIVALVING GAUNTLET,BOOT OR BO | 180.00 |
| 131157 | REMOVAL PORT A CATH | 435.00 |
| 16004 | REMOVE CERUMEN IMPACTED | 117.20 |
| 170863 | REMOVE CERUMEN IMPACTED | 117.20 |
| 3032540 | RENAGEL (SEVELAMER) 800MG TAB | 2.00 |
| 23061 | RENAL DUPLEX | 474.55 |
| 331680 | RENAL FUNCTION PANEL | 96.00 |
| 23062 | RENAL LIMITED/UNILATERAL DUPLEX | 451.00 |
| 1403679 | RENAL/INC/UP/URETER | 89.80 |
| 790705 | RENIN ACTIVITY | 119.00 |
| 303704 | RENVELA (SEVELAMER CARBONATE) 800MG TAB | 2.00 |
| 1403406 | REP/TRA/TRACH/BRONCH | 89.80 |
| 131143 | REPAIR COMPLEX 1.1CM TO 2.5CM | 435.00 |
| 131208 | REPAIR COMPLEX SCALP ADDTL 5CM SEP PROCE | 435.00 |
| 131207 | REPAIR COMPLEX SCALP,ARMS AND/OR LEGS | 435.00 |
| 131130 | REPAIR COMPLEX, EYELIDS, NOSE, EARS | 435.00 |
| 131212 | REPAIR DONOR SITE FOR SKIN GRAFT | 1,542.00 |
| 131120 | REPAIR EXTENSOR TENDON | 556.00 |
| 16015 | REPAIR NAIL BED | 258.00 |
| 171077 | REPAIR NAIL BED | 541.00 |
| 131199 | REPAIR OF ADVANCEMENT OF PROFUNDUS TENDO | 2,000.00 |
| 16142 | REPAIR OF SPICA,BODY CAST OR JACKET | 184.00 |
| 170518 | REPAIR OF SPICA,BODY CAST OR JACKET | 231.00 |
| 131132 | REPAIR SPIGELIAN HERNIA | 2,750.00 |
| 93069 | REPAIR TENDON OR MUSCLE UPPER ARM; ELBOW | 2,226.00 |
| 131139 | REPAIR TENDON OR MUSCLE UPPER ARM;ELBOW | 2,750.00 |
| 131103 | REPAIR UMBILICAL HERNIA | 2,000.00 |
| 380161 | REPAIR UMBILICAL HERNIA; 5YRS OR OVER; R | 1,033.85 |
| 16013 | REPLACE SUPRA PUBIC COMPLICATED | 265.40 |
| 171075 | REPLACE SUPRA PUBIC COMPLICATED | 347.00 |
| 16012 | REPLACE SUPRA PUBIC SIMPLE | 265.40 |
| 171074 | REPLACE SUPRA PUBIC SIMPLE | 265.40 |
| 380146 | REPLACEMENT OF 24 FRENCH MIC TUBE | 1,226.25 |
| 791235 | REPTILASE TIME | 98.00 |
| 3031780 | REQUIP (rOPINIRole) 0.25MG TAB | 2.00 |
| 3032529 | REQUIP (rOPINIRole) 1MG TAB | 2.00 |
| 516077 | RESECTOSCOPE LOOP 24FR | 467.00 |
| 516085 | RESECTOSCOPE LOOP 27FR | 467.00 |
| 303460 | RESTASIS 0.05% (cycloSPORINE) BX30 | 165.20 |
| 3011345 | RESTORIL (TEMAZEPAM) 15MG CAP | 2.00 |
| 330574 | RETICULOCYTE COUNT | 19.00 |
| 516481 | RETRACTOR PLASTIC RINGS | 295.00 |
| 517612 | RETRIEVER BRONCHOSCOPY NET | 250.00 |
| 241108 | RETROGRADES | 548.90 |
| 303534 | REVATIO (SILDENAFIL CITRATE) 20MG TAB | 2.00 |
| 330624 | RHEUMATOID FACTOR (QUANT) | 22.00 |
| 83136 | RHEUMATOLOGY TELEMEDICINE | 65.00 |
| 512139 | RHINO RAPID 4.5 CM ANTERIOR | 184.00 |
| 512140 | RHINO RAPID 5.5 CM ANTERIOR | 183.50 |
| 512141 | RHINO RAPID 7.5CM ANTERIOR/POSTERIOR | 189.50 |
| 512146 | RHINO RAPID 9.0 CM POSTERIOR | 357.00 |
| 512132 | RHINO ROCKET, MED. | 50.00 |
| 339612 | RHOGAM INJECTION | 314.00 |
| 502028 | RIB BELT MENS UNIVERSAL | 92.60 |
| 505625 | RIB BELT WOMEN UNIVERSAL | 24.10 |
| 1403273 | RIB/RESECTION | 89.80 |
| 790791 | RIBOSOME P AB (IGG) | 50.00 |
| 240215 | RIBS 2 VIEWS LEFT | 241.60 |
| 240216 | RIBS 2 VIEWS RIGHT | 241.60 |
| 240217 | RIBS 3 VIEW W/CHEST | 340.70 |
| 240218 | RIBS 3 VIEWS BILATERAL | 309.00 |
| 240219 | RIBS 4 VIEWS + PA CHEST | 533.70 |
| 3026020 | RID SPRAY (FOR BEDDING) | 10.00 |
| 3025055 | RIFADIN (RIFAMPIN) 300MG CAP | 2.00 |
| 3031003 | RIFADIN 600 MG IV | 400.30 |
| 3027499 | risperDAL (risperiDONE) 1MG TAB | 2.00 |
| 303273 | risperDAL (risperiDONE)0.25MG TAB | 2.00 |
| 3011428 | RITALIN (METHYLPHENIDATE) 5MG TAB | 2.00 |
| 3032127 | riTUXimab(RITUXAN):100MG | 2,338.60 |
| 798007 | RNA POLYMERASE 3 (IGG) ANTIBODY | 149.00 |
| 790108 | RNP ANTIBODY (IGG) | 130.00 |
| 790905 | RNP AUTO-ANTIBODY (IGG) | 130.00 |
| 3011469 | ROBAXIN (METHOCARBAMOL) 500MG TAB | 2.00 |
| 3032507 | ROBINUL (GLYCOPYRROLATE) 0.2MG/ML 5ML | 29.40 |
| 3011535 | ROBITUSSIN (guaiFENesin) 5ML SYRUP | 2.00 |
| 3011568 | ROBITUSSIN A-C (guaiFENesin/COD) 5ML | 2.00 |
| 3023456 | ROBITUSSIN DAC(guaiFENesin/PSE/COD) 5ML | 2.00 |
| 3011659 | ROBITUSSIN DM (guaiFENesin/DM) 5ML | 2.00 |
| 3011519 | ROBITUSSIN SYR(GUAIFENESIN) 120ML | 23.25 |
| 3026509 | ROCALTROL (CALCITRIOL) 0.25MCG CAP | 2.00 |
| 3021781 | ROCEPHIN (cefTRIAXone) 250MG INJ | 121.60 |
| 3031117 | ROCEPHIN (cefTRIAXone) 500MG VIAL | 138.60 |
| 310142 | ROCEPHIN 2GM VIAL | 391.80 |
| 310140 | ROCEPHIN 500 MG/ NS 50ML | 136.20 |
| 311615 | ROCEPHIN(cefTRIAXone): 1GM VIAL | 179.35 |
| 790621 | ROM PLUS | 245.00 |
| 3024546 | ROMAZICON (FLUMAZENIL) 0.1MG/ML 5ML VIAL | 339.50 |
| 517687 | ROOKE BOOT LARGE | 450.00 |
| 517661 | ROOKE BOOT SMALL | 450.00 |
| 93078 | ROTATOR CUFF REPAIR | 3,232.00 |
| 514019 | ROTICULATOR 4.8 ETHICON AX55G | 720.00 |
| 3024918 | ROWASA (MESALAMINE) 4GM 60ML ENEMA | 20.00 |
| 3032044 | ROXANOL 20MG/ML 1ML oral soln | 2.00 |
| 790818 | RPR (W/REFLEX) | 13.00 |
| 791530 | RSV SCREEN | 115.00 |
| 798068 | RUBELLA (IGG) | 30.00 |
| 790714 | RUBELLA (IGM) | 108.00 |
| 792100 | RUBEOLA (IGG) | 45.00 |
| 792101 | RUBEOLA (IGM) | 45.00 |
| 3032606 | RYTHMOL (PROPAFENONE) 150MG TAB | 2.00 |
| 3022813 | RYTHMOL SR(PROPAFENONE) 225MG TAB | 2.00 |
| 790771 | SACCHAROMYCES CEREVISIAE AB (IGA) | 470.00 |
| 13115 | SACRAL ILIAC INJECTION | 618.00 |
| 13116 | SACRAL ILIAC INJECTION | 1,236.00 |
| 15010 | SACROILIAC INJECTION | 618.00 |
| 240290 | SACRUM-COCCYX | 232.90 |
| 502314 | SAGITTAL MICRO BLADE 14X41.04.MM | 275.00 |
| 502313 | SAGITTAL MICRO BLADE 5.5 X25.5 X0.4MM | 67.00 |
| 502315 | SAGITTAL MICRO BLADE 9.5 X 25.5X0.4MM | 67.00 |
| 710013 | SALES TAX ANSERING SERVICE | 9.45 |
| 710005 | SALES-CLERICAL (TYPING) | 32.80 |
| 790202 | SALICYLATE (ASPIRIN) | 100.00 |
| 3026384 | SALIVA SUBSTITUTE LIQUID | 10.00 |
| 3077832 | SANDIMMUNE (CYCLOSPORINE) 25MG CAP | 2.00 |
| 3025956 | SANDOSTATIN (OCTREOTIDE) 100MCG/ML | 96.20 |
| 3025964 | sandoSTATIN (OCTREOTIDE) 50MCG/ML vial | 43.00 |
| 3078841 | SANDOSTATIN LAR DEPOT IM PWDFORSUSP 20MG | 9,794.62 |
| 3078165 | SANDOSTATIN LAR DEPOT IM PWDFORSUSP 30MG | 12,737.40 |
| 303585 | SARNA ANTI-ITCH LOTION 222ML | 15.00 |
| 509978 | SAW BLADE DUAL CUT 18.5MMX7.0MM | 241.00 |
| 509981 | SAW BLADE SAGITTAL /CUT EDGE 13.0 | 319.00 |
| 509980 | SAW BLADE SAGITTAL /CUT EDGE 18.0 | 319.00 |
| 509970 | SAW BLADE KNEES RECIPROCATING | 224.00 |
| 509570 | SAW BLADE KNEES SAGITAL | 190.00 |
| 509990 | SAW BLADE MICRO 100 OSCILLATING | 330.00 |
| 240233 | SC Joints >=3V’s | 174.40 |
| 5494274 | SCALPELS, DISPOSABLE #11 | 8.30 |
| 240332 | SCAPULA LEFT | 221.30 |
| 240333 | SCAPULA RIGHT | 221.30 |
| 16964 | SCAPULAR NO MANIPULATION | 660.00 |
| 171103 | SCAPULAR W/O MANIPULATION | 875.00 |
| 790906 | SCL-70 ANTIBODY (IGG) | 180.00 |
| 790088 | SCL-70 AUTO ANTIBODY | 130.00 |
| 514353 | SCLEROTHERAPY NEEDLE DISP INTERJECT | 177.00 |
| 244052 | SCOLIOSIS | 140.00 |
| 244053 | SCOLIOSIS 2-3 VIEWS | 225.00 |
| 244054 | SCOLIOSIS 4-5 VIEWS | 244.00 |
| 244055 | SCOLIOSIS 6 VIEWS MINIMUM | 291.00 |
| 511564 | SCOPE BRONCH LARGE | 900.00 |
| 511563 | SCOPE BRONCH REGULAR | 780.00 |
| 511561 | SCOPE BRONCH SLIM | 780.00 |
| 13105 | SCOPE PROC ADD 30 MIN | 649.00 |
| 134899 | SCOPE PROC MAJOR 1ST 1/2 HR | 1,390.00 |
| 511567 | SCOPE RESOLUTION CLIP | 504.00 |
| 13104 | SCOPE RM PROC MINOR 1ST 1/2 HR | 1,090.00 |
| 511566 | SCOPE WARMER | 26.00 |
| 5414189 | SCOPE WARMER SEAL | 58.00 |
| 380001 | SCOPE WITH BIOPSY | 1,006.25 |
| 380020 | SCOPE WITH BIOPSY | 1,155.20 |
| 578501 | SCREW BONE DISTRACTION (DR.MERRITT) | 420.00 |
| 16959 | SECONDARY CLOSURE OF SURGICAL WOUND | 1,975.00 |
| 171101 | SECONDARY CLOSURE OF SURGICAL WOUND | 2,560.00 |
| 517730 | SECURE STRAP 5MM ABSORBABLE | 1,775.00 |
| 330582 | SEDIMENTATION RATE | 36.00 |
| 23070 | SEGMENTAL ARTERIAL WITH DOPPLER | 642.60 |
| 23071 | SEGMENTAL ARTERIAL WITH DOPPLER LIMITED/ | 421.40 |
| 790879 | SELENIUM (SERUM) | 88.00 |
| 790979 | SEMEN (FERTILITY) | 219.00 |
| 330707 | SEMEN ANALYSIS (POST VASECTOMY) | 97.00 |
| 1403844 | SEMINAL/VESICLES | 89.80 |
| 3011899 | SENOKOT (SENNA CONCENTRATE) TAB | 2.00 |
| 3004456 | SENOKOT S TAB | 2.00 |
| 5596579 | SENSICARE SKIN PROTECTANT | 30.30 |
| 303705 | SENSIPAR (CINACALCET HCL) 30MG TAB | 55.20 |
| 330956 | SENSITIVITY MIC | 98.00 |
| 3030920 | SENSORCAINE MPF BUP 0.75%/DEX 8.25% 2ML | 29.40 |
| 517402 | SEPRA FILM ADHESIVE BARRIER OR ONLY | 790.00 |
| 131126 | SEPTOPLASTY | 2,000.00 |
| 303579 | SEROquel (QUEtiapine FUMARATE) XR 200MG | 2.00 |
| 303493 | SEROquel (QUEtiapine FUMARATE) XR 400MG | 2.00 |
| 3030901 | SEROquel (QUEtiapine) 100MG TAB | 2.00 |
| 3030898 | SEROquel (QUEtiapine) 25MG TAB | 2.00 |
| 790765 | SEROTONIN (SERUM) | 170.00 |
| 790988 | SEX HORMONE BINDING GLOBULIN | 109.00 |
| 574692 | SHAVER BLADE 4.0 ACROMIONIZER | 273.00 |
| 515377 | SHEATH INTRODUCER FOR PACEMAKERS | 425.00 |
| 3078602 | SHINGRIX VACCINE KIT 1 DOSE/2 VIALS | 462.25 |
| 93034 | SHORT ARM CAST | 280.00 |
| 16607 | SHORT ARM CAST FOREARM TO HAND | 263.00 |
| 170512 | SHORT ARM CAST FOREARM TO HAND | 310.00 |
| 93035 | SHORT ARM SPIKA CAST | 263.00 |
| 93029 | SHORT ARM SPLINT FOREARM TO HAND STATIC | 197.00 |
| 16610 | SHORT LEG CAST NBW | 305.00 |
| 93038 | SHORT LEG CAST NBW | 305.00 |
| 16611 | SHORT LEG CAST WALKING OR AMBULATORY TYP | 355.00 |
| 93039 | SHORT LEG CAST WALKING OR AMBULATORY TYP | 355.00 |
| 16603 | SHORT LEG SPLINT CALF TO FOOT | 165.00 |
| 93031 | SHORT LEG SPLINT CALF TO FOOT | 165.00 |
| 170514 | SHORT LEG SPLINT CALF TO FOOT | 243.00 |
| 574702 | SHOULD/ MULTIFIX S-ULTRA 5.5MM KNOTL ANC | 1,347.00 |
| 574704 | SHOULDER 1.8mm DISP KIT Q-FIX | 900.00 |
| 574699 | SHOULDER 1.8mm SUTURE ANCHOR | 1,275.00 |
| 574697 | SHOULDER 3.8 DISPOSABLE AWL | 266.00 |
| 574685 | SHOULDER AMBIENT TURBO VAC 90 | 1,050.00 |
| 574680 | SHOULDER BONECUTTER FULL RADIUS 5.5MM | 488.00 |
| 574687 | SHOULDER BONECUTTER PLATINUM 4.5 | 465.00 |
| 574690 | SHOULDER DBL PUMP CASSETTE | 300.00 |
| 574681 | SHOULDER DYONICS 5.5MM ELITE ACRO BURR | 408.00 |
| 574698 | SHOULDER FIRSTPASS SUTURE PASSER | 867.00 |
| 502309 | SHOULDER IMMOBILIZER LG | 13.60 |
| 502291 | SHOULDER IMMOBILIZER MED | 13.60 |
| 502283 | SHOULDER IMMOBILIZER SM | 15.10 |
| 502317 | SHOULDER IMMOBILIZER XLG | 22.90 |
| 16122 | SHOULDER JOINT MANIPULATION W/ANESTHES | 634.00 |
| 170495 | SHOULDER JOINT MANIPULATION W/ANESTHES | 887.00 |
| 574090 | SHOULDER LATERAL TRACTION ARM SLEEVE | 240.00 |
| 240340 | SHOULDER LEFT 1 VIEW | 197.80 |
| 240357 | SHOULDER LEFT 2 VIEWS | 303.20 |
| 574689 | SHOULDER PUMP TUBING SINGLE | 300.00 |
| 240341 | SHOULDER RIGHT 1 VIEW | 197.80 |
| 240358 | SHOULDER RIGHT 2 VIEWS | 303.20 |
| 16137 | SHOULDER SPICA | 1,655.00 |
| 170507 | SHOULDER SPICA | 1,655.00 |
| 574693 | SHOULDER STABILIZATION KIT | 396.00 |
| 574686 | SHOULDER STONECUTTER BURR 5.5 | 408.00 |
| 137013 | SHOULDER SUBACROMIAL DECOMPRESSION | 936.60 |
| 137012 | SHOULDER SUBACROMIAL DECOMPRESSION | 1,833.00 |
| 93073 | SHOULDER SUBACROMIAL SPACE DECOMPRESSIO | 1,423.00 |
| 137036 | SHOULDER SUBACROMIAL SPACE DECOMPRESSION | 934.20 |
| 574688 | SHOULDER SUSPENSION KIT | 396.00 |
| 170511 | SHOULDER TO HAND LONG ARM CAST | 314.00 |
| 16605 | SHOULDER TO HAND LONG ARM CAST | 362.00 |
| 574695 | SHOULDER ULTRABAND CO-BRAID SUTURE | 98.00 |
| 574700 | SHOULDER ULTRABAND II 2 BLUE SUTURE 38 | 103.00 |
| 574696 | SHOULDER ULTRABAND WHITE SUTURE | 98.00 |
| 1404586 | SHOULDER/ARTERIES | 89.80 |
| 1404537 | SHOULDER/ARTHROSCOPE | 89.80 |
| 1404503 | SHOULDER/AXILLA/INTE | 98.40 |
| 1404636 | SHOULDER/CAST | 89.80 |
| 1404529 | SHOULDER/CLOSED | 98.40 |
| 1404560 | SHOULDER/DISARTICUL | 89.80 |
| 1404511 | SHOULDER/NER/MUS/TEN | 98.40 |
| 1504511 | SHOULDER/NER/MUS/TEN | 98.40 |
| 1404545 | SHOULDER/OPEN | 98.40 |
| 1404552 | SHOULDER/RED/RESECT | 89.80 |
| 1404644 | SHOULDER/SPICA | 89.80 |
| 1404578 | SHOULDER/TOTAL/REPLA | 89.80 |
| 240316 | SI JOINTS <3V. | 162.80 |
| 240320 | SI JOINTS >3 VIEWS | 310.20 |
| 241959 | SIALOGRAM | 783.00 |
| 240200 | SIALOGRAPHY SI | 429.30 |
| 135327 | SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC | 344.56 |
| 134402 | SIGMOIDOSCOPY, D | 1,101.30 |
| 511979 | SILASTIC DRAIN | 476.00 |
| 3012038 | SILVADENE (SSD,THERMAZENE) 400GM CREAM | 66.60 |
| 3012046 | SILVADENE (SSD,THERMAZENE) 50GM CREAM | 20.00 |
| 3018951 | SILVER NITRATE APPLICATOR | 2.00 |
| 3008622 | SIMETHECONE DROPS 30ML HH | 10.00 |
| 1403182 | SIMPLE LIGATION | 89.80 |
| 3026525 | SINEMET CR (CARBIDOPA/LEVO) 25/100MG TAB | 2.00 |
| 3012129 | SINEMET(CARBIDOPA&LEVODOPA) 25/250MG TAB | 2.00 |
| 3012111 | SINEMET(CARBIDOPA/LEVODOPA) 25/100MG TAB | 2.00 |
| 3018175 | SINEquan (DOXEPIN) 10MG CAP | 2.00 |
| 3012137 | SINEquan (DOXEPIN) 25MG CAP | 2.00 |
| 3031210 | SINGULAIR (MONTELUKAST) 10MG TAB | 2.00 |
| 3030859 | SINGULAIR (MONTELUKAST) 4MG CHEW TAB | 2.00 |
| 240125 | SINUSES < 3V’s | 232.90 |
| 240126 | SINUSES >= 3V’s | 326.60 |
| 512834 | SITZMARK RINGS | 121.00 |
| 380028 | SKILLED CARE SNF LEVEL 1 | 81.00 |
| 507005 | SKIN TEMPERATURE PROBE | 39.40 |
| 1403190 | SKIN/CHEST/SUBQ/ANTE | 98.40 |
| 1403240 | SKIN/HEAD,NECK POSTERIOR TRUNK | 89.80 |
| 1403141 | SKIN/NECK/SUBQ | 89.80 |
| 140300 | SKIN/SALIVARY/BIOPSY | 85.50 |
| 1403000 | SKIN/SALIVARY/BIOPSY | 89.80 |
| 240133 | SKULL <4 Vws | 232.90 |
| 240134 | SKULL >= 4V’s | 361.70 |
| 5571049 | SLEEPSACK SWADDLE FLEECE NEWBORN | 486.90 |
| 240050 | SMALL BOWEL | 420.20 |
| 16451 | SMALL JOINT INJECTION | 122.00 |
| 170624 | SMALL JOINT INJECTION | 195.80 |
| 331325 | SMEAR BLOOD (PATH REVIEW) | 70.00 |
| 18070 | SMOKING CESSATION >10 MIN | 50.90 |
| 18075 | SMOKING CESSATION 3-10 MIN | 50.90 |
| 578602 | SMOOTH GUIDE WIRE BULLET TIP | 510.00 |
| 578605 | SMOOTH GUIDE WIRE INTRMEDULLARY FIX | 312.00 |
| 475670 | SNF-DISCHARGE 30 MIN OR LESS | 133.00 |
| 581156 | SOCK -AID | 50.00 |
| 3027663 | SOD ACETATE INJ | 29.40 |
| 3012194 | SOD BICARB 8.4% 50ML PREFILLED SYRINGE | 118.55 |
| 3015635 | SOD BICARB SYR 4.2% 10ML INJ | 60.00 |
| 331341 | SODIUM (24HR URINE) | 29.00 |
| 331432 | SODIUM (RANDOM URINE) | 29.00 |
| 330400 | SODIUM (SERUM) | 44.00 |
| 3027507 | SODIUM BICARBONATE 650MG TABLET | 2.00 |
| 3078806 | SODIUM CHLORID SOLN 0.9% 10ML VIAL | 17.00 |
| 3018050 | SODIUM CHLORIDE CONCENTRATE:4MEQ/ML IV | 29.40 |
| 3078271 | SODIUM CHLORIDE INHALATION SOLUTION 3% | 3.00 |
| 310690 | SODIUM CHLORIDE IRRIGATION 3000ML | 65.00 |
| 791283 | SOLUBLE TRANSFERRIN RECEPTOR | 262.00 |
| 3012277 | solu-CORTEF (HYDROCORTISONE) 250MG VIAL | 46.70 |
| 3012285 | solu-CORTEF VIAL(HYDROCORTISONE) 100MG | 29.40 |
| 3012251 | solu-CORTEF VIAL(HYDROCORTISONE) 500MG | 84.50 |
| 3012293 | solu-MEDROL (methylPREDNISol) 125MG VIAL | 29.40 |
| 3019215 | solu-MEDROL (methylPREDNISol) 40MG VIAL | 29.40 |
| 3012301 | solu-MEDROL(methylPREDNISol) 500MG VIAL | 84.50 |
| 3024470 | solu-MEDROL(methylPREDNISol)1000MG VIAL | 136.20 |
| 791444 | SPECIAL COAG INTERP (VON W PROFILE) | 109.00 |
| 791242 | SPECIAL COAGULATION INTERPRETATION | 109.00 |
| 791613 | SPECIAL STAIN GROUP I | 32.00 |
| 791605 | SPECIAL STAIN GROUP II | 50.00 |
| 83005 | SPECIALTY CLINIC INTERNET ACCESS | 27.00 |
| 508368 | SPECIMEN COLLECTOR SOCK W/ELBOW | 85.00 |
| 791465 | SPECIMEN PROCESSING | 23.00 |
| 5595006 | SPINAL INTRODUCER 20GA X 1 1/4 | 29.60 |
| 136613 | SPINAL PUNCTURE TO REMOVE CSF | 729.00 |
| 136605 | SPINAL PUNCTURE, LUMBAR | 685.00 |
| 504536 | SPINAL TRAY PENCAN | 71.00 |
| 596102 | SPINAL/SPROTTE/PENCIL POINT W/INTRODUCER | 83.00 |
| 240175 | SPINE SINGLE VIEW | 175.40 |
| 3032572 | SPIRIVA 18MCG INH: 5 DAY INH | 80.70 |
| 3078585 | SPIRONOLACTONE ORAL TABLET 100MG H.H. | 2.85 |
| 3000215 | SPIRONOLACTONE(ALDACTONE) 25MG TAB | 2.00 |
| 514028 | SPLINT ELBOW POSTERIOR LARGE ER | 156.40 |
| 514129 | SPLINT ELBOW POSTERIOR MEDIUM ER | 22.04 |
| 514128 | SPLINT ELBOW POSTERIOR SMALL ER | 32.00 |
| 581196 | SPLINT FOREARM ADULT LT | 15.00 |
| 581197 | SPLINT FOREARM ADULT RT | 15.00 |
| 581192 | SPLINT FOREARM CHILD LT | 14.50 |
| 581193 | SPLINT FOREARM CHILD RT | 14.90 |
| 581194 | SPLINT FOREARM YOUTH LT | 14.00 |
| 581195 | SPLINT FOREARM YOUTH RT | 15.17 |
| 581222 | SPLINT POSTERIOR, EXTRA WIDE | 261.00 |
| 581191 | SPLINT POSTERIOR,LEFT, SHOE SZ 3-6 WOM. | 55.50 |
| 581211 | SPLINT POSTERIOR,RIGHT, SHOE S 9-11 MEN | 55.50 |
| 581190 | SPLINT POSTERIOR,RIGHT, SHOE SZ 3-6 WOM. | 54.50 |
| 581210 | SPLINT POSTERIOR,RIGHT, SHOE SZ 6-9 WOM. | 56.70 |
| 5512431 | SPONGE WECK CEL | 31.70 |
| 512122 | SPONGES NEURO | 50.00 |
| 579018 | SPOT INK – OR | 180.00 |
| 596097 | SPROTTE CANNULA W/INTRODUCER 24GX43/4 | 63.00 |
| 596100 | SPROTTE NEEDLE 25GX31/2 | 52.00 |
| 790889 | SS-A/RO AB (IGG) | 130.00 |
| 790089 | SSA-AUTO ANTIBODY | 130.00 |
| 790890 | SS-B/LA AB (IGG) | 130.00 |
| 790090 | SSB-AUTO ANTIBODY | 130.00 |
| 41006 | ST BEHAV & QUAL ANALYSIS OF VOICE/RESONA | 149.90 |
| 41039 | ST COGNITIVE SKILLS DEVELOP EA 15MIN | 74.90 |
| 41042 | ST DEVELOPMENTAL TEST EXTENDED | 182.70 |
| 41005 | ST EVAL OF SPEECH SOUND PROD W/LANG COMP | 149.90 |
| 41036 | ST EVAL OF SWALLOWING | 195.50 |
| 41045 | ST EVAL OF SWALLOWING VIDEO | 291.50 |
| 41032 | ST EVAL/FIT PROSTHETIC DEVICE | 272.80 |
| 41034 | ST EVAL/SPEECH GEN DEVICE EA ADDL 30 MIN | 57.40 |
| 41033 | ST EVAL/SPEECH GENERATED DEVICE 1ST HR | 292.70 |
| 41003 | ST EVALUATION OF SPEECH FLUENCY | 149.90 |
| 41004 | ST EVALUATION OF SPEECH SOUND PROD | 149.90 |
| 41043 | ST NEUROBEHAVIORAL STATUS EXAM PER HR | 215.70 |
| 41022 | ST SPEECH EVAL | 216.30 |
| 41014 | ST SPEECH THERAPY | 179.00 |
| 41025 | ST SPEECH THERAPY/MAPLE HEIGHTS | 139.30 |
| 41035 | ST SWALLOWING TREATMENT | 148.40 |
| 41046 | ST THERAPEUTIC SVS SPEECH GEN DEVICE | 162.80 |
| 791236 | STACLOT LA | 148.00 |
| 3012442 | STADOL (BUTORPHANOL) 1MG/ML INJ | 46.95 |
| 3012459 | STADOL (BUTORPHANOL) 2MG/ML INJ | 75.20 |
| 3032309 | STADOL(BUTORPHANOL)NASAL 2.5ML SPRAY | 20.00 |
| 137045 | STANDARD SHOULDER SUBACROMIAL | 305.40 |
| 1405021 | STANDBY ANESTHESIA | 89.80 |
| 517938 | STAPLER INSORB C-SECTION OR ONLY | 212.00 |
| 517935 | STAPLER SKIN WIDE PXW35 | 33.00 |
| 512027 | STATAK 2.5MM SOFT TISSUE ATTACHMENT | 592.00 |
| 517778 | STATAK 5.0MM SOFT TISSUE ATTACHMENT | 580.00 |
| 568369 | STATLOCK PICC PLUS SECURE | 34.00 |
| 516482 | STAY HOOKS FOR LONE STAR RETRACTOR | 220.00 |
| 515760 | STEEL BEADED SUTURE WIRE .97MM X 60.96CM | 63.00 |
| 515761 | STEEL BEADED SUTURE WIRE1.2MM X 60.96CM | 63.00 |
| 515667 | STEINMANN PINS THREADED 1/8 | 46.00 |
| 515670 | STEINMANN PINS THREADED 3/16 | 46.00 |
| 515664 | STEINMANN PINS THREADED 3/32 | 46.00 |
| 515669 | STEINMANN PINS THREADED 5/32 | 46.00 |
| 515663 | STEINMANN PINS THREADED 5/64 | 46.00 |
| 515666 | STEINMANN PINS THREADED 7/64 | 46.00 |
| 515668 | STEINMANN PINS THREADED 9/64 | 46.00 |
| 3078811 | STELARA SUBCUTANEOUS SOLUTION 45MG/0.5ML | 24,965.00 |
| 3015163 | STERILE WATER 20ML VIAL | 2.00 |
| 311516 | STERILE WATER IRRIGATION 1000ML | 50.00 |
| 310732 | STERILE WATER IRRIGATION 3000ML | 80.00 |
| 310542 | STERILE WATER IRRIGATION 500ML | 25.00 |
| 240225 | STERNUM >=2V’s | 268.10 |
| 5404694 | STOCKINETTE 2 DELTA TERRY NET S | 3.50 |
| 5404695 | STOCKINETTE 3 DELTA TERRY NET S | 3.50 |
| 5404696 | STOCKINETTE 4 DELTA TERRY NET S | 3.50 |
| 509536 | STOMA MEASURING DEVI | 64.40 |
| 790250 | STONE ANALYSIS | 265.00 |
| 791069 | STOOL CRYPTOSPORIDIUM ANTIGEN | 76.00 |
| 790681 | STOOL FAT (72 HR) | 185.00 |
| 790763 | STOOL FAT (RANDOM) | 118.00 |
| 790617 | STOOL GIARDIA ANTIGEN | 76.00 |
| 791049 | STOOL LACTOFERRIN | 72.00 |
| 331127 | STOOL LEUKOCYTES | 52.00 |
| 790664 | STOOL OVA & PARASITE (O&P) | 40.00 |
| 790799 | STOOL PATHOGEN PANEL (PCR) | 1,340.00 |
| 791076 | STOOL ROTAVIRUS | 41.00 |
| 791270 | STRATIFY JCV AB (W/REFLEX) | 101.00 |
| 790072 | STRATIFY JCV AB INHIBITION ASSAY | 2,261.00 |
| 791401 | STREP PNEUMONIAE (AGGLUTINATION)(EACH) | 28.00 |
| 331176 | STREP SCREEN (QUICK) | 62.00 |
| 23017 | STRESS ECHOCARDIOGRAM | 412.00 |
| 23072 | STRESS ECHOCARDIOGRAM | 1,170.70 |
| 83064 | STRESS TEST | 232.00 |
| 791014 | STRIATIONAL MUSCLE ANTIBODIES | 140.00 |
| 70825 | SUB HOSP CARE 2-3 COMP DETAILED | 204.00 |
| 11005 | SUBCU OR IM INJECTION | 69.20 |
| 1403125 | SUBDURAL TAP | 85.50 |
| 3012533 | SUBLIMAZE(fentaNYL) 50MCG/1ML 2ML INJ | 35.50 |
| 131125 | SUBMUCOUS RESECTION INTERIOR TURBINATE | 1,000.00 |
| 1313 | SUBSTANCE ASSESSMENT | 400.00 |
| 16128 | SUBSTANCE ASSESSMENT | 400.00 |
| 3011188 | SUCCINYLCHOLINE 20MG/ML 10ML | 48.95 |
| 500931 | SUCTION CANNISTER 12 LITER | 96.00 |
| 3012574 | SUDAFED (PSEUDOEPHEDRINE) 60MG TAB | 2.00 |
| 3030977 | SULFACETAMIDE 10% OPHTH 15ML | 53.60 |
| 790828 | SULFATE (24HR URINE) | 23.00 |
| 83016 | SUPPORT SERVICES | 20.00 |
| 501911 | SURGICAL LIGHT DISPOSABLE | 1,577.00 |
| 501592 | SURGICEL .5 X 2 | 186.00 |
| 501590 | SURGICEL 2X3 | 340.00 |
| 512040 | SURGICEL 4X8 | 372.00 |
| 3031101 | SURVANTA (SURFACTANT) 25MG/ML 8ML INJ | 1,952.50 |
| 508888 | SUTURE 0-PROLENE C827G OR | 80.00 |
| 504268 | SUTURE 1-0 VICRYL J757T OR DR.MERRITT | 42.00 |
| 503775 | SUTURE 2-0 TICRON TAPER OR ONLY | 19.00 |
| 508795 | SUTURE 3-0 STAINLESS STEEL SUTURE DR.SR | 11.00 |
| 503777 | SUTURE 3-0 TICRON TAPER – OR ONLY | 26.00 |
| 504267 | SUTURE 3-0 VICRYL VCP634T OR DR.MERRITT | 12.00 |
| 504269 | SUTURE 3-0 VICRYL VCP824G OR DR.MERRITT | 29.00 |
| 503776 | SUTURE 4-0 ETIBOND TAPER – OR ONLY | 53.00 |
| 508510 | SUTURE 4-0 PRO 8621H W/KEITH NEEDLE | 14.30 |
| 509788 | SUTURE 4-0 PROLENE 8683G DUNLAP/SLOAN | 14.00 |
| 508870 | SUTURE 6-0 M8807 8807OR | 276.00 |
| 505763 | SUTURE 6-0 VICRYL J492 | 23.00 |
| 505588 | SUTURE ARTHREX 4-0 FIBERLOOP/FIBERWIRE | 250.00 |
| 578615 | SUTURE BOOTIES | 30.00 |
| 515491 | SUTURE BRIDGE | 40.00 |
| 504404 | SUTURE CHROMIC 1 48G OR | 36.00 |
| 508025 | SUTURE CHROMIC 1 925H OR | 15.00 |
| 503950 | SUTURE CHROMIC 2-0 811H OR | 18.00 |
| 503984 | SUTURE CHROMIC 2-0 G123H | 19.00 |
| 503968 | SUTURE CHROMIC 3-0 G122H OR | 19.00 |
| 508868 | SUTURE CHROMIC 4-0 1654G OB ONLY | 37.00 |
| 504008 | SUTURE CHROMIC 4-0 G121H | 20.00 |
| 504321 | SUTURE CHROMIC 4-0 U203H | 20.00 |
| 509387 | SUTURE DERM 6-0 569G SAME AS 1755-13 | 38.00 |
| 504073 | SUTURE DEX 2-0 7248-51 /POLY CL-831 | 20.00 |
| 507480 | SUTURE DEXON 4-0 7536-31 | 51.00 |
| 513058 | SUTURE ETHIBOND X518H OR | 16.00 |
| 513059 | SUTURE ETHIBOND X865H OR ONLY | 10.00 |
| 503699 | SUTURE ETHILON 3-0 1663G | 25.00 |
| 503738 | SUTURE ETHILON 0- L886T TAPER POINT OR | 124.20 |
| 503695 | SUTURE ETHILON 4-0 662G | 11.00 |
| 503737 | SUTURE ETHILON 5-0 1855G | 25.00 |
| 504198 | SUTURE ETHILON 6-0 697G OR | 20.00 |
| 504206 | SUTURE ETHILON 8-0 2808G OR | 145.00 |
| 503646 | SUTURE MERSILENE 2 R495T OR | 55.00 |
| 516721 | SUTURE MONOCRYL 3-0 Y427H OR | 34.00 |
| 509783 | SUTURE MONOCRYL 4-0 Y823G | 36.00 |
| 574773 | SUTURE PASSER 12 STERILE | 179.00 |
| 508182 | SUTURE PDS II Z569T OR | 16.00 |
| 516655 | SUTURE PDS Z346H OR | 15.00 |
| 508181 | SUTURE PDS Z370T OR | 14.00 |
| 504266 | SUTURE PDS Z880G | 27.00 |
| 508579 | SUTURE PROLENE 0 8418H OR | 19.00 |
| 509080 | SUTURE PROLENE 0 8690H | 20.00 |
| 508520 | SUTURE PROLENE 2-0 8685H | 16.00 |
| 508521 | SUTURE PROLENE 2-0 8853H | 32.00 |
| 509643 | SUTURE PROLENE 2-0 8977H OR | 38.00 |
| 507930 | SUTURE PROLENE 3-0 8522H OR / ANITA | 29.00 |
| 507928 | SUTURE PROLENE 3-0 8687H | 33.00 |
| 508793 | SUTURE PROLENE 4-0 8682G | 33.40 |
| 505575 | SUTURE PROLENE 4-0 8699G | 34.00 |
| 504263 | SUTURE PROLENE 5-0 8698G | 29.00 |
| 504461 | SUTURE PROLENE 6-0 8695 | 36.00 |
| 508827 | SUTURE PROLENE 6-0 8805H OR 8709H NEW # | 105.45 |
| 508801 | SUTURE PROLENE 7-0 8304H OR | 104.55 |
| 508511 | SUTURE SILK 624 W/KEITH NEEDLE | 8.78 |
| 594176 | SUTURE SILK 0 424H OR | 10.00 |
| 508512 | SUTURE SILK 0 680H | 10.00 |
| 516366 | SUTURE SILK 2-0 423H OR ONLY | 10.00 |
| 516367 | SUTURE SILK 2-0 K833H | 10.00 |
| 509628 | SUTURE SILK 4-0 783G DR. BRUNING ONLY | 47.00 |
| 516370 | SUTURE SILK 5-0 K870H OR ONLY | 23.00 |
| 515715 | SUTURE SILK 6-0 769G NO REORDER | 51.00 |
| 505590 | SUTURE TENDON SUPRAMID OR ONLY | 64.00 |
| 503778 | SUTURE TICRON 3-0 3109-43 | 55.00 |
| 503794 | SUTURE TICRON 4-0 3058-33/SCD3059G | 54.00 |
| 507359 | SUTURE VICRYL 0 CR/8 J727D OR | 65.00 |
| 507357 | SUTURE VICRYL 0 CR/8 J740 OR | 67.00 |
| 516325 | SUTURE VICRYL 0 J207G | 34.60 |
| 509338 | SUTURE VICRYL 0 J-346H OR | 11.00 |
| 509345 | SUTURE VICRYL 0 J-458H DR. MERRITT | 14.00 |
| 509340 | SUTURE VICRYL 0 J-494H OR | 26.00 |
| 509341 | SUTURE VICRYL 0 J-496G OR | 22.00 |
| 516713 | SUTURE VICRYL 0 J603H OR | 11.00 |
| 509339 | SUTURE VICRYL 0 VCP305H OR | 12.00 |
| 509355 | SUTURE VICRYL 0 VCP376 | 83.00 |
| 506848 | SUTURE VICRYL 1 J268 OR ONLY | 10.00 |
| 507373 | SUTURE VICRYL 1 CXT J371H OR | 10.00 |
| 506851 | SUTURE VICRYL 2-0 J328H | 28.00 |
| 506847 | SUTURE VICRYL 2-0 J339H | 10.00 |
| 507399 | SUTURE VICRYL 3-0 VCP931H | 21.00 |
| 517808 | SUTURE VICRYL 3-0 VR944 OB/DR. KAHL | 20.00 |
| 507407 | SUTURE VICRYL 3-0 J258H | 10.00 |
| 517604 | SUTURE VICRYL 3-0 J527H OR | 20.00 |
| 514058 | SUTURE VICRYL 3-0 J772D OR | 67.00 |
| 509700 | SUTURE VICRYL 4-0 J214H | 10.00 |
| 507209 | SUTURE VICRYL 4-0 J315H | 10.00 |
| 509718 | SUTURE VICRYL 5-0 J213H | 21.00 |
| 517803 | SUTURE VICRYL 6-0 J492 OR EYE DR. | 23.00 |
| 594273 | SUTURE VICRYL 6-0 J510G | 28.00 |
| 517802 | SUTURE VICRYL 6-0 J552G OR | 58.00 |
| 509619 | SUTURE VICRYL 8-0 J548G OR | 83.00 |
| 504988 | SUTURE VICRYL J106T OR DR.HAMBURGER | 27.00 |
| 508178 | SUTURE VICRYL J344H OR DR.HAMBURGER | 11.00 |
| 508871 | SUTURE VICRYL J552 OR | 52.00 |
| 509346 | SUTURE VICRYL J748T DR. MERRITT | 39.00 |
| 506849 | SUTURE VICRYL2-0 J266H OR ONLY | 11.00 |
| 3012723 | SYMMETREL (AMANTADINE) 100MG CAP | 2.00 |
| 3030942 | SYMMETREL SYRUP 30ML | 2.00 |
| 1404016 | SYMPHYSIS/PUBIS/CLOS | 89.80 |
| 1404024 | SYMPHYSIS/PUBIS/OPEN | 89.80 |
| 5405005 | SYN STOCKINETTE 2 | 3.70 |
| 5405039 | SYN STOCKINETTE 3 | 4.60 |
| 5412078 | SYN STOCKINETTE 5 | 3.50 |
| 5405013 | SYN STOCKINETTE 4 | 4.60 |
| 131206 | SYNOVECTOMY, TENDON SHEATH, RADICAL, FLE | 1,542.00 |
| 3012764 | SYNTHROID (LEVOTHYROXINE NA) 0.025MG TAB | 2.00 |
| 3012780 | SYNTHROID (LEVOTHYROXINE NA) 0.05MG TAB | 2.00 |
| 3020718 | SYNTHROID (LEVOTHYROXINE NA) 0.075MG TAB | 2.00 |
| 3024645 | SYNTHROID (LEVOTHYROXINE NA) 0.088MG TAB | 2.00 |
| 3012798 | SYNTHROID (LEVOTHYROXINE NA) 0.10MG TAB | 2.00 |
| 3026301 | SYNTHROID (LEVOTHYROXINE NA) 0.112MG TAB | 2.00 |
| 3024819 | SYNTHROID (LEVOTHYROXINE NA) 0.125MG TAB | 2.00 |
| 3012814 | SYNTHROID (LEVOTHYROXINE NA) 0.15MG TAB | 2.00 |
| 3030691 | SYNTHROID (LEVOTHYROXINE NA) 0.175MG TAB | 2.00 |
| 3012806 | SYNTHROID (LEVOTHYROXINE NA) 0.20MG TAB | 2.00 |
| 3025816 | SYNTHROID (LEVOTHYROXINE NA) 100 MCG SDV | 583.20 |
| 3078153 | SYNVISC ONE INJECTION SOLUTION 8MG/1ML | 1,400.00 |
| 791325 | SYPHILIS AB (IGG) | 49.00 |
| 791280 | SYPHILIS AB (IGG)(W/REFLEX) | 49.00 |
| 5508397 | SYRINGE BULB | 19.40 |
| 5508398 | SYRINGE BULB 2OZ BLUE OB | 19.40 |
| 512100 | T & A SUCTION COAG | 34.00 |
| 330063 | T3 FREE | 219.00 |
| 791016 | T3 REVERSE | 69.00 |
| 790268 | T3 UPTAKE | 77.00 |
| 790062 | T4 FREE (BY DIALYSIS) | 437.00 |
| 791688 | T4 FREE (THYROXINE) | 110.00 |
| 514016 | TA 60 RELOAD ETHICON XR60B | 271.00 |
| 514014 | TA 60 STAPLER ETHICON TX60B | 342.00 |
| 517023 | TACK STAINLESS STEEL/HEMORRHAGE OCC PIN | 1,197.00 |
| 330417 | TACROLIMUS (PROGRAF) | 263.00 |
| 3020114 | TAMBOCOR TAB(FLECAINIDE ACETATE) 100MG | 2.00 |
| 3030793 | TAMIFLU (OSELTAMIVIR) 75MG CAP | 6.00 |
| 3078618 | TAMIFLU ORAL CAPSULE 30MG | 6.00 |
| 303523 | TAMIFLU SUSPENSION 6MG/ML 60ML | 118.20 |
| 1405180 | TAP BLOCK; ABDOMINAL PLANE BLOCK; UNILAT | 636.00 |
| 3030642 | TAPAZOLE (METHIMAZOLE) 10 MG TAB | 2.00 |
| 514619 | TAPE UMBILICAL COTTON | 28.40 |
| 3027432 | TAXOL (PACLitaxel) :30MG/5ML | 517.80 |
| 3077861 | TAZTIA XT (DILTIAZEM) XT 120MG CAPSULE | 2.00 |
| 330130 | TB SKIN TEST | 15.00 |
| 244002 | TC HDP (per mCi) | 286.80 |
| 244004 | TC MAA (per mCi) | 197.80 |
| 244006 | TC MAG3 (per mCi) | 802.90 |
| 244008 | TC MEBROFENIN (per mCi) | 117.10 |
| 244012 | TC PERTECHNETATE (20MCI) | 215.40 |
| 244010 | TC SODIUM PERTECHNETATE 10MCI | 166.30 |
| 244014 | TC SULFUR COLLOID (per mCi) | 250.50 |
| 578610 | TEAR DROP GUIDE WIRE | 487.00 |
| 3012970 | TEARS NATURAL DROPS 15ML | 15.00 |
| 3030978 | TEARS NATURALE 0.030Z: UNIT DOSE | 2.00 |
| 83003 | TECH PER 1/2 DAY INTERVALS | 80.00 |
| 5500055 | TED HOSE STOCKING XLR | 24.00 |
| 134202 | TEE ECHO | 1,326.50 |
| 134200 | TEE ECHO DOPPLER | 313.70 |
| 134201 | TEE ECHO WITH COLOR | 457.70 |
| 303716 | TEFLARO (CEFTAROLINE FOSAMIL) 400MG | 200.80 |
| 303717 | TEFLARO (CEFTAROLINE FOSAMIL) 600MG | 200.80 |
| 501887 | TEGADERM CHG 4X4 | 64.00 |
| 507818 | TEGADERM HYDROCOLLOID THIN | 27.00 |
| 507816 | TEGADERM SACRAL | 80.00 |
| 790490 | TEGRETOL (CARBAMAZEPINE) | 29.00 |
| 3031094 | TEGretol (carBAMazepine) 100MG/5ML 30ML | 12.00 |
| 3013010 | TEGretol (carBAMazepine)200MG TAB | 2.00 |
| 3030999 | TEGRETOL(CARBAMAZEPINE)XR 400MG TAB | 4.00 |
| 83132 | TELEMEDICINE ORIGINATING SITE FACILITY | 65.00 |
| 93088 | TELEPHONE E/M 11-20 MINUTES | 40.00 |
| 93089 | TELEPHONE E/M 21-30 MINUTES | 65.00 |
| 93087 | TELEPHONE E/M 5-10 MINUTES | 40.00 |
| 3030885 | TEMOVATE (CLOB.PROP) 0.05% 15GM CR | 10.00 |
| 515645 | TENDON COLOR CODED SIZING SET | 945.00 |
| 93091 | TENDON SHEATH INCISION | 1,445.00 |
| 515641 | TENDON SPACER ROD/ 3MM | 3,826.00 |
| 515642 | TENDON SPACER ROD/ 4MM | 1,553.00 |
| 515644 | TENDON SPACER ROD/ 6MM | 1,553.00 |
| 3017706 | TESSALON (BENZONATATE) 100MG PERLE | 2.00 |
| 791464 | TESTOSTERONE TOTAL | 65.00 |
| 3013218 | TETANUS IMMUNE GLOB 250 UNITS/ML INJ | 1,001.10 |
| 790070 | TETANUS TOXOID (IGG) | 107.00 |
| 3034001 | TETRACAINE 0.5% OPHT. SOLN 4ml | 10.00 |
| 3012616 | TETRACYCLINE 250MG CAP | 2.00 |
| 514109 | T-FASTENERS | 343.00 |
| 330418 | THEOPHYLLINE | 380.64 |
| 3078225 | THEOPHYLLINE ORAL TAB ER 400MG | 4.00 |
| 5414411 | THERABAND BLACK | 8.00 |
| 5408603 | THERABAND BLUE | 8.00 |
| 5414429 | THERABAND GREEN | 8.00 |
| 5414437 | THERABAND RED | 8.00 |
| 5414445 | THERABAND YELLOW | 8.00 |
| 3017078 | THERAGESIC CREAM | 10.00 |
| 3015742 | THERAGRAN (MULTI VIT) 30 ML LIQ | 12.00 |
| 3013309 | THERAGRAN-M (THERAPEUTIC MVI W/MIN) TAB | 2.00 |
| 11280 | THERAPEUTIC PHLEBOTOMY | 138.30 |
| 514478 | THERAPUTTY RED | 13.70 |
| 3026137 | THIAMINE 100MG TAB | 2.00 |
| 3019629 | THIAMINE 100MG/ML 2ML INJ | 47.85 |
| 791223 | THIOPURINE METHYLTRANSFERASE (RBC)(TPMT) | 889.00 |
| 3013333 | THIOTEPA VIAL(THIOPLEX) 15MG | 2,094.05 |
| 532526 | THORACENTESIS SET | 15.00 |
| 3032526 | THORACENTESIS SET | 69.45 |
| 507508 | THORACENTESIS TRAY (XRAY) | 132.00 |
| 16910 | THORACENTESIS W/ US | 420.00 |
| 16901 | THORACENTESIS W/O US | 775.00 |
| 16902 | THORACENTESIS W/O US | 775.00 |
| 171048 | THORACENTESIS W/US | 420.00 |
| 516820 | THORACIC VENT | 720.00 |
| 1403364 | THORACOTOMY/LUNG/PLE | 89.80 |
| 3013432 | THORAZINE (chlorproMAZINE) 25MG TAB | 2.00 |
| 3013382 | THORAZINE (chlorproMAZINE) 25MG/ML INJ | 73.90 |
| 791024 | THORAZINE(CHLORPROMAZINE)(MEDTOX) | 80.00 |
| 1403281 | THOROCOPLASTY | 89.80 |
| 790959 | THROMBIN TIME | 132.00 |
| 303391 | THROMBIN TOPICAL (RECOTHROM) 5000 UNITS | 249.75 |
| 791219 | THROMBOPHILIA PROFILE | 132.00 |
| 503526 | THUMB SPICA SPLINT LEFT LARGE | 25.70 |
| 503525 | THUMB SPICA SPLINT LEFT MEDIUM | 25.70 |
| 503524 | THUMB SPICA SPLINT LEFT SMALL | 41.87 |
| 503528 | THUMB SPICA SPLINT RIGHT MEDIUM | 41.87 |
| 503529 | THUMB SPICA SPLINT RIGHT LARGE | 25.70 |
| 503527 | THUMB SPICA SPLINT RIGHT SMALL | 29.00 |
| 3032590 | THYROGEN (THYROTROPIN ALPHA) 1.1MG INJ | 3,342.50 |
| 790710 | THYROGLOBULIN AB SCREEN | 76.00 |
| 791285 | THYROGLOBULIN MASS SPECTROMETRY | 621.00 |
| 790751 | THYROGLOBULIN TUMOR MARKER & SCREEN | 52.00 |
| 790085 | THYROID STIMULATING IMMUNOGLOBULIN (TSI) | 279.00 |
| 790086 | THYROPEROXIDASE AB (TPO) | 57.00 |
| 790676 | THYROTROPIN RECEPTOR ANTIBODY | 150.00 |
| 790774 | THYROXIN-BINDING GLOBULIN (TBG) | 149.00 |
| 581200 | TIB.FIB YOUTH KNEE LGT | 60.00 |
| 581205 | TIB/FIB ADULT HIP LGT | 81.80 |
| 581201 | TIB/FIB ADULT KNEE LGT | 60.00 |
| 581203 | TIB/FIB CHILD HIP LGT | 87.70 |
| 581199 | TIB/FIB CHILD KNEE LGT | 273.70 |
| 581202 | TIB/FIB SM CHILD HIP LGT | 99.00 |
| 581198 | TIB/FIB SM CHILD KNEE LGT | 58.18 |
| 581204 | TIB/FIB YOUTH HIP LGT | 84.30 |
| 1404420 | TIB/FIB/OSTEOT/PLAST | 89.80 |
| 790243 | TIBC (IRON BINDING CAPACITY) | 109.00 |
| 240498 | TIBIA & FIBULA LEFT 2 VIEWS | 232.90 |
| 240499 | TIBIA & FIBULA RIGHT 2 VIEWS | 232.90 |
| 16989 | TIBIAL NO MANIPULATION | 1,000.00 |
| 171128 | TIBIAL NO MANIPULATION | 1,293.00 |
| 16990 | TIBIAL W/ MANIPULATION | 1,698.00 |
| 171129 | TIBIAL W/ MANIPULATION | 2,240.00 |
| 514075 | TI-KNOT DEVICE | 525.00 |
| 514076 | TI-KNOT RELOAD | 210.00 |
| 3013580 | TIMOPTIC 0.25% (TIMOLOL) 5ML OPHTH SOLN | 10.00 |
| 3013598 | TIMOPTIC 0.5% (TIMOLOL) 5ML OPH SOLN | 10.00 |
| 3029974 | TIMOPTIC XE 0.25%(TIMOLOL) OPHTH GEL 5ML | 35.70 |
| 303430 | TIMOPTIC-XE 0.5% (TIMOLOL) OPHTH GEL 5ML | 39.20 |
| 790111 | TISSUE (IGA)TRANSGLUTAMINASE | 144.00 |
| 790900 | TISSUE (IGG) TRANSGLUTAMINASE | 144.00 |
| 791452 | TISSUE CULTURE NEOPLASTIC DISORDERS (BM) | 618.00 |
| 791621 | TISSUE GROSS ONLY | 20.00 |
| 790144 | TISSUE LEVEL II | 28.00 |
| 790151 | TISSUE LEVEL III | 31.00 |
| 790169 | TISSUE LEVEL IV | 200.00 |
| 791630 | TISSUE LEVEL V | 71.00 |
| 790177 | TISSUE LEVEL VI | 91.00 |
| 791469 | TISSUE/MAYO PATH CONSULT | 558.00 |
| 791539 | TITANIUM (SERUM) | 500.00 |
| 517921 | TLS DRAIN O.R. (DR.MERRITT) | 158.00 |
| 240142 | TMJ BILATERAL | 232.90 |
| 3030903 | TNKASE (TENECTEPLASE) 50MG INJ | 11,109.50 |
| 3025378 | TOBRADEX (TOBRAMY&DEXAM) 2.5ML OPH SOLN | 78.00 |
| 790096 | TOBRAMYCIN | 53.00 |
| 790972 | TOBRAMYCIN (PEAK) | 53.00 |
| 3020395 | TOBRAMYCIN 0.3% 5ML OPH SOLN | 10.00 |
| 3028240 | TOBREX (TOBRAMYCIN) 0.3% 3.5GM OPH OINT | 108.20 |
| 241819 | TOES LEFT >= 2V | 221.30 |
| 241820 | TOES RIGHT >=2V’s | 221.30 |
| 240688 | TOMO | 298.50 |
| 136578 | TONSIL AND ADENOID REMOVAL | 2,000.00 |
| 136589 | TONSILLECTOMY 12 YEARS AND OVER | 2,000.00 |
| 136530 | TONSILLECTOMY AGE 12 OR OVER | 2,000.00 |
| 13110 | TONSILLECTOMY YOUNGER THAN 12 | 2,000.00 |
| 3080834 | TOPAMAX (TOPIRAMATE) 100MG TAB | 2.00 |
| 303660 | TOPAMAX (TOPIRAMATE) 25MG TAB | 2.00 |
| 790098 | TOPIRAMATE | 174.00 |
| 3029552 | TOPOTECAN (HYCAMTIN) 4MG INJ | 3,530.95 |
| 3032605 | TOPROL XL (METOPROLOL SUCC) 25MG TAB | 2.00 |
| 3031269 | TOPROL XL (METOPROLOL SUCC) 50MG TAB | 2.00 |
| 3023696 | TORADOL (KETOROLAC) 30MG VIAL | 29.40 |
| 3023704 | TORADOL (KETOROLAC) 60MG VIAL | 29.40 |
| 303453 | TORISEL (TEMSIROLIMUS) 25MG KIT | 3,939.20 |
| 3029248 | TORSEMIDE(DEMADEX) 20MG TAB | 2.00 |
| 380113 | TOTAL HYSTERECTOMY (CORPUS AND CERVIX);W | 2,537.50 |
| 131210 | TOTAL THYROID LOBECTOMY, PARTIAL | 2,000.00 |
| 1403687 | TOTAL/CYSTECTOMY | 89.80 |
| 1404271 | TOTAL/KNEE/REPLACEMENT | 89.80 |
| 505780 | TOURNIQUET SZ 24 OR ONLY | 165.00 |
| 505789 | TOURNIQUET SZ 30 OR ONLY | 178.00 |
| 500578 | TOURNIQUET SZ 42 OR ONLY | 210.00 |
| 791100 | TOXICOLOGY SCREEN (URINE) | 233.00 |
| 790836 | TOXOPLASMA (IGG) ANTIBODY | 84.00 |
| 790830 | TOXOPLASMA (IGM) ANTIBODY | 84.00 |
| 3020338 | TPA (ACTIVASE) W/DILUENT 100MG INJ | 16,311.50 |
| 516291 | TRACH CANNULA INNER SIZE 8 | 238.00 |
| 517309 | TRACH INNER CANNULA SIZE 6 SHILEY | 29.00 |
| 501252 | TRACH TUBE 3.5 PED SHILEY | 498.80 |
| 501250 | TRACH TUBE 3.O PED SHILEY | 483.00 |
| 501251 | TRACH TUBE 4.0 PED SHILEY | 483.00 |
| 517299 | TRACH TUBE 4.5 PED SHILEY | 231.70 |
| 517307 | TRACH TUBE 5.0 PED SHILEY | 483.00 |
| 517308 | TRACH TUBE 6.0 SHILEY FENESTRATED CUFFED | 351.00 |
| 517310 | TRACH TUBE 6.0 SHILEY UNCUFF/NONFEN. | 352.00 |
| 517311 | TRACH TUBE KIT 8 SHILEY | 313.00 |
| 516572 | TRACH TUBES 6.0 FENESTRATED CUFFED | 287.00 |
| 516523 | TRACH TUBES 6.0 FENESTRATED UNCUFFED | 350.00 |
| 516580 | TRACH TUBES 7.0 FENESTRATED CUFFED | 270.00 |
| 516531 | TRACH TUBES 7.0 FENESTRATED UNCUFFED | 279.00 |
| 516598 | TRACH TUBES 8.0 FENESTRATED CUFFED | 334.00 |
| 516549 | TRACH TUBES 8.0 FENESTRATED UNCUFFED | 220.00 |
| 516606 | TRACH TUBES 9.0 FENESTRATED CUFFED | 334.00 |
| 516556 | TRACH TUBES 9.0 FENESTRATED UNCUFFED | 335.90 |
| 516614 | TRACH TUBES10.0 FENESTRATED CUFFED | 287.00 |
| 516564 | TRACH TUBES10.0 FENESTRATED UNCUFFED | 127.00 |
| 515575 | TRACHEOSTOMY PEDIATRIC QUICK TUBE | 501.00 |
| 515574 | TRACHEOSTOMY QUICK TUBE | 492.00 |
| 3077841 | TRADJENTA (LINAGLIPTIN) 5MG TAB | 2.00 |
| 303293 | TRANDATE (LABETALOL) 100MG TAB | 2.00 |
| 3031673 | TRANDATE (LABETALOL) 5MG/1ML 4ML INJ | 61.35 |
| 3030048 | TRANDATE MDV(LABETALOL) 100MG/20ML | 155.00 |
| 3077941 | TRANexaMIC AC 100MG/ML VL (1000MG/10ML) | 192.50 |
| 1403489 | TRANS/ABD/DIAPH/HERN | 89.80 |
| 83002 | TRANSCRIPTION PER HOUR | 16.00 |
| 3013770 | TRANSDERM-SCOP(SCOPOLAMINE) 1.5MG PATCH | 17.60 |
| 790632 | TRANSFERRIN | 69.00 |
| 15006 | TRANSFORAMINAL – CERVICAL/THORACIC | 568.00 |
| 15008 | TRANSFORAMINAL – LUMBAR/SACRAL | 1,138.00 |
| 131171 | TRANSFORANIMAL; CERVICAL/THORACIC | 850.00 |
| 110122 | TRANSFUSION BLOOD OR BLOOD PRODUCTS | 702.70 |
| 790963 | TRANSPORTATION DRUG SCREEN (COLLECT FEE) | 20.00 |
| 1403794 | TRANSURETHERAL/PROC | 81.30 |
| 1403737 | TRANSVEN/UMBRELL/INS | 89.80 |
| 1403356 | TRANSVENOUS/PACEMAKE | 81.30 |
| 3031138 | TRAVANTAN DROPS 2.5ML | 111.70 |
| 303573 | TREANDA (BENDAMUSTINE) 100MG VL 20ML | 5,890.40 |
| 380136 | TREAT FX DISTAL RADIAL | 668.00 |
| 131159 | TREAT FX DISTAL RADIAL | 1,542.00 |
| 380132 | TREATMENT OF CLOSED DISTAL RADIAL FRACTU | 817.50 |
| 16133 | TREATMENT ROOM | 59.00 |
| 132000 | TREATMENT ROOM | 435.40 |
| 13106 | TREATMENT ROOM 1ST 30 MIN | 435.00 |
| 13107 | TREATMENT ROOM ADDL 30 MIN | 326.00 |
| 3017110 | TRENtal (PENTOXIFYLLINE) 400MG TAB | 2.00 |
| 3078511 | TRESIBA SUBCU SOLUTION 200U/1ML 3ML FLEX | 218.00 |
| 3018274 | TRIAMCINOLONE 0.025% 60ML LOT. | 83.90 |
| 3018233 | TRIAMCINOLONE 0.1% 15GM CREAM | 10.00 |
| 3026160 | TRIAMCINOLONE 0.1% 15GM OINT | 10.00 |
| 3006972 | TRIAMCINOLONE 40MG/ML INJ | 39.50 |
| 791279 | TRICHROM STAIN | 48.00 |
| 3032621 | TRICOR (FENOFIBRATE) 145MG TAB | 2.00 |
| 3032275 | TRICOR (FENOFIBRATE) 48MG TAB | 2.00 |
| 137027 | TRIGGER FINGER | 1,542.00 |
| 330426 | TRIGLYCERIDES | 45.00 |
| 303577 | TRILEPTAL (OXcarbazepine)300MG TAB | 2.00 |
| 303538 | TRILIPIX (FENOFIBRIC ACID) 135MG CAP | 2.00 |
| 16075 | TRIMALLEOLAR ANKLE NO MANIPULATION | 980.00 |
| 171143 | TRIMALLEOLAR ANKLE NO MANIPULATION | 1,234.00 |
| 16076 | TRIMALLEOLAR ANKLE W/ MANIPULATION | 1,664.00 |
| 171144 | TRIMALLEOLAR ANKLE W/ MANIPULATION | 2,427.00 |
| 3013945 | TRIMPEX (TRIMETHOPRIM) 100MG TAB | 2.00 |
| 3019223 | TRIPLE DYE APPLICATOR 1OZ | 2.00 |
| 514021 | TROCAR REDUCER ETHICON MS512 | 27.86 |
| 514029 | TROCAR, 12MM ETHICON | 354.00 |
| 512192 | TROCAR, 8 MM | 277.00 |
| 514089 | TROCAR, HUSSAN BLUNTPORT 5MM – 12MM | 435.00 |
| 594244 | TROCAR,10/11MM ETHICON | 124.00 |
| 514124 | TROCAR,5MM ETHICON BLADED 100mm | 238.00 |
| 514123 | TROCAR,5MM ETHICON BLADED 150mm DR. HAMB | 124.00 |
| 514125 | TROCAR,5MM ETHICON BLADED 75mm | 115.00 |
| 331994 | TROPONIN | 142.00 |
| 500253 | TRU-CUT BIOPSY NEEDLE | 71.00 |
| 517939 | TRUNODE GAMMA PROBE | 1,497.00 |
| 3029289 | TRUSOPT 2% OPHTH SOLN 10ML | 20.00 |
| 331499 | TSH | 150.00 |
| 791256 | TSH W/HAMA TREATMENT | 150.00 |
| 578029 | T-TUBE 10 FR | 37.50 |
| 578030 | T-TUBE 12 FR | 35.00 |
| 578031 | T-TUBE 14 FR | 40.00 |
| 578032 | T-TUBE 16 FR | 67.00 |
| 578240 | T-TUBE 18FR | 67.00 |
| 578241 | T-TUBE 20FR | 35.00 |
| 578587 | T-TUBE 24 FR | 67.00 |
| 578191 | T-TUBE 8 FR | 35.00 |
| 588501 | T-TUBE SILICONE 12 FR | 498.00 |
| 588502 | T-TUBE SILICONE 16 FR | 498.00 |
| 588500 | T-TUBE SILICONE 8 FR | 498.00 |
| 1403712 | TUBAL LIGATION/TRANSECTION | 89.80 |
| 5401004 | TUBE GAUZE 1 , SIZE 2 | 4.60 |
| 5412090 | TUBE GAUZE 1 1/2 | 3.50 |
| 5512039 | TUBE GAUZE SIZE 1 5/8 | 4.60 |
| 5412039 | TUBE GAUZE SZ 1 5/8 | 3.50 |
| 3015510 | TUBERSOL INJ(APLISOL) 1 TU/0.1ML | 29.40 |
| 574091 | TUBING MAIN PUMP | 305.00 |
| 3027747 | TUCKS WIPES(WITCH HAZEL PADS)BOX OF 10 | 10.00 |
| 3019116 | TUMS TAB(CALCIUM CARBONATE) | 2.00 |
| 512266 | TUR BASKET RECEPTOR | 213.00 |
| 3032524 | TUR Y SET | 58.20 |
| 1403802 | TUR/BLADDER/TUMOR | 89.80 |
| 1403810 | TUR/PROSTATE | 89.80 |
| 516822 | TURBINATOR WAND | 783.00 |
| 578584 | TWISTER RETRIEVAL DEVICE/RESCUE NET | 396.00 |
| 3029529 | TWOCAL HN LIQUID 240ML | 9.60 |
| 303378 | TYGACIL 50MG (TIGECYCLINE) INJ | 363.30 |
| 3018696 | TYLENOL (ACETAMINOPHEN) 120MG SUPP | 2.00 |
| 3017680 | TYLENOL (ACETAMINOPHEN) 325MG SUPP | 2.00 |
| 3015791 | TYLENOL (ACETAMINOPHEN) 650MG SUPP | 2.00 |
| 3020528 | TYLENOL (ACETAMINOPHEN) CHILD 160MG/5ML | 2.00 |
| 303755 | TYLENOL CHILDRENS 80MG/2.5ML SUSP | 2.00 |
| 3032536 | TYLENOL PM X-STR (ACETAMINO/DIPHENH)TAB | 2.00 |
| 3014133 | TYLENOL/COD (ACETAMINOPHEN/COD) #3 TAB | 2.00 |
| 3014109 | TYLENOL/COD (ACETAMINOPHEN/COD) 15ML ELI | 2.00 |
| 136577 | TYMPANOSTOMY | 1,542.00 |
| 1403034 | TYMPANOTOMY | 82.40 |
| 240037 | UGI W/AIR SMALL BOWEL | 811.80 |
| 240035 | UGI W/AIR W/KUB | 630.80 |
| 240030 | UGI W/AIR W/O KUB | 622.70 |
| 240041 | UGI W/KUB | 361.70 |
| 240040 | UGI W/O KUB | 512.60 |
| 240043 | UGI/SMALL BOWEL | 699.90 |
| 137023 | ULNAR NERVE TRANSPOSITION (CTS) | 1,101.10 |
| 93085 | ULNAR NERVE TRANSPOSITION (CTS) | 1,950.00 |
| 16972 | ULNAR SHAFT NO MANIPULATION | 724.00 |
| 171111 | ULNAR SHAFT NO MANIPULATION | 911.00 |
| 16973 | ULNAR SHAFT W/ MANIPULATION | 1,418.00 |
| 171112 | ULNAR SHAFT W/ MANIPULATION | 1,817.00 |
| 3013484 | ULORIC (FEBUXOSTAT) 40MG TAB | 2.00 |
| 514904 | ULTRA PRO II X-RAY | 87.50 |
| 244024 | ULTRA TAG KIT | 245.90 |
| 574774 | ULTRABRAID 2 COBRAID 38 LENGTH SINGLE | 103.00 |
| 574775 | ULTRABRAID 2 WHITE 38 LENGTH SINGLE | 103.00 |
| 3028210 | ULTRAM (traMADol) 50MG TAB | 2.50 |
| 3021559 | UNASYN (AMPICILLIN/SULBACTAM) 1.5GM VIAL | 31.85 |
| 3021153 | UNASYN (AMPICILLIN/SULBACTAM): 3GM VIAL | 60.60 |
| 1403851 | UNDES/TESTIS/UNI/BI | 89.80 |
| 136571 | UNLISTED DENTOALVEOLAR STRUCTURE | 2,000.00 |
| 39184 | UNLISTED MODALITY | 71.40 |
| 39440 | UNLISTED PROCEDURE | 71.40 |
| 790715 | UNSTABLE HEMOGLOBIN (BLOOD)(REFLEX) | 178.00 |
| 16054 | UP TO 2.5 CM | 237.00 |
| 170434 | UP TO 2.5 CM | 273.90 |
| 16904 | UP TO 2.5 CM | 300.00 |
| 170293 | UP TO 2.5 CM | 319.30 |
| 170384 | UP TO 2.5 CM | 323.90 |
| 170343 | UP TO 2.5 CM | 334.20 |
| 170459 | UP TO 2.5 CM | 371.70 |
| 16942 | UP TO 2.5 CM | 427.00 |
| 16946 | UP TO 2.5 CM | 525.00 |
| 16938 | UP TO 2.5CM | 427.00 |
| 1403455 | UP/ABD/HERNIA/REPAIR | 98.40 |
| 1503455 | UP/ABD/HERNIA/REPAIR | 98.40 |
| 1403414 | UP/ABD/WALL/ANTERIOR | 89.80 |
| 1403430 | UP/ABD/WALL/POSTERIOR | 89.80 |
| 1404248 | UP/TIB/FIB/PAT/CLOSE | 89.80 |
| 1404255 | UP/TIB/FIB/PAT/OPEN | 89.80 |
| 380125 | UPPER GASTROINTESTINAL ENDOSCOPY | 2,721.25 |
| 380157 | UPPER GASTROINTESTINAL ENDOSCOPY;W/DILAT | 1,427.15 |
| 1404784 | UPPER/ARM/ARTERIES | 89.80 |
| 1404792 | UPPER/ARM/EMBOLECTOM | 89.80 |
| 1404818 | UPPER/ARM/PHLEBORRBA | 89.80 |
| 1404800 | UPPER/ARM/VEINS | 89.80 |
| 1143448 | UPPER/GI/ENDOSCOPIC | 98.40 |
| 1503448 | UPPER/GI/ENDOSCOPIC | 98.40 |
| 790962 | UREA NITROGEN (24HR URINE) | 30.00 |
| 3014208 | URECHOLINE (BETHANECHOL) 25MG TAB | 2.00 |
| 241452 | URETHROCYSTOGRAPHY SI | 200.90 |
| 330434 | URIC ACID | 43.00 |
| 798087 | URIC ACID (24HR URINE) | 33.00 |
| 791101 | URINE DRUG SCREEN | 258.00 |
| 500485 | URINE METER | 38.00 |
| 330641 | URINE MICROSCOPIC ONLY | 32.00 |
| 331044 | URINE VOLUME MEASURE (TIMED COLLECTION) | 39.00 |
| 3014232 | URISPAS (flavoxATE) 100MG TAB | 2.00 |
| 3032601 | UROXATRAL (ALFUZOSIN) 10MG TAB | 2.00 |
| 240761 | US ABD BACK WALL COMPLETE | 502.20 |
| 240795 | US ABD BACK WALL LIMITED | 420.20 |
| 241573 | US ABD LTD/UNILAT DUPLEX | 325.40 |
| 241322 | US ABDOMEN COMPLETE | 518.50 |
| 241827 | US ABDOMEN LIMITED | 408.20 |
| 241916 | US ABDOMINAL AORTIC ANEURYSM – SCREENING | 201.60 |
| 241915 | US ABDOMINAL DUPLEX | 584.10 |
| 241613 | US ART DOPPLER BILAT | 362.40 |
| 241363 | US ARTERIAL BILATERAL LOWER | 584.10 |
| 240220 | US ARTERIAL BILATERAL UPPER | 584.10 |
| 241900 | US ARTERIAL UNILATERAL LOWER | 325.40 |
| 240221 | US ARTERIAL UNILATERAL UPPER | 325.40 |
| 240222 | US ARTHROCENTESIS INJ | 232.39 |
| 241536 | US BREAST RIGHT UNILATERAL | 287.00 |
| 241538 | US BREAST(S) | 315.70 |
| 242990 | US CARDIOCENTESIS SI | 355.80 |
| 240829 | US CAROTID BILAT | 1,110.70 |
| 241920 | US CAROTID LTD/UNILAT | 560.70 |
| 240830 | US CRANIAL ARTERY, LIMITED | 204.10 |
| 241574 | US DUPLEX SCAN | 325.40 |
| 241850 | US ECHO EXAM OF HEAD | 380.40 |
| 242056 | US EXTREMITIES | 455.30 |
| 242057 | US EXTREMITIES; LIMITED ANATOMIC SPCFIC | 455.30 |
| 242031 | US FETAL BIOPHYSICAL PROFILE NON-STRESS | 361.70 |
| 241587 | US GUIDE (BX,ASP,INJ,LOC) SI | 355.80 |
| 243000 | US GUIDE VASCULAR ACCESS SI | 99.50 |
| 244041 | US GUIDED PARACENTESIS W/IMAGING GUIDANC | 731.00 |
| 240853 | US GUIDED THORACENTESIS | 678.00 |
| 241504 | US HEAD AND NECK | 338.30 |
| 872032 | US INJECTION ASPIRATION OF MAJOR JOINT | 93.00 |
| 241603 | US LE ART DOPPLER STUDY BILAT W/EX | 255.20 |
| 240807 | US OB INITIAL < THAN 14 WKS | 467.00 |
| 240803 | US OB INITIAL EVAL >14 WKS | 478.70 |
| 240805 | US OB INITIAL MULTIPLE FETUS >14WKS | 221.30 |
| 240811 | US OB LIMITED | 326.60 |
| 241835 | US OB MULTI | 719.80 |
| 240804 | US OB OF MULTIPLE FETUS LESS THAN 14 WKS | 209.50 |
| 241843 | US OB RE-EVAL < OR > 14 WKS | 478.70 |
| 240815 | US OB RE-EVAL MULTIPLE FETUS >14WKS | 221.30 |
| 240806 | US OB USING TRANSVAGINAL PROBE | 443.70 |
| 240852 | US PELVIC LIMITED | 268.10 |
| 240837 | US PELVIS | 420.20 |
| 241905 | US RENAL DUPLEX | 518.70 |
| 241910 | US RENAL LTD/UNILAT DUPLEX | 451.00 |
| 241868 | US SCROTUM | 373.40 |
| 241892 | US SEGMENTAL ARTERIAL W/DOPPLER | 642.60 |
| 241918 | US SEGMENTAL ARTERIAL W/DOPPLER LTD | 421.40 |
| 240787 | US TRANSVAGINAL | 338.30 |
| 241553 | US VENOUS DOPPLER BILATERAL | 822.80 |
| 241884 | US VENOUS DOPPLER UNILATERAL | 644.90 |
| 512321 | VACURETTE CURVED 7 MM CURETTE | 70.60 |
| 512320 | VACURETTE CURVED 8 MM CURETTE | 71.00 |
| 509967 | VACUUM MIXING SYSTEM COMPACT | 375.00 |
| 11131 | VAD FLUSH | 76.20 |
| 512316 | VAG PACKING | 36.00 |
| 1403927 | VAG/DELIVERY | 89.80 |
| 1403919 | VAG/HYSTERECTOMY | 98.40 |
| 1503919 | VAG/HYSTERECTOMY | 98.40 |
| 1403893 | VAG/PROC/VAG/CER | 98.40 |
| 1503893 | VAG/PROC/VAG/CER | 98.40 |
| 13113 | VAGINAL HYSTERECTOMY; UNDER 250 GRAMS | 2,200.00 |
| 303451 | VALISONE (BETAMETHASONE VAL) 0.1% CRM | 20.00 |
| 3014356 | VALIUM (DIAZEPAM) 2MG TAB | 2.00 |
| 3014364 | VALIUM (DIAZEPAM) 5MG TAB | 2.00 |
| 3019876 | VALium (DIAZEPAM) 5MG/ML 10ML VIAL | 116.65 |
| 3014331 | VALIUM (DIAZEPAM) 5MG/ML 2ML | 40.90 |
| 790798 | VALPROIC ACID (DEPAKOTE) | 22.00 |
| 3031069 | VALTREX (valACYclovir HCL) 500MG TAB | 2.00 |
| 791540 | VANADIUM (SERUM) | 509.00 |
| 791316 | VANCOMYCIN | 192.00 |
| 303275 | VANCOMYCIN 1GM VIAL | 35.00 |
| 3077887 | VANCOMYCIN 500MG VIAL | 29.40 |
| 303738 | VANCOMYCIN 750MG VIAL | 29.40 |
| 3078277 | VANCOMYCIN KIT ORAL 50MG/ML 300ML | 87.10 |
| 303483 | VANCOMYCIN VIAL:1GM | 35.00 |
| 509635 | VARI-A-PULSE STRYKER | 223.00 |
| 790019 | VARICELLA ZOSTER (IGG) | 44.00 |
| 791052 | VARICELLA ZOSTER (IGM) | 44.00 |
| 330626 | VARICELLA ZOSTER (PCR) | 145.00 |
| 514924 | VASCULAR GRAFT 10 X 80 | 2,417.00 |
| 514926 | VASCULAR GRAFT 5.0 D X 50 CM L VECTRA | 2,498.00 |
| 514927 | VASCULAR GRAFT 6 LONG X 10 VECTRA | 1,752.00 |
| 514925 | VASCULAR GRAFT 6.0 D X 20 CM L VECTRA | 1,553.00 |
| 514928 | VASCULAR GRAFT 6.0 D X 50 CM L VECTRA | 5,557.00 |
| 512333 | VASCULAR GRAFT 6MMX40 CM | 1,652.00 |
| 516184 | VASCULAR GRAFT HEMASHIELD WOVEN 1X6 | 439.00 |
| 514551 | VASCULAR GRAFT KNITTED 18X9 | 1,437.00 |
| 514569 | VASCULAR GRAFT KNITTED 20X10 | 1,437.00 |
| 514577 | VASCULAR GRAFT KNITTED 24X12 | 1,437.00 |
| 514929 | VASCULAR GRAFT VENAFLO STRAIGHT V5006C | 2,100.00 |
| 514585 | VASCULAR GRAFT WOVEN 18X9 | 1,437.00 |
| 514593 | VASCULAR GRAFT WOVEN 20X10 | 2,600.00 |
| 514601 | VASCULAR GRAFT WOVEN 24X12 | 1,437.00 |
| 512357 | VASCULAR TOURN KIT | 28.00 |
| 1404917 | VASCULAR/SHUNT | 89.80 |
| 131215 | VASECTOMY UNILATERAL OR BILATERAL INCL | 435.00 |
| 137049 | VASECTOMY UNILATERAL OR BILATERAL INCL | 983.88 |
| 1403837 | VASECTOMY,UNILATERAL OR BILATERAL | 89.80 |
| 790138 | VASOACTIVE INTESTINAL POLYPEPTIDE | 320.00 |
| 3019553 | VASOTEC (ENALAPRIL) 10MG TAB | 2.00 |
| 3019991 | VASOTEC (ENALAPRIL) 5MG TAB | 2.00 |
| 3014307 | V-CILLIN K TAB(PEN VK) 500MG | 2.00 |
| 3078293 | VECTIBIX INTRAVENOUS SOL 20MG/1ML 100MG | 3,043.50 |
| 3078394 | VECTIBIX INTRAVENOUS SOL. 20MG/1ML 400MG | 10,900.50 |
| 1404164 | VEINS/UPPER/LEG | 89.80 |
| 303494 | VELCADE DS(BORTEZOMIB) 3.5MG | 4,446.90 |
| 330996 | VENIPUNCTURE | 30.00 |
| 16920 | VENIPUNCTURE UNDER 3 YRS FEMORAL | 50.00 |
| 171057 | VENIPUNCTURE UNDER 3 YRS FEMORAL | 50.00 |
| 16922 | VENIPUNCTURE UNDER 3 YRS OTHER VEIN | 45.00 |
| 171059 | VENIPUNCTURE UNDER 3 YRS OTHER VEIN | 45.00 |
| 16921 | VENIPUNCTURE UNDER 3 YRS SCALP | 42.00 |
| 171058 | VENIPUNCTURE UNDER 3 YRS SCALP | 42.00 |
| 240670 | VENO EXT BILAT SI | 1,501.50 |
| 240660 | VENO LEFT UNILAT SI | 1,000.20 |
| 241983 | VENO LEFT UNILATERAL INJ | 847.00 |
| 240662 | VENO LEFT UNILATERAL SI | 551.00 |
| 240663 | VENO RIGHT UNILAT SI | 644.90 |
| 241984 | VENO RIGHT UNILATERAL INJ | 847.00 |
| 3031120 | VENOFER (IRON SUCROSE) 100MG/5ML INJ | 277.65 |
| 23068 | VENOUS BILATERAL | 822.80 |
| 23069 | VENOUS LIMITED/UNILATERAL | 667.00 |
| 512790 | VENSTAR RESUSITATE CIRCUIT OB | 33.15 |
| 1403588 | VENT/INCESIONAL/HERN | 98.40 |
| 18006 | VENTILATOR ASSIST & MGMT; SUBS | 326.60 |
| 593030 | VENTILATOR CIRCUIT AUTOVENT -RT | 49.00 |
| 514940 | VENTILATOR CIRCUIT RT DARK BLUE | 44.00 |
| 593027 | VENTILATOR CIRCUIT RT NEW ESPIRIT | 45.00 |
| 3011113 | VENTOLIN (ALBUTEROL) HFA INHALER (INPT) | 25.00 |
| 303384 | VERSED (MIDAZOLAM) 1MG/ML 5ML | 29.40 |
| 3031018 | VERSED (MIDAZOLAM) 2MG/ML ORAL SUSP | 2.00 |
| 303689 | VERSED (MIDAZOLAM) 50MG/10ML *5MG/ML* | 31.30 |
| 3024793 | VERSED VIAL(MIDAZOLAM) 2MG/2ML INJ | 29.40 |
| 3020205 | VERSED VIAL(MIDAZOLAM)25MG/5ML 5ML | 62.70 |
| 515954 | VERSYS CEMENTED STEM LG 14 | 3,870.00 |
| 515947 | VERSYS CEMENTED STEM MED 12 | 3,848.00 |
| 515939 | VERSYS CEMENTED STEM SM 11 | 3,848.00 |
| 515970 | VERSYS CEMENTED STEM X-LG 18 | 2,633.00 |
| 515962 | VERSYS CEMENTED STEM X-LG 16 | 2,633.00 |
| 515996 | VERSYS CENTRALIZER 10MM | 356.00 |
| 516002 | VERSYS CENTRALIZER 11MM | 366.00 |
| 516010 | VERSYS CENTRALIZER 12MM | 315.00 |
| 516028 | VERSYS CENTRALIZER 13MM | 417.00 |
| 516036 | VERSYS CENTRALIZER 14MM | 366.00 |
| 516044 | VERSYS CENTRALIZER 15MM | 356.00 |
| 516051 | VERSYS CENTRALIZER 16MM | 356.00 |
| 516069 | VERSYS CENTRALIZER 17MM | 356.00 |
| 515988 | VERSYS CENTRALIZER 9MM | 356.00 |
| 515777 | VERSYS FEMORAL HEAD 22MM +0 | 1,798.00 |
| 515814 | VERSYS FEMORAL HEAD 28MM +10.5 | 1,666.00 |
| 515798 | VERSYS FEMORAL HEAD 28MM +3.5 | 1,924.00 |
| 515006 | VERSYS FEMORAL HEAD 28MM +7 | 1,617.00 |
| 515825 | VERSYS FEMORAL HEAD 28MM +7.0MM | 2,022.00 |
| 515780 | VERSYS FEMORAL HEAD 28MM 0 | 1,924.00 |
| 515772 | VERSYS FEMORAL HEAD 28MM -3.5 | 1,924.00 |
| 515863 | VERSYS FEMORAL HEAD 32MM +10.5 | 1,798.00 |
| 515855 | VERSYS FEMORAL HEAD 32MM +7 | 1,404.00 |
| 515830 | VERSYS FEMORAL HEAD 32MM 0 | 2,819.00 |
| 515822 | VERSYS FEMORAL HEAD 32MM -3.5 | 1,320.00 |
| 515871 | VERSYS PRESS FIT STEM SM 11 | 2,633.00 |
| 3032614 | VESICARE (SOLIFENACIN) 5MG TAB | 2.00 |
| 515516 | VESSEL DIALTOR 5.0 FR | 26.00 |
| 515558 | VESSEL DILATOR 10.0 FR | 27.00 |
| 515517 | VESSEL DILATOR 6.0 FR | 31.00 |
| 515533 | VESSEL DILATOR 8.0 FR | 31.00 |
| 515541 | VESSEL DILATOR 9.0 FR | 27.00 |
| 578503 | VESSEL LOOP WHITE | 27.50 |
| 578007 | VESSEL LOOP YELLOW | 28.00 |
| 303568 | VFEND (VORICONAZOLE)10MG/ML 20ML INJ | 475.61 |
| 3015692 | VIBRAMYCIN VIAL(DOXYCYCLINE) 100MG | 89.40 |
| 3031153 | VICKS VAPORUB 1.76 OZ | 10.00 |
| 303490 | VIDAZA (azaCITIDine) 100MG | 1,600.90 |
| 242346 | VIDEO SWALLOW(SPEECH THERAPY) | 431.90 |
| 3078510 | Viibryd Oral Tablet 40MG | 18.00 |
| 3077877 | VIMPAT (LACOSAMIDE) 50MG TABLET | 16.00 |
| 3019801 | vinBLASTine:VIAL(VELBAN,VELSAR) 1MG/ML 1 | 160.80 |
| 3016971 | vinCRIStine VIAL(ONCOVIN) 1MG/ML 2ML | 306.50 |
| 3022805 | vinCRIStine:VIAL(ONCOVIN) 1MG/ML 1ML | 171.70 |
| 3078409 | VINORELBINE INTRAVE SOLN 10MG/1ML 5ML | 313.20 |
| 3031084 | VISKEN (PINDOLOL) 10MG TAB | 2.00 |
| 3014612 | VISTARIL (hydrOXYzine) 50MG/ML 1ML | 29.40 |
| 3000934 | VISTARIL TAB(hydrOXYzine) 25MG | 2.00 |
| 303584 | VISTIDE (CIDOFOVIR) 375MG VIAL 5ML | 2,157.85 |
| 798073 | VITAMIN A (FREE RETINOL) | 62.00 |
| 3031855 | VITAMIN A 10,000 UNITS TAB | 2.00 |
| 790634 | VITAMIN B1 (THIAMIN) | 76.00 |
| 3030477 | VITAMIN B12 100 MCG TAB | 2.00 |
| 303331 | VITAMIN B12 500MCG TAB | 2.00 |
| 790881 | VITAMIN B3 (NIACIN) | 115.00 |
| 790926 | VITAMIN B6 (PYRIDOXAL 5-PHOSHATE) | 236.00 |
| 3028349 | VITAMIN B6 (PYRIDOXINE) 50MG TAB | 2.00 |
| 790882 | VITAMIN C (ASCORBIC ACID) | 119.00 |
| 303535 | VITAMIN D 1000 UNITS TAB | 2.00 |
| 3077891 | VITAMIN D3 5000 IU TAB | 3.00 |
| 790635 | VITAMIN E (ALPHA TOCOPHEROL) | 91.00 |
| 3014653 | VITAMIN E 400 UNITS CAP | 2.00 |
| 790986 | VITAMIN K | 249.00 |
| 3078464 | VITAMIN K ORAL 10MG/10ML (1MG/ML) | 105.79 |
| 1403067 | VITRECTOMY | 89.80 |
| 791225 | VMA (24HR URINE) | 122.00 |
| 790955 | VOLTAGE-GATED CALCIUM CHANNEL AB ASSAY | 60.00 |
| 303693 | VOLTAREN (DICLOFENAC NA) 1% GEL 100GM | 45.60 |
| 3020908 | VOLTAREN (DICLOFENAC NA) 50MG TAB | 2.00 |
| 791326 | VON WILLEBRAND FACTOR ACTIVITY | 232.00 |
| 790876 | VON WILLEBRAND FACTOR ANTIGEN | 129.00 |
| 791551 | VON WILLEBRAND FACTOR MULTIMER ANALYSIS | 158.00 |
| 3077924 | VORTEX CHAMBR W/CD MASK | 20.00 |
| 3014703 | VOSOL 15 ML OTIC SOLN | 25.00 |
| 3014687 | VOSOL HC 10ML OTIC SOLN | 89.20 |
| 791515 | VRE SURVEILLANCE | 115.00 |
| 1403778 | VULVECTOMY | 89.80 |
| 512423 | WATSON BLADES | 101.50 |
| 330541 | WBC | 34.00 |
| 16143 | WEDGING OF CAST (EX. CLUBFOOT CAST) | 214.00 |
| 170520 | WEDGING OF CAST (EX. CLUBFOOT CAST) | 294.00 |
| 303393 | WELCHOL (COLESEVELAM) 625MG TAB | 2.00 |
| 3030808 | WELLBUTRIN SR 150MG TAB | 2.00 |
| 3025659 | WELLBUTRIN (buPROPion) 75MG TAB | 2.00 |
| 3024629 | WELLBUTRIN SR (buPROPion) 100MG TAB | 2.00 |
| 3032587 | WELLBUTRIN XL (buPROPion) 150MG TAB | 2.00 |
| 331615 | WELLNESS CBC | 90.00 |
| 331622 | WELLNESS CHOLESTEROL SCREEN | 113.00 |
| 791002 | WELLNESS GLYCOSOLATED HGB (A1C) | 97.00 |
| 331633 | WELLNESS PSA | 163.00 |
| 331002 | WET MOUNT | 45.00 |
| 1403513 | WHIPPLE/PANCRETECTOM | 89.80 |
| 16612 | WINDOWING OF CAST | 36.40 |
| 93040 | WINDOWING OF CAST | 91.00 |
| 170519 | WINDOWING OF CAST | 198.00 |
| 511562 | WINGMAN STRYKER | 215.00 |
| 39481 | WORK HARDING,INT 2HR | 58.90 |
| 39334 | WOUND CARE/SELECTIVE >20CM | 193.80 |
| 514046 | WOUND DRES HYDROGEL/ TUBE COMFEEL | 71.00 |
| 500288 | WOUND IRRIGATION IRRIMAX | 126.00 |
| 517403 | WOUND PROTECTOR RETRACTOR OR ONLY | 178.00 |
| 514073 | WOUNDVAC CANISTER KIT | 151.00 |
| 514092 | WOUNDVAC DRESSING KIT LARGE | 171.00 |
| 514071 | WOUNDVAC DRESSING KIT MEDIUM | 196.00 |
| 514099 | WOUNDVAC DRESSING KIT SIZE SMALL | 156.00 |
| 514002 | WOUNDVAC GRANUFOAM LARGE DRESSING | 274.00 |
| 514004 | WOUNDVAC GRANUFOAM SMALL DRESSING | 49.00 |
| 514003 | WOUNDVAC GRANUFOAM XL DRESSING | 318.00 |
| 514006 | WOUNDVAC SENSATRAC PAD | 88.00 |
| 514001 | WOUNDVAC WHITE FOAM LARGE DRESSING KIT | 198.00 |
| 514005 | WOUNDVAC WHITE FOAM SMALL DRESSING KIT | 82.00 |
| 514078 | WOUNDVAC Y CONNECTORS | 44.00 |
| 137007 | WRIST FRACTURE CLOSED REDUCTION | 668.50 |
| 240415 | WRIST LEFT 2 VIEWS | 186.20 |
| 240423 | WRIST LEFT 3 VIEWS | 256.40 |
| 504913 | WRIST ORTHOFIX FIXATOR | 3,290.00 |
| 240516 | WRIST RIGHT 2 VIEWS | 186.20 |
| 240424 | WRIST RIGHT 3 VIEWS | 256.40 |
| 503307 | WRIST SPLINT COCKUP XSM L | 10.51 |
| 503323 | WRIST SPLINT COCKUP LG L | 11.20 |
| 503273 | WRIST SPLINT COCKUP LG R | 11.20 |
| 503661 | WRIST SPLINT COCKUP MED L | 16.90 |
| 503265 | WRIST SPLINT COCKUP MED R | 11.20 |
| 503315 | WRIST SPLINT COCKUP SM L | 17.10 |
| 503257 | WRIST SPLINT COCKUP SM R | 10.90 |
| 503331 | WRIST SPLINT COCKUP XLG L | 11.20 |
| 503281 | WRIST SPLINT COCKUP XLG R | 17.10 |
| 503240 | WRIST SPLINT COCKUP XSM R | 11.20 |
| 502457 | WRIST SPLINT LARGE LEFT | 13.00 |
| 502440 | WRIST SPLINT LARGE RIGHT | 21.20 |
| 502523 | WRIST SPLINT MED LEFT | 13.00 |
| 502432 | WRIST SPLINT MED RIGHT | 21.20 |
| 502416 | WRIST SPLINT SMALL LEFT | 21.20 |
| 502424 | WRIST SPLINT SMALL RIGHT | 13.00 |
| 502473 | WRIST SPLINT XLG LEFT | 21.20 |
| 502465 | WRIST SPLINT XLG RIGHT | 21.20 |
| 503190 | WRIST SPLINT XSM LEFT | 96.90 |
| 502408 | WRIST SPLINT XSM-RIGHT | 13.00 |
| 504907 | WRISTJACK SYSTEM | 4,050.00 |
| 303757 | XARELTO (RIVAROXABAN) 10MG TAB | 2.00 |
| 3032597 | XELODA (CAPECITABINE) 500MG TAB | 2.00 |
| 244016 | XENON 133 GAS (per 10mCi) | 294.90 |
| 303580 | XGEVA (DENOSUMAB) 120MG SDV | 5,863.20 |
| 3078130 | XIAFLEX INJ POWDER FOR SOLUTION 0.9MG | 8,855.90 |
| 307778 | XIFAXAN (RIFAXIMIN) 550MG TAB | 64.20 |
| 303558 | XOLAIR (OMALIZUMAB) 150MG VIAL | 2,178.60 |
| 3031039 | XOPENEX (LEVALBUTEROL) 0.63MG/3ML NEB | 2.00 |
| 3030917 | XOPENEX (LEVALBUTEROL) 1.25MG/3ML NEB | 2.00 |
| 303368 | XOPENEX (LEVALBUTEROL) HFA INH 15GM | 56.00 |
| 501913 | XPAK PROBE | 929.00 |
| 242059 | XRAY FEMALE GENITAL TRACT | 467.70 |
| 240138 | XRAY JAW JOINT | 303.20 |
| 241588 | XRAY PROCEDURE ROOM | 306.70 |
| 3018415 | XYLOCAINE (LIDOCAINE) W/EPI 1% 10ML INJ | 29.40 |
| 3018407 | XYLOCAINE (LIDOCAINE) W/EPI 2% 20ML | 41.30 |
| 3030965 | XYLOCAINE 1.5% W/EPI 5ML | 58.00 |
| 7925535 | XYLOCAINE 5% DEX 7.5 | 56.30 |
| 3025535 | XYLOCAINE(LIDOCAINE)1% 2ML VIAL | 29.40 |
| 3014844 | XYLOCAINE(LIDOCAINE)1% 50ML | 29.40 |
| 3015460 | XYLOCAINE(LIDOCAINE)1%:10ML INJ | 29.40 |
| 3015114 | XYLOCAINE(LIDOCAINE)2% 10ML | 29.40 |
| 3014851 | XYLOCAINE(LIDOCAINE)2% 50ML INJ | 29.40 |
| 3014869 | XYLOCAINE(LIDOCAINE)2% JELLY 30ML | 15.00 |
| 3020676 | XYLOCAINE(LIDOCAINE)2% UROJET 5ML | 10.00 |
| 3014901 | XYLOCAINE(LIDOCAINE)2% VISCOUS 15ML | 2.00 |
| 3018399 | XYLOCAINE(LIDOCAINE)W/EPI 1% 20ML | 29.40 |
| 3019512 | XYLOCAINE-MPF (LIDOCAINE) 0.5% 50ML INJ | 29.40 |
| 3031114 | XYLOCAINE-MPF (LIDOCAINE-MPF) 2% 5ML SDV | 29.40 |
| 3031116 | XYLOCAINE-MPF 2%/EPI 1:200K VIAL 10ML | 29.40 |
| 131100 | YAG LASER | 1,350.00 |
| 3077918 | YERvoy (IPILimuMAB) 200MG/40ML | 70,100.00 |
| 3077919 | YERvoy (IPILimuMAB) 50MG/10ML | 17,525.00 |
| 303737 | ZALTRAP (AFILBERCEPT) 200MG/8ML VIAL | 9,331.20 |
| 3031085 | ZANAFLEX (tiZANidine) 4MG TAB | 2.00 |
| 3016062 | ZANTAC (RANITIDINE) 150MG TAB | 2.00 |
| 3030960 | ZANTAC 150MG/10ML SYRUP UD | 2.00 |
| 3023177 | ZANTAC:INJ(RANITIDINE) 150MG | 85.80 |
| 3014968 | ZAROXOLYN (METOLAZONE) 2.5MG TAB | 2.00 |
| 578493 | ZCH FEMERAL STEM SMALL | 5,967.00 |
| 578494 | ZCH FEMRAL STEM MED | 5,967.00 |
| 3030204 | ZEBETA (BISOPROLOL) 5MG TAB | 2.00 |
| 3030821 | ZEMURON(ROCURONIUM) INJ 10MG/ML 10ML | 96.75 |
| 3031146 | ZETIA (EZETIMIBE) 10 MG TAB | 2.00 |
| 790066 | ZINC (SERUM) | 70.00 |
| 3030097 | ZINC 50MG TAB | 2.00 |
| 3015007 | ZINC OXIDE 60GM OINT | 10.00 |
| 3030725 | ZINECARD (DEXRAZOXANE) 250MG INJ | 628.40 |
| 3025238 | ZITHROMAX (AZITHROMYCIN) 250MG TAB | 2.00 |
| 303496 | ZITHROMAX (AZITHROMYCIN) 500MG ADVANTAGE | 48.00 |
| 3030824 | ZITHROMAX 500MG VIAL | 137.75 |
| 310143 | ZITHROMAX 500MG/ NS 250ML | 209.15 |
| 3029040 | ZITHROMAX(AZITHROMYCIN)200MG/5ML 22.5SUS | 20.00 |
| 3030893 | ZOCOR (SIMVASTATIN) 20MG TAB | 2.00 |
| 303729 | ZOCOR (SIMVASTATIN) 40MG TAB | 2.00 |
| 3030869 | ZOFRAN (ONDANSETRON ) 4MG VIAL | 71.85 |
| 303340 | ZOFRAN (ONDANSETRON) 2MG/2.5ML ORAL SOLN | 2.00 |
| 3025972 | ZOFRAN (ONDANSETRON) 4MG TAB | 2.00 |
| 3032077 | ZOFRAN (ONDANSETRON):1MG USE FOR CHEMO | 30.70 |
| 303455 | ZOFRAN ODT (ONDANSETRON) 4MG TABLET | 2.00 |
| 3024694 | ZOLOFT (SERTRALINE) 50MG TAB | 2.00 |
| 307769 | ZOLOFT (SERTRALINE) 50MG TAB H.H. | 2.00 |
| 3031049 | ZOMETA (ZOLEDRONIC ACID) 4MG | 657.75 |
| 3032574 | ZONEGRAN (ZONISAMIDE) 100MG CAP | 2.00 |
| 790745 | ZONISAMIDE | 174.00 |
| 3031194 | ZOSTRIX 0.1% CREAM 2oz | 25.00 |
| 3077838 | ZOSYN: (PIPERACILLIN/TAZOBACTAM) 4.5GM | 52.40 |
| 3030957 | ZOSYN: (PIPRACIL/TAZOBACTAM) 2.25GM | 26.20 |
| 3030923 | ZOSYN: (PIPRACIL/TAZOBACTAM) 3.375GM | 39.30 |
| 3017409 | ZOVIRAX (ACYCLOVIR) 15GM OINT | 371.30 |
| 3024850 | ZOVIRAX (ACYCLOVIR):500MG/10ML INJ | 69.30 |
| 303294 | zyPREXA (OLANZapine) 10MG INJ | 180.50 |
| 3030935 | zyPREXA (OLANZapine) 5MG TAB | 2.00 |
| 3030837 | zyrTEC 1MG/ML 15ML SYRUP | 2.00 |
| 3031148 | ZYVOX (LINEZOLID) 600MG TAB | 2.00 |
| 3032553 | ZYVOX (LINEZOLID) 600MG/300ML INJ | 502.60 |