1 ROOM & BOARD SEMI-PRIV 1,150.00 day 10 ROOM & …...270048 P ABDUCTION BLK MED 169.00 each 270049 P ABDUCTION BLK LG 183.00 each 270050 RECTAL TUBE 1.66 each 270051 RESTON FOAM 6.00

Item Number Item Description Price Unit

1 ROOM & BOARD SEMI-PRIV 1,150.00 day

10 ROOM & BOARD PVT 1,725.00 day

250001 PHARMACY 0.00 span 100% MARKUP

259001 DRUGS/OTHER 0.00 span 100% MARKUP

270001 FOLEY CATH TRAY STER, 16FR 3.20 each

270002 FCS 16/30 STERILE 3.00 each




270006 FCS 20/30 3.00 each

270007 FCS 20/5 3.00 each









270016 IRRIGATION TRAY STERILE 4.20 each

270017 URINARY DRAIN BAG STERILE 5.40 each

270018 COUDE CATH 20FR/5CC 19.60 each

270019 FACE MASK 10.00 each

270020 FOLEY CATH CLAMP 1.60 each

270021 FOLEY CATH STRAP 18.42 each

270022 FOLEY CATH PLUG 1.20 each

270023 FOLEY CATH TRAY, STER 18FR 19.60 each

270024 CATHETER TRAY 16FR/5CC 19.60 each

270025 HAND RESTRAINT 23.50 each

270026 HEELBO 61.66 each

270029 IRRIG SYRINGE 3.20 each

270030 CATHETER SUPPLIES 0.00 each 100% MARKUP

270031 HOYER LIFT CANVAS 96.00 each

270032 ENTERAL SUPPLIES 0.00 each 100% MARKUP

270033 IV SUPPLIES 1.49 each

270034 KARAYA PASTE 3.85 each

270035 KERLIX 4" STERILE 1.36 each

270037 KLING 3" STERI(CONFORMNG) 9.50 each

270038 LEVINE TUBE, 18FR 1.96 each

270039 LEG BAG 4.02 each

270040 LEVINE TUBE, 14FR 1.96 each

270041 LEVINE TUBE 16FR 1.96 each

270042 LEVINE TUBE 12FR 1.96 each

270043 NASAL CANNULA 0.84 each

270044 OXYGEN MASK 0.84 each

270045 P FOOT POS BLK 46.25 each

270046 P PAT SUPPORT STRAP 21.50 each

270047 P ABDUCTION BLK SM 153.00 each

270048 P ABDUCTION BLK MED 169.00 each

270049 P ABDUCTION BLK LG 183.00 each

270050 RECTAL TUBE 1.66 each

270051 RESTON FOAM 6.00 each

270052 SAFETY VEST 37.50 each

270053 SURGI PAD, ABD 2X2 5.00 each

270056 STERI PAD 1.56 each

270057 GAUZE PAD 2X2 5.00 each

270059 GAUZE 4 X4 STERILE 8 PLY 8.50 each

270060 STOMA 8X8 (BOX) 32.00 each

270061 SURGI PAD, ABD 5X9 0.70 each

270062 SUR-FIT FLANGE 1-1/2 46.00 each


270064 TRACH CAREKIT 46.00 each


270066 SUR-FIT BAG 30 1-1/2 40.00 each

270067 SUR-FIT BAG 30 1-3/4 40.00 each

270068 SUR-FIT BAG 30 2-1/4 40.00 each

270069 SUR-FIT BAG 30 2-3/4 40.00 each

270070 SUR-FIT BELT 9.00 each

270071 SUR-FIT UROST BAG 1-1/4 40.00 each

270072 SUTURE REMOVAL KIT STERIL 1.12 each

270073 SYR 10 CC STERILE 0.70 each




270077 SYR INSULIN #7 0.48 each

270078 GLUCOSE STRIP/LANCET 0.72 each

270079 TELFA PAD (NON-ADHERE) 11.80 each

270080 TEXAS CATH 25MM 3.16 each

270081 TEXAS CATH 29MM 3.16 each

270084 TRACH CARE KIT 0.70 each

270085 URETHAL CATH TRAY STERILE 3.06 each

270087 SYR 3 CC NO NEEDLE 0.90 each

270090 WRIST RESTRAINT 11.00 each

270091 WOUND MANAG KIT STERILE 11.50 each

270092 SUR-FIT FLANGE CAP 15.00 each

270093 SKIN BARRIER CREAM 0.00 each 100% MARKUP

270094 SUCTION CATHETER 1.88 each

270095 BODY ALIGN ROLL 0.00 each 100% MARKUP

270096 LEG POSITIONER 5.00 each

270097 ARM POSITIONER 66.00 each

270098 LIMB ALIGN ROLL 5.00 each

270099 BODY CONTROL RESTRAINT 17.50 each

270100 POSITION ROLL 22.00 each

270101 O2 DAILY 7.00 each

270102 OXYGEN TRANSPORT 15.00 each

270103 AEROSOL MASK 0.10 each

270104 AEROSOL TUBING 1.08 each

270105 NEBULIZER, MASK/MOUTH 2.10 each

270106 SIDE ARM NEB SET 2.60 each

270107 HUMIDIFIER, PREFILLED, O2 4.40 each

270108 TRACH MASK 2.24 each

270109 DISPOSABLE OXYGEN JAR 6.00 each

270110 COMPRESSOR MASK 31.66 each

270111 MISC RESP SUPPLIES 0.00 each 100% MARKUP

270112 ASPIRATING TUBE STERILE 6.00 each

270113 VENTI MASK 4.50 each

270114 YANKAUER SUCT STERILE 1.24 each

270115 AIRWAY, ORAL 100mm 0.50 each

270116 NON-REBREATHER MASK 3.04 each

270117 RESPIRATORY DRAIN BAG 2.45 each

270118 SUCTION CANISTER 1200 CC 27.50 each

270119 JET NEBULIZER 4.00 each

270120 INCENTIVE SPIROMETER 20.00 each

270121 WEIGHTED CUP 14.60 each

270122 POSEY LATERAL STABILIZER 54.00 each

270123 FOAM POSITION WEDGE W/COV 40.00 each

270124 BUMPER BED RAIL 38.00 each

270125 WHEELCHAIR PAD W/COVER 52.00 each

270126 POSEY PALM CONE 40.00 each

270127 GEL CUSHION 53.00 each

270128 W/C VELCRO BELT 60' 20.00 each

270129 W/C VELCRO BELT 72" 25.90 each

270130 SHEEPSKIN HEEL PROTECTOR 9.00 each

270131 SOFT BELT 20.00 each

270132 SOFT BELT BUCKLE 20.00 each

270133 AIRWAY, 60mm 1.16 each



270136 SILVER NITRATE 0.25 each

270140 QUICK RELEASE BELT 19.50 each

270141 OVERLAP W/C BELT 17.00 each

270142 IRIS MATTRESS W/COVER 53.50 each

270143 DRAINAGE BAG HOLDER 14.00 each

270144 FOOT BLOCK 48.50 each

270145 GAIT BELT 13.98 each

270146 BUNNY BOOTS 50.40 each

270147 CATHETER, MALE EXTERNAL M 4.00 each

270148 CATHETER, MALE EXTERNAL L 4.00 each

270149 KLING 4" STERI(CONFORMNG) 4.20 each

270150 GAUZE PAD 3X3 1.36 each

270152 STERI-STRIP 72.00 each

270154 STERI STRIP 1/2 X 4" 3.08 each

270156 JELLY, LUBRICATING 3GM 0.50 each

270166 HEEL PROTECTOR FOAM 22.76 each

270175 SYRINGE 60 CC STERILE 3.28 each

270177 POSEY GRIP 41.90 each

270178 MITTENS, SOFT PALM 33.74 each

270179 WHEELCHAIR PADDED BELT 47.90 each

270180 LOPEZ VALVE 4.80 each

270181 KNEE POSTITION SPLINT 43.50 each

270182 CARVE-IT CENTER ATTACH 38.34 each

270183 KNEE SEPARATOR-VINYL COVR 39.98 each

270184 HEAD REST 45.00 each

270185 BACK REST-RECLINE W/CHAIR 269.00 each

270189 WHEELCHAIR BODY WRAP 14.50 each

270199 MISC OTHER SUPPLIES 0.00 each 100% MARKUP

270200 SPECIAL SUPPLIES 0.00 each 100% MARKUP

270201 OTC DRESSING 0.00 each 100% MARKUP

270202 TRAPEZE RENTAL 80.00 each

270203 AIR MATTRESS / PUMP 25.00 each

270204 SUCTION MACHINE RENTAL 10.00 each

270205 K-PAD & PUMP RENTAL 15.00 each

270206 LAPIDUS MATTRESS 25.00 each

270207 A-RENTAL 8.25 day

270208 AIR COMPRESSOR RENTAL 38.00 each

270209 HEATED AERO W/COMPRESSOR 42.00 each

270210 HEATED AERO W/SIDEARM NEB 42.00 each

270211 IPPB SET UP 17.00 mo

270212 IPPB CIRCUITS 4.00 each

270213 WATER MATTRESS RENTAL 25.00 each

270214 AMBU BAG 38.00 each

270215 BED CRADLE 42.50 each

270216 OXYGEN CONCENTRATOR 100.00 each

270217 NEBULIZER 10.00 each

270218 PULMO-AIDE 0.00 each 100% MARKUP

270219 MED EQUIP/RENTAL 0.00 each 100% MARKUP

270220 LYMPY PUMP / FOOT 70.00 each

270221 LYMPY PUMP / ARM 180.00 each

270222 TRACTION EVAL 550.00 each

270223 TRACTION THERAPY 600.00 each

270225 GEL HYPER GEL 15GM 11.00 each

270232 DUEODERM EXTRA THIN 27.40 each

270233 TRIPLE CARE E P C OINTMNT 0.48 each

270234 MESALT KIT 2.94 each

270235 DRAIN SPONGE 4X4 22.00 each

270236 PETRO-GAUZE DRSSG 4X4 2.40 each

270237 VASELINE GAUZE DRSSG 3X9 1.50 each

270238 PERSONAL CLEANSER (PERI) 1.50 each

270239 ZINC OXIDE OINTMENT 2.30 each

270240 POLYMER ISLAND DRSG 2X3 3.80 each

270241 TEGSORB HYDROCOLL 2X3 3.80 each

270242 TEGADERM 4X4 13.00 each

270243 COVERDERM 4X4 107.00 each

270244 STERILE SCALPEL 1.98 each

270247 Y-PORT CONNECTOR 9.78 each

270251 NORMAL SALINE .9% 100ml 0.50 each

270252 TEGADERM + PAD 1.00 each

270260 LOW AIR MATTRESS 40.00 each

270261 MICRO MINI EVAL 250.00 each

270264 TUBING, CORRIGATED COIL 2.80 each

270265 CVP DRESSING CHANGE KIT 11.92 each

270270 DEBRIDEMENT KIT 16.20 each

270278 SLIDE GUARD WEDGE 178.00 each

270299 MISC THERAPY SUPPLIES 0.00 each 100% MARKUP

270301 CARD HOLDER 7.00 each

270302 HAND HELPER EXERCISE AIDE 11.00 each

270303 LAP BOARD 15.00 each

270304 MAPLE PARING 16.00 each

270305 REACHERS 22.50 each

270306 ROLLER KNIFE 3.00 day

270307 1/2 AIR SPLINT 9.25 each

270308 DRESSING STICK 5.56 each

270309 ELEVATED SPONGE ARM REST 26.00 each

270310 FOAM ELEVATED ARM INSERTS 15.00 each

270311 FULL AIR SPLINT 11.50 each

270313 QUICK CLIP SPEED CUTTER 11.00 each

270314 ROCKER KNIFE 8.00 each

270315 SHOE HORN 6" PLASTIC 3.00 each

270317 SOCK AIDE 12.60 each

270318 SUSPENSION HEMI-SLING 19.00 each

270319 UTENSIL SET 16.00 each

270320 VINYL WHEELCHAIR CUSHION 10.00 each

270321 WALKER BAG 21.00 each

270322 WALKER BASKET 16.00 each

270323 WHEELCHAIR BAG 60.00 each

270324 ZIM JAR OPENER 10.00 each

270325 THERAPUTTY 3.50 each

270326 TED HOSE, KNEE HI, SM 7.24 each

270327 DISPOSABLE AMBU BAGS 31.32 each

270328 MONTGOMERY STRAP 2.50 each

270329 TED HOSE, THIGH HI SM 7.26 each

270330 TED HOSE, KNEE HI MED 7.26 each

270331 TED HOSE, KNEE HI LG 7.26 each

270332 TED HOSE, KNEE HI XL 7.26 each

270333 TED HOSE, THIGH HI MED 12.52 each

270334 TED HOSE, THIGH HI LG 12.52 each

270335 TED HOSE, THIGH HI XL 12.52 each

270336 WHEELCHAR CUSHION, STANDARD 62.46 each

270340 WRIST BRACE 33.00 each

270341 ELASTIC SHOELACES 13.00 each

270342 ABDOMINAL SUPPORT 27.50 each

270343 STUMP SHRINKER 67.50 each

270344 MULTI PODUS BOOT 95.36 each

270345 DARCO SHOES 24.20 each

270346 ARM SLEEVE 26.70 each

270347 SCD LEG COMPRESSOR 9.00 each

270401 ACE BANDAGE 2" 5.20 each




270406 ARM SLING 14.50 each

270410 EXTENSION TUBING 2.00 each

270411 GASTRO TUBE, 18FR 100.00 each

270412 GASTRO TUBE, 14FR 100.00 each

270413 EGG CRATE MATTRESS 38.75 each

270414 EGG CRATE PAD 18.50 each

270418 EYE PADS #3 0.40 each

270423 GEO MATTRESS 81.50 each

270424 GEO CUSHION 39.50 each

270430 IRRIGATION SET OVERHEAD 12.50 each

270431 ISOLATION GOWNS #10 24.00 each

270432 ISOLATION TRAY 0.40 each

270433 OINTMENT A&B 1.24 each

270501 BODY WEDGE 45.50 each

270503 SUCTION CATH 12FR 1.12 each

270505 SKIN STAPLE REMOVER STERI 14.50 each

270506 BITE (JAW LOCK) 0.40 each

270507 SYR 20CC W/O NEEDLE 1.00 each

270508 SUCTION & CUP KIT STERILE 1.60 each

270509 ELBOW PADS 13.90 each

270510 FORCEPS 1.75 each

270512 INCISION DRAIN TRAY STERI 14.00 each

270516 K-Y JELLY 3.36 each

270520 HEATING PAD (KPAD) 31.24 each

270600 URINARY BAG (MED) 15.98 each

270610 HEAT AERO W / SIDEARM NEB 0.00 each 100% MARKUP

270611 IPPB MACHINE RENTAL 0.00 each 100% MARKUP

270612 IPB CIRCUITS 0.00 each 100% MARKUP

270613 WATER MATTRESS RENTAL. 0.00 each 100% MARKUP

270661 PERIPHERAL IV ACCESS KIT 23.00 each

270662 PORT ACCESS PAK 22G X 3/4 10.50 each

270663 PORT ACCESS PAK 20G X 3/4 10.50 each

270664 CENTRAL LINE/PICO PAK 24.00 each

270665 GRAVITY DELIV PAK 3 DOSE 11.25 each

270666 SA PUMP PAK .22 FILT 3/DS 8.25 each

270667 SECONDARY DELIV PAK 10.76 each

270668 SA PUMP PAK 1/2 FILT 8.25 each

270669 IV START KIT 4.50 each

270670 CLAVE CONNECTOR EXT SET 5.80 each

270671 IV CATHETER NEEDLE 22GAX1 4.58 each

270672 IV CATH NEEDLE 24GA X.75 4.58 each

270673 IV CATH NEEDLE 18GA 4.58 each

270674 IV CATH NEEDLE 20GA 4.58 each

270675 ISOTONER GLOVE SMALL RIGHT 15.72 each

270676 ISOTONER GLOVE SMALL LEFT 15.72 each

270677 ISOTONER GLOVE MEDI RIGHT 15.72 each

270678 ISOTONER GLOVE MEDI LEFT 15.72 each

270679 ISOTONER GLOVE LARGE RIGHT 15.72 each

270680 ISOTONER GLOVE LARGE LEFT 15.72 each

270681 LEG LIFTER 16.00 each

270682 ELECTRODES 2" ROUND 9.42 each

270683 ELECTRODES 2 X 3 9.42 each

270684 ELECTRODES SMALL 9.42 each

270685 ANKLE FOOT ORTHOSIS SM RIGHT 50.76 each

270686 ANKLE FOOT ORTHOSIS SM LEFT 50.76 each

270687 ANKLE FOOT ORTHOSIS MED RIGHT 50.76 each

270688 ANKLE FOOT ORTHOSIS MED LEFT 50.76 each

270689 ANKLE FOOT ORTHOSIS LARGE RIGHT 50.76 each

270690 ANKLE FOOT ORTHOSIS LARGE LEFT 50.76 each

270691 ACRO COMFORT SHOULDER SUPPORT SMALL 136.00 each

270692 ACRO COMFORT SHOULDER SUPPORT MEDIUM 136.00 each

270693 ACRO COMFORT SHOULDER SUPPORT LARGE 136.00 each

270694 LUMBAR SACRAL SUPPORT 27.50 each

270695 ARM SLING W/PAD 11.58 each

270696 SHOE LACES 1.98 each

270697 HIP REPLACEMENT KIT 43.50 each

270698 HIP REPLACEMENT KIT COMPLETE 32" 43.50 each

270699 CERVICAL COLLAR SOFT - UNIVERSE 26.52 each

270700 REACHER 32" 21.90 each

270701 ENTERAL FEEDING 0.00 each 100% MARKUP

270702 DARCO SHOES MALE - LARGE 19.80 each

270703 DARCO SHOES MALE - SMALL 19.80 each

270704 DARCO SHOES MALE - XL 19.80 each

270705 DARCO SHOES WOMAN - LARGE 19.80 each

270706 DARCO SHOES WOMAN - MEDIUM 19.80 each

270707 DARCO SHOES WOMAN - SMALL 19.80 each

270708 DARCO SHOES WOMAN - XL 19.80 each

270709 ACRO COMFORT SHOULD XL 136.00 each

270710 LYNX WHFO LARGE RIGHT 91.00 each

270711 LYNX WHFO LARGE LEFT 91.00 each

270712 LYNX WHFO MEDIUM RIGHT 91.00 each

270713 LYNX WHFO MEDIUM LEFT 91.00 each

270714 LYNX WHFO SMALL RIGHT 91.00 each

270715 LYNX WHFO SMALL LEFT 91.00 each

270716 WHEELCHAIR GLOVE LARGE 15.98 each

270717 WHEELCHAIR GLOVE XL 15.98 each

270718 TOILET AID 53.90 each

270719 SAFETY BELT LARGE (GAIT BELT) 15.92 each

270771 GLUCERNA Q 15.92 each

270772 Disposable cannula LPC 6 DCT 120.00 each

270773 Disposable cannula LPC 8 DCT 120.00 each

270776 ARTIFICIAL TEARS-SINGLE USE 16.38 each

270780 BASIC LIFE SUPPORT 0.00 each 100% MARKUP

270800 WIPE BARR NOSTING CAVILON 1.08 each

270801 CLEAR ACRL DRSG 3" X 3.75" 5.62 each

270802 DRSG TEGADERM ACRYL 4.4" X 5 8.88 each

270803 TEGADERM FM DRSG ADH 4 X 4.5" 10.00 each

270804 TEGADERM FM DRSG ADH 5/8X61/8 12.00 each

270805 TEGADERM FM DRSG 51/2X51/2" 12.00 each

270806 TEGADERM FM DRSG NADH 4X4 8.00 each

270807 TEGADERM HG ALG DRSG 4X4 6.60 each

270808 TEGADERM HG ALG DRSG ROPE 8.30 each

270809 GEL HYDROGEL 15GM TUBE 7.16 each

270810 TEGADERM DRSG THN 2.75 X 3.5 5.08 each

270811 TEGADERM DRSG SACL 4.9 X 5.5 18.32 each

270812 CREAM DURABLE BARR 3.25OZ 9.76 each

270813 TEGADERM AG DRSG 4X5 15.40 each

270818 DECLOGGER 20-22 FR 18.30 each



270821 XEROFORM DRESSING 2.28 each

270822 CALCIUM ALGINATE DRESSING 4X4 6.56 each

270823 PRISMA WOUND DRESSING 34.08 each

270824 DENTURE ADHESIVE CREAM 6.04 each

270825 HEMOCCULT SLIDES & DEVELOPER 1.68 each

270826 HUMIDIFIER BOTTLE DISPOSAL 3.50 each

270827 IV TPN/NON DEHP SOLUTION SET 14.72 each

270828 IV TUBING 1 PORT 9.58 each

270829 IV TUBING 3 PORT 14.50 each

270830 IV EXTENSION SET 8.98 each

270831 IV VIAL ADAPTER LUER ACTIVATED 7.28 each

270832 ISOLATION SLING 68.00 each

270833 DRAINABLE POUCH 46.00 each

270834 PROTINEX 100 38.18 each

270835 PROTINEX WC 63.06 each

270836 ISOSOURCE 1.5 1500ML RTH 5.82 each

270837 DIABETISOURCE AC 1500ML RTH 13.08 each

270838 NUTREN PULMR RTH 6.00 each

270839 DISPOSABLE BLOOD PRESS CUFF 40.00 each

270840 CPAP TUBING 50.00 day

270841 FACE MASK -SMALL 270.00 day

270842 FACE MASK -LARGE 370.00 day

270843 BED EXTENDER ADJUSTABLE 300.00 each

270844 ANTI FUNGAL CREAM W/MOISTURIZER BAZA 27.00 each

270845 ANTI FUNGAL CREAM (PLAIN) 7.00 each

270846 NUTRISHIELD CREAM 11.00 each

270847 FREEDOM SPLINT 51.04 each

270848 STOCKING 3X KNEE HIGH 14.16 each

270849 STOCKING 2X KNEE HIGH 14.16 each

270850 DONUTS CUSHION 28.60 each

270851 EDEMA GLOVES 14.44 each

270852 LONG GLOVES 23.30 each

270853 LATERAL BOLSTER 165.30 each

270854 MUELLER KNEE BRACE S-M 66.60 each

270855 MUELLER KNEE BRACE L-XL 66.60 each

270856 CVA SLING S-M 38.30 each

270857 CVA SLING L-XL 38.30 each

270858 REDDI KNEE BRACE S/M/L/XL/XXL/3XL 98.90 each

270859 HAND SPLINT S/M/L 17.40 each

270860 AIRSPLINT ANKLE 47.50 each

270861 GAUZE 5X9 BX25 8.10 each

270862 AQUAGUARD MOISTURE BARRIER 364.00 each

270863 PNEUMATIC SLEEVES/DVT GARMENT 39.00 each

270864 HEP LOCK/SMALLBORE EXT SET 696.34 each

270865 BLOOD COLLECTION SET 217.60 each

270866 BLOOD PRESSURE CUFF 190.00 each

270867 ULTRASOUND GEL 37.26 each

270868 PROTEIN SUPPLEMENT 182.40 each

270869 COLOSTOMY BAGS/DRAINAGE POUCHES 33.72 each

270870 POMMEL WEDGE CUSHION 150.00 each

270871 LARYNGEAL MIRROR 14.98 each

270872 LARYNGEAL HEXAGON HANDLE 14.98 each

270878 GAUZE <=16 in no w/sal w/o b 4.74 each

270879 ALGINATE DRESSING <=16 sq in 16.38 each

270881 TRANSPARENT FILM <= 16 sq in 3.42 each

270885 IMPREG GAUZE no h20/sal/yard 4.28 each

270886 CONFORM BAND n/s w<3 0.36 each

270887 TAPE, ALL TYPES, PER 18 SQ IN 0.24 each

270888 ABSORPT DRG >16 <=48 w/o bdr 7.26 each

270891 ADHESIVE REMOVER WIPES ANY PER 50 23.78 each

270897 GAUZE, ALL TYPES, PER LINEAR YD 0.66 each

270900 COMPRESSION STOCKING (knee high) 96.32 each

270901 COMPRESSION STOCKING (thigh high) 114.66 each

270902 COLLAGEN DRESSING, 16 SQ IN OR LESS 47.32 each

270903 SKIN SEALANTS, ANY TYPE/SIZE 0.00 each 100% MARKUP

270904 FOLEY CATH INSERTION TRAY 26.89 each

270905 GLUCOMETER TEST STRIPS 40.75 each

270906 MEDFIX RETENSION TAPE 7.50 each

270907 ABD PADS 5X9 0.80 each

270908 FOLEY 16FR 10ML 3.00 each




270912 UTI-STAT 43.43 each

270914 ZINC PASTE IMP BDG >=3<5 YR 2.86 each

270919 ASPIRA BAG DRAINAGE 1000ML 188.02 each

270920 ASPIRA DRESSING KIT 79.38 each

272001 STERILE SUPPLIES 0.00 each 100% MARKUP

272003 DRAPE SHEET - STERILE 0.00 each 100% MARKUP

291003 AIR MATTRESS / PUMP RENTAL 0.00 each 100% MARKUP

291004 RENTAL SUCTION MACHINE 75.00 each

291005 K-PAD RENTAL 0.00 each 100% MARKUP

291006 LAPIDUS MATTRESS RENTAL 0.00 each 100% MARKUP

291007 A RENTAL FEEDING PUMP 0.00 each 100% MARKUP

291009 HEATED AERON W/COMPRESSOR 0.00 each 100% MARKUP

291010 HEAT AERO W/SIDE ARM NEB 0.00 each 100% MARKUP

291014 AMBU BAG - RENTAL 0.00 each 100% MARKUP

291016 RENTAL - CONCENTRATOR 100.00 each

291017 RENTAL - NEBULIZER 50.00 each

291018 PULMO-AIDE RENTAL 0.00 each 100% MARKUP

291019 CPAP RENTAL (DAILY) 30.00 day

291020 BI-PAP RENTAL (DAILY) 39.00 day

291021 HUMIDIFIER - HEATED (DAILY) 5.00 day

300001 LABORATORY 0.00 each 100% MARKUP

300002 ABSCESS CULTURE 87070 44.00 each

300003 ABSCESS C&S/SUSCEPT 87070 44.00 each

300004 AEROBIC C&S 87070 105.00 each

300005 AEROBIC C&S FOR ID 87075 29.00 each

300007 ALBUMIN SERUM QUAN 82040 126.00 each

300008 ALBUMIN URINE QUAN 82042 126.00 each

300009 ALK PHOSPHATASE 84075 8.00 each

300010 ALK PHOSPHATASE ISO 84078 42.50 each

300011 AMIKACIN 80150 43.22 each

300012 AMINO ACD SCREEN PL 82128 57.50 each

300013 AMINO ACD SCREEN UR 82128 65.50 each

300014 AMINOPHYLLINE 80198 40.50 each

300015 AMITRIPTYLINE 80152 49.00 each

300016 AMMONIA; BLOOD 82140 44.00 each

300017 AMYLASE 82150 24.00 each

300018 ANA 86038 31.00 each

300019 ANAEROBIC CULTURE 87045 105.00 each

300020 ANAEROBIC C&S 87045 37.00 each

300021 ANEMIA GEN PROFILE 80.00 each

300022 ASO TITER 86060 23.00 each

300023 ARTHRITIS PROFILE 1 35.00 each



300026 ASCORBIC ACID 82180 45.50 each

300027 ASPIRATE CULTURE 87070 44.00 each

300028 ASPIRATE C&S 87070 44.00 each

300029 ASPIRIN-SALICYLATE 80196 19.50 each

300030 AUSTRALIA ANTIGEN 28.50 each

300031 ACID PHOSPHATASE 84060 14.00 each

300032 ACETONE QUALITATIVE 82009 11.00 each

300033 ACID FAST CULTURE 87116 44.00 each

300034 ALPHA I FETOPRO SER 82105 48.08 each

300035 ANTICONVULSANT #2 54.00 each

300036 ANTI-DNA AB/DOUBLE 86225 40.50 each

300037 ANTI-CONVULSANT PROF #2 54.00 each

300038 GRAM NEG UR MIC GN05 24.14 each

300039 ALCOHOL (ETHYL) 82055 40.00 each

300040 ANTI-HCV 86317 208.00 each

300041 B 12 VITAMIN 82607 126.00 each

300042 B-12 VIT/FOLIC ACID 72.00 each

300043 BACTERICIDAL LEVEL 87197 61.00 each

300044 BARBITURATE QUAL/UR 80101 18.00 each

300045 BARBITURATE QUAN/SR 82205 46.00 each

300046 BENADRYL 80299 56.00 each

300047 BENCE JONES PROTEIN 86325 80.50 each

300048 BILIRUBIN - AMNIOTIC 82143 26.50 each

300049 BILIRUBIN TOTAL 82247 10.00 each

300050 BILIRUBIN TOT/DIR 82248 13.00 each

300051 BILIRUBIN URINE 7.00 each

300052 BLEEDING TIME 85002 12.50 each

300053 BLOOD CULTURE A&A 87040 101.00 each

300054 BLOOD CLT/ANAEROBIC 87040 35.00 each

300055 BUN SERUM 84520 60.00 each

300056 BUN URINE 84540 17.00 each

300057 BUTAZOLIDIN 80299 69.50 each

300058 BACTERIA SUSCEPTIBILITY 87077 40.00 each

300059 BLOOD SMEAR 85060 15.00 each

300061 CARBOXYHEMOGLOBIN 82375 41.50 each

300066 CA 125 64.00 each

300067 CAROTENE 30.00 each

300069 C-REACTIVE PROTEIN 86140 75.00 each

300070 COMPLEMENT C1Q COMP 86160 60.00 each

300072 COMPLEMENT C2 COMPO 86160 70.50 each



300075 CALCIUM, IONIZED 82310 57.00 each

300077 CARBON DIOXIDE CONT 82374 11.00 each

300078 CARBAMAZEPINE 40.68 each

300079 CATHETER(IV) C&S 87070 90.00 each

300080 CBC WITH DIFF 85025 72.00 each

300081 CBC WITHOUT DIFF 85027 72.00 each

300082 CEA 82378 201.00 each

300083 CHOLESTEROL EST/TOT 82465 38.00 each

300084 CHOLESTEROL,HDL 83718 24.00 each

300085 CHOLESTEROL, TOTAL 82465 11.00 each

300086 COAGULATION DX PROF 85999 42.50 each

300087 COAGULATION TIME 85345 12.00 each

300088 COLLAGEN DX PROFILE 82523 76.50 each

300090 COMPLEMENT TOTAL 86162 80.50 each

300091 COMP DRUG ANALYSIS 80102 160.00 each

300092 COOMBS DIRECT 86880 12.00 each

300093 COOMBS INDIRECT 86885 13.00 each

300094 CORON RISK PROF 1 141.00 each

300095 CORON RISK PROF II 62.00 each

300096 CPK ISOENZYMES 82552 153.00 each

300097 CPK 82550 45.00 each

300099 CREATINE SERUM 82540 51.00 each

300100 CREATINE URINE 82540 21.50 each

300101 CREATININE 82565 51.00 each

300102 CORTISOL SERUM 82533 50.00 each

300103 CLOSTRIDIUM DIFF 87803 130.00 each

300104 CHOLYGLYCINE (BILE) 82240 61.50 each

300105 COUMADIN LEVEL 80299 70.50 each

300106 CALCIUM, SERUM/URINE 82310 13.00 each

300107 CHLORIDE, BLOOD 82435 11.00 each

300108 CRYSTALS, SYN FLUID 89060 10.00 each

300109 CBC & PLATELET CNT 85025 17.00 each

300110 CLOSTRIDIUM DIFF TX 87803 130.00 each

300113 DARVON 80299 18.00 each

300114 DATRIL 82003 57.50 each

300115 DEMEROL 83799 73.50 each

300116 DIAZEPAM SERUM 80154 46.00 each

300117 DIGITOXIN 40.50 each

300118 DIGOXIN 80162 138.00 each

300119 DILANTIN 138.00 each

300120 DISOPYRAMIDE 80299 53.00 each

300121 DESYREL 80299 89.00 each

300122 DRUG ANALYSIS COMP 80102 213.00 each

300131 EAR CULTURE 87070 21.50 each

300132 EAR C&S 87070 21.50 each

300133 EB VIRUS ANTIBODIES 86663 106.00 each

300134 ELECTROLYTES 80051 81.00 each

300135 ELECTROPHORESIS HGB 83020 44.00 each

300136 ELECTROPHORESIS SER 84165 26.50 each

300137 ELECTROPHORESIS UR 84165 53.00 each

300138 ENVIRONMENTAL CULT 22.50 each

300139 EOSINOPHIL CT, BLOOD 89190 12.00 each

300140 ERTHROCYTE SED RATE 85651 57.00 each

300142 ESTROGEN FRACT SER 82671 211.50 each

300143 ESTROGEN FRACT UR 82671 201.50 each

300144 ESTROGEN, TOTAL SER 82672 92.00 each

300145 ETHANOL 82055 40.50 each

300146 ENA 76.50 each

300147 EYE CULTURE 87070 21.50 each

300148 EYE C&S 87070 21.50 each

300160 FATTY ACIDS, FREE 82725 54.00 each

300161 FECES CULTURE 87046 31.00 each

300162 FECES C&S 87046 34.50 each

300163 FECES, OCCULT BLOOD 82270 40.00 each

300164 FECES, ROUTINE EXAM 35.50 each

300165 FOLIC ACID, RBC 82747 84.50 each

300166 FOLIC ACID, SERUM 82746 120.00 each

300167 FSH & LH 80426 99.50 each

300169 FSH SERUM 83001 58.00 each

300170 FUNGUS CULTURE 87101 30.00 each

300171 FUNGUS ORG ID 87106 52.50 each

300173 FERRITIN 82728 159.00 each

300176 FIBRINOGEN 85384 28.00 each

300183 GALACTOSE, QUANT 82760 114.50 each

300184 GAMMA GLOBULIN 82784 20.00 each

300185 GERAMYCIN 80170 49.00 each

300186 GLUCOSE 82947 57.00 each

300187 GLYCOSYLATED HGBA1 83036 13.00 each

300188 GRAM STAIN 87205 51.00 each

300189 GUAIAC 82270 10.00 each

300190 BLOOD GLUCOSE MONITORING 6.64 each

300191 GGTP 82977 24.00 each

300192 GENTAMICIN 80170 147.00 each

300193 GLUCOSE - 6 HRS 95250 295.00 each

300194 GENITAL C&S 87070 21.50 each

300195 GLYCO HEMOGLOBIN 171.00 each

300199 HEMOSIDERIN 83070 24.00 each

300200 HEMOGRAM 85014 72.00 each

300201 HALDOL 80173 90.50 each

300202 HEMATOCRIT 85014 50.00 each

300203 HCT & HGB 80414 8.50 each

300204 HAEMOPHILUS INFLUEN 86684 62.50 each

300205 HEP-B SURFACE ANTIG 87340 28.50 each

300206 HEP-B/E ANTIGEN 87350 41.00 each

300207 HEP-A ANTIBODY 86708 144.00 each

300208 HEP-A ANTIBODY IGM 86709 37.00 each

300209 HEPATITIS DX PROF I 80074 133.50 each

300210 HERPES SIMPLEX ISO 61.00 each

300211 HERPES I OR II 57.00 each

300212 HERPES I/II A.C.T. 112.50 each

300217 HERPES ZOSTER VIRUS 63.00 each

300218 HLA-B 8 86812 80.50 each

300219 HLA-B 27 86812 80.50 each

300220 HYPERTENSION SC/PRO 25.50 each

300221 HYPERTHYROID PROF 51.50 each

300222 HYPOTHYROID PROFILE 63.50 each

300223 HAPTOGLOBIN 83010 147.00 each

300224 HEP-B SURF ANTIBODY 86706 28.50 each

300225 HIV ANTIBODIES SCREEN 141.00 each

300226 HEMOGLOBIN 85018 36.00 each

300227 HCG, QUANTITATIVE 84702 46.00 each

300228 HEART DISEASE PROF 30.00 each

300230 HCG BETA 70.00 each

300235 IMMUNE COMPLEX C1Q 86332 76.50 each

300236 IMMUNE COMPLEX RCA 86332 112.00 each

300237 IMMUNOELECT SERUM 86320 80.50 each

300238 IMMUNOELECT URINE 86325 80.50 each

300239 IMMUNOGLOBULIN A 82784 37.50 each

300240 IMMUNOGLOBULIN D 82784 49.50 each

300241 IMMUNOGLOBULIN E 82785 50.00 each

300242 IMMUNOGLOB. G SERUM 82784 37.50 each

300243 IMMUNOGLOBULIN M 82784 37.50 each

300244 IMMUNOGLOBULIN QUAN 65.50 each

300245 INDERAL 80299 51.00 each

300246 INFECTIOUS MONO 86663 12.00 each

300247 INFLUENZA A/B PROF 84.50 each

300248 INSULIN 83525 35.50 each

300249 IRON/IRON BIND CAP 83550 28.00 each

300250 IRON BINDING CAP 83550 120.00 each

300251 IRON SERUM 83540 51.00 each

300252 IRON URINE 83540 113.50 each

300253 ISOENZYMES 42.50 each

300254 IMIPRAMINE SERUM 80174 72.50 each

300255 INTRINSIC FACTOR AB 43.00 each

300260 JOINT FLUID C&S 89060 44.00 each

300261 K O H PREP 16.50 each

300270 HEPATIC PANEL 23.42 each

300277 L/S RATIO 83661 72.50 each

300278 LACTIC ACID 83605 40.00 each

300279 LDH 83615 11.00 each

300280 LDH ISOENZYMES 83625 42.50 each

300281 LDL CHOLESTEROL FX 83716 36.00 each

300282 LE CELL PREP 23.00 each

300283 LEG, PNEUMOPHILA D/S 179.00 each

300286 LEUKOCYTE COUNT 85048 7.00 each

300287 LH 83002 57.00 each

300288 LH/FSH EVALUATION 80426 99.50 each

300289 LIBRIUM SERUM 80299 46.00 each

300290 LIPASE SERUM 83690 30.00 each

300291 LIPIDS TOTAL SERUM 19.00 each

300292 LIPIDS, TOTAL SCREEN 89125 18.00 each

300293 LIPID DX COMPREHEN 80061 46.50 each

300294 LIPID MONITOR PROF 80061 16.50 each

300295 LIPOPRO ELECTROPHOR 83715 46.50 each

300296 LITHIUM 80178 18.00 each

300297 LIVER DX PROFILE I 80076 90.00 each

300298 LIVER DX PROFILE II 44.00 each

300299 LIVER DX PROFILE III 49.00 each

300304 LANOXIN 80162 40.00 each

300305 LEAD, QUANT, BLOOD 83655 36.00 each

300306 LIDOCAINE 80176 42.50 each

300315 MAGNESIUM SERUM 83735 60.00 each

300316 MAGNESIUM URINE 83735 17.50 each

300317 MANGANESE BLOOD 83785 107.50 each

300319 THC SCREEN 18.00 each

300322 MELANIN 84510 37.00 each

300323 MEPROBOMATE 83805 53.00 each

300324 METHAQUALONE SERUM 80299 53.00 each

300325 METHOTREXATE 80299 75.50 each

300326 MILTOWN 83805 53.00 each

300327 M B C 41.00 each

300328 MIC 87186 41.00 each

300329 MOLD GROUP-RAST 114.50 each

300330 METHEMOGLOBIN 83050 96.00 each

300335 COMP METABOLIC PANEL 120.00 each

300340 MONILIA CULTURE 30.00 each

300341 MONONUCLEOSIS HA 46.00 each

300342 MONO TEST 86300 12.00 each

300345 MULT MYELOMA (MGS) 142.00 each

300346 MUMPS EVAL SINGLE 86735 87.50 each

300347 MUMPS ACUTE & CONV 86735 161.00 each

300349 MYCOBACTERIA CULT 87116 44.00 each

300350 MYCOBACTERIA ORG ID 87118 44.00 each

300351 MYSOLINE 80188 44.00 each

300354 MELLARIL 84022 49.50 each

300355 MAGNESIUM RBC 83735 47.00 each

300363 NASOPHARYNX CULTURE 87070 21.50 each

300364 NASOPHARYNX C&S 87070 21.50 each

300365 NEBCIN 80299 49.00 each

300366 NOREPINEPHRINE PL 82383 125.50 each

300367 NOREPINEPHRINE UR 82382 145.50 each

300368 NOSE CULTURE 87070 21.50 each

300369 NOSE C&S 87070 21.50 each

300372 NORPRAMINE 49.00 each

300380 O & P 87177 117.00 each

300382 OSMOLALITY 83930 32.50 each

300383 OCCULT BLOOD 40.00 each

300388 PREALBUMIN LEVEL 126.00 each

300389 PEP SERUM 30.00 each

300390 PTH (TERM) 142.50 each

300394 PARATHYROID HORMONE 140.00 each

300395 PHENYTOIN DILANTIN 36.75 each

300396 PHENOBARBITAL 80184 46.00 each

300397 PLATELET ANTIBODY SCREEN 96.00 each

300398 PHOSPHORUS, INORG 84100 54.00 each

300399 PITUITARY GONAD 80426 99.50 each

300400 PLATELET COUNT 85032 54.00 each

300401 POTASSIUM SERUM 84132 54.00 each

300402 POTASSIUM URINE 84133 60.00 each

300403 POTASSIUM FECES 39.00 each

300404 PROGESTERONE 84144 58.00 each

300405 PRONESTYL 80190 55.00 each

300406 PROTEIN SERUM 84155 54.00 each

300407 PROTEIN URINE 84156 18.00 each

300408 PROTEIN ELECTRO SER 84165 26.50 each

300409 PROTEIN ELECTRO UR 84165 53.00 each

300410 PROTHROMBIN CONSUMP 85611 26.50 each

300411 PROTHROMBIN TIME 85610 64.00 each

300412 PROLACTIN 84146 63.50 each

300413 PTT 85730 18.00 each

300414 PROZAC LEVEL 80299 80.00 each

300415 PROSTATE SPEC ANTIGEN 84153 210.00 each

300418 PROFILE #3 24.00 each

300423 QUAALUDE 80299 53.00 each

300424 QUINIDINE 80299 46.00 each

300428 PROFILE 8 + IRON 61.00 each

300435 RA RHEUMATOID FACT 76350 14.00 each

300436 RBC FOLATE 82747 110.00 each

300437 RENAL DX PROFILE 80069 25.00 each

300438 RETICULOCYTE CELL 85044 34.00 each

300439 RUBELLA-SINGLE SP 86762 21.50 each

300449 SEDIMENTATION RATE 57.00 each

300450 SALICYLATES 80196 19.50 each

300451 SERUM BACTER LEVEL 87197 61.00 each

300452 SERUM PROT ELECTRO 84165 26.50 each

300453 SERUM PROT IMM-ELEC 86320 80.50 each

300454 SGOT 84450 11.00 each

300455 SGPT 84460 11.00 each

300456 SJOGREN'S ANTIBODY 76.50 each

300457 SKIN CULTURE 87070 21.50 each

300458 SMAC 6 & CREATINE 12.00 each

300459 SMA 7 12.00 each

300460 SMA 17 16.00 each

300461 SMAC 25 19.00 each

300462 SODIUM; SERUM 84295 11.00 each

300463 SODIUM; URINE 84300 11.00 each

300464 SODIUM; FECES 84302 76.50 each

300465 SPUTUM CULTURE 89220 99.00 each

300466 SPUTUM C & S 89220 21.50 each

300467 STREP SCREEN 00112 13.00 each

300468 STREP EXOENZYME A/T 31.00 each

300470 STREP PNEUMONIAE 82.00 each

300471 SULFONAMIDES 84400 68.00 each

300472 SYPHILIS RPR 86592 10.00 each

300473 STOOL C & S/PARASITES 21.50 each

300480 TROPONIN LEVEL 84484 76.00 each

300483 T3 FREE 84481 148.50 each

300484 T3 83539 46.50 each

300485 T3 TOTAL & T4 51.50 each

300486 T3 UPTAKE 81.00 each

300487 T3 UPTAKE & T4 84479 19.50 each

300488 T4 TOTAL 84436 15.50 each

300489 T4 BIND GLOBULIN 84442 79.00 each

300490 TAGAMET 80299 62.50 each

300491 TALWIN 80299 45.00 each

300492 TB CULTURE 87116 44.00 each

300493 TB SMEAR 87206 18.00 each

300494 TBG 84442 79.00 each

300495 TEGRETOL 70.00 each

300496 TESTOSTERONE, TOT, SR 84403 81.00 each

300497 TESTOSTERONE, FREE + 84402 152.50 each

300498 THEOPHYLLINE 80198 40.50 each

300499 THIAMINE 84425 87.50 each

300500 THORAZINE SERUM 80299 57.50 each

300501 THROAT CULTURE 87070 48.00 each

300502 THROAT C & S 87070 21.50 each

300503 THYROID SCREEN PROF 20.00 each

300504 TSH 84443 189.00 each

300505 THYROID, TOTAL EVAL 84442 98.50 each

300506 TOBRAMYCIN 80200 49.00 each

300507 TOFRANIL 80174 72.50 each

300508 TRANXENE 80154 46.00 each

300509 TRIGLYCERIDES 84478 14.00 each

300510 TSH & T4 63.50 each

300511 THYROID DISEASE PROF 20.00 each

300513 TYLENOL 82003 57.50 each

300515 THYROXINE, FREE 84439 135.00 each

300516 THYROXINE T-4 19.50 each

300517 T4 FREE 84439 29.50 each

300520 THYROID PROF I 20.00 each

300521 TRANSFERRIN 37.00 each

300524 URINE COLONY COUNT 87086 190.00 each

300525 UREA CLEARANCE 84545 35.00 each

300526 URETHRAL CULTURE 87070 21.50 each

300527 URETHRAL C & S 87070 21.50 each

300528 URIC ACID 84550 60.00 each

300529 URINALYSIS 81000 93.00 each

300530 URINE CULTURE 87088 93.00 each

300531 URINE C & S 87088 48.00 each

300532 UROBILINOGEN STOOL 84577 65.50 each

300533 UROBILINOGEN URINE 84580 33.50 each

300545 VAGINAL CULTURE 87070 21.50 each

300546 VAGINAL C & S 87070 21.50 each

300547 VALIUM 80154 46.00 each

300548 VITAMIN A 84590 72.00 each

300549 VITAMIN B1 84425 87.50 each

300550 VITAMIN B6 84207 135.50 each

300551 VITAMIN C 82180 45.50 each

300552 VITAMIN D 82307 176.50 each

300553 VITAMIN E 84446 57.00 each

300554 VANCOMYCIN 80299 147.00 each

300555 VALPROIC ACID 80164 44.00 each

300556 RPR 50.00 each

300557 PROSTATIC SPECIFIC 84153 50.00 each

300564 WBC 85048 12.00 each

300565 WBC DIFFERENTIAL 85007 20.00 each

300566 WOUND CULTURE 87070 99.00 each

300567 WOUND CULTURE W/S 87070 21.50 each

300578 ZOLOFT 139.00 each

300579 YEAST CULTURE 87106 43.00 each

300580 ZINC BLOOD 84630 95.00 each

300581 SPECIAL LAB HANDLING 7.00 each

300582 HEMOCULT TEST - SNF 12.00 each

300583 LAB TECH CALL BACK 20.00 each

300584 INFLUENZA A AG 35.00 each

300585 INFLUENZA B AG 35.00 each

300590 YEAST C&S 87106 127.50 each

300602 CROSSMATCH 0.00 each 100% MARKUP

300603 SYRINGE 0.00 each 100% MARKUP

300604 BLOOD TYPE 0.00 each 100% MARKUP

300605 BMP 96.00 each

300606 STAT PHLEBOTOMY CHARGE 135.00 each

300607 STAT COURIER CHARGE 20.00 each

300608 CIRCULATING ANTIC 18.56 each

300609 FLOWCYTOMETRY 250.00 each

300610 FLOW CYTOMETRY ADD'L MARKER 218.00 each

300611 FLOW CYTOMETRY INTERPRETATION >16 MARKER 312.00 each

300612 FLOW CYTOMETRY INTERPRET. 9-15 MARKERS 312.00 each

300613 FLOW CYTOMETRY INTERPRET. 2-8 MARKERS 312.00 each

300614 HIV VIRAL LOAD 441.00 each

300615 ALDOSTERONE SERUM 116.84 each

300617 RENIN ACTIVITY 61.46 each

300618 D-DIMMER 28.44 each

300619 HIV-1 GENOTYPE 553.55 each

300620 HIV 1 PHENO. 1,024.08 each

300621 HIV 1 PHENO ADDL. 109.26 each

300922 HELICOBACTER PYLORI 57.00 each

300923 NATRIURETIC PEP 95.00 each

300924 HOMOCYSTEINE 506.00 each

300925 CULTURE STOOL 86.24 each

300926 ID-UR-PRESUMP 22.56 each

300927 E COLI 86.24 each

300928 CUTL STL ADDL 26.36 each

300929 GASTRIN (SERUM) 50.28 each

300930 PT MIXING PANEL 66.12 each

300931 MOLEC. CYTOGENETICS 46.30 each

300932 MOLEC. CYTOGENETICS 46.30 each

300933 MOLEC. CYTO. INTERPRET 46.30 each

300934 BETA 2 GLYCOPROTEIN 105.70 each

300935 CARDIOLIPIN AB 105.70 each

300936 ANTI-PHOSPHATIDYLSE 105.70 each

300937 HEP C VIRUS AB 40.92 each

300938 PROSTATE SP AG 52.74 each

300939 METHYLMALONIC ACID 48.36 each

300940 UNDILUTED RUSSELL VIP 26.54 each

300941 DILUTED RUSSELL VIP 26.54 each

300942 MOLECULAR EXTRACTION 7.12 each

300943 GENETIC EXAMINATION 7.12 each

300944 MOLECULE ISOLATE 7.12 each

300945 MOLECULAR ENZ. DIGE. 7.12 each

300946 NUCLEIC ACID PROBE. 7.12 each

300947 MOLECULAR MUTATION 46.84 each

300948 MOLECULAR AMP. SINGLE 46.84 each

300949 MOLECULAR MUTATION IDENT. 46.84 each

300950 PROTEIN S FUNCT 43.92 each

300951 PROTEIN C FUNCT 39.64 each

300952 PROTEIN S FREE 43.92 each

300953 FRUCTOSAMINE 43.22 each

300954 HEP C RNA bDNA 122.82 each

300955 NEUTROPHIL ANTIBO 69.12 each

300956 EOSINOPHIL COUNT 7.30 each

300957 US RETRO COMPLETE 92.12 each

300958 HEPARIN NEUTRALIZAT. 42.64 each

300960 HEP B CORE TOTAL 34.56 each

300961 CHLAMYD AMP DNA PRO 83.30 each

300962 GC AMPLIFIED DNA PRO 83.30 each

300963 B-2 MICROGLOBULIN 46.38 each

300964 HELPER T CELL COU. 11.72 each

300966 GIARDIA CRYPTO EXAM 25.52 each

300967 FTA ABS 37.00 each

300968 CHOLINESTERASE RB 16.62 each

300969 RH TYPE 8.34 each

300970 SURG PATH LVL 5 254.48 each

300971 PATH DECALCIFICATION 12.96 each

300972 SURG PATH LVL 4 136.76 each

300974 PHOSPHOLIPIDS SER. 19.54 each

300975 TUMOR ANTIGEN 57.00 each

300976 TACROLIMUS 38.34 each

300977 HELPER/SUPRESSOR 19.54 each

300978 PATH PAS STAIN GR 133.04 each

300979 CANCER ANTIGEN 57.00 each

300980 HEP B DNA QUANT. 119.70 each

300981 SMEAR FOR WB 11.92 each

300982 CYCLOSPORINE 48.62 each

300984 COPPER SERUM 34.68 each

300985 GROWTH HORMONE 46.58 each

300986 CYTOLOGY URINE 362.28 each

300987 VIRUS CULTURE 72.84 each

300988 METANEPHRINE 24 H 47.34 each

300991 LEVETIRACETAM 39.98 each

300992 KB-ACINETOBACTER 20.14 each

300993 CHLORIDE RAND UR 9.50 each

300995 IMMUNOFIX URINE 85.70 each

300997 SHIGA TOXINS I & II 33.04 each

300998 LAB STAT CHARGE 26.00 each

300999 DRAW FEE - BLOOD 7.00 each

301000 THYROGLOBULIN SERUM 41.40 each

301001 THYROGLOBULIN AB 46.90 each

301002 SYPHILIS EIA SCR 37.94 each

301003 PLATELET/HEPARIN 53.64 each

301004 IMMUNOFIXATION Ig 65.24 each

301005 FC 1ST MARK 158.08 each

301006 FC ADDITIONAL (28) 2,657.76 each

301007 FC PROF INTER 16++ MRKS 216.66 each

301008 ACTH IGE 15.24 each

301009 VISCOSITY SERUM 34.10 each

301010 PLATELET FACTOR 4 38.00 each

301011 HIV WESTERN BLO 56.52 each

301012 GRANULOCYTE AB 43.00 each

301013 CRP HIGH SENS 37.00 each

301014 FECAL FAT QUAL 15.00 each

301015 C-PEPTIDE 55.00 each

301016 DHEA SERUM 74.00 each

301017 DRUG SCR ANY # HI 41.00 each

301018 VITAMIN D 125 113.00 each

301019 LYMPH CHORIO AB 37.00 each

301020 OCCULT BLD GASTRI 10.00 each

301021 STREPTOCOCCUS TYPING 15.00 each

301022 HEP C GENOTYPING 725.00 each

301023 CERULOPLASMIN 31.00 each

301024 PARIETAL CELL AB 33.00 each

301025 ANTIBODY SCREEN 24.00 each

301026 ERYTHROPOIETIN 55.00 each

301027 ESTRIOL TOTAL SERUM 70.00 each

301028 SMOOTH MUSCLE AB 35.00 each

301029 THYROID PEROXIDASE 42.00 each

301030 THYROID STIM IMMUN 52.00 each

301031 LAMOTRIGINE 42.00 each

301032 HERPES TYPE I IGG 37.00 each

301033 HERPES TYPE II IGG 53.00 each

301034 VITAMIN D25, D2 & D3 270.00 each

301035 CHROMIUM 60.00 each

301036 STRONGYLOIDES AB 40.00 each

301037 FECAL BILIRUBIN TEST 15.00 each

301038 HYDROXYBUPROPION 40.00 each

301039 CONC & INTERP 208.00 each

301040 CATECHOLAMINE FRACT 67.00 each

301041 CYTO SMEAR SCR & INTERP 160.00 each

301042 IMMUNO KAPPA/LAMB 80.00 each

301043 FACTOR VII FUNCT 50.00 each

301044 GABAPENTIN 40.00 each

301045 PT MIXING STUDY 18.00 each

301046 IMMUNOGLOBULIN IG 26.00 each

301047 NIACIN 35.00 each

301048 DRUG ABUSE SCREEN 41.00 each

301049 HEPATITIS BE AB 35.00 each

301050 ACET RECEPTOR BINDING ANTIBODY 38.00 each

301051 RBC CHARGE 10.00 each

301052 MYCOPLASMA IGG 40.00 each

301053 LEGIONELLA AG URI 35.00 each

301054 ANTI-CCP 37.00 each

301055 QUANTIFERON-TB 180.00 each

301056 CA 27.29 57.00 each

301057 CA 15-3 57.00 each

301058 CIRCULATING TUMOR CELL 435.00 each

301059 CIRCULATING TUMOR CELL 435.00 each

301060 CULTURE G C 30.00 each

301061 CYTOLOGY, THIN PRE 60.00 each

301062 ABO TYPE 9.00 each

301063 BCR/ABL FISH 1,460.00 each

301064 C-TELOPEPTIDE 53.00 each

301065 HEMOGLOBIN ELECT. 35.00 each

301066 IODINE MS QN 50.00 each

301067 SULFONYLUREA URINE 50.00 each

301068 PROCALCITONIN 56.00 each

301069 SHIGA TOXINS I&II EHEC 98.00 each

301070 PROSTATE CANCER SCREENING; PSA TEST 50.46 each

301071 SEROTONIN LEVEL 41.60 each

301072 ADRENOCORTICOTROPIC HORMONE (ACTH) 106.00 each

302001 TB TEST 15.00 each

307001 ABG (w/ Res[ Asst Chrg) 124.00 each

307002 OXYGEN SATURATION TEST 80.00 each

320001 X-RAY ABDOMEN(KUB) 1 VIEW 120.00 each

320002 X-RAY ABDOMEN (KUB) F&U 135.00 each

320010 X-RAY ANKLE, 3 VIEWS 135.00 each

320020 X-RAY ARM (FOREARM) 135.00 each

320030 X-RAY CERVICAL SPINE 2 VW 150.00 each

320050 X-RAY CLAVICLE 142.50 each

320060 X-RAY COCCYX & SACRUM 150.00 each

320070 X-RAY DORSAL(THORACID)SPI 150.00 each

320080 X-RAY ELBOW (3 VIEWS) 135.00 each

320085 X-RAY ELBOW (2 VIEWS) 135.00 each

320090 X-RAY FACIAL BONES, 3 VIEW 120.00 each

320095 X-RAY SHOULDER, 1 VIEW 71.25 each

320100 X-RAY FEMUR, 2 VIEWS 150.00 each

320110 X-RAY FINGERS, 2 VIEWS 135.00 each

320120 X-RAY FOOT, 2 VIEWS 135.00 each

320130 X-RAY HAND, 3 VIEWS 135.00 each

320135 X-RAY HAND (2 VIEWS) 135.00 each

320140 X-RAY HEEL OS-CALCIS 2 VW 135.00 each

320150 X-RAY HIP, 2 VIEWS 150.00 each

320160 X-RAY HUMERUS, 2 VIEWS 142.50 each

320170 X-RAY KNEE, 3 VIEWS 142.50 each

320180 X-RAY LEG, 2 VIEWS 150.00 each

320190 X-RAY LUMBAR SPINE, 2 VIEWS 150.00 each

320200 X-RAY MANDIBLE (JAW) 2 VIEWS 340.00 each

320210 X-RAY NASAL BONES, 3 VIEWS 150.00 each

320220 X-RAY ORBIT, 4 VIEWS 150.00 each

320230 X-RAY PELVIS (2 VIEWS) 135.00 each

320240 X-RAY RAD/ULNER (FOREARM) 2 VWS 150.00 each

320250 X-RAY RIBS, 2 VIEWS 142.50 each

320260 X-RAY SCAPULA 34.00 each

320270 X-RAY SHOULDER, 2 VIEWS 142.50 each

320280 X-RAY SINUSES, 3 VIEWS 150.00 each

320290 X-RAY SKULL SERIES,4 VIEW 150.00 each

320295 X-RAY SKULL 4 VIEWS/LESS 0.00 each 100% MARKUP

320300 X-RAY STERNUM, 2 VIEWS 135.00 each

320310 X-RAY TIBIA & FIBULA, 2 VWS 142.50 each

320320 X-RAY TM JOINTS-BILATERAL 150.00 each

320321 SWALLOW STUDY 0.00 each 100% MARKUP

320330 X-RAY TOES, 2 VIEWS 135.00 each

320340 X-RAY WRIST, 3 VIEWS 142.50 each

320341 X-RAY HIP, BILATERAL 61.58 each

320342 X-RAY KNEE (COMPLETE) 65.42 each

320343 X-RAY FOOT, COMPLETE 3 VIEWS 30.06 each

320344 X-RAY PARANASAL SINUS, < 3 VIEWS 33.54 each

320350 X-RAY SLP COMPONENT/MBS 0.00 each 100% MARKUP

320377 X-RAY HIP, UNILAT, 1 VIEW 88.00 each

320398 X-RAY WRIST, 2 VIEWS 88.00 each

320443 X-RAY CALCANEOUS (MIN 2 VIEWS) 41.58 each

320445 X-RAY CHEST (W/ APICAL LORDOTIC) 60.78 each

320445 X-RAY CHEST (W/ APICAL LORDOTIC) 60.78 each

320446 X-RAY ANKLE, 2 VIEWS 30.64 each

320447 X-RAY CHEST, 2 VIEWS; WITH OBLIQUE PROJ 65.00 each

320448 ANGIOGRAPHY, EXTREMITY, UNILATERAL 630.00 each

320449 ANGIOPLASTY, PERIPHERAL ARTERY 590.00 each

320450 ANGIOPLASTY, EACH ADDITIONAL 360.00 each

320451 X-RAY KNEE, 1-2 VIEWS 92.00 each

320452 X-RAY HIP, UNI, 2+ VIEWS 87.30 each

320453 X-RAY BOTH HIPS, 2+ VIEWS 83.68 each

320454 X-RAY BOTH HIPS, 3-4 VIEWS 103.78 each

320455 X-RAY FEMUR, MIN 2 VIEWS 68.98 each

320456 X-RAY RIBS, UNILAT, 3+ VIEWS 77.94 each

320457 X-RAY BOTH HIPS, 5 VIEWS 120.00 each

320458 X-RAY EXAM ENTIRE SPINE 4/5 VIEWS 142.00 each

320459 X-RAY RIBS, BILAT, 3 VIEWS 78.00 each

320460 X-RAY HIP UNILATERAL, 1 VIEW 119.00 each

320461 X-RAY EXAM OF JAW 4/> VIEWS 78.00 each

320462 SACROILIAC JOINT MIN 3 VIEWS 200.00 each

320463 X-RAY HIPS UNI -PELVIS MIN 4 VIEWS 218.88 each

320990 X-RAY TRANSPORTATION CHRG 125.00 each

320991 X-RAY SETUP FEE 56.00 each

320992 X-RAY WKEND/HOLIDAY/NC 75.00 each

320993 X-RAY TRANSPORT MULTIPLE 75.00 each

320995 COMP SPINE 200.00 each

320996 CLAVICLE (LT) 56.44 each

320997 NON-VASCULAR EXTREM-ULTRASOUND 0.00 each 100% MARKUP

320998 C.T. SCAN CERVICAL SPINE W/O CONTRAST 0.00 each 100% MARKUP

324040 X-RAY CHEST, 1 VIEW 120.00 each

324041 X-RAY CHEST, W/LAT, 2 VIEW 120.00 each

324042 X-RAY OF CHEST, 1 VIEW 23.34 each

324043 X-RAY OF CHEST, 2 VIEWS 41.86 each

324044 X-RAY OF ABDOMEN, 1 VIEW 39.00 each

324045 X-RAY OF ABDOMEN, 2 VIEWS 46.30 each

324046 X-RAY OF ABDOMEN, 3 VIEWS 53.70 each

990626 PT PRIVATE PAY SESSION 65.00 each

990636 OT PRIVATE PAY SESSION 65.00 each

990646 ST PRIVATE PAY SESSION 65.00 each

998001 PEDICURE 20.00 each

998010 PERMANENT 45.00 each

998015 PERMANENT (L'OREAL) 55.00 each

998020 PERMANENT (WELLA) 50.00 each

998100 SHAMPOO 8.00 each

998105 SHAMPOO/HAIRCUT 16.00 each

998110 SHAMPOO/HAIRCUT/MANICURE 25.00 each

998115 SHAMPOO/MEDICATED 4.00 each

998116 MED/SHAMPOO & BLOW DRY 10.00 each

998120 SHAMPOO/CONDITIONER/SET 21.00 each

998125 SHAMPOO/HAIRCUT/BEARD 30.00 each

998126 MED/SHAMPOO H/C & BLOW DRY 18.00 each

998127 MED/SHAMPOO H/C & SET 26.00 each

998130 SHAMPOO & SET 16.00 each

998132 SHAMPOO & BLOW DRY 10.00 each

998135 SHAMPOO/SET(LONG/BEDSIDE) 21.00 each

998140 SHAMPOO & SET UPDO 11.00 each

998300 BEARD TRIM/SHAVE 8.00 each

998305 SHAMPOO & BLOW-DRY 16.00 each

998310 HAIR COLOR 26.00 each

998311 COLOR COMBO 20.00 each

998312 COLOR/DYE HAIR (LONG/HVY) 22.00 each

998315 COMBOUT 4.00 each

998320 CONDITIONER OR RINSE 3.00 each

998325 CONDITIONER-B 4.00 each

998330 SET HAIR 21.00 each

998335 HAIRCUT 21.00 each

998337 EXCESS H/C-EX. LONG HAIR 26.00 each

998338 HAIRCUT (LONG HAIR) 12.00 each

998340 HAIR CUT/FACIAL HAIR 11.00 each

998341 FACIAL HAIR 3.00 each

998345 NECKLINE TRIM 10.00 each

998350 RELAXER 35.00 each

998355 SCALP TREATMENT 37.00 each

998360 STYLE CUT 8.00 each

998365 MANICURE-PLAIN 8.00 each

998370 WAXING (FACE) 18.00 each

998375 PEDICURE-IN BED 10.00 each

998400 MISC BEAUTY SUPPLIES 0.00 each 100% MARKUP

998500 DEPILATION/FACE 8.00 each

998999 BEAUTY / BARBER 0.00 each 100% MARKUP

1 ROOM & BOARD SEMI-PRIV 1,150.00 day 10 ROOM & …...270048 P ABDUCTION BLK MED 169.00 each 270049 P ABDUCTION BLK LG 183.00 each 270050 RECTAL TUBE 1.66 each 270051 RESTON FOAM 6.00

Documents