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) 10001712,0360,55250,,,,,VASECTOMY,5644.23,5644.23,,,,,,,,,,,,, 10002119,0360,69990,,,,,OPERATING MICROSCOPE ADD ON,3826.16,3826.16,,,,,,,,,,,,, 10002120,0360,69990,,,,,OPERATING MICROSCOPE ADD ON,3826.16,3826.16,,,,,,,,,,,,, 10003004,0750,91110,,,,,PILLCAM PLACEMENT,2682.54,2682.54,,,,,,,,,,,,, 10003005,0761,99211,,,,,ASD NURSING SERVICE,191.13,191.13,63.77,64.98,,,,,,,63.77,,,64.98,64.98 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 4,26624.17,26624.17,9052.22,9052.22,,,,,,,9052.22,,,, 10003161,0278,C1880,,,,,INFERIOR VENA CAVA FILTER,9098.10,9098.10,,,,,,,,,,,,, 10005617,0480,51798,,,,,US PV RESIDUAL URINE BLDR SCAN,187.37,187.37,63.71,63.71,,,,,,,63.71,,,63.71,63.71 10007010,0920,91035,,,,,BRAVO PH MONITORING,1650.50,1650.50,285.23,614.39,,,,,,,285.23,,,614.39,614.39 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,1657.51,1657.51,550.12,784.85,,,,,,,550.12,,,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,,,,,,,,,,,,, 10008052,0360,46930,,,,,DESTRUCTION INTERNAL HEMORRHOID THERMAL,3344.27,3344.27,,,,,,,,,,,,, 1007204,0762,G0378,,,,,LEVEL 1 OBSERVATION EACH ADDL HR,49.20,49.20,20.77,25.00,,,,,,,20.77,,,25.00,25.00 1007205,0762,G0378,,,,,LEVEL 2 OBSERVATION EACH ADDL HR,71.75,71.75,20.77,25.00,,,,,,,20.77,,,25.00,25.00 1007210,0762,G0378,,,,,LEVEL 1 OBSERVATION FIRST HR,256.25,256.25,20.77,25.00,,,,,,,20.77,,,25.00,25.00 1007211,0762,G0378,,,,,LEVEL 2 OBSERVATION FIRST HR,333.13,333.13,20.77,25.00,,,,,,,20.77,,,25.00,25.00 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,109.47,109.47,7.18,13.19,,,13.19,,,,7.18,,,10.78,10.78 1007224,0391,36430,,,,,TRANSFUSION BLOOD PRODUCTS,1168.97,1168.97,398.02,792.20,,,,,,,398.02,,,792.20,792.20 1007225,0260,96360,,,,,HYDRATION IV INFUSION INIT 31-60 MINS,400.73,400.73,133.49,277.32,,,,,,,133.49,,,277.32,277.32 1007226,0260,96361,,,,,HYDRATE IV INFUSION ADD-ON,210.16,210.16,71.43,84.57,,,,,,,71.43,,,84.57,84.57 1007227,0260,96365,,,,,THER/PROPH/DIAG IV INF INIT =<1 HR,579.84,579.84,197.55,252.93,,,,,,,197.55,,,252.93,252.93 1007228,0260,96366,,,,,THER/PROPH/DIAG IV INF ADDON,210.16,210.16,71.48,112.28,,,,,,,71.48,,,112.28,112.28 1007230,0260,96375,,,,,"IV PUSH, SEQUENTIAL, NEW DRUG",174.62,174.62,58.68,72.20,,,,,,,58.68,,,72.20,72.20 1007235,0762,G0379,,,,,DIRECT REFERRAL FOR OBSERVATION SVCS,1649.65,1649.65,,,,,,,,,,,,, 1007401,0260,96372,,,,,INJECTION SC/IM,145.20,145.20,45.80,49.01,,,,,,,49.01,,,45.80,45.80 1007402,0260,96374,,,,,"IV PUSH, INITIAL",309.37,309.37,105.22,151.07,,,,,,,105.22,,,151.07,151.07 1007403,0260,96376,,,,,"IV PUSH, SEQUENTIAL, SAME DRUG+30 MIN",174.62,174.62,59.40,60.83,,,,,,,59.40,,,60.83,60.83 1007500,0480,92950,,,,,CARDIOPULMONARY RESUSCITATION,756.20,756.20,,,,,,,,,,,,, 1007501,0300,82272,,,,,HEMOCCULT,16.10,16.10,,,,,,,,,,,,, 1007502,0761,51702,,,,,FOLEY CATHETER INSERTION,305.29,305.29,103.94,103.94,,,,,,,103.94,,,, 1007503,0761,51701,,,,,STRAIGHT CATHETERIZATION,312.92,312.92,,,,,,,,,,,,, 1007504,0300,82948,,,,,CAPILLARY BLOOD GLUCOSE,26.39,26.39,8.73,9.01,,,,,,,8.73,,,9.01,9.01 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,145.20,145.20,48.93,48.93,,,,,,,48.93,,,, 1007508,0260,96367,,,,,TX/PROPH/DG ADDL SEQ IV INF,210.16,210.16,71.41,71.98,,,,,,,71.41,,,71.98,71.98 1007510,0771,90472,,,,,IMMUNIZATION ADMIN EA ADDL,85.77,85.77,,,,,,,,,,,,, 1080000,0960,99211GF,,,,,OFFICE VISIT ESTABLISHED LEVEL 1,32.00,32.00,,,,,,,,,,,,, 1080004,0335,96409,,,,,CHEMO ADMINISTRATION INTRAVENOUS PUSH,148.75,148.75,,,,,,,,,,,,, 1090000,0761,99211,,,,,"OP VISIT, EST PT, LEVEL 1",191.13,191.13,63.77,64.98,,,,,,,63.77,,,64.98,64.98 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,400.73,400.73,133.49,277.32,,,,,,,133.49,,,277.32,277.32 1090103,0260,96361,,,,,HYDRATE IV INFUSION ADD-ON,210.16,210.16,71.43,84.57,,,,,,,71.43,,,84.57,84.57 1090104,0260,96365,,,,,THER/PROPH/DIAG IV INF INIT =<1 HR,579.84,579.84,197.55,252.93,,,,,,,197.55,,,252.93,252.93 1090105,0260,96366,,,,,THER/PROPH/DIAG IV INF ADDON,210.16,210.16,71.48,112.28,,,,,,,71.48,,,112.28,112.28 1090106,0260,96374,,,,,THER/PROPH/DIAG INJ IV PUSH,309.37,309.37,105.22,151.07,,,,,,,105.22,,,151.07,151.07 1090107,0510,96376,,,,,TX/PRO/DX INJ SAME DRUG ADDON,122.08,122.08,99.62,99.62,,,,,,,,,,99.62,99.62 1090108,0260,96375,,,,,"IV PUSH, SEQUENTIAL, NEW DRUG",141.66,141.66,58.68,72.20,,,,,,,58.68,,,72.20,72.20 1090109,0771,90471,,,,,IMMUNIZATION ADMIN 1 VACCINE,145.20,145.20,48.93,48.93,,,,,,,48.93,,,, 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,26.39,26.39,8.81,8.95,,,,,,,8.81,,,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",210.16,210.16,71.41,71.98,,,,,,,71.41,,,71.98,71.98 1090121,0771,90472,,,,,IMMUNIZATION ADMINISTRATION EA ADDL,85.77,85.77,,,,,,,,,,,,, 1090122,0761,G0463,,,,,Hosp OP Clinic Visit - MC,192.30,192.30,65.27,65.38,,,,,,,65.27,,,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,124.23,124.23,21.76,21.76,,,,,,,21.76,,,, 12000016,0964,01916,,,,,ANESTH DX ARTERIOGRAPHY,124.23,124.23,22.12,22.12,,,,,,,22.12,,,, 12000017,0963,01916,,,,,ANESTH DX ARTERIOGRAPHY,155.29,155.29,,,,,,,,,,,,, 12000018,0964,00731,,,,,ANES UPR GI NDSC PX NOS,124.23,124.23,19.33,19.33,,,,,,,19.33,,,, 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,124.23,124.23,26.29,26.29,,,,,,,26.29,,,, 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,124.23,124.23,15.92,15.92,,,,,,,15.92,,,, 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,124.23,124.23,9.79,9.79,,,,,,,9.79,,,, 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,124.23,124.23,0.02,41.66,,,0.02,,,,41.66,,,, 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,,,,,,,,,,,,, 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,124.23,124.23,41.75,41.75,,,,,,,41.75,,,, 12000043,0963,01270,,,,,ANESTH THIGH ARTERIES SURG,155.29,155.29,,,,,,,,,,,,, 12000044,0964,01270,,,,,ANESTH THIGH ARTERIES SURG,124.23,124.23,14.72,14.72,,,,,,,14.72,,,, 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,124.23,124.23,15.29,15.29,,,,,,,15.29,,,, 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,124.23,124.23,41.80,41.80,,,,,,,41.80,,,, 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,,,,,,,,,,,,, 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,124.23,124.23,18.30,18.30,,,,,,,18.30,,,, 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,124.23,124.23,42.24,42.24,,,,,,,42.24,,,, 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,124.23,124.23,41.33,41.33,,,,,,,41.33,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 12000318,0964,01638,,,,,ANESTH SHOULDER REPLACEMENT,124.23,124.23,,,,,,,,,,,,, 14000013,0450,96375,,,,,"IV PUSH, SEQUENTIAL, NEW DRUG",141.66,141.66,0.00,70.58,,,0.00,,,,48.18,,,70.58,70.58 14000014,0450,96372,,,,,INJECTION SC/IM,145.20,145.20,0.00,92.93,,,0.00,,,,48.63,,,92.93,92.93 14000015,0450,96360,,,,,"HYDRATION IV,INITIAL,31MIN TO 1HR",400.73,400.73,134.28,136.84,,,,,,,134.28,,,136.84,136.84 14000016,0450,96361,,,,,"HYDRATION IV, ADDL HR",210.16,210.16,0.00,101.31,,,0.00,,,,71.53,,,101.31,101.31 14000017,0450,96365,,,,,"IV INFUSION, INITIAL, UP TO 1 HR",579.84,579.84,197.38,228.95,,,,,,,197.38,,,228.95,228.95 14000018,0450,96366,,,,,"IV INFUSION, ADDL HR",210.16,210.16,71.10,71.10,,,,,,,71.10,,,, 14000019,0450,96374,,,,,"IV PUSH, INITIAL",309.37,309.37,0.00,166.13,,,0.00,,,,105.19,,,166.13,166.13 14000020,0450,96376,,,,,"IV PUSH, SEQUENTIAL, SAME DRUG",174.62,174.62,0.00,91.33,,,0.00,,,,59.41,,,91.33,91.33 14000021,0450,96368,,,,,"IV INFUSION, CONCURRENT",131.10,131.10,,,,,,,,,,,,, 14000040,0450,96367,,,,,"IV INFUSION, SEQUENT, UP TO 1 HR",210.16,210.16,71.16,106.20,,,,,,,71.16,,,106.20,106.20 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 25,5403.72,5403.72,1832.94,1832.94,,,,,,,1832.94,,,, 14000059,0761,15276,,,,,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADD,1677.00,1677.00,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14000601,0450,10061,,,,,I&D ABSCESS:COMPLIC/MX,783.40,783.40,,,,,,,,,,,,, 14000602,0450,56405,,,,,I&D ABSCESS; PERINEUM,946.37,946.37,,,,,,,,,,,,, 14000605,0450,26412,,,,,REP ET HAND; W FG EA TENDON,9077.39,9077.39,,,,,,,,,,,,, 14001186,0300,36415,,,,,ROUTINE VENIPUNCTURE,109.47,109.47,7.18,13.19,,,13.19,,,,7.18,,,10.78,10.78 14003010,0450,36591,,,,,"COLLECT BLOOD, COMPL IMPLANT VAD",312.92,312.92,103.38,103.38,,,,,,,103.38,,,, 14003044,0450,11420,,,,,EXC BEN LES SCALP; 0.5 CM/LESS,3153.90,3153.90,,,,,,,,,,,,, 14003284,0450,20552,,,,,INJ TRIGGER POINT 1/2 MUSCL,773.43,773.43,,,,,,,,,,,,, 14003287,0450,11730,,,,,AVULS OF NAIL PLATE PART OR COMPL SIMPLE,394.52,394.52,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14006004,0450,10120,,,,,INCS & REMOV FB SUBQ TISS; SIMPL,755.17,755.17,,,,,,,,,,,,, 14006007,0450,10160,,,,,PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,765.62,765.62,,,,,,,,,,,,, 14006040,0450,11402,,,,,EXC TR-EXT B9+MARG 1.1-2 CM,2031.33,2031.33,,,,,,,,,,,,, 14006079,0450,11740,,,,,EVACUATION SUBUNGUAL HEMATOMA,187.14,187.14,,,,,,,,,,,,, 14006080,0450,11750,,,,,EXC NAIL/MATRIX PART/COMPLT PERM,783.40,783.40,,,,,,,,,,,,, 14006083,0450,11760,,,,,REPR NAIL BED,1554.97,1554.97,,,,,,,,,,,,, 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,,,, 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,,,,,,,,,,,,, 14006101,0450,12015,,,,,SIMPL REPR FACE/MUCOUS 7.60-12.50CM,394.52,394.52,134.14,134.14,,,,,,,134.14,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14006121,0450,12054,,,,,INTMD WND REPAIR FACE/MM 7.6-12.5 CM,1045.88,1045.88,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14006165,0450,16020,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES SM,404.38,404.38,,,,,,,,,,,,, 14006212,0450,20103,,,,,EXPLO PENTR WOUND (SEP PRO); EXTREM,1965.94,1965.94,,,,,,,,,,,,, 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,,,, 14006278,0450,23650,,,,,CLO TX SHLDR DISLOC W/MANIP;WO ANES,576.98,576.98,,,,,,,,,,,,, 14006310,0450,24640,,,,,CL TX NURSEMAID ELBOW W MANIP,737.50,737.50,,,,,,,,,,,,, 14006338,0450,25565,,,,,CL TX RADIAL & ULNA FX W MANIP,4541.95,4541.95,,,,,,,,,,,,, 14006340,0450,25605,,,,,CLOSED TREATMENT DISRAL RADIAL FRACTURE,4176.23,4176.23,,,,,,,,,,,,, 14006351,0450,26010,,,,,DRAINAGE FINGER ABSCESS; SIMPL,261.84,261.84,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14006417,0450,27560,,,,,CLO TX PATELLAR DISLOC; WO ANES,685.78,685.78,,,,,,,,,,,,, 14006442,0450,27818,,,,,CLO TX TRIMALLEOLAR ANK FX; W/MANIP,4178.01,4178.01,,,,,,,,,,,,, 14006472,0450,28495,,,,,CL TX FX GT PHALANX(S); W MANIP,685.78,685.78,,,,,,,,,,,,, 14006500,0450,29065,,,,,APPLY LONG ARM CAST,798.34,798.34,,,,,,,,,,,,, 14006501,0450,29075,,,,,APPLIC; ELBOW TO FINGER,713.41,713.41,,,,,,,,,,,,, 14006503,0450,29105,,,,,APPLIC; LONG ARM SPLINT,429.33,429.33,,,,,,,,,,,,, 14006504,0450,29125,,,,,APPLIC; SHORT ARM SPLINT; STATOC,312.92,312.92,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14006512,0450,29425,,,,,APPLIC SHORT LEG CAST,814.31,814.31,,,,,,,,,,,,, 14006518,0450,29505,,,,,APPLIC LONG LEG SPLINT,419.02,419.02,,,,,,,,,,,,, 14006519,0450,29515,,,,,APPLIC SHORT LEG SPLINT,409.21,409.21,,,,,,,,,,,,, 14006521,0450,29705,,,,,REMOV/BIVALV; FULL ARM/LEG CAST,713.41,713.41,,,,,,,,,,,,, 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,,,, 14006543,0450,30901,,,,,CONTROL NASAL HEMORR ANT SIMP,334.88,334.88,113.86,113.86,,,,,,,113.86,,,113.86,113.86 14006750,0450,46083,,,,,INCS THROMBOSED HEMORRHOID EXT,787.71,787.71,,,,,,,,,,,,, 14006846,0450,62270,,,,,SPINAL PUNCT LUMBAR DX,1698.14,1698.14,,,,,,,,,,,,, 14006870,0450,64450,,,,,INJ ANES AGENT; OTHER PERIPHERAL,1740.59,1740.59,,,,,,,,,,,,, 14006884,0450,65205,,,,,REMOV FB EXT EYE; CONJUNC SUPERF,332.24,332.24,,,,,,,,,,,,, 14006886,0450,65220,,,,,REMOV FB EXT EYE;CORNEAL WO LAMP,361.14,361.14,,,,,,,,,,,,, 14006890,0450,67938,,,,,REMOV EMBEDDED FB EYELID,921.41,921.41,,,,,,,,,,,,, 14006891,0450,30906,,,,,CTRL POST EPISTAX SQ,693.57,693.57,,,,,,,,,,,,, 14006896,0450,69000,,,,,DRAIN EXT EAR ABSCESS; SIMPL,1949.22,1949.22,,,,,,,,,,,,, 14006899,0981,69000,,,,,DRAIN EXT EAR ABSCESS; SIMPL,516.08,516.08,,,,,,,,,,,,, 14006922,0771,90471,,,,,"IMMUN ADMIN, ONE VACCINE",145.20,145.20,48.93,48.93,,,,,,,48.93,,,, 14006923,0771,G0009,,,,,ADMIN PNEUMONIA VACCINE- MC,145.20,145.20,,,,,,,,,,,,, 14006927,0771,90472,,,,,IMMUNIZATION ADMIN EA ADDL,85.77,85.77,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14007003,0761,46040,,,,,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,3427.65,3427.65,,,,,,,,,,,,, 14007062,0450,99281,,,,,"ER VISIT, LEVEL 1",203.51,203.51,68.73,135.61,,,135.61,,,,68.73,,,104.57,104.57 14007063,0450,99282,,,,,"ER VISIT, LEVEL 2",375.80,375.80,126.23,251.10,,,251.10,,,,126.23,,,190.57,190.57 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",2230.78,2230.78,756.08,769.62,,,,,,,756.08,,,769.62,769.62 14007070,0450,99292,,,,,"CRITICAL CARE, ADDL 30 MIN",1086.05,1086.05,357.29,357.29,,,,,,,357.29,,,, 14007074,0300,82272,,,,,"OCCULT BLOOD, FECES, SINGLE-DIAGNOSTIC",16.11,16.11,,,,,,,,,,,,, 14008001,0450,12041,,,,,INTMD WND REPAIR N-HF/GENIT,879.30,879.30,,,,,,,,,,,,, 14008004,0300,86580,,,,,TB INTERDERMAL TEST,43.59,43.59,,,,,,,,,,,,, 14008006,0450,92977,,,,,THROMBOLYSIS CORONARY; IV INFUSION,685.68,685.68,,,,,,,,,,,,, 14008013,0450,51701,,,,,CATH URETHRA; SIMPL,312.92,312.92,105.43,105.43,,,,,,,105.43,,,, 14008014,0300,82962,,,,,"GLUCOSE,QUANT,BLD REAGENT STRP",26.39,26.39,8.81,8.95,,,,,,,8.81,,,8.95,8.95 14008019,0450,51702,,,,,INSERTION TEMPORARY INDWELLING BLADDER,305.29,305.29,104.17,104.41,,,,,,,104.17,,,104.41,104.41 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14010002,0981,10060,,,,,I&D ABCESS; SIMPL/SNGL,376.51,376.51,,,,,,,,,,,,, 14010003,0981,10061,,,,,I&D ABSCESS:COMPLIC/MX,738.11,738.11,,,,,,,,,,,,, 14010006,0981,10120,,,,,INCS & REMOV FB SUBQ TISS; SIMPL,415.17,415.17,,,,,,,,,,,,, 14010009,0981,10160,,,,,PUNCT ASPIR ABSCES/HEMAT/BULL/CYST,366.62,366.62,,,,,,,,,,,,, 14010033,0981,11402,,,,,EXC TR-EXT B9+MARG 1.1-2 CM,368.00,368.00,,,,,,,,,,,,, 14010037,0981,11420,,,,,EXC BEN LES SCALP; 0.5 CM/LESS,350.27,350.27,,,,,,,,,,,,, 14010051,0981,11730,,,,,AVULS OF NAIL PLATE PART OR COMPL SIMPLE,138.05,138.05,,,,,,,,,,,,, 14010053,0981,11740,,,,,EVACUATION SUBUNGUAL HEMATOMA,96.09,96.09,,,,,,,,,,,,, 14010054,0981,11750,,,,,EXC NAIL/MATRIX PART/COMPLT PERM,783.40,783.40,,,,,,,,,,,,, 14010057,0981,11760,,,,,REPR NAIL BED,515.31,515.31,,,,,,,,,,,,, 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,,,, 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,,,,,,,,,,,,, 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 14010078,0981,12054,,,,,LAYER CLO FACE/LIPS; 7.6 TO 12.5CM,997.00,997.00,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14010089,0981,16020,,,,,DSG/DEBRID INIT/SUBSQT; WO ANES SM,261.88,261.88,,,,,,,,,,,,, 14010091,0981,16030,,,,,DRS&/DBRDMT PRTL-THKNS BURNS 1,655.74,655.74,,,,,,,,,,,,, 14010100,0981,20103,,,,,EXPLO PENTR WOUND (SEP PRO); EXTREM,3871.81,3871.81,,,,,,,,,,,,, 14010103,0981,20552,,,,,INJ TRIGGER POINT 1/2 MUSCL,223.55,223.55,,,,,,,,,,,,, 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,,,, 14010118,0981,23650,,,,,CLO TX SHLDR DISLOC W/MANIP;WO ANES,583.61,583.61,,,,,,,,,,,,, 14010126,0981,24640,,,,,CL TX NURSEMAID ELBOW W MANIP,503.70,503.70,,,,,,,,,,,,, 14010134,0981,25565,,,,,CL TX RADIAL & ULNA FX W MANIP,4541.95,4541.95,,,,,,,,,,,,, 14010136,0981,25605,,,,,CLOSED TREATMENT DISRAL RADIAL FRACTURE,2029.54,2029.54,,,,,,,,,,,,, 14010139,0450,26010,,,,,DRAINAGE FINGER ABSCESS; SIMPL,239.37,239.37,,,,,,,,,,,,, 14010142,0981,26418,,,,,ER REPAIR EXT. TENDON FINGER PRI/SEC,2783.50,2783.50,,,,,,,,,,,,, 14010152,0981,26770,,,,,CLO TX IP JT DISLOC W/WMANIP; WO ANES,1012.66,1012.66,,,,,,,,,,,,, 14010155,0981,27560,,,,,CLO TX PATELLAR DISLOC; WO ANES,1365.35,1365.35,,,,,,,,,,,,, 14010163,0981,27818,,,,,CLO TX TRIMALLEOLAR ANK FX; W/MANIP,2146.76,2146.76,,,,,,,,,,,,, 14010175,0981,29065,,,,,APPLY LONG ARM CAST,579.23,579.23,,,,,,,,,,,,, 14010176,0981,29075,,,,,APPLIC; ELBOW TO FINGER,362.19,362.19,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14010189,0981,29705,,,,,REMOV/BIVALV; FULL ARM/LEG CAST,312.56,312.56,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14010209,0981,36620,,,,,ART CATH-SAMPL (SEP PRO); PERG,327.34,327.34,,,,,,,,,,,,, 14010223,0981,46083,,,,,INCS THROMBOSED HEMORRHOID EXT,762.39,762.39,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14010236,0981,56405,,,,,I&D ABSCESS; PERINEUM,442.44,442.44,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14010242,0981,65220,,,,,REMOV FB EXT EYE;CORNEAL WO LAMP,167.14,167.14,,,,,,,,,,,,, 14010246,0981,69200,,,,,REM FB EXT AUDITORY CANAL; WO ANESTH,334.73,334.73,,,,,,,,,,,,, 14010252,0981,67938,,,,,REMOVE EMBEDDED FB EYLID,887.00,887.00,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14010262,0981,12001,,,,,SIMPL REPR SCLP/TRUNK; 2.5 CM/LESS,256.78,256.78,52.50,52.50,,,,,,,52.50,,,, 14010267,0981,17250,,,,,CHEMICAL CAUTERIZATION PRO FEE,146.00,146.00,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 14020192,0981,30300,,,,,REMOV FB INTRANASAL; RIGHT,553.00,553.00,,,,,,,,,,,,, 14020229,0981,51701,,,,,INSERT BLADDER CATHETER,195.78,195.78,,,,,,,,,,,,, 14020246,0450,69200,,,,,REM FB EXT AUDITORY CANAL; WO ANESTH,360.44,360.44,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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 2,244.72,244.72,0.00,49.27,,,,,,,49.27,,,0.00,0.00 14099283,0981,99283,,,,,ER PHYSICIAN LEVEL 3,361.14,361.14,0.00,74.07,,,,,,,74.07,,,0.00,0.00 14099284,0981,99284,,,,,ER PHYSICIAN LEVEL 4,517.42,517.42,0.00,136.18,,,,,,,136.18,,,0.00,0.00 14099285,0981,99285,,,,,ER PHYSICIAN LEVEL 5,770.06,770.06,197.76,197.76,,,,,,,197.76,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16000002,0270,A4389,,,,,BAG OSTOMY 1 3/4 DRAINABLE,20.50,20.50,,,,,,,,,,,,, 16000036,0272,A4344,,,,,CATH SILICONE 16FR 5CC,22.44,22.44,,,,,,,,,,,,, 16000038,0272,A4344,,,,,CATH SILICONE 18FR 5CC,20.50,20.50,,,,,,,,,,,,, 16000041,0272,A4344,,,,,CATH SILICONE 24FR 5CC,20.50,20.50,,,,,,,,,,,,, 16000044,0272,A4344,,,,,CATH SILICONE 28FR 5CC,20.50,20.50,,,,,,,,,,,,, 16000061,0270,A4371,,,,,POWDER PREMIUM (OSTOMY CARE),20.50,20.50,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16000186,0278,C1768,,,,,GRAFT HEMASHIELD GOLD 20MMX10MMXL40CM,3122.08,3122.08,,,,,,,,,,,,, 16000187,0278,C1768,,,,,GRAFT HEMASHIELD GOLD 22MMX11MMXL40CM,2730.56,2730.56,,,,,,,,,,,,, 16000194,0272,A6262,,,,,MEDIFIL PARTICLES COLLAGEN 1GR,77.71,77.71,,,,,,,,,,,,, 16000195,0278,C1781,,,,,MESH FLAT SHEET 6X6,654.32,654.32,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000196,0278,C1781,,,,,PHASIX PLUG AND PATCH,758.14,758.14,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000197,0278,C1781,,,,,PROLENE HERNIA SYSTEM MESH,1757.79,1757.79,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000198,0278,C1781,,,,,PHASIX MESH 3x4,6979.99,6979.99,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000200,0278,C1757,,,,,CATH FOGARTY ART EMB 4FR 80 LATEX FREE,190.01,190.01,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000201,0278,C1757,,,,,CATH FOGARTY ART EMB 3 FR LATEX FREE,191.02,191.02,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000202,0278,C1757,,,,,CATH ART EMB 3 FR,187.80,187.80,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000203,0278,C1757,,,,,CATH ANGIOGRAPHIC 4FR BERN 65CM,58.84,58.84,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000204,0278,C1757,,,,,CATH ART EMB 4FR 80,187.80,187.80,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000205,0278,C1781,,,,,PHASIX MESH 4x6,9352.16,9352.16,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000206,0278,C1757,,,,,CATH ART EMBOLECTOMY 5FR,187.73,187.73,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000207,0278,C1781,,,,,MESH PROLENE 3.0 X 6.,384.29,384.29,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000208,0278,C1781,,,,,MESH PROLENE 12 X 12,400.88,400.88,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000209,0278,C1781,,,,,MESH OVAL 4X6,1218.75,1218.75,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000210,0278,C1781,,,,,PHASIX MESH 6X8,15359.39,15359.39,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 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 8x10,25940.31,25940.31,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000215,0278,C1768,,,,,GRAFT THIN WALL 8MMX60CM,4242.61,4242.61,,,,,,,,,,,,, 16000218,0278,C1781,,,,,SURGIMESH XB,5631.78,5631.78,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000219,0278,C1757,,,,,CATH ART EMB,190.01,190.01,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000220,0278,C1768,,,,,GRAFT VASC 6MM 40CM,2518.94,2518.94,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16000225,0278,C1781,,,,,PHASIX MESH 10x12,50242.28,50242.28,630.48,3726.72,,,,,,,630.48,,,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,26384.02,26384.02,630.48,3726.72,,,,,,,630.48,,,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,199.30,199.30,243.37,248.02,,,,,,,243.37,,,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,,,,,,,,,,,,, 16000294,0278,C1769,,,,,GUIDE WIRE 7.5 35-480,354.97,354.97,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16000474,0278,C1769,,,,,GUIDE WIRE PC ROADRUNNER,204.87,204.87,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16000478,0278,C1769,,,,,GUIDE WIRE ROADRUNNER .018 300CM,563.18,563.18,100.91,131.80,,,,,,,100.91,,,131.80,131.80 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,8574.62,8574.62,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000531,0278,C1874,,,,,STENT ICAST 6MMX59MMX80CM,9240.61,9240.61,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000532,0278,C1874,,,,,STENT ICAST 10MMX38MMX80CM,8574.62,8574.62,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000533,0278,C1874,,,,,STENT TACSHIELD 3X6,1631.68,1631.68,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000534,0278,C1874,,,,,STENT TACSHIELD 4X6,1764.87,1764.87,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000535,0278,C1874,,,,,STENT TACSHIELD 5X5,1764.87,1764.87,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000536,0278,C1874,,,,,STENT TACSHIELD 6X8,2843.78,2843.78,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000537,0278,C1874,,,,,STENT TACSHIELD 8X10,4645.28,4645.28,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000538,0278,C1874,,,,,STENT TACSHIELD 8X12,5094.82,5094.82,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16000590,0278,C1757,,,,,CATH ART EMB 7.5 FR,341.32,341.32,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000630,0278,C1757,,,,,CATH HEMO 20FR 30CC,20.50,20.50,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000640,0278,C1757,,,,,CATH HEMO 22FR 30CC,20.50,20.50,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000651,0278,C1757,,,,,CATH HEMO 24FR 30CC,20.50,20.50,19.52,23.44,,,,,,,23.44,,,19.52,19.52 16000668,0278,C1725,,,,,CATH SPIROFLEX 4F 135CM,5311.27,5311.27,463.57,463.57,,,,,,,463.57,,,, 16000669,0278,C1725,,,,,CATH SPIROFLEX 5F 135CM,5311.27,5311.27,463.57,463.57,,,,,,,463.57,,,, 16000670,0278,C1725,,,,,CATH SPIROFLEX 6F 120CM,6426.80,6426.80,463.57,463.57,,,,,,,463.57,,,, 16000671,0278,C1725,,,,,CATH SPIROFLEX 6F 90CM,7758.78,7758.78,463.57,463.57,,,,,,,463.57,,,, 16000672,0278,C1725,,,,,CATH SPIROFLEX 6F 50CM,2996.95,2996.95,463.57,463.57,,,,,,,463.57,,,, 16000690,0272,A4330,,,,,CATH COUNCIL 20FR 5CC TIP,51.35,51.35,,,,,,,,,,,,, 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,,,, 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,,,,,,,,,,,,, 16000735,0278,C1768,,,,,GRAFT BIFURCATED 16/,3198.16,3198.16,,,,,,,,,,,,, 16000736,0278,C1768,,,,,GRAFT BIFURCATED 18/9/,2662.29,2662.29,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16000746,0272,A4344,,,,,CATH SILICONE 12FR 5CC,20.50,20.50,,,,,,,,,,,,, 16000765,0272,A4344,,,,,CATH SILICONE 24FR 5CC,22.78,22.78,,,,,,,,,,,,, 16000798,0278,C1752,,,,,CATH HEMO 16FR 30CC,20.50,20.50,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16000816,0278,C1768,,,,,GRAFT THIN WALLED REMOVABLE RINGS,4314.29,4314.29,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16000843,0278,C1781,,,,,MESH PATCH DUAL 20X30,7543.17,7543.17,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000844,0278,C1781,,,,,MESH PATCH DUAL 15X19,4010.51,4010.51,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000846,0278,C1781,,,,,MESH PATCH DUAL10X15,2160.56,2160.56,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000847,0278,C1781,,,,,MESH PATCH SOFT TISSUE 15X,5928.72,5928.72,630.48,3726.72,,,,,,,630.48,,,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,,,,,,,,,,,,, 16000860,0272,A4346,,,,,CATH 3WAY 24FR 30CC,44.74,44.74,,,,,,,,,,,,, 16000865,0272,A4346,,,,,CATH 3WAY 26FR 30CC IRRIGATION,35.34,35.34,,,,,,,,,,,,, 16000883,0278,C1781,,,,,MESH SOFT TISUE 10 X,2058.16,2058.16,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16000969,0278,C1894,,,,,DILATOR NAVAGATION HD 12/14 FR,673.83,673.83,176.61,176.61,,,,,,,176.61,,,, 16001041,0278,C2631,,,,,T.V.T URINARY,2952.42,2952.42,,,,,,,,,,,,, 16001042,0278,C2631,,,,,TVT ADVANTAGE SYSTEM,4783.33,4783.33,,,,,,,,,,,,, 16001125,0278,C1760,,,,,VASOSEAL ES,767.97,767.97,,,,,,,,,,,,, 16001280,0278,C1768,,,,,GRAFT VASC 22,1484.74,1484.74,,,,,,,,,,,,, 16001281,0278,C1768,,,,,GRAFT VASC 26,1621.27,1621.27,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16001390,0272,A7521,,,,,TUBE TRACH 8 DCT DISPOSABLE,188.27,188.27,,,,,,,,,,,,, 16001391,0272,A7521,,,,,TUBE TRACH 8 FEN DISPOSABLE,172.71,172.71,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16001402,0278,C1781,,,,,MESH DEXON 25X15CM,902.32,902.32,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16001403,0278,C1781,,,,,MESH DEXON 20X10CM,876.00,876.00,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16001405,0278,C1788,,,,,"PORT, 19MM, STRAIGHT, 80MM",972.74,972.74,330.73,330.73,,,,,,,330.73,,,, 16001408,0278,C1788,,,,,PRO PORT SYSTEM LOW PROFILE 1.6MM 8.5FR,972.74,972.74,330.73,330.73,,,,,,,330.73,,,, 16001409,0278,C1781,,,,,MESH VICRYL KNITTED 12 X12,4233.55,4233.55,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16001410,0278,C1781,,,,,MESH VICRYL WOV 12 X12,3101.37,3101.37,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16001429,0278,C1874,,,,,STENT WALLFLEX ESOPHAGEAL 23MMX125MM,9265.58,9265.58,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001430,0278,C1874,,,,,STENT POLYFLEX 18X90,6992.89,6992.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001431,0278,C1874,,,,,STENT POLYFLEX 18X120,6992.89,6992.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001432,0278,C1874,,,,,STENT POLYFLEX ESOPHAGEAL 16X20X90,6160.41,6160.41,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001433,0278,C1874,,,,,STENT POLYFLEX ESOPHAGEAL 18X23X120,6160.41,6160.41,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001434,0278,C1874,,,,,STENT POLYFLEX 21X120,6992.89,6992.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001435,0278,C1874,,,,,STENT WALLFLEX ESOPHAGEAL,8408.12,8408.12,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001436,0278,C1781,,,,,MESH MARLEX 10 X 14,628.03,628.03,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16001437,0278,C1874,,,,,STENT WALLFLEX COLONIC,8741.12,8741.12,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001438,0278,L8600,,,,,BREAST PROSTHESIS IMPLANTABLE,3071.87,3071.87,,,,,,,,,,,,, 16001439,0278,C1781,,,,,MESH MYCRO 6CM X 12CM,457.37,457.37,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16001440,0278,C1874,,,,,STENT WALLFLEX ESOPHAGEAL 23X155MM,8915.94,8915.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001441,0278,C1874,,,,,STENT WALLFLEX ESOPHAGEAL 18MM X 153MM,7727.57,7727.57,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001442,0278,C1874,,,,,WALLFLEX EXOPHAGEAL PARTIALLY COVERED 23,7727.57,7727.57,243.37,248.02,,,,,,,243.37,,,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,,,,,,,,,,,,, 16001570,0278,C1874,,,,,STENT BALLOON CORINT 7MM/15MM,3812.79,3812.79,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16001600,0278,C1769,,,,,GUIDE WIRE PLATINUM PLUS,508.56,508.56,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16001806,0272,C1751,,,,,CATH LUMEN MULTI KIT,163.02,163.02,,,,,,,,,,,,, 16001875,0258,J7042,,,,,SOLUTION DEXTROSE 5% 100ML,20.00,20.00,,,,,,,,,,,,, 16001876,0258,J7042,,,,,SOLUTION DEXTROSE 5% ADVANTAGE,20.00,20.00,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16001921,0258,J7042,,,,,SOLUTION SODIUM CHLORIDE 3%,23.62,23.62,,,,,,,,,,,,, 16001925,0258,J7120,,,,,LACTATED RINGERS 1000 ML,20.00,20.00,,,,,,,,,,,,, 16001933,0636,Q4186,,,,,DRESSING EPIFIX 3X3 CM,651.08,651.08,229.88,229.88,,,,,,,229.88,,,, 16001962,0258,J7060,,,,,WATER STERILE 500ML,20.00,20.00,,,,,,,,,,,,, 16001992,0258,J7042,,,,,DNU SOLUTION LACTATED RINGERS,20.00,20.00,,,,,,,,,,,,, 16002025,0278,C1766,,,,,OCCLUDER VASCULAR 1.5,251.99,251.99,85.68,85.68,,,,,,,,,,85.68,85.68 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,,,,,,,,,,,,, 16002320,0272,A4340,,,,,CATH COUDE 12FR SILICONE,59.84,59.84,,,,,,,,,,,,, 16002402,0278,C1874,,,,,STENT PALMAZ UNMOUNTED XL 40C,5444.47,5444.47,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16002403,0278,C1874,,,,,STENT PALMAZ UNMOUNTED XL 50C,5827.41,5827.41,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16002850,0278,C1874,,,,,STENT PALMAZ 5FR X 80CM,3812.79,3812.79,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16002972,0272,C1713,,,,,HEMOSTATIC MATRIX FLOSEAL 5ML,1321.94,1321.94,,,,,,,,,,,,, 16003070,0272,A4338,,,,,CATH SILICONE 14FR 5CC,20.50,20.50,,,,,,,,,,,,, 16003664,0272,C1751,,,,,CATH GROSHONG SINGLE LUMEN 7FR,1781.52,1781.52,,,,,,,,,,,,, 16004166,0272,C1769,,,,,CATH BENTSON WIRE .035X180 CM TSFB 35,71.59,71.59,,,,,,,,,,,,, 16004421,0272,A4624,,,,,CATH SUCTION 6 FR,20.00,20.00,,,,,,,,,,,,, 16004423,0272,A4624,,,,,CATH SUCTION 8FR,20.50,20.50,,,,,,,,,,,,, 16004444,0272,A4340,,,,,CATH COUDE 14FR 10CC - 5CC PACKAGE,37.60,37.60,,,,,,,,,,,,, 16004451,0272,C1729,,,,,CATH MALECOT 24FR LATEX FREE,167.44,167.44,,,,,,,,,,,,, 16004477,0278,A4648,,,,,MARKER BREAST BIOPSY 17G. 10CM ULTRA CLI,245.08,245.08,,,,,,,,,,,,, 16004497,0270,A4405,,,,,PASTE KARAYA 7910,21.44,21.44,,,,,,,,,,,,, 16004520,0272,A6154,,,,,BARRIER POST OP CUT TO FIT,52.90,52.90,,,,,,,,,,,,, 16004523,0272,A4338,,,,,DX-PH PROBE,416.24,416.24,,,,,,,,,,,,, 16004663,0278,C1880,,,,,KIT TRAPEASE INTRODUCER,2625.54,2625.54,,,,,,,,,,,,, 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,,,,,,,,,,,,, 16004917,0272,C1725,,,,,TUBE ET NO CUFF 4.0,20.00,20.00,,,,,,,,,,,,, 16005004,0278,C1894,,,,,DRYSEAL SHEATH DSL1628,915.74,915.74,176.61,176.61,,,,,,,176.61,,,, 16005005,0278,C1874,,,,,EXCLUDER RLT261418,36629.45,36629.45,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005006,0278,C1874,,,,,EXCLUDER PLC181400,15018.07,15018.07,243.37,248.02,,,,,,,243.37,,,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,1615.03,1615.03,463.57,463.57,,,,,,,463.57,,,, 16005009,0278,C1894,,,,,DRYSEAL SHEATH DSL1228,915.74,915.74,176.61,176.61,,,,,,,176.61,,,, 16005010,0278,C1874,,,,,EXCLUDER RLT281418,36629.45,36629.45,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005012,0278,C1887,,,,,8 FR DESTINATION SHEATH,458.87,458.87,,,,,,,,,,,,, 16005020,0278,C1768,,,,,GRAFT MAIN BODY,27189.04,27189.04,,,,,,,,,,,,, 16005021,0278,C1768,,,,,GRAFT LEG CONTROL,12553.91,12553.91,,,,,,,,,,,,, 16005035,0278,C1874,,,,,EXCLUDER RLT231218,35098.20,35098.20,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005036,0278,C1874,,,,,EXCLUDER PLC141200,14335.65,14335.65,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005037,0278,C1874,,,,,EXCLUDER PLL161207,10069.92,10069.92,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005039,0278,C1894,,,,,DRYSEAL SHEATH DSF1633,1415.25,1415.25,176.61,176.61,,,,,,,176.61,,,, 16005194,0272,C1725,,,,,CATH OCCULDER OCCULISION 26FRX100CM,822.51,822.51,,,,,,,,,,,,, 16005195,0272,C1725,,,,,CATH OCCULDER OCCULSION 34FRX100CM,822.51,822.51,,,,,,,,,,,,, 16005422,0278,C1874,,,,,STENT 4.8FRX24CM URET,695.96,695.96,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005423,0278,C1874,,,,,STENT 4.BFR 26 CM URET,695.96,695.96,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005426,0278,C1874,,,,,STENT 7FR X 26CM URETERAL SOFT,492.37,492.37,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005427,0278,C1874,,,,,STENT 7FR X 24CM URETERAL SOFT,492.37,492.37,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005429,0278,C1874,,,,,STENT CAROTID 6MMX30MM,7325.89,7325.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005430,0278,C1874,,,,,STENT CAROTID 6MMX20MM,7325.89,7325.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16005431,0278,C1874,,,,,STENT CAROTID 7MMX20MM,7325.89,7325.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 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,,,,,,,,,,,,, 16006080,0278,C1769,,,,,GUIDE WIRE STEERABLE,466.19,466.19,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16006120,0278,C1874,,,,,DNU STENT SMART 6X20CM,5162.75,5162.75,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16006121,0278,C1874,,,,,STENT SMART 14X40,4706.72,4706.72,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16006122,0278,C1874,,,,,STENT SMART 14X60,4706.72,4706.72,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16006411,0278,C1874,,,,,SHEATH 6FR 11C BRIGHT,130.09,130.09,243.37,248.02,,,,,,,243.37,,,248.02,248.02 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,275.22,275.22,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007204,0278,C1874,,,,,STENT WALL 20 X 40 CM,3979.29,3979.29,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007210,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,10822.34,10822.34,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007211,0278,C1874,,,,,VIABAHN BALLOON EXPANDABLE ENDOPROSTHESI,10838.99,10838.99,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007212,0278,C1874,,,,,VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,11108.71,11108.71,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007215,0278,C1874,,,,,VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,11108.71,11108.71,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007216,0278,C1874,,,,,VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,11108.71,11108.71,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007217,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,23166.46,23166.46,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007218,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,12833.63,12833.63,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007219,0278,C1874,,,,,VIABAHN VBX BALLOON EXPANDABLE ENDOPROST,11385.27,11385.27,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007220,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,11388.60,11388.60,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007221,0278,C1874,,,,,VIABAHN ENDOPROSTHESIS,13153.50,13153.50,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007225,0278,C1874,,,,,VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,11088.90,11088.90,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007226,0278,C1874,,,,,VIABAHN BX BALLOON ENDO 7FR 135CM CATH H,11088.90,11088.90,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007280,0278,C1874,,,,,STENT PALMAZ 7FR X 80 CM CORINTHIAN,3916.02,3916.02,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007299,0278,C1769,,,,,GUIDE WIRE AMPLATE,201.72,201.72,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007300,0278,C1874,,,,,STENT SMART 10X20X120,4944.98,4944.98,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007301,0278,C1874,,,,,DNU STENT SMART 12X30X80,4706.89,4706.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007302,0278,C1874,,,,,STENT SMART 14X40X80,4706.72,4706.72,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007307,0272,C1725,,,,,CATHETER CENTESIS ONE STEP 6FR,133.20,133.20,,,,,,,,,,,,, 16007310,0278,C1725,,,,,CATH GUIDE 6FR 90CM PV MACH 1,200.90,200.90,463.57,463.57,,,,,,,463.57,,,, 16007312,0278,C1725,,,,,CATH GUIDE RUNWAY MP2,532.79,532.79,463.57,463.57,,,,,,,463.57,,,, 16007313,0278,C1725,,,,,CATH GUIDE RUNWAY JR4,532.79,532.79,463.57,463.57,,,,,,,463.57,,,, 16007328,0278,C1874,,,,,STENT EPIC 10X20 x 75CM SELF EXPANDING,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007329,0278,C1874,,,,,STENT EPIC 12X60X75CM SELF EXPANDING VA,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007330,0278,C1874,,,,,STENT EPIC 6X30 SELF EXPANDING VASCULAR,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007331,0278,C1874,,,,,STENT EPIC 6X60 SELF EXPANDING VASCULAR,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007332,0278,C1874,,,,,STENT EPIC 8X30 SELF EXPANDING VASCULAR,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007333,0278,C1874,,,,,STENT EPIC 8X40 SELF EXPANDING VASCULAR,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007334,0278,C1874,,,,,STENT EPIC 8X60 SELF EXPANDING VASCULAR,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007335,0278,C1874,,,,,STENT EPIC 10X40 SELF EXPANDING VASCULAR,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007336,0278,C1874,,,,,STENT EPIC 10X60 SELF EXPANDING VASCULAR,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007337,0278,C1874,,,,,STENT EPIC 10X40X120 VASCULAR,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007338,0278,C1874,,,,,STENT EPIC 10X20X120 SELF EXPANDING VASC,3995.94,3995.94,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007339,0278,C1769,,,,,GUIDE WIRE V-14 300CM,716.96,716.96,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007340,0278,C1769,,,,,GUIDE WIRE V-18 300CM,387.64,387.64,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007350,0278,C1769,,,,,GUIDE WIRE TSFNB-38-1,38.74,38.74,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007406,0278,C1874,,,,,STENT SMART 8X20,4944.98,4944.98,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007410,0278,C1874,,,,,STENT WALL 10FR 20X60 230 CM,5439.48,5439.48,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007411,0278,C1874,,,,,STENT WALL 10FR 22X60 230 CM,5439.48,5439.48,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007412,0278,C1874,,,,,STENT WALL 10FR 20X60 230 CM,5439.48,5439.48,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007413,0278,C1874,,,,,STENT WALL 10FR 22X60 135 CM,5439.48,5439.48,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007447,0278,C1874,,,,,STENT BEV WL 7.5 10X42X75,3579.70,3579.70,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007448,0278,C1769,,,,,GUIDE WIRE ANPLATZ STIFF,195.84,195.84,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007460,0278,C1874,,,,,STENT WALL B10687110,3579.70,3579.70,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007470,0278,C1874,,,,,STENT WALL B8607110,3579.70,3579.70,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007597,0278,C1725,,,,,BALLON DILATATION CATH XXL 7F 12MM X 2C,954.19,954.19,463.57,463.57,,,,,,,463.57,,,, 16007600,0278,C1769,,,,,GUIDE WIRE 180CM PLATINUM,411.29,411.29,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007601,0278,C1874,,,,,STENT 24MMX3.5MM,6626.60,6626.60,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007602,0278,C1874,,,,,STENT PROMUS PREMIER 4.00MM X 12MM,6992.89,6992.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007604,0278,C1725,,,,,CATH DILATION 2.5MMX10CMX135CM,1135.01,1135.01,463.57,463.57,,,,,,,463.57,,,, 16007605,0278,C1725,,,,,CATH DILATION 3.0MMX10CMX135CM,1135.01,1135.01,463.57,463.57,,,,,,,463.57,,,, 16007607,0278,C1725,,,,,CATH POLAR 2.5MMX100CMX135CM,2996.95,2996.95,463.57,463.57,,,,,,,463.57,,,, 16007612,0272,C1769,,,,,GUIDE WIRE LT 46 602,368.79,368.79,,,,,,,,,,,,, 16007613,0278,C1769,,,,,GUIDE WIRE M 46-254,246.79,246.79,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007616,0278,C1769,,,,,GUIDE WIRE CRAGG FX46-214,737.25,737.25,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007622,0278,C1874,,,,,STENT ICAST 8X59X80,9407.11,9407.11,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007623,0278,C1874,,,,,STENT URETHERAL SOFT 6X26,679.31,679.31,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007624,0278,C1874,,,,,STENT URETHERAL SOFT 6X24,695.96,695.96,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007625,0278,C1874,,,,,STENT URETHERAL SOFT 4.87FRX22CM,679.31,679.31,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007626,0278,C1874,,,,,STENT COLONIC 4CM 31FR,3740.40,3740.40,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007627,0278,C1874,,,,,STENT COLONIC 6CM 31FR,3901.90,3901.90,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007628,0278,C1874,,,,,STENT COLONIC 10CM 31FR,4696.49,4696.49,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007629,0278,C1874,,,,,STENT URETHERAL SOFT 6X22-30,708.62,708.62,243.37,248.02,,,,,,,243.37,,,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 1 598 942,399.59,399.59,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007633,0278,C1874,,,,,STENT PERCUFLEX 8FRX30CM,639.02,639.02,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007637,0278,C1874,,,,,STENT EXPRESS RENAL 5X15 90CM,4134.29,4134.29,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007639,0272,C1725,,,,,COYOTE ES MONORAIL 3X20X114,1176.80,1176.80,,,,,,,,,,,,, 16007640,0278,C1769,,,,,GUIDE WIRE 9316,74.58,74.58,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007641,0278,C1769,,,,,GUIDE WIRE ANGIOGUARD EMBOLI,5827.41,5827.41,100.91,131.80,,,,,,,100.91,,,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,,,,,,,,,,,,, 16007646,0278,C1725,,,,,SYMMETRY BALLOON DILATION CATH 2.5MMX100,1075.59,1075.59,463.57,463.57,,,,,,,463.57,,,, 16007647,0278,C1874,,,,,STENT URETHERAL SOFT PERCUFLEX CONTOUR V,708.62,708.62,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007650,0278,C1769,,,,,GUIDE WIRE 9911,65.64,65.64,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007654,0278,C1769,,,,,GUIDE WIRE AMPLATZ EMERALD .035X180CM,188.69,188.69,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007655,0278,C1769,,,,,GUIDE WIRE STRAIGHT CATH EXCHANGE,59.45,59.45,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007656,0278,C1769,,,,,GUIDE WIRE AMPLATZ EMERALD,172.20,172.20,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007658,0278,C1769,,,,,GUIDE MPA1 586 842,366.29,366.29,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007659,0278,C1769,,,,,GUIDE SON 1 586 880,366.29,366.29,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007661,0278,C1769,,,,,GUIDE WIRE TM 480 A,500.66,500.66,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007662,0278,C1769,,,,,GUIDE WIRE TM 260 A,283.05,283.05,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007669,0272,C1769,,,,,GUIDE WIRE ROSEN 260,111.36,111.36,,,,,,,,,,,,, 16007671,0278,C1769,,,,,GUIDE WIRE STIFF D.035 L260 STRAIGHT,108.40,108.40,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007673,0278,C1769,,,,,GUIDE WIRE PLAT PLUS,313.89,313.89,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007674,0278,C1769,,,,,GUIDE WIRE 46-601,288.05,288.05,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007675,0278,C1769,,,,,GUIDE WIRE 68029,71.75,71.75,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007677,0278,C1769,,,,,GUIDE WIRE 55601,62.52,62.52,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007678,0278,C1769,,,,,GUIDE WIRE PLATINUM PLUS 300CM .014,394.50,394.50,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007679,0278,C1769,,,,,GUIDE WIRE AMPLATZ STIFF 46 51A,193.52,193.52,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007684,0272,C1725,,,,,CATH BALLOON STERLING 3.0MMX60MM 150CM,791.00,791.00,,,,,,,,,,,,, 16007723,0272,C1729,,,,,CATH DRAINAGE 18 FR LOOP TYPE W/O STYLET,385.95,385.95,,,,,,,,,,,,, 16007738,0278,C1725,,,,,CATH BALLOON DIAMOND ULTRA 7X4X75,582.74,582.74,463.57,463.57,,,,,,,463.57,,,, 16007759,0278,C1725,,,,,CATH BALLOON 5FRX110CM FLOW ASSISTED,1137.74,1137.74,463.57,463.57,,,,,,,463.57,,,, 16007769,0272,C1725,,,,,CATH BALLOON 5MMX4CMX8CM,1126.19,1126.19,,,,,,,,,,,,, 16007772,0272,C1725,,,,,CATH BALLOON MUSTANG 7X40X75CM,599.39,599.39,,,,,,,,,,,,, 16007781,0278,C2625,,,,,FANELLI BILIARY STENT SET,2097.87,2097.87,,,,,,,,,,,,, 16007790,0272,C1726,,,,,CATH ACHALASIA BALLOON DILATOR 30MM,2047.92,2047.92,,,,,,,,,,,,, 16007791,0272,C1726,,,,,CATH ACHALASIA BALLOON DILATOR 35MM,2099.12,2099.12,,,,,,,,,,,,, 16007795,0272,C1726,,,,,BALLOON ESOPHAGEAL FIXED WIRE 5865,692.19,692.19,,,,,,,,,,,,, 16007805,0272,C1725,,,,,CATH BALLOON MUSTANG 8X40X75,599.39,599.39,,,,,,,,,,,,, 16007825,0278,C1725,,,,,CATH BALLOON CODA 9FR 120CM,1475.17,1475.17,463.57,463.57,,,,,,,463.57,,,, 16007831,0278,C1874,,,,,STENT INTRO SYSTEM 10-7,410.22,410.22,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007832,0272,C1769,,,,,GUIDE WIRE - STRAIGHT TIP 0.35 150CM,160.51,160.51,,,,,,,,,,,,, 16007833,0278,C1769,,,,,GLIDE WIRE 46 154,195.61,195.61,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007834,0278,C1769,,,,,GLIDE WIRE 46-152,174.14,174.14,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007835,0278,C1874,,,,,STENT INTRO SYSTEM 10-5,586.07,586.07,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007846,0278,C1887,,,,,CATH MICRO INFUSION 2.9DX150LX5,649.34,649.34,,,,,,,,,,,,, 16007847,0278,C1887,,,,,CATH MICRO INFUSION 2.9DX150LX10,649.34,649.34,,,,,,,,,,,,, 16007861,0278,C1769,,,,,CATH TNT GUIDEWIRE TR,337.91,337.91,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007878,0278,C1725,,,,,CATH BALLOON DIL 10X40 MUSTANG,599.39,599.39,463.57,463.57,,,,,,,463.57,,,, 16007880,0278,C1725,,,,,CATH BALLOON DILATION STERLING 4x20x135,1126.19,1126.19,463.57,463.57,,,,,,,463.57,,,, 16007881,0278,C1725,,,,,CATH BALLOON 5X2X80 STERLING,1126.19,1126.19,463.57,463.57,,,,,,,463.57,,,, 16007882,0278,C1725,,,,,CATH BALLOON 4X4X135 STERLING,1126.19,1126.19,463.57,463.57,,,,,,,463.57,,,, 16007883,0278,C1725,,,,,CATH BALLOON 4X40X145 COYOTE,1126.19,1126.19,463.57,463.57,,,,,,,463.57,,,, 16007884,0278,C1769,,,,,GUIDE WIRE ROADRUNNER .035 260CM,339.65,339.65,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007885,0278,C1725,,,,,CATH BALLOON 3X40X145 COYOTE,1126.19,1126.19,463.57,463.57,,,,,,,463.57,,,, 16007886,0278,C1769,,,,,GUIDE WIRE 197303,30.75,30.75,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007925,0278,C1725,,,,,CATH BALLOON COYOTE ES 3X40X146,1176.82,1176.82,463.57,463.57,,,,,,,463.57,,,, 16007936,0278,C1874,,,,,STENT WALL 22X35,3844.76,3844.76,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007937,0278,C1874,,,,,STENT WALL 20X40,3844.76,3844.76,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007955,0278,C1769,,,,,GUIDE WIRE .035 X 180,234.39,234.39,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007956,0278,C1769,,,,,GUIDE WIRE .035 X 260 STRAIGHT TIP,189.88,189.88,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16007982,0278,C1874,,,,,STENT WALL 6X45X75,3759.51,3759.51,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007985,0272,C1769,,,,,GUIDE WIRE RLPC ROAD RUNNER,279.89,279.89,,,,,,,,,,,,, 16007990,0278,C1874,,,,,STENT PALMZ BAL EXP,2730.56,2730.56,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007996,0278,C1874,,,,,STENT PRLOAD P3008M,3379.90,3379.90,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007997,0278,C1874,,,,,STENT PALMAZ 8MM2908,3379.90,3379.90,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16007999,0278,C1874,,,,,STENT PALMZ EXP BALL,2730.56,2730.56,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16008000,0278,Q4196,,,,,PURAPLY AM 2X2 COMMERCIAL 4SQ CM,2497.50,2497.50,,,,,,,,,,,,, 16008044,0272,C1725,,,,,CATH BALLOON MUSTANG 9X40X75,599.39,599.39,,,,,,,,,,,,, 16008047,0272,C1725,,,,,CATH BALLOON COYOTE 2X20X142,1126.19,1126.19,,,,,,,,,,,,, 16008080,0270,A4615,,,,,OPTIFLOW NASAL CANNULA SMALL,95.45,95.45,,,,,,,,,,,,, 16008081,0270,A4615,,,,,OPTIFLOW NASAL CANNULA MEDIUM,97.84,97.84,,,,,,,,,,,,, 16008400,0278,C1874,,,,,STENT MEMOTHERM 8 X 40,3369.91,3369.91,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16008401,0278,C1874,,,,,STENT ACCULINK 6-80X30 190CM,7492.39,7492.39,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16008403,0278,C1725,,,,,CATH BALLOON 95-15,706.97,706.97,463.57,463.57,,,,,,,463.57,,,, 16008408,0278,C1874,,,,,STENT SMART 8X40,4978.28,4978.28,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16008430,0278,C1874,,,,,DNU STENT SMART 10X40,5477.77,5477.77,243.37,248.02,,,,,,,243.37,,,248.02,248.02 16008502,0278,C1725,,,,,CATH POLAR 3X100X135X0.014,2996.95,2996.95,463.57,463.57,,,,,,,463.57,,,, 16008503,0278,C1725,,,,,CATH POLAR 4X40X135X0.014,2663.96,2663.96,463.57,463.57,,,,,,,463.57,,,, 16008504,0278,C1725,,,,,CATH POLAR 6X40X135X0.014,2663.96,2663.96,463.57,463.57,,,,,,,463.57,,,, 16008505,0278,C1725,,,,,CATH POLAR 2.5X40X135X0.014,2663.96,2663.96,463.57,463.57,,,,,,,463.57,,,, 16008506,0278,C1725,,,,,CATH POLAR,2663.96,2663.96,463.57,463.57,,,,,,,463.57,,,, 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,,,,,,,,,,,,, 16008921,0278,C1874,,,,,STENT POLYFLEX 21X90,6992.89,6992.89,243.37,248.02,,,,,,,243.37,,,248.02,248.02 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,,,,,,,,,,,,, 16009100,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 5X15,4581.18,4581.18,,,,,,,,,,,,, 16009105,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 5X12,4811.78,4811.78,,,,,,,,,,,,, 16009110,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 7X29,4478.78,4478.78,,,,,,,,,,,,, 16009115,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 8X29,4254.85,4254.85,,,,,,,,,,,,, 16009120,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 7X39,4413.01,4413.01,,,,,,,,,,,,, 16009125,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 8X39,4413.01,4413.01,,,,,,,,,,,,, 16009130,0278,C1887,,,,,CATH GUIDE 55CM 6F,280.31,280.31,,,,,,,,,,,,, 16009145,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 6X12,4581.18,4581.18,,,,,,,,,,,,, 16009150,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 6X15,4581.18,4581.18,,,,,,,,,,,,, 16009155,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 5X18,4811.78,4811.78,,,,,,,,,,,,, 16009160,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 6X18,4581.18,4581.18,,,,,,,,,,,,, 16009165,0278,C2625,,,,,STENT TRANSHEPATIC BILIARY 6X23,4634.46,4634.46,,,,,,,,,,,,, 16009170,0278,C2625,,,,,STENT BLUE 5MMX18MMX80CM,4438.82,4438.82,,,,,,,,,,,,, 16009175,0278,C2625,,,,,STENT BLUE 5MMX24MMX80CM,4634.62,4634.62,,,,,,,,,,,,, 16009180,0278,C2625,,,,,STENT RENAL BILIARY 5X15X90,4134.30,4134.30,,,,,,,,,,,,, 16009185,0278,C2625,,,,,STENT RENAL BILIARY 5X19X90,4134.30,4134.30,,,,,,,,,,,,, 16009190,0278,C2625,,,,,STENT RENAL BILIARY 6X14X90,4134.30,4134.30,,,,,,,,,,,,, 16009195,0278,C2625,,,,,STENT RENAL BILIARY 6X18X90,4134.30,4134.30,,,,,,,,,,,,, 16009200,0278,C2625,,,,,STENT RENAL BILIARY 4X19X90,4134.30,4134.30,,,,,,,,,,,,, 16009221,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 13,18314.72,18314.72,1960.76,1960.76,,,,,,,1960.76,,,, 16009222,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 14,18314.72,18314.72,1960.76,1960.76,,,,,,,1960.76,,,, 16009223,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 15,18314.72,18314.72,1960.76,1960.76,,,,,,,1960.76,,,, 16009224,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 16,18314.72,18314.72,1960.76,1960.76,,,,,,,1960.76,,,, 16009225,0278,L8699,,,,,REFLUX MANAGEMENT SYSTEM SIZE 17,18772.59,18772.59,1960.76,1960.76,,,,,,,1960.76,,,, 16009300,0278,C2625,,,,,STENT TRUNK IPSILATERIAL LEG,24301.98,24301.98,,,,,,,,,,,,, 16009305,0278,C1874,,,,,STENT CONTRALATERAL LEG 12MM X 14CM,11218.60,11218.60,243.37,248.02,,,,,,,243.37,,,248.02,248.02 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,,,,,,,,,,,,, 16009999,0278,C1887,,,,,CATH BRITE TIP 6FR-.070-55CM-MPA-1,279.25,279.25,,,,,,,,,,,,, 16100001,0278,C1713,,,,,TROCHANTERIC NAIL KIT 180 TI GAMMA 3,3696.24,3696.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100002,0278,C1713,,,,,LAG SCREW TI GAMMA 3,1398.58,1398.58,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100003,0278,C1713,,,,,LOCKING SCREW FULLY THREADED,580.24,580.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100004,0278,C1769,,,,,K-WIRE,333.00,333.00,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100005,0278,C1769,,,,,GUIDE WIRE BALL TIPPED STERILE,582.74,582.74,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100006,0278,C1769,,,,,GUIDE WIRE PARTIALLY THREADED,86.10,86.10,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100007,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 150MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100008,0278,C1725,,,,,ULTRAVERSE 035 4.0MMX80MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100009,0278,C1768,,,,,GRAFT 10/10 BTB,11987.82,11987.82,,,,,,,,,,,,, 16100010,0278,C1713,,,,,PLATE LCP VOLAR DISTAL RADIUS 4H RIGHT,2467.49,2467.49,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100011,0278,C1713,,,,,SCREW 2.4 LOCKING SLF-TPNG 14MM RECESS,346.31,346.31,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100012,0278,C1713,,,,,SCREW 2.4 LOCKING SLF-TPNG 22MM RECESS,346.31,346.31,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100013,0278,C1713,,,,,SCREW 2.4 LOCKING SLF-TPNG 24MM RECESS,346.31,346.31,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100014,0278,C1713,,,,,SCREW 2.4 CORTEX SLF-TPNG 14MM RECESS,198.85,198.85,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100015,0278,C1713,,,,,SCREW LAG 2.4MM X 16MM X 2,499.49,499.49,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100016,0278,C1725,,,,,ULTRAVERSE 035 4.0MMX60MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100017,0278,C1725,,,,,LUTONIX 035 DCB 5F,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100018,0278,C1713,,,,,SCREW 3.5 X 10MM LOCKING CORTICAL SC,283.05,283.05,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100019,0278,C1713,,,,,SCREW 3.5 X 8MM LOCKING CORTICAL SC,283.05,283.05,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100020,0278,C1713,,,,,SCREW 2.3X20MM THREADED LOCKING,290.13,290.13,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100021,0278,C1713,,,,,SCREW 3.5X12.0 MM CORTICAL SCREW,112.50,112.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100022,0278,C1713,,,,,SCREW 3.5 X 12MM LOCKING CORTICAL SC,283.05,283.05,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100023,0278,C1713,,,,,SCREW 2.3X24MM THREADED LOCKING,283.05,283.05,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100024,0278,C1713,,,,,SCREW 2.3X22MM THREADED LOCKING,283.05,283.05,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100025,0278,C1713,,,,,SCREW 3.5 X 16MM CORTICAL,112.50,112.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100026,0278,C1713,,,,,SCREW 3.5 X 18MM CORTICAL,249.75,249.75,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100027,0278,C1713,,,,,SCREW 3.5 X 14MM CORTICAL,112.50,112.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100028,0278,C1713,,,,,SCREW SUPER REVO SUTURE ANCHOR KIT,716.77,716.77,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100029,0278,C1725,,,,,ULTRAVERSE 03550 MM X 60MMX130CM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100030,0278,C1713,,,,,SCREW 2.7 CORTEX 16MM,140.42,140.42,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100031,0278,C1713,,,,,SCREW 2.4 CORTEX 20MM,366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100032,0278,C1713,,,,,SCREW 2.4 CORTEX 24MM,366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100033,0278,C1713,,,,,SCREW 2.4 CORTEX 26MM,366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100034,0278,C1713,,,,,SCREW 2.4 CORTEX 28MM,366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100035,0278,C1713,,,,,SCREW 2.4 LOCKING 18MM,366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100036,0278,C1713,,,,,SCREW 2.7 CORTEX 14MM,140.42,140.42,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100037,0278,C1713,,,,,SCREW 3.5 LOCKING 36MM,392.93,392.93,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100038,0278,C1713,,,,,SCREW3.5 LOCKING 50MM,392.93,392.93,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100039,0278,C1713,,,,,SCREW 3.5 CORTEX 30MM,94.30,94.30,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100040,0278,C1725,,,,,LUTONIX 035 5.0MM X 60MM,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100041,0278,C1713,,,,,SCREW LAG VHS W/COMP SCREW,935.72,935.72,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100042,0278,C1713,,,,,SCREW 3.5 CORTEX12MM,103.52,103.52,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100043,0278,C1713,,,,,SCREW 4.0 CORTEX16MM,90.20,90.20,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100044,0278,C1713,,,,,SCREW 4.0 CORTEX18MM,88.25,88.25,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100045,0278,C1713,,,,,SCREW 4.0 CORTEX20MM,86.10,86.10,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100046,0278,C1713,,,,,SCREW LAG VHS W/COMP SCREW,1102.21,1102.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100047,0278,C1713,,,,,SCREW LAG VHS W/COMP SCREW,1102.21,1102.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100048,0278,C1713,,,,,SCREW 4.0 CORTEX18MM,90.20,90.20,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100049,0278,C1725,,,,,LUTONIX 035 4.0MM X 60MM,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100050,0278,C1713,,,,,FIXATION PINS SET OF 3,832.49,832.49,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100051,0278,C1725,,,,,ULTRAVERSE 035 5.0MMX40MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100052,0278,C1725,,,,,ULTRAVERSE 035 6.0MM X 40MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100053,0278,C1725,,,,,LUTONIX 035 6.0MM X 100MM,5379.15,5379.15,463.57,463.57,,,,,,,463.57,,,, 16100054,0278,C1725,,,,,LUTONIX 035 5.0MM X 40MM,5379.15,5379.15,463.57,463.57,,,,,,,463.57,,,, 16100056,0272,C1725,,,,,ULTRAVERSE 035 6.0MM X 80MM,316.35,316.35,,,,,,,,,,,,, 16100057,0278,C1725,,,,,LUTONIX 035 6.0MM X 60MM,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100059,0278,C1725,,,,,LUTONIX 035 7.0MM X 60MM,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100060,0278,C1713,,,,,SCREW PROPEL 9X30MM I/F,333.00,333.00,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100061,0278,C1713,,,,,SCREW CANNULATED 2.4 10MM,749.24,749.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100062,0278,C1713,,,,,SCREW CANNULATED 2.4 16MM,749.24,749.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100063,0278,C1713,,,,,SCREW CANNULATED 2.4 15MM,749.24,749.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100064,0278,C1713,,,,,SCREW CANNULATED 2.4 14MM,767.97,767.97,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100065,0278,C1713,,,,,GUARDSMAN FEM IFS 9X30MM,341.32,341.32,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100066,0278,C1713,,,,,SUTURE ANCHOR TITANIUM 4.0MM,853.30,853.30,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100067,0278,C1725,,,,,LUTONIX 035 5.0MM X 60MM,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100068,0278,C1781,,,,,BIO A TISSUE REINFORCEMENT 8X8,1413.09,1413.09,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100069,0278,C1725,,,,,ULTRAVERSE 035 4.0MMX40MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100074,0278,C1725,,,,,LUTONIX 035 5.0MMX100MM,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100075,0278,C1725,,,,,LUTONIX 035 5.0MM X 150MM,4994.93,4994.93,463.57,463.57,,,,,,,463.57,,,, 16100076,0278,C1725,,,,,LUTONIX 035 5F,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100077,0278,C1725,,,,,LUTONIX 035 DCB 5F,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100078,0278,C1781,,,,,BIO A TISSUE REINFORCEMENT 10X30,6730.83,6730.83,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100079,0278,C1781,,,,,BIO A TISSUE REINFORCEMENT 20X30,12642.68,12642.68,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100080,0278,C1725,,,,,ULTRAVERSE 035 4.0MMX100MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100081,0278,C1725,,,,,ULTRAVERSE 035 5.0 MM X 100MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100082,0278,C1725,,,,,LUTONIX035DCB5F,4994.93,4994.93,463.57,463.57,,,,,,,463.57,,,, 16100085,0278,C1725,,,,,LUTONIX035DCB5F,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100086,0278,C1713,,,,,SCREW FEMORAL 8MM X 25MM,341.32,341.32,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100087,0278,C1713,,,,,SCREW PROPEL TIBIAL,341.32,341.32,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100088,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 40MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100089,0278,C1725,,,,,LUTONIX 035 5.0MM X 40MM 130CM,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100100,0278,C1713,,,,,PLATE NARROW VOLAR DISTAL RADIOUS RT,2730.56,2730.56,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100101,0278,C1713,,,,,PLATE NARROW VOLAR DISTAL RADIUS RT,2730.56,2730.56,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100102,0278,C1713,,,,,PLATE DISTAL RADIUS RT STANDARD,2730.56,2730.56,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100103,0278,C1713,,,,,PLATE DISTAL RADIUS FIBULA LT 4H 86MM,2269.78,2269.78,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100109,0278,C1769,,,,,GUIDE WIRE,469.31,469.31,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100119,0278,C1713,,,,,COTTON WEDGE 7MM,8277.01,8277.01,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100120,0278,C1713,,,,,EVANS WEDGE 10MM,9471.63,9471.63,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100121,0272,C1713,,,,,DRILL 2.0X110MM SOLID MEASURING AO,1058.09,1058.09,,,,,,,,,,,,, 16100122,0278,C1713,,,,,K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 2.,168.10,168.10,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100123,0278,C1713,,,,,OLIVE WIRE SMOOTH 1.4MM,580.24,580.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100124,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 2.7X18,1058.09,1058.09,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100125,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 2.7X12MM,819.17,819.17,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100126,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREQ 2.7X14MM,819.17,819.17,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100127,0278,C1713,,,,,HEVANS PLATE MEDOIUM LEFT 20MM,7509.04,7509.04,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100128,0278,C1713,,,,,DRILL 4.6X220MM CANNULATED 3/16 SQ CONN,1279.95,1279.95,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100129,0278,C1713,,,,,K-WIRE SINGLE TROCAR TIP SMOOTH W/ FLOUR,511.98,511.98,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100130,0278,C1713,,,,,MONSTER CANNULATED MEDIUM THREAD SCREW H,4420.10,4420.10,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100131,0278,C1713,,,,,MONSTER CANNULATED MEDIUM THREADED SCREW,4420.10,4420.10,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100132,0278,C1725,,,,,LUTONIX 035 4MM X 40MM 130CM,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100133,0278,C1713,,,,,3.5MM CORTICAL SCREW SELF-TAP SMALL HEX,115.31,115.31,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100134,0278,C1713,,,,,CRUSHED CANCELLOUS CHIPS 15CC 1-4MM,1952.35,1952.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100135,0278,C1769,,,,,GUIDE WIRE,469.31,469.31,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100136,0278,C1713,,,,,DRILL 2.4X140MM SOLID MEASURING LONG AO,1058.09,1058.09,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100137,0278,C1725,,,,,ULTRAVERSE 035 5.0 MM X 150MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100138,0278,C1713,,,,,MTP PLATE SHORT-SHORT LEFT 2-HOLE DISTAL,8072.21,8072.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100139,0278,C1713,,,,,K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,176.50,176.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100140,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 3.5X20MM,1126.35,1126.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100141,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 3.5X20MM,1126.35,1126.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100142,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 3.5X14MM,819.17,819.17,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100143,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 3.5X16MM,819.17,819.17,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100144,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 3.5X20MM,819.17,819.17,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100145,0278,C1713,,,,,MINI-MONSTER CANNULATED SHORT THREAD SCR,1416.48,1416.48,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100146,0278,C1713,,,,,COUNTERSINK 3.5MM HEADLESS,1058.09,1058.09,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100147,0278,C1713,,,,,DRILL 2.3X120MM CANNULATED AO,1058.09,1058.09,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100148,0278,C1713,,,,,K-WIRE SINGLE ENDED TROCAR TIP SMOOTH 1.,176.50,176.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100152,0278,C1725,,,,,LUTONIX 035 5X80,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100153,0278,C1725,,,,,LUTONIX 035 5X80,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100154,0278,C1725,,,,,LUTONIX 035 4X60 5F,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100155,0278,C1725,,,,,LUTONIX 035 4X80 5F,4162.44,4162.44,463.57,463.57,,,,,,,463.57,,,, 16100156,0278,C1725,,,,,ULTRAVERSE 035 6.0MM X 100MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100157,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 100MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100158,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 80MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100159,0278,C1725,,,,,ULTRAVERSE 035 7.0MM X 150MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100161,0278,C1725,,,,,ULTRAVERSE 035 6.0MM X 120MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100162,0278,C1725,,,,,ULTRAVERSE 035 6.0MM X 60MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100163,0278,C1725,,,,,ULTRAVERSE 035 5.0MM X 120MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100164,0278,C1725,,,,,ULTRAVERSE 035 5.0MM X 80MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100165,0278,C1725,,,,,ULTRAVERSE 035 4.0MM X 150MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100166,0278,C1725,,,,,ULTRAVERSE 035 4.0MM X 120MM,316.35,316.35,463.57,463.57,,,,,,,463.57,,,, 16100167,0278,C1713,,,,,MINI-MONSTER CANNULATED SHORT THREADED S,1194.62,1194.62,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100168,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 2.7X16MM,819.17,819.17,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100169,0278,C1713,,,,,R3CON NON-LOCKING PLATE SCREW 2.7X15MM,819.17,819.17,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100170,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 2.7X15MM,1126.35,1126.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100171,0278,C1713,,,,,R3CON LOCKING PLATE SCREW 2.7X12MM,1126.35,1126.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100172,0278,C1713,,,,,MTP PLATE 0 DEGREE LONG RIGHT,8072.21,8072.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100173,0278,C1713,,,,,MTP SPIN GUARD FEMALE REAMER 19MM,2218.58,2218.58,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100174,0278,C1762,,,,,MTP DISC 19X5MM,12543.51,12543.51,,,,,,,,,,,,, 16100175,0278,C1781,,,,,MESH XL 10X14,6126.69,6126.69,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100176,0278,C1781,,,,,MESH XL 8X12,4693.15,4693.15,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100177,0278,C1781,,,,,MESH OVAL 6X9IN,3020.69,3020.69,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100178,0278,C1781,,,,,MESH RECTANGLE 4X6IN,1279.95,1279.95,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100179,0278,C1781,,,,,MESH SQUARE 5X5IN,1416.48,1416.48,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100180,0278,C1781,,,,,MESH HERNIA,4095.84,4095.84,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100181,0278,C1781,,,,,MESH HERNIA,2559.90,2559.90,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100182,0278,C1781,,,,,MESH HERNIA,1757.79,1757.79,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100183,0278,C1781,,,,,MESH HERNIA,1928.46,1928.46,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100184,0278,C1781,,,,,MESH HERNIA,2832.96,2832.96,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100185,0278,C1781,,,,,MESH,2480.54,2480.54,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100186,0278,C1781,,,,,MESH VENTRALIGHT ST ECHO 4.5,3988.32,3988.32,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100187,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 6,4758.00,4758.00,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100188,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 10x15CM,13925.85,13925.85,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100189,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 15CM CIRCL,4960.47,4960.47,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100190,0278,C1781,,,,,MESH HERNIA C-QUR 25CM X 35 CM,5542.06,5542.06,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100191,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 10X13 EL,11937.15,11937.15,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100192,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 8X10 EL,9270.24,9270.24,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100193,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 20CM CIRCL,8167.78,8167.78,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100194,0278,C1781,,,,,MESH SURGICAL ABSORBABLE PATCH 4INW X 5I,3988.33,3988.33,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100195,0278,C1781,,,,,MESH SURGICAL PARTIALLY ABSORBABLE PATCH,4758.00,4758.00,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100196,0278,C1781,,,,,MESH VENTRIO ST HERNIA PATCH 15.5CMX25.7,8711.51,8711.51,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100197,0278,C1781,,,,,MESH VENTRALIGHT ST WITH ECHO 6X8,5913.46,5913.46,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100198,0278,C1781,,,,,MESH VENTRIO ST HERNIA PATCH 3X3,2414.15,2414.15,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100199,0278,C1713,,,,,XEMPLIFI DBM GEL 5 CC,3413.25,3413.25,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100205,0278,C1776,,,,,PERC ROD 45MM,2414.21,2414.21,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100210,0278,C1781,,,,,MESH HERNIA C-QUR 20CM X 30 CM,4245.31,4245.31,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100215,0278,C1781,,,,,MESH HERNIA C-QUR 10CM X 15CM,1157.81,1157.81,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100222,0278,C1889,,,,,6X14X11 CORNERSTONE PSR,3071.93,3071.93,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36 16100226,0278,C1713,,,,,CREO AMP 6.5X40MM MODULAR CANNULATED SCR,2047.95,2047.95,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100227,0278,C1713,,,,,CREO AMP 6.5X45MM MODULAR CANNULATED SCR,2047.95,2047.95,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100228,0278,C1776,,,,,CREO MIS LOCKING CAP,499.50,499.50,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100229,0278,C1713,,,,,CREO MIS MODULAR POLYAXIAL TULIP 10MM RE,2047.95,2047.95,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100230,0278,C1713,,,,,ANCHOR 5.5MM BONE,1348.21,1348.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100233,0278,C1713,,,,,CREO MIS 5.5MM CURVED ROD TITANIUM ALLOY,1279.97,1279.97,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100234,0278,C1713,,,,,"CREO MIS 5.5MM CURVED ROD, TITANIUM ALLO",1279.97,1279.97,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100236,0272,L8699,,,,,"1.6MM NITINOL K-WIRE, 500MM, BLUNT TIP",511.99,511.99,,,,,,,,,,,,, 16100238,0278,C1713,,,,,XEMPLIFI DBM GEL 1CC,853.31,853.31,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100239,0278,L8699,,,,,XTEND ANTERIOR CERVICAL PLATE 1-LEVEL 12,3413.25,3413.25,1960.76,1960.76,,,,,,,1960.76,,,, 16100240,0278,C1713,,,,,SCREW LAG VHS W/COMP SCREW,1064.91,1064.91,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100241,0278,C1713,,,,,"SCREW FEMORAL INTERF. 8MMX20MM,3.5MM",341.32,341.32,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100242,0278,C1713,,,,,"SCREW FEMORAL INTERF. 9MMX25MM,3.5MM",341.32,341.32,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100244,0278,L8699,,,,,XTEND ANTERIOR CERVICAL PLATE 2-LEVEL 26,3413.25,3413.25,1960.76,1960.76,,,,,,,1960.76,,,, 16100247,0278,C1713,,,,,AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 14MM,1959.21,1959.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100250,0278,C1713,,,,,SCREW 2.7MM 14MM,217.59,217.59,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100251,0278,C1713,,,,,PLATE VARI-ANGLE 4 HOLE,1440.37,1440.37,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100252,0278,C1713,,,,,SCREW LAG W/COMP 12.7MM X 70MM,579.20,579.20,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100253,0278,C1713,,,,,SCREW CORTIAL SCREW 4.5SS,113.47,113.47,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100255,0278,C1713,,,,,PIN THREADED TIP GD 2.5MM X 9,174.14,174.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100256,0278,C1713,,,,,PLATE KEYLESS 4 HOLE,1621.27,1621.27,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100257,0278,C1713,,,,,SCREW LAG W/COMP,959.11,959.11,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100258,0278,C1713,,,,,SCREW CORTIAL SCREW 4.5SS,113.47,113.47,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100259,0278,C1713,,,,,SCREW CORTIAL SCREW 4.5SS,134.48,134.48,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100260,0278,C1713,,,,,PLATE 4 HOLE 8 HOLE HEAD,2867.09,2867.09,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100261,0278,C1713,,,,,PLATE 5 HOLE,2952.42,2952.42,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100262,0278,C1713,,,,,PLATE 3 HOLE 3.5 LCP,5000.34,5000.34,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100263,0278,C1713,,,,,PLATE 6 HOLE VHS VARI-ANGLE,1621.27,1621.27,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100264,0278,C1713,,,,,PLATE 4 HOLE VHS VARI-ANGLE,1911.39,1911.39,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100265,0278,C1713,,,,,PLATE 7 HOLE 3.5 LCP,648.51,648.51,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100266,0278,C1713,,,,,PLATE 2 HOLE 56MM,1911.39,1911.39,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100275,0278,C1713,,,,,SCREW 2.2MM 14MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100276,0278,C1713,,,,,SCREW LOCKING 2.7MM 13MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100277,0278,C1713,,,,,SCREW LOCKING 2.7MM 15MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100278,0278,C1713,,,,,"3.5MM ULS ONE-THIRD TUBULAR PLT 8H, 107M",620.18,620.18,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100279,0278,C1713,,,,,"3.5MM ULS ONE-THIRD TUBULAR PLT 10H, 133",632.80,632.80,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100283,0278,C1713,,,,,SCREW 2.4 LOCKING 2.7MM 20MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100284,0278,C1713,,,,,SCREW 2.4 LOCKING 2.7MM 18MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100285,0278,C1713,,,,,SCREW 2.4 LOCKING 2.7MM 16MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100286,0278,C1713,,,,,SCREW 2.4 LOCKING 2.7MM 12MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100287,0278,C1713,,,,,SCREW 2.7MM 16MM,217.59,217.59,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100288,0278,C1713,,,,,SCREW 2.7MM 14MM,217.59,217.59,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100289,0278,C1713,,,,,SCREW 2.7MM 12MM,217.59,217.59,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100291,0278,C1713,,,,,DVR CROSSLOCK PLATE LEFT,3664.23,3664.23,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100292,0278,C1713,,,,,LP NON LOCK 2.7MM X 10MM,217.60,217.60,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100293,0278,C1713,,,,,DVR CROSSLOCK PLATE RIGHT,3664.23,3664.23,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100306,0278,C1713,,,,,LP NON LOCK 2.7MMX 18MM,217.60,217.60,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100307,0278,C1713,,,,,SCREW LOCKING 2.7MM 14MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100308,0278,C1713,,,,,DVR LOCK NARROW MINI L,3664.23,3664.23,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100309,0278,C1713,,,,,LOCK SCREW SQUARE 2.7MMX14MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100311,0278,C1713,,,,,DVR LOCK NARROW L,3664.23,3664.23,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100312,0278,C1713,,,,,SCREW LOCKING 2.7MM 8MM,432.28,432.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100313,0278,C1769,,,,,GUIDE WIRE .91MMX80MM SS,197.52,197.52,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100314,0278,C1713,,,,,CREO AMP 6.5X35MM MODULAR CANNULATED SCR,2047.95,2047.95,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100317,0278,C1713,,,,,15MM 4.0 VARIABLE SCREW/MEDTRONIC,1287.65,1287.65,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100321,0278,C1713,,,,,CREO MIS 5.5X50mm CURVED ROD TITANIUM AL,1279.97,1279.97,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100322,0278,C1713,,,,,5X14X11 CORNERSTONE PSR,3071.93,3071.93,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100323,0278,C1713,,,,,PLATE 19MM,3327.92,3327.92,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100324,0278,C1713,,,,,4X15MM SCREW,1287.65,1287.65,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 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 16100331,0278,C1713,,,,,PERI SCREW 3.55X16MM,162.09,162.09,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100332,0278,C1713,,,,,3.5 MM CANNULATED SCREW,663.52,663.52,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100333,0278,C1713,,,,,PERI SCREW 3.5X MM X 26 W/ 2.7 MM,162.09,162.09,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100334,0278,C1713,,,,,DISTAL LATERAL FIBULA LOCKING PLATE,2366.71,2366.71,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100335,0278,C1713,,,,,2.7MM CORTICAL SCREW 16MM,97.33,97.33,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100336,0278,C1713,,,,,2.7MM CORTICAL SCREW 18MM,97.33,97.33,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100337,0278,C1713,,,,,DISTAL LATERAL FIBULA LOCKING PLATE 4H 8,2308.99,2308.99,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100339,0278,C1713,,,,,SCREW 3.5 CORTEX 14MM,111.37,111.37,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100340,0278,C1713,,,,,SCREW 3.5 CORTEX 16MM,108.65,108.65,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100341,0278,C1713,,,,,SCREW 3.5 CORTEX 18MM,111.37,111.37,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100342,0278,C1713,,,,,SCREW EXT. STEM,238.10,238.10,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100344,0278,C1713,,,,,TAO Q-C FOR 3.5MM SCREWS 110MM,321.04,321.04,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100345,0278,C1713,,,,,SCREW FORTE CANCELLOUS 4.0MMX14MM FULL T,227.19,227.19,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100346,0278,C1713,,,,,DISTAL LATERAL FIBULA LOCKING PLATE 6H 1,2469.52,2469.52,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100347,0278,C1713,,,,,CREO AMP 6.5X50MM MODULAR CANNULATED SCR,1998.00,1998.00,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100349,0278,C1713,,,,,SCREW FORTE CANCELLOUS 4.0MMX16MM FULL T,227.19,227.19,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100359,0278,C1713,,,,,4.0 MM CANNULATED SCREW 1/3 THD 48MM,708.58,708.58,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100363,0278,C1713,,,,,4.0MM CANNULATED SCREW 1/3 THD 4MM,674.70,674.70,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 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,1256.24,1256.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100366,0278,C1713,,,,,CREO AMP 7.5X40MM CANNULATED SCREW,1998.00,1998.00,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100367,0278,C1713,,,,,CREO AMP 7.5X45MM CANNULATED SCREW,1998.00,1998.00,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100373,0278,C1713,,,,,"QCKFIX SCREW, TI, CANC, PT, 3.0X28MM",499.50,499.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100374,0278,C1713,,,,,"QCKFIX SCREW, TI, CANC, PT, 3.0X30MM",499.50,499.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 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,,,,,,,,,,,,, 16100378,0278,C1713,,,,,PLATE 19MM ZEVO,3246.75,3246.75,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100379,0278,C1713,,,,,3.15X15MM FIXED SCREW,1256.24,1256.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100385,0278,C1781,,,,,MESH VENTRALIGHT ST 30.5X35.6CM,9927.40,9927.40,630.48,3726.72,,,,,,,630.48,,,3726.72,3726.72 16100390,0278,C1776,,,,,FEMORAL HEAD,1356.96,1356.96,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100391,0278,C1713,,,,,PEDICLE ACCESSS KIT,1665.00,1665.00,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100400,0278,C1713,,,,,PLATE 3-HOLE DVR,2653.97,2653.97,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100401,0278,L8699,,,,,CERVICAL CAGE CIF 6 DEG -07,9973.20,9973.20,1960.76,1960.76,,,,,,,1960.76,,,, 16100402,0278,L8699,,,,,CERVICAL CAGE CIF 6 DEG -08,9973.20,9973.20,1960.76,1960.76,,,,,,,1960.76,,,, 16100403,0278,L8699,,,,,CERVICAL PLATE 10MM,8533.00,8533.00,1960.76,1960.76,,,,,,,1960.76,,,, 16100404,0278,L8699,,,,,CERVICAL PLATE 14 MM,8324.88,8324.88,1960.76,1960.76,,,,,,,1960.76,,,, 16100405,0278,C1769,,,,,K-WIRE 1.6,65.60,65.60,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100406,0278,C1769,,,,,K-WIRE,539.45,539.45,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100409,0360,20930,,,,,BONE GRAFT I FACTOR 2.5CC,5200.00,5200.00,,,,,,,,,,,,, 16100411,0278,C1713,,,,,DISTRACTION PIN 12MM,832.49,832.49,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100412,0278,L8699,,,,,CERVICAL PLATE,1535.94,1535.94,1960.76,1960.76,,,,,,,1960.76,,,, 16100415,0278,C1713,,,,,SCREW MULTI DIRECTIONAL 24MM,492.83,492.83,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100416,0278,C1713,,,,,SCREW 2.5 LOCKING 24MM,266.40,266.40,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100417,0278,C1713,,,,,SCREW 3.5 LOCKING 12MM,266.40,266.40,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100419,0278,L8699,,,,,"TESERA SC CAGE, 16MMX13.5MMX6MM, 7",16383.35,16383.35,1960.76,1960.76,,,,,,,1960.76,,,, 16100421,0278,L8699,,,,,"CERVICAL CAGE CIF, 6 DEG, -06",9973.20,9973.20,1960.76,1960.76,,,,,,,1960.76,,,, 16100422,0278,L8699,,,,,"1-LEVEL, 12MM CERVICAL PLATE",8324.88,8324.88,1960.76,1960.76,,,,,,,1960.76,,,, 16100423,0278,C1713,,,,,DISTRACTION PIN 14MM,853.30,853.30,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100424,0278,C1713,,,,,7MM 4 HOLE ANTERIOR PLATE,8324.88,8324.88,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100425,0278,C1713,,,,,7MM LOCKING COVER,832.49,832.49,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100426,0278,C1713,,,,,3.5MM VARIABLE SCREW SELF DRILLING 14MM,1365.28,1365.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100428,0278,C1713,,,,,"INTERBODY, 16X14X7MM 7 DEGREE STERILE",9973.20,9973.20,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100429,0278,L8699,,,,,MOBI-C CERVICAL DISC PROSTHESIS,20216.68,20216.68,1960.76,1960.76,,,,,,,1960.76,,,, 16100435,0278,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 80MM,825.31,825.31,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100436,0278,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 85MM,805.18,805.18,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100439,0278,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 70MM,805.18,805.18,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100443,0278,C1713,,,,,6.5MM CANNULATED SCREW 16MM THD 75MM,805.18,805.18,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100502,0278,C1768,,,,,GRAFT,25903.68,25903.68,,,,,,,,,,,,, 16100503,0278,C1768,,,,,GRAFT - LINE EXTENDER,10572.59,10572.59,,,,,,,,,,,,, 16100534,0278,C1713,,,,,BONE SCREW 6.5x35,236.46,236.46,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100537,0278,C1713,,,,,Z NAIL 5.0X30 CORT SCREW FA,691.46,691.46,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100538,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 64 OO,8909.61,8909.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100539,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 62NN,8909.61,8909.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100545,0278,C1713,,,,,Z NAIL 5.0X32.5 CORT SCREW,708.75,708.75,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100547,0278,C1713,,,,,Z NAIL 5.0X27.5 CORT SCREW,691.46,691.46,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100549,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, II 32",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100550,0278,C1713,,,,,PLATE TIBIA NCB PROXIMAL,2708.44,2708.44,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100551,0278,C1713,,,,,PERI SCREW 3.5MMX10MM W2.7MM HEAD,158.14,158.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100552,0278,C1713,,,,,PERI SCREW 3.5MM X 12MM W/2.7 HEAD,158.14,158.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100553,0278,C1713,,,,,PERI SCREW 3.5MM X 12MM W/2.7 HEAD,158.14,158.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100554,0278,C1713,,,,,PERI SCREW 3.5MM X 24MM W/2.7 HEAD,158.14,158.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100556,0278,C1713,,,,,PERI SCREW 3.5MM X 40MM W/2.7 HEAD,158.14,158.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100557,0278,C1713,,,,,LOCKING SCREW 3.5MM X 20MM W/2.7 HEAD,358.10,358.10,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100559,0278,C1713,,,,,BONE SCREW,236.46,236.46,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100567,0278,C1713,,,,,BONE SCREW 6.5 X 20,236.46,236.46,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100580,0278,C1713,,,,,SCREW CORTICAL 2.7X22MM,86.78,86.78,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100581,0278,C1713,,,,,SCREW CORTICAL 2.7X14MM,84.66,84.66,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100590,0278,C1713,,,,,PERIARTICULAR CORTICAL SCREW 16MMX3.5MM,158.14,158.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100600,0278,C1769,,,,,GUIDE WIRE 1.6,147.60,147.60,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16100602,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, JJ 32",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100603,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL,8909.61,8909.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100604,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, HH 32",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100617,0278,C1776,,,,,FEMORAL COMPONENT SIZE E,13919.19,13919.19,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100619,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 56 KK,8909.61,8909.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100623,0278,C1776,,,,,FEMORAL COMPONENT SIZE G,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100624,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE G,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100625,0278,C1776,,,,,STEMMED TIBIAL COMPONENT PRECOAT SIZE 7,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100626,0278,C1776,,,,,"LPS-FLEX GSF OPTION FEMORAL, SIZE C-LT",6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100627,0278,C1713,,,,,Z NAIL 10.5X110 LAG SCREW,1974.37,1974.37,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100628,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, KK 32",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100629,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE EF,3954.31,3954.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100630,0278,C1713,,,,,SCREW CANNULATED 4.5 40MM,665.99,665.99,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100631,0278,C1713,,,,,SCREW CANNULATED 4.5 52MM,852.47,852.47,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100633,0278,C1713,,,,,SCREW CANNULATED 7.3MM 100MM,852.47,852.47,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100634,0278,C1713,,,,,SCREW CANNULATED 7.3MM 115MM,873.78,873.78,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100635,0278,C1713,,,,,SCREW CANNULATED7.3 95MM,852.47,852.47,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100636,0278,C1713,,,,,SCREW CANNULATED 4.5 52MM,774.80,774.80,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100637,0278,C1776,,,,,FEMORAL COMPONENT SIZE E-LT,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100638,0278,C1776,,,,,ALL-POLY PATELLA 38MM,1920.85,1920.85,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100640,0278,C1776,,,,,FEMORAL COMPONENT SIZE D LEFT,10755.74,10755.74,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100641,0278,C1776,,,,,FEMORAL HEAD 32MM-3.5,2056.24,2056.24,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100642,0278,C1776,,,,,VERSYS FM MC CLR 15X160MM STD NECK,12021.12,12021.12,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100643,0278,C1713,,,,,PERIARTICULAR LOCKING SCREW 2.4MMX14MM,370.42,370.42,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100644,0278,C1713,,,,,PERI LOCKING SCREW 3.5MMX16MM,370.42,370.42,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100645,0278,C1713,,,,,SCREW CANNULATED 3.5MMX50MM 1/2 THREAD,647.34,647.34,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100648,0278,C1776,,,,,FEMORAL HEAD 32MM+0,1356.95,1356.95,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100649,0278,C1776,,,,,VERSYS 6 INCH BEADED FC 14X160MM STD NEC,8305.49,8305.49,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100653,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, NN 32",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100654,0278,C1776,,,,,VERSYS 6 INCH BEADED FC 15X160MM STD BOD,8305.49,8305.49,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100655,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, OO 32",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100656,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100657,0278,C1776,,,,,CONTINUUM LONGEVITY NEUTRAL LINER II 36X,3172.32,3172.32,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100658,0278,C1776,,,,,CONTINUUM CLUSTER-HOLE SHELL 52 II,5282.33,5282.33,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100659,0278,C1713,,,,,Z NAIL 5.0X100 LAG SREW,1926.21,1926.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100661,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 52 II,8909.61,8909.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100662,0278,C1776,,,,,NEXGEN LPS-FLEX OPTION FEMORAL SIZE G-LT,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100663,0278,C1776,,,,,MODULAR HEAD 32MM+3MM NECK,1356.95,1356.95,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100664,0278,C1713,,,,,Z NAIL 10.5X105 LAG SCREW,1926.21,1926.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100666,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100668,0278,C1776,,,,,CONTINUUM CLUSTER-HOLE SHELL 50 HH,8909.61,8909.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100676,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR EF,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100677,0278,C1713,,,,,PERI SCREW 3.5MM X 20MM W/2.7MM HEAD SEL,158.14,158.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100679,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 48 GG,8909.61,8909.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 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,,,,,,,,,,,,, 16100688,0278,C1713,,,,,4.0MM CANNULATED SCREW 1/3 THD 46MM,688.11,688.11,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100690,0278,C1713,,,,,Z NAIL 5.0X40 CORT SCREW FA,691.46,691.46,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100691,0278,C1713,,,,,Z NAIL 5.0X42.5 CORT SCREW,708.75,708.75,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100692,0278,C1713,,,,,Z NAIL CPM 11.5MMX36CM,7976.58,7976.58,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 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,,,,,,,,,,,,, 16100703,0278,C1713,,,,,CERAMENT BONE VOID FILLER 18CC,19020.67,19020.67,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100704,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER LL 36M,3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100706,0278,C1776,,,,,MODULAR HEAD 36MM +3MM NECK,2692.14,2692.14,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100707,0278,C1713,,,,,Z NAIL 10.5X85 LAG SCREW,1926.24,1926.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100711,0278,C1776,,,,,BIPOLAR LINER 42/43 OD X 22MM ID,738.51,738.51,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 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,1098.68,1098.68,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100715,0278,C1776,,,,,ARCOS 1PC 9.5X175MM BRCH BODY STD,10988.83,10988.83,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100716,0278,C1776,,,,,22.2MM DIA COCR MOD HD - 5 NK,1355.64,1355.64,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 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,,,,,,,,,,,,, 16100814,0278,C1776,,,,,NEXGEN LPS 5-6 12 MM,3008.61,3008.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100815,0278,C1776,,,,,NEXGEN LPS FEMORAL SIZE E RT,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100816,0278,C1776,,,,,NEXGEN LPS FEMORAL SIZE F RT,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100817,0278,C1776,,,,,NEXGEN LPS FLEX FEMORAL SIZE F LT,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100818,0278,C1776,,,,,NEXGEN LPS 5-6 17 MM,2936.38,2936.38,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100821,0278,C1713,,,,,BONE SCREW 6.5 X 25 SELF TAP,236.46,236.46,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100822,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 15,6515.71,6515.71,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100823,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ7 L,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100824,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE F L,3008.66,3008.66,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100825,0278,C1776,,,,,ARCOS 16X175MM BRCH BODY STD,10989.00,10989.00,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100826,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE F r,3252.41,3252.41,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100835,0278,C1713,,,,,PERI SCREW 3.5MM X 22MM W/2.7MM HEAD SEL,158.14,158.14,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100836,0278,C1713,,,,,SCREW FORTE CANCELLOUS 4.0MMX20MM FULL T,227.21,227.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100852,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE E,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100866,0278,C1776,,,,,PROLONG HIGHLY CROSSLINKED POLYETHYLENE,1920.85,1920.85,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100867,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100868,0278,C1776,,,,,TAPER STEM PLUG NEXGEN,1586.15,1586.15,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100869,0278,C1776,,,,,LEGACY KNE POSTERIOR STABILIZED,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100870,0278,C1713,,,,,PALACOS R+G 1X40 SINGLE BONE CEMENT,982.34,982.34,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100872,0278,C1776,,,,,STEMMED TIBIAL COMPONENT PRECOAT SIZE 5,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100873,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE E,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100874,0278,C1776,,,,,STEMMED TIBIAL COMPONENT PRECOAT SIZE 4,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100875,0278,C1776,,,,,ALL-POLY PATELLA 32MM,1920.85,1920.85,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100876,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SIZE C,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100877,0278,C1776,,,,,LEGACY KNE POSTERIOR STABILIZED SIZE D,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100878,0278,C1776,,,,,"NEXGEN PROLONG ALLPOLY PATELLA, 29MM",1920.85,1920.85,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100880,0278,C1776,,,,,LEGACY KNE POSTERIOR STABILIZED SIZE R-L,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100881,0278,C1776,,,,,NEXGEN PRECOAT STEMTIBIAL PLATE SZ 4,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100882,0278,C1776,,,,,LEGACY KNEE POSTERIOR STABILIZED SZ CD,3954.31,3954.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100883,0278,C1776,,,,,LEGACY KNE POSTERIOR STABILIZED SIZE D-L,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100884,0278,C1776,,,,,STEMMED TIBIAL COMPONENT PRECOAT SIZE 6,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100886,0278,C1713,,,,,REFOBACIN BONE CEMENT R 1X40 US,982.35,982.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100887,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100888,0278,C1713,,,,,HEADLESS TROCAR DRILL PIN75MM,945.87,945.87,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100899,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100902,0278,C1776,,,,,NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 3,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100904,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR CD,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100914,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100915,0278,C1776,,,,,NEXGEN PRECOAT STEMMED TIBIAL PLATE SZ 2,4745.18,4745.18,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100916,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PSIZE CD 12MM,3862.33,3862.33,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100917,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100918,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100919,0278,C1776,,,,,NEXGEN LPS-FLEX FIXED PROLONG ART SUR CD,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100922,0278,C1776,,,,,ARCOS 13X175M BRCH BODY STD,10988.83,10988.83,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100923,0278,C1776,,,,,ARCOS 12X175MM BRCH BODY STD,10988.83,10988.83,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100924,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR GH,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100925,0278,C1776,,,,,NEXGEN LPS FLEX FIXED PROLONG ART SUR EF,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100926,0278,C1776,,,,,ACROS 1PC 14X175MM BRCH BODY STD,10988.83,10988.83,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100928,0278,C1713,,,,,PSN 2.5MM FEMALE SCREW 25MM,472.95,472.95,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100929,0278,C1776,,,,,PSN FEM PS CMT CCR NRW SIZE 5 L,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100932,0278,C1776,,,,,PSN ASF PS 16MM VE L 3-5 CD,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100933,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE D L,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100934,0278,C1776,,,,,ALL POLY PAT VE 32MM DIA,1920.85,1920.85,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100935,0278,C1776,,,,,ARCOS 11X175MM BRCH BODY STD,10988.83,10988.83,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100936,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ8 L,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100937,0278,C1776,,,,,PSN ASF PS 10MM VE L 6-9 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100938,0278,C1776,,,,,PSN TIB STM 5 DEG SZ G L,3252.41,3252.41,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100939,0278,C1776,,,,,ALL POLY PAT VE 38 MM DIA,1920.87,1920.87,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100944,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ10 L,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100945,0278,C1776,,,,,PSN ASF PS 12MM VE L 10-12 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100946,0278,C1776,,,,,ALL POLY PAT VE 41 MM DIA,1920.87,1920.87,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100947,0278,C1776,,,,,"BIOLOX DELTA FEM HEAD, 32MM, +0MM",3474.32,3474.32,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100948,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ9 R,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100949,0278,C1776,,,,,PSN TIB STM 5 DEG SZ E R,3252.41,3252.41,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100951,0278,C1776,,,,,PSN ASF PS 10MM VE R 6-9 EF,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100952,0278,C1776,,,,,ALL POLY PAT VE 35 MM DIA,1920.87,1920.87,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100953,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ8 R,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100954,0278,C1776,,,,,PSN ASF PS 16MM VE L 6-9 CD,3008.60,3008.60,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100955,0278,C1776,,,,,PSN ASF PS 11MM VE R 6-9 EF,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100956,0278,C1776,,,,,PSN FEM PS CMT CCR NRW SIZE 6 R,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100957,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 12.5,6515.71,6515.71,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100958,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ10 R,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100959,0278,C1776,,,,,PSN ASF PS 10MM VE L 10-12 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100960,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ11 R,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100961,0278,C1776,,,,,PSN ASF PS 10MM VE R 10-12 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100962,0278,C1776,,,,,PSN ASF PS 10MM VE L 6-9 EF,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100963,0278,C1776,,,,,BF HUMERAL HEAD 15MMX46MM,4372.48,4372.48,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100964,0278,C1776,,,,,TM HUMERAL STEM 48 DEG 11MMX130MM,11183.20,11183.20,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100965,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ9 R,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100966,0278,C1776,,,,,PSN TIB STM 5 DEG SZ G R,3252.41,3252.41,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100967,0278,C1776,,,,,PSN ASF PS 11MM VE R 6-9 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100968,0278,C1776,,,,,PSN ASF PS 10MM VE L 10-12 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100969,0278,C1776,,,,,PSN ASF PS 12MM VE R 10-12 GH,3008.66,3008.66,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100972,0278,C1776,,,,,ALL POLY PAT VE 38 MM DIA,1920.87,1920.87,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100975,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ11 L,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100976,0278,C1776,,,,,PSN FEM PS CMT CCR STD SZ7 L,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100977,0278,C1776,,,,,PSN ASF PS 12MM VE L 6-9 EF,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100978,0278,C1776,,,,,PSN ASF PS 10MM VE R 6-9 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100979,0278,C1713,,,,,GEMINUS VOLAR DISTAL RADIUS,3593.07,3593.07,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100980,0278,C1713,,,,,SMOOTH PEG LOCKING 2.00X16MM,369.27,369.27,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100981,0278,C1713,,,,,SMOOTH PEG LOCKING 2.0X18MM,369.27,369.27,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100982,0278,C1713,,,,,SMOOTH PEG LOCKING 2.7X22MM,396.27,396.27,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100983,0278,C1713,,,,,HIGH COMPRESSION LOCKING PEG 2.7X22MM,426.24,426.24,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100984,0278,C1713,,,,,SCREW CORTICAL LOCKING 3.5X10MM,392.94,392.94,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100985,0278,C1713,,,,,SCREW CORTICAL LOCKING 3.5X12MM,392.94,392.94,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100986,0278,C1713,,,,,SCREW CORTICAL NON LOCKING 3.5X10MM,386.28,386.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16100987,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER LL 32X,3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100988,0278,C1776,,,,,32MM MOD HEAD COCR +6mm NECK,1355.62,1355.62,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100989,0278,C1776,,,,,ARCOS 12X175MM BRCH BODY HI,10988.83,10988.83,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100990,0278,C1776,,,,,"CONTINUUM VIVACIT-E NEUTRAL LINER, KK 32",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100991,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER II 32X,3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100992,0278,C1776,,,,,PSN FEM PS CMT CCR NRW SZ7 R,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100993,0278,C1776,,,,,PSN ASF PS 12MM VE L 6-9 EF,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100996,0278,C1776,,,,,PSN ASF PS 14MM VE L 10-12 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100998,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE E L,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16100999,0636,Q4186,,,,,DRESSING EPIFIX 2X3,635.20,635.20,229.88,229.88,,,,,,,229.88,,,, 16101000,0278,C1713,,,,,PIN GUIDE 3.2 MM,639.35,639.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101001,0278,C1713,,,,,SCREW LAG 85MM,937.92,937.92,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101002,0278,C1713,,,,,SCREW 4.7 X 25.4 MM,195.48,195.48,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 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,3466.21,3466.21,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 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,3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101014,0278,C1776,,,,,PSN ASF PS 10MM VE L 10-11 EF,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101015,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE F L,3333.72,3333.72,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101016,0278,C1776,,,,,PSN ASF PS 14MM VE L 6-9 GH,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101017,0278,C1776,,,,,PSN TIB STM 5 DEG SZ E L,3252.41,3252.41,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101018,0278,C1776,,,,,PSN ASF PS 14MM VE R 6-9 EF,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101020,0278,C1776,,,,,CER BIOLOXD OPTION HD 32MM,3473.36,3473.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 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",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101023,0278,C1776,,,,,CER BIOLOXD OPTION HD 36MM,3473.36,3473.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101024,0278,C1889,,,,,CER OPTION TYPE 1 TPR SLEEVE +6,945.89,945.89,2620.06,15624.36,,,,,,,2620.06,,,15624.36,15624.36 16101026,0278,C1713,,,,,COMP REV SHLDR 9 IN STEINMANN,530.20,530.20,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101028,0278,C1776,,,,,COMP RVS 25MM BSPLT HA+ADPTR,5744.25,5744.25,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101029,0278,C1713,,,,,HMRL BEARING 36 MM + 3 VITE,6127.20,6127.20,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101030,0278,C1776,,,,,HMRL TRAY +3 STD,5296.20,5296.20,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101031,0278,C1713,,,,,COMP NLK SCR 3.5HEX 4.75X25 ST,471.03,471.03,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101032,0278,C1713,,,,,COMP NLK SCR 3.5HEX 4.75X20 ST,471.03,471.03,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101033,0278,C1776,,,,,COMP RVRS SHLDR GLNSP STD 36MM,4583.91,4583.91,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101034,0278,C1713,,,,,COMP RVS CNTRL 6.5X25MM ST/RST,463.37,463.37,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101035,0278,C1713,,,,,AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 15MM,1984.68,1984.68,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101036,0278,C1713,,,,,CANNULATED COMPRESSION SCREW W/ S.S.,1651.68,1651.68,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101037,0278,C1713,,,,,AUTOFIX COMPR SCREW MOD T7 DR 2.5 X 17MM,1984.68,1984.68,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101100,0278,C1713,,,,,PLATE 135 DEGREE 3 HOLE,1442.37,1442.37,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101101,0278,C1713,,,,,SCREW CORTICAL NON LOCKING 3.5X12MM,386.28,386.28,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101102,0278,C1769,,,,,K-WIRE 1.6X127MM,143.50,143.50,100.91,131.80,,,,,,,100.91,,,131.80,131.80 16101103,0278,C1713,,,,,DRILL SOLID SIDE CUTTING 2X40MM,459.54,459.54,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101104,0278,C1713,,,,,DRILL SOLID SIDE CUTTING 2.5X40MM,469.53,469.53,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101105,0278,C1713,,,,,DRIVER PEG TORQUE,462.87,462.87,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101223,0278,C1713,,,,,XEMPLIFI DBM PUTTY 5 CC,3330.00,3330.00,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101224,0278,C1713,,,,,CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,1248.75,1248.75,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101225,0278,C1713,,,,,CREO MIS 5.5mm CURVED ROD TITANIUM ALLOY,1248.75,1248.75,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101226,0278,C1713,,,,,CREO MIS 5.5X40MM CURVED ROD TITANIUM AL,1279.97,1279.97,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101227,0278,C1713,,,,,CREO AMP 6.5X45MM MODULAR CANNULATED SCR,1998.00,1998.00,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101230,0278,C1776,,,,,COLONIAL ACDF SPACER 12X14 7DEGREE 7MM,3330.00,3330.00,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101232,0278,C1776,,,,,COLONIAL ACDF SPACER 12X14 7DEGREE 6MM,3330.00,3330.00,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101233,0278,C1776,,,,,COLONIAL ACDF SPACER 12X14 7DEGREE 10MM,3300.00,3300.00,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101234,0278,C1713,,,,,BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,749.25,749.25,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101235,0278,L8699,,,,,RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,3300.00,3300.00,1960.76,1960.76,,,,,,,1960.76,,,, 16101236,0278,C1713,,,,,XEMPLIFI DBM PUTTY 1 CC,832.50,832.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101237,0278,L8699,,,,,RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,3300.00,3300.00,1960.76,1960.76,,,,,,,1960.76,,,, 16101238,0278,C1713,,,,,BONE SCREW 4.2MM VARIABLE ANGLE SELF DRI,749.25,749.25,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101239,0278,L8699,,,,,RESONATE ANTERIOR CERVICAL PLATE 1-LEVEL,3300.00,3300.00,1960.76,1960.76,,,,,,,1960.76,,,, 16101240,0278,L8699,,,,,RESONATE ANTERIOR CERVICAL PLATE 2-LEVEL,3300.00,3300.00,1960.76,1960.76,,,,,,,1960.76,,,, 1610167,0278,C1713,,,,,MINI-MONSTER CANNULATED SHORT THREADED S,1137.50,1137.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16101933,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE D R,3252.36,3252.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101940,0636,Q4186,,,,,EPIFIX 2.0x2.0 CM,908.36,908.36,229.88,229.88,,,,,,,229.88,,,, 16101945,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ6 L,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101946,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ5 R,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101948,0278,C1776,,,,,PSN FEM PS CMT CRR NRW SZ6 R,6752.07,6752.07,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101951,0278,C1776,,,,,PSN ASF PS 12MM VE R 6-9 CD,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101952,0278,C1776,,,,,PSN ASF PS 10MM VE R 6-9 CD,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101953,0278,C1776,,,,,JOINT DEVICE (IMPLANTABLE),3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101954,0278,C1776,,,,,PSN ASF PS 11MM VE L 3-5 CD,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16101955,0636,Q4186,,,,,EPIFIX 5.0X6.0 CM,650.98,650.98,229.88,229.88,,,,,,,229.88,,,, 16101956,0636,Q4186,,,,,EPIFIX 4.0X4.0 CM,635.09,635.09,229.88,229.88,,,,,,,229.88,,,, 16101957,0636,Q4186,,,,,EPIFIX 3.0 X 4.0 CM CONSIGN,0.01,0.01,229.88,229.88,,,,,,,229.88,,,, 16101958,0636,Q4186,,,,,DRESSING EPIFIX 18MM DISC,2479.19,2479.19,229.88,229.88,,,,,,,229.88,,,, 16101960,0636,Q4186,,,,,EPIFIX 2.0x4.0 CM,575.99,575.99,229.88,229.88,,,,,,,229.88,,,, 16103013,0278,C1884,,,,,EMBOSHIELD NAV PROTECT SYSTEM,5644.27,5644.27,,,,,,,,,,,,, 16108000,0636,Q4101,,,,,APLIGRAPH PER SQ CM,4412.18,4412.18,,,,,,,,,,,,, 16108001,0278,C1713,,,,,BB-TAK,166.56,166.56,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108002,0278,C1713,,,,,"BB-TAK, THREADED",283.05,283.05,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108003,0278,C1713,,,,,"LO-PRO SCRW,TI,3.0MMX 14MMCORT",366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108004,0278,C1713,,,,,"LO-PRO SCRW,TI,3.0MMX 16MMCORT",366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108005,0278,C1713,,,,,"LO-PRO SCRW,TI,3.0MMX 18MMCORT",366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108007,0278,C1713,,,,,"LO-PRO SCRW,TI,3X 28MMCANN,PT THD",409.58,409.58,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108008,0278,C1769,,,,,"GUIDEWIRE, .045 X5.91",28.70,28.70,100.91,131.80,,,,,,,100.91,,,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",366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108013,0278,C1713,,,,,"LO-PRO MTP PLT TM CONTRD,SHT,L,TI",2663.96,2663.96,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108014,0278,C1713,,,,,SPEEDBRG IMP SYS W/BIO-COMP SWVLK,5794.11,5794.11,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 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",2647.31,2647.31,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108021,0278,C1713,,,,,LO-PRO SCREW TI 3.0MMX20CORT,366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108022,0278,C1713,,,,,"LO-PRO SCRW,TI,3.0MMX 22MMCORT",366.29,366.29,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108023,0278,C1713,,,,,3.0X12MM VAL SCREW TI,466.19,466.19,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108024,0278,C1713,,,,,3.0X14MM VAL SCREW TI,466.19,466.19,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108025,0278,C1713,,,,,3.0X20MM VAL SCREW TI,466.19,466.19,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108026,0278,C1713,,,,,"LO-PRO MTP PLATE STR, LONG TI",2663.96,2663.96,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108027,0278,C1713,,,,,PHALANGEAL REAMER 22MM,1498.48,1498.48,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108028,0278,C1713,,,,,METATARSAL REAMER 22MM,1498.48,1498.48,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108030,0278,C1713,,,,,SPEEDBRG IMP SYS W/BIO-COMP SWVLK,6519.31,6519.31,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108031,0278,C1713,,,,,FHL IMPLANT SYSTEM 6.25 MM,4978.35,4978.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108032,0278,C1713,,,,,TENO SCREW KIT DISP.,649.35,649.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108033,0278,C1713,,,,,COMPR FT SCREW MINI 3.5 X 32MM,1165.50,1165.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108034,0278,C1713,,,,,COMPR FT SCREW MINI 3.5 X 34MM,1165.50,1165.50,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108035,0272,A4649,,,,,G-WIRE W/TRCR TIP .45 W/ LASER LINE,61.50,61.50,,,,,,,,,,,,, 16108037,0272,A4649,,,,,DRILL PROFILE MINI CMP FT,499.50,499.50,,,,,,,,,,,,, 16108039,0278,C1713,,,,,COMPR FT SCRE XL 7 X 55MM,2314.35,2314.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108040,0278,C1713,,,,,COMPR FT SCREW XL 7 X 60MM,2314.35,2314.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 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,,,,,,,,,,,,, 16108116,0278,C1713,,,,,"IMPLANT SYS, BIOC ACHILLES SPEEEDB W JUM",6643.35,6643.35,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108117,0278,C1713,,,,,"IMPLANT SYS, BIOC ACHILLES SPEEDB W/JUMP",2044.88,2044.88,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16108118,0278,L8699,,,,,UROLIFT UL400 DELIVERY DEVICE & IMPLANT,3246.75,3246.75,1960.76,1960.76,,,,,,,1960.76,,,, 16109009,0278,C1713,,,,,"3.2MM THREAD PIN, 508MM",444.51,444.51,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16109019,0278,C1713,,,,,3MMx100CM TEARDROP GD,580.34,580.34,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16109023,0278,C1776,,,,,FEMORAL NAIL 10MMX21.5CM 130 R,5309.41,5309.41,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109024,0278,C1776,,,,,BIPOLAR LINER 53/54/55MM OD X 28MM ID,738.51,738.51,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109025,0278,C1776,,,,,BIPOLAR SHELL 55MM OD,1739.89,1739.89,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109027,0272,C1769,,,,,BALL TIP GUIDE WIRE 3.0MMX100CM,419.84,419.84,,,,,,,,,,,,, 16109029,0272,C1769,,,,,BALL NOSE GUIDE WIRE 80CM,600.06,600.06,,,,,,,,,,,,, 16109030,0278,C1713,,,,,PIN 2.0MM,333.40,333.40,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16109031,0272,C1769,,,,,BALL NOSE GUIDE WIRE 100CM,491.51,491.51,,,,,,,,,,,,, 16109090,0278,C1776,,,,,VERSYS 6 INCH BEADED FC 11X160MM STD NEC,8305.49,8305.49,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109091,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 10,6515.71,6515.71,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109092,0278,C1776,,,,,12/14 COCR FEMORAL HEAD 32MM + 0,1356.98,1356.98,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109093,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 50 HH,8909.75,8909.75,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109094,0278,C1776,,,,,CONTINUUM VIVACIT-E NEUTRAL LINER HH 32x,3172.36,3172.36,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109099,0278,C1776,,,,,BIPOLAR SHEL 47MM OD,1098.68,1098.68,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109100,0278,C1776,,,,,MODULAR NECK 12/14 NECK TAPER,2364.69,2364.69,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109101,0278,C1776,,,,,MODULAR NECK 12/14 TAPER,2364.69,2364.69,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109102,0278,C1776,,,,,MODULAR NEX C 12/14 NECK TAPER,2364.69,2364.69,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109103,0278,C1776,,,,,BIPOLAR LINER 47/48/49MM OD X 28MM ID,738.51,738.51,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109104,0278,C1776,,,,,BIPOLAR SHELL 48MM OD,738.51,738.51,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109105,0278,C1776,,,,,VERSYS PRESS FIT LD/FX SZ 11X120MM,4428.83,4428.83,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109106,0278,C1776,,,,,12/14 COCE FEMORAL HEAD 28MM,1356.95,1356.95,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109107,0278,C1776,,,,,MODULAR NECK E 12/14 TAPER,12021.12,12021.12,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109108,0278,C1776,,,,,BIPOLAR SHELL 49MM OD,1098.68,1098.68,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109109,0278,C1776,,,,,VERSYS FM MC CLR 13X140MM STD NECK,12021.12,12021.12,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109111,0278,C1776,,,,,HIP PROSTHESIS TAPER ML,6515.62,6515.62,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109113,0278,C1776,,,,,HIP PROSTHESIS TAPER SZ 12.5,6515.61,6515.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109114,0278,C1776,,,,,MODULAR NEX G 12/14 NECK TAPER,2364.69,2364.69,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109115,0278,C1776,,,,,"CONTINUUM LONGEVITY NEUTRAL LINER, MM 32",3172.31,3172.31,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109116,0278,C1776,,,,,CONTINUUM MULTI-HOLE SHELL 58LL,8909.61,8909.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109117,0278,C1776,,,,,VERSYS FM MC CLR 12X140MM STD NECK,12021.12,12021.12,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109118,0278,C1776,,,,,MODULAR NEX B 12/14 NECK TAPER,2364.69,2364.69,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109119,0278,C1776,,,,,HIP PROSTHESIS TAPER SZ 16.25,6515.61,6515.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109122,0278,C1776,,,,,VERSYS ADVOCATE CEMENTED STEM 11X120 STA,5271.40,5271.40,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109123,0278,C1713,,,,,VERSYS DISTAL CENTRALIZER 11MM,236.46,236.46,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16109124,0278,C1776,,,,,12/14 COCR FEMORAL HEAD 36MM +7.0,2692.10,2692.10,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109125,0278,C1713,,,,,HIVAC 7 SINGLE/DOUBLE SINGLE,887.43,887.43,401.35,1543.03,,,,,,,401.35,,,1543.03,1543.03 16109126,0278,C1776,,,,,BIPOLAR SHELL 53MM OD,1098.68,1098.68,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109127,0278,C1776,,,,,VERSYS PRESS FIT LD/FX SZ 15X140MM,2990.43,2990.43,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109128,0278,C1776,,,,,HIP PROSTHESIS TAPER SZ 11,6515.62,6515.62,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109129,0278,C1776,,,,,32MM MOD HEAD COCR STD NECK,1355.62,1355.62,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109135,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 9,6515.61,6515.61,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109137,0278,C1776,,,,,MODULAR NEX R NECK TAPER,2364.69,2364.69,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109145,0278,C1776,,,,,M/L TAPER KINECTIV STEM SIZE 13.5,6515.71,6515.71,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109196,0278,C1776,,,,,PSN FEM PS CMT CCR NRW SIZE 5 R,6752.17,6752.17,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109197,0278,C1776,,,,,PSN ASF PS 10MM VE R 3-5 CD,3008.65,3008.65,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 16109198,0278,C1776,,,,,PSN TIB STM 5 DEG SIZE D R,3252.41,3252.41,407.59,1232.05,,,,,,,1232.05,,,407.59,407.59 18010002,0360,22869,,,,,INSJ STABLJ DEV W/O DCMPRN,66477.70,66477.70,,,,,,,,,,,,, 18010003,0360,63650,,,,,NEUROMONITORING SERVICES PERC IMPL NS EL,20599.38,20599.38,,,,,,,,,,,,, 18010004,0360,63685,,,,,INC/REPL SPINE NSTIM PG/RCVR,96082.80,96082.80,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,43.86,43.86,48.93,48.93,,,,,,,48.93,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 29001001,0920,95806,,,,,HOME SLEEP TEST,1035.40,1035.40,348.22,530.25,,,,,,,348.22,,,530.25,530.25 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 30000214,0410,94002,,,,,VENT INIT DAY MANAGEMENT,1957.22,1957.22,,,,,,,,,,,,, 30001194,0482,93017,,,,,EKG STRESS TEST,845.94,845.94,287.57,421.84,,,,,,,287.57,,,421.84,421.84 30001195,0730,93041,,,,,EKG RHYTHM STRIP,195.00,195.00,,,,,,,,,,,,, 30001200,0730,93005,,,,,EKG 12 LEAD,198.27,198.27,66.51,132.48,,,132.48,,,,66.51,,,87.01,87.01 30001201,0482,93017,,,,,DOBUTAMINE STRESS TEST EKG ONLY,845.94,845.94,287.57,421.84,,,,,,,287.57,,,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,,,,,,,,,,,,, 30007370,0731,93225,,,,,HOLTER MONITOR HOOKUP ONLY,357.10,357.10,121.46,156.84,,,,,,,121.46,,,156.84,156.84 30008012,0410,94640,,,,,NEB/MDI INITIAL,655.37,655.37,215.92,436.71,,,436.71,,,,219.33,,,215.92,215.92 30008110,0300,89220,,,,,SPUTUM INDUCT 0.9% SALINE,489.81,489.81,,,,,,,,,,,,, 30008128,0460,94150,,,,,VITAL CAPACITY ONLY,510.72,510.72,,,,,,,,,,,,, 30008136,0460,94760,,,,,PULSE OX,48.84,48.84,16.35,17.90,,,,,,,16.35,,,17.90,17.90 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,655.37,655.37,215.92,436.71,,,436.71,,,,219.33,,,215.92,215.92 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,649.46,649.46,214.06,214.06,,,,,,,214.06,,,, 30008284,0300,36600,,,,,ARTERIAL PUNCTURE,363.07,363.07,123.08,123.75,,,,,,,123.08,,,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,,,,,,,,,,,,, 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,,,, 30008606,0460,94726,,,,,IGV PLETHYSMOGRAPHY,867.09,867.09,289.91,580.95,,,580.95,,,,289.91,,,530.91,530.91 30008705,0410,94003,,,,,VENT SUBS DAY MANAGEMENT,1605.39,1605.39,,,,,,,,,,,,, 30008706,0460,94200,,,,,MAX VOL VENT-ONLY,366.03,366.03,,,,,,,,,,,,, 30009025,0460,94680,,,,,GAS ANALYSIS,475.04,475.04,,,,,,,,,,,,, 30009026,0460,94762,,,,,PULSE OX OVERNIGHT STUDY,475.04,475.04,159.45,159.45,,,,,,,159.45,,,, 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,,,,,,,, 3001000,0969,99304,,,,,INITIAL VISIT LOW,79.25,79.25,,,,,,,,,,,,, 3001001,0969,99305,,,,,INITIAL VISIT MODERATE,105.00,105.00,,,,,,,,,,,,, 3001002,0969,99306,,,,,INITIAL VISIT HIGH,143.25,143.25,,,,,,,,,,,,, 3001003,0969,99307GF,,,,,SUBSEQUENT VISIT PROBLEM FOCUSED,48.50,48.50,,,,,,,,,,,,, 3001004,0969,99308GF,,,,,SUBSEQUENT VISIT LOW,70.00,70.00,,,,,,,,,,,,, 3001005,0969,99309GF,,,,,SUBSEQUENT VISIT MODERATE,91.75,91.75,,,,,,,,,,,,, 3001006,0969,99310GF,,,,,SUBSEQUENT VISIT HIGH,109.25,109.25,,,,,,,,,,,,, 3002001,0960,99212GF,,,,,OFFICE VISIT ESTABLISHED FOCUSED,48.50,48.50,,,,,,,,,,,,, 3002002,0960,99213GF,GF,,,,OFFICE VISIT ESTABLISHED DETAILED,74.50,74.50,,,,,,,,,,,,, 3002003,0960,99214GF,,,,,OFFICE VISIT ESTABLISHED COMP,118.25,118.25,,,,,,,,,,,,, 3002004,0960,99215GF,,,,,OFFICE VISIT ESTABLISHED COMPLEX,153.25,153.25,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 31004011,0420,97016GP,GP,,,,PT VASOPNEUMATIC DEVICES,50.00,50.00,,,,,,,,,,,,, 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,110.50,110.50,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 31009605,0420,97140,GP,,,,PT MYOFACIAL RELEASE,168.38,168.38,56.25,112.20,,,112.20,,,,56.25,,,56.54,56.54 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,,,,,,,,,,,,, 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,190.17,190.17,64.66,64.66,,,,,,,64.66,,,, 34002000,0948,G0238,,,,,PULMONARY REHAB 15 MIN SESSION FOR NON C,108.17,108.17,,,,,,,,,,,,, 35000002,0943,93798,,,,,CARDIAC REHAB PHASE 2 W ECG MONITOR,356.63,356.63,119.70,199.76,,,,,,,119.70,,,199.76,199.76 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,2858.80,2858.80,971.47,1524.88,,,,,,,971.47,,,1524.88,1524.88 39008504,0611,70553,,,,,MMRI BRAIN WITH AND WITHOUT CONTRAST,3682.97,3682.97,1252.78,1848.85,,,,,,,1252.78,,,1848.85,1848.85 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,,,,1060.49,,,1788.01,1788.01 39008542,0612,72146,,,,,MMRI THORACTIC SPINE W/O CONTRAST,3066.91,3066.91,1046.33,2502.60,,,,,,,1046.33,,,2502.60,2502.60 39008545,0612,72148,,,,,MMRI LUMBAR SPINE W/O CONTRAST,3066.91,3066.91,910.00,1407.71,,,910.00,,,,1042.10,,,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,,,, 39008581,0614,72195,,,,,MMRI PELVIS W/O CONTRAST,3295.09,3295.09,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,261.67,261.67,0.00,5.27,,,0.00,,,,3.76,,,5.27,5.27 39008648,0636,A9579,,,,,MMRI CONTRAST GADOLINIUM,11.07,11.07,0.00,5.27,,,0.00,,,,3.76,,,5.27,5.27 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,3706.66,3706.66,1258.04,3024.63,,,,,,,1258.04,,,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,,,1365.52,1365.52 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 40000011,0301,80048,,,,,BASIC METABOLIC PANEL POINT OF CARE,91.94,91.94,43.08,96.34,,,96.34,,,,43.08,,,58.98,58.98 40000012,0301,80053,,,,,COMP METABOLIC PANEL POINT OF CARE,168.18,168.18,69.07,113.93,,,113.93,,,,69.07,,,89.14,89.14 40000013,0301,82150,,,,,AMYLASE POINT OF CARE,193.75,193.75,44.89,50.71,,,,,,,50.71,,,44.89,44.89 40000014,0301,82550,,,,,CK POINT OF CARE,76.00,76.00,26.95,51.57,,,,,,,26.95,,,51.57,51.57 40000015,0300,85025,,,,,BACK UP CBC,57.69,57.69,28.53,48.60,,,48.60,,,,28.53,,,37.49,37.49 40000016,0301,82553,,,,,CK-MB POINT OF CARE,104.57,104.57,42.58,73.53,,,71.42,,,,42.58,,,73.53,73.53 40000017,0301,84484,,,,,TROPONIN POINT OF CARE,158.00,158.00,47.34,74.25,,,71.42,,,,47.34,,,74.25,74.25 40000018,0301,83874,,,,,MYOGLOBIN POINT OF CARE,143.00,143.00,44.99,74.64,,,,,,,44.99,,,74.64,74.64 40000026,0300,87077,,,,,ORG ID REF LAB,64.90,64.90,22.31,43.91,,,43.91,,,,22.31,,,25.40,25.40 40000035,0301,84550,,,,,URIC ACID POINT OF CARE,52.60,52.60,15.83,30.26,,,30.26,,,,15.83,,,27.22,27.22 40000055,0301,80051,,,,,ELECTROLYTE PANEL,73.16,73.16,30.21,33.51,,,,,,,33.51,,,30.21,30.21 40000071,0301,80076,,,,,HEPATIC PANEL,117.58,117.58,46.62,174.85,,,174.85,,,,46.62,,,76.63,76.63 40000072,0300,85025,,,,,EMPLOYEE CBC,165.00,165.00,28.53,48.60,,,48.60,,,,28.53,,,37.49,37.49 40000073,0300,81003,,,,,EMPLOYEE URINALYSIS,5.15,5.15,12.84,25.69,,,25.69,,,,12.84,,,17.51,17.51 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,,,,,,,,,,,,, 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,,,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,,,,,,,,,,,,, 40000121,0301,82040,,,,,ALBUMIN SERUM,44.30,44.30,7.52,8.98,,,,,,,7.52,,,8.98,8.98 40000122,0301,82040,,,,,ALBUMIN REFERRED,11.00,11.00,7.52,8.98,,,,,,,7.52,,,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,,,,,,,,,,,,, 40000132,0301,82300,,,,,CADMIUM - BLOOD,103.02,103.02,,,,,,,,,,,,, 40000135,0300,86735,,,,,MUMPS AB IGM,82.68,82.68,,,,,,,,,,,,, 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,193.75,193.75,44.89,50.71,,,,,,,50.71,,,44.89,44.89 40000150,0301,82150,,,,,AMYLASE BODY FLUID,86.00,86.00,44.89,50.71,,,,,,,50.71,,,44.89,44.89 40000151,0301,83690,,,,,LIPASE-BODY FLUID,95.00,95.00,29.14,54.36,,,54.36,,,,29.14,,,46.19,46.19 40000152,0300,C9803,,,,,SPEC COLL SNF/LAB COVID-19,89.11,89.11,0.00,37.23,,,0.00,,,,30.31,,,37.23,37.23 40000153,0300,G2023,,,,,SPECIMEN COLLECT COVID-19,82.11,82.11,27.92,27.92,,,,,,,27.92,,,27.92,27.92 40000154,0301,84520,,,,,UREA NITROGEN SERUM,44.30,44.30,11.07,28.06,,,11.07,,,,19.35,,,28.06,28.06 40000155,0300,86612,,,,,BLASTOMYCES AB-BY ID,55.63,55.63,,,,,,,,,,,,, 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,193.75,193.75,44.89,50.71,,,,,,,50.71,,,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,297.50,297.50,100.00,114.12,,,100.00,,,,101.16,,,114.12,114.12 40000188,0301,82248,,,,,BILIRUBIN DIRECT,44.88,44.88,18.56,30.26,,,30.26,,,,18.56,,,29.27,29.27 40000196,0301,82310,,,,,CALCIUM-SERUM,44.30,44.30,15.03,15.29,,,,,,,15.03,,,15.29,15.29 40000220,0301,82465,,,,,CHOLESTEROL TOTAL,44.30,44.30,,,,,,,,,,,,, 40000238,0301,82550,,,,,CK SERUM,76.00,76.00,26.95,51.57,,,,,,,26.95,,,51.57,51.57 40000239,0301,82550,,,,,REFERRED CK,76.00,76.00,26.95,51.57,,,,,,,26.95,,,51.57,51.57 40000246,0301,82565,,,,,CREATININE-SERUM,50.40,50.40,11.07,31.41,,,11.07,,,,21.13,,,31.41,31.41 40000249,0301,82570,,,,,CREATININE-BODY FLUI,53.60,53.60,19.92,25.68,,,,,,,19.92,,,25.68,25.68 40000250,0301,82570,,,,,CREATININE-URINE,53.60,53.60,19.92,25.68,,,,,,,19.92,,,25.68,25.68 40000251,0301,82570,,,,,CREATININE 24 HR URINE,53.60,53.60,19.92,25.68,,,,,,,19.92,,,25.68,25.68 40000253,0301,82575,,,,,CREATININE CLEARANCE,96.59,96.59,32.74,32.84,,,,,,,32.74,,,32.84,32.84 40000279,0301,82947,,,,,GLUCOSE,42.00,42.00,17.79,18.47,,,,,,,18.47,,,17.79,17.79 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",114.00,114.00,31.05,38.76,,,,,,,31.05,,,38.76,38.76 40000336,0301,83605,,,,,"LACTIC ACID, VENOUS",91.94,91.94,31.05,38.76,,,,,,,31.05,,,38.76,38.76 40000337,0301,83615,,,,,LDH SERUM,59.00,59.00,20.24,36.15,,,,,,,20.24,,,36.15,36.15 40000338,0301,83615,,,,,LDH BODY FLUID,59.00,59.00,20.24,36.15,,,,,,,20.24,,,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,44.30,44.30,15.04,15.51,,,,,,,15.04,,,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 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 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,44.30,44.30,14.95,15.06,,,,,,,14.95,,,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,,,, 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,52.60,52.60,15.83,30.26,,,30.26,,,,15.83,,,27.22,27.22 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,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 40000500,0310,81235,,,,,EGFR GENE ANALYSIS,579.49,579.49,,,,,,,,,,,,, 40000501,0310,81301,,,,,MSI ANALYSIS,473.89,473.89,,,,,,,,,,,,, 40000502,0300,83516,,,,,DGP IGG,63.61,63.61,21.13,21.13,,,,,,,21.13,,,, 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,,,, 40000510,0310,88363,,,,,ARCHIVAL TISSUE MOLECULAR,40.18,40.18,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,16.64,16.64,2.76,5.55,,,,,,,5.55,,,2.76,2.76 40000543,0300,85018,,,,,HEMOGLOBIN X,73.80,73.80,12.24,14.13,,,,,,,14.13,,,12.24,12.24 40000544,0300,83051,,,,,HEMOGLOBIN - PLASMA,93.75,93.75,,,,,,,,,,,,, 40000545,0300,85018,,,,,HEMOGLOBIN BLOOD GAS,33.00,33.00,12.24,14.13,,,,,,,14.13,,,12.24,12.24 40000584,0300,85048,,,,,WBC X,24.47,24.47,,,,,,,,,,,,, 40000600,0300,85049,,,,,PLATELET COUNT X,27.56,27.56,,,,,,,,,,,,, 40000603,0300,85032,,,,,PLATELET COUNT-MAN,65.00,65.00,,,,,,,,,,,,, 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),50.00,50.00,18.76,33.02,,,33.02,,,,18.76,,,21.71,21.71 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,81.00,81.00,27.51,48.60,,,48.60,,,,27.51,,,38.45,38.45 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,67.00,67.00,28.52,41.54,,,40.81,,,,28.52,,,41.54,41.54 40000640,0302,86235,,,,,SCL-70 AB,19.76,19.76,,,,,,,,,,,,, 40000642,0300,85652,,,,,SED RATE ESR,49.00,49.00,19.68,41.48,,,41.48,,,,19.68,,,25.35,25.35 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 40000683,0300,83883,,,,,ASO TITER,221.00,221.00,28.80,28.80,,,,,,,,,,28.80,28.80 40000699,0300,86003,,,,,RAST TEST (ALLERGEN),29.40,29.40,6.93,6.93,,,,,,,6.93,,,, 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,617.20,617.20,210.43,447.38,,,,,,,210.43,,,447.38,447.38 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,67.00,67.00,28.52,41.54,,,40.81,,,,28.52,,,41.54,41.54 40000725,0300,86157,,,,,COLD AGGLUTININS,62.33,62.33,,,,,,,,,,,,, 40000726,0301,82525,,,,,COPPER SERUM,63.61,63.61,,,,,,,,,,,,, 40000727,0301,84255,,,,,SELENIUM,102.72,102.72,,,,,,,,,,,,, 40000728,0301,82525,,,,,COPPER URINE,133.93,133.93,,,,,,,,,,,,, 40000810,0300,86735,,,,,MUMPS ANTIBODY IGG,38.90,38.90,,,,,,,,,,,,, 40000816,0301,84703,,,,,PREG TEST(UCG)UR,101.00,101.00,34.34,76.90,,,59.08,,,,34.34,,,76.90,76.90 40000820,0301,84703,,,,,PREG TEST (HCG) SER,101.00,101.00,34.34,76.90,,,59.08,,,,34.34,,,76.90,76.90 40000824,0300,81003,,,,,URINALYSIS C/S IF INDICATED,37.85,37.85,12.84,25.69,,,25.69,,,,12.84,,,17.51,17.51 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,80.61,80.61,27.32,27.41,,,,,,,27.32,,,27.41,27.41 40000861,0301,83921,,,,,METHYLMALONIC ACID,166.38,166.38,55.44,55.44,,,,,,,55.44,,,, 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,57.00,57.00,18.92,38.19,,,38.19,,,,18.92,,,26.38,26.38 40000874,0300,87270,,,,,CHLAMYDIA TRACH OMATIS DFA,84.48,84.48,,,,,,,,,,,,, 40000875,0300,87177,,,,,OVA & PARASITE SMEAR-DIRECT,50.48,50.48,,,,,,,,,,,,, 40000884,0300,86255,,,,,FLUORES NONINFECT AGENT AB;EA,101.25,101.25,49.05,49.30,,,,,,,49.05,,,49.30,49.30 40000885,0300,86256,,,,,FLUORES NONINFECT AGENT TITER,101.25,101.25,,,,,,,,,,,,, 40000886,0300,86255,,,,,"SMOOTH MUSCLE AB, IGG",54.09,54.09,49.05,49.30,,,,,,,49.05,,,49.30,49.30 40000887,0300,86256,,,,,SMOOTH MUSCLE TITER,54.34,54.34,,,,,,,,,,,,, 40000888,0300,86255,,,,,RETUCULIN AB IGA,89.36,89.36,49.05,49.30,,,,,,,49.05,,,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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 40000920,0306,87186,,,,,SUSCEPT SLOW GROWER,696.42,696.42,30.25,50.36,,,50.36,,,,30.25,,,33.05,33.05 40000923,0300,87081,,,,,CULTURE-STREP ONLY,76.35,76.35,36.24,48.67,,,,,,,36.24,,,48.67,48.67 40000931,0306,87186,,,,,SUSCEPTIBILITY 1,74.43,74.43,30.25,50.36,,,50.36,,,,30.25,,,33.05,33.05 40000932,0306,87186,,,,,SUSCEPTIBILITY 2,91.20,91.20,30.25,50.36,,,50.36,,,,30.25,,,33.05,33.05 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,,,,,,,,,,,,, 40000964,0300,87070,,,,,CULTURE-EXUDATE/WND,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40000980,0300,87070,,,,,CULTURE-TISSUE,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40000995,0300,87075,,,,,CULTURE-ANAEROBIC,133.00,133.00,16.67,89.11,,,89.11,,,,34.69,,,16.67,16.67 40000998,0300,87040,,,,,CULTURE BLOOD 1,157.50,157.50,41.03,50.74,,,,,,,41.03,,,50.74,50.74 40000999,0300,87040,,,,,CULTURE BLOOD 2,106.89,106.89,41.03,50.74,,,,,,,41.03,,,50.74,50.74 40001005,0300,87070,,,,,CULTURE-BRONC WASH,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40001006,0306,87081,,,,,CULTURE-MRSA PRE OP,92.72,92.72,36.86,62.73,,,62.73,,,,36.86,,,53.10,53.10 40001007,0300,87081,,,,,CULTURE MRSA SURVEILLANCE,76.35,76.35,36.24,48.67,,,,,,,36.24,,,48.67,48.67 40001008,0300,87081,,,,,CULTURE - LEGIONELLA,79.86,79.86,36.24,48.67,,,,,,,36.24,,,48.67,48.67 40001009,0300,87081,,,,,CULTURE VRE,76.35,76.35,36.24,48.67,,,,,,,36.24,,,48.67,48.67 40001010,0300,86927,,,,,FROZEN COMPONENT THAWING,701.17,701.17,,,,,,,,,,,,, 40001012,0300,87070,,,,,CULTURE UROGENITAL,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40001013,0300,87081,,,,,CULTURE VRE SCREEN,76.35,76.35,36.24,48.67,,,,,,,36.24,,,48.67,48.67 40001038,0300,87070,,,,,CULTURE-SPUTUM,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40001046,0300,87070,,,,,CULTURE-SPINAL FLUID,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40001053,0300,87070,,,,,CULTURE-EAR,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40001061,0300,87070,,,,,CULTURE-EYE,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40001079,0306,87086,,,,,CULTURE-URINE,87.00,87.00,31.25,50.43,,,50.43,,,,31.25,,,42.44,42.44 40001087,0300,87070,,,,,CULTURE-THROAT,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40001095,0300,87070,,,,,CULTURE-NOSE,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40001107,0301,80048,,,,,BASIC MET PANEL,116.28,116.28,43.08,96.34,,,96.34,,,,43.08,,,58.98,58.98 40001112,0301,80053,,,,,COMP MET PANEL,168.18,168.18,69.07,113.93,,,113.93,,,,69.07,,,89.14,89.14 40001113,0300,83516,,,,,IM. ASSAY NOT INFECTIOUS AG OR AB,58.00,58.00,21.13,21.13,,,,,,,21.13,,,, 40001114,0301,83520,,,,,RNA POLYMERASE III IGG,133.93,133.93,,,,,,,,,,,,, 40001115,0300,83516,,,,,GLUTAMIC ACID DECARBOXYIASE AB,86.54,86.54,21.13,21.13,,,,,,,21.13,,,, 40001116,0301,83516,,,,,HISTONE AB,66.96,66.96,,,,,,,,,,,,, 40001185,0300,36416,,,,,BLOOD DRAW - CAPILLARY,16.23,16.23,,,,,,,,,,,,, 40001186,0300,36415,,,,,BLOOD DRAWING,16.23,16.23,7.18,13.19,,,13.19,,,,7.18,,,10.78,10.78 40001238,0301,82553,,,,,CK-MB,131.00,131.00,42.58,73.53,,,71.42,,,,42.58,,,73.53,73.53 40001239,0301,82552,,,,,CK ISOENZYMES,70.31,70.31,,,,,,,,,,,,, 40001276,0300,86738,,,,,MYCOPLASMA PN IgG,49.98,49.98,,,,,,,,,,,,, 40001278,0301,83874,,,,,MYOGLOBIN-SERUM,143.00,143.00,44.99,74.64,,,,,,,44.99,,,74.64,74.64 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 40001307,0300,86789,,,,,WEST NILE VIRUS ABS,183.38,183.38,,,,,,,,,,,,, 40001308,0300,86790,,,,,HTLV I/II ANTIBODIES,37.09,37.09,,,,,,,,,,,,, 40001320,0300,86920,,,,,CROSSMATCH UNIT 2,344.94,344.94,117.41,164.19,,,,,,,117.41,,,164.19,164.19 40001325,0300,86920,,,,,CROSSMATCH,344.94,344.94,117.41,164.19,,,,,,,117.41,,,164.19,164.19 40001327,0300,86901,,,,,BLD TYPG RH ONLY,102.15,102.15,34.93,68.44,,,68.44,,,,34.93,,,57.53,57.53 40001335,0300,86850,,,,,ANTIBODY SCREEN,159.87,159.87,55.27,107.11,,,107.11,,,,55.27,,,92.88,92.88 40001336,0300,86971,,,,,RBC ENZYME TREATMENT,133.93,133.93,45.16,109.29,,,,,,,45.16,,,109.29,109.29 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,100.44,100.44,33.47,81.96,,,,,,,33.47,,,81.96,81.96 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,,,,,,,,,,,,, 40001475,0301,82803,,,,,ARTERIAL BLD GAS EPOC,235.00,235.00,66.98,68.13,,,,,,,66.98,,,68.13,68.13 40001478,0300,87149,,,,,TB IDENTIFICATION,117.96,117.96,,,,,,,,,,,,, 40001479,0300,87077,,,,,BACTERIAL ID 1,64.90,64.90,22.31,43.91,,,43.91,,,,22.31,,,25.40,25.40 40001480,0300,87077,,,,,REF BACTERIAL ID(MULTI-STEP),125.00,125.00,22.31,43.91,,,43.91,,,,22.31,,,25.40,25.40 40001481,0300,87077,,,,,BACTERIAL ID 2,64.90,64.90,22.31,43.91,,,43.91,,,,22.31,,,25.40,25.40 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,,,,,,,,,,,,, 40001509,0301,84443,,,,,TSH,132.00,132.00,50.25,89.01,,,89.01,,,,50.25,,,65.42,65.42 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,103.20,103.20,40.52,52.07,,,,,,,40.52,,,52.07,52.07 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,145.00,145.00,49.05,49.30,,,,,,,49.05,,,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,34.25,34.25,7.10,8.55,,,,,,,8.55,,,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,,,, 40001543,0301,84120,,,,,"PORPHYRINS, URINE",103.02,103.02,,,,,,,,,,,,, 40001544,0301,84110,,,,,PORPHOBILINOGEN URINE,72.11,72.11,,,,,,,,,,,,, 40001565,0301,82105,,,,,ALPHAFETOPROT MATRNL,84.22,84.22,28.58,68.72,,,,,,,28.58,,,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,,,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,,,23.99,23.99 40001573,0301,82107,,,,,ALPHA FETOPROTEIN L3,254.21,254.21,,,,,,,,,,,,, 40001574,0301,82105,,,,,ALPHA FETOPROT TM,84.22,84.22,28.58,68.72,,,,,,,28.58,,,68.72,68.72 40001576,0301,80299,,,,,INTRACONAZOLE,116.15,116.15,,,,,,,,,,,,, 40001610,0300,86787,,,,,VARICELLA ZOSTER IGG,37.85,37.85,,,,,,,,,,,,, 40001611,0300,86787,,,,,VARICELLA ZOSTER IGM,37.85,37.85,,,,,,,,,,,,, 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,63.61,63.61,21.20,21.20,,,,,,,21.20,,,, 40001681,0301,84165,,,,,ELCTRPHRSS-PROTEIN SERU,97.00,97.00,42.31,49.74,,,,,,,42.31,,,49.74,49.74 40001682,0301,83883,,,,,FREE LIGHT CHAINS SERUM,221.00,221.00,31.73,47.59,,,,,,,47.59,,,31.73,31.73 40001683,0301,83883,,,,,FREE LIGHT CHAINS K/L SERUM,113.00,113.00,31.73,47.59,,,,,,,47.59,,,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,63.61,63.61,21.20,21.20,,,,,,,21.20,,,, 40001707,0301,84234,,,,,FROZ PROG RECEPTOR,244.16,244.16,,,,,,,,,,,,, 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,,,,,,,,,,,,, 40001772,0301,83690,,,,,LIPASE-SERUM,95.00,95.00,29.14,54.36,,,54.36,,,,29.14,,,46.19,46.19 40001775,0301,80061,,,,,LIPID PROFILE,118.65,118.65,48.60,94.01,,,94.01,,,,48.60,,,75.04,75.04 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 40001804,0301,83825,,,,,MERCURY QUANTITATIVE,96.32,96.32,,,,,,,,,,,,, 40001805,0301,83789,,,,,IODINE SPOT URINE,133.93,133.93,,,,,,,,,,,,, 40001830,0301,83036,,,,,GLYCOHEMOGLOBIN,184.00,184.00,44.48,81.15,,,81.15,,,,44.48,,,59.90,59.90 40001845,0301,83003,,,,,HUMAN GROWTH HORMONE,81.39,81.39,,,,,,,,,,,,, 40001871,0301,82746,,,,,FOLIC ACID,78.04,78.04,26.45,30.58,,,,,,,26.45,,,30.58,30.58 40001888,0301,84482,,,,,T3 REVERSE,65.93,65.93,,,,,,,,,,,,, 40001889,0301,84480,,,,,T3 (TRIIODOTHYRONINE),104.31,104.31,41.62,101.01,,,101.01,,,,41.62,,,58.32,58.32 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,,,,,,,,,,,,, 40001921,0300,86376,,,,,THYROID PEROXIDASE AB,89.89,89.89,30.56,73.35,,,,,,,30.56,,,73.35,73.35 40001922,0300,86376,,,,,MICROSOME LIV/KID AB,72.22,72.22,30.56,73.35,,,,,,,30.56,,,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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,130.00,130.00,43.72,51.65,,,,,,,51.65,,,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,,,,,,,, 40002049,0300,86317,,,,,TETANUS AB,70.57,70.57,,,,,,,,,,,,, 40002050,0300,86317,,,,,DIPHTHERIA AB,70.57,70.57,,,,,,,,,,,,, 40002051,0300,86317,,,,,PNEUMOCOCCAL AB,8.01,8.01,,,,,,,,,,,,, 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,,,,,,,,,,,,, 40002127,0300,83540,,,,,IRON,49.45,49.45,16.77,33.13,,,33.13,,,,16.77,,,19.10,19.10 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,,,,,,,,,,,,, 40002218,0301,82378,,,,,CEA,161.00,161.00,53.39,57.86,,,,,,,53.39,,,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,56.66,56.66,22.55,23.59,,,,,,,23.59,,,22.55,22.55 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,77.27,77.27,26.23,52.11,,,52.11,,,,26.23,,,37.05,37.05 40002291,0300,89050,,,,,CELL COUNT BODY FL,89.00,89.00,30.26,30.26,,,,,,,30.26,,,, 40002293,0301,82390,,,,,CERULOPLASMIN,86.80,86.80,29.51,29.51,,,,,,,,,,29.51,29.51 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,,,,,,,,,,,,, 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,234.37,234.37,79.03,191.25,,,,,,,79.03,,,191.25,191.25 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,,,, 40002358,0300,85025,,,,,CBC-AUTOMATED DIFFERENTIAL,86.25,86.25,28.53,48.60,,,48.60,,,,28.53,,,37.49,37.49 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,114.87,114.87,43.67,98.21,,,98.21,,,,43.67,,,67.14,67.14 40002441,0301,84439,,,,,DIALYSIS FREE T4,87.05,87.05,43.67,98.21,,,98.21,,,,43.67,,,67.14,67.14 40002523,0301,80162,,,,,DIGOXIN,124.00,124.00,41.83,48.07,,,,,,,48.07,,,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),140.00,140.00,49.81,68.75,,,,,,,49.81,,,68.75,68.75 40002536,0301,84591,,,,,NIACIN,284.59,284.59,,,,,,,,,,,,, 40002549,0300,81001,,,,,URINALYSIS/MICROSCOPIC CS IF INDICATED,57.83,57.83,22.05,47.32,,,47.32,,,,22.05,,,30.85,30.85 40002556,0300,86900,,,,,BLD TYPING ABO ONLY,187.30,187.30,61.95,125.49,,,125.49,,,,61.95,,,96.13,96.13 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,158.00,158.00,47.34,74.25,,,71.42,,,,47.34,,,74.25,74.25 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,,,,,,,, 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,118.00,118.00,42.09,79.06,,,79.06,,,,42.09,,,47.80,47.80 40002770,0301,84153,,,,,PSA SCREENING,133.41,133.41,51.77,89.82,,,89.82,,,,51.77,,,86.17,86.17 40002775,0301,84154,,,,,FREE AND TOTAL PSA,115.00,115.00,,,,,,,,,,,,, 40002776,0302,86316,,,,,PRO 2 PSA,124.42,124.42,,,,,,,,,,,,, 40002804,0301,82943,,,,,GLUCAGON,100.18,100.18,34.06,34.06,,,,,,,34.06,,,, 40002838,0301,82085,,,,,ALDOLASE,54.09,54.09,,,,,,,,,,,,, 40002846,0301,82140,,,,,AMMONIA,74.43,74.43,25.06,25.06,,,,,,,25.06,,,, 40002853,0300,86701,,,,,ELISA,62.33,62.33,,,,,,,,,,,,, 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 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 0157,58.00,58.00,17.24,52.53,,,,,,,17.24,,,52.53,52.53 40002907,0306,87015,,,,,CONCENTRATION STEC,20.87,20.87,7.10,8.55,,,,,,,8.55,,,7.10,7.10 40002908,0306,87427,,,,,SHIGA TOXIN 1,67.15,67.15,19.94,45.90,,,,,,,19.94,,,45.90,45.90 40002909,0306,87427,,,,,SHIGA TOXIN 2,67.15,67.15,19.94,45.90,,,,,,,19.94,,,45.90,45.90 40002910,0300,87045,,,,,CULTURE-SALMONELLA/SHIGELLA,105.00,105.00,31.91,94.18,,,,,,,31.91,,,94.18,94.18 40002911,0301,83020,,,,,ELCTRPHRSS HGB,180.54,180.54,61.38,61.38,,,,,,,,,,61.38,61.38 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,103.02,103.02,34.73,64.86,,,60.17,,,,34.73,,,64.86,64.86 40002948,0300,87899,,,,,CAMPYLOBACTER ANTIGEN,77.50,77.50,14.71,20.28,,,,,,,20.28,,,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,146.28,146.28,54.46,98.01,,,98.01,,,,54.46,,,65.15,65.15 40002955,0301,84270,,,,,SEX HORMONE BINDING GLOBULIN,75.47,75.47,25.70,55.72,,,50.56,,,,25.70,,,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 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,,,,,,,,,,,,, 40002989,0301,84702,,,,,BHCG TUMOR MARKER,77.52,77.52,,,,,,,,,,,,, 40002994,0301,82077,,,,,ALCOHOL ETOH,81.39,81.39,,,,,,,,,,,,, 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,112.00,112.00,38.19,75.04,,,75.04,,,,38.19,,,55.00,55.00 40003018,0300,87046,,,,,CULTURE-CAMPYLOBACTR,85.00,85.00,17.24,52.53,,,,,,,17.24,,,52.53,52.53 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,,,,,,,,,,,,, 40003110,0302,86708,,,,,HEP A IGG,66.96,66.96,22.77,22.77,,,,,,,22.77,,,, 40003111,0302,86709,,,,,HEP A IGM,37.85,37.85,12.87,12.87,,,,,,,12.87,,,, 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,227.00,227.00,82.94,141.19,,,,,,,82.94,,,141.19,141.19 40003140,0301,82784,,,,,IMMUNOGLOBULIN G,56.91,56.91,19.28,19.92,,,,,,,19.28,,,19.92,19.92 40003155,0301,82784,,,,,IMMUNOGLOBULIN A,56.91,56.91,19.28,19.92,,,,,,,19.28,,,19.92,19.92 40003156,0301,82784,,,,,IMMUNOGLOBULIN D,83.51,83.51,19.28,19.92,,,,,,,19.28,,,19.92,19.92 40003160,0300,86334,,,,,ELCTRPHRSS-IMMUNO,149.00,149.00,40.38,69.51,,,,,,,69.51,,,40.38,40.38 40003162,0300,86335,,,,,IMMUNOELPHSIS-NOT BLOOD,167.00,167.00,38.45,38.45,,,,,,,38.45,,,, 40003164,0301,82785,,,,,IMMUNOGLOBULIN E,82.68,82.68,17.40,17.40,,,,,,,17.40,,,, 40003166,0301,82784,,,,,IMMUNOGLOBULIN M,56.91,56.91,19.28,19.92,,,,,,,19.28,,,19.92,19.92 40003168,0301,82785,,,,,ALLERGENS UPPER RESP,38.67,38.67,17.40,17.40,,,,,,,17.40,,,, 40003169,0300,86335,,,,,IFE URINE QUALITATIVE,115.38,115.38,38.45,38.45,,,,,,,38.45,,,, 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 27-29,149.00,149.00,61.06,61.06,,,,,,,61.06,,,, 40003216,0300,86304,,,,,CA-125,152.10,152.10,33.63,67.55,,,67.55,,,,53.01,,,33.63,33.63 40003220,0300,86300,,,,,CA-15-3,149.00,149.00,61.06,61.06,,,,,,,61.06,,,, 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 40003265,0301,82375,,,,,CARBON MONOXIDE,24.47,24.47,8.32,12.20,,,,,,,8.32,,,12.20,12.20 40003281,0300,86141,,,,,C-REACTIVE PROTEIN HS,102.14,102.14,31.37,51.63,,,43.79,,,,31.37,,,51.63,51.63 40003285,0301,83718,,,,,HDL-CHOL DIRECT,52.79,52.79,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,221.00,221.00,31.73,47.59,,,,,,,47.59,,,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,,,22.59,22.59 40003407,0300,86706,,,,,HEP B SURFACE AB QUANT,94.62,94.62,22.59,22.59,,,,,,,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 B12,120.00,120.00,43.65,153.68,,,153.68,,,,43.65,,,56.31,56.31 40003524,0301,82805,,,,,ABG WITH MEASURED SO2,156.08,156.08,,,,,,,,,,,,, 40003547,0302,86780,,,,,SYPHILIS IGG,19.18,19.18,,,,,,,,,,,,, 40003613,0300,87305,,,,,ASPERGILLUS ANTIGEN,138.46,138.46,,,,,,,,,,,,, 40003646,0301,83945,,,,,OXALATE,66.45,66.45,,,,,,,,,,,,, 40003703,0300,86618,,,,,LYME DISEASE AB,104.31,104.31,35.37,85.12,,,,,,,35.37,,,85.12,85.12 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,,,,,,,,,,,,, 40003775,0300,85303,,,,,PROTEIN C FUNCTIONAL,134.18,134.18,45.62,45.62,,,,,,,45.62,,,, 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,334.81,334.81,114.17,115.72,,,,,,,114.17,,,115.72,115.72 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,,,,,,,,,,,,, 40003845,0301,84202,,,,,ZINC PROTOPROPHYRIN,42.52,42.52,,,,,,,,,,,,, 40003893,0301,82340,,,,,CALCIUM 24HR URINE,62.33,62.33,20.98,20.98,,,,,,,20.98,,,, 40003943,0301,84481,,,,,FREE T3,105.86,105.86,35.93,70.93,,,70.93,,,,35.93,,,62.60,62.60 40003992,0300,87077,,,,,CLO-TEST,86.80,86.80,22.31,43.91,,,43.91,,,,22.31,,,25.40,25.40 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,,,,,,,,,,,,, 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 40004132,0300,85379,,,,,D-DIMER QUANTITATIVE,146.50,146.50,51.39,85.32,,,81.62,,,,51.39,,,85.32,85.32 40004133,0300,85362,,,,,FIBRIN SPLIT PRODUCTS,36.51,36.51,,,,,,,,,,,,, 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,,,,,,,,,,,,, 40004207,0301,84207,,,,,VITAMIN B 6,127.48,127.48,43.73,43.73,,,,,,,43.73,,,, 40004213,0301,83735,,,,,MAGNESIUM URINE,72.00,72.00,28.05,48.24,,,48.24,,,,28.05,,,31.32,31.32 40004214,0301,83735,,,,,MAGNESIUM SERUM,72.00,72.00,28.05,48.24,,,48.24,,,,28.05,,,31.32,31.32 40004215,0301,83735,,,,,MAGNESIUM 24 HR URINE,32.45,32.45,28.05,48.24,,,48.24,,,,28.05,,,31.32,31.32 40004219,0300,86757,,,,,ROCKY MTN IGG,86.80,86.80,,,,,,,,,,,,, 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,,,, 40004251,0300,84305,,,,,SOMATOMEDIN C,96.84,96.84,,,,,,,,,,,,, 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,,,, 40004291,0300,89051,,,,,CELL COUNT/DIF BDYFL,97.90,97.90,28.48,28.48,,,,,,,28.48,,,, 40004298,0390,P9012,,,,,CRYOPRECIPITATE PER UNIT,229.00,229.00,,,,,,,,,,,,, 40004299,0300,87328,,,,,CRYPTOSPORIDIUM AG,80.61,80.61,27.23,27.23,,,,,,,27.23,,,, 40004326,0301,82180,,,,,VITAMIN C,56.91,56.91,,,,,,,,,,,,, 40004327,0301,82306,,,,,VITAMIN D 25 HYDROXY,131.09,131.09,51.69,91.80,,,87.83,,,,51.69,,,91.80,91.80 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),80.39,80.39,27.06,27.06,,,,,,,27.06,,,, 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,,,,,,,,,,,,, 40004370,0301,84432,,,,,THYROGLOBULIN,81.39,81.39,27.12,27.12,,,,,,,27.12,,,, 40004538,0301,80069,,,,,RENAL PANEL,129.60,129.60,51.23,66.23,,,,,,,51.23,,,66.23,66.23 40004628,0300,85732,,,,,APTT CIRCULATING INHIBITOR,29.11,29.11,,,,,,,,,,,,, 40004968,0301,82627,,,,,DHEA SULFATE,105.86,105.86,,,,,,,,,,,,, 40004969,0301,82626,,,,,DHEA,47.13,47.13,,,,,,,,,,,,, 40004971,0300,82010,,,,,BETA HYDROXYBUTYRATE,92.72,92.72,,,,,,,,,,,,, 40004990,0301,82330,,,,,CALCIUM-IONIZED,91.94,91.94,31.24,45.85,,,,,,,31.24,,,45.85,45.85 40005020,0300,83516,,,,,TISSUE TRANSGLUATMINASE IGG,62.33,62.33,21.13,21.13,,,,,,,21.13,,,, 40005022,0300,83516,,,,,TISSUE TRANGLUTAMINASE IGA,62.33,62.33,21.13,21.13,,,,,,,21.13,,,, 40005023,0300,86255,,,,,"MITOCHONDRIAL AB, IGG",62.33,62.33,49.05,49.30,,,,,,,49.05,,,49.30,49.30 40005024,0300,83516,,,,,GLIADIN AB IGA,62.33,62.33,21.13,21.13,,,,,,,21.13,,,, 40005025,0300,83516,,,,,GLIADIN AB IGG,62.33,62.33,21.13,21.13,,,,,,,21.13,,,, 40005027,0300,83516,,,,,DGP IGA,63.61,63.61,21.13,21.13,,,,,,,21.13,,,, 40005028,0302,86235,,,,,RIBOSOME P ANTIBODY IGG,21.53,21.53,,,,,,,,,,,,, 40005029,0300,83516,,,,,MYELIN ASSOC GLYCOPROTEIN AB IGM,72.32,72.32,21.13,21.13,,,,,,,21.13,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,52.57,52.57,20.18,48.96,,,,,,,20.18,,,48.96,48.96 40005229,0301,84466,,,,,TIBC / TRANSFERRIN,97.00,97.00,32.71,64.99,,,64.99,,,,32.71,,,33.37,33.37 40005237,0301,80307,,,,,ACETMNPHEN (TYLENOL),96.32,96.32,73.16,73.16,,,73.16,,,,,,,, 40005238,0301,82009,,,,,ACETONE,27.56,27.56,,,,,,,,,,,,, 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,,,, 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,121.00,121.00,29.24,76.06,,,37.79,,,,29.24,,,76.06,76.06 40005611,0306,87493,,,,,C DIFFICILE TOXIC GENE,179.00,179.00,61.79,93.18,,,,,,,61.79,,,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,,,,,,,,,,,,, 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,329.00,329.00,147.89,221.13,,,,,,,147.89,,,221.13,221.13 40005619,0300,87798,,,,,JC VIRUS,436.80,436.80,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,342.18,342.18,122.99,122.99,,,,,,,122.99,,,, 40007064,0310,88332,,,,,FROZEN SECTION (EA ADDN),107.31,107.31,26.01,26.01,,,,,,,26.01,,,, 40007065,0310,88300,,,,,GROSS EXAM,102.15,102.15,34.44,34.44,,,,,,,34.44,,,, 40007069,0311,88173,,,,,CYTOLOGY FINE NEEDLE ASPIRATE,228.76,228.76,77.78,95.75,,,,,,,95.75,,,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,,,,,,,,,,,,, 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,166.86,166.86,54.66,130.45,,,109.19,,,,54.66,,,130.45,130.45 40007102,0312,88313,,,,,SPECIAL STAIN GROUP II (OTHER),162.00,162.00,54.14,61.86,,,,,,,61.86,,,54.14,54.14 40007103,0312,88313,,,,,MAYO SPEC STN II,282.00,282.00,54.14,61.86,,,,,,,61.86,,,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,133.93,133.93,45.53,90.89,,,90.89,,,,45.53,,,64.13,64.13 40007128,0310,88341,,,,,IMMUNOCYTOCHEM EACH ADDITIONAL AB,85.86,85.86,29.19,57.53,,,57.53,,,,29.23,,,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,185.69,185.69,63.13,75.90,,,,,,,75.90,,,63.13,63.13 40007210,0311,88175,,,,,PAP AUTO REVIEW,110.23,110.23,,,,,,,,,,,,, 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,,,,,,,,,,,,, 40007219,0311,G0124,,,,,PAP SMEAR THIN LAYER PHYSICIAN ITRP,100.18,100.18,,,,,,,,,,,,, 40007220,0311,88148,,,,,PAP SMEAR DIAGNOSITIC,111.99,111.99,,,,,,,,,,,,, 40007247,0300,86480,,,,,TB QUANTIFERON,184.14,184.14,62.61,62.61,,,,,,,62.61,,,62.61,62.61 40007318,0301,83880,,,,,BRAIN NATRIURETIC PEPTIDE,226.16,226.16,64.97,84.24,,,,,,,64.97,,,84.24,84.24 40007345,0300,86403,,,,,CRYPTOCOCCAL AG-CSF,70.57,70.57,,,,,,,,,,,,, 40007346,0300,86403,,,,,CRYPTOCOCCAL AG-SERUM,70.57,70.57,,,,,,,,,,,,, 40007474,0310,88302,,,,,LEVEL 2 GROSS MICRO,142.00,142.00,,,,,,,,,,,,, 40007475,0310,88304,,,,,LEVEL 3 GROSS MICRO,179.84,179.84,64.51,117.90,,,,,,,64.51,,,117.90,117.90 40007476,0310,88305,,,,,LEVEL 4 GROSS MICRO,244.00,244.00,86.24,228.95,,,228.95,,,,86.24,,,157.33,157.33 40007477,0310,88307,,,,,LEVEL 5 GROSS MICRO,351.55,351.55,118.65,150.64,,,,,,,150.64,,,118.65,118.65 40007478,0310,88309,,,,,LEVEL 6 GROSS MICRO,666.75,666.75,323.97,323.97,,,,,,,323.97,,,, 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,,,,,,,,,,,,, 40007527,0310,88237,,,,,"BONE MARROW, MSMART",6351.04,6351.04,139.95,139.95,,,,,,,139.95,,,, 40007533,0300,89060,,,,,BODY FLUID CRYSTALS,74.00,74.00,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,, 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,,,,,,,,,,,,, 40007606,0300,82642,,,,,"DIHYDROTESTOSTERONE, SERUM",104.49,104.49,34.82,34.82,,,,,,,34.82,,,, 40007607,0300,87635,,,,,SARS-CoV-2 NAA,169.32,169.32,54.39,72.99,,,54.39,,,,57.58,,,72.99,72.99 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),169.32,169.32,54.39,72.99,,,54.39,,,,57.58,,,72.99,72.99 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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 40021307,0300,86788,,,,,WEST NILE VIRUS IGM,177.97,177.97,,,,,,,,,,,,, 40021434,0301,84075,,,,,ALK PHOS ISOS (TOTAL),44.30,44.30,,,,,,,,,,,,, 40021617,0300,86696,,,,,HERPES SIMPLEX IgG TYPE II,63.10,63.10,,,,,,,,,,,,, 40021707,0300,84233,,,,,FROZ EST RECEPTOR,236.95,236.95,,,,,,,,,,,,, 40021952,0300,86710,,,,,INFLUENZA A AB IgM,111.00,111.00,,,,,,,,,,,,, 40021955,0301,83527,,,,,FREE INSULIN,49.96,49.96,,,,,,,,,,,,, 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,,,, 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,133.41,133.41,51.77,89.82,,,89.82,,,,51.77,,,86.17,86.17 40022771,0301,84153,,,,,PSA - REFERRED,133.41,133.41,51.77,89.82,,,89.82,,,,51.77,,,86.17,86.17 40024219,0300,86757,,,,,ROCKY MTN IgM,84.22,84.22,,,,,,,,,,,,, 40024370,0300,86800,,,,,THYROGLOBULIN ANTIBODY,59.24,59.24,19.74,19.74,,,,,,,19.74,,,, 40031305,0300,86665,,,,,EBV ABS-VCA IgG,63.10,63.10,21.45,51.49,,,,,,,21.45,,,51.49,51.49 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,,,, 40032370,0300,85246,,,,,FACT VIII vWF/Ag,92.72,92.72,,,,,,,,,,,,, 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,,,,,,,,,,,,, 40044295,0301,82595,,,,,CRYOGLOBULIN QUANT,40.96,40.96,,,,,,,,,,,,, 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,1236.24,1236.24,420.03,423.41,,,,,,,420.03,,,423.41,423.41 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,370.26,370.26,124.48,125.38,,,,,,,124.48,,,125.38,125.38 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",427.66,427.66,143.04,146.03,,,,,,,143.04,,,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,370.26,370.26,123.93,125.89,,,,,,,123.93,,,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,3964.47,3964.47,1347.48,1829.60,,,,,,,1347.48,,,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,,,,,,,,,,,,, 42000207,0341,78226,,,,,NM HEPATOBILIARY HIDA SCAN WO CCK,1499.97,1499.97,,,,,,,,,,,,, 42000209,0341,78227,,,,,NM HEPATOBILLIARY HIDA SCAN WITH CCK,1545.30,1545.30,524.53,1260.96,,,,,,,524.53,,,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,,,,,,,,,,,,, 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,172.65,172.65,64.57,155.23,,,,,,,64.57,,,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),583.09,583.09,109.66,148.98,,,,,,,109.66,,,148.98,148.98 42000296,0343,A9503,,,,,NM BONE DOSE (TCMDP),108.51,108.51,38.81,53.34,,,,,,,38.81,,,53.34,53.34 42000300,0343,A9540,,,,,NM TCMAA-1 LUNG PERFUSION <=10.00 mci,450.43,450.43,,,,,,,,,,,,, 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,,,,,,,,,,,,, 42000429,0341,78195,,,,,NM LYMPHOSCINTIGRAPY,2131.23,2131.23,739.54,739.54,,,,,,,739.54,,,, 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,,,,,,,,,,,,, 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,,,, 42001035,0402,76942,,,,,SONO GUIDED NEEDLE PLACEMENT,514.21,514.21,174.83,174.83,,,,,,,174.83,,,, 42001056,0402,76705,,,,,SONO LLQ RLQ,527.07,527.07,176.93,342.34,,,,,,,176.93,,,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,527.07,527.07,176.41,179.46,,,,,,,176.41,,,179.46,179.46 42001122,0402,76770,,,,,SONO RETROPEROTINEAL,527.07,527.07,,,,,,,,,,,,, 42001130,0402,76775,,,,,SONO ABDOMINAL AORTA,527.07,527.07,177.58,205.20,,,,,,,177.58,,,205.20,205.20 42001148,0402,76705,,,,,SONO SPLEEN,527.07,527.07,176.93,342.34,,,,,,,176.93,,,342.34,342.34 42001155,0402,76705,,,,,SONO PANCREAS,527.07,527.07,176.93,342.34,,,,,,,176.93,,,342.34,342.34 42001163,0402,76775,,,,,SONO KIDNEYS BILATERAL,527.07,527.07,177.58,205.20,,,,,,,177.58,,,205.20,205.20 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,527.07,527.07,176.93,342.34,,,,,,,176.93,,,342.34,342.34 42001189,0402,76705,,,,,SONO LIVER,527.07,527.07,176.93,342.34,,,,,,,176.93,,,342.34,342.34 42001197,0402,76700,,,,,SONO ABDOMEN COMPLETE,527.07,527.07,176.24,274.22,,,,,,,176.24,,,274.22,274.22 42001205,0402,76705,,,,,SONO ABDMEN LMTD,527.07,527.07,176.93,342.34,,,,,,,176.93,,,342.34,342.34 42001213,0402,76536,,,,,SONO THYROID,527.07,527.07,177.52,300.93,,,,,,,177.52,,,300.93,300.93 42001215,0402,76536,,,,,SONO PAROTID,527.07,527.07,177.52,300.93,,,,,,,177.52,,,300.93,300.93 42001220,0402,76830,,,,,SONO TRANSVAGINAL,527.07,527.07,174.83,174.83,,,,,,,174.83,,,, 42001222,0402,76882,,,,,SONO EXTREMITY (NON VASCULAR),514.21,514.21,174.11,174.83,,,,,,,174.11,,,174.83,174.83 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,527.07,527.07,177.52,300.93,,,,,,,177.52,,,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,327.24,327.24,116.23,277.67,,,,,,,116.23,,,277.67,277.67 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,,,,,,,,,,,,, 42002075,0320,73565,,,,,XR KNEE STDG AP BILT,272.41,272.41,89.62,121.06,,,,,,,89.62,,,121.06,121.06 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,,,,,,,,,,,,, 42002105,0320,73660TALT,,,,,XR TOE LEFT GREAT TOE,272.40,272.40,,,,,,,,,,,,, 42002115,0320,73660T9,,,,,XR TOE RIGHT 5TH,272.40,272.40,,,,,,,,,,,,, 42002179,0320,72170,,,,,XR PELVIS 1/2 VWS,382.56,382.56,87.09,127.79,,,,,,,127.79,,,87.09,87.09 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,,,,,,,,,,,,, 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 42002330,0320,72070,,,,,XR TSPINE AP&LAT,386.88,386.88,130.26,130.26,,,,,,,130.26,,,, 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,386.88,386.88,129.46,194.52,,,,,,,129.46,,,194.52,194.52 42002393,0320,72072,,,,,XR THORACIC 3 VWS,386.88,386.88,128.33,259.21,,,259.21,,,,129.35,,,128.33,128.33 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,345.55,345.55,116.23,277.67,,,,,,,116.23,,,277.67,277.67 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 42002542,0324,71046,,,,,XR CHEST 2 PA LAT,204.86,204.86,68.69,136.93,,,136.93,,,,68.69,,,111.40,111.40 42002555,0324,71045,,,,,XR CHEST 1 VIEW,237.59,237.59,79.66,159.87,,,158.32,,,,79.66,,,159.87,159.87 42002559,0324,71045,,,,,XR CHEST PORTABLE 1 VIEW AP,231.80,231.80,79.66,159.87,,,158.32,,,,79.66,,,159.87,159.87 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 42002705,0320,73660T6,,,,,XR TOE RIGHT 2ND,272.40,272.40,,,,,,,,,,,,, 42002708,0320,70110,,,,,XR MANDIBLE COMPLETE,345.55,345.55,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,777.80,777.80,263.36,263.36,,,,,,,263.36,,,, 42002810,0320,76000,,,,,FL BRONCOSCOPY/ERCP,734.20,734.20,263.36,263.36,,,,,,,263.36,,,, 42002811,0320,77001,,,,,FLUOROGUIDE FOR VEIN DEVICE,520.25,520.25,,,,,,,,,,,,, 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,590.30,590.30,200.37,200.70,,,,,,,200.37,,,200.70,200.70 42002819,0320,77003,,,,,FLUOROGUIDE FOR SPINE INJECT,590.30,590.30,,,,,,,,,,,,, 42002823,0320,74220,,,,,X-RAY XM ESOPHAGUS 1CNTRST,621.96,621.96,209.18,211.47,,,,,,,209.18,,,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,1303.35,1303.35,437.07,443.14,,,,,,,437.07,,,443.14,443.14 42002873,0360,51610,,,,,INJECTION RETRO URETHVCYSTGRAM,227.82,227.82,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,, 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,421.33,421.33,142.63,239.65,,,,,,,142.63,,,239.65,239.65 42002997,0320,74019,,,,,XR ABDOMEN 2 VIEWS,382.56,382.56,85.58,127.96,,,,,,,127.96,,,85.58,85.58 42002998,0320,74021,,,,,XR ABDOMEN 3+ VIEWS,400.21,400.21,134.41,326.57,,,,,,,134.41,,,326.57,326.57 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,316.79,316.79,106.35,167.32,,,,,,,106.35,,,167.32,167.32 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,,,,,,,,,,,,, 42003057,0401,77066,,,,,MAMMO DIGITAL DIAGNOSTIC BILATERAL,433.47,433.47,144.71,349.40,,,,,,,144.71,,,349.40,349.40 42003059,0401,77065RT,,,,,MAMMO DIGITAL DIAGNOSTIC RIGHT,296.99,296.99,,,,,,,,,,,,, 42003060,0401,G0279,,,,,MAMMO DIAG TOMOSYNTHESIS,104.43,104.43,35.07,56.11,,,,,,,35.07,,,56.11,56.11 42003061,0403,77063,,,,,MAMMO TOMO BILATERAL,104.43,104.43,34.97,69.78,,,69.78,,,,34.97,,,65.78,65.78 42003062,0403,77067,,,,,MAMMO DIG SCR BILAT INCLUD CAD,315.60,315.60,91.31,210.88,,,210.88,,,,91.31,,,179.03,179.03 42003160,0320,73092,,,,,XR PED UPPER EXT BIL,382.56,382.56,,,,,,,,,,,,, 42003177,0320,74290,,,,,XR CHOLECYSTOGRAPHY ORAL,658.81,658.81,,,,,,,,,,,,, 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,,,,,,,,,,,,, 42003665,0360,19283,,,,,MAMMO STEREOTACTIC NEEDLE LOC RIGHT BRST,1562.08,1562.08,,,,,,,,,,,,, 42003667,0360,19081,,,,,MAMMO BREAST STEREO UNILAT + WIRE,3061.44,3061.44,,,,,,,,,,,,, 42003668,0360,1908150,,,,,MAMMO STEREO BIOPSY BILAT + WIRE,3061.44,3061.44,,,,,,,,,,,,, 42003672,0320,76098,,,,,MAMMO SURGICAL SPECIMEN,1643.75,1643.75,,,,,,,,,,,,, 42003805,0360,32555,,,,,LUNG CYST ASPRI,1616.59,1616.59,,,,,,,,,,,,, 42003810,0360,49406,,,,,ANG RETRO PERI CYST ASP,4853.60,4853.60,,,,,,,,,,,,, 42006000,0320,77080,,,,,DNU DXA BONE DENSITY AXIAL,345.55,345.55,115.58,230.25,,,230.25,,,,115.78,,,115.58,115.58 42006001,0320,77081,,,,,DXA BONE DENSITY / PERIPHERAL,208.66,208.66,,,,,,,,,,,,, 42006003,0320,77080,,,,,DXA BONE DENSITY AXIAL,345.55,345.55,115.58,230.25,,,230.25,,,,115.78,,,115.58,115.58 42006500,0320,76496,,,,,ANG UNLISTED FLURO PROCEDURE,300.16,300.16,,,,,,,,,,,,, 42007500,0636,A9579JW,,,,,MMRI CONTRAST GADOL WASTE,11.35,11.35,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,9228.36,9228.36,3137.64,3137.64,,,,,,,3137.64,,,, 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,,,,,,,,,,,,, 43005561,0323,75741,,,,,ANG PULMONARY ANGIO UNIL,9228.36,9228.36,,,,,,,,,,,,, 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,,,, 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,,,,,,,,,,,,, 43005618,0360,37224,,,,,ANG PTA FEM-POP,15375.21,15375.21,5608.82,5608.82,,,,,,,5608.82,,,, 43005640,0323,75716,,,,,ANG EXTREMITY BILATERAL ANGIOGRAPHY,9228.36,9228.36,3137.64,3137.64,,,,,,,3137.64,,,, 43005641,0323,75710,,,,,ANG EXTREMITY UNILATER ANGIO,9228.36,9228.36,3133.27,3133.27,,,,,,,3133.27,,,, 43005647,0323,75726,,,,,ANG SELECTIVE VISCERAL,9228.36,9228.36,,,,,,,,,,,,, 43005651,0323,75774,,,,,ANG ADD SELECTIVE VESSEL ADD ON,7032.09,7032.09,,,,,,,,,,,,, 43005661,0360,37236,,,,,ANG TRANSCATHETER PERCUTANEOUS STENT,32995.24,32995.24,,,,,,,,,,,,, 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,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,, 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,11220.11,11220.11,3783.42,3783.42,,,,,,,3783.42,,,, 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,,,,,,,,,,,,, 43005838,0360,75978,,,,,ANG PTA VENOUS (AVF),7303.82,7303.82,,,,,,,,,,,,, 43005841,0360,37242,,,,,ANG EMBOLIZATION OCCLUSION ARTERY,33820.12,33820.12,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,15305.31,15305.31,6071.11,6071.11,,,,,,,6071.11,,,, 43005903,0360,36224,,,,,ANG ICA SELECTIVE,15305.31,15305.31,,,,,,,,,,,,, 43005904,0360,36225,,,,,ANG SUBCLAVIAN/INNOMIWATE W VERT,9228.36,9228.36,,,,,,,,,,,,, 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,4577.44,4577.44,,,,,,,,,,,,, 43005913,0360,37218,,,,,ANG STENT PLACEMENT ANTE CCA/IMMOM,4577.44,4577.44,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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 44000006,0350,74261,,,,,CT VIRTUAL COLONOSCOPY DIAGNOSTIC,527.98,527.98,,,,,,,,,,,,, 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,1143.33,1143.33,384.52,650.30,,,520.00,,,,384.52,,,650.30,650.30 44003425,0351,70450,,,,,CT HEAD W/O IV CONTRAST,2095.94,2095.94,712.85,1404.28,,,1404.28,,,,712.85,,,836.60,836.60 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,,,, 44003482,0350,70490,,,,,CT NECK W/O IV CONTRAST,2155.46,2155.46,729.28,1715.96,,,,,,,729.28,,,1715.96,1715.96 44003490,0350,70491,,,,,CT NECK WITH IV CONTRAST,2515.02,2515.02,836.83,1715.43,,,,,,,836.83,,,1715.43,1715.43 44003503,0350,74174,,,,,CTA ABDOMEN PELVIS,3810.94,3810.94,1274.65,1274.65,,,,,,,1274.65,,,, 44003508,0350,70492,,,,,CT NECK WO/W IV CONTRAST,2831.81,2831.81,,,,,,,,,,,,, 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,3282.96,3282.96,1099.57,1099.57,,,,,,,1099.57,,,, 44003516,0350,71250,,,,,CT CHEST W/O IV CONTRAST,2294.06,2294.06,767.46,959.93,,,,,,,767.46,,,959.93,959.93 44003518,0350,75574,,,,,CTA HRT W/ 3D IMAGE,3296.69,3296.69,,,,,,,,,,,,, 44003524,0350,71260,,,,,CT CHEST WITH IV CONTRAST,2649.39,2649.39,884.98,1765.40,,,1765.40,,,,884.98,,,1611.04,1611.04 44003532,0350,71270,,,,,CT CHEST W/WO IV CONTRAST,2966.18,2966.18,,,,,,,,,,,,, 44003540,0350,72192,,,,,CT PELVIS W/O IV CONTRAST,2294.06,2294.06,772.15,774.31,,,,,,,774.31,,,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,3494.15,3494.15,1168.95,1538.19,,,,,,,1168.95,,,1538.19,1538.19 44003583,0350,74177,,,,,CT ABD PELVIS WITH IV CONTRAST,3916.54,3916.54,1311.06,2609.75,,,2609.75,,,,1311.06,,,2053.08,2053.08 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,2325.48,2325.48,780.55,1098.53,,,,,,,780.55,,,1098.53,1098.53 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,2294.06,2294.06,774.68,783.34,,,,,,,774.68,,,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,2294.06,2294.06,769.88,991.26,,,,,,,769.88,,,991.26,991.26 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,,,,,,,,,,,,, 44003748,0350,73200,,,,,CT UPP EXT W/O IV CONTRAST,2192.69,2192.69,721.34,1131.99,,,,,1131.99,1131.99,721.34,,,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,,,,,,,,,,,,, 45001166,0402,76775,,,,,SONO BLADDER SCAN,514.21,514.21,177.58,205.20,,,,,,,177.58,,,205.20,205.20 45004118,0921,93922,,,,,VL ANKLE/BRACHIAL INDEX (ABI/TBI),905.74,905.74,303.84,305.63,,,,,,,303.84,,,305.63,305.63 45004126,0921,93923,,,,,VL SEGMENTAL ARTERY PRESSURES,905.74,905.74,274.17,309.28,,,,,,,274.17,,,309.28,309.28 45004130,0921,93923,,,,,VL TOE PRESSURES,905.74,905.74,274.17,309.28,,,,,,,274.17,,,309.28,309.28 45004131,0921,93923,,,,,VL FINGER PRESSURES,905.74,905.74,274.17,309.28,,,,,,,274.17,,,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,601.37,601.37,274.17,309.28,,,,,,,274.17,,,309.28,309.28 45004175,0921,93880TC,,,,,VL CAROTID DUPLEX BILATERAL,1222.33,1222.33,,,,,,,,,,,,, 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 45004220,0921,93931RT,,,,,VL ARTERIAL DUPLEX RIGHT ARM,905.74,905.74,,,,,,,,,,,,, 45004222,0921,93931LT,,,,,VL ARTERIAL DUPLEX LEFT ARM,905.74,905.74,,,,,,,,,,,,, 45004225,0921,93925,,,,,VL ARTERIAL DUPLEX LEG BILATERAL,1252.89,1252.89,419.14,421.25,,,,,,,419.14,,,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,1252.89,1252.89,418.54,639.49,,,,,,,418.54,,,639.49,639.49 45004241,0921,93975,,,,,VL RENAL ARTERY DUPLEX COMPLETE,1252.89,1252.89,418.54,639.49,,,,,,,418.54,,,639.49,639.49 45004242,0921,93975,,,,,VL ABDOMINAL VENOUS DUPLEX,1252.89,1252.89,418.54,639.49,,,,,,,418.54,,,639.49,639.49 45004245,0921,93976,,,,,VL RENAL ARTERY DUPLEX LIMITED,840.54,840.54,,,,,,,,,,,,, 45004316,0921,93978TC,,,,,VL AA ILIAC DUPLEX,1222.33,1222.33,,,,,,,,,,,,, 45004317,0921,93978,,,,,VL RENAL BYPASS GRAFT DUPLEX,914.20,914.20,,,,,,,,,,,,, 45004320,0921,93979,,,,,VL AA ILIAC DUPLEX LTD,914.20,914.20,306.14,306.14,,,,,,,306.14,,,, 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,966.07,966.07,344.89,443.72,,,,,,,344.89,,,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,966.07,966.07,344.89,443.72,,,,,,,344.89,,,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,1435.51,1435.51,344.89,443.72,,,,,,,344.89,,,443.72,443.72 45004373,0921,93970,,,,,VL VEIN MAPPING COMPLETE,990.22,990.22,344.89,443.72,,,,,,,344.89,,,443.72,443.72 45004374,0921,93971,,,,,VL VEIN MAPPING LIMITED,527.07,527.07,,,,,,,,,,,,, 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,257.55,257.55,87.91,128.43,,,,,,,87.91,,,128.43,128.43 45004402,0921,G0365,,,,,VL DIALYSIS GRAFT PRE OP VESSEL MAPPING,1222.33,1222.33,,,,,,,,,,,,, 45008990,0480,93312,,,,,ECHO TEE IMAGING,2339.18,2339.18,,,,,,,,,,,,, 45009032,0480,93325,,,,,ECHO DOPPLER COLOR FLOW MAPPING ADD ON,458.18,458.18,,,,,,,,,,,,, 45009220,0480,93308,,,,,ECHO 2-D ECHOCARDIOGRAM LIMITED STUDY,657.25,657.25,,,,,,,,,,,,, 45009324,0480,93306,,,,,ECHO 2-D ECHOCARDIOGRAM COMPLETE STUDY,1430.40,1430.40,479.00,686.79,,,,,,,479.00,,,686.79,686.79 45009325,0480,93350,,,,,ECHO DOBUTAMINE STRESS ECHOCARDIOGRAM,1395.51,1395.51,470.56,470.56,,,,,,,470.56,,,, 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 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,261.67,261.67,0.00,5.27,,,0.00,,,,3.76,,,5.27,5.27 46008648,0636,A9579,,,,,MRI CONTRAST GADOLINIUM,11.07,11.07,0.00,5.27,,,0.00,,,,3.76,,,5.27,5.27 46008649,0615,70549,,,,,MMRA NECK WO W/ CONTRAST,3373.91,3373.91,,,,,,,,,,,,, 46008651,0350,71250,,,,,HIGH RESOLUTION CT CHEST,2294.06,2294.06,767.46,959.93,,,,,,,767.46,,,959.93,959.93 46008652,0610,C8901,,,,,MMRA ABDOMEN WO CONTRAST,2831.32,2831.32,,,,,,,,,,,,, 47000017,0636,J2795,,,,,ROPIVACAINE 1% 10MG/ML 10ML INJ (NAROPIN,30.91,30.91,35.80,35.80,,,,,,,35.80,,,, 47000021,0637,A9270GY,,,,,QUINAPRIL 20MG TAB (ACCUPRIL),6.25,6.25,,,,,,,,,,,,, 47000035,0636,J8600,,,,,MELPHALAN 2MG TAB (ALKERAN),11.29,11.29,,,,,,,,,,,,, 47000051,0636,J0285,,,,,AMPHOTERICIN INJ 50MG,111.80,111.80,,,,,,,,,,,,, 47000062,0636,J9000,,,,,ADRIAMYCIN INJ 10MG/5ML,110.46,110.46,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47000151,0636,J0696,,,,,CEFTRIAXONE INJ 500MG (ROCEPHIN),95.41,95.41,67.54,81.29,,,,,,,67.54,,,81.29,81.29 47000285,0636,J3010,,,,,FENTANYL 500MCG/10ML INJ (SUBLIMAZE),25.80,25.80,10.52,20.78,,,20.78,,,,10.52,,,10.85,10.85 47000490,0637,A9270GY,,,,,AMANTADINE 100MG CAP(SYMMETREL),6.25,6.25,,,,,,,,,,,,, 47000501,0636,J1644,,,,,"HEPARIN SOD/0.45%NS 25,000U/250ML PREMIX",56.44,56.44,10.82,11.68,,,,,,,11.68,,,10.82,10.82 47000503,0636,J7060,,,,,D5W 5% 100ML IV FLUID,32.52,32.52,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47000518,0636,J1442,,,,,FILGRASTIM 300MCG/ML INJ (NEUPOGEN),779.91,779.91,,,,,,,,,,,,, 47000520,0258,J7050,,,,,NACL 0.9% IV 250ML IV FLUID,40.31,40.31,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47000543,0636,J2780,,,,,RANITIDINE 150MG/6ML INJ (ZANTAC),40.31,40.31,13.60,13.60,,,,,,,13.60,,,, 47000548,0636,J3411,,,,,THIAMINE HCL 200MG/2ML INJ,47.03,47.03,,,,,,,,,,,,, 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,,,, 47000563,0636,J1580,,,,,GENTAMICIN 80MG/2ML INJ,32.52,32.52,12.25,21.87,,,21.87,,,,12.25,,,13.78,13.78 47000566,0636,J2597,,,,,DESMOPRESSIN 4MCG/ML 10ML MDV INJ (DDAVP,762.44,762.44,,,,,,,,,,,,, 47000578,0636,J2543,,,,,PIPERACILLIN/TAZOBACTAM 3GM/.375GM INJ,69.88,69.88,23.74,23.76,,,,,,,23.74,,,23.76,23.76 47000593,0636,J2001,,,,,LIDOCAINE 2000MG/250ML PREMIX (XYLOCAINE,95.94,95.94,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47000623,0636,J2930,,,,,SOLU MDRL INJ 250MG,118.79,118.79,11.32,19.15,,,,,,,11.32,,,19.15,19.15 47000671,0636,S0039,,,,,SMZ TMP 400-80/5 10ML INJ (BACTRIM),41.12,41.12,,,,,,,,,,,,, 47000675,0636,J2400,,,,,CHLOROPROCAINE MPF 2% INJ (NESACAINE),55.09,55.09,,,,,,,,,,,,, 47000677,0636,S0028,,,,,FAMOTIDINE 20MG/50ML PREMIX (PEPCID),38.97,38.97,,,,,,,,,,,,, 47000687,0636,J0256,,,,,PROLASTIN INJ 1000MG,710.04,710.04,,,,,,,,,,,,, 47000689,0636,J7060,,,,,D5W 5% 250ML IV FLUID,40.31,40.31,,,,,,,,,,,,, 47000737,0636,J2405,,,,,ONDANSETRON 4MG/2ML INJ (ZOFRAN),29.29,29.29,9.97,21.98,,,19.75,,,,9.97,,,21.98,21.98 47000757,0636,J3430,,,,,PHYTONADIONE 10MG/ML INJ (VITAMIN K),258.50,258.50,87.60,87.60,,,,,,,87.60,,,, 47000760,0636,J2930,,,,,METHYLPREDNISOLONE 2GM INJ (SOLU-MEDROL),240.26,240.26,11.32,19.15,,,,,,,11.32,,,19.15,19.15 47000765,0636,J3535,,,,,IPRATROPIUM BROM HFA 18MCG INHALER(ATROV,314.17,314.17,,,,,,,,,,,,, 47000767,0636,J1644,,,,,"HEPARIN 5,000units/ML INJ",32.79,32.79,10.82,11.68,,,,,,,11.68,,,10.82,10.82 47000769,0250,J7644,,,,,IPRATROPIUM BROM U/D NEB (ATROVENT),10.75,10.75,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47000817,0343,A9569,,,,,TECHNETIUM Tc 99 EXAMETAZIME DOSE,415.22,415.22,,,,,,,,,,,,, 47000819,0343,A9505,,,,,THALLIUM TI 201 THALLOUS CHLORIDE,415.22,415.22,,,,,,,,,,,,, 47000828,0636,J0696,,,,,CEFTRIAXONE 1000MG INJ (ROCEPHIN),197.58,197.58,67.54,81.29,,,,,,,67.54,,,81.29,81.29 47000842,0250,J7611,,,,,ALBUTEROL SOL 0.5%-20ML BOTTLE,57.78,57.78,,,,,,,,,,,,, 47000843,0636,J2001,,,,,LEVOTHYROXINE SOD INJ 0.1MG (SYNTHROID),394.78,394.78,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47000853,0636,J9000,,,,,DOXORUBICIN 50MG VIAL (ADRIAMYCIN),533.47,533.47,,,,,,,,,,,,, 47000860,0637,J0630,,,,,CALCITONIN SALMON 200IU/ML 2ML INJ,172.54,172.54,,,,,,,,,,,,, 47000862,0636,J0713,,,,,CEFTAZIDIME 1000MG INJ (FORTAZ),55.09,55.09,,,,,,,,,,,,, 47000890,0636,J2175,,,,,DEMEROL CARPUJECT 100MG,32.79,32.79,,,,,,,,,,,,, 47000893,0636,J3535,,,,,FLUTICASONE HFA 220MCG MDI (FLOVENT),2008.44,2008.44,,,,,,,,,,,,, 47000898,0636,J2060,,,,,LORAZEPAM 2MG/1ML INJ (ATIVAN),47.30,47.30,16.09,38.60,,,,,,,16.09,,,38.60,38.60 47000905,0636,S0020,,,,,BUPIVACAINE 0.75% 30ML INJ (MARCAINE),41.12,41.12,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47000930,0636,J1245,,,,,DIPYRIDAMOLE 50MG/10ML SDV (PERSANTINE),50.26,50.26,,,,,,,,,,,,, 47000960,0636,J1645,,,,,DALTEPARIN 2500U/0.2ML INJ,67.19,67.19,,,,,,,,,,,,, 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 47000976,0637,J3030,,,,,SUMATRIPTAN 6MG/0.5ML INJ (IMITREX),365.50,365.50,,,,,,,,,,,,, 47000980,0636,J0153,,,,,ADENOSINE 6MG/2ML INJ (ADENOCARD),50.26,50.26,16.99,16.99,,,,,,,16.99,,,, 47000982,0636,J1742,,,,,IBUTILIDE INJ 1MG/10ML INJ (CORVERT),864.03,864.03,,,,,,,,,,,,, 47000997,0636,J2310,,,,,NALOXONE HCL 0.4MG/ML INJ (NARCAN),81.70,81.70,,,,,,,,,,,,, 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),44.34,44.34,10.60,20.84,,,20.84,,,,10.60,,,10.72,10.72 47001042,0636,J9070,,,,,CYCLOPHPSPHAMIDE INJ 100MG (CYTOXAN),28.49,28.49,,,,,,,,,,,,, 47001051,0636,J9000,,,,,DOXORUBICIN 10MG VIAL (ADRIAMYCIN),233.27,233.27,,,,,,,,,,,,, 47001059,0636,J2001,,,,,LIDOCAINE MPF 2% 10ML POLYAMP (XYLO),32.52,32.52,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47001061,0636,J2795,,,,,ROPIVACAINE 1% 10MG/ML 20ML INJ (NAROPIN,117.13,117.13,35.80,35.80,,,,,,,35.80,,,, 47001085,0636,J3370,,,,,VANCOMYCIN 1000MG INJ (VANCOCIN),71.49,71.49,23.80,25.02,,,,,,,23.80,,,25.02,25.02 47001115,0636,J1956,,,,,LEVOFLOXACIN 500MG/100ML IVPB PREMIX,175.22,175.22,60.28,61.50,,,,,,,61.50,,,60.28,60.28 47001119,0636,90389,,,,,TETANUS TOX PF SDV VIAL,99.97,99.97,,,,,,,,,,,,, 47001123,0636,S0157,,,,,BECAPLERMIN GEL 0.01% 15GM (REGRANEX),1839.59,1839.59,,,,,,,,,,,,, 47001126,0636,J3010,,,,,FENTANYL 100MCG/2ML INJ (SUBLIMAZE),30.91,30.91,10.52,20.78,,,20.78,,,,10.52,,,10.85,10.85 47001181,0636,J1642,,,,,HEP-LOCK INJ 100U/ML 30ML,30.91,30.91,,,,,,,,,,,,, 47001199,0637,J7517,,,,,MYCOPHENOLATE 500MG TAB (CELLCEPT),24.50,24.50,,,,,,,,,,,,, 47001357,0636,J2930,,,,,METHYLPREDNISOLONE 500MG/4ML INJ,79.28,79.28,11.32,19.15,,,,,,,11.32,,,19.15,19.15 47001433,0636,J0558,,,,,BICILLIN CR INJ 600000 UNITS,53.75,53.75,,,,,,,,,,,,, 47001602,0250,J7614,,,,,LEVALBUTEROL 0.63MG NEB (XOPENEX),28.81,28.81,,,,,,,,,,,,, 47001614,0636,J2355,,,,,OPRELVEKIN 5MG INJ (NEUMEGA),1029.58,1029.58,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47001786,0636,Q0164,,,,,PROCHLORPERAZINE 10MG TAB (COMPAZINE),6.72,6.72,,,,,,,,,,,,, 47001966,0636,J0133,,,,,ACYCLOVIR 500MG INJ (ZOVIRAX),214.14,214.14,,,,,,,,,,,,, 47001974,0636,J1940,,,,,FUROSEMIDE 40MG/4ML INJ (LASIX),46.49,46.49,9.87,15.72,,,,,,,15.72,,,9.87,9.87 47001976,0636,J8540,,,,,DEXAMETHASONE 4MG TAB,6.72,6.72,2.47,2.47,,,,,,,2.47,,,, 47002075,0636,J2805,,,,,SINCALIDE 5MCG INJ (KINEVAC),430.43,430.43,146.11,351.23,,,,,,,146.11,,,351.23,351.23 47002139,0636,J1160,,,,,DIGOXIN 0.50MG/2ML INJ (LANOXIN),26.34,26.34,9.14,9.14,,,,,,,9.14,,,, 47002204,0636,J0290,,,,,AMPICILLIN 1000 MG INJ,40.31,40.31,,,,,,,,,,,,, 47002212,0636,J0290,,,,,AMPICILLIN 2000MG INJ,38.97,38.97,,,,,,,,,,,,, 47002223,0636,J3250,,,,,TRIMETHOBENZAMIDE 200MG/2ML INJ (TIGAN),32.52,32.52,,,,,,,,,,,,, 47002238,0636,J0280,,,,,AMINOPHYLLINE INJ 25MG/ML 10ML,58.65,58.65,,,,,,,,,,,,, 47002246,0636,J1200,,,,,DIPHENHYDRAMINE 50MG/ML INJ (BENADRYL),30.91,30.91,10.48,20.32,,,,,,,10.48,,,20.32,20.32 47002360,0636,J3301,,,,,TRIAMCINOLONE 40MG/ML 5ML MDV (KENALOG),169.04,169.04,16.42,16.74,,,,,,,16.42,,,16.74,16.74 47002501,0636,J1364,,,,,ERYTHROMYCIN 1000MG INJ (ERITHROCIN),86.27,86.27,,,,,,,,,,,,, 47002514,0636,J3301,,,,,TRIAMCINOLONE 40MG/1ML INJ (KENALOG),48.29,48.29,16.42,16.74,,,,,,,16.42,,,16.74,16.74 47002626,0636,J0694,,,,,CEFOXITIN 1000MG VIAL (MEFOXIN),50.26,50.26,17.32,17.32,,,,,,,17.32,,,, 47002637,0636,J3230,,,,,CHLORPROMAZINE 25MG/1ML INJ (THORAZIN,35.48,35.48,,,,,,,,,,,,, 47002642,0636,Q0161,,,,,CHLORPROMAZINE 25MG TAB,32.96,32.96,,,,,,,,,,,,, 47002790,0636,J2920,,,,,METHYLPREDNISOLONE 40MG/1ML INJ (SOLU-ME,32.52,32.52,11.06,11.06,,,,,,,,,,11.06,11.06 47002808,0636,J2930,,,,,METHYLPREDNISOLONE 1000 MG/8ML INJ,293.09,293.09,11.32,19.15,,,,,,,11.32,,,19.15,19.15 47002816,0636,J2930,,,,,METHYLPREDNISOLONE 125 MG/2ML INJ,33.32,33.32,11.32,19.15,,,,,,,11.32,,,19.15,19.15 47002832,0636,J0595,,,,,STADOL INJ 2MG/ML,38.16,38.16,,,,,,,,,,,,, 47002835,0637,J2354,,,,,OCTREOTICLE 0.05MG (SANDOSTATIN),37.63,37.63,,,,,,,,,,,,, 47002865,0636,J3360,,,,,DIAZEPAM 10MG/2ML INJ (VALIUM),148.10,148.10,49.94,120.85,,,,,,,49.94,,,120.85,120.85 47002899,0636,J2270,,,,,MORPHINE SULFATE 2MG/ML INJ,32.52,32.52,10.79,26.76,,,22.21,,,,10.79,,,26.76,26.76 47002925,0636,J2001,,,,,LIDOCAINE 2GM PREMIX (XYLOCAINE),101.05,101.05,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47002927,0636,J2001,,,,,LIDOCAINE 2% 5ML VIAL,30.91,30.91,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47002931,0636,J3480,,,,,D5W/0.45%NS + 20MEQ KCL 1000ML IV FLUID,74.98,74.98,,,,,,,,,,,,, 47003099,0636,J1940,,,,,FUROSEMIDE 100MG/10ML INJ (LASIX),30.91,30.91,9.87,15.72,,,,,,,15.72,,,9.87,9.87 47003172,0636,J2001,,,,,LIDOCAINE 1% 2ML INJ MPF (XYLOCAINE),30.91,30.91,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47003214,0636,J2001,,,,,LIDOCAINE 1% 20ML INJ (XYLOCAINE),30.91,30.91,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47003375,0636,J3490,,,,,GLYCOPYRROLATE 0.4MG/2ML INJ (ROBINUL),123.63,123.63,34.17,42.00,,,,,,,42.00,,,34.17,34.17 47003384,0636,J3246,,,,,TIROFIBAN 12.5 MG/250ML PREMIX (AGGRASTA,1914.84,1914.84,,,,,,,,,,,,, 47003388,0636,J1750,,,,,IRON DEXTRAN 100MG/2ML INJ (INFED),165.55,165.55,56.29,56.29,,,,,,,56.29,,,56.29,56.29 47003406,0636,J0702,,,,,BETAMETHASONE AF 0.05% CRM (DIPROLENE),303.96,303.96,,,,,,,,,,,,, 47003412,0636,J1940,,,,,FUROSEMIDE 20MG INJ (LASIX),30.91,30.91,9.87,15.72,,,,,,,15.72,,,9.87,9.87 47003462,0636,J8498,,,,,PROCHLORPERAZINE 25MG SUPPS,14.78,14.78,5.03,5.03,,,,,,,,,,5.03,5.03 47003512,0636,J1020,,,,,METHYLPREDNISOLONE 80MG/ML INJ (DEPO-MED,45.42,45.42,,,,,,,,,,,,, 47003514,0636,J1030,,,,,METHYLPREDNISOLONE ACE 40MG/ML INJ (DEPO,54.55,54.55,15.41,17.24,,,,,,,17.24,,,15.41,15.41 47003587,0636,J2175,,,,,MEPERIDINE HCL 100MG INJ (DEMEROL),32.47,32.47,,,,,,,,,,,,, 47003611,0636,J2175,,,,,MEPERIDINE HCL 50MG INJ (DEMEROL),30.91,30.91,,,,,,,,,,,,, 47003742,0636,J2250,,,,,MIDAZOLAM 2MG/2ML VIAL (VERSED),30.91,30.91,10.60,20.84,,,20.84,,,,10.60,,,10.72,10.72 47003760,0636,J3370,,,,,VANCOMYCIN INJ 500MG,49.72,49.72,23.80,25.02,,,,,,,23.80,,,25.02,25.02 47003809,0636,J3420,,,,,CYANOCOBALAMIN 1000MCG INJ (VIT B12),54.12,54.12,,,,,,,,,,,,, 47003884,0636,Q0163,,,,,DIPHENHYDRAMINE 12.5MG/5ML ELIXIR (BENAD,32.79,32.79,2.28,2.28,,,,,,,2.28,,,, 47003940,0636,J3370,,,,,VANCOMYCIN 500MG INJ (VANCOCIN),41.12,41.12,23.80,25.02,,,,,,,23.80,,,25.02,25.02 47004105,0636,J7509,,,,,METHYLPREDNISOLONE 4MG DOSEPAK (MEDROL,55.09,55.09,,,,,,,,,,,,, 47004277,0636,J7512,,,,,PREDNISONE 20MG TAB,6.72,6.72,2.28,2.28,,,,,,,2.28,,,, 47004279,0636,J2270,,,,,MORPHINE SULFATE PCA 30MG/30ML,71.49,71.49,10.79,26.76,,,22.21,,,,10.79,,,26.76,26.76 47004287,0636,J2175,,,,,MEPERIDINE PCA 300MG (DEMEROL),76.86,76.86,,,,,,,,,,,,, 47004312,0636,J0461,,,,,ATROPINE 0.5 MG 5ML SYR,27.14,27.14,21.84,22.02,,,,,,,21.84,,,22.02,22.02 47004353,0636,90714,,,,,TETANUS/DIPH VACC (DECAVAC),90.57,90.57,,,,,,,,,,,,, 47004384,0636,J2370,,,,,PHENYLEPHRINE 10MG/1ML INJ (NEO),36.28,36.28,12.32,12.34,,,,,,,12.32,,,12.34,12.34 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,,,,,,,,,,,,, 47004583,0636,J0295,,,,,AMPICILLIN & SULBACTAM 3000MG INJ(UNASYN,52.67,52.67,15.76,15.76,,,,,,,15.76,,,, 47004601,0636,J2270,,,,,MORPHINE 10MG/10ML AMP (ASTRAMORPH),73.37,73.37,10.79,26.76,,,22.21,,,,10.79,,,26.76,26.76 47004617,0250,J7611,,,,,ALBUTEROL SOL 0.5%-0.5ML DOSE,3.76,3.76,,,,,,,,,,,,, 47004717,0636,J2310,,,,,NARCAN INJ 0.4MG/ML,32.79,32.79,,,,,,,,,,,,, 47004781,0636,J1885,,,,,KETORALAC 30MG/1ML INJ (TORADOL),44.34,44.34,14.36,40.19,,,40.19,,,,14.36,,,23.64,23.64 47005079,0636,J1250,,,,,DOBUTAMINE 250MG/20ML INJ,27.95,27.95,9.42,9.42,,,,,,,9.42,,,, 47005127,0636,J2001,,,,,LIDOCAINE 0.5% 50ML VIAL (XYLOCAINE),30.91,30.91,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47005135,0636,J2001,,,,,LIDOCAINE 1% 5ML INJ MPF (XYLOCAINE),30.91,30.91,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47005178,0636,J1265,,,,,DOPAMINE 400MG/250ML PREMIX,147.01,147.01,49.98,49.98,,,,,,,,,,49.98,49.98 47005260,0250,J2704,,,,,PROPOFOL 10MG/ML 20ML INJ,30.20,30.20,,,,,,,,,,,,, 47005300,0636,J2150,,,,,MANNITOL 25% 50ML VIAL (ARIDOL),93.61,93.61,,,,,,,,,,,,, 47005485,0636,J2001,,,,,LIDOCAINE 2% 20MG/ML 5ML SYR (XYLOCAINE),59.39,59.39,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47005608,0636,Q0163,,,,,DIPHENHYDRAMINE 25MG CAP(BENADRYL),6.72,6.72,2.28,2.28,,,,,,,2.28,,,, 47005815,0636,J3010,,,,,FENTANYL 250MCG/5ML INJ (SUBLIMAZE),30.91,30.91,10.52,20.78,,,20.78,,,,10.52,,,10.85,10.85 47006085,0636,J8540,,,,,DEXAMETHASONE 2MG TAB,7.26,7.26,2.47,2.47,,,,,,,2.47,,,, 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,,,, 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,,,, 47006381,0636,J1790,,,,,DROPERIDOL INJ 2.5MG/ML 2ML AMP,30.91,30.91,,,,,,,,,,,,, 47006562,0636,Q0144,,,,,AZITHROMYCIN 250MG TAB (ZITHROMAX),30.91,30.91,,,,,,,,,,,,, 47006597,0636,J8610,,,,,METHOTREXATE 2.5MG TAB,14.78,14.78,,,,,,,,,,,,, 47006713,0636,J1100,,,,,DEXAMETHASONE 4MG/ML 5ML INJ SDV,30.91,30.91,10.57,21.11,,,21.11,,,,10.57,,,11.68,11.68 47006739,0636,J0702,,,,,BETAMETHASONE 6MG/ML 5ML INJ (CELESTONE),106.42,106.42,,,,,,,,,,,,, 47006944,0636,J2300,,,,,NALBUPHINE 10MG/ML 1ML INJ (NUBAIN),126.31,126.31,,,,,,,,,,,,, 47007234,0636,J1610,,,,,GLUCAGON 1MG HYPOKIT INJ (GLUCAGEN),301.27,301.27,301.03,301.03,,,,,,,301.03,,,, 47007322,0636,J2270,,,,,MORPHINE SULFATE 10MG/ML INJ,30.91,30.91,10.79,26.76,,,22.21,,,,10.79,,,26.76,26.76 47007588,0636,J1100,,,,,DEXAMETHASONE SOD PHOS 10MG/ML 1ML INJ,32.79,32.79,10.57,21.11,,,21.11,,,,10.57,,,11.68,11.68 47007629,0637,J2354,,,,,OCTREOTIDE 100MCG/ML INJ (SANDOSTATIN),73.91,73.91,,,,,,,,,,,,, 47007637,0636,90732,,,,,PNEUMOVAX 23 INJ 0.5ML,542.80,542.80,,,,,,,,,,,,, 47008023,0300,86580,,,,,TUBERSOL 5TU/0.1ML INJ,32.52,32.52,,,,,,,,,,,,, 47008030,0636,J1450,,,,,FLUCONAZOLE PREMIX 200MG (DIFLUCAN),337.01,337.01,,,,,,,,,,,,, 47008106,0636,J1410,,,,,CONJUGATED ESTROGENS 25MG INJ (PREMARIN),1531.49,1531.49,531.43,531.43,,,,,,,531.43,,,, 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,32.52,32.52,10.97,11.38,,,,,,,10.97,,,11.38,11.38 47008368,0636,J0360,,,,,HYDRALAZINE HCL 20MG/ML INJ,77.94,77.94,26.35,54.33,,,,,,,26.35,,,54.33,54.33 47008404,0636,J1644,,,,,"HEPARIN 10,000units/ML INJ",35.48,35.48,10.82,11.68,,,,,,,11.68,,,10.82,10.82 47008487,0250,J1642,,,,,HEPARIN LOCK 500UNIT/5ML FLUSH,32.52,32.52,,,,,,,,,,,,, 47008668,0636,J2720,,,,,PROTAMINE SULFATE 50MG/5ML INJ,50.52,50.52,17.15,17.18,,,,,,,17.15,,,17.18,17.18 47008759,0636,J0743,,,,,IMIPENEM/CILASTATIN 500MG INJ (PRIMAXIN),116.37,116.37,40.15,40.15,,,,,,,40.15,,,, 47009099,0636,J1644,,,,,"HEPARIN 1,000units/ML 1ML INJ",39.51,39.51,10.82,11.68,,,,,,,11.68,,,10.82,10.82 47009118,0636,J1644,,,,,HEPARIN SODIUM INJ( 1MU/,32.79,32.79,10.82,11.68,,,,,,,11.68,,,10.82,10.82 47009122,0636,J0780,,,,,PROCHLORPERAZINE 10MG/2ML INJ (COMPAZINE,44.34,44.34,15.08,15.08,,,,,,,15.08,,,, 47009162,0636,J1670,,,,,TETANUS INJ 250U (BAY-TET),496.38,496.38,,,,,,,,,,,,, 47009394,0636,J7500,,,,,AZATHIOPRINE 50MG TAB (IMURAN),7.26,7.26,,,,,,,,,,,,, 47009435,0636,J2765,,,,,METOCLOPRAMIDE 10MG/2ML INJ (REGLAN),32.52,32.52,11.06,13.89,,,,,,,11.06,,,13.89,13.89 47009526,0636,J0696,,,,,CEFTRIAXONE 1000MG ADV VIAL (ROCEPHIN),38.70,38.70,67.54,81.29,,,,,,,67.54,,,81.29,81.29 47009724,0636,S0017,,,,,AMINOCAPROIC ACID 250MG/ML 20ML INJ (AMI,61.01,61.01,,,,,,,,,,,,, 47009774,0636,J1800,,,,,PROPRANOLOL 1MG/1ML INJ (INDERAL),32.79,32.79,,,,,,,,,,,,, 47009996,0636,J3475,,,,,MAGNESIUM SULFATE 1000MG/2ML INJ,55.09,55.09,,,,,,,,,,,,, 47009998,0636,J1644,,,,,HEPARIN INJ 1000U/ML 30ML,32.52,32.52,10.82,11.68,,,,,,,11.68,,,10.82,10.82 47080018,0636,J2780,,,,,RANITIDINE 50MG/2ML IV (ZANTAC),32.79,32.79,13.60,13.60,,,,,,,13.60,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47080045,0636,J3010,,,,,FENTANYL 1000MCG/20ML INJ (SUBLIMAZE),133.30,133.30,10.52,20.78,,,20.78,,,,10.52,,,10.85,10.85 47080048,0636,J7192,,,,,FACTOR 8 REC. 1127 U/VIAL,6807.71,6807.71,,,,,,,,,,,,, 47080051,0636,Q9968,,,,,LYMPHAZURIN 1% INJ 5ML(ISOSULFAN BLUE),4563.64,4563.64,1174.58,1174.58,,,,,,,1174.58,,,, 47080059,0636,90746,,,,,HEP B VAC RECOMB 20MCG/ML 1ML INJ,294.01,294.01,,,,,,,,,,,,, 47080072,0636,J8530,,,,,CYCLOPHOSPHAMIDE 25MG TAB (CYTOXAN),5.91,5.91,,,,,,,,,,,,, 47080076,0636,J7131,,,,,NACL 3% 500ML HYPERTONIC SALINE IVF,29.56,29.56,9.97,9.97,,,,,,,9.97,,,, 47080081,0636,J2325,,,,,NESIRITIDE 1.5MG INJ (NATRECOR),2107.27,2107.27,,,,,,,,,,,,, 47080082,0636,J1644,,,,,"HEPARIN 10,000units/10ML INJ",29.56,29.56,10.82,11.68,,,,,,,11.68,,,10.82,10.82 47080090,0636,J2020,,,,,Linezolid PREMIX 600MG/300ML IVPB (ZYV,420.06,420.06,,,,,,,,,,,,, 47080098,0636,Q0162,,,,,ONDANSETRON ODT 4MG TAB (ZOFRAN ODT),99.39,99.39,39.64,82.07,,,,,,,39.64,,,82.07,82.07 47080109,0636,J1071,,,,,DEPOTESTOSTERONE CYP 200MG INJ 1ML,97.83,97.83,,,,,,,,,,,,, 47080110,0636,J0690,,,,,CEFAZOLIN 1000MG INJ (ANCEF),34.94,34.94,11.89,23.50,,,23.50,,,,11.89,,,17.60,17.60 47080114,0636,Q0169,,,,,PROMETHAZINE 25MG TAB (PHENERGAN),5.91,5.91,,,,,,,,,,,,, 47080125,0636,Q0173,,,,,TRIMETHOBENZAMIDE 300MG CAP (TIGAN),6.72,6.72,,,,,,,,,,,,, 47080127,0636,J1100,,,,,DEXAMETHASONE 10MG INJ SDV,34.94,34.94,10.57,21.11,,,21.11,,,,10.57,,,11.68,11.68 47080129,0636,J2997,,,,,ALTEPLASE 2MG (CATHFLO ACTIVASE),303.96,303.96,11351.74,11351.74,,,,,,,11351.74,,,, 47080132,0636,J3489,,,,,ZOLEDRONIC ACID 4MG INJ (ZOMETA),3663.06,3663.06,1469.26,1511.65,,,,,,,1469.26,,,1511.65,1511.65 47080133,0636,90648,,,,,HIB VACCINE (W/TET),115.56,115.56,,,,,,,,,,,,, 47080138,0636,J7131,,,,,NACL 7% 5ML NEB,8.60,8.60,9.97,9.97,,,,,,,9.97,,,, 47080143,0636,J1260,,,,,DOLASETRON 12.5MG INJ (ANZEMET),66.11,66.11,,,,,,,,,,,,, 47080154,0636,J0878,,,,,DAPTOMYCIN 500MG VIAL (CUBICIN),525.14,525.14,,,,,,,,,,,,, 47080157,0250,J7614,,,,,LEVALBUTEROL 1.25MG NEB (XOPENEX),12.09,12.09,,,,,,,,,,,,, 47080161,0636,J1335,,,,,ERTAPENEM 1000MG INJ (INVANZ),604.07,604.07,205.34,262.06,,,,,,,205.34,,,262.06,262.06 47080167,0636,90658,,,,,INFLUENZA ADULT VACCINE,70.47,70.47,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47080175,0636,J3490,,,,,METOPROLOL 5MG/5ML INJ (LOPRESSOR),27.41,27.41,34.17,42.00,,,,,,,42.00,,,34.17,34.17 47080177,0637,A9270GY,,,,,MODAFINIL100MG TAB (PROVIGIL),18.75,18.75,,,,,,,,,,,,, 47080179,0637,J1815,,,,,INSULIN GLARGINE PEN (LANTUS SOLOSTAR,438.90,438.90,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47080199,0636,J0461,,,,,ATROPINE 1MG/10ML INJ ABBOJECT,64.77,64.77,21.84,22.02,,,,,,,21.84,,,22.02,22.02 47080212,0250,A9180,,,,,PERMETHRIN 1% CRM RINSE,31.00,31.00,,,,,,,,,,,,, 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 47080229,0636,J1956,,,,,LEVOFLOXACIN 750MG/150ML IVPB PREMIX,228.71,228.71,60.28,61.50,,,,,,,61.50,,,60.28,60.28 47080237,0636,J3486,,,,,ZIPRASIDONE 20MG/ML IM INJ (GEODON),50.26,50.26,,,,,,,,,,,,, 47080243,0636,J9190,,,,,FLUOROURACIL 1 GM VIAL (50MG/1ML; 20ML),29.83,29.83,,,,,,,,,,,,, 47080248,0636,J1652,,,,,FONDAPARINUX 2.5MG/0.5ML INJ (ARIXTRA),160.17,160.17,,,,,,,,,,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47080272,0636,J2280,,,,,MOXIFLOXACIN 400MG/250ML PREMIX IVPB (AV,130.34,130.34,,,,,,,,,,,,, 47080283,0636,J3475,,,,,MEGESTROL 20MG TAB (MEGACE),6.72,6.72,,,,,,,,,,,,, 47080289,0636,J0583,,,,,BIVALIRUDIN 250MG INJ (ANGIOMAX),1932.31,1932.31,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47080317,0636,J3010,,,,,FENTANYL 2500MCG/50ML INJ (SUBLIMAZE),31.44,31.44,10.52,20.78,,,20.78,,,,10.52,,,10.85,10.85 47080325,0636,J1610,,,,,GLUCAGON 1MG INJ (GLUCAGEN),885.37,885.37,301.03,301.03,,,,,,,301.03,,,, 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,4319.01,4319.01,1469.26,1511.65,,,,,,,1469.26,,,1511.65,1511.65 47080330,0636,J2001,,,,,LIDOCAINE 0.5% 50 ML MDV (XYLOCAINE),27.14,27.14,10.53,20.91,,,20.91,,,,10.53,,,11.43,11.43 47080453,0636,J1570,,,,,GANCICLOVIR 500MG INJ (CYTOVENE),237.84,237.84,,,,,,,,,,,,, 47080459,0636,J0456,,,,,AZITHROMYCIN 500MG INJ (ZITHROMAX),73.37,73.37,12.48,24.90,,,,,,,24.90,,,12.48,12.48 47080475,0636,J2270,,,,,MORPHINE SULFATE 4MG/ML INJ,29.02,29.02,10.79,26.76,,,22.21,,,,10.79,,,26.76,26.76 47080476,0636,J7510,,,,,PREDNISOLONE 15MG/5ML ELIXIR (PEDIAPRED),6.72,6.72,,,,,,,,,,,,, 47080479,0637,J1815,,,,,INSULIN GLARGINE 100U/ML 10 ML VIAL (LA,382.16,382.16,,,,,,,,,,,,, 47080487,0636,S0074,,,,,CEFOTETAN 1000MG VIAL (CEFOTAN),50.52,50.52,,,,,,,,,,,,, 47080502,0636,Q0163,,,,,DIPHENHYDRAMINE 12.5MG/5ML ORAL SYR,5.91,5.91,2.28,2.28,,,,,,,2.28,,,, 47080507,0636,J1885,,,,,KETOROLAC 15MG/1ML INJ (TORADOL),29.02,29.02,14.36,40.19,,,40.19,,,,14.36,,,23.64,23.64 47080512,0250,J7620,,,,,IPRATROPIUM/ALBUTEROL 3ML NEB (DUONEB),9.50,9.50,,,,,,,,,,,,, 47080513,0636,J1644,,,,,"HEPARIN 10,000U/ML 5 ML INJ",66.92,66.92,10.82,11.68,,,,,,,11.68,,,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,,,,,,,,,,,,, 47080517,0636,J1756,,,,,IRON SUCROSE 100MG/5ML INJ (VENOFER),247.68,247.68,83.91,83.91,,,,,,,83.91,,,, 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,,,, 47080534,0637,A9270GY,,,,,NADOLOL 80MG TAB (CORGARD),6.00,6.00,,,,,,,,,,,,, 47080536,0636,90653,,,,,INFLUENZA HIGH DOSE VACCINE,131.15,131.15,,,,,,,,,,,,, 47080539,0636,J0885,,,,,"EPOETIN ALPHA 40,000 U (PROCRIT)",4390.14,4390.14,,,,,,,,,,,,, 47080559,0636,J0131,,,,,ACETAMINOPHEN PREMIX IVPB: 1000MG/100ML,244.43,244.43,83.18,165.36,,,165.36,,,,83.18,,,105.67,105.67 47080560,0636,J1642,,,,,HEPARIN 100 U /ML 5ML SYR,16.66,16.66,,,,,,,,,,,,, 47080566,0636,J2916,,,,,FERRIC GLUCONATE 62.5 MG/5ML VIAL (FERRL,174.15,174.15,,,,,,,,,,,,, 47080569,0250,J1572,,,,,FLEBOGAMMA 10GM/100ML,1086.00,1086.00,,,,,,,,,,,,, 47080570,0250,J1572,,,,,FLEBOGAMMA 20GM/400ML,2171.75,2171.75,,,,,,,,,,,,, 47080577,0636,J1165,,,,,PHENYTOIN 100MG/2ML INJ (DILANTIN),27.95,27.95,,,,,,,,,,,,, 47080579,0636,J3475,,,,,MAGNESIUM SULFATE 5000MG/10ML INJ,89.49,89.49,,,,,,,,,,,,, 47080581,0250,J1170,,,,,HYDROMORPHONE 10MG/ML SDV (DILAUDID HP),26.00,26.00,,,,,,,,,,,,, 47080590,0637,J1815,,,,,INSULIN REGULAR 100 U/ML 10 ML VIAL (HUM,325.72,325.72,,,,,,,,,,,,, 47080593,0636,J1170,,,,,HYDROMORPHONE PCA 0.2MG/ML (DILAUDID PCA,83.85,83.85,8.90,17.65,,,17.65,,,,8.90,,,17.40,17.40 47080597,0636,J0132,,,,,ACETYLCYSTEINE 6000MG/30ML INJ,955.14,955.14,,,,,,,,,,,,, 47080599,0636,Q0162,,,,,ONDANSETRON ODT 8MG TAB (ZOFRAN ODT),165.55,165.55,39.64,82.07,,,,,,,39.64,,,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,,,,,,,,,,,,, 47080609,0636,J1741,,,,,IBUPROFEN 800MG/8ML INJ (CALDOLOR),55.90,55.90,,,,,,,,,,,,, 47080615,0250,J1950,,,,,LUPRON DEPOT 22.5MG 3 MONTH KIT,9679.75,9679.75,,,,,,,,,,,,, 47080616,0637,J1815,,,,,INSULIN DETEMIR 10ML VIAL (LEVEMIR),604.96,604.96,,,,,,,,,,,,, 47080622,0636,J1580,,,,,GENTAMICIN 40MG/ML 20ML VIAL,104.49,104.49,12.25,21.87,,,21.87,,,,12.25,,,13.78,13.78 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,190.23,190.23,64.57,155.23,,,,,,,64.57,,,155.23,155.23 47080630,0343,A9560,,,,,NM MUGA DOSE (PYP),138.67,138.67,,,,,,,,,,,,, 47080631,0343,A9500,,,,,NM CARDIOLITE DOSE (TC),322.64,322.64,109.66,148.98,,,,,,,109.66,,,148.98,148.98 47080632,0343,A9503,,,,,NM BONE DOSE (TCMDP),114.38,114.38,38.81,53.34,,,,,,,38.81,,,53.34,53.34 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,,,,,,,,,,,,, 47080640,0250,J9280,,,,,MITOMYCIN 40MG VIAL,5662.56,5662.56,,,,,,,,,,,,, 47080646,0343,A9516,,,,,NM IODINE 123,302.07,302.07,,,,,,,,,,,,, 47080647,0636,J9357,,,,,VALRUBICIN 800MG/20ML (VALSTAR),20985.08,20985.08,,,,,,,,,,,,, 47080649,0343,A9567,,,,,TECHNETIUM Tc 99 PENTELATE DIAGNOSTIC,415.22,415.22,,,,,,,,,,,,, 47080652,0636,J0883,,,,,ARGATROBAN 125MG/125ML PREMIX,3141.42,3141.42,,,,,,,,,,,,, 47080654,0636,J2795,,,,,ROPIVACAINE 1% 20ML INJ (NAROPIN),56.44,56.44,35.80,35.80,,,,,,,35.80,,,, 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,,,,,,,,,,,,, 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,,,,,,,,,,,,, 47080677,0636,J2785,,,,,REGADENOSON 0.4MG/5ML INJ,1253.67,1253.67,425.78,430.43,,,,,,,425.78,,,430.43,430.43 47080680,0636,J1170,,,,,HYDROMORPHONE 1MG/ML INJ,26.34,26.34,8.90,17.65,,,17.65,,,,8.90,,,17.40,17.40 47080701,0636,J1250,,,,,DOBUTAMINE 250MG/250ML PREMIX,76.86,76.86,9.42,9.42,,,,,,,9.42,,,, 47080709,0636,J2550,,,,,PROMETHAZINE 25MG/ML 1ML INJ (PHENERGAN,26.34,26.34,,,,,,,,,,,,, 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),223.17,223.17,75.93,182.11,,,,,,,75.93,,,182.11,182.11 47080744,0636,J0133,,,,,ACYCLOVIR 1000MG/20ML INJ,144.48,144.48,,,,,,,,,,,,, 47080749,0636,C9290,,,,,BUPIVICAINE LIPOSOM 1.3% 20ML (EXPAREL),1854.50,1854.50,,,,,,,,,,,,, 47080888,0250,J7626,,,,,BUDESONIDE NEB 0.5MG/2ML(PULMICORT),66.30,66.30,,,,,,,,,,,,, 47080895,0636,J1953,,,,,LEVETIRACETAM 1000MG IVPB PREMIX,235.32,235.32,,,,,,,,,,,,, 47080900,0636,Q0138,,,,,FERUMOXYTOL 510MG/17ML INJ(FERAHEME),2643.47,2643.47,,,,,,,,,,,,, 47080910,0636,J1953,,,,,LEVETIRACETAM 500MG PREMIX (KEPPRA),141.15,141.15,,,,,,,,,,,,, 47080917,0636,J0282,,,,,AMIODARONE 450MG/9ML (50MG/ML)CORDARONE,37.89,37.89,21.82,21.82,,,,,,,21.82,,,, 47080922,0636,J1953,,,,,LEVETIRACETAM 500MG/5ML 5ML INJ,25.21,25.21,,,,,,,,,,,,, 47080948,0250,J7608,,,,,ACETYLCYSTEINE 20% INH RESP SOLN 4ML(MUC,68.75,68.75,,,,,,,,,,,,, 47081065,0636,J0878,,,,,DAPTOMYCIN 500MG IV,2298.74,2298.74,,,,,,,,,,,,, 47081073,0636,J1439,,,,,INJECTAFER IV SOLN 750MG/15ML,4766.16,4766.16,,,,,,,,,,,,, 47081145,0636,90670,,,,,PNEUMOCCAL VACCINE 13,845.53,845.53,,,,,,,,,,,,, 47081146,0250,J2150,,,,,MANNITOL 20% 500 ML,93.61,93.61,,,,,,,,,,,,, 47081148,0636,90586,,,,,BCG INJ,749.00,749.00,,,,,,,,,,,,, 47081452,0636,J0885,,,,,EPOETIN ALPHA 2000 UNITS (PROCRIT),253.06,253.06,,,,,,,,,,,,, 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,,,,,,,,,,,,, 9999999,0275,C1785,,,,,Craneware Test Charge 1,11700.00,11700.00,,,,,,,,,,,,,