Item Number Item Description CPT Code Current Price 170409 ...

Item Number Item Description CPT Code Current Price

170409 CL EPINEPHRINE 1:1000 INJ 1MG/ML:1ML J0171 $32.54

171135 PHYTONADIONE neonate (VIT K1)INJ : 1MG J3430 $38.36

310085 OP OBSERVATION BASE-ER G0378 $488.00

310093 OP OBSERVATION HR-ER G0378 $45.00

310095 OP OBSERVATION 1/4 HR G0379 $11.25

310158 OP OBSERV TEL HR-ER G0378 $63.00

310160 OP OBSERV-TEL-1/4 HR G0379 $15.75

310185 OP OBSERVATION BASE-DIRECT ADMIT G0379 $488.00

310193 OP OBSERVATION HR-DIRECT ADMIT G0378 $45.00

310258 OP OBSERV TEL HR-DIRECT ADMIT G0379 $63.00

310301 OP OBS TEL BASE-ER G0378 $683.00

310401 OP OBS TEL BASE-DIRECT ADMIT G0379 $683.00

331500 INSERTION EMERGENCY AIRWAY 31500 $317.00

390471 IMMUNIZATION ADMIN 90471 $52.00

390472 ADMIN IMMUM-MULTI 90472 $15.00

400002 DEPO PROVERA 150 MG J1050 $97.00

400091 PAP COLLECTION/SPECIMAN-MEDICARE ONLY Q0091 $96.00

400696 CEFtriaxONE (ROCEPHIN) 500MG:IM INJ J0696 $39.00

400888 PROMETHAZINE INJ: 25MG J2950 $57.00

402039 INFLUENZA VACCINE 90686 $35.00

403099 KETOROLAC INJ: 15MG J1885 $32.00

404561 PESSARY A4561 $108.00

410060 DRAIN SKIN ABSCESS SINGLE, SIMPLE 10060 $233.00

410080 INCISION AND DRAINAGE OF PILONIDAL CYST; 10080 $380.00

410101 PELVIC EXAM-MEDICARE ONLY G0101 $95.00

410400 HOSPITALITY ROOM BASE $50.00

410410 INCISION LINGUAL FRENUM 41010 $474.00

411100 BIOPSY SKIN LESION 11100 $173.00

411200 REMOVAL SKIN TAGS 11200 $169.00

411400 EXC TR-EXT .5<CM 11400 $276.00

411401 EXC TR-EXT .6 TO 1.0 CM 11401 $316.00

411402 EXC TR-EXT 1.1-2 CM 11402 $361.00

411420 EXC H-F-NK 0.5<CM 11420 $264.00

411421 EXC H-F-NK-SP B9+MARG 0.6-1 11421 $297.00

411422 EXC H-F-NK-SP B9+MARG 1.1-2 11422 $391.00

411440 EXC FAC-MM 0.5<CM 11440 $322.00

411981 INSERTION OF NONBIODEGRADABLE IMPLANT 11981 $332.00

411982 REMOVAL OF NONBIODEGRADABLE IMPLANT 11982 $377.00

411983 REM W/REINSERTION, NON BIO DRUG DEL IMPL 11983 $574.00

412001 SPF WOUND 2.5 OR < 12001 $357.00

414150 CIRCUMCISION SURGICAL EXCISION OTHER THA 54150 $351.00

417110 DESTRUCTION FLAT WARTS ETC UP TO 14 17110 $227.00

417301 SKYLA IUD J7301 $971.00

419101 BIOPSY OF BREAST,INCISIONAL 19101 $785.00

419120 EXCISION OF CYST, FIBROADENOMA OR OTHER 19120 $1,067.00

421050 DEPO PROVERA 150 MG J1050 $122.00

431500 INSET EMERGENCY AIRWAY 31500 $347.00

436510 CATHERIZATION, UMBILICAL VEIN, NEWBORN F 36510 $194.00

440806 INCISION OF LABIAL FRENUM(FRENOTOMY) 40806 $225.00

440819 EXCISION OF FRENUM, LABIAL OR BUCCAL(FRE 40819 $685.00


441115 EXCISION OF LINGUAL FRENUM 41115 $516.00

450114 OFFICE FERN TEST Q0114 $13.00

453060 DRAINAGE OF UREHRA ABSCESS 53060 $376.00


456405 I & D OF VULVA/PERINEUM 56405 $272.00

456420 DRAINAGE OF GLAND ABSCESS 56420 $328.00

456515 DESTRUCTION LESION(S), VULVA; EXTENSIVE 56515 $547.00

456605 BIOPSY OF VULVA/PERINEUM 56605 $210.00

456606 BIOPSY OF VULVA/PERINEUM, ADD LESION 56606 $100.00

456700 HYMENECTOMY,PARTIAL EXCISION OF HYMEN 56700 $460.00

456810 REPAIR OF PERINEUM 56810 $650.00

457100 BIOPSY OF VAGINA 57100 $221.00

457120 CLOSURE OF VAGINA 57120 $1,263.00

457160 PESSARY INSERTION 57160 $142.00

457420 COLOPOSCOPY OF THE ENTIRE VAGINA, WITH C 57420 $289.00

457452 EXAM OF CERVIX W/SCOPE 57452 $276.00

457454 BX /CURETT OF CERVIX W/SCOPE 57454 $389.00

457455 BIOPSY OF CERVIX W/SCOPE 57455 $360.00

457456 ENDOCERV CURETTAGE W/SCOPE 57456 $340.00

457500 BIOPSY OF CERVIX 57500 $339.00

458100 BIOPSY ENDOMETRIAL SUCTION TYPE 58100 $279.00

458300 INSERT INTAUTERINE DEVICE 58300 $205.00

458301 REMOVE INTRAUTERINE DEVICE 58301 $245.00

458558 HYSTEROSCOPY, BIOPSY OP 58558 $770.00

458563 HYSTEROSCOPY, ABLATION OP 58563 $906.00

458605 DIVISION OF FALLOPIAN TUBE INPT 58605 $817.00

458611 LIGATE OVIDUCT(S) ADD ON C-SECTION 58611 $1,755.00

458615 OCC FALLOPIAN TUBE BY VAG/SUPRAPUBIC 58615 $619.00

459200 INSERTION CERVICAL DILATOR/PROSTAG 59200 $151.00

459300 EPISIOTOMY OR VAGINAL REPAIR 59300 $494.00

459400 VAGINAL DELIVERY GLOBAL 59400 $3,843.00

459409 VAGINAL DELIVERY ONLY 59409 $1,737.00

459410 VAGINAL DELIVERY W/POSTPARTEM CARE 59410 $1,997.00

459414 DELIVERY PLACENTA 59414 $169.00

459425 ANTEPARTUM CARE 4-6 VISITS GLOBAL 59425 $949.00

459426 ANTEPARTUM CARE 7 OR MORE VISITS GLOBAL 59426 $1,692.00

459430 POSTPARTUM FOLLOW UP VISIT ONLY 59430 $366.00

459515 C SECTION DELIVERY W/POSTPARTEM 59515 $2,401.00

459610 VBAC GLOBAL 59610 $3,402.00

459612 VBAC DELIVERY ONLY 59612 $1,826.00

459812 TREATMENT OF MISCARRIAGE 59812 $764.00

459820 TREATMENT OF MISSED ABORTION 1ST TRI 59820 $926.00

469020 DRAINAGE EXTERNAL AUDITORY CANAL, ABSCES 69020 $493.00

469209 REMOVE IMPACTED EAR WAX UNI 69209 $31.00

481003 URINALYSIS-DIP 81003 $15.00

481025 PREG TEST URINE 81025 $32.00

487210 .KOH PREP 87210 $33.00

487880 STREP, GROUP A DETECTION IMMUNOASSAY W/O 87880 $21.00

490082 BETAMETHASONE SOD PHOS/BETA ACET: INJ SU J0702 $175.00

490471 ADMIN IMMUN-SINGLE 90471 $55.00

490472 ADMIN IMMUM-MULTI 90472 $15.00

490649 GARDASIL 90649 $184.00

490651 HPV VACCINE NONVALENT IM 90651 $215.00

490715 DTAP ADULT 90715 $65.00

496372 THER/PROPH/DIAG IN, SC/IM 96372 $56.00

499070 SPECIAL SUPPLIES 99070 $108.00

499201 OFFICE/OUTPT VST NE 99201 $86.00




499205 NEW LEVEL 5 (99205) 99205 $344.00




499214 OFFICE/OUTPT VST 99214 $173.00

499215 OFFICE/OUTPT VST EST 99215 $242.00

499217 OBSERVATION CARE DISCHARGE 99217 $139.00

499218 OBSERVATION CARE 99218 $133.00


499222 INITIAL HOSPITAL CARE 99222 $252.00

499224 SUBSEQUENT OBSERVATION CARE 99224 $67.00

499225 SUBSEQUENT OBSERVATION CARE 99225 $118.00

499232 SUBSEQUENT HOSPITAL CARE 99232 $136.00

499234 OBSERV/HOSP SAME DATE 99234 $274.00

499236 ADMIT/DISCHARGE SAME DAY OP 99236 $447.00

499238 HOSPITAL DISCHARGE DAY 99238 $177.00

499239 HOSPITAL DISCHARGE DAY>30 MIN 99239 $233.00

499283 EMERGENCY DEPT VISIT 99283 $130.00

499291 CRITICAL CARE FIRST HOUR 99291 $388.00

499292 CRITICAL CARE ADDL 30 MIN 99292 $162.00

499381 PREV VST NEW INFANT 99381 $184.00

499382 PREV VST NEW 1-4 99382 $167.00

499383 PREV VST NEW 5-11 99383 $174.00

499384 PREV VST NEW 12-17 99384 $190.00

499385 PREV VST NEW 18-39 99385 $190.00

499386 PREV VST NEW 40-64 99386 $219.00

499387 PREV VST NEW 65+ 99387 $240.00

499391 PREV VST EST INFANT LESS THAN 1 YEAR 99391 $142.00

499392 PREV VST EST 1-4 99392 $143.00

499393 PREV VST EST 5-11 99393 $143.00

499394 PREV VST EST 12-17 99394 $156.00

499395 PREV VST EST 18-39 99395 $168.00

499396 PREV VST EST 40-64 99396 $179.00

499397 PREV VST EXT 65+ 99397 $196.00

499452 INTERPROF PHONE/INTERNET/ELECT RECORD RE 99452 $97.00

499460 INIT NB EM PER DAY 99460 $159.00

499462 SBSQ NB EM PER DAY 99462 $73.00

499463 SAME DAY NB DISCHARGE 99463 $203.00

499465 NB RESUSCITATION 99465 $294.00

499468 INITIAL INPATIENT NEONATAL CRITICAL CARE 99468 $1,619.00

499485 SUPRV INTERFAC TRANSPORT 99485 $116.00

499486 SUPRV INTERFAC TRANSPORT ADDL 99486 $102.00

500023 CHEMO BY IV-INITIAL HOUR 96413 $584.00

500104 PICC LINE/MIDLINE INSERT 36569 $745.00

500168 WOUND REPAIR WITH ADHESIVE G0168 $29.00

500171 BLOOD TRANSFUSION 36430 $1,128.00

500239 IV INFUSION BAMLANIVIMAB M0239 $584.00

500244 CASIRIVIMAB/IMDEVIMAB REGEN-COV M0245 $584.00

500245 BAMLANIVIMAB & ETESEVIMAB INFUSION M0245 $584.00

536550 MECH REMOVAL CATH MATERIAL 36595 $570.00

536591 COLLECTION OF BLOOD FROM VAD 36591 $61.00

576942 US NEEDLE BIOPSY S AND I 76942 $621.00

596360 HYDRATION BASE-1 HOUR 96360 $703.00

596361 HYDRATION-ADDITIONAL HOUR 96361 $116.00

596365 IV THERAPY-INITIAL HOUR 96365 $584.00

596366 IV THERAPY-EACH ADDL HOUR 96366 $120.00

596367 IV THERAPY-ADD SEQ INFUSION 96367 $703.00

596368 IV THERAPY-CONCURRENT INFUSION 96368 $620.00

596372 THER/DIAG INJECTION 96372 $56.00

596374 IV PUSH INITIAL DRUG 96374 $120.00

596375 IV PUSH EA ADDL NEW DRUG 96375 $120.00

596376 TX/PRO/DX INJ NEW DRUG ADD ON 96376 $36.00

596401 NON HORM CHEMO INJECTION 96401 $189.00

596402 CHEMO HORMONIAL ANTI-NEOPLASTIC 96402 $584.00

596409 CHEMO ADMIN IV PUSH 96409 $266.00

596411 CHEMO ADMIN IV PUSH EA ADDL NEW 96411 $228.00

596415 CHEMO BY IV-EA ADDL HOUR 96415 $120.00

596416 INITIAL SET UP OF PORTABLE PUMP 96521 $443.00

596417 CHEMO ADMIN SEQUENTIAL INF 96417 $584.00

596521 REFILL/MAINT PORTABLE PUMP 96521 $320.00

596523 IRRIG DRUG DELIVERY DEVICE 96523 $65.00

597605 NEG. PRESSURE <50CM 97605 $424.00

597606 NEG. PRESSURE >50CM 97606 $756.00

599201 LEVEL 1 NEW 99201 $86.00

599202 LEVEL 2 NEW 99202 $134.00

599203 LEVEL 3 NEW 99203 $184.00

599204 LEVEL 4 NEW 99204 $267.00

599205 LEVEL 5 NEW 99205 $344.00

599211 LEVEL 1 ESTAB 99211 $50.00

599213 LEVEL 3 ESTAB 99213 $108.00

599214 LEVEL 4 ESTAB 99214 $173.00

599215 LEVEL 5 ESTAB 99215 $242.00

659073 PEMBROLIZUMAB (KEYTRUDA) INJECTION:100 M J9271 $14,893.56

899203 LEVEL 3 NEW 99203 $505.00

899204 LEVEL 4 NEW 99204 $765.00

899205 LEVEL 5 NEW 99205 $977.00

899213 LEVEL 3 ESTABLISHED OP 99213 $108.00



1010060 INCISION & DRAINAGE OF ABCESS-SIMPLE 10060 $324.00

1020610 ARTHROCENTESIS, ASPIRATION AND/OR INJECT 20610 $164.00

1031500 INSERTION EMERGENCY AIRWAY 31500 $320.00

1092150 OP-CPR 92950 $661.00

1092950 IP-CPR 92950 $661.00

1099134 IP-ADMIT/DISCHARGE SAME DAY DETAIL 99234 $274.00

1099135 IP-ADMIT/DISCHARGE SAME DAY COMP 99235 $361.00


1099156 OP-PROLONGED CARE-1ST HOUR 99356 $249.00

1099157 OP-PROLONGED CARE-EA 30 MINS 99357 $237.00

1099191 OP-CRITICAL CARE-1ST HOUR 99291 $519.00

1099192 OP-CRITICAL CARE-EACH ADD 30 MINS 99292 $250.00

1099217 OP-OBSERVATION DAY DISCHARGE 99217 $167.00

1099218 OP-INITIAL OBSERVATION STRAIGHTFORWARD 99218 $181.00

1099219 OP-OUTPATIENT MODERATE 99219 $292.00

1099220 OP-OUTPATIENT HIGH 99220 $364.00

1099221 IP-H&P LOW COMPLEXITY 99231 $180.00

1099222 IP-H&P MODERATE COMPLEXITY 99222 $255.00

1099223 IP-H&P HIGH COMPLEXITY 99223 $380.00

1099224 OP-DAILY VISIT LOW COMPLEXITY 99224 $66.00

1099225 OP-DAILY VISIT MODERATE COMPLEXITY 99225 $119.00

1099226 OP-DAILY VISIT HIGH COMPLEXITY 99226 $179.00

1099231 IP-HOSPITAL VISIT-LOW COMPLEXITY 99231 $94.00

1099232 IP-HOSPITAL VISIT-MODERATE COMPLEXITY 99232 $137.00

1099233 IP-HOSPITAL VISIT-HIGH COMPLEXITY 99233 $227.00

1099234 SAME DAY ADMIT/DC LOW COMPLEXITY- 40MIN 99234 $274.00

1099235 SAME DAY ADMIT/DC MOD COMPLEXITY- 50MIN 99235 $361.00

1099236 SAME DAY ADMIT/DC HIGH COMPLEXITY- 55MIN 99236 $451.00

1099238 IP-HOSPITAL DISCHARGE <30 MIN 99238 $164.00

1099239 IP-HOSPITAL DISCHARGE >30 MIN 99239 $236.00

1099291 IP-CRITICAL CARE-1ST HOUR 99291 $519.00

1099292 IP-CRITICAL CARE-EACH ADD 30 MIN 99292 $250.00

1099304 SNF-ADMIT STRAIGHTFORWARD 99304 $157.00

1099305 SNF-ADMIT MODERATE 99305 $221.00

1099306 SNF-ADMIT HIGH COMPLEX 99306 $335.00

1099307 SNF-VISIT STRAIGHTFORWARD 99307 $92.00

1099308 SNF-VISIT LOW COMPLEXITY 99308 $114.00

1099309 SNF-VISIT MODERATE COMPLEXITY 99309 $154.00

1099310 SNF-VISIT HIGH COMPLEXITY 99310 $223.00

1099315 SNF-DISCHARGE DAY <31 MIN 99315 $162.00

1099316 SNF-DISCHARGE DAY >31 MIN 99315 $197.00

1099356 IP-PROLONGED CARE-FIRST HOUR 99356 $250.00

1099357 IP-PROLONGED CARE-EACH ADD 30 MINS 99357 $237.00

1600002 PRE-EMPLOYMENT PHYSICAL 99499 $134.00

1600072 NON MEDICARE/XIX ADMIN PNEUMOVAX VACCINE 90471 $55.00

1600091 PAP COLLECTION/SPECIMAN-MEDICARE ONLY Q0091 $96.00

1600210 ADMIN SARS-CoV-2 MODERNA VACCINE 1ST 0011A $55.00

1600220 ADMIN SARS-CoV-2 MODERNA VACCINE 2ND 0012A $55.00

1600304 SNF-1 ADMIT STRAIGHFORWARD 99304 $172.00

1600305 SNF-2 ADMIT MODERATE COMPLEXITY 99305 $211.00

1600306 SNF-3 ADMIT HIGH COMPLEXITY 99306 $344.00

1600307 SNF-1 SUBSEQ VISIT STRAIGHT FORWARD 99307 $83.00

1600308 SNF-2 SUBSEQ VISIT LOW COMPLEXITY 99308 $120.00

1600309 SNF-3 SUBSEQ VISIT MODERATE COMPLEXITY 99309 $169.00

1600310 SNF-4 SUBSEQ VISIT HIGH COMPLEXITY 99310 $211.00

1600402 WELCOME TO MEDICARE VISIT G0402 $215.00

1600438 MEDICARE ANNUAL WELLNESS G0438 $147.00

1600439 SUB VISIT TO MEDICARE ANNUAL WELLNESS G0439 $98.00

1600630 SUTURE REMOVAL BY DIFFERENT DR S0630 $48.00

1600783 INJ-B12 J3420 $8.00

1604561 PESSARY (RUBBER) MEDICARE PATIENT A4561 $108.00

1607040 NORMAL SALINE 500 ML INFUSION J7040 $26.00

1610060 DRAINAGE OF SKIN ABSCESS 10060 $233.00

1610101 PELVIC EXAM-MEDICARE ONLY G0101 $95.00

1610120 REMOVE FOREIGN BODY 10120 $311.00

1610140 I & D HEMATOMA, SEROMA, FLUID COLLECTION 10140 $374.00

1611055 TRIM SKIN LESION 11055 $98.00

1611100 BIOPSY OF SKIN LESION 11100 $173.00

1611102 TANGENTIAL BX SKIN SINGLE LESION 11102 $86.00

1611103 TANGENTIAL BX SKIN EA SEP/ADD 11103 $53.00

1611104 PUNCH BX SKIN SINGLE LESION 11104 $118.00

1611105 PUNCH BX SKIN EA SEP/ADDL 11105 $64.00

1611106 INCISIONAL BX SKIN SINGLE LESION 11106 $143.00

1611107 INCISIONAL BX EA SEP/ADDL 11107 $78.00

1611200 REM SKIN TAGS; ANY AREA; UP TO 15 11200 $169.00

1611311 SHAVE LESION FACE ECT .6 TO 1.0 CM 11311 $240.00

1611400 EXC TR-EXT B9+MARG 0.5 CM< 11400 $259.00

1611403 EXCISION BENIGN LESION 2.1 TO 3.0 CM 11403 $418.00

1611421 EXC H-F-NK-SP B9+MARG 0.6-1 11421 $284.00

1611422 EXC H-F-NK-SP B9 MARG 1.1-2CM 11422 $351.00

1611440 EXCISION, OTHER BENIGN, .5 CM OR LESS 11440 $318.00

1611750 REMOVAL OF NAIL BED 11750 $470.00

1611981 CONTRACEPTIVE IMPLANT INSERTION 11981 $332.00

1611982 REMOVAL OF NONBIODEGRADABLE IMPLANT 11982 $377.00

1611983 REM W/REINSERTION, NON BIO DRUG DEL IMPL 11983 $574.00

1612001 RPR S/N/AX/GEN/TMK 2.5 CM/< 12001 $357.00

1612011 RPR LACERATION 2.5CM OR LESS 12011 $207.00

1612013 REPAIR SPF WOUNDS 12013 $415.00

1612014 RPR LACERATION 2.6-5.0 CM 12013 $216.00

1617000 DESTRUCT PREMALI 1ST LESION 17000 $173.00

1617003 DESTRUCT PREMALIGNANT LESION 2-14 17003 $41.00


1617111 DESTRUCTION WARTS ETC 15 OR MORE 17111 $303.00

1620552 INJ TRIGGER POINT 1/2 MUSCL 20552 $122.00

1620600 DRAIN/INJECT JOINT/BURSA 20600 $104.00

1620610 DRN/INJCT JNT/BURSA 20610 $247.00

1636415 VENIPUNCTURE 36415 $41.00

1640806 INCISION OF LABIAL FRENUM 40806 $225.00

1640819 EXCISE LIP OR CHEEK FOLD 40819 $685.00



1645942 ANTEPARTUM CARE 4-6 VISITS GLOBAL 59425 $1,011.00

1656405 I & D OF VULVA OR PERINEAL ABSCESS 56405 $272.00

1656420 I&D BARTHOLINS GLAND ABSCESS 56420 $328.00

1656501 VULVA SIMPLE 56501 $314.00

1656605 BIOPSY OF VULVA/PERINEUM 56605 $210.00

1656606 BIOPSY OF VULVA/PERINEUM EACH ADDL 56606 $100.00

1656820 VULVA 56820 $279.00

1656821 VULVA WITH BIOPSY 56821 $372.00

1657100 BIOPSY OF VAGINA 57100 $221.00

1657160 PESSARY INSERTION OR FITTING 57160 $142.00

1657420 ENTIRE VAGINA+CERVIX IF PRESENT 57420 $289.00

1657421 ENTIRE VAGINA+BIOPSY CERVIX+VAGINA 57421 $393.00

1657452 CERVIX+UPPER/ADJACENT VAGINA 57452 $276.00

1657454 BX/CURETT OF CERVIX W/SCOPE 57454 $389.00

1657455 BIOPSY OF CERVIX W/SCOPE 57455 $360.00

1657456 CERVIX+UPPER/ADJ VAGINA+ECC 57456 $340.00

1657460 BX OF CERVIX W/SCOPE, LEEP 57460 $772.00

1657500 BIOPSY OF CERVIX 57500 $339.00

1657505 ENDOCERVICAL CURETTAGE 57505 $251.00

1658100 BIOPSY ENDOMETRIAL SUCTION TYPE 58100 $279.00

1658110 ENDOMETRIAL BIOPSY W/COLOPOSCOPY 58110 $124.00

1658300 IUD INSERTION 58300 $205.00

1658301 IUD REMOVAL 58301 $245.00

1659025 NON STRESS TEST CLINIC 59025 $144.00


1659426 ANTEPARTUM CARE 7 OR MORE VISITS GLOBAL 59426 $1,692.00

1659430 POSTPARTUM FOLLOW UP VISIT ONLY 59430 $366.00

1659510 C SECTION ROUTINE GLOBAL 59510 $4,349.00

1659514 C SECTION DELIVERY ONLY 59514 $2,051.00

1659515 C SECTION DELIVERY W/POSTPARTEM 59515 $2,401.00

1665205 RMV FOREIGN BODY EYE 65205 $126.00

1669200 CLEAR OUT EAR CANEL 69200 $152.00

1669209 REMOVE IMPACTED EAR WAX UNI 69209 $27.00

1669210 RMV IMPACT EAR WAX 69210 $120.00

1676998 US GUIDE INTRAOP 76998 $329.00

1681003 CL URINALYSIS-DIP 81003 $15.00

1681025 PREG TEST URINE 81025 $32.00

1682962 BLOOD SUGAR 82962 $24.00

1687260 COVID 19 AG 15 HCHC 87260 $61.00

1687430 STAT STREP SCREEN 87430 $51.00

1687449 LAB TEST INFLUENZA 87449 $16.00

1690384 RH FULL DOSE IM 90384 $94.00


1690472 ADMIN IMMUN-MULTI 90472 $15.00

1690658 INFLUENZA VACCINE 90658 $34.00

1690715 DTAP ADULT 90715 $65.00

1690732 INJ PNEUMONIA 90732 $75.00

1690782 INJECTION-HEP B 90746 $75.00

1694640 INHALATION THERAPY 94640 $63.00

1694760 MSURE BLD OXY LEVEL 94760 $12.00

1695115 ALLERGY SHOT-SINGLE 95115 $33.00

1695117 ALLERGY SHOT-2 TO 4 95117 $39.00

1696110 DEVELOPMENTAL SCREEN 96110 $10.00

1696127 BEHAV ASSMT W/SCORE & DOCUMENTATION 96127 $12.00

1696161 POST PARTUM DEPRESSION SCREEN 96161 $4.00

1696365 THER/PROPH/DIAG IV INF INIT 96365 $129.00

1696372 THERAPEUTIC INJECTION 96372 $56.00

1699173 VISUAL ACUITY SCREEN 99173 $5.00

1699201 NEW LEVEL 1 (99201) 99201 $86.00

1699202 NEW LEVEL 2 (99202) 99202 $134.00

1699203 NEW LEVEL 3 (99203) 99203 $184.00

1699204 NEW LEVEL 4 (99204) 99204 $267.00

1699205 NEW LEVEL 5 (99205) 99205 $344.00

1699211 EST LEVEL 1 (99211) 99211 $50.00

1699212 EST LEVEL 2 (99212) 99212 $77.00

1699213 EST LEVEL 3 (99213) 99213 $108.00

1699214 EST LEVEL 4 (99214) 99214 $173.00

1699215 EST LEVEL 5 (99215) 99215 $242.00

1699234 SNF-ADMIT/DISCHARGE SAME DAY DETAIL 40 99234 $274.00

1699235 SNF-ADMIT/DISCHARGE SAME DAY COMP 50 MIN 99235 $361.00

1699236 SNF-ADMIT/DISCHARGE SAME DAY COMP 55 MIN 99236 $447.00

1699237 ICF-ADMIT/DISCHARGE SAME DAY DETAIL 40 99234 $274.00

1699238 ICF-ADMIT/DISCHARGE SAME DAY COMP 50 MIN 99235 $361.00

1699239 ICF-ADMIT/DISCHARGE SAME DAY COMP 55 MIN 99236 $447.00

1699304 ICF-1 ADMIT STRAIGHFORWARD 99304 $172.00

1699305 ICF-2 ADMIT MODERATE COMPLEXITY 99305 $211.00

1699306 ICF-3 ADMIT HIGH COMPLEXITY 99306 $344.00

1699307 ICF-1 SUBSEQ VISIT STRAIGHTFORWARD 99307 $83.00

1699308 ICF-2 SUBSEQ VISIT LOW COMPLEXITY 99308 $120.00

1699309 ICF-3 SUBSEQ VISIT MODERATE COMPLEXITY 99309 $169.00

1699310 ICF-4 SUBSEQ VISIT HIGH COMPLEXITY 99310 $211.00

1699315 SNF-DISCHARGE DAY <31 MINS 99315 $160.00

1699316 SNF-DISCHARGE DAY >31 MINS 99316 $197.00

1699317 ICF-DISCHARGE DAY <31 MINS 99315 $160.00

1699318 ICF-DISCHARGE DAY >31 MINS 99316 $197.00

1699381 PREV VST NEW INFANT LESS THAN 1 YEAR 99381 $184.00

1699382 PREV VST NEW 1-4 99382 $167.00

1699383 PREV VST NEW 5-11 99383 $174.00

1699384 PREV VST NEW 12-17 99384 $190.00

1699385 PREV VST NEW 18-39 99385 $190.00

1699386 PREV VST NEW 40-64 99386 $219.00

1699387 PREV VST NEW 65+ 99387 $240.00

1699391 PREV VST EST INFANT LESS THAN 1 YEAR 99391 $142.00

1699392 PREV VST EST 1-4 99392 $143.00

1699393 PREV VST EST 5-11 99393 $143.00

1699394 PREV VST EST 12-17 99394 $156.00

1699395 PREV VST EST 18-39 99395 $168.00

1699396 PREV VST EST 40-64 99396 $179.00

1699397 PREV VST EXT 65+ 99397 $196.00

1699398 PREV VST EXT 65+ 99397 $196.00

1699441 TELEPHONE EVALUATION 5-10 MINUTES 99441 $22.00



1699499 DOT PHYSICAL 99499 $134.00

1700039 DAILY SERV HEMO-SKILLED $682.00

1700041 CL NON MEDICARE/XIX PNEUMOVAX 23 .5ML 90732 $102.00

1700120 CL BACITRACIN OINT 500U : 30GM A9270 $12.70

1700126 CL DIPHENHYDRAM INJ SDV 50MG/ML:1ML J1200 $20.98

1700144 CL BICILLIN LA INJ 1.2 MILLION UNITS J0558 $64.79

1700164 CL BUPIVACAINE INJ SDV:.50% $12.40

1700182 CL CARBAMIDE PEROX (DEBROX)SOL 6.5%:15ML $13.39

1700307 CL METHYLPREDNISOLONE INJ SDV:40MG/ML J1030 $29.94

1700544 CL IBUPROFEN(MOTRIN)TAB:800MG A9270 $2.50

1700578 CL NON MEDICARE/XIX PREVNAR 13 PNEU 90670 $375.00

1700658 CL METOCLOPRAMIDE INJ 5MG/ML:2ML J2765 $33.51

1700662 CL NON/MED/MEDICAID HD INFLUENZA VACCINT 90662 $63.00

1700686 CL NON MED/MEDICAID VIR VAC INFLUENZA 90686 $63.00

1700770 CL NALBUPHINE(NUBAIN)INJ 20MG/ML:1ML J2300 $42.86

1700775 CL XIAFLEX SU VIAL .9MG J0775 $7,389.43

1700888 CL PROMETHAZINE INJ SDV: 25MG/ML J2550 $49.88

1700889 CL PROMETHAZINE INJ: 50MG J2550 $31.10

1700948 CL SILVER SULFADIAZ(SILVADENE)CRM : 20GM A9270 $14.10

1700989 CL WATER FOR INJ SDV : 10ML $21.04

1701034 CL TENIVAC TETANUS DIPTH VACCINE : 0.5ML 90714 $59.85

1701050 CL DEPO PROVERA INJECTION 1ML J1050 $117.00

1701078 CL TRIAMCINOLONE OINT 0.1% : 15GM A9270 $11.20

1701135 CL VITAMIN K NEONATAL 1MG INJ J3430 $38.36

1701148 CL LIDOCAINE W/EPI 1% : 20ML J2001 $21.04

1701694 CL IBUPROFEN TABLETS : 200MG A9270 $2.50

1702176 CL SODIUM CHLOR INHALATION 0.9%: 3ML $2.50

1702192 CL MUPIROCIN (BACTROBAN) OINT 2% : 22GM A9270 $100.70

1702211 CL DESITIN MAX STRENGTH OINT : 60GM A9270 $12.90

1702267 CL LIDOCANE (XYLOCAINE) JELLY 2% : 5ML $20.30

1702268 CL NEOM/BAC/PO(TRIPLE ANTIBIOTIC)PCK:1GM A9270 $3.50

1702425 CL MEDROXYPROGESTONE ACETATE INJ:150MG J3490 $117.85

1702471 CL TRIAMCINOLONE INJ 10MG/5ML:5ML J3301 $31.23

1702806 CL GENTAMICIN 40MG/ML: IM 2ML INJ J1580 $33.16

1702968 CL ALBUTEROL UD INHAL SOL 0.08%: 3ML $2.50

1703099 CL KETOROLAC INJ: 15MG J1885 $27.50

1703294 CL SODIUM CHLORIDE INJ SDV .9%: 10ML $15.91

1703400 CL HYDROCORTISONE CRM 1% : 30GM A9270 $11.90

1703490 CL CYANOCOLBALAMIN(VIT B-12)INJ:1000MCG J3420 $37.29

1703696 CL CEFTRIAXONE 1GM J0696 $56.00

1706006 CL LIDOCAINE (XYLOCAINE)MPF 1% :2ML $29.90

1707296 CL KYLEENA IUD J7296 $1,102.00

1707298 CL MIRENA IUD J7298 $1,644.21

1707300 CL PARAGARD J7300 $821.00

1707307 CL NEXPLANON IMPLANT J7307 $924.00

1707325 CL SYNVIC ONE INJ:6ML J7325 $1,653.00

1707773 CL NYSTATIN(MYCOSTATIN)CR 100MU/GM:15GM A9270 $12.80

1709260 CL METHOTREXATE 50MG J9260 $38.00

1709582 CL METHYLPREDNISOLONE INJ SDV :80MG/1ML J1030 $37.24

1710012 CL ACETAMINOPHEN (TYLENOL) LIQ 160mg/5ml A9270 $2.50

1710347 CL DIPHENYDRAMINE LIQUID 12.5MG/5ML:5ML A9270 $2.50

1710540 CL IBUPROFEN ORAL SUSP 100MG/5ML: 5ML A9270 $2.50

1716989 CL ACETAMINOPHEN(TYLENOL)TAB:325MG A9270 $2.50

1717301 CL SKYLA J7301 $929.00

1717307 CL IMPLANON IMPLANT J7307 $924.00

1718850 CL KETOROLAC INJ IM: 60MG J1885 $28.90

1740297 CL BOOSTRIX TDAP VACCINE:0.5ML 90715 $67.61

1740358 CL DESITIN CREAMY OINTMENT:60GM A9270 $13.30

1755454 CL IPRATROPIUM/ALBUTEROL INH NEBX : 3ML $2.50

1756824 CL CEFTRIAXONE INJ SDV 500MG J0696 $23.38

1756988 CL INFARIX VACCINE DTAP: 0.5 ML 90700 $42.20

1770121 CL TRIAMCINOLONE 40MG/ML J3301 $21.23

1780533 CL DEXAMETHASONE INJ SDV:10MG/1ML J1100 $22.24

1781067 CL KETOROLAC INJ SDV : 30MG/ML J1885 $22.52

1786580 CL TUBERCULIN PPD TEST 86580 $48.14

1789966 CL LIDOCAINE (LMX-4)4% CREAM:5 GM A9270 $27.00

1790082 CL BETAMETHASONE INJ MDV: 6MG/ML J0702 $61.94

1790376 CL RABIES Ig 90376 $325.00

1790411 CL ORTHOVISC SYRINGE 15MG/ML: 2 ML J7324 $534.80

1790632 CL HEP A VACCINE ADULT IM 90632 $61.00

1790649 CL GARDISIL 90649 $329.96

1790651 CL HPV VACCINE 90651 $206.00

1790675 CL RABIES VACCINE 90675 $300.00

1790714 CL TD ADULT 90714 $52.00

1790741 CL TETRACAINE EYE DROPS 0.5% : 4ML $31.03

1790746 CL HEPATITIS B INJ: 20MCG 90746 $195.70

1790875 CL LIDOCAINE INJ SDV 1% :5ML $14.06

1790887 CL BACTERIOSTATIC SODIUM CHLORIDE: 10ML $4.99

1794060 CL IMMUNIZATION THROUGH 18 YEARS 90460 $53.00

1795588 CL SALINE CENTRAL LINE FLUSH: 10ML $26.30

1900136 PERITONEAL HEMO-IP $296.00

2100087 CIRCUMCISION INFANT 54150 $158.00

2300117 C-SECTION PREP $93.00

2310007 DELIVERY SERVICE $1,209.00

2310011 LABOR BASE $921.00

2310014 OBS ASSESMENT BASE DIRECT ADMIT G0379 $399.00

2310022 OBS OBSERVATION HRL G0378 $46.00

2310049 NON STRESS TEST 59025 $138.00

2310057 INJECTION FEE OP 96372 $54.00

2310082 LABOR-HOURLY $100.00

2376815 LIMITED OB 76815 $167.00

2376817 TRANSVAGINAL OB 76817 $202.00

2401442 EXC BENIGN LES; FACE ETC; 1.1-2 cm 11442 $421.00

2404100 AMINOFILL-1000 Q4100 $2,525.00

2404101 AMINOFILL-0500 Q4100 $1,290.00

2404186 EPIFIX GRAFT PER SQUARE CM Q4186 $214.00

2409612 PHO DOC > 1 CECAL LDMK COM EX G9612 $5.00

2409614 NO PHOTODOC CECAL LDMK EXAM G9614 $5.00

2410021 FINE NEEDLE ASP W/OUT IMAGING GUIDE 10021 $179.00

2410060 INC AND DRAIN OF ABSCESS; SIMPLE 10060 $233.00

2410061 INC AND DRAIN OF ABSCESS; COMP/MULT 10061 $431.00

2410080 INC AND DRAIN PILONIDAL CYST; SIMPL 10080 $380.00

2410104 COLOREC CANCER SCREENING FLEXSIG G0104 $416.00

2410120 INC AND REM FOREIGN BODY SUBCU; SIM 10120 $258.00

2410140 INC AND DRAIN HEMATOMA SEROMA OR FL 10140 $353.00

2410160 PUNCTURE ASPIRATION OF ABSCESS HEMA 10160 $289.00

2411042 DEBRIDEMENT SKIN AND SUBCU 11042 $205.00

2411043 DEBRIDEMENT SKIN SUBCU AND MUSCLE 11043 $706.00

2411101 BIOPSY SKIN ADD-ON 11101 $69.00

2411200 REM SKIN TAGS; ANY AREA; UP TO 15 11200 $169.00

2411296 MASTOTOMY 19296 $8,777.00

2411301 SHAVE SINGLE; TRUNK ETC .6-1 CM 11301 $209.00

2411310 SHAVE SINGLE; FACE ETC UP TO .5 CM 11310 $240.00

2411311 SHAVE LESION FACE ECT .6 TO 1.0 CM 11311 $240.00

2411400 EXC BENIGN LES; TRUNK ETC; UP TO .5 11400 $276.00

2411401 EXC BENIGN LES; TRUNK ETC; .6-1 CM 11401 $316.00

2411402 EXC BENIGN LES; TRUNK ETC; 1.1-2 CM 11402 $361.00



2411406 EXC BENIGN LES; TRUNK ETC; 4+ CM 11406 $666.00

2411420 EXCISION, BENIGN LESION, EXCEPT SKIN TAG 11420 $264.00

2411421 EXC BENIGN LES; SCALP ETC; .6-1 CM 11421 $297.00

2411422 EXC BENIGN LES; SCALP ETC; 1.1-2 CM 11422 $391.00


2411426 EXC BENIGN LES; SCALP ETC; 4+ CM 11426 $804.00

2411440 EXC BENIGN LES; FACE ETC; UP TO .5 11440 $322.00

2411441 EXC BENIGN LES; FACE ETC;.6-1 CM 11441 $373.00

2411442 EXC BENIGN LES; FACE ETC; 1.1-2 cm 11442 $421.00

2411443 EXC BENIGN LES; FACE ETC 11443 $574.00

2411450 EXC SUBCU TISSUE FOR HIDRADENITIS SIMPLE 11450 $885.00

2411462 EXCISION OF SKIN/SUBCUTANEOUS TISSUE FOR 11462 $993.00

2411470 EXC SUBCU TISSUE FOR HIDRADENITIS INTERM 11470 $948.00

2411600 EXC MAL LES; TRUNK ETC; UP TO .5 CM 11600 $411.00

2411601 EXC MAL LES; TRUNK ETC; .6-1 CM 11601 $490.00

2411602 EXC MAL LES; TRUNK ETC; 1.1-2 CM 11602 $533.00

2411603 EXC MAL LES; TRUNK ETC; 2.1-3 CM 11603 $611.00

2411606 EXC MAL LES; TRUNK ETC; 4.0+ CM 11606 $949.00

2411620 EXC MAL LES; SCALP ETC; UP TO .5 CM 11620 $471.00

2411621 EXC MAL LES; SCALP ETC; .6-1 CM 11621 $494.00

2411622 EXC MAL LES; SCALP ETC; 1.1-2 CM 11622 $558.00

2411623 EXC MAL LES; SCALP ETC; 2.1-3 CM 11623 $655.00

2411626 EXC MAL LES; SCALP ETC; 4+ CM 11626 $921.00

2411640 EXC MAL LES; FACE ETC; UP TO .5 CM 11640 $430.00

2411642 EXC MAL LES; FACE ETC;1.1 TO 2.0 11642 $610.00

2411730 AVULSION NAIL PLATE; SIMPLE; SINGLE 11730 $227.00

2411750 EXC NAIL AND MATRIX; PERM REMOVAL 11750 $470.00

2411770 EXC PILONIDAL CYST OR SINUS; SIMPLE 11770 $603.00

2411771 EXC PILONIDAL CYST OR SINUS; EXTENS 11771 $1,234.00

2411772 EXC PILONIDAL CYST OR SINUS; COMP 11772 $1,620.00

2412001 SIMPLE REPAIR 2.5 CM OR LESS 12001 $357.00

2412002 SIMPLE REPAIR 2.6-7.5 CM 12002 $347.00

2412005 SIMPLE REPAIR 12.6-20.0 CM 12005 $551.00

2412006 SIMPLE REP SUPERFICIAL WOUNDS 12006 $686.00

2412011 SIMPLE REPAIR FACE ETC 2.5 CM OR LE 12011 $379.00

2412014 SIMPLE REPAIR WOUNDS FACE,EARS,EYELIDS,N 12014 $489.00

2412031 INTERMED REPAIR SCALP ETC UP TO 2.5 12031 $428.00

2412032 INTERMED REPAIR SCALP ETC 2.6-7.5 CM 12032 $673.00

2412034 INTERMED REPAIR SCALP ETC 7.6-12.5 CM 12034 $666.00

2412035 INTER LAC 12.6-20CM 12035 $703.00

2412041 LAYER CLOSURE NECK HANDS FEET ETC 12041 $544.00

2412042 INT LAC 2.6-7.5 NHF 12042 $615.00

2412044 INT LAC 7.6-12.5 NHFG 12044 $784.00

2412051 CLOSURE WND FACE,EARS, ETC>2.5 CM 12051 $544.00

2412053 INT LAC 5.1-7.5 12053 $1,234.00

2412296 MASTOTOMY 19296 $8,777.00

2412551 CHEST TUBE 32551 $473.00

2413100 REPAIR, COMPLEX, TRUNK, 1.1-2.5 CM 13100 $849.00

2413101 REPAIR COMPLEX TRUNK 2.5CM TO 7.5CM 13101 $889.00

2413102 REPAIR COMPLEX TRUNK ADD'L 5CM OR LESS 13102 $248.00

2413121 LAYER CLOSURE COMPLEX WOUND 2.6-7.5C 13121 $1,060.00

2413122 REPAIR,COMPLEX,SCALP,ARMS,AND/OR LEGS;EA 13122 $358.00

2413132 COMPLEX RPR F/C/C/M/N/AX/G/H/F 13132 $1,171.00

2413160 SECONDARY CLOSURE OF SURG WOUND EXT 13160 $2,416.00

2413239 UPPER GI ENDOSCOPY, BIOPSY 43239 $923.00

2413246 OPERATIVE UPPER GI ENDOSCOPY 43246 $681.00

2413830 PLACE GASTROSTOMY TUBE 43830 $1,690.00

2414005 FREEING OF BOWEL ADHESION 44005 $3,211.00

2414075 EXC SOFT TISSUE TUMOR UP ARM SUBC <3CM 24075 $1,179.00

2414120 REMOVAL OF SMALL INTESTINE 44120 $3,567.00

2414140 PARTIAL REMOVAL OF COLON 44140 $3,137.00



2414180 LAP ENTEROLYSIS 44180 $3,566.00

2414202 LAP BOWEL RESECTION 44202 $3,735.00

2414204 LAP COLECTOMY PART'L ANASTOMOSIS 44320 $3,908.00

2414388 COLONOSCOPY THRU STOMA 44388 $919.00

2414620 REPAIR BOWEL OPENING 44620 $2,533.00

2414955 APPENDECTOMY other 44955 $232.00

2415331 SIGMOIDOSCOPY AND BIOPSY 45331 $457.00

2415570 FORMATION OF DIRECT OR TUBED PEDICLE,WIT 15570 $2,469.00

2415736 MUSCLE/MYOCUTANEOUS/FASCIOCUTANEOUS FLAP 15736 $3,608.00

2415738 MUSCLE FLAP, LOWER EXTREMITIES 15738 $3,608.00

2416000 BURN TREATMENT 1ST DEGREE LOCAL 16000 $167.00

2416020 BURN DEBRIDEMENT; WO ANES; SMALL 16020 $202.00

2416569 INSERT PICC CATH 36569 $745.00

2416600 DIAGNOSTIC ANOSCOPY 46600 $214.00

2417000 DESTRUCT BEN OR PREMALIG LESION 1ST 17000 $173.00

2417003 DESTRUCT BEN OR PREMALIG LESION 2-1 17003 $41.00

2417100 BIOPSY LIVER, WEDGE 47100 $2,060.00


2417285 PARAVAGINAL DEFECT REPAIR, VAG APPROACH 57285 $1,755.00

2417323 BIOPSY, SOFT TISSUE, SUPERFICIAL 27323 $659.00

2417379 UL LAP LIVER 47379 $853.00

2417447 MEDIAL&LATERAL COMP W/ORW/O PATELLA RESU 27447 $3,737.00

2417609 LIGATION OR BIOPSY OF TEMPORAL ARTERY 37609 $767.00

2417840 EXC LESION EYELID W/O CLOSURE OR SIMP CL 67840 $759.00

2417999 UNLISTED PROC SKIN, MUCOUS MEMBRANE 17999 $891.00

2418525 BIOPSY/REMOVAL LYMPH NODES 38525 $1,256.00

2418570 LAP BIOPSY RETROPERITONEAL LYMPH NODE 38570 $1,290.00

2418792 INJ IDENTIFICATION OF SENTINEL NODE 38792 $103.00

2418999 OTHER PROC, LYMPHATIC/HEMIC SYSTEM 38999 $624.00

2419000 PUNCTURE ASPIRATION 19000 $272.00

2419001 PUNCTURE ASPIRATION; EA ADDL CYST 19001 $69.00

2419100 BIOPSY OF BREAST; PERC NEEDLE; WO I 19100 $330.00

2419101 BIOPSY OF BREAST; OPEN INCISIONAL 19101 $785.00

2419102 SP-BX BREAST-CORE-IMAG GUID 19081 $551.00

2419120 EXC CYST ETC; OPEN 1 OR MORE LES 19120 $1,067.00

2419125 EXC BREAST LES W PREOP PL; OPEN ; SI 19125 $1,176.00

2419296 MASTOTOMY 19296 $8,777.00

2419300 REMOVAL OF BREAST TISSUE 19300 $1,411.00

2419301 MASTECTOMY PARTIAL 19301 $1,827.00

2419302 MASTECTOMY PARTIAL W AX LYMPHADEHEC 19302 $2,053.00

2419303 MASTECOMY SIMPLE COMPLETE 19303 $2,825.00

2419304 MASTECOMY SUBCUTANEOUS 19304 $1,487.00

2419307 MASTECTOMY MOD RAD INC AX LYMPH NOD 19307 $2,673.00

2419402 REMOVE FOREIGN BODY, ABDOMEN 49402 $2,296.00

2419653 LAP VENT/ABD HERNIA PROC COMPLICATED 49653 $2,360.00

2420102 EXPLORE PENETRATING WOUND ABD/FLANK 20102 $1,091.00

2420103 EXPLORE PENTRATING WOUND EXTREMITY 20103 $1,336.00

2420240 BIOPSY BONE, OPEN; SUPERFICIAL 20240 $603.00

2420520 RMVL FOREIGN BODY, MUSCLE, SIMPLE 20520 $552.00

2420525 RMVL FOREIGN BODY, MUSCLE, COMPLEX 20525 $1,154.00

2421013 EXC FACE TUM DEEP <2 CM 21013 $1,265.00

2421550 BIOPSY SOFT TISSUE NECK OR THORAX 21550 $581.00

2421552 EX NECK LES SC= 3CM 21552 $1,213.00

2421555 EX TUMOR NECK, THORAX SUBCUTANEOUS 21555 $996.00

2421556 EXCISE TUMOR, TISSUENECK/THORAX DEEP 21556 $1,428.00

2421931 EXC BACK LES SC= 3 CM 21931 $1,215.00

2421933 EXC BACK TUM= 5CM 21933 $1,903.00

2422900 EXCISION, ABDOMINAL WALL TUMOR, SUBFACIA 22900 $1,546.00

2422901 EXC BACK TUM DEEP= 5CM-1 22901 $1,686.00

2423044 ARTHROTOMY WITH EXPLORATION, DRAINAGE OR 23044 $1,576.00

2423071 EXC SHOULDER LES SC >3 CM 23071 $1,133.00

2423073 EXC SHOULDER TUM DEEP > 5 CM 23073 $1,922.00

2423075 EXC SOFT TISSUE TUMOR SHOULDER 23075 $603.00

2424071 EXC ARM/ELBOW LES SC = 3 CM 24071 $1,110.00

2424075 EXC SOFT TISSUE TUMOR UP ARM SUBC <3CM 24075 $1,179.00

2424076 EXC SOFT TISSUE TUMOR UPPER ARM DEEP 24076 $1,411.00

2425020 DECOMPRESSION FASCIOTOMY FOREARM/WR 25020 $1,640.00

2425065 BIOPSY SOFT TISSUE FOREARM/WRIST SU 25065 $558.00

2426010 DRAINAGE OF FINGER ABSCESS/SIMPLE 26010 $615.00

2427043 EXC HIP PELVIS LES SC > 3 CM 27043 $1,278.00

2427049 RADICAL RESECTION TUMOR SOFT TISSUE 27049 $3,010.00

2427130 ARTHROPLASTY ACETABULAR AND PROXIMAL FEM 27130 $3,730.00

2427236 OPEN TX FEMORAL FX, PROXIMAL END, NECK, 27236 $3,290.00

2427323 BIOPSY, SOFT TISSUE, SUPERFICIAL 27323 $659.00

2427327 EXC TUMOR THIGH/KNEE <3CM 27327 $1,237.00

2427337 EXC THIGH/KNEE LES SC > 3 CM 27337 $1,168.00

2427339 EXC THIGH/KNEE TUM DEEP >5CM 27339 $2,091.00

2427446 ARTHROPLASTY KNEE CON & PLAT MED/LA 27446 $2,730.00

2427487 SECONDARY RECONSTRUCTION FOR REVISION OF 27487 $3,806.00

2427590 AMPUTATION THIGH THRU FEMUR 27590 $2,355.00

2427619 EXC LEG/ANKLE TUM DEEP <5CM 27619 $977.00

2427691 TRSF TENDON OR TRANS TENDON, WMUSCLE RED 27691 $2,069.00

2427880 AMPUTATION LEG THRU TIBIA/FIBULA 27880 $1,814.00

2428104 EXCISION OR CURETTAGE OF BONE CYST OR BE 28104 $1,467.00

2428190 REM OF FOREIGN BODY FOOT; SUBCU 28190 $538.00

2428192 REMOVE FOREIGN BODY; DEEP 28192 $995.00

2431500 INTUBATION ENDO EMERGENCY PROCEDURE 31500 $347.00

2432551 CHEST TUBE 32551 $473.00

2432556 PERQ DRAINAGE PLEURA INSERT CATH W/O IMA 32556 $3,735.00

2435840 EXPLORATION OF POSTOP HEM,THROMB;ABDOMEN 35840 $3,229.00

2436556 INSERT NON-TUNNEL CV CATH 36556 $652.00

2436558 INSERT TUNNELED CV CATH 36558 $2,187.00

2436561 INSERT TUNNELED CV CATH 36561 $3,047.00

2436571 INSERT PICVAD CATH 36571 $3,258.00

2436575 REPAIR TUNNELED CV CATH 36575 $428.00

2436581 REPLACE TUNNELED CV CATH 36581 $1,980.00

2436582 REPLACE TUNNELED CV CATH 36582 $3,065.00

2436589 REMOVAL TUNNELED CV CATH 36589 $428.00

2436590 REMOVAL TUNNELED CV CATH 36590 $681.00

2436821 AV FUSION DIRECT ANY SITE 36821 $1,696.00

2437609 LIGATION OR BIOPSY OF TEMPORAL ARTERY 37609 $767.00

2437799 UNLISTED VASCULAR PROCEDURE 37799 $3,229.00

2438300 DRAINAGE OF LYMPH NODE ABCESS 38300 $654.00

2438500 BIOPSY/REMOVAL, LYMPH NODES 38500 $748.00

2438510 BIO/REM LYMPH NODES/EXC DEEP CERVICAL 38510 $1,343.00

2438525 BIOPSY/REMOVAL LYMPH NODES 38525 $1,256.00

2438562 REMOVAL, PELVIC LYMPH NODES 38562 $2,119.00

2438570 LAP BIOPSY RETROPERITONEAL LYMPH NODE 38570 $1,290.00

2438745 REMOVE ARMPIT LYMPH NODES 38745 $2,546.00

2438792 INJ IDENTIFICATION OF SENTINEL NODE 38792 $103.00

2438900 IO MAP OF SENT LYMPH NODE 38900 $365.00

2438999 OTHER PROC, LYMPHATIC/HEMIC SYSTEM 38999 $624.00

2443200 ESOPHAGUS ENDOSCOPY 43200 $580.00

2443215 ESOPHAGUS ENDOSCOPY 43215 $489.00

2443235 UPPR GI ENDOSCOPY, DIAGNOSIS 43235 $802.00

2443239 UPPER GI ENDOSCOPY, BIOPSY 43239 $923.00


2443247 EXOPHAGOGASTRODUODENOSCOPY; W REM FB 43247 $644.00

2443248 UPPR GI ENDOSCOPY/GUIDE WIRE 43248 $507.00

2443249 ESOPH ENDOSCOPY DILATION 43249 $2,300.00


2443254 EDG TRANSORAL ENDOSCOPIC MUCOSAL RESECTI 43254 $701.00

2443760 CHANGE GASTROSTOMY TUBE 43760 $471.00

2443830 PLACE GASTROSTOMY TUBE 43830 $1,690.00

2443840 REPAIR OF STOMACH LESION 43840 $3,896.00

2444005 FREEING OF BOWEL ADHESION 44005 $3,211.00

2444010 INCISION OF SMALL BOWEL 44010 $2,529.00

2444015 INSERT NEEDLE CATH BOWEL 44015 $434.00

2444050 LAPAROTOMY REDUCTION OF VOLVULUS,INTUSSU 44050 $2,578.00



2444130 BOWEL TO BOWEL FUSION 44130 $3,769.00

2444139 MOBILIZATION OF COLON 44139 $364.00





2444160 REMOVAL OF COLON 44160 $3,630.00

2444180 LAP, ENTEROLYSIS 44180 $3,566.00

2444188 LAP, COLOSTOMY 44188 $3,566.00

2444202 LAP BOWEL RESECTION 44202 $3,735.00

2444204 LAP COLECTOMY PART'L ANASTOMOSIS 44320 $3,908.00

2444320 COLOSTOMY 44320 $3,908.00

2444388 COLONOSCOPY THRU STOMA 44388 $919.00

2444389 FIBEROPTIC COLONOSCOPY THROUGH COLOSTOMY 44389 $1,075.00

2444394 COLONOSCOPY THRU STOMA; REMOVAL/BY SNARE 44394 $1,335.00

2444602 SUTURE, SMALL INTESTINE 44602 $4,071.00




2444800 EXCISION OF BOWEL POUCH 44800 $2,239.00

2444950 APPENDECTOMY 44950 $1,502.00

2444955 APPENDECTOMY other 44955 $232.00

2444960 APPENDECTOMY 44960 $2,005.00

2444970 LAPAROSCOPY, APPENDECTOMY 44970 $1,680.00

2445100 BIOPSY ANORECTAL WALL, ANAL APPROACH 45100 $832.00

2445110 REMOVAL OF RECTUM 45110 $5,419.00

2445171 EXC RECT TUM TRANSANAL PART 45171 $1,650.00

2445300 PROCTOSIGMOIDOSCOPY DX 45300 $267.00

2445305 PROCTOSIGMOIDOSCOPY W/BX 45305 $441.00

2445330 DIAGNOSTIC SIGMOIDOSCOPY 45330 $353.00

2445331 SIGMOIDOSCOPY AND BIOPSY 45331 $457.00

2445338 SIGMOIDOSCOPY W/ TUMOR REMOVE 45338 $832.00

2445378 DIAGNOSTIC COLONOSCOPY 45378 $1,054.00

2445380 COLONOSCOPY AND BIOPSY 45380 $1,257.00

2445381 COLONOSCOPY SUBMUCOUS INJ 45381 $988.00

2445383 COLONOSCOPY ABLATION OF LESION 45378 $1,054.00

2445384 LESION REMOVE COLONOSCOPY 45384 $1,240.00

2445385 LESION REMOVE COLONOSCOPY 45385 $1,417.00

2445563 EXPLORATION/REPAIR OF RECTUM 45563 $4,744.00

2445990 SURG DX EXAM, ANORECTRAL 45990 $322.00

2446020 PLACEMENT OF SETON 46020 $665.00

2446030 REMOVAL OF RECTAL MARKER 46030 $284.00

2446040 INCISION OF RECTAL ABSCESS 46040 $1,170.00

2446045 INCISION OF RECTAL ABSCESS 46045 $1,215.00

2446050 INCISION OF ANAL ABSCESS 46050 $399.00

2446080 INCISION OF ANAL SPHINCTER 46080 $518.00

2446083 INCISE EXTERNAL HEMORRHOID 46083 $378.00

2446220 REMOVAL OF ANAL TAG 46220 $554.00

2446221 LIGATION OF HEMORRHOID(S) 46221 $537.00

2446230 REMOVAL OF ANAL TAGS 46230 $579.00

2446250 HEMORRHOIDECTOMY, EXTERNAL, COMPLETE 46250 $1,252.00

2446255 HEMORRHOIDECTOMY 46255 $1,084.00

2446260 HEMORRHOIDECTOMY 46260 $1,037.00

2446270 REMOVAL OF ANAL FISTULA 46270 $1,089.00

2446275 REMOVAL OF ANAL FISTULA 46275 $1,163.00

2446320 REMOVAL OF HEMORRHOID CLOT 46320 $383.00

2446600 DIAGNOSTIC ANOSCOPY 46600 $214.00

2446606 ANOSCOPY AND BIOPSY 46606 $526.00

2446922 SURGICAL EXCISION ANAL LESION (S) 46922 $575.00

2446924 DESTRUCTION, ANAL LESION(S) 46924 $1,140.00

2446945 REMOVE BY LIGAT INT HEM GRP 46945 $744.00

2447000 NEEDLE BIOPSY LIVER 47001 $812.00

2447001 NEEDLE BIOPSY, LIVER ADD-ON 47001 $883.00

2447100 BIOPSY LIVER, WEDGE 47100 $2,060.00

2447350 REPAIR LIVER WOUND 47350 $3,995.00

2447379 UL LAP LIVER 47379 $853.00

2447480 INCISION OF GALLBLADDER 47480 $2,506.00

2447550 BILE DUCT ENDOSCOPY ADD-ON 47550 $499.00

2447562 LAPAROSCOPIC CHOLECYSTECTOMY 47562 $1,709.00

2447563 LAPARO CHOLECYSTECTOMY/GRAPH 47563 $1,762.00

2447564 LAPARO CHOLECYSTECTOMY/EXPLR 47564 $2,547.00

2447570 LAPARO CHOLECYSTOENTEROSTOMY 47570 $2,271.00

2447579 LAPAROSCOPE PROC, BILIARY 47579 $2,271.00

2447600 REMOVAL OF GALLBLADDER 47600 $2,419.00

2447605 REMOVAL OF GALLBLADDER 47605 $2,871.00

2447610 REMOVAL OF GALLBALDDER 47610 $3,669.00

2449000 EXPLORATION OF ABDOMEN 49000 $2,270.00

2449002 DRAIN ABDOMEN ABSCESS 49002 $2,305.00

2449020 DRAIN ABDOMEN ABSCESS 49020 $4,639.00

2449180 BIOPSY, ABDOMINAL MASS 49180 $434.00

2449255 REMOVAL OF OMENTUM 49255 $2,304.00

2449320 DIAG LAPARO SEPARATE PROC 49320 $761.00

2449321 LAPAROSCOPY, SURGICAL W/BIOPSY 49321 $1,154.00

2449322 LAPAROSCOPY, SURGICAL, ABDOMEN, PERITONE 49322 $887.00

2449329 LYSIS OF ADHESIONS LAPAROSCOPIC 49329 $2,615.00

2449421 INSERT ABDOM DRAIN, PERM 49421 $1,154.00

2449422 REMOVE PERM CANNULA/CATHETER 49422 $1,151.00

2449500 RPR ING HERNIA, INIT, REDUCE 49500 $1,200.00

2449505 PRP I/HERN INIT REDUC>5YR 49505 $1,192.00

2449507 PRP I/HERN INIT BLOCK>5YR 49507 $1,858.00

2449520 REREPAIRING HERNIA, REDUCE 49520 $1,843.00

2449521 REREPAIRING HERNIA, BLOCKED 49521 $2,241.00

2449525 REPAIRING HERNIA, SLIDING 49525 $1,671.00

2449550 RPR REM HERNIA, INIT, REDUCE 49550 $1,677.00

2449553 RPR FEM HERNIA, INIT BLOCKED 49553 $1,834.00

2449560 RPR VENTRAL HERN INIT, REDUC 49560 $1,721.00

2449561 RPR VENTRAL HERN INIT, BLOCK 49561 $2,720.00

2449565 REREPAIR VENTRL HERN, REDUCE 49565 $2,238.00

2449566 REREPAIR VENTRL HERN, BLOCK 49566 $2,749.00

2449568 HERNIA REPAIR W/MESH 49568 $654.00

2449570 RPR EPIGASTRIC HERN, REDUCE 49570 $935.00

2449572 RPR EPIGASTRIC HERN, BLOCKED 49572 $1,481.00

2449580 RPR UMBIL HERN, REDUC<5YR 49580 $932.00

2449585 RPR UMBIL HERN, REDUC >5YR 49585 $1,007.00

2449587 RPR UMBIL HERN, BLOCK>5YR 49587 $1,195.00

2449590 REPAIR SPIGELIAN HERNIA 49590 $1,663.00

2449652 LAP VENT/ABD HERNIA REPAIR 49652 $1,877.00

2449653 LAP VENT/ABD HERNIA PROC COMPLICATED 49653 $2,360.00

2449654 LAP INC HERNIA REPAIR 49654 $2,327.00

2449900 REPAIR OF ABDOMINAL WALL 49900 $2,390.00

2449999 ABDOMEN SURGERY PROCEDURE 49999 $2,390.00

2451860 CYSTORRHAPHY,SUT BLADDER, INJ/RUPT COMPL 51860 $2,067.00

2455040 EXCISION HYDROCELE,UNILATERAL 55040 $923.00

2457268 REPAIR OF BOWEL BULGE 57268 $1,493.00

2458662 LAP, SURG; W/FULGURATION/EXCISION LESION 58662 $1,761.00

2458671 LAPAROSCOPY, TUBAL BLOCK 58671 $1,122.00

2458740 LYSIS OF ADHESIONS 58740 $2,399.00

2460225 THYROID LOBECTOMY INCL ISTHMUSECTOMY 60225 $2,366.00


2464425 INJ ILIOINGUINAL, ILIOHYPOGASTRIC NERVES 64425 $310.00

2465738 MUSCLE FLAP, LOWER EXTREMITIES 15738 $3,608.00

2467840 EXC LESION EYELID W/O CLOSURE OR SIMP CL 67840 $759.00

2474300 X-RAY BILE DUCTS/PANCREAS 74300 $164.00

2474301 X-RAYS AT SURGERY ADD-ON 74301 $83.00

2475827 VEIN X-RAY, CHEST 75827 $921.00

2476000 FLUOROSCOPE EXAMINATION 76000 $218.00

2490105 COLONOSCOPY W/HIGH RISK G0105 $1,054.00

2490121 ROUTINE COLONOSCOPY G0121 $1,054.00

2496372 THER/PROPH/DIAG IN, SC/IM 96372 $56.00

2497597 ACTIVE WOUND CARE/20 CM OR < 97597 $111.00

2497599 ACTIVE WOUND CARE/20 CM OR < 97597 $111.00

2497602 REMOVAL OF DEVITALIZED TISSUE/WOUND CARE 97602 $82.00

2499050 MEDICAL SERVICES AFTER HRS 99050 $39.00


2499201 OFFICE VISIT NEW (99201) 99201 $86.00

2499202 OFFICE VISIT NEW (99202) 99202 $134.00

2499203 OFFICE VISIT NEW (99203) 99203 $184.00

2499204 OFFICE VISIT NEW (99204) 99204 $267.00

2499205 OFFICE VISIT NEW (99205) 99205 $344.00

2499211 OFFICE VISIT EST (99211) 99211 $50.00

2499212 OFFICE VISIT EST (99212) 99212 $77.00

2499213 OFFICE VISIT EST (99213) 99213 $108.00

2499214 OFFICE VISIT EST (99214) 99214 $173.00

2499215 OFFICE VISIT EST (99215) 99215 $242.00

2499217 OBSERVATION CARE DISCHARGE 99217 $139.00







2499225 OP- DAILY VISIT 99225 $118.00




2499234 OP-ADMIT/DISHARGE SAME DAY DETAIL 99234 $274.00

2499238 HOSPITAL DISCHARG DAY 99238 $177.00

2499241 OFFICE CONSULTATION 99241 $176.00





2499251 INPATIENT CONSULTATION 20 MIN 99251 $101.00



2499254 INPATIENT CONSULTATION 99254 $342.00






2499291 CRITICAL CARE-1ST 99291 $590.00

2499307 NURSING FAC CARE, SUBSEQ 99307 $83.00

2499308 NURSING FAC CARE, SUBSEQ 99308 $120.00

2499315 NURSING FAC CARE, DISCHARGE 99315 $160.00

2499401 PREV MEDICINE COUNSELING 99401 $64.00

2499402 PREV MEDICINE COUNSELING 30 MINS 99402 $108.00



2499441 TELEPHONE EVALUATION 5-10 99441 $22.00



2500010 OR LEVEL 1 $1,110.00

2500020 OR LEVEL 2 $3,882.00

2500030 OR LEVEL 3 $5,989.00

2500040 OR LEVEL 4 $8,873.00

2500045 OR UNIT $111.00

2500444 EDSI $2,570.00

2501341 PHACOEMULSIFICATION ASPIRATION CATARACT $5,052.00

2504513 EGD $1,266.00

2504523 COLONOSCOPY $2,503.00

2504525 COLONOSCOPY W/BIOPSY $3,612.00

2504542 COLONOSCOPY W/POLYPECTOMY $3,612.00

2702265 MESH PERFIX LIGHT PLUG XL 0117080 $437.00

2702267 GRAFT PURAPLY AM $2,614.00

2702290 OMNI SURGICAL SYSTEM $2,718.00

2702820 CEMENT, BONE SIMPLEX P 40GM C1713 $225.00

2702821 CEMENT, SIMPLEX HV C1713 $225.00

2702822 CEMENT, SIMPLEX HV W/ GENTAMICIN C1713 $585.00

2709590 TORIC LENS V2632 $1,171.00

2709605 RESTOR LENS $1,736.00

2710111 IMPLANT #1 $539.00

2710222 IMPLANT #2 $1,077.00

2710333 IMPLANT #3 $5,385.00

2710444 IMPLANT #4 $10,769.00

2716963 LENS SPECIAL V2632 $730.00

2720111 OR SUPPLY #1 $269.00

2720222 OR SUPPLY #2 $539.00

2720333 OR SUPPLY #3 $1,077.00

2720444 OR SUPPLY #4 $2,154.00

2721000 KNEE ALIGN II 133631 $10,403.00

2725001 TRIATHLON PS X3 TIBIAL INSERT SZ5 C1776 $2,962.00

2725002 TRIATHLON PS X3 TIBIAL INSERT SZ5 511 C1776 $2,962.00

2725003 TRIATHLON PS FEM COMPONENT SZ5 501 C1776 $4,738.00

2725004 TRIATHLON PRIM TIB BASEPLATE SZ3 C1776 $2,962.00





2725009 TRIDENT HEMISPHERICAL HA CLUSTER 56MM C1776 $2,962.00

2725010 INSERT,TRIDENT 10* X3 36MM ID SZF C1776 $2,962.00

2725011 DELTA V-40 CERAMIC HEAD 36/0 C1776 $2,962.00

2725012 STEM, ACCOLADE II SIZE 5 127 DEG C1776 $6,396.00

2725013 SCREW, CANCELLOUS Ti 6.5MM X 25MM C1713 $316.00


2725015 VITAGEL RT C1713 $1,065.00


2725017 TRIATHLON PS FEM COMPONENT SZ4 C1776 $4,738.00



2725020 TRIATHLON TS BASEPLATE SZ7 C1776 $3,554.00






2725026 TRIATHLON PS X3 TIBIAL INSERT SZ4 C1776 $2,962.00

2725027 TRIDENT HEMISPHERICAL HA CLUSTER 54MM E C1776 $2,875.00

2725028 HEAD, FEMORAL COCR 36MM/+5* LFIT V40 C1776 $1,495.00

2725029 TRIDENT X3 ECCENTRIC 10* 36MM C1776 $2,875.00



2725032 KIT, NAIL Ti TROCHANTERIC 11X180MM C1713 $3,068.00





2725037 HEAD, FEMORAL COCR 36MM/ 0* LFIT V40 C1776 $1,495.00

2725038 SCREW, LOCKING SELF-TAP 5MM X 36MM C1713 $361.00






2725044 PLATE, FEMORAL TI 166M LFT DL 11 HOLE ST C1776 $4,242.00


2725046 STEM, HUMERAL 9MM X 113MML PF REUNION C1776 $8,155.00

2725047 HUMERAL INSERT 36MM X 6MM THK X3 REUNION C1776 $3,764.00

2725048 BASEPLATE, GLENOID FIXATION 48MML ST C1776 $3,764.00

2725049 SCREW, PERIPHERAL 4.5MM x 16MM C1713 $418.00


2725051 GLENOSPHERE, 36MM DIA X 2MM C1776 $3,764.00

2725052 SCREW, CENTER 6.5MM x 32MM C1713 $418.00


2725054 SCREW, COMPRESS SS 2.5MM X 22MML T7 AUT C1713 $1,085.00


2725056 SHELL, Ti TRIDENT HEMISPHERICAL SZE 60MM C1776 $2,875.00

2725057 STEM, FEMORAL ACCOLADE II SZ7 127* C1776 $6,211.00

2725058 SHELL, Ti TRIDENT HEMISPHERICAL SZE 52MM C1776 $2,875.00

2725059 STEM, COCR FEM SZ3 43MM X 131MML 35MML C1776 $4,025.00

2725060 HEAD, UNIVERSAL UHR BIPOLAR 28MM X 47MM C1776 $1,725.00

2725061 SPACER, FEMORAL UNIV DISTAL 15MM HIP C1776 $330.00


2725063 SCREW, LOCKING Ti T2 F/T 5MM X 35MM ST C1713 $399.00

2725064 SCREW, LOCKING Ti T2 F/T 5MM X 37.5MM ST C1713 $399.00

2725065 KIT, NAIL Ti TROCHANTERIC 10MM DIA DISTL C1713 $3,726.00

2725066 SCREW, CANCELLOUS Ti 8MM X 17.5MM GAMMA C1713 $418.00

2725067 SCREW, LAG Ti 10.5MM X 105MM C1713 $1,199.00

2725068 KIT, NAIL Ti TROCHANTERIC 11MM DIA DISTL C1713 $2,860.00


2725070 REAMER, SHAFT 8MM X 448MML W/AO FIT C1776 $811.00

2725071 SCREW, COMPRESSN HEADLESS 5X44MM 658144 C1713 $1,288.00

2725072 SCREW, COMPRESSN HEADLESS 7X75MM 658375 C1713 $2,059.00


2725074 HUMERAL CUP 32MM DIA X 4MM THK REUNION C1776 $3,764.00



2725077 PLATE, FEMORAL Ti 89MM 4 HOLE 2MM THK C1776 $1,600.00

2725078 SCREW, BONE T10 3.5MM X 12MM C1713 $190.00




2725082 SCREW, LOCKING T10 3.5MM X 10MM C1713 $353.00


2725084 TRIATHLON PRIM TIB BASEPLATE 700 C1776 $2,962.00

2725085 TRIATHLON PS X3 TIBIAL INSERT 711 C1776 $2,962.00

2725086 SCREW, CANNULATED ASNIS III Ti 4.0X44MM C1713 $361.00







2725093 TRIATHLON PS FEM COMPONENT SZ 5 502 C1776 $4,600.00



2725096 PIN, FIXATION 3.5IN FLUTED HEADLESS C1713 $722.00



2725099 HEAD, FEMORAL COCR 36MM -5MM LFIT V40 C1776 $1,495.00

2725100 INSERT, TRIDENT 10* ACETABULAR SIZE E 36 C1776 $2,875.00


2725102 HEAD, FEMORAL COCR 28MM/ +4MM LFIT V40 C1776 $1,495.00


2725104 INSERT, TIBIAL SZ4 TRIATHLON 16MM THK C1776 $6,323.00




2725108 SCREW, LOCKING T7 FT 2.7MM X18MM C1713 $249.00







2725115 SCREW, PERIPHERAL 4.5MM X 32MM C1713 $418.00


2725117 HUMERAL CUP 32MM DIA X 10MM THK REUNION C1776 $3,764.00

2725118 PLATE, WRIST FUSION STANDARD BEND 120MM C1776 $3,060.00

2725119 SCREW, LOCKING T8 FULL THREAD 2.4MM X 12 C1713 $342.00



2725122 SCREW, BONE T10 LOCKING 3.5MM X 18MM C1713 $451.00



2725125 PLATE, DISTAL FIB 3 HOLE 40-20903 C1776 $1,600.00





2725130 SCREW, BONE T8 FULL THREAD 2.4MM / L14MM C1713 $200.00

2725131 SCREW, BONE T10 3.5MM DIA 14MML FULL THR C1713 $246.00




2725135 SCREW, S-FIX SV-30 2.5X30MM C1713 $1,406.00


2725137 TRIATHLON PATELLA ASYMMETRIC X3 C1776 $1,611.00

2725138 TRIATHLON PKR FMR #4 RM/LL C1776 $4,600.00

2725139 TRIATHLON PKR INSERT X3 SZ4 RM/LL 8MM C1776 $2,962.00

2725140 TRIATHLON PKR BASEPLATE #4 RM/LL C1776 $2,875.00

2725141 TIGHTROPE, MINI 1.1MM AR-8919DS C1762 $1,872.00

2725142 CEMENT, BONE SIMPLEX P TOBRAMYCIN C1713 $914.00

2725143 ALLOSYNC PUTTY, 5CC C1762 $1,673.00

2725144 ALLOSYNC PUTTY, 2.5CC C1776 $920.00

2725145 ALLOSYNC PUTTY, 1CC C1776 $418.00



2725148 SCREW, CANNULATED ASNIS III SS 4X50MM C1713 $370.00

2725149 PLATE, DISTAL MEDIAL TIBIA RT 4 HOLE L97 C1776 $3,856.00

2725150 SCREW, COMPRESSION HEADLESS 4X32MM C1713 $1,392.00

2725151 SCREW, COMPRESSION HEADLESS 4X34MM C1713 $1,392.00

2725152 SCREW, LOCKING 4MM X 40MM C1713 $397.00


2725154 SCREW, CORTEX TI 3.5X34MM C1713 $82.00



2725157 HEAD, FEMORAL COCR 28MM +0MM LFIT V40 C1776 $1,495.00


2725159 TRIATHLON TS FEM COMPONENT SZ3 LEFT C1776 $15,842.00


2725161 INSERT, TIBIAL SZ4 TRIATHLON TS PLUS C1776 $6,323.00

2725162 POST, TRIATHLON AUGMENT SZ3 5MM C1776 $6,323.00

2725163 STEM, TRIATHLON CEMENTED 12X50MM C1776 $2,790.00


2725165 TRIATHLON STEM EXTENDER 25MM C1776 $2,550.00

2725166 PLUG, BONE MED 6215-5-011 $306.00

2725167 PLUG, BONE LG 6215-5-021 $306.00

2725168 SPACER, FEMORAL UNIV DISTAL 13MM HIP C1776 $330.00

2725169 STEM, COCR ACCOLADE C CS 127 NK C1776 $4,025.00


2725171 PIN, HALF FIXATION 5 X 120MM 5018-5-120 C1713 $315.00

2725172 COUPLING EXT FIX MLTIPLN 4/5/6MM 4922-1- C1713 $1,848.00

2725173 ROD EXTERNAL FIXATION 11X300MM 4922-8-30 C1713 $964.00

2725174 PIN, EXTERNAL FIXATION 4X250M 5030-5-200 C1713 $293.00

2725175 SCREW, CANNULATED LAG 3X16MM C1713 $418.00



2725178 SCREW, CORTICAL SELF-TAP 3.5MM X 12MM C1713 $66.00





2725183 SCREW, CANCELLOUS SS 4.0X14MM C1713 $63.00




2725187 PLATE, LOCKING COMPR 6 HOLE/L84MM C1776 $320.00

2725188 PLATE, LOCKING COMPR 7 HOLE/L97MM C1776 $320.00

2725189 SCREW, CANNULATED ASNIS III SS 6.5X70MM C1713 $578.00


2725191 PLATE, LOCKING RECON 6 HOLE/L72MM C1776 $1,018.00






2725197 PLATE, VOLAR SMARTLOCK DR STD LFT LONG C1776 $2,151.00

2725198 PLATE, VOLAR SMARTLOCK DR RIGHT C1776 $2,151.00




2725202 PLATE, LOCKING RECON 5 HOLE/L60MM C1776 $879.00

2725203 SCREW, LIZ FRANZ 4.5X42MM C1713 $3,310.00

2725204 STEM, HUMERAL 17MM PF REUNION TSA C1776 $8,155.00

2725205 HEAD, HUMERAL 56X22 SR STD REUNION TSA C1776 $3,137.00

2725206 KIT CROSS PIN FIXATION ARTHRO 2.7MM C1713 $1,340.00

2725207 SCREW INTERFERENCE CANNULATED 10MM 23MML C1713 $1,131.00


2725209 SCREW, HEADLESS 3.0X34MM C1713 $932.00

2725210 SCREW, HEADLESS 3.0X36MM C1713 $932.00

2725211 REAMER, MTP CONE 18MM C1713 $769.00

2725212 REAMER, MTP CONE 20MM C1713 $807.00

2725213 REAMER, MTP CUP 20MM C1713 $807.00

2725214 COUPLING EXT FIX ROD TO ROD 4922-1-010 C1713 $1,848.00

2725215 COUPLING EXT FIX PIN TO ROD 4922-1-020 C1713 $1,185.00

2725216 ROD EXTERNAL FIXATN 11X250MM 4922-8-250 C1713 $939.00


2725218 PIN, EXTERNAL TRANSFIX 5X250M 5030-5-250 C1713 $383.00

2725219 TRIATHLON PS X3 TIBIAL INSERT 413 C1776 $2,962.00



2725222 TRIATHLON TS FEM COMPONENT SZ5 RT C1776 $15,842.00



2725225 TRIATHLON TIBIAL AUGMENT LM/RL SZ5 5MM C1776 $2,738.00

2725226 TRIATHLON TIBIAL AUGMENT RM/LL SZ5 5MM C1776 $2,738.00



2725229 SCREW, CANN COMPRESS SS 3.0MM X 36MML C1713 $987.00

2725230 SPADE, TWO-STEP HAMMER TOE 3.4X3X8MM C1713 $1,872.00


2725232 PLATE, DISTAL FEM Ti 40.5MM 3 HL 2MM THK C1776 $913.00


2725234 SCREW, MILAGRO ADVANCE 9X23MM C1713 $1,142.00

2725235 KIT ACL ACC DISP C1713 $1,565.00

2725236 SCREW, TIGER CANNULATED 2.0X14MM C1713 $314.00



2725239 SCREW, CANNULATD TI COUNTERSNK 3/4MM DIA C1713 $470.00


2725241 REAMER, CONCAVE 10MM C1776 $627.00

2725242 REAMER, CONVEX 10MM C1776 $627.00





2725247 KIT, LONG NAIL Ti R1/5 RIGHT 11X380X125 C1713 $5,044.00

2725248 STEM, COCR FEM SZ4 46X137X35MM 6057-043D C1776 $4,025.00

2725249 PLUG, BONE SM 6215-5-001 $306.00

2725250 HEAD, HUMERAL 52X17 REUNION TSA-SR 4MM C1776 $3,137.00

2725251 STEM, HUMERAL 15MM X 99MML PF REUNION S C1776 $8,155.00

2725252 STEM, HUMERAL 16MM X 101MML PF REUNION S C1776 $8,155.00

2725253 PLATE, BONE LOCKING TUBULAR 1/3 C1776 $311.00

2725254 SCREW, LOCKING BONE ST 3X14MM C1713 $177.00


2725256 PIN CLAMP, HOFFMANN3 5 HOLE 2 POSTS 30* C1713 $2,103.00

2725257 ROD MRI SEMI CIRCULAR CURVED 8X174MM C1713 $615.00

2725258 ANCHOR SUTURE 3.5MM DIA KNOTLESS PITON C1713 $1,516.00

2725259 ANCHOR SUTURE 3.5MM DIA 9.6MML GRAVITY C1713 $1,083.00


2725261 SCREW, MUC STRT THD 4.3X46MM C1713 $1,248.00

2725262 SCREW, MUC STRT THD 4.3X28MM C1713 $1,248.00

2725263 SCREW, MUC HL 3.0X32MM C1713 $1,018.00

2725264 SCREW, MUC HL 3.0X34MM C1713 $1,018.00

2725265 SCREW, MUC HL 3.0X28MM C1713 $1,018.00

2725266 MESH VENTRALEX ST SM PATCH 1.7IN 5950007 C1781 $873.00

2725267 SCREW, MUC HL 3.0X26MM C1713 $1,018.00

2725268 SCREW, MUC HL 3.0X24MM C1713 $1,018.00


2725270 SCREW, TI LAG 10.5X100MM C1713 $1,199.00





2725275 STEM, HUMERAL 13MM REUNION TSA CEMENTED C1776 $7,633.00


2725277 SCREW, LOCKING Ti T2 F/T 5 X 42.5MM ST C1713 $399.00

2725278 SCREW, LAG Ti 10.5MM X 110MM 3060-0110S C1713 $1,199.00

2725279 KIT, NAIL LONG Ti TROCHANTERIC 11X380MM C1713 $5,044.00



2725282 STEM, HUMERAL 19X104MM PF REUNION S C1776 $8,155.00

2725283 SCREW, CANNULATED ASNIS MICRO 2.0X15/6MM C1713 $414.00

2725284 INSERT, TRIDENT 10* ACETABULAR SIZE G 36 C1776 $2,875.00


2725286 TRIDENT TIP IMPACTOR 28MM DIA CUP INSERT C1776 $834.00

2725287 TRIDENT TIP IMPACTOR 32MM DIA CUP INSERT C1776 $834.00




2725291 PLATE, OLECRANON 4 HOLE/LEFT C1776 $2,163.00


2725293 PLATE, STRT LATERAL FIB 96MML 7 HOLE TI C1776 $913.00

2725294 PLATE, PROXIMAL LAT HUM LFT 4 HOLE L99MM C1776 $3,490.00






2725300 IMPLANT SYS CPR MN SCORPION DX AR-8690DS C1762 $3,272.00


2725302 SCREW, ASNIS III SS CANN SCR 6.5X95MM C1713 $578.00



2725305 SCREW, BONE T10 FT LOCKING 3.5MM X 12MM C1713 $451.00




2725309 PLATE, R HEAD STANDARD RIM C1776 $1,891.00

2725310 SCREW, AUTOFIX COMPR MOD T7 DR 2.0 X 20M C1713 $600.00

2725311 SCREW, CORTICAL MOD T7 DRIVE 2.7 X 12MM C1713 $135.00






2725317 SCREW, LOCKING SS 2.7 X 16 MM C1713 $210.00

2725318 SCREW, LOCKING SS 2.7 X 20 MM C1713 $210.00

2725319 DELTA V-40 CERAMIC HEAD 36/+5 6570-0-236 C1776 $2,962.00

2725320 STEM, ACCOLADE II SIZE 1 127* 6721-0127 C1776 $6,396.00

2725321 ALLOGRAFT DBM PLUS PUTTY 5CC C1762 $2,482.00


2725323 SCREW, ANCHORAGE LOCKING 3MM X 18MM C1713 $810.00




2725327 SCREW, ANCHORAGE STANDARD 3MM X 16MM C1713 $559.00



2725330 PIN, FIXATION ANCHORAGE C1713 $363.00

2725331 REAMER, ANCHORAGE 2.0 MM X 110 MM CALIBR C1776 $797.00


2725333 SHELL, TRIDENT HEMISPHER HA CLUSTER 50MM C1776 $2,875.00

2725334 INSERT, TRIDENT 0 DEG INSERT 36MM C1776 $2,875.00




2725338 HEAD, FEMORAL COCR 28MM -4MM LFIT V40 C1776 $1,495.00


2725340 SCREW, CHAMFERED 6.5 X 50MM C1713 $4,037.00

2725341 SCREW, LOCKING T7 FT 2.7MM X14MM C1713 $249.00

2725342 PLATE, VOLAR SMARTLOCK DR STD LFT C1776 $1,819.00

2725343 SCREW, BONE T7 2.3 x 14MM C1713 $185.00

2725344 DELTA V-40 CERAMIC HEAD 36/+25 65700536 C1776 $2,962.00





2725349 SCREW, T2 ANKLE COMPRESSION C1713 $389.00

2725350 END CAP 12MM X +15 C1713 $437.00

2725351 NAIL, T2 ANKLE 11x200MM LEFT C1713 $4,837.00

2725352 SCREW, T2 SHAFT 5X50MM C1713 $429.00


2725354 END CAP T2 +10MM C1713 $389.00

2725355 NAIL, T2 STD TIBIAL 11x315MM C1713 $3,163.00

2725356 SPADE, TWO-STEP HAMMER TOE 2.6X2.4X10MM C1713 $1,836.00

2725357 SPADE, TWO-STEP HAMMER TOE 2.6X2.4X12MM C1713 $1,836.00

2725358 REAMER, CONCAVE 8MM C1776 $627.00

2725359 REAMER, CONVEX 8MM C1776 $627.00

2725360 PLATE, ANCHORAGE-MTP LS PLP10461 C1776 $5,765.00

2725361 PLATE, ANCHORAGE-MTP LONG PLATE RS10462 C1776 $5,906.00



2725364 PLATE, VOLAR SMARTLOCK DR RIGHT STD C1776 $1,819.00

2725365 KIT, NAIL LONG Ti TROCHANTERIC 11X360MM C1713 $5,044.00

2725366 SCREW, COMPRESSN HEADLESS 7XL45MM 658345 C1713 $974.00

2725367 SCREW, COMPRESSN HEADLESS 7XL50MM 658350 C1713 $974.00

2725368 PLATE, FIBULA 101MM 5 HOLE 2MM THK C1776 $1,304.00


2725370 SCREW, CHAMFERED 4.5 X 50MM C1713 $4,037.00

2725371 WASHER, ASNIS III 6.5/8.0 SS 390016 C1713 $85.00

2725372 SCREW, JONES 5.5X55MM C1713 $4,812.00

2725373 STEM, ACCOLADE II SIZE 7 132* 6720-0737 C1776 $6,396.00

2725374 INSERT, TRIDENT II TRITANIUM CLSTRHL 60G C1776 $2,875.00

2725375 SCREW, HEX SCREW 6.5MM LOW PROFILE 30MM C1713 $299.00


2725377 SCREW, BONE T10 3.5 X 38MM FL TRD C1713 $246.00

2725378 SCREW, BONE T10 3.5 X 50MM FL TRD C1713 $246.00

2725379 PLATE, OLECRANON 6 HOLE/LEFT C1776 $2,163.00

2725380 SET, MIS BUNIONETTE BROACH PROSTEP C1713 $673.00

2725381 SCREW, CANNULTD ASNIS III SS 6.5X85MM ST C1713 $632.00

2725382 SCREW, CANNULTD ASNIS III SS 6.5X90MM ST C1713 $632.00

2725383 SCREW, CORTICAL SELF-TAP SS 349618 C1713 $67.00


2725385 PIN, APEX S/D HALF 60THR 5021-6-180 C1713 $329.00

2725386 PLATE, PROXIMAL LAT HUM LFT 3 HOLE L86MM C1776 $4,261.00

2725387 SCREW, LOCKING 4MM X 32MM 661032 C1713 $397.00

2725388 SCREW, LOCKING 4MM X 46MM 661046 C1713 $397.00

2725389 SCREW, CORTEX TI 3.5X32MM 661432 C1713 $82.00


2725391 PLATE, DISTAL LAT FIB 6 HOLE 40-20906 C1776 $2,682.00

2725392 TRIATHLON TS FEM COMPONENT SZ4 RIGHT C1776 $15,842.00



2725395 TRIATHLON TIBIAL AUGMENT LM/RL SZ3 5MM C1776 $2,738.00

2725396 TRIATHLON TIBIAL AUGMENT RM/LL SZ3 5MM C1776 $2,738.00




2725400 PIP ALLOGFT 2.0X15 TENFUSE PIP C1762 $4,508.00

2725401 ALLOGRAFT BTB PRE SHAPED C1762 $7,946.00

2725402 TIGHTROPE, KNOTLESS AR-8926SS C1762 $2,457.00

2725403 GYNECARE TVT OBTURATOR W/MESH 810081L C1771 $2,802.00

2725404 IMPLANT SYS, BIOCOMPOSITE ACHILLES SPDBR C1762 $5,814.00

2725405 ALLOGRAFT DBM PLUS PUTTY 10CC C1762 $4,150.00

2725406 END CAP, T2 SCN FULLY THREADED C1713 $408.00


2725408 SCREW, LIZ FRANZ 4.5X36MM C1713 $3,495.00

2725409 PIN, SELF-DRILL HALF APEX 3/5X20X120MM C1713 $432.00




2725413 PLATE, DISTAL LAT FIBULA 7 HOLE 40-20907 C1776 $1,803.00

2725414 SCREW, BONE T10 3.5MM X 50MM 40-35050 C1713 $190.00


2725416 SCREW, COMPRESSN HEADLESS 7XL85MM 658385 C1713 $1,342.00

2725417 SCREW, COMPRESSN HEADLESS 7XL90MM 658390 C1713 $1,342.00

2725418 PLATE, OLECRANON 6 HOLE/RT C1776 $2,593.00


2725420 SCREW, BONE T10 LOCKING 3.5 X 55MM C1713 $451.00




2725425 LAPIPLASTY SYSTEM 2, ANATOMIC BIPLNR IMP C1713 $10,873.00

2725426 LAPIPLASTY SYSTEM 1, ANATOMIC BIPLNR IMP C1713 $8,568.00

2725427 SCREW, BONE T10 3.5MM X 28MM 40-35028 C1713 $190.00

2725428 TIGHTROPE, KNOTLESS TITANIUM AR-8926T C1762 $2,457.00

2725440 STENT URETERAL 6FR DIA 26CML PIGTAIL STR $273.00



2725450 TUBE VENT ARMSTRONG GROMMET 70146067 $26.00

2725451 TUBE VENT DONALDSON 245702 $15.00

2725452 TUBE VENT RICHARD 70241072 $53.00

2725455 KIT BAND SURGICAL FALOPE 8MM X 32CM A4264 $416.00

2725460 CEMENT, BONE 5ML INJECTABLE 897005 C1713 $4,519.00

2725470 ALLOMATRIX PUTTY, 1CC C1776 $745.00

2725475 PLUG, PERFIX MED 0112760 C1781 $307.00

2725476 PLUG, PERFIX LG 0112770 C1781 $312.00

2725477 PLUG, PERFIX XL 0112780 C1781 $361.00

2725478 KIT POWER PORT 1808000 C1781 $884.00

2725500 LENS, ACRYSOF TORIC SN6AT_ V2787 $1,192.00

2725501 LENS, TECNIS MULITFOCAL ZMB00 V2788 $1,820.00

2725502 LENS, TECNIS MULITFOCAL ZKB00 V2788 $1,820.00

2725503 LENS, TECNIS MULITFOCAL ZLB00 V2788 $1,820.00

2725504 LENS, TECNIS MONOFOCAL PCBOO V2632 $831.00

2725505 LENS, ULTRASERT AU00TO PRELOAD W/SN60WF V2632 $831.00

2725506 LENS, TORIC MULTIFOCAL SV25T V2788 $1,820.00

2725507 LENS, TECNIS SYMFONY ZXR00 V2788 $1,820.00

2725508 LENS, TECNIS SYMFONY TORIC/EDOF ZXT V2788 $1,960.00

2725509 LENS, MI60L V2632 $831.00

2725510 LENS, ACRYSOF MONOFOCAL MULTIPC MN60AC V2632 $831.00

2725511 LENS, ACRYSOF TORIC SN6AT_ V2787 $1,192.00

2725512 LENS, TECNIS TORIC ASPHERIC ZCT V2787 $1,192.00

2725513 LENS, ACRYSOF TORIC SN60AT V2787 $345.00

2725514 LENS, ACRYSOF PANOPTIX TFNT00 V2788 $2,030.00

2725515 SHUNT MICRO-BYPASS GLAUCOMA TRABECULAR C1783 $5,960.00

2725516 LENS, TORIC II MULTIFOCAL ZKU150 V2788 $2,009.00

2725517 LENS, TORIC II MULTIFOCAL ZLU150 V2788 $2,009.00

2725518 LENS, TECNIS TORIC MONOFOC ASPHERIC ZCU V2787 $1,192.00

2725520 LENS, TECNIS MONOFOCAL DCBOO V2632 $831.00

2725521 LENS, VIVITY IOL DFT015 V2788 $2,030.00

2725522 LENS, VIVITY TORIC DFT*** V2788 $2,030.00

2725550 HEALIX PEEK 3.4MM ANCHOR SUTURE C1713 $953.00

2725551 HEALIX PEEK 5.5MM ANCHOR SUTURE C1713 $1,123.00

2725552 HEALIX PEEK 4.5MM ANCHOR SUTURE C1713 $1,134.00

2725553 HEALIX PEEK ADV 4.9MM ANCHOR SUT 222423 C1713 $1,224.00

2725650 MESH VENTRALEX ST MED 2.5IN 5950008 C1781 $1,014.00

2725651 MESH HERNIA MARLEX PERFIX 3X6IN 0112680 C1781 $86.00

2725652 MESH PERFIX LIGHT PLUG LARGE 0117070 C1781 $374.00

2725653 MESH VENTRALEX HERNIA ST XL 595009 C1781 $1,244.00

2725654 MESH PERFIX LIGHT PLUG MED 0117060 C1781 $374.00

2725660 GRAFT, DECELLULARIZED 2.5X3.5MM AFLEX301 Q4125 $7,957.00

2725661 GRAFT, DERMIS 15X4.5X3MM DOD15453 Q4125 $1,214.00

2725671 AMNIOFILL, 1000CC Q4100 $4,705.00

2725672 AMNIOFILL, 500CC Q4100 $2,405.00

2725673 EPIFIX, GRAFT HUMAN TISSUE 7X7CM Q4186 $19,539.00

2725674 EPIFIX, GRAFT HUMAN TISSUE 4X4CM Q4186 $6,225.00

2725675 ALLOGRAFT, COLL-E-DERM ACELLULAR DERMIS C1762 $3,764.00

2725676 AMNIOFIX 2X12CM APS-5212 Q4100 $2,405.00

2800289 ARTHOSCOPY,KNEE SURGICAL, REMOVEAL G0289 $237.00

2800702 CELESTONE 1/2 CC / 3MG J0702 $16.00

2800775 XIAFLEX J0775 $5,593.00

2801020 DEPO MEDROL 20 MG J1020 $16.00

2801030 DEPO MEDROL 40 MG J1030 $16.00

2801040 DEPO MEDROL 80 MG J1040 $37.00

2803301 KENALOG 10MG J3301 $16.00

2803960 VERASENSE ORTHO SENSOR 0396T $927.00

2804006 LAF (11 YEARS & UP) FIBERGLASS Q4006 $208.00

2804008 LAF (UNDER 11 YEARS) FIBERGLASS Q4008 $96.00

2804010 SAF (11YEARS AND UP) FIBERGLASS Q4010 $176.00

2804012 SAF (UNDER 11YEARS) FIBERGLASS Q4012 $59.00

2804030 LLF (11 YEARS & OVER) FIBERGLASS Q4030 $150.00

2804032 LLF (UNDER 11 YEARS) FIBERGLASS Q4032 $176.00

2804038 SLWF (11 YEARS & OVER) FIBERGLASS Q4038 $176.00

2804040 SLWF (UNDER 11 YEARS) FIBERGLASS Q4040 $91.00

2804051 WATERPROOF LINER Q4051 $118.00

2804131 EPIFIX PER SQUARE CENTIMETER Q4186 $196.00

2804139 AMNIO OR BIODMATRIX Q4139 $900.00

2807321 SUPARTZ J7321 $294.00

2807323 EUFLEXXA J7323 $478.00

2807324 ORTHOVISC J7324 $509.00

2807325 CL SYNVISC ONE 48MG J7325 $4,190.00

2808450 SPLINT,PREFAVRICATED,DIGIT S8450 $11.00

2810060 INCISION AND DRAINAGE OF ABSCESS-SIMPLE 10060 $233.00

2810120 REMOVAL FOREIGN BODY-MESH 10120 $258.00

2810121 REMOVE FOREIGN BODY 10121 $643.00

2810140 INCISION AND DRAINAGE OF HEMATOMA, SEROM 10140 $353.00

2810180 I&D, COMPLEX, POSTOP WOUND 10180 $616.00

2811000 WOUND DEBRIDEMENT/INFECTED SKIN 11000 $143.00

2811010 WOUND DEBRIDEMENT/INFECTED SKIN 11010 $1,177.00

2811012 DEB SKIN BONE AT FX SITE 11012 $1,919.00

2811042 DEBRIDEMENT, SUBCU 20 SQ CM OR LESS 11042 $205.00

2811043 DEBRIDEMENT SKIN SUBCU AND MUSCLE 11043 $706.00

2811044 WOUND DEBRIDE/SKIN SUBQ TISSUE 11044 $168.00

2811045 DEB SUBQ TISSUE ADD-ON-IP 11045 $101.00

2811046 DEB SUBQ TISSUE ADD-ON-OP 11045 $101.00

2811100 BIOPSY SKIN SUBCU OR MUC; SINGLE LE 11100 $173.00

2811106 INCAL BX SKIN SINGLE LESION 11106 $301.00

2811401 EXCISION BENIGN LESIONS,TRUNK,ARMS,LEGS- 11401 $316.00

2811403 EXCISION BENIGN LESION 2.1 - 3.0 CM 11403 $418.00

2811420 EXCISION BENIGN LESION SCALP 0.5 CM 11420 $264.00

2811421 EXCISION BENIGN LESIONS,SCALP,NECK,HAND- 11421 $297.00

2811422 EXCISION BENIGN LESION SCALP 1.1 - 2 11422 $391.00

2811620 EXC H-F-NK-SP MAL+MARG 0.5/< - 398.00 11620 $471.00

2811730 AVULSION TOE NAIL PLATE,PARTIAL OR COMPL 11730 $227.00

2811750 REMOVAL OF NAILBED 11750 $364.00

2811760 REPAIR NAIL BED 11760 $303.00

2812001 REPAIR WOUNDS OF SCALP,NECK,AXI < 2.5CM 12001 $357.00

2812004 RPR, S/N/AX/GEN/TRK 7.6-12.5 CM 12004 $318.00

2812032 LAYER CLOSURE WOUND INTERM 2.6-7.5CM 12032 $673.00

2812041 LAYER CLOSURE OF WOUNDS OF NECK,HANDS,FE 12041 $544.00

2813120 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEG 13120 $873.00

2813121 REPARI COMP SCALP/ARMS/LEG 13121 $1,060.00

2813131 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, 13131 $1,035.00

2813132 REPAIR COMPLEX LACERATION 2.6-7.5C 13132 $1,472.00

2814040 ADJACENT TISSUE TRSF, FOREHEAD, CHEEKS, 14040 $2,046.00

2815240 FULL THICKNESS GRAFT, FREE INCLUDING DIR 15240 $2,229.00

2815271 APP SKN SUB GRFT T/A/L AREA/<100SCM /<1S 15271 $378.00

2815736 MUSCLE/MYOCUTANEOUS/FASCIOCUTANEOUS FLAP 15736 $3,608.00

2817536 OPEN TX TIBIAL FX, PROXIMAL; BICONDYLAR, 27536 $3,272.00

2817999 NON EXCISIONAL DEBRIDEMENT 17999 $891.00

2818810 AMPUTATION, METATARSAL, WITH TOE, SINGLE 28810 $1,595.00

2819300 REMOVAL OF BREAST TISSUE 19300 $1,411.00

2819871 KNEE ARTHRO FOR INFECT:LAVAGE&DRAIN 29871 $1,392.00

2820240 BIOPSY, BONE, EXCISIONAL; SUPERFICIAL 20240 $603.00

2820520 EXCISION FOREIGN BODY IN MUSCLE,SIMPLE 20520 $552.00

2820527 INJECTION, ENZYME, PALMAR FACIAL CORD 20527 $205.00

2820550 INJ-TENDON SHEATH 20550 $224.00

2820552 INJ-TRIGGER POINT 20552 $129.00

2820553 TRIGGER POINT 3 OR MORE MUSCLES 20553 $145.00

2820600 INJ/ASP-SM (FINGER/TOE) 20600 $130.00

2820605 INJ/ASP-M (WRIST/ELBOW/ANKLE) 20605 $224.00

2820606 INJ (WRIST/ELBOW/ANKLE) 20606 $224.00

2820610 INJ/ASP-L(SHOULDER/HIP/KNEE) 20610 $247.00

2820611 INJ/ASP-BIL(SHOULDER/HIP/KNEE) 20610 $369.00

2820670 REMOVAL OF IMPLANT; SUPERFICIAL 20670 $1,026.00

2820680 REMOVAL IMPLANT LEG DEEP 20680 $1,445.00

2820690 APPLICATION OF UNIPLANE, UNILATERAL FIX 20690 $1,505.00

2820692 APPLICATION OF EXT. FIXATION SYSTEM 20692 $3,043.00

2820694 APPLY MULTI/UNI EXTERNAL FIX SYSTEM 20694 $993.00

2820696 COMP MULTIPLANE EXT FIXATION 20696 $2,652.00

2820697 COMP MULTIPLANE EXT FIXATION 20696 $2,652.00

2820985 CPTR-ASST DIR MS PX 20985 $371.00

2823065 BIOPSY, SOFT TISSUE SHOULDER AREA; SUPER 23065 $585.00

2823120 CLAVICULECTOMY; PARTIAL 23120 $1,600.00

2823130 ACROMIOP/ACROMIONECTOMY, PART WWO 23130 $1,662.00

2823140 EXC/CURETGE BONE CYST,BENIGN TUMOR CLA 23140 $1,431.00

2823180 PARTIAL EXCISION BONE, CLAVICA 23180 $1,626.00

2823405 TENOTOMY,SHOULDER AREA SING TENDON 23405 $1,690.00

2823410 REPAIR RUPTURED MUSCULOTENDINOUS CUFF AC 23410 $2,253.00

2823420 REPAIR COMPLETE SHOULDER CUFF AVULSION,C 23420 $2,654.00

2823470 ARTHROPLASTY, GLENOHUMERAL JOINT, HEMIAR 23470 $3,209.00

2823472 ARTHROPLASTY WITH GLENOID AND PROXIMAL H 23472 $4,007.00

2823473 REVIS SHOULDER ARTHRPLASTY HUMERAL/GLENO 23473 $3,618.00

2823474 REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOI 23474 $4,692.00

2823500 CLSD TRTMT OF CLAVICULAR FRACT W/O MANIP 23500 $530.00

2823570 CLOSED TX SCAPULAR FX; W/O MANIPULATION 23570 $573.00

2823600 CLSD TRTMT PROX HUMERAL FX W/O MANIP 23600 $765.00

2823615 TREAT HUMERUS FRACTURE 23615 $2,199.00

2823620 CLSD TRMT GTR HUMERAL TUBEROSITY FX 23620 $812.00

2823650 CLOSED TX SHOULDER DISLOCATION, W/MANIPU 23650 $843.00

2823655 DISLOCATION SHOULDER CLOSED, CLOSED MANI 23655 $1,008.00

2823665 CLSD TX SHOULD DISL, W/FX GR HUMERAL TUB 23665 $1,107.00

2823931 INCISION/DRAINAGE, UPPER ARM/ELBOW AREA; 23931 $716.00

2824065 BIOPSY,SOFT TISSUE OF UP ARM/ELBOW AREA 24065 $707.00

2824101 EXPLORE/TREAT ELBOW JOINT 24101 $1,237.00

2824105 EXCISION OLECRANON BURSA 24105 $849.00


2824341 REPAIR, TENDON/MUSCLE, UPPER ARM/ELBOW, 24341 $2,041.00

2824342 DISTAL BICEP REPAIR W/WO TENDON GRAFT 24342 $2,091.00

2824359 REPAIR ELBOW DEB/ATTCH OPEN 24359 $1,802.00

2824500 FX HUMERAL SHAFT, CLOSED W/0 REDUCTION, 24500 $912.00


2824514 TREAT HUMERUS FRACTURE-OP 24515 $2,146.00

2824515 TREAT HUMERUS FRACTURE-IP 24515 $3,730.00

2824516 OPEN TX HUMERAL SHAFT FX; W/INSERTION IN 24516 $2,339.00


2824560 CLTRMT HUMER EPICOND FX MED/LAT WO MAN 24560 $883.00

2824576 CLOSED TX HUMERAL CONDYLAR FX, W/O MANIP 24576 $868.00

2824635 OPEN TX MONTEGGIA FRACTURE DISLOCATION E 24635 $1,675.00

2824650 CLSD TRMT FX RADIAL HEAD/NECK W/O MANI 24650 $718.00

2824655 CLOSED TX RADIAL HEAD OR NECK FX W/MANIP 24655 $1,204.00

2824665 TREAT RADIUS FRACTURE 27327 $1,595.00

2824666 OPEN TX RADIAL HEAD/NECK FX, W-W/O INT F 24666 $2,049.00

2824670 CLOSED TX ULNAR FRACTURE PROX END W/O MA 24670 $726.00

2824685 FX ULNAR OPEN W/FIXATION 24685 $1,638.00

2825000 INCISION EXT TENDON SHEATH WRIST 25000 $864.00

2825066 BIOPSY,SOFT TISSUE FOREARM/WRIST;DEEP 25066 $948.00

2825071 EXC FOREARM LES SC > 3 CM 25071 $1,159.00

2825075 EXCISION SOFT TISSUE FOREARM/WRIST 25075 $1,027.00

2825076 EXCISION, TUMOR, SOFT TISSUE FOREARM/WRI 25076 $1,410.00

2825100 BIOPSY OF WRIST JOINT 25100 $773.00

2825101 EXPLORE/TREAT WRIST JOINT 25101 $1,099.00

2825110 REMOVE WRIST TENDON LESION 25110 $760.00

2825111 EXCISION GANGLION WRIST 25111 $968.00

2825116 REMOVE WRIST/FOREARM LESION 25116 $1,489.00

2825120 EXCISION/CURETTAGE BONE CYST/BENIGN TUMO 25120 $1,344.00

2825260 REPAIR, TENDON OR MUSCLE, FLEXOR; PRIMAR 25260 $1,704.00

2825270 REPAIR,TENDON/MUSCLE,EXTENSOR,FOREARM/WR 25270 $1,322.00

2825275 REPAIR FOREARM TENDON SHEATH 25275 $1,830.00

2825290 TENOTNMU, OPEN, SINGLE, FLEXOR OR EXTENO 25290 $1,188.00

2825447 ARTHROPLASTY, INTERPOSITION,INTERCARTAL/ 25447 $2,240.00

2825477 ARTHROPLASTY, INTERPOSITION, INTERCARTAL 25447 $2,240.00

2825500 RADIAL SHAFT FX 25500 $744.00

2825515 OPEN TREATMENT RADIAL SHAFT FRACTURE 25515 $1,815.00

2825526 TREAT FRACTURE OF RADIUS 25526 $2,130.00

2825530 FRACTURE ULNAR SHFT,CLOSED,WITHOUT REDUC 25530 $719.00

2825545 OPEN TREATMENT OF ULNAR SHAFT FRACTURE 25545 $1,429.00

2825560 FX RADIAL ULNAR SHAFT W/O MANIPULATION 25560 $996.00

2825565 FRACTURE RADIAL & ULNAR SHAFT, CLSED, MA 25565 $1,439.00

2825575 TREAT FRACTURE RADIUS/ULNA 25575 $2,206.00

2825576 TREAT FRACTURE RADIUS/ULNA 25575 $2,206.00

2825600 CLSD TREAT OF DISTAL RADIAL FRAC W/O MAP 25600 $825.00

2825605 CLSD TX DISTAL RADIAL FX W/MAN 25605 $1,184.00

2825606 FX DISTAL RADIUS W/SKELETAL FIXATION 25606 $1,181.00

2825607 FX DISTAL RADIUS W/INTERNAL FIXATION 25607 $1,667.00

2825608 FX DISTAL RADIUS INTRA-ARTICULAR W/F 25608 $1,914.00

2825609 TREAT FX RADIAL 3 + FRAG 25609 $2,814.00

2825622 CLSD TX CARPAL SCAPHOID FX W/O MAN 25622 $765.00

2825628 OPEN TX CARPAL SCAPHOID NAVICULAR FRACTU 25628 $1,969.00

2825630 TREAT WRIST BONE FRACTURE 25630 $677.00

2825635 TREAT WRIST BONE FRACTURE 25635 $1,213.00

2825650 CLOSED TX ULNAR STYLOID FX 25650 $866.00

2825651 PIN ULNAR STYLOID FRACTURE 25651 $1,309.00

2825652 OPEN TX ULNAR STYOID FX 25652 $1,620.00

2825825 FUSION HAND BONES W/GRAFT 25825 $1,878.00

2825999 FUSION WRIST BONES WITH ALLOGRAFT & PIN 25999 $2,101.00

2826011 DRAINAGE FINGER ABSCESS;COMPLICATED 26011 $615.00

2826037 DECOMPRESS FINGERS/HAND 26037 $1,382.00

2826045 RELEASE PALM CONTRACTURE 26045 $1,149.00

2826055 INCISION TENDON SHEATH 26055 $1,276.00

2826080 ARTHROTOMY WITH EXPLORATION, DRAINAGE OR 26080 $1,061.00

2826115 EXCISION OF BENIGN TUMOR; SUBCUTANEOUS 26115 $1,379.00

2826121 RELEASE PALM CONTRACTURE 26121 $1,483.00

2826123 FASSCIECTOMY, PALMAR WITH OR WITHOUT Z-P 26123 $2,257.00

2826160 EXCISION LESION HAND OR FINGER 26160 $1,014.00

2826236 EXCISION BONE PARTIAL,CRATERIZATION,SAUC 26236 $1,199.00

2826340 MANIPULATION, FINGER JOINT, W/ANESTHESIA 26340 $824.00

2826341 MANIPULATION, PALMER FASCIAL CORD 26341 $269.00

2826350 FLEXOR TENDON REPAIR OR ADVANCEMENT,SING 26350 $1,899.00

2826356 FLEXOR TENDON REPAIR OR ADV, SINGLE IN 26356 $3,002.00

2826370 REPAIR/ADVANCEMENT, PROFUNDUS TENDON; PR 26370 $2,013.00

2826410 EXTENSOR TENDON REPAIR, DORSUM OF HAND, 26410 $1,535.00

2826418 RPR EXTENSON TENDON FINGER W/GRAFT 26418 $1,517.00

2826455 TENOTOMY, FLEXOR, FINGER, OPEN, EACH TEN 26455 $959.00

2826477 TENDON SHORTENING 26477 $1,452.00

2826480 TRANSFER/TRANSPLANT TENDON, CARPOMETACAR 26480 $1,997.00

2826483 TENDON TRANSFER OR TRANSPLANT, CARPOMETA 26483 $2,258.00

2826497 FINGER TENDON TRANSFER 26497 $2,148.00

2826530 ARTHROPLASTY METACARPOPHALANGEAL JOINT,S 26530 $1,464.00

2826531 REVISE KNUCKLE WITH IMPLANT 26531 $1,461.00

2826567 CORRECT FINGER DEFORMITY 26567 $1,617.00

2826600 FX METACARPAL W/O MAN 26600 $518.00

2826605 CLOSED TX METACARPAL FX, SINGLE; W/MANIP 26605 $872.00

2826608 PERCUTANEOUS SKELETAL FIXATION METACARPA 26608 $1,287.00

2826615 OPEN TX METACARPAL FX SINGLE EA BONE 26615 $1,449.00

2826715 TREAT KNUCKLE DISLOCATION 26715 $1,439.00

2826720 TRMT FX PHALANGEAL W/O MANIPULATION 26720 $359.00

2826725 TREATMENT OF CLOSED PHALANGEAL SHAFT FRA 26725 $905.00

2826727 FX PHALANGEAL SHAFT W/SKELETAL FIX M 26727 $1,166.00

2826735 OPEN TX PHALANGEAL SHAFT FRACTURE PROX/M 26735 $1,614.00

2826740 CLOSED TX ARTICULAR FX, METACARPOPHALANG 26740 $942.00

2826750 CLOSED TX DISTAL PHALANGEAL FX, FINGER/T 26750 $458.00

2826755 TREATMENT OF CLOSED DISTAL PHALANGEAL FR 26755 $850.00

2826765 OPEN TREAT DISTAL PHALANGEAL FX 26765 $1,184.00

2826770 CLOSED TX INTERPHALANGEAL JOINT DISLOC, 26770 $751.00

2826775 DISLOCATION INTERPHALANGEAL-JOINT,SINGLE 26775 $1,039.00

2826843 ARTHODESIS, CARPOMETACARPAL JOINT, DIGIT 26843 $1,981.00

2826850 ARTHRODESIS METACARPOPHALANGEAL JOINT,WI 26850 $1,839.00

2826860 ARTHRODESIS INTERPHALANGEAL JOINT,WITH O 26860 $1,511.00

2826951 AMPUTATION FINGER/THUMB DIRECT CL 26951 $1,638.00

2826952 AMPUTATION FINGER OR THUMB V-Y HOOD 26952 $1,577.00

2826989 PROCEDURE OF HANDS/FINGERS 26989 $423.00

2827004 REMOVAL OF ANKLE IMPLANT 27704 $1,278.00

2827036 CAPSULECTOMY, HIP, W-W/O EXCISION HETERO 27036 $2,833.00

2827045 EXC HIP/ PELV DEEP 5 CM-INPATIENT 27045 $3,639.00

2827046 EXC HIP/ PELV DEEP 5 CM-OUTPATIENT 27045 $1,725.00

2827120 ACETABULOPLASTY; WHITEMAN OR COLONNA TY 27120 $3,277.00

2827125 ARTHROPLASTY,PROSTHESIS 27125 $3,114.00

2827130 TOTAL HIP, FEMORAL COMPONENT ONLY 27130 $3,730.00

2827134 REVISE HIP JOINT REPLACEMENT 27134 $4,795.00

2827197 CLSD TX PELVIC RING FX 27197 $294.00

2827220 FRACTURE ACETABULUM OR HIP SOCKET, CLOSE 27220 $1,335.00

2827235 FEMORAL FX PERCUTANEOUSS 27235 $2,238.00

2827236 FEMURAL FX OPEN TREATMENT 27236 $3,290.00

2827238 FRACTURE FEMUR INTER OR PERTRO CLS/W 27238 $1,248.00

2827240 CLOSED TX 'INTER', PER OR SUBTROCHANTERI 27240 $2,425.00

2827244 FRACTURE FEMUR INTERTROCHANTERIC OR PERT 27244 $3,381.00

2827245 OPEN TX 'INTER','PER', OR 'SUB'TROCHANTE 27245 $3,382.00

2827252 CLSD TREAT HIP DISLOCATION W/ANES 27252 $1,917.00

2827265 TREATMENT OF HIP DISLOCATION, WITHOUT AN 27265 $1,084.00

2827266 CLSD TREAT POST HIP DISLOC W/GEN ANE 27266 $1,870.00

2827301 INCISION AND DRAINAGE OF DEEP ABSCESS, I 27301 $1,815.00

2827310 EXPLORATION OF KNWW JOINT 27310 $1,794.00

2827327 EXCISION THIGH MASS 27327 $1,237.00

2827328 EXCISION,TUMOR, THIGH/KNEE AREA, DEEP/SU 27328 $1,754.00

2827331 ARTHRO CAPSULOTOMY KNEE, SYN BIO W/JOINT 27331 $1,266.00

2827340 EXCISION BURSA PREPATELLAR 27340 $1,008.00


2827380 REPAIR OF KNEECAP TENDON 27380 $1,464.00

2827385 SUTURE QUADRICEPS/HAMSTRING MUSCLE RUPTU 27385 $1,425.00

2827403 OPEN MENISCUS REPAIR 27403 $1,632.00

2827405 REPAIR, PRIMARY, TORN LIGAMENT AND/OR CA 27405 $1,831.00

2827416 OSTEOCHONDRAL KNEE AUTOGRAFT 27416 $2,662.00

2827422 RECONSTRUCTION PATELLA FOR RECURRENT DIS 27422 $1,875.00

2827428 KNEE RECONSTRUCTION 27428 $3,000.00

2827430 QUADRICEPSPLASTY 27430 $2,007.00

2827440 ARTHROPLASTY KNEE TIBAL PLATEAU 27440 $2,054.00

2827446 ARTHOPLASTY KNEE COND & PLAT MED/LA 27446 $2,730.00

2827447 ARTHOPLASTY KNEE MED AND LAT COMPARMENT 27447 $3,737.00

2827486 REVISION TOTAL KNEE ARTHROPLASTY, W-W/O 27486 $3,834.00

2827487 REVISION TOTAL KNEE ARTHRO 27487 $3,806.00

2827488 REMOVE TOTAL KNEE PROSTHESIS, METHYLMETC 27488 $3,041.00

2827511 OPEN TX FEMORAL FX W/INT FIXATION 27511 $2,124.00

2827514 OPEN TX FEMORAL FX, DISTAL END, MEDIAL/L 27514 $2,450.00

2827520 FX PATELLA W/O MAN 27520 $765.00

2827524 FRACTURE PATELLA,CLOSED OR OPEN,OPEN RED 27524 $2,107.00

2827530 CLOSED TX TIBIAL FX, PROXIMAL; WO MANIP 27530 $756.00

2827532 TREAT KNEE FRACTURE 27532 $1,528.00

2827535 OP TREAT TIBIAL FX W/INT FIXATION 27535 $1,883.00

2827536 OPEN TX TIBIAL FX, PROXIMAL; BICONDYLAR, 27536 $3,272.00

2827538 TREAT KNEE FRACTURE 27538 $1,211.00

2827570 MANIP KNEE JOINT UNDER GENERAL ANESTHESI 27570 $415.00

2827590 FEMURAL FX OPEN TREATMENT 27590 $2,355.00

2827599 UNLSTD KNEE EXOSTOSIS 27599 $1,567.00

2827619 EXCISION, TUMOR, LEG/ANKLE AREA; DEEP 27619 $1,271.00

2827620 ARTHROTOMY CAPSULOTOMY ANKLE FOR BIOPSY 27620 $1,226.00

2827630 REMOVAL OF TENDON LESION 27630 $1,386.00

2827632 EXC LEG/ANKLE LES SC > 3 CM 27632 $1,129.00

2827635 EXCISION/CURETTAGE OF BONE CYST/BENIGH 27635 $1,617.00

2827650 SUTURE, PRIMARY, RUPTURED ACHILLES TENDO 27650 $1,511.00

2827652 REPAIR, PRIMARY, OPEN/PERCUT, RUPTURED A 27652 $1,728.00

2827654 REPAIR ACHILLES TENDON 27654 $1,760.00

2827658 REPAIR OR SUTURE OF FLEXOR TENDON OF LEG 27658 $1,028.00

2827664 REPAIR OF LEG TENDON EACH 27664 $900.00

2827676 REPAIR LOWER LEG TENDONS 27676 $1,466.00

2827685 LENGHTEN OR SHORTEN OR TENDON;SINGLE 27685 $1,477.00

2827687 GASTROCNEMIUS RECESSION 27687 $1,271.00

2827691 TRSF TENDON/TRNSPLNT TENDON WMUSCLE REDI 27691 $2,069.00

2827695 REPR PRIMARY DISRUPTED LIGAMENT ANKL 27695 $1,427.00

2827698 SUTURE LIGAMENT ANKLE,SECONDARY REPAIR C 27698 $1,752.00

2827726 REPAIR FIBULA NONUNION 27726 $2,409.00

2827750 CLOSED TX TIBIAL SHAFT FX; W/O MANIPULAT 27750 $951.00

2827756 OPEN TREATMENT OF CLOSED OR OPEN FIBIAL 27756 $1,582.00

2827758 OPEN TX TIBIAL SHAFT FX, W/PLATE/SCREWS, 27758 $2,448.00

2827759 OPEN TREATMENT OF TIBIA FRACTURE 27759 $2,797.00

2827760 CLSD TRMT MEDIAL MALLEOLUS FRACTURE W/O 27760 $642.00

2827762 CLTX MED ANKLE FX W/MNPJ -OP 27762 $1,158.00

2827763 CLTX MED ANKLE FX W/MNPJ -IP 27762 $1,158.00

2827766 OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE 27766 $1,508.00

2827767 CLTX POST ANKLE FX 27767 $685.00

2827780 FX FIBULA PROXIMAL EXTREMITY OR SHAFT, C 27780 $782.00

2827784 OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRA 27784 $1,969.00

2827786 CLOSED TX DISTAL FIBULAR FX; W/O MANIP 27786 $861.00

2827792 FX OPEN DISTAL FIBULA W/INT FIX 27792 $1,545.00

2827808 CLOSED TX BIMALLEOLAR ANKLE FX WO/MNPJ 27808 $835.00

2827810 TREATMENT OF ANKLE FRACTURE 27327 $1,035.00

2827811 TREATMENT OF ANKLE FRACTURE 27810 $1,035.00

2827814 OPEN TREATMENT BIMALLEOLAR ANKLE FRACTUR 27814 $2,121.00

2827816 CLOSED TX TRIMALLEOLAR ANKLE FX; W/O MAN 27816 $822.00

2827818 FRACTURE ANKLE TRIMALLEOLAR,CLOSED,CLOSE 27818 $1,306.00

2827822 OPEN TX TRIMALLEOLAR ANKLE W/O FIX PST 27822 $1,964.00

2827824 CLSD TRMT FX DISTAL TIBIA 27824 $910.00

2827825 CLSD TREAT FX TIBIA W/MANIP AND TRACTI 27825 $1,213.00

2827827 OPEN TREAT TIBIA ONLY W/ INTERNAL FI 27827 $2,318.00

2827828 TREAT LOWER LEG FRACTURE 27828 $3,219.00

2827829 OPEN TX DISTAL TIBOFIBULAR DIS W-W/O FIX 27829 $1,703.00

2827832 TREAT LOWER LEG DISLOCATION 27832 $1,686.00

2827870 FUSION OF ANKLE JOINT OPEN 27870 $2,509.00

2827880 AMPUTATION LEG THRU TIBIA/FIBULA 27880 $1,814.00

2827899 FT/ANKLE OSTEOMY&GSTROCNENIUS 27899 $567.00

2828022 EXPLORATION OF FOOT JOINT 28022 $1,059.00

2828043 EXCISION, BENIGN TUMOR; SUBCUTANEOUS 28043 $1,097.00

2828090 EXCISION LESION FOOT 28090 $1,172.00

2828100 REMOVAL OF ANKLE/HELL LESION 28100 $1,502.00


2828107 REMOVE/GRAFT FOOT LESTION 28107 $1,140.00

2828118 REMOVAL OF HEAL BONE 28118 $1,338.00

2828119 OSTECTOMY CALCANEOUS FOR SPUR 28119 $1,155.00

2828120 EXCISION BONE PARTIAL, CRATERIZATION, SA 28120 $1,758.00

2828122 PARTIAL EXCISION BONE; TARSAL/METATARSAL 28122 $1,648.00

2828200 REPAIR TENDON OR SUTURE,FLEXOR,FOOT,SING 28200 $1,374.00

2828230 TENOTOMY FLEXOR,OPEN,FOOT,SINGLE OR MULT 28230 $1,206.00

2828285 HAMMER TOE OPERATION,ONE TOE,INTERPHALAN 28285 $1,460.00

2828288 OSTECTOMY, PART,EXOSTEC OR COND, SIN ME 28288 $1,582.00

2828295 CORRECTION HALLUX VALGUS 28295 $2,347.00

2828296 HALLUX VALGUS COR BY EXOST W/ MET OSTEOM 28296 $1,878.00

2828300 OSTEOROMY INCLD INT FIX,SWYER OR CHAMBER 28300 $1,804.00

2828308 INCISION OF METATARSAL 28308 $1,546.00

2828315 SESAMOIDECTOMY-FIRST TOE 28315 $1,315.00

2828320 REPAIR TARSAL BONES AS OS CALCIS,ASTRAGA 28320 $1,668.00

2828400 TX OF HEEL FRACTURE 28400 $548.00

2828430 CLSD TRTMT OF TALUS FX W/O MAN 28430 $650.00

2828445 FRACTURE ASTRAGALUS,CLOSED OR OPEN,OPEN 28445 $2,935.00

2828450 FRACTURE TARSAL-BONE EXCEPT ASTAGALSU AN 28450 $543.00

2828455 TX TARSAL BONE FX; W/MANIPULATION 28455 $818.00

2828470 CLSD TREATMENT METATARSAL FX 28470 $385.00

2828476 TREAT METATARSAL FRACTURE 27327 $781.00

2828485 OPEN TREAT METATARSAL FX W/INT FIX 28485 $1,177.00

2828490 CLSD TRTMT OF FRACT GRT TOE/PHANL W/O MA 28490 $390.00

2828510 CLOSED TX FX PHALANX/PHALANGES, NOT GRT 28510 $311.00

2828515 FRACTURE PHALANX OR PHALANGES OTHER THAN 28515 $409.00

2828525 OPEN TREAT FX PHALANX W/INT FIXATION 28525 $1,119.00

2828645 REPAIR TOE DISLOCATION 28645 $1,629.00

2828700 REMOVAL OF CAST 29700 $128.00

2828725 ARTHRODESIS: SUBTALAR 28725 $1,995.00

2828730 FUSION OF FOOT BONES 28730 $1,798.00

2828737 ARTHRODESIS,NAVICULAR-CUNEIFORM,WITH TEN 28737 $1,899.00

2828740 ARTHRODESIS, MIDTARSAL/TARSOMETATARSAL, 28740 $2,307.00

2828750 ARTHRODESIS GREAT-TOE METATARSOPHALANGEA 28750 $2,245.00

2828820 AMPUTATION TOE METATARSOPHALANGEAL JOINT 28820 $1,239.00

2828899 PROCEDURE TOES 28899 $1,698.00

2829065 LONG ARM (SHOULDER TO HAND) 29065 $412.00

2829075 SHORT ARM (FOREHAND TO HAND) 29075 $294.00

2829085 NAVICULAR GAUNLET 29085 $252.00

2829105 LONG ARM (SHOULDER TO HAND) 29105 $237.00

2829125 SHORT ARM (FOREHAND TO HAND) 29125 $213.00

2829130 FINGER SPLINT-STATIC 29130 $155.00

2829131 FINGER SPLINT-DYNAMIC 29131 $213.00

2829345 LONG LEG 29345 $460.00

2829355 LONG LEG WALKER 29355 $502.00

2829365 CYLINDER 29365 $443.00

2829405 SHORT LEG 29405 $412.00

2829425 SHORT LEG WALKER 29425 $470.00

2829435 PATELLAR TENDON 29435 $530.00

2829505 LONG LEG (THIGH TO FOOT) 29505 $353.00

2829515 SHORT LEG (CALL TO FOOT) 29515 $266.00

2829580 UNNA BOOT 29580 $173.00

2829700 REMOVAL OF CAST 29700 $128.00

2829701 REMOVAL OF CAST 29700 $33.00

2829806 SHOULDER ARTHROSCOPY/SURGERY 29806 $2,433.00

2829807 ARTHROSCOPY, SHOULDER, SURGICAL; REPAIR 29807 $2,904.00

2829819 SHOULDER ARTHROSCOPY 29819 $1,562.00




2829824 ARTHROSCOPY, SHOULDER, SURGICAL, DISTAL 29824 $1,629.00

2829826 ARTH, SHOULD, SURG DECOM SUB SPACE 29826 $452.00

2829827 ARTHROSCOPY, SHOULD, SURG W ROTAUR CUFF 29827 $2,896.00

2829828 ARTHROSCOPY BICEPS TENODESIS 29828 $2,491.00

2829846 WRIST ARTHROSCOPY WITH DEBRIDEMENT 29846 $1,423.00

2829866 AUTGRAFT IMPLNT KNEE W/SCOPE 29866 $2,504.00

2829871 KNEE ARTHRO FOR INFECT:LAVAGE&DRAIN 29871 $1,392.00

2829873 ARTHROSCOPE KNEE W/LATERAL RELEASE 29873 $1,154.00

2829874 ARTHROSCOPY, HIP, SURGICAL; W/REMOVAL LO 29874 $1,507.00

2829875 KNEE ARTHROSCOPY 29875 $1,342.00

2829876 ARTHROSCOPY, KNEE, SURGICAL; SYNOVECTOMY 29876 $1,800.00

2829877 ARTHROSCOPE KNEE DEBRID CARTILAGE 29877 $1,354.00

2829879 ARTHRO KNEE, SURG ADB ARTHO/MUL DRILLING 29879 $1,779.00

2829880 ARTHROSCOPE KNEE W/MENISCECTOMY 29880 $1,472.00

2829881 ARTHROSCOPE KNEE W/MENISCECTOMY 29881 $1,430.00

2829882 ARTHROSCOPY, KNEE, SURGICAL WITH MENISCU 29882 $1,715.00

2829883 KNEE ARTHROSCOPY/SURGERY 29883 $2,008.00

2829888 KNEE ARTHRO-LIGAMENT REPAIR 29888 $2,666.00

2829891 ARTHROSCOPY, ANKEL, SURGICAL; EXCISION O 29891 $1,867.00

2829894 ARTHROSCOPY, ANKLE, SURGICAL; W/REMOVAL 29894 $1,377.00

2829895 ANKLE ARTHROSCOPY 29895 $1,307.00

2829897 ANKLE ARTHROSCOPY 29897 $1,390.00

2829898 ANKLE ARTHOSCOPY 29898 $1,554.00

2829899 ARTHROSCOPY, ANKLE, SURGICAL; WITH ANKLE 29899 $2,874.00

2829907 SUBTALAR ARTHRO W/FUSION 29907 $2,339.00

2835206 REPAIR BLOOD VESSEL OR A-V FISTULA UP EX 35206 $2,137.00

2851860 CYSTORRHAPHY /SUTURE BLADDER 51860 $2,067.00

2852970 REMOVAL OF CAST 29700 $33.00

2864708 NEUROLYSIS, MAJOR PERIPHERAL NERVE, ARM 64708 $1,366.00

2864718 NEUROPLASTY ULNAR NERVE ELBOW 64718 $1,413.00

2864719 NEUROLYSIS AND/OR TRANSPOSTION; ULNAR NE 64719 $1,087.00

2864721 NEUROPLASTY/TRANS MED NERVE@CARPAL TUNN 64721 $1,165.00

2864782 REMOVE LIMB NERVE LESION 64782 $1,124.00

2864831 SUTURE OF NERVE (NEURORRHAPHY),DIGITAL,H 64831 $1,873.00

2876882 US XTR NON-VASC LMTD 76882 $96.00

2890471 IMMUNIZATION ADMIN 90471 $55.00

2890697 DTAP-IPVHIB-HELPB 90697 $122.00

2892150 OP-CPR 92950 $655.00

2892950 IP-CPR 92950 $655.00

2896372 INJECTION 96372 $56.00

2897597 WOUND DEBRIDEMENT, ACTIVE WOUND 97597 $111.00




2899156 OP-PROLONGED CARE-1ST HOUR 99356 $248.00

2899157 OP-PROLONGED CARE-EA 30 MINS 99357 $235.00

2899191 OP-CRITICAL CARE-1ST HOUR 99291 $590.00

2899192 OP-CRITICAL CARE-EACH ADD 30 MINS 99292 $248.00

2899201 OFFICE/OUTPATIENT VISIT, NEW LEVEL 1 99201 $86.00





2899211 OFFICE/OUTPATIENT VISIT, ESTAB LEVEL 1 99211 $50.00





2899217 OP-OBSERVATION DAY DISCHARGE 99217 $139.00

2899218 OP-INITIAL OBSERVATION STRAIGHTFORWARD 99218 $133.00

2899219 OP-OUTPATIENT MODERATE 99219 $244.00

2899220 OP-OUTPATIENT HIGH 99220 $361.00

2899221 IP-H&P LOW COMPLEXITY 99221 $186.00

2899222 IP-H&P MODERATE COMPLEXITY 99222 $252.00

2899223 IP-H&P HIGH COMPLEXITY 99223 $377.00

2899224 OP-DAILY VISIT LOW COMPLEXITY 99224 $67.00

2899225 OP-DAILY VISIT MODERATE COMPLEXITY 99225 $118.00

2899226 OP-DAILY VISIT HIGH COMPLEXITY 99226 $176.00

2899231 IP-SUBSEQUENT-LOW COMPLEXITY 99231 $94.00

2899232 IP-HOSPITAL VISIT-MODERATE COMPLEXITY 99232 $136.00

2899233 IP-HOSPITAL VISIT-HIGH COMPLEXITY 99233 $225.00

2899234 OP-ADMIT/DISHARGE SAME DAY DETAIL 99234 $274.00

2899235 OP-ADMIT/DISHARGE SAME DAY COMPREHENSIVE 99235 $358.00

2899236 OP-ADMIT/DISHARGE SAME DAY COMPREHENSIVE 99236 $447.00

2899238 IP-HOSPITAL DISCHARGE <30 MIN 99238 $177.00

2899239 IP-HOSPITAL DISCHARGE >30 MIN 99239 $233.00

2899241 OFFICE/OUTPATIENT VISIT, INIT LEVEL 1 99241 $176.00






2899282 EMERGENCY ROOM VISIT LEVEL 2 99282 $189.00

2899291 IP-CRITICAL CARE-1ST HOUR 99291 $590.00

2899292 IP-CRITICAL CARE-EACH ADD 30 MIN 99292 $248.00

2899304 SNF-ADMIT STRAIGHTFORWARD 99304 $172.00

2899305 SNF-ADMIT MODERATE 99305 $211.00

2899306 SNF-ADMIT HIGH COMPLEX 99306 $344.00

2899307 SNF-VISIT STRAIGHTFORWARD 99307 $83.00

2899308 SNF-VISIT LOW COMPLEXITY 99308 $120.00

2899309 SNF-VISIT MODERATE COMPLEXITY 99309 $169.00

2899310 SNF-VISIT HIGH COMPLEXITY 99310 $211.00

2899315 SNF-DISCHARGE DAY <31 MIN 99315 $160.00

2899316 SNF-DISCHARGE DAY >31 MIN 99316 $195.00

2899356 IP-PROLONGED CARE-FIRST HOUR 99356 $248.00

2899357 IP-PROLONGED CARE-EACH ADD 30 MINS 99357 $235.00

2899441 TELEPHONE EVAL 5-10 MIN 99441 $22.00



2910008 PACU-BASE 15MIN $209.00

2910062 PACU-ADD 15 MIN $69.00

2925000 KIT, NOVASURE $7,026.00

2925001 ZIP 16, SKIN CLOSURE DEVICE PS1160 $151.00




2925005 KIT TRIALYSIS 45703-1A $136.00

2925006 STAPLER, ECHELON FLEX POWERED PLUS 45MM $464.00

2925007 STAPLER RELOAD ENDOPTH ECHLN 45MM GST45W $245.00

2925008 LIGASURE, LF1937 DEVICES MARYLAND $870.00

2925009 NEEDLE, EXPRESSEW III $420.00

2925010 BLADE FALCON SAW 25MM X 90MM 67251270090 $784.00

2925011 BLADE SAW RECIP 70X12.5MM 0277096275 $50.00

2925012 WAND, EVAC 70 COBLATOR $151.00

2925013 BIT, CANNULATED ASNIS III 4.9MM TWIST C1713 $970.00

2925014 GUIDE WIRE, ASNIS III THRD 3.2X300MM C1713 $108.00

2925173 ROD EXTERNL FIXATION 11X300MM 4922-8-300 C1713 $723.00

2925174 ROD EXTERNL FIXATION 11X350MM 4922-8-350 C1713 $723.00

2925214 COUPLING EXT FIX ROD TO ROD 4922-1-010 C1713 $1,295.00

2925215 COUPLING EXT FIX PIN TO ROD 4922-1-020 C1713 $1,354.00


2925217 PIN, HALF FIXATION 5X150MM 5018-5-150 C1713 $315.00

2925218 PIN, EXTERNAL TRANSFIX 5X250M 5030-5-250 C1713 $293.00

2925219 CAP EXTERNAL FIXATION 5MM BLUE C1713 $100.00

2925220 CAP EXTERNAL FIXATION 4MM WHITE C1713 $97.00

2925256 PIN CLAMP, HOFFMANN3 5 HOLE 2 POSTS 30* C1713 $1,683.00

3099211 LEVEL 1 ESTAB 99211 $52.00

3099212 LEVEL 2 ESTAB 99212 $77.00

3099213 LEVEL 3 ESTAB 99213 $103.00

3099214 LEVEL 4 ESTAB 99214 $152.00

3099215 LEVEL 5 ESTAB 99215 $206.00

3300016 LEVEL 1 EVAL/MGT 99281 $156.00

3300024 LEVEL 2 EVAL/MGT 99282 $203.00

3300032 LEVEL 3 EVAL/MGT 99283 $286.00

3300059 LEVEL 4 EVAL/MGT 99284 $434.00

3300069 LEVEL 5 EVAL/MGT 99285 $683.00

3300121 LEVEL 1 EVAL/MGT 99281 $156.00

3300148 LEVEL 2 EVAL/MGT 99282 $203.00

3300156 LEVEL 3 EVAL/MGT 99283 $286.00

3300164 LEVEL 4 EVAL/MGT 99284 $434.00

3300172 LEVEL 5 EVAL/MGT 99285 $683.00

3300199 CRITICAL CARE 1 HR 99291 $891.00

3300202 CRIT CR EA ADD 1/2H 99292 $443.00

3300229 CR CR 1 HR W/PROC 99291 $891.00

3300237 CR CR ADD 1/2 W PROC 99292 $443.00

3300318 CARDIOPUL RESUS CPR 92950 $1,028.00

3300334 CARDIOVERSION 92960 $710.00

3300385 ENDOTRACH INTUBAT 31500 $766.00

3300601 I & D ABCESS SIMP 10060 $276.00

3300644 I & REM FB SIMPLE 10120 $314.00

3300792 SIM LAC <2.6 BSHF 12001 $386.00

3300806 SIM LAC 2.6-7.5 BSHF 12002 $447.00

3300814 SIM LAC7.6-12.5BSHF 12004 $572.00

3300849 SIM LAC>20CM BSHF 12006 $858.00

3300857 SIM LAC <2.6 FCE 12011 $422.00

3300865 SIM LAC 2.6-5 FCE 12013 $630.00

3300873 SIM LAC 5.1-7.5 FCE 12014 $822.00

3300881 SIM LAC 7.6-12.5FCE 12015 $941.00

3300903 SIM LAC 12.6-20 FCE 12016 $1,085.00

3300946 INT LAC <2.6 BS 12031 $513.00

3300954 INT LAC 2.6-7.5 BS 12032 $636.00

3300962 INT LAC 7.6-12.5 BS 12034 $716.00

3300969 INTER LAC 12.6-20CM 12035 $766.00

3301012 INT LAC <2.6 NHF 12041 $545.00

3301039 INT LAC 2.6-7.5 NHF 12042 $683.00

3301047 INT LAC7.6-12.5 NHF 12044 $871.00

3301055 INT LAC 12.5-20 NHF 12045 $1,235.00

3301063 INT LAC <2.5 FEE 12051 $630.00

3301071 INT LAC 2.6-5 FEE 12052 $766.00

3301098 INT LAC 5.1-7.5 FEE 12053 $1,321.00

3301101 INT LAC 7.6-12.5FEE 12054 $1,529.00

3301446 NURSEMAID ELBOW 24640 $368.00

3302027 CONT ANT/NASAL HEM 30901 $277.00

3302183 REM IMPACT CERUMEN 69210 $130.00

3302361 LUMBAR PUNCTURE 62270 $386.00

3302442 CORNEAL FB REMOVAL 65220 $231.00

3302485 REMOVAL FB COMP 10121 $464.00

3302493 CONJUN FB REMOVAL 65205 $231.00

3302507 CONT POS/NASAL HEM 30905 $277.00

3302515 REMOVE FB INTANASAL 30300 $326.00

3302523 CORNEAL FB REM-W LP 65222 $388.00

3302531 ANT EPISTAXIS COM P 30903 $475.00

3302574 INTRAOSSEOUS INFUSI 36680 $406.00

3310080 I & D PILONIDAL CYST 10080 $379.00

3310140 I D HEMO,SEROME, OR FLUID COLLECT 10140 $559.00

3310160 PUNTURE DRAINAGE OF LESION 10160 $372.00

3311000 DEBRIDEMENT OF INFECTED SKIN 11000 $160.00

3311042 DEBRIDE SKIN/TISSUE-1ST 20 SQ CM OR LESS 11042 $261.00

3311043 DEB MUSC/FASCIA 20 SQ CM/< 11043 $614.00

3311102 TANGENTIAL BIOPSY OF SKIN:SINGLE LESION 11102 $233.00

3311104 PUNCH BIOPSY OF SKIN:SINGLE LESION 11104 $292.00

3311200 REMOVAL OF SKIN TAGS 11200 $237.00


3311441 EXCISION BENIGN LESIONS,FACE,EARS,EYES-0 11441 $418.00

3311720 PEBRIDEMENT NAIL 1-5 11720 $94.00

3311730 AVULISION NAIL PLATE 11730 $244.00

3311740 EVAC. SUBUNGUAL HEM. 11740 $123.00

3311750 EXCISION FINGER OR TOE NAIL/NAIL MATRIX, 11750 $619.00

3311760 REPARI OF NAIL BED, SIMPLE 11760 $655.00

3312055 INT LAC 12.6 - 20.0 CM 12055 $1,063.00


3313121 REPAIR, COMPLEX, SCALP, ARMS, AND/OR LEG 13121 $1,179.00


3313131 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, 13131 $1,074.00

3313132 CMPLX LAC 2.6-7.5 CM FACE, H, F 13132 $1,042.00

3313151 REPAIR, COMPLEX, EYELIDS, NOSE, EARS, LI 13151 $1,186.00

3313152 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND 13152 $1,427.00

3313153 REPAIR,COMPLEX,EYELIDS,NOSE,EARS AND/OR 13153 $476.00

3316000 INITIAL TREATMENT OF BURN(S) 16000 $170.00

3316020 DRESS OR DEBRIDE BURN SMALL 1-2 DEGREE 16020 $158.00

3317250 CHEMICAL CAUTERIZATION GRAN TISS 17250 $135.00

3320103 EXP OF PENETRATING WOUND,EXT 20103 $804.00

3320525 REMOVAL OF FOREIGN BODY IN MUSCLE OR TEN 20525 $1,287.00

3320551 INJ TENDON ORIGIN/INSERTION 20551 $131.00

3320552 TRIGGER POINT/SINGLE OR MULT/ 1-2 MUSCLE 20552 $121.00

3320553 SING/MULT TRIGGER PTS 3 OR MORE MUSCLE 20553 $142.00

3320600 ARTHROCENTESIS,ASP,OR INJECT SM JT 20600 $165.00

3320605 ARTHROCENTESIS,ASP,OR INJECT INT JT 20605 $168.00

3320610 ARTHROCENTESIS ASP,OR INJECT MAJOR JT 20610 $201.00

3321310 CLSD TX NASAL FX W/O MANIP 21310 $155.00

3321320 CLOSED TXT FO NASAL BONE, WITH STABLE 21320 $613.00

3321480 CLSD TX TEMPOROMANIBULAR DISLOC 21480 $153.00

3323500 CLSD TX CLAVICLE FX W/0 MANIP 23500 $893.00

3323540 CLSD TX AC JOINT DISLOCATE W/O MANIP 23540 $891.00

3323545 CLSD TX AC DISLOC W/MANIP 23545 $1,279.00

3323600 CLSD TX PROXIMAL HUMERUS FX W/O MANIP 23600 $1,263.00

3323650 CLSD TX SHOULDER DISLOC. W/MANIP W/O ANE 23650 $905.00

3323655 CLSD TX SHOULDER DISLOC. W/MANIP W/ANES 23655 $1,074.00

3324500 CLSD TREAT HUMERAL EX W/O MANIP 24500 $1,342.00

3324600 TX CLSD ELBOW DISOC W/O ANEST 24600 $755.00

3324605 CLSO TX OLE DISLOC W/ ANES 24605 $1,259.00

3324650 CLSD TX RADIAL HEAD FX W/O MANIP 24650 $954.00

3324655 CLOSED TREATMENT RADIAL HEAD/NECK FRATUR 24655 $1,251.00

3325150 CLSD TX ULMR STYLOID EX 25650 $1,217.00

3325565 CLSD TX FX RADIUS & ULNA W/ MAN 25565 $683.00

3325600 CLSD TX DISTAL RADIAL FX W/O MAN 25600 $972.00

3325605 CLSD TX DISTAL RADIAL FX W/MAN 25605 $1,266.00

3325622 CLSD TX NAVICULAR FX W/O MANIP 25622 $1,114.00

3326010 I & D FINGER ABSCESS, SIMPLE 26010 $272.00


3326600 CLSD TX METACARPAL FX W/O MANIP 26600 $900.00

3326605 CLSD TX METACARPAL FX W MINIP 26605 $719.00

3326700 TREAT KNUCKLE DISLOCATION 26700 $799.00

3326720 CLSD TX FINGER FRACTURE W/MANIP EA 26720 $719.00

3326725 CLSD TX FINGER FRACTURE W/O MANIP EA 26725 $1,337.00

3326750 CLSD TX DISTAL TUFT FX W/O MANIP 26750 $719.00

3326770 CLSD TX DIP OR PIP DISLOC W/MANIP 26770 $1,062.00

3326775 DISLOCATION INTERPHALANGEAL-JOINT,SINGLE 26775 $1,070.00

3326785 OPEN TX INTERPHALANGEAL JOINT DISLOCATIO 26785 $1,481.00

3327250 CLOSED HIP REDUCTION 27250 $428.00

3327265 TREATMENT OF HIP DISLOCATION, WITHOUT AN 27265 $1,116.00

3327268 CLTX THIGH FX W/MNPJ 27268 $1,318.00

3327510 CLOSED TX FEMERAL FRACTURE W/MANIP 27510 $1,518.00

3327532 FRACTURE TIBIA PROXIMAL,PLATEAU,CLOSED,C 27532 $1,664.00

3327560 CLSD TX PATELLAR DISLOC W/O ANEST 27560 $1,367.00

3327780 CLSD TX PROCIMAL FIBULA FX W/O MANIP 27780 $1,138.00

3327786 CLSD TX DIS FIBULE W/O MANIP 27786 $1,199.00

3327788 FRACTURE FIBULA DISTAL EXTREMITY, LATERA 27788 $1,041.00

3327810 CLSD TX CLAVICLE FX W/0 MANIP 23500 $893.00

3327811 CLOSED TX BIMALLEOLAR ANKLE FX W MANIP 27810 $1,153.00

3327818 CLSD TX BIMALLEOLAR ANKLE FX W/MANIP 27818 $838.00

3327840 CLSD TX ANKLE DISLOC W/O ANEST 27840 $1,240.00

3328190 REMOVAL OF F.B. FOOT, SUB 28190 $360.00

3328470 CLSD TX METATARSAL FX W/O MANIP EA 28470 $862.00

3328490 CLSD TX BIG TOE FX W/O MANIP 28490 $527.00

3328510 CLSD TX TOE FX W/O MANIP 28510 $504.00

3328630 CLSD TX METATARSOPHAL JT DISLOC 28630 $766.00

3328660 CLSD TX CLOSED IPI DICLOC 28660 $400.00

3329105 APPLY LONG ARM SPLINT 29105 $283.00

3329125 APPLY SHORT ARM SPLINT 29125 $197.00

3329240 STRAPPING SHOULDER 29240 $158.00

3329505 APPLY LONG LEG SPLINT 29505 $195.00

3329515 APPLY SHORT LEG SPLINT (CALF TO FOOT) 29515 $243.00

3329530 STRAPPING KNEE IMMOBLIZER 29530 $71.00

3329700 REMOVAL OF CAST 29700 $128.00

3329705 REMOVAL OR BIVALVING,GAUNTLET,BOOT,BODY 29705 $181.00

3330000 DRAINAGE ABSCESS/HEMATOMA, NASAL, INTERN 30000 $621.00

3330906 SUBSEQUENT NASAL HEMMO 30906 $262.00

3331502 TRACHEOTOMY TUBE CHANGE 31502 $121.00

3331605 CRICOTHYROIDOSTOMY 31605 $529.00

3332551 TUBE THORACOSTOMY INCL WATER SEAL 32551 $672.00

3332554 THORACENTESIS NEEDLE/CATH PLEURA W/O IMA 32554 $504.00

3332555 ASPIRATE PLEURA WITH IMAGING 32555 $649.00

3335206 REAPIR BLOOD VESSELSOR A-V FISTULA, UPPE 35206 $2,304.00

3335226 REPARI BLOOD VESSEL,FIRECT, LOWER EXT 35226 $2,382.00

3336430 TRANSFUSION, BLOOD OR BLOOD COMPONENTS 36430 $101.00


3336568 INSERTION OF PICC W/O SUB PORT OR PUMP U 36568 $536.00

3336569 PIC LN WO SUB PORT/PUMP AGE 5 AND > 36569 $603.00

3336572 INSERTION OF PICC W/O SUB PORT OR PUMP U 36572 $1,029.00

3336573 INSERTION OF PICC W/O SUB PORT OR PUMP 5 36573 $966.00

3336584 REPLACE, COMPLETE OR A PICC W/O 36584 $503.00

3337195 THROMBOLYTIC THERAPY STROKE 37195 $659.00

3340800 I\D ABSCESS,CYST,VESTIBLE OF MOUTH,S/M 40800 $483.00

3340804 REMOVAL EMBEDDED FB,MOUTH SIMPLE 40804 $405.00

3340830 CLSD LAC VEST <2.5CM 40830 $740.00

3340831 CLSD LAC VEST >2.5CM 40831 $1,062.00

3341000 I&D ABSCESS/CYST/HEMATOMA TONGUE/FLOOR O 41000 $429.00

3341250 MOUTH LAC < 2.6CM 41250 $612.00

3341252 TONGUE LAC > 2.6 CM 41252 $1,025.00

3341800 I\D ABSCESS DENTDAL VEOLAR 41800 $467.00

3342700 I & D PERITONSILLAR ABCESS 42700 $482.00

3342725 DRAINAGE ABSCESS RETROPHARYNGEAL OR PARA 42725 $2,027.00

3343762 REPLACE OF GASTROSTOMY TUBE NOT REQUIRIN 43762 $545.00

3343763 REPLACE OF GASTROSTOMY TUBE REQUIRING 43763 $809.00

3344500 LONG GI TUBE (SEPARATE) 44500 $51.00

3345005 INCISION AND DRAINAGE OF SUBMUCOUS ABSCE 45005 $743.00

3346040 INCISION AND DRAINAGE OF ISCHIORECTAL AN 46040 $1,448.00

3346050 I D PERIANEL ABSCES 46050 $403.00

3346083 INCISION-THROMBOSED HEMORROID, EXT 46083 $383.00

3346600 ANOSCOPY DIAGNOSTIC 46600 $157.00

3349082 ABDOM PARACENTESIS DX/THER W/O IMAGING G 49082 $572.00

3349083 ABDOMEN PARACENTESIS W/IMAGING 49083 $717.00

3351700 BLADDER IRRIGATION, SIMP, LAVAGE &/OR IN 51700 $447.00

3351705 CHANGE OF CYSTOSTOMY TUBE,SIMPLE 51705 $253.00

3353060 DRAINAGEOF SKENE'S GLAND ABCESS OR CYST 53060 $532.00

3356405 I\D OF VULVA OR PERINEAL ABSCESS 56405 $424.00

3356420 I\D BARTHOLIN ABSCESS 56420 $378.00



3364400 N BLCOK INJ TRIGEMINAL 43763 $323.00

3364402 INJECT, ANESTH AGENT/FACIAL NERVE 64402 $126.00

3364450 NERVE BLOCK ONLY 64450 $144.00

3365435 REMOVAL CORNEAL RUST RING 65435 $766.00

3367700 I\D ABSCESS EYELID 67700 $412.00

3367938 REMOVE FOREIGN BODY EYELID 67938 $497.00

3369000 I\D EXT EAR 69000 $452.00

3369200 REMOVE FOREIGN BODY EAR 69200 $261.00

3392511 NASOPHARYNGOSCOPY 92511 $276.00

3397597 ACTIVE WOUND CARE/20 CM OR< 97597 $120.00

3399151 MOD SED SAME PHYS/QHP <5 YRS 99151 $55.00

3399152 MOD SED SAME PHYS/QHP 5/>YRS 99152 $81.00

3399153 MOD SED SAME PHYS/QHP EA 99153 $19.00

3399155 MOD SED OTH PHYS/QHP <5 YRS 99155 $85.00

3399156 MOD SED OTH PHYS/QHP 5/>YRS 99156 $65.00

3399157 MOD SED OTHER PHYS/QHP EA 99157 $84.00

3399238 HOSPITAL DISCHARGE DAY 99238 $156.00

3496360 HYDRATION BASE-1 HOUR 96360 $784.00

3496361 HYDRATION-ADDITIONAL HOUR 96361 $130.00

3496365 IV THERAPY-INITIAL HOUR 96365 $652.00

3496366 IV THERAPY-EACH ADDITIONAL HOUR 96366 $134.00

3496367 IV THERAPY-ADD SEQ INFUSION 96367 $784.00

3496368 IV THERAPY-CONCURRENT INFUSION 96368 $652.00

3496372 INJECTION 96372 $79.00

3496374 IV PUSH INITIAL DRUG 96374 $134.00

3496375 IV PUSH EA ADDL NEW DRUG 96375 $134.00

3496376 EACH ADD SEQ IVP, SAME DRUG (<30 MIN) 96376 $134.00

3500018 ER LEVEL 1 99281 $147.00

3500026 ER LEVEL II 99282 $232.00

3500034 ER LEVEL III 99283 $321.00

3500042 ER LEVEL IV 99284 $474.00

3500069 ER LEVEL V 99285 $626.00


3500390 TRAUMA TEAM W/ CRITICAL CARE G0390 $877.00

3500417 CRITICAL CARE 30-74 MINS 99291 $1,319.00

3500425 CRITICAL CARE ADD 30 MIN 99292 $118.00

3500654 FB REM EXT EYE EMB 65210 $57.00

3500697 NASL HEMOR ANT SMPL 30901 $70.00

3500719 NASL HEMOR ANT CMPX 30903 $119.00

3500727 NASL HEMOR POST INI 30905 $70.00

3500735 NASL HEMOR POST SUB 30906 $67.00

3502192 PELVIC BINDER L2192 $471.00

3510060 I & D ABCESS SIMP 10060 $69.00

3510061 I & D ABSCESS COMP 10061 $101.00

3510080 I & D PILONIDAL CYST 10080 $95.00

3510120 I & REM FB SIMPLE 10120 $79.00

3510121 REMOVAL FB COMP 10121 $117.00

3510140 ID HEMO, SEROME OR FLUID COLLECT 10140 $139.00

3510160 PUNTURE DRAINAGE OF LESION 10160 $93.00

3511000 DEBRIDEMENT OF INFECTED SKIN 11000 $41.00

3511042 DEBRIDE SKIN/TISSUE 11042 $66.00

3511043 DEB MUSC/FASCIA 20 SQ CM/< 11043 $154.00

3511102 TANGENTIAL BIOPSY OF SKIN:SINGLE LESION 11102 $58.00

3511104 PUNCH BIOPSY OF SKIN:SINGLE LESION 11104 $73.00

3511200 REMOVAL OF SKIN TAGS 11200 $59.00


3511441 EXCISION BENIGN LESIONS,FACE,EARS,EYES-0 11441 $105.00

3511720 PEBRIDEMENT NAIL 1-5 11720 $26.00

3511730 AVULISION OF NASAL PLATE 11730 $63.00

3511740 EVAC SUBUNGUAL HEM 11740 $32.00

3511750 EXCISION FINGER OR TOE NAIL/NAIL MATRIX, 11750 $156.00

3511760 REPAIR OF NAIL BED, SIMPLE 11760 $165.00

3512001 SIM LAC <2.6 BSHF 12001 $96.00

3512002 SIM LAC <2.6-7.5BSHF 12002 $113.00

3512004 SIM LAC 7.6 -12.5 BSHF 12004 $143.00

3512005 SIM LAC 12.6- 20CM BSHF 12005 $202.00

3512006 SIM LAC > 20CM BSHF 12006 $214.00

3512011 SIM LAC <2.6 FCE 12011 $107.00

3512013 SIM LAC 2.6-5 FCE 12013 $158.00

3512014 SIM LAC 5.1-7.5 FCE 12014 $206.00

3512015 SIM LAC 7.6-12.5 FCE 12015 $237.00

3512016 SIM LAC 12.6-20 FCE 12016 $273.00

3512031 INT LAC <2.6 BS 12031 $130.00

3512032 INT LAC 2.6-7.5 BS 12032 $160.00

3512034 INT LAC 7.6-12.5 BS 12034 $179.00

3512035 INTERLAC 12.6-20 CM 12035 $193.00

3512041 INT LAC <2.6 NHF 12041 $137.00

3512042 INT LAC 2.6-7.5 NHF 12042 $171.00

3512044 INTER LAC 7.6-12.5 NHF 12044 $217.00

3512045 INT LAC 12.5-20 NHF 12045 $309.00

3512051 INT LAC < 2.5 FEE 12051 $158.00

3512052 INT LAC 2.6-5 FEE 12052 $193.00

3512053 INT LAC 5.1-7.5 FEE 12053 $329.00

3512054 INT LAC 7.6-12.5 FEE 12054 $383.00

3512055 INT LAC 12.6-20.0 CM 12055 $265.00




3513131 REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, 13131 $270.00

3513132 CMPLX LAC 2.6-7.5CM FACE, H,F 13132 $261.00

3513151 REPAIR, COMPLEX, EYELIDS, NOSE, EARS, LI 13151 $298.00

3513152 REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND 13152 $357.00

3513153 REPAIR,COMPLEX,EYELIDS,NOSE,EARS AND/OR 13153 $120.00

3516000 INITIAL TREATMENT OF BURN(S) 16000 $43.00

3516020 BURN DRESS/SM 1-2 16020 $41.00

3517250 CHEMICAL CAUTERIZATION GRAN TISS 17250 $34.00

3520103 EXP OF PENETRATING WOUND EXT 20103 $203.00

3520525 REMOVAL OF FOREIGN BODY IN MUSCLE OR TEN 20525 $322.00

3520551 INJ TENDON ORIGIN/INSERTION 20551 $33.00

3520552 TRIGGER POINT/SINGLE OR MULT/ 1-2 MUSCLE 20552 $32.00

3520553 SING/MULT TRIGGER PTS 3 OR MORE MUSCLE 20553 $37.00

3520600 ARTHRO,ASP, OR INJEST SM JT W/O US 20600 $42.00

3520605 ARTHRO,ASP, OR INJEST INT JT W/O US 20605 $43.00

3520610 ARTHRO,ASP, OR INJEST MAJOR JT W/O US 20610 $50.00

3521310 CLSD TX NASAL W/O MANIP 21310 $40.00

3521320 CLSD TX NASAL BONE FRACTURE, WITH STABLE 21320 $154.00

3521480 CLSD TX TEMPOROMANIBULAR DISLOC 21480 $40.00

3523500 CLSD TX CLAVICLE FX W/O MANIP 23500 $224.00

3523540 CLSD TX AC JOINT DISLOCATED W/O MANIP 23540 $224.00

3523545 CLSD TX AC DISLOC W/MANIP 23545 $320.00

3523600 CLSD TX PROXIMAL HUMERUS FX W/O MANIP 23600 $317.00

3523650 CLSD TX SHOULDER DISLOC W/MANIP W/O ANES 23650 $226.00

3524500 CLSD TREAT HUMERAL EX W/O MANIP 24500 $336.00

3524600 TXCLSD ELBOW DISLOC W/O ANEST 24600 $190.00

3524640 NURSEMAID ELBOW 24640 $93.00

3524650 CLSD TX RADIAL HEAD FX W/O MANIP 24650 $240.00

3524655 CLOSED TREATMENT RADIAL HEAD/NECK FRATUR 24655 $314.00

3525565 CLSD TX RADIUS & ULNA W/MAN 25565 $171.00

3525600 CLSD TX DISTAL RADIAL FX W/O MAN 25600 $244.00

3525622 CLSD TX NAVICULAR FX W/O MANIP 25622 $279.00

3525650 CLSD TX ULMR STYLOID EX 25650 $306.00

3526010 I & D ABCESS FINGER SIMPLE 26010 $68.00


3526600 CLSD TX METACARPAL FX W/O MANIP 26600 $225.00

3526605 CLSD TX METACARPAL FX W MINIP 26605 $181.00

3526700 TREAT KNUCKLE DISLOCATION 26700 $201.00

3526720 CLSD TX FINGER FRACTURE W/O MANIP 26720 $181.00

3526725 CLSD TX FINGER FRACTURE W/MANIP EA 26725 $335.00

3526750 CLSD TX DISTAL TUFT FX W/O MANIP 26750 $181.00

3526770 CLSD TX DIP OR PIP DISLOC W/MANIP 26770 $265.00

3526775 DISLOCATION INTERPHALANGEAL-JOINT,SINGLE 26775 $269.00

3526785 OPEN TX INTERPHALANGEAL JOINT DISLOCATIO 26785 $371.00

3527250 CLOSED HIP REDUCTION 27250 $107.00

3527265 TREATMENT OF HIP DISLOCATION, WITHOUT AN 27265 $279.00

3527268 CLTX THIGH FX W/MNPJ 27268 $329.00

3527510 CLOSED TX FEMERAL FRACTURE W/MANIP 27510 $379.00

3527532 FRACTURE TIBIA PROXIMAL,PLATEAU,CLOSED,C 27532 $417.00

3527560 CLSD TX PATELLAR DISLOC W/O ANES 27560 $344.00

3527780 CLSD TX PROCIMAL FIBULA FX W/O MANIP 27780 $285.00

3527786 CLSD TX DIS FIBULE W/O MANIP 27786 $301.00

3527788 FRACTURE FIBULA DISTAL EXTREMITY, LATERA 27788 $260.00

3527810 CLSD TX BIMALLEOLAR FX W/O MANIP 27810 $224.00

3527811 CLSD TX CLAVICLE FX W/O MANIP 23500 $224.00

3527812 CLOSED TX BIMALLEOLAR ANKLE FX W MANIP 27810 $289.00

3527818 CLSD TX BIMALLEOLAR ANKLE FX W/MANIP 27818 $210.00

3527840 CLSD TX ANKLE DISLOC W/O ANEST 27840 $310.00

3528190 REMOVAL OF F.B. FOOT SUB 28190 $91.00

3528470 CLSD TX METATARSAL FX W/O MANIP EA 28470 $214.00

3528490 CLSD TX BIG TOE FX W/O MANIP 28490 $133.00

3528510 CLSD TX TOE FX W/O MANIP 28510 $126.00

3528630 CLSD TX METATARSOPHAL JT DISLOC 28630 $193.00

3528660 CLSD TX CLOSED IPI DICLOC 28660 $99.00

3529105 APPLY LONG ARM SPLINT 29105 $71.00

3529125 APPLY SHORT ARM SPLINT 29125 $49.00

3529130 APPLY OF FINGER SPLINT, STATIC 29130 $36.00

3529240 STRAPPING SHOULDER 29240 $41.00

3529505 APPLY LONG LEG SPLINT 29505 $49.00

3529515 APPLY SHORT LEG SPLINT (CALF TO FOOT) 29515 $63.00

3529530 STRAPPING KNEE IMMOBLIZER 29530 $18.00

3529700 REMOVAL OF CAST 29700 $33.00

3529705 REMOVAL OR BIVALVING,GAUNTLET,BOOT,BODY 29705 $46.00

3530000 DRAINAGE ABSCESS/HEMATOMA, NASAL, INTERN 30000 $156.00

3530300 REMOVE FB INTANASAL 30300 $83.00

3530901 CONT ANT/NASAL HEM 30901 $70.00

3531500 ENDOTRACH INTUBAT 31500 $193.00

3531502 TRACHEOTOMY TUBE CHANGE 31502 $31.00

3531605 CRICOTHYROIDOSTOMY 31605 $133.00

3532551 TUBE THORACOSTOMY INCL WATER SEAL 32551 $168.00

3532554 THORACENTESIS NEEDLE/CATH PLEURA W/O IMA 32554 $128.00

3532555 ASPIRATE PLEURA WITH IMAGING 32555 $163.00

3535206 REAPIR BLOOD VESSELSOR A-V FISTULA, UPPE 35206 $577.00

3535226 REPAIR BLOOD VESSEL, LOWER EXTREMITY 35226 $597.00

3536430 TRANSFUSION BLOOD OR BLOO COMPONETS 36430 $27.00




3536573 INSERTION OF PICC W/O SUB PORT OR PUMP 5 36573 $242.00

3536584 REPLACE, COMPLETE OR A PICC W/O 36584 $126.00

3536680 INTRAOSSEOUS INFUSION 36680 $101.00

3537195 THROMBOLYTIC THERAPY STROKE 37195 $165.00

3540800 I/D ABSCESS,CYST VESTIBLE OF MOUTH, S/M 40800 $121.00

3540804 REMOVAL EMBEDDED FB, MOUTH SIMPLE 40804 $101.00

3540830 CLSD LAC VEST <2.5 CM 40830 $186.00

3540831 CLSD LAC VEST >2.5 CM 40831 $265.00

3541000 I&D ABSCESS/CYST/HEMATOMA TONGUE/FLOOR O 41000 $108.00

3541250 MOUTH LAC <2.6CM 41250 $155.00

3541252 TONGUE LAC >2.6 CM 41252 $255.00

3541800 I/D ABSCESS DENTDAL ALVEOLAR 41800 $117.00

3542700 I & D PERITONSILLAR ABSCESS 42700 $120.00

3542725 DRAINAGE ABSCESS RETROPHARYNGEAL OR PARA 42725 $507.00

3543752 NASO- OR ORO-GASTRIC TUBE PLACEMENT,PHYS 43752 $98.00

3543762 REPLACE OF GASTROSTOMY TUBE NOT REQUIRIN 43762 $137.00

3543763 REPLACE OF GASTROSTOMY TUBE REQUIRING 43763 $203.00

3544500 LONG GI TUBE (SEPARATE) 44500 $13.00

3545005 INCISION AND DRAINAGE OF SUBMUCOUS ABSCE 45005 $186.00

3546040 INCISION AND DRAINAGE OF ISCHIORECTAL AN 46040 $362.00

3546050 I&D PERIANAL ABCESS 46050 $101.00

3546083 INCISION-THROMBOSED HEMORROID EXT 46083 $96.00

3546600 ANOSCOPY; DIAGNOSTIC 46600 $41.00

3549082 ABDOM PARACENTESIS DX/THER W/O IMAGING G 49082 $120.00

3549083 ABDOMEN PARACENTESIS W/IMAGING 49083 $154.00

3551700 BLADDER IRRIRATION, SIMP, LAVAGE &/OR IN 51700 $113.00

3551701 INSERT BLADDER CATHETER 51701 $202.00

3551702 INSERT TEMP BLADDER CATH 51702 $253.00

3551705 CHANGE OF CYSTOSTOMY TUBE,SIMPLE 51705 $64.00

3551798 US URINE CAPACITY MEASURE 43753 $45.00

3553060 DRAINAGE OF SKENE'S GLAND ABCESS OR CYST 53060 $134.00

3556405 I/D OF VULVA OR PERINEAL ABSCESS 56405 $107.00

3556420 I/D BARTHOLIN ABSCESS 56420 $95.00

3558301 REMOVAL OF INTRAUTERINE DEVICE 58301 $70.00

3559409 VAGINAL DELIVERY ONLY 59409 $435.00

3562270 LUMBAR PUNCTURE 62270 $96.00

3562273 INJECTION EPIDUAL 62273 $70.00

3564400 N BLOCK INJ TRIGEMINAL 43763 $81.00

3564402 INJECTION ANES AGENT/FACIAL NERVE 64402 $31.00

3564450 NERVE BLOCK ONLY 64450 $37.00

3565205 CONJUN FB REMOVAL SUPERF 65205 $57.00

3565220 CORNEAL FB REMOVAL 65220 $57.00

3565222 CORNEAL FB REM-W LP 65222 $97.00

3565435 REMOVAL CORNEAL RUST RING 65435 $193.00

3567700 I/D ABSCESS EYELID 67700 $103.00

3567938 REMOVE FOREIGN BODY EYELID 67938 $124.00

3569000 I/D EXT EAR 69000 $114.00

3569200 REMOVE FOREIGN BODY EAR 69200 $66.00

3569210 REM IMPACT CERUMEN, UNILATERAL 69210 $33.00


3591105 GASTRIC LAVAGE 43753 $98.00

3592511 NASOPHARYNGOSCOPY 92511 $69.00

3592950 CARDIOPUL RESUS CRP 92950 $256.00

3592960 CARDIOVERSION 92960 $177.00

3596372 INJECTION 96372 $79.00

3597597 ACTIVE WOUND CARE/20 CM OR< 97597 $31.00

3599151 MOD SED SAME PHYS/QHP <5 YRS 99151 $13.00

3599152 MOD SED SAME PHYS/QHP 5/>YRS 99152 $21.00

3599153 MOD SED SAME PHYS/QHP EA 99153 $19.00

3599155 MOD SED OTH PHYS/QHP <5 YRS 99155 $22.00

3599156 MOD SED OTH PHYS/QHP 5/>YRS 99156 $16.00

3599157 MOD SED OTHER PHYS/QHP EA 99157 $21.00

3599211 TRIAGE/ASSESSMENT 99211 $40.00

3700100 TRANSPORT-CAR A0100 $1,110.00

3700998 AMBULANCE A0998 $444.00

3713024 AMB-ADD ATTENDANT A0999 $372.00

3713059 AMBULANCE-BLS-EMERG A0429 $702.00

3713105 AMB-ALS1-EMERGENCY A0427 $1,093.00

3713202 AMBULANCE-ALS2 A0433 $1,338.00

3713229 AMB-ALS2-RESUSCITAT A0433 $1,764.00

3713237 AMB-ALS1-NON-EMERG A0426 $852.00

3713245 AMB-ADV CARE- NO TRF A0999 $444.00

3713474 AMBULANCE-BLS A0428 $577.00

3713539 AMBULANCE-MILEAGE A0425 $24.00

3713555 AMBULANCE-SCT A0434 $1,700.00

3725322 PLATE, ANCHORAGE-MTP LS PLP10461 C1776 $5,652.00

4281003 CL URINALYSIS-DIP 81003 $15.00

4281004 CL OB URINALYSIS-DIP 81003 $15.00

4281025 CL PREGNANCY TEST URINE 81025 $30.00

4282272 CL OCCULT BLD #1 82272 $28.00

4282962 CL BLOOD SUGAR 82962 $23.00

4285018 CL HEMOGLOBIN 85018 $18.00

4287260 CL COVID 19 AG 15 87426 $60.00

4287430 CL STAT STREP SCREEN 87880 $49.00

4287449 CL LAB TEST INFLUENZA 87449 $16.00

4300003 SARS-OcV-2 87635 $201.00

4300009 .INFLUENZA A 87804 $61.00

4300013 .INFLUENZA B 87804 $61.00

4300015 IGE AB SINGLE ALLERGEN 86003 $67.00

4300016 IGE AB MULTI ALLERGEN 86003 $97.00

4300017 THIAMINE ERYTHROCYTES 84425 $238.00

4300018 .HERPES SIMPLEX 1-IGG 86695 $102.00

4300023 RAPID HIV 86703 $59.00

4300025 HEMOGRAM 85027 $49.00

4300026 HERPES SIMPLEX 1/2 IGM COMBINATION 86694 $102.00

4300027 .RBC CSF 89050 $30.00

4300028 .CSF DIFF 89051 $31.00

4300029 TOXPLASMA AB IGG 86777 $124.00

4300030 ID 1ST ORG URINE 87077 $44.00

4300031 ID 1ST ORG OTHER 87077 $44.00

4300032 ID ADD'L ORG URINE 87077 $44.00

4300033 ID ADD'L ORG OTHER 87077 $44.00

4300034 HALDOL (HALPERIDOL) 80173 $194.00

4300035 CULTURE ACID FAST & SMEAR 87116 $30.00

4300037 RUBELLA 86762 $35.00

4300038 .T4 FREE-CHARGE 84439 $65.00

4300039 .FREE T3-CHARGE 84481 $65.00

4300040 .GLUCOSE ADD'L SPEC 82952 $24.00

4300042 DOT BREATH ALCHOL 82075 $50.00

4300045 CLOSTRIDIUM DIFF AG MOLECULAR 87493 $164.00

4300046 DIGOXIN, SERUM OR PLASMA 80162 $98.00

4300051 MTHFR DNA TESTING 81291 $165.00

4300053 ROCKY MT FEVER AB 86757 $190.00

4300055 CLOZAPINE, SERUM OR PLASMA 80159 $114.00

4300062 DILANTIN/PHENYTOIN, SERUM OR PLASMA 80185 $77.00

4300064 VON WILLEBRAND FACTOR ANTIGEN 85245 $289.00

4300065 FACTOR V111 ACTIVITY ASSAY 85240 $184.00

4300067 MYOGLOBIN URINE QUANT 83874 $23.00

4300072 C1 ESTERASE INHIBITOR 86161 $99.00

4300076 BILIRUBIN DIRECT 82248 $27.00

4300079 PROTHROMBIN II ACTIVITY 81240 $240.00

4300081 INSULIN-LIKE GROWTH FACTOR 1 84305 $316.00

4300082 DHEA, SERUM 82626 $258.00

4300083 T3 FREE 84481 $144.00

4300084 T3 REVERSE 84482 $276.00

4300085 BB PLATELET PHERESIS EACH UNIT P9035 $718.00

4300086 VITAMIN D, 25-HYDROXY 82306 $247.00

4300087 WELLNESS COVID-19 PCR U0003 $143.00

4300088 OCCUP HLTH CBC W/DIFF $46.00

4300089 PHENOBARBITAL, SERUM 80299 $92.00

4300090 AMINO ACIDS QUANT PLASMA 82139 $808.00

4300092 CA 15-3 86300 $158.00

4300093 NTX-TELOPEPTIDE,URINE 82523 $207.00

4300094 ANTI-DNASE B 86215 $110.00

4300095 COPPER PLASMA 82525 $114.00

4300096 ANTI-HCV 86803 $107.00

4300097 THEOPHYLLINE, SERUM 80198 $75.00

4300098 TACROLIMUS (FK506), WHOLE BLOOD 80197 $249.00

4300099 1,25 DIHYDROXY VITAMIN D SERUM 82652 $391.00

4300109 TOPIRAMATE, SERUM 80201 $173.00

4300110 LEVETIRACETAM (KEPPRA),SERUM 80177 $144.00

4300111 LIPOPROTEIN A, SERUM 82172 $168.00

4300113 .THYROGLOBULIN TUMOR MARKER 84432 $118.00

4300116 LAMOTRIGINE (LAMICTAL), SERUM 80175 $148.00

4300117 T-UPTAKE 84479 $78.00

4300118 TOXOPLASMA AB, IGM 86778 $186.00

4300123 .HELICOBACTER PYLORI AB IGG 86677 $109.00

4300125 .OLIGOCLONAL BANDS, CSF 83916 $94.00

4300126 CMV AB IGG 86644 $136.00

4300127 ANTI HBc, TOTAL 86704 $68.00

4300128 .OLIGOCLONAL BANDS, SERUM 83916 $94.00

4300132 INSULIN, FREE & TOTAL 83527 $148.00

4300133 ANDROSTENEDIONE, SERUM 82157 $289.00

4300134 CMV IGM AB 86645 $136.00

4300135 LEGAL BLOOD ALCOHOL 36415 $111.00

4300140 GLUCOSE 6 PHOSPHATE 82955 $135.00

4300142 .NEPHELOMETRY EACH ANALYTE 83883 $66.00

4300144 CADMIUM, BLOOD 82300 $150.00

4300145 MYCOPHENOLIC ACID 80180 $267.00

4300147 .ANNA-1, S 86256 $100.00

4300148 .ANNA-2, S 86256 $100.00

4300149 .ANNA-3, S 86256 $100.00

4300150 .PCA-1 86256 $100.00

4300151 5HIAA URINE 83497 $162.00

4300152 .PCA-2 86256 $100.00

4300153 .PCA-TR 86256 $100.00

4300154 .AMPHIPHYSIN AB 86256 $100.00

4300155 .CRMP-5IGG 86256 $100.00

4300157 .CALCIUM, N-TYPE 83519 $100.00

4300158 .HEPATITIS C ANTIBODY (RIBA) 86804 $429.00

4300159 .CALCIUM, P/Q-TYPE 83519 $100.00

4300160 ACH RECEPTOR AB 83519 $136.00

4300164 .S PNEUMONIAE 86403 $65.00

4300165 .N MENINGITIDIS GRP A 86403 $65.00

4300166 .ENDOMYSIAL AB IGA 86256 $261.00

4300167 .N MENINGITIDIS GRP B 86403 $65.00

4300168 .E COLI K1 86403 $65.00

4300169 .H INFLUENZAE 86403 $65.00

4300171 CMV DNA QUANTITATIVE PCR 87497 $350.00

4300174 REDUCING SUBSTANCES STOOL 81005 $23.00

4300177 LUPUS ANTICOAGULANT EVAL W/REF 85613 $153.00

4300178 THROMBIN TIME 85670 $153.00

4300179 FACTOR V LEIDEN MUTATION 81241 $106.00

4300182 GABAPENTIN, PLASMA 80171 $168.00

4300186 HEP B SURFACE AB 86706 $42.00

4300187 GLUTAMIC ACID DECARBOXYLASE AB 86341 $96.00

4300190 CYCLIC CITRULLINATED PEPTIDE AB 83516 $122.00

4300192 .VITAMIN B1 84425 $116.00

4300194 ALCOHOL 80307 $84.00

4300199 SELENIUM, SERUM 84255 $219.00

4300200 CRYPTOSPORIDIUM AG, FECES 87328 $131.00

4300201 NEISSERIA GONORRHOEAE BY DNA 87591 $148.00

4300203 SIROLIMUS BLOOD, WHOLE BLOOD 80195 $191.00

4300204 SCLERODERMA ANTIBODY (Scl-70) 86235 $137.00

4300205 DRUG SCREEN, URINE, EMPLOYER 80307 $18.00

4300208 LIPID PANEL 80061 $65.00

4300210 .HERPES SIMPLEX TYPE 1 86695 $78.00

4300211 .HERPES SIMPLEX TYPE 2 86696 $78.00

4300212 RISPERDAL 80299 $157.00

4300214 ACHR BINDING ABS 83519 $182.00

4300216 B12 LEVEL, SERUM 82607 $78.00

4300217 METANEPHRINES PLASMA 83835 $292.00

4300223 SEROTONIN SERUM 84260 $144.00

4300224 LITHIUM, SERUM 80178 $41.00

4300226 .CYSTIC FIBROSIS 83516 $24.00

4300228 TUBERCULOSIS SKIN TEST 86580 $15.00

4300230 FRUCTOSAMINE SERUM 82985 $97.00

4300232 IMMUNOFIXATION ELECTROPHORESIS, SERUM 86344 $187.00

4300233 CARNITINE, TOTAL AND FREE 82379 $67.00

4300235 IMMUNOGLOBULIN D 82784 $225.00

4300236 LACTIC ACID, PLASMA 83605 $277.00

4300240 AMIODARONE (Cordarone), SERUM 80299 $208.00

4300247 TREPONEMA PALLIDUM ABS REFLEX RPR TPPA 86592 $30.00

4300255 CULTURE GROUP B 87081 $33.00

4300259 CEA 82378 $126.00

4300261 STONE ANALYSIS QUAL 82365 $136.00

4300263 PATERNITY TEST COLLECTION FEE $45.00

4300267 AMMONIA, PLASMA 82140 $75.00

4300275 CARBON MONOXIDE, BLOOD 82375 $59.00

4300291 OSMOLALITY SERUM 83930 $39.00

4300298 DOT CONFIRM BR ALCH 82075 $45.00

4300301 RSV NASAL ANTIGEN 87420 $137.00

4300305 IRON BINDING CAPACITY(TIBC) 83550 $36.00

4300306 WELLNESS HEMOGRAM 85027 $31.00

4300307 WELLNESS COMPREHENSIVE METABOLIC 80053 $46.00

4300308 WELLNESS BASIC METABOLIC 80048 $33.00

4300309 WELLNESS LIPID 80061 $38.00

4300310 WELLNESS GLUCOSE 82947 $18.00

4300311 WELLNESS CHOLESTEROL 82465 $18.00

4300312 WELLNESS VITAMIN B12 82607 $49.00

4300313 METHEMOGLOBIN 83050 $156.00

4300314 WELLNESS IRON/IRON BINDING CAPACITY 83540 $50.00

4300315 WELLNESS ABO/RH 86900 $40.00

4300316 WELLNESS TSH 84443 $41.00

4300317 WELLNESS FERRITIN 82728 $41.00

4300318 WELLNESS PSA 84153 $45.00

4300319 WELLNESS GLYCO HGB 83036 $22.00

4300320 WELLNESS VITAMIN D 82306 $71.00

4300334 TSI 84445 $500.00

4300336 BASIC METABOLIC PANEL 80048 $72.00

4300344 COMPREHENSIVE METABOLIC PANEL 80053 $88.00

4300352 HEPATIC FUNCTION PANEL 80076 $87.00

4300356 GLYCOSYLATED HGB 83036 $45.00

4300364 CORTISOL SERUM, AM 82533 $75.00

4300378 PROTEIN ELECTROPHORESIS, SERUM 84165 $110.00

4300395 .AUTOMATED DIFF 85004 $30.00

4300399 PRIMIDONE(MYSOLINE), SERUM 80188 $75.00

4300402 IRON, SERUM 83540 $44.00

4300409 .MANUAL DIFF 85007 $31.00

4300415 CHARGE CBC AUTO DIFF 85025 $64.00

4300423 BODY FLUID SPECIFIC GRAVITY 84315 $26.00

4300429 HEP B SURFACE AG WITH REFLEX 87340 $33.00

4300437 ANA 86038 $83.00

4300445 ETHOSUXIMIDE (ZARONTIN) 80168 $157.00

4300453 T3 84480 $65.00

4300458 TOTAL PROTEIN BODY FLUID 84157 $26.00

4300466 CRYSTALS 89060 $41.00

4300472 HCV AB SCREENING G0472 $107.00

4300474 SPECIFIC GRAV BODY FLUID 84315 $26.00

4300475 HIV 1/2 AB SCREENING G0475 $63.00

4300504 GLUCOSE BODY FLUID 82945 $30.00

4300526 TSH 84443 $85.00

4300534 T4 FREE 84439 $65.00

4300539 .WBC'S CSF 89050 $30.00

4300542 QUINIDINE, SERUM 80194 $75.00

4300547 .SSA 86235 $173.00

4300563 .SSB 86235 $173.00

4300569 FOLATE, SERUM 82746 $78.00

4300577 LEAD VENOUS 83655 $83.00

4300601 .RNP 86235 $173.00

4300623 GENTAMICIN-RANDOM 80170 $75.00

4300631 TOBRAMYCIN, SERUM 80200 $75.00

4300638 AMYLASE BODY FLUID 82150 $51.00

4300646 ALBUMIN BODY FLUID 82042 $41.00

4300658 PSEUDOCHOLINESTERASE 82480 $82.00

4300735 D-DIMER, PLASMA 85379 $147.00

4300743 RAPID URINE DRUG SCREEN 80306 $98.00

4300808 MICROALBUMIN 24HOUR 82043 $148.00

4300812 MICROALBUMIN RANDOM 82043 $131.00

4300816 TROPONIN QUANTITATIVE 84484 $72.00

4300828 HDL 83718 $40.00

4300832 LEGIONELLA AG, URINE 87449 $189.00

4300844 FERRITIN 82728 $55.00

4300867 TRANSFERRIN 84466 $96.00

4300875 GLOMERULAR BASE MEM AB IGG 83520 $317.00

4300887 CARBAMAZEPINE/TEGRETOL, SERUM OR PLASMA 80156 $75.00

4300905 VALPROIC ACID TOTAL/DEPAKOTE, SERUM 80164 $159.00

4300913 CA 27-29 86300 $193.00

4300921 THYROPEROXIDASE 86376 $150.00

4300933 ACUTE HEPATITIS SCREEN 80074 $310.00

4300948 PINWORM EXAM 87172 $34.00

4300956 .GLIADIN AB IG A 83516 $157.00

4300964 .GLIADIN IGA 83516 $80.00

4300972 .UA NON-AUTO NO MICRO 81002 $27.00

4300976 PROCAINAMIDE/NAPA, SERUM 80192 $120.00

4300984 PROSTATE-SPECIFIC AG 84153 $131.00

4300992 PROSTATIC ACID PHOSPATASE 84066 $132.00

4300999 UA/W/REFLEX CULTURE (LE OR NITRITE POS) 81003 $28.00

4301006 HTLV1 86687 $132.00

4301018 PTH INTACT, BLOOD 83970 $344.00

4301022 MYOGLOBIN SERUM QUANT 83874 $193.00

4301057 RENAL FUNCTION PANEL 80069 $78.00

4301065 PSA SCREEN G0103 $131.00

4301073 STREP SCREEN 87430 $35.00

4301077 IMMUNOGLOB IGG 82784 $87.00

4301085 IMMUNOGLOB IGA, SERUM 82784 $87.00

4301093 IMMUNOGLOB IGM 82784 $87.00

4301103 CPK MB&CPK TOTAL 82553 $98.00

4301111 HOMOCYSTEINE 83090 $291.00

4301115 LIPASE 83690 $67.00

4301123 AFP TUMOR MARKER 82105 $137.00

4301138 T4 THYROXINE TOTAL 84436 $70.00

4301162 CRP CARDIAC HS, SERUM 86141 $110.00

4301166 FSH 83001 $122.00

4301174 LUTEINIZING HORMONE 83002 $124.00

4301197 MATERNAL QUAD SCREEN 82105 $371.00

4301204 RENIN ACTIVITY 84244 $203.00

4301212 ALPHA I ANTITRIPSIN 82103 $140.00

4301219 CULTURE FUNGAL SKIN 87101 $26.00

4301235 CULTURE FUNGAL OTHER 87102 $34.00

4301239 .AMITRIPTYLINE 80335 $156.00

4301243 CULTURE SENSITIVITY WELAND #6045 87186 $126.00

4301251 CENTROMERE ANTIBODY 83516 $131.00

4301255 NORTRIPTYLINE, SERUM 80335 $77.00

4301263 17-OH PROGESTERONE 83498 $237.00

4301286 CORTISOL PM, SERUM 82533 $147.00

4301298 TESTOSTERONE TOTAL 84403 $166.00

4301301 HCG SERUM QUANT 84702 $97.00

4301328 HLA-B27 86812 $202.00

4301332 FUNGAL TITERS-BLASO,HISTO, COCCID 36563 86849 $63.00

4301336 ESTRADIOL, SERUM 82670 $217.00

4301344 PROLACTIN, SERUM 84146 $170.00

4301352 ALP ISOENZYMES 84080 $170.00

4301359 GLUCOSE TOL 3HR PREGNANCY 82951 $63.00

4301375 HEPATITIS BE AB SERUM 86707 $119.00

4301379 C-PEPTIDE 84681 $171.00

4301383 HEPATITIS BE AG 87350 $119.00

4301409 C3 86160 $115.00

4301413 AMIKACIN, PEAK 80150 $165.00

4301441 .HERPES SIMPLEX I & II, IGG 86694 $289.00

4301448 BORDETELLA PERTUSSIS PCR 87798 $63.00

4301468 LIDOCAINE, SERUM 80176 $115.00

4301484 ALDOSTERONE 82088 $386.00

4301492 MERCURY, BLOOD 83825 $177.00

4301514 CATECHOLAMINE PLASMA 82384 $314.00

4301522 ANTI-DNA(DS-DNA) 86225 $108.00

4301537 NEONATAL SCREEN 84437 $140.00

4301553 17 KETOSTEROIDS, URINE 83586 $195.00

4301561 .HERPES SIMPLEX 2-IGG 86696 $102.00

4301565 CA 125 86304 $193.00

4301573 PORPHYRINS URINE QUANT 84120 $237.00

4301581 PROGESTERONE, SERUM 84144 $157.00

4301603 DHEA -SULFATE 82627 $228.00

4301611 PROZAC, SERUM 80299 $201.00

4301626 LYMES DISEASE 86618 $63.00

4301642 .LUPUS ANTICOAGULANT COMPREHS 80500 $500.00

4301646 GASTRIN 82941 $136.00

4301662 HAPTOGLOBIN 83010 $144.00

4301677 PSA TOTAL & FREE 84154 $279.00

4301693 MYCOPLASMA PNEUMO AB 86738 $63.00

4301707 CULTURE NASAL FOR STAPH 87081 $33.00

4301715 PROTEIN S FUNCTIONAL 85306 $472.00

4301723 Q FEVER, SERUM 86638 $63.00

4301735 MITOCHONODRIAL ABS 86256 $116.00

4301743 ALDOLASE 82085 $83.00

4301766 SYNOVIAL FLD GROUP 89051 $156.00

4301778 .EPSTEIN-BARR VIRUS AB PROFILE 86665 $404.00

4301782 TICK IDENTIFICATION 87172 $24.00

4301786 CYCLOSPORINE, WHOLE BLOOD 80158 $224.00

4301794 FOLIC ACID, RBC 82747 $221.00

4301808 PLATELET ANTIBODY SERUM 86022 $267.00

4301812 TRICHINELLA AB, SERUM 86784 $63.00

4301816 IONIZED CALCIUM 82330 $14.00

4301824 IGE SERUM 82785 $99.00

4301832 .IGM 82784 $87.00

4301859 CRYPTOCOCCUS ANTIGEN 87327 $172.00

4301863 CULTURE BLOOD ADD'L SETS 87040 $83.00

4301867 CLONAZEPAM, SERUM 80346 $191.00

4301871 ID ADD'L ORGANISM 87102 $44.00

4301875 CERULOPLASMIN 82390 $113.00

4301901 .GLIADIN AB IG G 83516 $157.00

4301905 ARSENIC, BLOOD 82175 $176.00

4301913 .DILANTIN-TOTAL 80185 $110.00

4301921 ERYTHROPOIETIN, SERUM 82668 $219.00

4301936 DRUG ABUSE SCREEN, MECONIUM 80307 $285.00

4301948 HEMOGLOBIN PLASMA 83051 $86.00

4301952 .NORTRIPTYLINE 80335 $88.00

4301964 CALCITONIN 82308 $264.00

4301972 GLUCAGON 82943 $243.00

4302045 .IGG TOTAL 82784 $84.00

4302061 ALDOSTERONE AND RENIN ACTIVITY PLASMA 84244 $190.00

4302088 WEST NILE VIRUS, IGM 86788 $59.00

4302096 BB FRESH FROZEN PLASMA P9017 $187.00

4302118 BB RHOGAM J2790 $203.00

4302126 BB PRBC TRANSFUSED P9016 $324.00

4302169 BB IRRADIATION CHARGE 86945 $87.00

4302177 METHYLMALONIC ACID, SERUM 83921 $304.00

4302185 pro-BRAIN NATRIURETIC PEPTIDE 83880 $253.00

4302193 PREALBUMIN, SERUM 84134 $65.00

4302207 GLUCOSE BLOOD ACCUCHECK 82962 $34.00

4302215 BLOOD BY GASTRO 82271 $26.00

4302223 HEMATOPATHOLOGY CONSULT 85060 $391.00

4302258 TISSUE TRANSGLUTAMINASE IGA ANTIBODIES 83516 $107.00

4302266 FLECAINIDE 80299 $49.00

4303628 PLACENTAL ALPHA MICROGLOBULIN-1 84112 $180.00

4304629 HIV 1/2 AB 86703 $63.00

4309803 cOVID-19 SPECIMEN COLLECTION C9803 $28.00

4310011 SM ANTIBODIES 88235 $173.00

4310038 TESTOSTERONE TOTAL ADULTS 84403 $231.00

4310046 TESTOSTERONE FREE 84402 $166.00

4310119 CANDIDA ANTIBODIES, IgA, IgG, IgM 86628 $158.00

4310135 GALACTOSEMIA 82760 $27.00

4310216 CORD BLOOD GASES 82803 $116.00

4310224 DILANTIN FREE 80186 $224.00

4310275 DESIPRAMINE, SERUM 80335 $97.00

4310496 BODY FLUID WBC W/DIFF 89051 $33.00

4310518 CHROMIUM, PLASMA 82495 $203.00

4310577 ARSENIC URINE 82175 $176.00

4310585 DISOPYRAMIDE, SERUM 80299 $176.00

4310658 FELBAMATE, SERUM 80299 $150.00

4310666 TOTAL BILE ACIDS, SERUM 82239 $135.00

4310682 CULTURE, YERSINIA STOOL 87046 $128.00

4310704 INSULIN, SERUM 83525 $156.00

4336415 VENIPUNCTURE, PATIENT SUPPLIED KIT 36415 $45.00

4336416 C OF C-MT. PLEASANT SCHOOL 99199 $28.00

4336417 OCCUP HLTH VENIPUNCTURE 36415 $18.00

4336540 VENOUS ACCESS CHARGE 36591 $63.00

4350005 ARTERIAL COLL FEE 36600 $113.00

4350024 CULTURE BLOOD 1ST SET 87040 $83.00

4350034 VDRL 86592 $31.00

4350035 AMYLASE, SERUM OR PLASMA 82150 $51.00

4350042 ASO-QUANTITATIVE 86060 $55.00

4350043 AMYLASE URINE 82150 $61.00

4350048 CHAIN OF CUST DRAW FEE-LAB AND DOT 99199 $43.00

4350051 HCG SERUM QUAL 84703 $59.00

4350058 BB CROSSMATCH 1ST UNIT 86922 $156.00

4350064 VENIPUNCTURE 36415 $18.00

4350069 CRP 86140 $75.00

4350078 ALKALINE PHOSPHATASE 84075 $42.00

4350085 RF FACTOR, QUALITATITVE, SERUM 86430 $35.00

4350086 GLUCOSE, SERUM OR PLASMA 82947 $32.00

4350093 MONO TEST 86308 $39.00

4350094 UREA NITROGEN, SERUM OR PLASMA 84520 $33.00

4350104 BB ANTIBODY SCREEN 86850 $37.00

4350108 TOTAL BILIRUBIN 82247 $43.00

4350112 BB DIRECT COOMBS 86880 $37.00

4350116 NEONATAL BILIRUBIN 82248 $43.00

4350123 FECAL FAT-QUALITATIVE 82705 $36.00

4350124 CALCIUM, SERUM OR PLASMA 82310 $37.00

4350132 CREATININE, SERUM OR PLASMA 82565 $39.00

4350159 CHOLESTEROL, SERUM OR PLASMA 82465 $31.00

4350167 LDH 83615 $68.00

4350175 AST/SGOT 84450 $44.00

4350183 CPK, TOTAL 82550 $68.00

4350205 ELECTROLYTE PANEL, SERUM OR PLASMA 80051 $51.00

4350213 CARBON DIOXIDE,SERUM OR PLASMA 82374 $32.00

4350221 CHLORIDE, SERUM OR PLASMA 82435 $32.00

4350248 SODIUM, SERUM OR PLASMA 84295 $36.00

4350256 POTASSIUM, SERUM OR PLASMA 84132 $41.00

4350264 GLUCOSE TOL 2 HR 82951 $63.00

4350272 GLUCOSE TOL 1 1/2HR 82951 $63.00

4350299 ACETAMINOPHEN, SERUM OR PLASMA 80307 $83.00

4350302 PHOSPHORUS, SERUM OR PLASMA 84100 $34.00

4350329 ALT/SGPT 84460 $43.00

4350337 ALBUMIN, SERUM OR PLASMA 82040 $42.00

4350345 TRIGLYCERIDES 84478 $36.00

4350353 URIC ACID, SERUM OR PLASMA 84550 $39.00

4350361 SALICYLATE, SERUM OR PLASMA 80307 $66.00

4350388 TOTAL PROTEIN, SERUM OR PLASMA 84155 $43.00

4350396 SERUM ACETONE QUAL 82009 $35.00

4350418 GLUCOSE CSF 82945 $32.00

4350434 PROTEIN CSF 84157 $31.00

4350442 CSF CELL COUNTS 89050 $33.00

4351087 PH ARTERIAL BLOOD 82800 $49.00

4351139 GGT 82977 $43.00

4351147 CREATININE CLEARANCE 82575 $42.00

4351155 UREA NITROGEN URINE 84540 $36.00

4351163 MAGNESIUM, SERUM OR PLASMA 83735 $45.00

4351171 CALCIUM URINE RANDOM 82340 $39.00

4351179 CALCIUM URINE 24 HR 82340 $39.00

4351198 CHLORIDE URINE 24 HR 82436 $39.00

4351201 CREATININE URINE 24HR 82570 $39.00

4351208 CREATININE URINE RANDOM 82570 $39.00

4351228 POTASSIUM URINE 24 HR 84133 $39.00

4351232 BB CROSSMATCH ADD'L 86922 $156.00

4351236 SODIUM URINE 24 HOUR 84300 $39.00

4351244 OSMOLALITY URINE 83935 $39.00

4351252 PROTEIN ELECT URINE, RANDOM 84166 $96.00

4351279 PHOSPHORUS URINE 84105 $39.00

4351283 ANTI-HBc IgM 86705 $26.00

4351287 PROTEIN TOTAL URINE 84156 $39.00

4351295 URIC ACID,URINE 24 HRS 84560 $39.00

4351306 BLOOD GASES 82803 $122.00

4351307 VENOUS BLOOD GASES 82803 $33.00

4351309 CATECHOLAMINES URINE 24HR 82384 $270.00

4351317 METANEPHRINES, 24 HR URINE 83835 $169.00

4351325 VMA 24 HOUR URINE 84585 $184.00

4351368 .17-KGS 83582 $172.00

4351376 .17-KETOSTERIODS 83586 $126.00

4351392 GLUCOSE-PP 82950 $30.00

4351406 .GLUCOSE TOL 1 HR 82951 $63.00

4351414 GLUCOSE TOL 2 HR 82952 $15.00

4351422 GLUCOSE TOL 3 HR 82951 $63.00

4351481 ZINC, PLASMA 84630 $131.00

4351503 SM & SM/RNP ANTIBODIES (ANTI-ENA), SERUM 86235 $203.00

4351511 VANCOMYCIN, SERUM 80202 $92.00

4351538 COMPLEMENT CH50 86162 $208.00

4351566 COMPLEMENT C4 86160 $115.00

4351568 ANCA ANTIBODY PROFILE 86256 $314.00

4351589 HGB S SCREEN 85660 $100.00

4351597 CAROTENE SERUM 82380 $147.00

4351651 BB ABO 86900 $33.00

4351678 BB RH 86901 $33.00

4351686 RUBEOLA-IGM 86765 $137.00

4351694 RUBEOLA(MEASLES)AB, IGG 86765 $143.00

4351813 FTA-ABS 86780 $117.00

4351856 CRYOGLOBULIN SCREEN W/REF PROF 82595 $190.00

4351899 HISTOPLASMA ANTIBODIES 86171 $173.00

4351937 VISCOSITY,SERUM 85810 $182.00

4362101 .HEMOGRAM 85027 $49.00

4362403 WBC 85048 $26.00

4362608 MAN. DIFF W/WBC COUNT 85007 $30.00

4365704 POST VASECTOMY EXAM 89321 $65.00

4368002 HEMOGLOBIN 85018 $18.00

4368118 HEMATOCRIT 85014 $18.00

4368126 SEMEN ANALYSIS WITH STRICT MORPHOLOGY 89320 $366.00

4370406 PLATELET COUNT 85049 $35.00

4370902 PROTHROMBIN TIME, PLASMA 85610 $33.00

4370929 PTT, PLASMA 85730 $42.00

4371305 RETIC COUNT 85045 $35.00

4372018 SED RATE 85651 $31.00

4372034 NASAL SMEAR-EOS/WBC 89190 $31.00

4372085 ANTITHROMBIN III 85300 $253.00

4372093 PROTEIN C, FUNCTIONAL 85303 $364.00

4376541 OCCULT BLD #1, NEOPLASM SCREENING G0328 $30.00

4380048 OCCUP HLTH BASIC METABOLIC PANEL 80048 $33.00

4380049 PICCOLO BASIC METABOLIC PANEL 80048 $72.00

4380050 GENERAL HEALTH PANEL 80050 $209.00

4380051 EPOC BASIC METABOLIC PANEL,WHOLE BLOOD 80048 $72.00

4380052 LYTES, SERUM OR PLASMA PICCOLO 80051 $51.00

4380053 OCCUP HLTH COMPREHENSIVE METABOLIC PANEL 80053 $46.00

4380054 PLASMA, PICCOLO ALBUMIN, SERUM OR PLASMA 80053 $88.00

4380055 .PRENATAL PANEL 80055 $215.00

4380056 .PRENATAL GROUP TESTING ONLY! 80055 $215.00

4380057 COMPREHENSIVE METABOLIC PICCOLO 80053 $88.00

4380076 PICCOLO LIVER PANEL 80076 $87.00

4380150 AMIKACIN, TROUGH 80150 $65.00

4380160 .DESIPRAMINE SEE IMIPRAMINE/DESIPRAMINE 80335 $70.00

4380169 EVEROLIMUS 80197 $137.00

4380170 GENTAMICIN-TROUGH 80170 $75.00

4380174 .IMIPRAMINE SEE IMIPRAMINE/DESIPRAMINE 80335 $66.00

4380300 METHOTREXATE 80299 $44.00

4380323 NICOTINE & COTINNE, URINE 80323 $66.00

4381001 UA W/MICRO 81001 $38.00

4381003 UA DIP AUTO 81003 $28.00

4381015 URINALYSIS,MICROSCOPIC ONLY 81015 $16.00

4381025 HCG URINE QUAL 81025 $28.00

4381206 BCR/ABL1 GENE REARRANGEMENT, QN 81206 $249.00

4381207 .BCR/ABL MINOR BREAKPOINT 81207 $219.00

4381403 BB RED CELL MOLECULAR TYPING MVRBC 81403 $265.00

4382040 ALBUMIN, SERUM OR PLASMA PICCOLO 82040 $32.00

4382041 PICCOLO BASIC METABOLIC PANEL,SERUM 82040 $42.00

4382055 ETHANOL, URINE 80320 $143.00

4382105 MATERNAL SCREEN NTD (AFP ONLY) 82105 $97.00

4382106 MATERNAL SCREEN INTEGRATED PART 2 82105 $463.00

4382107 MATERNAL SCREEN INTEGRATED PART 1 82105 $463.00

4382150 PICCOLO AMYLASE SERUM OR PLASMA 82150 $51.00

4382272 OCCULT BLD #1 82272 $30.00

4382273 OCCULT BLD #2 82272 $30.00

4382274 OCCULT BLD #3 82272 $30.00

4382275 .OCCULT BLD #3, NON NEOPLASM SCREENING 82272 $30.00

4382491 OXYCARBAZEPINE(TRILEPTAL), SERUM 80183 $171.00

4382507 CITRATE, URINE 82507 $145.00

4382525 .COPPER SERUM 82525 $114.00

4382526 COPPER URINE 82525 $63.00

4382533 CORTISOL PRE COSYNTROPIN INJECTION 82533 $75.00

4382534 CORTISOL POST COSYNTROPIN INJECTION 82533 $75.00

4382542 ZONEGRAN (ZONISAMIDE), SERUM 80203 $187.00

4382543 TPMT(THIOPURINE METABOLITES) 82657 $363.00

4382544 IODINE, SERUM OR PLASMA 82542 $82.00

4382550 CPK TOTAL, SERUM OR PLASMA PICCOLO 82550 $68.00

4382552 CKISOENZYMES 82552 $207.00

4382565 CREATININE PICCOLO 82565 $39.00

4382672 ESTROGEN, TOTAL 82672 $255.00

4382677 ESTRIOL 82677 $56.00

4382679 ESTRONE, SERUM 82679 $41.00

4382732 FETAL FIBRONECTIN 82731 $526.00

4382787 .IGG SUBCLASS 4 82787 $446.00

4382800 GASES, BLOOD, PH ONLY 82800 $36.00

4382803 VENOUS BLOOD GASES 82803 $33.00

4382948 GLUCOSE, SERUM OR PLASMA PICCOLO 82947 $32.00

4382950 GLUCOSE TOL 1 HR PRENATAL SCREEN 82950 $32.00

4382977 GGT SERUM OR PLASMA PICCOLO 82977 $43.00

4383003 GROWTH HORMONE SERUM 83003 $137.00

4383013 H. PYLORI BREATH TEST 83013 $99.00

4383014 H. PYLORI PEDIATRIC BREATH TEST <18 YEAR 83013 $99.00

4383021 HEMOGLOBULINOPATHY EVALUATION 83021 $27.00

4383036 OCCUP HLTH GLYCO HB 83036 $22.00

4383516 TISSUE TRANSGLUTAMINASE AB (IGG) 83516 $52.00

4383519 THYROTROPIN RECEPTOR AB 83519 $180.00

4383520 PANCREATIC ELASTASE,STOOL 83520 $253.00

4383521 THYPTASE 83520 $51.00

4383606 LACTIC ACID, PICCOLO 83605 $277.00

4383653 OCCUP HLTH OSHA LEAD W/ZPP (ZINC) 83655 $43.00

4383655 LEAD CAPILLARY 83655 $83.00

4383656 OCCUP HLTH LEAD BLOOD 83655 $31.00

4383721 LDL DIRECT 83721 $106.00

4383725 MAGNESIUM WHOLE BLOOD RBC 83735 $57.00

4383735 MAGNESIUM, SERUM OR PLASMA PICCOLO 83735 $45.00

4383785 MANGANESE, BLOOD 82175 $49.00

4383887 NICOTINE & METABOLITES, BLOOD 80307 $130.00

4383993 CALPROTECTIN, STOOL 83993 $169.00

4384100 PHOSPHORUS, SERUM OR PLASMA PICCOLO 84100 $45.00

4384145 PROCALCITONIN 84145 $91.00

4384146 PROCALCITONIN V 84145 $139.00

4384238 SOLUBLE TRANSFERRIN RECEPTOR 84238 $154.00

4384270 SEX HORMONE BINDING GLOBULIN, SERUM 84270 $151.00

4384300 SODIUM URINE RANDOM V 84300 $39.00

4384402 TESTOSTERONE FREE $51.00

4384403 TESTOSTERONE PEDIATRICS 84403 $183.00

4384432 .THYROGLOBULIN 84432 $70.00

4384433 THYROGLOBULIN PANEL 84432 $33.00

4384520 BUM,SERUM OR PLASMA PICCOLO 84520 $33.00

4384590 VITAMIN A, SERUM 84590 $164.00

4385041 RED BLOOD CELL COUNT AUTOMATED 85041 $13.00

4385250 FACTOR IX 85250 $291.00

4385303 .PROTEIN C ACTIVITY 85302 $289.00

4385549 MURAMIDASE(LYSOZYME) 85549 $212.00

4385732 .PTT SUBSTITUITION,PLASMA FRACTIONS,EACH 85732 $49.00

4386021 PROTEINASE-3 AB (ANTI-PR-3) 86021 $67.00

4386022 MYELOPEROXIDASE AB (MPO) 86021 $67.00

4386038 ANA W/REFX TITER/PATTERN/CASCADE CLEVELA 86038 $83.00

4386039 ANA TITER 86039 $9.00

4386140 CRP SERUM OR PLASMA PICCOLO 86140 $75.00

4386146 BETA-2-GLYCOPROTEIN I AB IgG 86146 $179.00

4386226 ANTI DNA SINGLE STRANDED IGG 86226 $120.00

4386235 JO-1-AB 86235 $37.00

4386255 ENDOMYSIAL ANTIBODY SCREEN, IGA 86255 $128.00

4386316 CHROMOGRANIN A 86316 $137.00

4386334 MONOCLONAL PROTEIN - TP,SPE,IFE 86334 $253.00

4386336 INHIBIN A 86336 $48.00

4386340 INTRINSIC FACTOR ANTIBODIES 86340 $46.00

4386431 RHEUMATOID FACTOR,QUANTITATIVE 86431 $26.00

4386480 TB TEST GAMMA INTERFERON 86480 $114.00

4386481 OCCUP HLTH TB QUANTIFERON GOLD 86480 $122.00

4386617 LYMES WESTERN BLOT 86617 $157.00

4386632 CHLAMYDIA AB IGM 86632 $136.00

4386644 CYTOMEGALOVIRUS Ab IgG IgM 86644 $187.00

4386663 EPSTEIN BARR AB IgG 86663 $151.00

4386665 EPSTEIN BARR VIRUS IGM 86665 $72.00

4386704 OCCUP HLTH ANTI HBc, TOTAL 86704 $66.00

4386706 OCCUP HLTH HEP B SURFACE AB 86706 $41.00

4386735 OCCUP HLTH MUMPS AB IGG 86735 $61.00

4386757 RICKETTSIA ABS IGG IGM W/REFLEX TO TITER 86757 $50.00

4386763 OCCUP HLTH RUBELLA IGG 86762 $31.00

4386765 OCCUP HLTH RUBEOLA(MEASLES)AB, IGG 86765 $61.00

4386769 COVID-19 AB IGG QUEST- DO NOT ORDER 86769 $84.00

4386771 WELLNESS COVID AB IGG 86769 $77.00

4386772 COVID 19 AB IGG IGM 86769 $184.00

4386773 WELLNESS COVID 19 ABS IGG & IGM 86769 $168.00

4386774 COVID AB IGG V 86769 $92.00

4386775 COVID-19 AB TOTAL & IGG ABS V 86769 $184.00

4386787 OCCUP HLTH VARICELLA AB IGG 86787 $31.00

4386800 .THYROGLOBULIN AB 86800 $69.00

4386801 THYROGLOBULIN ABS 86800 $15.00

4386802 THYROPEROXIDASE AND THYROGLOBULIN ABS 86376 $26.00

4386803 OCCUP HLTH ANTI HCV 86803 $66.00

4386804 THYROGLOBULIN (THYROID CANCER MONITOR) 86800 $33.00

4386849 BB ANTIBODY SCREEN MVRBC 86850 $55.00

4386860 BB ANTIBODY ELUTION MVRBC 86860 $107.00

4386870 BB AB ID PANEL EA MVRBC 86870 $87.00

4386880 BB DIRECT COOMBS EA PHASE MVRBC 86880 $44.00

4386898 BB RH MVRBC 86901 $33.00

4386899 BB ABO MVRBC 86900 $33.00

4386906 BB ANTIGEN TIERED PATIENT 86905 $79.00

4386970 BB CHEMICAL TREATMENT OF RBCS MVRBC 86970 $65.00

4386971 BB ENZYME TREATMENT OF RBCS MVRBC 86971 $45.00

4386972 BB RETIC SICKLE CELL SEP MVRBC 86972 $68.00

4386978 BB ALLOGENIC ADSORPTION, EA MVRBC 86978 $54.00

4387071 CULTURE AEROBIC WELAND 87071 $66.00

4387072 HCHC AEROBIC CULTURE 87071 $66.00

4387075 CULTURE TISSUE ANAEROBIC HEML 87075 $75.00

4387077 CULTURE AERO ISO ADDL ID METH 87077 $63.00

4387078 ORGANISM ID, WELAND 87077 $44.00

4387079 GRP B STREP MOLECULAR 87077 $96.00




4387189 SENSITIVITY WELAND #6054 87186 $126.00


4387209 CYCLOSPORA, STOOL 87209 $21.00

4387255 CULTURE, HERPES SIMPLEX VIRUS 87255 $154.00

4387260 COVID-19 AG 15 HCHC 87426 $61.00

4387261 WELLNESS COVID-19 AG 87260 $87.00

4387338 HELICOBACTER PYLORI FECES 87338 $241.00

4387341 OCCUP HLTH HEP B SURFACE AG WITH FLEX 87340 $33.00

4387426 COVID-19 ANTIGEN V 87426 $82.00

4387480 CANDIDA DIR PROBE 87480 $48.00


4387487 CHLAMYDOPHILA PNEUMONIA, AMPLIFIED 87486 $56.00

4387502 INFLUENZA MOLECULAR 87502 $201.00

4387507 GI PANEL, AMP PROBE 87507 $389.00

4387510 GARDNERALIS VAG DNA DIR PROBE 87510 $48.00

4387517 HEP B VIRUS DNA, QUANT, PCR 87517 $87.00

4387522 OCCUP HLTH HCV RNA, QUANTITATIVE RT PRC 87522 $66.00

4387536 HIV-1 RNA BY PCR 87536 $394.00

4387581 MYCOPLASMA PNEUMONIAE, AMP 87581 $56.00

4387621 HPV THIN PREP 87624 $141.00

4387626 HPV 16, 18/45 GENOTYPING 87625 $141.00

4387631 FLU/RSV MOLECULAR WELAND 87631 $169.00

4387633 RESPIRATORY VIRUS, MULTIPLE 87633 $215.00

4387634 RSV MOLECULAR 87634 $243.00

4387635 CoV-2 PCR HCHC PRESURGICAL 87635 $201.00

4387637 SARS-CoV-2/FLU/RSV/CEPHEID HCHC 87637 $580.00

4387641 MRSA NASAL SCREEN 87641 $92.00

4387651 GRP A STREP MOLECULAR 87651 $80.00

4387660 TRICHOMONAS VAGIN DIR PROBE 87660 $48.00

4387661 TRICHOMONAS AMPLIFIED DNA 87661 $187.00

4387798 BARTONELLA (CAT SCRATCH) 86611 $428.00

4387800 BK VIRUS QUANTITIATIVE 87799 $357.00

4387902 HCV RNA, QUANTITATIVE RT PCR 87522 $369.00

4388169 PAP REFLEX HPV GC/CHLAMYDIA/TRICH 88175 $97.00

4388170 PAP REFLEX HPV &GC/CHLAMYDIA 88175 $97.00

4388174 PAP &HPV, REFLEX GENOTYPE 16,18,45 88175 $239.00

4388175 PAP THIN PREP 88175 $97.00

4388300 GROSS ONLY LEVEL 1 88300 $87.00

4388302 GROSS & MICRO LEVEL II 88302 $181.00

4388304 GROSS & MICRO LEVEL III 88304 $202.00

4388305 GROSS & MICRO LEVEL IV 88305 $270.00

4388307 GROSS & MICRO LEVEL V 88307 $570.00

4388309 GROSS & MIRCO LEVEL VI 88309 $792.00

4388311 SURG PATH DECAL 88311 $26.00

4388312 SPECIAL STAIN GROUP 1 88312 $314.00

4388313 SPECIAL STAIN GROUP 2 88313 $257.00

4388314 SPECIAL STAIN W/FRZN SEC 88314 $262.00

4388323 CONSULT REQ SLIDE PREP 88323 $227.00

4388329 CONSULT DURING SURG W/GROSS TISSUE EXAM 88329 $93.00

4388331 CONSULT DURING SURG W/FRZN 88331 $203.00

4388332 ADDITIONAL FROZEN SEC 88332 $111.00

4388333 CONSULT DURING SURG W/CYTO TOUCH PREP 88333 $186.00

4388334 CONSULT DURING SURG W/CYTOLOGIC EXAM AS 88334 $115.00

4388342 SPECIAL STAIN IMM-PER 88342 $244.00

4388713 PAP & REFLEX HPV 88175 $97.00

4393209 .MICROSCOPIC URINE 81015 $16.00

4393608 UA W/MICRO W/REFLEX CULTURE (>10 WBC) 81001 $38.00

4393705 PH BODY FLUID 83986 $31.00

4393721 GLUCOSE URINE 81003 $23.00

4395516 CULTURE ANAEROBIC 87075 $75.00

4395524 CULTURE STOOL INC SAL & SHIG 87045 $75.00

4395532 CULTURE SPUTUM 87070 $57.00

4395559 OVA & PARASITES, STOOL 87177 $80.00

4395567 CULTURE URINE 87086 $69.00

4395575 CULTURE WOUND 87070 $66.00

4395591 CULTURE BODY-FLUID 87070 $66.00

4397403 GRAM STAIN 87205 $31.00

4397918 CULTURE ROUTINE 87070 $66.00

4397927 CULTURE FULL THROAT 87070 $37.00

4397942 KOH PREP 87210 $31.00

4397977 CHLAMYDIA TRACHOMATIS, DNA 87491 $92.00

4398035 SENSITIVITY 87186 $66.00

4398086 STOOL WBC/RBC SMEAR 89055 $31.00

4398094 GIARDIA AND CRYPTPSPORIDIUM ANTIGEN 87328 $59.00

4398108 CULTURE-VIRUS 87252 $243.00

4398124 CORTISOL, URINE 82530 $225.00

4398132 THERAP PHLEBOTOMY 99195 $86.00

4398167 ANTI-SMOOTH MUSCLE ANTIBODIES 83516 $147.00

4398205 BB ANTIGEN TIERED UNIT 86902 $79.00

4398248 ALDOSTERONE URINE 82088 $329.00

4398337 DOXEPIN, SERUM OR PLASMA 80335 $202.00

4398345 VARICELLA ANTBODY, QUALITATIVE 86787 $180.00

4398353 ROTAVIRUS AG, STOOL 87425 $131.00

4398388 ACTH 82024 $364.00

4398396 BETA-2-MICROGLOBULIN 82232 $156.00

4398417 CA 19-9 86301 $189.00

4398426 .PARVOVIRUS AB IGG/IGM 86747 $209.00

4398434 VITAMIN B6 84207 $325.00

4398469 HEAVY METAL SCREEN URINE, 24 HOURS 83015 $352.00

4398485 FECAL FAT QUANTITATIVE 82710 $215.00

4398493 BB ANTIBODY TITER EA MVRBC 86886 $80.00

4398507 .TOTAL VOLUME 81050 $16.00

4398515 VARICELLA ZOSTER, IGM 86787 $143.00

4398523 ANTI-HAV IGM/IGG 86708 $124.00

4398531 ANTI-HAV-IGM 86709 $137.00

4398558 OXALATE URINE 83945 $152.00

4398574 CARDIOLIPIN IGG 86147 $158.00

4398582 CARDIOLIPIN IGM 86147 $158.00

4398612 ANGIO CONVT ENZYME 82164 $148.00

4398655 CHLAMYDIA IGG 86631 $190.00

4398698 HBS AG (CONFIRMATORY) 87340 $100.00

4398701 HIV ULTRA SENSITIVE RNA QN 87536 $157.00

4398728 ANTI HISTONE 83516 $176.00

4398736 MAGNESIUM URINE 83735 $84.00

4398752 MUMPS AB IGG 86735 $126.00

4398779 MUMPS AB IGM 86735 $126.00

4500035 HOLTER RECORD 93225 $686.00

4500272 EVENT MONITOR RECORDING 93270 $942.00

4500418 24 HOUR BP MONITOR 93784 $147.00

4501007 EKG TRACING ONLY 93005 $126.00

4593000 EKG W INTERP/REPORT 93000 $252.00

4593001 EKG SUBSQUENTS 93000 $252.00

4593010 EKG INTERP ONLY 93010 $125.00

4593226 HOLTER MONITOR TECH COMPONENT 93226 $887.00

4593271 EVENT MONITOR TECH. COMPONENT 93271 $942.00

4700353 SLEEP STUDY 95810 $2,453.00

4700361 SLEEP STUDY W/PAP 95811 $3,000.00

4700420 MULTI SLEEP LATENCY 95805 $1,984.00

4795806 SLEEP STUDY-UNATTENDED 95806 $389.00

4795810 SLEEP STUDY-NON COMPLETE 95810 $3,000.00

4795812 EEG 95812 $578.00

4900029 CARDIAC STRESS 93017 $400.00

5100017 SP-UROGRAPHY-ANTEGRADE 74425 $307.00

5100068 SP-L/SPINE MYELOGRAPHY 72265 $677.00

5100076 SHOULDER 1 VIEW LT 73020 $118.00

5100077 SHOULDER 1 VIEW RT 73020 $118.00

5100084 UPPER EXT INFANT <1 YR OLD 2VWS 73092 $109.00

5100106 KNEES-AP STANDING 73565 $121.00

5100112 COLON-THRAPUETIC 74283 $427.00

5100114 LOWER EXT-INFANT < 2 VIEW 73592 $120.00

5100149 UGI W/O AIR W/O KUB 74240 $374.00

5100165 SP-PUCN ASP-BREAST CYST 19000 $241.00

5100203 SP-INJ SINUS TRACT/DIAG 20501 $183.00

5100211 SP-INJ SHO ARTHRO LT 23350 $262.00

5100212 SP-INJ SHO ARTHRO RT 23350 $262.00

5100238 SP-INJ WRIST ARTHRO LT 25246 $329.00

5100239 SP-INJ WRIST ARTHRO RT 25246 $329.00

5100246 SP-INJ KNEE ARTHRO LT 27369 $269.00

5100247 SP-INJ KNEE ARTHRO RT 27369 $269.00

5100319 SP-INTRO LONG GI TUBE 44500 $246.00

5100351 SP-BX PANCREAS 48102 $1,159.00

5100394 SP-BX ABD RETROPERITONEAL MASS 49180 $883.00

5100416 SP-BX-RENAL 50200 $883.00

5100424 SP-ASP/INJ RENAL CYST OR PELVIS 50390 $883.00

5100459 SP-INJ FOR LOOPOGRAM 50690 $250.00

5100467 SP-INJ FOR CYSTO/VCUG 51600 $199.00

5100475 SP-INJ RETROGRADE URETHRO 51610 $312.00

5100483 SP-INJ HYSTERO 58340 $253.00

5100491 SP-BX THYROID 60100 $353.00

5100661 SP-BX LIVER 47000 $883.00

5100726 SKULL < 4 VIEWS 70250 $208.00

5100769 VIDEO SWALLOW 74230 $316.00

5100785 SP-INJ EXT VENOGRAM LT 36005 $262.00

5100786 SP-INJ EXT VENOGRAM RT 36005 $262.00

5100807 EYE-FOR FOREIGN BODY 70030 $177.00

5101005 MANDIBLE LESS THAN 4VWS 70100 $147.00

5101013 MANDIBLE BILATERAL 4+VWS 70110 $193.00

5101048 FOREIGN BODY SURVEY-CHILD NOSE/REC 76010 $145.00

5101072 SP-FLUORO GUIDE FOR NEEDLE PLACE 77002 $380.00

5101099 SP-INJ HIP W/ANETHESIA LT 27095 $539.00

5101100 SP-INJ HIP W/ANETHESIA RT 27095 $539.00

5101102 SP-HIP ARTHROGRAM LT 73525 $506.00

5101103 SP-HIP ARTHROGRAM RT 73525 $506.00

5101129 SP-ABSCESS DRAINAGE 75989 $501.00

5101234 SP-INJ MYELOGRAPHY 62284 $634.00

5101307 MASTOIDS MIN 3V 70130 $225.00

5101382 SP-PUNC ASP-ABSCESS/HEMA/CYST 10160 $238.00

5101455 SP-DUCTOGRAM/GALACTOGRAM/SINGLE 77053 $495.00

5101501 FACIAL BONES MIN 3V 70150 $254.00

5101587 SP-ABD PARACENTESIS 49083 $756.00

5101609 NOSE MIN 3V 70160 $129.00

5101684 SP-BX PLEURA 32400 $516.00

5101692 SP-BX LUNG/MEDIASTINUM 32405 $883.00

5101765 SINUSES <3VIEW 70210 $133.00

5101803 SP-SPINAL PUNCTURE/LUM DX 62270 $350.00

5101846 UGI W/O AIR W/KUB 74241 $435.00

5101854 UGI W/AIR W/KUB 74247 $469.00

5101862 BONE SURVEY COMPLETE 77075 $366.00

5101889 SP-C/SPINE MYELOGRAPHY 72240 $638.00

5101951 SP-PUNC/ASP HYDROCELE 55000 $241.00

5101978 SP-REPOSITION/CENTRAL VEN CATH 36597 $342.00

5101986 SP-INC AND DRAIN HEMATOMA/SEROMA 10140 $652.00

5102001 SINUSES CMP MIN 3 V 70220 $213.00

5102036 SP-DUCTOGRAM/GALACTOGRAM/MULTIPLE 77054 $448.00

5102044 SP-INJ ANKLE ARTHRO LT 27648 $553.00

5102045 SP-INJ ANKLE ARTHRO RT 27648 $553.00

5102052 FACIAL BONES >3VWS 70140 $147.00

5102087 CHEST 3 VWS 71047 $165.00

5102095 STERNOCLAVICULAR JOINT 71130 $128.00

5102109 T-SPINE 4 VWS 72074 $196.00

5102117 L-SPINE COMPLETE/INC BENDING VWS 72114 $264.00

5102125 L-SPINE-BENDING VWS ONLY 72120 $157.00

5102133 SP-WRIST ARTHROGRAM LT 73115 $253.00

5102134 SP-WRIST ARTHROGRAM RT 73115 $253.00

5102141 OR CHOLANG ADDIT 74301 $158.00

5102168 FINGER LT 73140 $121.00

5102169 FINGER RT 73140 $121.00

5102273 TOE LT 73660 $92.00

5102274 TOE RT 73660 $92.00

5102435 SP-FLUORO GUIDE AND LOCAL 77003 $141.00

5102478 SP-EPIDURAL-L/SPINE 62323 $887.00

5102486 SP-INJ FACET/L-SP SINGLE 64493 $521.00

5102494 SP-BX BONE-DEEP LT 20225 $758.00

5102495 SP-BX BONE-DEEP RT 20225 $758.00

5102508 ABD 3 VWS 74021 $165.00

5102516 S/I JOINTS LESS THAN 3 VWS 72200 $151.00

5102559 SP-VCUG 74455 $239.00

5102567 SP-HIP ARTHRO LT 27093 $1,652.00

5102568 SP-HIP ARTHRO RT 27093 $1,652.00

5102583 SP-BX LYMPH NODE 38505 $385.00

5102591 SP-URETHROCYSTOGRAPHY 74450 $80.00

5102605 SKULL MIN 4 VIEW 70260 $253.00

5102621 UGI W/O AIR W SMALL BOWEL 74245 $428.00

5102624 SP-PUNC ASP-BREAST-ADD'L CYST 19001 $101.00

5102869 SP-INC & DRAIN ABSCESS 10060 $318.00

5102885 SP-INC/DRAIN RECTAL ABSCESS 46040 $1,384.00

5102893 SP-INC/DRAIN PERIANAL ABSCESS 46050 $431.00

5102904 SP-DRAIN PERIVESICAL ABSCESS 51080 $1,932.00

5102923 SP-BX MUSCLE 20206 $233.00

5102931 SP-BX SOFT TIS NECK/THORAX 21550 $557.00

5102958 SP-BX PROSTATE 55700 $566.00

5102982 FWP CHEST 2 VWS 71046 $145.00

5103016 SP-FINE NEEDLE ASP-PROSTATE 10022 $332.00

5103024 FWP-CHEST 1 VW 71045 $121.00

5103067 SP-CHANGE OF GASTRO TUBE 43760 $242.00

5103075 SP-REPOSITION/GASTRIC FEEDING TUBE 43761 $428.00

5103318 TMJ S-BILATERAL 70330 $201.00

5103504 NECK SOFT TISSUE 70360 $110.00

5110005 SP FINE NEEDLE ASP US GUIDE 10005 $621.00

5110006 SP FINE NEEDLE ASP US GUIDE ADD LESION 10006 $621.00

5110007 SP FINE NEEDLE ASP CT GUIDE 10009 $732.00


5110009 CHEST 1 VW 71045 $121.00

5110010 SP FINE NEEDLE ASP CT GUIDE ADD LESION 10010 $377.00

5110030 SP-PERC DRAIN BY CATHETER SOFT TISSUE 10030 $2,909.00

5110106 CHEST 2 VWS 71046 $177.00

5110203 RIBS-BIL W 1 VW CHEST 71111 $240.00

5111102 RIBS-UNI W 1 VW CHEST LT 71101 $177.00

5111103 RIBS-UNI W 1 VW CHEST RT 71101 $177.00

5111218 STERNUM MIN 2VIEW 71120 $153.00

5119081 SP-BREAST BIOPSY STEREOTACTIC 19081 $2,971.00

5119082 SP-BREAST BIOPSY STEREO ADD LES 19082 $1,388.00

5119281 SP-BREAST NEEDLE LOC MAMMO 19281 $865.00

5119282 SP-BREAST NEEDLE LOC MAMMO ADD LESION 19282 $450.00

5119283 SP-BREAST NEEDLE LOC STEREO GUIDE 19283 $1,743.00

5119284 SP-BREAST NEEDLE LOC GUIDE ADD LESION 19284 $1,327.00

5119285 SP-BREAST NEEDLE LOC ULTRASOUND GUIDE 19285 $1,392.00

5120602 C SPINE COMPLETE 72052 $254.00

5120605 SP-INJ INTERM JOINT 20605 $213.00

5120610 SP-INJ LT JOINT W/ANESTHESIA 20610 $452.00

5120611 SP-INJ RT JOINT W/ANESTHESIA 20610 $452.00

5120718 T-SPINE 3 VWS 72072 $165.00

5121102 L-SPINE MIN 4 VWS 72110 $254.00

5121404 SACRUM/COCCYX 72220 $147.00

5121706 PELVIS 72170 $121.00

5122001 S/I JOINTS MORE THAN 3 VWS 72202 $190.00

5125005 CLAVICLE LT 73000 $126.00

5125006 CLAVICLE RT 73000 $126.00

5125102 SCAPULA LT 73010 $129.00

5125103 SCAPULA RT 73010 $129.00

5125307 HUMERUS MIN 2V LT 73060 $126.00

5125308 HUMERUS MIN 2V RT 73060 $126.00

5125404 ELBOW 3 VWS LT 73080 $137.00

5125405 ELBOW 3 VWS RT 73080 $137.00

5125501 FOREARM LT 73090 $121.00

5125502 FOREARM RT 73090 $121.00

5125609 WRIST 3 VWS LT 73110 $126.00

5125610 WRIST 3 VWS RT 73110 $126.00

5125706 HAND 3 VWS LT 73130 $121.00

5125707 HAND 3 VWS RT 73130 $121.00

5126001 SHOULDER 2 OR 3 VWS LT 73030 $158.00

5126002 SHOULDER 2 OR 3 VWS RT 73030 $158.00

5127096 SP-INJ S I JOINT 27096 $799.00

5130402 KNEE 3 VWS LT 73562 $137.00

5130403 KNEE 3 VWS RT 73562 $137.00

5130518 LOWER LEG LT 73590 $121.00

5130519 LOWER LEG RT 73590 $121.00

5130607 ANKLE 3VWS LT 73610 $121.00

5130608 ANKLE 3VWS RT 73610 $121.00

5130704 FOOT 3 VWS LT 73630 $121.00

5130705 FOOT 3 VWS RT 73630 $121.00

5132555 SP THORACENTESIS 32555 $756.00

5132557 SP-PLEURAL DRAINAGE 32557 $446.00

5135018 ABD 1 VW (KUB) 74018 $121.00

5135107 ABD 2 VWS INC CHEST 1VW 74022 $183.00

5135301 ABD 2 VWS DECUB OR UPRIGHT 74019 $165.00

5135608 ESOPHAGUS 74220 $285.00

5135705 SMALL BOWEL 74250 $300.00

5135802 UGI W/AIR 74246 $404.00

5136019 COLON 74270 $416.00

5136205 COLON WITH AIR 74280 $566.00

5136598 SP-INJ CENTRAL CATH 36598 $381.00

5136604 OR CHOLANGIOGRAM 74300 $1,061.00

5137508 SP-CYSTOGRAPHY 0 74430 $473.00

5137915 SP-RENAL CYST STUDY 74470 $360.00

5137958 SP-VENOGRAM-UNI LT 75820 $329.00

5137959 SP-VENOGRAM-UNI RT 75820 $329.00

5137966 SP-VENOGRAM-BIL 75822 $495.00

5145402 BONE AGE STUDY 77072 $121.00

5145518 BONE LENGTH STUDY 77073 $183.00

5149400 SP-INJ AIR-CONT PERT CAV 49400 $366.00

5149405 SP-PEC DRAIN BY CATHETER VISCERAL 49405 $3,498.00

5149406 SP-PERC DRAIN PERI OR RETROPERITONEAL 49406 $1,379.00

5149407 SP-PERC DRAIN TRANSVAGINAL/TRANSRECTAL 49407 $2,991.00

5149424 SP INJ GASTRIC TUBE 49424 $732.00

5159039 FLUORO<1HR 76000 $241.00

5159063 ORBITS MIN 4V 70200 $287.00

5159071 SALIVARY GLND-CALCU 70380 $167.00

5159128 CHEST 4VWS 71048 $196.00

5159152 L-SPINE 2-3 VWS 72100 $165.00

5159179 SPINE-ANY LEVEL-SINGLE VW 72020 $109.00

5159187 C SPINE 2-3 VIEWS 72040 $137.00

5159209 PELVIS W/OBLIQUES 72190 $153.00

5159217 A/C JOINTS 73050 $145.00

5159225 WRIST 2 VIEWS LT 73100 $109.00

5159226 WRIST 2 VIEWS RT 73100 $109.00

5159233 HAND 2 VIEWS LT 73120 $109.00

5159234 HAND 2 VIEWS RT 73120 $109.00

5159276 KNEE 1-2 VWS LT 73560 $121.00

5159277 KNEE 1-2 VWS RT 73560 $121.00

5159284 KNEE 4 OR MORE VWS LT 73564 $153.00

5159285 KNEE 4 OR MORE VWS RT 73564 $153.00

5159292 ANKLE 2 VWS LT 73600 $109.00

5159293 ANKLE 2 VWS RT 73600 $109.00

5159306 FOOT 2VWS LT 73620 $109.00

5159307 FOOT 2VWS RT 73620 $109.00

5159314 CALCANEUS MIN 2V LT 73650 $109.00

5159315 CALCANEUS MIN 2V RT 73650 $109.00

5159365 BONE SURVEY-INFANT 77076 $183.00

5159374 MM DIG MAMMO SC 77067 $390.00

5159375 MM DIG MAMMO BI 77066 $438.00

5159376 MM DIG MAMMO UNI RT 77065 $362.00

5159379 MM DIG MAMMO UNI LT 77065 $362.00

5159403 RIBS-UNI 2 VWS LT 71100 $137.00

5159404 RIBS-UNI 2 VWS RT 71100 $137.00

5159411 RIBS-BILATERAL 3 VWS 71110 $206.00

5159438 C SPINE 4 VWS 72050 $208.00

5159446 T-SPINE 2 VWS 72070 $153.00

5159454 THORACOLUMBAR-2 VWS 72080 $153.00

5159462 ELBOW 2 VWS LT 73070 $121.00

5159463 ELBOW 2 VWS RT 73070 $121.00

5159535 SP-KNEE ARTHROGRAM LT 73580 $411.00

5159536 SP-KNEE ARTHROGRAM RT 73580 $411.00

5159586 SP-HYSTEROSALPINGOGRAPHY 74740 $360.00

5159624 SP-BREAST SURGICAL SPECIMAN 76098 $70.00

5159632 SP-SHOULDER ARTHROGRAM LT 73040 $495.00

5159633 SP-SHOULDER ARTHROGRAM RT 73040 $495.00

5159667 SP-ABSCESS/FISTULA/SINUS TRACT 76080 $411.00

5159675 SMALL BOWEL W/ENTEROCLYSIS TUBE 74251 $691.00

5159683 SP-GI TUBE INSERTION 74340 $565.00

5159691 SP-INJ FOR MAM DUCT/GALACTO 19030 $353.00

5159713 UGI W/AIR W/SMALL BOWEL 74248 $596.00

5159721 SP-ANKLE ARTHROGRAM LT 73615 $495.00

5159722 SP-ANKLE ARTHROGRAM RT 73615 $495.00

5162302 SP C-SPINE MYELOGRAPHY 62302 $956.00

5162303 SP T-SPINE MYELOGRAPHY 62303 $1,186.00

5162304 SP L-SPINE MYELOGRAPHY 62304 $972.00

5162305 SP MYELOGRAPHY 2 OR MORE 62305 $1,372.00

5162321 SP-EPIDURAL - T/SPINE 62321 $750.00

5164476 SP-IN FACET ADD'T LEVEL-L-SPINE 64494 $494.00

5172081 SPINE ENTIRE 1 VIEW 72081 $186.00

5172082 SPINE ENTIRE 2 OR 3 VIEWS 72082 $254.00

5172083 SPINE ENTIRE 4 OR 5 VIEWS 72083 $368.00

5172084 SPINE ENTIRE 6 OR MORE VIEWS 72084 $483.00

5172255 SP-MYELOGRAPHY-T-SPINE 72255 $792.00

5173501 LT HIP 1 VIEW WITH PELVIS WHEN PERFORMED 73501 $150.00

5173502 RT HIP 1 VIEW WITH PELVIS WHEN PERFORMED 73501 $150.00

5173503 LT HIP 2 OR 3 VIEWS WITH PELVIS WHEN PER 73502 $228.00

5173504 RT HIP 2 OR 3 VIEWS WITH PELVIS WHEN PER 73502 $228.00

5173505 LT HIP 4 OR MORE VIEWS WITH PELVIS WHEN 73503 $287.00

5173506 RT HIP 4 OR MORE VIEWS WITH PELVIS WHEN 73503 $287.00

5173507 HIP PINNING LT 73502 $582.00

5173508 HIP PINNING RT 73502 $582.00

5173521 HIPS BILAT 2 VIEWS WITH PELVIS WHEN PERF 73521 $246.00

5173522 HIPS BILAT 3 OR MORE VIEWS WITH PELVIS W 73522 $360.00

5173523 HIPS BILAT 5 OR MORE VIEWS WITH PELVIS W 73523 $473.00

5173551 LT FEMUR 1 VIEW 73551 $86.00

5173552 RT FEMUR 1 VIEW 73551 $86.00

5173553 LT FEMUR 2 VIEWS 73552 $172.00

5173554 RT FEMUR 2 VIEW 73552 $172.00

5174190 SP-PERITONEOGRAM 74190 $283.00

5175998 SP-FLUORO GU-CENTRAL VEN ACCESS 77001 $381.00

5177000 MM 3D UNI LT 77061 $32.00

5177001 MM 3D BI 77062 $32.00

5177003 MM 3D SC 77063 $32.00

5177022 MM 3D UNI RT 77061 $32.00

5177067 MM SC UNI LT 77067 $390.00

5177068 MM SC UNI RT 77067 $390.00

5177080 DEXA-BONE DENSITY AXIAL SKELETON 77080 $329.00

5300010 US VENOUS UE BILAT 93970 $983.00

5300011 US VENOUS UE UNI LT 93971 $926.00

5300012 US VENOUS UE UNI RT 93971 $926.00

5300022 US ARTERIAL LE BILAT 93925 $645.00

5300049 US ARTERIAL LE UNI LT 93926 $431.00

5300050 US ARTERIAL LE UNI RT 93926 $431.00

5300057 US ARTERIAL UE UNI LT 93931 $457.00

5300058 US ARTERIAL UE UNI RT 93931 $457.00

5300065 US VENOUS LE BILAT 93970 $1,344.00

5300081 US TRANS KIDNEY 76775 $326.00

5300102 US PELVIC LMTD MOD 76857 $332.00

5300103 US PELVIC LIMITED 76857 $332.00

5300111 US CHEST-SONO 76604 $329.00

5300138 US RETROPER-SONO 76770 $474.00

5300146 US PLETHYSMOGRAPHY ML 93923 $523.00

5300154 US ABD VAS DOPP/COMP 93975 $942.00

5300162 US BRAIN ULTRASOUND 76506 $357.00

5300189 US ECHO SPINAL CANAL 76800 $464.00

5300219 US PLEY STUDY UPP/LOW EXT SING/BI 93922 $319.00

5300227 US PLEY-REST AND STRESS 93924 $614.00

5300235 US ABD VAS DOPP/LIM 93976 $818.00

5300243 US HYSTEROSONOGRAPHY 76831 $447.00

5300251 US ARTERIAL UE BILAT 93930 $506.00

5300278 US DUP-SCAN EX CRANIEL ARTER-LT 93882 $326.00

5300279 US DUP-SCAN EX CRANIEL ARTER-RT 93882 $340.00

5300286 US DIALYSIS ACCESS 93990 $366.00

5300316 US AMNIOCENTESIS DIAG 59000 $527.00

5300324 US HIPS-INFANT DYNAMIC 76885 $428.00

5300332 US HIPS INFANT STATIC 76886 $423.00

5300367 US OB 1ST TRI SINGL 76801 $360.00

5300375 US OB 1ST TRI ADDL 76802 $398.00

5300383 US OB>14 LIM ADD 76810 $509.00

5300405 US OB>14 COM ADD 76812 $558.00

5300413 US OB TRANSVAGINAL 76817 $494.00



5310079 US RETRO PER LTD 76775 $314.00

5310133 US OB 2ND/3RD TRI LTD 76815 $350.00

5310168 US OB FOLLOW-UP/REPEAT 76816 $332.00


5310281 US ABDOMEN COMPLETE 76700 $596.00

5310303 US ABDOMEN LIMITED 76705 $350.00

5310346 US TESTICULAR 76870 $350.00

5310354 US SFT TISSUE HD NK 76536 $316.00

5310362 US PELVIC 76856 $494.00

5310363 US PELVIC MOD 76856 $494.00

5310389 US OB>14 WKS COMPLETE 76805 $436.00

5310419 US OB BIOPHYSICAL PROFILE 76819 $366.00

5310435 US CAROTID DUPL EX-CRANIEL ART-BI 93880 $926.00

5310451 US VENOUS LE UNI LT 93971 $926.00

5310452 US VENOUS LE UNI RT 93971 $926.00

5310478 US TRANSVAGINAL 76830 $507.00

5310480 US PROSTATE/TRANS REC 76872 $491.00

5310508 US GUIDE/AMNIOCENTES 76946 $366.00

5319083 SP BREAST BIOPSY ULTRASOUND 19083 $2,212.00

5319084 SP-BREAST BIOPSY US ADD LESION 19084 $1,388.00

5319285 SP-BREAST NEEDLE LOC ULTRASOUND GUIDE 19285 $1,392.00

5319286 SP-BREAST NEEDLE LOC ULTRASOUND GUIDE 19286 $977.00

5376642 US BREAST RT LMTD 76642 $240.00

5376643 US BREAST LT LMTD 76642 $240.00

5376706 US AAA SCREENING 76706 $314.00

5376881 US EXT NONVASCULAR COMPLETE 76881 $876.00

5376882 US EXT NON VASCULAR LIMITED 76882 $583.00

5376937 SP-US GU FOR VASCULAR ACCESS 76937 $315.00

5500029 CT SO TISSUE NECK W 70491 $1,888.00

5500037 CT C/SPINE-W/O 72125 $1,649.00

5500045 CT T-SPINE WITHOUT AND WITH 72130 $2,427.00

5500061 CT L-SPINE W 72132 $2,223.00

5500088 CT L-SPINE WITHOUT AND WITH 72133 $2,271.00

5500185 CT T-SPINE W 72129 $2,097.00

5500193 CT SO TISSUE NECK W/O 70490 $1,845.00

5500207 CT SO TISSUE NECK WITHOUT AND WITH 70492 $2,434.00

5500584 CT C/SPINE W 72126 $2,241.00

5500649 CT ANGIO-NECK 70498 $1,822.00

5500665 CT ABD ANGIO 74175 $2,156.00

5500746 CT UPR EXT ANGIO LT 73206 $1,936.00

5500747 CT UPR EXT ANGIO RT 73206 $1,936.00

5500754 CT LOWER EXT ANGIO LT 73706 $1,936.00

5500755 CT LOWER EXT ANGIO RT 73706 $1,936.00

5500762 CT CHEST-ANGIO 71275 $2,914.00

5500789 CT ANGIO-HEAD 70496 $2,056.00

5500991 CT VIRTUAL COLON DX 74261 $3,627.00

5501009 CT SINUS W 70487 $1,333.00

5501017 CT SINUS WITHOUT AND WITH 70488 $1,371.00

5501025 CT SINUS W/O 70486 $1,252.00

5510288 CT HEAD W/O 70450 $1,175.00

5510296 CT HEAD-W 70460 $1,333.00

5510318 CT HEAD WITHOUT AND WITH 70470 $1,412.00

5510326 CT CHEST-W/O 71250 $1,268.00

5510334 CT CHEST - W 71260 $1,488.00

5510342 CT CHEST-WITHOUT AND WITH 71270 $1,787.00

5510369 CT ABD W/O 74150 $1,252.00

5510377 CT ABD W 74160 $1,488.00

5510385 CT ABD WITHOUT AND WITH 74170 $1,787.00

5510393 CT PELVIS W/O 72192 $1,252.00

5510431 CT PELVIS W 72193 $1,519.00

5510458 CT PELVIS WITHOUT AND WITH 72194 $1,583.00

5510466 CT L-SPINE W/O 72131 $2,097.00

5510474 CT T-SPINE W/O 72128 $2,021.00

5510482 CT UPR EXT W/O LT 73200 $1,864.00

5510483 CT UPR EXT W/O RT 73200 $1,864.00

5510504 CT UPR EXT W LT 73201 $1,903.00

5510505 CT UPR EXT W RT 73201 $1,903.00

5510512 CT UPR EXT WITHOUT AND WITH 73202 $1,974.00

5510513 CT UPR EXT WITHOUT AND WITH 73202 $1,974.00

5510539 CT LOWER EXT W/O LT 73700 $1,864.00

5510540 CT LOWER EXT W/O RT 73700 $1,864.00

5510547 CT LOWER EXT W LT 73701 $1,974.00

5510548 CT LOWER EXT W RT 73701 $1,974.00

5510555 CT LOWER EXT WITHOUT AND WITH 73702 $2,051.00

5510556 CT LOWER EXT WITHOUT AND WITH 73702 $1,364.00

5510563 CT MAX FACIAL W/O 70486 $1,940.00

5510571 CT MAX FACIAL W 70487 $2,021.00

5510598 CT MAX FACIAL WITHOUT AND WITH 70488 $2,057.00

5510628 CT BX GUIDE 77012 $1,017.00

5510695 CT ORBITS/POS FOSS/W/O 70480 $1,864.00

5510709 CT ORBTIS/P F WITH 70481 $2,021.00

5510717 CT ORBTIS/P F WITHOUT AND WITH 70482 $2,075.00

5510881 CT C/SPINE WITHOUT AND WITH 72127 $2,550.00

5572191 CT ANGIO PELVIS 72191 $1,306.00

5574174 CT ABD/PEL ANGIO 74174 $2,693.00

5574176 CT ABD/PEL WITHOUT 74176 $2,505.00

5574177 CT ABD/PEL WITH 74177 $3,006.00

5574178 CT ABD/PEL WITHOUT 1 OR BOTH 74178 $4,257.00

5575571 CT HEART CALCIUM SCORING 75571 $121.00

5575635 CT ABD ANGIO-W/ LL RUNOFF 75635 $7,189.00

5700017 MRI-PELVIS W 72196 $2,635.00

5700025 MRA-PELVIS WITHOUT AND WITH 72198 $2,181.00

5700033 MRI-UP EXT WITHOUT AND WITH 73220 $1,996.00

5700034 MRI-UP EXT WITHOUT AND WITH 73220 $1,996.00

5700041 MRI-LOWER EXT-JOINT W/O LT 73721 $2,296.00

5700042 MRI-LOWER EXT-JOINT W/O RT 73721 $2,296.00

5700068 MRI-LOWER EXT WITHOUT AND WITH 73720 $3,763.00

5700069 MRI-LOWER EXT WITHOUT AND WITH 73720 $3,763.00

5700076 MRI-ABD W/O 74181 $2,024.00

5700114 MRI-CHEST W/O 71550 $2,024.00

5700149 MRI-T/SPINE W/O 72146 $2,208.00

5700157 MRI-T/SPINE W 72147 $2,430.00

5700165 MRI-T/SPINE WITHOUT AND WITH 72157 $3,310.00

5700173 MRI L SPINE W/O 72148 $2,155.00

5700181 MRI L/SPINE W 72149 $2,557.00

5700203 MRI L SPINE WITHOUT AND WITH 72158 $3,838.00

5700211 MRA-SPINAL CANAL WO/W 72159 $2,370.00

5700238 MRI-TMJ'S 70336 $1,988.00

5700246 MRI-ORB FACE/NECK W/O 70540 $1,997.00

5700262 MRI BRAIN W/O 70551 $1,997.00

5700289 MRI BRAIN/STEM W 70552 $2,396.00

5700297 MRI-BRAIN WITHOUT AND WITH 70553 $4,062.00

5700319 MRI-C/SPINE W/O 72141 $2,024.00

5700327 MRI-C/SPINE W 72142 $2,430.00

5700335 MRI-C/SPINE WITHOUT AND WITH 72156 $4,062.00

5700386 MRI-BONE MARROW BLOOD 77084 $2,024.00

5700408 MRI-UPR EXT JOINT W/O LT 73221 $1,811.00

5700409 MRI-UPR EXT JOINT W/O RT 73221 $1,811.00

5700416 MRA-UPR EXT 73225 $1,909.00

5700459 MRI-UPR EXT W/O LT 73218 $1,913.00

5700460 MRI-UPR EXT W/O RT 73218 $1,913.00

5700467 MRI-UPR EXT W LT 73219 $2,291.00

5700468 MRI-UPR EXT W RT 73219 $2,291.00

5700475 MRI-UPR EXT JT W LT 73222 $2,291.00

5700476 MRI-UPR EXT JT W RT 73222 $2,291.00

5700491 MRI-PELVIS W/O 72195 $1,942.00

5700505 MRI-PELVIS WITHOUT AND WITH 72197 $4,151.00

5700513 MRA-HEAD W 70545 $2,181.00

5700521 MRA-HEAD WITHOUT AND WITH 70546 $3,765.00

5700548 MRA-NECK W/O 70547 $1,988.00

5700556 MRA-NECK W 70548 $2,181.00

5700564 MRA-NECK WITHOUT AND WITH 70549 $3,912.00

5700572 MRI-LOWER EXT W/O LT 73718 $2,296.00

5700573 MRI-LOWER EXT W/O RT 73718 $2,296.00

5700599 MRI-LOWER EXT W LT 73719 $2,935.00

5700600 MRI-LOWER EXT W RT 73719 $2,935.00

5700602 MRI-LOWER EXT JOINT W LT 73722 $2,291.00

5700603 MRI-LOWER EXT JOINT W RT 73722 $2,291.00

5700629 MRI-LOWER EXT JT WITHOUT AND WITH 73723 $4,116.00

5700630 MRI-LOWER EXT JT WITHOUT AND WITH 73723 $4,116.00

5700637 MRI-ABD W 74182 $2,325.00

5700645 MRI-ABD WITHOUT AND WITH 74183 $4,151.00

5700653 MRI CHEST W 71551 $2,325.00

5700661 MRI-CHEST WITHOUT AND WITH 71552 $4,291.00

5700688 MRI-ORB/FACE/NECK-W 70542 $2,291.00

5700696 MRI-ORB FACE NECK WITHOUT AND WITH 70543 $4,116.00

5700718 MRA-HEAD W/O 70544 $1,988.00

5700726 MRA-CHEST WITHOUT AND WITH 71555 $2,117.00

5700769 MRA-LOW EXT W OR W/O 73725 $2,117.00

5700783 MRI-UPR JOINT WITHOUT AND WITH 73223 $4,116.00

5700784 MRI-UPR JOINT WITHOUT AND WITH 73223 $4,116.00

5700793 MRA-ABD W OR W/O 74185 $2,117.00

5708912 MRA-LOWER EXT W/CONTRAST 73725 $2,557.00

5900366 PET FDG A9552 $805.00

5978814 PET CT TUMOR-LIM AREA 78814 $4,170.00

5978815 PET CT TUMOR-SKUL-MID THIGH 78815 $4,747.00

5978816 PET CT TUMOR-FULL BODY 78816 $4,840.00

6100118 NM-BONE-LIMITED 78300 $548.00

6100126 NM-BONE-3-PHASE 78315 $1,113.00

6100215 NM-PARATHYROID IMAGING 78070 $472.00

6100223 NM-BONE-SPECT 78320 $1,142.00

6100282 NM-THYROID ABLATION-HYPERTHYROIDISM 79005 $1,186.00

6100312 NM-THYROID CA-METASTATIS-WB 78018 $954.00

6100339 NM-MYO PERF-MULTI STUDIES-SPECT 78452 $2,499.00

6100347 NM-MUGA 78472 $1,023.00

6100436 NM-GASTRIC EMPTYING 78264 $932.00

6100495 NM-VOIDING CYSTOGRAM 78740 $756.00

6100576 NM-TUMOR LOCALIZATION-MULTI AREAS 78801 $523.00

6100894 NM-BONE-MULTIPLE AREAS 78305 $742.00

6100924 NM-CARDIAC BLOOD POOL-GATED 78496 $377.00

6110075 NM BONE-WHOLE BODY 78306 $886.00

6110083 NM-LIVER-SPLEEN IMAGING 78215 $674.00

6110105 NM-PERFUSION LUNG SCAN 78580 $674.00

6110121 NM-CCK HIDA 78227 $1,093.00

6110156 NM-RENAL-FLOW/FUNCTION-SINGLE STUDY 78707 $713.00

6110164 NM-TUMOR LOCALIZATION-WHOLE BODY 78802 $660.00

6110199 NM-TUMOR LOCALIZATION-LIM AREA 78800 $523.00

6110253 NM-GI BLEED SCAN 78278 $1,121.00

6110741 NM-INTESTINE IMAGING:MECKEL'S 78290 $1,084.00

6110768 NM-TESTICULAR W/FLOW 78761 $806.00

6110857 NM-VENOUS THROMBOSIS IMA-BIL 78458 $354.00

6110865 NM-INFLAMMATION LOCAL-WHOLE BODY 78806 $1,186.00

6110873 WBC LIMITED STUDY 78805 $863.00

6178012 NM-THYROID SINGLE 78012 $470.00

6178013 NM-THYROID IMAGING 78013 $507.00

6178014 NM-THYROID MULTI 78014 $643.00

6178070 NM-PARATHYROID PLANAR 78070 $472.00

6178071 NM-PARATHYROID SPECT 78071 $944.00

6178072 NM-PARATHYROID CT 78072 $472.00

6178102 NM-BONE MARROW LTD 78102 $560.00

6178195 NM-SENTINEL NODE IMAGING 78195 $1,106.00

6178226 NM-HIDA 78226 $969.00

6178464 NM-MYO PERF SPECT SINGLE 78451 $2,031.00

6178588 NM-PERF/VENT 78582 $1,166.00

6178805 NM-INFLAMMATION LIMITED 78800 $1,334.00

6200355 RX-TL 201/3.5 A9505 $822.00

6200363 RX-TL 201/1.5 A9505 $670.00

6200371 RX-MDP A9503 $578.00

6200398 RX-SESTAMIBI REST 10MCI A9500 $727.00

6200487 RX-MAG 3 A9562 $1,005.00

6200517 RX-TC DTPA A9539 $715.00

6200525 RX-TCMAA A9540 $533.00

6200541 RX-I-123 A9516 $661.00

6200568 RX-SULFER COLLOID A9541 $868.00

6200592 RX-TC CHOLTEC A9537 $410.00

6200606 RX-IN III - WBC A9570 $3,661.00

6200614 RX-TC99M DMSA A9551 $811.00

6200657 RX-TC99M PERTECHNETATE-STRAIGHT A9512 $631.00

6200797 RX-DISOFENIN A9510 $333.00

6200813 RX-I-131 A9517 $677.00

6209500 RX-SESTAMIBI STRESS 30MCI A9500 $727.00

6209502 RX-TC TETROFOSMIN A9502 $523.00

6209561 RX-HDP A9561 $588.00

6219537 RX-MEBROFENIN A9537 $604.00

6300012 ECHO 2-D LIMITED 93308 $479.00

6300039 DOPPLER ECHO/FLU 93321 $174.00

6300047 DOPPLER COLOR FLOW 93325 $444.00

6300098 ECHO-CONG CARD ANOM 93303 $986.00

6300101 ECHO-TRANSTHORACIC LIMITED STUDY 93304 $533.00

6393350 ECHO-STRESS 93350 $737.00

6393360 ECHO-TRANSTHORACIC COMPLETE 93306 $1,862.00

6500002 VITAMIN A&D OINT : 60GM A9270 $10.20

6500007 MOMETASONE(ASMANEX)INHALER:220MCG A9270 $402.40

6500009 ACETAMINOPHEN(TYLENOL)BULK ELX : 120ML A9270 $16.90

6500010 ACETAMINOPHEN (TYLENOL) SUPP : 120MG A9270 $1.53



6500015 ACETAMINOPHEN(TYLENOL X-STR)TAB:500MG A9270 $2.50

6500016 ACETIC ACID 0.25% IRRIG SOL : 1000ML $13.00

6500017 ACETYLCYSTEINE (MUCOLYTIC) 20% SOL :30ML $32.50

6500020 CHARCOAL ACTIVATED (ACTIDOSE) LIQ : 25GM A9270 $19.90

6500023 ACT CHARCOAL/SORB (ACTIDOSE) SUSP : 50GM A9270 $40.70

6500026 ALTEPLASE (ACTIVASE) INJ : 100MG J2997 $15,270.17

6500028 niFEDipine (NIFEDICAL **XL**) TAB : 30MG A9270 $3.50

6500029 niFEDipine (NIFEDICAL**XL**) TAB : 60MG A9270 $6.14

6500030 BENZOIN (AEROZOIN) SPRAY : 105GM A9270 $17.70

6500031 ALBUMIN HUMAN 25% INJ : 50ML P9047 $153.84

6500033 SPIRONOLAC/HCTZ(ALDACTAZIDE) TAB 25/25MG A9270 $2.50

6500038 ALLOPURINOL (ZYLOPRIM) TAB : 100MG A9270 $2.50

6500039 ALLOPURINOL (ZYLOPRIM) TAB : 300MG A9270 $2.50

6500041 alprAZOLAM (XANAX) TAB : 0.5MG A9270 $2.50

6500042 ALTERNAGEL (ALUMINUM HYDROXIDE) A9270 $15.90

6500046 AMANTADINE (SYMMETREL) CAP : 100MG A9270 $2.50

6500047 ZOLPIDEM TART (AMBIEN) TAB : 10MG A9270 $12.10

6500048 BENZOCAINE (CETACAINE) AEROSOL: 5 GM $163.52

6500052 AMINOPHYLLINE INJ 25MG/ML:20ML J0280 $27.40

6500057 AMITRIPTYLINE (ELAVIL) TAB : 25MG A9270 $2.50


6500059 AMOXICILLIN (AMOXIL) SUSP 50MG/ML:100ML A9270 $16.10

6500063 AMOXICILLIN (AMOXIL) CAP : 500MG A9270 $2.50

6500065 AMPHOTERICIN B INJ : 50MG J0285 $88.70

6500067 AMPICILLIN (POLYCILLIN) 1GM:IM INJ J0290 $47.50

6500069 AMPICILLIN (POLYCILLIN) 250MG:IM INJ J0290 $35.90

6500070 AMPICILLIN (POLYCILLIN) 500MG:IM INJ J0290 $36.50

6500072 AMYL NITRITE 2% INHALENT $2.25

6500077 SUCCINYLCHOLIN(QUELICIN)INJ 20MG/ML:10ML J0330 $51.49

6500078 PHYSOSTIGMINE (ANTILIRIUM) INJ :1MG $38.80

6500080 HYDROCORTISONE(ANUSOL-HC)2.5% CRM:30GM A9270 $64.90

6500081 HYDROCORTISONE ACE(ANUSOL-HC)SUPP:25MG A9270 $2.50

6500082 ACETAMINOP(TYLENOL)DROP 80MG/0.8ML:15ML A9270 $12.20

6500086 TUBERCULIN PPD (APLISOL) INJ : 0.1ML 86580 $48.14

6500091 PAMIDRONATE (AREDIA) INJ : 90MG J2430 $499.20

6500094 AMMONIA 15% INHALENT:0.33ML $2.50

6500097 ASPIRIN (ASA) TAB : 325MG A9270 $2.50

6500102 ASPIRIN SUPP : 600MG A9270 $3.77

6500103 ATENOLOL (TENORMIN) TAB : 25MG A9270 $2.50

6500104 ATENOLOL (TENORMIN) TAB : 50MG A9270 $2.50

6500105 ATROPINE SULFATE INJ 0.4MG/ML: 1ML J0461 $6.90

6500106 ATROPINE LIFEJECT INJ 0.1MG/ML:10ML J0461 $36.96

6500111 AMOXICILLIN/CLAV (AUGMENTIN) TAB : 250MG A9270 $7.70



6500118 NEO/BACITR/POLY(NEOSPORIN)OPTH OINT:3.5G A9270 $42.50

6500120 BACITRACIN OINT 500U : 30GM A9270 $12.70

6500122 BECLOMETHASONE(BECONASE AQ) SPRAY : 25GM A9270 $403.00

6500124 BISMUTH SUBSALICY (KAOPECTATE) LIQ :30ML A9270 $2.50

6500126 DIPHENHYDRAM(BENADRYL)INJ 50MG/ML:1ML J1200 $27.60

6500128 DICYCLOMINE (BENTYL)INJ 10MG/ML:2ML J0500 $253.42

6500130 BENZOIN COMPOUND TINCTURE : 60ML $13.00

6500132 BENZTROPINE (COGENTIN) TAB : 1MG A9270 $2.50

6500135 POVIDONE-IODINE(BETADINE)10% OINT : 30GM A9270 $13.20

6500140 BETHANECHOL (URECHOLINE) TAB : 10MG A9270 $3.50

6500141 BETHANECHOL (URECHOLINE) TAB : 25MG A9270 $4.70

6500142 CLARITHROMYCIN (BIAXIN) TAB : 250MG A9270 $11.80

6500143 CLARITHROMYCIN (BIAXIN) TAB : 500MG A9270 $11.02

6500144 PEN G BENZ&PROC(BICILLIN C-R)INJ:600000U J0558 $141.50

6500146 PEN G BENZ(BICILLIN L-A) INJ:600000U:1ML J0561 $101.40

6500147 BISACODYL SUPP: 10MG A9270 $2.50

6500148 BISACODYL (DULCOLAX) TAB : 5MG A9270 $2.50

6500153 terBUTaline (BRETHINE) TAB : 2.5MG A9270 $2.50

6500161 BUPIVACAINE MPF(MARCAINE) 0.25% INJ:10ML $32.46

6500163 BUPIVACAINE W/EPI 0.5% MDV : 50ML $49.00

6500164 BUPIVACAINE (MARCAINE) MPF 0.5% INJ:10ML $31.30

6500165 BUPRENORPHINE HCL (BUPRENEX) INJ : 0.3MG $66.60

6500166 buSPIRone HCL (BUSPAR) TAB : 5MG A9270 $2.50

6500167 buSPIRone HCL (BUSPAR) TAB : 10MG A9270 $3.70

6500170 CALAMINE LOTION : 120ML A9270 $11.30

6500171 CALCIUM CHLORIDE ABBOJECT 100MG/ML :10ML $34.80

6500175 CALCIUM GLUCONATE J0610 $32.80

6500176 CALCIUM LACT TAB : 650MG A9270 $2.50

6500178 capTOPril (CAPOTEN) TAB : 12.5MG A9270 $2.50

6500179 capTOPril (CAPOTEN) TAB : 25MG A9270 $2.50

6500181 SUCRALFATE (CARAFATE) TAB : 1GM A9270 $4.60

6500182 CARBAMIDE PEROXIDE (DEBROX)SOL 6.5%:15ML $12.50

6500183 CARBIDOPA/LEVOD(SINEMET)TAB 25/100MG A9270 $2.50

6500184 CARBIDOPA/LEVODOPA(SINEMET)TAB 25/250MG A9270 $2.60

6500187 DILTIAZEM **LA**(CARDIZEM LA):180MG A9270 $10.35

6500188 DILTIAZEM **LA**(CARDIZEM LA) TAB:240MG A9270 $9.65

6500189 DILTIAZEM **LA**(CARDIZEM LA)TAB:300MG A9270 $12.53

6500190 DILTIAZEM **ER** (CARDIZEM LA) CAP:300MG A9270 $3.30

6500192 CARISOPRODOL (SOMA) TAB : 350MG A9270 $2.50

6500193 CASPOFUNGIN (CANCIDAS) INJ: 70 MG J0637 $1,119.80

6500194 CEFACLOR (CECLOR) SUSP 50MG/ML : 75ML A9270 $73.50

6500195 CEFazolin (KEFZOL) 1GM: IM INJ J0690 $28.80

6500197 CEFAZOLIN (KEFZOL) 500MG: IM INJ J0690 $33.30

6500199 ASCORBIC ACID (CENOLATE) INJ : 500MG $30.80

6500201 PHENOL (CEPASTAT) LOZENGES:18 A9270 $12.80

6500203 CEPHALEXIN (KEFLEX) SUSP 50MG/ML : 100ML A9270 $49.20

6500205 TH CEPHALEXIN 250MG CAP (KEFLEX): A9270 $22.40

6500206 CEPHALEXIN (KEFLEX) CAP : 500MG A9270 $3.60

6500210 CHLORAL HYDRATE(NOCTEC)SYP 100MG/ML:5ML A9270 $2.60

6500211 PHENOL/SOD PHENO(CHLORASEPTIC)LIQ:180ML A9270 $14.70

6500213 BENZOC/MENTHOL(CHLORASEPTIC)LOZENGE:18 A9270 $13.00

6500217 CHLORDIAZEPOXIDE (LIBRIUM) CAP : 5MG A9270 $2.50

6500221 CHLORPHENIRAMINE TAB: 4MG A9270 $2.50

6500222 chlorproMAZINE (THORAZINE) TAB : 10MG A9270 $2.50




6500227 chlorproMAZINE(THORAZINE)INJ 25MG/ML:1ML J3230 $45.90

6500228 chlorproPAMIDE (DIABINESE) TAB : 100MG A9270 $2.50

6500245 CITRATE OF MAGNESIA SOL : 296ML A9270 $11.40

6500246 CLINDAMYCIN (CLEOCIN) INJ : 600MG $53.29

6500249 CLINDAMYCIN (CLEOCIN) INJ : 900MG $41.10

6500255 CODEINE PHOSPHATE INJ 30MG/ML:2ML J0745 $32.60

6500256 CODEINE SULFATE TAB : 15MG A9270 $6.50

6500257 CODEINE SULFATE TAB : 30MG A9270 $2.50

6500258 BENZTROPINE(COGENTIN)INJ 1MG/ML:2ML J0515 $221.00

6500259 BACITRACIN INJ : 50000 UNITS $61.10

6500260 COLCHICINE TAB : 0.6MG A9270 $15.13

6500264 PROCHLORPERAZINE TAB : 10MG A9270 $2.50

6500266 DINOPROSTONE (CERVIDIL) VAG : 10MG $1,053.73

6500269 HYDROCORT(COLOCORT)ENEMA 1.67MG/ML:60ML A9270 $17.70

6500271 WARFARIN (COUMADIN) TAB : 7.5MG A9270 $4.70

6500272 WARFARIN (COUMADIN) TAB : 1MG A9270 $3.00

6500273 WARFARIN (COUMADIN) TAB : 2.5MG A9270 $3.20



6500282 CYANOCOLBALAMIN(VITAMIN B-12)INJ:1000MCG J3420 $37.29

6500283 CYCLOBENZAPRINE (FLEXERIL) TAB : 10MG A9270 $3.00

6500285 CYPROHEPTADINE(PERIACTIN)TAB :4MG A9270 $2.50

6500286 LIOTHYRONINE NA (CYTOMEL) TAB : 25MCG A9270 $2.73

6500287 CYCLOPHOSPHAMIDE (CYTOXAN) INJ : 2GM J9070 $797.00

6500297 DEXAMETHASONE (DECADRON) TAB : 1MG A9270 $2.50

6500303 MEPERIDINE HCL (DEMEROL) INJ : 50MG J2175 $29.70



6500306 VALPROIC ACID (DEPAKENE) CAP : 250MG A9270 $2.50

6500307 METHYLPREDNISOLONE(DEPO-MEDROL)INJ:40MG J1030 $50.94

6500308 TRAZODONE HCL (DESERYL) TAB : 50MG A9270 $2.50

6500311 DEXAMETHASONE (DECADRON) TAB : 4MG A9270 $2.50

6500312 DEXAMETHASONE (DECADRON) INJ 4MG/ML:5ML J1100 $35.24

6500317 DEXTROSE 5% INJ : 500ML $57.00

6500319 DEXTROSE 5% INJ : 100ML $25.50

6500320 DEXTROSE 50% LIFEJECT INJ 25GM : 50ML $41.06

6500321 DIHYDROERGOTAMINE(DHE-45)INJ 1MG/ML:1ML J1110 $434.91

6500324 DIAZEPAM (VALIUM) TAB : 5MG A9270 $2.50

6500326 DIAZEPAM (VALIUM) TAB : 2MG A9270 $2.50

6500327 DICLOFENAC (VOLTAREN) TAB : 75MG A9270 $3.60

6500328 DIFLUPREDNATE(DUREZOL)OPH EMULSION 0.05% $334.46

6500330 FLUCONAZOLE (DIFLUCAN) TAB : 50MG A9270 $14.50

6500335 PHENYTOIN(DILANTIN)CHEW INFATAB:50MG A9270 $4.20

6500336 PHENYTOIN (DILANTIN) CAP : 100MG A9270 $4.47

6500337 PHENYTOIN (DILANTIN-125) SUSP : 5ML A9270 $2.50

6500338 HYDROMORPHONE(DILAUDID)INJ : 4MG J1170 $29.40

6500341 DILTIAZEM (CARDIZEM) TAB : 30MG A9270 $2.50

6500346 DIPHTHERIA-TET TOX PEDIATRIC INJ:0.5ML 90702 $118.10

6500348 DIPHENHYDRAMINE(BENADRYL)CAP: 25MG A9270 $2.50

6500350 DIPHENOXYLATE (LOMOTIL) TAB 2.5/0.025MG A9270 $2.50

6500352 BETAMETHASONE D(DIPROSONE)0.05% CRM:15GM A9270 $19.80

6500357 DObutAMINE 250MG/D5W 250ML PREMIX J1250 $41.35

6500358 DObutAMINE (DObutREX)INJ 12.5MG/ML:20ML J1250 $33.80

6500359 DOCUSATE CALCIUM (SURFAK) CAP : 240MG A9270 $2.50

6500363 DOCUSATE SODIUM LIQ 10MG/ML:10ML A9270 $2.50

6500365 DOCUSATE SODIUM CAP : 100MG A9270 $2.50

6500368 ALUMINUM S04/CALCIUM (DOMEBORO) PACKET A9270 $23.90

6500369 BELLADONNA ALKD (DONNATAL) ELIXIR :5ML A9270 $11.98

6500371 PHENOBARB/BELLADONNA (DONNATAL) TAB A9270 $2.50

6500373 dopAMINE 40MG/ML: 1ML J1265 $3.05

6500374 DOXAPRAM HCL (DOPRAM) INJ 20MG/ML:1ML $14.70

6500376 DOXEPIN HCL (SINEQUAN) CAP:25MG A9270 $2.50

6500377 DOXEPIN HCL (SINEQUAN) CAP:10MG A9270 $2.50

6500380 DOXYCYCLINE (VIBRAMYCIN) INJ : 100MG $73.30

6500381 DOXYCYCLINE (VIBRAMYCIN) CAP : 100MG A9270 $3.60

6500383 DOXYCYCLINE (VIBRAMYCIN) CAPSULE 50 MG A9270 $2.50

6500389 TRIAMTERENE (DYRENIUM) CAP:50MG A9270 $3.00

6500392 ERTHROMYCIN BASE TAB:250MG A9270 $1.50

6500394 FLUOROURACIL (EFUDEX) 5% CRM : 40GM A9270 $717.60

6500401 oxyCODONE/APAP (ENDOCET) TAB 5/325MG A9270 $2.50

6500402 HEPATITIS B VAC (ENGERIX-B) INJ : 20MCG 90746 $195.70

6500407 ASPIRIN EC (ECOTRIN) TAB : 325MG A9270 $2.50

6500408 EPINEPHRINE 1:1000 MDV 1MG/ML 30ML:1ML J0171 $25.73

6500409 EPINEPHRINE 1:1000 INJ 1MG/ML:1ML J0171 $32.54

6500410 EPINEPHRINE ABBOJECT LONG 0.1MG : 10ML J0171 $32.50

6500411 EPINEPHRINE ABBOJECT SHORT 0.1MG : 10ML J0171 $32.20

6500412 ERGOCALCIFEROL (VITAMIN D) CAP:50,000 UN A9270 $3.80

6500416 ERYTHROMYCIN BASE (ERY-TAB) TAB:333MG A9270 $2.50

6500418 ERYTHROMYCIN (ERYTHROCIN) INJ : 500MG J1364 $238.07

6500421 ERYTHROMYCIN (ILOTYCIN)OPTH OINT :1GM A9270 $32.27

6500423 LITHIUM CARBONATE (ESKALITH) CAP : 300MG A9270 $2.50

6500425 ETHYL CHLORIDE SPRAY A9270 $89.70

6500429 FENTANYL (SUBLIMAZE)INJ 0.05MG/ML:2ML J3010 $27.88

6500430 FERROUS SULF (FEOSOL) ELX : 5ML A9270 $2.50

6500432 ASA/CAFF/BUTALBITAL (FIORINAL) CAP A9270 $2.50

6500435 fluocinoLONE ACE(SYNALAR)0.025% CRM:15GM A9270 $19.60

6500436 fluocinoNIDE (LIDEX) 0.05% CRM : 30GM A9270 $36.20

6500437 FLUORESCEIN SOD STRIPS :0.6MG $2.50

6500441 FOLIC ACID(FOLVITE)INJ 5MG/ML:1ML $30.60

6500442 FOLIC ACID (FOLVITE) TAB : 1MG A9270 $2.50

6500444 CEFTAZIDIME (FORTAZ) 1GM: INJ J0713 $64.90

6500450 FUROSEMIDE (LASIX) INJ 100MG: 10ML J1940 $26.77

6500451 FUROSEMIDE (LASIX) INJ 20MG : 2ML J1940 $26.12

6500453 FUROSEMIDE (LASIX) SOL 10MG/ML : 60ML A9270 $27.10

6500454 FUROSEMIDE (LASIX) TAB : 20MG A9270 $2.50


6500461 GENTAMICIN (GARAMYCIN) 0.1% OINT : 15GM A9270 $40.53

6500463 ALUM HYD/MAG CAR (GAVISCON) SUSP : 355ML A9270 $16.00

6500464 SIMETHICONE (GENASYME) DROP 66MG/ML:30ML A9270 $2.50

6500467 GENTAMICIN PEDIATRIC 10MG/ML:IM 2ML J1580 $38.10

6500471 glipiZIDE (GLUCOTROL) TAB : 5MG A9270 $2.50

6500472 GLUCAGON INJ : 1MG J1610 $763.86

6500473 glipiZIDE (GLUCOTROL) TAB : 10MG A9270 $2.50

6500474 GLUCOSE (GLUTOSE-15) GEL : 15GM A9270 $30.81

6500477 glyBURIDE (DIABETA) TAB : 5MG A9270 $2.50

6500478 GLYCERIN ADULT SUPP A9270 $2.50

6500479 GLYCOPYRROLATE(ROBINUL) INJ:0.2MG/ML-1ML $42.50

6500480 GRANULEX SPRAY $54.20

6500482 HEPATITIS B IMM GLOB (NABI-HB) INJ : 5ML 90371 $2,116.60

6500488 HALOPERIDOL (HALDOL) TAB : 1MG A9270 $2.00

6500489 HALOPERIDOL (HALDOL)INJ 5MG/ML:1ML J1630 $46.23

6500491 HALOPERIDOL (HALDOL) SOL 2MG/ML : 120ML A9270 $37.50

6500492 HALOPERIDOL (HALDOL) TAB : 0.5MG A9270 $2.50

6500498 HEPARIN/NACL PREMIX 50 UNITS/ML : 500ML J1644 $38.60

6500500 HEPARIN LOCK FLUSH INJ 100 U/ML :5ML J1642 $33.90

6500501 HEPARIN SOD MDV INJ 1000 UNITS/ML:1ML J1644 $7.95

6500502 HEPARIN SODIUM PORCINE INJ : 5000 UNITS J1644 $38.00

6500503 HETASTARCH (HESPAN) 6% IV : 500ML $70.50

6500506 CHLORHEXIDINE GLUC(HIBICLENS)SOL4%:120ML A9270 $14.70

6500508 HISTOPLASMIN DILUTE INJ $25.80

6500511 HYDRALAZINE(APRESOLINE)INJ 20MG/ML:1ML J0360 $71.80

6500512 HYDRALAZINE (APRESOLINE) TAB : 10MG A9270 $2.50

6500514 HYDROCHLOROTHIAZIDE (HCTZ) TAB : 25MG A9270 $2.50

6500515 HYDROCHLOROTHIAZIDE (HCTZ) TAB : 50MG A9270 $2.50

6500516 HYDROCODONE/APAP(LORTAB)TAB 5/500MG A9270 $2.50

6500518 HYDROCORTISONE 1% OINT : 30GM A9270 $9.80

6500520 HYDROCORTISONE (CORTEF) TAB : 10MG A9270 $2.50

6500521 HYDROGEN PEROXIDE 3% SOL : 473ML A9270 $10.80

6500522 HYDROMORPHONE(DILAUDID)TAB : 2MG A9270 $2.50

6500526 HYDROXYZINE HCL (ATARAX) INJ : 25MG J3410 $34.80

6500527 HYDROXYZINE HCL (ATARAX) INJ :100 MG/2ML J3410 $28.40

6500529 HYDROXYZINE HCL (ATARAX) TAB : 10MG A9270 $2.50


6500531 HYDROXYZINE pamoate (VISTARIL) CAP: 25MG A9270 $2.50

6500532 HYDROXYZINE HCL(ATARAX)SYRUP 2MG/ML:5ML A9270 $2.50

6500534 TETANUS IMMUNE GLOB(BAY-TET)INJ:250UNIT J1670 $791.40

6500536 ARTIFICIAL TEARS SOL(TEARS NATII) : 15ML A9270 $12.80

6500539 TERAZOSIN HCL (HYTRIN) CAP : 1MG A9270 $6.50

6500541 IBUPROFEN(MOTRIN)TAB:400MG A9270 $2.50



6500547 IMIPRAMINE (TOFRANIL) TAB : 10MG A9270 $2.50

6500550 PROPRANOLOL HCL (INDERAL) INJ : 1MG J1800 $44.50

6500551 INDOMETHACIN **SR* (INDOCIN SR) CAP:75MG A9270 $5.90

6500552 INDOMETHACIN (INDOCIN) CAP : 25MG A9270 $2.50

6500553 INFLUENZA VIR VAC SP (QUAD) VACCINE Q2039 $52.10

6500555 REG INSULIN (NOVOLIN R) A9270 $1.53

6500556 INSULIN 70/30(NOVOLIN) 100UNITS/ML:10ML A9270 $1.33

6500557 INSULIN NPH (NOVOLIN) 100 UNITS/ML:10ML A9270 $153.80

6500560 INSULIN ASP INJ(NOVOLOG FLEXPEN):100U/ML A9270 $673.44

6500561 GUAIFENESIN/CODEINE LIQ : 5ML A9270 $3.30

6500564 ISONIAZIDE TAB (I-N-H) : 300MG A9270 $1.00

6500565 ISRADIPINE CR (DYNACIRC) TAB: 5 MG A9270 $7.50

6500567 VERAPAMIL **SR** (ISOPTIN SR) TAB :240MG A9270 $4.30

6500568 VERAPAMIL (CALAN) TAB : 40MG A9270 $2.50

6500569 ATROPINE(ISOPTO ATROPINE)1% OPTH SOL:2ML $14.10

6500570 PILOCARPINE (PILOCAR) OPTH SOL 2% : 15ML A9270 $30.70

6500571 SCOPOLAMINE (ISOPTO HYOS) SOL 0.25%:5ML $97.29

6500572 ISOSORBIDE DInitrate TAB:10MG A9270 $2.25



6500577 LIOTHYRONINE NA(CYTOMEL)TAB: 5 MCG A9270 $2.50

6500579 LACTATED RINGERS IV SOL : 1000ML $74.00

6500580 DIGOXIN (LANOXIN) INJ 0.25MG/ML: 2ML J1160 $32.50

6500589 LIDOCAINE/D5W PREMIX BAG 0.4%: 250 ML J2001 $38.30

6500590 LIDOCAINE LIFEJECT INJ 20MG/ML : 5ML $35.19

6500591 LIDOCAINE/D5W PREMIX BAG 0.4% : 500ML J2001 $81.90

6500592 LIDOCAINE (XYLOCAINE) 2% MDV : 1 VIAL J2001 $15.48

6500593 LIDOCAINE (XYLOCAINE) 2% VISCOUS : 100ML $8.89

6500594 LIDOCAINE W/EPI 0.5% MDV : 1 VIAL $19.06

6500599 LOPERAMIDE (IMODIUM) CAP : 2MG A9270 $2.50

6500600 GEMFIBROZIL (LOPID) TAB : 600MG A9270 $2.50

6500602 LORazepam (ATIVAN) TAB : 0.5MG A9270 $2.50

6500603 LORazepam (ATIVAN) TAB : 1MG A9270 $2.50

6500605 CLOTRIMAZOLE (LOTRIMIN) 1% CRM : 15GM A9270 $14.30

6500606 CLOTRIMAZOLE/BETAMET(LOTRISONE)CRM:15GM A9270 $50.00

6500611 MULTIVITAMINS (NO VIT K) INJ : 10ML $179.60

6500612 ALUMINUM/MG HYDROX (MAALOX) SUSP:148ML A9270 $12.40

6500613 NITROFURANTOIN (MACRODANTIN) CAP : 50MG A9270 $4.99

6500614 MAGNESIUM SULF INJ 500MG/ML (10GM):20ML J3475 $23.30

6500615 MAGNESIUM SULFATE 500 MG/ML(1GM)-2 ML J3475 $27.70

6500617 MANNITOL 20% PREMIX: 500ML $77.10

6500619 DEXAMETHASONE(MAXIDEX)OPTH SUSP 0.1%:5ML $132.91

6500620 MECLIZINE (BONINE) CHEWABLE TAB : 25MG A9270 $2.50

6500621 MECLIZINE (ANTIVERT) TAB : 12.5MG A9270 $2.50

6500624 MEDROXYPROGESTERONE (PROVERA)TAB : 2.5MG A9270 $2.25

6500625 CefOXitin (MEFOXIN) : 2GM IM INJ J0694 $83.67

6500626 CefOXitin (MEFOXIN) 1GM:IM INJ J0694 $54.20

6500629 MEGESTROL ACETATE (MEGACE) TAB : 40MG A9270 $2.60

6500631 THIORIDAZINE HCL (MELLARIL) TAB : 50MG A9270 $2.40

6500638 PHYTONADIONE (MEPHYTON) TAB : 5MG A9270 $37.83

6500639 MEPIVACAINE (CARBOCAINE) 1% MDV : 50ML J0670 $2.50

6500640 MEPIVACAINE HCL (POLOCAINE) 1% MDV:50ML J0670 $51.10

6500641 MEPIVACAINE MPF (POLOCAINE) 2% INJ :20ML J0670 $38.60

6500645 PYRIDOSTIGMINE (MESTINON) TAB : 60MG A9270 $1.50

6500647 PSYLLIUM (METAMUCIL) PACKET A9270 $2.50

6500649 METHYLERGONOVINE (METHERGINE)INJ : 0.2MG J2210 $43.50

6500650 METHYLERGONOVINE (METHERGINE)TAB : 0.2MG A9270 $171.31

6500653 METHYLDOPA (ALDOMET) TAB : 250MG A9270 $2.25

6500654 METHYLDOPATE (ALDOMET)INJ 50MG/ML:5ML J0210 $155.00

6500656 METHYLPHENIDATE (RITALIN) TAB : 10MG A9270 $2.25

6500657 SULFA/SOD/PRED(BLEPHAMIDE)OPTH SUSP:5ML A9270 $143.50

6500658 METOCLOPRAMIDE INJ 5MG/ML:2ML J2765 $33.51

6500659 METOCLOPRAMIDE TAB: 5MG A9270 $2.50

6500660 METOCLOPRAMIDE TAB: 10MG A9270 $2.50

6500662 METOPROLOL tart. (LOPRESSOR) TAB : 50MG A9270 $2.50

6500664 metroNIDAZOLE (FLAGYL) TAB : 250MG A9270 $2.74

6500665 METRONIDAZOLE/NS 500 MG:100 M PREDEFINED $30.72

6500667 MULTIPLE VITAMINS/MINERAL (CENTRUM) TAB A9270 $2.50

6500668 MICONAZOLE NIT(MONISTAT-DERM)2% CRM:30GM A9270 $18.10

6500669 MICONAZOLE (MONISTAT) 2% CRM : 45GM A9270 $15.70

6500671 POTASSIUM CHLORIDE (MICRO-K) CAP : 8MEQ A9270 $2.50

6500672 aMILoride HCL (MIDAMOR) TAB : 5MG A9270 $3.35

6500673 MILK OF MAGNESIA SUSP UD : 30ML A9270 $2.50

6500676 MORPHINE PCA 1MG/ML: 30ML J2270 $51.60

6500677 MORPHINE SULFATE INJ : 25MG J2270 $25.25

6500678 MORPHINE ORAL SOL 2MG/ML : 5ML A9270 $2.50

6500679 MORPHINE INJ: 10MG CARPUJECT J2270 $28.70





6500687 MORPHINE **CR**(MS CONTIN)TAB:15MG A9270 $2.50



6500704 NYSTATIN/TRIAM (MYCOLOG) OINT : 15GM A9270 $44.78

6500705 NYSTATIN(NYSTOP)POWDER 100000 UNITS:15GM A9270 $71.40

6500708 SIMETHICONE (MYLICON) TAB : 80MG A9270 $2.50

6500710 PRIMIDONE (MYSOLINE) TAB : 250MG A9270 $2.50

6500712 NADOLOL (CORGARD) TAB : 20MG A9270 $2.50

6500714 NALBUPHINE(NUBAIN)INJ 10MG/ML:1ML J2300 $29.00

6500716 NAPHAZOL/PHENIR (NAPHCON A)OPTH SOL:15ML A9270 $22.00

6500717 NAPROXEN SOD (ANAPROX) TAB : 275MG A9270 $2.17

6500718 NAPROXEN (NAPROSYN) TAB : 250MG A9270 $2.50

6500719 NAPROXEN (NAPROSYN) TAB : 375MG A9270 $2.90

6500722 NALOXONE HCL (NARCAN) INJ 1MG/ML:2ML J2310 $75.10

6500723 PHENELZINE SULFATE (NARDIL) TAB : 15MG A9270 $2.25

6500732 PHENYLEPHRINE SPRAY 0.25% : 15ML A9270 $13.90

6500733 NEO/POLY/HC(CORTISPORIN) OTIC SUSP:10ML A9270 $264.37

6500734 NEOMY/POLY/HC(CORTISPORIN)OTIC SOL:10ML A9270 $264.37

6500735 NEOM/GRAM/POLY(NEOSPORIN)OPTH SOL:10ML A9270 $78.80

6500739 NEPHROVITE (NEPHROCAPS) CAP A9270 $2.50

6500742 NICOTINIC ACID (NIACIN) TAB : 100MG A9270 $1.00

6500744 NIFEDIPINE (PROCARDIA) CAP : 20MG A9270 $4.30

6500747 NITROGLYCERIN (NITRO) PATCH 0.3MG/HR A9270 $10.66

6500748 NITROGLYCERIN (NITROBID) OINT : 1GM A9270 $2.50

6500751 NITROGLYCERIN PREMIX 0.1 MG/ML : 250ML $79.90

6500752 NITROGLYCERIN (NITROBID) CAP : 9MG A9270 $2.60

6500753 NITROGLYCERIN (NITROBID) CAP : 6.5MG A9270 $2.50

6500754 NITROGLYCERIN(NITROSTAT)SL TAB 0.3MG:100 A9270 $36.20

6500755 NITROGLYCERIN (NITROSTAT)SL 0.4MG : 25's A9270 $91.44

6500756 NITROGLYCERIN(NITROSTAT)SL TAB 0.6MG:100 A9270 $57.10

6500757 KETOCONAZOL (NIZORAL) TAB : 200MG A9270 $8.30

6500759 VECURONIUM BROM (NORCURON) INJ : 10ML $52.64

6500760 ORPHENADRINE CIT(NORFLEX)INJ 30MG/ML:2ML J2360 $78.30

6500761 ORPHENADRINE CITRATE(NORFLEX)TAB: 100MG A9270 $5.70

6500767 DESIPRAMINE (NORPRAMIN) TAB : 25MG A9270 $2.50

6500768 amLODIPine (NORVASC) TAB : 5MG A9270 $4.50

6500770 NALBUPHINE(NUBAIN)INJ 20MG/ML:1ML J2300 $42.86

6500773 NYSTATIN(MYCOSTATIN)CR 100MU/GM:15GM A9270 $12.80

6500774 NYSTATIN (MYCOSTATIN) ORAL SUSP : 60ML A9270 $44.04

6500775 NYSTATIN/TRIAMCIN (MYCOLOG) CRM : 15GM A9270 $61.88

6500776 MULTIVITAMINS W/MIN (OCUVITE) TAB A9270 $2.50

6500781 PECTIN/CME-CELL/GEL (ORABASE)PASTE:5GM A9270 $9.60

6500785 MANNITOL 25%(250MG/ML):50ML J2150 $28.20

6500791 OXYBUTYNIN**XL** (DITROPAN XL) TAB : 5MG A9270 $8.20

6500793 OXYTOCIN (PITOCIN) INJ : 10 UNITS J2590 $36.70

6500799 PAROXETINE (PAXIL) TAB : 20MG A9270 $7.10

6500802 PENICILLIN G POTASSIUM INJ : 20MU J2540 $140.06

6500803 PENICILLIN V POT (PEN V POT) TAB : 500MG A9270 $2.50

6500804 PENICILL V POT(PEN VK)SUSP 50MG/ML:100ML A9270 $12.80

6500808 FAMOTIDINE (PEPCID) TAB : 20MG A9270 $4.60

6500810 PERPHENAZINE/AMITRIP (TRIAVIL)TAB 2/10MG A9270 $2.50

6500811 PERPHENAZIN/AMITRIP (TRIAVIL) 2/25MG A9270 $2.50

6500812 DIPYRIDAMOLE (PERSANTINE) TAB:75MG A9270 $5.60

6500813 PHENAZOPYRIDINE (PYRIDIUM) TAB : 100MG A9270 $2.50

6500814 PROMETHAZINE(PHENERGAN)SYR 6.25MG/5ML:5 A9270 $6.18

6500815 PROMETHAZINE SUPP : 12.5MG A9270 $11.28

6500816 PROMETHAZINE SUPP : 25MG A9270 $4.80

6500822 PHENOBARBITAL INJ : 130MG J2560 $36.80

6500824 PHENYLEPHRINE(AK-DILATE)OPTH SOL 10%:5ML $12.50

6500825 PHENYLEPHRINE(NEOSYNEPHERINE)INJ 1%:1ML J2370 $33.20

6500826 PHENY/SHA LIVER/CCB (PREPARATION H) SUPP A9270 $1.50

6500827 PHENYTOIN SOD (DILANTIN)INJ 50MG/ML:5ML J1165 $33.74

6500828 HEXACHLOROPHENE (PHISOHEX) LIQ 3%:473ML A9270 $92.00


6500838 VASOPRESSIN(PITRESSIN)INJ 20 U/ML:1ML $43.90

6500841 PNEUMOCOCCAL VA (PNEUMOVAX 23) INJ : 23 90732 $238.14

6500848 POTASSIUM CHLORIDE (KLOR-CON) TAB : 8MEQ A9270 $2.50

6500849 POTASSIUM CHLORIDE (KCL)INJ 2MEQ/ML:10ML J3480 $26.50

6500850 POTASSIUM CHLORIDE(KCL)INJ 2MEQ/ML:20ML J3480 $26.60

6500851 POTASSIUM CHLORIDE 2MEQ/ML 30ML J3480 $28.20

6500852 POTASSIUM PHOSPHATE $27.20

6500853 POTASSIUM ACETATE INJ : 2MEQ $26.60

6500859 PRAZOSIN (MINIPRES) CAP : 5MG A9270 $2.25

6500861 predniSONE(DELTASONE)ORAL SOL 1MG/ML:5ML A9270 $2.50

6500862 predniSONE (DELTASONE) TAB : 1MG A9270 $2.50




6500866 ESTROGENS CONJUGAT (PREMARIN) INJ : 25MG J1410 $516.71

6500867 ESTROGENS CONJUG (PREMARIN)TAB : 0.625MG A9270 $5.25

6500868 ESTROGENS CONJUG (PREMARIN) TAB : 1.25MG A9270 $3.50

6500871 PROBENECID (BENEMID) TAB : 500MG A9270 $2.60

6500873 PROCAINAMIDE(PRONESTYL)INJ 100MG/ML:10ML J2690 $64.47

6500880 PROCHLORPERAZINE SUPP:25MG A9270 $780.00



6500896 PROPRANOLOL HCL (INDERAL) TAB : 10MG A9270 $2.50

6500898 PROPRANOLOL HCL (INDERAL) TAB : 40MG A9270 $2.50

6500902 OXACILLIN (BACTOCILL) 1GM:IM INJ J2700 $59.53

6500906 NEOSTIGMIN (BLOXIVERZ) INJ :1MG/ML 10ML J2710 $29.70

6500907 PROTAMINE SULFATE INJ : 10MG J2720 $37.40

6500914 PYRIDOXINE HCL (VITAMIN B-6) TAB : 50MG A9270 $2.50

6500916 quiNIDine ER(QUINIDEX EXTENTAB) : 300MG A9270 $2.50

6500917 quiNIDine GLUCONATE INJ : 80MG $83.40

6500918 quiNIDine TAB : 200MG A9270 $2.50

6500921 quiNINE SULFATE CAP : 325MG A9270 $2.40

6500923 RABIES VAC ADSOR INJ : 2.5IU 90675 $1,082.95

6500927 RIFAMPIN (RIFADIN) CAP : 150MG A9270 $3.20

6500933 CEFtriaxONE (ROCEPHIN) 2GM:IM INJ J0696 $217.10

6500937 SODIUM CHLORIDE LOCK FLUSH : 3ML $26.63

6500939 SALSALATE (DISALCID) TAB : 500MG A9270 $2.50

6500940 SALSALATE (DISALCID) TAB : 750MG A9270 $2.50

6500943 SELENIUM SULFIDE LOT 2.5% : 120ML A9270 $29.70

6500944 SENNA TAB : 8.6MG A9270 $2.50

6500945 OXAZEPAM (SERAX) CAP : 15MG A9270 $1.00

6500948 SILVER SULFADIAZINE(SILVADENE)CRM : 20GM A9270 $14.10

6500949 SILVER SULFADIAZINE(SILVADENE)CRM:50GM A9270 $18.30

6500950 SILVER SULFADIAZINE(SILVADENE)CRM :400GM A9270 $71.90

6500951 CARBIDOPA/LEVODOPA(SINEMET) TAB 10/100MG A9270 $2.50

6500955 TRIMETHOPRIM/SULFA(SMX/TMP) TAB 400/80MG A9270 $2.50

6500959 SODIUM SULFACETAMIDE 10% SOL : 15ML A9270 $59.61

6500960 SODIUM ACETATE $31.30

6500961 SODIUM BICARBONATE 8.4% ABBOJECT : 10ML $52.69

6500962 SODIUM CHLORIDE 0.9% INJ : 100ML $30.80

6500963 SODIUM CHLORIDE TAB : 1GM A9270 $1.50

6500964 SODIUM CHLORIDE IV SOL 0.45% : 500ML $38.80


6500966 SODIUM BICARBONATE 4% (NEUT) INJ : 5ML $37.01


6500970 SODIUM CHLORIDE 0.9% INJ ADV : 250ML $32.56

6500971 SODIUM CHLORIDE 0.9% ADV INJ : 50ML $30.60

6500972 SODIUM CHLORIDE 0.9% IV SOLN : 250ML $57.00

6500973 SODIUM CHLORIDE $22.10

6500974 SODIUM PHOSPHATE INJ : 3MM $27.30

6500975 METHYLPREDISOLONE(SOLU-MEDROL)INJ:500MG J2930 $97.22

6500983 SPIRONOLACTONE (ALDACTONE) TAB : 25MG A9270 $2.50

6500984 POTASSIUM IODINE (SSKI) SOL : 30ML A9270 $36.20

6500988 WATER FOR INJ(STERILE WATER) INJ : 100ML $17.40

6500989 WATER FOR INJ(STERILE WATER) INJ : 10ML $27.81

6500994 SULFASALAZINE (AZULFIDINE) TAB : 500MG A9270 $2.50

6500995 SULINDAC (CLINORIL) TAB : 150MG A9270 $2.60

6500996 SULINDAC (CLINORIL) TAB : 200MG A9270 $3.15

6501006 LEVOTHYROX (SYNTHROID) : 0.025MG A9270 $2.50




6501019 TAMOXIFEN CIT (NOLVADEX) TAB : 10MG A9270 $3.10

6501020 LUBRICANT EYE DROPS(TEARS RENEWED): 15ML A9270 $15.00

6501023 CARBAMAZEPINE (TEGRETOL) TAB : 200MG A9270 $2.50

6501026 TEMAZEPAM (RESTORIL) CAP : 15MG A9270 $2.50

6501033 TETANUS TOXOID ADSOR INJ : 0.5ML $128.10

6501034 TETANUS/DIPHTHERIA (ADULT) INJ : 0.5ML 90714 $104.78

6501035 TETRACAINE OPTH SOL 0.5% : 2ML $31.27

6501036 TETRACYCLINE (SUMYCIN) CAP : 250MG A9270 $2.50

6501039 THEOPHYLLINE ER(THEO-DUR)TAB:300MG A9270 $2.50

6501045 MULTIVITAMINS (CENTRUM) LIQ : 236 ML A9270 $15.80

6501046 THIAMINE HCL (VITAMIN B1) TAB : 100MG A9270 $2.50

6501048 THIOTHIXENE (NAVANE) CAP : 5MG A9270 $2.25

6501053 TIMOLOL (TIMOPTIC) OPTH SOL 0.25% : 5ML A9270 $39.00

6501054 TIMOLOL (TIMOPTIC) OPTH SOL 0.5% : 5ML A9270 $44.20

6501057 TOBRA/DEXAM (TOBRADEX) OPTH SUSP : 5ML A9270 $329.83


6501066 DESOXIMETASONE (TOPICORT) CRM 0.25%:15GM A9270 $149.90

6501068 KETOROLAC INJ IM: 60MG J1885 $28.90

6501070 ATRACURIUM BESYLATE(TRACIUM)INJ:100MG/10 $67.30



6501077 TRIAMCINOLONE (KENALOG) CRM 0.1% : 15GM A9270 $14.30

6501078 TRIAMCINOLONE (KENALOG) OINT 0.1% : 15GM A9270 $11.20

6501079 TRIAMCINOLONE (KENALOG) CRM 0.025% :15GM A9270 $11.00

6501081 TRIHEXYPHENIDYL (ARTANE) TAB : 2MG A9270 $2.50


6501087 NEOM/BACIT/PO(TRIPLE ANTIBIOT)OINT:30GM A9270 $13.60

6501090 HAMAMELIS LEAF/GLYCE (TUCKS) PAD A9270 $13.70

6501094 HYDROcod/CHLORPHEN (TUSSIONEX) SUSP:5ML A9270 $18.70

6501099 ACETAMINOPHEN W/COD(TYLENOL #3): 1 TAB A9270 $2.50

6501100 AMPICILLIN/SULBACT (UNASYN)3 GM:IM J0295 $69.80

6501106 FLAVOXATE HCL (URISPAS) TAB : 100MG A9270 $3.80

6501108 BETAMETHASONE VAL(VALISONE) CRM 0.1%:15G A9270 $16.10

6501113 VANCOMYCIN (VANCOCIN) INJ : 1000MG J3370 $65.60

6501114 VANCOMYCIN (VANCOCIN) ADV INJ : 500MG J3370 $46.60

6501115 VANCOMYCIN (VANCOCIN) INJ : 500MG J3370 $46.90

6501117 VANCOMYCIN (VANCOCIN) ADV INJ : 1GM J3370 $78.45

6501119 ALBUTEROL(PROVENTIL) INH SOL BULK : 20ML $15.70

6501121 VERAPAMIL HCL (CALAN) INJ 2.5MG/ML:2ML $28.70



6501125 MIDAZOLAM (VERSED)INJ 1MG/ML:2ML J2250 $27.97

6501126 MIDAZOLAM HCL(VERSED)INJ 5MG/ML:2ML J2250 $28.89

6501135 PHYTONADIONE neonate (VIT K1)INJ : 1MG J3430 $38.36

6501143 PEN G PROCAINE(WYCILLIN)INJ 600000U:1ML J2510 $62.20

6501144 PEN G PROCAINE(WYCILLIN)INJ 1200000U:2ML J2510 $85.90

6501147 LIDOCAINE MDV (XYLOCAINE) INJ 0.5% :1ML $2.78

6501148 LIDOCAINE W/EPI MDV INJ 1% :1 VIAL $11.20

6501150 LIDOCAINE 2%W/EPI 1:100,000 MDV INJ: VIA $22.13

6501151 LIDOCAINE TOPICAL SOL 4% : 50ML $26.31

6501152 LIDOCAINE HCL (XYLOCAINE) OINT 5% : 35GM $189.80

6501157 RANITIDINE HCL (ZANTAC) TAB : 150MG A9270 $2.00

6501158 meTOLaZONE (ZAROXOLYN) TAB : 2.5 MG A9270 $3.40

6501159 meTOLaZONE (ZAROXOLYN) TAB : 5MG A9270 $9.28

6501161 AZITHROMYCIN (ZITHROMAX) TAB : 250MG A9270 $20.24

6501162 SIMVASTATIN (ZOCOR) TAB : 10MG A9270 $2.50


6501165 ACYCLOVIR (ZOVIRAX) OINT 5% : 30GM A9270 $498.90

6501219 FLECAINIDE (TAMBOCOR) TAB : 100MG A9270 $7.10

6501229 THIOTHIXENE (NAVANE) CAP : 1MG A9270 $2.25

6501234 NA FERRIC GLUCON (FERRLECIT)INJ : 12.5MG J2916 $44.80

6501236 TRIAMTERNE/HCTZ (MAXZIDE) TAB 75/50MG A9270 $2.40

6501239 ACETAMINOPHEN(TYLENOL)MELTAWAY TAB:80MG A9270 $2.50

6501242 MOEXIPRIL (UNIVASC) TAB : 7.5MG A9270 $3.57

6501258 BUPROPION SR (WELLBUTRIN) TAB : 150MG A9270 $13.30

6501260 ONDANSETRON (ZOFRAN) TAB : 8MG A9270 $107.30

6501261 ACYCLOVIR (ZOVIRAX) CAP : 200MG A9270 $2.50

6501268 BIOTENE MOUTHWASH SOL : 473ML A9270 $15.00

6501276 BUTORPHANOL (STADOL) SPRAY 10MG : 2.5ML A9270 $195.70

6501414 ANTIPYRINE/BENZ (AURALGAN)OTIC SOL :15ML A9270 $31.10

6501469 PROPYLENE GLYCOL LIQ : 5ML A9270 $8.50

6501470 CARBAMAZEPINE(TEGRETOL)SUSP 20MG/ML: 5ML A9270 $2.50

6501561 POTASSIUM CHLOR (K-CLON-M) TAB : 10MEQ A9270 $4.10

6501562 POTASSIUM CHLOR (KLOR-CON M) TAB : 20MEQ A9270 $2.50

6501568 POTASSIUM CHLOR EFFER(K-LYTE)TAB : 25MEQ A9270 $2.50

6501572 TRAIAMCINOLONE(KENALOG)0.1% LOTION:60ML A9270 $110.30

6501578 PETRO/MINERAL OIL(LACRI-LUBE)OINT:3.5GM A9270 $24.60

6501582 NASAL SPRAY MOISTURIZING(DEEP SEA):45ML A9270 $12.10

6501584 glipiZIDE **XL** (GLUCOTROL XL): 5MG A9270 $2.50

6501585 metFORMin (GLUCOPHAGE) TAB : 500MG A9270 $2.50

6501586 GENTAMICIN : 1MG J1580 $0.80

6501587 DIGOXIN (LANOXIN) TAB : 0.125MG A9270 $2.50

6501588 DIGOXIN (LANOXIN) TAB : 0.25MG A9270 $2.50



6501591 LEVOTHYROX(SYNTHROID) : 0.125MG A9270 $2.50

6501592 LEVOTHYROX(SYNTHROID) : 0.175MG A9270 $2.50

6501594 RISPERIDONE (RISPERDAL) TAB : 1MG A9270 $3.97

6501596 FUROSEMIDE (LASIX) INJ 40MG : 4ML J1940 $30.59

6501599 FERROUS SULFATE (FEOSOL) TAB : 325MG A9270 $2.50

6501600 VALPROIC ACID (DEPAKENE)LIQ 50MG/ML:5ML A9270 $7.30

6501602 PHENYLEP/PYRILAM/DM(CODIMAL DM):5ML $2.50

6501605 ERGOCALCIF (CALCIFEROL) DRP 8000/ML:60ML $289.50

6501609 TROLAMINE SALICYLATE(ASPERCREME)CRM:85GM A9270 $16.00

6501611 SENNOSIDES (EX LAX) TAB A9270 $2.00

6501612 TIMOLOL (TIMOPTIC XE)OPTH SOL 0.25% :5ML A9270 $295.70

6501613 TIMOLOL (TIMOPTIC XE) OPTH SOL 0.5% :5ML A9270 $91.10

6501614 PHOSPHO SODA LIQ : 45ML A9270 $9.30

6501615 TAO/DESTITIN/VIT/A&D (GOOP) OINT : 90GM A9270 $20.10

6501617 OXYBUTYNIN (DITROPAN) SYR 1MG/ML : 5ML A9270 $2.50

6501621 GLYCERIN SOL : 5ML A9270 $2.50

6501625 IODINE STRONG SOL : 15ML A9270 $57.20

6501626 MINERAL OIL LIGHT SPRAY : 30ML A9270 $6.30

6501627 HYDROcodone/APAP (LORTAB) ELX : 5ML A9270 $2.50

6501628 DIGOXIN ORAL LIQ 0.05MG/ML : 60ML A9270 $90.50

6501631 PSYLLIUM (METAMUCIL) PWD BULK : 368GM A9270 $21.20

6501633 NAPROXEN (NAPROSYN) SUSP 25MG/ML: 5ML A9270 $2.50

6501634 PRIMIDONE (MYSOLINE) SUSP : 50MG A9270 $14.30

6501637 BISMUTH SUBSALICY(PEPTO BISMOL)LIQ:120ML A9270 $12.50

6501639 predniSOLone (ORAPRED)SYR 3MG/ML:20ML J7510 $74.91

6501640 PROMETHAZINE VC (PHENERGAN VC) SYR : 5ML A9270 $2.50

6501641 CYLCLOSPOR(SANDIMMUNE)SOL 100MG/ML:50ML A9270 $1,274.10

6501642 PROMETHAZINE VC/COD(PHENE/VC/COD)LIQ:5ML A9270 $2.50

6501649 SALVIA SYNTHETIC (SALIVART) SOL : 120ML A9270 $13.20

6501651 LIDOCAINE (XYLOCAINE) 10% SPRAY : 30M $129.70

6501652 niFEDipine**XL* (PROCARDIA XL TAB) :90MG A9270 $6.70

6501661 MESALAMINE (ROWASA) ENEMA 6.67MG : 60ML A9270 $43.30

6501668 ZOLPIDEM TART (AMBIEN) TAB : 5MG A9270 $9.60

6501670 CEFACLOR (CECLOR) CAP : 250MG A9270 $5.20

6501671 ceFUROxime (CEFTIN) TAB : 250MG A9270 $11.50

6501672 VERAPAMIL **SR** (ISOPTIN SR) TAB :180MG A9270 $3.20

6501673 LORATADINE (CLARITIN) TAB : 10MG A9270 $2.50

6501674 DIVALPROEX (DEPAKOTE) TAB DR : 250MG A9270 $12.78

6501675 DIVALPROEX (DEPAKOTE) TAB : 125MG A9270 $2.91

6501677 MISOPROSTOL (CYTOTEC) TAB : 100MCG A9270 $2.50

6501678 PROCHLORPERAZINE TAB : 5MG A9270 $2.50

6501679 cloNIDINE (CATAPRES) TAB : 0.1MG A9270 $2.50

6501680 CEFADROXIL (DURICEF) CAP:500MG A9270 $16.20

6501682 VENLAFAXINE (EFFEXOR) TAB : 25MG A9270 $5.10

6501687 APAP/BUTABARB/CAFF (FIORICET) TAB A9270 $2.50

6501688 FERROUS GLUCON TAB : 324MG (5 GR) A9270 $2.50

6501689 VENLAFAXINE (EFFEXOR) TAB:37.5MG A9270 $5.20

6501690 VITAMIN/MIN (GERITOL) COMPLETE TAB A9270 $2.50

6501692 GUIAFENESIN-LA (MUCINEX) TAB : 600MG A9270 $2.50

6501694 IBUPROFEN (ADVIL) TAB : 200MG A9270 $2.50

6501697 terBINafine (LAMISIL) TAB : 250MG A9270 $19.20

6501698 DONEPEZIL (ARICEPT) TAB : 5MG A9270 $22.75

6501699 HYOSCYAMINE SA (LEVBID) TAB : 0.375MG A9270 $3.60

6501700 ENOXAPARIN (LOVENOX) INJ : 30MG J1650 $94.90

6501701 glyBURIDE (GLYNASE) TAB : 3MG A9270 $2.50

6501702 NIFEDipine (PROCARDIA) CAP : 10MG A9270 $2.50

6501703 CALCIUM/VIT D (OSCAL) TAB : 500MG A9270 $2.50

6501704 BISMUTH SUBSALIC(PEPTO BISMOL)TAB:262MG A9270 $2.50

6501706 PRAVASTATIN (PRAVACHOL) TAB : 20MG A9270 $8.60

6501708 LISINOPRIL (ZESTRIL) TAB : 10MG A9270 $2.60

6501709 PROBENECID/COLCHICINE TAB 500/0.5MG A9270 $2.50

6501710 PROMETHAZINE (PHENERGAN) TAB : 25MG A9270 $2.50

6501720 CETIRIZINE (ZYrtec) TAB : 10MG A9270 $3.22

6501729 SALMETEROL (SEREVENT) DISKUS 50MCG A9270 $695.60

6501730 FLUTICASONE (FLONASE)NASAL SPRAY : 16GM A9270 $195.70

6501731 ESTROPIPATE (ORTHO-EST) TAB:1.5MG A9270 $2.50

6501798 PROPRANOLOL **LA** (INDERAL LA) CAP:80MG A9270 $12.80


6501807 CLARITHROMYCIN(BIAXIN)SUSP 50MG/ML:100ML A9270 $215.60

6501808 CALCITROL (ROCALTROL) CAP : 0.25MCG A9270 $3.20

6501809 FINASTERIDE (PROSCAR) TAB : 5MG A9270 $8.20

6501810 FLUOXETINE (PROZAC) CAP : 10MG A9270 $6.80

6501812 PSEUDOEPHEDRINE (SUDAFED) TAB : 60MG A9270 $2.50

6501813 NABUMETONE (RELAFEN) TAB : 500MG A9270 $3.40

6501814 SMX/TMP (BACTRIM) SUSP 200MG/40MG: 5ML A9270 $2.50

6501823 PHYTONADIONE adult (VITAMIN K1)INJ :10MG J3430 $95.07

6501825 SODIUM CHLORIDE 0.9% ADV : 100ML $30.60

6501827 FLUCONAZOLE/NS 200MG:100ML PRE-DEFINED J1450 $53.49

6501829 NAPROXEN CR (NAPRELEN CR) TAB : 375MG A9270 $8.20

6501832 TPN ***WITH LIPIDS** CENTRAL LINE $520.00

6501834 TPN PERIPHERAL LINE **NO LIPIDS** $520.00

6501836 LABETALOL (TRANDATE) TAB : 200MG A9270 $2.50

6501837 CALCIUM CARBONATE (TUMS) TAB : 500MG A9270 $2.50

6501838 CALCIUM CARBONATE (TUMS E X) TAB : 750MG A9270 $2.50

6501839 ENALAPRIL (VASOTEC) TAB : 2.5MG A9270 $2.50

6501840 ENALAPRIL (VASOTEC) TAB : 5MG A9270 $2.50

6501841 ASCORBIC ACID (VITAMIN C) TAB : 250MG A9270 $2.50

6501843 ZINC SULFATE CAP : 220MG A9270 $1.50

6501845 POTASSIUM CHLORIDE SOL 1.33MEQ/ML : 15ML A9270 $2.50

6501857 GABAPENTIN (NEURONTIN) CAP : 400MG A9270 $3.50


6501867 COSYNTROPIN (CORTROSYN) INJ : 0.25MG J0834 $257.60

6501868 DEXTROSE 5% IV SOLN : 1000ML $57.00


6501892 METHYLCELLULOSE (CITRUCEL) POWDE : 454GM A9270 $21.10

6501896 QUINAPRIL (ACCUPRIL) TAB : 10MG A9270 $2.50

6501898 URSODIOL (ACTIGALL) CAP : 300MG A9270 $7.40

6501899 ALBUTEROL (PROVENTIL) TAB : 4MG A9270 $2.50

6501903 AMOXICILLIN (AMOXIL) CHEW TAB : 250MG A9270 $2.50

6501905 AMPICILLIN (POLYCILLIN) CAP : 500MG A9270 $2.50

6501906 FLURBIPROFEN (ANSAID) TAB : 100MG A9270 $3.10

6501907 MESALAMINE (ASACOL) TAB : 400MG A9270 $5.33

6501908 ASA/AL & MG HYD CA (ASCRIPTIN)TAB:325MG A9270 $2.50

6501910 terBUTaline (BRETHINE) TAB : 5MG A9270 $2.50

6501911 niCARDipine (CARDENE) CAP : 20MG A9270 $2.50

6501912 niCARDipine (CARDENE) CAP : 30MG A9270 $2.50

6501914 DILTIAZEM **LA**(CARDIZEM LA)TAB:120MG A9270 $6.20

6501920 DOXAZOSIN (CARDURA) TAB : 1MG A9270 $2.50

6501922 CHLORDIAZEP/CLIDIN (LIBRAX) CAP 5/2.5 MG A9270 $2.50

6501924 CHLORTHALIDONE (HYGROTON) TAB : 25MG A9270 $2.50

6501929 AMIODARONE (CORDARONE) TAB : 200MG A9270 $8.60

6501931 LOSARTAN (COZAAR): TAB 50MG A9270 $6.99

6501935 MEPERIDINE (DEMEROL) PCA 10MG/ML : 30ML J2175 $52.20

6501938 AMOX/CLAV (AUGMENTIN) SUSP 50MG/ML:100ML A9270 $224.80

6501939 CEFPROZIL (CEFZIL) SUSP 50MG/ML : 75ML A9270 $149.40

6501940 CLINDAMYCIN (CLEOCIN) SUSP 15MG/ML:100ML A9270 $158.90

6501941 CEFADROXIL (DURICEF) SUSP 100MG/ML:75ML A9270 $164.20

6501947 ceFIXime (SUPRAX) SUSP 20MG/ML : 50ML A9270 $341.60

6501950 OXAPROZIN (DAYPRO) TAB : 600MG A9270 $3.80

6501951 TORSEMIDE (DEMADEX) TAB : 20MG A9270 $2.50

6501952 acetaZOLAMIDE (DIAMOX) TAB : 250MG A9270 $1.40

6501957 AZTREONAM (AZACTAM) 1 GM INJECTION $127.80

6501958 ETIDRONATE (DIDRONEL) TAB : 200MG A9270 $30.80

6501969 SELEGILINE (ELDEPRYL) CAP:5MG A9270 $6.00

6501971 ASPIRIN ENTERIC COATED (ECOTRIN)TAB:81MG A9270 $2.50

6501974 APC CPD (EXCEDRIN) X-STR TAB A9270 $2.50

6501976 FLUTAMIDE CAP : 125MG A9270 $5.43

6501979 POLYCARBOPHIL (FIBERCON) TAB : 625MG A9270 $2.50

6501980 FLUDROCORTISONE (FLORINEF) TAB : 0.1MG A9270 $2.50

6501985 ALENDRONATE (FOSAMAX) TAB : 10MG A9270 $2.50

6501986 ALUM & MAG HY (GAVISCON) TAB 80/20MG A9270 $2.50

6501987 metFORMin (GLUCOPHAGE) TAB : 850MG A9270 $3.20

6501989 D5W LR IV SOLN : 1000ML $52.50

6501991 FEXOFENADINE (ALLEGRA) TAB : 60MG A9270 $3.70

6501992 RAMIPRIL (ALTACE) CAP : 5MG A9270 $5.50

6501999 NOREPINEPHRINE(LEVOPHED)INJ 1MG/ML:4ML $34.98

6502001 FENTANYL(DURAGESIC)PATCH 100MCG/H A9270 $163.80

6502002 FENTANYL(DURAGESIC)PATCH 25MCG/HR A9270 $37.50

6502003 glipiZIDE **XL** (GLUCOTROL XL) : 10MG A9270 $2.50


6502006 HYDRALAZINE (APRESOLINE) TAB : 25MG A9270 $2.50

6502007 HYDROXYUREA (HYDREA) CAP : 500MG A9270 $3.40

6502008 TERAZOSIN HCL (HYTRIN) CAP : 5MG A9270 $4.16

6502010 SUMATRIPTAN (IMITREX) TAB : 50MG A9270 $66.50

6502011 PROPRANOLOL **LA** (INDERAL LA)CAP:60MG A9270 $2.90

6502015 PROPRANOLOL **LA** (INDERAL LA)CAP:120MG A9270 $5.30

6502018 SODIUM BICARBONATE TAB : 650MG A9270 $2.50

6502019 ISOXSUPRINE (VASODILAN) TAB : 10MG A9270 $2.50

6502021 LACTASE (LACTAID) 9000 FCC UNIT :TAB A9270 $30.60

6502023 HYOSCYAMINE (LEVSIN)**SL** TAB : 0.125MG A9270 $2.50

6502027 PHOSPHATE MIX(NEUTRA-PHOS)PACKET : 250MG A9270 $2.00

6502028 ENALAPRILAT (VASOTEC) INJ : 1.25MG $31.24

6502030 ETODOLAC (LODINE) CAP : 300MG A9270 $3.80

6502031 BENAZEPRIL (LOTENSIN) TAB : 5MG A9270 $2.73

6502033 INDAPAMIDE (LOZOL) TAB : 2.5MG A9270 $2.50

6502035 METHYLPREDNIS(MEDROL DOSEPAK)TAB 4MG:21 A9270 $203.01

6502038 METHOCARBAMOL (ROBAXIN) TAB : 500MG A9270 $2.25

6502042 ISOMETHEPT/DICHLO/AP (MIDRIN) CAP A9270 $9.49

6502046 ETHAMBUTOL (MYAMBUTOL) TAB : 400MG A9270 $4.50

6502048 PRIMIDONE (MYSOLINE) TAB : 50MG A9270 $2.50

6502049 NAPROXEN CR (NAPRELEN CR) TAB : 500MG A9270 $3.50




6502054 NICOTINE POLACRIL(NICORETTE) GUM 2MG: A9270 $3.99

6502057 DESIPRAMINE (NORPRAMIN) TAB : 10MG A9270 $2.50

6502058 NORTRIPTYLINE (PAMELOR) CAP : 25MG A9270 $2.50

6502060 PALIPERIDONE ER(INVEGA ER) TAB: 3 MG A9270 $40.90

6502063 METOPROLOL succ *ER* (TOPROL XL) : 50MG A9270 $2.80

6502065 ACETIC ACID (VOSOL) OTIC SOL 2% : 60ML A9270 $187.20

6502066 COUGH DROPS (HALLS) A9270 $7.80


6502068 BROMOCRIPTINE (PARLODEL) TAB : 2.5MG A9270 $8.90

6502070 TRANYLCYPROMINE (PARNATE) TAB : 10MG A9270 $1.30

6502071 ERTHROMYCIN PARTICL (PCE) TAB : 333MG A9270 $20.00

6502073 D5W 1/2NS + KCL 40MEQ IV : 1000ML J3480 $57.00

6502074 D5W 1/2NS + KCL 20MEQ IV : 1000ML $28.80

6502075 D5W 1/4NS + KCL 20MEQ IV : 1000ML $30.00

6502077 NAFCILLIN (NAFCIL) INJ : 2GM $92.00


6502079 D5W NS + KCL 20MEQ IV : 1000ML $30.00

6502081 ADENOSINE (ADENOCARD)INJ 3MG/ML:4ML J0153 $109.30

6502082 ESMOLOL (BREVIBLOC) 10MG/ML:10ML $84.80

6502083 D5W NS + KCL 40MEQ IV : 1000ML $30.00

6502084 D5W LR + KCL 20MEQ IV : 1000ML $30.00

6502085 D5W LR + KCL 40MEQ IV : 1000ML $30.00

6502087 AZITHROMYCIN (Z-PACK) TAB : 250MG A9270 $121.30

6502091 MILK OF MAGNESIA (MOM) TAB : 311MG A9270 $1.00

6502092 HYDROXYCHLORQUIN (PLAQUENIL)TAB:200MG A9270 $3.20

6502093 FELODIPINE (PLENDIL-ER) TAB : 5MG A9270 $4.00

6502095 ESTROGENS CONJUGATE(PREMARIN)TAB : 0.3MG A9270 $5.25

6502096 ESTROGENS CONJUGATE(PREMARIN)TAB : 0.9MG A9270 $4.30

6502099 MEDROXYPROGESTERONE (PROVERA) TAB : 5MG A9270 $2.25

6502101 PYRAZINAMIDE TAB : 500MG A9270 $3.20

6502102 quiNIDine GLUC (QUNINAGLUTE) TAB : 324MG A9270 $2.50

6502103 NABUMETONE (RELAFEN) TAB : 750MG A9270 $4.10

6502109 NEFAZODONE (SERZONE) TAB : 100MG A9270 $4.00

6502110 CARBIDOPA/LEVOD(SINEMET-CR)TAB 25/100MG A9270 $2.90

6502111 CARBIDOPA/LEVOD(SINEMET-CR):50/200MG A9270 $4.80

6502112 METAXALONE (SKELAXIN) TAB : 800MG A9270 $10.50


6502120 meTHIMaZOLE (TAPAZOLE) TAB : 5MG A9270 $2.50

6502123 CARBAMAZEPINE *ER (TEGRETOL-XR)TAB:200MG A9270 $2.50

6502131 TICLOPIDINE (TICLID) TAB : 250MG A9270 $16.12

6502134 PENTOXIFYLLINE (TRENTAL) TAB : 400MG A9270 $2.00

6502135 TRIAMTERENE/HCTZ CAP 50/25MG A9270 $2.50

6502145 ATORVASTATIN (LIPITOR) TAB : 10MG A9270 $8.30

6502149 VITAMIN E CAP : 200 IU A9270 $2.50

6502150 VITAMIN E CAP : 400 IU A9270 $2.50

6502151 VITAMIN E CAP : 1000 IU A9270 $2.50

6502152 buPROPion (WELLBUTRIN) TAB : 75MG A9270 $2.50

6502153 buPROPion (WELLBUTRIN) TAB : 100MG A9270 $2.50

6502154 LISINOPRIL/HCTZ(ZESTORETIC)TAB 10/12.5MG A9270 $2.90

6502155 LISINOPRIL/HCTZ(ZESTORETIC)TAB 20/12.5MG A9270 $3.20

6502156 LISINOPRIL/HCTZ(ZESTORETIC)TAB 20/25MG A9270 $3.14

6502157 BISOPROLOL/HCTZ (ZIAC) TAB 2.5/6.25MG A9270 $3.00

6502159 ONDANSETRON (ZOFRAN) ODT TAB : 4MG A9270 $58.00

6502162 OLANZAPINE (ZYprexa) TAB : 5MG A9270 $34.40

6502163 OXYMETAZOLINE (AFRIN) SPRAY 0.05% : 30ML A9270 $14.10

6502167 HEXLRESORCINOL (SUCRETS) LOZENGE A9270 $8.40

6502168 NITROGLYCERIN(NITROLINGUAL)SPRAY 0.4MG $12.50

6502170 IPRATROPIUM HFA(ATROVENT)INH:12.9GM A9270 $1,123.77

6502173 BECLOMETHASONE (QVAR) INH:40 MCG A9270 $204.70

6502174 PIRBUTEROL (MAXAIR) INH : 14GM A9270 $316.70

6502176 SODIUM CHLOR INHALATION 0.9%: 3ML $2.50

6502177 SODIUM CHLORIDE INH 0.9% : 15ML $5.07

6502184 AQUAPHILIC OINT : 454GM A9270 $22.80

6502185 AQUAPHILIC W/CARBAMD OINT : 454GM A9270 $26.00

6502186 FERRIC SUBSULFATE (ASTRINGYN) SOL :8GM $28.80

6502191 BACITRACIN/POLYMY(POLYSPORIN)OINT: 30GM A9270 $17.90

6502192 MUPIROCIN (BACTROBAN) OINT 2% : 22GM A9270 $100.70

6502193 MICONAZOLE NIT (BAZA) CRM 2% : 142GM A9270 $20.50

6502194 METHYL SALIC/MENTHOL(BEN GAY) CRM : 57GM A9270 $13.90

6502195 POVIDONE/IODINE(BETADINE)UD PCKT:1GM A9270 $2.50

6502196 BENZOCAINE (BENZODENT) CR : 7GM A9270 $12.70

6502197 ENEMA (FLEET ENEMA) A9270 $1.50

6502198 BIOTENE TOOTHPASTE : 126GM A9270 $83.20

6502199 CLONIDINE (CATAPRES-TTS) PATCH 0.1MG A9270 $66.10



6502204 COLLODION- LIQ : 120ML A9270 $37.00


6502208 BACTIRACIN/POL/NEO(CORTISPORIN)OINT:15GM A9270 $255.66

6502210 SOD HYPOCHLORITE 0.25%(DAKIN'S SOL)473ML A9270 $23.00

6502211 DESITIN MAX STRENGTH OINT : 60GM A9270 $12.90

6502212 DIAZEPAM (VALIUM) INJ 5MG/ML : 2ML J3360 $34.50

6502213 DIPHENHYDRAMINE (BENADRYL) CRM 2% : 30GM A9270 $16.60

6502217 MOMETASONE (ELOCON) CRM 0.1% : 15GM A9270 $69.60

6502218 MOMETASONE (ELOCON) OINT 0.1% : 15GM A9270 $63.20

6502219 MOMETASONE (ELOCON) LOTION 0.1% : 30ML A9270 $77.70

6502222 ESTRADIOL (ESTRADERM) PATCH 0.1MG A9270 $22.60

6502223 EUCERIN CRM : 120GM A9270 $16.40

6502225 THIOPENTAL SODIUM (PENTOTHAL)INJ : 500MG $33.90

6502226 AMPICILLIN (POLYCILLIN) 2GM:IM INJ J0290 $60.30

6502227 fluocinoNIDE (LIDEX) CRM 1% : 60GM A9270 $71.00

6502228 FLUOROURACIL (FLUORPLEX) CRM 1% : 30GM A9270 $1,201.20

6502229 ABSORB GELATIN (GELFOAM) SPG SIZE 100 $132.57

6502230 GENTIAN VIOLET SOL 1% : 30ML A9270 $8.40

6502232 terBINafine (LAMISIL-AF) CRM 1% : 30GM A9270 $31.80

6502233 LANOLIN HYDROUS OINT : 60GM A9270 $15.80

6502234 fluocinoNIDE (LIDEX) SOL 0.05% : 20ML A9270 $67.20

6502235 LINDANE (KWELL) LOTION 1% : 60ML A9270 $355.90

6502236 LINDANE (KWELL) SHAMPOO 1% : 60ML A9270 $355.90

6502240 MICONAZOLE (MONISTAT) VAGINAL SUPP 7's A9270 $16.10

6502241 MINERAL OIL LIQ STERILE:25ML A9270 $15.08

6502243 KETOCONAZOLE (NIZORAL) SHAMPOO 2%: 120ML A9270 $72.20

6502245 NICOTINE TRANSDERMAL PATCH 7MG A9270 $6.30



6502248 KETOCONAZOLE (NIZORAL) CRM 2% :30GM A9270 $42.77

6502249 DILTIAZEM (CARDIZEM) TAB : 90MG A9270 $2.70

6502250 SALIVA SUBSTITUTE(SALIVART)SPRAY:40ML A9270 $176.00

6502257 ESTROGENS CONJ (PREMARIN) VAG CRM : 43GM A9270 $382.50

6502259 PEG-3550/ELECTROLYTE (COLYTE) SOL:4000ML $82.90

6502262 SWEEN CRM : 57GM A9270 $12.20

6502264 NEUTROGENA (T GEL) SHAMPOO : 251ML A9270 $18.80

6502265 THROMBIN ***TOPICAL*** : 5000 UNITS $223.91

6502266 TRIAMCINOLONE(KENALOG) OINT 0.1% : 454GM A9270 $78.00

6502267 LIDOCANE HCL (XYLOCAINE) JELLY 2% : 5ML $20.30

6502268 NEOMY/BACITRAC(TRIPLE ANTIBIOTIC)PCK:1GM A9270 $3.50

6502269 VICKS VAPORUB OINT : 90GM A9270 $16.80

6502271 CAPSAICIN (ZOSTRIX) CRM 0.025% : 60GM A9270 $17.90

6502272 BALANCED SALT (BSS) SOL : 15ML $18.80

6502274 SOD CHLORI (ADSORBONAC) OPTH SOL 5%:15ML A9270 $31.50

6502276 LODOXAMIDE (ALOMIDE) OPTH SOL 0.1% :10ML A9270 $168.40

6502277 BRIMONIDIN(ALPHAGAN) OPTH SOL 0.2% : 5ML A9270 $84.90

6502279 ORAJEL GEL : 10GM A9270 $11.60

6502280 ATROPINE SUL OPTH OINT 1%:3.5GM $39.90

6502282 LEVOBUNOLOL(BETAGAN)OPTH SOL 0.5%:5ML $41.20

6502284 SULFACET/PRED(BLEPHAMIDE)OPTH OINT:3.5GM A9270 $163.75

6502286 CELLUVISC OPTH SOL 1% : 30'S $26.90

6502288 NEO/POLY/HC (CORTISPORIN)OPTH SUSP:7.5ML A9270 $191.80

6502289 CYCLOPENTOLATE(CYCLOGYL)OPTH SOL 1%:2ML $20.00

6502291 FLUOROMETHOLONE (FML)OPTH SUSP 0.1%: 5ML A9270 $26.20

6502292 FLUOROMETHOLONE(FML)OPTH OINT 0.1%:3.5GM A9270 $94.70

6502293 GENTAMICIN(GARAMYCIN)OPTH SOL 0.3% : 5ML A9270 $57.90

6502296 APRACLONIDINE(IOPIDINE)OPTH SOL 1%:0.1ML A9270 $128.49

6502299 NEOMY/POLY/DEXAME(MAXITROL)OPTH SUSP:5ML A9270 $179.30

6502300 NEOMY/POLY/DEXA(MAXITROL)OPTH OINT:3.5GM A9270 $114.40

6502302 CARBACHOL (MIOSTAT)OPTH SOL 0.01% :1.5ML A9270 $83.60

6502303 SODIUM CHLORIDE(SALINE) OPTH SOL 5%:15ML A9270 $30.30

6502304 TROPICAMIDE OPTH SOL 1% : 2ML $10.00

6502305 PHENYLEPHRINE(MYDFRIN)OPTH SOL 2.5%:3ML $23.34

6502306 TROPICAMIDE(MYDRIACYL) OPTH SOL 1%: 15ML $94.00

6502307 DESMOPRESSIN ACET(DDAVP)4MCG/ML:1ML J2597 $198.34

6502308 FLURBIPROFEN(OCUFEN)OPTH SOL 0.03%:2.5ML $22.70

6502309 OFLOXACIN (OCUFLOX) OPTH SOL 0.3% : 5ML A9270 $108.50

6502311 PILOCARPINE (PILOPINE HS)OPTH GEL 4%:4GM A9270 $190.16

6502317 TRIMETHORP/POLY(POLYTRIM)OPTH SOL :10ML A9270 $45.30

6502319 LUBRICANT EYE DROPS (REFRESH) 30's A9270 $26.10

6502320 DIGOXIN IMMUNE FAB (DIGIFAB) INJ :40MG J1162 $9,837.50

6502321 EPOETIN ALFA (EPOGEN) INJ : 10,000 UNITS J0885 $423.74

6502323 EPOETIN ALFA (EPOGEN) INJ : 4,000 UNITS J0885 $181.10

6502324 LUBRICANT EYE DROP (REFRESH PLUS) 30's A9270 $21.10

6502325 LUBRICANT (REFRESH P M)OPTH OINT : 3.5GM A9270 $21.90

6502326 LUBRICANT (TEARS NAT II)EYE DROP:15ML A9270 $23.40

6502327 SOD CHLORIDE 0.45% IV SOLN : 1000ML $52.60

6502328 TOBRA/DEXAM (TOBRADEX)OPTH OINT:3.5GM $638.09

6502329 TOBRAMYCIN (TOBREX)OPTH OINT 0.3%:3.5GM A9270 $345.07

6502331 GLYCERIN PEDIATRIC SUPP A9270 $2.50

6502332 DORZOLAMIDE (TRUSOPT)OPTH SOL 2%: 10ML A9270 $220.35

6502334 RIMEXOLONE (VEXOL) OPTH SUSP 1% : 5ML A9270 $95.90


6502339 LUBRIDERM LOTION : 177ML A9270 $8.40

6502340 ALUM/MG HYD/SIME SUSP : 355ML A9270 $12.50

6502346 INSULIN LISPRO(HUMALOG)100 UNIT/ML:10ML A9270 $1.30

6502347 INDOMETHACIN (INDOCIN) SUPP : 50MG A9270 $26.80

6502348 LACTOBACILLUS (LACTINEX) GRANULES A9270 $26.80

6502349 CALCITONIN(MIACALCIN)NASAL SPR:2200IU A9270 $385.50

6502353 FAMOTIDINE (PEPCID)INJ 10MG/ML:2ML $26.90

6502365 D5W 1/4NS IV SOLN : 1000ML $49.50

6502366 AMIKACIN (AMIKIN) INJ 250MG/ML:2ML J0278 $101.57

6502368 PROGESTERONE MDV INJ : 50MG J2675 $22.50

6502369 OXACILLIN (BACTOCILL) 2GM:IM INJ J2700 $92.00

6502371 SODIUM CHLORIDE BACT INJ : 30ML $18.00

6502372 ZAFIRLUKAST (ACCOLATE) TAB : 20MG A9270 $5.20

6502373 LIDOCAINE (XYLOCAINE) MDV INJ 1%: 1ML $2.50

6502374 RIFAMPIN (RIFADIN) CAP : 300MG A9270 $6.80

6502375 METHOTREXATE TAB : 2.5MG A9270 $3.90

6502378 CHLORHEXIDINE GLU(HIBICLENS)SOL 4%:946ML A9270 $36.00

6502382 SPINAL TRAYS $319.60

6502383 EPIDURAL TRAYS $344.80

6502384 ZINC OXIDE OINT 20% : 30GM A9270 $11.60

6502385 SILVER NITRATE 1% SOL : 1000ML $12.50

6502387 SINCALIDE (KINEVAC) INJ : 5MCG J2805 $285.39


6502395 CEFOtaxIME (CLAFORAN) 1GM:IM INJ J0698 $50.54

6502397 SMX/TMP (BACTRIM) INJ 400/80MG $36.00

6502398 TOBRAMYCIN (NEBCIN) INJ 40MG/ML:2ML J3260 $30.02

6502399 CEFOtaxIME (CLAFORAN) 2GM:IM INJ J0698 $38.23

6502400 TICARCILLIN/CLAVU (TIMENTIN) INJ : 3.1GM $69.20

6502402 AMPICILLIN/SULBACT (UNASYN)1.5GM:IM J0295 $67.09

6502403 PIPERACILLIN/TAZO (ZOSYN) INJ : 3.375GM J2543 $51.61


6502405 ACYCLOVIR (ZOVIRAX) INJ : 500MG J0133 $51.00

6502409 BUMETANIDE (BUMEX) INJ 0.5MG : 2ML $29.40

6502410 BUMETANIDE (BUMEX) INJ 0.25MG/ML : 4ML $28.60

6502411 METHYLPREDNISOL (SOLU-MEDROL) INJ : 40MG J2920 $40.41

6502412 BUMETANIDE (BUMEX) INJ 0.25MG : 10ML $40.50

6502413 CAFFEINE/NA BENZOATE INJ : 250MG $45.30

6502414 CALCIUM CHLORIDE 10% INJ 100MG : 10ML $27.10

6502415 IRRIG SODIUM CHLORIDE 0.9% SOLN : 1000ML $47.00

6502416 DICLOFENAC/MIS (ARTHROTEC) TAB 50/200MG A9270 $5.20

6502417 FEXOFENADINE (ALLEGRA-**D*) TAB 60/120MG A9270 $6.20

6502418 ANASTROZOLE (ARIMIDEX) TAB : 1MG A9270 $28.60

6502424 GANCICLOVIR (CYTOVENE) INJ : 50MG J1570 $186.70

6502425 MEDROXYPROGESTONE(DEPO-PROVERA)INJ:150MG J1050 $269.73

6502426 DEFEROXAMINE (DESFERAL) INJ : 500MG J0895 $54.12

6502427 DEXAMETHASONE (DECADRON) INJ 4MG/ML:30ML J1100 $79.70

6502429 DEXTROSE INJ 10% : 5ML $30.00

6502430 POLYMYXIN B INJ : 500,000 UNITS $66.30

6502432 LYMPHOCYTE IMMUNE (ATGAM) INJ : 50MG J7504 $5,193.76

6502433 INDAPAMIDE (LOZOL) TAB : 1.25MG A9270 $2.25

6502434 CLOTRIMAZOLE(LOTRIMIN AF) SOL 1% : 10ML A9270 $16.00

6502441 OCTREOTIDE ACET(SANDOSTATIN)INJ:100 MCG J2354 $557.05

6502442 TETANUS/DIPHTH-PED INJ : 0.5ML 90702 $30.90

6502445 TRIFLURIDINE (VIROPTIC) OPTH 1% : 7.5ML A9270 $813.59

6502446 ERYTHROMYCIN (ERYPED) SUSP 40MG/ML:100ML A9270 $551.20

6502447 VARICELLA-ZOST IG INJ : 125 UNITS 90396 $1,512.00

6502448 NYSTATIN (MYCOSTATIN) OINT 100,000U:15GM A9270 $12.30

6502450 ROCURONIUM (ZEMURON) INJ : 10MG $61.10

6502453 DIPHENHYDRAMINE (BENADRYL) MDV : 50MG J1200 $2.60

6502454 CHLOROTHIAZIDE (DIURIL) INJ : 500MG J1205 $955.80

6502456 ePHEDrine SULF INJ 50MG/ML:1ML J0171 $172.62

6502457 FLUPHENAZINE (PROLIXIN)INJ 25MG/ML:5ML J2680 $198.30

6502458 FLUORESCEIN (FLUORESCITE) INJ 10% $106.10

6502459 HALOPERIDOL (HALDOL DECANOAT) INJ : 50MG J1631 $449.40


6502463 HEPARIN MDV-30 INJ : 100 UNITS J1642 $12.25

6502466 SUMATRIPTAN (IMITREX) INJ 6MG: 0.5 ML J3030 $216.31

6502467 INDIGOTINDI(INDIGO CARMINE)INJ 0.8%:5ML $49.98

6502468 INDOMETHACIN (INDOCIN) INJ : 1MG $1,765.50

6502469 IRON DEXTRAN (INFED) INJ : 50MG J1750 $118.10

6502471 TRIAMCINOLONE(KENALOG)INJ 40MG/ML:1ML J3301 $54.30

6502472 KETAMINE INJ 100MG/ML:5ML $57.60

6502475 METOPROLOL (LOPRESSOR)INJ 1MG/ML:5ML $30.07

6502477 CARBOPROST (HEMABATE) INJ : 250MCG $1,093.83

6502478 PEN G BENZ (BICILLIN)CR : 900/300MG J0558 $154.90

6502479 PEN G BENZ(BICILLIN)LA 1,200,000 UNITS J0561 $473.73

6502480 PEN G BENZ (BICILLIN)LA 2,400,000 UNITS J0561 $921.92

6502481 CALCITONIN (MIACALCIN) INJ : 200 IU J0630 $7,125.00

6502484 FOSPHENYTOIN(cereBYX)IN 50MG PE/ML:2ML Q2009 $99.90

6502487 MULTI-VITAMIN W/VIT K A9270 $56.66

6502488 ESTRADIOL CYP (DEPO-ESTRADIOL) INJ : 5MG J1000 $25.00

6502489 EPOETIN (EPOGEN) INJ : 3,000 UNITS J0885 $144.63

6502497 METHOCARBAMOL(ROBAXIN) INJ 100MG/ML:10ML $115.90

6502498 PYRIDOSTIGMINE (REGONOL): 5MG/ML-2ML $100.89

6502502 PAPAVERINE MDV INJ 30MG/ML: 1ML J2440 $26.70

6502503 DIPYRIDAMOLE (PERSANTINE)INJ 5MG/ML:1ML J1245 $20.25

6502507 SOD TETRADEC (SOTRADECOL) INJ 3% $58.30

6502509 THIAMINE HCL (VITAMIN B1) INJ : 100MG J3411 $57.40

6502510 TRACE ELEMENTS A9270 $34.80

6502513 BUPIVACAINE (MARCAINE) INJ 0.25%:30ML $33.00

6502519 ONDANSETRON (ZOFRAN) INJ MDV 2MG/ML:1ML J2405 $29.00


6502521 BUPIVACAINE(SENSORCAINE)INJ 0.75%:10ML $32.40

6502524 LIDOCAINE (XYLOCAINE) MPF INJ 4% : 50ML $34.10

6502525 LIDOCAINE (XYLOCAINE) MPF INJ 1% : 30ML $51.70

6502526 LIDOCAINE (XYLOCAINE) UROJECT 2% : $20.90

6502527 LIDOCAINE (XYLOCAINE) MPF INJ 0.5%:50ML $57.80

6502538 AQUAPHIL/MENTHOL OINT 0.25% : 454GM A9270 $27.40

6502550 SPORTSCREME CRM : 90GM A9270 $11.30

6502568 TRIAMCINOLONE/AQUAPHILIC OINT .05%:454GM A9270 $42.10

6502602 AQUAPHILIC/GLYCERIN LOTION : 480ML A9270 $35.90

6502606 ISOSORBIDE DInitrate ER TAB:40MG A9270 $2.25

6502608 MINERAL OIL HEAVY LIQ : 473ML A9270 $15.50

6502610 IOVERSOL HAND HELD (OPTIRAY-320): 50ML Q9965 $3,012.00

6502612 CLINDAMYCIN (CLEOCIN) 300MG:IM INJ $34.30

6502626 LAMIVUDINE (EPIVIR) TAB:100MG A9270 $40.25

6502633 SILVER NITRATE SOL 1% : 100ML $37.50

6502638 DISOPYRA CR (NORPACE CR) CAP : 150MG A9270 $5.90

6502640 NEOMYCIN IRRIGATION SOL 1% : 1000ML $42.30

6502643 BUPIVACAINE(MARCAINE) EYE INJ 0.75%:10ML $33.22

6502644 PROPARACAINE(ALCAINE)OPTH SOL 0.5%:15ML A9270 $22.60

6502647 XYLOCAINE INTRAOCULAR SOL 1% $15.10

6502648 HYDROCORT,VANCO,AMIKACIN INJ $83.40

6502652 SILVER NITRATE SOL 1:10.000 : 1000ML $12.50

6502653 LIDO/MAALOX/DONNA(GI COCKTAIL):60ML A9270 $176.61

6502655 B AND C VITAMIN (Z-BEC) TAB A9270 $6.50

6502657 AZITHROMYCIN (ZITHROMAX) INJ : 500MG J0456 $99.80

6502659 CEFPROZIL (CEFZIL) TAB : 250MG A9270 $10.70

6502660 MAGNESIUM SULFATE (EPSOM SALT) GRN:454GM A9270 $2.60

6502661 CARVEDILOL (COREG) TAB : 3.125MG A9270 $5.60

6502662 acetaZOLAMIDE SODIUM(DIAMOX) INJ : 500MG J1120 $165.40

6502663 PEDIATRIC TOPICAL (TOPICAL ANES) SOL $5.00

6502664 PHENYLEPHRINE(NEOSYNEPHRINE)OPTH SOL:2ML A9270 $9.40

6502668 NAFCILLIN (NAFCIL) INJ : 1GM $59.53

6502673 BABY (JOHNSON'S) SHAMPOO : 105ML A9270 $11.40

6502678 HEPARIN FLUSH INJ 10UNITS/ML:5ML J1642 $35.10

6502689 GENTAMICIN IRRIGATION SOLUTION $21.40

6502699 SUMATRIPTAN (IMITREX)NASAL SPRAY : 5MG A9270 $713.40

6502700 FLUTICASONE (FLOVENT) INH 220MCG : 12GM A9270 $1,181.62


6502724 ACETIC ACID 36% SOL $33.00

6502758 CALAMINE FORMULA(CALMOSEPTIN):120GM A9270 $19.50

6502769 MICONAZOLE (ZEASORB AF) POWDER 2% : 85GM A9270 $12.60

6502772 ESTRADIOL (ESTRACE) TAB:1MG A9270 $2.50

6502785 amLODIPine (NORVASC) TAB : 2.5MG A9270 $4.50

6502789 COCAINE TOPICAL SOL 4%: 4 ML $106.80

6502793 APRACLONIDINE (IOPIDINE) OPTH 0.5%:5ML A9270 $168.30

6502794 METHYLDOPA (ALDOMET) TAB : 500MG A9270 $2.25

6502795 LEVOFLOXACIN /D5W 500MG:100ML PRE-DEF J1956 $139.00

6502798 oxyCODONE **ER**(oxyCONTIN)TAB:10MG A9270 $5.59

6502799 oxyCODONE **ER**(oxyCONTIN)TAB: 80MG A9270 $35.67

6502800 oxyCODONE immed release (ROXICODONE):5MG A9270 $2.50

6502801 METOPROLOL succ *ER* (TOPROL XL) :100MG A9270 $3.60

6502803 ATENOLOL/CHLORTH (TENORETIC) TAB 50/25MG A9270 $7.50

6502806 GENTAMICIN 40MG/ML: IM 2ML INJ J1580 $33.16

6502847 CARMEX OINT A9270 $10.70

6502855 NICOTINE POLAC (NICORETTE) GUM 4MG : 108 A9270 $52.80

6502859 CYCLOSPORINE (NEORAL) CAP : 100MG J7502 $14.30

6502862 CETAPHIL LOTION : 473ML A9270 $33.74


6502867 ABSORBABLE GELATIN (GELFILM) GEL $4,019.03

6502868 DESFLURANE (SUPRANE) GAS $496.59

6502869 MAGNEVIST INJ A9579 $283.96

6502870 ABSORBABLE GELATIN (GELFILM) OPT $47.00

6502873 ALBUTEROL SULF ER(VOLMAX ER)TAB: 4MG A9270 $3.70

6502878 D5W 1/2NS IV SOLN : 500ML $82.00

6502880 PROCARBAZINE HCL (MATULANE) CAP : 50MG A9270 $2.25

6502884 HYDROMORPHONE HCL(DILAUDID-HP)INJ : 10MG J1170 $33.10

6502889 MEGESTROL ACE (MEGACE) SOL 40MG/ML:240ML A9270 $236.40

6502894 VANCOMYCIN EYE : 20MG A9270 $29.30

6502897 LIDOCAINE/EPI (XYLOCAINE/EPI) INJ:50ML $2.25

6502899 CISATRACURIUM (NIMBEX)INJ 2MG/ML:10ML $98.03

6502912 PSYLLIUM FIBER (METAMUCIL) CRACKERS : 2 A9270 $2.25

6502954 PLASMA PROTEIN (PLASMANATE) INJ 5%:50ML $58.30

6502958 TET NYS HC BENADRYL (POWELL'S) SOL:480ML A9270 $26.80

6502960 IFOSFAMIDE (IFEX) INJ : 1000MG J9208 $319.90

6502962 PSEUDOEPHEDRINE (DECOFED) LIQ : 6MG/ML A9270 $2.90

6502964 CLOTRIMAZOLE VAG CRM 1% : 45GM A9270 $31.20

6502965 FUROSEMIDE (LASIX) DRIP 1MG/ML : 240ML J1940 $45.20

6502966 TRIAMCIN/LUBRIDERM LOTION 0.1% : 180ML A9270 $68.10

6502968 ALBUTEROL UD INHAL SOL 0.083%: 3ML $3.15

6502975 EPINEPHRINE(ADRENALIN) TOP SOL:1MG/ML A9270 $8.45

6502978 DICLOFENAC (VOLTAREN **XR**) TAB : 100MG A9270 $7.40

6502979 PROPOFOL (DIPRIVAN) INJ 10MG/ML:20ML J2704 $43.80

6502986 METHSUXIMIDE (CELONTIN) CAP : 300MG A9270 $2.50

6502991 METHOHEXITAL (BREVITAL) INJ 10MG/ML:50ML $140.10

6502992 ATROPINE MDV INJ 0.4MG : 20ML J0461 $62.70

6502993 METHYLPREDNISOLONE (MEDROL) TAB : 4MG J7509 $2.25

6503000 DIPYRIDAMOLE (PERSANTINE) TAB:25MG A9270 $2.50

6503001 HYDROCORTISONE NA(SOLU-CORTEF)INJ:250MG J1720 $51.52

6503002 HYDROCORTISONE NA(SOLU-CORTEF)INJ:100MG J1720 $81.84

6503003 METHYLPREDNISOLONE INJ 62.5MG/ML:2ML J2930 $55.33

6503004 CLORAZEPATE DIP (TRANXENE) TAB : 3.75MG A9270 $3.40

6503005 INDINAVIR (CRIXIVAN) CAP : 400MG A9270 $8.30

6503006 LAMIVUDINE (EPIVIR) TAB:150MG A9270 $16.10

6503007 PHENOBARBITAL ELIXIR 4MG/ML: 5ML A9270 $2.25

6503008 IRON POLYSACCHAR CPLX(NIFEREX-150):150MG A9270 $3.10

6503010 NITROGYLCERIN (NITRO) PATCH 0.2MG/HR A9270 $4.30


6503016 NEOMYCIN TAB : 500MG A9270 $3.54

6503017 THIORIDAZINE HCL (MELLARIL) TAB : 10MG A9270 $1.00

6503018 TRIAMCINOLONE DENTAL PASTE 0.1% : 5GM A9270 $74.00

6503019 PROPYLTHIOURACIL (PTU) TAB : 50MG A9270 $2.50

6503022 APAP/COD (TYLENOL/COD #4) TAB 60/300MG A9270 $2.25

6503024 IOVERSOL (OPTIRAY 320) INJ 68% : 50ML Q9965 $136.50

6503031 PIROXICAM (FELDENE) CAP : 20MG A9270 $7.10

6503032 PIROXICAM (FELDENE) CAP : 10MG A9270 $3.60

6503034 IOVERSOL (OPITRAY 320) INJ 68% : 150ML Q9965 $4,696.90

6503035 ALOE VERA GEL : 360GM A9270 $12.00

6503037 LEVOFLOXACIN (LEVAQUIN) TAB : 500MG A9270 $28.55


6503062 DIBUCAINE (NUPERCAINAL) OINT 1% : 30GM A9270 $13.50

6503066 KETOROLAC (ACULAR) OPTH SOL 0.5% : 5ML $327.57

6503068 clonAZEPAM (KLONIPIN) TAB : 0.5MG A9270 $2.50

6503069 terBUTaline SULF (BRETHINE) INJ : 1MG J3105 $37.50

6503080 fluocinoLONE (FLUONID) SOL 0.01% : 60ML A9270 $37.60

6503082 CHLORHEXIDINE (PERIDEX) LIQ 0.12% :480ML A9270 $27.30

6503083 PENICILLIN V K (PEN VK)SOL 25MG/ML:100ML A9270 $7.95

6503087 SOD CHLORIDE IRRIGATION SOL 0.9%:1000ML $6.40

6503089 NA CITRATE/CITRIC AC (CITRATE) SOL A9270 $1.50

6503091 VICKS FORMULA 44 SYR : 120ML A9270 $12.80

6503094 CEFPODOXIME (VANTIN) SUSP 10MG/ML:100ML A9270 $158.90

6503097 ICY HOT CRM : 35GM A9270 $13.00

6503099 KETOROLAC INJ: 15MG J1885 $27.50

6503100 MORPHINE SULF SR(ORAMORPH) SR TAB : 15MG A9270 $2.25

6503101 MENINOCOCCAL A/C/Y/W (MENOMUNE) VAC 90734 $333.90

6503106 SELENIUM SULF(SELSUN BLUE)SHAMPOO:210ML A9270 $15.90

6503107 METRONIDAZOLE(METROGEL)VAG GEL .75%:70GM A9270 $212.80

6503111 chlorproPAMIDE (DIABINESE) TAB : 250MG A9270 $2.50

6503117 SUMATRIPTAN (IMITREX) TAB : 25MG A9270 $71.50

6503118 CETAPHIL CRM : 454GM A9270 $16.20

6503119 BUPIVACAINE(MARCAINE)MPF INJ 0.5%:30ML $36.28

6503126 CELECOXIB (celeBREX) CAP : 100MG A9270 $6.30

6503128 LUBRIDERM/MENTHOL LOT 0.25% : 177ML A9270 $23.80

6503129 MONTELUKAST SODIUM (SINGULAIR) TAB : 5MG A9270 $9.50

6503135 TOLTERODINE TARTRATE (DETROL) TAB : 2MG A9270 $7.51

6503136 TOLTERODINE **LA** (DETROL LA) CAP : 4MG A9270 $21.98

6503140 FLUCONAZOLE (DIFLUCAN) SUSP 40MG/ML:35ML A9270 $273.00

6503141 PANCRELIPASE DELAYED RELEASE CAP: 5000 U A9270 $2.50

6503150 ENOXAPARIN (LOVENOX) INJ : 40MG J1650 $122.73

6503152 BICALUTAMIDE (CASODEX) TAB : 50MG A9270 $48.30

6503153 NAPROXEN SODIUM (ALEVE) TAB : 220MG A9270 $2.25

6503154 ITRACONAZOLE (SPORANOX) CAP : 100MG A9270 $19.50

6503157 THYROID TAB : 120MG A9270 $2.50

6503160 CEPACOL MOUTHWASH SOL 0.05% : 710ML A9270 $13.60

6503162 TOBRAMYCIN (NEBCIN) INJ : 1200MG J3260 $904.50

6503163 AQUAPHILIC/1% HC OINT 1% : 454GM A9270 $50.20

6503165 LEVOCARNITINE (CARNITOR) TAB : 330MG A9270 $2.60

6503167 TESTOSTERONE ENANTHA INJ : 200MG J3121 $69.20

6503168 AQUAPH/MEN/UR OINT 0.25%:454GM A9270 $24.90

6503170 IPRATROP/ALBUTEROL(COMBIVENT)INH:4 GM A9270 $624.91

6503171 CLOBETASOL PROP(TEMOVATE)SOL 0.05%:25ML A9270 $53.50

6503173 LOSARTAN/HCTZ (HYZAAR) TAB 50/12.5MG A9270 $6.00

6503175 LIDOCAINE/NYSTATIN/MAALOX SUSP : 300ML A9270 $35.30

6503176 buPROPion (WELLBUTRIN)** SR **TAB: 100MG A9270 $4.40

6503177 LOSARTAN (COZAAR) TAB : 25MG A9270 $5.10

6503179 DILTIAZEM (CARDIZEM) INJ 5MG/ML:5ML $31.70

6503180 MONTELUKAST SODIUM(SINGULAIR) TAB : 10MG A9270 $18.95

6503185 BENZONATATE (TESSALON PERLE) CAP : 100MG A9270 $2.50

6503188 TRIAMCIN/AQUAPHILIC OINT 0.025% : 454GM A9270 $56.00

6503190 IRON ELEMENTAL (SLOW FE) TAB : 45MG A9270 $2.50


6503192 HYOSCYAMINE LIQ : 5ML A9270 $2.90

6503195 CLOPIDOGREL (PLAVIX) TAB : 75MG A9270 $21.40

6503201 IPRATR BRO(ATROVENT)NASAL SPR 0.06%:15ML A9270 $114.20

6503202 CARISOPRODOL/ASA(SOMA CMPD)TAB 200/325MG A9270 $3.50

6503205 METOPROLOL succ *ER* (TOPROL XL)::200MG A9270 $4.40

6503227 BENEFIBER PWD : 155GM A9270 $18.30

6503230 HYDROCODONE/APAP(LORTAB)TAB 10/650MG A9270 $2.50

6503250 MAALOX/NYSTATIN SUSP EQUAL PARTS : 50ML A9270 $18.60

6503256 NS 1/3 + 1/3AA + 1/3H202 SOL : 480ML $10.00

6503262 LIDOCAINE/MAALOX(GI COCKTAIL)SUSP:120ML A9270 $187.50

6503270 NAPHAZOLINE(ALBALON)OPTH SOL 0.1%:15ML A9270 $18.60

6503272 RALOXIFENE (EVISTA) TAB : 60MG A9270 $9.40

6503274 ASPIRIN CHEWABLE (BABY ASA) TAB : 81MG A9270 $2.50

6503277 CARBAMAZEPINE (TEGRETOL) CHEWABLE: 100MG A9270 $2.50

6503278 TRIMETH/SULFA(SMX/TMP* DS*)TAB 800/160MG A9270 $2.50

6503279 PENICILLIN V POT (PEN V K) TAB : 250MG A9270 $2.50

6503280 BACLOFEN (LIORESAL) TAB : 10MG A9270 $2.50

6503281 MULTIVITAMINS CAP A9270 $2.50


6503288 CALCIUM/VIT D (OSCAL) TAB : 250MG A9270 $2.50

6503289 POTASSIUM CHLOR(MICRO-K) 10MEQ:CAP A9270 $2.50


6503291 BACITRACIN OPTH OINT : 3.5GM A9270 $149.40

6503293 CLINDAMYCIN (CLEOCIN) CAP : 150MG A9270 $2.50

6503294 SODIUM CHLORIDE 0.9% (STERILE)INJ : 10ML $27.47

6503298 AMLODIPINE/BENAZEPRIL(LOTREL) CAP 5/10MG A9270 $7.10

6503299 HYDROXYZINE HCL (ATARAX) INJ : 50MG J3410 $35.30

6503300 CIPROFLOXACIN ORAL SUS 500MG/5ML : 100ML A9270 $355.60

6503304 CEFEPIME (MAXIPIME) 2 GM INJ : J0692 $75.40

6503305 CEFEPIME (MAXIPIME) 1 GM INJ : J0692 $77.90

6503309 alprAZOLAM (XANAX) TAB : 0.25MG A9270 $2.50

6503310 PROMETHAZINE (PHENERGAN) SUPP : 50MG A9270 $21.40

6503312 TETRAHYDROZOLINE(VISINE)OPTH DROP :15ML A9270 $9.20

6503322 DICLOFENAC/MISO (ARTHROTEC) TAB 75/200MG A9270 $7.00

6503328 OXYBUTYNIN (DITROPAN) TAB : 5MG A9270 $2.50

6503329 MECLIZINE (ANTIVERT) TAB : 25MG A9270 $2.50

6503330 LORazepam (ATIVAN) INJ 2MG/ML:1ML J2060 $33.42


6503350 NALBUPHINE PCA 1MG/ML : 30ML $78.50

6503372 THIORIDAZINE (MELLARIL) TAB : 25MG A9270 $1.50

6503377 BUMETANIDE (BUMEX) TAB : 1MG A9270 $2.50


6503379 LEVOCARNITIN(CARNITOR)SOL 100MG/ML:118ML A9270 $93.60

6503380 PROCHLORPERAZINE INJ 5MG/ML:2ML J0780 $34.40

6503394 IPRATROPIUM (ATROVENT) NEB 0.02% :UD $4.58

6503395 glyBURIDE (DIABETA) TAB : 2.5MG A9270 $2.50

6503396 CEPHALEXIN (KEFLEX) CAP : 250MG A9270 $2.50

6503399 NALOXONE (NARCAN) INJ 0.4MG/ML:1ML J2310 $56.30

6503400 HYDROCORTISONE CRM 1% : 30GM A9270 $11.90

6503404 TAMSULOSIN (FLOMAX) CAP : 0.4MG A9270 $10.70

6503405 AL/MAG HYDROX/SIM(MYLANTA-II)SUSP:355ML A9270 $9.90

6503410 NAPROXEN EC (NAPROSYN) EC TAB:375MG A9270 $2.60


6503416 SCALPICIN SOL : 75ML A9270 $19.00

6503420 LACTOBACILLUS (FLORANEX) TAB A9270 $20.00

6503428 MORPHINE DRIP INJ 1MG/ML : 250ML $43.10

6503429 MENTHOL (MINERAL ICE) GEL 2% : 226.8GM A9270 $20.00

6503430 oxyCODONE ORAL SOL 1MG/ML:5ML A9270 $6.10

6503432 GLUCOSE TAB 10'S A9270 $12.00

6503456 NITROPRUSSIDE (NITROPRESS) INJ : 50MG $52.10

6503466 SULFASALAZINE ENTAB(AZULFIDINE)TAB:500MG A9270 $2.50

6503491 QUETIAPINE (SEROQUEL) TAB : 25MG A9270 $6.90

6503495 BUPIVACAINE SPINAL INJ 0.75% : 2ML $37.55

6503496 VALSARTAN (DIOVAN) TAB : 80MG A9270 $6.80

6503500 NYSTATIN/MYLANTA SUSP EQUAL PARTS : 70ML A9270 $25.00

6503512 FAMOTIDINE (PEPCID) TAB : 10MG A9270 $2.50

6503513 DORZOL 2%/TIMOP 0.5%(COSOPT)OPTH SL:10ML A9270 $318.80

6503514 VENLAFAXINE (EFFEXOR** XR**) CAP: 37.5MG A9270 $11.50

6503516 TORSEMIDE (DEMADEX)10MG/ML INJ:5ML J3265 $44.00

6503520 CYANOCOLBALAMINE(VIT B-12)TAB:500MCG A9270 $2.50

6503521 CALCIUM CARBONATE (CALCIUM)TAB:600MG A9270 $2.50

6503548 FAMOTIDINE (PEPCID) SUSP 8MG/ML:50ML A9270 $532.50

6503550 HYOSCYAMINE (LEVSIN) TAB : 0.125MG A9270 $2.25

6503560 NAPHAZOL/PHENIR (OCUHIST) OPTH SOL:15ML A9270 $12.10


6503569 NARATRIPTAN (AMERGE) TAB : 2.5MG A9270 $43.60

6503570 TETRACAINE (PONTOCAINE) INJ 1% : 2ML $37.80

6503580 FLUOXETINE (PROZAC)LIQ 4MG/ML: 5ML A9270 $25.95

6503589 FELODIPINE (PLENDIL-ER) TAB : 2.5MG A9270 $4.00

6503590 BECAPLERMIN (REGRANEX) GEL 0.01% : 15GM A9270 $1,031.00

6503595 LEVOCARNITINE (L-CARNITINE) CAP : 250MG A9270 $2.25

6503599 JOINT RITIS R/O SOL : 90ML A9270 $31.30

6503603 KETOROLAC TAB: 10MG A9270 $2.60

6503616 FLUOXYMESTERONE (HALOTESTIN) TAB : 10MG A9270 $3.70

6503617 IMIPENEM/CILASTATIN 500 MG INJ:500MG $135.30

6503625 ETIDRONATE (DIDRONEL) TAB : 400MG A9270 $13.20

6503657 MIDAZOLAM HCL (VERSED) SYR 2MG/ML: A9270 $19.10

6503660 LOPERAMIDE (IMODIUM AD) LIQ : 120ML A9270 $15.60

6503669 APAP/DIPHENHY (TYLENOL PM) TAB 500/25MG A9270 $2.50

6503679 CIPROFLOXACIN(CILOXAN)OP OINT 0.3%:3.5GM A9270 $671.40

6503689 SODIUM CHLORIDE 0.9% MB+ : 50ML $28.50

6503690 SODIUM CHLORIDE 0.9% MB+ : 100ML $28.50

6503696 CEFtriaxONE (ROCEPHIN) 1GM:IM INJ J0696 $144.60

6503713 FAMCICLOVIR (FAMVIR) TAB : 500MG A9270 $36.70

6503718 TRIAMCINO(NASACORT AQ)NASAL SPRAY:16.5GM A9270 $327.70

6503725 SODIUM CHLORIDE 0.9% SOLN : 25ML $28.50

6503729 RESERPINE TAB : 0.1MG A9270 $1.50

6503741 AMPHOTERICIN B LIPOS (ABELCET) INJ : 5MG J0289 $276.40

6503780 THYROID TAB : 30MG A9270 $2.00

6503789 MULTIVITAMIN WITH IRON(ONE/DAY W/FE)TAB A9270 $2.50

6503790 MOMETASONE(NASONEX) NASAL SPRAY : 50MCG A9270 $301.21

6503799 CALCIUM CITRATE/VIT D (CITRACAL): 200MG A9270 $2.50

6503831 METHYLENE BLUE INJ 1% : 10ML Q9968 $61.53

6503832 DROPERIDOL (INAPSINE) INJ : 2.5MG J1790 $36.10

6503833 METOCLOPRAMIDE (REGLAN) SOL 1MG/ML: 10ML A9270 $2.50

6503834 DIPHENOXYLATE/ATROPINE(LOMOTIL)LIQ:0.5MG A9270 $15.70

6503835 SULFACETAMIDE/PREDNIS (VASOCIDIN)SOL:5ML A9270 $48.80

6503890 CALCIUM/VIT D(CALTRATE) TAB:600MG/400IU A9270 $2.50

6503892 PREPARATION-H OINT : 60GM A9270 $26.60

6503896 TRIAMCINOLONE ACE (KENALOG)INJ 40MG:10ML J3301 $210.15

6503899 CHOLECALCIFEROL (VITAMIN D) TAB : 400IU A9270 $2.50

6503928 DIVALPROEX **ER* (DEPAKOTE ER)TAB: 500MG A9270 $16.20

6503963 LOTEPREDNOL (LOTEMAX) OPTH : 5ML $448.73

6503978 OLOPATADINE (PATANOL) OPTH SOL 0.1%:5ML A9270 $344.20

6503980 ACYCLOVIR (ZOVIRAX) TAB : 800MG A9270 $30.20

6503985 EPINEPHRINE (EPI-PEN) INJ : 0.3MG J0171 $437.72

6503987 carVEDilol (COREG) TAB : 25MG A9270 $5.60

6503989 KANAMYCIN(KANTREX)INJ 333.33MG/ML:3ML J1840 $72.20

6503991 BETAXOLOL(BETOPTIC-S)OPT SUSP 0.25%:10ML A9270 $282.50

6503995 HYDROGEN PEROX 50% AND WATER 50%SOL:30ML A9270 $2.50

6504008 ALUMINUM HYDROX (AMPHOJEL) SUSP :360ML A9270 $10.90

6504030 MORPHINE SULF immed release TAB : 30MG A9270 $2.50

6504055 GALANTAMINE HBR TAB : 4MG A9270 $6.60

6504152 OMEGA-3 FISH OIL CAP : 500MG A9270 $2.50

6504162 ERYTHROMYCIN BASE FILMTAB 250 MG A9270 $2.25

6504168 METHYLPHENIDATE (RITALIN) TAB : 5MG A9270 $2.50

6504251 MILK OF MAGNESIA (MINT) SUSP : 360ML A9270 $10.50


6504459 NAPROXEN EC (NAPROSYN EC) TAB : 500MG A9270 $3.30

6504489 FLUTICASONE/SALMETEROL DISKUS 250/50MG A9270 $283.24

6504540 AKWA TEAR (LACRILUBE) OPTH SOL : 15ML A9270 $9.70

6504556 GLYBURIDE/METF(GLUCOVANCE) 1.25/250MG A9270 $2.50

6504569 SENNA(SENOKOT)CONC SYRUP 1.76MG/ML:237ML A9270 $46.80

6504690 TIZANIDINE HCL (ZANAFLEX) TAB : 4MG A9270 $3.80

6504698 NITROFURANTOIN (MACRODANTIN) CAP : 25MG A9270 $2.25

6504889 B & L EYE WASH SOL : 118ML A9270 $9.00

6505189 HYOSCYAMINE (LEVSIN) INJ : 0.5MG J1980 $103.00

6505269 TOPIRAMATE (TOPAMAX) TAB : 25MG A9270 $7.40

6505478 MEMANTINE (NAMENDA) TAB : 10MG A9270 $8.50

6505569 SPIRONOLACTONE (ALDACTONE) TAB : 100MG A9270 $3.70

6505584 ALFUZOSIN (UROXATRAL) TAB : 10MG A9270 $10.86

6505589 SALINE NASAL GEL (AYR) : 14.1GM A9270 $13.10

6505647 FLUTICASONE(FLOVENT HFA INH 110MCG:12GM A9270 $761.67

6505649 glipiZIDE **XL** (GLUCOTROL XL) : 2.5MG A9270 $2.50

6505667 DUTASTERIDE (AVODART) CAP : 0.5MG A9270 $11.00

6505687 CALCIUM CARBONATE (CALCIUM) TAB : 600MG A9270 $14.80

6505698 LUBRICANT (THERATEARS) OPTH SOL : 15ML A9270 $16.40

6505824 RAMIPRIL (ALTACE) CAP : 1.25MG A9270 $4.00

6505874 ALBUTEROL HFA (PROVENTIL HFA)INH:18GM A9270 $48.80

6505879 VITAMIN B COMPLEX: TAB A9270 $2.50

6505890 BENAZEPRIL (LOTENSIN) TAB : 20MG A9270 $2.70

6505896 LEVALBUTEROL (XOPENEX) NEB 0.63MG : 3ML $21.98

6505898 ESTRADIOL TAB : 0.5MG A9270 $2.50

6505980 ZINC OXIDE (TRIPLE PASTE) OINT : 60GM A9270 $15.00

6505987 FENOFIBRATE (TRICOR) TAB : 160MG A9270 $6.20

6505999 LANSOPRAZOLE (PREVACID) CAP : 30MG A9270 $13.70

6506006 LIDOCAINE (XYLOCAINE)MPF 1% 10 MG/ML:2ML $29.90

6506060 CEFTAZIDIME (FORTAZ) 2 GM: INJ J0713 $53.62

6506069 LIDOCAINE HCL (XYLOCAINE) JEL 2% : 30ML $43.40

6506159 FAMCICLOVIR (FAMVIR) TAB: 250MG A9270 $9.20

6506269 MENTHOL/CAMPHOR (SARNA) LOT : 225ML A9270 $20.40

6506325 SELENIUM TAB : 50MCG A9270 $2.25

6506329 IRBESTAN (AVAPRO) TAB : 150MG A9270 $7.31

6506429 CLOTRIMAZOLE (LOTRIMIN-AF) CRM 1% : 30GM A9270 $18.40

6506447 HYDROCODONE/APAP(LORTAB)TAB 2.5/500MG A9270 $2.50

6506458 ROPINIROLE (REQUIP) TAB : 0.25MG A9270 $5.50

6506521 FLUTICASONE(FLOVENT)HFA 44MCG : 10.6GM A9270 $497.87

6506547 ATROPINE (SAL-TROPINE) TAB : 0.4MG A9270 $2.50

6506585 SODIUM CHLORIDE 23.4% INJ 4MEQ : 30ML $1.00

6506589 CLOTRIMAZOLE (MYCELEX) TROCHE : 10MG A9270 $4.20

6506598 CILOSTAZOL (PLETAL) TAB : 100MG A9270 $4.80

6506631 fluocinoNIDE (LIDEX) SOL 0.05% : 60ML A9270 $39.00

6506689 MINOXIDIL (LONITEN) TAB : 2.5MG A9270 $2.50

6506874 PHENYTOIN(DILANTIN)INJ 50MG/ML:2ML J1165 $34.57

6506879 HALOBETASOL (ULTRAVATE) OINT 0.05% :50GM A9270 $172.30

6506895 ACETAMINOPHEN (TYLENOL) BULK TAB : 500MG A9270 $1.50

6506954 GLYBURIDE/MET (GLUCOVANCE) TAB 2.5/500MG A9270 $2.80

6506984 MILK OF MAGNESIA (MOM) SUSP BULK : 360ML A9270 $7.30

6506987 DRONABINOL (MARINOL) CAP : 5MG A9270 $38.70

6506989 ACETAMINOPHEN (TYLENOL) BULK TAB : 325MG A9270 $3.00

6507412 MENTHOL (BIO-FREEZE) GEL 4% : 120GM A9270 $31.20

6507541 ZIPRASIDONE (GEODON) CAP : 20MG A9270 $19.40

6507596 TEMAZEPAM (RESTORIL) CAP : 7.5MG A9270 $2.50

6507689 BUDESONIDE(RHINOCORT AQUA)NASAL SPR: 9GM A9270 $424.22

6507789 METHYLPHENIDATE LA (RITALIN LA) CAP:20MG A9270 $6.80

6507898 AZATHIOPRINE (IMURAN) TAB : 50MG A9270 $3.41


6508133 THEOPHYLLINE ER(THEO-DUR)TAB:450MG A9270 $2.50

6508412 BECLOMETHASONE (QVAR) INH : 80MCG A9270 $709.77

6508413 DILTIAZEM **SR** (CARDIZEM SR) CAP: 60MG A9270 $2.50

6508421 RISEDRONATE (ACTONEL) TAB : 30MG A9270 $62.60

6508543 CIPROFLOXACIN/HC(CIPRO HC)OTIC SUSP:10ML A9270 $932.33

6508556 MELOXICAM (MOBIC) TAB : 7.5MG A9270 $4.50

6508574 CAPSAICIN HP(CAPSICUM-HP)CRM 0.075%:60GM A9270 $27.10

6508598 LAMOTRIGINE (LAMICTAL) TAB : 200MG A9270 $18.00

6508599 buPROPion(WELLBUTRIN **XL**)TAB 150MG A9270 $16.80

6508632 VALACYCLOVIR (VALTREX) TAB : 500MG A9270 $17.00

6508633 GLYBURIDE/MET (GLUCOVANCE) TAB 5/500MG A9270 $2.80

6508645 metFORMin *XR* (GLUCOPHAGE XR)TAB :500MG A9270 $2.50

6508654 LORazepam INTEN (ATIVAN) LIQ 2MG/ML:1ML A9270 $4.20

6508664 NISOLDIPINE (SULAR) TAB : 40MG A9270 $6.30

6508665 BEANO TAB A9270 $13.80

6508689 VITAMIN E CREAM : 113GM A9270 $8.20

6508745 VALPROATE NA(DEPACON)INJ 100MG/ML:5ML $56.00

6508754 CYCLOPENTOLATE (CYCLOGEL) OPTH 0.5%:15ML A9270 $70.90

6508774 LIDOCAINE/PRILOCAINE (EMLA) CRM 2.5%:5GM A9270 $20.00

6508779 OCUSOFT LID SCRUB PAD : 30 A9270 $25.20

6508796 FEXOFENADINE (ALLEGRA) TAB : 180MG A9270 $6.40

6508819 ECONAZOLE NITRATE(SPECTAZOLE)CRM 1%:15GM A9270 $45.80

6508874 LEVOCARNITINE (CARNITOR) INJ : 200MG J1955 $124.90

6508912 ESTROPIPATE (OGEN 1.25MG) :EQUIV = 1.5MG A9270 $2.25

6508957 CLOBETASOL PROP (CLOBEX) OINT 0.05%:15GM A9270 $64.30

6508959 FLUTICASONE/SALM DISKUS 100/50MG: A9270 $991.80


6508978 CHLOROTHIAZIDE (DIURIL) TAB : 500MG A9270 $2.50

6508990 ESCITALOPRAM OXALATE(LEXAPRO) TAB : 10MG A9270 $7.80

6509008 ILEX SKIN PROTECT : 60GM A9270 $20.20


6509025 AZITHROMYCIN(ZITHROMAX)SUSP 20MG/ML:15ML A9270 $85.70

6509036 GLIMPIRIDE (AMARYL) TAB : 4MG A9270 $3.20

6509056 NAPROXEN (ANAPROX DS) TAB : 550MG A9270 $3.40

6509086 LIDOCAINE-PRES FR(XYLOCAINE)INJ 1%:125ML $12.35

6509105 PSEUDOEPHEDRINE (SUDAFED) LIQ: 120ML A9270 $13.30

6509215 D5W NS IV SOLN : 1000ML $52.00


6509423 TRIAMCINOLONE (KENALOG) OINT 0.5% : 15GM A9270 $15.30

6509521 DESMOPRESSIN ACE (DDAVP) TAB : 0.2MG A9270 $11.40

6509544 BENZOCAINE (AMERICAINE) OINT 20% : 60GM A9270 $14.60


6509582 METHYLPREDNISOLONE(DEPO-MEDROL)INJ:80MG J1030 $69.92

6509623 MUPIROCIN (BACTROBAN) CRM 2% : 15GM A9270 $355.58

6509625 LEVOFLOXACIN : 250 MG PREMIX BAG J1956 $82.00

6509651 METHOCARBAMOL (ROBAXIN) TAB : 750MG A9270 $2.25

6509654 PREMARIN/PROG (PREMPRO) TAB 0.625/2.5MG A9270 $5.50

6509656 SODIUM HYPOCHLORITE SOL 0.125% : 240ML A9270 $6.59

6509661 LAC-HYDRIN 12% CRM : 140GM A9270 $60.80

6509665 CHLORDIAZEPOXIDE (LIBRIUM) CAP : 25MG A9270 $2.50

6509666 ESTROGEN/TESTOSTERONE(ESTRATEST)TAB A9270 $5.10

6509686 ZALEPLON (SONATA) CAP : 5MG A9270 $11.50


6509766 TOLTERODINE TARTRA (DETROL) TAB : 1MG A9270 $9.57

6509787 OPRELVEKIN (NEUMEGA) INJ : 5MG J2355 $60.80

6509856 APAP/COD(TYLENOL/COD):120ML TAKE HOME A9270 $16.90

6509865 NITROFURANTOIN (FURADANTIN) SUSP : 5MG A9270 $213.00

6509874 GENTEAL OPHTHALMIC GEL A9270 $21.99

6509875 GLIMEPIRIDE (AMARYL) TAB : 2MG A9270 $2.40


6509877 CARDEC DM (RONDEC DM) DROPS : 30ML A9270 $119.90

6509887 RAMIPRIL (ALTACE) CAP : 2.5MG A9270 $5.30

6509888 OLANZAPINE (ZYprexa) TAB : 2.5MG A9270 $21.40

6509945 metroNIDAZOLE ER (FLAGYL ER) TAB : 750MG A9270 $33.10

6509956 fluocinoNIDE (LIDEX) OINT 0.05% : 60GM A9270 $119.70

6509957 ETOMIDATE INJ 2MG/ML:20ML $107.50

6509965 IRBESARTAN/HCTZ (AVALIDE) TAB 300/12.5MG A9270 $7.60

6509980 DICLOFENAC (VOLTAREN) TAB : 50MG A9270 $2.60

6509982 METHYLPHENIDATE SR(RITALIN SR)TAB : 20MG A9270 $2.90

6509987 IRBESARTAN/HCTZ (AVALIDE) TAB 150/12.5MG A9270 $8.83

6509988 TRIAMCIN/LUBRIDERM LOT 0.05% : 180ML A9270 $27.60


6510012 ACETAMINOPHEN (TYLENOL) LIQ 32MG/ML:5ML A9270 $2.50

6510032 ALBUTEROL(PROVENTIL)SYR 2MG/5ML : 5ML $2.50

6510085 APAP/CODEINE (TYLENOL/COD) ELX : 5ML A9270 $2.50

6510182 SUCRALFATE (CARAFATE)SUSP 100MG/ML:10ML A9270 $13.81


6510344 BROMPHENIRAM/PSE (DIMETAPP DM) ELX : 5ML A9270 $2.50

6510347 DIPHENYDRAM(BENADRYL)SOL 2.5MG/ML:5ML A9270 $2.50


6510531 HYDROXYZINE pamoate (VISTARIL) CAP: 50MG A9270 $2.50

6510540 IBUPROFEN(MOTRIN) SUSP 20MG/ML: 5ML A9270 $2.50

6510579 LACTATED RINGERS IV SOLN : 500ML $57.00

6510833 TPN CENTRAL LINE **NO LIPIDS** $540.00

6511242 MOEXIPRIL (UNIVASC) TAB : 15MG A9270 $3.74

6511542 capTOPril (CAPOTEN) TAB : 50MG A9270 $3.10

6511545 ALTEPLASE CATHFLO (ACTIVASE) INJ : 2MG J2997 $347.73

6511799 PACLITAXEL PROT-BND (ABRAXANE):100MG J9264 $4,032.48

6511896 QUINAPRIL (ACCUPRIL) TAB : 40MG A9270 $3.18

6511989 D5W LR IV SOLN : 500ML $52.00

6512105 ZIDOVUDINE (RETROVIR) CAP : 100MG A9270 $5.10

6512162 OLANZAPINE (ZYprexa) TAB : 15MG A9270 $39.00

6512414 GALANTAMINE HBR TAB : 12MG A9270 $6.90

6512449 LATANOPROST(XALATAN)OPTH 0.005%:2.5ML A9270 $487.63

6512454 AMLODIPINE/BENAZEPRIL(LOTREL)CAP 5/20MG A9270 $7.40

6512547 TALCOM POWDER A9270 $15.80

6512548 RACEMIC EPINEPHERINE SOL 2.25%:0.5ML $3.30

6512578 OFLOXACIN (FLOXIN) OTIC SOL 0.3% : 5ML A9270 $192.40

6512588 AMIODARONE (CORDARONE) INJ 50MG/ML:9ML J0282 $38.90

6512859 CYCLOSPORINE (NEORAL) CAP : 25MG A9270 $3.60


6515478 ABCIXIMAB (REOPRO) INJ : 2MG J0130 $2,151.56

6515689 ACETIC ACID SOL 3% : 120ML $14.50

6516101 NITROFURANTOIN (MACROBID) CAP : 100MG A9270 $6.20

6516589 ACETYLCYSTEINE(MUCOMYST)20% RESP TX:3ML $9.80

6516988 GOSERELIN ACETATE (ZOLADEX) INJ: 10.8MG J9202 $3,692.00

6516989 ACETAMINOPHEN(TYLENOL)TAB:325MG A9270 $2.50

6516995 VERAPAMIL **SR** (ISOPTIN SR) CAP :120MG A9270 $3.60

6518689 D5W 1/2NS IV SOLN : 1000ML $58.00

6519855 RABIES IMMUNE GLOBULIN : 300 IU/2ML 90375 $1,531.36

6519957 SOLOSITE WOUND GEL : 90GM $32.80

6520890 SOD POLYSTYRENE (KAYEXALATE) SUSP : 15GM A9270 $16.40

6520891 THEOPHYLLINE SOL 5.33MG/ML :5ML A9270 $2.50

6520893 BELLADONNA/OPIUM (B&O #16A) SUPP : 60MG A9270 $80.53

6520894 MORPHINE (ASTRAMORPH) PF INJ 1MG/ML:10ML J2270 $54.50

6520895 HYDROMORPHONE(DILAUDID)INJ 2MG/ML:1ML J1170 $27.70

6520897 MORPHINE-PF(ASTRAMORPH/PF)INJ 1MG/ML:2ML J2270 $53.30

6520898 MORPHINE SULF SR(ORAMORPH SR) TAB : 30MG A9270 $4.20

6520900 BELLADONNA/OPIUM(B&O NO15A)SUPP : 30MG A9270 $44.15

6521254 LETROZOLE (FEMARA) TAB : 2.5MG A9270 $24.50

6521458 VENLAFAXINE (EFFEXOR **XR**) CAP : 150MG A9270 $14.30

6521663 PROMETHAZINE DM(PHENERGAN DM) SYR :5ML A9270 $2.50


6522145 NS 1/3 1/3H202/1/3AA SOL : 1000ML $12.50

6522325 MEAS/MUMPS/RUBELLA (MMR VACCINE) 90707 $199.09

6522448 LACTULOSE (DUPHALAC) SOL: 30ML A9270 $5.70


6522545 LITHIUM (LITHOBID **SR**) TAB : 300MG A9270 $2.50

6522564 HYDROMORPHONE PCA 0.1MG/ML:30ML J1170 $61.40


6522666 METOPROLOL tart. (LOPRESSOR) TAB : 100MG A9270 $2.50

6523547 SOTALOL (BETAPACE) TAB : 80MG A9270 $6.70

6523568 BETAMETHASONE (VALISONE)CRM 0.1% : 45GM A9270 $23.30

6525215 amLODiPine (NORVASC) TAB : 10MG A9270 $5.60

6525216 OXYBUTYNIN**XL** (DITROPAN XL) TAB :10MG A9270 $8.60

6525217 DONEPEZIL (ARICEPT) TAB : 10MG A9270 $22.75

6525218 ESCITALOPRAM OXALATE(LEXAPRO) TAB : 20MG A9270 $11.10

6525478 PREVIDENT 500 PLUS PASTE : 51GM A9270 $24.50

6525487 BORIC ACID GRN : 113GM $18.00

6525644 TRAMADOL TAB 50MG: TAKE HOME A9270 $12.40

6525688 REPAGLINIDE (PRANDIN) TAB : 1MG A9270 $4.40

6525847 AMOXICILLIN CHEW TAB(TAKE HOME):250MG A9270 $9.00

6525874 TRAMADOL (ULTRAM) TAB : 50MG A9270 $2.50

6529617 APAP (TYLENOL ARTHRITIS)TAB: 650MG A9270 $2.50

6530110 POTASSIUM CHLORIDE (K-TAB) TAB : 10MEQ A9270 $4.40

6530395 AZITHROMYCIN(ZITHROMAX)SUSP 40MG/ML:15ML A9270 $381.26

6531115 NITROGLYCERIN (NITROSTAT)0.4MG:1 TAB A9270 $6.15

6531166 IOPAMIDOL (ISOVUE-M 200) INJ 41% Q9965 $233.20

6532117 PROMETHAZINE/COD(PHENERGAN/COD)SYR: 5ML A9270 $2.50

6532659 CHOLINE/MG SALICY (TRILISATE)TAB : 750MG A9270 $2.50

6533009 NEOMY/POLYM/HC(CORTISPORIN)CRM : 7.5GM A9270 $239.70

6533365 HYDROCHLOROTHIAZIDE (HCTZ) CAP : 12.5MG A9270 $2.50

6533652 LEVOFLOXACIN (LEVAQUIN):750MG PREMIX J1956 $176.50

6533658 VANCOMYCIN (VANCOCIN) CAP : 250MG A9270 $169.50

6533659 ESTRADIOL (ESTRACE) CRM 0.01% : 43GM A9270 $349.47

6535689 AA H2O2 NS MIXTURE(AA H2O2 NS) SOL ML A9270 $12.50

6536598 ISOSORBIDE MONOnitrateTAB ER:30MG A9270 $2.91

6536599 ISOSORBIDE MONONITRATE TAB:60MG A9270 $2.50

6536600 LABETALOL (TRANDATE) TAB : 100MG A9270 $2.50

6536602 CITALOPRAM (celeXA) TAB : 40MG A9270 $3.50

6536603 PREDNISOLONE(INFLAMASE FORTE)SUSP 1% A9270 $146.43

6536604 TRIAMTERENE/HCTZ(DYAZIDE)CAP 37.5/25MG A9270 $2.50

6536605 SERTRALINE HCL (ZOLOFT) TAB : 100MG A9270 $7.33

6540012 CEFtriaxONE /NS 2 GM:50 ML PREDEFINED J0696 $245.60

6540025 PIPERACILLIN/TAZOBAC /NS 3.375 :100 ML J2543 $109.40

6540042 PAROXETINE **CR** (PAXIL CR)TAB: 12.5MG A9270 $8.90

6540043 GLYCOPYRROLATE (ROBINUL) TAB: 1MG A9270 $3.50

6540044 HYDROcodone/APAP(LORTAB) 7.5/650MG A9270 $2.50

6540045 LISINOPRIL (ZESTRIL) TAB: 2.5MG A9270 $2.50

6540046 ENOXAPARIN SOD (LOVENOX) INJ: 100MG J1650 $269.70

6540047 ENOXAPARIN SOD (LOVENOX) INJ: 120MG J1650 $318.70

6540048 LABETALOL (TRANDATE) INJ 5MG/ML:1ML $3.13

6540050 CLARITHROMYCIN(BIAXIN *XL*) ER TAB:500MG A9270 $13.00

6540051 MYCOPHENOLATE (CELLCEPT)CAP:250MG A9270 $8.90

6540052 IRBESARTAN (AVAPRO) TAB: 75MG A9270 $6.94

6540053 AMINOPHYLLINE TAB: 100MG A9270 $2.25

6540054 ASA/DIPYRIDAMOLE(AGGRENOX)CAP:25/200MG A9270 $8.94

6540055 GUAIFENESIN **DM* (ROBITUSSIN DM)SYR:5ML A9270 $2.50

6540056 ACETAMINOPHEN(TYLENOL X-STR)TAB:1000MG A9270 $2.50

6540058 DICYCLOMINE (BENTYL) CAP: 10MG A9270 $2.50

6540059 GUAIFENESIN (ROBITUSSIN)SYR:5ML A9270 $2.50

6540062 FLUCONAZOLE (DIFLUCAN) TAB: 200MG A9270 $37.30

6540063 DILTIAZEM **SR** (CARDIZEM SR) CAP:90MG A9270 $2.80

6540064 FOLIC ACID TAB: 0.4MG A9270 $2.50

6540065 TIAGABINE HCL (GABITRIL)TAB: 4MG A9270 $13.94

6540066 GLUCOSE TEST STRIP (GLUCOSTIX):EA A9270 $1.50

6540068 ISOSORBIDE MONOnitrate TAB:20MG A9270 $2.50

6540069 MIRTAZAPINE SOLUBLE(REMERON)TAB:30MG A9270 $7.00

6540073 LANSOPRAZ SOLUTAB(PREVACID SOLUTAB):30MG A9270 $14.20

6540085 LEVOFLOXACIN /D5W 250MG:50 ML PREDEFINED $89.90

6540086 DEXTROSE 5% INJ: 50ML $25.50

6540087 SODIUM CITRATE/CITRIC ACID ORAL SOL:30ML A9270 $2.50

6540088 ALUM/MAG HYDROX/SIMETH (MYLANTA): 30ML A9270 $2.50

6540090 CARBAMIDE PEROXIDE(GLY-OXIDE):15ML $15.10

6540091 FLUNISOLIDE NASAL(NASAREL)SOL:25ML A9270 $164.03

6540092 HYDROcodone/APAP 5/500:TAKE HOME A9270 $14.00

6540110 INSULIN REGULAR U-100:ONE TIME DOSE A9270 $3.20

6540111 INSULIN NPH U-100: ONE TIME DOSE A9270 $3.20

6540112 INSULIN 70/30 U-100 mix: ONE TIME DOSE A9270 $3.20

6540117 KCL 20MEQ 1/2 NS IV SOL: 1000ML $30.00

6540118 MAALOX ONE TIME ONLY DOSE:30ML A9270 $2.50

6540119 PROCHLORPERAZINE 5MG TAKE HOME A9270 $12.00

6540123 ALKALOL NASAL SPRAY: 15ML A9270 $6.50

6540124 TYLENOL ARTHRITIS CAPLET 650 MG: 1 EA A9270 $2.50

6540128 CALCIUM ACETATE (PHOSLO)GELCAP: 667MG A9270 $2.50

6540129 LIDOCAINE/PRILOCAINE(EMLA)CREAM: 30GM A9270 $119.50

6540143 ORAL BALANCE MOIST GEL A9270 $12.50

6540146 CONJ.ESTROGEN (PREMARIN) TAB: 0.45MG A9270 $2.80

6540147 D2.5W 1/2NS IV SOLN: 1000ML $52.00

6540150 LEVAQUIN /D5W 750MG:150 ML PRE-DEFIN J1956 $176.20

6540151 CHOLESTRYAMINE (PREVALITE)PACKET:4 GM A9270 $4.10

6540152 RISPERDAL ORAL SOLUTION 1 MG/ML:30 ML A9270 $326.70

6540154 LEVOFLOXACIN (LEVAQUIN):500MG PREMIX J1956 $139.00

6540157 CELECOXIB (celeBREX) CAP: 200MG A9270 $10.90

6540160 TIOTROPIUM (SPIRIVA) 18MCG HANDIHALER A9270 $230.15

6540161 LEVALBUTEROL (XOPENEX) NEB 1.25MG: 3ML $13.36

6540162 TRIAMCINOLONE/AQUAPHILIC 0.05%: 454GM A9270 $56.00

6540163 BACTROBAN OINT IN 1 LITER NORMAL SALINE $135.20

6540165 PRENATAL VIT (NATALCARE PIC FORTE):TAB A9270 $2.50

6540166 CEFDINIR (OMNICEF) 300 MG CAPSULES A9270 $13.30

6540179 TRIAMCINOLONE/AQUAPHILIC 0.1%:454GM A9270 $42.10

6540180 ROSUVASTATIN (CRESTOR)TAB:5MG A9270 $11.20




6540184 TRANDOLAPRIL (MAVIK) TAB:1MG A9270 $3.10

6540186 LOVASTATIN (MEVACOR) TABLET: 20 MG A9270 $6.16

6540187 NYSTATIN/MAALOX/LIDOCAINE VISC: 90ML A9270 $24.70

6540188 TOPIRAMATE (TOPOMAX) TAB: 100 MG A9270 $17.90

6540189 DEXTROAMPHETAMINE SR CAPSULE: 15 MG A9270 $3.20

6540190 MEGESTROL ACETATE (MEGACE)TAB: 20MG A9270 $2.50

6540191 MELPHALAN (ALKERAN) TAB: 2MG A9270 $12.30

6540192 HYDROCORT VAL(WESTCORT)CR 0.2%:15GM A9270 $40.40

6540193 MIDODRINE (ORVATEN)TAB: 10MG A9270 $12.70

6540195 CYMBALTA (DULOXETINE) CAPSULE: 30 MG A9270 $14.54

6540199 HUMATE P INJECTION (ANTIHEMO/VW): 500 IU J7192 $2.50

6540202 CIPROFLOXACIN/DEXAM(CIPRODEX)OTIC:7.5ML J7342 $351.94

6540204 NITROGLYCERIN PREMIX 0.1 MG/ML:250 ML $30.59

6540205 TERCONAZOLE (TERAZOL 3) VAG SUPP: 3'S A9270 $125.10

6540207 LAMOTRIGINE(LAMICTAL)TAB:25MG A9270 $10.80

6540211 CIPROFLOXACIN(CILOXAN)0.3% OPHT SOL:2.5 A9270 $123.10

6540213 ESTROVEN CAPLET:1 EA A9270 $2.50

6540214 OLMESARTAN/HCTZ (BENICAR HCT) 40/25 A9270 $7.60

6540216 RIVASTIGMINE(EXELON)OR SOL 2MG/ML:120ML A9270 $848.00

6540218 P-EPHED/CETIRIZINE(ZYrtecD)TAB:5/120MG A9270 $3.10

6540220 TACROLIMUS(PROTOPIC)OINT 0.03%: 30GM A9270 $279.90

6540221 GOLD BOND MED BODY POWDER:113GM A9270 $14.90

6540223 MAGNESIUM GLUCONATE (MAGONATE): 500 MG A9270 $2.25

6540224 PEROXYL ORAL CLEANSER:236ML A9270 $11.40

6540225 OLMESARTAN/HCTZ(BENICAR HCT)40/12.5MG:1 A9270 $8.10

6540227 TACROLIMUS (PROGRAF)CAP: 1 MG A9270 $12.50

6540228 TACROLIMUS (PROGRAF) CAP: 0.5 MG A9270 $6.50

6540229 SILDENAFIL (VIAGRA)TAB: 50 MG A9270 $27.90

6540230 PHENYLEPHRINE/HARD FAT (ANU-MED) SUPP A9270 $2.50

6540233 NIACIN EXTENDED RELEASE (NIASPAN): 500MG A9270 $6.50

6540234 AZELASTINE HCL OPHTH. SOL(OPTIVAR):0.05% A9270 $222.10

6540235 OXYBUTYNIN (OXYTROL) PATCH: 3.9 MG A9270 $77.01

6540236 DIPHENHYDRAMINE/NYSTATIN MOUTHWASH:240ML A9270 $98.50

6540240 TETRACAINE(PONTOCAINE)TOPICAL 2%: 30ML $51.20

6540241 POT CITRATE/CITRIC ACID ORAL SOL: 15ML A9270 $1.60

6540242 TELMISARTAN (MICARDIS)TAB: 80MG A9270 $6.70

6540243 SIMETHICONE (MYLANTA)TAB:125MG A9270 $2.50

6540244 GOSERELIN (ZOLADEX)INJ:10.8 MG J9202 $3,896.34

6540245 LORATADINE REDI-TAB(CLARITIN):10MG A9270 $2.50

6540246 FENOFIBRATE (TRICOR) TAB: 145 MG A9270 $9.90

6540248 DARIFENACIN (ENABLEX) TAB: 7.5 MG A9270 $13.29

6540249 ZINC GLUCONATE(EQUIV ZINC 50MG) TAB A9270 $2.50

6540250 RABEPRAZOLE (ACIPHEX) TAB: 20 MG A9270 $13.20

6540251 FLUOROMETHOLONE 0.1%(FLAREX):5ML A9270 $26.20

6540252 HYPROMELLOSE(GONAK)OPTH SOL 2.5%:15ML A9270 $29.10

6540256 CINACALCET (SENSIPAR) TAB: 30MG A9270 $37.20

6540257 ZIPRASIDONE (GEODON)INJ:20MG J3486 $106.79

6540258 CANDESARTAN (ATACAND) TAB: 32 MG A9270 $7.50

6540259 ERTAPENEM (INVANZ) INJ:1GM J1335 $256.84

6540263 VERAPAMIL (VERELAN PM):200MG A9270 $10.30

6540264 THYROID TABLET: 180 MG A9270 $2.25

6540265 VANCOMYCIN (VANCOCIN)CAP: 125MG A9270 $81.40

6540266 BUDESONIDE (PULMICORT) INHALER:180MCG A9270 $425.40

6540267 ZOLMITRIPTAN (ZOMIG) TAB: 5MG A9270 $71.40

6540268 TROSPIUM (SANCTURA) TAB: 20MG A9270 $4.10

6540270 VALSARTAN (DIOVAN):40MG A9270 $5.70

6540271 NYSTATIN/DIPHENHYDRAMINE EQUAL PRT:120ML A9270 $12.70

6540272 CETUXIMAB (ERBITUX)2MG/ML:100ML J9055 $3,811.19

6540276 CIPROFLOXACIN (CIPRO) TABLET: 250 MG A9270 $11.50

6540277 TIGECYCLINE (TYGACIL)50MG INJ J3243 $448.77

6540279 TRIAMTERENE/HCTZ 37.5/25MG:TAB A9270 $2.50

6540280 ALKA-SELTZER PLUS COLD& FLU EFF. TABLET A9270 $11.20

6540281 MOXIFLOXACIN (AVELOX) TAB: 400 MG A9270 $31.90

6540282 GUAIFENESIN/**DM** 600MG/30MG:TAB A9270 $6.29

6540283 MITOMYCIN TOPICAL 0.2MG/ML:0.5ML $50.00

6540284 QUINAPRIL (ACCUPRIL)TAB:20MG A9270 $3.20

6540285 OMEPRAZOLE (PRILOSEC) CAP:20MG A9270 $10.40

6540286 PAROXETINE **CR** (PAXIL CR)TAB:37.5MG A9270 $8.90

6540287 RISPERIDONE(RISPERDAL)TAB:3MG A9270 $19.60

6540288 DILTIAZEM (CARDIZEM)TAB:60MG A9270 $2.50

6540289 PAROXETINE (PAXIL)TAB:40MG A9270 $5.70

6540290 FLINTSTONE VITAMINS A9270 $2.50

6540291 CEFDINIR (OMNICEF)50MG/ML:60ML A9270 $258.70

6540292 CALCIUM/MAGNESIUM/ZINC TABLET A9270 $2.50

6540293 BANANA BAG/NS 1000ML: PRE-DEFINED $177.90

6540295 FOLIC ACID,B-12,B-6(FOLTX 2.5/2/25MG):TB A9270 $2.00

6540296 OSELTAMIVIR(TAMIFLU)CAP 75MG A9270 $25.07

6540297 Tdap-ADULT (BOOSTRIX) :0.5ML 90715 $148.89

6540298 OLMESARTAN(BENICAR)TAB:20MG A9270 $7.08

6540299 AZITHROMYCIN(Z-MAX)ORAL SUSP:2GM A9270 $150.10

6540300 CYMBALTA (DULOXETINE) CAPSULE: 20 MG A9270 $12.51

6540302 TRIAMCINOLONE ACETONIDE OINT 0.1%:80 GM A9270 $28.70

6540303 KCL 40MEQ D5W-1/4NS:1000ML J3480 $52.00

6540305 PREGABALIN (LYRICA) CAP: 50MG A9270 $6.10

6540306 BISOPROLOL/HCTZ (ZIAC) TAB 10/6.25MG A9270 $3.00

6540308 MINOCYCLINE(MINOCIN)CAP:50MG A9270 $7.70

6540309 MINOCYCLINE(MINOCIN)TAB:75MG A9270 $11.20

6540310 IBANDRONATE(BONIVA)INJ:1MG J1740 $1,395.27

6540311 ACETYLCYSTEINE(ACETADOTE)INJ:6000MG J0132 $496.30

6540315 OMEPRAZOLE (PRILOSEC):40MG A9270 $19.20

6540316 VERAPAMIL (VERELAN PM):300MG A9270 $9.60

6540317 HYDROcodone/APAP(LORTAB)TAB 7.5/500MG A9270 $2.50

6540319 MORPHINE SULFATE IR TAB:15MG A9270 $2.25

6540320 NEPAFENAC(NEVANAC)OPTH 0.1%:3ML $204.80

6540323 NITRO 0.2%,1% HYDROCORT IN ZINC OXIDE A9270 $15.00

6540327 HUMALOG MIX 50/50 INJECTION A9270 $425.40

6540328 VALGANCICLOVIR(VALCYTE)TAB:450MG A9270 $86.80

6540332 HYDROcod/APAP(LORTAB)ELIX:30ML TAKE HOME A9270 $13.87

6540335 CYCLOPHOSPHAMIDE (CYTOXAN) CAP: 50MG A9270 $10.00

6540336 KETOPROFEN ER CAPSULE:200MG A9270 $7.00

6540337 CLORAZEPATE (TRANXENE) TAB: 7.5 MG A9270 $2.50

6540338 SOLIFENACIN SUCCINATE (VESICARE) TAB:5MG A9270 $13.30

6540339 LEVETIRACETAM (KEPPRA) TAB: 750 MG A9270 $12.40

6540342 INSULIN ASPART(NOVOLOG)100UNITS/ML:10ML A9270 $4.82

6540343 ESOMEPRAZOLE (NEXIUM) CAP: 40 MG A9270 $13.18

6540344 DICLOXACILLIN(DYNAPEN):250MG A9270 $2.50

6540346 EXENATIDE(BYETTA)250MCG/ML:1.2ML A9270 $986.18

6540347 CEFazolin /D5W 1 GM : 50 ML PREDEFINED J0690 $38.20

6540348 CEFtriaxONE /D5W 1 GM: 50 MLPREDEFINED J0696 $61.20

6540350 APAP/BUTAB/CF/COD(FIORICET W/COD):1 CAP A9270 $2.25

6540351 CefOXitin /D5W 1 GM:50 ML PREDEFINED J0694 $57.00

6540352 GALANTAMINE (RAZADYNE ER) CAP: 8 MG A9270 $17.80

6540353 METRONIDAZOLE 1GM/1000ML NS IRRIGATION $51.40

6540354 CefOXitin /D5W 2GM:50 ML PREDEFINED J0694 $86.10

6540356 LIDOCAINE CREAM (LIDOSENSE) 4% : 30 GM A9270 $122.90

6540357 ACCUZYME/BACTROBAN OINTMENT 50:50:60GM A9270 $296.60

6540358 DESITIN CREAMY OINTMENT:60GM A9270 $13.30

6540360 IBANDRONATE (BONIVA)TAB: 150MG A9270 $337.07


6540364 NESIRITIDE (NATRECOR) INJ: 1.5 MG J2325 $1,639.20

6540366 ALENDRONATE (FOSAMAX)ORAL SOL: 70MG/75ML A9270 $259.70

6540368 LOSARTAN (COZAAR) TAB: 100 MG A9270 $6.90

6540373 GUM MASTIC/STORAX(MASTISOL)LIQ:15ML A9270 $27.10

6540374 COLESEVELAM (WELCHOL) TAB: 625MG A9270 $3.00

6540375 VASELINE PACKET:EA A9270 $2.50

6540376 PRAMOXINE (PROCTOFOAM):15GM A9270 $102.20

6540377 LANTHANUM(FOSRENOL)TAB:500MG A9270 $20.40

6540379 OXYMORPHONE (OPANA ER)TAB:10MG A9270 $9.80

6540380 OXYMORPHONE (OPANA ER)TAB:20MG A9270 $17.30

6540382 INS ASP PRT/INS ASP(NOVOLOG mix 70/30):I A9270 $4.79

6540383 PREDNISOLONE ACETATE(PRED MILD):0.12% SU A9270 $64.50

6540384 PREGABALIN (LYRICA) CAP: 75 MG A9270 $28.11


6540387 TERIPARATIDE (FORTEO)20 MCG:2.4 ML A9270 $2,620.00

6540388 TRAVOPROST(TRAVATAN Z) OPHTH. SOL: 2.5ML A9270 $334.10

6540392 INSULIN DETEMIR(LEVEMIR)INJ:100 UNIT/ML A9270 $6.93

6540394 CANDESARTAN (ATACAND) TAB: 4 MG A9270 $5.30

6540395 RAMELTEON(ROZEREM)TAB:8 MG A9270 $11.50

6540396 PANTOPRAZOLE(PROTONIX)IV :40MG C9113 $64.00

6540398 FLECAINIDE (TAMBOCOR) TAB: 50 MG A9270 $2.20

6540598 PANTOPRAZOLE (PROTONIX) TAB: 40MG A9270 $20.85

6544448 AMLODIPINE/BENAZEPRIL(LOTREL)2.5/10:CAP A9270 $7.70

6544517 GALANTAMINE HBR SOL 4MG/ML:100ML $458.40

6544547 INSULIN GLARGIN(LANTUS) 100 UNIT/ML: A9270 $10.59

6544548 SEVELAMER (RENAGEL) TAB : 800MG A9270 $7.54

6544574 MAG/CAL CARBONA (MAGNEBIND) TAB : 300MG A9270 $2.25

6544578 LOTEPREDNOL (ALREX) OPT 0.2% : 5ML $666.64

6544783 MIDODRINE (ORVATEN) TAB: 5 MG A9270 $6.80

6545417 * ONDANSETRON (ZOFRAN) TAB : 4MG $63.40

6545457 LEVETIRACETAM (KEPPRA) TAB : 500MG A9270 $10.20

6545462 LIDOCAINE (LIDODERM) PATCH 5% A9270 $20.07

6545478 GENTAMICIN (GARAMYCIN) CRM 0.1% : 15GM A9270 $40.53

6545487 RISPERIDONE (RISPERDAL) TAB : 0.5MG A9270 $11.60

6545547 ALBUTEROL (ACCUNEB) SOL : 1.25MG $4.32

6545568 IRON SUCROSE (VENOFER)INJ 20MG/ML:5ML J1756 $203.90

6545698 PRAMIPEXOLE (MIRAPEX) TAB : 0.125MG A9270 $9.39

6545877 DILTIAZEM(CARDIZEM)TAB:120MG A9270 $3.60

6545888 IOVERSOL 100M(OPTIRAY 320)INJ 68%:100ML Q9965 $138.10

6546587 MIRTAZAPINE (REMERON) TAB : 30MG A9270 $7.30

6547801 MINERAL OIL/LANOLIN OIL(ALPHA KERI): OIL A9270 $38.10

6550000 BUPIVICAINE(MARCAINE) 0.5% W/EPI: 10ML $32.15

6550001 INTERFERON BETA 1A(AVONEX)INJ:30MCG J1826 $1,061.10

6550002 RIFAXIMIN (XIFAXAN)TAB: 200MG A9270 $11.30

6550003 KCL 20MEQ/STERILE H2O 100ML:RIDER PREMIX J3480 $32.40

6550004 KCL 40MEQ/STERILE H20 100ML:RIDER PREMIX J3480 $35.70

6550008 VARENICLINE(CHANTIX)TAB: 0.5MG A9270 $6.99

6550009 VARENICLINE(CHANTIX)TAB: 1MG A9270 $6.99

6550010 ESZOPICLONE (LUNESTA) TAB: 1MG A9270 $24.39

6550011 ROPINIROLE (REQUIP) TAB: 1MG A9270 $6.60

6550012 LIDOCAINE/TETRACAINE PATCH:70/70MG A9270 $41.60


6550014 METRONIDAZOLE(METROGEL)TOP GEL 1%:60GM A9270 $527.44

6550015 NIMODIPINE(NIMOTOP)CAPSULE: 30MG A9270 $27.00

6550017 ESTROGEN/MEDRO (PREMPRO) TAB 0.45/1.5MG A9270 $6.66

6550018 DIVALPROEX SODIUM(DEPAKOTE ER)TAB: 250MG A9270 $5.51

6550019 BENZOCAINE/RESORCINOL (VAGISIL) CREAM A9270 $13.20

6550020 POTASSIUM CHLORIDE(KLOR-CON)PACKET:20MEQ A9270 $2.50

6550024 ETODOLAC (LODINE) CAP : 400MG A9270 $3.90

6550025 TERCONAZOLE (TERAZOL)-7 VAG CR:45GM A9270 $125.10

6550028 LEVOFLOX(LEVAQUIN)ORAL SOL 25MG/ML:10ML A9270 $20.00

6550029 FLUOCINOL(DERMA-SMOOTHE FS)SCALP OIL:120 A9270 $95.40

6550030 DIMENHYDRINATE (DRAMAMINE) TAB: 50 MG A9270 $2.50

6550031 ENALAPRIL (VASOTEC) TAB: 20 MG A9270 $4.00

6550032 VITAMIN D3: 1000 IU (25 MCG) TAB A9270 $2.50

6550033 LOSARTAN/HCTZ (HYZAAR) TAB: 100MG/25MG A9270 $7.40

6550035 HYDROCORT/PRAMOX (PRAMOSONE)1% CREAM:30G A9270 $203.01

6550036 TAZAROTENE (TAZORAC) 1% CREAM : 30 GM A9270 $320.90

6550037 OLANSAPINE/FLUOXETINE 3MG/25MG:1 CAP A9270 $18.00

6550038 GUAIFENESIN/P-EPHEDRINE (MUCINEX D): TAB A9270 $2.50

6550039 GARLIC TABLETS:1EA A9270 $2.50

6550040 CHOLECALCIFEROL(VITAMIN D) TAB: 1000 IU $2.50

6550042 FOSPHENYTOIN (cereBYX)IN 50MG PE/ML:10ML Q2009 $40.80

6550043 IBUPROFEN CHILDREN DROP 40 MG/ML:15 ML A9270 $14.90

6550044 TRIAMCINOLONE 0.1% OINT/BACTROBAN:30G A9270 $121.10

6550045 PERMETHRIN (ELIMITE) CREAM 5%: 60GM A9270 $73.10

6550046 NEDOCROMIL (ALOCRIL) OPHTH SOL 2%: 5ML A9270 $242.40

6550047 PHILLIPS CHERRY MILK OF MAGNESIA: 355ML A9270 $14.10

6550048 ELETRIPTAN (RELPAX) TAB: 40 MG A9270 $55.20

6550049 SALICYLIC ACID (COMPOUND W) 17% LIQ: A9270 $18.00

6550050 DIPHENHYDRAMINE/NYSTATIN/HYDROCORTISONE A9270 $28.75

6550051 ME-COBAL/LM-FOLATE/PYRID(METANX) TAB A9270 $2.50

6550052 NORGEST-ETHIN EST (OGESTREL):0.5/0.05MG A9270 $116.80

6550053 ARMOUR (THYROID) TAB: 60 MG A9270 $4.20

6550054 PANTOPRAZOLE (PROTONIX) TAB: 20 MG A9270 $14.38

6550055 VANCOMYCIN IRRIGATION SOL 0.05%: 1000 ML $42.30

6550056 PEG-3350/BIS (HALFLYTLELY) PREP KIT $165.49

6550059 NORETHINDRONE (AYGESTIN) TAB: 5 MG A9270 $5.80

6550060 NORETHINDRONE (AYGESTIN) TAB: 5 MG A9270 $5.80

6550063 GUAIF/COD (ROBITUSSIN AC): 4OZ TAKE HOME A9270 $14.80

6550064 MULTIVITAMIN TAB A9270 $2.50

6550067 SERTRALINE (ZOLOFT) TAB: 25 MG A9270 $7.11

6550068 DARIFENACIN (ENABLEX) TAB: 15 MG A9270 $12.60

6550069 LEVALBUTEROL(XOPENEX)INH: 15GM A9270 $136.50

6550098 KETOPROFEN CAP: 50MG A9270 $2.50

6550102 BETAMETHASONE(DIPROSONE) OINT 0.05%:15GM A9270 $19.50

6550125 TPN $560.00

6550557 carVEDilol ***CR***(COREG-CR) CAP: 10MG A9270 $20.65

6550565 PROTONIX IV FOR ER $62.50

6551548 PANHEMATIN (HEMIN) INJ : 313MG J1640 $2,152.20

6552322 ESTROGEN/MEDRO (PREMPRO) TAB 0.3/1.5MG A9270 $6.40

6552389 POVIDONE-IODINE (BETADINE) DOUCHE A9270 $14.20

6552414 GALANTAMINE HBR (RAZADYNE) TAB : 8MG A9270 $8.30

6552461 ADALIMUMAB (HUMIRA) INJ : 40MG J0135 $4,977.90

6552648 TOLTERODINE **LA** (DETROL LA) CAP : 2MG A9270 $23.82




6552689 DICYCLOMINE (BENTYL) CAP 10MG:TAKE HOME A9270 $16.00

6554477 PHENAZOPYRIDINE TAB 100MG: TAKE HOME A9270 $13.60


6554687 MEPIVACAINE (CARBOCAINE) 2% MDV : 50ML J0670 $72.60

6554689 SMX/TMP SUSP 60ML TAKE HOME FOR ER A9270 $17.30

6554789 AZELASTINE(ASTELIN)NASAL SPRAY:30ML A9270 $304.02

6554879 oxyCODONE(ROXICODONE)INTENSOL 20MG/ML:30 A9270 $161.33

6554897 AMOX/CLAV (AUGMENTIN) SUSP 80MG/ML:100ML A9270 $179.20

6555056 BROMFENAC(XIBROM)OPTH SOL 0.09%:2.5ML $389.38

6555057 INTRINSIC B12/FOLATE TABLET A9270 $2.25

6555058 FENOFIBRATE (TRICOR) TAB: 48 MG A9270 $3.90

6555124 FOLIC ACID B-6 B-12 (FOLTX) TAB A9270 $1.50

6555154 HYDROMORPHONE (DILAUDID) TAB : 4MG A9270 $2.50

6555156 ACYCLOVIR (ZOVIRAX) SUSP : 40MG A9270 $284.50

6555164 ARTIFICAL TEARS (ISOPTO TEARS) OPTH SOL A9270 $48.80

6555201 METOPROLOL succ *ER* (TOPROL XL) :25MG A9270 $2.80

6555214 VENLAFAXINE (EFFEXOR **XR**) CAP : 75MG A9270 $9.30



6555244 DEXTROSE 5% IV : 150ML $28.80

6555247 MOEXIPRIL/HC (UNIRETIC) TAB 15/12.5MG A9270 $3.50



6555261 HYDROCORTISONE(CORTAID) CRM 0.5% : 30GM A9270 $11.70

6555264 MAGNESIUM SO4 PREMIX 40MG/ML : 1000ML J3475 $42.30


6555267 HEPATITIS A VAC (HAVRIX) 1 ML : 1440EL.U 90632 $207.60

6555347 PROGESTERONE (PROMETRIUM) CAP EA : 100MG A9270 $3.80

6555415 MEROPENEM (MERREM) INJ : 1GM J2185 $236.90

6555443 PROMETHAZINE (PHENERGAN) TAB : 12.5MG A9270 $2.50

6555454 IPRATROP/ALBU UD NEBULIZER SOL : 3ML $5.70

6555458 DIAZEPAM REC (DIASTAT PED) GEL EA : 5MG A9270 $1,083.00

6555462 METOPROLOL tart.(LOPRESSOR) TAB : 25MG A9270 $2.50

6555467 COLESTIPOL (COLESTID) TAB : 1GM A9270 $2.50

6555468 INSULIN HUMALOG *MIX* 75/25 100 UNITS/ML A9270 $289.30

6555487 TESTOSTERONE GEL (ANDROGEL) GEL 1% A9270 $408.80

6555526 KCL 30MEQ D5W 1/2NS IV SOLN : 1000ML $28.80


6555530 KCL 20MEQ NS IV SOLN : 1000ML $30.00

6555531 KCL 40MEQ NS IV SOLN : 1000ML $28.80

6555546 FLUOXETINE (PROZAC) CAP : 20MG A9270 $26.30

6555548 ACETIC ACID/HC(ACETASOL HC) OTIC :10ML A9270 $98.40

6555555 SCOPOLAMINE (TRANSDERM SC) PATCH : 1.5MG A9270 $54.86

6555564 PARICALCITOL (ZEMPLAR) INJ : 1MCG J2501 $39.50

6555568 HALOBETASOL (ULTRAVATE) CRM 0.05% : 50GM A9270 $500.11



6555624 D10/0.2NS SOL :1000ML $78.30

6555645 fluocinoLONE (SYNALAR) CRM 0.01% : 15GM A9270 $10.30

6555648 MUPIROCIN (BACTROBAN) NASAL OINT : 1GM A9270 $55.86

6555652 POLYMYXIN/TRIMETHOP (POLY-TRIM) SOL A9270 $45.30

6555658 PROPAFENONE (RHYTHMOL) TAB : 150MG A9270 $4.30

6555661 ENALAPRIL (VASOTEC) TAB : 10MG A9270 $2.80

6555684 ALPROSTADIL(PROSTIN VR)INJ 500MCG/ML:1ML J0270 $858.00

6555687 METHADONE TAB : 5MG A9270 $2.50

6555689 APAP W/COD TAB 300/30MG : TAKE HOME MED A9270 $24.79

6555698 DOPAMINE PREMIX 400MG/D5W:250ML J1265 $63.00


6555849 PREVIDENT RINSE A9270 $25.40

6555869 GATIFLOXACIN (ZYMAR) OPTH SOL 0.3% : 5ML A9270 $207.40

6555877 RISPERIDONE (RISPERDAL) TAB : 0.25MG A9270 $3.40

6555894 CLOTRIMAZOLE/BETAM(LOTRISONE)LOTION:30ML A9270 $162.00

6555895 oxyCODONE/APAP (ENDOCET) TAB 7.5/500MG A9270 $2.80

6556241 LINEZOLID (ZYVOX) TAB : 600MG A9270 $583.30

6556247 UREA/MO PETROLAT (VANAMIDE) CRM 40%:85GM A9270 $100.10

6556289 DIAZEPAM(VALIUM)ORAL CONC SOL 5MG/5ML A9270 $4.37

6556548 CHOLESTYRAMINE (QUESTRAN) POWDER:378GM A9270 $145.00

6556558 RIVASTIGMINE (EXELON) CAP : 1.5MG A9270 $8.60

6556559 RIVASTIGMINE (EXELON) CAP : 3MG A9270 $10.10

6556560 RIZATRIPTAN ODT (MAXALT-MLT) TAB: 5 MG A9270 $83.25

6556564 TIROFIBAN (AGGRASTAT) INJ ML : 50MCG J3246 $1,590.70

6556587 MIRTAZAPINE (REMERON) TAB : 15MG A9270 $7.06

6556824 CEFtriaxONE (ROCEPHIN) 500MG:IM INJ J0696 $33.80

6556897 PRAMIPEXOLE (MIRAPEX) TAB : 0.5MG A9270 $9.39

6556898 HYDROcod/IBU (VICOPROFEN) TAB 7.5/200MG A9270 $3.00

6556987 FAT EMULSION 20% $82.80

6556988 DTAP PEDIATRIC(INFANRIX)VACCINE: 0.5 ML 90700 $93.20

6558564 HEPATITIS B VACC ped (ENGERIX):10MCG/0.5 90744 $94.50

6558958 NATEGLINIDE (STARLIX) TAB : 60MG A9270 $4.80

6558966 SS INSULIN REGULAR- HIGH RESISTANCE A9270 $135.50

6558987 BISACODYL SUPP BULK (12'S) : 10MG A9270 $7.60

6558989 SS INSULIN LISPRO-VERY LOW RESISTANCE A9270 $253.10

6558990 SS INSULIN LISPRO- LOW RESISTANCE A9270 $253.10

6558991 SS INSULIN LISPRO- MEDIUM RESISTANCE A9270 $253.10

6558992 SS INSULIN LISPRO- HIGH RESISTANCE A9270 $253.10

6558993 SS INSULIN REGULAR-VERY LOW RESISTANCE A9270 $135.50

6558994 SS INSULIN REGULAR- LOW RESISTANCE A9270 $135.50

6558995 SS INSULIN REGULAR- MEDIUM RESISTANCE A9270 $135.50

6559847 PIOGLITAZONE (ACTOS) TAB : 15MG A9270 $15.10

6560023 INSULIN LISPRO(HUMALOG): ONE TIME DOSE A9270 $23.10

6562514 FLUCONAZOLE (DIFLUCAN) SUSP 10MG/ML:35ML A9270 $93.10

6563594 SIROLIMUS (RAPAMUNE) TAB : 1MG A9270 $26.40

6563598 INFLIXIMAB(REMICADE)INJ 10MG/ML:10ML J1745 $3,668.69

6565421 DESLORATADINE (CLARINEX) TAB : 5MG A9270 $10.60

6565487 DIATRIZOATE (GASTROVIEW) SOL Q9958 $798.80

6565654 TRANDOLAPRIL (MAVIK) TAB : 4MG A9270 $3.20

6565889 TRAMADOL/APAP (ULTRACET) TAB 37.5/325MG A9270 $3.00

6565890 POTASSIUM CHLORIDE(KLOR-CON) TAB : 10MEQ A9270 $2.50

6565985 FAMOTIDINE /NS 50ML:20MG PREDEFINDED $42.80

6565987 SENNA WITH DOCUSATE TAB A9270 $2.50

6565988 TYPHOID (TYPHIM) INJ : 0.5ML 90691 $177.40

6566254 CHOLINE/MG SALIC (TRILISATE) TAB : 500MG A9270 $2.50

6566315 CARB/LEVODOPA 25/100 A9270 $2.00

6566528 ARIPIRAZOLE (ABILIFY) TAB : 10MG A9270 $47.22

6566584 TENECTEPLASE (TNK-ASE) INJ EA : 50MG J3101 $2,120.80

6566587 DALTEPARIN SOD (FRAGMIN) INJ : 2500 IU J1645 $81.00

6566588 BRINZOLAMIDE (AZOPT) OPTH SUSP 1% : 10ML A9270 $447.20

6566598 CALAMINE/GLY (CALAMINE/GLY) LOTION 15% A9270 $5.76

6566659 ENTACOPONE (COMTAN) TAB : 200MG A9270 $17.03

6566958 RECOMBIVAX (RECOMBIVAX) INJ ML : 40MCG 90740 $564.10

6566985 SORBITOL SOLUTION 70%: 30ML A9270 $2.25

6569584 ONDANSETRON (ZOFRAN) SOL 0.8MG/ML:50ML A9270 $623.60

6569957 FLUMAZENIL(ROMAZICON)INJ 0.1MG/ML:5ML $153.00

6569978 PSYLLIUM SF (METAMUCIL) PWD BULK : 450GM A9270 $24.00

6570374 POVIDONE/IODINE(BETADINE)SWAB:EA A9270 $2.50

6574455 LIDOCAINE (XYLOCAINE) VISCOUS 2%:15ML $2.80

6574485 DAPTOMYCIN(CUBICIN):500MG J0878 $868.72

6577421 VARICELLA VACCINE $169.10

6577458 MOXIFLOXACIN(VIGAMOX)OPTH SOL 0.5% :3 ML A9270 $315.85

6577845 COLLAGENASE (SANTYL) OINT : 30GM A9270 $234.00

6577888 MAGIC MOUTHWASH A9270 $10.35

6578266 CYCLOSPORINE(RESTASIS) 0.05%:12ML A9270 $553.18

6578302 SEVELAMER CARBONATE (RENVELA):800MG A9270 $6.03

6578459 POLYETHYLENE GLYGOL (MIRALAX) PWD:238GM A9270 $26.30

6578496 CEFtriaxONE(ROCEPHIN)2GM/NS 100ML FOR ER J0696 $254.00

6578747 MESALAMINE (PENTASA) CAP : 250MG A9270 $12.07

6578954 CETIRIZINE (ZYrtec) TAB : 5MG A9270 $6.50

6578964 OXCARBAZEPINE (TRILEPTAL) TAB : 150MG A9270 $3.80

6579000 REGADENOSON (LEXISCAN) INJ:0.08MG/ML 5ML J2785 $703.07

6580095 ZONISAMIDE(ZONEGRAN)CAP:100MG A9270 $6.70

6580428 ALENDRONATE/**D**(FOSAMAX **D**) 70/2800 A9270 $63.80

6580532 HYDROXYZINE HCL(ATARAX)SYRUP 2MG/ML:30ML A9270 $6.60

6580533 DEXAMETHASONE INJ ****10MG/ML****:1ML J1100 $30.82

6581067 KETOROLAC INJ : 30MG J1885 $31.65

6582254 CLONIDINE(DURACLON)100MCG/ML:10ML J0735 $162.28

6582256 MAG SULF 4GM/100ML STERILE WATER PREMIX J3475 $44.40

6582257 MAG SULF 20GM/500ML STERILE WATER PREMIX J3475 $40.60

6582455 LIDOCAINE 1% W/EPI 1:200,000 MPF: 30ML J0280 $58.50

6582564 BUPIVACAINE 0.25% W/EPI: 10ML $49.50

6584237 MESALAMINE (PENTASA): 500MG A9270 $6.50

6584425 INSULIN ASPART(NOVOLOG):ONE TIME DOSE A9270 $12.60

6584447 CEFIXIME (SUPRAX) CAP: 400MG A9270 $72.00

6584457 PEDVAXHIB-LIQUID VAC $94.00

6584571 carVEDilol *** CR***(COREG-CR)CAP: 40MG A9270 $10.40

6584587 DICLOFENAC (VOLTAREN) 1% GEL: 100GM A9270 $144.12

6585225 DILUTED DAKIN'S SOL(DI-DAK-SOL) : 473 ML A9270 $20.30

6585264 INSULIN GLARGINE(LANTUS)100UNIT/ML:PEN A9270 $111.96

6585265 CALCIUM CARBONATE TAB : 1250 MG A9270 $2.50

6585427 TRAZODONE HCL (DESERYL) TAB : 150MG A9270 $3.90

6585445 CEFACLOR (CECLOR) SUSP 75 MG/ML : 50 ML A9270 $68.60

6585544 SOD FLUORIDE GEL(PREVIDENT) 1.1%:60GM A9270 $26.60

6585556 KCL 10MEQ/D10-NS: 1000ML A9270 $28.70

6585558 ZOLEDRONIC ACID (RECLAST)/100 ML J3489 $3,406.66

6585589 FLORAJEN-3 CAPSULE #30 A9270 $14.95

6585622 ONDANSETRON(ZOFRAN) 4MG/5ML:50ML $623.60

6585624 ETOPOSIDE (VP-16) CAP : 50MG A9270 $157.62

6585762 FLUTICASONE/SALMETEROL DISKUS 500/50MG A9270 $774.18

6585866 BACITRACIN OINT 500U :0.9GM FOIL PCKT A9270 $2.50

6585966 IOTHALAMATE (CONRAY) 60% 50ML Q9965 $62.40

6586565 CEFazolin (KEFZOL) :2GM IM INJ J0690 $37.50

6586651 SOD FLUORIDE 1.1%(DENTA 5000) CR RINSE A9270 $20.80

6586654 PROMETH W/CODEINE: TAKE HOME 30ML A9270 $9.10

6587265 FERRIC SUBSULFATE PASTE :8 ML A9270 $29.90

6587457 POLIOVIRUS (IPOL) VACCINE 90713 $74.50

6587555 ISOSORBIDE Dinitrate TAB:2.5MG SUBLING A9270 $2.50

6587744 ARNOLD'S TRI-CREAM: 90GM A9270 $82.79

6587767 DEXRAZOXANE 500 MG:INJ J1190 $1,871.00

6587777 AMINO ACID A9270 $210.90

6587778 MYCOPHENOLATE (MYFORTIC): 360 MG A9270 $16.90

6587779 CHLORHEXIDINE GLUC(HIBICLENS)SOL4%:240ML A9270 $16.50

6587782 CALCIUM CITRATE (CITRACAL) TAB : 200MG A9270 $2.50

6587784 SITAGLIPTIN (JANUVIA) TAB: 100MG A9270 $36.99

6587854 METHYLPHENIDATE (CONCERTA) TAB : 36MG A9270 $9.60

6587855 CITALOPRAM (celeXA) TAB: 10MG A9270 $6.80

6587872 EPTIFIBATIDE (INTEGRILIN) INJ : 0.75MG J1327 $548.20

6587873 EPTIFIBATIDE (INTEGRILIN) INJ : 2MG J1327 $188.80

6587888 CEFTRIAXONE: ADV 1GM J0696 $43.10

6587892 RIVASTIGMINE (EXELON)PATCH: 4.6 MG A9270 $22.07

6588215 LACTOBACILLUS GG (CULTURELLE) CAP A9270 $2.50

6588244 DIPHENHYDRAMINE(BENADRYL)CAP:50MG A9270 $2.50

6588411 DALTEPARIN SOD (FRAGMIN) INJ : 18,000 IU J1645 $382.73

6588425 LIDOCAINE(XYLOCAINE) 2% MDV:20 ML $2.50

6588475 GLUCOSAMINE CAP : 500MG A9270 $2.25

6588478 BRIMONIDINE(ALPHAGAN P)OPT SOL 0.15%:5ML A9270 $183.80

6588487 MYCOPHENOLATE (CELLCEPT) TAB : 500MG A9270 $26.57

6588510 TRACE ELEMENT :5 A9270 $42.10

6588521 OPIUM TINCTURE 10MG/ML: 120ML A9270 $1,721.10

6588531 BUDESONIDE/FORMOT(SYMBICORT) :160/4.5 A9270 $696.31

6588554 SILV/TRIAMCIN/CLOTRIMAZOLE CREAM: 45GM A9270 $20.00


6588596 TRICHLOROACETIC SOL 85% A9270 $7.00

6588597 MAGNESIUM OXIDE (MAG-OX) TAB : 400MG A9270 $2.50

6588598 NIX RINSE SOL : 60ML A9270 $36.80

6588599 NIX CONTROL SPRAY : 150ML A9270 $13.50

6588666 STERILE WATER:2000ML $44.40

6588667 DESVENLAFAXINE (PRISTIQ)TAB:50MG A9270 $11.70

6588698 EZETIMIBE (ZETIA) TAB : 10MG A9270 $11.31

6588759 BUDESONIDE (PULMICORT) SOL : 0.25MG/2ML $16.40

6588760 BUDESONIDE (PULMICORT) SOL : 0.5MG/2ML $19.30

6588771 ALVIMOPAN (ENTEREG) CAP: 12 MG A9270 $490.99

6588774 CEFTRIAXONE: ADV 2GM J0696 $32.76

6588775 AMIODARONE (CORDARONE) INJ 50MG/ML:3ML J0282 $29.40

6588779 DEXTROSE A9270 $62.10

6588845 SODIUM CHLORIDE **3%**(HYPERTONIC):500ML $43.00

6588847 DEXTROSE 70%:2000ML $192.77

6588859 LEUPROLIDE (LUPRON DEPOT) INJ : 22.5MG J9217 $13,206.75

6588874 CEFazolin 2GM/NS 100ML FOR ER J0690 $38.30

6588878 RIFAMPIN INJ:600MG $279.40

6588884 INSULIN HUM REG IV DRIP 1 UNIT/ML:100 ML $58.50

6588888 ALISKIREN (TEKTURNA): TAB 150MG $18.23

6588899 INSULIN GLULISINE(APIDRA) 100UNIT/ML A9270 $279.60

6588958 ANESTHETIC (NUPERCAINAL) OINT : 60GM A9270 $21.50

6588985 URSODIOL (URSO) TAB : 250MG A9270 $5.90

6588987 NEOMYCIN IRRIGAT SOL 40% : 100ML $26.00

6589478 BISOPROLOL/HCTZ (ZIAC) TAB 5/6.25MG A9270 $3.00

6589574 LEVOFLOXACIN (LEVAQUIN)INJ 25 MG/ML:20ML J1956 $143.70


6589667 BUPIVICAINE W/EPI 0.25% SDV 30ML $40.90

6589678 STERILE WATER FOR IRRIG 1000ML $24.00

6589695 ALBUTEROL HFA (PROAIR HFA)INH:8.5 GM A9270 $198.35

6589714 CLOPIDOGREL (PLAVIX) TAB :****300 MG**** A9270 $74.99



6589777 OMEGA-3 (LOVAZA)CAP:1GM A9270 $4.00

6589784 METIPRANOLOL (OPTIPRANOLOL) SOL 0.3%:5ML A9270 $43.20

6589859 ESTRADIOL (ESTRADERM) PATCH 0.05MG A9270 $21.90

6589877 ARTIFICAL TEARS(BION TEARS)OPTH SOL 0.3% A9270 $33.80

6589878 IMMUNE GLOBULIN (GAMASTAN):2ML J1460 $166.20

6589892 PENICILLIN G :5,000,000 UNIT J0561 $62.71

6589898 ROPIVACAINE(NAROPIN) 10MG/ML:10ML J2795 $51.40

6589965 BRIMONIDINE(ALPHAGAN P)OPT SOL 0.1%:5ML A9270 $286.55

6589966 LIDOCAINE (LMX-4)4% CREAM:5 GM A9270 $27.00

6589974 MORPHINE **CR**(AVINZA) CAP: 30MG A9270 $10.10

6589998 ROPIVACAINE(NAROPIN) 2 MG/ML:200ML J2795 $224.17

6589999 ROPIVACAINE(NAROPIN) 2 MG/ML:100ML J2795 $145.58

6590001 HEPARIN 100 UNIT/ML SYRINGE:10ML J1642 $33.90

6590002 MERCAPTOPURINE (PURINETHOL): 50MG $6.00

6590022 CENTR SILV ULTRA WOMENS MULTIVIT/MINERAL A9270 $2.50

6590029 AMPHOTER B/STERILE WATER IRR 50MG/1000ML $92.00

6590030 FLUCONAZOLE/NS 400 MG:200 ML PREDEFINED $235.40

6590048 SILDENAFIL (REVATIO) TAB: 20 MG A9270 $46.80

6590050 FOSAPREPITANT DIMEGLUM(EMEND) INJ:150 MG J1453 $900.57

6590051 FOSAPREPITANT (EMEND)/NS 150 ML PRED J1453 $823.70

6590057 FONDAPARINUX (ARIXTRA) INJ:10MG/0.8ML J1652 $396.60

6590063 KCL 10MEQ/STERILE H2O 100ML:RIDER PREMIX J3480 $33.21

6590072 VTE PROPHYL ENOXAPARIN(LOVENOX)INJ: 40MG J1650 $122.73

6590073 VTE PROPHYL ENOXAPARIN(LOVENOX)INJ: 30MG J1650 $94.90

6590078 NITAZOXANIDE (ALINIA) TAB: 500 MG A9270 $64.30

6590082 BETAMETHASONE SOD PHOS/BETA ACET: INJ SU J0702 $163.28

6590085 LEFLUNOMIDE (ARAVA) TABLET: 10 MG A9270 $42.70

6590087 SODIUM THIOSULFATE 10% INJECTION: 100 MG $71.80

6590093 CISPLATIN/NS: 45 MG/ 500 ML: PREDEFINED J9060 $823.70

6590100 DOCETAXEL (TAXOTERE) INJ: 20 MG/ML: 4 ML J9171 $5,662.97

6590106 ASCORBIC ACID INJECTION 500 MG/ML: 50 ML $68.37

6590107 ABATACEPT/MALTOSE (ORENCIA) INJ: 250 MG J0129 $3,082.14

6590110 VANCOMYCIN IRRIGATION SOL 0.025%:1000 ML $42.30

6590111 DECITABINE (DACOGEN) INJ: 50 MG J0894 $4,988.36

6590116 LEVETIRACETAM (KEPRRA)INJ 100MG/ML:5ML J1953 $107.98

6590127 ATOMOXETINE (STRATTERA) CAP: 60MG A9270 $17.85

6590141 TISSEEL FIBRIN SEALANT FROZEN: 4ML $681.25

6590143 LEVOTHYROXINE (SYNTHROID) TAB: 0.137 MG A9270 $2.50

6590144 PHENOBARBITAL TABLET 15 MG A9270 $2.50

6590145 SOD FLUORIDE 1.1% DENTAL CREAM PREVIDENT A9270 $56.25

6590149 LITHIUM CARBONATE CAP: 150MG A9270 $2.50

6590162 TELAVANCIN (VIBATIV) 750 MG INJ J3095 $633.40

6590167 CEFTRAROLINE (TEFLARO) 600 MG INJECTION J0712 $158.25

6590173 RISPERDONE MICROSPHERE (RISPERDAL): 50MG J2794 $1,660.50

6590174 BENZOCAINE/MENTHOL/ALOE/LANO(DERMOPLAST) A9270 $9.95

6590181 CETIRIZINE HCL ORAL SOL 1 MG/ML-5 ML A9270 $2.50

6590192 LANOLIN HPA (LANSINOH) OINTMENT: 7GM A9270 $4.10

6590193 FERUMOXYTOL (FERAHEME) INJ: 510 MG Q0138 $2,668.61

6590197 PHOSPHORATED CHO SOLN(EMETROL): 4OZ A9270 $26.60

6590198 LANSOPRAZ SOLUTAB(PREVACID SOLUTAB):15MG A9270 $19.46

6590201 FENTANYL/ROPIVACAIN EPIDURAL:100MCG/0.2% J3010 $109.26

6590207 CEFazolin/D5W 2 GM: 50 ML PREDEFINED J0690 $65.70

6590208 ERIBULIN (HALAVEN) INJECTION: 1 MG J9179 $2,733.12

6590224 RIVAROXABAN (XARELTO) ORAL TABLET 10MG A9270 $32.72

6590232 DENOSUMAB (PROLIA) INJ: 60MG J0897 $2,574.00

6590247 CARBAMAZEPINE ER (TEGRETOL-XR) TAB:100MG A9270 $2.49

6590248 RIFAXIMIN (XIFAXAN) 550 MG TABLET A9270 $64.22

6590251 LEVOTHYROXINE (SYNTHROID) INJ: 100MCG $196.60

6590254 ACETAMINOPHEN(OFIRMEV)10MG/ML INJ:1000MG J0131 $83.89

6590255 MAGNESIUM CHLORIDE (MAG 64) TAB A9270 $2.50

6590261 predniSOLone (ORAPRED) SYR 3MG/ML:10ML J7510 $74.91

6590268 MUPIROCIN/COLLANGENASE 50/50 MIX: OINT $600.00

6590270 DICLOFENAC EC TAB : 25MG A9270 $3.59

6590271 FOSCARNET (FOSCAVIR) INJ/250 ML: 6000 MG J1455 $722.30

6590274 GENTEAL OPHTHALMIC GEL DROPS A9270 $21.20

6590275 REG INSULIN (HUMULIN R) 100UNIT/ML:10ML A9270 $0.31

6590276 ACETAMINOPHEN LIQUID 80MG/2.5ML:60ML A9270 $23.20

6590277 VANCOMYCIN EYE POST: 1MG $20.30

6590278 THIOTHIXENE (NAVANE) CAP : 2 MG A9270 $2.25

6590284 MICAFUNGIN (MYCAMINE) INJECTION: 100 MG J2248 $608.40

6590289 LORazepam (ATIVAN) TAB : 2MG A9270 $3.32


6590297 HEPARIN/D5W PREMIX 50 UNITS/ML : 500ML $38.60

6590298 DENOSUMAB (XGEVA) INJ: 120MG J0897 $2,574.00

6590303 MORPHINE INJ: 10MG VIAL* J2270 $28.70

6590306 HYDROCODONE/APAP TAB 5MG/325MG A9270 $3.00

6590314 OSELTAMIVIR 6 MG/ML(TAMIFLU) ORAL SUSP: A9270 $316.70

6590316 OXYTOCIN 30 UNITS/NS 500ML PRE-DEFINED J2590 $78.92

6590317 FIDAXOMICIN (DIFICID) TAB: 200MG A9270 $625.00

6590323 TESTOSTERONE CYP INJECTION:200 MG/ML J1071 $102.60

6590324 BIMATOPROST(LUMIGAN)0.01% OPHTH SOL:2.5M A9270 $515.11

6590325 LINAGLIPTIN (TRADJENTA) TAB: 5MG A9270 $25.11

6590330 PALIVIZUMAB(SYNAGIS) INJ 100MG/ML:1ML 90378 $7,300.75

6590345 TOBRAMYCIN OPHTHALMIC SOLUTION 0.03%:5ML A9270 $88.40


6590358 LEUCOVORIN INJ 20MG/ML:17.5ML J0640 $333.48

6590360 NALBUPHINE(NUBAIN)INJ 10MG/0.5ML:0.5ML $31.55

6590366 CARFILZOMIB (KYPROLIS) INJECTION: 60 MG J9047 $5,198.00

6590373 MAGNESIUM SULF /D5W :1GM PREDEFINED J3475 $58.50

6590374 EDROPHONIUM (ENLON) INJECTION 10MG/ML:15 $155.00

6590388 CLINDAMYCIN/D5W 900MG: 50ML PRE-DEFINED $91.50

6590389 CLINDAMYCIN/D5W 600MG: 50 ML PREDEFINED $46.80

6590390 HYDROCODONE/APAP TAB 10MG/325MG A9270 $3.50

6590393 NEBIVOLOL (BYSTOLIC) TAB: 20 MG A9270 $7.60

6590406 POVIDONE-IODINE OPHTH SOLN 5%:30ML $42.69

6590410 NEPAFENAC (ILEVRO) OPHTHALMIC SUSP 0.3% $460.84

6590411 HYALURONAN (ORTHOVISC) 30MG INJ: 2 ML J7324 $1,263.08

6590417 FENTANYL (SUBLIMAZE)INJ 0.05MG/ML:5ML J3010 $71.03

6590418 ALFENTANIL (ALFENTA) 500MCG/ML:2ML J3010 $79.23

6590420 MEPIVACAINE MPF(POLOCAINE)1.5% INJ :30ML J0670 $38.60

6590425 COMBINED SPINAL/EPIDURAL TRAY $110.80

6590442 ROPIVACAINE (NAROPIN)5 MG/ML INJ:100 ML J2795 $214.70

6590443 LIDOCAINE VISCOUS HCL 2% SOLUTION: 15 ML $2.80

6590447 HYDROcodone/APAP TAB 7.5/325MG A9270 $2.50

6590448 oxyCODONE/APAP TAB 7.5/325MG A9270 $7.10

6590449 HYDROcodone/APAP 5/325:TAKE HOME A9270 $17.95

6590456 PERPHENAZINE ORAL TABLET 8MG A9270 $5.00

6590465 BOTOX IM PWD FOR SOLN 100U J0585 $829.94

6590466 HYDROcodone/APAP 5 MG/217 MG SOLN : 10ML A9270 $11.92

6590471 BALANCED SALT (BSS) SOL : 500ML $88.35

6590488 TRANEXAMIC ACID INJ 100MG/ML:10ML $183.11


6590498 CEFUROXIME (ZINACEF) INJECTION: 1.5 GM J0697 $60.00

6590501 CAFFEINE CITRATE INJ : 60MG $58.50

6590515 MULTIVIT INFUSION VIT K : PRE-DEFINED J3430 $177.90

6590523 PULMICORT FLEXHALER 180MCG/ACTUATION A9270 $651.17

6590531 IPRATROP/ALBUTEROL(COMBIVENT)RESPIM:4 GM A9270 $1,164.83

6590532 ROPIVACAINE (NAROPIN) 5MG/ML INJ:30 ML J2795 $65.08

6590533 THROMBIN **TOPICAL** SPRAY : 20000 UNITS $965.90

6590539 INSULIN NPH (HUMULIN N )100 UNIT/ML:10ML A9270 $31.00

6590540 INSULIN 70/30 (HUMULIN) 100UNIT/ML:10ML A9270 $0.46

6590542 NF-LEFLUNOMIDE ORAL TABLET 20MG $2.50

6590543 ESTROPIPATE (ORTHO-EST) TAB: 0.75 MG A9270 $2.50

6590573 DEXMEDETOMIDINE 100MCG/1ML INJ:2ML $102.00

6590575 DARBEPOETIN(ARANESP)25MCG/ML: 1ML J0881 $2,107.25

6590577 TRIPTORELIN (TRELSTAR) INJ : 22.5MG J3315 $15,857.00

6590578 PNEUMOCOCCAL VA (PREVNAR 13) INJ : 13 90670 $526.38

6590579 MENTHOL (PERFORM) GEL : 120GM A9270 $36.37

6590580 predniSOLone (ORAPRED) SYR 3MG/ML:5 ML J7510 $37.44

6590585 OSELTAMIVIR(TAMIFLU)CAP 30MG A9270 $25.07

6590587 PROMETHAZINE/NS 50ML: 25 MG PREDEFINED $77.98

6590588 POLYETHYLENE GLYGOL (MIRALAX) PWD:17GM A9270 $2.50

6590589 PRAMOXINE 1% (SARNA SENSITI) LOT : 225ML A9270 $20.40

6590590 SODIUM CHLOR 0.9% BB IV NON DEHP : 250ML $61.18

6590591 QUEASE EASE SCENT PACK : 0.2 ML A9270 $26.00

6590592 AMIODARONE (NEXTERONE)100ML:150MG PREMIX J0282 $106.29

6590593 GENTAMICIN /NS 50 ML: 80 MG J1580 $79.40

6590594 SODIUM CHLOR 0.9% BB IV NON DEHP : 500ML J7050 $67.00

6590595 ADENOSINE (ADENOCARD)INJ 3MG/ML:2ML J0153 $24.29

6590596 LIDOCAINE 2% W/EPI 1:200,000 MPF: 20ML J0280 $62.50

6590597 SEVOFLURANE (ULTANE) GAS $586.56

6590598 BISOPROLOL FUMARATE TAB : 5MG A9270 $12.19

6590600 MORPHINE CONC SOL 20MG/ML: 0.5 ML $6.25

6590601 APIXABAN (ELIQUIS) TAB: 2.5 MG A9270 $16.40

6590603 TRYPAN BLUE OPHT SOL (VISION BLUE) 0.06% $106.49

6590610 HEPARIN/0.45%SOD CHL 50 UNITS/ML : 500ML J1644 $38.60

6590615 MOMETAS/FORMOTE (DULERA) INH:200MCG/5MCG $616.25

6590619 IMIPENIM/CILASTATIN (PRIMAXIN)INJ: 250MG $64.00

6590622 PERTUZUMAB (PERJETA) INJECTION: 420 MG J9306 $13,878.20

6590626 PHENTOLAMINE MESY (REGITINE) INJ: 5MG J2760 $1,326.00

6590628 NICARDIPINE (CARDENE) 200ML: 40MG PREMIX $617.50

6590639 AMIODARONE (CORDARONE) TAB :100MG A9270 $19.31

6590645 IVERMECTIN (STROMECTROL) TAB: 3 MG A9270 $12.90

6590647 LIDOCAINE (XYLOCAINE) MPF 2% 20MG/ML:5ML $29.90

6590654 SODIUM CHL 0.9% (STERILE) IV : 100ML $22.60

6590656 PROMETHAZINE/NS 50ML: 12.5 MG PREDEFINED $77.98

6590657 AZTREONAM (AZACTAM) 2 GM INJECTION $208.88

6590666 PHENYLEPHRINE/KETOROLA(OMIDRIA): 1%/0.3% J1097 $598.95

6590667 NIVOLUMAB (OPDIVO) INJECTION: 100 MG J9299 $8,032.09

6590669 OXYTOCIN 10 UNITS/LR 500ML PRE-DEFINED $66.69

6590686 INFLUENZA VIR VAC QUADRIVAILENT VACCINE 90694 $52.10

6590698 IMMUNE GLOBULIN *IVIG(GAMMAGARD)INJ:30GM J1569 $6,901.50

6590713 MIDAZOLAM / NS 1MG/1ML 50ML PRE-DEFINED $185.47

6590719 ABATACEPT/MALTOSE (ORENCIA) INJ: 250 MG J0129 $2,805.10

6590722 MIDAZOLAM (VERSED) 2 MG/ML SYRUP: 5 ML A9270 $19.10

6590724 RAMUCIRUMAB (CYRAMZA) 500 MG INJECTION: J9308 $17,708.90

6590725 RAMUCIRUMAB (CYRAMZA) 100 MG INJECTION J9308 $3,561.80

6590727 KETOROLAC TROMET OPHTH SOLN 0.5%:TAKE HO $41.37

6590728 OFLOXACIN OPTH SOL 0.3% 5ML:TAKE HOME A9270 $108.50

6590735 FOSFOMYCIN (MONUROL) PACKET: 3 GM $250.28

6590739 CEFtriaxONE /D5W 2 GM: 50 MLPREDEFINED J0696 $97.82


6590743 NF-Simbrinza Ophthalmic Suspension 0.2%- $535.65

6590753 ONDANSETRON 4MG ODT TAB TH :4MG A9270 $92.45

6590754 AMOXICILLIN/CLAVULAN TAB TH: 875MG/125MG A9270 $25.00

6590755 PROMETHAZINE (PHENERGAN) TAB TH: 25MG Q0169 $25.00

6590756 SULFAM/TRIME(SMX/TMP DS)TAB TH 800/160MG A9270 $20.00

6590757 CLINDAMYCIN (CLEOCIN) CAP TH : 150MG A9270 $25.00

6590758 PROTHROMBIN COM CON (KCENTRA) :500 UNITS J3590 $3,445.00

6590762 ROMIPLOSTIM (NPLATE) INJECTION: 250 MCG J2796 $4,987.05

6590767 ALBUTEROL HFA (PROAIR HFA)INH TH :8.5 GM $188.45

6590781 TROPIC/CYCLOPENT/PHENYL EYE 1/1/2.5%:5ML $99.00

6590782 LIDOCAINE/PHENYLEPHRINE 1/1.5% EYE:1ML $74.88

6590783 TROPIC/CYCLOPE/PHENY EYE 1/1/2.5%:0.5ML $16.00

6590784 OLANZAPINE (ZYPREXA) IM INJ:10MG J3486 $105.99

6590785 TICAGRELOR (BRILINTA ) TAB: 90 MG A9270 $18.05

6590786 CLINIMIX PVN 2.75% / 5% TPN: 1000ML $651.63

6590787 CLINIMIX E CVN 4.25% / 25% TPN: 1000ML $797.63

6590788 PEGFILGRASTIM (NEULASTA ONPRO) KIT: 6MG J2505 $19,502.15

6590790 OFATUMUMAB (ARZERRA) INJ 1000 MG J9302 $17,715.80

6590796 TRIAMCINOLON/MOXIFLOXACIN PF INJ: 15/1MG $55.00

6590799 MAG SULF 2GM/ 50ML STERILE WATER PREMIX J3475 $72.85

6590800 iDARUcizuMAB (PRAXBIND) INJ :2 X 2.5GM J3590 $10,920.00

6590801 DABIGATRAN (PRADAXA) CAP: 75 MG A9270 $19.29

6590806 ROPIVACAIN 0.125%/MORPHINEPF 7.5MG:250ML J2795 $256.67

6590807 PROPOFOL (DIPRIVAN) INJ 10MG/ML:100ML J2704 $87.60

6590817 SODIUM CHLORIDE 0.9% (STERILE)INJ :20ML $12.95

6590821 NF-Breo Ellipta Inh Pwd 100MCG/1Actuatio $418.15

6590832 DALBAVANCIN (DALVANCE) 500MG INJ J0875 $1,659.00

6590840 ADO-TRASTUZUMAB EMTANSINE (KADCYLA) INJ: J9354 $9,595.80

6590847 HYALURONAN (VITRASE) 200U/ML INJ: 1.2 ML J3471 $587.76

6590852 EVICEL FIBRIN SEALANT 2ML: 2 X 2 ML J3471 $874.48

6590857 MEROPENEM (MERREM) INJ: 500 MG J2185 $43.70

6590861 NYSTATIN ORAL SUSP 100,000U/ML: 5ML A9270 $4.42

6590862 NYSTATIN ORAL SUSP 100,000U/ML TH: 2X5ML A9270 $10.00

6590863 ONDANSETRO(ZOFRAN) ORALSOLN 0.8MG/ML:5ML A9270 $39.83

6590864 ONDANSETRON ORAL SOLN TH 0.8MG/ML:5ML A9270 $39.83

6590866 PENTAMIDINE (NEBUPENT) NEBU POWD : 300MG J2545 $550.75

6590875 LIDOCAINE (XYLOCAINE)MPF 1% 10 MG/ML:5ML $11.61

6590883 DEXAMETHASONE INJ **10MG/ML** PF:1ML J1100 $35.00

6590887 SODIUM CHLORIDE BACT INJ : 10ML $5.99

6590888 HYDROGEN PEROXIDE 3% SOL : 118ML A9270 $7.45

6590898 MEPOLIZUMAB (NUCALA) INJECTION: 1 MG J2182 $89.75

6590899 KETAMINE INJ 100MG/ML:1 ML $16.51

6590911 ROPIVACAINE 2 MG/ML ***BAG*** : 200ML J2795 $241.08

6590918 ALBUMIN HUMAN **5%** INJ : 50ML P9047 $59.12

6590926 ARIPIRAZOLE (ABILIFY) TAB : 5 MG A9270 $83.48


6590932 TH CEPHALEXIN (KEFLEX) SU 50MG/ML :100ML A9270 $48.75

6590946 TOCILIZUMAB (ACTEMRA) 20 MG/ML: 4 ML J3262 $1,387.80

6590952 RABIES IMMUNE GLOBULIN : **300 IU/1ML** 90375 $2,215.64

6590953 IPILIMUMAB (YERVOY) INJ: 5 MG/ML J9228 $23,698.30

6590957 DARBEPOETIN(ARANESP) 100MCG/ML: 1ML J0881 $2,414.88

6590965 LIDO/MAALOX/DONNA(GI COCKTAIL):60ML A9270 $192.67

6590968 ALUM/MG HYD/SIME SUSP : 30ML A9270 $7.30

6590969 DEXAMETHASON/MOXIFLOXACI SDV INJ: 1/5MG $62.50

6590976 TH KETOROLAC (TORADOL) TAB : 10MG A9270 $20.00

6590995 LIDOCANE HCL (GLYDOL) JELLY 2% : 6ML $18.60

6591000 KETAMINE INJ 50MG/ML:10ML $33.05

6591009 FERRIC CARBOXYMALTOSE (INJECTAFER) INJ: J1439 $3,215.20

6591012 BRENTUXIMAB (ADCETRIS) INJ:50MG J9042 $25,284.60

6591014 BENDAMUSTINE(TREANDA) INJ: 100 MG J9033 $8,441.35

6591015 BLEOMYCIN (BLENOXANE) INJ : 15 UNITS J9040 $246.00

6591016 CABAZITAXEL (JEVTANA) INJ: 60MG/1.5ML J9043 $25,741.30

6591017 CIDOFOVIR (VISTIDE) INJ 75MG/ML:5ML J0740 $2,333.80

6591018 CARBOplatin (PARAPLATIN) INJ: 450MG J9045 $317.50

6591020 CISplatin INJ 1MG/ML: 100ML J9060 $121.80


6591023 ETOPOSIDE (VP-16)INJ 20MG/ML:5ML J9181 $55.50

6591024 FILGASTRIM (NEUPOGEN) INJ : 480MCG J1442 $1,636.42

6591025 FILGRASTIM (NEUPOGEN) INJ : 300MCG J1442 $3.36

6591030 BEVACIZUMAB (AVASTIN) INJ : 400MG J9035 $8,568.64

6591031 CYCLOPHOSPHAMIDE(CYTOXAN)INJ:2000MG J9070 $286.30

6591032 DACARBAZINE (DTIC-DOME) INJ : 200MG J9130 $79.10

6591033 DEXAMETHASONE INJ: 4 MG/ML-1 ML J1100 $29.31

6591034 DOCETAXEL (TAXOTERE)INJ 10MG/ML:8ML J9171 $6,555.39

6591035 DOXORUBICIN LIPOSOMAL INJ 2MG/ML:10ML J9000 $3,705.29

6591036 DOXORUBICIN(ADRIAMYCIN)INJ 2MG/ML:100ML J9000 $464.35

6591038 ELOXATIN : INJ 100 MG J9263 $330.00

6591039 EPOETIN A (EPOGEN) INJ : 20,000 UNITS J0885 $829.10

6591040 FLUOROURACIL (5-FU) INJ 50MG/ML:20ML J9190 $43.80

6591041 FULVESTRANT (FASLODEX) INJ : 250MG J9395 $6,329.42

6591042 GEMCITABINE(GEMZAR)INJ:1000MG J9201 $2,445.14

6591043 GRANISETRON (KYTRIL) INJ : 1MG J1626 $84.28

6591044 GRANISETRON (KYTRIL) TAB : 1MG A9270 $153.50

6591045 IMMUNE GLOBULIN *10%(GAMUNEX)INJ:10GM J1561 $3,119.00

6591046 IMMUNE GLOBULIN *10%(GAMUNEX)INJ:5GM J1561 $1,572.00


6591048 IMMUNE GLOBULIN* IVIG(GAMMAGARD)INJ:20GM J1569 $7,196.70

6591049 IRINOTECAN (CAMPTOSAR) INJ 20MG/ML:5ML J9206 $302.68

6591050 LEUCOVORIN INJ 10MG/ML:50ML J0640 $72.60

6591051 LEUPROLIDE (LUPRON DEPOT) INJ : 3.75MG J1950 $3,265.60

6591052 METHOTREXATE INJ 25MG/ML :2ML J9260 $38.00

6591053 MITOMYCIN (MUTAMYCIN) INJ : 20MG J9280 $592.90

6591054 OCTREOTIDE(SANDOSTATIN)LAR/DEPO:20MG SYR J2353 $12,735.61

6591055 OXALIPLATIN : INJ 100 MG J9263 $4,485.44

6591062 DURVALUMAB (IMFINIZI) INJ:500 MG J9173 $11,764.70

6591071 CL TEST MEDICATION $11.00

6591083 RASBURICASE (ELITEK): 1.5 MG J2783 $953.33

6591104 PACLITAXEL (TAXOL) INJ 6MG/ML:50ML J9267 $212.85

6591105 PALONOSETRON HCL (ALOXI) INJ:0.25MG/5ML J2469 $1,415.96

6591106 PAMIDRONATE (AREDIA) INJ : 90MG J2430 $499.20

6591107 PEGFILGRASTIM (NEULASTA) INJ : 6MG J2505 $19,627.10

6591108 PEMETREXED (ALIMTA) INJ: 500MG J9305 $11,022.68

6591109 RITUXIMAB (RITUXAN) INJ 10MG/ML:50ML J9312 $11,631.84

6591110 TOPOTECAN HCL (HYCAMTIN) INJ : 4MG J9351 $3,372.40

6591111 VINBLASTINE INJ 1MG/ML: 10ML J9360 $16.71

6591112 ZOLEDRONIC ACID (ZOMETA) INJ: 4MG/5ML J3489 $2,819.30

6591113 INFLIXIMAB(REMICADE)INJ 10MG/ML:10ML J1745 $3,668.69

6591114 EPOGEN (EPOETIN)INJ: 40,000 UNITS J0885 $2,840.80

6591115 VINCRISTINE INJ 1MG/ML:2ML J9370 $76.50

6591116 VINORELBINE (NAVELBINE)INJ 10MG/ML:1 ML J9390 $383.80

6591117 ELOXATIN : INJ 100 MG J9263 $330.00

6591124 TRASTUZUMAB (HERCEPTIN):150MG J9355 $5,145.53

6591131 DRONABINOL (MARINOL) CAP : 2.5MG A9270 $38.70

6591132 HIGH DOSE INFLUENZA (FLUZONE) VACCINE 90662 $62.50

6591140 CL HEPATITIS B INJ: 20MCG $195.70

6591149 DILTIAZEM (CARDIZEM) INJ 5MG/ML:25ML $312.50

6591151 RITUXIMAB (RITUXAN) INJ 10MG/ML:10ML J9312 $3,100.40

6591152 TOCILIZUMAB (ACTEMRA) 20 MG/ML: 10ML J3262 $3,693.80

6591153 TOCILIZUMAB (ACTEMRA) 20 MG/ML: 20 ML J3262 $7,387.55

6591160 FILGRASTRIM-SNDZ (ZARXIO) INJ : 480MCG Q5101 $1,448.65

6591194 IMMUNE GLOBULIN IVIG(GAMMAGARD)INJ:20GM J1569 $8,649.89

6591212 OBINUTUZUMAB (GAZYVA) INECTION: 1000 MG J9301 $21,967.60

6591214 GOLIMUMAB (SIMPONI) INECTION: 50 MG J1602 $6,320.10

6591222 OXYCODONE 5MG : TAKE HOME MED A9270 $20.00

6591234 TH BENZONATATE (TESSALON) CAP : 100MG A9270 $25.95

6591238 OMALIZUMAB (XOLAIR) INJECTION: 150 MG J2357 $3,545.90

6591240 CHLORHEXIDINE (PERIDEX) LIQ 0.12% :15ML A9270 $10.53

6591241 PROBIOTIC DIGESTIVE TABLET A9270 $2.75

6591260 NF-Clindamycin Phosphate Gel/Jelly 1% $429.50

6591263 TH NITROGLYCERIN SL 0.4MG : 25's A9270 $35.39

6591264 PEGFILGRASTIM cbqv (UDENYCA) INJ : 6MG Q5111 $13,777.50

6591269 ATEZOLIZUMAB (TECENTRIQ) INJ: 10 MG J9022 $260.42

6591278 FAM-TRASTUZUMAB DERUXTECAN INJ (ENHERTU) J9358 $7,601.70

6591281 NF-Vyzulta Ophthalmic Solution 0.024% $1,262.04

6591290 NF-Stiolto Respimat Inh 2.5-2.5MCG/1Act $1,340.10

6591305 REMDESIVIR (VEKLURY) INJ 5MG/ML: 20ML J3490 $1,639.96

6591317 BAMLANIVIMAB INJ 35MG/ML : 20ML J3490 $1.00

6591318 BAMLANIVIMAB INJ / NS 250ML: 700MG PREDE J3490 $10.00

6591319 DEXMEDETOMIDINE 400MCG /NS 100ML : PREDE $260.00

6591332 PSEUDOEPHEDRINE (SUDAFED) TAB : 30MG A9270 $2.60

6591342 CYCLOPENTOLATE(CYCLOGYL)OPHTH SOL 2%:2ML $37.95

6591350 CYCLO 1%,TROPIC 1% ,PHENYL 2.5% OPH: 1ML $55.85

6591352 BAMLANIVIMAB INJ / NS 100ML: 700MG PREDE J3490 $1.00

6591356 INSULIN REG IV (MYXREDL 1 UNIT/ML:100 ML $109.20

6591363 VANCOMYCIN 2000 MG PREMIX:400ML $100.00



6591366 VANCOMYCIN 1250 MG PREMIX: 250ML $67.86

6591367 CEFEPIME/D5W 1GM:50 ML PREDEFINED $69.90

6591369 TIOTROPIUM BROMIDE & OLODATEROL INH $1,392.75

6591376 ETESEVIMAB INJ 35MG/ML : 20ML J3490 $1.00

6591377 BAMLANIV/ETESEVI / NS 100ML: 700/1400MG J3490 $1.00

6591389 FONDAPARINUX (ARIXTRA) INJ:5 MG/0.4ML J1652 $353.08

6591390 FONDAPARINUX (ARIXTRA) INJ:2.5MG/0.5ML J1652 $150.02

6591398 AZITHROMYCIN (ZITHROMAX) ADV INJ : 500MG J0456 $99.80

6591407 VISTASEAL SEALANT 2ML: 2 ML C9399 $325.18

6593156 AQUAPHOR OINT A9270 $34.60

6595234 LEVETIRACETAM (KEPPRA) ORAL SOL 100MG/ML A9270 $7.90

6595588 SALINE CENTRAL LINE FLUSH: 10ML $26.30

6595645 RENA-VITE RX TAB A9270 $2.50

6595684 RAMIPRIL (ALTACE) CAP : 10MG A9270 $6.40

6595686 SPINAL TRAYS:OB (SPINAL TR-OB) TRY EA $41.00

6596654 KETOROLAC 0.45%(ACUVAIL) OPTH SOL: 0.4ML $721.03

6596663 DALTEPARIN (FRAGMIN) INJECTION:5000 IU J1645 $115.42

6596812 ENOXAPARIN (LOVENOX) INJ ML : 120MG J1650 $273.70

6598451 CLOBETASOL GEL 0.05%: 30GM A9270 $38.60

6598544 FOSINOPRIL (MONOPRIL) TAB: 10MG A9270 $2.52

6598547 CARBAMAZEPINE **SR**(CARBATROL ER):300MG A9270 $3.70

6598564 ESTROGEN/MEDRO (PREMPRO) TAB 0.625/5MG A9270 $6.66

6598578 GLUCOSAMINE/CHONDRONTIN CAP 500/400MG A9270 $2.50

6598678 TRIAMCINALONE (KENALOG) CRM 0.025% :80GM A9270 $13.70

6598748 ISOSULFAN BLUE (LYMPHAZURIN) 10MG/ML:5ML Q9968 $1,809.30

6598842 LACOSAMIDE (VIMPAT): 50 MG TAB A9270 $18.67

6598843 LACOSAMIDE (VIMPAT): 100 MG TAB A9270 $12.20

6598854 TELAVANCIN (VIBATIV): INJ 250MG J3095 $181.00

6598877 MENTHOL (STOPAIN) ANALGESIC: 240ML A9270 $19.10

6598888 INTERFERON BETA-1B(BETASERON)INJ:0.3MG J1830 $397.80

6598958 HIBTITER INJ 90647 $362.20

6599099 MULTIPLE VITAMIN (FOLBEE PLUS) TAB A9270 $2.50



6599625 predniSONE TAB 5MG TAKE HOME A9270 $12.40

6599657 MICONAZOLE NIT(MONISTAT-3)4% VAG CRM A9270 $23.40

6599658 LEVOFLOXACIN(LEVAQUIN)250MG:TAKE HOME A9270 $44.70

6599662 DIVALPROEX (DEPAKOTE **SPRINKLE*): 125MG A9270 $2.79

6599664 METHYLNALTREXONE (RELISTOR):12MG/0.6ML A9270 $149.80

6599665 ALBUTEROL INH SOL 0.083%:TAKE HOME A9270 $10.40

6599845 GENTAMICIN (GENTAK) OPTH OINT : 3.5 GM A9270 $51.20

6599856 IODOSORB GEL WOUND CLEAN DRESS:40GM $282.90


6599874 TAMIFLU SUSPENSION ****15 MG/ML*** CMPD A9270 $223.60

6599901 CIPROFLOXACIN *(CIPRO) TABLET: 500 MG A9270 $13.75

6599965 MORPHINE (ROXANOL) CONC SOL 20MG/ML:30ML $48.50

6599974 CHERRY SYRUP: 473 ML A9270 $2.50


6700002 SOL .45NS 20MEQ 2B1357X $64.00

6700003 SOL .9%SC 100CC QP 2B1302 $64.00

6700004 SOL .9%SC 50CC QP 2B1301 $64.00

6700005 SOL 1000NS 40MEQ 2B1984X $64.00

6700006 SOL 1000NS IRRI 2B7114X $64.00

6700007 SOL 20KCL NS 2B1764X $64.00

6700008 SOL D/.45SC 20 MEQ 2B1654X $64.00

6700009 SOL D/.9 SC 20 MEQ 2B2434X $64.00

6700010 SOL D/.9 SC 40 MEQ 2B2454X $64.00

6700012 SOL D5 SC.5 500CC 2B1703Q $64.00

6700013 SOL D5.2NS 30MEQ 2B1624 $64.00

6700014 SOL D5/.5NS 10MEQ 2B1644X $64.00

6700015 SOL D5/.5NS 30MEQ 2B1664X $64.00

6700016 SOL D5/LR 20 MEQ 2B2224X $64.00

6700017 SOL D5/LR 40 MEQ 2B2244 $64.00

6700065 SOL D/.25SC 20MEQ 2B1614X $35.00

6700073 D/.25SC 40 MEQ KCL J3480 $35.00

6740687 SOL 2B0062Q D5/W 250CC $67.00

6740695 SOL 2B0063Q D5/W 500CC $67.00

6740709 SOL 2B0064X D5/W 1000CC $67.00

6740717 SOL 2B0163Q D10/W 500CC $67.00

6740725 SOL 2B0164X D10/W 1000CC $67.00

6740733 SOL 2B1024X D2.5/.45 SC 1000CC $67.00

6740741 SOL 2B1064X D5/.9SC 1000CC $67.00

6740768 SOL 2B1074X D5/.45SC 1000CC $67.00

6740776 SOL 2B1093QC D5/.2SC 500CC $67.00

6740784 SOL 2B1094X D5/.2SC 1000CC $67.00

6740792 SOL NS 250CC 2B1322Q $67.00

6740806 SOL NS 500CC 2B1323Q $67.00

6740814 SOL NS 1000CC 2B1324X $67.00

6740822 SOL 2B2073Q D5/LR 500CC $67.00

6740849 SOL 2B2074X D5/LR 1000CC $67.00

6740857 SOL LR 500CC 2B2323Q $67.00

6740865 SOL LR 1000CC 2B2324X $67.00

6740873 SOL ST WATER IR 1000CC 2F7114 $67.00

6740881 SOL NS IRRIG 1000CC 2F7124 $67.00

6743317 SOL SOD CHL .45 2B1314X $63.00

6743643 SOL 2B1674 D/.45SC 40MEQ $67.00

6900150 SARGROMOSTIM (LEUKINE) INJ: 250 MCG J2820 $605.40

6900313 DEXAMETHASONE INJ: 4 MG/ML-1 ML J1100 $29.31

6900434 FLUDARABINE (FLUDARA) INJ : 50MG J9185 $919.70

6901133 CIDOFOVIR (VISTIDE) INJ 75MG/ML:5ML J0740 $2,333.80

6901762 ONDANSETRON INJ 2MG/ML: 2ML J2405 $28.25

6901833 INTERFERON ALFA (INTRON) INJ : 1M IU J9214 $26.50

6902960 IFOSFAMIDE (IFEX) INJ : 1000MG J9208 $452.50

6902981 INTERFERON ALFA-2B (INTRON-A)INJ:10MI U J9214 $472.06

6903468 MITOXANTRONE(NOVANTRONE)INJ 2MG/ML:10ML J9293 $1,117.00

6940098 IMMUNE GLOBULIN (POLY-GAM)INJ:5GM J1566 $1,138.80




6940115 IMMUNE GLOBULIN* IVIG(GAMMAGARD)INJ:1 GM J1569 $383.60


6954784 RISPERDONE MICROSPHERE(RISPERDAL):37.5MG J2794 $1,181.20

6956882 BORTEZOMID (VELCADE): 3.5MG J9041 $5,048.30

6985266 PANITUMUMAB(VECTIBIX)20MG/ML:20ML J9303 $13,075.92

6985588 TEMSIROLIMUS 25MG/ML:INJ KIT J9330 $4,000.60

6988896 AZACITIDINE(VIDAZA) :INJ SQ 25MG/ML:4ML J9025 $1,324.97

6990250 LEUPROLIDE (ELIGARD) INJ.: 45 MG J9217 $7,693.40

6990251 PALONOSETRON HCL (ALOXI) INJ:0.25MG/5ML J2469 $1,415.96

7111505 ANESTHESIA GENERAL $438.00

7111513 ANESTHESIA SPINAL $319.00

7111521 ANESTHESIA IV BLOCK $341.00

7111548 ANESTHES MONITORED $299.00

7111572 ANESTHES GASES $22.00

7111629 DESFLURANE $94.00

7112404 EPIDURAL TRAY $254.00

7112447 SALEM SUMP W/VALVE $60.00

7112455 IV CATH W/TUBE $19.00

7123058 ANEST GEN WITH MASK $418.00

7123066 REGIONAL ANESTHESIA BLOCK $367.00

7123074 ET TUBE / LMA $30.00

7123082 ANESHESIA EQUIP (INFUSION PUMP) $96.00

7123112 ANESTHES GASES $22.00

7124127 INJECTION SETUP $46.00

7124305 FIBER OPTIC BRONCH $596.00

7124413 DIFFICULT AIRWAY EQUIP CART $1,387.00

7200702 ANES FOR PERCUTAN LIVER BX 00702 $122.00

7220550 INJECTION SINGLE TENDON SHEATH LIAGAMENT 20552 $366.00

7220552 TRIGGER POINT INJECTIONS, 1 OR 2 MSK 20552 $365.00

7220553 TRIGGER POINT INJECTIONS, 3 OR MORE MSK 20553 $122.00

7220600 ARTHROCENTESIS, ASP/INJECT,SMALL JOINT 20600 $122.00

7220605 INJ/ASP-M (WRIST/ELBOW/ANKLE) 20605 $488.00

7220610 INJECTION MAJOR JOINT OR BURSA 20610 $366.00

7227096 SACROILIAC JOINT (SI) INJECTIONS 27096 $122.00

7252321 EPIDURAL INJECT W/IMAGING CERVICAL/THORA 62321 $122.00

7262320 EPIDURAL INJECTION W/O IMAGING, CERVICAL 62320 $1,220.00

7262321 EPIDURAL INJECTION WITH IMAGING CERV/THO 62321 $1,220.00

7262322 EPIDURAL INJECTION WITHOUT IMAGING,LUMBA 62322 $976.00

7262323 EPIDURAL INJECTION WITH IMAGING 62323 $1,215.00

7262326 INDWELLING CATHETER, CONT INFUS LUMBAR 62326 $1,220.00

7264400 INJECT TRIGEMINAL NERVE, ANY DIV OR BRAN 64400 $610.00

7264405 GREATER OCCIPITAL NERVE BLOCK 64405 $608.00

7264415 BRACHIAL PLEXUS BLOCK, SINGLE INJECTION 64415 $972.00

7264418 SUPRSCAPULAR NERVE BLOCK 64418 $610.00

7264420 INTERCOSTAL NERVE BLOCK, SINGLE 64420 $122.00

7264421 INTERCOSTAL NERVE BLOCK, MULTI 64421 $976.00

7264425 ILIOINGUINAL, ILIOHYPOGASTRIC NERVE BLCO 64425 $122.00

7264448 FEMORAL NERVE INFUSION VIA CATHETER 64448 $1,464.00

7264450 OTHER PERIPHERAL NERVE BLOCK 64450 $610.00

7264461 PARABERTEBRAL BLOCK-SINGLE INJECT 64461 $608.00

7264462 PARABERTEBRAL BLOCK-2ND LEVEL 64462 $122.00

7264479 CERVIAL TRANSFORAMINAL EPIDURAL STEROID 64479 $1,830.00

7264483 LUMBAR TRASFORAMINAL ESI 64483 $1,821.00

7264486 ANESTHETIST FEES 64486 $608.00

7264490 INJECTION, PARAVERTEBRAL FACET, CERVICAL 64490 $122.00

7264491 INJECTION, FACET, CERVICAL 2ND LEVEL 64491 $122.00

7264493 LUMBAR FACET INJECTION 64493 $122.00

7264494 LUMBAR FACET INJECTION-ADD LEVEL 64494 $122.00

7264505 SPHENOPALATINE GANGLION INJECTION 64505 $976.00

7264510 STELLATE GANGLION BLOCK 64510 $854.00

7264520 LUMBAR/THORACIC SYMPATHETIC BLOCK 64520 $976.00

7299201 EVAL & MANAGEMENT, NEW PATIENT 99201 $243.00

7299211 OUTPATIENT VISIT FOR ESTABLISHED PATIENT 99211 $122.00

7299212 OUTPAT VISIST E/M OF ESTABLISHED PT 99212 $122.00

7299465 NEWBOARN INTUBATIUON/RESUSCITATION 99465 $122.00





















7311165 ANESTHETIST FEES $122.00


































































































































7323554 Sciatic Nerve Block, Single injection 64445 $851.00




































7324364 ANESTHETIST FEES 01967 $1,830.00


7324399 ANESTHETIST FEES C1777 $122.00





7324534 ANESTHETIST FEES $122.00









7324771 Femoral Nerve Block, Single Injection 64447 $851.00













7500002 6 MIN WALK TEST 94618 $207.00

7500992 THER EXER EX GROUP G0424 $296.00

7501026 RESPIR MUSCLE TRAIN G0237 $87.00

7501034 RESPIRATORY FUNTION INDIVIDUAL G0238 $87.00

7501042 RESPIR FUNCTION GRP G0239 $87.00

7700040 OXYGEN/HR $29.00

7900019 CPT SUBSEQUENT MANUAL 94668 $56.00

7900020 VOCATIONAL MASK FITTING $31.00

7900062 PULSE OXIMETRY-MULT 94761 $89.00

7900127 CPT INITIAL MANUAL 94667 $94.00

7900313 BIPAP/CPAP DAY 94660 $553.00

7900375 SMOKING CESSATION & IT;10 99406 $67.00

7900376 SMOKING CESSATION & GT;10 99407 $67.00

7900763 OVERNIGHT OXIMETRY 94762 $304.00

7900801 NITROGEN WASHOUT 94727 $200.00

7900828 DLCO DIFFUSING CAP 94729 $336.00

7900836 PULM STRESS TEST CX 94621 $402.00

7900844 PEP THERAPY INITIAL 94664 $233.00

7901083 VENTILATOR PER DAY 94003 $954.00

7901123 VENTILATOR INITIAL NON ED 94002 $246.00

7910001 PRE/POST PFT 94060 $286.00

7920015 SPIROMETRY-PFT 94010 $248.00

7930004 AEROSOL TREATMENT 94640 $71.00

7993339 PULSE OXI-SINGLE 94760 $42.00

7994664 NEB TREATMENT FOR SPUTUM INDUCTION 94640 $88.00

7994669 CPT MECHANICAL 94669 $135.00

8111221 CARDIAC RH W/MONIT 93798 $234.00

8310012 PT MECHANICAL TRACTION 97012 $59.00

8310144 PT GAIT TRAINING 15M 97116 $79.00

8310187 PT WHEELCHAIR MGT 15M 97542 $56.00

8310241 PT MASSAGE 15M 97124 $72.00

8310381 PT ULTRASOUND/PHONO 15M 97035 $63.00

8310497 PT THERAPEUTIC EXERCISE PER 15 MINS 97110 $80.00

8310616 PT IONTOPHORESIS PER 15 MINS 97033 $72.00

8311329 PT WORK HARD INIT 2HR 97545 $395.00

8311337 PT WORK HARD ADD 1HR 97546 $154.00

8311434 PT THER ACTIVITES 15M 97530 $80.00

8311477 PT NEUROMUSC RE-ED 15M 97112 $87.00

8311663 PT PROSTHETIC TRAIN15M 97761 $80.00

8311701 PT WORK SCREEN-15MIN 97750 $51.00

8311736 PT MANUAL THERAPY 15M 97140 $83.00

8311787 PT SELF CARE/HOME MGT 97535 $80.00

8311906 PT AQUATIC EX PER 15 MINS 97113 $80.00

8311949 PT ELECTRICAL STIMULATION 97032 $56.00

8312023 PT INCONTC BIOFEEDBACK 90911 $140.00

8312031 PT MUSCLE RETRN BIOFDB 90901 $101.00

8312066 PT GROUP THERAPY ORDER 97150 $41.00

8312112 PT VASOPNEUMATIC DEV 97016 $37.00

8395992 CANALITH REPOSITIONING PROCEDURE 95992 $56.00

8397161 PT EVALUATION LOW 97161 $140.00

8397162 PT EVALUATION MEDIUM 97162 $156.00

8397163 PT EVALUATION HIGH 97163 $171.00

8397164 PT RE EVALUATION 97164 $98.00

8397763 PT ORTHOTIC & PROSTHETIC SUB 97763 $80.00

8500043 ST SPEECH/LANG THERAPY 92507 $163.00

8500108 ST SWALLOW ORAL TRTMNT 92526 $165.00

8500116 ST BEDSIDE SWALLOW EVALUATION 92611 $273.00

8500124 ST VIDEO SWALLOW EVALUATION 92610 $273.00

8592521 EVALUATION OF SPEECH FLUENCY 92521 $137.00

8592522 EVALUATION OF SPEECH SOUND PRODUCTION 92522 $111.00

8592523 EVAL OF SP/SOUND PROD/LAN COMP/EXPRESS 92523 $231.00

8592524 BEHAVIORAL & QUALITATIVE ANALY OF VOICE 92524 $116.00

8900014 OT SELF CARE/HOME MGMT PER 15 MINS 97535 $80.00

8900022 OT THER ACTIVITIES 15M 97530 $80.00

8900057 OT FLUIDOTHERAPY 97022 $63.00

8900138 OT ORTHOTICS 15M 97760 $80.00

8900243 OT THERAPUE EX-15" 97110 $80.00

8900308 OT WHEELCHAIR MGT 15M 97542 $56.00

8900324 OT US 15M 97035 $63.00

8900332 OT IONTO 15M 97033 $72.00

8900359 OT ELECTROTHERAPY 97032 $46.00

8900499 OT NEUROMSCLR RE-ED 15M 97112 $87.00

8900502 OT MANUAL THPY 15M 97140 $83.00

8900667 OT FCA 15 MIN 97750 $66.00

8900693 OT WORK TOLERANCE 15 97750 $51.00

8903702 ELBOW ORTHOSIS RT L3702 $321.00

8903806 WRIST FINGER HAND DYNAMIC RT L3806 $505.00

8903808 WHF ORTHOSIS RT L3808 $381.00

8903906 WRIST HAND ORTHOSIS RT L3906 $439.00

8903913 HAND FINGER ORTHOSIS RT L3913 $301.00

8903921 HAND FINGER DYNAMIC RT L3921 $357.00

8903933 FINGER ORTHOSIS RT L3933 $237.00

8903964 ELBOW WRIST HAND DYNAMIC RT L3764 $826.00

8913702 ELBOW ORTHOSIS LT L3702 $321.00

8913806 WRIST FINGER HAND DYNAMIC LT L3806 $505.00

8913808 WHF ORTHOSIS LT L3808 $381.00

8913906 WRIST HAND ORTHOSIS LT L3906 $439.00

8913913 HAND FINGER ORTHOSIS LT L3913 $301.00

8913921 HAND FINGER DYNAMIC LT L3921 $357.00

8913933 FINGER ORTHOSIS LT L3933 $237.00

8913964 ELBOW WRIST HAND DYNAMIC LT L3764 $826.00

8964550 OT TENS APPLICATION 64550 $73.00

8997165 OT EVALUATION LOW 97165 $140.00

8997166 OT EVALUATION MEDIUM 97166 $156.00

8997167 OT EVALUATION HIGH 97167 $171.00

8997168 OT RE EVALUATION 97168 $98.00

8997537 OT COMMUNITY/WORK REINTEGRATION PER 15 M 97537 $77.00

8997763 OT ORTHOTICS & PROSTHETIC SUB 97763 $80.00

8997764 OT ORTHOTICS & PROSTHETIC SUB 15M 97763 $80.00

9000463 HOSPITAL OUTPATIENT CLINIC VISIT G0463 $51.00

9003014 TELEHEALTH FACILITY FEE Q3014 $51.00

9090832 16-37 MINS. INDIVIDUAL PHYCHOTHERAPY 90832 $332.00



9090846 FAMILY PHYCHOTHERAPY W/O PATIENT PRESENT 90846 $383.00

9090847 FAMILY PHYCHOTHERAPY W/ PATIENT PRESENT 90847 $383.00

9090853 GROUP PHYCHOTHERAPY 90853 $301.00

9100028 DIABETIC TRAINING 30 MIN G0108 $98.00

9100052 DIABETIC TEAM TRAIN 30 MIN G0109 $42.00

9100079 DIABETES TRAINING I 30 MIN G0108 $98.00

9100095 DIABETES FOLLOW-UP 30 MIN G0108 $98.00

9100109 INSULIN RESIST SYND 30 MIN G0108 $98.00

9195249 PERSONAL CGM-STARTUP/TRAINING 95249 $114.00

9195250 CONTINUOUS GLUCOSE MONITOR 95250 $286.00

9200100 INITIAL DIETARY ASSESSMENT 97802 $20.00

9200150 DIETARY ASSESSMENT FOLLOWUP 97803 $20.00

9297804 GROUP MNT 97804 $19.00

ROOM CHARGE-MEDICAL/SURGICAL $1,523.00

ROOM CHARGE-SKILLED $1,017.00

ROOM CHARGE-SCU $2,772.00

ROOM CHARGE-LTC PRIVATE $256.00

ROOM CHARGE-LTC SEMI PRIVIATE $211.00

ROOM CHARGE-LSN $402.00

Item Number Item Description CPT Code Current Price 170409 ...

Documents