Header 11

Hospital Price List

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Charge_Code Charge_Description Rev_Cd CPT/HCPCS Charge_Amt
31701000 SEMI-PRIVATE ROOM 121   1,649.00
31701002 1:1 INCR NURSING CARE 230   177.00
31701004 I&D ABSCESS;COMPLEX/MULTI 361 10061 655.00
31701005 PUNCTURE DRAINAGE OF LESION 361 10160 470.00
31701006 DEBRIDE SQ TISSUUE <=1ST 20 361 11042 424.00
31701007 BIOPSY SKIN SQ LESION 361 11100 375.00
31701008 BIOPSY SKIN SQ EA ADDTL LES 361 11101 117.00
31701009 REMOVAL SKIN TAGS MULTIPLE 361 11200 315.00
31701010 DEBRIDE NAILS; 6 OR MORE 361 11721 159.00
31701011 SIMPLE RPR SF WND 5.1-7.5 C 361 12014 509.00
31701012 DRESSING CHNG UNDER ANESTHE 361 15852 167.00
31701014 INSERTION CHEST TUBE 361 32551 630.00
31701015 INSERT NON TUNNELED CV CATH 361 36556 854.00
31701016 TC INSERT TUNNELED CV CATH 361 36558 2,898.00
31701018 TC I&D ABSCESS; THROAT 361 42720 1,659.00
31701020 SPINAL PUNCTURE LUMBAR DX 361 62270 580.00
31701025 2:1 INCR NURSING CARE 230   177.00
31701029 TC DRAIN FINGER ABSCESS SIM 361 26010 443.00
31701031 STRAPPING; UNNA BOOT 361 29580 191.00
31701032 TC REPAIR SF WOUND; 2.5CM/L 361 12011 400.00
31701034 IP TELEMETRY/HRLY 732 93042 45.00
31701035 TRIM NONDYSTROPHIC NAILS 361 11719 49.00
31701036 CARDIOVERSION EXTERNAL 361 92960 874.00
31701037 DEBRIDEMENT NAILS 1-5 361 11720 117.00
31701038 CHANGE GASTROSTOMY TUBE 361 43760 1,745.00
31701039 DEBRIDE INFECTED SKIN <10% 361 11000 195.00
31701041 THORACENTESIS W/IMAGING 361 32555 358.00
31701042 TANGENTIAL BIOPSY OF SKIN 361 11102 324.00
31701043 EACH ADDITIONAL LESION 361 11103 276.00
31701044 PUNCH BIOPSY OF SKIN LESION 361 11104 324.00
31701045 EACH ADDITIONAL BIOPSY 361 11105 276.00
31701046 INCISIONAL BIOPSY OF SKIN 361 11106 324.00
31701047 EACH ADDITIONAL BIOPSY 361 11107 276.00
31710012 CRITICAL CARE 1ST 30-74 MIN 960 99291 572.00
31710017 CRITICAL CARE EA ADDL 30MIN 960 99292 292.00
31710027 I&D ABSCESS;COMPLICATED/MU 960 10061 403.00
31710034 DEBRIDE SQ TISSUUE <=1ST 20 960 11042 190.00
31710036 BIOPSY SKIN SQ LESION 960 11100 167.00
31710040 IP PROLONGED SRVCS; 1ST HR 960 99356 219.00
31710042 IP HOSP CARE SAME DAY A/D 960 99236 484.00
31710051 PROLONGED SRVCS EA ADDTL 30 960 99357 197.00
31710061 I&D ABCESS; PERITONSILLAR 960 42700 457.00
31710063 IP HOSP CARE SAME DAY A/D 960 99235 370.00
31710067 SPINAL PUNCTURE LUMBAR DX 960 62270 361.00
31710068 PUNCTURE ASPIRATION OF ABSC 960 10160 229.00
31710075 INSERTION CHEST TUBE 960 32551 643.00
31710076 IP HOSP CARE SAME DAY A/D 960 99234 281.00
31710080 INSERT NON-TUNNELED CV CATH 960 36556 529.00
31710082 BIOPSY SKIN SQ EA ADDTL LES 960 11101 82.00
31710083 REPAIR SUPERFICIAL WOUND 960 12014 519.00
31710085 REMOVAL SKIN TAGS MULTIPLE 960 11200 153.00
31710088 DEBRIDE NAILS; 6 OR MORE 960 11721 75.00
31710090 DRESSING CHANGE NON BURNS 960 15852 129.00
31710092 I&D ABSCESS; THROAT 960 42720 1,023.00
31711568 INSERT TUNNELED CV CATH 960 36558 1,613.00
31711570 DRAIN FINGER ABSCESS SIMPLE 960 26010 502.00
31711572 STRAPPING; UNNA BOOT 960 29580 119.00
31711573 REPAIR SF WOUND; 2.5CM/LESS 960 12011 384.00
31711574 INITIAL HOSPITAL CARE; LOW 960 99221 200.00
31711575 INIT HOSP CARE; MODERATE 960 99222 268.00
31711576 INITIAL HOSPITAL CARE; HIGH 960 99223 357.00
31711577 SUBSEQ HOSPITAL CARE; LOW 960 99231 96.00
31711578 SUBSEQ HOSPITAL CARE; MODER 960 99232 141.00
31711579 SUBSEQ HOSPITAL CARE; HIGH 960 99233 206.00
31711580 HOSP DISCHARGE; <=30 MINS 960 99238 159.00
31711581 HOSPITAL DISCHARGE >30 MINS 960 99239 224.00
31711582 TRIM NONDYSTROPHIC NAILS 960 11719 36.00
31711583 DEBRIDEMENT NAILS;1-5 960 11720 48.00
31711584 THORACENTESIS WO IMAGING 960 32554 687.00
31711585 CHANGE GASTROSTOMY TUBE 960 43760 690.00
31711586 MNT; EA 15MIN 960 97802 61.00
31711587 MEDICAL NUTRI SUBSEQ, INDIV 960 97803 53.00
31711588 DEBRIDE INFECTED SKIN <10% 960 11000 108.00
31711589 RMV CERUMEN IRRIG/LAVAGE;UN 960 69209 74.00
31711590 THORACENTESIS W/IMAGING 960 32555 755.00
31711591 TANGENTIAL BIOPSY OF SKIN 960 11102 164.00
31711592 EACH ADDITIONAL LESION 960 11103 66.00
31711593 PUNCH BIOPSY OF SKIN 960 11104 164.00
31711594 EACH ADDITIONAL LESION 960 11105 66.00
31711595 INCISIONAL BIOPSY OF SKIN 960 11106 164.00
31711596 EACH ADDITIONAL LESION 960 11107 66.00
31711597 REPOSITIION OF A FEEDING TU 960 43761 517.00
31711598 REPLACEMENT GASTRO TUBE 960 43762 517.00
31711599 REVISION OF GASTRO TRACT 960 43763 517.00
32912000 PED INITIAL HOSP CARE; LOW 960 99221 200.00
32912001 PED INIT HOSP CARE; MODERAT 960 99222 268.00
32912002 PED INIT HOSP CARE; HIGH 960 99223 357.00
32912003 PED SUBSEQ HOSP CARE; LOW 960 99231 96.00
32912004 PED SUBSEQ HOSP CARE;MODERA 960 99232 141.00
32912005 PED SUBSEQ HOSP CARE; HIGH 960 99233 206.00
32912006 PED HOSP DISCH; <=30 MINS 960 99238 159.00
32912007 PED HOSP DISCH >30 MINS 960 99239 224.00
32912008 INIT IP PED CRITICAL CARE;D 960 99471 2,778.00
33801000 OBSTETRICS SEMI-PRIVATE 122   1,649.00
33810001 OB INITIAL HOSP CARE; LOW 960 99221 200.00
33810002 OB INIT HOSP CARE; MODERATE 960 99222 268.00
33810003 OB INIT HOSP CARE; HIGH 960 99223 357.00
33810004 OB SUBSEQ HOSP CARE; LOW 960 99231 96.00
33810005 OB SUBSEQ HOSP CARE; MODERA 960 99232 141.00
33810006 OB SUBSEQ HOSP CARE; HIGH 960 99233 206.00
33810007 OB HOSP DISCH; <=30 MINS 960 99238 159.00
33810008 OB HOSP DISCH >30 MINS 960 99239 224.00
33810009 SAME DAY A/D; MODERATE 960 99235 370.00
33811010 INSERTION BAKRI BALLOON 960 59899 303.00
35301000 NEWBORN BOARDER BABY 171   502.00
35301009 CIRCUMCISION 723 54150 441.00
35301010 NEWBORN HEARING SCREEN OAE 471 92586 43.00
35301011 NEWBORN HEARING SCREEN ABR 471 92588 43.00
35301012 BILIBRUBIN TRANSCUTANEOUS 301 88720 26.00
35301015 CATH UMBLICAL ARTERY 361 36600 226.00
35301016 INCR NURSING 1:1 NURSERY 231   177.00
35301017 1:2 INCR NURSING/NEWBORN 231   177.00
35301019 UMBILICAL VEIN CATHETER 361 36660 224.00
35301020 FRENECTOMY 361 40819 1,046.00
35301021 UMBILICAL VEIN CATH NEWBORN 361 36510 280.00
35310001 INITIAL NEWBORN CARE 960 99460 195.00
35310002 SUBSEQ DAY NEWBORN CARE 960 99462 103.00
35310003 DELIVERY ROOM RESUSCITATION 960 99465 821.00
35310005 NEWBORN SAME DAY A/D 960 99463 230.00
35310006 CIRCUMCISION W/REGIONAL BLO 960 54150 470.00
35310011 UMBILICAL VEIN CATHETER 960 36660 366.00
35310012 NEWBORN HOSP DISCH <30 MINS 960 99238 159.00
35310013 CATHETERIZATION OF UMBLICIA 960 36510 427.00
35310014 INTUBATION ENDOTRACHEAL EME 960 31500 399.00
35310015 NB INITIAL CARE; HIGH 960 99223 357.00
35310016 NEWBORN SUBSEQ CARE; HIGH 960 99233 206.00
35310073 NBN HOSP DISCH >30 960 99239 223.00
35310074 INITIAL CARE NEWBORN; ICS 960 99477 1,654.00
35310075 NB INITIAL CARE; LOW 960 99221 200.00
35310076 NB INITIAL CARE; MODERATE 960 99222 268.00
35310077 NEWBORN SUBSEQ HOSPITAL CAR 960 99231 96.00
35310078 NEWBORN SUBSEQ CARE; MODERA 960 99232 141.00
35310079 VENIPUNCTURE SCALP VEIN <3 960 36405 68.00
35310080 VENIPUNCTURE OTH VEIN <3 YE 960 36406 57.00
35310081 SUBSEQUENT HOSPITAL CARE OF 960 99479 1,079.00
35310082 FRENECTOMY 960 40819 609.00
35310083 SUBSEQ IP NB CRITICAL CARE 960 99469 2,925.00
35310084 INIT IP NB CRITICAL CARE;DA 960 99468 4,800.00
35310085 CRITICAL CARE 30-74 MINUTES 960 99291 572.00
35310086 CRITICAL CARE EA 30 MINS 960 99292 292.00
40101001 ER ROOM LEVEL 1 (ACEP) 450 99281 231.00
40101002 ER ROOM LEVEL 2 450 99282 364.00
40101022 ER ROOM LEVEL 3 450 99283 606.00
40101024 ER ROOM LEVEL 4 450 99284 910.00
40101025 ER ROOM LEVEL 5 450 99285 1,342.00
40101026 ER CRITICAL CARE ACEP 450 99291 1,806.00
40101027 ER CRITICAL CARE W/PROCEDUR 450 99291 1,181.00
40101041 ADMIN IMMUN INITIAL 771 90471 54.00
40101042 IMMUN ADMIN EA ADDL 771 90472 41.00
40101191 INTRO NEEDLE/INTRACATH VEIN 450 36000 113.00
40102022 TC INCIS/RMVL FB SIMPLE SUB 450 10120 552.00
40102023 TC CNTRL NASAL HEMORR;COMPL 450 30903 882.00
40102024 TC APPL LONG LEG SPLINT 450 29505 305.00
40102025 TC APPL FINGER SPLINT STATI 450 29130 154.00
40102026 TC SMPL RPR SF WND 7.6-12.5 450 12004 464.00
40102027 TC DRAIN/INJECT INTER JT/BU 450 20605 234.00
40102028 TC RPR INTER WND <=2.5 CM 450 12031 863.00
40102029 TC CNTRL NASAL HEMORRHAGE S 450 30901 348.00
40102030 INJ TRIGGER POINT 1/2 MUSCL 450 20552 198.00
40102031 TC RPR INTER WND 7.3-12.5 C 450 12034 1,129.00
40102032 TC N BLOCK OTHER; PERIPHERA 450 64450 287.00
40102033 DRAIN/INJ JT/BURSA W/O US 450 20610 216.00
40102034 RPR INTER WND 2.6-7.5 CM 450 12042 1,044.00
40102035 ER CRITICAL CARE EA ADDL 30 450 99292 491.00
40102036 CATH FOR SPEC COLLECTION 300 P9612 13.00
40102150 PULSE OXIMETRY,SINGLE 450 94760 63.00
40102161 POST-OP FOLLOW UP VISIT 450 99024 -
40102175 IV PUSH; EA ADDTL NEW DRUG/ 260 96375 85.00
40102176 OP VISIT EST; MINIMAL 450 99211 56.00
40102180 LEGAL BLOOD DRAW 450   -
40102181 IV PUSH; EA ADDTL SAME DRUG 260 96376 74.00
40102183 BLADDER SCAN 450 51798 89.00
40102184 ADMIN INFLUENZA VIRUS; MC O 771 G0008 81.00
40102187 ER SPINAL LUMBAR PUNCTURE;D 450 62270 368.00
40102189 TC SIMPLE RPR SF WOUND<=2.5 450 12001 330.00
40102190 TC SIMPLE RPR SF WND 2.6-7. 450 12002 397.00
40102191 TC APPL SHORT ARM SPLINT;ST 450 29125 237.00
40102192 TC REPAIR SF WOUND; 2.5CM/L 450 12011 400.00
40102193 TC I&D ABSCESS, SIMPLE 450 10060 418.00
40102194 TC RPR INTER WOUND 2.6-7.5 450 12032 1,105.00
40102195 TC APPL LONG ARM SPLINT 450 29105 322.00
40102196 TC APPL SHORT LEG SPLINT 450 29515 263.00
40102197 TC CLSD TX SHLDR DISL W/MAN 450 23650 1,143.00
40102198 TC SIMPLE RPR SF WND 2.6-5. 450 12013 439.00
40102199 TC I&D ABSCESS COMPLEX/MULT 450 10061 736.00
40102200 INCIS/RMVL FB SQ TISSUE CMP 450 10121 998.00
40102201 TC INJ SINGLE TENDON/LIGAME 450 20550 208.00
40102202 INSERT INDWELLING CATH 450 51702 251.00
40102203 TC CATH STRAIGHT IN/OUT 450 51701 195.00
40102204 TC N BLOCK INJ;INTERCOST;SN 450 64420 415.00
40102205 TC I&D BARTHOLINS GLAND 450 56420 442.00
40102206 TC INTUBATION ENDOTRACHEAL 450 31500 1,055.00
40102207 TC RPR COMPLEX 1.1-2.5 CM 450 13131 1,394.00
40102208 TC RPR INTERM WND 2.5 CM/LE 450 12041 878.00
40102209 TC CLTX METACARPAL FX WO MA 450 26600 1,068.00
40102210 TC DRESS/DEBRIDE P-THICK BU 450 16020 293.00
40102211 TC DEBRIDE SKIN/MUSCLE/BONE 450 11012 2,569.00
40102212 ADMIN PNEUMOVAX VACCINE; MC 771 G0009 81.00
40102213 TC AMPUTATION FINGER/THUMB 450 26951 2,336.00
40102214 TC DRAIN FINGER ABSCESS SIM 450 26010 443.00
40102215 RMVL CERUMEN W/INSTRUMENT U 450 69210 188.00
40102216 TC REMOVAL OF NAIL BED 450 11750 803.00
40102217 TC REVISE FINGER JOINT 450 26535 1,494.00
40102218 TC DRAINAGE OF GUM LESION 450 41800 1,037.00
40102219 TC TREAT FRACTURE RADIUS/UL 450 25605 1,982.00
40102220 TC PUNCTURE DRAINAGE OF LES 450 10160 470.00
40102221 TC TREAT HIP DISLOC W/ANES 450 27266 2,080.00
40102222 TC REMOVE FOREIGN BODY EYE 450 65222 248.00
40102223 TC CLTX METACARPAL FX W/MAN 450 26605 1,168.00
40102224 TC REPAIR COMPLEX 2.6-7.5 C 450 13132 1,720.00
40102225 INSERT NON TUNNELED CV CATH 450 36556 854.00
40102226 TC ABD PARACENTESIS W/IMAGI 450 49083 1,153.00
40102227 TC CLTX FINGER DISLOC WO AN 450 26770 1,001.00
40102228 TC RPR INTERM WNDS;2.6-7.5 450 12052 1,062.00
40102229 TC BLADDER IRRIGATION 450 51700 274.00
40102230 I&D ABSCESS; PERITONSILLAR 450 42700 711.00
40102231 TC CLO TX TEMPOROMANDIBULAR 450 21480 360.00
40102232 TC ABD PARACENTESIS WO IMAG 450 49082 641.00
40102233 TC INSERTION CHEST TUBE 450 32551 630.00
40102235 SPEC COLL CENTRAL/PERIPH CA 450 36592 154.00
40102236 TC DRAIN SCROTAL WALL ABSCE 450 55100 769.00
40102237 TC CLOSED TX RADIAL/ULNA FX 450 25565 1,866.00
40102238 SIMPLE RPR WND 12.6-20.0 CM 450 12005 594.00
40102239 TC I&D PERIANAL ABSCESS; SF 450 46050 722.00
40102240 DEBRIDE SQ TISSUUE <=1ST 20 450 11042 424.00
40102242 CHANGE CYSTOSTOMY TUBE;SIMP 450 51705 322.00
40102243 TREATMENT OF ANKLE FRACTURE 450 27810 1,688.00
40102244 RPR INTERM WOUND 12.6-20.0 450 12035 1,369.00
40102245 CLSD TX SHOULDER DISLOC/FX 450 23655 1,436.00
40102246 I&D COMPLEX POSTOP INFECTIO 450 10180 881.00
40102247 AVULSION NAIL PLATE SIMPLE 450 11730 354.00
40102248 TC CLSD TX ANKLE DISLOCATIO 450 27840 1,338.00
40102249 TC CHG GASTROSTOMY TUBE 450 43760 1,745.00
40102250 RPR INTERM WOUND;<= 2.5CM 450 12051 895.00
40102251 RPR EXTENSOR TENDON, FINGER 450 26418 2,035.00
40102252 TC ANOSCOPY; DX 450 46600 318.00
40102253 TREAT FINGER FX; EACH 450 26740 754.00
40102254 DRAIN CEREBRO SPINAL FLUID 450 62272 729.00
40102255 DEBRIDE INFECTED SKIN <10% 450 11000 195.00
40102256 TC CARDIOVERSION EXTERNAL 450 92960 874.00
40102257 TC I&D FOREARM/WRIST LES;DE 450 25028 1,897.00
40102258 TC AMPUTATION FINGER/THUMB 450 26952 2,296.00
40102259 CLSD TX FINGER FX; EA 450 26725 1,208.00
40102260 REPAIR NAIL BED 450 11760 828.00
40102261 FNA W/O IMAGING 1ST LESION 450 10021 531.00
40102262 TC N BLOCK INJ FACIAL 450 64402 442.00
40102263 TC RPR INT WOUND;12.6-20.0 450 12045 1,427.00
40102264 TC SMPL RPR SF WOUND;5.1-7. 450 12014 506.00
40102265 TC DRAIN NOSE LESION 450 30000 803.00
40102266 TX SF WOUND, SIMPLE CLOSURE 450 12020 952.00
40102267 CLOSED ELBOW DISLOC W/ANEST 450 24605 1,578.00
40102268 TREAT HUMERUS FRACTURE 450 24505 1,674.00
40102269 TC I&D UPPER ARM/ELBOW AREA 450 23931 963.00
40102270 TC CLTX ELBOW DISLOCATION 450 24640 466.00
40102271 TC I&D HEMATOMA/SEROMA/FLUI 450 10140 588.00
40102272 I&D VULVA/PERINEAL ABSCESS 450 56405 393.00
40102273 INJ; SINGLE/MULTIPLE TRIGGE 450 20553 226.00
40102274 TC RMVL HEMMORRHOID CLOT 450 46320 662.00
40102275 TC CHEMICAL CAUTERY, TISSUE 450 17250 265.00
40102276 TC COMPLEX RPR S/A/L; 2.6-7 450 13121 887.00
40102277 TC COMPLEX RPR EA ADDL 5CM 450 13122 443.00
40102278 TC TX SF WOUND DEHISENCE 450 12021 543.00
40102279 TC CLTX FX GREAT TO WO MANI 450 28490 485.00
40102280 TC RMVL FB XTERNL EYE CORNE 450 65220 248.00
40102281 TC I&D RECTAL ABSCESS 450 46040 1,780.00
40102282 TC CONTROL NOSEBLEED 450 30905 411.00
40102283 INSERT NEEDLE BONE CAVITY 450 36680 691.00
40102284 TEMPORARY EXTERNAL PACING 450 92953 593.00
40102285 TC REPAIR DIGIT NERVE 450 64831 2,312.00
40102287 TC DRAINAGE MOUTH LESION 450 40800 778.00
40102288 RMVL FB EXTERNAL EYE 450 65205 210.00
40102289 RMVL FB MUSCLE/TENDON;SIMPL 450 20520 681.00
40102290 EXPLORE WOUND EXTREMITY 450 20103 1,948.00
40102291 CLSD TX HIP DISLC; W/ANESTH 450 27252 2,566.00
40102292 REPAIR SUPERFICIAL WOUND 450 12006 668.00
40102293 CLTX ANKLE DISLC REQ ANESTH 450 27842 1,667.00
40102294 REMOVAL FB FOOT DEEP 450 28193 1,809.00
40102295 CLSD TX TOE DSLOC; W/O ANES 450 28660 421.00
40102296 SIMPLE RPR WOUNDS; 7.6-12.5 450 12015 616.00
40102297 RPR INTERM WOUNDS 450 12053 1,087.00
40102298 RMV CERUMEN IRRIG/LAVAGE;UN 450 69209 37.00
40102299 CLSD TX HUMERUS FX W/MANIP 450 23605 1,497.00
40102300 INCISION EYELID FOLD 450 67715 1,839.00
40102302 PROCTOSIGMOIDOSCOPY VOLVUL 450 45321 368.00
40102303 INSERT BLADDER CATH COMPLEX 450 51703 403.00
40102304 UMBILICAL VEIN CATH NEWBORN 450 36510 280.00
40102305 CNTRL OROPHARYNGEAL HEM SIM 450 42960 232.00
40102306 REPAIR OF LIP 450 40654 1,423.00
40110001 EACH ADDTL 5 CM OR LESS FOR 981 13133 419.00
40110002 OP VISIT NEW; MODERATE 981 99203 193.00
40111000 SIMPLE REPAIR SUPERFICIAL W 981 12004 465.00
40111002 RPR INTERM WOUND 12.6-20.0 981 12035 752.00
40111005 APPL LONG LEG SPLINT 981 29505 195.00
40111010 SPINAL PUNCTURE,LUMBAR,DX 981 62270 361.00
40111012 DRAIN/INJECT INTER JT/BURSA 981 20605 155.00
40111014 DRAIN/INJ JT/BURSA W/O US 981 20610 200.00
40111016 DRAIN/INJ JOINT/BURSA W/O U 981 20600 141.00
40111017 CLTX SHOULDER DISLOCATION 981 23655 1,030.00
40111018 AVULSION NAIL PLATE PARTIAL 981 11730 168.00
40111021 DRESS/DEBRIDE P-THICK BURN 981 16020 179.00
40111022 I&D ABSCESS SIMPLE 981 10060 202.00
40111023 CLTX METACARPAL FX WO MANIP 981 26600 621.00
40111025 CLOSED TREATMENT NASAL BONE 981 21315 617.00
40111026 APPLICATION CAST; LONG ARM 981 29065 348.00
40111027 APPLICATION LONG LEG CAST 981 29345 389.00
40111029 REMOVAL/BIVALVING; GAUNTLET 981 29700 116.00
40111030 N BLOCK OTHER; PERIPHERAL 981 64450 206.00
40111031 APPL CAST; SHORT ARM 981 29075 311.00
40111032 APPLICATION SHORT LEG CAST 981 29405 258.00
40111037 CLSD TX ANKLE DISLOCATION 981 27840 929.00
40111040 REMOVAL FOREIGN BODY EXTERN 981 65210 201.00
40111041 REMOVAL FB EXT EYE;CORNEAL 981 65222 230.00
40111050 CONTROL NASAL HEMORRHAGE, A 981 30903 390.00
40111051 DRESS/DEBRIDE BURNS;<10% 981 16030 391.00
40111054 CONTROL NOSEBLEED 981 30905 568.00
40111063 CLOSED TREATMENT DISTAL RAD 981 25600 806.00
40111065 CLSD TX RADIAL FX; W/MANIPU 981 25605 1,529.00
40111066 CLOSED TREATMENT PATELLAR D 981 27560 964.00
40111072 CRITICAL CARE FIRST 30-74 M 981 99291 658.00
40111073 CLOSED TREATMENT FINGER FX; 981 26725 825.00
40111076 ER CRITICAL CARE EA ADDL 30 981 99292 336.00
40111077 I&D PILONIDAL CYST;SIMPLE 981 10080 337.00
40111079 ER VISIT LEVEL 1 981 99281 123.00
40111081 ER VISIT LEVEL 2 981 99282 193.00
40111082 ER VISIT LEVEL 3 981 99283 312.00
40111084 ER VISIT LEVEL 4 981 99284 507.00
40111086 ER VISIT LEVEL 5 981 99285 762.00
40111087 EVACUATION SUBUNGUAL HEMATO 981 11740 106.00
40111089 EXCISION BENIGN LESION, TRU 981 11402 311.00
40111090 EXC NAIL MATRIX PERM RMVL 981 11750 422.00
40111093 DEBRIDE SQ TISSUE <=1ST 20C 981 11042 190.00
40111098 INJECTION, ANESTHETIC AGENT 981 64402 311.00
40111099 RMVL FB EXTERNAL EYE CORNEA 981 65220 172.00
40111101 REMOVAL FOREIGN BODY EXTERN 981 69200 232.00
40111102 PUNCTURE ASPIRATION ABSCESS 981 10160 229.00
40111103 REMOVAL FOREIGN BODY INTRAN 981 30300 377.00
40111105 INCISION/RMVL FB SIMPLE SUB 981 10120 252.00
40111108 REMOVAL FB EXT EYE 981 65205 167.00
40111109 TREAT ELBOW DISLOCATION 981 24640 340.00
40111112 CLOSED TREATMENT RADIAL SHA 981 25500 707.00
40111122 REPAIR INTER WND; 2.6-7.5 C 981 12031 384.00
40111123 SERIAL TONOMETRY EXAM 981 92100 142.00
40111125 I&D HEMATOMA/SEROMA/FLUID 981 10140 286.00
40111126 CLSD TX SHOULD DISL W/MANIP 981 23650 821.00
40111132 CLOSED TREATMENT HUMERAL SH 981 24500 894.00
40111135 APPLICATION FINGER SPLINT; 981 29130 102.00
40111136 APPLICATION SHORT LEG SPLIN 981 29515 162.00
40111137 APPL LONG ARM SPLINT 981 29105 214.00
40111141 APPL SHORT ARM SPLINT;STATI 981 29125 159.00
40111156 RMVL CERUMEN W/INSTRUMENT U 981 69210 106.00
40111158 I&D ABSCESS;COMPLEX/MULTI 981 10061 403.00
40111159 INSERTION CHEST TUBE 981 32551 643.00
40111162 DRAINAGE OF FINGER ABSCESS 981 26010 473.00
40111170 INJ; SINGLE TENDON/LIGAMENT 981 20550 154.00
40111171 CLOSED TREATMENT RADIAL & U 981 25565 1,594.00
40111173 CLTX FINGER DISLOC WO ANEST 981 26770 633.00
40111174 CLSD TX TOE DISLOC; W/O ANE 981 28660 305.00
40111177 CLOSED TREATMENT INTERTROCH 981 27238 1,482.00
40111179 INTUBATION ENDOTRACHEAL EME 981 31500 399.00
40111185 CLOSED TREATMENT METATARSAL 981 28470 594.00
40111189 CLTX METACARPAL FX W/MANIP 981 26605 864.00
40111192 CLOSED TREATMENT ACROMIOCLA 981 23540 564.00
40111194 RPR INTERM WOUNDS FACE 981 12052 528.00
40111195 SIMPLE RPR SF WOUND;2.5CM/L 981 12011 384.00
40111196 REPAIR INTERMEDIATE WOUNDS 981 12054 794.00
40111197 REPAIR INTER WND 2.6-7.5 CM 981 12042 499.00
40111198 COMPLEX RPR S/A/L; 2.6-7.5 981 13121 752.00
40111199 COMPLEX REPAIR 2.6-7.5 CM 981 13132 958.00
40111200 SIMPLE REPAIR SUPERFICIAL W 981 12015 652.00
40111201 REPAIR INTER WND 7.6-12.5 C 981 12034 580.00
40111202 REPAIR INTERMEDIATE WOUNDS 981 12044 645.00
40111203 INTMD WOUND RPR <=2.5CM 981 12051 490.00
40111204 SIMPLE RPR WND 12.6-20.0 CM 981 12005 588.00
40111206 SIMPLE RPR SF WOUND 2.6-7.5 981 12002 389.00
40111207 RPR COMPLEX WOUND 2.5-7.5 C 981 13131 676.00
40111208 SIMPLE RPR SF WOUND 2.6-5.0 981 12013 437.00
40111210 REPAIR INTERMEDIATE WOUNDS 981 12032 476.00
40111211 RPR INTERM WOUNDS 5.1-7.5CM 981 12053 647.00
40111213 REPAIR SUPERFICIAL WOUND 981 12014 519.00
40111214 SIMPLE REPAIR SUPERFICIAL W 981 12006 692.00
40111215 RPR INTERM WOUND 2.5 CM/LES 981 12041 433.00
40111216 SIMPLE REPAIR SF WOUND 981 12001 339.00
40111227 CLOSED TREATMENT CLAVICULAR 981 23500 580.00
40111228 AMPUTATION FINGER/THUMB 981 26951 1,682.00
40111230 INCISION/RMV FB SUBQ TISSUE 981 10121 517.00
40111232 LAC RPR CMPLX;2.6-7.5 CM 981 13152 1,118.00
40111236 TRMT CLOSED ELBOW DISL WO A 981 24600 854.00
40111238 REPAIR COMPLEX SCALP, ARMS 981 13120 575.00
40111240 CLOSED TREATMENT PROXIMAL H 981 23600 838.00
40111302 DRESSINGS AND/OR DEBRIDEMEN 981 16025 281.00
40111310 CLOSED TREATMENT PROXIMAL F 981 27780 735.00
40112000 REPAIR NAIL BED 981 11760 538.00
40112003 PHYSICIAN DIRECTION OF EMS/ 981 99288 338.00
40112006 CLOSED TREATMENT PHALANGEAL 981 26720 492.00
40112008 CLOSED TX TEMPOROMANDIBULAR 981 21480 266.00
40112011 RMVL FB MUSCLE/TENDON;DEEP 981 20525 1,110.00
40112012 CLOSED TREATMENT TIBIAL SHA 981 27750 1,065.00
40112017 CLOSED TREATMENT RADIAL & U 981 25560 789.00
40112024 REPAIR COMPLEX TRUNK; 2.6-7 981 13101 676.00
40112025 RHYTHM ECG;INTER&RPT ONLY 981 93042 26.00
40112028 CLOSED TREATMENT RADIAL SHA 981 25505 1,336.00
40112031 CLOSED TREATMENT FRACTURE P 981 28515 397.00
40112034 CONTROL NASAL HEMORRHAGE, A 981 30901 256.00
40112042 CLOSED TREATMENT CARPAL BON 981 25630 764.00
40112055 I&D COMPLEX POSTOP WOUND IN 981 10180 573.00
40112060 DEBRD BOND/FASCIA <=20CM 981 11044 859.00
40112072 CLOSED TREATMENT ARTICULAR 981 26740 600.00
40112085 EXPLORE WOUND EXTREMITY 981 20103 1,297.00
40112090 CLOSED TREATMENT CARPOMETAC 981 26670 823.00
40112094 INJECTION, ANESTHETIC AGENT 981 64420 423.00
40112095 INCISION THROMBOSED HEMORRH 981 46083 386.00
40112098 DRAINAGE EXTERNAL AUDITORY 981 69020 411.00
40112101 DRAINAGE GUM LESION 981 41800 402.00
40112102 CLOSED TREATMENT DISTAL PHA 981 26755 714.00
40112107 I&D OF BARTHOLIN'S GLAND 981 56420 368.00
40112111 CLSD TX HIP DISL;W/ANEST 981 27252 2,123.00
40112112 CLTX ANKLE DISLC REQ ANESTH 981 27842 1,329.00
40112113 BLEPHAROTOMY DRAINAGE ABSCE 981 67700 477.00
40112114 EACH ADDTL 5 CM OR LESS FOR 981 13122 320.00
40112118 INITIAL TREATMENT 1ST DEGRE 981 16000 149.00
40112119 I&D VULVA/PERINEAL ABSCESS 981 56405 350.00
40112122 TRACHEOSTOMY, EMERGENCY PRO 981 31605 473.00
40112123 INJ TRIGGER POINT 1/2 MUSCL 981 20552 163.00
40112125 TRACHEOSTOMY, EMERGENCY PRO 981 31603 1,050.00
40112130 REMOVAL INTRAUTERINE DEVICE 981 58301 246.00
40112131 CLOSED TREATMENT TRIMALLEOL 981 27818 1,476.00
40112132 INSERTION TEMPORARY INDWELL 981 51702 225.00
40112141 INJECTION(S); SINGLE/MULTIP 981 20553 192.00
40112142 INSERT BLADDER CATH (ND) 981 51701 167.00
40112144 CLTX BIMAL ANKLE FX W/MANIP 981 27810 1,421.00
40112149 OP VISIT EST; MINIMAL 981 99211 50.00
40112150 ASPIRATION BLADDER W/INSERT 981 51102 758.00
40112151 REMOVAL FOREIGN BODY SHOULD 981 23330 710.00
40112152 DILATION CERVICAL CANAL, IN 981 57800 215.00
40112153 INSERT NON-TUNNELED CV CATH 981 36556 529.00
40112157 CLOSED TREATMENT METATARSOP 981 28630 355.00
40112163 POST-OP FOLLOW UP VISIT 981 99024 -
40112167 RMVL HEMMORRHOID CLOT 981 46320 437.00
40112175 REMOVAL SKIN TAGS MULTIPLE 981 11200 153.00
40112183 DMV PHY 18-39 YRS (AMB PERS 981 99385 44.00
40112184 DMV PHY 40-64 YRS (AMB PERS 981 99386 44.00
40112185 CLOSED TREATMENT CALCANEAL 981 28400 744.00
40112186 DILATION FEMALE URETHRA INC 981 53660 201.00
40112187 REMOVAL FB DEEP FOOT 981 28193 1,227.00
40112188 INCISION EYELID FOLD 981 67715 604.00
40113013 CLOSED TREATMENT DISTAL FIB 981 27786 823.00
40113014 REMOVAL OF IMPLANT; SUPERFI 981 20670 874.00
40113015 FULL THICKNESS GRAFT INCLUD 981 15240 1,981.00
40113016 BIOPSY BREAST; OPEN INCISIO 981 19101 803.00
40113018 CLOSED TREATMENT RADIAL HEA 981 24655 1,160.00
40113019 REPLCEMENT DUODENOSTOMY/JEJ 981 49451 2,293.00
40113020 DRAINAGE OF FINGER ABSCESS 981 26011 1,010.00
40113021 CLOSED TREATMENT INTERTROCH 981 27240 3,308.00
40113022 OPEN TREATMENT TRANS-SCAPHO 981 25685 2,330.00
40113023 REPLACEMENT GASTROSTOMY/CEC 981 49450 2,145.00
40113024 CATHETERIZATION UMBILICAL V 981 36510 415.00
40113025 CLOSED TREATMENT ULNAR SHAF 981 25530 695.00
40113026 CHANGE CYSTOSTOMY TUBE, SIM 981 51705 284.00
40113027 INTRODUCTION ANY HEMOSTATIC 981 57180 321.00
40113029 NEGATIVE PRESSURE WOUND THE 981 97606 126.00
40113030 I&D DEEP ABSCESS, BURSA OR 981 27301 1,618.00
40113031 OP VISIT EST; MODERATE/HIGH 981 99214 173.00
40113033 OP VISIT NEW; MODERATE/HIGH 981 99204 277.00
40113034 OP VISIT EST; MODERATE/HIGH 981 99215 246.00
40113035 OP VISIT NEW;MODERATE/HIGH 981 99205 340.00
40113036 DEBRIDEMENT WOUND CARE; <= 981 97597 112.00
40113037 REMOVAL FECAL IMPACTION/FOR 981 45915 651.00
40113038 CARDIOVERSION; EXTERNAL 981 92960 523.00
40113039 OPEN TREATMENT ACUTE/CHRONI 981 24615 2,360.00
40113040 DEBRIDEMENT INCL REMOVAL FO 981 11010 1,070.00
40113041 CLOSURE SF WOUND DEHISENCE 981 12021 279.00
40113042 CLOSED TREATMENT SCAPULAR F 981 23575 1,136.00
40113043 CLOSED TREATMENT MEDIAL MAL 981 27762 1,329.00
40113044 OP VISIT NEW PT; LOW/MOD CO 981 99202 131.00
40113045 NEGATIVE PRESSURE WOUND THE 981 97605 89.00
40113047 CARDIOPULMONARY RESUSCITATI 981 92950 611.00
40113048 ASP/INJ BONE CYST 981 20615 471.00
40113049 ASP/INJ BONE CYST 981 20615 471.00
40113050 DEBRIDE INFECTED SKIN <10% 981 11000 108.00
40113051 TX CLOSED ELBOW DISLOC W/AN 981 24605 1,153.00
40113052 CLSD TX HUMERUS FX W/MANIP 981 23605 1,272.00
40113053 PROCTOSIGMOIDOSCOPY VOLVUL 960 45321 257.00
40113054 INSERT BLADDER CATH COMPLEX 960 51703 324.00
40113055 BEHAV CHNG SMOKING 3-10 MIN 981 99406 33.00
40114103 CLSD TX CLAVICULAR FX W/MAN 981 23505 917.00
40114104 OP VISIT EST; MINOR 981 99213 114.00
40114105 LIGATE/DIVIDE/EXCISE VEIN 981 37785 858.00
40114106 CLSD TX DISTAL FIBULA;W/MAN 981 27788 1,225.00
40114107 CLOSED TX TOE FRACTURE W/O 981 28510 333.00
40114108 LARYNGOSCOPY, DIAGNOSTIC 981 31505 214.00
40114109 THORACENTESIS W/IMAGING 981 32555 1,531.00
40114110 DRAIN CEREBRO SPINAL FLUID 981 62272 487.00
40114111 IRRIG CORPORA CAVVERNOS 981 54220 589.00
40114112 REPAIR COMPLEX; 1.1-2.5 CM 981 13151 825.00
40114113 CLSD TX POST HIP ARTHRP W/A 981 27266 1,704.00
40114114 ABD PARACENTESIS W/IMAGING 981 49083 886.00
40114115 I&D ABCESS; PERITONSILLAR 981 42700 457.00
40114116 ABD PARACENTESIS WO IMAGE 981 49082 509.00
40114117 DRAIN SCROTAL WALL ABSCESS 981 55100 633.00
40114118 I&D PERIANAL ABSCESS; SF 981 46050 459.00
40114119 CHG GASTROSTOMY TUBE 981 43760 690.00
40114120 I&D FOREARM/WRIST; DEEP 981 25028 1,556.00
40114121 AMPUTATION FINGER/THUMB 981 26952 2,063.00
40114122 FNA W/O IMAGING 1ST LESION 981 10021 324.00
40114123 US GUIDANCE VASCULAR ACCESS 981 76937 67.00
40114124 RER INTER WND; 12.6-20.0 CM 981 12045 904.00
40114125 DRAINAGE NOSE LESION 981 30000 428.00
40114127 TX SF WOUND, SIMPLE CLOSURE 981 12020 523.00
40114128 TREAT HUMERAL SHAFT FRACTUR 981 24505 1,403.00
40114129 I&D UPPER ARM/ELBOW AREA,BU 981 23931 711.00
40114130 CHEMICAL CAUTERY, TISSUE 981 17250 146.00
40114131 CLSD TX FX GREAT TOE WO MAN 981 28490 371.00
40114132 I&D RECTAL ABSCESS 981 46040 1,131.00
40114133 REPAIR DIGIT, NERVE 981 64831 2,381.00
40114134 DRAINAGE MOUTH LESION 981 40800 402.00
40114135 RMVL FB MUSCLE/TENDON;SIMPL 981 20520 458.00
40114136 RMV CERUMEN IRRIG/LAVAGE;UN 981 69209 74.00
40114137 CNTRL OROPHARYNGEAL HEM SIM 981 42960 839.00
40114138 REPAIR OF LIP 981 40654 1,658.00
42300014 CONCURRENT INFUSION 260 96368 118.00
42301001 OBV CARE LVL I EA HOUR 762   71.00
42301004 IV INFUSION; MEDICINE;1ST H 260 96365 352.00
42301005 IV INFUSION MEDICINE ADDTL 260 96366 120.00
42301006 IV INF,HYDRATION,1ST HR. 260 96360 443.00
42301007 IV INFUSION HYDRATION ADDTL 260 96361 246.00
42301008 BLOOD TRANSFUSION SRVC 391 36430 985.00
42301009 IP/OP BLADDER SCAN 361 51798 89.00
42301010 ADDTL SEQUENTIAL INFUSION 260 96367 196.00
42301011 DIRECT ADT TO OBSERV CARE 762 G0379 336.00
42301020 TRIAGE LEVEL 1; EST PATIENT 761 99211 70.00
42301021 TRIAGE LEVEL 2; EST PATIENT 761 99212 155.00
42301022 TRIAGE LEVEL 3; EST PATIENT 761 99213 258.00
42301023 TRIAGE LEVEL 4; EST PATIENT 761 99214 378.00
42301024 TRIAGE LEVEL 5; EST PATIENT 761 99215 506.00
42301026 I&D ABSCESS; SIMPLE/SINGLE 361 10060 418.00
42301027 TC I&D ABSCESS,COMPLEX/MULT 361 10061 736.00
42301028 TC I&D HEMATOMA/SEROMA/FLUI 361 10140 588.00
42301029 INJ TRIGGER POINT 1/2 MUSCL 361 20552 198.00
42301030 DRAIN/INJ JT/BURSA W/O US 361 20610 216.00
42301031 TC CONTROL NASAL HEMORRHAGE 361 30905 951.00
42301032 TC INSERT NON TUNNEL CV CAT 361 36556 854.00
42301033 I&D ABSCESS;PERITONSILLAR 361 42700 711.00
42301034 TC ABD PARACENTESIS WO IMAG 361 49082 641.00
42301035 TC CATH STRAIGHT I/O 361 51701 195.00
42301036 INSERT INDWELLING CATH 361 51702 251.00
42301038 TC COLLECT BLOOD VAD 361 36591 140.00
42301039 SPEC COLL CENTRAL/PERIPH CA 361 36592 154.00
42301041 AMNIOCENTESIS, DX 361 59000 457.00
42301042 TC OCCIPITAL NERVE BLOCK 361 64405 369.00
42301043 NEG PRESSURE WND TX; 50CM 361 97605 152.00
42301045 MINOR EXAM; NEW PATIENT 761 99201 155.00
42301046 LOW COMPLEXITY EXAM; NEW PT 761 99202 266.00
42301047 MODERATE COMPLEX EXAM;NEW P 761 99203 382.00
42301048 MODERATE/HI COMPLEX; NEW PT 761 99204 585.00
42301049 HIGH COMPLEX EXAM;NEW PT 761 99205 722.00
42301050 TC DRAIN SCROTAL WALL ABSCE 361 55100 769.00
42301051 TC DRAIN CEREBRO SPINAL FLU 361 62272 743.00
42301052 FNA W/O IMAGING 1ST LESION 361 10021 436.00
42301053 TC ABD PARACENTESIS W/IMAGI 361 49083 1,153.00
42301054 INTUBATION ENDOTRACHEAL 361 31500 1,055.00
42301055 THORACENTESIS WO IMAGING 361 32554 830.00
42301056 OBSERV W/TELEMETRY 762   117.00
42301057 CHANGE CYSTOSTOMY TUBE;SIMP 361 51705 322.00
42301058 OBSERV CARE W/INCR NRSNG CA 762   249.00
42301059 OBV CARE W/TELE & INCR NRSN 762   294.00
42301060 INSERT CERVICAL DILATOR 361 59200 375.00
42301061 DIAGNOSTIC ANOSCOPY 361 46600 134.00
42301062 INSERT NEEDLE BONE CAVITY 361 36680 691.00
42301063 INSERT INDWELL PLEURAL CATH 361 32550 3,757.00
42310001 INIT OBSERV CARE;LOW 960 99218 169.00
42310002 INIT OBSERV CARE;MODERATE 960 99219 252.00
42310003 INIT OBSERV CARE;HIGH 960 99220 257.00
42310004 OBSERV CARE DISCHARGE 960 99217 159.00
42310018 OBS;SAME DAY A/D;HIGH 960 99236 484.00
42310019 OBS;SAME DAY A/D;MOD 960 99235 370.00
42310020 OBS;SAME DAY A/D;LOW 960 99234 281.00
42310028 I&D ABCESS;SIMPLE/SINGLE 960 10060 202.00
42310029 DRAIN/INJ JT/BURSA W/O US 960 20610 200.00
42310032 OP VISIT EST; LOW/MODERATE 960 99213 114.00
42310036 INSERT NON TUNNEL CV CATH 960 36556 529.00
42310040 OP VISIT EST 10 MINS 960 99212 83.00
42310041 OP VISIT NEW; MODERATE 960 99203 188.00
42310042 PROLONGED SRVC;DIRECT CONTA 960 99354 203.00
42310043 TRIGGER PT INJ; 1/2 MUSCLES 960 20552 163.00
42310044 PROLONGED SRVC EACH ADDTL 3 960 99355 191.00
42310045 OP VISIT EST; MODERATE/HIGH 960 99214 173.00
42310046 CONTROL NASAL HEMORRHAGE 960 30905 568.00
42310047 OP VISIT EST; MODERATE/HIGH 960 99215 246.00
42310051 OP VISIT NEW; MODERATE/HIGH 960 99205 340.00
42310052 OP VISIT NEW; MODERATE/HIGH 960 99204 277.00
42310053 OCCIPITAL NERVE BLOCK 960 64405 291.00
42310054 OBSV CARE SUBSEQ DAY; LOW 960 99224 70.00
42310055 OBSV CARE SUBSEQ DAY; MODER 960 99225 123.00
42310056 OBSV CARE SUBSEQ DAY; HIGH 960 99226 186.00
42310057 AMNIOCENTESIS, DX 960 59000 478.00
42310058 I&D ABSCESS, COMPLX/MULTI 960 10061 403.00
42310061 OP VISIT NEW; LOW/MOD 960 99202 131.00
42310062 NEG PRESSURE WND TX; <50 CM 960 97605 89.00
42311009 OBS PROLONGED SRVCS; 1ST HR 960 99356 219.00
42311010 PROLONGED SRVC EA ADDTL 30 960 99357 197.00
42311011 I&D HEMATOMA/SEROMA/FLUID 960 10140 286.00
42311012 I&D ABSCESS;PERITONSILLAR 960 42700 457.00
42311013 ABD PARACENTESIS WO IMAGE 960 49082 509.00
42311014 THORACENTESIS WO IMAGING 960 32554 687.00
42311015 DRAIN SCROTAL WALL ABSCESS 960 55100 633.00
42311016 DRAIN CEREBRO FLUID 960 62272 464.00
42311017 FNA W/O IMAGING 1ST LESION 960 10021 314.00
42311018 ABD PARACENTESIS W/IMAGING 960 49083 886.00
42311019 INSERT CERVICAL DILATOR 960 59200 250.00
42311020 DIAGNOSTIC ANOSCOPY 960 46600 186.00
42311021 DRAIN/INJ JT/BURSA W/O US 960 20610 200.00
42311063 INSERT INDWELL PLEURAL CATH 960 32550 1,271.00
44001000 VAGINAL DELIVERY LVL 1 729   1,470.00
44001002 IP FETAL NST 720 59025 503.00
44001013 VAGINAL DELIVERY LVL II 729   -
44001014 VAGINAL DELIVERY LVL III 729   -
44001015 VAGINAL DELIVERY LVL IV 729   -
44001016 TC SCALP ELECTRODE INSERTIO 361 59050 216.00
44001018 BLOOD PATCH, EPIDURAL 720 62273 422.00
44001029 OB BED 122   1,649.00
44001030 EPISOTOMY/VAG RPR 729 59300 658.00
44011000 VAGINAL DELIVERY ONLY 960 59409 2,132.00
44011003 PHY STANDBY;EA 30 MINS 960 99360 307.00
44011004 AMNIOINFUSION INCL U/S GUID 960 59070 1,038.00
44011005 L&D INIT HOSP CARE; LOW 960 99221 200.00
44011006 L&D INIT HOSP CARE; MODERAT 960 99222 268.00
44011007 L&D INIT HOSP CARE; HIGH 960 99223 357.00
44011008 L&D SUBSEQ HOSP CARE; LOW 960 99231 96.00
44011009 L&D SUBSEQ HOSP CARE; MODER 960 99232 141.00
44011010 L&D SUBSEQ HOSP CARE; HIGH 960 99233 206.00
44011011 L&D HOSP DISCHARGE; <=30 MI 960 99238 159.00
44011012 L&D HOSP DISCHARGE >30 MINS 960 99239 224.00
44011013 EPISIOTOMY OR VAGINAL RPR 960 59300 691.00
44011014 INDUCE ABORTION INC ADT/VIS 960 59855 1,692.00
44201012 RECOVERY ROOM 1ST HOUR 710   622.00
44201013 RECOVERY ROOM EA ADDTL 15 M 710   156.00
44201019 OR LEVEL 1 MINOR FIRST HOUR 360   2,676.00
44201020 OR LEVEL 1 MINOR EACH ADDTL 360   662.00
44201021 OR LVL 2 MAJOR FIRST HOUR 360   6,284.00
44201022 OR LVL 2 MAJOR EA ADDTL 15M 360   1,563.00
44201023 ABORT SX PRE ANEST 360   -
44201041 LAP RECUR INC HERNIA RPR 360 49657 9,148.00
44201042 ASPRATION OF BLADDER BY NEE 360 51102 2,204.00
44210005 MASTECTOMY, MODIFIED RADICA 975 19307 3,193.00
44210007 RMV FB MUSCLE/TENDON;DEEP 975 20525 1,110.00
44210008 APPENDECTOMY 975 44950 1,947.00
44210009 EXC B9 LES;2.1-3.0 CM 975 11403 384.00
44210011 C-SECTION DELIVERY ONLY 975 59514 2,582.00
44210012 EXC PILONIDAL CYST;EXT 975 11771 1,347.00
44210015 EXC MALIG LES;0.6-1.0 CM 975 11641 450.00
44210018 EXC MALIG LES;>4.0 CM 975 11606 806.00
44210019 EXC B9 LES;1.1-2.0 CM 975 11442 389.00
44210021 RERPR ING HERNIA,REDUCE 975 49520 1,933.00
44210027 RPR I/HERNIA INIT,REDUCE>5Y 975 49505 1,705.00
44210028 REMOVE OVARY(S)/TUBE(S) 975 58720 2,565.00
44210029 LYSIS OF ADHESIONS 975 58740 2,405.00
44210034 EXC BREAST LESION;SINGLE 975 19125 1,298.00
44210042 PARTIAL REMOVAL OF COLON 975 44140 3,837.00
44210043 FREEING BOWEL ADHESION 975 44005 2,920.00
44210054 P-MASTECTOMY W/LES RMVL 975 19302 2,676.00
44210056 I&D ABSCESS;SIMPLE/SINGLE 975 10060 202.00
44210057 I&D RECTAL ABSCESS 975 46040 1,079.00
44210059 RPR UMB HERN REDUCE >5YR 975 49585 1,471.00
44210061 D&C DX;NON-OB 975 58120 943.00
44210063 RERPR ING HERNIA;BLOCKED 975 49521 2,086.00
44210064 EXC WRIST TENDON LESION 975 25111 1,194.00
44210069 RPR FEMORAL HERNIA INIT;BLK 975 49553 1,903.00
44210072 APPENDECTOMY;RUPT W/ABSC 975 44960 2,398.00
44210075 REMOVAL OF SMALL INTESTINE 975 44120 3,367.00
44210079 NEEDLE BIOPSY LIVER;ADD-ON 975 47001 377.00
44210087 TX MISSED ABORT;2ND TRI 975 59821 1,196.00
44210089 IMPLANT MESH OPEN HERNIA RP 975 49568 843.00
44210090 RPR VENTRAL HERN INIT BLOCK 975 49561 2,596.00
44210091 LAP TX ECTOPIC PREGNANCY 975 59151 2,643.00
44210099 VASECTOMY;UNI/BI 975 55250 1,098.00
44210101 HEMORRHOIDECTOMY,SIMPLE 975 46255 1,283.00
44210107 TOTAL ABD HYSTERECTOMY 975 58150 3,503.00
44210112 MASTECTOMY SIMPLE COMPLETE 975 19303 2,275.00
44210113 EXPL LAP,EXPL CELIOTOMY 975 49000 2,352.00
44210129 RPR COMPLX; 2.6-7.5CM 975 13132 958.00
44210130 LATE CLOSURE OF WOUND 975 13160 1,839.00
44210132 TX INCOMPL AB ANY TRIMESTER 975 59812 1,007.00
44210133 RMV TONSILS&ADNOIDS;<12YR 975 42820 1,079.00
44210138 CIRCUMCISION >28 DAYS 975 54161 736.00
44210141 RPR UMB HERNIA;>5YRS,BLKD 975 49587 1,706.00
44210172 DEBRIDE SQ TISSUUE <=1ST 20 975 11042 190.00
44210174 TX ECTOPIC PREGNANCY 975 59150 1,193.00
44210177 EXC B9 LES;>4.0 CM 975 11406 655.00
44210178 EXC B9 LES;<=0.5CM 975 11400 224.00
44210179 VAGINAL HYSTERECTOMY 975 58260 3,021.00
44210196 HEMORRHOIDECTOMY COMPLEX 975 46260 1,652.00
44210199 AMPUTATE LWR LEG 975 27880 2,652.00
44210201 RMV TONSILS & ADENOIDS >12Y 975 42821 1,131.00
44210205 EXPLORE PARATHYROID GLAND 975 60500 3,193.00
44210208 I&D ABSCESS;MULTI/COMPLEX 975 10061 403.00
44210210 LIGATE OVIDUCT(S) W/C-SECTI 975 58611 709.00
44210212 I&D COMPLEX PO WOUND INFECT 975 10180 573.00
44210215 TOTAL THYROID LOBECTOMY 975 60220 2,615.00
44210216 BX/RMV LYMPH NODE DEEP AX 975 38525 1,168.00
44210220 TONSILLECTOMY;>12YRS 975 42826 1,031.00
44210223 RPR ING HERNIA,INIT,REDUC 975 49500 1,671.00
44210228 REMOVE BREAST LESION 975 19120 1,178.00
44210229 EXC B9 LES;0.6-1.0 CM 975 11401 263.00
44210232 REVISE CERVIX 975 57720 1,178.00
44210245 CORRECT BUNION ANY METOD 975 28296 2,323.00
44210250 APPENDECTOMY; DONE W/OTH SX 975 44955 340.00
44210255 TX MISSED AB; 1ST TRIMESTER 975 59820 1,097.00
44210256 BX/EXC LYMPH NODES SUPERF 975 38500 786.00
44210261 RPR VENTRAL HERN INIT REDUC 975 49560 2,189.00
44210262 EXC HYDROCELE;UNILATERAL 975 55040 1,278.00
44210264 DEBRD BONE/FASCIA;<=20 SQ C 975 11044 859.00
44210268 RAD ABD HYSTERECTOMY 975 58210 7,326.00
44210278 CORRECT BUNION ANY METHOD 975 28292 1,874.00
44210280 BX/RMV LYMPH NODES DEEP 975 38510 1,247.00
44210283 RPR EXTENSOR TENDON FINGER 975 26418 1,897.00
44210291 DEBRD MUSCLE/FASCIA; <=20SQ 975 11043 571.00
44210299 EXC TUMOR NECK, SF <5 CM 975 21556 1,352.00
44210303 RPR BOWEL OPENING 975 44625 3,047.00
44210308 D&C;POSTPARTUM 975 59160 824.00
44210310 BIOPSY LIVER NEEDLE PERCU 975 47000 538.00
44210313 I&D HEMATOMA/FLUID 975 10140 286.00
44210328 GASTRORRHAPHY 975 43840 3,066.00
44210337 SPLENECTOMY TOTAL 975 38100 3,213.00
44210340 EXC MALIG LES;1.1-2.0 CM 975 11642 546.00
44210346 RMV THYROID;TOTAL 975 60240 3,592.00
44210347 EXC MALIG LES;>4.0 CM 975 11646 1,148.00
44210353 INSERT CHEST TUBE 975 32551 643.00
44210358 DRAIN ABDOMINAL ABSCESS 975 49020 3,646.00
44210365 INCISION METATARSAL 975 28308 1,326.00
44210376 RMV SKIN TAGS;1-15 LESION 975 11200 153.00
44210381 RPR ING HERNIA;BLKD>5YRS 975 49507 2,029.00
44210382 DELIVERY OF PLACENTA 975 59414 410.00
44210388 RERPR VENT HERNIA,BLOCK 975 49566 2,678.00
44210389 LAP ING HERNIA RPR INIT 975 49650 1,561.00
44210390 LAP;TUBAL LIGATION 975 58670 1,591.00
44210396 LAP CHOLECYSTECTOMY/GRAPH 975 47563 2,900.00
44210399 LAP,APPENDECTOMY 975 44970 1,954.00
44210403 LAPAROSCOPY,DX 975 49320 1,397.00
44210404 LAP SURG; CHOLECYSTECTOMY 975 47562 2,730.00
44210406 ENTERORRHAPHY; SINGLE PERFO 975 44602 3,254.00
44210410 LAP,FUNDOPLASTY 975 43280 3,520.00
44210420 UNLSTD PX;LAP,HERNIA FEMORA 975 49659 1,523.00
44210422 LAP,VAG HYSTERECTOMY <250 G 975 58550 3,315.00
44210428 RPR BOWEL OPENING 975 44626 4,195.00
44210434 LAP W/RMVL ADNEXAL STRUCTUR 975 58661 2,513.00
44210441 RPR BOWEL POUCH,VAGINAL 975 57268 1,674.00
44210442 RPR BLADDER & VAGINA 975 57240 1,638.00
44210447 I&D ABCESS;PERITONSILLAR 975 42700 457.00
44210449 EXC TUMOR HAND;SQ <1.5 CM 975 26115 1,463.00
44210450 LAP,W/FULGURATION/EXC LESIO 975 58662 2,465.00
44210454 INSERT PM ATRIAL & VENT 975 33208 1,947.00
44210457 BIOPSY LIVER;WEDGE 975 47100 2,074.00
44210459 I&D THIGH/KNEE LESION 975 27301 1,618.00
44210461 AMPUTATE TOE/METATARSAL 975 28810 1,284.00
44210464 COLECTOMY,PARTIAL;W/COLOSTO 975 44143 4,209.00
44210471 SKIN SPLIT GRAFT 975 15100 2,130.00
44210473 FNA W/IMAGING 975 10022 347.00
44210478 AMPUTATE TOE 975 28820 1,233.00
44210491 VENOGRAPHY, EXTREMITY S&I 975 75820 380.00
44210493 INSERT PM; VENTRICULAR 975 33207 1,850.00
44210500 LAP W/LYSIS OF ADHESIONS 975 58660 2,273.00
44210509 RERPR VENT HERNIA,REDUCE 975 49565 2,298.00
44210510 MOBILIZATION OF COLON 975 44139 447.00
44210517 DOUBLE OSTEOTOMY 975 28299 2,335.00
44210520 RPR PERINEUM (NON OB) 975 56810 899.00
44210524 RPR INCOMPL CIRCUMCISION 975 54163 686.00
44210528 LAP,W/BIOPSY SNGL/MULTI 975 49321 1,421.00
44210534 KNEE ARTHROSCOPY W/MENISC 975 29881 3,072.00
44210535 KNEE ARTHROSCOPY/DEBRIDE 975 29877 2,792.00
44210537 CARPAL TUNNEL SURGERY 975 64721 1,733.00
44210539 WOUND RPR CMPLX;2.6-7.5CM 975 13121 752.00
44210540 AMPUTATION FINGER/THUMB 975 26951 1,682.00
44210541 SLING OPERATION STRESS INCO 975 57288 2,637.00
44210542 CONIZATION CERVIX 975 57520 1,181.00
44210547 DRESSING CHANGE NON BURNS 975 15852 129.00
44210549 TUBE/NEEDLE CATHETER JEJUNO 975 44015 755.00
44210552 HYSTEROSCOPY,BX 975 58558 1,350.00
44210553 RMV FOOT BONE;PARTIAL 975 28122 1,536.00
44210554 RMVL IMPLANT; DEEP 975 20680 1,268.00
44210555 RMV TOE;PARTIAL 975 28124 1,031.00
44210556 REL FOOT CONTRACTURE 975 28270 990.00
44210557 RMV NAIL BED,PRTL/COMP 975 11750 422.00
44210559 WOUND RPR EACH ADDTL 5CM OR 975 13122 320.00
44210566 RMV OMENTUM 975 49255 2,084.00
44210567 SKIN FULL GRAFT;<=20SQ CM 975 15220 1,650.00
44210574 EXC LES TENDON SHEATH 975 26160 1,534.00
44210580 EPISIOTOMY OR VAGINAL RPR 975 59300 691.00
44210583 HYSTERECTOMY,PARTIAL 975 58180 3,380.00
44210588 INSERT TUNNELED CVAD 975 36561 2,261.00
44210591 INSERT NON-TUNNEL CV CATH 975 36556 529.00
44210601 LAP,HERNIA RPR,RECUR 975 49651 1,867.00
44210604 ARTHRODESIS,GREAT TOE;METAT 975 28750 2,041.00
44210622 CYSTOSCOPY 975 52000 547.00
44210638 INSERT TUNNELED CV CATH 975 36558 1,613.00
44210646 EXC B9 LES;3.1-4.0 CM 975 11404 462.00
44210649 REMOVE SACRUM PRESSURE 975 15931 1,541.00
44210652 RMV TUNNELED CV PORT 975 36590 834.00
44210654 REPAIR VAGINA 975 57260 2,347.00
44210658 OSTECTOMY,PARTIAL 975 28110 1,150.00
44210669 AMPUTATE THRU METATARSAL 975 28805 1,937.00
44210680 TENDON SHEATH INCISION 975 26055 1,520.00
44210682 EXC PAROTID GLAND/LESION 975 42415 3,689.00
44210696 I&D,ANAL ABSCESS,SF 975 46050 406.00
44210707 LAP,ENTEROLYSIS 975 44180 2,642.00
44210719 RPR RECTUM & VAGINA 975 57250 1,702.00
44210724 RELEASE URETER 975 50715 4,491.00
44210726 RPR BLADDER WOUND,SIMPLE 975 51860 3,116.00
44210738 RMV VAGINAL F/B W/ANESTH 975 57415 450.00
44210741 REVISE ULNAR @ ELBOW 975 64718 2,185.00
44210745 EXC INTERDIGITAL NEUROMA;EA 975 28080 1,130.00
44210746 EXC MALIG LES;>4.0 CM 975 11626 938.00
44210747 DEBRIDE INFECTED SKIN<10% 975 11000 108.00
44210749 EXC TUMOR LEG/ANKLE;SQ 975 27618 1,108.00
44210754 INSERT TISSUE EXPANDER 975 11960 2,694.00
44210759 DRAIN FINGER ABSC;CMPL 975 26011 1,010.00
44210765 REMOVAL OF IUD 975 58301 246.00
44210777 I&D VULVA/PERINEAL ABSCES 975 56405 350.00
44210798 RPR HALLUX RIGIDUS W/O IMPL 960 28289 1,789.00
44211028 CORRECTION,HAMMERTOE 975 28285 1,170.00
44211037 RMV FB,NASAL; GEN ANEST 975 30310 618.00
44211039 EXC CHEST WALL TUMOR 975 19260 3,301.00
44211041 CONTROL BLEED; POST TONSILL 975 42962 1,292.00
44211044 RMVL FALLOPIAN TUBE 975 58700 2,179.00
44211047 PROCTECTOMY;PARTIAL 975 45111 3,266.00
44211054 PROCTOSIGMOIDOSCOPY DX 975 45300 205.00
44211056 ILEOSTOMY/JEJUNOSTOMY 975 44310 2,828.00
44211058 CLSD TX RADIAL FX; W/MANIPU 975 25605 1,529.00
44211059 VULVA LESION 975 56440 680.00
44211062 TAH RAD DEBULK/RMV LYMPH 975 58954 7,797.00
44211072 AMPUTATE TOE; PARTIAL 975 28825 1,114.00
44211075 EXC MALIG LES; 2.1 TO 3.0 C 975 11643 685.00
44211082 I&D BELOW FASCIA, FOOT 975 28002 951.00
44211083 NEG PRESSURE WND TX;<=50 CM 975 97605 89.00
44211085 WOUND REPAIR COMPLEX EACH A 975 13133 419.00
44211092 EXPLORE SMALL INTESTINE 975 44020 2,817.00
44211095 DEBRIDE GENITALIA & PERINEU 975 11004 1,446.00
44211097 LAP VENT/ABD HERNIA RPR 975 49652 2,094.00
44211098 LAP RECUR INC HERNIA RPR 975 49657 4,166.00
44212000 EXC BARTHOLIN'S GLAND/CYST 975 56740 1,027.00
44212004 LAP INCISIONAL HERNIA;REDUC 975 49654 2,528.00
44212006 LIGATE MAJOR ARTERY; EXTREM 975 37618 1,310.00
44212008 RPR SIMPLE; <= 2.5 CM 975 12001 339.00
44212013 ARTHRODESIS,GREAT TOE,INTER 975 28755 1,271.00
44212015 LAP, INC HERNIA RPR REDUCIB 975 49656 2,919.00
44212017 INTESTINAL STRICTUROPLASTY 975 44615 3,205.00
44212021 EXC MALIG LES; 2.1 - 3.0 CM 975 11623 555.00
44212022 LAP,COLECTOMY,PARTIAL W/ANA 975 44204 4,387.00
44212025 TX SF WOUND, SIMPLE CLSR 975 12020 486.00
44212026 RMV TISSUE EXPANDER 975 11971 1,122.00
44212031 INST/RPLC DEFIB W/LEADS 975 33249 3,174.00
44212032 EXC SPERMATOCELE 975 54840 1,264.00
44212034 EXC,TUMOR,THIGH/KNEE;=> 3CM 975 27337 1,681.00
44212035 PYLOROPLASTY 975 43800 2,969.00
44212036 EXC OF UMBILICUS 975 49250 1,792.00
44212038 RMV FB EXT AUDITORY CANAL 975 69205 405.00
44212039 EXC TUMOR SOFT TISSUE; =>2C 975 21012 985.00
44212041 LAP,INCISIONAL RPR; INCARC/ 975 49655 2,889.00
44212045 INSERT LFT VENTRICULAR PACI 975 33225 1,366.00
44212046 ELECTROPHYSIOLOGIC EVALUATI 480 93641 1,164.00
44212048 COLECTOMY PRTL W/RMVL ILEUM 975 44205 3,912.00
44212054 OOPHORECTOMY,PRTL/TTL,UNI/B 975 58940 1,947.00
44212055 LAPARO-VAG HYST INCL T/O 975 58552 3,342.00
44212068 INSERT PULSE GEN W/EXIST LE 975 33240 1,539.00
44212074 EXC BACK/FLANK SOFT TISSUE; 975 21931 1,551.00
44212076 DRAIN SCROTAL WALL ABSCESS 975 55100 633.00
44212078 EXC,TUMOR,SOFT TISSUE; >3CM 975 27632 1,299.00
44212082 EXC BRANCHIAL CLEFT CYST 975 42815 2,126.00
44212108 CORRECTION OF BUNION 975 28298 2,168.00
44212109 EXC HYDROCELE; BI-LAT 975 55041 1,694.00
44212110 OSTECTOMY FOR SPUR 975 28119 1,451.00
44212111 MOBILIZATION (TAKE DOWN) 975 44213 613.00
44212114 LAP,TTL HYSTERECTOMY; <=250 975 58571 3,289.00
44212117 LAPARO-VAG HYST W/T/O COMPL 975 58554 3,860.00
44212118 ORCHIECTOMY RADICAL INGUINA 975 54530 1,849.00
44212119 DEBRD BONE/FASCIA ADDL 20CM 975 11047 192.00
44212120 DEBRD MUSCLE/FASCIA ADDL 20 975 11046 118.00
44212121 REVISON STOMACH W/RECONSTRU 975 43860 4,858.00
44212122 ANOSCOPY W/BIOPSY 975 46606 480.00
44212123 REPAIR ANAL SPHINCTER INCON 975 46750 2,259.00
44212124 REPOSITION PACING-DEFIB LEA 975 33215 897.00
44212125 MASTECTOMY FOR GYNECMASTIA 975 19300 1,502.00
44212126 EXPLORE PENETRATING WOUND 975 20102 1,167.00
44212127 EXC LESION,MOUTH VESTIBULE 975 40812 611.00
44212128 IMPLANT PT-ACT EVENT RECORD 975 33282 983.00
44212129 REMOVAL FOREIGN BODY ABDOME 975 49402 2,587.00
44212130 RPR INTERMED WOUNDS; <=2.5 975 12031 384.00
44212131 RMV/REPLACE PM DUAL LEAD 975 33228 1,252.00
44212132 EXC PILONIDAL CYST/SINUS;SI 975 11770 759.00
44212133 SIMPLE RPR 2.6-5.0 CM 975 12013 437.00
44212231 EXC LESION MOUTH W/O RPR 975 40810 404.00
44212232 EXC LESION MOUTH W/COMPELX 975 40814 869.00
44212233 BRONCHOSCOPY W/RMVL FB 975 31635 1,000.00
44212234 CLOSURE BOWEL FISTULA 975 44650 5,093.00
44212235 EXC TUMOR ABD WALL SC <3 CM 975 22902 2,057.00
44212236 I&D BELOW FASCIA,FOOT 975 28003 1,271.00
44212237 REPAIR OF HYDROCELE 975 55060 1,204.00
44212238 COLPOPEXY VAGINAL X-PERITON 975 57282 2,045.00
44212239 CYSTO W/URETERAL MEATOTOMY 975 52290 776.00
44212240 BIOPSY PROSTATE 975 55700 588.00
44212241 U/S GUIDE FOR BIOPSY; PC 975 76942 248.00
44212242 U/S TRANSRECTAL; PC 960 76872 234.00
44212243 AMPUTATE FINGER/THUMB W/FLA 975 26952 2,109.00
44212244 ORCHIOPEXY 975 54640 2,143.00
44212245 INCISION/REMOVAL FB;COMPLEX 975 10121 531.00
44212246 LIGATE HEMORRHOIDS; SINGLE 975 46945 622.00
44212247 PARTIAL EXC TALUS/CALCANEUS 975 28120 1,649.00
44212248 I&D VAGINAL HEMATOMA 975 57022 545.00
44212249 SUTURE LARGE INTESTINE 975 44604 3,623.00
44212250 RMV ELECTRODE TRANSVENOUS 975 33244 2,816.00
44212251 INSERT 1 ELECTRODE PM-DEFIB 975 33216 1,244.00
44212252 EXC/CURETTAGE BONE CYST TOE 975 28108 1,031.00
44212253 MASTECTOMY,PARTIAL 975 19301 1,505.00
44212254 EXC TUMOR NECK;5 CM OR > 975 21554 2,137.00
44212255 CLSD TX RADIAL/ULNAR FRACTU 975 25565 1,594.00
44212256 EXC TUMOR FOOT/TOE SQ >= 1. 975 28039 1,437.00
44212257 CHOLECYSTECTOMY W/EXPLORATI 975 47564 3,256.00
44212258 EXC ARM/ELBOW LES SC >3 CM 975 24071 1,536.00
44212261 RMV/REPLC CVD GEN SNGL LEAD 975 33262 1,302.00
44212263 PARTIAL REMOVAL COLON 975 44141 4,469.00
44212264 EXC B9 LESION;0.6-1.0 CM 975 11441 342.00
44212265 FUSE PANCREATIC CYST & BOWE 975 48520 3,983.00
44212266 EXC MALIG LESION; 1.1-2.0 C 975 11602 422.00
44212267 RPR CPLX TRUNK; 2.6-7.5CM 975 13101 679.00
44212268 EXC SUBMANDIBULAR GLAND 975 42440 1,867.00
44212270 EXC HYDROCELE SPERMATIC COR 975 55500 1,287.00
44212271 ESOPHAGOSCOPY W/RMV FB 975 43215 838.00
44212272 EXPLORATION OF HIP JOINT 975 27033 3,247.00
44212273 REMOVE FEMUR LESION 975 27062 1,476.00
44212274 REMOVAL OF NAIL PLATE 975 11730 172.00
44212275 RMVL NAIL PLATE EA ADDTL 975 11732 89.00
44212276 LAP COLECTOMY/COLOPROCTOSTO 975 44207 5,114.00
44212277 MANIPULATION KNEE JT; GEN A 975 27570 616.00
44212278 TREAT ECTOPIC PREGNANCY 975 59121 2,082.00
44212279 UNLISTED PROCEDURE, LIVER 975 47379 2,292.00
44212281 IO MAP OF SENTINEL NODE 975 38900 415.00
44212282 LYSIS/EXC PENILE ADHESIONS 975 54162 639.00
44212283 REPAIR SF WOUND; 2.5CM/LESS 975 12011 384.00
44212284 REMOVAL ANAL FISTULA 975 46280 1,482.00
44212285 EXC FACE B9 LESION; 0.5 < C 975 11440 265.00
44212286 I&D ABSCESS SOFT TISSUE 975 20005 728.00
44212287 DESTRUCION LESION(S); ANUS 975 46922 652.00
44212288 MASTOTOMY W/EXPL/DRAIN ABSC 975 19020 1,041.00
44212289 GASTROSTOMY, OPEN 975 43830 2,112.00
44212290 AMNIOCENTESIS; DX 975 59000 499.00
44212291 REDUCE BOWEL OBSTRUCTION 975 44050 2,865.00
44212292 AMPUTATION FOLLOW-UP SURGER 975 27886 2,295.00
44212293 LAP; ASPIRATION CYST/CAVITY 975 49322 1,477.00
44212294 INTERMD WOUND RPR; 2.6-7.5 975 12032 502.00
44212295 EXCISE PAROTID GLAND/LESION 975 42410 1,861.00
44212296 FLUORO CVAD PLCMENT; PC 975 77001 78.00
44212297 REPAIR FOOT TENDON 975 28208 1,086.00
44212298 PARTIAL REMOVAL OF TOE 975 28153 1,031.00
44212299 REMOVAL TAIL BONE ULCER 975 15920 1,357.00
44212300 MASTECTOMY SUBQ 975 19304 1,671.00
44212301 RPR S/N/AX/GEN/TRNK 2.6-7.5 975 12002 421.00
44212303 REPAIR INTER WND; 7.6-12.5C 975 12034 679.00
44212304 REPAIR RUPTURED SPLEEN 975 38115 3,774.00
44212305 OPEN TX ANKLE FRACTURE 975 27814 2,704.00
44212306 BIOPSY OF PENIS 975 54100 393.00
44212307 ARTHROSCOPY ROTATOR CUFF RP 975 29827 3,621.00
44212308 ARTHROSCOPY PRTL RMVL COLLA 975 29824 2,365.00
44212309 ARTHROSCOPY LIGMNT RELEASE 975 29826 2,499.00
44212310 COLOSTOMY 975 44320 3,058.00
44212311 LAP; VENT/ABD HERNIA 975 49653 2,584.00
44212312 ABDOMEN SURGERY PX; UNLISTE 975 49999 774.00
44212313 REMOVE SKIN NERVE LESION 975 64774 1,416.00
44212314 SKIN FULL GRAFT TRUNK 975 15200 1,749.00
44212315 ARTHROSCOPY SHOULDER BICEPS 975 29828 3,273.00
44212316 RMVL FB DEEP THIGH/KNEE 975 27372 1,401.00
44212317 KNEE ARTHRO W/MENISECTOMY 975 29880 3,393.00
44212318 DRAINAGE MOUTH LESION 975 41015 966.00
44212319 I&D BARTHOLINS GLAND 975 56420 370.00
44212320 REPAIR DEGENERATED KNEECAP 975 27418 3,131.00
44212321 INCISION OF KNEE JOINT 975 27435 2,066.00
44212322 KNEE ARTHROSCOPY/SURGERY 975 29875 2,508.00
44212323 U/S GUIDE VASCULAR ACCESS 975 76937 63.00
44212324 EXPLORE WOUND NECK 975 20100 2,082.00
44212325 INSERT TUNNEL IP CATH 975 49421 1,191.00
44212326 DEBRIDE SQ TISSUE ADD 20SQ 975 11045 87.00
44212327 TREAT ANKLE DISLOCATION 975 27846 2,454.00
44212328 TREAT LOWER LEG JOINT 975 27829 2,052.00
44212329 HYSTEROSCOPY ABLATION 975 58562 1,110.00
44212330 PERQ DEV BREAST 1ST US IMAG 975 19285 1,103.00
44212331 SLITTING OF PREPUCE 975 54001 545.00
44212332 EXC THIGH/KNEE TUMOR DEEP<5 975 27328 1,654.00
44212333 REMOVE EAR CANAL LESIONS(S) 975 69145 1,140.00
44212334 PLACEMENT OF SETON 975 46020 714.00
44212335 MEATOTOMY; EXCEPT INFANT 975 53020 418.00
44212336 REPAIR OF METATARSAL 975 28322 2,024.00
44212337 REPAIR ROTATOR CUFF ACUTE 975 23410 2,930.00
44212338 REPAIR BICEPS TENDON 975 23430 1,063.00
44212339 EXC NECK LES SC 3CM=> 975 21552 1,171.00
44212340 TREATMENT ANKLE FRACTURE 975 27822 2,621.00
44212342 THORACENTESIS W/IMAGING 975 32555 793.00
44212343 LAP HERNIA RPR; OBTURATOR 975 49659 1,561.00
44212344 INCISION DEEP OPEN BONE COR 975 27303 1,883.00
44212345 REMOVAL KNEECAP BURSA 975 27340 1,260.00
44212346 BRONCHOSCOPY W/BIOPSY 975 31625 721.00
44212347 BROCOSCOPE DX W/BRUSHING 975 31623 677.00
44212348 BREAST DEVICE PREQ PLACEMEN 975 19281 537.00
44212349 FUSION KNUCKLE JNT SNGL DIG 975 26516 2,293.00
44212350 TREAT METACARPAL FX; EA BON 975 26608 1,536.00
44212351 LAP; COLOSTOMY 975 44188 3,229.00
44212352 ARTHROSCOPY W/LYSIS ADHESIO 975 29884 2,498.00
44212353 EXC TUMOR BACK/FLANK SF=>5C 975 21933 2,051.00
44212354 ARTHOSCOPY SHOULDER DEBRID 975 29823 2,513.00
44212355 TREAT ANKLE FRACTURE 975 27792 2,059.00
44212356 REMOVE ANAL FIST INTER 975 46275 1,329.00
44212357 TENOTOMY, ELBOW LATERAL/MED 975 24358 1,645.00
44212358 EXC B9 LESION; 3.1-4.0 CM 975 11424 497.00
44212359 EXC URETHRAL CARUNCLE 975 53265 625.00
44212360 CAPSULORRHAPY SURGICAL 975 29806 3,569.00
44212361 REPAIR SLAP LESION SURGICAL 975 29807 3,440.00
44212362 WOUND PREP 1ST 100 SQ CM 975 15002 900.00
44212363 WOUND PREP ADDTL 100CM 975 15003 259.00
44212364 EXC ARM/ELBOW TUMOR SUBQ >5 975 24073 1,892.00
44212365 CLSD TREATMNT DISTAL FNGR F 975 26755 714.00
44212366 OPEN TX CLAVICULAR FX W/MAN 975 23515 2,004.00
44212367 EXC SOFT TISSUE HAND/FINGER 975 26113 1,722.00
44212368 EXC LESION SPERMATIC CORD 975 55520 1,234.00
44212369 EXC SHOULDER LES SC; =>3CM 975 23071 1,174.00
44212370 LAP RPR HIATAL HERNIA W/O M 975 43281 5,215.00
44212371 ACL REPAIR/RECONSTRUCTION 975 29888 4,026.00
44212372 LAP PROCTECTOMY COMPLETE 975 45395 5,354.00
44212373 CL TX TIBIAL FX W/O MANIP 975 27530 1,050.00
44212374 APPL EXT FIXATION SYSTEM UN 975 20690 1,613.00
44212375 EXC SOFT TISSUE HAND =>1.5C 975 26111 1,413.00
44212376 BIOPSY SKIN SINGLE LESION 975 11100 175.00
44212377 SPERMATIC CORD UNLSTD PX 975 55559 567.00
44212378 METACARPAL FX TX EACH BONE 975 26615 1,790.00
44212379 UNLSTD LAP PROC; STOMACH 975 43659 1,398.00
44212380 OPEN TX FX GREAT TOE 975 28505 1,536.00
44212381 FASCIECTOMY PLANTAR FASCIA 975 28060 1,221.00
44212382 RMVL & RPLC PM GEN SNGL LEA 975 33227 920.00
44212383 RPR RUPTURED ROTATOR CUFF 975 23412 3,260.00
44212384 ARTHROSCOPY,SHOULDER DEBRID 975 29822 2,255.00
44212385 UNLST PROC; MALE GENITAL 975 55899 895.00
44212386 EXC OLECRANON BURSA 975 24105 1,177.00
44212387 EXC ISCHIAL PRESSURE ULCER 975 15940 1,883.00
44212388 ARTHROSCOPY RMVL LOOSE/FB K 975 29874 2,273.00
44212389 ABRASION ARTHROPLASTY KNEE 975 29879 2,688.00
44212390 RMVL FB SCROTUM 975 55120 895.00
44212391 CLSTX POST ANKLE FX W/MANIP 975 27768 1,383.00
44212392 I&D TESTIS/SCROTAL SPACE 975 54700 635.00
44212393 EXC FACE-MM B9+MARG 2.1-3 C 975 11443 484.00
44212394 INTMD RPR FACE/MM 2.6-5.0 C 975 12052 608.00
44212395 ARTHRO LOOSE BODY & CHONDRO 975 G0289 285.00
44212396 CHANGE BLADDER TUBE COMPLEX 975 51710 389.00
44212397 REMOVE DRUG IMPLANT DEVICE 975 11982 327.00
44212398 RMV ADJ GASTRIC DEVICES 975 43774 3,334.00
44212399 EXC EXCESSIVE SKIN ABD 975 15830 3,737.00
44212400 REMOVE LOWER LEG BONE LESIO 975 26735 2,081.00
44212401 PARTIAL RMVL OF LIVER 975 47120 7,512.00
44212402 LAPAROSCOPIC MYOMECTOMY 975 58545 2,898.00
44212403 TENOTOMU LATERAL/MEDIAL PER 975 24357 1,481.00
44212404 CYSTOSCOPY & TREATMENT 975 52224 2,160.00
44212405 EXC B9 LES 1.1-2.0 CM 975 11422 341.00
44212406 EXC B9 LES 1.6-1.0CM 975 11421 287.00
44212407 EXC RECTAL TUMOR TRANSANAL 975 45172 2,413.00
44212408 LIGATION OF HEMORRHOID(S) 975 46221 594.00
44212409 REV COLOSTOMY COMPLICATED 975 44345 2,609.00
44212410 TISSUE TRNSF =<10SQ CM 975 14060 1,708.00
44212411 TREAT FRACTURE RADIUS & ULN 975 25574 2,151.00
44212412 LAP CLOSE ENTEROSTOMY 975 44227 4,374.00
44212413 BIOPSY THIGH/KNEE SOFT TISS 975 27323 455.00
44212414 EXCISION PILONIDAL CYST 960 11772 861.00
44212415 ADJACENT TISSUE TRANSFER 960 14021 1,174.00
44212416 EXCISION MALIGNANT LESION 2 960 11603 334.00
44212417 EXCISION MALIGNANT LESION 2 960 11603 334.00
44212418 EXCISION B9 LESION <4CM 960 11426 431.00
44212419 INTERMED REPAIR SKIN/NECK 960 12042 351.00
44212420 INTERMEDIATE LACERATION REP 960 12037 639.00
44212421 EXCISION THROMBOSED HEMMORR 960 46320 240.00
44212422 EXCISION RECTAL MASS 960 45171 898.00
44212423 EXTENSOR TENDON REPAIR 960 26426 960.00
44212424 INTERMEDIATE WOUND REPAIR < 975 12051 344.00
44212425 CLOSED REDUCTION/PERCUTANEO 960 26727 770.00
44212426 GASTROCNEMIUS RECESSION 960 27687 2,431.00
44212427 HALLUX RIGIDUS REPAIR WITH 960 28291 1,223.00
44212428 REPAIR MIDFACE FLAP 975 15730 1,838.00
44212429 EXCISION PLACEMENT OF IORT 975 19294 1,604.00
44212430 ENDOSCOPY WTH REMOV OF TISS 975 31253 1,877.00
44212431 ENDOSCOPY TOTAL ANT/POST 975 31257 1,085.00
44212432 ENDOSCOPY TOTAL FRONTAL SIN 975 31259 1,877.00
44212433 ENDOSCOPY WTH DIALATION 975 31298 793.00
44212434 TREATMENT OF ANAL FISTULA 975 46270 2,987.00
44212435 ADJACENT TISSUE TRANSFER 975 14001 2,039.00
44212436 ASPRITION OF BLADDER BY NEE 975 51102 1,012.00
44212437 AMP SECONDARY CLOSURE 975 27884 2,721.00
44212438 PELV LYMPH INCLUD ILIAC,GAS 975 38770 4,550.00
44212439 I&D ISCHIORECTAL/INTRA ABSC 975 46060 1,974.00
44212440 INTUBATION,ENDOTRACHEAL,EME 975 31500 903.00
44212441 LAPROSCOPY SUPRACERVICAL HY 975 58542 4,156.00
44212442 THYROIDECTOMY REMOVAL/REMAI 975 60260 4,956.00
44212443 REPAIR INTER WND 5.1-7.5 CM 975 12053 325.00
44212444 ANORECTAL EXAM DIAGNOSTIC 960 45990 300.00
44212445 LAP W TOTAL HYSTERECTOMY < 960 58570 2,527.00
44212446 MARSUPIALIZATION CYST OR LI 975 47300 2,040.00
44212447 EXCISION OF LIPOMA > 3M 975 22903 1,121.00
44212448 COLECTOMY PARTIAL W COLOPRO 975 44145 4,125.00
44212449 CYSTORRHAPHY SUTURE OF BLAD 975 51865 2,417.00
44212450 PELVIC EXAM UNDER ANESTH 975 57410 365.00
44212451 BRONCHSCOPY W NEEDLE BIOPSY 975 31629 867.00
44212452 REPAIR INGUINAL HERNIA SLID 975 49525 1,614.00
44212453 TANGENTIAL BIOPSY OF SKIN 975 11102 164.00
44212454 EACH ADDITIONAL LESION 975 11103 66.00
44212455 PUNCH BIOPSY OF SKIN LESION 975 11104 164.00
44212456 EACH ADDITIONAL LESION 975 11105 66.00
44212457 INCISIONAL BIOPSY OF SKIN 975 11106 164.00
44212458 EACH ADDITIONAL LESION 975 11107 66.00
44212459 CYSTOLITHOTOMY W STONE REMO 975 51050 1,454.00
44501782 ANESTHESIA MAC/15M 370   214.00
44501783 ANESTHESIA GENERAL/15M 370   214.00
44501784 LOCAL/REGIONAL 15 MIN 370   123.00
44501826 TC INTUBATION; EMERGENCY 370 31500 1,055.00
44501827 TC SPINAL LUMBAR PUNCTURE;D 370 62270 580.00
44501828 TC INJ EPIDURAL PATCH 370 62273 422.00
44511000 ANESTH LOWER LEG BONE SURG 964 1480 214.00
44511001 NONINVASIVE IMAGING 964 1922 204.00
44511003 ANESTH BLADDER SURGERY 964 910 214.00
44511004 ANESTH LOWER ARM 964 1830 214.00
44511006 ANESTH SURGERY OF SHOULDER 964 1630 214.00
44511007 ANESTH KNEE AREA SURGERY 964 1360 214.00
44511016 ANESTH SURGERY OF ABDOMEN 964 860 214.00
44511019 ANESTH SURG LOWER ABDOMEN 964 840 214.00
44511020 ANESTH HEAD/NECK/PTRUNK 964 300 214.00
44511025 ANESTH HIP JOINT PROCEDURE 964 1200 214.00
44511027 ANESTH MALE GENITALIA SURG 964 920 214.00
44511038 ANESTH UPPER ARM SURGERY 964 1740 214.00
44511090 ANESTH ANORECTAL SURGERY 964 902 214.00
44511092 ANESTH REPAIR OF HERNIA 964 830 214.00
44511106 ANESTH SKIN EXT/PER/ATRUNK 964 400 214.00
44511127 INTUBATION;EMERGENCY 964 31500 214.00
44511129 ANESTH CORRECT HEART RHYTHM 964 410 214.00
44511132 LENS SURGERY 964 142 214.00
44511157 ANESTH UPPR ARM PROCEDURE 964 1730 214.00
44511167 ANESTH SURG ON VAG/URETHRAL 964 942 214.00
44511193 ANESTH KNEE JOINT PROCEDURE 964 1380 214.00
44511195 ANESTH SURGERY OF BREAST 964 404 214.00
44511200 ANESTH NECK ORGAN 1YR/> 964 320 214.00
44511209 ANESTH EAR SURGERY 964 120 214.00
44511249 ANESTH SURG UPPER ABDOMEN 964 790 214.00
44511254 ANESTH KNEE JOINT SURGERY 964 1400 214.00
44511255 ANESTH LOWER ARM PROCEDURE 964 1820 214.00
44511296 ANESTH HIP JOINT SURGERY 964 1210 214.00
44511329 ANESTH SURGERY OF SHOULDER 964 1610 214.00
44511337 ANESTH UPPER LEG SURGERY 964 1250 214.00
44511344 ANESTH HYSTERECTOMY 964 846 214.00
44511358 ANESTH VAGINAL PROCEDURES 964 940 214.00
44511379 ANESTH VAGINAL HYSTERECTOMY 964 944 214.00
44511382 ANESTH REPAIR OF HERNIA 964 832 214.00
44511450 ANESTH SALIVARY GLAND 964 100 214.00
44511559 ANESTH PELVIS SX 964 844 214.00
44511564 ANESTH TESTIS SUSPENSION 964 930 214.00
44511587 ANESTH HYSTEROSCOPE/GRAPH 964 952 214.00
44511623 ANESTH REPAIR OF HERNIA 964 750 214.00
44511624 ANESTH LOWER LEG SURGERY 964 1470 214.00
44511638 HOSP MANAGE CONT DRUG ADMIN 964 1996 214.00
44511698 ANESTH SURGERY OF SHOULDER 964 450 214.00
44511745 ANESTH NOSE/SINUS SURGERY 964 160 214.00
44511746 ANESTH RADICAL LEG SURGERY 964 1482 214.00
44511752 ANESTH ELBOW AREA SURGERY 964 1710 214.00
44511766 ANESTH LOWER ARM SURGERY 964 1810 214.00
44511769 ANESTH VASCULAR ACCESS 964 532 214.00
44511771 ANESTH CS DELIVERY 964 1961 214.00
44511773 ANESTH PROCEDURE ON MOUTH 964 170 214.00
44511776 ANESTH SHOULDER PROCEDURE 964 1620 214.00
44511778 ANESTH LOWER LEG PROCEDURE 964 1462 214.00
44511786 ANESTH/ANALG VAG DELIVERY 964 1967 214.00
44511787 ANESTH PACEMAKER INSERTION 964 530 214.00
44511788 ANESTH TUBAL LIGATION 964 851 214.00
44511789 ANESTH VASECTOMY 964 921 214.00
44511791 ANESTH KNEE AREA SURGERY 964 1392 214.00
44511792 ANES/ANALG CS DELIVERY ADD 964 1968 214.00
44511794 SPINAL PUNCTURE,LUMBAR;DX 964 62270 368.00
44511796 ANESTH KNEE AREA SURGERY 964 1320 214.00
44511805 ANESTH ABDOMINAL WALL SURG 964 800 214.00
44511806 ANESTH INC/MISSED AB PROC 964 1965 214.00
44511807 INJ,EPIDURAL PATCH 964 62273 516.00
44511814 ANESTH CHEST PROCEDURES 964 520 214.00
44511816 ANESTH REPAIR OF HERNIA 964 752 214.00
44511818 ANESTH LWR ARM ARTERIES 964 1840 214.00
44511819 ANESTH LOWER ARM CASTING 964 1860 214.00
44511820 ANESTH KIDNEY/URETER SURGER 964 862 214.00
44511821 ANESTH EAR EXAM 964 124 214.00
44511822 ANESTH CARDIOVERTER/DEFIB 964 534 214.00
44511823 ANESTH FOR LIVER BIOPSY 964 702 214.00
44511825 ANESTH FACE/SKULL BONE SURG 964 190 214.00
44511826 ANESTH LOWER LEG REVISION 964 1484 214.00
44511827 ANESTH LUMBAR PUNCTURE 964 635 214.00
44511829 ANESTH PELVIS SURGERY 964 1120 214.00
44511830 ANESTH UPPR ARM TENDON SURG 964 1712 214.00
44511831 ANESTH KNEE AREA SURGERY 964 1390 214.00
44511834 ANESTH SURGERY FOR OBESITY 964 797 214.00
44511835 ANESTH HEMORR/EXCISE LIVER 964 792 214.00
44511837 ANESTHESIA FOR PROCEDURE 964 1474 214.00
44511838 ANESTH UPPER GI VISUALIZE 964 731 225.00
44511839 ANESTH UPPER GI VISUALIZE 964 732 225.00
44511840 ANESTH LOW INTESTINE SCOPE 964 811 107.00
44511841 SCREENING COLONOSCOPY 964 812 107.00
44511842 ANESTH LOW/UPPER INTES SCOP 964 813 137.00
44700723 ACE SHEARS 272   2,492.00
44700724 CARTIVA SYNTHETIC CARTILAGE 278 L8699 0,200.00
44700725 CAPIO SUTURING DEVICE 272 C2631 1,275.00
44701003 AMNIHOOK/AROM COT 272 A9999 20.00
44701020 FOLEY CATH TRAY 278 C1729 109.00
44701033 ABG KIT 272   57.00
44701043 AEROSOCHAMBER 271 A4627 27.00
44701068 PINS STEINMAN ANY SIZE 278 C1713 141.00
44701097 ANKLE BRACE-AIRSPORT ANY SZ 274 L1906 131.00
44701099 COMPRESSION STOCKINGS ANY S 270 A6549 38.00
44701135 PROTECTOR,HEEL/ELBOW 270   32.00
44701176 STRAINER, URINE 270   19.00
44701217 UA COLLECT SURE CATCH INFAN 270   9.00
44701259 RESUSCITATION BAG INFANT 272   138.00
44701264 HEMOSTAT 2X3 SURGICELL 272   245.00
44701267 HEMOSTAT 4X8 SURGICEL 272   426.00
44701277 FETAL SCALP ELECTRODE 272 A9999 29.00
44701323 ACRYSOF IQ IOLS 276 C1780 811.00
44701387 CATHETER THORACIC ANY SZ 278 C1729 412.00
44701394 K-WIRES TROCAR POINT ANY SZ 278 C1713 237.00
44701396 TUBE FEEDING ANY SZ 270 B4083 7.00
44701401 CATHETER SUCTION ANY SZ 272 A4624 24.00
44701408 RED ROBINSON/STRAIGHT CATH 272 A4351 14.00
44701411 KNEE SLEEVE ANY SZ 271 A4467 66.00
44701417 CATH EMBOLECTOMY ANY SZ 278 C1757 259.00
44701440 CATH UMBILICAL SNGL ANY SZ 278 C1751 83.00
44701445 CATHETER SUCTION TRACHEOSTO 272   176.00
44701461 PATELLA STABILIZER W/JOINTS 271 A4467 105.00
44701465 CATH URETERAL ANY SZ/TYPE 272 C1758 138.00
44701485 CHIBA NEEDLE PROSTATE 272 G0416 50.00
44701500 CLAVICLE STRAP ANY SZ 274 L3670 32.00
44701501 SO FIG 8 PREFAB ANY SZ 274 L3650 47.00
44701550 LOPEZ VALVE 272   13.00
44701556 TRAY;LUMBAR PUNCTURE PEDI 272   161.00
44701558 TRAY; LUMBAR PUNCTURE ADULT 272   188.00
44701563 BARD MESH 10X14 278 C1781 428.00
44701564 BARD MESH 2X4 278 C1781 523.00
44701603 MECONIUM ASPIRATOR 270   34.00
44701678 CENTRAL LINE TRIPLE LUMEN 278 C1751 213.00
44701709 URINARY LEG BAG 272   15.00
44701724 DRAINAGE CATHETHER 278 C1729 180.00
44701726 DRAINAGE BAG BEDSIDE CLOSED 272 A4357 24.00
44701749 TEGADERM DRESSING ANY SZ 272 A6258 6.00
44701756 THUMB SPICA ANY SZ 274 L3807 138.00
44701769 K-PAD 271   51.00
44701776 DUODERM DRESSING <16 SQ IN 250 A6237 25.00
44701827 TUBE TRACHEOSTOMY ANY SZ 272   310.00
44701842 OSTOMY IRRIGATION SET 272 A4400 20.00
44701855 EPIDURAL TRAY 272   269.00
44701867 DRESSING TRAUMA MULTI 272   39.00
44701888 INCENTIVE SPIROMETER 270   20.00
44701896 PATCH EYE PRESSURE 270   39.00
44701906 SET IV VOLUTROL 270   54.00
44701920 CATHETER FOLEY ANY SZ/TYPE 278 C1729 65.00
44701923 CATH KIT FEMALE STRAIGHT 278 C1729 15.00
44701998 CATHETER STRAIGHT TIP ANY S 278 A4351 30.00
44702004 CATHETER CONDOM ANY SZ 272 A4349 6.00
44702007 PEAK FLOW METER 270   119.00
44702010 VACURETTE 8MM 272   97.00
44702014 VACURETTE 12MM 272   97.00
44702017 PENROSE DRAIN ANY SZ 278 C1729 24.00
44702020 VACUUM, KIWI 272   128.00
44702024 GRAFT VASCULAR GORTEX STD 278 C1768 1,577.00
44702063 TRAY WET PREP 272   34.00
44702067 DRESSING XEROFORM 1X8 272 A6222 4.00
44702070 XEROFORM DRESSING 5X9 272 A6223 12.00
44702078 BARD MESH 6X6 278 C1781 631.00
44702081 PURSTRING 65 DISP NST 272   545.00
44702127 PLEUR-EVAC 272   167.00
44702133 RIB BELT UNIVERSAL 271   39.00
44702136 PNEUOMOTHORAX SET 272 C1729 428.00
44702147 POST OP SHOE ANY SZ 274 L3260 35.00
44702148 BACK SUPPORT INDUSTRIAL ANY 270 L1499 88.00
44702168 URINE CONTAINER MEASUREMENT 271 A4327 5.00
44702177 SPINAL ANES TRAY 272   192.00
44702233 SUTURE REMOVAL TRAY 270   -
44703038 IRRIJET PRESSURE IRRIGATION 270   45.00
44703040 CATHETER, INDWELLING 16FR 3 272 C1726 79.00
44703063 DUODERM DRESSING 17-48 INCH 250 A6238 57.00
44703075 DEXTROSE 5% 50ML INJ 250   12.00
44703089 IRRIGANT STERILE WATER 500M 270   6.00
44703119 PCA SET 270   50.00
44703186 SCD LEG SQUEEZERS ANY SZ 270   138.00
44703190 INFUSION POWER PORT IMPLANT 278 C1788 1,552.00
44703213 ACCUSTICK INTRODUCER SYST 278 C1894 491.00
44703248 VACURETTE 10MM 272   56.00
44703251 HUMIDIFIER BUBBLE 270   60.00
44703299 CATHETER EPISTAXIS 272   269.00
44703315 MEROCEL NASAL PACKING 270   104.00
44703367 TRACH CARE SYSTEM 272   -
44703377 ENDO RETRACT 272   595.00
44703380 SURGIFOAM/GEL 272   989.00
44703434 CATHETER GROSHONG SNGL ANY 278 C1751 827.00
44703452 ORTHOCORD SUTURE ANCHOR 278 C1713 184.00
44703460 CATHETER COUDE TIP ANY SZ 278 A4352 74.00
44703466 BIOPSY GUN, BREAST 272   320.00
44703500 MESH BARD PLUG 278 C1781 794.00
44703505 ABDOMINAL BINDER ANY SZ 270 A4463 65.00
44703515 EVS SHOULDER BRACE ANY SZ 274 L3999 245.00
44703531 SWAB PROCTO 271   -
44703610 WRIST SUPPORT W/EXTENSION 274 L3908 51.00
44703668 LOCKING SCREW ANY SZ 278 C1713 753.00
44703680 DERMABOND PEN 272 G0168 150.00
44703806 PESSARY RUBBER 271 A4561 212.07
44703816 BARD MESH 3X6 278 C1781 488.00
44703818 DRAIN BLAKE ANY SZ 278 C1729 270.00
44703848 TUBE LAVACUATOR ANY SZ 270   64.00
44703894 HICKMAN REPAIR KIT ANY SZ 272   321.00
44703896 RESERVOIR JP DRAIN 272   49.00
44703901 TUBING PUMP ARTHROSCOPY 272   323.00
44703908 MDI AERO CHAMBER 270   96.00
44703924 BREAST MARKER 278 A4648 357.00
44703956 ACCUSTICK INTRO 278 C1894 440.00
44703970 LEAD,PM; NOT TRANSVENOUS 275 C1898 1,619.00
44703973 IUPC CATHETER 272   121.00
44703994 DVT SLEEVE 30 270   -
44704006 SEPRAMESH 4X8 278 C1781 1,445.00
44704009 PHOTOTHERAPY SUPPLIES 271   384.00
44704012 CRICOTHYROTOMY CATH SET 272   1,196.00
44704027 CV CATHETER RPR KIT ANY SZ 272   481.00
44704038 CANCELLOUS SCREW ANY SZ 278 C1713 165.00
44704100 ELBOW SLEEVE 270   41.00
44704107 BAKRI PP BALLOON 272   825.00
44704118 PM SINGLE RATE-RESP 275 C1786 1,657.00
44704124 SHOE DIABETIC ANY SZ 270 A5500 428.00
44704150 ADHESION BARRIER,INTERCEED 278 C1765 799.00
44704166 SEPRAFILM 278 C1781 918.00
44704170 FOLLOWER HEYMAN ANY SZ 272   48.00
44704171 FIBRIN SEALANT EVICEL 278 C9250 935.00
44704180 PM DUAL RATE-RESP 275 C1785 0,119.00
44704187 FOOT DROP SPLINT PREFAB 274 L4398 17.00
44704194 HEEL PAD ANY SZ 274 L3485 42.00
44704200 AICD, DUAL CHAMBER 275 C1721 2,381.00
44704203 CARDIOVERTER-DEFIBRILLATOR 275 C1882 8,429.00
44704206 BREAST BX SYSTEM (CELERO) 272   768.00
44704211 CRICOTHYROTOMY TRAY 272   1,076.00
44704214 FUSION KNEE BRACE ANY SZ 274 L1845 1,040.00
44704215 FUSION XT KNEE BRACE ANY SZ 274 L1845 2,561.00
44704219 CATH GROSHONG DUAL ANY SZ 278 C1751 918.00
44704223 CATH UMBILICAL DBL ANY SZ 278 C1751 140.00
44704237 GROSHONG REPAIR KIT ANY SZ 272   479.00
44704238 CATHETER HICKMAN ANY SZ SNG 278 C1751 427.00
44704253 RAPID RHINO 270   154.00
44704266 SLING ARM ANY SZ/TYPE 270 A4565 22.00
44704271 BAIR HUGGER ANY SZ 270   132.00
44704280 NASOGASTRIC TUBE ANY SZ 270   133.00
44704283 DONJOY SHOULDER ORTHO ANY S 274 L3670 251.00
44704301 ANKLE BRACE STIRRUP/AIRSPOR 274 L4350 118.00
44704309 ANKLE BRACE STABILIZING ANY 274 L1902 54.00
44704314 KO KNEE BRACE ANY SZ 274 L1820 133.00
44704315 CATH CENTRAL LINE SINGLE LU 278 C1751 941.00
44704323 REPLOGLE CATH ANY SZ 270 A4605 67.00
44704332 CERVICAL COLLAR FOAM ANY SZ 274 L0120 32.00
44704342 FINGER COT PADDED ANY SZ 271 A4570 7.00
44704357 BIOSEAL SHOULDER IMMOBILEZE 274 L3650 151.00
44704359 KNEE BRACE CUSTOM DJO/DEFIA 274 L1846 1,484.00
44704370 MATTRESS, WARMING PORTABLE     -
44704371 DUALMESH - GORE 278 C1781 3,225.00
44704419 SUPRAPUBIC CATH ANY SZ 278 C2627 321.00
44704424 WALKING BOOT NON-PNEUMATIC 274 L4387 128.00
44704442 FINGER SPLINT ANY TYPE/SZ 270 A4570 5.00
44704466 FINGER PROTECTOR ANY SZ 270 L3933 9.00
44704467 DORSIWEDGE FOOT SPLINT 274 L4398 85.00
44704471 HINGED KNEE STABILIZER 274 L1810 126.00
44704488 TENNIS ELBOW STRAP 271 A4467 54.00
44704510 WRIST SUPPORT CTS ANY SZ 274 L3908 40.00
44704541 CHOPAT KNEE STRAP 271 A4467 84.00
44704543 TEEPEE THUMB SUPPORT ANY SZ 274 L3923 26.00
44704548 TUBING PUMP FLUID WARMING 270   74.00
44704550 CHEST DRAIN VALVE 270 A7040 919.00
44704562 IMPLANTABLE EVENT RECORDER 278 C1764 8,146.00
44704564 FASTIN RC SCREW W/ORTHORCOR 278 C1713 1,357.00
44704572 FOOT INSERT MOLDED BI-LAT 274 L3020 457.00
44704573 LUMBAR ORTHOSIS FLEXIBLE 274 L0625 85.00
44704574 ARCH PAD METATARSAL LONG 274 L3060 44.00
44704575 ALCON TORIC IOL 276 C1780 1,524.00
44704576 ALCON ACRYLIC IOL 276 C1780 811.00
44704578 VENTRALEX MESH 278 C1781 1,292.00
44704579 JOINT DEVICE PATELLAR 278 C1776 3,612.00
44704580 HV BONE CEMENT 278 C1713 608.00
44704583 3D MAX MESH 278 C1781 946.00
44704584 CORTEX SLF TPNG SCREW ANY S 278 C1713 392.00
44704585 SCREW SLF TPNG W/STARDRIVE 278 C1713 753.00
44704586 KNUCKLE ORTHOSIS 274 L3807 152.00
44704587 CORTICAL SCREW ANY SZ 278 C1713 349.00
44704588 WALKING BOOT PNEUMATIC 274 L4360 761.00
44704589 HUMERUS FX BRACE 274 L3980 497.00
44704590 GAIT IMPLANT W/SIZERS 278 L8642 4,827.00
44704591 CLAVICLE PLATE 7 HOLE 278 C1713 3,133.00
44704592 SURGICAL SUPPLY; ACL KIT 272 A4649 1,552.00
44704593 MILAGRO SCREWS ANY SZ 278 C1713 1,539.00
44704594 FOLEY TRAY ONLY 278 C1729 69.00
44704595 LCP 1/3 PLATE 69MM 6 HOLES 278 C1713 1,008.00
44704596 PROLENE MESH 3X6 278 C1781 333.00
44704597 HEALIX ADV ANCHOR W/ORTHCOR 278 C1713 1,542.00
44704598 OROGASTRIC TUBING NBN 270   7.00
44704599 CERVICAL RIPENING BALLOON 278 C1726 222.00
44704601 ADAPTIC DRESSING 3X3 272 A6222 5.00
44704602 ADAPTIC DRESSING 3X8 272 A6223 6.00
44706510 AICD SINGLE CHAMBER 275 C1722 9,710.00
44706511 LEAD ENDOCARDIAL DUAL COIL 275 C1895 8,261.00
44706513 IRRIGANT STERILE WATER 2000 270 A4217 9.00
44706515 EVS SHOULDER BRACE ANY SZ 274 L3999 245.00
44706538 VENTRALEX HERNIA PATCH,MED 278 C1781 1,358.00
44706539 VENTRALEX HENRIA PATCH,LG 278 C1781 1,467.00
44706540 GRYPHON ANCHOR SUTURES 278 C1713 1,551.00
44706541 CANNULATED SCREW ANY SZ 278 C1713 473.00
44706542 QUICKFIX SCREW ANY SZ 278 C1713 919.00
44706544 CENTRAL/PICC LINE DRSNG KIT 272   67.00
44706545 KO IMMOBILIZER ADJUST JOINT 274 L1832 473.00
44706546 HEMOSTAT .5X2 SURGICEL 272   118.00
44706547 KANGAROO PUMP/FEEDING SET 270   66.00
44706548 ENTERAL FORMULA 270 B4102 4.00
44706549 CERVICAL COLLR SEMI-RIGID 274 L0174 221.00
44706551 EXTERNAL TISSUE EXPANDER 272 A4649 2,748.00
44706552 ARCH SUPPORT METATARSAL EAC 274 L3050 44.00
44706553 LEAD CARDIOVERTER-DEFIBRILL 278 C1777 7,286.00
44706554 LEAD CORONARY VENOUS SYSTEM 278 C1900 8,673.00
44706555 TRANSVAGINAL SLING 278 C1771 1,741.00
44706556 HEALIX ADV KNOTLESS ANCHOR 278 C1713 1,552.00
44706558 CIANNA MEDICAL SAVI CATH 278 A4649 8,663.00
44706559 SONICBEAT 270 A4648 750.00
44706560 EDORA PACEMAKER 270 C1786 5,600.00
44706561 PEG FEEDING TUBE 270   918.00
45000001 CULTURE SCREEN, CAMPY 306 87046 63.00
45000004 COAGULASE 306 87147 19.00
45000005 A DISC 306 87147 19.00
45000006 STREP A LATEX 306 87147 19.00
45000007 STREP B LATEX 306 87147 19.00
45000008 BETALYSIN 306 87158 19.00
45000009 NH RAPID 306 87158 19.00
45001000 SGPT 301 84460 117.00
45001004 CULT CERVIX 306 87070 186.00
45001009 KETONES/QUANT 301 82010 131.00
45001012 CHLAMYDIA AG 306 87810 131.00
45001017 CULT ORGANISM ID 306 87077 129.00
45001018 LDH (LACTIC DEHYDROGENASE) 301 83615 65.00
45001028 CK-MB ISOENZYME 301 82553 208.00
45001030 WBC STOOL 306 87205 87.00
45001033 CLOSTRIDIUM DIFFICILE TOXIN 306 87324 153.00
45001037 CULT BRONCHIAL WASH 306 87070 186.00
45001038 LDH, BODY FLUID 301 83615 124.00
45001040 CALCIUM, URINE, QUANT 301 82340 156.00
45001041 LIPASE 301 83690 159.00
45001043 LIPID PANEL 301 80061 172.00
45001044 CELL COUNT&DIFF(BODY FLD) 309 89051 145.00
45001045 MAGNESIUM 301 83735 117.00
45001048 CULT BODY FLUID 306 87070 208.00
45001051 MONO TEST (HETEROPHILE) 302 86308 120.00
45001055 AMMONIA 301 82140 153.00
45001056 HIV SCREEN 302 86703 106.00
45001057 CULT NASOPHARYNGEAL 306 87070 172.00
45001060 CULT NOSE 306 87070 172.00
45001062 OCCULT BLOOD OTHER SOURCE 301 82271 75.00
45001063 URINALYSIS, PARTIAL 307 81003 56.00
45001067 COOMB'S DIRECT 302 86880 108.00
45001068 CULT PERITONEAL FLUID 306 87070 208.00
45001070 PH, BODY FLUID 301 83986 40.00
45001073 PHENOBARBITAL 301 80184 186.00
45001080 CPK (TOTAL) 301 82550 117.00
45001081 PHOSPHORUS 301 84100 65.00
45001084 PHOSPHORUS, URINE 301 84105 128.00
45001090 CREATININE CLEARANCE 301 82575 224.00
45001091 CREATININE URINE 24HR 301 82570 117.00
45001093 CULT PLEURAL FLUID 306 87070 208.00
45001096 CULT CSF 306 87070 208.00
45001099 CULT BETA STREP 306 87070 124.00
45001100 POOLING OF PLATELETS/CRYO 302 86965 134.00
45001104 SEMEN (POST VASECTOMY) 309 89321 100.00
45001106 CULT GC ONLY 306 87070 63.00
45001107 POTASSIUM 301 84132 101.00
45001113 CULT URINE 306 87086 124.00
45001114 CULT YERSINIA ONLY 306 87046 63.00
45001115 POTASSIUM, URINE 301 84133 101.00
45001117 PRENATAL PANEL 301 80055 390.00
45001118 PREGNANCY EPT(URINE) 307 81025 119.00
45001123 PSA,TOTAL 301 84153 212.00
45001125 CULT OTHER SOURCE 306 87070 186.00
45001126 PROTEIN, BODY FLUID 301 84157 124.00
45001130 PROTEIN, URINE 24HR 301 84156 124.00
45001133 PROTIME 305 85610 110.00
45001137 PTT 305 85730 145.00
45001140 DIGOXIN 301 80162 186.00
45001142 DILANTIN 301 80185 186.00
45001144 CULT STOOL 306 87045 134.00
45001149 CULT EAR 306 87070 172.00
45001150 PREGNANCY EPT(SERUM) 301 84703 119.00
45001151 STREP SCREEN RAPID 306 87880 114.00
45001155 ELECTROLYTES 301 80051 110.00
45001156 BLOOD SMEAR W/O DIFF 305 85008 125.00
45001159 STREPTOZYME 302 86063 124.00
45001161 RSV AG 301 87420 124.00
45001162 CULT SYNOVIAL FLUID 306 87070 208.00
45001163 RA TEST QUAL 302 86430 110.00
45001166 RA TEST QUANT 302 86431 138.00
45001169 CULT EYE 306 87070 186.00
45001170 VANCOMYCIN LEVEL 301 80202 57.00
45001171 RPR QUAL 302 86592 100.00
45001179 CULT ABSCESS/DRAINAGE 306 87070 186.00
45001180 RETIC COUNT 305 85044 117.00
45001188 RUBELLA SCREEN 302 86762 129.00
45001191 TEGRETOL 301 80156 186.00
45001192 ALBUMIN SERUM 301 82040 117.00
45001194 THEOPHYLLINE 301 80198 186.00
45001196 CULT THROAT 306 87070 172.00
45001199 TSH 301 84443 200.00
45001200 AMYLASE 301 82150 124.00
45001201 SED RATE 305 85651 117.00
45001202 AMYLASE (BODY FLUID) 301 82150 124.00
45001204 AMYLASE, URINE 301 82150 124.00
45001205 SEMEN ANALYSIS COMPLETE 309 89320 200.00
45001206 CULT ANAEROBIC 306 87075 172.00
45001207 PATHOLOGY SENDOUT 300 99001 74.00
45001213 TOTAL PROTEIN 301 84155 117.00
45001215 CULT SKIN/WOUND 306 87070 186.00
45001216 ANTIBIOTIC SENSITIVITY 306 87184 104.00
45001217 SGOT 301 84450 117.00
45001218 SODIUM 301 84295 101.00
45001221 HCG QUANT 301 84702 159.00
45001222 SODIUM, URINE 301 84300 101.00
45001224 CULT SPUTUM 306 87070 186.00
45001225 BILIRUBIN, DIRECT 301 82248 117.00
45001226 TRANSFUSION REACT STUDY 310 86078 301.00
45001227 BILIRUBIN, TOTAL 301 82247 117.00
45001232 CULTURE BLOOD 306 87040 188.00
45001233 BLOOD PRODUCT POOLING 302 86965 88.00
45001234 TRIGLYCERIDES 301 84478 65.00
45001236 BLOOD TYPE RH 302 86901 85.00
45001237 UREA NITROGEN 301 84520 117.00
45001238 GGT GAMMA GT 301 82977 168.00
45001239 CULT URETHRAL 306 87070 172.00
45001240 URIC ACID 301 84550 65.00
45001241 GENTAMICIN 301 80170 186.00
45001242 URIC ACID, URINE 301 84560 124.00
45001244 URINALYSIS W/MICRO 307 81001 110.00
45001245 GIARDIA IMMUNOASSAY QN 306 87329 124.00
45001246 CHLORIDE URINE 301 82436 101.00
45001247 GLUC TOL EA EXTRA SPEC>3 301 82952 93.00
45001249 GLUCOSE 301 82947 93.00
45001251 GLUCOSE TOLERANCE 3 SP 301 82951 298.00
45001252 GLUCOSE W/GLUCOSE BEV 301 82950 124.00
45001253 URINE MICROSCOPIC ONLY 307 81015 63.00
45001255 GLUCOSE, BODY FLUID 301 82945 117.00
45001256 VALPROIC ACID 301 80165 186.00
45001257 WET MOUNT 306 87210 100.00
45001258 GLUCOSE(FINGERSTICK) 301 82962 93.00
45001260 HEMOGLOBIN A1C 301 83036 179.00
45001263 GRAM STAIN 306 87205 100.00
45001265 SEND OUT FEE 300 99001 53.00
45001266 HDL CHOLESTEROL DIRECT 301 83718 124.00
45001268 HEMATOCRIT (SPUN) 305 85013 82.00
45001269 HEMOGRAM 305 85027 101.00
45001273 IRON 301 83540 139.00
45001274 IRON-BINDING CAPACITY 301 83550 139.00
45001291 PROTEIN URINE RANDOM 301 84156 114.00
45001319 CALCIUM 300 82310 117.00
45001321 CALCIUM URINE RANDOM 301 82340 112.00
45001349 ALKALINE PHOSPHATASE 300 84075 117.00
45001373 BLEEDING TIME TEMPLATE 300 85002 124.00
45001375 CHOLESTEROL SERUM TOTAL 300 82465 65.00
45001376 BLOOD TYPE ABO 300 86900 75.00
45001389 CREATININE 300 82565 117.00
45001486 D DIMER (QUANT) 305 85379 169.00
45001514 H. PYLORI AB 302 86677 114.00
45001531 PHLEBOTOMY (ROUTINE) 300 36415 38.00
45001533 ENVIRONMENTAL CULTURE 306 87070 61.00
45001544 INFLUENZA A (RAPID) 306 87400 128.00
45001556 PREALBUMIN 301 84134 50.00
45001570 URINE MEASUREMENT 307 81050 26.00
45001571 CARBON DIOXIDE (CO2) 301 82374 29.00
45001572 COMP MET PANEL (14) (CMP) 301 80053 179.00
45001573 BASIC METABOLIC PANEL(8) 301 80048 153.00
45001574 HEPATIC PANEL 301 80076 138.00
45001581 T-4 (FREE) 301 84439 167.00
45001583 TROPONIN 301 84484 208.00
45001585 UREA NITROGEN (URINE) 301 84540 125.00
45001615 MIC 306 87186 124.00
45001620 RENAL FUNCTION (10) 301 80069 148.00
45001631 LDL CHOLESTEROL DIRECT 301 83721 57.00
45001632 CBC AUTO DIFF 305 85025 146.00
45001640 MANUAL DIFF (SMEAR ONLY) 305 85007 -
45001642 MICROALBUMIN (RANDOM URINE) 301 82043 131.00
45001644 NT PROBNP 301 83880 183.00
45001645 INFLUENZA B (RAPID) 306 87400 104.00
45001655 CREATININE URINE (RANDOM) 301 82570 117.00
45001692 PKU COLLECTION & CARD 300 36416 7.00
45001696 OCCULT BLOOD FECES SCR 301 82270 67.00
45001697 MAGNESIUM (URINE) 301 83735 112.00
45001699 MICROALBUIMIN (24HR URINE) 301 82043 153.00
45001700 MICROALBUMIN/CREAT RATIO (U 300 82043 191.00
45001703 LACTIC ACID 301 83605 126.00
45001704 MRSA ADMIT 300 87081 45.00
45001705 AMNISURE ROM 301 84112 216.00
45001706 MRSA DISCHARGE 301 87081 45.00
45001707 GEN HLTH PANEL (CBC,CMP,TSH 300 80050 499.00
45001708 TSH KIT CODE 301 80050 190.00
45001709 CMP KIT CODE 301 80050 170.00
45001710 CBC AUTO DIFF KIT CODE 301 80050 139.00
45001711 URIC ACID 24 HR URINE 301 84560 124.00
45001712 CREATININE (OTHER SOURCE) 301 82570 36.00
45001713 OCCULT BLOOD FECES DIAGNOST 301 82272 67.00
45001714 E.COLI 0157 (SHIGATOXIN) 306 87335 124.00
45001716 SALICYLATES, BLOOD 300 80329 205.00
45001719 ACETOMINPHEN, BLOOD 300 80329 205.00
45001720 ALCOHOL, BLOOD 300 80320 206.00
45001721 MRSA SCREENING/OP 300 87081 45.00
45001722 VITAMIN D 301 82306 200.00
45001723 DRUG COLLECTION FEE 300 99001 53.00
45001725 C. DIFFICILE HDA - PDH 306 87493 159.00
45001726 PDH DRUG SCREEN 300 80307 138.00
45001727 DRUG SCREEN/ABUSE PANEL-PDH 300 80307 171.00
45001729 GROUP B STREP AMPLIFIED 306 87081 90.00
45001730 MAGNESIUM, 24HR URINE 301 83735 117.00
45009000 TEST IP CARDIAC PANEL 301   534.00
45009001 TEST ER CARDIAC PANEL 300   718.00
45009003 IMMUNOLOGY QUAN MULTIALLERG 302 86008 245.00
45009004 ZIKA VIRUS 302 86794 106.00
45009999 IT USE ONLY FOR TEST 300   534.00
45100001 CERULOPLASMIN 301 82390 6.36
45100002 PANEL USE ONLY/4510P001 301 82105 54.00
45100003 PANEL USE ONLY/4510P001 301 82677 54.00
45100004 PANEL USE ONLY/4510P001 301 84702 54.00
45100005 B-2 MICROGLOBULINS 301 82232 8.50
45100006 AMINO ACID PROFILE,QN,PLASM 301 82139 450.00
45101021 LD-1 ISOENZYME 301 83625 19.00
45101049 AFB CULTURE 306 87116 46.00
45101050 ALDOLASE 301 82085 3.00
45101052 NAF RES STAPH SCREEN 306 87081 34.00
45101053 ALPHA 1 ANTITRYPSIN TOTAL 301 82103 6.64
45101058 ADH PLASMA 301 84588 68.00
45101066 LEGIONELLA PNEUMOPHILA AB 302 86713 13.82
45101069 MYCOPLASMA PNEU ABS IGG/IGM 302 86738 70.01
45101072 CA 125 SERUM SERIAL MONITOR 302 86304 18.38
45101075 CALCIUM IONIZED 301 82330 5.00
45101076 CARBON MONOXIDE WHOLE BLOOD 301 82375 19.75
45101078 CEA SERIAL MONITOR 301 82378 17.34
45101082 COMPLEMENT C 3 302 86160 6.45
45101083 COMPLEMENT C4 302 86160 4.03
45101085 COMPLEMENT TOTAL 302 86162 5.53
45101086 PIN WORM PREP (DIRECT) 306 87172 90.00
45101088 CORTISOL-AM 301 82533 6.13
45101094 CRYOGOBULIN QUALW/QUANT REF 301 82595 4.20
45101095 CMV AB (IGG) 302 86644 6.13
45101101 FOLATE 301 82746 5.26
45101103 GASTRIN 301 82941 9.68
45101105 HAPTOGLOBIN 301 83010 8.57
45101109 HEPATITIS A AB, IGM AB 302 86709 5.78
45101111 HEP B SURFACE AB 302 86706 3.85
45101112 HEP VACCINE SCREEN 302 86706 24.00
45101119 IMMUNOELECTROPHORESIS NS 302 86325 68.00
45101122 IMMUNOELECTROPHORESIS SE 302 86320 56.00
45101128 LEAD, BLOOD (ADULT) 301 83655 3.50
45101131 LITHIUM 301 80178 5.20
45101134 LYMES ANTIBODY 302 86617 26.00
45101135 MYOGLOBIN 301 83874 28.25
45101136 OSMOLALITY SERUM 301 83930 5.53
45101138 QUINIDINE 301 80194 35.00
45101139 OSMOLALITY URINE 301 83935 5.76
45101141 OVA & PARASITES 306 87177 10.00
45101143 PAP SMEAR 311 88150 29.00
45101145 PORPHOBILINOGEN QUAL 301 84106 14.00
45101147 PORPHYRINS QUANT 301 84120 26.25
45101148 PROTEIN ELECTROPHORESIS 301 84165 8.49
45101154 PTH (PARATHYROID HORMONE) I 301 83970 5.00
45101164 ROTOVIRUS DIRECT 306 87425 34.84
45101165 SCHLICTER TEST 306 87197 51.00
45101167 TRYPSIN (FECES QUAL) 301 84488 15.00
45101168 T-4 (THYROXINE) 301 84436 3.70
45101172 FDP TEST 305 85362 92.00
45101173 VIT B 12 (001503) 301 82607 4.50
45101174 T3 UPTAKE 300 84479 3.50
45101176 VIT D 301 82306 10.00
45101178 FIBRINOGEN ACTIVITY 305 85384 5.03
45101182 FRUCTOSAMINE 301 82985 6.31
45101187 HEP ACUTE(4) PANEL 301 80074 21.29
45101189 AFB SMEAR 306 87206 56.00
45101209 ANAEROBE IDENTIFICATION ONL 306 87076 84.88
45101212 ANA 302 86038 4.37
45101223 TRANSFERRIN 300 84466 7.74
45101433 METHYMALONIC ACID,SERUM 301 83921 20.00
45101436 LEGIONELLA ANTIBODY 302 86713 56.00
45101437 COLD AGGLUTININ TITER QUANT 302 86157 10.00
45101451 FERRITIN 301 82728 4.75
45101456 B. PERTUSSIS CULT/SMEAR 306 87070 36.00
45101457 COPROPORPHYRIN (URINE) 301 84120 12.31
45101458 ALA AMINOLEVULINIC ACID 301 82135 25.96
45101459 PORPHOBILINOGEN QUANT 301 84110 10.07
45101460 UROBILINOGEN (QUANT) 301 84580 58.00
45101461 ANTIADRENAL AB 302 86256 39.39
45101462 THYROID ABS 302 86376 14.03
45101463 A.C.T.H. PLASMA 301 82024 24.51
45101485 PNEUMOCYSTIS SMEAR 306 87281 35.00
45101487 TOXOPLASMA AB,IGG 302 86777 8.75
45101488 TOXOPLASMA GONDII AB,IGM,QN 302 86778 12.45
45101489 CRYPTOCOCCUS AG 302 86641 24.00
45101500 HOMOCYST(E)INE, PLASMA 301 83090 29.00
45101506 BRUCELLOSIS AB 302 86622 8.00
45101507 Q.FEVER (RICKETTSIA AB) 302 86638 35.00
45101508 COXSACKIE VIRUS (B1-6) 302 86658 62.00
45101509 COXSACKIE VIRUS (A-7,9,10 302 86658 64.00
45101510 BORRELIA AB 301 86618 32.00
45101511 BORRELIA SMEAR 306 87207 40.00
45101512 FETAL LUNG MATURITY 301 83661 112.00
45101513 COCCIDIOIDAL (CMP.FX-UCD) 302 86171 84.32
45101517 MYCOPLASMA PNEUMO AB IGG 302 86738 53.00
45101518 ADENOVIRUS AB QUANT 302 86603 100.00
45101519 ENTEROVIRUS AB PROFILE 302 86658 203.00
45101520 INFLUENZA A&B AB QUANT 302 86710 26.78
45101521 PARAINFLUENZA AB 302 86790 36.00
45101522 COCCI AB TITER 302 86635 24.75
45101523 HEP B SURFACE AG 306 87340 3.85
45101524 T3-TOTAL 301 84480 6.00
45101525 T-3 (FREE) 301 84481 5.00
45101526 THYROGLOBULIN AB 302 86800 8.53
45101527 HYDROXY CHLOROQUINE 301 80299 89.00
45101528 ANTISTREPTOLYSIN O AB (ASO) 302 86060 4.15
45101529 TOBRAMYCIN 301 80200 14.34
45101535 PROCAINAMIDE SERUM/PLASMA 301 80192 50.00
45101536 RICKETTSIA AB 302 86757 46.00
45101538 EHRLICHIA ABS. 302 86256 59.00
45101539 LEPTOSPIROSIS AB (I.H.A.) 302 86720 32.00
45101540 LEPTOSPIRAL CULTURE 306 87081 111.00
45101541 EPSTEIN BARR VIRUS 302 86663 110.00
45101542 CRP QUANT 302 86140 4.75
45101543 PLATELET AB QUAL 302 86022 116.00
45101545 CHLAMYDIA AB (IGG) 302 86631 13.82
45101546 MYCOPLASMA PNEUMO AB IGM 302 86738 18.00
45101547 CA 19-9 W/O SERIAL MONITOR 302 86301 10.00
45101549 HCV ANTIBODY 302 86803 6.05
45101550 VIRUS CULTURE 300 87252 37.71
45101551 CATECHOLAMINES (URINE) 301 82382 123.00
45101552 METANEPHRINES FRAC PLASMA F 301 83835 35.00
45101553 VANILLYLMANDELIC ACID VMA 301 84585 89.00
45101554 HLA-B27 300 81374 23.64
45101555 PROSTATIC ACID PHOS SERUM 301 84066 7.44
45101557 CULT HERPES 306 87252 43.00
45101558 KLONOPIN (CLONAZEPAM) 301 80299 72.00
45101559 VARICELLA ZOSTER AB,IGM 302 86787 16.59
45101563 PROTEIN C AG 305 85302 131.75
45101564 PROTEIN S AG 305 85305 85.00
45101565 REFERENCE FUNGUS CULTURE 306 87106 42.00
45101576 MRSA (MIC) 306 87186 28.00
45101577 CORTROSYN STIMULATION 301 80400 204.00
45101579 ALDOSTERONE-24 HR URINE 301 82088 21.00
45101582 RENIN ACTIVITY PLASMA 301 84244 14.88
45101586 PROTEIN C, FUNCTIONAL 305 85303 27.65
45101587 PROTEIN S,FUNCTIONAL 305 85306 35.02
45101588 ANTITHROMBIN III; FUNCT 305 85300 24.88
45101589 FACTOR V LEIDEN 301 81241 65.66
45101591 AFP TUMOR MARKER 301 82105 7.00
45101592 STONE ANALYSIS (KIDNEY) 301 82370 38.00
45101593 AMA 302 86255 9.22
45101594 OXYLATE (URINE 24HR) 301 83945 10.51
45101595 CITRATE (URINE 24 HR) 301 82507 19.12
45101597 IGG SUBCLASS 4 301 82787 14.22
45101602 HISTOPLASMA 302 86698 73.00
45101603 RUBEOLA ANTIBODIES,IGM 302 86765 9.68
45101605 LATEX SPECIFIC IGE QUANT 302 86003 17.00
45101617 ISOSPORA (STOOL) 306 87206 16.00
45101618 CRYPTOSPORIDIUM (STOOL) 302 86255 49.00
45101619 MICROSPORICIA (STOOL) 306 87207 77.00
45101621 LH (LUTENIZING HORMONE) 301 83002 10.00
45101622 FSH 301 83001 6.50
45101623 TESTOSTERONE 301 84403 5.00
45101624 LEUKOCYTE ALK PHOS (LAP) 305 85540 3.25
45101625 BACT AGS X6 302 86403 42.00
45101626 HCV RNA QUAL W/REFLEX 306 87521 144.00
45101627 TRAZADONE LEVEL 301 80299 34.00
45101628 MALARIA AB 302 86750 186.00
45101629 CULT CHLAMYDIA ISOLATI 306 87140 19.00
45101635 FIBRONECTIN AGGRECATES 300 83520 123.00
45101636 GONADOTROPIN RELEASING 301 83727 262.00
45101646 HCV GENOTYPE 301 87902 196.96
45101647 HBVCORE RFX GENO 302 86704 24.75
45101648 LATEX SPECIFIC IGE 301 86003 17.00
45101649 CARNITINE F&T 301 82379 26.57
45101650 AMINO ACIDS (PLASMA) 301 82131 546.00
45101652 ORGANIC ACID ANALYSIS,URINE 301 83919 96.76
45101653 CHOLINESTERASE (PLASMA) 301 82480 15.00
45101654 BILE SALTS (STOOL) 301 82239 18.00
45101659 E.COLI 300 87046 31.00
45101660 CYCLIC AMP URINE 300 82030 48.00
45101677 IBD (PROMETHIUS LAB) 300 83520 220.00
45101678 CRYSTAL EXAM (MISC FLD) 300 89060 9.21
45101680 HEMOGLOBIN ELECTR. 300 83021 26.00
45101681 PUSD HEP B ANTIBODY 302 86706 -
45101682 GALACTOSE TRANSFERASE-PKU 301 82776 18.25
45101683 HEMOGLOBIN CHROMAT-PKU 301 83021 18.25
45101685 PROLACTIN 301 84146 7.88
45101686 CHYLMD TRACH,DNA,AMP PROB 306 87491 120.00
45101687 N.GONORRHOEAE,DNA,AMP PRO 306 87591 118.00
45101688 PROTEIN,E-PHORESIS/URINE 301 84166 1.87
45101689 IMMUNFIX E-PHORESIS SERUM 302 86335 30.95
45101691 MASS SPECTROMETERY QUANT PK 301 83789 19.75
45101693 ASSAY PROGESTERONE-PKU 301 83498 18.25
45101694 HSV TYPES 1/2 IGM 302 86694 13.99
45101695 HERPES SIMPLES VIRUS I/II,I 302 86694 20.00
45101696 H. PYLORI,IGM,IGG,IGA AB 302 86677 41.82
45101697 ANTI-SMITH ABS 302 86235 17.95
45101698 ANTI-CENTROMERE B AB 302 86235 58.20
45101699 HEP A AB 302 86708 5.79
45101700 INSULIN 302 83525 4.37
45101701 TISSUE CULTURE, LYMPOCYTE 300 88230 112.84
45101702 CHROMOSOME ANALYSIS; 15-20 300 88262 112.84
45101703 CYTO/MOLECULAR REPORT 310 88291 112.84
45101704 C-PEPTIDE 300 84681 6.50
45101705 GAD-65 AUTOANTIBODY 301 83519 30.00
45101706 LEVETIRACETAM SERUM/PLASMA 300 80177 20.00
45101707 B PERTUSSIS NASAL CULT 300 87070 15.00
45101708 B. PERTUSSIS AB (IGA,G,M) 302 86615 126.83
45101709 ANTINEUTROPHILE CYT AB* 300 86255 132.00
45101710 DRUG SCREEN (MECONIUM) 300 80301 91.00
45101711 FLOW CYTOMETRY 319 88184 498.00
45101712 FLOW CYTOMETRY, EA ADDTL 319 88185 15.50
45101713 CYTOMETRY INTERP (16 OR MOR 319 88189 498.00
45101716 PANEL USE ONLY/4510P005 301 82088 16.00
45101717 PANEL USE ONLY/4510P005 301 84244 16.00
45101720 FECAL FAT,QUANT 300 82710 15.67
45101721 PANEL USE ONLY/4510P007 301 84165 4.00
45101722 PANEL USE ONLY/4510P007 301 84155 3.99
45101723 CAROTENE BETA 300 82380 12.38
45101724 COPPER,SERUM 300 82525 16.59
45101725 PANEL USE ONLY/4510P008 301 84075 5.00
45101726 PANEL USE ONLY/4510P008 301 84080 5.00
45101727 FECAL FAT,QUAL 300 82705 9.00
45101728 PANEL USE ONLY/4510P009 301 82784 15.47
45101729 PANEL USE ONLY/4510P009 302 86334 15.48
45101730 NUCLEOTIDASE 5'- 300 83915 6.58
45101731 PANEL USE ONLY/4510P010 301 84436 6.00
45101732 PANEL USE ONLY/4510P010 301 84442 6.00
45101733 PANEL USE ONLY/4510P011 301 82380 33.00
45101734 PANEL USE ONLY/4510P011 301 84590 33.00
45101735 IG G 300 82784 4.84
45101736 IG A 300 82784 4.84
45101737 IG M 300 82784 4.84
45101738 TRACE METAL ZINC SERUM 300 84630 4.84
45101739 IG E, TOTAL 300 82785 7.00
45101740 REVERSE T3 300 84482 23.04
45101741 PANEL USE ONLY/4510P012 301 82785 10.76
45101742 PANEL USE ONLY/4510P012 301 82784 10.76
45101743 PANEL USE ONLY/4510P013 301 82525 15.76
45101744 PANEL USE ONLY/4510P013 301 82570 15.76
45101745 5-HIAA,QUANT.,24 HR URINE 300 83497 10.40
45101746 DHEA 300 82626 9.00
45101747 CATECHOLAMINES,UR,FREE,24 H 301 82384 19.75
45101748 GROWTH HORMONE, SERUM 300 83003 8.98
45101749 PROGESTERONE 300 84144 9.20
45101750 CORTISOL, URINARY FREE 300 82530 11.49
45101751 ESTRADIOL,SENSITIVE 301 82670 29.77
45101752 ESTROGENS, TOTAL 300 82672 19.25
45101753 ESTRIOL (SERUM) 300 82677 15.90
45101754 C1 ESTERASE INHIBITOR 300 86160 9.68
45101755 VITAMIN B6 300 84207 23.04
45101756 DHEA-S 300 82627 11.00
45101757 LACTIC ACID, PLASMA 300 83605 19.25
45101758 KETONE BODIES, SERUM 300 82009 11.50
45101759 CALCITONIN SERUM 300 82308 43.00
45101760 HEMATOPATH CONSULT,PER SMEA 300 85060 24.00
45101761 EOSINOPHIL COUNT 300 85048 4.00
45101762 RA FACTOR (REF) 302 86431 4.61
45101763 ACTIN (SMOOTH MUSCLE) ANTIB 300 83516 9.22
45101765 PANEL USE ONLY/4510P014 302 86376 7.01
45101766 PANEL USE ONLY/4510P014 302 86800 7.02
45101767 PANEL USE ONLY/4510P015 301 82175 39.00
45101768 PANEL USE ONLY/4510P015 302 82570 38.00
45101769 ETHANOL, URINE 300 80320 8.00
45101770 DOXEPIN (SINEQUAN), SERUM 300 80335 20.00
45101771 DISOPYRAMIDE, SERUM 300 80299 21.00
45101772 PANEL USE ONLY/4510P190 306 87045 11.16
45101773 PANEL USE ONLY/4510P190 306 87046 11.16
45101774 PANEL USE ONLY/4510P190 306 87427 11.18
45101775 PARASITE EXAM, BLOOD 300 87207 17.00
45101776 PARASITE ID, WORM 300 87169 12.00
45101777 HSV CULT & TYPE 300 87255 22.00
45101778 ORGANISM ID, MOLD 300 87107 28.00
45101779 FUNGUS (MYCOLOGY) CULTURE 300 87101 15.25
45101780 PANEL USE ONLY/4510P017 306 87110 7.37
45101781 PANEL USE ONLY/4510P017 306 87140 7.37
45101782 PANEL USE ONLY/4510P018 306 87177 5.00
45101783 PANEL USE ONLY/4510P018 300 87209 5.00
45101784 ORGANISM ID, BACTERIA 306 87077 14.00
45101785 SUSCEPTIBILITY,AER + ANAERO 306 87186 14.00
45101787 ANGIOTENSIN-CONVERTING ENZY 300 82164 6.00
45101788 OSTEOCALCIN, SERUM 300 83937 33.00
45101789 THYROTROPIN RECEPTOR AB, SE 301 83519 17.00
45101790 TRYPSIN 301 83519 59.88
45101793 AFP SERUM OPEN SPINA BIFIDA 301 82105 14.00
45101794 ANTIHISTONE ANTIBODIES 302 86235 40.00
45101795 SJOGREN'S AB,ANTI-SS-A/-SS- 302 86235 17.00
45101796 LYME IGG/IGM AB 302 86618 18.00
45101797 FECAL REDUCING SUBSTANCES 301 84377 15.00
45101798 HEP B CORE AB, IGM 302 86705 6.00
45101799 VITAMIN A, SERUM 301 84590 14.00
45101800 METHANOL 301 84600 86.00
45101801 PANEL USE ONLY/4510P019 301 83001 8.00
45101802 PANEL USE ONLY/4510P019 301 83002 8.00
45101803 CORTISOL (3 SPECIMENS) 301 82533 41.00
45101804 PANEL USE ONLY/4510P020 301 82175 22.00
45101805 PANEL USE ONLY/4510P020 301 83655 22.00
45101806 PANEL USE ONLY/4510P020 301 83825 22.00
45101809 PANEL USE ONLY/4510P022 301 82705 10.00
45101810 PANEL USE ONLY/4510P022 300 89160 10.00
45101814 PANEL USE ONLY/4510P024 302 86038 5.00
45101815 PANEL USE ONLY/4510P024 302 86235 5.00
45101817 MANGANESE,PLASMA 301 83785 77.00
45101818 BENZODIAZAPINE SCREEN,URINE 300 80301 24.00
45101820 LYSOZYME,SERUM 305 85549 15.00
45101821 VITAMIN E,SERUM 301 84446 12.38
45101822 VIT D, 1.25 DIHYDROXY 301 82652 18.00
45101825 SEX HORM BINDING GLOB,SERUM 301 84270 18.43
45101826 PANEL 083824 300 86703 7.00
45101827 CATECHOLAMINES PLASMA 301 82384 49.00
45101828 PANEL USE ONLY/4510P026 305 85240 118.00
45101829 PANEL USE ONLY/4510P026 305 85245 118.00
45101830 PANEL USE ONLY/4510P026 305 85246 118.00
45101831 ACHR AB, ALL 301 83519 234.00
45101832 PANEL USE ONLY/4510P027 301 83661 58.00
45101833 PANEL USE ONLY/4510P027 301 84081 58.00
45101834 PANEL USE ONLY/4510P027NE U 301 82570 58.00
45101836 ANTI-DSDNA ANTIBODIES 302 86225 7.00
45101837 CHLAMYDIA/GC,DNA PROBE 306 87800 45.00
45101838 RUBEOLA ANTIBODIES, IGG 302 86765 7.88
45101839 PANEL USE ONLY/4510P028 302 86704 33.00
45101840 PANEL USE ONLY/4510P028 302 86705 -
45101841 PANEL USE ONLY/4510P029 310 82150 -
45101842 PANEL USE ONLY/4510P029 301 82664 -
45101843 PANEL USE ONLY/4510P030 305 85730 -
45101844 PANEL USE ONLY/4510P030 305 85732 -
45101847 PANEL USE ONLY/4510P032 305 85732 -
45101848 PANEL USE ONLY/4510P032 305 85613 -
45101849 PANEL USE ONLY/4510P033 301 83021 7.87
45101850 PANEL USE ONLY/4510P033 305 85660 7.88
45101853 PANEL USE ONLY/4510P035 302 86632 -
45101854 PANEL USE ONLY/4510P034 302 86631 -
45101855 PANEL USE ONLY/4510P036 302 86788 36.62
45101856 PANEL USE ONLY/4510P036 302 86789 36.62
45101857 PANEL USE ONLY/4510P037 301 84402 9.00
45101858 PANEL USE ONLT/4510P037 301 84403 9.00
45101859 PANEL USE ONLY/4510P038 301 82523 6.00
45101860 PANEL USE ONLY/4510P038 301 82570 6.00
45101861 PANEL USE ONLY/4510P039 302 86256 17.32
45101862 PANEL USE ONLY/4510P039 301 83520 17.32
45101863 PANEL USE ONLY/4510P040 305 85305 -
45101864 PANEL USE ONLY/4510P040 305 85306 -
45101865 PANEL USE ONLY/4510P041 302 86695 18.38
45101866 PANEL USE ONLY/4510P041 302 86696 18.37
45101867 PANEL USE ONLY/4510P042 302 86225 89.00
45101868 PANEL USE ONLY/4510P042 302 86235 89.00
45101869 PANEL USE ONLY/4510P043 301 82784 -
45101870 PANEL USE ONLY/4510P043 301 83516 -
45101871 PANEL USE ONLY/4510P044 301 82784 19.00
45101872 PANEL USE ONLY/4510P044 301 83516 19.00
45101873 PANEL USE ONLY/4510P044 302 86255 19.00
45101874 PANEL USE ONLY/IGA/IGD/IGG/ 301 82784 16.00
45101875 PANEL USE ONLY/IMMUNOASSAY 301 83516 16.00
45101876 PANEL USE ONLY/FLUORESCENT 302 86255 16.00
45101877 PANEL USE ONLY/4510P046 302 86255 12.00
45101878 PANEL USE ONLY/4510P046 301 83516 12.00
45101880 PANEL USE ONLY/4510P046 301 82784 12.00
45101881 PANEL USE ONLY/4510P047 306 87206 8.00
45101882 PANEL USE ONLY/4510P047 306 87015 8.00
45101883 PANEL USE ONLY/4510P048 306 87116 13.00
45101884 PANEL USE ONLY/4510P048 306 87206 13.00
45101885 PANEL USE ONLY/4510P048 306 87015 13.00
45101886 PANEL USE ONLY/4510P049 306 87116 9.00
45101887 PANEL USE ONLY/4510P049 306 87015 9.00
45101888 PANEL USE ONLY/4510P049 306 87206 9.00
45101889 PANEL USE ONLY/4510P050 306 87015 -
45101890 PANEL USE ONLY/4510P050 306 87206 -
45101891 PANEL USE ONLY/4510P051 306 87491 16.00
45101892 PANEL USE ONLY/4510P051 306 87591 16.00
45101893 PANEL USE ONLY/4510P052 306 87254 21.34
45101894 PANEL USE ONLY/4510P052 306 87255 21.34
45101895 PANEL USE ONLY/4510P053 306 87101 14.00
45101896 PANEL USE ONLY/4510P053 306 87206 14.00
45101897 PANEL USE ONLY/4510P054 301 82784 31.00
45101898 PANEL USE ONLY/4510P054 301 82787 31.00
45101899 PANEL USE ONLY/4510P055 302 86663 18.00
45101900 PANEL USE ONLY/4510P055 302 86664 18.00
45101901 PANEL USE ONLY/4510P055 302 86665 18.00
45101902 PANEL USE ONLY/4510P056 301 84165 5.00
45101903 PANEL USE ONLY/4510P056 301 84155 5.00
45101904 PANEL USE ONLY/FLUORESCENT 302 86255 -
45101905 PANEL USE ONLY/RIA NON AB 301 83519 -
45101906 PANEL USE ONLY/4510P058 305 85302 33.00
45101907 PANEL USE ONLY/4510P058 305 85303 33.00
45101908 PANEL USE ONLY/4510P059 301 84166 5.00
45101909 PANEL USE ONLY/4510P059 301 84156 5.00
45101910 PANEL USE ONLY/4510P060 301 84153 7.00
45101911 PANEL USE ONLY/4510P060 301 84154 7.00
45101912 PANEL USE ONLY/COLLAGEN CRO 301 82523 -
45101913 PANEL USE ONLY/CREATININE 301 82570 -
45101914 PANEL USE ONLY/4510P062 302 86003 20.00
45101915 PANEL USE ONLY/USE 4510P062 302 86005 20.00
45101916 PANEL USE ONLY/AMINO ACIDS 301 82136 -
45101917 PANEL USE ONLY/ORGANIC ACID 301 83918 -
45101918 CYTOMEGALOVIRUS AB, IGM 302 86645 8.00
45101919 EBV AB VCA, IGM 302 86665 13.00
45101920 CHLAMYDIA, DNA PROBE 306 87490 22.00
45101922 CORTISOL (RANDOM) 301 82533 6.13
45101923 ANTIPHOSPHATIDYLSERINE IGG/ 302 86148 368.00
45101924 OSMOLALITY, FECAL 301 84999 6.00
45101925 SERONTONIN, SERUM 301 84260 23.00
45101926 C1 ESTERASE INHIBITOR, FUNC 302 86161 51.00
45101927 CRP CARDIAC 302 86141 6.00
45101928 CALCULI, URINARY 301 82360 14.00
45101929 FREE K+ L LT 301 83883 82.00
45101930 VIT B-1-(THIAMINE) PLASMA 301 84425 16.00
45101931 VIT B1 (THIAMINE) BLOOD 301 84425 16.36
45101932 BABESIA MICROTI ANTIBODY 302 86753 96.00
45101933 ENTEROVIRUS RT- PCR 306 87498 314.00
45101934 B PERTUSSIS/B PARATUSSIS RT 306 87798 100.00
45101935 PNEUMOCOCCAL IMMUNITY 7 TYP 302 86317 254.00
45101936 PNEUMOCOCCAL IMMUNITY 14 TY 302 86317 508.00
45101937 CMV QUANT DNA PCR(PLASMA) 306 87497 207.00
45101938 ERYTHROPOIETIN (EPO), SERUM 301 82668 6.50
45101939 CA 27.29 302 86300 11.00
45101940 HCV QUANTITATIVE PCR GRAPH 306 87522 648.00
45101941 PSA, ULTRASENSITIVE W/O SER 301 84153 30.00
45101942 THYROID STIMULATING IG 301 84445 52.00
45101943 CHROMOGRANIN A 302 86316 45.00
45101944 LP-PLA2 301 83698 79.00
45101945 AFP W/AFP-L3% 301 82107 257.00
45101946 CANCER ANTIGEN (CA) 15-3 302 86300 12.26
45101947 HCV AB W/RFLX TO RIBA 302 86803 6.00
45101948 HISTAMINE DETERMINATION, UR 301 83088 205.00
45101949 TESTOSTERONE, FREE, DIRECT 301 84402 25.00
45101950 ANTIPANCREATIC ISLET CELLS 302 86341 20.00
45101951 ANTI-DNA (SS) IGG, AB, QN 302 86226 32.00
45101952 ANTICARDIOLIP AB, IGA/G/M, 302 86147 34.00
45101953 LYME DISEASE AB, QUANT, IGM 302 86618 19.00
45101954 ANCA 302 86256 7.00
45101955 HSV TYPE 2-SPECIFIC AB,IGG 302 86696 19.00
45101956 PARVOVIRUS B19, HUMAN, IGG/ 302 86747 39.00
45101957 GLIADIN IGG/IGA AB PROF, EI 301 83516 41.00
45101958 PANEL 163550 302 86702 90.00
45101959 LYME, WESTERN BLOT. SERUM 302 86617 32.00
45101960 TETANUS ANTITOXOID IGG AB 302 86317 31.00
45101961 ANTIMYELOPEROXIDASE (MPO) A 301 83520 13.82
45101962 CHLAMYDIA/GC, DNA PROBE W/R 306 87800 17.00
45101963 N GONORRHOEAE DNA PROBE W/R 306 87590 9.00
45101964 HTLV-I/II ANTIBODIES, QUAL 302 86790 94.00
45101965 T-TRANSGLUTAMINASE (TTG) IG 301 83516 18.00
45101966 EHRLICHIA AB (4) 302 86666 75.00
45101967 ANA W/RFLX IF + 302 86038 4.00
45101968 CCP IGG/IGA AB 302 86200 20.00
45101970 ANA W/REFLEX 302 86038 73.00
45101971 H. PYLORI STOOL AG, EIA 306 87338 37.50
45101972 E COLI SHIGA TOXIN EIA 306 87427 33.13
45101973 AEROBE ID & SUSCEPT 306 87077 16.00
45101974 VIRAL CULTURE RAPID VARICEL 306 87254 73.41
45101975 HSV CULT W/O TYPING 306 87255 18.43
45101976 CHLAMYDIA TRACHOMATIS, NAA 306 87491 17.00
45101977 XYLOSE TOL 2-HR/ADULT/NO UR 301 84620 14.00
45101978 LYME AB/WESTERN BLOT RFLX ( 302 86618 38.00
45101979 THYROID CASCADE PROFILE 301 84443 5.00
45101980 CA 27.29 (SERIAL MONITOR) 302 86300 11.00
45101981 CA 15-3 SERIAL 302 86300 45.00
45101982 PROTHROMBIN FRAGMENT 1+2 MO 301 83520 160.00
45101983 C-TELOPEPTIDE, SERUM 301 82523 113.40
45101984 GLYCOMARK 301 84378 45.00
45101985 DIHYDROTESTOSTERONE 301 80327 68.40
45101987 HELPER T-LYMPH-CD4 302 86361 72.00
45101988 CD4/CD8 RATIO PROFILE 302 86360 46.08
45101989 HCV RT-PCR QUANT NON-GRAPH 306 87522 126.10
45101990 HCV RT-PCR QNT GRAPH 306 87522 126.00
45101991 HCV RNA, PCR, QI (QUANTRFLX 306 87521 88.00
45101992 HCV RNA-PCR QUAL 306 87521 88.00
45101993 RNA, REAL TIME PCR (GRAPH) 306 87536 87.54
45101994 HCV RNA-PCR QNT RFX GENO 306 87522 126.00
45101995 HCV RNA DET QI RFX GEN 306 87521 88.00
45101996 HBV PCR QUANT NON GRAPH 306 87517 155.00
45101997 HBV RT PCR QUANT GRAPH 306 87517 230.00
45101998 TACROLIMUS (FK506), BLOOD 300 80197 55.29
45101999 CLOZAPINE (CLOZARIL), SERUM 300 80159 17.51
45102003 TOPIRAMATE (TOPAMAX), SERUM 300 80201 30.64
45102007 LAMOTRIGINE (LAMICTAL), SER 301 80175 32.25
45102008 LEAD BLD PEDI 301 83655 3.50
45102012 FETAL FIBRONECTIN 301 82731 155.00
45102013 PANEL USE ONLY/4510P006 301 82607 5.00
45102014 PANEL USE ONLY/4510P006 301 82746 5.00
45102015 HEP C AB (RFLX TO VERIF) 302 86803 6.00
45102017 HBV DNA-PCR QUAL 306 87516 271.00
45102019 TPO (THYROID PEROXIDASE ABS 302 86376 5.50
45102026 PANEL USE ONLY/4510P065 301 82172 24.25
45102027 PANEL USE ONLY/4510P065 301 82247 24.25
45102028 PANEL USE ONLY/4510P065 301 82977 24.25
45102029 PANEL USE ONLY/4510P065 301 83010 24.25
45102030 PANEL USE ONLY/4510P065 301 83883 24.25
45102031 PANEL USE ONLY/4510P065 301 84460 24.25
45102034 PANEL USE ONLY/CREATININE 301 82570 -
45102035 PANEL USE ONLY/VMA URINE 301 84585 -
45102041 BETA-2 GLYCOPROTEIN (3) 302 86146 9.00
45102042 IGF-1 301 84305 15.00
45102043 PLATELET AB 302 86022 607.00
45102044 HEP B CORE AB-TOTAL 302 86704 7.10
45102046 FREE K & L LT CHAINS QN 301 83883 40.00
45102047 PANEL USE ONLY/4510P069 301 84436 -
45102048 PANEL USE ONLY/4510P069 301 84479 6.00
45102050 ANTI CCP AB 302 86200 10.00
45102051 PANEL USE ONLY/4510P070 302 86735 6.00
45102052 PANEL USE ONLY/4510P070 302 86762 6.00
45102053 PANEL USE ONLY/4510P065 302 86765 6.00
45102060 PANEL USE ONLY/4510P081 301 82955 5.00
45102061 PANEL USE ONLY/4510P081 305 85041 5.00
45102063 HP5 302 86704 11.00
45102064 HP5 302 86706 11.00
45102065 HP5 302 86708 11.00
45102066 PANEL USE ONLY/4510P082 302 86803 11.00
45102067 PANEL USE ONLY/HBSAG 306 87340 11.00
45102073 ANTI PLATELET AB'S (4) 302 86022 383.00
45102074 EBV-VCA AB IGG 302 86665 13.13
45102076 ANTI PHOSPHOLIPID AB 302 86147 33.00
45102085 HYMENOPTERA PROFILE (5) 302 86003 20.00
45103000 FTA-ABS 302 86780 8.98
45103006 PANEL USE ONLY/CHLAMYDIA 302 86631 -
45103007 PANEL USE ONLY/CHLAMYDIA IG 302 86632 -
45103008 PANEL USE/4510P136 301 84402 20.00
45103009 PANEL USE ONLY/4510P136 301 84403 20.00
45103010 THYROID STIMULATION IMMUN A 301 84445 21.00
45103012 ANTITHYROIGLOBULIN A/B 302 86800 9.00
45103013 ANTI-68KD AB 301 84181 180.75
45103014 ANDROSTENEDIONE 301 82157 21.00
45103015 PANEL USE ONLY/B CELLS TTL 302 86355 -
45103016 PANEL USE ONLY/T CELLS TTL 302 86359 -
45103017 PANEL USE ONLY/T CELLS 302 86360 -
45103018 LEGIONELLA PNEUMOPHILA 1; 1 302 86849 29.00
45103019 ANTI-J01 AB 302 86235 40.00
45103020 IMMUNOGLOBULINS A,G,M QUANT 301 82784 14.52
45103022 VARICELLA IGG 302 86787 9.00
45103031 ANTITHROMBIN AT ACTIVITY 305 85300 23.41
45103040 FACTOR VIII ACTIVITY 305 85240 68.00
45103041 ACTIVATED PROTEIN C RESISTA 305 85307 31.00
45103043 HIV WESTERN BLOT 302 86689 39.00
45103044 FOOD ALLERGY; TREE NUT 302 86849 77.00
45103045 ALLERGEN SPECIFIC-PINON 302 86003 4.00
45103046 ALLERGEN SPECIFIC-PISTACHIO 302 86003 4.00
45103047 ALLERGEN SPECIFIC-PEANUT 302 86003 4.00
45103048 ALLERGEN SPECIFIC-MACADAMIA 302 86003 4.00
45103051 DILUTE RUSSELL VIPER VENOM 305 85613 15.00
45103052 ENDOMYSIAL AB (IGA) 302 86255 13.00
45103053 TISSUE TRANSGLUTAMINASE (TT 301 83516 18.00
45103054 STREPOCOCCUS PNEUMONIAE AG 306 87899 31.00
45103055 PANEL USE ONLY/4510P151 302 86671 38.00
45103056 DEXAMETHASONE 301 80375 71.00
45103057 ANA IFA 302 86038 4.00
45103059 PANEL USE ONLY/DNA AB 302 86225 -
45103060 PANEL USE ONLY/NUCLEAR ANTI 302 86235 462.00
45103061 PANEL USE ONLY/4510P096 301 82550 4.00
45103062 PANEL USE ONLY/4510P096 301 82552 4.00
45103063 SCHISTOSOMA AB-828935 302 86849 107.00
45103064 PANEL USE ONLY/4510P097 300 80061 49.50
45103065 PANEL USE ONLY/4510P097 301 83704 49.50
45103069 PANEL USE ONLY/4510P069 302 86003 191.00
45103070 PANEL USE ONLY/4510P069 302 86005 191.00
45103071 PTH-RELATED PEPTIDE 301 83519 24.00
45103072 HEPATITIS BE AG 306 87350 6.00
45103073 HEPATITIS BE AB 302 86707 7.00
45103075 IODINE 24HR URINE 301 83789 62.00
45103076 VIT D 25-HYDROXY + D2 & D3 301 82306 93.50
45103077 PANEL USE ONLY/PHENOTYPE AN 306 87903 -
45103078 PANEL USE ONLY/EA ADDTL DRU 307 87904 354.00
45103080 DEXAMETHASONE SUPPRESSION T 301 82533 60.00
45103081 ALPHA-SUBUNIT 301 83520 53.00
45103082 TISSUE TRANSGLUTAMINASE-TTG 301 83516 13.00
45103083 VASOACTIVE INTESTINAL POLYP 301 84586 83.00
45103084 LIVER KIDNEY MICROSOMAL AB 302 86376 5.00
45103085 PANEL USE ONLY/4510P124 301 82175 9.00
45103086 PANEL USE ONLY/4510P124 301 82570 9.00
45103087 PANEL USE ONLY/4510P124 301 83655 9.00
45103088 PANEL USE ONLY/4510P124 301 83825 9.00
45103089 PANEL USE ONLY/4510P125 301 84156 12.00
45103090 PANEL USE ONLY/4510P125 301 84166 12.00
45103091 PANEL USE ONLY/4510P125 302 86335 12.00
45103092 INDIA INK PREP 306 87210 28.00
45103093 HSV TYPE 1/2,DNA PCR 306 87529 108.64
45103094 LYME DISEASE WEST BLOT CSF 302 86617 48.15
45103095 CRYPTOCOCCUS AB, QUANT 302 86641 39.39
45103102 17-A-HYDROXYPROGESTERONE 301 83498 18.00
45103103 FIBRINOGEN DEGRADATION PROD 305 85362 15.10
45103104 PANEL USE ONLY/FIBRINOGEN A 305 85384 -
45103105 PANEL USE ONLY/FIBRINOGEN A 305 85385 -
45103106 PANEL USE ONLY/REPTILASE TE 305 85635 -
45103107 PANEL USE ONLY/THROMBIN TIM 305 85670 88.00
45103114 PANEL USE ONLY/ANTI-CBIR1 301 83520 64.00
45103117 PANEL USE ONLYIMMUNOAAY NON 301 83516 -
45103118 PANEL USE ONLY/ANA TITER 302 86039 -
45103119 PANEL USE ONLY/COMPLIMENT A 302 86160 -
45103120 PANEL USE ONLY/DNA AB 302 86225 -
45103121 PANEL USE ONLY/NUCLEAR ANTI 302 86235 144.00
45103122 PANEL USE ONLY/FLUORESCENT 302 86255 -
45103123 PANEL USE ONLY/FLORESCENT A 302 86256 -
45103124 PANEL USE ONLY/MICROSOMAL A 302 86376 -
45103125 PANEL USE ONLY/RH FACTOR QU 302 86431 -
45103126 ALLERGENS, ZONE 15 X26 302 86603 748.00
45103127 PANEL USE ONLY/HEB B CORE A 302 86704 -
45103128 PANEL USE ONLY/HEB B CORE A 302 86705 -
45103129 PANEL USE ONLY/AMINO ACIDS 301 82139 74.00
45103130 PANEL USE ONLY/4510P107 301 82570 74.00
45103131 HSV I/II IGC 302 86694 97.00
45103132 HSV IGM I/II COMBINATION 302 86694 14.00
45103133 HCV QUANT PCR NGI QUANTASUR 306 87522 243.00
45103134 PANEL USE ONLY/SEE 4510P108 302 86225 9.48
45103135 PANEL USE ONLY/4510P108 302 86235 9.47
45103136 PANEL USE ONLY/4510P108 302 86431 9.47
45103137 SELENIUM 301 84255 38.93
45103138 C-PEPTIDE 24 HR URINE 301 84681 16.00
45103139 CHROMIUM PLASMA 301 82495 32.00
45103140 COBALT PLASMA 301 83018 83.00
45103141 C2 (COMPLEMENTC2) 302 86160 2.00
45103142 INTRINSIC FACTOR ABS 302 86340 11.06
45103143 OCCULT BLOOD FECAL IMMUNOAS 301 82274 68.00
45103144 PTT 305 85730 1.00
45103146 VITAMIN B2 RIBOFLAVIN 301 84252 11.00
45103147 VITAMIN B5 301 84591 207.00
45103148 FETAL CELL STAIN 305 85460 67.00
45103149 INHIBIN B 301 83520 122.00
45103150 LEPTIN 301 83520 53.00
45103151 PANEL USE ONLY/4510P109 301 83525 45.00
45103152 PANEL USE ONLY/SEE 4510P109 301 83527 45.00
45103153 PANEL USE ONLY/4510P110 301 82747 7.60
45103154 PANEL USE ONLY/4510P110 305 85014 7.61
45103155 PANEL USE ONLY/ENCEPHALITIS 302 86651 -
45103156 PANEL USE ONLY/EASTERN EQUI 302 86652 -
45103157 PANEL USE ONLY/ST LOUIS 302 86653 -
45103158 PANEL USE ONLY/WESTERN EQUI 302 86654 -
45103159 VIT B3 NIACIN & MOTABOLITE 301 84591 310.00
45103160 ANTIPHOSPHATIDYLSERINE X 3 302 86148 69.00
45103162 ARTHROPOD ID (TICK ID) 306 87999 73.00
45103176 H PYLORI AB IGG 302 86677 13.80
45103182 PANEL USE ONLY/FLOW CYTOMET 319 88184 -
45103183 PANEL USE ONLY/EA ADDTL MAR 319 88185 -
45103184 PANEL USE ONLY/EA ADDTL MAR 319 88185 -
45103185 PANEL USE ONLY/EA ADDTL MAR 319 88185 -
45103186 PANEL USE ONLY/FLOW CYTOMET 319 88184 -
45103187 PANEL USE ONLY/EA ADDTL MAR 319 88185 -
45103188 ANEROBIC CULTURE (008904) 306 87075 14.00
45103189 PANEL USE ONLY/4510P118 306 87076 33.00
45103190 PANEL USE ONLY/4510P118 306 87186 33.00
45103191 ANTI-MULLERIAN HORMONE 301 83516 69.00
45103192 PANEL USE ONLY/PHENOBARBITA 300 80184 -
45103193 PANEL USE ONLY/PRIMIDONE 300 80188 -
45103196 PANEL USE ONLY/4510P120 301 84165 7.00
45103197 PANEL USE ONLY/4510P120 302 86334 7.00
45103203 ANTIPARIETAL CELL AB 301 83516 10.00
45103204 PANEL USE ONLY/CREATININE O 301 82570 -
45103205 PANEL USE ONLY/NICKEL 301 83885 -
45103206 PANEL USE ONLY/OSMOLALITY B 301 83930 -
45103207 PANEL USE ONLY/VASOPRESSIN 301 84588 -
45103208 QUANTIFERON GOLD TB ASSAY 302 86480 55.00
45103209 QUANT CYSTINE 301 82131 60.00
45103210 SULFATE QUANT 301 84392 10.00
45103211 AMIKACIN 300 80150 13.00
45103212 CRYOFIBRINOGEN 301 82585 4.00
45103213 MERCURY-BLOOD 301 83825 34.00
45103214 AMYLASE, BODY FLUID 301 82150 5.14
45103220 ASPERGILLUS AB QUANT DID X3 302 86606 22.92
45103221 VIT C 301 82180 13.00
45103222 Interleukin-6 301 83520 88.00
45103230 HUMAN HERPES VIRUS 6 302 86790 15.00
45103231 URINE CYTOLOGY 311 88112 36.00
45103232 IMMUNE COMPLEXES, C1Q BINDI 302 86332 10.00
45103233 EBV PCR QUANT 306 87799 232.80
45103234 ANTISCLERODERMA 70 ANTIBODI 302 86235 11.00
45103236 LIPOPROTEIN (A) 301 83695 10.94
45103237 PANEL USE ONLY/CALCIUM URIN 301 82340 -
45103238 PANEL USE ONLY/CITRATE 301 82507 -
45103239 PANEL USE ONLY/CREATININE O 301 82570 -
45103240 PANEL USE ONLY/OXALATE 301 83945 -
45103241 PANEL USE ONLY/SODIUM URINE 301 84300 -
45103242 PANEL USE ONLY/URIC ACID OT 301 84560 -
45103243 RNP ANTIBODIES 302 86235 13.00
45103244 TESTOSTERONE HYPO TTL 301 84403 7.00
45103245 CYTOPATH FLUIDS NONGYN 310 88104 14.00
45103246 CYTOPATH CONCENTRATION 310 88104 14.00
45103247 CYTOPATH CELLULAR ENHANCEME 310 88112 29.45
45103248 CYTOPATH URINE 3-5 PROBES M 310 88120 46.00
45103249 CYTOPATH URINE 3-5 PROBES A 310 88121 46.00
45103250 CYTOPATH SMEAR ANY OTHER 310 88160 14.00
45103251 CYTOPATH DX FNA ASPIRATE 310 88172 14.00
45103252 CYTOPATH FNA ASPIRATE; I&R 310 88173 29.00
45103253 CYTOPATH FNA EVAL EACH ADDT 310 88177 9.00
45103254 FLOW CYTOMETRY; CELL/DNA 310 88182 29.00
45103255 FLOW CYTOMETRY; TECH ONLY 1 310 88184 14.00
45103256 FLOW CYTOMETRY; EA ADDTL TE 310 88185 14.00
45103257 FLOW CYTOMETRY; INTERP 2-8 310 88187 9.00
45103258 FLOW CYTOMETRY;INTERP 9-15 310 88188 29.00
45103259 FLOW CYTOMETRY;INTER >16 MA 310 88189 29.00
45103260 LEVEL 1-SURGICAL PATHOLOGY 310 88300 9.00
45103261 LEVEL II SURGICAL PATHOLOGY 310 88302 13.66
45103262 LEVEL III-SURGICAL PATHOLOG 310 88304 29.45
45103263 LEVEL IV-SURGICAL PATHOLOGY 310 88305 29.45
45103264 LEVEL V-SURGICAL PATHOLOGY 310 88307 46.16
45103265 LEVEL VI-SURGICAL PATHOLOGY 310 88309 46.00
45103266 DECALCIFICATION PROCEDURE 310 88311 9.00
45103267 SPECIAL STAINS EA; GROUP 1 310 88312 14.00
45103268 SPECIAL STAINS EA, GROUP II 310 88313 14.00
45103269 SPECIAL STAINS; HISTOCHEMIC 310 88314 14.00
45103270 ENZYME CONSTITUENTS EACH 310 88319 14.00
45103271 CONSULT/REPORT REFERRED SLI 310 88321 14.00
45103272 CONSULT/REPORT PREP SLIDES 310 88323 29.00
45103273 CONSULT/RPT RVW RECORDS/SPE 310 88325 46.00
45103274 PATH CONSULT INTRAOP 310 88329 14.00
45103275 PATH CONSULT INTRAOP W/SPEC 310 88331 29.00
45103276 PATH CONSULT INTRAOP;EA ADD 310 88332 9.00
45103277 PATH CONSULT W/TOUCH PREP;F 310 88333 14.00
45103278 PATH CONSULT W/TOUCH PREP E 310 88334 14.00
45103279 IMMUNOCYTOCHEMISTRY EA AB 310 88342 29.45
45103280 ELECTRON MICROSCOPY;DX 310 88348 132.00
45103281 MORPHOMETRIC ANALYSIS MANUA 310 88360 29.45
45103282 MORPHOMETRIC ANALYSIS QUANT 310 88361 46.00
45103284 MORPHOMETRIC ANALYSIS COMP 310 88367 29.00
45103285 MORPHOMETRIC ANALYSIS MANUA 310 88368 46.00
45103286 ALDOSTERONE 301 82088 17.00
45103287 ESTRADIOL 301 82670 18.00
45103288 INFLUENZA A&B, RT-PCR 306 87798 250.00
45103289 PANEL USE ONLY/4510P127 301 84156 17.00
45103290 PANEL USE ONLY/4510P127 301 84166 17.00
45103291 MUMPS ANTIBODIES, IGM 302 86735 10.00
45103292 MUMPS ANTIBODIES,IGG 302 86735 7.00
45103296 TRECS (PKU PKG) 300 81479 -
45103297 LIPID CASCADE 300 80061 5.00
45103298 PANEL USE ONLY/4510P128 300 80061 -
45103299 PANEL USE ONLY/4510P128 301 83700 -
45103300 PROCALCITONIN 301 84145 261.00
45103301 COCCIDIOIDES ABS IGG/M 302 86635 53.00
45103302 TRYPTASE 301 83520 141.00
45103303 CYTOPATH,CONCENTRATION,SACC 310 88108 14.00
45103304 PANEL USE ONLY/P4510P129 301 84156 11.00
45103305 PANEL USE ONLY/4510P129 301 84166 11.00
45103306 PANEL USE ONLY/4510P129 301 86335 11.00
45103307 ANA REFLEX CASCADE 302 86038 4.37
45103308 PANEL USE ONLY 4510P130 301 84155 33.00
45103309 PANEL USE ONLY 4510P130 301 84165 33.00
45103310 THROMBIN-ANTITHROMBIN COMPL 301 83520 170.00
45103311 JAK2 MUTATION ANALYSIS 300 81270 194.00
45103312 PANEL USE ONLY/4510P131 301 83883 16.00
45103313 PANEL USE ONLY/4510P131 301 84155 16.00
45103314 PANEL USE ONLY/4510P131 301 84165 16.00
45103315 PANEL USE ONLY/4510P132 301 82232 8.00
45103316 PANEL USE ONLY/4510P132 301 84275 8.00
45103317 PANEL USE ONLY/4510P133 305 85613 -
45103318 PANEL USE ONLY/4510P133 305 85670 95.00
45103319 PANEL USE ONLY/4510P133 305 85705 -
45103320 PANEL USE ONLY/4510P133 305 85732 -
45103322 PANEL USE ONLY/4510P134 301 82310 5.00
45103323 PANEL USE ONLY/4510P134 301 83970 5.00
45103324 ANTIGLOMERCULAR BM AB 301 83516 30.00
45103325 FACTOR II DNA ANALYSIS 300 81240 99.85
45103326 CORTISOL 2 SPECIMENS 301 82533 12.00
45103327 APO E GENOTYPING;CARDIO RIS 300 81401 325.00
45103328 IG A, QUANT 301 82784 5.00
45103329 BORDATELLA PERTUSSIS SMEAR 306 87265 16.00
45103330 LYME TTL AB/REFLEX 302 86618 18.00
45103331 INFLUENZA A RT-PCR H1N1 306 87501 225.00
45103333 PANEL USE ONLY/4510P135 301 82380 15.00
45103334 PANEL USE ONLY/4510P135 301 84446 15.00
45103335 PANEL USE ONLY/4510P135 301 84590 15.00
45103336 HEREDITARY HEMOCHROMATOSIS 310 81256 100.00
45103337 PANEL USE ONLY/4510P137 306 87900 343.00
45103338 PANEL USE ONLY/4510P137 306 87902 343.00
45103339 NOROVIRUS, RT-PCR 306 87798 171.00
45103340 PREGNENOLONE,MASS SPECTROME 301 84140 30.00
45103341 PANEL USE ONLY/USE 4510P138 300 81332 129.00
45103342 PANEL USE ONLY/USE 4510P138 301 82103 129.00
45103343 HAEMOPHILUS INFLUENZA B,IGG 302 86684 94.00
45103344 ASPERGILLUS FUMIGATUS 302 86003 4.00
45103345 TETANUS ANTITOXOID AB 302 86317 16.00
45103346 PANEL USE ONLY/4510P139 302 86671 27.00
45103347 PANEL USE ONLY/4510P139 302 86331 27.00
45103348 PANEL USE ONLY/4510P139 302 86602 27.00
45103349 PANEL USE ONLY/4510P139 302 86606 27.00
45103350 EOSINOPHIL,URINE 306 87205 3.00
45103352 ANABOLIC STEROID SCREEN,URI 300 80303 125.00
45103353 PANEL USE ONLY/4510P140 301 82570 6.00
45103354 PANEL USE ONLY/PANEL 4510P1 301 83497 6.00
45103355 F010-IGE SESEME SEED 302 86003 4.00
45103356 F309-IGE CHICK PEA 302 86003 4.00
45103357 TICK/LYME IDENTIFICATION 306 87999 50.00
45103358 PANEL USE ONLY/4510P141 307 83661 27.00
45103359 PANEL USE ONLY/4510P141 307 84081 27.00
45103360 HIV-1 QUANT PCR NONGRAPH 307 87536 88.00
45103361 CA125 PRESENCE OF HAMA 302 86304 50.00
45103362 PANEL USE ONLY/4510P142 301 82175 24.00
45103363 PANEL USE ONLY/4510P142 301 82300 24.00
45103364 PANEL USE ONLY/4510P142 301 83655 24.00
45103365 PANEL USE ONLY/4510P142 301 83825 24.00
45103366 CEA 301 82378 7.88
45103367 CA-125 SERUM 302 86304 8.00
45103368 PANEL USE ONLY/4510P143 300 80185 16.00
45103369 PANEL USE ONLY/4510P143 300 80186 16.00
45103371 AMYLASE ISOENZYMES 301 82150 35.00
45103372 ALLERGEN PROFILE FOOD BASIC 302 86003 24.00
45103373 LYMES AB TOTAL IGM RESPONSE 302 86618 38.00
45103374 PANEL USE ONLY/4510P144 301 83516 22.35
45103375 PANEL USE ONLY/4510P144 301 82784 22.36
45103377 HCV GENOTYPING NON REFLEX 306 87902 197.00
45103382 PANEL USE ONLY/4510P146 301 82175 13.00
45103383 PANEL USE ONLY/4510P146 301 82300 13.00
45103384 PANEL USE ONLY/4510P145 301 82570 13.00
45103385 PANEL USE ONLY/4510P146 301 83655 13.00
45103386 PANEL USE ONLY/4510P145 301 83825 13.00
45103387 PANEL USE/4510P147 301 82172 20.69
45103388 PANEL USE/4510P147 301 82947 5.24
45103389 PANEL USE/4510P147 301 83010 16.79
45103390 PANEL USE/4510P147 301 82977 9.61
45103391 PANEL USE/4510P147 301 84450 6.91
45103392 PANEL USE/4510P147 301 82247 6.69
45103393 PANEL USE/4510P147 301 84460 7.08
45103394 PANEL USE/4510P147 301 84478 7.67
45103395 PANEL USE/4510P147 301 82465 5.80
45103396 PANEL USE/4510P147 301 83883 18.15
45103397 ANTITHROMBIN ANTIGEN 305 85301 18.00
45103398 PROTEIN C ACTIVITY 305 85303 72.00
45103399 TSH 301 84443 5.00
45103400 PANEL USE/4510P148 306 87491 17.00
45103401 PANEL USE/4510P148 306 87591 17.00
45103402 INSULIN 4 SPECIMENS 301 83525 70.00
45103403 INSULIN 5 SPECIMEN 301 83525 22.00
45103404 PANEL USE/4510P149 301 82784 14.00
45103405 PANEL USE/4510P149 301 83516 14.00
45103407 INSULIN AUTO AB 302 86337 27.00
45103408 IA2 AUTO AB 302 86341 84.00
45103409 PANEL USE ONLY/4510P150 301 82384 16.00
45103410 PANEL USE ONLY/4510P150 302 84585 16.00
45103411 HCV REFLEX TO QUANT RT 302 86803 6.00
45103412 HCV RT/PCR QUANT 306 87522 126.00
45103413 PANEL USE ONLY/4510P151 302 86671 38.00
45103414 LEGIONELLA URINE AG 306 87449 23.00
45103417 INTERLEUKIN 28B 310 81400 300.00
45103418 C DIFF BY PCR 306 87493 83.00
45103420 IGFBP-1 301 83520 45.00
45103427 IG D, QUANT 301 82784 10.00
45103428 PANEL USE ONLY/4510P153 301 82784 5.00
45103429 PANEL USE ONLY/4510P153 301 82784 5.00
45103430 PANEL USE ONLY/4510P153 301 82784 5.00
45103431 PANEL USE ONLY/4510P153 301 84155 5.00
45103432 PANEL USE ONLY/4510P153 301 84165 5.00
45103433 PANEL USE ONLY/4510P153 302 86334 5.00
45103434 GIARDIA, DIRECT DETECTION E 306 87329 15.00
45103435 CYCLOSPORINE BLOOD IMMUNOAS 300 80158 16.00
45103436 CYSTIC FIBROSIS PROFILE 32 300 81220 113.73
45103437 PCP CONFIRMATION, URINE 301 83992 22.00
45103438 HCV RNA NNA QUAL 306 87521 88.00
45103439 UREA NITROGEN 301 84520 4.00
45103440 PLASMA PORPHYRINS 301 84311 22.00
45103441 RIBOSOMAL P PROTIEN AB 301 83516 44.00
45103442 CANDIDA AB QUAL 302 86628 36.00
45103443 RUBELLA AB, IG 302 86762 5.00
45103444 THYROGLOBULIN REFLEX PROFIL 302 86800 14.00
45103445 NEUROMYELITIS OPTICA IGG, A 301 83520 579.00
45103446 HIV 1 DNA, PCR, QUAL 306 87535 64.00
45103447 PANEL USE ONLY/4510P154 301 82785 332.00
45103448 PANEL USE ONLY/4510P154 301 86003 332.00
45103449 PANEL USE ONLY/4510P155 301 82785 332.00
45103450 PANEL USE ONLY/4510P155 301 86003 332.00
45103451 PANEL USE ONLY/4510P156 301 84156 11.00
45103452 PANEL USE ONLY/4510P156 301 84166 11.00
45103453 PANEL USE ONLY/4510P156 302 86335 11.00
45103454 WMV SUPER QUAL PT/PCR 306 87798 221.00
45103455 ACHR BINDING AB'S 301 83519 28.00
45103456 17-OH PROGESTERONE SERUM LC 301 83498 19.00
45103457 PNEUMOCOCCAL IM (14) 302 86609 28.00
45103458 TREPONEMA AB 302 86780 9.00
45103459 Q FEVER AB IGG 302 86638 18.00
45103460 ALLERGEN PROFILE HYMENOPTER 302 86003 24.00
45103461 BILE ACIDS 301 82239 12.00
45103462 HEP B SURFACE AB QUANT 302 86317 19.00
45103463 CRYPTOSPORDIUM EIA 306 87328 122.75
45103464 GLUTATHIONE TTL 301 82978 75.00
45103465 HBA1C WITH EAG 301 83036 6.00
45103466 TRYPANOSOMA AB IGM 302 86753 32.00
45103467 TRYPANOSOMA AB IGG 302 86753 32.00
45103468 ALPHA 1 ANTITRYPSIN DEF DNA 300 81332 194.00
45103469 CENCENTRATION AFB 306 87116 11.00
45103470 FACTOR VII ACTIVITY 305 85230 53.00
45103471 TESTOSTERONE TTL WOMEN,CHIL 301 84403 28.00
45103473 PANEL USE ONLY/4510P157 306 87901 129.00
45103474 PANEL USE ONLY/4510P157 306 87900 129.00
45103475 PANEL USE ONLY/4510P157 306 87536 129.00
45103476 CALPROTECTIN FECAL 301 83993 200.00
45103477 PANEL USE ONLY/4510P158 302 86788 36.62
45103478 PANEL USE ONLY/4510P158 302 86789 36.62
45103479 ROCKY MT SPOTTED FEVER IGG 302 86757 145.00
45103480 ROCKY MT SPOTTED FEVER IGM 302 86757 145.00
45103481 RESPIRATORY VIRUS PROFILE P 306 87633 490.00
45103482 ETHOSUXIMIDE SERUM 300 80168 15.00
45103483 PANEL USE ONLY/4510P159 301 82043 4.00
45103484 PANEL USE ONLY/4510P159 301 82570 4.00
45103487 MARFAN REFLEX PANEL 300 81408 2,945.00
45103488 VITAMIN K 301 84597 175.00
45103489 PANEL USE ONLY/4510P161 301 84432 29.00
45103490 PANEL USE ONLY/4510P161 302 86800 29.00
45103491 VARICELLA ZOSTER VIRUS DNA 306 87798 228.00
45103492 CHLAMYDIA TRACH CONJ SWAB N 306 87491 17.00
45103493 PANEL USE ONLY/4510P162 302 86355 46.00
45103494 PANEL USE ONLY/4510P162 302 86357 46.00
45103495 PANEL USE ONLY/4510P162 302 86359 46.00
45103496 PANEL USE ONLY/4510P162 302 86360 46.00
45103497 BARIUM SERUM/PLASMA 301 83018 136.00
45103498 ALUMINUM PLASMA/SERUM 301 82108 14.00
45103499 STRONTIUM SERUM/PLASMA 301 83018 107.00
45103500 PANEL USE ONLY/4510P163 305 85240 140.00
45103501 PANEL USE ONLY/4510P163 305 85250 140.00
45103502 PANEL USE ONLY/4510P163 305 85270 140.00
45103503 PANEL USE ONLY/4510P163 305 85280 140.00
45103504 SULFONYLUREA ANALYSIS 300 80377 167.00
45103505 B-HYDROXYBUTYRATE 301 82010 36.00
45103506 PROINSULIN 301 84206 33.00
45103507 BARTONELLA AB PROFILE 302 86611 25.00
45103508 HGB FRACT W/O SOLUBILITY 301 83021 10.00
45103509 REAL TIME ABBOTT 306 87536 440.00
45103510 PANEL USE ONLY/4510P164 301 84402 16.00
45103511 PANEL USE ONLY/4510P164 301 84403 16.00
45103512 M TUBERCULOSOS DETECTION 306 87556 100.00
45103513 SPUTUM CYTOLOGY 310 88108 83.00
45103514 SURGICAL PATH 1ST SIT 310 88305 65.00
45103516 LYME DISEASE,BB,REAL TIME P 306 87476 118.00
45103517 PANEL USE ONLY/4510P165 301 83525 5.00
45103518 PANEL USE ONLY/4510P165 301 84681 5.00
45103519 HCV RNA QUAL 306 87521 88.00
45103520 PANCREATIC ELASTASE FECAL 301 82656 245.00
45103521 PANEL USE ONLY/4510P166 301 82040 19.00
45103522 PANEL USE ONLY/4510P166 301 84270 19.00
45103523 PANEL USE ONLY/4510P166 301 84403 19.00
45103524 CYSTAFIN C 301 82610 122.00
45103525 COCCIDIOIDES AB CF 302 86635 49.00
45103526 PANEL USE ONLY/4510P167 301 84436 4.00
45103527 PANEL USE ONLY/4510P167 301 84443 4.00
45103528 PANEL USE ONLY/4510P167 301 84479 4.00
45103529 KAPPA URINE 301 83883 45.00
45103530 KOH STAIN 306 87206 13.25
45103531 THROMBIN TIME 305 85670 18.00
45103532 OXCARBAZEPINE 300 80183 9.00
45103533 SALIVARY CORTISOL MS 301 82533 47.00
45103534 ETG/ETS URINE 300 80302 111.00
45103536 FIBRINOGEN ANTIGEN 305 85385 94.00
45103537 ALLERGEN PROFILE, MOLD 302 86003 53.00
45103538 FUNGAL AB, QUANT 302 86606 35.00
45103539 SALIVARY CORTISOL, MS (X2) 301 82533 94.00
45103540 PANEL USE ONLY/PANEL 4510P1 305 85598 49.00
45103541 PANEL USE ONLY/PANEL 4510P1 305 85610 49.00
45103542 PANEL USE ONLY/4510P168 305 85613 49.00
45103543 PANEL USE ONLY/4510P168 305 85670 49.00
45103544 PANEL USE ONLY/4510P168 305 85730 49.00
45103545 PANEL USE ONLY/4510P168 305 85732 49.00
45103546 PANEL USE ONLY/4510P168 302 86146 49.00
45103547 PANEL USE ONLY/4510P168 302 86147 49.00
45103548 ANNA TYPE I; RI AB 302 86255 26.00
45103549 ANNA TYPE II; HU AB 302 86255 26.00
45103550 JAK2 V617F MUTATION DETECTI 300 81270 194.40
45103551 SPECIFIC ALLERGEN-CORN 302 86003 4.00
45103553 LACTOFERRIN FECAL QUANT 301 83631 132.75
45103554 HIV 1/2 ANTIBODY 302 86701 43.81
45103555 HB SOLU + RFLX FRAC 305 85660 11.82
45103556 HCV QUANT RNA 306 87522 647.75
45103557 PANEL USE ONLY/SEE 4510P169 301 82495 51.31
45103558 PANEL USE ONLY/SEE 4510P169 301 83018 51.32
45103559 THYROGLOBULIN AB & IMA/RIA 302 86800 8.53
45103560 EOSINOPHIL CATIONIC PROTEIN 302 86849 146.00
45103561 PANEL USE ONLY/SEE 4510P170 302 86356 79.69
45103562 PANEL USE ONLY/SEE 4510P170 302 86357 79.69
45103563 PANEL USE ONLY/4510P170 302 86359 79.69
45103564 MAGNESIUM RBC 301 83735 38.93
45103565 RPR QUANT 302 86593 4.50
45103566 BRCA1, BRCA2 ANALYSIS 310 81162 2,400.00
45103567 RPR/REFLEX TPPA 302 86592 2.99
45103568 PANEL USE ONLY/4510P171 301 84402 19.65
45103569 PANEL USE ONLY/4510P171 301 84403 19.65
45103571 MONO TEST QUAL 302 86308 7.55
45103572 HCV QUANT RNA PCR NG 307 87522 126.10
45103573 ZINC, RBC 301 84630 92.50
45103574 IODINE SERUM/PLASMA ROOM 301 83789 61.50
45103575 PANEL USE ONLY/4510P172 301 82157 254.25
45103576 PANEL USE ONLY/4510P172 301 82533 254.25
45103577 SYPHILIS SCREENING 302 86780 8.75
45103578 PANEL USE ONLY/4510P173 301 83540 8.64
45103579 PANEL USE ONLY/4510P173 301 84466 17.04
45103580 THC SCREEN/CONFIRMATION 300 80301 42.68
45103581 VDRL CEREBROSPINAL FLUID 302 86592 5.07
45103582 OLIGOCLONAL BANDING 301 83916 30.09
45103583 SIROLIMUS WHOLE BLOOD 300 80195 23.04
45103584 CA 19-9 W/SERIAL MONITOR 302 86301 68.53
45103585 PANEL USE ONL/4510P174 302 86592 73.88
45103586 PANEL USE ONLY/4510P174 302 86618 73.87
45103587 PANEL USE ONLY/4510P175 301 82040 11.75
45103588 PANEL USE ONLY/4510P175 301 82042 11.75
45103589 PANEL USE ONLY/4510P175 301 82784 11.75
45103590 PANEL USE ONLY/4510P176 302 84156 9.63
45103591 PANEL USE ONLY/4510P176 302 84166 9.62
45103592 PANEL USE ONLY/4510P177 301 81003 61.03
45103593 PANEL USE ONLY/4510P177 301 82030 61.03
45103594 PANEL USE ONLY/4510P177 301 82340 61.03
45103595 PANEL USE ONLY/4510P177 301 82570 61.03
45103596 PANEL USE ONLY/4510P177 301 83735 61.03
45103597 PANEL USE ONLY/4510P177 301 83945 61.03
45103598 PANEL USE ONLY/4510P177 301 83986 61.03
45103599 PANEL USE ONLY/4510P177 301 84105 61.03
45103600 PANEL USE ONLY/4510P177 301 84300 61.03
45103601 PANEL USE ONLY/4510P177 301 84392 61.03
45103602 YEAST ONLY CULTURE 306 87101 15.25
45103603 DRUG SUPER PANEL 10+ALC 300 80307 81.68
45103604 HBV RT PCR QUANT NON-GRAPH 306 87517 218.25
45103606 CORTISOL AM & PM (X2) 301 82533 12.26
45103607 METANEPHRINES, FRAC,QUANT,U 301 83835 23.04
45103608 HALDOL SERUM 300 80173 21.01
45103609 SEROQUEL SERUM 300 80342 113.25
45103610 HGB A1C 301 83036 6.31
45103611 ALLERGEN PROFILE GRAIN (X6) 302 86003 24.00
45103612 PANEL USE ONLY/4510P178 302 86704 5.85
45103613 PANEL USE ONLY/4510P178 302 86705 5.85
45103614 PANEL USE ONLY/4510P178 302 86706 5.84
45103615 PANEL USE ONLY/4510P178 302 86707 5.84
45103616 PANEL USE ONLY/4510P178 302 86803 5.84
45103617 PANEL USE ONLY/4510P178 306 87340 5.84
45103618 PANEL USE ONLY/4510P178 306 87350 5.84
45103619 PANEL USE ONLY/4510P179 301 84436 5.06
45103620 PANEL USE ONLY/4510P179 301 84443 5.06
45103621 PANEL USE ONLY/4510P179 301 84479 5.06
45103622 PANEL USE ONLY/4510P179 301 84480 5.06
45103623 GLUTEN SENSITIVITY SCREEN 301 83516 220.00
45103626 ALLERGEN PROFILE MILK 302 86003 24.00
45103627 PSA ULTRA W/SERIAL 301 84153 30.21
45103628 TETANUS/DIPTHERIA AB PROFIL 302 86317 26.76
45103629 BORDETELLA PERTUSSIS AB IGG 302 86615 19.40
45103630 ALLERGEN SPECIFIC CHOCOLATE 302 86003 4.00
45103631 ALLERGEN SPECIFIC EGG WHIT 302 86003 4.00
45103632 ALLERGEN SPECIFIC EGG YOLK 302 86003 4.00
45103633 ALLERGEN SPECIFIC MILK 302 86003 24.25
45103634 ALLERGEN SPECIFIC SOYBEAN 302 86003 4.00
45103635 ALLERGEN SPECIFIC WHEAT 302 86003 24.25
45103636 STRONGLOIDES IGG AB QUAL EI 302 86682 92.25
45103637 SALMONELLA TYPHI/PARATYPHI 302 86768 72.00
45103638 THYROGLOBULIN AB/THYROGLOBU 302 86800 8.53
45103639 FACTOR IX ACTIVITY 305 85250 67.90
45103640 PANEL USE ONLY/4510P177 301 82507 61.03
45103641 PANEL USE ONLY/4510P177 301 84560 61.02
45103642 HLA ANTIGEN B*57:01 300 81381 103.50
45103643 PANEL USE ONLY/4510P180 302 82103 9.73
45103644 PANEL USE ONLY/4510P180 302 82104 9.73
45103645 HEPATITIS D VIRUS 302 86692 15.00
45103646 CELL CNT SYNOVIAL FL W/O CR 300 89051 16.43
45103647 GLUCOSE, BODY FLUID 301 82945 3.60
45103648 PROTEIN TTL, BODY FLUID 301 84157 3.60
45103649 LACTIC ACIT DEHYDROGENASE B 301 83615 3.92
45103650 MTHFR DNA ANALYSIS 300 81291 85.36
45103651 PANEL USE/4510P181 301 82951 7.31
45103652 PANEL USE ONLY/4510P181 301 82952 7.31
45103654 RETIC COUNT REF 305 85045 3.50
45103655 LUTENIZING HORMONES X3 301 83002 30.00
45103656 IMMUNOHISTO ANTB ADDL SLIDE 310 88341 29.45
45103657 FSH 3 SPECIMENS 301 83001 79.50
45103658 NICOTINE METABOLITE URINE 300 80307 3.75
45103659 ETG/ETS URINE 300 80307 11.00
45103660 MECONIUM 9 PANEL/DRUG SCREE 300 80307 91.00
45103662 METHAQUALONE SCREEN URINE 300 80307 35.00
45103663 LD-LIPOPROTEIN 301 83704 80.28
45103664 TESTOSTERONE F/WKLYBD+T LC/ 301 84410 27.65
45103665 TESTOSTERONE F&W BOUND 301 84410 27.65
45103666 PANEL USE ONLY/4510P182 301 82103 9.73
45103667 PANEL USE ONLY/4510P182 301 82104 9.73
45103668 AEROBIC BACTERIAL 306 87070 11.00
45103669 SMITH ANTIBODIES 302 86235 58.20
45103670 IODINE, RANDOM URINE 301 83789 61.50
45103671 PANLE USE ONLY/4510P026 301 83520 118.00
45103672 PANEL USE ONLY/4510P026 305 85730 118.00
45103673 PANEL USE ONLY/4510P183 302 86695 18.37
45103674 PANEL USE ONLY/4510P183 302 86696 18.38
45103675 ANIT-SMOOTH MUSCLE/MITOCHON 301 83516 18.44
45103676 VALPORIC ACID FREE 300 80165 47.28
45103677 HCG QUANT SERUM/PLASMA 301 84702 8.29
45103678 PANEL USE ONLY/4510P184 302 86200 58.50
45103679 PANEL USE ONLY/4510P184 302 86431 58.50
45103680 ALLERGEN SPECIFIC SHELLFISH 302 86003 24.00
45103681 RUBELLA AG IGM 302 86762 10.51
45103682 PANEL USE ONLY/4510P185 302 86704 6.00
45103683 PANEL USE ONLY/4510P185 302 86705 6.00
45103684 PANEL USE ONLY/4510P185 302 86706 5.80
45103685 PANEL USE ONLY/4510P185 302 86707 5.80
45103686 PANEL USE ONLY/4510P185 302 86708 5.80
45103687 PANEL USE ONLY/4510P185 302 86709 5.80
45103688 PANEL USE ONLY/4510P185 306 87340 5.80
45103689 PANEL USE ONLY/4510P185 306 87350 5.80
45103690 MYASTHENIA GRAVIS PROFILE I 301 83519 56.22
45103691 ANTI-DNASE B AB 302 86215 16.69
45103692 ESTRONE 301 82679 35.02
45103693 PANEL USE ONLY/4510P186 302 86357 47.03
45103694 PANEL USE ONLY/4510P186 302 86356 47.02
45103695 DERMATOPHYTE CULTURE 306 87101 77.00
45103696 PANEL USE ONLY/4510P187 302 86256 41.25
45103697 PANEL USE ONLY/4510P187 302 86671 41.25
45103698 HEPATITIS E VIRUS (HEV) IGG 302 86790 40.25
45103699 HEPATITIS E VIRUS (HEV) IGM 302 86790 40.25
45103700 CREATININE, BODY FLUID 302 82570 4.21
45103701 ALBUMIN, BODY FLUID 301 82042 4.21
45103702 ANA, MULTIPLEX, REFLEX 302 86038 4.37
45103703 TULAREMIA (X2) 302 86668 54.15
45103704 HGB SOLUBILITY 305 85660 4.53
45103705 ANTI-YO ANTIBODIES 305 86256 26.48
45103706 CYCLOSORA SMEAR STOOL 306 87015 20.00
45103707 PARASITE EXAMINATION WHOLE 306 87207 17.00
45103708 CLOST DIFFICILE TOXIN 306 87324 15.00
45103710 CYTOPATHOLOGY (PAP) 306 88175 54.75
45103711 (HPV) HIGH RISK TYPES 306 87624 54.75
45103712 GENITAL CULTURE, ROUTINE 306 87070 13.25
45103713 BLOOD CULTURE ROUTINE 306 87040 11.00
45103714 METHICILLIN RESIST STAPH CU 306 87081 27.00
45103715 THYROID STIM HORM(PKU PKG) 301 84443 18.25
45103716 BIOTINIDASE (PKU PKG) 300 82261 18.25
45103717 IRT (PKU PKG) 300 83516 18.25
45103718 TISSUE EXAM BY PATHOLOGIST 306 88305 64.64
45103719 LIGHT MICROSCOPY 306 88314 200.10
45103720 ENZYME HISTOCHEMICAL FROZEN 306 88319 557.84
45103721 IMMUNOHISTOCHEMICAL 306 88341 48.65
45103722 IMMUNOHISTOCHEMICAL STAIN 306 88342 60.60
45103723 STOOL CULTURE 306 87045 33.50
45103724 PANEL CODE/4501P035 306 87804 20.50
45103725 PANEL CODE/4501P035 306 87804 20.50
45103726 PBG QUANTITATIVE, 24-HOUR U 301 84110 10.07
45103727 UREAPLASMA/MYCOPLASMA HOMIN 301 87109 23.57
45103728 HCV AB WITH REFLEX 301 86803 107.00
45103729 ALLERGEN PROFILE, FOOD, NUT 301 86003 28.00
45103730 STOOL CULTURE 301 87045 33.50
45103731 ALLERGEN PROFILE, PED 0-3YR 301 86003 20.00
45103732 HIV-1 QUANT REAL TIME 301 87536 82.37
45103734 CLOMIPRAMINE SERUM OR BLOOD 301 80335 16.65
45103735 ZINC WHOLE BLOOD 301 84630 62.75
45103736 HISTAMINE DETERMINATION WHO 301 83088 6.29
45103737 PYRROLES URINE (RANDOM) 301 84311 79.00
45103738 MANGANESE WHOLE BLOOD 301 83785 32.04
45103739 HCV ANTIBODY W/REFLUX TO QU 301 86803 347.25
45103740 FACTOR V ACTIVITY 301 85220 59.00
45103741 HORSE HANDER 301 86003 4.00
45103742 HEPATITIS PROFILE IV A&B/P1 301 86704 5.39
45103743 HEPATITIS PROFILE IV/P192 301 86706 5.38
45103744 HEPATITIS PROFILE IV/P192 301 86708 5.38
45103745 HEPATITIS PROFILE IV/P192 301 86709 5.38
45103746 LACTATE 11HYDROGENASE/P193 301 83615 5.77
45103747 LACTATE DEHYDROGENASE/P193 301 83625 5.78
45103748 KIDNEY STONE EVALUATION I/P 301 82435 83.33
45103749 KIDNEY STONE EVALUATION I/P 301 82507 83.33
45103750 KIDNEY STONE EVALUATION/P19 301 82575 83.33
45103751 KIDNEY STONE EVALUATION I/P 301 83945 83.33
45103752 KIDNEY STONE EVALUATION/P19 301 83986 83.33
45103753 KIDNEY EVALUATION I/P194 301 84100 83.37
45103754 KIDNEY STONE EVALUATION I/P 301 81003 83.33
45103755 KIDNEY STONE EVALUATION I/P 301 82040 83.33
45103756 KIDNEY STONE EVALUATION I/P 301 82131 83.33
45103757 KIDNEY STONE EVALUATION I/P 301 82310 83.33
45103758 KIDNEY STONE EVALUATION I/P 301 82330 83.33
45103759 KIDNEY STONE EVALUATION I/P 301 82340 83.33
45103760 HEPATIC FUNCTION PANEL 301 80076 3.46
45103761 URIC ACID 301 84550 3.38
45103762 METABOLIC PANEL (8), BASIC 301 80048 3.47
45103763 PHOSPHORUS 301 82550 3.38
45103764 MAGNESIUM 301 83735 3.38
45103765 PHOSPHORUS 301 84100 3.38
45103766 CYCLOSPORINE BLOOD 301 80158 16.47
45103767 VON WILLEBRAND FACTOR(VWF)A 301 85246 65.03
45103769 HSV TYPE 1-SPECIFIC AB, IGG 301 86695 14.30
45103770 PTH-RP 301 82397 23.68
45103771 GENTAMICIN, SERUM, TROUGH 301 80170 14.57
45103772 GENTAMICIN, SERUM, PEAK 301 80170 14.57
45103773 EPSTEIN-BARR VIRUS (EBV) 301 87798 214.02
45103774 POTASSIUM RANDOM URINE 301 84133 5.62
45401004 PRBC'S (EA UNIT) 381 P9016 278.00
45401010 PLATELETS PHERESIS LEUKO RE 384 P9035 670.00
45401012 PLATELET PHERESIS LEUKOCYTE 384 P9034 670.00
45401016 FRESH FROZEN PLASMA EA UNIT 383 P9017 92.00
45401036 CMV TESTING (PER UNIT) 302 86644 37.00
45401037 IRRADIATION (PER UNIT) 302 86945 58.00
45401038 UBS AG TYPING(CLASS II) 300 86902 71.00
45401039 UBS AG TYPING(CLASS I) 300 86902 56.00
45401040 UBS ELUTION 309 86860 166.00
45401041 UBS ANTIGEN TYPE CLASS II 309 86902 71.00
45401042 UBS NEAT AB ID 309 86870 56.00
45401175 FFP/CRYO PREPARATION 302 86927 62.00
45401200 BLOOD TYPE ABO 300 86900 79.00
45401201 ANTIBODY SCREEN 302 86850 150.00
45401202 COOMB'S DIRECT 302 86880 113.00
45401204 CROSSMATCH, EACH 302 86920 296.00
45401205 BLOOD TYPE RH 302 86901 89.00
45401665 UBS EXTENDED PHENOTYPE 300 86905 201.00
45401666 UBS BLOOD TYPE ABO 300 86900 23.00
45401667 UBS BLOOD TYPE RH 300 86901 23.00
45401668 UBS LISS AB ID 300 86870 104.00
45401669 UBS 4C AB ID 300 86870 58.00
45401670 UBS DAT 300 86880 23.00
45401671 UBS ABD DISCREPANCY 300 86850 86.00
45401672 UBS ADSORPTION 300 86978 114.00
45401673 UBS PEG AB ID 300 86870 104.00
45401674 UBS RH PHENOTYPE 300 86906 69.00
45401675 UBS RBC TREATMENT EGA 300 86970 172.00
45401676 UBS ABO/RH GROUPING 300 86900 33.00
45401677 UBS, AB DETECT PT 300 86850 70.00
45401678 HANDLING FEE;UBS STAT CHARG 300 99001 184.00
45401679 UBS AG TYPING (PT) 300 86905 34.00
45401680 PLATELET AB SCREEN 302 86022 293.00
45401682 H&P RBC'S EA UNIT 390 P9016 34.00
45401683 H&P FRESH FROZEN PLASMA EA 390 P9017 34.00
45401684 H&P PLATELETS APHERESIS 390 P9035 34.00
45401686 RED CELL PHENOTYPE 310 81403 399.00
45401687 AB DETECTION (SCREEN)-GEL 300 86850 108.00
45401688 ANTIBODY IDENTIFICATION PAN 300 86870 108.00
45401689 COLD AGGLUTININ SCREEN 300 86156 60.00
45401690 COLD AGGLUTININ TITER€€€€€€ 300 86157 141.00
45401691 DONATH-LANDSEINER/4540P005 300 86940 193.00
45401692 DONATH-LANDSEINER/4540P005 300 86941 193.00
45401693 DRUGS DEPENDENT ANTIBODY ST 300 86970 103.00
45401694 DRUGS DEPENDENT ANTIBODY ST 300 86975 103.00
45401695 DRUGS DEPENDENT ANTIBODY ST 300 86976 103.00
45401696 DRUGS DEPENDENT ANTIBODY ST 300 86850 103.00
45401697 ENZYME TREATMENT PANEL 300 86971 67.00
45401698 ENZYME TREATMENT PANEL 300 86870 67.00
45401699 LECTIN STUDY€€ 300 86999 108.00
45401700 MOLECULAR EXTENDED RED CELL 300 81479 190.00
45401701 MOLECULAR EXTENDED RED CELL 300 81403 190.00
45401702 MOLECULAR GENOTYPE PLATELET 300 81479 341.00
45401703 PLATELET CROSSMATCH-SP€€€ 300 86022 100.00
45401704 RED€CELL SEPARATION€€€ 300 86999 189.00
45401705 SPECIAL SERUM STUDIES€€€€€€ 300 86977 146.00
45401706 SPECIAL SERUM STUDIES 300 86975 146.00
45401707 TITRATION STUDIES (PER TITR 300 86886 158.00
45401709 ANTIBODY IDENTIFICATION 301 86870 129.00
46301004 FLURO BILE DUCTS/PANCREAS/C 320 74300 473.00
46301008 CLAVICLE, COMPLETE 320 73000 191.00
46301010 AC JOINTS BILATERAL 320 73050 229.00
46301012 CYSTOGRAM;MIN 3 VIEWS 320 74430 353.00
46301013 CYSTOGRAM VOIDING 320 74455 511.00
46301014 STERNUM 2 VIEWS 320 71120 233.00
46301017 TEMPOROMANDIBULAR JOINTS 320 70330 307.00
46301018 U/S ARTERIAL U/L EXT,BI-LAT 921 93922 503.00
46301019 ANKLE MIN 3 VIEWS 320 73610 272.00
46301020 THORACIC SPINE 2 VIEWS 320 72070 234.00
46301021 ANKLE LIMITED; 2 VIEWS 320 73600 212.00
46301022 U/S CAROTID-DOPPLER;BILATER 921 93880 977.00
46301023 THORACO-LUMBAR 2 VIEWS 320 72080 239.00
46301029 TIBIA & FIBULA; MIN 2 VIEWS 320 73590 223.00
46301037 BARIUM ENEMA W/ OR W/O KUB 320 74270 658.00
46301038 ELBOW COMPL; MIN 3 VIEWS 320 73080 223.00
46301039 TOES 2 VIEWS 320 73660 139.00
46301040 BARIUM ENEMA AIR CONTRAST 320 74280 846.00
46301041 ELBOW LTD 2 VIEWS 320 73070 196.00
46301043 BONE AGE STUDIES 320 77072 190.00
46301045 BONE SURVEY COMPLETE 320 77075 563.00
46301046 BARIUM SWALLOW 320 74220 393.00
46301049 FACIAL LIMITED;< 3 VIEWS 320 70140 244.00
46301051 FACIAL W/ORBITS 4 VIEWS 320 70200 373.00
46301053 CERVICAL SPINE;MIN 4 VIEWS 320 72050 412.00
46301054 FACIAL, COMPLETE; MIN 3 VIE 320 70150 406.00
46301056 CERVICAL SPINE LTD 2-3 VIEW 320 72040 300.00
46301059 FINGERS XRAY, MIN 2 VIEW 320 73140 148.00
46301060 UGI W/SBFT 320 74245 785.00
46301061 FISTULA/SINUS TRACT 320 76080 274.00
46301062 U/S ABDOMINAL 402 76700 630.00
46301064 CERVICAL W-FLEX & EXT 320 72052 527.00
46301066 U/S ABDOMEN;LTD 402 76705 512.00
46301069 FOOT COMPL 3 VIEWS 320 73630 267.00
46301070 U/S GUIDE AMINOCENTESIS 402 76946 487.00
46301072 FOOT LTD 2 VIEWS 320 73620 179.00
46301073 FOREARM 2 VIEWS 320 73090 189.00
46301077 U/S RENAL/AORTA RETROPERI C 402 76770 399.00
46301081 HAND COMPLETE-3 VIEWS 320 73130 274.00
46301082 U/S FETUS(S) LIMITED 402 76815 511.00
46301084 HAND LTD 2 VIEWS 320 73120 171.00
46301085 HEEL 2 VIEWS 320 73650 225.00
46301096 HUMERUS-MIN 2 VIEWS 320 73060 497.00
46301100 U/S PELVIC (NON OB) 402 76856 502.00
46301102 U/S OB >/=14WKS,SINGLE 402 76805 502.00
46301103 U/S SCROTUM & CONTENTS 402 76870 426.00
46301106 U/S SFT TISSUE HEAD/NECK 402 76536 426.00
46301107 U/S TRANSVAGINAL NON-OB 402 76830 357.00
46301108 KNEE, 3 VIEWS 320 73562 284.00
46301110 KNEE 1 OR 2 VIEWS 320 73560 196.00
46301112 LS SPINE COMPLETE;MIN 4 VIE 320 72110 480.00
46301114 LS SPINE LTD;2 OR 3 VIEWS 320 72100 311.00
46301121 UROGRAPHY IVP 320 74400 1,218.00
46301122 MANDIBLE COMPLETE;MIN 4 VIE 320 70110 310.00
46301124 VENOGRAM BILATERAL 320 75822 658.00
46301127 WRIST COMPLETE;MIN 3 VIEWS 320 73110 242.00
46301130 WRIST LTD;2 VIEWS 320 73100 196.00
46301131 NASAL BONES; MIN 3 VIEWS 320 70160 239.00
46301136 PELVIS 1 OR 2 VIEWS 320 72170 168.00
46301141 RIBS BILATERAL;3 VIEWS 320 71110 449.00
46301142 RIBS UNILATERAL;2 VIEWS 320 71100 327.00
46301143 SACROILIAC JOINTS;3 OR MORE 320 72202 271.00
46301144 SACRUM & COCCYX; MIN 2 VIEW 320 72220 249.00
46301145 SCAPULA 320 73010 219.00
46301148 SHOULDER COMPLETE;MIN 2 VIE 320 73030 273.00
46301149 SHOULDER LTD;1 VIEW 320 73020 201.00
46301150 SINUSES COMPLETE;MIN 3 VIEW 320 70220 349.00
46301151 SKULL COMPLETE;MIN 4 VIEWS 320 70260 520.00
46301152 SKULL LTD;< 4 VIEWS 320 70250 249.00
46301153 SMALL BOWEL STUDY 320 74250 448.00
46301154 SPINE SINGLE VIEW 320 72020 152.00
46301155 U/S GUIDE NEEDLE PLACEMNT 402 76942 1,072.00
46301180 RAD EXAM; SURGICAL SPECIMEN 320 76098 148.00
46301186 ACUTE ABDOMEN SERIES 320 74022 447.00
46301187 SOFT TISSUE NECK 320 70360 205.00
46301188 VENOGRAPHY EXT,UNILATERAL 320 75820 484.00
46301190 BONE LENGTH STUDIES 320 77073 249.00
46301206 FLUORGUIDE CV ACCESS 320 77001 340.00
46301208 US OB LESS 14 WEEKS,SINGLE 402 76801 616.00
46301209 U/S OB FOLLOW-UP 402 76816 410.00
46301211 U/S TRANSVAGINAL OB 402 76817 449.00
46301213 U/S TRANSRECTAL 402 76872 542.00
46301217 FLUORO NDL PLACEMENT 320 77002 342.00
46301668 DXA BONE DENSITY AXIAL 320 77080 658.00
46301669 DXA BONE DENSITY EXTREMITY 320 77081 202.00
46301671 U/S PELVIC LIMITED (NON OB) 402 76857 415.00
46301673 U/S VASCULAR STUDY; LTD (AB 921 93976 1,015.00
46301674 U/S VASCULAR STUDY; LTD, AO 921 93979 753.00
46301676 KNEE 4 OR MORE VIEW 320 73564 372.00
46301677 UGI TRACT +-DLYD FLMS W/KUB 320 74241 697.00
46301678 UGI, AIR CONTR; WITH KUB 320 74247 786.00
46301679 OB US <14 WKS, ADDED FETUS 402 76802 356.00
46301680 OB US >/= 14 WKS, ADDED FET 402 76810 461.00
46301681 OB US DETAILED, ADDED FETUS 402 76812 849.00
46301683 U/S ABD RETROPERITONEAL; LT 402 76775 339.00
46301684 U/S EXT VENOUS STUDY;BI-LAT 929 93970 1,130.00
46301685 U/S EXT VENOUS STUDY;UNI-LA 920 93971 754.00
46301686 U/S LWR EXT ARTERIES; LTD U 921 93926 862.00
46301687 RIB SERIES; BI-LAT W/CHEST 320 71111 234.00
46301688 RIBS UNI 2V W/PA CHEST 3V M 320 71101 527.00
46301690 U/S CHEST 402 76604 373.00
46301691 U/S FETAL UMBIL ARTERY 402 76820 295.00
46301692 L-SPINE W/FLEX & EXT 320 72114 669.00
46301693 U/S FETAL BPP W/O NST 402 76819 391.00
46301694 U/S GUIDEANCE VASCULAR ACCE 402 76937 102.00
46301695 U/S, EXTREMITY, NON-VASCULA 402 76881 949.00
46301696 L-SPINE, BENDING ONLY, MIN 320 72120 284.00
46301698 U/S OB FOLLOW UP PORTABLE 320 76816 393.00
46302009 US CHEST W/NEEDLE PLCMT PAN 402   1,445.00
46302013 U/S LIVER BIOPSY PANEL 402   1,584.00
46302015 CYSTO INJECTION 320 51600 688.00
46302016 CYSTO VOIDING INJECTION 320 51600 688.00
46302019 CLAVICLE,COMPLETE-RT 320 73000 191.00
46302020 CLAVICLE,COMPLETE-LT 320 73000 191.00
46302021 SCAPULA COMPLETE-RT 320 73010 219.00
46302022 SCAPULA COMPLETE-LT 320 73010 219.00
46302023 SHOULDER-RT COMPLETE 320 73030 273.00
46302024 SHOULDER LT-COMPLETE 320 73030 273.00
46302025 HUMERUS-RT 2 VIEWS MIN 320 73060 497.00
46302026 HUMERUS-LT; MIN 2 VIEWS 320 73060 497.00
46302027 ELBOW-RT LIMITED 320 73070 196.00
46302028 ELBOW-LT LIMITED 320 73070 196.00
46302029 ELBOW-RT COMPLETE 320 73080 223.00
46302030 ELBOW-LT COMPLETE 320 73080 223.00
46302031 FOREARM-RT 2 VIEWS 320 73090 189.00
46302032 FOREARM-LT 2 VIEWS 320 73090 189.00
46302033 WRIST-RT LIMITED 320 73100 196.00
46302034 WRIST-LT LIMITED 320 73100 196.00
46302035 SHOULDER-RT LIMITED 320 73020 201.00
46302036 SHOULDER-LT LIMITED 320 73020 201.00
46302037 WRIST-RT COMPLETE 320 73110 242.00
46302038 WRIST-LT COMPLETE 320 73110 242.00
46302039 HAND-RT LIMITED 320 73120 171.00
46302040 HAND-LT LIMITED 320 73120 171.00
46302041 HAND-RT COMPLETE 320 73130 274.00
46302042 HAND-LT COMPLETE 320 73130 274.00
46302045 KNEE-RT LIMITED 320 73560 196.00
46302046 KNEE-LT LIMITED 320 73560 196.00
46302047 KNEE-RT COMPLETE 320 73564 372.00
46302048 KNEE-LT COMPLETE 320 73564 372.00
46302049 TIBIA & FIBULA-RT 320 73590 223.00
46302050 TIBIA & FIBULA-LT 320 73590 223.00
46302051 ANKLE-RT COMPLETE 320 73610 272.00
46302052 ANKLE-LT COMPLETE 320 73610 272.00
46302053 ANKLE-RT LIMITED 320 73600 212.00
46302054 ANKLE-LT LIMITED 320 73600 212.00
46302055 FOOT-RT LIMITED 320 73620 179.00
46302056 FOOT-LT LIMITED 320 73620 179.00
46302057 FOOT-RT COMPLETE 320 73630 267.00
46302058 FOOT-LT COMPLETE 320 73630 267.00
46302059 HEEL-RT 320 73650 225.00
46302060 HEEL-LT 320 73650 225.00
46302065 RIBS UNLAT-RT; 2 VIEWS 320 71100 327.00
46302066 RIBS UNLAT-LT; 2 VIEWS 320 71100 327.00
46302067 MAMMO SCREEN BI-LAT 403 77067 381.00
46302068 MAMMO DIAGNOSTIC BILAT 401 77066 461.00
46302069 MAMMO DIAGNOSTIC UNI-LAT 401 77065 360.00
46302070 MAMMO SCRN IMPLANTS BI-LAT 403 77067 381.00
46302071 MAMMO SCRN UNI-LAT 403 77067 381.00
46302072 U/S BREAST LTD UNI- 402 76642 512.00
46302073 U/S BREAST COMPLETE UNI- 402 76641 568.00
46302074 HIP LTD-RT W/PELVIS 320 73501 293.00
46302075 HIP LTD-LT W/PELVIS 1V 320 73501 293.00
46302076 HIP UNI RT W/PELVIS 2-3V 320 73502 273.00
46302077 HIP UNI LT W/PELVIS 2-3V 320 73502 273.00
46302078 HIPS BILAT W/PELVIS 2V 320 73521 234.00
46302079 FEMUR-RT 2V 320 73552 233.00
46302080 FEMUR-LT 2V 320 73552 233.00
46302081 SCOLIOSIS EVALUATION 320 72081 269.00
46302082 MAMMO SCRN IMPLANTS UNI-LAT 403 77067 381.00
46302083 U/S ABDL AORTA;SCREEN AAA 402 76706 355.00
46302086 CHEST 1 VIEW 324 71045 211.00
46302087 CHEST 2 VIEWS 324 71046 296.00
46302088 CHEST X-RAY 4/> 320 71048 332.00
46302089 ABDOMEN SINGLE VIEW 320 74018 201.00
46302090 ABDOMEN 2 VIEWS 320 74019 265.00
46302091 CHEST 3 VIEWS 320 71047 553.00
46601000 MRI BRAIN WO FOL W/CONTRAST 610 70553 3,499.00
46601001 MRI BRAIN WO CONTRAST 610 70551 2,229.00
46601002 MRI JT UPR EXT WO CONTRAST 610 73221 2,042.00
46601003 MRI JT LWR EXT WO CONTRAST 610 73721 2,067.00
46601004 MRI C-SPINE WO CONTRAST 610 72141 2,237.00
46601007 MRI UPR EXT NJ WO FOL W/CON 610 73220 2,091.00
46601009 MRI ABD WO CONTRAST 610 74181 2,277.00
46601012 MRI L-SPINE WO CONTRAST 610 72148 2,352.00
46601013 MRI ORBIT/FACE/NECK WO CONT 610 70540 2,526.00
46601014 MRI T-SPINE WO CONTRAST 610 72146 2,272.00
46601015 MRI L-SPINE WO FOL W/CONTR 610 72158 3,462.00
46601016 MRI PELVIS WO CONTRAST 610 72195 2,208.00
46601017 MRI LWR EXT NJ WO FOL W/CON 610 73720 2,230.00
46601018 MRI CHEST WO CONTR 610 71550 2,948.00
46601022 MR ANGIO HEAD WO CONTRAST 610 70544 2,230.00
46601024 MR ANGIO NECK WO CONTRAST 610 70547 2,230.00
46601026 MRI NJT UPR EXT WO CONTR 610 73218 2,041.00
46601027 MRI NJT LWR EXT WO CONTR 610 73718 2,129.00
46601035 MRI JT LWR EXT WO FOL W/CON 610 73723 2,896.00
46601036 MRI ABD;WO FOL W/CONTR 610 74183 4,591.00
46602000 MRI THORACIC SPINE WO FOL W 610 72157 4,430.00
46602001 MRI C-SPINE W/O FOL W/CONTR 610 72156 4,674.00
46602002 MRI JT UPR EXT W/CONTR 610 73222 2,374.00
46602004 MRI,CHEST WO FOL W/CONTR 610 71552 2,831.00
46602006 MRI ORBIT/FACE/NECK W/O FOL 610 70543 2,316.00
46602007 MRI PELVIS W/O FOL W/CONTR 610 72197 2,447.00
46602008 MRI ABD W/CONTRAST 610 74182 1,654.00
46602009 MRI LUMBAR W/CONTR 610 72149 1,469.00
46602010 MRI BRAIN W/CONTRAST 610 70552 2,016.00
46602011 MRA NECK W/CONTRAST 610 70548 1,306.00
46602012 MRA HEAD (BRAIN) W/CONTRAST 610 70545 1,211.00
46602013 MRI LWR EXT OTH/THN JT;W/CO 610 73719 1,412.00
46602014 MRI UPPER EXT W/O FOL BY W/ 610 73223 1,197.00
46801000 CT ABDOMEN W/CONTRAST 352 74160 1,646.00
46801001 CT ABD WO CONTRAST 352 74150 1,345.00
46801002 CT UPR EXT WO CONTRAST 352 73200 1,332.00
46801004 CT C-SPINE WO CONTRAST 352 72125 1,462.00
46801005 CT ORBIT/EAR/FOSSA WO CONTR 351 70480 1,139.00
46801006 CT ORBIT/EAR/FOSSA W/CONTRA 351 70481 1,842.00
46801007 CT CHEST W/CONTRAST 352 71260 1,981.00
46801008 CT T-SPINE WO CONTRAST 352 72128 1,467.00
46801009 CT GUIDE NEEDLE PLACEMENT 350 77012 1,895.00
46801010 CT GUIDE FOR LOCALIZATION 350 77011 2,102.00
46801012 CT HEAD/BRAIN WO CONTRAST 351 70450 1,215.00
46801013 CT HEAD/BRAIN WO FOL W/CONT 351 70470 2,346.00
46801014 CT LWR EXT WO CONTRAST 359 73700 1,420.00
46801015 CT L-SPINE WO CONTRAST 352 72131 1,455.00
46801018 CT PELVIS W/CONTRAST 352 72193 1,880.00
46801019 CT CHEST WO CONTRAST 352 71250 1,358.00
46801020 CT FACIAL WO CONTRAST 351 70486 770.00
46801027 CT RECONS W/CONCUR SUPV 350 76376 202.00
46801028 CT SOFT TISSUE NECK W/CONTR 359 70491 2,242.00
46801030 CT SOFT TISSUE NECK WO CON 359 70490 1,416.00
46801031 CT PELVIS WO CONTRAST 352 72192 1,471.00
46801032 CT LWR EXT W/CONTRAST 350 73701 1,743.00
46801033 CT UPR EXT W/CONTRAST 350 73201 1,674.00
46801657 CT MAXILLOFACIAL W/CONTRAST 351 70487 1,507.00
46801658 CT ANGIO,HEAD 351 70496 2,426.00
46801659 CT ANGIO,NECK 352 70498 2,426.00
46801660 CT ANGIO,CHEST 352 71275 2,750.00
46801661 CT ANGIO PELVIC WO FOL W/CO 352 72191 2,850.00
46801662 CT ANGIO UPR EXT W/CONT 352 73206 2,659.00
46801663 CT ANGIO LWR EXT W/CONT 352 73706 2,683.00
46801664 CT ANGIO ABD WO FOL W/CONTR 352 74175 2,869.00
46801665 CTA AORTA W/RUN OFF 352 75635 3,499.00
46801674 CT CHEST WO FOL W/CONTRAST 352 71270 2,028.00
46801675 CT HEAD/BRAIN W/CONTRAST 351 70460 1,473.00
46801676 CT ABD WO FOL W/CONTRAST 352 74170 2,043.00
46801677 CT PELVIS WO FOL W/CONTRAST 352 72194 1,998.00
46801679 CT C-SPINE W/CONTR 352 72126 1,735.00
46801682 CT ORBIT/EAR/FOSSA WO FOL W 351 70482 2,120.00
46801684 CT T-SPINE W/CONTR 352 72129 1,723.00
46801685 CT L-SPINE W/CONTR 352 72132 1,723.00
46801687 BONE LENGTH STUDIES 320 77073 190.00
46801688 CT ABD/PELVIS; W/O CONTR 350 74176 877.00
46801689 CT ABD/PELVIS; W/CONTR 350 74177 1,557.00
46801690 CT ABD/PELVIS; WO CONTR FOL 350 74178 1,919.00
46802003 CT CHEST/ABD/PELVIS WO PANE 352   2,233.00
46802004 CT CHEST/ABD/PELVIS W/CON P 352   3,537.00
46802020 CTA ABD/PELVIS W/CONTRAST 352 74174 1,290.00
46802021 CT CERV SPINE; WO FOL W/CON 352 72127 1,020.00
46802022 CT SFT TSUE NCK WO FOL W/CO 359 70492 2,439.00
47100002 INSULIN LISPRO 100U/ML INJ 636 J1815 92.00
47100003 INSULIN HUMAN REG 100U/ML I 636 J1815 53.00
47100004 TRIAMCINOLONE 40MG/ML SDV I 636 J3301 86.00
47100005 IBANDRONATE 3MG/3ML INJ 636 J1740 985.00
47100007 IMIPENEM-CILASTATIN 500MG I 636 J0743 395.00
47100010 MMR-II 0.5ML INJ VACC 636 90707 417.00
47100011 PNEUMOCOCCAL 13 VALENT VACC 636 90670 874.00
47100015 METHYLPREDNISOLONE 4MG TABP 636 J7509 63.00
47100017 ESTRADIOL CYPIONATE 5MG/ML 636 J1000 248.00
47100020 CLINDAMYCIN 300MG/2ML INJ 636 J3490 134.00
47100030 PHENYLEPHRINE 0.5% NASAL SP 250   13.00
47100039 FLUTICASONE NASAL SPR 250   208.00
47100042 DEXAMETHASONE 4MG TAB 250   6.00
47100046 WARFARIN 5MG TAB 250   6.00
47100049 CYCLOPENTOLATE 2% OPHTH SOL 250   78.00
47100052 TOBRAMYCIN-DEXAMETH OPHTH O 250   461.00
47100053 TETRACAINE 0.5% OPHTH SOL 250   39.00
47100054 SCOPOLAMINE 1.5MG PATCH 250   97.00
47100062 NITROGLYCERIN 0.4MG SL TAB 250   6.00
47100063 SEVOFLURANE INHALATION GAS 250   780.00
47100064 LEVOTHYROXINE 100MCG TAB 250   6.00
47100065 METHERGINE 0.2MG/ML INJ 636 J2210 42.00
47100077 METFORMIN 500MG TAB 250   11.00
47100078 AMOXICILLIN CLAV 875/125MG 250   27.00
47100081 CEPHALEXIN 500MG CAP 250   12.00
47100082 PENICILLIN VK 125MG/5ML PO 250   122.00
47100083 PENICILLIN VK 250MG/5ML PO 250   122.00
47100085 CEPHALEXIN 250MG/5ML SUSP 250   170.00
47100087 CITALOPRAM 20MG TAB 250   6.00
47100088 PREDNISOLONE 15MG/5ML PO SY 250   12.00
47100097 GUAIFENESIN/CODEINE 5ML ORA 250   6.00
47100100 SERTRALINE 100MG TAB 250   21.00
47100109 KETOCONAZOLE 2% TOP CRM 250   133.00
47100121 FLUTICAS/SALMETROL 100/50 I 250   795.00
47100123 FLUTICAS/SALMETEROL 250/50 250   794.00
47100124 FLUTICAS/SALMETEROL 500/50 250   1,019.00
47100127 IPRATROP/ALBUTEROL 0.5/3MG 636 J7620 12.00
47100135 DEXTROSE 5% IVPB MIX BAG 50 258 J7060 71.00
47100136 DEXTROSE 5% IV MIX BAG 100M 258 J7060 71.00
47100137 SOD CHLOR 0.9% IV MIX BAG 5 258 J7040 12.00
47100138 SOD CHLOR 0.9% IV MIX BAG10 250   13.00
47100140 CEFAZOLIN/D5W 1GM IV PREMIX 636 J0690 122.00
47100141 CEFOTETAN/D5W 1GM IV PREMIX 636 J3490 131.00
47100143 DEXTROSE 5% 500ML INJ 636 J7060 18.00
47100144 DEXTROSE 5%/WATER IV 250 ML 258 J7070 16.00
47100145 DEXTROSE 10%/WATER IV 500ML 258 J3490 105.00
47100146 DEXTROSE 5%/SOD CHLOR IV100 258 J7070 13.00
47100147 DEXTROSE 5%/NS 0.45% IV 100 258 J7070 13.00
47100149 LACTATED RINGERS IV 1000ML 258 J7120 105.00
47100150 DEXTR 5% LACTATED RINGERS 1 258 J7120 105.00
47100152 SODIUM CHLORIDE 0.9% IV 500 258 J7040 8.00
47100153 SODIUM CHLORIDE 0.9% IV 250 258 J7050 8.00
47100154 SODIUM CLORIDE 0.45% IV 100 258 J7040 16.00
47100155 SODIUM CHLORIDE 3% IV 500ML 258 J7040 105.00
47100156 SOD CHLOR 0.9%+20MEQ KCL 10 258 J3480 16.00
47100157 LIDOCAINE/D5W 2GM/500ML IVP 636 J2001 30.00
47100159 NITROGLYCERIN OINT 1GM=1" T 250   21.00
47100161 CROTALIDAE IMMUME FAB 1GM I 636 J0840 8,720.00
47100162 DIGOXIN IMMUNE FAB 40MG INJ 636 J1162 3,617.00
47100163 BENZOCAINE SPRAY TOP 250   180.00
47100167 FAMOTIDINE 20MG IV PREMIX 250   46.00
47100174 FENTANYL 100MCG/HR PATCH 250   63.00
47100175 ETHYL CHLORIDE SPRAY 250   222.00
47100177 CHERRY SYRUP 30ML 250   6.00
47100182 OXYCODONE IR 5MG TAB 250   21.00
47100187 VERAPAMIL INJ ISOPTIN/CALAN 250   38.25
47100188 BUPIVACAINE 0.25% INJ 30ML 636 J3490 51.00
47100189 BUPIVACAINE 0.5% INJ 50ML V 250   51.00
47100190 MEPERIDINE 25MG/ML INJ 636 J2175 47.00
47100193 NALOXONE 0.4MG/ML INJ 636 J2310 96.00
47100197 DIAZEPAM 10MG/2ML INJ 636 J3360 68.00
47100200 ATROPINE 0.1MG/ML INJ 10ML 636 J0461 56.00
47100203 DEXTROSE 25% INJ PFS 250   59.00
47100205 MORPHINE PCA 30MG/30ML INJ 636 J2270 139.00
47100206 KETAMINE 50MG/ML INJ 10ML 250   135.00
47100207 LABETALOL 5MG/ML INJ 20ML 250   55.00
47100213 LIDOCAINE/EPI 1% 20ML INJ 250   7.00
47100217 BUPIVACAINE/DEXTROSE INJ 250   51.00
47100219 KETOROLAC 60MG/2ML INJ 636 J1885 25.00
47100221 LIDOCAINE 1% INJ 50ML MDV 636 J2001 20.00
47100222 LIDOCAINE 2% INJ 20ML MDV 250   17.00
47100223 LIDOCAINE MPF 2% INJ 5ML 636 J3490 7.00
47100224 LIDOCAINE 4% INJ 5ML 250   25.00
47100227 LIDOCAINE 5%/DEXTROSE 7.5% 636 J3490 28.00
47100230 STERILE WATER FOR INJ 10ML 250   7.00
47100231 STERILE WATER FOR INJ 100ML 250   20.00
47100232 SODIUM CHLORIDE 9.5% 10ML V 250   11.00
47100234 LIDOCAINE PF 100MG/5ML IV 636 J2001 20.00
47100236 EPINEPHRINE PFS 1MG/10ML IN 636 J0171 60.00
47100238 SODIUM BICARB 4.2% PFS PED 636 J3490 74.00
47100241 FUROSEMIDE 40MG/4ML INJ 636 J1940 44.00
47100244 SODIUM BICARB 50MEQ/50ML IV 250   58.00
47100245 SUCCINYLCHOLINE 200MG/10ML 636 J0330 60.00
47100247 DEXTROSE INJ 50% VIAL 250   66.00
47100250 ETOMIDATE 20MG/10ML INJ 250   177.00
47100251 MAGNESIUM SULF 20GM/500ML I 636 J3475 48.00
47100253 POTASSIUM CHLORIDE 10MEQ IV 636 J3480 57.00
47100254 EPINEPHRINE 1MG INJ AMP 636 J0171 60.00
47100255 CEFTRIAXONE 1GM INJ 636 J0696 186.00
47100259 BUPIVACAINE/EPI 0.25% INJ 250   51.00
47100260 FENTANYL 100MCG/2ML INJ 636 J3010 74.00
47100261 FENTANYL 250MCG/5ML INJ 636 J3010 18.00
47100262 PHYTONADIONE 10MG/ML INJ 636 J3430 260.00
47100264 SODIUM HYPOCHLORITE 0.25% M 250   40.00
47100268 PROMETHAZINE/CODEINE SYR OR 250   49.00
47100269 PHENYTOIN 125MG/5ML SUSP OR 250   6.00
47100271 SODIUM CHLORIDE 0.9% 3ML IN 250   6.00
47100273 METHYLENE BLUE 1% INJ 636 Q9968 28.00
47100283 COCAINE 4% SOLN TOP 250   967.00
47100288 DEXTROSE 50% PFS 50ML IV 250   60.00
47100291 COSYNTROPIN 0.25MG INJ 636 J0834 569.00
47100292 EPINEPHRINE 1MG/ML INJ 30ML 636 J0171 167.00
47100295 ESTRADIOL 0.5MG TAB 250   6.00
47100301 DIHYDROERGOTAMINE 1MG INJ 636 J1110 266.00
47100302 NYSTATIN POWDER TOP 250   149.00
47100303 ASPIRIN 300MG SUPP PR 250   9.00
47100305 DICYCLOMINE 10MG CAP 250   21.00
47100310 TIOTROPIUM 18MCG CAP INHL 250   453.00
47100311 ASPIRIN CHEW 81MG TAB 250   6.00
47100316 DIPHENHYDRAMINE 12.5MG/5ML 250   6.00
47100324 HYDROMORPHONE 2MG/ML INJ 636 J1170 27.00
47100325 DIPHENHYDRAMINE 50MG INJ 636 J1200 46.00
47100327 PHENYTOIN 100MG/2ML INJ 636 J1165 68.00
47100329 SODIUM BICARBONATE 650MG TA 250   8.00
47100335 ACETAMINOPHEN 120MG SUPP PR 250   4.00
47100336 PROCHLORPERAZINE 25MG SUPP 250   21.00
47100337 ACETAMINOPHEN 325MG SUPP PR 250   6.00
47100338 ACETAMINOPHEN 650MG SUPP PR 250   8.00
47100339 HYDROCORTISONE 25MG SUPP PR 250   68.00
47100340 PROMETHAZINE 25MG SUPP PR 250   21.00
47100341 PROMETHAZINE 12.5MG SUPP PR 250   21.00
47100356 AMOXICILLIN 125MG/5ML SUSP 250   25.00
47100362 THIAMINE 100MG TAB 250   6.00
47100363 BENZTROPINE 1MG TAB 250   8.00
47100368 VERAPAMIL 80MG TAB 250   21.00
47100369 VERAPAMIL ER 120MG TAB 250   21.00
47100373 DIPHENHYDRAMINE 25MG CAP 250   6.00
47100376 ENALAPRIL 5MG TAB 250   21.00
47100378 OXYMETAZOLINE NASAL SPRAY 250   12.00
47100380 CHOLECALCIFEROL 1000UNITS T 250   6.00
47100381 GEMFIBROZIL 600MG TAB 250   7.00
47100385 TAMSULOSIN 0.4MG CAP 250   12.00
47100386 CARBAMAZEPINE 200MG TAB 250   21.00
47100390 MIDAZOLAM 2MG/2ML INJ 636 J2250 50.00
47100391 MIDAZOLAM 5MG/5ML INJ 636 J2250 50.00
47100394 MORPHINE 10MG/ML INJ 636 J2270 48.00
47100402 POLYETHYLENE GLYCOL POWDER 250   21.00
47100404 SILVER NITRATE APPLICATOR 250   6.00
47100412 FLUORESCEIN OPHTH STRIP EA 250   6.00
47100413 PHYSOSTIGMINE 2MG/2ML INJ 636 J3490 222.00
47100414 EPHEDRINE 50MG/1ML INJ 636 J3490 293.00
47100415 LIDOCAINE 2% GEL 5ML 250   32.00
47100416 LIDOCAINE 2% GEL 30ML 250   63.00
47100420 NEOMYCIN-POLY-HC OTIC SUSP 250   439.00
47100422 PROPARACAINE 0.5% OPH SOL 250   49.00
47100428 ERYTHROMYCIN OPHTH OINT 250   32.00
47100432 HEPARIN 5000 UNITS/ML INJ 636 J1644 46.00
47100436 PANCRELIPASE 5000-27000-170 250   21.00
47100438 OXYTOCIN INJ 10UNIT/ML 1ML 636 J2590 64.00
47100443 MUPIROCIN 2% OINT 250   80.00
47100444 SALINE NASAL SPRAY 44ML 250   17.00
47100445 PSEUDOEPHEDRINE 30MG TAB 250   14.00
47100449 LUBRICANT OPHTH OINT 3.5GM 250   36.00
47100450 RABIES IMMUNE GLOBULIN 2ML 636 90375 3,050.00
47100454 DTAP/POLIO/HIB 0.5ML INJ VA 636 90698 548.00
47100455 HAEMOPHILUS B INJ 0.5ML VAC 636 90648 200.00
47100456 TUBERCULIN PPD 0.1ML INJ 302 86580 45.00
47100457 POLIOVIRUS 0.5ML INJ VACC 636 90713 208.00
47100459 DOXYLAMINE 25MG TAB 250   6.00
47100466 ALTEPLASE 100MG INJ 636 J2997 5,993.00
47100467 ALBUTEROL 0.5% INH NEB SOL 636 J7611 67.00
47100468 SULFAMETHOX/TMP 200-40MG/5M 250   122.00
47100469 LEVONORGESTREL 20MCG/24HR I 636 J7298 2,681.00
47100470 LEVOFLOXACIN/D5W 750MG/150M 636 J1956 142.00
47100472 LEVOFLOXACIN/D5W 500MG/100M 636 J1956 142.00
47100474 RISPERIDONE 1MG TAB 250   36.00
47100480 METOLAZONE 5MG TAB 250   9.00
47100481 DIPHENOXYLATE/ATROPINE TAB 250   6.00
47100484 AMITRIPTYLINE 25MG TAB 250   6.00
47100485 CHLORDIAZEPOXIDE 25MG CAP 250   6.00
47100488 METOPROLOL 25MG TAB 250   6.00
47100492 GLIMEPIRIDE 2MG TAB 250   21.00
47100497 LOPERAMIDE 2MG CAP 250   23.00
47100501 PAROXETINE 20MG TAB 250   17.00
47100505 CLONAZEPAM 1MG TAB 250   6.00
47100509 TRIAMTERENE/HCTZ 37.5/25 CA 250   21.00
47100513 HYDROCORTISONE 1% CRM TOP 250   9.00
47100519 BENZOIN COMP TINCTURE TOP 250   17.00
47100520 MULTI VITAMIN 10ML INJ 636 J3490 54.00
47100521 PROPRANOLOL 1MG/ML INJ 636 J1800 49.00
47100522 ENALAPRIL 2.5MG/2ML INJ 250 J3490 61.00
47100525 ESMOLOL 100MG/10ML INJ 250   176.00
47100526 METOPROLOL 5MG/5ML INJ 250   50.00
47100538 DTAP HEPB IPV 0.5ML INJ VAC 636 90723 352.00
47100541 HEP A PED/ADOL 0.5ML INJ VA 636 90633 431.00
47100542 HEP A ADULT 0.5ML INJ VACC 636 90632 331.00
47100543 TDAP 0.5ML INJ VACC 636 90715 202.00
47100551 AZITHROMYCIN 1200MG/30ML SU 250   179.00
47100552 SULFASALAZINE 500MG TAB 250   21.00
47100554 LACTULOSE 20GM/30ML SOL 250   8.00
47100560 TIMOLOL 0.25% OPHTH SOL 5ML 250   150.00
47100561 TIMOLOL 0.5% OPHTH SOL 5ML 250   92.00
47100563 PREDNISOLONE 1% OPHTH SUSP 250   68.00
47100573 OXYTOCIN 10UNITS/ML INJ 636 J2590 67.00
47100574 THIAMINE 200MG/2ML INJ 636 J3411 81.00
47100577 DEXAMETHASONE 4MG 636 J1100 12.00
47100578 GENTAMICIN 20MG/2ML INJ 636 J1580 193.00
47100579 FOLIC ACID 5MG/ML INJ MDV 636 J3490 132.00
47100582 CEFAZOLIN 1GM INJ 636 J0690 6.00
47100583 LEVOTHYROXINE 100MCG INJ 258   546.00
47100588 ROPIVACAINE 2MG/ML INJ 200M 636 J2795 85.00
47100589 ROPIVACAINE 2MG/ML INJ 100M 636 J2795 155.00
47100590 MORPHINE PF 10MG/10ML INJ 636 J2274 66.00
47100597 NEOSTIGMINE 10MG/10ML INJ 636 J2710 536.00
47100598 CEFOTETAN 2GM INJ 250   156.00
47100599 AMPICILLIN 1GM INJ 636 J0290 156.00
47100603 BUPIVACAINE INJ EPI SENSOR- 250   47.00
47100604 CHLOROPROCAINE 2% INJ 20ML 636 J2400 133.00
47100605 LIDOCAINE/EPI 2% 20ML INJ M 250   18.00
47100606 LIDOCAINE 1% PF 50MG/5ML IN 636 J2001 16.00
47100607 VALPROATE SOD 500MG/5ML INJ 636 J3490 89.00
47100608 HYDRALAZINE 20MG/ML INJ 636 J0360 88.00
47100610 LEVALBUTEROL 1.25MG NEB IHL 250 J7612 58.00
47100615 ASPIRIN EC 325MG TAB 250   6.00
47100618 CARISOPRODOL 350MG TAB 250   21.00
47100619 CLONIDINE 0.1MG TAB 250   21.00
47100622 DILTIAZEM HCL 30MG TAB 250   21.00
47100624 FUROSEMIDE 40MG TAB 250   21.00
47100628 METOCLOPRAMIDE 10MG TAB 250   21.00
47100632 SIMETHICONE 80MG CHEW TAB 250   8.00
47100633 SPIRONALACTONE 50MG TAB 250   21.00
47100635 TEMAZEPAM 15MG CAP 250   7.00
47100640 DILTIAZEM CD 180MG CAP 250   21.00
47100644 MIRTAZAPINE 30MG TAB 250   17.00
47100647 SIMVASTATIN 20MG TAB 250   27.00
47100653 PREDNISONE 5MG TAB 250   21.00
47100656 RABIES 2.5U INJ VACC 636 90675 1,481.00
47100660 TRAMADOL 50MG TAB 250   21.00
47100664 TESTOSTERONE 200MG/ML INJ 636 J1071 140.00
47100681 TENECTEPLASE 50MG INJ 636 J3101 4,278.00
47100684 HEPARIN 25000 UN/D5W 250ML 636 J1644 189.00
47100686 NOREPINEPHRINE 4MG/4ML INJ 636 J3490 84.00
47100688 PHYTONADIONE 1MG/0.5ML INJ 636 J3430 90.00
47100691 MIDAZOLAM 10MG/2ML INJ 636 J2250 50.00
47100692 FAT EMULSION 20% 250ML IV 636 J3490 200.00
47100696 SODIUM CHLORIDE 0.9% 1000ML 258 J7030 13.00
47100699 LACTATED RINGERS IRRIG LR 250   46.00
47100702 KCL 20MEQ/D5/0.45% NACL 100 250   105.00
47100703 DEXTROSE 5%/1000ML INJ 258 J7060 18.00
47100705 BUPIVACAINE/EPI 0.5% MPF IN 250   51.00
47101698 BARIUM SULFATE 98% SUSP 250   76.00
47105006 SODIUM CHLORIDE 0.9 100ML 258 J7050 23.00
47105008 LIDOCAINE 2% JELLY 5ML 250   29.00
47105010 LIDOCAINE 1% MPF INJ 2ML 250   8.00
47105013 HYDROCORTISONE 100MG INJ 636 J1720 67.00
47105022 RHO D IMMUNE GLOB 300MCG IN 636 J2790 781.00
47105023 HEPARIN FLUSH 100 UNITS/ML 636 J1642 6.00
47105024 SODIUM CHLORIDE 0.9% FLUSH 250   7.00
47105026 SODIUM PHOSPHATE ENEMA PR 250   9.00
47105031 ENOXAPARIN 40MG/0.4ML INJ 636 J1650 234.00
47105033 ENOXAPARIN 30MG/0.3ML INJ 636 J1650 184.00
47105035 ENOXAPARIN 100MG/ML INJ 636 J1650 524.00
47105038 AMOXICILLIN 250MG CAP 250   6.00
47105040 ATROPINE 0.5MG/5ML INJ PFS 636 J0461 49.00
47105041 ERTAPENEM 1GM INJ 636 J1335 590.00
47105042 INSULIN NPH HUMAN 100U/ML I 636 J1815 53.00
47105051 NAFCILLIN 2GM INJ 250   122.00
47105052 NITROGLYCERIN PATCH 0.1MG/H 250   38.00
47105053 NITROGLYCERIN 25MG/250ML DR 250   98.00
47105054 ORTHOVISC 15MG INJ 636 J7324 838.00
47105056 GLYCERIN SUPPOS ADULT 250   21.00
47105057 SULCRALFATE 1GM/10ML ORAL S 250   41.00
47105058 LORAZEPEPAM 2MG/ML INJ 636 J2060 11.00
47105060 MILK OF MAGNESIA ORAL 30ML 250   4.00
47105061 ZOLEDRONIC 5MG/100ML INJ 636 J3489 868.00
47105062 IBUPROFEN 600MG TAB 250   14.00
47105066 SODIUM CHLORIDE BACTERIOSTA 250   4.00
47105067 BENZOCAINE/MENTHOL SPRAY 250   27.00
47105068 PEGFILGRASTIM 6MG/0.6ML INJ 636 J2505 9,097.00
47105069 LANOLIN 7GM OINT TOP 250   13.00
47105070 POLYETHYLENE GLYCOL ORAL400 250   40.00
47105072 PNEUMOCOCCAL13 0.5ML INJ VA 636 90670 874.00
47105073 ZOSTER 0.5ML INJ VACC 250 90736 1,064.00
47105074 VARICELLA 0.5ML INJ VACC 250 90716 712.00
47105075 VFC ROTAVIRUS 1 ML ORAL VAC 636 90680 21.00
47105077 TDAP 0.5ML VACC 636 90715 204.00
47105086 MELOXICAM 7.5MG TAB 250   18.00
47105092 CARBOPROST 250MG/ML INJ 250   516.00
47105096 MENINGOCOCCAL 0.5ML INJ VAC 636 90734 681.00
47105098 PODOPHYLLUM RESIN 25% TOPIC 250   377.00
47105104 SPIRONOLACTONE 25MG TAB 250   6.00
47105107 PHENYTOIN 250MG/5ML INJ 636 J1165 13.00
47105109 PHENOBARBITAL 65MG/ML INJ 636 J2560 71.00
47105110 DARBEPOETIN ALFA 100MCG/0.5 636 J0882 2,836.00
47105117 FLUCONAZOLE/NACL 200MG/100M 636 J1450 592.00
47105122 IOPAMIDOL 76% 200ML 636 Q9967 257.00
47105123 IOPAMIDOL 76% - 125ML 636 Q9967 177.00
47105124 GADOTERIDOL 279.3MG/ML INJ 255 A9579 498.00
47105128 PENICILLIN G 1.2MMU/2ML INJ 636 J0561 750.00
47105130 VFC INFLUENZA INTRANASAL VA 636 90672 21.00
47105132 LEVONORGESTREL14MCG/24HR IU 250 J7301 2,731.00
47105133 PHENAZOPHYRIDINE 95MG TAB 250   6.00
47105135 PILOCARPING HCI 1% OPHTH SO 250   492.00
47105137 DENOSUMAB 60MG/ML INJ 636 J0897 3,345.00
47105138 FINASTERIDE 5MG TAB 250   13.00
47105142 ADM IV SOLN EA ADDTL 258 X7702 105.00
47105144 PARAGARD IUD 636 J7300 2,381.00
47105145 CEFEPIME HCL 1GM INJ 636 J0692 89.00
47105148 ROTAVIRUS 1ML ORAL VACC 250 90681 547.00
47105149 CEFTRIAXONE 2GM INJ 636 J0696 109.00
47105153 RIVAROXABAN 15MG TAB 250   62.00
47105154 MEDROXYPROGESTERONE 150MG I 636 J1050 651.00
47105155 DOCUSATE SODIUM 150MG/15ML 250   24.00
47105156 PERFLUTREN PROT-A .22MG/ML 255 Q9956 929.00
47105157 OCTREOTIDE 30MG INJ 636 J2353 5,133.00
47105158 NEOMYC/BACITRAC/POLYMYX OIN 250   6.00
47105159 LEVOTHYROXINE 25MCG TAB 250   6.00
47105160 SODIUM BICARB 2.4MEQ/5ML IN 636 J3490 53.00
47105162 VFC TDAP 0.5ML INJ VACC 636 90715 21.00
47105169 MONTELUKAST 10MG TAB 250   6.00
47105170 OMEPRAZOLE 20MG CAP 250   6.00
47105178 PROCHLORPERAZINE 5 MG TAB 250   6.00
47105183 LEVETIRACETAM 500MG TAB 250   6.00
47105184 PRENATAL VIT PLUS FE TAB 250   6.00
47105188 KETOROLAC 60MG/2ML INJ 636 J1885 8.00
47105189 CETIRIZINE 10MG TAB 250   6.00
47105192 BACITRACIN 50,000 UNITS INJ 636 J3490 36.00
47105193 BETAMETHASONE 6MG/ML INJ 5M 636 J0702 219.00
47105194 CALCIUM CHL10% PFS 636 J3490 57.00
47105195 DEXAMETHASONE 4MG/ML INJ 636 J1100 6.00
47105197 FENTANYL 100MCG/2ML INJ 636 J3010 8.00
47105198 FUROSEMIDE 20MG TAB 250   6.00
47105199 METRONIDAZOLE 500MG/100ML P 250   7.00
47105202 METOCLOPRAMIDE 10MG IVP 636 J2765 6.00
47105205 ZINC GLUCONATE 50MG TAB 250   6.00
47105207 PIPERACILL/TAZOB 3.375GM PR 636 J2543 42.00
47105210 VENLAFAXINE ER 75MG CAP 250   6.00
47105211 LIDOCAINE/PRILOCAINE 2.5% C 250   52.00
47105213 GENTAMICIN 40MG/ML INJ 636 J1580 6.00
47105216 ZOLEDRONIC ACID 4MG/5ML INJ 636 J3489 2,880.00
47105218 BETHANECHOLL 5MG TAB 250   6.00
47105221 HYDROCODONE/APAP 10/325MG T 250   6.00
47105223 VFC ROTAVIRUS 1ML ORAL VACC 250 90681 21.00
47105224 DULOXETINE ER 20MG TAB 250   24.00
47105225 LEVONORGESTREL 1.5MG TAB 250   223.00
47105226 TRAZODONE 50MG TAB 250   8.00
47105227 METRONIDAZOLE 250MG TAB 250   21.00
47105229 PHENYLEPHRINE 2.5% OPTH 250   195.00
47105230 DOCUSATE 100MG/10ML ORAL LI 250   6.00
47105231 TROPICAMIDE 1% OPHTH 250   31.00
47105232 ALBUTEROL SULF 8.5GM INHL 250   319.00
47105233 IBUPROFEN 100MG/5ML ORAL SU 250   12.00
47105234 ALBUTEROL 90MCG HFA INH 250   441.00
47105236 MEROPENEM 1GM IV 636 J2185 79.00
47105238 IRON SUCROSE 100MG/5ML 636 J1756 194.00
47105239 ESTRADIOL VALERATE 20MG/ML 636 J1380 763.00
47105240 SUCROSE 24% ORAL SOL 250   8.00
47105243 CYANOCOBALAMIN 1000MCG TAB 250   8.00
47105246 KETOROLAC 30MG/ML INJ 636 J1885 7.00
47105248 NEOSTIGMINE 1MG/ML INJ 636 J2710 413.00
47105249 HYDROCHLOROTHIAZIDE 25MG TA 250   6.00
47105250 DOXYCYCLINE 100MG IV 636 J3490 116.00
47105251 BUPIVACAINE 0.25% INJ 250   21.00
47105253 BACITRACIN OINT 500U/G EA P 250   6.00
47105254 ACYCLOVIR 200MG CAP 250   6.00
47105255 DENOSUMAB 120MG/1.7ML SQ IN 636 J0897 6,500.00
47105256 VANCOMYCIN 1GM INJ 636 J3370 24.00
47105258 AMOXILL 500MG CAP 9PK TO GO 250   13.00
47105259 VFC HPV9 0.5ML INJ VACC 636 90649 21.00
47105260 VFC MMRV 0.5ML INJ VACC 636 90710 21.00
47105261 ZITHROMAX 500MG TAB TO-GO 250   19.00
47105262 KEFLEX 500MG CAP 10PK TO GO 250   11.00
47105263 IBUPROFEN 400MG TAB TO-GO 250   7.00
47105264 PENICILLIN VK 500MG TAB TO- 250   12.00
47105265 PREDNISONE 20MG TAB TO-GO 250   9.00
47105266 TRIMETH SULFA DS TAB TO-GO 250   7.00
47105267 CYCLOBENZAPRINE 10MG TAB TO 250   6.00
47105268 DIPHENHYDRAMINE 25MG CAP TO 250   6.00
47105269 MECLIZINE 25MG CHEWTAB TO-G 250   6.00
47105271 ALPROSTADIL 500MCG/ML INJ 636 J0270 501.00
47105272 ARTIFICIAL TEAR OINTMENT 250   74.00
47105273 ONDANSETRON 4MG TAB TO-GO 250   14.00
47105274 CLINDAMYCIN 150MG CAP TO-GO 250   8.00
47105275 AMOX/POT 875/125MG TAB TO-G 250   27.00
47105276 AZITHR 200MG/5ML SUSP TO-GO 250   59.00
47105277 AMOX 250MG/5ML SUSP TO-GO B 250   12.00
47105278 AMOX/POT 400-57 SUSP TO-GO 250   31.00
47105279 LEVOFLOXACIN 250MG TAB TO-G 250   8.00
47105280 CEPHALEXIN 250MG/5ML SUSP T 250   69.00
47105281 PENCILLIN VK 250MG/5ML TO-G 250   25.00
47105282 APAP/CODEINE 300-30MG TO-GO 250   16.00
47105283 TRAMADOL 50MG TAB TO-GO 250   16.00
47105284 VENTOLIN INHALER 8GM TO-GO 250   72.00
47105285 CHOLESTYRAMINE 4GM ORAL POW 250   16.00
47105286 HYDROCODON/APAP 5-325 TAB 5 250   9.00
47105289 PIOGLITAZONE 15MG TAB 250   6.00
47105290 CLARITHROMYCIN 500MG TAB 250   24.00
47105293 DTAP-IPV 0.5ML INJ VACC 636 90696 251.00
47105295 MESALAMINE DR 800MG TAB 250   45.00
47105296 VARICELLA 0.5ML INJ VACC 250 90716 705.00
47105297 RITUXMAB 500MG/50ML 636 J9310 4,368.00
47105298 LEVOTHYROXINE 50MCG TAB 250   6.00
47105299 VALPROIC ACID 250MG ORAL SO 250   6.00
47105300 PEDIALYTE PKT ORAL 250   8.00
47105301 ROPIVACAINE HCL 200MG/100ML 636 J2795 193.00
47105302 AMIODARONE 200MG TAB 250   6.00
47105303 DOBUTAMINE 250MG/250ML D5W 636 J1250 41.00
47105306 PANTOPRAZOLE 40MG INJ 250   31.00
47105307 BUDESONID 0.25MG/2ML INHL 250   41.00
47105309 VFC HAEMOPHILUS B 0.5ML VAC 636 90648 21.00
47105310 DOCUSATE SODIUM 250MG CAP 250   6.00
47105312 LORATADINE 10MG TAB 250   6.00
47105313 CELECOXIB 100MG CAP 250   9.00
47105314 CLOTRIMAZOLE 10MG LOZENGE 250   6.00
47105316 ISOSORBIDE 30MG TAB ER 250   6.00
47105317 LEVOTHYROXINE 25MCG TAB 250   6.00
47105318 APAP 160MG/5ML SUSP UNIT DO 250   6.00
47105320 APAP W/CODEINE 120MG/5ML EL 250   6.00
47105323 ACETYLCYSTEINE 200MG/ML MIS 250   39.00
47105325 FILGRASTIM 480MCG/0.8ML INJ 636 J1442 2,684.00
47105326 MORPHINE SULFATE 10MG/ML 636 J2270 8.00
47105327 LIPIDS 20% PARENTERAL NUTR 250   66.00
47105328 INFLUENZA QUAD 6-35M PF 16/ 636 90685 138.00
47105329 APAP W/COD 300MG/30MG TAB 250   6.00
47105331 ACYLOVIR 500MG/10ML 636 J0133 27.00
47105332 ALBUTEROL 0.83MG/ML INHL 3M 636 J7613 6.00
47105334 ALLOPURINOL 100MG TAB 250   17.00
47105335 AMANTADINE 100MG CAP 250   119.00
47105336 AMINOCAPROIC ACID 250MG/ML 636 J3490 38.00
47105337 AMINO ACID 4.25%/D10W/LYTES 636 J3490 161.00
47105339 AMITRIPTYLINE 10MG TAB 250   8.00
47105341 AMLODIPINE 5MG TAB 250   6.00
47105342 AMOX 250MG/5ML SUSP 100ML B 250   12.00
47105343 AMOXICILLIN 500MG CAP 250   6.00
47105345 AMPICILLIN/SULBACTAM 3GM IN 636 J0295 39.00
47105347 ASCORBIC ACID 500MG TAB 250   6.00
47105351 SUMATRIPTAN 6MG/0.5ML INJ 636 J3030 47.00
47105352 SILVER SULFADIAZINE 1% CRM 250   55.00
47105353 ASPIRIN EC 325MG TAB 250   21.00
47105355 ATENOLOL 25MG TAB 250   6.00
47105356 ATRACURIUM 10MG/ML INJ 636 J3490 32.00
47105357 AZITHROMYCIN 500MG INJ 636 J0456 92.00
47105358 BACITRACIN ZINC OINTMENT 1G 250   27.00
47105360 BELLADONNA ALK/PB 5ML 250   96.00
47105364 BISACODYL 5MG TAB 250   21.00
47105365 BISCODYL 10MG SUPP 250   6.00
47105366 BUMETANIDE 0.25MG/10ML INJ 636 J3490 14.00
47105367 BUMETANIDE 1MG TAB 250   21.00
47105369 BUSPIRONE 5MG TAB 250   6.00
47105370 CALCIUM GLUCONATE 1GM/10ML 636 J3490 32.00
47105371 CALCIUM W/VIT D 250/125 TAB 250   6.00
47105373 CARVEDILOL 6.25MG TAB 250   6.00
47105375 RABIES IG IM/SC 150IU/10ML 636 90375 1,255.00
47105376 HYDROMORPHONE 2MG/ML INJ 636 J1170 8.00
47105377 PNEUMOCOCCAL 23 0.5ML INJ V 636 90732 492.00
47105378 CEFTAZIDIME 1GM INJ 636 J0713 28.00
47105381 CEFTRIAXONE 500MG INJ 636 J0696 7.00
47105382 CEPHALEXIN 250MG CAP 250   6.00
47105384 CHLORASEPTIC SPRAY 20ML 250   14.00
47105385 CIPROFLOXACIN 500MG TAB 250   6.00
47105387 CLINDAMYCIN 150MG CAP 250   6.00
47105389 HAEMOPHILUS B 0.5ML INJ VAC 636 90648 60.00
47105390 HYDROXYZINE PAMOATE 25MG CA 250   6.00
47105391 NAPROXEN 250MG TAB 250   6.00
47105392 HYDRALAZINE 10MG TAB 250   6.00
47105393 CLOPIDOGREL 75MG TAB 250   6.00
47105394 XYLOCAINE 1% MPF/SDV 30ML 636 J3490 19.00
47105395 LIDO/PRILOCAINE 2.5%/2.5% 3 250   55.00
47105396 VALSARTAN 80MG TAB 250   6.00
47105397 NYSTATIN 100MU/5ML SUSP 250   6.00
47105398 ONDANSETRON 4MG/2ML INJ 636 J2405 6.00
47105399 XYLOCAINE 2% SDV 400MG/20ML 636 J3490 8.00
47105400 VITAMIN A&D OINTMENT 56GM/T 250   13.00
47105401 PENICILLIN G BENZATH 1.2MU/ 636 J0561 750.00
47105403 DESMOPRESSIN 4MCG/ML INJ 636 J2597 249.00
47105404 DEXTROSE 50% PFS D50 25G/50 250   43.00
47105405 DIAZEPAM 5MG TAB 250   6.00
47105406 DIGOXIN 0.125MG TAB 250   7.00
47105407 GLYCOPYRROLATE 0.2MG/ML INJ 636 J3490 48.00
47105408 CIPROFLOXACIN 400MG/200ML I 636 J0744 20.00
47105410 DILTIAZEM 5MG/ML INJ 25ML 636 J3490 27.00
47105411 DILTIAZEM 5MG/ML INJ 5ML 636 J3490 11.00
47105412 DIVALPROEX ER 250MG 250   6.00
47105413 DIVALPROEX SOD DR 250MG TAB 250   6.00
47105414 DOCUSATE SODIUM 100MG SOFTG 250   6.00
47105415 DONEPEZIL 5MG TAB 250   7.00
47105417 DOXYCYCLINE 100MG CAP 250   14.00
47105419 ESCITALOPRAM 10MG TAB 250   6.00
47105420 FAMOTIDINE 20MG TAB 250   6.00
47105421 DULOXETINE DR 30MG CAP 250   6.00
47105422 FENTANYL 25MCG/HR PATCH 250   47.00
47105423 FENTANYL 50MCG/72HR PATCH 250   71.00
47105426 FLUMAZENIL 0.5MG/5ML INJ 636 J3490 7.00
47105427 FLUOXETINE 20MG CAP 250   6.00
47105428 FUROSEMIDE 40MG/4ML INJ 636 J1940 14.00
47105430 GABAPENTIN 100MG CAP 250   6.00
47105434 TERBUTALINE 1MG/1ML INJ 636 J3105 9.00
47105435 VITAMIN B-6 100MG TAB 250   6.00
47105436 NICOTINE TRANSDERMAL 21MCG 250   11.00
47105438 AZITHROMYCIN 250MG TAB 250   8.00
47105442 GEMFIBROZIL 600MG TAB 250   11.00
47105445 GLUCAGON 1MG INJ 636 J1610 554.00
47105447 GUAIFENSIN ER 600MG TAB 250   7.00
47105448 GUAIFENSIN ER 600MG TAB 250   6.00
47105449 HYDROCODONE/APAP 5/325MG TA 250   6.00
47105450 HYDROMORPHONE 2MG TAB 250   6.00
47105451 IBUPROFEN 200MG TAB 250   6.00
47105452 IBUPROFEN 800MG TAB 250   6.00
47105453 INDOMETHACIN 25MG CAP 250   6.00
47105454 HALOPERIDOL 5MG/ML INJ 636 J1630 6.00
47105455 INSULIN HUMAN 70/30 100U/3M 636 J1815 29.00
47105456 IPRATROPIUM BROMIDE INH SOL 636 J7644 6.00
47105457 ISOSORBIDE DINITRATE 20MG T 250   6.00
47105458 LEVETIRACETAM 500MG/5ML INJ 636 J1953 77.00
47105460 LIDOCAINE 2% VISCOUS ORAL 1 250   6.00
47105461 LISINOPRIL 5MG TAB 250   6.00
47105463 LISINOPRIL 20MG TAB 250   6.00
47105464 ONDANSETRON 4MG ODT TAB 250   6.00
47105465 BUPIVACAINE 0.5% INJ 30ML V 636 J3490 8.00
47105466 CLONIDINE 0.1MG TAB 250   6.00
47105467 FENTANYL 100MCG/2ML INJ 636 J3010 6.00
47105468 LANOXIN 500MCG/2ML INJ 636 J1160 35.00
47105469 SODIUM HYALURONATE 2.5ML IN 636 J7321 1,460.00
47105470 EYE IRRIGATION SOLN 250   25.00
47105471 GENTAMICIN OPTH OINT 3.5GM 250   64.00
47105472 MAGNESIUM CIT 296ML ORAL SO 250   11.00
47105473 DAPTOMYCIN 500MG/10ML 636 J0878 1,628.00
47105474 POTASSIUM CHLORIDE ER 20MEQ 250   6.00
47105476 ARTIFICAL TEARS SOLN OPTH 250   13.00
47105477 TRIAMCINOLONE 40MG/ML MDV I 636 J3301 86.00
47105478 AQUACEL AG 1.2% TOP GEL 250   69.00
47105479 VENLAFAXINE 75MG CAP 250   6.00
47105480 FLUCONAZOLE 100MG TAB 250   11.00
47105481 PROPOFOL 10MG/20ML INJ 636 J3490 17.00
47105482 HEPATITIS B VACC ADULT 0.5M 636 90746 253.00
47105483 VECURONIUM 10MG/10ML INJ 636 J3490 21.00
47105484 ACETAMINOPHEN 160MG/5ML SUS 250   6.00
47105486 HEPATITIS B VACC =>20YRS 636 90746 253.00
47105487 MICONAZOLE 2% CREAM 250   19.00
47105488 OXYCODONE/APAP 5/325MG TAB 250   6.00
47105489 PHENLEPHRINE 1ML INJ 636 J2370 32.00
47105491 OLANZAPINE 10MG TAB 250   6.00
47105492 PROMETHAZINE 25MG TAB 250   6.00
47105493 PROPRANOLOL 10MG TAG 250   6.00
47105494 PROMETHAZINE 50MG/ML INJ 636 J2550 8.00
47105495 LITHIUM CARBONATE 300MG CAP 250   6.00
47105496 LORAZEPAM 0.5MG TAB 250   6.00
47105497 LORAZEPAM 1MG TAB 250   6.00
47105498 LOSARTAN 50MG TAB 250   6.00
47105499 MAGNESIUM SULF IGM/100ML IV 636 J3475 35.00
47105500 MAGNESIUM SULF 4GM/100ML IV 636 J3475 35.00
47105501 MECLIZINE CHEWABLE 25MG 250   6.00
47105502 METOPROLOL 50MG TAB 250   6.00
47105504 MICONAZOLE 2% VAG CREAM 250   23.00
47105505 MISOPROSTOL 100MCG TAB 250   7.00
47105506 MULTI VIT/MINERALS TAB 250   6.00
47105508 ROPIVACAINE HCL 400MG/200ML 636 J2795 437.00
47105509 ROPIVACAINE HCL 0.2% 2MG/2M 636 J2795 70.00
47105510 NAROPIN 0.2% 2MG/100ML IVP 636 J2795 192.00
47105512 CLOTRIMAZOLE 1% TOP CRM 30G 250   14.00
47105513 NICOTINE PATCH PATCH 14MG/2 250   12.00
47105514 PROMETHAZINE ORAL 6.25MG/5M 250   18.00
47105515 PROTAMINE 250MG/25ML INJ 636 J2720 139.00
47105516 PYRIDOXINE TAB 100MG 250   6.00
47105517 RIVAROXABAN 10MG TAB 250   65.00
47105518 PROMETHAZINE SD INJ 25MG/ML 636 J2550 8.00
47105519 NICOTINE 7MG PATCH 250   11.00
47105520 NIFEDIPINE 10MG CAP 250   8.00
47105521 OXYBUTYNIN 5MG TAB 250   6.00
47105522 OXYCODONE IR 5MG TAB 250   6.00
47105523 PENICILLIN VK 500MG TAB 250   6.00
47105524 NIFEDIPINE ER 30MG TAB 250   6.00
47105525 PHENOL SORE THROAT SPRAY 20 250   15.00
47105526 PHENYLEPHRINE 1% NASAL SPRA 250   29.00
47105527 PHENYLEPHRINE 10MG/1ML INJ 636 J2370 32.00
47105529 PIPERACILLIN TAZOBACT 4.5GM 636 J2543 55.00
47105530 POTASSIUM CL TAB 20MEQ 250   6.00
47105531 POTASSIUM CL TAB 8MEQ 250   6.00
47105532 POTASSIUM PHOS SDV 3MM0L/5M 636 J3490 60.00
47105534 PROMETHAZINE INJ 50MG/ML 636 J2550 8.00
47105535 QUETIAPINE 100MG TAB 250   6.00
47105537 PROPAFENONE 150MG TAB 250   6.00
47105539 SULFAMETHOX/TMP 800/160 TAB 250   6.00
47105540 IMMUNE GLOBULIN 500MG/KG 636 J1569 8,336.00
47105541 SILVER SULFADIAZINE 1% CRM 250   54.00
47105542 SIMETHICONE 20MG/0.3ML ORAL 250   11.00
47105543 SODIUM BICARB PFS 8.4% 636 J3490 60.00
47105544 SPIRONOLACTONE 25MG TAB 250   6.00
47105546 SULFACETAMIDE 10% OPHTH SOL 250   232.00
47105547 SULFAMETHOX/TMP 400-80MG IN 636 J3490 33.00
47105548 SULFAMETH/TRIM 80-16MG/ML I 636 J3490 66.00
47105549 SUCRALFATE SUSP 1GM/10ML SU 250   47.00
47105550 ISOSORBIDE DINITRATE 20MG T 250   6.00
47105551 TERAZOSIN 1MG CAP 250   8.00
47105553 TOPIRAMATE 25MG TAB 250   8.00
47105554 VANCOMYCIN 500MG INJ 636 J3370 14.00
47105555 MEGESTROL 400MG/10ML ORAL 250   16.00
47105556 ALBUTEROL SULFATE 90MCG/8GM 250   117.00
47105557 HALOPERIDOL 1MG TAB 250   6.00
47105559 FAMOTIDINE 20MG TAB 250   6.00
47105560 VFC/MM VARICELLA VACC 636 90716 21.00
47105561 VFC/MM TDAP 0.5ML INJ VACC 636 90715 21.00
47105562 VFC/MM ROTAVIRUS 1ML ORAL V 250 90680 21.00
47105563 VFC/MM ROTAVIRUS 1ML ORAL V 636 90680 21.00
47105564 VFC/MM POLIOVIRUS VACC 636 90713 21.00
47105565 VFC/MM PNEUMOCOCCAL13 VACC 636 90670 21.00
47105566 VFC/MM MMR 0.5ML INJ VACC 636 90707 21.00
47105567 VFC/MM MENINGOCOCCAL VACC 636 90734 21.00
47105571 VFC/MM HEP-B VACC 636 90744 21.00
47105572 VFC/MM HEP-A 0.5ML INJ VACC 636 90633 21.00
47105573 VFC/MM HAEMOPHILUS B VACC 636 90648 21.00
47105574 VFC/MM DTAP IPV VACC 636 90696 21.00
47105575 VFC/MM DTAP HIB IPV 0.5ML V 636 90698 21.00
47105576 VFC/MM DTAP HEPB IPV VACC 636 90723 21.00
47105578 WARFARIN 2MG TAB 250   6.00
47105579 NEOMYCIN/BACIT/POLY PKT 250   6.00
47105580 HPV 9 0.5ML INJ VACC 636 90649 1,002.00
47105581 MMR/VARICELLA 0.5ML INJ VAC 636 90710 1,053.00
47105582 BACLOFEN 10MG TAB 250   6.00
47105583 DILTIAZEM CD 120MG CAP 250   6.00
47105584 PHENYTOIN ER 100MG CAP 250   6.00
47105585 BUPROPION SR 150MG TAB 250   7.00
47105586 GLYBURIDE 5MG TAB 250   6.00
47105587 RAMIPRIL 2.5MG CAP 250   6.00
47105588 PRALIDOXIME 1GM INJ 636 J2730 685.00
47105589 DULOXETINE DR 20MG CAP 250   7.00
47105590 BENAZEPRIL 10MG TAB 250   6.00
47105591 LEVOTHYROXINE 88MCG TAB 250   6.00
47105592 OXYBUTYNIN 5MG TAB 250   6.00
47105593 ACETAZOLAMIDE 500MG INJ 636 J1120 117.00
47105594 GUAIFENESIN 5ML UNIT DOSE 250   6.00
47105595 TETANUS IMM GLOBULIN INJ 25 636 J1670 2,389.00
47105597 LABETOLOL HCL 100MG TAB 250   6.00
47105598 MINOXIDIL 2.5MG 250   6.00
47105599 NALTREXONE HCL 50MG TAB 250   13.00
47105601 RALTEGRAVIR POTASS 400MG TA 250   145.00
47105602 BUPHRENORPH8MG/NALOXONE2MG 250   32.00
47105603 EMTRICITAB200/TENOFOVIR300 250   326.00
47105604 MENTHOL/ZINC OXIDE 3.5GM PK 250   6.00
47105605 ZINC SULFATE 220MG TAB 250   6.00
47105606 VFC/MM DTAP VACC 636 90700 21.00
47105607 VFC/MM HPV9 0.5ML INJ VACC 636 90649 21.00
47105608 PSYLLIUM HUSK 12G PKT 250   6.00
47105609 SERTRALINE 25MG TAB 250   9.00
47105612 CALCIUM CARBONATE 500MG CHE 250   6.00
47105613 DIPHENHYDRAMINE 25MG/10ML E 250   8.00
47105614 BACITRACIN 500U/GM OINT 250   7.00
47105615 VFC MMRV 0.5ML INJ VACC 636 90710 21.00
47105616 ZOLEDRONIC ACID 5MG/100ML 636 J3489 837.00
47105617 VFC/MM MMR-V 0.5ML INJ VACC 636 90710 21.00
47105618 ABATACEPT 250MG INJ 636 J0129 3,061.00
47105619 ACETYLCYSTEINE 10% INHL/PO 250   33.00
47105620 FERRIC CARBOXYMALTOSE 50MG/ 636 J1439 3,300.00
47105622 PREDNISONE 20MG TAB 250   6.00
47105623 FOLIC ACID 1MG TAB 250   6.00
47105624 MIVACURIUM CHLORIDE 2MG/5ML 636 J3490 142.00
47105626 DOXAZOSIN 2MG TAB 250   6.00
47105627 FERROUS SULFATE EC 325MG 250   6.00
47105628 METHYLENE BLUE 0.5% 50MG/10 636 Q9968 833.00
47105629 NALOXONE PFS 2MG/2ML 636 J2310 166.00
47105630 PRAMIPEXOLE 0.25MG TAB 250   6.00
47105631 VFC ROTAVIRUS 1ML ORAL VACC 250 90681 21.00
47105632 CARBI/LEVODOPA 25/100MG TAB 250   21.00
47105633 GUAIFEN/DM 100-10MG/5ML SYR 250 J3490 16.00
47105634 EPOETIN 20,000 UNITS INJ 636 J0885 1,368.00
47105635 ADENOSINE 6MG/2ML INJ 636 J0153 62.00
47105636 ALPRAZOLAM 0.5MG TAB 250   21.00
47105637 AMIODARONE 50MG/9ML INJ 636 J0282 15.00
47105638 AMIODARONE 150MG/3ML INJ 636 J0282 6.00
47105639 AMMONIA INHALANT 250   6.00
47105641 VFC/MM MMRV 0.5 INJ VACC 636 90710 21.00
47105642 BETHAMETHASONE 6MG/ML 636 J0702 218.00
47105643 INFLUENZA QUAD 0.5 ML INJ V 636 90686 108.00
47105644 COLCHICINE 0.6 MG TAB 250   53.00
47105646 CLONIDINE 0.1MG/24HR PATCH 250   99.00
47105647 CYCLOBENZAPRINE 10MG TAB 250   6.00
47105648 GLIPIZIDE 5MG TAB 250   6.00
47105649 LORAZEPAM 0.5MG TAB 250   6.00
47105650 SENNOSIDES 8.6MG TAB 250   6.00
47105651 LABETALOL 5MG/ML INJ 20ML 258 J3490 54.00
47105652 NICARDIPINE 25MG/10ML INJ 636 J3490 99.00
47105653 PIPERACILL/TAZOB 3.375GM 636 J2543 30.00
47105654 ZOLEDRONIC ACIDMANNITOL/WAT 636 J3489 833.00
47105655 GLYCERIN SUPPOS INFANT PR 250   6.00
47105656 XYLOCAINE/EPINEPHRINE 1% IN 636 J2001 10.00
47105657 INFLUENZA QUAD 0.25ML INJ V 636 90685 105.00
47105658 TRANEXAMIC ACID 636 J3490 71.00
47105659 ATROPINE SULFATE 0.4MG/ML I 636 J0461 27.00
47105660 AMOX/POT 400MG/57MG BOTTLE 636 J3490 63.00
47105661 GENTAMICIN SULF OPHT 3MG/ML 636 J1580 33.00
47105662 MORPHINE SULFATE 4MG/ML INJ 636 J2270 7.00
47105663 STERILE WATER 10ML DILUENT 636 A4216 6.00
47105664 TERBUTALINE 1MG/ML INJ 636 J3105 15.00
47105665 LIDOCAINE HCL 1% MPF 2ML IN 636 J2001 7.00
47105666 PHENYTOIN 100MG/4ML INJ 636 J1165 30.00
47105670 SOD TETRADECYL SULF 10MG/ML 636 J3490 77.00
47105671 VFC INFLUENZA PF VACC 636 90685 21.00
47105674 MEDROXYPROGESTERONE 10MG TA 250   9.00
47105675 HYDROMORPHONE 1MG/ML INJ 636 J1170 11.00
47105678 DANTRIUM 20MG IV SDV 636   550.00
47105679 DOPAMINE HCL INJ 200MG/5ML 636 J1265 17.00
47105680 POTASSIUM CHL 10MEQ TAB 250   6.00
47105681 DOBUTAMINE 250MG/250ML IVPB 636 J1250 187.00
47105682 PANTOPRAZOLE 20MG TAB 250   6.00
47105683 MORPHINE ER 15MG TAB 250   6.00
47105684 METOPROLOL SUCC ER 25MG TAB 250   6.00
47105685 OSELTAMIVIR 75 MG TAB 250   61.00
47105686 POTASSIUM CHL 10MEQ/50ML IN 636 J3480 122.00
47105687 DICLOFENAC TOP GEL 1% 250   183.00
47105689 GABAPENTIN 300MG CAP 250   6.00
47105690 ADENOSINE INJ 12MG/4ML 636 J0153 80.00
47105693 VFC MENINGOCOCCAL 0.5ML VAC 636 90734 21.00
47105694 ROTAVIRUS 1ML ORAL VACC 250 90681 574.00
47105695 METHYLPREDNISOLONE 1GM INJ 636 J2930 141.00
47105696 SODIUM CHLORIDE 7% 4ML 250 A4216 6.00
47105698 NITROFURANTOIN 50MG TAB 250   15.00
47105699 BUMETANIDE .25 MG 636 J3490 13.00
47105700 DEXTROSE 10%/250ML 636 J7799 14.00
47105701 SODIUM BICARBONATE 650 MG T 250   5.50
47105702 ACETAMINOPHEN 325MG TAB 250   6.00
47105703 CIPROFLOXACIN INJ 400MG/200 636 J0744 13.65
47105704 CETIRIZINE HCL 10MG TAB 250   6.00
47105705 ALBUMIN HUMAN 12.5MG/50ML I 636 P9047 277.20
47105706 MIRTAZAPINE 30MG TAB 250   6.00
47105707 ISOSORBIDE DINITRATE 20MG T 250   6.00
47105708 HYDROXYZINE 10MG TAB 250   6.00
47105709 FILGRASTIM 300MCG/0.5ML INJ 636 J1442 1,558.35
47105710 MORPHINE 10MG/0.5ML ORAL 250   12.00
47105711 PHENOB/HYOSC/ATROP/SCOP ELI 250   167.70
47105712 EPHEDRINE 50MG/ML INJ 636 J3490 117.80
47105713 HAEMOPHILUS B INJ 0.5 INJ V 636 90648 68.70
47105714 POLIOVIRUS 0.5ML INJ VACC 636 90713 170.85
47105715 CLINDAMYCIN 900MG/6ML INJ 636   18.20
47105716 LIDOCAINE HCL 1% MPF 50MG/5 250   10.80
47105717 LIDOCAINE HCL 2% SDV 250   10.85
47105718 FOMEPIZOLE 1.5G/1.5ML INJ 250 J1451 3,300.00
47105719 CIPROFLOXACIN 500MG *6-PAK* 250   8.00
47105720 MICONAZOLE NITRATE CREAM 2% 250 J3490 9.00
47105721 BUPIVACAINE 0.5% 50MG/10ML 636 J2001 9.00
47105722 KETAMINE 100MG/ML INJ SDV 250 J3490 54.00
47105723 LORAZEPAM 1MG TAB *10-PAK* 250   7.00
47105724 ZOSTER VACC 0.5ML INJ 636 90750 823.00
47105725 ROTAVIRUS VACC 1ML ORAL 636 90681 521.00
47105726 VFC HPV-9 O.5ML INJ VACC 636 90649 21.00
47105727 VFC MMR 0.5ML INJ VACC 636 90707 21.00
47105728 VFC POLIOVIRUS 0.5ML INJ VA 636 90713 21.00
47105729 VFC INFLUENZA 6MO & UP VACC 636 90686 21.00
47105730 INFLUENZA VACC 6MTHS AND OL 636 90686 108.00
47105731 APAP-CODEINE 300-30MG SOLN 250   9.00
47105732 DEGARELIX 80MG INJ 636   1,557.00
47105733 MEDROXYPROGESTERONE 150MG I 636 96372 217.20
47105734 POTASSIUM CHL 10MEQ/100ML I 636 96365 35.00
47105735 BUPIVACAINE 0.5% MPF 10ML 636   23.00
47105736 ARTIFICIAL TEARS OINT 3.5GM 636   18.00
47105737 ESTONOGESTREL 68MG SUBDERMA 636 J7307 2,804.00
47105738 SODIUM HYPOCHLORITE 0.5% MI 250   62.00
47105739 TETANUS/DIPHTHERIA >7 Y/O 636 90714 113.00
47105740 LABETALOL 5MG/ML INJ. 636   10.00
47105741 SULFAMETHOX/TMP 800/160 SUS 250   9.00
47105742 SUCROSE 24% ORAL 15ML 250   6.00
47106000 INFLIXIMAB 100MG INJ 636 J1745 3,473.00
47106001 RACEPINEPHRINE 2.25% INHL 250   48.00
47106003 MAGNESIUM CHL 64MG TAB 250   6.00
47106009 CYANOCOBALAMIN INJ 1000MCG 636 J3420 11.00
47106017 CYANOCOBALAMIN 1000MCG INJ 636 J3420 13.52
47106018 CALCIUM CARBONATE 500MG TAB 250   6.00
47106019 BENZOCAINE/MENTH 15/3.6MG L 250   6.00
47106021 CEFTRIAXONE/D5W 1GM PREMIX 636 J0696 129.00
47106033 VFC MMR-II 0.5ML INJ VACC 636 90707 21.00
47106035 DTAP 0.5ML INJ VACC 636 90700 140.00
47106036 VFC DTAP 0.5ML INJ VACC 636 90700 21.00
47106037 VFC POLIOVIRUS 0.5ML INJ VA 636 90713 21.00
47106038 VFC DTAP HEPB IPV 0.5ML VAC 636 90723 21.00
47106039 VFC DTAP-IPV-HIB 0.5ML VACC 636 90698 21.00
47106040 VFC PNEUMOCOCCAL13 VACC 636 90670 21.00
47106041 VFC VARICELLA 0.5ML INJ VAC 636 90716 21.00
47106042 MENINGOCOCCAL 0.5ML INJ VAC 636 90734 654.00
47106043 VFC MENINGOCOCCAL 0.5ML VAC 636 90734 21.00
47106044 VFC DTAP IPV 0.5ML INJ VACC 636 90696 21.00
47106060 PIPER/TAZ 3.375G/15ML 636 J2543 143.00
47106062 PHENOBARBITAL 32.4MG TAB 250   6.00
47106077 HEP-B PED/ADOL 0.5ML INJ VA 636 90744 72.00
47106091 SODIUM POLYSTYR SUSP 15G/60 250   26.00
47106097 VFC TDAP 0.5ML INJ VACC 636 90715 20.00
47106098 VFC HEP-B 0.5ML INJ VACC 636 90744 21.00
47107003 PREGABALIN 50MG CAP 250   53.55
47107015 ATORVASTATIN 20MG TAB 250   6.00
47107017 PENTOXIFYLLINE 400MG TAB 250   21.00
47107023 TETRACAINE 1% 20MG/2ML INJ 636   63.00
47107026 ZINC OXIDE 30GM TOP OINT 250   12.00
47107027 DARBEOPEOTIN ALFA 500MCG IN 636 J0881 4,360.00
47107029 DTAP 0.5ML INJ VACC 636 90700 195.00
47107033 METHYLPREDNISOLONE 125MG/2M 636 J2930 47.00
47107034 METHYLPREDNISOLONE SOLU 40M 636 J2920 33.00
47107040 IRON DEXTRAN 100MG/2ML INJ 636 J1750 159.00
47107044 VFC DTAP 0.5ML INJ VACC 636 90700 21.00
47107058 OCTREOTIDE 20MG INJ 636 J2353 9,918.00
47107059 TOCILIZUMAB 400MG/20ML INJ 636 J3262 5,882.00
47107061 LEVOFLOXACIN 250MG TAB 250   70.00
47107062 LEVOTHYROXINE 75MCG TAB 250   6.00
47107066 DTAP-IPV 0.5ML INJ VACC 636 90696 324.00
47107071 BALANCED SALINE 500ML IRRIG 250   192.00
47107074 FERRIC SUBSULFATE 8GM TOP 250   136.00
47107080 OSELTAMIVIR 45MG CAP 250   26.00
47107081 OSELTAMIVIR 75MG CAP 250   89.00
47107082 OSELTAMIVIR 6MG/ML ORAL SUS 250   238.00
47107083 ACIDOPHILUS/BIFIDO 460MG CA 250   6.00
47107085 MAGNESIUM OXIDE 400 MG TAB 250   6.00
47107087 METHADONE 10MG TAB 250   6.00
47107088 MAGNESIUM SULF 1GM/2ML INJ 636 J3475 11.00
47107089 TERCONAZOLE 0.4% VAG CRM 45 250   60.00
47107091 SODIUM THIOSUL 250MG/ML INJ 250   327.00
47107094 OCTREOTIDE 30MG INJ 636 J2353 4,481.00
47107097 INSULIN GLARGINE 100U/ML IN 636 J1815 240.00
47107103 INSULIN HUMAN 70/30 INJ 3ML 636 J1815 259.00
47107112 ROCURONIUM 50MG/5ML INJ 250   48.00
47107222 ALUM/MAG/SIMETH SUSP 30ML 250   6.00
47107224 ESTRADIOL 0.1MG/DAY PATCH 250   48.00
47107225 LEUPROLIDE 22.5MG INJ 636 J9217 2,277.00
47107226 NYSTATIN CREAM 250   44.00
47107229 PHOSPHATE SODIUM PACKET 250   6.00
47107231 TRIAMCINOLONE 30GM CREAM 250   21.00
47107232 MANNITOL 20% 500ML IV PREMI 636 J2150 115.00
47107234 TD-TETANUS DIPH 0.5ML INJ V 636 90714 164.00
47107235 ZOLPIDEM 5MG TAB 250   6.00
47107242 ACETYLCYSTEINE 6GM/30ML INJ 636 J0132 584.00
47107243 WARFARIN 1MG TAB 250   6.00
47107248 VFC HEP-A 0.5ML INJ VACC 636 90633 21.00
47107250 TRYPAN BLUE - INTRAOCULAR I 636 Q9968 336.00
47107258 PANTOPRAZOLE 40MG TAB 250   6.00
47107264 PENICILLIN G POTASS 5MMU IN 636 J2540 59.00
47107265 PRAZOSIN 1MG CAP 250   6.00
47107267 ALBUTEROL INHALER 90MCG HFA 250   105.00
47107273 PNEUMOCOCCAL23 0.5ML INJ VA 636 90732 492.00
47107274 CHARCOAL W/SORBITAL 25GM OR 250   110.00
47107275 ALTEPLASE 2MG INJ 636 J2997 820.00
47107276 CHARCOAL 25GM ORAL SOL 250   110.00
47107283 GLUCOSE 40% ORAL GEL 250   30.00
47107285 DILTIAZEM 125MG/25ML INJ 250   50.00
47107291 MINERAL OIL STERILE TOPICAL 250   19.00
47107292 LIDOCAINE-EPINEPHRINE-TETRA 250   58.00
47107293 MINERAL OIL ENEMA 250   18.00
47107294 SODIUM NITRITE 300MG/10ML I 636   509.00
47107297 EPOETIN 10000U/ML INJ 636 J0885 1,118.00
47200001 ARTERIAL BLOOD WITHDRAWL 361 36600 139.00
47200003 GASES, BLOOD, PH ONLY 301 82800 49.00
47200005 COLLECT CAPILLARY BLOOD SPE 410 36416 21.00
47200006 FLOW VOLUME LOOP 460 94375 292.00
47200008 LUNG FUNCTION TEST (MBC/MVV 460 94200 102.00
47201005 PH OTHER BODY FLUID 301 83986 132.00
47201018 NEWBORN RESUSCITATION 720 99465 747.00
47201020 OXIMETRY CONT MONITOR 1ST D 460 94762 330.00
47201026 PULSE OX, MULTIPLE 460 94761 219.00
47201029 OXIMETRY SINGLE STUDY 460 94760 89.00
47201037 OXYGEN ADMIN SUBSEQ DAY 270   419.00
47201038 AIRWAY CLEARANCE SUBSEQUENT 410 94668 240.00
47201045 CPR 480 92950 933.00
47201057 CATH ASPIRATION NASOTRACHEA 410 31720 193.00
47201064 OXYGEN ADMINSTRATION INITIA 270   455.00
47201088 VENTILATION MGMT/ASSIST INI 410 94002 1,739.00
47201089 VENTILATOR MGMT;SUBQ DAY 410 94003 1,739.00
47201093 INTUBATION ASSIST 410 31500 573.00
47201122 ECG 12 LEAD M/C WELCOME 730 G0404 302.00
47201127 ECHO W/DOP & CF DOP 483 93306 1,715.00
47202001 CPAP (BI-PAP);INIT/MGMT 410 94660 1,739.00
47202003 HHN TX; SUBSEQUENT 410 94640 255.00
47202004 HHN TX, INITIAL 410 94640 255.00
47202008 IPPB TREATMENT,INITIAL 410 94640 91.00
47202010 DEMO/EVAL RT TX 410 94664 208.00
47202011 CONT INHALATION TX; 1ST HR 412 94644 219.00
47202012 CONT INHALATION TX; EA HOUR 412 94645 88.00
47202013 BLOOD GASES W/O2 SAT, DIREC 301 82805 198.00
47202014 CARBON MONOXIDE; QUANT 301 82375 79.00
47202015 METHEMOGLOBIN, QUANT 301 83050 48.00
47202016 HEMOGLOBIN; HGB 300 85018 19.00
47202017 U/S LWR EXT,ARTERIES,BI-LAT 920 93925 1,368.00
47202018 PHYSIOLOGIC STUDY BILAT U/L 920 93922 503.00
47202020 U/S EXTRACRANIAL ARTERIES;B 920 93880 1,038.00
47202021 U/S RENAL ARTERIES 920 93975 1,583.00
47202022 U/S EXT VENOUS STUDY; BI-LA 920 93970 1,130.00
47202023 U/S EXT VENOUS STUDY; UNI-L 920 93971 754.00
47202025 OXIMETRY CONT MONITOR SUBQ 460 94762 243.00
47202026 U/S LWR EXT,ARTERIES,UNI-LA 920 93926 670.00
47202028 U/S UPPER EXT, BI-LAT 920 93930 660.00
47202029 DUP-SCAN UPPER EXTREM; UNI/ 920 93931 443.00
47202030 AIRWAY CLEARANCE, INITIAL 410 94667 489.00
47202031 IPPB TX, SUBSEQ 410 94640 91.00
47202033 HOLTER MONITOR ANALYSIS W/R 731 93226 382.00
47202034 ADMIN DEFINITY CONTRAST 480 93352 114.00
47202035 AORTA-ILIAC LTD STUDY 920 93979 566.00
47202037 ECG 12 LEAD 730 93005 302.00
47202038 EKG;WELCOME M/C VISIT 730 G0404 302.00
47202039 ECG RYTHM STRIP; 1-3 LEADS 730 93041 140.00
47202040 EVENT MONITOR/OP TEACH HOOK 731 93268 2,478.00
47202041 STRESS TEST TRACING ONLY 482 93017 171.00
47202046 ECHO DOPPLER 483 93320 447.00
47202048 DOPPLER COLORFLOW 483 93325 257.00
47202049 ECHO;FOLLOW-UP/LTD STUDY 483 93308 533.00
47202050 ECHO WO DOP/CF DOP 483 93307 1,011.00
47202051 PATIENT TEACHING 410 99211 219.00
47202053 PEAK FLOW TX 460 94060 365.00
47202054 FUNCTIONAL RESIDUAL CAP 460 94727 183.00
47202055 VITAL CAPACITY 460 94150 201.00
47202056 CARBON MONOXIDE DIFF CAP 460 94729 252.00
47202057 PULMONARY/SPIROMETRY SCREEN 460 94010 207.00
47202058 DUPLEX SCAN AORTA COMPLETE 920 93978 789.00
47202059 CPAP (BI-PAP) SUBSEQ DAY 410 94660 1,739.00
47202060 MDI TX, INITIAL 410 94640 174.00
47202061 MDI TREATMENT SUBSEQUENT 410 94640 70.00
47202062 LIFEWATCH HOLT MONITOR 731 93225 509.00
47202063 STRESS ECHO COMPLETE 483 93351 915.00
47202064 EVENT MONITOR 731 93270 27.00
47211002 STRESS TEST;SUPV ONLY 985 93016 96.00
47211003 STRESS TEST I&R ONLY 985 93018 90.00
47211006 ECHO W/O DOP & CF DOP;PC 985 93307 224.00
47211007 DOPPLER ECHO EXAM; PC 985 93320 141.00
47211008 ECHO; FOLLOW UP OR LTD STUD 985 93308 125.00
47211114 DOPPLER COLOR FLOW;PC 985 93325 118.00
47211121 EKG;INTERP&RPT ONLY 985 93010 44.00
47211129 EKG INTERP/RPT MC ONLY 985 G0405 44.00
47211130 RHYTHM ECG, INTERP & RPT 985 93042 22.00
47211131 U/S LWR EXT ARTERIES;PC 960 93925 221.00
47211132 ECHO W/DOP & CF DOP;PC 985 93306 268.00
47211135 PHYSIOLOGIC STUDY;PC 960 93922 107.00
47211136 U/S EXTRACRANIAL ARTERIES;P 960 93880 192.00
47211137 U/S RENAL ARTERY;PC 960 93975 315.00
47211138 VENOUS STUDY BI-LAT;PC 960 93970 155.00
47211139 VENOUS STUDY UNI-LAT;PC 960 93971 108.00
47211140 U/S LWR EXT,ARTERIES,UNI-LA 960 93926 122.00
47211141 LIFEWATCH HOLTER/EVENT R&I 985 93272 86.00
47211143 U/S UPPER EXT,BI-LAT;PC 960 93930 148.00
47211144 U/S UPPER EXT,UNI-LAT;PC 960 93931 78.00
47211145 PROGRAM CARDIO DEVICE; EVAL 960 93279 155.00
47211148 AORTIC SCAN LTD; PC 960 93979 82.00
47211149 AORTIC SCAN COMPLETE;PC 960 93978 226.00
47211150 STRESS ECHO COMPLETE;PC 985 93351 186.00
47600001 PROCTOSIGMOIDOSCOPY;DX 750 45300 331.00
47600003 LIGATION HEMORRHOIDS,SNGL 750 46945 963.00
47600004 LARYNGOSCOPY,DIRECT W/BX 750 31535 748.00
47601001 COLONOSCOPY W/SNARE 750 45385 2,367.00
47601007 COLONOSCOPY W/HOT BX 750 45384 2,154.00
47601009 COLONOSCOPY BX;SNGL/MULTI 750 45380 2,154.00
47601012 EGD ESOPH W/DILATION <30 MM 750 43249 2,030.00
47601013 COLONOSCOPY DIAGNOSTIC 750 45378 2,154.00
47601015 EGD W/BIOPSY 750 43239 2,030.00
47601016 SIGMOIDOSCOPY W/BX, S/M 750 45331 1,034.00
47601017 SIGMOIDOSCOPY;DX 750 45330 1,034.00
47601018 EGD;CONTROL BLEED 750 43255 2,030.00
47601020 LARYNGOSCOPY,INDIRECT,DX 750 31505 459.00
47601021 EGD W/HOT BIOPSY 750 43250 2,030.00
47601024 ENDO W/TUBE PLACEMENT 750 43246 2,461.00
47601025 NASAL ENDO; DX 750 31231 232.00
47601031 COLONOSCOPY W/CNTRL BLEED 750 45382 2,154.00
47601032 COLONOSCOPY W/RMVL FB 750 45379 2,154.00
47601034 EGD DILATE GASTRIC STRICTUR 750 43245 2,030.00
47601036 SIGMOIDOSCOPY W/SNARE 750 45338 1,313.00
47601060 EGD W/BAND LIGATION 750 43244 2,030.00
47601061 UGI ENDO W/INJ;SCLEROSIS 750 43243 2,030.00
47601067 DX BRONCHOSCOPE/WASH 750 31622 2,397.00
47601068 INJ SCLEROSING SOLU,HEMOR 750 46500 722.00
47601069 EGD W/RMVL FOREIGN BODY 750 43247 2,030.00
47601070 BIOPSY, NASOPHARYNX 750 42806 869.00
47601200 LIGATE INTERNAL HEMORRHOIDS 750 46946 1,066.00
47601300 COLONOSCOPY W/LIGATION 750 45398 2,154.00
47601301 PROCTOSIGMOIDOSCOPY W/BX 750 45305 705.00
47601302 COLSC THRU STOMA W/HOT BIOP 750 44392 988.00
47601798 CYSTOSCOPY 750 52000 1,785.00
47601803 SIGMOID W/SUBMUCOUS INJ 750 45335 372.00
47601804 COLONOSCOPY,SUBMUCOUS INJ 750 45381 1,812.00
47601805 ESOPH ENDO W/BX 750 43202 1,187.00
47601806 SIGMOIDOSCOPY W/HOT BX 750 45333 1,114.00
47601807 ESOPHAGUS ENDOSCOPY 750 43200 900.00
47601820 UGI ENDO W/INJ; SUBMUC 750 43236 1,477.00
47601821 COLONOSCOPY (STOMA) 750 44388 1,371.00
47601822 HEMORRHOIDECTOMY,SIMPLE LIG 750 46221 861.00
47601823 CYSTOURETHROSCOPY, W/CALIB 750 52281 1,260.00
47601824 UGI ENDO; DIAGNOSTIC 750 43235 1,117.00
47601825 CYSTOURETHROSCOPY W/RMVL FB 750 52310 1,037.00
47601826 SIGMOIDOSCOPY W/DECOMPRESSI 750 45337 543.00
47601827 UNLISTED PX, STOMACH 750 43999 2,030.00
47601828 NASOPHARYNGOSCOPY W/ ENDOSC 750 92511 444.00
47601829 UGI, RMVL BY SNARE;TUMOR,PO 750 43251 679.00
47601830 ANOSCOPY W/DILATION 750 46604 1,933.00
47601831 COLONOSCOPY DX,HIGH RISK 750 G0105 2,154.00
47601832 CYSTOSCOPY W/RMVL OF CLOTS 750 52001 1,293.00
47601833 CYSTO W/RMVL FB; COMPLICATE 750 52315 1,458.00
47601834 COLONOSCOPY W/ABLATION 750 45388 1,892.00
47601835 DIAGNOSTIC ANOSCOPY; SPX 750 46600 134.00
47601836 SIGMOIDOSCOPY W/ABLATION 750 45346 1,185.00
47601837 MOD SED SAME PHYS/QHP 5/>YR 750 99152 76.00
47601838 MOD SED SAME PHYS/QHP EA AD 750 99153 39.00
47601839 COLONOSCOPY W/SNARE (STOMA) 750 44394 1,298.00
47601840 SIGMOIDOSCOPY FOR BLEEDING 750 45334 1,164.00
47601841 ESOPHAGOSCOPY;W/RMV FB 750 43215 1,752.00
47601842 COLONOSCOPY WITH DILATION 750 45386 1,152.00
47601843 COLONOSCOPY VIA STOMA WITH 750 44389 1,170.00
47610174 LIGATE HEMORRHOIDS,SNGL 960 46945 592.00
47611002 SIGMOIDOSCOPY;DX 960 45330 302.00
47611003 UGI ENDO;W/TUBE PLACEMENT 960 43246 1,019.00
47611005 COLONOSCOPY W/BX 960 45380 1,119.00
47611006 COLONOSCOPY W/HOT BX 960 45384 1,242.00
47611007 UGI ENDO;W/RMVL FB 960 43247 837.00
47611008 UGI ENDOSCOPY;DX 960 43235 710.00
47611011 SIGMOIDOSCOPY W/BX;S/M 960 45331 393.00
47611014 HEMORRHOIDECTOMY;SMPL LIG 960 46221 480.00
47611015 COLONOSCOPY;RMVL BY SNARE 960 45385 1,346.00
47611016 COLONOSCOPY;W/CNTRL BLEED 960 45382 1,276.00
47611018 DX BRONCHOSCOPE/WASH 960 31622 711.00
47611019 NASOPHARYNGOSCOPY W/ENDO 960 92511 338.00
47611020 ESOPHAGOSCOPY;W/RMV FB 960 43215 754.00
47611023 ESOPHAGUS ENDOSCOPY 960 43200 698.00
47611032 SIGMOIDOSCOPY W/HOT BX 960 45333 589.00
47611035 EGD BIOPSY SINGLE/MULTIPLE 960 43239 840.00
47611036 EGD W/REMOVAL BY SNARE 960 43251 926.00
47611037 BRONCHOSCOPY;W/BRUSHING 960 31623 677.00
47611040 EGD ESOPG W/DILATION <30 MM 960 43249 840.00
47611041 PROCTOSIGMOIDOSCOPY,DX 960 45300 196.00
47611042 UGI ENDO;W/CNTRL BLEEDING 960 43255 992.00
47611045 EGD DILATE STRICTURE 960 43245 799.00
47611046 COLONOSCOPY W/SNARE (STOMA) 960 44394 1,140.00
47611600 SIGMOIDOSCOPY W/DECOMPRESSI 960 45337 495.00
47611713 COLONOSCOPY DIAGNOSTIC 960 45378 985.00
47611714 CYSTOSCOPY 960 52000 522.00
47611717 UGI ENDO W/LIGATION 960 43244 977.00
47611718 COLONOSCOPY W/ABLATION 960 45388 1,358.00
47611719 COLSC THRU STOMA W/HOT BIOP 960 44392 922.00
47611720 ANOSCOPY DIAGNOSTIC; SPX 960 46600 186.00
47611721 SIGMOIDOSCOPY W/ABLATION 960 45346 605.00
47611806 COLONOSCOPY THRU STOMA;DX 960 44388 864.00
47611809 CYSTOURETHROSCOP W/RMV FB 960 52310 803.00
47611810 CYSTOURETHROSCOPY W/CALIB 960 52281 894.00
47611817 COLONOSCOPY,SUBMUCOUS INJ 960 45381 1,107.00
47611819 I&D RECTAL ABSCESS 960 46040 1,028.00
47611820 UGI ENDO W/SUBMUC INJ 960 43236 898.00
47611821 BIOPSY; NASOPHARYNX 960 42806 566.00
47611822 LIGATE HEMORRHOIDS;MULTIPLE 960 46946 854.00
47611823 UGI ENDO W/HOT BIOPSY 960 43250 860.00
47611824 INJ SCLEROSING SOLU, HEMORR 960 46500 333.00
47611826 LARYNGOSCOPY,DIRECT W/BX 960 31535 897.00
47611828 ANOSCOPY W/DILATION 960 46604 732.00
47611829 COLONOSCOPY DX, HI RISK 960 G0105 985.00
47611830 CYSTOSCOPY W/RMVL OF CLOTS 960 52001 921.00
47611831 MANIP OF TMJ W/ANESTHESIA 960 21073 1,129.00
47611832 CYSTO W/RMVL FB; COMPLICATE 960 52315 1,355.00
47611834 PROCTOSIGMOIDOSCOPY W/BX 750 45305 432.00
47611835 COLONSOCOPY W/LIGATION 960 45398 1,346.00
47611836 SIGMOIDOSCOPY W/SUBMUC INJ 960 45335 555.00
47611838 OP VISIT NEW; MODERATE/HIGH 960 99204 277.00
47611839 SIGMOIDOSCOPY FOR BLEEDING 960 45334 249.00
47611840 PF MOD SED SAME PHYS/QHP 5/ 960 99152 124.00
47611841 COLONOSCOPY WITH DILATION 960 45386 1,093.00
47611843 SIGMOIDOSCOPY WITH SNARE 960 45338 516.00
47611844 COLONOSCOPY VIA STOMA WITH 960 44389 1,439.00
47711000 THERAPEUTIC PX; 15 MINS 420 97110 106.00
47711001 GAIT TRAINING/15 MINS 420 97116 96.00
47711002 THERAPEUTIC ACTIVITIES/15 M 420 97530 116.00
47711005 NEUROMUSCULAR RE-EDUCATE 15 420 97112 112.00
47711006 MYOFACIAL RELEASE EA 15MINS 420 97140 100.00
47711007 COMM/WORK REINTEGRATION DIR 420 97537 100.00
47711008 PT EVAL LOW COMPLEX 420 97161 251.00
47711009 PT EVAL MOD COMPLEX 420 97162 282.00
47711010 PT EVAL HIGH COMPLEX 420 97163 314.00
47711011 PT RE-EVAL ESTAB PLAN CARE 420 97164 142.00
48700010 PUNCTURE ASP BREAST CYST 761 19000 715.00
48700011 THYROID NEEDLE BX 761 60100 491.00
48701002 THERAPEUTIC PHLEBOTOMY 940 99195 156.00
48701026 FETAL NST TC 920 59025 503.00
48701040 AMNIOCENTESIS;DX ONLY 761 59000 696.00
48701045 CARDIOVERSION EXTERNAL 761 92960 1,540.00
48701049 INSERT NON-TUNNEL CV CATH 761 36556 200.00
48701050 FNA W/IMAGE 761 10022 695.00
48701051 IV PUSH, SINGLE/INITIAL DRU 260 96374 207.00
48701053 THER/PROPH/DX INJ IM/SQ 260 96372 74.00
48701061 CHEMO,ANTI-NEOPLASM,SQ/IM 331 96401 300.00
48701062 CHEMO HORMN ANTINEO SQ/IM 331 96402 171.00
48701064 BX,PROSTATE;NEEDLE/PUNCH 761 55700 1,197.00
48701066 ASP/INJ THYROID CYST 761 60300 424.00
48701067 OP VISIT EST; NURSING VISIT 761 99211 56.00
48701068 DRAIN/INJ JT/BURSA W/O US 761 20610 311.00
48701071 REPLACE DUOD/JEJ TUBE 761 49451 3,555.00
48701073 DRESSING CHANGE NON BURNS 761 15852 126.00
48701074 POST-OP F/U VISIT 761 99024 -
48701075 I&D OF ABSCESS; COMPLICATED 761 10061 691.00
48701079 BLADDER SCAN 761 51798 89.00
48701085 TRIGGER PT INJ; 1/2 MUSCLES 761 20552 156.00
48701086 NEEDLE BIOPSY,MUSCLE 761 20206 746.00
48701087 BLADDER IRRIGAION/INSTILLAT 761 51700 274.00
48701088 EXC CYST, BREAST LESION 761 19120 1,813.00
48701089 LIVER BX; PERCUTANEOUS 761 47000 1,335.00
48701093 YAG LASER 761 66821 1,217.00
48701095 CHEMO ADM IV INF 1 HR, INIT 335 96413 597.00
48701096 CHEMO ADM IV INF, EA ADDTL 335 96415 134.00
48701098 ENDOVENOUS ABLATION 761 36475 6,875.00
48701099 I&D HEMATOMA/SEROMA/FLUID 761 10140 572.00
48701100 NEWBORN HEARING SCREEN OAE 471 92586 43.00
48701101 NEWBORN HEARING SCREEN ABR 471 92588 43.00
48701102 ABD PARACENTESIS W/IMAGING 761 49083 1,153.00
48701103 BREAST BX W/LOCALIZATION CL 761 19083 2,396.00
48701104 BREAST BX EA ADDTL LESION 761 19084 1,922.00
48701105 MANIPULATION KNEE; GEN ANES 761 27570 542.00
48701106 CONTRAST INJ,EVAL CV DEVICE 761 36598 397.00
48701107 SHOULDER MANIP UNDER ANESTH 761 23700 705.00
48701108 IRRIGATE IMPLANTED VAD 761 96523 88.00
48701109 ASPIRATION HYDROCELE 761 55000 414.00
48701110 IMPLANT PT-ACT EVENT RECORD 761 33282 817.00
48701111 BIOPSY LYMPH NODE SF NEEDLE 761 38505 431.00
48701112 BX ABD/RETROPERITONEAL MASS 761 49180 552.00
48701113 MOD SED SAME PHYS/QHP 5/>YR 761 99152 76.00
48701114 MOD SED SAME PHYS/QHP EA AD 750 99153 39.00
48701115 PLACEMENT OF BREAST CATHETE 761 19296 8,513.00
48701116 REMOVAL FOREIGN BODY/UPPER 761 24201 2,906.00
48701117 THORACENTESIS ASP W/IMAGING 761 32555 891.00
48701118 EACH ADDITION LESION 761 10004 300.00
48701119 FNA BX W ULTRASOUND 761 10005 432.00
48701120 EACH ADDITION LESION 761 10006 300.00
48701121 FNA BX W FLOUROSCOPY 761 10007 432.00
48701122 EACH ADDITION LESION 761 10008 300.00
48710002 ASP/INJ THYROID CYST 960 60300 310.00
48710015 CARDIOVERSION ELECTRIC 960 92960 523.00
48711002 LUMBAR SPINE PUNCTURE 960 62270 361.00
48711005 PROLNGD OP SRVCS;F/F 1ST HR 960 99354 203.00
48711021 INSERT TEMP BLADDER CATH 960 51702 225.00
48711024 OP VISIT;25 MINUTES 960 99214 173.00
48711033 PUNCTURE ASP BREAST CYST 960 19000 249.00
48711035 U/S GUIDE NEEDLE PLACEMENT; 960 76942 248.00
48711038 FETAL NST; PROF COMP 960 59025 80.00
48711042 FNA W/IMAGE 960 10022 347.00
48711049 OP VISIT LOW/MODERATE 960 99213 114.00
48711061 INSERT NON-TUNNEL CV CATH 960 36556 529.00
48711062 PUNCTURE ASPIRATION EACH AD 960 19001 106.00
48711063 BX,PROSTATE;NEEDLE/PUNCH 960 55700 588.00
48711065 U/S TRANSRECTAL;PC 960 76872 234.00
48711067 OP VISIT EST; MINIMAL 960 99211 50.00
48711084 REPLACE DUOD/JEJ TUBE 960 49451 2,293.00
48711085 I&D, COMPLEX, POSTOP WOUND 960 10180 573.00
48711086 ASP/INJ INTER JOINT/BURSA 960 20605 155.00
48711087 BIOPSY THYROID 960 60100 320.00
48711089 I&D OF ABSCESS; COMPL/MULTI 960 10061 403.00
48711090 POST-OP F/U VISIT 960 99024 -
48711091 OP VISIT EST; MINOR 960 99212 83.00
48711092 PROLONGED SERVICES EACH ADD 960 99355 191.00
48711095 0P VISIT NEW; MINOR 960 99201 104.00
48711096 OP VISIT; NEW PT 960 99202 131.00
48711099 OP VISIT NEW PT;MOD/HIGH 960 99205 340.00
48712000 NEG PRESSURE WND TX; <=50 C 960 97605 89.00
48712003 BIOPSY,MUSCLE,PERC NEEDLE 960 20206 347.00
48712004 EXC CYST, BREAST B9/MALIG L 960 19120 1,178.00
48712005 DRAIN/INJ JT/BURSA W/O US 960 20610 177.00
48712006 LIVER BIOPSY; PERCUTANEOUS 960 47000 538.00
48712007 FLURORSCOPY 1 HR PHY TIME 960 76000 286.00
48712009 ENDOVENOUS ABLATION VEIN 960 36475 5,489.00
48712010 I&D HEMATOMA/SEROMA/FLUID 960 10140 286.00
48712011 TX MISSED ABORT; 1ST TRI 960 59820 1,097.00
48712012 ABD PARACENTESIS W/IMAGING 960 49083 886.00
48712013 BREAST BIOPSY W/DEVICE 1ST 960 19083 1,582.00
48712014 BREAST BIOPSY EA ADDTL LESI 960 19084 1,268.00
48712015 INJ W/FLUOR EVAL CV DEVICE 960 36598 375.00
48712016 FIXATE SHOULDER W/ANESTHESI 960 23700 749.00
48712018 DRAINAGE OF HYDROCELE 960 55000 321.00
48712019 IMPLANT PT-ACT EVENT RECORD 960 33282 1,011.00
48712020 LYMPH NODE SF BIOPSY NEEDLE 960 38505 337.00
48712021 BX ABD/RETROPERITONEAL MASS 960 49180 442.00
48712022 ABD PARACENTESIS WO IMAGE 960 49082 402.00
48712023 PF MOD SED SAME PHYS/QHP 5/ 960 99152 124.00
48712024 KNEE JOINT MANIPULATION 960 27570 231.00
48712025 PLACEMENT OF BREAST CATHETE 960 19296 7,331.00
48712026 REMOVAL FOREIGN/BODY UPPER 960 24201 2,235.00
48712027 THORACENTESIS ASP W/IMAGING 960 32555 416.00
48712028 UNLISTED ABDOMINAL PROCEDUR 982 49999 1,225.00
48712029 EACH ADDITION LESION 982 10004 200.00
48712030 FNA BX W ULTRASOUND 1ST LES 982 10005 300.00
48712031 EACH ADDITION LESION 982 10006 200.00
48712032 FNA BX W FLOUROSCOPY 982 10007 300.00
48712033 EACH ADDITION LESION 982 10007 200.00
71870104 UNSPEC REMOV PROSTHODONTIC 521 D5899 84.00
71870105 CROWN CEMENTING 521 D6740 936.00
74101000 EXC B9 LESION; 0.5CM OR LES 521 11400 280.00
74101003 FINGERSTICK GLUCOSE 521 82962 28.00
74101004 ANOSCOPY DIAGNOSTIC 521 46600 230.00
74101005 OCCULT BLOOD FECES SCREENIN 521 82270 27.00
74101008 PURE TONE HEARING TEST AIR 471 92551 44.00
74101009 BLOOD COUNT; HEMOGLOBIN 521 85018 23.00
74101010 I&D ABSCESS;SIMPLE 521 10060 255.00
74101012 PARE/CUT B9 LESIONS; 2-4 521 11056 101.00
74101013 PARE/CUT B9 LESION >4 521 11057 119.00
74101014 OP VISIT NEW; MINOR 521 99201 104.00
74101015 TRIM NONDYSTROPHIC NAILS 521 11719 44.00
74101020 INSERTION INTRAUTERINE DEVI 521 58300 351.00
74101021 REMOVAL INTRAUTERINE DEVICE 521 58301 321.00
74101022 SMEAR, WET MOUNT (KOH) 521 87210 36.00
74101023 OP VISIT EST; MINIMAL 521 99211 61.00
74101025 VISUAL FIELD EXAM, LTD 521 92081 24.00
74101028 OP VISIT NEW; LOW/MODERATE 521 99202 158.00
74101030 OP VISIT EST; MINOR 521 99212 100.00
74101032 URINE PREGNANCY TEST VISUAL 521 81025 43.00
74101033 STREPTOCOCCUS, GROUP A SCRE 521 87880 67.00
74101036 OP VISIT NEW;MODERATE 521 99203 232.00
74101037 COLPOSCOPY OF CERVIX INCLUD 521 57454 576.00
74101038 OP VISIT EST; MINOR 521 99213 137.00
74101041 OP VISIT NEW;MODERATE/HIGH 521 99204 332.00
74101042 OP VISIT EST; MODERATE/HIGH 521 99214 205.00
74101043 OP VISIT NEW; MODERATE/HIGH 521 99205 410.00
74101044 OP VISIT EST;MODERATE/HIGH 521 99215 292.00
74101047 DESTR PREMALIG LES;1ST LES 521 17000 186.00
74101051 RMVL CERUMEN W/INSTRUMENT U 521 69210 130.00
74101052 PUNTURE ASP ABSCESS/HEMATOM 521 10160 290.00
74101053 PARE/CUT B9 LESION, SINGLE 521 11055 85.00
74101054 VASECTOMY UNI/BILATURAL INC 521 55250