CDM Item Number,Revenue Code,Service ID,Service Mod1,Service Mod2,Service Mod3,Service Mod4,Service Description,Gross Charge,Discounted Cash Price,Minimum Negotiated Charge,Maximum Negotiated Charge,Payer Negotiated Charge: Blue Cross Blue Shield of IL (Plan: All),Payer Negotiated Charge: Blue Cross Blue Shield of IL (Plan: Default),Payer Negotiated Charge: Cigna (Plan: All),Payer Negotiated Charge: Healthlink PPO (Plan: All),Payer Negotiated Charge: Medicaid Illinois (Plan: All),Payer Negotiated Charge: Medicaid Illinois (Plan: Default),Payer Negotiated Charge: Medicare A IL J6 (Plan: All),Payer Negotiated Charge: Medicare B IL J6 (Plan: All),Payer Negotiated Charge: Medicare Railroad Palmetto GBA (Plan: All),Payer Negotiated Charge: United Healthcare (Plan: All),Payer Negotiated Charge: United Healthcare (Plan: Default)
10000925,0360,36245,,,,,INTRA-ARTERIAL-SEL CATH/ARTERIAL,0.00,0.00,3814.84,3814.84,,,,,,,3814.84,,,,
10000926,0360,36246,,,,,INTRA-ARTERIAL-SEL CATH/ABD/PELVIC,0.00,0.00,3854.11,3854.11,,,,,,,3854.11,,,,
10000927,0360,36247,,,,,INTRA-ARTERIAL-SEL CATH/THIRD ORDER,0.00,0.00,3838.40,3838.40,,,,,,,3838.40,,,,
10001700,0360,,,,,,REMOVAL OF SKIN TAGS UP TO 15,855.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001701,0360,,,,,,EXCISION OF NEVUS SINGLE OR MULTIPLE >5,855.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001702,0360,,,,,,EXCISION OF LESION SINGLE OR MULTIPLE L5,855.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001703,0360,,,,,,SIMPLE WOUND DEBRIDEMENT CLEAN,855.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001704,0360,,,,,,SONO GUIDED ASPIRATION BIOPSY,855.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001705,0360,,,,,,SIMPLE WOUND EXPLORATION,855.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001706,0360,,,,,,SMPL WOUND EXPLOR W/ RMVL FOREIGN BD,855.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001707,0360,,,,,,EXCISION SINGLE NAIL MATRIX FNG TOE,1644.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001708,0360,,,,,,EXCISION OF NEVUS MULTIPLE >4,1644.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001709,0360,,,,,,EXCISION OF LESION MULTIPLE >4,1644.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001710,0360,,,,,,INCISION DRAINAGE ABSCESS OR WOUND,1644.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001711,0360,,,,,,WOUND DEBRIDEMENT CONTAMINATION,1644.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001712,0360,55250,,,,,VASECTOMY,5644.23,5644.23,,,,,,,,,,,,,
10001713,0360,,,,,,SCLEROTHERAPY SPIDER VEINS,1644.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10001714,0761,,,,,,SPECIAL PROCEDURE FIRST 30 MIN.,157.25,0.00,2231.53,2231.53,2231.53,2231.53,,,,,,,,,
10001715,0761,,,,,,SPECIAL PROCEDURE EACH ADDITIONAL 15,78.75,0.00,2231.53,2231.53,2231.53,2231.53,,,,,,,,,
10002001,0360,,,,,,CARDIO VASCULAR LEVEL 1,147.33,147.33,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002002,0360,,,,,,CARDIO VASCULAR LEVEL 2,136.55,136.55,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002003,0360,,,,,,CARDIO VASCULAR LEVEL 3,154.85,154.85,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002004,0360,,,,,,CARDIO VASCULAR LEVEL 4,165.62,165.62,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002005,0360,,,,,,CARDIO VASCULAR LEVEL 5,171.84,171.84,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002006,0360,,,,,,CARDIO VASCULAR LEVEL 1 UNSCHEDULED,108.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002007,0360,,,,,,CARDIO VASCULAR LEVEL 2 UNSCHEDULED,106.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002008,0360,,,,,,CARDIO VASCULAR LEVEL 3 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002009,0360,,,,,,CARDIO VASCULAR LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002010,0360,,,,,,CARDIO VASCULAR LEVEL 5 UNSCHEDULED,126.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002011,0360,,,,,,ENDOCRINE LEVEL 1,133.95,133.95,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002012,0360,,,,,,ENDOCRINE LEVEL 2,135.26,135.26,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002013,0360,,,,,,ENDOCRINE LEVEL 3,152.23,152.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002014,0360,,,,,,ENDOCRINE LEVEL 4,165.62,165.62,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002015,0360,,,,,,ENDOCRINE LEVEL 5,171.84,171.84,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002016,0360,,,,,,ENDOCRINE LEVEL 1 UNSCHEDULED,108.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002017,0360,,,,,,ENDOCRINE LEVEL 2 UNSCHEDULED,106.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002018,0360,,,,,,ENDOCRINE LEVEL 3 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002019,0360,,,,,,ENDOCRINE LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002020,0360,,,,,,ENDOCRINE LEVEL 5 UNSCHEDULED,126.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002021,0360,,,,,,GASTROINTESTINAL LEVEL 1,135.26,135.26,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002022,0360,,,,,,GASTROINTESTINAL LEVEL 2,135.26,135.26,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002023,0360,,,,,,GASTROINTESTINAL LEVEL 3,152.23,152.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002024,0360,,,,,,GASTROINTESTINAL LEVEL 4,163.02,163.02,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002025,0360,,,,,,GASTROINTESTINAL LEVEL 5,169.23,169.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002026,0360,,,,,,GASTROINTESTINAL LEVEL 1 UNSCHEDULED,105.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002027,0360,,,,,,GASTROINTESTINAL LEVEL 2 UNSCHEDULED,104.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002028,0360,,,,,,GASTROINTESTINAL LEVEL 3 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002029,0360,,,,,,GASTROINTESTINAL LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002030,0360,,,,,,GASTROINTESTINAL LEVEL 5 UNSCHEDULED,125.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002031,0360,,,,,,GYNECOLOGICAL LEVEL 1,133.95,133.95,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002032,0360,,,,,,GYNECOLOGICAL LEVEL 2,135.25,135.25,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002033,0360,,,,,,GYNECOLOGICAL LEVEL 3,152.23,152.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002034,0360,,,,,,GYNECOLOGICAL LEVEL 4,163.02,163.02,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002035,0360,,,,,,GYNECOLOGICAL LEVEL 5,169.23,169.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002036,0360,,,,,,GYNECOLOGICAL LEVEL 1 UNSCHEDULED,109.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002037,0360,,,,,,GYNECOLOGICAL LEVEL 2 UNSCHEDULED,107.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002038,0360,,,,,,GYNECOLOGICAL LEVEL 3 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002039,0360,,,,,,GYNECOLOGICAL LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002040,0360,,,,,,GYNECOLOGICAL LEVEL 5 UNSCHEDULED,125.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002041,0360,,,,,,URINARY LEVEL 1,157.85,157.85,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002042,0360,,,,,,URINARY LEVEL 2,163.49,163.49,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002043,0360,,,,,,URINARY LEVEL 3,169.13,169.13,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002044,0360,,,,,,URINARY LEVEL 4,177.02,177.02,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002045,0360,,,,,,URINARY LEVEL 5,183.78,183.78,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002046,0360,,,,,,URINARY LEVEL 1 UNSCHEDULED,108.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002047,0360,,,,,,URINARY LEVEL 2 UNSCHEDULED,106.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002048,0360,,,,,,URINARY LEVEL 3 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002049,0360,,,,,,URINARY LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002050,0360,,,,,,URINARY LEVEL 5 UNSCHEDULED,127.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002051,0360,,,,,,INTEGUMENTARY LEVEL 1,133.95,133.95,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002052,0360,,,,,,INTEGUMENTARY LEVEL 2,135.26,135.26,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002053,0360,,,,,,INTEGUMENTARY LEVEL 3,152.23,152.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002054,0360,,,,,,INTEGUMENTARY LEVEL 4,163.02,163.02,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002055,0360,,,,,,INTEGUMENTARY LEVEL 5,169.23,169.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002056,0360,,,,,,INTEGUMENTARY LEVEL 1 UNSCHEDULED,109.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002057,0360,,,,,,INTEGUMENTARY LEVEL 2 UNSCHEDULED,108.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002058,0360,,,,,,INTEGUMENTARY LEVEL 3 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002059,0360,,,,,,INTEGUMENTARY LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002060,0360,,,,,,INTEGUMENTARY LEVEL 5 UNSCHEDULED,125.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002061,0360,,,,,,NEUROLOGICAL LEVEL 1,134.60,134.60,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002062,0360,,,,,,NEUROLOGICAL LEVEL 2,135.89,135.89,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002063,0360,,,,,,NEUROLOGICAL LEVEL 3,153.23,153.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002064,0360,,,,,,NEUROLOGICAL LEVEL 4,163.02,163.02,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002065,0360,,,,,,NEUROLOGICAL LEVEL 5,169.23,169.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002066,0360,,,,,,NEUROLOGICAL LEVEL 1 UNSCHEDULED,108.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002067,0360,,,,,,NEUROLOGICAL LEVEL 2 UNSCHEDULED,106.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002068,0360,,,,,,NEUROLOGICAL LEVEL 3 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002069,0360,,,,,,NEUROLOGICAL LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002070,0360,,,,,,NEUROLOGICAL LEVEL 5 UNSCHEDULED,125.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002071,0360,,,,,,RESPIRATORY LEVEL 1,133.95,133.95,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002072,0360,,,,,,RESPIRATORY LEVEL 2,135.26,135.26,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002073,0360,,,,,,RESPIRATORY LEVEL 3,152.23,152.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002074,0360,,,,,,RESPIRATORY LEVEL 4,161.70,161.70,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002075,0360,,,,,,RESPIRATORY LEVEL 5,175.43,175.43,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002076,0360,,,,,,RESPIRATORY LEVEL 1 UNSCHEDULED,107.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002077,0360,,,,,,RESPIRATORY LEVEL 2 UNSCHEDULED,106.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002078,0360,,,,,,RESPIRATORY LEVEL 3 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002079,0360,,,,,,RESPIRATORY LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002080,0360,,,,,,RESPIRATORY LEVEL 5 UNSCHEDULED,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002081,0360,,,,,,SKELETAL LEVEL 1 SCHEDULED,102.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002082,0360,,,,,,SKELETAL LEVEL 2 SCHEDULED,103.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002083,0360,,,,,,SKELETAL LEVEL 3 SCHEDULED,116.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002084,0360,,,,,,SKELETAL LEVEL 4,169.88,169.88,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002085,0360,,,,,,SKELETAL LEVEL 5,183.93,183.93,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002086,0360,,,,,,SKELETAL LEVEL 1,140.48,140.48,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002087,0360,,,,,,SKELETAL LEVEL 2,142.11,142.11,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002088,0360,,,,,,SKELETAL LEVEL 3,165.30,165.30,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002089,0360,,,,,,SKELETAL LEVEL 4 UNSCHEDULED,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002090,0360,,,,,,SKELETAL LEVEL 5 UNSCHEDULED,125.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002091,0360,,,,,,CANCEL LEVEL 1 PRIOR TO ANESTHESIA,51.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002092,0360,,,,,,CANCEL LEVEL 2 PRIOR TO ANESTHESIA,51.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002093,0360,,,,,,CANCEL LEVEL 3 PRIOR TO ANESTHESIA,58.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002094,0360,,,,,,CANCEL LEVEL 4 PRIOR TO ANESTHESIA,62.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002095,0360,,,,,,CANCEL LEVEL 5 PRIOR TO ANESTHESIA,61.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002096,0360,,,,,,CANCEL LEVEL 1 AFTER ANESTH INDUCT,70.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002097,0360,,,,,,CANCEL LEVEL 2 AFTER ANESTH INDUCT,69.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002098,0360,,,,,,CANCEL LEVEL 3 AFTER ANESTH INDUCT,126.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002099,0360,,,,,,CANCEL LEVEL 4 AFTER ANESTH INDUCT,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002100,0360,,,,,,CANCEL LEVEL 5 AFTER ANESTH INDUCT,81.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002101,0360,,,,,,BRONCHOSCOPY,4357.74,4357.74,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002102,0360,,,,,,UPPER GI ENDOSCOPY,3450.39,3450.39,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002103,0360,,,,,,MODERATE SEDATION TOTAL MINUTES,19.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002105,0710,,,,,,PACU PHASE 1,51.95,51.95,7.32,20.43,20.43,20.43,12.35,,,,7.32,,,7.35,7.35
10002106,0710,,,,,,ASD PHASE 2,15.68,15.68,7.32,20.43,20.43,20.43,12.35,,,,7.32,,,7.35,7.35
10002107,0360,,,,,,EDG COLONOSCOPY W/ DILAT,5966.15,5966.15,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002108,0360,,,,,,COLONOSCOPY,3450.39,3450.39,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002109,0360,,,,,,EDG COLONOSCOPY,4355.82,4355.82,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002110,0360,,,,,,DX. SINGLE ENDOSCOPY W / WO  BX.,2912.58,2912.58,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002111,0360,,,,,,MULTIPLE ENDOSCOPIES W/WO BIOPSY,3495.21,3495.21,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002112,0360,,,,,,THERAPEUTIC SINGLE ENDO PLUS MINOR,4077.84,4077.84,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002113,0360,,,,,,ERCP,8616.37,8616.37,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002114,0360,,,,,,SPINE LEVEL 1,149.84,149.84,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002115,0360,,,,,,SPINE LEVEL 2,151.58,151.58,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002116,0360,,,,,,SPINE LEVEL 3,176.33,176.33,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002117,0360,,,,,,SPINE LEVEL 4,181.20,181.20,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002118,0360,,,,,,SPINE LEVEL 5,226.39,226.39,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10002119,0360,69990,,,,,OPERATING MICROSCOPE ADD ON,3826.16,3826.16,,,,,,,,,,,,,
10002120,0360,69990,,,,,OPERATING MICROSCOPE ADD ON,3826.16,3826.16,,,,,,,,,,,,,
10002999,0360,,,,,,MINOR PROCEDURE RAD,2682.43,2682.43,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003000,0360,,,,,,MINOR PROCEDURE,2682.43,2682.43,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003001,0360,,,,,,PAIN CLINIC PROCEDURE,2352.78,2352.78,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003002,0360,,,,,,PAIN CLINIC LEVEL 2,3028.36,3028.36,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003003,0360,,,,,,BEDSIDE PROCEDURE,2044.23,2044.23,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003004,0750,91110,,,,,PILLCAM PLACEMENT,2682.54,2682.54,,,,,,,,,,,,,
10003005,0761,99211,,,,,ASD NURSING SERVICE,191.13,191.13,63.90,64.98,,,,,,,63.90,,,64.98,64.98
10003100,0360,,,,,,ACL RECONSTRUCTION,20116.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003101,0360,,,,,,KNEE ARTHROSCOPY,15953.90,15953.90,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003102,0360,,,,,,ORIF DISTAL EXTREMITY,10281.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003103,0360,,,,,,ORIF HIP,12797.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003104,0360,,,,,,ORIF PATELLA,13601.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003105,0360,,,,,,QUADRICEP TENDON REPAIR,11821.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003106,0360,,,,,,ROTATOR CUFF REPAIR,19280.41,19280.41,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003107,0360,,,,,,SHOULDER ARTHROSCOPY,18815.65,18815.65,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003108,0360,,,,,,SHOULDER DECOMPRESSION DIS CLAVICAL,16736.99,16736.99,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003109,0360,,,,,,SHOULDER RESURFACE/ARTHROPLASTY,17784.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003110,0360,,,,,,TOPAZ TENOTOMY,10422.90,10422.90,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003111,0360,,,,,,TOTAL KNEE REPLACEMENT,17639.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003112,0360,,,,,,TOTAL HIP REPLACEMENT,15779.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003113,0360,,,,,,ARTHRODESIS,8368.03,8368.03,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003114,0360,,,,,,BUNIONECTOMY,10328.30,10328.30,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003151,0360,,,,,,CYSTOSCOPY,8103.26,8103.26,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003152,0360,,,,,,LITHOTRIPSY,16993.21,16993.21,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003153,0360,51700,,,,,BLADDER INSTILLATION,353.75,0.00,,,,,,,,,,,,,
10003154,0360,,,,,,ESWL Rental,5740.00,5740.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003155,0360,52441,,,,,CYSTO INSERTION TRANSPROSTATIC IMPLANT S,5500.00,5500.00,,,,,,,,,,,,,
10003156,0360,52442,,,,,ADDL TRANSPROSTATIC IMPLANT,1450.00,1450.00,,,,,,,,,,,,,
10003157,0360,C9739,,,,,CYSTO W/ INSERT 1 TO 3 IMPLANTS MC,14091.30,14091.30,,,,,,,,,,,,,
10003158,0360,C9740,,,,,CYSTO W/ INSERT TRANSPROSTATIC IMPLANT 4,26624.17,26624.17,,,,,,,,,,,,,
10003161,0278,C1880,,,,,INFERIOR VENA CAVA FILTER,9098.10,9098.10,,,,,,,,,,,,,
10003162,0360,,,,,,MEDIPORT PLACEMENT,10007.92,10007.92,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003163,0360,,,,,,LAPAROSCOPIC CHOLECYSTECTOMY,14410.35,14410.35,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003164,0360,,,,,,LAPAROSCOPIC NISSEN FUNDOPLICATION,23919.47,23919.47,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003165,0360,,,,,,LAPAROSCOPIC NISSEN CHOLECYSTECTOMY,23919.47,23919.47,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10003166,0360,,,,,,PACEMAKER PLACEMENT,17056.22,17056.22,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10004046,0360,,,,,,OR LEVEL 5 1HR 30 MINUTES,8820.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10004057,0360,,,,,,SCHEDULED CASE,110.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10004058,0360,,,,,,UNSCHEDULED CASE (NOT ON CALL),220.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10004059,0360,,,,,,DISCONTINUED PROCEDURE LEVEL I,55.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10004060,0360,,,,,,DISCONTINUED PROCEDURE LEVEL II,110.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10004061,0360,,,,,,DISCONTINUED PROCEDURE LEVEL III,165.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10004062,0360,,,,,,DISCONTINUED PROCEDURE LEVEL IV,220.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10004063,0360,,,,,,DISCONTINUED PROCEDURE LEVEL V,275.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10005617,0480,51798,,,,,US PV RESIDUAL URINE BLDR SCAN,187.37,187.37,63.71,63.71,,,,,,,63.71,,,63.71,63.71
10006007,0710,,,,,,RECOVERY RM PHASE I FIRST 1/2 HOUR,736.75,0.00,7.32,20.43,20.43,20.43,12.35,,,,7.32,,,7.35,7.35
10006015,0710,99205,,,,,RECOVERY ROOM PHASE 1 ADDITIONAL 1/2 HR,484.00,0.00,,,,,,,,,,,,,
10006016,0360,,,,,,EACH ADDITIONAL 15 MIN PACU I,375.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10006017,0360,,,,,,EACH ADDITIONAL 15MIN PACU II,259.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10006018,0360,,,,,,EXTEND RECOVERY >6 HOURS PACU II,6223.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10006019,0360,,,,,,PACU PHASE I AND PHASE II,2452.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10006020,0360,,,,,,ASD W ADDITIONAL DX SERVICES,129.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10006743,0360,45999,,,,,ENEMA,285.50,0.00,,,,,,,,,,,,,
10006972,0360,36425,,,,,VENIPUNCTURE CUTDOWN,17.25,0.00,,,,,,,,,,,,,
10006973,0360,36556,,,,,CENTRAL VENOUS CATHETER,869.00,0.00,0.00,0.00,,,,,,,0.00,,,,
10006974,0360,36600,,,,,WITHDRAWAL OF ARTERIAL BLOOD,17.25,0.00,,,,,,,,,,,,,
10006975,0360,36593,,,,,DECLOTTING BY THROMBOLYTIC AGENT,192.50,0.00,,,,,,,,,,,,,
10006976,0360,36430,,,,,BLOOD TRANSFUSION,263.50,0.00,,,,,,,,,,,,,
10006977,0360,82948,,,,,GLUCOSE BLOOD REAGENT STRIP,4.50,0.00,,,,,,,,,,,,,
10006988,0360,96374,,,,,IV PUSH MEDICATION INITIAL,118.50,0.00,,,,,,,,,,,,,
10006989,0360,96372,,,,,IM INJ ANTIBIOTIC,122.50,0.00,,,,,,,,,,,,,
10006991,0360,96375,,,,,IV PUSH MEDICATION EACH SUBSEQUENT,122.50,0.00,,,,,,,,,,,,,
10007010,0920,91035,,,,,BRAVO PH MONITORING,1650.50,1650.50,283.45,614.39,,,,,,,283.45,,,614.39,614.39
10007011,0360,,,,,,ADDITIONAL 15MIN. LEVEL 2,490.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007012,0360,,,,,,ADDITIONAL 15MIN. LEVEL 1,478.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007013,0360,,,,,,OR LEVEL 1 30 MIN,957.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007014,0360,,,,,,OR LEVEL 2 TWO HOURS,3557.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007015,0360,,,,,,OR LEVEL 1 ONE HOUR,1849.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007016,0360,,,,,,OR LEVEL 1  ONE 1/2 HOUR,2774.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007017,0360,,,,,,OR LEVEL 2 30 MINUTES,1423.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007018,0360,,,,,,OR LEVEL 2 ONE HOUR,2208.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007019,0360,,,,,,OR LEVEL 2 ONE 1/2 HOURS,2945.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007020,0360,,,,,,OR LEVEL 3 30 MINUTES,2208.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007021,0360,,,,,,ADDITIONAL 15 MIN. LEVEL 3,552.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007022,0360,,,,,,OR LEVEL 3 ONE HOUR,2945.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007039,0360,,,,,,ADDITIONAL 15MIN. LEVEL 4,809.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007040,0360,,,,,,OR LEVEL 4      0.5HR,2626.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007041,0360,,,,,,OR LEVEL 5 30 MINUTES,6402.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007042,0360,,,,,,OR LEVEL 4 1HOUR,4785.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007043,0360,,,,,,OR LEVEL 5 1HOUR,8098.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007044,0360,,,,,,OR LEVEL 3 1HR 30 MIN,3681.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007045,0360,,,,,,OR LEVEL 4 1HR 30 MIN,5690.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007048,0360,,,,,,OR LEVEL 3 2 HOURS,4418.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007049,0360,,,,,,OR LEVEL 4 2 HOURS,6995.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007050,0360,,,,,,ADDITIONAL 15 MIN LEVEL 5,1251.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007051,0360,,,,,,OR LEVEL 5 2 HOURS,11043.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007052,0360,,,,,,OR LEVEL 3 2HR 30 MIN,4979.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007053,0360,,,,,,OR LEVEL 4 2 HR 30 MIN,8098.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007055,0360,,,,,,OR LEVEL 5 2.5 HOURS,12516.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007056,0360,,,,,,OR LEVEL 3 3 HOURS,5690.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007057,0360,,,,,,OR LEVEL 4 3 HOURS,8892.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007058,0360,,,,,,OR LEVEL 5 3 HOURS,13987.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007059,0360,,,,,,OR LEVEL 3 4 HOURS,7114.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007060,0360,,,,,,OR LEVEL 4 4 HOURS,9959.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007061,0360,,,,,,OR LEVEL 5 4 HOURS,14938.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007062,0360,,,,,,OR LEVEL 4 5 HOURS,11026.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007063,0360,,,,,,OR LEVEL 5 5 HOURS,16360.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007064,0360,,,,,,OR LEVEL 4 6 HOURS,12093.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007065,0360,,,,,,OR LEVEL 5 6 HOURS,17783.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007066,0360,,,,,,OR LEVEL 5 7 HOURS,19205.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007067,0360,,,,,,OR LEVEL 5 8 HOURS,20628.75,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007068,0360,,,,,,OR LEVEL 5 9 HOURS,22051.00,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007069,0360,,,,,,OR LEVEL 5 10HOURS,23474.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007070,0360,,,,,,EACH ADDITIONAL 15 MIN PAC U 1,375.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007072,0710,,,,,,RECOVERY RM FIRST 1/2 HOUR PHASE 2,501.00,0.00,7.32,20.43,20.43,20.43,12.35,,,,7.32,,,7.35,7.35
10007073,0710,,,,,,RECOVERY RM PHASE 2 EA ADD 30MIN,284.25,0.00,7.32,20.43,20.43,20.43,12.35,,,,7.32,,,7.35,7.35
10007074,0360,,,,,,EACH ADDITIONAL 15 MIN PACU  II,259.25,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007075,0360,,,,,,EXTENDED RECOVERY >6 HOURS PAC U II,6223.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007076,0360,,,,,,PACU  PHASE 1 AND PHASE II,2452.50,0.00,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10007077,0710,,,,,,ASD W ADDITIONAL DX SERVICES,129.50,0.00,7.32,20.43,20.43,20.43,12.35,,,,7.32,,,7.35,7.35
10007086,0360,96365,,,,,INFUSION THER OTHER THAN CHEMO,362.50,0.00,,,,,,,,,,,,,
10008013,0360,51701,,,,,CATH URETHRA; SIMPL,106.50,0.00,,,,,,,,,,,,,
10008014,0360,82948,,,,,GLUCOSE BLOOD REAGENT STRIP,25.00,0.00,,,,,,,,,,,,,
10008015,0360,G0107,,,,,COLORECTAL SCRN; HI RISK IND,18.50,0.00,,,,,,,,,,,,,
10008020,0360,51702,,,,,INSERTION TEMP INDWELLING CATH SIMP,106.50,0.00,,,,,,,,,,,,,
10008021,0360,50590,,,,,LITHOTRIPSY UNILATERAL,11646.78,11646.78,8532.80,8532.80,,,,,,,8532.80,,,,
10008022,0360,5059050,,,,,LITHOTRIPSY BILAT,17499.25,17499.25,,,,,,,,,,,,,
10008023,0750,91010,,,,,ESOPHAGEAL MANOMETRY,1657.51,1657.51,540.02,784.85,,,,,,,540.02,,,784.85,784.85
10008024,0360,50590,,,,,ARTHROSCOPY,11323.03,11323.03,8532.80,8532.80,,,,,,,8532.80,,,,
10008025,0750,91034,,,,,RESTECH GASTROESOPH REFLUX W NASAL PH,1657.51,1657.51,,,,,,,,,,,,,
10008050,0360,,,,,,FLEXIBLE SIGMOIDOSCOPY,2405.91,2405.91,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10008051,0360,,,,,,LAP GASTROESOPH SPHINC AUG,23919.47,23919.47,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10008052,0360,46930,,,,,DESTRUCTION INTERNAL HEMORRHOID THERMAL,3344.27,3344.27,,,,,,,,,,,,,
10008053,0360,,,,,,HOLMIUM LASER,2913.75,2913.75,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
10009001,0274,,,,,,SUPPLIES/DEVICES,1061.00,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
1002160,0164,,,,,,ISOLATION,63.89,63.89,,,,,,,,,,,,,
1007204,0762,G0378,,,,,LEVEL 1 OBSERVATION EACH ADDL HR,49.20,49.20,21.01,24.53,,,,,,,21.01,,,24.53,24.53
1007205,0762,G0378,,,,,LEVEL 2 OBSERVATION EACH ADDL HR,71.75,71.75,21.01,24.53,,,,,,,21.01,,,24.53,24.53
1007206,0762,,,,,,OBSERV SUBSEQUENT DATE SEVERE,57.25,0.00,56.74,56.74,56.74,56.74,,,,,,,,,
1007210,0762,G0378,,,,,LEVEL 1 OBSERVATION FIRST HR,256.25,256.25,21.01,24.53,,,,,,,21.01,,,24.53,24.53
1007211,0762,G0378,,,,,LEVEL 2 OBSERVATION FIRST HR,333.13,333.13,21.01,24.53,,,,,,,21.01,,,24.53,24.53
1007213,0710,,,,,,PHASE II RECOVERY FIRST 1/2 HR,510.30,510.30,7.32,20.43,20.43,20.43,12.35,,,,7.32,,,7.35,7.35
1007214,0710,,,,,,PHASE II RECOVERY ADDL 1/2 HR,285.90,285.90,7.32,20.43,20.43,20.43,12.35,,,,7.32,,,7.35,7.35
1007215,0480,92960,,,,,EXTERNAL ELECTRICAL CARDIOVERSION,1563.88,1563.88,,,,,,,,,,,,,
1007216,0480,92953,,,,,TEMPORARY TRANSCUTANEOUS PACING,1602.98,1602.98,,,,,,,,,,,,,
1007217,0300,36415,,,,,ROUTINE VENIPUNCTURE,109.47,109.47,7.20,13.12,,,13.12,,,,7.20,,,10.41,10.41
1007224,0391,36430,,,,,TRANSFUSION BLOOD PRODUCTS,1168.97,1168.97,399.60,766.83,,,,,,,399.60,,,766.83,766.83
1007225,0260,96360,,,,,HYDRATION IV INFUSION INIT 31-60 MINS,400.73,400.73,134.22,277.32,,,,,,,134.22,,,277.32,277.32
1007226,0260,96361,,,,,HYDRATE IV INFUSION ADD-ON,210.16,210.16,71.47,85.25,,,,,,,71.47,,,85.25,85.25
1007227,0260,96365,,,,,THER/PROPH/DIAG IV INF INIT =<1 HR,579.84,579.84,198.11,241.70,,,,,,,198.11,,,241.70,241.70
1007228,0260,96366,,,,,THER/PROPH/DIAG IV INF ADDON,210.16,210.16,71.48,109.47,,,,,,,71.48,,,109.47,109.47
1007230,0260,96375,,,,,"IV PUSH, SEQUENTIAL, NEW DRUG",174.62,174.62,58.45,69.48,,,,,,,58.45,,,69.48,69.48
1007232,0761,90715,,,,,TCTANUS/DIPTH TOX-ADULT-IM/JET INJ,45.00,0.00,,,,,,,,,,,,,
1007235,0762,G0379,,,,,DIRECT REFERRAL FOR OBSERVATION SVCS,1649.65,1649.65,,,,,,,,,,,,,
1007401,0260,96372,,,,,INJECTION SC/IM,145.20,145.20,45.66,49.02,,,,,,,49.02,,,45.66,45.66
1007402,0260,96374,,,,,"IV PUSH, INITIAL",309.37,309.37,105.46,145.44,,,,,,,105.46,,,145.44,145.44
1007403,0260,96376,,,,,"IV PUSH, SEQUENTIAL, SAME DRUG+30 MIN",174.62,174.62,59.40,60.58,,,,,,,59.40,,,60.58,60.58
10074500,0279,,,,,,GAMMA PROBE RENTAL,3100.00,0.00,,,,,,,,,,,,,
1007500,0480,92950,,,,,CARDIOPULMONARY RESUSCITATION,756.20,756.20,,,,,,,,,,,,,
1007501,0300,82272,,,,,HEMOCCULT,16.10,16.10,,,,,,,,,,,,,
1007502,0761,51702,,,,,FOLEY CATHETER INSERTION,305.29,305.29,104.10,104.10,,,,,,,104.10,,,,
1007503,0761,51701,,,,,STRAIGHT CATHETERIZATION,312.92,312.92,,,,,,,,,,,,,
1007504,0300,82948,,,,,CAPILLARY BLOOD GLUCOSE,26.39,26.39,8.74,8.80,,,,,,,8.74,,,8.80,8.80
1007505,0761,36593,,,,,DECLOTTING BY THROMBOLYTIC AGENT,685.68,685.68,,,,,,,,,,,,,
1007506,0761,36591,,,,,COLLECTION OF BLOOD FROM VENOUS ACC,312.92,312.92,,,,,,,,,,,,,
1007507,0771,90471,,,,,IMMUNIZATION ADMIN 1 VACCINE,145.20,145.20,48.89,48.89,,,,,,,48.89,,,,
1007508,0260,96367,,,,,TX/PROPH/DG ADDL SEQ IV INF,210.16,210.16,71.40,71.98,,,,,,,71.40,,,71.98,71.98
1007510,0771,90472,,,,,IMMUNIZATION ADMIN EA ADDL,85.77,85.77,,,,,,,,,,,,,
1008100,0762,99218,,,,,OBSERVATION LOW IDPA 1 - 6.5 HOURS,401.50,0.00,,,,,,,,,,,,,
1008101,0762,99218,,,,,OBSERVATION LOW IDPA 6.51-12.5 HOURS,629.00,0.00,,,,,,,,,,,,,
1008102,0762,99218,,,,,OBSERVATION LOW IDPA 12.5-23 HOURS,1027.00,0.00,,,,,,,,,,,,,
1080000,0960,99211GF,,,,,OFFICE VISIT ESTABLISHED LEVEL 1,0.00,0.00,,,,,,,,,,,,,
1080004,0335,96409,,,,,CHEMO ADMINISTRATION INTRAVENOUS PUSH,148.75,148.75,,,,,,,,,,,,,
1080009,0300,82948,,,,,CAPILLARY BLOOD GLUCOSE,0.00,0.00,8.74,8.80,,,,,,,8.74,,,8.80,8.80
1080010,0391,36430,,,,,TRANSFUSION BLD/BLD COMPONENTS,716.00,0.00,399.60,766.83,,,,,,,399.60,,,766.83,766.83
1080041,0335,96413,,,,,CHEMO THERAPY ADMIN IV SINGLE DRUG,353.75,0.00,,,,,,,,,,,,,
1090000,0761,99211,,,,,"OP VISIT, EST PT, LEVEL 1",191.13,191.13,63.90,64.98,,,,,,,63.90,,,64.98,64.98
1090001,0510,99212,,,,,"OP VISIT, EST PT, LEVEL 2",228.50,0.00,,,,,,,,,,,,,
1090002,0510,99213,,,,,"OP VISIT, EST PT, LEVEL 3",228.50,0.00,,,,,,,,,,,,,
1090003,0510,99214,,,,,"OP VISIT, EST PT, LEVEL 4",297.25,0.00,,,,,,,,,,,,,
1090004,0510,99215,,,,,"OP VISIT, EST PT, LEVEL 5",376.00,0.00,,,,,,,,,,,,,
1090050,0510,51700,,,,,BLADDER INSTILLATION,353.75,0.00,,,,,,,,,,,,,
1090100,0510,90718,,,,,ADULT TETANUS TOXOID,83.25,0.00,,,,,,,,,,,,,
1090101,0510,96372,,,,,THER/PROPH/DIAG INJ SC/IM,145.20,145.20,49.37,49.37,,,,,,,49.37,,,49.37,49.37
1090102,0260,96360,,,,,HYDRATION IV INFUSION INIT 31-60 MINS,400.73,400.73,134.22,277.32,,,,,,,134.22,,,277.32,277.32
1090103,0260,96361,,,,,HYDRATE IV INFUSION ADD-ON,210.16,210.16,71.47,85.25,,,,,,,71.47,,,85.25,85.25
1090104,0260,96365,,,,,THER/PROPH/DIAG IV INF INIT =<1 HR,579.84,579.84,198.11,241.70,,,,,,,198.11,,,241.70,241.70
1090105,0260,96366,,,,,THER/PROPH/DIAG IV INF ADDON,210.16,210.16,71.48,109.47,,,,,,,71.48,,,109.47,109.47
1090106,0260,96374,,,,,THER/PROPH/DIAG INJ IV PUSH,309.37,309.37,105.46,145.44,,,,,,,105.46,,,145.44,145.44
1090107,0510,96376,,,,,TX/PRO/DX INJ SAME DRUG ADDON,122.08,122.08,42.51,99.62,,,,,,,42.51,,,99.62,99.62
1090108,0260,96375,,,,,"IV PUSH, SEQUENTIAL, NEW DRUG",141.66,141.66,58.45,69.48,,,,,,,58.45,,,69.48,69.48
1090109,0771,90471,,,,,IMMUNIZATION ADMIN 1 VACCINE,145.20,145.20,48.89,48.89,,,,,,,48.89,,,,
1090110,0510,36591,,,,,BLOOD COLLECTION/IMPLANTABLE DEVICE,312.92,312.92,103.81,106.85,,,,,,,103.81,,,106.85,106.85
1090111,0510,36593,,,,,IMPLANTED DEVICE DECLOTTING,685.68,685.68,,,,,,,,,,,,,
1090112,0300,82962,,,,,CAPILLARY BLOOD GLUCOSE,26.39,26.39,8.82,8.95,,,,,,,8.82,,,8.95,8.95
1090114,0510,51702,,,,,FOLEY CATHETER INSERTION,305.29,305.29,,,,,,,,,,,,,
1090115,0300,82272,,,,,"OCCULT BLOOD,FECES,SINGLE-DIAGNOSTIC",16.11,16.11,,,,,,,,,,,,,
1090118,0260,96368,,,,,"IV INFUSION, CONCURRENT",131.10,131.10,,,,,,,,,,,,,
1090119,0260,96523,,,,,IRRIGATION VAD/PORT FLUSH,191.98,191.98,63.68,63.68,,,,,,,63.68,,,,
1090120,0260,96367,,,,,"IV INFUSION, SEQUENTIAL NEW",210.16,210.16,71.40,71.98,,,,,,,71.40,,,71.98,71.98
1090121,0771,90472,,,,,IMMUNIZATION ADMINISTRATION EA ADDL,85.77,85.77,,,,,,,,,,,,,
1090122,0761,G0463,,,,,Hosp OP Clinic Visit - MC,192.30,192.30,65.24,65.38,,,,,,,65.24,,,65.38,65.38
12000001,0963,00812,,,,,ANES LWR INTST SCR COLSC,155.29,155.29,,,,,,,,,,,,,
12000002,0963,00731,,,,,ANES UPR GI NDSC PX NOS,155.29,155.29,,,,,,,,,,,,,
12000003,0963,00811,,,,,ANES LWR INTST NDSC NOS,155.29,155.29,,,,,,,,,,,,,
12000004,0963,00790,,,,,ANESTH SURG UPPER ABDOMEN,155.29,155.29,,,,,,,,,,,,,
12000005,0963,01810,,,,,ANESTH LOWER ARM SURGERY,155.29,155.29,,,,,,,,,,,,,
12000006,0963,00400,,,,,ANESTH SKIN EXT/PER/ATRUNK,155.29,155.29,,,,,,,,,,,,,
12000007,0963,00830,,,,,ANESTH REPAIR OF HERNIA LOWER NOS,155.29,155.29,,,,,,,,,,,,,
12000008,0963,01214,,,,,ANESTH HIP ARTHROPLASTY,155.29,155.29,,,,,,,,,,,,,
12000010,0963,01402,,,,,ANESTH KNEE ARTHROPLASTY,155.29,155.29,,,,,,,,,,,,,
12000011,0963,01610,,,,,ANESTH SURGERY OF SHOULDER,155.29,155.29,,,,,,,,,,,,,
12000012,0963,00813,,,,,ANES UPR LWR GI NDSC PX,155.29,155.29,,,,,,,,,,,,,
12000013,0963,01920,,,,,ANESTH CATHETERIZE HEART,155.29,155.29,,,,,,,,,,,,,
12000014,0964,01920,,,,,ANESTH CATHETERIZED HEART,124.23,124.23,,,,,,,,,,,,,
12000015,0964,00812,,,,,ANES LWR INTST SCR COLSC,124.23,124.23,17.36,17.36,,,,,,,17.36,,,,
12000016,0964,01916,,,,,ANESTH DX ARTERIOGRAPHY,124.23,124.23,18.06,18.06,,,,,,,18.06,,,,
12000017,0963,01916,,,,,ANESTH DX ARTERIOGRAPHY,155.29,155.29,,,,,,,,,,,,,
12000018,0964,00731,,,,,ANES UPR GI NDSC PX NOS,124.23,124.23,17.40,17.40,,,,,,,17.40,,,,
12000019,0963,01926,,,,,ANES TX INTERV RAD HRT/CRAN,155.29,155.29,,,,,,,,,,,,,
12000020,0964,01926,,,,,ANES TX INTERV RAD HRT/CRAN,124.23,124.23,,,,,,,,,,,,,
12000021,0964,00811,,,,,ANES LWR INTST NDSC NOS,124.23,124.23,21.86,21.86,,,,,,,21.86,,,,
12000022,0963,00532,,,,,ANESTH VASCULAR ACCESS,155.29,155.29,,,,,,,,,,,,,
12000023,0964,00532,,,,,ANESTH VASCULAR ACCESS,124.23,124.23,,,,,,,,,,,,,
12000024,0964,00790,,,,,ANESTH SURG UPPER ABDOMEN,124.23,124.23,19.23,19.23,,,,,,,19.23,,,,
12000025,0963,01922,,,,,ANESTH CAT OR MRI SCAN,155.29,155.29,,,,,,,,,,,,,
12000026,0964,01922,,,,,ANESTH CAT OR MRI SCANN,124.23,124.23,,,,,,,,,,,,,
12000027,0964,01810,,,,,ANESTH LOWER ARM SURGERY,124.23,124.23,13.44,13.44,,,,,,,13.44,,,,
12000028,0964,00813,,,,,ANES UPR LWR GI NDSC PX,124.23,124.23,14.88,14.88,,,,,,,14.88,,,,
12000029,0964,00400,,,,,ANESTH SKIN EXT/PER/ATRUNK,124.23,124.23,0.02,17.42,,,0.02,,,,17.42,,,,
12000030,0963,01951,,,,,ANESTH BURN LESS 4 PERCENT,155.29,155.29,,,,,,,,,,,,,
12000031,0964,01951,,,,,ANESTH BURN LESS 4 PERCENT,124.23,124.23,,,,,,,,,,,,,
12000032,0963,01952,,,,,ANESTH BURN 4-9 PERCENT,155.29,155.29,,,,,,,,,,,,,
12000033,0964,01952,,,,,ANESTH BURN 4-9 PERCENT,124.23,124.23,,,,,,,,,,,,,
12000034,0963,01953,,,,,ANESTH BURN EACH 9 PERCENT,155.29,155.29,,,,,,,,,,,,,
12000035,0964,01953,,,,,ANESTH BURN EACH 9 PERCENT,124.23,124.23,,,,,,,,,,,,,
12000036,0964,99100,,,,,SPECIAL ANESTHESIA SERVICE <1 OR >70 YRS,0.00,0.00,,,,,,,,,,,,,
12000037,0963,01200,,,,,ANESTH HIP JOINT PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000038,0964,01200,,,,,ANESTH HIP JOINT PROCEDURE,124.23,124.23,,,,,,,,,,,,,
12000039,0963,00520,,,,,ANESTH CHEST PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000040,0964,00520,,,,,ANESTH CHEST PROCEDURE,124.23,124.23,,,,,,,,,,,,,
12000041,0963,00902,,,,,ANESTH ANORECTAL SURGERY,155.29,155.29,,,,,,,,,,,,,
12000042,0964,00902,,,,,ANESTH ANORECTAL SURGERY,124.23,124.23,40.87,40.87,,,,,,,40.87,,,,
12000043,0963,01270,,,,,ANESTH THIGH ARTERIES SURG,155.29,155.29,,,,,,,,,,,,,
12000044,0964,01270,,,,,ANESTH THIGH ARTERIES SURG,124.23,124.23,18.12,18.12,,,,,,,18.12,,,,
12000045,0963,00320,,,,,ANESTH NECK ORGAN 1YR/>,155.29,155.29,,,,,,,,,,,,,
12000046,0964,00320,,,,,ANESTH NECK ORGAN 1YR/>,124.23,124.23,27.92,27.92,,,,,,,27.92,,,,
12000047,0964,01214,,,,,ANESTH HIP ARTHROPLASTY,124.23,124.23,,,,,,,,,,,,,
12000048,0963,01480,,,,,ANESTH LOWER LEG BONE SURG,155.29,155.29,,,,,,,,,,,,,
12000049,0964,01480,,,,,ANESTH LOWER LEG BONE SURG,124.23,124.23,,,,,,,,,,,,,
12000050,0963,01250,,,,,ANESTH UPPER LEG SURGERY,155.29,155.29,,,,,,,,,,,,,
12000051,0964,01250,,,,,ANESTH UPPER LEG SURGERY,124.23,124.23,,,,,,,,,,,,,
12000052,0963,01440,,,,,ANESTH KENN ARTERIES SURG,155.29,155.29,,,,,,,,,,,,,
12000053,0964,01440,,,,,ANESTH KNEE SRTERIES SURG,124.23,124.23,6.66,6.66,,,,,,,6.66,,,,
12000054,0963,00846,,,,,ANESTH HYSTERECTOMY,155.29,155.29,,,,,,,,,,,,,
12000055,0964,00846,,,,,ANESTH HYSTERECTOMY,124.23,124.23,,,,,,,,,,,,,
12000056,0963,00904,,,,,ANESTH PERINEAL SURGERY,155.29,155.29,,,,,,,,,,,,,
12000057,0964,00904,,,,,ANESTH PERINEAL SURGERY,124.23,124.23,,,,,,,,,,,,,
12000058,0963,00300,,,,,ANESTH HEAD/NECK/PTRUNK,155.29,155.29,,,,,,,,,,,,,
12000059,0964,00300,,,,,ANESTH HEAD/NECK/PTRUNK,124.23,124.23,13.14,13.14,,,,,,,13.14,,,,
12000060,0963,00752,,,,,ANESTH REPAIR OF HERNIA,155.29,155.29,,,,,,,,,,,,,
12000061,0964,00752,,,,,ANESTH REPAIR OF HERNIA,124.23,124.23,,,,,,,,,,,,,
12000062,0963,00524,,,,,ANESTH CHEST DRAINAGE,155.29,155.29,,,,,,,,,,,,,
12000063,0964,00524,,,,,ANESTH CHEST DRAINAGE,124.23,124.23,,,,,,,,,,,,,
12000064,0963,01520,,,,,ANESTH LOWER LEG VEIN SURG NOS,155.29,155.29,,,,,,,,,,,,,
12000065,0964,01520,,,,,ANESTH LOWER LEG WEIN SURG NOS,124.23,124.23,,,,,,,,,,,,,
12000066,0963,00702,,,,,ANESTH FOR LIVER BIOPSY,155.29,155.29,,,,,,,,,,,,,
12000067,0964,00702,,,,,ANESTH FOR LIVER BIOPSY,124.23,124.23,,,,,,,,,,,,,
12000068,0963,01630,,,,,ANESTH SURGERY OF SHOULDER NOS,151.50,151.50,,,,,,,,,,,,,
12000069,0964,01630,,,,,ANESTH SURGERY OF SHOULDER NOS,121.20,121.20,,,,,,,,,,,,,
12000070,0963,01260,,,,,ANESTH UPPER LEG VEINS SURG,155.29,155.29,,,,,,,,,,,,,
12000071,0964,01260,,,,,ANESTH UPPER LEG VEINS SURG,124.23,124.23,,,,,,,,,,,,,
12000072,0963,01420,,,,,ANESTH KNEE JOINT CASTING,155.29,155.29,,,,,,,,,,,,,
12000073,0964,01420,,,,,ANESTH KNEE JOINT CASTING,124.23,124.23,,,,,,,,,,,,,
12000074,0963,00730,,,,,ANESTH ABDOMINAL WALL SURG UPPER POST,155.29,155.29,,,,,,,,,,,,,
12000075,0964,00730,,,,,ANESTH ADBOMINAL WALL SURG UPPER POST,124.23,124.23,,,,,,,,,,,,,
12000076,0963,01472,,,,,ANESTH ACHILLES TENDON SURG,155.29,155.29,,,,,,,,,,,,,
12000077,0964,01472,,,,,ANESTH ACHILLES TENDON SURG,124.23,124.23,,,,,,,,,,,,,
12000078,0963,00100,,,,,ANESTH SALIVARY GLAND,155.29,155.29,,,,,,,,,,,,,
12000079,0964,00100,,,,,ANESTH SALIVARY GLAND,124.23,124.23,,,,,,,,,,,,,
12000080,0963,01992,,,,,ANESTH N BLOCK/INJ PRONE,155.29,155.29,,,,,,,,,,,,,
12000081,0964,01992,,,,,ANESTH N BLOCK/INJ PRONE,124.23,124.23,,,,,,,,,,,,,
12000082,0963,00700,,,,,ANESTH ABDO WALL SURG UPPER ANT NOS,155.29,155.29,,,,,,,,,,,,,
12000083,0964,00700,,,,,ANESTH ABDO WALL SURG UPPER ANT NOS,124.23,124.23,,,,,,,,,,,,,
12000084,0964,00830,,,,,ANESTH REPAIR OF HERNIA LOWER NOS,124.23,124.23,42.24,42.24,,,,,,,42.24,,,,
12000085,0963,00560,,,,,ANESTH HEART SURG W/O PUMP,155.29,155.29,,,,,,,,,,,,,
12000086,0964,00560,,,,,ANESTH HEART SURG W/O PUMP,124.23,124.23,,,,,,,,,,,,,
12000087,0963,00770,,,,,ANESTH BLOOD VESSEL REPAIR,155.29,155.29,,,,,,,,,,,,,
12000088,0964,00770,,,,,ANESTH BLOOD VESSEL REPAIR,124.23,124.23,,,,,,,,,,,,,
12000089,0963,00350,,,,,ANESTH NECK VESSEL SURGERY NOS,155.29,155.29,,,,,,,,,,,,,
12000090,0964,00350,,,,,ANESTH NECK VESSEL SURGERY NOS,124.23,124.23,,,,,,,,,,,,,
12000091,0963,01470,,,,,ANESTH LOWER LEG SURGERY NOS,155.29,155.29,,,,,,,,,,,,,
12000092,0964,01470,,,,,ANESTH LOWER LEG SURGERY NOS,124.23,124.23,,,,,,,,,,,,,
12000093,0963,62322,,,,,NJX INTERLAMINAR LMBR/SAC,806.46,806.46,,,,,,,,,,,,,
12000094,0963,00500,,,,,ANESTH ESOPHAGEAL SURGERY,155.29,155.29,,,,,,,,,,,,,
12000095,0964,00500,,,,,ANESTH ESOPHAGEAL SURGERY,124.23,124.23,,,,,,,,,,,,,
12000096,0963,00940,,,,,ANESTH VAGINAL PROCEDURES,155.29,155.29,,,,,,,,,,,,,
12000097,0964,00940,,,,,ANESTH VAGINAL PROCEDURES,124.23,124.23,42.24,42.24,,,,,,,42.24,,,,
12000098,0963,00600,,,,,ANESTH CERV SPINE CORD SURGERY,155.29,155.29,,,,,,,,,,,,,
12000099,0964,00600,,,,,ANESTH CERV SPINE CORD SURGERY,124.23,124.23,,,,,,,,,,,,,
12000100,0963,00604,,,,,ANESTH SITTING PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000101,0964,00604,,,,,ANESTH SITTING PROCEDURE,124.23,124.23,,,,,,,,,,,,,
12000102,0963,01936,,,,,ANESTH PERC IMG TX SP PROC,155.29,155.29,,,,,,,,,,,,,
12000103,0964,01936,,,,,ANESTH PERC IMG TX SP PROC,124.23,124.23,,,,,,,,,,,,,
12000104,0963,01210,,,,,ANESTH HIP JOINT SURGERY,155.29,155.29,,,,,,,,,,,,,
12000105,0964,01210,,,,,ANESTH HIP JOINT SURGERY,124.23,124.23,,,,,,,,,,,,,
12000106,0963,01230,,,,,ANESTH SURGERY OF FEMUR,155.29,155.29,,,,,,,,,,,,,
12000107,0964,01230,,,,,ANESTH SURGERY OF FEMUR,124.23,124.23,,,,,,,,,,,,,
12000108,0964,01402,,,,,ANESTH KNEE ARTHROPLASTY,124.23,124.23,41.47,41.47,,,,,,,41.47,,,,
12000109,0963,00830,,,,,ANESTH REPAIR OF HERNIA LOWER NOS,155.29,155.29,,,,,,,,,,,,,
12000110,0963,00902,,,,,ANESTH ANORECTAL SURGERY,155.29,155.29,,,,,,,,,,,,,
12000111,0963,00812,,,,,ANES LWR INTST SCR COLSC,155.29,155.29,,,,,,,,,,,,,
12000112,0963,00811,,,,,ANES LWR INTST NDSC NOS,155.29,155.29,,,,,,,,,,,,,
12000113,0963,00731,,,,,ANES UPR GI NDSC PX NOS,155.29,155.29,,,,,,,,,,,,,
12000114,0963,00790,,,,,ANESTH SURG UPPER ABDOMEN,155.29,155.29,,,,,,,,,,,,,
12000115,0963,01810,,,,,ANESTH LOWER ARM SURGERY,155.29,155.29,,,,,,,,,,,,,
12000116,0963,00400,,,,,ANESTH SKIN EXT/PER/ATRUNK,155.29,155.29,,,,,,,,,,,,,
12000117,0963,01214,,,,,ANESTH HIP ARTHROPLASTY,155.29,155.29,,,,,,,,,,,,,
12000118,0963,99100,,,,,SPECIAL ANESTHESIA SERVICE <1 OR >70 YRS,0.00,0.00,,,,,,,,,,,,,
12000119,0963,01402,,,,,ANESTH KNEE ARTHROPLASTY,155.29,155.29,,,,,,,,,,,,,
12000120,0963,01610,,,,,ANESTH SURGERY OF SHOULDER,155.29,155.29,,,,,,,,,,,,,
12000121,0963,00813,,,,,ANES UPR LWR GI NDSC PX,155.29,155.29,,,,,,,,,,,,,
12000122,0963,01920,,,,,ANESTH CATHETERIZE HEART,155.29,155.29,,,,,,,,,,,,,
12000123,0963,00910,,,,,ANESTH BLADDER SURGERY,155.29,155.29,,,,,,,,,,,,,
12000124,0964,00910,,,,,ANESTH BLADDER SURGERY,124.23,124.23,19.04,19.04,,,,,,,19.04,,,,
12000125,0963,00910,,,,,ANESTH BLADDER SURGERY,155.29,155.29,,,,,,,,,,,,,
12000126,0963,00670,,,,,ANESTH EXT SPINE CORD SURGERY,155.29,155.29,,,,,,,,,,,,,
12000127,0963,00670,,,,,ANESTH EXT SPINE CORD SURGERY,155.29,155.29,,,,,,,,,,,,,
12000128,0964,00670,,,,,ANESTH EXT SPINE CORD SURGERY,124.23,124.23,41.74,41.74,,,,,,,41.74,,,,
12000129,0963,00320,,,,,ANESTH NECK ORGAN 1YR/>,155.29,155.29,,,,,,,,,,,,,
12000130,0963,00404,,,,,ANESTH SURGERY OF BREAST RADICAL,155.29,155.29,,,,,,,,,,,,,
12000131,0963,00404,,,,,ANESTH SURGERY OF BREAST RADICAL,155.29,155.29,,,,,,,,,,,,,
12000132,0964,00404,,,,,ANESTH SURGERY OF BREAST RADICAL,124.23,124.23,,,,,,,,,,,,,
12000133,0963,01916,,,,,ANESTH DX ARTERIOGRAPHY,155.29,155.29,,,,,,,,,,,,,
12000134,0963,00862,,,,,ANESTH KIDNEY/URETER SURG,155.29,155.29,,,,,,,,,,,,,
12000135,0963,00862,,,,,ANESTH KIDNEY/URETER SURG,155.29,155.29,,,,,,,,,,,,,
12000136,0964,00862,,,,,ANESTH KIDNEY/URETER SURG,124.23,124.23,,,,,,,,,,,,,
12000137,0963,01926,,,,,ANES TX INTERV RAD HRT/CRAN,155.29,155.29,,,,,,,,,,,,,
12000138,0963,01400,,,,,ANESTH KNEE JOINT SURGERY,155.29,155.29,,,,,,,,,,,,,
12000139,0963,01400,,,,,ANESTH KNEE JOINT SURGERY,155.29,155.29,,,,,,,,,,,,,
12000140,0964,01400,,,,,ANESTH KNEE JOINT SURGERY,124.23,124.23,,,,,,,,,,,,,
12000141,0963,00532,,,,,ANESTH VASCULAR ACCESS,155.29,155.29,,,,,,,,,,,,,
12000142,0963,00802,,,,,ANESTH FAT LAYER REMOVAL,155.29,155.29,,,,,,,,,,,,,
12000143,0963,00802,,,,,ANESTH FAT LAYER REMOVAL,155.29,155.29,,,,,,,,,,,,,
12000144,0964,00802,,,,,ANESTH FAT LAYER REMOVAL,124.23,124.23,,,,,,,,,,,,,
12000145,0963,01922,,,,,ANESTH CAT OR MRI SCAN,155.29,155.29,,,,,,,,,,,,,
12000146,0963,27096,,,,,SIJ ANESTH/SETROID INJ,953.46,953.46,,,,,,,,,,,,,
12000147,0963,01951,,,,,ANESTH BURN LESS 4 PERCENT,155.29,155.29,,,,,,,,,,,,,
12000148,0963,00840,,,,,ANESTH SURG LOWER ABDOMEN,155.29,155.29,,,,,,,,,,,,,
12000149,0963,00840,,,,,ANESTH SURG LOWER ABDOMENT,155.29,155.29,,,,,,,,,,,,,
12000150,0964,00840,,,,,ANESTH SURG LOWER ABDOMEN,124.23,124.23,,,,,,,,,,,,,
12000151,0963,01820,,,,,ANESTH LOWER ARM PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000152,0963,01820,,,,,ANESTH LOWER ARM PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000153,0964,01820,,,,,ANESTH LOWER ARM PROCEDURE,124.23,124.23,,,,,,,,,,,,,
12000154,0963,00540,,,,,ANESTH CHEST SURGERY,155.29,155.29,,,,,,,,,,,,,
12000155,0963,00540,,,,,ANESTH CHEST SURGERY,155.29,155.29,,,,,,,,,,,,,
12000156,0964,00540,,,,,ANESTH CHEST SURGERY,124.23,124.23,,,,,,,,,,,,,
12000157,0963,01952,,,,,ANESTH BURN 4-9 PERCENT,155.29,155.29,,,,,,,,,,,,,
12000158,0963,01112,,,,,ANESTH BONE ASPIRATE/BX,155.29,155.29,,,,,,,,,,,,,
12000159,0963,01112,,,,,ANESTH CHEST SURGERY,155.29,155.29,,,,,,,,,,,,,
12000160,0963,01953,,,,,ANESTH BURN EACH 9 PERCENT,155.29,155.29,,,,,,,,,,,,,
12000161,0964,01112,,,,,ANESTH BONE ASPIRATE/BX,124.23,124.23,21.37,21.37,,,,,,,21.37,,,,
12000162,0964,00140,,,,,ANESTH PROCEDURES ON EYE,124.23,124.23,,,,,,,,,,,,,
12000163,0963,00140,,,,,ANESTH PROCEDURES ON EYE,155.29,155.29,,,,,,,,,,,,,
12000164,0963,00140,,,,,ANESTH PROCEDURE ON EYE,155.29,155.29,,,,,,,,,,,,,
12000165,0963,01200,,,,,ANESTH HIP JOINT PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000166,0964,01844,,,,,ANESTH VASCULAR SHUNT SURG,124.23,124.23,0.00,41.21,,,,,,,41.21,,,0.00,0.00
12000167,0963,01844,,,,,ANESTH VASCULAR SHUNT SURG,155.29,155.29,,,,,,,,,,,,,
12000168,0963,01844,,,,,ANESTH VASCULAR SHUNT SURG,155.29,155.29,,,,,,,,,,,,,
12000169,0963,00520,,,,,ANESTH CHEST PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000170,0963,01270,,,,,ANESTH THIGH ARTERIES SURG,155.29,155.29,,,,,,,,,,,,,
12000171,0963,01480,,,,,ANESTH LOWER LEG BONE SURG,155.29,155.29,,,,,,,,,,,,,
12000172,0963,01250,,,,,ANESTH UPPER LEG SURGERY,155.29,155.29,,,,,,,,,,,,,
12000173,0963,01440,,,,,ANESTH KENN ARTERIES SURG,155.29,155.29,,,,,,,,,,,,,
12000174,0963,00846,,,,,ANESTH HYSTERECTOMY,155.29,155.29,,,,,,,,,,,,,
12000175,0963,00904,,,,,ANESTH PERINEAL SURGERY,155.29,155.29,,,,,,,,,,,,,
12000176,0963,00300,,,,,ANESTH HEAD/NECK/PTRUNK,155.29,155.29,,,,,,,,,,,,,
12000177,0963,00752,,,,,ANESTH REPAIR OF HERNIA,155.29,155.29,,,,,,,,,,,,,
12000178,0963,00524,,,,,ANESTH CHEST DRAINAGE,155.29,155.29,,,,,,,,,,,,,
12000179,0963,01520,,,,,ANESTH LOWER LEG VEIN SURG NOS,155.29,155.29,,,,,,,,,,,,,
12000180,0963,00702,,,,,ANESTH FOR LIVER BIOPSY,155.29,155.29,,,,,,,,,,,,,
12000181,0963,01630,,,,,ANESTH SURGERY OF SHOULDER NOS,151.50,151.50,,,,,,,,,,,,,
12000182,0963,62320,,,,,NJX INTERLAMINAR CRV/THRC,712.38,712.38,,,,,,,,,,,,,
12000183,0963,01260,,,,,ANESTH UPPER LEG VEINS SURG,155.29,155.29,,,,,,,,,,,,,
12000184,0964,62322,,,,,NJX INTERLAMINAR LMBR/SAC,816.92,816.92,,,,,,,,,,,,,
12000185,0963,62323,,,,,NJX INTERLAMINAR LMBR/SAC,905.08,905.08,,,,,,,,,,,,,
12000186,0964,01620,,,,,ANESTH SHOULDER PROCEDURE,124.23,124.23,,,,,,,,,,,,,
12000187,0963,01620,,,,,ANESTH SHOULDER PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000188,0963,01620,,,,,ANESTH SHOULDER PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000189,0963,01420,,,,,ANESTH KNEE JOINT CASTING,155.29,155.29,,,,,,,,,,,,,
12000190,0963,00730,,,,,ANESTH ABDOMINAL WALL SURG UPPER POST,155.29,155.29,,,,,,,,,,,,,
12000191,0963,00600,,,,,ANESTH CERV SPINE CORD SURGERY,155.29,155.29,,,,,,,,,,,,,
12000192,0963,01230,,,,,ANESTH SURGERY OF FEMUR,155.29,155.29,,,,,,,,,,,,,
12000193,0963,01472,,,,,ANESTH ACHILLES TENDON SURG,155.29,155.29,,,,,,,,,,,,,
12000194,0963,00100,,,,,ANESTH SALIVARY GLAND,155.29,155.29,,,,,,,,,,,,,
12000195,0963,00800,,,,,ANESTH ABDO WALL SURG LOWER ANT NOS,155.29,155.29,,,,,,,,,,,,,
12000196,0964,00800,,,,,ANESTH ABDO WALL SURG LOWER ANT NOS,124.23,124.23,,,,,,,,,,,,,
12000197,0963,00800,,,,,ANESTH ABDO WALL SURG LOWER ANT NOS,155.29,155.29,,,,,,,,,,,,,
12000198,0963,01992,,,,,ANESTH N BLOCK/INJ PRONE,155.29,155.29,,,,,,,,,,,,,
12000199,0963,00700,,,,,ANESTH ABDO WALL SURG UPPER ANT NOS,155.29,155.29,,,,,,,,,,,,,
12000200,0963,01924,,,,,ANES THER INTERVEN RAD ART,155.29,155.29,,,,,,,,,,,,,
12000201,0964,01924,,,,,ANES THER INTERVEN RAD ART,124.23,124.23,,,,,,,,,,,,,
12000202,0963,01924,,,,,ANES THER INTERVEN RAD ART,155.29,155.29,,,,,,,,,,,,,
12000203,0963,00560,,,,,ANESTH HEART SURG W/O PUMP,155.29,155.29,,,,,,,,,,,,,
12000204,0963,00770,,,,,ANESTH BLOOD VESSEL REPAIR,155.29,155.29,,,,,,,,,,,,,
12000205,0963,01320,,,,,ANESTH KNEE AREA SURGERY,155.29,155.29,,,,,,,,,,,,,
12000206,0964,01320,,,,,ANESTH KNEE AREA SURGERY,124.23,124.23,,,,,,,,,,,,,
12000207,0963,01320,,,,,ANESTH KNEE AREA SURGERY,155.29,155.29,,,,,,,,,,,,,
12000208,0963,00350,,,,,ANESTH NECK VESSEL SURGERY NOS,155.29,155.29,,,,,,,,,,,,,
12000209,0963,01470,,,,,ANESTH LOWER LEG SURGERY NOS,155.29,155.29,,,,,,,,,,,,,
12000210,0963,00832,,,,,ANESTH REPAIR OF HERNIA V&A,155.29,155.29,,,,,,,,,,,,,
12000211,0964,00832,,,,,ANESTH REPAIR OF HERNIA V&A,124.23,124.23,,,,,,,,,,,,,
12000212,0963,00832,,,,,ANESTH REPAIR OF HERNIA V&A,155.29,155.29,,,,,,,,,,,,,
12000213,0963,00500,,,,,ANESTH ESOPHAGEAL SURGERY,155.29,155.29,,,,,,,,,,,,,
12000214,0963,00940,,,,,ANESTH VAGINAL PROCEDURES,155.29,155.29,,,,,,,,,,,,,
12000215,0963,00604,,,,,ANESTH SITTING PROCEDURE,155.29,155.29,,,,,,,,,,,,,
12000216,0963,01936,,,,,ANESTH PERC IMG TX SP PROC,155.29,155.29,,,,,,,,,,,,,
12000217,0963,01210,,,,,ANESTH HIP JOINT SURGERY,155.29,155.29,,,,,,,,,,,,,
12000218,0963,00630,,,,,ANESTH LUMBAR SPINE CORD DURGERY,155.29,155.29,,,,,,,,,,,,,
12000219,0964,00630,,,,,ANESTH LUMBAR SPINE CORD SURGERY,124.23,124.23,40.88,40.88,,,,,,,40.88,,,,
12000220,0963,00630,,,,,ANESTH LUMBAR SPINE CORD SURGERY,155.29,155.29,,,,,,,,,,,,,
12000221,0963,01274,,,,,ANESTH FEMORAL EMBOLECTOMY,155.29,155.29,,,,,,,,,,,,,
12000222,0964,01274,,,,,ANESTH FEMORAL EMBOLECTOMY,124.23,124.23,,,,,,,,,,,,,
12000223,0963,01274,,,,,ANESTH FEMORAL EMBOLECTOMY,155.29,155.29,,,,,,,,,,,,,
12000224,0964,01932,,,,,ANES TX INTERV RAD TH VEIN,124.23,124.23,,,,,,,,,,,,,
12000225,0963,01932,,,,,ANES TX INTERV RAD TH VEIN,155.29,155.29,,,,,,,,,,,,,
12000226,0963,01932,,,,,ANES TX INTERV RAD TH VEIN,155.29,155.29,,,,,,,,,,,,,
12000227,0963,00914,,,,,ANESTH REMOVAL OF PROSTATE RESECTION,155.29,155.29,,,,,,,,,,,,,
12000228,0963,00914,,,,,ANESTH REMOVAL OF PROSTATE RESECTION,155.29,155.29,,,,,,,,,,,,,
12000229,0964,00914,,,,,ANESTH REMOVAL OF PROSTATE RESECTION,124.23,124.23,,,,,,,,,,,,,
12000300,0963,00528,,,,,ANES MEDIASCPY & DX THORSCPY,155.29,155.29,,,,,,,,,,,,,
12000301,0963,00528,,,,,ANES MEDIASCPY & DX THORSCPY,155.29,155.29,,,,,,,,,,,,,
12000302,0964,00528,,,,,ANES MEDIASCPY & DX THORSCPY,124.23,124.23,,,,,,,,,,,,,
12000303,0963,64421,,,,,NJX AA&/STRD NTRCOST NRV EA,653.03,653.03,,,,,,,,,,,,,
12000304,0963,64488,,,,,TAP BLOCK BI INJECTION,817.54,817.54,,,,,,,,,,,,,
12000305,0964,00921,,,,,ANESTH VASECTOMY,124.23,124.23,,,,,,,,,,,,,
12000306,0963,00921,,,,,ANESTH VASECTOMY,155.29,155.29,,,,,,,,,,,,,
12000307,0963,00921,,,,,ANESTH VASECTOMY,155.29,155.29,,,,,,,,,,,,,
12000308,0964,00912,,,,,ANESTH BLADDER TUMOR SURG,124.23,124.23,19.79,19.79,,,,,,,19.79,,,,
12000309,0963,00912,,,,,ANESTH BLADDER TUMOR SURG,155.29,155.29,,,,,,,,,,,,,
12000310,0963,00912,,,,,ANESTH BLADDER TUMOR SURG,155.29,155.29,,,,,,,,,,,,,
12000311,0963,01392,,,,,ANESTH KNEE AREA SURGERY UPPER,155.29,155.29,,,,,,,,,,,,,
12000312,0964,01392,,,,,ANESTH KNEE AREA SURGERY UPPER,124.23,124.23,,,,,,,,,,,,,
12000313,0963,01392,,,,,ANESTH KNEE AREA SURGERY UPPER,155.29,155.29,,,,,,,,,,,,,
12000314,0964,99140,,,,,ANES COMPLICJ EMER COND,0.00,0.00,,,,,,,,,,,,,
12000315,0964,00920,,,,,ANESTH GENITALIA SURGERY,124.23,124.23,,,,,,,,,,,,,
12000316,0964,00918,,,,,TRANSURETHRAL PROCEDURE,124.23,124.23,42.24,42.24,,,,,,,42.24,,,,
12000317,0964,00541,,,,,ANESTH THORACOTOMY W 1 LUNG VENT,124.23,124.23,,,,,,,,,,,,,
12005058,0370,,,,,,ANES SUPPLIES 1ST HOUR,758.50,0.00,27.52,83.75,83.75,83.75,58.38,,,,27.52,,,28.29,28.29
12005060,0370,,,,,,ANESTHESIA  FIRST 15 MINS,945.08,945.08,27.52,83.75,83.75,83.75,58.38,,,,27.52,,,28.29,28.29
12005061,0370,,,,,,ANESTHESIA  EACH ADDITIONAL MINUTE,63.03,63.03,27.52,83.75,83.75,83.75,58.38,,,,27.52,,,28.29,28.29
12005074,0370,,,,,,ANES EQ&SUPP ADD 15 MIN,129.50,0.00,27.52,83.75,83.75,83.75,58.38,,,,27.52,,,28.29,28.29
14000005,0451,29405,,,,,APPLIC SHORT LEG CAST,267.75,0.00,,,,,,,,,,,,,
14000006,0456,29405,,,,,APPLIC SHORT LEG CAST,267.75,0.00,,,,,,,,,,,,,
14000007,0450,28192,,,,,REMOV FB FT; SUBQ,669.50,0.00,,,,,,,,,,,,,
14000008,0451,28192,,,,,REMOV FB FT; SUBQ,669.50,0.00,,,,,,,,,,,,,
14000009,0456,28192,,,,,REMOV FB FT; SUBQ,669.50,0.00,,,,,,,,,,,,,
14000010,0450,37799,,,,,UNLISTED VASCULAR PROCEDURE,0.01,0.00,,,,,,,,,,,,,
14000013,0450,96375,,,,,"IV PUSH, SEQUENTIAL, NEW DRUG",141.66,141.66,0.00,65.57,,,0.00,,,,48.26,,,65.57,65.57
14000014,0450,96372,,,,,INJECTION SC/IM,145.20,145.20,0.00,84.68,,,0.00,,,,48.62,,,84.68,84.68
14000015,0450,96360,,,,,"HYDRATION IV,INITIAL,31MIN TO 1HR",400.73,400.73,134.29,136.84,,,,,,,134.29,,,136.84,136.84
14000016,0450,96361,,,,,"HYDRATION IV, ADDL HR",210.16,210.16,0.00,94.95,,,0.00,,,,71.71,,,94.95,94.95
14000017,0450,96365,,,,,"IV INFUSION, INITIAL, UP TO 1 HR",579.84,579.84,197.61,206.89,,,,,,,197.61,,,206.89,206.89
14000018,0450,96366,,,,,"IV INFUSION, ADDL HR",210.16,210.16,72.04,72.04,,,,,,,72.04,,,,
14000019,0450,96374,,,,,"IV PUSH, INITIAL",309.37,309.37,0.00,160.54,,,0.00,,,,105.41,,,160.54,160.54
14000020,0450,96376,,,,,"IV PUSH, SEQUENTIAL, SAME DRUG",174.62,174.62,0.00,91.33,,,0.00,,,,59.53,,,91.33,91.33
14000021,0450,96368,,,,,"IV INFUSION, CONCURRENT",131.10,131.10,,,,,,,,,,,,,
14000022,0456,96372,,,,,INJECTION SC/IM,118.50,0.00,,,,,,,,,,,,,
14000023,0451,,,,,,SQ IM THERA OR PROPH DRUG,118.50,0.00,,,,,,,,,,,,,
14000024,0456,,,,,,IV INFUSION 1ST HOUR,379.50,0.00,,,,,,,,,,,,,
14000025,0451,,,,,,IV INFUSION 1ST HOUR,379.50,0.00,,,,,,,,,,,,,
14000026,0456,96361,,,,,IV INFUSION HYDRATION EACH ADDTL HR,204.00,0.00,,,,,,,,,,,,,
14000027,0451,,,,,,IV INFUSION HYDRATION EACH ADDTL HR,204.00,0.00,,,,,,,,,,,,,
14000029,0300,,,,,,INTERDERMAL TUBERCULIN,17.75,0.00,0.00,96.73,96.73,96.73,,,,,,,,0.00,0.00
14000030,0456,,,,,,IV INFUSION PROPH 1ST HOUR,379.50,0.00,,,,,,,,,,,,,
14000031,0451,,,,,,IV INFUSION PROPH 1ST HOUR,379.50,0.00,,,,,,,,,,,,,
14000032,0456,,,,,,IV INFUSION PROPH ADDTL HOUR,204.00,0.00,,,,,,,,,,,,,
14000033,0451,,,,,,IV INFUSION PROPH ADDTL HOUR,204.00,0.00,,,,,,,,,,,,,
14000034,0456,96374,,,,,"IV PUSH, INITIAL",169.50,0.00,,,,,,,,,,,,,
14000035,0260,96374,,,,,IV PUSH INITIAL DRUG,169.50,0.00,105.46,145.44,,,,,,,105.46,,,145.44,145.44
14000036,0456,,,,,,"IV PUSH, SEQUENTIAL, SAME DRUG",169.50,0.00,,,,,,,,,,,,,
14000037,0451,,,,,,IV PUSH EACH SEQ DRUG,169.50,0.00,,,,,,,,,,,,,
14000038,0456,96375,,,,,"IV PUSH, SEQUENTIAL, NEW DRUG",118.50,0.00,115.60,115.60,,,,,,,,,,115.60,115.60
14000039,0260,96375,,,,,"IV PUSH, SEQUENTIAL, NEW DRUG",118.50,0.00,58.45,69.48,,,,,,,58.45,,,69.48,69.48
14000040,0450,96367,,,,,"IV INFUSION, SEQUENT, UP TO 1 HR",210.16,210.16,72.22,106.20,,,,,,,72.22,,,106.20,106.20
14000045,0451,96367,,,,,"IV INFUSION, SEQUENTIAL NEW",204.00,0.00,,,,,,,,,,,,,
14000047,0456,96367,,,,,"IV INFUSION, SEQUENTIAL NEW",204.00,0.00,,,,,,,,,,,,,
14000050,0456,11760,,,,,REPR NAIL BED,297.50,0.00,,,,,,,,,,,,,
14000051,0450,42310,,,,,DRNG ABSCESS SUBMAXIL SUBLING ORAL,640.53,0.00,,,,,,,,,,,,,
14000052,0450,43760,,,,,CHANEGASTROSTOMYTUBEPERCUTNOIMAGIN,481.23,0.00,,,,,,,,,,,,,
14000053,0450,51705,,,,,CYSTOSTOMY TUBE CHANGE,723.33,723.33,,,,,,,,,,,,,
14000054,0761,15271,,,,,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1,5403.72,5403.72,1827.53,1827.53,,,,,,,1827.53,,,,
14000055,0761,15272,,,,,APP SKN SUB GRFT T/A/L AREA/100SQ CM EA,1285.10,1285.10,,,,,,,,,,,,,
14000056,0761,15273,,,,,SKIN SUB GRFT T/ARM/LG CHILD,9914.39,9914.39,,,,,,,,,,,,,
14000057,0761,15274,,,,,APP SKN SUB GRFT T/A/L AREA>=100SCM ADL,2240.50,2240.50,,,,,,,,,,,,,
14000058,0761,15275,,,,,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM 1ST 25,5403.72,5403.72,1831.21,1831.21,,,,,,,1831.21,,,,
14000059,0761,15276,,,,,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADD,1677.00,1677.00,,,,,,,,,,,,,
14000060,0451,40831,,,,,CLO LACERATIONMOUTH;OVER 2.5CM/COMPLEX,643.75,0.00,,,,,,,,,,,,,
14000061,0456,40831,,,,,CLOLACERATIONMOUTH;OVER2.5CM/COMPLEX,643.75,0.00,,,,,,,,,,,,,
14000062,0450,40831,,,,,CLO LAC ERATIONMOUTH;OVER 2.5/COMPLEX,643.75,0.00,,,,,,,,,,,,,
14000064,0761,15278,,,,,SKN SUB GRFT F/N/H/F/G CH ADD,2825.00,2825.00,,,,,,,,,,,,,
14000065,0450,17250,,,,,CHEMICAL CAUTERIZATION,404.38,404.38,,,,,,,,,,,,,
14000066,0761,15277,,,,,SUB GRFT F/S/N/H/F/G/M/D>=100SCM 1STSQ C,5403.72,5403.72,1822.13,1822.13,,,,,,,1822.13,,,,
14000067,0761,11042,,,,,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM,1090.57,1090.57,370.79,370.79,,,,,,,370.79,,,,
14000068,0761,11045,,,,,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ,599.63,599.63,,,,,,,,,,,,,
14000069,0761,97602,,,,,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANE,595.52,595.52,,,,,,,,,,,,,
14000070,0510,97605,,,,,NEGATIVE PRESSURE WOUND THERAPY DME <= 5,595.52,595.52,200.01,200.01,,,,,,,200.01,,,,
14000071,0761,97606,,,,,NEGATIVE PRESSURE WOUND THERAPY DME <= 5,1090.58,1090.58,,,,,,,,,,,,,
14000080,0450,46060,,,,,INCISION & DRAIN OF A PERIRECTAL ABSCESS,314.50,0.00,,,,,,,,,,,,,
14000090,0450,11000,,,,,DEBR EXZ INF SKIN 10% BS,1517.05,1517.05,,,,,,,,,,,,,
14000091,0450,16030,,,,,DRS&/DBRDMT PRTL-THKNS BURNS 1,1004.22,1004.22,,,,,,,,,,,,,
14000100,0450,35207,,,,,REPAIR BLOOD VESSEL HAND OR FINGER,314.50,0.00,,,,,,,,,,,,,
14000101,0450,35226,,,,,REPAIR BLOOD VESSEL LOWER EXTREMITY,337.25,0.00,,,,,,,,,,,,,
14000105,0450,26989,,,,,SURG PROCED NOS FINGER HAND,381.50,0.00,,,,,,,,,,,,,
14000106,0450,26765,,,,,OPEN REDUCTION DISSTAL PHALANGEAL FX,1011.25,0.00,,,,,,,,,,,,,
14000500,0451,,,,,,DECLOTTING BY THROMBOLYTIC AGENT,68.50,0.00,,,,,,,,,,,,,
14000501,0451,,,,,,INSERTION TEMPORARY INDWELLING BLADDER,133.25,0.00,,,,,,,,,,,,,
14000502,0451,,,,,,NB RESUSCITATION,549.75,0.00,,,,,,,,,,,,,
14000503,0456,,,,,,NB RESUSCITATION,549.75,0.00,,,,,,,,,,,,,
14000504,0456,,,,,,INSERTION TEMPORARY INDWELLING BLADDER,133.25,0.00,,,,,,,,,,,,,
14000505,0450,51703,,,,,INSERT TEMP BLADDER CATH/COMPLCAT,173.00,0.00,,,,,,,,,,,,,
14000506,0451,51703,,,,,INSERT TEMP BLADDER CATH/COMPLCATED,173.00,0.00,,,,,,,,,,,,,
14000507,0456,51703,,,,,INSERT TEMP BLADDER CATH/COMPLCATED,173.00,0.00,,,,,,,,,,,,,
14000550,0456,11042,,,,,DEBRID; SKIN & SUBQ TISS,560.75,0.00,,,,,,,,,,,,,
14000551,0456,29505,,,,,APPLIC LONG LEG SPLINT,230.50,0.00,,,,,,,,,,,,,
14000552,0456,29515,,,,,APPLIC SHORT LEG SPLINT,230.50,0.00,,,,,,,,,,,,,
14000553,0456,6520526,,,,,REMOV FB EXT EYE; CONJUNC SUPERF,322.50,0.00,,,,,,,,,,,,,
14000601,0450,10061,,,,,I&D ABSCESS:COMPLIC/MX,783.40,783.40,,,,,,,,,,,,,
14000602,0450,56405,,,,,I&D ABSCESS; PERINEUM,946.37,946.37,,,,,,,,,,,,,
14000603,0450,54700,,,,,INCISION & DRAINAGE OF EPIDIDYMIS,805.50,0.00,,,,,,,,,,,,,
14000604,0450,56420,,,,,I&D ABSCESS BARHOLINS GLAND,392.79,0.00,,,,,,,,,,,,,
14000605,0450,26412,,,,,REP ET HAND; W FG EA TENDON,9077.39,9077.39,,,,,,,,,,,,,
14001186,0300,36415,,,,,ROUTINE VENIPUNCTURE,109.47,109.47,7.20,13.12,,,13.12,,,,7.20,,,10.41,10.41
14003010,0450,36591,,,,,"COLLECT BLOOD, COMPL IMPLANT VAD",312.92,312.92,103.38,103.38,,,,,,,103.38,,,,
14003011,0456,,,,,,VENOUS ACCESS DEVICE BLOOD COLL,120.00,0.00,,,,,,,,,,,,,
14003012,0451,,,,,,VENOUS ACCESS DEVICE BLOOD COLL,120.00,0.00,,,,,,,,,,,,,
14003043,0450,11406,,,,,EXC BEN LES TRUNK; OVER 4.0 CM,794.75,0.00,,,,,,,,,,,,,
14003044,0450,11420,,,,,EXC BEN LES SCALP; 0.5 CM/LESS,3153.90,3153.90,,,,,,,,,,,,,
14003178,0450,45300,,,,,PROCTOSIG RIGID W/W/O COLLECT,346.00,0.00,,,,,,,,,,,,,
14003186,0450,45330,,,,,EMER RM SIGMOIDOSCOP,346.00,0.00,,,,,,,,,,,,,
14003187,0450,36550,,,,,DECLOTTING BY THROMBOLYTIC AGENT,523.25,0.00,,,,,,,,,,,,,
14003188,0456,,,,,,DECLOTTING BY THROMBOLYTIC AGENT,523.25,0.00,,,,,,,,,,,,,
14003189,0451,,,,,,DECLOTTING BY THROMBOLYTIC AGENT,523.25,0.00,,,,,,,,,,,,,
14003270,0450,26433,,,,,REPAIR OF EXTENSOR TENDON DISTAL INSERT.,1625.75,0.00,,,,,,,,,,,,,
14003284,0450,20552,,,,,INJ TRIGGER POINT 1/2 MUSCL,773.43,773.43,,,,,,,,,,,,,
14003285,0450,20553,,,,,TRIGGER POINT INJ. THREE OR MORE MUSCLES,289.50,0.00,,,,,,,,,,,,,
14003287,0450,11730,,,,,AVULS OF NAIL PLATE PART OR COMPL SIMPLE,394.52,394.52,,,,,,,,,,,,,
14004000,0456,1205226,,,,,LAYER CLO FACE/LIPS 2.6-5.0CM,314.50,0.00,,,,,,,,,,,,,
14005999,0450,46040,,,,,I&D RECTAL ABCESS,2747.25,0.00,,,,,,,,,,,,,
14006000,0450,10060,,,,,I&D ABCESS; SIMPL/SNGL,404.38,404.38,134.14,321.93,,,,,,,134.14,,,321.93,321.93
14006001,0761,10021,,,,,FNA BX W/O IMG GDN 1ST LES,1056.74,1056.74,,,,,,,,,,,,,
14006002,0450,10080,,,,,I & D PILONIDAL CYST: SIMPL,243.50,0.00,,,,,,,,,,,,,
14006004,0450,10120,,,,,INCS & REMOV FB SUBQ TISS; SIMPL,755.17,755.17,,,,,,,,,,,,,
14006005,0450,10121,,,,,INCS & REMOV SUBQ TISS; COMPLIC,794.75,0.00,,,,,,,,,,,,,
14006006,0450,10140,,,,,I&D HEMATOMA/SEROMA/FLUID COLLEC,448.50,0.00,,,,,,,,,,,,,
14006007,0450,10160,,,,,PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,765.62,765.62,,,,,,,,,,,,,
14006008,0450,10022,,,,,FINE NEEDLE ASPIRATION W/GUIDANCE,487.00,0.00,,,,,,,,,,,,,
14006009,0456,10060,,,,,I&D ABCESS; SIMPL/SNGL,296.75,0.00,,,,,,,,,,,,,
14006010,0456,10120,,,,,INCS & REMOV FB SUBQ TISS; SIMPL,243.50,0.00,,,,,,,,,,,,,
14006011,0450,11010,,,,,DEBRID W/REMOV MAT;SKIN & SUBQ,1522.00,0.00,,,,,,,,,,,,,
14006012,0450,11011,,,,,DEBRID W/REMOV MAT;SKIN-SBQ-MUSC,1522.00,0.00,,,,,,,,,,,,,
14006013,0450,11012,,,,,DEBRID W/REM MAT;SKIN-MUSC-BONE,1522.00,0.00,,,,,,,,,,,,,
14006014,0450,97597,,,,,RMVL DEVITAL TIS 20CM<,307.75,0.00,,,,,,,,,,,,,
14006015,0450,97598,,,,,RMVL DEVITAL TIS ADDL 20CM,273.00,0.00,,,,,,,,,,,,,
14006016,0450,11042,,,,,DEBRID; SKIN & SUBQ TISS,560.75,0.00,,,,,,,,,,,,,
14006017,0450,11043,,,,,DEBRID; SKIN-SUBQ TISS-MUSCL,431.50,0.00,,,,,,,,,,,,,
14006018,0450,11044,,,,,DEBRID; SKIN-SUBQ TISS-MUSCL-BONE,1518.00,0.00,,,,,,,,,,,,,
14006019,0450,11055,,,,,PARING/CUTTING BEN LES; 1LES,217.00,0.00,,,,,,,,,,,,,
14006020,0450,11056,,,,,PARING//CUTTING BENLES;2-4 LES,217.00,0.00,,,,,,,,,,,,,
14006021,0450,11057,,,,,PARING/CUTTING BEN LES ;> 4 LES,217.00,0.00,,,,,,,,,,,,,
14006022,0450,11100,,,,,BX SKIN/SUBQ TISS(SEP PRO); 1 LES,122.25,0.00,,,,,,,,,,,,,
14006023,0450,11101,,,,,BX SKIN/SUBQ TIS (SEP PRO); EA ADD,115.50,0.00,,,,,,,,,,,,,
14006024,0456,1016026,,,,,PUNCTASPIR ABSCES/HEMAT/BULL/CYST,243.50,0.00,,,,,,,,,,,,,
14006025,0450,11201,,,,,REMOVE SKIN TAGS;EA ADD 10 LES,217.00,0.00,,,,,,,,,,,,,
14006026,0450,11300,,,,,SHAVING 1 LES TRUNK; 0.5CM/LESS,110.50,0.00,,,,,,,,,,,,,
14006027,0450,11301,,,,,SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM,118.50,0.00,,,,,,,,,,,,,
14006028,0450,11302,,,,,SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM,182.75,0.00,,,,,,,,,,,,,
14006029,0450,11303,,,,,SHAVING 1 LES TRUNK; OVER 2.0 CM,217.00,0.00,,,,,,,,,,,,,
14006030,0450,11305,,,,,SHAVING 1 LES SCALP; 0.5CM/LESS,118.50,0.00,,,,,,,,,,,,,
14006031,0450,11306,,,,,SHAVING 1 LES SCALP; 0.6 TO 1.0 CM,118.50,0.00,,,,,,,,,,,,,
14006032,0450,11307,,,,,SHAVING 1 LES SCALP;1.1 TO 2.0 CM,182.75,0.00,,,,,,,,,,,,,
14006033,0450,11308,,,,,SHAVING 1 LES SCALP; OVER 2.0 CM,229.00,0.00,,,,,,,,,,,,,
14006034,0450,11310,,,,,SHAVING  1 LES FACE;0.5CM/LESS,118.50,0.00,,,,,,,,,,,,,
14006035,0450,11311,,,,,SHAVING 1 LES FACE; 0.6 TO 1.0 CM,118.50,0.00,,,,,,,,,,,,,
14006036,0450,11312,,,,,SHAVING 1 LES FACE;1 TO 2.0 CM,217.00,0.00,,,,,,,,,,,,,
14006037,0450,11313,,,,,SHAVING 1 LES FACE; OVER 2.0 CM,431.50,0.00,,,,,,,,,,,,,
14006038,0450,11400,,,,,EXC BEN LES TRUNK;0.5 CM/LESS,488.25,0.00,,,,,,,,,,,,,
14006039,0450,11401,,,,,EXC BEN LES TRUNK; 0.6 TO 1.0 CM,488.25,0.00,,,,,,,,,,,,,
14006040,0450,11402,,,,,EXC TR-EXT B9+MARG 1.1-2 CM,2031.33,2031.33,,,,,,,,,,,,,
14006041,0450,11403,,,,,EXC BEN LES TRUNK; 2.1 TO 3.0 CM,794.75,0.00,,,,,,,,,,,,,
14006042,0450,11404,,,,,EXC BEN LES TRUNK; 3.1 TO 4.0 CM,794.75,0.00,,,,,,,,,,,,,
14006045,0450,11421,,,,,EXC BEN LES  SCALP 0.6 TO  1.0CM0,488.25,0.00,,,,,,,,,,,,,
14006046,0450,11422,,,,,EXC BEN LES SCALP; 1.1 TO 2.0 CM,488.25,0.00,,,,,,,,,,,,,
14006047,0450,11423,,,,,EXC BEN LES SCALP; 2.1 TO 3.0 CM,794.75,0.00,,,,,,,,,,,,,
14006049,0450,11426,,,,,EXC BEN LES SCALP; OVER 4.0 CM,1522.00,0.00,,,,,,,,,,,,,
14006050,0450,11440,,,,,EXC BEN LES FACE; 0.5 CM/LESS,488.25,0.00,,,,,,,,,,,,,
14006051,0450,11441,,,,,EXC BEN LES FACE; 0.6 TO 1.Q CM,488.25,0.00,,,,,,,,,,,,,
14006052,0450,11442,,,,,EXC BEN LES FACE; 1.1 TO 2.0 CM,502.50,0.00,,,,,,,,,,,,,
14006053,0450,11443,,,,,EXC BEN LES FACE; 2.1 TO 3.0 CM,794.75,0.00,,,,,,,,,,,,,
14006054,0450,11444,,,,,EXC BEN FACE; 3.1 TO 4.0 CM,794.75,0.00,,,,,,,,,,,,,
14006055,0450,11446,,,,,EXC BEN LES FACE; OVER 4.0 CM,1522.00,0.00,,,,,,,,,,,,,
14006074,0450,11719,,,,,TRIM NONDYSTROPHIC NAILS-ANY NUMBER,91.00,0.00,,,,,,,,,,,,,
14006075,0450,11720,,,,,DEBRID NAIL(S) ANY METHOD(S);1 TO 5,91.00,0.00,,,,,,,,,,,,,
14006076,0450,11721,,,,,DEBRID NAIL(S) ANY METHOD(S); 6/MORE,91.00,0.00,,,,,,,,,,,,,
14006078,0450,11732,,,,,AVULSION PLATE PART/COMPLT SIMPL; EA,167.00,0.00,,,,,,,,,,,,,
14006079,0450,11740,,,,,EVACUATION SUBUNGUAL HEMATOMA,187.14,187.14,,,,,,,,,,,,,
14006080,0450,11750,,,,,EXC NAIL/MATRIX PART/COMPLT PERM,783.40,783.40,,,,,,,,,,,,,
14006081,0450,11752,,,,,EXC NAIL/MATRIX PERM;AMPUT DISTAL,1522.00,0.00,,,,,,,,,,,,,
14006082,0450,11755,,,,,BX NAIL UNIT ANY METHD(SEP PRO),488.25,0.00,,,,,,,,,,,,,
14006083,0450,11760,,,,,REPR NAIL BED,1554.97,1554.97,,,,,,,,,,,,,
14006084,0456,11750,,,,,EXC NAIL/MATRIX PART/COMPLT PERM,488.25,0.00,,,,,,,,,,,,,
14006085,0456,10160,,,,,PUNCTASPIR ABSCES/HEMAT/BULL/CYST,243.50,0.00,,,,,,,,,,,,,
14006090,0456,12001,,,,,SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA,278.75,0.00,,,,,,,,,,,,,
14006091,0450,12001,,,,,SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,394.52,394.52,134.14,321.93,,,,,,,134.14,,,321.93,321.93
14006092,0450,12002,,,,,SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,394.52,394.52,134.14,138.08,,,,,,,134.14,,,138.08,138.08
14006093,0450,12004,,,,,SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,394.52,394.52,134.14,134.14,,,,,,,134.14,,,,
14006094,0450,12005,,,,,SREP S/N/A/G/TR/E; 12.6-20.0CM,1045.88,1045.88,355.60,355.60,,,,,,,355.60,,,,
14006095,0456,12002,,,,,SIMPL REPR SCLP,297.50,0.00,,,,,,,,,,,,,
14006097,0450,12011,,,,,SIMPL REPR FACE/MUCOUS; 2.5/LESS,394.52,394.52,134.14,134.14,,,,,,,134.14,,,134.14,134.14
14006098,0450,12013,,,,,SR FCE/EAR/EYE/INSE/LIP 2.6-5,394.52,394.52,,,,,,,,,,,,,
14006099,0450,12014,,,,,SIMPL REPR FACE/MUCOUS 5.1-7.5CM,394.52,394.52,,,,,,,,,,,,,
14006100,0456,12011,,,,,SIMPL REPR FACE/MUCOUS; 2.5/LESS IDPA,297.50,0.00,,,,,,,,,,,,,
14006101,0450,12015,,,,,SIMPL REPR FACE/MUCOUS 7.60-12.50CM,394.52,394.52,134.14,134.14,,,,,,,134.14,,,,
14006104,0450,12020,,,,,TX SUPERF WOUND DEHISCENCE;SIMPL,314.50,0.00,,,,,,,,,,,,,
14006105,0450,12021,,,,,TX SUPERF WOUND DEHISCENCE; W/PACK,298.50,0.00,,,,,,,,,,,,,
14006106,0450,12031,,,,,LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,979.73,979.73,,,,,,,,,,,,,
14006107,0450,12032,,,,,LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,755.18,755.18,,,,,,,,,,,,,
14006108,0450,12034,,,,,LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,979.73,979.73,,,,,,,,,,,,,
14006110,0450,12035,,,,,INTMD WND REPAIR S/A/T/EXT,1030.97,1030.97,,,,,,,,,,,,,
14006111,0450,12006,,,,,SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM,246.00,0.00,,,,,,,,,,,,,
14006113,0450,12042,,,,,INTMD WND REPAIR N-HF/GENIT,755.18,755.18,,,,,,,,,,,,,
14006118,0450,12051,,,,,LAYER CLO FACE/LIPS; 2.5CM/LESS,755.18,755.18,,,,,,,,,,,,,
14006119,0450,12052,,,,,INTMD WND REPAIR FACE/MM 2.6-5.0 CM,979.73,979.73,,,,,,,,,,,,,
14006120,0450,12053,,,,,LAYER CLO FACE/LIPS; 5.1 TO 7.5CM,314.50,0.00,,,,,,,,,,,,,
14006121,0450,12054,,,,,INTMD WND REPAIR FACE/MM 7.6-12.5 CM,1045.88,1045.88,,,,,,,,,,,,,
14006128,0450,13120,,,,,REPR COMPLX SCLP /EXTREM;1.1-2.5CM,484.00,0.00,,,,,,,,,,,,,
14006129,0450,13121,,,,,REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,1517.05,1517.05,,,,,,,,,,,,,
14006130,0450,13122,,,,,C REP S/A/L; EA ADD 5 CM/<,504.69,504.69,,,,,,,,,,,,,
14006131,0450,13131,,,,,REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,1435.25,1435.25,,,,,,,,,,,,,
14006132,0450,13132,,,,,REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,1516.40,1516.40,,,,,,,,,,,,,
14006157,0450,15931,,,,,EXC SACRAL PRESS ULCER W/PRIM SUTUR,1522.00,0.00,,,,,,,,,,,,,
14006161,0450,15999,,,,,UNLISTED PROC EXC PRESS ULCER,1522.00,0.00,,,,,,,,,,,,,
14006162,0450,16000,,,,,INT TX 1ST DEGREE BURN W/LOCAL TX,217.00,0.00,,,,,,,,,,,,,
14006165,0450,16020,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES SM,404.38,404.38,,,,,,,,,,,,,
14006170,0450,16025,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES MED,193.50,0.00,,,,,,,,,,,,,
14006173,0450,17000,,,,,DESTRCT-ANY METHD-BEN LES; W/ANE;1,72.25,0.00,,,,,,,,,,,,,
14006174,0450,17003,,,,,"DESTRCT-ANY METHD-BEN LES 2-14, EA",68.50,0.00,,,,,,,,,,,,,
14006175,0450,17004,,,,,DESTRCT-ANY METHD-BEN LES 15/>LESS,352.50,0.00,,,,,,,,,,,,,
14006176,0450,17110,,,,,DESTRCT  WARTS/MOLLUSCUM TO 14 LES,72.25,0.00,,,,,,,,,,,,,
14006177,0450,17111,,,,,DESTRCT WARTS/MOLLUSCUM;15/>LES,331.75,0.00,,,,,,,,,,,,,
14006180,0456,16020,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES SM,217.00,0.00,,,,,,,,,,,,,
14006198,0450,19000,,,,,PUNCT ASPIRAT CYST BREAST,225.00,0.00,,,,,,,,,,,,,
14006199,0450,19001,,,,,PUNCT ASPIR CYST BREAST; EA AD CYST,225.00,0.00,,,,,,,,,,,,,
14006208,0450,10060,,,,,INC SOFT TISSUE ABSC;SPRFCL,259.25,0.00,134.14,321.93,,,,,,,134.14,,,321.93,321.93
14006210,0450,20100,,,,,ESPLOR PENETR WOND (SEP PRO) NECK,256.75,0.00,,,,,,,,,,,,,
14006211,0450,20102,,,,,EXPLOR WOUND (SEP PRO);ABD/FLNK/BK,1476.00,0.00,,,,,,,,,,,,,
14006212,0450,20103,,,,,EXPLO PENTR WOUND (SEP PRO); EXTREM,1965.94,1965.94,,,,,,,,,,,,,
14006221,0450,20520,,,,,REMOV FB MUSCL/TENDON; SIMPL,488.25,0.00,,,,,,,,,,,,,
14006223,0450,20550,,,,,INJ TENDON SHEATH/LIG/TRIG PT/CYST,257.75,0.00,,,,,,,,,,,,,
14006224,0450,20600,,,,,ARTHROCENTESIS/ASPRIN/ING; SMJT,257.75,0.00,,,,,,,,,,,,,
14006225,0450,20605,,,,,ARTHROCENTESIS/ASPRI/INJ; INTERM JT,749.18,749.18,,,,,,,,,,,,,
14006226,0450,20610,,,,,ARTHROCENTESIS MAJOR JT/BURSA,749.18,749.18,254.72,254.72,,,,,,,254.72,,,,
14006227,0450,20615,,,,,ASPIRAT & INJ TX BONE CYST,238.25,0.00,,,,,,,,,,,,,
14006229,0450,21300,,,,,CLO TX SKULL FX WO OR,1464.25,0.00,,,,,,,,,,,,,
14006230,0450,21310,,,,,CLO TX NASAL BONE FX WO MANIP,1464.25,0.00,,,,,,,,,,,,,
14006231,0450,21315,,,,,CLO TX NASAL BONE FX; WO STABILIZAT,1464.25,0.00,,,,,,,,,,,,,
14006232,0450,21320,,,,,CLO TX NASAL BONE FX; W/STABILAZAT,1464.25,0.00,,,,,,,,,,,,,
14006236,0450,20610,,,,,ARTHROCENTESIS MAJOR JT/BURSA,257.75,0.00,254.72,254.72,,,,,,,254.72,,,,
14006237,0450,21450,,,,,CLO TX MANDIB FX; WO MANIP,218.25,0.00,,,,,,,,,,,,,
14006238,0450,21451,,,,,CLO TX MANDIB FX; W/MANIP,1518.00,0.00,,,,,,,,,,,,,
14006239,0450,21480,,,,,CLO TX TM DISLOC; INIT/SUBSQT,206.75,0.00,,,,,,,,,,,,,
14006240,0450,21485,,,,,CLO TX TM DISLOC; COMPLIC INIT/SUBS,1464.25,0.00,,,,,,,,,,,,,
14006241,0450,21493,,,,,CLO TX HYOID FX; WO MANIP,631.50,0.00,,,,,,,,,,,,,
14006242,0450,21494,,,,,CLO TX HYOID FX; W/MANIP,669.75,0.00,,,,,,,,,,,,,
14006244,0450,21499,,,,,UNLISTED MS PROC HEAD,1464.25,0.00,,,,,,,,,,,,,
14006245,0450,21501,,,,,I&D DEEP ABSCESS SOFT TISS NECK,749.75,0.00,,,,,,,,,,,,,
14006247,0450,21550,,,,,BX SOFT TISS NECK/THORAZ,488.25,0.00,,,,,,,,,,,,,
14006250,0450,21800,,,,,CLO TX RIB FX UNCOMP EA,200.00,0.00,,,,,,,,,,,,,
14006251,0450,21820,,,,,CLO TX STERNUM FX,213.00,0.00,,,,,,,,,,,,,
14006252,0450,21899,,,,,UNLISTED PROC NEC/THORAZ,631.50,0.00,,,,,,,,,,,,,
14006253,0450,21920,,,,,BX SOFT TISS BACK/FLANK; SUPERF,794.75,0.00,,,,,,,,,,,,,
14006254,0450,21930,,,,,EXC TUMOR SOFT TISS BACK/FLANK,1522.00,0.00,,,,,,,,,,,,,
14006255,0450,22305,,,,,CLO TX VERTEBRAL PROCESS FX,213.00,0.00,,,,,,,,,,,,,
14006256,0450,22310,,,,,CLO TX VERT BODY FX WO MINIP-W/CAST,213.00,0.00,,,,,,,,,,,,,
14006265,0450,23330,,,,,REMOVE FB SHOULDER; SUBQ,488.25,0.00,,,,,,,,,,,,,
14006266,0450,23500,,,,,CLO TX CLAV FX; WO MANIP,213.00,0.00,,,,,,,,,,,,,
14006268,0450,23520,,,,,CLO TX STERNOCLAV DISLOC; W/O MANIP,213.00,0.00,,,,,,,,,,,,,
14006269,0450,23525,,,,,CLO TX STERNOCLAV DISLOC; W/MANIP,213.00,0.00,,,,,,,,,,,,,
14006270,0450,23540,,,,,CLO TX ACROMIOCLAV DISLOC; WO MINIP,213.00,0.00,,,,,,,,,,,,,
14006271,0450,23545,,,,,CLO TX ACROMIOCLAV DISLOC; W/ MINIP,213.00,0.00,,,,,,,,,,,,,
14006272,0450,23570,,,,,CLO TX SCAPULAR FX; WO MANIP,213.00,0.00,,,,,,,,,,,,,
14006273,0450,23575,,,,,CLO TX SCAP FX; W/MANIP W/WO TRACT,213.00,0.00,,,,,,,,,,,,,
14006274,0450,23600,,,,,CLO TX PROX HUMERAL FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006275,0450,23605,,,,,CLO TX PROX HUMER FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006276,0450,23620,,,,,CLO TX GR HUMERAL TUBER FX; WO,280.50,0.00,,,,,,,,,,,,,
14006277,0450,23625,,,,,CLO TX GR HUMERAL TUBER FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006278,0450,23650,,,,,CLO TX SHLDR DISLOC W/MANIP;WO ANES,576.98,576.98,,,,,,,,,,,,,
14006281,0450,23675,,,,,CLO TX SHLDR DISLOC W/FX W/MAN,280.50,0.00,,,,,,,,,,,,,
14006287,0450,24065,,,,,BX SOFT TISS UP ARM/ELBOW; SUPERF,794.75,0.00,,,,,,,,,,,,,
14006289,0450,24075,,,,,EXC TUMOR UPPER ARM/ELBOW; SUBSQ,1277.25,0.00,,,,,,,,,,,,,
14006291,0450,24200,,,,,REMOV FB UPPER ARM/ELBOW; SUBSQ,488.25,0.00,,,,,,,,,,,,,
14006299,0450,24500,,,,,CLO TX HUMERAL SHAFT FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006300,0450,24505,,,,,CLO TX HUMERAL FX; W/MANIP W/WO TRA,280.50,0.00,,,,,,,,,,,,,
14006301,0450,24530,,,,,CLO TX SUPRACONDYL HUMER FX; W/O MAN,280.50,0.00,,,,,,,,,,,,,
14006302,0450,24535,,,,,CLO TX SYOERCONDYL HUMER FX;W/MAN,280.50,0.00,,,,,,,,,,,,,
14006303,0450,24560,,,,,CLO TX HUMER EPICOND FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006305,0450,24576,,,,,CLO TX HUMERAL CONDYL FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006306,0450,24577,,,,,CLO TX HUMERAL CONDYL FX; W MAN,280.50,0.00,,,,,,,,,,,,,
14006307,0450,24600,,,,,TX CLO ELBOW DISLOC; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006308,0450,24605,,,,,TX CLOSED ELBOW DISLOC WITH ANESTHESIA,3404.00,0.00,,,,,,,,,,,,,
14006310,0450,24640,,,,,CL TX  NURSEMAID ELBOW  W MANIP,737.50,737.50,,,,,,,,,,,,,
14006311,0450,24650,,,,,CLO TX RADIAL HEAD/NECK FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006312,0450,24655,,,,,CLO TX RADIAL HEAD/NECK FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006313,0450,24670,,,,,CLO RX ULNAR FX PROX END; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006314,0450,24675,,,,,CLO TX ULNAR FX  PROX END; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006321,0450,25065,,,,,BX SOFT TISS FOREARM/WRIST; SUPERF,794.75,0.00,,,,,,,,,,,,,
14006323,0450,25075,,,,,EXC TUMOR FOREARM/WRIST AREA; SUBQ,794.75,0.00,,,,,,,,,,,,,
14006332,0450,25500,,,,,CLO TX RADIAL SHAFT FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006333,0450,25505,,,,,CLO TX RADIAL SHAFT FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006334,0450,25520,,,,,CLO TX RADIAL FX W/DISLOC RAD/ULNA,280.50,0.00,,,,,,,,,,,,,
14006335,0450,25530,,,,,CLO TX ULNAR SHAFT FX WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006336,0450,25535,,,,,CLO TX ULNAR SHAFT FX W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006337,0450,25560,,,,,CLO TX RAD & ULNA SHAFT FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006338,0450,25565,,,,,CL TX RADIAL & ULNA FX W MANIP,4541.95,4541.95,,,,,,,,,,,,,
14006339,0450,25600,,,,,CLO TX DIST RAD FX; WO MANIP,372.75,0.00,,,,,,,,,,,,,
14006340,0450,25605,,,,,CLOSED TREATMENT DISRAL RADIAL FRACTURE,4176.23,4176.23,,,,,,,,,,,,,
14006341,0450,25622,,,,,CLO TX CARPAL SCAPHOID FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006342,0450,25624,,,,,CLO TX CARPAL SCAPHOID FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006343,0450,25630,,,,,CLO TX CARPAL BONE FX; WO MANIP EA,280.50,0.00,,,,,,,,,,,,,
14006344,0450,25635,,,,,CLO TX CARPAL BONE FX; W/MANIP EA,280.50,0.00,,,,,,,,,,,,,
14006345,0450,25650,,,,,CLO TX ULNAR STYLOID FX,280.50,0.00,,,,,,,,,,,,,
14006346,0450,25660,,,,,CLO TX RADIOCARPAL DISLOC W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006347,0450,25675,,,,,CLO TX RADIOULNAR DISLOC W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006348,0450,25680,,,,,CLO TX TRANS-SCAPHOPERILUNAR W/MANI,280.50,0.00,,,,,,,,,,,,,
14006349,0450,25690,,,,,CLO TX LUNATE DISLOC W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006351,0450,26010,,,,,DRAINAGE FINGER ABSCESS; SIMPL,261.84,261.84,,,,,,,,,,,,,
14006359,0450,26600,,,,,CLO TX METACARP FX 1; WO MANIP,372.75,0.00,,,,,,,,,,,,,
14006360,0450,26605,,,,,CLO TX METACARP FX 1; W/MANIP EA,280.50,0.00,,,,,,,,,,,,,
14006361,0450,26607,,,,,CLO TX METACARPAL FX W/MANIP W/FIXA,280.50,0.00,,,,,,,,,,,,,
14006363,0450,26641,,,,,CLO TX CARPOMETA DISLOC THUMB W/MAN,280.50,0.00,,,,,,,,,,,,,
14006364,0450,26645,,,,,CLO TX CARPOMETACAR FX THUMB W/MAN,280.50,0.00,,,,,,,,,,,,,
14006366,0450,26670,,,,,CLO TX DISLOC-NOT THUMB; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006369,0450,26700,,,,,CLO TX MCP DISLOC-1W/MANIP-WO ANES,213.00,0.00,,,,,,,,,,,,,
14006371,0450,26720,,,,,CLO TX PHALANGEAL FX; WO MANIP EA,213.00,0.00,,,,,,,,,,,,,
14006372,0450,26725,,,,,CLO TX PHALANGEAL FX; W/WO TRACT,213.00,0.00,,,,,,,,,,,,,
14006373,0450,26755,,,,,CL TX D PHAL FX FGRR/THMB; W MANIP,685.79,685.79,,,,,,,,,,,,,
14006379,0450,26770,,,,,CLO TX IP JT DISLOC W/WMANIP; WO ANES,591.41,591.41,,,,,,,,,,,,,
14006380,0450,57180,,,,,INTRO VAGINAL PACKING NON OB,380.01,0.00,,,,,,,,,,,,,
14006390,0450,27086,,,,,REMOV FB PELVIS/HIP; SUBQ TISS,488.25,0.00,,,,,,,,,,,,,
14006392,0450,27193,,,,,CLO TX PELVIC RING FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006394,0450,27220,,,,,CLO TX ACETABULUM FX; WO/ MANIP,280.50,0.00,,,,,,,,,,,,,
14006395,0450,27230,,,,,CLO TX FEM FX PROX END NECK; WO MAN,280.50,0.00,,,,,,,,,,,,,
14006397,0450,27246,,,,,CLO TX GREATER TROCH FX WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006398,0450,27250,,,,,CLO TX HIP DISLOC TRAUMA; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006400,0450,27258,,,,,TX SPON HIP DISLOC; WO ANES/MANIP,280.50,0.00,,,,,,,,,,,,,
14006404,0450,24565,,,,,CLO HUMER EPICOND FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006409,0450,27500,,,,,CLO TX FEMORAL SHAFT FX WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006410,0450,27501,,,,,CLO TX SUPRACONDYL FEM FX WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006411,0450,27520,,,,,CLO TX PATELLAR FX WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006412,0450,27530,,,,,CLO TX TIBIAL FX PROX;WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006413,0450,27532,,,,,CLO TX TIB FX; W/WO MANIP W/TRACT,280.50,0.00,,,,,,,,,,,,,
14006414,0450,27538,,,,,CLO TX FX KNEE W/WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006415,0450,27550,,,,,CLO TX KNEE DISLOC; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006417,0450,27560,,,,,CLO TX PATELLAR DISLOC; WO ANES,685.78,685.78,,,,,,,,,,,,,
14006424,0450,27603,,,,,I&D LEG/ANK; DEEP ABSCESS/HEMATOMA,796.00,0.00,,,,,,,,,,,,,
14006426,0450,27613,,,,,BX SOFT TISS LEG/ANK AREA; SUPERF,794.75,0.00,,,,,,,,,,,,,
14006430,0450,27750,,,,,CLO TX TIBIAL SHAFT FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006431,0450,27752,,,,,CLO TX TIB FX; W/MANIP W/WO TRACT,280.50,0.00,,,,,,,,,,,,,
14006432,0450,27760,,,,,CLO TX MEDIAL MALLEOLUS FX; WO MANI,280.50,0.00,,,,,,,,,,,,,
14006433,0450,27762,,,,,CLO TX MED MALLEOLUS FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006435,0450,27780,,,,,CLO TX PROX FIB/SHAFT FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006436,0450,27781,,,,,CLO TX PROX FIB/SHAFT FX; W MANIP,280.50,0.00,,,,,,,,,,,,,
14006437,0450,27786,,,,,CLO TX DISTAL FIBULAR FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006438,0450,27788,,,,,CLO  TX DISTAL FIBULAR FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006439,0450,27788,,,,,CLO TX BIMALLEOLAR ANK FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006440,0450,27810,,,,,CLO TX BIMALLEOLAR ANK FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006441,0450,27816,,,,,CLO TX TRIMALLEOLAR ANK FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006442,0450,27818,,,,,CLO TX TRIMALLEOLAR ANK FX; W/MANIP,4178.01,4178.01,,,,,,,,,,,,,
14006443,0450,27824,,,,,CLO TX FX ARTICUL-DIST TIB; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006444,0450,27825,,,,,CLO TX FX DIST TIB; W/TRACT/ANES,280.50,0.00,,,,,,,,,,,,,
14006445,0450,27830,,,,,CLO TX PROX TIB-FIB JT DISL; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006447,0450,27840,,,,,CLO TX ANK DISLOC; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006459,0450,28190,,,,,REMOV FB FT; SUBQ,488.25,0.00,,,,,,,,,,,,,
14006462,0450,28400,,,,,CLO TX CALCAN FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006463,0450,28405,,,,,CLO TX CALCAN FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006464,0450,28430,,,,,CLO TX TALUS FX; WO MANIP,280.50,0.00,,,,,,,,,,,,,
14006465,0450,28435,,,,,CLO TX TALUS FX; W/MANIP,280.50,0.00,,,,,,,,,,,,,
14006466,0450,28450,,,,,TX TARSAL BONE FX; WO MANIP EA,280.50,0.00,,,,,,,,,,,,,
14006467,0450,28470,,,,,CLO TX METATARSAL FX; WO MANIP EA.,280.50,0.00,,,,,,,,,,,,,
14006468,0450,28475,,,,,CLO TX METATARSAL FX; W/MANIP EA,280.50,0.00,,,,,,,,,,,,,
14006471,0450,28490,,,,,CLO TX FX GRT TOE PHALANX; WO MANIP,213.00,0.00,,,,,,,,,,,,,
14006472,0450,28495,,,,,CL TX FX GT PHALANX(S); W MANIP,685.78,685.78,,,,,,,,,,,,,
14006475,0450,28510,,,,,CLO TX FX PHALNX NOT GR TOE; WO/MAN,213.00,0.00,,,,,,,,,,,,,
14006476,0450,28515,,,,,CLO TX FX PHALNX NOT GR TOE; W/MANI,213.00,0.00,,,,,,,,,,,,,
14006478,0450,28530,,,,,CLSD TX SESAMOID FX,280.50,0.00,,,,,,,,,,,,,
14006480,0450,28540,,,,,CLO TX TARSAL BONE DISLOC; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006484,0450,28570,,,,,CLO TX TALOTARS JT DISLO; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006488,0450,28600,,,,,CLO TX TARSOMETAT JT DISLOC; WO ANES,280.50,0.00,,,,,,,,,,,,,
14006492,0450,28630,,,,,CLO TX METARSOPHAL JT DISL; WO ANES,213.00,0.00,,,,,,,,,,,,,
14006496,0450,28660,,,,,CLO TX IP JT DISLOC; WO ANES,213.00,0.00,,,,,,,,,,,,,
14006500,0450,29065,,,,,APPLY LONG ARM CAST,798.34,798.34,,,,,,,,,,,,,
14006501,0450,29075,,,,,APPLIC; ELBOW TO FINGER,713.41,713.41,,,,,,,,,,,,,
14006502,0450,29085,,,,,APPLIC; HAND & LOWER FOREARM,230.50,0.00,,,,,,,,,,,,,
14006503,0450,29105,,,,,APPLIC; LONG ARM SPLINT,429.33,429.33,,,,,,,,,,,,,
14006504,0450,29125,,,,,APPLIC; SHORT ARM SPLINT; STATOC,312.92,312.92,,,,,,,,,,,,,
14006505,0456,29125,,,,,APPLIC; SHORT ARM SPLINT; STATOC,230.50,0.00,,,,,,,,,,,,,
14006506,0450,29130,,,,,APPLY FINGER SPLINT; STATIC,188.08,188.08,,,,,,,,,,,,,
14006507,0450,29240,,,,,STRAPPING; SHOULDER,358.26,358.26,,,,,,,,,,,,,
14006508,0450,29345,,,,,APPLIC LONG LEG CAST,713.41,713.41,,,,,,,,,,,,,
14006509,0456,29105,,,,,APPLIC; LONG ARM SPLINT,225.00,0.00,,,,,,,,,,,,,
14006510,0450,29358,,,,,APPLIC LONG LEG CAST BRACE,225.00,0.00,,,,,,,,,,,,,
14006512,0450,29425,,,,,APPLIC SHORT LEG CAST,814.31,814.31,,,,,,,,,,,,,
14006513,0450,29425,,,,,APPLIC SHORT LEG CAST; WALKING/AMB,225.00,0.00,,,,,,,,,,,,,
14006514,0456,,,,,,APPLIC FINGER SPLINT; STATIC,213.00,0.00,,,,,,,,,,,,,
14006515,0451,,,,,,APPLIC; SHORT ARM SPLINT; STATOC,230.50,0.00,,,,,,,,,,,,,
14006516,0450,29445,,,,,APPLIC RIGID TOT CONTACT LEG CAST,225.00,0.00,,,,,,,,,,,,,
14006517,0451,,,,,,APPLIC SHORT LEG SPLINT,230.50,0.00,,,,,,,,,,,,,
14006518,0450,29505,,,,,APPLIC LONG LEG SPLINT,419.02,419.02,,,,,,,,,,,,,
14006519,0450,29515,,,,,APPLIC SHORT LEG SPLINT,409.21,409.21,,,,,,,,,,,,,
14006520,0450,29580,,,,,STRAPPING; UNNA BOOT,132.75,0.00,,,,,,,,,,,,,
14006521,0450,29705,,,,,REMOV/BIVALV; FULL ARM/LEG CAST,713.41,713.41,,,,,,,,,,,,,
14006522,0450,29710,,,,,REMOV/BIVALV; SHOULDER/HIP SPICA,140.75,0.00,,,,,,,,,,,,,
14006523,0450,29715,,,,,REMOV/BIVALV; TURNBUCKLE JACKET,140.75,0.00,,,,,,,,,,,,,
14006524,0450,29730,,,,,WINDOWING CAST,132.75,0.00,,,,,,,,,,,,,
14006525,0450,29740,,,,,WEDGING CAST,140.75,0.00,,,,,,,,,,,,,
14006533,0450,30300,,,,,REMOV FB INTRANASAL; RIGHT,372.79,372.79,,,,,,,,,,,,,
14006537,0450,30905,,,,,CNTRL POST EPISTAX INIT,353.41,353.41,,,,,,,,,,,,,
14006539,0450,31500,,,,,INTUBATION ENDOTRACHEAL EMER PROC,607.74,607.74,222.59,222.59,,,,,,,222.59,,,,
14006540,0450,31502,,,,,TRACHEOT TUBE CHANGE BEFOR FISTULA,288.25,0.00,,,,,,,,,,,,,
14006541,0450,31505,,,,,LARYNGOSCOPY INDIREC; DX (SEP PROC),154.00,0.00,,,,,,,,,,,,,
14006542,0450,31510,,,,,LARYNGOSCOPY INDIRECT; W/BX,1658.75,0.00,,,,,,,,,,,,,
14006543,0450,30901,,,,,CONTROL NASAL HEMORR ANT SIMP,334.88,334.88,113.86,113.86,,,,,,,113.86,,,113.86,113.86
14006544,0450,31512,,,,,LARYNGOSCOPY INDIRECT; W/REMOV LES,1658.75,0.00,,,,,,,,,,,,,
14006547,0450,31520,,,,,LARYNGOSCP DIR W/WO TREACHEO DX NB,164.50,0.00,,,,,,,,,,,,,
14006550,0450,31575,,,,,LARYNGOSCOPY  FLEX FIBEROPTIC; DX,72.25,0.00,,,,,,,,,,,,,
14006552,0450,31577,,,,,LARYNGOSCPY FIBEROPTIC; W/REMOV FB,501.25,0.00,,,,,,,,,,,,,
14006556,0450,31603,,,,,TRACHEOSTOMY EMER PROC; TRANSTRACH,1518.00,0.00,,,,,,,,,,,,,
14006558,0450,31605,,,,,TRACH EMER PROC; CRICOTHYROID MEMBR,1518.00,0.00,,,,,,,,,,,,,
14006570,0450,32421,,,,,THORACENTESIS-ASPIR-INT/SUBSQT,444.75,0.00,,,,,,,,,,,,,
14006571,0450,32422,,,,,THORACENTESIS W/INSRT TUBE (SEP PROC),444.75,0.00,,,,,,,,,,,,,
14006572,0450,32421,,,,,THORACENTESIS,1096.75,0.00,,,,,,,,,,,,,
14006573,0450,32551,,,,,TUBE THORACOSTOMY (SEP PROC),469.75,0.00,,,,,,,,,,,,,
14006579,0450,33210,,,,,INSRT/REPLC TEMP 1 ELECT (SEP PROC),791.75,0.00,,,,,,,,,,,,,
14006580,0450,33211,,,,,INSRT/REPLC TEMP ELECTROD (SEP PROS),791.75,0.00,,,,,,,,,,,,,
14006586,0450,36420,,,,,VENIPUNCT CUTDOWN; < 1YR,659.00,0.00,,,,,,,,,,,,,
14006587,0450,36425,,,,,VENIPUNCT CUTDOWN; AGE 1/OVER,659.00,0.00,,,,,,,,,,,,,
14006588,0391,36430,,,,,"BLOOD TRANSFUSION, COMPONENTS",716.00,0.00,399.60,766.83,,,,,,,399.60,,,766.83,766.83
14006589,0456,,,,,,BLOOD PRODUCT TRANSFUSION,716.00,0.00,,,,,,,,,,,,,
14006590,0451,,,,,,BLOOD PRODUCT TRANSFUSION,716.00,0.00,,,,,,,,,,,,,
14006595,0450,36556,,,,,INS CENTRAL VENOUS ACCESS >5,659.00,0.00,,,,,,,,,,,,,
14006596,0761,36556,,,,,PLCMT CENT VENOUS CATH; PERQ <5YR,2300.00,0.00,,,,,,,,,,,,,
14006603,0450,38300,,,,,DRAINAGE LYMPH NODE ABSCESS;SIMPL,749.75,0.00,,,,,,,,,,,,,
14006605,0450,38505,,,,,BX/EXC LYMPH NODE; BY NEEDLE SUPERF,660.50,0.00,,,,,,,,,,,,,
14006608,0450,40490,,,,,BX LIP,631.50,0.00,,,,,,,,,,,,,
14006610,0450,40800,,,,,DRAIN ABSCESS VESTIBULE MOUTH;SIMPL,206.75,0.00,,,,,,,,,,,,,
14006611,0450,40804,,,,,REMOV EMBEDDED FB MOUTH; SIMPL,218.25,0.00,,,,,,,,,,,,,
14006613,0450,40808,,,,,BX VESTIBULE MOUTH,206.75,0.00,,,,,,,,,,,,,
14006614,0450,40830,,,,,CLO LACERATION MOUTH; 2.5 CM/LESS,218.25,0.00,,,,,,,,,,,,,
14006618,0450,41005,,,,,INTRAORAL I&D ABSCESS; SUBLINGUAL,218.25,0.00,,,,,,,,,,,,,
14006622,0450,41015,,,,,EXTRAORAL I&D ABSCESS; SUBLINGUAL,631.50,0.00,,,,,,,,,,,,,
14006639,0450,41800,,,,,DRAIN ABSCESS DENTOALVEOLAR STRUCT,206.75,0.00,,,,,,,,,,,,,
14006659,0450,42960,,,,,CONTROL OROPHARYNG HEMORR; SIMPL,285.50,0.00,,,,,,,,,,,,,
14006660,0450,42970,,,,,CONTROL NASOPHARYNG HEMORR; SIMPL,285.50,0.00,,,,,,,,,,,,,
14006671,0451,97598,,,,,RMVL DEVITAL TIS ADDL 20CM,273.00,0.00,,,,,,,,,,,,,
14006672,0456,97598,,,,,RMVL DEVITAL TIS ADDL 20CM,273.00,0.00,,,,,,,,,,,,,
14006673,0451,97597,,,,,RMVL DEVITAL TIS 20CM<,307.75,0.00,,,,,,,,,,,,,
14006674,0456,97597,,,,,RMVL DEVITAL TIS 20CM<,307.75,0.00,,,,,,,,,,,,,
14006708,0450,45005,,,,,I&D SUBMUCOSAL ABSCESS RECTUM,302.50,0.00,,,,,,,,,,,,,
14006713,0450,45300,,,,,PROCTOSIG RIGID W/W/O COLLECT,229.00,0.00,,,,,,,,,,,,,
14006714,0450,45303,,,,,PROCSIGMOSCOPY RIGID; W/DILAT,346.00,0.00,,,,,,,,,,,,,
14006715,0450,45305,,,,,PROCSIGMOSCOPY RIGID; W/BX 1/MX,346.00,0.00,,,,,,,,,,,,,
14006720,0450,45317,,,,,PROCSIGMOIDOS RIGID;W/CONTROL BLD,366.00,0.00,,,,,,,,,,,,,
14006747,0450,46050,,,,,I&D PERIANAL ABSCESS SUPERF,2300.75,0.00,,,,,,,,,,,,,
14006750,0450,46083,,,,,INCS THROMBOSED HEMORRHOID EXT,787.71,787.71,,,,,,,,,,,,,
14006755,0450,46221,,,,,HEMORRHOIDECTOMY BY SIMPL LIG,285.50,0.00,,,,,,,,,,,,,
14006764,0450,46320,,,,,ENUCLEATION EXT THROBOTIC HEMORRHO,302.50,0.00,,,,,,,,,,,,,
14006765,0450,46500,,,,,INJ SCLEROSING SOLUTION HEMORRHOIDS,285.50,0.00,,,,,,,,,,,,,
14006791,0450,49080,,,,,PERITONEOCENTESIS;INIT,444.75,0.00,,,,,,,,,,,,,
14006803,0450,53600,,,,,DILAT URETHRAL STRICT-MALE; INIT,280.50,0.00,,,,,,,,,,,,,
14006806,0450,53620,,,,,DILAT URETHRAL FILLIFORM-MALE; INIT,475.00,0.00,,,,,,,,,,,,,
14006824,0450,55100,,,,,DRAINAGE SCROTAL WALL ABSCESS,749.75,0.00,,,,,,,,,,,,,
14006833,0450,59409,,,,,VAG DELIV ONLY,1447.00,0.00,,,,,,,,,,,,,
14006834,0450,59414,,,,,DELIV PLACENTA (SEPART PROC),1364.25,0.00,,,,,,,,,,,,,
14006846,0450,62270,,,,,SPINAL PUNCT LUMBAR DX,1698.14,1698.14,,,,,,,,,,,,,
14006869,0450,62311,,,,,LUMBA SACRAL (CAUDAL),1255.00,0.00,,,,,,,,,,,,,
14006870,0450,64450,,,,,INJ ANES AGENT; OTHER PERIPHERAL,1740.59,1740.59,,,,,,,,,,,,,
14006871,0450,62310,,,,,CERVICAL INJECTION,297.50,0.00,,,,,,,,,,,,,
14006884,0450,65205,,,,,REMOV FB EXT EYE; CONJUNC SUPERF,332.24,332.24,,,,,,,,,,,,,
14006885,0450,65210,,,,,REMOV FB EXT EYE; CONJUNC EMBEDDED,322.50,0.00,,,,,,,,,,,,,
14006886,0450,65220,,,,,REMOV FB EXT EYE;CORNEAL WO LAMP,361.14,361.14,,,,,,,,,,,,,
14006888,0450,67700,,,,,BLEPHAROTOMY DRAIN ABSCESS EYELID,361.75,0.00,,,,,,,,,,,,,
14006889,0450,67810,,,,,BX EYELID,361.75,0.00,,,,,,,,,,,,,
14006890,0450,67938,,,,,REMOV EMBEDDED FB EYELID,921.41,921.41,,,,,,,,,,,,,
14006891,0450,30906,,,,,CTRL POST EPISTAX SQ,693.57,693.57,,,,,,,,,,,,,
14006894,0450,68810,,,,,PROBE NASOLACRIM DUCT W/WO IRRIG.G,342.00,0.00,,,,,,,,,,,,,
14006895,0450,68899,,,,,UNLISTED PROC LACRIMAL SYST,322.50,0.00,,,,,,,,,,,,,
14006896,0450,69000,,,,,DRAIN EXT EAR ABSCESS; SIMPL,1949.22,1949.22,,,,,,,,,,,,,
14006897,0450,69020,,,,,DRAIN EXT AUDITORY CANAL ABSCESS,243.50,0.00,,,,,,,,,,,,,
14006898,0450,69100,,,,,BX EXT EAR,488.25,0.00,,,,,,,,,,,,,
14006899,0981,69000,,,,,DRAIN EXT EAR ABSCESS; SIMPL,516.08,516.08,,,,,,,,,,,,,
14006900,0450,69110,,,,,EXC EXT EAR; PART SIMPL REPR,794.75,0.00,,,,,,,,,,,,,
14006903,0450,69210,,,,,REMOV IMPACTED CERUMEN (SEP PRO),127.75,0.00,,,,,,,,,,,,,
14006909,0450,43752,,,,,NG TUBE PLACEMENT W/FLUORO,465.75,0.00,,,,,,,,,,,,,
14006920,0456,,,,,,"IMMUN ADMIN, ONE VACCINE",83.25,0.00,,,,,,,,,,,,,
14006921,0451,,,,,,"IMMUN ADMIN, ONE VACCINE",83.25,0.00,,,,,,,,,,,,,
14006922,0771,90471,,,,,"IMMUN ADMIN, ONE VACCINE",145.20,145.20,48.89,48.89,,,,,,,48.89,,,,
14006923,0771,G0009,,,,,ADMIN PNEUMONIA VACCINE- MC,145.20,145.20,,,,,,,,,,,,,
14006927,0771,90472,,,,,IMMUNIZATION ADMIN EA ADDL,85.77,85.77,,,,,,,,,,,,,
14006977,0636,90732,,,,,PNEUMOCOCCAL POLYSACCH VAC-ADULT,25.00,0.00,,,,,,,,,,,,,
14006978,0450,90733,,,,,MENINGOCOCCAL POLYSACCH VAC-SUBSQ,226.00,0.00,,,,,,,,,,,,,
14006979,0450,90735,,,,,JAPANESE ENCEPHALITIS VAC-SUBQ USE,226.00,0.00,,,,,,,,,,,,,
14006981,0636,90746,,,,,HEPATITIS B VAC ADULT DOSE-IM USE,44.50,0.00,,,,,,,,,,,,,
14006984,0636,90748,,,,,HEP B/HEMOPHILUS INFLU B VAC-IM USE,851.25,0.00,,,,,,,,,,,,,
14006995,0920,92326,,,,,REPLAC CONTACT LENS,65.75,0.00,,,,,,,,,,,,,
14006997,0450,92950,,,,,CARDIOPULMONARY RESUSCITATION,756.20,756.20,249.46,249.46,,,,,,,249.46,,,,
14007000,0450,92953,,,,,TEMPORARY TRANSCUTANEOUS PACING,1602.98,1602.98,,,,,,,,,,,,,
14007001,0450,92960,,,,,"CARDIOVERSION ELECTIVE, EXTERN",1563.88,1563.88,,,,,,,,,,,,,
14007002,0480,92961,,,,,CARDIOVERS ELEC-CONVER ARRHY; INT,1149.00,0.00,,,,,,,,,,,,,
14007003,0761,46040,,,,,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,3427.65,3427.65,,,,,,,,,,,,,
14007005,0730,93005,,,,,ECG-ROUTINE 12 LEAD  TRACING ONLY,47.50,0.00,66.49,132.36,,,132.36,,,,66.49,,,87.17,87.17
14007007,0730,93041,,,,,RHYTHM ECG 1-3 LEADS; TRACING ONLY,82.00,0.00,,,,,,,,,,,,,
14007062,0450,99281,,,,,"ER VISIT, LEVEL 1",203.51,203.51,68.71,135.61,,,135.61,,,,68.71,,,103.72,103.72
14007063,0450,99282,,,,,"ER VISIT, LEVEL 2",375.80,375.80,126.20,250.87,,,250.87,,,,126.20,,,186.01,186.01
14007064,0450,9928325,,,,,"ER VISIT, LEVEL 3",672.58,672.58,,,,,,,,,,,,,
14007066,0450,9928425,,,,,"ER VISIT, LEVEL 4",1122.18,1122.18,,,,,,,,,,,,,
14007067,0450,9928525,,,,,"ER VISIT, LEVEL 5",1668.01,1668.01,,,,,,,,,,,,,
14007068,0450,99291,,,,,"CRITICAL CARE, 1ST 30-74 MIN",2230.78,2230.78,757.97,769.62,,,,,,,757.97,,,769.62,769.62
14007069,0450,99465,,,,,NB RESUSCITATION,549.75,0.00,,,,,,,,,,,,,
14007070,0450,99292,,,,,"CRITICAL CARE, ADDL 30 MIN",1086.05,1086.05,360.75,360.75,,,,,,,360.75,,,,
14007073,0300,82272,,,,,COLORECTAL SCRN; HI RISK IND,346.00,0.00,,,,,,,,,,,,,
14007074,0300,82272,,,,,"OCCULT BLOOD, FECES, SINGLE-DIAGNOSTIC",16.11,16.11,,,,,,,,,,,,,
14007089,0331,96542,,,,,CHEMO BY BOTH INFUSION AND O,353.75,0.00,,,,,,,,,,,,,
14008001,0450,12041,,,,,INTMD WND REPAIR N-HF/GENIT,879.30,879.30,305.34,305.34,,,,,,,305.34,,,,
14008002,0450,36410,,,,,VENIPUNCT> 3YR W/MD SKILL (SEP PRO),43.50,0.00,,,,,,,,,,,,,
14008004,0300,86580,,,,,TB INTERDERMAL TEST,43.59,43.59,,,,,,,,,,,,,
14008006,0450,92977,,,,,THROMBOLYSIS CORONARY; IV INFUSION,685.68,685.68,,,,,,,,,,,,,
14008011,0451,,,,,,CATH URETHRA; SIMPLE,133.25,0.00,,,,,,,,,,,,,
14008013,0450,51701,,,,,CATH URETHRA; SIMPL,312.92,312.92,105.60,105.60,,,,,,,105.60,,,,
14008014,0300,82962,,,,,"GLUCOSE,QUANT,BLD REAGENT STRP",26.39,26.39,8.82,8.95,,,,,,,8.82,,,8.95,8.95
14008017,0450,27256,,,,,TX SPON HIP DISLOC; WO ANES/MANIP,165.75,0.00,,,,,,,,,,,,,
14008019,0450,51702,,,,,INSERTION TEMPORARY INDWELLING BLADDER,305.29,305.29,104.71,104.82,,,,,,,104.71,,,104.82,104.82
14008020,0450,51701,,,,,INSERTION NONINDWELLING BLADDER CATH,106.50,0.00,105.60,105.60,,,,,,,105.60,,,,
14008025,0451,99281,,,,,"ER VISIT, LEVEL 1 IDPA",168.25,0.00,,,,,,,,,,,,,
14008026,0456,99282,,,,,"ER VISIT, LEVEL 2 IDPA",277.00,0.00,299.17,299.17,,,,,,,,,,299.17,299.17
14008027,0456,99283,,,,,"ER VISIT, LEVEL 3 IDPA",437.50,0.00,,,,,,,,,,,,,
14008028,0450,9928425,,,,,"ER VISIT, LEVEL 4 IDPA",703.75,0.00,,,,,,,,,,,,,
14008029,0450,99285,,,,,"ER VISIT, LEVEL 5 IDPA",1044.50,0.00,,,,,,,,,,,,,
14008030,0450,64402,,,,,INJ ANESTHETIC AGENT FACIAL NERVE,882.60,882.60,,,,,,,,,,,,,
14008031,0450,69209,,,,,REMOVE IMPACTED EAR WAX UNI,187.22,187.22,63.65,63.65,,,,,,,63.65,,,,
14008032,0450,51798,,,,,US PV RESIDUAL URINE BLDR SCAN,192.05,192.05,,,,,,,,,,,,,
14008035,0450,29131,,,,,APPLICATION OF FINGER SPLINT: DYNAMIC,188.08,188.08,,,,,,,,,,,,,
14008036,0450,29435,,,,,APPY PATELLAR TENDON BEARING CAST,792.62,792.62,,,,,,,,,,,,,
14008102,0762,99218,,,,,OBSERVATION LOW IDPA 12.51-23 HRS.,313.50,0.00,,,,,,,,,,,,,
14009004,0981,99291,,,,,ER PHYSICIAN CRITICAL CARE 1ST HOUR,938.77,938.77,0.00,248.15,,,,,,,248.15,,,0.00,0.00
14010000,0960,10021,,,,,FINE NEEDLE ASPIRATION W/O GUIDANCE,474.45,474.45,,,,,,,,,,,,,
14010001,0450,1002226,,,,,FINE NEEDLE ASPIRATION W/GUIDANCE,280.25,0.00,,,,,,,,,,,,,
14010002,0981,10060,,,,,I&D ABCESS; SIMPL/SNGL,376.51,376.51,,,,,,,,,,,,,
14010003,0981,10061,,,,,I&D ABSCESS:COMPLIC/MX,738.11,738.11,,,,,,,,,,,,,
14010004,0450,1008026,,,,,I & D PILONIDAL CYST: SIMPL,257.50,0.00,,,,,,,,,,,,,
14010005,0450,1008126,,,,,I&D PILONIDAL CYST; COMPLIC,772.50,0.00,,,,,,,,,,,,,
14010006,0981,10120,,,,,INCS & REMOV FB SUBQ TISS; SIMPL,415.17,415.17,,,,,,,,,,,,,
14010007,0450,1012126,,,,,INCS & REMOV SUBQ TISS; COMPLIC,695.25,0.00,,,,,,,,,,,,,
14010008,0450,1014026,,,,,I&D HEMATOMA/SEROMA/FLUID COLLEC,257.50,0.00,,,,,,,,,,,,,
14010009,0981,10160,,,,,PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,366.62,366.62,,,,,,,,,,,,,
14010010,0450,1101026,,,,,DEBRID W/REMOV MAT;SKIN & SUBQ,566.50,0.00,,,,,,,,,,,,,
14010011,0450,1101126,,,,,DEBRID W/REMOV MAT;SKIN-SBQ-MUSC,669.50,0.00,,,,,,,,,,,,,
14010012,0450,1101226,,,,,DEBRID W/REM MAT;SKIN-MUSC-BONE,772.50,0.00,,,,,,,,,,,,,
14010013,0450,1104126,,,,,DEBRID; SKIN FULL THICK,128.75,0.00,,,,,,,,,,,,,
14010014,0450,1104226,,,,,DEBRID; SKIN & SUBQ TISS,386.25,0.00,,,,,,,,,,,,,
14010015,0450,1104326,,,,,DEBRID; SKIN-SUBQ TISS-MUSCL,695.25,0.00,,,,,,,,,,,,,
14010016,0450,1104426,,,,,DEBRID; SKIN-SUBQ TISS-MUSCL-BONE,978.50,0.00,,,,,,,,,,,,,
14010017,0450,1105526,,,,,PARING/CUTTING BEN LES; 1LES,77.25,0.00,,,,,,,,,,,,,
14010018,0450,1110026,,,,,BX SKIN/SUBQ TISS(SEP PRO); 1 LES,151.50,0.00,,,,,,,,,,,,,
14010019,0450,1110126,,,,,BX SKIN/SUBQ TIS (SEP PRO); EA ADD,51.50,0.00,,,,,,,,,,,,,
14010020,0450,1120126,,,,,REMOVE SKIN TAGS;EA ADD 10 LES,77.25,0.00,,,,,,,,,,,,,
14010021,0450,1130026,,,,,SHAVING 1 LES TRUNK; 0.5CM/LESS,103.00,0.00,,,,,,,,,,,,,
14010022,0450,1130126,,,,,SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM,128.75,0.00,,,,,,,,,,,,,
14010023,0450,1130226,,,,,SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM,149.25,0.00,,,,,,,,,,,,,
14010024,0450,1130326,,,,,SHAVING 1 LES TRUNK; OVER 2.0 CM,180.25,0.00,,,,,,,,,,,,,
14010025,0450,1130626,,,,,SHAVING 1 LES SCALP; 0.6 TO 1.0 CM,134.00,0.00,,,,,,,,,,,,,
14010026,0450,1130726,,,,,SHAVING 1 LES SCALP;1.1 TO 2.0 CM,159.75,0.00,,,,,,,,,,,,,
14010027,0450,1130826,,,,,SHAVING 1 LES SCALP; OVER 2.0 CM,180.25,0.00,,,,,,,,,,,,,
14010028,0450,1131026,,,,,SHAVING  1 LES FACE;0.5CM/LESS,128.75,0.00,,,,,,,,,,,,,
14010029,0450,1131126,,,,,SHAVING 1 LES FACE; 0.6 TO 1.0 CM,149.25,0.00,,,,,,,,,,,,,
14010030,0450,1131326,,,,,SHAVING 1 LES FACE; OVER 2.0 CM,216.25,0.00,,,,,,,,,,,,,
14010031,0450,1140026,,,,,EXC BEN LES TRUNK;0.5 CM/LESS,170.00,0.00,,,,,,,,,,,,,
14010032,0450,1140126,,,,,EXC BEN LES TRUNK; 0.6 TO 1.0 CM,206.00,0.00,,,,,,,,,,,,,
14010033,0981,11402,,,,,EXC TR-EXT B9+MARG 1.1-2 CM,368.00,368.00,,,,,,,,,,,,,
14010034,0450,1140326,,,,,EXC BEN LES TRUNK; 2.1 TO 3.0 CM,334.75,0.00,,,,,,,,,,,,,
14010035,0450,1140426,,,,,EXC BEN LES TRUNK; 3.1 TO 4.0 CM,437.75,0.00,,,,,,,,,,,,,
14010036,0450,1140626,,,,,EXC BEN LES TRUNK; OVER 4.0 CM,643.75,0.00,,,,,,,,,,,,,
14010037,0981,11420,,,,,EXC BEN LES SCALP; 0.5 CM/LESS,350.27,350.27,,,,,,,,,,,,,
14010038,0450,1142126,,,,,EXC BEN LES  SCALP 0.6 TO  1.0CM0,221.50,0.00,,,,,,,,,,,,,
14010039,0450,1142226,,,,,EXC BEN LES SCALP; 1.1 TO 2.0 CM,298.75,0.00,,,,,,,,,,,,,
14010040,0450,1142326,,,,,EXC BEN LES SCALP; 2.1 TO 3.0 CM,396.50,0.00,,,,,,,,,,,,,
14010041,0450,1142626,,,,,EXC BEN LES SCALP; OVER 4.0 CM,559.25,0.00,,,,,,,,,,,,,
14010042,0450,1144026,,,,,EXC BEN LES FACE; 0.5 CM/LESS,216.25,0.00,,,,,,,,,,,,,
14010043,0450,1144126,,,,,EXC BEN LES FACE; 0.6 TO 1.Q CM,309.00,0.00,,,,,,,,,,,,,
14010044,0450,1144226,,,,,EXC BEN LES FACE; 1.1 TO 2.0 CM,386.25,0.00,,,,,,,,,,,,,
14010045,0450,1144326,,,,,EXC BEN LES FACE; 2.1 TO 3.0 CM,453.25,0.00,,,,,,,,,,,,,
14010046,0450,1144426,,,,,EXC BEN FACE; 3.1 TO 4.0 CM,515.00,0.00,,,,,,,,,,,,,
14010047,0450,1144626,,,,,EXC BEN LES FACE; OVER 4.0 CM,618.00,0.00,,,,,,,,,,,,,
14010048,0450,1164026,,,,,EXC MALIG LES FACE; 0.5 CM/LESS,309.00,0.00,,,,,,,,,,,,,
14010049,0450,1171926,,,,,TRIM NONDYSTROPHIC NAILS-ANY NUMBER,36.00,0.00,,,,,,,,,,,,,
14010050,0450,1172026,,,,,DEBRID NAIL(S) ANY METHOD(S);1 TO 5,113.25,0.00,,,,,,,,,,,,,
14010051,0981,11730,,,,,AVULS OF NAIL PLATE PART OR COMPL SIMPLE,138.05,138.05,,,,,,,,,,,,,
14010052,0450,1173226,,,,,AVULSION PLATE PART/COMPLT SIMPL; EA,72.00,0.00,,,,,,,,,,,,,
14010053,0981,11740,,,,,EVACUATION SUBUNGUAL HEMATOMA,96.09,96.09,,,,,,,,,,,,,
14010054,0981,11750,,,,,EXC NAIL/MATRIX PART/COMPLT PERM,783.40,783.40,,,,,,,,,,,,,
14010055,0450,1175226,,,,,EXC NAIL/MATRIX PERM;AMPUT DISTAL,515.00,0.00,,,,,,,,,,,,,
14010056,0450,1175526,,,,,BX NAIL UNIT ANY METHD(SEP PRO),195.75,0.00,,,,,,,,,,,,,
14010057,0981,11760,,,,,REPR NAIL BED,515.31,515.31,,,,,,,,,,,,,
14010058,0450,1177226,,,,,EXC PILONIDAL CYST/SINUS;COMPLIC,2472.00,0.00,,,,,,,,,,,,,
14010059,0456,1200126,,,,,SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA,249.25,0.00,,,,,,,,,,,,,
14010060,0981,12002,,,,,SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,344.86,344.86,0.00,70.01,,,,,,,70.01,,,0.00,0.00
14010061,0981,12004,,,,,SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,435.01,435.01,87.54,87.54,,,,,,,87.54,,,,
14010062,0981,12005,,,,,SIMPL REPR SCLP/TRUNK; 12.6-20.0CM,813.55,813.55,114.64,114.64,,,,,,,114.64,,,,
14010063,0450,1200626,,,,,SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM,520.25,0.00,,,,,,,,,,,,,
14010064,0981,12011,,,,,SIMPL REPR FACE/MUCOUS; 2.5/LESS,281.24,281.24,0.00,66.35,,,,,,,66.35,,,0.00,0.00
14010065,0981,12013,,,,,SR FCE/EAR/EYE/INSE/LIP 2.6-5,344.86,344.86,70.53,70.53,,,,,,,70.53,,,,
14010066,0981,12014,,,,,SIMPL REPR FACE/MUCOUS 5.1-7.5CM,678.90,678.90,,,,,,,,,,,,,
14010067,0450,1202026,,,,,TX SUPERF WOUND DEHISCENCE;SIMPL,350.25,0.00,,,,,,,,,,,,,
14010068,0450,1202126,,,,,TX SUPERF WOUND DEHISCENCE; W/PACK,412.00,0.00,,,,,,,,,,,,,
14010069,0981,12031,,,,,LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,600.61,600.61,,,,,,,,,,,,,
14010070,0981,12032,,,,,LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,742.77,742.77,,,,,,,,,,,,,
14010071,0981,12034,,,,,LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,937.48,937.48,,,,,,,,,,,,,
14010072,0981,12035,,,,,LAYER CLO UNSPECIF,730.87,730.87,,,,,,,,,,,,,
14010073,0981,12041,,,,,INTMD WND REPAIR N-HF/GENIT,701.57,701.57,,,,,,,,,,,,,
14010074,0981,12042,,,,,LAYER CLO NECK/FT/GENIT; 2.6-7.5,751.02,751.02,,,,,,,,,,,,,
14010075,0981,12051,,,,,LAYER CLO FACE/LIPS; 2.5CM/LESS,785.01,785.01,0.00,0.00,,,,,,,,,,0.00,0.00
14010076,0450,1205226,,,,,LAYER CLO FACE/LIPS; 2.6 TO 5.0CM,489.25,0.00,,,,,,,,,,,,,
14010077,0450,1205326,,,,,LAYER CLO FACE/LIPS; 5.1 TO 7.5CM,535.50,0.00,,,,,,,,,,,,,
14010078,0981,12054,,,,,LAYER CLO FACE/LIPS; 7.6 TO 12.5CM,997.00,997.00,,,,,,,,,,,,,
14010079,0450,1312026,,,,,REPR COMPLX SCLP /EXTREM;1.1-2.5CM,437.75,0.00,,,,,,,,,,,,,
14010080,0981,13121,,,,,REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,1152.79,1152.79,,,,,,,,,,,,,
14010081,0981,13122,,,,,C REP S/A/L; EA ADD 5 CM/<,343.35,343.35,,,,,,,,,,,,,
14010082,0981,13131,,,,,REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,975.62,975.62,,,,,,,,,,,,,
14010083,0981,13132,,,,,REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,1430.95,1430.95,,,,,,,,,,,,,
14010084,0450,1313326,,,,,REPR CMPLX-FAC/HAND/FT; EA ADD 5CM,463.50,0.00,,,,,,,,,,,,,
14010085,0450,1315126,,,,,REPR COMPLX LIDS/LIPS; 1.1-2.5CM,803.50,0.00,,,,,,,,,,,,,
14010086,0450,1540026,,,,,APPLIC XENOGFT SKIN; 100 SQ CM/LESS,772.50,0.00,,,,,,,,,,,,,
14010087,0450,1593126,,,,,EXC SACRAL PRESS ULCER W/PRIM SUTUR,1699.50,0.00,,,,,,,,,,,,,
14010088,0450,1600026,,,,,INT TX 1ST DEGREE BURN W/LOCAL TX,61.75,0.00,,,,,,,,,,,,,
14010089,0981,16020,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES SM,261.88,261.88,,,,,,,,,,,,,
14010090,0450,1602526,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES MED,231.75,0.00,,,,,,,,,,,,,
14010091,0981,16030,,,,,DRS&/DBRDMT PRTL-THKNS BURNS 1,655.74,655.74,,,,,,,,,,,,,
14010092,0450,1700026,,,,,DESTRCT-ANY METHD-BEN LES; W/ANE;1,128.75,0.00,,,,,,,,,,,,,
14010093,0450,1700326,,,,,"DESTRCT-ANY METHD-BEN LES 2-14, EA",31.00,0.00,,,,,,,,,,,,,
14010094,0450,1711026,,,,,DESTRCT  WARTS/MOLLUSCUM TO 14 LES,128.75,0.00,,,,,,,,,,,,,
14010095,0450,1711126,,,,,DESTRCT WARTS/MOLLUSCUM;15/>LES,170.00,0.00,,,,,,,,,,,,,
14010096,0450,1900026,,,,,PUNCT ASPIRAT CYST BREAST,154.50,0.00,,,,,,,,,,,,,
14010097,0450,1900126,,,,,PUNCT ASPIR CYST BREAST; EA AD CYST,77.25,0.00,,,,,,,,,,,,,
14010098,0450,1910026,,,,,BX BREAST; NEEDLE CORE(SEP PROC),386.25,0.00,,,,,,,,,,,,,
14010099,0450,2010226,,,,,EXPLOR WOUND (SEP PRO);ABD/FLNK/BK,1236.00,0.00,,,,,,,,,,,,,
14010100,0981,20103,,,,,EXPLO PENTR WOUND (SEP PRO); EXTREM,3871.81,3871.81,,,,,,,,,,,,,
14010101,0450,2052026,,,,,REMOV FB MUSCL/TENDON; SIMPL,355.25,0.00,,,,,,,,,,,,,
14010102,0450,2055026,,,,,INJ TENDON SHEATH/LIG/TRIG PT/CYST,103.00,0.00,,,,,,,,,,,,,
14010103,0981,20552,,,,,INJ TRIGGER POINT 1/2 MUSCL,223.55,223.55,,,,,,,,,,,,,
14010104,0450,2055326,,,,,TRIGGER POINT INJ. THREE OR MORE MUSCLES,154.50,0.00,,,,,,,,,,,,,
14010105,0981,20605,,,,,ARTHROCENTESIS/ASPRI/INJ; INTERM JT,225.61,225.61,,,,,,,,,,,,,
14010106,0981,20610,,,,,ARTHROCENTESIS MAJOR JT/BURSA,287.43,287.43,52.91,52.91,,,,,,,52.91,,,,
14010107,0450,2061526,,,,,ASPIRAT & INJ TX BONE CYST,334.75,0.00,,,,,,,,,,,,,
14010108,0450,2150126,,,,,I&D DEEP ABSCESS SOFT TISS NECK,901.25,0.00,,,,,,,,,,,,,
14010109,0450,2155026,,,,,BX SOFT TISS NECK/THORAZ,437.75,0.00,,,,,,,,,,,,,
14010110,0450,2180026,,,,,CLO TX RIB FX UNCOMP EA,200.75,0.00,,,,,,,,,,,,,
14010111,0450,2182026,,,,,CLO TX STERNUM FX,453.25,0.00,,,,,,,,,,,,,
14010112,0450,2192026,,,,,BX SOFT TISS BACK/FLANK; SUPERF,412.00,0.00,,,,,,,,,,,,,
14010113,0450,2193026,,,,,EXC TUMOR SOFT TISS BACK/FLANK,1370.00,0.00,,,,,,,,,,,,,
14010114,0450,2350026,,,,,CLO TX CLAV FX; WO MANIP,453.25,0.00,,,,,,,,,,,,,
14010115,0450,2354026,,,,,CLO TX ACROMIOCLAV DISLOC; WO MINIP,515.00,0.00,,,,,,,,,,,,,
14010116,0450,2357026,,,,,CLO TX SCAPULAR FX; WO MANIP,540.75,0.00,,,,,,,,,,,,,
14010117,0450,2360026,,,,,CLO TX PROX HUMERAL FX; WO MANIP,690.00,0.00,,,,,,,,,,,,,
14010118,0981,23650,,,,,CLO TX SHLDR DISLOC W/MANIP;WO ANES,583.61,583.61,,,,,,,,,,,,,
14010119,0450,2406526,,,,,BX SOFT TISS UP ARM/ELBOW; SUPERF,231.75,0.00,,,,,,,,,,,,,
14010120,0450,2407526,,,,,EXC TUMOR UPPER ARM/ELBOW; SUBSQ,679.75,0.00,,,,,,,,,,,,,
14010121,0450,2450026,,,,,CLO TX HUMERAL SHAFT FX; WO MANIP,762.25,0.00,,,,,,,,,,,,,
14010122,0450,2453026,,,,,CLO TX SUPRACONDYL HUMER FX; W/O MAN,762.25,0.00,,,,,,,,,,,,,
14010123,0450,2457626,,,,,CLO TX HUMERAL CONDYL FX; WO MANIP,618.00,0.00,,,,,,,,,,,,,
14010124,0450,2460026,,,,,TX CLO ELBOW DISLOC; WO ANES,679.75,0.00,,,,,,,,,,,,,
14010125,0981,2460526,,,,,TX CLOSED ELBOW DISLOC WITH ANESTHESIA,1184.50,0.00,,,,,,,,,,,,,
14010126,0981,24640,,,,,CL TX  NURSEMAID ELBOW  W MANIP,503.70,503.70,,,,,,,,,,,,,
14010127,0450,2465026,,,,,CLO TX RADIAL HEAD/NECK FX; WO MANIP,576.75,0.00,,,,,,,,,,,,,
14010128,0450,2467026,,,,,CLO RX ULNAR FX PROX END; WO MANIP,721.00,0.00,,,,,,,,,,,,,
14010129,0450,2507526,,,,,EXC TUMOR FOREARM/WRIST AREA; SUBQ,1143.25,0.00,,,,,,,,,,,,,
14010130,0450,2550026,,,,,CLO TX RADIAL SHAFT FX; WO MANIP,592.25,0.00,,,,,,,,,,,,,
14010131,0450,2550526,,,,,CLO TX RADIAL SHAFT FX; W/MANIP,1143.25,0.00,,,,,,,,,,,,,
14010132,0450,2553026,,,,,CLO TX ULNAR SHAFT FX WO MANIP,592.25,0.00,,,,,,,,,,,,,
14010133,0450,2556026,,,,,CLO TX RAD & ULNA SHAFT FX; WO MANIP,643.75,0.00,,,,,,,,,,,,,
14010134,0981,25565,,,,,CL TX RADIAL & ULNA FX W MANIP,4541.95,4541.95,,,,,,,,,,,,,
14010135,0450,2560026,,,,,CLO TX DIST RAD FX; WO MANIP,717.00,0.00,,,,,,,,,,,,,
14010136,0981,25605,,,,,CLOSED TREATMENT DISRAL RADIAL FRACTURE,2029.54,2029.54,,,,,,,,,,,,,
14010137,0450,2562226,,,,,CLO TX CARPAL SCAPHOID FX; WO MANIP,721.00,0.00,,,,,,,,,,,,,
14010138,0450,2563026,,,,,CLO TX CARPAL BONE FX; WO MANIP EA,643.75,0.00,,,,,,,,,,,,,
14010139,0450,26010,,,,,DRAINAGE FINGER ABSCESS; SIMPL,239.37,239.37,,,,,,,,,,,,,
14010140,0450,2601126,,,,,DRAINAGE FINGER ABSCESS; COMPLIC,731.25,0.00,,,,,,,,,,,,,
14010141,0450,2641026,,,,,"REPAIR, EXTENSOR TENDON, HAND",1771.50,0.00,,,,,,,,,,,,,
14010142,0981,26418,,,,,ER REPAIR EXT. TENDON FINGER PRI/SEC,2783.50,2783.50,,,,,,,,,,,,,
14010143,0450,2643326,,,,,REPAIR OF EXTENSOR TENDON DISTAL INSERT.,1545.00,0.00,,,,,,,,,,,,,
14010144,0450,2660026,,,,,CLO TX METACARP FX 1; WO MANIP,489.25,0.00,,,,,,,,,,,,,
14010145,0450,2660526,,,,,CLO TX METACARP FX 1; W/MANIP EA,633.50,0.00,,,,,,,,,,,,,
14010146,0450,2664126,,,,,CLO TX CARPOMETA DISLOC THUMB W/MAN,659.25,0.00,,,,,,,,,,,,,
14010147,0450,2664526,,,,,CLO TX CARPOMETACAR FX THUMB W/MAN,906.50,0.00,,,,,,,,,,,,,
14010148,0450,2670026,,,,,CLO TX MCP DISLOC-1W/MANIP-WO ANES,489.25,0.00,,,,,,,,,,,,,
14010149,0450,2672026,,,,,CLO TX PHALANGEAL FX; WO MANIP EA,365.75,0.00,,,,,,,,,,,,,
14010150,0450,2672526,,,,,CLO TX PHALANGEAL FX; W/WO TRACT,633.50,0.00,,,,,,,,,,,,,
14010151,0450,2676526,,,,,OPEN REDUCTION DISSTAL PHALANGEAL FX,1225.75,0.00,,,,,,,,,,,,,
14010152,0981,26770,,,,,CLO TX IP JT DISLOC W/WMANIP; WO ANES,1012.66,1012.66,,,,,,,,,,,,,
14010153,0450,2750026,,,,,CLO TX FEMORAL SHAFT FX WO MANIP,1261.75,0.00,,,,,,,,,,,,,
14010154,0450,2753026,,,,,CLO TX TIBIAL FX PROX;WO MANIP,829.25,0.00,,,,,,,,,,,,,
14010155,0981,27560,,,,,CLO TX PATELLAR DISLOC; WO ANES,1365.35,1365.35,,,,,,,,,,,,,
14010156,0450,2760326,,,,,I&D LEG/ANK; DEEP ABSCESS/HEMATOMA,1004.25,0.00,,,,,,,,,,,,,
14010157,0450,2775026,,,,,CLO TX TIBIAL SHAFT FX; WO MANIP,767.25,0.00,,,,,,,,,,,,,
14010158,0450,2775226,,,,,CLO TX TIB FX; W/MANIP W/WO TRACT,1493.50,0.00,,,,,,,,,,,,,
14010159,0450,2776026,,,,,CLO TX MEDIAL MALLEOLUS FX; WO MANI,721.00,0.00,,,,,,,,,,,,,
14010160,0450,2776226,,,,,CLO TX MED MALLEOLUS FX; W/MANIP,556.25,0.00,,,,,,,,,,,,,
14010161,0450,2778626,,,,,CLO TX DISTAL FIBULAR FX; WO MANIP,643.75,0.00,,,,,,,,,,,,,
14010162,0450,2778826,,,,,CLO  TX DISTAL FIBULAR FX; W/MANIP,1133.00,0.00,,,,,,,,,,,,,
14010163,0981,27818,,,,,CLO TX TRIMALLEOLAR ANK FX; W/MANIP,2146.76,2146.76,,,,,,,,,,,,,
14010164,0450,2782526,,,,,CLO TX FX DIST TIB; W/TRACT/ANES,1606.75,0.00,,,,,,,,,,,,,
14010165,0450,2784026,,,,,CLO TX ANK DISLOC; WO ANES,767.25,0.00,,,,,,,,,,,,,
14010166,0450,2819026,,,,,REMOV FB FT; SUBQ,772.50,0.00,,,,,,,,,,,,,
14010167,0450,2840026,,,,,CLO TX CALCAN FX; WO MANIP,633.50,0.00,,,,,,,,,,,,,
14010168,0450,2845026,,,,,TX TARSAL BONE FX; WO MANIP EA,515.00,0.00,,,,,,,,,,,,,
14010169,0450,2847026,,,,,CLO TX METATARSAL FX; WO MANIP EA.,473.75,0.00,,,,,,,,,,,,,
14010170,0450,2847526,,,,,CLO TX METATARSAL FX; W/MANIP EA,654.00,0.00,,,,,,,,,,,,,
14010171,0450,2849026,,,,,CLO TX FX GRT TOE PHALANX; WO MANIP,267.75,0.00,,,,,,,,,,,,,
14010172,0450,2851026,,,,,CLO TX FX PHALNX NOT GR TOE; WO/MAN,257.50,0.00,,,,,,,,,,,,,
14010173,0450,2851526,,,,,CLO TX FX PHALNX NOT GR TOE; W/MANI,329.50,0.00,,,,,,,,,,,,,
14010174,0450,2860026,,,,,CLO TX TARSOMETAT JT DISLOC; WO ANES,437.75,0.00,,,,,,,,,,,,,
14010175,0981,29065,,,,,APPLY LONG ARM CAST,579.23,579.23,,,,,,,,,,,,,
14010176,0981,29075,,,,,APPLIC; ELBOW TO FINGER,362.19,362.19,,,,,,,,,,,,,
14010177,0450,2908526,,,,,APPLIC; HAND & LOWER FOREARM,154.50,0.00,,,,,,,,,,,,,
14010178,0981,29105,,,,,APPLIC; LONG ARM SPLINT,388.59,388.59,,,,,,,,,,,,,
14010179,0981,29125,,,,,APPLIC; SHORT ARM SPLINT; STATOC,244.72,244.72,44.55,44.55,,,,,,,44.55,,,,
14010180,0981,29130,,,,,APPLY FINGER SPLINT; STATIC,147.01,147.01,,,,,,,,,,,,,
14010181,0981,29240,,,,,STRAPPING; SHOULDER,113.54,113.54,,,,,,,,,,,,,
14010182,0981,29345,,,,,APPLIC LONG LEG CAST,543.81,543.81,,,,,,,,,,,,,
14010183,0981,29405,,,,,APPLIC SHORT LEG CAST,360.08,360.08,,,,,,,,,,,,,
14010184,0450,2942526,,,,,APPLIC SHORT LEG CAST; WALKING/AMB,267.75,0.00,,,,,,,,,,,,,
14010185,0450,2944526,,,,,APPLIC RIGID TOT CONTACT LEG CAST,484.00,0.00,,,,,,,,,,,,,
14010186,0981,29505,,,,,APPLIC LONG LEG SPLINT,352.33,352.33,56.80,56.80,,,,,,,56.80,,,,
14010187,0981,29515,,,,,APPLIC SHORT LEG SPLINT,299.89,299.89,,,,,,,,,,,,,
14010188,0450,2958026,,,,,STRAPPING; UNNA BOOT,103.00,0.00,,,,,,,,,,,,,
14010189,0981,29705,,,,,REMOV/BIVALV; FULL ARM/LEG CAST,312.56,312.56,,,,,,,,,,,,,
14010190,0450,2973026,,,,,WINDOWING CAST,73.25,0.00,,,,,,,,,,,,,
14010191,0450,2974026,,,,,WEDGING CAST,128.75,0.00,,,,,,,,,,,,,
14010192,0450,3030026,,,,,REMOV FB INTRANASAL; RIGHT,149.25,0.00,,,,,,,,,,,,,
14010193,0981,30901,,,,,CONTRL NASAL HEMORR-ANT-SIMPL,379.11,379.11,0.00,66.48,,,,,,,66.48,,,0.00,0.00
14010194,0981,30905,,,,,CNTRL POST EPISTAX INIT,527.72,527.72,,,,,,,,,,,,,
14010195,0981,31500,,,,,INTUBATION ENDOTRACHEAL EMER PROC,710.65,710.65,,,,,,,,,,,,,
14010196,0450,3150226,,,,,TRACHEOT TUBE CHANGE BEFOR FISTULA,314.25,0.00,,,,,,,,,,,,,
14010197,0450,3150526,,,,,LARYNGOSCOPY INDIREC; DX (SEP PROC),237.00,0.00,,,,,,,,,,,,,
14010198,0450,3151026,,,,,LARYNGOSCOPY INDIRECT; W/BX,654.00,0.00,,,,,,,,,,,,,
14010199,0450,3157526,,,,,LARYNGOSCOPY  FLEX FIBEROPTIC; DX,319.25,0.00,,,,,,,,,,,,,
14010200,0450,3160326,,,,,TRACHEOSTOMY EMER PROC; TRANSTRACH,1076.25,0.00,,,,,,,,,,,,,
14010201,0450,3160526,,,,,TRACH EMER PROC; CRICOTHYROID MEMBR,947.50,0.00,,,,,,,,,,,,,
14010202,0450,3242126,,,,,THORACENTESIS,772.50,0.00,,,,,,,,,,,,,
14010203,0450,3321026,,,,,INSRT/REPLC TEMP 1 ELECT (SEP PROC),772.50,0.00,,,,,,,,,,,,,
14010204,0450,3522626,,,,,REPAIR BLOOD VESSEL LOWER EXTREMITY,2662.50,0.00,,,,,,,,,,,,,
14010205,0450,3641026,,,,,VENIPUNCT> 3YR W/MD SKILL (SEP PRO),77.25,0.00,,,,,,,,,,,,,
14010206,0450,3642526,,,,,VENIPUNCT CUTDOWN; AGE 1/OVER,164.75,0.00,,,,,,,,,,,,,
14010207,0450,3655626,,,,,INS CENTRAL VENOUS ACCESS >5,378.00,0.00,,,,,,,,,,,,,
14010208,0450,3660026,,,,,ART PUNCT WITHDRAWAL BLD DX;,113.25,0.00,,,,,,,,,,,,,
14010209,0981,36620,,,,,ART CATH-SAMPL (SEP PRO); PERG,327.34,327.34,,,,,,,,,,,,,
14010210,0450,3830026,,,,,DRAINAGE LYMPH NODE ABSCESS;SIMPL,298.75,0.00,,,,,,,,,,,,,
14010211,0450,3850526,,,,,BX/EXC LYMPH NODE; BY NEEDLE SUPERF,473.75,0.00,,,,,,,,,,,,,
14010212,0450,4049026,,,,,BX LIP,185.50,0.00,,,,,,,,,,,,,
14010213,0450,4080826,,,,,BX VESTIBULE MOUTH,267.75,0.00,,,,,,,,,,,,,
14010214,0450,4375226,,,,,NG TUBE PLACEMENT W/FLUORO,180.25,0.00,,,,,,,,,,,,,
14010215,0450,4500526,,,,,I&D SUBMUCOSAL ABSCESS RECTUM,489.25,0.00,,,,,,,,,,,,,
14010216,0450,4530026,,,,,PROCTOSIG RIGID W/W/O COLLECT,257.50,0.00,,,,,,,,,,,,,
14010217,0450,4530326,,,,,PROCSIGMOSCOPY RIGID; W/DILAT,283.25,0.00,,,,,,,,,,,,,
14010218,0450,4530526,,,,,PROCSIGMOSCOPY RIGID; W/BX 1/MX,334.75,0.00,,,,,,,,,,,,,
14010219,0450,4533026,,,,,EMER RM SIGMOIDOSCOP,437.75,0.00,,,,,,,,,,,,,
14010220,0450,4604026,,,,,I&D RECTAL ABCESS,1287.50,0.00,,,,,,,,,,,,,
14010221,0450,4605026,,,,,I&D PERIANAL ABSCESS SUPERF,391.50,0.00,,,,,,,,,,,,,
14010222,0450,4606026,,,,,INCISION & DRAIN OF A PERIRECTAL ABSCESS,2034.25,0.00,,,,,,,,,,,,,
14010223,0981,46083,,,,,INCS THROMBOSED HEMORRHOID EXT,762.39,762.39,,,,,,,,,,,,,
14010224,0450,4622126,,,,,HEMORRHOIDECTOMY BY SIMPL LIG,231.75,0.00,,,,,,,,,,,,,
14010225,0450,4632026,,,,,ENUCLEATION EXT THROBOTIC HEMORRHO,293.50,0.00,,,,,,,,,,,,,
14010226,0450,4693526,,,,,DESTRCT HEMORRHOIDS ANY METHOD:EXT,525.25,0.00,,,,,,,,,,,,,
14010227,0450,4908026,,,,,PERITONEOCENTESIS;INIT,772.50,0.00,,,,,,,,,,,,,
14010228,0450,5170026,,,,,BLADDER IRRIGA SIMPL LAVAGE,164.75,0.00,,,,,,,,,,,,,
14010229,0450,5170126,,,,,CATH URETHRA; SIMPLE,92.75,0.00,,,,,,,,,,,,,
14010230,0981,51702,,,,,INSERTION TEMPORARY INDWELLING BLADDER,267.85,267.85,29.77,29.77,,,,,,,29.77,,,,
14010231,0981,51705,,,,,CYSTOSTOMY TUBE CHANGE,350.27,350.27,,,,,,,,,,,,,
14010232,0450,5360026,,,,,DILAT URETHRAL STRICT-MALE; INIT,207.00,0.00,,,,,,,,,,,,,
14010233,0450,5362026,,,,,DILAT URETHRAL FILLIFORM-MALE; INIT,267.75,0.00,,,,,,,,,,,,,
14010234,0450,5470026,,,,,INCISION & DRAINAGE OF EPIDIDYMIS,463.50,0.00,,,,,,,,,,,,,
14010235,0450,5510026,,,,,DRAINAGE SCROTAL WALL ABSCESS,237.00,0.00,,,,,,,,,,,,,
14010236,0981,56405,,,,,I&D ABSCESS; PERINEUM,442.44,442.44,,,,,,,,,,,,,
14010237,0450,6010026,,,,,BX THYROID PERCUT CORE NEEDLE,314.25,0.00,,,,,,,,,,,,,
14010238,0981,62270,,,,,SPINAL PUNCT LUMBAR DX,562.49,562.49,,,,,,,,,,,,,
14010239,0981,64450,,,,,INJ ANES AGENT; OTHER PERIPHERAL,277.71,277.71,,,,,,,,,,,,,
14010240,0981,65205,,,,,REMOV FB EXT EYE; CONJUNC SUPERF,167.44,167.44,,,,,,,,,,,,,
14010241,0450,6521026,,,,,REMOV FB EXT EYE; CONJUNC EMBEDDED,164.75,0.00,,,,,,,,,,,,,
14010242,0981,65220,,,,,REMOV FB EXT EYE;CORNEAL WO LAMP,167.14,167.14,,,,,,,,,,,,,
14010243,0450,6781026,,,,,BX EYELID,283.25,0.00,,,,,,,,,,,,,
14010244,0450,6910026,,,,,BX EXT EAR,293.50,0.00,,,,,,,,,,,,,
14010245,0450,6911026,,,,,EXC EXT EAR; PART SIMPL REPR,1179.25,0.00,,,,,,,,,,,,,
14010246,0981,69200,,,,,REM FB EXT AUDITORY CANAL; WO ANESTH,334.73,334.73,,,,,,,,,,,,,
14010247,0450,6921026,,,,,REMOV IMPACTED CERUMEN (SEP PRO),77.25,0.00,,,,,,,,,,,,,
14010248,0450,4375326,,,,,GASTRIC INTUB & ASPIR/LAVAGE-TX,425.50,0.00,,,,,,,,,,,,,
14010249,0480,9296026,,,,,"CARDIOVERSION ELECTIVE, EXTERN",370.75,0.00,,,,,,,,,,,,,
14010250,0981,5642026,,,,,I&D ABSCESS BARHOLINS GLAND,274.56,0.00,,,,,,,,,,,,,
14010251,0981,2781026,,,,,CLO TX BIMALLEOLAR ANK FX; W/MANIP,1271.04,0.00,,,,,,,,,,,,,
14010252,0981,67938,,,,,REMOVE EMBEDDED FB EYLID,887.00,887.00,,,,,,,,,,,,,
14010255,0456,1201126,,,,,SIMPL REPR FACE;2.5/LESS,273.00,0.00,,,,,,,,,,,,,
14010256,0981,12015,,,,,SIMPL REPR FACE/MUCOUS 7.60-12.50 cm,854.04,854.04,113.85,113.85,,,,,,,113.85,,,,
14010260,0981,12052,,,,,INTMD WND REPAIR FACE/MM 2.6-5.0 CM,837.55,837.55,,,,,,,,,,,,,
14010261,0450,1016026,,,,,PUNCTASPIR ABSCES/HEMAT/BULL/CYST,154.50,0.00,,,,,,,,,,,,,
14010262,0981,12001,,,,,SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,256.78,256.78,52.23,52.23,,,,,,,52.23,,,,
14010263,0450,4083126,,,,,CLOLACERATIONMOUTH;OVER 2.5CM/COMPLEX,643.75,0.00,,,,,,,,,,,,,
14010265,0450,4231026,,,,,DRNG ABCESS SUBMAXIL SUBLING ORAL,310.00,0.00,,,,,,,,,,,,,
14010266,0450,4376026,,,,,CHANGEASTROSTOMYTUBEPERCUTNDIMAGIN,250.00,0.00,,,,,,,,,,,,,
14010267,0981,17250,,,,,CHEMICAL CAUTERIZATION PRO FEE,146.00,146.00,,,,,,,,,,,,,
14010270,0450,97597,,,,,RMVL DEVITAL TIS 20CM<,307.75,0.00,,,,,,,,,,,,,
14010271,0450,97598,,,,,RMVL DEVITAL TIS ADDL 20CM,273.00,0.00,,,,,,,,,,,,,
14010300,0450,5170326,,,,,INSERT TEMP BLADDER CATH/COMPLCAT,180.25,0.00,,,,,,,,,,,,,
14010301,0451,5170326,,,,,INSERT TEMP BLADDER CATH/COMPLCATED,180.25,0.00,,,,,,,,,,,,,
14010302,0456,5170326,,,,,INSERT TEMP BLADDER CATH/COMPLCATED,180.25,0.00,,,,,,,,,,,,,
14010303,0450,2819226,,,,,REMOV FB FT; SUBQ,669.50,0.00,,,,,,,,,,,,,
14010304,0981,26755,,,,,CL TX D PHAL FX FGRR/THMB; W MANIP,1149.94,1149.94,,,,,,,,,,,,,
14010305,0981,11000,,,,,DEBR EXZ INF SKIN 10% BS,158.65,158.65,,,,,,,,,,,,,
14010306,0981,28495,,,,,CL TX FX GT PHALANX(S); W MANIP,651.52,651.52,,,,,,,,,,,,,
14010307,0450,26418,,,,,ER REPAIR EXT. TENDON FINGER PRI/SEC,8368.02,8368.02,,,,,,,,,,,,,
14010308,0981,26412,,,,,REP ET HAND; W FG EA TENDON,2894.37,2894.37,,,,,,,,,,,,,
14010311,0981,29435,,,,,APPY PATELLAR TENDON BEARING CAST,442.05,442.05,,,,,,,,,,,,,
14010312,0981,30906,,,,,CTRL POST EPISTAX SQ,765.05,765.05,,,,,,,,,,,,,
14015100,0260,96365,,,,,INFUSION THERAPY EXCEPT CHEMO 1ST HOUR,134.25,0.00,198.11,241.70,,,,,,,198.11,,,241.70,241.70
14016639,0450,4180026,,,,,DRAIN ABSCESS DENTOALVEOLAR STRUCT,288.50,0.00,,,,,,,,,,,,,
14016640,0981,64402,,,,,INJ ANESTHETIC AGENT FACIAL NERVE,374.99,374.99,,,,,,,,,,,,,
14016641,0981,27265,,,,,CL TX POST HIIP DISLOC WO ANESTH,926.55,926.55,,,,,,,,,,,,,
14016642,0981,29131,,,,,APPLICATION OF FINGER SPLING: DYNAMIC,266.74,266.74,,,,,,,,,,,,,
14016643,0981,29280,,,,,STRAPPING HAND/FINGER,131.48,131.48,,,,,,,,,,,,,
14016644,0981,23655,,,,,CL TX SHLDR DISL W MANIP W ANESTH,1119.30,1119.30,,,,,,,,,,,,,
14020001,0451,1002226,,,,,FINE NEEDLE ASPIRATION W/GUIDANCE,280.25,0.00,,,,,,,,,,,,,
14020002,0451,1006026,,,,,I&D ABCESS; SIMPL/SNGL,226.50,0.00,,,,,,,,,,,,,
14020003,0451,1006126,,,,,I&D ABSCESS:COMPLIC/MX,741.50,0.00,,,,,,,,,,,,,
14020004,0451,1008026,,,,,I & D PILONIDAL CYST: SIMPL,257.50,0.00,,,,,,,,,,,,,
14020005,0451,1008126,,,,,I&D PILONIDAL CYST; COMPLIC,772.50,0.00,,,,,,,,,,,,,
14020006,0451,1012026,,,,,INCS & REMOV FB SUBQ TISS; SIMPL,283.25,0.00,,,,,,,,,,,,,
14020007,0451,1012126,,,,,INCS & REMOV SUBQ TISS; COMPLIC,695.25,0.00,,,,,,,,,,,,,
14020008,0451,1014026,,,,,I&D HEMATOMA/SEROMA/FLUID COLLEC,257.50,0.00,,,,,,,,,,,,,
14020009,0451,1016026,,,,,PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,154.50,0.00,,,,,,,,,,,,,
14020010,0451,1101026,,,,,DEBRID W/REMOV MAT;SKIN & SUBQ,566.50,0.00,,,,,,,,,,,,,
14020011,0451,1101126,,,,,DEBRID W/REMOV MAT;SKIN-SBQ-MUSC,669.50,0.00,,,,,,,,,,,,,
14020012,0451,1101226,,,,,DEBRID W/REM MAT;SKIN-MUSC-BONE,772.50,0.00,,,,,,,,,,,,,
14020013,0451,1104126,,,,,DEBRID; SKIN FULL THICK,128.75,0.00,,,,,,,,,,,,,
14020014,0451,1104226,,,,,DEBRID; SKIN & SUBQ TISS,386.25,0.00,,,,,,,,,,,,,
14020015,0451,1104326,,,,,DEBRID; SKIN-SUBQ TISS-MUSCL,695.25,0.00,,,,,,,,,,,,,
14020016,0451,1104426,,,,,DEBRID; SKIN-SUBQ TISS-MUSCL-BONE,978.50,0.00,,,,,,,,,,,,,
14020017,0451,1105526,,,,,PARING/CUTTING BEN LES; 1LES,77.25,0.00,,,,,,,,,,,,,
14020018,0451,1110026,,,,,BX SKIN/SUBQ TISS(SEP PRO); 1 LES,151.50,0.00,,,,,,,,,,,,,
14020019,0451,1110126,,,,,BX SKIN/SUBQ TIS (SEP PRO); EA ADD,51.50,0.00,,,,,,,,,,,,,
14020020,0451,1120126,,,,,REMOVE SKIN TAGS;EA ADD 10 LES,77.25,0.00,,,,,,,,,,,,,
14020021,0451,1130026,,,,,SHAVING 1 LES TRUNK; 0.5CM/LESS,103.00,0.00,,,,,,,,,,,,,
14020022,0451,1130126,,,,,SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM,128.75,0.00,,,,,,,,,,,,,
14020023,0451,1130226,,,,,SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM,149.25,0.00,,,,,,,,,,,,,
14020024,0451,1130326,,,,,SHAVING 1 LES TRUNK; OVER 2.0 CM,180.25,0.00,,,,,,,,,,,,,
14020025,0451,1130626,,,,,SHAVING 1 LES SCALP; 0.6 TO 1.0 CM,134.00,0.00,,,,,,,,,,,,,
14020026,0451,1130726,,,,,SHAVING 1 LES SCALP;1.1 TO 2.0 CM,159.75,0.00,,,,,,,,,,,,,
14020027,0451,1130826,,,,,SHAVING 1 LES SCALP; OVER 2.0 CM,180.25,0.00,,,,,,,,,,,,,
14020028,0451,1131026,,,,,SHAVING  1 LES FACE;0.5CM/LESS,128.75,0.00,,,,,,,,,,,,,
14020029,0451,1131126,,,,,SHAVING 1 LES FACE; 0.6 TO 1.0 CM,149.25,0.00,,,,,,,,,,,,,
14020030,0451,1131326,,,,,SHAVING 1 LES FACE; OVER 2.0 CM,216.25,0.00,,,,,,,,,,,,,
14020031,0451,1140026,,,,,EXC BEN LES TRUNK;0.5 CM/LESS,170.00,0.00,,,,,,,,,,,,,
14020032,0451,1140126,,,,,EXC BEN LES TRUNK; 0.6 TO 1.0 CM,206.00,0.00,,,,,,,,,,,,,
14020033,0451,1140226,,,,,EXC BEN LES TRUNK; 1.1 TO 2.0 CM,262.75,0.00,,,,,,,,,,,,,
14020034,0451,1140326,,,,,EXC BEN LES TRUNK; 2.1 TO 3.0 CM,334.75,0.00,,,,,,,,,,,,,
14020035,0451,1140426,,,,,EXC BEN LES TRUNK; 3.1 TO 4.0 CM,437.75,0.00,,,,,,,,,,,,,
14020036,0451,1140626,,,,,EXC BEN LES TRUNK; OVER 4.0 CM,643.75,0.00,,,,,,,,,,,,,
14020037,0451,1142026,,,,,EXC BEN LES SCALP; 0.5 CM/LESS,190.50,0.00,,,,,,,,,,,,,
14020038,0451,1142126,,,,,EXC BEN LES  SCALP 0.6 TO  1.0CM0,221.50,0.00,,,,,,,,,,,,,
14020039,0451,1142226,,,,,EXC BEN LES SCALP; 1.1 TO 2.0 CM,298.75,0.00,,,,,,,,,,,,,
14020040,0451,1142326,,,,,EXC BEN LES SCALP; 2.1 TO 3.0 CM,396.50,0.00,,,,,,,,,,,,,
14020041,0451,1142626,,,,,EXC BEN LES SCALP; OVER 4.0 CM,559.25,0.00,,,,,,,,,,,,,
14020042,0451,1144026,,,,,EXC BEN LES FACE; 0.5 CM/LESS,216.25,0.00,,,,,,,,,,,,,
14020043,0451,1144126,,,,,EXC BEN LES FACE; 0.6 TO 1.Q CM,309.00,0.00,,,,,,,,,,,,,
14020044,0451,1144226,,,,,EXC BEN LES FACE; 1.1 TO 2.0 CM,386.25,0.00,,,,,,,,,,,,,
14020045,0451,1144326,,,,,EXC BEN LES FACE; 2.1 TO 3.0 CM,453.25,0.00,,,,,,,,,,,,,
14020046,0451,1144426,,,,,EXC BEN FACE; 3.1 TO 4.0 CM,515.00,0.00,,,,,,,,,,,,,
14020047,0451,1144626,,,,,EXC BEN LES FACE; OVER 4.0 CM,618.00,0.00,,,,,,,,,,,,,
14020048,0451,1164026,,,,,EXC MALIG LES FACE; 0.5 CM/LESS,309.00,0.00,,,,,,,,,,,,,
14020049,0451,1171926,,,,,TRIM NONDYSTROPHIC NAILS-ANY NUMBER,36.00,0.00,,,,,,,,,,,,,
14020050,0451,1172026,,,,,DEBRID NAIL(S) ANY METHOD(S);1 TO 5,113.25,0.00,,,,,,,,,,,,,
14020051,0451,1173026,,,,,AVULS OF NAIL PLATE PART OR COMPL SIMPLE,283.25,0.00,,,,,,,,,,,,,
14020052,0451,1173226,,,,,AVULSION PLATE PART/COMPLT SIMPL; EA,72.00,0.00,,,,,,,,,,,,,
14020053,0451,1174026,,,,,EVACUATION SUBUNGUAL HEMATOMA,87.50,0.00,,,,,,,,,,,,,
14020054,0451,1175026,,,,,EXC NAIL/MATRIX PART/COMPLT PERM,463.50,0.00,,,,,,,,,,,,,
14020055,0451,1175226,,,,,EXC NAIL/MATRIX PERM;AMPUT DISTAL,515.00,0.00,,,,,,,,,,,,,
14020056,0451,1175526,,,,,BX NAIL UNIT ANY METHD(SEP PRO),195.75,0.00,,,,,,,,,,,,,
14020057,0451,1176026,,,,,REPR NAIL BED,360.50,0.00,,,,,,,,,,,,,
14020058,0451,1177226,,,,,EXC PILONIDAL CYST/SINUS;COMPLIC,2472.00,0.00,,,,,,,,,,,,,
14020059,0451,1200126,,,,,SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS IDPA,249.25,0.00,,,,,,,,,,,,,
14020060,0451,1200226,,,,,SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,334.75,0.00,,,,,,,,,,,,,
14020061,0451,1200426,,,,,SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,422.25,0.00,,,,,,,,,,,,,
14020062,0451,1200526,,,,,SIMPL REPR SCLP/TRUNK; 12.6-20.0CM,499.50,0.00,,,,,,,,,,,,,
14020063,0451,1200626,,,,,SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM,520.25,0.00,,,,,,,,,,,,,
14020064,0451,1201126,,,,,SIMPL REPR FACE/MUCOUS; 2.5/LESS,273.00,0.00,,,,,,,,,,,,,
14020065,0451,1201326,,,,,SR FCE/EAR/EYE/INSE/LIP 2.6-5,334.75,0.00,,,,,,,,,,,,,
14020066,0451,1201426,,,,,SIMPL REPR FACE/MUCOUS 5.1-7.5CM,360.50,0.00,,,,,,,,,,,,,
14020067,0451,1202026,,,,,TX SUPERF WOUND DEHISCENCE;SIMPL,350.25,0.00,,,,,,,,,,,,,
14020068,0451,1202126,,,,,TX SUPERF WOUND DEHISCENCE; W/PACK,412.00,0.00,,,,,,,,,,,,,
14020069,0451,1203126,,,,,LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,288.50,0.00,,,,,,,,,,,,,
14020070,0451,1203226,,,,,LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,473.75,0.00,,,,,,,,,,,,,
14020071,0451,1203426,,,,,LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,499.50,0.00,,,,,,,,,,,,,
14020072,0451,1203526,,,,,LAYER CLO UNSPECIF,566.50,0.00,,,,,,,,,,,,,
14020073,0451,1204126,,,,,INTMD WND REPAIR N-HF/GENIT,334.75,0.00,,,,,,,,,,,,,
14020074,0451,1204226,,,,,LAYER CLO NECK/FT/GENIT; 2.6-7.5,437.75,0.00,,,,,,,,,,,,,
14020075,0451,1205126,,,,,LAYER CLO FACE/LIPS; 2.5CM/LESS,437.75,0.00,,,,,,,,,,,,,
14020076,0451,1205226,,,,,LAYER CLO FACE/LIPS; 2.6 TO 5.0CM,489.25,0.00,,,,,,,,,,,,,
14020077,0451,1205326,,,,,LAYER CLO FACE/LIPS; 5.1 TO 7.5CM,535.50,0.00,,,,,,,,,,,,,
14020078,0451,1205426,,,,,LAYER CLO FACE/LIPS; 7.6 TO 12.5CM,721.00,0.00,,,,,,,,,,,,,
14020079,0451,1312026,,,,,REPR COMPLX SCLP /EXTREM;1.1-2.5CM,437.75,0.00,,,,,,,,,,,,,
14020080,0451,1312126,,,,,REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,690.00,0.00,,,,,,,,,,,,,
14020081,0451,1312226,,,,,REBR CMPLX-SCLP/ARM/LEG; EA AD 5CM,185.50,0.00,,,,,,,,,,,,,
14020082,0451,1313126,,,,,REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,566.50,0.00,,,,,,,,,,,,,
14020083,0451,1313226,,,,,REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,901.25,0.00,,,,,,,,,,,,,
14020084,0450,13133,,,,,REPR CMPLX-FAC/HAND/FT; EA ADD 5CM,463.50,0.00,,,,,,,,,,,,,
14020085,0451,1315126,,,,,REPR COMPLX LIDS/LIPS; 1.1-2.5CM,803.50,0.00,,,,,,,,,,,,,
14020086,0451,1540026,,,,,APPLIC XENOGFT SKIN; 100 SQ CM/LESS,772.50,0.00,,,,,,,,,,,,,
14020087,0451,1593126,,,,,EXC SACRAL PRESS ULCER W/PRIM SUTUR,1699.50,0.00,,,,,,,,,,,,,
14020088,0451,1600026,,,,,INT TX 1ST DEGREE BURN W/LOCAL TX,61.75,0.00,,,,,,,,,,,,,
14020089,0451,1602026,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES SM,113.25,0.00,,,,,,,,,,,,,
14020090,0451,1602526,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES MED,231.75,0.00,,,,,,,,,,,,,
14020091,0451,1603026,,,,,DSG/DEBRID INT/SUBSQT; WO ANES LG,340.00,0.00,,,,,,,,,,,,,
14020092,0451,1700026,,,,,DESTRCT-ANY METHD-BEN LES; W/ANE;1,128.75,0.00,,,,,,,,,,,,,
14020093,0451,1700326,,,,,"DESTRCT-ANY METHD-BEN LES 2-14, EA",31.00,0.00,,,,,,,,,,,,,
14020094,0451,1711026,,,,,DESTRCT  WARTS/MOLLUSCUM TO 14 LES,128.75,0.00,,,,,,,,,,,,,
14020095,0451,1711126,,,,,DESTRCT WARTS/MOLLUSCUM;15/>LES,170.00,0.00,,,,,,,,,,,,,
14020096,0451,1900026,,,,,PUNCT ASPIRAT CYST BREAST,154.50,0.00,,,,,,,,,,,,,
14020097,0451,1900126,,,,,PUNCT ASPIR CYST BREAST; EA AD CYST,77.25,0.00,,,,,,,,,,,,,
14020098,0451,1910026,,,,,BX BREAST; NEEDLE CORE(SEP PROC),386.25,0.00,,,,,,,,,,,,,
14020099,0451,2010226,,,,,EXPLOR WOUND (SEP PRO);ABD/FLNK/BK,1236.00,0.00,,,,,,,,,,,,,
14020100,0451,2010326,,,,,EXPLO PENTR WOUND (SEP PRO); EXTREM,1339.00,0.00,,,,,,,,,,,,,
14020101,0451,2052026,,,,,REMOV FB MUSCL/TENDON; SIMPL,355.25,0.00,,,,,,,,,,,,,
14020102,0451,2055026,,,,,INJ TENDON SHEATH/LIG/TRIG PT/CYST,103.00,0.00,,,,,,,,,,,,,
14020103,0451,2055226,,,,,TRIGGER POINT INJECTION ONE/TWO MUSCLES,103.00,0.00,,,,,,,,,,,,,
14020104,0451,2055326,,,,,TRIGGER POINT INJ. THREE OR MORE MUSCLES,154.50,0.00,,,,,,,,,,,,,
14020105,0451,2060526,,,,,ARTHROCENTESIS/ASPRI/INJ; INTERM JT,103.00,0.00,,,,,,,,,,,,,
14020106,0451,2061026,,,,,ARTHROCENTESIS MAJOR JT/BURSA,149.25,0.00,,,,,,,,,,,,,
14020107,0451,2061526,,,,,ASPIRAT & INJ TX BONE CYST,334.75,0.00,,,,,,,,,,,,,
14020108,0451,2150126,,,,,I&D DEEP ABSCESS SOFT TISS NECK,901.25,0.00,,,,,,,,,,,,,
14020109,0451,2155026,,,,,BX SOFT TISS NECK/THORAZ,437.75,0.00,,,,,,,,,,,,,
14020110,0451,2180026,,,,,CLO TX RIB FX UNCOMP EA,200.75,0.00,,,,,,,,,,,,,
14020111,0451,2182026,,,,,CLO TX STERNUM FX,453.25,0.00,,,,,,,,,,,,,
14020112,0451,2192026,,,,,BX SOFT TISS BACK/FLANK; SUPERF,412.00,0.00,,,,,,,,,,,,,
14020113,0451,2193026,,,,,EXC TUMOR SOFT TISS BACK/FLANK,1370.00,0.00,,,,,,,,,,,,,
14020114,0451,2350026,,,,,CLO TX CLAV FX; WO MANIP,453.25,0.00,,,,,,,,,,,,,
14020115,0451,2354026,,,,,CLO TX ACROMIOCLAV DISLOC; WO MINIP,515.00,0.00,,,,,,,,,,,,,
14020116,0451,2357026,,,,,CLO TX SCAPULAR FX; WO MANIP,540.75,0.00,,,,,,,,,,,,,
14020117,0451,2360026,,,,,CLO TX PROX HUMERAL FX; WO MANIP,690.00,0.00,,,,,,,,,,,,,
14020118,0451,2365026,,,,,CLO TX SHLDR DISLOC W/MANIP;WO ANES,566.50,0.00,,,,,,,,,,,,,
14020119,0451,2406526,,,,,BX SOFT TISS UP ARM/ELBOW; SUPERF,231.75,0.00,,,,,,,,,,,,,
14020120,0451,2407526,,,,,EXC TUMOR UPPER ARM/ELBOW; SUBSQ,679.75,0.00,,,,,,,,,,,,,
14020121,0451,2450026,,,,,CLO TX HUMERAL SHAFT FX; WO MANIP,762.25,0.00,,,,,,,,,,,,,
14020122,0451,2453026,,,,,CLO TX SUPRACONDYL HUMER FX; W/O MAN,762.25,0.00,,,,,,,,,,,,,
14020123,0451,2457626,,,,,CLO TX HUMERAL CONDYL FX; WO MANIP,618.00,0.00,,,,,,,,,,,,,
14020124,0451,2460026,,,,,TX CLO ELBOW DISLOC; WO ANES,679.75,0.00,,,,,,,,,,,,,
14020125,0451,2460526,,,,,TX CLOSED ELBOW DISLOC WITH ANESTHESIA,1184.50,0.00,,,,,,,,,,,,,
14020126,0451,2464026,,,,,CLO TX RADIAL HEAD SUBLUXA CHILD,273.00,0.00,,,,,,,,,,,,,
14020127,0451,2465026,,,,,CLO TX RADIAL HEAD/NECK FX; WO MANIP,576.75,0.00,,,,,,,,,,,,,
14020128,0451,2467026,,,,,CLO RX ULNAR FX PROX END; WO MANIP,721.00,0.00,,,,,,,,,,,,,
14020129,0451,2507526,,,,,EXC TUMOR FOREARM/WRIST AREA; SUBQ,1143.25,0.00,,,,,,,,,,,,,
14020130,0451,2550026,,,,,CLO TX RADIAL SHAFT FX; WO MANIP,592.25,0.00,,,,,,,,,,,,,
14020131,0451,2550526,,,,,CLO TX RADIAL SHAFT FX; W/MANIP,1143.25,0.00,,,,,,,,,,,,,
14020132,0451,2553026,,,,,CLO TX ULNAR SHAFT FX WO MANIP,592.25,0.00,,,,,,,,,,,,,
14020133,0451,2556026,,,,,CLO TX RAD & ULNA SHAFT FX; WO MANIP,643.75,0.00,,,,,,,,,,,,,
14020134,0451,2556526,,,,,CLO TX RAD & ULNA SHAFT FX; W/MANIP,1287.50,0.00,,,,,,,,,,,,,
14020135,0451,2560026,,,,,CLO TX DIST RAD FX; WO MANIP,717.00,0.00,,,,,,,,,,,,,
14020136,0451,2560526,,,,,CLOSED TREATMENT DISRAL RADIAL FRACTURE,1251.50,0.00,,,,,,,,,,,,,
14020137,0451,2562226,,,,,CLO TX CARPAL SCAPHOID FX; WO MANIP,721.00,0.00,,,,,,,,,,,,,
14020138,0451,2563026,,,,,CLO TX CARPAL BONE FX; WO MANIP EA,643.75,0.00,,,,,,,,,,,,,
14020139,0451,2601026,,,,,DRAINAGE FINGER ABSCESS; SIMPL,237.00,0.00,,,,,,,,,,,,,
14020140,0451,2601126,,,,,DRAINAGE FINGER ABSCESS; COMPLIC,731.25,0.00,,,,,,,,,,,,,
14020141,0451,2641026,,,,,"REPAIR, EXTENSOR TENDON, HAND",1771.50,0.00,,,,,,,,,,,,,
14020142,0451,2641826,,,,,ER REPAIR EXT. TENDON FINGER PRI/SEC,1462.50,0.00,,,,,,,,,,,,,
14020143,0451,2643326,,,,,REPAIR OF EXTENSOR TENDON DISTAL INSERT.,1545.00,0.00,,,,,,,,,,,,,
14020144,0451,2660026,,,,,CLO TX METACARP FX 1; WO MANIP,489.25,0.00,,,,,,,,,,,,,
14020145,0451,2660526,,,,,CLO TX METACARP FX 1; W/MANIP EA,633.50,0.00,,,,,,,,,,,,,
14020146,0451,2664126,,,,,CLO TX CARPOMETA DISLOC THUMB W/MAN,659.25,0.00,,,,,,,,,,,,,
14020147,0451,2664526,,,,,CLO TX CARPOMETACAR FX THUMB W/MAN,906.50,0.00,,,,,,,,,,,,,
14020148,0451,2670026,,,,,CLO TX MCP DISLOC-1W/MANIP-WO ANES,489.25,0.00,,,,,,,,,,,,,
14020149,0451,2672026,,,,,CLO TX PHALANGEAL FX; WO MANIP EA,365.75,0.00,,,,,,,,,,,,,
14020150,0451,2672526,,,,,CLO TX PHALANGEAL FX; W/WO TRACT,633.50,0.00,,,,,,,,,,,,,
14020151,0451,2676526,,,,,OPEN REDUCTION DISSTAL PHALANGEAL FX,1225.75,0.00,,,,,,,,,,,,,
14020152,0451,2677026,,,,,CLO TX IP JT DISLOC W/WMANIP; WO ANES,489.25,0.00,,,,,,,,,,,,,
14020153,0451,2750026,,,,,CLO TX FEMORAL SHAFT FX WO MANIP,1261.75,0.00,,,,,,,,,,,,,
14020154,0451,2753026,,,,,CLO TX TIBIAL FX PROX;WO MANIP,829.25,0.00,,,,,,,,,,,,,
14020155,0451,2756026,,,,,CLO TX PATELLAR DISLOC; WO ANES,453.25,0.00,,,,,,,,,,,,,
14020156,0451,2760326,,,,,I&D LEG/ANK; DEEP ABSCESS/HEMATOMA,1004.25,0.00,,,,,,,,,,,,,
14020157,0451,2775026,,,,,CLO TX TIBIAL SHAFT FX; WO MANIP,767.25,0.00,,,,,,,,,,,,,
14020158,0451,2775226,,,,,CLO TX TIB FX; W/MANIP W/WO TRACT,1493.50,0.00,,,,,,,,,,,,,
14020159,0451,2776026,,,,,CLO TX MEDIAL MALLEOLUS FX; WO MANI,721.00,0.00,,,,,,,,,,,,,
14020160,0451,2776226,,,,,CLO TX MED MALLEOLUS FX; W/MANIP,556.25,0.00,,,,,,,,,,,,,
14020161,0451,2778626,,,,,CLO TX DISTAL FIBULAR FX; WO MANIP,643.75,0.00,,,,,,,,,,,,,
14020162,0451,2778826,,,,,CLO  TX DISTAL FIBULAR FX; W/MANIP,1133.00,0.00,,,,,,,,,,,,,
14020163,0451,2781826,,,,,CLO TX TRIMALLEOLAR ANK FX; W/MANIP,1406.00,0.00,,,,,,,,,,,,,
14020164,0451,2782526,,,,,CLO TX FX DIST TIB; W/TRACT/ANES,1606.75,0.00,,,,,,,,,,,,,
14020165,0451,2784026,,,,,CLO TX ANK DISLOC; WO ANES,767.25,0.00,,,,,,,,,,,,,
14020166,0451,2819026,,,,,REMOV FB FT; SUBQ,772.50,0.00,,,,,,,,,,,,,
14020167,0451,2840026,,,,,CLO TX CALCAN FX; WO MANIP,633.50,0.00,,,,,,,,,,,,,
14020168,0451,2845026,,,,,TX TARSAL BONE FX; WO MANIP EA,515.00,0.00,,,,,,,,,,,,,
14020169,0451,2847026,,,,,CLO TX METATARSAL FX; WO MANIP EA.,473.75,0.00,,,,,,,,,,,,,
14020170,0451,2847526,,,,,CLO TX METATARSAL FX; W/MANIP EA,654.00,0.00,,,,,,,,,,,,,
14020171,0451,2849026,,,,,CLO TX FX GRT TOE PHALANX; WO MANIP,267.75,0.00,,,,,,,,,,,,,
14020172,0451,2851026,,,,,CLO TX FX PHALNX NOT GR TOE; WO/MAN,257.50,0.00,,,,,,,,,,,,,
14020173,0451,2851526,,,,,CLO TX FX PHALNX NOT GR TOE; W/MANI,329.50,0.00,,,,,,,,,,,,,
14020174,0451,2860026,,,,,CLO TX TARSOMETAT JT DISLOC; WO ANES,437.75,0.00,,,,,,,,,,,,,
14020175,0451,2906526,,,,,APPLIC; SHOULDER TO HAND,273.00,0.00,,,,,,,,,,,,,
14020176,0451,2907526,,,,,APPLIC; ELBOW TO FINGER,221.50,0.00,,,,,,,,,,,,,
14020177,0451,2908526,,,,,APPLIC; HAND & LOWER FOREARM,154.50,0.00,,,,,,,,,,,,,
14020178,0451,2910526,,,,,APPLIC; LONG ARM SPLINT,231.75,0.00,,,,,,,,,,,,,
14020179,0451,2912526,,,,,APPLIC; SHORT ARM SPLINT; STATOC,231.75,0.00,,,,,,,,,,,,,
14020180,0451,2913026,,,,,APPLIC FINGER SPLINT; STATIC,77.25,0.00,,,,,,,,,,,,,
14020181,0451,2924026,,,,,APPLIC SLING SHOULDER,77.25,0.00,,,,,,,,,,,,,
14020182,0451,2934526,,,,,APPLIC LONG LEG CAST,273.00,0.00,,,,,,,,,,,,,
14020183,0451,2940526,,,,,APPLIC SHORT LEG CAST,283.25,0.00,,,,,,,,,,,,,
14020184,0451,2942526,,,,,APPLIC SHORT LEG CAST; WALKING/AMB,267.75,0.00,,,,,,,,,,,,,
14020185,0451,2944526,,,,,APPLIC RIGID TOT CONTACT LEG CAST,484.00,0.00,,,,,,,,,,,,,
14020186,0451,2950526,,,,,APPLIC LONG LEG SPLINT,190.50,0.00,,,,,,,,,,,,,
14020187,0451,2951526,,,,,APPLIC SHORT LEG SPLINT,123.50,0.00,,,,,,,,,,,,,
14020188,0451,2958026,,,,,STRAPPING; UNNA BOOT,103.00,0.00,,,,,,,,,,,,,
14020189,0451,2970526,,,,,REMOV/BIVALV; FULL ARM/LEG CAST,92.75,0.00,,,,,,,,,,,,,
14020190,0451,2973026,,,,,WINDOWING CAST,73.25,0.00,,,,,,,,,,,,,
14020191,0451,2974026,,,,,WEDGING CAST,128.75,0.00,,,,,,,,,,,,,
14020192,0981,30300,,,,,REMOV FB INTRANASAL; RIGHT,553.00,553.00,,,,,,,,,,,,,
14020193,0451,3090126,,,,,CONTRL NASAL HEMORR-ANT-SIMPL,190.50,0.00,,,,,,,,,,,,,
14020194,0451,3090526,,,,,CONTRL NASAL HEMORR-POST W/PACKING,509.75,0.00,,,,,,,,,,,,,
14020195,0451,3150026,,,,,INTUBATION ENDOTRACHEAL EMER PROC,412.00,0.00,,,,,,,,,,,,,
14020196,0451,3150226,,,,,TRACHEOT TUBE CHANGE BEFOR FISTULA,314.25,0.00,,,,,,,,,,,,,
14020197,0451,3150526,,,,,LARYNGOSCOPY INDIREC; DX (SEP PROC),237.00,0.00,,,,,,,,,,,,,
14020198,0451,3151026,,,,,LARYNGOSCOPY INDIRECT; W/BX,654.00,0.00,,,,,,,,,,,,,
14020199,0451,3157526,,,,,LARYNGOSCOPY  FLEX FIBEROPTIC; DX,319.25,0.00,,,,,,,,,,,,,
14020200,0451,3160326,,,,,TRACHEOSTOMY EMER PROC; TRANSTRACH,1076.25,0.00,,,,,,,,,,,,,
14020201,0451,3160526,,,,,TRACH EMER PROC; CRICOTHYROID MEMBR,947.50,0.00,,,,,,,,,,,,,
14020202,0451,3242126,,,,,THORACENTESIS,772.50,0.00,,,,,,,,,,,,,
14020203,0451,3321026,,,,,INSRT/REPLC TEMP 1 ELECT (SEP PROC),772.50,0.00,,,,,,,,,,,,,
14020204,0451,3522626,,,,,REPAIR BLOOD VESSEL LOWER EXTREMITY,2662.50,0.00,,,,,,,,,,,,,
14020205,0451,3641026,,,,,VENIPUNCT> 3YR W/MD SKILL (SEP PRO),77.25,0.00,,,,,,,,,,,,,
14020206,0451,3642526,,,,,VENIPUNCT CUTDOWN; AGE 1/OVER,164.75,0.00,,,,,,,,,,,,,
14020207,0451,3655626,,,,,INS CENTRAL VENOUS ACCESS >5,378.00,0.00,,,,,,,,,,,,,
14020208,0451,3660026,,,,,ART PUNCT WITHDRAWAL BLD DX;,113.25,0.00,,,,,,,,,,,,,
14020209,0451,3662026,,,,,ART CATH-SAMPL (SEP PRO); PERG,310.00,0.00,,,,,,,,,,,,,
14020210,0451,3830026,,,,,DRAINAGE LYMPH NODE ABSCESS;SIMPL,298.75,0.00,,,,,,,,,,,,,
14020211,0451,3850526,,,,,BX/EXC LYMPH NODE; BY NEEDLE SUPERF,473.75,0.00,,,,,,,,,,,,,
14020212,0451,4049026,,,,,BX LIP,185.50,0.00,,,,,,,,,,,,,
14020213,0451,4080826,,,,,BX VESTIBULE MOUTH,267.75,0.00,,,,,,,,,,,,,
14020214,0451,4375226,,,,,NG TUBE PLACEMENT W/FLUORO,180.25,0.00,,,,,,,,,,,,,
14020215,0451,4500526,,,,,I&D SUBMUCOSAL ABSCESS RECTUM,489.25,0.00,,,,,,,,,,,,,
14020216,0451,4530026,,,,,PROCTOSIG RIGID W/W/O COLLECT,257.50,0.00,,,,,,,,,,,,,
14020217,0451,4530326,,,,,PROCSIGMOSCOPY RIGID; W/DILAT,283.25,0.00,,,,,,,,,,,,,
14020218,0451,4530526,,,,,PROCSIGMOSCOPY RIGID; W/BX 1/MX,334.75,0.00,,,,,,,,,,,,,
14020219,0451,4533026,,,,,EMER RM SIGMOIDOSCOP,437.75,0.00,,,,,,,,,,,,,
14020220,0451,4604026,,,,,I&D RECTAL ABCESS,1287.50,0.00,,,,,,,,,,,,,
14020221,0451,4605026,,,,,I&D PERIANAL ABSCESS SUPERF,391.50,0.00,,,,,,,,,,,,,
14020222,0451,4606026,,,,,INCISION & DRAIN OF A PERIRECTAL ABSCESS,2034.25,0.00,,,,,,,,,,,,,
14020223,0451,4608326,,,,,INCS THROMBOSED HEMORRHOID EXT,257.50,0.00,,,,,,,,,,,,,
14020224,0451,4622126,,,,,HEMORRHOIDECTOMY BY SIMPL LIG,231.75,0.00,,,,,,,,,,,,,
14020225,0451,4632026,,,,,ENUCLEATION EXT THROBOTIC HEMORRHO,293.50,0.00,,,,,,,,,,,,,
14020226,0451,4693526,,,,,DESTRCT HEMORRHOIDS ANY METHOD:EXT,525.25,0.00,,,,,,,,,,,,,
14020227,0451,4908026,,,,,PERITONEOCENTESIS;INIT,772.50,0.00,,,,,,,,,,,,,
14020228,0451,5170026,,,,,BLADDER IRRIGA SIMPL LAVAGE,164.75,0.00,,,,,,,,,,,,,
14020229,0981,51701,,,,,INSERT BLADDER CATHETER,195.78,195.78,,,,,,,,,,,,,
14020230,0451,5170226,,,,,INSERTION TEMPORARY INDWELLING BLADDER,134.00,0.00,,,,,,,,,,,,,
14020231,0451,5170526,,,,,CYSTOSTOMY TUBE CHANGE,350.25,0.00,,,,,,,,,,,,,
14020232,0451,5360026,,,,,DILAT URETHRAL STRICT-MALE; INIT,207.00,0.00,,,,,,,,,,,,,
14020233,0451,5362026,,,,,DILAT URETHRAL FILLIFORM-MALE; INIT,267.75,0.00,,,,,,,,,,,,,
14020234,0451,5470026,,,,,INCISION & DRAINAGE OF EPIDIDYMIS,463.50,0.00,,,,,,,,,,,,,
14020235,0451,5510026,,,,,DRAINAGE SCROTAL WALL ABSCESS,237.00,0.00,,,,,,,,,,,,,
14020236,0451,5640526,,,,,I&D ABSCESS; PERINEUM,309.00,0.00,,,,,,,,,,,,,
14020237,0451,6010026,,,,,BX THYROID PERCUT CORE NEEDLE,314.25,0.00,,,,,,,,,,,,,
14020238,0451,6227026,,,,,SPINAL PUNCT LUMBAR DX,334.75,0.00,,,,,,,,,,,,,
14020239,0451,6445026,,,,,INJ ANES AGENT; OTHER PERIPHERAL,314.25,0.00,,,,,,,,,,,,,
14020240,0451,6520526,,,,,REMOV FB EXT EYE; CONJUNC SUPERF,144.25,0.00,,,,,,,,,,,,,
14020241,0451,6521026,,,,,REMOV FB EXT EYE; CONJUNC EMBEDDED,164.75,0.00,,,,,,,,,,,,,
14020242,0451,6522026,,,,,REMOV FB EXT EYE;CORNEAL WO LAMP,200.75,0.00,,,,,,,,,,,,,
14020243,0451,6781026,,,,,BX EYELID,283.25,0.00,,,,,,,,,,,,,
14020244,0451,6910026,,,,,BX EXT EAR,293.50,0.00,,,,,,,,,,,,,
14020245,0451,6911026,,,,,EXC EXT EAR; PART SIMPL REPR,1179.25,0.00,,,,,,,,,,,,,
14020246,0450,69200,,,,,REM FB EXT AUDITORY CANAL; WO ANESTH,360.44,360.44,,,,,,,,,,,,,
14020247,0451,6921026,,,,,REMOV IMPACTED CERUMEN (SEP PRO),77.25,0.00,,,,,,,,,,,,,
14020248,0451,4375326,,,,,GASTRIC INTUB & ASPIR/LAVAGE-TX,425.50,0.00,,,,,,,,,,,,,
14020249,0450,27265,,,,,CL TX POST HIP DISLOC WO ANESTH,723.03,723.03,,,,,,,,,,,,,
14020250,0450,29280,,,,,STRAPPING HAND/FINGER,108.07,108.07,,,,,,,,,,,,,
14020251,0450,23655,,,,,CL TX SHLDR DISL W MANIP W ANESTH,4482.76,4482.76,,,,,,,,,,,,,
14020252,0450,29260,,,,,STRAPPING ELBOW OR WRIST,114.10,114.10,,,,,,,,,,,,,
14020253,0981,29260,,,,,STRAPPING ELBOW OR WRIST,123.00,123.00,,,,,,,,,,,,,
14020260,0451,1205226,,,,,LAYER CLO FACE/LIPS 2.6 TO 5.0CM,489.25,0.00,,,,,,,,,,,,,
14020261,0451,1016026,,,,,PUNCTASPIR ABSCES/HEMAT/BULL/CYST,154.50,0.00,,,,,,,,,,,,,
14020262,0451,1002126,,,,,FINE NEEDLE ASPIRATION W/O GUIDANCE,252.25,0.00,,,,,,,,,,,,,
14020263,0451,4083126,,,,,CLOLACERATIONMOUTH;OVER 2.5CM/COMPLEX,643.75,0.00,,,,,,,,,,,,,
14020264,0451,2819226,,,,,REMOV FB FT; SUBQ,669.50,0.00,,,,,,,,,,,,,
14020265,0451,97597,,,,,RMVL DEVITAL TIS 20CM<,307.75,0.00,,,,,,,,,,,,,
14020266,0451,97598,,,,,RMVL DEVITAL TIS ADDL 20CM,273.00,0.00,,,,,,,,,,,,,
14026639,0451,4180026,,,,,DRAIN ABSCESS DENTOALVEOLAR STRUCT,288.50,0.00,,,,,,,,,,,,,
14030000,0456,1002126,,,,,FINE NEEDLE ASPIRATION W/O GUIDANCE,252.25,0.00,,,,,,,,,,,,,
14030001,0456,1002226,,,,,FINE NEEDLE ASPIRATION W/GUIDANCE,280.25,0.00,,,,,,,,,,,,,
14030002,0456,1006026,,,,,I&D ABCESS; SIMPL/SNGL,226.50,0.00,,,,,,,,,,,,,
14030003,0456,1006126,,,,,I&D ABSCESS:COMPLIC/MX,741.50,0.00,,,,,,,,,,,,,
14030004,0456,1008026,,,,,I & D PILONIDAL CYST: SIMPL,257.50,0.00,,,,,,,,,,,,,
14030005,0456,1008126,,,,,I&D PILONIDAL CYST; COMPLIC,772.50,0.00,,,,,,,,,,,,,
14030006,0456,1012026,,,,,INCS & REMOV FB SUBQ TISS; SIMPL,283.25,0.00,,,,,,,,,,,,,
14030007,0456,1012126,,,,,INCS & REMOV SUBQ TISS; COMPLIC,695.25,0.00,,,,,,,,,,,,,
14030008,0456,1014026,,,,,I&D HEMATOMA/SEROMA/FLUID COLLEC,257.50,0.00,,,,,,,,,,,,,
14030009,0456,1016026,,,,,PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,154.50,0.00,,,,,,,,,,,,,
14030010,0456,1101026,,,,,DEBRID W/REMOV MAT;SKIN & SUBQ,566.50,0.00,,,,,,,,,,,,,
14030011,0456,1101126,,,,,DEBRID W/REMOV MAT;SKIN-SBQ-MUSC,669.50,0.00,,,,,,,,,,,,,
14030012,0456,1101226,,,,,DEBRID W/REM MAT;SKIN-MUSC-BONE,772.50,0.00,,,,,,,,,,,,,
14030013,0456,1104126,,,,,DEBRID; SKIN FULL THICK,128.75,0.00,,,,,,,,,,,,,
14030014,0456,1104226,,,,,DEBRID; SKIN & SUBQ TISS,386.25,0.00,,,,,,,,,,,,,
14030015,0456,1104326,,,,,DEBRID; SKIN-SUBQ TISS-MUSCL,695.25,0.00,,,,,,,,,,,,,
14030016,0456,1104426,,,,,DEBRID; SKIN-SUBQ TISS-MUSCL-BONE,978.50,0.00,,,,,,,,,,,,,
14030017,0456,1105526,,,,,PARING/CUTTING BEN LES; 1LES,77.25,0.00,,,,,,,,,,,,,
14030018,0456,1110026,,,,,BX SKIN/SUBQ TISS(SEP PRO); 1 LES,151.50,0.00,,,,,,,,,,,,,
14030019,0456,1110126,,,,,BX SKIN/SUBQ TIS (SEP PRO); EA ADD,51.50,0.00,,,,,,,,,,,,,
14030020,0456,1120126,,,,,REMOVE SKIN TAGS;EA ADD 10 LES,77.25,0.00,,,,,,,,,,,,,
14030021,0456,1130026,,,,,SHAVING 1 LES TRUNK; 0.5CM/LESS,103.00,0.00,,,,,,,,,,,,,
14030022,0456,1130126,,,,,SHAVING 1 LES TRUNK' 0.6 TO 1.0 CM,128.75,0.00,,,,,,,,,,,,,
14030023,0456,1130226,,,,,SHAVING 1 LES TRUNK; 1.1 TO 2.0 CM,149.25,0.00,,,,,,,,,,,,,
14030024,0456,1130326,,,,,SHAVING 1 LES TRUNK; OVER 2.0 CM,180.25,0.00,,,,,,,,,,,,,
14030025,0456,1130626,,,,,SHAVING 1 LES SCALP; 0.6 TO 1.0 CM,134.00,0.00,,,,,,,,,,,,,
14030026,0456,1130726,,,,,SHAVING 1 LES SCALP;1.1 TO 2.0 CM,159.75,0.00,,,,,,,,,,,,,
14030027,0456,1130826,,,,,SHAVING 1 LES SCALP; OVER 2.0 CM,180.25,0.00,,,,,,,,,,,,,
14030028,0456,1131026,,,,,SHAVING  1 LES FACE;0.5CM/LESS,128.75,0.00,,,,,,,,,,,,,
14030029,0456,1131126,,,,,SHAVING 1 LES FACE; 0.6 TO 1.0 CM,149.25,0.00,,,,,,,,,,,,,
14030030,0456,1131326,,,,,SHAVING 1 LES FACE; OVER 2.0 CM,216.25,0.00,,,,,,,,,,,,,
14030031,0456,1140026,,,,,EXC BEN LES TRUNK;0.5 CM/LESS,170.00,0.00,,,,,,,,,,,,,
14030032,0456,1140126,,,,,EXC BEN LES TRUNK; 0.6 TO 1.0 CM,206.00,0.00,,,,,,,,,,,,,
14030033,0450,1140226,,,,,EXC BEN LES TRUNK; 1.1 TO 2.0 CM,262.75,0.00,,,,,,,,,,,,,
14030034,0456,1140326,,,,,EXC BEN LES TRUNK; 2.1 TO 3.0 CM,334.75,0.00,,,,,,,,,,,,,
14030035,0456,1140426,,,,,EXC BEN LES TRUNK; 3.1 TO 4.0 CM,437.75,0.00,,,,,,,,,,,,,
14030036,0456,1140626,,,,,EXC BEN LES TRUNK; OVER 4.0 CM,643.75,0.00,,,,,,,,,,,,,
14030037,0456,1142026,,,,,EXC BEN LES SCALP; 0.5 CM/LESS,190.50,0.00,,,,,,,,,,,,,
14030038,0456,1142126,,,,,EXC BEN LES  SCALP 0.6 TO  1.0CM0,221.50,0.00,,,,,,,,,,,,,
14030039,0456,1142226,,,,,EXC BEN LES SCALP; 1.1 TO 2.0 CM,298.75,0.00,,,,,,,,,,,,,
14030040,0456,1142326,,,,,EXC BEN LES SCALP; 2.1 TO 3.0 CM,396.50,0.00,,,,,,,,,,,,,
14030041,0456,1142626,,,,,EXC BEN LES SCALP; OVER 4.0 CM,559.25,0.00,,,,,,,,,,,,,
14030042,0456,1144026,,,,,EXC BEN LES FACE; 0.5 CM/LESS,216.25,0.00,,,,,,,,,,,,,
14030043,0456,1144126,,,,,EXC BEN LES FACE; 0.6 TO 1.Q CM,309.00,0.00,,,,,,,,,,,,,
14030044,0456,1144226,,,,,EXC BEN LES FACE; 1.1 TO 2.0 CM,386.25,0.00,,,,,,,,,,,,,
14030045,0456,1144326,,,,,EXC BEN LES FACE; 2.1 TO 3.0 CM,453.25,0.00,,,,,,,,,,,,,
14030046,0456,1144426,,,,,EXC BEN FACE; 3.1 TO 4.0 CM,515.00,0.00,,,,,,,,,,,,,
14030047,0456,1144626,,,,,EXC BEN LES FACE; OVER 4.0 CM,618.00,0.00,,,,,,,,,,,,,
14030048,0456,1164026,,,,,EXC MALIG LES FACE; 0.5 CM/LESS,309.00,0.00,,,,,,,,,,,,,
14030049,0456,1171926,,,,,TRIM NONDYSTROPHIC NAILS-ANY NUMBER,36.00,0.00,,,,,,,,,,,,,
14030050,0456,1172026,,,,,DEBRID NAIL(S) ANY METHOD(S);1 TO 5,113.25,0.00,,,,,,,,,,,,,
14030051,0456,1173026,,,,,AVULS OF NAIL PLATE PART OR COMPL SIMPLE,283.25,0.00,,,,,,,,,,,,,
14030052,0456,1173226,,,,,AVULSION PLATE PART/COMPLT SIMPL; EA,72.00,0.00,,,,,,,,,,,,,
14030053,0456,1174026,,,,,EVACUATION SUBUNGUAL HEMATOMA,87.50,0.00,,,,,,,,,,,,,
14030054,0456,1175026,,,,,EXC NAIL/MATRIX PART/COMPLT PERM,463.50,0.00,,,,,,,,,,,,,
14030055,0456,1175226,,,,,EXC NAIL/MATRIX PERM;AMPUT DISTAL,515.00,0.00,,,,,,,,,,,,,
14030056,0456,1175526,,,,,BX NAIL UNIT ANY METHD(SEP PRO),195.75,0.00,,,,,,,,,,,,,
14030057,0456,1176026,,,,,REPR NAIL BED,360.50,0.00,,,,,,,,,,,,,
14030058,0456,1177226,,,,,EXC PILONIDAL CYST/SINUS;COMPLIC,2472.00,0.00,,,,,,,,,,,,,
14030060,0456,1200226,,,,,SIMPL REPR SCLP/TRUNK; 2.6-7.5 CM,334.75,0.00,,,,,,,,,,,,,
14030061,0456,1200426,,,,,SIMPL REPR SCLP/TRUNK; 7.6-12.5 CM,422.25,0.00,,,,,,,,,,,,,
14030062,0456,1200526,,,,,SIMPL REPR SCLP/TRUNK; 12.6-20.0CM,499.50,0.00,,,,,,,,,,,,,
14030063,0456,1200626,,,,,SF WOUND SIMPLE REPAIR 20.1CM - 30.0CM,520.25,0.00,,,,,,,,,,,,,
14030064,0456,1201126,,,,,SIMPL REPR FACE/MUCOUS; 2.5/LESS,273.00,0.00,,,,,,,,,,,,,
14030065,0456,1201326,,,,,SR FCE/EAR/EYE/INSE/LIP 2.6-5,334.75,0.00,,,,,,,,,,,,,
14030066,0456,1201426,,,,,SIMPL REPR FACE/MUCOUS 5.1-7.5CM,360.50,0.00,,,,,,,,,,,,,
14030067,0456,1202026,,,,,TX SUPERF WOUND DEHISCENCE;SIMPL,350.25,0.00,,,,,,,,,,,,,
14030068,0456,1202126,,,,,TX SUPERF WOUND DEHISCENCE; W/PACK,412.00,0.00,,,,,,,,,,,,,
14030069,0456,1203126,,,,,LAYER CLO SCLP/TRUNK; 2.5 CM/LESS,288.50,0.00,,,,,,,,,,,,,
14030070,0456,1203226,,,,,LAYER CLO SCLP/TRUNK;2.6 TO 7.5CM,473.75,0.00,,,,,,,,,,,,,
14030071,0456,1203426,,,,,LAYER CLO SCLP/TRUNK; 7.6 TP 12.5,499.50,0.00,,,,,,,,,,,,,
14030072,0456,1203526,,,,,LAYER CLO UNSPECIF,566.50,0.00,,,,,,,,,,,,,
14030073,0456,1204126,,,,,INTMD WND REPAIR N-HF/GENIT,334.75,0.00,,,,,,,,,,,,,
14030074,0456,1204226,,,,,LAYER CLO NECK/FT/GENIT; 2.6-7.5,437.75,0.00,,,,,,,,,,,,,
14030075,0456,1205126,,,,,LAYER CLO FACE/LIPS; 2.5CM/LESS,437.75,0.00,,,,,,,,,,,,,
14030076,0456,1205226,,,,,LAYER CLO FACE/LIPS; 2.6 TO 5.0CM,489.25,0.00,,,,,,,,,,,,,
14030077,0456,1205326,,,,,LAYER CLO FACE/LIPS; 5.1 TO 7.5CM,535.50,0.00,,,,,,,,,,,,,
14030078,0456,1205426,,,,,LAYER CLO FACE/LIPS; 7.6 TO 12.5CM,721.00,0.00,,,,,,,,,,,,,
14030079,0456,1312026,,,,,REPR COMPLX SCLP /EXTREM;1.1-2.5CM,437.75,0.00,,,,,,,,,,,,,
14030080,0456,1312126,,,,,REPR COMPLX  SCLP/EXTREM; 2.6-7.5CM,690.00,0.00,,,,,,,,,,,,,
14030081,0456,1312226,,,,,REBR CMPLX-SCLP/ARM/LEG; EA AD 5CM,185.50,0.00,,,,,,,,,,,,,
14030082,0456,1313126,,,,,REPR COMPLX FOREHEAD/AX/FT; 1.1-2.5,566.50,0.00,,,,,,,,,,,,,
14030083,0456,1313226,,,,,REPR COMPLX FOREHEAD/AX/FT; 2.6-7.5CM,901.25,0.00,,,,,,,,,,,,,
14030084,0456,1313326,,,,,REPR CMPLX-FAC/HAND/FT; EA ADD 5CM,463.50,0.00,,,,,,,,,,,,,
14030085,0456,1315126,,,,,REPR COMPLX LIDS/LIPS; 1.1-2.5CM,803.50,0.00,,,,,,,,,,,,,
14030086,0456,1540026,,,,,APPLIC XENOGFT SKIN; 100 SQ CM/LESS,772.50,0.00,,,,,,,,,,,,,
14030087,0456,1593126,,,,,EXC SACRAL PRESS ULCER W/PRIM SUTUR,1699.50,0.00,,,,,,,,,,,,,
14030088,0456,1600026,,,,,INT TX 1ST DEGREE BURN W/LOCAL TX,61.75,0.00,,,,,,,,,,,,,
14030089,0456,1602026,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES SM,113.25,0.00,,,,,,,,,,,,,
14030090,0456,1602526,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES MED,231.75,0.00,,,,,,,,,,,,,
14030091,0456,1603026,,,,,DSG/DEBRID INT/SUBSQT; WO ANES LG,340.00,0.00,,,,,,,,,,,,,
14030092,0456,1700026,,,,,DESTRCT-ANY METHD-BEN LES; W/ANE;1,128.75,0.00,,,,,,,,,,,,,
14030093,0456,1700326,,,,,"DESTRCT-ANY METHD-BEN LES 2-14, EA",31.00,0.00,,,,,,,,,,,,,
14030094,0456,1711026,,,,,DESTRCT  WARTS/MOLLUSCUM TO 14 LES,128.75,0.00,,,,,,,,,,,,,
14030095,0456,1711126,,,,,DESTRCT WARTS/MOLLUSCUM;15/>LES,170.00,0.00,,,,,,,,,,,,,
14030096,0456,1900026,,,,,PUNCT ASPIRAT CYST BREAST,154.50,0.00,,,,,,,,,,,,,
14030097,0456,1900126,,,,,PUNCT ASPIR CYST BREAST; EA AD CYST,77.25,0.00,,,,,,,,,,,,,
14030098,0456,1910026,,,,,BX BREAST; NEEDLE CORE(SEP PROC),386.25,0.00,,,,,,,,,,,,,
14030099,0456,2010226,,,,,EXPLOR WOUND (SEP PRO);ABD/FLNK/BK,1236.00,0.00,,,,,,,,,,,,,
14030100,0456,2010326,,,,,EXPLO PENTR WOUND (SEP PRO); EXTREM,1339.00,0.00,,,,,,,,,,,,,
14030101,0456,2052026,,,,,REMOV FB MUSCL/TENDON; SIMPL,355.25,0.00,,,,,,,,,,,,,
14030102,0456,2055026,,,,,INJ TENDON SHEATH/LIG/TRIG PT/CYST,103.00,0.00,,,,,,,,,,,,,
14030103,0456,2055226,,,,,TRIGGER POINT INJECTION ONE/TWO MUSCLES,103.00,0.00,,,,,,,,,,,,,
14030104,0456,2055326,,,,,TRIGGER POINT INJ. THREE OR MORE MUSCLES,154.50,0.00,,,,,,,,,,,,,
14030105,0456,2060526,,,,,ARTHROCENTESIS/ASPRI/INJ; INTERM JT,103.00,0.00,,,,,,,,,,,,,
14030106,0456,2061026,,,,,ARTHROCENTESIS MAJOR JT/BURSA,149.25,0.00,,,,,,,,,,,,,
14030107,0456,2061526,,,,,ASPIRAT & INJ TX BONE CYST,334.75,0.00,,,,,,,,,,,,,
14030108,0456,2150126,,,,,I&D DEEP ABSCESS SOFT TISS NECK,901.25,0.00,,,,,,,,,,,,,
14030109,0456,2155026,,,,,BX SOFT TISS NECK/THORAZ,437.75,0.00,,,,,,,,,,,,,
14030110,0456,2180026,,,,,CLO TX RIB FX UNCOMP EA,200.75,0.00,,,,,,,,,,,,,
14030111,0456,2182026,,,,,CLO TX STERNUM FX,453.25,0.00,,,,,,,,,,,,,
14030112,0456,2192026,,,,,BX SOFT TISS BACK/FLANK; SUPERF,412.00,0.00,,,,,,,,,,,,,
14030113,0456,2193026,,,,,EXC TUMOR SOFT TISS BACK/FLANK,1370.00,0.00,,,,,,,,,,,,,
14030114,0456,2350026,,,,,CLO TX CLAV FX; WO MANIP,453.25,0.00,,,,,,,,,,,,,
14030115,0456,2354026,,,,,CLO TX ACROMIOCLAV DISLOC; WO MINIP,515.00,0.00,,,,,,,,,,,,,
14030116,0456,2357026,,,,,CLO TX SCAPULAR FX; WO MANIP,540.75,0.00,,,,,,,,,,,,,
14030117,0456,2360026,,,,,CLO TX PROX HUMERAL FX; WO MANIP,690.00,0.00,,,,,,,,,,,,,
14030118,0456,2365026,,,,,CLO TX SHLDR DISLOC W/MANIP;WO ANES,566.50,0.00,,,,,,,,,,,,,
14030119,0456,2406526,,,,,BX SOFT TISS UP ARM/ELBOW; SUPERF,231.75,0.00,,,,,,,,,,,,,
14030120,0456,2407526,,,,,EXC TUMOR UPPER ARM/ELBOW; SUBSQ,679.75,0.00,,,,,,,,,,,,,
14030121,0456,2450026,,,,,CLO TX HUMERAL SHAFT FX; WO MANIP,762.25,0.00,,,,,,,,,,,,,
14030122,0456,2453026,,,,,CLO TX SUPRACONDYL HUMER FX; W/O MAN,762.25,0.00,,,,,,,,,,,,,
14030123,0456,2457626,,,,,CLO TX HUMERAL CONDYL FX; WO MANIP,618.00,0.00,,,,,,,,,,,,,
14030124,0456,2460026,,,,,TX CLO ELBOW DISLOC; WO ANES,679.75,0.00,,,,,,,,,,,,,
14030125,0456,2460526,,,,,TX CLOSED ELBOW DISLOC WITH ANESTHESIA,1184.50,0.00,,,,,,,,,,,,,
14030126,0456,2464026,,,,,CLO TX RADIAL HEAD SUBLUXA CHILD,273.00,0.00,,,,,,,,,,,,,
14030127,0456,2465026,,,,,CLO TX RADIAL HEAD/NECK FX; WO MANIP,576.75,0.00,,,,,,,,,,,,,
14030128,0456,2467026,,,,,CLO RX ULNAR FX PROX END; WO MANIP,721.00,0.00,,,,,,,,,,,,,
14030129,0456,2507526,,,,,EXC TUMOR FOREARM/WRIST AREA; SUBQ,1143.25,0.00,,,,,,,,,,,,,
14030130,0456,2550026,,,,,CLO TX RADIAL SHAFT FX; WO MANIP,592.25,0.00,,,,,,,,,,,,,
14030131,0456,2550526,,,,,CLO TX RADIAL SHAFT FX; W/MANIP,1143.25,0.00,,,,,,,,,,,,,
14030132,0456,2553026,,,,,CLO TX ULNAR SHAFT FX WO MANIP,592.25,0.00,,,,,,,,,,,,,
14030133,0456,2556026,,,,,CLO TX RAD & ULNA SHAFT FX; WO MANIP,643.75,0.00,,,,,,,,,,,,,
14030134,0456,2556526,,,,,CLO TX RAD & ULNA SHAFT FX; W/MANIP,1287.50,0.00,,,,,,,,,,,,,
14030135,0456,2560026,,,,,CLO TX DIST RAD FX; WO MANIP,717.00,0.00,,,,,,,,,,,,,
14030136,0456,2560526,,,,,CLOSED TREATMENT DISRAL RADIAL FRACTURE,1251.50,0.00,,,,,,,,,,,,,
14030137,0456,2562226,,,,,CLO TX CARPAL SCAPHOID FX; WO MANIP,721.00,0.00,,,,,,,,,,,,,
14030138,0456,2563026,,,,,CLO TX CARPAL BONE FX; WO MANIP EA,643.75,0.00,,,,,,,,,,,,,
14030139,0456,2601026,,,,,DRAINAGE FINGER ABSCESS; SIMPL,237.00,0.00,,,,,,,,,,,,,
14030140,0456,2601126,,,,,DRAINAGE FINGER ABSCESS; COMPLIC,731.25,0.00,,,,,,,,,,,,,
14030141,0456,2641026,,,,,"REPAIR, EXTENSOR TENDON, HAND",1771.50,0.00,,,,,,,,,,,,,
14030142,0456,2641826,,,,,ER REPAIR EXT. TENDON FINGER PRI/SEC,1462.50,0.00,,,,,,,,,,,,,
14030143,0456,2643326,,,,,REPAIR OF EXTENSOR TENDON DISTAL INSERT.,1545.00,0.00,,,,,,,,,,,,,
14030144,0456,2660026,,,,,CLO TX METACARP FX 1; WO MANIP,489.25,0.00,,,,,,,,,,,,,
14030145,0456,2660526,,,,,CLO TX METACARP FX 1; W/MANIP EA,633.50,0.00,,,,,,,,,,,,,
14030146,0456,2664126,,,,,CLO TX CARPOMETA DISLOC THUMB W/MAN,659.25,0.00,,,,,,,,,,,,,
14030147,0456,2664526,,,,,CLO TX CARPOMETACAR FX THUMB W/MAN,906.50,0.00,,,,,,,,,,,,,
14030148,0456,2670026,,,,,CLO TX MCP DISLOC-1W/MANIP-WO ANES,489.25,0.00,,,,,,,,,,,,,
14030149,0456,2672026,,,,,CLO TX PHALANGEAL FX; WO MANIP EA,365.75,0.00,,,,,,,,,,,,,
14030150,0456,2672526,,,,,CLO TX PHALANGEAL FX; W/WO TRACT,633.50,0.00,,,,,,,,,,,,,
14030151,0456,2676526,,,,,OPEN REDUCTION DISSTAL PHALANGEAL FX,1225.75,0.00,,,,,,,,,,,,,
14030152,0456,2677026,,,,,CLO TX IP JT DISLOC W/WMANIP; WO ANES,489.25,0.00,,,,,,,,,,,,,
14030153,0456,2750026,,,,,CLO TX FEMORAL SHAFT FX WO MANIP,1261.75,0.00,,,,,,,,,,,,,
14030154,0456,2753026,,,,,CLO TX TIBIAL FX PROX;WO MANIP,829.25,0.00,,,,,,,,,,,,,
14030155,0456,2756026,,,,,CLO TX PATELLAR DISLOC; WO ANES,453.25,0.00,,,,,,,,,,,,,
14030156,0456,2760326,,,,,I&D LEG/ANK; DEEP ABSCESS/HEMATOMA,1004.25,0.00,,,,,,,,,,,,,
14030157,0456,2775026,,,,,CLO TX TIBIAL SHAFT FX; WO MANIP,767.25,0.00,,,,,,,,,,,,,
14030158,0456,2775226,,,,,CLO TX TIB FX; W/MANIP W/WO TRACT,1493.50,0.00,,,,,,,,,,,,,
14030159,0456,2776026,,,,,CLO TX MEDIAL MALLEOLUS FX; WO MANI,721.00,0.00,,,,,,,,,,,,,
14030160,0456,2776226,,,,,CLO TX MED MALLEOLUS FX; W/MANIP,556.25,0.00,,,,,,,,,,,,,
14030161,0456,2778626,,,,,CLO TX DISTAL FIBULAR FX; WO MANIP,643.75,0.00,,,,,,,,,,,,,
14030162,0456,2778826,,,,,CLO  TX DISTAL FIBULAR FX; W/MANIP,1133.00,0.00,,,,,,,,,,,,,
14030163,0456,2781826,,,,,CLO TX TRIMALLEOLAR ANK FX; W/MANIP,1406.00,0.00,,,,,,,,,,,,,
14030164,0456,2782526,,,,,CLO TX FX DIST TIB; W/TRACT/ANES,1606.75,0.00,,,,,,,,,,,,,
14030165,0456,2784026,,,,,CLO TX ANK DISLOC; WO ANES,767.25,0.00,,,,,,,,,,,,,
14030166,0456,2819026,,,,,REMOV FB FT; SUBQ,772.50,0.00,,,,,,,,,,,,,
14030167,0456,2840026,,,,,CLO TX CALCAN FX; WO MANIP,633.50,0.00,,,,,,,,,,,,,
14030168,0456,2845026,,,,,TX TARSAL BONE FX; WO MANIP EA,515.00,0.00,,,,,,,,,,,,,
14030169,0456,2847026,,,,,CLO TX METATARSAL FX; WO MANIP EA.,473.75,0.00,,,,,,,,,,,,,
14030170,0456,2847526,,,,,CLO TX METATARSAL FX; W/MANIP EA,654.00,0.00,,,,,,,,,,,,,
14030171,0456,2849026,,,,,CLO TX FX GRT TOE PHALANX; WO MANIP,267.75,0.00,,,,,,,,,,,,,
14030172,0456,2851026,,,,,CLO TX FX PHALNX NOT GR TOE; WO/MAN,257.50,0.00,,,,,,,,,,,,,
14030173,0456,2851526,,,,,CLO TX FX PHALNX NOT GR TOE; W/MANI,329.50,0.00,,,,,,,,,,,,,
14030174,0456,2860026,,,,,CLO TX TARSOMETAT JT DISLOC; WO ANES,437.75,0.00,,,,,,,,,,,,,
14030175,0456,2906526,,,,,APPLIC; SHOULDER TO HAND,273.00,0.00,,,,,,,,,,,,,
14030176,0456,2907526,,,,,APPLIC; ELBOW TO FINGER,221.50,0.00,,,,,,,,,,,,,
14030177,0456,2908526,,,,,APPLIC; HAND & LOWER FOREARM,154.50,0.00,,,,,,,,,,,,,
14030178,0456,2910526,,,,,APPLIC; LONG ARM SPLINT,231.75,0.00,,,,,,,,,,,,,
14030179,0456,2912526,,,,,APPLIC; SHORT ARM SPLINT; STATOC,231.75,0.00,,,,,,,,,,,,,
14030180,0456,2913026,,,,,APPLIC FINGER SPLINT; STATIC,77.25,0.00,,,,,,,,,,,,,
14030181,0456,2924026,,,,,APPLIC SLING SHOULDER,77.25,0.00,,,,,,,,,,,,,
14030182,0456,2934526,,,,,APPLIC LONG LEG CAST,273.00,0.00,,,,,,,,,,,,,
14030183,0456,2940526,,,,,APPLIC SHORT LEG CAST,283.25,0.00,,,,,,,,,,,,,
14030184,0456,2942526,,,,,APPLIC SHORT LEG CAST; WALKING/AMB,267.75,0.00,,,,,,,,,,,,,
14030185,0456,2944526,,,,,APPLIC RIGID TOT CONTACT LEG CAST,484.00,0.00,,,,,,,,,,,,,
14030186,0456,2950526,,,,,APPLIC LONG LEG SPLINT,190.50,0.00,,,,,,,,,,,,,
14030187,0456,2951526,,,,,APPLIC SHORT LEG SPLINT,123.50,0.00,,,,,,,,,,,,,
14030188,0456,2958026,,,,,STRAPPING; UNNA BOOT,103.00,0.00,,,,,,,,,,,,,
14030189,0456,2970526,,,,,REMOV/BIVALV; FULL ARM/LEG CAST,92.75,0.00,,,,,,,,,,,,,
14030190,0456,2973026,,,,,WINDOWING CAST,73.25,0.00,,,,,,,,,,,,,
14030191,0456,2974026,,,,,WEDGING CAST,128.75,0.00,,,,,,,,,,,,,
14030192,0456,3030026,,,,,REMOV FB INTRANASAL; RIGHT,149.25,0.00,,,,,,,,,,,,,
14030193,0456,3090126,,,,,CONTRL NASAL HEMORR-ANT-SIMPL,190.50,0.00,,,,,,,,,,,,,
14030194,0456,3090526,,,,,CONTRL NASAL HEMORR-POST W/PACKING,509.75,0.00,,,,,,,,,,,,,
14030195,0456,3150026,,,,,INTUBATION ENDOTRACHEAL EMER PROC,412.00,0.00,,,,,,,,,,,,,
14030196,0456,3150226,,,,,TRACHEOT TUBE CHANGE BEFOR FISTULA,314.25,0.00,,,,,,,,,,,,,
14030197,0456,3150526,,,,,LARYNGOSCOPY INDIREC; DX (SEP PROC),237.00,0.00,,,,,,,,,,,,,
14030198,0456,3151026,,,,,LARYNGOSCOPY INDIRECT; W/BX,654.00,0.00,,,,,,,,,,,,,
14030199,0456,3157526,,,,,LARYNGOSCOPY  FLEX FIBEROPTIC; DX,319.25,0.00,,,,,,,,,,,,,
14030200,0456,3160326,,,,,TRACHEOSTOMY EMER PROC; TRANSTRACH,1076.25,0.00,,,,,,,,,,,,,
14030201,0456,3160526,,,,,TRACH EMER PROC; CRICOTHYROID MEMBR,947.50,0.00,,,,,,,,,,,,,
14030202,0456,3242126,,,,,THORACENTESIS,772.50,0.00,,,,,,,,,,,,,
14030203,0456,3321026,,,,,INSRT/REPLC TEMP 1 ELECT (SEP PROC),772.50,0.00,,,,,,,,,,,,,
14030204,0456,3522626,,,,,REPAIR BLOOD VESSEL LOWER EXTREMITY,2662.50,0.00,,,,,,,,,,,,,
14030205,0456,3641026,,,,,VENIPUNCT> 3YR W/MD SKILL (SEP PRO),77.25,0.00,,,,,,,,,,,,,
14030206,0456,3642526,,,,,VENIPUNCT CUTDOWN; AGE 1/OVER,164.75,0.00,,,,,,,,,,,,,
14030207,0456,3655626,,,,,INS CENTRAL VENOUS ACCESS >5,378.00,0.00,,,,,,,,,,,,,
14030208,0456,3660026,,,,,ART PUNCT WITHDRAWAL BLD DX;,113.25,0.00,,,,,,,,,,,,,
14030209,0456,3662026,,,,,ART CATH-SAMPL (SEP PRO); PERG,310.00,0.00,,,,,,,,,,,,,
14030210,0456,3830026,,,,,DRAINAGE LYMPH NODE ABSCESS;SIMPL,298.75,0.00,,,,,,,,,,,,,
14030211,0456,3850526,,,,,BX/EXC LYMPH NODE; BY NEEDLE SUPERF,473.75,0.00,,,,,,,,,,,,,
14030212,0456,4049026,,,,,BX LIP,185.50,0.00,,,,,,,,,,,,,
14030213,0456,4080826,,,,,BX VESTIBULE MOUTH,267.75,0.00,,,,,,,,,,,,,
14030214,0456,4375226,,,,,NG TUBE PLACEMENT W/FLUORO,180.25,0.00,,,,,,,,,,,,,
14030215,0456,4500526,,,,,I&D SUBMUCOSAL ABSCESS RECTUM,489.25,0.00,,,,,,,,,,,,,
14030216,0456,4530026,,,,,PROCTOSIG RIGID W/W/O COLLECT,257.50,0.00,,,,,,,,,,,,,
14030217,0456,4530326,,,,,PROCSIGMOSCOPY RIGID; W/DILAT,283.25,0.00,,,,,,,,,,,,,
14030218,0456,4530526,,,,,PROCSIGMOSCOPY RIGID; W/BX 1/MX,334.75,0.00,,,,,,,,,,,,,
14030219,0456,4533026,,,,,EMER RM SIGMOIDOSCOP,437.75,0.00,,,,,,,,,,,,,
14030220,0456,4604026,,,,,I&D RECTAL ABCESS,1287.50,0.00,,,,,,,,,,,,,
14030221,0456,4605026,,,,,I&D PERIANAL ABSCESS SUPERF,391.50,0.00,,,,,,,,,,,,,
14030222,0456,4606026,,,,,INCISION & DRAIN OF A PERIRECTAL ABSCESS,2034.25,0.00,,,,,,,,,,,,,
14030223,0456,4608326,,,,,INCS THROMBOSED HEMORRHOID EXT,257.50,0.00,,,,,,,,,,,,,
14030224,0456,4622126,,,,,HEMORRHOIDECTOMY BY SIMPL LIG,231.75,0.00,,,,,,,,,,,,,
14030225,0456,4632026,,,,,ENUCLEATION EXT THROBOTIC HEMORRHO,293.50,0.00,,,,,,,,,,,,,
14030226,0456,4693526,,,,,DESTRCT HEMORRHOIDS ANY METHOD:EXT,525.25,0.00,,,,,,,,,,,,,
14030227,0456,4908026,,,,,PERITONEOCENTESIS;INIT,772.50,0.00,,,,,,,,,,,,,
14030228,0456,5170026,,,,,BLADDER IRRIGA SIMPL LAVAGE,164.75,0.00,,,,,,,,,,,,,
14030230,0456,5170226,,,,,INSERTION TEMPORARY INDWELLING BLADDER,134.00,0.00,,,,,,,,,,,,,
14030231,0456,5170526,,,,,CYSTOSTOMY TUBE CHANGE,350.25,0.00,,,,,,,,,,,,,
14030232,0456,5360026,,,,,DILAT URETHRAL STRICT-MALE; INIT,207.00,0.00,,,,,,,,,,,,,
14030233,0456,5362026,,,,,DILAT URETHRAL FILLIFORM-MALE; INIT,267.75,0.00,,,,,,,,,,,,,
14030234,0456,5470026,,,,,INCISION & DRAINAGE OF EPIDIDYMIS,463.50,0.00,,,,,,,,,,,,,
14030235,0456,5510026,,,,,DRAINAGE SCROTAL WALL ABSCESS,237.00,0.00,,,,,,,,,,,,,
14030236,0456,5640526,,,,,I&D ABSCESS; PERINEUM,309.00,0.00,,,,,,,,,,,,,
14030237,0456,6010026,,,,,BX THYROID PERCUT CORE NEEDLE,314.25,0.00,,,,,,,,,,,,,
14030238,0456,6227026,,,,,SPINAL PUNCT LUMBAR DX,334.75,0.00,,,,,,,,,,,,,
14030239,0456,6445026,,,,,INJ ANES AGENT; OTHER PERIPHERAL,314.25,0.00,,,,,,,,,,,,,
14030241,0456,6521026,,,,,REMOV FB EXT EYE; CONJUNC EMBEDDED,164.75,0.00,,,,,,,,,,,,,
14030242,0456,6522026,,,,,REMOV FB EXT EYE;CORNEAL WO LAMP,200.75,0.00,,,,,,,,,,,,,
14030243,0456,6781026,,,,,BX EYELID,283.25,0.00,,,,,,,,,,,,,
14030244,0456,6910026,,,,,BX EXT EAR,293.50,0.00,,,,,,,,,,,,,
14030245,0456,6911026,,,,,EXC EXT EAR; PART SIMPL REPR,1179.25,0.00,,,,,,,,,,,,,
14030246,0456,6920026,,,,,"REMOV FB-EXT AUDIT CANAL; WO ANES, RIGHT",216.25,0.00,,,,,,,,,,,,,
14030247,0456,6921026,,,,,REMOV IMPACTED CERUMEN (SEP PRO),77.25,0.00,,,,,,,,,,,,,
14030248,0456,4375326,,,,,GASTRIC INTUB & ASPIR/LAVAGE-TX,425.50,0.00,,,,,,,,,,,,,
14030249,0456,4083126,,,,,CLOLACERATIONMOUTH;OVER 2.5CM/COMPLEX,643.75,0.00,,,,,,,,,,,,,
14030250,0456,2819226,,,,,REMOV FB FT; SUBQ,669.50,0.00,,,,,,,,,,,,,
14030251,0456,97598,,,,,RMVL DEVITAL TIS ADDL 20CM,273.00,0.00,,,,,,,,,,,,,
14030252,0456,97597,,,,,RMVL DEVITAL TIS 20CM<,307.75,0.00,,,,,,,,,,,,,
14030255,0456,1602026,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES SM,113.25,0.00,,,,,,,,,,,,,
14036639,0456,4180026,,,,,DRAIN ABSCESS DENTOALVEOLAR STRUCT,288.50,0.00,,,,,,,,,,,,,
14099281,0981,99281,,,,,ER PHYSICIAN LEVEL 1,174.76,174.76,0.00,25.77,,,,,,,25.77,,,0.00,0.00
14099282,0981,99282,,,,,ER PHYSICIAN LEVEL 2,244.72,244.72,0.00,49.11,,,,,,,49.11,,,0.00,0.00
14099283,0981,99283,,,,,ER PHYSICIAN LEVEL 3,361.14,361.14,0.00,73.93,,,,,,,73.93,,,0.00,0.00
14099284,0981,99284,,,,,ER PHYSICIAN LEVEL 4,517.42,517.42,0.00,135.84,,,,,,,135.84,,,0.00,0.00
14099285,0981,99285,,,,,ER PHYSICIAN LEVEL 5,770.06,770.06,197.32,197.32,,,,,,,197.32,,,,
14099292,0981,99292,,,,,ER PHYSICIAN CRITICAL CARE ADDL 30 MINS,457.75,0.00,,,,,,,,,,,,,
15001075,0636,J7325,,,,,SYNVISC ONE INJ,3939.00,3939.00,,,,,,,,,,,,,
15002001,0983,99201,,,,,OFFICE/OP VISIT NEW I,81.39,81.39,,,,,,,,,,,,,
15002002,0983,99202,,,,,OFFICE/OP VISIT NEW II,134.96,134.96,,,,,,,,,,,,,
15002003,0983,99203,,,,,OFFICE/OP VISIT NEW III,196.77,196.77,,,,,,,,,,,,,
15002004,0983,99204,,,,,OFFICE/OP VISIT NEW IV,294.64,294.64,,,,,,,,,,,,,
15002005,0983,99212,,,,,OFFICE/OP VISIT EST I,85.54,85.54,28.74,28.74,,,,,,,28.74,,,,
15002006,0983,99213,,,,,OFFICE/OP VISIT EST II,128.82,128.82,,,,,,,,,,,,,
15002007,0983,99214,,,,,OFFICE/OP VISIT EST III,189.02,189.02,,,,,,,,,,,,,
15002008,0983,99215,,,,,OFFICE/OP VISIT EST IV,268.21,268.21,,,,,,,,,,,,,
15002009,0983,99241,,,,,OFFICE CONSULTATION I,134.11,134.11,,,,,,,,,,,,,
15002010,0983,99242,,,,,OFFICE CONSULTATION II,201.69,201.69,,,,,,,,,,,,,
15002011,0983,99243,,,,,OFFICE CONSULTATION III,271.38,271.38,,,,,,,,,,,,,
15002012,0983,99244,,,,,OFFICE CONSULTATION IV,378.03,378.03,,,,,,,,,,,,,
15002013,0980,99024,,,,,POST OP FOLLOW UP VISIT,0.00,0.00,,,,,,,,,,,,,
15003001,0983,20526,,,,,CARPAL TUNNEL TX INJ,279.82,279.82,,,,,,,,,,,,,
15003002,0983,20550,,,,,INJ SGL TENDON SHTH OR LIGAMENT,195.74,195.74,,,,,,,,,,,,,
15003003,0983,20550,,,,,INJ TENDON ORIGIN/INSERTION,195.74,195.74,,,,,,,,,,,,,
15003004,0983,20600,,,,,DRAIN/INJ SMALL JOINT/BURSA W/O US,178.22,178.22,,,,,,,,,,,,,
15003005,0983,20605,,,,,DRAIN/INJ INTER JOINT/BURSA W/O US,201.92,201.92,,,,,,,,,,,,,
15003006,0983,20610,,,,,DRAIN/INJ MAJOR JOINT/BURSA W/O US,257.55,257.55,,,,,,,,,,,,,
15003007,0983,20612,,,,,ASPIRATE/INJ,222.80,222.80,,,,,,,,,,,,,
15003008,0983,64455,,,,,N BLOCK INJ PLANTAR DIGIT,163.67,163.67,,,,,,,,,,,,,
15003009,0636,J3590,,,,,SKIN SUBSTITUTE NOS- AMNIOFIX,2534.29,2534.29,,,,,,,,,,,,,
15003010,0636,J7325,,,,,SYNVISC SYRINGE 3 x 16mg/2mL PER MG,78.81,78.81,,,,,,,,,,,,,
15003011,0636,J7323,,,,,EUFLEXXA INJ PER DOSE,1034.06,1034.06,,,,,,,,,,,,,
15003012,0636,J7323,,,,,EUFLEXXA INJ PER DOSE,1063.60,1063.60,,,,,,,,,,,,,
15003013,0636,J7326,,,,,GEL-ONE PER DOSE,2495.00,2495.00,,,,,,,,,,,,,
15004001,0983,29065,,,,,APPLICATION LONG ARM CAST,376.97,376.97,,,,,,,,,,,,,
15004002,0983,29075,,,,,APPLICATION OF FOREARM CAST,325.23,325.23,,,,,,,,,,,,,
15004003,0983,29085,,,,,APPLY HAND/WRIST CAST,342.12,342.12,,,,,,,,,,,,,
15004004,0983,29086,,,,,APPLY FINGER CAST,228.08,228.08,,,,,,,,,,,,,
15004005,0983,29345,,,,,APPLICATION OF LONG LEG CAST,473.07,473.07,,,,,,,,,,,,,
15004006,0983,29405,,,,,APPLY SHORT LEG CAST,312.56,312.56,,,,,,,,,,,,,
15004007,0983,29425,,,,,APPLY WLKR SHORT LEG CAST,338.96,338.96,,,,,,,,,,,,,
15004008,0983,29105,,,,,APPLY LONG ARM SPLINT,348.47,348.47,,,,,,,,,,,,,
15004009,0983,29125,,,,,APPLY FOREARM SPLINT,258.71,258.71,,,,,,,,,,,,,
15004010,0983,29130,,,,,APPLICATION OF FINGER SPLINT,150.41,150.41,,,,,,,,,,,,,
15004011,0983,29515,,,,,APPLICATION OF LOWER LEG SPLINT,260.82,260.82,,,,,,,,,,,,,
15101001,0975,27125,,,,,"PARTIAL HIP REPL, PROSTHESIS",4192.91,4192.91,,,,,,,,,,,,,
15101002,0975,27130,,,,,TOTAL HIP ARTHROPL,5751.61,5751.61,,,,,,,,,,,,,
15101003,0975,27132,,,,,CONV TO TOTAL HIP ARTHROPL,6840.53,6840.53,,,,,,,,,,,,,
15101004,0975,27134,,,,,"REVISE TOTAL HIP ARTHROPL, BOTH COMP",7919.15,7919.15,,,,,,,,,,,,,
15101005,0975,27137,,,,,"REVISE TOTAL HIP ARTHROPL, ACETABUL",6094.66,6094.66,,,,,,,,,,,,,
15101006,0975,27138,,,,,"REVISE TOTAL HIP ARTHROPL, FEMORAL",6257.43,6257.43,,,,,,,,,,,,,
15101007,0975,27445,,,,,"ARTHROPL KNEE, CONTRAINED PROSTH",5761.91,5761.91,,,,,,,,,,,,,
15101008,0975,27446,,,,,"ARTHROPL KNEE C&P, MEDIAL LAT",4964.53,4964.53,,,,,,,,,,,,,
15101009,0975,27447,,,,,TOT KNEE ARTHROPLASTY,6476.87,6476.87,,,,,,,,,,,,,
15101010,0975,27486,,,,,REVISE/REPLACE KNEE JOINT 1 COMPONENT,5895.83,5895.83,,,,,,,,,,,,,
15101011,0975,27487,,,,,REVISE/REPLACE KNEE JOINT TIB&FIB COMPON,7824.37,7824.37,,,,,,,,,,,,,
15101012,0975,25608,,,,,TREAT FX RAD INTRA-ARTICUL; 2 FRAGS,3078.11,3078.11,,,,,,,,,,,,,
15101013,0975,25000,,,,,INSC EXTENSOR TENDON SHEATH,1569.15,1569.15,,,,,,,,,,,,,
15101014,0975,27130AS,,,,,TOTAL HIP ARTHROPL-PA ASSIST,5751.61,5751.61,,,,,,,,,,,,,
15101015,0975,27447AS,,,,,TOT KNEE ARTHROPLASTY-PA ASST,6476.87,6476.87,,,,,,,,,,,,,
15101016,0975,64450,,,,,INJ ANESTH; OTHR PERPHERAL NRV/BRANCH,237.59,237.59,,,,,,,,,,,,,
15101017,0975,24685,,,,,OPEN TX ULNAR FRACTURE PROXIMAL END,2738.09,2738.09,,,,,,,,,,,,,
15101018,0975,24685AS,,,,,OPEN TREATMENT ULNAR FRACTURE PA ASSIST,2738.09,2738.09,,,,,,,,,,,,,
15101019,0975,64447,,,,,INJ ANESTHETIC AGENT FEMORAL,863.77,863.77,,,,,,,,,,,,,
15101020,0360,,,,,,ORTHOPEDICS I,113.52,113.52,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
15101021,0360,,,,,,ORTHOPEDICS II,114.83,114.83,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
15101022,0360,,,,,,ORTHOPEDICS III,133.58,133.58,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
15101023,0360,,,,,,ORTHOPEDICS IV,137.28,137.28,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
15101024,0360,,,,,,ORTHOPEDICS V,148.63,148.63,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
15101025,0975,27245,,,,,TREAT INTER PR SUBTRCHNTRIC FEM FX 1,5828.87,5828.87,,,,,,,,,,,,,
15101026,0975,27245AS,,,,,TREAT INTER PR SUBTRCHNTRIC FEM FX 1-PA,5828.87,5828.87,,,,,,,,,,,,,
15101027,0975,29880,,,,,ARTHRS KNEE W/MENISCECTOMY MED,4157.89,4157.89,,,,,,,,,,,,,
15101028,0360,,,,,,ORTHOPEDICS MINOR PROCEDURE,2167.61,2167.61,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
15101029,0975,23130,,,,,ACROMIOPL/ACROMIONECT PARTIAL,2229.12,2229.12,,,,,,,,,,,,,
15101030,0975,23412,,,,,REPAIR ROTATOR CUFF; CHRONIC,3725.41,3725.41,,,,,,,,,,,,,
15101031,0975,23130AS,,,,,ACROMIOPL/ACROMIONECT PARTIAL-ASST,2392.46,2392.46,,,,,,,,,,,,,
15101032,0975,23412AS,,,,,REPAIR ROTATOR CUFF; CHRONIC-ASST,3725.41,3725.41,,,,,,,,,,,,,
15101033,0975,29881,,,,,KNEE ARTHROPLASTY SURG W/ MENISCECTOMY,3422.32,3422.32,,,,,,,,,,,,,
15101034,0975,26123,,,,,FASCT PRTL PALMAR 1 DGT PROX IPHA,4081.26,4081.26,,,,,,,,,,,,,
15101035,0975,26125,,,,,FASCT PRTL PALMAR ADDL DGT PROX IPHA,1575.49,1575.49,,,,,,,,,,,,,
15101036,0975,27570,,,,,MANIPULATE KNEE JNT UNDER ANESTH,810.97,810.97,,,,,,,,,,,,,
15101037,0975,64721,,,,,NEUROPLASTY MEDIAN NERVE AT CARP TUNNEL,1983.13,1983.13,,,,,,,,,,,,,
15101038,0975,27236,,,,,BIPOLAR HIP REPLACEMENT,5227.23,5227.23,,,,,,,,,,,,,
15101039,0975,27236AS,,,,,BIPOLAR HIP REPLACEMENT-ASST,5227.23,5227.23,,,,,,,,,,,,,
15101040,0975,25609,,,,,TREAT FX RADIAL 3 + FRAG,4044.31,4044.31,,,,,,,,,,,,,
15101041,0975,25609AS,,,,,TREAT FX RADIAL 3 + FRAG,4044.31,4044.31,,,,,,,,,,,,,
15101042,0975,64718,,,,,NEUROPLASTY ULNAR NERVE AT ELBOW,2504.42,2504.42,,,,,,,,,,,,,
15101043,0975,24105,,,,,EXCISE OLECRANON BURSA,1520.58,1520.58,,,,,,,,,,,,,
15101044,0975,27332,,,,,ARTHROT KNEE W MENISC MED OR LAT,2907.04,2907.04,,,,,,,,,,,,,
15101045,0975,27792,,,,,OPEN TX DISTAL FIBULAR FRACT LAT MALLEOL,2686.76,2686.76,,,,,,,,,,,,,
15101046,0975,27766,,,,,OPEN TREATMENT MEDIAL MALLEOLUS,2638.83,2638.83,,,,,,,,,,,,,
15101047,0975,27792AS,,,,,OPEN TX DISTAL FIBULAR FRACT LAT MALLEOL,2686.76,2686.76,,,,,,,,,,,,,
15101048,0975,27766AS,,,,,OPEN TREATMENT MEDIAL MALLEOLUS,2638.83,2638.83,,,,,,,,,,,,,
15101049,0975,29807,,,,,ARTHROSCOPY SHOULDER SURGICAL REPAIR OF,4363.21,4363.21,,,,,,,,,,,,,
15101051,0975,29827,,,,,ARTHROSCOPY SHOULDER SURGICAL WITH ROTAT,4511.25,4511.25,,,,,,,,,,,,,
15101052,0975,27132AS,,,,,CONV TO TOTAL HIP ARTHROPL,6840.53,6840.53,,,,,,,,,,,,,
15101053,0975,29875,,,,,ARTHROSCOPY KNEE SYNOVECTOMY L,2683.18,2683.18,,,,,,,,,,,,,
15101054,0975,29879,,,,,ARTHROSCOPY KNEE; ABRAS ARTHROPL,3242.83,3242.83,,,,,,,,,,,,,
15101055,0975,26160,,,,,EXC TNDN SHTH LES HND/FING,2240.73,2240.73,,,,,,,,,,,,,
15101056,0975,26055,,,,,TENDON SHEATH INCISION,2223.84,2223.84,,,,,,,,,,,,,
15101057,0975,23420,,,,,RECONSTRUCTION ROTATOR CUFF AV,3707.46,3707.46,,,,,,,,,,,,,
15101058,0975,23420AS,,,,,RECONSTRUCTION ROTATOR CUFF AV,3707.46,3707.46,,,,,,,,,,,,,
15101059,0975,23410,,,,,OPEN REPAIR ROTATOR CUFF,3401.23,3401.23,,,,,,,,,,,,,
15101060,0975,23410AS,,,,,OPEN REPAIR ROTATOR CUFF,3401.23,3401.23,,,,,,,,,,,,,
15101061,0975,25608AS,,,,,TREAT FX RAD INTRA-ARTICUL; 2 FRAGS,2987.88,2987.88,,,,,,,,,,,,,
15101062,0975,25607,,,,,TREAT FX RAD EXTRA-ARTICUL,8215.33,8215.33,,,,,,,,,,,,,
15101063,0975,25607AS,,,,,TREAT FX RAD EXTRA-ARTICUL,8215.33,8215.33,,,,,,,,,,,,,
15101064,0975,11424,,,,,EXCBLES S/N/EX G 3.1-4.0 CM,2605.04,2605.04,,,,,,,,,,,,,
15101065,0975,29879AS,,,,,ARTHROSCOPY KNEE; ABRAS ARTHROPL,3242.83,3242.83,,,,,,,,,,,,,
15101066,0975,29881AS,,,,,KNEE ARTHROSCOPY/SURGERY,3507.88,3507.88,,,,,,,,,,,,,
15101067,0975,27814,,,,,OPEN TX BIMALLEOLAR ANKLE FX,9648.35,9648.35,,,,,,,,,,,,,
15101068,0975,26735,,,,,OPEN TX PHALANG SHAFT FRACT PROX/MIDDLE,5437.68,5437.68,,,,,,,,,,,,,
15101069,0975,26765,,,,,OPEN TX DISTAL PHALANG FRACT EA,4001.27,4001.27,,,,,,,,,,,,,
15101070,0975,26410,,,,,REP ET HAND WO FG EA TENDON,2952.45,2952.45,,,,,,,,,,,,,
15101071,0975,11760,,,,,REPAIR NAIL BED,1019.66,1019.66,,,,,,,,,,,,,
15101072,0975,27814AS,,,,,OPEN TX BIMALLEOLAR ANKLE FX,9648.35,9648.35,,,,,,,,,,,,,
15101073,0975,27829,,,,,TREAT LOWER LEG JOINT,2810.70,2810.70,,,,,,,,,,,,,
15101074,0975,10140,,,,,I&D HEMATOMA/FLUID,983.49,983.49,,,,,,,,,,,,,
15101075,0975,11042,,,,,DEB SUBQ TISSUE 20 SQ CM,724.67,724.67,,,,,,,,,,,,,
15101076,0975,24359,,,,,REPAIR ELBOW DEB/ATTCH OPEN,4221.41,4221.41,,,,,,,,,,,,,
15101077,0975,27266,,,,,CL TX POSTOP HIP DISLOC W ANESTH,2369.69,2369.69,,,,,,,,,,,,,
15101078,0975,27235,,,,,PERC FIX FEM PROX NK FX,3029.14,3029.14,,,,,,,,,,,,,
15101079,0975,27266AS,,,,,CL TX POSTOP HIP DISLOC W ANESTH,2369.69,2369.69,,,,,,,,,,,,,
15101080,0975,29880AS,,,,,ARTHRS KNEE W/MENISCECTOMY MED,4261.84,4261.84,,,,,,,,,,,,,
15101081,0975,26727,,,,,PERC SK FIX UNST PHAL SHFT FX PR/MID PH,1402.76,1402.76,,,,,,,,,,,,,
15101082,0975,25111,,,,,EXC 1' WRITS GANGLION,998.28,998.28,,,,,,,,,,,,,
15101083,0636,J7325,,,,,SYNVISC OR SYNVISC-ONE 1 MG,109.93,109.93,,,,,,,,,,,,,
15101084,0975,20680,,,,,REM IMPL DEEP,1409.23,1409.23,,,,,,,,,,,,,
15101085,0975,20551,,,,,INJ TENDON ORIGIN/INSERT,128.76,128.76,,,,,,,,,,,,,
15101086,0975,27760,,,,,CL TX MEDIAL ANKLE FX,918.40,918.40,,,,,,,,,,,,,
15101087,0975,11044,,,,,DEB BONE 20 SQ CM,711.26,711.26,,,,,,,,,,,,,
15101088,0975,23600,,,,,CL TX PROX HUMERAL FX WO MANIP,933.02,933.02,,,,,,,,,,,,,
15101089,0975,27758,,,,,TREATMENT OF TIBIA FRACTURE,2783.72,2783.72,,,,,,,,,,,,,
15101090,0975,27758AS,,,,,TREATMENT OF TIBIA FRACTURE,2783.72,2783.72,,,,,,,,,,,,,
15101091,0975,25622,,,,,CL TX CARPAL SCAPHOID FX WO MANIP,831.84,831.84,,,,,,,,,,,,,
15101092,0975,27259,,,,,OP TX SP HIP DISLOC W FEM SHORTEN,4762.17,4762.17,,,,,,,,,,,,,
15101093,0975,25600,,,,,CLTX DSTL RADIAL FX/SPIPHYSL SEP WO MNP,843.08,843.08,,,,,,,,,,,,,
15101094,0975,26750,,,,,CL TX D PHAL FX FGR/THMB WO MANIP,576.36,576.36,,,,,,,,,,,,,
15101095,0975,27333,,,,,ARTHROT KNEE W MENISC; MED & LAT,2132.75,2132.75,,,,,,,,,,,,,
15101096,0975,27524,,,,,OP TX PATEL FX W IF &/REP,2487.36,2487.36,,,,,,,,,,,,,
15101097,0975,27524AS,,,,,OP TX PATEL FX W IF &/REP,2487.36,2487.36,,,,,,,,,,,,,
15101098,0983,2060050,,,,,DRAIN/INJ SMALL JOINT/BURSA W/O US BILAT,273.98,273.98,,,,,,,,,,,,,
15101099,0983,2060550,,,,,DRAIN/INJ INTER JOINT/BURSA W/O US BILAT,310.49,310.49,,,,,,,,,,,,,
15101100,0975,12020,,,,,TX S WND DEHISC; SMPL,548.38,548.38,,,,,,,,,,,,,
15101101,0975,24516,,,,,TX HUMERUS SH FX W IMPANT,2739.82,2739.82,,,,,,,,,,,,,
15101102,0975,27506,,,,,OP TX FEM SFT FX W INS IM IMPL,3999.55,3999.55,,,,,,,,,,,,,
15101103,0975,29876,,,,,KNEE ARTHROSCOPY/SURGERY 2+ COMPART,2299.07,2299.07,,,,,,,,,,,,,
15102000,0983,2061050,,,,,DRAIN/INJ MAJOR JOINT/BURSA W/O US BILAT,384.89,384.89,,,,,,,,,,,,,
15102001,0983,20552,,,,,INJ TRIGGER POINT 1/2 MUSCL,229.14,229.14,,,,,,,,,,,,,
15102002,0983,29540,,,,,STRAPPING ANKLE AND/OR FOOT,74.83,74.83,,,,,,,,,,,,,
16000001,0271,,,,,,DNU BAG OSTOMY 1 3/4  DRAINABLE0,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000002,0270,A4389,,,,,BAG OSTOMY 1 3/4  DRAINABLE,20.50,20.50,,,,,,,,,,,,,
16000003,0272,,,,,,SUTURE PROLENE 4-0 PC-5 ETH 8631G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000004,0272,,,,,,SUTURE ETHILON 4-0 PC-5 ETH 1894G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000006,0272,,,,,,SUTURE ETHILON 5-0 PC-3 ETH 1965G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000007,0272,,,,,,SUTURE ETHILON 6-0 PC-1,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000008,0272,,,,,,SUTURE CHROMIC 5-0 P-3 ETH 687G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000009,0272,,,,,,DASH IT HALLOW  DIRECT ACESS,1300.43,1300.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600001,0270,,,,,,DNU SWITCH NETGEAR,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16000010,0272,,,,,,SUTURE PROLENE 6-0 BV-1 30  ETH 8709H,59.80,59.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000011,0272,,,,,,FROVA INTUBATING INTRODUCER 8F,320.98,320.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000012,0272,,,,,,RAPI-FIT FROVA INTUBATING INTRODUCER 14F,308.15,308.15,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000013,0272,,,,,,RAPID-FIT FROVA INTUBATING INTRODUCER 14,261.04,261.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000014,0272,,,,,,RETOGRADE INTUBATION SET 11F,522.23,522.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000015,0272,,,,,,RETROGRADE INTUBATION SET REPLACEMENT WI,192.67,192.67,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000016,0272,,,,,,SUTURE GORTEX 2-0 CV-2 2N08A,75.31,75.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000017,0272,,,,,,SUTURE VICRYL 4-0 RB-1 ETH J214H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000018,0258,,,,,,SHIELD EYE WITH GARTER,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16000019,0272,,,,,,SUTURE VICRYL 3-0 TIES ETH J110T,27.74,27.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000020,0272,,,,,,SOFT TIPPED AIRWAY EXCHANGE CATHETER 11F,211.58,211.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000022,0272,,,,,,SUTURE CHROMIC 3-0 SH ETH G122H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000023,0272,,,,,,SUTURE MONOCRYL 4-0 PS-2 ETH Y426H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000025,0272,,,,,,ENK OXYGEN FLOW MODULATOR SET 6F,466.79,466.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000027,0272,,,,,,SUTURE SILK 2-0 18  TIE ETH A185H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000033,0272,,,,,,SUTURE RETENTION BRIDGES ETH RSB5,35.18,35.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000035,0272,,,,,,SUTURE PROLENE 4-0 RB-1 ETH 8557H,28.07,28.07,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000036,0272,A4344,,,,,CATH SILICONE 16FR 5CC,22.44,22.44,,,,,,,,,,,,,
16000037,0272,,,,,,SUTURE PROLENE 5-0 C-1 ETH 8720H,50.31,50.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000038,0272,A4344,,,,,CATH SILICONE 18FR 5CC,20.50,20.50,,,,,,,,,,,,,
16000041,0272,A4344,,,,,CATH SILICONE 24FR 5CC,20.50,20.50,,,,,,,,,,,,,
16000042,0272,,,,,,SUTURE PROLENE 5-0 P-3 ETH 8698G,23.28,23.28,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000044,0272,A4344,,,,,CATH SILICONE 28FR 5CC,20.50,20.50,,,,,,,,,,,,,
16000047,0272,,,,,,SUTURE SILK 2-0 K-S ETH 623H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000048,0272,,,,,,SUTURE ETHILON 6-0 C-2 ETH 667G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000049,0272,,,,,,SUTURE ETHILON 2-0 ETH 664G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000050,0272,,,,,,SUTURE ETHILON 3-0 FS-1 ETH 663H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000051,0272,,,,,,SUTURE ETHILON 4-0 FS-2 ETH 662G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000052,0272,,,,,,SUTURE ETHILON 6-0 PS-3 ETH 1665G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000053,0272,,,,,,SUTURE ETHILON 4-0 FS-2 ETH 662H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000055,0272,,,,,,SUTURE PROLENE #1 TP-1 LOOPED ETH D9487,159.60,159.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000056,0272,,,,,,SUTURE PROLENE MONO BLUE 1.60 TP-1 ETH 8,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000057,0272,,,,,,SUTURE PDS #1 TP-1 LOOPED ETH Z880G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000058,0272,,,,,,SUTURE PROLENE 0 SH ETH 8834H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000059,0272,A4415,,,,,DNU BAG BLUE 2 3/4  (70MM)FLANGE,26.50,0.00,,,,,,,,,,,,,
1600006,0270,,,,,,DNU CULTURETTE SWABS DUAL FOR STRESS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16000060,0272,A4425,,,,,DNU BAG POUCH BLUE 2 3/4  (70MM)FLANGE,21.00,0.00,,,,,,,,,,,,,
16000061,0270,A4371,,,,,POWDER PREMIUM (OSTOMY CARE),20.50,20.50,,,,,,,,,,,,,
16000062,0271,A4385,,,,,DNU RINGS BARRIER INSIDE DIA 1 3/16,25.00,0.00,,,,,,,,,,,,,
16000063,0272,,,,,,SUTURE SILK 3-0 18  TIES  ETH A-184H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000064,0272,,,,,,SUTURE SILK 3-0 30  TIES ETH A304H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000065,0272,A4385,,,,,DNU STRIPS BARRIER SZ/60 GRAMS,31.00,0.00,,,,,,,,,,,,,
16000072,0272,,,,,,SUTURE SILK 2-0 FS ETH 685-G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000074,0272,,,,,,SUTURE ETHILON 3-0 FS-1 ETH 663G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000077,0272,,,,,,SUTURE PROLENE #1 CT-X ETH 8455-H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000078,0272,,,,,,SUTURE PROLENE 0 V-34 ETH 8444H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000079,0272,,,,,,SUTURE PROLENE 3-0 FS-2 ETH 8665G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600008,0270,,,,,,DNU ELECTRODES DIAGNOSTIC,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16000080,0272,,,,,,SUTURE PROLENE 7-0 P-6 ETH 8648G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000084,0272,,,,,,SUTURE SILK 2-0 SH 30  ETH K833H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000085,0272,A4338,,,,,*BRAVO CAPSULE DELIVERY SYSTEM,989.83,989.83,,,,,,,,,,,,,
16000086,0272,,,,,,PATENCY CAPSULE,126.08,126.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000087,0272,A4338,,,,,*BRAVO CAPSULE DELVRY STM NON CALIBR NEW,1018.51,1018.51,,,,,,,,,,,,,
16000090,0272,,,,,,CATH MALECOT 26FR,105.52,105.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000091,0272,,,,,,SUTURE PDS #1 TP-1 ETH Z879G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000092,0272,,,,,,SUTURE PDS 4-0 RB-1 ETH Z304H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000093,0272,,,,,,SUTURE PDS 0 CT-2 ETH Z334H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000095,0272,,,,,,SUTURE PDS 2-0 CT-1 ETH Z339H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000096,0272,,,,,,SUTURE PDS 3-0 SH ETH Z316H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000097,0272,,,,,,SUTURE PDS 2-0 SH ETH Z317H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000101,0272,,,,,,SUTURE PDS 5-0 II P-3 ETH Z493G,24.58,24.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000102,0272,,,,,,DNU GASKET OSTOMY LOOP KARAYA,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000107,0272,,,,,,SUTURE CHROMIC 2-0 CT-3 ETH 893H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000108,0272,,,,,,SUTURE PROLENE 6-0 P-1 ETH 8697G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000109,0272,,,,,,SUTURE CHROMIC 3-0  RB-1 ETHU204H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000119,0272,,,,,,SUTURE SILK 2-0 SH CR/8 ETH C012D,29.37,29.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000120,0272,,,,,,SUTURE SILK 3-0 SH CR/8  ETH C013D,29.20,29.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000121,0272,,,,,,SUTURE SILK 3-0 SH 30  CR/8 ETH C017T,32.56,32.56,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000122,0272,,,,,,SUTURE SILK 4-0 30  TIES  ETH SA83H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000123,0272,,,,,,SUTURE VICRYL 2-0 SH CR/8  ETH C013D,37.06,37.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000125,0272,,,,,,SUTURE SILK 4-0 30  TIES  ETH A303H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000126,0272,,,,,,SUTURE MONOCRYL 3-0 PS-1 ETH Y936H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000127,0272,,,,,,SUTURE MONOCRYL 2-0 ETH Y945H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000128,0272,,,,,,SUTURE MONOCRYL 3-0 PS-2 ETH Y497G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600013,0272,,,,,,CORE MAESTRO DIFFUSER,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000139,0272,,,,,,CATH FOGARTY BILRY 5F,345.82,345.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600014,0272,,,,,,CORE MAESTRO OIL CARTRIDGE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000152,0272,,,,,,SHEATH 23CM BRITE TI,164.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000153,0272,,,,,,CATH 7.5FR CHOLANGOGRAM,170.72,170.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000155,0272,,,,,,STETHOSCOPE ESOPHAGEAL,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000156,0272,,,,,,GELPORT  LAPAROSCOPIC  SYSTEM,1962.62,1962.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000158,0272,,,,,,CATH MUSHROOM 45FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000162,0272,,,,,,CATH THORACIC 16FR,31.22,31.22,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000163,0272,,,,,,CATH THORACIC 20FR,46.57,46.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000173,0272,,,,,,BRUSH CYTOLOGY DISPOSABLE,137.08,137.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000175,0272,,,,,,NEEDLE INTRAOSSEOUS 15G 25MM 40KGS,466.24,466.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000176,0272,,,,,,NEEDLE INTRAOSSEOUS 15G 15MM 3-39KGS,463.52,463.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000177,0272,,,,,,NEEDLE INTRAOSSEOUS 15G 45MM BARIATRIC,463.52,463.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000178,0272,,,,,,EZ-STABILIZER,75.64,75.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000180,0278,C1768,,,,,GRAFT BIFURCATED 16 X,1467.68,1467.68,,,,,,,,,,,,,
16000181,0278,C1768,,,,,GRAFT AAA BIFURCATED MAIN BODY,25257.67,25257.67,,,,,,,,,,,,,
16000182,0278,C1768,,,,,GRAFT AAA ILIAC LEG GRAFT,9215.63,9215.63,,,,,,,,,,,,,
16000183,0278,C1768,,,,,GRAFT AAA ILIAC LEG GRAFT,9215.63,9215.63,,,,,,,,,,,,,
16000185,0278,,,,,,GRAFT,1791.93,1791.93,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16000186,0278,C1768,,,,,GRAFT HEMASHIELD GOLD 20MMX10MMXL40CM,3122.08,3122.08,,,,,,,,,,,,,
16000187,0278,C1768,,,,,GRAFT HEMASHIELD GOLD 22MMX11MMXL40CM,2730.56,2730.56,,,,,,,,,,,,,
16000189,0272,,,,,,SUTURE VICRYL 4-0 TF ETH J434H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000191,0272,,,,,,DRESSING HYDROFERA BLUE W/FILM 4X4,26.34,26.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000192,0272,,,,,,WIPE INSTRUMENT-MENTR,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000193,0271,,,,,,MEDIHONEY 1.5OZ TUBE,48.88,48.88,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000194,0272,A6262,,,,,MEDIFIL PARTICLES COLLAGEN 1GR,77.71,77.71,,,,,,,,,,,,,
16000195,0278,C1781,,,,,MESH FLAT SHEET 6X6,654.32,654.32,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000196,0278,C1781,,,,,PHASIX PLUG AND PATCH,758.14,758.14,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000197,0278,C1781,,,,,PROLENE HERNIA SYSTEM MESH,1757.79,1757.79,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000198,0278,C1781,,,,,PHASIX MESH 3x4,6979.99,6979.99,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000199,0272,,,,,,SUTURE ETHILON 5-0 P-3 ETH 698-G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000200,0278,C1757,,,,,CATH FOGARTY ART EMB 4FR 80 LATEX FREE,190.01,190.01,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000201,0278,C1757,,,,,CATH FOGARTY ART EMB 3 FR LATEX FREE,191.02,191.02,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000202,0278,C1757,,,,,CATH ART EMB 3 FR,187.80,187.80,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000203,0278,C1757,,,,,CATH ANGIOGRAPHIC 4FR BERN 65CM,58.84,58.84,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000204,0278,C1757,,,,,CATH ART EMB 4FR 80,187.80,187.80,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000205,0278,C1781,,,,,PHASIX MESH 4x6,9352.16,9352.16,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000206,0278,C1757,,,,,CATH ART EMBOLECTOMY 5FR,187.73,187.73,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000207,0278,C1781,,,,,MESH PROLENE 3.0 X 6.,384.29,384.29,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000208,0278,C1781,,,,,MESH PROLENE 12 X 12,400.88,400.88,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000209,0278,C1781,,,,,MESH OVAL 4X6,1218.75,1218.75,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000210,0278,C1781,,,,,PHASIX MESH 6X8,15359.39,15359.39,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000211,0272,,,,,,DRESSING  AQUACEL  AG 4.5  X 4,37.14,37.14,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000212,0278,C1768,,,,,GRAFT PTFE BIFURCATED 18X9X40,3198.16,3198.16,,,,,,,,,,,,,
16000213,0278,C1768,,,,,GRAFT PTFE BIFURCATED 20X10X40,1618.64,1618.64,,,,,,,,,,,,,
16000214,0278,C1781,,,,,PHASIX MESH 8x10,25940.31,25940.31,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000215,0278,C1768,,,,,GRAFT THIN WALL 8MMX60CM,4242.61,4242.61,,,,,,,,,,,,,
16000216,0272,,,,,,T-ANCHORS HERNIA SET,204.19,204.19,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000217,0278,C1781,,,,,MESH PROLENE 3.0 X 6.0 PROLITE,238.93,238.93,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000218,0278,C1781,,,,,SURGIMESH XB,5631.78,5631.78,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000219,0278,C1757,,,,,CATH ART EMB,190.01,190.01,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000220,0278,C1768,,,,,GRAFT VASC 6MM 40CM,2518.94,2518.94,,,,,,,,,,,,,
16000221,0278,C1768,,,,,GRAFT 18 X 9MM BIFR,0.00,0.00,,,,,,,,,,,,,
16000222,0278,C1768,,,,,GRAFT VASC 4MM-7MM THIN-WALLED,5816.09,5816.09,,,,,,,,,,,,,
16000223,0278,C1768,,,,,GRAFT RINGED 6 X 90,4665.84,4665.84,,,,,,,,,,,,,
16000224,0278,,,,,,KII FIOS FIRST ENTRY 11MM X 150M,204.87,204.87,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16000225,0278,C1781,,,,,PHASIX MESH 10x12,50242.28,50242.28,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000226,0278,C1768,,,,,GRAFT VASC 14MMX7MM 40 CM,3119.66,3119.66,,,,,,,,,,,,,
16000227,0278,C1768,,,,,GRAFT VASC 12MMX6MM 40 CM,2450.67,2450.67,,,,,,,,,,,,,
16000228,0278,C1768,,,,,GRAFT HEMASHIELD GOLD,2730.56,2730.56,,,,,,,,,,,,,
16000229,0278,C1768,,,,,GRAFT HEMASHIELD GOLD,2730.56,2730.56,,,,,,,,,,,,,
16000230,0278,C1781,,,,,PHASIX MESH 15CMX20CM,26384.02,26384.02,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000235,0278,C1768,,,,,GRAFT VASC 8MM 80CM,5334.83,5334.83,,,,,,,,,,,,,
16000237,0278,C1768,,,,,GRAFT VASC 6-4.5X80CM DISTAFLOW,8277.01,8277.01,,,,,,,,,,,,,
16000238,0278,C1768,,,,,GRAFT VASC 6MMX80CM FLEX SM W/STAND,6607.95,6607.95,,,,,,,,,,,,,
16000240,0278,C1768,,,,,GRAFT THIN WALL 6MMX60CM PTFE,4242.61,4242.61,,,,,,,,,,,,,
16000241,0278,C1768,,,,,GRAFT DERMAL & EPIDERMAL TISSUE,6655.73,6655.73,,,,,,,,,,,,,
16000242,0278,C1768,,,,,VASCULAR GRAFT 35 CM,4911.60,4911.60,,,,,,,,,,,,,
16000245,0278,C1768,,,,,DERMIS AXIS 6X8 CM,5836.57,5836.57,,,,,,,,,,,,,
16000248,0278,C1768,,,,,VASCULAR GRAFT,4546.38,4546.38,,,,,,,,,,,,,
16000251,0278,C1768,,,,,GRAFT VASC 6MMX40CM,3583.86,3583.86,,,,,,,,,,,,,
16000252,0278,C1768,,,,,GRAFT VASC 8MMX80CM,6826.40,6826.40,,,,,,,,,,,,,
16000253,0278,C1768,,,,,GRAFT VASC 6MMX80CM,8055.15,8055.15,,,,,,,,,,,,,
16000254,0278,C1768,,,,,GRAFT VASC 8MMX80CM,8140.48,8140.48,,,,,,,,,,,,,
16000255,0278,C1768,,,,,GRAFT VASC 4MMX7MMTAPEREDX45CM,4106.08,4106.08,,,,,,,,,,,,,
16000271,0278,C1768,,,,,GRAFT VASC 8MM-100CM THIN-WALLED,5396.27,5396.27,,,,,,,,,,,,,
16000272,0278,C1768,,,,,GRAFT 4.5MM-6.5MMX70CM THIN WALLED,2925.11,2925.11,,,,,,,,,,,,,
16000273,0278,C1874,,,,,STENT GUIDE LEMAITRE,199.30,199.30,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000274,0278,C1768,,,,,GRAFT VASC 8MM-58CM THIN-WALLED,2787.35,2787.35,,,,,,,,,,,,,
16000275,0278,C1768,,,,,GRAFT VASC 8MM-42CM THIN-WALLED,2018.43,2018.43,,,,,,,,,,,,,
16000278,0271,,,,,,STOCKING DONNER,125.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000279,0272,,,,,,STAPLER ROTCUL55-4.8,914.46,914.46,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000280,0272,,,,,,STAPLER ROTCUL55-4.8,739.57,739.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000287,0272,,,,,,PAPILLOTOME COTTON DOUBLE LUMEN,533.04,533.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000293,0278,C1769,,,,,GUIDE WIRE THSF 35 480,0.00,0.00,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16000294,0278,C1769,,,,,GUIDE WIRE 7.5 35-480,354.97,354.97,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16000313,0272,,,,,,NEEDLE SPINAL 20GX3.54MONO,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000322,0272,,,,,,SUTURE DEXON PRE-1 ETH 9532-215-0,29.80,29.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000333,0272,,,,,,SUTURE SILK 3-0 PS-1 ETH 1684G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000436,0271,,,,,,NEBULIZER VORTRAN PERCUSSIVE,334.50,334.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000437,0270,,,,,,EXERCISER VOLUMETRIC 4000ML,20.50,20.50,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16000443,0272,,,,,,AQUA-PACK,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000444,0272,,,,,,AQUA-PACK 1000 ML,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000450,0272,,,,,,LINE PRESSURE MONITOR,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000456,0272,,,,,,SUTURE PDS 0 CT-1 ETH Z346H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000472,0272,,,,,,CATHETER -PTA DILATATION,710.75,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000473,0272,,,,,,S-CURVE URETHRAL DILATOR SET W/ AQ HYDRO,920.38,920.38,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000474,0278,C1769,,,,,GUIDE WIRE PC ROADRUNNER,204.87,204.87,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16000475,0272,,,,,,CYSTIC DUCT INTRODUCER,319.14,319.14,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000476,0272,,,,,,S-CURVE URETHRAL DILATOR 22 FR,162.68,162.68,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000477,0272,,,,,,SUTURE VICRYL 2-0 SH ETH J417H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000478,0278,C1769,,,,,GUIDE WIRE ROADRUNNER .018 300CM,563.18,563.18,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16000485,0278,,,,,,GRAFT PRE SHAPED,3071.87,3071.87,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16000489,0278,C1768,,,,,GRAFT STRAIGHT 6MMX60CM REMV RING THIN W,4000.27,4000.27,,,,,,,,,,,,,
16000490,0278,C1768,,,,,GRAFT STRAIGHT 8MMX80CM PTFE REM RING TH,4495.18,4495.18,,,,,,,,,,,,,
16000493,0278,C1768,,,,,GRAFT DISTA FLOW SM CUFF 80CMX6M,6607.95,6607.95,,,,,,,,,,,,,
16000530,0278,C1874,,,,,STENT ICAST 8MMX38MMX80CM,8574.62,8574.62,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000531,0278,C1874,,,,,STENT ICAST 6MMX59MMX80CM,9240.61,9240.61,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000532,0278,C1874,,,,,STENT ICAST 10MMX38MMX80CM,8574.62,8574.62,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000533,0278,C1874,,,,,STENT TACSHIELD 3X6,1631.68,1631.68,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000534,0278,C1874,,,,,STENT TACSHIELD 4X6,1764.87,1764.87,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000535,0278,C1874,,,,,STENT TACSHIELD 5X5,1764.87,1764.87,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000536,0278,C1874,,,,,STENT TACSHIELD 6X8,2843.78,2843.78,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000537,0278,C1874,,,,,STENT TACSHIELD 8X10,4645.28,4645.28,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000538,0278,C1874,,,,,STENT TACSHIELD 8X12,5094.82,5094.82,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16000540,0272,,,,,,US CBL EXTNS DISPOSABLE,126.08,126.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000541,0272,,,,,,WRENCH KIT ASSEM-BLY KIT,147.09,147.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000553,0272,,,,,,VALVE-HEIMLICH,130.28,130.28,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000554,0272,,,,,,SUTURE VICRYL 5-0 TF ETH J433H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000590,0278,C1757,,,,,CATH ART EMB 7.5 FR,341.32,341.32,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000600,0272,,,,,,CATH MUSHROOM 32FR,34.72,34.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000611,0272,,,,,,CATH BRONCHO 41FR L,217.44,217.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000612,0272,,,,,,CATH BRONCHO 39F LEF,217.44,217.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000615,0272,,,,,,CATH BRONCHO 39FR RIG,178.51,178.51,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000617,0272,,,,,,CATH BRONCHO 37FR RIGH,178.51,178.51,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000618,0272,,,,,,CATH BRONCHO 37FR LEF,313.88,313.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000630,0278,C1757,,,,,CATH HEMO 20FR 30CC,20.50,20.50,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000631,0272,,,,,,CATH SILICONE 20FR 5CC,36.06,36.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000640,0278,C1757,,,,,CATH HEMO 22FR 30CC,20.50,20.50,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000641,0272,,,,,,CATH SILICONE 22FR 5CC RETENTION,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000645,0272,,,,,,SUTURE ETHILON 5-0 PC-5 ETH 1895G,22.23,22.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000650,0272,,,,,,CATH SILICONE 24FR 5CC RETENTION,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000651,0278,C1757,,,,,CATH HEMO 24FR 30CC,20.50,20.50,19.52,24.13,,,,,,,24.13,,,19.52,19.52
16000652,0272,,,,,,CATH THORACIC 24FR,33.54,33.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000653,0272,,,,,,CATH THORACIC STRAIGHT 28FR,22.61,22.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600066,0270,A4364,,,,,SPRAY ADHESIVE MEDICAL,0.00,0.00,,,,,,,,,,,,,
16000660,0272,,,,,,CATH THORACIC 36FR,21.05,21.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000665,0272,,,,,,CATH THORACIC 32FR,37.36,37.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000666,0272,,,,,,CATH THORACIC 36FR RIGHT ANGLE,76.65,76.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000668,0278,C1725,,,,,CATH SPIROFLEX 4F 135CM,5311.27,5311.27,471.51,471.51,,,,,,,471.51,,,,
16000669,0278,C1725,,,,,CATH SPIROFLEX 5F 135CM,5311.27,5311.27,471.51,471.51,,,,,,,471.51,,,,
16000670,0278,C1725,,,,,CATH SPIROFLEX 6F 120CM,6426.80,6426.80,471.51,471.51,,,,,,,471.51,,,,
16000671,0278,C1725,,,,,CATH SPIROFLEX 6F 90CM,7758.78,7758.78,471.51,471.51,,,,,,,471.51,,,,
16000672,0278,C1725,,,,,CATH SPIROFLEX 6F 50CM,2996.95,2996.95,471.51,471.51,,,,,,,471.51,,,,
16000690,0272,A4330,,,,,CATH COUNCIL 20FR 5CC TIP,51.35,51.35,,,,,,,,,,,,,
16000691,0272,,,,,,CATH 16FR 5CC LATEX,55.18,55.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000692,0272,,,,,,CATH 18FR 5CC LATEX,55.18,55.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000693,0272,C1758,,,,,"CATH, DUAL LUMEN URETHERAL",405.33,405.33,,,,,,,,,,,,,
16000694,0278,C1894,,,,,DILATOR 8/10 SHEATH SET,287.88,287.88,176.61,176.61,,,,,,,176.61,,,,
16000695,0272,,,,,,CATH COUNCIL 22FR 5CC,55.09,55.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000696,0272,A4330,,,,,CATH COUNCIL  TIP 16FR 5CC,81.73,81.73,,,,,,,,,,,,,
16000697,0272,A4330,,,,,CATH COUNCIL  TIP 18FR 5CC,81.73,81.73,,,,,,,,,,,,,
16000698,0272,A4330,,,,,CATH COUNCIL TIP 20FR 5CC,81.73,81.73,,,,,,,,,,,,,
16000699,0272,C1894,,,,,DILATOR NAVIGATION 12/14FR,673.83,673.83,,,,,,,,,,,,,
16000704,0272,,,,,,CATH FLEXIMA  APD J TIP 8X20,320.67,320.67,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000705,0272,,,,,,CATH ALL PURPOSE 10FR,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000706,0271,,,,,,DRAIN KIT PLEURX CATH,2894.39,2894.39,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000707,0272,,,,,,BRUSH CYTOLOGY 3.0/85,60.28,60.28,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000708,0271,,,,,,PLEURX PERITONEAL CATH KIT,1962.62,1962.62,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000709,0271,,,,,,PLEURX PERITONEAL CATHETER STARTER KIT,2894.39,2894.39,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000710,0272,,,,,,CATH ALL PURPOSE 16FR,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000711,0272,,,,,,CATH RED RUBBER COUDE TIP 16 FR,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000712,0272,,,,,,CATH ALL PURPOSE 20FR,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000713,0271,,,,,,PLEURX DRAINAGE SYSTEM 1000ML,201.38,201.38,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000716,0272,,,,,,MOSS G-TUBE PEG KIT 18FR,1748.55,1748.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000717,0272,,,,,,MOSS TUBE GASTROSTOMY 18FR,1228.75,1228.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000718,0272,,,,,,TUBE GASTRONOMY 18FR 20CC,331.09,331.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000719,0272,,,,,,TUBE GASTRONOMY 22FR 20CC,187.80,187.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000720,0272,,,,,,TUBE GASTROSTOMY 20FR 20CC,232.10,232.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000721,0272,,,,,,MEASURING STOMA DEVICE,134.48,134.48,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000722,0272,,,,,,TRAY INTRODUCER 9 FR,151.54,151.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000723,0272,,,,,,KIT BUTTON REPLACEMENT 18FR,956.96,956.96,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000724,0272,,,,,,KIT BUTTON REPLACEMENT 18FR X 2.4CM,1265.54,1265.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000725,0272,,,,,,CATH STRAIGHT 12,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000726,0272,,,,,,KIT BUTTON REPLACEMENT 18FR,382.27,382.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000727,0272,,,,,,KIT BUTTON REPLACEMENT 28FR X 2,1505.24,1505.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000728,0272,,,,,,KIT BUTTON REPLACEMENT 28,1266.30,1266.30,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000729,0272,,,,,,KIT BUTTON REPLACEMENT 28,1160.48,1160.48,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000730,0272,,,,,,KIT BUTTON REPLACEMENT 24,1505.24,1505.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000731,0272,,,,,,KIT BUTTON REPLACEMENT 24FR,1064.91,1064.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000732,0272,,,,,,KIT BUTTON REPLACEMENT 24,914.36,914.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000734,0272,,,,,,KIT BUTTON REPLACEMENT 24,892.90,892.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000735,0278,C1768,,,,,GRAFT BIFURCATED 16/,3198.16,3198.16,,,,,,,,,,,,,
16000736,0278,C1768,,,,,GRAFT BIFURCATED 18/9/,2662.29,2662.29,,,,,,,,,,,,,
16000737,0270,,,,,,EXERCISER VOLUMETRIC 2500ML,20.50,20.50,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16000738,0278,C1768,,,,,GRAFT HEMOSHIELD GOLD TUBE 16MMX30CM,1911.39,1911.39,,,,,,,,,,,,,
16000740,0278,C1768,,,,,GRAFT SURGISIS BIODESIGN 20X20,23346.28,23346.28,,,,,,,,,,,,,
16000742,0278,C1768,,,,,GRAFT SURGISIS BIODESIGN 20X30,32101.13,32101.13,,,,,,,,,,,,,
16000745,0272,,,,,,RETAINER FISC (FISH),112.21,112.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000746,0272,A4344,,,,,CATH SILICONE 12FR 5CC,20.50,20.50,,,,,,,,,,,,,
16000750,0272,,,,,,RETAINER GLASSMAN JUMBO,172.30,172.30,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000751,0272,,,,,,DEFOGGER FRED,64.59,64.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000752,0272,,,,,,SET BLOOD/FLUID WARMI,41.77,41.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000753,0272,,,,,,CATH SILICONE 22FR 5CC,30.68,30.68,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000756,0272,,,,,,CLEARIFY VISUALIZATION SYSTEM,176.04,176.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000765,0272,A4344,,,,,CATH SILICONE 24FR 5CC,22.78,22.78,,,,,,,,,,,,,
16000770,0272,,,,,,CATH SILICONE 26FR 5CC RETENTION,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000780,0272,,,,,,SYSTEM CD-SET BAXTER,120.99,120.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000791,0272,,,,,,CATH SILICONE 14FR 30CC,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000796,0272,,,,,,CATH SILICONE 16FR 30CC,21.18,21.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000798,0278,C1752,,,,,CATH HEMO 16FR 30CC,20.50,20.50,,,,,,,,,,,,,
1600080,0272,,,,,,DNU ASSEMBLY MANOSHIELD EG,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000800,0272,A4338,,,,,CATH SILICONE 18FR 30CC,20.50,20.50,,,,,,,,,,,,,
16000801,0278,C1768,,,,,GRAFT VASC VENAFLO II 6MMX40CM STRAI,2174.21,2174.21,,,,,,,,,,,,,
16000802,0272,A4344,,,,,CATHETER 6FR FOLEY  PEDIATRIC,93.38,93.38,,,,,,,,,,,,,
16000803,0272,A4344,,,,,CATHETER 8FR FOLEY  PEDIATRIC,24.08,24.08,,,,,,,,,,,,,
16000804,0272,,,,,,CATHETER - AINTREE INTUBATION,189.60,189.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000805,0272,,,,,,SPECI-CATH KIT FEMALE,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000806,0272,,,,,,CATH SILICONE 20FR 30CC,21.18,21.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000808,0272,,,,,,CATH SILICONE 20FR 30CC 2WAY,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000810,0272,,,,,,CATH SILICONE 22FR 30CC,26.68,26.68,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000812,0272,,,,,,DNU CATH SILICONE 24FR 30CC,58.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000815,0272,,,,,,CATH SILICONE 26FR 30CC,27.10,27.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000816,0278,C1768,,,,,GRAFT THIN WALLED REMOVABLE RINGS,4314.29,4314.29,,,,,,,,,,,,,
16000817,0272,,,,,,CATH SILICONE 28FR 5CC RETENTION,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000818,0278,C1768,,,,,GRAFT RINGED 10 X 80,4693.22,4693.22,,,,,,,,,,,,,
16000819,0278,C1768,,,,,GRAFT STRETCH 6MMX40CM,1720.25,1720.25,,,,,,,,,,,,,
16000823,0278,C1768,,,,,GRAFT VASC 6 X 10,5495.25,5495.25,,,,,,,,,,,,,
16000830,0272,A4344,,,,,CATH SILICONE 10FR 3CC M/L PEDIATRIC,32.52,32.52,,,,,,,,,,,,,
16000833,0278,C1768,,,,,GRAFT BI-FURCATED 16X8,3122.08,3122.08,,,,,,,,,,,,,
16000836,0278,C1768,,,,,GRAFT STRAIGHT 8MMX80,3341.52,3341.52,,,,,,,,,,,,,
16000837,0278,C1768,,,,,GRAFT VASC 6MMX40CM,3310.80,3310.80,,,,,,,,,,,,,
16000838,0278,,,,,,MESH ATRIUM CQUR 15X20CM,2480.54,2480.54,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16000843,0278,C1781,,,,,MESH PATCH DUAL 20X30,7543.17,7543.17,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000844,0278,C1781,,,,,MESH PATCH DUAL 15X19,4010.51,4010.51,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000845,0272,,,,,,CATH TEXAS STYLE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000846,0278,C1781,,,,,MESH PATCH DUAL10X15,2160.56,2160.56,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000847,0278,C1781,,,,,MESH PATCH SOFT TISSUE 15X,5928.72,5928.72,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000848,0278,C1768,,,,,GRAFT BIFURCATED KNITTED 12MMX6MM,2167.38,2167.38,,,,,,,,,,,,,
16000849,0278,C1768,,,,,GRAFT VASC PROPATEN 6MMX80CM,8055.15,8055.15,,,,,,,,,,,,,
16000850,0278,C1768,,,,,GRAFT VASC PROPATEN 6MMX50CM,5324.59,5324.59,,,,,,,,,,,,,
16000851,0278,C1768,,,,,GRAFT VASC PROPATEN 8MMX50CM,5324.59,5324.59,,,,,,,,,,,,,
16000852,0272,A4346,,,,,CATH 3WAY 18FR 5CC IRRIGATION,39.59,39.59,,,,,,,,,,,,,
16000853,0272,A4340,,,,,CATH 3WAY 16FR 5CC IRRIGATION,35.26,35.26,,,,,,,,,,,,,
16000855,0272,A4346,,,,,CATH 3WAY 22FR 30CC IRRIGATION,37.32,37.32,,,,,,,,,,,,,
16000857,0272,C1769,,,,,WIRE - K,366.00,0.00,,,,,,,,,,,,,
16000858,0278,,,,,,FIXION PF NAIL,2730.75,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16000859,0278,,,,,,FIXION PF PEG,795.75,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16000860,0272,A4346,,,,,CATH 3WAY 24FR 30CC,44.74,44.74,,,,,,,,,,,,,
16000865,0272,A4346,,,,,CATH 3WAY 26FR 30CC IRRIGATION,35.34,35.34,,,,,,,,,,,,,
16000867,0272,,,,,,CATH ANGIO 4FR-.035-100CM-JB2,67.08,67.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000868,0272,,,,,,CATH ANGIO 4FR-.035-100CM-H1,67.08,67.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000870,0272,,,,,,CATH URETHRAL 14F BAX,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000871,0272,,,,,,TROCAR ARGYLE 16FR,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000872,0272,,,,,,TROCAR ARGYLE 20FR,128.22,128.22,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000876,0272,,,,,,TRAY CATHETER 16 FR LF,29.00,29.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000877,0272,,,,,,CATH 8FR CONE TIP URETERAL,70.85,70.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000878,0272,,,,,,TRAY CATHETER W/D FDL,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000879,0272,,,,,,CATH 5FR CONE TIP URETERAL,69.08,69.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000882,0272,,,,,,CATH ANGIO 4FR-.035-100CM,58.84,58.84,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000883,0278,C1781,,,,,MESH SOFT TISUE 10 X,2058.16,2058.16,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16000884,0272,,,,,,CATH ANGIO 14G 5.25,52.57,52.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000888,0272,,,,,,PRO PORT SYSTEM,955.70,955.70,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000889,0278,,,,,,PORT TITANIUM IMPLATED W/CATH,2262.95,2262.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16000890,0272,,,,,,TRAY URETHRAL 14FR D,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000895,0272,,,,,,SET NEPHROSTOMY ULTRATHANE,724.14,724.14,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000896,0272,,,,,,PERCUTANEOUS NEPHROSTOMY SET,740.66,740.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000900,0272,,,,,,CATH NEPHROSTOMY 10FR PERCUFLEX,428.08,428.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000946,0272,,,,,,SUTURE VICRYL #1 CT-1 ETH J947H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16000969,0278,C1894,,,,,DILATOR NAVAGATION HD 12/14 FR,673.83,673.83,176.61,176.61,,,,,,,176.61,,,,
16000975,0271,,,,,,SM SLEEVE COMPRESSION,158.77,158.77,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000976,0271,,,,,,MED SLEEVE COMPRESSION,116.62,116.62,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000977,0271,,,,,,LG SLEEVE COMPRESSION,172.72,172.72,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000978,0271,,,,,,SLEEVE SCD EXTRA LARGE BARIATRIC,193.22,193.22,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16000979,0271,,,,,,SLEEVE SCD MEDIUM KNEE,146.50,146.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001001,0272,,,,,,SNARE 4FR AMPLTZ 10/,836.24,836.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001010,0272,,,,,,CATH PERCUTANEOUS 10F 30CM,209.34,209.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001012,0272,,,,,,CATH PERCUTANEOUS 12FR,184.39,184.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001023,0272,,,,,,SET TRIPLE PRESSURE,218.26,218.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001024,0272,,,,,,KIT PRESSURE MONITORI,75.64,75.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600103,0272,,,,,,DNU BLANKET BARRIER SKIN,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001032,0272,,,,,,SLIVARY DUCT CATHETER,324.26,324.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001040,0278,,,,,,SLING TRANSVAGINAL MID-URETHRAL SYSTEM,3037.75,3037.75,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001041,0278,C2631,,,,,T.V.T URINARY,2952.42,2952.42,,,,,,,,,,,,,
16001042,0278,C2631,,,,,TVT ADVANTAGE SYSTEM,4783.33,4783.33,,,,,,,,,,,,,
16001044,0278,,,,,,SLING SYSTEM MID URETHRAL,4232.37,4232.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
1600105,0271,,,,,,DNU PENLET BLOOD SAMPLER LIFESCAN,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001073,0272,,,,,,FLEX POINT ELECTRODE UNIV ROLLERBLL,404.13,404.13,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001074,0272,,,,,,ELECTRODE UNIV ROLLERBLL,467.47,467.47,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001075,0272,,,,,,ELECTRODE COLLINS KNIFE 22/24 FR,236.54,236.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001120,0278,,,,,,SHUNT 6 INCH CARDIT ARTERY,147.63,147.63,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001125,0278,C1760,,,,,VASOSEAL ES,767.97,767.97,,,,,,,,,,,,,
1600117,0272,,,,,,DNU TUBE STOMACH ARGYLE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001200,0272,,,,,,FORCEP BIOPSY W/NEED,38.16,38.16,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001201,0272,,,,,,BIOPSY RADIAL JAW HOT,147.09,147.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001203,0272,,,,,,STAPLER CURVED 29MM,1120.11,1120.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001204,0272,,,,,,STAPLER DISP MULTIFIER,26.26,26.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001205,0272,,,,,,STAPLER 35W,25.88,25.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001206,0272,,,,,,STAPLER 21 MM CURVED,1194.89,1194.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001207,0272,,,,,,STAPLER 35W 3M ORTH,37.36,37.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001208,0272,,,,,,STAPLER LINEAR 30 V T,254.69,254.69,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001209,0272,,,,,,LINEAR CUTTER 55MM,238.78,238.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001210,0272,,,,,,SHEARS 5 MM CURVED HARMONIC,1222.99,1222.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001214,0272,,,,,,HEMOCLIP 25 MED TA,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001215,0272,,,,,,HEMOCLIP INSTINCT EMDPSCOPIC,614.37,614.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001216,0272,,,,,,CLIP HEMOLOK WECK LARGE,114.93,114.93,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001217,0272,,,,,,***STAPLER 33 MM CURVED,716.45,716.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001218,0272,,,,,,MICROFX OCD UNIVERSAL DRILL,1919.92,1919.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001219,0272,,,,,,HEMOSPRAY,5000.34,5000.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001220,0272,,,,,,***STAPLER CURVED 25MM,716.48,716.48,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001221,0272,,,,,,STAPLER ECS 21 MM ENDOSCOPIC,1269.33,1269.33,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001222,0272,,,,,,STAPLER PROXIMATE LINEAR TX30G,366.88,366.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001224,0272,,,,,,STAPLER PROXIMATE LINEAR RELOAD,138.18,138.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001225,0272,,,,,,LINEAR CUTTER 75 MM,356.37,356.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001226,0272,,,,,,STAPLER PROXIMATE LINEAR RELOAD,136.16,136.16,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001227,0272,,,,,,RELOAD LINEAR CUTTER,190.12,190.12,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600123,0270,,,,,,DNU IRON OUT,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16001231,0272,,,,,,SCALPEL HARMONIC HAND HELD 36CM,1138.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001232,0272,,,,,,DNU SCALPEL HARMONIC HAND HELD 14CM,785.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001233,0272,,,,,,CUTTER 4.0MM TOMCAT,209.32,209.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001234,0272,,,,,,CUTTER ANGLED AGGRESSIVE 5.0MM,169.70,169.70,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001235,0272,,,,,,BUR 5.5MM ROUND 12 FLUTE - HOLLOW,221.01,221.01,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001236,0272,,,,,,BUR 4.0MM BARREL 12 FLUTE HOLLOW,198.00,198.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001237,0272,,,,,,BUR 5.5MM BARREL 12 FLUTE HOLLOW,221.01,221.01,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001238,0272,,,,,,CUTTER 4.0 AGGRESSIVE PLUS,171.41,171.41,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001239,0272,,,,,,CUTTER 4.0MM RESECTOR,194.63,194.63,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001240,0272,,,,,,SERFAS ENERGY SUPER 90-S,604.71,604.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001241,0272,,,,,,PROBE 3.5MM HOOK SERFAS ENERGY,455.36,455.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001242,0272,,,,,,*TUBE SET FLOSTEADY,186.44,186.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001243,0272,,,,,,SCALPEL HARMONIC HAND HELD 36CM,1285.25,1285.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001244,0272,,,,,,TUBING INSUFFLATION HYSTEROSCOPIC CROSS/,212.16,212.16,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001245,0272,,,,,,TUBING INSUFFLATION ARTHROSCOPIC INFLOW,229.62,229.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001280,0278,C1768,,,,,GRAFT VASC 22,1484.74,1484.74,,,,,,,,,,,,,
16001281,0278,C1768,,,,,GRAFT VASC 26,1621.27,1621.27,,,,,,,,,,,,,
16001300,0272,,,,,,DRAIN SILICONE 10FR,25.84,25.84,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001303,0272,,,,,,DRAIN SILICONE 7MM FLAT,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001304,0272,,,,,,DRAIN JACKSON PRATT 10MM FLAT,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001307,0272,,,,,,RESERVOIR 100ML JACK/,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001309,0272,,,,,,DRAIN SILICONE 15FR,27.36,27.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001312,0272,,,,,,DRAIN JACKSON PRATT 19FR,25.59,25.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001316,0272,,,,,,SURGICEL FIBRILLAR 2 X4,287.30,287.30,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001322,0272,,,,,,TB-0009OF SET,1279.95,1279.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001323,0272,,,,,,DRAIN  T  10FR BARD,28.58,28.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001324,0272,,,,,,HANDPIECE THUNDERBEAT 20CM,1621.27,1621.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001325,0272,,,,,,HANDPIECE THUNDERBEAT 35CM,1450.61,1450.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001326,0272,,,,,,DRAIN  T  12FR BARD,28.58,28.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001327,0272,,,,,,DRAIN  T  14FR,55.47,55.47,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001328,0272,,,,,,DRAIN  T  16FR 1001B,31.14,31.14,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001329,0272,,,,,,DRAIN  T  18 FR,50.59,50.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001330,0272,,,,,,DRAIN DEAVER T-TUBE 20 FR,28.58,28.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001347,0272,,,,,,SNARE POLYPECTOMY X-SMALL,50.43,50.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001348,0272,,,,,,SNARE POLYPECTOMY LARGE,50.43,50.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001355,0272,,,,,,SUTURE 6-0 VICRYL PS-3,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001380,0272,A7521,,,,,TUBE TRACH 4,210.25,210.25,,,,,,,,,,,,,
16001381,0272,A7521,,,,,TUBE TRACH FENESTRATED 4,212.61,212.61,,,,,,,,,,,,,
16001382,0272,A7521,,,,,TUBE TRACH 6 LPC,205.45,205.45,,,,,,,,,,,,,
16001383,0272,A7521,,,,,TUBE TRACH FENESTRATED 6,212.33,212.33,,,,,,,,,,,,,
16001384,0272,,,,,,TUBE TRACH 8,210.31,210.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001385,0272,,,,,,TUBE TRACH FENESTRATED 8,208.29,208.29,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001386,0272,A7521,,,,,TUBE TRACH CUFFED 8,204.19,204.19,,,,,,,,,,,,,
16001387,0272,A7521,,,,,TUBE TRACH 10,214.89,214.89,,,,,,,,,,,,,
16001388,0272,A7521,,,,,TUBE TRACH 10 FEN,203.27,203.27,,,,,,,,,,,,,
16001389,0272,,,,,,TUBE SHILEY 8 DIC FENESTRATED,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001390,0272,A7521,,,,,TUBE TRACH 8 DCT DISPOSABLE,188.27,188.27,,,,,,,,,,,,,
16001391,0272,A7521,,,,,TUBE TRACH 8 FEN DISPOSABLE,172.71,172.71,,,,,,,,,,,,,
16001392,0272,,,,,,TUBE TRACH 6 SHILEY DISPOSABLE,203.03,203.03,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001393,0272,A7520,,,,,TUBE TRACH 4 SHILEY CUFFLESS,200.12,200.12,,,,,,,,,,,,,
16001394,0272,A7520,,,,,TUBE TRACH 6 SHILEY CUFFLESS,198.78,198.78,,,,,,,,,,,,,
16001395,0272,A7520,,,,,TUBE TRACH 4 SHILEY FEN CUFFLESS,171.03,171.03,,,,,,,,,,,,,
16001396,0272,A7520,,,,,TUBE TRACH 6 SHILEY FEN CUFFLESS,192.85,192.85,,,,,,,,,,,,,
16001397,0272,A7520,,,,,TUBE TRACH 7 SHILEY W/ CUFF,184.65,184.65,,,,,,,,,,,,,
16001398,0272,A7520,,,,,TUBE TRACH 6.5 SHILEY W/ CUFF,184.65,184.65,,,,,,,,,,,,,
16001400,0272,,,,,,SET EXTENSION LUER LOCK 76CM 4.0ML.,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001401,0272,,,,,,DNU SET LIPID FILTER 1.2 MICRON LUER LCK,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001402,0278,C1781,,,,,MESH DEXON 25X15CM,902.32,902.32,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16001403,0278,C1781,,,,,MESH DEXON 20X10CM,876.00,876.00,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16001405,0278,C1788,,,,,"PORT, 19MM, STRAIGHT, 80MM",972.74,972.74,332.09,332.09,,,,,,,332.09,,,,
16001406,0278,,,,,,POWERPORT DUO MRI IMPLANTABLE 9.5 CF,1945.52,1945.52,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001407,0278,,,,,,PRO PORT SYSTEM SINGLE LUMEN 1.6MM 8.5FR,918.15,918.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001408,0278,C1788,,,,,PRO PORT SYSTEM LOW PROFILE 1.6MM 8.5FR,972.74,972.74,332.09,332.09,,,,,,,332.09,,,,
16001409,0278,C1781,,,,,MESH VICRYL KNITTED 12 X12,4233.55,4233.55,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16001410,0278,C1781,,,,,MESH VICRYL WOV 12 X12,3101.37,3101.37,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16001411,0272,,,,,,PORT MARS 19X60MM STRAIGHT DISPOSABLE,679.88,679.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001412,0272,,,,,,PORT MARS 19X40MM STRAIGHT DISPOSABLE,679.88,679.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001413,0278,,,,,,PORT MARS 19X70MM STRAIGHT DISPOSABLE,778.22,778.22,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001414,0278,,,,,,PORT MARS 19X40MM STRAIGHT DISPOSABLE,679.88,679.88,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001415,0278,,,,,,PORT MARS 19X90MM STRAIGHT DISPOSABLE,778.22,778.22,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001416,0278,,,,,,PORT MARS 19X 120MM STRAIGHT DISPOSABLE,914.75,914.75,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001417,0278,,,,,,PORT MARS 19X100MM STRAIGHT DISPOSABLE,914.75,914.75,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001418,0278,,,,,,PORT MARS 19X110MM STRAIGHT DISPOSABLE,914.75,914.75,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001428,0272,,,,,,LIGATOR,246.08,246.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001429,0278,C1874,,,,,STENT WALLFLEX ESOPHAGEAL 23MMX125MM,9265.58,9265.58,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001430,0278,C1874,,,,,STENT POLYFLEX 18X90,6992.89,6992.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001431,0278,C1874,,,,,STENT POLYFLEX 18X120,6992.89,6992.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001432,0278,C1874,,,,,STENT POLYFLEX ESOPHAGEAL 16X20X90,6160.41,6160.41,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001433,0278,C1874,,,,,STENT POLYFLEX ESOPHAGEAL 18X23X120,6160.41,6160.41,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001434,0278,C1874,,,,,STENT POLYFLEX 21X120,6992.89,6992.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001435,0278,C1874,,,,,STENT WALLFLEX ESOPHAGEAL,8408.12,8408.12,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001436,0278,C1781,,,,,MESH MARLEX 10 X 14,628.03,628.03,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16001437,0278,C1874,,,,,STENT WALLFLEX COLONIC,8741.12,8741.12,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001438,0278,L8600,,,,,BREAST PROSTHESIS IMPLANTABLE,3071.87,3071.87,,,,,,,,,,,,,
16001439,0278,C1781,,,,,MESH MYCRO 6CM X 12CM,457.37,457.37,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16001440,0278,C1874,,,,,STENT WALLFLEX ESOPHAGEAL 23X155MM,8915.94,8915.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001441,0278,C1874,,,,,STENT WALLFLEX ESOPHAGEAL 18MM X 153MM,7727.57,7727.57,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001442,0278,C1874,,,,,WALLFLEX EXOPHAGEAL PARTIALLY COVERED 23,7727.57,7727.57,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001443,0272,A7520,,,,,TUBE TRACH 6 SHILEY CUFFED FENESTRATED D,165.30,165.30,,,,,,,,,,,,,
16001444,0272,A7520,,,,,TUBE TRACH 6 SHILEY XL CUFFED,258.17,258.17,,,,,,,,,,,,,
16001445,0272,A7520,,,,,TUBE TRACH 8 XL SHILEY CUFFED,258.17,258.17,,,,,,,,,,,,,
16001446,0272,A7520,,,,,TUBE TRACH 5 SHILEY XL CUFFLED,258.17,258.17,,,,,,,,,,,,,
16001453,0272,,,,,,SIZER 68HP 500CC,189.11,189.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001476,0272,,,,,,TUNNELER INSRT HICKMA,172.88,172.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001477,0272,,,,,,FLEX PORT 20 MM,197.86,197.86,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001478,0271,,,,,,SET PRIMARY GRAVITY WITH 2 PORTS,20.50,20.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001479,0272,,,,,,FLEXPATH 15 MM,470.42,470.42,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001481,0271,,,,,,SET SOLUSET,20.50,20.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001483,0272,,,,,,CATH LUMEN 4FR 3,337.91,337.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001484,0272,,,,,,CATH LUMEN 3FR 3,337.91,337.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001485,0272,,,,,,CATH LUMEN 5FR 3,337.91,337.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001490,0278,,,,,,SECURFIT STEM,18714.57,18714.57,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001491,0272,,,,,,TRIDENT SHELL,6986.82,6986.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001492,0272,,,,,,TRIDENT LINER,5962.86,5962.86,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001494,0271,,,,,,SET BLOOD Y-TYPE B2 I,20.50,20.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001520,0271,,,,,,SET OMNI-FLOW WITH 2 PORTS,98.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001570,0278,C1874,,,,,STENT BALLOON CORINT 7MM/15MM,3812.79,3812.79,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16001587,0272,,,,,,SET INFUSION 20 X 1X,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001590,0272,,,,,,ADAPTER FIBER OPTIC S,45.73,45.73,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001600,0278,C1769,,,,,GUIDE WIRE PLATINUM PLUS,508.56,508.56,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16001605,0271,,,,,,SET BLOOD PUMP,42.32,42.32,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001607,0271,,,,,,DNU SET BLOOD PUMP,41.50,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001608,0278,,,,,,C TAPER 36 MM HEAD,4123.14,4123.14,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
1600164,0270,,,,,,DNU BANDAGE 10CM COMPRILAN COMPRESSION,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1600166,0270,,,,,,DNU BANDAGE 6CM COMPRILAN COMPRESSION,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1600168,0270,,,,,,DNU BANDAGE 12CM COMPRILAN COMPRESSION,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1600169,0270,,,,,,DNU ARTIFLEX,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16001700,0272,,,,,,SET PNEUMOTHORAX LANDERS,387.60,387.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001705,0271,,,,,,SET NITRO 40IN,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001715,0271,,,,,,SET ANESTHESIA PUMP,29.20,29.20,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001721,0271,,,,,,SET BLOOD Y-TYPE 90,20.50,20.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001743,0278,,,,,,PROSTHESIS 20MM X 10MM,1737.31,1737.31,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16001784,0272,,,,,,CATH AIR EX C-CAE19,208.55,208.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001786,0272,,,,,,CATH AIR EXCHANGE,208.55,208.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600179,0270,,,,,,DNU SOLUTION CONTROL HIGH SURESTEP PRO,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1600180,0270,,,,,,DNU SOLUTION CONTROL LOW SURESTEP PRO,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16001801,0272,,,,,,KIT ARTERIAL LINE,61.78,61.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001802,0272,,,,,,CATH BRITE TIP 6FR-.070-90CM,297.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001806,0272,C1751,,,,,CATH LUMEN MULTI KIT,163.02,163.02,,,,,,,,,,,,,
16001807,0272,,,,,,CATH SET-CNTRL VEIN,59.46,59.46,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001808,0272,,,,,,CATH KIT RADIAL ART,67.24,67.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001810,0272,,,,,,LOOP CUTTING 24 FR,214.11,214.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001815,0272,,,,,,NEEDLE EPIDURAL TUOHY 17GA,74.76,74.76,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001816,0272,,,,,,NEEDLE TUOHY EPID,58.41,58.41,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001817,0272,,,,,,NEEDLE-TUOHY EPID,21.14,21.14,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001819,0272,,,,,,STIMUCATH CONT NERVE BLK SET 17GX4CM,221.48,221.48,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001820,0272,,,,,,STIMUCATH CONT NERVE BLCK SET 17GX8CM,212.27,212.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001825,0272,,,,,,NEEDLE NERVE BLOCK PROBLO,39.92,39.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001827,0272,,,,,,SET PNEUMOTHORAX TPT,327.67,327.67,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001838,0272,,,,,,TUBE EXTENSION 8,29.77,29.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001848,0271,,,,,,TUBING PCA MINI BORE,20.50,20.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001850,0272,,,,,,DRAINAGE UNIT THORA SEAL,197.38,197.38,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001851,0272,,,,,,COLLECTION UNIT,126.92,126.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001853,0271,,,,,,SET NITROGLYCERIN 107,28.75,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001856,0258,,,,,,SOLUTION POTASSIUM CHLORIDE,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001860,0272,,,,,,PLUG ANAL FISTULA,3225.47,3225.47,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001863,0272,,,,,,SENSOR BIS XP QUATRO,88.38,88.38,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001872,0271,,,,,,SET CO 2 TUBING,43.83,43.83,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001873,0271,,,,,,SET CO 2 TUBING STRYKER HIGH FLOW,184.68,184.68,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16001875,0258,J7042,,,,,SOLUTION DEXTROSE 5% 100ML,20.00,20.00,,,,,,,,,,,,,
16001876,0258,J7042,,,,,SOLUTION DEXTROSE 5% ADVANTAGE,20.00,20.00,,,,,,,,,,,,,
16001879,0258,,,,,,SOLUTION POTASSIUM CHLORIDE 1000ML,27.76,27.76,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001880,0258,J7042,,,,,SOLUTION DEXTROSE 5% 250ML,20.00,20.00,,,,,,,,,,,,,
16001882,0258,J7042,,,,,SOLUTION DEXTROSE 10% 1000,22.34,22.34,,,,,,,,,,,,,
16001883,0258,J7042,,,,,SOLUTION DEXTROSE 10%,20.00,20.00,,,,,,,,,,,,,
16001885,0258,J7042,,,,,SOLUTION DEXTROSE 5% 500ML,20.00,20.00,,,,,,,,,,,,,
16001888,0272,,,,,,SET INFUSION WING 20GA,33.24,33.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001890,0258,,,,,,SOLUTION DEXTROSE 5% 1000ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001891,0272,,,,,,SET ANESTHESIA 1.5ML,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001895,0258,J7042,,,,,SOLUTION DEXTROSE 5% SOD CHLORIDE .225,20.00,20.00,,,,,,,,,,,,,
16001899,0258,J7042,,,,,SOLUTION DEXTROSE 5% SOD CHLORIDE .45,20.00,20.00,,,,,,,,,,,,,
16001900,0258,,,,,,SOLUTION DEXTROSE 5% SOD CHLORIDE .45,23.66,23.66,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001905,0258,,,,,,SOLUTION DEXTROSE 5% SOD CHLORIDE .9%,24.24,24.24,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001910,0258,,,,,,SOLUTION DEXTROSE 5% LAC/RINGER,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001915,0258,,,,,,SOLUTION DEXTROSE 5% LAC/RINGER,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001920,0258,,,,,,SOLUTION LACTATED RINGERS,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001921,0258,J7042,,,,,SOLUTION SODIUM CHLORIDE 3%,23.62,23.62,,,,,,,,,,,,,
16001925,0258,J7120,,,,,LACTATED RINGERS 1000 ML,20.00,20.00,,,,,,,,,,,,,
16001929,0272,,,,,,CLEARSIGHT FINGER CUFF LARGE,1194.64,1194.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001930,0272,,,,,,CLEARSIGHT FINGER CUFF MEDIUM,1194.64,1194.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001931,0272,,,,,,CLEARSIGHT FINGER CUFF SMALL,1194.64,1194.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001932,0272,,,,,,FLOTRAC SENSOR,1194.64,1194.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001933,0636,Q4186,,,,,DRESSING EPIFIX 3X3 CM,651.08,651.08,231.74,231.74,,,,,,,231.74,,,,
16001934,0258,,,,,,SOLUTION SODIUM CHLORIDE .9% 100ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001935,0258,,,,,,SOLUTION SODIUM CHLORIDE .9%  50ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001936,0258,,,,,,SOLUTION SOD CHLORIDE .9% 250ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001937,0258,,,,,,SOLUTION SODIUM CHLORIDE .9% AS,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001938,0272,,,,,,SUTURE TRICON 2 BLUE 30 T-56/HGS-21,25.25,24.63,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16001941,0258,,,,,,SOLUTION SOD CHLORIDE .9% 500,23.66,23.66,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001945,0258,,,,,,SODIUM CHLORIDE .9%,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001950,0258,,,,,,SOLUTION SODIUM CHLORIDE .9% IR,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001955,0258,,,,,,SODIUM CHLORIDE .9% 1000ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001956,0258,,,,,,SOLUTION SODIUM CHLORIDE .9% IR,30.80,30.80,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001957,0258,,,,,,SOLUTION SODIUM CHLORIDE .9% 1500ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001962,0258,J7060,,,,,WATER STERILE 500ML,20.00,20.00,,,,,,,,,,,,,
16001965,0258,,,,,,WATER STERILE 1000ML,20.00,20.00,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001966,0258,,,,,,SOLUTION WATER STERILE 3000ML,39.17,39.17,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001967,0258,,,,,,SOLUTION WATER STERILE 1000ML,20.00,20.00,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001968,0258,,,,,,SOLUTION WATER STERILE 1500ML BOTTLE,20.00,20.00,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001972,0258,,,,,,SOLUTION GLYCINE 3000,50.51,50.51,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16001992,0258,J7042,,,,,DNU SOLUTION LACTATED RINGERS,20.00,20.00,,,,,,,,,,,,,
1600200,0272,,,,,,DNU DRESSING HYDROFERA BLUE W/FILM 4X4,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600201,0272,,,,,,DNU MEDIFIL PARTICLES COLLAGEN 5M,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600202,0271,,,,,,DNU MEDIHONEY 1.5OZ TUBE,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16002020,0272,,,,,,NEEDLE NERVE BLOCK,27.57,27.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002024,0278,,,,,,OCCLUDER VASCULAR 1.0,184.91,184.91,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16002025,0278,C1766,,,,,OCCLUDER VASCULAR 1.5,251.99,251.99,85.68,85.68,,,,,,,,,,85.68,85.68
16002026,0278,,,,,,OCCLUDER VASCULAR 2.0,237.55,237.55,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16002027,0278,,,,,,OCCLUDER VASCULAR 2.5,237.55,237.55,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16002035,0258,,,,,,SOLUTION MANITOL 20%,68.16,68.16,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16002045,0258,,,,,,SOLUTION SODIUM CHLORIDE .45% 1000ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16002046,0258,,,,,,SOLUTION SODIUM CHLORIDE .45% 250ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16002047,0258,,,,,,SOLUTION SODIUM CHLORIDE .45% 500ML,20.50,20.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16002058,0258,,,,,,SOLUTION PREMIX POTASSIUM CHL,32.65,32.65,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16002085,0272,,,,,,SET MANIFOLD EXT CAT 25CM,36.18,36.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002100,0272,,,,,,TUBE BLAKEMORE 20FR,1081.88,1081.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002103,0278,,,,,,SHUNT-DENVR VENS-SRG,3751.11,3751.11,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16002152,0272,,,,,,SUTURE TAPE 18  COTTON UMBILICAL U10T,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002170,0271,,,,,,VASCU-GUARD W/APEX PROCESSING,675.95,675.95,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16002178,0272,,,,,,LG LIGACLIP,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002180,0272,,,,,,LS100 LIGACLIP,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002185,0272,,,,,,LIGACLIP HORIZON,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002211,0272,,,,,,DRESSING  AQUACEL  AG 4  X 13.5,147.43,147.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002222,0272,,,,,,SUTURE ETHILON #2 LR ETH 490T,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002232,0271,,,,,,KIT EDLICH GAS LAVGE,27.19,27.19,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1600229,0272,,,,,,DNU SOLUTION DEXTAN 40 10% .9% SODIUM CH,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002300,0272,A4340,,,,,CATH COUDE 18FR 5CC,35.60,35.60,,,,,,,,,,,,,
16002301,0272,A4340,,,,,CATH COUDE 16FR 5CC,38.45,38.45,,,,,,,,,,,,,
16002302,0272,A4340,,,,,CATH COUDE 20FR 5CC,35.62,35.62,,,,,,,,,,,,,
16002310,0272,,,,,,CATH COUDE 22FR 30CC 3 WAY,79.05,79.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002315,0272,,,,,,*CATH COUDE 24FR 30CC 3 WAY,79.05,79.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002320,0272,A4340,,,,,CATH COUDE 12FR SILICONE,59.84,59.84,,,,,,,,,,,,,
16002325,0272,,,,,,CATH COUDE 14FR SILICONE,59.84,59.84,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002345,0272,,,,,,SHEATH INTRODUCER CP-,96.66,96.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002346,0272,,,,,,SHEATH INTRODUCER CL-,176.50,176.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002391,0272,,,,,,STAPLER TA90 4.8/D,1110.60,1110.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002400,0272,,,,,,RELOAD TA 90 4.8,177.72,177.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002401,0272,,,,,,RELOAD TA 90 3.5,173.39,173.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002402,0278,C1874,,,,,STENT PALMAZ UNMOUNTED XL 40C,5444.47,5444.47,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16002403,0278,C1874,,,,,STENT PALMAZ UNMOUNTED XL 50C,5827.41,5827.41,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16002420,0272,,,,,,CATH PIGTAIL 5FR W/M,128.18,128.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600245,0272,,,,,,DNU PROBE RECTAL/ESOPHAGEAL DISPOSABLE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002547,0272,,,,,,CATH SUPER TORQUE VERTEBRAL 5FR,62.82,62.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002576,0272,,,,,,SNARE 25MM 65CM,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002581,0272,,,,,,STAPLER TA55 3.5,238.24,238.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002582,0272,,,,,,STAPLER TA55/408D,378.86,378.86,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002585,0272,,,,,,RELOAD UNIT 4.8 TA55,148.81,148.81,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002616,0272,,,,,,RELOAD UNIT TA55 3.5,205.32,205.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002618,0272,,,,,,SET VASCULAR DIALATOR,197.44,197.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002619,0272,,,,,,6FR 20CM VASCULAR DIALATOR,76.57,76.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002620,0272,,,,,,8FR 20CM  VASCULAR DIALATOR,76.57,76.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002621,0272,,,,,,10FR 20CM VASCULAR DIALATOR,76.57,76.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002622,0272,,,,,,12FR 20CM VASCULAR DIALATOR,76.57,76.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002623,0272,,,,,,14FR 20CM VASCULAR DIALATOR,76.57,76.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002704,0272,,,,,,NEEDLE STIMULATOR 21G X 1.5  (40MM),39.29,39.29,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002705,0272,,,,,,NEEDLE STIMULATOR 21G X 3 1/8 (80MM),41.81,41.81,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002706,0272,,,,,,NEEDLE STIMULATOR 21G X 2 (50MM),39.29,39.29,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002707,0272,,,,,,21G 4  ECHOSTIM ECHOGENIC INSULATED NEE,49.37,49.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002708,0272,,,,,,*21G 6  ECHOBLOCK ECHOGENIC NON-INSULTE,41.81,41.81,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002709,0272,,,,,,*20G 6  ECHOBLOCK PTC30 ECHOGENIC NON-IN,33.40,33.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002710,0272,,,,,,22G 2  ECHOBLOCK PTC ECHOGENIC NEEDLE,27.32,27.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002711,0272,,,,,,17G 6  ECHOTUOHY EPIDURAL NEEDLES,49.79,49.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002712,0272,,,,,,18G 8  TUOHY NEEDLES,45.59,45.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002713,0272,,,,,,22G 6  TUOHY NEEDLES,45.59,45.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002714,0272,,,,,,Y22G 3.5  TUOHY NEEDLES,37.61,37.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002715,0272,,,,,,*22G 6  ECHOBLOCK PTC30 ECHOGENIC NON-IN,33.40,33.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002716,0272,,,,,,20G 8  ECHOBLOCK PTC30 ECHOGENIC NON-IN,33.40,33.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002717,0272,,,,,,*22G 8  ECHOBLOCK PTC30 ECHGENIC NON-INS,33.40,33.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002784,0272,,,,,,COLD SNARE  EXACTO 2.4MM 230CM,105.06,105.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002785,0272,,,,,,SNARE 15MM 120MM,1126.35,1126.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002786,0272,,,,,,SNARE STANDARD 9-15DX120CML CATH,1041.02,1041.02,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002807,0272,,,,,,FELT PTFE TEFLON,310.61,310.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600283,0272,,,,,,DNU DRAPE STERILE CAMERA,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002850,0278,C1874,,,,,STENT PALMAZ 5FR X 80CM,3812.79,3812.79,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16002960,0272,,,,,,ADHESIVE DERMABOND,85.19,85.19,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002961,0272,,,,,,DERMABOND SKIN CLOSURE SYSTEM,284.18,284.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002962,0272,,,,,,DERMABOND PRINEO SKIN CLOSURE SYSTEM,473.85,473.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002963,0272,,,,,,SKINAFFIX TOPICAL SKIN ADHESIVE,41.27,41.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002965,0272,,,,,,ADHESIVE SURE&CLOSE WOUND CLOSURE SYS,79.51,79.51,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002970,0272,,,,,,ADHESIVE BIO-GLUE,2679.36,2679.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002971,0272,,,,,,SURGICAL SEALANT 4ML COSEAL,2050.00,2050.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002972,0272,C1713,,,,,HEMOSTATIC MATRIX FLOSEAL 5ML,1321.94,1321.94,,,,,,,,,,,,,
16002973,0272,,,,,,TACHOSIL SEALANT PATCH,2219.20,2219.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002974,0272,,,,,,DURASEAL EXACT 5ML,4289.71,4289.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002975,0272,,,,,,DURAGEN SECURE 3X3,3406.81,3406.81,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002976,0272,,,,,,DURASEAL 8CM APPLICATOR,849.20,849.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002977,0272,,,,,,ENDOSCOPIC APPLICATOR FLOSEAL,220.47,220.47,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002978,0272,,,,,,FIBRIN SEALANT 4ML TISSEEL,845.97,845.97,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16002979,0272,,,,,,ENDOSCOPIC APPLICATOR TISSEEL SPRAY SET,460.98,460.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003003,0271,,,,,,BAG OSTOMY 2  DRAINABLE,20.50,20.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16003005,0271,,,,,,BAG OSTOMY 3  DRAINABLE,20.50,20.50,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16003006,0271,,,,,,DNU BAG OSTOMY 1 3/4  DRAINABLE,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16003008,0272,,,,,,BAG OSTOMY CUT TO FIT,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003010,0272,,,,,,SUTURE HI-FI 1X40,101.49,101.49,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003011,0272,,,,,,SUTURE HI-FI 1X40  2 QTY TELFLEX,172.30,172.30,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003014,0272,,,,,,SUTURE VICRYL 3-0 SH ETH J415H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003015,0272,,,,,,DNU SUTURE CAPIO NONABSORBABLE,146.67,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003016,0272,,,,,,SUTURE SILK 2-0 CT-1 ETH 423H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003017,0272,,,,,,SUTURE MONOCRYL 5-0 PS-2 ETH Y495G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003018,0272,,,,,,SUTURE VICRYL 3-0 SH 18  J864D,38.12,38.12,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003019,0278,,,,,,TUBE CONNECTOR SHUNT,199.50,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16003020,0272,,,,,,DNU SUTURE CAPIO ABSORBABLE,146.67,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003021,0272,,,,,,CATH VENOUS SHUNT,222.75,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003023,0272,,,,,,SUTURE PROLENE 7-0 BV-1 30  ETH 8703H,87.04,87.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003024,0272,,,,,,SUTURE PROLENE 2-0 SH 48  ETH 8533H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003025,0272,,,,,,SUTURE PROLENE 3-0 SH 48  ETH 8534H,28.96,28.96,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003026,0272,,,,,,SUTURE SILK 2-0 SH 30   ETH C016D,46.39,46.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003027,0272,,,,,,SUTURE SILK 2-0 CT-1 ETH C022D,34.20,34.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003028,0272,,,,,,SUTURE SILK 3-0 REEL ETH LA-54-G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003029,0272,,,,,,SUTURE SILK 2-0 REEL ETH LA55G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003030,0272,,,,,,SUTURE SILK 2-0 30  TIES ETH SA-85H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003031,0272,,,,,,DNU SUTURE ETHILON 2-0 KS 30  ETH 628H,33.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003032,0272,,,,,,SUTURE CHROMIC #1 CT-1 ETH 925H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003033,0272,,,,,,DNU SUTURE MONOCRYL 4-0 P-3 ETH Y494G,31.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003034,0272,,,,,,SUTURE MONOCRYL 5-0 P-3 ETH Y493G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003035,0272,,,,,,DNU SUTURE MONOCRYL 3-0 PS-2 ETH Y497G,31.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003036,0272,,,,,,SUTURE STAINLESS STEEL M682G,80.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003037,0272,,,,,,SUTURE VICRYL 3-0 SH ETH J416H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003038,0272,,,,,,SUTURE VICRYL 5-0 P-3 ETH J493G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003039,0272,,,,,,SUTURE VICRYL 2-0 CT-1 ETH J945H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003040,0272,,,,,,SUTURE VICRYL 2-0 UR-5 ETH J375H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003041,0272,,,,,,SUTURE VICRYL 4-0 TIES ETH J643H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003042,0272,,,,,,SUTURE VICRYL 0 CT-1 ETH J946H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003043,0272,,,,,,SUTURE ETHILON 7-0 P-6 18  ETH 1647G,21.36,21.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003044,0272,,,,,,SUTURE ETHILON P-3 ETH699G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003045,0272,,,,,,SUTURE PLAIN 6-0 (FAST ACTING)ETH 1916G,33.32,33.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003046,0272,,,,,,SUTURE ETHIBOND #2 LR ETH X496T,22.55,22.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003047,0272,,,,,,SUTURE PROLENE 4-0 PS-2 ETH 8682G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003048,0272,,,,,,SUTURE PDS 6-0 II P-1 ETH Z489G,23.11,23.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003049,0272,,,,,,SUTURE PROLENE 2-0 SH 36  ETH 8523H,28.77,28.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003050,0272,,,,,,SUTURE VICRYL ETH J232,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003051,0272,,,,,,SUTURE SILK 6-0 P-3 ETH 1639G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003052,0272,,,,,,SUTURE SILK 4-0 SH ETH K831H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003053,0272,,,,,,SUTURE VICRYL 0 CT-1 ETH J346H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003054,0272,,,,,,SUTURE VICRYL 0 UR-5 ETH J376H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003055,0272,,,,,,SUTURE VICRYL 0 8-18 J740D,37.99,37.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003056,0272,,,,,,SUTURE VICRYL 4-0 PS-2 ETH J496H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003057,0272,,,,,,SUTURE PLAIN 3-0 CT' ETH 842H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003058,0272,,,,,,SUTURE CHROMIC 4-0 SH ETH G121H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003059,0272,,,,,,SUTURE CHROMIC 0 CT' ETH 924H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003060,0272,,,,,,SUTURE CHROMIC 2-0 CT' ETH 923H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003061,0272,,,,,,SUTURE PROLENE 6-0 BV-1 ETH 8805H,103.04,103.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003062,0272,,,,,,SUTURE MERSILENE 2-0 SH ETH R833H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003063,0272,,,,,,SUTURE ETHIBOND 1 EXCEL OS-4 ETH X518H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003064,0272,,,,,,SUTURE GZM 7-776 TEVDEK II 2 C-2,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003065,0272,,,,,,SUTURE MONOCRYL 4-0 PC-3 ETH Y845G,28.45,28.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003066,0272,,,,,,SUTURE VICRYL 1 CTX ETH J977H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003067,0272,,,,,,DNU SUTURE ETH J549H,24.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003068,0272,,,,,,SUTURE ETHIBOND 0 CT-1 ETH X424H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003069,0272,,,,,,SUTURE ETHIBOND 4-0 X871H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003070,0272,A4338,,,,,CATH SILICONE 14FR 5CC,20.50,20.50,,,,,,,,,,,,,
16003071,0272,,,,,,DNU ENDO STITCH W/SURG 2-0 GRN 48  ES-9,194.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003072,0272,,,,,,DNU ENDO STITCH 10MM SUTURING DEVICE,503.75,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003073,0272,,,,,,DNU PROTACK 5 MM,982.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003074,0272,,,,,,SUTURE TI-CON COATED BRAIDED 5,45.22,45.22,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003075,0272,,,,,,SUTURE ETHIBOND EXCEL X833H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003076,0272,,,,,,SUTURE ETHIBOND 0 V-34 X444H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003077,0272,,,,,,SUTURE ETHIBOND 0 OS-2 CX74T,34.71,34.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003078,0272,,,,,,SUTURE VICRYL 70CM CP-2 J870H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003079,0272,,,,,,SUTURE ETHIBOND 0 CX45D,66.17,66.17,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003080,0272,,,,,,SUTURE VICRYL 2-0 ETH J269H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003081,0272,,,,,,SUTURE VICRYL CT-1 J260H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003100,0272,,,,,,SUTURE SILK 0 30  TIES ETH SA86G 0,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003101,0272,,,,,,SUTURE SILK 3-0 FS-1 ETH 684H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003102,0272,,,,,,SUTURE SILK 3-0 K-S ETH 622H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003103,0272,,,,,,SUTURE SILK 4-0 KS ETH 621H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003104,0272,,,,,,SUTURE SILK 5-0 FS-2 ETH 682G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003105,0272,,,,,,SUTURE SILK 5-0 P-3 ETH 640G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003106,0272,,,,,,SUTURE SILK 6-0 C-3 ETH 711G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003107,0272,,,,,,SUTURE SILK 0 CT-1 ETH 424H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003108,0272,,,,,,SUTURE SILK 3-0 SH 30  ETH K832H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003109,0272,,,,,,SUTURE VICRYL 0 TIES ETH J616H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003110,0272,,,,,,SUTURE VICRYL 4-0 P-3 ETH J494H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003111,0272,,,,,,SUTURE VICRYL 2-0 UR-6 ETH J602H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003112,0272,,,,,,SUTURE PROLENE 2-0 KS ETH 8623H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003113,0272,,,,,,SUTURE PROLENE 2-0 FS-1 ETH 8685H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003114,0272,,,,,,SUTURE PROLENE 3-0 KS ETH 8622H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003115,0272,,,,,,SUTURE PROLENE 4-0 KS ETH 8621H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003116,0272,,,,,,SUTURE PROLENE 4-0 FS-2 ETH 8683G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003117,0272,,,,,,SUTURE PROLENE 5-0 FS-2 ETH 8661G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003118,0272,,,,,,SUTURE PROLENE 5-0 PS-5 ETH 8655G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003119,0272,,,,,,SUTURE PROLENE #1 CT-1 ETH 8425H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003120,0272,,,,,,SUTURE PROLENE 0 MO-7 CR/8 ETH C841G,71.87,71.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003121,0272,,,,,,SUTURE PROLENE 3-0 SH 36  ETH 8522H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003122,0272,,,,,,SUTURE PROLENE 3-0 V-7 ETH 8976H,26.64,26.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003123,0272,,,,,,SUTURE PROLENE 4-0 SH 36  ETH 8521H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003124,0272,,,,,,SUTURE PROLENE 5-0 BV-1 ETH 9702H,106.54,106.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003125,0272,,,,,,SUTURE PDS 4-0 SH ETH 9706H,33.04,33.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003126,0272,,,,,,SUTURE PDS 4-0 II FS-1 ETH Z441H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003127,0272,,,,,,SUTURE PDS #1 CT-1 ETH Z347H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003128,0272,,,,,,SUTURE PDS 4-0 SH ETH Z315H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003129,0272,,,,,,SUTURE CHROMIC #1 TIES ETH S115H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003130,0272,,,,,,SUTURE CHROMIC 0 TIES ETH S114H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003131,0272,,,,,,SUTURE CHROMIC #2 TP-1 ETH GL31G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003132,0272,,,,,,SUTURE CHROMIC #1 TP-1 ETH GL30G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003133,0272,,,,,,SUTURE CHROMIC 0 BP-1 ETH 47T,23.20,23.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003134,0272,,,,,,SUTURE CHROMIC 2-0 SH ETH G123H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003135,0272,,,,,,SUTURE CHROMIC 3-0 CT-3 ETH 892H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003136,0272,,,,,,SUTURE CHROMIC 4-0 RB-1 ETH U203H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003137,0272,,,,,,SUTURE PLAIN 2-0 CT-1 ETH 843H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003138,0272,,,,,,SUTURE ETHILON 2-0 FS ETH 664H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003139,0272,,,,,,SUTURE ETHILON 5-0 FS-2 ETH 661G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003140,0272,,,,,,SUTURE ETHILON 6-0 FS-3 DNR,47.11,47.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003141,0272,,,,,,SUTURE CHROMIC 2-0 SH ETH 883H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003142,0272,,,,,,SUTURE TAPE 36 COTTON UMBILICAL ETH U12T,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003143,0272,,,,,,SUTURE CHROMIC 3-0 CT-2 ETH 882H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003144,0272,,,,,,SUTURE SURGICAL STEEL #7 CCS ETH M655G,77.07,77.07,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003145,0272,,,,,,SUTURE SURGICAL STEEL #5 CCS ETH M653G,73.46,73.46,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003146,0272,,,,,,SUTURE GORE 3N10B 3-0 GORTEX CV3,87.67,87.67,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003147,0272,,,,,,SUTURE GORE 4N02A 4-0 GORTEX CV4,105.74,105.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003148,0272,,,,,,SUTURE GORE 5N02A 5-0 GORTEX CV5,113.80,113.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003149,0272,,,,,,SUTURE PROLENE #2 MS/3 ETH 3846T,49.63,49.63,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003150,0272,,,,,,SUTURE SILK 4-0 FS-2 ETH 683G,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003151,0272,,,,,,SUTURE GORE 6M02A 6-0 GORTEX CV6,118.01,118.01,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003152,0272,,,,,,SUTURE 3-0 VICRYL CT-1 J258H,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003153,0272,,,,,,SUTURE 5-0 NUROLON,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003154,0272,,,,,,SUTURE 6-0 NUROLON,22.53,22.53,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003155,0272,,,,,,SUTURE 4-0 PDS II PS-2 NEEDLE 18,26.35,26.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003156,0272,,,,,,SUTURE 2-0 VICRYL CDT-2 NEEDLE 2,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003157,0272,,,,,,SUTURE 5-0 PDS RB-1 NEEDLE,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003158,0272,,,,,,SUTURE EHTICON ENDOLOOPS,122.21,122.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003159,0272,,,,,,SUTURE EHTIBOND EXCEL 1 CT,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003160,0272,,,,,,SUTURE EHTBOND EXCEL 5CCS,61.42,61.42,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003161,0272,,,,,,SUTURE VICRYL 27,37.72,37.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003162,0272,,,,,,PACK SHOULDER SPLIT,138.54,138.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003199,0272,,,,,,SUTURE BONE WAX,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600331,0272,,,,,,DNU DRESSING VIGILON 4 X,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600332,0272,,,,,,DNU DRESSING VIGILON 6X8,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16003664,0272,C1751,,,,,CATH GROSHONG SINGLE LUMEN 7FR,1781.52,1781.52,,,,,,,,,,,,,
16003665,0272,,,,,,CATH GROSHONG DUAL LUMEN 9.5FR,1116.27,1116.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004000,0272,,,,,,MASK LMA DISPOSABLE SZ 3,154.44,154.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004001,0272,,,,,,MASK LMA DISPOSABLE SZ 4,92.45,92.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004002,0272,,,,,,MASK LMA DISPOSABLE SZ 5,92.45,92.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004063,0272,,,,,,PACK ORTHO UPPER EXTREMITY,73.92,73.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004064,0272,,,,,,PACK ORTHO LOWER EXTREMITY,169.26,169.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004065,0272,,,,,,PACK CYSTO,23.41,23.41,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004068,0272,,,,,,PACK ORTHO MAJOR,76.11,76.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004082,0272,,,,,,PACK ORTHOARTS HIP W/ POCKET,189.74,189.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004084,0272,,,,,,PACK BASIC II,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004085,0272,,,,,,PACK KNEE ARTHROSCOPY/FLUID CONTROL,201.98,201.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004086,0272,,,,,,PACK UNIVERSAL,68.27,68.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004087,0272,,,,,,PACK SHOULDER ARTHROSCOPY ORTHOARTS,200.59,200.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004088,0272,,,,,,PACK UNIVERSAL SPLIT SURGICAL AURORA,51.35,51.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004090,0272,,,,,,PACK OB III,48.16,48.16,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004092,0272,,,,,,PACK EENT I,38.79,38.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004093,0272,,,,,,PACK LAP 111,32.85,32.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004102,0272,,,,,,CATH PERCUTANEOUS 14 FR,204.23,204.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004166,0272,C1769,,,,,CATH BENTSON WIRE .035X180 CM TSFB 35,71.59,71.59,,,,,,,,,,,,,
16004207,0272,,,,,,TUBE ENDOTRACHEAL 8.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004209,0272,,,,,,TUBE NASOPHARYNGEAL 28,48.20,48.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004210,0272,,,,,,TUBE COMBITUBE 41FR.,243.46,243.46,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004211,0272,,,,,,TUBE TRACH MLT 6.0,41.08,41.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004212,0272,,,,,,TUBE TRACH MLT 4.0,41.90,41.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004213,0272,,,,,,TUBE TRACH ORAL RAE CUFFED 6.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004214,0272,,,,,,TUBE NASOPHARYNGEAL 2,21.57,21.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004217,0272,,,,,,TUBE NASAL RAE-FLEX 7.0,22.75,22.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004218,0272,,,,,,TUBE NASAL RAE-FLEX 7.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004219,0272,,,,,,TUBE TRACH ORAL RAE FLEX CUFFED 7.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004220,0272,,,,,,TUBE NASOPHARYNGEAL 2,23.49,23.49,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004221,0272,,,,,,TUBE TRACH ORAL RAE FLEX CUFFED 8.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004222,0272,,,,,,TUBE TRACH CUFFED 4.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004271,0272,,,,,,TUBE NASAL RAE NR W/O CUFF 4.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004272,0272,,,,,,TUBE NASAL RAE NR W/O CUFF 4.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004273,0272,,,,,,TUBE NASAL RAE NR W/O CUFF 5.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004274,0272,,,,,,TUBE NASAL RAE NR W/O CUFF 5.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004275,0272,,,,,,TUBE NASAL RAE R E W/ CUFF 3.5,93.40,93.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004276,0272,,,,,,TUBE NASAL RAE R E W/ CUFF 4.0,88.07,88.07,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004277,0272,,,,,,TUBE NASAL RAE R E W/ CUFF 4.5,88.40,88.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004278,0272,,,,,,TUBE NASAL RAE R E W/ CUFF 5.0,93.41,93.41,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004297,0272,,,,,,NEEDLE BIOPSY TRU-CUT,53.09,53.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004299,0272,,,,,,NEEDLE CO-AXIAL INTRODUCER 15 GAX11.8,75.64,75.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004310,0272,,,,,,NEEDLE TIP SINGLE USE,221.88,221.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004315,0272,,,,,,ADHESIVE MASTISOL LIQ,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004383,0272,,,,,,TLAB TRANSJUGULAR LIVER BIOPSY KIT,1748.22,1748.22,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004384,0272,,,,,,*AMPLATZER VASCULAR PLUG II 22MM,2770.52,2770.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004385,0272,,,,,,NEEDLE CHIBA COAXIAL SET 14CM,156.54,156.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004387,0272,,,,,,CATH 4 FR SIM1  NON-HYDROPHILLIC,159.90,159.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004389,0272,,,,,,CATH 4 FR BERENSTEIN 65 CM,68.88,68.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004390,0272,,,,,,NEEDLE COAXIAL INTRO 19X10,76.79,76.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004391,0272,,,,,,NEEDLE COAXIAL INTRO 19X15,78.71,78.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004392,0272,,,,,,INSTRUMENT 18 GAUGE,176.49,176.49,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004393,0272,,,,,,NEEDLE CO-AXIAL INTRODUCER,73.80,73.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004394,0272,,,,,,PUNCH BIOPSY 2MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004395,0272,,,,,,PUNCH BIOPSY 1MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004396,0272,,,,,,PUNCH BIOPSY 3MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004397,0272,,,,,,TRAY BONE MARROW BIOPSY MONOJECT,198.92,198.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004398,0272,,,,,,TRAY BONE MARROW BIOPSY JAMSHIDI,74.98,74.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004399,0272,,,,,,COAXIAL SETS WITH CHIBA NEEDLE 14CM,155.70,155.70,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004400,0272,,,,,,PLUG FISTULA ANAL,3856.91,3856.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004401,0272,,,,,,*AMPLATZER VASCULAR PLUG II 20MM,2839.78,2839.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004402,0272,,,,,,*AMPLATZER VASCULAR PLUG II 14MM,2770.52,2770.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004403,0272,,,,,,NEEDLE BIOPSY 20GX3.5,42.23,42.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004404,0272,,,,,,INSTRUMENT 16 GA,169.89,169.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004405,0272,,,,,,*BIOPSY TEMNO EVOL 20X20,188.60,188.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004406,0272,,,,,,BIOPSY ACHIEVE 20X15,111.47,111.47,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004407,0272,,,,,,PUNCH AORTIC CLEANCUT 3.5MM,76.01,76.01,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004408,0272,,,,,,PUNCH AORTIC CLEANCUT 5.0MM,89.54,89.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004409,0272,,,,,,*AMPLATZER VASCULAR PLUG II 10MM,2770.52,2770.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004410,0272,,,,,,*AMPLATZER VASCULAR PLUG II 12MM,2770.52,2770.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004411,0272,,,,,,*AMPLATZER VASCULAR PLUG II 16MM,2839.78,2839.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004412,0272,,,,,,AMPLATZER VASCULAR PLUG 4 4MM,3163.45,3163.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004413,0272,,,,,,*AMPLATZER VASCULAR PLUG 4 6MM,3163.45,3163.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004414,0272,,,,,,AMPLATZER VASCULAR PLUG 4 8MM,3163.45,3163.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004415,0272,,,,,,CATH W/GLOVE 14 SCTN,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004416,0272,A4624,,,,,CATH SUCTION 14FR,0.00,0.00,,,,,,,,,,,,,
16004419,0272,,,,,,CATH SUCTION 12FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004420,0272,,,,,,CATH SUCTION #10,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004421,0272,A4624,,,,,CATH SUCTION 6 FR,20.00,20.00,,,,,,,,,,,,,
16004422,0272,,,,,,CATH 4 FR JB 1 TEMP OPEN END,65.44,65.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004423,0272,A4624,,,,,CATH SUCTION 8FR,20.50,20.50,,,,,,,,,,,,,
16004435,0272,,,,,,CATH ALL PURPOSE 14FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004436,0272,,,,,,CATH  14FR NATURAL LATEX,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004440,0272,,,,,,CATH VERSI 18FR,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004444,0272,A4340,,,,,CATH COUDE 14FR 10CC - 5CC PACKAGE,37.60,37.60,,,,,,,,,,,,,
16004445,0272,,,,,,CATH MALECOT 22FR,102.91,102.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004450,0272,,,,,,CATH MALECOT 24FR,105.52,105.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004451,0272,C1729,,,,,CATH MALECOT 24FR LATEX FREE,167.44,167.44,,,,,,,,,,,,,
16004453,0272,,,,,,TUBE ET REINFORCED NO CUFF 2.5,120.83,120.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004454,0272,,,,,,TUBE ET REINFORCED NO CUFF 3.0,120.83,120.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004455,0272,,,,,,TUBE ET REINFORCED NO CUFF 3.5,117.30,117.30,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004456,0272,,,,,,TUBE ET REINFORCED NO CUFF 4.0,120.83,120.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004457,0272,,,,,,TUBE ET REINFORCED NO CUFF 4.5,121.62,121.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004460,0272,,,,,,CATH MALECOT 28FR,102.95,102.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004461,0272,,,,,,CATH MALECOT 30FR,102.95,102.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004462,0272,,,,,,CATH MUSHROOM 20FR,71.22,71.22,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004463,0272,,,,,,CATH MUSHROOM 22FR,71.22,71.22,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004464,0272,,,,,,TUBE ET REINFORCED W/CUFF 5,91.47,91.47,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004465,0272,,,,,,*TUBE ET REINFORCED W/CUFF 5.5,91.47,91.47,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004466,0272,,,,,,TUBE ET REINFORCED W/CUFF 6.0,157.43,157.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004467,0272,,,,,,TUBE ET REINFORCED W/CUFF 6.5,100.61,100.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004470,0272,,,,,,CATH BAKER JEJUNOSTOMY 16 F,1250.33,1250.33,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004471,0272,,,,,,KIT GASTROJEJUNOSTOMY SET,1383.09,1383.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004472,0272,,,,,,CATH GASTROJEJUNOSTOMY REPLAC CATH,303.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004474,0272,,,,,,DNU BAG OSTOMY 1 1/2  DRAINABLE,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004476,0272,,,,,,CAUTERY TIP SURGICAL,45.01,45.01,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004477,0278,A4648,,,,,MARKER BREAST BIOPSY 17G. 10CM ULTRA CLI,245.08,245.08,,,,,,,,,,,,,
16004478,0272,,,,,,TIP SCISSOR METZENBAUM,212.66,212.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004482,0272,,,,,,BAG OSTOMY 1 1/2  DRAINABLE,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004486,0272,,,,,,DNU BAG OSTOMY 1  SEALED,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004487,0272,,,,,,DNU BAG OSTOMY 1 1/4  SEALED   0,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004488,0272,,,,,,DNU BAG OSTOMY 1 1/2 SEALED,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004489,0272,,,,,,DNU BAG OSTOMY 1 3/4  SEALED,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004490,0272,,,,,,DNU BAG OSTOMY 3  SEALED,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004491,0272,,,,,,BAG OSTOMY 1/4  DRAINABLE,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004494,0271,,,,,,BAG COLOSTOMY FLANGE 2 3/4 70MM,20.00,20.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16004497,0270,A4405,,,,,PASTE KARAYA 7910,21.44,21.44,,,,,,,,,,,,,
16004498,0271,,,,,,FLANGE FLEX 2.25 INCH,104.34,104.34,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16004504,0272,,,,,,DNU BAG OSTOMY 2 1/2  DRAINABLE,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004505,0272,,,,,,BAG OSTOMY 2  DRAINABLE,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004506,0271,,,,,,DNU FLANGE CLOSED END,83.25,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16004507,0272,,,,,,BAG UROSTOMY 1,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004508,0272,,,,,,DNU DRAIN TUBE UROSTOMY,38.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004510,0272,,,,,,DNU BAG OSTOMY 2 1/2  SEALED,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004511,0272,A4365,,,,,DNU BAG OSTOMY 3  DEODORIZER FILTER,21.00,0.00,,,,,,,,,,,,,
16004512,0272,,,,,,DNU BAG OSTOMY 1 1/8  DRAINABLE,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004513,0272,A4365,,,,,DNU BAG OSTOMY 64MM (2 1/2 ),21.00,0.00,,,,,,,,,,,,,
16004516,0272,A4421,,,,,DNU DRAIN STOMA IRRIGATOR,23.75,0.00,,,,,,,,,,,,,
16004517,0271,,,,,,FLANGE FLEXWARE 2 3/4X 2 1/4,20.00,20.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16004518,0272,A4421,,,,,DNU KIT STOMA IRRIGATOR,21.00,0.00,,,,,,,,,,,,,
16004519,0272,,,,,,BARRIER POST OP CUT TO FIT,35.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004520,0272,A6154,,,,,BARRIER POST OP CUT TO FIT,52.90,52.90,,,,,,,,,,,,,
16004521,0272,,,,,,DNU BAG OSTOMY 2  SEALED,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004523,0272,A4338,,,,,DX-PH PROBE,416.24,416.24,,,,,,,,,,,,,
16004524,0271,,,,,,BARRIER SKIN 4X4,20.00,20.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16004526,0272,,,,,,DNU OSTOMY LOOP STARTER SET 3 1/2,25.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004527,0272,,,,,,DNU OSTOMY LOOP DRAINABLE,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004529,0271,,,,,,POUCH CLOSED W/FILTER 1 3/16,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16004538,0271,,,,,,POUCH POST OP,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16004547,0272,,,,,,DRESSING EZ DERM  (MEDISKIN),212.25,212.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004549,0272,,,,,,THERASKIN 2X3,4143.75,4143.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004550,0272,,,,,,DRESSING EZ DERM 3X4 (MEDISKIN),195.61,195.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004556,0272,,,,,,TUBE ENDOTRACHEAL 6.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004606,0272,,,,,,DNU TUBE ET ORAL RAE NO CUFF 3.0,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004607,0272,,,,,,TUBE ET ORAL RAE NO CUFF 3.5,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004608,0272,,,,,,TUBE ET ORAL RAE NO CUFF 4.0,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004609,0272,,,,,,TUBE ET NO CUFF 2.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004610,0272,,,,,,TUBE ET NO CUFF 3.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004611,0272,,,,,,TUBE ET NO CUFF 3.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004612,0272,,,,,,TUBE ET NO CUFF 4.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004615,0272,,,,,,SET T-U-R  Y  TYPE IR,40.26,40.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004616,0272,,,,,,*TUBE LEVINE 10FR ARGY,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004662,0278,,,,,,SYSTEM FILTER G2 FOR PERMANENT PLACEMENT,2770.50,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16004663,0278,C1880,,,,,KIT TRAPEASE INTRODUCER,2625.54,2625.54,,,,,,,,,,,,,
16004664,0272,,,,,,CATH SAVVY BALLOON 3X6X80,668.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004665,0272,,,,,,CATH SAVVY BALLOON 3X10X80,668.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004704,0272,,,,,,NEEDLE BIOPSY 18GA X,69.70,69.70,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004706,0272,,,,,,ENDO GIA II 60-4.8,530.66,530.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004707,0272,,,,,,ENDO GIA PURPLE 60MM MED/THICK RELOAD,1477.23,1477.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004708,0272,,,,,,ENDO GIA BLACK 60MM ARTICULATING EXTRA-T,1799.66,1799.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004709,0272,,,,,,NEEDLE KOPANS BREAST 20G/9CM,99.03,99.03,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004710,0272,,,,,,NEEDLE BREAST KOPANS 20GA/9CM,73.23,73.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004716,0272,,,,,,CAUTERY PENCIL DISP,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004718,0272,,,,,,STAPLER ENDO GIA UNIVERSAL,1106.29,1106.29,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004719,0272,,,,,,DNU RELOAD ENDO GIA ROTICULATING 60-4.8,843.21,843.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004720,0272,,,,,,DNU RELOAD ENDO GIA ROTICULATING 60-3.5,1524.92,1524.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004724,0272,,,,,,TUBE ET 7.5MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004727,0272,,,,,,TUBE NASAL RAE W/CUFF 6.0,90.04,90.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004728,0272,,,,,,TUBE NASAL RAE W/CUFF 6.5,93.40,93.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004729,0272,,,,,,TUBE NASAL RAE W/CUFF 7.0,92.45,92.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004741,0272,,,,,,TUBE TRACH LARYNGOFLEX SZ 8,253.00,253.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004742,0272,,,,,,TUBE TRACH LARYNGOFLEX SZ 9,257.68,257.68,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004743,0272,,,,,,TUBE TRACH LARYNGOFLEX SZ 10,257.68,257.68,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004744,0272,,,,,,TUBE TRACH LARYNGOFLEX SZ 7,291.18,291.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004753,0272,,,,,,DNU TUBE TRACH 4.5FR 8646,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004756,0272,,,,,,TUBE ENDOTRACHEAL 6.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004757,0272,,,,,,TUBE ENDOTRACHEAL 7.0,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004758,0272,,,,,,TUBE ENDOTRACHEAL 7.5MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004759,0272,,,,,,TUBE ENDOTRACHEAL 8.0MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004761,0272,,,,,,TUBE ENDOTRACHEAL 9.0MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004762,0272,,,,,,TUBE ENDOTRACHEAL 9.5MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004763,0272,,,,,,TUBE TRACH 7.5 HI-LO CUFFED,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004764,0272,,,,,,TUBE TRACH 7.0 HI-LO CUFFED,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004765,0272,,,,,,TUBE TRACH 8.0 HI-LO CUFFED,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004767,0272,,,,,,TUBE TRACH ORAL RAE CUFFED 5.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004770,0272,,,,,,DNU TUBE TRACH CUFFED 5.0,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004771,0272,,,,,,TUBE TRACH ORAL RAE CUFFED 6.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004773,0272,,,,,,TUBE TRACH CUFFED 8.0,36.82,36.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004774,0272,,,,,,TUBE TRACH CUFFED 8.5,36.78,36.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004778,0272,,,,,,TUBE TRACH CUFFED,25.75,25.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004781,0272,,,,,,TUBE NASAL RAE  R E W/ CUFF 7.5,93.39,93.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004782,0272,,,,,,TUBE NASAL RAE  R E W/ CUFF 8,90.77,90.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004786,0272,,,,,,TUBE TRACH ORAL RAE CUFFED 5.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004787,0272,,,,,,TUBE TRACH ORAL RAE CUFFED 5.0,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004788,0272,,,,,,TUBE TRACH ORAL RAE CUFFED 6.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004789,0272,,,,,,TUBE TRACH ORAL RAE CUFFED 4.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004796,0272,,,,,,TUBE TRACH MLT 5.0,37.74,37.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004801,0278,C1887,,,,,CATH VISTA BRIGHT TIP 6FX55CM H-STICK,279.25,279.25,,,,,,,,,,,,,
16004802,0278,C1887,,,,,CATH VISTA BRITE TIP 6F INTERNAL MAMMARY,678.20,678.20,,,,,,,,,,,,,
16004805,0272,,,,,,CATH VISTA BRIGHT TIP 6FX55CM RDC(1),262.75,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004807,0272,,,,,,TUBE TRACH ORAL RAE CUFFED 7.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004838,0272,,,,,,TUBE NASAL RAE R E W/ CUFF 5.5,97.09,97.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004885,0272,,,,,,CATH BAKER JEJUNSOTOMY 16FR 108 LONG 15C,692.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004900,0272,,,,,,*SHOULDER SUSPENSION KIT,323.27,323.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004917,0272,C1725,,,,,TUBE ET NO CUFF 4.0,20.00,20.00,,,,,,,,,,,,,
16004919,0272,,,,,,TUBE ET W/CUFF 5.0,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004930,0272,,,,,,SET CYSTO IRRIGATION,24.89,24.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004985,0272,,,,,,TUBE LEVINE 14FR,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16004990,0274,B4082,,,,,*TUBE NG LEVINE 16FR ARGY,20.00,20.00,,,,,,,,,,,,,
16004999,0272,,,,,,*TUBE SALEM SUMP 18FR,54.89,54.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005000,0274,B4082,,,,,*TUBE LEVINE 18FR,20.00,20.00,,,,,,,,,,,,,
16005001,0272,,,,,,*TUBE SALEM SUMP 16FR,54.89,54.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005002,0272,,,,,,TUBE SALEM SUMP 14FR,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005003,0272,,,,,,*TUBE SALEM SUMP 12FR,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005004,0278,C1894,,,,,DRYSEAL SHEATH DSL1628,915.74,915.74,176.61,176.61,,,,,,,176.61,,,,
16005005,0278,C1874,,,,,EXCLUDER RLT261418,36629.45,36629.45,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005006,0278,C1874,,,,,EXCLUDER PLC181400,15018.07,15018.07,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005007,0278,C1894,,,,,DRYSEAL SHEATH DSL1828,1098.88,1098.88,176.61,176.61,,,,,,,176.61,,,,
16005008,0278,C1725,,,,,Q50 PLUS STENT GRAFT BALLOON CATH,1615.03,1615.03,471.51,471.51,,,,,,,471.51,,,,
16005009,0278,C1894,,,,,DRYSEAL SHEATH DSL1228,915.74,915.74,176.61,176.61,,,,,,,176.61,,,,
16005010,0278,C1874,,,,,EXCLUDER RLT281418,36629.45,36629.45,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005011,0272,,,,,,SHEATH 5FR BRITE TIP,143.50,143.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005012,0278,C1887,,,,,8 FR DESTINATION SHEATH,458.87,458.87,,,,,,,,,,,,,
16005014,0272,,,,,,SHEATH,443.71,443.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005015,0272,,,,,,SHEATH,432.89,432.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005016,0272,,,,,,SHEATH INTRODUCER 6FR SHUTTLE,785.87,785.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005017,0272,,,,,,SHEATH DESTINATION 90CM,549.44,549.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005018,0258,,,,,,HEMOSTATIC ABSORBABLE PARTICLES,452.87,452.87,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
16005019,0272,,,,,,SHEATH DESTINATION 45CM,476.18,476.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005020,0278,C1768,,,,,GRAFT MAIN BODY,27189.04,27189.04,,,,,,,,,,,,,
16005021,0278,C1768,,,,,GRAFT LEG CONTROL,12553.91,12553.91,,,,,,,,,,,,,
16005022,0272,,,,,,DNU ENDO RETRACT 5MM,347.78,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005023,0272,,,,,,ENDO RETRACT 10MM,757.32,757.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005024,0272,,,,,,GRASPER ROTICULATOR 5MM,919.64,919.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005025,0272,,,,,,RELOADS ENDO STAPLER ETHICON,198.91,198.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005026,0272,,,,,,SILS DISSECTOR 5MM,1072.91,1072.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005027,0272,,,,,,SHEATH DESTINATION RDC RENAL CATH 6FR 45,476.18,476.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005028,0272,,,,,,MARGINMARKER WITH CLIPS,575.53,575.53,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005029,0272,,,,,,SHEATH DESTINATION RDC RENAL 5FR 45CM,488.08,488.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005032,0272,,,,,,CATH EPIDURAL,49.53,49.53,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005034,0272,,,,,,TROCAR THORACIC 12MM,249.77,249.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005035,0278,C1874,,,,,EXCLUDER RLT231218,35098.20,35098.20,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005036,0278,C1874,,,,,EXCLUDER PLC141200,14335.65,14335.65,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005037,0278,C1874,,,,,EXCLUDER PLL161207,10069.92,10069.92,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005038,0278,C1894,,,,,DRYSEAL SHEATH DSF1233,0.00,0.00,176.61,176.61,,,,,,,176.61,,,,
16005039,0278,C1894,,,,,DRYSEAL SHEATH DSF1633,1415.25,1415.25,176.61,176.61,,,,,,,176.61,,,,
16005040,0272,C1725,,,,,CATH OCCULDER OCCULSION MOLDING MOB37,0.00,0.00,,,,,,,,,,,,,
16005048,0272,,,,,,TRAY PONSKY PULL PEG,1215.45,1215.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005070,0278,,,,,,TISSUE EXPANDERS,4693.15,4693.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16005130,0272,,,,,,LIGASURE EXACT DISSECTOR,2076.92,2076.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005131,0272,,,,,,DNU CLIP APPLIER 10MM EN,250.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005132,0272,,,,,,LIGASURE IMPACT,2266.39,2266.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005133,0272,,,,,,LIGASURE SMALL JAW,1500.57,1500.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005134,0272,,,,,,LIGASURE BLUNT TIP 5 MM,1798.17,1798.17,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005135,0272,,,,,,DNU CLIP APPLIER LIGAMAX 5,419.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005136,0272,,,,,,PENCIL FORCE TRIVERSE BOVIE,164.00,164.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005137,0272,,,,,,LIGASURE ATLAS 10MM 37CM HAND SWITCHING,1587.21,1587.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005138,0272,,,,,,LIGASURE CURVED MARYLAND 5MM 23CM,2071.13,2071.13,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005139,0272,,,,,,LIGASURE CURVED MARYLAND 5MM 37CM,1928.60,1928.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005140,0272,,,,,,VISIPORT PLUS OPTICAL TROCAR 5-12MM,475.21,475.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005150,0272,,,,,,L-HOOK ELECTRODE 33CM,182.85,182.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005151,0272,,,,,,L-HOOK ELECTRODE 45CM,171.07,171.07,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005154,0272,,,,,,CATH BERENSTEIN II .038 X 100 CM,49.32,49.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005155,0272,,,,,,BOVIE 4,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005156,0272,,,,,,SCISSOR 5MMX35CM,155.80,155.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005157,0272,,,,,,BAG SPECIMEN RETRIEVAL SYSTEM,249.75,249.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005158,0272,,,,,,TROCAR BALLOON 12X100,88.00,88.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005159,0272,,,,,,TROCAR 5X100 OPT SEP SYS,71.75,71.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005160,0272,,,,,,SLEEVE CANN/SEAL,26.65,26.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005161,0272,,,,,,DNU SLEEVE ADV FIX  CANN/SEAL,31.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005162,0272,,,,,,TROCAR 11x100 THR OPT SEP SYS,112.75,112.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005163,0272,,,,,,SLEEVE 11X100MM THR CAN/SEAL,56.37,56.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005164,0272,,,,,,DNU SLEEVE 11X100MM ADVFIX CAN/SEAL,72.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005165,0272,,,,,,TROCAR 15X150 NON BLADED,194.75,194.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005166,0272,,,,,,DNU TROCAR 15X100 NON BLADED,200.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005167,0271,,,,,,CAUTERY PENCIL,50.43,50.43,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16005168,0272,,,,,,BLADE ELECTRODE,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005169,0272,,,,,,NEEDLE ELECTRODE,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005170,0272,,,,,,BLADE 6,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005171,0272,,,,,,DNU BALLOON 5MM ORIGIN PORT,72.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005172,0272,,,,,,CLIP APPLIER 5MM,349.64,349.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005173,0272,,,,,,CLIP APPLIER 10MM,238.93,238.93,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005174,0272,,,,,,KII FIOS FIRST ENTRY 11MM X 150M,131.20,131.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005175,0272,,,,,,KII FIOS FIRST ENTRY 5MM X 150MM,67.65,67.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005176,0272,,,,,,*KII SLEEVE 5 X 150,30.75,30.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005177,0272,,,,,,KII SLEEVE 11 X 150,51.25,51.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005178,0272,,,,,,KII OPTICAL ACCESS SYSTEM Z THREAD,198.85,198.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005179,0272,,,,,,OPTIC PORT 5MM,77.90,77.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005180,0272,,,,,,CLIP APPLIER AUTO ENDO 5MM,432.89,432.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005181,0272,,,,,,TROCAR 5x100 NO BALLOON,71.75,71.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005182,0272,,,,,,TROCAR 5x150,77.90,77.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005183,0272,,,,,,SLEEVE 5 X 100,32.80,32.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005184,0272,,,,,,ACCESS NEEDLE STEP INSUFFLATION,144.20,144.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005185,0272,,,,,,"NEEDLE, SURGINEEDLE 150MM LONG PNEUMOPER",68.72,68.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005186,0272,,,,,,SPECIMEN RETRIEVAL SYSTEM 3X6,176.19,176.19,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005187,0272,,,,,,ENDOSCOPIC PEANUT DEVICE 5MM,206.39,206.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005188,0272,,,,,,OPTIC PORT 11x100,118.90,118.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005189,0272,,,,,,OPTICAL PORT SLEEVE 11 X 100,58.42,58.42,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005190,0272,,,,,,CLIP APPLIER 5MM ENDOCLIP III,1379.43,1379.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005191,0272,,,,,,CLIP APPLIER 10MM ENDOCLIP III,1136.77,1136.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005192,0272,,,,,,DRAIN ROUND WOUND W/ TROCAR 10FR,27.44,27.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005193,0272,,,,,,12X150 KII OPTICAL ACCESS SYSTEM,118.90,118.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005194,0272,C1725,,,,,CATH OCCULDER OCCULISION 26FRX100CM,822.51,822.51,,,,,,,,,,,,,
16005195,0272,C1725,,,,,CATH OCCULDER OCCULSION 34FRX100CM,822.51,822.51,,,,,,,,,,,,,
16005200,0272,,,,,,CATH ART EMB 2FR,260.14,260.14,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005204,0272,,,,,,TRAY SPINAL PENCIL PO W/O LIDOCAINE,52.23,52.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005205,0272,,,,,,TRAY LUMBAR PUNCTURE PED,22.79,22.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005206,0272,,,,,,RELOAD LINEAR CUTTER,209.02,209.02,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005207,0272,,,,,,TRAY EPIDURAL PAINPAK,70.17,70.17,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005208,0272,,,,,,TRAY SPINAL PENCIL LIDOCAINE,59.24,59.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005209,0272,,,,,,TRAY CONTINOUS EPIDUR,81.59,81.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005210,0272,,,,,,TRAY LUMBAR PUNCTURE,44.69,44.69,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005213,0272,,,,,,TRAY THORACENTISIS,182.00,182.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005217,0272,,,,,,TRAY NERVE BLOCK CONT STIM,456.43,456.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005218,0272,,,,,,TRAY SPINAL NEEDLE PEACAN,73.75,73.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005219,0272,,,,,,SET NERVE BLOCK CONT TUOHY,117.26,117.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005220,0272,,,,,,SET NERVE BLOCK CONT TUOHY,103.03,103.03,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005221,0272,,,,,,TRAY NERVE BLOCK CONT STIM,308.20,308.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005222,0272,,,,,,SET NERVE BLOCK CONT TUOHY,103.07,103.07,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005238,0272,,,,,,SHEATH SUPER R/O  8FR 11CM,147.60,147.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005256,0272,,,,,,TIPLESS STONE EXTRACTOR,1115.55,1115.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005257,0272,,,,,,EXTRACTOR EBL 8.5-20,589.40,589.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005258,0272,,,,,,EXTRACTOR STONE EBL,496.62,496.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005259,0272,,,,,,WIRE BASKET MWB-2X4,1375.27,1375.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005260,0272,,,,,,BASKET MEMORY POLYP RETRIEVER 7FR,1258.74,1258.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005285,0272,,,,,,BLADE BEAVER 3M,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005286,0272,,,,,,BLADE BEAVER 5MM,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005388,0272,,,,,,STYLET INTUBATING 14,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005389,0272,,,,,,STYLET INTUBATING 10FR,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005390,0272,,,,,,BASKET RETRIEVER ZERO TIP,1186.31,1186.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005391,0272,,,,,,BASKET STONE RETRACTOR TIPLESS 1.5FR,989.64,989.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005392,0272,,,,,,BASKET STONE SKYLITE TIPLESS 1.9FR,799.20,799.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005401,0272,,,,,,"ULTRABLATOR 30 DEGREE, THREE RIB",270.32,270.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005402,0272,,,,,,"ULTRABLATOR 90 DEGREE, THREE RIB",270.32,270.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005403,0272,,,,,,BAG OSTOMY 2 1/2  DRAINABLE,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005422,0278,C1874,,,,,STENT 4.8FRX24CM URET,695.96,695.96,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005423,0278,C1874,,,,,STENT 4.BFR 26 CM URET,695.96,695.96,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005426,0278,C1874,,,,,STENT 7FR X 26CM URETERAL SOFT,492.37,492.37,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005427,0278,C1874,,,,,STENT 7FR X 24CM URETERAL SOFT,492.37,492.37,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005428,0272,,,,,,CATH 18FR X 4CM URETERAL BALLOON,1562.92,1562.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005429,0278,C1874,,,,,STENT CAROTID 6MMX30MM,7325.89,7325.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005430,0278,C1874,,,,,STENT CAROTID 6MMX20MM,7325.89,7325.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005431,0278,C1874,,,,,STENT CAROTID 7MMX20MM,7325.89,7325.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16005505,0272,,,,,,PAPILLOTOME HUIBRESGS,802.52,802.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005512,0272,,,,,,ENDOPATH PROBE SHAFT,74.41,74.41,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005513,0272,,,,,,DNU SHAFT EPS 04,142.72,142.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005514,0272,,,,,,CONTROL FOOT,142.31,142.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005515,0272,,,,,,ENDOPATH ELECTRODE SHAFT,74.41,74.41,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005517,0272,,,,,,TUBE NASOPHARYNGEAL 32,24.10,24.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005519,0272,,,,,,TUBE NASOPHARYNGEAL 30,23.49,23.49,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005520,0272,,,,,,DNU TRAY THORACOSTOMY,59.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005530,0272,,,,,,VALVE TRACH/VENT SWALLOWING,223.27,223.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005591,0272,,,,,,URINEMETER 2000 CC,28.00,28.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005606,0272,,,,,,PACK ANGIO (CUSTOM),221.58,221.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005740,0272,,,,,,SET MANOMETER W/STOPC,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005798,0272,,,,,,COIL EMBOLIZATION 5 X,178.96,178.96,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005816,0272,,,,,,TUBE TRACH 3.0 CUFFED,21.52,21.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005819,0272,,,,,,TUBE TRACH 5.0 UNCUFFED,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005820,0272,,,,,,TUBE ORAL RAE CUFFED 4.0,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005821,0272,,,,,,TUBE TRACH 2.5 UNCUFFED,106.31,106.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005823,0272,,,,,,TUBE TRACH 4.0 UNCUFFED,68.55,68.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005841,0272,,,,,,PH PROBE PAC-50015M,176.50,176.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005842,0272,,,,,,TUBE ET MICROCUFF PED 3.5MM,36.86,36.86,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005843,0272,,,,,,TUBE ET MICROCUFF PED 4.0MM,78.39,78.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005844,0272,,,,,,TUBE ET MICROCUFF PED 4.5MM,44.98,44.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005845,0272,,,,,,TUBE ET MICROCUFF PED 5.0MM,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005846,0272,,,,,,TUBE ET MICROCUFF PED 5.0MM,44.98,44.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005887,0272,,,,,,TUBE TRACH 4.0 UNCUFFED,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005888,0272,,,,,,TUBE TRACH 4.0 CUFFED,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16005894,0275,C1899,,,,,LEADWIRE 4470,3163.45,3163.45,,,,,,,,,,,,,
16005895,0275,C1899,,,,,LEADWIRE 4457,3163.45,3163.45,,,,,,,,,,,,,
16005899,0275,C1785,,,,,AUTOMATIC ICD IMPLANT,58274.13,58274.13,,,,,,,,,,,,,
16005900,0275,C1896,,,,,LEADWIRE 0148-141619  ICD,23309.65,23309.65,,,,,,,,,,,,,
16006050,0272,,,,,,INTRODUCER HEMOSTASIS 6FR 12CM,34.23,34.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006051,0272,,,,,,INTRODUCER HEMOSTASIS 6FR 5CM,41.00,41.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006053,0272,,,,,,NEEDLE ASPERATION 21G 13MM,191.64,191.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006054,0272,,,,,,NEEDLE ASPERATION 21G W/PORT 13MM,258.77,258.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006055,0272,,,,,,NEEDLE ASPIRATION NA2 SMOOTHSHOT 21G,265.24,265.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006056,0272,,,,,,NEEDLE SPINAL 18 X 3 1/2,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006057,0272,,,,,,NEEDLE 22 X 3/4 NON-C,48.13,48.13,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006060,0272,,,,,,TUBE UNIVENT ENDO 6.5,596.06,596.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006061,0272,,,,,,TUBE UNIVENT 6.0,596.06,596.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006062,0272,,,,,,TUBE UNIVENT ENDO 7.5MM,596.06,596.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006063,0272,,,,,,TUBE UNIVENT ENDO 7.0MM,596.06,596.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006064,0272,,,,,,TUBE UNIVENT ENDO 8.5,596.06,596.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006065,0272,,,,,,TUBE UNIVENT ENDO 8.0,596.06,596.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006066,0272,,,,,,NEEDLE SPINAL 22 X 3.5,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006068,0272,,,,,,DNU NEEDLE SPINAL 22 X 5,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006073,0272,,,,,,NEEDLE RIGHT ANGLE 20,29.15,29.15,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006074,0272,,,,,,NEEDLE 20 X 3/4 NDN-C,23.62,23.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006076,0272,,,,,,NEEDLE 22 X 1 NON-COR,49.61,49.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006078,0272,,,,,,NEEDLE 19 X 1.5 NON-CORING RT,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006079,0272,,,,,,NEEDLE 19 X 3/4 NDN-C,22.57,22.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006080,0278,C1769,,,,,GUIDE WIRE STEERABLE,466.19,466.19,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16006100,0272,,,,,,ALEXIS WOUND PROTECTOR/RETRACTOR X-LARG,296.37,296.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006101,0272,,,,,,ALEXIS WOUND PROTECTOR/RETRACTOR XX-LARG,449.54,449.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006102,0272,,,,,,ALEXIS WOUND PROTECTOR/RETRACTOR LARGE,243.09,243.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006103,0272,,,,,,ALEXIS WOUND PROTECTOR/RETRACTOR MEDIU,177.55,177.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006120,0278,C1874,,,,,DNU STENT SMART 6X20CM,5162.75,5162.75,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16006121,0278,C1874,,,,,STENT SMART 14X40,4706.72,4706.72,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16006122,0278,C1874,,,,,STENT SMART 14X60,4706.72,4706.72,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16006201,0272,,,,,,DNU SENSOR OXISENSOR II N-25,42.72,42.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006202,0272,,,,,,SYRINGE EPIDURAL 7CC,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006203,0272,,,,,,LIGACLIP ALLPORT M/L,1847.13,1847.13,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006204,0272,,,,,,UROSTOMY POST OP 3/4,30.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006205,0272,,,,,,BLADE BEAVER MINI,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006402,0272,,,,,,CATH ULTRA 5FR/120CM,899.09,899.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006411,0278,C1874,,,,,SHEATH 6FR 11C BRIGHT,130.09,130.09,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16006438,0272,,,,,,DNU CATH 5X2X120 ULTRA DI,631.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006610,0272,,,,,,*CATH BRONCHO 41FR RIGHT,386.72,386.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006820,0270,,,,,,NEEDLE SPINAL 22 X 8 INCH,63.04,63.04,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16006821,0272,,,,,,NEEDLE SPINAL 25G 3 1/2,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006822,0272,,,,,,NEEDLE SPINAL 20G X6IN LONG LENGTH WITH,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006823,0272,,,,,,NEEDLE SPINAL 18G X 6IN LONG LENGTH,23.86,23.86,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006826,0272,,,,,,NEEDLE SPINAL 22X5,30.75,30.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006827,0272,,,,,,NEEDLE SPINAL 20X5,30.75,30.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006828,0272,,,,,,NEEDLE SPINAL TOUHY 20X5G,44.08,44.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16006829,0272,,,,,,NEEDLE SPINAL TOUHY 22X5G,44.08,44.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007000,0272,,,,,,BASKET STONE 2.4 FR GEMINI 3 WIRE,991.48,991.48,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007010,0272,,,,,,SHEATH 7FR BRIGHT TIP 5.5CM,107.75,107.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007011,0272,,,,,,SHEATH 7FR BRIGHT TI,130.09,130.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007112,0272,C1887,,,,,CATH PIGTAIL 4FR 110CM,49.20,49.20,,,,,,,,,,,,,
16007114,0272,C1887,,,,,CATH PIGTAIL 4FR  65CM,57.40,57.40,,,,,,,,,,,,,
16007115,0272,C1887,,,,,CATH PIGTAIL FLUSH 70CM,904.41,904.41,,,,,,,,,,,,,
16007147,0278,C1769,,,,,GUIDE WIRE 300CM X 035 STORQ,275.22,275.22,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007197,0272,,,,,,WIRE INFUSION KATZEN,669.32,669.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007204,0278,C1874,,,,,STENT WALL 20 X 40 CM,3979.29,3979.29,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007207,0272,,,,,,CATH SELECTIVE C2X.035X65CM,58.84,58.84,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007210,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,10822.34,10822.34,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007211,0278,C1874,,,,,VIABAHN BALLOON EXPANDABLE ENDOPROSTHESI,10838.99,10838.99,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007212,0278,C1874,,,,,VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,11108.71,11108.71,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007213,0272,,,,,,CATH GLIDE TERUMO 4FR 65 LONG,229.44,229.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007214,0272,,,,,,CATH GLIDE TERUMO 120CM,229.44,229.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007215,0278,C1874,,,,,VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,11108.71,11108.71,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007216,0278,C1874,,,,,VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,11108.71,11108.71,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007217,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,23166.46,23166.46,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007218,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,12833.63,12833.63,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007219,0278,C1874,,,,,VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,11385.27,11385.27,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007220,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,11388.60,11388.60,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007221,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,13153.50,13153.50,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007223,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,24092.55,0.00,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007225,0278,C1874,,,,,VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,11088.90,11088.90,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007226,0278,C1874,,,,,VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,11088.90,11088.90,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007229,0270,,,,,,ACAPELLA DM BLUE W/T GHPC MED FLOW,162.19,162.19,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16007233,0272,,,,,,SHEATH 6FR BRITE TIP 23CM,139.52,139.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007234,0272,,,,,,SHEATH 7FR BRITE TIP,142.64,142.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007235,0272,,,,,,SHEATH 7FR BRITE TIP 23CM .97MM,163.06,163.06,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007236,0272,,,,,,SHEATH 7FR X 11CM BRITE TIP,129.44,129.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007237,0272,,,,,,SHEATH 8FR X 35CM BRITE TIP,141.61,141.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007238,0272,,,,,,SHEATH 9FR X 23CM BRITE TIP,143.34,143.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007239,0272,,,,,,SHEATH 10FR X 11CM BRITE TIP,129.44,129.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007240,0272,,,,,,SHEATH 9FR X 35CM BRITE TIP,232.83,232.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007241,0272,,,,,,SHEATH 6FR BRITE TIP 5.5CM,105.12,105.12,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007250,0272,,,,,,SHEATH SUPER 9FR,92.75,92.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007252,0272,,,,,,SHEATH SUPER 10FR,36.46,36.46,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007280,0278,C1874,,,,,STENT PALMAZ 7FR X 80 CM CORINTHIAN,3916.02,3916.02,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007285,0272,,,,,,*CATH BLUE MAX 5.8 FR,862.46,862.46,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007290,0272,,,,,,CATHETER STERLING MONORAIL BALLOON DILAT,749.75,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007291,0272,,,,,,CATH TRANSIT MICRO 3MMX135CM,1082.23,1082.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007296,0272,,,,,,CATH GLIDE 4FR 173,235.18,235.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007297,0272,,,,,,CATH GLIDE 4FR 65CM,238.09,238.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007298,0272,,,,,,WIRE MAGIC TORQUE,240.25,240.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007299,0278,C1769,,,,,GUIDE WIRE AMPLATE,201.72,201.72,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007300,0278,C1874,,,,,STENT SMART 10X20X120,4944.98,4944.98,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007301,0278,C1874,,,,,DNU STENT SMART 12X30X80,4706.89,4706.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007302,0278,C1874,,,,,STENT SMART 14X40X80,4706.72,4706.72,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007303,0272,,,,,,CATH DILATION PTA PRO 8MMX4CMX80CM,723.60,723.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007304,0272,,,,,,CATH PIGTAIL 4FR 65CM,399.59,399.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007305,0272,,,,,,CATH PIGTAIL 4FR 100CM,143.50,143.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007306,0272,,,,,,CATH PIGTAIL 5FR 65CM,426.65,426.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007307,0272,C1725,,,,,CATHETER CENTESIS ONE STEP 6FR,133.20,133.20,,,,,,,,,,,,,
16007310,0278,C1725,,,,,CATH GUIDE 6FR 90CM PV MACH 1,200.90,200.90,471.51,471.51,,,,,,,471.51,,,,
16007312,0278,C1725,,,,,CATH GUIDE RUNWAY MP2,532.79,532.79,471.51,471.51,,,,,,,471.51,,,,
16007313,0278,C1725,,,,,CATH GUIDE RUNWAY JR4,532.79,532.79,471.51,471.51,,,,,,,471.51,,,,
16007321,0272,,,,,,CATH VIPER SMALL VESSEL BA,1345.30,1345.30,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007325,0272,,,,,,KIT BIO PREP,998.98,998.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007326,0272,,,,,,BONE CEMENT MIXING AND DELIVERY SYSTEM C,401.25,401.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007328,0278,C1874,,,,,STENT EPIC 10X20  x 75CM SELF EXPANDING,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007329,0278,C1874,,,,,STENT EPIC 12X60X75CM  SELF EXPANDING VA,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007330,0278,C1874,,,,,STENT EPIC 6X30 SELF EXPANDING VASCULAR,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007331,0278,C1874,,,,,STENT EPIC 6X60 SELF EXPANDING VASCULAR,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007332,0278,C1874,,,,,STENT EPIC 8X30 SELF EXPANDING VASCULAR,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007333,0278,C1874,,,,,STENT EPIC 8X40 SELF EXPANDING VASCULAR,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007334,0278,C1874,,,,,STENT EPIC 8X60 SELF EXPANDING VASCULAR,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007335,0278,C1874,,,,,STENT EPIC 10X40 SELF EXPANDING VASCULAR,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007336,0278,C1874,,,,,STENT EPIC 10X60 SELF EXPANDING VASCULAR,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007337,0278,C1874,,,,,STENT EPIC 10X40X120 VASCULAR,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007338,0278,C1874,,,,,STENT EPIC 10X20X120 SELF EXPANDING VASC,3995.94,3995.94,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007339,0278,C1769,,,,,GUIDE WIRE V-14 300CM,716.96,716.96,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007340,0278,C1769,,,,,GUIDE WIRE V-18 300CM,387.64,387.64,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007348,0272,,,,,,CATH PIGTAIL 5FR,75.85,75.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007349,0272,,,,,,CATH PIGTAIL 5FR 90CM,62.73,62.73,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007350,0278,C1769,,,,,GUIDE WIRE TSFNB-38-1,38.74,38.74,104.89,131.80,,,,,,,104.89,,,131.80,131.80
1600737,0270,,,,,,DNU EXERCISER VOLUMETRIC 2500ML,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16007400,0272,,,,,,COIL TORNADO 3MM 2MM,364.19,364.19,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007401,0272,,,,,,COIL TORNADO 4MM 2MM,355.31,355.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007402,0272,,,,,,COIL TORNADO 5MM 2MM,355.31,355.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007403,0272,,,,,,COIL TORNADO 6MM 2MM,355.31,355.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007406,0278,C1874,,,,,STENT SMART 8X20,4944.98,4944.98,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007410,0278,C1874,,,,,STENT WALL 10FR 20X60 230 CM,5439.48,5439.48,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007411,0278,C1874,,,,,STENT WALL 10FR 22X60 230 CM,5439.48,5439.48,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007412,0278,C1874,,,,,STENT WALL 10FR 20X60 230 CM,5439.48,5439.48,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007413,0278,C1874,,,,,STENT WALL 10FR 22X60 135 CM,5439.48,5439.48,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007420,0272,,,,,,PASSER (PUNCTURE CLOSURE DEVICE,203.72,203.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007446,0272,,,,,,GUIDE WIRE AX 21 480,237.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007447,0278,C1874,,,,,STENT BEV WL 7.5 10X42X75,3579.70,3579.70,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007448,0278,C1769,,,,,GUIDE WIRE ANPLATZ STIFF,195.84,195.84,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007460,0278,C1874,,,,,STENT WALL B10687110,3579.70,3579.70,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007470,0278,C1874,,,,,STENT WALL B8607110,3579.70,3579.70,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007498,0272,,,,,,CATH TNT PER GD15-87,315.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007501,0272,,,,,,CATH POWER FLEX 80 CM,705.12,705.12,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007506,0272,,,,,,CATH BRONCHO 35FR LEFT,212.15,212.15,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007508,0272,,,,,,CATH COOK 159683,155.15,155.15,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007509,0272,,,,,,CATH 5FR-100CM-.035-STRAIGHT,57.40,57.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007512,0272,,,,,,SHEATH FLO CHECK 4FR X 12CM,29.11,29.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007515,0272,,,,,,CATH STRAIGHT P5.0B-38-65-M-NS-0 CUST4-6,109.63,109.63,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007530,0272,,,,,,CATH STRAIGHT .035 4FR 100 CM,124.97,124.97,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007532,0272,,,,,,CATH TORCON ADV/5FR,76.69,76.69,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007541,0272,,,,,,WIRE KIRCHNER .045,27.67,27.67,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007543,0272,,,,,,WIRE KIRCHNER .9MM LENGTH 9  STYLE 7,20.50,20.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007549,0272,,,,,,CATH TRIGUIDE 7FR,337.91,337.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007557,0272,,,,,,NEEDLE C-SDIN 15.5 G 3CM,422.50,422.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007558,0272,,,,,,NEEDLE INTRA CDIN 14G  3CM,215.44,215.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007559,0272,,,,,,NEEDLE C-DIN 16G 3CM,182.94,182.94,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007565,0272,,,,,,CATH PIGTAIL 4FR X 125CM INFINITY,138.38,138.38,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007566,0272,,,,,,CATH STRAIGHT 5.0,88.60,88.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007567,0272,,,,,,CATH STRAIGHT 4FR,71.75,71.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007568,0272,,,,,,WIRE INFUSION KATZEN,636.02,636.02,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007588,0272,,,,,,CATH STRAIGHT 4FR 125CM,71.75,71.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007597,0278,C1725,,,,,BALLON DILATATION CATH XXL 7F 12MM X 2C,954.19,954.19,471.51,471.51,,,,,,,471.51,,,,
16007598,0278,C1725,,,,,*BALLOON DILATATION CATH XXL 7FR 14MM X,954.19,954.19,471.51,471.51,,,,,,,471.51,,,,
16007600,0278,C1769,,,,,GUIDE WIRE 180CM PLATINUM,411.29,411.29,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007601,0278,C1874,,,,,STENT 24MMX3.5MM,6626.60,6626.60,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007602,0278,C1874,,,,,STENT PROMUS PREMIER 4.00MM X 12MM,6992.89,6992.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007603,0272,,,,,,CATH HI-FLOW 4FR 110CM,75.85,75.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007604,0278,C1725,,,,,CATH DILATION 2.5MMX10CMX135CM,1135.01,1135.01,471.51,471.51,,,,,,,471.51,,,,
16007605,0278,C1725,,,,,CATH DILATION 3.0MMX10CMX135CM,1135.01,1135.01,471.51,471.51,,,,,,,471.51,,,,
16007607,0278,C1725,,,,,CATH POLAR 2.5MMX100CMX135CM,2996.95,2996.95,471.51,471.51,,,,,,,471.51,,,,
16007609,0272,,,,,,CATH BALLOON STERLING 5MMX12CMX80CM,791.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007612,0272,C1769,,,,,GUIDE WIRE LT 46 602,368.79,368.79,,,,,,,,,,,,,
16007613,0278,C1769,,,,,GUIDE WIRE M 46-254,246.79,246.79,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007614,0272,,,,,,CATH PIGTAIL COOK 5057,62.32,62.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007615,0272,C1769,,,,,TORQUE DEVICE 7017 DNU,69.75,0.00,,,,,,,,,,,,,
16007616,0278,C1769,,,,,GUIDE WIRE CRAGG FX46-214,737.25,737.25,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007617,0272,,,,,,SHUTTLE SL 6FR 90CM,500.66,500.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007618,0272,,,,,,SHUTTLE SL 7FR 90CM,500.66,500.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007619,0272,,,,,,CATH SLIP 5FR 100CM HI,207.52,207.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007620,0272,,,,,,CATH SLIP 5FR 100CM JB1,207.52,207.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007621,0272,,,,,,CATH SLIP 5FR 100CM JB2,207.52,207.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007622,0278,C1874,,,,,STENT ICAST 8X59X80,9407.11,9407.11,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007623,0278,C1874,,,,,STENT URETHERAL SOFT 6X26,679.31,679.31,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007624,0278,C1874,,,,,STENT URETHERAL SOFT 6X24,695.96,695.96,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007625,0278,C1874,,,,,STENT URETHERAL SOFT 4.87FRX22CM,679.31,679.31,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007626,0278,C1874,,,,,STENT COLONIC 4CM 31FR,3740.40,3740.40,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007627,0278,C1874,,,,,STENT COLONIC 6CM 31FR,3901.90,3901.90,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007628,0278,C1874,,,,,STENT COLONIC 10CM 31FR,4696.49,4696.49,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007629,0278,C1874,,,,,STENT URETHERAL SOFT 6X22-30,708.62,708.62,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007630,0272,C1725,,,,,CATH BALLOON STERLING 6MMX40CMX135QCM,1126.19,1126.19,,,,,,,,,,,,,
16007631,0272,C1725,,,,,CATH PTA BALLOON DILATION 4MMX40CMX146CM,994.65,994.65,,,,,,,,,,,,,
16007632,0278,C1769,,,,,GUIDE  MPA 1 598 942,399.59,399.59,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007633,0278,C1874,,,,,STENT PERCUFLEX 8FRX30CM,639.02,639.02,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007635,0272,,,,,,CATH 4FR 100CM .035 IMAGER II SELECTIVE,57.40,57.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007636,0272,,,,,,CATH 4FR 65CM .035 IMAGER II SELECTIVE,57.40,57.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007637,0278,C1874,,,,,STENT EXPRESS RENAL 5X15 90CM,4134.29,4134.29,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007638,0272,,,,,,GATEWAY ADVANTAGE Y-ADAPTER,156.62,156.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007639,0272,C1725,,,,,COYOTE ES MONORAIL 3X20X114,1176.80,1176.80,,,,,,,,,,,,,
16007640,0278,C1769,,,,,GUIDE WIRE 9316,74.58,74.58,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007641,0278,C1769,,,,,GUIDE WIRE ANGIOGUARD EMBOLI,5827.41,5827.41,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007642,0272,C1725,,,,,STERLING OVER THE WIRE 5X40,1126.19,1126.19,,,,,,,,,,,,,
16007643,0272,C1725,,,,,STERLING OVER THE WIRE BALLOON,1126.19,1126.19,,,,,,,,,,,,,
16007644,0272,C1725,,,,,STERLING OVER THE WIRE BALLOON 6X20X135,1126.19,1126.19,,,,,,,,,,,,,
16007645,0278,,,,,,STENT ESOPHAGEAL W/DUA 12CM,8604.59,8604.59,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16007646,0278,C1725,,,,,SYMMETRY BALLOON DILATION CATH 2.5MMX100,1075.59,1075.59,471.51,471.51,,,,,,,471.51,,,,
16007647,0278,C1874,,,,,STENT URETHERAL SOFT PERCUFLEX CONTOUR V,708.62,708.62,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007650,0278,C1769,,,,,GUIDE WIRE 9911,65.64,65.64,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007651,0272,,,,,,CATH STRAIGHT 4FRX65CMX.035 0 SIDE HOLES,102.50,102.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007652,0272,,,,,,CATH STRAIGHT 4FRX100CMX.035 0 SIDE HOLE,86.10,86.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007653,0272,,,,,,CATH STRAIGHT 4FRX65CM,77.90,77.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007654,0278,C1769,,,,,GUIDE WIRE AMPLATZ EMERALD .035X180CM,188.69,188.69,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007655,0278,C1769,,,,,GUIDE WIRE STRAIGHT CATH EXCHANGE,59.45,59.45,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007656,0278,C1769,,,,,GUIDE WIRE AMPLATZ EMERALD,172.20,172.20,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007657,0272,,,,,,CATH STRAIGHT 4FRX65CM,77.90,77.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007658,0278,C1769,,,,,GUIDE MPA1 586 842,366.29,366.29,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007659,0278,C1769,,,,,GUIDE SON 1 586 880,366.29,366.29,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007660,0272,,,,,,SHEATH 5FR CHECK-FLO,74.58,74.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007661,0278,C1769,,,,,GUIDE WIRE TM 480 A,500.66,500.66,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007662,0278,C1769,,,,,GUIDE WIRE TM 260 A,283.05,283.05,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007663,0272,,,,,,IMPRESS KA2 CATHETER 4F 65CM,162.09,162.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007664,0272,,,,,,9FR 35CM FLEXOR CHECK FLO INTRODUCER SET,539.45,539.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007665,0272,,,,,,MULITPORT  ADAPTER,143.50,143.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007666,0272,,,,,,DNU ADAPTER HEMOSTASIS VALVE,27.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007667,0272,,,,,,NEEDLE W/SELDINGER SHIELD ONE WALL,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007669,0272,C1769,,,,,GUIDE WIRE ROSEN 260,111.36,111.36,,,,,,,,,,,,,
16007671,0278,C1769,,,,,GUIDE WIRE STIFF D.035 L260 STRAIGHT,108.40,108.40,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007672,0272,,,,,,GUIDE WIRE STIFF D.035 L180 STRAIGHT,199.38,199.38,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007673,0278,C1769,,,,,GUIDE WIRE PLAT PLUS,313.89,313.89,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007674,0278,C1769,,,,,GUIDE WIRE 46-601,288.05,288.05,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007675,0278,C1769,,,,,GUIDE WIRE 68029,71.75,71.75,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007677,0278,C1769,,,,,GUIDE WIRE 55601,62.52,62.52,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007678,0278,C1769,,,,,GUIDE WIRE PLATINUM PLUS 300CM .014,394.50,394.50,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007679,0278,C1769,,,,,GUIDE WIRE AMPLATZ STIFF 46 51A,193.52,193.52,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007680,0272,,,,,,CATH PIGTAIL 4FR 100 CM,164.94,164.94,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007681,0272,,,,,,CATH PIGTAIL 5FR,72.77,72.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007683,0272,,,,,,CATH DILATION 6MMX4CMX80CM,582.74,582.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007684,0272,C1725,,,,,CATH BALLOON STERLING 3.0MMX60MM 150CM,791.00,791.00,,,,,,,,,,,,,
16007686,0272,,,,,,CATH 156894 (CUSTOM),62.32,62.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007688,0272,,,,,,SHEATH 8FR/25CM 15-64,141.45,141.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007691,0272,,,,,,CATH PIGTAIL 5FR,81.79,81.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007692,0272,,,,,,CATH STRAIGHT 4FR  .035X80CM,117.87,117.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007698,0272,,,,,,CATH TUNNEL 14.5FR RT 28CM,1148.83,1148.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007699,0272,,,,,,CATH TUNNEL 14.5FR RT 32CM,1148.83,1148.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007700,0272,,,,,,CATH BALLOON  DILATORS 30DX90CMX10CMX.03,2047.95,2047.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007702,0272,,,,,,CATH STRAIGHT 5.0,65.60,65.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007703,0272,,,,,,"*CATH PERMCATH 19CM, 36CM OVERALL",739.28,739.28,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007705,0272,,,,,,CATH SPY G 4 FR .038-100CM-JR 3.5,41.00,41.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007706,0272,,,,,,CATH SPY G 4 FR .038-100CM-JL 3.5,42.02,42.02,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007707,0272,,,,,,"CATH PERMCATH 23CM, 40CM OVERALL",758.56,758.56,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007708,0272,,,,,,CATH SPY G 4 FR .038-100CM-JR 5,63.47,63.47,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007709,0272,,,,,,SET MICROPUNCTURE 4.0,128.74,128.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007710,0272,,,,,,CATH PERMCATH 40CM,567.05,567.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007711,0272,,,,,,CATH SPY G 4 FR .038-100CM-JL 5,102.50,102.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007716,0272,,,,,,CATH ULTRA THIN DIAM 4X80CM,705.95,705.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007717,0272,,,,,,CATH 5FR SIM-1 SIDEWINDER,62.82,62.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007719,0272,,,,,,CATH OCCLUSION BALLOON,2078.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007720,0272,,,,,,CATH SIMMONS II,62.32,62.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007721,0272,,,,,,CATH DRAINAGE FLEXIMA APD/10/20,312.85,312.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007722,0272,,,,,,CATH DRAINAGE FLEXIMA APD/12/25,312.85,312.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007723,0272,C1729,,,,,CATH DRAINAGE 18 FR LOOP TYPE W/O STYLET,385.95,385.95,,,,,,,,,,,,,
16007724,0272,,,,,,CATH DRAINAGE 16 FR LOOP W/O STYLET,290.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007726,0272,,,,,,CATH POLY RADPICC LINE,167.02,167.02,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007727,0272,,,,,,CATH DRAINAGE FLEXIMA 14FR,320.67,320.67,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007728,0272,,,,,,CATH POWERPICC,327.40,327.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007731,0272,,,,,,CATH SUPRAPUBIC INTRODUCER,77.90,77.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007734,0272,,,,,,MICROPUNCTURE WIRE,82.00,82.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007735,0272,,,,,,DNU CATH FLEXIMA APD J TIP 10X20,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007738,0278,C1725,,,,,CATH BALLOON DIAMOND ULTRA 7X4X75,582.74,582.74,471.51,471.51,,,,,,,471.51,,,,
16007743,0272,,,,,,GUIDEWIRE SHEATH FLO CHECK 4FR X 11CM,21.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007744,0272,,,,,,CATH PIGTAIL 5FR 100CM,57.40,57.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007748,0272,,,,,,CATH C2 4FR,71.44,71.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007751,0272,,,,,,CATH COBRA II 65CM 4FR,75.85,75.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007752,0272,,,,,,CATH COBRA 2 AT 100 4FR,65.44,65.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007759,0278,C1725,,,,,CATH BALLOON 5FRX110CM FLOW ASSISTED,1137.74,1137.74,471.51,471.51,,,,,,,471.51,,,,
16007763,0272,,,,,,CATH SOFT-VU 4FR 80CM,149.24,149.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007764,0272,,,,,,*CATH 5FR SOFT-VU,141.04,141.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007765,0272,C1729,,,,,*CATH BILIARY DRAINAGE 8.5FR,469.52,469.52,,,,,,,,,,,,,
16007767,0272,,,,,,CATH RUTNER 8F CONE TIPPED,65.27,65.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007768,0272,,,,,,CATH OPEN ENDED URETE,67.65,67.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007769,0272,C1725,,,,,CATH BALLOON 5MMX4CMX8CM,1126.19,1126.19,,,,,,,,,,,,,
16007770,0272,,,,,,CATH THRUWAY 190CMX0.14,428.84,428.84,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007771,0272,,,,,,CATH ULTRA THIN DIAMOND 7MMX2CMX75CM,582.74,582.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007772,0272,C1725,,,,,CATH BALLOON MUSTANG 7X40X75CM,599.39,599.39,,,,,,,,,,,,,
16007775,0272,,,,,,ADAPTER INTUBATED FOR CAPONE CO2 SENSOR,40.68,40.68,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007776,0272,,,,,,ADAPTER NON INTUBATED W/O2 SEATING CAPON,37.02,37.02,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007777,0272,,,,,,CATH THRUWAY 300CMX0.14,445.98,445.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007780,0272,,,,,,SET MICROPUNTURE MPIS,108.65,108.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007781,0278,C2625,,,,,FANELLI BILIARY STENT SET,2097.87,2097.87,1434.61,1434.61,,,,,,,1434.61,,,,
16007782,0272,,,,,,DILATOR NOTTINGHAM,714.95,714.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007784,0272,,,,,,DILATOR VESSEL,25.71,25.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007786,0272,,,,,,DIALATOR VESSEL 26146,21.98,21.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007788,0272,,,,,,DILATOR 48-153,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007789,0272,,,,,,SET DIALATOR 50-314,324.26,324.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007790,0272,C1726,,,,,CATH ACHALASIA BALLOON DILATOR 30MM,2047.92,2047.92,,,,,,,,,,,,,
16007791,0272,C1726,,,,,CATH ACHALASIA BALLOON DILATOR 35MM,2099.12,2099.12,,,,,,,,,,,,,
16007792,0272,,,,,,WIRE INFUSION 46-192,669.32,669.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007793,0272,,,,,,CATH ACHALASIA BALLOON DILATOR 40MM,2047.92,2047.92,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007794,0272,,,,,,WIRE INFUSION KATZEN,669.32,669.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007795,0272,C1726,,,,,BALLOON ESOPHAGEAL FIXED WIRE 5865,692.19,692.19,,,,,,,,,,,,,
16007796,0272,,,,,,CATH POLY RADPICC DUAL LINE,213.55,213.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007798,0272,,,,,,DILATOR VESSEL COOK,52.73,52.73,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007799,0272,,,,,,DILATOR JCD 8.0-38-20,35.79,35.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007800,0272,,,,,,DILATOR JCD 8.0-38-20,57.40,57.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007801,0272,,,,,,COON 14 FR DILATOR,155.80,155.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007803,0272,,,,,,SHEATH W/UNI-VALVE 10,74.82,74.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007805,0272,C1725,,,,,CATH BALLOON MUSTANG 8X40X75,599.39,599.39,,,,,,,,,,,,,
16007807,0272,,,,,,SHEATH 9FR X 10CM PINNACLE,143.50,143.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007808,0272,,,,,,SUTURE SILK 4-0 18  TIES ETH A183H,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007809,0272,C1725,,,,,*CATH BALLOON MUSTANG 8X40X135,599.39,599.39,,,,,,,,,,,,,
16007810,0272,,,,,,SYRINGE INJECTION MEDRAD,36.89,36.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007811,0272,,,,,,WAND TURBINATE REFLEX-45,597.31,597.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007812,0272,,,,,,WAND EVAC-XTRA TONSIL/ADENOID,582.74,582.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007813,0272,,,,,,SHEATH 9FR X 11CM INTERVENTIONAL,143.50,143.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007814,0272,,,,,,WIRE SUPER STIFF .035X75CM,132.22,132.22,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007815,0272,,,,,,SYRINGE INJECTION 200,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007816,0272,,,,,,5 FR DILATOR (CUSTOM),138.68,138.68,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007817,0272,,,,,,COON 7 FR DILATOR (CUSTOM),73.71,73.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007818,0272,,,,,,COON 6 FR DILATOR 20CM .038,65.35,65.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007822,0272,C1725,,,,,*CATH BALLOON MUSTANG 8X30X75,599.39,599.39,,,,,,,,,,,,,
16007823,0272,,,,,,COON 10 FR DILATOR,159.69,159.69,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007824,0272,,,,,,CATH BALLOON CODA 10FR 100CM,860.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007825,0278,C1725,,,,,CATH BALLOON CODA 9FR 120CM,1475.17,1475.17,471.51,471.51,,,,,,,471.51,,,,
16007826,0272,,,,,,COON 12 FR DILATOR,159.69,159.69,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007829,0272,,,,,,CATH SUPER TORQUE 5FR/J,75.85,75.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007830,0272,,,,,,TORQUE VISE,26.36,26.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007831,0278,C1874,,,,,STENT INTRO SYSTEM 10-7,410.22,410.22,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007832,0272,C1769,,,,,GUIDE WIRE - STRAIGHT TIP 0.35  150CM,160.51,160.51,,,,,,,,,,,,,
16007833,0278,C1769,,,,,GLIDE WIRE 46 154,195.61,195.61,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007834,0278,C1769,,,,,GLIDE WIRE 46-152,174.14,174.14,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007835,0278,C1874,,,,,STENT INTRO SYSTEM 10-5,586.07,586.07,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007837,0272,,,,,,CATH GLO TIP ERCP,196.75,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007840,0272,,,,,,SHEATH INTRODUCER 7 F,79.95,79.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007841,0272,,,,,,CATH MICRO 3FR 150CM L HI-FLOW,1248.73,1248.73,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007842,0272,,,,,,SHEATH INTRODUCER 15-712-1,79.95,79.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007843,0272,,,,,,INTRODUCER SHEATH 15-731,141.45,141.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007844,0272,,,,,,SHEATH PINNACLE 15-73,141.45,141.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007845,0272,,,,,,INTRODUCER COUDE TIP 15X70CM,32.27,32.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007846,0278,C1887,,,,,CATH MICRO INFUSION 2.9DX150LX5,649.34,649.34,,,,,,,,,,,,,
16007847,0278,C1887,,,,,CATH MICRO INFUSION 2.9DX150LX10,649.34,649.34,,,,,,,,,,,,,
16007848,0272,,,,,,PAINPUMP BLOCK AID REUSABLE,1130.85,1130.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007849,0272,,,,,,PAINPUMP 2 400ML,698.12,698.12,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007850,0278,,,,,,DNU STENT URETERAL 6FR X 22-30CM,340.00,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16007853,0272,,,,,,SHEATH SUPER 15-735B,145.71,145.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007855,0272,,,,,,PERITONEAL DIALYSIS CATH UNIVERSAL TENCK,178.05,178.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007856,0272,,,,,,GUIDEWIRE THRUWAY 300CM 49-297,445.98,445.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007857,0272,,,,,,CHRONIC CATHETER ACCESSORY 16FR,158.26,158.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007858,0272,,,,,,CATH PERITONEAL DIALYSIS TENCKHOFF 47CM,192.33,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007859,0272,,,,,,WIRE GUIDE EXTRA STIFF LUNDERQUIST,339.65,339.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007860,0272,,,,,,TWISTER PLUS 22LD ROTATABLE RETRIEVAL DE,233.10,233.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007861,0278,C1769,,,,,CATH TNT GUIDEWIRE TR,337.91,337.91,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007862,0272,,,,,,TWISTER PLUS 26LD ROTATABLE RETREVAL DEV,233.10,233.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007863,0272,,,,,,RETRIEVER SUTURE BLUE LASSO,161.95,161.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007865,0272,,,,,,RETRIEVER SUTURE 10.1,898.02,898.02,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007867,0272,,,,,,RETRIEVER ROTH NET FOOD BOLUS PLATINUM,349.64,349.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007871,0272,,,,,,CATH SYMMETRY,1075.57,1075.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007874,0272,,,,,,CATH STRAIGHT 5 FR .038X70CM,99.42,99.42,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007875,0272,,,,,,CATH STRAIGHT 5 FR .038X100CM,99.42,99.42,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007876,0272,,,,,,CATH WIRE 5 FR .035X260CM,259.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007877,0272,,,,,,KIT BLOOD CONSERVATION 1/4  WOUND DRAIN,412.08,412.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007878,0278,C1725,,,,,CATH BALLOON DIL 10X40 MUSTANG,599.39,599.39,471.51,471.51,,,,,,,471.51,,,,
16007879,0272,,,,,,HYDROPHILIC WIRE GUIDE HIWIRE,286.38,286.38,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007880,0278,C1725,,,,,CATH BALLOON DILATION STERLING 4x20x135,1126.19,1126.19,471.51,471.51,,,,,,,471.51,,,,
16007881,0278,C1725,,,,,CATH BALLOON 5X2X80 STERLING,1126.19,1126.19,471.51,471.51,,,,,,,471.51,,,,
16007882,0278,C1725,,,,,CATH BALLOON 4X4X135 STERLING,1126.19,1126.19,471.51,471.51,,,,,,,471.51,,,,
16007883,0278,C1725,,,,,CATH BALLOON 4X40X145 COYOTE,1126.19,1126.19,471.51,471.51,,,,,,,471.51,,,,
16007884,0278,C1769,,,,,GUIDE WIRE  ROADRUNNER .035 260CM,339.65,339.65,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007885,0278,C1725,,,,,CATH BALLOON 3X40X145 COYOTE,1126.19,1126.19,471.51,471.51,,,,,,,471.51,,,,
16007886,0278,C1769,,,,,GUIDE WIRE 197303,30.75,30.75,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007887,0272,,,,,,4FR WOVEN FILIFORM SPIRAL TIP,238.62,238.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007888,0272,,,,,,PERI-STRIPS DRY,688.44,688.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007889,0272,,,,,,5F WOVEN FILIFORMS SPIRAL TIP,244.59,244.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007890,0272,,,,,,6F WOVEN FILIFORMS SPIRAL TIP,244.59,244.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007891,0272,,,,,,8FR WOVEN PHILLIPS FOLLOWER,367.05,367.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007892,0272,,,,,,10FR WOVEN PHILLIPS FOLLOWER,358.10,358.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007893,0272,,,,,,12FR WOVEN PHILLIPS FOLLOWER,358.10,358.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007894,0272,,,,,,14FR WOVEN PHILLIPS FOLLOWER,358.10,358.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007895,0272,,,,,,VASC RET FORC 191687,1001.32,1001.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007896,0272,,,,,,16FR WOVEN PHILLIPS FOLLOWER,367.05,367.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007897,0272,,,,,,18FR WOVEN PHILLIPS FOLLOWER,367.05,367.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007898,0272,,,,,,20FR WOVEN PHILLIPS FOLLOWER,358.10,358.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007900,0272,,,,,,CATH PIGTAIL 7FR,62.32,62.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007901,0272,,,,,,22FR WOVEN PHILLIPS FOLLOWER,358.10,358.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007902,0272,,,,,,COIL EMBOLIZATION,178.96,178.96,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007903,0272,,,,,,COIL EMBOLIZATION,183.43,183.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007904,0272,,,,,,COIL EMBOLIZATION MWC,178.96,178.96,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007905,0272,,,,,,COIL EMBOLIZATION,189.11,189.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007906,0272,,,,,,COIL EMBOLIZATION 959,184.50,184.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007907,0272,,,,,,COIL EMBOLIZATION 390,183.43,183.43,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007908,0272,,,,,,COIL EMBOLIZATION 5 X,178.96,178.96,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007909,0272,,,,,,COIL EMBOLIZATION 5 X,178.96,178.96,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007910,0272,,,,,,HUMIDIFIER PRE-FILLED,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007911,0272,,,,,,COIL EMBOLIZATION MWC,219.78,219.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007912,0272,,,,,,SHEATH 14 FR X 30 CM,166.56,166.56,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007913,0272,,,,,,SHEATH 10 FR 90 CM DA,307.19,307.19,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007914,0272,,,,,,SHEATH 12FR X 75CM 40,341.32,341.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007915,0272,,,,,,24FR WOVEN PHILLIPS FOLLOWER,358.10,358.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007917,0272,,,,,,SHEATH 7FR LONG 501-6,175.73,175.73,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007918,0272,,,,,,SET COPE LOOP NEPRROSTOMY,567.82,567.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007919,0271,,,,,,HIGH FLOW MULTI 8FR 5,77.90,77.90,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16007921,0272,,,,,,WIRE SENSOR DUAL FLEX PTFE,254.34,254.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007922,0272,,,,,,PACK TUR LINGERMAN,230.25,230.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007925,0278,C1725,,,,,CATH BALLOON COYOTE ES 3X40X146,1176.82,1176.82,471.51,471.51,,,,,,,471.51,,,,
16007927,0272,,,,,,COIL EMBOLIZATION 38-,219.78,219.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007928,0272,,,,,,DNU SHEATH INTRO 10FR 501,87.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007931,0272,,,,,,CATH SUCTION IN LINE ENDOTRACHEAL KIT,64.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007932,0272,,,,,,COIL EMBOLIZATION MReye 35-2-3,316.35,316.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007933,0272,,,,,,COIL EMBOLIZATION MReye 35-3-3,316.35,316.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007934,0272,,,,,,COIL EMBOLIZATION MReye 35-3-4,406.26,406.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007935,0272,,,,,,COIL EMBOLIZATION MReye 35-3-5,416.42,416.42,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007936,0278,C1874,,,,,STENT WALL 22X35,3844.76,3844.76,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007937,0278,C1874,,,,,STENT WALL 20X40,3844.76,3844.76,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007938,0272,,,,,,CATH SUCTION IN LINE ENDOTRACH REPLACEM,23.57,23.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007939,0272,,,,,,SHEATH 11FR 10CM,79.95,79.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007940,0272,,,,,,CATH SUCTION ENDOTRACH 14 FR,35.60,35.60,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007942,0272,,,,,,CATH SYMMETRY 4X2 135,1163.39,1163.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007943,0272,,,,,,SHEATH 5FR ULTIMUM HEMOSTASIS INTRODUCER,34.23,34.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007944,0272,,,,,,CATH SYMMETRY 3X4X135,1163.39,1163.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007946,0272,,,,,,CATH SYMMETRY 2 X 2 X,1295.35,1295.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007947,0272,,,,,,CATH SYMMETRY 3X2X135,1163.39,1163.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007948,0272,,,,,,CATH SYMMETRY BALLOON 3X100,685.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007949,0272,,,,,,CATH SYMMETRY 5X,1075.57,1075.57,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007955,0278,C1769,,,,,GUIDE WIRE .035 X 180,234.39,234.39,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007956,0278,C1769,,,,,GUIDE WIRE .035 X 260 STRAIGHT TIP,189.88,189.88,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16007959,0272,,,,,,CATH POWER FLEX 8 X 3,722.75,722.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007965,0272,,,,,,SENSOR OXYGEN ADULT NELLCOR OXIMAX,55.35,55.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007969,0272,,,,,,SHEATH UTLTIMUM 5 FR X 23 CM,73.80,73.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007982,0278,C1874,,,,,STENT WALL 6X45X75,3759.51,3759.51,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007983,0272,,,,,,CATH SYMMETRY 2X4X135,1135.01,1135.01,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007985,0272,C1769,,,,,GUIDE WIRE RLPC ROAD RUNNER,279.89,279.89,,,,,,,,,,,,,
16007988,0272,,,,,,CATH SPY G 4 FR .038-100CM-3DRC,102.50,102.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007989,0272,,,,,,CATH SPY GLASS 4 FR .038-100CM-JL4,102.50,102.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007990,0278,C1874,,,,,STENT PALMZ BAL EXP,2730.56,2730.56,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007992,0272,,,,,,CATH PLTFRM 6FR 4MA1,333.00,333.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007994,0272,,,,,,DNU CATH SYMMETRY 6X4X90,712.75,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007995,0272,,,,,,CATH PLTFM 6FR 4MC,333.00,333.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16007996,0278,C1874,,,,,STENT PRLOAD P3008M,3379.90,3379.90,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007997,0278,C1874,,,,,STENT PALMAZ 8MM2908,3379.90,3379.90,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16007999,0278,C1874,,,,,STENT PALMZ EXP BALL,2730.56,2730.56,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16008000,0278,Q4196,,,,,PURAPLY AM 2X2 COMMERCIAL 4SQ CM,2497.50,2497.50,,,,,,,,,,,,,
16008005,0272,,,,,,BREAST IMPLANT SIZER CONTOUR PROFILE SAL,166.56,166.56,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008006,0278,,,,,,CONTOUR PROFILE SALINE MAMMARY SIZERS,184.50,184.50,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16008007,0278,,,,,,CONTOUR PROFILE SALINE MAMMARY IMPLANT,2747.21,2747.21,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16008011,0278,,,,,,CONTOUR PROFILE SALINE MAMMARY IMPLANT,1997.97,1997.97,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16008012,0278,,,,,,CONTOUR PROFILE SALINE MAMMARY IMPLANT,3995.94,3995.94,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16008015,0272,,,,,,SHEATH STRAIGHT 6FR X 45CM,465.53,465.53,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008016,0272,,,,,,SHEATH ANGLED 6FR X 45CM,458.87,458.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008017,0272,,,,,,SHEATH STRAIGHT 7FR X 45CM,458.87,458.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008018,0272,,,,,,SHEATH ANGLED 7FR X 45CM,458.87,458.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008020,0272,,,,,,SHEATH ACCESS 13/15x36CM,673.83,673.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008021,0272,,,,,,SHEATH ACCESS 11/13X36CM,673.83,673.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008022,0272,,,,,,SINGLE ACTION PUMP,254.45,254.45,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008036,0271,,,,,,SENSOR FLOW,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16008044,0272,C1725,,,,,CATH BALLOON MUSTANG 9X40X75,599.39,599.39,,,,,,,,,,,,,
16008047,0272,C1725,,,,,CATH BALLOON COYOTE 2X20X142,1126.19,1126.19,,,,,,,,,,,,,
16008049,0272,C1725,,,,,*CATH BALLOON COYOTE 3X20X143,1126.19,1126.19,,,,,,,,,,,,,
16008055,0272,,,,,,TROCAR 10/12MM ETHICON,247.62,247.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008062,0370,,,,,,CIRCUIT ANESTHESIA PED 2 LITER BAG,24.35,24.35,27.52,83.75,83.75,83.75,58.38,,,,27.52,,,28.29,28.29
16008063,0370,,,,,,CIRCUIT ANESTHESIA,27.10,27.10,27.52,83.75,83.75,83.75,58.38,,,,27.52,,,28.29,28.29
16008065,0270,,,,,,CIRCUIT JACKSON-REES MODIFIED PED,74.80,74.80,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16008068,0272,,,,,,STOPCOCK 3-WAY,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008070,0270,,,,,,CIRCUIT JACKSON-REES 2 LITER,47.15,47.15,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16008071,0272,,,,,,DNU MANIFOLD HI-FLO STOPCOCK,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008073,0272,,,,,,SET ULTRA EXTENSION 36,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008076,0272,,,,,,MANIFOLD TWO PORT,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008077,0272,,,,,,MANIFOLD THREE PORT,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008078,0272,,,,,,STOPCOCK THREE GANG,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008079,0271,,,,,,CIRCUIT VENT W/MR290 SINGLE LIMB HEATED,143.09,143.09,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16008080,0270,A4615,,,,,OPTIFLOW NASAL CANNULA SMALL,95.45,95.45,,,,,,,,,,,,,
16008081,0270,A4615,,,,,OPTIFLOW NASAL CANNULA MEDIUM,97.84,97.84,,,,,,,,,,,,,
16008082,0272,,,,,,GRASPER REPOSABLE 38CM,219.78,219.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008084,0272,,,,,,DISPOSABLE 5MM BABCOCK,172.73,172.73,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008085,0272,,,,,,GRASPER 10MM BABCOCK,211.48,211.48,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008086,0272,,,,,,DNU GRASPER BABCOCK SINGLE ACTION,1336.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008087,0272,,,,,,DNU GRASPER BABCOCK DOUBLE ACTION,1336.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008097,0272,,,,,,DNU DUET TRS 45-4.8,1224.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008098,0272,,,,,,DNU DUET TRS 60-4.8,1048.75,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008099,0272,,,,,,CATH SPYGLASS JR 3.5,45.10,45.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008100,0272,,,,,,NEEDLE DISPOSABLE PROBLOC INSULATED,63.71,63.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008105,0272,,,,,,NEEDLE HAKKA BLOCK BEVEL 152MM25G,29.20,29.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008107,0272,,,,,,NEEDLE ATRAUMATIC SPROTTE SPINAL 22G31/2,40.79,40.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008108,0272,,,,,,NEEDLE ATRAUMATIC SPROTTE SPINAL 22G 6,48.38,48.38,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008109,0272,,,,,,NEEDLE ATRAUMATIC SPROTTE SPINAL 25G31/2,40.79,40.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008110,0272,,,,,,NEEDLE HAKKO TUOHY 6  17G,45.59,45.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008111,0272,,,,,,NEEDLE HAKKO TUOHY 3 1/2  17G,67.44,67.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008112,0272,,,,,,NEEDLE HAKKO TUOHY 6  22G,30.75,30.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008113,0272,,,,,,NEEDLE HAKKO TUOHY 6  25G,29.72,29.72,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008114,0272,,,,,,NEEDLE HAKKO TWIN-BUEL SPINAL 22G 3 1/2,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008115,0272,,,,,,*NEEDLE HAKKO TWIN-BUEL SPINAL 25G 3 1/2,20.00,20.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008116,0272,,,,,,NEEDLE HAKKO ECHOGENIC 7  22G,32.59,32.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008117,0272,,,,,,NEEDLE HAKKO ECHOGENIC 6  25G,32.59,32.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008118,0272,,,,,,NEEDLE HAKKO ECHOGENIC 4  25G,28.49,28.49,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008119,0272,,,,,,NEEDLE REG SPROTTE + MAGNI HUB 25G 3 1/2,41.81,41.81,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008121,0272,,,,,,NEEDLE REG SPROTE + MAGNI HUB 27G 3 1/2,40.79,40.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008122,0272,,,,,,SET TIP DEFLECT EBDOBRONCHIA BLOCKER,591.40,591.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008123,0272,,,,,,SET BLOCKER 5.0,591.40,591.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008124,0272,,,,,,SET BLOCKER 7.0,591.40,591.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008125,0272,,,,,,SET BLOCKER 9.0 78CM,606.18,606.18,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008126,0272,,,,,,SET BLOCKER ELCIP 9.0,541.85,541.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008130,0272,,,,,,NEEDLE ECHOBLOCK MSK 22G X 2  (50MM),35.09,35.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008131,0272,,,,,,NEEDLE ECHOBLOCK MSK 22G X 3 1/8  (80MM),34.23,34.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008132,0272,,,,,,NEEDLE ECHOBLOCK NON-INS 21G X 2  (50MM),34.23,34.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008133,0272,,,,,,NEEDLE MLE PTC LUER 22G X 2 3/8,26.65,26.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008134,0272,,,,,,NEEDLE MLE PTC LUER 22G X 3 1/2,28.49,28.49,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008135,0272,,,,,,NEEDLE TUOHY MLE 17G X 3 1/2,40.79,40.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008136,0272,,,,,,NEEDLE TUOHY MLE 18G X 3 1/2,40.79,40.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600827,0270,,,,,,MEMORY 4 GB PHYSICIAN,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1600828,0270,,,,,,COMPUTER SYSTEM PHYSICIAN,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16008400,0278,C1874,,,,,STENT MEMOTHERM 8 X 40,3369.91,3369.91,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16008401,0278,C1874,,,,,STENT ACCULINK 6-80X30 190CM,7492.39,7492.39,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16008402,0278,,,,,,FILTER ACCUNET 190CM,5161.42,5161.42,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16008403,0278,C1725,,,,,CATH BALLOON 95-15,706.97,706.97,471.51,471.51,,,,,,,471.51,,,,
16008404,0272,,,,,,CATH BALLOON 89-15,690.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008405,0272,,,,,,CATH KUMAR CHOLANGIOGRAPHY,138.38,138.38,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008406,0272,,,,,,CATH CHOLANGIOGRAM 5FR,179.82,179.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008408,0278,C1874,,,,,STENT SMART 8X40,4978.28,4978.28,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16008410,0272,,,,,,CATH T-TUBE 12FR,27.88,27.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008412,0272,,,,,,CATH T-TUBE 16FR,27.14,27.14,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008430,0278,C1874,,,,,DNU STENT SMART 10X40,5477.77,5477.77,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16008456,0272,,,,,,DRAIN HEMOVAC 400 ML,86.99,86.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1600850,0270,,,,,,DNU PRINTER LEXMARK LASER T652N,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16008502,0278,C1725,,,,,CATH POLAR 3X100X135X0.014,2996.95,2996.95,471.51,471.51,,,,,,,471.51,,,,
16008503,0278,C1725,,,,,CATH POLAR 4X40X135X0.014,2663.96,2663.96,471.51,471.51,,,,,,,471.51,,,,
16008504,0278,C1725,,,,,CATH POLAR 6X40X135X0.014,2663.96,2663.96,471.51,471.51,,,,,,,471.51,,,,
16008505,0278,C1725,,,,,CATH POLAR 2.5X40X135X0.014,2663.96,2663.96,471.51,471.51,,,,,,,471.51,,,,
16008506,0278,C1725,,,,,CATH POLAR,2663.96,2663.96,471.51,471.51,,,,,,,471.51,,,,
16008518,0278,C1876,,,,,STENT SMART 7X80X40,4706.89,4706.89,,,,,,,,,,,,,
16008519,0278,C1876,,,,,CATH GUID BRI TIP MP-A-1 100CM 6FR .070,372.95,372.95,,,,,,,,,,,,,
16008520,0278,C1876,,,,,STENT SMART 6X2X80,4445.48,4445.48,,,,,,,,,,,,,
16008521,0278,C1876,,,,,STENT SMART 6X2X135,4445.48,4445.48,,,,,,,,,,,,,
16008522,0278,C1876,,,,,STENT SMART 7X2X80,4445.48,4445.48,,,,,,,,,,,,,
16008523,0278,C1876,,,,,STENT SMART 7X2X135,4944.98,4944.98,,,,,,,,,,,,,
16008524,0278,C1876,,,,,STENT SMART 8X2X80,4445.48,4445.48,,,,,,,,,,,,,
16008525,0278,C1876,,,,,STENT SMART 8X2X135,4944.98,4944.98,,,,,,,,,,,,,
16008526,0278,C1876,,,,,STENT SMART 6X4X80,4928.33,4928.33,,,,,,,,,,,,,
16008527,0278,C1876,,,,,STENT SMART 6X4X135,4928.33,4928.33,,,,,,,,,,,,,
16008528,0278,C1876,,,,,STENT SMART 7X4X80,4928.33,4928.33,,,,,,,,,,,,,
16008529,0278,C1876,,,,,STENT SMART 7X4X135,4928.33,4928.33,,,,,,,,,,,,,
16008530,0278,C1876,,,,,STENT SMART 8X4X80,4928.33,4928.33,,,,,,,,,,,,,
16008531,0278,C1876,,,,,STENT SMART 8X4X135,5477.77,5477.77,,,,,,,,,,,,,
16008532,0278,C1876,,,,,STENT SMART 6X6X80,4928.33,4928.33,,,,,,,,,,,,,
16008533,0278,C1876,,,,,DNU STENT SMART 6X6X135,6326.90,6326.90,,,,,,,,,,,,,
16008534,0278,C1876,,,,,STENT SMART 7X6X80,4928.33,4928.33,,,,,,,,,,,,,
16008535,0278,C1876,,,,,STENT SMART 7X60MM 6FR,5477.77,5477.77,,,,,,,,,,,,,
16008536,0278,C1876,,,,,STENT SMART 8X6X80,4928.33,4928.33,,,,,,,,,,,,,
16008537,0278,C1876,,,,,STENT SMART 8X6X135,4928.33,4928.33,,,,,,,,,,,,,
16008600,0278,99070,,,,,IMPLANT GEL-FILLED BREAST,1737.75,0.00,,,,,,,,,,,,,
16008601,0278,99070,,,,,IMPLANT GEL-FILLED BREAST,1737.75,0.00,,,,,,,,,,,,,
16008602,0278,99070,,,,,IMPLANT GEL-FILLED BREAST,1737.75,0.00,,,,,,,,,,,,,
16008610,0272,,,,,,SIZIER SALINE,184.50,184.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008814,0272,,,,,,SUTURE PROLENE 0 CT-1 ETH C821G,74.21,74.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008816,0274,,,,,,BRACE KNEE SMALL,159.75,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008817,0274,,,,,,BRACE KNEE MEDIUM,159.75,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008818,0274,,,,,,BRACE KNEE LARGE,159.75,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008819,0270,,,,,,BRACE KNEEX-LARGE,159.75,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16008823,0274,,,,,,STRAPS PATELLA TENDON SMALL,46.50,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008824,0274,,,,,,STRAPS PATELLA TENDON MEDIUM,46.50,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008825,0274,,,,,,STRAPS PATELLA TENDON LARGE,46.50,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008826,0274,,,,,,KNEE SUPPORT X-SMALL,49.75,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008827,0274,,,,,,KNEE SUPPORT SMALL,49.75,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008828,0274,,,,,,KNEE SUPPORT MEDIUM,49.75,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008829,0271,,,,,,SLEEVE THIGH SMALL,63.50,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16008830,0271,,,,,,SLEEVE THIGH MEDIUM,63.50,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16008831,0274,,,,,,NEOPRENE ELBOW,44.50,0.00,6.93,20.00,20.00,20.00,,,,,,,,6.93,6.93
16008920,0272,,,,,,SYRINGE INFLATION ENCORE 26,153.66,153.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008921,0278,C1874,,,,,STENT POLYFLEX 21X90,6992.89,6992.89,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16008922,0272,,,,,,WIRE HYDRA JAG .035X260CM STRAIGHT TIP,697.63,697.63,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008923,0272,C1769,,,,,JAGWIRE .038IN X 260CM,512.81,512.81,,,,,,,,,,,,,
16008924,0272,C1769,,,,,JAGWIRE .035IN X 450CM,728.33,728.33,,,,,,,,,,,,,
16008925,0272,C1769,,,,,JAGWIRE .035IN X 450CM,1106.13,1106.13,,,,,,,,,,,,,
16008991,0272,,,,,,DRAIN SET-END NSL BILY,576.83,576.83,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16008993,0272,,,,,,CATH GLO-TIP ANGLED ERCP,266.40,266.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009000,0271,,,,,,SET NITROGLYCERIN 107,21.61,21.61,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009001,0271,,,,,,SET BLOOD PUMP SMARTSITE,28.13,28.13,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009002,0271,,,,,,TUBING PCA MINI BORE ALARIS,20.00,20.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009003,0271,,,,,,SET BLOOD Y-TYPE GRAVITY SMARTSITE,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009004,0271,,,,,,SET PRIMARY GRAVITY WITH 2 PORTS,20.00,20.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009005,0271,,,,,,SET INFUSION EPIDURAL MICROBORE,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009006,0271,,,,,,SET INFUSION 4 PORT SMARTSITE,20.66,20.66,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009007,0271,,,,,,SET INFUSION  SHORT 2 PIECE,21.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009009,0272,,,,,,CLOSURE FAST PREM PCK MIS 7F07,3993.44,3993.44,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009010,0272,,,,,,INFILTRATION TUBING SET,61.50,61.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009011,0272,,,,,,MICRO INTRODUCER,125.05,125.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009012,0272,,,,,,BURR FLUTED 3MM MATCHSTICK,879.11,879.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009013,0272,,,,,,BURR 6.4MM CYLINDRICAL CARBIDE,832.49,832.49,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009014,0272,,,,,,BURR 3.2MM FLUTED CARBIDE SIDE CUTTER,792.53,792.53,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009015,0272,,,,,,BURR SPINAL,609.39,609.39,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009040,0272,,,,,,CLIP FIXING DEVICE DISPOSABLE,283.05,283.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009050,0272,,,,,,SUTURE CAPTURING DEVICE CAPIO CL,2214.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009080,0272,,,,,,CATH 7FR ULTRA THINK DIAMOND,597.31,597.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009100,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 5X15,4581.18,4581.18,1434.61,1434.61,,,,,,,1434.61,,,,
16009101,0272,,,,,,DISP TOURNIQUET CUFF 18X3,76.74,76.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009102,0272,,,,,,DISP TOURNIQUET 24X4,85.27,85.27,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009103,0272,,,,,,DISP TOURNIQUET CUFF 34X4,95.82,95.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009104,0272,,,,,,*ABSORBABLE FIXATION SYSTEM,2297.67,2297.67,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009105,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 5X12,4811.78,4811.78,1434.61,1434.61,,,,,,,1434.61,,,,
16009106,0272,,,,,,CLARIVEIN IC 65CM,2164.50,2164.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009107,0270,,,,,,CAPNOLINE SMART H PLUS ADULT W/02,63.59,63.59,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
16009108,0272,,,,,,FIXATION DEVICE LAPAROSCOPIC,2580.71,2580.71,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009109,0272,,,,,,CLARIVEIN IC 85CM,2218.61,2218.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009110,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 7X29,4478.78,4478.78,1434.61,1434.61,,,,,,,1434.61,,,,
16009115,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 8X29,4254.85,4254.85,1434.61,1434.61,,,,,,,1434.61,,,,
16009120,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 7X39,4413.01,4413.01,1434.61,1434.61,,,,,,,1434.61,,,,
16009125,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 8X39,4413.01,4413.01,1434.61,1434.61,,,,,,,1434.61,,,,
16009130,0278,C1887,,,,,CATH GUIDE  55CM 6F,280.31,280.31,,,,,,,,,,,,,
16009136,0272,,,,,,CATH BERENSTEIN 4 FR X 125 CM,116.23,116.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009137,0272,,,,,,CATH CROSS OVER TEMPO 5F 65 CM 0 SIDE,90.20,90.20,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009138,0272,,,,,,CATH BERENSTEIN 4 FR X 150 CM,209.79,209.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009145,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 6X12,4581.18,4581.18,1434.61,1434.61,,,,,,,1434.61,,,,
16009150,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 6X15,4581.18,4581.18,1434.61,1434.61,,,,,,,1434.61,,,,
16009155,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 5X18,4811.78,4811.78,1434.61,1434.61,,,,,,,1434.61,,,,
16009160,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 6X18,4581.18,4581.18,1434.61,1434.61,,,,,,,1434.61,,,,
16009165,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 6X23,4634.46,4634.46,1434.61,1434.61,,,,,,,1434.61,,,,
16009170,0278,C2625,,,,,STENT BLUE 5MMX18MMX80CM,4438.82,4438.82,1434.61,1434.61,,,,,,,1434.61,,,,
16009175,0278,C2625,,,,,STENT BLUE 5MMX24MMX80CM,4634.62,4634.62,1434.61,1434.61,,,,,,,1434.61,,,,
16009180,0278,C2625,,,,,STENT RENAL BILIARY 5X15X90,4134.30,4134.30,1434.61,1434.61,,,,,,,1434.61,,,,
16009185,0278,C2625,,,,,STENT RENAL BILIARY 5X19X90,4134.30,4134.30,1434.61,1434.61,,,,,,,1434.61,,,,
16009190,0278,C2625,,,,,STENT RENAL BILIARY 6X14X90,4134.30,4134.30,1434.61,1434.61,,,,,,,1434.61,,,,
16009195,0278,C2625,,,,,STENT RENAL BILIARY 6X18X90,4134.30,4134.30,1434.61,1434.61,,,,,,,1434.61,,,,
16009200,0278,C2625,,,,,STENT RENAL BILIARY 4X19X90,4134.30,4134.30,1434.61,1434.61,,,,,,,1434.61,,,,
16009220,0272,,,,,,TUBE MINNESOTA 18FR,2130.50,2130.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009221,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 13,18314.72,18314.72,5014.86,5014.86,,,,,,,5014.86,,,,
16009222,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 14,18314.72,18314.72,5014.86,5014.86,,,,,,,5014.86,,,,
16009223,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 15,18314.72,18314.72,5014.86,5014.86,,,,,,,5014.86,,,,
16009224,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 16,18314.72,18314.72,5014.86,5014.86,,,,,,,5014.86,,,,
16009225,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 17,18772.59,18772.59,5014.86,5014.86,,,,,,,5014.86,,,,
16009226,0272,,,,,,REFLUX SIZING TOOL,511.98,511.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009300,0278,C2625,,,,,STENT TRUNK IPSILATERIAL LEG,24301.98,24301.98,1434.61,1434.61,,,,,,,1434.61,,,,
16009305,0278,C1874,,,,,STENT CONTRALATERAL LEG 12MM X 14CM,11218.60,11218.60,248.02,252.74,,,,,,,252.74,,,248.02,248.02
16009310,0272,,,,,,SHEATH INTRODUCER 18FR X 30CM,409.58,409.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009311,0272,,,,,,SHEATH INTRODUCER 12FR X 30CM,255.99,255.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009585,0278,C1768,,,,,GRAFT AORTIC HEMASHIE 16X30,2034.94,2034.94,,,,,,,,,,,,,
16009586,0278,C1768,,,,,GRAFT WALL ENDOPROSTHEIS,6493.40,6493.40,,,,,,,,,,,,,
16009587,0278,C1768,,,,,GRAFT WALL ENDOPROSTHEIS 8MM X 30MM,6655.73,6655.73,,,,,,,,,,,,,
16009588,0278,C1768,,,,,GRAFT WALL ENDOPROSTHEIS 8MM X 70MM,7492.39,7492.39,,,,,,,,,,,,,
16009590,0278,C1768,,,,,GRAFT AORTIC HEMASHIE 18X30,1864.77,1864.77,,,,,,,,,,,,,
16009591,0278,C1768,,,,,GRAFT SURGISIS BIODESIGN 9X14,2659.86,2659.86,,,,,,,,,,,,,
16009595,0278,C1768,,,,,GRAFT HEMASHIELD 20X3,1481.83,1481.83,,,,,,,,,,,,,
16009600,0278,C1768,,,,,GRAFT BIFURCATED 14 X 7,2167.80,2167.80,,,,,,,,,,,,,
16009610,0278,C1768,,,,,GRAFT BIFURCATED 18,3287.39,3287.39,,,,,,,,,,,,,
16009735,0272,A4344,,,,,CATH SILICONE 16FR 5CC LF,20.50,20.50,,,,,,,,,,,,,
16009737,0271,,,,,,KIT MENISECTOMY BASIC,170.72,170.72,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16009946,0272,,,,,,SHEATH INTRO CL-07524,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16009999,0278,C1887,,,,,CATH BRITE TIP 6FR-.070-55CM-MPA-1,279.25,279.25,,,,,,,,,,,,,
1601020,0270,,,,,,PHONE WHITE/COMMONS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601021,0270,,,,,,PHONE DESK IVORY,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601029,0270,,,,,,BULB WELCH ALLYN SPECULUM 08800,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601180,0272,,,,,,DNU DRAPE STERI 3M 1040,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601185,0272,,,,,,DRAPE THYROID,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601188,0272,,,,,,DRAPE IMPERVIOUS SPLIT DRAPE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601189,0272,,,,,,TIP CLEANER ELECTOSURGICAL 2X2 STERILE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601325,0272,,,,,,DNU DRAIN  T  10FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601330,0272,,,,,,DNU DRAIN  T  20 FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601342,0272,,,,,,DNU DRAIN SUMP 28FR VENTRAL,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601450,0272,,,,,,DNU OSTOMY T LOOP ROD,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601475,0270,,,,,,FILTER BS PFT SPIROPALM,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601479,0270,,,,,,SET PRIMARY PUMP,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601480,0270,,,,,,ADAPTER MALE PLUGS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601482,0270,,,,,,SET EXTENSION,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601512,0270,,,,,,DNU CLEANER 15 GAL SPAR DISH DET GLO,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601518,0270,,,,,,SET J LOOP SINGLE,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601521,0270,,,,,,CONNECTOR DOUBLE J LOOP,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601522,0270,,,,,,ADAPTER VIAL,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601602,0270,,,,,,DNU CLEANER SPAR TUF ON GREASE 15 GAL,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601605,0270,,,,,,DNU CLEANER SPAR TUF ON GREASE 5 GAL,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601680,0272,,,,,,DNU HYDRATOR INSU-FLOW HE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601813,0272,,,,,,DNU ANGIOSCOPE 1.7MM DISPOSABLE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601814,0272,,,,,,DNU ANGIOSCOPE 2.3MM DISPOSABLE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1601857,0270,,,,,,SET SECONDARY 40 INCH,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601906,0270,,,,,,DNU SOLUTION SODIUM CHLORIDE .9%,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1601991,0270,,,,,,DNU SOLUTION DEXTROSE 70%,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1602022,0272,,,,,,DNU DRESSING LYOFOAM 4X4,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1602032,0271,,,,,,TANK OXYGEN GRAB AND GO,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602033,0271,,,,,,TANK OXYGEN STEM,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602034,0271,,,,,,TANK TALL NITROUS,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602035,0271,,,,,,TANK DIETARY SODA MACHINE TANK,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602036,0271,,,,,,TANK CO2,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602503,0272,,,,,,BILATERAL ORTHOMAX EX SURGICAL DRAPE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1602512,0271,,,,,,LIFESAVER MINTS,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602617,0271,,,,,,"CHART LABEL, PURPLE",0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602618,0271,,,,,,"CHART LABEL, BLUE",0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602619,0271,,,,,,"CHART LABEL, YELLOW",0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602621,0271,,,,,,"CHART LABEL, PINK",0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602622,0271,,,,,,"CHART LABEL, GRAY",0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602623,0271,,,,,,"CHART LABEL, WHITE, BLANK",0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1602801,0272,,,,,,DNU CHLORAPREP W/TEAL TINT 26ML,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1604077,0270,,,,,,DNU GOWN PREVENTION SMALL K-C,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604080,0270,,,,,,DNU GOWN PREVENTION X-LARGE KIMB CLARK,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604159,0272,,,,,,DNU WIPE INSTRUMENT-MENTR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1604199,0271,,,,,,HOOKUP UNIVERSAL 24 HR,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1604200,0271,,,,,,DETERGENT IN TUBE,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1604237,0272,,,,,,BOWL GUIDEWIRE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1604247,0270,,,,,,DEODORANT MEN/WOMEN,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604260,0270,,,,,,DNU SHAMPOO GENTLE RAIN 4 OZ,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604311,0272,,,,,,TRACH CLOSED SUCTION,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1604473,0272,,,,,,DNU ADAPTER FEEDING EXTERNAL,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1604529,0270,,,,,,CONTAINER SHARP 1 QUART,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604532,0270,,,,,,DNU BLANKET KARAYA,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604534,0270,,,,,,DNU COLLECT/WOUND DRAIN,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604546,0270,,,,,,CONTAINER WALL SHARPS HOLDER 5 QT,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604548,0272,,,,,,DNU CONNECTOR TUBING ARGYLE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1604606,0272,,,,,,DNU TUBE ET ORAL RAE NO CUFF 3.0,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1604750,0270,,,,,,DNU TUBE TRACH PORTEX 126,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604751,0270,,,,,,DNU TUBE TRACH PORTEX 126,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604769,0270,,,,,,DNU TUBE TRACH CUFFED 6.5,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604772,0270,,,,,,DNU TUBE TRACH CUFFED 7.0,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604775,0270,,,,,,DNU TUBE ENDOTRACHEAL 9.0,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604779,0270,,,,,,DNU TUBE TRACH CUFFED 7.0,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604798,0270,,,,,,DNU SOAP SURGI-STAIN,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1604874,0270,,,,,,DNU GLOVE ORTHOPAEDIC 7,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605026,0270,,,,,,DNU MARKER SKIN STER DEV,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605033,0270,,,,,,DNU KIT EPISTAT NASAL CATH,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605130,0270,,,,,,DNU NEEDLE PNEUMO 120MM P,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605180,0270,,,,,,DNU SLIPPER SOCK UNISI,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605226,0270,,,,,,DNU BARA LYME,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605288,0270,,,,,,DNU BLADE REMOVAL QLICK SMART,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605385,0270,,,,,,STOPCOCK 3-WAY,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605393,0270,,,,,,CANISTER SUCTION 2000,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605396,0270,,,,,,DNU TUBE SUCTION POOLE,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605470,0270,,,,,,DNU TUBE FEEDING BOLUS 24,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605496,0270,,,,,,DNU ADHESIVE IT STAYS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1605516,0270,,,,,,DNU KIT EMERGENCY TRACH,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1606000,0270,,,,,,DNU TABBIES LABEL/FILE FOLDER PROTECTOR,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1606069,0272,,,,,,DNU SPINAL NEEDLE 26GX3 1/2,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1606201,0272,,,,,,SENSOR OXYGEN ADULT/CHILD OXIMAX MAX-N,43.79,43.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1606204,0272,,,,,,DNU UROSTOMY POST OP 3/4,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1606251,0271,,,,,,POLAR CUBE SYSTEM BY BREG,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1607012,0270,,,,,,DNU INK CARTRIDGE LEX X340H11G,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607024,0270,,,,,,INK CARTRIDGE H-P (CO0477) C4127X,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607028,0270,,,,,,IMAGING UNIT LEXMARK MS/MX 310/410,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607051,0270,,,,,,DNU INK CARTRIDGE HEW Q6511A,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607074,0270,,,,,,DNU INK CARTRIDGE #78 BL EPSON,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607075,0270,,,,,,DNU INK CARTRIDGE #78 CY EP,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607076,0270,,,,,,DNU INK CARTRIDGE #78 MAG EPSON,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607077,0270,,,,,,DNU INK CARTRIDGE #78 YEL EPSON,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607078,0270,,,,,,DNU INK CARTRIDGE #78 LT CYAN EPSON,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607079,0270,,,,,,DNU INK CARTRIDGE #78 LIGHT MAG EPSON,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607082,0270,,,,,,DNU INK CART LEX 12015SA,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607088,0270,,,,,,DNU INK CARTCYAN LEXC500H2CG,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607089,0270,,,,,,DNU INK CART MAG LEXC500H2MG,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607090,0270,,,,,,DNU INK CARTRIDGE YEL LEXC500H2YG,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607125,0270,,,,,,DNU TAPE VHS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607127,0270,,,,,,DNU CORRECTION FILM DRYLINE REFILL CART,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607171,0270,,,,,,DNU DRYLINE CORRECTION FILM,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607174,0270,,,,,,DNU CALENDAR AT A GLANCE REFILLS 3 1/2X6,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607203,0270,,,,,,DNU MAILERS CD,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607216,0270,,,,,,DNU INK ROLLER DIETARY CASH REGISTER,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607221,0270,,,,,,DNU CALENDAR DESK PAD,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607229,0270,,,,,,ACAPELLA DM BLUE W/TGHPC MED FLOW,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607232,0270,,,,,,MOUSE PADS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607246,0272,,,,,,CANNULA TRACH SIZE 8 FENETRATED,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1607248,0271,,,,,,CANNULA TRACH XL 6,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1607249,0271,,,,,,CANNULA TRACH XL 8,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1607250,0271,,,,,,CANNULA TRACH XL 5,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
1607308,0270,,,,,,DNU INK CARTRIDGE FAX MACHINE (DR. MATT),0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607326,0270,,,,,,DNU INK CARTRIDGE BLACK C544X1KG,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607328,0270,,,,,,DNU INK CARTRIDGE MAGENTA C544X1MG,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607343,0270,,,,,,DNU INK CARTRIDGE BROTHER TN450,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607346,0270,,,,,,DNU CORRECTION FILM DRYLINE REFILL,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607830,0272,,,,,,DASH IT HALLOW DIRECT ACCESS SYSTEM,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1607920,0270,,,,,,CANNULA NASAL OVER/EAR,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607927,0270,,,,,,CANNULA NASAL INFANT,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1607998,0270,,,,,,DNU WIRELESS MOUSE,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608006,0270,,,,,,DNU TV LCD 32,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608007,0270,,,,,,MONITOR 17  LCD,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608008,0270,,,,,,DNU MOUSE FOR LAPTOP,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608012,0270,,,,,,DNU POWER SUPPLY,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608013,0270,,,,,,DNU CD-RW DRIVE,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608015,0270,,,,,,DNU CD-RW/DVD,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608018,0270,,,,,,DNU VIDEO CARD,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608020,0270,,,,,,DNU TRENDWARE 2-PORT SWITCH W'INCABLES,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608025,0270,,,,,,DNU CARD NETWORK,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608027,0270,,,,,,DNU CABLE USB 10',0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608031,0270,,,,,,DNU MOUSE OPTICAL WHEEL,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608032,0270,,,,,,MICROSOFT OFFICE STANDARD 2013,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608034,0270,,,,,,DNU VALVE PEEP 12.5CM 9012,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608037,0270,,,,,,DNU VALVE PEEP 9010 10CM,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608042,0272,,,,,,DNU ANGIOSCOPE 1.5MM 7000,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608043,0272,,,,,,DNU ANGIOSCOPE 2.3MM 7000 PASSIVE,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608060,0270,,,,,,DNU ATOMIZER GLASS METAL TOP W/BULB,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608082,0270,,,,,,DNU SET ENDOSCOPIC IRRIGA,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608089,0272,,,,,,DNU ANGIOSCOPE 2.5 DEFLECT 70,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608106,0270,,,,,,DNU NEEDLE MANCO CONTINUOUS EPIDURAL,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608110,0278,,,,,,DRAPE LAPRASCOPIC ABDOMINAL,0.00,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
1608111,0272,,,,,,TUBE LEVINE 10FR ARGY,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608112,0272,,,,,,TUBE SALEM SUMP 12FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608113,0272,,,,,,TUBE NASOJEJUNOSTOMY 10FR 140CM,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608114,0272,,,,,,TUBE NG LEVINE 16FR ARGY,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608115,0272,,,,,,TUBE SALEM PUMP 16FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608116,0272,,,,,,TUBE LEVINE 18FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608117,0272,,,,,,TUBE SALEM PUMP 18FR,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608118,0272,,,,,,BRAVO CAPSULE DELVRY STM NON CALIBR NEW,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608119,0272,,,,,,BRAVO CAPSULE DELIVER SYSTEM,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608301,0272,,,,,,DNU AIR CAST ANKLE LEFT,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608302,0272,,,,,,DNU AIR CAST ANKLE RIGHT,0.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
1608336,0270,,,,,,CASTING PLASTER 2,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608362,0270,,,,,,IMMOBILIZER KNEE XL,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608363,0270,,,,,,IMMOBILIZER KNEE XXL,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608369,0270,,,,,,STOCKING JUZO AD SIZE 3 NOBLESSE COLOR,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608370,0270,,,,,,STOCKING JUZO AD SIZE 4 NOBLESSE COLOR,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608371,0270,,,,,,SHOE POST-OP LADIES L,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608372,0270,,,,,,SHOE POST-OP LADIES M,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608373,0270,,,,,,SHOE POST-OP LADIES S,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608374,0270,,,,,,SHOE POST-OP MEN X-LARGE,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608375,0270,,,,,,SHOE POST-OP MENS LAR,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608394,0270,,,,,,SOCKS POST OP UN STERILE 18 X6 X5,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608411,0270,,,,,,SPLINT WRIST C/U LT MED DLX,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1608891,0270,,,,,,DNU BATTERY CASE FOR PULSE OX,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1609007,0270,,,,,,VAC NEG PRESSURE WND THRPY PUMP CLASSIC,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1609015,0270,,,,,,VAC NEG PRESSURE WND THRPY PUMP MINI,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1609022,0270,,,,,,DRESSING WOUND VAC SMALL ATS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1609120,0278,C1821,,,,,INDIRECT DECOMPRESSION IMPLANT 8MM,0.00,0.00,,,,,,,,,,,,,
1609121,0278,C1821,,,,,INDIRECT DECOMPRESSION IMPLANT 10MM,0.00,0.00,,,,,,,,,,,,,
1609122,0278,C1821,,,,,INDIRECT DECOMPRESSION IMPLANT 12MM,0.00,0.00,,,,,,,,,,,,,
1609123,0278,C1821,,,,,INDIRECT DECOMPRESSION IMPLANT 14MM,0.00,0.00,,,,,,,,,,,,,
1609124,0278,C1821,,,,,INDIRECT DECOMPRESSION IMPLANT 16MM,0.00,0.00,,,,,,,,,,,,,
1609222,0270,,,,,,COLLAR STIFNECK PEDIATRIC,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1609223,0270,,,,,,COLLAR STIFNECK ADULT,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
1609352,0271,,,,,,ENVELOPE STEAM STERILIZATION RECORD,0.00,0.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16100000,0272,,,,,,SUTURE ANCHOR 4.5 GROSS FT.,765.89,765.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100001,0278,C1713,,,,,TROCHANTERIC NAIL KIT 180 TI GAMMA 3,3696.24,3696.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100002,0278,C1713,,,,,LAG SCREW TI GAMMA 3,1398.58,1398.58,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100003,0278,C1713,,,,,LOCKING SCREW FULLY THREADED,580.24,580.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100004,0278,C1769,,,,,K-WIRE,333.00,333.00,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100005,0278,C1769,,,,,GUIDE WIRE BALL TIPPED STERILE,582.74,582.74,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100006,0278,C1769,,,,,GUIDE WIRE PARTIALLY THREADED,86.10,86.10,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100007,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 150MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100008,0278,C1725,,,,,ULTRAVERSE 035 4.0MMX80MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100009,0278,C1768,,,,,GRAFT 10/10 BTB,11987.82,11987.82,,,,,,,,,,,,,
16100010,0278,C1713,,,,,PLATE LCP VOLAR DISTAL RADIUS 4H RIGHT,2467.49,2467.49,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100011,0278,C1713,,,,,SCREW 2.4 LOCKING SLF-TPNG 14MM RECESS,346.31,346.31,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100012,0278,C1713,,,,,SCREW 2.4 LOCKING SLF-TPNG 22MM RECESS,346.31,346.31,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100013,0278,C1713,,,,,SCREW 2.4 LOCKING SLF-TPNG 24MM RECESS,346.31,346.31,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100014,0278,C1713,,,,,SCREW 2.4 CORTEX SLF-TPNG 14MM RECESS,198.85,198.85,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100015,0278,C1713,,,,,SCREW LAG 2.4MM X 16MM X 2,499.49,499.49,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100016,0278,C1725,,,,,ULTRAVERSE 035 4.0MMX60MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100017,0278,C1725,,,,,LUTONIX 035 DCB 5F,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100018,0278,C1713,,,,,SCREW 3.5 X 10MM LOCKING CORTICAL SC,283.05,283.05,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100019,0278,C1713,,,,,SCREW 3.5 X 8MM LOCKING CORTICAL SC,283.05,283.05,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100020,0278,C1713,,,,,SCREW 2.3X20MM THREADED LOCKING,290.13,290.13,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100021,0278,C1713,,,,,SCREW 3.5X12.0 MM CORTICAL SCREW,112.50,112.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100022,0278,C1713,,,,,SCREW 3.5 X 12MM LOCKING CORTICAL SC,283.05,283.05,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100023,0278,C1713,,,,,SCREW 2.3X24MM THREADED LOCKING,283.05,283.05,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100024,0278,C1713,,,,,SCREW 2.3X22MM THREADED LOCKING,283.05,283.05,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100025,0278,C1713,,,,,SCREW 3.5 X 16MM  CORTICAL,112.50,112.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100026,0278,C1713,,,,,SCREW 3.5 X 18MM  CORTICAL,249.75,249.75,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100027,0278,C1713,,,,,SCREW 3.5 X 14MM  CORTICAL,112.50,112.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100028,0278,C1713,,,,,SCREW SUPER REVO SUTURE ANCHOR KIT,716.77,716.77,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100029,0278,C1725,,,,,ULTRAVERSE 03550 MM X 60MMX130CM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100030,0278,C1713,,,,,SCREW 2.7 CORTEX 16MM,140.42,140.42,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100031,0278,C1713,,,,,SCREW 2.4 CORTEX 20MM,366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100032,0278,C1713,,,,,SCREW 2.4 CORTEX 24MM,366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100033,0278,C1713,,,,,SCREW 2.4 CORTEX 26MM,366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100034,0278,C1713,,,,,SCREW 2.4 CORTEX 28MM,366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100035,0278,C1713,,,,,SCREW 2.4 LOCKING  18MM,366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100036,0278,C1713,,,,,SCREW 2.7 CORTEX 14MM,140.42,140.42,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100037,0278,C1713,,,,,SCREW 3.5 LOCKING 36MM,392.93,392.93,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100038,0278,C1713,,,,,SCREW3.5 LOCKING 50MM,392.93,392.93,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100039,0278,C1713,,,,,SCREW 3.5 CORTEX 30MM,94.30,94.30,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100040,0278,C1725,,,,,LUTONIX 035  5.0MM X 60MM,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100041,0278,C1713,,,,,SCREW LAG VHS W/COMP SCREW,935.72,935.72,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100042,0278,C1713,,,,,SCREW 3.5 CORTEX12MM,103.52,103.52,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100043,0278,C1713,,,,,SCREW 4.0 CORTEX16MM,90.20,90.20,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100044,0278,C1713,,,,,SCREW 4.0 CORTEX18MM,88.25,88.25,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100045,0278,C1713,,,,,SCREW 4.0 CORTEX20MM,86.10,86.10,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100046,0278,C1713,,,,,SCREW LAG VHS W/COMP SCREW,1102.21,1102.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100047,0278,C1713,,,,,SCREW LAG VHS W/COMP SCREW,1102.21,1102.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100048,0278,C1713,,,,,SCREW 4.0 CORTEX18MM,90.20,90.20,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100049,0278,C1725,,,,,LUTONIX 035  4.0MM X 60MM,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100050,0278,C1713,,,,,FIXATION PINS SET OF 3,832.49,832.49,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100051,0278,C1725,,,,,ULTRAVERSE 035 5.0MMX40MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100052,0278,C1725,,,,,ULTRAVERSE 035 6.0MM X 40MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100053,0278,C1725,,,,,LUTONIX 035 6.0MM X 100MM,5379.15,5379.15,471.51,471.51,,,,,,,471.51,,,,
16100054,0278,C1725,,,,,LUTONIX 035 5.0MM X 40MM,5379.15,5379.15,471.51,471.51,,,,,,,471.51,,,,
16100055,0278,,,,,,KIT RADIUS DISTAL,8324.88,8324.88,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100056,0272,C1725,,,,,ULTRAVERSE 035 6.0MM X 80MM,316.35,316.35,,,,,,,,,,,,,
16100057,0278,C1725,,,,,LUTONIX 035  6.0MM X 60MM,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100058,0278,,,,,,KIT RADIUS DISTAL,8533.00,8533.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100059,0278,C1725,,,,,LUTONIX 035 7.0MM X 60MM,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100060,0278,C1713,,,,,SCREW PROPEL 9X30MM I/F,333.00,333.00,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100061,0278,C1713,,,,,SCREW CANNULATED 2.4 10MM,749.24,749.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100062,0278,C1713,,,,,SCREW CANNULATED 2.4 16MM,749.24,749.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100063,0278,C1713,,,,,SCREW CANNULATED 2.4 15MM,749.24,749.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100064,0278,C1713,,,,,SCREW CANNULATED 2.4 14MM,767.97,767.97,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100065,0278,C1713,,,,,GUARDSMAN FEM IFS 9X30MM,341.32,341.32,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100066,0278,C1713,,,,,SUTURE ANCHOR TITANIUM 4.0MM,853.30,853.30,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100067,0278,C1725,,,,,LUTONIX 035 5.0MM X 60MM,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100068,0278,C1781,,,,,BIO A TISSUE REINFORCEMENT 8X8,1413.09,1413.09,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100069,0278,C1725,,,,,ULTRAVERSE 035 4.0MMX40MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100070,0278,,,,,,CONGRUENT TRIBIAL INSERT 1/2 14MM RT,4969.62,4969.62,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100071,0278,,,,,,CONGRUENT TRIBIAL INSERT 1/2 12MM RT,3860.32,3860.32,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100072,0278,,,,,,CONGRUENT TIBIAL INSERT,3860.32,3860.32,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100073,0278,,,,,,CONGRUENT TIBIAL INSERT SIZE 5/6 12MM RT,4334.77,4334.77,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100074,0278,C1725,,,,,LUTONIX 035  5.0MMX100MM,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100075,0278,C1725,,,,,LUTONIX 035  5.0MM X 150MM,4994.93,4994.93,471.51,471.51,,,,,,,471.51,,,,
16100076,0278,C1725,,,,,LUTONIX 035 5F,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100077,0278,C1725,,,,,LUTONIX 035 DCB 5F,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100078,0278,C1781,,,,,BIO A TISSUE REINFORCEMENT 10X30,6730.83,6730.83,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100079,0278,C1781,,,,,BIO A TISSUE REINFORCEMENT 20X30,12642.68,12642.68,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100080,0278,C1725,,,,,ULTRAVERSE 035 4.0MMX100MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100081,0278,C1725,,,,,ULTRAVERSE 035 5.0 MM X 100MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100082,0278,C1725,,,,,LUTONIX035DCB5F,4994.93,4994.93,471.51,471.51,,,,,,,471.51,,,,
16100083,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT,8686.59,8686.59,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100084,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 3 LEFT,8519.35,8519.35,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100085,0278,C1725,,,,,LUTONIX035DCB5F,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100086,0278,C1713,,,,,SCREW FEMORAL 8MM X 25MM,341.32,341.32,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100087,0278,C1713,,,,,SCREW PROPEL TIBIAL,341.32,341.32,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100088,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 40MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100089,0278,C1725,,,,,LUTONIX 035 5.0MM X 40MM 130CM,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100090,0278,,,,,,PIN GUIDE 2.5MM,303.78,303.78,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100091,0278,,,,,,POST TAPER HEMICAP 15.6MM,2457.50,2457.50,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100092,0278,,,,,,ARTICULAR HEMICAP 52MMX48MM,17304.92,17304.92,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100093,0278,,,,,,ANCHOR SUTURE TITANIUM 5.5 MM,972.77,972.77,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100094,0278,,,,,,SCREW 6.5X40MM EXTENDED TAB,5848.18,5848.18,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100095,0278,,,,,,ANCHOR SUTURE PEEK 5.5MM,1324.32,1324.32,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100096,0278,,,,,,ROD 6X40MM,1162.53,1162.53,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100097,0278,,,,,,SET SCREW,844.16,844.16,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100098,0278,,,,,,SCREW 6.5X35MM EXTENDED TAB,5848.18,5848.18,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100099,0278,,,,,,GUIDE WIRE,469.31,469.31,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100100,0278,C1713,,,,,PLATE NARROW VOLAR DISTAL RADIOUS RT,2730.56,2730.56,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100101,0278,C1713,,,,,PLATE NARROW VOLAR DISTAL RADIUS RT,2730.56,2730.56,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100102,0278,C1713,,,,,PLATE DISTAL RADIUS RT STANDARD,2730.56,2730.56,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100103,0278,C1713,,,,,PLATE DISTAL RADIUS FIBULA LT 4H 86MM,2269.78,2269.78,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100104,0272,,,,,,JASHIDI NEEDLE,554.64,554.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100105,0278,,,,,,ARTICULATING CAGE 11X30X9,11092.90,11092.90,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100106,0278,,,,,,ARTICULATING CAGE 11X30X10,11092.90,11092.90,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100107,0278,,,,,,SCREW 6.5X40MM EXTENDED TAB,5848.18,5848.18,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100108,0272,,,,,,JASHIDI NEEDLE,554.64,554.64,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100109,0278,C1769,,,,,GUIDE WIRE,469.31,469.31,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100110,0278,,,,,,SCREW 6.5X45 TIGER MIS,5848.18,5848.18,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100111,0278,,,,,,SCREW 6.5X40 TIGER MIS,5848.18,5848.18,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100112,0278,,,,,,SET SCREW,844.16,844.16,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100113,0278,,,,,,ROD MIS  5.5X45MM,1162.53,1162.53,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100114,0278,,,,,,ARTICULATING CAGE 30X11X11,11092.90,11092.90,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100115,0278,,,,,,SCREW 6.5X50MM EXTENDED TAB,5848.18,5848.18,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100116,0278,,,,,,SCREW 6.5X45MM EXTENDED TAB,5848.18,5848.18,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100117,0278,,,,,,GUIDE WIRE,469.31,469.31,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100118,0272,,,,,,OSTEO-SITE NEEDLE BIOPSY BONE,1314.08,1314.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100119,0278,C1713,,,,,COTTON WEDGE 7MM,8277.01,8277.01,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100120,0278,C1713,,,,,EVANS WEDGE 10MM,9471.63,9471.63,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100121,0272,C1713,,,,,DRILL 2.0X110MM SOLID MEASURING AO,1058.09,1058.09,,,,,,,,,,,,,
16100122,0278,C1713,,,,,K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 2.,168.10,168.10,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100123,0278,C1713,,,,,OLIVE WIRE SMOOTH 1.4MM,580.24,580.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100124,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 2.7X18,1058.09,1058.09,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100125,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 2.7X12MM,819.17,819.17,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100126,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREQ 2.7X14MM,819.17,819.17,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100127,0278,C1713,,,,,HEVANS PLATE MEDOIUM LEFT 20MM,7509.04,7509.04,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100128,0278,C1713,,,,,DRILL 4.6X220MM CANNULATED 3/16  SQ CONN,1279.95,1279.95,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100129,0278,C1713,,,,,K-WIRE SINGLE TROCAR TIP SMOOTH W/ FLOUR,511.98,511.98,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100130,0278,C1713,,,,,MONSTER CANNULATED MEDIUM THREAD SCREW H,4420.10,4420.10,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100131,0278,C1713,,,,,MONSTER CANNULATED MEDIUM THREADED SCREW,4420.10,4420.10,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100132,0278,C1725,,,,,LUTONIX 035  4MM X 40MM 130CM,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100133,0278,C1713,,,,,3.5MM CORTICAL SCREW SELF-TAP SMALL HEX,115.31,115.31,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100134,0278,C1713,,,,,CRUSHED CANCELLOUS CHIPS 15CC 1-4MM,1952.35,1952.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100135,0278,C1769,,,,,GUIDE WIRE,469.31,469.31,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100136,0278,C1713,,,,,DRILL 2.4X140MM SOLID MEASURING LONG AO,1058.09,1058.09,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100137,0278,C1725,,,,,ULTRAVERSE 035 5.0 MM X 150MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100138,0278,C1713,,,,,MTP PLATE SHORT-SHORT LEFT 2-HOLE DISTAL,8072.21,8072.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100139,0278,C1713,,,,,K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,176.50,176.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100140,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 3.5X20MM,1126.35,1126.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100141,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 3.5X20MM,1126.35,1126.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100142,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 3.5X14MM,819.17,819.17,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100143,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 3.5X16MM,819.17,819.17,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100144,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 3.5X20MM,819.17,819.17,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100145,0278,C1713,,,,,MINI-MONSTER CANNULATED SHORT THREAD SCR,1416.48,1416.48,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100146,0278,C1713,,,,,COUNTERSINK 3.5MM HEADLESS,1058.09,1058.09,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100147,0278,C1713,,,,,DRILL 2.3X120MM CANNULATED AO,1058.09,1058.09,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100148,0278,C1713,,,,,K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,176.50,176.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100149,0278,,,,,,PIN 33MM HEADED,375.45,375.45,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100150,0278,,,,,,PIN,436.89,436.89,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100151,0278,,,,,,PIN TENSION BAND 70CM,392.51,392.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100152,0278,C1725,,,,,LUTONIX 035  5X80,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100153,0278,C1725,,,,,LUTONIX 035  5X80,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100154,0278,C1725,,,,,LUTONIX 035  4X60 5F,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100155,0278,C1725,,,,,LUTONIX 035  4X80 5F,4162.44,4162.44,471.51,471.51,,,,,,,471.51,,,,
16100156,0278,C1725,,,,,ULTRAVERSE 035 6.0MM X 100MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100157,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 100MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100158,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 80MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100159,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 150MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100160,0278,,,,,,HEAD RESURFACING 50X16,18516.60,18516.60,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100161,0278,C1725,,,,,ULTRAVERSE 035 6.0MM X 120MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100162,0278,C1725,,,,,ULTRAVERSE 035 6.0MM X 60MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100163,0278,C1725,,,,,ULTRAVERSE 035 5.0MM X 120MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100164,0278,C1725,,,,,ULTRAVERSE 035 5.0MM X 80MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100165,0278,C1725,,,,,ULTRAVERSE 035 4.0MM X 150MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100166,0278,C1725,,,,,ULTRAVERSE 035 4.0MM X 120MM,316.35,316.35,471.51,471.51,,,,,,,471.51,,,,
16100167,0278,C1713,,,,,MINI-MONSTER CANNULATED SHORT THREADED S,1194.62,1194.62,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100168,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 2.7X16MM,819.17,819.17,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100169,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 2.7X15MM,819.17,819.17,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100170,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 2.7X15MM,1126.35,1126.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100171,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 2.7X12MM,1126.35,1126.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100172,0278,C1713,,,,,MTP PLATE 0 DEGREE LONG RIGHT,8072.21,8072.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100173,0278,C1713,,,,,MTP SPIN GUARD FEMALE REAMER 19MM,2218.58,2218.58,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100174,0278,C1762,,,,,MTP DISC 19X5MM,12543.51,12543.51,,,,,,,,,,,,,
16100175,0278,C1781,,,,,MESH XL 10X14,6126.69,6126.69,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100176,0278,C1781,,,,,MESH XL 8X12,4693.15,4693.15,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100177,0278,C1781,,,,,MESH OVAL 6X9IN,3020.69,3020.69,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100178,0278,C1781,,,,,MESH RECTANGLE 4X6IN,1279.95,1279.95,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100179,0278,C1781,,,,,MESH SQUARE 5X5IN,1416.48,1416.48,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100180,0278,C1781,,,,,MESH HERNIA,4095.84,4095.84,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100181,0278,C1781,,,,,MESH  HERNIA,2559.90,2559.90,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100182,0278,C1781,,,,,MESH  HERNIA,1757.79,1757.79,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100183,0278,C1781,,,,,MESH  HERNIA,1928.46,1928.46,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100184,0278,C1781,,,,,MESH  HERNIA,2832.96,2832.96,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100185,0278,C1781,,,,,MESH,2480.54,2480.54,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100186,0278,C1781,,,,,MESH VENTRALIGHT ST ECHO 4.5,3988.32,3988.32,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100187,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 6,4758.00,4758.00,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100188,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 10x15CM,13925.85,13925.85,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100189,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 15CM CIRCL,4960.47,4960.47,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
1610019,0278,C1713,,,,,SCREW  LAG 2.4 MM X 16 MM X2,0.00,0.00,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100190,0278,C1781,,,,,MESH HERNIA C-QUR 25CM X 35 CM,5542.06,5542.06,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100191,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 10X13 EL,11937.15,11937.15,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100192,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 8X10 EL,9270.24,9270.24,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100193,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 20CM CIRCL,8167.78,8167.78,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100194,0278,C1781,,,,,MESH SURGICAL ABSORBABLE PATCH 4INW X 5I,3988.33,3988.33,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100195,0278,C1781,,,,,MESH SURGICAL PARTIALLY ABSORBABLE PATCH,4758.00,4758.00,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100196,0278,C1781,,,,,MESH VENTRIO ST HERNIA PATCH 15.5CMX25.7,8711.51,8711.51,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100197,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 6X8,5913.46,5913.46,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100198,0278,C1781,,,,,MESH VENTRIO ST HERNIA PATCH 3X3,2414.15,2414.15,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100199,0278,C1713,,,,,XEMPLIFI DBM GEL 5 CC,3413.25,3413.25,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100200,0278,,,,,,PLATLET RICH PLASMA,2628.16,2628.16,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100201,0278,,,,,,SET SCREW,682.64,682.64,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100202,0278,,,,,,VOYAGER 7.5X45,4266.50,4266.50,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100203,0278,,,,,,ELEVATE 28X7,15700.71,15700.71,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100204,0278,,,,,,VOYAGER 6.5X45,4266.50,4266.50,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100205,0278,C1776,,,,,PERC ROD 45MM,2414.21,2414.21,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100207,0278,,,,,,NEEDLE TROCAR PAK,488.08,488.08,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100208,0278,,,,,,NEEDLE BEVELED PAK,488.08,488.08,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100209,0278,,,,,,BAYONEXES KNIFE,1333.70,1333.70,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100210,0278,C1781,,,,,MESH HERNIA C-QUR 20CM X 30 CM,4245.31,4245.31,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100211,0272,,,,,,GUIDE WIRE,258.55,258.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100212,0278,,,,,,ELEVATE 9X28MM,15700.71,15700.71,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100213,0278,,,,,,40MM ECLIF PLATE,3669.24,3669.24,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100214,0278,,,,,,VOYAGER 7.5X50,4266.50,4266.50,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100215,0278,C1781,,,,,MESH HERNIA C-QUR 10CM X 15CM,1157.81,1157.81,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100216,0278,,,,,,PERC ROD 30MM,2474.57,2474.57,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100217,0278,,,,,,4.0X14MM FIXED SCREW,1287.65,1287.65,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100218,0278,,,,,,4.0X14MM VARIABLE SCREW,1287.65,1287.65,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100219,0278,,,,,,10X14X11 CORNERSTONE PSR,3071.93,3071.93,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100220,0278,,,,,,OPTEFORM 5CC,5648.85,5648.85,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100221,0278,,,,,,OPTEFORM  10CC,9437.49,9437.49,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100222,0278,C1889,,,,,6X14X11 CORNERSTONE PSR,3071.93,3071.93,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16100223,0278,,,,,,XEMPLIFI DBM PUTTY 10 CC,5973.19,5973.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100224,0278,,,,,,RISE SPACER 8X22MM 7-13MM,19626.19,19626.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100225,0278,,,,,,SHEATH INTRODUCER 6F,197.52,197.52,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100226,0278,C1713,,,,,CREO AMP 6.5X40MM MODULAR CANNULATED SCR,2047.95,2047.95,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100227,0278,C1713,,,,,CREO AMP 6.5X45MM MODULAR CANNULATED SCR,2047.95,2047.95,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100228,0278,C1776,,,,,CREO MIS LOCKING CAP,499.50,499.50,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100229,0278,C1713,,,,,CREO MIS MODULAR POLYAXIAL TULIP 10MM RE,2047.95,2047.95,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100230,0278,C1713,,,,,ANCHOR 5.5MM BONE,1348.21,1348.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100231,0272,,,,,,DRILL 4.5 MM,853.30,853.30,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100232,0272,,,,,,DRILL 3.5 MM,853.30,853.30,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100233,0278,C1713,,,,,CREO MIS 5.5MM CURVED ROD TITANIUM ALLOY,1279.97,1279.97,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100234,0278,C1713,,,,,"CREO MIS 5.5MM CURVED ROD, TITANIUM ALLO",1279.97,1279.97,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100235,0272,,,,,,1.6MM K-WIRE 500MM BLUNT TIP,511.99,511.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100236,0272,L8699,,,,,"1.6MM NITINOL K-WIRE, 500MM, BLUNT TIP",511.99,511.99,,,,,,,,,,,,,
16100237,0278,,,,,,"RISE SPACER, 10X26MM, 8-15MM, 10DEGREE",19626.19,19626.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100238,0278,C1713,,,,,XEMPLIFI DBM GEL 1CC,853.31,853.31,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100239,0278,L8699,,,,,XTEND ANTERIOR CERVICAL PLATE 1-LEVEL 12,3413.25,3413.25,5014.86,5014.86,,,,,,,5014.86,,,,
16100240,0278,C1713,,,,,SCREW LAG VHS W/COMP SCREW,1064.91,1064.91,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100241,0278,C1713,,,,,"SCREW FEMORAL INTERF. 8MMX20MM,3.5MM",341.32,341.32,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100242,0278,C1713,,,,,"SCREW FEMORAL INTERF. 9MMX25MM,3.5MM",341.32,341.32,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100243,0278,,,,,,"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",767.98,767.98,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100244,0278,L8699,,,,,XTEND ANTERIOR CERVICAL PLATE 2-LEVEL 26,3413.25,3413.25,5014.86,5014.86,,,,,,,5014.86,,,,
16100245,0278,,,,,,"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",767.98,767.98,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100246,0278,,,,,,"XTEND 4.2MM VARIABLE ANGLE SCREW, SELF-D",767.98,767.98,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100247,0278,C1713,,,,,AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 14MM,1959.21,1959.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100248,0278,,,,,,SCREW CANNULATED COMPRESSION S.S,1611.05,1611.05,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100249,0278,,,,,,K-WIRE SINGLE TROCAR POINT,189.11,189.11,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100250,0278,C1713,,,,,SCREW 2.7MM  14MM,217.59,217.59,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100251,0278,C1713,,,,,PLATE VARI-ANGLE 4 HOLE,1440.37,1440.37,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100252,0278,C1713,,,,,SCREW LAG W/COMP 12.7MM X 70MM,579.20,579.20,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100253,0278,C1713,,,,,SCREW CORTIAL SCREW 4.5SS,113.47,113.47,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100254,0278,,,,,,TIBIAL INSERT SIZE 4 15MM,7065.32,7065.32,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100255,0278,C1713,,,,,PIN THREADED TIP GD 2.5MM X 9,174.14,174.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100256,0278,C1713,,,,,PLATE KEYLESS 4 HOLE,1621.27,1621.27,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100257,0278,C1713,,,,,SCREW LAG W/COMP,959.11,959.11,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100258,0278,C1713,,,,,SCREW CORTIAL SCREW 4.5SS,113.47,113.47,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100259,0278,C1713,,,,,SCREW CORTIAL SCREW 4.5SS,134.48,134.48,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100260,0278,C1713,,,,,PLATE 4 HOLE 8 HOLE HEAD,2867.09,2867.09,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100261,0278,C1713,,,,,PLATE 5 HOLE,2952.42,2952.42,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100262,0278,C1713,,,,,PLATE 3 HOLE 3.5 LCP,5000.34,5000.34,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100263,0278,C1713,,,,,PLATE 6 HOLE VHS VARI-ANGLE,1621.27,1621.27,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100264,0278,C1713,,,,,PLATE 4 HOLE VHS VARI-ANGLE,1911.39,1911.39,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100265,0278,C1713,,,,,PLATE 7 HOLE 3.5 LCP,648.51,648.51,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100266,0278,C1713,,,,,PLATE 2 HOLE 56MM,1911.39,1911.39,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100267,0278,,,,,,TIBIAL INSERT,7338.37,7338.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100268,0278,,,,,,TIBIAL INSERT,4769.95,4769.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100269,0278,,,,,,TIBIAL INSERT,7406.64,7406.64,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100270,0278,,,,,,"PLATE STANDARD TUBE135MM DIA.,4 HOLE",1478.43,1478.43,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100271,0278,,,,,,SCREW- 44MM,88.17,88.17,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100272,0278,,,,,,SCREW - 46MM,88.17,88.17,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100273,0278,,,,,,SCREW - 90MM,937.92,937.92,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100274,0278,,,,,,SCREW COMPRESSION 1,200.37,200.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100275,0278,C1713,,,,,SCREW 2.2MM  14MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100276,0278,C1713,,,,,SCREW LOCKING 2.7MM 13MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100277,0278,C1713,,,,,SCREW LOCKING 2.7MM 15MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100278,0278,C1713,,,,,"3.5MM ULS ONE-THIRD TUBULAR PLT 8H, 107M",620.18,620.18,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100279,0278,C1713,,,,,"3.5MM ULS ONE-THIRD TUBULAR PLT 10H, 133",632.80,632.80,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100280,0278,,,,,,PLATE 10MM 46MM RIB,3054.82,3054.82,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100281,0272,,,,,,SCREW RIB 10MM,324.26,324.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100282,0272,,,,,,DRILL BIT 2.2MM,409.07,409.07,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100283,0278,C1713,,,,,SCREW 2.4 LOCKING 2.7MM 20MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100284,0278,C1713,,,,,SCREW 2.4 LOCKING 2.7MM  18MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100285,0278,C1713,,,,,SCREW 2.4 LOCKING 2.7MM   16MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100286,0278,C1713,,,,,SCREW 2.4 LOCKING 2.7MM 12MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100287,0278,C1713,,,,,SCREW 2.7MM  16MM,217.59,217.59,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100288,0278,C1713,,,,,SCREW 2.7MM  14MM,217.59,217.59,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100289,0278,C1713,,,,,SCREW 2.7MM  12MM,217.59,217.59,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100290,0272,,,,,,TOPAZ MICRO DEDRIDER,1238.99,1238.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100291,0278,C1713,,,,,DVR CROSSLOCK PLATE LEFT,3664.23,3664.23,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100292,0278,C1713,,,,,LP NON LOCK 2.7MM X 10MM,217.60,217.60,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100293,0278,C1713,,,,,DVR CROSSLOCK PLATE RIGHT,3664.23,3664.23,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100294,0278,,,,,,DNU PATELLA,2507.70,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100295,0278,,,,,,TIBIAL INSERT,7406.64,7406.64,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100296,0278,,,,,,STEM FLUTED EXTENSION,4106.59,4106.59,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100297,0278,,,,,,TIBIAL AUG. BLK,5409.92,5409.92,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100298,0278,,,,,,TIBIAL INSERT CR SLOPE,5127.14,5127.14,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100299,0278,,,,,,TIBIAL INSERT CR SLOPE,7696.77,7696.77,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100300,0278,,,,,,ACETABULAR CUP,19345.30,19345.30,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100301,0278,,,,,,SUMMIT STEW SIZE 2 HI-OFF SET,20546.26,20546.26,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100302,0272,,,,,,SLEEVE ADAPTOR T2,1382.35,1382.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100303,0278,,,,,,STEM EXTENSION,6075.49,6075.49,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100304,0272,,,,,,DRILL BIT QUICK RELEASE,709.95,709.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100305,0278,,,,,,TIBIAL INSERT CR SLOPE,4732.74,4732.74,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100306,0278,C1713,,,,,LP NON LOCK 2.7MMX 18MM,217.60,217.60,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100307,0278,C1713,,,,,SCREW LOCKING 2.7MM 14MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100308,0278,C1713,,,,,DVR LOCK NARROW MINI L,3664.23,3664.23,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100309,0278,C1713,,,,,LOCK SCREW SQUARE 2.7MMX14MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100310,0278,,,,,,FEMORAL UNI INPLANT,7789.06,7789.06,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100311,0278,C1713,,,,,DVR LOCK NARROW L,3664.23,3664.23,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100312,0278,C1713,,,,,SCREW LOCKING 2.7MM 8MM,432.28,432.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100313,0278,C1769,,,,,GUIDE WIRE .91MMX80MM SS,197.52,197.52,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100314,0278,C1713,,,,,CREO AMP 6.5X35MM MODULAR CANNULATED SCR,2047.95,2047.95,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100315,0278,,,,,,ADAPTOR TAPER SLEEVE,1382.35,1382.35,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100316,0278,,,,,,PUTTY 1CC,689.48,689.48,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100317,0278,C1713,,,,,15MM 4.0 VARIABLE SCREW/MEDTRONIC,1287.65,1287.65,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100318,0278,,,,,,PLATE 35MM 21LV ATLANTIS,3669.24,3669.24,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100319,0272,,,,,,TICRON 2 BLUE 30 T-56/HGS-21,908.88,908.88,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100320,0278,,,,,,HIP STEM TAPERED W/POROCOAT,20546.26,20546.26,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100321,0278,C1713,,,,,CREO MIS 5.5X50mm CURVED ROD TITANIUM AL,1279.97,1279.97,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100322,0278,C1713,,,,,5X14X11 CORNERSTONE PSR,3071.93,3071.93,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100323,0278,C1713,,,,,PLATE 19MM,3327.92,3327.92,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100324,0278,C1713,,,,,4X15MM SCREW,1287.65,1287.65,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100325,0278,C1762,,,,,TISSUE SPINAL GRAFT,689.48,689.48,,,,,,,,,,,,,
16100326,0278,C1889,,,,,"RISE SPACER, 10X26MM, 7-14MM",19626.19,19626.19,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16100327,0278,C1889,,,,,RISE SPACER 10X30MM 8-15MM 10 DEGREE,19626.19,19626.19,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16100328,0278,,,,,,OVERTUBEGUARDUS 8.6-10.0 25CM,649.35,649.35,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100330,0272,,,,,,TIP SUCTION ORTHO,100.86,100.86,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100331,0278,C1713,,,,,PERI SCREW  3.55X16MM,162.09,162.09,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100332,0278,C1713,,,,,3.5 MM CANNULATED SCREW,663.52,663.52,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100333,0278,C1713,,,,,PERI SCREW 3.5X MM X 26 W/ 2.7 MM,162.09,162.09,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100334,0278,C1713,,,,,DISTAL LATERAL FIBULA LOCKING PLATE,2366.71,2366.71,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100335,0278,C1713,,,,,2.7MM CORTICAL SCREW 16MM,97.33,97.33,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100336,0278,C1713,,,,,2.7MM CORTICAL SCREW 18MM,97.33,97.33,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100337,0278,C1713,,,,,DISTAL LATERAL FIBULA LOCKING PLATE 4H 8,2308.99,2308.99,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100338,0272,,,,,,SCREW FORTE CANCELLOUS 4.0MMX10MM FULL T,232.87,232.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100339,0278,C1713,,,,,SCREW 3.5 CORTEX 14MM,111.37,111.37,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100340,0278,C1713,,,,,SCREW 3.5 CORTEX 16MM,108.65,108.65,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100341,0278,C1713,,,,,SCREW 3.5 CORTEX 18MM,111.37,111.37,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100342,0278,C1713,,,,,SCREW EXT. STEM,238.10,238.10,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100343,0272,,,,,,2.7MM STANDARD DRILL,456.87,456.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100344,0278,C1713,,,,,TAO Q-C FOR 3.5MM SCREWS 110MM,321.04,321.04,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100345,0278,C1713,,,,,SCREW FORTE CANCELLOUS 4.0MMX14MM FULL T,227.19,227.19,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100346,0278,C1713,,,,,DISTAL LATERAL FIBULA LOCKING PLATE 6H 1,2469.52,2469.52,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100347,0278,C1713,,,,,CREO AMP 6.5X50MM MODULAR CANNULATED SCR,1998.00,1998.00,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100349,0278,C1713,,,,,SCREW FORTE CANCELLOUS 4.0MMX16MM FULL T,227.19,227.19,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100350,0278,,,,,,TRAY TIBIAL TRAPEZOID,12354.11,12354.11,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100351,0272,,,,,,TRAY TIBIAL TRAPEZOID,8564.80,8564.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100352,0272,,,,,,TRAY TIBIAL TRAP,8564.80,8564.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100353,0278,,,,,,TIBIAL INSERT,6560.00,6560.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100354,0272,,,,,,TRAY TIBIAL TRAP,11843.80,11843.80,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100355,0278,,,,,,TIBIAL INSERT CR SLOPE,6893.00,6893.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100356,0278,,,,,,TRAY TIBIAL TRAPEZOID,12662.96,12662.96,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100357,0272,,,,,,TRAY TIBIAL TRAPEZOID,13174.95,13174.95,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100358,0278,,,,,,TIBIAL INSERT SIZE 4 15MM,7695.51,7695.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100359,0278,C1713,,,,,4.0 MM CANNULATED SCREW 1/3 THD 48MM,708.58,708.58,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100360,0278,,,,,,TIBIAL INSERT SIZE 4 9MM,4403.53,4403.53,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100361,0278,,,,,,TIBIAL INSERT SIZE 3 11MM SLOPE,7065.32,7065.32,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100362,0278,,,,,,TIBIAL INSERT SIZE 3 13MM SLOPE,6893.00,6893.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100363,0278,C1713,,,,,4.0MM CANNULATED SCREW 1/3 THD 4MM,674.70,674.70,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100364,0278,C1889,,,,,35MM ECLIF PLATE,3669.24,3669.24,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16100365,0278,C1713,,,,,4.0 X 15MM FIXED SCREW,1256.24,1256.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100366,0278,C1713,,,,,CREO AMP 7.5X40MM CANNULATED SCREW,1998.00,1998.00,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100367,0278,C1713,,,,,CREO AMP 7.5X45MM CANNULATED SCREW,1998.00,1998.00,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100370,0278,,,,,,FEMORAL POROUS SIZE 4 LEFT,14019.20,14019.20,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100371,0278,,,,,,FEMORAL HEAD 28MM +10,4101.67,4101.67,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100372,0278,,,,,,FEMORAL POROUS,13343.94,13343.94,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100373,0278,C1713,,,,,"QCKFIX SCREW, TI, CANC, PT, 3.0X28MM",499.50,499.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100374,0278,C1713,,,,,"QCKFIX SCREW, TI, CANC, PT, 3.0X30MM",499.50,499.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100375,0272,A4649,,,,,"THD GDWIRE W TRCR TIP, .45  W/LASER",82.00,82.00,,,,,,,,,,,,,
16100376,0272,A4649,,,,,"COUNTERSINK, 3.0MM, CANNULATED",582.75,582.75,,,,,,,,,,,,,
16100377,0278,,,,,,FEMORAL POROUS,20529.14,20529.14,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100378,0278,C1713,,,,,PLATE 19MM ZEVO,3246.75,3246.75,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100379,0278,C1713,,,,,3.15X15MM FIXED SCREW,1256.24,1256.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100380,0278,,,,,,HEAD RESURFACING 50X19,21757.89,21757.89,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100381,0272,,,,,,CLIP OTSC SYSTEM SET 12/6GC 165CM,1961.37,1961.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100382,0272,,,,,,CLIP OTSC SYSTEM SET 12/6T 220CM,1844.82,1844.82,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100383,0272,,,,,,CLIP OTSC SYSTEM SET 11/6T 165CM,1458.54,1458.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100384,0278,,,,,,ANCHOR OTSC 165CM,1468.53,1468.53,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100385,0278,C1781,,,,,MESH VENTRALIGHT ST 30.5X35.6CM,9927.40,9927.40,652.76,3726.72,,,,,,,652.76,,,3726.72,3726.72
16100390,0278,C1776,,,,,FEMORAL HEAD,1356.96,1356.96,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100391,0278,C1713,,,,,PEDICLE ACCESSS KIT,1665.00,1665.00,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100400,0278,C1713,,,,,PLATE 3-HOLE DVR,2653.97,2653.97,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100401,0278,L8699,,,,,CERVICAL CAGE CIF 6 DEG -07,9973.20,9973.20,5014.86,5014.86,,,,,,,5014.86,,,,
16100402,0278,L8699,,,,,CERVICAL CAGE CIF 6 DEG -08,9973.20,9973.20,5014.86,5014.86,,,,,,,5014.86,,,,
16100403,0278,L8699,,,,,CERVICAL PLATE 10MM,8533.00,8533.00,5014.86,5014.86,,,,,,,5014.86,,,,
16100404,0278,L8699,,,,,CERVICAL PLATE 14 MM,8324.88,8324.88,5014.86,5014.86,,,,,,,5014.86,,,,
16100405,0278,C1769,,,,,K-WIRE 1.6,65.60,65.60,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100406,0278,C1769,,,,,K-WIRE,539.45,539.45,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100407,0272,,,,,,DRILL BIT 12MM,665.99,665.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100408,0278,,,,,,SCREW SELF DRILLING 4.0X14MM,1331.98,1331.98,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100409,0360,20930,,,,,BONE GRAFT I FACTOR 2.5CC,5200.00,5200.00,,,,,,,,,,,,,
16100410,0278,,,,,,SCREW SELF DRILLING 4.0X12MM,1331.98,1331.98,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100411,0278,C1713,,,,,DISTRACTION PIN 12MM,832.49,832.49,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100412,0278,L8699,,,,,CERVICAL PLATE,1535.94,1535.94,5014.86,5014.86,,,,,,,5014.86,,,,
16100413,0278,,,,,,"CERVICAL 3.5MM SELF DRILLING SCREW, 12MM",1082.23,1082.23,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100414,0278,,,,,,"CERVICAL 3.5MM SELF DRILLING SCREW, 14MM",1082.23,1082.23,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100415,0278,C1713,,,,,SCREW MULTI DIRECTIONAL 24MM,492.83,492.83,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100416,0278,C1713,,,,,SCREW 2.5 LOCKING 24MM,266.40,266.40,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100417,0278,C1713,,,,,SCREW 3.5 LOCKING 12MM,266.40,266.40,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100418,0278,,,,,,"CERVICAL 4.0MM SELF DRILLING SCREW, 12MM",1082.23,1082.23,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100419,0278,L8699,,,,,"TESERA SC CAGE, 16MMX13.5MMX6MM, 7",16383.35,16383.35,5014.86,5014.86,,,,,,,5014.86,,,,
16100420,0272,,,,,,INSERTS MULTI 2.0,219.78,219.78,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100421,0278,L8699,,,,,"CERVICAL CAGE CIF, 6 DEG, -06",9973.20,9973.20,5014.86,5014.86,,,,,,,5014.86,,,,
16100422,0278,L8699,,,,,"1-LEVEL, 12MM CERVICAL PLATE",8324.88,8324.88,5014.86,5014.86,,,,,,,5014.86,,,,
16100423,0278,C1713,,,,,DISTRACTION PIN 14MM,853.30,853.30,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100424,0278,C1713,,,,,7MM 4 HOLE ANTERIOR PLATE,8324.88,8324.88,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100425,0278,C1713,,,,,7MM LOCKING COVER,832.49,832.49,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100426,0278,C1713,,,,,3.5MM VARIABLE SCREW SELF DRILLING 14MM,1365.28,1365.28,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100427,0272,,,,,,"DRILL, 12MM",665.99,665.99,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100428,0278,C1713,,,,,"INTERBODY, 16X14X7MM 7 DEGREE STERILE",9973.20,9973.20,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100429,0278,L8699,,,,,MOBI-C CERVICAL DISC PROSTHESIS,20216.68,20216.68,5014.86,5014.86,,,,,,,5014.86,,,,
16100430,0272,,,,,,CANNULATED DRILL Q-C,1901.53,1901.53,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100431,0278,,,,,,PIN GUIDE 1.6MM X 9IN PARTIAL THREAD,273.06,273.06,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100432,0278,,,,,,WASHER 3. AND 4.0 SCREW,151.54,151.54,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100433,0278,,,,,,SCREW CANNULATED 4.0X60MM 1/2 THREAD,622.11,622.11,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100434,0272,,,,,,CANNULATED DRILL Q-C 4.5MM,1901.53,1901.53,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100435,0278,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 80MM,825.31,825.31,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100436,0278,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 85MM,805.18,805.18,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100437,0272,,,,,,3.2MM X 9IN PARTIAL THD TROCAR TIP GDE P,308.85,308.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100438,0272,,,,,,"1.6MM X 6IN SMOOTH TROCARTIP GDE PIN, 5/",197.66,197.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100439,0278,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 70MM,805.18,805.18,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100440,0278,,,,,,CABLE CERCLAGE 1.8MMX22  GRIP,1233.44,1233.44,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100441,0278,,,,,,CABLE CERCLAGE 1.8MMX635MM  COCR,1308.83,1308.83,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100442,0278,,,,,,GTR 5 HOLE EXTENDED W/4 CABLES,13469.48,13469.48,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100443,0278,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 75MM,805.18,805.18,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100445,0278,,,,,,WIRE K 2.0X150MM,255.37,255.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100450,0272,,,,,,SUTURE ORTHOCORD,97.70,97.70,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100451,0278,,,,,,ANCHOR HEALIX 4.5MM,1135.51,1135.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100470,0272,,,,,,CARBOJET TUBE,529.04,529.04,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100480,0278,,,,,,SCREW- 40MM,86.02,86.02,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100481,0278,,,,,,FEMORAL FIXATION 4 HOLE 135 DEGREE,1442.37,1442.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100482,0278,,,,,,SCREW LAG 70MM 12.7 MM,937.92,937.92,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100483,0272,,,,,,GUIDE WIRE 3.2X230MM,585.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100484,0272,,,,,,IMPACTOR HEAD,472.85,472.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100485,0278,,,,,,SCREW COMPRESSION 1/2 IN,241.75,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100486,0278,,,,,,SCREW- 42MM,86.02,86.02,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100500,0272,,,,,,SHEATH 18FR,416.24,416.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100501,0272,,,,,,SHEATH 12FR,263.07,263.07,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100502,0278,C1768,,,,,GRAFT,25903.68,25903.68,,,,,,,,,,,,,
16100503,0278,C1768,,,,,GRAFT - LINE EXTENDER,10572.59,10572.59,,,,,,,,,,,,,
16100504,0278,,,,,,GRAFT 10 10,12287.52,12287.52,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100520,0278,,,,,,FEMUR POROUS,20529.14,20529.14,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100521,0272,,,,,,TRAY TIBIAL TRAP,12853.61,12853.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100522,0278,,,,,,TIBIAL INSERT CR SLOPE,7509.04,7509.04,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100523,0272,C1713,,,,,DNU DRILL BIT,1277.25,0.00,,,,,,,,,,,,,
16100524,0278,,,,,,PROXIMAL TIBIAL SPACER,5461.12,5461.12,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100525,0278,,,,,,CREO MIS 5.5MM 80MM CURVED ROD TITANIUM,1248.75,1248.75,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100530,0278,,,,,,SCREW 4.0MM - 40 MM LENGTH,477.84,477.84,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100531,0278,,,,,,SCREW 4.0MM - 44 MM LENGTH,466.19,466.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100532,0278,,,,,,SCREW 4.0MM - 48 MM LENGTH,466.19,466.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100533,0278,,,,,,SCREW 4.0MM - 50 MM LENGTH,466.19,466.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100534,0278,C1713,,,,,BONE SCREW 6.5x35,236.46,236.46,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100535,0272,,,,,,K-WIRE .35X6 DBL TRO 6PK NS,285.87,285.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100536,0272,,,,,,K-WIRE .045X6 DBL TRO 6PK NS,285.87,285.87,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100537,0278,C1713,,,,,Z NAIL 5.0X30 CORT SCREW FA,691.46,691.46,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100538,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 64 OO,8909.61,8909.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100539,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 62NN,8909.61,8909.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100540,0278,,,,,,SCREW LOCKING CAP NCB,699.71,699.71,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100541,0278,,,,,,SCREW 5.0 CANCELLOUS 65MM,632.69,632.69,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100542,0278,,,,,,SCREW 5.0 CANCELLOUS 80MM,632.69,632.69,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100543,0278,,,,,,SCREW 5.0 CANCELLOUS 85MM,648.51,648.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100544,0278,,,,,,"SCREW NCB 5.0,L. 34MM",749.24,749.24,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100545,0278,C1713,,,,,Z NAIL 5.0X32.5 CORT SCREW,708.75,708.75,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100546,0272,,,,,,"NCB DRILL BIT 4.3MM,L. 195MM",512.81,512.81,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100547,0278,C1713,,,,,Z NAIL 5.0X27.5 CORT SCREW,691.46,691.46,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100548,0271,,,,,,CALIBRATED DRILL 4.3MM LONG,382.78,382.78,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
16100549,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, II 32",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100550,0278,C1713,,,,,PLATE TIBIA NCB PROXIMAL,2708.44,2708.44,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100551,0278,C1713,,,,,PERI SCREW 3.5MMX10MM W2.7MM HEAD,158.14,158.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100552,0278,C1713,,,,,PERI SCREW 3.5MM X 12MM W/2.7 HEAD,158.14,158.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100553,0278,C1713,,,,,PERI SCREW 3.5MM X 12MM W/2.7 HEAD,158.14,158.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100554,0278,C1713,,,,,PERI SCREW 3.5MM X 24MM W/2.7 HEAD,158.14,158.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100555,0278,,,,,,BONE SCREW 6.5 X 30MM,487.00,487.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100556,0278,C1713,,,,,PERI SCREW 3.5MM X 40MM W/2.7 HEAD,158.14,158.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100557,0278,C1713,,,,,LOCKING SCREW 3.5MM X 20MM W/2.7 HEAD,358.10,358.10,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100558,0278,,,,,,"FEMORAL STEM SZ 11, 145MM",19144.12,19144.12,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100559,0278,C1713,,,,,BONE SCREW,236.46,236.46,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100560,0272,,,,,,NCB  QC 3.3MM X 195MM,566.09,566.09,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100561,0272,,,,,,2.5MM QC 180MM BIT,426.23,426.23,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100562,0278,,,,,,GUIDE WIRE NCB-PH,86.50,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100563,0278,,,,,,"FEMORAL STEM SZ 14, 160MM",17748.63,17748.63,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100564,0278,,,,,,FEMORAL HEAD 36MM O.D.,4058.38,4058.38,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100565,0278,,,,,,"CROWN CUP 2, 36MM I.D.",6133.52,6133.52,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100566,0278,,,,,,DRILL BIT 20MM 4.5 NOVATION,229.77,229.77,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100567,0278,C1713,,,,,BONE SCREW 6.5 X 20,236.46,236.46,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100568,0278,,,,,,CUP CLUSTER-HOLE SHELL,7142.74,7142.74,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100569,0278,,,,,,CUP CROWN CLUSTER-HOLE,6950.94,6950.94,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100570,0278,,,,,,DISTAL VOTAR RADIAL LOCKING PLATE,2748.82,2748.82,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100571,0278,,,,,,PERIARTICULAR LOCKING PEG,209.42,209.42,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100572,0278,,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX20MM,356.58,356.58,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100573,0278,,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX22MM,347.88,347.88,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100574,0278,,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX14MM,276.95,276.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100575,0272,,,,,,BIT 1.8MM,965.69,965.69,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100576,0278,,,,,,K-WIRES 1.6MMX150MM,261.75,261.75,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100577,0278,,,,,,DISTAL VOTAR RADIAL LOCKING PLATE,2880.40,2880.40,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100578,0278,,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX18MM,356.58,356.58,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100579,0278,,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX16MM,276.95,276.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100580,0278,C1713,,,,,SCREW CORTICAL 2.7X22MM,86.78,86.78,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100581,0278,C1713,,,,,SCREW CORTICAL 2.7X14MM,84.66,84.66,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100582,0278,,,,,,DISTAL VOTAR RADIAL LOCKING PLATE,2681.78,2681.78,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100583,0278,,,,,,K-WIRES TROCAR POINT 1.25MM X 150MM,255.37,255.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100584,0278,,,,,,ELEMENT STEM,17671.49,17671.49,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100585,0272,,,,,,DRILL BIT Q-C 2.5MM DIA 110MM,265.79,265.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100586,0278,,,,,,FEMORAL HEAD 36MM O.D.,6137.62,6137.62,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100587,0278,,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX12MM,276.95,276.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100588,0278,,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX18MM,276.95,276.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100589,0278,,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX22MM,276.95,276.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100590,0278,C1713,,,,,PERIARTICULAR CORTICAL SCREW 16MMX3.5MM,158.14,158.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100591,0278,,,,,,LOCKING SCREW,343.78,343.78,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100592,0272,,,,,,2.0 STANDARD DRILL QC 175MM LONG,2469.52,2469.52,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100593,0272,,,,,,2.0 STANDARD DRILL QC 100MM LONG,222.65,222.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100594,0272,,,,,,2.5 STANDARD DRILL QC 110MM LONG,222.65,222.65,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100595,0272,,,,,,K-WIRE,255.37,255.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100596,0272,,,,,,PLATE PERIARTICULAR DISTAL LATERAL FIBUL,2455.74,2455.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100597,0272,,,,,,SCREW FORTE CANCELLOUS 4.0MMX18MM,227.19,227.19,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100598,0272,,,,,,SCREW FORTE CANCELLOUS 4.0MMX20MM,193.24,193.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100599,0272,,,,,,SCREW FORTE CANCELLOUS 4.0MMX22MM,193.24,193.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100600,0278,C1769,,,,,GUIDE WIRE 1.6,147.60,147.60,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16100601,0278,,,,,,DRILL BIT 30MM 4.5,229.77,229.77,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100602,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, JJ 32",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100603,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL,8909.61,8909.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100604,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, HH 32",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100605,0278,,,,,,PERI SCREW 3.5MM X 24MM W/2.7MM HEAD SEL,149.69,149.69,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100606,0278,,,,,,ELEMENT STEM,18677.19,18677.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100607,0278,,,,,,FEMORAL HEAD BIOLOX,7868.01,7868.01,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100608,0278,,,,,,CROWN CUP NOVATION,6950.94,6950.94,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100609,0278,,,,,,CROWN CUP NOVATION LINER,6482.58,6482.58,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100610,0272,,,,,,CANNULATED DRILL TRINKLE END,1618.36,1618.36,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100611,0272,,,,,,GUIDE PIN 2.4MMX9IN PARTIAL THREAD TRO,413.08,413.08,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100612,0272,,,,,,WASHER FOR 4.5MM SCREW,155.33,155.33,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100613,0272,,,,,,CANNULATED SCREW 4.5MMX70MM 1/3 THREAD,667.93,667.93,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100614,0272,,,,,,GUIDE PIN 1.6MM X 9IN PARTIAL THREAD TIP,392.93,392.93,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100615,0272,,,,,,WASHER FOR 5.5 THRU 7.5 SCREWS,151.54,151.54,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100616,0272,,,,,,GUIDE PIN 3.2MM X 12IN PARTIAL THRD TIP,412.91,412.91,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100617,0278,C1776,,,,,FEMORAL COMPONENT SIZE E,13919.19,13919.19,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100618,0278,,,,,,SCREW CANNULATED 4.0MMX46MM 1/2 THREAD,622.11,622.11,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100619,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 56 KK,8909.61,8909.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100620,0278,,,,,,SCREW CANNULATED 6.5MMX80MMX16MM THREAD,771.90,771.90,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100621,0278,,,,,,SCREW CANNULATED 6.5MMX85MMX16MM THREAD,753.07,753.07,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100622,0278,,,,,,SCREW CANNULATED 6.5MMX100MMX16MM THREAD,753.07,753.07,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100623,0278,C1776,,,,,FEMORAL COMPONENT SIZE G,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100624,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE G,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100625,0278,C1776,,,,,STEMMED TIBIAL COMPONENT PRECOAT SIZE 7,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100626,0278,C1776,,,,,"LPS-FLEX GSF OPTION FEMORAL, SIZE C-LT",6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100627,0278,C1713,,,,,Z NAIL 10.5X110 LAG SCREW,1974.37,1974.37,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100628,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, KK 32",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100629,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE EF,3954.31,3954.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100630,0278,C1713,,,,,SCREW CANNULATED 4.5 40MM,665.99,665.99,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100631,0278,C1713,,,,,SCREW CANNULATED 4.5  52MM,852.47,852.47,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100632,0278,,,,,,WASHER 10 MM,119.77,119.77,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100633,0278,C1713,,,,,SCREW CANNULATED 7.3MM  100MM,852.47,852.47,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100634,0278,C1713,,,,,SCREW CANNULATED 7.3MM  115MM,873.78,873.78,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100635,0278,C1713,,,,,SCREW CANNULATED7.3  95MM,852.47,852.47,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100636,0278,C1713,,,,,SCREW CANNULATED 4.5 52MM,774.80,774.80,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100637,0278,C1776,,,,,FEMORAL COMPONENT SIZE E-LT,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100638,0278,C1776,,,,,ALL-POLY PATELLA 38MM,1920.85,1920.85,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100639,0272,,,,,,PATELLA REAMER BLADE SIZE 46,349.25,349.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100640,0278,C1776,,,,,FEMORAL COMPONENT SIZE D LEFT,10755.74,10755.74,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100641,0278,C1776,,,,,FEMORAL HEAD 32MM-3.5,2056.24,2056.24,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100642,0278,C1776,,,,,VERSYS FM MC CLR 15X160MM STD NECK,12021.12,12021.12,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100643,0278,C1713,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX14MM,370.42,370.42,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100644,0278,C1713,,,,,PERI LOCKING SCREW 3.5MMX16MM,370.42,370.42,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100645,0278,C1713,,,,,SCREW CANNULATED 3.5MMX50MM 1/2 THREAD,647.34,647.34,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100646,0272,,,,,,GUIDE PIN 1.6MM X 6IN PARTIAL THREAD TIP,308.85,308.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100647,0272,,,,,,DRILL BIT Q-C 3.5MM DIA 110MM,259.31,259.31,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100648,0278,C1776,,,,,FEMORAL HEAD 32MM+0,1356.95,1356.95,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100649,0278,C1776,,,,,VERSYS 6 INCH BEADED FC 14X160MM STD NEC,8305.49,8305.49,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100650,0272,,,,,,SUTURE PASS THROUGH,167.21,167.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100651,0272,,,,,,SUTURE PASS THROUGH,167.21,167.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100652,0272,,,,,,SUTURE PASS THROUGH,167.21,167.21,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100653,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, NN 32",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100654,0278,C1776,,,,,VERSYS 6 INCH BEADED FC 15X160MM STD BOD,8305.49,8305.49,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100655,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, OO 32",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100656,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100657,0278,C1776,,,,,CONTINUUM LONGEVITY NEUTRAL LINER II 36X,3172.32,3172.32,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100658,0278,C1776,,,,,CONTINUUM CLUSTER-HOLE SHELL 52 II,5282.33,5282.33,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100659,0278,C1713,,,,,Z NAIL 5.0X100 LAG SREW,1926.21,1926.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100660,0272,,,,,,PASSER TWO PIN,734.26,734.26,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100661,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 52 II,8909.61,8909.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100662,0278,C1776,,,,,NEXGEN LPS-FLEX OPTION FEMORAL SIZE G-LT,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100663,0278,C1776,,,,,MODULAR HEAD 32MM+3MM NECK,1356.95,1356.95,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100664,0278,C1713,,,,,Z NAIL 10.5X105 LAG SCREW,1926.21,1926.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100665,0278,,,,,,Z NAIL CPM 11.5MMX21.5CM 130R,5309.41,5309.41,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100666,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100667,0272,,,,,,GDE PIN 3.2MM X 12IN PARTIAL THD TROCAR,308.68,308.68,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100668,0278,C1776,,,,,CONTINUUM CLUSTER-HOLE SHELL 50 HH,8909.61,8909.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100669,0272,,,,,,SCREW FORTE CANCELLOUS 4.0MMX22MM FULL T,227.19,227.19,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100670,0272,,,,,,ACL KIT CAYENNE,1664.97,1664.97,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100671,0278,,,,,,SCREW 9 MM X 25MM,1348.21,1348.21,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100672,0278,,,,,,SCREW 8 MM X 25MM,1315.33,1315.33,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100673,0272,,,,,,BLADE CONMED,265.73,265.73,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100674,0272,,,,,,KNIFE ACL GRAFT DEPUY,530.41,530.41,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100675,0278,,,,,,SCREW 8 MM X 25MM,1315.33,1315.33,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100676,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100677,0278,C1713,,,,,PERI SCREW 3.5MM X 20MM W/2.7MM HEAD SEL,158.14,158.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100678,0272,,,,,,6.5MM CANNULATED SCREW 16MM THD 100MM,803.19,803.19,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100679,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 48 GG,8909.61,8909.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100680,0278,,,,,,SCREW SPEED,1165.48,1165.48,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100681,0272,,,,,,PATELLA REAMER BLADE SIZE 51,349.25,349.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100682,0272,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 105MM,803.19,803.19,,,,,,,,,,,,,
16100683,0272,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 110MM,803.19,803.19,,,,,,,,,,,,,
16100685,0278,,,,,,WIRE MAGNUM,102.50,102.50,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100686,0278,,,,,,DISTAL LATERAL FIBULA RADIAL LOCKING 10H,2839.96,2839.96,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100687,0278,,,,,,PIN GUIDE 1.6MM X 6IN PARTIAL THREAD,316.41,316.41,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100688,0278,C1713,,,,,4.0MM CANNULATED SCREW 1/3 THD 46MM,688.11,688.11,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100689,0272,,,,,,DRILL HAND FREE 4.3MM 152.5MM,358.11,358.11,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100690,0278,C1713,,,,,Z NAIL 5.0X40 CORT SCREW FA,691.46,691.46,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100691,0278,C1713,,,,,Z NAIL 5.0X42.5 CORT SCREW,708.75,708.75,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100692,0278,C1713,,,,,Z NAIL CPM 11.5MMX36CM,7976.58,7976.58,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100693,0272,,,,,,DRILL HAND FREE 3.3MM,629.74,629.74,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100694,0272,,,,,,DRILL CALIB HUM AFFIXUS,1678.32,1678.32,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100695,0272,C1713,,,,,AFFIXUS HUM BALL NOSE GW ST,1398.60,1398.60,,,,,,,,,,,,,
16100696,0272,C1769,,,,,WIRE AIRSCH W/TROCAR 2.5MM,172.20,172.20,,,,,,,,,,,,,
16100697,0272,C1713,,,,,SCREW BLUNT TIP AFFIXUS 4X56MM,745.92,745.92,,,,,,,,,,,,,
16100698,0272,C1713,,,,,SCREW BONE ANN CORT 4X30MM,722.61,722.61,,,,,,,,,,,,,
16100699,0272,C1713,,,,,NAIL PROXIMAL HUMERUS RT LONG AFFIXUS 8.,7272.72,7272.72,,,,,,,,,,,,,
16100700,0278,,,,,,CEMEX GENTA,1798.17,1798.17,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100701,0278,,,,,,PASTE BONE 10 CC,6992.89,6992.89,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100702,0278,,,,,,PASTE BONE OPTECURE,4395.53,4395.53,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100703,0278,C1713,,,,,CERAMENT BONE VOID FILLER 18CC,19020.67,19020.67,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100704,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER LL 36M,3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100705,0278,,,,,,"FEMORAL STEM SZ 16, 170MM",18677.19,18677.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100706,0278,C1776,,,,,MODULAR HEAD 36MM +3MM NECK,2692.14,2692.14,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100707,0278,C1713,,,,,Z NAIL 10.5X85 LAG SCREW,1926.24,1926.24,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100710,0278,,,,,,LOFT PFJ SIZE 3,19047.31,19047.31,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100711,0278,C1776,,,,,BIPOLAR LINER 42/43 OD X 22MM ID,738.51,738.51,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100712,0272,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 95MM,803.20,803.20,,,,,,,,,,,,,
16100713,0272,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 115MM,803.20,803.20,,,,,,,,,,,,,
16100714,0278,C1776,,,,,BIPOLAR SHEL 43MM OD,1098.68,1098.68,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100715,0278,C1776,,,,,ARCOS 1PC 9.5X175MM BRCH BODY STD,10988.83,10988.83,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100716,0278,C1776,,,,,22.2MM DIA COCR MOD HD - 5 NK,1355.64,1355.64,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100719,0275,C1785,,,,,PACEMAKER LV GENERATOR,14984.77,14984.77,,,,,,,,,,,,,
16100720,0275,C1785,,,,,PACEMAKER DUAL CHAMBER WITHOUT LEADS,18314.72,18314.72,,,,,,,,,,,,,
16100721,0275,C1785,,,,,PACEMAKER DUAL CHAMBER,13652.80,13652.80,,,,,,,,,,,,,
16100725,0278,,,,,,PACEMAKER LEAD,2472.00,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100726,0278,,,,,,PACEMAKER LEAD,2472.00,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100744,0278,,,,,,FEMORAL HEAD,3975.96,3975.96,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100745,0278,,,,,,DNU PEG PETELLA,2196.00,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100746,0278,,,,,,PETELLA POLY 41 MM,1920.85,1920.85,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100749,0278,,,,,,PEG PETELLA 23 MM,2783.51,2783.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100750,0278,,,,,,DNU PEG PETELLA 23 MM,5170.50,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100751,0278,,,,,,CONGRUENT TIBIAL INSERT,4848.41,4848.41,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100752,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 3 RIGHT,8311.56,8311.56,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100753,0278,,,,,,FEMORAL COMPONENT SIZE 4 RIGHT,13849.26,13849.26,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100754,0272,,,,,,BLADE LINVATEC/HALL 60X13X1.27,366.29,366.29,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100756,0278,,,,,,FEMORAL COMPONENT RLP POROUS SIZE 4,12330.80,12330.80,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100757,0278,,,,,,FEMORAL COMPONENT RLP POROUS SIZE 5,13403.05,13403.05,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100758,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 4 RIGHT,7399.15,7399.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100759,0278,,,,,,CONGRUENT TRIBIAL INSERT 3/4 10MM RT,3766.17,3766.17,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100760,0278,,,,,,FEMORAL COMPONENT RLP POROUS SIZE 3,12330.80,12330.80,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100761,0278,,,,,,FEMORAL COMPONENT POROUS SIZE 3 LEFT,13849.26,13849.26,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100762,0278,,,,,,CONGRUENT TRIBIAL INSERT,4848.41,4848.41,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100763,0278,,,,,,FEMORAL COMPONENT SIZE 3,13403.05,13403.05,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100764,0278,,,,,,CONGRUENT TRIBIAL INSERT,4334.77,4334.77,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100765,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 2 RIGHT,8686.59,8686.59,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100766,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 1 RIGHT,7399.15,7399.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100767,0278,,,,,,BASEPLATE CCM TIBIAL 2 LEFT,7584.13,7584.13,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100768,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 5 LEFT,7399.15,7399.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100769,0278,,,,,,BASEPLATE CCM TIBIAL 4 LEFT,7399.15,7399.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100770,0278,,,,,,STEM P SERIES,20479.19,20479.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100771,0278,,,,,,FEMORAL HEAD,3787.82,3787.82,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100772,0278,,,,,,BIPOLAR,5577.67,5577.67,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100773,0278,,,,,,CONGRUENT TRIBIAL INSERT 1/2 14MM RT,4229.04,4229.04,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100774,0278,,,,,,FEMORAL HEAD,5161.42,5161.42,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100775,0278,,,,,,FEMORAL COMPONENT RLP POROUS SIZE 2 RT,13849.26,13849.26,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100776,0278,,,,,,BIPOLAR COMPONENT 28X55,4649.28,4649.28,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100777,0278,,,,,,BIPOLAR,6314.42,6314.42,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100778,0278,,,,,,BIPOLAR,4765.51,4765.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100779,0278,,,,,,BIPOLAR,6493.40,6493.40,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100780,0272,,,,,,PRP KIT PROCEDURE,452.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100781,0272,,,,,,KIT APPLICATOR,716.77,716.77,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100782,0278,,,,,,CONGRUENT TRIBIAL INSERT 3/4 10MM LT,3766.17,3766.17,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100783,0278,,,,,,BIPOLAR,6992.89,6992.89,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100784,0278,,,,,,BIPOLAR,6493.40,6493.40,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100785,0278,,,,,,STEM P SERIES,25973.61,25973.61,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100786,0278,,,,,,STEM P SERIES,25973.61,25973.61,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100787,0278,,,,,,FEMORAL HEAD,4101.67,4101.67,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100788,0278,,,,,,BIPOLAR,4649.28,4649.28,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100789,0278,,,,,,BIPOLAR COMPONENT,4765.51,4765.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100790,0278,,,,,,FEMORAL COMPONENT RLP POROUS COCR 6,16902.83,16902.83,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100791,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 6 LEFT,8311.56,8311.56,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100792,0278,,,,,,CONGRUENT TRIBIAL INSERT 5/16 10MM LEFT,4229.04,4229.04,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100793,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 6 RIGHT,8311.56,8311.56,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100794,0278,,,,,,FEMORAL COMPONENT RLP POROUS SIZE 6 RT,16902.83,16902.83,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100795,0278,,,,,,ELEMENT STEM,18677.19,18677.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100796,0278,,,,,,TIBIAL INSERT CR SLOPE,4880.88,4880.88,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100800,0278,,,,,,FEMUR POROUS SIZE 4,12330.80,12330.80,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100801,0278,,,,,,STEM P SERIES,25307.62,25307.62,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100802,0278,,,,,,STEM P SERIES,23975.64,23975.64,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100803,0278,,,,,,STEM P SERIES,23975.64,23975.64,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100804,0278,,,,,,STEM P SERIES,25973.61,25973.61,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100806,0278,,,,,,STEM P SERIES,25307.62,25307.62,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100809,0278,,,,,,ELEMENT STEM,26639.60,26639.60,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100810,0278,,,,,,FEMORAL POROUS,19729.95,19729.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100811,0278,,,,,,TRAY TIBIAL TRAP,12354.11,12354.11,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100812,0278,,,,,,TIBIAL INSERT,6893.00,6893.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100814,0278,C1776,,,,,NEXGEN LPS 5-6 12 MM,3008.61,3008.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100815,0278,C1776,,,,,NEXGEN LPS FEMORAL SIZE E RT,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100816,0278,C1776,,,,,NEXGEN LPS FEMORAL SIZE F RT,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100817,0278,C1776,,,,,NEXGEN LPS FLEX FEMORAL SIZE F LT,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100818,0278,C1776,,,,,NEXGEN LPS 5-6 17 MM,2936.38,2936.38,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100820,0278,,,,,,DURAT DEG INS,4741.85,4741.85,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100821,0278,C1713,,,,,BONE SCREW 6.5 X 25 SELF TAP,236.46,236.46,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100822,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 15,6515.71,6515.71,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100823,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ7 L,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100824,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE F L,3008.66,3008.66,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100825,0278,C1776,,,,,ARCOS 16X175MM BRCH BODY STD,10989.00,10989.00,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100826,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE F r,3252.41,3252.41,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100830,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 4 LEFT,7399.15,7399.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100831,0278,,,,,,BASEPLATE CCM STEM TIBIAL SIZE 5 RIGHT,7399.15,7399.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100834,0278,,,,,,FEMORAL POROUS SIZE 3 LEFT,14019.20,14019.20,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100835,0278,C1713,,,,,PERI SCREW 3.5MM X 22MM W/2.7MM HEAD SEL,158.14,158.14,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100836,0278,C1713,,,,,SCREW FORTE CANCELLOUS 4.0MMX20MM FULL T,227.21,227.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100850,0278,,,,,,CONGRUENT TRIBIAL INSERT 3/4 14MM LEFT,4229.04,4229.04,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100851,0278,,,,,,CONGRUENT TRIBIAL INSERT 5/16 12MM LEFT,3860.32,3860.32,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100852,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE E,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100853,0278,,,,,,BASEPLATE CCM TIBIAL COCR 4 LEFT,7399.15,7399.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100854,0278,,,,,,FEMORAL COMPONENT RLP POROUS COCR 5,12639.07,12639.07,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100855,0278,,,,,,PEG PETELLA 26 MM,4012.59,4012.59,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100856,0278,,,,,,TIBIAL INSERT PCL SIZE 3/4 10MM,3766.17,3766.17,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100857,0278,,,,,,BASEPLATE CCM TIBIAL COCR 3 LEFT,8519.35,8519.35,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100858,0278,,,,,,FEMORAL POROUS SZ 5 RIGHT,21042.37,21042.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100859,0278,,,,,,TRAY TIBIAL TRAP SZ 5F/5T,13174.95,13174.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100860,0278,,,,,,TIBIAL INSERT SIZE 5 15MM,6560.00,6560.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100861,0278,,,,,,FEMORAL POROUS SZ 4 RIGHT,12625.17,12625.17,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100862,0278,,,,,,PEG PETELLA,4012.59,4012.59,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100863,0278,,,,,,PEG PATELLA,4283.57,4283.57,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100864,0278,,,,,,"FEMORAL STEM SZ 15, 165MM",17240.48,17240.48,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100865,0278,,,,,,BIPOLAR COMPONENT,4545.38,4545.38,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100866,0278,C1776,,,,,PROLONG HIGHLY CROSSLINKED POLYETHYLENE,1920.85,1920.85,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100867,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100868,0278,C1776,,,,,TAPER STEM PLUG NEXGEN,1586.15,1586.15,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100869,0278,C1776,,,,,LEGACY KNE POSTERIOR STABILIZED,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100870,0278,C1713,,,,,PALACOS R+G 1X40 SINGLE BONE CEMENT,982.34,982.34,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100871,0278,,,,,,PATELLA REAMING BLADE,349.25,349.25,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100872,0278,C1776,,,,,STEMMED TIBIAL COMPONENT PRECOAT SIZE 5,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100873,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE E,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100874,0278,C1776,,,,,STEMMED TIBIAL COMPONENT PRECOAT SIZE 4,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100875,0278,C1776,,,,,ALL-POLY PATELLA 32MM,1920.85,1920.85,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100876,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE C,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100877,0278,C1776,,,,,LEGACY KNE POSTERIOR STABILIZED SIZE D,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100878,0278,C1776,,,,,"NEXGEN PROLONG ALLPOLY PATELLA, 29MM",1920.85,1920.85,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100879,0272,,,,,,PATELLA REAMER BLADE SIZE 38,349.25,349.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100880,0278,C1776,,,,,LEGACY KNE POSTERIOR STABILIZED SIZE R-L,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100881,0278,C1776,,,,,NEXGEN PRECOAT STEMTIBIAL PLATE SZ 4,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100882,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SZ CD,3954.31,3954.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100883,0278,C1776,,,,,LEGACY KNE POSTERIOR STABILIZED SIZE D-L,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100884,0278,C1776,,,,,STEMMED TIBIAL COMPONENT PRECOAT SIZE 6,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100885,0272,,,,,,PATELLA REAMER BLADE SIZE 35,349.25,349.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100886,0278,C1713,,,,,REFOBACIN BONE CEMENT R 1X40 US,982.35,982.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100887,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100888,0278,C1713,,,,,HEADLESS TROCAR DRILL PIN75MM,945.87,945.87,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100899,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100900,0278,,,,,,CUP MAGNUM 580DX521D,18361.34,18361.34,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100901,0278,,,,,,CUP MAGNUM PF 480DX42ID,19373.65,19373.65,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100902,0278,C1776,,,,,NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 3,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100903,0278,,,,,,CUP MAGNUM PF 500DX44ID,20950.21,20950.21,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100904,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR CD,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100905,0278,,,,,,CUP MAGNUM 620DX561D  M2A,18361.34,18361.34,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100906,0278,,,,,,CUP MAGNUM 50ODX48ID,19550.80,19550.80,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100907,0278,,,,,,MAGNUM PF CUP 50ODX46ID,20439.23,20439.23,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100908,0278,,,,,,CUP MAGNUM 54ODX48ID,19373.65,19373.65,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100909,0278,,,,,,ACT ARTIC HD ARCOM XL 28X46MM,9616.00,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100910,0278,,,,,,ACT ARTIC HD ARCOM XL 28X44MM,9616.00,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100911,0278,,,,,,M2A MAGNUM PF CUP 50ODX44ID,20439.23,20439.23,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100912,0278,,,,,,ACT ARTIC HD ARCOM XL 28X50MM,9616.00,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100913,0278,,,,,,CUP MAGNUS 56ODX50ID,20439.23,20439.23,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100914,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100915,0278,C1776,,,,,NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 2,4745.18,4745.18,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100916,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PSIZE CD 12MM,3862.33,3862.33,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100917,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100918,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100919,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100920,0278,,,,,,MAGNUM 12/14 TPR 52-60 STD,1931.37,1931.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100921,0278,,,,,,MAGNUM 12/14 TPR 52-60 +9,1931.37,1931.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100922,0278,C1776,,,,,ARCOS 13X175M BRCH BODY STD,10988.83,10988.83,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100923,0278,C1776,,,,,ARCOS 12X175MM BRCH BODY STD,10988.83,10988.83,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100924,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100925,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100926,0278,C1776,,,,,ACROS 1PC 14X175MM BRCH BODY STD,10988.83,10988.83,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100927,0278,,,,,,28MM MOD HD STD NECK TP1 TAPER,1355.62,1355.62,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100928,0278,C1713,,,,,PSN 2.5MM FEMALE SCREW 25MM,472.95,472.95,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16100929,0278,C1776,,,,,PSN FEM PS CMT CCR NRW SIZE 5 L,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100930,0278,,,,,,CER BIOLOXD OPTION HD 28MM,9636.88,9636.88,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100931,0278,,,,,,CER OPTION 12/14 TPR SLEEVE +4,1115.53,1115.53,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100932,0278,C1776,,,,,PSN ASF PS 16MM VE L 3-5 CD,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100933,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE D L,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100934,0278,C1776,,,,,ALL POLY PAT VE 32MM DIA,1920.85,1920.85,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100935,0278,C1776,,,,,ARCOS 11X175MM BRCH BODY STD,10988.83,10988.83,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100936,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ8 L,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100937,0278,C1776,,,,,PSN ASF PS 10MM VE L 6-9 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100938,0278,C1776,,,,,PSN TIB STM 5 DEG SZ G L,3252.41,3252.41,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100939,0278,C1776,,,,,ALL POLY PAT VE 38 MM DIA,1920.87,1920.87,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100940,0278,,,,,,MAGNUM MOD HD SZ 52MM,7140.42,7140.42,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100941,0278,,,,,,MAGNUM MOD HD SZ 56MM,6966.26,6966.26,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100942,0278,,,,,,CUP MAGNUM M2A  12/14 TPR 42-50+3,2037.93,2037.93,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100943,0278,,,,,,MAGUM M2A MOD HD SZ 48MM,7352.53,7352.53,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100944,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ10 L,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100945,0278,C1776,,,,,PSN ASF PS 12MM VE L 10-12 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100946,0278,C1776,,,,,ALL POLY PAT VE 41 MM DIA,1920.87,1920.87,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100947,0278,C1776,,,,,"BIOLOX DELTA FEM HEAD, 32MM, +0MM",3474.32,3474.32,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100948,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ9 R,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100949,0278,C1776,,,,,PSN TIB STM 5 DEG SZ E R,3252.41,3252.41,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100950,0278,,,,,,ACT ARTIC E1 28MM ID X 42MM OD,9300.55,9300.55,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100951,0278,C1776,,,,,PSN ASF PS 10MM VE R 6-9 EF,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100952,0278,C1776,,,,,ALL POLY PAT VE 35 MM DIA,1920.87,1920.87,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100953,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ8 R,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100954,0278,C1776,,,,,PSN ASF PS 16MM VE L 6-9 CD,3008.60,3008.60,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100955,0278,C1776,,,,,PSN ASF PS 11MM VE R 6-9 EF,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100956,0278,C1776,,,,,PSN FEM PS CMT CCR NRW SIZE 6 R,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100957,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 12.5,6515.71,6515.71,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100958,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ10 R,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100959,0278,C1776,,,,,PSN ASF PS 10MM VE L 10-12 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100960,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ11 R,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100961,0278,C1776,,,,,PSN ASF PS 10MM VE R 10-12 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100962,0278,C1776,,,,,PSN ASF PS 10MM VE L 6-9 EF,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100963,0278,C1776,,,,,BF HUMERAL HEAD 15MMX46MM,4372.48,4372.48,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100964,0278,C1776,,,,,TM HUMERAL STEM 48 DEG 11MMX130MM,11183.20,11183.20,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100965,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ9 R,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100966,0278,C1776,,,,,PSN TIB STM 5 DEG SZ G R,3252.41,3252.41,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100967,0278,C1776,,,,,PSN ASF PS 11MM VE R 6-9 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100968,0278,C1776,,,,,PSN ASF PS 10MM VE L 10-12 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100969,0278,C1776,,,,,PSN ASF PS 12MM VE R 10-12 GH,3008.66,3008.66,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100970,0278,,,,,,PSN FEM PS CMT CCR STD SZ12 R,6752.17,6752.17,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100971,0278,,,,,,PSN ASF PS 11MM VE R 10-12 GH,3008.65,3008.65,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100972,0278,C1776,,,,,ALL POLY PAT VE 38 MM DIA,1920.87,1920.87,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100975,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ11 L,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100976,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ7 L,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100977,0278,C1776,,,,,PSN ASF PS 12MM VE L 6-9 EF,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100978,0278,C1776,,,,,PSN ASF PS 10MM VE R 6-9 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100987,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100988,0278,C1776,,,,,32MM MOD HEAD COCR +6mm NECK,1355.62,1355.62,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100989,0278,C1776,,,,,ARCOS 12X175MM BRCH BODY HI,10988.83,10988.83,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100990,0278,C1776,,,,,"CONTINUUM VIVACIT-E NEUTRAL LINER, KK 32",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100991,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER II 32X,3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100992,0278,C1776,,,,,PSN FEM PS CMT CCR NRW SZ7 R,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100993,0278,C1776,,,,,PSN ASF PS 12MM VE L 6-9 EF,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100994,0278,,,,,,"CABLE GRIP SYS,4X40MM",1889.21,1889.21,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100995,0278,,,,,,CABLE GRIP SYS W/TWO CRIMP 4X35MM,1889.21,1889.21,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16100996,0278,C1776,,,,,PSN ASF PS 14MM VE L 10-12 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100997,0272,,,,,,PATELLA REAMER BLADE SIZE 41,349.25,349.25,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16100998,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE E L,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16100999,0636,Q4186,,,,,DRESSING EPIFIX 2X3,635.20,635.20,231.74,231.74,,,,,,,231.74,,,,
16101000,0278,C1713,,,,,PIN GUIDE 3.2 MM,639.35,639.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101001,0278,C1713,,,,,SCREW LAG 85MM,937.92,937.92,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101002,0278,C1713,,,,,SCREW 4.7 X 25.4 MM,195.48,195.48,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101003,0278,,,,,,SCREW 4.5 X 44MM,133.09,133.09,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16101004,0278,,,,,,SCREW 4.5 X 38MM,133.09,133.09,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16101005,0278,,,,,,SCREW 2.4 X 16MM CANNOLATED,516.14,516.14,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16101006,0278,C1889,,,,,AFB1115-AVAFLEXBALLOON 11G 15MM,8491.37,8491.37,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16101007,0278,C1713,,,,,AUTOPLEX W/VERTAPLEX HV,3466.21,3466.21,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101008,0278,,,,,,IVAS 11G BIOPSY,292.54,292.54,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16101009,0278,C1889,,,,,CURETTE 11G,1968.80,1968.80,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16101010,0278,C1889,,,,,11G IVAS ACCESS CANNULA,243.12,243.12,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16101011,0278,C1889,,,,,11G 20MM AVAFLEX KIT,8491.37,8491.37,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16101012,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER GG 32X,3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101014,0278,C1776,,,,,PSN ASF PS 10MM VE L 10-11 EF,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101015,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE F L,3333.72,3333.72,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101016,0278,C1776,,,,,PSN ASF PS 14MM VE L 6-9 GH,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101017,0278,C1776,,,,,PSN TIB STM 5 DEG SZ E L,3252.41,3252.41,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101018,0278,C1776,,,,,PSN ASF PS 14MM VE R 6-9 EF,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101020,0278,C1776,,,,,CER BIOLOXD OPTION HD 32MM,3473.36,3473.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101021,0278,C1889,,,,,CER OPTION TYPE 1 TPR SLEEVE +3,945.89,945.89,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16101022,0278,C1776,,,,,"CONTINUUM VIVACIT-E NEUTRAL LINER,  JJ 3",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101023,0278,C1776,,,,,CER BIOLOXD OPTION HD 36MM,3473.36,3473.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101024,0278,C1889,,,,,CER OPTION TYPE 1 TPR SLEEVE +6,945.89,945.89,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36
16101025,0272,,,,,,COMP RVS 2.7 MM DIA DRL,750.58,750.58,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16101026,0278,C1713,,,,,COMP REV SHLDR 9 IN STEINMANN,530.20,530.20,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101027,0272,,,,,,COMP RVS 3.2 MM DRL,547.62,547.62,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16101028,0278,C1776,,,,,COMP RVS 25MM BSPLT HA+ADPTR,5744.25,5744.25,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101029,0278,C1713,,,,,HMRL BEARING 36 MM + 3 VITE,6127.20,6127.20,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101030,0278,C1776,,,,,HMRL TRAY +3 STD,5296.20,5296.20,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101031,0278,C1713,,,,,COMP NLK SCR 3.5HEX 4.75X25 ST,471.03,471.03,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101032,0278,C1713,,,,,COMP NLK SCR 3.5HEX 4.75X20 ST,471.03,471.03,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101033,0278,C1776,,,,,COMP RVRS SHLDR GLNSP STD 36MM,4583.91,4583.91,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101034,0278,C1713,,,,,COMP RVS CNTRL 6.5X25MM ST/RST,463.37,463.37,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101100,0278,C1713,,,,,PLATE 135 DEGREE 3 HOLE,1442.37,1442.37,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101200,0278,,,,,,NITINOL SPEED 18X18X15MM,5102.74,5102.74,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16101201,0272,,,,,,GUIDE,1315.33,1315.33,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16101223,0278,C1713,,,,,XEMPLIFI DBM PUTTY 5 CC,3330.00,3330.00,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101224,0278,C1713,,,,,CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,1248.75,1248.75,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101225,0278,C1713,,,,,CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,1248.75,1248.75,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101226,0278,C1713,,,,,CREO MIS 5.5X40MM CURVED ROD TITANIUM AL,1279.97,1279.97,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101227,0278,C1713,,,,,CREO AMP 6.5X45MM MODULAR CANNULATED SCR,1998.00,1998.00,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101228,0278,,,,,,SUSTAIN RADIOLUCENT SPACER 8X22 8MM,19147.50,19147.50,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16101229,0278,,,,,,CREO MIS MODULAR POLYAXIAL TULIP 30MM RE,2047.95,2047.95,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16101230,0278,C1776,,,,,COLONIAL ACDF SPACER 12X14 7DEGREE 7MM,3330.00,3330.00,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101231,0278,,,,,,XEMPLIFI DBM PUTTY 3 CC,2247.75,2247.75,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16101232,0278,C1776,,,,,COLONIAL ACDF SPACER 12X14 7DEGREE 6MM,3330.00,3330.00,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101233,0278,C1776,,,,,COLONIAL ACDF SPACER 12X14 7DEGREE 10MM,3300.00,3300.00,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101234,0278,C1713,,,,,BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,749.25,749.25,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101235,0278,L8699,,,,,RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,3300.00,3300.00,5014.86,5014.86,,,,,,,5014.86,,,,
16101236,0278,C1713,,,,,XEMPLIFI DBM PUTTY 1 CC,832.50,832.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101237,0278,L8699,,,,,RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,3300.00,3300.00,5014.86,5014.86,,,,,,,5014.86,,,,
16101238,0278,C1713,,,,,BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,749.25,749.25,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101239,0278,L8699,,,,,RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,3300.00,3300.00,5014.86,5014.86,,,,,,,5014.86,,,,
16101240,0278,L8699,,,,,RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,3300.00,3300.00,5014.86,5014.86,,,,,,,5014.86,,,,
1610167,0278,C1713,,,,,MINI-MONSTER CANNULATED SHORT THREADED S,1137.50,1137.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16101933,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE D R,3252.36,3252.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101940,0636,Q4186,,,,,EPIFIX 2.0x2.0 CM,908.36,908.36,231.74,231.74,,,,,,,231.74,,,,
16101945,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ6 L,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101946,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ5 R,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101948,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ6 R,6752.07,6752.07,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101951,0278,C1776,,,,,PSN ASF PS 12MM VE R 6-9 CD,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101952,0278,C1776,,,,,PSN ASF PS 10MM VE R 6-9 CD,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101953,0278,C1776,,,,,JOINT DEVICE (IMPLANTABLE),3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101954,0278,C1776,,,,,PSN ASF PS 11MM VE L 3-5 CD,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16101955,0636,Q4186,,,,,EPIFIX 5.0X6.0 CM,650.98,650.98,231.74,231.74,,,,,,,231.74,,,,
16101956,0636,Q4186,,,,,EPIFIX 4.0X4.0 CM,635.09,635.09,231.74,231.74,,,,,,,231.74,,,,
16101957,0636,Q4186,,,,,EPIFIX 3.0 X 4.0 CM CONSIGN,0.01,0.01,231.74,231.74,,,,,,,231.74,,,,
16101958,0636,Q4186,,,,,DRESSING EPIFIX 18MM DISC,2479.19,2479.19,231.74,231.74,,,,,,,231.74,,,,
16101959,0636,J3590,,,,,AMNIOFILL 100.0MG,0.00,0.00,,,,,,,,,,,,,
16101960,0636,Q4186,,,,,EPIFIX 2.0x4.0 CM,575.99,575.99,231.74,231.74,,,,,,,231.74,,,,
16101970,0636,Q4186,,,,,EPIFIX MESH 4X4.5CM,0.00,0.00,231.74,231.74,,,,,,,231.74,,,,
16102000,0272,,,,,,DRILL BIT 3.2,169.89,169.89,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16102001,0272,,,,,,TIP IMPACTOR,1645.00,1645.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16102002,0272,,,,,,TAP LAG SCREW,3754.51,3754.51,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16102003,0278,,,,,,DRILL BIT 1.7,935.72,935.72,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102004,0278,,,,,,HUMERAL STEM,7878.66,7878.66,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102005,0278,,,,,,HUMERAL HEAD,5995.58,5995.58,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102006,0278,,,,,,REPLICATOR PLATE TORQUE SCREW DRIVER,4945.81,4945.81,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102010,0278,,,,,,HUMERAL STEM,10589.24,10589.24,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102011,0278,,,,,,HUMERAL ADAPTER TRAY,7294.26,7294.26,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102012,0278,,,,,,GLENOID PLATE,6060.51,6060.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102013,0278,,,,,,GLENOSPHERE,8091.78,8091.78,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102014,0278,,,,,,HUMERAL LINER,4611.98,4611.98,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102015,0278,,,,,,TORQUE DEFINING SCREW,1006.47,1006.47,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102016,0272,,,,,,DRILL BITS,1212.10,1212.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16102017,0278,,,,,,GLENOSPHERE LOCKING SCREW,465.36,465.36,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102018,0278,,,,,,COMPRESSION SCREW/LOCKING CAP KIT,665.99,665.99,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102019,0278,,,,,,COMPRESSION SCREW/LOCKING CAP KIT,665.99,665.99,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102020,0278,,,,,,COMPRESSION SCREW/LOCKING CAP KIT,665.99,665.99,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102021,0278,,,,,,COMPRESSION SCREW/LOCKING CAP KIT,465.36,465.36,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102022,0278,,,,,,COMPRESSION SCREW/LOCKING CAP KIT,465.36,465.36,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102023,0278,,,,,,COMPRESSION SCREW/LOCKING CAP KIT,476.99,476.99,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102025,0278,,,,,,HUMERAL STEM,7359.19,7359.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102026,0278,,,,,,GLENOSPHERE,5768.31,5768.31,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16102027,0278,,,,,,HUMERAL LINER,3283.50,3283.50,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16103000,0278,,,,,,VENOUS OUTFLOW COMPONENT,7675.53,7675.53,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16103001,0278,,,,,,ARTERIAL GRAFT COMPONENT,3363.25,3363.25,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16103002,0278,,,,,,ACCESSORY COMPONENT KIT,1698.27,1698.27,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16103012,0272,,,,,,"VIATRAC 14 PLUS 4X20, 135CM",982.34,982.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16103013,0278,C1884,,,,,EMBOSHIELD NAV PROTECT SYSTEM,5644.27,5644.27,,,,,,,,,,,,,
16103014,0278,,,,,,STENT XACT 8-6X30,8345.27,8345.27,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16103015,0272,,,,,,"VIATRAC 14 PLUS 4X30, 135CM",982.34,982.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16103016,0272,,,,,,"VIATRAC 14 PLUS 6X30, 135CM",982.34,982.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16103017,0278,,,,,,STENT XACT 10-8MMX40MM,8141.73,8141.73,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16103018,0272,,,,,,"VIATRAC 14 PLUS 5X30, 135CM",982.34,982.34,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16107600,0278,,,,,,GUIDE WIRE .035X4  P/T,86.50,0.00,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16107601,0278,,,,,,CROWN CUP CLUSTER HOLE SHELL,7530.18,7530.18,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16107602,0278,,,,,,CROWN CUP GXL LINER,6644.64,6644.64,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16107603,0278,,,,,,FEMORAL STEM ELEMENT,18677.19,18677.19,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16107604,0278,,,,,,FEMORAL HEAD COCR 28MM DIA 3MM NK,1355.62,1355.62,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16107605,0278,,,,,,FEMORAL HEAD COCR,4393.87,4393.87,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16107606,0278,,,,,,FEMORAL HEAD COCR,4393.87,4393.87,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16108000,0636,Q4101,,,,,APLIGRAPH PER SQ CM,4412.18,4412.18,,,,,,,,,,,,,
16108001,0278,C1713,,,,,BB-TAK,166.56,166.56,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108002,0278,C1713,,,,,"BB-TAK, THREADED",283.05,283.05,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108003,0278,C1713,,,,,"LO-PRO SCRW,TI,3.0MMX 14MMCORT",366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108004,0278,C1713,,,,,"LO-PRO SCRW,TI,3.0MMX 16MMCORT",366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108005,0278,C1713,,,,,"LO-PRO SCRW,TI,3.0MMX 18MMCORT",366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108006,0272,,,,,,"CANNULATED DRILL BIT, 2.0MM (AO)",179.37,179.37,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108007,0278,C1713,,,,,"LO-PRO SCRW,TI,3X 28MMCANN,PT THD",409.58,409.58,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108008,0278,C1769,,,,,"GUIDEWIRE, .045 X5.91",28.70,28.70,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16108009,0272,C1713,,,,,"LO-PRO LOCK SCRW,TI3.0MMX 14MM",459.53,459.53,,,,,,,,,,,,,
16108010,0278,C1713,,,,,"LO-PRO LOCK SCRW,TI,3.0MMX 16M",366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108011,0278,C1769,,,,,.062  GUIDE WIRE WITH TROCAR TIP,61.50,61.50,104.89,131.80,,,,,,,104.89,,,131.80,131.80
16108012,0272,,,,,,"DRILL BIT, 2.0MM (AO)",283.05,283.05,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108013,0278,C1713,,,,,"LO-PRO MTP PLT TM CONTRD,SHT,L,TI",2663.96,2663.96,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108014,0278,C1713,,,,,SPEEDBRG IMP SYS W/BIO-COMP SWVLK,5794.11,5794.11,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108015,0272,A4649,,,,,CANNULATED DRILL 3.5MM,582.74,582.74,,,,,,,,,,,,,
16108016,0272,A4649,,,,,BONE TAP 4.5MM CANNULATED,597.31,597.31,,,,,,,,,,,,,
16108017,0272,A4649,,,,,BONE TAP 5.5MM CANNULATED,582.74,582.74,,,,,,,,,,,,,
16108018,0272,A4649,,,,,BONE TAP 6.0MM,582.74,582.74,,,,,,,,,,,,,
16108019,0272,A4649,,,,,GUIDEWIRE W/TRCR TIP 2MMX200MM,597.31,597.31,,,,,,,,,,,,,
16108020,0278,C1713,,,,,"LO-PRO SCRW,TI,5.5MMX45MM",2647.31,2647.31,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108021,0278,C1713,,,,,LO-PRO SCREW TI 3.0MMX20CORT,366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108022,0278,C1713,,,,,"LO-PRO SCRW,TI,3.0MMX 22MMCORT",366.29,366.29,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108023,0278,C1713,,,,,3.0X12MM VAL SCREW TI,466.19,466.19,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108024,0278,C1713,,,,,3.0X14MM VAL SCREW TI,466.19,466.19,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108025,0278,C1713,,,,,3.0X20MM VAL SCREW TI,466.19,466.19,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108026,0278,C1713,,,,,"LO-PRO MTP PLATE STR, LONG TI",2663.96,2663.96,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108027,0278,C1713,,,,,PHALANGEAL REAMER 22MM,1498.48,1498.48,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108028,0278,C1713,,,,,METATARSAL REAMER 22MM,1498.48,1498.48,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108029,0278,,,,,,DECELLULARIZED DERMIS,30229.29,30229.29,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16108030,0278,C1713,,,,,SPEEDBRG IMP SYS W/BIO-COMP SWVLK,6519.31,6519.31,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108031,0278,C1713,,,,,FHL IMPLANT SYSTEM 6.25 MM,4978.35,4978.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108032,0278,C1713,,,,,TENO SCREW KIT DISP.,649.35,649.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108033,0278,C1713,,,,,COMPR FT SCREW MINI 3.5 X 32MM,1165.50,1165.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108034,0278,C1713,,,,,COMPR FT SCREW MINI 3.5 X 34MM,1165.50,1165.50,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108035,0272,A4649,,,,,G-WIRE W/TRCR TIP .45 W/ LASER LINE,61.50,61.50,,,,,,,,,,,,,
16108036,0272,,,,,,DRILL BIT2.7MM CMP FT CALIBRATED,649.35,649.35,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108037,0272,A4649,,,,,DRILL PROFILE MINI CMP FT,499.50,499.50,,,,,,,,,,,,,
16108038,0272,,,,,,DRL BIT 5.0MM CANN,582.75,582.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108039,0278,C1713,,,,,COMPR FT SCRE XL 7 X 55MM,2314.35,2314.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108040,0278,C1713,,,,,COMPR FT SCREW XL 7 X 60MM,2314.35,2314.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108041,0272,A4649,,,,,GUIDEWIRE W/TRCR TIP 2.4MMX9.25,61.50,61.50,,,,,,,,,,,,,
16108042,0272,A4649,,,,,GUIDEWIRE W/TRCR TIP 2.4MMX9.25,123.00,123.00,,,,,,,,,,,,,
16108100,0278,,,,,,MAIN PUMP TUBING,208.29,208.29,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16108101,0272,,,,,,MULTIFIRE SCORPION NEEDLE,580.24,580.24,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108102,0272,,,,,,SUTURE ANCH BIOCOMP SWI-VELOCK C CLD 4.7,1331.98,1331.98,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108103,0272,,,,,,CANNULA TWIST-IN NOTCHED,102.50,102.50,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108104,0272,,,,,,FIBERLINK,166.56,166.56,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108105,0278,,,,,,BONE CUTTER 4.0MMX13CM,219.78,219.78,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16108106,0272,,,,,,FIBERTAPE,170.66,170.66,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108107,0278,,,,,,SYNDESMOSIS TIGHTROPE XP IMPLANT STAINLE,4978.28,4978.28,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16108109,0272,,,,,,FIBERWIRE #2 BLU 38  W/2 STR DP NDL,180.40,180.40,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108110,0278,,,,,,TORPEDO 4.0MMX13CM,336.32,336.32,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16108111,0272,,,,,,TAPERES CRVD NDL 26MM 1/2 CIRCLEX/LOOP,77.90,77.90,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108112,0272,,,,,,"PUNCH, DISP CRKSCREW SWVLK ANCHS",249.75,249.75,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108113,0272,,,,,,DBL LOADED 4.75MM BIO-COMP SWVLK,1388.61,1388.61,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108114,0272,,,,,,"BIO-COMP SWIVELOCK C, FT, 4.75X19.1MM",1565.10,1565.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108115,0272,,,,,,"BIO-COMP, SWIVELOCK C, TT, 4.75X19.1MM",1565.10,1565.10,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16108116,0278,C1713,,,,,"IMPLANT SYS, BIOC ACHILLES SPEEEDB W JUM",6643.35,6643.35,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108117,0278,C1713,,,,,"IMPLANT SYS, BIOC ACHILLES SPEEDB W/JUMP",2044.88,2044.88,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16108118,0278,L8699,,,,,UROLIFT UL400 DELIVERY DEVICE & IMPLANT,3246.75,3246.75,5014.86,5014.86,,,,,,,5014.86,,,,
16109000,0272,,,,,,ABIATOR LIGHTWAVE SUCTION,337.50,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109009,0278,C1713,,,,,"3.2MM THREAD PIN, 508MM",444.51,444.51,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16109010,0272,,,,,,CODA SHAVER 4.2MM,140.73,140.73,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109011,0278,,,,,,SCREW COMPRESSION LAG,195.48,195.48,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109012,0278,,,,,,FEMORAL NAIL,5442.15,5442.15,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109013,0278,,,,,,LAG SCREW 80MM,2196.07,2196.07,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109014,0272,,,,,,GUIDE WIRE TEAR DROP,705.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109015,0272,,,,,,GUIDE PIN 3.2MM,865.79,865.79,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109016,0278,,,,,,SCREW LAG 80MM 12.7 MM,937.92,937.92,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109017,0278,,,,,,FEMORAL FIXATION 3 HOLE 135 DEGREE,1442.37,1442.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109018,0278,,,,,,SCREW CORTICAL 4.5MM 40MM,64.41,64.41,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109019,0278,C1713,,,,,3MMx100CM TEARDROP GD,580.34,580.34,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16109020,0272,,,,,,TUBE SET 24K,161.00,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109021,0272,,,,,,TUBE SET 24K,33.25,0.00,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109022,0278,,,,,,Z NAIL 10.5X95 LAG SCREW 75MM,1926.21,1926.21,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109023,0278,C1776,,,,,FEMORAL NAIL 10MMX21.5CM 130 R,5309.41,5309.41,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109024,0278,C1776,,,,,BIPOLAR LINER 53/54/55MM OD X 28MM ID,738.51,738.51,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109025,0278,C1776,,,,,BIPOLAR SHELL 55MM OD,1739.89,1739.89,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109026,0278,,,,,,Z NAIL CPM 10MMX21.5CM 130L,5309.41,5309.41,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109027,0272,C1769,,,,,BALL TIP GUIDE WIRE 3.0MMX100CM,419.84,419.84,,,,,,,,,,,,,
16109028,0278,,,,,,LAG SCREW 10.5X90 Z NAIL,1926.21,1926.21,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109029,0272,C1769,,,,,BALL NOSE GUIDE WIRE 80CM,600.06,600.06,,,,,,,,,,,,,
16109030,0278,C1713,,,,,PIN 2.0MM,333.40,333.40,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16109031,0272,C1769,,,,,BALL NOSE GUIDE WIRE 100CM,491.51,491.51,,,,,,,,,,,,,
16109090,0278,C1776,,,,,VERSYS 6 INCH BEADED FC 11X160MM STD NEC,8305.49,8305.49,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109091,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 10,6515.71,6515.71,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109092,0278,C1776,,,,,12/14 COCR FEMORAL HEAD 32MM + 0,1356.98,1356.98,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109093,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 50 HH,8909.75,8909.75,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109094,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER HH 32x,3172.36,3172.36,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109099,0278,C1776,,,,,BIPOLAR SHEL 47MM OD,1098.68,1098.68,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109100,0278,C1776,,,,,MODULAR NECK 12/14 NECK TAPER,2364.69,2364.69,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109101,0278,C1776,,,,,MODULAR NECK 12/14 TAPER,2364.69,2364.69,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109102,0278,C1776,,,,,MODULAR NEX C 12/14 NECK TAPER,2364.69,2364.69,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109103,0278,C1776,,,,,BIPOLAR LINER 47/48/49MM OD X 28MM ID,738.51,738.51,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109104,0278,C1776,,,,,BIPOLAR SHELL 48MM OD,738.51,738.51,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109105,0278,C1776,,,,,VERSYS PRESS FIT LD/FX SZ 11X120MM,4428.83,4428.83,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109106,0278,C1776,,,,,12/14 COCE FEMORAL HEAD 28MM,1356.95,1356.95,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109107,0278,C1776,,,,,MODULAR NECK E 12/14 TAPER,12021.12,12021.12,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109108,0278,C1776,,,,,BIPOLAR SHELL 49MM OD,1098.68,1098.68,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109109,0278,C1776,,,,,VERSYS FM MC CLR 13X140MM STD NECK,12021.12,12021.12,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109110,0278,,,,,,HIP PROSTHESIS TAPER 7.5,6515.61,6515.61,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109111,0278,C1776,,,,,HIP PROSTHESIS TAPER ML,6515.62,6515.62,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109112,0278,,,,,,HIP PROSTHESIS TAPER 6,12021.12,12021.12,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109113,0278,C1776,,,,,HIP PROSTHESIS TAPER SZ 12.5,6515.61,6515.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109114,0278,C1776,,,,,MODULAR NEX G 12/14 NECK TAPER,2364.69,2364.69,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109115,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, MM 32",3172.31,3172.31,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109116,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 58LL,8909.61,8909.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109117,0278,C1776,,,,,VERSYS FM MC CLR 12X140MM STD NECK,12021.12,12021.12,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109118,0278,C1776,,,,,MODULAR NEX B 12/14 NECK TAPER,2364.69,2364.69,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109119,0278,C1776,,,,,HIP PROSTHESIS TAPER SZ 16.25,6515.61,6515.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109120,0278,,,,,,HEAD METASUL LDH 44 CODE J TAPER 18/20,6325.01,6325.01,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109121,0278,,,,,,HEAD METASUL LDH 50 CODE P TAPER 18/20,6856.37,6856.37,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109122,0278,C1776,,,,,VERSYS ADVOCATE CEMENTED STEM 11X120 STA,5271.40,5271.40,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109123,0278,C1713,,,,,VERSYS DISTAL CENTRALIZER 11MM,236.46,236.46,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16109124,0278,C1776,,,,,12/14 COCR FEMORAL HEAD 36MM +7.0,2692.10,2692.10,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109125,0278,C1713,,,,,HIVAC 7 SINGLE/DOUBLE SINGLE,887.43,887.43,427.71,1201.92,,,,,,,427.71,,,1201.92,1201.92
16109126,0278,C1776,,,,,BIPOLAR SHELL 53MM OD,1098.68,1098.68,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109127,0278,C1776,,,,,VERSYS PRESS FIT LD/FX SZ 15X140MM,2990.43,2990.43,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109128,0278,C1776,,,,,HIP PROSTHESIS TAPER SZ 11,6515.62,6515.62,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109129,0278,C1776,,,,,32MM MOD HEAD COCR STD NECK,1355.62,1355.62,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109130,0278,,,,,,ACETABULAR METASUL DUROM 50/044 CODE J,14265.51,14265.51,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109131,0278,,,,,,ACETABULAR METASUL DUROM 56/050 CODE J,15850.56,15850.56,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109132,0278,,,,,,ACETABULAR COMPONENT STD 28MM,7991.88,7991.88,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109133,0278,,,,,,ACETABULAR COMPONENT ELEV RM 28MM,7991.88,7991.88,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109134,0278,,,,,,FEMORAL HEAD 28MM,3862.74,3862.74,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109135,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 9,6515.61,6515.61,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109136,0272,,,,,,DISPOSABLE FLEXDRILL 15M,398.59,398.59,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109137,0278,C1776,,,,,MODULAR NEX R NECK TAPER,2364.69,2364.69,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109138,0272,,,,,,MODULAR DRILL BIT 3.2X30,408.55,408.55,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109140,0278,,,,,,HEAD ADAPTER METASUL TAPER 12/14-18/20,675.81,675.81,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
16109141,0272,,,,,,HIP PACK,832.49,832.49,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16109145,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 13.5,6515.71,6515.71,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109196,0278,C1776,,,,,PSN FEM PS CMT CCR NRW SIZE 5 R,6752.17,6752.17,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109197,0278,C1776,,,,,PSN ASF PS 10MM VE R 3-5 CD,3008.65,3008.65,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109198,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE D R,3252.41,3252.41,722.45,1228.17,,,,,,,1228.17,,,722.45,722.45
16109200,0272,,,,,,CABLE & SLEEVE SET 1.6MM,1460.85,1460.85,40.52,113.43,101.91,101.91,113.43,,,,40.52,,,62.54,62.54
16476100,0270,,,,,,DNU SYRINGE 10 ML SOD CHLORIDE INJECTION,6.25,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
18010001,0360,,,,,,NEUROMONITORING SERVICES ANS,2059.11,2059.11,0.00,5179.78,5179.78,5179.78,,,,,,,,0.00,0.00
18010002,0360,22869,,,,,INSJ STABLJ DEV W/O DCMPRN,66477.70,66477.70,,,,,,,,,,,,,
18020600,0983,20600,,,,,DRAIN/INJ SM JNT/BURSA,193.00,193.00,,,,,,,,,,,,,
18020602,0519,96372,,,,,ADMIN INJ SC/IM,172.80,172.80,,,,,,,,,,,,,
18020603,0983,20552,,,,,INJ TRIG PT 1/2 MSCL,750.75,750.75,,,,,,,,,,,,,
18020604,0983,20553,,,,,INJ TRIG PT > 3 MSCL,750.75,750.75,,,,,,,,,,,,,
18020605,0983,20605,,,,,DRAIN/INJ INT JNT/BURSA,219.00,219.00,,,,,,,,,,,,,
18020610,0983,20610,,,,,DRAIN/INJ MAJ JNT/BURSA,279.00,279.00,,,,,,,,,,,,,
18020611,0983,0232T,,,,,PRP NJX,5669.30,5669.30,,,,,,,,,,,,,
18020612,0983,J9250,,,,,METHOTREXATE 5mg,49.56,49.56,,,,,,,,,,,,,
18020613,0983,J7327,,,,,MONOVISC INJ PER DOSE,2819.01,2819.01,,,,,,,,,,,,,
18020614,0983,J0897,,,,,DENOSUMAG INJ PROLIA 1 mg,58.00,58.00,,,,,,,,,,,,,
18099201,0983,99201,,,,,NEW PATIENT SIMPLE 10 MIN,89.00,89.00,,,,,,,,,,,,,
18099202,0983,99202,,,,,NEW PATIENT LMT 20 MIN,146.00,146.00,,,,,,,,,,,,,
18099203,0983,99203,,,,,NEW PATIENT LOW 30 MIN,213.00,213.00,,,,,,,,,,,,,
18099204,0983,99204,,,,,NEW PATIENT MOD 45 MIN,319.00,319.00,,,,,,,,,,,,,
18099205,0983,99205,,,,,NEW PATIENT COMP 60 MIN,410.00,410.00,,,,,,,,,,,,,
18099211,0983,99211,,,,,EST PATIENT SIMPLE,50.00,50.00,,,,,,,,,,,,,
18099212,0983,99212,,,,,EST PATIENT LMT 10 MIN,89.00,89.00,28.74,28.74,,,,,,,28.74,,,,
18099213,0983,99213,,,,,EST PATIENT LOW 15 MIN,134.00,134.00,,,,,,,,,,,,,
18099214,0983,99214,,,,,EST PATIENT MOD 25 MIN,197.00,197.00,,,,,,,,,,,,,
18099215,0983,99214,,,,,EST PATIENT COMP 40 MIN,279.00,279.00,,,,,,,,,,,,,
18099241,0960,99241,,,,,OP CONSULT LEVEL 1,142.00,142.00,,,,,,,,,,,,,
18099242,0960,99242,,,,,OP CONSULT LEVEL 2,214.00,214.00,,,,,,,,,,,,,
18099243,0960,99243,,,,,OP CONSULT LEVEL 3,288.00,288.00,,,,,,,,,,,,,
18099244,0960,99244,,,,,OFFICE CONSULTATION,402.00,402.00,,,,,,,,,,,,,
18099245,0960,99245,,,,,OP CONSULT LEVEL 5,503.00,503.00,,,,,,,,,,,,,
18099354,0960,99354,,,,,PRO LONG SERV 1ST HOUR,206.00,206.00,,,,,,,,,,,,,
18099355,0960,99355,,,,,PRO LONG SERV EACH ADD 30,177.00,177.00,,,,,,,,,,,,,
18099358,0960,99358,,,,,EXT SERV 1ST HOUR,209.00,209.00,,,,,,,,,,,,,
18099359,0960,99359,,,,,EXT SERV EA ADDL 30 MIN,147.00,147.00,,,,,,,,,,,,,
2000000,0239,,,,,,NURSING HOME,0.00,0.00,,,,,,,,,,,,,
2000053,0129,,,,,,ROOM HOLDING CHARGE,0.00,0.00,,,,,,,,,,,,,
20001000,0983,10120,,,,,INC & REM FB SQ; SMPL,411.06,411.06,,,,,,,,,,,,,
20001001,0983,11200,,,,,REM SKIN TAGS; = 15 LESIONS,233.58,233.58,,,,,,,,,,,,,
20001002,0983,20610,,,,,DRAIN/INJ MAJOR JOINT/BURSA W/O US,284.58,284.58,,,,,,,,,,,,,
20001003,0983,29260,,,,,STRAPPING; ELBOW OR WRIST,136.68,136.68,,,,,,,,,,,,,
20001004,0510,69209,,,,,REMOVE IMPACTED EAR WAX UNI,153.00,153.00,,,,,,,,,,,,,
20001005,0983,69210,,,,,REMOVE IMPACTED EAR WAX UNI,130.56,130.56,,,,,,,,,,,,,
20001006,0983,81002,,,,,N-AUTOM URINALYS WO MICRO,13.26,13.26,,,,,,,,,,,,,
20001007,0983,86580,,,,,SKIN TEST; TB ID,29.58,29.58,,,,,,,,,,,,,
20001008,0771,90471,,,,,IMMUNIZATION ADMIN 1 VACCINE,43.86,43.86,48.89,48.89,,,,,,,48.89,,,,
20001009,0771,90472,,,,,IMMUNIZATION ADM; EA ADDTL VACCINE,26.52,26.52,,,,,,,,,,,,,
20001010,0983,90633,,,,,HEPA VACC PED/ADOL 2 DOSE IM,74.46,74.46,,,,,,,,,,,,,
20001011,0983,90647,,,,,HIB PRP-OMP VACC 3 DOSE IM,57.12,57.12,,,,,,,,,,,,,
20001012,0983,9064726,,,,,HIB PRP-OMP VACC 3 DOSE IM,26.00,26.00,,,,,,,,,,,,,
20001013,0983,90648,,,,,HIB PRP-T VACCINE 4 DOSE IM,57.12,57.12,,,,,,,,,,,,,
20001014,0983,9064826,,,,,HIB PRP-T VACCINE 4 DOSE IM,26.00,26.00,,,,,,,,,,,,,
20001015,0983,90653,,,,,IIV ADJUVANT VACCINE IM,31.62,31.62,,,,,,,,,,,,,
20001016,0983,90658,,,,,IIV3 VACCINE SPLT 0.5 ML IM,31.62,31.62,,,,,,,,,,,,,
20001017,0983,90670,,,,,PCV13 VACCINE IM,232.56,232.56,,,,,,,,,,,,,
20001018,0983,90681,,,,,RV1 VACC 2 DOSE LIVE ORAL,187.68,187.68,,,,,,,,,,,,,
20001019,0983,90700,,,,,DTAP VACCINE < 7 YRS IM,60.18,60.18,,,,,,,,,,,,,
20001020,0983,90707,,,,,SQ MMR VACCINE,98.94,98.94,,,,,,,,,,,,,
20001021,0983,90713,,,,,POLIOVIRUS IPV SC/IM,62.22,62.22,,,,,,,,,,,,,
20001022,0983,90715,,,,,TDAP VACCINE >7 IM,83.64,83.64,,,,,,,,,,,,,
20001023,0983,90716,,,,,VAR VACCINE LIVE SUBQ,160.14,160.14,,,,,,,,,,,,,
20001024,0983,90723,,,,,DTAP-HEP B-IPV VACCINE IM,139.74,139.74,,,,,,,,,,,,,
20001025,0983,90732,,,,,PPSV23 VACC 2 YRS+ SUBQ/IM,111.18,111.18,,,,,,,,,,,,,
20001026,0983,90733,,,,,MPSV4 VACCINE SUBQ,186.66,186.66,,,,,,,,,,,,,
20001027,0983,90734,,,,,MCV4 MENACWY VACCINE IM,191.76,191.76,,,,,,,,,,,,,
20001028,0918,96110,,,,,DEVELOPMENTAL SCREEN W/SCORE,28.56,28.56,,,,,,,,,,,,,
20001029,0960,99024,,,,,POST-OP FOLLOW-UP VISIT,68.34,68.34,,,,,,,,,,,,,
20001030,0983,99080,,,,,SPECIAL REPORTS,36.72,36.72,,,,,,,,,,,,,
20001031,0983,99203,,,,,OFFICE/OUTPATIENT VISIT NEW 30 MIN,217.26,217.26,,,,,,,,,,,,,
20001032,0983,99204,,,,,OFFICE/OUTPATIENT VISIT NEW 45 MIN,325.38,325.38,,,,,,,,,,,,,
20001033,0983,99205,,,,,OFFICE/OUTPATIENT VISIT NEW 60 MIN +,418.20,418.20,,,,,,,,,,,,,
20001034,0983,99211,,,,,OFFICE/OUTPATIENT VISIT EST 5 MIN,51.00,51.00,,,,,,,,,,,,,
20001035,0983,99212,,,,,OFFICE/OUTPATIENT VISIT EST 10 MIN,90.78,90.78,28.74,28.74,,,,,,,28.74,,,,
20001036,0983,99213,,,,,OFFICE/OUTPATIENT VISIT EST 15 MIN,136.68,136.68,,,,,,,,,,,,,
20001037,0983,99214,,,,,OFFICE/OUTPATIENT VISIT EST 25 MIN,200.94,200.94,,,,,,,,,,,,,
20001038,0983,99217,,,,,OBSERVATION CARE DISCHARGE,191.76,191.76,,,,,,,,,,,,,
20001039,0983,99220,,,,,INITIAL OBSERVATION CARE 70 MIN,452.88,452.88,,,,,,,,,,,,,
20001040,0983,99222,,,,,INITIAL HOSPITAL CARE 50 MIN,302.94,302.94,,,,,,,,,,,,,
20001041,0983,99233,,,,,SUBSEQUENT HOSPITAL CARE 35 MIN,240.72,240.72,,,,,,,,,,,,,
20001042,0983,99238,,,,,HOSP DC DAY MANAGEMENT; 30 MIN/< (MD),173.40,173.40,,,,,,,,,,,,,
20001043,0983,99305,,,,,NURSING FACILITY CARE INIT 35 MIN,234.60,234.60,,,,,,,,,,,,,
20001044,0983,99307,,,,,NURSING FAC CARE SUBSEQ 10 MIN,83.64,83.64,,,,,,,,,,,,,
20001045,0983,99308,,,,,NURSING FAC CARE SUBSEQ 15 MIN,124.44,124.44,,,,,,,,,,,,,
20001046,0983,99309,,,,,NURSING FAC CARE SUBSEQ 25 MIN,162.18,162.18,,,,,,,,,,,,,
20001047,0983,99315,,,,,SNF DISCHARGE DAY; 30 MINUTES,138.72,138.72,,,,,,,,,,,,,
20001048,0515,99381,,,,,INIT PM E/M NEW PAT INF <1 YR,196.86,196.86,,,,,,,,,,,,,
20001049,0515,99382,,,,,INIT PM E/M NEW PAT 1-4 YRS,209.10,209.10,,,,,,,,,,,,,
20001050,0515,99383,,,,,PREV VISIT NEW AGE 5-11,211.14,211.14,,,,,,,,,,,,,
20001051,0515,99384,,,,,PREV VISIT NEW AGE 12-17,233.58,233.58,,,,,,,,,,,,,
20001052,0770,99385,,,,,PREV VISIT NEW AGE 18-39,273.92,273.92,,,,,,,,,,,,,
20001053,0510,99386,,,,,PREV VISIT NEW AGE 40-64,297.84,297.84,,,,,,,,,,,,,
20001054,0510,99387,,,,,INIT PM E/M NEW PAT 65+ YRS,303.96,303.96,,,,,,,,,,,,,
20001055,0515,99391,,,,,PER PM REEVAL EST PAT INF <1 YR,171.36,171.36,,,,,,,,,,,,,
20001056,0515,99392,,,,,PREV VISIT EST AGE 1-4,181.56,181.56,,,,,,,,,,,,,
20001057,0515,99393,,,,,PREV VISIT EST AGE 5-11,183.60,183.60,,,,,,,,,,,,,
20001058,0515,99394,,,,,PREV VISIT EST AGE 12-17,200.94,200.94,,,,,,,,,,,,,
20001059,0770,99395,,,,,PREV VISIT EST AGE 18-39,235.24,235.24,,,,,,,,,,,,,
20001060,0770,99396,,,,,REV VISIT EST AGE 40-64,245.82,245.82,,,,,,,,,,,,,
20001061,0770,99397,,,,,PER PM REEVAL EST PAT 65+ YR,260.10,260.10,,,,,,,,,,,,,
20001062,0983,,,,,,INFLUENZA IA W DO,51.00,51.00,,,,,,,,,,,,,
20001063,0983,87880QW,,,,,STREP A ASSAY W/OPTIC,51.00,51.00,,,,,,,,,,,,,
20001064,0771,G0008,,,,,ADMIN FLU VIRUS VACCINE,36.49,36.49,,,,,,,,,,,,,
20001065,0771,G0009,,,,,ADMIN PNEUMONIA VACCINE,38.98,38.98,,,,,,,,,,,,,
20001066,0983,G0101,,,,,CA SCRNING PELV & BRST EXAM,93.51,93.51,,,,,,,,,,,,,
20001067,0983,G0402,,,,,"INIT PREVENTIVE EXAM, NEW BENEFICIARY",275.61,275.61,,,,,,,,,,,,,
20001068,0983,G0438,,,,,PPPS INITIAL VISIT,312.22,312.22,,,,,,,,,,,,,
20001069,0983,G0439,,,,,PPPS SUBSEQ VISIT,224.75,224.75,,,,,,,,,,,,,
20001070,0983,J2920,,,,,METHYLPREDNISOLONE INJ TO 40 MG,17.37,17.37,,,,,,,,,,,,,
20001071,0983,Q0091,,,,,OBTAINING SCREEN PAP SMEAR,79.39,79.39,,,,,,,,,,,,,
20001072,0983,Q2037,,,,,FLUVIRIN VACC 3 YRS & > IM,31.30,31.30,,,,,,,,,,,,,
20001073,0510,99201,,,,,OFFICE/OUTPATIENT VISIT NEW,90.78,90.78,,,,,,,,,,,,,
20001074,0510,99202,,,,,OFFICE/OUTPATIENT VISIT NEW,148.92,148.92,,,,,,,,,,,,,
20001075,0419,94640,,,,,AIRWAY INHALATION TREATMENT,73.44,73.44,,,,,,,,,,,,,
20001076,0983,85018QW,,,,,HEMACUE,44.88,44.88,,,,,,,,,,,,,
20001077,0305,85014,,,,,HEMATOCRIT,16.07,16.07,,,,,,,,,,,,,
20001078,0983,17110,,,,,DESTRUCTION B9 LESIONS 1-14,298.00,298.00,,,,,,,,,,,,,
20001080,0983,99211,,,,,NURSIN SERVICE,40.00,40.00,,,,,,,,,,,,,
20006500,0440,92507,,,,,SPEECH THERAPY PER 15 MIN,154.50,0.00,,,,,,,,,,,,,
20006502,0440,92507,,,,,SPEECH THERAPY PER 30 MIN,168.50,0.00,,,,,,,,,,,,,
20006506,0440,92507,,,,,SPEECH THERAPY PER 1 HOUR,201.25,0.00,,,,,,,,,,,,,
2000900,0270,,,,,,ATTENDS-NH,5.89,5.89,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
20009000,0270,,,,,,K PUMP,35.88,35.88,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
2000901,0270,,,,,,ATTENDS-ECF,3.59,3.59,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
2002000,0440,,,,,,AMBULATION TRAINING PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002002,0440,,,,,,BED MOBILITY PRACTICE PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002004,0440,,,,,,BATHING EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002006,0440,,,,,,CANE EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002008,0440,,,,,,DRESSING EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002010,0440,,,,,,ENDURANCE TRAINING PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002012,0440,,,,,,GROOMING EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002014,0440,,,,,,TRANSFER TRAINING PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002016,0440,,,,,,HOT PACK TREATMENTS PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002018,0440,,,,,,ICE PACK TREATMENTS PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002020,0440,,,,,,LOWER EXTREMITY EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002022,0440,,,,,,MAT EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002024,0440,,,,,,RANGE OF MOTION EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002026,0440,,,,,,SPLINTING PROCEDURES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002028,0440,,,,,,TOILETING EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2002030,0440,,,,,,UPPPER EXTREMITY EXERCISES PER 10 MIN,5.75,0.00,,,,,,,,,,,,,
2004110,0990,,,,,,NURSING PRI DUTY NH,0.00,0.00,,,,,,,,,,,,,
2005000,0440,,,,,,ADULT DAY CARE SERVICES PER HOUR,9.25,0.00,,,,,,,,,,,,,
2005001,0440,,,,,,ADULT DAY CARE MEAL,4.75,0.00,,,,,,,,,,,,,
2006002,0270,,,,,,ATTEND WIPES-NH,2.31,2.31,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
2006003,0270,,,,,,ATTEND WIPES-ECF,2.31,2.31,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
2006504,0440,92507,,,,,SPEECH THERAPY PER 45 MIN,188.25,0.00,,,,,,,,,,,,,
2007095,0239,,,,,,NH NURS SER MISC,0.00,0.00,,,,,,,,,,,,,
2007390,0732,,,,,,TELEMETRY-N H DAILY,211.75,0.00,,,,,,,,,,,,,
2008161,0129,,,,,,LATE PAYMENT FEE,0.00,0.00,,,,,,,,,,,,,
2008162,0129,,,,,,APR 1-14 @ $92 A DAY,0.00,0.00,,,,,,,,,,,,,
2008163,0129,,,,,,APR 1-14 @ $95 A DAY,0.00,0.00,,,,,,,,,,,,,
2008164,0129,,,,,,APR 1-14 @ $97 A DAY,0.00,0.00,,,,,,,,,,,,,
2008165,0995,,,,,,MEDICAID PROGRAM TAX,0.00,0.00,,,,,,,,,,,,,
2008166,0129,,,,,,APR 1-14 @ $100 A DAY,0.00,0.00,,,,,,,,,,,,,
2008167,0129,,,,,,APR 1-14 @ $110 A DAY,0.00,0.00,,,,,,,,,,,,,
2008168,0129,,,,,,APR 1-14 @ $93 A DAY,0.00,0.00,,,,,,,,,,,,,
2008169,0129,,,,,,APR 1-14 @ $88 A DAY,0.00,0.00,,,,,,,,,,,,,
2008170,0129,,,,,,NOV 1998 @ $85 PER DAY,0.00,0.00,,,,,,,,,,,,,
2008171,0129,,,,,,SEPT 1998 @ $94 PER DAY,0.00,0.00,,,,,,,,,,,,,
2008172,0129,,,,,,APR 1-14 @ $96 A DAY,0.00,0.00,,,,,,,,,,,,,
2008173,0129,,,,,,APR 1-14 @ $105 A DAY,0.00,0.00,,,,,,,,,,,,,
2008174,0129,,,,,,SEPT 1998 @ $87 PER DAY,0.00,0.00,,,,,,,,,,,,,
2008175,0129,,,,,,APR 1-14 @ $91 A DAY,0.00,0.00,,,,,,,,,,,,,
2008176,0129,,,,,,APR 1-14 @ $102 A DAY,0.00,0.00,,,,,,,,,,,,,
2008177,0129,,,,,,NH RM & BD @ $117 A DAY,0.00,0.00,,,,,,,,,,,,,
2008178,0129,,,,,,NH RM & BD @ $105 A DAY,0.00,0.00,,,,,,,,,,,,,
2008179,0129,,,,,,NH-RESPITE @100 A DAY,0.00,0.00,,,,,,,,,,,,,
2008180,0129,,,,,,NH RM & BD @ $90.00 A DAY,0.00,0.00,,,,,,,,,,,,,
2008181,0129,,,,,,NH RM & BD @ $110 A DAY,0.00,0.00,,,,,,,,,,,,,
2008182,0129,,,,,,NH RM & BD @ $115 A DAY,0.00,0.00,,,,,,,,,,,,,
2008183,0129,,,,,,NH RM & BD @ $100 A DAY,119.92,119.92,,,,,,,,,,,,,
2008184,0129,,,,,,NH RM & BD @ $137.50,157.85,157.85,,,,,,,,,,,,,
2008185,0129,,,,,,NH RM & BD @ $120 A DAY,143.76,143.76,,,,,,,,,,,,,
2008186,0129,,,,,,NH RM & BD @ $125 A DAY,162.97,162.97,,,,,,,,,,,,,
2008188,0129,,,,,,NH RM & BD @ $135 A DAY,161.95,161.95,,,,,,,,,,,,,
2008189,0129,,,,,,NH RM & BD @ $130 A DAY,133.25,133.25,,,,,,,,,,,,,
2008190,0129,,,,,,NH RM & BED @ $140 A DAY,180.91,180.91,,,,,,,,,,,,,
2008191,0129,,,,,,NH RM & BD @ $150 A DAY,153.75,153.75,,,,,,,,,,,,,
2008192,0129,,,,,,NH RM & BD @ $80 A DAY,104.29,104.29,,,,,,,,,,,,,
2008193,0129,,,,,,NH RM & BD @ $67 A DAY,87.64,87.64,,,,,,,,,,,,,
2008194,0129,,,,,,NH RM & BD @ $41 A DAY,54.07,54.07,,,,,,,,,,,,,
2008195,0129,,,,,,NH RM & BD @ $160 A DAY,164.00,164.00,,,,,,,,,,,,,
2008198,0129,,,,,,NH RM & BD @ $155 A DAY,201.41,201.41,,,,,,,,,,,,,
2008199,0129,,,,,,NH RM & BD @ $145 A DAY,0.00,0.00,,,,,,,,,,,,,
2008200,0129,,,,,,NH RM & BED @ $145 A DAY,148.63,148.63,,,,,,,,,,,,,
2008201,0129,,,,,,NH RM & BD @ $155 A DAY,0.00,0.00,,,,,,,,,,,,,
2008203,0129,,,,,,NH RM & BD @ $165 A DAY,0.00,0.00,,,,,,,,,,,,,
2008204,0129,,,,,,NH RM & BD @ $135 A DAY,0.00,0.00,,,,,,,,,,,,,
2008205,0129,,,,,,NH-RESPITE @125 A DAY,0.00,0.00,,,,,,,,,,,,,
2008206,0129,,,,,,NH-RESPITE @140 A DAY,0.00,0.00,,,,,,,,,,,,,
2008207,0129,,,,,,NH RM & BD @ $170 A DAY,0.00,0.00,,,,,,,,,,,,,
2008208,0129,,,,,,NH RM & BD @,0.00,0.00,,,,,,,,,,,,,
2008209,0129,,,,,,NH RM & BD @ $210 A DAY,0.00,0.00,,,,,,,,,,,,,
2008210,0129,,,,,,NH RM & BD @ $180 A DAY,0.00,0.00,,,,,,,,,,,,,
2008211,0129,,,,,,NH RM & BD @ $190 A DAY,0.00,0.00,,,,,,,,,,,,,
2008212,0129,,,,,,NH RM & BD @ $175 A DAY,179.38,179.38,,,,,,,,,,,,,
2008213,0129,,,,,,NH RM & BD @ $250 A DAY,0.00,0.00,,,,,,,,,,,,,
2008214,0129,,,,,,NH RM & BD @ $185 A DAY,189.63,189.63,,,,,,,,,,,,,
2008215,0129,,,,,,NH RM & BD @ $215 A DAY,0.00,0.00,,,,,,,,,,,,,
2008216,0129,,,,,,NH RM & BD @ $360 A DAY,0.00,0.00,,,,,,,,,,,,,
2008217,0129,,,,,,NH RM & BD @ $200 A DAY,0.00,0.00,,,,,,,,,,,,,
2008221,0129,,,,,,NH RM & BD @ $184 A DAY,0.00,0.00,,,,,,,,,,,,,
2008222,0129,,,,,,NH RM & BD @ $228 A DAY,0.00,0.00,,,,,,,,,,,,,
2009000,0270,,,,,,K PUMP,35.88,35.88,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
28000005,0900,90791,,,,,INITIAL EVALUATION/ASSESSMENT,265.25,0.00,,,,,,,,,,,,,
28000010,0915,90853,,,,,GROUP THERAPY,233.25,0.00,,,,,,,,,,,,,
28000015,0914,90833,,,,,INDIVIDUAL THERAPY 45MIN.,254.75,0.00,,,,,,,,,,,,,
28000020,0914,90837,,,,,INDIVIDUAL THERAPY 60 MIN.,328.75,0.00,,,,,,,,,,,,,
28000025,0914,90832,,,,,INDIVIDUAL THERAPY 30 MIN.,132.50,0.00,,,,,,,,,,,,,
28000030,0916,90846,,,,,FAMILY THERAPY WO/PATIENT 1 HR,259.75,0.00,,,,,,,,,,,,,
28000035,0916,90847,,,,,FAMILY THERAPY W/PATIENT 1 HR,281.25,0.00,,,,,,,,,,,,,
28000040,0914,90833,,,,,INDIVIDUAL THERAPY W/E&M 30 MIN,132.50,0.00,,,,,,,,,,,,,
29001001,0920,95806,,,,,HOME SLEEP TEST,1035.40,1035.40,347.47,549.80,,,,,,,347.47,,,549.80,549.80
29001002,0920,95810,,,,,POLYSOMNOGRAPHY WO PAP,6597.09,6597.09,2243.01,2243.01,,,,,,,2243.01,,,,
29001003,0920,95811,,,,,POLYSOMNOGRAPHY W PAP,6597.09,6597.09,2237.54,2243.01,,,,,,,2237.54,,,2243.01,2243.01
30000100,0450,31500,,,,,INTUBATION HOSPITAL,678.12,678.12,222.59,222.59,,,,,,,222.59,,,,
30000149,0460,94060,,,,,SPIROMETRY P & P,845.94,845.94,287.79,566.78,,,566.78,,,,287.79,,,530.91,530.91
30000160,0460,94070,,,,,BR PROV W/METHACHOLINE,534.00,0.00,,,,,,,,,,,,,
30000165,0460,94620TC,,,,,BR PROV W EXERCISE,534.00,0.00,,,,,,,,,,,,,
30000214,0410,94002,,,,,VENT INIT DAY MANAGEMENT,1957.22,1957.22,,,,,,,,,,,,,
30001194,0482,93017,,,,,EKG STRESS TEST,845.94,845.94,288.19,421.84,,,,,,,288.19,,,421.84,421.84
30001195,0730,93041,,,,,EKG RHYTHM STRIP,195.00,195.00,,,,,,,,,,,,,
30001200,0730,93005,,,,,EKG 12 LEAD,198.27,198.27,66.49,132.36,,,132.36,,,,66.49,,,87.17,87.17
30001201,0482,93017,,,,,DOBUTAMINE STRESS TEST EKG ONLY,845.94,845.94,288.19,421.84,,,,,,,288.19,,,421.84,421.84
30002210,0410,94644,,,,,CONT NEB (INT.HR),655.37,655.37,,,,,,,,,,,,,
30002235,0410,94645,,,,,CONT NEB (SUB HR),655.37,655.37,,,,,,,,,,,,,
30002645,0410,94664,,,,,DEMO/EVAL TX OP,649.46,649.46,,,,,,,,,,,,,
30004770,0460,94770,,,,,END TIDAL CO2 MONITORING,867.09,867.09,,,,,,,,,,,,,
30007088,0271,,,,,,OXYGEN PER HOUR,14.00,14.00,9.89,98.90,85.87,85.87,98.90,,,,14.72,,,9.89,9.89
30007091,0480,92950,,,,,CODE ATTENDENT HOSP,640.75,0.00,,,,,,,,,,,,,
30007094,0450,92950,,,,,CODE ATTENDANT ER,640.75,0.00,249.46,249.46,,,,,,,249.46,,,,
30007369,0731,93226,,,,,HOLTOR MON ANAL/RPRT,0.00,0.00,,,,,,,,,,,,,
30007370,0731,93225,,,,,HOLTER MONITOR HOOKUP ONLY,357.10,357.10,121.77,149.74,,,,,,,121.77,,,149.74,149.74
30008012,0410,94640,,,,,NEB/MDI INITIAL,655.37,655.37,210.89,436.71,,,436.71,,,,219.84,,,210.89,210.89
30008110,0300,89220,,,,,SPUTUM INDUCT 0.9% SALINE,489.81,489.81,,,,,,,,,,,,,
30008111,0410,,,,,,INCENTIVE SPIROMETRY,0.00,0.00,0.00,534.90,534.90,534.90,,,,,,,,0.00,0.00
30008112,0410,,,,,,INCENTIVE SPIROMETRY SUB,0.00,0.00,0.00,534.90,534.90,534.90,,,,,,,,0.00,0.00
30008128,0460,94150,,,,,VITAL CAPACITY ONLY,510.72,510.72,,,,,,,,,,,,,
30008136,0460,94760,,,,,PULSE OX,48.84,48.84,16.36,17.39,,,,,,,16.36,,,17.39,17.39
30008169,0410,94664,,,,,DEMONSTRATION & EVALUATION OF TX,649.46,649.46,,,,,,,,,,,,,
30008193,0410,94667,,,,,CPT INITIAL,369.36,369.36,,,,,,,,,,,,,
30008201,0460,94010,,,,,SPIROMTRY PRE ONLY,475.04,475.04,,,,,,,,,,,,,
30008235,0410,94640,,,,,NEB/MDI SUB,655.37,655.37,210.89,436.71,,,436.71,,,,219.84,,,210.89,210.89
30008243,0410,94668,,,,,CPT SUBSEQUENT,369.36,369.36,121.51,121.51,,,,,,,121.51,,,,
30008256,0460,94729,,,,,LUNG DIFFUSION,249.14,249.14,84.72,166.92,,,166.92,,,,84.72,,,156.36,156.36
30008257,0410,94660,,,,,BIPAP CPAP MANAGEMENT,649.46,649.46,216.97,216.97,,,,,,,216.97,,,,
30008284,0300,36600,,,,,ARTERIAL PUNCTURE,363.07,363.07,123.20,123.75,,,,,,,123.20,,,123.75,123.75
30008286,0460,94727,,,,,FUNCTIONAL RESIDUAL CAPACITY,475.04,475.04,,,,,,,,,,,,,
30008293,0460,94750,,,,,PULMONARY COMPLNC STDY,475.04,475.04,,,,,,,,,,,,,
30008326,0460,94150,,,,,"Vital Capacity, Total",475.04,475.04,,,,,,,,,,,,,
30008334,0460,94375,,,,,FV LOOP ONLY,867.09,867.09,,,,,,,,,,,,,
30008335,0410,94640,,,,,MDI INITIAL,248.25,0.00,210.89,436.71,,,436.71,,,,219.84,,,210.89,210.89
30008336,0412,9464076,,,,,MDI SUBS,72.25,0.00,,,,,,,,,,,,,
30008367,0460,94761,,,,,PULSE OX MULTIPLE DETERMINATIONS,132.00,132.00,44.23,44.52,,,,,,,44.23,,,44.52,44.52
30008420,0410,94002,,,,,NIPPV INIT,1957.22,1957.22,,,,,,,,,,,,,
30008422,0410,94003,,,,,NIPPV SUBS,1605.39,1605.39,,,,,,,,,,,,,
30008516,0410,31720,,,,,NASOTRACHEAL SX,649.46,649.46,,,,,,,,,,,,,
30008571,0450,31500,,,,,INTUBATION/ASSIST (ED),660.11,660.11,222.59,222.59,,,,,,,222.59,,,,
30008573,0450,31500,,,,,INTUBATION/ASSIST EMERG,678.12,678.12,222.59,222.59,,,,,,,222.59,,,,
30008600,0412,94640,,,,,INTERMITTANT POSSITIVE PRESSURE,97.25,0.00,,,,,,,,,,,,,
30008605,0412,9464076,,,,,IPPB SUBS RX,72.25,0.00,,,,,,,,,,,,,
30008606,0460,94726,,,,,IGV PLETHYSMOGRAPHY,867.09,867.09,289.78,580.95,,,580.95,,,,289.78,,,530.91,530.91
30008607,0460,,,,,,AIRWAY RESISTANCE PLETH,0.00,0.00,0.00,405.62,405.62,405.62,,,,,,,,0.00,0.00
30008701,0270,,,,,,OXYGEN PER DAY,215.41,215.41,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
30008705,0410,94003,,,,,VENT SUBS DAY MANAGEMENT,1605.39,1605.39,,,,,,,,,,,,,
30008706,0460,94200,,,,,MAX VOL VENT-ONLY,366.03,366.03,,,,,,,,,,,,,
30008999,0410,,,,,,ACAPELLA,0.00,0.00,0.00,534.90,534.90,534.90,,,,,,,,0.00,0.00
30009015,0460,94360,,,,,DNU RAW VENT,185.50,0.00,,,,,,,,,,,,,
30009025,0460,94680,,,,,GAS ANALYSIS,475.04,475.04,,,,,,,,,,,,,
30009026,0460,94762,,,,,PULSE OX OVERNIGHT STUDY,475.04,475.04,159.11,159.11,,,,,,,159.11,,,,
30009027,0410,,,,,,APNEA LINK SCREENING,0.00,0.00,0.00,534.90,534.90,534.90,,,,,,,,0.00,0.00
30009028,0730,9300576,,,,,EKG 12 LEAD SUBSEQUENT,198.27,198.27,,,,,,,,,,,,,
30009029,0460,94618,,,,,"PULSE OX 6 MINUTE WALK TEST includes HR,",372.15,372.15,124.99,126.02,,,,,,,126.02,,,124.99,124.99
30009030,0942,99406,,,,,SMOKING CESSATION,106.01,106.01,70.64,70.64,,,70.64,,,,,,,,
30009031,0732,93228,,,,,EKG EVENT MONITOR,0.00,0.00,,,,,,,,,,,,,
30009032,0731,93270,,,,,EKG KING OF HEARTS EVENT MONITOR,217.50,0.00,,,,,,,,,,,,,
30009996,0220,,,,,,ARTERIAL BLOOD DRAW,0.00,0.00,,,,,,,,,,,,,
30009997,0220,,,,,,CARDIO CANCEL ORDER,0.00,0.00,,,,,,,,,,,,,
3001000,0969,99304,,,,,INITIAL VISIT LOW,0.00,0.00,,,,,,,,,,,,,
3001001,0969,99305,,,,,INITIAL VISIT MODERATE,0.00,0.00,,,,,,,,,,,,,
3001002,0969,99306,,,,,INITIAL VISIT HIGH,0.00,0.00,,,,,,,,,,,,,
3001003,0969,99307GF,,,,,SUBSEQUENT VISIT PROBLEM FOCUSED,0.00,0.00,,,,,,,,,,,,,
3001004,0969,99308GF,,,,,SUBSEQUENT VISIT LOW,0.00,0.00,,,,,,,,,,,,,
3001005,0969,99309GF,,,,,SUBSEQUENT VISIT MODERATE,0.00,0.00,,,,,,,,,,,,,
3001006,0969,99310GF,,,,,SUBSEQUENT VISIT HIGH,0.00,0.00,,,,,,,,,,,,,
3001010,0360,20610,,,,,ARTHROCENTESIS MAJOR JT/BURSA,127.00,0.00,889.78,912.03,,,,,,,889.78,,,912.03,912.03
3001011,0762,99220GF,,,,,INITIAL OBSERVATION CARE HIGH,240.75,0.00,,,,,,,,,,,,,
3001012,0987,99223GF,,,,,INITIAL HOSPITAL CARE HIGH,245.25,0.00,,,,,,,,,,,,,
3001013,0762,99219GF,,,,,INITIAL OBSERVATION CARE MODERATE,170.75,0.00,,,,,,,,,,,,,
3001014,0987,99238GF,,,,,HOSPITAL DISCHARGE MANAGEMENT <30 MIN,131.25,0.00,,,,,,,,,,,,,
3001015,0987,99232GF,,,,,SUBSEQUENT HOSP E&M W/2 COMPONENTS,87.50,0.00,,,,,,,,,,,,,
3001016,0987,99222GF,,,,,INITIAL HOSP E&M W/3 COMPONENTS,183.75,0.00,,,,,,,,,,,,,
3001017,0960,99315GF,,,,,NUR FAC DISCHARGE DAY MANAGMT<30MIN,74.50,0.00,,,,,,,,,,,,,
3001018,0360,49561AS,,,,,REPAIR INCIS/VENT HERNIA; INCAR/STRANG,2801.50,0.00,,,,,,,,,,,,,
3001019,0360,49568AS,,,,,IMPLANTATION OF MESH,656.75,0.00,,,,,,,,,,,,,
3001020,0987,19301AS,,,,,MASTECTOMY PARTIAL,2101.25,0.00,,,,,,,,,,,,,
3001025,0360,49505AS,,,,,REPAIR INITIAL INGUINAL HERNIA,2407.75,0.00,,,,,,,,,,,,,
3001026,0302,86580,,,,,TB INTRADERMAL TEST,10.50,0.00,,,,,,,,,,,,,
3002001,0960,99212GF,,,,,OFFICE VISIT ESTABLISHED FOCUSED,0.00,0.00,,,,,,,,,,,,,
3002002,0960,99213GF,GF,,,,OFFICE VISIT ESTABLISHED DETAILED,0.00,0.00,,,,,,,,,,,,,
3002003,0960,99214GF,,,,,OFFICE VISIT ESTABLISHED COMP,0.00,0.00,,,,,,,,,,,,,
3002004,0960,99215GF,,,,,OFFICE VISIT ESTABLISHED COMPLEX,0.00,0.00,,,,,,,,,,,,,
3002005,0960,99348GF,,,,,HOME VISIT LOW COMPLEXITY ESTAB PT.,97.75,0.00,,,,,,,,,,,,,
3002006,0960,99201GF,,,,,OFFICE VISIT NEW FOCUSED,52.50,0.00,,,,,,,,,,,,,
3002007,0960,99202GF,,,,,OFFICE VISIT NEW EXPANDED,78.75,0.00,,,,,,,,,,,,,
3002008,0960,99203GF,,,,,OFFICE VISIT NEW DETAILED,122.50,0.00,,,,,,,,,,,,,
3002009,0960,99204GF,,,,,OFFICE VISIT NEW COMPREHENSIVE,175.00,0.00,,,,,,,,,,,,,
3002010,0960,99205GF,,,,,OFFICE VISIT NEW COMPLEX,240.75,0.00,,,,,,,,,,,,,
3002020,0761,29580,,,,,STRAPPING; UNNA BOOT,87.50,0.00,,,,,,,,,,,,,
3002021,0360,1110026,,,,,BX SKIN/SUBQ TISS(SEP PRO); 1 LES,128.75,0.00,,,,,,,,,,,,,
3002022,0360,17110,,,,,DESTRCT  WARTS/MOLLUSCUM TO 14 LES,109.50,0.00,,,,,,,,,,,,,
3002023,0360,11200,,,,,REMOVAL OF SKIN TAGS; UP TO 15,240.75,0.00,,,,,,,,,,,,,
3002024,0360,69210,,,,,REMOV IMPACTED CERUMEN (SEP PRO),65.75,0.00,,,,,,,,,,,,,
3002025,0360,20552,,,,,TRIGGER POINT INJECTION ONE/TWO MUSCLES,87.50,0.00,,,,,,,,,,,,,
3002026,0360,10060,,,,,I&D ABCESS; SIMPL/SNGL,192.50,0.00,832.68,1797.23,,,1797.23,,,,1262.42,,,832.68,832.68
3002027,0360,10140,,,,,I&D HEMATOMA/SEROMA/FLUID COLLEC,219.00,0.00,0.00,0.00,,,,,,,0.00,,,,
3002028,0360,56405,,,,,I&D ABSCESS; PERINEUM,262.75,0.00,,,,,,,,,,,,,
3002100,0510,97597,,,,,SELECT DEBRIDEMENT 20 CM OR LESS,197.00,0.00,,,,,,,,,,,,,
3002101,0510,30901GF,,,,,CONTROL NASAL HEMORR ANT SIMP,269.50,0.00,,,,,,,,,,,,,
31000010,0434,97165GO,,,,,OT EVAL LOW COMPLEX 20 MIN,341.74,341.74,,,,,,,,,,,,,
31000011,0434,97166GO,,,,,OT EVAL MOD COMPLEX 30 MIN,396.64,396.64,,,,,,,,,,,,,
31000012,0434,97167GO,,,,,OT EVAL HIGH COMPLEX 45 MINS,453.56,453.56,,,,,,,,,,,,,
31000051,0444,92521GN,,,,,ST EVALUATION FLUENCY,557.15,557.15,,,,,,,,,,,,,
31000052,0444,92522GN,,,,,ST EVALUATION SOUND PRODUCTION,557.15,557.15,,,,,,,,,,,,,
31000053,0444,92523GN,,,,,ST EVALUATION SOUND PROD/COMPREHENSION,557.15,557.15,,,,,,,,,,,,,
31000054,0444,92524GN,,,,,ST ANALYSIS VOICE RESONANCE,557.15,557.15,,,,,,,,,,,,,
31000055,0440,97127GN,,,,,ST COGNITIVE SKILL DEVELOPMENT,87.28,87.28,,,,,,,,,,,,,
31000192,0424,97161GP,,,,,PT EVAL LOW COMPLEX 20 MIN,337.46,337.46,,,,,,,,,,,,,
31000193,0424,97162GP,,,,,PT EVAL MOD COMPLEX 30 MIN,396.68,396.68,,,,,,,,,,,,,
31000194,0424,97163GP,,,,,PT EVAL HIGH COMPLEX 45 MIN,462.41,462.41,,,,,,,,,,,,,
31001000,0434,97003GO,,,,,OT OCCUPATIONAL THERAPY EVALUATION,198.75,0.00,,,,,,,,,,,,,
31001001,0434,,,,,,OT RE-EVAL EST PLAN CARE,212.56,212.56,,,,,,,,,,,,,
31001010,0430,97110GO,GO,,,,"OT THERAPEUTIC EXERCISE,15 MINUTES",152.72,152.72,,,,,,,,,,,,,
31001020,0430,97530GO,,,,,"OT THERAPEUTIC ACTIVITIES, 15 MINUTES",134.28,134.28,,,,,,,,,,,,,
31003150,0430,97112GO,,,,,OT NEUROMUSC RE-EDUCATION 15 MIN.,152.72,152.72,,,,,,,,,,,,,
31003160,0430,97761GO,GO,,,,"OT PROSTHETIC TRAINING, 15 MIN.",76.29,76.29,,,,,,,,,,,,,
31003170,0430,97535GO,,,,,OT SELF CARE/HOME MGMT TRN 15 MIN.,134.11,134.11,,,,,,,,,,,,,
31003175,0420,97605GP,,,,,NEGATIVE PRESS WOUND TX 50 CM OR GREATER,237.25,0.00,,,,,,,,,,,,,
31003176,0420,97606GP,,,,,NEGATIVE PRESSURE TX GREATER THAN 50 CM,237.25,0.00,,,,,,,,,,,,,
31004011,0420,97016GP,GP,,,,PT VASOPNEUMATIC DEVICES,50.00,0.00,,,,,,,,,,,,,
31004036,0420,97032GP,,,,,"PT TENS, ELEC STIM MANUAL, 15 MINUTES",160.00,160.00,,,,,,,,,,,,,
31004063,0420,97598,,,,,SELECT DEBRIDEMENT GREATER THAN 20 CM,577.08,577.08,,,,,,,,,,,,,
31004064,0420,97597,,,,,SELECT DEBRIDEMENT 20 CM OR LESS,642.67,642.67,,,,,,,,,,,,,
31004068,0420,29220,GP,,,,PT STRAPPING-LOW BACK,110.50,0.00,,,,,,,,,,,,,
31004070,0420,29240,GP,,,,PT STRAPPING-SHOULDER,191.98,191.98,,,,,,,,,,,,,
31004071,0420,29530,GP,,,,PT TAPING- KNEE,187.30,187.30,,,,,,,,,,,,,
31004072,0420,64550,GP,,,,PT TENS APPLICATION,83.64,83.64,,,,,,,,,,,,,
31004077,0420,97110GP,,,,,"PT THERAPEUTIC EXERCISE, 15 MINS.",152.72,152.72,,,,,,,,,,,,,
31004078,0420,97113GP,,,,,"PT AQUATIC THERAPY, 15 MINS",170.81,170.81,,,,,,,,,,,,,
31004087,0420,97112GP,,,,,"PT NEUROMUSC, 15 MINS.",152.72,152.72,,,,,,,,,,,,,
31004101,0420,97116GP,,,,,"PT GAIT TRAINING, 15 MINUTES",148.20,148.20,,,,,,,,,,,,,
31004127,0420,97022GP,,,,,PT WHIRLPOOL,210.89,210.89,,,,,,,,,,,,,
31004155,0420,97761GO,,,,,"PT PROSTHETIC TRAINING, 15 MIN",72.25,0.00,,,,,,,,,,,,,
31004170,0424,97164GP,GP,,,,PT RE EVALUATION,213.71,213.71,,,,,,,,,,,,,
31004184,0420,97012GP,GP,,,,PT MECHANICAL TRACTION,160.93,160.93,,,,,,,,,,,,,
31004186,0420,97763GP,,,,,"PT CHECKOUT ORTH/PROST USE, 15MIN",156.15,156.15,,,,,,,,,,,,,
31004187,0430,97762GO,,,,,OT CHECKOUT ORTH/PROST USE 15MIN,81.25,0.00,,,,,,,,,,,,,
31004192,0424,97001GP,GP,,,,PT EVALUATION,225.00,0.00,,,,,,,,,,,,,
31004218,0420,97535GP,,,,,PT SELF CARE/HOME MGMT TRN 15 MIN,134.11,134.11,,,,,,,,,,,,,
31004242,0420,97035GP,GP,,,,"PT ULTRASOUND, 15 MINUTES",167.07,167.07,,,,,,,,,,,,,
31004266,0420,97530GP,,,,,"PT THERAPEUTIC ACTIVITY,  15 MINUTES",134.28,134.28,,,,,,,,,,,,,
31004267,0420,97033GP,,,,,"PT IONTOPHORESIS, 15 MINUTES",227.81,227.81,,,,,,,,,,,,,
31004330,0429,G0283GP,GP,,,,ELECTRICAL STIMULATION (UNATTENDED),117.26,117.26,,,,,,,,,,,,,
31004350,0918,96120,,,,,NEUROPSYCHOLOGICAL TESTING ADMIN W/COMP,27.50,0.00,,,,,,,,,,,,,
31004351,0918,96125,,,,,STANDARDIZED COGNITIVE ASSESSMENT,376.18,376.18,,,,,,,,,,,,,
31004360,0420,97750GP,,,,,"PHYSICAL PERFORMANCE TESTING, 15 MINUTES",67.89,67.89,,,,,,,,,,,,,
31004370,0420,95992GP,,,,,"CANALITH REPOSITIONING, UNTIMED",303.40,303.40,,,,,,,,,,,,,
31005010,0440,92507GN,GN,,,,"ST TREAT SPEECH LANG VOICE, INDIV I",358.75,358.75,,,,,,,,,,,,,
31005012,0440,92507GN,GN,,,,"ST TREAT SPEECH LANG VOICE, INDIV II",379.25,379.25,,,,,,,,,,,,,
31005014,0440,92507GN,GN,,,,"ST TREAT SPEECH LANG VOICE, INDIV III",410.00,410.00,,,,,,,,,,,,,
31005016,0440,92507GN,GN,,,,"ST TREAT SPEECH LANG VOICE, INDIV IV",379.25,379.25,,,,,,,,,,,,,
31005020,0444,92611GN,GN,,,,ST VIDEO SWALLOWING EVAL,733.00,733.00,,,,,,,,,,,,,
31005024,0440,96105GN,GN,,,,ST ASPHAGIA ASSESS W/REPORT PER HR,407.73,407.73,,,,,,,,,,,,,
31005026,0444,92610GN,,,,,ST SWALLOW EVALUATION,751.33,751.33,,,,,,,,,,,,,
31005028,0440,92526GN,GN,,,,ST TX OF SWALLOW/ORAL DYSFUNCTION,384.38,384.38,,,,,,,,,,,,,
31005032,0440,92526GN,GN,,,,ST DYSPHAGIA TREATMENT,384.38,384.38,,,,,,,,,,,,,
31007000,0420,G8978CHGP,,,,,MOBILITY CURRENT STATUS,0.01,0.00,,,,,,,,,,,,,
31007001,0420,G8978CIGP,,,,,MOBILITY CURRENT STATUS,0.01,0.00,,,,,,,,,,,,,
31007002,0420,G8978CJGP,,,,,MOBILITY CURRENT STATUS,0.01,0.00,,,,,,,,,,,,,
31007003,0420,G8978CKGP,,,,,MOBILITY CURRENT STATUS,0.01,0.00,,,,,,,,,,,,,
31007004,0420,G8978CLGP,,,,,MOBILITY CURRENT STATUS,0.01,0.00,,,,,,,,,,,,,
31007005,0420,G8978CMGP,,,,,MOBILITY CURRENT STATUS,0.01,0.00,,,,,,,,,,,,,
31007006,0420,G8978CNGP,,,,,MOBILITY CURRENT STATUS,0.01,0.00,,,,,,,,,,,,,
31007010,0420,G8979CHGP,,,,,MOBILITY GOAL,0.01,0.00,,,,,,,,,,,,,
31007011,0420,G8979CIGP,,,,,MOBILITY GOAL,0.01,0.00,,,,,,,,,,,,,
31007012,0420,G8979CJGP,,,,,MOBILITY GOAL,0.01,0.00,,,,,,,,,,,,,
31007013,0420,G8979CKGP,,,,,MOBILITY GOAL,0.01,0.00,,,,,,,,,,,,,
31007014,0420,G8979CLGP,,,,,MOBILITY GOAL,0.01,0.00,,,,,,,,,,,,,
31007015,0420,G8979CMGP,,,,,MOBILITY GOAL,0.01,0.00,,,,,,,,,,,,,
31007016,0420,G8979CNGP,,,,,MOBILITY GOAL,0.01,0.00,,,,,,,,,,,,,
31007020,0420,G8980CHGP,,,,,MOBILITY DISCHARGE,0.01,0.00,,,,,,,,,,,,,
31007021,0420,G8980CIGP,,,,,MOBILITY DISCHARGE,0.01,0.00,,,,,,,,,,,,,
31007022,0420,G8980CJGP,,,,,MOBILITY DISCHARGE,0.01,0.00,,,,,,,,,,,,,
31007023,0420,G8980CKGP,,,,,MOBILITY DISCHARGE,0.01,0.00,,,,,,,,,,,,,
31007024,0420,G8980CLGP,,,,,MOBILITY DISCHARGE,0.01,0.00,,,,,,,,,,,,,
31007025,0420,G8980CMGP,,,,,MOBILITY DISCHARGE,0.01,0.00,,,,,,,,,,,,,
31007026,0420,G8980CNGP,,,,,MOBILITY DISCHARGE,0.01,0.00,,,,,,,,,,,,,
31007030,0420,G8978CHGP,,,,,MOBILITY CURRENT STATUS I,0.01,0.00,,,,,,,,,,,,,
31007031,0420,G8978CIGP,,,,,MOBILITY CURRENT STATUS II,0.01,0.00,,,,,,,,,,,,,
31007032,0420,G8978CJGP,,,,,MOBILITY CURRENT STATUS III,0.01,0.00,,,,,,,,,,,,,
31007033,0420,G8978CKGP,,,,,MOBILITY CURRENT STATUS IV,0.01,0.00,,,,,,,,,,,,,
31007034,0420,G8978CLGP,,,,,MOBILITY CURRENT STATUS V,0.01,0.00,,,,,,,,,,,,,
31007035,0420,G8978CMGP,,,,,MOBILITY CURRENT STATUS VI,0.01,0.00,,,,,,,,,,,,,
31007036,0420,G8978CNGP,,,,,MOBILITY CURRENT STATUS VII,0.01,0.00,,,,,,,,,,,,,
31007037,0420,G8979CHGP,,,,,MOBILITY GOAL I,0.01,0.00,,,,,,,,,,,,,
31007038,0420,G8979CIGP,,,,,MOBILITY GOAL II,0.01,0.00,,,,,,,,,,,,,
31007039,0420,G8979CJGP,,,,,MOBILITY GOAL III,0.01,0.00,,,,,,,,,,,,,
31007040,0420,G8979CKGP,,,,,MOBILITY GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007041,0420,G8979CLGP,,,,,MOBILITY GOAL V,0.01,0.00,,,,,,,,,,,,,
31007042,0420,G8979CMGP,,,,,MOBILITY GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007043,0420,G8979CNGP,,,,,MOBILITY GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007044,0420,G8980CHGP,,,,,MOBILITY DISCHARGE I,0.01,0.00,,,,,,,,,,,,,
31007045,0420,G8980CIGP,,,,,MOBILITY DISCHARGE II,0.01,0.00,,,,,,,,,,,,,
31007046,0420,G8980CJGP,,,,,MOBILITY DISCHARGE III,0.01,0.00,,,,,,,,,,,,,
31007047,0420,G8980CKGP,,,,,MOBILITY DISCHARGE IV,0.01,0.00,,,,,,,,,,,,,
31007048,0420,G8980CLGP,,,,,MOBILITY DISCHARGE V,0.01,0.00,,,,,,,,,,,,,
31007049,0420,G8980CMGP,,,,,MOBILITY DISCHARGE VI,0.01,0.00,,,,,,,,,,,,,
31007050,0420,G8980CNGP,,,,,MOBILITY DISCHARGE VII,0.01,0.00,,,,,,,,,,,,,
31007051,0420,G8981CHGP,,,,,CHANGING BODY POSITION CURRENT I,0.01,0.00,,,,,,,,,,,,,
31007052,0420,G8981CIGP,,,,,CHANGING BODY POSITION CURRENT II,0.01,0.00,,,,,,,,,,,,,
31007053,0420,G8981CJGP,,,,,CHANGING BODY POSITION CURRENT III,0.01,0.00,,,,,,,,,,,,,
31007054,0420,G8981CKGP,,,,,CHANGING BODY POSITION CURRENT IV,0.01,0.00,,,,,,,,,,,,,
31007055,0420,G8981CLGP,,,,,CHANGING BODY POSITION CURRENT V,0.01,0.00,,,,,,,,,,,,,
31007056,0420,G8981CMGP,,,,,CHANGING BODY POSITION CURRENT VI,0.01,0.00,,,,,,,,,,,,,
31007057,0420,G8981CNGP,,,,,CHANGING BODY POSITION CURRENT VII,0.01,0.00,,,,,,,,,,,,,
31007058,0420,G8982CHGP,,,,,CHANGING BODY POSITION GOAL I,0.01,0.00,,,,,,,,,,,,,
31007059,0420,G8982CIGP,,,,,CHANGING BODY POSITION GOAL II,0.01,0.00,,,,,,,,,,,,,
31007060,0420,G8982CJGP,,,,,CHANGING BODY POSITION GOAL III,0.01,0.00,,,,,,,,,,,,,
31007061,0420,G8982CKGP,,,,,CHANGING BODY POSITION GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007062,0420,G8982CLGP,,,,,CHANGING BODY POSITION GOAL V,0.01,0.00,,,,,,,,,,,,,
31007063,0420,G8982CMGP,,,,,CHANGING BODY POSITION GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007064,0420,G8982CNGP,,,,,CHANGING BODY POSITION GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007065,0420,G8983CHGP,,,,,CHANGING BODY POSITION DISCHARGE I,0.01,0.00,,,,,,,,,,,,,
31007066,0420,G8983CIGP,,,,,CHANGING BODY POSITION DISCHARGE II,0.01,0.00,,,,,,,,,,,,,
31007067,0420,G8983CJGP,,,,,CHANGING BODY POSITION DISCHARGE III,0.01,0.00,,,,,,,,,,,,,
31007068,0420,G8983CKGP,,,,,CHANGING BODY POSITION DISCHARGE IV,0.01,0.00,,,,,,,,,,,,,
31007069,0420,G8983CLGP,,,,,CHANGING BODY POSITION DISCHARGE V,0.01,0.00,,,,,,,,,,,,,
31007070,0420,G8983CMGP,,,,,CHANGING BODY POSITION DISCHARGE VI,0.01,0.00,,,,,,,,,,,,,
31007071,0420,G8983CNGP,,,,,CHANGING BODY POSITION DISCHARGE VII,0.01,0.00,,,,,,,,,,,,,
31007072,0420,G8984CHGP,,,,,CARRYING MOVING OBJECTS CURRENT I,0.01,0.00,,,,,,,,,,,,,
31007073,0420,G8984CIGP,,,,,CARRYING MOVING OBJECTS CURRENT II,0.01,0.00,,,,,,,,,,,,,
31007074,0420,G8984CJGP,,,,,CARRYING MOVING OBJECTS CURRENT III,0.01,0.00,,,,,,,,,,,,,
31007075,0420,G8984CKGP,,,,,CARRYING MOVING OBJECTS CURRENT IV,0.01,0.00,,,,,,,,,,,,,
31007076,0420,G8984CLGP,,,,,CARRYING MOVING OBJECTS CURRENT V,0.01,0.00,,,,,,,,,,,,,
31007077,0420,G8984CMGP,,,,,CARRYING MOVING OBJECTS CURRENT VI,0.01,0.00,,,,,,,,,,,,,
31007078,0420,G8984CNGP,,,,,CARRYING MOVING OBJECTS CURRENT VII,0.01,0.00,,,,,,,,,,,,,
31007079,0420,G8985CHGP,,,,,CARRYING MOVING OBJECTS GOAL I,0.01,0.00,,,,,,,,,,,,,
31007080,0420,G8985CIGP,,,,,CARRYING MOVING OBJECTS GOAL II,0.01,0.00,,,,,,,,,,,,,
31007081,0420,G8985CJGP,,,,,CARRYING MOVING OBJECTS GOAL III,0.01,0.00,,,,,,,,,,,,,
31007082,0420,G8985CKGP,,,,,CARRYING MOVING OBJECTS GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007083,0420,G8985CLGP,,,,,CARRYING MOVING OBJECTS GOAL V,0.01,0.00,,,,,,,,,,,,,
31007084,0420,G8985CMGP,,,,,CARRYING MOVING OBJECTS GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007085,0420,G8985CNGP,,,,,CARRYING MOVING OBJECTS GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007086,0420,G8986CHGP,,,,,CARRYING MOVING OBJECTS DISCHARGE I,0.01,0.00,,,,,,,,,,,,,
31007087,0420,G8986CIGP,,,,,CARRYING MOVING OBJECTS DISCHARGE II,0.01,0.00,,,,,,,,,,,,,
31007088,0420,G8986CJGP,,,,,CARRYING MOVING OBJECTS DISCHARGE III,0.01,0.00,,,,,,,,,,,,,
31007089,0420,G8986CKGP,,,,,CARRYING MOVING OBJECTS DISCHARGE IV,0.01,0.00,,,,,,,,,,,,,
31007090,0420,G8986CLGP,,,,,CARRYING MOVING OBJECTS DISCHARGE V,0.01,0.00,,,,,,,,,,,,,
31007091,0420,G8986CMGP,,,,,CARRYING MOVING OBJECTS DISCHARGE VI,0.01,0.00,,,,,,,,,,,,,
31007092,0420,G8986CNGP,,,,,CARRYING MOVING OBJECTS DISCHARGE VII,0.01,0.00,,,,,,,,,,,,,
31007093,0420,G8987CHGP,,,,,SELF CARE CURRENT I,0.01,0.00,,,,,,,,,,,,,
31007094,0420,G8987CIGP,,,,,SELF CARE CURRENT II,0.01,0.00,,,,,,,,,,,,,
31007095,0420,G8987CJGP,,,,,SELF CARE CURRENT III,0.01,0.00,,,,,,,,,,,,,
31007096,0420,G8987CKGP,,,,,SELF CARE CURRENT IV,0.01,0.00,,,,,,,,,,,,,
31007097,0420,G8987CLGP,,,,,SELF CARE CURRENT V,0.01,0.00,,,,,,,,,,,,,
31007098,0420,G8987CMGP,,,,,SELF CARE CURRENT VI,0.01,0.00,,,,,,,,,,,,,
31007099,0420,G8987CNGP,,,,,SELF CARE CURRENT VII,0.01,0.00,,,,,,,,,,,,,
31007100,0420,G8988CHGP,,,,,SELF CARE GOAL I,0.01,0.00,,,,,,,,,,,,,
31007101,0420,G8988CIGP,,,,,SELF CARE GOAL II,0.01,0.00,,,,,,,,,,,,,
31007102,0420,G8988CJGP,,,,,SELF CARE GOAL III,0.01,0.00,,,,,,,,,,,,,
31007103,0420,G8988CKGP,,,,,SELF CARE GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007104,0420,G8988CLGP,,,,,SELF CARE GOAL V,0.01,0.00,,,,,,,,,,,,,
31007105,0420,G8988CMGP,,,,,SELF CARE GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007106,0420,G8988CNGP,,,,,SELF CARE GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007107,0420,G8989CHGP,,,,,SELF CARE DISCHARGE I,0.01,0.00,,,,,,,,,,,,,
31007108,0420,G8989CIGP,,,,,SELF CARE DISCHARGE II,0.01,0.00,,,,,,,,,,,,,
31007109,0420,G8989CJGP,,,,,SELF CARE DISCHARGE III,0.01,0.00,,,,,,,,,,,,,
31007110,0420,G8989CKGP,,,,,SELF CARE DISCHARGE IV,0.01,0.00,,,,,,,,,,,,,
31007111,0420,G8989CLGP,,,,,SELF CARE DISCHARGE V,0.01,0.00,,,,,,,,,,,,,
31007112,0420,G8989CMGP,,,,,SELF CARE DISCHARGE VI,0.01,0.00,,,,,,,,,,,,,
31007113,0420,G8989CNGP,,,,,SELF CARE DISCHARGE VII,0.01,0.00,,,,,,,,,,,,,
31007114,0420,G8990CHGP,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT I,0.01,0.00,,,,,,,,,,,,,
31007115,0420,G8990CIGP,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT II,0.01,0.00,,,,,,,,,,,,,
31007116,0420,G8990CJGP,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT III,0.01,0.00,,,,,,,,,,,,,
31007117,0420,G8990CKGP,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT IV,0.01,0.00,,,,,,,,,,,,,
31007118,0420,G8990CLGP,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT V,0.01,0.00,,,,,,,,,,,,,
31007119,0420,G8990CMGP,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT VI,0.01,0.00,,,,,,,,,,,,,
31007120,0420,G8990CNGP,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT VII,0.01,0.00,,,,,,,,,,,,,
31007121,0420,G8991CHGP,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL I,0.01,0.00,,,,,,,,,,,,,
31007122,0420,G8991CIGP,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL II,0.01,0.00,,,,,,,,,,,,,
31007123,0420,G8991CJGP,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL III,0.01,0.00,,,,,,,,,,,,,
31007124,0420,G8991CKGP,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007125,0420,G8991CLGP,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL V,0.01,0.00,,,,,,,,,,,,,
31007126,0420,G8991CMGP,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007127,0420,G8991CNGP,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007128,0420,G8992CHGP,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH I,0.01,0.00,,,,,,,,,,,,,
31007129,0420,G8992CIGP,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH II,0.01,0.00,,,,,,,,,,,,,
31007130,0420,G8992CJGP,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH III,0.01,0.00,,,,,,,,,,,,,
31007131,0420,G8992CKGP,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH IV,0.01,0.00,,,,,,,,,,,,,
31007132,0420,G8992CLGP,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH V,0.01,0.00,,,,,,,,,,,,,
31007133,0420,G8992CMGP,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH VI,0.01,0.00,,,,,,,,,,,,,
31007134,0420,G8992CNGP,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH VII,0.01,0.00,,,,,,,,,,,,,
31007135,0420,G8993CHGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR I,0.01,0.00,,,,,,,,,,,,,
31007136,0420,G8993CIGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR II,0.01,0.00,,,,,,,,,,,,,
31007137,0420,G8993CJGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR III,0.01,0.00,,,,,,,,,,,,,
31007138,0420,G8993CKGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR IV,0.01,0.00,,,,,,,,,,,,,
31007139,0420,G8993CLGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR V,0.01,0.00,,,,,,,,,,,,,
31007140,0420,G8993CMGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR VI,0.01,0.00,,,,,,,,,,,,,
31007141,0420,G8993CNGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR VII,0.01,0.00,,,,,,,,,,,,,
31007142,0420,G8994CHGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL I,0.01,0.00,,,,,,,,,,,,,
31007143,0420,G8994CIGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL II,0.01,0.00,,,,,,,,,,,,,
31007144,0420,G8994CJGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL III,0.01,0.00,,,,,,,,,,,,,
31007145,0420,G8994CKGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007146,0420,G8994CLGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL V,0.01,0.00,,,,,,,,,,,,,
31007147,0420,G8994CMGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007148,0420,G8994CNGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007149,0420,G8995CHGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT DISCH I,0.01,0.00,,,,,,,,,,,,,
31007150,0420,G8995CIGP,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT DISCH II,0.01,0.00,,,,,,,,,,,,,
31007151,0420,G8995CJGP,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH III,0.01,0.00,,,,,,,,,,,,,
31007152,0420,G8995CKGP,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH IV,0.01,0.00,,,,,,,,,,,,,
31007153,0420,G8995CLGP,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH V,0.01,0.00,,,,,,,,,,,,,
31007154,0420,G8995CMGP,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH VI,0.01,0.00,,,,,,,,,,,,,
31007155,0420,G8995CNGP,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH VII,0.01,0.00,,,,,,,,,,,,,
31007156,0430,G8978CHGO,,,,,MOBILITY CURRENT STATUS I,0.01,0.00,,,,,,,,,,,,,
31007157,0430,G8978CIGO,,,,,MOBILITY CURRENT STATUS II,0.01,0.00,,,,,,,,,,,,,
31007158,0430,G8978CJGO,,,,,MOBILITY CURRENT STATUS III,0.01,0.00,,,,,,,,,,,,,
31007159,0430,G8978CKGO,,,,,MOBILITY CURRENT STATUS IV,0.01,0.00,,,,,,,,,,,,,
31007160,0430,G8978CLGO,,,,,MOBILITY CURRENT STATUS V,0.01,0.00,,,,,,,,,,,,,
31007161,0430,G8978CMGO,,,,,MOBILITY CURRENT STATUS VI,0.01,0.00,,,,,,,,,,,,,
31007162,0430,G8978CNGO,,,,,MOBILITY CURRENT STATUS VII,0.01,0.00,,,,,,,,,,,,,
31007163,0430,G8979CHGO,,,,,MOBILITY GOAL I,0.01,0.00,,,,,,,,,,,,,
31007164,0430,G8979CIGO,,,,,MOBILITY GOAL II,0.01,0.00,,,,,,,,,,,,,
31007165,0430,G8979CJGO,,,,,MOBILITY GOAL III,0.01,0.00,,,,,,,,,,,,,
31007166,0430,G8979CKGO,,,,,MOBILITY GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007167,0430,G8979CLGO,,,,,MOBILITY GOAL V,0.01,0.00,,,,,,,,,,,,,
31007168,0430,G8979CMGO,,,,,MOBILITY GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007169,0430,G8979CNGO,,,,,MOBILITY GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007170,0430,G8980CHGO,,,,,MOBILITY DISCHARGE I,0.01,0.00,,,,,,,,,,,,,
31007171,0430,G8980CIGO,,,,,MOBILITY DISCHARGE II,0.01,0.00,,,,,,,,,,,,,
31007172,0430,G8980CJGO,,,,,MOBILITY DISCHARGE III,0.01,0.00,,,,,,,,,,,,,
31007173,0430,G8980CKGO,,,,,MOBILITY DISCHARGE IV,0.01,0.00,,,,,,,,,,,,,
31007174,0430,G8980CLGO,,,,,MOBILITY DISCHARGE V,0.01,0.00,,,,,,,,,,,,,
31007175,0430,G8980CMGO,,,,,MOBILITY DISCHARGE VI,0.01,0.00,,,,,,,,,,,,,
31007176,0430,G8980CNGO,,,,,MOBILITY DISCHARGE VII,0.01,0.00,,,,,,,,,,,,,
31007177,0430,G8981CHGO,,,,,CHANGING BODY POSITION CURRENT I,0.01,0.00,,,,,,,,,,,,,
31007178,0430,G8981CIGO,,,,,CHANGING BODY POSITION CURRENT II,0.01,0.00,,,,,,,,,,,,,
31007179,0430,G8981CJGO,,,,,CHANGING BODY POSITION CURRENT III,0.01,0.00,,,,,,,,,,,,,
31007180,0430,G8981CKGO,,,,,CHANGING BODY POSITION CURRENT IV,0.01,0.00,,,,,,,,,,,,,
31007181,0430,G8981CLGO,,,,,CHANGING BODY POSITION CURRENT V,0.01,0.00,,,,,,,,,,,,,
31007182,0430,G8981CMGO,,,,,CHANGING BODY POSITION CURRENT VI,0.01,0.00,,,,,,,,,,,,,
31007183,0430,G8981CNGO,,,,,CHANGING BODY POSITION CURRENT VII,0.01,0.00,,,,,,,,,,,,,
31007184,0430,G8982CHGO,,,,,CHANGING BODY POSITION GOAL I,0.01,0.00,,,,,,,,,,,,,
31007185,0430,G8982CIGO,,,,,CHANGING BODY POSITION GOAL II,0.01,0.00,,,,,,,,,,,,,
31007186,0430,G8982CJGO,,,,,CHANGING BODY POSITION GOAL III,0.01,0.00,,,,,,,,,,,,,
31007187,0430,G8982CKGO,,,,,CHANGING BODY POSITION GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007188,0430,G8982CLGO,,,,,CHANGING BODY POSITION GOAL V,0.01,0.00,,,,,,,,,,,,,
31007189,0430,G8982CMGO,,,,,CHANGING BODY POSITION GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007190,0430,G8982CNGO,,,,,CHANGING BODY POSITION GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007191,0430,G8983CHGO,,,,,CHANGING BODY POSITION DISCHARGE I,0.01,0.00,,,,,,,,,,,,,
31007192,0430,G8983CIGO,,,,,CHANGING BODY POSITION DISCHARGE II,0.01,0.00,,,,,,,,,,,,,
31007193,0430,G8983CJGO,,,,,CHANGING BODY POSITION DISCHARGE III,0.01,0.00,,,,,,,,,,,,,
31007194,0430,G8983CKGO,,,,,CHANGING BODY POSITION DISCHARGE IV,0.01,0.00,,,,,,,,,,,,,
31007195,0430,G8983CLGO,,,,,CHANGING BODY POSITION DISCHARGE V,0.01,0.00,,,,,,,,,,,,,
31007196,0430,G8983CMGO,,,,,CHANGING BODY POSITION DISCHARGE VI,0.01,0.00,,,,,,,,,,,,,
31007197,0430,G8983CNGO,,,,,CHANGING BODY POSITION DISCHARGE VII,0.01,0.00,,,,,,,,,,,,,
31007198,0430,G8984CHGO,,,,,CARRYING MOVING OBJECTS CURRENT I,0.01,0.00,,,,,,,,,,,,,
31007199,0430,G8984CIGO,,,,,CARRYING MOVING OBJECTS CURRENT II,0.01,0.00,,,,,,,,,,,,,
31007200,0430,G8984CJGO,,,,,CARRYING MOVING OBJECTS CURRENT III,0.01,0.00,,,,,,,,,,,,,
31007201,0430,G8984CKGO,,,,,CARRYING MOVING OBJECTS CURRENT IV,0.01,0.00,,,,,,,,,,,,,
31007202,0430,G8984CLGO,,,,,CARRYING MOVING OBJECTS CURRENT V,0.01,0.00,,,,,,,,,,,,,
31007203,0430,G8984CMGO,,,,,CARRYING MOVING OBJECTS CURRENT VI,0.01,0.00,,,,,,,,,,,,,
31007204,0430,G8984CNGO,,,,,CARRYING MOVING OBJECTS CURRENT VII,0.01,0.00,,,,,,,,,,,,,
31007205,0430,G8985CHGO,,,,,CARRYING MOVING OBJECTS GOAL I,0.01,0.00,,,,,,,,,,,,,
31007206,0430,G8985CIGO,,,,,CARRYING MOVING OBJECTS GOAL II,0.01,0.00,,,,,,,,,,,,,
31007207,0430,G8985CJGO,,,,,CARRYING MOVING OBJECTS GOAL III,0.01,0.00,,,,,,,,,,,,,
31007208,0430,G8985CKGO,,,,,CARRYING MOVING OBJECTS GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007209,0430,G8985CLGO,,,,,CARRYING MOVING OBJECTS GOAL V,0.01,0.00,,,,,,,,,,,,,
31007210,0430,G8985CMGO,,,,,CARRYING MOVING OBJECTS GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007211,0430,G8985CNGO,,,,,CARRYING MOVING OBJECTS GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007212,0430,G8986CHGO,,,,,CARRYING MOVING OBJECTS DISCHARGE I,0.01,0.00,,,,,,,,,,,,,
31007213,0430,G8986CIGO,,,,,CARRYING MOVING OBJECTS DISCHARGE II,0.01,0.00,,,,,,,,,,,,,
31007214,0430,G8986CJGO,,,,,CARRYING MOVING OBJECTS DISCHARGE III,0.01,0.00,,,,,,,,,,,,,
31007215,0430,G8986CKGO,,,,,CARRYING MOVING OBJECTS DISCHARGE IV,0.01,0.00,,,,,,,,,,,,,
31007216,0430,G8986CLGO,,,,,CARRYING MOVING OBJECTS DISCHARGE V,0.01,0.00,,,,,,,,,,,,,
31007217,0430,G8986CMGO,,,,,CARRYING MOVING OBJECTS DISCHARGE VI,0.01,0.00,,,,,,,,,,,,,
31007218,0430,G8986CNGO,,,,,CARRYING MOVING OBJECTS DISCHARGE VII,0.01,0.00,,,,,,,,,,,,,
31007219,0430,G8987CHGO,,,,,SELF CARE CURRENT I,0.01,0.00,,,,,,,,,,,,,
31007220,0430,G8987CIGO,,,,,SELF CARE CURRENT II,0.01,0.00,,,,,,,,,,,,,
31007221,0430,G8987CJGO,,,,,SELF CARE CURRENT III,0.01,0.00,,,,,,,,,,,,,
31007222,0430,G8987CKGO,,,,,SELF CARE CURRENT IV,0.01,0.00,,,,,,,,,,,,,
31007223,0430,G8987CLGO,,,,,SELF CARE CURRENT V,0.01,0.00,,,,,,,,,,,,,
31007224,0430,G8987CMGO,,,,,SELF CARE CURRENT VI,0.01,0.00,,,,,,,,,,,,,
31007225,0430,G8987CNGO,,,,,SELF CARE CURRENT VII,0.01,0.00,,,,,,,,,,,,,
31007226,0430,G8988CHGO,,,,,SELF CARE GOAL I,0.01,0.00,,,,,,,,,,,,,
31007227,0430,G8988CIGO,,,,,SELF CARE GOAL II,0.01,0.00,,,,,,,,,,,,,
31007228,0430,G8988CJGO,,,,,SELF CARE GOAL III,0.01,0.00,,,,,,,,,,,,,
31007229,0430,G8988CKGO,,,,,SELF CARE GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007230,0430,G8988CLGO,,,,,SELF CARE GOAL V,0.01,0.00,,,,,,,,,,,,,
31007231,0430,G8988CMGO,,,,,SELF CARE GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007232,0430,G8988CNGO,,,,,SELF CARE GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007233,0430,G8989CHGO,,,,,SELF CARE DISCHARGE I,0.01,0.00,,,,,,,,,,,,,
31007234,0430,G8989CIGO,,,,,SELF CARE DISCHARGE II,0.01,0.00,,,,,,,,,,,,,
31007235,0430,G8989CJGO,,,,,SELF CARE DISCHARGE III,0.01,0.00,,,,,,,,,,,,,
31007236,0430,G8989CKGO,,,,,SELF CARE DISCHARGE IV,0.01,0.00,,,,,,,,,,,,,
31007237,0430,G8989CLGO,,,,,SELF CARE DISCHARGE V,0.01,0.00,,,,,,,,,,,,,
31007238,0430,G8989CMGO,,,,,SELF CARE DISCHARGE VI,0.01,0.00,,,,,,,,,,,,,
31007239,0430,G8989CNGO,,,,,SELF CARE DISCHARGE VII,0.01,0.00,,,,,,,,,,,,,
31007240,0430,G8990CHGO,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT I,0.01,0.00,,,,,,,,,,,,,
31007241,0430,G8990CIGO,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT II,0.01,0.00,,,,,,,,,,,,,
31007242,0430,G8990CJGO,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT III,0.01,0.00,,,,,,,,,,,,,
31007243,0430,G8990CKGO,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT IV,0.01,0.00,,,,,,,,,,,,,
31007244,0430,G8990CLGO,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT V,0.01,0.00,,,,,,,,,,,,,
31007245,0430,G8990CMGO,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT VI,0.01,0.00,,,,,,,,,,,,,
31007246,0430,G8990CNGO,,,,,OTHER PT PRIMARY FUNCT LIMIT CURRENT VII,0.01,0.00,,,,,,,,,,,,,
31007247,0430,G8991CHGO,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL I,0.01,0.00,,,,,,,,,,,,,
31007248,0430,G8991CIGO,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL II,0.01,0.00,,,,,,,,,,,,,
31007249,0430,G8991CJGO,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL III,0.01,0.00,,,,,,,,,,,,,
31007250,0430,G8991CKGO,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007251,0430,G8991CLGO,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL V,0.01,0.00,,,,,,,,,,,,,
31007252,0430,G8991CMGO,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007253,0430,G8991CNGO,,,,,OTHER PT PRIMARY FUNCT LIMIT GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007254,0430,G8992CHGO,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH I,0.01,0.00,,,,,,,,,,,,,
31007255,0430,G8992CIGO,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH II,0.01,0.00,,,,,,,,,,,,,
31007256,0430,G8992CJGO,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH III,0.01,0.00,,,,,,,,,,,,,
31007257,0430,G8992CKGO,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH IV,0.01,0.00,,,,,,,,,,,,,
31007258,0430,G8992CLGO,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH V,0.01,0.00,,,,,,,,,,,,,
31007259,0430,G8992CMGO,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH VI,0.01,0.00,,,,,,,,,,,,,
31007260,0430,G8992CNGO,,,,,OTHER PT PRIMARY FUNCT LIMIT DISCH VII,0.01,0.00,,,,,,,,,,,,,
31007261,0430,G8993CHGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR I,0.01,0.00,,,,,,,,,,,,,
31007262,0430,G8993CIGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR II,0.01,0.00,,,,,,,,,,,,,
31007263,0430,G8993CJGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR III,0.01,0.00,,,,,,,,,,,,,
31007264,0430,G8993CKGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR IV,0.01,0.00,,,,,,,,,,,,,
31007265,0430,G8993CLGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR V,0.01,0.00,,,,,,,,,,,,,
31007266,0430,G8993CMGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR VI,0.01,0.00,,,,,,,,,,,,,
31007267,0430,G8993CNGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT CURR VII,0.01,0.00,,,,,,,,,,,,,
31007268,0430,G8994CHGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL I,0.01,0.00,,,,,,,,,,,,,
31007269,0430,G8994CIGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL II,0.01,0.00,,,,,,,,,,,,,
31007270,0430,G8994CJGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL III,0.01,0.00,,,,,,,,,,,,,
31007271,0430,G8994CKGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL IV,0.01,0.00,,,,,,,,,,,,,
31007272,0430,G8994CLGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL V,0.01,0.00,,,,,,,,,,,,,
31007273,0430,G8994CMGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL VI,0.01,0.00,,,,,,,,,,,,,
31007274,0430,G8994CNGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT GOAL VII,0.01,0.00,,,,,,,,,,,,,
31007275,0430,G8995CHGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT DISCH I,0.01,0.00,,,,,,,,,,,,,
31007276,0430,G8995CIGO,,,,,OTHER PT SUBSEQUENT FUNCT LIMIT DISCH II,0.01,0.00,,,,,,,,,,,,,
31007277,0430,G8995CJGO,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH III,0.01,0.00,,,,,,,,,,,,,
31007278,0430,G8995CKGO,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH IV,0.01,0.00,,,,,,,,,,,,,
31007279,0430,G8995CLGO,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH V,0.01,0.00,,,,,,,,,,,,,
31007280,0430,G8995CMGO,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH VI,0.01,0.00,,,,,,,,,,,,,
31007281,0430,G8995CNGO,,,,,OTHER PT SUBSEQUENT FUNC LIMIT DISCH VII,0.01,0.00,,,,,,,,,,,,,
31007400,0440,G8996CHGN,,,,,SWALLOW (CURRENT) I,0.01,0.00,,,,,,,,,,,,,
31007401,0440,G8996CIGN,,,,,SWALLOW (CURRENT) II,0.01,0.00,,,,,,,,,,,,,
31007402,0440,G8996CIGN,,,,,SWALLOW (CURRENT) III,0.01,0.00,,,,,,,,,,,,,
31007403,0440,G8996CKGN,,,,,SWALLOW (CURRENT) IV,0.01,0.00,,,,,,,,,,,,,
31007404,0440,G8996CLGN,,,,,SWALLOW (CURRENT) V,0.01,0.00,,,,,,,,,,,,,
31007405,0440,G8996CMGN,,,,,SWALLOW (CURRENT) VI,0.01,0.00,,,,,,,,,,,,,
31007406,0440,G8996CNGN,,,,,SWALLOW (CURRENT) VII,0.01,0.00,,,,,,,,,,,,,
31007407,0440,G8997CNGN,,,,,SWALLOW (GOAL) I,0.01,0.00,,,,,,,,,,,,,
31007408,0440,G8997CIGN,,,,,SWALLOW (GOAL) II,0.01,0.00,,,,,,,,,,,,,
31007409,0440,G8997CJGN,,,,,SWALLOW (GOAL) III,0.01,0.00,,,,,,,,,,,,,
31007410,0440,G8997CKGN,,,,,SWALLOW (GOAL) IV,0.01,0.00,,,,,,,,,,,,,
31007411,0440,G8997CLGN,,,,,SWALLOW (GOAL) V,0.01,0.00,,,,,,,,,,,,,
31007412,0440,G8997CMGN,,,,,SWALLOW (GOAL) VI,0.01,0.00,,,,,,,,,,,,,
31007413,0440,G8997CNGN,,,,,SWALLOW (GOAL) VII,0.01,0.00,,,,,,,,,,,,,
31007414,0440,G8998CHGN,,,,,SWALLOW (DC) I,0.01,0.00,,,,,,,,,,,,,
31007415,0440,G8998CIGN,,,,,SWALLOW (DC) II,0.01,0.00,,,,,,,,,,,,,
31007416,0440,G8998CJGN,,,,,SWALLOW (DC) III,0.01,0.00,,,,,,,,,,,,,
31007417,0440,G8998CKGN,,,,,SWALLOW (DC) IV,0.01,0.00,,,,,,,,,,,,,
31007418,0440,G8998CLGN,,,,,SWALLOW (DC) V,0.01,0.00,,,,,,,,,,,,,
31007419,0440,G8998CMGN,,,,,SWALLOW (DC) VI,0.01,0.00,,,,,,,,,,,,,
31007420,0440,G8998CNGN,,,,,SWALLOW (DC) VII,0.01,0.00,,,,,,,,,,,,,
31007421,0440,G8999CHGN,,,,,MOTOR SPEECH (CURRENT) I,0.01,0.00,,,,,,,,,,,,,
31007422,0440,G8999CIGN,,,,,MOTOR SPEECH (CURRENT) II,0.01,0.00,,,,,,,,,,,,,
31007423,0440,G8999CJGN,,,,,MOTOR SPEECH (CURRENT) III,0.01,0.00,,,,,,,,,,,,,
31007424,0440,G8999CKGN,,,,,MOTOR SPEECH (CURRENT) IV,0.01,0.00,,,,,,,,,,,,,
31007425,0440,G8999CLGN,,,,,MOTOR SPEECH (CURRENT) V,0.01,0.00,,,,,,,,,,,,,
31007426,0440,G8999CMGN,,,,,MOTOR SPEECH (CURRENT) VI,0.01,0.00,,,,,,,,,,,,,
31007427,0440,G8999CNGN,,,,,MOTOR SPEECH (CURRENT) VII,0.01,0.00,,,,,,,,,,,,,
31007428,0440,G9186CHGN,,,,,MOTOR SPEECH (GOAL) I,0.01,0.00,,,,,,,,,,,,,
31007429,0440,G9186CIGN,,,,,MOTOR SPEECH (GOAL) II,0.01,0.00,,,,,,,,,,,,,
31007430,0440,G9186CJGN,,,,,MOTOR SPEECH (GOAL) III,0.01,0.00,,,,,,,,,,,,,
31007431,0440,G9186CKGN,,,,,MOTOR SPEECH (GOAL) IV,0.01,0.00,,,,,,,,,,,,,
31007432,0440,G9186CLGN,,,,,MOTOR SPEECH (GOAL) V,0.01,0.00,,,,,,,,,,,,,
31007433,0440,G9186CMGN,,,,,MOTOR SPEECH (GOAL) VI,0.01,0.00,,,,,,,,,,,,,
31007434,0440,G9186CNGN,,,,,MOTOR SPEECH (GOAL) VII,0.01,0.00,,,,,,,,,,,,,
31007435,0440,G9158CHGN,,,,,MOTOR SPEECH (DC) I,0.01,0.00,,,,,,,,,,,,,
31007436,0440,G9158CIGN,,,,,MOTOR SPEECH (DC) II,0.01,0.00,,,,,,,,,,,,,
31007437,0440,G9158CJGN,,,,,MOTOR SPEECH (DC) III,0.01,0.00,,,,,,,,,,,,,
31007438,0440,G9158CKGN,,,,,MOTOR SPEECH (DC) IV,0.01,0.00,,,,,,,,,,,,,
31007439,0440,G9158CLGN,,,,,MOTOR SPEECH (DC) V,0.01,0.00,,,,,,,,,,,,,
31007440,0440,G9158CMGN,,,,,MOTOR SPEECH (DC) VI,0.01,0.00,,,,,,,,,,,,,
31007441,0440,G9158CNGN,,,,,MOTOR SPEECH (DC) VII,0.01,0.00,,,,,,,,,,,,,
31007442,0440,G9159CHGN,,,,,LANG COMP (CURRENT) I,0.01,0.00,,,,,,,,,,,,,
31007443,0440,G9159CIGN,,,,,LANG COMP (CURRENT) II,0.01,0.00,,,,,,,,,,,,,
31007444,0440,G9159CJGN,,,,,LANG COMP (CURRENT) III,0.01,0.00,,,,,,,,,,,,,
31007445,0440,G9159CKGN,,,,,LANG COMP (CURRENT) IV,0.01,0.00,,,,,,,,,,,,,
31007446,0440,G9159CLGN,,,,,LANG COMP (CURRENT) V,0.01,0.00,,,,,,,,,,,,,
31007447,0440,G9159CMGN,,,,,LANG COMP (CURRENT) VI,0.01,0.00,,,,,,,,,,,,,
31007448,0440,G9159CNGN,,,,,LANG COMP (CURRENT) VII,0.01,0.00,,,,,,,,,,,,,
31007449,0440,G9160CHGN,,,,,LANG COMP (GOAL) I,0.01,0.00,,,,,,,,,,,,,
31007450,0440,G9160CIGN,,,,,LANG COMP (GOAL) II,0.01,0.00,,,,,,,,,,,,,
31007451,0440,G9160CJGN,,,,,LANG COMP (GOAL) III,0.01,0.00,,,,,,,,,,,,,
31007452,0440,G9160CKGN,,,,,LANG COMP (GOAL) IV,0.01,0.00,,,,,,,,,,,,,
31007453,0440,G9160CLGN,,,,,LANG COMP (GOAL) V,0.01,0.00,,,,,,,,,,,,,
31007454,0440,G9160CMGN,,,,,LANG COMP (GOAL) VI,0.01,0.00,,,,,,,,,,,,,
31007455,0440,G9160CNGN,,,,,LANG COMP (GOAL) VII,0.01,0.00,,,,,,,,,,,,,
31007456,0440,G9161CHGN,,,,,LANG COMP (DC) I,0.01,0.00,,,,,,,,,,,,,
31007457,0440,G9161CIGN,,,,,LANG COMP (DC) II,0.01,0.00,,,,,,,,,,,,,
31007458,0440,G9161CJGN,,,,,LANG COMP (DC) III,0.01,0.00,,,,,,,,,,,,,
31007459,0440,G9161CKGN,,,,,LANG COMP (DC) IV,0.01,0.00,,,,,,,,,,,,,
31007460,0440,G9161CLGN,,,,,LANG COMP (DC) V,0.01,0.00,,,,,,,,,,,,,
31007461,0440,G9161CMGN,,,,,LANG COMP (DC) VI,0.01,0.00,,,,,,,,,,,,,
31007462,0440,G9161CNGN,,,,,LANG COMP (DC) VII,0.01,0.00,,,,,,,,,,,,,
31007463,0440,G9162CHGN,,,,,LANG EXPRESS (CURRENT) I,0.01,0.00,,,,,,,,,,,,,
31007464,0440,G9162CIGN,,,,,LANG EXPRESS (CURRENT) II,0.01,0.00,,,,,,,,,,,,,
31007465,0440,G9162CJGN,,,,,LANG EXPRESS (CURRENT) III,0.01,0.00,,,,,,,,,,,,,
31007466,0440,G9162CKGN,,,,,LANG EXPRESS (CURRENT) IV,0.01,0.00,,,,,,,,,,,,,
31007467,0440,G9162CLGN,,,,,LANG EXPRESS (CURRENT) V,0.01,0.00,,,,,,,,,,,,,
31007468,0440,G9162CMGN,,,,,LANG EXPRESS (CURRENT) VI,0.01,0.00,,,,,,,,,,,,,
31007469,0440,G9162CNGN,,,,,LANG EXPRESS (CURRENT) VII,0.01,0.00,,,,,,,,,,,,,
31007470,0440,G9163CHGN,,,,,LANG EXPRESS (GOAL) I,0.01,0.00,,,,,,,,,,,,,
31007471,0440,G9163CIGN,,,,,LANG EXPRESS (GOAL) II,0.01,0.00,,,,,,,,,,,,,
31007472,0440,G9163CJGN,,,,,LANG EXPRESS (GOAL) III,0.01,0.00,,,,,,,,,,,,,
31007473,0440,G9163CKGN,,,,,LANG EXPRESS (GOAL) IV,0.01,0.00,,,,,,,,,,,,,
31007474,0440,G9163CLGN,,,,,LANG EXPRESS (GOAL) V,0.01,0.00,,,,,,,,,,,,,
31007475,0440,G9163CMGN,,,,,LANG EXPRESS (GOAL) VI,0.01,0.00,,,,,,,,,,,,,
31007476,0440,G9163CNGN,,,,,LANG EXPRESS (GOAL) VII,0.01,0.00,,,,,,,,,,,,,
31007477,0440,G9164CHGN,,,,,LANG EXPRESS (DC) I,0.01,0.00,,,,,,,,,,,,,
31007478,0440,G9164CIGN,,,,,LANG EXPRESS (DC) II,0.01,0.00,,,,,,,,,,,,,
31007479,0440,G9164CJGN,,,,,LANG EXPRESS (DC) III,0.01,0.00,,,,,,,,,,,,,
31007480,0440,G9164CKGN,,,,,LANG EXPRESS (DC) IV,0.01,0.00,,,,,,,,,,,,,
31007481,0440,G9164CLGN,,,,,LANG EXPRESS (DC) V,0.01,0.00,,,,,,,,,,,,,
31007482,0440,G9164CMGN,,,,,LANG EXPRESS (DC) VI,0.01,0.00,,,,,,,,,,,,,
31007483,0440,G9164CNGN,,,,,LANG EXPRESS (DC) VII,0.01,0.00,,,,,,,,,,,,,
31007484,0440,G9165CHGN,,,,,ATTEN (CURRENT) I,0.01,0.00,,,,,,,,,,,,,
31007485,0440,G9165CIGN,,,,,ATTEN (CURRENT) II,0.01,0.00,,,,,,,,,,,,,
31007486,0440,G9165CJGN,,,,,ATTEN (CURRENT) III,0.01,0.00,,,,,,,,,,,,,
31007487,0440,G9165CKGN,,,,,ATTEN (CURRENT) IV,0.01,0.00,,,,,,,,,,,,,
31007488,0440,G9165CLGN,,,,,ATTEN (CURRENT) V,0.01,0.00,,,,,,,,,,,,,
31007489,0440,G9165CMGN,,,,,ATTEN (CURRENT) VI,0.01,0.00,,,,,,,,,,,,,
31007490,0440,G9165CNGN,,,,,ATTEN (CURRENT) VII,0.01,0.00,,,,,,,,,,,,,
31007491,0440,G9166CHGN,,,,,ATTEN (GOAL) I,0.01,0.00,,,,,,,,,,,,,
31007492,0440,G9166CIGN,,,,,ATTEN (GOAL) II,0.01,0.00,,,,,,,,,,,,,
31007493,0440,G9166CJGN,,,,,ATTEN (GOAL) III,0.01,0.00,,,,,,,,,,,,,
31007494,0440,G9166CKGN,,,,,ATTEN (GOAL) IV,0.01,0.00,,,,,,,,,,,,,
31007495,0440,G9166CLGN,,,,,ATTEN (GOAL) V,0.01,0.00,,,,,,,,,,,,,
31007496,0440,G9166CMGN,,,,,ATTEN (GOAL) VI,0.01,0.00,,,,,,,,,,,,,
31007497,0440,G9166CNGN,,,,,ATTEN (GOAL) VII,0.01,0.00,,,,,,,,,,,,,
31007498,0440,G9167CHGN,,,,,ATTEN (DC) I,0.01,0.00,,,,,,,,,,,,,
31007499,0440,G9167CIGN,,,,,ATTEN (DC) II,0.01,0.00,,,,,,,,,,,,,
31007500,0440,G9167CJGN,,,,,ATTEN (DC) III,0.01,0.00,,,,,,,,,,,,,
31007501,0440,G9167CKGN,,,,,ATTEN (DC) IV,0.01,0.00,,,,,,,,,,,,,
31007502,0440,G9167CLGN,,,,,ATTEN (DC) V,0.01,0.00,,,,,,,,,,,,,
31007503,0440,G9167CMGN,,,,,ATTEN (DC) VI,0.01,0.00,,,,,,,,,,,,,
31007504,0440,G9167CNGN,,,,,ATTEN (DC) VII,0.01,0.00,,,,,,,,,,,,,
31007505,0440,G9168CHGN,,,,,MEMORY (CURRENT) I,0.01,0.00,,,,,,,,,,,,,
31007506,0440,G9168CIGN,,,,,MEMORY (CURRENT) II,0.01,0.00,,,,,,,,,,,,,
31007507,0440,G9168CJGN,,,,,MEMORY (CURRENT) III,0.01,0.00,,,,,,,,,,,,,
31007508,0440,G9168CKGN,,,,,MEMORY (CURRENT) IV,0.01,0.00,,,,,,,,,,,,,
31007509,0440,G9168CLGN,,,,,MEMORY (CURRENT) V,0.01,0.00,,,,,,,,,,,,,
31007510,0440,G9168CMGN,,,,,MEMORY (CURRENT) VI,0.01,0.00,,,,,,,,,,,,,
31007511,0440,G9168CNGN,,,,,MEMORY (CURRENT) VII,0.01,0.00,,,,,,,,,,,,,
31007512,0440,G9169CHGN,,,,,MEMORY (GOAL) I,0.01,0.00,,,,,,,,,,,,,
31007513,0440,G9169CIGN,,,,,MEMORY (GOAL) II,0.01,0.00,,,,,,,,,,,,,
31007514,0440,G9169CJGN,,,,,MEMORY (GOAL) III,0.01,0.00,,,,,,,,,,,,,
31007515,0440,G9169CKGN,,,,,MEMORY (GOAL) IV,0.01,0.00,,,,,,,,,,,,,
31007516,0440,G9169CLGN,,,,,MEMORY (GOAL) V,0.01,0.00,,,,,,,,,,,,,
31007517,0440,G9169CMGN,,,,,MEMORY (GOAL) VI,0.01,0.00,,,,,,,,,,,,,
31007518,0440,G9169CNGN,,,,,MEMORY (GOAL) VII,0.01,0.00,,,,,,,,,,,,,
31007519,0440,G9170CHGN,,,,,MEMORY (DC) I,0.01,0.00,,,,,,,,,,,,,
31007520,0440,G9170CIGN,,,,,MEMORY (DC) II,0.01,0.00,,,,,,,,,,,,,
31007521,0440,G9170CJGN,,,,,MEMORY (DC) III,0.01,0.00,,,,,,,,,,,,,
31007522,0440,G9170CKGN,,,,,MEMORY (DC) IV,0.01,0.00,,,,,,,,,,,,,
31007523,0440,G9170CLGN,,,,,MEMORY (DC) V,0.01,0.00,,,,,,,,,,,,,
31007524,0440,G9170CMGN,,,,,MEMORY (DC) VI,0.01,0.00,,,,,,,,,,,,,
31007525,0440,G9170CNGN,,,,,MEMORY (DC) VII,0.01,0.00,,,,,,,,,,,,,
31007526,0440,G9171CHGN,,,,,VOICE (CURRENT) I,0.01,0.00,,,,,,,,,,,,,
31007527,0440,G9171CIGN,,,,,VOICE (CURRENT) II,0.01,0.00,,,,,,,,,,,,,
31007528,0440,G9171CJGN,,,,,VOICE (CURRENT) III,0.01,0.00,,,,,,,,,,,,,
31007529,0440,G9171CKGN,,,,,VOICE (CURRENT) IV,0.01,0.00,,,,,,,,,,,,,
31007530,0440,G9171CLGN,,,,,VOICE (CURRENT) V,0.01,0.00,,,,,,,,,,,,,
31007531,0440,G9171CMGN,,,,,VOICE (CURRENT) VI,0.01,0.00,,,,,,,,,,,,,
31007532,0440,G9171CNGN,,,,,VOICE (CURRENT) VII,0.01,0.00,,,,,,,,,,,,,
31007533,0440,G9172CHGN,,,,,VOICE (GOAL) I,0.01,0.00,,,,,,,,,,,,,
31007534,0440,G9172CIGN,,,,,VOICE (GOAL) II,0.01,0.00,,,,,,,,,,,,,
31007535,0440,G9172CJGN,,,,,VOICE (GOAL) III,0.01,0.00,,,,,,,,,,,,,
31007536,0440,G9172CKGN,,,,,VOICE (GOAL) IV,0.01,0.00,,,,,,,,,,,,,
31007537,0440,G9172CLGN,,,,,VOICE (GOAL) V,0.01,0.00,,,,,,,,,,,,,
31007538,0440,G9172CMGN,,,,,VOICE (GOAL) VI,0.01,0.00,,,,,,,,,,,,,
31007539,0440,G9172CNGN,,,,,VOICE (GOAL) VII,0.01,0.00,,,,,,,,,,,,,
31007540,0440,G9173CHGN,,,,,VOICE (DC) I,0.01,0.00,,,,,,,,,,,,,
31007541,0440,G9173CIGN,,,,,VOICE (DC) II,0.01,0.00,,,,,,,,,,,,,
31007542,0440,G9173CJGN,,,,,VOICE (DC) III,0.01,0.00,,,,,,,,,,,,,
31007543,0440,G9173CKGN,,,,,VOICE (DC) IV,0.01,0.00,,,,,,,,,,,,,
31007544,0440,G9173CLGN,,,,,VOICE (DC) V,0.01,0.00,,,,,,,,,,,,,
31007545,0440,G9173CMGN,,,,,VOICE (DC) VI,0.01,0.00,,,,,,,,,,,,,
31007546,0440,G9173CNGN,,,,,VOICE (DC) VII,0.01,0.00,,,,,,,,,,,,,
31007547,0440,G9174CHGN,,,,,SPEECH LANG (CURRENT) I,0.01,0.00,,,,,,,,,,,,,
31007548,0440,G9174CIGN,,,,,SPEECH LANG (CURRENT) II,0.01,0.00,,,,,,,,,,,,,
31007549,0440,G9174CJGN,,,,,SPEECH LANG (CURRENT) III,0.01,0.00,,,,,,,,,,,,,
31007550,0440,G9174CKGN,,,,,SPEECH LANG (CURRENT) IV,0.01,0.00,,,,,,,,,,,,,
31007551,0440,G9174CLGN,,,,,SPEECH LANG (CURRENT) V,0.01,0.00,,,,,,,,,,,,,
31007552,0440,G9174CMGN,,,,,SPEECH LANG (CURRENT) VI,0.01,0.00,,,,,,,,,,,,,
31007553,0440,G9174CNGN,,,,,SPEECH LANG (CURRENT) VII,0.01,0.00,,,,,,,,,,,,,
31007554,0440,G9175CHGN,,,,,SPEECH LANG (GOAL) I,0.01,0.00,,,,,,,,,,,,,
31007555,0440,G9175CIGN,,,,,SPEECH LANG (GOAL) II,0.01,0.00,,,,,,,,,,,,,
31007556,0440,G9175CJGN,,,,,SPEECH LANG (GOAL) III,0.01,0.00,,,,,,,,,,,,,
31007557,0440,G9175CKGN,,,,,SPEECH LANG (GOAL) IV,0.01,0.00,,,,,,,,,,,,,
31007558,0440,G9175CLGN,,,,,SPEECH LANG (GOAL) V,0.01,0.00,,,,,,,,,,,,,
31007559,0440,G9175CMGN,,,,,SPEECH LANG (GOAL) VI,0.01,0.00,,,,,,,,,,,,,
31007560,0440,G9175CNGN,,,,,SPEECH LANG (GOAL) VII,0.01,0.00,,,,,,,,,,,,,
31007561,0440,G9176CHGN,,,,,SPEECH LANG (DC) I,0.01,0.00,,,,,,,,,,,,,
31007562,0440,G9176CIGN,,,,,SPEECH LANG (DC) II,0.01,0.00,,,,,,,,,,,,,
31007563,0440,G9176CJGN,,,,,SPEECH LANG (DC) III,0.01,0.00,,,,,,,,,,,,,
31007564,0440,G9176CKGN,,,,,SPEECH LANG (DC) IV,0.01,0.00,,,,,,,,,,,,,
31007565,0440,G9176CLGN,,,,,SPEECH LANG (DC) V,0.01,0.00,,,,,,,,,,,,,
31007566,0440,G9176CMGN,,,,,SPEECH LANG (DC) VI,0.01,0.00,,,,,,,,,,,,,
31007567,0440,G9176CNGN,,,,,SPEECH LANG (DC) VII,0.01,0.00,,,,,,,,,,,,,
31009605,0420,97140,GP,,,,PT MYOFACIAL RELEASE,168.38,168.38,54.92,101.25,,,101.25,,,,54.92,,,56.35,56.35
31009607,0420,97140GP,,,,,"PT MANUAL THERAPY,15 MINUTES",168.38,168.38,,,,,,,,,,,,,
31009608,0440,97129,,,,,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTE,165.00,165.00,,,,,,,,,,,,,
31009609,0440,97130,,,,,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MI,158.88,158.88,,,,,,,,,,,,,
32000001,0943,93798,,,,,CARDIAC REHAB PHASE 2 W ECG MONITOR,115.50,0.00,119.76,205.18,,,,,,,119.76,,,205.18,205.18
33001000,0420,97140,,,,,"MM MANUAL THERAPY,15 MINUTES",93.86,93.86,,,,,,,,,,,,,
33002000,0420,97124,,,,,MM MASSAGETHERAPY,82.42,82.42,,,,,,,,,,,,,
34001000,0948,G0424,,,,,PULMONARY REHAB 1 HR SESSION FOR COPD DX,190.17,190.17,60.85,64.71,,,,,,,64.71,,,60.85,60.85
34001500,0948,G0424KX,,,,,PULMONARY REHAB 1 HOUR SESSION > 36 FOR,0.00,0.00,,,,,,,,,,,,,
34002000,0948,G0238,,,,,PULMONARY REHAB 15 MIN SESSION FOR NON C,108.17,108.17,,,,,,,,,,,,,
34003000,0948,G0239,,,,,PULMONARY REHAB GROUP SESSION FOR NON CO,0.00,0.00,,,,,,,,,,,,,
35000002,0943,93798,,,,,CARDIAC REHAB PHASE 2 W ECG MONITOR,356.63,356.63,119.76,205.18,,,,,,,119.76,,,205.18,205.18
39000001,0611,,,,,,MMRI,0.00,0.00,3112.39,3112.39,3112.39,3112.39,,,,,,,,,
39000010,0610,74185,,,,,MMRA Abdomen w/wo contrast,2532.23,2532.23,,,,,,,,,,,,,
39000011,0610,73222,,,,,MMRI U EXTR; ANY JOINT W CONTRAST,3477.96,3477.96,,,,,,,,,,,,,
39001224,0615,70544,,,,,MMRA BRAIN WITHOUT CONTRAST,2858.80,2858.80,,,,,,,,,,,,,
39001225,0615,70546,,,,,MMRA BRAIN WITH CONTRAST,3373.91,3373.91,,,,,,,,,,,,,
39001226,0615,70547,,,,,MMRA NECK WO CONTRAST,2858.80,2858.80,,,,,,,,,,,,,
39001233,0612,72147,,,,,MMRI THORACTIC SPINE W/CONTRAST,3478.99,3478.99,,,,,,,,,,,,,
39001234,0612,72149,,,,,MMRI LUMBAR SPINE WITH CONTRAST,3582.01,3582.01,,,,,,,,,,,,,
39001235,0612,72142,,,,,MMRI CERVICAL SPINE WITH CONTRAST,3582.01,3582.01,,,,,,,,,,,,,
39008503,0611,70551,,,,,MMRI BRAIN W/O CONTRAST,2858.80,2858.80,973.68,1469.42,,,,,,,973.68,,,1469.42,1469.42
39008504,0611,70553,,,,,MMRI BRAIN WITH AND WITHOUT CONTRAST,3682.97,3682.97,1252.78,1848.85,,,,,,,1252.78,,,1848.85,1848.85
39008506,0610,76393,,,,,MMRI LOCALIZIN BIOPSY,942.00,0.00,,,,,,,,,,,,,
39008509,0614,70540,,,,,MMRI ORBIT / FACE / NECK W/O CONTRAST,3089.57,3089.57,,,,,,,,,,,,,
39008539,0612,72141,,,,,MMRI CERVICAL SPINE W/O CONTRAST,3143.58,3143.58,910.00,1788.01,,,910.00,,,,1058.82,,,1788.01,1788.01
39008542,0612,72146,,,,,MMRI THORACTIC SPINE W/O CONTRAST,3066.91,3066.91,1050.14,1742.01,,,,,,,1050.14,,,1742.01,1742.01
39008545,0612,72148,,,,,MMRI LUMBAR SPINE W/O CONTRAST,3066.91,3066.91,910.00,1407.71,,,910.00,,,,1044.09,,,1407.71,1407.71
39008551,0614,71550,,,,,MMRI CHEST W/O CONTRAST,2386.72,2386.72,,,,,,,,,,,,,
39008554,0614,74181,,,,,MMRI ABDOMEN W/O CONTRAST,3295.09,3295.09,1120.33,1120.33,,,,,,,1120.33,,,,
39008560,0611,70544,,,,,MMRI  HEAD & / OR NECK,2273.25,0.00,,,,,,,,,,,,,
39008581,0614,72195,,,,,MMRI PELVIS W/O CONTRAST,3295.09,3295.09,,,,,,,,,,,,,
39008584,0610,76499,,,,,MMRI SPECIFY,2032.50,0.00,,,,,,,,,,,,,
39008585,0610,73221RT,,,,,MMRI ELBOW JT RIGHT W/O CONTRAST,3205.98,3205.98,,,,,,,,,,,,,
39008586,0610,73221LT,,,,,MMRI ELBOW LEFT - W/O CONTRAST,3205.98,3205.98,,,,,,,,,,,,,
39008587,0610,73221RT,,,,,MMRI SHOULDER JT RIGHT W/O CONTRAST,3090.86,3090.86,,,,,,,,,,,,,
39008588,0610,73221LT,,,,,MMRI SHOULDER JT LEFT W/O CONTRAST,3090.86,3090.86,,,,,,,,,,,,,
39008590,0610,71550,,,,,MMRI GREAT VESSELS,3667.51,3667.51,,,,,,,,,,,,,
39008591,0614,73218LT,,,,,MMRI UPPER EXTREMITY LEFT - W/O CONTRAST,3102.96,3102.96,,,,,,,,,,,,,
39008593,0610,73218RT,,,,,MMRI UPPER EXTREMITY RT W/O CONTRAST,3102.96,3102.96,,,,,,,,,,,,,
39008595,0610,73219RT,,,,,MMRI UPPER EXTREMITY  RIGHT W/CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008596,0610,75552,,,,,MMRI CARDIAC,2073.00,0.00,,,,,,,,,,,,,
39008597,0614,73219LT,,,,,MMRI UPPER EXTREMITY LEFT - W/CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008612,0614,73721RT,,,,,MMRI KNEE RIGHT - W/O CONTRAST,3090.86,3090.86,,,,,,,,,,,,,
39008613,0614,73721LT,,,,,MMRI KNEE LEFT - W/O CONTRAST,3090.86,3090.86,,,,,,,,,,,,,
39008616,0610,73721LT,,,,,MMRI HIP JT LEFT - WITHOUT CONTRAST,3090.86,3090.86,,,,,,,,,,,,,
39008617,0610,73721RT,,,,,MMRI HIP JT RIGHT W/O CONTRAST,3090.86,3090.86,,,,,,,,,,,,,
39008618,0610,73222LT,,,,,MMRI SHOULDER LT W/CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008619,0610,73222RT,,,,,MMRI SHOULDER JT RIGHT W/CONTRAST,3515.82,3515.82,,,,,,,,,,,,,
39008620,0614,73718RT,,,,,MMRI LOWER EXT RIGHT W/O CONTRAST,3090.86,3090.86,,,,,,,,,,,,,
39008621,0614,73719RT,,,,,MMRI LOWER EXT RIGHT WITH CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008622,0614,73720RT,,,,,MMRI LOWER EXT RIGHT WO/W CONTRAST,3824.10,3824.10,,,,,,,,,,,,,
39008624,0614,73718LT,,,,,MMRI LOWER EXT LEFT - WITHOUT CONTRAST,3090.86,3090.86,,,,,,,,,,,,,
39008625,0614,73719LT,,,,,MMRI LOWER EXT LEFT - WITH CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008627,0614,73720LT,,,,,MMRI LOWER EXT LEFT WO / W CONTRAST,3824.10,3824.10,,,,,,,,,,,,,
39008640,0610,,,,,,MMRI TESLASCAN,529.00,0.00,3353.93,3353.93,3353.93,3353.93,,,,,,,,,
39008644,0611,70553,,,,,MMRI BRAIN /+CONT,2458.31,2458.31,1252.78,1848.85,,,,,,,1252.78,,,1848.85,1848.85
39008647,0636,A9579,,,,,MMRI CONTRAST MEDIA,261.67,261.67,0.00,5.59,,,0.00,,,,3.77,,,5.59,5.59
39008648,0636,A9579,,,,,MMRI CONTRAST GADOLINIUM,11.07,11.07,0.00,5.59,,,0.00,,,,3.77,,,5.59,5.59
39008650,0611,70552,,,,,MMRI BRAIN W/CONTRAST GADOLINIUM,3373.91,3373.91,,,,,,,,,,,,,
39008659,0614,70542,,,,,MMRI ORBIT/FACE/NECK WITH CONTRAST,3501.65,3501.65,,,,,,,,,,,,,
39008660,0614,70540,,,,,MMRI ORBIT/FACE/NECK W/O,3089.57,3089.57,,,,,,,,,,,,,
39008661,0614,70543,,,,,MMRI ORBIT / FACE / NECK WO / W CONTRAST,3810.71,3810.71,,,,,,,,,,,,,
39008704,0612,72156,,,,,MMRI CERVICAL SPINE WO / W CONTRAST,3891.07,3891.07,1317.51,1322.96,,,,,,,1317.51,,,1322.96,1322.96
39008710,0612,72157,,,,,MMRI THORACIC SPINE WO/W CONTRAST,3788.05,3788.05,1287.94,1287.94,,,,,,,1287.94,,,,
39008716,0612,72158,,,,,MMRI LUMBAR WO/W CONTRAST,3891.07,3891.07,1322.96,1322.96,,,,,,,1322.96,,,1322.96,1322.96
39008718,0614,71551,,,,,MMRI CHEST WITH CONTRAST,2901.82,2901.82,,,,,,,,,,,,,
39008728,0614,71552,,,,,MMRI CHEST WO / W CONTRAST,3210.88,3210.88,,,,,,,,,,,,,
39008734,0610,74183,,,,,MMRI ABDOMEN WO/W CONTRAST,3706.66,3706.66,1259.89,3024.63,,,,,,,1259.89,,,3024.63,3024.63
39008736,0614,74182,,,,,MMRI ABDOMEN WITH CONTRAST,3857.33,3857.33,,,,,,,,,,,,,
39008774,0614,72196,,,,,MMRI PELVIS WITH CONTRAST,3707.17,3707.17,,,,,,,,,,,,,
39008776,0614,72197,,,,,MMRI PELVIS WO / W CONTRAST,4016.23,4016.23,1365.52,1365.52,,,,,,,1365.52,,,,
39008779,0610,76499,,,,,MMRI SPECIFY F/U,1016.75,0.00,,,,,,,,,,,,,
39008785,0610,73223RT,,,,,MMRI SHOULDER JT RIGHT WO/W CONTRAST,3824.88,3824.88,,,,,,,,,,,,,
39008786,0610,73223LT,,,,,MMRI SHOULDER JT LEFT WO/W CONTRAST,3824.88,3824.88,,,,,,,,,,,,,
39008787,0610,73223RT,,,,,MMRI ELBOW JT RIGHT WO/W CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008788,0610,73223LT,,,,,MMRI ELBOW JT LEFT WO/W CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008791,0610,71550,,,,,MMRI GREAT VESSELS WO / W CONTRAST,4285.63,4285.63,,,,,,,,,,,,,
39008797,0610,75553,,,,,MMRI CARDIAC W/CONT,2573.00,0.00,,,,,,,,,,,,,
39008806,0614,73220RT,,,,,MMRI UPPER EXTREMITY RIGHT WO/W CONTRAST,3824.10,3824.10,,,,,,,,,,,,,
39008807,0610,73220LT,,,,,MMRI UPPER EXTREMITY LEFT WO/W CONTRAST,3824.10,3824.10,,,,,,,,,,,,,
39008829,0614,73723LT,,,,,MMRI KNEE LEFT WO / W CONTRAST,3824.10,3824.10,,,,,,,,,,,,,
39008830,0614,73723RT,,,,,MMRI KNEE RIGHT WO / W CONTRAST,3824.10,3824.10,,,,,,,,,,,,,
39008831,0614,73722RT,,,,,MMRI KNEE RIGHT W/CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008832,0614,73722LT,,,,,MMRI KNEE LEFT W/CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008834,0610,73723RT,,,,,MMRI HIP JT RIGHT WO/W CONTRAST,3824.10,3824.10,,,,,,,,,,,,,
39008835,0610,73723LT,,,,,MMRI HIP JT LEFT WO/W CONTRAST,3824.10,3824.10,,,,,,,,,,,,,
39008836,0610,73722RT,,,,,MMRI HIP JT RIGHT W/CONTRAST,3515.04,3515.04,,,,,,,,,,,,,
39008837,0610,73722LT,,,,,MMRI HIP JT LEFT W/CONTRAST,1573.63,1573.63,,,,,,,,,,,,,
4000000,0150,,,,,,ARD/IND LIVING,0.00,0.00,,,,,,,,,,,,,
40000011,0301,80048,,,,,BASIC METABOLIC PANEL POINT OF CARE,91.94,91.94,42.47,93.32,,,93.32,,,,42.47,,,57.52,57.52
40000012,0301,80053,,,,,COMP METABOLIC PANEL POINT OF CARE,168.18,168.18,68.67,114.14,,,114.14,,,,68.67,,,89.90,89.90
40000013,0301,82150,,,,,AMYLASE POINT OF CARE,193.75,193.75,44.89,50.08,,,,,,,50.08,,,44.89,44.89
40000014,0301,82550,,,,,CK POINT OF CARE,76.00,76.00,26.65,50.68,,,,,,,26.65,,,50.68,50.68
40000015,0300,85025,,,,,BACK UP CBC,57.69,57.69,27.89,46.76,,,46.76,,,,27.89,,,37.02,37.02
40000016,0301,82553,,,,,CK-MB POINT OF CARE,104.57,104.57,42.02,73.80,,,71.42,,,,42.02,,,73.80,73.80
40000017,0301,84484,,,,,TROPONIN POINT OF CARE,158.00,158.00,46.10,74.51,,,71.42,,,,46.10,,,74.51,74.51
40000018,0301,83874,,,,,MYOGLOBIN POINT OF CARE,143.00,143.00,44.13,73.84,,,,,,,44.13,,,73.84,73.84
40000019,0300,81003,,,,,URINE DIPSTICK NURSING,0.00,0.00,12.85,25.73,,,25.73,,,,12.85,,,17.32,17.32
40000023,0300,,,,,,CULTURE ORDER,0.00,0.00,0.00,96.73,96.73,96.73,,,,,,,,0.00,0.00
40000026,0300,87077,,,,,ORG ID REF LAB,64.90,64.90,22.35,43.91,,,43.91,,,,22.35,,,25.87,25.87
40000035,0301,84550,,,,,URIC ACID POINT OF CARE,52.60,52.60,15.68,30.29,,,30.26,,,,15.68,,,30.29,30.29
40000055,0301,80051,,,,,ELECTROLYTE PANEL,73.16,73.16,29.32,32.94,,,,,,,32.94,,,29.32,29.32
40000071,0301,80076,,,,,HEPATIC PANEL,117.58,117.58,45.91,174.85,,,174.85,,,,45.91,,,74.15,74.15
40000072,0300,85025,,,,,EMPLOYEE CBC,165.00,165.00,27.89,46.76,,,46.76,,,,27.89,,,37.02,37.02
40000073,0300,81003,,,,,EMPLOYEE URINALYSIS,5.15,5.15,12.85,25.73,,,25.73,,,,12.85,,,17.32,17.32
40000074,0301,80305,,,,,EMPLOYEE NICOTINE SCREEN,3.71,3.71,,,,,,,,,,,,,
40000075,0300,80323,,,,,EMPLOYEE NICOTINE CONFIRM,19.97,19.97,,,,,,,,,,,,,
40000076,0300,86762,,,,,EMPLOYEE RUBELLA,9.35,9.35,,,,,,,,,,,,,
40000077,0300,86765,,,,,EMPLOYEE RUBEOLA,19.19,19.19,,,,,,,,,,,,,
40000078,0300,86735,,,,,EMPLOYEE MUMPS,13.11,13.11,20.86,20.86,,,,,,,20.86,,,,
40000079,0300,86787,,,,,EMPLOYEE VARICELLA,12.03,12.03,,,,,,,,,,,,,
40000080,0300,86706,,,,,EMPLOYEE HEP B AB,227.00,227.00,22.59,22.59,,,,,,,22.59,,,,
40000081,0300,86480,,,,,EMPLOYEE QUANTIFERON TB,56.66,56.66,62.61,62.61,,,,,,,62.61,,,62.61,62.61
40000082,0301,80320,,,,,EMPLOYEE ALCOHOL,19.57,19.57,,,,,,,,,,,,,
40000083,0300,87389,,,,,EMPLOYEE HIV 1/2,18.96,0.00,,,,,,,,,,,,,
40000084,0300,87340,,,,,EMPLOYEE HEP B AG,12.50,0.00,21.63,21.63,,,,,,,,,,21.63,21.63
40000085,0300,86803,,,,,EMPLOYEE HEP C AB,13.57,0.00,27.23,27.23,,,,,,,27.23,,,,
40000121,0301,82040,,,,,ALBUMIN SERUM,44.30,44.30,6.98,8.98,,,,,,,6.98,,,8.98,8.98
40000122,0301,82040,,,,,ALBUMIN REFERRED,11.00,11.00,6.98,8.98,,,,,,,6.98,,,8.98,8.98
40000125,0301,82042,,,,,"ALBUMIN URINE, OR OTHER SOURCES",19.06,19.06,6.35,6.35,,,,,,,6.35,,,,
40000126,0301,83018,,,,,COBALT BLOOD,46.16,46.16,,,,,,,,,,,,,
40000127,0301,82495,,,,,CHROMIUM SERUM,32.97,32.97,,,,,,,,,,,,,
40000128,0301,83018,,,,,IODINE URINE,509.95,509.95,,,,,,,,,,,,,
40000129,0301,82175,,,,,ARSENIC FRACTIONATED,251.12,251.12,,,,,,,,,,,,,
40000130,0301,82175,,,,,ARSENIC - QUANTITATIVE,91.94,91.94,,,,,,,,,,,,,
40000131,0301,82190,,,,,ATOMIC ABSORPTION SPECT. EA ANALYTE,459.50,0.00,,,,,,,,,,,,,
40000132,0301,82300,,,,,CADMIUM - BLOOD,103.02,103.02,,,,,,,,,,,,,
40000133,0301,82108,,,,,ALUMINUM - SERUM,84.25,0.00,,,,,,,,,,,,,
40000135,0300,86735,,,,,MUMPS AB IGM,82.68,82.68,20.86,20.86,,,,,,,20.86,,,,
40000136,0302,86747,,,,,B-19 PARVOVIRUS IGG,56.49,56.49,,,,,,,,,,,,,
40000137,0302,86747,,,,,B-19 PARVOVIRUS IGM,56.49,56.49,,,,,,,,,,,,,
40000145,0301,83695,,,,,LIPOPROTEIN (LITTLE A),60.52,60.52,,,,,,,,,,,,,
40000147,0301,82150,,,,,AMYLASE SERUM,193.75,193.75,44.89,50.08,,,,,,,50.08,,,44.89,44.89
40000150,0301,82150,,,,,AMYLASE BODY FLUID,86.00,86.00,44.89,50.08,,,,,,,50.08,,,44.89,44.89
40000151,0301,83690,,,,,LIPASE-BODY FLUID,95.00,95.00,28.99,54.36,,,54.36,,,,28.99,,,46.28,46.28
40000152,0300,C9803,,,,,SPEC COLL SNF/LAB COVID-19,89.11,89.11,0.00,37.43,,,0.00,,,,30.31,,,37.43,37.43
40000153,0300,G2023,,,,,SPECIMEN COLLECT COVID-19,82.11,82.11,27.92,27.92,,,,,,,27.92,,,,
40000154,0301,84520,,,,,UREA NITROGEN SERUM,44.30,44.30,11.07,29.50,,,11.07,,,,19.28,,,29.50,29.50
40000155,0300,86612,,,,,BLASTOMYCES AB-BY ID,55.63,55.63,,,,,,,,,,,,,
40000159,0301,84540,,,,,RENAL FAILURE INDICIES 5,18.50,0.00,,,,,,,,,,,,,
40000160,0301,84540,,,,,UREA NITROGEN URINE,59.00,59.00,,,,,,,,,,,,,
40000161,0301,84540,,,,,UREA NITROGEN 24 HR URINE,59.00,59.00,,,,,,,,,,,,,
40000162,0301,82150,,,,,AMYLASE URINE,193.75,193.75,44.89,50.08,,,,,,,50.08,,,44.89,44.89
40000165,0301,82164,,,,,ANGIOTENSIN I - CONVERTING ENZYME (ACE),74.43,74.43,25.31,25.31,,,,,,,25.31,,,,
40000168,0301,82374,,,,,TCO2 BICARBONATE,32.00,32.00,,,,,,,,,,,,,
40000170,0301,82247,,,,,BILIRUBIN TOTAL,44.30,44.30,36.15,36.15,,,,,,,,,,36.15,36.15
40000171,0300,U0003,,,,,SARS-COV-2 COVID-19 AMP PRB HIGH THROUGH,297.50,297.50,100.00,115.58,,,100.00,,,,101.16,,,115.58,115.58
40000188,0301,82248,,,,,BILIRUBIN DIRECT,44.88,44.88,18.70,30.26,,,30.26,,,,18.70,,,25.50,25.50
40000196,0301,82310,,,,,CALCIUM-SERUM,44.30,44.30,15.03,15.51,,,,,,,15.03,,,15.51,15.51
40000220,0301,82465,,,,,CHOLESTEROL TOTAL,44.30,44.30,,,,,,,,,,,,,
40000238,0301,82550,,,,,CK SERUM,76.00,76.00,26.65,50.68,,,,,,,26.65,,,50.68,50.68
40000239,0301,82550,,,,,REFERRED CK,76.00,76.00,26.65,50.68,,,,,,,26.65,,,50.68,50.68
40000246,0301,82565,,,,,CREATININE-SERUM,50.40,50.40,11.07,32.51,,,11.07,,,,21.01,,,32.51,32.51
40000249,0301,82570,,,,,CREATININE-BODY FLUI,53.60,53.60,19.83,25.68,,,,,,,19.83,,,25.68,25.68
40000250,0301,82570,,,,,CREATININE-URINE,53.60,53.60,19.83,25.68,,,,,,,19.83,,,25.68,25.68
40000251,0301,82570,,,,,CREATININE 24 HR URINE,53.60,53.60,19.83,25.68,,,,,,,19.83,,,25.68,25.68
40000252,0301,82570,,,,,RENAL FAILURE INDICIES 4,18.50,0.00,19.83,25.68,,,,,,,19.83,,,25.68,25.68
40000253,0301,82575,,,,,CREATININE CLEARANCE,96.59,96.59,32.72,32.84,,,,,,,32.72,,,32.84,32.84
40000279,0301,82947,,,,,GLUCOSE,42.00,42.00,17.79,18.13,,,,,,,18.13,,,17.79,17.79
40000287,0301,82950,,,,,GLUCOSE PRANDIAL,38.25,0.00,,,,,,,,,,,,,
40000288,0301,82945,,,,,RENAL FAILURE INDICIES 3,18.50,0.00,14.86,14.86,,,,,,,14.86,,,,
40000289,0301,82945,,,,,GLUCOSE URINE,44.30,44.30,14.86,14.86,,,,,,,14.86,,,,
40000290,0301,82945,,,,,GLUCOSE 24 HR URINE,19.06,19.06,14.86,14.86,,,,,,,14.86,,,,
40000291,0301,82945,,,,,GLUCOSE BODY FLUID,44.30,44.30,14.86,14.86,,,,,,,14.86,,,,
40000295,0301,82951,,,,,GLUCOSE TLRNCE (1ST 3 SPEC.),117.96,117.96,,,,,,,,,,,,,
40000303,0301,82952,,,,,GLUCOSE TOL SR HOUR 4,19.06,19.06,,,,,,,,,,,,,
40000304,0301,82952,,,,,GLUCOSE TOL SR HOUR 5,19.06,19.06,,,,,,,,,,,,,
40000335,0301,83605,,,,,"LACTIC ACID, ARTERIAL",114.00,114.00,31.11,38.76,,,,,,,31.11,,,38.76,38.76
40000336,0301,83605,,,,,"LACTIC ACID, VENOUS",91.94,91.94,31.11,38.76,,,,,,,31.11,,,38.76,38.76
40000337,0301,83615,,,,,LDH SERUM,59.00,59.00,20.04,36.15,,,,,,,20.04,,,36.15,36.15
40000338,0301,83615,,,,,LDH BODY FLUID,59.00,59.00,20.04,36.15,,,,,,,20.04,,,36.15,36.15
40000339,0300,83630,,,,,LACTOFERIN STOOL,88.08,88.08,,,,,,,,,,,,,
40000344,0301,84105,,,,,PHOSPHORUS URINE,101.28,101.28,,,,,,,,,,,,,
40000345,0301,84100,,,,,PHOSPHORUS SERUM,44.30,44.30,15.05,15.51,,,,,,,15.05,,,15.51,15.51
40000346,0301,84105,,,,,PHOPHORUS 24 HR URINE,46.00,46.00,,,,,,,,,,,,,
40000350,0301,84133,,,,,POTASSIUM URINE,48.86,48.86,9.77,9.77,,,,,,,9.77,,,,
40000351,0301,84133,,,,,POTASSIUM 24 HR URINE,48.86,48.86,9.77,9.77,,,,,,,9.77,,,,
40000352,0301,84132,,,,,POTASSIUM BLOOD,47.00,47.00,15.02,15.98,,,,,,,15.02,,,15.98,15.98
40000353,0301,84132,,,,,FULL ARTERIAL PROFILE 3,18.50,0.00,15.02,15.98,,,,,,,15.02,,,15.98,15.98
40000354,0301,84134,,,,,PREALBUMIN,81.39,81.39,27.92,27.92,,,,,,,27.92,,,,
40000355,0301,84132,,,,,POTASSIUM BLOOD GAS,47.00,47.00,15.02,15.98,,,,,,,15.02,,,15.98,15.98
40000360,0300,82157,,,,,ANDROSTENDIONE,130.25,0.00,,,,,,,,,,,,,
40000367,0300,85549,,,,,"LYSOZYME, SERUM OR BODY FLUID",59.00,0.00,,,,,,,,,,,,,
40000373,0301,83930,,,,,OSMOLALITY SERUM MEASURED,27.82,27.82,,,,,,,,,,,,,
40000374,0301,83935,,,,,OSMOLALITY URINE MEASURED,40.18,40.18,13.39,13.39,,,,,,,13.39,,,,
40000375,0301,83986,,,,,PH BODY FLUID,52.79,52.79,17.77,17.77,,,,,,,17.77,,,,
40000394,0301,84450,,,,,AST SERUM,44.30,44.30,15.06,15.06,,,,,,,15.06,,,,
40000402,0301,84460,,,,,ALT SERUM,44.30,44.30,14.96,15.06,,,,,,,14.96,,,15.06,15.06
40000405,0301,82671,,,,,ESTROGEN SERUM FRACTION,189.82,189.82,64.83,154.89,,,128.42,,,,64.83,,,154.89,154.89
40000410,0301,82977,,,,,GAMMA GT,44.81,44.81,15.24,15.24,,,,,,,15.24,,,,
40000427,0301,84295,,,,,FULL ARTERIAL PROFILE 2,43.00,0.00,15.06,15.06,,,,,,,,,,15.06,15.06
40000428,0301,84295,,,,,SODIUM BLOOD,44.30,44.30,15.06,15.06,,,,,,,,,,15.06,15.06
40000429,0301,84302,,,,,SODIUM BF,44.30,44.30,,,,,,,,,,,,,
40000430,0301,84295,,,,,SODIUM BLOOD GAS,44.30,44.30,15.06,15.06,,,,,,,,,,15.06,15.06
40000433,0300,86162,,,,,COMPLEMENT TOTAL (CH50),97.61,97.61,,,,,,,,,,,,,
40000436,0301,84155,,,,,PROTEIN TOTAL,90.00,90.00,,,,,,,,,,,,,
40000437,0301,84155,,,,,TOTAL PROTEIN REF LAB,42.00,42.00,,,,,,,,,,,,,
40000444,0301,84550,,,,,URIC ACID SERUM,52.60,52.60,15.68,30.29,,,30.26,,,,15.68,,,30.29,30.29
40000446,0301,84560,,,,,URIC ACID BF/URINE,44.40,44.40,15.03,15.03,,,,,,,15.03,,,,
40000447,0301,84560,,,,,URIC ACID 24 HR URINE,44.40,44.40,15.03,15.03,,,,,,,15.03,,,,
40000459,0301,,,,,,MCH X,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40000469,0300,85002,,,,,BLEEDING TIME,105.00,105.00,,,,,,,,,,,,,
40000481,0310,81403,,,,,JAK2 EXON 12,1087.89,1087.89,,,,,,,,,,,,,
40000483,0310,81401,,,,,TPMT GENETICS,1058.02,1058.02,,,,,,,,,,,,,
40000484,0310,81403,,,,,KRAS VAREXON,355.42,355.42,,,,,,,,,,,,,
40000485,0310,81275,,,,,KRAS GENE ANALYSIS,355.42,355.42,,,,,,,,,,,,,
40000486,0310,81256,,,,,HEMOCHROMATOSIS HFE 3 MUTATIONS,255.56,255.56,,,,,,,,,,,,,
40000487,0310,81479,,,,,IBD SGI DIAGNOSTIC,88.13,0.00,,,,,,,,,,,,,
40000488,0310,81291,,,,,MTHFR,255.35,255.35,,,,,,,,,,,,,
40000489,0310,81240,,,,,PROTHROMBIN GENE MUTATION,272.35,272.35,,,,,,,,,,,,,
40000490,0310,81241,,,,,FACTOR V LEIDEN I,230.76,230.76,,,,,,,,,,,,,
40000491,0310,81270,,,,,JAK 2 GENE ANALYSIS,386.32,386.32,,,,,,,,,,,,,
40000492,0311,88271,,,,,CYTOGENETICS DNA PROBE FISH MDS,271.06,271.06,90.32,90.32,,,,,,,90.32,,,,
40000493,0311,88271,,,,,MOLECULAR CYTOGENETICS DNA PROBE,275.72,275.72,90.32,90.32,,,,,,,90.32,,,,
40000494,0310,88368,,,,,INSITU HYBRID MORPHOMETRIC MANUAL,734.02,734.02,,,,,,,,,,,,,
40000495,0300,85244,,,,,FACTOR VIII RELATED AG,134.18,134.18,,,,,,,,,,,,,
40000496,0311,88273,,,,,MOLECULAR CYTOGENETICS FISH 10-30,159.17,159.17,,,,,,,,,,,,,
40000497,0310,88364,,,,,INSITU HYBRID MORPHOMETRIC AUTO,373.19,373.19,,,,,,,,,,,,,
40000498,0310,88381,,,,,MICRODISSECTION NAMUAL,61.81,61.81,,,,,,,,,,,,,
40000499,0310,88368,,,,,ALK MORPHOMETRIC ANALYSIS,701.17,701.17,,,,,,,,,,,,,
4000050,0150,,,,,,MED TRAY REFILL,0.00,0.00,,,,,,,,,,,,,
40000500,0310,81235,,,,,EGFR GENE ANALYSIS,579.49,579.49,,,,,,,,,,,,,
40000501,0310,81301,,,,,MSI ANALYSIS,473.89,473.89,,,,,,,,,,,,,
40000502,0300,83516,,,,,DGP IGG,63.61,63.61,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40000503,0310,81206,,,,,BCR ABL BY PCR,1162.77,1162.77,,,,,,,,,,,,,
40000504,0310,81162,,,,,BRCA 1 AND 2,5691.86,5691.86,,,,,,,,,,,,,
40000505,0301,82668,,,,,ERYTHROPOIETIN,105.86,105.86,35.27,35.27,,,,,,,35.27,,,,
40000506,0311,88271,,,,,MOLECULAR CYTO DNA PROBE-MAYO,1816.59,1816.59,90.32,90.32,,,,,,,90.32,,,,
40000507,0311,88271,,,,,CYTO DNA PROBE BALLF,484.17,484.17,90.32,90.32,,,,,,,90.32,,,,
4000051,0150,,,,,,SPECIAL ESCORT SVC,0.00,0.00,,,,,,,,,,,,,
40000510,0310,88363,,,,,ARCHIVAL TISSUE MOLECULAR,40.18,40.18,13.97,13.97,,,,,,,13.97,,,,
40000511,0311,88271,,,,,FISH PLASMA CELL MAYO,736.59,736.59,90.32,90.32,,,,,,,90.32,,,,
40000513,0301,83516,,,,,GBM GLOM BASEMENT MEMBRANE,17.98,17.98,,,,,,,,,,,,,
40000514,0311,88271,,,,,MISC MOL CYTO DNA PROBE,65.65,65.65,90.32,90.32,,,,,,,90.32,,,,
40000519,0300,89190,,,,,EOSINOPHIL COUNT NASAL,47.64,47.64,,,,,,,,,,,,,
4000052,0150,,,,,,MEAL ADJUSTMENT,0.00,0.00,,,,,,,,,,,,,
40000520,0300,81015,,,,,EOSINOPHILS URINE,9.79,9.79,,,,,,,,,,,,,
40000521,0300,81015,,,,,URINE MICROSCOPIC,13.66,13.66,,,,,,,,,,,,,
40000526,0300,85520,,,,,HEPARIN ANTI-XA,69.28,69.28,,,,,,,,,,,,,
40000527,0300,85384,,,,,FIBRINOGEN,114.87,114.87,,,,,,,,,,,,,
40000528,0305,85397,,,,,FACTOR VWF GPIBM,311.84,311.84,,,,,,,,,,,,,
40000535,0300,85014,,,,,HEMATOCRIT X,16.64,16.64,2.76,5.54,,,,,,,5.54,,,2.76,2.76
4000054,0150,,,,,,ROOM HOLDING CHARGE-COMMONS,0.00,0.00,,,,,,,,,,,,,
40000543,0300,85018,,,,,HEMOGLOBIN X,73.80,73.80,11.97,12.24,,,,,,,11.97,,,12.24,12.24
40000544,0300,83051,,,,,HEMOGLOBIN - PLASMA,93.75,93.75,,,,,,,,,,,,,
40000545,0300,85018,,,,,HEMOGLOBIN BLOOD GAS,33.00,33.00,11.97,12.24,,,,,,,11.97,,,12.24,12.24
40000547,0300,,,,,,RBC X,0.00,0.00,0.00,96.73,96.73,96.73,,,,,,,,0.00,0.00
40000548,0301,,,,,,MCV X,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40000584,0300,85048,,,,,WBC X,24.47,24.47,,,,,,,,,,,,,
40000586,0300,85540,,,,,LEUK ALKA PHOS(LAP),52.50,0.00,,,,,,,,,,,,,
40000600,0300,85049,,,,,PLATELET COUNT X,27.56,27.56,,,,,,,,,,,,,
40000603,0300,85032,,,,,PLATELET COUNT-MAN,65.00,65.00,,,,,,,,,,,,,
40000604,0305,85032,,,,,WBC COUNT MANUAL,46.25,0.00,,,,,,,,,,,,,
40000606,0390,P9059,,,,,PLASMA FROZEN WITHIN 24 HOURS,244.68,244.68,84.91,84.91,,,,,,,84.91,,,,
40000610,0301,84244,,,,,RENIN LEVEL,104.31,104.31,35.47,35.47,,,,,,,35.47,,,,
40000611,0300,84238,,,,,SOLUBLE TRANSFERRIN RECEPTOR,75.97,75.97,,,,,,,,,,,,,
40000617,0305,85597,,,,,HEXAGONAL PHASE PHOSPHOLIPID,68.51,68.51,,,,,,,,,,,,,
40000618,0300,85610,,,,,PT(PROTHROMBIN TIME),50.00,50.00,18.66,32.54,,,32.54,,,,18.66,,,21.62,21.62
40000619,0300,85670,,,,,THROMBIN TIME,51.77,51.77,,,,,,,,,,,,,
40000620,0300,85613,,,,,DILUTE RUSSELL VIPER VENOM TIME,86.80,86.80,,,,,,,,,,,,,
40000621,0300,85611,,,,,PT MIXING STUDY,17.77,17.77,,,,,,,,,,,,,
40000626,0300,85730,,,,,PTT PARTL THRMBPLSTN,81.00,81.00,26.94,42.92,,,42.92,,,,26.94,,,37.14,37.14
40000627,0300,85307,,,,,APC RESISTANCE PROFILE,100.18,100.18,,,,,,,,,,,,,
40000628,0300,85732,,,,,APTT MIXING STUDY,29.11,29.11,,,,,,,,,,,,,
40000629,0300,85810,,,,,VISCOSITY,67.97,67.97,,,,,,,,,,,,,
40000634,0300,85045,,,,,RETICULOCYTE COUNT,93.75,93.75,31.88,32.26,,,,,,,32.26,,,31.88,31.88
40000638,0300,86430,,,,,RA FACTOR-FLUID,67.00,67.00,28.26,41.54,,,40.81,,,,28.26,,,41.54,41.54
40000640,0302,86235,,,,,SCL-70 AB,19.76,19.76,,,,,,,,,,,,,
40000642,0300,85652,,,,,SED RATE ESR,49.00,49.00,19.40,41.48,,,41.48,,,,19.40,,,25.19,25.19
40000645,0300,89325,,,,,SPERM ANTIBODIES,286.75,0.00,,,,,,,,,,,,,
40000659,0300,85660,,,,,SICKLE CELL SCREEN,16.10,16.10,,,,,,,,,,,,,
40000660,0301,83516,,,,,ANTI PM/SCL-100,301.33,301.33,,,,,,,,,,,,,
40000665,0300,86593,,,,,RPR QUANT,61.04,61.04,,,,,,,,,,,,,
40000667,0300,86592,,,,,RPR QUAL,45.84,45.84,,,,,,,,,,,,,
40000669,0300,87420,,,,,RSV,63.61,63.61,,,,,,,,,,,,,
40000675,0300,86308,,,,,MONO TEST,69.00,69.00,47.70,47.70,,,,,,,,,,47.70,47.70
40000676,0300,86308,,,,,HETEROPHILE ANTIBODY,27.00,0.00,47.70,47.70,,,,,,,,,,47.70,47.70
40000683,0300,83883,,,,,ASO TITER,221.00,221.00,28.80,28.80,,,,,,,,,,28.80,28.80
40000695,0300,86332,,,,,RAJI CELL ASSAY,131.50,0.00,,,,,,,,,,,,,
40000698,0300,86000,,,,,FEBRILE AGGLUTININS,31.50,0.00,,,,,,,,,,,,,
40000699,0300,86003,,,,,RAST TEST (ALLERGEN),29.40,29.40,6.93,6.93,,,,,,,6.93,,,,
40000700,0300,86331,,,,,IMMUNODI FUSION,14.25,0.00,,,,,,,,,,,,,
40000701,0302,86003,,,,,GALACTOSE ALPHA ALLERGEN,76.45,76.45,,,,,,,,,,,,,
40000702,0300,86003,,,,,ALLERGEN PENICILLIN,76.45,76.45,6.93,6.93,,,,,,,6.93,,,,
40000703,0300,86003,,,,,ALLERGEN APPLE,76.45,76.45,6.93,6.93,,,,,,,6.93,,,,
40000704,0300,86003,,,,,ALLERGENS BRAZIL NUT,76.45,76.45,6.93,6.93,,,,,,,6.93,,,,
40000705,0300,86003,,,,,ALLERGENS PISTACHIO,29.40,29.40,6.93,6.93,,,,,,,6.93,,,,
40000712,0390,P9016,,,,,RBC S PER UNIT,617.20,617.20,211.13,433.32,,,,,,,211.13,,,433.32,433.32
40000713,0390,P9040,,,,,RBC L/R IRRADIATED,896.07,896.07,,,,,,,,,,,,,
40000715,0300,86431,,,,,RA TITER QUANT,71.85,71.85,24.45,49.07,,,49.07,,,,24.45,,,,
40000717,0300,86430,,,,,RA FACTOR QUAL,67.00,67.00,28.26,41.54,,,40.81,,,,28.26,,,41.54,41.54
40000720,0301,82482,,,,,RBC CHOLINESTERASE,72.25,0.00,,,,,,,,,,,,,
40000725,0300,86157,,,,,COLD AGGLUTININS,62.33,62.33,,,,,,,,,,,,,
40000726,0301,82525,,,,,COPPER SERUM,63.61,63.61,21.81,21.81,,,,,,,21.81,,,,
40000727,0301,84255,,,,,SELENIUM,102.72,102.72,,,,,,,,,,,,,
40000728,0301,82525,,,,,COPPER URINE,133.93,133.93,21.81,21.81,,,,,,,21.81,,,,
40000790,0300,81002,,,,,URINE DIPSTICK,23.75,0.00,,,,,,,,,,,,,
40000810,0300,86735,,,,,MUMPS ANTIBODY IGG,38.90,38.90,20.86,20.86,,,,,,,20.86,,,,
40000816,0301,84703,,,,,PREG TEST(UCG)UR,101.00,101.00,34.34,73.58,,,56.22,,,,34.34,,,73.58,73.58
40000820,0301,84703,,,,,PREG TEST (HCG) SER,101.00,101.00,34.34,73.58,,,56.22,,,,34.34,,,73.58,73.58
40000824,0300,81003,,,,,URINALYSIS C/S IF INDICATED,37.85,37.85,12.85,25.73,,,25.73,,,,12.85,,,17.32,17.32
40000832,0300,81050,,,,,URINE VOLUME,21.63,21.63,,,,,,,,,,,,,
40000840,0300,87172,,,,,PINWORMS TAPE TEST,51.51,51.51,,,,,,,,,,,,,
40000841,0306,87169,,,,,PARASITE MACROSCOPIC,25.65,25.65,,,,,,,,,,,,,
40000850,0390,P9035,,,,,"PLATELETS, PHERESIS",1876.35,1876.35,,,,,,,,,,,,,
40000857,0300,87329,,,,,GIARDIA AG,80.61,80.61,27.35,27.41,,,,,,,27.35,,,27.41,27.41
40000860,0301,84600,,,,,METHANOL BLOOD,56.25,0.00,,,,,,,,,,,,,
40000861,0301,83921,,,,,METHYLMALONIC ACID,166.38,166.38,55.44,55.44,,,,,,,55.44,,,,
40000865,0301,82270,,,,,BLD OCCULT - COLORECTAL SCREENING,18.50,0.00,,,,,,,,,,,,,
40000866,0301,82271,,,,,BLD OCCULT - OTHER SOURCES THAN FEC,18.50,0.00,,,,,,,,,,,,,
40000867,0301,82272,,,,,BLD OCCULT - FECES NONSCREENING,18.50,0.00,,,,,,,,,,,,,
40000868,0300,82274QW,QW,,,,BLD OCCULT FECAL IMMUNO CHEMICAL,107.00,107.00,,,,,,,,,,,,,
40000869,0300,82274,,,,,BLD OCCULT FECAL IMMUNO DIAGNOSTIC,70.00,70.00,15.44,15.44,,,,,,,15.44,,,,
40000872,0300,87209,,,,,TRICHROME STAIN,86.54,86.54,,,,,,,,,,,,,
40000873,0306,87205,,,,,GRAM STAIN,57.00,57.00,18.36,38.19,,,38.19,,,,18.36,,,25.57,25.57
40000874,0300,87270,,,,,CHLAMYDIA TRACH OMATIS DFA,84.48,84.48,,,,,,,,,,,,,
40000875,0300,87177,,,,,OVA & PARASITE SMEAR-DIRECT,50.48,50.48,,,,,,,,,,,,,
40000876,0300,87272,,,,,FLUORESCENT TECHNIQUE CRYPTOSPORIDM,45.50,0.00,,,,,,,,,,,,,
40000884,0300,86255,,,,,FLUORES NONINFECT AGENT AB;EA,101.25,101.25,49.19,49.30,,,,,,,49.19,,,49.30,49.30
40000885,0300,86256,,,,,FLUORES NONINFECT AGENT TITER,101.25,101.25,,,,,,,,,,,,,
40000886,0300,86255,,,,,"SMOOTH MUSCLE AB, IGG",54.09,54.09,49.19,49.30,,,,,,,49.19,,,49.30,49.30
40000887,0300,86256,,,,,SMOOTH MUSCLE TITER,54.34,54.34,,,,,,,,,,,,,
40000888,0300,86255,,,,,RETUCULIN AB IGA,89.36,89.36,49.19,49.30,,,,,,,49.19,,,49.30,49.30
40000889,0302,86255,,,,,AGNA 1,207.59,207.59,,,,,,,,,,,,,
40000890,0302,86255,,,,,AMPHIPHYSIN,207.59,207.59,,,,,,,,,,,,,
40000891,0302,86255,,,,,ANNA 1,207.59,207.59,,,,,,,,,,,,,
40000892,0302,86255,,,,,ANNA 2,207.59,207.59,,,,,,,,,,,,,
40000893,0302,86255,,,,,ANNA 3,207.59,207.59,,,,,,,,,,,,,
40000894,0302,86255,,,,,CRMP 5 IGG,207.59,207.59,,,,,,,,,,,,,
40000895,0302,86255,,,,,PCA 1,207.59,207.59,,,,,,,,,,,,,
40000896,0302,86255,,,,,PCA 2,207.59,207.59,,,,,,,,,,,,,
40000897,0302,86255,,,,,PCA TR,207.59,207.59,,,,,,,,,,,,,
40000898,0302,86255,,,,,ENDOMYSIAL AB,164.06,164.06,,,,,,,,,,,,,
40000900,0301,80154,,,,,VALIUM (DIAZEPAM),96.00,0.00,,,,,,,,,,,,,
40000914,0306,87185,,,,,SENSI ENZYME DIRECT,9.03,9.03,,,,,,,,,,,,,
40000915,0300,87184,,,,,SENSITIVITY ORGANISM 1,81.11,81.11,,,,,,,,,,,,,
40000916,0300,87186,,,,,REF SUSCEPTIBILITY,74.43,74.43,,,,,,,,,,,,,
40000917,0300,87184,,,,,SENSITIVITY ORGANISM 2,72.25,0.00,,,,,,,,,,,,,
40000918,0300,87184,,,,,SENSITIVITY ORGANISM 3,72.25,0.00,,,,,,,,,,,,,
40000919,0300,87184,,,,,SENSITIVITY ORGANISM 4,72.25,0.00,,,,,,,,,,,,,
40000920,0306,87186,,,,,SUSCEPT SLOW GROWER,696.42,696.42,30.22,50.36,,,50.36,,,,30.22,,,33.59,33.59
40000923,0300,87081,,,,,CULTURE-STREP ONLY,76.35,76.35,37.82,52.80,,,,,,,37.82,,,52.80,52.80
40000931,0306,87186,,,,,SUSCEPTIBILITY 1,74.43,74.43,30.22,50.36,,,50.36,,,,30.22,,,33.59,33.59
40000932,0306,87186,,,,,SUSCEPTIBILITY 2,91.20,91.20,30.22,50.36,,,50.36,,,,30.22,,,33.59,33.59
40000933,0306,87186,,,,,SUSCEPTIBILITY 3,72.25,0.00,30.22,50.36,,,50.36,,,,30.22,,,33.59,33.59
40000934,0306,87186,,,,,SUSCEPTIBILITY 4,72.25,0.00,30.22,50.36,,,50.36,,,,30.22,,,33.59,33.59
40000935,0306,87181,,,,,SENSITIVITY REFERRED,50.30,50.30,,,,,,,,,,,,,
40000955,0301,82232,,,,,BETA-2-MICRGLBLN SER,81.39,81.39,27.67,27.67,,,,,,,27.67,,,,
40000956,0300,87880,,,,,STREP A ANTIGEN,65.00,65.00,15.46,15.46,,,,,,,15.46,,,,
40000964,0300,87070,,,,,CULTURE-EXUDATE/WND,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40000972,0300,87045,,,,,CULTURE-FECES,0.00,0.00,29.86,94.18,,,,,,,29.86,,,94.18,94.18
40000980,0300,87070,,,,,CULTURE-TISSUE,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40000995,0300,87075,,,,,CULTURE-ANAEROBIC,133.00,133.00,16.67,89.11,,,89.11,,,,33.55,,,16.67,16.67
40000998,0300,87040,,,,,CULTURE BLOOD 1,157.50,157.50,33.65,40.44,,,,,,,40.44,,,33.65,33.65
40000999,0300,87040,,,,,CULTURE BLOOD 2,106.89,106.89,33.65,40.44,,,,,,,40.44,,,33.65,33.65
40001004,0300,87081,,,,,CULTURE-GC,38.25,0.00,37.82,52.80,,,,,,,37.82,,,52.80,52.80
40001005,0300,87070,,,,,CULTURE-BRONC WASH,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40001006,0306,87081,,,,,CULTURE-MRSA PRE OP,92.72,92.72,36.64,62.93,,,62.93,,,,36.64,,,51.52,51.52
40001007,0300,87081,,,,,CULTURE MRSA SURVEILLANCE,76.35,76.35,37.82,52.80,,,,,,,37.82,,,52.80,52.80
40001008,0300,87081,,,,,CULTURE - LEGIONELLA,79.86,79.86,37.82,52.80,,,,,,,37.82,,,52.80,52.80
40001009,0300,87081,,,,,CULTURE VRE,76.35,76.35,37.82,52.80,,,,,,,37.82,,,52.80,52.80
40001010,0300,86927,,,,,FROZEN COMPONENT THAWING,701.17,701.17,,,,,,,,,,,,,
40001012,0300,87070,,,,,CULTURE UROGENITAL,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40001013,0300,87081,,,,,CULTURE VRE SCREEN,76.35,76.35,37.82,52.80,,,,,,,37.82,,,52.80,52.80
40001038,0300,87070,,,,,CULTURE-SPUTUM,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40001046,0300,87070,,,,,CULTURE-SPINAL FLUID,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40001053,0300,87070,,,,,CULTURE-EAR,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40001061,0300,87070,,,,,CULTURE-EYE,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40001079,0306,87086,,,,,CULTURE-URINE,87.00,87.00,30.50,48.86,,,48.86,,,,30.50,,,41.72,41.72
40001087,0300,87070,,,,,CULTURE-THROAT,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40001095,0300,87070,,,,,CULTURE-NOSE,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40001107,0301,80048,,,,,BASIC MET PANEL,116.28,116.28,42.47,93.32,,,93.32,,,,42.47,,,57.52,57.52
40001111,0300,83516,,,,,ANTI-GBM PANEL (GBM ELISA),182.75,0.00,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40001112,0301,80053,,,,,COMP MET PANEL,168.18,168.18,68.67,114.14,,,114.14,,,,68.67,,,89.90,89.90
40001113,0300,83516,,,,,IM. ASSAY NOT INFECTIOUS AG OR AB,58.00,58.00,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40001114,0301,83520,,,,,RNA POLYMERASE III IGG,133.93,133.93,,,,,,,,,,,,,
40001115,0300,83516,,,,,GLUTAMIC ACID DECARBOXYIASE AB,86.54,86.54,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40001116,0301,83516,,,,,HISTONE AB,66.96,66.96,,,,,,,,,,,,,
40001141,0301,83586,,,,,17 KETOSTEROIDS (TOTAL),83.25,0.00,,,,,,,,,,,,,
40001142,0301,83498,,,,,17 HYDROXYPROGESTERONE,94.75,0.00,,,,,,,,,,,,,
40001185,0300,36416,,,,,BLOOD DRAW - CAPILLARY,16.23,16.23,,,,,,,,,,,,,
40001186,0300,36415,,,,,BLOOD DRAWING,16.23,16.23,7.20,13.12,,,13.12,,,,7.20,,,10.41,10.41
40001212,0750,43756,,,,,MELTZER-LYONS TEST,46.25,0.00,,,,,,,,,,,,,
40001238,0301,82553,,,,,CK-MB,131.00,131.00,42.02,73.80,,,71.42,,,,42.02,,,73.80,73.80
40001239,0301,82552,,,,,CK ISOENZYMES,70.31,70.31,,,,,,,,,,,,,
40001276,0300,86738,,,,,MYCOPLASMA PN IgG,49.98,49.98,,,,,,,,,,,,,
40001278,0301,83874,,,,,MYOGLOBIN-SERUM,143.00,143.00,44.13,73.84,,,,,,,44.13,,,73.84,73.84
40001279,0301,80192,,,,,PROCAINMIDE & NAPA,88.00,0.00,,,,,,,,,,,,,
40001280,0301,80188,,,,,PRIMIDONE-MYSOLINE,88.00,0.00,,,,,,,,,,,,,
40001285,0300,89320,,,,,SEMEN ANALYSIS,76.25,0.00,,,,,,,,,,,,,
40001293,0940,99195,,,,,PHLEBOTOMY THERAPUTIC,305.29,305.29,103.23,103.23,,,,,,,103.23,,,,
40001304,0306,87799,,,,,EBV QUANT PCR,284.59,284.59,,,,,,,,,,,,,
40001305,0300,86663,,,,,EBV ABS-EA,48.93,48.93,16.64,39.93,,,,,,,16.64,,,39.93,39.93
40001306,0300,86790,,,,,HANTA VIRUS IgG,94.75,0.00,,,,,,,,,,,,,
40001307,0300,86789,,,,,WEST NILE VIRUS ABS,183.38,183.38,,,,,,,,,,,,,
40001308,0300,86790,,,,,HTLV I/II ANTIBODIES,37.09,37.09,,,,,,,,,,,,,
40001309,0302,86790,,,,,PARAINFLUENZA IGG,48.25,0.00,,,,,,,,,,,,,
40001319,0300,86922,,,,,CROSSMATCH AHG,99.00,0.00,,,,,,,,,,,,,
40001320,0300,86920,,,,,CROSSMATCH UNIT 2,344.94,344.94,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001321,0300,86920,,,,,CROSSMATCH UNIT 3,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001322,0300,86920,,,,,CROSSMATCH UNIT 4,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001323,0300,86920,,,,,CROSSMATCH UNIT 5,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001324,0300,86920,,,,,CROSSMATCH UNIT 6,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001325,0300,86920,,,,,CROSSMATCH,344.94,344.94,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001326,0300,86920,,,,,CROSSMATCH UNIT 12,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001327,0300,86901,,,,,BLD TYPG RH ONLY,102.15,102.15,34.95,54.72,,,,,,,34.95,,,54.72,54.72
40001328,0300,86920,,,,,CROSSMATCH UNIT 7,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001329,0300,86920,,,,,CROSSMATCH UNIT 8,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001330,0300,86921,,,,,CROSSMATCH 37C,84.25,0.00,,,,,,,,,,,,,
40001331,0300,86920,,,,,CROSSMATCH UNIT 9,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001332,0300,86920,,,,,CROSSMATCH UNIT 10,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001333,0300,86920,,,,,CROSSMATCH UNIT 11,69.75,0.00,117.59,172.01,,,,,,,117.59,,,172.01,172.01
40001335,0300,86850,,,,,ANTIBODY SCREEN,159.87,159.87,55.35,88.48,,,,,,,55.35,,,88.48,88.48
40001336,0300,86971,,,,,RBC ENZYME TREATMENT,133.93,133.93,45.16,45.16,,,,,,,45.16,,,,
40001337,0300,86805,,,,,PLATELET CROSSMATCH MACE 1,224.32,224.32,,,,,,,,,,,,,
40001338,0300,86922,,,,,PLATELET CROSSMATCH MACE 2,352.33,352.33,,,,,,,,,,,,,
40001343,0300,86880,,,,,DIRECT COOMBS TEST,100.44,100.44,33.47,33.47,,,,,,,33.47,,,,
40001345,0300,86682,,,,,ECHINOCOCCUS AB,87.00,0.00,,,,,,,,,,,,,
40001426,0301,82088,,,,,ALDOSTERNE URINE,125.43,125.43,42.65,42.65,,,,,,,42.65,,,,
40001427,0301,84075,,,,,ALKALINE PHOSPHATASE,44.30,44.30,,,,,,,,,,,,,
40001434,0301,84080,,,,,ALK PHOS ISOS,115.00,115.00,,,,,,,,,,,,,
40001440,0300,86651,,,,,ARBOVIRUS PANEL California,51.25,0.00,,,,,,,,,,,,,
40001468,0301,,,,,,PH E,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40001469,0301,,,,,,PCO2 E,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40001470,0301,,,,,,PO2 E,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40001471,0301,,,,,,HCO3 E,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40001472,0301,,,,,,TCO2 E,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40001473,0301,,,,,,BASE EXCESS E,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40001474,0301,,,,,,SO2 E,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40001475,0301,82803,,,,,ARTERIAL BLD GAS EPOC,235.00,235.00,62.85,68.13,,,,,,,62.85,,,68.13,68.13
40001478,0300,87149,,,,,TB IDENTIFICATION,117.96,117.96,,,,,,,,,,,,,
40001479,0300,87077,,,,,BACTERIAL ID 1,64.90,64.90,22.35,43.91,,,43.91,,,,22.35,,,25.87,25.87
40001480,0300,87077,,,,,REF BACTERIAL ID(MULTI-STEP),125.00,125.00,22.35,43.91,,,43.91,,,,22.35,,,25.87,25.87
40001481,0300,87077,,,,,BACTERIAL ID 2,64.90,64.90,22.35,43.91,,,43.91,,,,22.35,,,25.87,25.87
40001482,0300,87077,,,,,BACTERIAL ID 3,63.00,0.00,22.35,43.91,,,43.91,,,,22.35,,,25.87,25.87
40001483,0300,87077,,,,,BACTERIAL ID 4,63.00,0.00,22.35,43.91,,,43.91,,,,22.35,,,25.87,25.87
40001484,0306,87076,,,,,ANAEROBIC BACT ID,19.39,19.39,,,,,,,,,,,,,
40001491,0300,87102,,,,,CULTURE-FUNGUS,50.48,50.48,17.05,17.67,,,,,,,17.05,,,17.67,17.67
40001492,0306,87107,,,,,FUNGUS MOLD ID,131.30,131.30,,,,,,,,,,,,,
40001493,0306,87107,,,,,FUNGUS ID PANEL,200.23,200.23,,,,,,,,,,,,,
40001494,0306,87153,,,,,ID DNA/RNA SEQUENCING,403.42,403.42,,,,,,,,,,,,,
40001495,0300,86606,,,,,ASPERGUILLUS AB TITER,105.47,105.47,,,,,,,,,,,,,
40001500,0301,84620,,,,,D-XYLOSE,123.75,0.00,,,,,,,,,,,,,
40001509,0301,84443,,,,,TSH,132.00,132.00,50.00,88.21,,,88.21,,,,50.00,,,66.69,66.69
40001510,0301,84445,,,,,THYROID STIMULATING IMMUNOGLOBULIN,192.91,192.91,,,,,,,,,,,,,
40001511,0301,83520,,,,,THYROTROPIN REC AB,91.17,91.17,,,,,,,,,,,,,
40001517,0301,82384,,,,,CATECHLMNS/FRACT URINE,114.60,114.60,,,,,,,,,,,,,
40001518,0301,82384,,,,,CATECHLMNS/PLASMA,114.60,114.60,,,,,,,,,,,,,
40001525,0300,86038,,,,,ANA SCREEN,103.20,103.20,40.17,48.11,,,,,,,40.17,,,48.11,48.11
40001526,0300,86039,,,,,ANA TITER,87.80,87.80,,,,,,,,,,,,,
40001528,0301,83050,,,,,METHEMOGLOBIN QUANT,19.06,19.06,6.48,6.48,,,,,,,,,,6.48,6.48
40001530,0300,86255,,,,,ANCA IgG,145.00,145.00,49.19,49.30,,,,,,,49.19,,,49.30,49.30
40001531,0300,86256,,,,,ANCA TITER,58.21,58.21,,,,,,,,,,,,,
40001533,0301,83835,,,,,METANEPHRINE 24 HR UR,84.22,84.22,96.63,187.75,,,,,,,96.63,,,187.75,187.75
40001535,0300,86644,,,,,CMV AB IGG,86.80,86.80,29.51,29.51,,,,,,,29.51,,,,
40001538,0300,86645,,,,,CMV AB IGM,86.80,86.80,29.51,29.51,,,,,,,29.51,,,,
40001539,0306,87015,,,,,CONCENTRATION AFB,34.25,34.25,7.10,8.43,,,,,,,8.43,,,7.10,7.10
40001540,0306,87206,,,,,ACID FAST STAIN,27.56,27.56,9.33,9.65,,,,,,,9.33,,,9.65,9.65
40001541,0306,87116,,,,,CULTURE-AFB,227.01,227.01,76.90,76.90,,,,,,,76.90,,,,
40001542,0301,82135,,,,,AMINOLEVULINIC ACID URINE,91.75,0.00,,,,,,,,,,,,,
40001543,0301,84120,,,,,"PORPHYRINS, URINE",103.02,103.02,,,,,,,,,,,,,
40001544,0301,84110,,,,,PORPHOBILINOGEN URINE,72.11,72.11,,,,,,,,,,,,,
40001565,0301,82105,,,,,ALPHAFETOPROT MATRNL,84.22,84.22,28.62,68.72,,,,,,,28.62,,,68.72,68.72
40001566,0301,82088,,,,,ALDOSTERNE SERUM,125.43,125.43,42.65,42.65,,,,,,,42.65,,,,
40001570,0301,82103,,,,,ALPHA 1 ANTITRYPSIN,70.57,70.57,23.99,23.99,,,,,,,23.99,,,,
40001571,0301,82104,,,,,ALPHA 1 ANTITRYPSIN - PHENOTYPE,168.18,168.18,,,,,,,,,,,,,
40001572,0301,82103,,,,,STOOL ALPHA 1 ANTITRYPSIN,70.57,70.57,23.99,23.99,,,,,,,23.99,,,,
40001573,0301,82107,,,,,ALPHA FETOPROTEIN L3,254.21,254.21,,,,,,,,,,,,,
40001574,0301,82105,,,,,ALPHA FETOPROT TM,84.22,84.22,28.62,68.72,,,,,,,28.62,,,68.72,68.72
40001575,0300,86753,,,,,AMOEBIC AB TITER,185.50,0.00,,,,,,,,,,,,,
40001576,0301,80299,,,,,INTRACONAZOLE,116.15,116.15,,,,,,,,,,,,,
40001577,0301,80299,,,,,AMIODARONE,76.25,0.00,,,,,,,,,,,,,
40001580,0300,86612,,,,,BLASTOMYCES AB-BY CF,85.50,0.00,,,,,,,,,,,,,
40001610,0300,86787,,,,,VARICELLA ZOSTER IGG,37.85,37.85,,,,,,,,,,,,,
40001611,0300,86787,,,,,VARICELLA ZOSTER IGM,37.85,37.85,,,,,,,,,,,,,
40001615,0300,86695,,,,,HERPES SIMPLX IGM TYPE I,87.00,0.00,,,,,,,,,,,,,
40001617,0300,86695,,,,,HERP SIMPLX IGG  I AND 2,70.57,70.57,,,,,,,,,,,,,
40001618,0300,86696,,,,,HSV 2 GLYCOPROTEIN G AB IGG,167.92,167.92,,,,,,,,,,,,,
40001619,0302,86694,,,,,HERPES SIMPLX IGM TYPES 1 AND 2,65.65,65.65,,,,,,,,,,,,,
40001624,0300,86592,,,,,VDRL,35.29,35.29,,,,,,,,,,,,,
40001626,0301,82800,,,,,PH VENOUS BLOOD,52.79,52.79,,,,,,,,,,,,,
40001657,0301,84066,,,,,PRSTTC ACD PHOS,66.45,66.45,,,,,,,,,,,,,
40001680,0301,84166,,,,,ELCTRPHRSS URINE PROTEIN,63.61,63.61,21.51,21.51,,,,,,,21.51,,,,
40001681,0301,84165,,,,,ELCTRPHRSS-PROTEIN SERU,97.00,97.00,40.79,53.09,,,,,,,40.79,,,53.09,53.09
40001682,0301,83883,,,,,FREE LIGHT CHAINS SERUM,221.00,221.00,31.73,46.16,,,,,,,46.16,,,31.73,31.73
40001683,0301,83883,,,,,FREE LIGHT CHAINS K/L SERUM,113.00,113.00,31.73,46.16,,,,,,,46.16,,,31.73,31.73
40001684,0300,83883,,,,,FREE LITE CHAINS - KAPPA URINE,113.00,113.00,28.80,28.80,,,,,,,,,,28.80,28.80
40001685,0300,83883,,,,,FREE LITE CHAINS  LAMBDA URINE,113.00,113.00,28.80,28.80,,,,,,,,,,28.80,28.80
40001686,0301,84166,,,,,ELECTROPHORESIS URINE RANDOM,63.61,63.61,21.51,21.51,,,,,,,21.51,,,,
40001707,0301,84234,,,,,FROZ PROG RECEPTOR,244.16,244.16,,,,,,,,,,,,,
40001713,0301,82672,,,,,ESTRGN-TOTL SER/UR,288.25,0.00,,,,,,,,,,,,,
40001715,0301,82533,,,,,CORTISOL BLOOD (TOTAL),81.39,81.39,27.45,27.45,,,,,,,27.45,,,,
40001716,0301,82530,,,,,FREE CORTISOL SERUM,78.56,78.56,,,,,,,,,,,,,
40001717,0301,82533,,,,,CORTISOL SALIVA,133.93,133.93,27.45,27.45,,,,,,,27.45,,,,
40001764,0300,87491,,,,,CHLAMYDIA BY LCR,113.84,113.84,,,,,,,,,,,,,
40001770,0300,86635,,,,,COCCIDIOIDES AB BY CF,75.97,75.97,,,,,,,,,,,,,
40001771,0300,86658,,,,,COXSACKIE A VIRUS AB A7,46.25,0.00,,,,,,,,,,,,,
40001772,0301,83690,,,,,LIPASE-SERUM,95.00,95.00,28.99,54.36,,,54.36,,,,28.99,,,46.28,46.28
40001773,0300,86658,,,,,COXSACKIE B VIRUS AB B1,44.50,0.00,,,,,,,,,,,,,
40001775,0301,80061,,,,,LIPID PROFILE,118.65,118.65,48.47,94.11,,,94.11,,,,48.47,,,75.94,75.94
40001776,0301,80050,,,,,GENERAL HEALTH PANEL,351.81,351.81,,,,,,,,,,,,,
40001798,0301,80178,,,,,LITHIUM,75.27,75.27,21.13,21.13,,,,,,,,,,21.13,21.13
40001800,0300,83788,,,,,MASS SPECTROMETRY ANALYTE,174.00,0.00,,,,,,,,,,,,,
40001804,0301,83825,,,,,MERCURY QUANTITATIVE,96.32,96.32,,,,,,,,,,,,,
40001805,0301,83789,,,,,IODINE SPOT URINE,133.93,133.93,,,,,,,,,,,,,
40001830,0301,83036,,,,,GLYCOHEMOGLOBIN,87.00,87.00,42.29,71.84,,,71.84,,,,42.29,,,57.49,57.49
40001845,0301,83003,,,,,HUMAN GROWTH HORMONE,81.39,81.39,,,,,,,,,,,,,
40001855,0301,83700,,,,,ELCTRPHRSS LIPO,342.00,0.00,,,,,,,,,,,,,
40001863,0301,84155,,,,,PROTEIN 24 HR URINE,23.75,0.00,,,,,,,,,,,,,
40001870,0301,84202,,,,,FREE ERYTHRCT PROTOPORPH,79.00,0.00,,,,,,,,,,,,,
40001871,0301,82746,,,,,FOLIC ACID,78.04,78.04,26.47,30.82,,,,,,,26.47,,,30.82,30.82
40001888,0301,84482,,,,,T3 REVERSE,65.93,65.93,,,,,,,,,,,,,
40001889,0301,84480,,,,,T3 (TRIIODOTHYRONINE),104.31,104.31,41.35,101.01,,,101.01,,,,41.35,,,60.79,60.79
40001890,0300,86698,,,,,HISTOPLASMA AB (ID),52.79,52.79,17.95,17.95,,,,,,,17.95,,,,
40001891,0300,87385,,,,,HISTOPLASMA AG URINE,164.83,164.83,,,,,,,,,,,,,
40001892,0300,87385,,,,,HISTOPLASMA AG SERUM,164.83,164.83,,,,,,,,,,,,,
40001900,0312,88347,,,,,IMMUNO FLUORESCENT Ab INDIRECT,139.00,0.00,,,,,,,,,,,,,
40001921,0300,86376,,,,,THYROID PEROXIDASE AB,89.89,89.89,30.63,73.35,,,,,,,30.63,,,73.35,73.35
40001922,0300,86376,,,,,MICROSOME LIV/KID AB,72.22,72.22,30.63,73.35,,,,,,,30.63,,,73.35,73.35
40001947,0301,80170,,,,,GENTAMYCIN RANDOM,107.14,107.14,,,,,,,,,,,,,
40001948,0301,80170,,,,,GENTAMYCIN THROUGH,162.00,162.00,,,,,,,,,,,,,
40001949,0301,80170,,,,,GENTAMYCIN PEAK,107.14,107.14,,,,,,,,,,,,,
40001950,0300,83525,,,,,INSULIN 2 HOUR,91.50,0.00,32.05,32.05,,,,,,,32.05,,,,
40001951,0300,83520,,,,,LEPTIN,141.65,141.65,,,,,,,,,,,,,
40001952,0300,86710,,,,,INFLUENZA A AB IgG,111.00,111.00,,,,,,,,,,,,,
40001953,0300,83520,,,,,TRYPTASE,71.40,71.40,,,,,,,,,,,,,
40001954,0300,83525,,,,,INSULIN SERUM,94.26,94.26,32.05,32.05,,,,,,,32.05,,,,
40001955,0301,83527,,,,,FREE INSULIN (TOTAL ),45.84,45.84,,,,,,,,,,,,,
40001956,0301,83835,,,,,FREE PLASMA METANEPHRINES,285.63,285.63,96.63,187.75,,,,,,,96.63,,,187.75,187.75
40001957,0302,86340,,,,,INTRINSIC FACTOR,77.52,77.52,,,,,,,,,,,,,
40001958,0300,83150,,,,,HOMOVANILLIC ACID,91.00,0.00,,,,,,,,,,,,,
40001960,0300,86337,,,,,INSULIN ABS,218.25,0.00,,,,,,,,,,,,,
40001961,0300,83519,,,,,ACETYCHOLINE RECEPTOR BINDING AB,234.37,234.37,,,,,,,,,,,,,
40001962,0300,83519,,,,,ACETYCHOLINE RECEPTOR BLOCKING AB,105.60,105.60,,,,,,,,,,,,,
40001963,0300,83520,,,,,MANNOSE BINDING LECTIN,172.04,172.04,,,,,,,,,,,,,
40001964,0302,83520,,,,,CYTOKINES,87.00,0.00,,,,,,,,,,,,,
40001965,0300,83519,,,,,VOLTAGE GATED CALCIUM CHANNEL,236.07,236.07,,,,,,,,,,,,,
40001966,0300,83519,,,,,ACETYCHOLINE REC MODULATING AB,209.67,209.67,,,,,,,,,,,,,
40001967,0300,83520,,,,,ANTI MULLERIAN HORMONE,216.34,216.34,,,,,,,,,,,,,
40001968,0300,83519,,,,,MUSK AUTOANTIBODY,1810.68,1810.68,,,,,,,,,,,,,
40001969,0300,83519,,,,,ACHR GANG NEURON AB,234.37,234.37,,,,,,,,,,,,,
40001970,0300,83519,,,,,NEURONAL VGKC AUTO AB,234.37,234.37,,,,,,,,,,,,,
40001971,0301,83520,,,,,STRIATIONAL AB,224.32,224.32,,,,,,,,,,,,,
40001996,0301,80184,,,,,PHENOBARBITOL,113.00,113.00,,,,,,,,,,,,,
40002001,0300,,,,,,CANCELED TEST LAB,0.00,0.00,0.00,96.73,96.73,96.73,,,,,,,,0.00,0.00
40002002,0301,80156,,,,,TEGRETOL (CARBAM),133.00,133.00,50.71,50.71,,,,,,,50.71,,,,
40002003,0301,80157,,,,,CARBAMAZEPINE FREE,81.50,81.50,,,,,,,,,,,,,
40002009,0301,80186,,,,,"DILANTIN, FREE",103.00,103.00,,,,,,,,,,,,,
40002010,0301,80185,,,,,DILANTIN,130.00,130.00,43.72,50.68,,,,,,,50.68,,,43.72,43.72
40002011,0301,80195,,,,,SIROLIMUS,140.00,140.00,,,,,,,,,,,,,
40002012,0301,80197,,,,,TACROLIMUS(FK 506),222.26,222.26,75.57,75.57,,,,,,,75.57,,,,
40002043,0301,80307,,,,,TOX SCREEN URINE,109.20,109.20,73.16,73.16,,,73.16,,,,,,,,
40002045,0301,80101,,,,,DRUG SCREEN EACH ANALYTE,11.00,0.00,,,,,,,,,,,,,
40002048,0300,86777,,,,,TOXOPLASMOSIS ABS IgG,85.50,0.00,,,,,,,,,,,,,
40002049,0300,86317,,,,,TETANUS AB,70.57,70.57,17.05,17.05,,,,,,,17.05,,,,
40002050,0300,86317,,,,,DIPHTHERIA AB,70.57,70.57,17.05,17.05,,,,,,,17.05,,,,
40002051,0300,86317,,,,,PNEUMOCOCCAL AB,8.01,8.01,17.05,17.05,,,,,,,17.05,,,,
40002069,0301,83497,,,,,5 HIAA SEROTONIN,54.09,54.09,18.39,18.39,,,,,,,18.39,,,,
40002070,0301,83498,,,,,17 HYDROXYPROGESTERONE,67.03,67.03,,,,,,,,,,,,,
40002085,0301,84585,,,,,VMA 24 HR URINE,111.70,111.70,,,,,,,,,,,,,
40002119,0300,87252,,,,,CULTURE - VIRAL,106.36,106.36,,,,,,,,,,,,,
40002120,0300,87253,,,,,VIRUS ISOLATION,61.00,0.00,,,,,,,,,,,,,
40002127,0300,83540,,,,,IRON,49.45,49.45,16.77,33.13,,,33.13,,,,16.77,,,20.58,20.58
40002135,0300,87624,,,,,HPV DNA,157.11,157.11,,,,,,,,,,,,,
40002186,0301,84630,,,,,ZINC,61.04,61.04,,,,,,,,,,,,,
40002187,0301,84630,,,,,ZINC RBC,307.00,307.00,,,,,,,,,,,,,
40002210,0301,82379,,,,,CARNITINE QUATITATIVE,112.00,0.00,,,,,,,,,,,,,
40002218,0301,82378,,,,,CEA,161.00,161.00,51.48,57.86,,,,,,,51.48,,,57.86,57.86
40002250,0301,82677,,,,,ESTRIOL,74.94,74.94,,,,,,,,,,,,,
40002251,0301,82670,,,,,ESTRADIOL,82.68,82.68,28.11,67.47,,,,,,,28.11,,,67.47,67.47
40002253,0302,86336,,,,,INHIBIN-MATERNAL SERUM,84.48,84.48,,,,,,,,,,,,,
40002254,0301,83520,,,,,INHIBIN B,235.14,235.14,,,,,,,,,,,,,
40002283,0301,84156,,,,,PROTEIN URINE,56.66,56.66,23.02,23.79,,,,,,,23.79,,,23.02,23.02
40002284,0301,84157,,,,,"PROTEIN, CSF",56.66,56.66,14.91,14.91,,,,,,,14.91,,,,
40002285,0301,84157,,,,,PROTEIN BODY FLUID,44.30,44.30,14.91,14.91,,,,,,,14.91,,,,
40002287,0301,82043,,,,,MICROALBUMIN URINE,77.27,77.27,26.25,52.28,,,52.28,,,,26.25,,,38.16,38.16
40002288,0301,82043,,,,,"MICROALBUMIN , QUANTITATIVE",46.25,0.00,26.25,52.28,,,52.28,,,,26.25,,,38.16,38.16
40002291,0300,89050,,,,,CELL COUNT BODY FL,89.00,89.00,18.71,30.26,,,,,,,30.26,,,18.71,18.71
40002293,0301,82390,,,,,CERULOPLASMIN,86.80,86.80,,,,,,,,,,,,,
40002294,0301,82397,,,,,IGF BINDING PROTEINS,51.50,0.00,32.98,32.98,,,,,,,32.98,,,,
40002295,0301,82397,,,,,VASCULAR ENDOTHELIAL GROWTH FACTOR,206.04,206.04,32.98,32.98,,,,,,,32.98,,,,
40002320,0300,80158,,,,,CYCLOSPORINE,145.00,145.00,,,,,,,,,,,,,
40002323,0300,87337,,,,,E HISTOLYTICA AG DETCTN,61.75,0.00,,,,,,,,,,,,,
40002337,0300,86972,,,,,RBC PRETREATMENT DENSITY GRADIENT,150.67,150.67,,,,,,,,,,,,,
40002338,0300,86970,,,,,RBC CHEMICAL TREATMENT,102.15,102.15,,,,,,,,,,,,,
40002339,0300,86978,,,,,ADSORPTION,71.60,71.60,,,,,,,,,,,,,
40002340,0300,86860,,,,,"ELUTION, ANTIBODY",344.94,344.94,116.31,116.31,,,,,,,116.31,,,,
40002341,0300,86870,,,,,ANTIBODY ID,234.37,234.37,79.03,79.03,,,,,,,79.03,,,,
40002342,0302,86146,,,,,B2 GLYCOPROTEIN 1 AB - IGG,24.03,24.03,8.17,8.17,,,,,,,8.17,,,,
40002343,0300,86147,,,,,CARDIOLIPIN AB-IgG,100.44,100.44,34.15,34.15,,,,,,,34.15,,,,
40002344,0300,86148,,,,,PHOSPHATIDYLSERINE AB - IGG,84.25,0.00,,,,,,,,,,,,,
40002358,0300,85025,,,,,CBC-AUTOMATED DIFFERENTIAL,86.25,86.25,27.89,46.76,,,46.76,,,,27.89,,,37.02,37.02
40002359,0300,85007,,,,,MANUAL DIFFERENTIAL,20.34,20.34,6.88,11.86,,,,,,,6.88,,,11.86,11.86
40002360,0300,85027,,,,,HEMOGRAM,54.09,54.09,18.28,31.54,,,,,,,18.28,,,31.54,31.54
40002362,0302,86235,,,,,SMITH ANTIBODY IGG,19.65,19.65,,,,,,,,,,,,,
40002363,0302,86235,,,,,RNP AB,22.74,22.74,,,,,,,,,,,,,
40002365,0300,85230,,,,,FACTOR 7 ASSAY,134.18,134.18,,,,,,,,,,,,,
40002366,0302,86235,,,,,SSA ANTIBODIES IGG,19.65,19.65,,,,,,,,,,,,,
40002367,0302,86235,,,,,SSB ABS IGG,19.65,19.65,,,,,,,,,,,,,
40002369,0302,86235,,,,,"JO-1 ANTIBODY, IGG",20.43,20.43,,,,,,,,,,,,,
40002370,0300,85240,,,,,FACT VIII ASSAY,88.08,88.08,,,,,,,,,,,,,
40002371,0300,85210,,,,,FACTOR II ASSAY,84.73,84.73,,,,,,,,,,,,,
40002372,0302,86235,,,,,CHROMATIN,21.63,21.63,,,,,,,,,,,,,
40002373,0302,86235,,,,,SM/RNP AB,19.65,19.65,,,,,,,,,,,,,
40002374,0305,85130,,,,,ANTI XA,231.03,231.03,,,,,,,,,,,,,
40002376,0300,85220,,,,,FACTOR 5 ASSAY,134.18,134.18,,,,,,,,,,,,,
40002385,0300,86710,,,,,INFLUENZA B ANTIBODY IGG,67.73,67.73,,,,,,,,,,,,,
40002440,0301,84439,,,,,T4 FREE,114.87,114.87,43.50,93.27,,,93.27,,,,43.50,,,67.31,67.31
40002441,0301,84439,,,,,DIALYSIS FREE T4,87.05,87.05,43.50,93.27,,,93.27,,,,43.50,,,67.31,67.31
40002523,0301,80162,,,,,DIGOXIN,124.00,124.00,41.83,47.43,,,,,,,47.43,,,41.83,41.83
40002525,0300,83986,,,,,STOOL PH,19.06,19.06,,,,,,,,,,,,,
40002526,0300,83993,,,,,CALPROTECTIN FECAL,540.86,540.86,,,,,,,,,,,,,
40002531,0301,80198,,,,,THEOPHYLLINE,128.62,128.62,,,,,,,,,,,,,
40002535,0301,84425,,,,,THIAMINE (VIT B1),140.00,140.00,49.00,65.76,,,,,,,49.00,,,65.76,65.76
40002536,0301,84591,,,,,NIACIN,284.59,284.59,,,,,,,,,,,,,
40002549,0300,81001,,,,,URINALYSIS/MICROSCOPIC CS IF INDICATED,57.83,57.83,21.87,44.89,,,44.89,,,,21.87,,,30.82,30.82
40002553,0301,83874,,,,,MYOGLOBIN-URINE,65.75,0.00,44.13,73.84,,,,,,,44.13,,,73.84,73.84
40002556,0300,86900,,,,,BLD TYPING ABO ONLY,187.30,187.30,61.86,90.97,,,,,,,61.86,,,90.97,90.97
40002562,0300,87591,,,,,NEIS GONOR BY LCR,113.84,113.84,,,,,,,,,,,,,
40002563,0306,87581,,,,,MYCOPLASMA PNEUMO PCR,101.72,101.72,33.89,33.89,,,,,,,33.89,,,,
40002564,0306,87532,,,,,HERPES VIRUS6 PCR,246.19,246.19,,,,,,,,,,,,,
40002565,0306,87556,,,,,M TUBERCULOSIS PCR,475.96,475.96,,,,,,,,,,,,,
40002580,0301,84478,,,,,TRIGLYCERIDES,53.00,53.00,,,,,,,,,,,,,
40002584,0300,86689,,,,,WESTERN BLOT,153.24,153.24,,,,,,,,,,,,,
40002595,0301,84484,,,,,TROPONIN,158.00,158.00,46.10,74.51,,,71.42,,,,46.10,,,74.51,74.51
40002655,0301,80307,,,,,TOX-DAV5 NONDOT,127.74,127.74,73.16,73.16,,,73.16,,,,,,,,
40002660,0301,80307,,,,,TOX DAU DOT,127.74,127.74,73.16,73.16,,,73.16,,,,,,,,
40002661,0301,80307,,,,,HMC NEW EMPLOYEE DRUG SCREEN,12.60,12.60,73.16,73.16,,,73.16,,,,,,,,
40002664,0301,83916,,,,,OLIGOCLONAL BANDS,39.50,0.00,,,,,,,,,,,,,
40002671,0301,80307,,,,,TOX-DAU 7,74.43,74.43,73.16,73.16,,,73.16,,,,,,,,
40002713,0300,87210,,,,,WET MOUNT/KOH PREP,47.64,47.64,,,,,,,,,,,,,
40002739,0301,84436,,,,,T4 TOTAL,77.52,77.52,16.11,16.11,,,,,,,16.11,,,,
40002762,0301,82728,,,,,FERRITIN,118.00,118.00,41.58,79.06,,,79.06,,,,41.58,,,49.08,49.08
40002770,0301,84153,,,,,PSA SCREENING,133.41,133.41,51.86,90.13,,,90.13,,,,51.86,,,88.82,88.82
40002775,0301,84154,,,,,FREE AND TOTAL PSA,115.00,115.00,,,,,,,,,,,,,
40002776,0302,86316,,,,,PRO 2 PSA,124.42,124.42,,,,,,,,,,,,,
40002788,0300,87324,,,,,DNU   C DIFF TOXIN A & B,140.25,0.00,,,,,,,,,,,,,
40002789,0300,87230,,,,,DNU         C DIFFICILE CYTOTOXIN ASSAY,84.50,0.00,,,,,,,,,,,,,
40002804,0301,82943,,,,,GLUCAGON,100.18,100.18,34.06,34.06,,,,,,,34.06,,,,
40002820,0301,80194,,,,,QUINIDINE,79.00,0.00,,,,,,,,,,,,,
40002838,0301,82085,,,,,ALDOLASE,54.09,54.09,,,,,,,,,,,,,
40002846,0301,82140,,,,,AMMONIA,74.43,74.43,25.06,25.06,,,,,,,25.06,,,,
40002847,0300,82139,,,,,AMINO ACID PLASMA QT 6 OR MORE,128.50,0.00,,,,,,,,,,,,,
40002853,0300,86701,,,,,ELISA,62.33,62.33,,,,,,,,,,,,,
40002854,0300,86703,,,,,HIV 1/2 AB,53.50,0.00,,,,,,,,,,,,,
40002855,0306,87389,,,,,HIV 1/2 ANTIGEN ANTIBODY,109.82,109.82,,,,,,,,,,,,,
40002857,0310,81373,,,,,HLAB27,102.90,102.90,,,,,,,,,,,,,
40002859,0301,83090,,,,,HOMOCYSTEINE,150.00,150.00,48.96,92.06,,,,,,,48.96,,,92.06,92.06
40002860,0301,83088,,,,,HISTAMINE URINE,80.00,0.00,,,,,,,,,,,,,
40002887,0301,83001,,,,,FSH,128.00,128.00,43.52,104.45,,,76.66,,,,43.52,,,104.45,104.45
40002906,0300,87046,,,,,CULTURE-E COLI 0157,58.00,58.00,16.02,52.53,,,,,,,16.02,,,52.53,52.53
40002907,0306,87015,,,,,CONCENTRATION STEC,20.87,20.87,7.10,8.43,,,,,,,8.43,,,7.10,7.10
40002908,0306,87427,,,,,SHIGA TOXIN 1,67.15,67.15,18.57,45.90,,,,,,,18.57,,,45.90,45.90
40002909,0306,87427,,,,,SHIGA TOXIN 2,67.15,67.15,18.57,45.90,,,,,,,18.57,,,45.90,45.90
40002910,0300,87045,,,,,CULTURE-SALMONELLA/SHIGELLA,105.00,105.00,29.86,94.18,,,,,,,29.86,,,94.18,94.18
40002911,0301,83020,,,,,ELCTRPHRSS HGB,180.54,180.54,61.38,61.38,,,,,,,,,,61.38,61.38
40002912,0301,83021,,,,,"CHROMATOGRAPHY, HGB",52.25,0.00,,,,,,,,,,,,,
40002929,0300,86713,,,,,LEGIONELLA AB SCREEN,90.66,90.66,,,,,,,,,,,,,
40002942,0300,87801,,,,,LEGIONELLA PCR,301.42,301.42,,,,,,,,,,,,,
40002943,0300,87801,,,,,CT/GC AMPLIFIED DETECTION,104.31,104.31,,,,,,,,,,,,,
40002944,0300,87801,,,,,B PERTUSSIS PCR,252.00,252.00,,,,,,,,,,,,,
40002945,0300,87110,,,,,CULTURE CHLAMYDIA,120.53,120.53,,,,,,,,,,,,,
40002946,0300,87804,,,,,INFLUENZA A/B ANTIGEN,103.02,103.02,34.87,64.86,,,60.17,,,,34.87,,,64.86,64.86
40002947,0300,86632,,,,,CHLAMYDIA AB PANEL-IGM(C. TRACOMATIS),52.50,0.00,,,,,,,,,,,,,
40002948,0300,87899,,,,,CAMPYLOBACTER ANTIGEN,77.50,77.50,14.71,19.35,,,,,,,19.35,,,14.71,14.71
40002950,0301,82507,,,,,CITRATE URINE,103.02,103.02,,,,,,,,,,,,,
40002951,0301,84402,,,,,FREE TESTOSTERONE-FEMALE,93.75,93.75,31.88,31.88,,,,,,,31.88,,,,
40002952,0301,84403,,,,,TESTOSTERONE TOTAL,146.28,146.28,52.08,88.06,,,88.06,,,,52.08,,,63.83,63.83
40002955,0301,84270,,,,,SEX HORMONE BINDING GLOBULIN,75.47,75.47,25.75,55.72,,,50.56,,,,25.75,,,55.72,55.72
40002956,0300,89321,,,,,SEMEN POST VAS,54.94,54.94,,,,,,,,,,,,,
40002960,0301,83002,,,,,LEUTENIZ HRMN(LH),98.90,98.90,80.70,80.70,,,,,,,,,,80.70,80.70
40002961,0301,83727,,,,,GONADOTROPIN RELEASING HORMONE,599.50,0.00,,,,,,,,,,,,,
40002978,0301,80202,,,,,VANCOMYCIN TROUGH,283.50,283.50,73.84,73.84,,,,,,,73.84,,,,
40002979,0301,80202,,,,,VANCOMYCIN PEAK,207.00,207.00,73.84,73.84,,,,,,,73.84,,,,
40002980,0301,84586,,,,,VASO INTESTNL POLYPEPTD,185.00,185.00,,,,,,,,,,,,,
40002986,0301,84702,,,,,BHCG-QUANT,77.52,77.52,26.59,26.59,,,,,,,26.59,,,,
40002989,0301,84702,,,,,BHCG TUMOR MARKER,77.52,77.52,26.59,26.59,,,,,,,26.59,,,,
40002994,0301,80307,,,,,ALCOHOL ETOH,81.39,81.39,73.16,73.16,,,73.16,,,,,,,,
40002995,0301,80320,,,,,CHAIN OF CUSTODY URINE ALCOHOL,38.12,38.12,,,,,,,,,,,,,
40002997,0301,83655,,,,,LEAD LEVEL,70.00,70.00,18.96,76.66,,,,,,,18.96,,,76.66,76.66
40003012,0301,83010,,,,,HAPTOGLOBIN,73.14,73.14,,,,,,,,,,,,,
40003014,0300,87070,,,,,CULTURE-BODY FLUID,112.00,112.00,36.65,75.04,,,75.04,,,,36.65,,,55.00,55.00
40003018,0300,87046,,,,,CULTURE-CAMPYLOBACTR,25.50,0.00,16.02,52.53,,,,,,,16.02,,,52.53,52.53
40003059,0301,80150,,,,,AMIKACIN,65.75,0.00,,,,,,,,,,,,,
40003061,0301,80335,,,,,AMITRIPTYLINE LEVL,85.77,85.77,,,,,,,,,,,,,
40003062,0301,80335,,,,,NORTRIPTYLINE,55.80,55.80,,,,,,,,,,,,,
40003091,0300,86803,,,,,HEP C AB,80.10,80.10,27.23,27.23,,,,,,,27.23,,,,
40003092,0300,87902,,,,,HEP C GENOTYPE,455.86,455.86,,,,,,,,,,,,,
40003100,0300,87380,,,,,HEP D ANTIGEN,0.00,0.00,,,,,,,,,,,,,
40003101,0300,86692,,,,,HEP DELTA ANTIBODY,134.25,0.00,,,,,,,,,,,,,
40003109,0300,86708,,,,,HEP A AB TOTAL,69.75,0.00,,,,,,,,,,,,,
40003110,0302,86708,,,,,HEP A IGG,66.96,66.96,22.77,22.77,,,,,,,22.77,,,,
40003111,0302,86709,,,,,HEP A IGM,37.85,37.85,12.91,12.91,,,,,,,12.91,,,,
40003117,0300,86704,,,,,HEP B CORE AB TOTAL,77.52,77.52,,,,,,,,,,,,,
40003118,0300,86705,,,,,HEPATITIS B CORE AB - IGM,98.24,98.24,,,,,,,,,,,,,
40003125,0301,83970,,,,,PTH-PARTHYRD HRMN,227.00,227.00,82.17,141.19,,,,,,,82.17,,,141.19,141.19
40003130,0300,86022,,,,,HEPARIN IND PLTLT AB,250.00,0.00,,,,,,,,,,,,,
40003140,0301,82784,,,,,IMMUNOGLOBULIN G,56.91,56.91,19.31,19.92,,,,,,,19.31,,,19.92,19.92
40003141,0301,82787,,,,,IGG SUBCLASS 1,43.00,0.00,,,,,,,,,,,,,
40003142,0301,82787,,,,,IGG SUBCLASS 2,43.00,0.00,,,,,,,,,,,,,
40003143,0301,82787,,,,,IGG SUBCLASS 3,43.00,0.00,,,,,,,,,,,,,
40003144,0301,82787,,,,,IGG SUBCLASS 4,43.00,0.00,,,,,,,,,,,,,
40003155,0301,82784,,,,,IMMUNOGLOBULIN A,56.91,56.91,19.31,19.92,,,,,,,19.31,,,19.92,19.92
40003156,0301,82784,,,,,IMMUNOGLOBULIN D,83.51,83.51,19.31,19.92,,,,,,,19.31,,,19.92,19.92
40003160,0300,86334,,,,,ELCTRPHRSS-IMMUNO,149.00,149.00,40.38,67.21,,,,,,,67.21,,,40.38,40.38
40003162,0300,86335,,,,,IMMUNOELPHSIS-NOT BLOOD,167.00,167.00,39.01,39.01,,,,,,,39.01,,,,
40003163,0302,86003,,,,,ALLERGENS ADULT FOOD,22.40,0.00,,,,,,,,,,,,,
40003164,0301,82785,,,,,IMMUNOGLOBULIN E,82.68,82.68,17.40,17.40,,,,,,,17.40,,,,
40003166,0301,82784,,,,,IMMUNOGLOBULIN M,56.91,56.91,19.31,19.92,,,,,,,19.31,,,19.92,19.92
40003167,0301,80174,,,,,IMIPRAMINE,83.25,0.00,,,,,,,,,,,,,
40003168,0301,82785,,,,,ALLERGENS UPPER RESP,38.67,38.67,17.40,17.40,,,,,,,17.40,,,,
40003169,0300,86335,,,,,IFE URINE QUALITATIVE,115.38,115.38,39.01,39.01,,,,,,,39.01,,,,
40003170,0300,86003,,,,,ALLERGENS COMMON FOOD,22.40,22.40,6.93,6.93,,,,,,,6.93,,,,
40003172,0301,82785,,,,,ALLERGENS FOOD PROFILE,38.67,38.67,17.40,17.40,,,,,,,17.40,,,,
40003173,0301,82785,,,,,ALLERGENS CHILDHOOD MARCH PROFILE,38.67,38.67,17.40,17.40,,,,,,,17.40,,,,
40003174,0300,87425,,,,,ROTAVIRUS,81.39,81.39,,,,,,,,,,,,,
40003185,0300,86677,,,,,H PYLORI ANTIBODY,105.08,105.08,,,,,,,,,,,,,
40003186,0300,87338,,,,,H PYLORI AG FECES,172.04,172.04,58.49,58.49,,,,,,,58.49,,,,
40003187,0300,86677,,,,,H PYLORI IGM,377.74,377.74,,,,,,,,,,,,,
40003208,0301,82308,,,,,CALCITONIN,124.65,124.65,,,,,,,,,,,,,
40003210,0300,86300,,,,,CA 27-29,149.00,149.00,63.66,63.66,,,,,,,63.66,,,,
40003216,0300,86304,,,,,CA-125,152.10,152.10,33.63,67.55,,,67.55,,,,53.16,,,33.63,33.63
40003220,0300,86300,,,,,CA-15-3,149.00,149.00,63.66,63.66,,,,,,,63.66,,,,
40003224,0302,86225,,,,,DS DNA,16.74,16.74,,,,,,,,,,,,,
40003240,0301,84144,,,,,PROGESTERONE,122.00,122.00,41.48,64.98,,,,,,,41.48,,,64.98,64.98
40003241,0301,84140,,,,,PREGNENOLONE,62.00,0.00,,,,,,,,,,,,,
40003244,0301,83070,,,,,HEMOSIDERIN-URINE QUAL,43.50,0.00,,,,,,,,,,,,,
40003250,0300,86753,,,,,ENTAM HISTLYT AB,92.00,0.00,,,,,,,,,,,,,
40003265,0301,82375,,,,,CARBON MONOXIDE,24.47,24.47,8.34,12.20,,,,,,,8.34,,,12.20,12.20
40003281,0300,86141,,,,,C-REACTIVE PROTEIN HS,102.14,102.14,30.67,51.55,,,43.79,,,,30.67,,,51.55,51.55
40003285,0301,83718,,,,,HDL-CHOL DIRECT,52.79,52.79,,,,,,,,,,,,,
40003300,0300,86671,,,,,SACCHAROMYCES CERVISIAE AB IGG,81.75,0.00,,,,,,,,,,,,,
40003301,0300,86671,,,,,SACCHAROMYCES CERVISIAE AB IGA,81.75,0.00,,,,,,,,,,,,,
40003315,0300,86762,,,,,RUBELLA,32.70,32.70,,,,,,,,,,,,,
40003316,0300,86765,,,,,RUBEOLA IGM,66.45,66.45,,,,,,,,,,,,,
40003317,0300,86765,,,,,RUBEOLA,66.45,66.45,,,,,,,,,,,,,
40003318,0301,,,,,,SALICYLATE,62.33,62.33,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40003319,0300,80323,,,,,NICOTINE URINE,99.83,99.83,,,,,,,,,,,,,
40003320,0301,80323,,,,,NICOTINE SERUM,117.19,117.19,,,,,,,,,,,,,
40003340,0300,86160,,,,,C3 COMPLEMENT,70.57,70.57,,,,,,,,,,,,,
40003341,0300,86200,,,,,CYCLIC CITR PEPTIDE AB IGG,116.93,116.93,40.93,40.93,,,,,,,,,,40.93,40.93
40003342,0300,86161,,,,,COMPLEMENT COMPONENT 1 FUNCTIONAL,190.32,190.32,,,,,,,,,,,,,
40003343,0300,86160,,,,,COMPLEMENT 2,105.86,105.86,,,,,,,,,,,,,
40003344,0300,86160,,,,,COMPLEMENT 4,73.14,73.14,,,,,,,,,,,,,
40003345,0301,83520,,,,,C1 ESTERASE INHIBITOR FUNCTIONAL,167.41,167.41,,,,,,,,,,,,,
40003346,0301,83883,,,,,C1 ESTERASE INHIBITOR LEVEL,221.00,221.00,31.73,46.16,,,,,,,46.16,,,31.73,31.73
40003347,0302,86160,,,,,C1Q COMPLEMENT,117.19,117.19,,,,,,,,,,,,,
40003372,0300,85300,,,,,ANTITHROMBIN III,134.00,134.00,45.56,45.56,,,,,,,45.56,,,,
40003373,0305,85301,,,,,ANTITHROMBIN 3 ANTIGEN,94.78,94.78,,,,,,,,,,,,,
40003398,0300,86301,,,,,CA-19-9,142.00,142.00,38.07,38.07,,,,,,,38.07,,,,
40003406,0300,86706,,,,,HEP B SUR AB,66.45,66.45,22.59,22.59,,,,,,,22.59,,,,
40003407,0300,86706,,,,,HEP B SURFACE AB QUANT,94.62,94.62,22.59,22.59,,,,,,,22.59,,,,
40003448,0301,80200,,,,,TOBRAMYCIN,136.00,136.00,,,,,,,,,,,,,
40003449,0300,87449,,,,,LEGIONELLA ANTIGEN,93.75,93.75,,,,,,,,,,,,,
40003450,0306,87449,,,,,BLASTOMYCES ANTIGEN,364.94,364.94,,,,,,,,,,,,,
40003451,0306,87899,,,,,STREP PNEUMO AG,110.52,110.52,,,,,,,,,,,,,
40003455,0301,82941,,,,,GASTRIN,86.80,86.80,,,,,,,,,,,,,
40003463,0301,82607,,,,,VITAMIN B12,120.00,120.00,42.95,153.68,,,153.68,,,,42.95,,,57.01,57.01
40003505,0301,82380,,,,,CAROTENE,65.75,0.00,,,,,,,,,,,,,
40003524,0301,82805,,,,,ABG WITH MEASURED SO2,156.08,156.08,,,,,,,,,,,,,
40003525,0301,,,,,,HCO3 O,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40003526,0301,,,,,,PCO2 O,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40003527,0301,,,,,,PO2 0,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40003529,0301,,,,,,TCO2 O,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40003530,0301,,,,,,BASE EXCESS O,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40003531,0301,,,,,,SO2 O,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40003532,0301,,,,,,PH O,0.00,0.00,0.00,137.96,137.96,137.96,,,,,,,,0.00,0.00
40003547,0302,86780,,,,,SYPHILIS IGG,19.18,19.18,,,,,,,,,,,,,
40003604,0302,86325,,,,,BENCE-JONES SCREEN,61.75,0.00,,,,,,,,,,,,,
40003612,0300,87324,,,,,C DIFF ANTIGEN,46.25,0.00,,,,,,,,,,,,,
40003613,0300,87305,,,,,ASPERGILLUS ANTIGEN,138.46,138.46,,,,,,,,,,,,,
40003646,0301,83945,,,,,OXALATE,66.45,66.45,,,,,,,,,,,,,
40003701,0300,86615,,,,,BORDATELLA PERTUSSIS IGG,53.75,0.00,,,,,,,,,,,,,
40003702,0300,86615,,,,,BORDATELLA PERTUSSIS IGM,53.75,0.00,,,,,,,,,,,,,
40003703,0300,86618,,,,,LYME DISEASE AB,104.31,104.31,35.37,85.12,,,,,,,35.37,,,85.12,85.12
40003704,0300,86615,,,,,B PERTUSSIS IGA,53.75,0.00,,,,,,,,,,,,,
40003705,0300,86617,,,,,LYME DISEASE WESTERN BLOT,125.17,125.17,,,,,,,,,,,,,
40003706,0300,86611,,,,,B HENSLAE CAT SCRATCH IGG AND IGM,37.09,37.09,,,,,,,,,,,,,
40003707,0300,86611,,,,,BARTONELLA HENSLAE CAT SCRATCH IGM,37.09,37.09,,,,,,,,,,,,,
40003708,0300,86615,,,,,B PERTUSSIS IGG,59.34,59.34,,,,,,,,,,,,,
40003709,0300,86615,,,,,B PERTUSSIS IGM,59.34,59.34,,,,,,,,,,,,,
40003710,0300,86615,,,,,B PERTUSSIS IGA,59.34,59.34,,,,,,,,,,,,,
40003711,0300,87340,,,,,HEP B SUR AG,63.61,63.61,21.63,21.63,,,,,,,,,,21.63,21.63
40003712,0300,87341,,,,,CONFIRMATION HEP B S AG,196.71,196.71,,,,,,,,,,,,,
40003774,0300,85302,,,,,PROTEIN C ANTIGEN,115.50,0.00,,,,,,,,,,,,,
40003775,0300,85303,,,,,PROTEIN C FUNCTIONAL,134.18,134.18,45.62,45.62,,,,,,,45.62,,,,
40003776,0300,85305,,,,,PROTEIN S TOTAL,115.50,0.00,,,,,,,,,,,,,
40003777,0300,85306,,,,,PROTEIN S FUNCTIONAL,134.18,134.18,45.62,45.62,,,,,,,45.62,,,,
40003778,0301,84146,,,,,PROLACTIN,101.99,101.99,83.22,83.22,,,,,,,,,,83.22,83.22
40003779,0301,84145,,,,,PROCALCITONIN,334.81,334.81,114.24,115.72,,,,,,,114.24,,,115.72,115.72
40003800,0301,82491,,,,,FLUCYTOSINE,112.00,0.00,,,,,,,,,,,,,
40003802,0301,80171,,,,,GABAPENTIN,91.00,0.00,,,,,,,,,,,,,
40003803,0301,82491,,,,,CHROMATOG - QUANT IMURAN,330.00,0.00,,,,,,,,,,,,,
40003804,0301,82480,,,,,CHOLINESTERASE SERUM,24.75,0.00,,,,,,,,,,,,,
40003805,0301,82482,,,,,CHILINESTERASE RBC,51.75,0.00,,,,,,,,,,,,,
40003806,0301,82542,,,,,6 MMPN,132.12,132.12,,,,,,,,,,,,,
40003807,0301,82542,,,,,6 TGN,181.58,181.58,,,,,,,,,,,,,
40003842,0300,84206,,,,,PROINSULIN,60.58,60.58,,,,,,,,,,,,,
40003843,0301,84260,,,,,SEROTONIN,150.41,150.41,,,,,,,,,,,,,
40003844,0300,80299,,,,,CRYSTODIGIN (DIGITOXIN),100.00,0.00,,,,,,,,,,,,,
40003845,0301,84202,,,,,ZINC PROTOPROPHYRIN,42.52,42.52,,,,,,,,,,,,,
40003873,0301,83873,,,,,MYELIN BASIC-CSF,84.25,0.00,,,,,,,,,,,,,
40003884,0300,86720,,,,,LEPTOSPIRA AB,83.25,0.00,,,,,,,,,,,,,
40003885,0301,83491,,,,,17HYDROCORTSTRD,100.00,0.00,,,,,,,,,,,,,
40003893,0301,82340,,,,,CALCIUM 24HR URINE,62.33,62.33,20.98,20.98,,,,,,,20.98,,,,
40003943,0301,84481,,,,,FREE T3,105.86,105.86,35.96,70.93,,,70.93,,,,35.96,,,59.29,59.29
40003992,0300,87077,,,,,CLO-TEST,86.80,86.80,22.35,43.91,,,43.91,,,,22.35,,,25.87,25.87
40003993,0301,83014,,,,,H PYLORI DRUG ADMINISTRATION,23.69,23.69,,,,,,,,,,,,,
40003994,0301,83013,,,,,H PYLORI BREATH TEST,130.57,130.57,,,,,,,,,,,,,
40004001,0310,81479,,,,,IBD SGI DIAGNOSTIC,90.79,90.79,,,,,,,,,,,,,
40004002,0300,86140,,,,,C REACTIVE PROTEIN,46.36,46.36,,,,,,,,,,,,,
40004003,0300,83520,,,,,PROMETHEUS ASCA IGG,38.63,38.63,,,,,,,,,,,,,
40004004,0300,83520,,,,,PROMETHEUS ASCA IGA,38.63,38.63,,,,,,,,,,,,,
40004005,0300,81479,,,,,PROMETHEUS  IGA,38.63,38.63,,,,,,,,,,,,,
40004006,0300,83520,,,,,PROMETHEUS ANTI OMPC IGA,38.63,38.63,,,,,,,,,,,,,
40004007,0300,83520,,,,,PROMETHEUS ANTI CBIR1,38.63,38.63,,,,,,,,,,,,,
40004008,0300,83520,,,,,PROMETHEUS FLAZ,30.91,30.91,,,,,,,,,,,,,
40004009,0300,83520,,,,,PROMETHEUS FLAX,30.91,30.91,,,,,,,,,,,,,
40004010,0300,82397,,,,,PROMETHEUS VEGF,30.91,30.91,,,,,,,,,,,,,
40004011,0301,82397,,,,,PROMETHEUS ICAM,30.91,30.91,32.98,32.98,,,,,,,32.98,,,,
40004012,0301,82397,,,,,PROMETHEUS VCAM,30.91,30.91,32.98,32.98,,,,,,,32.98,,,,
40004013,0301,82397,,,,,PROMETHEUS SAA,30.91,30.91,32.98,32.98,,,,,,,32.98,,,,
40004014,0312,88346,,,,,PROMETHEUS PANCA,374.99,374.99,,,,,,,,,,,,,
40004015,0312,88350,,,,,PROMETHEUS DNASE SENSITIVITY,374.99,374.99,,,,,,,,,,,,,
40004016,0310,81479,,,,,IBD SGI DIAGNOSTIC,0.00,0.00,,,,,,,,,,,,,
40004017,0310,,,,,,PROMETHEUS IBD SGI DIAGNOSTIC,0.00,0.00,0.00,269.12,269.12,269.12,,,,,,,,0.00,0.00
40004018,0310,81450,,,,,ONCOHEME NGS,5908.50,5908.50,,,,,,,,,,,,,
40004019,0300,81511,,,,,QUAD 1 MARKER,128.35,128.35,,,,,,,,,,,,,
40004065,0301,84681,,,,,C-PEPTIDE,98.90,98.90,33.63,33.63,,,,,,,33.63,,,,
40004081,0301,80164,,,,,VALPROIC ACID DEPAKENE,130.75,130.75,25.83,50.61,,,,,,,25.83,,,50.61,50.61
40004131,0300,85378,,,,,D-DIMER SEMI-QUANT,65.75,0.00,,,,,,,,,,,,,
40004132,0300,85379,,,,,D-DIMER QUANTITATIVE,146.50,146.50,51.05,85.32,,,81.62,,,,51.05,,,85.32,85.32
40004133,0300,85362,,,,,FIBRIN SPLIT PRODUCTS,36.51,36.51,,,,,,,,,,,,,
40004179,0301,82523,,,,,"N-TELOPEPTIDE, URINE",99.50,0.00,,,,,,,,,,,,,
40004180,0301,82530,,,,,CORTISOL - URINE (FREE),78.56,78.56,,,,,,,,,,,,,
40004198,0300,86707,,,,,HEP BE AB,99.06,99.06,,,,,,,,,,,,,
40004199,0300,87350,,,,,HEP BE AG,56.91,56.91,,,,,,,,,,,,,
40004206,0300,87350,,,,,HEP BE AG,69.75,0.00,,,,,,,,,,,,,
40004207,0301,84207,,,,,VITAMIN B 6,127.48,127.48,43.73,43.73,,,,,,,43.73,,,,
40004213,0301,83735,,,,,MAGNESIUM URINE,72.00,72.00,27.97,48.24,,,48.24,,,,27.97,,,31.32,31.32
40004214,0301,83735,,,,,MAGNESIUM SERUM,72.00,72.00,27.97,48.24,,,48.24,,,,27.97,,,31.32,31.32
40004215,0301,83735,,,,,MAGNESIUM 24 HR URINE,32.45,32.45,27.97,48.24,,,48.24,,,,27.97,,,31.32,31.32
40004216,0300,87207,,,,,MALARIA SMEAR,42.25,0.00,,,,,,,,,,,,,
40004217,0300,86757,,,,,TYPHUS AB IGG,50.00,0.00,,,,,,,,,,,,,
40004218,0300,86638,,,,,Q FEVER AB,87.00,0.00,,,,,,,,,,,,,
40004219,0300,86757,,,,,ROCKY MTN IGG,86.80,86.80,,,,,,,,,,,,,
40004221,0300,86622,,,,,BRUCELLA AB,58.00,0.00,,,,,,,,,,,,,
40004223,0300,86668,,,,,FRANCISELLA AB,76.25,0.00,,,,,,,,,,,,,
40004247,0301,84300,,,,,RENAL FAILURE INDICIES 2,18.50,0.00,15.91,15.91,,,,,,,15.91,,,,
40004248,0301,84300,,,,,SODIUM URINE,56.00,56.00,15.91,15.91,,,,,,,15.91,,,,
40004249,0301,84300,,,,,SODIUM 24 HR URINE,56.00,56.00,15.91,15.91,,,,,,,15.91,,,,
40004250,0301,84307,,,,,SOMATOSTATIN,212.00,0.00,,,,,,,,,,,,,
40004251,0300,84305,,,,,SOMATOMEDIN C,96.84,96.84,,,,,,,,,,,,,
40004255,0301,84252,,,,,VITAMIN B 2,176.25,0.00,,,,,,,,,,,,,
40004260,0300,81002,,,,,SPECIFIC GRAV URINE,25.00,0.00,,,,,,,,,,,,,
40004261,0301,82542,,,,,PTH RELATED PEPTIDE,179.00,0.00,,,,,,,,,,,,,
40004262,0300,81002,,,,,URINE PH,19.22,19.22,,,,,,,,,,,,,
40004265,0301,84315,,,,,SPECFC GRAV BODY FL,25.75,25.75,,,,,,,,,,,,,
40004268,0300,85335,,,,,FACTOR INHIBITOR TEST,146.90,146.90,,,,,,,,,,,,,
40004271,0300,85300,,,,,LUPUS INHIBITOR,134.00,134.00,45.56,45.56,,,,,,,45.56,,,,
40004280,0301,82436,,,,,CHLORIDE-URINE,51.50,51.50,6.39,6.39,,,,,,,6.39,,,,
40004281,0301,82436,,,,,CHLORIDE 24 HR URINE,86.30,86.30,6.39,6.39,,,,,,,6.39,,,,
40004285,0301,82435,,,,,CHLORIDE-SERUM,31.00,31.00,,,,,,,,,,,,,
40004287,0301,82438,,,,,CHLORIDE-BODY FLUID,19.06,19.06,,,,,,,,,,,,,
40004289,0310,88264,,,,,ANALYZE 20 - 25 CELLS CHROMOSOME,352.33,352.33,120.32,120.32,,,,,,,120.32,,,,
40004290,0310,88262,,,,,CHROMOSOME ANALYSIS,206.75,0.00,,,,,,,,,,,,,
40004291,0300,89051,,,,,CELL COUNT/DIF BDYFL,97.90,97.90,28.48,28.48,,,,,,,28.48,,,,
40004293,0301,82480,,,,,CHOLINESTERASE SERUM,54.00,0.00,,,,,,,,,,,,,
40004295,0301,82595,,,,,CRYOGLOBULIN QUAL/SEMI-QUANT,41.00,0.00,,,,,,,,,,,,,
40004297,0300,86641,,,,,CRYPTOCOCCUS AB,100.00,0.00,,,,,,,,,,,,,
40004298,0390,P9012,,,,,CRYOPRECIPITATE PER UNIT,229.00,229.00,,,,,,,,,,,,,
40004299,0300,87328,,,,,CRYPTOSPORIDIUM AG,80.61,80.61,27.19,27.19,,,,,,,27.19,,,,
40004300,0301,84022,,,,,THIORIDAZINE(MELLARIL),79.00,0.00,,,,,,,,,,,,,
40004313,0301,80182,,,,,NORTRIPTYLINE,68.50,0.00,,,,,,,,,,,,,
40004326,0301,82180,,,,,VITAMIN C,56.91,56.91,,,,,,,,,,,,,
40004327,0301,82306,,,,,VITAMIN D 25 HYDROXY,131.09,131.09,52.13,93.91,,,88.69,,,,52.13,,,93.91,93.91
40004328,0301,82652,,,,,VITAMIN D 125,88.85,88.85,,,,,,,,,,,,,
40004329,0300,84446,,,,,VITAMIN E,69.02,69.02,,,,,,,,,,,,,
40004330,0300,84590,,,,,VITAMIN A (RETINOL),80.39,80.39,27.23,27.23,,,,,,,27.23,,,,
40004331,0300,84597,,,,,VITAMIN K1,151.69,151.69,,,,,,,,,,,,,
40004332,0301,82172,,,,,APOLIPOPROTEIN B,73.92,73.92,,,,,,,,,,,,,
40004333,0301,80327,,,,,5 A DIHYDROTESTOSTERONE,104.49,104.49,,,,,,,,,,,,,
40004334,0301,84588,,,,,VASOPRESSIN ADH,143.97,143.97,,,,,,,,,,,,,
40004335,0301,82657,,,,,DIHYDRODAMINE,630.17,630.17,,,,,,,,,,,,,
40004339,0301,83721,,,,,LDL-CHOL DIRECT,52.79,52.79,,,,,,,,,,,,,
40004340,0301,82656,,,,,ELASTASE STOOL,240.23,240.23,,,,,,,,,,,,,
40004354,0301,80176,,,,,LIDOCAINE,79.00,0.00,,,,,,,,,,,,,
40004370,0301,84432,,,,,THYROGLOBULIN,81.39,81.39,27.12,27.12,,,,,,,27.12,,,,
40004538,0301,80069,,,,,RENAL PANEL,129.60,129.60,51.95,66.23,,,,,,,51.95,,,66.23,66.23
40004628,0300,85732,,,,,APTT CIRCULATING INHIBITOR,29.11,29.11,,,,,,,,,,,,,
40004832,0300,87556,,,,,M TB DIRECT DETECT,417.25,0.00,,,,,,,,,,,,,
4000492,0636,,,,,,Tc99mm  Ceretec,632.75,0.00,15.98,15.98,15.98,15.98,,,,,,,,,
40004968,0301,82627,,,,,DHEA SULFATE,105.86,105.86,,,,,,,,,,,,,
40004969,0301,82626,,,,,DHEA,47.13,47.13,,,,,,,,,,,,,
40004970,0301,80160,,,,,DESIPRAMINE,79.00,0.00,,,,,,,,,,,,,
40004971,0300,82010,,,,,BETA HYDROXYBUTYRATE,92.72,92.72,,,,,,,,,,,,,
40004972,0301,80160,,,,,CLOZAPINE,48.06,0.00,,,,,,,,,,,,,
40004990,0301,82330,,,,,CALCIUM-IONIZED,91.94,91.94,31.24,53.14,,,,,,,31.24,,,53.14,53.14
40004991,0301,82330,,,,,FULL ARTERIAL PROFILE 5,59.25,0.00,31.24,53.14,,,,,,,31.24,,,53.14,53.14
40005013,0301,84060,,,,,ACID PHOSPHATASE TOTAL,43.50,0.00,,,,,,,,,,,,,
40005020,0300,83516,,,,,TISSUE TRANSGLUATMINASE IGG,62.33,62.33,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40005021,0300,83520,,,,,IMMASSAY QUANT BY RADPHARM,88.50,0.00,,,,,,,,,,,,,
40005022,0300,83516,,,,,TISSUE TRANGLUTAMINASE IGA,62.33,62.33,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40005023,0300,86255,,,,,"MITOCHONDRIAL AB, IGG",62.33,62.33,49.19,49.30,,,,,,,49.19,,,49.30,49.30
40005024,0300,83516,,,,,GLIADIN AB IGA,62.33,62.33,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40005025,0300,83516,,,,,GLIADIN AB IGG,62.33,62.33,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40005027,0300,83516,,,,,DGP IGA,63.61,63.61,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40005028,0302,86235,,,,,RIBOSOME P ANTIBODY IGG,21.53,21.53,,,,,,,,,,,,,
40005029,0300,83516,,,,,MYELIN ASSOC GLYCOPROTEIN AB IGM,72.32,72.32,21.13,67.88,,,,,,,21.13,,,67.88,67.88
40005030,0302,86235,,,,,CENTROMERE AB,20.43,20.43,,,,,,,,,,,,,
40005031,0300,86256,,,,,ANTIMITOCHONDRIAL ABS,32.43,32.43,,,,,,,,,,,,,
40005056,0300,80180,,,,,MYCOPHENOLIC ACID,91.69,91.69,,,,,,,,,,,,,
40005057,0300,80299,,,,,CLOMIPRAMINE LEVEL,77.75,0.00,,,,,,,,,,,,,
40005058,0301,80177,,,,,KEPPRA (LEVETIRACETAM),137.79,137.79,46.85,46.85,,,,,,,46.85,,,,
40005059,0301,80201,,,,,TOPIRAMATE (TOPAMAX),115.38,115.38,,,,,,,,,,,,,
40005060,0301,80183,,,,,OXCARBAZEPINE (TRILEPTAL),94.26,94.26,,,,,,,,,,,,,
40005061,0301,80175,,,,,LAMOTRIGINE,69.28,69.28,23.44,23.44,,,,,,,23.44,,,,
40005062,0301,80339,,,,,LACOSAMIDE (VIMPAT),450.71,450.71,,,,,,,,,,,,,
40005063,0301,80339,,,,,CLOBAZAM,273.20,273.20,,,,,,,,,,,,,
40005100,0310,81406,,,,,RET PROTO ONCOGENE,4021.80,4021.80,,,,,,,,,,,,,
40005132,0300,82955,,,,,GLUCOSE 6 PHOSPHATE DEHYDROGENAS E,52.00,0.00,,,,,,,,,,,,,
40005135,0300,89125,,,,,URINE FAT,43.50,0.00,,,,,,,,,,,,,
40005138,0300,82952,,,,,GLUCOSE TOL UR ADDHR,10.50,0.00,,,,,,,,,,,,,
40005139,0301,82705,,,,,FECAL FAT QUALITATIVE,44.81,44.81,,,,,,,,,,,,,
40005140,0301,82710,,,,,FECAL FAT (QUANT),103.54,103.54,35.20,35.20,,,,,,,35.20,,,,
40005143,0300,89055,,,,,FECAL WBC,52.57,52.57,18.54,48.96,,,,,,,18.54,,,48.96,48.96
40005144,0301,84126,,,,,STOOL-24 HR PROTOPORPHYR,276.25,0.00,,,,,,,,,,,,,
40005145,0301,84302,,,,,FECAL SODIUM,24.50,0.00,,,,,,,,,,,,,
40005146,0301,84133,,,,,FECAL POTASSIUM,24.25,0.00,9.77,9.77,,,,,,,9.77,,,,
40005147,0301,82438,,,,,FECAL CHLORIDE,24.25,0.00,,,,,,,,,,,,,
40005161,0300,86618,,,,,LYME AB CSF,101.25,0.00,35.37,85.12,,,,,,,35.37,,,85.12,85.12
40005229,0301,84466,,,,,TIBC / TRANSFERRIN,97.00,97.00,32.42,64.99,,,64.99,,,,32.42,,,35.58,35.58
40005237,0301,80307,,,,,ACETMNPHEN (TYLENOL),96.32,96.32,73.16,73.16,,,73.16,,,,,,,,
40005238,0301,82009,,,,,ACETONE,27.56,27.56,,,,,,,,,,,,,
40005240,0301,82017,,,,,ACYICARNITINE QUANTITATIVE,319.50,0.00,,,,,,,,,,,,,
40005242,0301,82024,,,,,ACTH HORMONE,172.04,172.04,,,,,,,,,,,,,
40005245,0301,80400,,,,,ACTH STIMULATION,276.00,276.00,,,,,,,,,,,,,
40005251,0301,82747,,,,,RBC FOLATE,93.75,93.75,,,,,,,,,,,,,
40005252,0301,82340,,,,,CALCIUM UR QUANT,19.06,19.06,20.98,20.98,,,,,,,20.98,,,,
40005294,0300,87081,,,,,CULTURE PERTUSS,190.75,0.00,37.82,52.80,,,,,,,37.82,,,52.80,52.80
40005435,0301,80154,,,,,CLONAZEPAM/BENZO,79.00,0.00,,,,,,,,,,,,,
40005601,0306,87507,,,,,GASTRO PATHOGENS,984.75,984.75,334.82,344.66,,,,,,,334.82,,,344.66,344.66
40005602,0306,87498,,,,,ENTEROVIRUS PCR PLASMA,196.95,196.95,,,,,,,,,,,,,
40005606,0306,87505,,,,,GI PARASITE PANEL,780.00,780.00,,,,,,,,,,,,,
40005609,0306,87497,,,,,CMV QUANTITATIVE PCR,324.51,324.51,,,,,,,,,,,,,
40005610,0306,87651,,,,,STREP GRP A MOLECULAR,121.00,121.00,23.37,76.06,,,37.79,,,,23.37,,,76.06,76.06
40005611,0306,87493,,,,,C DIFFICILE TOXIC GENE,179.00,179.00,61.14,98.69,,,98.69,,,,61.14,,,93.18,93.18
40005612,0306,87517,,,,,HEPATITIS B VIRAL DNA,315.76,315.76,,,,,,,,,,,,,
40005613,0300,86804,,,,,HEPATITIS C RIBA,215.31,215.31,,,,,,,,,,,,,
40005614,0300,87496,,,,,CMV BY PCR,166.00,0.00,,,,,,,,,,,,,
40005615,0300,87522,,,,,HEPATITIS C RNA PCR QUA,366.26,366.26,,,,,,,,,,,,,
40005616,0300,87799,,,,,BK VIRUS URINE,477.50,477.50,,,,,,,,,,,,,
40005617,0300,87529,,,,,HERPES SIMPLEX BY PCR,267.85,267.85,,,,,,,,,,,,,
40005618,0301,80074,,,,,HEPATITIS PANEL ACUTE,329.00,329.00,147.89,173.80,,,,,,,147.89,,,173.80,173.80
40005619,0300,87798,,,,,JC VIRUS,436.80,436.80,,,,,,,,,,,,,
40005620,0306,87521,,,,,HEP C RNA QUALITATIVE,240.00,0.00,,,,,,,,,,,,,
40005621,0306,87798,,,,,B. PERTUSSIS/PARAPERTUSIS PCR,274.11,274.11,91.34,91.34,,,,,,,91.34,,,,
40005622,0300,87798,,,,,NOROVIRUS 1 PCR,325.44,325.44,,,,,,,,,,,,,
40005623,0300,87798,,,,,NOROVIRUS 2 PCR,325.44,325.44,,,,,,,,,,,,,
40005624,0306,87799,,,,,JC POLYOMA VIRUS PCR,1008.94,1008.94,,,,,,,,,,,,,
40005625,0306,87480,,,,,CANDIDA NA PROBE,47.15,47.15,,,,,,,,,,,,,
40005626,0306,87510,,,,,GARDNERELLA PROBE,47.15,47.15,,,,,,,,,,,,,
40005627,0306,87660,,,,,TRICH VAG PROBE,47.15,47.15,,,,,,,,,,,,,
40005628,0300,87529,,,,,HSV PCR NON CSF,177.78,177.78,,,,,,,,,,,,,
40005629,0300,87529,,,,,HSV PCR NON CSF CHARGE ONLY,178.82,178.82,,,,,,,,,,,,,
40005630,0306,87798,,,,,ZIKA VIRUS BY PCR,736.59,736.59,91.34,91.34,,,,,,,91.34,,,,
40005631,0302,86790,,,,,ZIKA IGM,502.22,502.22,,,,,,,,,,,,,
40005632,0306,87486,,,,,CHLAM PNEUMO PROBE,101.72,101.72,33.89,33.89,,,,,,,33.89,,,,
40005633,0306,87633,,,,,RESP VIRUS 12-25 TARGETS,101.72,101.72,33.89,33.89,,,,,,,33.89,,,,
40005946,0300,86713,,,,,LEGIONELLA IGM AB,74.43,74.43,,,,,,,,,,,,,
40006646,0300,84479,,,,,T3 UPTAKE,42.24,42.24,,,,,,,,,,,,,
40006903,0300,86902,,,,,RBC ANTIGEN SCREEN/UNIT,137.95,137.95,45.97,45.97,,,,,,,45.97,,,,
40006904,0300,86905,,,,,RBC ANTIGEN SCREEN/PATIENT,137.95,137.95,,,,,,,,,,,,,
40006905,0300,86902,,,,,RBC ANTIGEN TIER 4,371.91,371.91,45.97,45.97,,,,,,,45.97,,,,
40006906,0300,86904,,,,,BLD TYPE-SERUM,108.00,108.00,,,,,,,,,,,,,
40006907,0300,0001U,,,,,RBC MOLECULAR TYPE,676.20,676.20,,,,,,,,,,,,,
40007050,0300,85250,,,,,FACTOR IX ASSAY,134.18,134.18,,,,,,,,,,,,,
40007051,0300,85270,,,,,FACTOR XI ASSAY,137.53,137.53,,,,,,,,,,,,,
40007052,0300,85280,,,,,FACTOR XII ASSAY,137.79,137.79,,,,,,,,,,,,,
40007053,0300,85260,,,,,FACTOR X ASSAY,138.05,138.05,,,,,,,,,,,,,
40007054,0300,85290,,,,,FACTOR XIII,54.52,54.52,,,,,,,,,,,,,
40007055,0310,88360,,,,,TISSUE IHC ERA/PRA,701.17,701.17,,,,,,,,,,,,,
40007056,0310,88361,,,,,BREAST RECEPTOR,234.37,234.37,81.51,81.51,,,,,,,81.51,,,,
40007057,0310,88365,,,,,TISSUE INSITU HYBRID,342.18,342.18,116.26,116.26,,,,,,,116.26,,,,
40007058,0310,88365,,,,,TISSUE INSITU HYBRID MAYO,1313.82,1313.82,116.26,116.26,,,,,,,116.26,,,,
40007063,0310,88331,,,,,FRZ SECTION,342.18,342.18,126.54,126.54,,,,,,,126.54,,,,
40007064,0310,88332,,,,,FROZEN SECTION (EA ADDN),107.31,107.31,26.01,26.01,,,,,,,26.01,,,,
40007065,0310,88300,,,,,GROSS EXAM,102.15,102.15,34.77,34.77,,,,,,,34.77,,,,
40007069,0311,88173,,,,,CYTOLOGY FINE NEEDLE ASPIRATE,228.76,228.76,77.78,91.75,,,,,,,91.75,,,77.78,77.78
40007070,0310,88321,,,,,CONSULTATION MAYO CLINIC,548.53,548.53,,,,,,,,,,,,,
40007071,0310,88329,,,,,PATH CONSULT,318.21,318.21,,,,,,,,,,,,,
40007072,0310,88323,,,,,MAYO CONSULT SLIDEPREP,548.53,548.53,,,,,,,,,,,,,
40007073,0310,88325,,,,,MAYO COMP CONSULT,548.53,548.53,,,,,,,,,,,,,
40007075,0312,88348TC,,,,,ELECTRON MICROSCOPY,647.50,0.00,,,,,,,,,,,,,
40007095,0300,82360,,,,,STONE ANALYSIS (CHEMICAL),71.00,0.00,,,,,,,,,,,,,
40007096,0300,82365,,,,,STONE ANALYSIS ( INFRARED SPEC ),102.70,102.70,36.21,153.41,,,,,,,36.21,,,153.41,153.41
40007100,0310,88311,,,,,DECALCIFICATION,66.45,66.45,23.26,38.86,,,,,,,38.86,,,23.26,23.26
40007101,0312,88312,,,,,SPECIAL STAINS GRP I,166.86,166.86,54.83,130.45,,,109.19,,,,54.83,,,130.45,130.45
40007102,0312,88313,,,,,SPECIAL STAIN GROUP II (OTHER),162.00,162.00,54.14,62.21,,,,,,,62.21,,,54.14,54.14
40007103,0312,88313,,,,,MAYO SPEC STN II,282.00,282.00,54.14,62.21,,,,,,,62.21,,,54.14,54.14
40007123,0310,88312,,,,,FUNGAL STAIN,166.86,166.86,39.62,39.62,,,,,,,39.62,,,,
40007125,0312,88342,,,,,IMMUNOCYTOCHEM FIRST AB,133.93,133.93,45.57,91.04,,,91.04,,,,45.57,,,66.64,66.64
40007126,0310,88342,,,,,IMMUNOCYTOCHEM FIRST G,83.34,0.00,,,,,,,,,,,,,
40007127,0310,,,,,,IMMUNOCYTOCHEM EACH ADD AB G,83.34,0.00,0.00,269.12,269.12,269.12,,,,,,,,0.00,0.00
40007128,0310,88341,,,,,IMMUNOCYTOCHEM EACH ADDITIONAL AB,85.86,85.86,29.19,57.53,,,57.53,,,,29.26,,,29.19,29.19
40007129,0312,88344,,,,,IMMUNO PER SPEC;MULIPLEX AB,133.93,133.93,45.16,45.16,,,,,,,45.16,,,,
40007203,0310,88108,,,,,CYTOLOGY NONGYN,134.30,134.30,,,,,,,,,,,,,
40007206,0310,88161,,,,,CYTO NGYN SPUTUM,103.00,103.00,,,,,,,,,,,,,
40007207,0310,88112,,,,,CELLULAR ENHANCEMENT,185.69,185.69,63.13,75.38,,,,,,,75.38,,,63.13,63.13
40007210,0311,88175,,,,,PAP AUTO REVIEW,110.23,110.23,,,,,,,,,,,,,
40007211,0311,88143,,,,,PAP SMEAR MANUAL,97.25,0.00,,,,,,,,,,,,,
40007212,0311,88142,,,,,PAP SMEAR ROUTINE,100.18,100.18,81.75,95.20,,,95.20,,,,,,,81.75,81.75
40007213,0311,88141,,,,,PAP PATH REVIEW,27.30,27.30,,,,,,,,,,,,,
40007214,0311,G0145,,,,,PAP SMEAR LOW/HI,100.18,100.18,34.16,34.16,,,,,,,34.16,,,,
40007215,0311,88174,,,,,PAP AUTO VERIFY,233.00,233.00,,,,,,,,,,,,,
40007216,0311,G0143,,,,,PAP SMEAR MANUAL SCREEN & RESCREEN,100.18,100.18,,,,,,,,,,,,,
40007217,0311,G0144,,,,,PAP SMEAR LOW RISK FP R AND V,100.18,100.18,,,,,,,,,,,,,
40007218,0311,G0123,,,,,PAP SMEAR THIN LAYER SCREEN,0.00,0.00,,,,,,,,,,,,,
40007219,0311,G0124,,,,,PAP SMEAR THIN LAYER PHYSICIAN ITRP,100.18,100.18,,,,,,,,,,,,,
40007220,0311,88148,,,,,PAP SMEAR DIAGNOSITIC,111.99,111.99,,,,,,,,,,,,,
40007246,0300,86406,,,,,CRYPTOCOCCAL TITER,65.00,0.00,,,,,,,,,,,,,
40007247,0300,86480,,,,,TB QUANTIFERON,184.14,184.14,62.61,62.61,,,,,,,62.61,,,62.61,62.61
40007248,0300,86406,,,,,STREPTOCOCCUS TITER,65.00,0.00,,,,,,,,,,,,,
40007318,0301,83880,,,,,BRAIN NATRIURETIC PEPTIDE,226.16,226.16,61.92,83.91,,,,,,,61.92,,,83.91,83.91
40007345,0300,86403,,,,,CRYPTOCOCCAL AG-CSF,70.57,70.57,,,,,,,,,,,,,
40007346,0300,86403,,,,,CRYPTOCOCCAL AG-SERUM,70.57,70.57,,,,,,,,,,,,,
40007348,0300,86403,,,,,STREPTOCOCCUS SCREEN SERUM,68.50,0.00,,,,,,,,,,,,,
40007474,0310,88302,,,,,LEVEL 2 GROSS MICRO,142.00,142.00,,,,,,,,,,,,,
40007475,0310,88304,,,,,LEVEL 3 GROSS MICRO,179.84,179.84,64.07,117.90,,,,,,,64.07,,,117.90,117.90
40007476,0310,88305,,,,,LEVEL 4 GROSS MICRO,244.00,244.00,85.21,209.48,,,209.48,,,,85.21,,,157.62,157.62
40007477,0310,88307,,,,,LEVEL 5 GROSS MICRO,351.55,351.55,118.36,152.12,,,,,,,152.12,,,118.36,118.36
40007478,0310,88309,,,,,LEVEL 6 GROSS MICRO,666.75,666.75,323.97,323.97,,,,,,,323.97,,,,
40007500,0310,88300,,,,,SP LV1 GROSS,73.75,0.00,34.77,34.77,,,,,,,34.77,,,,
40007515,0310,85060,,,,,BLOOD SMEAR PERIPHERAL,0.00,0.00,,,,,,,,,,,,,
40007523,0310,88239,,,,,TISSUE CX NEOPLASTIC,2683.55,2683.55,,,,,,,,,,,,,
40007524,0310,88237,,,,,"BONE MARROW, TISSUE CULTURE",467.79,467.79,139.95,139.95,,,,,,,139.95,,,,
40007525,0310,88104,,,,,CYTOLOGY NGYN BRUSHING,148.00,148.00,,,,,,,,,,,,,
40007526,0311,88160,,,,,CYTOPATHOLOGY OTHER THAN GYN,130.25,0.00,,,,,,,,,,,,,
40007527,0310,88237,,,,,"BONE MARROW, MSMART",6351.04,6351.04,139.95,139.95,,,,,,,139.95,,,,
40007531,0311,88172,,,,,FNA-BX IMM EVAL,74.25,0.00,,,,,,,,,,,,,
40007533,0300,89060,,,,,BODY FLUID CRYSTALS,74.00,74.00,10.88,10.88,,,,,,,,,,10.88,10.88
40007537,0300,86022,,,,,PLATELET AB  (INDIRECT),322.45,322.45,,,,,,,,,,,,,
40007538,0311,88182,,,,,PLSMA CELL 1ST MARKER BM,342.18,342.18,,,,,,,,,,,,,
40007539,0311,88184,,,,,FLOW CYTOMETRY FIRST MARKER,200.00,200.00,39.47,39.47,,,,,,,39.47,,,,
40007540,0311,88185,,,,,FLOW CYTOMETRY EACH ADD MARKER,67.73,67.73,23.24,23.24,,,,,,,23.24,,,,
40007541,0300,86360,,,,,"CD4 AND CD8, ABSOLUTE COUNT",75.97,75.97,,,,,,,,,,,,,
40007542,0300,86361,,,,,CD4 COUNT,71.08,71.08,,,,,,,,,,,,,
40007544,0302,86356,,,,,MONONUCLEAR CELL AG QUANT,88.25,0.00,,,,,,,,,,,,,
40007545,0300,86355,,,,,B CELLS TOTAL,90.92,90.92,,,,,,,,,,,,,
40007546,0300,86357,,,,,NATURAL KILLER CELLS,90.92,90.92,,,,,,,,,,,,,
40007547,0300,86359,,,,,T CELLS TOTAL,90.92,90.92,,,,,,,,,,,,,
40007548,0300,86352,,,,,NEUTROPHIL OXIDATIVE BURST,280.21,280.21,,,,,,,,,,,,,
40007549,0302,86352,,,,,CHRONIC URTICARIA INDEX,262.45,262.45,,,,,,,,,,,,,
40007550,0300,80299,,,,,ADALIMUMAB ACTIVITY,842.82,842.82,,,,,,,,,,,,,
40007551,0300,82397,,,,,ADALIMUMAB ANTIBODY,657.15,657.15,,,,,,,,,,,,,
40007553,0311,88187,,,,,FLOWCYTO INT 2-8 MARK,90.87,90.87,,,,,,,,,,,,,
40007554,0311,88182,,,,,FLOWCYTO CELL CYCLE DNA,120.74,120.74,,,,,,,,,,,,,
40007555,0311,88184,,,,,PLSMA CELL 1ST SURF MARK BM,701.17,701.17,39.47,39.47,,,,,,,39.47,,,,
40007561,0302,86353,,,,,LYMPHOCYTE TRANSFORMATION,87.00,0.00,,,,,,,,,,,,,
40007562,0302,86341,,,,,ISLET AG 2 AB,727.22,727.22,,,,,,,,,,,,,
40007563,0302,86341,,,,,GAD ANTIBODY,85.62,85.62,,,,,,,,,,,,,
40007600,0302,86316,,,,,CHROMOGRANIN A,167.66,167.66,,,,,,,,,,,,,
40007601,0301,83951,,,,,DES GAMMA CARBOXY PROTHROMBIN,240.29,240.29,,,,,,,,,,,,,
40007602,0300,87118,,,,,ID MALDI-TOF MASS SPEC AFB,295.37,295.37,,,,,,,,,,,,,
40007603,0301,82397,,,,,PTH RELATED PEPTIDE,96.75,96.75,32.98,32.98,,,,,,,32.98,,,,
40007604,0300,81596,,,,,FIBROTEST-ACTITEST,462.00,462.00,,,,,,,,,,,,,
40007605,0300,,,,,,"Carbamazepine-10,11-Epoxide",57.85,57.85,0.00,96.73,96.73,96.73,,,,,,,,0.00,0.00
40007606,0300,82642,,,,,"DIHYDROTESTOSTERONE, SERUM",104.49,104.49,34.82,34.82,,,,,,,34.82,,,,
40007607,0300,87635,,,,,SARS-CoV-2 NAA,169.32,169.32,55.16,73.80,,,55.16,,,,57.58,,,73.80,73.80
40007608,0300,86341,,,,,ZINC TRANSPORTER 8 ANTIBODY,495.00,495.00,,,,,,,,,,,,,
40007609,0300,86769,,,,,SARS COV-2 IGG,65.00,65.00,22.10,28.42,,,,,,,22.10,,,28.42,28.42
40007610,0300,87635,,,,,SARS-CoV-2 NAA (HMC),169.32,169.32,55.16,73.80,,,55.16,,,,57.58,,,73.80,73.80
40007611,0300,87641,,,,,MRSA SCREEN MOLECULAR,150.00,150.00,,,,,,,,,,,,,
40007612,0300,87426,,,,,SARS RAPID ANTIGEN,127.05,127.05,43.20,43.20,,,,,,,43.20,,,,
40007613,0300,0241U,,,,,RESP 4PLEX PANEL,224.40,224.40,,,,,,,,,,,,,
40007614,0319,88291,,,,,CYTOGEN/MOLECULAR INTERP/REPORT,100.00,100.00,,,,,,,,,,,,,
40008113,0310,85097,,,,,BM ASP INTERP,795.30,795.30,270.40,270.40,,,,,,,270.40,,,,
40009232,0300,82131,,,,,HOMOCYSTINE URINE,147.83,147.83,,,,,,,,,,,,,
40009233,0300,82131,,,,,PHOSPHOETHANOLAMINE URINE,640.75,0.00,,,,,,,,,,,,,
40009234,0301,82136,,,,,CYSTINE URINE,224.26,224.26,,,,,,,,,,,,,
40009236,0302,86235,,,,,NUCLEAR ANTIGEN ANTIBODY,85.74,85.74,,,,,,,,,,,,,
40009237,0300,84305,,,,,"IGF-1, LC/MS, S",51.38,51.38,,,,,,,,,,,,,
40010493,0311,88274,,,,,INTERPHASE INSITU HYBRIDIZATION,100.44,100.44,,,,,,,,,,,,,
40010494,0311,88275,,,,,IN SITU HYBRID 100 TO 300 CELLS,169.72,169.72,,,,,,,,,,,,,
4001220,0150,,,,,,ASSISTED LVG-RM & BD,0.00,0.00,,,,,,,,,,,,,
4001221,0150,,,,,,ASSIST LVG-RM/BD ADJ,0.00,0.00,,,,,,,,,,,,,
4001222,0150,,,,,,FURNISHED UNIT FEE,0.00,0.00,,,,,,,,,,,,,
4001223,0150,,,,,,PREPAYMENT CREDIT,0.00,0.00,,,,,,,,,,,,,
4001224,0150,,,,,,IND LVG-RM & BD,0.00,0.00,,,,,,,,,,,,,
4001225,0150,,,,,,IND LVG-RM/BD ADJ,0.00,0.00,,,,,,,,,,,,,
4001226,0150,,,,,,IL-HOUSEKEEPING,0.00,0.00,,,,,,,,,,,,,
4001227,0150,,,,,,IL-LAUNDRY,0.00,0.00,,,,,,,,,,,,,
4001228,0150,,,,,,IL-RM/BD-ADJ,0.00,0.00,,,,,,,,,,,,,
4001229,0150,,,,,,12/13 CREDIT,0.00,0.00,,,,,,,,,,,,,
4001230,0150,,,,,,IL-WELLNESS DUES,0.00,0.00,,,,,,,,,,,,,
4001231,0150,,,,,,IL-ST0RAGE FEE,0.00,0.00,,,,,,,,,,,,,
4001232,0150,,,,,,IL-ADDITIONAL SERVICE,0.00,0.00,,,,,,,,,,,,,
4001233,0150,,,,,,AUTO ALERT,20.00,0.00,,,,,,,,,,,,,
4001300,0150,,,,,,STOCKINGS,0.00,0.00,,,,,,,,,,,,,
40021111,0300,86255,,,,,ANTI-GBM PANEL (GBM IGA),177.50,0.00,49.19,49.30,,,,,,,49.19,,,49.30,49.30
40021276,0300,86738,,,,,MYCOPLASMA PN IgM,65.68,65.68,,,,,,,,,,,,,
40021305,0300,86664,,,,,EBV ABS-EBNA,54.09,54.09,18.39,44.14,,,,,,,18.39,,,44.14,44.14
40021306,0300,86790,,,,,HANTA VIRUS IgM,92.00,0.00,,,,,,,,,,,,,
40021307,0300,86788,,,,,WEST NILE VIRUS IGM,177.97,177.97,,,,,,,,,,,,,
40021434,0301,84075,,,,,ALK PHOS ISOS (TOTAL),44.30,44.30,,,,,,,,,,,,,
40021440,0300,86652,,,,,ARBOVIRUS PANEL Eastern Equine,49.75,0.00,,,,,,,,,,,,,
40021615,0300,86696,,,,,HERPES SIMPLX IGM TYPE II,48.50,0.00,,,,,,,,,,,,,
40021617,0300,86696,,,,,HERPES SIMPLEX IgG TYPE II,63.10,63.10,,,,,,,,,,,,,
40021707,0300,84233,,,,,FROZ EST RECEPTOR,236.95,236.95,,,,,,,,,,,,,
40021771,0300,86658,,,,,COXSACKIE A VIRUS AB A9,45.00,0.00,,,,,,,,,,,,,
40021773,0300,86658,,,,,COXSACKIE B VIRUS AB B2,43.25,0.00,,,,,,,,,,,,,
40021952,0300,86710,,,,,INFLUENZA A AB IgM,111.00,111.00,,,,,,,,,,,,,
40021955,0301,83527,,,,,FREE INSULIN,49.96,49.96,,,,,,,,,,,,,
40022048,0300,86778,,,,,TOXOPLASMOSIS ABS IgM,70.25,0.00,,,,,,,,,,,,,
40022342,0302,86146,,,,,B2 GLYCOPROTEIN 1 AB IGA,24.03,24.03,8.17,8.17,,,,,,,8.17,,,,
40022343,0300,86147,,,,,CARDIOLIPIN AB-IgM,100.44,100.44,34.15,34.15,,,,,,,34.15,,,,
40022344,0300,86148,,,,,PHOSPHATIDYLSERINE AB IGM,81.75,0.00,,,,,,,,,,,,,
40022370,0300,85245,,,,,FACT VIII (RISTCTN),114.10,114.10,,,,,,,,,,,,,
40022385,0300,86710,,,,,INFLVENZA B ANTIBODY IGM,111.00,111.00,,,,,,,,,,,,,
40022770,0301,84153,,,,,PSA - DIAGNOSTIC,133.41,133.41,51.86,90.13,,,90.13,,,,51.86,,,88.82,88.82
40022771,0301,84153,,,,,PSA - REFERRED,133.41,133.41,51.86,90.13,,,90.13,,,,51.86,,,88.82,88.82
40022947,0300,86632,,,,,CHLAMYDIA AB PANEL-IGM(C. PNEUMONIA),51.00,0.00,,,,,,,,,,,,,
40024217,0300,86757,,,,,TYPHUS AB IGM,48.50,0.00,,,,,,,,,,,,,
40024219,0300,86757,,,,,ROCKY MTN IgM,84.22,84.22,,,,,,,,,,,,,
40024290,0310,88230,,,,,CHROMOSOME AN/TISSUE CULTURE,200.75,0.00,,,,,,,,,,,,,
40024370,0300,86800,,,,,THYROGLOBULIN ANTIBODY,59.24,59.24,19.74,19.74,,,,,,,19.74,,,,
40027212,0311,88142,,,,,PAP SMEAR DIAGNOSTIC,94.50,0.00,81.75,95.20,,,95.20,,,,,,,81.75,81.75
40031111,0300,86255,,,,,ANTI-GBM PANEL (GBM IGG),177.50,0.00,49.19,49.30,,,,,,,49.19,,,49.30,49.30
40031305,0300,86665,,,,,EBV ABS-VCA IgG,63.10,63.10,21.45,51.49,,,,,,,21.45,,,51.49,51.49
40031440,0300,86653,,,,,ARBOVIRUS PANEL St. Louis,49.75,0.00,,,,,,,,,,,,,
40031771,0300,86658,,,,,COXSACKIE A VIRUS AB A10,45.00,0.00,,,,,,,,,,,,,
40031773,0300,86658,,,,,COXSACKIE B VIRUS AB B3,43.25,0.00,,,,,,,,,,,,,
40032342,0302,86146,,,,,B2 GLYCOPROTEIN 1 AB IGM,24.03,24.03,8.17,8.17,,,,,,,8.17,,,,
40032343,0300,86147,,,,,CARDIOLIPIN AB - IGA,100.44,100.44,34.15,34.15,,,,,,,34.15,,,,
40032344,0300,86148,,,,,PHOSPHATIDYLSERINE AB IGA,81.75,0.00,,,,,,,,,,,,,
40032370,0300,85246,,,,,FACT VIII vWF/Ag,92.72,92.72,,,,,,,,,,,,,
40032947,0300,86632,,,,,CHLAMYDIA AB PANEL-IGM(C. PSITTACI),51.00,0.00,,,,,,,,,,,,,
40041305,0300,86665,,,,,EBV ABS-VCA IgM,63.10,63.10,21.45,51.49,,,,,,,21.45,,,51.49,51.49
40041306,0300,G0499,,,,,HEPB SCREEN HIGH RISK INDIV MEDICARE,151.50,151.50,,,,,,,,,,,,,
40041307,0300,86305,,,,,HUMAN EPIDIDYMIS PROTEIN 4,353.50,353.50,,,,,,,,,,,,,
40041308,0310,88314,,,,,HISTOCHEMICAL STAINS ADD-ON,141.40,141.40,,,,,,,,,,,,,
40041309,0310,88319,,,,,ENZYME HISTOCHEMISTRY,191.90,191.90,,,,,,,,,,,,,
40041310,0310,88189,,,,,FLOW CYTOMETRY INTERPRETATION 16/> MARKE,282.55,282.55,97.06,97.06,,,,,,,97.06,,,,
40041311,0310,88188,,,,,FLOW CYTOMETRY INTERP 9-15 MARKERS,215.58,215.58,,,,,,,,,,,,,
40041312,0301,82135,,,,,AMINOLEVULINIC ACID DELTA,201.80,201.80,,,,,,,,,,,,,
40041313,0301,84110,,,,,PORPHOBILINOGEN URINE; QUAN,88.84,88.84,,,,,,,,,,,,,
40041440,0300,86654,,,,,ARBOVIRUS PANEL Western Equine,49.75,0.00,,,,,,,,,,,,,
40041771,0300,86658,,,,,COXSACKIE A VIRUS AB A16,45.00,0.00,,,,,,,,,,,,,
40041773,0300,86658,,,,,COXSACKIE B VIRUS AB B4,43.25,0.00,,,,,,,,,,,,,
40042370,0300,85247,,,,,FACTOR 8 VWF MULTIMERIC,280.75,0.00,,,,,,,,,,,,,
40044295,0301,82595,,,,,CRYOGLOBULIN QUANT,40.96,40.96,,,,,,,,,,,,,
40051773,0300,86658,,,,,COXSACKIE B VIRUS AB B5,43.25,0.00,,,,,,,,,,,,,
40061773,0300,86658,,,,,COXSACKIE B VIRUS AB B6,43.25,0.00,,,,,,,,,,,,,
42000017,0341,78499,,,,,NM AORTOGRAM,1113.76,1113.76,,,,,,,,,,,,,
42000020,0341,78800,,,,,NM LABEL WHITE BLOOD CELL SCAN,3711.30,3711.30,,,,,,,,,,,,,
42000025,0341,78104,,,,,NM BONE MARROW,1267.15,1267.15,,,,,,,,,,,,,
42000030,0341,78315,,,,,NM BONE SCAN 3 PHASE,1133.22,1133.22,385.29,385.29,,,,,,,,,,385.29,385.29
42000031,0341,78803,,,,,NM BONE/JOINT SPECT,1854.36,1854.36,,,,,,,,,,,,,
42000033,0341,78306,,,,,NM BONE TOTAL,1236.24,1236.24,420.51,424.44,,,,,,,420.51,,,424.44,424.44
42000034,0320,72080,,,,,"XR spine, thoracolum junc 2VW+",370.26,370.26,,,,,,,,,,,,,
42000035,0320,72081,,,,,XR Spine; 1 VW Scoliotic exam,370.26,370.26,,,,,,,,,,,,,
42000036,0320,72082,,,,,XR spine; 2 or 3 VW scoliotic exam,427.66,427.66,,,,,,,,,,,,,
42000037,0320,72083,,,,,XR spine; 4 or 5 VW scoliotic exxam,658.81,658.81,,,,,,,,,,,,,
42000038,0320,72084,,,,,XR spine; min 6VW scoliotic exam,658.81,658.81,,,,,,,,,,,,,
42000039,0320,73501,,,,,XR hip; unilat 1VW,370.26,370.26,,,,,,,,,,,,,
42000040,0320,73502,,,,,XR hip; unilat 2-3VWS,370.26,370.26,124.48,142.27,,,,,,,124.48,,,142.27,142.27
42000041,0320,73503,,,,,"XR hip; unilat, min 4VW",427.66,427.66,,,,,,,,,,,,,
42000042,0320,73521,,,,,"XR hip; bilat, 2VW",427.66,427.66,141.94,141.94,,,,,,,141.94,,,,
42000043,0320,73522,,,,,"XR hip; bilat, 3-4VW",427.66,427.66,143.17,146.03,,,,,,,143.17,,,146.03,146.03
42000044,0320,73523,,,,,"XR hip; bilat, min 5 VW",658.81,658.81,221.27,224.64,,,,,,,221.27,,,224.64,224.64
42000045,0320,73551,,,,,XR femur 1VW,370.26,370.26,,,,,,,,,,,,,
42000046,0320,73552,,,,,XR femur min 2 VW,370.26,370.26,124.01,125.89,,,,,,,124.01,,,125.89,125.89
42000058,0341,78290,,,,,NM BOWEL (MECKELS) STUDY,1900.72,1900.72,,,,,,,,,,,,,
42000060,0340,78800,,,,,NM MIRALUMA,1113.76,1113.76,,,,,,,,,,,,,
42000066,0341,78605,,,,,NM BRAIN(STATIC),1477.74,1477.74,,,,,,,,,,,,,
42000082,0341,78699,,,,,NM DYNAMIC BRAIN,1517.41,1517.41,,,,,,,,,,,,,
42000090,0341,78472,,,,,NM CARDC BLD PL,1390.77,1390.77,,,,,,,,,,,,,
42000093,0341,78452,,,,,NM MYOCARD SPECT 1 DAY PROTOCOL,3964.47,3964.47,1350.32,1829.60,,,,,,,1350.32,,,1829.60,1829.60
42000094,0341,78451,,,,,NM MYOCARD SPECT 2 DAY PROTOCOL,3964.21,3964.21,,,,,,,,,,,,,
42000108,0341,78466,,,,,NM CRDC MYOCARD I,1227.48,1227.48,,,,,,,,,,,,,
42000116,0341,78630,,,,,NM CISTERNOGRAM,1555.34,1555.34,,,,,,,,,,,,,
42000165,0341,78300,,,,,NM JOINT LMTD AREA,1113.76,1113.76,,,,,,,,,,,,,
42000173,0341,78305,,,,,NM JOINT MLTP AREA,1124.46,1124.46,,,,,,,,,,,,,
42000181,0341,78201,,,,,NM LIVER,1420.26,1420.26,,,,,,,,,,,,,
42000199,0341,78215,,,,,NM LIVER & SPLEEN,1737.05,1737.05,,,,,,,,,,,,,
42000200,0360,50200,,,,,INTRO PROC-KDN BX,908.25,0.00,,,,,,,,,,,,,
42000207,0341,78226,,,,,NM HEPATOBILIARY HIDA SCAN WO CCK,1499.97,1499.97,,,,,,,,,,,,,
42000209,0341,78227,,,,,NM HEPATOBILLIARY HIDA SCAN WITH CCK,1545.30,1545.30,526.57,1260.96,,,,,,,526.57,,,1260.96,1260.96
42000223,0341,78580,,,,,NM LUNG PRFSN STDY,1236.24,1236.24,,,,,,,,,,,,,
42000231,0341,78579,,,,,NM LUNG VENTILATION,1113.76,1113.76,,,,,,,,,,,,,
42000248,0341,78580,,,,,NM LUNG PERFUSION,1200.00,0.00,,,,,,,,,,,,,
42000249,0341,78582,,,,,NM LUNG VENT & PERF. (VQ),502.22,502.22,,,,,,,,,,,,,
42000250,0341,78598,,,,,NM LUNG QUANTITATIVE,1477.74,1477.74,,,,,,,,,,,,,
42000253,0341,78267,,,,,NM UREA BREATH TEST C-14; ACQUISITION,710.84,710.84,,,,,,,,,,,,,
42000254,0341,78268,,,,,NM UREA BREATH TEST C-14; ANALYSIS,355.42,355.42,,,,,,,,,,,,,
42000256,0341,78473,,,,,NM MUGA SCAN,1533.97,1533.97,,,,,,,,,,,,,
42000272,0341,78700,,,,,NM RENAL,1359.86,1359.86,461.08,462.35,,,,,,,461.08,,,462.35,462.35
42000280,0341,78701,,,,,NM RENL W/ARTFLW,1509.24,1509.24,,,,,,,,,,,,,
42000281,0250,A9698,,,,,SITZ MARK NON-RAD CONTRAST MATERIALNOC,85.45,85.45,,,,,,,,,,,,,
42000289,0343,A9512,,,,,NM TECHNETIUM PERTECHNETATE,105.85,105.85,,,,,,,,,,,,,
42000290,0343,A9562,,,,,NM RENAL DOSE (TC MAG3),407.87,407.87,454.63,534.72,,,,,,,454.63,,,534.72,534.72
42000291,0343,A9537,,,,,NM HEPATOBILIARY DOSE-CHO,172.65,172.65,64.82,155.23,,,,,,,64.82,,,155.23,155.23
42000292,0343,A9539,,,,,NM LUNG VENTIL DOSE(DTPA) <=25.00 mci,450.43,450.43,,,,,,,,,,,,,
42000294,0343,A9560,,,,,NM MUGA DOSE (PYP),136.22,136.22,,,,,,,,,,,,,
42000295,0343,A9500,,,,,NM CARDIOLITE DOSE (TC),583.09,583.09,109.90,148.98,,,,,,,109.90,,,148.98,148.98
42000296,0343,A9503,,,,,NM BONE DOSE (TCMDP),108.51,108.51,38.81,56.95,,,,,,,38.81,,,56.95,56.95
42000300,0343,A9540,,,,,NM TCMAA-1 LUNG PERFUSION <=10.00 mci,450.43,450.43,,,,,,,,,,,,,
42000301,0341,78480,,,,,NM EJECTION FRACTION-MYOC,1065.25,0.00,,,,,,,,,,,,,
42000302,0341,78464,,,,,NM MYOCARD PERFUSION-SING,1475.50,0.00,,,,,,,,,,,,,
42000303,0341,78453,,,,,NM MYOCARDIO-WALL MOTION,1477.74,1477.74,,,,,,,,,,,,,
42000304,0340,78708,,,,,NM RENAL W/PHARMACY,1477.74,1477.74,502.43,502.43,,,,,,,502.43,,,,
42000308,0343,A9541,,,,,NM Tc99m Sulfur Colloid,528.51,528.51,177.95,177.95,,,,,,,177.95,,,,
42000314,0341,78185,,,,,NM SPLEEN W/FLOW,1113.76,1113.76,,,,,,,,,,,,,
42000322,0340,78013,,,,,NM THYROID,1224.91,1224.91,,,,,,,,,,,,,
42000324,0341,78070,,,,,NM PARATHYROID IMAGING,1113.76,1113.76,378.68,378.68,,,,,,,378.68,,,,
42000330,0340,78012,,,,,NM THYROID UPTAKE,1113.76,1113.76,,,,,,,,,,,,,
42000345,0341,78018,,,,,NM THYROID MET SCAN-WHOLE BODY,1430.95,1430.95,,,,,,,,,,,,,
42000348,0340,78014,,,,,NM THYROID UPTAKE&SCN,1113.76,1113.76,,,,,,,,,,,,,
42000360,0341,78645,,,,,NM SHUNT EVALUATION,1113.76,1113.76,,,,,,,,,,,,,
42000362,0341,78761,,,,,NM TESTICULAR IMAGING W/VASCULAR FLOW,1149.15,1149.15,,,,,,,,,,,,,
42000371,0341,78458,,,,,NM VENOGRAM,1113.76,1113.76,,,,,,,,,,,,,
42000389,0341,78445,,,,,NM VENOGRAM/LUNG,1230.57,1230.57,,,,,,,,,,,,,
42000390,0341,78740,,,,,NM VOIDING CYSTO,1113.76,1113.76,,,,,,,,,,,,,
42000421,0341,,,,,,NM ANY ADD FLOW STDY,403.75,0.00,2363.81,2363.81,2363.81,2363.81,,,,,,,,,
42000429,0341,78195,,,,,NM LYMPHOSCINTIGRAPY,2131.23,2131.23,739.54,739.54,,,,,,,739.54,,,,
42000439,0341,,,,,,NM CHRG ON CALL,377.75,0.00,2363.81,2363.81,2363.81,2363.81,,,,,,,,,
42000447,0341,,,,,,NM CHRG CONCUR ON CAL,213.00,0.00,2363.81,2363.81,2363.81,2363.81,,,,,,,,,
42000454,0341,78230,,,,,NM PAROTID,1141.60,1141.60,,,,,,,,,,,,,
42000462,0340,78262,,,,,NM GASTRIC REFLUX STUDY,1141.60,1141.60,,,,,,,,,,,,,
42000470,0341,78278,,,,,NM GI BLEED LOC,1141.60,1141.60,,,,,,,,,,,,,
42000488,0341,78264,,,,,NM GASTRIC EMPTYING STUDY,1117.77,1117.77,378.79,378.79,,,,,,,378.79,,,,
42000490,0341,78802,,,,,NM Absesses/Infec whole body,3711.30,3711.30,,,,,,,,,,,,,
42000491,0341,78399,,,,,NM UNLISTED NUCLEAR MEDICINE STUDY,1000.00,0.00,,,,,,,,,,,,,
42001000,0402,76998,,,,,US GUIDE INTRAOP,725.18,725.18,,,,,,,,,,,,,
42001007,0402,76870,,,,,SONO SCROTUM,527.07,527.07,177.58,177.58,,,,,,,177.58,,,,
42001016,0402,76880RT,,,,,SONO KNEE RIGHT,263.25,0.00,,,,,,,,,,,,,
42001017,0402,76880LT,,,,,SONO KNEE LEFT,263.25,0.00,,,,,,,,,,,,,
42001035,0402,76942,,,,,SONO GUIDED NEEDLE PLACEMENT,514.21,514.21,174.83,174.83,,,,,,,174.83,,,,
42001056,0402,76705,,,,,SONO LLQ RLQ,527.07,527.07,176.80,342.34,,,,,,,176.80,,,342.34,342.34
42001064,0402,76856,,,,,SONO PELVIC,527.07,527.07,178.11,430.09,,,353.14,,,,178.11,,,430.09,430.09
42001106,0402,76815,,,,,SONO PREGNCY FTL AGE LIMITED,527.07,527.07,,,,,,,,,,,,,
42001114,0402,76857,,,,,SONO POST VOID RESIDUAL,527.07,527.07,176.49,179.46,,,,,,,176.49,,,179.46,179.46
42001122,0402,76770,,,,,SONO RETROPEROTINEAL,527.07,527.07,,,,,,,,,,,,,
42001130,0402,76775,,,,,SONO ABDOMINAL AORTA,527.07,527.07,177.65,208.45,,,,,,,177.65,,,208.45,208.45
42001148,0402,76705,,,,,SONO SPLEEN,527.07,527.07,176.80,342.34,,,,,,,176.80,,,342.34,342.34
42001155,0402,76705,,,,,SONO PANCREAS,527.07,527.07,176.80,342.34,,,,,,,176.80,,,342.34,342.34
42001163,0402,76775,,,,,SONO KIDNEYS BILATERAL,527.07,527.07,177.65,208.45,,,,,,,177.65,,,208.45,208.45
42001164,0402,76775RT,,,,,SONO KIDNEY RIGHT,527.07,527.07,,,,,,,,,,,,,
42001165,0402,76775LT,,,,,SONO KIDNEY LEFT,527.07,527.07,,,,,,,,,,,,,
42001171,0402,76705,,,,,SONO GALL BLADDR,527.07,527.07,176.80,342.34,,,,,,,176.80,,,342.34,342.34
42001189,0402,76705,,,,,SONO LIVER,527.07,527.07,176.80,342.34,,,,,,,176.80,,,342.34,342.34
42001197,0402,76700,,,,,SONO ABDOMEN COMPLETE,527.07,527.07,176.24,255.94,,,,,,,176.24,,,255.94,255.94
42001205,0402,76705,,,,,SONO ABDMEN LMTD,527.07,527.07,176.80,342.34,,,,,,,176.80,,,342.34,342.34
42001213,0402,76536,,,,,SONO THYROID,527.07,527.07,177.51,300.93,,,,,,,177.51,,,300.93,300.93
42001215,0402,76536,,,,,SONO PAROTID,527.07,527.07,177.51,300.93,,,,,,,177.51,,,300.93,300.93
42001220,0402,76830,,,,,SONO TRANSVAGINAL,527.07,527.07,174.83,174.83,,,,,,,174.83,,,,
42001221,0402,76882,,,,,SONO EXTREMITY BILATERAL (NON VASC),275.00,0.00,174.11,174.83,,,,,,,174.11,,,174.83,174.83
42001222,0402,76882,,,,,SONO EXTREMITY (NON VASCULAR),514.21,514.21,174.11,174.83,,,,,,,174.11,,,174.83,174.83
42001223,0402,76882,,,,,SONO EXTREMITY LEFT (NON-VASC),275.00,0.00,174.11,174.83,,,,,,,174.11,,,174.83,174.83
42001239,0402,7653650,,,,,SONO NECK BILATERAL,527.07,527.07,,,,,,,,,,,,,
42001240,0402,76536RT,,,,,SONO NECK RIGHT,527.07,527.07,,,,,,,,,,,,,
42001241,0402,76536LT,,,,,SONO NECK LEFT,527.07,527.07,,,,,,,,,,,,,
42001247,0402,76536,,,,,SONO SOFT TISSUE H+N,527.07,527.07,177.51,300.93,,,,,,,177.51,,,300.93,300.93
42001300,0402,76604,,,,,SONO CHEST,527.07,527.07,,,,,,,,,,,,,
42001304,0402,76641RT,,,,,SONO BREAST RIGHT COMPLETE,725.18,725.18,,,,,,,,,,,,,
42001305,0402,76641LT,,,,,SONO BREAST LEFT COMPLETE,725.18,725.18,,,,,,,,,,,,,
42001308,0402,76642RT,,,,,SONO BREAST RIGHT,527.07,527.07,,,,,,,,,,,,,
42001309,0402,76642LT,,,,,SONO BREAST LEFT LIMITED,527.07,527.07,,,,,,,,,,,,,
42001310,0402,76970,,,,,US FOLLOW UP STUDY,205.43,205.43,,,,,,,,,,,,,
42002003,0320,73630LT,,,,,XR FOOT LEFT,272.40,272.40,,,,,,,,,,,,,
42002005,0320,73630RT,,,,,XR FOOT RIGHT,272.40,272.40,,,,,,,,,,,,,
42002010,0320,73620,,,,,XR FOOT 2 VIEW,272.40,272.40,,,,,,,,,,,,,
42002040,0320,72040,,,,,XR C SPINE AP LAT,327.24,327.24,116.09,276.81,,,,,,,116.09,,,276.81,276.81
42002046,0320,73610RT,,,,,XR ANKLE RT 3V,337.90,337.90,,,,,,,,,,,,,
42002047,0320,73610LT,,,,,XR ANKLE LT 3V,337.36,337.36,,,,,,,,,,,,,
42002054,0320,73590RT,,,,,XR LOWER LEG RIGHT,362.72,362.72,,,,,,,,,,,,,
42002055,0320,73590LT,,,,,XR LOWER LEG LEFT,362.72,362.72,,,,,,,,,,,,,
42002070,0320,73564RT,,,,,XR KNEE COMPLETE,336.00,0.00,,,,,,,,,,,,,
42002071,0320,73564LT,,,,,XR KNEE COMPLETE,336.00,0.00,,,,,,,,,,,,,
42002075,0320,73565,,,,,XR KNEE STDG AP BILT,272.41,272.41,87.70,115.46,,,,,,,87.70,,,115.46,115.46
42002087,0320,73564LT,,,,,XR KNEE 4 VIEW LEFT,386.88,386.88,,,,,,,,,,,,,
42002088,0320,73564RT,,,,,XR KNEE 4 VIEW RIGHT,386.88,386.88,,,,,,,,,,,,,
42002095,0320,73560LT,,,,,XR KNEE 2 VIEWS LEFT,272.41,272.41,,,,,,,,,,,,,
42002096,0320,73560RT,,,,,XR KNEE 2 VIEWS RIGHT,272.41,272.41,,,,,,,,,,,,,
42002097,0320,73562LT,,,,,XR EXAM OF KNEE 3 LT,351.18,351.18,,,,,,,,,,,,,
42002098,0320,73562RT,,,,,XR EXAM OF KNEE 3 RT,351.18,351.18,,,,,,,,,,,,,
42002100,0320,7356050,,,,,XR KNEE BILATERAL,408.62,408.62,,,,,,,,,,,,,
42002103,0320,73550LT,,,,,XR FEMUR 2 VWS LEFT,231.75,0.00,,,,,,,,,,,,,
42002104,0320,73550RT,,,,,XR FEMUR 2VWS RIGHT,231.75,0.00,,,,,,,,,,,,,
42002105,0320,73660TALT,,,,,XR TOE LEFT GREAT TOE,272.40,272.40,,,,,,,,,,,,,
42002115,0320,73660T9,,,,,XR TOE RIGHT 5TH,272.40,272.40,,,,,,,,,,,,,
42002153,0320,73510RT,,,,,XR HIP COMPLETE RIGHT,333.25,0.00,,,,,,,,,,,,,
42002154,0320,73510LT,,,,,XR HIP COMPLETE LEFT,333.25,0.00,,,,,,,,,,,,,
42002179,0320,72170,,,,,XR PELVIS 1/2 VWS,382.56,382.56,127.22,130.63,,,,,,,127.22,,,130.63,130.63
42002180,0320,73540,,,,,XR PEL HIP INFANT,209.50,0.00,,,,,,,,,,,,,
42002186,0320,77075,,,,,XR SKELETAL SURVEY,917.52,917.52,,,,,,,,,,,,,
42002187,0320,77072,,,,,XR BONE AGE,345.55,345.55,,,,,,,,,,,,,
42002195,0320,71130,,,,,XR STRNO CLVCLR JN,289.24,289.24,,,,,,,,,,,,,
42002205,0320,73660T1,,,,,XR TOE LEFT 2ND,272.40,272.40,,,,,,,,,,,,,
42002208,0320,73130,,,,,XR HAND MIN 3 VWS,217.00,217.00,,,,,,,,,,,,,
42002209,0320,73130LT,,,,,XR HAND MIN 3 VWS LT,272.41,272.41,,,,,,,,,,,,,
42002210,0320,73120LT,,,,,XR HAND 2 VIEW LEFT,386.88,386.88,,,,,,,,,,,,,
42002211,0320,73130RT,,,,,XR HAND 3 VWS RT,272.41,272.41,,,,,,,,,,,,,
42002212,0320,73140FA,,,,,XR FINGER LEFT THUMB,272.41,272.41,,,,,,,,,,,,,
42002213,0320,73120RT,,,,,XR HAND 2 VIEW RIGHT,386.88,386.88,,,,,,,,,,,,,
42002214,0320,73140F1,,,,,XR FINGER-2ND DIGIT LEFT,272.41,272.41,,,,,,,,,,,,,
42002215,0320,73140F2,,,,,XR FINGER-3RD DIGIT LEFT,272.41,272.41,,,,,,,,,,,,,
42002216,0320,73140F3,,,,,XR FINGER-4TH DIGIT LEFT,272.41,272.41,,,,,,,,,,,,,
42002217,0320,73140F4,,,,,XR FINGER-5TH DIGIT LEFT,272.41,272.41,,,,,,,,,,,,,
42002218,0320,73140F5,,,,,XR FINGER RIGHT THUMB,272.41,272.41,,,,,,,,,,,,,
42002219,0320,73140F6,,,,,XR FINGER-2ND DIGIT RIGHT,272.41,272.41,,,,,,,,,,,,,
42002221,0320,73140F7,,,,,XR FINGER-3RD DIGIT RIGHT,272.41,272.41,,,,,,,,,,,,,
42002222,0320,73140F8,,,,,XR FINGER-4TH DIGIT RIGHT,272.41,272.41,,,,,,,,,,,,,
42002223,0320,73140F9,,,,,XR FINGER-5TH DIGIT RIGHT,272.41,272.41,,,,,,,,,,,,,
42002228,0320,73110LT,,,,,XR WRIST LEFT,272.40,272.40,,,,,,,,,,,,,
42002229,0320,73110RT,,,,,XR WRIST RIGHT,272.40,272.40,,,,,,,,,,,,,
42002237,0320,73090RT,,,,,XR FOREARM RIGHT,296.19,296.19,,,,,,,,,,,,,
42002239,0320,73090LT,,,,,XR FOREARM LEFT,296.19,296.19,,,,,,,,,,,,,
42002252,0320,73060RT,,,,,XR HUMERUS RIGHT,362.72,362.72,,,,,,,,,,,,,
42002253,0320,73060LT,,,,,XR HUMERUS LEFT,362.72,362.72,,,,,,,,,,,,,
42002260,0320,73010RT,,,,,XR SCAPULA COMPLETE RT,382.56,382.56,,,,,,,,,,,,,
42002261,0320,73010LT,,,,,XR SCAPULA COMPLETE LT,382.56,382.56,,,,,,,,,,,,,
42002262,0320,7301050,,,,,XR SCAPULA COMPLETE BIL,432.42,432.42,,,,,,,,,,,,,
42002277,0320,73000LT,,,,,XR CLAVICLE COMPLETE LT,295.04,295.04,,,,,,,,,,,,,
42002278,0320,73000RT,,,,,XR CLAVICLE COMPLETE RT,295.04,295.04,,,,,,,,,,,,,
42002279,0320,73020LT,,,,,XR SHOULDER LEFT 1 VIEW,272.40,272.40,,,,,,,,,,,,,
42002280,0320,73020RT,,,,,XR SHOULDER RIGHT 1 VIEW,272.40,272.40,,,,,,,,,,,,,
42002284,0320,73030LT,,,,,XR SHOULDER COMPLETE LT,283.53,283.53,,,,,,,,,,,,,
42002285,0320,7303050,,,,,XR SHOULDER COMPLETE BILATERAL,432.42,432.42,,,,,,,,,,,,,
42002286,0320,73030RT,,,,,XR SHOULDER COMPLETE RT,284.58,284.58,,,,,,,,,,,,,
42002288,0320,7300050,,,,,XR CLAVICLE BILATERAL,442.54,442.54,,,,,,,,,,,,,
42002289,0320,73060,,,,,X-RAY EXAM OF HUMERUS 2+ VIEWS,544.08,544.08,,,,,,,,,,,,,
42002290,0320,7307050,,,,,XR ELBOW 2v BILATERAL,410.65,410.65,,,,,,,,,,,,,
42002291,0320,7308050,,,,,XR ELBOW 3v BILATERAL,554.38,554.38,,,,,,,,,,,,,
42002292,0320,7309050,,,,,XR FOREARM BILATERAL,444.30,444.30,,,,,,,,,,,,,
42002293,0320,7311050,,,,,XR WRIST BILATERAL,325.50,325.50,,,,,,,,,,,,,
42002294,0320,7312050,,,,,XR HAND BILATERAL,345.55,345.55,,,,,,,,,,,,,
42002295,0320,7351050,,,,,XR HIP BILATERAL,499.88,0.00,,,,,,,,,,,,,
42002296,0320,7355050,,,,,XR FEMUR BILATERAL,347.62,0.00,,,,,,,,,,,,,
42002297,0320,7359050,,,,,XR LOWER LEG BILATERAL,544.08,544.08,,,,,,,,,,,,,
42002298,0320,7361050,,,,,XR ANKLE BILATERAL,492.19,492.19,,,,,,,,,,,,,
42002299,0320,7363050,,,,,XR FOOT BILATERAL,383.23,383.23,,,,,,,,,,,,,
42002300,0320,73050,,,,,XR AC JOINTS BILATERAL,389.64,389.64,,,,,,,,,,,,,
42002305,0320,73660T2,,,,,XR TOE LEFT 3RD,272.40,272.40,,,,,,,,,,,,,
42002310,0320,70360,,,,,XR NECK SOFT TISSE,274.02,274.02,92.04,218.15,,,,,,,92.04,,,218.15,218.15
42002328,0320,72010,,,,,XR SPINE ENTIRE,879.00,0.00,,,,,,,,,,,,,
42002330,0320,72070,,,,,XR TSPINE AP&LAT,386.88,386.88,129.94,129.94,,,,,,,129.94,,,,
42002344,0320,72200,,,,,XR SACRO ILIAC JNT,382.56,382.56,,,,,,,,,,,,,
42002351,0320,72220,,,,,XR COCCYX & SACRUM,296.46,296.46,99.57,236.01,,,,,,,99.57,,,236.01,236.01
42002369,0320,72220,,,,,XR SACRUM COCCYX,782.44,782.44,99.57,236.01,,,,,,,99.57,,,236.01,236.01
42002377,0320,72110,,,,,XR LMBR SPNE MN 4VWS,489.44,489.44,162.02,162.02,,,,,,,162.02,,,,
42002378,0320,72265,,,,,LUMBAR MYELOGRAM,2267.13,2267.13,,,,,,,,,,,,,
42002379,0320,72020,,,,,XR SPINE 1 VIEW,220.69,220.69,,,,,,,,,,,,,
42002380,0320,72114,,,,,XR LSPINE W FLEX EXTENSION,528.51,528.51,180.20,180.47,,,,,,,180.20,,,180.47,180.47
42002381,0320,72120,,,,,XR LUMBAR FLEXION EXTENSION 2V,373.23,373.23,126.64,126.64,,,,,,,126.64,,,,
42002385,0320,72100,,,,,XR LUMBAR SPN 2/3 VIEW,386.88,386.88,129.62,194.07,,,,,,,129.62,,,194.07,194.07
42002393,0320,72072,,,,,XR THORACIC 3 VWS,386.88,386.88,129.50,259.21,,,259.21,,,,129.50,,,218.16,218.16
42002405,0320,73660T3,,,,,XR TOE LEFT 4TH,272.40,272.40,,,,,,,,,,,,,
42002427,0320,72050,,,,,XR CERVCL 4/5 VWS,411.57,411.57,138.18,138.18,,,,,,,138.18,,,,
42002428,0320,72052,,,,,XR C SPINE 6 VWS,355.19,355.19,,,,,,,,,,,,,
42002435,0320,72040,,,,,XR CERVICAL SPINE AP/LATERAL,345.55,345.55,116.09,276.81,,,,,,,116.09,,,276.81,276.81
42002436,0320,72240,,,,,XR CERVICAL MYELOGRAM,2267.13,2267.13,,,,,,,,,,,,,
42002442,0320,73070,,,,,XR ELBOW LT 2 VIEWS,273.76,273.76,90.81,90.81,,,,,,,90.81,,,,
42002443,0320,73070,,,,,XR ELBOW RT 2 VIEW,273.76,273.76,90.81,90.81,,,,,,,90.81,,,,
42002445,0320,73080RT,,,,,XR ELBOW RIGHT 3 VIEW,369.58,369.58,,,,,,,,,,,,,
42002446,0320,73080LT,,,,,XR ELBOW LEFT 3 VIEW,369.58,369.58,,,,,,,,,,,,,
42002450,0320,73650RT,,,,,XR CALCANEUS RIGHT (HEEL),272.40,272.40,,,,,,,,,,,,,
42002451,0320,73650LT,,,,,XR CALCANEUS LEFT (HEEL),272.40,272.40,,,,,,,,,,,,,
42002473,0320,73592LT,,,,,XR LOWER EXT. INFANT LEFT,273.76,273.76,,,,,,,,,,,,,
42002474,0320,73592RT,,,,,XR LOWER EXT. INFANT RIGHT,273.76,273.76,,,,,,,,,,,,,
42002478,0320,76010,,,,,XR BABYGRAM,199.50,0.00,,,,,,,,,,,,,
42002492,0320,71120,,,,,XR STERNUM,294.62,294.62,100.17,100.17,,,,,,,,,,100.17,100.17
42002500,0320,71111,,,,,XR RIBS BILATERAL MIN 4 VWS,400.73,400.73,125.11,136.25,,,,,,,136.25,,,125.11,125.11
42002505,0320,73660T4,,,,,XR TOE LEFT 5TH,272.40,272.40,,,,,,,,,,,,,
42002518,0320,71101RT,,,,,XR RIBS/CHEST RIGHT MIN 3VWS,386.88,386.88,,,,,,,,,,,,,
42002519,0320,71101LT,,,,,XR RIBS/CHEST LEFT MIN 3 VWS,386.88,386.88,,,,,,,,,,,,,
42002534,0324,71030,,,,,XR CHEST COMPLETE,258.00,0.00,,,,,,,,,,,,,
42002542,0324,71046,,,,,XR CHEST 2 PA LAT,204.86,204.86,68.72,136.88,,,136.88,,,,68.72,,,111.07,111.07
42002555,0324,71045,,,,,XR CHEST 1 VIEW,237.59,237.59,79.66,163.97,,,158.32,,,,79.66,,,163.97,163.97
42002559,0324,71045,,,,,XR CHEST PORTABLE 1 VIEW AP,231.80,231.80,79.66,163.97,,,158.32,,,,79.66,,,163.97,163.97
42002560,0324,71035,,,,,XR CHEST SPECIAL VIEWS,218.50,0.00,,,,,,,,,,,,,
42002561,0324,71047,,,,,XR CHEST2 VWS FRONT LAT W/ LORDOTIC,372.65,372.65,,,,,,,,,,,,,
42002565,0324,71048,,,,,XR CHEST 4+ VWS,372.65,372.65,,,,,,,,,,,,,
42002567,0320,72069,,,,,XR SCOLIOSIS SURVY,223.50,0.00,,,,,,,,,,,,,
42002575,0320,70150,,,,,XR FACIAL BONES COMPLETE,386.88,386.88,,,,,,,,,,,,,
42002605,0320,73660T5RT,,,,,XR TOE RIGHT GREAT TOE,272.40,272.40,,,,,,,,,,,,,
42002617,0320,70160,,,,,XR NASAL BONES COMPLETE,274.02,274.02,,,,,,,,,,,,,
42002625,0320,70200,,,,,XR ORBITS,345.55,345.55,,,,,,,,,,,,,
42002633,0320,70220,,,,,XR SINUSES COMPLETE,348.20,348.20,,,,,,,,,,,,,
42002674,0320,70330,,,,,XR TMJ BIL,231.75,0.00,,,,,,,,,,,,,
42002682,0320,70328,,,,,XR TMJ UNI,201.75,0.00,,,,,,,,,,,,,
42002705,0320,73660T6,,,,,XR TOE RIGHT 2ND,272.40,272.40,,,,,,,,,,,,,
42002708,0320,70110,,,,,XR MANDIBLE COMPLETE,345.55,345.55,,,,,,,,,,,,,
42002716,0320,70140,,,,,XR ZYGOMATIC ARCH <3VWS,259.50,0.00,,,,,,,,,,,,,
42002724,0320,70190,,,,,XR OPTC FRMNA RHSE,316.00,0.00,,,,,,,,,,,,,
42002726,0320,70200,,,,,XR ORBITS MRI SCREENING,0.00,0.00,,,,,,,,,,,,,
42002740,0320,70250,,,,,XR SKULL LESS THAN 4 VIEWS,355.19,355.19,120.76,120.76,,,,,,,120.76,,,,
42002757,0320,70260,,,,,XR SKULL COMPLETE,386.88,386.88,,,,,,,,,,,,,
42002770,0320,74245,,,,,XR UGI/SM BOWEL NO CONTRAST,642.74,642.74,,,,,,,,,,,,,
42002773,0320,74270,,,,,X-RAY XM COLON 1CNTRST STD,770.32,770.32,,,,,,,,,,,,,
42002800,0324,71023,,,,,CHEST SINGLE VIEW W FLUOROSCOPY,327.24,327.24,,,,,,,,,,,,,
42002801,0324,71034,,,,,CHEST COMPLETE WITH FLUOROSCOPY,327.24,327.24,,,,,,,,,,,,,
42002802,0320,73530,,,,,HIP XRAY INTRAOPERATIVE,523.50,0.00,,,,,,,,,,,,,
42002805,0320,73660T7,,,,,XR TOE RIGHT 3RD,272.40,272.40,,,,,,,,,,,,,
42002807,0320,74240,,,,,XR UGI/SM BOWEL,658.81,658.81,203.42,500.41,,,,,,,203.42,,,500.41,500.41
42002808,0320,75989,,,,,ANG ABSCESS DRAINAGE /FLURO US CT GUIDED,437.44,437.44,,,,,,,,,,,,,
42002809,0320,76000,,,,,FL FLUORO TIME 60 MINUTES,777.80,777.80,264.67,264.67,,,,,,,264.67,,,,
42002810,0320,76000,,,,,FL BRONCOSCOPY/ERCP,734.20,734.20,264.67,264.67,,,,,,,264.67,,,,
42002811,0320,77001,,,,,FLUOROGUIDE FOR VEIN DEVICE,520.25,520.25,,,,,,,,,,,,,
42002812,0320,77003,,,,,FLURO GUIDANCE NEEDLE LOCALIZATION,309.00,0.00,,,,,,,,,,,,,
42002815,0320,74240,,,,,XR UGI,613.25,613.25,203.42,500.41,,,,,,,203.42,,,500.41,500.41
42002817,0320,77002,,,,,NEEDLE LOCALIZATION BY XRAY,590.30,590.30,200.29,200.70,,,,,,,200.29,,,200.70,200.70
42002818,0320,77001,,,,,FLVORO GUIDED MEDIPORT/VENOUS ACCES,359.00,0.00,,,,,,,,,,,,,
42002819,0320,77003,,,,,FLUOROGUIDE FOR SPINE INJECT,590.30,590.30,,,,,,,,,,,,,
42002823,0320,74220,,,,,X-RAY XM ESOPHAGUS 1CNTRST,621.96,621.96,173.09,211.47,,,,,,,173.09,,,211.47,211.47
42002856,0320,74455,,,,,XR CYSTOGRAM VDNG,1303.35,1303.35,,,,,,,,,,,,,
42002858,0320,74251,,,,,X-RAY XM SM INT 2CNTRST STD,836.84,836.84,,,,,,,,,,,,,
42002864,0320,74430,,,,,XR CYSTOGRAM,1271.56,1271.56,432.33,432.33,,,,,,,432.33,,,,
42002865,0360,51600,,,,,INJECTION CYSTOGRAM,222.26,222.26,0.00,0.00,,,,,,,0.00,,,,
42002870,0320,74450,,,,,XR URETHROGRAM RETROGRADE,658.81,658.81,,,,,,,,,,,,,
42002871,0320,74420,,,,,UROGRAPHY RETOGRADE,1303.35,1303.35,436.73,443.14,,,,,,,436.73,,,443.14,443.14
42002872,0320,74450,,,,,XR RETROGRADE OR,774.25,0.00,,,,,,,,,,,,,
42002873,0360,51610,,,,,INJECTION RETRO URETHVCYSTGRAM,227.82,227.82,,,,,,,,,,,,,
42002890,0320,74480,,,,,INTRODUCTION URETHAL CATHETER1STENT,1436.50,0.00,,,,,,,,,,,,,
42002891,0320,74485,,,,,DILATION URETHRA - URETERS NEPHROSTOM,5899.26,5899.26,,,,,,,,,,,,,
42002898,0320,74400,,,,,XR IVP,680.83,680.83,,,,,,,,,,,,,
42002905,0320,73660T8,,,,,XR TOE RIGHT 4TH,272.40,272.40,,,,,,,,,,,,,
42002914,0320,74305,,,,,XR CHOLANGIOGRAM T TUBE,569.60,0.00,,,,,,,,,,,,,
42002915,0360,47505,,,,,XR INJECTION T-TUBE CHOLANGIOGRAM,309.50,0.00,,,,,,,,,,,,,
42002916,0360,47500,,,,,XR INJECTION PERQ CHOLANGIOGRAM,309.50,0.00,,,,,,,,,,,,,
42002917,0360,47630,,,,,XR EXTRACT BILE STONE PERA,509.50,0.00,,,,,,,,,,,,,
42002918,0320,74301,,,,,XR CHOLANGIOGRAM ADDITIONAL INTRAOP,622.59,622.59,,,,,,,,,,,,,
42002930,0320,74300,,,,,XR CHOLANGIOGRAM INTRAOP,829.31,829.31,284.87,284.87,,,,,,,284.87,,,,
42002931,0320,74301,,,,,ANG ADDITIONAL SET CHOLANGIOGRAPHY,327.75,0.00,,,,,,,,,,,,,
42002932,0320,74320,,,,,"XR CHOLANGIOGRAPHY,PERCUTANEOUS",589.00,0.00,,,,,,,,,,,,,
42002934,0320,74327,,,,,XR BILIARY STONE REMOVAL,768.00,0.00,,,,,,,,,,,,,
42002935,0320,74360,,,,,INTRALUMINAL DILATION ESOPHOGUS,527.21,527.21,,,,,,,,,,,,,
42002936,0320,74340,,,,,INTRO GI TUBE WITH FLUORO OR FILM,292.84,292.84,,,,,,,,,,,,,
42002937,0320,49440,,,,,ANG PERCUTANEOUS PLACEMENT GASTRO TUBE,3733.86,3733.86,,,,,,,,,,,,,
42002938,0320,74355,,,,,ANG PERCUT PLACEMENT ENTERCLYSIS TUBE,414.92,414.92,,,,,,,,,,,,,
42002989,0320,74022,,,,,XR ABDOMEN 3 VW/1VW CHST,421.33,421.33,142.54,239.65,,,,,,,142.54,,,239.65,239.65
42002997,0320,74019,,,,,XR ABDOMEN 2 VIEWS,382.56,382.56,85.58,118.31,,,,,,,118.31,,,85.58,85.58
42002998,0320,74021,,,,,XR ABDOMEN 3+ VIEWS,400.21,400.21,134.41,134.41,,,,,,,134.41,,,,
4200300,0320,7356050,,,,,XR BILATERAL KNEE,408.62,408.62,,,,,,,,,,,,,
42003000,0320,74241,,,,,XR UGI W KUB NO CONTRAST,420.58,420.58,,,,,,,,,,,,,
42003003,0320,74018,,,,,XR ABDOMEN 1 VIEW KUB,316.79,316.79,106.31,174.77,,,,,,,106.31,,,174.77,174.77
42003051,0401,77051,,,,,MAMMO DIAGNOSTIC MAMMO,96.00,0.00,,,,,,,,,,,,,
42003052,0401,77055RT,,,,,MAMMO DIAGNOSTIC RIGHT MAMMOGRAPHY,96.00,0.00,,,,,,,,,,,,,
42003053,0401,77065LT,,,,,MAMMO DIGITAL DIAGNOSTICE LEFT WITH CAD,296.99,296.99,,,,,,,,,,,,,
42003054,0403,G0202,,,,,MAMMO SCREEN BILATERAL INCL CAD,371.25,371.25,,,,,,,,,,,,,
42003055,0401,77065LT,,,,,MAMMO DIGITAL DIAGNOSTIC LEFT,296.99,296.99,,,,,,,,,,,,,
42003056,0401,77065RT,RT,,,,MAMMO DIGITAL DIAGNOSTIC RIGHTWITH CAD,281.25,0.00,,,,,,,,,,,,,
42003057,0401,77066,,,,,MAMMO DIGITAL DIAGNOSTIC BILATERAL,433.47,433.47,145.07,349.40,,,288.84,,,,145.07,,,349.40,349.40
42003058,0401,,,,,,MAMMMO BILATERAL,151.25,151.25,232.13,232.13,232.13,232.13,,,,,,,,,
42003059,0401,77065RT,,,,,MAMMO DIGITAL DIAGNOSTIC RIGHT,296.99,296.99,,,,,,,,,,,,,
42003060,0401,G0279,,,,,MAMMO DIAG TOMOSYNTHESIS,104.43,104.43,35.09,69.58,,,69.58,,,,35.09,,,59.55,59.55
42003061,0403,77063,,,,,MAMMO TOMO BILATERAL,104.43,104.43,34.95,69.58,,,69.58,,,,34.95,,,64.79,64.79
42003062,0403,77067,,,,,MAMMO DIG SCR BILAT INCLUD CAD,315.60,315.60,91.23,210.30,,,210.30,,,,91.23,,,175.16,175.16
42003075,0401,77056,,,,,MAMMO DIAGNOSTIC BILATERAL MAMMOGRAPHY,151.25,0.00,,,,,,,,,,,,,
42003100,0490,19291,,,,,MAMMO PREOP WIRE PLACEMENT ADDITIONAL,260.25,0.00,,,,,,,,,,,,,
42003160,0320,73092,,,,,XR PED UPPER EXT BIL,382.56,382.56,,,,,,,,,,,,,
42003177,0320,74290,,,,,XR CHOLECYSTOGRAPHY ORAL,658.81,658.81,,,,,,,,,,,,,
42003179,0320,74291,,,,,XR DELAYED GB,377.50,0.00,,,,,,,,,,,,,
42003185,0320,72069,,,,,XR SPINE STNDMG AP,299.00,0.00,,,,,,,,,,,,,
42003201,0320,74250,,,,,XR SMALL X-RAY XM SM INT 1CNTRST STD,621.87,621.87,,,,,,,,,,,,,
42003219,0320,76080,,,,,XR FISTULOGRAM,1603.66,1603.66,,,,,,,,,,,,,
42003227,0320,74280,,,,,XR FLURO BARIUM ENEMA AIR X-RAY XM COLON,1320.20,1320.20,,,,,,,,,,,,,
42003240,0360,32405,,,,,INTRO PROC-LUNG BX,593.25,0.00,,,,,,,,,,,,,
42003663,0401,19281,,,,,MAMMO NEEDLE LOCALIZATION RIGHT BREAST,442.25,0.00,,,,,,,,,,,,,
42003664,0320,77032LT,,,,,MAMMO NEEDLE LOCALIZATION LEFT BREAST,442.25,0.00,,,,,,,,,,,,,
42003665,0360,19283,,,,,MAMMO STEREOTACTIC NEEDLE LOC RIGHT BRST,1562.08,1562.08,,,,,,,,,,,,,
42003666,0360,19284,,,,,MAMMO STEREOTACTIC NEEDLE LOC LEFT BRST,1026.00,0.00,,,,,,,,,,,,,
42003667,0360,19081,,,,,MAMMO BREAST STEREO UNILAT + WIRE,3061.44,3061.44,,,,,,,,,,,,,
42003668,0360,1908150,,,,,MAMMO STEREO BIOPSY BILAT + WIRE,3061.44,3061.44,,,,,,,,,,,,,
42003669,0360,19082,,,,,MAMMO BREAST STERO UNILAT AD LESIONS,1026.00,0.00,,,,,,,,,,,,,
42003670,0360,19282,,,,,MAMMO BREAST NEEDLE LOC EACH ADD'L,442.25,0.00,,,,,,,,,,,,,
42003672,0320,76098,,,,,MAMMO SURGICAL SPECIMEN,1643.75,1643.75,,,,,,,,,,,,,
42003705,0490,19290,,,,,MAMMO PREOP WIRE PLACEMENT INITIAL,578.75,0.00,,,,,,,,,,,,,
42003710,0320,20501,,,,,XR INJ PROC 9 SISTUL,238.00,0.00,,,,,,,,,,,,,
42003715,0360,51610,,,,,INJ PROC-RETROG,163.25,0.00,,,,,,,,,,,,,
42003720,0360,51600,,,,,INJ PROC-CYSTO,108.00,0.00,0.00,0.00,,,,,,,0.00,,,,
42003800,0360,50390,,,,,KIDNEY CYST ASPR,513.00,0.00,,,,,,,,,,,,,
42003805,0360,32555,,,,,LUNG CYST ASPRI,1616.59,1616.59,,,,,,,,,,,,,
42003810,0360,49406,,,,,ANG RETRO PERI CYST ASP,4853.60,4853.60,,,,,,,,,,,,,
42003815,0360,19001,,,,,INTRO CYST ASP-BRST,342.00,0.00,,,,,,,,,,,,,
42003820,0360,19000,,,,,INTRO CYST ASP-BRST,342.00,0.00,,,,,,,,,,,,,
42004415,0921,93875,,,,,OCULA PLETHYSMOGPHY,356.75,0.00,,,,,,,,,,,,,
42005001,0320,77086,,,,,DXA BONE DENSITY VERT FX ASS,178.02,0.00,,,,,,,,,,,,,
42005002,0450,20604,,,,,ARTHROCENTESIS/ASPRI/INJ; SML JT US,633.39,0.00,,,,,,,,,,,,,
42005003,0450,20606,,,,,ARTHROCENTESIS/ASPRI/INJ; INTJT US,633.39,0.00,,,,,,,,,,,,,
42005004,0450,20611,,,,,ARTHROCENTESIS/ASPRI/INJ; MAJ JT US,633.39,0.00,,,,,,,,,,,,,
42005005,0450,62302,,,,,Myelography Lumbar Injection Cervical,1842.12,0.00,,,,,,,,,,,,,
42005006,0450,62303,,,,,Myelography Lumbar Injection Thoracic,1842.12,0.00,,,,,,,,,,,,,
42005007,0450,62304,,,,,Myelography Lumbar Injection Lumbrosacr,1842.12,0.00,,,,,,,,,,,,,
42005008,0450,62305,,,,,Myelography Lumbar Injection- 2 or more,1842.12,0.00,,,,,,,,,,,,,
42005009,0450,62284,,,,,Inj Proc for Myelography Tomo Lum,0.00,0.00,,,,,,,,,,,,,
42006000,0320,77080,,,,,DNU DXA BONE DENSITY AXIAL,345.55,345.55,115.58,230.25,,,230.25,,,,115.70,,,115.58,115.58
42006001,0320,77081,,,,,DXA BONE DENSITY / PERIPHERAL,208.66,208.66,,,,,,,,,,,,,
42006002,0320,77082,,,,,DXA BONE DENSITY INCL VERT FX,178.02,0.00,,,,,,,,,,,,,
42006003,0320,77080,,,,,DXA BONE DENSITY AXIAL,345.55,345.55,115.58,230.25,,,230.25,,,,115.70,,,115.58,115.58
42006500,0320,76496,,,,,ANG UNLISTED FLURO PROCEDURE,300.16,300.16,,,,,,,,,,,,,
42007000,0360,47000,,,,,INTRO PROC-LIV BX,530.25,0.00,200.56,380.66,,,,,,,200.56,,,380.66,380.66
42007500,0636,A9579JW,,,,,MMRI CONTRAST GADOL WASTE,11.35,11.35,,,,,,,,,,,,,
42007600,0404,,,,,,OUTSIDE PET SCAN EXAM,8825.00,8825.00,,,,,,,,,,,,,
42007999,0320,71035,,,,,XR CHEST ONE VIEW SPECIAL,197.60,197.60,,,,,,,,,,,,,
42008015,0320,76001,,,,,FLUORO GUIDE > 1 hours,1139.51,1139.51,,,,,,,,,,,,,
42008324,0320,74230,,,,,X-RAY XM SWLNG FUNCJ C+,606.79,606.79,,,,,,,,,,,,,
42009010,0360,49010,,,,,INTRO PROC RETROP BX,3174.50,0.00,,,,,,,,,,,,,
42009100,0360,19100,,,,,INTRO PROC-BRST BX,3232.75,3232.75,,,,,,,,,,,,,
42009101,0360,19083,,,,,BX BREAST 1st LES US GUID,4140.39,4140.39,,,,,,,,,,,,,
42009102,0341,A9516,,,,,IODINE I-123 SOD IODIDE PER 100 UCI TO 9,345.48,345.48,,,,,,,,,,,,,
42009103,0320,77077,,,,,XR JOINT SURVEY SINGLE VIEW 2+ JOINTS,378.54,378.54,,,,,,,,,,,,,
42009104,0320,74221,,,,,X-RAY XM ESOPHAGUS 2CNTRST,621.96,621.96,,,,,,,,,,,,,
42009105,0320,74248,,,,,X-RAY SM INT F-THRU STD,375.00,375.00,,,,,,,,,,,,,
42009999,0220,,,,,,=>RADIOLOGY CANCEL ORDER<=,0.00,0.00,,,,,,,,,,,,,
43001000,0321,,,,,,ANGIO UNBILLABLE,0.00,0.00,,,,,,,,,,,,,
43004850,0360,35476,,,,,ANG PTA ARTERIAL ANASTOMOSIS AVF,12069.00,0.00,,,,,,,,,,,,,
43005000,0636,Q9967,,,,,CONTRAST ISOVUE 300,0.80,0.80,0.00,0.34,,,0.00,,,,0.27,,,0.34,0.34
43005001,0636,Q9967JW,,,,,CONTRAST ISOVUE 300 WASTE,0.80,0.80,,,,,,,,,,,,,
43005537,0323,75625,,,,,ANG ABDOMINAL AORTOGRPHY,9228.36,9228.36,3148.20,3148.20,,,,,,,3148.20,,,,
43005539,0321,75665,,,,,ANG UNILAT CAROTID & CEREB,2890.25,0.00,,,,,,,,,,,,,
43005541,0321,75676,,,,,ANG UNILAT CERVCL CAROTD,1165.50,0.00,,,,,,,,,,,,,
43005542,0321,75680,,,,,ANG CERVICAL CAROTID ANGIO BICATERAL,2890.25,0.00,,,,,,,,,,,,,
43005545,0323,75605,,,,,ANG THORACTIC AORTOGRAPHY,15305.31,15305.31,5160.95,5160.95,,,,,,,5160.95,,,,
43005553,0323,75630,,,,,ANG ABDM AORTGRPHY W ROFF,9228.36,9228.36,,,,,,,,,,,,,
43005555,0321,75685,,,,,ANG VERTEBRAL ANGIOGRPHY,2537.75,0.00,,,,,,,,,,,,,
43005561,0323,75741,,,,,ANG PULMONARY ANGIO UNIL,9228.36,9228.36,,,,,,,,,,,,,
43005569,0321,75650,,,,,ANG CERVICO CEREBRL ANGI,2890.25,0.00,,,,,,,,,,,,,
43005577,0321,75671,,,,,ANG BILAT CAROTID CEREBR,3005.75,0.00,,,,,,,,,,,,,
43005580,0320,75889,,,,,ANG HEPATIC VENOGRAM,9228.36,9228.36,,,,,,,,,,,,,
43005585,0320,75825,,,,,ANG INFERIOR VENACAVGRPH,9228.36,9228.36,3137.64,3137.64,,,,,,,3137.64,,,,
43005593,0320,75827,,,,,ANG SUPERIOR VENACAVOGRP,2236.33,2236.33,760.35,760.35,,,,,,,760.35,,,,
43005595,0321,75743,,,,,ANG PULMONARY ANGIO BILAT,6659.46,0.00,,,,,,,,,,,,,
43005601,0360,36251,,,,,ANG SELECTIVE UNILATERAL RENAL,9103.05,9103.05,,,,,,,,,,,,,
43005602,0360,36253,,,,,SUPER SELECTIVE RENAL UNILATERAL,15305.31,15305.31,,,,,,,,,,,,,
43005606,0360,36254,,,,,SUPER SELECTIVE RENAL BILATERAL,9228.36,9228.36,0.00,0.00,,,,,,,0.00,,,,
43005607,0360,36252,,,,,ANG SELECTIV RENAL BILAT,14500.00,14500.00,5031.50,5031.50,,,,,,,5031.50,,,,
43005608,0321,G0275,,,,,ANG RENAL ANGIO W/CORONARY ANGIO,1248.50,0.00,,,,,,,,,,,,,
43005609,0360,37191,,,,,ANG GREENFIELD FILTER,2041.25,0.00,,,,,,,,,,,,,
43005615,0321,75893,,,,,ANG RENAL VEIN RENIN,665.75,0.00,,,,,,,,,,,,,
43005617,0320,75962,,,,,ANG PTA EXTREMITY ANGIOPLASTY,12069.15,0.00,,,,,,,,,,,,,
43005618,0360,37224,,,,,ANG PTA FEM-POP,15375.21,15375.21,5608.82,5608.82,,,,,,,5608.82,,,,
43005625,0320,75964,,,,,ANG PTA EACH ADDITIONAL EXTREMITY VESSE,6916.05,0.00,,,,,,,,,,,,,
43005633,0321,75660,,,,,ANG UNILAT CAROTID,1248.50,0.00,,,,,,,,,,,,,
43005635,0321,75962,,,,,ANG PTA BRACHIOCEPHALIC,2890.25,0.00,,,,,,,,,,,,,
43005640,0323,75716,,,,,ANG EXTREMITY BILATERAL ANGIOGRAPHY,9228.36,9228.36,3148.20,3148.20,,,,,,,3148.20,,,,
43005641,0323,75710,,,,,ANG EXTREMITY UNILATER ANGIO,9228.36,9228.36,3133.27,3133.27,,,,,,,3133.27,,,,
43005642,0321,G0278,,,,,ANG ILIAL/FEMORAL W CORONARY ANGIO,1248.50,0.00,,,,,,,,,,,,,
43005647,0323,75726,,,,,ANG SELECTIVE VISCERAL,9228.36,9228.36,,,,,,,,,,,,,
43005649,0321,75960,,,,,ANG STENT INTRAVASCULAR,12069.24,0.00,,,,,,,,,,,,,
43005651,0323,75774,,,,,ANG ADD SELECTIVE VESSEL ADD ON,7032.09,7032.09,,,,,,,,,,,,,
43005657,0320,75966,,,,,ANG RENAL PTA,13832.07,0.00,,,,,,,,,,,,,
43005658,0320,75968,,,,,ANG PTA EACH ADDITIONAL REUAL/VISCOART,6916.05,0.00,,,,,,,,,,,,,
43005660,0360,37201,,,,,ANG TRANSCATHETER THERAPY THROMBOLYSIS,1578.50,0.00,,,,,,,,,,,,,
43005661,0360,37236,,,,,ANG TRANSCATHETER PERCUTANEOUS STENT,32995.24,32995.24,,,,,,,,,,,,,
43005662,0360,37206,,,,,ANG TRANSCATHETER PERCUTANEOUS STENT AD,13230.00,0.00,,,,,,,,,,,,,
43005663,0360,37241,,,,,ANG EMBOLIZATION OR OCCLUSION VEIN,33820.12,33820.12,,,,,,,,,,,,,
43005673,0320,75894,,,,,ANG TRANSCATHETER EMBOLIZATION,23708.55,23708.55,8060.91,8060.91,,,,,,,8060.91,,,,
43005675,0320,75820,,,,,ANG VENOGRPHY EXT UNILAT,2236.33,2236.33,760.35,760.35,,,,,,,760.35,,,,
43005676,0360,36500,,,,,ANG VENOUS SAMPLE COLLECTION,2148.03,0.00,,,,,,,,,,,,,
43005677,0320,75822,,,,,ANG VENOGRPHY EXTR BILAT,5431.66,5431.66,,,,,,,,,,,,,
43005678,0320,75831,,,,,ANG RENAL VENOGRAPHY - UNILATERAL,9228.36,9228.36,,,,,,,,,,,,,
43005679,0320,75833,,,,,ANG RENAL VENOGRPHY BIL,9228.36,9228.36,,,,,,,,,,,,,
43005680,0320,75893,,,,,ANG VENOUS SAMPLING,15305.31,15305.31,,,,,,,,,,,,,
43005681,0320,75896,,,,,ANG TRANSCATH INFUSION,3469.50,0.00,,,,,,,,,,,,,
43005683,0323,75736,,,,,ANG PELVIC SELECTIVE,9228.36,9228.36,3137.64,3137.64,,,,,,,3137.64,,,,
43005685,0323,75710,,,,,ANG EXTREMITY UNILATERAL,9228.36,9228.36,3133.27,3133.27,,,,,,,3133.27,,,,
43005687,0320,75898,,,,,ANG ANGIOGRAM EXISNG CATH,5567.45,5567.45,,,,,,,,,,,,,
43005689,0481,93555,,,,,ANGIMAGING S&I CARDIAL CATH. VENT. ATRIA,1636.75,0.00,,,,,,,,,,,,,
43005691,0481,93556,,,,,ANG IMAGING S&I CORONARY ANGIO,1352.50,0.00,,,,,,,,,,,,,
43005693,0481,93508,,,,,ANG CORONARY ANGIO W/O LH CATH,2561.25,0.00,,,,,,,,,,,,,
43005695,0481,93545,,,,,ANG SELECTIVE CORONARY ANGIO,1210.25,0.00,,,,,,,,,,,,,
43005697,0481,93539,,,,,ANG SELECTIVE ARTERIAL CONDUIT,1352.50,0.00,,,,,,,,,,,,,
43005699,0481,93540,,,,,ANG SELECTIVE VENOUS CONDUIT,1352.50,0.00,,,,,,,,,,,,,
43005701,0481,93544,,,,,ANG AORTOGRAM,924.75,0.00,,,,,,,,,,,,,
43005703,0481,93510,,,,,ANG LEFT HEART CATH,2561.25,0.00,,,,,,,,,,,,,
43005705,0481,93543,,,,,ANG SELECT. LEFT VENTRICULAR OR ARTERIAL,924.75,0.00,,,,,,,,,,,,,
43005707,0481,93454,,,,,ANG CATHETER IN CORONARY ARTERY ANGIO,9727.59,9727.59,3226.71,3307.38,,,,,,,3307.38,,,3226.71,3226.71
43005708,0481,93455,,,,,ANG ANGIO BYPASS GRAFT,9727.59,9727.59,,,,,,,,,,,,,
43005709,0481,93452,,,,,ANG LEFT HEART CATH WITH VENTRICLE,9727.59,9727.59,,,,,,,,,,,,,
43005710,0481,93451,,,,,ANG RIGHT HEART CATH WITH 02,9727.59,9727.59,,,,,,,,,,,,,
43005711,0481,93458,,,,,ANG NATIVE CORONARY ANGIL W/L+ HEART,9727.59,9727.59,,,,,,,,,,,,,
43005712,0481,93459,,,,,ANG NATIVE CORONARY AND BYPASS GRAFT,9727.59,9727.59,,,,,,,,,,,,,
43005713,0481,93567,,,,,ANG SUPRAVALVULAR AORTOGRAPHY,7948.56,0.00,,,,,,,,,,,,,
43005714,0481,93503,,,,,ANG SWAN-GUNZ CATHETERIZATION,5567.45,5567.45,,,,,,,,,,,,,
43005800,0360,37220,,,,,ANG PTA ILIAL ARTERY,16496.52,16496.52,,,,,,,,,,,,,
43005801,0360,37221,,,,,ANG PTA/STENT ILIAL ARTERY,32995.24,32995.24,,,,,,,,,,,,,
43005802,0360,37222,,,,,ANG PTA ADDITIONAL ILIAC ARTERY,12069.15,0.00,,,,,,,,,,,,,
43005803,0360,37224,,,,,ANG PTA FEMORAL-POPLITEAL ARTERY,16496.52,16496.52,5608.82,5608.82,,,,,,,5608.82,,,,
43005804,0360,37223,,,,,ANG PTA AND STENT ADDITIONAL ILIAC,18484.94,18484.94,,,,,,,,,,,,,
43005805,0360,37226,,,,,ANG PTA FEMORAL-POPLITEAL W/STENT,32995.24,32995.24,,,,,,,,,,,,,
43005806,0360,37228,,,,,ANG PTA TIBIAL ARTERY,32995.24,32995.24,,,,,,,,,,,,,
43005807,0360,37230,,,,,ANG PTA STENT TIBIAL ARTERY,53080.10,53080.10,,,,,,,,,,,,,
43005808,0360,37232,,,,,ANG ADDITIONAL PTA TIBIAL ARTERY,12069.15,0.00,,,,,,,,,,,,,
43005809,0360,37234,,,,,ANG ADDITIONAL PTA W/STENT TIBIAL,18573.10,18573.10,,,,,,,,,,,,,
43005810,0360,36147,,,,,ANG AV FISTULA DIRECT STICK,2803.16,2803.16,,,,,,,,,,,,,
43005811,0360,36148,,,,,ANG AV FISTULA INTERVENTION,2148.03,0.00,,,,,,,,,,,,,
43005812,0360,37215,,,,,ANG CAROTID STENT W/ PROTECTION,26754.77,26754.77,,,,,,,,,,,,,
43005813,0360,37216,,,,,ANG CAROTID STENT W/OUT PROTECTION,26754.77,26754.77,,,,,,,,,,,,,
43005814,0360,37236,,,,,ANG ART STENT NON-LWR ETRMTY IST,22799.25,0.00,,,,,,,,,,,,,
43005815,0360,75791,,,,,ANG AVF RIGHT FEMORAL ACCESS,2170.77,2170.77,,,,,,,,,,,,,
43005816,0360,36200,,,,,ANG CATHETER AORTA FEMORAL ACCESS,7032.09,7032.09,2390.91,2390.91,,,,,,,2390.91,,,,
43005817,0360,36120,,,,,ANG CATHETER AORTA AXILLARY ACCESS,6659.46,0.00,,,,,,,,,,,,,
43005818,0360,36140,,,,,ANG CATHETER EXTREMITY ARTERY,7032.09,7032.09,912.02,912.02,,,,,,,912.02,,,,
43005819,0360,36215,,,,,ANG ARTERIAL SELECTIVE 1ST ORDER,7323.79,7323.79,2380.62,2380.62,,,,,,,2380.62,,,,
43005820,0360,35471,,,,,ANG PTA RENAL ARTERY,14924.49,14924.49,,,,,,,,,,,,,
43005821,0360,36216,,,,,ANG ARTERIAL SELECTIVE 2ND ORDER,11220.11,11220.11,,,,,,,,,,,,,
43005822,0360,36217,,,,,ANG ARTERIAL SELECTIVE 3RD ORDER,11220.11,11220.11,3814.84,3814.84,,,,,,,3814.84,,,,
43005823,0360,36218,,,,,ANG ARTERIAL ADDITIONAL 2ND OR 3RD,11220.11,11220.11,,,,,,,,,,,,,
43005824,0360,36245,,,,,ANG ABDOMEN 1ST ORDER,11220.11,11220.11,3814.84,3814.84,,,,,,,3814.84,,,,
43005825,0360,36246,,,,,ANG ABDOMEN 2ND ORDER,11220.11,11220.11,3854.11,3854.11,,,,,,,3854.11,,,,
43005826,0360,36247,,,,,ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER,11220.11,11220.11,3838.40,3838.40,,,,,,,3838.40,,,,
43005827,0360,36248,,,,,"ANG ADDITIONAL 1,2,3 ORDER, EACH",11220.11,11220.11,,,,,,,,,,,,,
43005828,0360,36010,,,,,ANG VENA CAVA VENOGRAPHY,3736.64,3736.64,1270.46,1270.46,,,,,,,1270.46,,,,
43005829,0360,36011,,,,,ANG CATHETER VEIN 1ST ORDER,3723.56,3723.56,,,,,,,,,,,,,
43005830,0360,36012,,,,,ANG CATHETER VEIN 2ND ORDER,4524.54,4524.54,,,,,,,,,,,,,
43005831,0360,36013,,,,,ANG CATHETER RV OR MAIN PA,2495.52,2495.52,,,,,,,,,,,,,
43005832,0360,36014,,,,,ANG SELECT RT OR LT PULMONARY ART,3751.50,3751.50,,,,,,,,,,,,,
43005833,0360,36015,,,,,ANG CATHETER SEGMENTAL PULMONARY A,3843.75,3843.75,,,,,,,,,,,,,
43005834,0360,36598,,,,,ANG INJECTION EXISTING CATHETER,1158.25,1158.25,,,,,,,,,,,,,
43005835,0360,36593,,,,,ANG CYSIS CLOTTED CATHETER/DEVICE,1134.67,1134.67,,,,,,,,,,,,,
43005836,0360,37191,,,,,ANG VENA LAVA FILTER PLACEMENT,15305.21,15305.21,,,,,,,,,,,,,
43005837,0360,36010,,,,,ANG INFERIOR/SUPERIOR CAVAGRAM,0.00,0.00,1270.46,1270.46,,,,,,,1270.46,,,,
43005838,0360,75978,,,,,ANG PTA VENOUS (AVF),7303.82,7303.82,,,,,,,,,,,,,
43005839,0360,37191,,,,,ANG THROMBOLYSIS,0.00,0.00,,,,,,,,,,,,,
43005840,0360,37202,,,,,ANG INFUSION NON THROWOLSIS,3469.50,0.00,,,,,,,,,,,,,
43005841,0360,37242,,,,,ANG EMBOLIZATION OCCLUSION ARTERY,33820.12,33820.12,,,,,,,,,,,,,
43005842,0321,37209,,,,,ANG CATHETER EXCHANGE-THROWOLYTIC,0.00,0.00,,,,,,,,,,,,,
43005843,0360,35476,,,,,ANG VEIN PTA SURGICAL,12069.15,0.00,,,,,,,,,,,,,
43005844,0360,37237,,,,,ANG ART STENT NON-LWR EXTMTY ADDITIONAL,11026.03,0.00,,,,,,,,,,,,,
43005845,0360,37238,,,,,ANG STENT PLACEMENT VEIN INITIAL,32747.95,32747.95,11134.30,11134.30,,,,,,,11134.30,,,,
43005846,0360,37239,,,,,ANG STENT VEIN EACH ADDITIONAL,13722.26,13722.26,,,,,,,,,,,,,
43005847,0360,37246,,,,,"ANG PTA  AORTA , RENAL OR MESENTERIC",15759.59,15759.59,,,,,,,,,,,,,
43005848,0360,37241,,,,,ANG EMBOLIZATION VEIN,32747.95,32747.95,,,,,,,,,,,,,
43005849,0360,37244,,,,,ANG EMBOLIZATION HEMMORRHAGE A OR V,33820.12,33820.12,,,,,,,,,,,,,
43005850,0360,35476,,,,,ANG PTA ARTERIAL ANASTOMOSIS AVF,12069.00,0.00,,,,,,,,,,,,,
43005851,0360,35476,,,,,ANG PTA VENOUS ANASTOMOSIS AVP,14924.49,14924.49,,,,,,,,,,,,,
43005900,0360,36221,,,,,ANG THORACIC AORTA WITH CAROTID AN,9228.36,9228.36,,,,,,,,,,,,,
43005901,0360,36222,,,,,ANG CCA SELECTIVE WITH CAROTID ANG,9228.36,9228.36,,,,,,,,,,,,,
43005902,0360,36223,,,,,ANG CCA SELECTIVE WITH CEREBRAL,15305.31,15305.31,6107.55,6107.55,,,,,,,6107.55,,,,
43005903,0360,36224,,,,,ANG ICA SELECTIVE,15305.31,15305.31,,,,,,,,,,,,,
43005904,0360,36225,,,,,ANG SUBCLAVIAN/INNOMIWATE W VERT,9228.36,9228.36,3158.76,3158.76,,,,,,,3158.76,,,,
43005905,0360,36226,,,,,ANG VERTEBRAL ARTERY SELECTIVE,15305.31,15305.31,,,,,,,,,,,,,
43005906,0360,36227,,,,,ANG ECA SELECTIVE ADD ON,12660.00,12660.00,,,,,,,,,,,,,
43005907,0360,36228,,,,,ANG ICA/VERTEBRAL BRANCH SELECTIVE,9898.38,9898.38,,,,,,,,,,,,,
43005908,0360,37213,,,,,ANG CATHETER EXCHANGE ART/VEIN,7712.51,7712.51,,,,,,,,,,,,,
43005909,0360,37211,,,,,ANG ARTERIAL INFUSION LYSIS INITIAL,15687.94,15687.94,,,,,,,,,,,,,
43005910,0360,37212,,,,,ANG VENOUS INFUSION LYSIS INITIAL,9459.07,9459.07,,,,,,,,,,,,,
43005911,0360,37214,,,,,ANG CESSATION OF THROMBOLYSIS,7712.51,7712.51,,,,,,,,,,,,,
43005912,0360,37217,,,,,ANG STENT PLACEMENT RETRO CCA/INNOM,4577.44,0.00,,,,,,,,,,,,,
43005913,0360,37218,,,,,ANG STENT PLACEMENT ANTE CCA/IMMOM,4577.44,0.00,,,,,,,,,,,,,
43005914,0321,36903,,,,,ANG INTRO CATH DIALYSIS CIRCUIT,32995.24,32995.24,,,,,,,,,,,,,
43005915,0321,36901,,,,,ANG AVF/GRAFT DIAGNOSTIC ANGIO,5371.72,5371.72,1826.38,1826.38,,,,,,,1826.38,,,1826.38,1826.38
43005916,0321,36902,,,,,ANG PTA AVF/GRAFT,16496.52,16496.52,5608.82,5608.82,,,,,,,5608.82,,,,
43005917,0360,36473,,,,,ENDOVENOUSE MCHNCHEM 1ST VEIN,9228.36,9228.36,,,,,,,,,,,,,
43005918,0360,36474,,,,,ENDOVENOUS MCHNCHEM ADD ON,4143.95,4143.95,,,,,,,,,,,,,
43005919,0360,37248,,,,,"ANG PTA  VEIN, INITIAL OR SAME",15375.21,0.00,,,,,,,,,,,,,
43005920,0360,3622250,,,,,ANG CCA SELECTIVE WITH CAROTID ANG BILAT,14188.60,14188.60,,,,,,,,,,,,,
43005921,0481,93454,,,,,ANG CATHETER IN CORONARY ARTERY ANGIO BI,14591.38,14591.38,3226.71,3307.38,,,,,,,3307.38,,,3226.71,3226.71
43005999,0360,3622350,,,,,ANG BILAT CCA SELECTIVE W/ CEREBRAL,22957.97,22957.97,,,,,,,,,,,,,
43006000,0322,73040,,,,,SHOULDER ARTHROGRAM,875.50,0.00,,,,,,,,,,,,,
43006001,0360,23350,,,,,INJECTION PROCEDURE SHOULDER ARTHR,684.31,684.31,,,,,,,,,,,,,
43006010,0360,25246,,,,,INJECTION PROCEDURE FOR WRIST ARTHOGRAPH,465.65,465.65,,,,,,,,,,,,,
43006011,0360,G0278,,,,,ILIAC ART ANGIO CARDIAC CATH,1896.78,1896.78,,,,,,,,,,,,,
43006090,0360,3622650,,,,,ANG VERTEBRAL ARTERY SELECTIVE,22957.97,22957.97,,,,,,,,,,,,,
43009999,0360,3624750,,,,,ANG ABDOMEN/LOWER EXTREMITY 3RD ORDER BI,16830.00,16830.00,,,,,,,,,,,,,
44000001,0350,76376,,,,,CT 3D RECONSTRUCTION,1336.06,1336.06,,,,,,,,,,,,,
44000003,0350,74263,,,,,CT VIRTUAL COLONOSCOPY SCREENING,527.98,527.98,,,,,,,,,,,,,
44000004,0350,75571,,,,,CT CORONARY CALCIUM SCORING SCREEN,104.54,104.54,101.99,101.99,,,,,,,,,,101.99,101.99
44000005,0350,,,,,,CT VC/CCS COMBO SCREENING,626.25,0.00,3020.01,3020.01,3020.01,3020.01,,,,,,,,,
44000006,0350,74261,,,,,CT VIRTUAL COLONOSCOPY DIAGNOSTIC,527.98,527.98,,,,,,,,,,,,,
44000063,0350,77078,,,,,CT BONE MINERAL DENSITY,302.50,0.00,,,,,,,,,,,,,
44003201,0350,73201,,,,,CT UPPER EXT WITH CONT,2551.45,2551.45,,,,,,,,,,,,,
44003417,0350,70488,,,,,CT MAXILLOFACIAL WO/W IV CONTRAST,1848.98,1848.98,,,,,,,,,,,,,
44003420,0350,70486,,,,,CT MAXILLOFACIAL W/O IV CONTRAST,1143.33,1143.33,383.99,650.30,,,520.00,,,,383.99,,,650.30,650.30
44003425,0351,70450,,,,,CT HEAD W/O IV CONTRAST,2095.94,2095.94,713.90,1404.28,,,1404.28,,,,713.90,,,839.89,839.89
44003433,0351,70460,,,,,CT HEAD WITH IV CONTRAST,2446.72,2446.72,825.67,825.67,,,,,,,825.67,,,,
44003441,0351,70470,,,,,CT HEAD W/WO IV CONTRAST,2755.78,2755.78,936.97,936.97,,,,,,,936.97,,,,
44003466,0350,70481,,,,,CT IAC ORB SELLA WITH IV CONTRAST,1282.50,0.00,,,,,,,,,,,,,
44003482,0350,70490,,,,,CT NECK W/O IV CONTRAST,2155.46,2155.46,728.39,1715.96,,,,,,,728.39,,,1715.96,1715.96
44003490,0350,70491,,,,,CT NECK WITH IV CONTRAST,2515.02,2515.02,840.17,1715.43,,,,,,,840.17,,,1715.43,1715.43
44003500,0350,73706RT,,,,,CTA LOWER EXTREMITY ANGIO RIGHT,1728.00,0.00,,,,,,,,,,,,,
44003501,0350,73706LT,,,,,CTA LOWER EXTREMITY ANGIO LEFT,1728.00,0.00,,,,,,,,,,,,,
44003503,0350,74174,,,,,CTA ABDOMEN PELVIS,3810.94,3810.94,1276.87,1276.87,,,,,,,1276.87,,,,
44003504,0350,73206RT,,,,,CTA UPPER EXTRENITY ANGIO RIGHT,1728.00,0.00,,,,,,,,,,,,,
44003505,0350,73206LT,,,,,CTA UPPER EXTRENITY ANGIO LEFT,1728.00,0.00,,,,,,,,,,,,,
44003507,0350,7370650,,,,,CTA LOWER EXTREMITY ANGIO BILATERAL,2128.00,0.00,,,,,,,,,,,,,
44003508,0350,70492,,,,,CT NECK WO/W IV CONTRAST,2831.81,2831.81,,,,,,,,,,,,,
44003509,0350,7320650,,,,,CTA UPPER EXTRENITY ANGIO BILATERAL,2128.00,0.00,,,,,,,,,,,,,
44003510,0350,72191,,,,,CTA PELVIS ANGIOGRAPHY,3282.96,3282.96,,,,,,,,,,,,,
44003511,0350,75635,,,,,CTA AORTO-ILIAC RUNOFF,4866.89,4866.89,1654.74,1654.74,,,,,,,1654.74,,,,
44003512,0350,74175,,,,,CTA ABDOMEN ANGIOGRAPHY,3282.96,3282.96,,,,,,,,,,,,,
44003513,0350,70496,,,,,CTA HEAD ANGIOGRAPHY,2754.98,2754.98,936.69,936.69,,,,,,,936.69,,,,
44003514,0350,70498,,,,,CTA NECK ANGIOGRAPHY,3282.96,3282.96,1109.40,1109.40,,,,,,,1109.40,,,,
44003515,0350,71275,,,,,CTA CHEST ANGIOGRAPHY,3282.96,3282.96,1100.31,1100.31,,,,,,,1100.31,,,,
44003516,0350,71250,,,,,CT CHEST W/O IV CONTRAST,2294.06,2294.06,768.36,959.93,,,,,,,768.36,,,959.93,959.93
44003518,0350,75574,,,,,CTA HRT W/ 3D IMAGE,3296.69,3296.69,,,,,,,,,,,,,
44003524,0350,71260,,,,,CT CHEST WITH IV CONTRAST,2649.39,2649.39,885.42,1765.40,,,1765.40,,,,885.42,,,1545.08,1545.08
44003532,0350,71270,,,,,CT CHEST W/WO IV CONTRAST,2966.18,2966.18,,,,,,,,,,,,,
44003535,0350,76375,,,,,CT RECONSTRUCTION,665.75,0.00,,,,,,,,,,,,,
44003540,0350,72192,,,,,CT PELVIS W/O IV CONTRAST,2294.06,2294.06,772.15,773.98,,,,,,,773.98,,,772.15,772.15
44003557,0350,72193,,,,,CT PELVIS WITH IV CONTRAST,2584.77,2584.77,878.82,878.82,,,,,,,878.82,,,,
44003565,0350,72194,,,,,CT PELVIS W/WO IV CONTRAST,2966.98,2966.98,,,,,,,,,,,,,
44003573,0350,74150,,,,,CT ABDOMEN W/O IV CONTRAST,2294.06,2294.06,754.69,754.69,,,,,,,754.69,,,,
44003581,0350,74160,,,,,CT ABDOMEN  WITH IV CONTRAST,2584.77,2584.77,904.67,904.67,,,,,,,,,,904.67,904.67
44003582,0350,74176,,,,,CT ABD PELVIS WO IV CONTRAST,3494.15,3494.15,1169.44,1509.53,,,,,,,1169.44,,,1509.53,1509.53
44003583,0350,74177,,,,,CT ABD PELVIS WITH IV CONTRAST,3916.54,3916.54,1310.97,2609.75,,,2609.75,,,,1310.97,,,2063.14,2063.14
44003584,0350,74178,,,,,CT ABD PELVIS W/WO IV CONTRAST,4233.32,4233.32,1434.19,1439.33,,,,,,,1434.19,,,1439.33,1439.33
44003599,0350,74170,,,,,CT ABDOMEN W/WO IV CONTRAST,2966.18,2966.18,,,,,,,,,,,,,
44003607,0350,72125,,,,,CT C SPINE W/O IV CONTRAST,2325.48,2325.48,780.90,1149.85,,,,,,,780.90,,,1149.85,1149.85
44003609,0350,72126,,,,,CT CERV SPINE W CONTR,2432.61,2432.61,,,,,,,,,,,,,
44003611,0350,72127,,,,,CT CERV SPINE W & WO CONTR,2432.61,2432.61,,,,,,,,,,,,,
44003620,0350,72128,,,,,CT T SPINE W/O IV/IT CONTRAST,2294.06,2294.06,774.24,783.34,,,,,,,774.24,,,783.34,783.34
44003622,0350,72129,,,,,CT THORACIC SPINE W CONTR,2432.61,2432.61,,,,,,,,,,,,,
44003623,0350,72131,,,,,CT L SPINE W/O IV/IT CONTRAST,2294.06,2294.06,769.58,1044.08,,,,,,,769.58,,,1044.08,1044.08
44003624,0350,72130,,,,,CT THORACIC SPINE W & WO CONTR,2432.61,2432.61,,,,,,,,,,,,,
44003625,0350,72132,,,,,CT L SPINE W CONTRAST,1164.22,1164.22,,,,,,,,,,,,,
44003627,0350,72133,,,,,CT LS W & WO CONTRAST,2432.61,2432.61,,,,,,,,,,,,,
44003680,0350,77012,,,,,CT NEEDLE PLACEMENT/BIOPSY,2360.44,2360.44,719.00,765.12,,,,,,,765.12,,,719.00,719.00
44003700,0350,75989,,,,,CT GUIDANCE FOR NEEDLE PLACEMENT,2416.03,2416.03,811.92,811.92,,,,,,,811.92,,,,
44003701,0350,77012,,,,,CT GUIDED NEEDLE PLACEMENT BX ASP,2246.87,2246.87,719.00,765.12,,,,,,,765.12,,,719.00,719.00
44003722,0350,70480,,,,,CT IAC ORB SELLA W/O IV CONTRAST,1851.37,1851.37,,,,,,,,,,,,,
44003730,0350,70482,,,,,CT IAC WO/W IV CONTRAST,1497.00,0.00,,,,,,,,,,,,,
44003748,0350,73200,,,,,CT UPP EXT W/O IV CONTRAST,2192.69,2192.69,735.84,1131.99,,,,,1131.99,1131.99,735.84,,,748.72,748.72
44003750,0350,70487,,,,,CT MAXILLOFACIAL WITH IV CONTRAST,1532.19,1532.19,,,,,,,,,,,,,
44003755,0350,73202,,,,,CT EXTRMTS BTH UPPER W/WO IV CONTRAST,1460.39,1460.39,,,,,,,,,,,,,
44003761,0350,73700RT,,,,,CT LOWER EXT W/O IV CONT RIGHT,2192.69,2192.69,,,,,,,,,,,,,
44003762,0350,73700LT,,,,,CT LOWER EXT W/O IV CONTRAST LEFT,2192.69,2192.69,,,,,,,,,,,,,
44003763,0350,7370050,,,,,CT LOWER EXT W/O IV CONTRAST BILATERAL,2276.64,2276.64,,,,,,,,,,,,,
44003765,0350,7370150,,,,,CT LOWER EXT WITH IV CONTRAST BILATERAL,1362.71,1362.71,,,,,,,,,,,,,
44003766,0350,73701RT,,,,,CT LOWER EXT WITH IV CONTRAST RIGHT,2551.18,2551.18,,,,,,,,,,,,,
44003767,0350,73701LT,,,,,CT LOWER EXT WITH IV CONTRAST LEFT,2551.18,2551.18,,,,,,,,,,,,,
44003771,0350,7370250,,,,,CT LOWER EXT WO/W IV CONTRAST BILTERAL,2585.24,2585.24,,,,,,,,,,,,,
44003772,0350,73702RT,,,,,CT LOWER EXT WO/W IV CONTRAST RIGHT,2646.22,2646.22,,,,,,,,,,,,,
44003773,0350,73702LT,,,,,CT LOWER EXT WO/W IV CONTRAST LEFT,2646.22,2646.22,,,,,,,,,,,,,
44003774,0350,74261,,,,,CT COLONOGRAPHY DX,2101.25,2101.25,,,,,,,,,,,,,
44003775,0350,74263,,,,,CT COLONOGRAPHY SCRN,2562.50,2562.50,,,,,,,,,,,,,
44004230,0320,72265,,,,,CT LUMAR MYELOGRAM,2263.35,2263.35,,,,,,,,,,,,,
45000000,0921,,,,,,VL VASCULAR LAB,0.00,0.00,0.00,1046.37,1046.37,1046.37,,,,,,,,0.00,0.00
45000001,0921,93882,,,,,VL STROKE SCREEN,0.00,0.00,,,,,,,,,,,,,
45000002,0921,93979,,,,,VL AAA FREE SCREEN,0.00,0.00,306.14,306.14,,,,,,,306.14,,,,
45000003,0921,93922,,,,,VL PAD FREE SCREEN,0.00,0.00,303.09,303.94,,,,,,,303.94,,,303.09,303.09
45000004,0510,G0389TC,,,,,VL AAA MEDICAL SCREEN,150.75,0.00,,,,,,,,,,,,,
45001166,0402,76775,,,,,SONO BLADDER SCAN,514.21,514.21,177.65,208.45,,,,,,,177.65,,,208.45,208.45
45004118,0921,93922,,,,,VL ANKLE/BRACHIAL INDEX (ABI/TBI),905.74,905.74,303.09,303.94,,,,,,,303.94,,,303.09,303.09
45004126,0921,93923,,,,,VL SEGMENTAL ARTERY PRESSURES,905.74,905.74,280.78,309.28,,,,,,,280.78,,,309.28,309.28
45004127,0921,93923TC,,,,,VL PBI WITH ABI/TBI,569.50,0.00,,,,,,,,,,,,,
45004130,0921,93923,,,,,VL TOE PRESSURES,905.74,905.74,280.78,309.28,,,,,,,280.78,,,309.28,309.28
45004131,0921,93923,,,,,VL FINGER PRESSURES,905.74,905.74,280.78,309.28,,,,,,,280.78,,,309.28,309.28
45004134,0921,93924,,,,,VL ABI WITH EXERCISE,893.18,893.18,303.68,303.68,,,,,,,303.68,,,303.68,303.68
45004167,0921,93923,,,,,VL THORACIC OUTLET EVAL,601.37,601.37,280.78,309.28,,,,,,,280.78,,,309.28,309.28
45004175,0921,93880TC,,,,,VL CAROTID DUPLEX BILATERAL,1222.33,1222.33,,,,,,,,,,,,,
45004176,0921,0126T,,,,,VL IMT MEASUREMENT CAROTID ARTERY,132.50,0.00,,,,,,,,,,,,,
45004182,0921,93882,,,,,VL CAROTID DUPLEX LIMITED,568.92,568.92,,,,,,,,,,,,,
45004183,0921,93882RT,,,,,VL CAROTID DUPLEX RIGHT,647.74,647.74,,,,,,,,,,,,,
45004184,0921,93882,,,,,VL CAROTID DUPLEX LIMITED,663.93,663.93,,,,,,,,,,,,,
45004185,0921,93882,TC,,,,VL TEMPORAL ARTERY DUPLEX,663.93,663.93,,,,,,,,,,,,,
45004217,0921,93930,,,,,VL ARTERIAL DUPLEX ARM BILATERAL,1252.89,1252.89,415.59,415.59,,,,,,,,,,415.59,415.59
45004218,0921,93930TC,,,,,VL BYPASS GRAFT DUPLEX ARM BILATERAL,857.75,0.00,,,,,,,,,,,,,
45004219,0921,93931TCRT,,,,,VL BYPASS GRAFT RIGHT ARM,571.00,0.00,,,,,,,,,,,,,
45004220,0921,93931RT,,,,,VL ARTERIAL DUPLEX RIGHT ARM,905.74,905.74,,,,,,,,,,,,,
45004221,0921,93931TCLT,,,,,VL BYPASS GRAFT LEFT ARM,571.00,0.00,,,,,,,,,,,,,
45004222,0921,93931LT,,,,,VL ARTERIAL DUPLEX LEFT ARM,905.74,905.74,,,,,,,,,,,,,
45004225,0921,93925,,,,,VL ARTERIAL DUPLEX LEG BILATERAL,1252.89,1252.89,418.85,421.25,,,,,,,418.85,,,421.25,421.25
45004230,0921,93926RT,,,,,VL ARTERIAL DUPLEX RIGHT LEG,905.74,905.74,,,,,,,,,,,,,
45004231,0921,93926LT,,,,,VL ARTERIAL DUPLEX LEFT LEG,905.74,905.74,,,,,,,,,,,,,
45004233,0921,93975,,,,,VL MESENTERIC ART DPLX,1252.89,1252.89,418.29,556.24,,,,,,,418.29,,,556.24,556.24
45004235,0921,93976TC,,,,,VL MESENTERIC ART DPLX LTD,796.00,0.00,,,,,,,,,,,,,
45004241,0921,93975,,,,,VL RENAL ARTERY DUPLEX COMPLETE,1252.89,1252.89,418.29,556.24,,,,,,,418.29,,,556.24,556.24
45004242,0921,93975,,,,,VL ABDOMINAL VENOUS DUPLEX,1252.89,1252.89,418.29,556.24,,,,,,,418.29,,,556.24,556.24
45004243,0921,93975TC,,,,,VL PELVIC SCROTAL DUPLEX,1186.50,0.00,,,,,,,,,,,,,
45004245,0921,93976,,,,,VL RENAL ARTERY DUPLEX LIMITED,840.54,840.54,,,,,,,,,,,,,
45004246,0921,93976TCLT,,,,,VL RENAL ARTERY DUPLEX LEFT,796.00,0.00,,,,,,,,,,,,,
45004314,0921,93980,,,,,VL AA ILIAC DUPLEX COMPLETE,577.50,0.00,,,,,,,,,,,,,
45004316,0921,93978TC,,,,,VL AA ILIAC DUPLEX,1222.33,1222.33,,,,,,,,,,,,,
45004317,0921,93978,,,,,VL RENAL BYPASS GRAFT DUPLEX,914.20,914.20,,,,,,,,,,,,,
45004318,0921,93978TC,,,,,VL VENA CAVA DUPLEX,865.75,0.00,,,,,,,,,,,,,
45004319,0921,93978TCLT,,,,,VL RENAL BYPASS GRAFT DUPLEX LEFT,865.75,0.00,,,,,,,,,,,,,
45004320,0921,93979,,,,,VL AA ILIAC DUPLEX LTD,914.20,914.20,306.14,306.14,,,,,,,306.14,,,,
45004321,0921,93979TCLT,,,,,VL AA LEFT ILIAC DUPLEX LTD,577.50,0.00,,,,,,,,,,,,,
45004340,0921,93925TC,,,,,VL BYPASS GRAFT LEG BILATERAL,831.25,0.00,,,,,,,,,,,,,
45004345,0921,93926RT,,,,,VL BYPASS GRAFT RIGHT LEG,905.74,905.74,,,,,,,,,,,,,
45004346,0921,93926LT,,,,,VL BYPASS GRAFT LEFT LEG,905.74,905.74,,,,,,,,,,,,,
45004357,0921,93970,,,,,VL DEEP VEIN DUPLEX BIL. LEG,966.07,966.07,345.18,443.72,,,,,,,345.18,,,443.72,443.72
45004365,0921,93971RT,,,,,VL DEEP VEIN DUPLEX RIGHT LEG,767.24,767.24,,,,,,,,,,,,,
45004366,0921,93971LT,,,,,VL DEEP VEIN DUPLEX LEFT LEG,767.24,767.24,,,,,,,,,,,,,
45004368,0921,93970,,,,,VL DEEP VEIN DUPLEX BIL. ARM,966.07,966.07,345.18,443.72,,,,,,,345.18,,,443.72,443.72
45004369,0921,93971RT,,,,,VL DEEP VEIN DUPLEX RIGHT ARM,767.24,767.24,,,,,,,,,,,,,
45004370,0921,93971LT,,,,,VL DEEP VEIN DUPLEX LEFT ARM,767.24,767.24,,,,,,,,,,,,,
45004371,0921,93970,,,,,VL VENOUS REFLUX DUPLEX,1435.51,1435.51,345.18,443.72,,,,,,,345.18,,,443.72,443.72
45004373,0921,93970,,,,,VL VEIN MAPPING COMPLETE,990.22,990.22,345.18,443.72,,,,,,,345.18,,,443.72,443.72
45004374,0921,93971,,,,,VL VEIN MAPPING LIMITED,527.07,527.07,,,,,,,,,,,,,
45004375,0921,93971TCLT,,,,,VL VEIN MAPPING LEFT LEG,415.75,0.00,,,,,,,,,,,,,
45004376,0921,93970TC,,,,,VL VEIN MAPPING BILATERAL ARM,642.00,0.00,,,,,,,,,,,,,
45004377,0921,93971TCRT,,,,,VL VEIN MAPPING RIGHT ARM,415.75,0.00,,,,,,,,,,,,,
45004378,0921,93971TCLT,,,,,VL VEIN MAPPING LEFT ARM,744.75,0.00,,,,,,,,,,,,,
45004399,0921,93965,,,,,VL VENOUS REFLUX EVALUATION,421.69,421.69,,,,,,,,,,,,,
45004400,0921,93990,,,,,VL DIALYSIS ACCESS DUPLEX,786.42,786.42,264.12,267.38,,,,,,,264.12,,,267.38,267.38
45004401,0402,76937,,,,,VL US GUIDED VASCULAR ACCESS,257.55,257.55,87.57,88.12,,,,,,,88.12,,,87.57,87.57
45004402,0921,G0365,,,,,VL DIALYSIS GRAFT PRE OP VESSEL MAPPING,1222.33,1222.33,,,,,,,,,,,,,
45004999,0921,,,,,,VL VIDEO OR CD COPY OF PATIENT EXAM,15.75,0.00,0.00,1046.37,1046.37,1046.37,,,,,,,,0.00,0.00
45005000,0920,93998,,,,,VL ADD VASC,0.00,0.00,,,,,,,,,,,,,
45008990,0480,93312,,,,,ECHO TEE IMAGING,2339.18,2339.18,,,,,,,,,,,,,
45009024,0480,93320TC,,,,,ECHO DOPPLER STUDY OF HEART COMPLETE,444.75,0.00,,,,,,,,,,,,,
45009032,0480,93325,,,,,ECHO DOPPLER COLOR FLOW MAPPING ADD ON,458.18,458.18,,,,,,,,,,,,,
45009082,0480,93321TC,,,,,ECHO DOPPLER OF HEART LIMITED STUDY,444.75,0.00,,,,,,,,,,,,,
45009220,0480,93308,,,,,ECHO 2-D ECHOCARDIOGRAM LIMITED STUDY,657.25,657.25,,,,,,,,,,,,,
45009320,0480,93307,,,,,ECHO 2-D IMAGE ONLY,585.75,0.00,,,,,,,,,,,,,
45009323,0480,93303TC,,,,,ECHO LIMITED STUDY CONGENITAL DEFECT,452.75,0.00,,,,,,,,,,,,,
45009324,0480,93306,,,,,ECHO 2-D ECHOCARDIOGRAM COMPLETE STUDY,1430.40,1430.40,479.04,685.06,,,,,,,479.04,,,685.06,685.06
45009325,0480,93350,,,,,ECHO DOBUTAMINE STRESS ECHOCARDIOGRAM,1395.51,1395.51,470.56,470.56,,,,,,,470.56,,,,
45009326,0250,,TC,,,,ECHO INJECTION DOBUTAMINE PER 250MG,51.25,0.00,,,,,,,,,,,,,
45009327,0482,93016,,,,,ECHO STRESS ECHO PHYSICIAN SUPERVISION,89.25,0.00,,,,,,,,,,,,,
45009328,0636,,TC,,,,ECHO INJECTION OF OPTISON CONTRAST,595.75,0.00,,,,,,,,,,,,,
45009329,0480,93350,,,,,ECHO TREADMILL STRESS ECHOCARDIOGRAM,1395.51,1395.51,470.56,470.56,,,,,,,470.56,,,,
45009330,0480,C8929,,,,,ECHO TTE w/ or w/o FOL w/ cont doppler,2199.44,2199.44,,,,,,,,,,,,,
45009331,0480,C8924,,,,,ECHO 2D TTE W/ OR W/O FOL W/ CONT F/U,1418.01,1418.01,,,,,,,,,,,,,
45009332,0480,C8925,,,,,ECHO 2D TEE W/ OR W/O FOL W/ CONT INTERP,2199.44,2199.44,,,,,,,,,,,,,
45009333,0480,C8928,,,,,ECHO TTE W/ OR W/O FOL W/ CONT STRESS,2199.44,2199.44,,,,,,,,,,,,,
45009334,0480,C8930,,,,,ECHO TTE W/ OR W/O CONTR CONT ECG,2199.44,2199.44,,,,,,,,,,,,,
45009335,0254,Q9957,,,,,"DEFINITY INJ, PERFLUTREN LIPID MICROSPHE",588.17,588.17,,,,,,,,,,,,,
45009336,0921,93985,,,,,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL,955.34,955.34,316.89,316.89,,,,,,,316.89,,,,
45009337,0921,93986,,,,,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL,459.90,459.90,152.55,152.55,,,,,,,152.55,,,,
45009345,0480,51798,,,,,US PV RESIDUAL URINE BLDR SCAN,187.37,187.37,63.71,63.71,,,,,,,63.71,,,63.71,63.71
45009999,0220,,,,,,=>VASCULAR/US CANCEL ORDER<=,0.00,0.00,,,,,,,,,,,,,
46000000,0611,,,,,,MRI,0.00,0.00,3112.39,3112.39,3112.39,3112.39,,,,,,,,,
46008644,0611,70553,,,,,MRI BRAIN /+CONT,2458.31,2458.31,1252.78,1848.85,,,,,,,1252.78,,,1848.85,1848.85
46008647,0636,A9579,,,,,MRI CONTRAST MEDIA,261.67,261.67,0.00,5.59,,,0.00,,,,3.77,,,5.59,5.59
46008648,0636,A9579,,,,,MRI CONTRAST GADOLINIUM,11.07,11.07,0.00,5.59,,,0.00,,,,3.77,,,5.59,5.59
46008649,0615,70549,,,,,MMRA NECK WO W/ CONTRAST,3373.91,3373.91,,,,,,,,,,,,,
46008650,0350,,,,,,CT Thorax Lung Cancer Screening,465.86,465.86,3020.01,3020.01,3020.01,3020.01,,,,,,,,,
46008651,0350,71250,,,,,HIGH RESOLUTION CT CHEST,2294.06,2294.06,768.36,959.93,,,,,,,768.36,,,959.93,959.93
46008652,0610,C8901,,,,,MMRA ABDOMEN WO CONTRAST,2831.32,2831.32,,,,,,,,,,,,,
47000005,0258,,,,,,HETASTARCH 6% 500ML INJ (HESPAN),191.08,191.08,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000006,0250,,,,,,BENZONATATE 100MG CAP (TESSALON),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000007,0250,,,,,,CLARITIN D 5MG/120MG TAB 12 HOUR,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000010,0250,,,,,,CENTRUM SILVER TAB,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000012,0250,,,,,,CYCLOPENTOLATE OPTH SOL 1% 5ML (CYCLOGYL,74.98,74.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000014,0637,,,,,,FAMCICLOVIR 500MG TAB (FAMVIR),30.91,30.91,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000015,0250,,,,,,PHENOBARBITAL 60MG/ML 2ML INJ,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000016,0637,,,,,,HYOSCYAMINE 0.375MG TAB (LEVBID),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000017,0636,J2795,,,,,ROPIVACAINE 1% 10MG/ML 10ML INJ (NAROPIN,30.91,30.91,35.34,35.34,,,,,,,35.34,,,,
47000018,0637,,,,,,GUAIFENESIN DM 20mg/200MG 10ML(ROBITUSSI,6.13,6.13,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000021,0637,A9270GY,,,,,QUINAPRIL 20MG TAB (ACCUPRIL),6.25,6.25,,,,,,,,,,,,,
47000022,0250,,,,,,TRACE ELEMENTS INJ 5ML,68.45,68.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000023,0637,A9270GY,,,,,TRIAM/HCTZ 50/25MG CAP (DYAZIDE),6.75,0.00,,,,,,,,,,,,,
47000024,0250,,,,,,ESTRADIOL 0.5MG TAB (ESTRACE),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000026,0250,,,,,,CIMETIDINE 800MG TAB (TEGAMET),12.63,12.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000027,0637,,,,,,LISINOPRIL 10MG TAB (ZESTRIL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000030,0637,,,,,,SPIRONOLACTONE/HCTZ 25/25MG TAB (ALDACTA,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000031,0637,,,,,,SPIRONOLACTONE 25MG TAB (ALDACTONE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000035,0636,J8600,,,,,MELPHALAN 2MG TAB (ALKERAN),11.29,11.29,,,,,,,,,,,,,
47000036,0250,,,,,,ENOXAPARIN SQ 150MG/ML  (LOVENOX),320.35,320.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000041,0637,,,,,,AMITRIPTYLINE 25MG TAB (ELAVIL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000043,0637,,,,,,SODIUM CHLORIDE 1000MG TAB,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000044,0250,,,,,,AMPICILLIN 500MG CAP,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000047,0637,,,,,,ALUMINUM HYDROXIDE 320MG/5ML GEL 120ML,18.81,18.81,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000049,0637,,,,,,CEFADROXIL 500MG CAP (DURICEF),18.81,18.81,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000051,0636,J0285,,,,,AMPHOTERICIN INJ 50MG,111.80,111.80,,,,,,,,,,,,,
47000052,0250,,,,,,ACETOHEXAMIDE 500MG TAB (DYMELOR),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000055,0637,,,,,,SERTRALINE 50MG TAB (ZOLOFT),10.75,10.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000056,0250,,,,,,NITROPRUSSIDE 50MG/2ML INJ (NITROPRESS),1391.65,1391.65,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000059,0250,,,,,,FLEXALL GEL,13.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000062,0636,J9000,,,,,ADRIAMYCIN INJ 10MG/5ML,110.46,110.46,,,,,,,,,,,,,
47000078,0250,,,,,,NYSTATIN SUSP 100MU/ML 60ML,41.66,41.66,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000090,0250,,,,,,CIPRODEX OTIC SUSP 7.5ML,710.31,710.31,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000091,0250,,,,,,LANSOPRAZOLE 30MG SOLUTAB (PREVACID),51.87,51.87,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000135,0637,A9270GY,,,,,LEVOTHYROXINE 0.2MG TAB (SYNTHROID),6.75,0.00,,,,,,,,,,,,,
47000138,0258,S0072,,,,,AMIKIN INJ 1GM/4ML,322.50,0.00,,,,,,,,,,,,,
47000143,0636,J9370,,,,,VINCRISTINE (VINCASAR PFS),47.57,47.57,,,,,,,,,,,,,
47000144,0636,J9070,,,,,CYCLOPHOSPHAMIDE 2 GRM SDV (CYTOXAN),4695.60,4695.60,,,,,,,,,,,,,
47000145,0636,J2469,,,,,PALONOSETRON 0.25MG/5ML (ALOXI),2014.01,2014.01,,,,,,,,,,,,,
47000146,0636,J2505,,,,,PEGFILGASTRIM (NEULASTA),19972.96,19972.96,,,,,,,,,,,,,
47000147,0250,,,,,,WARFARIN 2.5MG TAB (COUMADIN),6.18,6.18,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000148,0250,A9270GY,,,,,NITROGLYCERIN 0.3MG/HR PATCH (NITRO-DUR),18.50,0.00,,,,,,,,,,,,,
47000151,0636,J0696,,,,,CEFTRIAXONE INJ 500MG (ROCEPHIN),95.41,95.41,67.78,134.95,,,134.95,,,,67.78,,,75.19,75.19
47000160,0250,,,,,,HYPOTEARS OPTH OINT,41.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000169,0250,,,,,,NEO/POLY/HC OTIC SUSP(CORTISPORIN OTIC),450.98,450.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000177,0637,,,,,,NABUMETONE 500MG TAB (RELAFEN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000178,0250,,,,,,WARFARIN 10MG TAB (COUMADIN),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000194,0250,,,,,,DIVALPROEX DR 250MG TAB (DEPAKOTE),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000201,0637,,,,,,BENAZEPRIL 10MG TAB(LOTENSIN),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000203,0250,,,,,,POLYETHYLENEGLYCOL PWD (COLYTE),21.23,21.23,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000241,0250,,,,,,RU TUSS TAB,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000244,0637,,,,,,VERAPAMIL SR 180MG TAB (ISOPTIN SR),10.71,10.71,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000277,0250,,,,,,LITHIUM CARBONATE CR 300MG TAB (LITHOBID,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000285,0636,J3010,,,,,FENTANYL 500MCG/10ML INJ (SUBLIMAZE),25.80,25.80,10.54,20.86,,,20.86,,,,10.54,,,10.76,10.76
47000320,0637,,,,,,SULFASALAZINE DR 500MG TAB (SULFAZINE),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000334,0250,,,,,,DOXEPIN HCL 100MG CAP (SINEQUAN),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000335,0250,,,,,,IBUPROFEN 600MG TAB (MOTRIN),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000350,0250,,,,,,ISONIAZID 300MG TAB (NIAZID),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000377,0250,,,,,,MAGNESIUM SULFATE SYR INJ 50% 10ML,68.26,68.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000384,0250,,,,,,STERILE WATER INJ 10ML,16.39,16.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000426,0250,,,,,,FLUMAZENIL 0.5MG/5ML INJ (ROMAZICON),44.07,44.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000433,0637,,,,,,ECONAZOLE CRM 1% 15GM (SPECTAZOLE),121.70,121.70,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000441,0250,,,,,,CARB/LEVO 25/250MG TAB (SINEMET),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000458,0250,,,,,,SILVER SULFADIAZINE 1%CREAM 50GM (SILVAD,63.96,63.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000466,0250,,,,,,SOD CHLORIDE 250ML ADV,26.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000474,0250,,,,,,SOD CHLORIDE 3% 500ML,116.10,116.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000490,0637,A9270GY,,,,,AMANTADINE 100MG CAP(SYMMETREL),6.25,6.25,,,,,,,,,,,,,
47000495,0258,,,,,,AMINO ACID 10% INJ (AMINOSYN),250.47,250.47,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000496,0258,,,,,,LIPOSYN II 20% 500ML INJ,276.01,276.01,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000497,0258,,,,,,D 70W 70% 500ML,109.11,109.11,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000498,0258,,,,,,D10W 10% 1000ML IV FLUID,36.82,36.82,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000500,0250,,,,,,A & D OINT 60GM,22.57,22.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000501,0636,J1644,,,,,"HEPARIN SOD/0.45%NS 25,000U/250ML PREMIX",56.44,56.44,10.82,11.70,,,,,,,11.70,,,10.82,10.82
47000503,0636,J7060,,,,,D5W 5% 100ML IV FLUID,32.52,32.52,,,,,,,,,,,,,
47000505,0258,,,,,,DEXTROSE INJ 5% 250ML,28.49,28.49,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000506,0636,J7060,,,,,D5W 5% 500ML IV FLUID,28.49,28.49,,,,,,,,,,,,,
47000509,0636,J7042,,,,,D5W/0.45% NS 1000ML IV FLUID,33.86,33.86,,,,,,,,,,,,,
47000510,0258,,,,,,D5W/0.9%NS 1000ML IV FLUID,33.86,33.86,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000512,0258,,,,,,D5W/LR  1000ML IV FLUID,39.51,39.51,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000514,0258,,,,,,LACTATED RINGER 1000ML IV FLUID,35.48,35.48,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000515,0258,,,,,,NACL 0.45% 1000ML IV FLUID,32.79,32.79,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000518,0636,J1442,,,,,FILGRASTIM 300MCG/ML INJ (NEUPOGEN),779.91,779.91,,,,,,,,,,,,,
47000519,0258,,,,,,NACL 0.9% 100ML IV FLUID,29.56,29.56,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000520,0258,J7050,,,,,NACL 0.9% IV 250ML IV FLUID,40.31,40.31,,,,,,,,,,,,,
47000521,0258,,,,,,NACL 0.9% 100ML IV MINI BAG,45.50,45.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000522,0636,J7040,,,,,NACL 0.9% IV 500ML IV FLUID,28.49,28.49,9.83,9.83,,,,,,,9.83,,,,
47000523,0258,J7030,,,,,NACL 0.9% 1000ML IV FLUID,29.83,29.83,,,,,,,,,,,,,
47000525,0258,,,,,,STERILE WATER IRRIG 500ML,38.16,38.16,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000527,0250,,,,,,ACETIC ACID SOL 0.25%,124.16,124.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000531,0258,,,,,,D 50W 50% 500ML,87.88,87.88,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000532,0250,,,,,,SELENIUM SUL SHAMPOO 2.5% 118ML,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000534,0258,,,,,,SODIUM CHLOR SOL 0.9% 1000ML,84.92,84.92,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000535,0250,,,,,,SODIUM CHLORIDE 100MEQ/40ML INJ,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000536,0250,,,,,,SELENIUM AC INJ 40MCG/ML 10ML,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000537,0250,,,,,,POTASSIUM PHOSPHATE 3MM/ML 15ML INJ,126.40,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000538,0250,,,,,,SODIUM ACETATE 2MEQ/ML 50ML,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000542,0250,,,,,,POTASSIUM ACETATE 40MEQ/20ML 20ML INJ,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000543,0636,J2780,,,,,RANITIDINE 150MG/6ML INJ (ZANTAC),40.31,40.31,13.60,13.60,,,,,,,13.60,,,,
47000544,0250,,,,,,CHLORHEXIDINE GLUCONATE 4% 120ML SOL (HI,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000545,0637,,,,,,FINASTERIDE 5MG TAB (PROSCAR),11.29,11.29,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000548,0636,J3411,,,,,THIAMINE HCL  200MG/2ML INJ,47.03,47.03,,,,,,,,,,,,,
47000549,0250,,,,,,SUCRALFATE 1GM/10ML 120ML SUSP,53.75,53.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000550,0258,,,,,,SODIUM CHLORIDE SOL 0.9% 3000ML,33.86,33.86,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000552,0636,J7042,,,,,D5W/0.225% NS 1000ML IV FLUID,33.86,33.86,,,,,,,,,,,,,
47000554,0636,J7040,,,,,D5W 5% 1000ML IV FLUID,30.91,30.91,9.83,9.83,,,,,,,9.83,,,,
47000561,0250,,,,,,EUCERIN 120GM CRM,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000562,0637,,,,,,MEGESTROL ORAL SUSP 40MG/ML 240ML (MEGAC,239.19,239.19,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000563,0636,J1580,,,,,GENTAMICIN 80MG/2ML INJ,32.52,32.52,12.69,21.87,,,21.87,,,,12.69,,,14.15,14.15
47000564,0250,,,,,,ETOMIDATE 2MG/ML 20ML INJ (AMIDATE),133.30,133.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000566,0636,J2597,,,,,DESMOPRESSIN 4MCG/ML 10ML MDV INJ (DDAVP,762.44,762.44,,,,,,,,,,,,,
47000567,0250,,,,,,DESMOPRESSIN 0.01% NASAL SPRAY (DDAVP),540.73,540.73,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000568,0637,,,,,,INTRACONAZOLE 10 MG/ML 120ML ORAL SUSP,1107.79,1107.79,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000569,0250,,,,,,METHOTREXATE INJ 50MG/2ML,30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000573,0637,,,,,,PSEUDOEPHEDRINE 30MG TAB (SUDAFED),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000575,0250,,,,,,HYDROCORTISONE 25MG SUPPS (ANUSOL),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000578,0636,J2543,,,,,PIPERACILLIN/TAZOBACTAM 3GM/.375GM INJ,69.88,69.88,23.76,23.76,,,,,,,23.76,,,23.76,23.76
47000579,0250,,,,,,NACL 0.9% 20ML INJ,8.06,8.06,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000580,0250,,,,,,ETHYL CHLOR AER,52.67,52.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000586,0250,,,,,,ESMOLOL 10MG/ML INJ 10ML  (BREVIBLOC),83.58,83.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000587,0250,,,,,,MORPHINE 1MG/ML 2ML AMP (ASTRAMORPH),49.72,49.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000588,0637,,,,,,LEVOTHYROXINE  0.075MG TAB (SYNTHROID),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000593,0636,J2001,,,,,LIDOCAINE 2000MG/250ML PREMIX (XYLOCAINE,95.94,95.94,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47000594,0250,,,,,,MYCOLOG 30GR CRM (NYSTATIN/TRIAMCIN),151.79,151.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000595,0250,,,,,,GAVISCON SUSP,30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000596,0637,A9270GY,,,,,SIMVASTATIN 10MG TAB (ZOCOR),11.25,0.00,,,,,,,,,,,,,
47000601,0250,,,,,,DEXTROSE 50% SYRINGE  25GM/50ML,87.34,87.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000604,0250,,,,,,XYLOCAINE HCL INJ 4%,38.16,38.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000605,0250,,,,,,ALBUMIN 25% 50ML (PLASBUMIN),907.84,907.84,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000606,0250,,,,,,CHARCOAL AQUA  ACTIDOSE 50GM,26.82,26.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000612,0637,,,,,,LEVOTHYROXINE  0.05MG TAB (SYNTHROID),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000614,0250,,,,,,ROCURONIUM 100MG/10ML INJ,170.54,170.54,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000617,0250,,,,,,ALFENTANIL INJ 500MCG/ML (ALFENTA),34.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000618,0250,,,,,,DAKINS FULL STR 1000ML,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000621,0250,,,,,,KETOCONAZOLE 2% 15GM CRM (NIZORAL),79.28,79.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000623,0636,J2930,,,,,SOLU MDRL INJ 250MG,118.79,118.79,11.38,17.54,,,,,,,11.38,,,17.54,17.54
47000624,0250,,,,,,LIDOCAINE/PRILOCAINE 2.5-2.5% CRM 5GM,34.67,34.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000628,0250,,,,,,GENTAMICIN OPTH SOL 0.3% 5ML (GENTAK),46.76,46.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000631,0250,,,,,,SODIUM BICARB 8.4 % INJ 50ML VIAL,55.95,55.95,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000632,0250,,,,,,BENZOCAINE SPRY  0.5ML (HURRICAINE),54.90,54.90,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000633,0250,,,,,,ALUMINUM SULF & CALC ACETATE 2%(DOMBERO),36.82,36.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000635,0637,,,,,,TRIMOX SUSP: 250/5ML 80ML,32.79,32.79,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000636,0637,A9270GY,,,,,AMOXICILLIN/CAVULANATE 125MG/5ML 75ML SU,119.75,0.00,,,,,,,,,,,,,
47000637,0250,,,,,,CECLOR SUSP 250/5ML,141.36,141.36,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000638,0250,,,,,,ALBUTEROL 2MG/5ML 5ML SYRUP,38.43,38.43,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000639,0250,,,,,,SSD CRM 1%,251.55,251.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000641,0250,,,,,,CORTISONE 25MG TAB (CORTONE),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000643,0637,,,,,,PROPRANOLOL 10MG TAB (INDERAL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000644,0250,,,,,,VASOPRESSIN  20U/1ML INJ (PITRESSIN),32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000645,0250,,,,,,BUTALBITAL/ASA/CAFFEINE CAP (FIORINAL),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000646,0250,,,,,,BUPIVACAINE SPINAL 0.75% 2ML AMP (MARCAI,30.91,30.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000647,0637,,,,,,LITHIUM CARBONATE CAP 300MG,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000653,0637,,,,,,CALCIUM ACETATE 667MG CAP (PHOSLO),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000654,0250,,,,,,NACL 0.9% IV 50ML IV FLUID,22.57,22.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000655,0250,,,,,,NOVOCAIN INJ 10%,30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000658,0250,,,,,,THIOPENTAL 500MG INJ (PENTOTHAL),81.70,81.70,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000659,0250,,,,,,LIDOCAINE/PRILOCAINE 2.5%/2.5% 5GM TUBE,39.51,39.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000662,0250,,,,,,ARTIFICIAL TEARS OPHTH SOLN,18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000663,0250,,,,,,SODIUM BICARB 8.4% PEDIATRIC ABBOJECT,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000664,0250,J0690,,,,,CEFAZOLIN SODIUM INJ 1GM,38.25,0.00,,,,,,,,,,,,,
47000667,0250,,,,,,GARAMYCIN OINT 0.1% 15GM,25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000668,0250,,,,,,SILVER NITRATE STICK,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000671,0636,S0039,,,,,SMZ TMP 400-80/5 10ML INJ (BACTRIM),41.12,41.12,,,,,,,,,,,,,
47000673,0250,,,,,,DURAGESIC SYSTEM 100MCG,149.96,149.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000675,0636,J2400,,,,,CHLOROPROCAINE MPF 2% INJ (NESACAINE),55.09,55.09,,,,,,,,,,,,,
47000676,0250,,,,,,SUCCINYLCHOLINE 20MG/ML 10ML INJ (ANECTI,159.10,159.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000677,0636,S0028,,,,,FAMOTIDINE 20MG/50ML PREMIX (PEPCID),38.97,38.97,,,,,,,,,,,,,
47000678,0250,,,,,,DILTIAZEM INJ 25MG/5ML,57.78,57.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000680,0250,,,,,,SODIUM BICARB 8.4% ABBOJECT 50ML,56.76,56.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000687,0636,J0256,,,,,PROLASTIN INJ 1000MG,710.04,710.04,,,,,,,,,,,,,
47000688,0250,,,,,,NACL 0.9% 250ML ADV,41.12,41.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000689,0636,J7060,,,,,D5W 5% 250ML IV FLUID,40.31,40.31,,,,,,,,,,,,,
47000690,0637,,,,,,ALLOPURINOL 100MG TAB (ZYLOPRIM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000692,0250,,,,,,BACIT/POLYM OPTH OINT (POLYSPORIN),93.52,93.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000698,0250,,,,,,DOXEPIN HCL 75MG CAP (SINEQUAN),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000701,0250,,,,,,VALPROIC ACID 250MG/5ML SYRUP (DEPAKENE),84.92,84.92,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000702,0250,,,,,,LEVOTHYROXINE  0.15MG TAB (SYNTHROID),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000703,0250,,,,,,NEOSTIGMINE 10MG/10ML INJ(PROSTIGMIN),504.39,504.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000705,0637,,,,,,SOTALOL 80MG TAB (BETAPACE),11.29,11.29,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000707,0250,,,,,,ETHACRYNIC ACID 50MG INJ (EDECRIN),81.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000710,0637,,,,,,CARB/LEVO CR 50/200MG TAB (SINEMET),8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000711,0637,,,,,,CARB/LEVO CR 25/100MG TAB (SINEMET),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000713,0250,,,,,,MAGNESIUM SU INJ 50%,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000717,0250,,,,,,CAPSAICIN 0.025% CRM,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000718,0637,,,,,,LIOTHYRONINE 25MCG TAB,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000720,0250,,,,,,INDIGO CARMINE 5ML INJ,851.40,851.40,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000721,0250,,,,,,CENTRUM LIQ,36.82,36.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000725,0250,,,,,,RACEMIC EPINEPHRINE INH SOLN 2.25% 0.5ML,52.67,52.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000727,0637,,,,,,PAROXETINE 20MG TAB (PAXIL),10.21,10.21,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000728,0250,,,,,,MINERAL OIL USP 160Z,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000732,0637,,,,,,NITROGLYCERIN 2%OINT 30GM TUBE (NITROB,102.38,102.38,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000733,0250,,,,,,POTASSIUM 20 MEQ/15ML ELIXER,89.82,89.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000734,0637,,,,,,ZOLPIDEM 5MG TAB (AMBIEN),8.06,8.06,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000736,0250,,,,,,SODIUM ACETATE 40MEQ/20ML INJ,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000737,0636,J2405,,,,,ONDANSETRON 4MG/2ML INJ (ZOFRAN),29.29,29.29,9.99,19.82,,,19.82,,,,9.99,,,14.98,14.98
47000741,0250,,,,,,STERILE WATER  20ML INJ,28.49,28.49,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000746,0637,,,,,,DILTIAZEM CD 120MG CAP (CARDIZEM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000757,0636,J3430,,,,,PHYTONADIONE 10MG/ML INJ (VITAMIN K),258.50,258.50,87.60,87.60,,,,,,,87.60,,,,
47000759,0250,,,,,,BUMETANIDE 2.5MG/10ML INJ(BUMEX),18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000760,0636,J2930,,,,,METHYLPREDNISOLONE 2GM INJ (SOLU-MEDROL),240.26,240.26,11.38,17.54,,,,,,,11.38,,,17.54,17.54
47000761,0637,,,,,,METFORMIN 500MG TAB (GLUCOPHAGE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000763,0250,,,,,,SMZ/TMP 200MG/40MG/5ML  SUSP (SEPTRA),52.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000765,0636,J3535,,,,,IPRATROPIUM BROM HFA 18MCG INHALER(ATROV,314.17,314.17,,,,,,,,,,,,,
47000766,0250,,,,,,IMIPRAMINE HCL 10MG TAB (TOFRANIL),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000767,0636,J1644,,,,,"HEPARIN 5,000units/ML INJ",32.79,32.79,10.82,11.70,,,,,,,11.70,,,10.82,10.82
47000769,0250,J7644,,,,,IPRATROPIUM BROM U/D NEB (ATROVENT),10.75,10.75,,,,,,,,,,,,,
47000770,0250,,,,,,DILTIAZEM INJ 50MG/10ML,90.30,90.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000773,0637,,,,,,OXYMETAZOLINE 0.05% NASAL SPRAY(AFRIN),25.80,25.80,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000774,0250,,,,,,SIMETHICONE 40MG/0.6ML DROP (GAS-X),32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000775,0250,J7613,,,,,ALBUTEROL SULF NEB SOL 0.083% 3ML,10.26,10.26,,,,,,,,,,,,,
47000776,0636,J0744,,,,,CIPROFLOXACIN 400MG/200ML IVPB(CIPRO),113.14,113.14,,,,,,,,,,,,,
47000780,0250,,,,,,ESTERIFIED ESTROGENS & METHYLTESTOSTERON,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000781,0250,,,,,,CHLOROPROCAINE MPF 3% INJ (NESACAINE),107.45,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000786,0258,,,,,,NALOXONE HCL INJ 0.4MG/,30.50,0.00,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47000787,0250,,,,,,VENLAFAXINE XR 37.5MG TAB (EFFEXOR),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000788,0250,,,,,,BACITRACIN OINT 30GM TUBE,18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000789,0250,,,,,,PHENYLEPHRINE PED DROP (NEO-SYNEPHRINE),25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000790,0637,,,,,,ASPIRIN EC 81MG TAB,6.25,6.25,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000802,0250,,,,,,ULTRAM TAB 50MG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000803,0250,,,,,,DIPRIVAN INJ 10MG/ML,81.97,81.97,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000814,0250,,,,,,SODIUM POLYSTYRENE 15GM/60ML SUSP (KAYEX,74.17,74.17,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000816,0250,,,,,,SODIUM POLYSTYRENE 15GM/60ML (KAYEXALATE,31.44,31.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000817,0343,A9569,,,,,TECHNETIUM Tc 99 EXAMETAZIME DOSE,415.22,415.22,,,,,,,,,,,,,
47000818,0250,,,,,,HYDROXYCHLOROQUINE 200MG TAB (PLAQUENIL),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000819,0343,A9505,,,,,THALLIUM TI 201 THALLOUS CHLORIDE,415.22,415.22,,,,,,,,,,,,,
47000825,0637,,,,,,TERAZOSIN 2MG CAP (HYTRIN),8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000828,0636,J0696,,,,,CEFTRIAXONE 1000MG INJ (ROCEPHIN),197.58,197.58,67.78,134.95,,,134.95,,,,67.78,,,75.19,75.19
47000830,0637,,,,,,NYSTATIN OINT 100MU/GM 30GM TUBE,25.53,25.53,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000831,0637,,,,,,TERAZOSIN 5MG CAP (HYTRIN),8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000833,0637,,,,,,RISPERDONE 1MG TAB (RISPERDAL),12.09,12.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000834,0637,,,,,,HYDROCORTISONE 2.5% 30GM CRM (CORTIZONE),40.31,40.31,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000838,0250,,,,,,FLUPHENAZINE HCL TAB 5MG,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000840,0250,,,,,,FLUPHENAZINE HCL 1MG TAB (PROLIXIN),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000842,0250,J7611,,,,,ALBUTEROL SOL 0.5%-20ML BOTTLE,57.78,57.78,,,,,,,,,,,,,
47000843,0636,J2001,,,,,LEVOTHYROXINE SOD INJ 0.1MG (SYNTHROID),394.78,394.78,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47000844,0637,,,,,,ITRACONAZOLE 100MG CAP (SPORANOX),32.79,32.79,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000846,0250,,,,,,CONTIGEN SKIN TEST SYR,154.26,154.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000849,0250,,,,,,ALENDRONATE 10MG TAB (FOSAMAX),9.94,9.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000853,0636,J9000,,,,,DOXORUBICIN 50MG VIAL (ADRIAMYCIN),533.47,533.47,,,,,,,,,,,,,
47000855,0278,,,,,,CONTIGEN IMPLANT SYR,1568.16,1568.16,0.00,2602.16,2602.16,2602.16,,,,,174.46,,,0.00,0.00
47000856,0250,,,,,,AMMONIUM LACTATE LOT 12% (LAC-HYDRIN),63.69,63.69,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000860,0637,J0630,,,,,CALCITONIN SALMON 200IU/ML 2ML INJ,172.54,172.54,,,,,,,,,,,,,
47000862,0636,J0713,,,,,CEFTAZIDIME 1000MG INJ (FORTAZ),55.09,55.09,,,,,,,,,,,,,
47000863,0637,,,,,,RANITIDINE 150MG TAB (ZANTAC),8.06,8.06,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000864,0637,A9270GY,,,,,RANITIDINE 300MG (ZANTAC) TAB,15.25,0.00,,,,,,,,,,,,,
47000867,0637,A9270GY,,,,,MESALAMINE 400MG TAB (ASACOL),6.75,0.00,,,,,,,,,,,,,
47000868,0637,,,,,,GABAPENTIN 100MG CAP (NEURONTIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000869,0637,,,,,,CYCLOSPORINE 25MG CAP (SANDIMMUNE),8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000872,0250,,,,,,FLUOXETINE 10MG CAP,11.29,11.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000877,0250,,,,,,FAMCICLOVIR 250MG TAB (FAMVIR),15.86,15.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000878,0250,,,,,,SUMATRIPTAN 50MG TAB (IMITREX),69.34,69.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000881,0637,,,,,,ISOSORBIDE MONONITRATE ER 60MG TAB(IMDUR,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000882,0250,,,,,,CISTRACURIUM 2MG/ML INJ (NIMBEX),80.89,80.89,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000883,0250,,,,,,METHACHOLINE 100MG PWD (PROVOCHOLINE),261.76,261.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000884,0637,,,,,,ANASTRAZOLE 1MG TAB (ARIMIDEX),30.91,30.91,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000886,0250,,,,,,GLIPIZIDE XL 5MG TAB (GLUCOTROL XL),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000888,0250,,,,,,CHROMAGEN FORTE CAP,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000890,0636,J2175,,,,,DEMEROL CARPUJECT 100MG,32.79,32.79,,,,,,,,,,,,,
47000893,0636,J3535,,,,,FLUTICASONE HFA 220MCG MDI (FLOVENT),2008.44,2008.44,,,,,,,,,,,,,
47000895,0250,,,,,,FLUTICASONE HFA 110MCG MDI (FLOVENT),1293.05,1293.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000898,0636,J2060,,,,,LORAZEPAM 2MG/1ML INJ (ATIVAN),47.30,47.30,16.09,38.60,,,,,,,16.09,,,38.60,38.60
47000899,0250,,,,,,IONAMIN CAP 15MG,1.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000901,0250,,,,,,FLUTICASONE HFA 44MCG MDI (FLOVENT),196.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000905,0636,S0020,,,,,BUPIVACAINE 0.75% 30ML INJ (MARCAINE),41.12,41.12,,,,,,,,,,,,,
47000906,0637,,,,,,CETIRIZINE 10MG TAB (ZYRTEC),8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000907,0250,,,,,,"BACITRACIN INJ 50,000 UNITS",57.24,57.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000909,0250,,,,,,DNAZOL100MG CAP (DANOCRINE),9.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000911,0250,,,,,,MORPHINE SULFATE CR 15MG TAB (MS CONTIN),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000913,0250,,,,,,AMINOACID 8% INJ (HEPATAMINE),504.98,504.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000917,0636,,,,,,BOTOX INJ 200 UNITS,6200.60,6200.60,15.98,15.98,15.98,15.98,,,,,,,,,
47000922,0637,J1815,,,,,INSULIN LISPRO 100U/ML 3ML VIAL INJ (HUM,215.00,215.00,,,,,,,,,,,,,
47000923,0636,J7509,,,,,METHYLPREDNISOLONE 4MG TAB (MEDROL),7.26,7.26,,,,,,,,,,,,,
47000924,0637,,,,,,AMOXICILLIN/CLAVULANATE 875/125MG TAB,21.23,21.23,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000925,0250,,,,,,PHENOBARBITAL 40MG/10ML U/D ELIXIR,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000926,0250,,,,,,CONGO RED AMPULE,25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000930,0636,J1245,,,,,DIPYRIDAMOLE 50MG/10ML SDV (PERSANTINE),50.26,50.26,,,,,,,,,,,,,
47000933,0637,,,,,,LATANOPROST EYE DROP 0.005% 2.5ML (XALAT,165.55,165.55,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000934,0637,,,,,,LORATIDINE/PSEUDOEPHEDRINE 10MG/240MG TA,12.63,12.63,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000945,0250,,,,,,REMIFENTANIL 2MG INJ (ULTIVA),100.51,100.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000947,0250,,,,,,REMIFENTANIL 1MG/3ML INJ (ULTIVA),237.19,237.19,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000948,0250,,,,,,MELATONIN 3MG TAB,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000949,0250,,,,,,CAFF/NA BENZ INJ 500MG,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000951,0637,,,,,,VITAMIN E 400U CAP,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000952,0637,,,,,,ACARBOSE 25MG TAB (PRECOSE),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000955,0250,,,,,,HYDROCORTISONE CRM (ANUSOL-HC),130.07,130.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000959,0250,,,,,,BRIMONIDINE OPHTH SOL (ALPHAGAN),110.46,110.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000960,0636,J1645,,,,,DALTEPARIN 2500U/0.2ML INJ,67.19,67.19,,,,,,,,,,,,,
47000961,0250,,,,,,SSD CRE 1% 400 GRAM,125.77,125.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000962,0636,J1645,,,,,DALTEPARIN 5000U/0.2ML INJ,182.91,182.91,,,,,,,,,,,,,
47000965,0636,Q0144,,,,,AZITHROMYCIN 200MG/5ML 15ML SUSP,124.16,124.16,,,,,,,,,,,,,
47000971,0636,J0461,,,,,ATROPINE SULF 0.4MG/ML INJ,30.91,30.91,21.84,22.02,,,,,,,21.84,,,22.02,22.02
47000972,0637,,,,,,MULTI VITAMIN TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000976,0637,J3030,,,,,SUMATRIPTAN 6MG/0.5ML INJ (IMITREX),365.50,365.50,,,,,,,,,,,,,
47000977,0250,,,,,,SYNTHROID TAB 175MCG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000980,0636,J0153,,,,,ADENOSINE 6MG/2ML INJ (ADENOCARD),50.26,50.26,16.99,16.99,,,,,,,16.99,,,,
47000981,0637,,,,,,WARFARIN 3MG TAB (COUMADIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000982,0636,J1742,,,,,IBUTILIDE INJ 1MG/10ML INJ (CORVERT),864.03,864.03,,,,,,,,,,,,,
47000984,0637,,,,,,METFORMIN 850MG TAB (GLUCOPHAGE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000986,0637,,,,,,LEVOFLOXACIN 500MG TAB (LEVAQUIN),43.27,43.27,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47000990,0250,,,,,,FLUCONAZOLE 50MG/5ML SUSP (DIFLUCAN),141.36,141.36,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000991,0250,,,,,,FLUCONAZOLE 200MG/5ML SUSP (DIFLUCAN),511.70,511.70,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000995,0250,,,,,,SULFACETAMIDE 10% OPHTH SOLN (BLEPH-10),251.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47000997,0636,J2310,,,,,NALOXONE HCL 0.4MG/ML INJ (NARCAN),81.70,81.70,28.37,28.37,,,,,,,28.37,,,,
47000999,0637,,,,,,PANCRELIPASE 10 CAP (CREON),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001000,0250,,,,,,CLONAZEPAM TAB 1MG,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001001,0250,,,,,,DISOPYRAMIDE PHOS CAP 150MG,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001004,0250,,,,,,DIBUCAINE 1% OINT (NUPERCAINAL),24.46,24.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001009,0637,,,,,,ORPHENADRINE 100MG TAB (NORFLEX),8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001010,0250,,,,,,QUINIDEX EXTENTAB 300MG,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001012,0637,,,,,,PROPRANOLOL LA 60MG CAP (INDERAL LA),8.85,8.85,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001013,0250,,,,,,POTASSIUM CAP 10MEQ,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001016,0250,,,,,,VALSARTAN 80MG TAB (DIOVAN),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001017,0637,,,,,,BUPROPION SR 150MG TAB (WELLBUTRIN SR),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001018,0636,,,,,,ALBUMIN INJ 25GM/100ML,731.25,0.00,15.98,15.98,15.98,15.98,,,,,,,,,
47001019,0250,,,,,,LEVOBUNOLOL OPTH SOL 0.5% (BETAGAN),77.67,77.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001025,0637,,,,,,MAGNESIUM OXIDE 400MG TAB (MAG OX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001026,0250,,,,,,SUMATRIPTAN 100MG TAB (IMITREX),108.09,108.09,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001027,0250,,,,,,TROLAMINE (ASPERCREME),25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001032,0250,,,,,,CROMOLYN SODIUM 20MG NEB (GASTROCROM),10.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001033,0250,,,,,,DOCUSATE SODIUM 60MG/15ML SYRUP (DSS),30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001034,0250,,,,,,NEO/POLY/DEX SUSP 0.1%,39.51,39.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001035,0250,,,,,,SSD CREAM 1% 50 GRAM,36.82,36.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001036,0636,J0282,,,,,AMIODARONE 150MG/3ML (50MG/ML)(CORDARONE,62.89,62.89,21.82,21.82,,,,,,,21.82,,,,
47001038,0636,J2250,,,,,MIDAZOLAM 5MG/5ML VIAL (VERSED),44.34,44.34,10.61,20.91,,,20.91,,,,10.61,,,10.65,10.65
47001039,0250,,,,,,DURICEF CAP 500MG,9.94,9.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001041,0637,,,,,,GLYBURIDE 3MG (DIABETA),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001042,0636,J9070,,,,,CYCLOPHPSPHAMIDE INJ 100MG (CYTOXAN),28.49,28.49,,,,,,,,,,,,,
47001044,0258,,,,,,JOBST THIGH HIGH LARGE B,312.56,312.56,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47001045,0250,,,,,,TETRACYCLINE SUSP 125MG,30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001048,0250,,,,,,ACETYLCYSTINE 20% 30ML ORAL SOL(MUCO,40.31,40.31,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001049,0637,,,,,,TERBINAFINE 250MG TAB (LAMISIL),33.86,33.86,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001050,0637,,,,,,TORSEMIDE 20MG TAB (DEMADEX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001051,0636,J9000,,,,,DOXORUBICIN 10MG VIAL (ADRIAMYCIN),233.27,233.27,,,,,,,,,,,,,
47001056,0250,,,,,,RANITIDINE HCL TAB 300MG,13.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001058,0250,,,,,,LIDOCAINE 1% W/EPI 20ML (XYLOCAINE),32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001059,0636,J2001,,,,,LIDOCAINE MPF 2% 10ML POLYAMP (XYLO),32.52,32.52,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47001060,0250,,,,,,ALUMINUM HYDROXIDE 600MG/5ML SUSP (AMPHO,30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001061,0636,J2795,,,,,ROPIVACAINE 1% 10MG/ML 20ML INJ (NAROPIN,117.13,117.13,35.34,35.34,,,,,,,35.34,,,,
47001062,0250,,,,,,HYDROXYZINE HCL 50MG TAB (ATARAX),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001069,0637,,,,,,PRAMOXINE & HYDROCORTISONE 1% 10GM AEROS,145.93,145.93,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001071,0637,,,,,,CARVEDILOL 6.25MG TAB (COREG),8.06,8.06,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001072,0637,,,,,,TOBRAMYCIN & DEXAMETHASONE 3.5GM OINT,124.16,124.16,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001075,0637,,,,,,MECLIZINE HCL 25MG TAB (ANTIVERT),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001077,0637,,,,,,METOPROLOL XL SUCC 50MG (TOPROL XL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001078,0250,,,,,,KETAMINE 50MG/ML INJ 10ML (KETALAR),83.58,83.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001080,0250,,,,,,D5W/0.45%NS + 40MEQ KCL 1000ML IV FLUID,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001082,0636,J3480,,,,,D5W/0.45%NS + 30MEQ KCL 1000ML IV FLUID,0.00,0.00,,,,,,,,,,,,,
47001085,0636,J3370,,,,,VANCOMYCIN 1000MG INJ (VANCOCIN),71.49,71.49,23.78,25.02,,,,,,,23.78,,,25.02,25.02
47001088,0637,,,,,,CARBAMAZEPINE ER 200MG TAB (TEGRETOL),17.47,17.47,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001090,0250,,,,,,DAKINS 1/2 STR  0.25%  473ML,46.23,46.23,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001095,0637,,,,,,BICALUTAMIDE 50MG TAB (CASODEX),55.09,55.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001098,0637,,,,,,RALOXIFENE 60MG TAB,31.53,31.53,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001101,0250,,,,,,STERILE TALC PACKET,168.24,168.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001104,0637,,,,,,CLOPIDOGREL 75MG TAB (PLAVIX),14.78,14.78,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001106,0637,,,,,,OLOPATADINE OPHTH 0.1% 5ML (PATANOL),231.93,231.93,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001107,0637,,,,,,MIRTAZAPINE 15MG TAB,10.75,10.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001108,0250,,,,,,FLUTICASONE NASAL SPRAY 0.05% (FLONASE),196.46,196.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001110,0637,A9270GY,,,,,MINOCYCLINE 50MG CAP (MINOCIN),6.25,0.00,,,,,,,,,,,,,
47001114,0250,,,,,,LEVOFLOXACIN 25MG/ML 20ML (LEVAQUIN),228.71,228.71,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001115,0636,J1956,,,,,LEVOFLOXACIN 500MG/100ML IVPB PREMIX,175.22,175.22,60.28,61.50,,,,,,,61.50,,,60.28,60.28
47001117,0637,,,,,,HYDROCORTISONE 25MG SUPPS (ANUCORT HC),97.39,97.39,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001118,0250,,,,,,SSD CREAM 1% 50GM,23.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001119,0636,90389,,,,,TETANUS TOX PF SDV VIAL,99.97,99.97,,,,,,,,,,,,,
47001122,0637,,,,,,CARBAMAZEPINE XR 400MG TAB (TEGRETOL XR),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001123,0636,S0157,,,,,BECAPLERMIN GEL 0.01% 15GM (REGRANEX),1839.59,1839.59,,,,,,,,,,,,,
47001126,0636,J3010,,,,,FENTANYL 100MCG/2ML INJ (SUBLIMAZE),30.91,30.91,10.54,20.86,,,20.86,,,,10.54,,,10.76,10.76
47001128,0637,A9270GY,,,,,TOLTERODINE 2 MG TAB (DETROL),6.25,0.00,,,,,,,,,,,,,
47001129,0250,,,,,,NACL 0.9% 10ML SALINE LOCK/ FLUSH,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001132,0250,,,,,,NEO/POLY/DEX EYE DROP 5ML,30.10,30.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001133,0637,,,,,,HYDRALAZINE 25MG TAB,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001135,0250,,,,,,MORRHUATE SOD INJ 5% 30ML VIAL,216.61,216.61,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001143,0637,,,,,,LEVOTHYROXINE  0.112MG TAB (SYNTHROID),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001145,0250,,,,,,MONTELUKAST 10MG TAB,10.75,10.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001151,0250,,,,,,ANTIPYRINE/BENZOCAINE OTIC SOLN(AURALGAN,24.99,24.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001158,0637,,,,,,ASPIRIN 325MG TAB,6.75,6.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001160,0250,,,,,,PENTOSAN POLYSULFATE SODIUM 100MG CAP,8.60,8.60,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001165,0250,,,,,,DOXAZOSIN 4MG TAB (CARDURA),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001173,0637,,,,,,AMOXICILLIN 250MG/5ML 80ML SUSP,35.15,35.15,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001177,0250,,,,,,HYDROCORTISONE 30MG SUPP (PROCTOCORT),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001181,0636,J1642,,,,,HEP-LOCK INJ 100U/ML 30ML,30.91,30.91,,,,,,,,,,,,,
47001191,0250,,,,,,GAS-X EX ST LIQ 50MG/5ML,23.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001192,0637,,,,,,OLANZAPINE 5MG TAB (ZYPREXA),87.37,87.37,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001193,0250,,,,,,RIZATRIPTAN MLT 10MG TAB (MAXALT),93.79,93.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001197,0250,,,,,,REMERON TAB 30MG,11.29,11.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001198,0637,,,,,,BUDESONIDE 180MCG (PULMICORT &FLEXIHALER,371.95,371.95,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001199,0637,J7517,,,,,MYCOPHENOLATE 500MG TAB (CELLCEPT),24.50,0.00,,,,,,,,,,,,,
47001200,0637,,,,,,GLYBURIDE 2.5MG TAB (DIABETA),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001216,0637,,,,,,HYDROXYZINE HCL 25MG TAB (ATARAX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001219,0250,,,,,,BELLADONNA&OPIUM 16A 16.2MG/60MG SUPP,215.74,215.74,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001221,0250,,,,,,CYANOCOBALAMIN INJ 1000,15.86,15.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001224,0250,,,,,,LORAZEPAM TAB 0.5MG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001232,0637,,,,,,LORAZEPAM 1MG TAB (ATIVAN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001252,0250,,,,,,ESMOLOL 250MG/ML INJ (BREVIBLOC),397.21,397.21,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001257,0637,,,,,,AMOXICILLIN/CLAVULANATE 500/125MG TAB,18.81,18.81,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001290,0250,,,,,,HYDROCORTISONE 250MG/2ML  INJ (SOLU-CORT,74.78,74.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001308,0250,,,,,,BUTORPHANOL 2MG/ML INJ (STADOL),36.82,36.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001324,0250,,,,,,HYDROCORTISONE 100MG/2ML INJ (SOLU-CORTE,75.90,75.90,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001326,0250,,,,,,BACITRACIN OINT 500U/G,25.80,25.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001349,0637,,,,,,TERBUTALINE 2.5MG TAB (BRETHINE),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001356,0250,,,,,,BRETHINE TAB 5MG (TERBUTALINE),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001357,0636,J2930,,,,,METHYLPREDNISOLONE 500MG/4ML INJ,79.28,79.28,11.38,17.54,,,,,,,11.38,,,17.54,17.54
47001359,0250,,,,,,SODIUM CITRATE/CITRIC ACID 120ML (BICITR,18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001373,0250,,,,,,POTASSIUM IODIDE SOLUTION 1000MG/ML,52.67,52.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001380,0637,,,,,,BUMETANIDE 1MG TAB (BUMEX),8.51,8.51,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001398,0250,,,,,,BUMETANIDE 0.5MG TAB (BUMEX),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001400,0637,,,,,,DONEPEZIL 10MG TAB (ARICEPT),19.89,19.89,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001405,0637,A9270GY,,,,,TRIAM/HCTZ 37.5/25MG TAB (MAXIDE),6.75,0.00,,,,,,,,,,,,,
47001406,0637,,,,,,BUSPIRONE 5MG TAB (BUSPAR),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001407,0637,,,,,,PRAMIPEXOLE 0.125MG TAB (MIRAPEX),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001433,0636,J0558,,,,,BICILLIN CR INJ 600000 UNITS,53.75,53.75,,,,,,,,,,,,,
47001438,0636,J1162,,,,,DIGIBIND INJ 38MG,1614.00,0.00,,,,,,,,,,,,,
47001471,0637,,,,,,CAPTOPRIL 25MG TAB (CAPOTEN),12.63,12.63,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001474,0637,,,,,,AMPICILLIN 250MG CAP,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001486,0250,,,,,,DIPYRIDAMOLE 75MG TAB (PERSANTINE),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001489,0250,,,,,,SUCRALFATE 1000MG TAB (CARAFATE),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001497,0637,,,,,,DILTIAZEM HCL 30MG TAB (CARDIZEM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001505,0250,,,,,,DILTIAZEM HCL 60MG TAB (CARDIZEM),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001508,0250,,,,,,HYDROCORTISONE OINT (ANUSOL HC),25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001555,0250,,,,,,SILVER SULFADIAZINE 1% CREAM 400GM(SILVA,138.41,138.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001596,0250,,,,,,MULTIVITAMIN 10ML INJ,288.10,288.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001597,0250,,,,,,LEVOTHYROXINE 0.125MG TAB (SYNTHROID),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001602,0250,J7614,,,,,LEVALBUTEROL 0.63MG NEB (XOPENEX),28.81,28.81,,,,,,,,,,,,,
47001607,0250,,,,,,IPRATROPIUM/ALBUTEROL INHALER (COMBIVENT,2200.52,2200.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001610,0250,,,,,,CARVEDILOL 3.125MG TAB (COREG),8.60,8.60,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001614,0636,J2355,,,,,OPRELVEKIN 5MG INJ (NEUMEGA),1029.58,1029.58,,,,,,,,,,,,,
47001615,0250,,,,,,DIPHENHYDRAMINE 1% CRM (BENADRYL),25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001617,0250,,,,,,AYR SALINE GEL NASAL,23.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001620,0250,,,,,,SCLEROSOL AEROSOL (STERILE TALC),593.94,593.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001625,0637,,,,,,PAROXETINE 10MG TAB (PAXIL),11.29,11.29,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001628,0637,,,,,,SODIUM BICARB 650MG TAB,5.38,5.38,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001629,0637,,,,,,TAMULOSIN 0.4MG CAP (FLOMAX),18.11,18.11,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001638,0636,Q0161,,,,,CHLORPROMAZINE HCL 25MG TAB (THORAZINE,7.26,7.26,,,,,,,,,,,,,
47001649,0636,J3105,,,,,TERBUTALINE 1MG/ML 1ML INJ (BRETHINE),32.79,32.79,,,,,,,,,,,,,
47001650,0637,,,,,,LORATADINE 10MG TAB (CLARITIN),10.75,10.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001661,0637,,,,,,CLINDAMYCIN HCL 150MG CAP (CLEOCIN),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001687,0250,,,,,,SULINDAC 200MG TAB (CLINORIL),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001695,0637,,,,,,BENZTROPINE MESYLATE 1MG TAB (COGENTIN),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001702,0637,,,,,,CLARITHROMYCIN 500MG TAB (BIAXIN),26.77,26.77,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001728,0250,,,,,,BETOPTIC OPTH SOL 0.5% 5ML,111.80,111.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001730,0637,,,,,,BETAMETHASONE S OPTH 0.25% 5ML SUSP,144.32,144.32,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001737,0250,,,,,,COLCHICINE 0.6MG TAB (COLCRYS),47.95,47.95,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001750,0250,,,,,,CARBAMAZEPINE 100MG CHEW TAB (TEGRETOL),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001754,0250,,,,,,BISMUTH SUSP 8OZ (KAOPECTATE),32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001772,0637,,,,,,OXYBUTYNIN 5MG TAB (DITROPAN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001786,0636,Q0164,,,,,PROCHLORPERAZINE 10MG TAB (COMPAZINE),6.72,6.72,,,,,,,,,,,,,
47001787,0250,,,,,,THEOCLEAR LA 260 CAPS 2,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001789,0250,,,,,,MUPIROCIN OINT 2% 22 GM (BACTROBAN),169.58,169.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001802,0250,,,,,,NADOLOL 40MG TAB (CORGARD),17.07,17.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001805,0250,,,,,,FLUDROCORTISONE 0.1MG TAB (FLORINEF),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001826,0250,,,,,,LIDOCAINE INJ 1% 50ML MDV (XYLOCAINE),27.14,27.14,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001828,0250,,,,,,COUMADIN TAB 2.5MG,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001836,0637,,,,,,WARFARIN 2MG TAB (COUMADIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001838,0250,,,,,,WARFARIN 4MG TAB,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001854,0250,,,,,,AMOXICILLIN/CLAVULANATE 250MG TAB (AUGME,9.94,9.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001855,0250,,,,,,CEFAZOLIN 1GM INJ ADV (KEFZOL),38.97,38.97,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001888,0637,,,,,,DILTIAZEM CD 180MG CAP (CARDIZEM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001925,0637,,,,,,MAGNESIUM ALUM 30ML U/D SUSP (MAALOX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001948,0637,,,,,,NIFEDIPINE 10MG CAP (PROCARDIA),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001966,0636,J0133,,,,,ACYCLOVIR 500MG INJ (ZOVIRAX),214.14,214.14,,,,,,,,,,,,,
47001968,0637,,,,,,TRAZODONE 50MG TAB (DESERYL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001970,0250,,,,,,DAPSONE 25MG TAB,6.45,6.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001971,0637,,,,,,RIFAMPIN 300MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001974,0636,J1940,,,,,FUROSEMIDE 40MG/4ML INJ (LASIX),46.49,46.49,9.66,15.73,,,,,,,15.73,,,9.66,9.66
47001976,0636,J8540,,,,,DEXAMETHASONE 4MG TAB,6.72,6.72,2.47,2.47,,,,,,,2.47,,,,
47001977,0250,,,,,,DOXAPRAM 20MG/ML 20ML (DOPRAM),373.29,373.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001978,0637,,,,,,CEPHALEXIN 125MG/5ML SUSP (KEFLEX),36.82,36.82,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001979,0637,,,,,,AZITHROMYCIN 250MG TAB-PACK  (Z-PAK),192.42,192.42,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47001980,0250,,,,,,PHYSOSTIGMINE 1MG/1ML,18.27,18.27,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47001992,0637,,,,,,GLYBURIDE 5MG TAB (DIABETA),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002009,0250,,,,,,TOBRAMYCIN  80MG/2ML INJ,47.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002019,0250,,,,,,BUPRENORPHINE 0.324MG/ML INJ (BUPRENEX),32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002023,0250,,,,,,ISOSORBIDE MONO 20MG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002040,0250,,,,,,DICLOXACILLIN 500MG CAP,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002055,0250,,,,,,TETANUS TOX PED VACCINE,83.04,83.04,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002057,0637,,,,,,DIGOXIN 0.25MG TAB (LANOXIN),10.48,10.48,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002065,0250,,,,,,DIGOXIN 0.125MG TAB (LANOXIN),12.36,12.36,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002075,0636,J2805,,,,,SINCALIDE 5MCG INJ (KINEVAC),430.43,430.43,146.67,351.23,,,,,,,146.67,,,351.23,351.23
47002091,0637,,,,,,GEMFIBROZIL 600MG TAB (LOPID),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002099,0637,,,,,,PHENYTOIN 100MG CAP (DILANTIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002108,0250,,,,,,SCOPOLAMINE SCOP DISC (TRANSDERM SCOP),34.40,34.40,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002126,0250,,,,,,CAPTOPRIL 12.5MG TAB (CAPOTEN),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002139,0636,J1160,,,,,DIGOXIN 0.50MG/2ML INJ (LANOXIN),26.34,26.34,9.14,9.14,,,,,,,9.14,,,,
47002170,0637,,,,,,ASPIRIN 600MG SUPP,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002183,0637,,,,,,BUSPIRONE 10MG TAB (BUSPAR),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002188,0637,,,,,,ASPIRIN 300MG SUPP,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002191,0250,,,,,,CEPHALEXIN 500MG CAP (KEFLEX),8.60,8.60,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002204,0636,J0290,,,,,AMPICILLIN 1000 MG INJ,40.31,40.31,,,,,,,,,,,,,
47002207,0637,,,,,,ACETAMINOPHEN 325MG SUPP (TYLENOL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002208,0637,,,,,,CLONAZEPAM 0.5MG TAB (KLONOPIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002212,0636,J0290,,,,,AMPICILLIN 2000MG INJ,38.97,38.97,,,,,,,,,,,,,
47002217,0637,,,,,,CIPROFLOXACIN 500MG TAB (CIPRO),18.81,18.81,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002223,0636,J3250,,,,,TRIMETHOBENZAMIDE 200MG/2ML INJ (TIGAN),32.52,32.52,,,,,,,,,,,,,
47002232,0250,,,,,,CHLORPROMAZINE 100MG TAB (THORAZINE),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002238,0636,J0280,,,,,AMINOPHYLLINE INJ 25MG/ML 10ML,58.65,58.65,,,,,,,,,,,,,
47002246,0636,J1200,,,,,DIPHENHYDRAMINE 50MG/ML INJ  (BENADRYL),30.91,30.91,10.48,17.87,,,,,,,10.48,,,17.87,17.87
47002248,0637,,,,,,TRIAM/HCTZ 37.5/25MG CAP (DYAZIDE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002271,0637,,,,,,ASPIRIN EC 325MG TAB,6.75,6.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002289,0250,,,,,,ERYTHROMYCIN 400MG FILMTABS (E.E.S.),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002324,0637,,,,,,CARISOPRODOL 350MG TAB (SOMA),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002329,0250,,,,,,CLINDAMYCIN 600MG/4ML  4ML INJ (CLEOCIN),52.67,52.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002355,0637,,,,,,GUAIFENESIN W/CODEINE 5ML U/D ELIXIR (T,5.64,5.64,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002360,0636,J3301,,,,,TRIAMCINOLONE 40MG/ML 5ML MDV (KENALOG),169.04,169.04,16.42,16.42,,,,,,,16.42,,,16.42,16.42
47002397,0250,,,,,,THROMBIN TOPICAL 5000 IU,141.36,141.36,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002420,0250,,,,,,ERYTHROMYCIN 250MG TAB (ERY-TAB),69.13,69.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002422,0637,,,,,,TRIAMCINOLONE 0.025% 80 GM CRM (KENALOG),47.95,47.95,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002453,0250,,,,,,ESTRADIOL 1MG TAB (ESTRACE),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002477,0637,,,,,,SALINE ENEMA (FLEET),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002487,0637,,,,,,FERROUS SULFATE 325 MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002493,0250,,,,,,ERYTHROMYCIN 500MG ADV (ERYTHROCIN),45.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002496,0250,,,,,,CHLORPROMAZINE 50MG TAB (THORAZINE),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002501,0636,J1364,,,,,ERYTHROMYCIN 1000MG INJ (ERITHROCIN),86.27,86.27,,,,,,,,,,,,,
47002511,0250,,,,,,BUTALBITAL/ASPIRIN/CAFFEINE TAB,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002514,0636,J3301,,,,,TRIAMCINOLONE 40MG/1ML INJ (KENALOG),48.29,48.29,16.42,16.42,,,,,,,16.42,,,16.42,16.42
47002527,0250,,,,,,POTASSIUM CHLORIDE 40MEQ/20ML INJ,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002530,0637,,,,,,CLONIDINE TTS-3 PATCH (CATAPRES),95.41,95.41,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002535,0250,,,,,,POTASSIUM CHLORIDE 10MEQ/5ML INJ,30.91,30.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002537,0637,,,,,,CYCLOBENZAPRINE 10MG TAB (FLEXERIL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002545,0250,,,,,,FOLIC ACID 1MG TAB,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002549,0250,,,,,,FOLIC ACID INJ 5MG/ML,55.09,55.09,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002571,0250,,,,,,LACTULOSE 10GM/15ML U/D CUP,9.94,9.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002576,0250,,,,,,LINCOMYCIN 300MG/ML INJ (LINCOCIN),55.63,55.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002595,0250,,,,,,POLYCARBOPHIL 500MG TAB (FIBERCON),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002602,0637,,,,,,HALOPERIDOL 5MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002610,0637,,,,,,HALOPERIDOL 1MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002626,0636,J0694,,,,,CEFOXITIN 1000MG VIAL (MEFOXIN),50.26,50.26,17.32,17.32,,,,,,,17.32,,,,
47002628,0250,,,,,,HALOPERIDOL 0.5MG TAB (HALDOL),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002637,0636,J3230,,,,,CHLORPROMAZINE 25MG/1ML INJ (THORAZIN,35.48,35.48,,,,,,,,,,,,,
47002642,0636,Q0161,,,,,CHLORPROMAZINE 25MG TAB,32.96,32.96,,,,,,,,,,,,,
47002644,0250,,,,,,HALOPERIDOL TABS 2MG,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002667,0637,,,,,,CITRATE OF MAG 300ML LIQ,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002675,0250,,,,,,MINERAL OIL 472ML BOTTLE,29.67,29.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002683,0250,,,,,,MYLANTA SUSP,14.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002701,0637,,,,,,HYDROXYUREA 500MG CAP (HYDREA),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002709,0250,,,,,,MILK OF MAG SUSP 30 ML,6.99,6.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002725,0250,,,,,,NUPERCAINAL 1% OINT 60 GM TUBE,24.46,24.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002728,0637,,,,,,HYDROCODONE & CHLORPHENIRAMINE 5ML SUSP,30.91,30.91,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002758,0250,,,,,,HEXACHLOROPHENE 3% LIQ SOAP(PHISOHEX),60.74,60.74,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002766,0637,,,,,,GUAIFENESIN 100MG/5ML (ROBITUSSIN),6.13,6.13,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002784,0637,,,,,,LOPERAMIDE HCL 2MG CAP (IMODIUM),8.25,8.25,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002790,0636,J2920,,,,,METHYLPREDNISOLONE 40MG/1ML INJ (SOLU-ME,32.52,32.52,11.06,11.06,,,,,,,,,,11.06,11.06
47002793,0637,,,,,,ACETAMINOPHEN SUPP 650MG (TYLENOL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002808,0636,J2930,,,,,METHYLPREDNISOLONE 1000 MG/8ML INJ,293.09,293.09,11.38,17.54,,,,,,,11.38,,,17.54,17.54
47002816,0636,J2930,,,,,METHYLPREDNISOLONE 125 MG/2ML INJ,33.32,33.32,11.38,17.54,,,,,,,11.38,,,17.54,17.54
47002818,0637,,,,,,PROPRANOLOL LA 80MG CAP (INDERAL LA),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002832,0636,J0595,,,,,STADOL INJ 2MG/ML,38.16,38.16,,,,,,,,,,,,,
47002834,0637,,,,,,PROPRANOLOL 40MG TAB (INDERAL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002835,0637,J2354,,,,,OCTREOTICLE 0.05MG (SANDOSTATIN),37.63,37.63,,,,,,,,,,,,,
47002843,0637,,,,,,CLONIDINE HCL 0.1MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002847,0637,,,,,,CLONIDINE HCL 0.2MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002865,0636,J3360,,,,,DIAZEPAM 10MG/2ML INJ (VALIUM),148.10,148.10,49.94,120.85,,,,,,,49.94,,,120.85,120.85
47002883,0250,,,,,,INDOMETHACIN 50MG CAP (INDOCIN),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002891,0250,,,,,,INDOMETHACIN 25MG CAP (INDOCIN),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002894,0250,,,,,,CARA KLENZ WOUND CLEANSE,70.68,70.68,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002899,0636,J2270,,,,,MORPHINE SULFATE 2MG/ML INJ,32.52,32.52,10.79,23.74,,,22.21,,,,10.79,,,23.74,23.74
47002902,0250,,,,,,COUMADIN TABS 7.5MG,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002910,0250,,,,,,NEO/POLY/HC OTIC SOLN (CORTISPORIN),65.58,65.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002925,0636,J2001,,,,,LIDOCAINE 2GM PREMIX (XYLOCAINE),101.05,101.05,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47002927,0636,J2001,,,,,LIDOCAINE 2% 5ML VIAL,30.91,30.91,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47002931,0636,J3480,,,,,D5W/0.45%NS + 20MEQ KCL 1000ML IV FLUID,74.98,74.98,,,,,,,,,,,,,
47002933,0637,,,,,,VERAPAMIL HCL 120MG TAB (CALAN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002934,0637,,,,,,TOBRAMYCIN & DEXAMETHASONE OPTH 2.5ML,247.79,247.79,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47002976,0250,,,,,,LIDOCAINE 2% 50ML INJ (XYLOCAINE),32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47002982,0250,,,,,,ISOSORBIDE DINITRATE 20MG TAB (ISORDIL),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003006,0250,,,,,,ISOSORBIDE DIN 10MG (ISORDIL TITRADOSE),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003014,0637,A9270GY,,,,,POTASSIUM CHLORIDE 20 MEQ TAB (K-DUR),6.25,0.00,,,,,,,,,,,,,
47003071,0637,,,,,,CEPHALEXIN 250MG CAP (KEFLEX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003090,0250,,,,,,NEO/POLY/HC OTIC SUSP (CORTISPORIN),116.10,116.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003099,0636,J1940,,,,,FUROSEMIDE 100MG/10ML INJ (LASIX),30.91,30.91,9.66,15.73,,,,,,,15.73,,,9.66,9.66
47003116,0250,,,,,,HYDROCORTISONE 100MG/60ML (CORTENEMA),46.76,46.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003121,0637,,,,,,FUROSEMIDE 40MG TAB (LASIX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003139,0637,,,,,,FUROSEMIDE 20MG TAB (LASIX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003147,0637,,,,,,FUROSEMIDE 80MG TAB (LASIX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003154,0637,A9270GY,,,,,CHLORAMBUCIL 2MG TAB (LEUKERAN),6.75,0.00,,,,,,,,,,,,,
47003155,0637,,,,,,BETHANECHOL 25MG TAB (URECHOLINE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003162,0250,,,,,,LEVOTHROID TABS 25MCG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003170,0250,,,,,,LEVOTHROID TABS 150MCG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003172,0636,J2001,,,,,LIDOCAINE 1% 2ML INJ MPF (XYLOCAINE),30.91,30.91,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47003188,0250,,,,,,LEVOTHROID TABS 200MCG,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003197,0250,,,,,,AZTREONAM INJ 1000MG (AZACTAM),149.64,149.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003204,0250,,,,,,LEVOTHROID TABS 100MCG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003212,0250,,,,,,LEVOTHROID TABS 50MCG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003214,0636,J2001,,,,,LIDOCAINE 1% 20ML INJ (XYLOCAINE),30.91,30.91,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47003221,0637,,,,,,LEVOTHYROXINE  0.1MG TAB (SYNTHROID),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003231,0250,,,,,,CALCIUM CHLORIDE 10ML INJ,26.07,26.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003238,0637,,,,,,CHLORDIAZEPOXIDE 25MG CAP (LIBRIUM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003248,0637,,,,,,CHLORDIAZEPOXIDE 10MG CAP (LIBRIUM),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003253,0637,,,,,,DIPHENOXYLATE/ATROPINE TAB (LOMOTIL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003263,0250,,,,,,INDAPAMIDE 2.5MG TAB (LOZOL),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003272,0250,,,,,,CALCIUM GLUCONATE 10% 50ML INJ,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003279,0637,,,,,,HYOSCYAMINE 0.125MG SL TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003295,0637,,,,,,METOPROLOL TART 50MG TAB (LOPRESSOR),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003321,0250,,,,,,NOREPINEPHRINE BITART 4MG/4ML INJ (LE,51.06,51.06,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003329,0637,,,,,,NITROFURANTOIN 100MG CAP (MACROBID),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003345,0637,,,,,,NITROFURANTOIN 50MG CAP (MACRODANTIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003370,0250,,,,,,CHLORDIAZEPOXIDE 5MG CAP (LIBRIUM),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003371,0637,,,,,,AMOXICILLIN 875MG TAB,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003373,0250,,,,,,LEFLUNOMIDE 20MG TAB (ARAVA),38.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003375,0636,J3490,,,,,GLYCOPYRROLATE 0.4MG/2ML INJ (ROBINUL),123.63,123.63,35.71,42.08,,,,,,,42.08,,,35.71,35.71
47003381,0250,,,,,,CHLOROTHIAZIDE 500MG TAB  (DIURIL),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003384,0636,J3246,,,,,TIROFIBAN 12.5 MG/250ML PREMIX (AGGRASTA,1914.84,1914.84,,,,,,,,,,,,,
47003387,0250,,,,,,DEXTROSE 5% 100 CC BAG,25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003388,0636,J1750,,,,,IRON DEXTRAN 100MG/2ML INJ (INFED),165.55,165.55,56.29,56.29,,,,,,,56.29,,,56.29,56.29
47003389,0250,,,,,,CERUMENEX DROP,90.57,90.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003393,0250,,,,,,ESTRATEST TAB,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003396,0637,,,,,,CELECOXIB 100MG CAP (CELEBREX),10.44,10.44,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003397,0250,,,,,,CELECOXIB 200MG CAP (CELEBREX),18.50,18.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003399,0250,,,,,,CYCLOSPORINE 50MG/ML 5ML INJ (SANDIMMUNE,125.77,125.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003400,0637,,,,,,LEVOTHYROXINE SOD 0.088MG,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003401,0637,,,,,,CITALOPRAM 20MG TAB (CELEXA),9.94,9.94,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003405,0637,,,,,,METRONIDAZOLE 0.75% TOPICAL GEL,137.33,137.33,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003406,0636,J0702,,,,,BETAMETHASONE AF 0.05% CRM (DIPROLENE),303.96,303.96,,,,,,,,,,,,,
47003407,0250,,,,,,BAC/NEO/POLY OPHTH OINT 3.5GM OINT(NEOSP,66.92,66.92,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003412,0636,J1940,,,,,FUROSEMIDE 20MG INJ (LASIX),30.91,30.91,9.66,15.73,,,,,,,15.73,,,9.66,9.66
47003416,0637,,,,,,APRACLONIDINE OPTH SOL 0.5% 5ML (IOPIDIN,206.40,206.40,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003417,0637,,,,,,CALCITONIN NASAL SPRAY 3.7ML (MIACALCIN),123.09,123.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003418,0637,,GY,,,,DORZOLAMIDE/TIMOLOL EYE DROP (COSOPT),193.77,193.77,,,,,,,,,,,,,
47003462,0636,J8498,,,,,PROCHLORPERAZINE 25MG SUPPS,14.78,14.78,5.03,5.03,,,,,,,,,,5.03,5.03
47003485,0637,,,,,,PSYLLIUM PKT (METAMUCIL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003502,0250,,,,,,ENALAPRILAT 2.5MG/2ML SDV (VASOTEC),62.89,62.89,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003503,0637,,,,,,OMEPRAZOLE 20MG CAP (PRILOSEC),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003512,0636,J1020,,,,,METHYLPREDNISOLONE 80MG/ML INJ (DEPO-MED,45.42,45.42,,,,,,,,,,,,,
47003514,0636,J1030,,,,,METHYLPREDNISOLONE ACE 40MG/ML INJ (DEPO,54.55,54.55,13.84,16.82,,,,,,,16.82,,,13.84,13.84
47003527,0637,A9270GY,,,,,POTASSIUM CHLORIDE 10MEQ CAP (MICRO-K),6.25,0.00,,,,,,,,,,,,,
47003536,0250,,,,,,DOXYCYCLINE 200MG INJ (DOXY-200),140.02,140.02,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003584,0637,A9270GY,,,,,MINOCYCLINE 100MG CAP (MINOCIN),9.25,0.00,,,,,,,,,,,,,
47003587,0636,J2175,,,,,MEPERIDINE HCL 100MG INJ (DEMEROL),32.47,32.47,,,,,,,,,,,,,
47003593,0250,,,,,,TRIFLURIDINE OPTH SOL 1% (VIROPTIC),258.81,258.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003600,0250,,,,,,FENTANYL 25MCG/HR PATCH (DURAGESIC),87.30,87.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003603,0250,,,,,,MEPERIDINE HCL INJ 25MG,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003611,0636,J2175,,,,,MEPERIDINE HCL 50MG INJ (DEMEROL),30.91,30.91,,,,,,,,,,,,,
47003637,0250,,,,,,MEPERIDINE HCL INJ 75MG,30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003661,0250,,,,,,MORPHINE SULFATE CR 30MG TAB (MS CONTIN),9.41,9.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003677,0637,,,,,,BACLOFEN 10MG TAB,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003717,0637,,,,,,SIMETHICONE 80MG CHEW TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003742,0636,J2250,,,,,MIDAZOLAM 2MG/2ML VIAL (VERSED),30.91,30.91,10.61,20.91,,,20.91,,,,10.61,,,10.65,10.65
47003757,0250,,,,,,SODIUM PHOSPHATE 45MMOL/15ML INJ,56.44,56.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003760,0636,J3370,,,,,VANCOMYCIN INJ 500MG,49.72,49.72,23.78,25.02,,,,,,,23.78,,,25.02,25.02
47003766,0637,,,,,,NAPROXEN 500MG TAB (NAPROSYN),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003768,0250,,,,,,NYSTOP 60GM TOPICAL PWD (MYCOSTATIN),142.44,142.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003809,0636,J3420,,,,,CYANOCOBALAMIN 1000MCG INJ (VIT B12),54.12,54.12,,,,,,,,,,,,,
47003816,0637,,,,,,NEOMYCIN SULF 500MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003857,0637,,,,,,NITROGLYCERIN 0.4MG/HR PATCH (NITRO-DUR),12.09,12.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47003865,0250,,,,,,FENTANYL 50MCG/HR PATCH (DURAGESIC),99.71,99.71,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003882,0250,,,,,,VEPESID INJ 20MG/ML,574.05,574.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003884,0636,Q0163,,,,,DIPHENHYDRAMINE 12.5MG/5ML ELIXIR (BENAD,32.79,32.79,2.28,2.28,,,,,,,2.28,,,,
47003892,0250,,,,,,CARBAMIDE PEROXIDE 6.5% EARWAX REMOVAL,18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003917,0250,,,,,,LACRALUBE OPHTH OINT 3.5GM TUBE,24.99,24.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003923,0637,A9270GY,,,,,TAMOXIFEN 10MG TAB (NOLVADEX),8.00,0.00,,,,,,,,,,,,,
47003940,0636,J3370,,,,,VANCOMYCIN 500MG INJ (VANCOCIN),41.12,41.12,23.78,25.02,,,,,,,23.78,,,25.02,25.02
47003949,0250,,,,,,NORMODYNE TABS 100MG,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003973,0250,,,,,,ACETIC ACID 2% W/ HYDROCORTISONE 15ML,39.51,39.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47003980,0250,,,,,,DESIPRAMINE HCL 75MG TAB (NORPRAMIN),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004004,0637,,,,,,GUAIFENSIN 200MG TAB (ORGANIDIN),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004014,0250,,,,,,BUPIVACAINE 0.25% W/ EPI 10ML VIAL,18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004048,0250,,,,,,NEO/POLY/DEX OPHTH SUSP(MAXITROL SUSP),85.40,85.40,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004053,0637,,,,,,CALCIUM W/VITAMIN D 250/125MG TAB,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004079,0637,,,,,,CALCIUM 500+D TAB (OS-CAL+D),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004089,0258,,,,,,DEXTRAN 40 10%-NACL 0.9% 500ML,125.77,125.77,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47004095,0637,,,,,,WARFARIN 4MG TAB (COUMADIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004105,0636,J7509,,,,,METHYLPREDNISOLONE 4MG DOSEPAK (MEDROL,55.09,55.09,,,,,,,,,,,,,
47004137,0637,,,,,,PENICILLIN V POTASSIUM 250MG TAB(PEN-VK),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004145,0637,,,,,,PENICILLIN V POTASSIUM 500MG TAB (PEN-VK,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004194,0250,,,,,,DIPYRIDAMOLE 25MG TAB (PERSANTINE),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004202,0250,,,,,,DIPYRIDAMOLE 50MG TAB (PERSANTINE),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004221,0637,,,,,,BELLADON/PHENOBARB 5ML LIQ (DONNATAL),42.19,42.19,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004228,0250,,,,,,PROMETHAZINE 12.5MG SUPPS (PHENERGAN),14.96,14.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004251,0637,,,,,,PHENOBARBITAL 32.4 MG TAB,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004277,0636,J7512,,,,,PREDNISONE 20MG TAB,6.72,6.72,2.28,2.28,,,,,,,2.28,,,,
47004279,0636,J2270,,,,,MORPHINE SULFATE PCA 30MG/30ML,71.49,71.49,10.79,23.74,,,22.21,,,,10.79,,,23.74,23.74
47004285,0637,,,,,,PREDNISONE 10MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004287,0636,J2175,,,,,MEPERIDINE PCA 300MG (DEMEROL),76.86,76.86,,,,,,,,,,,,,
47004293,0637,,,,,,PREDNISONE 5MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004312,0636,J0461,,,,,ATROPINE 0.5 MG 5ML SYR,27.14,27.14,21.84,22.02,,,,,,,21.84,,,22.02,22.02
47004319,0637,,,,,,NITROGLYCERIN 0.4MG (1/150 GR)  #25 (NIT,24.46,24.46,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004327,0637,,,,,,CONJUGATED ESTROGENS 0.625MG TAB (PREMAR,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004335,0637,,,,,,CONJUGATED ESTROGENS 0.3MG TAB (PREMARIN,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004338,0250,,,,,,EYE WASH 120ML SOL (PURIFIED WATER),25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004345,0637,,,,,,METHADONE HCL 10MG TAB (DOLOPHINE),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004351,0637,,,,,,VITAMIN C 500MG TAB (ASCORBIC ACID),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004353,0636,90714,,,,,TETANUS/DIPH VACC (DECAVAC),90.57,90.57,,,,,,,,,,,,,
47004384,0636,J2370,,,,,PHENYLEPHRINE 10MG/1ML INJ (NEO),36.28,36.28,12.31,12.34,,,,,,,12.31,,,12.34,12.34
47004401,0637,,,,,,BETHANECHOL 10MG TAB (URECHOLINE),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004435,0636,J0295,,,,,AMPICILLIN & SULBACTAM 1500MG INJ(UNASYN,40.31,40.31,15.76,15.76,,,,,,,15.76,,,,
47004445,0636,J1165,,,,,PHENYTOIN INJ 50MG/ML 5ML VIAL (DILANTIN,32.52,32.52,,,,,,,,,,,,,
47004447,0250,,,,,,PHENYTOIN 125MG/5ML 237ML SUSP (DILANTIN,146.63,146.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004467,0637,,,,,,PHENAZOPYRIDINE 100MG TAB (PYRIDIUM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004484,0637,,,,,,VERAPAMIL HCL 80MG TAB (CALAN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004501,0637,,,,,,METRONIDAZOLE 250MG TAB (FLAGYL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004509,0637,,,,,,CHOLESTYRAMINE PWD PKT (QUESTRAN),14.51,14.51,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004520,0637,,,,,,TRAMADOL 50MG TAB (ULTRAM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004542,0637,,,,,,TOBRAMYCIN OPTH  0.3% 5ML SOL,146.20,146.20,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004544,0637,,,,,,BISACODYL SUPP 10MG,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004574,0637,A9270GY,,,,,QUININE 324MG CAP (QUALAQUIN),6.25,0.00,,,,,,,,,,,,,
47004583,0636,J0295,,,,,AMPICILLIN & SULBACTAM 3000MG INJ(UNASYN,52.67,52.67,15.76,15.76,,,,,,,15.76,,,,
47004590,0637,,,,,,METOCLOPRAMIDE 10MG TAB (REGLAN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004601,0636,J2270,,,,,MORPHINE 10MG/10ML AMP (ASTRAMORPH),73.37,73.37,10.79,23.74,,,22.21,,,,10.79,,,23.74,23.74
47004616,0637,,,,,,TEMAZEPAM 15MG CAP (RESTORIL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004617,0250,J7611,,,,,ALBUTEROL SOL 0.5%-0.5ML DOSE,3.76,3.76,,,,,,,,,,,,,
47004625,0637,,,,,,ACETAMINOPHEN 120MG SUPP (TYLENOL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004627,0250,,,,,,ERTHROMYCIN 200MG/5ML SUSP (E.E.S.),1191.37,1191.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004640,0250,,,,,,RITALIN TABS 10MG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004643,0250,,,,,,ERYTHROMYCIN 500MG INJ (ERYTHROCIN),268.23,268.23,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004657,0637,,,,,,METHYLPHENIDATE 5MG TAB (RITALIN),7.75,7.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004690,0250,,,,,,DAKINS 1/4 STR  0.125%  473ML,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004717,0636,J2310,,,,,NARCAN INJ 0.4MG/ML,32.79,32.79,28.37,28.37,,,,,,,28.37,,,,
47004731,0250,,,,,,ROCALTROL CAPS 0.25MCG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004732,0250,,,,,,EPHEDRINE SULFATE INJ 50MG,244.03,244.03,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004734,0250,,,,,,EPINEPHRINE 1MG/ML AMP,75.25,75.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004741,0250,,,,,,TUBERSOL INJ 5TU/0.1ML,15.86,15.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004757,0637,,,,,,TRIAMCINOLONE 0.1% 15GM CRM (KENALOG),25.80,25.80,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004780,0637,,,,,,SULFAMETHOXAZOLE/TMP DS 800/160MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004781,0636,J1885,,,,,KETORALAC 30MG/1ML INJ (TORADOL),44.34,44.34,14.29,42.28,,,42.28,,,,14.29,,,22.16,22.16
47004783,0250,,,,,,KETOROLAC 60MG/2ML 2ML VIAL (TORADOL),44.34,44.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004816,0250,,,,,,BUPIVACAINE 0.5% W/ EPI 30ML VIAL (MARCA,30.91,30.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004822,0637,,,,,,CARB/LEVO 10/100MG TAB (SINEMET),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004830,0637,,,,,,CARB/LEVO 25/100MG TAB (SINEMET),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004855,0250,,,,,,DOXEPIN HCL 50MG CAP (SINEQUAN),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004863,0250,,,,,,DOXEPIN HCL 10MG CAP (SINEQUAN),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004864,0250,,,,,,VERAPAMIL HCL 5MG/2ML INJ,150.50,150.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004871,0250,,,,,,DOXEPIN HCL 25MG CAP (SINEQUAN),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004874,0250,,,,,,NATURE'S TEAR DROPS,23.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004875,0637,A9270GY,,,,,FOSINOPRIL 10MG TAB (MONOPRIL),6.25,0.00,,,,,,,,,,,,,
47004880,0637,,,,,,ISOSORBIDE MONONITRATE 20MG TAB (ISMO),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004898,0250,,,,,,KETOROLAC 10MG TAB (TORADOL),6.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47004921,0637,,,,,,POTASSIUM CHLORIDE  8MEQ TAB (KLOR-CON),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004963,0637,,,,,,CLONIDINE TTS -2 PATCH (CATAPRES),98.36,98.36,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47004971,0637,,,,,,LABETALOL 100MG TAB (TRANDATE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005011,0250,,,,,,BUPIVACAINE 0.25% 10ML INJ (MARCAINE),32.47,32.47,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005012,0250,,,,,,MAGNESIUM SULFATE 50% ORAL LIQ 60ML,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005020,0250,,,,,,EPINEPH 1:10000 INJ ABBOJECT,54.02,54.02,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005076,0637,,,,,,ATENOLOL 50MG TAB (TENORMIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005079,0636,J1250,,,,,DOBUTAMINE 250MG/20ML INJ,27.95,27.95,9.42,9.42,,,,,,,9.42,,,,
47005084,0637,,,,,,TETRACYCLINE HCL 250MG CAP,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005102,0250,,,,,,MINERAL OIL LIGHT 10ML (MURI-LUBE),71.81,71.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005118,0250,,,,,,THEOPHYLLINE CR 300MG TAB (THEO-DUR),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005126,0250,,,,,,THEOPHYLLINE ER 400MG TAB (THEO-DUR),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005127,0636,J2001,,,,,LIDOCAINE 0.5% 50ML VIAL (XYLOCAINE),30.91,30.91,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47005135,0636,J2001,,,,,LIDOCAINE 1% 5ML INJ MPF (XYLOCAINE),30.91,30.91,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47005143,0250,,,,,,LIDOCAINE 0.5% W/EPI 50ML (XYLOCAINE MPF,30.91,30.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005150,0250,,,,,,XYLO 1%EPI 1:100000 INJ,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005152,0637,,,,,,AMITRIPTYLINE 10MG TAB (ELAVIL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005159,0637,,,,,,MULTI VIT W/ MINERAL TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005167,0637,,,,,,THIAMINE 100MG TAB (VITAMIN B1),51.34,51.34,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005178,0636,J1265,,,,,DOPAMINE 400MG/250ML PREMIX,147.01,147.01,49.98,49.98,,,,,,,,,,49.98,49.98
47005235,0250,,,,,,TRIP ANTIBIOTIC OPHTH OI,18.54,18.54,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005258,0250,,,,,,IMIPRAMINE HCL 25MG TAB (TOFRANIL),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005260,0250,J2704,,,,,PROPOFOL 10MG/ML 20ML INJ,30.20,30.20,,,,,,,,,,,,,
47005285,0637,,,,,,CEPHALEXIN 250MG/5ML 100ML SUSP (KELFEX),67.72,67.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005300,0636,J2150,,,,,MANNITOL 25% 50ML VIAL (ARIDOL),93.61,93.61,,,,,,,,,,,,,
47005320,0250,,,,,,XYLOCAINE INJ 1% 50CC,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005333,0250,,,,,,LIDOCAINE 2% W/EPI SDV 10ML (XYLOCAINE M,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005383,0250,,,,,,CLOTRIMAZOLE 10MG LOZENGE (MYCELEX),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005417,0250,,,,,,NEO/POLY/DEX OPHTH OINT(MAXITROL OINT),32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005440,0250,,,,,,LIDOCAINE TOPICAL 4% 50ML  SOL (XYLOCAIN,277.95,277.95,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005442,0637,,,,,,CIPROFLOXACIN 250MG TAB (CIPRO),14.78,14.78,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005456,0637,,,,,,ACETAMINOPHEN XS 500MG CAPLET (TYLENOL X,6.75,6.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005464,0637,,,,,,ACETAMINOPHEN W/CODEINE #3 TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005465,0250,,,,,,LIDOCAINE W/EPI INJ 1.5% 5ML (XYLOCAINE,53.75,53.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005466,0250,,,,,,NEO/POLY/GRAM OPHTH SOLN (NEOSPORIN),266.34,266.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005480,0637,,,,,,ACETAMINOPHEN 325MG TAB (TYLENOL),6.75,6.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005481,0250,,,,,,LIDOCAINE JELLY 2% 30ML (XYLOCAINE),82.24,82.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005485,0636,J2001,,,,,LIDOCAINE 2% 20MG/ML 5ML SYR (XYLOCAINE),59.39,59.39,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47005524,0250,,,,,,AMOXICILLIN 500MG CAP,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005530,0637,,,,,,DIAZEPAM 5MG TAB (VALIUM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005532,0637,,,,,,BUPROPION 100MG TAB (WELLBUTRIN),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005533,0637,,,,,,WARFARIN 5MG TAB (COUMADIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005555,0250,,,,,,DIAZEPAM 2MG TAB (VALIUM),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005560,0250,,,,,,NITROLINGUAL 0.4MG SPRAY (NITROSTAT),70.68,70.68,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005574,0637,,,,,,AMIODARONE 200MG TAB (PACERONE),16.39,16.39,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005589,0637,,,,,,ENALAPRIL 10MG TAB (VASOTEC),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005597,0637,,,,,,ENALAPRIL 5MG TAB (VASOTEC),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005608,0636,Q0163,,,,,DIPHENHYDRAMINE 25MG CAP(BENADRYL),6.72,6.72,2.28,2.28,,,,,,,2.28,,,,
47005639,0637,A9270GY,,,,,HYDROCODONE/APAP TAB 5/500MG (VICODIN),6.25,0.00,,,,,,,,,,,,,
47005670,0250,,,,,,HYDROXYZINE PAM 50MG CAP (VISTARIL),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005688,0250,,,,,,HYDROXYZINE PAM 100MG CAP (VISTARIL),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005696,0250,,,,,,NICOTINE PATCH 21MG/DAY,24.46,24.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005698,0250,,,,,,NICOTINE PATCH 14MG/DAY,25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005731,0637,,,,,,BELLADONNA /PHENOBARB TAB (DONNATAL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005757,0250,,,,,,Nitroglycerin/D5W : 50MG/250ML PREMIX,88.96,88.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005772,0250,,,,,,FERROUS SULFATE 220MG ELIXIR,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005779,0637,,,,,,ALPRAZOLAM 0.5MG TAB (XANAX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005815,0636,J3010,,,,,FENTANYL 250MCG/5ML INJ (SUBLIMAZE),30.91,30.91,10.54,20.86,,,20.86,,,,10.54,,,10.76,10.76
47005822,0250,,,,,,FML OPHTH SUSP 0.1%,87.88,87.88,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005830,0636,90724,,,,,INFLUENZA VIRUS VACCINE (FLUZONE),28.75,0.00,,,,,,,,,,,,,
47005842,0637,,,,,,TRIPLE ANTIBIOTIC OINT PKT (NEOSPORIN),6.75,0.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47005848,0250,,,,,,METRONIDAZOLE 5MG/ML IV,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005961,0250,,,,,,CEPHALEXIN SUSP 250MG/5ML,58.05,58.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005987,0250,,,,,,NYSTATIN CREAM 30GM,25.80,25.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47005988,0250,,,,,,CEFACLOR 125MG/5ML 75ML SUSP,69.34,69.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006028,0250,,,,,,BUTALBITAL/ACETAMINOPHEN/CAFFEINE TAB,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006069,0250,,,,,,CEFUROXIME 250MG TAB (CEFTIN),16.93,16.93,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006085,0636,J8540,,,,,DEXAMETHASONE 2MG TAB,7.26,7.26,2.47,2.47,,,,,,,2.47,,,,
47006092,0250,,,,,,DESIPRAMINE HCL 25MG TAB (NORPRAMIN),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006126,0250,,,,,,ORPHENADRINE 60MG/2ML  2ML INJ (NORFLEX),106.42,106.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006142,0250,,,,,,IRON COMPLEX 150MG CAP (FERREX),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006143,0250,,,,,,CECLOR SUSP 125MG/5ML,77.67,77.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006150,0636,J0744,,,,,CIPROFLOXACIN INJ 400MG/40ML (CIPRO),27.95,27.95,,,,,,,,,,,,,
47006168,0636,J0834,,,,,COSYNTROPIN 0.25MG INJ (CORTROSYN),549.95,549.95,,,,,,,,,,,,,
47006258,0636,Q9968,,,,,METHYLENE BLUE 0.5% 10ML,1731.67,1731.67,1174.58,1174.58,,,,,,,1174.58,,,,
47006275,0637,,,,,,ALLOPURINOL 300MG TAB (ZYLOPRIM),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006283,0250,,,,,,EUCERIN 40Z CRM,36.93,36.93,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006317,0636,J9190,,,,,FLUOROURACIL 500MG/10ML INJ (ADRUCIL),32.52,32.52,,,,,,,,,,,,,
47006343,0636,J9070,,,,,CYCLOPHOSPHAMIDE 1000MG INJ (CYTOXAN),2917.72,2917.72,,,,,,,,,,,,,
47006356,0636,J2780,,,,,ZANTAC INJ 25MG/ML,32.79,32.79,13.60,13.60,,,,,,,13.60,,,,
47006365,0250,,,,,,DURAGESIC SYSTEM 75MCG,138.67,138.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006381,0636,J1790,,,,,DROPERIDOL INJ 2.5MG/ML 2ML AMP,30.91,30.91,,,,,,,,,,,,,
47006432,0250,,,,,,ALCOHOL DEHYDRATED 1ML AMP INJ,51.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006469,0637,,,,,,AMLODIPINE 10MG TAB,10.75,10.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006471,0637,,,,,,AMLODIPINE 5 MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006473,0637,,,,,,LISINOPRIL 20MG TAB (ZESTRIL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006480,0637,,,,,,CALCIUM 500MG TAB (OSCAL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006497,0250,,,,,,METOLAZONE 5 MG TAB (ZAROXOLYN),14.24,14.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006498,0250,,,,,,BUPIVACAINE 0.5% INJ 10ML (MARCAINE),32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006510,0250,J0133,,,,,ACYCLOVIR INJ 500MG,144.75,0.00,,,,,,,,,,,,,
47006549,0250,,,,,,D 50W 50% VIAL 50ML,32.52,32.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006562,0636,Q0144,,,,,AZITHROMYCIN 250MG TAB (ZITHROMAX),30.91,30.91,,,,,,,,,,,,,
47006564,0637,,,,,,BISACODYL 5MG EC TAB (DULCOLAX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006580,0250,,,,,,ERYTHROMYCIN 250MG CAP (ERY-TAB),25.94,25.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006597,0636,J8610,,,,,METHOTREXATE 2.5MG TAB,14.78,14.78,,,,,,,,,,,,,
47006639,0637,,,,,,SALINE NASAL SPRAY (OCEAN),15.05,15.05,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006648,0637,,,,,,CLONIDINE TTS -1 PATCH (CATAPRES),43.27,43.27,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006713,0636,J1100,,,,,DEXAMETHASONE 4MG/ML 5ML INJ SDV,30.91,30.91,10.60,21.11,,,21.11,,,,10.60,,,11.63,11.63
47006721,0250,,,,,,MEPIVACAINE 1% 20ML INJ (CARBOCAINE),73.64,73.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006739,0636,J0702,,,,,BETAMETHASONE 6MG/ML 5ML INJ (CELESTONE),106.42,106.42,,,,,,,,,,,,,
47006747,0637,,,,,,DICYCLOMINE 10MG CAP (BENTYL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006806,0250,,,,,,DILTIAZEM 300MG CAP (CARDIZEM CD),12.63,12.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006812,0637,,,,,,DILTIAZEM ER 90MG CAP (CARDIZEM),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006814,0637,,,,,,DOXAZOSIN 1MG TAB (CARDURA),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006836,0250,,,,,,DOXYCYCLINE 100MG INJ (VIBRAMYCIN),78.28,78.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006838,0250,,,,,,DOCUSATE SODIUM 100MG CAP (COLACE),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006860,0250,,,,,,VECURONIUM 10MG INJ (NORCURON),101.86,101.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006886,0250,,,,,,LABETALOL 100MG/20ML INJ (TRANDATE),64.50,64.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47006944,0636,J2300,,,,,NALBUPHINE 10MG/ML  1ML INJ (NUBAIN),126.31,126.31,,,,,,,,,,,,,
47006960,0637,,,,,,DOCUSATE CALCIUM 240MG CAP (SURFAK),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47006970,0250,,,,,,PROSIGHT TAB (OCUVITE) I CAPS,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007083,0250,,,,,,GAVISCON SUSP,30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007109,0250,,,,,,GLIPIZIDE 10MG TAB (GLUCOTROL),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007125,0250,,,,,,GENTAMYCIN OPTH SOL,35.48,35.48,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007133,0637,,,,,,POLYETHYLENE GLYCOL-ELECTROLYTE SOL (GOL,75.25,75.25,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47007208,0250,,,,,,GRANULEX AEROSOL 4OZ,90.57,90.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007232,0250,,,,,,GLYCERIN ADULT SUPP,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007234,0636,J1610,,,,,GLUCAGON 1MG HYPOKIT INJ (GLUCAGEN),301.27,301.27,303.09,303.09,,,,,,,303.09,,,,
47007272,0637,,,,,,METRONIDAZOLE 500MG TAB (FLAGYL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47007281,0250,,,,,,GENTAMICIN SULFATE CRM,25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007299,0250,,,,,,GENTAMICIN SULFATE 0.1%OINT  15GM,212.33,212.33,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007315,0250,,,,,,GENTAMICIN OPHTH OINT 3.5GM(GENTAK),84.55,84.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007322,0636,J2270,,,,,MORPHINE SULFATE 10MG/ML INJ,30.91,30.91,10.79,23.74,,,22.21,,,,10.79,,,23.74,23.74
47007349,0250,,,,,,GLIPIZIDE 5MG TAB (GLUCOTROL),7.50,7.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007350,0250,,,,,,DIAZOXIDE 15MG/ML 20ML INJ (HYPERSTAT),485.36,485.36,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007355,0637,A9270GY,,,,,TRIAM/HCTZ 75/50MG TAB (MAXIDE),6.75,0.00,,,,,,,,,,,,,
47007413,0250,,,,,,TETRACAINE 0.5% EYE DROP,464.40,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007414,0250,,,,,,ERYTHROMYCIN EC 333MG (ERY-TAB),6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007430,0637,,,,,,IBUPROFEN 200MG TAB (MOTRIN),1.34,1.34,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47007447,0636,J9217,,,,,LUPRON DEPOT INJ 7.5MG,2308.75,0.00,,,,,,,,,,,,,
47007505,0250,,,,,,CHLORPHENIRAMINE MAL 4MG TAB (CHLORPHEN),7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007565,0250,,,,,,DILTIAZEM 240MG CAP (CARDIZEM CD),9.94,9.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007588,0636,J1100,,,,,DEXAMETHASONE SOD PHOS 10MG/ML 1ML INJ,32.79,32.79,10.60,21.11,,,21.11,,,,10.60,,,11.63,11.63
47007629,0637,J2354,,,,,OCTREOTIDE 100MCG/ML INJ (SANDOSTATIN),73.91,73.91,,,,,,,,,,,,,
47007637,0636,90732,,,,,PNEUMOVAX 23 INJ 0.5ML,542.80,542.80,,,,,,,,,,,,,
47007646,0637,,,,,,CEFUROXIME 500MG TAB (CEFTIN),32.52,32.52,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47007648,0250,,,,,,CEFOXITIN 500MG TAB,30.91,30.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007650,0250,,,,,,CEFPROZIL 250MG/5ML SUSP 50ML (CEFZIL),136.26,136.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007654,0250,,,,,,CEFOXITIN 250MG TAB (CEFZIL),15.86,15.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007677,0250,,,,,,FAMOTIDINE 20MG TAB (PEPCID),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007680,0250,,,,,,LIDOCAINE VISCOUS 2% 100ML (XYLOCAINE),56.76,56.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007711,0250,,,,,,DICLOXACILLIN 250MG CAP,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007751,0637,,,,,,FLUOXETINE 20MG CAP,12.09,12.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47007760,0250,,,,,,BACITRACIN OPHTH OINT 3.5GM TUBE,307.18,307.18,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007769,0250,,,,,,PENICILLIN V POTASSIUM 250MG/5ML SUSP (P,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007785,0250,,,,,,PENICILLIN G SODIUM 5MU INJ,180.87,180.87,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007919,0250,,,,,,CORTISPORIN OPTH OINT,124.16,124.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007943,0250,,,,,,ERYTHROMYCIN OPHTH OINT 0.5% (ILOTYCIN),24.46,24.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47007992,0250,,,,,,DOXYCYCLINE 100MG CAP (VIBRAMYCIN),23.92,23.92,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008023,0300,86580,,,,,TUBERSOL  5TU/0.1ML INJ,32.52,32.52,,,,,,,,,,,,,
47008030,0636,J1450,,,,,FLUCONAZOLE PREMIX 200MG (DIFLUCAN),337.01,337.01,,,,,,,,,,,,,
47008032,0637,,,,,,FLUCONAZOLE 100MG TAB (DIFLUCAN),34.94,34.94,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47008034,0250,,,,,,FLUCONAZOLE 200MG TAB (DIFLUCAN),56.44,56.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008106,0636,J1410,,,,,CONJUGATED ESTROGENS 25MG INJ (PREMARIN),1531.49,1531.49,531.43,531.43,,,,,,,531.43,,,,
47008130,0637,,,,,,CONJUGATED ESTROGENS 0.625MG/GM 42.5GM C,195.11,195.11,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47008263,0636,Q0177,,,,,HYDROXYZINE PAM 25MG CAP (VISTARIL),6.72,6.72,2.26,2.26,,,,,,,2.26,,,,
47008270,0636,J3535,,,,,ALBUTEROL HFA 90MCG (VENTOLIN HFA),138.67,138.67,,,,,,,,,,,,,
47008346,0636,J2590,,,,,OXYTOCIN 10U/1ML INJ (PITOCIN),32.79,32.79,,,,,,,,,,,,,
47008347,0636,J1630,,,,,HALOPERIDOL LACT 5MG/1ML INJ,32.52,32.52,11.18,11.38,,,,,,,11.18,,,11.38,11.38
47008361,0250,,,,,,VASOPRESSIN INJ 10U/0.5,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008368,0636,J0360,,,,,HYDRALAZINE HCL 20MG/ML INJ,77.94,77.94,26.34,48.45,,,,,,,26.34,,,48.45,48.45
47008370,0250,,,,,,HYDROXYZINE HCL 50MG/1ML INJ (VISTARIL),115.81,115.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008387,0637,,,,,,PREDNISONE OPTH 1% 5ML SUSP (PRED-FORTE),79.28,79.28,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47008388,0250,,,,,,HYDROCORTISONE 2.5% OINT (CORTIZONE),25.53,25.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008404,0636,J1644,,,,,"HEPARIN 10,000units/ML  INJ",35.48,35.48,10.82,11.70,,,,,,,11.70,,,10.82,10.82
47008429,0250,,,,,,IMIPENEM & CILASTATIN 500MG ADV INJ (PRI,134.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008486,0250,,,,,,PROMETHAZINE 25MG SUPP (PHENERGAN),16.39,16.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008487,0250,J1642,,,,,HEPARIN LOCK  500UNIT/5ML  FLUSH,32.52,32.52,,,,,,,,,,,,,
47008495,0637,,,,,,HYDROCORTISONE 1% CRM (CORTIZONE),25.53,25.53,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47008536,0250,,,,,,PAPAVERINE HCL 60MG/2ML 2ML INJ,213.68,213.68,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008602,0637,,,,,,HYDROCHLOROTHIAZIDE 25MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47008643,0250,,,,,,PAREGORIC LIQUID 5ML,14.24,14.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008668,0636,J2720,,,,,PROTAMINE SULFATE 50MG/5ML INJ,50.52,50.52,17.18,17.19,,,,,,,17.19,,,17.18,17.18
47008676,0250,,,,,,PREDNISONE 1MG TAB,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008693,0637,,,,,,IBUPROFEN 800MG TAB (MOTRIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47008726,0637,,,,,,NITROGLYCERIN 0.2MG/HR PATCH (NITRO-DUR),12.09,12.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47008759,0636,J0743,,,,,IMIPENEM/CILASTATIN 500MG INJ (PRIMAXIN),116.37,116.37,40.19,40.19,,,,,,,40.19,,,,
47008866,0637,,,,,,PROPYLTHIOURACIL 50MG TAB,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47008889,0250,,,,,,FERROGEL FORTE CAP,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47008891,0636,J0886,,,,,EPOETIN ALPHA 10MU/ML INJ (W/ DIALYSIS),496.25,0.00,,,,,,,,,,,,,
47009011,0250,,,,,,NICOTINE PATCH  7MG/DAY,23.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009014,0250,,,,,,HYPOTEARS OPTH SOL,25.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009099,0636,J1644,,,,,"HEPARIN 1,000units/ML 1ML INJ",39.51,39.51,10.82,11.70,,,,,,,11.70,,,10.82,10.82
47009118,0636,J1644,,,,,HEPARIN SODIUM INJ( 1MU/,32.79,32.79,10.82,11.70,,,,,,,11.70,,,10.82,10.82
47009121,0250,,,,,,HYDROMET 5ML DOSE (HYCODAN),5.91,5.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009122,0636,J0780,,,,,PROCHLORPERAZINE 10MG/2ML INJ (COMPAZINE,44.34,44.34,15.08,15.08,,,,,,,15.08,,,,
47009142,0250,,,,,,PROCARDIA XL 90 MG,12.63,12.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009146,0250,,,,,,PHENOBARB SOD INJ 130MG,32.79,32.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009161,0637,,,,,,NIFEDIPINE XL 30 MG TAB (PROCARDIA XL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47009162,0636,J1670,,,,,TETANUS INJ 250U (BAY-TET),496.38,496.38,,,,,,,,,,,,,
47009179,0637,,,,,,AMOXICILLIN 250MG CAP,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47009394,0636,J7500,,,,,AZATHIOPRINE 50MG TAB (IMURAN),7.26,7.26,,,,,,,,,,,,,
47009410,0250,,,,,,ISOPROTERENOL HCL INJ 0,54.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009415,0250,,,,,,ISUPREL HCL INJ 0.2MG/M,80.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009435,0636,J2765,,,,,METOCLOPRAMIDE 10MG/2ML INJ (REGLAN),32.52,32.52,11.06,13.89,,,,,,,11.06,,,13.89,13.89
47009436,0250,,,,,,ISOPROTERENOL 1MG/5ML AMP (ISUPREL),1126.44,1126.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009480,0250,,,,,,REFRESH PM LUB OPTH,36.82,36.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009500,0637,,,,,,LEVOTHYROXINE  0.025MG TAB (SYNTHROID),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47009526,0636,J0696,,,,,CEFTRIAXONE 1000MG ADV VIAL (ROCEPHIN),38.70,38.70,67.78,134.95,,,134.95,,,,67.78,,,75.19,75.19
47009634,0637,,,,,,ASPIRIN 81MG CHEW TAB,6.75,6.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47009717,0637,,,,,,WARFARIN 1MG TAB (COUMADIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47009724,0636,S0017,,,,,AMINOCAPROIC ACID 250MG/ML 20ML INJ (AMI,61.01,61.01,,,,,,,,,,,,,
47009766,0637,,,,,,VERAPAMIL SR 240MG TAB (ISOPTIN SR),10.91,10.91,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47009774,0636,J1800,,,,,PROPRANOLOL 1MG/1ML INJ (INDERAL),32.79,32.79,,,,,,,,,,,,,
47009881,0637,,,,,,IBUPROFEN 400 MG TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47009949,0250,,,,,,IPECAC SYRUP 1.4MG/ML,6.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009964,0250,,,,,,ISOSORBIDE DIN 40MG TAB (ISORDIL TITRADO,6.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009989,0250,,,,,,POLYMYXIN B/TRIMETHOPRIM OPHTH DROPS,36.55,36.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009994,0250,,,,,,AMPICILLIN & SULBACTAM 1.5GM ADV INJ,37.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009995,0250,,,,,,AMPICILLIN & SULBACTAM 3GM ADV INJ (UNAS,65.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009996,0636,J3475,,,,,MAGNESIUM SULFATE 1000MG/2ML INJ,55.09,55.09,,,,,,,,,,,,,
47009997,0250,,,,,,TPN-FAT,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47009998,0636,J1644,,,,,HEPARIN INJ 1000U/ML 30ML,32.52,32.52,10.82,11.70,,,,,,,11.70,,,10.82,10.82
47080002,0258,,,,,,SOD BICARB INJ:50MEQ 50ML,32.79,32.79,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47080006,0250,,,,,,Cefazolin/NS IVPB: 1000MG/100ML(ANCEF),0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080008,0250,,,,,,Imipenem&cilastatin/NS IVPB: 500MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080009,0250,,,,,,Piperacillin&Taz/NS IVPB 3.375GM/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080010,0250,,,,,,Vancomycin/NS IVPB: 1000MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080011,0250,,,,,,EPIDURAL,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080012,0250,,,,,,RANITIDINE D5W IVPB150MG/250ML (ZANTAC D,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080013,0250,,,,,,Phenylephrine/NS IVPB: 10MG/250ML (NEO),0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080014,0250,,,,,,Diltiazem/NS IVPB: 125MG/125ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080015,0637,,,,,,MELATONIN 5MG TAB,6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080016,0250,,,,,,SELF ADMINISTERED DRUG,154.80,154.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080017,0636,,,,,,IV TEMPLATE,281737.00,0.00,15.98,15.98,15.98,15.98,,,,,,,,,
47080018,0636,J2780,,,,,RANITIDINE 50MG/2ML IV (ZANTAC),32.79,32.79,13.60,13.60,,,,,,,13.60,,,,
47080019,0637,,,,,,CARBAMAZEPINE 200MG TAB (TEGRETOL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080020,0636,J9201,,,,,GEMCITABINE 1GM VIAL (GEMZAR),1897.00,0.00,,,,,,,,,,,,,
47080027,0636,P9047,,,,,ALBUMIN 25% (12.5GM/50ML) INJ,464.40,464.40,157.90,159.06,,,,,,,157.90,,,159.06,159.06
47080031,0636,J9070,,,,,CYCLOPHOSPHAMIDE 500MG INJ (CYTOXAN),113.14,113.14,,,,,,,,,,,,,
47080032,0636,J9000,,,,,DOXORUBICIN 20MG VIAL (ADRIAMYCIN),329.49,329.49,,,,,,,,,,,,,
47080033,0250,,,,,,CIPRO HC EAR DROP 10ML BOTTLE,289.71,289.71,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080036,0637,,,,,,OXYCODONE SR 20MG TAB (OXYCONTIN),11.29,11.29,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080038,0636,J1442,,,,,FILGRASTIM 480MCG/0.8 ML INJ (NEUPOGEN),2742.20,2742.20,,,,,,,,,,,,,
47080039,0636,J2993,,,,,RETEPLASE 10 UNIT HALFKIT (RETAVASE),4205.13,4205.13,,,,,,,,,,,,,
47080040,0636,J1327,,,,,EPTIFIBATIDE 2MG/ML 100ML VIAL (INTEG,1930.16,1930.16,,,,,,,,,,,,,
47080041,0250,J2353,,,,,OCTREOTIDE LAR DEP 30MG (SANDOSTATIN),6971.75,0.00,,,,,,,,,,,,,
47080043,0250,,,,,,OSMOLITE 8OZ LIQ,8.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080045,0636,J3010,,,,,FENTANYL 1000MCG/20ML INJ (SUBLIMAZE),133.30,133.30,10.54,20.86,,,20.86,,,,10.54,,,10.76,10.76
47080046,0637,,,,,,TIZANIDINE 4MG TAB (ZANAFLEX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080048,0636,J7192,,,,,FACTOR 8 REC. 1127 U/VIAL,6807.71,6807.71,,,,,,,,,,,,,
47080049,0250,,,,,,LETROZOLE 2.5MG TAB (FEMARA),30.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080050,0250,,,,,,CALCIUM CHLORIDE 10% INJ 1000MG/10ML,104.32,104.32,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080051,0636,Q9968,,,,,LYMPHAZURIN 1% INJ 5ML(ISOSULFAN BLUE),4563.64,4563.64,1174.58,1174.58,,,,,,,1174.58,,,,
47080052,0250,,,,,,DILTIAZEM INJ 125MG/25ML,104.81,104.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080054,0637,,,,,,CILOSTAZOL 100MG TAB (PLETAL),8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080055,0637,,,,,,TOPIRAMATE 25MG TAB (TOPAMAX),9.94,9.94,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080057,0637,,,,,,LEVOTHYROXINE 0.137MCG TAB (SYNTHROID),5.91,5.91,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080058,0250,J1573,,,,,HEP B IMM GLOB 5ML,2690.00,0.00,,,,,,,,,,,,,
47080059,0636,90746,,,,,HEP B VAC RECOMB 20MCG/ML 1ML INJ,294.01,294.01,,,,,,,,,,,,,
47080060,0637,A9270GY,,,,,PRAVASTATIN TAB: 20MG (PRAVACHOL),11.75,0.00,,,,,,,,,,,,,
47080063,0637,,,,,,HYDROCORTISONE 2.5% CRM (RECTAL USE),94.06,94.06,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080068,0250,,,,,,VITAMIN A 50MG/ML 2ML VIAL (AQUASOL),95.94,95.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080069,0637,,,,,,LIOTHYRONINE 5MCG TAB,5.91,5.91,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080071,0637,,,,,,CALCIUM CARBONATE 500MG TAB (TUMS),1.34,1.34,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080072,0636,J8530,,,,,CYCLOPHOSPHAMIDE 25MG TAB (CYTOXAN),5.91,5.91,,,,,,,,,,,,,
47080073,0637,,,,,,METOPROLOL XL SUCC 100MG (TOPROL XL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080074,0636,J2820,,,,,SARGRAMOSTIM 500MCG VIAL (LEUKINE),1176.00,0.00,,,,,,,,,,,,,
47080075,0250,,,,,,MISC PT HOME MED,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080076,0636,J7131,,,,,NACL 3% 500ML HYPERTONIC SALINE IVF,29.56,29.56,9.97,9.97,,,,,,,9.97,,,,
47080080,0250,,,,,,PHENOL 10ML TOPICAL,30.91,30.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080081,0636,J2325,,,,,NESIRITIDE 1.5MG INJ (NATRECOR),2107.27,2107.27,,,,,,,,,,,,,
47080082,0636,J1644,,,,,"HEPARIN 10,000units/10ML INJ",29.56,29.56,10.82,11.70,,,,,,,11.70,,,10.82,10.82
47080083,0637,,,,,,MOXIFLOXACIN 400MG TAB (AVELOX),116.94,116.94,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080087,0637,,,,,,ZIPRASIDONE 20MG CAP (GEODON),18.81,18.81,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080088,0250,,,,,,PANCURONIUM 10MG/5ML AMP,55.09,55.09,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080089,0637,,,,,,LINEZOLID 600MG TAB (ZYVOX),274.93,274.93,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080090,0636,J2020,,,,,Linezolid PREMIX  600MG/300ML IVPB  (ZYV,420.06,420.06,,,,,,,,,,,,,
47080091,0250,J2770,,,,,QUINUPRISTIN & DALFOPRISTIN 500MG VIAL,363.00,0.00,,,,,,,,,,,,,
47080092,0637,,,,,,TRAMADOL/APAP 37.5/325MG TAB (ULTRACET),3.76,3.76,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080093,0250,,,,,,HIGH PROTEIN SHAKES,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080094,0250,,,,,,BALSALAZIDE 750MG TAB (COLAZAL),5.91,5.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080096,0250,,,,,,EPINEPH 1:1000 30MG/30ML INJ,34.94,34.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080097,0637,,,,,,ACETAMINOPHEN ELIXIR 5ML DOSE,3.76,3.76,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080098,0636,Q0162,,,,,ONDANSETRON ODT 4MG TAB (ZOFRAN ODT),99.39,99.39,40.03,82.07,,,,,,,40.03,,,82.07,82.07
47080100,0250,,,,,,FOLBEE TAB (FOLTX),5.64,5.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080101,0636,J0886,,,,,EPOETIN ALPHA 20000 U (W/ DIALYSIS) (PRO,977.25,0.00,,,,,,,,,,,,,
47080102,0250,,,,,,PODOPHYLLUM RESIN (PODOCON-25),196.46,196.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080103,0637,,,,,,PRAMIPEXOLE  0.25MG TAB (MIRAPEX),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080106,0250,,,,,,VANICREAM 16OZ JAR,41.12,41.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080107,0637,,,,,,TOLTERODINE ER 4MG CAP (DETROL),14.78,14.78,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080108,0637,,,,,,PSEUDOEPHEDRINE 120MG 12 HR TAB (SUDAFED,4.03,4.03,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080109,0636,J1071,,,,,DEPOTESTOSTERONE CYP 200MG INJ 1ML,97.83,97.83,,,,,,,,,,,,,
47080110,0636,J0690,,,,,CEFAZOLIN 1000MG INJ (ANCEF),34.94,34.94,11.91,23.50,,,23.50,,,,11.91,,,15.48,15.48
47080111,0250,,,,,,POST GASTRECTOMY FLUIDS,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080112,0637,,,,,,ZINC SULFATE 220MG CAP (EQUIV 50MG),6.75,6.75,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080114,0636,Q0169,,,,,PROMETHAZINE 25MG TAB (PHENERGAN),5.91,5.91,,,,,,,,,,,,,
47080116,0637,,,,,,SALINE NASAL GEL  AYR,15.05,15.05,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080117,0637,A9270GY,,,,,NEPHRO-VITE TAB,5.75,0.00,,,,,,,,,,,,,
47080118,0637,,,,,,ENSURE HIGH PROTEIN SUPPLEMENT 240ML,10.50,0.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080119,0250,,,,,,HALOPERIDOL 2MG/ML SOL (HALDOL),145.93,145.93,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080120,0637,,,,,,OLANZAPINE 10MG TAB (ZYPREXA),42.46,42.46,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080121,0250,,,,,,COCAINE 4% SOL,160.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080122,0250,,,,,,ENCOURAGE FLUIDS,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080125,0636,Q0173,,,,,TRIMETHOBENZAMIDE 300MG CAP (TIGAN),6.72,6.72,,,,,,,,,,,,,
47080126,0637,,,,,,PRIMIDONE 50MG TAB (MYSOLINE),6.13,6.13,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080127,0636,J1100,,,,,DEXAMETHASONE 10MG INJ SDV,34.94,34.94,10.60,21.11,,,21.11,,,,10.60,,,11.63,11.63
47080129,0636,J2997,,,,,ALTEPLASE 2MG (CATHFLO ACTIVASE),303.96,303.96,11351.74,11351.74,,,,,,,11351.74,,,,
47080131,0250,,,,,,LUGOL'S SOLUTION,63.69,63.69,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080132,0636,J3489,,,,,ZOLEDRONIC ACID 4MG INJ (ZOMETA),3663.06,3663.06,1469.36,1511.65,,,,,,,1469.36,,,1511.65,1511.65
47080133,0636,90648,,,,,HIB VACCINE (W/TET),115.56,115.56,,,,,,,,,,,,,
47080135,0637,A9270GY,,,,,SIMVASTATIN 40MG TAB (ZOCOR),18.75,0.00,,,,,,,,,,,,,
47080136,0250,,,,,,FLUIDS,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080137,0250,,,,,,DESMOPRESSIN 4MCG/ML 1ML AMP (DDAVP),110.19,110.19,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080138,0636,J7131,,,,,NACL 7% 5ML NEB,8.60,8.60,9.97,9.97,,,,,,,9.97,,,,
47080139,0637,,,,,,FLORANEX TAB,28.49,28.49,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080140,0250,,,,,,DOCUSATE SODIUM 10MG/ML LIQ 120ML,14.78,14.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080141,0250,,,,,,CALCIUM GLUCONATE 1000MG/10ML,155.27,155.27,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080142,0250,,,,,,BOOST DIABETIC SUPPLEMENT,11.50,11.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080143,0636,J1260,,,,,DOLASETRON 12.5MG INJ (ANZEMET),66.11,66.11,,,,,,,,,,,,,
47080144,0250,,,,,,EMPTY IV CONTAINER 250ML,18.27,18.27,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080145,0250,,,,,,MULTIVITAMIN LIQ (CENTAMIN),25.00,25.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080146,0250,,,,,,PERUVIAN BALSAM,65.75,65.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080147,0250,,,,,,FENTANYL 100MCG/HR PATCH (DURAGESIC),185.97,185.97,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080148,0250,,,,,,FENTANYL 75MCG/HR PATCH (DURAGESIC),181.94,181.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080149,0250,,,,,,CHARCOAL ACTIDOSE WITH SORBITOL (80Z),82.77,82.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080150,0250,,,,,,EMPTY STERILIZED VIAL 30ML,4.03,4.03,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080151,0250,,,,,,GLIMEPIRIDE 4MG TAB (AMARYL),5.64,5.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080152,0250,,,,,,EPINEPHRINE 0.3MG/0.3ML AUTO PEN,994.11,994.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080153,0637,,,,,,LIDOCAINE VISCOUS 15ML U/D (XYLOCAINE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080154,0636,J0878,,,,,DAPTOMYCIN 500MG VIAL (CUBICIN),525.14,525.14,,,,,,,,,,,,,
47080155,0637,,,,,,VANCOMYCIN 250MG (VANCOCIN),65.31,65.31,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080156,0250,,,,,,ESMOLOL 2500MG/250ML  PREMIX (BREVIBLOC),2413.27,2413.27,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080157,0250,J7614,,,,,LEVALBUTEROL 1.25MG NEB (XOPENEX),12.09,12.09,,,,,,,,,,,,,
47080158,0250,,,,,,CHLORHEXIDINE ORAL RINSE (PERIDEX),39.24,39.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080160,0637,,,,,,GALANTAMINE 4MG TAB (RAZADYNE),12.09,12.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080161,0636,J1335,,,,,ERTAPENEM 1000MG INJ (INVANZ),604.07,604.07,205.75,262.06,,,,,,,205.75,,,262.06,262.06
47080162,0637,,,,,,ALENDRONATE 70MG WEEKLY TAB (FOSAMAX),82.24,82.24,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080163,0637,,,,,,GABAPENTIN 300MG CAP (NEURONTIN),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080164,0637,,,,,,TIOTROPIUM HANDIHALER (SPIRIVA),465.22,465.22,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080165,0250,,,,,,VANICREAM 4OZ TUBE,16.93,16.93,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080166,0637,,,,,,QUETIAPINE 25MG TAB (SEROQUEL),8.06,8.06,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080167,0636,90658,,,,,INFLUENZA ADULT VACCINE,70.47,70.47,,,,,,,,,,,,,
47080168,0637,,,,,,HYDROCORTISONE 2.5% LOT,106.42,106.42,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080169,0637,,,,,,ACYCLOVIR 400MG TAB (ZOVIRAX),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080170,0636,J0735,,,,,CLONIDINE 100MCG/ML 10ML VIAL (DURACLON),258.27,258.27,,,,,,,,,,,,,
47080171,0637,A9270GY,,,,,TOPIRAMATE 100MG TAB(TOPAMAX),18.00,18.00,,,,,,,,,,,,,
47080172,0637,A9270GY,,,,,KETOCONAZOLE 200MG (TAB),12.50,12.50,,,,,,,,,,,,,
47080173,0250,,,,,,ACCU CHECK BLOOD GLUCOSE MONITORING,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080174,0637,,,,,,AMOXICILLIN/CLAVULANATE 400MG SUSP (AUGM,292.67,292.67,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080175,0636,J3490,,,,,METOPROLOL 5MG/5ML INJ (LOPRESSOR),27.41,27.41,35.71,42.08,,,,,,,42.08,,,35.71,35.71
47080176,0250,,,,,,CULTURELLE W/LACTOBACILLUS CAP,5.25,5.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080177,0637,A9270GY,,,,,MODAFINIL100MG TAB (PROVIGIL),18.75,18.75,,,,,,,,,,,,,
47080179,0637,J1815,,,,,INSULIN GLARGINE PEN (LANTUS SOLOSTAR,438.90,438.90,,,,,,,,,,,,,
47080180,0250,,,,,,DIPHTHERIA/TETANUS TOX PEDIATRIC,51.06,51.06,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080181,0250,,,,,,VALPROATE SODIUM 500MG/5ML INJ,31.71,31.71,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080182,0636,J1450,,,,,Fluconazole/PREMIX IVPB: 200MG/100ML,96.30,96.30,,,,,,,,,,,,,
47080185,0637,A9270GY,,,,,TRIPLE ANTIBIOTIC OINT 1LB JAR (NEOSPORI,198.00,198.00,,,,,,,,,,,,,
47080187,0637,,,,,,OXYBUTYNIN XL 5MG TAB (DITROPAN XL),18.54,18.54,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080188,0250,,,,,,MED PASS SUPPLEMENT,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080189,0250,,,,,,SUCRALFATE 1000MG/10ML (CARAFATE),52.35,52.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080190,0250,,,,,,LIDOCAINE 5% PATCH (LIDODERM),38.16,38.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080193,0250,,,,,,DEXMEDETOMIDINE 200MCG/2ML INJ,306.11,306.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080194,0637,,,,,,OXYCODONE CR 10MG TAB (OXYCONTIN),8.06,8.06,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080195,0637,,,,,,OXYCODONE 5MG CAP (ROXICODONE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080197,0637,,,,,,"VITAMIN A 10,000U CAP",3.76,3.76,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080198,0637,,,,,,POTASSIUM CHLORIDE 10MEQ TAB (KLOR CON),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080199,0636,J0461,,,,,ATROPINE 1MG/10ML INJ ABBOJECT,64.77,64.77,21.84,22.02,,,,,,,21.84,,,22.02,22.02
47080200,0637,,,,,,ENSURE,10.50,10.50,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080201,0250,,,,,,DOCUSATE SODIUM 50MG/5ML LIQ (DSS),22.75,22.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080203,0250,,,,,,DANTROLENE 50MG CAP  (DANTRIUM),7.52,7.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080205,0250,,,,,,MULTIVITAMIN LIQUID 240ML,24.72,24.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080206,0637,,,,,,MICONAZOLE 2% 30GM CRM (LOTRIMIN AF),51.60,51.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080209,0637,,,,,,POLYETHYLENE GLYCOL 3350 17GM PKT (MIRAL,12.92,12.92,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080211,0637,,,,,,VANCOMYCIN 125MG CAP (VANCOCIN),134.63,134.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080212,0250,A9180,,,,,PERMETHRIN 1% CRM RINSE,31.00,0.00,,,,,,,,,,,,,
47080214,0250,,,,,,PHENYLEPHRINE 0.25% NASAL SPRAY (NEO-SYN,14.24,14.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080215,0250,,,,,,LOLLIPOPS FENTANYL (ACTIQ),65.00,65.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080216,0637,,,,,,ACETAMINOPHEN W/CODEINE ORAL SOLN 5ML,2.42,2.42,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080218,0637,,,,,,TRAVOPROST 0.004% EYE DROP 2.5ML (TRAVAT,375.98,375.98,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080220,0636,J1750,,,,,IRON DEXTRAN COMPLEX 50MG/ML 1ML SDV (DE,136.26,136.26,56.29,56.29,,,,,,,56.29,,,56.29,56.29
47080221,0250,,,,,,TOLTERODINE 2MG CAP (DETROL),14.51,14.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080222,0250,,,,,,PREGABALIN 25MG CAP (LYRICA),36.25,36.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080223,0637,,,,,,GUAIFENESIN 600MG TAB (MUCINEX),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080224,0637,,,,,,PENTOXIFYLLINE 400MG TAB ER (TRENTAL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080225,0250,,,,,,BUPIVACAINE 0.5% 30ML INJ (MARCAINE),26.34,26.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080226,0250,,,,,,PREGABALIN 150MG CAP (LYRICA),9.67,9.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080227,0250,,,,,,METRONIDAZOLE 500MG/100ML IVPB PREMIX,33.86,33.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080228,0250,,,,,,CINNAMON 1000MG CAP,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080229,0636,J1956,,,,,LEVOFLOXACIN 750MG/150ML IVPB PREMIX,228.71,228.71,60.28,61.50,,,,,,,61.50,,,60.28,60.28
47080230,0637,,,,,,FERROUS SULFATE 200MG TAB (FEOSOL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080232,0250,,,,,,CHLORASEPTIC MUCOUS MEMBRANE SPRAY 1.4%,17.47,17.47,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080233,0250,,,,,,MEPHYTON 5MG TAB (VITAMIN K),115.62,115.62,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080234,0250,,,,,,BOOST LIQ 240 ML CAN,10.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080236,0637,,,,,,EZETIMIBE 10MG TAB (ZETIA),31.71,31.71,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080237,0636,J3486,,,,,ZIPRASIDONE 20MG/ML IM INJ (GEODON),50.26,50.26,,,,,,,,,,,,,
47080238,0637,,,,,,PINK BISMUTH 262MG CHEWABLE TAB,1.34,1.34,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080239,0637,,,,,,HYDRALAZINE HCL 10MG TAB,6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080240,0637,,,,,,CALCITRIOL 0.5MCG CAP (ROCALTROL),8.87,8.87,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080241,0637,,,,,,TRIPLE ANTIBIOTIC OINT 30GM TUBE (NEOSPO,12.36,12.36,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080242,0250,,,,,,ESTRIDIOL VAG CRM 42.5GM TUBE (ESTRACE),1333.90,1333.90,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080243,0636,J9190,,,,,FLUOROURACIL 1 GM VIAL (50MG/1ML; 20ML),29.83,29.83,,,,,,,,,,,,,
47080245,0250,,,,,,SENNA 8.6MG TAB (SENOKOT),6.45,6.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080246,0250,,,,,,DULOXETINE 30MG CAP (CYMBALTA),33.11,33.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080247,0250,,,,,,WARFARIN 5MG INJ (COUMADIN),84.39,84.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080248,0636,J1652,,,,,FONDAPARINUX 2.5MG/0.5ML INJ (ARIXTRA),160.17,160.17,,,,,,,,,,,,,
47080249,0637,,,,,,MORPHINE SULFATE CONC 20MG/ML 30ML,72.56,72.56,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080250,0637,,,,,,FENOFIBRATE 145MG TAB (TRICOR),14.78,14.78,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080251,0637,,,,,,FLUTICASONE & SALMETEROL 100/50 INHALER,217.42,217.42,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080252,0637,,,,,,ZINC OXIDE 454GM OINT TUB,57.78,57.78,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080253,0637,,,,,,FLUTICASONE & SALMETEROL 250/50 DISKUS,615.80,615.80,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080255,0250,,,,,,BUMETANIDE 2MG TAB (BUMEX),6.45,6.45,48.95,162.50,134.76,134.76,162.50,,,,68.33,,,48.95,48.95
47080256,0250,,,,,,INSULIN ASPART PREFILLED PEN (NOVOLOG),576.72,576.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080257,0637,J1815,,,,,INSULIN ASPART PROTAMINE/ASPART 70/30 PE,576.72,576.72,,,,,,,,,,,,,
47080258,0637,J1815,,,,,INSULIN DETEMIR PREFILLED PEN (LEVEMIR),476.99,476.99,,,,,,,,,,,,,
47080259,0637,,,,,,CALCITRIOL 0.25 MCG LIQ CAP (ROCALTROL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080260,0250,,,,,,ESOMEPRAZOLE 40MG INJ (NEXIUM),230.39,230.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080261,0250,,,,,,STERILE WATER FOR INJECTION 1000 ML,5.38,5.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080262,0637,,,,,,AMOX/CLAVULANATE 200MG/28.5MG 50ML,69.88,69.88,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080264,0637,,,,,,PEDIALYTE 237ML BOTTLE,12.09,12.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080265,0637,,,,,,FLUTICASONE & SALMETEROL 500/50 DISKUS,1003.66,1003.66,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080266,0250,J2353,,,,,OCTREOTIDE LAR DEPOT 20MG (SANDOSTATIN),13088.50,0.00,,,,,,,,,,,,,
47080267,0636,J0885,,,,,"EPOETIN ALPHA  20,000U (PROCRIT)",2530.46,2530.46,,,,,,,,,,,,,
47080268,0636,J0885,,,,,"EPOETIN ALPHA 10,000 U (PROCRIT)",1654.81,1654.81,,,,,,,,,,,,,
47080269,0637,A9270GY,,,,,LITHIUM CARBONATE TAB ER 450MG,6.25,0.00,,,,,,,,,,,,,
47080270,0250,,,,,,CLOTRIMAZOLE 1% 30GM CRM (LOTRIMIN),27.14,27.14,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080271,0250,,,,,,B TOTAL LIQ 30 ML DROPPER BOTTLE,30.37,30.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080272,0636,J2280,,,,,MOXIFLOXACIN 400MG/250ML PREMIX IVPB (AV,130.34,130.34,,,,,,,,,,,,,
47080273,0637,,,,,,ACETAMINOPHEN 160MG/5ML U/D CUPS (TYLENO,6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080274,0637,,,,,,QUETIAPINE 100MG TAB (SEROQUEL),15.32,15.32,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080275,0250,,,,,,RIVASTIGIMINE 3MG CAP (EXELON),13.17,13.17,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080276,0250,,,,,,RIVASTIGMINE 1.5MG CAP (EXELON),13.17,13.17,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080277,0637,,,,,,MEMANTINE 5MG TAB (NAMENDA),10.48,10.48,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080278,0250,,,,,,MENOMUNE-A/C/Y/W-135  INJ 0.05MG,578.78,578.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080280,0637,A9270GY,,,,,IRBESARTAN 150MG TAB (AVAPRO),6.25,0.00,,,,,,,,,,,,,
47080282,0250,,,,,,PREGABALIN 50MG CAP (LYRICA),41.20,41.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080283,0636,J3475,,,,,MEGESTROL 20MG TAB (MEGACE),6.72,6.72,,,,,,,,,,,,,
47080285,0637,,,,,,CARBOXYMETHYLCELLULOSE OPHTH DROP 15ML,29.83,29.83,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080286,0637,,,,,,PREGABALIN 75MG CAP (LYRICA),29.82,29.82,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080287,0637,,,,,,RANOLAZINE 500MG TAB (RANEXA),10.21,10.21,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080289,0636,J0583,,,,,BIVALIRUDIN 250MG INJ (ANGIOMAX),1932.31,1932.31,,,,,,,,,,,,,
47080290,0637,,,,,,SOLIFENACIN 5MG TAB (VESICARE),38.05,38.05,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080291,0637,,,,,,DICLOFENAC&MISOPROSTOL 50MG TAB (ARTHROT,9.14,9.14,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080292,0250,J2260,,,,,MILRINONE 20MG/100ML PREMIX (PRIMACOR),82.00,0.00,,,,,,,,,,,,,
47080293,0637,,,,,,PIOGLITAZONE 30MG TAB (ACTOS),26.07,26.07,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080294,0250,,,,,,JUZO COMPRESSION STOCKINGS,84.12,84.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080295,0250,,,,,,CEPASTAT LOZENGE,12.36,12.36,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080296,0250,,,,,,GLIPIZIDE XL 2.5MG TAB (GLUCOTROL XL),6.45,6.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080297,0250,,,,,,VARENICLINE 0.5MG TAB(1 CARD OF 11 TABS),65.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080298,0250,,,,,,VARENICLINE 1MG TAB (1 CARD OF 28 TAB),174.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080299,0637,,,,,,HYDROCODONE/APAP 7.5/325MG 15 ML ELIXIR,14.51,14.51,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080301,0637,A9270GY,,,,,TELMISARTAN 80MG TAB (MYCARDIS),8.25,0.00,,,,,,,,,,,,,
47080302,0250,,,,,,HYDROMORPHONE 2MG TAB (DILAUDID),6.45,6.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080303,0250,,,,,,RIFAXIMIN 200MG TAB (XIFAXIN),70.55,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080305,0637,,,,,,OXYCODONE/APAP 5/325MG TAB (PERCOCET),10.80,10.80,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080307,0637,,,,,,OSELTAMIVIR 75MG CAP (TAMIFLU),66.47,66.47,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080308,0250,,,,,,DEMECLOCYCLINE 150MG TAB,45.71,45.71,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080309,0250,,,,,,FIBERSOURCE (TUBE FEED),10.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080310,0250,,,,,,BOOST HIGH PROTEIN,10.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080311,0637,A9270GY,,,,,FOSINOPRIL 20 MG TAB (MONOPRIL),6.50,0.00,,,,,,,,,,,,,
47080312,0637,,,,,,LEVETIRACETAM 500MG TAB (KEPPRA),14.24,14.24,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080313,0637,,,,,,IBUPROFEN 100MG/5ML U/D CUP,6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080314,0636,J2997,,,,,ALTEPLASE 100MG INJ  (ACTIVASE),33664.70,33664.70,11351.74,11351.74,,,,,,,11351.74,,,,
47080315,0636,J2274,,,,,MORPHINE 0.5MG/ML 10 ML VIAL (DURAMORPH),463.32,463.32,,,,,,,,,,,,,
47080316,0637,,,,,,MISOPROSTOL 200MCG TAB (CYTOTEC),6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080317,0636,J3010,,,,,FENTANYL 2500MCG/50ML INJ (SUBLIMAZE),31.44,31.44,10.54,20.86,,,20.86,,,,10.54,,,10.76,10.76
47080318,0250,,,,,,AMMONIA INHALANTS,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080319,0250,,,,,,AMMONIUM LACTATE 12% CRM (LAC-HYDRIN),50.26,50.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080320,0250,,,,,,CYANIDE ANTIDOTE KIT,738.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080321,0250,,,,,,CLIDINIUM/CPZ 5MG/2.5MG CAP (LIBRAX),6.45,6.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080322,0250,,,,,,COLLODION FLEXIBLE 5 ML,433.01,433.01,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080323,0250,,,,,,HEPATITIS A VACCINE INACTIVATED (HAVRIX),282.72,282.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080325,0636,J1610,,,,,GLUCAGON 1MG INJ (GLUCAGEN),885.37,885.37,303.09,303.09,,,,,,,303.09,,,,
47080326,0250,,,,,,GLUCOSE TAB,6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080327,0636,J1720,,,,,HYDROCORTISONE 500MG/4ML INJ (SOLU-CORTE,56.97,56.97,,,,,,,,,,,,,
47080328,0636,J0153,,,,,ADENOSINE 90MG/30ML VIAL (ADENOCARD),903.81,903.81,16.99,16.99,,,,,,,16.99,,,,
47080329,0636,J3489,,,,,ZOLEDRONIC ACID 5MG/100ML PREMIX (RECLAS,4319.01,4319.01,1469.36,1511.65,,,,,,,1469.36,,,1511.65,1511.65
47080330,0636,J2001,,,,,LIDOCAINE 0.5% 50 ML MDV (XYLOCAINE),27.14,27.14,10.55,20.98,,,20.98,,,,10.55,,,11.32,11.32
47080332,0250,,,,,,LIDOCAINE-MPF 2% VIAL 5ML (XYLOCAINE-MPF,27.14,27.14,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080333,0250,,,,,,NEO/POLY/BACT OPHTH OINT (NESPORIN OPHTH,23.65,23.65,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080334,0637,,,,,,MOMETASONE FUROATE 0.1% 15GM CRM (ELOCON,101.05,101.05,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080335,0637,,,,,,LUBIPROSTONE 24MCG CAP (AMITIZA),15.05,15.05,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080336,0637,,,,,,HYDROCODONE/APAP TAB 10/325 MG (NORCO),6.99,6.99,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080338,0250,,,,,,SEVOFLURANE INHALATION ANESTHETIC (ULTAN,861.07,861.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080339,0250,,,,,,VASELINE 2.5OZ TUBE,7.52,7.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080440,0250,,,,,,ETOMIDATE 20MG/10ML AMP (AMIDATE),88.42,88.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080441,0637,,,,,,PROBIOTIC CAP,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080442,0250,,,,,,FENTANYL 12 MCG/HR PATCH (DURAGESIC),87.29,87.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080443,0637,A9270GY,,,,,TACROLIMUS 1MG CAP (PROGRAF),17.50,0.00,,,,,,,,,,,,,
47080444,0637,,,,,,DICLOFENAC 1% 100GM TOPICAL GEL  (VOLTAR,248.11,248.11,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080445,0637,,,,,,ASPIRIN & DIPYRIDAMOL 200MG CAP (AGGRENO,10.48,10.48,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080446,0637,,,,,,OXCARBAZEPINE 150MG TAB (TRILEPTAL),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080447,0637,A9270GY,,,,,METHIMAZOLE 10 MG TAB (TAPAZOLE),6.00,0.00,,,,,,,,,,,,,
47080448,0250,,,,,,MAGIC MOUTHWASH 120 ML,237.15,237.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080451,0250,J0287,,,,,ABELCET B LIPOSOMAL 100MG VIAL,794.50,0.00,,,,,,,,,,,,,
47080452,0637,,,,,,URSODIOL 300MG CAP (ACTIGALL),9.14,9.14,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080453,0636,J1570,,,,,GANCICLOVIR 500MG INJ (CYTOVENE),237.84,237.84,,,,,,,,,,,,,
47080454,0637,,,,,,CYCLOSPORINE 25MG MICRO (NEORAL),7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080456,0250,,,,,,VENLAFAXINE XR 75MG CAP (EFFEXOR),16.66,16.66,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080457,0637,A9270GY,,,,,MINOXIDIL 10MG TAB (LONITEN),6.25,0.00,,,,,,,,,,,,,
47080458,0250,,,,,,DIVALPROEX ER 250MG TAB (DEPAKOTE),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080459,0636,J0456,,,,,AZITHROMYCIN 500MG INJ (ZITHROMAX),73.37,73.37,12.48,25.04,,,,,,,25.04,,,12.48,12.48
47080461,0250,,,,,,PEPTINEX 240 ML ORAL FEED,43.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080463,0250,J2185,,,,,MEROPENEM 1GM IV (MERREM),261.50,0.00,,,,,,,,,,,,,
47080464,0250,,,,,,IMMUNE GLOBULIN 5GM VIAL (GAMMAGARD S/D),1583.47,1583.47,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080465,0637,,,,,,"VIT D 50,000IU CAP (ERGOCALCIFEROL)",6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080466,0250,,,,,,ESCITALOPAM 10 MG TAB (LEXAPRO),11.56,11.56,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080467,0250,,,,,,NAFCILLIN 2000MG INJ,72.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080468,0250,,,,,,OXACILLIN 2GM ADV INJ,87.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080469,0250,,,,,,CHLORTHALIDONE 50MG TAB (THALITONE),6.72,6.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080470,0637,,,,,,PYRIDOXINE  B6 25MG,7.26,7.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080471,0250,,,,,,HALFLYTELY BOWEL PREP W/BISAC TAB,205.86,205.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080472,0250,,,,,,EXCEDRIN MIGRAINE TAB,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080473,0250,,,,,,PROPOFOL 500MG/50ML INJ,89.49,89.49,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080474,0637,,,,,,VITAMIN B-12 500MCG TAB,6.13,6.13,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080475,0636,J2270,,,,,MORPHINE SULFATE 4MG/ML INJ,29.02,29.02,10.79,23.74,,,22.21,,,,10.79,,,23.74,23.74
47080476,0636,J7510,,,,,PREDNISOLONE 15MG/5ML ELIXIR (PEDIAPRED),6.72,6.72,,,,,,,,,,,,,
47080477,0250,,,,,,METRONIDAZOLE 20MG/ML SUSP,11.82,11.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080478,0637,,,,,,VITAMIN D3 1000U TAB,6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080479,0637,J1815,,,,,INSULIN GLARGINE 100U/ML 10 ML VIAL (LA,382.16,382.16,,,,,,,,,,,,,
47080480,0637,,,,,,ROPINIROLE 0.5MG TAB (REQUIP),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080481,0637,,,,,,NULYTELY 4000ML BOWEL PREP,99.44,99.44,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080482,0250,,,,,,DULOXETINE 20MG CAP (CYMBALTA),15.05,15.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080484,0250,,,,,,ENTACAPONE 200MG TAB (COMTAN),12.63,12.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080485,0250,,,,,,FISH OIL 500MG CAP,6.75,6.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080486,0637,,,,,,METFORMIN ER 500MG TAB (GLUCOPHAGE XR),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080487,0636,S0074,,,,,CEFOTETAN 1000MG VIAL (CEFOTAN),50.52,50.52,,,,,,,,,,,,,
47080488,0637,,,,,,VENLAFAXINE 75MG TAB (EFFEXOR),9.41,9.41,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080490,0637,,,,,,BUDESONIDE & FORMOTEROL 160/4.5 INHALER,1417.54,1417.54,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080500,0637,,,,,,HEMORRHOIDAL GEL (PREPARATION H),15.05,15.05,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080502,0636,Q0163,,,,,DIPHENHYDRAMINE 12.5MG/5ML ORAL SYR,5.91,5.91,2.28,2.28,,,,,,,2.28,,,,
47080503,0250,J2680,,,,,FLUPHENAZINE DECANOATE 25MG/ML INJ,165.00,0.00,,,,,,,,,,,,,
47080504,0637,,,,,,GLYCERIN PEDIATRIC SUPPS,1.34,1.34,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080505,0250,,,,,,CHLORHEXIDINE GLUCONATE 4% SCRUB 8 OZ,23.38,23.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080506,0250,,,,,,CHLORHEXIDINE GLUCONATE 4% SCRUB 32 OZ,46.76,46.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080507,0636,J1885,,,,,KETOROLAC 15MG/1ML INJ (TORADOL),29.02,29.02,14.29,42.28,,,42.28,,,,14.29,,,22.16,22.16
47080508,0637,,,,,,BETAXOLOL 0.5% OPTH SUSP (BETOPTIC),138.67,138.67,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080510,0637,,,,,,PULMOCARE 240ML TUBE FEEDING,8.50,0.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080512,0250,J7620,,,,,IPRATROPIUM/ALBUTEROL 3ML NEB (DUONEB),9.50,9.50,,,,,,,,,,,,,
47080513,0636,J1644,,,,,"HEPARIN 10,000U/ML  5 ML INJ",66.92,66.92,10.82,11.70,,,,,,,11.70,,,10.82,10.82
47080514,0637,A9270GY,,,,,MIDODRINE 5MG TAB,11.63,11.63,,,,,,,,,,,,,
47080515,0250,J2310,,,,,NALOXONE 2MG/2ML SYR (NARCAN),166.63,166.63,,,,,,,,,,,,,
47080516,0637,,,,,,LAMOTRIGINE 100MG TAB (LAMICTAL),9.14,9.14,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080517,0636,J1756,,,,,IRON SUCROSE 100MG/5ML INJ (VENOFER),247.68,247.68,84.23,84.23,,,,,,,84.23,,,,
47080518,0637,,,,,,VITAMIN D3 400U TAB,1.07,1.07,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080519,0250,,,,,,LET SOLUTION,22.57,22.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080520,0250,,,,,,LIDOCAINE 2% W/EPI 10ML VIAL (XYLOCAINE,15.86,15.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080521,0637,,,,,,HALLS SF COUGH DROP,5.64,5.64,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080522,0637,,,,,,DEXTROMETHORPHAN COUGH SYRUP 3 OZ (DELSY,38.97,38.97,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080523,0637,,,,,,METOPROLOL TART 25MG TAB (LOPRESSOR),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080524,0637,,,,,,ESOMEPRAZOLE 40MG TAB (NEXIUM),23.38,23.38,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080525,0636,Q0161,,,,,CHLORPROMAZINE 10MG TAB (THORAZINE),6.72,6.72,,,,,,,,,,,,,
47080526,0636,J2997,,,,,ALTEPLASE 2MG (CATHFLO ACTIVASE),504.44,504.44,11351.74,11351.74,,,,,,,11351.74,,,,
47080527,0637,,,,,,VALACYCLOVIR 1000MG TAB (VALTREX),44.61,44.61,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080528,0637,,,,,,OSMOPREP TAB,11.25,0.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080529,0637,A9270GY,,,,,HYDROCODONE/APAP TAB 10/650MG (LORCET),6.00,0.00,,,,,,,,,,,,,
47080530,0637,,,,,,ACETAMINOPHEN 325MG/10.15ML ELIXIR (TYLE,6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080531,0637,,,,,,CARB/LEVO/ENTAC 100MG TAB (STALEVO),15.86,15.86,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080532,0637,,,,,,IRBESARTAN/HYDROCHLOROTHIAZIDE 300/25MG,17.25,0.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080533,0637,,,,,,PRESERVISION W/ LUTEIN SOFTGEL,5.91,5.91,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080534,0637,A9270GY,,,,,NADOLOL 80MG TAB (CORGARD),6.00,0.00,,,,,,,,,,,,,
47080536,0636,90653,,,,,INFLUENZA HIGH DOSE VACCINE,131.15,131.15,,,,,,,,,,,,,
47080537,0637,,,,,,ROPINIROLE 1MG TAB (REQUIP),6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080538,0637,,,,,,CHLORTHALIDONE 25MG TAB (THALITONE),6.72,6.72,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080539,0636,J0885,,,,,"EPOETIN ALPHA 40,000 U (PROCRIT)",4390.14,4390.14,,,,,,,,,,,,,
47080541,0637,,,,,,DNU METOPROLOL XL TAB: 25MG (TOPROL),6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080542,0637,,,,,,NYSTATIN 100MU/ML SUSP 5ML U/D CUP,11.90,11.90,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080543,0637,,,,,,MUPIROCIN 15 GM CRM (BACTROBAN),259.34,259.34,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080544,0250,,,,,,IVPB TRACKING,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080545,0250,,,,,,Ertapenem/NS IVPB: 1000MG/100ML (INVANZ),0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080546,0250,,,,,,Esomeprazole/NS IVPB:40MG/50ML(NEXIUM),0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080547,0250,,,,,,Ceftriaxone/NS IVPB: 1000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080548,0250,,,,,,Ampicillin&sulbact/NS IVPB: 1500MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080549,0250,,,,,,Ampicillin&Sulbact/NS IVPB: 3000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080550,0250,,,,,,Gentamicin/NS IVPB: 80MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080551,0250,,,,,,Ampicillin/NS IVPB:  2000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080552,0250,,,,,,CRANBERRY TABLETS 450MG,6.75,6.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080559,0636,J0131,,,,,ACETAMINOPHEN PREMIX IVPB: 1000MG/100ML,244.43,244.43,82.93,165.36,,,165.36,,,,82.93,,,101.74,101.74
47080560,0636,J1642,,,,,HEPARIN 100 U /ML 5ML SYR,16.66,16.66,,,,,,,,,,,,,
47080562,0637,,,,,,ARIPIPRAZOLE 5MG TAB (ABILIFY),137.60,137.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080563,0250,,,,,,MEPIVICAINE 2% 20ML INJ (CARBOCAINE),30.91,30.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080564,0637,,,,,,SPIRONOLACTONE 50MG TAB (ALDACTONE),6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080566,0636,J2916,,,,,FERRIC GLUCONATE 62.5 MG/5ML VIAL (FERRL,174.15,174.15,,,,,,,,,,,,,
47080567,0637,,,,,,HYDROCODONE/APAP TAB 5/325MG (NORCO),10.80,10.80,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080568,0250,,,,,,ACETYLCYSTEINE 10% 30ML VIAL (MUCOMYST),79.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080569,0250,J1572,,,,,FLEBOGAMMA 10GM/100ML,1086.00,0.00,,,,,,,,,,,,,
47080570,0250,J1572,,,,,FLEBOGAMMA 20GM/400ML,2171.75,0.00,,,,,,,,,,,,,
47080572,0250,,,,,,NF-MELOXICAM ORAL TABLET 7.5MG,10.75,10.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080573,0250,,,,,,ALCOHOL DEHYDRATED 5ML AMP INJ,202.64,202.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080575,0637,,,,,,DUTASTERIDE 0.5 MG CAP (AVODART),17.74,17.74,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080576,0637,,,,,,ERYTHROMYCIN 200MG/5ML SUSP (E.E.S),1781.02,1781.02,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080577,0636,J1165,,,,,PHENYTOIN 100MG/2ML INJ (DILANTIN),27.95,27.95,,,,,,,,,,,,,
47080578,0250,,,,,,HIGH PROTEIN PUDDING,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080579,0636,J3475,,,,,MAGNESIUM SULFATE 5000MG/10ML INJ,89.49,89.49,,,,,,,,,,,,,
47080580,0250,,,,,,MULTITRACE-4 MDV 10ML,91.38,91.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080581,0250,J1170,,,,,HYDROMORPHONE 10MG/ML SDV (DILAUDID HP),26.00,0.00,,,,,,,,,,,,,
47080582,0637,,,,,,CARVEDILOL 12.5 MG TAB (COREG),9.67,9.67,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080583,0637,,,,,,DIALYVITE RENAL MVI TAB,8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080584,0637,,,,,,DABIGATRAN 150 MG CAP (PRADAXA),19.89,19.89,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080586,0637,,,,,,BIMATOPROST 0.03% OPHTH 2.5ML (LUMIGAN),441.56,441.56,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080587,0637,,,,,,POTASSIUM CITRATE TAB 10MEQ (UROCIT K),6.99,6.99,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080588,0250,,,,,,POLIDOCANOL 1% 2ML INJ (ASCLERA),376.52,376.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080589,0250,,,,,,INTRALIPID 20% 500ML,276.01,276.01,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080590,0637,J1815,,,,,INSULIN REGULAR 100 U/ML 10 ML VIAL (HUM,325.72,325.72,,,,,,,,,,,,,
47080591,0637,,,,,,METHAZOLAMIDE 25MG TAB (NEPTAZANE),6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080592,0637,,,,,,VENLAFAXINE XR 150MG CAP (EFFEXOR XR),23.38,23.38,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080593,0636,J1170,,,,,HYDROMORPHONE PCA 0.2MG/ML (DILAUDID PCA,83.85,83.85,8.89,17.65,,,17.65,,,,8.89,,,17.40,17.40
47080594,0250,,,,,,NACL 0.9% BACTERIOSTATIC 20ML VIAL,27.95,27.95,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080595,0637,,,,,,NUTRIHEP (HEPATIC FORM) SUPP 250ML,73.91,73.91,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080596,0250,,,,,,PREFILLED SYR 0.5ML TDaP (ADACEL),200.22,200.22,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080597,0636,J0132,,,,,ACETYLCYSTEINE 6000MG/30ML INJ,955.14,955.14,,,,,,,,,,,,,
47080598,0637,,,,,,VASOLEX 60GM OINT,249.67,249.67,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080599,0636,Q0162,,,,,ONDANSETRON ODT 8MG TAB (ZOFRAN ODT),165.55,165.55,40.03,82.07,,,,,,,40.03,,,82.07,82.07
47080600,0636,J1652,,,,,FONDAPARINUX 5MG/0.4ML INJ (ARIXTRA),543.41,543.41,,,,,,,,,,,,,
47080601,0636,J1652,,,,,FONDAPARINUX 7.5MG/0.6ML INJ (ARIXTRA),374.10,374.10,,,,,,,,,,,,,
47080602,0250,,,,,,LEVOTHRYOXINE 100MCG INJ,313.63,313.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080603,0637,,,,,,VITAMIN A & D OINT 56.7GM TUBE,9.94,9.94,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080604,0250,,,,,,NACL 0.45% 250ML IV FLUID,27.95,27.95,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080605,0637,,,,,,ATORVASTATIN 40MG TAB (LIPITOR),25.26,25.26,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080606,0637,,,,,,ATORVASTATIN 10MG TAB (LIPITOR),17.47,17.47,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080607,0637,,,,,,NEOSTIGMINE 15MG TAB (PROSTIGMIN),8.60,8.60,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080608,0637,,,,,,VITAMIN B-12 250 MCG TAB,6.50,6.50,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080609,0636,J1741,,,,,IBUPROFEN 800MG/8ML INJ (CALDOLOR),55.90,55.90,,,,,,,,,,,,,
47080610,0637,,GY,,,,HYDROCORTISONE 5MG TAB (CORTEF),6.18,6.18,,,,,,,,,,,,,
47080611,0637,,,,,,SEVELAMER HCL 800MG TAB (RENAGEL),15.32,15.32,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080612,0637,,,,,,RIVAROXABAN 10MG (XARELTO),38.70,38.70,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080613,0250,,,,,,ENOXAPARIN SQ 40MG/0.4ML (LOVENOX),143.78,143.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080614,0637,,,,,,DIVALPROEX  ER 500MG TAB,20.59,20.59,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080615,0250,J1950,,,,,LUPRON DEPOT 22.5MG 3 MONTH KIT,9679.75,0.00,,,,,,,,,,,,,
47080616,0637,J1815,,,,,INSULIN DETEMIR 10ML VIAL (LEVEMIR),604.96,604.96,,,,,,,,,,,,,
47080620,0637,,,,,,MELOXICAM 7.5MG TAB (MOBIC),13.97,13.97,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080621,0637,,,,,,TRIMETHOPRIM 100MG TAB (PRIMSOL),6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080622,0636,J1580,,,,,GENTAMICIN 40MG/ML 20ML VIAL,104.49,104.49,12.69,21.87,,,21.87,,,,12.69,,,14.15,14.15
47080623,0637,,,,,,CARBOXYMETHYLCELLULOSE EYE OINT 3.5GM,37.63,37.63,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080624,0250,,,,,,ENOXAPARIN SQ 30MG/0.3ML (LOVENOX),119.86,119.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080626,0343,A9562,,,,,NM RENAL DOSE (TC MAG3),1572.72,1572.72,454.63,534.72,,,,,,,454.63,,,534.72,534.72
47080627,0343,A9537,,,,,NM HEPATOBILIARY DOSE- CHO,190.23,190.23,64.82,155.23,,,,,,,64.82,,,155.23,155.23
47080629,0637,,,,,,ROFLUMILAST 500MG TAB (DALIRESP),30.64,30.64,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080630,0343,A9560,,,,,NM MUGA DOSE (PYP),138.67,138.67,,,,,,,,,,,,,
47080631,0343,A9500,,,,,NM CARDIOLITE DOSE (TC),322.64,322.64,109.90,148.98,,,,,,,109.90,,,148.98,148.98
47080632,0343,A9503,,,,,NM BONE DOSE (TCMDP),114.38,114.38,38.81,56.95,,,,,,,38.81,,,56.95,56.95
47080635,0343,A9520,,,,,NM TC99 FILTERED,774.00,774.00,263.16,263.16,,,,,,,263.16,,,,
47080636,0343,A9521,,,,,NM Tc99m CERETEC,1993.05,1993.05,,,,,,,,,,,,,
47080637,0637,,,,,,SYSTANE BALANCE EYE DROP 10ML,38.70,38.70,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080638,0637,,,,,,DARIFENACIN 7.5MG TAB (ENABLEX),22.04,22.04,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080639,0250,,,,,,RIFAMPIN 600MG VIAL (RIFADIN),345.34,345.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080640,0250,J9280,,,,,MITOMYCIN 40MG VIAL,5662.56,5662.56,,,,,,,,,,,,,
47080641,0250,,,,,,MITOMYCIN 5MG VIAL,210.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080642,0637,,,,,,RAMIPRIL 10MG CAP (ALTACE),6.00,0.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080643,0250,,,,,,FEMORAL NERVE BLOCK,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080644,0250,,,,,,ENOXAPARIN SQ 100MG/ML  (LOVENOX),292.40,292.40,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080645,0637,,,,,,CORICIDIN HBP COUGH & CONGESTION,6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080646,0343,A9516,,,,,NM IODINE 123,302.07,302.07,,,,,,,,,,,,,
47080647,0636,J9357,,,,,VALRUBICIN 800MG/20ML (VALSTAR),20985.08,20985.08,,,,,,,,,,,,,
47080648,0250,,,,,,CEFTRIAXONE 2GM/100ML (ROCEPHIN),0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080649,0343,A9567,,,,,TECHNETIUM Tc 99 PENTELATE DIAGNOSTIC,415.22,415.22,,,,,,,,,,,,,
47080650,0250,A9270GY,,,,,ACETAZOLAMIDE 250MG TAB (DIAMOX),5.75,0.00,,,,,,,,,,,,,
47080651,0250,A9270GY,,,,,HYDROCODONE/IBUPROFEN 7.5MG/200MG (VICOP,6.25,0.00,,,,,,,,,,,,,
47080652,0636,J0883,,,,,ARGATROBAN 125MG/125ML PREMIX,3141.42,3141.42,,,,,,,,,,,,,
47080653,0250,,,,,,ACYCLOVIR 5% 15GM OINT (ZOVIRAX),603.61,603.61,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080654,0636,J2795,,,,,ROPIVACAINE 1% 20ML INJ (NAROPIN),56.44,56.44,35.34,35.34,,,,,,,35.34,,,,
47080655,0636,J1650,,,,,ENOXAPARIN SQ 60MG/0.6ML  (LOVENOX),127.92,127.92,43.49,43.49,,,,,,,43.49,,,,
47080656,0636,J0278,,,,,AMIKACIN 1000MG/4ML INJ,71.76,71.76,,,,,,,,,,,,,
47080657,0250,,,,,,Azithromcyin/NS IVPB: 500MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080658,0250,,,,,,NF-VIIBRYD ORAL TABLET 10MG,20.38,20.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080659,0250,,,,,,NIACIN ER 500MG TAB,23.47,23.47,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080660,0250,,,,,,NF- FELODIPINE TABLET ER 5MG,7.90,7.90,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080661,0250,,,,,,NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,24.33,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080662,0250,,,,,,NF-CLONAZEPAM ORAL TABLET 1MG,7.31,7.31,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080663,0250,,,,,,NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,20.96,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080664,0250,,,,,,NF-MECLICOT TAB 12.5MG,0.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080665,0250,,,,,,NF-MECLIZINE HCL ORAL TABLET 12.5MG,3.04,3.04,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080666,0250,,,,,,NF-BIOBRANE GLOVES,986.16,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080667,0250,,,,,,NF-CORDRAN SP TOPICAL CREAM 0.05%,8.43,8.43,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080668,0250,,,,,,NF-MEMANTINE HCL TAB 10MG,19.32,19.32,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080669,0250,,,,,,NF-NEO AC ORAL SYRUP 10MG-30MG-15MG/5ML,0.73,0.73,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080670,0250,,,,,,NF-JANUVIA ORAL TABLET 100MG,34.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080671,0343,A9512,,,,,NM Tc99m Pertechnetate Dose,106.68,106.68,,,,,,,,,,,,,
47080674,0636,J9267,,,,,PACLITAXEL 6MG/ML INJ,573.92,573.92,,,,,,,,,,,,,
47080675,0636,J9045,,,,,CARBOPLATIN 150 MG/15ML INJ,653.60,653.60,,,,,,,,,,,,,
47080676,0250,,,,,,REGADENOSON,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080677,0636,J2785,,,,,REGADENOSON 0.4MG/5ML INJ,1253.67,1253.67,426.93,430.43,,,,,,,426.93,,,430.43,430.43
47080678,0250,,,,,,NF-CHERATUSSIN AC SYR 10MG-100MG/5ML,0.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080679,0250,,,,,,NF-FEXOFENADINE HCL ORAL TABLET 180MG,28.10,28.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080680,0636,J1170,,,,,HYDROMORPHONE 1MG/ML INJ,26.34,26.34,8.89,17.65,,,17.65,,,,8.89,,,17.40,17.40
47080681,0250,,,,,,NF-LEVOTHYROXINE IV PWD FOR SOLN 100MCG,283.80,283.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080682,0250,,,,,,NF-ATACAND HCT TAB 16MG-12.5MG,12.58,12.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080683,0250,,,,,,NF-RISPERDAL ORAL TABLET 0.5MG,19.64,19.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080684,0250,,,,,,NF-LYRICA CAP 100MG,15.78,15.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080685,0250,,,,,,NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,12.33,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080686,0250,,,,,,NF-ISOSORBIDE DINITRATE ORAL TABLET 30MG,5.41,5.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080687,0250,,,,,,NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30,2.74,2.74,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080688,0250,,,,,,NF-PROTONIX ORAL TABLET 40MG,19.67,19.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080689,0250,,,,,,NF-ATORVASTATIN CALCIUM ORAL TAB 20MG,23.62,23.62,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080690,0250,,,,,,NF-PANTOPRAZOLE SODIUM ORAL TAB EC 40MG,24.10,24.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080691,0250,,,,,,NF-RABEPRAZOLE SODIUM TAB EC 20MG,37.98,37.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080692,0250,,,,,,NF-CRESTOR TAB 10MG,26.23,26.23,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080693,0250,,,,,,NF-ZESTRIL TABLET 10MG,6.04,6.04,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080694,0250,,,,,,NF-ESCITALOPRAM ORAL TABLET 10MG,1.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080695,0250,,,,,,NF-ESCITALOPRAM ORAL TABLET 20MG,18.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080696,0250,,,,,,NF-CITALOPRAM HBR ORAL TAB 40MG,1.42,1.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080697,0250,,,,,,NF-LISINOPRIL ORAL TABLET 10MG,4.42,4.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080698,0250,,,,,,NF-LISINOPRIL ORAL TABLET 40MG,6.71,6.71,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080699,0250,,,,,,NF-MELOXICAM ORAL TAB 15MG,21.76,21.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080700,0250,,,,,,NF-TRAZODONE HCL ORAL TABLET 100MG,3.15,3.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080701,0636,J1250,,,,,DOBUTAMINE 250MG/250ML PREMIX,76.86,76.86,9.42,9.42,,,,,,,9.42,,,,
47080702,0250,,,,,,NF-LEVOTHYROXINE ORAL TABLET 0.2MG,2.73,2.73,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080703,0250,,,,,,NF-MELATONIN 3MG,0.16,0.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080704,0250,,,,,,NF-LABETALOL HCL ORAL TABLET 200MG,3.26,3.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080705,0250,,,,,,NF-CLONAZEPAM DISINTEGRATING TAB 1MG,6.37,6.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080706,0250,,,,,,NF-DOXAZOSIN MESYLATE ORAL TABLET 8MG,4.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080707,0250,,,,,,NF-TERAZOSIN HCL CAP 2MG,6.90,6.90,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080709,0636,J2550,,,,,PROMETHAZINE 25MG/ML 1ML INJ (PHENERGAN,26.34,26.34,,,,,,,,,,,,,
47080710,0250,,,,,,NF-NIFEDIPINE ER TABLET 90MG,24.43,24.43,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080711,0636,J3360,,,,,DIAZEPAM 5 MG/ML 10 ML INJ,81.51,81.51,49.94,120.85,,,,,,,49.94,,,120.85,120.85
47080712,0636,90715,,,,,TETANUS TOX/DIPHTH/PERTUS INJ (ADACEL),223.17,223.17,76.03,182.11,,,,,,,76.03,,,182.11,182.11
47080713,0250,,,,,,NF-DEMECLOCYCLINE HCL TAB 300MG,73.39,73.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080714,0250,,,,,,NF-DEMECLOCYCLINE HCL ORAL TABLET 300MG,82.33,82.33,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080715,0250,,,,,,NF-BETAINE HYDROCHLORIDE POWDER,0.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080716,0250,,,,,,PROPARACAINE 0.5% OPHTH DROP,188.68,188.68,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080717,0250,,,,,,TERAZOSIN 1 MG CAP (HYTRIN),15.53,15.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080718,0250,,,,,,NF-TERAZOSIN HCL CAP 2MG,6.90,6.90,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080719,0250,,,,,,NF-PRADAXA ORAL CAPSULE 75MG,18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080720,0250,,,,,,NF-ICAPS ORIGINAL ORAL TABLET,0.66,0.66,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080721,0250,,,,,,TROPICAMIDE 1% OPHTH SOLN 2ML,43.00,43.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080722,0250,,,,,,NF-VOTRIENT TAB 200MG,278.74,278.74,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080723,0250,,,,,,NF-PRILOSEC CAP DR 40MG,40.04,40.04,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080724,0250,,,,,,NF-FERREX 150 FORTE CAP 25MCG-1MG-150MG,1.18,1.18,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080725,0250,,,,,,NF-MELOXICAM ORAL TABLET 15MG,19.38,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080726,0250,,,,,,NF-PROCARDIA XL TABLET 60MG,13.92,13.92,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080727,0250,,,,,,NF-EFFIENT ORAL TABLET 10MG,42.80,42.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080728,0250,,,,,,NF-FEOSOL ORAL TABLET 45MG,0.98,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080729,0250,,,,,,NF-MEPROBAMATE ORAL TABLET 200MG,6.02,6.02,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080730,0250,,,,,,NF-AMITRIPTYLINE HCL ORAL TABLET 100MG,5.67,5.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080731,0250,,,,,,NF-PRAZOSIN HCL CAP 1MG,2.06,2.06,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080732,0250,,,,,,NF-LISINOPRIL ORAL TABLET 10MG,3.16,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080733,0250,,,,,,NF-LISINOPRIL ORAL TABLET 40MG,6.16,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080734,0250,,,,,,NF-XARELTO TAB 20MG,39.84,39.84,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080735,0250,,,,,,NF-NIFEDIPINE EXTENDED RELEASE TABLET 90,13.02,13.02,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080736,0250,,,,,,NF-CALCIUM CITRATE + D TABLET,0.34,0.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080737,0250,,,,,,NF-ENALAPRIL MALEATE ORAL TABLET 2.5MG,3.15,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080738,0250,,,,,,NF-OYSCO D TABLET 250MG-125IU,0.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080739,0250,,,,,,NF-OXAPROZIN ORAL TABLET 600MG,6.60,6.60,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080740,0250,,,,,,NF-PANTOPRAZOLE SODIUM ORAL TAB EC 40MG,42.25,42.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080741,0250,,,,,,NF-FELODIPINE TAB ER 10MG,13.64,13.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080742,0250,,,,,,NF-OMEGA-3 CAPSULE,0.28,0.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080743,0250,,,,,,NF-ACYCLOVIR CAP 200MG,5.79,5.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080744,0636,J0133,,,,,ACYCLOVIR 1000MG/20ML INJ,144.48,144.48,,,,,,,,,,,,,
47080746,0258,,,,,,CLINIMIX 5/20 1000 ML,202.10,202.10,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47080749,0636,C9290,,,,,BUPIVICAINE LIPOSOM 1.3% 20ML  (EXPAREL),1854.50,1854.50,,,,,,,,,,,,,
47080750,0258,,,,,,CLINIMIX 5/20 2000 ML,367.50,367.50,8.06,22.30,22.30,22.30,18.17,,,,8.06,,,9.00,9.00
47080751,0250,,,,,,NF-ATENOLOL       TAB  100MG,4.87,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080752,0250,,,,,,NF-ZYRTEC ORAL TABLET 10MG,11.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080753,0250,,,,,,TPN-NO FAT,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080754,0250,,,,,,NF-ABILIFY TAB 10MG,98.80,98.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080755,0250,,,,,,NF-VIMOVO TAB DR 20MG-500MG,8.58,8.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080756,0250,,,,,,NF-VERAPAMIL HCL CAP ER 120MG,6.23,6.23,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080757,0250,,,,,,NF-RIFAXIMIN TAB 550MG,106.21,106.21,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080758,0250,,,,,,NF-ACETAMINOPHEN CAP 650MG,0.98,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080759,0250,,,,,,NF-LOSARTAN POTASSIUM ORAL TABLET 25MG,1.19,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080760,0250,,,,,,NF-XARELTO ORAL TABLET 20MG,39.84,39.84,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080761,0250,,,,,,DONEPEZIL 5MG TAB (ARICEPT),33.49,33.49,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080762,0250,,,,,,NF-AVALIDE ORAL TABLET 150MG-12.5MG,17.75,17.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080763,0250,,,,,,NF-ACTONEL TAB 35MG,181.83,181.83,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080764,0250,,,,,,NF-RIFAXIMIN TAB 550MG,113.65,113.65,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080765,0250,,,,,,NF-SPIRONOLACTONE ORAL TABLET 100MG,6.04,6.04,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080766,0250,,,,,,NF-METOCLOPRAMIDE HCL ORAL TABLET 5MG,2.29,2.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080767,0250,,,,,,DOCETAXEL 20MG/2ML INJ,857.26,857.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080768,0250,,,,,,NF-JANUVIA ORAL TABLET 100MG,42.30,42.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080769,0637,,,,,,SODIUM CITRATE & CITRIC ACID 15 ML SOLN,6.13,6.13,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080770,0637,,,,,,SULFASALAZINE 500 MG  TAB (AZULFADINE),6.13,6.13,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080771,0250,,,,,,NF-STALEVO 200 TAB 50MG-200MG-200MG,21.62,21.62,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080772,0250,,,,,,NF-OMEPRAZOLE CAP DR 40MG,2.98,2.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080773,0250,,,,,,NF-NASONEX SPRAY 0.05MG/INH,645.00,645.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080774,0250,,,,,,NF-LOSARTAN-HCTZ ORAL TABLET 100MG-25MG,14.65,14.65,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080775,0250,,,,,,NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,12.33,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080776,0250,,,,,,NF-RAPAFLO CAP 8MG,24.25,24.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080777,0250,,GY,,,,LIDOCAINE 2% TOPICAL 5 ML SYRINGE,29.67,29.67,,,,,,,,,,,,,
47080778,0637,,,,,,SILODOSIN 8MG CAP (RAPAFLO),24.25,24.25,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080779,0250,,,,,,NF-LUMIGAN OPHTH SOLN 0.01%,202.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080780,0250,,,,,,NF-PRAVACHOL ORAL TABLET 20MG,19.79,19.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080781,0250,,,,,,NF-LISINOPRIL AND HCTZ TABLET 20MG-25MG,5.22,5.22,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080782,0250,,,,,,NF-CARBAMAZEPINE CAP ER 200MG,1.73,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080783,0250,,,,,,NF-CARBAMAZEPINE CAP ER 200MG,18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080784,0250,,,,,,NF-CARBAMAZEPINE ORAL TAB ER 400MG,12.03,12.03,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080785,0250,,,,,,NF-DIOVAN TAB 320MG,26.21,26.21,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080786,0250,,,,,,NF-HYDRALAZINE HCL ORAL TABLET 100MG,4.35,4.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080787,0250,,,,,,NF-AMLODIPINE BESYLATE ORAL TABLET 10MG,10.83,10.83,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080788,0250,,,,,,NF-PLAVIX TAB 75MG,33.26,33.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080789,0250,,,,,,NF-ATENOLOL ORAL TABLET 100MG,11.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080790,0250,,,,,,NF-METFORMIN HCL ORAL TABLET 1000MG,20.64,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080791,0250,,,,,,NF-RANITIDINE HCL CAPSULE 300MG,11.79,11.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080792,0250,,,,,,NF-FLUDROCORTISONE ACETATE ORAL TAB 0.1M,7.46,7.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080793,0250,,,,,,NF-DYAZIDE CAPSULE,3.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080794,0250,,,,,,NF-POTASSIUM CHLORIDE CAP ER 10MEQ,8.74,8.74,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080795,0250,,,,,,NF-PREDNISONE ORAL TABLET 10MG,1.53,1.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080796,0250,,,,,,NF-GLYBURIDE        TAB  5MG,3.17,3.17,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080797,0250,,,,,,NF-HYDRALAZINE HCL ORAL TABLET 50MG,2.05,2.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080798,0250,,,,,,NF-PAROXETINE HCL ORAL TABLET 10MG,10.89,10.89,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080799,0250,,,,,,NF-OMEPRAZOLE CAP DR 20MG,22.88,22.88,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080800,0250,,,,,,NF-LOSARTAN K AND HCTZ TABLET 100MG-25MG,14.65,14.65,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080801,0250,,,,,,NF-AMLODIPINE & BENAZEPRIL HCL 5MG-10MG,11.64,11.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080802,0250,,,,,,NF-AMLODIPINE BESYLATE ORAL TABLET 5MG,7.44,7.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080803,0250,,,,,,NF-LEVOTHYROXINE ORAL TABLET 0.1MG,1.81,1.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080804,0250,,,,,,NF-GABAPENTIN ORAL TABLET 600MG,10.86,10.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080805,0250,,,,,,NF-TRAMADOL HCL TAB 50MG,7.16,7.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080806,0250,,,,,,NF-SPIRIVA INH/NEB CAP 18MCG,38.37,38.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080807,0250,,,,,,NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG,119.15,119.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080808,0250,,,,,,NF-ACETAMINOPHEN ORAL TABLET 325MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080809,0250,,,,,,NF-REMERON TAB 30MG,22.32,22.32,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080810,0250,,,,,,NF-CARBAMAZEPINE CAP ER 300MG,18.81,18.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080811,0637,,,,,,BAG BALM OINTMENT,35.09,35.09,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080812,0250,,,,,,NF-QUETIAPINE FUMARATE ORAL TABLET 100MG,3.26,3.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080813,0250,,,,,,NF-QUETIAPINE FUMARATE ORAL TABLET 50MG,28.24,28.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080814,0250,,,,,,NF-SERTRALINE HCL TAB 50MG,12.12,12.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080815,0250,,,,,,NF-METHADONE HCL TAB 5MG,1.05,1.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080816,0250,,,,,,NF-GABAPENTIN CAP 400MG,9.20,9.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080817,0250,,,,,,NF-ASACOL HD TAB DR 800MG,18.74,18.74,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080818,0250,,,,,,NF-PREDNISOLONE ACETATE INJ SUSP 25MG/1M,1.55,1.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080819,0250,,,,,,NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,9.76,9.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080820,0250,,,,,,NF-JANUVIA ORAL TABLET 100MG,42.30,42.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080821,0250,,,,,,NF-IMDUR TAB ER 30MG,8.85,8.85,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080822,0250,,,,,,NF-GLIMEPIRIDE ORAL TABLET 1MG,1.73,1.73,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080823,0250,,,,,,NF-LISINOPRIL AND HCTZ TABLET 10MG-12.5M,4.77,4.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080824,0250,,,,,,NF-LOSARTAN POTASSIUM ORAL TABLET 100MG,13.25,13.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080825,0250,,,,,,NF-PINDOLOL TABLET 10MG,6.07,6.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080826,0250,,,,,,NF-TRILIPIX CAP DR 135MG,28.67,28.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080827,0250,,,,,,NF-BUDESONIDE CAP DR 3MG,65.85,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080828,0250,,,,,,NF-WELCHOL ORAL TABLET 625MG,8.46,8.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080829,0250,,,,,,NF-COMBIGAN OPHTH SOLN 0.2%-0.5%,96.77,96.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080830,0250,,,,,,NF-LUMIGAN OPHTH SOLN 0.01%,216.10,216.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080831,0250,,,,,,NF-HYDROCODONE & HOMATROPINE SYR 5-1.5/5,1.70,1.70,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080832,0250,,,,,,NF-POLY VITAMIN LIQUID,0.56,0.56,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080833,0250,,,,,,NF-POLYETHYLENE GLYCOL 300 SOLUTION,2.15,2.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080834,0250,,,,,,NF-PRADAXA CAP 75MG,21.53,21.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080835,0250,,,,,,NF-ETODOLAC ORAL TABLET 400MG,7.31,7.31,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080836,0250,,,,,,NF-NITRO-DUR TD PATCH ER 0.1MG/1HR,17.36,17.36,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080837,0250,,,,,,NF-TEGRETOL-XR ORAL TAB ER 400MG,13.75,13.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080838,0250,,,,,,NF-BUPROPION HCL SR ORAL TABLET ER 200MG,16.48,16.48,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080839,0250,,,,,,NF-NORCO TAB 325MG-7.5MG,11.91,11.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080840,0250,,,,,,NF-METOLAZONE ORAL TABLET 5MG,7.00,7.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080841,0250,,,,,,NF-ATORVASTATIN CALCIUM ORAL TAB 20MG,22.28,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080842,0250,,,,,,NF-12 HOUR DECONGESTANT ORAL TAB ER 120M,1.90,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080843,0250,,,,,,NF-BISMUTH METALLICUM TABLET,0.53,0.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080844,0250,,,,,,CALCIUM GLUCONATE 500MG TAB,6.13,6.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080845,0250,,,,,,NF-LEVOTHYROXINE SODIUM ORAL TABLET 175M,4.05,4.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080846,0250,,,,,,NF-PRAVACHOL ORAL TABLET 40MG,28.93,28.93,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080847,0250,,,,,,NF-ORGAN-1 NR TAB 200MG,0.86,0.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080848,0250,,,,,,NF-MELOXICAM ORAL TABLET 15MG,20.83,20.83,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080849,0250,,,,,,NF-VITAMIN D ORAL CAPSULE 5000IU,0.51,0.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080850,0250,,,,,,SUPREP BOWEL PREP KIT,369.76,369.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080851,0250,,,,,,BOWEL PREP KIT 16 OZ,369.76,369.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080852,0250,,,,,,"VITAMIN D 50,000IU CAP (ERGOCALIFEROL)",6.13,6.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080854,0250,,,,,,VITAMIN D3 5000U CAP,6.13,6.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080855,0250,,,,,,CALCIUM CITRATE 250 MG TAB,6.13,6.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080856,0250,,,,,,NF-DESMOPRESSIN ACETATE ORAL TABLET 0.2M,16.17,16.17,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080857,0250,,,,,,NF-EPLERENONE ORAL TABLET 25MG,16.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080858,0250,,,,,,"HEPLOCK 10,000units/10ML SYRINGE",17.47,17.47,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080859,0250,,,,,,DESMOPRESSIN ACETATE 0.1MG TAB,12.99,12.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080860,0250,,,,,,CEFAZOLIN ADV IVPB 1GM/100ML (ANCEF),0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080861,0250,,,,,,NF-EPLERENONE ORAL TABLET 25MG,17.64,17.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080862,0250,,,,,,NF-ZIPRASIDONE HCL CAP 40MG,50.88,50.88,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080863,0250,,,,,,NF-PROCARBAZINE HCL CAP 50MG,2.99,2.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080864,0250,,,,,,HYDROMORPHONE 1MG/ML SOLN 8 ML,576.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080865,0250,,,,,,NF-AMLODIPINE BESYLATE ORAL TABLET 2.5MG,7.44,7.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080866,0250,,,,,,NF-LABETALOL HCL ORAL TABLET 200MG,4.54,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080867,0250,,,,,,NF-LISINOPRIL ORAL TABLET 40MG,9.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080868,0250,,,,,,NAPROXEN ORAL TABLET 220MG,6.13,6.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080869,0250,,,,,,NF-METFORMIN HCL ORAL TABLET 1000MG,8.11,8.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080870,0250,,,,,,NF-FEOSOL ORAL TABLET 45MG,0.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080871,0250,,,,,,NF-JANUVIA ORAL TABLET 50MG,44.42,44.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080872,0250,,,,,,NF-ENABLEX TAB ER 7.5MG,37.29,37.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080873,0250,,,,,,FIBERCON TAB 625MG,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080874,0250,,,,,,NF-FLUVASTATIN ORAL CAPSULE 20MG,19.59,19.59,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080875,0250,,,,,,NF-FERREX 150 CAPSULE 150MG,1.18,1.18,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080876,0250,,,,,,NF-OMEPRAZOLE CAP DR 40MG,25.54,25.54,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080877,0250,,,,,,NF-FLOVENT HFA INH/NEB AER PWD 0.22MG/1A,114.65,114.65,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080878,0250,,,,,,NF-SEREVENT DISKUS DISK 0.046MG/ACT,10.50,10.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080879,0250,,,,,,NF-MIRAPEX ORAL TABLET 1.5MG,9.57,9.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080880,0250,,,,,,NF-LISINOPRIL ORAL TABLET 5MG,2.06,2.06,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080881,0250,,,,,,NF-NIFEDIPINE ORAL TAB ER 60MG,9.66,9.66,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080882,0250,,,,,,NF-PROTONIX ORAL TABLET 40MG,19.67,19.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080883,0250,,,,,,NF-CYMBALTA CAP DR 30MG,19.32,19.32,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080884,0250,,,,,,PRASUGREL 10MG TAB (EFFIENT),42.73,42.73,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080885,0250,,,,,,NF-LOVASTATIN ORAL TABLET 40MG,16.94,16.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080886,0250,,,,,,NF-TIMOLOL MALEATE OPHTH SOLN 0.25%,11.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080887,0637,,,,,,FENOFIBRATE 160MG TAB (TRICOR),30.66,30.66,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080888,0250,J7626,,,,,BUDESONIDE NEB 0.5MG/2ML(PULMICORT),66.30,66.30,,,,,,,,,,,,,
47080889,0250,,,,,,NF-PROBENECID TAB 500MG,5.42,5.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080890,0250,,,,,,NF-HYDROXYZINE HCL ORAL TABLET 10MG,2.68,2.68,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080891,0250,,,,,,NF-HYDROCODONE AND APAP TAB 7.5MG-325MG,2.66,2.66,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080892,0250,,,,,,NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,3.75,3.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080893,0250,,,,,,NF-SIMVASTATIN ORAL TABLET  20MG,0.37,0.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080894,0250,,,,,,NF-K-DUR TAB ER 20MEQ,4.62,4.62,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080895,0636,J1953,,,,,LEVETIRACETAM 1000MG IVPB PREMIX,235.32,235.32,,,,,,,,,,,,,
47080896,0250,,,,,,NF-LISINOPRIL ORAL TABLET 2.5MG,2.78,2.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080898,0636,J1953,,,,,LEVETIRACETAM 500MG/5ML  5ML INJ,166.12,0.00,,,,,,,,,,,,,
47080899,0637,,,,,,HYDROCODONE/APAP TAB 7.5/325MG(NORCO),6.45,6.45,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080900,0636,Q0138,,,,,FERUMOXYTOL  510MG/17ML INJ(FERAHEME),2643.47,2643.47,,,,,,,,,,,,,
47080901,0250,,,,,,VANCOMYCIN NS IVPB 500MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080902,0250,,,,,,NF-GLIMEPIRIDE ORAL TABLET 2MG,3.79,3.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080903,0250,,,,,,GLIMEPERIDE 2MG TAB (AMARYL),6.13,6.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080904,0250,,,,,,NF-SIMVASTATIN ORAL TABLET 20MG,21.16,21.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080905,0250,,,,,,NF-POTASSIUM CHLORIDE ORAL TAB ER 20MEQ,4.27,4.27,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080906,0637,,,,,,SITAGLIPTIN 50MG TAB (JANUVIA),48.82,48.82,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080907,0250,,,,,,NF-METOLAZONE ORAL TABLET 5MG,6.48,6.48,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080908,0250,,,,,,NF-POTASSIUM CHLORIDE ORAL TAB ER 20MEQ,12.50,12.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080909,0250,,,,,,NF-DEXTROSE INJECTION 10%,0.01,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080910,0636,J1953,,,,,LEVETIRACETAM 500MG PREMIX (KEPPRA),141.15,141.15,,,,,,,,,,,,,
47080911,0250,,,,,,LEVETIRACETAM 100MG/ML ORAL SOLN 120ML,369.76,369.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080912,0250,,,,,,NF-TEMAZEPAM CAP 15MG,1.47,1.47,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080913,0250,,,,,,NF-TEMAZEPAM CAP 7.5MG,35.28,35.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080914,0250,,,,,,Acyclovir/NS IVPB : 500MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080915,0250,,,,,,NF-MORPHINE SULFATE IR ORAL TABLET 15MG,1.63,1.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080916,0250,,,,,,Amikacin/NS IVPB: 1000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080917,0636,J0282,,,,,AMIODARONE 450MG/9ML (50MG/ML)CORDARONE,37.89,37.89,21.82,21.82,,,,,,,21.82,,,,
47080918,0250,,,,,,Amiodarone/D5W IV:  150MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080919,0250,,,,,,AMPICILLIN& SULBAC/NS IVPB: 1500MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080920,0250,,,,,,Ampicillin&Sulbact/NS IVPB: 3000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080921,0250,,,,,,Aztreonam/NS IVPB: 1000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080922,0636,J1953,,,,,LEVETIRACETAM 500MG/5ML  5ML INJ,25.21,25.21,,,,,,,,,,,,,
47080923,0250,,,,,,Bumetanide/NS IVPB: 10MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080924,0250,,,,,,Cefoxitin/NS IVPB: 1000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080925,0250,,,,,,Ceftazidime/NS IVPB: 1000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080926,0637,,,,,,ATORVASTATIN 20MG TAB (LIPITOR),23.97,23.97,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080927,0250,,,,,,Clindamycin/NS IVPB: 300MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080928,0250,,,,,,Clindamycin/NS IVPB: 600MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080929,0250,,,,,,Ibutilide/NS IVPB: 1MG/50ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080930,0250,,,,,,Phenytoin/NS IVPB: 1000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080931,0250,,,,,,Doxycyline/NS IVPB: 100MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080932,0250,,,,,,Erythromycin/NS IVPB: 500MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080933,0250,,,,,,Levetiracetam/NS IVPB: 500MG/100ML (KEPP,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080934,0250,,,,,,Furosemide/NS IVPB: 100MG/90ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080935,0250,,,,,,NF-LEVAQUIN ORAL TABLET 750MG,94.37,94.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080936,0250,,,,,,Esomeprazole/NS IVPB: 96MG/96ML (NEX DRI,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080937,0250,,,,,,NF-KETOROLAC TROMETHAMINE OPHTH SOLN 0.5,85.02,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080938,0250,,,,,,Nitropress/D5 IVPB: 50MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080939,0250,,,,,,NF-KAYEXALATE PWD FOR SUSP,5.50,5.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080940,0250,,,,,,Ranitidine/D5W IVPB: 150MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080941,0250,,,,,,Vancomycin/NS IVPB: 500MG/250ML (VANCOCI,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080942,0250,,,,,,NF-PRAZOSIN HCL CAP 2MG,3.91,3.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080943,0250,,,,,,Insulin/NS IVPB: 100UNITS/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080944,0637,,,,,,NEPHRO-VITE TAB,6.18,6.18,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080945,0250,,,,,,POTASSIUM CHLORIDE/NS IVPB: 20MEQ/100ML,26.34,26.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080946,0250,,,,,,NF-CITALOPRAM ORAL TABLET 20MG,8.20,8.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080947,0637,A9270GY,,,,,NEPHRO-VITE TAB,5.75,0.00,,,,,,,,,,,,,
47080948,0250,J7608,,,,,ACETYLCYSTEINE 20% INH RESP SOLN 4ML(MUC,68.75,68.75,,,,,,,,,,,,,
47080949,0250,,,,,,**HEART VALVE REPLACEMENT**,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080950,0250,,,,,,**MITRAL VALVE PROLAPSE**,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080951,0250,,,,,,**JOINT REPLACEMENT**,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080952,0250,,,,,,NF-LISINOPRIL AND HCTZ TABLET 12.5MG-20M,5.16,5.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080953,0637,,,,,,NITROGLYCERIN 2% OINT 1 GM PKT(NITROBID),13.49,13.49,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47080954,0250,,,,,,TICAGRELOR 90MG TAB (BRILINTA),21.77,21.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080955,0250,,,,,,**FOR CHILDREN**,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080956,0636,Q0138,,,,,FERUMOXYTOL INJ 510MG/17ML,2557.40,0.00,,,,,,,,,,,,,
47080957,0250,,,,,,NF-CILOSTAZOL ORAL TABLET 50MG,7.85,7.85,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080958,0250,,,,,,NF-ALBUTEROL ORAL TABLET 4MG,2.51,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080959,0250,,,,,,NF-RAMIPRIL CAP 10MG,12.57,12.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080960,0250,,,,,,NF-CRESTOR TAB 20MG,16.39,16.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080961,0250,,,,,,NF-ISOSORBIDE DINITRATE ORAL TABLET 10MG,4.44,4.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080962,0250,,,,,,AMIODARONE/D5W IV: 360MG/200ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080963,0250,,,,,,EPINEPHRINE/NS IVPB: 1MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080964,0250,,,,,,NOREPINPHRINE/D5W IVPB: 4MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080965,0250,,,,,,MAGNESIUM SULF/NS IVPB: 1000MG/100ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080966,0250,,,,,,Vancomycin/NS IVPB: 750MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080967,0250,,,,,,Vancomycin/NS IVPB: 1250MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080968,0250,,,,,,Vancomycin/NS IVPB: 1500MG/250ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080969,0250,,,,,,NF-GALANTAMINE HBR ORAL CAP ER 8MG,26.25,26.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080970,0250,,,,,,NF-LISINOPRIL ORAL TABLET 40MG,2.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080971,0250,,,,,,NF-METOCLOPRAMIDE HCL ORAL TABLET 10MG,2.15,2.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080972,0250,,,,,,NF-METOCLOPRAMIDE HCL ORAL TABLET 5MG,2.29,2.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080973,0250,,,,,,NF-JANUVIA ORAL TABLET 100MG,50.09,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080975,0250,,,,,,TROPICAMIDE OPHTH SOLN 1% 2ML,40.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080976,0250,,,,,,NF-TIMOLOL MALEATE OPHTH SOLN 0.25%,4.91,4.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080977,0250,,,,,,NF-ALLOPURINOL ORAL TABLET 300MG,2.90,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080978,0250,,,,,,NF-TIMOPTIC IN OCUDOSE OPHTH SOLUTION 0.,25.16,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080979,0250,,,,,,NF-ALPHAGAN P OPHTH SOLN 0.1%,93.88,93.88,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080980,0250,,,,,,NF-DORZOLAMIDE HCL OPHTH SOLN 2%,28.70,28.70,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080981,0250,,,,,,NF-HYDREA CAPSULE 500MG,5.42,5.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080982,0250,,,,,,NF-CELEXA TAB 20MG,19.99,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080984,0250,,,,,,CLARITHROMYCIN ORAL SUSP 250MG/5ML 50ML,229.24,229.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080985,0250,,,,,,NF-PROBENECID AND COLCHICINE 500MG-0.5MG,70.64,70.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080986,0250,,,,,,NF-LITHIUM CARBONATE CAP 600MG,1.68,1.68,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080988,0250,,,,,,NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,13.31,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080989,0250,,,,,,NF-JALYN ORAL CAPSULE 0.5MG-0.4MG,24.33,24.33,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080990,0250,,,,,,NF-SIMVASTATIN ORAL TABLET 10MG,2.33,2.33,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080991,0250,,,,,,APIXABAN 2.5MG TABLET,38.20,38.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080992,0250,,,,,,NF-TRIAMTERENE AND HCTZ TABLET 75MG-50MG,4.78,4.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080993,0250,,,,,,NF-ZONISAMIDE CAP 25MG,27.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080994,0250,,,,,,NF-ZONISAMIDE CAP 50MG,4.71,4.71,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080995,0250,,,,,,NF-Zonisamide Oral Capsule 50MG,3.22,3.22,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080996,0250,,,,,,NF-FEOSOL ORAL TABLET 65MG,0.29,0.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080997,0250,,,,,,NF-CALCIUM 600/VITAMIN D CAPSULE,0.24,0.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080998,0250,,,,,,NF-AFINITOR ORAL TABLET 10MG,1643.56,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47080999,0250,,,,,,NF-EXEMESTANE ORAL TABLET 25MG,80.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081000,0250,,,,,,NF-Brimonidine Tartrate Ophth Soln 0.2%,15.05,15.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081001,0250,,,,,,NF-Dorzolamide Hydrochloride and Timolol,49.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081003,0250,,,,,,NF-DORZOLAMIDE HCL-TIMOLOL 22.3MG-6.8MG/,52.72,52.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081004,0250,,,,,,NF-PLAQUENIL TAB 200MG,22.05,22.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081005,0250,,,,,,NF-ARAVA ORAL TABLET 20MG,87.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081006,0250,,,,,,NF-VITAMIN B COMPLEX ORAL TABLET,0.41,0.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081008,0250,,,,,,NF-GLUCOS-AMINE ORAL CAPSULE 500MG,0.66,0.66,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081009,0250,,,,,,NF-DOPamine HCl Injection 160MG/ML,6.45,6.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081010,0250,,,,,,NF-RISPERDAL CONSTA IM PWD FOR SUSP ER 5,3323.81,3323.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081011,0250,,,,,,NF-NAMENDA XR ORAL CAPSULE ER 21MG,51.06,51.06,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081012,0250,,,,,,NF-QUETIAPINE FUMARATE ORAL TABLET 300MG,72.94,72.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081013,0250,,,,,,NF-ENEMA RECTAL LIQUID,0.02,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081014,0250,,,,,,NF-ARMOUR THYROID ORAL TABLET 90MG,1.64,1.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081015,0250,,,,,,NF-Pravastatin Sodium Oral Tablet 20MG,13.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081016,0250,,,,,,NF-SYSTANE BALANCE OPHTH SOLN 0.6%,4.49,4.49,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081017,0250,,,,,,NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.2%,14.64,14.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081018,0250,,,,,,NF-ELOCON CREAM 0.1%,10.89,10.89,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081019,0250,,,,,,NF-VITAMIN B COMPLEX CAPSULE,0.38,0.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081020,0250,,,,,,NF- FELODIPINE TABLET ER 5MG,7.79,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081021,0250,,,,,,NF-SYNTHROID ORAL TABLET 0.075MG,2.75,2.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081022,0250,,,,,,NF-SYNTHROID ORAL TABLET 0.1MG,2.82,2.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081023,0250,,,,,,NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,0.05,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081024,0250,,,,,,NF-MEPROBAMATE TAB 200MG,0.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081025,0250,,,,,,NF-MEPROBAMATE ORAL TABLET 200MG,29.56,29.56,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081026,0250,,,,,,BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,14.79,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081027,0250,,,,,,NF-CANDESARTAN CILEXETIL ORAL TABLET 32M,19.24,19.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081028,0250,,,,,,NF-LIBRAX CAPSULE,142.91,142.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081029,0250,,,,,,NF-FENOFIBRATE ORAL TABLET 145MG,20.60,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081030,0250,,,,,,NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,191.54,191.54,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081032,0250,,,,,,NF- ALTAVERA TAB 30MCG-0.15MG-NA,4.42,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081033,0250,,,,,,NF-TIMOLOL MALEATE OPHTH GEL DROP 0.5%,141.13,141.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081034,0250,,,,,,NF-Omeprazole Delayed-Release Capsule 40,36.55,36.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081035,0250,,,,,,NF-BUDESONIDE CAP DR 3MG,81.03,81.03,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081036,0250,,,,,,NF-15% AMINO ACIDS INTRAVENOUS SOLUTION,0.11,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081037,0250,,,,,,NF-METHIMAZOLE ORAL TABLET 5MG,7.29,7.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081038,0250,,,,,,NF-CHLORDIAZ/CLIDINIUM ORAL CAP 5MG-2.5M,4.07,4.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081039,0250,,,,,,NF-DUREZOL OPHTH EMUL 0.05%,110.63,110.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081040,0250,,,,,,LITHIUM CARBONATE CAP 300MG,6.13,6.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081041,0250,,,,,,NF-VASERETIC ORAL TABLET 10MG-25MG,58.01,58.01,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081042,0250,,,,,,NF-METHYLPHENIDATE ER ORAL TAB ER 20MG,7.43,7.43,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081043,0250,,,,,,NF-SIMBRINZA OPHTH SUSP 0.2%-1%,71.53,71.53,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081044,0250,,,,,,NF-SYSTANE OPHTH SOLUTION,2.52,2.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081045,0250,,,,,,NF-Eylea Intraocular Soln 40MG/1ML,177600.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081046,0250,,,,,,NF-Brimonidine Tartrate Ophth Soln 0.15%,90.30,90.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081047,0250,,,,,,NF-Pravastatin Sodium Oral Tablet 20MG,3.22,3.22,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081048,0250,,,,,,NF-BETIMOL OPHTH SOLN 0.25%,15.14,15.14,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081049,0250,,,,,,NF-FLAXSEED OIL CAPSULE 1000MG,0.28,0.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081050,0250,,,,,,NF-NITRO-DUR TRANSDERM PATCH ER 0.6MG/1H,25.45,25.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081051,0250,,,,,,NF-MIRTAZAPINE ORAL TABLET 30MG,5.54,5.54,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081052,0250,,,,,,NF-CENTRUM SILVER ORAL TABLET,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081053,0250,,,,,,NF-GEODON CAP 40MG,28.20,28.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081054,0250,,,,,,NF-ATIVAN TAB 0.5MG,5.94,5.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081055,0250,,,,,,NF-DILAUDID ORAL TABLET 4MG,3.09,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081056,0250,,,,,,NF-DILAUDID ORAL TABLET 4MG,9.35,9.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081057,0250,,,,,,NF-BALSALAZIDE DISODIUM CAP 750MG,11.34,11.34,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081058,0250,,,,,,NF-ALPHAGAN P OPHTH SOLN 0.15%,80.65,80.65,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081059,0250,,,,,,NF-CURASOL HYDROGEL SATURATED,20.68,20.68,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081060,0250,,,,,,NF-SIMVASTATIN ORAL TABLET 40MG,18.94,18.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081061,0250,,,,,,NF-RAMIPRIL  ORAL CAPSULE 2.5MG,20.32,20.32,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081062,0250,,,,,,NF-CELEXA TAB 20MG,27.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081063,0250,,,,,,NF-CELEXA TAB 20MG,13.39,13.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081064,0250,,,,,,NF-DEXILANT CAP DR 60MG,34.75,34.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081065,0636,J0878,,,,,DAPTOMYCIN 500MG IV,2298.74,2298.74,,,,,,,,,,,,,
47081066,0250,,,,,,NF-TESTOSTERONE GEL 50MG/5GM,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081067,0250,,,,,,NF-ANDROGEL GEL 1%,55.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081068,0250,,,,,,NF-ROBAXIN-750 ORAL TABLET 750MG,48.07,48.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081069,0250,,,,,,NF-RENVELA ORAL TABLET 800MG,24.10,24.10,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081070,0250,,,,,,NF-MYCOPHENOLATE MOFETIL ORAL TABLET 500,34.12,34.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081071,0250,,,,,,NF-MYCOPHENOLATE MOFETIL CAP 250MG,36.86,36.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081072,0250,,,,,,NF-PROGRAF CAP 1MG,22.48,22.48,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081073,0636,J1439,,,,,INJECTAFER IV SOLN 750MG/15ML,4766.16,4766.16,,,,,,,,,,,,,
47081074,0250,,,,,,NF-ENALAPRIL MALEATE ORAL TABLET 10MG,0.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081075,0250,,,,,,NF-ENALAPRIL-HYDROCHLOROTHIAZIDE TAB 10M,8.05,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081076,0250,,,,,,NF-ARICEPT TAB 23MG,70.80,70.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081077,0250,,,,,,NF-CRESTOR TAB 5MG,23.09,23.09,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081079,0250,,,,,,NF-METHIMAZOLE ORAL TABLET 5MG,1.91,1.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081080,0250,,,,,,NF-OCTREOTIDE ACETATE INJ SOLN 500MCG/1M,180.60,180.60,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081081,0250,,,,,,NF-1ST TIER UNIFINE PENTIPS NEEDLE DEVIC,0.89,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081082,0250,,,,,,NF-PREVACID CAP DR 30MG,93.39,93.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081083,0250,,,,,,NF-TROSPIUM CHLORIDE ORAL TABLET 20MG,12.20,12.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081084,0250,,,,,,NF-METHYLCELLULOSE 1500 CPS POWDER,5.48,5.48,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081085,0250,,,,,,NF-CO Q-10 LIQUID CAPSULE 100MG,1.98,1.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081086,0250,,,,,,"NF-LUTEIN ORAL CAPSULE, LIQUID FILLED 20",0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081087,0250,,,,,,NF-A & D TABLET,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081088,0250,,,,,,NF-VITAMIN B-12 SUBLINGUAL TABLET 1000MC,0.55,0.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081089,0250,,,,,,NF-CLONIDINE HCL  TAB  0.3MG,2.03,2.03,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081090,0250,,,,,,NF-METOPROLOL TARTRATE ORAL TABLET 100MG,3.92,3.92,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081091,0250,,,,,,NF-PHOSPHA 250 NEUTRAL ORAL TABLET,2.18,2.18,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081092,0250,,,,,,NF-NEXAVAR ORAL TABLET 200MG,213.59,213.59,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081093,0250,,,,,,NF-XIFAXAN ORAL TABLET 550MG,144.59,144.59,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081094,0250,,,,,,NF-OXYCODONE HCL ORAL TABLET 20MG,4.74,4.74,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081095,0250,,,,,,NF-B-100 COMPLEX TABLET,0.41,0.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081096,0250,,,,,,NF-CYTOMEL ORAL TABLET 5MCG,4.68,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081097,0250,,,,,,NF-SYNTHROID ORAL TABLET 75MCG,4.96,4.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081098,0250,,,,,,NF-ALPRAZOLAM    TAB  0.25MG,2.99,2.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081099,0250,,,,,,NF-RAMIPRIL CAP 10MG,11.67,11.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081100,0250,,,,,,NF-ALLEGRA ALLERGY ORAL TABLET 180MG,2.69,2.69,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081101,0250,,,,,,NF-BENAZEPRIL HCL ORAL TABLET 20MG,4.51,4.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081102,0250,,,,,,ESZOPICLONE 1MG TAB,19.11,19.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081103,0250,,,,,,NF-VENLAFAXINE HCL CAP ER 150MG,26.75,26.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081104,0250,,,,,,NF-ALPRAZOLAM    TAB  0.25MG,2.99,2.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081105,0250,,,,,,NF-AMITIZA ORAL LIQUID FILLED CAPSULE 8M,27.05,27.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081106,0250,,,,,,NF-CARDIZEM LA TAB EXTENDED RELEASE 360M,19.09,19.09,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081107,0636,,,,,,IV  TEMPLATE,614.90,614.90,15.98,15.98,15.98,15.98,,,,,,,,,
47081108,0250,,,,,,SODIUM TETRADECYL 1% INJ 2ML,201.58,201.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081109,0250,,,,,,SODIUM PHOSPHATE 45MMOL/5ML INJ,100.28,100.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081110,0636,,,,,,TIGECYCLINE 50MG/10ML INJ,614.90,614.90,15.98,15.98,15.98,15.98,,,,,,,,,
47081111,0250,,,,,,NF-HYDROCHLOROTHIAZIDE ORAL TABLET 50MG,0.97,0.97,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081112,0250,,,,,,"NF-FISH OIL LIQ CAP 1,000MG",0.28,0.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081113,0250,,,,,,NF-AUBAGIO TAB 14MG,935.84,935.84,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081114,0250,,,,,,NF-BENAZEPRIL HCL ORAL TABLET 40MG,4.69,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081115,0250,,,,,,NF-SIMVASTATIN ORAL TABLET 80MG,21.16,21.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081116,0250,,,,,,NF-BENAZEPRIL HCL ORAL TABLET 40MG,5.19,5.19,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081117,0250,,,,,,NF-PRESERVISION ORAL LIQUID CAPSULE,1.14,1.14,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081118,0250,,,,,,NF-LINZESS CAP 290MCG,47.67,47.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081119,0250,,,,,,NF-OXYCODONE HCL CAP 5MG,7.91,7.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081120,0250,,,,,,NF-OXYCODONE HCL ORAL TABLET 30MG,8.31,8.31,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081121,0250,,,,,,NF-BONIVA ORAL TABLET 150MG,860.87,860.87,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081122,0250,,,,,,NF-NITROGLYCERIN SL SPRAY 0.4MG/1SPRAY,289.70,289.70,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081123,0250,,,,,,NF-MORPHINE SULFATE CAP ER 30MG,24.98,24.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081124,0250,,,,,,NF-TARCEVA TAB 150MG,1153.95,1153.95,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081125,0250,,,,,,NF-COLESTIPOL HCL TAB 1GM,6.92,6.92,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081126,0250,,,,,,ZADITOR OPHTH SOLN 0.025%,52.42,52.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081127,0250,,,,,,NF-ZADITOR OPHTH SOLN 0.025%,10.06,10.06,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081128,0250,,,,,,NF-MICRO-K CAP ER 10MEQ,3.65,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081129,0250,,,,,,NF-MICRO-K CAPSULE 10MEQ,3.65,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081130,0250,,,,,,NF-PATADAY OPHTH SOLN 0.2%,326.52,326.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081131,0250,,,,,,NF-UCERIS ORAL EXTENDED RELEASE TABLET 9,252.38,252.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081132,0250,,,,,,NF-GLUCOSAMINE & CHONDR TAB 500MG-400MG,5.30,5.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081133,0250,,,,,,NF-MULTAQ ORAL TABLET 400MG,40.42,40.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081134,0250,,,,,,NF-VIACTIV CHEWABLE TABLET,0.66,0.66,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081135,0250,,,,,,NF-ALLEGRA ALLERGY ORAL TABLET 180MG,2.35,2.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081136,0250,,,,,,NF-UCERIS ORAL EXTENDED RELEASE TABLET 9,252.38,252.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081137,0250,,,,,,NF-ERYTHROCIN STEARATE FILMTAB TAB 250MG,1.82,1.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081138,0250,,,,,,NF-SPIRONOLACTONE ORAL TAB 50MG,3.50,3.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081139,0250,,,,,,NF-SIMVASTATIN ORAL TABLET  20MG,21.16,21.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081140,0250,,,,,,NF-FENOFIBRATE MICRO ORAL CAPSULE 134MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081141,0250,,,,,,NF-FENOFIBRATE ORAL TABLET 54MG,8.89,8.89,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081142,0250,,,,,,NF-ALBUTEROL INH/NEB SOLUTION 0.042%,6.57,6.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081143,0250,,,,,,"NF-PNEUMOCOCCAL 13-VALENT VACCINE, DIPHT",1616.37,1616.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081144,0250,,,,,,NF-NEXIUM CAP DR 40MG,51.16,51.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081145,0636,90670,,,,,PNEUMOCCAL VACCINE 13,845.53,845.53,,,,,,,,,,,,,
47081146,0250,J2150,,,,,MANNITOL 20% 500 ML,93.61,93.61,,,,,,,,,,,,,
47081147,0250,,,,,,NF-TORADOL TABLET 10MG,8.05,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081148,0636,90586,,,,,BCG INJ,749.00,749.00,,,,,,,,,,,,,
47081149,0250,,,,,,NF-PIOGLITAZONE ORAL TABLET 15MG,30.12,30.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081150,0250,,,,,,NF-VENLAFAXINE HYDROCHLORIDE CAP ER 150M,2.21,2.21,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081151,0250,,,,,,NF-ABILIFY TAB 30MG,216.96,216.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081152,0250,,,,,,NF-ATORVASTATIN CALCIUM ORAL TAB 80MG,46.35,46.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081153,0250,,,,,,NF-QUETIAPINE FUMARATE ORAL TABLET 50MG,28.24,28.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081154,0250,,,,,,NF-WELLBUTRIN XL 24 HR TAB ER 150MG,31.86,31.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081155,0250,,,,,,NF-CYMBALTA CAP DR 60MG,42.02,42.02,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081156,0250,,,,,,CARB/LEVO ER TAB 50MG-200MG,7.77,7.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081157,0250,,,,,,NF-CARB/LEVO TAB ER 50-200M,8.17,8.17,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081158,0250,,,,,,NF-SYSTANE ULTRA OPHTHALMIC SOLN 0.4%-0.,58.05,58.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081159,0250,,,,,,NF-MOBIC ORAL TABLET 15MG,17.59,17.59,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081160,0250,,,,,,NF-TESTOSTERONE CYPIONATE IM OIL 200MG/1,274.47,274.47,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081161,0250,,,,,,NF-CANDESARTAN CILEXETIL & HCTZ 16-12.5,16.36,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081162,0250,,,,,,NF-CANDESARTAN CILEXETIL TAB 16MG,16.69,16.69,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081163,0250,,,,,,NF-FLECAINIDE ACETATE TABLET 50MG,8.69,8.69,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081164,0250,,,,,,NF-ATACAND ORAL TABLET 8MG,5.16,5.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081165,0250,,,,,,NF-GILOTRIF ORAL TABLET 40MG,1113.44,1113.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081166,0250,,,,,,NF-GENTEAL OPHTHALMIC SOLUTION 0.2%,2.31,2.31,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081167,0250,,,,,,NF-ATENOLOL ORAL TABLET 100MG,11.93,11.93,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081168,0250,,,,,,NF-ATENOLOL ORAL TABLET 25MG,3.52,3.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081169,0250,,,,,,NF-VALSARTAN ORAL TABLET 320MG,27.19,27.19,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081170,0250,,,,,,NF-NITRO-DUR TRANSDERM PATCH ER 0.3MG/1H,25.55,25.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081171,0250,,,,,,TESTOSTERONE 200MG/ML INJ,123.11,123.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081172,0250,,,,,,NF-BIOTIN ORAL TABLET 1000MCG,0.19,0.19,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081173,0250,,,,,,NF-AMOXICILLIN TABLET 875MG,3.75,3.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081174,0250,,,,,,NF-NAMENDA XR CAP ER 28MG,55.41,55.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081175,0250,,,,,,NF-NUEDEXTA CAP 20MG-10MG,58.31,58.31,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081176,0250,,,,,,NF-MIACALCIN NASAL SPRAY 200IU/ACT,124.11,124.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081177,0250,,,,,,NF-ESTRACE VAGINAL CREAM 0.1MG/1GM,29.14,29.14,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081178,0250,,,,,,NF-HUMULIN N PEN INJECTION 100U/ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081179,0250,,,,,,NF-HUMULIN N INJECTION 100U/ML,62.23,62.23,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081180,0250,,,,,,NF-RisperDAL Tablet 0.5MG,39.77,39.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081181,0250,,,,,,NF-hydrALAZINE HCl Oral Tablet 25,2.15,2.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081182,0250,,,,,,NF-Zofran Tablet 8MG,190.28,190.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081183,0250,,,,,,NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,16.50,16.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081187,0250,,,,,,SUGAMMADEX 200MG/2ML INJ (BRIDION),540.35,540.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081188,0250,,,,,,NF-SENSIPAR ORAL TABLET 60MG,220.22,220.22,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081189,0250,,,,,,NF-CoQ10 In Oil Liquid Capsule 100MG-30I,1.07,1.07,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081190,0250,,,,,,NF-HYDROMORPHONE HCL ORAL TABLET 2MG,1.76,1.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081191,0250,,,,,,NF-TEARS NATURALE II OPHTH SOLUTION,2.98,2.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081192,0250,,,,,,NF-OMEPRAZOLE CAP DR 10MG,15.91,15.91,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081193,0250,,,,,,NF- KETOROLAC TROMETHAMINE 30MG/1ML,3.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081194,0250,,,,,,NF-FUROSEMIDE INJ SOLN 10MG/1ML,5.77,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081195,0250,,,,,,NF-OSTEO BI-FLEX ORAL TABLET 200MG-250MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081196,0250,,,,,,NF-RIVASTIGMINE TARTRATE CAP 6MG,29.57,29.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081197,0250,,,,,,NF-DILAUDID ORAL TABLET 4MG,6.98,6.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081198,0250,,,,,,HUMALOG MIX 75/25 INJECTION,126.73,126.73,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081199,0250,,,,,,NF-HUMALOG MIX 75/25 SUBQ SUSP 75U-25U/1,65.30,65.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081200,0250,,,,,,SULFAMETH/TMP SUSP 800/160/20ML,21.24,21.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081201,0250,,,,,,TRANEXAMIC ACID 1000MG/10ML  INJ,268.75,268.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081202,0250,,,,,,NF-SIMVASTATIN ORAL TABLET 10MG,12.06,12.06,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081203,0250,,,,,,NF-DICLOFENAC SODIUM ORAL TAB EC 50MG,5.44,5.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081204,0250,,,,,,NF-DICLOFENAC SODIUM ORAL TAB ER 100MG,32.58,32.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081205,0250,,,,,,NF-HUMALOG MIX 75/25 INJECTION,119.09,119.09,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081206,0250,,,,,,NF-SANCTURA XR CAP ER 60MG,26.58,26.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081207,0250,,,,,,NF-ATIVAN INJ SOLN 2MG/1ML,7.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081208,0250,,,,,,NF-LEVSIN SL TAB 0.125MG,4.15,4.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081209,0250,,,,,,NF-Calcitonin-Salmon Nasal Spray 200IU/1,128.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081210,0250,,,,,,NF-Calcitonin-Salmon Nasal Spray 200IU/1,128.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081211,0250,,,,,,NF-LEVSIN SL TAB 0.125MG,4.15,4.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081212,0250,,,,,,NF-DIOVAN HCT ORAL TABLET 160MG-12.5MG,29.32,29.32,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081213,0250,,,,,,NF-DIOVAN HCT ORAL TABLET 320MG-25MG,51.45,51.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081214,0250,,,,,,NF-CARVEDILOL ORAL TABLET 25MG,8.38,8.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081215,0250,,,,,,NF-ENALAPRIL MALEATE ORAL TABLET 20MG,10.83,10.83,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081216,0250,,,,,,NF-NICOTINE TD PATCH ER 14MG/24HR,9.17,9.17,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081217,0250,,,,,,NF-FEXOFENADINE HCL ORAL TABLET 180MG,1.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081218,0250,,,,,,NF-LEVOTHYROXINE SODIUM ORAL TABLET 137M,7.26,7.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081219,0250,,,,,,NF-AMBIEN CR EXTENDED-RELEASE TABLET 6.2,35.20,35.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081220,0250,,,,,,NF-ALTAVERA ORAL TABLET 0.15MG-30MCG,4.75,4.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081221,0250,,,,,,NF-LEVOBUNOLOL HCL OPHTH SOLN 0.5%,13.80,13.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081222,0250,,,,,,NF-BYSTOLIC TAB 20MG,17.57,17.57,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081223,0250,,,,,,NF-BYSTOLIC ORAL TABLET 5MG,17.30,17.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081224,0250,,,,,,NF-ZIAC ORAL TABLET 2.5MG-6.25MG,5.83,5.83,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081225,0250,,,,,,NF-LATANOPROST OPHTH SOLN 0.005%,197.63,197.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081226,0250,,,,,,NF-LATANOPROST OPHTH SOLN 0.005%,197.63,197.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081227,0250,,,,,,NF-Rocaltrol Liquid Filled Capsule 0.5MC,10.75,10.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081228,0250,,,,,,NF-Metadate CD Capsule ER 20MG,10.75,10.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081229,0637,,,,,,NOZIN NASAL SANITIZER AMP,8.78,8.78,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47081230,0637,,,,,,NOZIN NASAL SANITIZER 12ML,85.46,85.46,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47081231,0250,,,,,,NF-HYDROXYZINE HCL ORAL TAB 10MG,3.46,3.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081232,0250,,,,,,NF-HYDROXYZINE HCL ORAL TABLET 10MG,3.84,3.84,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081233,0250,,,,,,NF-LOTREL CAP 5MG-20MG,23.54,23.54,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081234,0250,,,,,,NF-CRESTOR ORAL TABLET 40MG,23.85,23.85,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081235,0250,,,,,,NF-Citalopram Oral Tablet 20MG,10.75,10.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081236,0250,,,,,,NF-LITHIUM CARBONATE ORAL TAB ER 450MG,1.99,1.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081237,0250,,,,,,NF-CELEXA TAB 10MG,34.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081238,0250,,,,,,NF-DALIRESP ORAL TABLET 500MCG,50.76,50.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081239,0250,,,,,,NF-CITRUCEL FIBER ORAL PWD FOR SUSP 2GM,0.16,0.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081240,0250,,,,,,NF-MORPHINE SULFATE TABLET 30MG,2.98,2.98,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081241,0250,,,,,,NF-DICLOFENAC SODIUM OPHTH SOLN 0.1%,15.05,15.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081242,0250,,,,,,PANTOPRAZOLE 40MG INJ (PROTONIX),36.55,36.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081243,0250,,,,,,NF-JAKAFI ORAL TABLET 15MG,910.40,910.40,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081244,0250,,,,,,NF-WELLBUTRIN TAB 100MG,16.78,16.78,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081247,0250,,,,,,NF-Tekturna Oral Tablet 150MG,15.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081248,0250,,,,,,NF-Tekturna Oral Tablet 300MG,32.25,32.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081249,0250,,,,,,NF-Gabapentin Oral Capsule 100MG,3.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081250,0250,,,,,,NF-Gabapentin Oral Capsule 100MG,2.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081251,0250,,,,,,NF-Meclizine HCl Oral Tablet 25MG,3.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081252,0250,,,,,,NF-Amitriptyline HCl Oral Tablet 25MG,2.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081253,0250,,,,,,NF-Allopurinol Oral Tablet 100MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081254,0250,,,,,,NF-ALPRAZolam Oral Tablet 0.25MG,2.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081255,0250,,,,,,NF-HYDROcodone-Acetaminophen 5-325MG,3.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081256,0250,,,,,,NF-TRAVATAN Z OPHTH SOLN 0.004%,309.40,309.40,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081257,0250,,,,,,NF-FIBERCON TAB 625MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081258,0250,,,,,,NF-LITHIUM CARBONATE CAP 150MG,0.56,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081259,0250,,,,,,NF-ARMOUR THYROID TABLET 60MG,3.14,3.14,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081260,0250,,,,,,NF-EYE VITAMINS AND MINERALS ORAL TABLET,0.20,0.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081261,0250,,,,,,NF-Calcium 600MG+D Oral Tablet 600MG-200,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081262,0250,,,,,,NF-PINDOLOL ORAL TABLET 10MG,6.44,6.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081263,0250,,,,,,NF-FLORASTOR ORAL CAPSULE 250MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081264,0250,,,,,,NF-OXYCODONE HCL-ACETAMINOPHEN ORAL TABL,15.26,15.26,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081265,0250,,,,,,NF-Sanctura XR Oral Cap ER 60MG,24.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081266,0250,,,,,,NF-LAMICTAL XR EXTENDED RELEASE TAB 200M,112.28,112.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081267,0250,,,,,,NF-CHROMIUM ORAL TABLET 200MCG,0.12,0.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081268,0250,,,,,,NF-FLAXSEED OIL CAPSULE 1300MG,0.40,0.40,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081269,0250,,,,,,NF-FEMARA TAB 2.5MG,120.75,120.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081270,0250,,,,,,NF-ABILIFY ORAL TABLET 2MG,153.41,153.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081271,0250,,,,,,NF-BENICAR ORAL TABLET 40MG,41.74,41.74,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081273,0636,,,,,,CEFUROXIME INJ PWD FOR SOLN 750MG,24.00,0.00,15.98,15.98,15.98,15.98,,,,,,,,,
47081274,0250,,,,,,NF-FLORAJEN3 ORAL CAPSULE,2.15,2.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081275,0250,,,,,,EDRPHONIUM INJ SOLUTION 10MG/1ML-15ML,412.80,412.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081276,0250,,,,,,NF-PYRIDOSTIGMINE BROMIDE TAB 60MG,3.43,3.43,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081277,0250,,,,,,NF-MICARDIS HCT TAB 40MG-12.5MG,30.58,30.58,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081278,0250,,,,,,NF-MICARDIS ORAL TABLET 40MG,9.20,9.20,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081279,0250,,,,,,NF-PRAVASTATIN SODIUM ORAL TABLET 10MG,13.82,13.82,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081280,0250,,,,,,NF-FISH OIL CONCENTRATE CAPSULE,0.45,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081281,0250,,,,,,NF-FISH OIL CAPSULE,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081282,0250,,,,,,NF-Pataday Ophthalmic Solution 0.2%,325.72,325.72,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081283,0250,,,,,,NF-SENNA PLUS ORAL TABLET 50MG-8.6MG,0.55,0.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081284,0250,,,,,,NF-HYDROMORPHONE HCL ORAL TABLET 4MG,2.63,2.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081285,0250,,,,,,Cefazolin/NS IVPB: 2000MG/100ML (ANCEF),0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081286,0250,,,,,,NF-RISPERDAL CONSTA IM PWD FOR SUSP ER 2,2048.52,2048.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081287,0250,,,,,,"NF-HEPARIN SODIUM INJ SOLN 2,500U/1ML",3.69,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081288,0250,,,,,,NF-OMEGA 3 CAPSULE 1000MG,0.30,0.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081289,0250,,,,,,NF-SERTRALINE HCL ORAL TABLET 100MG,9.41,9.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081290,0250,,,,,,NF-LATUDA ORAL TABLET 120MG,236.69,236.69,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081291,0250,,,,,,NF-LEFLUNOMIDE ORAL TABLET 20MG,19.29,19.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081292,0250,,,,,,NF-EFFEXOR XR ORAL CAP ER 37.5MG,19.25,19.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081293,0250,,,,,,NF-SIMBRINZA OPHTH SUSP 0.2%-1%,85.01,85.01,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081294,0250,,,,,,NF-ZOCOR ORAL TABLET 20MG,27.64,27.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081296,0250,,,,,,ATROPINE SULF EYE DROPS 1% 5ML,251.03,251.03,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081297,0250,,,,,,NF-ZOCOR ORAL TABLET 10MG,22.50,22.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081298,0250,,,,,,NF-REVATIO TAB 20MG,187.76,187.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081299,0250,,,,,,NF-RENVELA ORAL TABLET 800MG,29.12,29.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081300,0250,,,,,,NF-CLOBETASOL PROPIONATE CREAM 0.05%,36.75,36.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081301,0250,,,,,,NF-TERCONAZOLE VAG CRM 0.4%,4.11,4.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081302,0250,,,,,,NF-FELODIPINE EXTENDED-RELEASE TABLET 10,11.67,11.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081303,0250,,,,,,NF-URSODIOL TAB 500MG,20.44,20.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081304,0250,,,,,,NF-RIFAXIMIN TAB 200MG,50.04,50.04,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081305,0250,,,,,,NF-XIFAXAN ORAL TABLET 550MG,115.28,115.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081306,0250,,,,,,NF-LOVASTATIN ORAL TABLET 20MG,6.99,6.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081307,0250,,,,,,NF-SIMVASTATIN ORAL TABLET  20MG,19.68,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081308,0250,,,,,,NF-URSODIOL ORAL TABLET 500MG,20.44,20.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081309,0250,,,,,,NF-XIFAXAN ORAL TABLET 550MG,157.59,157.59,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081310,0250,,,,,,NF-ISONIAZID ORAL TABLET 300MG,3.61,3.61,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081311,0250,,,,,,NF-PYRIDOXINE HCL TABLET 50MG,0.45,0.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081312,0250,,,,,,NF-CITRACAL + D TABLET,0.62,0.62,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081313,0250,,,,,,NF-VITAMIN D ORAL CAPSULE 5000IU,0.51,0.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081314,0250,,,,,,NF-CENTRUM SILVER ORAL TABLET,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081315,0250,,,,,,NF-DIFICID ORAL TABLET 200MG,900.31,900.31,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081316,0250,,,,,,NF-THEOPHYLLINE 12 HR TAB ER 300MG,2.92,2.92,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081317,0250,,,,,,NF-FOSINOPRIL SODIUM ORAL TABLET 10MG,5.12,5.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081318,0250,,,,,,NF-VALSARTAN ORAL TABLET 40MG,17.44,17.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081319,0250,,,,,,NF-LOSARTAN POTASSIUM ORAL TABLET 50MG,10.41,10.41,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081320,0250,,,,,,ASCLERA 1% INJ 2ML,129.54,129.54,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081321,0250,,,,,,NF-CELEXA TAB 20MG,38.99,38.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081322,0250,,,,,,NF-PRAVASTATIN SODIUM ORAL TABLET 40MG,14.21,14.21,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081323,0250,,,,,,NF-MOMETASONE FUROATE NASAL SPRAY 0.05MG,52.87,52.87,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081324,0250,,,,,,NF-PANCREAZE CAP DR 10850U-2600U-6200U,3.24,3.24,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081325,0250,,,,,,NF-XIFAXAN ORAL TABLET 550MG,166.89,166.89,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081326,0250,,,,,,NF-ADVATE INTRAVENOUS PWD FOR SOLN 1IU,7.83,7.83,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081327,0250,,,,,,NF-ADVATE INTRAVENOUS PWD FOR SOLN 1IU,7.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081328,0250,,,,,,NF-RESTASIS MULTIDOSE OPHTH EMUL 0.05%,400.35,400.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081329,0250,,,,,,NF-IRON 100 PLUS ORAL TABLET,4.96,4.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081330,0250,,,,,,NF-VESICARE ORAL TABLET 10MG,49.68,49.68,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081331,0250,,,,,,NF-Methadone HCl Oral Tablet 10MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081332,0250,,,,,,NF-METHADONE HCL ORAL TABLET 10MG,0.64,0.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081333,0250,,,,,,NF-AMITRIPTYLINE HCL ORAL TABLET 100MG,10.92,10.92,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081334,0250,,,,,,MEGESTEROL ORAL SUSP 400MG/10ML,16.66,16.66,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081335,0250,,,,,,NF-XIFAXAN ORAL TABLET 550MG,166.89,166.89,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081336,0250,,,,,,NF-URSODIOL ORAL TABLET 500MG,24.05,24.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081337,0250,,,,,,NF-PATADAY OPHTH SOLN 0.2%,326.52,326.52,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081338,0250,,,,,,NF-SIMVASTATIN ORAL TABLET  20MG,21.16,21.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081339,0250,,,,,,NF-DICLOFENAC SODIUM DR TABLET 75MG,7.51,7.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081340,0250,,,,,,NF-ENTRESTO TAB 49MG-51MG,34.80,34.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081341,0250,,,,,,NF-ENTRESTO TAB 24MG-26MG,34.80,34.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081342,0250,,,,,,NF-PRAVASTATIN SODIUM ORAL TABLET 80MG,20.62,20.62,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081343,0250,,,,,,NF-WELLBUTRIN SR 12 HR TAB ER 100MG,30.30,30.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081344,0250,,,,,,NF-ZANTAC 300 TABLET 300MG,56.50,56.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081345,0250,,,,,,NF-HYZAAR ORAL TABLET 100MG-25MG,19.86,19.86,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081346,0250,,,,,,NF-HYDRALAZINE HCL ORAL TAB 50MG,5.15,5.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081347,0250,,,,,,NF-PROVERA ORAL TABLET 2.5MG,6.00,6.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081348,0250,,,,,,NF-MYRBETRIQ ORAL TABLET 50MG,55.63,55.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081349,0250,,,,,,NF-CYPROHEPTADINE HCL ORAL TABLET 4MG,2.73,2.73,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081350,0250,,,,,,NF-ESTERIFIED ESTROGENS-METHYLTESTOSTERO,3.45,3.45,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081351,0250,,,,,,NF-CO Q-10 CAPSULE 10MG,1.77,1.77,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081352,0250,,,,,,NF-EFUDEX CREAM 5%,46.97,46.97,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081353,0250,,,,,,NF-TRIAMCINOLONE  OIN  0.1%,0.28,0.28,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081354,0250,,,,,,NF-PROBIOTIC DIGESTIVE CARE CAP 20 BILLI,2.29,2.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081355,0250,,,,,,NF-PROBIOTIC DIGESTIVE CARE ORAL TAB 10M,2.61,2.61,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081356,0250,,,,,,NF-OYSCO 500 + D ORAL TABLET 500MG-200IU,0.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081357,0250,,,,,,NF-VITAMIN C TABLET 100MG,0.08,0.08,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081358,0250,,,,,,SELF ADMINISTERED DRUG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081359,0250,,,,,,HYDROXYZINE 50 MG/ ML  IM,34.96,34.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081360,0250,,,,,,NF-Morphine Sulfate Oral Cap ER 20MG,20.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081361,0250,,,,,,NF-Morphine Sulfate Oral Tab ER 15MG,5.38,5.38,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081362,0250,,,,,,NF-ARAVA ORAL TABLET 20MG,77.59,77.59,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081363,0250,,,,,,NF-NITROGLYCERIN SUBLINGUAL TABLET 0.3MG,2.02,2.02,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081364,0250,,,,,,NF-ASTEPRO NASAL SPRAY 205.5MCG/1ACT,26.61,26.61,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081365,0250,,,,,,NF-PREMARIN VAGINAL CREAM 0.625MG/1GM,59.42,59.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081366,0250,,,,,,NF-CHOLECALCIFEROL TAB 1000IU,0.81,0.81,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081367,0250,,,,,,NF-FLORAJEN3 ORAL CAPSULE,2.13,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081368,0250,,,,,,NF-DIOVAN HCT ORAL TABLET 320MG-12.5MG,54.37,54.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081369,0250,,,,,,NF-ALFUZOSIN HYDROCHLORIDE ER TABLET 10M,18.11,18.11,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081370,0250,,,,,,NF-METROGEL TOPICAL GEL 1%,31.37,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081371,0250,,,,,,NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY,0.51,0.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081372,0250,,,,,,NF-BIOTENE MOISTURIZING MOUTH ORAL SPRAY,0.51,0.51,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081373,0250,,,,,,NF-PRAVACHOL ORAL TABLET 20MG,19.79,19.79,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081374,0250,,,,,,ASCORBIC ACID INJ SOLN 500MG/1ML,466.93,466.93,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081375,0250,,,,,,NF-TRULICITY SUBQ SOLN 0.75MG/0.5ML,1615.08,1615.08,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081376,0250,,,,,,NF-JARDIANCE ORAL TABLET 25MG,74.05,74.05,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081377,0250,,,,,,NF-TIGAN CAP 300MG,19.55,19.55,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081378,0250,,,,,,NF-CYTOMEL ORAL TABLET 5MCG,4.68,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081379,0250,,,,,,NF-FAMOTIDINE INJECTION 10MG/ML,2.86,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081380,0250,,,,,,NF-FAMOTIDINE INJECTION 10MG/ML,1.42,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081381,0250,,,,,,NF-CLOBETASOL PROPIONATE CREAM 0.05%,36.75,36.75,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081382,0250,,,,,,NF-BETAMETHASONE DIP CREAM 0.05%,10.88,10.88,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081383,0250,,,,,,NF-AMERGE TAB 2.5MG,291.94,291.94,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081384,0250,,,,,,NF-IBUPROFEN ORAL TABLET 200MG,5.33,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081385,0250,,,,,,NF-LEVOTHYROXINE ORAL TABLET 200MCG,2.73,2.73,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081386,0250,,,,,,NF-CELEXA TAB 40MG,41.26,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081387,0250,,,,,,NF-AMLODIPINE & BENAZEPRIL HCL 5MG-20MG,12.29,12.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081388,0250,,,,,,NF-MORPHINE SULFATE CAP ER 30MG,24.42,24.42,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081389,0250,,,,,,MIVACURIUM 20MG/10 ML INJ,143.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081390,0250,,,,,,NF-CARDIZEM CD 24 HR CAP ER 240MG,203.96,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081391,0250,,,,,,NF-ADVAIR HFA 115/21 INH AER 115MCG-21MC,144.56,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081392,0250,,,,,,NF-BROVANA INH SOLN 15MCG/2ML,37.46,37.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081393,0250,,,,,,NF-INSPRA ORAL TABLET 50MG,49.12,49.12,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081394,0250,,,,,,NF-VICOPROFEN TABLET,15.76,15.76,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081395,0250,,,,,,NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 2,1.76,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081396,0250,,,,,,NF-ELIMITE TOPICAL CREAM 5%,495.00,495.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081397,0250,,,,,,NF-BUDESONIDE INH/NEB SUSP 0.25MG/2ML,20.92,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081398,0250,,,,,,NF-CRANBERRY CONCENTRATE CAPSULE 500MG,0.29,0.29,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081399,0250,,,,,,NF-TRIAMCINOLONE ACETONIDE NASAL SPRAY 5,33.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081400,0250,,,,,,NF-CALCIUM 600 TAB 600MG,0.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081401,0250,,,,,,NF-Cyclobenzaprine HCl Oral Tablet 5MG,6.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081402,0250,,,,,,NF-Calcium 500 + D Tablet,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081403,0250,,,,,,NF-BENAZEPRIL HCL ORAL TABLET 10MG,1.14,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081404,0250,,,,,,NF-ONGLYZA ORAL TABLET 5MG,42.96,42.96,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081405,0250,,,,,,NF-ENALAPRIL/HCTZ 10MG-25MG TABLET,5.25,5.25,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081406,0250,,,,,,NF-LEFLUNOMIDE ORAL TABLET 20MG,70.62,70.62,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081407,0250,,,,,,NF-ICAPS AREDS ORAL LIQUID FILLED CAPSUL,0.99,0.99,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081408,0250,,,,,,NF-PHENDIMETRAZINE ORAL CAP ER 105MG,4.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081409,0250,,,,,,NF-GLUCOSAMINE & CHONDROITIN 500MG-400MG,3.44,3.44,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081410,0250,,,,,,NF-IRON 100 WITH VITAMIN C ORAL TABLET,0.87,0.87,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081411,0250,,,,,,NF-MAG 200 ORAL TABLET 150MG-200MG,0.27,0.27,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081412,0250,,,,,,NF-OMEGA-3 OIL LIQUID FILLED CAPSULE 100,0.37,0.37,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081413,0250,,,,,,NF-VITAMIN B COMPLEX TAB,0.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081414,0250,,,,,,NF-BRILINTA ORAL TABLET 60MG,28.64,28.64,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081415,0250,,,,,,NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,12.13,12.13,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081416,0250,,,,,,NF-CITALOPRAM HYDROBROMIDE ORAL TAB 10MG,9.73,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081417,0250,,,,,,NF-CILOSTAZOL ORAL TABLET 50MG,7.30,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081418,0250,,,,,,NF-B-COMPLEX SL SOLN,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081419,0250,,,,,,NF-PRESERVISION AREDS LIQUID FILLED CAPS,0.97,0.97,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081420,0250,,,,,,NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M,0.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081421,0250,,,,,,NF-CRESTOR ORAL TABLET 10MG,23.95,23.95,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081422,0250,,,,,,NF-FIBERCON TAB 625MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081423,0250,,,,,,NF-SYSTANE BALANCE OPHTH SOLN 0.6%,4.18,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081424,0250,,,,,,NF-PREDNISOLONE ACETATE OPHTH SUSP 1%,43.23,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081425,0250,,,,,,NF-TRAVATAN Z OPHTH SOLN 0.004%,175.33,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081426,0250,,,,,,NF-LIALDA ORAL DELAYED-RELEASE TABLET 1.,48.30,48.30,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081427,0250,,,,,,NF-GLUCOSAMINE & CHONDR CAP 500MG-400MG,2.56,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081428,0250,,,,,,NF-CARTIA XT ORAL 24 HR CAP ER 120MG,4.79,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081429,0250,,,,,,NF-PRESERVISION AREDS ORAL LIQUID CAPSUL,1.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081430,0250,,,,,,NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M,75.38,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081431,0250,,,,,,NF-BUDESONIDE CAPSULE DELAYED RELEASE 3M,75.38,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081432,0250,,,,,,NF-CILOSTAZOL ORAL TABLET 50MG,7.30,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081433,0250,,,,,,NF-CRESTOR ORAL TABLET 5MG,44.87,44.87,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081434,0250,,,,,,NF-TRAVOPROST OPHTH SOLN 0.004%,314.29,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081435,0250,,,,,,NF-Budesonide Delayed Release Capsule 3M,75.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081436,0250,,,,,,NF-LOVASTATIN ORAL TABLET 20MG,11.87,11.87,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081437,0250,,,,,,NF-BRIMONIDINE TARTRATE OPHTH SOLN 0.15%,136.52,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081438,0250,,,,,,NF-CYTOMEL TABLET 25MCG,4.73,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081439,0250,,,,,,NF-VITAMIN B COMPLEX INJ SOLN,8.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081440,0250,,,,,,NF-ERYTHROMYCIN ORAL TABLET 500MG,4.73,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081441,0250,,,,,,NF-GABITRIL TABLET 16MG,63.49,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081442,0250,,,,,,NF-HYDROXYZINE HCL IM SOLN 50MG/1ML,1.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081443,0250,,,,,,NF-FELODIPINE EXTENDED RELEASE TAB 10MG,11.67,11.67,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081444,0250,,,,,,NF-CITALOPRAM HBR ORAL TAB 40MG,1.46,1.46,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081445,0250,,,,,,NF-CYANOCOBALAMIN INJ SOLN 1000MCG/1ML,21.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081446,0250,,,,,,NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML,6445.48,6445.48,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081447,0250,,,,,,NF-TRICOR ORAL TABLET 145MG,24.94,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081448,0250,,,,,,NF-SOTALOL HCL  ORAL TABLET 160MG,17.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081449,0250,,,,,,NF-TERIPARATIDE SUBQ SOLN 250MCG/1ML,6445.48,6445.48,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081450,0250,,,,,,NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,8.60,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081452,0636,J0885,,,,,EPOETIN ALPHA 2000 UNITS (PROCRIT),253.06,253.06,,,,,,,,,,,,,
47081453,0250,,,,,,NF-INSPRA ORAL TABLET 50MG,50.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081454,0250,,,,,,NF-VITAMIN D ORAL TABLET 2000IU,0.15,0.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081455,0250,,,,,,NF-1ST TIER UNIFINE PENTIPS PLUS DEVICE,1.11,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081456,0250,,,,,,NF-BACTRIM DS ORAL TABLET 800MG-160MG,9.63,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081457,0250,,,,,,NF-VISTARIL CAPSULE 50MG,14.38,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081458,0250,,,,,,NF-DALIRESP ORAL TABLET 500MCG,44.35,44.35,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081459,0250,,,,,,NF-MORPHINE SULFATE IR ORAL TABLET 15MG,1.65,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081460,0250,,,,,,NF-PRO-BIOTIC BLEND ORAL CAPSULE,0.18,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081461,0250,,,,,,NF-NICODERM CQ TD PATCH ER 14MG/24HR,8.97,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081462,0250,,,,,,NF-NIACIN ORAL TABLET 500MG,0.11,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081463,0250,,,,,,NF-METOPROLOL SUCCINATE ORAL TAB ER 25MG,17.31,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081464,0250,,,,,,NF-PRESERVISION AREDS 2 ORAL LIQ CAP,0.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081465,0250,,,,,,NF-CRANBERRY FRUIT CAPSULE 425MG,0.23,0.23,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081466,0250,,,,,,NF-CRAN-PLUS ORAL CAPSULE,0.67,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081467,0250,,,,,,NF-SIMVASTATIN ORAL TABLET  20MG,21.16,21.16,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081468,0250,,,,,,NF-CILOSTAZOL TAB 50MG,7.30,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081469,0250,,,,,,NF-CYCLOPENTOLATE HCL OPHTH SOLN 0.5%,20.51,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081470,0250,,,,,,NF-CYCLOPENTOLATE HCL OPHTH SOLN 1%,10.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081471,0250,,,,,,NF-ALPHAGAN P OPTHAMALIC SOLUTION  0.1%,137.63,137.63,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081472,0250,,,,,,NF-LATANOPROST OPHTH SOLN 0.005%,60.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081473,0250,,,,,,NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,6.38,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081474,0250,,,,,,NF-NOVOLIN N (NPH) SUBQ SUSP 100U/1ML,66.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081477,0250,,,,,,NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML,27.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081478,0250,,,,,,NF-HUMULIN 70/30 SUBQ SUSP 70U-30U/1ML,27.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081479,0250,,,,,,NF-JUBLIA TOPICAL APPLICATION SOLUTION 1,738.93,738.93,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081480,0250,,,,,,NF-METFORMIN HCL ORAL TABLET 850MG,4.79,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081481,0250,,,,,,NF-AMILORIDE HCL ORAL TABLET 5MG,7.34,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081482,0250,,,,,,NF-AMILORIDE HCL ORAL TABLET 5MG,7.34,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081483,0250,,,,,,NF-CEFAZOLIN NA-NACL IV SOLN 2GM-0.9%,2.28,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081484,0250,,,,,,NF-SACCHARIN CALCIUM POWDER,11.02,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081485,0250,,,,,,NF-SIMVASTATIN ORAL TABLET 40MG,19.57,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081486,0250,,,,,,NF-EVISTA TAB 60MG,24.15,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081487,0250,,,,,,NF-GABAPENTIN CAP 100MG,2.95,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081488,0250,,,,,,NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,127.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081489,0250,,,,,,NACL 0.9 % 150 ML IV,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081490,0250,,,,,,CEFEPIME 1 GM VIAL,32.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081491,0636,,,,,,TNKASE IV POWDER FOR SOLUTION 50MG,31155.20,0.00,15.98,15.98,15.98,15.98,,,,,,,,,
47081492,0250,,,,,,EPIDURAL,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081493,0250,,,,,,SOTALOL 150MG/10ML INJ,6782.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081494,0250,,,,,,NF-PAROXETINE HCL ORAL TABLET 40MG,1.96,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081495,0636,,,,,,PROCAINAMIDE 1000MG/10ML INJ,408.00,0.00,15.98,15.98,15.98,15.98,,,,,,,,,
47081496,0250,,,,,,NF-ADVAIR DISKUS 500/50 DISK,25.03,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081497,0636,,,,,,IV TEMPLATE,281737.00,0.00,15.98,15.98,15.98,15.98,,,,,,,,,
47081498,0636,J1170,,,,,HYDROMORPHONE 0.5MG/0.5ML INJ (DILAUDID),24.50,0.00,8.89,17.65,,,17.65,,,,8.89,,,17.40,17.40
47081499,0250,,,,,,NF-OSELTAMIVIR PHOSPHATE PWD FOR SUSP 6M,10.94,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081500,0250,,,,,,NF-RAMIPRIL CAP 10MG,14.13,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081501,0250,,,,,,NF-FEOSOL ORAL TABLET 45MG,0.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081502,0250,,,,,,NF-FEOSOL ORAL TABLET 65MG,0.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081503,0250,,,,,,NF-AFINITOR ORAL TABLET 5MG,2268.68,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081504,0250,,,,,,NF-DEXAMETHASONE ELIX 0.5MG/5ML,1.07,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081505,0250,,,,,,NF-FEOSOL ORAL TABLET 45MG,0.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081506,0250,,,,,,NF-CHLORDIAZEPOXIDE CAP 10MG,2.48,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081507,0250,,,,,,NF-LACTASE TABLET,0.52,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081508,0250,,,,,,NF-THEO-24 24 HR CAP ER 100MG,8.73,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081509,0250,,,,,,NF-AMILORIDE HCL ORAL TABLET 5MG,7.34,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081510,0250,,,,,,NF-BONIVA ORAL TABLET 150MG,621.68,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081511,0250,,,,,,NF-IBANDRONATE SODIUM ORAL TABLET 150MG,554.91,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081512,0250,,,,,,NF-TAMIFLU PWD FOR SUSP 6MG/1ML,9.65,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081513,0250,,,,,,NF-ZINC ACETATE CAP 25MG,6.53,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081514,0250,,,,,,NF-OCUVITE TABLET,0.39,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081515,0250,,,,,,NF-LISINOPRIL ORAL TABLET 40MG,6.16,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081516,0250,,,,,,NF-PULMICORT FLEXHALER INH/NEB 180MCG/1A,1039.24,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081517,0250,,,,,,NF-BUDESONIDE  INH/NEB PWD 180MCG/1ACT,1039.24,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081518,0250,,,,,,NF-MEDIHONEY TOPICAL GEL 80%,1.31,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081519,0250,,,,,,NF-PAPAYA ENZYME TABLET,13.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081520,0250,,,,,,NF-ARGININE ORAL CAPSULE 600MG,0.36,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081521,0250,,,,,,NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,0.05,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081522,0250,,,,,,NF-MARINOL LIQ CAP 5MG,109.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081523,0250,,,,,,NF-GLYNASE PRES-TAB ORAL TABLET 3MG,11.07,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081524,0250,,,,,,NF-ESTER C TABLET,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081525,0250,,,,,,NF-ALEVE ARTHRITIS TAB 220MG,0.32,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081526,0250,,,,,,NF-ALEVE CAP 220MG,0.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081527,0250,,,,,,NF-SAM-E 400 ORAL TABLET EC 400MG,5.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081528,0250,,,,,,NF-NYSTATIN/TRIAMCINOLONE ACETONID OINTM,21.27,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081529,0250,,,,,,NF-FENOFIBRATE AVPAK ORAL TABLET 48MG,7.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081530,0250,,,,,,POTASSIUM PHOSPHATE ORIGINAL TAB 500MG,2.05,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081531,0250,,,,,,NF-MODAFINIL AVPAK ORAL TABLET 200MG,141.40,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081532,0250,,,,,,NF-FOSINOPRIL SODIUM ORAL TABLET 40MG,4.76,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081533,0250,,,,,,NF-NEXIUM 24HR CAP DR 20MG,2.56,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081534,0250,,,,,,NF-BISOPROLOL FUMARATE TAB 5MG,15.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081535,0250,,,,,,NF-CALTRATE 600 TAB 600MG,0.57,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081536,0250,,,,,,NF-AFINITOR TAB 10MG,2493.13,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081537,0250,,,,,,NF-EXEMESTANE ORAL TABLET 25MG,80.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081538,0250,,,,,,NF-EXEMESTANE ORAL TABLET 25MG,80.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081539,0250,,,,,,NF-VITAMIN D ORAL TABLET 1000IU,0.11,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081540,0250,,,,,,NF-COENZYME Q10 LIQ CAP 100MG,2.03,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081541,0250,,,,,,NF-NIFEDIPINE AVPAK TAB ER 60MG,9.02,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081542,0250,,,,,,NF-VITAMIN B-12 ORAL SOLUTION 1000MCG/ML,0.51,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081543,0250,,,,,,NF-SAXAGLIPTIN HYDROCHLORIDE TAB 5MG,47.30,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081544,0250,,,,,,NF-PERFOROMIST INH SOLN 20MCG/2ML,38.89,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081545,0250,,,,,,NF-CARBOXYMETHYLCELLULOSE SODIUM-GLYCERI,4.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081546,0250,,,,,,NF-ALPRAZOLAM DISINTEGRATING TAB 2MG,17.15,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081547,0250,,,,,,NF-PROTONIX TAB EC 40MG,25.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081548,0250,,,,,,NF-QUINAPRIL HCL TAB 40MG,15.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081549,0250,,,,,,NF-BENAZEPRIL HCL-HCTZ TAB 10MG-12.5MG,8.27,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081550,0250,,,,,,NF-LOTENSIN HCT ORAL TABLET 10MG-12.5MG,11.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081551,0250,,,,,,NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML,26.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081552,0250,,,,,,NF-BUDESONIDE INH/NEB SUSP 0.5MG/2ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081553,0250,,,,,,NF-TRIAMCINOLONE ACETONIDE CREAM 0.025%,0.40,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081554,0250,,,,,,NF-TIMOLOL MALEATE OPHTH GEL DROP 0.25%,158.60,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081555,0250,,,,,,NF-TRADJENTA TAB 5MG,65.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081556,0250,,,,,,NF-TIMOLOL MALEATE OPHTH GEL DROP 0.5%,46.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081557,0250,,,,,,NF-MICROLIPID OIL,0.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081558,0250,,,,,,NF-LEUPROLIDE ACETATE IM 3 MONTH PWD FOR,21011.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081559,0250,,,,,,NF-CHLORASEPTIC MUCOUS MEMBRANE LONZENGE,0.64,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081560,0250,,,,,,NF-1ST TIER UNILET COMFORTOUCH LANCET,0.19,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081561,0250,,,,,,NF-COMBIGAN OPHTH SOLN 0.2%-0.5%,154.59,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081562,0250,,,,,,NF-CO Q-10 CAPSULE 50MG,1.49,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081563,0250,,,,,,NF-HYDROCORTISONE ACETATE CRM 2.5%,38.85,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081564,0250,,,,,,NF-ATOVAQUONE SUSP 750MG/5ML,9.97,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081565,0250,,,,,,NF-ATOVAQUONE ORAL SUSPENSION 750MG/5ML,26.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081566,0250,,,,,,NF-DULERA INH AER PWD 5MCG-100MCG/ACT,114.96,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081567,0637,,,,,,NF-JARDIANCE ORAL TABLET 25MG,74.39,0.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47081568,0250,,,,,,NF-NICOTINE TD PATCH ER 7MG/24HR,16.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081569,0250,,,,,,NF-BETASERON SUBQ KIT 0.3MG,1197.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081570,0250,,,,,,NF-BENAZEPRIL HCL ORAL TABLET 10MG,4.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081571,0250,,,,,,NF-BENICAR ORAL TABLET 5MG,27.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081572,0250,,,,,,NF-CYTOMEL TABLET 0.025MG,4.90,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081573,0250,,,,,,NF-CYTOMEL TABLET 25MCG,4.73,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081574,0250,,,,,,NF-VELTASSA POWDERFORSUSPENSION 8.4GM/1P,120.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081575,0250,,,,,,NF-CINNAMON ORAL CAPSULE 500MG,0.20,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081576,0250,,,,,,NF-SELENIUM TABLET 100MCG,0.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081577,0250,,,,,,NF-PROCTOCORT RECTAL CREAM 1%,6.90,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081578,0250,,,,,,NF-CALCIUM WITH VITAMIN D TAB 600MG-400I,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081579,0250,,,,,,NF-GAS-X ULTRA STRENGTH LIQ CAP 180MG,1.23,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081580,0250,,,,,,NF-SINUS PRESSURE&CONGESTION RELIEF PE 1,0.89,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081581,0250,,,,,,NF-MYLANTA SUSPENSION,0.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081582,0250,,,,,,NF-JARDIANCE ORAL TABLET 10MG,74.39,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081583,0250,,,,,,NF-TRAVOPROST OPHTH SOLN 0.004%,326.88,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081584,0250,,,,,,NF-TRAVATAN Z OPHTH SOLN 0.004%,326.88,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081585,0250,,,,,,NF-CREON ORAL DELAYED RELEASE CAPSULE,14.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081586,0250,,,,,,NF-VALSARTAN AND HYDROCHLOROTHIAZIDE TAB,17.11,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081587,0250,,,,,,NF-DAPTOMYCIN IV PWD FOR SOLN 350MG,1329.60,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081588,0250,,,,,,NF-ENTOCORT EC CAP DR 3MG,65.85,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081589,0250,,,,,,"NF-VITAMIN A CAPSULE 25,000IU",0.39,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081590,0250,,,,,,NF-BIOTIN ORAL CAPSULE 2500MCG,0.37,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081591,0250,,,,,,NF-JANUMET ORAL TABLET 50MG-1000MG,18.01,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081592,0250,,,,,,NF-BIMATOPROST OPHTH SOLN 0.01%,345.38,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081593,0250,,,,,,NF-ALPHAGAN P OPHTH SOLN 0.1%,140.24,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081594,0250,,,,,,NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,22.52,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081595,0250,,,,,,NF-AMILORIDE HCL TAB 5MG,5.16,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081596,0250,,,,,,NF-VITA-BEE WITH C ORAL TABLET,0.18,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081597,0250,,,,,,NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 0.125,8.29,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081598,0250,,,,,,NF-CELEXA TAB 40MG,27.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081599,0250,,,,,,NF-HYDROXYZINE PAMOATE CAP 50MG,2.40,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081600,0250,,,,,,NF-ALPHAGAN P OPHTH SOLN 0.1%,140.18,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081601,0250,,,,,,NF-RAMIPRIL CAP 10MG,15.01,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081602,0250,,,,,,NF-SEREVENT DISKUS INH PWD 50MCG/1ACTUAT,30.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081603,0250,,,,,,NF-TELMISARTAN ORAL TABLET 80MG,19.29,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081604,0250,,,,,,NF-TRELEGY ELLIPTA INH PWD,42.40,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081605,0250,,,,,,NF-TOBI INH/NEB SOLN 300MG/5ML,125.79,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081606,0250,,,,,,NF-COLESTIPOL HCL TAB 1GM,4.95,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081607,0250,,,,,,NF-PROVIGIL ORAL TABLET 200MG,213.07,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081608,0250,,,,,,NF-AMANTADINE HCL LIQ CAP 100MG,5.17,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081609,0250,,,,,,NF-MODAFINIL ORAL TABLET 100MG,88.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081610,0250,,,,,,NF-MODAFINIL ORAL TABLET 200MG,133.34,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081611,0250,,,,,,NF-VITAMIN A CAPSULE 8000IU,0.11,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081612,0250,,,,,,NF-FARXIGA ORAL TABLET 5MG,49.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081613,0250,,,,,,NF-BROVANA INH SOLN 15MCG/2ML,38.83,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081614,0250,,,,,,NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,4.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081615,0250,,,,,,NF-SYNJARDY ORAL TABLET 12.5MG-1000MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081616,0250,,,,,,NF-SYNJARDY XR ORAL TAB ER 12.5MG-1000MG,37.20,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081621,0250,,,,,,NF-CELEXA TABLET 20MG,19.69,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081622,0637,,,,,,KAYEXALATE PWDR,700.00,0.00,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47081623,0250,,,,,,NF-MILK THISTLE CAPSULE 150MG,0.88,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081624,0250,,,,,,NF-GARLIC CAPSULE 500MG,0.30,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081625,0250,,,,,,NF-TRIHEXYPHENIDYL HCL TAB 2MG,0.73,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081626,0250,,,,,,NF-NORGESTIM/ETHINYL ESTRADIOL 0.25MG-35,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081627,0250,,,,,,NF-QVAR REDIHALER INH AEROSOL LIQ 0.04MG,76.66,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081628,0250,,,,,,NF-METFORMIN HCL AVPAK TAB ER 500MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081629,0250,,,,,,NF-METFORMIN HCL ORAL TABLET 850MG,4.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081630,0250,,,,,,NF-BELBUCA BUCCAL FILM 600MCG,50.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081631,0250,,,,,,NF-MIRTAZAPINE DISINTEGRATING TAB 15MG,9.74,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081632,0250,,,,,,NF-TRANEXAMIC ACID ORAL TABLET 650MG,20.86,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081633,0250,,,,,,NF-RANITIDINE HCL ORAL SYRUP 15MG/1ML,2.96,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081634,0250,,,,,,NF-ESTRADIOL TRANSDERMAL SYS 0.1MG/24HR,45.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081635,0250,,,,,,NF-SODIUM CHLORIDE,0.02,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081636,0250,,,,,,NF-ACEBUTOLOL HCL CAP 200MG,4.03,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081637,0250,,,,,,NF-SELEGILINE HCL CAP 5MG,10.80,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081638,0250,,,,,,NF-NORGESTIMATE AND ETHINYL ESTRADIOL,5.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081639,0250,,,,,,NF-PYRIDOXINE TAB 100MG,0.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081640,0250,,,,,,NF-VITAMIN B COMPLEX TAB,2.12,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081641,0250,,,,,,NF-VITAMIN B12 TABLET 5000MCG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081642,0250,,,,,,SODIUM CHLORIDE 7% (RESP) 4ML,15.25,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081643,0250,,,,,,NF-SAW PALMETTO CAPSULE,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081644,0250,,,,,,NF-MACULAR HEALTH FORMULA ORAL CAPSULE,2.83,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081645,0250,,,,,,NF-DORZOLAMIDE HCL OPHTH SOLN 2%,26.96,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081646,0250,,,,,,NF-LUMIGAN OPHTH SOLN 0.01%,345.23,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081647,0250,,,,,,NF-NIACIN ORAL TABLET 100MG,0.14,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081648,0250,,,,,,"NF-OCTREOTIDE ACETATE INJ SOLN 1,000MCG/",630.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081649,0250,,,,,,NF-MORPHINE SULFATE IR ORAL TABLET 15MG,1.58,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081650,0250,,,,,,NF-PEDVAXHIB IM SOLN 7.5MCG/0.5ML,250.64,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081651,0250,,,,,,NF-VITAMIN K TABLET 0.1MG,0.17,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081652,0250,,,,,,NF-LINZESS CAP 145MCG,61.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081653,0250,,,,,,NF-MYRBETRIQ ORAL TABLET 50MG,56.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081654,0250,,,,,,NF-CYANOCOBALAMIN SL DISINTEGRATING TAB,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081655,0250,,,,,,NF-PRAVASTATIN SODIUM AVPAK TAB 20MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081656,0250,,,,,,NF-ALLEGRA-D 12 HOUR ORAL TAB ER 60MG-12,3.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081657,0250,,,,,,NF-CEFTRIAXONE INJ PWD FOR SOLN 2GM,365.64,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081658,0250,,,,,,NF-OXYCODONE HCL ORAL TAB 15MG,7.58,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081660,0250,,,,,,NF-TRANEXAMIC ACID ORAL TABLET 650MG,29.64,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081661,0250,,,,,,NF-PROTONIX ORAL ENTERIC-COATED TABLET 4,33.16,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081662,0250,,,,,,NF-SIMVASTATIN AVPAK ORAL TABLET 20MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081663,0250,,,,,,NF-TAGRISSO TAB 80MG,2338.63,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081664,0250,,,,,,NF-DIGESTIVE ENZYMES TABLET,0.36,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081665,0250,,,,,,NF-ZANTAC 150 ORAL TABLET 150MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081666,0250,,,,,,NF-GABAPENTIN AVPAK ORAL TABLET 800MG,11.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081667,0250,,,,,,NF-ZANTAC 150 TAB 150MG,17.39,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081668,0250,,,,,,NF-XYZAL ALLERGY 24HR ORAL TABLET 5MG,1.63,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081669,0250,,,,,,NF-ATROVENT HFA INH ORAL/NEB SOLN 17MCG,133.71,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081670,0250,,,,,,NF-BUTALB/APAP/CAFF TABLET 50MG-325MG-40,7.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081671,0250,,,,,,NF-MORPHINE SULFATE 24 HR CAP ER 45MG,33.98,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081672,0250,,,,,,NF-MUCINEX DM TAB ER,2.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081673,0250,,,,,,NF-LEXAPRO ORAL TABLET 10MG,16.72,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081674,0250,,,,,,NF-XTANDI LIQ CAP 40MG,436.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081675,0250,,,,,,NF-METOPROLOL SUCCINATE CAP ER 25MG,6.96,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081676,0250,,,,,,NF-METOPROLOL SUCCINATE ER TAB ER 25MG,4.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081677,0250,,,,,,NF-RIVASTIGMINE TD PATCH ER 9.5MG/24HR,40.45,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081678,0250,,,,,,NF-REFRESH OPHTH SOLUTION,1.38,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081679,0250,,,,,,NF-OXYBUTYNIN CHLORIDE ORAL TAB ER 5MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081680,0250,,,,,,NF-PAPAYA ENZYME TABLET,13.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081681,0250,,,,,,NF-FOLBEE-PLUS CZ TAB,2.83,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081682,0250,,,,,,NF-FOLIC ACID ORAL TABLET 0.8MG,0.05,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081683,0250,,,,,,NF-PRILOSEC CAP DR 20MG,25.42,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081684,0250,,,,,,NF-PROGESTERONE IM OIL 50MG/1ML,15.02,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081685,0250,,,,,,NF-VIVELLE-DOT TD PATCH ER 0.0375MG/24HR,72.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081686,0250,,,,,,NF-PROGESTERONE LIQ CAP 100MG,10.97,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081687,0250,,,,,,NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,2138.36,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081688,0250,,,,,,NF-DAPTOMYCIN IV PWD FOR SOLN 500MG,2138.32,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081689,0250,,,,,,NF-MICONAZOLE POWDER,159.60,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081690,0250,,,,,,NF-MICONAZOLE POWDER,168.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081691,0250,,,,,,NF-ENTRESTO ORAL TABLET 49MG-51MG,37.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081692,0250,,,,,,NF-WELLBUTRIN XL ORAL 24 HR TABLET ER 30,35.01,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081693,0250,,,,,,NF-ARMOUR THYROID TABLET 30MG,3.31,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081694,0250,,,,,,NF-GABAPENTIN SUSP 25MG/1ML,5.20,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081695,0250,,,,,,NF-GABAPENTIN ORAL SOLUTION 250MG/5ML,1.27,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081696,0250,,,,,,NF-GABAPENTIN AVPAK ORAL TABLET 600MG,9.53,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081697,0250,,,,,,NF-JANUVIA ORAL TABLET 100MG,68.74,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081698,0250,,,,,,NF-OXCARBAZEPINE ORAL TABLET 300MG,10.56,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081699,0250,,,,,,NF-PIOGLITAZONE HCL ORAL TABLET 45MG,46.46,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081700,0250,,,,,,NF-LISINOPRIL ORAL TABLET 10MG,3.97,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081701,0250,,,,,,NF-LISINOPRIL ORAL TABLET 10MG,0.90,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081702,0250,,,,,,NF-AMARYL TAB 4MG,19.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081703,0250,,,,,,NF-ZYPREXA TABLET 7.5MG,81.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081704,0250,,,,,,NF-GUAIFENESIN ORAL TABLET 400MG,11.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081705,0250,,,,,,NF-ANASTROZOLE ORAL TABLET 1MG,53.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081706,0250,,,,,,NF-VENLAFAXINE HCL AVPAK TAB 75MG,8.73,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081707,0250,,,,,,NF-OXYBUTYNIN CHLORIDE ORAL TAB ER 10MG,13.15,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081708,0250,,,,,,NF-CONCERTA TAB ER 36MG,27.18,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081709,0250,,,,,,NF-NITROSTAT TABLET 0.3MG,0.45,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081710,0250,,,,,,NF-OPDIVO INTRAVENOUS SOLUTION 10MG/1ML,1296.64,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081711,0250,,,,,,NF-BEVESPI AEROSPHERE INH 4.8MCG-9MCG/1A,163.89,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081712,0250,,,,,,NF-KETOCONAZOLE CREAM 2%,9.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081713,0250,,,,,,NF-HOMEOPATHIC CHEW TAB,1.09,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081714,0250,,,,,,NF-PROLENSA OPHTH SOLN 0.07%,426.67,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081715,0250,,,,,,NF-MURO-128 OPHTH OINTMENT 5%,99.43,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081716,0250,,,,,,BALOXAVIR 40 MG TAB,387.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081717,0250,,,,,,NF-ANORO ELLIPTA INH PWD 62.5MCG-25MCG/1,32.77,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081718,0250,,,,,,NF-TYLENOL ARTHRITIS ORAL TABLET ER 650M,0.67,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081719,0250,,,,,,NF-CEFOTAXIME INJECTION PWD FOR SOLN 1GM,26.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081720,0636,,,,,,KCENTRA 500 UNITS,5576.21,0.00,15.98,15.98,15.98,15.98,,,,,,,,,
47081721,0250,,,,,,NF-CHLORTHALIDONE ORAL TABLET 25MG,9.19,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081722,0250,,,,,,NF-LO LOESTRIN FE ORAL TAB,24.12,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081723,0250,,,,,,NF-VITAMIN B12 ORAL TABLET 500MCG,0.23,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081724,0250,,,,,,NF-VITAMIN B12 ORAL TABLET 1000MCG,0.38,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081725,0250,,,,,,NF-CYANOCOBALAMIN DIS TAB 5000MCG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081726,0250,,,,,,NF-TERAZOSIN HCL CAP 10MG,6.42,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081727,0250,,,,,,NF-CARDIZEM ORAL TABLET 60MG,48.19,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081728,0250,,,,,,NF-LIPITOR ORAL TABLET 20MG,19.31,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081729,0250,,,,,,NF-SPRINTEC TABLET,9.45,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081730,0250,,,,,,NF-ARICEPT ORAL TABLET 10MG,39.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081731,0250,,,,,,NF-NAMENDA TAB 10MG,35.58,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081732,0250,,,,,,NF-TUSSIN CF SOLN 20MG-400MG-10MG/10ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081733,0250,,,,,,NF-ACTOS ORAL TABLET 45MG,103.05,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081734,0250,,,,,,NF-DULOXETINE CAPSULE DELAYED RELEASE 60,27.92,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081735,0250,,,,,,NF-HYDROCHLOROTHIAZIDE CAP 12.5MG,1.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081736,0250,,,,,,NF-PRAMIPEXOLE DIHYDROCHLORIDE TAB 1MG,33.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081737,0250,,,,,,NF-FEXOFENADINE HCL ORAL TAB 180MG,2.57,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081738,0250,,,,,,NF-PULMICORT FLEX INH/NEB PWD 180MCG/1AC,751.48,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081739,0250,,,,,,NF-ESOMEPRAZOLE MAGNESIUM CAP DR 40MG,40.15,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081740,0250,,,,,,NF-LETROZOLE ORAL TABLET 2.5MG,72.46,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081741,0250,,,,,,NF-PRANDIN TAB 2MG,5.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081742,0250,,,,,,NF-JANUVIA ORAL TABLET 100MG,36.03,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081743,0250,,,,,,NF-PRESERVISION AREDS ORAL LIQUID CAPSUL,1.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081744,0250,,,,,,NF-PRESERVISION AREDS 2 LIQ CAP,0.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081745,0250,,,,,,NF-PRESERVISION AREDS 2 LIQ CAP,0.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081746,0250,,,,,,NF-PRANDIN TAB 2MG,5.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081747,0250,,,,,,NF-TURMERIC ORAL TABLET 1053MG,1.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081748,0250,,,,,,NF-TAURINE ORAL CAPSULE 500MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081749,0250,,,,,,"NF-COQ10 ORAL CAPSULE, LIQUID FILLED 200",1.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081750,0250,,,,,,NF-LEVOCARNITINE CAP 300MG,1.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081751,0250,,,,,,NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,104.43,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081752,0250,,,,,,NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,104.43,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081753,0250,,,,,,NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,104.43,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081754,0250,,,,,,NF-BASAGLAR KWIKPEN SUBQ SOLN 100U/1ML,104.43,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081755,0250,,,,,,NF-AUGMENTIN XR ORAL TABLET ER 1000MG,20.15,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081756,0250,,,,,,NF-PRAZOSIN HCL     CAP  2MG,5.09,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081757,0250,,,,,,NF-OFLOXACIN OPHTH SOLN 0.3%,48.45,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081758,0250,,,,,,NF-SILDENAFIL AVPAK ORAL TABLET 20MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081759,0250,,,,,,NF-OLANZAPINE AVPAK TAB 2.5MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081760,0250,,,,,,NF-TOUJEO SUBCUTANEOUS SOLUTION 300U/1ML,414.63,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081761,0250,,,,,,NF-ZOLOFT TAB 100MG,13.28,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081762,0250,,,,,,NF-SOTALOL HCL AF ORAL TABLET 160MG,53.79,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081763,0250,,,,,,NF-CYMBALTA CAP DR 20MG,22.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081764,0250,,,,,,NF-ESTRADIOL TRANSDERMAL SYS 0.05MG/24HR,45.34,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081765,0250,,,,,,NF-TRIAZOLAM ORAL TABLET 0.25MG,3.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081767,0250,,,,,,NF-TYLENOL PM EXTRA STRENGTH TABLET,0.45,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081768,0250,,,,,,NF-CITALOPRAM HYDROBROMIDE ORAL TABLET 1,9.83,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081769,0250,,,,,,NF-INCRUSE ELLIPTA INH PWD 62.5MCG/1ACT,48.51,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081770,0250,,,,,,NF-JANUVIA ORAL TABLET 50MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081771,0250,,,,,,NF-VYVANSE CAP 70MG,29.53,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081772,0250,,,,,,NF-ADDERALL TAB 30MG,33.77,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081773,0250,,,,,,"NF-PALIPERIDONE ORAL TABLET, ER 6MG",122.11,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081774,0250,,,,,,NF-LACTASE ENZYME ORAL TABLET 3000U,0.29,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081775,0250,,,,,,NF-SYSTANE OPHTH SOLUTION,2.34,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081776,0250,,,,,,NF-OMEGA-3 KRILL OIL CAPSULE LIQUID FILL,1.15,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081777,0250,,,,,,NF-CAPTOPRIL ORAL TABLET 100MG,15.23,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081778,0250,,,,,,NF-WELLBUTRIN ORAL TABLET 100MG,7.44,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081779,0250,,,,,,NF-AZELASTINE HCL NASAL SPRAY 137MCG/1AC,14.03,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081780,0250,,,,,,NF-PROPAFENONE HCL CAP ER 425MG,32.60,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081781,0250,,,,,,NF-ACARBOSE ORAL TABLET 25MG,3.64,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081782,0250,,,,,,NF-ACARBOSE ORAL TABLET 25MG,3.64,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081783,0250,,,,,,NF-GLIPIZIDE ORAL TAB ER 10MG,3.22,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081784,0250,,,,,,NF-GLIPIZIDE ORAL TABLET 10MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081785,0250,,,,,,NF-MYRBETRIQ ORAL TABLET 25MG,61.49,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081786,0250,,,,,,NF-ASMANEX TWIST INH/NEB POWDER 220MCG/A,739.36,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081787,0250,,,,,,NF-CANNABIDIOL SOLN 100MG/1ML,59.28,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081788,0637,,,,,,OSELTAMIVIR 30MG CAP (TAMIFLU),60.97,60.97,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47081790,0250,,,,,,NF-OMEGA-3 FISH OIL ORAL LIQ CAP 1000MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081791,0250,,,,,,NF-CO-Q-10 ORAL LIQUID CAPSULE 100MG,0.89,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081792,0250,,,,,,NF-JOINT BOOST ORAL TABLET,0.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081793,0250,,,,,,NF-ACCUPRIL ORAL TABLET 40MG,7.92,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081794,0250,,,,,,NF-SIMVASTATIN ORAL TABLET 20MG,19.57,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081796,0250,,,,,,NF-RAPAFLO CAP 8MG,41.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081797,0250,,,,,,NF-TRESIBA SUBQ SOLN 100U/1ML,162.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081798,0250,,,,,,NF-BYSTOLIC ORAL TABLET 10MG,22.92,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081799,0250,,,,,,NF-BREO ELLIPTA INH PWD 100MCG-25MCG/1AC,28.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081800,0250,,,,,,"NF-CREON 24,000 UNITS CAP",31.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081801,0250,,,,,,NF-TRANDOLAPRIL ORAL TABLET 4MG,4.60,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081802,0250,,,,,,NF-HALCION ORAL TABLET 0.25MG,26.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081803,0250,,,,,,NF-JANUVIA ORAL TABLET 100MG,75.74,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081804,0250,,,,,,NF-FLECTOR PATCH ER 1.3%,50.65,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081805,0250,,,,,,NF-BUPROPION HCL ORAL TABLET 75MG,3.18,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081806,0250,,,,,,NF-IBRANCE CAP 125MG,2845.57,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081807,0250,,,,,,NF-LIPITOR TAB 80MG,75.27,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081809,0250,,,,,,NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,0.06,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081810,0250,,,,,,NF-SYMBICORT INH AER LIQ 80MCG-4.5MCG,146.79,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081811,0250,,,,,,NF-PROVENTIL HFA INH SUSP 0.09MG/1ACT,50.98,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081812,0250,,,,,,NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,91.82,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081813,0250,,,,,,NF-VENTOLIN HFA INH SUSP 0.09MG/1ACT,12.26,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081814,0250,,,,,,NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,168.11,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081815,0250,,,,,,NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,153.98,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081816,0250,,,,,,NF-SYMBICORT INH AER LIQ 160MCG-4.5MCG/1,106.39,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081817,0250,,,,,,NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,91.82,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081818,0250,,,,,,NF-COMBIVENT INH AER PWD 103MCG-18MCG/1,91.82,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081819,0250,,,,,,NF-PROPAFENONE HCL CAP ER 425MG,40.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081820,0250,,,,,,NF-DILTIAZEM HCL CAPSULE 90MG,14.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081821,0250,,,,,,NF-MEMANTINE HCL ORAL TABLET 10MG,24.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081822,0250,,,,,,ALBUTEROL HFA INH SUSP 0.09MG/1ACT,12.50,12.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081823,0250,,,,,,IPRATROP/ALB RESP INH 100MCG-20MCG/ACT,20.50,20.50,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081824,0250,,,,,,NF-HYZAAR ORAL TABLET 50MG-12.5MG,8.19,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081825,0250,,,,,,NF-DONEPEZIL HCL ORAL TABLET 10MG,31.15,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081826,0250,,,,,,NF-VITAMIN E TABLET 100IU,0.24,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081827,0250,,,,,,INDOCYANINE GREEN INJ 25MG,520.50,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081828,0250,,,,,,NF-K-PHOS ORIGINAL TAB 500MG,2.22,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081829,0250,,,,,,NF-VIRT-GARD TAB 1MG-2.2MG-25MG,2.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081830,0250,,,,,,HALOPERIDOL DECAN 50MG/ML INJ,122.55,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081831,0250,,,,,,RAPID INTUBATION KIT,154.80,154.80,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081832,0250,,,,,,NF-FLECTOR PATCH ER 1.3%,101.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081835,0250,,,,,,NF-MORPHINE SULFATE CAP ER 20MG,21.43,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081836,0250,,,,,,NF-TIMOLOL MALEATE OPHTH GFS 0.5%,73.75,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081837,0250,,,,,,NF-DOXEPIN HCL CAP 10MG,0.81,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081838,0250,,,,,,NF-PROTEGRA ANTIOXIDANT CAPSULE,0.42,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081839,0250,,,,,,NF-GERITOL COMPLETE ORAL TABLET,0.36,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081840,0250,,,,,,NF-LETROZOLE AVPAK ORAL TAB 2.5MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081841,0250,,,,,,NF-ZINC ACETATE CAP 50MG,13.87,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081843,0250,,,,,,NF-PREDNISOLONE ACETATE OPHTH SUSP 0.12%,8.71,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081844,0250,,,,,,NF-ENTRESTO ORAL TABLET 24MG-26MG,43.58,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081845,0250,,,,,,NF-EFFEXOR XR EXTENDED RELEASE CAPSULE 7,29.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081846,0250,,,,,,NF-DILANTIN CAP ER 100MG,2.62,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081848,0250,,,,,,NF-FELODIPINE EXTENDED RELEASE TABLET 10,10.86,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081849,0250,,,,,,NF-CARTIA XT ORAL 24 HR CAP ER 240MG,8.20,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081851,0250,,,,,,NF-BICALUTAMIDE ORAL TABLET 50MG,65.86,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081852,0250,,,,,,NF-FELODIPINE ORAL TAB ER 10MG,10.86,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081853,0250,,,,,,NF-SUMATRIPTAN SUCCINATE ORAL TABLET 25M,108.21,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081855,0250,,,,,,NF-CINACALCET HCL ORAL TABLET 30MG,123.63,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081856,0250,,,,,,NF-MYRBETRIQ ORAL TABLET 50MG,64.81,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081857,0250,,,,,,NF-QUINAPRIL HCL TAB 10MG,15.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081858,0250,,,,,,NF-ISOSORBIDE MONONITRATE ORAL TAB ER 30,6.71,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081859,0250,,,,,,NF-LOTRIMIN AF TOPICAL POWDER 2%,0.28,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081860,0250,,,,,,NF-NORTRIPTYLINE HCL AVPAK CAP 10MG,2.26,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081861,0250,,,,,,NF-FELODIPINE EXTENDED RELEASE TABLET 5M,6.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081862,0636,,,,,,PAMIDRONATE INJ 30MG/10ML,139.32,139.32,15.98,15.98,15.98,15.98,,,,,,,,,
47081863,0250,,,,,,NF-LABETALOL HCL ORAL TABLET 300MG,4.08,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081864,0250,,,,,,NF-VENLAFAXINE HCL AVPAK TAB 50MG,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081865,0250,,,,,,NF-VENLAFAXINE HCL CAP ER 150MG,81.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081866,0250,,,,,,NF-VENLAFAXINE HCL ORAL TABLET 100MG,11.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081867,0250,,,,,,NF-ETHAMBUTOL HCL TAB 400MG,10.70,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081868,0250,,,,,,NF-RIFABUTIN CAP 150MG,18.60,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081869,0250,,,,,,NF-BIOTENE DRY MOUTH MOUTHWASH MM SOLUTI,0.05,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081870,0250,,,,,,NF-VITAL AF 1.2 CAL SUSP,0.13,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081871,0250,,,,,,NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG,16.68,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081872,0250,,,,,,NF-FLUVOXAMINE MALEATE ORAL TABLET 50MG,16.68,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081873,0250,,,,,,NF-FENOFIBRATE AVPAK ORAL TABLET 145MG,20.53,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081874,0250,,,,,,NF-LEVOCETIRIZINE DIHCL ORAL TABLET 5MG,12.31,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081875,0250,,,,,,NF-OXYMETAZOLINE HCL NASAL SPRAY 0.05%,1.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081876,0250,,,,,,NF-ELIQUIS TAB 5MG,37.67,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081877,0250,,,,,,NF-TIMOLOL MALEATE OPHTH SOLN 0.5%,15.35,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081878,0250,,,,,,NF-SILODOSIN CAP 4MG,35.85,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081879,0250,,,,,,NF-CLARINEX ORAL TABLET 5MG,35.04,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081880,0250,,,,,,NF-COQ10 ORAL CAPSULE 100MG,0.56,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081881,0250,,,,,,NF-ENALAPRIL MALEATE ORAL TABLET 2.5MG,5.83,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081882,0250,,,,,,NF-CELEXA TAB 20MG,45.41,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081883,0250,,,,,,NF-ZOCOR ORAL TABLET 40MG,38.69,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081884,0250,,,,,,NF-LEVOTHYROXINE SODIUM ORAL TABLET 175M,3.22,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081885,0250,,,,,,NF-EFFEXOR-XR CAP ER 150MG,44.29,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081886,0250,,,,,,NF-ZOLMITRIPTAN DISINTEGRATING TAB 5MG,620.93,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081887,0250,,,,,,NF-ZOLMITRIPTAN ORAL TABLET 5MG,224.16,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081889,0250,,,,,,NF-KRILL OIL ORAL LIQUID CAPSULE 500MG,0.96,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081890,0250,,,,,,NF-LOSARTAN AND HYDROCHLOROTHIAZIDE 100-,13.63,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081895,0250,,,,,,GABAPENTIN SOLN 250MG/5ML,34.00,34.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081896,0250,,,,,,ROCURONIUM 10MG/ML 5ML,45.15,45.15,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081897,0250,,,,,,NF-ZINC SULFATE CAP 220MG,0.48,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081898,0250,,,,,,REMDESIVIR IV SOLN 100MG/20ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081899,0250,,,,,,NF-REMDESIVIR IV SOLN 5MG/1ML,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081900,0250,,,,,,NF-FOLIC ACID AVPAK ORAL TABLET 0.4MG,1.10,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081901,0250,,,,,,NF-SYSTANE OPHTHALMIC OINTMENT 3%-94%,10.01,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081902,0250,,,,,,NF-CRANBERRY ORAL TABLET 450MG,0.14,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081903,0250,,,,,,NF-B COMPLEX TABLET,0.09,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081904,0250,,,,,,NF-GLIPIZIDE ER ORAL TAB ER 2.5MG,3.78,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081905,0250,,,,,,NF-CARTIA XT 24 HR CAP 180MG,6.66,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081906,0250,,,,,,NF-LUTEIN LIQUID FILLED CAPSULE 20MG,1.29,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081907,0250,,,,,,NF-PRESERVISION LUTEIN ORAL LIQUID CAPSU,0.76,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081908,0250,,,,,,NF-XOPENEX HFA INH/NEB AER PWD 0.045MG/1,21.84,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47081909,0250,,,,,,NF-HALDOL DECANOATE IM OIL 50MG/1ML,417.95,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47086654,0637,,,,,,LOSARTAN 50MG TAB (COZAAR),9.94,9.94,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
47086662,0637,,,,,,NEPRO 240 ML SUPPLEMENT,16.50,16.50,6.75,12.05,6.75,6.75,,,,,,,,12.05,12.05
4780303,0250,,,,,,RIFAXIMIN 200MG TAB (XIFAXAN),16.39,16.39,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
4780304,0250,,,,,,METHAZOLAMIDE 50MG,4.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
47999999,0250,,,,,,JUST LIKE TEMPLATE - ORAL,0.00,0.00,24.48,81.25,67.38,67.38,81.25,,,,34.16,,,24.48,24.48
53000001,0771,G0008,,,,,ADMIN OF FLU VIRUS VACCINE,10.25,0.00,,,,,,,,,,,,,
53000002,0636,90656,,,,,ADULT FLU PREFILLED SYRINGE,10.50,0.00,,,,,,,,,,,,,
53000003,0636,90655,,,,,PEDIATRIC PREFILLED SYRINGE,13.50,0.00,,,,,,,,,,,,,
53000004,0636,90662,,,,,INFLUENZA VIRUS VACCINE 65+,26.75,0.00,,,,,,,,,,,,,
53001000,0510,99211,,,,,O/P CLINCI VISIT LEVEL I,59.75,0.00,,,,,,,,,,,,,
58008910,0942,,,,,,INITIAL FOLLOW UP BPD-DS/PGD,0.00,0.00,67.39,67.39,67.39,67.39,,,,,,,,,
58008919,0942,97802,,,,,MNT INDIVIDUAL ASSESSMENT,67.99,67.99,31.14,31.14,,,,,,,31.14,,,,
58008921,0942,97803,,,,,MNT INDIVIDUAL FOLLOW-UP,60.78,60.78,,,,,,,,,,,,,
58008923,0942,97804,,,,,MNT GROUP ASSESSMENT,35.54,35.54,,,,,,,,,,,,,
58008924,0942,G0270,,,,,MNT INDIVIDUAL REASSESSMENT CHANGE COND,59.00,0.00,,,,,,,,,,,,,
58009814,0942,,,,,,CAL COUNT,11.50,0.00,67.39,67.39,67.39,67.39,,,,,,,,,
58009815,0270,,,,,,EXCHANGE LIST FOR WEIGHT MANAGEMENT,5.25,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
58009817,0270,,,,,,EXCHANGE LIST FOR MEAL PLANNING,6.50,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
58009818,0270,,,,,,FIRST STEP IN DIABETES MEAL PLANNING,2.50,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
60001000,0220,,,,,,TUBE FEEDING BOLUS,0.00,0.00,,,,,,,,,,,,,
60001006,0220,,,,,,ADA 1500,0.00,0.00,,,,,,,,,,,,,
60001007,0220,,,,,,ADA MECHANICAL SOFT 1500,0.00,0.00,,,,,,,,,,,,,
60001008,0220,,,,,,ADA PUREED 1500,0.00,0.00,,,,,,,,,,,,,
60001009,0220,,,,,,ADA 1500 2GM NA,0.00,0.00,,,,,,,,,,,,,
60001010,0220,,,,,,ADA 1800,0.00,0.00,,,,,,,,,,,,,
60001012,0220,,,,,,ADA PUREED 1800,0.00,0.00,,,,,,,,,,,,,
60001013,0220,,,,,,ADA 1800 2 GM NA,0.00,0.00,,,,,,,,,,,,,
60001018,0220,,,,,,CONSISTENT CARB MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001021,0220,,,,,,CONSISTENT CARB 2 GM NA MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001022,0220,,,,,,CONSISTENT CARB 2 GM NA PUREED,0.00,0.00,,,,,,,,,,,,,
60001023,0220,,,,,,FLUID RESTRICTED,0.00,0.00,,,,,,,,,,,,,
60001024,0220,,,,,,FLUID RESTRICTED MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001025,0220,,,,,,FLUID RESTRICTED PUREED,0.00,0.00,,,,,,,,,,,,,
60001026,0220,,,,,,GLUTEN FREE,0.00,0.00,,,,,,,,,,,,,
60001027,0220,,,,,,GLUTEN FREE MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001028,0220,,,,,,GLUTEN FREE PUREED,0.00,0.00,,,,,,,,,,,,,
60001029,0220,,,,,,HEALTHY HEART,0.00,0.00,,,,,,,,,,,,,
60001030,0220,,,,,,HEALTHY HEART MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001031,0220,,,,,,HEALTHY HEART PUREED,0.00,0.00,,,,,,,,,,,,,
60001032,0220,,,,,,LACTOSE FREE,0.00,0.00,,,,,,,,,,,,,
60001033,0220,,,,,,LACTOSE FREE MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001034,0220,,,,,,LACTOSE FREE PUREED,0.00,0.00,,,,,,,,,,,,,
60001035,0220,,,,,,LOW CHOLESTEROL,0.00,0.00,,,,,,,,,,,,,
60001036,0220,,,,,,LOW CHOLESTEROL MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001037,0220,,,,,,LOW CHOLESTEROL PUREED,0.00,0.00,,,,,,,,,,,,,
60001038,0220,,,,,,LOW FAT,0.00,0.00,,,,,,,,,,,,,
60001039,0220,,,,,,LOW FAT MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001040,0220,,,,,,LOW FAT PUREED,0.00,0.00,,,,,,,,,,,,,
60001041,0220,,,,,,2 GRAM NA,0.00,0.00,,,,,,,,,,,,,
60001042,0220,,,,,,2 GRAM NA MECHANICAL,0.00,0.00,,,,,,,,,,,,,
60001043,0220,,,,,,2 GRAM NA PUREED,0.00,0.00,,,,,,,,,,,,,
60001044,0220,,,,,,RENAL,0.00,0.00,,,,,,,,,,,,,
60001045,0220,,,,,,RENAL MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001046,0220,,,,,,RENAL PUREED,0.00,0.00,,,,,,,,,,,,,
60001047,0220,,,,,,LOW RESIDUE,0.00,0.00,,,,,,,,,,,,,
60001048,0220,,,,,,LOW RESIDUE MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001049,0220,,,,,,LOW RESIDUE PUREED,0.00,0.00,,,,,,,,,,,,,
60001050,0220,,,,,,FULL LIQUID,0.00,0.00,,,,,,,,,,,,,
60001051,0220,,,,,,CLEAR LIQUID,0.00,0.00,,,,,,,,,,,,,
60001052,0220,,,,,,NCS RESTRICTED CONCENTRATED SWEETS,0.00,0.00,,,,,,,,,,,,,
60001053,0220,,,,,,NCS MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001054,0220,,,,,,NCS PUREED,0.00,0.00,,,,,,,,,,,,,
60001055,0220,,,,,,NCS 2 GM NA,0.00,0.00,,,,,,,,,,,,,
60001056,0220,,,,,,NCS 2 GM NA MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001057,0220,,,,,,NCS 2 GM NA PUREED,0.00,0.00,,,,,,,,,,,,,
60001058,0220,,,,,,60 GM PRO 2 GM NA,0.00,0.00,,,,,,,,,,,,,
60001059,0220,,,,,,60 GM PRO 2 GM NA MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001060,0220,,,,,,60 GM PRO 2 GM NA PUREED,0.00,0.00,,,,,,,,,,,,,
60001061,0220,,,,,,VEGETARIAN LACTO OVO,0.00,0.00,,,,,,,,,,,,,
60001062,0220,,,,,,VEGETARIAN LACTO OVO MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001063,0220,,,,,,VEGETARIAN LACTO OVO PUREED,0.00,0.00,,,,,,,,,,,,,
60001064,0220,,,,,,HI CAL HI PRO,0.00,0.00,,,,,,,,,,,,,
60001065,0220,,,,,,HI CAL HI PRO MECHANICAL SOFT,0.00,0.00,,,,,,,,,,,,,
60001066,0220,,,,,,HI CAL HI PRO PUREED,0.00,0.00,,,,,,,,,,,,,
60001067,0220,,,,,,REGULAR MECHANICAL DIET,0.00,0.00,,,,,,,,,,,,,
60001068,0220,,,,,,REGULAR PUREE,0.00,0.00,,,,,,,,,,,,,
60001069,0220,,,,,,REGULAR,0.00,0.00,,,,,,,,,,,,,
60001070,0220,,,,,,TUBE FEEDING CONTINUOUS,0.00,0.00,,,,,,,,,,,,,
60009815,0510,,,,,,EXCHANGE LIST FOR WEIGHT MANAGEMENT,5.00,0.00,141.66,141.66,141.66,141.66,,,,,,,,,
60009817,0510,,,,,,EXCHANGE LIST FOR MEAL PLANNING,6.00,0.00,141.66,141.66,141.66,141.66,,,,,,,,,
60009992,0220,,,,,,DIETARY SUPPLEMENT,0.00,0.00,,,,,,,,,,,,,
60009993,0220,,,,,,DIETARY TUBE FEED/TPN ORDER,0.00,0.00,,,,,,,,,,,,,
60009994,0220,,,,,,DIET SPECIAL INSTRUCTIONS,0.00,0.00,,,,,,,,,,,,,
60009997,0220,,,,,,FOOD/BEVERAGE PREFERENCE,0.00,0.00,,,,,,,,,,,,,
60009998,0220,,,,,,GUEST TRAY,0.00,0.00,,,,,,,,,,,,,
60009999,0220,,,,,,=>DIET ORDER<=,0.00,0.00,,,,,,,,,,,,,
90909099,0320,,,,,,tester,0.00,0.00,0.00,326.23,326.23,326.23,,,,,,,,0.00,0.00
9898989,0320,77080,,,,,DXA BONE DENSITY STUDY,0.00,0.00,115.58,230.25,,,230.25,,,,115.70,,,115.58,115.58
9999888,0636,90669,,,,,Craneware Test Charge,704.42,687.24,,,,,,,,,,,,,
99999903,0270,,,,,,MISC - HELPING HANDS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
99999912,0270,,,,,,MISC - ANESTHESIOLOGY,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
99999914,0270,,,,,,MISC - EMERGENCY ROOM,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
99999928,0270,,,,,,MISC - RENEWED HOPE,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
99999961,0270,,,,,,MISC - PLANT OPERATIONS,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
99999966,0270,,,,,,MISC - HOUSEKEEPING,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
99999982,0270,,,,,,WORKMENS COMP,0.00,0.00,8.29,20.00,20.00,20.00,,,,,8.29,,,11.65,11.65
9999999,0275,C1785,,,,,Craneware Test Charge 1,11700.00,11700.00,,,,,,,,,,,,,