BMC Patient Charges October 2019-September 2020

The new CMS IPPS/LTCH PPS rule requires hospitals to make public a list of their standard changes online in a machine-readable format. Burnett Medical Center (BMC) supports the intent of these new regulations to educate patients on the cost of health care and patient financial responsibilities. Below is a listing of those charges.
Charge# Description Cost
3905325 PROTIME $ 56.00
3908675 ANTICOAGULATION CLINIC $ 51.00
3908677 ANTICOAGULATION CLINIC $ 51.00
3909192 COLLECT, CAPILLARY SPEC $ 6.00
3291000 ANESTHESIA PRO FEE $ 14.00
3291001 ANESTHESIA PRO FEE $ 14.00
3291002 ANESTHESIA PRO FEE $ 14.00
3291003 ANESTHESIA PRO FEE $ 14.00
3291004 ANESTHESIA PRO FEE $ 14.00
3291005 ANESTHESIA PRO FEE $ 14.00
3291006 ANESTHESIA PRO FEE $ 14.00
3291007 ANESTHESIA PRO FEE $ 14.00
3291008 ANESTHESIA PRO FEE $ 14.00
3291009 ANESTHESIA PRO FEE $ 14.00
3291010 ANESTHESIA PRO FEE $ 14.00
3291011 ANESTHESIA PRO FEE $ 14.00
3291012 ANESTHESIA PRO FEE $ 14.00
3291013 ANESTHESIA PRO FEE $ 14.00
3291014 ANESTHESIA PRO FEE $ 14.00
3291015 ANESTHESIA PRO FEE $ 14.00
3291016 ANESTHESIA PRO FEE $ 14.00
3291017 ANESTHESIA PRO FEE $ 14.00
3291018 ANESTHESIA PRO FEE $ 14.00
3291019 ANESTHESIA PRO FEE $ 14.00
3291020 ANESTHESIA PRO FEE $ 14.00
3291021 ANESTHESIA PRO FEE $ 14.00
3291022 ANESTHESIA PRO FEE $ 14.00
3291023 ANESTHESIA PRO FEE $ 14.00
3291024 ANESTHESIA PRO FEE $ 14.00
3291026 ANESTHESIA PRO FEE $ 14.00
3291027 ANESTHESIA PRO FEE $ 14.00
3291028 ANESTHESIA PRO FEE $ 14.00
3291029 ANESTHESIA PRO FEE $ 14.00
3291030 ANESTHESIA PRO FEE $ 14.00
3291031 ANESTHESIA PRO FEE $ 14.00
3291032 ANESTHESIA PRO FEE $ 14.00
3291033 ANESTHESIA PRO FEE $ 14.00
3291034 ANESTHESIA PRO FEE $ 14.00
3291035 ANESTHESIA PRO FEE $ 14.00
3291036 ANESTHESIA PRO FEE $ 14.00
3291037 ANESTHESIA PRO FEE $ 14.00
3291038 ANESTHESIA PRO FEE $ 14.00
3291039 ANESTHESIA PRO FEE $ 14.00
3291040 ANESTHESIA PRO FEE $ 14.00
3291041 ANESTHESIA PRO FEE $ 14.00
3291042 ANESTHESIA PRO FEE $ 14.00
3291043 ANESTHESIA PRO FEE $ 14.00
3291044 ANESTHESIA PRO FEE $ 14.00
3291045 ANESTHESIA PRO FEE $ 14.00
3291046 ANESTHESIA PRO FEE $ 14.00
3291047 ANESTHESIA PRO FEE $ 14.00
3291048 ANESTHESIA PRO FEE $ 14.00
3291049 ANESTHESIA PRO FEE $ 14.00
3291050 ANESTHESIA PRO FEE $ 14.00
3291051 ANESTHESIA PRO FEE $ 14.00
3291052 ANESTHESIA PRO FEE $ 14.00
3291053 ANESTHESIA PRO FEE $ 14.00
3291054 ANESTHESIA PRO FEE $ 14.00
3291055 ANESTHESIA PRO FEE $ 14.00
3291056 ANESTHESIA PRO FEE $ 14.00
3291057 ANESTHESIA PRO FEE $ 14.00
3291058 ANESTHESIA PRO FEE $ 14.00
3291059 ANESTHESIA PRO FEE $ 14.00
3291060 ANESTHESIA PRO FEE $ 14.00
3291061 ANESTHESIA PRO FEE $ 14.00
3291062 ANESTHESIA PRO FEE $ 14.00
3291063 ANESTHESIA PRO FEE $ 14.00
3291064 ANESTHESIA PRO FEE $ 14.00
3291065 ANESTHESIA PRO FEE $ 14.00
3291066 ANESTHESIA PRO FEE $ 14.00
3291067 ANESTHESIA PRO FEE $ 14.00
3291068 ANESTHESIA PRO FEE $ 14.00
3291069 ANESTHESIA PRO FEE $ 14.00
3291070 ANESTHESIA PRO FEE $ 14.00
3291071 ANESTHESIA PRO FEE $ 14.00
3291072 ANESTHESIA PRO FEE $ 14.00
3291073 ANESTHESIA PRO FEE $ 14.00
3291074 ANESTHESIA PRO FEE $ 14.00
3291075 ANESTHESIA PRO FEE $ 14.00
3291076 ANESTHESIA PRO FEE $ 14.00
3291077 ANESTHESIA PRO FEE $ 14.00
3291078 ANESTHESIA PRO FEE $ 14.00
3291079 ANESTHESIA PRO FEE $ 14.00
3291080 ANESTHESIA PRO FEE $ 14.00
3291081 ANESTHESIA PRO FEE $ 14.00
3291082 ANESTHESIA PRO FEE $ 14.00
3291083 ANESTHESIA PRO FEE $ 14.00
3291084 ANESTHESIA PRO FEE $ 14.00
3291085 ANESTHESIA PRO FEE $ 14.00
3291086 ANESTHESIA PRO FEE $ 14.00
3291087 ANESTHESIA PRO FEE $ 14.00
3291088 ANESTHESIA PRO FEE $ 14.00
3291089 ANESTHESIA PRO FEE $ 14.00
3291090 ANESTHESIA PRO FEE $ 14.00
3291091 ANESTHESIA PRO FEE $ 14.00
3291092 ANESTHESIA PRO FEE $ 14.00
3291093 ANESTHESIA PRO FEE $ 14.00
3291094 ANESTHESIA PRO FEE $ 14.00
3291095 ANESTHESIA PRO FEE $ 14.00
3291096 ANESTHESIA PRO FEE $ 14.00
3291097 ANESTHESIA PRO FEE $ 14.00
3291098 ANESTHESIA PRO FEE $ 14.00
3291099 ANESTHESIA PRO FEE $ 14.00
3291100 ANESTHESIA PRO FEE $ 14.00
3291101 ANESTHESIA PRO FEE $ 14.00
3291102 ANESTHESIA PRO FEE $ 14.00
3291103 ANESTHESIA PRO FEE $ 14.00
3291105 ANESTHESIA PRO FEE $ 14.00
3291106 ANESTHESIA PRO FEE $ 14.00
3291107 ANESTHESIA PRO FEE $ 14.00
3291108 ANESTHESIA PRO FEE $ 14.00
3291109 ANESTHESIA PRO FEE $ 14.00
3291110 ANESTHESIA PRO FEE $ 14.00
3291111 ANESTHESIA PRO FEE $ 14.00
3291112 ANESTHESIA PRO FEE $ 14.00
3291113 ANESTHESIA PRO FEE $ 14.00
3291204 ANESTHESIA PRO FEE $ 14.00
3292000 ANES PRO FEE $ 208.00
3292001 ANES PRO FEE $ 208.00
3292002 ANES PRO FEE $ 208.00
3292003 ANES PRO FEE $ 208.00
3292004 ANES PRO FEE $ 208.00
3292005 ANES PRO FEE $ 208.00
3292006 ANES PRO FEE $ 208.00
3292007 ANES PRO FEE $ 208.00
3292008 ANES PRO FEE $ 208.00
3292009 ANES PRO FEE $ 208.00
3292010 ANES PRO FEE $ 208.00
3292011 ANES PRO FEE $ 208.00
3292012 ANES PRO FEE $ 208.00
3292013 ANES PRO FEE $ 208.00
3292014 ANES PRO FEE $ 208.00
3292015 ANES PRO FEE $ 208.00
3292016 ANES PRO FEE $ 208.00
3292017 ANES PRO FEE $ 208.00
3292018 ANES PRO FEE $ 208.00
3292019 ANES PRO FEE $ 208.00
3292020 ANES PRO FEE $ 208.00
3292021 ANES PRO FEE $ 208.00
3292022 ANES PRO FEE $ 208.00
3292023 ANES PRO FEE $ 208.00
3292024 ANES PRO FEE $ 208.00
3292026 ANES PRO FEE $ 208.00
3292027 ANES PRO FEE $ 208.00
3292028 ANES PRO FEE $ 208.00
3292029 ANES PRO FEE $ 208.00
3292030 ANES PRO FEE $ 208.00
3292031 ANES PRO FEE $ 208.00
3292032 ANES PRO FEE $ 208.00
3292033 ANES PRO FEE $ 208.00
3292034 ANES PRO FEE $ 208.00
3292035 ANES PRO FEE $ 208.00
3292036 ANES PRO FEE $ 208.00
3292037 ANES PRO FEE $ 208.00
3292038 ANES PRO FEE $ 208.00
3292039 ANES PRO FEE $ 208.00
3292040 ANES PRO FEE $ 208.00
3292041 ANES PRO FEE $ 208.00
3292042 ANES PRO FEE $ 208.00
3292043 ANES PRO FEE $ 208.00
3292044 ANES PRO FEE $ 208.00
3292045 ANES PRO FEE $ 208.00
3292046 ANES PRO FEE $ 208.00
3292047 ANES PRO FEE $ 208.00
3292048 ANES PRO FEE $ 208.00
3292049 ANES PRO FEE $ 208.00
3292050 ANES PRO FEE $ 208.00
3292051 ANES PRO FEE $ 208.00
3292052 ANES PRO FEE $ 208.00
3292053 ANES PRO FEE $ 208.00
3292054 ANES PRO FEE $ 208.00
3292055 ANES PRO FEE $ 208.00
3292056 ANES PRO FEE $ 208.00
3292057 ANES PRO FEE $ 208.00
3292058 ANES PRO FEE $ 208.00
3292059 ANES PRO FEE $ 208.00
3292060 ANES PRO FEE $ 208.00
3292061 ANES PRO FEE $ 208.00
3292062 ANES PRO FEE $ 208.00
3292063 ANES PRO FEE $ 208.00
3292064 ANES PRO FEE $ 208.00
3292065 ANES PRO FEE $ 208.00
3292066 ANES PRO FEE $ 208.00
3292067 ANES PRO FEE $ 208.00
3292068 ANES PRO FEE $ 208.00
3292069 ANES PRO FEE $ 208.00
3292070 ANES PRO FEE $ 208.00
3292071 ANES PRO FEE $ 208.00
3292072 ANES PRO FEE $ 208.00
3292073 ANES PRO FEE $ 208.00
3292074 ANES PRO FEE $ 208.00
3292075 ANES PRO FEE $ 208.00
3292076 ANES PRO FEE $ 208.00
3292077 ANES PRO FEE $ 208.00
3292078 ANES PRO FEE $ 208.00
3292079 ANES PRO FEE $ 208.00
3292080 ANES PRO FEE $ 208.00
3292081 ANES PRO FEE $ 208.00
3292082 ANES PRO FEE $ 208.00
3292083 ANES PRO FEE $ 208.00
3292084 ANES PRO FEE $ 208.00
3292085 ANES PRO FEE $ 208.00
3292086 ANES PRO FEE $ 208.00
3292087 ANES PRO FEE $ 208.00
3292088 ANES PRO FEE $ 208.00
3292089 ANES PRO FEE $ 208.00
3292090 ANES PRO FEE $ 208.00
3292091 ANES PRO FEE $ 208.00
3292092 ANES PRO FEE $ 208.00
3292093 ANES PRO FEE $ 208.00
3292094 ANES PRO FEE $ 208.00
3292095 ANES PRO FEE $ 208.00
3292096 ANES PRO FEE $ 208.00
3292097 ANES PRO FEE $ 208.00
3292098 ANES PRO FEE $ 208.00
3292099 ANES PRO FEE $ 208.00
3292100 ANES PRO FEE $ 208.00
3292101 ANES PRO FEE $ 208.00
3292102 ANES PRO FEE $ 208.00
3292103 ANES PRO FEE $ 208.00
3292105 ANES PRO FEE $ 208.00
3292106 ANES PRO FEE $ 208.00
3292107 ANES PRO FEE $ 208.00
3292108 ANES PRO FEE $ 208.00
3292109 ANESTHESIA PRO FEE $ 208.00
3292110 ANES PRO FEE $ 208.00
3292111 ANES PRO FEE $ 208.00
3292112 ANES PRO FEE $ 208.00
3292113 ANES PRO FEE $ 208.00
3292204 ANES PRO FEE $ 208.00
3293000 TRIGGER POINT INJ 1-2 $ 247.00
3293001 TRIGGER POINT INJ 1-2 $ 247.00
3293002 TRIGGER POINT INJ 3+ $ 244.00
3293003 SACROILIAC JOINT INJ $ 737.00
3293004 SACROILIAC JOINT INJ $ 493.00
3293005 SACROILIAC JOINT INJ $ 493.00
3293006 INTUBATION/ EMERGENCY $ 932.00
3293007 LARYNGOSCOPY W/FB $ 622.00
3293008 INTRODUC/ NEEDLE PERIPHER $ 63.00
3293009 VENIPUNCTURE UNDER 3YO $ 63.00
3293010 VENIPUNCTURE 3YO & OLDER $ 63.00
3293011 PICC LINE INSERTION $ 624.00
3293012 PICC LINE INSERTION $ 624.00
3293013 REPLACEMENT/ PICC LINE $ 896.00
3293014 REMOVAL TUNNELED CV CATH $ 1,287.00
3293015 N/G TUBE PLACEMENT $ 484.00
3293016 LUMBAR PUNCTURE, DIAG $ 1,361.00
3293017 LUMBAR PUUNCTURE /REDUCED $ 1,361.00
3293018 LUMBAR PUNCTURE / DISCONT $ 476.00
3293019 SPINAL PUNCTURE / THERAPE $ 1,430.00
3293020 BLOOD PATCH $ 843.00
3293021 INJECTION /SUBS/SUBARACHN $ 1,361.00
3293023 CAUDAL STEROID INJECTION $ 593.00
3293024 LUMBAR EPIDURAL SGLE DISC $ 164.00
3293025 EPIDURAL / CATH PLACEMENT $ 792.00
3293026 EPIDURAL / CATH PLACEMENT $ 792.00
3293027 EPIDERMAL CONT INFUSION $ 727.00
3293028 FEMORAL NREVE BLK SGL BIL $ 507.00
3293029 FEMORLA NERVE BLK SGL LT $ 406.00
3293030 FEMORAL NERVE BLK SGL RT $ 406.00
3293031 TRANSFORAMEN EPIDURAL LUM $ 1,157.00
3293032 TRANSFORAMEN EPIDURAL LUM $ 187.00
3293033 TRANSFORAMEN EPIDURAL LUM $ 770.00
3293034 TRANSFORAMEN EPIDURAL LUM $ 770.00
3293035 TRANSFORAMEN EPID ADD BIL $ 727.00
3293036 TRANSFORAMEN EPIDURAL ADD $ 484.00
3293037 TRANSFORAMEN EPIDURAL ADD $ 484.00
3293038 CARDIOPULMONARY RESUSCIT $ 1,353.00
3293039 ANESTHESIA/ EXTREME AGE $ 0.00
3293040 ANESTHESIA / EMERGENCY $ 0.00
3293041 CONSCIOUS SEDATION < 5YRS $ 529.00
3293042 CONSCIOUS SEDATION 5YRS + $ 351.00
3293043 CONSCIOUS SEDATION EA 15M $ 351.00
3293046 OUTPATIENT VISIT NEW 10MN $ 153.00
3293047 OUTPATIENT VISIT NEW 20MN $ 299.00
3293048 OUTPATIENT VISIT NEW 30MN $ 385.00
3293049 OUTPATIENT VISIT NEW 45MN $ 764.00
3293050 OUTPATIENT VISIT NEW 60MN $ 988.00
3293051 OUTPATIENT VISIT EST 5MN $ 56.00
3293052 OUTPATIENT VISIT EST 10MN $ 152.00
3293053 OUTPATIENT VISIT EST 15MN $ 300.00
3293054 OUTPATIENT VISIT EST 25MN $ 462.00
3293055 OUTPATIENT VISIT EST 40MN $ 652.00
3293056 ATTENDANCE / STABIL BIRTH $ 554.00
3293057 RESUSCITATION/POS PRES VE $ 1,039.00
3293058 FEMORAL NERVE PAIN MGMT $ 406.00
3293059 FEMORAL NERVE PAIN MGMT $ 406.00
3293060 ARTERIAL PUNCTURE $ 86.00
3293061 ARTERIAL PUNCTURE $ 86.00
3293062 INTUBATION / EMERGENCY $ 932.00
3293063 US GUID VASCULAR ACCESS $ 267.00
3293064 FEMORAL NERVE BLK SINGLE $ 585.00
3293065 GASTRIC TUBE INSERTION $ 113.00
3293066 PLACE CATH JUGULAR VEIN $ 901.00
3293067 INTRODUC/ NEEDLE PERIPH $ 63.00
3293068 LARYNGOSCOPY / ASPIRATION $ 628.00
3293069 INTRODUC NEEDLE PERIPHER $ 63.00
3293071 LUMBAR PUNCTURE DIAG $ 1,361.00
3293072 SCIATIC NERVE INJECTION SNG LT $ 394.00
3293073 SCIATIC NERVE INJECTION SNG RT $ 394.00
3293074 INJECTION SUBST/ EPIDUR/SUBARACH $ 1,361.00
3293075 INJECTION DIAG/THERAP EPIDUR/SUBARACH $ 593.00
3293076 EPIDURAL/SUBARA CATH PLACEMENT $ 792.00
3293077 EPIDURAL CONT INFUSION $ 727.00
3295000 FLUORO GUIDANCE NEEDLE PL $ 211.00
3295001 US GUIDE NEEDLE PLACEMENT $ 211.00
3295002 FLUOROGUIDE SPINE INJEC $ 954.00
3295003 FLUORO GUIDANCE NEEDLE PL $ 211.00
3295004 US GUIDANCE NEEDLE PLACE $ 211.00
3295005 VENIPUNCTURE NON ROUT JUGUL/FEMORAL <3YO $ 150.00
3303880 VERSED 2MG/ ML ELIXIR $ 6.00
3305006 ACETAMINOPHEN SUPP 120MG $ 9.00
3305007 TYLENOL 325MG SUPP $ 9.00
3305008 ACETAMINOPHEN SUPP 650MG $ 9.00
3305020 TETRACAINE 1% AMP 2ML $ 40.00
3305027 ADENOSINE SRN 6MG/2ML $ 55.00
3305029 ALBUTEROL INHALER $ 67.00
3305031 BETAMETHASONE SUSP 3MG $ 30.00
3305036 SUCCINYLCHOLINE CHLOR 20M $ 29.00
3305049 AMIODARONE VL 30MG X 5 $ 52.00
3305053 ATROPINE INJ 0.4MG $ 27.00
3305100 ATROPINE 0.01MG (1MG/10ML) $ 0.00
3305124 ZEMURON 10MG $ 21.00
3305131 BETAMETHASONE 3MG INJ $ 25.00
3305178 CALCIUM CHLORIDE 1G/10ML $ 30.00
3305190 DEXAMETHASONE INJ 1MG/ML $ 3.00
3305199 HEMABATE 250 MCG/ML $ 186.00
3305213 CEFOXITIN 1GM INJ $ 58.00
3305253 CLINDAMYCIN 300MG/2ML X 3 $ 52.00
3305276 DANTROLENE 20MG VIAL MH $ 138.00
3305283 DOLASETRON 10 MG AMP $ 98.00
3305291 EPHEDRINE SRN 50MG/ 5ML $ 36.00
3305316 FENTANYL 2ML 100MCG $ 26.00
3305319 FLUTHANE - HALATHANE1/2HR $ 60.00
3305320 NITROUS OXIDE PER 30 MIN $ 29.00
3305329 DIPHENHYDRAMINE 50MG/ML $ 25.00
3305350 DOPAMINE 40MGX10/250ML $ 0.00
3305382 EPHEDRINE VL 50MG/ML $ 25.00
3305383 EPINEPHRINE 0.1MG VIAL X 10 $ 3.00
3305386 EPINEPHRINE 0.1MG SYR X 10 $ 3.00
3305432 DROPERIDOL 5MG $ 30.00
3305436 ISOFLURANE 1/2 HR $ 131.00
3305475 CEFAZOLIN 500MG $ 17.00
3305481 KETAMINE 150MG/ML $ 30.00
3305482 LABETALOL 5MG /ML 4ML $ 26.00
3305483 GENTAMYCIN 80MG INJ $ 47.00
3305489 LASIX 20MG $ 25.00
3305506 TORADOL 15MG INJ $ 25.00
3305523 HESPAN 500ML $ 42.00
3305529 HYDRALAZINE 20MG/ML $ 41.00
3305535 BUPIVECAINE /ML $ 21.00
3305536 BUPIVACAINE .025%/ML $ 21.00
3305537 MARCAINE PF SAB/EPID VL $ 25.00
3305539 FLUMAZENIL 0.5MG/5ML VIAL $ 33.00
3305543 MEPERIDINE 100MG $ 24.00
3305548 HYDROMORPHONE 2MG/ML $ 26.00
3305561 MORPHINE 10MG INJ $ 26.00
3305562 ASTRAMORPH PF 10MG INJ $ 22.00
3305563 SEVOFLURANE /ML $ 22.00
3305564 MARCAINE .75AMP SPINAL $ 19.00
3305578 INDIGO CARMINE $ 28.00
3305579 NA PENTOTHAL 500MG SYR $ 44.00
3305580 PROPOFOL 20ML/AMP $ 23.00
3305581 NALOXONE 0.4MG/ML 1ML VL $ 29.00
3305582 REMIFENTANIL VL 1MG $ 80.00
3305583 SUFENTANIL 100MCG/2ML $ 31.00
3305584 PROPOFOL 10MG (500MG VL) $ 1.00
3305586 PHENYLEPHRINE SYN 1MG/10M $ 41.00
3305587 PHENYLEPHRINE 10MG/ML VIAL $ 36.00
3305640 PROMETHAZINE 50MG $ 23.00
3305645 CAF SOD BENZ 500MG VIAL $ 29.00
3305648 PITOCIN INJ. 10U $ 55.00
3305662 LIDOCAINE DOSE 1% 10MG/ML $ 24.00
3305663 LIDOCAINE 2% 20MG/ML DOSE MPF $ 24.00
3305701 NEOSTIGMINE 0.5MG VL $ 24.00
3305717 METOCLOPRAMIDE 10MG/2CC $ 25.00
3305723 GLYCOPYROLATE 0.2MG/ML $ 21.00
3305750 METHERGINE AMP 02.MG/ML $ 35.00
3305752 METHYLPREDNS AC VL 40MG $ 16.00
3305754 METHYLPREDNS SS 125MG $ 17.00
3305767 METOPROLOL 5MG/5ML AMP $ 10.00
3305768 DEPO MEDROL 80MG $ 91.00
3305769 ESMOLOL 100MG /VIAL $ 51.00
3305778 MIDAZOLAM 1MG (2MG/2ML) X2 $ 13.00
3305780 MIDAZOLAM SRP DOS 2MG/ML $ 9.00
3305795 SUFENTANIL 50MCG/ML AMP $ 30.00
3305797 DES $ 227.00
3305820 NUBAIN 10MG VL $ 26.00
3305844 NITROGLYCERIN PASTE 2% 1 G $ 10.00
3305849 NITRO 0.4MG SL $ 9.00
3305850 NITROGLYCERIN 50MG/250ML $ 32.00
3305884 VERSED 1MG $ 23.00
3305885 MIDAZOLAM VL 1MG/ML X5 $ 5.00
3305915 PHENYLEPHRINE SPR 0.5% $ 22.00
3305928 ZOSYN 1.125GM (3.375) X 3 $ 25.00
3305943 LIDOCAINE 100MG PER VIAL $ 25.00
3305944 XYLOCAINE 0.5% 50CC $ 19.00
3305948 XYLOCAINE 1% 50CC $ 19.00
3305997 ZOFRAN 1MG IV $ 23.00
3306006 ADRENALIN INJ.1ML $ 22.00
3306007 VASOPRESSIN 20U VIAL $ 26.00
3306008 RACEPINEPHRINE 2.25% INHA $ 10.00
3306014 RANITIDINE 25MG (50MG) X 2 $ 27.00
3306069 SOD BICARB 50MEQ/50ML SYR $ 32.00
3306073 BICITRA 30ML PO $ 18.00
3306143 TRIAMCINOLIN 10MG INJ $ 28.00
3306169 VANCOMYCIN 500MG (1GM)X 2 $ 28.00
3306192 SCOPOLAMINE 1.5MG PATCH $ 41.00
3306251 SOLUCORTEF 100MG INJ $ 56.00
3306464 ETOMIDATE 2MG/ML 10ML $ 35.00
3306476 FAT EMULSION 20% 250ML BG $ 62.00
3306504 HYDROMORPHONE 1MG/ML $ 27.00
3306513 KETAMINE 50MG/ML $ 30.00
3306514 PHENYLEPHRINE 1MG/10ML SYR $ 28.00
3306516 LIDOCAINE LTA 360 KIT $ 25.00
3306517 LEVONORGESTR TAB 0.75MGX2 $ 51.00
3306625 EMLA CREAM $ 70.00
3306627 NEOSTIGMINE MDV DOSE 0.5MG $ 11.00
3306661 INTUBATION/EMERGENCY $ 893.00
3306702 LUMBAR PUNCTURE $ 455.00
3306703 BLOOD PATCH $ 465.00
3307117 TRIGGER POINT INJ 1-2 $ 661.00
3307500 ALPHA-STIM STIMULATOR $ 270.00
3307513 TRANSFORAMINAL EPIDURAL W IMAG $ 1,813.00
3307532 TRANSFORAMEN EPID EA ADD LEVEL $ 845.00
3307539 INJECTION PARAVERTABRAL JNT L/S $ 1,813.00
3307540 INJECTION, INTERLAMINAR,EPIDURAL, CERVIC $ 1,465.00
3308000 ANES GENERAL 1ST HR $ 548.00
3308001 ANES GENERAL ADD 15MN $ 138.00
3308112 ALBUTEROL INH SOL 3ML $ 8.00
3308113 NEOSTIGMINE DOSE 0.5MGX1 (J2710) $ 25.00
64484 TRANSFORMINAL EPIDURAL W IMAG EA + LEVEL $ 146.00
0298T EXT ELECTROCARDIOGRAPHIC INTERP 3/14 $ 68.00
10021 FINE NEEDLE ASPIRATION $ 417.00
10040 ACNE SURGERY $ 279.00
10060 I & D, ABCESS $ 320.00
10061 I & D ABCESS $ 564.00
10080 I&D PILONIDAL CYST $ 501.00
10081 DRAINAGE PILONIDAL CYST $ 756.00
10120 F-BODY REMOVAL, SUBQ,SIMPLE $ 423.00
10121 REMOVAL FOREIGN BODY $ 764.00
10140 I & D OF HEMATOMA $ 452.00
10160 ABCESS/PUNC ASPIRATION $ 362.00
10180 PHYS / COMPL DRAIN WOUND $ 679.00
1022F PNEUMOCOCCUS IMMUN STATUS $ 18.00
1030F INFLUENZA IMMUN STATUS $ 18.00
1055F VISUAL FUNCTIONAL STATUS $ 18.00
1090F URINARY INCONT ASSESS $ 18.00
11000 DEBRIDEMENT INFECTED SKIN $ 142.00
11005 PHYS/ DEBRIDE ABDOM WALL $ 2,125.00
11008 PHYS/ REMOVAL MESH $ 1,742.00
11010 DEBRIDE SKIN / FX $ 1,369.00
11042 DEBRIDEMENT SKIN,SUBCUT TISSUE $ 327.00
11043 DEBRIDE MUSCLE/FASCIA 20SQ CM < $ 563.00
11055 LESION,PARING,CUTTING HYPERK $ 134.00
11056 PARING/CUTTING LESION 2-4 $ 161.00
11057 PAIRING / CUTTING BENIGN LESION $ 189.00
11104 PUNCH BIOPSY OF SKIN, SNG LESION $ 317.00
11105 PUNCH BIOPSY SKIN EACH ADDITIONAL LESION $ 156.00
1111F DISCH MEDS RECONCILED W CURRENT MED LIST $ 0.00
11200 SKIN TAG REMOVAL 1-15 LESIONS $ 242.00
11201 SKIN TAG REMOVAL EA ADD 10 LESIONS $ 52.00
1125F PAIN SEVERITY QUANTIFIED; PAIN PRESENT $ 0.00
1126F PAIN SEVERITY QUANTIFIED; NO PAIN $ 0.00
11300 LESION,SHAVING 0.5 OR LESS $ 273.00
11301 LESION, SHAVING 0.6-1.0 CM $ 335.00
11302 LESION, SHAVING 1.1-2.0 CM $ 394.00
11303 LESION, SHAVING OVER 2.0 CM $ 433.00
11305 LESION, SHAVING <0.5CM $ 274.00
11306 SHAVING LESION 0.6-1.0 $ 338.00
11307 SHAVE SKIN LESION 1.1-2CM $ 398.00
11310 LESION, SHAVING FAC <0.5CM $ 316.00
11311 LESION, SHAVING FAC 0.6-1.0 $ 309.00
11312 SHAVE SKIN LESION 1.1-2.0 $ 449.00
11313 SHAVING DERMAL LESION FACIAL OVER 2.0CM $ 462.00
11400 EXC. LESION 0.5 OR LESS $ 344.00
11401 EXC. LESION 0.6-1.0CM $ 414.00
11402 EXC LESION 1.1-2.0 CM $ 458.00
11403 EXC. LESION 2.1-3.0 CM $ 528.00
11404 EXC. LESION 3.1-4.0 CM $ 597.00
11406 EXC. LESION OVER 4.0 CM $ 851.00
11420 LESION,EXCISION <0.5CM $ 341.00
11421 LESION, EXCISION 0.6-1.0 $ 436.00
11422 LESION, EXCISION 1.1-2.0 $ 485.00
11423 LESION, EXCISION 2.1-3.0 $ 557.00
11424 LESION, EXCISION 3.1-4.0 $ 639.00
11426 PHYS / EXC BENIGN LESION $ 903.00
11440 LESION,EXCISION FAC <0.5CM $ 376.00
11441 LESION, EXCISION FAC 0.6-1.0CM $ 465.00
11442 LESION,EXCISION FAC 1.1-2.0CM $ 519.00
11443 EXCISION LESION 2.1-3.0 $ 615.00
11444 EXC LESION 3.1-4.0 BENIGN FACE $ 769.00
11450 PHYS/ EXCISON SUBQ TISSUE $ 1,050.00
1159F MEDICATION LIST DOCUMENTED IN MED REC $ 0.00
11600 EXCISION, MALIGNANT LESION 0.5CM $ 533.00
11601 EXC LESION 0.6-1.0,TRUNK,ARMS,LEGS $ 632.00
11602 LESION,EXCISION 1.1-2.0 $ 686.00
11603 EXC LESION 2.1-3.0,TRUNKS LEGS ARMS $ 778.00
11604 EXC LESION 3.0-4.0,TUNK,LEGS,ARMS $ 866.00
11606 EXCISION, MALIG LESION 4.0+ $ 1,231.00
1160F REVIEW OF MEDS BY PRESCRIB PRACT/CL PHAR $ 0.00
11620 EXC LSION 0.5, LESS, SCALP, NECK $ 541.00
11621 LESION, EXCISION 0.6-1.0 $ 636.00
11622 EXC LESION 1.1-2.0,SCALP,NECK,HANDS $ 709.00
11623 EXC LESION 2.1-3.0,SCALP,NECKS,HANDS $ 827.00
11624 EXCIS MALIGNANT LESION 3+ $ 928.00
11626 PHYS/ EXCIS MALIG LES >4CM $ 1,119.00
11640 LESION, EXCISION FAC 1.5 < $ 558.00
11641 LESION, EXCISION FAC 0.6-1.0 $ 657.00
11642 LESION, EXCISION 1.1-2.0357 $ 751.00
11643 LESION, EXCISION 2.1-3.0 $ 881.00
11644 EXCISION LESION FACE 3.1-4 $ 1,043.00
11646 EXCISION, MALIGNANT LES FACIAL OVER 4CM $ 1,405.00
1170F FUNCTIONAL STATUS ASSESSED $ 0.00
11719 TOE NAILS/TRIMMING $ 59.00
11720 DEBRIDEMENT NAIL/S 1 -5 $ 80.00
11721 DEBRIDEMENT NAILS 6+ $ 119.00
11730 AVULSION OF NAIL PLATE $ 273.00
11740 SUBUNGUAL HEMATOMA $ 137.00
11750 EXCISION OF NAIL/MATRIX $ 617.00
11765 WEDGE EXCISION/SKIN NAIL FOLD $ 465.00
11770 PHYS / PILONIDAL CYST $ 797.00
11771 PHYS/PILONIDAL CYST/ EXT $ 1,561.00
11772 PHYS/PILONIDAL CYST COMPLI $ 1,901.00
11900 INJECTION, INTRALESIONAL $ 154.00
11901 INTRALESIONAL INJECTION >7 $ 191.00
11976 REMOVAL CONTRACEPTIVE CAPSULE $ 395.00
11981 INSERTION CONTRACEPTIVE $ 373.00
11982 REMOVAL DRUG IMPLANT DEVICE $ 407.00
11983 REMOVAL / REINSERT DRUG DELIVERY IMPLANT $ 558.00
12001 LAC. REPAIR SIMPLE 2.5CM OR LESS $ 356.00
12002 LAC. REPAIR SIMPLE 2.6-7.5CM $ 376.00
12004 LAC. REPAIR SIMPLE 7.6-12.5CM $ 443.00
12005 LAC REPAIR SIMPLE 12.6-20.0CM $ 551.00
12006 LAC REPAIR 20.1-30.0CM $ 684.00
12007 LAC REPAIR SIMPLE OVER 30.0CM $ 768.00
12011 LAC. REPAIR SIMPLE FAC 2.5CM OR LESS $ 376.00
12013 LAC. REPAIR SIMPLE FAC 2.6-5.0CM $ 414.00
12014 LAC. REPAIR SIMPLE FAC 5.1-7.5CM $ 488.00
12015 LAC REPAIR SIMPLE FAC 7.6-12.0CM $ 612.00
12016 LAC REPAIR SIMPLE FAC 1.6-20. $ 730.00
12017 LAC REPAIR SIMPLE FAC 20.1-30. $ 641.00
12018 LAC REPAIR SIMPLE FAC OVER 30. $ 773.00
12020 TX SUPERFICIAL WOUND DEHISCENCE $ 777.00
12031 LAC. REPAIR INTERMED 2.5CM OR LESS $ 659.00
12032 LAC REPAIR INTERMED 2.6-7.5CM $ 844.00
12034 LAC REPAIR INTERMED 7.6-12.5 $ 862.00
12035 LAC REPAIR INTERMED 12.6-20.0 $ 1,071.00
12036 LAC REAPIR INTERMED 20.1-30.0CM $ 1,165.00
12037 LAC REPAIR OVER 30.0CM $ 1,280.00
12041 LAC REPAIR INTER EXTRM 2.5 OR LESS $ 678.00
12042 LAC REPAIR INTER EXTR 2.6-7.5CM $ 797.00
12044 LAC REPAIR INTER EXTR 7.6-12. $ 995.00
12045 LAC REPAIR INTER EXTR 12.6-20. $ 1,110.00
12046 LAC REPAIR INTER EXTR 20.1 -30. $ 1,478.00
12047 LAC REPAIR INTER EXTR OVER 30 $ 1,621.00
12051 LAC REPAIR INTER FAC 2.5CM OR LESS $ 717.00
12052 LAC REPAIR INTER FAC 2.6-5.0CM $ 819.00
12053 LAC REPAIR INTR FAC 5.1-7.5CM $ 959.00
12054 LAC REPAIR INTER FAC 7.6-12.5CM $ 1,021.00
12055 LAC REPAIR INTER FAC 12.6-20.0 $ 1,306.00
12056 LAC REPAIR INTER FAC 20.1-30.0 $ 1,517.00
12057 LAC REPAIR INTER FAAC OVER 30.0 $ 1,672.00
13121 REPAIR COMPLEX 2.6-735CM $ 1,182.00
13122 REPAIR COMPLEX EA ADD 5CM $ 367.00
13132 REPAIR COMPLEX 2.6-7.5 CM $ 1,315.00
13160 PHYS/ CLOSURE SURG WOUND $ 2,192.00
15100 PHYS/ SKIN AUTOGRAFT $ 2,349.00
16000 INITIAL TX 1ST DEGREE BURN $ 189.00
16020 BURN/DRESSING,DEBRIDEMENT $ 226.00
17000 DESTR. LESION 1 $ 226.00
17003 DESTR. LESION 1-14 $ 22.00
17004 LESION,DESCTRUC ANY METHOD 15+ $ 468.00
17106 DESTR CUTANEOUS VASCULAR LESION $ 928.00
17110 DESTR./CRYO,FLAT WARTS<15 $ 311.00
17111 DESTR/CRYO,FLAT WARTS >15 $ 368.00
17250 CHEMICAL CAUTER/GRANU $ 222.00
17260 DESTRUC MALIGNANT LESION $ 260.00
17261 DESTRUC MALIGNANT LESION $ 376.00
17263 DESTRUCTION MALIG LESION 2.1-3.0CM $ 509.00
17280 DEST MALIGNANT LESION164 $ 392.00
17282 DEST MALIGNANT LESION $ 563.00
17999 SKIN TISSUE PROCEDURE $ 222.00
19000 DRAINAGE OF BREAST LESION $ 310.00
19001 BREAST / CYST PUNC ASPIR $ 73.00
19020 PHYS/ INCISION BREAST LESION $ 1,318.00
19100 PHYS/ BREAST BIOPSY $ 419.00
19101 BREAST BIOPSY $ 944.00
19120 REMOVAL BREAST LESION $ 1,339.00
19301 PHYS / PARTIAL MASTECTOMY $ 1,738.00
19318 PHYS/ BREAST REDUCTION $ 3,060.00
2014F MENTAL STATUS ASSESS $ 18.00
20520 PHYS/ REMOV FOREIGN BODY $ 563.00
20526 INJECTION, THERAPEUTIC CARPAL TUNNEL $ 204.00
20527 INJECTION / DUPUY CONTRACT $ 206.00
20550 INJ TENDON SHEATH, OR LIGAMENT $ 159.00
20550H INJ TENDON SHEATH, OR LIGAMENT $ 159.00
20551 INJECTION / TENDON $ 164.00
20551H INJECTION / TENDON $ 164.00
20552 INJECTION SING MULTI TRIGGER POINT $ 152.00
20553 TRIGGER POINT INJECTION $ 177.00
20600 ARTHROCENTESIS/ASPIRATION INJ $ 146.00
20600H ARTHROCENTESIS /ASPIRATION INJ $ 146.00
20605 ARTHROCENTESIS/INJ, INTERM JOINT $ 178.00
20605H ARTHROCENTESIS / INJ, INTERM JOINT $ 178.00
20610 ARTHROCENTESIS/INJ, MAJOR $ 209.00
20610H ARTHROCENTESIS / INJ, MAJOR $ 209.00
20612 ASPIRATION/INJECTION GANGLION CYST $ 164.00
20680H REMOVAL IMPLANT DEEP $ 1,643.00
21013 PHYS / EXCIS TUMOR FACE $ 1,437.00
21014 EXCISION TUMOR FACE / SCALP >2CM $ 1,360.00
21310 FRACTURE/ NASAL WO MANIP $ 377.00
21315 FRACTURE/ NASAL W/O STABILIZ $ 798.00
21320 FRACTURE/ NASAL W STABILIZ $ 731.00
21325 OPEN TX NOSE FX UMCOMPLIC $ 1,311.00
21330 OPEN TX NOSE FX W FIXATION $ 1,581.00
21337 CLOSED TX NASAL SEPTAL FX W /WO STABIL $ 758.00
21400 FRACTURE/ ORBIT WP MANIP $ 546.00
21480 FRACTURE/ TEMPORMANDIBULA $ 278.00
21501 I&D NECK/ CHEST LESION $ 1,274.00
21550 BIOPSY NECK/CHEST LESION $ 733.00
21552 EXCISION, TUMOR, SOFT TISSUE NECK 3CM+ $ 1,157.00
21800 FRACTURE/ RIB CLOSED $ 316.00
21820 FRACURE/ STERNUM CLOSED $ 394.00
21930 PHYS / EXC BACK LESION <3CM $ 1,306.00
21931 EXCISIN, TUMOR BACK / FLANK $ 1,266.00
21932 PHYS / EXC BACK TUMOR $ 1,775.00
21933 EXCIS TUMOR BACK >5CM $ 2,023.00
22305 FRACTURE/ VERTEBRAL $ 528.00
22310 FRACTURE/ VERTEBRAL WO MANIP $ 831.00
23500 FRACTURE/ CLAVICULAR $ 605.00
23505 FRACTURE/ CLAVIC W MANIP $ 965.00
23520 FRACTURE/ STERNOCLAV WO MANIP $ 632.00
23525 FRACTURE/ STERNOCLAV W MANIP $ 1,035.00
23540 FRACTURE/ ACROMIOCLAVICLE $ 617.00
23545 FRACTURE/ ACROMIOCLAV W MANIP $ 960.00
23570 FRACTURE/ SCAPULAR WO MANIP $ 636.00
23600 FRACTURE/PROX HUMERAL $ 904.00
23605 FRACTURE/ PROX HUMER W MANIP $ 1,271.00
23620 FRACTURE/ TUBEROSITY WO MANIP $ 744.00
23625 FRACTURE/ TUBEROSITY W MANIP $ 1,043.00
23650 FRACTURE/SHOULDER W/O MAN $ 868.00
23655 FRACTURE/SHOULDER W ANES $ 1,090.00
23700H MANIPULATION SHOULDER JOINT W ANESTHESIA $ 763.00
24076 PHYS / EXC TUMOR ARM/ELBOW $ 1,468.00
24500 FRACTURE/HUMERAL SHAFT $ 986.00
24505 FRCTURE/ HUMERUS W MANIP $ 1,370.00
24530 TREATMENT HUMERUS FRACTURE $ 1,047.00
24560 FRACTURE/ EPICONDYL LAT $ 891.00
24600 FRACTURE/ DISLOC ELBOW $ 1,006.00
24605 FRACTURE/ DISLOC ELBOW W ANES $ 1,279.00
24620 FRACTURE/ MONTEGGIA ELBOW $ 1,502.00
24640 FRACTURE/RADIAL HEAD CHILD $ 395.00
24650 FRACTURE/ RADIAL HEAD/NECK $ 727.00
24655 FRACTURE/ RADIAL HEAD W MAN $ 1,204.00
24670 FRACTURE/ ULNAR PROX WO MAN $ 805.00
24675 FRACTURE/ ULNAR W MANIP $ 1,249.00
25000H INCISION EXTENSOR TENDON SHEATH WRIST $ 829.00
25111 PHYS / EXC GANGLION WRIST $ 1,031.00
25111H EXCISION GANGLION WRIST PRIMARY $ 1,242.00
25112 PHYS / EXC GANGLION WRIST $ 1,050.00
25112H EXCISION GANGLION WRIST RECURRENT $ 1,500.00
25500 FRACTURE/RADIAL SHAFT WO $ 751.00
25505 FRACTURE/ RADIAL SHAFT W MANIP $ 1,379.00
25520 FRACTURE/ GALEAZZI RADIAL $ 1,541.00
25530 FRACTURE/ ULNAR SHAFT $ 727.00
25535 FRACTURE/ ULNAR SHAFT W MANIP $ 1,340.00
25560 FRACTURE/ RADIAL ULNAR SHAFT $ 770.00
25565 FRACTURE/RADIAL ULNAR W MANIP $ 1,426.00
25600 FRACTURE/DIATAL RADIAL $ 910.00
25605 FRACTURE/DISTAL RADIAL W MANIP $ 1,634.00
25622 FRACTURE/CARPAL SCAPHOID $ 843.00
25624 FRACTURE/ CARPAL SCAPHOID W MAN $ 1,308.00
25630 FRACTURE/CARPAL BONE $ 839.00
25635 FRACTURE/ CARPAL BONE W MANIP $ 1,244.00
25650 FRACTURE/ULNAR STYLOID $ 884.00
25660 FRACTURE/ RADIO-INTERCARPAL $ 1,120.00
25675 FRACTURE/ DISTAL RADIOULNA $ 1,217.00
25680 FRACTURE/ TRANS SCAPHOPERIULNA $ 1,304.00
25690 FRACTURE/ LUNATE DISLOCATION $ 1,305.00
26011H DAINAGE FINGER ABSCESS COMPLICATED $ 717.00
26055H TENSON SHEATH INCISION (TRIGGER FINGER) $ 1,202.00
26113 EXCISION TUMOR SOFT TISS HAND/FINGER $ 1,354.00
26115H EXCISION OF TUMOR, SOFT TISSUE HAND FING $ 1,292.00
26123H FASCIECTOMY, PART PALMER RELEASE $ 3,239.00
26125 FASCIECTOMY PARTIAL PALMAR RELEASE $ 711.00
26160 PHYS / REM TENDON SH LESION $ 1,603.00
26236 PARTIAL EXCISION BONE DISTAL PHAL/FINGER $ 1,141.00
26567 OSTEOTOMY PHALANX/ FINGER $ 1,765.00
26600 FRACTURE/METACARPAL WO MANIP $ 814.00
26605 FRACTURE/METACARPAL W MANIP $ 887.00
26641 FRACTURE/THUMB W MANIP $ 1,010.00
26650 FRACTURE/ THUMB BENNETT $ 1,298.00
26650H CARPOMETACARPAL FX DISLOC THUMB SKEL FIX $ 1,844.00
26670 FRACTURE/CARPOMETACARPAL $ 907.00
26700 CLOSED TX METACARPOPHALANGEAL $ 891.00
26720 FRACTURE/ PHALANGEAL SHAFT $ 549.00
26725 FRACTURE PHALANGEAL MANIP $ 927.00
26740 FRACTURE/ ARTICULAR CLOSED $ 632.00
26750 FRACTURE/ DISTAL PHALANGEAL $ 509.00
26755 FRACTURE/ DISTAL PHALANGEAL W MAN $ 867.00
26770 FRACTURE/DISLO INTERPHALANGE JOINT $ 763.00
27043 EXCISION TUMOR SOFT TISSUE PLEVIS / HIP $ 1,149.00
27096 INJECT SACROILIAC JOINT $ 500.00
27130 TOTAL HIP ASSIST $ 3,874.00
27200 FRACTURE/ COCCYX $ 494.00
27230 FRACTURE/ FEMUR $ 1,293.00
27246 FRACTURE/ GREATER TROCHANTER $ 1,045.00
27250 FRACTURE/HIP DISLOCATION $ 1,131.00
27252 FRACTURE/HIP W ANES $ 2,050.00
27266 FRACTURE POST HIP ARTHRO/ANES $ 1,571.00
27301 I&D DEEP ABSCESS, HEMATOMA $ 1,848.00
27301H I & D, DEEP ABSC,BURSA,HEMAT THIGH- KNEE $ 1,956.00
27340H EXCISION PREPATELLAR BURSA $ 914.00
27347H REMOVAL KNEE CYST $ 1,300.00
27447 TOTAL KNEE ASSIST $ 4,137.00
27447H TOTAL KNEE ARTHROPLASTY $ 5,283.00
27520 FRACTURE/ PATELLA WO MANIP $ 896.00
27530 FRACTURE/TIBIA WO MANIP $ 1,038.00
27532 FRACTURE/ TIBIA W MANIP $ 1,673.00
27550 FRACTURE/ KNEE DISLOCATION $ 1,364.00
27552 FRACTURE/ KNEE W ANES $ 1,696.00
27560 FRACTURE/ PATELLA WO ANES $ 1,014.00
27570 MANIPULATION KNEE JOINT/ ANESTHESIA $ 585.00
27603 I & D LEG, ANKLE, ABSCESS, HEMATOMA $ 1,432.00
27760 FRACTURE MEDIAL MALLEOLUS WO MAN $ 927.00
27780 FRACTURE/FIBULA $ 850.00
27786 FRACTURE/ LAT MALLEOLUS $ 878.00
27808 FRACTURE/ ANKLE $ 928.00
27810 FRACTURE/ BIMALLEOLAR ANKLE W MAN $ 1,292.00
27814H BIMALLEOLAR ANKLE FRACTURE OPEN $ 2,995.00
27816 FRACTURE/ TRIMALLEOLAR ANKLE WO $ 883.00
27824 FRACTURE/ CLOSED DISTAL TIBIA $ 860.00
27840 FRACTURE/ ANKLE DISLOCATION $ 1,025.00
27842 FRACTURE/ ANKLE DISLOC W ANES $ 1,349.00
28043 EXC TUMOR, SOFT TISSUE FOOT OR TOE SIMPL $ 1,035.00
28045H EXC TUMOR SOFTI TSSUE FOOT/TOE SUBFASCIA $ 1,354.00
28090H EXCISION, TENDON/SHEATH, CAPSULE FOOT $ 1,272.00
28173 PHYS/ RESEC METATAR TUMOR $ 2,115.00
28190 REMOVAL FB/ FOOT $ 730.00
28400 FRACTURE/ CALCANEAL $ 700.00
28430 FRACTURE/TALUS $ 657.00
28450 FRACTURE/ TARSAL BONE $ 605.00
28455 FRACTURE/ TARSAL W MANIP $ 778.00
28470 FRACTURE/METATARSAL WO MANIP $ 616.00
28475 FRACTURE/ METATARSAL W MANIP $ 707.00
28495 FRACTURE/ GREAT TOE W MANIP $ 500.00
28510 FRACTURE/ PHALANGE $ 346.00
28515 FRACTURE/ PHALANGE W MANIP $ 453.00
28540 FRACTURE/ TARSAL BONE DISLOC $ 547.00
28660 FRACTURE INTERPHALANGEAL JOINT DISLOC $ 324.00
28740H ARTHRODESIS, MIDTARSAL OR TARSOMETATARSA $ 2,421.00
29065 CAST SHOULDER TO HAND $ 268.00
29075 CAST ELBOW TO FINGER $ 242.00
29085 CAST/HAND,FOREARM GAUNTLET $ 264.00
29105 SPLINT, LONG ARM $ 244.00
29125 SPLINT SHORT ARM $ 182.00
29130 APPLICATION FINGER SPLINT $ 113.00
29345 CAST LONG LEG $ 376.00
29405 CAST SHORT LEG $ 232.00
29425 APPLICATION WALKING CAST $ 246.00
29505 SPLINT LONG LEG $ 234.00
29515 SPLINT SHORT LEG $ 201.00
29580 APPLIC. UNNA BOOT $ 147.00
29876H ARTHROSOCPY, KNEE SYNOVECTOMY $ 2,558.00
29879H ARTHROSCOPY, KNEE/ ABRASION ARTHROPLASTY $ 2,577.00
29880H ARTHROSCOPY, KNEE MENISECTO PARTIAL/LAT $ 2,188.00
29881H KNEE ARTHROSCOPY W MENISECTOMY $ 2,106.00
3008F BMI , DOCUMENTED $ 10.00
30100 INTRANASAL BIOPSY $ 406.00
30110 EXCISION NASAL POLYP SIMPLE $ 657.00
30115 REMOVAL NASAL POLYP $ 1,207.00
30125 REMOVAL NOSE LESION $ 1,691.00
30130 EXCISE INFERIOR TURBINATE $ 1,069.00
30140 RESECT INFERIOR TURBINATE $ 1,248.00
30300 REMOVE NASAL FOREIGN BODY $ 672.00
30310 REMOVE NASAL FB W ANES $ 579.00
3044F MOST RECENT HbA1c LEVEL<7.0% $ 0.00
3045F MOST RECENT HbA1c LEVEL 7.0-9.0% $ 0.00
30465 REPAIR NASAL STENOSIS $ 2,612.00
3046F MOST RECENT HbA1c LEVEL >9.0%** $ 0.00
30520 REPAIR NASAL SEPTUM $ 1,744.00
3060F POSITIVE MICROALBUMIN TEST $ 0.00
3061F NEGATIVE MICROALBUMINURIA TEST $ 0.00
3062F POSITIVE MICROALBUMINURIA TEST $ 0.00
30630 REPAIR NASAL SEPTUM DEFECT $ 1,744.00
3066F DOCUMENTATION OF TREATMENT NEPHROPATHY $ 0.00
3072F LOW RISK RETINOPATHY $ 0.00
3074F SYSTOLIC <140mmHG $ 0.00
3075F SYSTOLIC <140mmHG $ 0.00
3077F SYSTOLIC > 140 mmHg $ 0.00
3078F DIASTOLIC <80 mmHg $ 0.00
3079f DIASTOLIC 80-89 mmHg $ 0.00
3080F DIASTOLIC > 90 mmHg $ 0.00
30901 NASAL HEMORRHAGE,SIMPLE $ 265.00
30903 CONTROL NOSEBLEED ANTERIOR $ 586.00
30905 CONTROL NOSEBLEED POSTER $ 730.00
30906 CONTROL NOSEBLEED SUBSEQ $ 797.00
30930 FX NASAL INFERIOR TURBINATES $ 334.00
31000 IRRIG MAXILLARY SINUS $ 518.00
31020 EXPLOR MAXILLARY SINUS $ 1,378.00
31231 NASAL ENDOSCOPY DX $ 595.00
31231F NASAL ENDOSCOPY DX - (FROY) $ 595.00
31237 NASAL/SINUS ENDOSCOPY BX POLYP $ 912.00
31238 NASAL ENDOSCOPY/ HEMORRHAGE $ 932.00
31254 REVISION ETHMOID SINUS $ 743.00
31255 REM ETHMOID SINUS ANT/ POST $ 1,087.00
31256 EXPLORATORY MAXILLARY SINUS $ 541.00
31267 NASAL/ SINUS ENDOSCOPY MAXILLARY ANTROS $ 832.00
31500 INTUBATION $ 299.00
31511 ENDOSCOPY/ REMOVAL FOREIGN BODY $ 604.00
31515 LARYNGOSCOPY / ASPIRATION $ 589.00
31525 PHYS / LARYNGOSCOPY $ 706.00
31526 LARYNGOSCOPY W SCOPE DX $ 433.00
31530 LARYNGOSCOPY W FB REMOVAL $ 541.00
31531 LARYNGOSCOPY W FB REMOV SCOPE $ 582.00
31535 LARYNGOSCOPY W BIOPSY $ 521.00
31536 LARYNGOSCOPY BIOPSY DIRECT $ 579.00
31575 LARYNGOSCOPY, FLEXIBLE $ 320.00
31576 LARYNGOSCOPY W BIOPSY $ 632.00
31622 BRONCHOSCOPY DIAGNOSTIC $ 887.00
31625 BRONCHOSCOPY W BIOPSY $ 948.00
32551 THORACOSTOMY TUBE INSERT $ 474.00
32554 THORACENTESIS W/O IMAG $ 257.00
32555 THORACENTESIS W IMAG $ 320.00
35840 PHYS/ EXPLORATION ABDOMEN $ 4,600.00
36000 NEEDLE, INTRODUCTION VEIN $ 72.00
36415 VENIPUNCTURE $ 13.00
36489 CENTRAL VENOUS CATH PLACEMENT $ 477.00
36510 CATHETER UMBILICAL $ 391.00
36556 PHYS / CV CATHETER INSERT $ 653.00
36561 INSERT TUNNELED CV CATH 5YRS> $ 3,391.00
36569 PHYS/ INSERT PICC CATH $ 705.00
36576 PHYS / REP TUN CV CATH $ 1,085.00
36590 PHYS / REM TUNNEL CV CATH $ 814.00
37609 PHYS/ TEMPORAL ARTERY BIOPSY $ 878.00
37718 PHYS / LIGATION SAPH VEIN $ 1,237.00
38100 REMOVAL OF SPLEEN, TOTAL $ 3,088.00
38220 BONE MARROW ASPIRATION $ 432.00
38221 PHYS / BONE MARROW BIOPSY $ 458.00
38500 EXCISION LYMPH NODE $ 911.00
38510 EXC LYMPH NODE DEEP $ 1,426.00
4010F DOCUMENTATION TREATMENT NEPHROPATHY $ 0.00
40490 BIOPSY LIP $ 362.00
40806 INCISION LABIAL FRENUM $ 407.00
40808 BIOPSY VESTIBULE MOUTH $ 542.00
40810 EXCISION MOUTH LESION $ 595.00
40819 FRENULECTOMY $ 883.00
41010 FRENULOTOMY $ 596.00
41100 PHYS/ BIOPSY TONGUE 2/3 $ 481.00
41108 BIOPSY FLOOR OF MOUTH $ 433.00
41599 PHYS / REM TONGUE JEWELRY $ 98.00
42100 BIOPSY UVULA, PALATE $ 428.00
42104 EXC LESION MOUTH/ WO CLOS $ 620.00
42106 EXC LESION MOUTH W CLOS $ 780.00
42140 UVULECTOMY $ 739.00
42440 EXC SUBMANDIBULAR GLAND $ 1,144.00
42450 EXC SUBLINGUAL GLAND $ 1,289.00
42700 I & D TONSIL $ 546.00
42809 REM FOREIGN BODY PHARYNX $ 490.00
42820 TONSILLECTOMY/ ADENOID <12 $ 809.00
42821 TONSILLECTOMY / ADENOID >12 $ 841.00
42825 TONSILLECTOMY <12 YO $ 735.00
42826 TONSILLECTOMY >12 YO $ 705.00
42830 REMOVAL ADENOIDS <12 YO $ 585.00
42831 REMOVAL ADENOID >12 YO $ 631.00
42835 REM ADENOIDS 2ND <12 YO $ 545.00
42836 REMOVAL ADENOIDS 2ND >12 YO $ 676.00
42860 EXCISION TONSIL TAG $ 512.00
42960 POST TONSIL HEMOR SIMPLE $ 475.00
42970 POST ADENOID HEMOR SIMPLE $ 1,140.00
43200 ESOPHAGUS ENDOSCOPY $ 608.00
43202 ESOPHAGUS ENDOSCOPY BIOPSY $ 817.00
43215 ESOPHAGUS ENDOSCOPY FB REM $ 421.00
43216 ESOPHAGUS ENDOS/ LESION $ 626.00
43235 PHYS / EGD $ 844.00
43239 PHYS / EGD BIOPSY $ 973.00
43246 PHYS / GASTROSTOMY TUBE PLACE $ 696.00
43247 PHYS/ EGD FOREIGN BODY $ 792.00
43251 PHYS / EGD / POLYP $ 604.00
43752 PHYS / NASAL TUBE PLACE $ 163.00
43761 REPOSITION GASTRIC TUBE $ 328.00
44005 ENTEROLYSIS $ 2,941.00
44020 PHYS/ EXP SM INTESTINE $ 2,614.00
44110 PHYS/ EXCIS INTESTINE LESION $ 2,283.00
44120 PHYS/ REMOV SM INTESTINE $ 3,284.00
44140 COLECTOMY, PARTIAL $ 3,607.00
44388 PHYS / COLONOSCOPY STOMA $ 1,009.00
44680 REVISION OF INTESTINE $ 2,892.00
44799 INTESTINE/ UNLISTED PROCED $ 296.00
44950 APPENDECTOMY $ 1,726.00
44955 PHYS / APPENDECTOMY ADD $ 226.00
44960 APPENDIX/RUPTURED $ 2,347.00
44970 APPENDECTOMY, LAPROSCOPIC $ 1,608.00
45005 PHYS/ I & D ABCESS, RECTUM $ 765.00
45110 PROCTECTOMY/COMPLETE $ 4,994.00
45300 PROCTOSIGMOIDOSCOPY RIGID DIAGNOSTIC $ 306.00
45330 SIGMOIDOSCOPY $ 394.00
45331 SIGMOIDOSCOPY/BIOPSY $ 474.00
45378 PHYS / COLONOSCOPY $ 1,246.00
45380 PHYS / COLONOSCOPY BIOPSY $ 1,820.00
45381 PHYS/ COLONOSCOPY SUBMUC INJ $ 1,334.00
45385 PHYS / COLONOSCOPY POLYP $ 1,820.00
45560 REPAIR RECTOCELE $ 1,819.00
45990 PHYS/ ANORECTAL EXAM $ 289.00
46040 I&D PERIRECTAL ABCESS $ 1,477.00
46050 PHYS/ INCIS ANAL ABSC $ 575.00
46060 PHYS / INCIS RECTAL ABSCE $ 1,304.00
46080 PHYS/ SPHINCTEROTOMY $ 693.00
46083 INCIS THROMBOSED HEMORRHOID $ 495.00
46220 PHYS/ EXCIS ANAL TAG $ 582.00
46230 EXCISION EXTERNAL SKIN TAG $ 737.00
46250 HEMORRHOIDECTOMY,EXT $ 1,286.00
46255 PHYS / HEMORRHOIDECTOMY $ 1,611.00
46257 PHYS/ HEMORRHOIDECTOMY INT /EXT $ 1,151.00
46260 PHYS / HEMORRHOIDECTOMY $ 1,293.00
46275 PHYS/ REMOV ANAL FISTULA $ 1,496.00
46320 PHYS/ HEMORRHOID THROM EXT $ 515.00
46600 ANOSCOPY $ 253.00
46922 PHYS / LES DESTRUC ANUS $ 757.00
46930 PHYS / DESTROY INT HEMORRHOID $ 577.00
46945 PHYS/ HEMORRHOIDECTOMY/ LIGATION $ 869.00
46946 PHYS/ LIGATION HEMORRHOID $ 878.00
46999 PHYS / ANUS SURGERY PROCED $ 520.00
47100 BIOPSY LIVER WEDGE $ 2,063.00
47562 PHYS / LAP CHOLE $ 3,258.00
47600 CHOLECYSTECTOMY $ 2,903.00
49000 EXPLORATORY LAPAROTOMY $ 2,072.00
49020 PHYS/ DRAIN PERITONEAL ABCESS $ 4,271.00
49082 PHYS / PARACENTESIS ABD $ 492.00
49084 PHYS / PERITONEAL LAVAGE $ 279.00
49203 PHYS / EXC ABD TUMOR 5CM $ 3,213.00
49320 LAPAROSCOPY DIAGNOSTIC $ 848.00
49505 PHYS / REP ING HERNIA $ 2,056.00
49507 PHYS/ INGUINAL HERNIA $ 2,108.00
49520 PHYS/ INGUINAL HERNIA REP $ 2,260.00
49521 PHYS/INGUINAL HERNIA INCAR $ 2,034.00
49555 PHYS / FEMORLA HERNIA REP $ 1,596.00
49560 PHYS/ VENTRAL HERNIA $ 2,497.00
49561 PHYS / HERNIA REP, VENTRAL $ 2,495.00
49565 PHYS / INCIS HERNIA REPAIR $ 2,767.00
49566 VENTRAL HERNIA INCAR/STRANG $ 2,524.00
49568 PHYS / HERNIA REP, MESH $ 723.00
49585 UMBILICAL HERNIA REPAIR $ 1,196.00
49587 PHYS / UMB HERNIA REP INCAR/STRAN $ 1,384.00
49590 REPAIR SPIGELIAN HERNIA $ 1,534.00
49653 PHYS / LAP REP UMB HERNIA $ 3,070.00
49999 UNLISTED PROCEDURE $ 323.00
51102 ASPIRATION BLADDER/INSERT SUPRA CATH $ 814.00
51500 EXC URACHAL CYST/SINUS W W/O UB HERNIA $ 1,609.00
51700 IRRIGATION OF BLADDER $ 315.00
51701 INSERTI0N FOLEY/RESIDUAL $ 178.00
51702 INSERTION INDWELLING CATH $ 220.00
51703 INSERT BLADDER CATH, COMPLEX $ 377.00
51705 CHANGE CYSTOSTOMY TUBE, SIMPLE $ 241.00
51865 CYSTORRHAPHY, SUTURE BLADDER WOUND INJUR $ 2,245.00
52000 CYSTOSCOPY $ 578.00
52310 CYSTO, REMOVAL FB $ 687.00
53200 BIOPSY / URETHRA $ 403.00
54050 DESTRUCTION LESION/MALE218 $ 365.00
54150 CIRCUMCISION/CLAMP OR DEVICE $ 239.00
54160 CIRCUMCISION NEWBORN $ 338.00
54162 LYSIS PENILE LESION $ 743.00
55000 PHYS / DRAINAGE HYDROCELE $ 335.00
55040 PHYS / EXCIS HYDROCELE $ 926.00
55100 PHYS/ DRAINAGE SCROTUM ABSCESS $ 595.00
55250 VASECTOMY $ 1,258.00
56405 I & D VULVA / PERINEAL ABSCESS $ 416.00
56420 DRAINAGE GLAND ABSCESS $ 337.00
56501 LESION, DESTRUCTION/VULVA SIMPLE $ 361.00
56605 BIOPSY VULVA/ PERINEUM $ 246.00
56606 BIOPSY VULVA / PERINEUM $ 102.00
56700 PARTIAL HYMENECTOMY/REVIS OF HYMEN RING $ 465.00
57061 DESTRU VAGINAL LESION(S) $ 314.00
57100 BIOPSY/VAGINAL MUCOSA $ 242.00
57160 INSERTION PESSARY $ 211.00
57170 DIAPHRAGM,INSERTION W INSTRUC $ 205.00
57240 REPAIR BLADDER & VAGINA $ 1,822.00
57260 REPAIR VAGINA $ 2,275.00
57265 COMBINED ANTEROPOST COLP/ ENTEROCELE REP $ 2,381.00
57267 PHYS/ INSERT MESH PELVIC $ 711.00
57268 REPAIR ENTEROCELE / VAG APPROACH $ 1,266.00
57288 SLING OPERATION STRESS INCONTINENCE $ 1,857.00
57410 PELVIC EXAMINATION / ANESTHESIA $ 282.00
57452 COLPOSCOPY $ 299.00
57454 COLPOSCOPY/WITH BIOPSY $ 421.00
57455 COLPOSCOPY WITH BIOPSY CERVIX $ 377.00
57456 COLPOSCOPY CERVIX / ENDO CURRETAGE $ 356.00
57500 BIOPSY,EXCISION LOCAL LESION $ 357.00
57505 PHYS/ ENDOCERV CURETTAGE $ 282.00
57511 CRYOCAUTERY $ 400.00
57520 CONIZATION OF CERVIX $ 807.00
57522 CONIZATION OF CERVIX $ 696.00
57800 DILATION CERVICAL CANAL $ 165.00
58100 ENDOMETRIAL BIOPSY $ 301.00
58120 PHYS/ DILATION & CURETTAGE $ 708.00
58146 PHYS/ MYOMECTOMY ABDOM COMPLEX $ 3,141.00
58150 TOTAL HYSTERECTOMY $ 2,738.00
58180 SUPRACERVICAL ABDOMINAL HYSTERECTOMY $ 2,378.00
58260 VAGINAL HYSTERECTOMY $ 2,272.00
58262 VAGINAL HYSTERECTOMY W REM TUBE $ 2,512.00
58300 INSERTION OF INTRAUTERINE DEVICE $ 213.00
58301 REMOVAL INTRAUTERINE DEVICE $ 262.00
58353 ENDOMETRIAL ABLATION THERMAL $ 2,494.00
58541 LAP SUPRACERV HYSTERECTOMY $ 2,357.00
58550 VAGINAL HYSTERECTOMY $ 2,427.00
58552 LAPAROSCOPY/TUBES & OVARY $ 2,695.00
58554 LAPARO VAGINAL HYSTER W UTERUS >250 $ 3,584.00
58558 HYSTEROSCOPY W BIOP/POLYP W W/O D&C $ 1,048.00
58561 HYSTEROSCOPY WITH REMOVAL LEIOMYOMATA $ 925.00
58562 HYSTEROSCOPY REMOVAL FB $ 1,086.00
58563 HYSTEROSCOPY, ENDOMETRIAL ABLATION $ 4,529.00
58600 PHYS / TUBAL LIGATION $ 1,819.00
58605 TUBAL LIGATION POST PARTUM $ 904.00
58611 TUBAL LIGATION $ 213.00
58661 PHYS/ REM ADNEXAL STRUCT $ 1,766.00
58662 LAPAROSCOPY EXCISE LESIONS $ 1,812.00
58670 TUBAL LIGATION/ FULG OVIDUCTS $ 1,006.00
58671 LAPAROSCOPY OCCLUSION OVIDUCTS/ DEVICE $ 959.00
58720 REMOVAL OVARY/TUBES $ 1,981.00
58805 PHYS / DRAIN OVARIAN CYST $ 1,106.00
58925 PHYS/ OVARIAN CYSTECTOMY $ 2,411.00
58940 REMOVAL OF OVARY (S) $ 1,420.00
58956 INPT/ OMENTECTOMY $ 3,644.00
59120 PHYS/ TREAT ECTOPIC PREGN $ 2,203.00
59151 TREAT ECTOPIC PREGNANCY $ 1,999.00
59160 CURRETAGE/POSTPARTUM $ 575.00
59300 EPISIOTOMY/ VAGINAL REPAIR $ 532.00
59400 ROUTINE OB ANTEPARTUM CARE $ 5,737.00
59409 VAGINAL DELIVERY ONLY $ 2,256.00
59410 VAGINAL DELIVERY/POSTPARTUM $ 2,866.00
59412 CEPHALIC VERSION EXTERNAL $ 470.00
59414 PHYS / DELIVER PLACENTA $ 254.00
59425 ANTEPARTUM CARE ONLY $ 1,256.00
59426 ANTEPARTUM 7+ VISITS $ 2,244.00
59430 POSPARTUM CARE ONLY $ 501.00
59510 CESAREAN DELIVERY/PRE & POST PARTUM $ 6,362.00
59514 CESAREAN SECTION $ 2,548.00
59515 CESAREAN DELV/POSTPARTUM $ 3,473.00
59812 INCOMPLETE MISCARRIAGE $ 875.00
59820 TREATMENT MISSED ABORTION $ 1,049.00
62270 SPINAL PUNCTURE $ 442.00
62321 EPIDURAL STEROID INJECTION W/IMAGING $ 277.00
64400 INJECTION, ANES AGENT TRIGEMINAL NERVE $ 313.00
64405 INJECTION/OCCICPITAL NERVE $ 305.00
64420 INJECTION INTERCOSTAL NERVE, ANEST AGENT $ 277.00
64445 INJECTION/ SCIATIC NERVE $ 377.00
64450 INJECTION, PERIPHERAL BLOCK $ 285.00
64455 INJECT ANESTHETIC AGENT $ 133.00
64483 TRANSFORAMINAL EPIDURAL W IMAG $ 288.00
64493 INJECTION PARAVERTABRAL JNT L/S $ 232.00
64718H NEUROPLASTY/TRANSPOSIT, ULNAR NERVE ELBO $ 2,300.00
64721 PHYS/ CARPAL TUNNEL REL $ 1,784.00
64721H NEUROPLASTY/TRANSPOSITION MEDIAN NERVE $ 1,656.00
65205 REMOVAL FB EXTERNAL EYE/SUPERFICIAL $ 157.00
65220 FB REMOVAL CORNEAL,SLIT LAMP $ 160.00
67700 BLEPHAROTOMY,ABCESS EYELID $ 762.00
69100 BIOPSY EXTERNAL EAR $ 281.00
69105 BIOPSY AUDITORY CANAL $ 403.00
69200 REM FB AUDITORY CANAL $ 351.00
69205 REMOVAL FB EAR CANAL / ANES $ 283.00
69209 REMOVAL IMPACTED CERUMEN IRRIG/UNILAT $ 34.00
69210 EAR LAVAGE, MD $ 143.00
69220 DEBRIDEMENT MASTOID SIMPLE $ 397.00
69222 DEBRIDEMENT MASTOID COMPLEX $ 632.00
69310 REBUILD OUTER EAR CANAL $ 2,993.00
69420 MYRINGOTOMY / ASPIRATION $ 548.00
69421 MYRINGOTOMY NO TUBE ANES $ 419.00
69424 REMOVAL VENTILATION TUBE $ 368.00
69433 TYMPANOSTOMY W TUBES LOCAL $ 579.00
69436 TYMPANOSOTMY W TUBE $ 450.00
69540 EXCSION AURAL POLYP $ 603.00
69610 TYMPANIC MEMBRANE REPAIR $ 1,034.00
69801 LABYRINTHOTOMY $ 530.00
77002 FLUORO GUIDANCE NEEDLE PLACE $ 67.00
81002 URINALYSIS W/O MICROSCOPE $ 36.00
81003 URINALYSIS AUTO /MICRO $ 33.00
82075 BREATH ALCOHOL TEST $ 30.00
82948 GLUCOSE TESTING (NONLAB) $ 45.00
86580 PPD IMMUNIZATION $ 79.00
88164 PAP SMEAR DIAG $ 40.00
90375 RABIES IMMUNE GLOBULIN 2ML $ 1,097.00
903751 Rabies Immune Globulin 1500 Unit/10ml $ 5,084.00
90471 ADMINISTRATION OF IMMUNIZATION/SINGLE $ 10.00
90472 ADMINISTRATION OF IMMUNIZATION-2 OR MORE $ 10.00
90473 ADMIN IMMUNIZ INTRANASAL $ 10.00
90632 HEPATITIS A VACCINE $ 131.00
906321 Hepatitis A SDV Vaccine (1440u/ml) $ 139.00
90633 HEPATITIS A/PED/ADOLESC $ 64.00
90636 HEPATITIS A & B VACCINE $ 196.00
90647 HIB VACCINE $ 57.00
90649 H-PAPILLOMA VACC 3 DOSE IM $ 264.00
90649CL GARDASIL 9 SYRINGE (0.5 ML) $ 264.00
90651 HPV GARDASIL-9 IM 3 DOSE (0.5 ML) $ 336.00
90669 PNEUMOCOCCAL CONJUGATE VACCINE $ 40.00
90670 PNEUMOCOCCAL VAC 13 VAL $ 289.00
90675 RABIES VACCINE $ 467.00
90680 ROTAVIRUS VACCINE (ORAL) $ 157.00
90681 ROTAVIRUS VACCINEEE (ORAL) $ 222.00
90685 INFLUENZA VACCINE 0.25ML $ 30.00
90686 INFLUENZA VACCINE 0.5ML $ 30.00
90691 TYPHOID VACCINE $ 194.00
90696 DTAP & IPV 4-6 YO $ 111.00
90700 DTAP $ 54.00
90707 MMR VACCINE $ 145.00
90713 IPV POLIOVIRUS VACCINE $ 65.00
90715 TDAP VACCINE >7YO $ 73.00
907151 BOOSTRIX SDV (0.5ML) X1 $ 73.00
90716 VARICELLA VACCINE $ 222.00
90723 DTAP-HEPB-IPV VACCINE $ 142.00
90732 PNEUMOVAX $ 135.00
90734 MENINGOCOCCAL VACCINE IM $ 215.00
90736 ZOSTER VACCINE SQ $ 306.00
90744 HEPATITIS B AGE0-18YRS $ 53.00
90746 HEPATITIS B AGE >19YRS $ 119.00
90748 COMVAX $ 96.00
90792T PYSCHIATRIC DIAG EVAL W MEDICAL SERVICE $ 388.00
92504 EAR MICROSCOPY EXAM $ 86.00
92511 NASOPHARYNGOSCOPY $ 433.00
92511F NASOPHARYNGOSCOPY (FROY) $ 433.00
92551 AUDIOGRAM, SCREEN $ 33.00
92567 TYMPANOMETRY $ 53.00
92950 CPR $ 809.00
92960 CARDIOVERSION, ELECTIVE $ 731.00
93000 EKG WITH INTERP & REPORT $ 60.00
93005 EKG TRACING ONLY $ 36.00
93010 EKG / PRO FEE $ 24.00
93016 STRESS EKG SUPERVISION ONLY $ 62.00
93018 STRESS EKG/INTERP & REPORT $ 41.00
93227 EXT ELECTROCARDIOGRAPHIC INTERP 24/48HR $ 68.00
94010 SPIROMETRY,W/GRAPH $ 80.00
94060 SPIROMETRY, BRONCHOSPASM $ 140.00
94640 NEBULIZER TREATMENT $ 46.00
94664 NEBULIZER IPPB ETC DEMO/ EVAL $ 44.00
94760 PULSE OXIMETRY $ 7.00
95028 INTRACUT/INTRADER TESTS $ 38.00
95115 ALLERGY INJECTION, SINGLE $ 31.00
95117 ALLERGY INJECTION; 2 OR MORE $ 41.00
95250 GLUCOSE MONITORING CONTINU $ 453.00
95251 GLUCOSE MONITORING INTERP $ 117.00
95810 POLYSOMNOGRAPHY $ 344.00
95811 POLYSOMNOGRAPHY W CPAP $ 360.00
96110 DEVELOPMENTAL SCREENING $ 24.00
96360 IV INFUSION / HYDRATION $ 242.00
96372 ADMIN / INJECTION $ 10.00
96523 PORT FLUSH $ 62.00
97602 REMOVAL DEVITALIZED TISSUE FROM WOUND $ 160.00
99000 SPECIMEN HANDLING $ 26.00
99024 POST OP VISIT $ 0.00
99075 MEDICAL TESTIMONY / 15MN $ 150.00
99195 PHLEBOTOMY $ 306.00
99201 NEW VISIT-BRIEF $ 117.00
99202 NEW VISIT-LIMITED $ 199.00
99202H NEW VISIT - LIMITED $ 199.00
99203 NEW VISIT-LOW $ 288.00
99203H NEW VISIT - LOW $ 288.00
99203T NEW VISIT - LOW $ 288.00
99204 NEW VISIT-MODERATE $ 438.00
99204T NEW VISIT - MODERATE $ 438.00
99205 NEW VISIT-HIGH $ 545.00
99211 EST. VISIT-BRIEF $ 55.00
99212 EST. VISIT-LIMITED $ 117.00
99212F EST. VISIT - LIMITED $ 129.00
99212H EST VISIT- LIMITED $ 129.00
99212T EST VISIT - LIMITED $ 129.00
99213 EST. VISIT-LOW $ 150.00
99213F EST. VISIT-LOW $ 183.00
99213H EST. VISIT - LOW $ 183.00
99213T EST VISIT - LIMITED $ 183.00
99214 EST. VISIT-MODERATE $ 237.00
99214F EST. VISIT-MODERATE $ 280.00
99214H EST. VISIT - MODERATE $ 280.00
99214T EST VISIT - MODERATE $ 280.00
99215 EST. VISIT-HIGH $ 383.00
99215F EST. VISIT - HIGH $ 383.00
99217 OBSERVATION CARE DISCHARGE $ 190.00
99218 OBSERVATION LEVEL I $ 259.00
99219 OBSERVATION LEVEL II $ 356.00
99220 OBSERVATION LEVEL III $ 485.00
99221 INITIAL HOSP CARE $ 265.00
99222 INITIAL HOSP CARE $ 361.00
99223 INITIAL HOSP CARE $ 530.00
99224 OBSERV CARE / SUBSEQ $ 104.00
99225 OBSERV CARE / SUBSEQ $ 189.00
99226 OBSERV CARE / SUBSEQ $ 274.00
99231 SUBSEQ HOSP CARE $ 102.00
99232 SUBSEQ HOSP CARE $ 189.00
99233 SUBSEQ HOSP CARE $ 272.00
99234 OBSERVATION HOSPITAL CARE $ 350.00
99235 OBSERV/ IN PT CARE SA DAY $ 443.00
99236 OBSERV/ IN PT CARE SA DAY $ 571.00
99238 HOSPITAL DISCHARGE $ 191.00
99239 HOSPITAL DISCHARGE DAY $ 282.00
99241 OFFICE CONSULTATION VISIT $ 141.00
99242 OFFICE CONSULT EXP PROB $ 234.00
99243 OFFICE CONSULT DETAILED $ 318.00
99244 OFFICE CONSULT COMPRE $ 474.00
99245 OFFICE CONSULT COMP HIGH $ 579.00
99251 INPT CONSULTATION VISIT $ 126.00
99252 INPT CONSULTATION VISIT $ 195.00
99253 INPT CONSULTATION VISIT $ 300.00
99254 INPT CONSULTATION VISIT $ 431.00
99255 INPT CONSULTATION VISIT $ 536.00
99291 CRITICAL CARE FIRST HOUR $ 757.00
99304 NURSING FACILITY CARE LOW $ 244.00
99305 NURSING FACILITY CARE MOD $ 347.00
99306 NURSING FACILITY CARE HIGH $ 440.00
99307 NURS FAC CARE SUBSEQ $ 117.00
99308 NURS FAC CARE SUBSEQ $ 182.00
99309 NURS FAC CARE SUBSEQ $ 238.00
99310 NURSING FAC CARE SUBSEQ $ 357.00
99315 NURSING FAC DISCHARGE >30 $ 192.00
99316 NURSING FAC DISCHARGE >30 $ 275.00
99335 NURS HOME VISIT EST PT $ 249.00
99347 HOME VISIT EST PATIENT $ 146.00
99356 PROLONGED SERVICE INPATIENT $ 240.00
99357 PROLONGED SERVICE INPATIENT $ 239.00
99358 ATTORNEY CONSULT 1HR $ 285.00
99359 ATTORNEY CONSULT 30MIN $ 139.00
99381 NEW PREVENTATIVE VISIT; 0-1YR $ 294.00
99382 NEW PREVENTATIVE VISIT; 1-4YR $ 308.00
99383 NEW PREVENTATIVE VISIT; 5-11YR $ 319.00
99384 NEW PREVENTATIVE VISIT; 12-17YRS $ 362.00
99385 NEW PREVENTATIVE VISIT; 18-39YRS $ 349.00
99386 NEW PREVENTATIVE VISIT; 40-64YRS $ 405.00
99387 NEW PREVENTATIVE VISIT; 65+ $ 440.00
99391 EST. PREVENTATIVE VISIT; 0-1YR $ 264.00
99392 EST. PREVENTATIVE VISIT; 1-4YRS $ 282.00
99393 EST. PREVENTATIVE VISIT; 5-11YRS $ 282.00
99394 EST. PREVENTATIVE VISIT; 12-17YRS $ 309.00
99395 EST. PREVENTATIVE VISIT; 18-39YRS $ 314.00
99396 EST. PREVENTATIVE VISIT; 40-64YRS $ 336.00
99397 EST. PREVENTATIVE VISIT; 65+ $ 362.00
99401 PREVENT COUNSEL 15 MIN $ 96.00
99402 PREVENT COUNSEL 30" $ 164.00
99406 TOBACCO CESSATION COUNSEL $ 34.00
99407 SMOKING CESSATION COUNSELING >10" $ 70.00
99411 PREVENT VISIT GROUP $ 44.00
99455 DOT PHYSICAL $ 135.00
99456 DOT PHYSICIAL $ 135.00
99460 NEWBORN H&P1 $ 240.00
99462 IN PT VISIT/NEWBORN CARE $ 110.00
99463 NEWBORN CARE $ 304.00
99464 ATTENDANCE / DELIVERY $ 202.00
99465 NEWBORN RESUSCITATION $ 384.00
9999947 Hydrocodone/APAP 5-325 $ 0.00
9999955 OXYCODONE IR 5 MG TABLET $ 0.00
9999956 METOPROLOL SUCCINATE TABLET 100MG $ 0.00
9999961 LIDOCAINE/EPINEPHRINE 1% DOSE $ 0.00
A4284 BREAST SHIELD $ 32.00
A4310 INSERTION TRAY,NO FOLEY,BAG $ 10.00
A4314 FOLEY CATH TRAY WITH CATH $ 29.00
A4336 SELF CATH 6" FEMALE $ 5.00
A4344 FOLEY CATHETER $ 17.00
A4358 URINARY DRAINAGE BAG LEG $ 9.00
A4364 DERMABOND, SKIN ADHESIVE $ 72.00
A4463 ABDOMINAL SUPPORT 12" $ 27.00
A4550 STERILE TRAY $ 18.00
A4565 SLING $ 22.00
A4570 SPLINT $ 0.00
A4649 STERILE SUPPLY $ 0.00
A6207 PROFORE COMPRESSION BANDAGE $ 12.00
A6209 DRESSING 16 SQ" < $ 16.00
A6210 POLYMEM MAX 4.5X4.5 $ 25.00
A6441 PROFORE PADDING BANDAGE $ 12.00
A6443 PROFORE CONFORMING BANDAGE $ 12.00
A6449 PROFORE LIGHT CMPRESS BANDAGE $ 12.00
A6450 ACE BANDAGE > 3" $ 8.00
A6451 ACE BANDAGE < 3" $ 6.00
A6454 PROFORE SELF-ADHER BANDAGE $ 12.00
A7016 NEBUMINST $ 6.00
A9270 POST OP SHOE $ 26.00
A9284 SPIROMETER $ 11.00
AIC AIC $ 0.00
E0110 CRUTCH $ 44.00
E0112 CRUTCHES $ 44.00
E0114 CRUTCH / METAL $ 42.00
FAA99455 FAA BASIC-MED $ 225.00
G0008 ADMIN INFLUENZA VIRUS VACCINE $ 10.00
G0009 ADMIN PNEUMOCOCCAL VACCINE $ 10.00
G0010 ADM HEPATITIS B VACCINE $ 10.00
G0101 PHYS/ PELVIC/ BREAST EXAM $ 104.00
G0102 PROSTATE DIGITAL EXAM SCREEN $ 55.00
G0105 PHYS / COLONOSCOPY SCREEN $ 1,246.00
G0121 PHYS / COLONOSCOPY SCREEN $ 1,246.00
G0289 ARTHROSCOPY / REMOVAL FB CHONDROPLASTY $ 214.00
G0296 COUNSELING VISIT / LUNG CA SCREEN LDCT $ 75.00
G0364 PHYS/ BONE MARROW ASPIRATE $ 40.00
G0402 INITIAL PREVEN PHYS EXAM $ 451.00
G0403 EKG / INTERP REPORT SCREEN $ 24.00
G0405 EKG INTERP REPORT ONLY $ 24.00
G0438 ANNUAL WELLNESS VISIT $ 456.00
G0439 ANNUAL WELLNES VISIT SUBS $ 304.00
G0442 ANNUAL MISUSE ALCOHOL SCREENING 15" $ 42.00
G0443 BRF FACE/FACE BEHAV COUNS MISUSE ALC 15" $ 61.00
G0444 ANNUAL DEPRESSION SCREENING 15MN $ 52.00
G0447 OBESITY COUNS F/F 15MN $ 68.00
H0033 ORAL MED ADMIN DIR OBSERV $ 11.00
J0171 ADRENALIN/ EPINEPHR 0.1MG INJ (J0171) $ 8.00
J0171 CL EPINEPHRINE 0.1MG INJ (J0171) $ 1.00
J0171 RX EPINEPHRINE INJ 0.3 MG DOSE (J0171) $ 14.00
J0295 AMPICIL/SULBACT 1.5GM (J0295) $ 30.00
J0558 PEN G CR 100,000U X12 (J0558) $ 118.00
J0558 CL PEN G/BENZ/PROC 100,000 UNITS INJ(J0558) $ 10.00
J0561 PEN G L-A 100,000 UNITS (J0561) $ 146.00
J0561 CL PEN G/BENZATHIN 100,000 UNITS INJ(J0561) $ 12.00
J0561RX BICILLIN L-A INJ (J056) $ 18.00
J0570 PROBUPHINE 74.2 MG $ 5,966.00
J0690 CEFAZOLIN 500MG IV (J0690) $ 9.00
J0690 Cl CEFAZOLIN 500MG INJ (J0690) $ 5.00
J0696 CEFTRIAXONE 250MG X1 (J0696) $ 26.00
J0696 CL CEFTRIAXONE 250MG X2 (J0696) $ 14.00
J0696 CL1 CEFTRIAXONE 250MG INJ (J0696) $ 7.00
J0696 CL2 CEFTRIAXONE 250MG INJ (J0696) $ 4.00
J06962 CEFTRIAXONE 250MG X2 (J0696) $ 9.00
J0702 CELESTONE 3MG INJ (J0702) $ 65.00
J0702 CL BETAMETHASONE 3MG INJ (J0702) $ 9.00
J0725 NOVAREL 1000U INJ (J0725) $ 312.00
J0725 CL CHORIONIC/GONADOTR 1000 UNITS INJ(J0725) $ 31.00
J0780 PROCHLORPERAZINE 10MG INJ (J0780) $ 37.00
J0897 CL DENOSUMAB INJ 1MGX 60(J0897) $ 28.00
J1020 METHYLPREDNISOLONE 20MG INJ (J1020) $ 22.00
J1030 DEPO-MEDROL 40MG INJ (J1030) $ 14.00
J1050 CL MEDROXYPROGESTERONE 1MG INJ (J1050) $ 1.00
J1071 CL TESTOSTERONE CYP 1MG X200 (J1071) $ 0.27
J1100 DEXAMETHOSONE 1 MG X4 (J1100) $ 10.00
J1100 CL DEXAMETHASONE 1MG INJ (J1100) $ 3.00
J1160 DIGOXIN 0.5MG INJ (J1160) $ 23.00
J1170 HYDROMORPHONE 1MG (J1170) $ 29.00
J1200 DIPHENHYDRAMINE 50MG INJ (J1200) $ 29.00
J1335 ERTAPENEM 500MG INJ (J1335) $ 149.00
J1335 CL ERTAPENEM 500MG INJ (J1335) $ 75.00
J1580 GENTAMYCIN 80MG INJ (J1580) $ 29.00
J1610 GLUCAGON HCL 1 MG INJ (J1610) $ 281.00
J1630 HALOPERIDOL 5MG INJ (J1630) $ 33.00
J1650 ENOXAPARIN 10MG X3 INJ (J1650) $ 40.00
J1650 CL ENOXAPARIN 10MG INJ (J1650) $ 17.00
J1650 CL1 ENOXAPARIN 10MG INJ (J1650) $ 15.00
J1650 CL2 ENOXAPARIN 10MG INJ (J1650) $ 12.00
J1650 CL3 ENOXAPARIN 10MG INJ (J1650) $ 5.00
J1650 CL4 ENOXAPARIN 10MG X10 (J1650) $ 4.00
J1650 CL5 ENOXAPARIN 10MG X15 (J1650) $ 10.00
J1650 CL6 ENOXAPARIN 10MG X12 (J1650) $ 12.00
J1815 INSULIN 5 UNITS INJ (J1815) $ 8.00
J1885 KETOROLAC 15MG X1 (J1885) $ 29.00
J1885 CL KETOROLAC 15MG INJ (J1885) $ 14.00
J1885 CL1 KETOROLAC 15MG INJ (J1885) $ 7.00
J1940 FUROSEMIDE 20 MG IM X1(J1940) $ 33.00
J1940 CL FUROSEMIDE 20MG INJ (J1940) $ 14.00
J2060 LORAZEPAM 2MG INJ (J2060) $ 27.00
J2175 MEPERDINE 100MG INJ (J2175) $ 23.00
J2270 MORPHINE 2MG X1 INJ (J2270) $ 23.00
J2300 NALBUPHINE INJ 10MG X2 (J2300) $ 14.00
J2405 ONDANSETRON 1MG X4 INJ (J2405) $ 8.00
J2405 CL ONDANSETRON 1MG INJ (J2405) $ 7.00
J2550 PROMETHAZINE 25 MG X1 INJ (J2550) $ 27.00
J2790 RHOGAM INJECTION 300MCG X1 (J2790) $ 202.00
J2791 CL RHO(D) IG HUMAN RHOPHYLAC 100IU $ 17.00
J2920 METHYLPREDNISOLONE 40MG X1 (J2920) $ 33.00
J2930 METHYLPREDNISOLONE 125MG X1 (J2930) $ 37.00
J3010 FENTANYL 100MCG X1 INJ (J3010) $ 27.00
J3010 CL FENTANYL CITRATE 0.1MG INJ (J3010) $ 4.00
J3030 SUMATRIPTAN 6MG X1 INJ (J3030) $ 87.00
J3301 CL TRIAMCINOLONE 10MG INJ (J3301) $ 9.00
J3360 DIAZEPAM 5MG X2 INJ (J3360) $ 23.00
J3360 CL DIAZEPAM 5MG INJ (J3360) $ 12.00
J3410 HYDROXYZINE 25MG INJ (J3410) $ 12.00
$ 11.00
J3410 CL HYDROXYZINE 25MG INJ (J3410) $ 6.00
J3420 B-12 INJECTION (1000mcg x 1) (J3420) $ 34.00
J3430 RX PHYTONADIONE 1MG X10 INJ (J3430) $ 11.00
J3475 MAGNESIUM SULF 500MG INJ (J3475) $ 0.00
J7040 NORMAL SALINE 500ML NFUSION $ 24.00
J7050 .9NS 250ML X1 $ 0.00
J7120 LACTATED RINGERS 500ML $ 25.00
J7298 LEVONORGESTEL CONTRACEP MIRENA J7298 $ 1,116.00
J7300 INTRAUTERINE COPPER CONTRACEP (J7298) $ 1,090.00
J7301 SKYLA CONTRACEPTIVE SYS X1 (J7301) $ 1,110.00
J7307 NEXPLANON IMPLANT (J7307) $ 1,018.00
J7325 CL SYNVISC 1MG INJ (J7325) $ 30.00
J7506 PREDNISONE 1MG X5 TAB (J7512) $ 8.00
J7506 CL PREDNISONE 1MG X10 (J7512) $ 1.00
J7506 CL1 PREDNISONE 1MG X20 (J7512) $ 0.00
J7510 CL PREDNISOLONE ORAL 5MG (J7510) $ 6.00
J7512 CL PREDNISONE 1MG X5(J7512) TABLET $ 2.00
J9040 BLEOMYCIN 15 UNITS X1 INJ (J9040) $ 99.00
J9217 LUPRON DEPOT 7.5MG KIT (J9217) $ 2,949.00
J9250 METHOTREXATE 0.1-5MG INJ (J9250) $ 10.00
J9250 CL METHOTREXATE 5MG INJ (J9250) $ 1.00
L0120 CERVICAL COLLAR $ 15.00
L0220 RIB BELT $ 29.00
L0625 PREGNANCY BELT $ 100.00
L1810 KNEE BRACE ELASTIC W JOINTS $ 67.00
L1830 KNEE IMMOBILIZER $ 69.00
L1902 ANKLE SUPPORT/ELASTIC $ 27.00
L1906 ANKLE TRAINING BRACE $ 112.00
L2112 CAM WALKER $ 309.00
L2999 KNEE SLEEVE $ 0.00
L3260 CAST BOOT $ 34.00
L3480 HEEL CUP $ 37.00
L3485 HEEL CUP $ 32.00
L3650 CLAVICLE BRACE $ 18.00
L3670 SHOULDER IMMOBILIZER $ 42.00
L3702 TENNIS ELBOW SPLINT $ 39.00
L3807 THUMB SPICA SPLINT UNIV $ 29.00
L3908 LAC C-UP WRIST SPLINT $ 24.00
L3980 BRACE, WRIST UNIV $ 60.00
L3999 TENNIS ELBOW SUPPORT GEL/AIR $ 38.00
L4350 ANKLE STIRRUP SPLINT AIRCAST $ 112.00
L4386 CAM WALKER, ANKLE $ 309.00
MISC MISC CLINIC CHARGE $ 0.00
NO CHG MISC NO CHARGE $ 0.00
OB002 OB VISIT $ 0.00
P9612 CATHERIZATION FOR COLLECTION $ 25.00
PHARM PHARMACY ORAL DRUG $ 0.00
Q0162 ONDANESTRON 8MG TAB $ 45.00
Q3014 TELEHEALTH ORIGINATING SITE FACILITY FEE $ 50.00
Q4005 CAST/ LONG ARM ADULT $ 44.00
Q4006 CAST,FIBER LONG ARM ADULT $ 140.00
Q4007 CAST / LONG ARM PED $ 31.00
Q4008 CAST,FIBER LONG ARM PEDIATRIC $ 93.00
Q4009 CAST/SHORT ARM ADULT $ 31.00
Q4010 CAST, FIBER SHORT ARM ADULT $ 93.00
Q4011 CAST/ SHORT ARM PED $ 17.00
Q4012 CAST, FIBER SHORT ARM PED $ 44.00
Q4013 CAST, PLAST GAUNTLET ADULT $ 39.00
Q4014 CAST, FIBER GAUNTLET ADULT $ 91.00
Q4016 CAST, FIBER GAUNTLET PED $ 86.00
Q4017 SPLINT / LONG ARM ADULT $ 33.00
Q4018 LONG ARM SPLINT/FIBER ADULT $ 34.00
Q4019 SPLINT / LONG ARM PED $ 20.00
Q4020 LONG ARM SPLINT PED FIBER $ 20.00
Q4021 SPLINT/SHORT ARM ADULT $ 26.00
Q4022 CAST/FIBER SHORT ARM ADULT $ 26.00
Q4023 SPLINT / SHORT ARM PED $ 26.00
Q4024 CAST,FIBER SHORT ARM PED $ 26.00
Q4029 CAST / LONG LEG ADULT $ 51.00
Q4030 CAST, FIBER LONG LEG ADULT $ 131.00
Q4031 CAST / LONG LEG PED $ 34.00
Q4032 CAST, FIBER LONG LEG PEDIATRIC $ 93.00
Q4037 CST / SHORT LEG ADULT $ 41.00
Q4038 CAST, FIBER SHORT LEG ADULT $ 93.00
Q4039 CAST / SHORT LEG PED $ 31.00
Q4040 CAST, FIBER SHORT LEG PED $ 93.00
Q4041 SPLINT / LONG LEG ADULT $ 41.00
Q4043 SPLINT / LONG LEG PED $ 33.00
Q4045 SPLINT/SHORT LEG ADULT $ 41.00
Q4046 SHORT LEG SPLINT ADULT FIBE $ 41.00
Q4047 SPLINT / SHORT LEG PED $ 30.00
Q4048 SPLINT/SHORT LEG PED FIBER $ 31.00
S0020 BUPIVACAINE DOSE 0.5% $ 0.00
S0077 CLINDAMYCIN 300MG INJ $ 31.00
S0119 ONDANESTRON HCL 4MG ORAL X1 $ 39.00
S0183 PROCHLORPERAZINE 5MG TAB $ 7.00
S0302 MN CHILD & TEEN CHECK UP $ 0.00
S0303 MN HEALTH CHECK UP $ 0.00
S8096 PEAK FLO METER $ 25.00
X0100 TRIM TOENAILS $ 25.00
3400001 CARDIAC REHAB $ 564.00
3400002 EKG MONITORING $ 439.00
3400005 CARD REHAB DAY NO CHG $ 0.00
3327001 CT UPPER EXT W RT $ 2,799.00
3327005 CT UPPER EXT WO RT $ 2,236.00
3327006 CT UPPER EXT W LT $ 2,799.00
3327007 CT UPPER EXTR W/WO LT $ 3,735.00
3327012 CT ABD WO $ 1,676.00
3327013 CT ABD W $ 3,032.00
3327014 CT ABD W/WO (3 PHASE) $ 3,532.00
3327015 CT FACE/SINUSES WO $ 2,414.00
3327016 CT MAXILLA FACIAL W/ $ 2,959.00
3327019 CT ORBIT SELLA WO $ 3,007.00
3327020 CT ORBIT SELLA W $ 3,552.00
3327021 CT ORBIT SELLA W/WO $ 3,989.00
3327022 CT C-SPINE WO $ 2,278.00
3327023 CT C-SPINE W $ 2,838.00
3327024 CT C-SPINE W/WO $ 3,522.00
3327028 CT L-SPINE WO $ 2,255.00
3327029 CT L-SPINE W $ 2,842.00
3327034 CT L-SPINE W/WO $ 3,526.00
3327043 CT PELVIS WO $ 1,701.00
3327052 CT PELVIS W $ 3,043.00
3327053 CT PELVIS W/WO $ 3,465.00
3327054 CT NECK WO $ 2,240.00
3327055 CT NECK W $ 2,808.00
3327056 CT NECK W W/O $ 3,493.00
3327057 CT T-SPINE WO $ 2,265.00
3327058 CT T-SPINE W $ 2,852.00
3327059 CT T-SPINE W/WO $ 3,548.00
3327060 CT THORAX W/O $ 2,244.00
3327061 CT THORAX W/MEDIA $ 2,822.00
3327062 CT THORAX W/WO $ 3,514.00
3327065 CT HEAD WO $ 1,735.00
3327066 CT HEAD W $ 2,265.00
3327067 CT HEAD W/WO $ 2,201.00
3327068 CT EAR WO $ 3,007.00
3327070 CT THORAX WO LIM $ 2,244.00
3327073 CT RENDERING W/POSTPRO 3D $ 606.00
3327081 CT C-SPINE WO $ 2,278.00
3327082 CT ANGIO PELVIS $ 4,378.00
3327083 CT AB W LIM $ 3,032.00
3327095 CT L-SPINE WO $ 2,255.00
3327101 CT HEAD OR BRAIN WO $ 1,735.00
3327102 CT HEAD OR BRAIN WO $ 1,735.00
3327103 CT UPPER EXTR WO LT $ 2,236.00
3327105 CT LWR EXT WO LT $ 2,244.00
3327106 CT LWR EXT WO RT $ 2,244.00
3327107 CT LWR EXT W/ LT $ 2,846.00
3327108 CT LWR EXT W RT $ 2,846.00
3327109 CT LWR EXT W/O LT $ 3,727.00
3327110 CT LWR EXT W/WO RT $ 3,727.00
3327114 CT ANGIO CHEST $ 4,342.00
3327115 CT ANGIO HEAD $ 5,811.00
3327116 CT ANGIO ABD $ 4,388.00
3327117 CT PELVIS W/O LIMITED $ 1,701.00
3327118 CT ABD PELVIS W/O $ 2,031.00
3327119 CT ABD PELVIS W $ 3,590.00
3327120 CT ABD PELVIS W & W/O $ 4,279.00
3327121 CT THORAX W / MEDIA $ 2,822.00
3327122 CT ANGIO LOWER EXTREM WITH / BILAT $ 4,930.00
3327142 CT ABD WO LIMI $ 1,676.00
3327143 CT ESI $ 1,010.00
3327154 CT UPPER EXT W W/O RT $ 3,735.00
3327155 CTANGIO ABD BIL RUN OFF $ 4,666.00
3327156 CT C-SPINE W/O $ 2,278.00
3327157 CT ANGIO ABD PELVIS W $ 5,490.00
3327158 CT ANGIO NECK W CONT 3D $ 6,050.00
3327159 CT LOW-DOSE LUNG CANCER SCREENING $ 2,244.00
3476111 ECHO/STRESS TEST $ 1,912.00
3476112 ECHO/TECH COMPONENT $ 1,697.00
3476127 DOPPLER/TECH COMPONENT $ 615.00
3476128 COLOR FLOW MAP/TECH COMP $ 650.00
3476129 ECHOCARDIOGRAM $ 3,287.00
3476130 ECHOCARDIOGRAM / LIMITED $ 1,366.00
3476132 DOPPLER ECHO / LIMITED $ 358.00
3476133 DOPPLER ECHO / LIMITED $ 358.00
3476134 ECHO/ STRESS TEST $ 1,912.00
3476150 DEFINITY INJECTION PER ML $ 493.00
3476300 DUAL PACEMAKER ANALAYSIS $ 323.00
3476301 DUAL PACEMAKER REPROGRAM $ 227.00
3476302 PACER ANALYSIS $ 323.00
3476303 SINGLE PACEMAKER REPROGRA $ 227.00
3476305 ICD F/U SINGLE W REPROGRA $ 342.00
3476307 ICD F/U DUAL W REPROGRAM $ 342.00
3476308 ILR ANALYSIS $ 227.00
3476309 ICD ANALYSIS $ 342.00
3476310 PACER REPROGRAM BIV $ 227.00
3476311 ICD REPROGRAM BIV $ 342.00
3805002 ER INSERTION FOLEY CATH $ 174.00
3805003 ER PELVIC EXAM ANES $ 319.00
3805004 ER INSERT BALDDER CATH $ 122.00
3805005 MODERATE SEDATION 15" 5YRS > $ 462.00
3805006 MODERATE SEDATION EA + 15" $ 129.00
3805007 URINARY CATHETER COMPLICATED $ 331.00
3805008 INTRA ARTERIAL INJECTION $ 185.00
3805010 BIRTHING ROOM $ 2,313.00
3805011 REMOVAL DEEP FOREIGN BODY THIGH KNEE $ 3,500.00
3805500 ER ABCESS/COMPLEX I&D $ 531.00
3805501 ER/ABCESS/PUNC ASPIRATION $ 163.00
3805502 ER ABCESS/SIMP I&D $ 328.00
3805503 ER BURN/1ST DEGREE INITIA $ 274.00
3805504 ER DRESS/DEBRIDE PARTIAL THICK BURN MED $ 477.00
3805507 ER BURN / SM DEBRIDE / NO ANES $ 214.00
3805508 DRAINAGE FINGER ABSCESS $ 825.00
3805509 ER DRESSING/ DEBRIDE PART THICK BURNS $ 434.00
3805521 ER CYST/COMPLEX PILON ID $ 531.00
3805522 ER CYST/SIMP PILON ID $ 398.00
3805523 ER DEBRI (10% BODY) $ 77.00
3805524 ER DEDBRI EA ADD 10 $ 41.00
3805527 ER DEBRIDEMENT, SUBCUT $ 158.00
3805528 ER EAR IRRIGATION/LAVAGE $ 84.00
3805529 ER EAR/COMPLEX DRAIN EXT $ 647.00
3805530 ER EAR/DRAIN EXT AUD CANA $ 711.00
3805531 ER EAR/DRAIN ABCESS EXT $ 488.00
3805532 ER EAR/REMOVFB $ 203.00
3805534 ER EXCISION/FB COMP $ 660.00
3805535 ER EXCISION/REMOV FM SIMP $ 143.00
3805536 ER EYE/CORNEA FB W SLIT L $ 93.00
3805537 ER EAY/DRAIN LACRIMAL GLA $ 712.00
3805539 ER EYE/LACERATION SCLERA $ 784.00
3805540 ER EYE/REMOVFB EYELID $ 199.00
3805541 ER EYE/REMOVIMBEDDER F $ 108.00
3805543 ER FX ACROMIOC WO M $ 1,183.00
3805544 ER FRACT/ACROMIOCLAVICLE $ 859.00
3805545 ER FX/ANKLE $ 1,261.00
3805546 ER FX ANKLE DISLO W ANES $ 1,777.00
3805547 ER FX ANKLE DISLOCA $ 1,359.00
3805548 ER FX/CALCANEAL $ 1,044.00
3805549 ER FX/CARPAL BO W MAN $ 1,359.00
3805550 ER FX/CARPAL BONE $ 1,030.00
3805551 ER FX/CARPAL SCAP W MA $ 1,716.00
3805552 ER FX/CARPAL SCAPHOID $ 1,093.00
3805553 ER FX/CARPOMETACARPAL $ 1,059.00
3805554 ER FX/CLAVIC W MANIP $ 1,316.00
3805556 ER FX/CLAVICULAR $ 900.00
3805557 ER FX/COCCYX $ 759.00
3805558 ER FX/DIS ELBOW W ANES $ 2,082.00
3805559 ER FX/DISLO ELBOW $ 1,232.00
3805560 ER/FX/DIST PHALAN W MANI $ 1,067.00
3805561 ER/FX DISTAL PHALANGE $ 903.00
3805562 ER FX DISTAL RAD W MANIP $ 2,105.00
3805563 ER FX/DISTAL RADIAL $ 1,030.00
3805564 ER FX/DISTAL RADIOULNA $ 1,614.00
3805565 ER FX FEMORAL $ 1,764.00
3805566 ER FX FIBULA $ 1,127.00
3805567 ER FX/GALEAZZI RADIAL $ 2,054.00
3805568 ER FX/GREAT TOE W MAN $ 721.00
3805569 ER FX PHALANGES $ 594.00
3805570 ER FX/GREATER TROCHANT $ 1,543.00
3805571 ER FX HIP DISLOCATION $ 1,673.00
3805572 ER FX HUMERAL SHAFT $ 1,264.00
3805573 ER FX HUMERUS W MAN $ 1,848.00
3805574 ER FX KNEE DISLOCATION $ 1,725.00
3805575 ER FX/KNEE W ANES $ 2,399.00
3805576 ER FX/LAT. EPICONDYL $ 1,127.00
3805577 ER FX LAT. MALLEOUS $ 1,290.00
3805578 ER DX LUNATE DISLOCATION $ 1,888.00
3805579 ER FX/METACARPAL $ 1,246.00
3805580 ER FX/METACARPAL W MAN $ 1,254.00
3805581 ER FX METATARS W MAN $ 1,114.00
3805582 ER FX/METATARSAL WO MANI $ 869.00
3805583 ER FX MONTEGGIA ELBOW $ 2,137.00
3805584 ER FX/NASAL W STABILIZ $ 644.00
3805585 ER FX/NASAL WO MANI $ 172.00
3805586 ER FX/NASAL WO STABILIZ $ 447.00
3805587 ER FX/ORBIT WO MANIP $ 734.00
3805589 FX /MEDIAL MALLEOLUS $ 1,170.00
3805590 FX PATELLA WO ANES $ 1,152.00
3805591 ER FX PATELLA WO MANIP $ 1,193.00
3805592 ER FX/PHALAN/OPEN $ 2,051.00
3805594 ER FX/PHALANGES W MAMINP $ 696.00
3805595 ER FX/PROX HUMER W MANIP $ 1,734.00
3805596 ER FX/PROX HUMERAL $ 1,338.00
3805597 ER FX RAD HEAD CHILD $ 304.00
3805598 ER FX RAD SHAFT W MAN $ 1,838.00
3805599 ER FX/RAD ULNAR SHAFT $ 1,131.00
3805600 ER FX/RAD ULNAR W MANI $ 1,863.00
3805601 ER FX/RADIAL HEAD W MANI $ 1,640.00
3805602 ER FX RADIAL HEAD NECK $ 956.00
3805603 ER FX/RADIAL SHAFT WO $ 1,120.00
3805604 ER FX/RADIO-INTERCARAPAL $ 1,634.00
3805605 ER FX/RIB CLOSED $ 491.00
3805606 ER FX/SCAPULAR WO MANIP $ 1,005.00
3805607 ER CLOSED TX SHOULDER DISLOC MANIP/ANES $ 3,206.00
3805608 ER CLOSED TX SHOULDER DISLOC W MANIP $ 1,008.00
3805609 ER FX/STERNOCLAV W MAN $ 1,356.00
3805610 ER FX/STERNOCLAV WO MANI $ 947.00
3805611 ER FX/STERNUM CLOSED $ 643.00
3805612 ER FX/TALUS $ 915.00
3805613 ER FX/TARSAL BONE $ 882.00
3805614 ER TARSAL BONE DISLOCATION $ 937.00
3805615 ER FX/TARSAL BONE W MANIP $ 1,193.00
3805616 ER FX/TEMPOROMANDIBULA $ 188.00
3805617 ER FX/THUMB W MANIP $ 1,254.00
3805618 ER FX/THUMB BENNETT $ 2,366.00
3805619 ER FX/TIBIA W MANIP $ 2,190.00
3805620 ER FX/TIBIA WO MANIP $ 1,491.00
3805621 ER FX/TRANS-SCAPHOPERI $ 1,662.00
3805622 ER FX/TUBEROSITY W MANI $ 1,593.00
3805623 ER FX/TUBEROSITY WO MA $ 1,131.00
3805624 ER FX/ULNAR PROX WO MAN $ 1,055.00
3805625 ER FX/ULNAR SHAFT $ 980.00
3805626 ER FX/ULNAR SHAFT W MAN $ 1,811.00
3805627 ER FX/ULNAR STYLOID $ 1,129.00
3805628 ER FX/ULNAR W MANI $ 1,683.00
3805629 ER FX/VERTEBRAL $ 233.00
3805630 ER FX/VERTEBRAL WO MAN $ 1,437.00
3805631 ER HEMATOMA/INCISION DRAI $ 322.00
3805633 ER NAIL REP OF NAIL BE $ 428.00
3805634 ER NAIL/AVULSION OF PLATE $ 153.00
3805635 ER NAIL DEBRI $ 48.00
3805637 ER NAIL/EXCISION OF $ 601.00
3805638 ER NAIL/WEDGE EXCISION $ 182.00
3805639 ER NASAL DRAINAGE/ABCES $ 496.00
3805641 ER NASAL HEM/COMPLEX $ 174.00
3805642 ER NASAL HEM/PACK/CAUT $ 266.00
3805643 ER NASAL SEPTUM/DRAIN ABS $ 521.00
3805644 ER NASAL/REMOVFB $ 684.00
3805648 ER PERICARDIOCENTESIS INITIAL $ 636.00
3805649 ER PHARYNX REMOVFB $ 477.00
3805651 ER PINCH GRAFT/SNG/MUL $ 1,658.00
3805653 ER REMOV FB FOOT $ 668.00
3805655 ER REP SIMP 2.5CM $ 357.00
3805656 ER REP COMPLEX EXT 7.5 $ 1,189.00
3805657 ER REP COMPLE EXT 2.5 $ 1,055.00
3805658 ER REP/COMPLEX FAC 2.5 $ 1,113.00
3805659 ER REP/COMPL FAC 7.5 $ 1,400.00
3805660 ER REP / COMPL TRUNK 2.5 $ 914.00
3805661 ER REP/COMPL TRUNK 7.5 $ 1,134.00
3805662 ER REP/INTER EXT 7-6-12.5 $ 954.00
3805663 ER REP/INTER EXTR 12.6-20 $ 1,208.00
3805664 ER REP/INTER EXT 2.5CM $ 814.00
3805665 ER REP/INTER EXTR 2.6-7.5 $ 897.00
3805666 ER REP/INTER EXTR 20.1-30 $ 1,504.00
3805667 ER REP/INTER EXTR OVER 30 $ 1,615.00
3805668 ER REP/INTER FACE 12.6-20 $ 1,335.00
3805669 ER REP INTER 20.1-30CM $ 1,235.00
3805670 ER REP INTER 7.6-12.5 $ 919.00
3805671 ER REP INTER OVER 30CM $ 1,426.00
3805672 ER REP SIMP FACE 2.6-5.0 $ 405.00
3805673 ER REP/SIMP FACE 5.1-7.5 $ 475.00
3805674 ER REP/SIMP FACE 7.6-12.5 $ 578.00
3805675 ER REP SIMP 12.6-20.0 $ 528.00
3805676 ER REP SIMP 2.6-7.5CM $ 391.00
3805677 ER REP SIMP 20.1-30.0 $ 642.00
3805678 ER REP SIMP 7.6-12.5CM $ 451.00
3805679 ER REP SIMP FACIAL 2.5 $ 354.00
3805681 ER REP SIMP 30.0CM $ 706.00
3805682 ER SKIN TAGS/ANY AREA -15 $ 271.00
3805683 ER DESTRUCTION PENILE LESIONS $ 390.00
3805684 TREATMENT DISLOCATION FOOT $ 1,481.00
3805685 APPLICATION PASTE BOOT $ 160.00
3805688 ER REPAIR FINGER TENDON $ 2,380.00
3805690 ER REP / SIMP FACE 12.6-20.0 CM $ 649.00
3805695 ER REP INTER 2.5CM $ 688.00
3805696 ER REP INTER 2.6-7.5CM $ 875.00
3805697 ER REP INTER 12.6-20CM $ 1,073.00
3805698 ER REP INTER FACIAL 2.5CM $ 769.00
3805699 ER REP INTER FAC 2.6-5.0 $ 909.00
3805700 ER REP INTER FACE 5.1-7.5 $ 965.00
3805701 ER REP INTER FACE 7.6-12 $ 1,045.00
3805702 ER REP INTER FACE 20.1-30 $ 1,686.00
3805703 ER REP INTER FACE OVER 30 $ 1,675.00
3805705 ER REMOVFB DEEP $ 927.00
3805706 ER FX POSTERIOR PELVIC RING CLOSED TX $ 2,562.00
3805707 INTRAVENOUS START/SAL LOC $ 46.00
3805708 ER SHAVING LESION 1.0CM - 2 CM $ 282.00
3805709 ER DRAINAGE TONSIL ABSCESS $ 428.00
3805714 ER ART PUNCTURE $ 116.00
3805717 NASAL HEM/ANY METHOD $ 75.00
3805720 ER FX PHALANX $ 911.00
3805723 ER FX HIP DISLO ARTHRO $ 1,995.00
3805724 ER FX DISTAL TIBIA $ 1,316.00
3805725 ER DISLO FINGER $ 1,039.00
3805726 ER FX DISLO THUMB $ 1,492.00
3805727 ER DISLO HIP ANESTH $ 2,602.00
3805729 ER ANAL ABCESS $ 466.00
3805730 ER REP COMPLEX EACH AD $ 386.00
3805731 ER REP COMPLEX EA ADD $ 356.00
3805737 ER FX PHALANGE ARTICUL $ 596.00
3805738 ER CARDIOVERSION $ 259.00
3805739 ER FX ANKLE TRIMALL $ 1,707.00
3805742 ER FX TRIMALLEOLAR $ 1,036.00
3805743 ER FX GREAT TOE W/O MANIP $ 436.00
3805744 ER ANOSCOPY DIAGNOSTIC $ 199.00
3805746 ER APP SHORT LEG SPL $ 281.00
3805749 ER FX METATARSAL OPEN $ 1,615.00
3805750 ER I & D BARTHOLINS CYST $ 573.00
3805753 ER SPINAL TAP DIAGNOSTIC $ 124.00
3805754 ER FX PHALANG MANIP $ 1,615.00
3805755 ER FX SUPRACONDYLAR $ 1,754.00
3805757 ER DISLOC MCP JOINT $ 1,521.00
3805761 ER REP/ COMPLEX 1.1-2.5CM $ 901.00
3805763 ER INCISE EXTER HEMORRH $ 545.00
3805764 ER FX NASAL SEPTAL $ 1,995.00
3805765 ER REMOVTUNNELED CV CATH $ 861.00
3805768 ER FX PELVIC RING $ 2,562.00
3805769 ER DISLO PATELLA $ 2,538.00
3805775 ER FX DISTAL FIBULA $ 2,171.00
3805782 ER FX METATARSAL W O MA $ 869.00
3805787 ER FX TIBIA W W/O FIB FX $ 1,678.00
3805788 ER EXCIS LESION FACE 0.5 $ 244.00
3805789 ER DISLO FINGER W ANES $ 1,780.00
3805791 ER MEDIAL MALLEOLUS FX /M $ 2,427.00
3805794 ER DISLO POST HIP ARTHRO $ 2,225.00
3805798 ER FX LOWER JAW $ 1,564.00
3805800 ER THORA $ 465.00
3805802 ER THORA TUBE INSER $ 748.00
3805804 ER FX /BIMALLEOLAR W MA $ 2,369.00
3805807 ER DISLO FX SHOULDER $ 2,111.00
3805809 ER CYSTOSTOMY TUBE CHANGE $ 352.00
3805810 ER EXCIS BENIGN LES 0.5CM $ 388.00
3805813 ER REP LAC TONGUE 2.6 $ 1,055.00
3805814 ER INJ JOINT, BURSA $ 385.00
3805815 REMOVAL INTRAUTERINE DEV $ 352.00
3805816 REPAIR OF VAGINA $ 1,492.00
3805818 REMOVAL FOREIGN BODY SIMP $ 677.00
3805819 ER EYE FB CORNEA W/O SLIT $ 225.00
3805820 INJECTION SCIATIC NERVE $ 392.00
3805822 ER / DISLOCATION TOE $ 152.00
3805823 INJECT, EDIURAL PATCH $ 124.00
3805824 ER TRIGGER POINT INJ $ 181.00
3805825 ER / REPAIR TENDON TOE $ 1,260.00
3805826 REPAIR LEG TENDON $ 1,095.00
3805829 NASAL GAST TUBE PLACEMENT $ 209.00
3805830 BLOCK INJ/ PERIPHERAL $ 202.00
3805834 ER/ FX TIBIA DISLOC/ MANI $ 2,442.00
3805838 ER POST MALLEOLUS FX W MA $ 2,087.00
3805839 ER ET / INTUBATION $ 339.00
3805840 INJECTION/ OCCIPITAL NERV $ 399.00
3805841 ER NERVE BLOCK INJECTION $ 365.00
3805843 ER FX TALUS W MANIP $ 792.00
3805844 ER FX HUMERUS $ 1,607.00
3805845 ER REPAIR FINGER /TENDON $ 3,485.00
3805846 ER FX/ FEMORAL $ 3,437.00
3805848 ER FX DISTAL TIBIA MANIP $ 1,515.00
3805849 INTRAOSSEOUS LINE INSERT $ 167.00
3805850 GASTRIC TUBE INSERTION $ 57.00
3805851 ER / FX FIBULA $ 1,787.00
3805855 ER EXCIS BENIGN LES 0.6-1 $ 466.00
3805857 REPAIR TONGUE LACERATION 2.5> $ 797.00
3805858 CPAP INIT/MGMT $ 162.00
3805859 OSTEOTOMY PHALANX OR FINGER EA $ 1,726.00
3805865 ER REMOV FOREIGN BODY ARM $ 1,655.00
3805868 ER INJ / JOINT BURSA $ 390.00
3805869 ER DRAIN ABSCESS PALATE $ 530.00
3805870 NAIL / EVAC SUB HEMATOMA $ 144.00
3805871 AMPUTATION FINGER/ THUMB $ 2,737.00
3805876 ER INSERTION CHEST TUBE $ 734.00
3805878 FULL THICKNESS GRAFT/ CLOSURE $ 1,674.00
3805879 CATHERIZATION FOR URINE SAMPLE $ 24.00
3805880 SHAVE SKIN LESION 0.6-1.0CM $ 228.00
3805881 ER EXCISION HAND/FINGER LESION <1.5CM $ 723.00
3805882 ER EAR IRRIGATION / LAVAGE $ 51.00
3805883 ER CLOSED TX METATARSOPHALANGEAL JNT DIS $ 1,306.00
3805884 ER REMOVAL FB INTRANASAL / ANES $ 1,976.00
3805885 ER DISLOCATED FINGER W ANES $ 3,205.00
3805886 CLOSED TX FEMORAL SHAFT FX / REDUC W/O M $ 1,995.00
3805887 ER CLOSED REDUC TX FEMORAL FX DISTAL W/O $ 1,995.00
3805888 ER DISLOCATED TOE REDUCTION - INTERPHAL $ 1,283.00
3805889 ER INJ PARAVETEBRAL FACET W IMAGE GUID $ 1,596.00
3805890 ER INJECTION SINGLE TENDON W/O US GUID $ 581.00
3805961 FOREIGN BODY REM EYE $ 110.00
3805985 DIRECT ADM HOSP OBSV CARE $ 205.00
3805988 PHLEBOTOMY $ 360.00
3805998 ER SHORT LEG METAL SPLINT $ 80.00
3806004 TRACHEOTOMY $ 973.00
3806021 REP FOREARM TENDON/MUSCLE $ 1,176.00
3806022 I & D VULVA/PERINEUM $ 501.00
3806024 INCISION RECTAL ABSCESS $ 1,859.00
3806032 DEBRIDEMENT MUSCLE/ FASCIA <20CM OR LES $ 658.00
3806033 DEBRIDEMENT BONE < 20CM $ 972.00
3806034 DEBRIDEMENT ADDITIONAL 20CM SUBCUTANEOUS $ 109.00
3806035 DEBRIDEMENT ADDITIONAL 20CM MUSCLE $ 235.00
3806036 DEBRIDEMENT ADDITIONAL 20CM BONE $ 416.00
3806037 AVULSION NAIL PLATE EA ADDITIONAL $ 77.00
3806038 ER REPAIR SIMPLE FACIAL 20.1 - 30.0 CM $ 720.00
3806039 ER REPAIR SIMPLE FACIAL OVER 30.0CM $ 798.00
3806041 ER REPAIR COMPLEX EYELIDS EA ADD 5CM < $ 391.00
3806042 DRESSING / DEBRIDEMENT PART THICK >10% $ 563.00
3806043 ER TRIGGER POINT INJ 3+ MUSCLES $ 184.00
3806044 ER REMOV FOREIGN BODY SHOULDER SUBCUT $ 650.00
3806045 ER REMOV FOREIGN BODY SHOULDER DEEP $ 1,896.00
3806046 ER REMOVAL FOREIGN BODY UPPER ARM/ELBOW $ 588.00
3806047 ER FX SUPRACONDYLAR W MANIP $ 2,366.00
3806048 ER DRAINAGE FINGER ABSCESS SIMPLE $ 579.00
3806049 ER REP EXTENSOR TENDON W/O GRAFT EA TEND $ 2,344.00
3806050 ER REMOVAL FOREIGN BODY PELVIS/ HIP $ 675.00
3806051 ER REMOV FOREIGN BODY PELVIS / HIP DEEP $ 2,583.00
3806052 ER TX SPONTANEOUS HIP DISLOCATION $ 982.00
3806053 ER FX FEMORAL SHAFT W MANIP $ 3,183.00
3806054 ER FX SUPRACONDYLAR FEMORAL W MANIP $ 3,342.00
3806055 ER REMOVAL FOREIGN BODY FOOT DEEP $ 1,347.00
3806056 ER REMOVAL FOREIGN BODY FOOT COMPLICATED $ 1,591.00
3806057 DISLOCATION METATARSOPHALANGEAL JOINT $ 471.00
3806058 ER APPLICATION CAST LONG ARM $ 288.00
3806059 ER APPLICATION CAST SHORT ARM $ 263.00
3806060 ER APPLICATION SPLINT LONG ARM $ 252.00
3806061 ER APPLICATION SPLINT SHORT ARM $ 167.00
3806062 ER APPLICATION SPLINT FINGERS $ 121.00
3806063 ER STRAPPING THORAX $ 78.00
3806064 ER STRAPPING SHOULDER $ 78.00
3806065 ER STRAPPING ELBOW WRIST $ 67.00
3806066 ER STRAPPING HAND / FINGER $ 85.00
3806067 ER CAST LONG LEG $ 424.00
3806068 ER CAST SHORT LEG $ 255.00
3806069 ER SPLINT LONG LEG $ 211.00
3806070 ER STRAPPING KNEE $ 129.00
3806071 ER STRAPPING ANKLE / FOOT $ 296.00
3806072 ER STRAPPING TOES $ 50.00
3806073 ER TRACHEOSTOMY ER PROCEDURE $ 770.00
3806074 THORACOTOMY $ 3,358.00
3806075 THORACOTOMY W /CONTROL TRAUMATIC HEMORR $ 6,060.00
3806076 THORACOTOMY W CARDIAC MASSAGE $ 3,284.00
3806077 VENIPUNCTURE < 3 YEARS $ 80.00
3806078 VENIPUNCTURE > 3 YEARS $ 41.00
3806079 VENIPUNCTURE CUTDOWN < 1 YEAR $ 228.00
3806080 VENIPUNCTURE CUTDOWN > 1 YEAR $ 171.00
3806081 CENTRAL LINE LESS THAN 5 YEARS $ 462.00
3806082 CENTRAL LINE 5 YEARS OLDER $ 515.00
3806083 ARTERIAL LINE $ 220.00
3806084 REMOV FOREIGN BODY EAR/AN $ 465.00
3806085 ER CEREBRAL THROMBOLYSIS $ 0.00
3806086 REMOVAL FB SOFT TISSUE VESTIBULE MOUTH $ 490.00
3806087 REMOVAL FB SOFT TISSUE VESTIBULE COMPLIC $ 1,001.00
3806088 ER REPAIR LACERATION TONGUE < 2.5 CM $ 660.00
3806090 TRAUMA ACTIVATION $ 2,554.00
3806092 ER CARE I $ 378.00
3806093 ER CARE II $ 717.00
3806094 ER CARE III $ 1,211.00
3806095 ER CARE IV $ 1,606.00
3806096 ER CARE V $ 1,986.00
3806097 CRITICAL CARE 1ST HR $ 2,565.00
3806098 CRITICAL CARE EA ADD 1/2H $ 596.00
3806100 HEMORRHOID THROMBECTOMY $ 466.00
3806101 ANOSCOPY W REMOVAL FB $ 348.00
3806102 ABDOMINAL PARACENTSIS W IMAGING GUIDANCE $ 471.00
3806103 ER TRANS, BLOOD 0-2HR $ 352.00
3806105 ER CARDIOPULMONARY RESUS $ 345.00
3806106 ER TRANS, BLOOD 0-4HR $ 444.00
3806107 ER TRANS, BLOOD 0-6HR $ 760.00
3806108 ER TRANS, BLOOD 0-8HR $ 1,018.00
3806109 TRANSFUSION,BLOOD > 8HR $ 1,271.00
3806112 PERITONEAL LAVAGE $ 450.00
3806113 BLADDER SCAN $ 85.00
3806114 INCISION DRAINAGE SCROTAL ABSCESS $ 708.00
3806115 VAGINAL DELIVERY $ 3,361.00
3806116 DELIVERY PLACENTA $ 377.00
3806117 NERVE BLOCK, DENTAL BLOCK $ 295.00
3806118 TEMPORARY TRANSCUTANEOUS PACING $ 3.00
3806119 CORONARY THROMBOLYSIS $ 286.00
3806120 MODERATE SEDATION < 5 YEARS $ 100.00
3806121 ARTHROCENTESIS SM JOINT FINGER TOES $ 392.00
3806122 ARTHROCENTESIS SM JOINT W US GUIDANCE $ 582.00
3806123 ARTHROCENTESIS WRIST ELBOW W US GUID REP $ 580.00
3806124 ARTHROCENTESIS SHOULDER HIP W US GUID RE $ 575.00
3806125 MODERATE SEDATION < 5 YEARS $ 392.00
3806126 MODERATE SEDATION 5 YEARS OLDER $ 321.00
3806127 MODERATE SEDATION EA ADD 15 MN $ 244.00
3806128 REMOVAL CORNEA EPITHELIUM W W/O CHEMOCAU $ 190.00
3806129 REPLACEMENT GASTROSTOMY TUBE $ 513.00
3806167 ER ONE TOUCH $ 43.00
3806171 PARACENTESIS ABD W/O GUID $ 455.00
3806173 STRAPPING HIP $ 129.00
3806187 CRITICAL CARE 1ST HR $ 2,565.00
3806190 PEDIATRIC CRIT CARE $ 1,261.00
3806192 ER CARE 1 $ 378.00
3806193 ER CARE II $ 717.00
3806194 ER CARE III $ 1,211.00
3806195 ER CARE IV $ 1,606.00
3806196 ER CARE V $ 1,986.00
3806300 THORACENTESIS W/O IMAG $ 1,382.00
3806301 THORACENTESIS W IMAG $ 1,582.00
3806401 IV INFUSION / HYDRATION 31" TO 1HR $ 91.00
3806402 IV INFUSION / HYDRATION EA ADD HOUR $ 32.00
3806403 IV THERAPY INITIAL UP TO 1 HOUR $ 172.00
3806404 IV THERAPY EA ADD HOUR $ 52.00
3806405 IV THERAPY ADD SEQ INFUSION $ 52.00
3806406 IM INJECTION / THERAPEUTIC $ 143.00
3806407 IV PUSH $ 95.00
3806408 IV PUSH EA ADD $ 41.00
3806409 IV PORT FLUSH $ 186.00
3806410 IMMUNIZATION $ 29.00
3806411 IMMUNIZATION EA ADD VACCINE $ 25.00
3806412 IV PUSH / SAME SUBSTANCE $ 41.00
3806413 INFUSION THERAPY $ 172.00
3806414 IV THERAPY SEQ CONCURRENT INFUSION $ 52.00
3807121 ER LONG LEG SPLINT-ADULT $ 42.00
3807122 ER SHORT LEG SPLINT-ADULT $ 42.00
3807123 ER LONG ARM SPLINT-ADULT $ 33.00
3807124 ER SHORT ARM SPLINT-ADULT $ 26.00
3807125 ER LONG LEG SPLINT-CHILD $ 33.00
3807126 ER SHORT LEG SPLINT-CHILD $ 30.00
3807127 ER LONG ARM SPLINT-CHILD $ 20.00
3807128 ER SHORT ARM SPLINT-CHILD $ 26.00
3807200 ER CAST LONGARM ADULT FIB $ 142.00
3807201 ER CAST LONGARM PED FIB $ 93.00
3807202 ER CAST SHRTARM ADULT FIB $ 93.00
3807203 ER CAST SHRTARM PED FIB $ 45.00
3807204 ER CAST GAUNTLETADULT FIB $ 91.00
3807205 ER CAST GAUNTLETPED FIB $ 87.00
3807206 ER CAST LONGLEG ADULT FIB $ 133.00
3807207 ER CAST LONGLEG PED FIB $ 93.00
3807208 ER CAST/SHORT LEG ADULT $ 93.00
3807209 ER CAST SHORTLEG PED FIB $ 93.00
3807211 ER INJECTION JOINT, BURSA $ 238.00
3807212 WOUND CLOSURE ADHESIVE $ 44.00
3808601 ER SKIN TAG REMOVEA ADD L $ 45.00
3808602 ER REP COMPLEX 2.6-7.5CM $ 1,209.00
3808650 SANE EXAM $ 469.00
3808655 SANE EXAM SUSPECT $ 201.00
3802274 VENIPUNCTURE CUTDOWN < 1 YEAR $ 228.00
3806040 ER REPAIR COMPLEX TRUNK EA ADD 5CM OR < $ 314.00
3821000 ER PHYSICIAN I $ 151.00
3821005 ER PHYSICIAN I $ 151.00
3821008 ER PHYSICIAN I $ 151.00
3821100 ER PHYSICIAN II $ 280.00
3821105 ER PHYSICIAN II $ 280.00
3821108 ER PHYSICIAN II $ 280.00
3821200 ER PHYSICIAN III $ 375.00
3821205 ER PHYSICIAN III $ 375.00
3821208 ER PHYSICIAN III $ 375.00
3821300 ER PHYSICIAN IV $ 527.00
3821305 ER PHYSICIAN IV $ 527.00
3821308 ER PHYSICIAN IV $ 527.00
3821400 ER PHYSICIAN V $ 694.00
3821405 ER PHYSICIAN V $ 694.00
3821408 ER PHYSICIAN V $ 694.00
3821450 PEDIATRIC CRIT CARE $ 1,056.00
3821500 CRITICAL CARE/PHYS 1ST HR $ 869.00
3821505 CRITICAL CARE/PHYS 1ST HR $ 869.00
3821508 CRITICAL CARE/PHYS 1ST HR $ 869.00
3821510 CRITICAL CARE / PHYS EA 1/2 HR $ 523.00
3821525 CRIT CARE/PHYS EA 1/2 HR $ 523.00
3821530 PROLONGED SERVICE 1ST HR $ 376.00
3821605 CARDIOVERSION $ 537.00
3821606 INTRAOSSEOUS LINE INSERT $ 260.00
3821607 EKG INTERP AND REPORT $ 36.00
3821611 ARTERIAL PUNCTURE $ 69.00
3821616 ET / INTUBATION $ 485.00
3821617 PERICARDIOCENTESIS INITIAL $ 512.00
3821618 THORACOTOMY/CONTROL TRAUM $ 6,404.00
3821619 TRACHEOSTOMY $ 979.00
3821622 VENIPUNCTURE <3YO $ 43.00
3821623 VENIPUNCTURE > 3YO $ 41.00
3821624 CPR $ 818.00
3821625 THORACOSTOMY,TUBE,HEM,ABC $ 763.00
3821626 VEIN CUT DOWN > 1YO $ 176.00
3821627 GASTRIC INTUB / ASPIR / LAVAGE $ 117.00
3821631 ET / INTUBATION $ 485.00
3821632 BIOPSY ENDOMETRIAL SAMPLI $ 390.00
3821633 THORACOSTOMY, TUBE, HEM $ 388.00
3821637 NAIL/ AVULSION OF PLATE $ 223.00
3821638 REMOV TUNNEL CENT CATHETER $ 861.00
3821639 CLOSED TX METATARSOPHALANGEAL JNT DISLOC $ 328.00
3821640 DISLOCATED FINGER REDUCTION W ANES $ 935.00
3821641 CLOSED TX FEMORAL SHAFT FX W/O MANIP $ 1,178.00
3821642 CLOSED FX REDUC TX FEMORAL DISTAL W/O MA $ 1,212.00
3821643 DISLOCATED TOE REDUCTION - INTERPHAL $ 322.00
3821644 INJ PARAVETEBRAL FACET W IMAGE GUID $ 259.00
3821645 INJECTION SINGLE TENDON W/O US GUID $ 99.00
3821754 FRACTURE / ANKLE DISLOC W ANES $ 2,198.00
3821759 ABCESS / SIMPLE I & D $ 433.00
3821761 ABCESS/COMPLEX I & D $ 801.00
3821764 BREAST CYST ASPIRATION $ 189.00
3821765 CYST/COMPLEX PILONIDAL ID $ 765.00
3821766 CYST/SIMPLE PILONIDAL I&D $ 464.00
3821770 CYST/SIMPLE PILONIDAL I&D $ 464.00
3821771 REMOVAL FB / FOOT $ 603.00
3821772 REP FOREARM TENDON/MUSCLE $ 1,093.00
3821773 I & D VULVA/ PERINEUM $ 488.00
3821774 ABSCESS / COMPLEX I&D $ 801.00
3821775 PHYS /DESTRUCTION PENILE LESIONS $ 389.00
3821776 NAIL / AVULSION OF PLATE $ 223.00
3821780 CYST / COMPLEX PILONIDAL ID $ 765.00
3821781 I & D BARTHOLINS CYST $ 409.00
3821782 SPLINT / SHORT ARM $ 178.00
3821788 HEMATOMA/ INCISION-DRAIN $ 530.00
3821789 DEBRIDEMENT 10% BODY $ 63.00
3821790 REMOVAL FB/SUBCUTANEOUS $ 466.00
3821791 REMOVAL FB/COMPLEX SUBCUT $ 829.00
3821792 HEMATOMA/INCISION-DRAIN $ 530.00
3821793 ABSCESS/PUNC ASPIRATION $ 429.00
3821794 DEBRIDEMENT <10% BODY $ 126.00
3821796 REMOVAL FB / COMPLEX $ 829.00
3821798 DEBRIDEMENT SUBCUTANEOUS $ 274.00
3821801 SKIN TAGS/ANY AREA(TO 15) $ 329.00
3821827 EXCISION.REMOVAL FB SIMPL $ 466.00
3821845 EYE/REMOVAL SUPERFIC FB $ 200.00
3821846 FRACTURE/ACROMIPCLAV W MA $ 1,414.00
3821847 FRACTURE/ACROMIOCLAVICLE $ 1,027.00
3821848 FRACTURE/ANKLE $ 738.00
3821849 FRACTURE/ANKLE DISLO W AN $ 2,198.00
3821850 FRACTURE/ANKLE DISLOCATIO $ 1,671.00
3821851 FRACTURE/ CALCANEAL $ 1,039.00
3821852 FRACTURE/CARPAL BGO W MAN $ 1,790.00
3821853 EYE/CORNEA FB W SLIT LAMP $ 241.00
3821854 EYE/DRAIN LACRIMAL GLAND $ 609.00
3821855 EYE / FB CORNEA W/O SLIT LAMP $ 189.00
3821856 EYE/LACERATION SCLERA $ 642.00
3821857 EYE/REMOVAL FB EYE LID $ 532.00
3821858 EYE/REMOVAL IMBEDDED FB $ 242.00
3821859 FRACTURE/CARPAL BONE $ 1,254.00
3821860 FRACTURE/CARPAL SCAP W MA $ 1,931.00
3821861 FRACTURE/CARPAL SCAPHOID $ 1,245.00
3821862 FRACTURE/CARPOMETACARPAL $ 1,338.00
3821863 FRACTURE/CLAVICLE W MANIP $ 1,483.00
3821865 FRACTURE/CLAVICULAR $ 999.00
3821866 FRACTURE/DIS ELBOW W ANES $ 1,163.00
3821867 FRACTURE/DISLOC ELBOW $ 1,496.00
3821869 FRACTURE/DIST PHALAN W MA $ 1,222.00
3821870 FRACTURE/DIST PHALAN W MA $ 1,222.00
3821877 FRACTURE/DISTAL PHALANGE $ 452.00
3821878 FRACUTRE/DISTAL PHALANG $ 832.00
3821887 FRACTURE/DISTAL RADIAL $ 1,401.00
3821888 FRACTURE/DISTAL RADIOULNA $ 1,805.00
3821889 FRACTURE/FEMUR $ 2,096.00
3821890 FRACTURE/FIBULA $ 683.00
3821891 FRACTURE/GALEAZZI RADIAL $ 2,377.00
3821892 FRACUTRE/GREAT TOE W MANI $ 681.00
3821893 FRACTURE/DREAT TOE W/O MA $ 294.00
3821894 FRACTURE/GREATER TROCHANT $ 1,712.00
3821895 FRACTURE / HIP DISLOCATION $ 790.00
3821896 FRACTURE/HUMERAL SHAFT $ 800.00
3821897 FRACTURE/HUMERUS W MAN $ 2,011.00
3821898 FRACTURE/KNEE DISLOCATION $ 2,050.00
3821899 FRACTURE/KNEE W ANES $ 1,545.00
3821900 FRACTURE/ LAT EPICONDYL $ 1,293.00
3821901 FRACTURE/ LAT MALLEOLUS $ 699.00
3821902 FRACTURE/LUNATE DISLOCATI $ 2,127.00
3821903 FRACTURE/METACARPAL $ 679.00
3821908 FRACTURE/METACARPAL $ 1,246.00
3821912 FRACTURE/METACARPAL W MAN $ 1,314.00
3821913 FRACTURE/MEATACARPAL W MA $ 1,314.00
3821921 FRACTURE / METATARSAL W MANIP $ 1,017.00
3821928 FRACTURE/METATARSAL W MAN $ 1,017.00
3821930 FRACTURE/METATARSAL WO MA $ 500.00
3821938 FRACTURE/METATARSAL WO MA $ 936.00
3821939 FRACTURE/MONTEGGIA ELBOW $ 2,448.00
3821940 FRACTURE/PATELLA W ANES $ 2,766.00
3821941 DISLOCAT/PATELLA WO ANES $ 1,508.00
3821942 FRACTURE/PATELLA WO MANI $ 1,326.00
3821943 FRACTURE/PHALAN/OPEN $ 2,637.00
3821944 FRACTURE/PHALAN/OPEN $ 2,637.00
3821945 FRACTURE/DISTAL RADIAL $ 1,401.00
3821949 FRACTURE/MEDIAL MALLEOLUS $ 747.00
3821951 DISLOCATION/ FINGER $ 1,147.00
3821952 FRACTURE / PHALANGE $ 548.00
3821961 FRACTURE/PHALANGES W MANI $ 650.00
3821968 FRACTURE/PHALANGE W MAN $ 650.00
3821970 FRACTURE/PROX HUMER W MAN $ 1,892.00
3821971 FRACTURE/PROX HUMERAL $ 1,384.00
3821972 FRACTURE/RAD HEAD CHILD $ 427.00
3821973 FRACTURE/RAD SHAFT W MANI $ 2,048.00
3821974 FRACTURE/RAD ULNAR SHAFT $ 618.00
3821975 FRACTURE/RAD ULNA W MAN $ 2,099.00
3821976 FRACTURE / RADIAL HEAD W MANIP $ 1,779.00
3821977 FRACTURE/RADIAL HEAD NECK $ 590.00
3821979 FRACTURE/RADIO-INTERCARPA $ 1,824.00
3821981 FRACTURE/SCAPULAR WO MAN $ 1,073.00
3821982 CLOSED TX SHOULDER DISLOC MANIP/ANES $ 990.00
3821983 CLOSED TX SHOULDER DISLOCATION W MAN $ 1,293.00
3821984 FRACTURE / STERNOCLAV W MANIP $ 1,556.00
3821985 FRACTURE/STERNOCLAV WO MA $ 1,049.00
3821986 FRACTURE/TALUS $ 948.00
3821987 FRACTURE/TARSAL BONE $ 871.00
3821988 FRACTURE/TARSAL BONE $ 794.00
3821989 FRACTURE/TARSAL W MANIP $ 1,059.00
3821990 FRACTURE/ THUMB W MANIP $ 1,497.00
3821991 FRACTURE/ THUMB BENNETT $ 2,117.00
3821992 FRACTURE/TIBIA W MANIP $ 2,547.00
3821993 FRACTURE/ TIBIA WO MANIP $ 1,263.00
3821994 FRACTURE / SCAPHOPERI $ 2,126.00
3821995 FRACTURE/ TUBEROSITY W MA $ 1,577.00
3821996 FRACTURE / PHALANGEAL MANIP $ 1,356.00
3821997 FRACTURE DISTAL TIBIA $ 746.00
3821998 DISLOC / FINGER $ 1,147.00
3822000 REPAIR SIMPLE 2.5CM $ 157.00
3822002 REPAIR SIMPLE 2.5CM $ 157.00
3822036 FRACTURE/ ANKLE TRIMALL $ 1,936.00
3822039 FRACTURE/ PHALANX $ 450.00
3822040 FX/ TRIMALLEOLAR $ 1,284.00
3822041 FRACTURE/ ULNAR STYLOID $ 1,345.00
3822045 FRACTURE PHALANGE $ 832.00
3822049 FRACTURE CALCANEAL $ 1,039.00
3822052 FRACTURE/ LAT MALLEOLUS $ 1,290.00
3822060 FRACTURE PHALANGE MANIP $ 1,356.00
3822063 DISLOC MCP JOINT $ 1,360.00
3822073 FRACTURE/ DISTAL FIBULA $ 1,725.00
3822076 FRACTURE/ ORBIT W/O MANIP $ 718.00
3822077 FRACTURE/BIMALLEOLAR W MA $ 2,100.00
3822078 FRACTURE GREAT TOE $ 575.00
3822079 FRACTURE / PROX HUMERAL $ 755.00
3822082 FRACTURE/SCAPULA W/O MANI $ 1,073.00
3822083 STRAPPING OF SHOULDER $ 47.00
3822084 APPLIC LOWER LEG SPLINT $ 223.00
3822089 DEBRIDE SKIN/ FX $ 1,232.00
3822091 STRAPPING / KNEE $ 47.00
3822092 STRAPPING / KNEE $ 47.00
3822093 DISLOCATION/ THUMB $ 1,360.00
3822094 DISLOCATION / FX SHOULDER $ 1,760.00
3822096 FRACTURE/ DISTAL FIBULA $ 1,725.00
3822097 DISLOCATION / FX SHOULDER $ 1,760.00
3822098 FRACTURE/ ULNAR STYLOID $ 1,345.00
3822100 REPAIR SIMPLE 2.6-7.5CM $ 190.00
3822102 REPAIR SIMPLE 2.6-7.5CM $ 190.00
3822127 REPAIR SIMPLE 7.6-12.5 $ 226.00
3822129 DISLOC POST HIP PROS/ANES $ 2,560.00
3822131 REMOVAL FB FOOT $ 603.00
3822132 REMOVAL FOREIGN BODY SIMP $ 653.00
3822133 REMOVAL FOREIGN BODY $ 653.00
3822137 FRACTURE/ ANKLE TRIMALLEO $ 1,936.00
3822141 REPAIR TENDON TOE $ 1,386.00
3822143 FRACTURE/ CLAVICLE W MANI $ 1,483.00
3822144 FRACTURE/ KNEE DISLOCATIO $ 2,050.00
3822148 DRAINAGE ABSCESS PALATE $ 528.00
3822155 FRACTURE/ THUMB W MANIP $ 1,497.00
3822156 INJECTION/ OCCIPITAL NERV $ 276.00
3822157 NERVE BLOCK INJECTION $ 338.00
3822158 DISLOC / SHOULDER W ANES $ 1,778.00
3822159 FX / TRIMALLEOLAR $ 709.00
3822162 FRACTURE MEDIAL MALLEOLUS $ 1,374.00
3822163 FRACTURE / FEMORAL $ 3,020.00
3822181 FRACTURE/ TARSAL W MANIP $ 1,059.00
3822182 REPAIR FINGER TENDON $ 2,373.00
3822186 BLOCK INJ / PERIPHERAL NERVE $ 109.00
3822188 ABSCESS / PUNCTURE ASPIRATION $ 429.00
3822190 SHAVING LESION 1.1CM - 2CM $ 281.00
3822191 NASAL / REMOVAL FOREIGN BODY $ 587.00
3822192 DRAINAGE OF TONSIL ABSCESS $ 579.00
3822193 SHAVE SKIN LESION 0.6-1.0CM $ 228.00
3822194 REPAIR FINGER TENDON $ 2,373.00
3822195 DEBRIDEMENT MUSCLE FASCIA <20CM OR LESS $ 658.00
3822196 DEBRIDEMENT BONE <20CM $ 972.00
3822197 DEBRIDEMENT ADDITIONAL 20CM SUBCUTANEOUS $ 109.00
3822198 DEBRIDEMENT ADDITIONAL 20CM MUSCLE $ 235.00
3822199 DEBRIDEMENT ADDITIONAL 20CM BONE $ 416.00
3822200 REPAIR SIMPLE 7.6-12.5CM $ 226.00
3822224 FRACTURE/ DISTAL RAD W MA $ 1,246.00
3822225 REPAIR/INTER EXTR 7.6-12. $ 576.00
3822226 FRACTURE/ SHOULDER W MAN $ 1,293.00
3822229 FRACTURE/ DISTAL RAD W MA $ 2,294.00
3822233 FRACTURE / HUMERUS W MAN $ 2,011.00
3822234 NAIL / EVAC SUB HEMATOMA $ 146.00
3822235 INJECTION JOINT BURSA $ 92.00
3822237 FRACTURE / DISLOCATION ELBOW $ 2,082.00
3822241 FRACTURE / STERNOCLAV W MANIP $ 1,556.00
3822242 FULL THICKNESS GRAFT,CLOSURE $ 3,320.00
3822244 EXCISION LESION HAND/FINGER <1.5 CM $ 1,395.00
3822245 BLOCK INJ PERIPHERAL $ 202.00
3822246 EAR IRRIGATION / LAVAGE $ 34.00
3822247 AVULSION NAIL PLATE EA ADDITIONAL $ 77.00
3822248 REPAIR SIMPLE FACIAL 20.1 - 30.0CM $ 419.00
3822249 REPAIR SIMPLE FACIAL OVER 30.0CM $ 468.00
3822250 TRIGGER POINT INJECT 3+ MUSCLES $ 184.00
3822251 REMOVAL FOREIGN BODY SHOULDER SUBCUT $ 650.00
3822252 REMOVAL FOREIGN BODY SHOULDER DEEP $ 1,896.00
3822253 FRACTURE/ SUPRACONDYLAR W MANIP $ 2,366.00
3822254 DRAINAGE FINGER ABSCESS SIMPLE $ 579.00
3822255 REPAIR EXTENSOR TENDON W/O GRAFT EA TEND $ 2,344.00
3822256 REMOVAL FOREIGN BODY PELVIS / HIP $ 675.00
3822257 REMOVAL FOREIGN BODY PELVIS / HIP DEEP $ 2,583.00
3822258 TX SPONTANEOUS HIP DISLOCATION $ 982.00
3822259 FRACTURE FEMORAL SHAFT W MANIP $ 3,183.00
3822260 FX SUPRACONDYLAR FEMORAL W MANIP $ 3,342.00
3822261 REMOVAL FOREIGN BODY FOOT DEEP $ 1,347.00
3822262 REMOVAL FOREIGN BODY FOOT COMPLICATED $ 1,591.00
3822263 DISLOCATION METATARSOPHALANGEAL $ 471.00
3822264 STRAPPING THORAX $ 47.00
3822265 STRAPPING ELBOW /WRIST $ 48.00
3822266 STRAPPING HAND / FINGER $ 50.00
3822267 STRAPPING ANKLE / FOOT $ 45.00
3822268 STRAPPING TOES $ 29.00
3822269 TRACHEOSTOMY ER PROCEDURE $ 770.00
3822270 THORACOTOMY $ 3,358.00
3822271 THORACOTOMY W CARDIAC MASSAGE $ 3,284.00
3822272 PERIPHERAL IV PLACEMENT, EJ LINE PLACEME $ 41.00
3822273 VENIPUNCTURE < 3 YEARS $ 77.00
3822275 CENTRAL LINE LESS THAN 5 YEARS $ 462.00
3822276 CENTRAL LINE 5 YEARS OLDER $ 515.00
3822277 ARTERIAL LINE $ 220.00
3822278 CEREBRAL THROMBOLYSIS $ 0.00
3822279 REMOVAL FB SOFT TISSUE VESTIBULE MOUTH $ 490.00
3822280 REMOVAL FB SOFT TISSUE VESTIBULE COMPLIC $ 1,001.00
3822282 HEMORRHOID THROMBECTOMY $ 466.00
3822283 ANOSCOPY W REMOVAL FB $ 348.00
3822284 ABDOMINAL PARACENTESIS W IMAGING GUIDANC $ 471.00
3822285 PERITONEAL LAVAGE $ 450.00
3822286 INCISON DRAINAGE SCROTAL ABSCESS $ 708.00
3822287 VAGINAL DELIVERY $ 3,361.00
3822288 DELIVERY PLACENTA $ 377.00
3822289 STRAPPING HIP $ 47.00
3822290 CORONARY THROMBOLYSIS $ 286.00
3822291 MODERATE SEDATION < 5 YEARS $ 100.00
3822292 MODERATE SEDATON 5 YEARS > $ 53.00
3822293 MODERATE SEDATION EA ADD 15 MN $ 46.00
3822294 ARTHROCENTESIS SM JOINT FING TOES $ 88.00
3822295 ARTHROCENTESIS SM JOINT W US GUIDANCE $ 114.00
3822296 ARTHROCENTESIS WRIST ELBOW W US GUID REP $ 131.00
3822297 ARTHROCENTESIS SHOULDER HIP W US GUID RE $ 150.00
3822298 MODERATE SEDATION < 5 YEARS $ 392.00
3822299 MODERATE SEDATION 5 YEARS OLDER $ 321.00
3822300 REPAIR SIMPLE 12.6-20.0CM $ 279.00
3822301 REPAIR SIMPLE 12.6-20.0CM $ 279.00
3822325 SPLINT / FINGER $ 126.00
3822332 REMOVAL INTRAUTERINE DEV $ 300.00
3822334 INCISE EXTER HEMORRHOID $ 476.00
3822337 DISLOCAT/PATELLA W/O ANES $ 1,508.00
3822341 REMOVAL INTRAUTERINE DEVICE $ 300.00
3822345 NAIL / REPAIR NAIL BED $ 599.00
3822346 NAIL / REPAIR NAIL BED $ 599.00
3822354 MODERATE SEDATION EA ADD 15 MN $ 244.00
3822355 REMOVAL CORNEA EPITHELIUM W W/O CHEMOCAU $ 297.00
3822356 REPLACEMENT GASTROSTOMY TUBE $ 95.00
3822401 REPAIR SIMPLE 20.1-30.0CM $ 333.00
3822402 REPAIR SIMPLE 20.1-30.0CM $ 333.00
3822500 REPAIR SIMPLE OVER 30.0CM $ 403.00
3822502 REPAIR SIMPLE OVER 30.0CM $ 403.00
3822524 REPAIR OF VAGINA $ 1,337.00
3822526 INJECTION JOINT, BURSA $ 202.00
3822527 ABSCESS/ SIMPLE I & D $ 433.00
3822532 INJECTION JOINT BURSA $ 350.00
3822536 INJECTION JOINT, BURSA $ 202.00
3822537 DRAINAGE FINGER ABSCESS $ 822.00
3822538 INJECTION SCIATIC NERVE $ 293.00
3822539 INJECTION JOINT, BURSA $ 202.00
3822540 FRACTURE / TALUS W MANIP $ 1,436.00
3822541 NAIL / EVAC SUBUNG HEMATOMA $ 146.00
3822600 REPAIR SIMPLE FACIAL 2.5 $ 181.00
3822608 REPAIR/SIMPLE FACIAL 2.5C $ 181.00
3822700 REPAIR SIMPLE FAC 2.6-5.0 $ 190.00
3822712 REPAIR COMPLEX 2.6- 7.5CM $ 821.00
3822800 REPAIR SIMPLE FACIAL 5.1-7.5 $ 231.00
382289 NERVE BLOCK, DENTAL BLOCK $ 295.00
3822900 REPAIR SIMPLE FAC 7.6-12. $ 277.00
3822907 REPAIR SIMPLE FACIAL 12.6-20 $ 362.00
3822908 REPAIR SIMPLE FACIAL 1.6-20.0CM $ 362.00
3823000 REPAIR INTERMED 2.5CM $ 424.00
3823008 REPAIR INTERMED 2.5CM $ 424.00
3823100 REPAIR INTERMED 2.6-7.5CM $ 525.00
3823108 REPAIR INTERMED 2.6-7.5CM $ 525.00
3823200 REPAIR INTERMED 7.6-12.5C $ 558.00
3823208 REPAIR INTERMED 7.6-12.5C $ 558.00
3823300 REPAIR INTERMED 12.6-20CM $ 639.00
3823308 REPAIR INTERMED 12.6-20. CM $ 639.00
3823400 REPAIR INTERMED 20.1-30.CM $ 736.00
3823408 REPAIR INTERMED 20.1-30CM $ 736.00
3823500 REPAIR INTERMED OVER 30CM $ 853.00
3823508 REPAIR INTERMED OVER 30CM $ 853.00
3823600 REPAIR INTER EXTR 2.5CM $ 415.00
3823608 REPAIR INTER EXTR 2.5CM $ 415.00
3823623 FRACTURE/ DISTAL RADIOULN $ 1,805.00
3823700 REPAIR INTE EXT 2.6-7.5CM $ 540.00
3823708 REPAIR INTE EXTR 2.6-7.5C $ 540.00
3823724 FRACTURE GREAT TOE $ 306.00
3823800 REPAIR/INTER EXT 7.6-12.5 $ 576.00
3823900 REPAIR/INTER EXTR 12.6-20 $ 708.00
3823901 REPAIR / INTER EXTR 12.6-20CM $ 708.00
3823910 REPAIR INTER EXTR 20.1-30 $ 815.00
3823920 REPAIR/INTER EXTR OVER 30 $ 903.00
3824000 REPAIR/INTER FACIAL 2.5CM $ 468.00
3824001 REPAIR INTERMED FACE 2.5C $ 468.00
3824100 REPAIR/INTER FACE 2.6-7.5 $ 548.00
3824101 REPAIR/INTER FACE 2.6-7.5 $ 548.00
3824200 REPAIR/INTER FACE 5.1-7.5 $ 583.00
3824201 REPAIR/INTER FACE 5.1-7.5 $ 583.00
3824300 REPAIR INTER FACIAL 7.6-12 $ 593.00
3824400 REPAIR/INTER FACE 12.6-20 $ 789.00
3824500 REPAIR INTER FACEIAL 20.1-30 $ 989.00
3824600 REPAIR/INTER FACE OVER 30 $ 1,093.00
3824610 PINCH GRAFT SGL MULT $ 2,005.00
3824700 REPAIR/COMPLEX TRUNK 2.5C $ 553.00
3824701 REPAIR/COMPLEX TRUNK 2.5C $ 553.00
3824708 REPAIR COMPLEX EXTR 2.5CM $ 628.00
3824710 REPIAR COMPLEX TRUNK 7.5CM $ 1,134.00
3824712 REPAIR COMP EA +5CM $ 259.00
3824720 REPAIR COMPLEX EXTR 2.5 $ 628.00
3824730 REPAIR/COMPLEX EXTR 7.5C $ 704.00
3824740 REPAIR/COMPLEX FACIAL 2.5 $ 661.00
3824743 REPAIR/ COMPLEX 1.1- 2.5 $ 661.00
3824744 REPAIR COMPLEX EXT 7.5CM $ 704.00
3824750 REPAIR/COMPLEX FACIAL 7.5 $ 821.00
3824760 EA ADD 5CM OR LESS TRUNK $ 325.00
3824762 REPAIR SIMPLE FACIAL 2.6- $ 190.00
3824770 REPAIR COM EA 5CM OR LESS $ 259.00
3824771 REPAIR COMPLEX TRUNK 7.5C $ 670.00
3824772 REPAIR COMPLEX 1.1-2.5CM $ 753.00
3824773 REPAIR COMPLEX 1.1-2.5CM $ 753.00
3824780 REPAIR COMPL 5CM OR LESS $ 371.00
3824781 REPAIR COMPL 2.6-7.5 $ 903.00
3824784 REPAIR COMPL 5CM OR LESS $ 371.00
3824790 REPAIR COMP 5CM OR LESS $ 396.00
3824791 REPAIR LAC 2.5 TONGUE $ 713.00
3824793 REPAIR TONGUE LACERATION 2.5> $ 842.00
3824800 WOUND CLOSURE ADHESIVE $ 122.00
3824801 WOUND CLOSURE ADHESIVE $ 122.00
3825000 BURN/1ST DEGREE INITIAL $ 203.00
3825001 FRACTURE / PELVIC RING CLOSED TX $ 2,110.00
3825300 BURN SM DEBRIDEMENT NO ANES $ 242.00
3825400 BURN MED DEBRIDEMENT NO ANES $ 494.00
3825401 DRESS/ DEBRIDE PARTIAL THICK BURN MED $ 475.00
3825402 FRACTURE / TALUS W MANIP $ 1,436.00
3825500 BURN/LG DEBRIDE/NO ANES $ 587.00
3825501 INJECTION,JOINT,BURSA $ 113.00
3825502 PELVIC EXAM/ ANESTHESIA $ 176.00
3825530 AMPUTATION FINGER/ THUMB $ 2,894.00
3825531 AMPUTATION FINGER/ THUMB $ 2,894.00
3825533 FRACTURE/CARPAL SCAPHOID $ 1,245.00
3825540 FRACTURE / RAD ULNAR W MANIP $ 2,099.00
3825582 INCISE EXTER HEMORRHOID $ 476.00
3825586 REPAIR SIMPLE FAC 7.6-12 $ 277.00
3825595 FRACTURE / NASAL $ 119.00
3825597 FRACTURE/ ULNAR SHAFT $ 581.00
3825600 FRACTURE/CLAVICLE WO MAN $ 544.00
3825601 FRACTURE VERTEBRAL $ 775.00
3825602 FRACTURE/VERTEBRAL WO MAN $ 1,241.00
3825606 FRACTURE / ACROMIOCLAVICLE $ 1,027.00
3825607 FRACTURE / ACROMICLAVICLE W MANIP $ 1,414.00
3825610 FRACTURE/NASAL WO MANIPU $ 119.00
3825611 FRACTURE / PROX HUMERAL W MAN $ 1,892.00
3825612 FRACTURE/TUBEROSITY WO MA $ 1,153.00
3825613 FRACTURE/TUBEROSITY W MAN $ 1,577.00
3825616 FRACTURE/HUMERAL SHAFT $ 1,459.00
3825618 FRACTURE/DISLOC ELBOW $ 1,496.00
3825620 FRACTURE/NASAL WO STABLIZ $ 693.00
3825621 FRACTURE/MONTEGGIA ELBOW $ 2,448.00
3825622 FRACTURE/RAD HEAD CHILD $ 427.00
3825623 FRACTURE/RADIAL HEAD-NECK $ 1,081.00
3825624 FRACTURE / RADIAL HEAD W MANIP $ 1,779.00
3825625 FRACTURE/ULNAR PROX WO MA $ 644.00
3825626 FRACTURE/ULNAR W MAN $ 1,851.00
3825627 FRACTURE / RADIAL SHAFT WO $ 613.00
3825629 FRACTURE/GALEAZZI RADIAL $ 2,377.00
3825630 FRACTURE/NASAL W STABILIZ $ 608.00
3825631 FRACTURE/ULNAR SHAFT $ 1,065.00
3825632 FRACTURE/ULNAR SHAFT W MA $ 2,015.00
3825633 FRACTURE/RAD ULNAR SHAFT $ 1,131.00
3825638 FRACTURE/CARPAL SCAP W MA $ 1,931.00
3825639 FRACTURE/CARPAL BONE $ 1,254.00
3825641 FRACTURE/CARPAL BO W MAN $ 1,790.00
3825643 FRACTURE/RADIO-INTERCARPA $ 1,824.00
3825645 FRACTURE / TRANS- SCAPHOPERI $ 2,123.00
3825646 FRACTURE/LUNATE DISLOCAT $ 2,127.00
3825650 FRACTURE/STERNUM CLOSED $ 659.00
3825651 FRACTURE/THUMB-BENNETT $ 2,117.00
3825652 FRACTURE / CARPOMETACARPAL $ 1,338.00
3825655 FRACTURE/COCCYX $ 841.00
3825656 FRACTURE/FEMORAL $ 2,096.00
3825657 FRACTURE / GREATER TROCHANTER $ 1,712.00
3825658 FRACTURE / HIP DISLOCATION $ 790.00
3825659 FRACTURE/PATELLA WO MANIP $ 1,326.00
3825661 FRACTURER / TIBIA WO MANIP $ 1,263.00
3825666 FRACTURE/ANKLE $ 1,356.00
3825667 FRACTURE/ANKLE DISLOCATIO $ 1,671.00
3825669 FRACTURE/TALUS $ 948.00
3825671 FRACTURE/TARSAL BONE $ 871.00
3825676 FRACTURE/GREAT TOE W MANI $ 681.00
3825679 FRACTURE/TARSAL BONE $ 794.00
3825680 FRACTURE / ORBIT WO MANIP $ 718.00
3825681 CAST/SHOULDER TO HAND $ 304.00
3825682 CAST/ELBOW TO FINGER $ 278.00
3825683 CAST/HAND & FOREARM $ 300.00
3825684 CAST/HIP SPICA-ONE LEG $ 707.00
3825686 CAST/LONG WALKING $ 473.00
3825687 CAST/CYLINDER $ 390.00
3825688 CAST/SHORT LEG $ 132.00
3825689 CAST/SHORT WALKING $ 254.00
3825690 FRACTURE/TEMPOROMANDIBULA $ 143.00
3825691 SPLINT/LONG ARM $ 266.00
3825692 SPLINT/SHORT ARM $ 178.00
3825694 UNNA BOOT,REMOVAL/REPAIR $ 147.00
3825695 UNNA BOOT APPLICATION $ 158.00
3825696 SPLINT/LONG LEG $ 223.00
3825697 SPLINT/ SHORT LEG $ 223.00
3825698 CAST, FULL ARM/REMOVAL $ 206.00
3825700 NAIL/DEBRIDEMENT $ 64.00
3825701 CAST/HAND & FOREARM $ 300.00
3825704 FRACTURE / LAT EPICONDYL $ 1,293.00
3825705 FRACTURE / TIBIA W MANIP $ 2,547.00
3825708 REMOVAL FB DEEP/FINGER $ 1,103.00
3825709 DISLOCATION/HIP/ANESTHESI $ 3,336.00
3825711 CAST,FULL ARM/REMOVAL $ 206.00
3825713 CAST CYLINDER $ 390.00
3825714 CAST/ELBOW-FINGER $ 278.00
3825715 CAST/HIP SPICA,ONE LEG $ 707.00
3825716 CAST/LONG LEG $ 447.00
3825717 CAST/LONG WALKING $ 473.00
3825719 CAST/SHORT WALKING $ 254.00
3825730 NAIL / EXCISION OF $ 779.00
3825734 FRACTURE SUPRACONDYLAR $ 847.00
3825736 DISLOCATION POST HIP ARTH $ 1,795.00
3825737 DISLOC POST HIP ARTH/ANES $ 2,560.00
3825744 FRACTURE/ METATARSAL OPEN $ 2,362.00
3825750 NAIL / WEDGE EXCISION $ 420.00
3825752 FRACTURE/TIBIA/FIBULA $ 780.00
3825753 FRACTURE/NASAL SEPTAL $ 720.00
3825756 FRACTURE/ULNAR PROXIMAL $ 1,179.00
3825760 FRACTURE/DISTAL TIBIA $ 1,361.00
3825766 REPAIR/ INTER FACE 7.6-12 $ 593.00
3825778 FRACTURE / PELVIC RING $ 2,110.00
3825781 FRACTURE / ARTICULAR CLOSED $ 964.00
3825782 FRACTURE SUPRACONDYLAR $ 1,537.00
3825783 FRACTURE/PHALANGE ARTICUL $ 964.00
3825784 SPLINT/ LONG LEG $ 223.00
3825785 EXCISION LESION FACE 0.5C $ 561.00
3825786 DISLOCATION / FINGER W AN $ 1,555.00
3825788 FX PELVIC RING $ 2,110.00
3825789 REMOVAL NASAL FOREIGN BOD $ 944.00
3825791 MEDIAL MALLEOLUS FX / MAN $ 1,935.00
3825798 DISLOCATION POST HIP ARTH $ 1,795.00
3825804 FRACTURE/DISLO PATELLA AN $ 1,188.00
3825805 FRACTURE/DISLO PATELLA AN $ 2,136.00
3825806 REPAIR SIMPLE FAC 5.1-7.5 $ 231.00
3825810 FRACTURE /NASAL W/O STABI $ 759.00
3825811 FRACTURE/ LOWER JAW $ 2,266.00
3825818 REPAIR/ COMPLEX 2.5-5.0 $ 903.00
3825824 SPLINT / LONG ARM $ 266.00
3825827 SPLINT / FINGER $ 126.00
3825828 BIOPSY/REMOV LYMPH NODE $ 1,114.00
3825829 STRAPPING OF SHOULDER $ 47.00
3825831 CASTING STRAPPING PROCED $ 133.00
3825832 EXCIS BENIGN LESION 0.5CM $ 368.00
3825834 EXTERNAL PACING $ 48.00
3825835 CYSTOSTOMY TUBE/ CHANGE $ 227.00
3825836 INSERTION FOLEY CATHETER $ 132.00
3825837 FRACTURE/BIMALLEOLAR W MA $ 1,904.00
3825839 TRIGGER POINT INJECT 1-2 $ 168.00
3825841 REPAIR LAC TONGUE 2.6 $ 958.00
3825843 REMOVAL FB DEEP $ 1,103.00
3825844 FRACTURE COCCYX $ 841.00
3825847 DISLOCATION / TOE $ 180.00
3825849 TRIGGER POINT INJECTION $ 168.00
3825850 REPAIR LEG TENDON $ 1,687.00
3825852 FRACTURE / STERNUM CLOSED $ 659.00
3825853 FX / TIBIA DISLOC MANIP $ 2,199.00
3825854 INSERTION FOLEY CATHETER $ 132.00
3825855 FX / POST MALLEOLUS W MAN $ 1,954.00
3825859 FRACTURE / HUMERUS $ 2,219.00
3825860 REPAIR FINGER/ TENDON $ 3,170.00
3825862 FRACTURE DISTAL TIBIA MAN $ 2,176.00
3825864 THORACENTESIS W/O IMAG $ 400.00
3825865 THORACENTESIS W IMAG $ 496.00
3825866 FRACTURE FIBULA $ 1,726.00
3825868 FRACTURE/ RAD SHAFT W MAN $ 2,048.00
3825871 TREATMENT DISLOCATION TALOTARSAL $ 1,477.00
3825875 FRACTURE DISTAL TIBIA $ 2,176.00
3825881 DISLOCATION TOE $ 180.00
3825972 EAR IRRIGATION/LAVAGE $ 144.00
3825999 FRACTURE/FIBULA $ 1,258.00
3826000 NASAL DRAINAGE/ABCESS $ 537.00
3826100 NASAL SEPTUM/DRAIN ABSCES $ 540.00
3827029 DISLOCATION HIP ANES $ 3,336.00
3827031 EAR IRRIGATION/LAVAGE $ 144.00
3827032 EAR/COMPLEX DRAIN EXT $ 713.00
3827101 NASAL HEM / ANY METHOD $ 246.00
3827102 NASAL HEM / ANY METHOD $ 246.00
3827200 NASAL HEM/COMPLEX $ 350.00
3827400 NASAL HEM / NASAL PACK / CAUT $ 442.00
3827401 NASAL HEMOR/ PACK CAUT $ 442.00
3827500 EAR/DRAINAGE ABSCESS EXT $ 544.00
3827501 EAR/DRAINAGE ABCESS EXT $ 544.00
3827600 EAR/COMPLEX DRAINAGE EXT $ 713.00
3827700 EAR/DRAIN EXT AUD CANAL $ 654.00
3827701 EAR/DRAIN EXT AUD CANAL $ 654.00
3827800 EAR/REMOVAL FOREIGN BODY $ 263.00
3827801 EAR/REMOVAL FOREIGN BODY $ 116.00
3827802 REMOVAL FB/ARM DEEP $ 1,615.00
3827803 REMOVAL FB SUBCUT $ 621.00
3827805 REMOV FOREIGN BODY EAR/AN $ 464.00
3827902 APPLICATION SHORT ARM $ 219.00
3828101 ANOSCOPY $ 195.00
3828105 BREAST CYST ASPIRATION $ 189.00
3828107 NORPLANT REMOVAL $ 420.00
3828108 LUMBAR PUNCTURE $ 345.00
3828111 PHLEBOTOMY $ 453.00
3828113 ABD PARACENTESIS W/O IMAG $ 322.00
3828115 ANAL ABCESS $ 440.00
3828116 INCISION RECTAL ABSCESS $ 1,842.00
3828117 ANAL ABSCESS $ 440.00
3828201 NASAL HEM/COMPLEX $ 350.00
3828742 FX/DISLOC THUMB $ 1,733.00
3829001 PHARYNX / REMOVAL / FB $ 607.00
3829002 EYE / REMOVAL FB SUPERFICIAL $ 200.00
3829003 PHARYNX / REMOVAL FB $ 607.00
3829100 EYE / REMOVAL IMBEDDED FB $ 242.00
3829202 EYE / CORNEA FB W/O SLIT LAMP $ 189.00
3829300 EYE / CORNEA FB W SLIT LAMP $ 241.00
3829400 EYE/LACERATION SCLERA $ 642.00
3829600 EYE / REMOVAL FB EYELID $ 532.00
3829700 EYE/DRAIN LACRIMAL GLAND $ 609.00
385557 ARTHROCENTESIS SM JOINT FINER TOES $ 152.00
3450219 EKC ROUTINE $ 204.00
3450220 EKG TRACING W/O I&R $ 265.00
3450221 EKG TRACING W/O I&R $ 265.00
3450222 EKG TRACING W/O I&R $ 265.00
3450225 EKG $ 265.00
3450226 EKG $ 265.00
3450233 EKG RHYTHM $ 32.00
3450234 EKG RHYTHM $ 32.00
3450278 EKG STRESS $ 859.00
3450279 EKG STRESS / DISCONTINUED $ 859.00
3450280 EKG STRESS / REDUCED $ 859.00
3450347 ECG MONITOR / REPORT 48HR $ 425.00
3450348 EVENT MONITOR 30 DAY SET/ $ 197.00
3450500 ZIOPATCH 24-48 HRS ELECTROCARDIO MONITOR $ 286.00
3450501 ZIOPATCH 3-14 DAYS ELECTROCARDIO MONITOR $ 286.00
3452000 EMG/ 1 EXTREMITY $ 143.00
3452001 EMG/ 2 EXTREMITY $ 174.00
3452005 NEUROMUSCULAR JUNCTION $ 80.00
3452006 EMG/ 3 EXTREMITY $ 232.00
3453000 EEG/ AWAKE & DROWSY $ 546.00
3453001 EEG/ ASLEEP $ 455.00
3453002 EEG/AWAKE & ASLEEP RECORD $ 627.00
3453003 EEG/EXT 1HR MONITORING $ 594.00
3453004 EEG / RXT MORE THAN 1 HR $ 754.00
3453005 MONITORING 24HR AMBULATOR $ 945.00
3453006 MONITORING 24HR RECORD $ 4,050.00
3453007 SSER,UPPER LIMBS $ 216.00
3453008 SSER,LOWER LIMBS $ 216.00
3456221 TC-99M SESTAMIBI PER ST $ 300.00
3456223 MYOCARDIAL PERF/SINGLE $ 1,996.00
3456224 MYOCARDIAL PERFUS IMAG $ 3,342.00
3456225 MYOCARDIAL PERFUSION IMAG $ 3,342.00
3105652 ALLERGY INJECTIONS $ 31.00
3105653 ALLERGY INJECTIONS 2 + INJECT $ 41.00
3105655 THERAPEUTIC INJECTION $ 150.00
3105683 IM INJECTION/THERAPEUTIC $ 150.00
3105686 IV THERAPY/ 1 HR $ 795.00
3105687 IV THERAPY, ADD HR $ 152.00
3105693 IV THERAPY 1 HR $ 181.00
3105694 IV THERAPY ADD HR $ 55.00
3105700 THERAPEUTIC INJECTION $ 150.00
3602001 D5W 250ML GLASS $ 25.00
3602002 NITRO/D5W 250MG 50MG $ 23.00
3602003 KCL/H20 100ML $ 13.00
3602005 D5W 1000CC $ 29.00
3602056 D5 .45NS 20KCL $ 42.00
3602065 D5%-.9NS 1000CC $ 30.00
3602085 .9NS 1000CC $ 26.00
3602095 .9NS 250ML $ 22.00
3602100 .9NS 100CC $ 32.00
3602110 .45NS-WATER 1000CC $ 29.00
3602135 AMINOSYN 7% 500CC $ 146.00
3602140 LIPIDS 10% FAT EMULS $ 149.00
3602145 MANNITOL 20% 500CC $ 148.00
3602160 .9NS 100ML MINI BAG $ 30.00
3602305 LIDOCAINE 2GMS-250ML D5W $ 25.00
3602307 MAG SULFATE 40MG/ML 1000M $ 32.00
3602308 MAG SULFATE 40MG/ML 100ML $ 28.00
3602310 HYPERALIMENTATION (TPN)1L $ 233.00
3602312 NORMAL SALINE IRRIG 3L $ 41.00
3602313 STERILE WATER IRRIG 3L $ 41.00
3602315 500ML NS $ 28.00
3602317 GLYCINE 1.5% IRRIG. 3L $ 51.00
3602400 HEPARIN 25MU IN 500ML D5W $ 18.00
3602401 HESPAN 6% 500ML $ 36.00
3602405 DOPAMINE 400MG-D5W 250ML $ 83.00
3602406 EVAC. CONTAINER 2000ML $ 58.00
3602414 .9NS 20KCL 1L $ 44.00
3602999 IV MISC $ 0.00
3350001 HEALTH FAIR PANEL $ 31.00
3350002 HEALTH FAIR PANEL EMP/SPO $ 19.00
3350998 PATERNITY $ 30.00
3351001 OVA AND PARASITES $ 88.00
3351004 TRICHROME STAIN $ 88.00
3351006 OVA AND PARASITE #2 $ 88.00
3351007 OVA AND PARASITE #3 $ 88.00
3351042 CITRIC ACID, URINE ARUP $ 70.00
3351043 OXALATE, URINE ARUP $ 73.00
3351044 VOLUME MEASUREMENT $ 51.00
3351045 ALDOSTERONE, URINE ARUP $ 84.00
3351046 URINE CULTURE $ 109.00
3351047 VOLUME MEASUREMENT $ 51.00
3351050 WBC STOOL/ LACTOFERRIN $ 158.00
3351051 EXTERNAL PARASITE ID $ 71.00
3351052 WBC STOOL $ 71.00
3351053 WBC STOOL/ LACTOFERRIN #2 $ 158.00
3351054 WBC STOOL/ LACTOFERRIN #3 $ 158.00
3351055 BABESIA SPECIES ARUP $ 832.00
3351056 BABESIA MICROTI ARUP $ 277.00
3351900 B CELLS, TOTAL COUNT $ 80.00
3351901 NK CELLS, TOTAL COUNT $ 80.00
3351902 T CELLS, TOTAL COUNT $ 80.00
3351903 MONONUCLEAR CELL ANTIGEN, EA ANTIGEN $ 80.00
3351904 MONONUCLEAR CELL ANTIGEN, EA ANTIGEN $ 80.00
3351905 T CELLS; ABSOLUTE CD4 & CD8 COUNT/ RATIO $ 80.00
3352000 OCCULT BLOOD FECES 1-3 TE $ 42.00
3352001 OCCULT BLOOD $ 42.00
3352003 STOOL ADD PATHOGENS $ 68.00
3352008 OCCULT BLOOD TRI CARD $ 42.00
3352009 PROTEIN; ELECT FRACT(URIN $ 337.00
3352010 HYDROXYPREGNENOLONE 17 AS $ 386.00
3352011 PROTEIN;ELECT FRACT (URIN $ 337.00
3352012 DNA SEQ BACT ID ARUP $ 738.00
3352013 ALLERGEN SINGLE SPECIFIC IgG $ 56.00
3352014 ALLERGEN SINGLE SPECIFIC IgG $ 56.00
3352015 CHROMOSOME ANALYSIS 20-25 $ 558.00
3352017 GIARDIA AG , EIA $ 99.00
3352018 STOOL ADD PATHOGENS ADDIT $ 68.00
3352019 C DIFF TOXIN #2 $ 93.00
3352020 GC/ CHL - URINE $ 247.00
3352021 PHENYTOIN, FREE $ 199.00
3352022 HEP B SURF AG (REFLEX)I $ 146.00
3352024 NEPHELOMETRY $ 233.00
3352026 BK VIRUS QUANT PCR $ 1,519.00
3352027 MYCOPLASMA IGG/ IGM $ 133.00
3352028 IP STAIN / HERP CULT $ 147.00
3352029 PROTEIN ASSAY $ 73.00
3352030 TEGRETOL (CARBAMAZ) FREE $ 183.00
3352031 IGG 2 $ 70.00
3352033 CREATINE / ASSAY $ 378.00
3352036 PARVOVIRUS IGM $ 93.00
3352037 PARVOVIRUS IgM $ 93.00
3352039 OPIATES / CONF SERUM $ 216.00
3352040 HERPES SIMPLEX 2,AG,IF $ 203.00
3352041 ENTEROVIRUS / ANTIBODY $ 98.00
3352042 BARTONELLA, DNA, AMP PROB $ 591.00
3352043 ASSAY ADP / AMP $ 306.00
3352044 CALCIUM, TOTAL IONIZED $ 229.00
3352046 PROTEIN - FLUIDS $ 39.00
3352047 CYTOMEGALOVIRUS, DNA,QUAN $ 723.00
3352048 D-DIMER $ 88.00
3352049 MYELOPEROXIDASE $ 226.00
3352050 OSMOLALITY / URINE $ 51.00
3352051 IMMUNOFLUOR STUDY INDIR $ 129.00
3352052 IMMUNOFLOUR STDY INDIR $ 129.00
3352053 SEX HORMONE BINDING GLOBU $ 256.00
3352054 FIBRIN DEGRADATION $ 252.00
3352055 MASS SPECTROMETRY QUANT $ 71.00
3352056 MACROSCOPIC EXAM ARTHROPO $ 93.00
3352057 ENDOMYSIAL AB A TITER $ 293.00
3352058 DNAse AB $ 59.00
3352060 ALBUMIN / FLUID $ 37.00
3352061 BICARBONATE (HCO3) $ 84.00
3352063 PARVOVIRUS IgG $ 93.00
3352064 PARVOVIRUS IgG $ 93.00
3352065 H PYLORI ANTIBODY IgG ARU $ 67.00
3352066 H PYLORI ANTIBODY IgM ARU $ 67.00
3352067 MITOCHONDRAIL ANTI ARUP $ 131.00
3352068 TSH, W / REF 2 FREE T4 $ 146.00
3352069 FACTOR XI, ACTIVITY $ 275.00
3352070 INHIBIN B ARUP $ 544.00
3352071 GLUCOSE TOLER 3HR $ 168.00
3352072 CHOLESTEROL, FLUID ARUP $ 39.00
3352073 LACOSAMIDE ARUP $ 192.00
3352074 G-6-PD ARUP $ 84.00
3352075 BILIRUBIN, TOTAL BF ARUP $ 37.00
3352076 SPECIFIC GRAVITY ARUP $ 42.00
3352077 GANGLIOSIDE ANTI GM,GD,GQ $ 131.00
3352078 RUBELLA ANTIBODY IgG ARUP $ 51.00
3352079 TISSUE CULTURE $ 327.00
3352080 FETAL MATERNAL SCREEN AHL $ 202.00
3352081 KLEIHAUER-BETKE STAIN AHL $ 286.00
3352082 LACTATE $ 145.00
3352083 NOROVIRUS GRP 1&2 ARUP $ 551.00
3352084 CHROMOGRANIN A ARUP $ 255.00
3352085 NOROVIRUS GRP 1&2 ARUP $ 551.00
3352086 METHAMPHETAMINE / MEDTOX $ 216.00
3352087 MYELIN ASSOC GLYCOPROTEIN $ 131.00
3352088 MYELOPEROXIDASE AB-ARUP $ 131.00
3352089 SERINE PROTEASE 3- ARUP $ 131.00
3352090 ISLET CELL ANTI, IgG-ARUP $ 118.00
3352091 GLUTA ACID DECAR ANTI -AR $ 131.00
3352092 ARIPIPRAZOLE - ARUP $ 891.00
3352093 OLANZAPINE - ARUP $ 388.00
3352094 BPERT - ARUP $ 363.00
3352095 GBM-AbIgA - ARUP $ 337.00
3352096 GBM-AbIgG - ARUP $ 337.00
3352097 INFLUENZA ASSAY W/ OPTIC $ 133.00
3352098 PROSTATE SPEC ANTIG $ 315.00
3352099 GLUCOSE $ 31.00
3352100 GLUCOSE $ 31.00
3352101 CALCIUM $ 80.00
3352102 KETONES - SERUM $ 74.00
3352103 ARTERIAL BLOOD GASES $ 315.00
3352104 ACETAMINOPHEN/ INITIAL $ 268.00
3352105 CALCIUM $ 80.00
3352106 AMMONIA $ 245.00
3352107 GLUCOSE TOLER 3HR $ 168.00
3352108 ARTERIAL BG ADDITIONAL $ 315.00
3352111 HBsAg $ 32.00
3352112 ALBUMIN $ 84.00
3352113 BUN,UREA NITROGEN $ 73.00
3352114 HBcAb $ 35.00
3352115 SODIUM $ 71.00
3352116 SODIUM $ 71.00
3352117 HBsAB $ 51.00
3352118 HEP A AB $ 51.00
3352119 HIV $ 141.00
3352120 POTASSIUM $ 76.00
3352121 CARBON MONOXIDE $ 208.00
3352122 VIRAL CULTURE NON-RESP $ 327.00
3352123 BUN, ADDITIONAL $ 73.00
3352124 PROSTATE SPEC ANTIGEN $ 315.00
3352125 POTASSIUM $ 76.00
3352126 CHLORIDE $ 76.00
3352127 CHLORIDE $ 76.00
3352128 H PYLORI $ 67.00
3352130 CHOLESTEROL $ 65.00
3352131 TRIGLYCERIDE $ 97.00
3352132 HDL CHOLESTEROL $ 139.00
3352134 IGM ANTIBODY $ 76.00
3352135 PSA MC SCREEN $ 315.00
3352136 ALLERGEN EA ARUP $ 28.00
3352138 MYCOPLASMA PNEUMONIAE PCR ARUP $ 409.00
3352139 IGF BINDING PROTEIN -1 ARUP $ 575.00
3352141 MMA $ 133.00
3352143 BLADDER TUMOR AG $ 269.00
3352144 ROHIPNOL ARUP $ 21.00
3352146 TOBRAMYCIN NCL $ 272.00
3352147 TOTAL PROTEIN $ 73.00
3352148 BILI DIRECT $ 140.00
3352149 VIRUS ISOL/ID $ 572.00
3352150 ELECTROLYTE PANEL $ 46.00
3352151 URIC ACID $ 74.00
3352152 HEPATITIS PANEL $ 233.00
3352153 HEPATITIS C ANTIBODY $ 67.00
3352154 ELECTROLYTE PANEL $ 46.00
3352156 APOLIPOPROTEIN $ 219.00
3352158 CELIAC TTG-IgG $ 131.00
3352159 BETA 2 GLYCOPROTEIN IGG $ 109.00
3352160 BILI TOTAL $ 37.00
3352161 PCP CONFIRMATION $ 249.00
3352162 METADONE CONFIRMATION $ 276.00
3352164 ZINC $ 59.00
3352166 DHEA-S $ 51.00
3352167 HYDROXYPROGESTERONE $ 84.00
3352169 CELIAC GLIADIN-IgA $ 131.00
3352170 BETA 2 GLYCOPROTEIN IGM $ 109.00
3352171 PLATELET NEUTRALIZATION $ 221.00
3352172 PLATELET NEUTRALIZTION $ 221.00
3352173 THYROID STIM IMMUNE GLOBU $ 332.00
3352174 POTASSIUM FECAL ARUP $ 62.00
3352175 OSMOLATLITY FECAL ARUP $ 62.00
3352176 HERPES I AB $ 113.00
3352177 HERPES II AB $ 113.00
3352178 LIPOPROTEIN A $ 219.00
3352179 CALCITONIN $ 453.00
3352181 CELIAC GLIADIN IgG $ 131.00
3352182 SEROTONIN $ 383.00
3352183 ZINC PROTOPORPHYIN ARUP $ 73.00
3352184 IG - A NCL $ 56.00
3352185 CELIAC TTG-IgA $ 131.00
3352186 INHIBIN A $ 183.00
3352187 BABESIA IGG $ 99.00
3352189 SHIGA-LIKE TOXIN AG $ 80.00
3352190 SHIGA-LIKE TOXIN AG ADDIT $ 80.00
3352191 BLASTOMYCES ANTIBODY $ 98.00
3352195 CREATININE $ 86.00
3352196 CREATININE $ 86.00
3352199 VITAMIN B6 $ 95.00
3352200 HIV RNA QUAN REALTIME PCR $ 1,435.00
3352201 VITAMIN D 25OH $ 76.00
3352202 SOLU TRANSFERRIN REC ARUP $ 99.00
3352203 T CELLS, TOTAL COUNT $ 637.00
3352204 NK CELLS, TOTAL COUNT $ 637.00
3352205 T CELL, ABSOLUTE COUNT RA $ 792.00
3352206 PROTEIN C ANTIGEN $ 203.00
3352207 LACOSAMIDE ARUP $ 192.00
3352208 TOXOPLASMA IGG $ 51.00
3352209 BILI DIRECT $ 140.00
3352210 VENOUS BLOOD GASES $ 315.00
3352211 VENOUS BLOOD GASES $ 315.00
3352212 BORDETELLA PERTU/PARA PCR $ 247.00
3352213 OXYCARB $ 192.00
3352214 NON DESIGNATED DRUG $ 192.00
3352215 LAMICTAL (LAMOTRIGENE_ $ 91.00
3352216 MYCOPHENOLIC ACID (MPA) $ 118.00
3352217 ZONISAMIDE $ 192.00
3352218 KEPPRA (LEVETIRACETAM) $ 192.00
3352219 SEROQUEL (QUETIAPINE) $ 192.00
3352220 TOTAL PROTEIN (PART OF BJ $ 45.00
3352221 BILI NEONATE $ 140.00
3352222 ANCA $ 128.00
3352223 STOOL CULTURE YERSINIA $ 188.00
3352224 GLUCOSE CSF $ 30.00
3352225 PROTEIN CSF $ 39.00
3352226 TRICHROME STAIN #2 $ 88.00
3352227 TRICHROME STAIN #3 $ 88.00
3352228 C DIFF TOXIN #3 $ 93.00
3352229 STRIATED MUSCLE AB REFLEX $ 293.00
3352230 ESTROGENS / FRACTIONATED $ 208.00
3352231 HUMAN GROWTH HORMONE $ 84.00
3352232 THYROGLOBULIN ARUP $ 201.00
3352233 KOH WET PREP $ 71.00
3352236 MICRO STREP PANEL $ 124.00
3352237 SHIGA-LIKE TOXIN AG #3 $ 80.00
3352238 STOOL ADD PATHOGENS #3 $ 68.00
3352239 PROTEIN/ CREAT URINE ARUP $ 39.00
3352240 MMA / SERUM $ 133.00
3352241 HERPES SIMPLEX TYPE I $ 100.00
3352242 THYROID PEROXIDASE AB $ 51.00
3352247 OPIATES/ CONF URINE ARUP $ 191.00
3352248 MYCO TUBERCULO DNA AMP PR $ 1,080.00
3352249 ALLERGEN EA ADDITIONAL $ 28.00
3352250 PH, VENOUS BLOOD $ 142.00
3352251 LEISHMANIA ANTI, IgG $ 213.00
3352252 THIOPURINE METHYLTRANSFER $ 1,510.00
3352253 STREP TEST, RAPID $ 38.00
3352254 INFLUENZA VIRUS $ 100.00
3352255 HCG URINE $ 35.00
3352256 HETEROPHILE ANTIBODY $ 51.00
3352257 HETEROPHILE TITER $ 110.00
3352258 EHRLICHIA / ANAPLASMA ARU $ 832.00
3352259 VITAMIN K1/ SERUM ARUP $ 308.00
3352260 CHLAMYDIA TRACH AMP ARUP $ 119.00
3352261 CHLAMYDIA TRACH DNA ARUP $ 60.00
3352262 ACETONE QUAN ARUP $ 140.00
3352263 POLYCHLOR BIPHENYLS ARUP $ 604.00
3352264 CHOLINESTERASE,RBC ARUP $ 93.00
3352265 IG-A NCL $ 56.00
3352266 VARICELLA ZOSTER,AG IF $ 203.00
3352267 HERPES SIMPLEX 1,AG, IF $ 203.00
3352268 VIRAL CULTURE $ 327.00
3352269 VIRUS INOCULATION,SHELL $ 329.00
3352270 STREPTOCOCCL AG UA ARUP $ 203.00
3352271 RICKETTSIA ANTI $ 86.00
3352272 VIRUS ANTIBODY NOS $ 210.00
3352273 VIRUS ANTIBODY NOS $ 210.00
3352274 IG-G NCL $ 56.00
3352275 CLOSTRIDIUM DIFF TOXIN B $ 236.00
3352276 MICROSPORIDIA DFA $ 332.00
3352277 ARUP- SUSCEP MECA GENE DE $ 256.00
3352278 ESTRONE ARUP $ 422.00
3352279 5-A DIHYDROTESTOSTERONE $ 306.00
3352280 RABIES ANTIBODY, IgG ARUP $ 210.00
3352281 KEPPRA ARUP $ 233.00
3352282 LAMBDA ARUP $ 233.00
3352283 ENCEPHALITIS, CA ARUP $ 111.00
3352284 ENCEPHALITIS, EAST EQ IgG $ 111.00
3352285 ENCEPHALITIS, ST LOU ARUP $ 111.00
3352286 ENCEPHALITIS, WEST EQ IgG $ 111.00
3352287 KETONES-SERUM $ 74.00
3352288 ARGININE VASO HORMON ARUP $ 133.00
3352289 DNA MYCOBACTERIUM ARUP $ 338.00
3352290 GLYCOPHORIN - ARUP $ 453.00
3352291 CD59 - ARUP $ 453.00
3352292 GENERAL HEALTH PANEL $ 418.00
3352293 GFR / ARUP $ 42.00
3352294 HEP B CORE IGM - ARUP $ 76.00
3352295 LEPTIN - ARUP $ 544.00
3352296 PYRUVATE KINASE - ARUP $ 219.00
3352297 KYPHOSCOLIOTIC FORM, TYPE $ 2,802.00
3352298 CA 15-3 $ 76.00
3352300 CHEM 12 (CMP) $ 181.00
3352301 CHEM 12 (CMP) ADDITIONAL $ 181.00
3352302 CHEM 8 (BMP) $ 142.00
3352303 CHEM 8 (BMP) ADDITIONAL $ 142.00
3352304 STRIATED MUSCLE AB $ 128.00
3352305 RHEUMATOID FACTOR,QUAL $ 96.00
3352306 CALPROTECTIN, FECAL $ 715.00
3352307 ESTRADIOL BY TMS ARUP $ 156.00
3352308 PROTEIN/ CREAT URINE $ 39.00
3352309 OCCULT BLOOD-IMMUNO ASS-ARUP $ 141.00
3352310 SODIUM STOOL $ 82.00
3352311 INSULIN LIKE GROWTH FACT $ 88.00
3352312 FACTOR VIII ACTIVITY $ 109.00
3352313 RISTOCETIN COFACTOR $ 388.00
3352314 VON WILLEBRAND MULT $ 388.00
3352315 VON WILLEBRAND FACTOR $ 544.00
3352316 VITAMIN A $ 80.00
3352317 CARNITINE FREE / TOTAL $ 249.00
3352318 RENAL FUNCTION PANEL $ 150.00
3352319 IMMUNODIFFSUION/ IMMUNO $ 31.00
3352320 ASSAY OF CITRATE $ 468.00
3352321 ASSAY OF OXALATE $ 217.00
3352322 ASSAY OF URINE PHOSPHOROU $ 87.00
3352324 HERPES SIMPLEX VIRUS PCR $ 304.00
3352326 BORDETELLA ANTIBODY SERUM $ 99.00
3352328 ACETYLCHOLINE BLOCK RCPT $ 203.00
3352329 PHOSPHOLIPID ANTIBODY $ 422.00
3352330 PHOSPHOLIPID ANTIBODY $ 422.00
3352331 ENTEROVIRUS, DETECT PCR $ 591.00
3352332 GC / CHL -PROBE $ 111.00
3352333 T3 REVERSE $ 119.00
3352334 HEPATITIS B DNA QUANT $ 723.00
3352339 NEURONAL ANTIBODIES ARUP $ 794.00
3352340 OCCULT BLOOD IMMUNOLOGY $ 141.00
3352341 C DIFF TOXIN $ 93.00
3352342 VOLTAGE-GATED POTAS CHANN $ 1,000.00
3352343 ACETAMINOPHEN ADDITIONAL $ 268.00
3352345 COMPLIMENT COMPONENT ADDI $ 76.00
3352347 BNP $ 574.00
3352348 NICOTINE & METAB URINE $ 374.00
3352349 FACTOR V LEIDEN MUTA ARUP $ 315.00
3352350 WEST NILE VIRUS AB IGG $ 170.00
3352351 IMMUNODIFFUSION/ IMMUNO $ 31.00
3352352 BACTERIUM ANTIBODY $ 304.00
3352355 EPSTEIN-BARR ANTIBODY $ 53.00
3352356 HIV-1 $ 42.00
3352357 CCP ANTIBODY $ 100.00
3352358 HOMOVANILLIC ACID $ 236.00
3352359 HERPES VIRUS-6 PCR $ 1,098.00
3352360 FACTOR VII, ACTIVITY $ 301.00
3352361 CORTISOL, SALIVA ARUP $ 51.00
3352362 GLUCAGON - ARUP $ 101.00
3352363 DIPTHERIA ANTIB IgG ARUP $ 51.00
3352364 FUNGAL DNA PROBE ARUP $ 338.00
3352365 FUNGAL CULTURE ARUP $ 210.00
3352366 CHROMOGENIC FACTOR X ALLI $ 357.00
3352367 ACETYLCHOLINE BLOCK $ 203.00
3352368 VOLTAGE-GATED POTAS CHANN $ 1,000.00
3352369 ACETYLCHOLINE BINDIN RCPT $ 203.00
3352370 SUBOXONE $ 84.00
3352371 DRUGS ABUSE CONFIRM ARUP $ 219.00
3352372 SUSCEPTIBILITY-AFB/NOCARD $ 370.00
3352373 HEPATITIS Be VIRUS ANTI $ 69.00
3352374 HEPATITIS B VIRUS DNA QUA $ 440.00
3352375 CYSTIC FIBROSIS 32 MUT AR $ 715.00
3352376 HEMOCHROMATOSIS (HFE) ARU $ 453.00
3352377 RUFINAMIDE BANZEL-ARUP $ 817.00
3352378 BENZODIAZEPINES, URINE QUANT ARUP $ 179.00
3352379 WEST NILE VIRUS AB IGM $ 129.00
3352380 CANDIDA AB BY ID $ 98.00
3352381 CBC / BLD MORPH $ 136.00
3352382 TSH RECEPTOR AB - ARUP $ 544.00
3352383 ANNA -ARUP $ 128.00
3352384 PURKINJE CELL SCREEN-ARUP $ 128.00
3352385 ANTI-ADRENAL ANTIBOD ARUP $ 128.00
3352386 INTRIN FAC BLOCK ANTIB AR $ 172.00
3352389 QUANITIATION OF DRUG $ 192.00
3352390 TSH, W / REF 2 FREE T4 $ 136.00
3352391 XYLOSE ABSORPTION TEST AR $ 99.00
3352392 INFLUENZA ASSAY W/ OPTIC $ 133.00
3352393 LDH BODY FLUID ARUP $ 41.00
3352394 PROTEIN ASSAY $ 73.00
3352395 D-DIMER QUANTITATIVE $ 252.00
3352397 PANCREATIC ELAST, FECAL ARUP $ 576.00
3352398 GFR / ARUP $ 42.00
3352400 CHEM 8, i-STAT $ 142.00
3352401 CHEM 8, i-STAT $ 142.00
3352402 GLUCOSE, i- STAT $ 31.00
3352403 GLUCOSE, i-STAT $ 31.00
3352404 POTASSIUM, i-STAT $ 76.00
3352405 POTASSIUM, i-STAT $ 76.00
3352406 CREATININE, i-STAT $ 86.00
3352407 CREATININE, i-STAT $ 86.00
3352408 IONIZED CALCIUM, i-STAT $ 229.00
3352409 IONIZED CALCIUM, i-STAT $ 229.00
3352410 ARTERIAL BLOOD GAS, i-STAT $ 315.00
3352411 ARTERIAL BLOOD GAS, i-STAT $ 315.00
3352412 VENOUS BLOOD GAS, i-STAT $ 315.00
3352413 VENOUS BLOOD GAS, i-STAT $ 315.00
3352414 PH, ARTERIAL, i-STAT $ 142.00
3352415 PH, ARTERIAL, i-STAT $ 142.00
3352416 PH, VENOUS, i-STAT $ 142.00
3352417 PH, VENOUS, i-STAT $ 142.00
3352418 SULFATE, URINE $ 97.00
3352419 BETA-HYDROXYBUTYRIC ACID $ 88.00
3352420 SMOOTH MUSCLE AB IgG-ARUP $ 71.00
3352421 ERYTHRO PORPHYRIN ARUP $ 285.00
3352422 AFB CULTURE $ 255.00
3352423 FUNGAL DNA PROBE ARUP $ 338.00
3352424 DNA SEQ BACT ID ARUP $ 738.00
3352425 DNA MYCOBACTERIUM ARUP $ 338.00
3352426 21-HYDROXYLASE AB -ARUP $ 238.00
3352427 HIV-1 2 COMBO ANTIGEN-ARUP $ 124.00
3352428 HISTOPLASMA ANTI CF-ARUP $ 56.00
3352429 HISTOPLASMA ANTI CF-ARUP $ 56.00
3352430 HIV 1 ANTI CONF,WEST BLOT $ 250.00
3352431 DS DNA (CRITHID LUCIL)Ab IgG $ 107.00
3352432 BETHESDA QUANT FACTOR 8 BILL $ 408.00
3352433 ACID Hgb ELECTROPHORESIS BILL $ 84.00
3352434 ALK Hgb ELECTROPHORESIS BILL $ 40.00
3352435 ACETYLCHOLINE RECEP MOD ANTI $ 187.00
3352436 OXYCODONE/OXYMORPHONE SCRE REFLEX UA ARU $ 70.00
3352437 FACTOR XII, ACTIVITY ARUP $ 257.00
3352438 OXCARBA METABOLITE ARUP $ 124.00
3352439 KEPPRA ARUP $ 181.00
3352440 LAMOTRIGINE ARUP $ 72.00
3352441 HIV-1 ANTIBODY ARUP $ 268.00
3352442 HIV-2 ANTIBODY ARUP $ 268.00
3352443 ACETYLCHOLINE RECEPT ARUP $ 187.00
3352444 BORDETELLA PERTUS ARUP $ 187.00
3352445 BORDETELLA PERTUS ARUP $ 187.00
3352446 ZONISAMIDE ARUP $ 281.00
3352447 GABAPENTIN ARUP $ 101.00
3352448 A1C ARUP $ 60.00
3352449 VITAMIN B 7 (BIOTIN) ARUP $ 547.00
3352450 FELBAMATE ARUP $ 101.00
3352451 HEMOGLOBIN, PLASMA ARUP $ 80.00
3352452 CARNITINE, TOTAL ARUP $ 63.00
3352453 CARNITINE, FREE ARUP $ 63.00
3352454 VIRAL CULTURE,RESPIRATORY ARUP $ 308.00
3352455 PEMPHIGOID ANTI PANEL ARUP $ 505.00
3352456 PEMPHIGOID ANTI PANEL ARUP $ 505.00
3352457 PEMPHIGOID ANTI PANEL ARUP $ 505.00
3352458 PEMPHIGOID ANTI PANEL ARUP $ 505.00
3352459 MUMPS-PCR BUCCAL SWAB $ 1,608.00
3352460 AMP- CONFIRM- URINE-ARUP $ 191.00
3352461 OPI- CONFIRM- URINE-ARUP $ 191.00
3352462 DRUGS ABUSE CONFIRM $ 219.00
3352463 COCAINE / METABOLITE $ 216.00
3352464 METHADONE CONFIRM $ 276.00
3352465 NICTOTINE & METAB URINE $ 374.00
3352466 OPIATES CONF SERUM $ 216.00
3352467 OPIATES CONF URINE $ 216.00
3352469 METHAMPHETAMINE MEDTOX $ 216.00
3352470 AMPHET METHAMPHET CONFIRM $ 216.00
3352471 SALICYLATES ADDITIONAL $ 119.00
3352473 IMIPRAMINE /ANTIDEPRESSENTS $ 291.00
3352474 BENZODIAZEPINES $ 216.00
3352475 AMITRIPTYLINE $ 301.00
3352476 BLOOD ALCOHOL $ 183.00
3352477 ACETAMINOPHEN / INITIAL $ 268.00
3352478 DRUG SCREEN PANEL $ 252.00
3352479 PARECHOVIRUS PCR - ARUP $ 850.00
3352480 PROTHROMBIN (F2) MUTATION - ARUP $ 244.00
3352481 FYCOMPA -ARUP $ 981.00
3352482 MRSA - REFLEX LATEX ARUP $ 67.00
3352483 SUSCEPTIBILITY-SINGLE DRUG/ETEST ARUP $ 259.00
3352484 SELENIUM, SERUM/PLASMA - ARUP $ 70.00
3352485 HISTOPLASMA ANTI EIA, SERUM ARUP $ 579.00
3352486 HISTOPLASMA GALACTO ANTI QUAN EIA UA ARU $ 353.00
3352487 ANTIPHOS HS Ab IgG $ 183.00
3352488 ANTIPHOS HS Ab IgM $ 183.00
3352489 ASPERGILLUS / HYPERSENSITIVITY PANEL ARU $ 28.00
3352490 ASPERGILLUS/ HYPERSENSIT PANEL ADD ARUP $ 28.00
3352491 ALLERGEN SPECIFIC IgE QUAL - ARUP $ 28.00
3352492 SMA CARRIER SCREENING $ 742.00
3352493 ANKYLOSING SPONDYLITIS HLA-B27 GENO $ 637.00
3352494 LYSOZYME, SERUM ARUP $ 73.00
3352495 TOXOPLASMA ANTIBODY IgG ARUP $ 49.00
3352496 SUSCEPTIBILITY ARUP PEN PROTEIN 2A $ 62.00
3352497 SUSCEPTIBILITY ARUP PEN PROTEIN 2A (2ND) $ 62.00
3352498 HMGCR ANTIBODY ARUP $ 451.00
3352500 PROSTATIC ACID PHOSPHOTASE $ 164.00
3352501 ARUP MALDI - TOF - ANAEROBIC $ 308.00
3352502 TETANUS ANTIBODY $ 168.00
3352503 IODINE, SERUM ARUP $ 751.00
3352504 ANTI-MULLERIAN HORMONE ARUP $ 448.00
3352505 RHEUMATOID ARTHRITIS PANEL $ 74.00
3352506 RHEUMATOID FACTOR IgA ARUP $ 167.00
3352507 RA IgG ARUP $ 180.00
3352508 RHEUMATOID FACTORS IgM ARUP $ 167.00
3352510 GGT $ 122.00
3352511 SIROLIMUS TANDEM MASS SPECTRO ARUP $ 182.00
3352512 AMYLASE $ 110.00
3352513 AMYLASE $ 110.00
3352514 OSMOTIC FRAGILITY, RBC $ 112.00
3352515 METANEPHRINES, PLASMA $ 304.00
3352516 CATECHOLAMINES, PLASMA $ 150.00
3352519 LDH BODY FLUID ARUP $ 41.00
3352520 PH BODY FLUID ARUP $ 28.00
3352521 AMYLASE BODY FLUID ARUP $ 110.00
3352522 PHOSPHORUS $ 32.00
3352523 ACID PHOSPHATASE SER ARUP $ 124.00
3352524 MYOGLOBULIN, URINE ARUP $ 71.00
3352525 HEPARIN ANTI - Xa LMWt $ 440.00
3352526 AMPHETAMINES 1 OR 2 $ 94.00
3352527 METHYLENEDIOXYAMPHETAMINES (MDA,MDEA,MDM $ 94.00
3352528 MYOSITIS-SPECIFIC ANTIBODY PANEL ARUP $ 163.00
3352529 MYOSITIS-SPECIFIC ANTI PANEL PLUS ARUP $ 163.00
3352530 BABESIA SPECIES BY PCR ARUP $ 626.00
3352531 BABESIA SPECIES BY PCR / 2ND TEST $ 342.00
3352532 ANAPLASMA IgG ARUP $ 175.00
3352533 ANAPLASMA IgM ARUP $ 175.00
3352534 STOOL CULTURE, VIBRIO $ 188.00
3352535 GASTROINTESTINAL VIRAL PANEL / PCR $ 1,139.00
3352536 OPIATES, URINE, QUANTITATIVE $ 90.00
3352537 OPIATES, URINE, QUANTITATIVE $ 90.00
3352538 THC METABO URINE QNT $ 179.00
3352539 ALKALINE PHOSPHATASE $ 87.00
3352540 ADENOSINE DEAMINASE,PLEURAL FLUID ARUP $ 137.00
3352541 POLIO VIRUS Ab1 ARUP $ 195.00
3352542 POLIO VIRUS Ab2 ARUP $ 195.00
3352543 POLIO VIRUS Ab3 ARUP $ 195.00
3352545 BONE SPECIFIC ALK PHOS-AR $ 250.00
3352546 DRUG SCREEN PANEL CARD $ 252.00
3352547 DRUG SCREEN PANEL CARD / 59 $ 252.00
3352548 OXYCODONE/OXYMORPHONE SCRE REFLEX UA ARU $ 70.00
3352549 MICROALBUMIN / DIRECT TESTING $ 27.00
3352550 SMOOTH MUSCLE AB, IgG TITER ARUP $ 183.00
3352551 IFOB IMMUNO 1-3 TESTS $ 60.00
3352552 LDH $ 41.00
3352553 IFOB TEST SCREENING 1-3 TEST $ 60.00
3352554 FRUCTOSAMINE - ARUP $ 51.00
3352555 QUANTIFERON-TB GOLD ARUP $ 273.00
3352556 PROTEIN, TOTAL / URINE / REFRAC ARUP $ 135.00
3352557 IMMUNOFIX ELECTROPHOR URINE ARUP $ 135.00
3352558 NEPHELOMETRY / ANALYTE ARUP $ 135.00
3352559 NEPHELOMETRY / ANALYTE ARUP $ 135.00
3352562 NEISSERIA GONORRHOEAE AHL $ 119.00
3352563 FUNGUS ANITBODY (IBD) $ 117.00
3352564 FUNGAL ANITI ADDTL (IBD) $ 117.00
3352565 CPK $ 110.00
3352566 CPK ADDITONAL $ 110.00
3352567 FETAL CONGENITAL ABNORMALITIES ARUP $ 275.00
3352568 LYSOSOMAL ACID LIPASE ACTIVITY, DBS ARUP $ 1,075.00
3352569 COPPER $ 73.00
3352570 CPK - MB $ 118.00
3352571 CPK - MB ADDTIONAL $ 118.00
3352572 TROPONIN I $ 160.00
3352573 MYOGLOBIN $ 194.00
3352574 TROPONIN I ADDITIONAL $ 160.00
3352575 AST (SGOT) $ 87.00
3352576 MYOGLOBIN ADDITIONAL $ 194.00
3352577 CPK-MB (3RD SET) $ 118.00
3352578 TROPONIN I (3RD SET) $ 160.00
3352579 CLOBAZAM QUANT, SERUM /PLASMA $ 618.00
3352580 DRUG SCREEN PANEL CARD /59 $ 252.00
3352581 RA - IgA ARUP $ 180.00
3352582 RA - IgM ARUP $ 180.00
3352583 RHEUMATOID FACTOR - ARUP $ 63.00
3352584 BLOOD CULTURE DNA/RNA AMP PROBE ALLINA $ 91.00
3352585 CRP HS $ 133.00
3352586 ALT (SGPT) $ 88.00
3352587 BLOOD CULTURE DNA/RNA AMP PROBE ALLINA $ 91.00
3352588 CHEMILUMINESCENT ASSAY $ 812.00
3352589 PROTEIN S TOTAL AG $ 158.00
3352590 ANTITHROMBIN $ 141.00
3352591 PLASMINOGEN ACTIVITY $ 111.00
3352592 ANTITHROMBIN ADDITIONAL $ 141.00
3352593 PROTEIN C, FUNCT ADDITION $ 133.00
3352594 PROTEIN S,FUNC ADDITIONAL $ 216.00
3352595 ACTIVATED PROTEIN C $ 241.00
3352596 SPECIFIC GRAVITY BF ALLINA $ 24.00
3352597 HOMOCYSTINE ADDITIONAL $ 84.00
3352601 FLUORIDE ASSAY $ 313.00
3352609 THROMBIN TIME-REFLEX $ 82.00
3352610 PTT 1:1 MIX- REFLEX $ 59.00
3352611 DRVVT 1:1 MIX- REFLEX $ 109.00
3352612 HEX PHOS REFLEX $ 221.00
3352613 ENCEPHALITIS, EAST EQ IgM $ 250.00
3352614 ENCEPHALITIS, WEST EQ IgM $ 250.00
3352615 EPSTEIN-BARR VIRUS PCR $ 397.00
3352616 VARICELLA-ZOSTER VIRUS $ 422.00
3352617 CYTOMEGALOVIRUS PCR $ 505.00
3352618 HERPES SIMPLEX VIRUS CULT $ 73.00
3352619 HERPES SIMPLEX VIRUS CULT $ 73.00
3352620 WEST NILE VIRUS ANTI IgG $ 94.00
3352621 WEST NILE VIRUS ANTI IgM $ 94.00
3352622 ANTI - JO-1 IgG $ 135.00
3352623 ALT (SGPT) $ 88.00
3352624 AST (SGOT) $ 87.00
3352625 BILL CAPILLARY ELECTROPHORESIS ARUP $ 129.00
3352626 ALPHA GLOBIN HBA1 & HBA2 ARUP $ 2,051.00
3352627 GHST ALPHA GLOBIN HBA1 & HBA2 ARUP $ 68.00
3352628 HEMOGLOBIN EVAL REFLEX CASCADE ARUP $ 68.00
3352629 C-DIFF CULTURE ARUP $ 189.00
3352630 C-DIFF CYTOTOXIN REFLUX $ 124.00
3352631 FUNGI-BY MALDI-ARUP $ 308.00
3352632 AMIKACIN, PEAK LEVEL ARUP $ 60.00
3352633 EPSTEIN-BARR VIRUS ANTI PANEL 1 ARUP $ 55.00
3352634 THYROGLOBULIN SERUM ARUP $ 365.00
3352635 IG-G NCL ARUP ADD $ 56.00
3352636 IG-M NCL ARUP ADD $ 56.00
3352637 IMMUNOFIX ELECTROPHORESIS ARUP ADD $ 111.00
3352638 STREPTOCOCCUS GROUP B AMP PROBE ARUP $ 448.00
3352639 REFLEX DBL-STRANDED DNA $ 136.00
3352640 ALLERGEN SPECIFIC IgE ARUP $ 220.00
3352641 ALLERGEN SPECIFIC IgE ARUP ADDIT $ 220.00
3352642 TISSUE TRANSGLUTAMINASE tTG ANTI IgA AR $ 45.00
3352643 JAK2 EXON 12 MUTATION ANAL BY PCR ARUP $ 1,512.00
3352644 C DIFFICILE TOXIN B GENE RT-PCR ARUP $ 507.00
3352645 TISSUE TRANSGLUTAMINASE ANTIB IgG ARUP $ 110.00
3352646 BRUCELLA ANTIBODY ARUP $ 63.00
3352647 BLOOD ALCOHOL $ 183.00
3352648 EHLERS DANLOS SCREEN ARUP $ 806.00
3352649 LACOSAMIDE SERUM PLASMA ARUP $ 475.00
3352650 AMIODARONE / METABOLITE $ 91.00
3352651 PNEUMOCOCCAL ABS, IgG 23 $ 14.00
3352652 PNEUMOCOCCAL ABS, IgG 23 $ 14.00
3352653 H. INFLUENZA B Ab, IgG $ 56.00
3352654 ARSENIC / HEAVY METAL PANEL ARUP $ 56.00
3352655 LEAD / HEAVY METAL PANEL ARUP $ 56.00
3352656 CADMIUM / HEAVY METAL PANEL ARUP $ 56.00
3352657 CHLAMYDIA TRACHOMATIS TMA ARUP $ 183.00
3352658 RENIN / ARUP $ 244.00
3352659 rHEUMATOID FACTOR / LUPUS PANEL ARUP $ 31.00
3352660 RHEUMATOID FACTOR / LUPUS PANEL ARUP $ 31.00
3352661 COMPLEMENT ANTIGEN EA COMP LUPUS PANEL A $ 51.00
3352662 COMPLEMENT ANTIGEN EA COMP LUPUS PANEL A $ 51.00
3352663 TOTAL PSA W FREE PSA EFLEX ARUP $ 50.00
3352664 REPTILASE TIME REFLEX $ 125.00
3352665 HEPARIN NEUTRALIZATION $ 95.00
3352666 PHOSPHOLIPID NEUTRALIZATION $ 332.00
3352667 NICOTINE & METS S/P QUANT ARUP $ 164.00
3352668 LIPOPROTEIN -ARUP $ 76.00
3352669 LIPID PANEL ARUP $ 76.00
3352670 PTT REFLEX ARUP $ 95.00
3352671 PLATELET NEUTRALIZATION REFLEX ARUP $ 147.00
3352672 DILUTE RUSSELL VIPER VENOM REFLEX ARUP $ 59.00
3352673 DULUTE RUSSELL VIPER VENOM CONFIRM ARUP $ 103.00
3352770 CARBON DIOXIDE $ 84.00
3352771 ANAEROB ORG ID / MALDI-TOF ARUP $ 319.00
3352772 THYROID STIMULATING IMMUNOGLOBULINS ARUP $ 202.00
3352773 INSULIN-LIKE GROWTH FACTOR 2 ARUP $ 397.00
3352774 THYROID STIMULATING HORMONE ARUP $ 168.00
3352775 BUPRENORPHINE, URN, QUANT ARUP $ 180.00
3352776 FENTANYL & METABOLIC, URN, QUANT ARUP $ 351.00
3352777 JC VIRUS BY PCR $ 421.00
3352909 GLUCOSE, BODY FLUID $ 30.00
3352914 FLUID PROTEIN $ 39.00
3353011 HOMOCYSTINE $ 84.00
3353012 ALDOLASE $ 40.00
3353013 FACTOR IX ACTIVITY $ 201.00
3353014 THROMBIN TIME, PLASMA $ 82.00
3353024 ALDOSTERONE ARUP $ 244.00
3353048 AFP $ 73.00
3353049 HCG / QUANT $ 71.00
3353050 B-HCG-ARUP $ 71.00
3353060 ALPHA 1 ANTITRYPSIN TOTA $ 41.00
3353061 ALPHA-ANTITRYPSIN,PHENO $ 166.00
3353072 ANA ARUP $ 72.00
3353073 DBL STRANDED DNA $ 67.00
3353074 ANTI ENA $ 73.00
3353075 ANTI ENA $ 73.00
3353076 ANTI SSA $ 73.00
3353077 ANTI SSB $ 73.00
3353078 ANTI RNP $ 73.00
3353079 ANTI SCLER $ 73.00
3353080 ANTI SMITH $ 73.00
3353084 ASO (STREPTOLYSIN) AB $ 123.00
3353096 VITAMIN B12 $ 41.00
3353108 BENCE JONES $ 375.00
3353109 BABESIA IGM $ 99.00
3353120 CAROTENE $ 155.00
3353121 SOMATOSTATIN $ 160.00
3353144 CEA $ 71.00
3353156 COLD AGGLUTINIIN $ 88.00
3353180 CORTISOL TOTAL/SERUM $ 51.00
3353181 CORTISOL TOTAL/SERUM $ 51.00
3353192 C-REACTIVE PROTEIN $ 46.00
3353204 CRYOGLOBULINS $ 41.00
3353276 DIGOXIN $ 73.00
3353288 DILANTIN $ 223.00
3353312 ESTRIOL $ 85.00
3353313 ESTROGENS TOTAL $ 366.00
3353314 T PALLIDUM FTA IgG ARUP $ 86.00
3353315 T PALLIDUM FTA IgM ARUP $ 86.00
3353316 T PALLIDUM TP-PA ARUP $ 86.00
3353317 BORDETELLA PERTUSIS ARUP $ 196.00
3353336 FEBRILE AGG $ 118.00
3353348 FERRITIN $ 187.00
3353352 CRYSTAL FLUID $ 62.00
3353360 FOLATE $ 42.00
3353372 FSH SERUM $ 46.00
3353408 GASTRIN $ 73.00
3353409 GASTROCCULT $ 56.00
3353420 GENTAMICIN PEAK $ 277.00
3353421 GENTANICIN TROUGH $ 277.00
3353447 HERPES SIMPLEX TYPE II $ 100.00
3353452 STREP SCREEN $ 147.00
3353486 A1C $ 114.00
3353516 IRON $ 67.00
3353518 IRON BINDING $ 56.00
3353520 LACTATE $ 145.00
3353540 LDH ISO $ 216.00
3353546 LEAD $ 41.00
3353550 LH (LUTENIZING HORMONE) $ 59.00
3353552 LIPASE $ 114.00
3353553 PEPTIDE/ VASO INTESTI ARU $ 214.00
3353554 ANTIDIURETIC HORMONE AVH $ 133.00
3353576 LITHIUM $ 51.00
3353577 MICROSOMAL ANTIBODIES $ 51.00
3353584 MAGNESIUM / URINE ARUP $ 55.00
3353585 DILANTIN (SEND OUT) $ 223.00
3353586 TACROLIMUS $ 250.00
3353587 MAGNESIUM $ 113.00
3353588 MAGNESIUM $ 113.00
3353589 LYMES DISEASE $ 191.00
3353590 LYME CONFIRM $ 117.00
3353591 EHRLICHIA $ 58.00
3353592 LYME CONFIRM $ 117.00
3353593 EHRLICHIA $ 58.00
3353594 PROCALCITONIN - ARUP $ 934.00
3353600 METANEPHRINE $ 304.00
3353610 OSMOLALITY SERUM/PLASMA $ 51.00
3353636 PHENOBARB $ 67.00
3353648 PHOSPHORUS $ 32.00
3353657 PROCAINAMIDE / NAPA $ 283.00
3353659 RUBELLA ANTIBODY $ 47.00
3353660 PROTEIN ELECT $ 67.00
3353684 QUINIDINE $ 247.00
3353695 SALICYLATES ADDITIONAL $ 119.00
3353697 SALICYLATES $ 119.00
3353698 TESTOSTERONE FREE/TOTAL FEMALE/CHILD ARU $ 126.00
3353699 RPR (VDRL) $ 32.00
3353702 TEGRETOL (CARBAMAZEPINE) $ 69.00
3353707 THYROID HORMONE $ 110.00
3353709 T4 - ARUP $ 37.00
3353710 HEMOGLOBIN / CHROMATOGRAP $ 51.00
3353711 ROTAVIRUS AG EIA $ 47.00
3353712 N-TELOPEPTIDE, C-L UA ARU $ 159.00
3353713 CANDIDA SPECIES BY PCR $ 556.00
3353719 DIRECT LDL $ 59.00
3353720 THEOPHYLLINE $ 95.00
3353721 VANCOMYCIN, TROUGH $ 126.00
3353722 TOPIRAMATE $ 235.00
3353723 YEAST IDENTIFICATION/ ARU $ 175.00
3353724 YEAST SUCEPTIBILITY/ARUP $ 124.00
3353725 MALARIA ANTIBODY, IgG $ 489.00
3353726 HGB EVAL/ELECTOPHORESIS $ 76.00
3353727 PHENOLPHTHAL, FECAL ARUP $ 41.00
3353728 SENSIVITY-DISK DIFF ARUP $ 201.00
3353731 ANTIHISTAMINE AB - ARUP $ 728.00
3353732 CLOZAPINE & METABOLITES S/P, QUANT $ 106.00
3353743 TRANSFERRIN $ 51.00
3353744 TSH $ 146.00
3353745 CYCLOSPORINE (CSA) $ 128.00
3353746 D-DIMER, PLASMA $ 88.00
3353747 INFLUENZA VIRUS/ANTIBODY $ 166.00
3353748 T4 FREE $ 51.00
3353749 RSV $ 147.00
3353750 T3 TOTAL $ 32.00
3353751 PARATHORMONE $ 67.00
3353752 ARSENIC $ 320.00
3353753 MERCURY $ 59.00
3353754 CADMIUM $ 84.00
3353755 MICROALBUMIN CREATININE $ 87.00
3353756 RBC, FOLATE ARUP $ 196.00
3353757 ORGANIC ACIDS $ 277.00
3353758 CRYOGLOBULINS,SE QUANT $ 41.00
3353759 IgM ANTIBODY $ 59.00
3353765 PROGESTERONE ARUP $ 136.00
3353766 BORRELIA SPECIA BY PCR $ 437.00
3353767 CULTURE/ YEAST $ 210.00
3353768 YEAST CULTURE $ 175.00
3353769 ASPERGILLUS $ 98.00
3353770 CLOTTING FACTOR VIII $ 388.00
3353771 GABAPENTIN (NEURONTIN) $ 91.00
3353772 VITAMIN B1 THIAMINE $ 111.00
3353773 MEASLES RUBEOLA ABS IgG IgM ARUP $ 57.00
3353775 PROSTATE SPC ANTI FREE $ 124.00
3353776 HEPATITIS BE ANTIBODY $ 194.00
3353777 HEPATITIS BE ANTIGEN $ 193.00
3353779 OLIGOCLONAL BANDS $ 326.00
3353780 NEPHELOMETRY $ 233.00
3353781 CARDIOLIPIN $ 69.00
3353782 CARDIOLIPIN $ 69.00
3353783 LUPUS ANTICOAGULANT $ 109.00
3353784 LEGIONELLA AB IGM $ 168.00
3353786 PREALBUMIN $ 51.00
3353787 NMP 22 $ 255.00
3353789 FIBRINOGEN $ 71.00
3353791 PTT/LUPUS ANTI $ 109.00
3353792 TISSUE THROMBOPLAST INHIB $ 88.00
3353793 ANA REFLEX $ 73.00
3353794 RECEPTOR ASSAY, ESTROGEN $ 812.00
3353795 RECEPTOR ASSAY, PROGESTERONE $ 812.00
3353796 TESTOSTERONE,FREE $ 238.00
3353798 ERYTHROPOIETIN $ 84.00
3353799 RUBEOLA $ 57.00
3353800 VARICELLA-ZOSTER IgG $ 59.00
3353801 BNP $ 574.00
3353802 PROLACTIN $ 59.00
3353803 VANCOMYCIN, PEAK $ 126.00
3353804 LYME AG / URINE $ 84.00
3353806 CERULOPLASMIN $ 51.00
3353807 PROTEIN C, FUNCTIONAL $ 133.00
3353808 PROTEIN S,FUNCTIONAL $ 216.00
3353809 HOMOCYSTENE QUANT $ 363.00
3353810 OBSTETRIC PANEL $ 250.00
3353811 NEUTRALIZATION TEST $ 285.00
3353813 TREPONEMA PALLIDUM $ 119.00
3353814 NEUTROPHIL ASSOC AB $ 254.00
3353815 HEP C CONFIRM (REFLEX) $ 527.00
3353816 BILE CHOLYLGLYCINE $ 365.00
3353817 NUCLEOTIDASE 5 $ 188.00
3353818 CMV AB IGG $ 158.00
3353819 HIV-1 $ 298.00
3353820 EBV AB IGM $ 53.00
3353822 HAPTOGLOBIN,QUANTATIVE $ 56.00
3353823 DIRECT LDL $ 59.00
3353824 EBV AB IGG $ 53.00
3353825 RENIN $ 73.00
3353826 BONE MARROW SMEAR $ 245.00
3353829 PATH LEVEL IV $ 227.00
3353830 IRON STAINS $ 174.00
3353831 IMMUNOFIXATION,ELECTROPHO $ 111.00
3353832 IMMUNOFIXATION, URINE $ 111.00
3353833 HLA TYPING $ 180.00
3353834 FECAL FAT / QUAL $ 42.00
3353835 IgE $ 51.00
3353836 CHLORIDE OTHER THAN BLOOD $ 84.00
3353838 HEPATITIS PANEL ACUTE $ 233.00
3353840 HEP C RNA, PCR $ 591.00
3353842 AMITRIPTYLINE $ 301.00
3353843 CHLAMYDIA TRACHOMATIS $ 60.00
3353844 NEISSERIA GONORRHOEAE,DIR $ 338.00
3353845 CRYPTOSPORIDIUM GIARDIA $ 203.00
3353846 CRYPTOSPORIDIUM AG EIA $ 99.00
3353847 T3 FREE $ 56.00
3353848 HEP C QUAN NAAT $ 523.00
3353849 PARSITE SMEAR $ 99.00
3353850 BORDETELLA PERTUSIS $ 203.00
3353851 IMIPRAMINE $ 291.00
3353852 BREATH ALCOHOL TEST $ 35.00
3353853 GLUCOSE 1 HR OB $ 80.00
3353855 HCG SERUM QUAL $ 128.00
3353856 HCT $ 40.00
3353857 CBC W AUTO DIFF $ 136.00
3353858 CBC W/O DIFF $ 122.00
3353859 CA 27.29 $ 76.00
3353860 CA 125 $ 67.00
3353862 HIV ABY SCREEN $ 150.00
3353863 ANTIBODY SCREEN $ 88.00
3353864 GROUP B STREP CULTURE $ 172.00
3353865 PINWORM EXAM $ 71.00
3353866 KOH / SKIN SCRAPING $ 88.00
3353867 STREP TEST; RAPID $ 38.00
3353869 POST VASECTOMY SPERM EXAM $ 145.00
3353870 SEMEN ANALYSIS $ 205.00
3353871 HPV TYPING $ 186.00
3353872 HEP C VIRUS - GENOTYPE $ 554.00
3353873 DHEA $ 84.00
3353874 ANTITHROMBIN III AG $ 132.00
3353876 LYMES DISEASE $ 191.00
3353877 PAPILLOMAC HUMAN DIR PROB $ 145.00
3353878 PAPILLOMAV HUMAN QUAN $ 304.00
3353879 SICKLING OF RBC, REDUCTION $ 155.00
3353881 TOXOCARA ANTI IgG-ARUP $ 98.00
3353882 BARTONELLA HENSELAE IgG $ 98.00
3353883 URINALYSIS,NON AUTO/W/O M $ 42.00
3353884 ACETYLCHOLINE RECEPTOR BINDING ARUP $ 187.00
3353885 PAPILLOMAVIRUS HUMAN APL $ 186.00
3353886 COCCIDIOIDES $ 98.00
3353887 COCCIDIOIDES $ 98.00
3353888 H PYLORI STOOL $ 243.00
3353889 ADRENOCORTICOTROPIC HORMO $ 117.00
3353890 ACETYLCHOLINE RECEP NON-E $ 99.00
3353891 FIBRIN / FIBRINOGEN DEGRA $ 117.00
3353892 COLUMN CHROMATO,QUAN $ 216.00
3353893 HEP C RNA QUAN REAL TIME $ 509.00
3353896 INSULIN FREE $ 67.00
3353898 INFLUENZA VIRUS $ 100.00
3353899 FETAL FIBRONECTIN $ 503.00
3353900 CH50 $ 63.00
3353901 FACTOR II ACTIVITY $ 233.00
3353902 OSTEOCALCIN $ 166.00
3353904 PLATELET IMMUNOGLOB ASSAY $ 210.00
3353905 TOXOPLASMA, IGM $ 168.00
3353906 URTICARIA-INDUCING ACTIVITY ARUP $ 424.00
3353907 FRAGILE X (FMR1) ARUP $ 479.00
3353908 CORTISOL, FREE $ 93.00
3353909 FRAGILE X (FMR1) REFLEX METHYLATION ANAL $ 2,163.00
3353910 FECAL FAT, TIMED QUANT $ 459.00
3353913 MUMPS IGG $ 51.00
3353915 ANA REFLEX $ 73.00
3353916 INSULIN TOTAL $ 51.00
3353917 INSULIN ANTIBODIES $ 363.00
3353919 AMPHET METHAMPHET CONFIRM $ 216.00
3353920 PORPHYRINS QUANT $ FRACT $ 249.00
3353921 HERPES SIMPLEX TYPE 2 $ 189.00
3353922 DIHYDROXYVITAMIN D I25 $ 133.00
3353923 ACTIVATED PROTEIN C $ 241.00
3353925 ANGIOTENSIN I $ 56.00
3353926 ASPERGILLUS AB ADDITIONAL $ 98.00
3353927 FACTOR X ACTIVITY $ 1,192.00
3353929 INFLUENZA VIRUS $ 100.00
3353930 TCELL,ABSOLUTE COUNT $ 241.00
3353931 AMMONIA ADDITIONAL $ 245.00
3353933 GROUP B STREP CULTURE $ 172.00
3353934 GC CULTURE $ 172.00
3353935 KOH / SKIN SCRAPING $ 88.00
3353936 LIPASE $ 114.00
3353937 CRYPTOCOCCUS ANTI,CSF ARU $ 107.00
3353938 LYME DISEASE (CSF) ARUP $ 90.00
3353940 Manual Cell Count-BF $ 71.00
3353942 ACETYLCHOLINE RECEPTOR BLOCKING ARUP $ 187.00
3353943 ACETYLCHOLINE MODULATING RECEPTOR ARUP $ 187.00
3353988 5HIAA $ 94.00
3353989 BARTONELLA HENSELAE IgM $ 98.00
3354014 CULTURE WOUND, ADD SITE $ 109.00
3354015 CULTURE, Wnd or Sputum or Misc $ 109.00
3354016 BLOOD CULTURE ADDITIONAL $ 136.00
3354017 BLOOD CULTURE $ 136.00
3354020 CULTURE COMPLETE $ 109.00
3354066 STOOL CULTURE $ 207.00
3354067 STOOL CULTURE ADDITIONAL $ 207.00
3354068 STOOL CULTURE #3 $ 207.00
3354100 GRAM STAIN $ 71.00
3354101 ANAEROBE CULTURE $ 277.00
3354102 MRSA SURVEILLANCE/ ARUP $ 172.00
3354103 ANAEROBE CULTURE ADDITION $ 277.00
3354140 WET SMEAR $ 65.00
3354187 STREP A CULTURE $ 172.00
3354189 CLO TEST $ 187.00
3354201 SENSITIVITY $ 124.00
3354202 CULTURE, WOUNDSPUTUM,MS $ 109.00
3354203 CULTURE I.D. $ 136.00
3354204 BETA-LACTAMASE ARUP $ 80.00
3354205 CULTURE I.D. $ 132.00
3354206 SENSITIVITY $ 124.00
3354207 CULTURE I.D. $ 136.00
3354208 SENSITIVITY $ 124.00
3354209 COMPLEMENT;ANITGEN EA $ 76.00
3354211 CONCENTRATION,INF AGENT $ 114.00
3354212 AFB CULTURE ARUP $ 182.00
3354213 AFB SMEAR ONLY $ 97.00
3354214 ETHOSUXIMIDE $ 67.00
3354215 FUNGAL MOLD ID ARUP $ 582.00
3354216 FUNGAL CULTURE,HAIR,SKIN, $ 233.00
3354218 CA 19-9 $ 72.00
3354219 STOOL CULTURE ADDITIONAL $ 207.00
3354221 VITAMIN E ASSAY $ 240.00
3354222 DETECT AGENT NOS DNA AMP $ 1,436.00
3354223 CMV ANTIBODY, IGM $ 119.00
3354224 SENSITIVITY - ARUP $ 145.00
3354225 VITAMIN B-2 ASSAY $ 340.00
3354226 CULTURE I.D. - ARUP $ 136.00
3354227 CONCENTRATION, INF AGENT $ 63.00
3354228 CULTURE, BACT W ISOLAT/ID / ISOL ARUP $ 166.00
3354229 STOOL CULTURE ID ARUP $ 350.00
3354230 STOOL CULTURE ID ARUP $ 350.00
3355080 WBC $ 42.00
3355081 WBC $ 42.00
3355093 RBC $ 52.00
3355117 RETIC $ 71.00
3355125 HGB /HEMOGLOBULIN $ 40.00
3355126 HGB /HEMOGLOBIN ADDITIONA $ 40.00
3355127 HEMOGLOBIN (BY HEMOCUE) $ 40.00
3355129 PLATELET ADDITIONAL $ 73.00
3355130 PLATELET $ 73.00
3355132 LIVER PANEL (HEPATIC) $ 183.00
3355134 CBC NO DIFF ADD $ 122.00
3355135 LIVER PANEL (HEPATIC) $ 183.00
3355136 DEPAKOTE ( VALPROIC ACID) $ 88.00
3355138 HCT / HEMATOCRIT $ 40.00
3355141 HCT / HEMATOCRIT ADDITION $ 40.00
3355150 MANUAL DIFFERENTIAL $ 44.00
3355151 MANUAL DIFFERENTIAL ADDIT $ 44.00
3355152 QUANITATION OF DRUG $ 192.00
3355153 VALPROIC ACID TOTAL ARUP $ 155.00
3355154 VALPROIC ACID FREE ARUP $ 155.00
3355155 MANUAL DIFF NO CHG $ 0.00
3355182 SED RATE / ESR $ 65.00
3355325 PROTIME/ INR $ 66.00
3355326 PROTIME / INR ADDITIONAL $ 66.00
3355352 CBC W AUTO DIFF ADDITION $ 136.00
3355353 CBC W AUTO DIFF $ 136.00
3355482 CELL COUNT , FLUID $ 79.00
3355831 PTT $ 80.00
3355833 PTT $ 80.00
3355850 DRUG HAIRSTAT 5 REFLEX PANEL ARUP $ 316.00
3356000 URINALYSIS $ 55.00
3356003 CHLORIDE URINE $ 46.00
3356004 METANEPHRINE FRACTIONATED URINE ARUP $ 136.00
3356007 URINE MICRO $ 52.00
3356010 CORTISOL-URINE 24'-RANDOM $ 93.00
3356011 CADMIUM / URINE $ 84.00
3356012 BETA-2 MICROGLOBULIN/URIN $ 67.00
3356013 COPPER, URINE ARUP $ 73.00
3356014 BARIUM QUANTITATIVE URINE $ 533.00
3356015 CHROMIUM URINE $ 69.00
3356016 PHENOL EXPOSURE QUANT URINE $ 196.00
3356017 SILVER QUANTITATIVE URINE/ SERUM $ 420.00
3356018 PORPHOBILINOGEN, RANDOM URINE ARUP $ 160.00
3356023 LEGIONELLA AG, URINE $ 84.00
3356025 URINALYSIS / QUALITATIVE - ARUP $ 59.00
3356040 URINE OCCULT $ 42.00
3356043 URINE ALBUMIN $ 37.00
3356045 MICRO ALBUMIN URINE $ 97.00
3356060 URINE KETONES $ 42.00
3356068 AMYLASE, URINE $ 110.00
3356100 CREATININE UA RANDOM ARUP $ 87.00
3356101 CREATININE UA 24HR ARUP $ 87.00
3356127 URINE CALCIUM $ 100.00
3356128 THALLIUM, URINE $ 110.00
3356150 URIC ACID/ BODY FLUID $ 80.00
3356160 CREATIN CLEARANCE TIMED $ 67.00
3356162 CULTURE TYPING, IMMUNO $ 76.00
3356163 IMMUNOFIX/ E-PHORSIS URIN $ 398.00
3356164 CREATIN CLEARANCE TIMED $ 67.00
3356208 VMA TIMED URINE $ 94.00
3356224 PROTEIN TIMED URINE $ 73.00
3356243 CATECHOLAMINES URINE $ 156.00
3356377 SODIUM URINE $ 41.00
3356389 POTASSIUM URINE $ 41.00
3356402 HCG URINE $ 35.00
3356502 RH $ 107.00
3356503 THYROGLOBULIN ANTIBODY $ 58.00
3356504 ANTIBODY ID,RBC ANTI $ 124.00
3356810 LIPID PANEL $ 216.00
3357061 RHEUMATOID FACTOR $ 51.00
3357062 BRAC1 BRAC2 GENE ANALYSIS $ 2,222.00
3357088 MONO TEST $ 51.00
3357856 CELIAC PANEL $ 56.00
3357868 IG-G NCL $ 56.00
3357880 IG-M NCL $ 56.00
3358000 TROPONIN I,i-STAT $ 164.00
3358001 TROPONIN I, i STAT ADDIT $ 164.00
3358002 CK-MB, i-STAT $ 128.00
3358003 CK-MB, i-STAT ADDIT $ 128.00
3358011 BLOOD TYPE ABO $ 107.00
3358012 RH $ 107.00
3358013 TYPE COMPLETE $ 107.00
3358014 TYPE COMPLETE-2 $ 107.00
3358022 INFANT BLOOD TYPE ABO $ 107.00
3358023 INFANT RH $ 107.00
3358025 DU LAB $ 66.00
3358050 RH ONLY $ 107.00
3358108 DAT $ 97.00
3358109 ANTIBODY IDENTIFICATION $ 124.00
3358110 ANITBODY ELUTION $ 332.00
3358111 ANTIBODY ELUTION(RBC) $ 332.00
3358112 DAT $ 97.00
3358113 ANTIGEN SCREENING $ 154.00
3358114 ANTIGEN SCREENING $ 154.00
3358115 RH PHENOTYPING,COMPLETE $ 131.00
3358116 RH ANTIGEN SCREEN $ 145.00
3358117 RH ANTIGEN SCREENING $ 145.00
3358120 ANTIBODY SCREEN / ARC $ 109.00
3358123 ANTIHUMAN GLOBULIN TEST COOMBS $ 88.00
3358124 ANTIHUMAN GLOBULIN TEST COOMBS $ 88.00
3358125 PRETREATMENT RBC'S $ 213.00
3358126 PRETREATMENT OF SERUM RBC'S $ 219.00
3358127 INFECT AGENT DETECT NUCLEIC ACID STREPTO $ 281.00
3358201 CROSSMATCH-1 $ 291.00
3358202 CROSSMATCH-2 $ 291.00
3358203 CROSSMATCH-3 $ 291.00
3358205 ANTIGEN SCREENING $ 66.00
3358206 RARE TYPING $ 371.00
3358207 CROSSMATCH-1 $ 291.00
3358208 CROSSMATCH-2 $ 291.00
3358209 CROSSMATCH-3 $ 291.00
3358210 ANTIGEN SCREENING $ 66.00
3358530 STRIATED MUSCLE REFLEX $ 293.00
3358531 ANCA TITER REFLEX $ 293.00
3358532 FACTOR V ACTIVITY $ 133.00
3358533 C-PEPTIDE $ 67.00
3358534 RICKETTSIA $ 86.00
3358535 URINALYSIS COMPLETE $ 68.00
3358536 URINALYSIS W/O MICRO $ 39.00
3358537 URINALYSIS AUTO $ 68.00
3358538 URINALYSIS COMPLETE /59 $ 68.00
3359000 PATH/LEVEL I GROSS ONLY $ 76.00
3359001 PATH/LEVEL II GROSS & MIC $ 159.00
3359003 PATH/LEVEL III GROSS/MICR $ 166.00
3359004 PATH/LEVEL IV GROSS/MICRO $ 227.00
3359005 PATH/LEVEL V GROSS/MICRO $ 505.00
3359006 PATH/LEVEL VI GROSS/MICRO $ 702.00
3359008 PATH/SPECIAL STAIN #1 $ 261.00
3359009 PATH/SPECIAL STAIN #2 $ 174.00
3359010 PATH/CYTOL,VAGINA,CERVIX $ 46.00
3359011 PATH/CYTOL,FLUIDS,WASH,BR $ 147.00
3359012 PATH/ESTROGEN EVAL $ 27.00
3359013 PATH/DECALCIFICATION PROC $ 26.00
3359014 PATH/SPECIAL STAIN (ENZY) $ 188.00
3359015 PATH/IMMUNOPEROXIDASE/ANT $ 228.00
3359016 PATH/CYTOLOGY FLUIDS $ 178.00
3359017 PATH/CYTOLOGY,SCR & INTER $ 118.00
3359019 PATH/CYTOLGY NEEDLE ASPIR $ 250.00
3359020 CYTOL, CERVI $ 118.00
3359021 PERIPHERAL SMEAR AHL $ 86.00
3359022 DECALCIFICAT $ 26.00
3359023 STONE ANAL. W $ 217.00
3359024 PATH / PROGESTE $ 119.00
3359030 HEMOGRAM PLATELET COUNT $ 122.00
3359031 PAP SMEAR THIN PREP $ 94.00
3359032 CYTOLOGY SMEAR, OTHER $ 112.00
3359033 HER 2-FISH $ 228.00
3359034 CYTO FLUID THI PREPSMEAR $ 147.00
3359036 TISSUE CULTURE SOLID TUMOR $ 223.00
3359037 CHROMOSOME COUNT 15-20 CE $ 558.00
3359038 PAP SMEAR ROUTINE $ 118.00
3359039 FACTOR X CHROMOGE $ 202.00
3359040 CYTOGENETICS/MOLECULAR $ 96.00
3359041 TISSUE CULTURE/NONNEOPLAS $ 223.00
3359042 STONE ANAL $ 111.00
3359043 CULTURE SKIN/TISSUE BIOPS $ 223.00
3359044 CYTOPATHOLOGY,CERVICAL VA $ 99.00
3359046 CYTOPATHOLOGY,SELE CELLUL $ 160.00
3359047 MOLECULAR CYTOGENETICS $ 66.00
3359048 MOLECULAR CYTOGENETICS $ 66.00
3359049 INTERPHASE IN SITU HYBRID $ 180.00
3359050 CTYOGENOMIC SNP MICRO REFLEX ARUP $ 5,813.00
3359053 MORPHOMETRIC ANALYSIS COM $ 1,170.00
3359054 INSITU HYDRIDIZATION MANU $ 2,009.00
3359055 PHYSICIAN BLOOD BANK $ 593.00
3359056 AUTO DIFF / WBC COUNT $ 110.00
3359057 TISSUE CULT/ BONE MARROW $ 223.00
3359061 FLOWCYTOMETRY/ TC 1 MARKE $ 277.00
3359062 FLOWCYTOMETRY/TC ADD ON $ 167.00
3359063 FLOWCYTOMETRY/TC ADD ON $ 167.00
3359064 FLOWCYTOMETRY/READ 16 > $ 337.00
3359065 CELL MARKER STUDY $ 229.00
3359066 PAP SMEAR AUTO/THIN PREP $ 96.00
3359067 RETICULOCYTE BLOOD COUNT $ 68.00
3359068 FLOWCYTOMETRY INTERP $ 217.00
3359069 PATH/CYTO CERVIX VAGINAL $ 167.00
3359070 PATH/ LEVEL II GROSS & MI $ 159.00
3359071 PATH LEVEL III GROSS MICR $ 166.00
3359072 CHROMOSOME KAROTYPE $ 112.00
3359073 CHROMOSOME KAROTYPE $ 112.00
3359074 PATH/ SPECIAL STAIN #1 $ 261.00
3359075 FLOW CYTOMETRY/ READ 9-15 $ 277.00
3359076 MORPHOMETRIC ANALYSIS COM $ 1,170.00
3359077 INSTU HYRIDIZATION MANU $ 2,009.00
3359078 PATH/LEVEL V GROSS/ MICRO $ 505.00
3359079 PAP SMEAR SCREENING/ HAND $ 156.00
3359080 INSITU HYBRIDIZATION(FISH $ 1,416.00
3359081 INTERPHASE IN SITU HYBRID $ 180.00
3359082 TRANSFUSION RX / PHYS SER $ 593.00
3359083 CYTOGENICS, 10-30 $ 144.00
3359084 PATH/LEVEL VI GROSS/MICRO $ 948.00
3359085 TUMOR IMMUNOHISTO/ MANUAL $ 883.00
3359086 PATH/CYTOLOGY NEEDLE ASPI $ 250.00
3359087 PATH/LEVEL I GROSS ONLY $ 76.00
3359088 PATH/ IMMUNOFLUOR STUDY $ 210.00
3359089 PATH/ IMMUNOFLUOR STUDY $ 210.00
3359090 MONOCYTIC EHR DNA ALLINA $ 1,436.00
3359091 PATH/LEVEL IV GROSS/MICRO $ 227.00
3359092 JAK2 GENE MUTATION $ 693.00
3359093 CHROMOSOME ANAL, ADD CELL $ 85.00
3359095 CYTOPATH URINE 3-5 PROBES $ 2,487.00
3359096 DECALCIFICAT $ 26.00
3359100 PATH/ IMMUNOPEROXIDASE / ANT $ 228.00
3359101 IHC STAIN ADDL $ 228.00
3359102 HPV HIGH RISK $ 141.00
3359103 PROSTATE SATURATION BIOPSY $ 4,482.00
3359104 IHC STAIN MULTIPLEX $ 327.00
3359105 IHC STAIN MUTIPLEX $ 327.00
3359106 TUMOR IMMUNOHISTO/ MANUAL $ 883.00
3359107 CYG-GENERAL MORPH $ 2,050.00
3359108 CYG-GENERAL MORPH $ 2,050.00
3359109 CHROMOSOME COUNT 15-20 CLL ARUP $ 684.00
3359110 TISSUE CULTURE NON NEO ARUP $ 684.00
3359111 CYTOGENETICS MOLECULAR CTYO ARUP $ 684.00
3359112 CALR, GENE ANALYSIS $ 1,252.00
3359113 BRAF V600 MUTATION ASSAY ALLINA $ 918.00
3359114 EGFR MUTATION ANALYSIS ALLINA $ 1,683.00
3359115 MPL CODON 515 MUTATION DETEC, QUANT ARUP $ 1,814.00
3359116 EPOR MUTATION DETEC, SEQUENCING ARUP $ 1,814.00
3359117 BETA LACTAMASE - ALLINA $ 37.00
3359118 KB SUSCEPTIBILITY - ALLINA $ 54.00
3359119 E TEST - ALLINA $ 37.00
3359120 KB SUSCEPTIBILTY -ALLINA 2ND $ 54.00
3359121 T CELL PCR 1 $ 732.00
3359122 T CELL PCR 2 $ 706.00
3359123 TISSUE HOMOGENIZATION $ 42.00
3359124 EOSINOPHIL SMEAR $ 37.00
3359125 DNA EXTRACTION, SEQUENCING $ 216.00
3359190 VENIPUNCTURE $ 13.00
3359191 VENIPUNCTURE ADDITIONAL $ 13.00
3359192 CAPILLARY COLLECTION $ 6.00
3359193 COLLECTION BLOOD/ VENOUS $ 131.00
3359194 COLLECTION BLOOD/ VENOUS $ 131.00
3359195 SPECIMEN HANDLING $ 37.00
3359196 SPECIMEN HANDLING $ 37.00
3359198 CAPILLARY COLLECTION ADDI $ 6.00
3359201 ARTERIAL PUNCTURE $ 85.00
3359202 ARTERIAL PUNCTURE ADDITI $ 85.00
3359203 ARUP - PROCESS FEE $ 109.00
3359204 ARTERIAL PUNCTURE $ 86.00
3359205 ARUP - PROCESS FEE $ 109.00
3359206 VENIPUNCTURE (NO CHG) $ 0.00
3359210 MEDICAL NECESSITY TEST 0 CHARGE $ 0.00
3359382 TRAVEL LAB $ 27.00
3359393 PKU $ 604.00
3359395 PH FECAL $ 28.00
3359406 MECONIUM DRUG PANEL 10 $ 907.00
3359407 MECONIUM DRUG PANEL 9 $ 818.00
3359408 MECONIUM DRUG PANEL 8 $ 706.00
3359409 SEROGROUPING - ALLINA $ 40.00
3359509 FLUNITRAZEPAM & METABOLITES W/RFLX, U $ 669.00
3359510 GAMMA-HYDROXYBUTYRIC ACID SCREEN $ 712.00
3359600 MEDTOX TESTING $ 40.00
3359601 SPECIMEN HANDLING MEDTOX $ 30.00
3359602 DDC SPECIMEN HANDLING $ 23.00
3359880 DRUG TEST/S 1-7 DRUG TESTING $ 416.00
3359881 DRUG TEST 15-21 DRUG CLASSES $ 822.00
3359882 DRUG TEST 8-14 DRUG CLASSES $ 252.00
3359885 CONSULT REPORT REFERRED SLIDE PREP ELSEW $ 456.00
3368536 URINALYSIS W/O MICRO $ 39.00
3369010 PATH/CYTOL,VAGINA,CERVIX $ 46.00
3369196 SPECIMEN HANDLING $ 27.00
3370067 RHOPHYLAC 300MCG / 1500IU(RHOGAM) X15 $ 21.00
LAB LAB Conversion $ 0.00
3339026 MRI PROHANCE/GADOLIN 50ML $ 263.00
3339500 MRI TMJ JNT $ 3,622.00
3339501 MRI ORBIT,FACE,NECK $ 3,622.00
3339502 MRI BRAIN W/O $ 3,622.00
3339503 MRI BRAIN W $ 3,622.00
3339504 MRI BRAIN W W/O $ 3,622.00
3339505 MRI CHEST W/O $ 3,622.00
3339506 MRI C-SPINE W/O $ 3,622.00
3339507 MRI C-SPINE W $ 3,622.00
3339508 MRI T-SPINE $ 3,622.00
3339509 MRI T-SPINE W $ 3,622.00
3339510 MRI L-SPINE W/O $ 3,622.00
3339511 MRI L-SPINE W $ 3,622.00
3339512 MRI C-SPINE W W/O $ 3,622.00
3339513 MRI T-SPINE W W/O $ 3,622.00
3339514 MRI L-SPINE W W/O $ 3,622.00
3339515 MRI PELVIS W $ 3,622.00
3339516 MRI UPPER EXT W W/O LT $ 3,622.00
3339518 MRI LWR EXTR NON JNT LT W W/O $ 3,622.00
3339519 MRI LWR EXT JNT W/O RT $ 3,622.00
3339520 MRI ABD W/O $ 3,622.00
3339521 MRI ABD W W/O $ 3,622.00
3339524 MRA NECK W/O $ 3,622.00
3339525 MRA NECK W W/O $ 3,622.00
3339526 MRA HEAD W/O $ 3,622.00
3339527 MRI PELVIS / HIP W/O $ 3,622.00
3339528 MRI LWR EXT JNT W/O LT $ 3,622.00
3339529 MRI T-SPINE LIM $ 3,622.00
3339530 MRI UPPER EXT JNT RT $ 3,622.00
3339531 MRI UPPER EXT JNT LT $ 3,622.00
3339532 MRA UPPER EXT LT $ 3,622.00
3339533 MRA CHEST W W/O $ 3,622.00
3339534 MRA ABD W W/O $ 3,622.00
3339535 MRA NECK W $ 3,622.00
3339536 MRI LWR EXT NOT JNT RT WO $ 3,622.00
3339537 MRI C-SPINE LIM W/O $ 3,622.00
3339538 MRA SPINAL CANAL $ 3,622.00
3339539 MRI ORBIT,FACE,NECK W W/O $ 3,622.00
3339540 MRI LWR EXT NOT JNT LT WO $ 3,622.00
3339541 MRI LWR EXT JNT W W/O RT $ 3,622.00
3339542 MRA LWR EXT LT $ 3,622.00
3339543 MRI UPPER EXT NOT JNT RT $ 3,622.00
3339546 MRI LWR EXTR NON JNT RT W W/O $ 3,622.00
3339547 MRI LWR EXT JNT W W/O LT $ 3,622.00
3339548 MRI LWR EXT JNT W RT $ 3,622.00
3339549 MRA LWR EXT RT $ 3,622.00
3339550 MRA HEAD W W/O $ 3,622.00
3339551 MRI BRAIN / NEURO FUNC $ 3,622.00
3339552 MRI UPPER EXT NOT JNT LT $ 3,622.00
3339553 MRI BRAIN FUNCTION $ 3,622.00
3339554 MRI LWR EXT JNT W/O RT $ 3,622.00
3339555 MRA UPPER EXT RT $ 3,622.00
3339556 MRI IAC W W/O $ 3,622.00
3339557 MRI UPPER EXT JNT W $ 3,622.00
3339558 MRI UPPER EXT JNT W $ 3,622.00
3339559 MRI UPPER EXT W W/O RT $ 3,622.00
3339560 MRI LWR EXT W LT $ 3,622.00
3339561 MRI PELVIS / HIP W W/O $ 3,622.00
3339562 MRI ABD W $ 3,622.00
3339563 MRI UPPER EXT JNT W/WO RT $ 3,622.00
3339564 MRI UPPER EXT JNT W/WO LT $ 3,622.00
3339565 MRI CHEST W W/O CONTRAST $ 3,622.00
3339566 MRI BRAIN W $ 3,622.00
3339567 MRA HEAD W/O $ 3,622.00
3339568 MRI LWR EXT NO /JNT W RT $ 3,622.00
$ 3,622.00
3328608 NM RENOGRAM LT $ 1,989.00
3328618 NM MI WORK UP/PYP SCAN $ 1,739.00
3328619 NM GI BLEED & SULPHUR $ 3,230.00
3328620 NM MECKLES $ 3,238.00
3328621 NM BONE/JNT SCAN LIM $ 1,608.00
3328622 NM BONE SCAN MULT AREA $ 2,115.00
3328623 NM BONE SCAN TOTAL BODY $ 2,249.00
3328624 NM 3 PHASE BONE SCAN $ 3,209.00
3328627 NM LIVER & SPLEEN IMAGE $ 1,835.00
3328631 NM MUGA GAITED CARDIAC $ 1,985.00
3328632 NM GASTRIC EMPTYING STUDY $ 2,680.00
3328633 NM PY BREATH TEST $ 973.00
3328634 NM SPLEEN SCAN $ 2,059.00
3328638 NM RENAL SCAN LT $ 1,659.00
3328642 NM RENAL STUDY,SINGLE LT $ 1,226.00
3328644 NM PULM PERFUSION IMAG,PA $ 2,047.00
3328645 NM PARATHYROID $ 1,317.00
3328648 NM RENAL SCAN RT $ 1,659.00
3328649 NM RENOGRAM RT $ 1,989.00
3328650 NM RENAL STUDY SINGLE RT $ 1,226.00
3328651 NM HIDA SCAN $ 3,162.00
3328652 NM HIDA EF $ 4,390.00
3328653 NM ORAL RADIOPHARM THERAP $ 513.00
3328654 NM INDIUM BONE SCAN LIMIT $ 1,582.00
3328655 NM THYROID IMAGING VAS FL $ 2,262.00
3328656 NM KIDNEY IMAG W / MORPH LT $ 2,030.00
3328657 NM KIDNEY IMAG W / MORPH RT $ 2,030.00
3328658 NM KIDNEY IMAG W MORPH BILAT $ 2,536.00
3328659 NM RENAL STUDY BILATERAL $ 1,532.00
3328660 NM RENOGRAM BILATERAL $ 2,488.00
3328661 NM BSGI $ 2,244.00
3328663 NM PULMONARY VENTILATION PERFUSION IMAG $ 2,251.00
3050002 RM/BOARD SEMI PRIVATE $ 2,572.00
3050004 RM/BOARD OBSTETRIC $ 2,300.00
3050005 RM/BOARD SWING BED PRIV $ 950.00
3050006 RM/BOARD SWING LOA $ 0.00
3105651 GLUCOSE TESTING (NONLAB) $ 45.00
3105682 THERAPEUTIC INJ INTR ARTE $ 120.00
3105685 BLADDER IRRIGATION $ 310.00
3105688 COLLECTION/BLOOD VENOUS $ 81.00
3105689 ADMINISTRATION/HEP B VACC $ 53.00
3105690 IMMUNIZATION $ 31.00
3105691 COLLECTION/BLOOD VENOUS $ 81.00
3105692 IMMUNIZATION VACCINE $ 26.00
3105695 IV INFUS/HYDRATION EA 1HR $ 34.00
3105696 IV INFUS/HYDRATION $ 96.00
3105697 IV PUSH EA ADD $ 234.00
3105698 IV PUSH $ 234.00
3105699 IV THERAPY ADD SEQ INF $ 234.00
3105701 PORT FLUSH $ 196.00
3105702 IV PUSH $ 234.00
3105704 IMMUNIZATION ADMIN/ INFLU $ 10.00
3105705 IMMUNIZATION / ADMIN PNEU $ 10.00
3105706 BLADDER IRRIG/ CHEMO $ 477.00
3105707 GLUCOSE TESTING (NONLAB) $ 45.00
3105709 IV PUSH EA ADD $ 234.00
3105712 IV INFUSION / HYDRATION $ 96.00
3105800 IMPLANTABLE PUMP/PROGRA $ 464.00
3105801 INSERTION OF NEEDLE $ 54.00
3105802 ARTERIAL PUNCTURE $ 122.00
3105803 INSERT NON-TUNNEL CV CATH $ 789.00
3105804 INSERT PIC CATH 5YRS> $ 1,720.00
3105805 REPOSITION VENOUS CATH $ 351.00
3105806 NASAL GASTRIC TUBE INSERT $ 207.00
3105807 INJECTION JOINT/ BURSA $ 151.00
3105808 SHAVE SKIN LESION $ 281.00
3105811 PICC LINE INSERTION $ 500.00
3105812 PICC LINE INSERTION $ 500.00
3105813 REMOVAL CENT VENOUS CATH $ 1,100.00
3105814 REMOVAL CENT VENOUS CATH $ 1,100.00
3105816 DRAINAGE HYDROCELE $ 460.00
3105817 PICC LINE INSERTION $ 500.00
3105818 THORACENTESIS W/O IMAG $ 1,457.00
3105819 INSERT NON-TUNNEL CV CATH $ 789.00
3105820 REMOVAL TUNNELED CV CATH $ 776.00
3105821 THORACENTESIS W IMAGING $ 1,667.00
3105822 NEGATIVE PRESSURE WOUND THERAPY $ 360.00
3105823 PHLEBOTOMY $ 379.00
3106110 INTUBATION $ 703.00
3107020 NASOPHARYNGOSCOPY $ 369.00
3107021 DEBRIDE,SUBQ 1ST 20SQ CM $ 509.00
3107022 NEG PRESS THER 50 CM $ 160.00
3107023 DEBRD SEL 1ST 20SQCM $ 159.00
3107024 NEG PRESS THER >50CM $ 209.00
3805986 ER OBSERVATION EA.1HR $ 150.00
3806400 OBSERVATION HOURS $ 0.00
3650001 OT CONTRACT PRE-EMP EVAL $ 22.00
3650002 OT CCC SCREEN $ 0.00
3658003 OT EVAL LOW COMPLEXITY $ 230.00
3658004 OT TRAIN IN ADL 15 $ 259.00
3658005 OT EVAL MOD COMPLEXITY $ 252.00
3658006 OT ADLS 15 $ 259.00
3658007 OT THER EX 15 $ 259.00
3658008 OT COG/SENS INT 15 $ 259.00
3658009 OT THER ACT 15" $ 259.00
3658010 OT EVAL HIGH COMPLEXITY $ 274.00
3658011 OT NEURO RE-ED 15 $ 259.00
3658013 OT RE-EVALUATION $ 153.00
3658014 OT ORTHOTICS FIT/TRN 15 $ 240.00
3658015 OT W/C MGT FIT 15 $ 227.00
3658016 OT SENSORY SKILLS 15 $ 259.00
3658018 OT ULTRASOUND 15 $ 195.00
3658019 OT PHYS PERF TEST 15 $ 191.00
3658020 OT ORTHOTIC MGMT/TRAINING 15 $ 240.00
3658021 OT IONTOPHORESIS 15 $ 132.00
3658023 OT COG/SENS INT 15" 59 $ 259.00
3658024 OT ADLS 15" 59 $ 259.00
3658027 OT E-STIM MANUAL 15 $ 124.00
3658028 OT PARAFFIN BATH $ 0.00
3658029 OT CONTRACT GOOD SAM HC /VISIT OT $ 99.00
3658030 OT E-STIM ATTENDED 15 $ 124.00
3658031 OT THER EX 15 59 $ 259.00
3658032 OT THER ACT 15" 59 $ 259.00
3658033 OT NEURO RE-ED 15" 59 $ 259.00
3658034 OT COG/SENS INT 15 59 $ 259.00
3658035 OT CROSSBOW EVAL $ 64.00
3658036 OT TRAIN IN ADL 15MN 59 $ 259.00
3658037 THERAPEUTIC INTERVEN COG FUNC $ 107.00
3658038 ORTHOTIC PROSTHETIC MGMT / TRAIN 15MN $ 194.00
3659020 OT MOBILITY CURRENT G8978CH $ 0.00
3659021 OT MOBILITY CURRENT G8978CI $ 0.00
3659022 OT MOBILITY CURRENT G8978CJ $ 0.00
3659023 OT MOBILITY CURRENT G8978CK $ 0.00
3659024 OT MOBILITY CURRENT G8978CL $ 0.00
3659025 OT MOBILITY CURRENT G8978CM $ 0.00
3659026 OT MOBILITY CURRENT G8978CN $ 0.00
3659027 OT MOBILITY GOAL G8979CH $ 0.00
3659028 OT MOBILITY GOAL G8979CI $ 0.00
3659029 OT MOBILITY GOAL G8979CJ $ 0.00
3659030 OT MOBILITY GOAL G8979CK $ 0.00
3659031 OT MOBILITY GOAL G8979CL $ 0.00
3659032 OT MOBILITY GOAL G8979CM $ 0.00
3659033 OT MOBILITY GOAL G8979CN $ 0.00
3659034 OT MOBILITY D/C G8980CH $ 0.00
3659035 OT MOBILITY D/C G8980CI $ 0.00
3659036 OT MOBILITY D/C G8980CJ $ 0.00
3659037 OT MOBILITY D/C G8980CK $ 0.00
3659038 OT MOBILITY D/C G8980CL $ 0.00
3659039 OT MOBILITY D/C G8980CM $ 0.00
3659040 OT MOBILITY D/C G8980CN $ 0.00
3659041 OT BODY POSITION CURRENT G8981CH $ 0.00
3659042 OT BODY POSITION CURRENT G8981CI $ 0.00
3659043 OT BODY POSITION CURRENT G8981CJ $ 0.00
3659044 OT BODY POSITION CURRENT G8981CK $ 0.00
3659045 OT BODY POSITION CURRENT G8981CL $ 0.00
3659046 OT BODY POSITION CURRENT G8981CM $ 0.00
3659047 OT BODY POSITION CURRENT G8981CN $ 0.00
3659048 OT BODY POSITION GOAL G8982CH $ 0.00
3659049 OT BODY POSITION GOAL G8982CI $ 0.00
3659050 OT BODY POSITION GOAL G8982CJ $ 0.00
3659051 OT BODY POSITION GOALG8982CK $ 0.00
3659052 OT BODY POSITION GOAL G8982CL $ 0.00
3659053 OT BODY POSITION GOAL G8982CM $ 0.00
3659054 OT BODY POSITION GOAL G8982CN $ 0.00
3659055 OT BODY POSITION D/C G8983CH $ 0.00
3659056 OT BODY POSITION D/C G8983CI $ 0.00
3659057 OT BODY POSITION D/C G8983CJ $ 0.00
3659058 OT BODY POSITION D/C G8983CK $ 0.00
3659059 OT BODY POSITION D/C G8983CL $ 0.00
3659060 OT BODY POSITION D/C G8983CM $ 0.00
3659061 OT BODY POSITION D/C G8983CN $ 0.00
3659062 OT CARRYING CURRENT G8984CH $ 0.00
3659063 OT CARRYING CURRENT G8984CI $ 0.00
3659064 OT CARRYING CURRENT G8984CJ $ 0.00
3659065 OT CARRYING CURRENT G8984CK $ 0.00
3659066 OT CARRYING CURRENT G8984CL $ 0.00
3659067 OT CARRYING CURRENT G8984CM $ 0.00
3659068 OT CARRYING CURRENT G8984CN $ 0.00
3659069 OT CARRYING GOAL G8985CH $ 0.00
3659070 OT CARRYING GOAL G8985CI $ 0.00
3659071 OT CARRYING GOAL G8985CJ $ 0.00
3659072 OT CARRYING GOAL G8985CK $ 0.00
3659073 OT CARRYING GOAL G8985CL $ 0.00
3659074 OT CARRYING GOAL G8985CM $ 0.00
3659075 OT CARRYING GOAL G8985CN $ 0.00
3659076 OT CARRYING D/C G8986CH $ 0.00
3659077 OT CARRYING D/C G8986CI $ 0.00
3659078 OT CARRYING D/C G8986CJ $ 0.00
3659079 OT CARRYING D/C G8986CK $ 0.00
3659080 OT CARRYING D/C G8986CL $ 0.00
3659081 OT CARRYING D/C G8986CM $ 0.00
3659082 OT CARRYING D/C G8986CN $ 0.00
3659083 OT SELF CARE CURRENT G8987CH $ 0.00
3659084 OT SELF CARE CURRENT G8987CI $ 0.00
3659085 OT SELF CARE CURRENT G8987CJ $ 0.00
3659086 OT SELF CARE CURRENT G8987CK $ 0.00
3659087 OT SELF CARE CURRENT G8987CL $ 0.00
3659088 OT SELF CARE CURRENT G8987CM $ 0.00
3659089 OT SELF CARE CURRENT G8987CN $ 0.00
3659090 OT SELF CARE GOAL G8988CH $ 0.00
3659091 OT SELF CARE GOAL G8988CI $ 0.00
3659092 OT SELF CARE GOAL G8988CJ $ 0.00
3659093 OT SELF CARE GOAL G8988CK $ 0.00
3659094 OT SELFCARE GOAL G8988CL $ 0.00
3659095 OT SELF CARE GOAL G8988CM $ 0.00
3659096 OT SELF CARE GOAL G8988CN $ 0.00
3659097 OT SELF CARE D/C G8989CH $ 0.00
3659098 OT SELF CARE D/C G8989CI $ 0.00
3659099 OT SELF CARE D/C G8989CJ $ 0.00
3659100 OT SELF CARE D/C G8989CK $ 0.00
3659101 OT SELF CARE D/C G8989CL $ 0.00
3659102 OT SELF CARE D/C G8989CM $ 0.00
3659103 OT SELF CARE D/C G8989CN $ 0.00
3659104 OT OTHER PRIMARY CURRENT G8990CH $ 0.00
3659105 OT OTHER PRIMARY CURRENT G8990CI $ 0.00
3659106 OT OTHER PRIMARY CURRENT G8990CJ $ 0.00
3659107 OT OTHER PRIMARY CURRENT G8990CK $ 0.00
3659108 OT OTHER PRIMARY CURRENT G8990CL $ 0.00
3659109 OT OTHER PRIMARY CURRENT G8990CM $ 0.00
3659110 OT OTHER PRIMARY CURRENT G8990CN $ 0.00
3659111 OT OTHER PRIMARY GOAL G8991CH $ 0.00
3659112 OT OTHER PRIMARY GOAL G8991CI $ 0.00
3659113 OT OTHER PRIMARY GOAL G8991CJ $ 0.00
3659114 OT OTHER PRIMARY GOAL G8991CK $ 0.00
3659115 OT OTHER PRIMARY GOAL G8991CL $ 0.00
3659116 OT OTHER PRIMARY GOAL G8991CM $ 0.00
3659117 OT OTHER PRIMARY GOAL G8991CN $ 0.00
3659118 OT OTHER PRIMARY D/C G8992CH $ 0.00
3659119 OT OTHER PRIMARY D/C G8992CI $ 0.00
3659120 OT OTHER PRIMARY D/C G8992CJ $ 0.00
3659121 OT OTHER PRIMARY D/C G8992CK $ 0.00
3659122 OT OTHER PRIMARY D/C G8992CL $ 0.00
3659123 OT OTHER PRIMARY D/C G8992CM $ 0.00
3659124 OT OTHER PRIMARY D/C G8992CN $ 0.00
3659125 OT OTHER SUBSEQUE CURRENT G8993CH $ 0.00
3659126 OT OTHER SUBSEQUE CURRENT G8993CI $ 0.00
3659127 OT OTHER SUBSEQUE CURRENT G8993CJ $ 0.00
3659128 OT OTHER SUBSEQUE CURRENT G8993CK $ 0.00
3659129 OT OTHER SUBSEQUE CURRENT G8993CL $ 0.00
3659130 OT OTHER SUBSEQUE CURRENT G8993CM $ 0.00
3659131 OT OTHER SUBSEQUE CURRENT G8993CN $ 0.00
3659132 OT OTHER SUBSEQUE GOAL G8994CH $ 0.00
3659133 OT OTHER SUBSEQUE GOAL G8994CI $ 0.00
3659134 OT OTHER SUBSEQUE GOAL G8994CJ $ 0.00
3659135 OT OTHER SUBSEQUE GOAL G8994CK $ 0.00
3659136 OT OTHER SUBSEQUE GOAL G8994CL $ 0.00
3659137 OT OTHER SUBSEQUE GOAL G8994CM $ 0.00
3659138 OT OTHER SUBSEQUE D/C G8995CH $ 0.00
3659139 OT OTHER SUBSEQUE D/C G8995CI $ 0.00
3659140 OT OTHER SUBSEQUE D/C G8995CJ $ 0.00
3659141 OT OTHER SUBSEQUE D/C G8995CK $ 0.00
3659142 OT OTHER SUBSEQUE D/C G8995CL $ 0.00
3659143 OT OTHER SUBSEQUE D/C STATUS G8995CM $ 0.00
3659144 OT OTHER SUBSEQUE D/C G8995CN $ 0.00
3659163 OT OTHER SUBSEQUE GOAL G8994CN $ 0.00
3316686 RECOVERY ROOM FIRST 30 MN $ 1,005.00
3316687 RECOVERY ROOM ADD 15MN $ 289.00
3511000 DOCETAXEL 1MG INJ $ 25.82
3514500 VANCOMYCIN VL 500MG $ 12.00
3515000 APAP/ASA/CAFF TAB $ 8.00
3515001 APAP/BUTAL/CAFF CAP $ 8.00
3515005 ACETAMINPHN SUSP 160/5 $ 8.00
3515006 ACETAMINPHN SUPP 120MG $ 8.00
3515007 ACETAMINPHN SUPP 325MG $ 8.00
3515008 ACETAMINPHN SUPP 650MG $ 8.00
3515009 ACETAMINPHN TAB 325MG $ 8.00
3515010 ACETAMINPHN TAB 500MG $ 8.00
3515011 APAP/CODN ELIX 120-12/5ML $ 8.00
3515012 APAP/CODEINE TB 300-30MG $ 8.00
3515014 ACETAZOLAMIDE TAB 250MG $ 10.00
3515015 ACETYLCHOLN KIT OPH 1:100 $ 0.00
3515016 ACETLCYSTN 200MG/ML 30ML J7608 x 6 GM $ 41.00
3515017 ACIDOPHILUS CAP 460MG $ 8.00
3515018 ACT. CHARCOAL TAB 250MG $ 8.00
3515020 ACT.CHARC/SORB LQD 25GM $ 32.00
3515021 ACT.CHARC/SORB LQD 50GM $ 39.00
3515022 ACYCLOVIR CAP 200MG $ 9.00
3515023 ACYCLOVIR OINT 5% 15GM $ 500.00
3515024 ACYCLOVIR TAB 800MG $ 11.00
3515027 ADENOSIN SRN 6 MG/2 ML $ 33.00
3515028 ALBUTERL NB 5MG/ML 20ML $ 31.50
3515029 ALBUTEROL INHALER $ 110.00
3515030 ALBUTEROL NEB 2.5MG/3ML $ 8.00
3515031 ALBUTEROL 2MG/5ML 30ML $ 11.00
3515032 IPRATROP/ALBU INHALER $ 439.00
3515033 IPRA/ALBU NEB 2.5-0.5/3ML $ 10.00
3515034 ALENDRONATE TAB 35MG $ 36.00
3515035 ALENDRONATE TAB 70MG $ 36.00
3515036 ALLOPURINOL TAB 100MG $ 8.00
3515038 ALPRAZOLAM TAB 0.25MG $ 8.00
3515040 ALPRAZOLAM XR TAB 3MG $ 14.00
3515041 ALTEPLASE VL 1MG X100 $ 12,255.00
3515042 ALTEPLASE VL 2 MG $ 252.00
3515043 AMANTADINE CAP 100MG $ 10.00
3515044 AMANTADIN SYR 100MG/10ML $ 9.00
3515045 AMILORIDE TAB 5MG $ 8.25
3515046 AA/DEXT5/LYTE TPN 2000ML $ 194.75
3515047 AMINOCAPRC ACID 5GM/20ML $ 44.00
3515048 AMINOPHYLLINE 250MG/10ML $ 59.00
3515049 AMIODARONE VL 30MG X5 $ 48.00
3515050 AMIODARONE TAB 100MG $ 32.00
3515051 AMIODARONE TAB 200MG $ 8.00
3515052 AMITRIPTYLINE TAB 10MG $ 8.00
3515053 AMITRIPTYLINE TAB 25MG $ 8.00
3515054 AMITRIPTYLINE TAB 50MG $ 9.00
3515055 AMLODIPINE TAB 10MG $ 10.00
3515056 AMLODIPINE TAB 2.5MG $ 9.00
3515057 AMLODIPINE TAB 5MG $ 9.00
3515058 AMLODIP/BENAZ CAP 5-10MG $ 10.00
3515059 AMMONIA INH AMP INH $ 14.00
3515060 AMMONIUM LACT LOT 12% $ 34.00
3515061 AMOXICILLIN CHEW 250MG $ 8.00
3515062 AMOXICILLIN CAP 250MG $ 8.00
3515063 AMOXICILLIN CAP 500MG $ 8.00
3515064 AMOXICILLIN 500 MG 6 CAPS $ 16.50
3515065 AMOXICIL SUSP 125/5 100ML $ 11.00
3515066 AMOXICIL SUSP 250/5 150ML $ 15.00
3515067 AMOXICILLIN TAB 875MG $ 8.00
3515068 AMOX/KCLAV 400-57/5 100ML $ 114.00
3515069 AMOX/KCLAV 600-42/5 75ML $ 64.00
3515070 AMOX/KCLAV TAB 875-125MG $ 12.00
3515071 AMOX/KCLAV XR TAB 1000-62 $ 15.00
3515072 AMPHOTERICIN B VL 50MG $ 67.25
3515073 AMPICILLIN VL 500MG X2 (J0290) $ 51.00
3515074 AMPICIL/SULBACT 1.5GM (J0295) $ 50.00
3515075 AMPICIL/SULBACT 1.5GM X2 (J0295) $ 63.00
3515076 AMYLAS/LYPS/PROT 10000U $ 10.00
3515077 ANASTRAZOLE TAB 1MG $ 23.00
3515078 ANTIHEMOPHL FCT 1U X1200 $ 1,220.50
3515079 ANTIPY/BENZ/GLYC EAR DROP $ 22.00
3515080 APRACLON OPH DROP 0.5% $ 0.00
3515081 ASPIRIN TAB EC [81MG] $ 8.00
3515082 ARFORMOT NEB 15MCG/2ML $ 14.75
3515083 ARIPIPRAZOLE TAB 2MG $ 58.00
3515084 ARIPIPRAZOLE TAB 5MG $ 58.00
3515085 ARTIFICIAL TEARS OPH 1.4% $ 12.00
3515086 ARTIFICIAL TEARS OPH OINT $ 15.00
3515087 ASPIRIN CHEW TAB 81MG $ 8.00
3515088 ASPIRIN SUPP 300MG $ 9.00
3515089 ASPIRIN SUPP 600MG $ 9.00
3515090 ASPIRIN TAB 325MG $ 8.00
3515091 ASPIRIN TAB EC 325MG $ 0.00
3515092 ASA/CA/MG/AL TAB 325MG $ 7.00
3515093 ATENOLOL TAB 100MG $ 9.00
3515094 ATENOLOL TAB 25MG $ 8.00
3515095 ATENOLOL TAB 50MG $ 9.00
3515096 ATORVASTATIN TAB 10MG $ 8.00
3515097 ATORVASTATIN TAB 20MG $ 8.00
3515098 ATORVASTATIN TAB 40MG $ 8.00
3515099 ATORVASTATIN TAB 80MG $ 14.00
3515100 ATROPIN SRN 0.01MG X100 $ 32.00
3515101 ATROPINE OPH DROP 1% $ 84.00
3515102 ATROPIN SRN 0.01MG X50 $ 35.00
3515103 ATROPIN VL 0.01MG X100 $ 39.00
3515104 AZACITIDINE VL 1MG X100 $ 703.00
3515105 AZATHIOPRINE TAB 50MG $ 10.00
3515106 AZELASTINE NASAL SPRAY $ 142.75
3515107 AZITHROMYCIN SUSP 100/5 $ 60.00
3515108 AZITHROMYCIN SUSP 200/5 $ 60.00
3515109 AZITHROMYCIN SUSP 2GM $ 236.00
3515110 AZITHROMYCIN VL 500MG $ 53.00
3515111 AZITHROMYCIN TAB 250MG $ 16.00
3515113 AZITHROMYCIN TAB 500MG $ 34.00
3515114 BACITRACIN EYE OINT 3.5GM $ 138.00
3515115 BACITRACIN OINT 30 GM $ 14.00
3515116 BACITRACIN PKT 0.9 GM $ 12.00
3515117 BACLOFEN TAB 10MG $ 8.00
3515118 BACLOFEN TAB 20MG $ 9.00
3515119 BELLADON/PB ELIXIR 30 ML $ 21.25
3515120 BELLADON/PB TAB 16.2MG $ 7.00
3515121 BENAZEPRIL TAB 10MG $ 8.00
3515122 BENAZEPRIL TAB 5MG $ 9.00
3515123 BENZOCAINE GEL 20% $ 23.00
3515124 BENZOCN ORAL 20% /SPRAY $ 30.75
3515125 BENZOCN/RESORC CREAM $ 11.00
3515126 BENZCN/TETRCN/BUT /SPRAY $ 7.00
3515127 BENZOIN COMPD TINCTURE $ 8.00
3515128 BENZONATATE CAP 100MG $ 8.00
3515129 BENZONATATE CAP 200MG $ 8.00
3515130 BENZTROPINE TAB 0.5MG $ 9.00
3515131 BETAMETH VL 6MG/ML $ 18.00
3515132 BETAXOLOL OPH DROP 0.25% $ 460.00
3515133 BICALUTAMIDE TAB 50MG $ 34.00
3515134 ZZBIMATOPROST OPH DRP 0.0 $ 228.25
3515135 BISACODYL SUPP 10MG $ 8.00
3515136 BISACODYL TAB 5MG $ 8.00
3515137 BISMUTH CHEW TAB 262MG $ 8.00
3515138 BISMUTH SUSP 524MG/30ML $ 8.00
3515139 BLEOMYCIN VL 15U $ 114.00
3515140 BRIMONIDINE OPH DRP 0.10% $ 236.00
3515141 BRIMONIDINE OPH DRP 0.15% $ 222.00
3515142 BRIMONIDINE OPH DRP 0.20% $ 58.00
3515143 BRINZOLAMIDE OPH DROP 1% $ 415.00
3515144 BUDESONIDE INHALER $ 335.00
3515145 BUDESONIDE NEB 0.25MG/2ML $ 18.00
3515146 BUDESONIDE NEB 0.5MG/2ML $ 21.00
3515147 BUDESONIDE NEB 1MG/2ML $ 40.00
3515148 BUDES/FORMOT INHAL 80-4.5 $ 294.00
3515149 BUMETANIDE SDV 0.5MG/2ML $ 27.00
3515150 BUMETANIDE TAB 0.5MG $ 8.00
3515151 BUMETANIDE TAB 1MG $ 9.00
3515152 BUMETANIDE TAB 2MG $ 8.00
3515154 BUPIVACN DOSE 0.5% 1ML $ 0.00
3515155 BUPIVACN SDV 0.25% 30ML $ 12.00
3515156 BUPIVACN SDV 0.25% 10ML $ 15.00
3515157 BUPIVCN/EPI DOSE 0.5% 1ML $ 14.00
3515158 BUPRENORPH SRN 0.1MG X3 $ 40.00
3515159 BUPREN/NALOX TAB 2-0.5MG $ 12.75
3515160 BUPROPION SR TAB 100MG $ 9.00
3515161 BUPROPION SR TAB 150MG $ 9.00
$ 9.00
3515162 BUPROPION TAB 75MG $ 9.00
3515163 BUPROPION XL TAB 150MG $ 12.00
3515164 BUSPIRONE TAB 10MG $ 9.00
3515165 BUSPIRONE TAB 15MG $ 10.00
3515166 BUSPIRONE TAB 5MG $ 8.00
3515167 BUTORPHANOL NASAL SPRAY $ 152.00
3515168 CADEXOMER IODN GEL 0.9% $ 82.50
3515169 CAFF/SOD BENZ VL 250MG/ML $ 33.00
3515170 CALAMINE TOP SUSP 118ML $ 8.00
3515171 CALAMINE/ZINC OXIDE OINT $ 19.50
3515172 CALC ACET GELCAP 667MG $ 9.00
3515173 CALC CHEW 750MG =300MG $ 7.00
3515174 CALC CHEW 500MG =200MG $ 8.00
3515175 CALC SUSP 1250/5ML=500MG $ 8.00
3515176 CALC/MAG CHEW 550-110MG $ 8.00
3515177 CALC/VITS D+K CHEW 500MG $ 7.00
3515178 CALC CL SRN 1 GM/10ML $ 36.00
3515179 CALC CIT/VIT D TB 315-250 $ 8.00
3515180 CALC GLUC VL 1GM/10ML $ 34.00
3515181 CALC POLYCARB TAB 625MG $ 8.00
3515182 CALC/VIT D TAB 500MG-200U $ 8.00
3515183 CALCITONIN VL 200U/ML 2ML $ 37.75
3515184 CALCITONIN NASAL SPRAY $ 117.50
3515185 CALCITRIOL CAP 0.25MCG $ 9.00
3515186 CANDESARTAN TAB 32MG $ 10.25
3515187 CANDESARTAN TAB 4MG $ 9.50
3515188 CANDESARTAN TAB 8MG $ 9.50
3515189 CAPSAICIN CREAM 0.025% $ 24.50
3515190 CAPTOPRIL TAB 12.5MG $ 9.00
3515191 CARBAMAZEPINE TAB 200MG $ 9.00
3515192 CARBAM PEROX EAR DROP $ 10.00
3515193 CARB/LEVO CR TAB 50-200MG $ 9.00
3515194 CARB/LEVO ER TAB 25-100MG $ 8.00
3515195 CARB/LEVO TAB 10-100MG $ 10.00
3515196 CARB/LEVO TAB 25-100MG $ 8.00
3515197 CARB/LEVO TAB 25-250MG $ 8.00
3515198 CARBOPLATN VL 50MG X3 $ 71.00
3515199 CARBOPROST AMP 250MCG/ML $ 530.00
3515201 CARISOPRODOL TAB 350MG $ 8.00
3515202 CARTEOLOL DROP 1% OPH $ 36.00
3515203 CARVEDILOL TAB 12.5MG $ 10.00
3515204 CARVEDILOL TAB 25MG $ 10.00
3515205 CARVEDILOL TAB 3.125MG $ 10.00
3515206 CARVEDILOL TAB 6.25MG $ 10.00
3515208 CEFAZOLIN VL 500 MG X2 (J0690) $ 27.00
3515209 CEFAZOLIN PGBK 500 MG X2 (J0690) $ 51.00
3515210 CEFDINIR CAP 300MG $ 14.00
3515211 CEFIXIME SUSP 100/5 50ML $ 348.00
3515212 CEFOTAXIME VL 1GM $ 45.75
3515213 CEFOXITIN VL 1GM $ 53.00
3515214 CEFOXITIN PGBK 1GM $ 59.00
3515215 CEFOXITIN PGBK 1GM X2 $ 70.00
3515216 CEFTAZIDIME VL 500 MG X2 $ 51.00
3515217 CEFTRIAXON VL 250MG X4 (J0696) $ 27.00
3515218 CEFTRIAXON VL 250MG (J0696) $ 40.00
3515219 CEFTRIAXON VL 250MG X8 (J0696) $ 29.00
3515220 CEFTRIAXON VL 250MG X2 (J0696) $ 27.00
3515221 CEFTRIAXON PGBK 250MG X4 (J0696) $ 59.00
3515222 CEFTRIAXON PGBK 250MG X8 (J0696) $ 68.00
3515223 CEFUROXIME SP 250/5 100ML $ 372.00
3515224 CEFUROXIME TAB 250MG $ 12.00
3515225 CEFUROXIME TAB 500MG $ 16.00
3515226 CELECOXIB CAP 100MG $ 12.00
3515227 CELECOXIB CAP 200MG $ 23.00
3515228 CEPHALEXIN CAP 250MG $ 8.00
3515229 CEPHALEXIN CAP 500MG $ 9.00
3515230 CEPHALEXIN 500 MG 6 CAPS $ 21.75
3515231 CEPHALEXIN SP 250/5 100ML $ 8.00
3515232 CETIRIZINE TAB 10MG $ 10.00
3515233 CETIRIZINE TAB 5MG $ 10.00
3515234 CHLORL HYDR SRP 100MG/1ML $ 7.00
3515235 CHLORHEXIDINE GLUC LIQD $ 20.75
3515236 CHLORPROMAZ AMP 25MG/ML $ 56.00
3515237 CHLORPROMAZINE TAB 25MG $ 8.50
3515238 CHLORTHALIDONE TAB 25MG $ 10.00
3515239 CHOLESTYRAMINE PWD 4GM $ 82.75
3515240 CHOLESTYRAMINE PKT 4GM $ 11.00
3515241 CHOLIN/MG SALIC TAB 750MG $ 7.50
3515242 CILOSTAZOL TAB 50MG $ 9.00
3515243 CILOSTAZOL TABS 100MG $ 9.00
3515244 CIPROFLX PGBK 200MG X2 $ 51.00
3515245 CIPROFLOXACIN OPH DP 0.3% $ 39.75
3515246 CIPROFLOXACIN TAB 250MG $ 14.00
3515247 CIPROFLOXACIN TAB 500MG $ 14.00
3515248 CITALOPRAM TAB 10MG $ 10.00
3515249 CITALOPRAM TAB 20MG $ 10.00
3515250 CITALOPRAM TAB 40MG $ 11.00
3515251 CLARITHROMYCIN TAB 500MG $ 12.00
3515252 CLINDAMYCIN CAP 150MG $ 8.00
3515253 CLINDAMYCIN IV 300MG/2ML $ 31.00
3515254 CLINDAMYCIN TOP SOLN 1% $ 134.00
3515255 CLOBETASOL OINT 0.05% $ 335.00
3515256 CLONAZEPAM TAB 0.5MG $ 8.00
3515257 CLONAZEPAM TAB 1MG $ 8.00
3515258 CLONIDIN PATCH 0.1MG/24HR $ 114.00
3515259 CLONIDINE TAB 0.1MG $ 8.00
3515260 CLONIDINE TAB 0.2MG $ 8.00
3515261 CLOPIDOGREL TAB 75MG $ 12.00
3515262 CLOTRIMAZOLE CRM 1% $ 17.00
3515263 CLOTRIM/BETAMETH CRM $ 56.00
3515264 COCAINE SOLN 4% 4ML $ 112.75
3515265 COLCHICINE TAB 0.6MG $ 17.00
3515266 CONIVAPTAN AMP 20MG/100ML $ 730.00
3515267 COSYNTROPIN VL 0.25MG $ 203.00
3515268 CRANBERRY CAP 140MG $ 8.00
3515269 CROMOLYN DROP 4% OPH $ 63.00
3515270 CYCLOBENZAPRINE TAB 10MG $ 9.00
3515271 CYCLOBENZAPRIN 10MG 6 TAB $ 21.75
3515272 CYCLOBENZAPRINE TAB 5MG $ 9.00
3515273 CYCLOPENTOLATE OPH DRP 1% $ 0.00
3515275 CYPROHEPTADINE TAB 4MG $ 8.00
3515276 DANTROLENE VL 20MG $ 134.00
3515277 DARBEPOETN NON 1MCG X100 $ 1,130.00
3515278 DARBEPOETN NON 1MCG X200 $ 2,260.00
3515279 DARBEPOETN NON 1MCG X300 $ 3,590.00
3515280 DARBEPOETN NON 1MCG X40 $ 475.00
3515281 DARBEPOETN NON 1MCG X500 $ 5,750.00
3515282 DARBEPOETN NON 1MCG X60 $ 660.00
3515283 DARIFENACIN TAB 15MG $ 14.50
3515284 DARIFENACIN TAB 7.5MG $ 24.00
3515285 DEFEROXAMINE VL 500MG $ 37.00
3515286 DEMECLOCYCLINE TAB 300MG $ 24.00
3515287 DESFLURANE LIQD INH $ 196.00
3515288 DEXAMETHASON OPH DRP 0.1% $ 110.00
3515289 DEXAMETHASON VL 1MG X10 (J1100) $ 27.00
3515290 DEXAMETHASON VL 1MG X4 (J1100) $ 28.00
3515291 DEXAMETHSN TAB 0.25MG X4 (J8540) $ 8.00
3515292 DEXAMETHSN TAB 0.25MG X16 (J8540) $ 8.00
3515293 DEXTROMETHR SRP 7.5MG/5ML $ 19.75
3515294 D5W 250ML $ 18.00
3515295 DEXTROSE 50% SYN 50ML $ 35.00
3515296 DEXTROSE CHEW TAB $ 7.00
3515297 DIAZEPAM RCTL GEL 10MG $ 505.00
3515298 DIAZEPAM RCTL GEL 2.5MG $ 357.00
3515299 DIAZEPAM SRN 5MG X2 (J3360) $ 58.00
3515300 DIAZEPAM TAB 2MG $ 8.00
3515301 DIAZEPAM TAB 5MG $ 8.00
3515302 DICLOFENAC OPH DROP 0.1% $ 119.00
3515303 DICLOFENAC GEL 1% 100GM $ 107.00
3515304 DICLOFENAC TAB 75MG $ 9.00
3515305 DICLOXACILLIN CAP 250MG $ 7.25
3515306 DICYCLOMINE CAP 10MG $ 8.00
3515307 DICYCLOMINE TAB 20MG $ 8.00
3515308 DIGOXIN AMP 0.5MG INJ (J1160) $ 33.00
3515309 DIGOX IMN FAB VL 40MG/4ML $ 2,412.75
3515310 DIGOXIN SOLN 0.05MG/ML $ 107.00
3515311 DIGOXIN TAB 0.125MG $ 10.00
3515312 DIGOXIN TAB 0.25MG $ 9.00
3515313 DIHYDROERGOT AMP 1MG/ML $ 260.00
3515314 DILTIAZEM CAP CD 120MG $ 9.00
3515315 DILTIAZEM CAP CD 180MG $ 8.00
3515316 DILTIAZEM CAP CD 240MG $ 8.00
3515317 DILTIAZEM CAP CD 300MG $ 10.00
3515318 DILTIAZEM VL 125MG/25ML $ 57.00
3515319 DILTIAZEM VL 25MG/5ML $ 28.00
3515320 DILTIAZEM TAB 30MG $ 8.00
3515321 DILTIAZEM TAB 60MG $ 8.00
3515322 DILTIAZEM TAB 90MG $ 8.00
3515323 DIMENHYDRINATE CHEW 50MG $ 8.00
3515324 DINOPROSTONE SUPP 10MG $ 470.00
3515325 DIPHENHYDRAMINE CAP 25MG $ 8.00
3515326 DIPHENHYDRAMINE CAP 50MG $ 8.00
3515327 DIPHENHYDRAMINE CRM 2% $ 12.00
3515328 DIPHENHYDRAMN LIQD 12.5/5 $ 8.00
3515329 DIPHENHYDRAMIN VL 50MG INJ (J1200) $ 29.00
3515330 DIPHENOXYLAT/ATROPIN TAB $ 8.00
3515331 DIP/TET/AP INFANRIX $ 54.00
3515332 DIP/TET/AP TRIPEDIA $ 53.00
3515333 DIP/TET/AP ADACEL $ 96.00
3515334 DIP/TET/AP BOOSTRIX VL $ 70.00
3515335 DIP/TET/AP BOOSTRIX SYR $ 72.00
3515336 DIP/TET/AP/POLIO KINRIX $ 106.00
3515337 DIPYRIDM/ASA CAP 200-25MG $ 18.00
3515338 DIVALPROEX ER TAB 500MG $ 12.00
3515339 DIVALPROEX SPRK CAP 125MG $ 9.00
3515340 DIVALPROEX DR TAB 250MG $ 9.00
3515341 DM/PSEU/BRM SRP 10-30-2/5 $ 38.00
3515342 DOBUTAMINE VL 250MG/20ML $ 51.00
3515344 DOCUSATE SOD CAP 100MG $ 8.00
3515345 DOCUSATE SOD 100MG/10ML $ 8.00
3515346 DOLASETRON VL 10MG X10 $ 121.00
3515347 DONEPEZIL TAB 10MG $ 15.00
3515348 DONEPEZIL TAB 5MG $ 16.00
3515349 DOPAMINE VL 40MG/ML X5 $ 48.00
3515350 DOPAMINE DRIP 40MG X10 $ 61.00
3515351 DORZOL/TIMOLOL OPH DROP $ 113.00
3515352 DOXAZOSIN TAB 1MG $ 9.00
3515353 DOXAZOSIN TAB 2MG $ 9.00
3515354 DOXAZOSIN TAB 4MG $ 9.00
3515355 DOXEPIN CAP 25MG $ 8.00
3515356 DOXEPIN CREAM 5% $ 302.00
3515357 DOXYCYCLINE VL 100MG $ 74.00
3515358 DOXYCYCLINE TAB 100MG $ 10.00
3515359 DOXYLAMINE TAB 25MG $ 8.00
3515360 DRONABINOL GELCAP 2.5MG $ 14.00
3515361 DROPERIDOL AMP 5MG/2ML $ 28.00
3515362 DULOXETINE CAP 30MG $ 14.00
3515363 DULOXETINE CAP 60MG $ 14.00
3515364 DUTASTERIDE GELCAP 0.5MG $ 15.00
3515365 ECONAZOLE CREAM 1% $ 535.00
3515366 ELECTROLYTE/PEGS PWD SOLN $ 32.00
3515367 DRY MOUTH SPRAY 59ML $ 14.00
3515368 ELETRIPTAN TAB 40MG $ 71.00
3515369 DRY SKIN CREAM 16 OZ. $ 16.00
3515370 PETROLTM/AQUAPHOR 3 OZ. $ 15.00
3515371 DIAPER OINT ZINC OX 40% $ 12.00
3515372 VITAMIN A & D OINT 454 GM $ 39.00
3515373 ENALAPRIL TAB 10MG $ 9.00
3515374 ENALAPRIL TAB 20 MG $ 10.00
3515376 ENOXAPARIN SRN 10MG X10 (J1650) $ 150.00
3515377 ENOXAPARIN SRN 10MG X3 (J1650) $ 29.00
3515378 ENOXAPARIN SRN 10MG X4 (J1650) $ 30.00
3515379 ENOXAPARIN SRN 10MG X6 (J1650) $ 104.00
3515380 ENOXAPARIN SRN 10MG X8 (J1650) $ 35.00
3515381 ENTACAPONE TAB 200MG $ 15.00
3515382 EPHEDRINE VL 50MG/ML $ 78.00
3515383 EPINEPHRINE INJ 0.1MG X10 (J0171) $ 31.00
3515384 EPINEPHRN DOSE 0.1 MGX10 $ 9.00
3515385 EPINEPHRIN PEN 0.1MG X1.5 $ 655.00
3515386 EPINEPHRIN 10ML 0.1MG X10 (J0171) $ 33.00
3515387 EPINEPHRIN PEN 0.1MG X6 $ 475.00
3515388 EPOETIN NON 1000U X20 $ 416.00
3515389 EPOETIN NON 1000U X10 $ 205.50
3515390 EPOETIN NON 1000U X2 $ 57.50
3515391 EPOETIN NON 1000U X40 $ 948.50
3515392 ERTAPENEM VL 500MG X2 $ 216.00
3515393 ERYTHROMYC OINT 3.5 GM $ 34.00
3515394 ERYTHROMYC OINT 1 GM $ 22.00
3515395 ERYTHROMYCIN TAB 333MG $ 17.00
3515396 ESCITALOPRAM TAB 10MG $ 12.00
3515397 ESCITALOPRAM TAB 20MG $ 12.00
3515398 ESCITALOPRAM TAB 5MG $ 17.00
3515399 ESMOLOL VL 100MG/10ML $ 63.00
3515400 ESOMEPRAZOLE CAP 40MG $ 17.00
3515401 ESTROGEN CONJ CREAM $ 249.00
3515402 ESTROGEN CONJ TAB 0.3MG $ 12.00
3515403 ESTROGEN CONJ TAB 0.625MG $ 12.00
3515404 ESZOPICLONE TAB 2MG $ 14.50
3515405 ESZOPICLONE TAB 3MG $ 14.50
3515406 ETHACRYNIC ACID TAB 25MG $ 7.00
3515407 ETHYL CL ANESTH /SPRAY $ 57.00
3515408 ETOMIDATE AMP 40MG/20ML $ 38.00
3515409 EXEMESTANE TAB 25MG $ 23.25
3515410 EXENATIDE SYRN 10MCG $ 615.00
3515411 ZZEYE ANTIOXDANT TAB $ 7.00
3515412 EZETIMIBE TAB 10MG $ 22.00
3515413 EZETIM/SIMVAS TAB 10-10MG $ 11.25
3515414 EZETIM/SIMVAS TAB 10-20MG $ 12.00
3515415 EZETIM/SIMVAS TAB 10-40MG $ 12.00
3515416 FAMOTIDINE VL 20MG/2ML $ 9.00
3515417 FAMOTIDINE TAB 20MG $ 9.00
3515418 FAMOTIDINE CHEW 10MG $ 7.25
3515419 FELODIPINE TAB 2.5MG $ 8.50
3515420 FELODIPINE ER TAB 5MG $ 9.00
3515422 FENOFIBRATE TAB 145MG $ 14.00
3515423 FENTANYL AMP 100MCG/2ML $ 9.00
3515424 FENTANYL SDV 100MCG X2.5 $ 9.00
3515426 FENTANYL PAT 100MCG/HR $ 134.00
3515427 FENTANYL PAT 12MCG/HR $ 36.00
3515428 FENTANYL PAT 25MCG/HR $ 37.00
3515429 FENTANYL PAT 50MCG/HR $ 52.00
3515430 FENTANYL PAT 75MCG/HR $ 66.00
3515431 FERRIC GLUC 12.5MG/ML X5 $ 64.00
3515432 FERRIC SUBSULF SOLN $ 24.00
3515433 FERROUS FUM TAB 324MG $ 8.00
3515434 FERROUS GLUC TAB 324MG $ 8.00
3515435 FERRO S04 ELX 325MG/7.4ML $ 8.00
3515436 FERROUS SO4 TAB 325MG $ 8.00
3515437 FILGRASTIM VL 1 MCG X480 $ 505.75
3515438 FINASTERIDE TAB 5MG $ 11.00
3515439 FISH OIL GELCAP 1000MG $ 8.00
3515440 FLECAINIDE TAB 50MG $ 10.00
3515441 FLUCONAZOLE TAB 50MG $ 14.00
3515442 FLUCONAZL PB 200MG/100ML $ 20.00
3515443 FLUDROCORTISONE TAB 0.1MG $ 8.00
3515444 FLUMAZENIL VL 0.5MG/5ML $ 34.00
3515445 FLUOCINONIDE CREAM 0.05% $ 71.00
3515446 FLUORESCEIN STRIP 1MG $ 8.00
3515447 FLUORESCEIN/BENOX OPH DRP $ 21.00
3515448 FLUOXETINE CAP 10MG $ 10.00
3515449 FLUOXETINE CAP 20MG $ 10.00
3515450 FLUTIC/SALM DIS 500-50MCG $ 372.00
3515451 FLUTIC/SALM INH 115-21MCG $ 475.00
3515452 FLUTIC/SALM DIS 100-50MCG $ 258.00
3515453 FLUTIC/SALM DIS 250-50MCG $ 258.00
3515454 FLUTICASON INHALER 110MCG $ 367.00
3515455 FLUTICASON INHALER 220MCG $ 555.00
3515456 FLUTICASON NASL SPR 50MCG $ 111.00
3515457 FLUVASTATIN CAP 20MG $ 14.00
3515458 FLUVOXAMINE TAB 50MG $ 9.50
3515459 FOLIC ACID DOSE 1MG/0.2ML $ 100.00
3515460 FOLIC ACID TAB 400MCG $ 8.00
3515461 FOLIC ACID TAB 1MG $ 8.00
3515462 FORMOTEROL NEB 20MCG/2ML $ 14.50
3515463 FOSINOPRIL TAB 10MG $ 9.00
3515464 FOSINOPRIL TAB 20MG $ 9.00
3515465 FULVESTRNT SRN 25 MG X10 $ 1,028.00
3515466 FUROSEMIDE VL 20MG X5 (J1940) $ 31.00
3515467 FUROSEMIDE VL 20MG X1 (J1940) $ 30.00
3515468 FUROSEMIDE VL 20MG X2 (J1940) $ 29.00
3515469 FUROSEMIDE ORAL 10MG/ML $ 36.00
3515470 FUROSEMIDE TAB 20MG $ 8.00
3515471 FUROSEMIDE TAB 40MG $ 8.00
3515472 FUROSEMIDE TAB 80MG $ 8.00
3515473 GABAPENTIN CAP 100MG $ 8.00
3515474 GABAPENTIN CAP 300MG $ 8.00
3515475 GABAPENTIN CAP 400MG $ 9.00
3515476 GABAPENTIN TAB 600MG $ 10.00
3515477 GALANTAMINE TAB 4MG $ 12.00
3515479 GEMFIBROZIL TAB 600MG $ 10.00
3515480 GENTAMICIN OPH DROP 0.3% $ 68.00
3515481 SUFENTANIL AMP 50MCG/ML $ 14.00
3515482 GENTAMICIN OPH OINT 0.3% $ 35.00
3515483 GENTAMICIN IV 80MG/2ML $ 45.50
3515484 GLIMEPIRIDE TAB 2MG $ 8.00
3515485 GLIMEPIRIDE TAB 4MG $ 9.00
3515486 GLIPIZIDE ER TAB 10MG $ 8.00
3515487 GLIPIZIDE ER TAB 2.5MG $ 8.00
3515488 GLIPIZIDE ER TAB 5MG $ 8.00
3515489 GLIPIZIDE TAB 10MG $ 8.00
3515490 GLIPIZIDE TAB 5MG $ 8.00
3515491 GLUCAGON VL 1MG $ 310.00
3515492 GLUCOSAMINE TAB 500MG $ 8.00
3515493 GLUCOS/CHONDR TAB 500-400 $ 8.00
3515494 GLUCOSE GEL (15GM SUGAR) $ 11.00
3515495 GLYBURIDE TAB 5MG $ 8.00
3515496 GLYCERIN SUPP ADULT $ 8.00
3515497 GLYCERIN SUPP PED $ 8.00
3515498 GLYCOPYRROL VL 0.4MG/2ML $ 53.00
3515499 GUAIF/CODN SRP 100-10/5 $ 9.00
3515500 GUAIF/DM SRP 100-10MG/5ML $ 8.00
3515501 GUAIF/DM/PHEN 100-10-5/5 $ 12.00
3515502 GUAIFENESIN ER TAB 600MG $ 8.00
3515503 GUAIFENESIN SRP 100MG/5ML $ 8.00
3515504 HAEMOPH B VACC PEDVAXHIB $ 53.00
3515505 HALOPERIDOL VL 5MG/ML $ 33.00
3515506 HALOPERIDOL TAB 0.5MG $ 8.00
3515507 HALOPERIDOL TAB 1MG $ 8.00
3515509 DTAP/HEPB/POLIO PEDIARIX $ 142.00
3515510 HEPARIN FLUSH 10 UNT X50 $ 11.00
3515511 HEPARIN SYN 1000 UNT X5 $ 29.00
3515512 HEPARIN SYN 1000 UNT X5 $ 10.00
3515513 HEPARIN DRIP 1000 UNT X25 $ 56.00
3515515 HEPAT A VL 1440U HAVRIX $ 132.00
3515516 HEPAT A VL 720U HAVRIX $ 60.00
3515517 HEPAT A SRN 1440U HAVRIX $ 131.00
3515518 HEPAT A SRN 720U HAVRIX $ 64.00
3515519 HEPB/HEPA TWINRIX $ 193.00
3515520 HEPAT B 10MCG PED ENGERIX $ 53.00
3515521 HEPAT B 20MCG ADT ENGERIX $ 119.00
3515522 HEPB/HAEMOPH COMVAX $ 97.00
3515523 HETASTARCH DRIP 500ML $ 61.00
3515524 HISTRELIN IMPLANT 50MG $ 4,700.50
3515525 HOMATROPINE OPH DROP 2% $ 65.00
3515526 HOMATROPINE OPH DROP 5% $ 72.00
3515527 HUMAN PAPILLOMAVIRUS VL $ 252.00
3515528 HYLAN GF SRN 1MG X16 $ 381.75
3515529 HYDRALAZINE VL 20MG/ML $ 104.00
3515530 HYDRALAZINE TAB 25MG $ 8.00
3515531 HYDRALAZINE TAB 10MG $ 8.00
3515532 HYDROCHLOROTHIZ CP 12.5MG $ 8.00
3515533 HYDROCHLOROTHIZ TB 25MG $ 8.00
3515534 HYDROCOD/AP ELX 2.5-167/5 $ 16.00
3515535 HYDROCOD/APAP TAB 5-325MG $ 8.00
3515536 HYDROCOD/APAP TAB 5-500MG $ 3.25
3515537 HYDROCOD/APAP 5-500 6 TAB $ 14.50
3515538 HYDROCORTISONE SUPP 25MG $ 38.00
3515539 HYDROCORTISONE CREAM 1% $ 11.00
3515540 HYDROCORTSN CRM RCTL 2.5% $ 143.00
3515541 HYDROCORTISONE GEL 10% $ 181.00
3515542 HYDROCORTISONE OINT 1% $ 12.00
3515543 HYDROCORTISONE OINT 2.5% $ 20.00
3515545 HYDROCORTISON 100MG X 3 $ 55.00
3515546 HYDROCORTISONE TAB 10MG $ 9.00
3515547 HYDROCORTISONE TAB 5MG $ 8.00
3515548 HYDROMORPHONE SRN 2MG/ML $ 10.00
3515549 HYDROMORPHONE TAB 2MG $ 8.00
3515550 HYDROXYCHLOROQN TB 200MG $ 12.00
3515551 HYDRXYPROPMETHC DRP 2.5% $ 25.75
3515552 HYDROXYZINE VL 25MG X2 $ 52.00
3515553 HYDROXYZINE TAB 25MG $ 8.00
3515554 HYDROXYZINE PAM CAP 25MG $ 8.00
3515555 HYDROXYZINE PAM CAP 50MG $ 8.00
3515556 HYOSCYAMINE TAB 0.125MG $ 8.00
3515557 HYPROMELOS DRP 0.3% OPH $ 17.00
3515558 HYPROMELOS GEL 0.3% OPH $ 12.00
3515559 IBANDRONATE VL 1MG X3 $ 400.00
3515560 IBANDRONATE TAB 150MG $ 150.75
3515561 IBUPROFEN CHEW TAB 100MG $ 8.00
3515562 IBUPROFEN SUSP 100MG/5ML $ 8.00
3515563 IBUPROFEN TAB 200MG $ 8.00
3515564 IBUPROFEN TAB 400MG $ 8.00
3515565 IBUPROFEN TAB 600MG $ 8.00
3515566 IBUPROFEN TAB 800MG $ 8.00
3515567 IMIPENEM/CILAST 250MG X2 $ 65.00
$ 65.00
$ 65.00
3515568 IMIQUIMOD CREAM PKT 5% $ 16.00
3515569 IMUN GLOB VL 500MG X24 $ 2,059.75
3515570 IMUN GLOB VL 500MG X12 $ 1,033.75
3515572 IMUN GLOB 10% 500MG X20G $ 1,690.00
3515573 IMUN GLOB 10% 500MG X40 $ 3,375.00
3515574 IMUN GLOB 10% 500MG X40P $ 3,405.50
3515575 IMUN GLOB 10% 500MG X10P $ 858.50
3515576 IMUN GLOB 10% 500MG X10 $ 845.00
3515577 INDAPAMIDE TAB 1.25MG $ 9.00
3515578 INDIGO CARMINE AMP $ 24.25
3515579 INDINAVIR CAP 400MG $ 10.00
3515580 INDOMETHACIN CAP 25MG $ 8.00
3515581 INFLIXIMAB VL 10MG X10 $ 1,805.00
3515582 INHALER-AEROCHAMBER PLUS $ 67.00
3515583 INSULIN DETEMIR DOSE 5 UNITS (J1815) $ 9.00
3515584 INSULIN GLARGINE DOSE 5 UNIT (J1815) $ 9.00
3515585 INSULIN GLARGN PEN 5U X60 (J1815) $ 64.50
3515586 INSULIN LISPRO DOSE 5 UNIT (J1815) $ 9.00
3515587 INSULIN LISPRO PEN 5U X60 (J1815) $ 179.00
3515588 INSULIN NPH DOSE 5 UNIT (J1815) $ 8.00
3515589 INSULIN N/REG 70/30 DOSE 5 UNIT (J1815) $ 8.00
3515590 INSULIN N/LISP 75/25 DOSE 5 UNIT (J1815) $ 9.00
3515591 INSULIN REGULAR DOSE 5 UNIT (J1815) $ 8.00
3515592 INTERFERON BETA-1A 30MCG $ 954.50
3515594 IPECAC SYRUP 30ML $ 19.25
3515595 IPRATROPM NEB 0.5MG/2.5ML $ 9.00
3515596 IPRATROPIUM INHALER $ 425.00
3515597 IRBESARTAN TAB 150MG $ 11.00
3515598 IRBESARTAN TAB 300MG $ 12.00
3515599 IRON DEXTRAN 50MG (J1750)X20 (1000MG) $ 405.00
3515600 IRON SUCROSE VL 1MG X100 $ 105.00
3515601 IRON/C/B12/SA TAB $ 8.00
3515602 IRON/C/SA CAP $ 7.25
3515603 IRON/FE FUM/C/B12/FA TB $ 8.00
3515604 ISOSORBID DINITR TAB 10MG $ 9.00
3515605 ISOSORBID DINITR TAB 20MG $ 9.00
3515606 ISOSORBID MONO TAB 120MG $ 8.00
3515607 ISOSORBID MONO TAB 20MG $ 8.00
3515608 ISOSORBID MONO TAB 30MG $ 9.00
3515609 ISOSORBID MONO TAB 60MG $ 10.00
3515610 KETAMINE VL 100MG/ML 5ML $ 18.00
3515611 KETAMINE VL 10MG/ML 20ML $ 37.00
3515612 KETAMINE VL 50MG/ML 10ML $ 16.00
3515613 KETOCONAZOLE CREAM 2% $ 284.00
3515614 KETOCONAZOLE SHAMP00 2% $ 53.00
3515615 KETOCONAZOLE TAB 200MG $ 15.00
3515616 KETOROLAC OPH DROP 0.4% $ 332.00
3515617 KETOROLAC VL 15MG X1 (J1885) $ 26.00
3515618 KETOROLAC VL 15MG X2 (J1885) $ 27.00
3515619 KETOROLAC VL 15MG X4 (J1885) $ 27.00
3515620 KETOTIFEN OPH DROP 0.025% $ 17.00
3515621 LABETALOL VL 5MG/ML 20ML $ 26.00
3515622 LABETALOL TAB 100MG $ 8.00
3515623 LACTASE TAB 3000 UNT $ 8.00
3515624 LR 1000ML $ 18.00
3515625 LACTULOSE SOLN 20GM/30ML $ 8.00
3515626 LAMIVUDINE TAB 150MG $ 16.00
3515627 LAMOTRIGINE TAB 100MG $ 10.00
3515628 LANOLIN BREAST CREAM $ 9.00
3515629 LANSOPRAZOLE TAB 15MG $ 32.00
3515630 LANSOPRAZOLE CAP 30MG $ 14.00
3515631 LATANOPROST OPH DRP 0.005 $ 150.00
3515632 LEUCOVORIN VL 50MG X2 $ 140.00
3515633 LEUPROLID DPT-3 7.5MG X3 $ 2,948.25
3515635 LEUPROLID DPT-4 7.5MG X4 $ 6,805.00
3515636 LEUPROLID ELI 7.5MG X6 $ 3,029.25
3515638 LEVALBUTRL NEB 1.25MG/3ML $ 15.00
3515639 LEVALBUTEROL INHALER $ 74.50
3515640 LEVETIRACETAM TAB 250MG $ 8.00
3515641 LEVETIRACETAM TAB 500MG $ 11.00
3515642 LEVOFLOXACIN TAB 250MG $ 24.00
3515643 LEVOFLOXACIN TAB 500MG $ 32.00
3515644 LEVOFLOXACN PB 250MG X3 $ 53.00
3515645 LEVOFLOXACN PB 250MG X2 $ 59.00
3515646 LEVOTHYROXINE TAB 112MCG $ 8.00
3515647 LEVOTHYROXINE TAB 125MCG $ 8.00
3515648 LEVOTHYROXINE TAB 137MCG $ 8.00
3515649 LEVOTHYROXINE TAB 150MCG $ 8.00
3515650 LEVOTHYROXINE TAB 175MCG $ 8.00
3515651 LEVOTHYROXINE TAB 200MCG $ 8.00
3515652 LEVOTHYROXINE TAB 25MCG $ 8.00
3515653 LEVOTHYROXINE TAB 300MCG $ 8.00
3515654 LEVOTHYROXINE TAB 50MCG $ 8.00
3515655 LEVOTHYROXINE TAB 75MCG $ 8.00
3515656 LEVOTHYROXINE TAB 88MCG $ 8.00
3515657 LEVOTHYROXINE TAB 100MCG $ 8.00
3515658 LIDOCAINE CREAM 4% 15GM $ 17.00
3515659 LIDOCAIN AMP 4% 5ML $ 0.00
3515660 LIDOCAIN SRN 10MG X10 $ 11.00
3515661 LIDOCAINE JELLY 2% 10ML $ 16.00
3515662 LIDOCAIN DOSE 1% 1ML $ 0.00
3515663 LIDOCAIN DOSE 2% 1ML $ 0.00
3515664 LIDOCAIN AMP 1% 5ML $ 9.00
3515665 LIDOCAIN SDV 0.5% 50ML $ 8.00
3515666 LIDOCAN TOP 4% 50ML $ 48.00
3515667 LIDOCAN VIS 2% 100ML $ 24.00
3515668 LIDOCAIN DRIP 10MG X200 $ 15.00
3515669 LIDOCAIN/DEX 5-7.5% AMP $ 20.00
3515670 LIDOCAINE PATCH 5% $ 18.00
3515671 LIDOCAN/EPI AMP 1.5% 5ML $ 23.50
3515672 LIDOCAN/EPI DOSE 0.5% 1ML $ 20.75
3515674 LIDOCAN/EPI DOSE 1% 1ML $ 10.00
3515675 LIDOCAN/EPI DOSE 2% 1ML $ 9.00
3515676 LIDOCN/PRILOCN CRM 30GM $ 59.50
3515677 LINDANE LOT 1% 60ML $ 151.50
3515678 LINEZOLID TAB 600MG $ 280.00
3515679 LISINOPRIL TAB 10MG $ 8.00
3515680 LISINOPRIL TAB 2.5MG $ 8.00
3515681 LISINOPRIL TAB 20MG $ 9.00
3515682 LISINOPRIL TAB 30MG $ 9.00
3515683 LISINOPRIL TAB 40MG $ 8.00
3515684 LISINOPRIL TAB 5MG $ 8.00
3515685 LOPERAMIDE CAP 2MG $ 8.00
3515687 LOPERAMIDE LIQD 1MG/5ML $ 14.00
3515688 LOPERAMIDE LIQD 1MG/7.5ML $ 19.75
3515689 LOPERAMIDE TAB 2MG-24 $ 20.00
3515690 LORATADINE TAB 10MG $ 8.00
3515691 LORAZEPM CONC 2MG/ML 30ML $ 74.00
3515692 LORAZEPAM SDV 2MG X1 (J2060) $ 27.00
3515693 LORAZEPAM TAB 0.5MG $ 8.00
3515694 LORAZEPAM TAB 1MG $ 8.00
3515695 LOSARTAN TAB 25MG $ 8.00
3515696 LOSARTAN TAB 100MG $ 8.00
3515697 LOTEPREDNOL OPH DROP 0.5% $ 302.00
3515698 LOVASTATIN TAB 10MG $ 8.00
3515699 LOVASTATIN TAB 20MG $ 10.00
3515700 LUBIPROSTONE CAP 24MCG $ 15.00
3515701 LUTEIN TAB 20MG $ 8.00
3515702 MAG CITRATE SOLN $ 9.00
3515703 MAG/AL HYDROX 30ML UD $ 9.00
3515705 MAG/AL HYDROX/SIMTH DOSE $ 8.00
3515706 MAG HYDROX 400/5 16OZ $ 16.25
3515707 MAG HYDROX 400/5 30ML UD $ 9.00
3515709 MAGNESIUM OXID TAB 400MG $ 8.00
3515710 MAGNESIUM PGBK 4GM/100ML $ 17.00
$ 17.00
3515711 MAGNESIUM VL 500MG X2 $ 9.00
3515712 MAGNESIUM LVP 40GM/1000ML $ 46.00
3515713 MANNITOL PGBK 500ML $ 68.00
3515714 MANNITOL VL 25% 50ML $ 9.00
3515715 MEASLES/MUMPS/RUBELLA $ 117.00
3515716 MECLIZINE TAB 25MG $ 8.00
3515717 MEDROXYPROGST VL 1MG X150 (J1050) $ 105.00
3515718 MEDROXYPROGST TAB 2.5MG $ 8.00
3515719 MEGESTROL DOSE 20MG X40 $ 18.75
3515720 MELATONIN TAB 3MG $ 8.00
3515721 MELOXICAM TAB 15MG $ 12.00
3515722 MELOXICAM TAB 7.5MG $ 8.00
3515723 MEMANTINE TAB 10MG $ 8.00
3515724 MEMANTINE TAB 5MG $ 15.00
3515725 MENINGOCOCC VL MENACTRA $ 215.00
3515726 MENTHOL LOZENGE $ 8.00
3515727 MENTHOL/CAMPHOR LOTION $ 12.00
3515728 PHENOL LOZENGE $ 8.00
3515729 MEPERIDINE SRN 100MG (J2175) $ 52.00
3515730 MESALAMINE TAB 400MG $ 11.00
3515731 MESNA VL 200MG X5 $ 266.25
3515732 METAXALONE TAB 800MG $ 16.00
3515733 METFORMIN TAB 1000MG $ 9.00
3515734 METFORMIN TAB 500MG $ 8.00
3515735 METFORMIN ER TAB 500MG $ 9.00
3515736 METFORMIN ER TAB 750MG $ 9.00
3515737 METHAZOLAMIDE TAB 50MG $ 16.00
3515738 METHENAMINE HIPP TAB 1GM $ 10.00
3515740 METHIMAZOLE TAB 10MG $ 8.00
3515741 METHOCARBAMOL TAB 750MG $ 8.00
3515742 METHOTREXATE DOSE 5MG X10 $ 24.50
3515743 METHOTREXATE TAB 2.5MG $ 15.00
3515744 METHYLSALC/MENTH CRM 4OZ $ 17.75
3515746 METHYLCELLULOSE PWD 16OZ. $ 8.00
3515747 METHYLCELLULOSE PWD/DOSE $ 8.00
3515748 METHYLDOPA TAB 250MG $ 8.00
3515749 METHYLEN BLU VL 1MG X100 $ 250.00
3515750 METHYLERGONV AMP 0.2MG/ML $ 49.00
3515751 METHYLERGONOV TAB 0.2MG $ 8.50
3515752 METHYLPREDNS AC VL 40MG $ 17.00
3515753 METHYLPREDNSLN 4MG-21TAB $ 60.00
3515754 METHYLPREDNS SS 125MG $ 37.00
3515755 METHYLPREDNS SS 125MG X8 $ 114.00
3515756 METHYLPREDNS SS 40MG $ 33.00
3515757 METHYLPREDNS SS 125MG X4 $ 73.00
3515758 METHYLPREDNSLN TAB 4MG $ 10.00
3515759 METOCLOPRAMID VL 10MG/2ML $ 27.00
3515760 METOCLOPRAMIDE TAB 10MG $ 8.00
3515761 METOCLOPRAMIDE TAB 5MG $ 8.00
3515762 METOLAZONE TAB 2.5MG $ 10.00
3515763 METOLAZONE TAB 5MG $ 10.00
3515764 METOPROLOL SUCC TAB 100MG $ 9.00
3515765 METOPROLOL SUCC TAB 25MG $ 9.00
3515766 METOPROLOL SUCC TAB 50MG $ 9.00
3515767 METOPROLOL AMP 5MG/5ML $ 27.00
3515768 METOPROLOL TART TAB 25MG $ 8.00
3515769 METOPROLOL TART TAB 50MG $ 8.00
3515770 METOPROLOL TART TAB 100MG $ 8.00
3515771 METRONIDZL GEL 1% 70GM $ 228.00
3515772 METRONIDAZOLE TAB 250MG $ 8.00
3515773 METRONIDAZOLE TAB 500MG $ 8.00
3515774 METRONDZOL PB 500MG/100ML $ 48.00
3515775 MICONAZOLE CREAM 2% 30GM $ 11.00
3515776 MICONAZOLE-7 CREAM 2% $ 17.00
3515777 MICONAZOLE POWDER 2% $ 16.00
3515778 MIDAZOLAM VL 1MG/ML X2 $ 27.00
3515779 MIDAZOLAM VL DOSE 1MG/ML $ 26.00
3515780 MIDAZOLAM SRP DOS 2MG/ML $ 8.00
3515781 MIDODRINE TAB 5MG $ 10.00
3515782 MIGLITOL TAB 25MG $ 8.00
3515784 MIRTAZAPINE TAB 15MG $ 10.00
3515785 MIRTAZAPINE TAB 7.5MG $ 10.00
3515786 MIRTAZAPINE TAB 30MG $ 29.00
3515787 MISOPROSTOL TAB 100MCG $ 8.00
3515788 MISOPROSTOL TAB 200MCG $ 9.00
3515790 MOEXIPRIL TAB 15MG $ 9.50
3515791 MOLD EXTRACT TEST CANDIDA $ 34.00
3515792 MOMETASONE CRM 0.1% 45GM $ 74.00
3515793 MOMETASONE NASAL SPRAY $ 141.75
3515794 MONTELUKAST TAB 10MG $ 14.00
3515795 MORPHINE INJ 10MG X1 (J2270) $ 28.00
3515796 MORPHINE SRN 2MG X1 INJ (J2270) $ 28.00
3515797 MORPHINE SRN 4MG X1 INJ (J2270) $ 28.00
3515799 MORPHINE ER TAB 15MG $ 8.00
3515800 MORPHINE ER TAB 30MG $ 8.00
3515801 MORPHINE SOLN 10MG/5ML $ 68.00
3515802 MORPHINE SUPP 5MG $ 12.00
3515804 MOXIFLOXACN OPH DROP 0.5% $ 261.00
3515805 MOXIFLOXACIN TAB 400MG $ 59.00
3515806 MOXIFLOXACIN PB 100MG X4 $ 107.00
3515807 MULTIVIT W/ IRON TAB $ 8.00
3515808 MULTIVIT/FE/MIN LQD 15ML $ 8.00
3515809 MULTIVIT/FE/MIN LQD 240ML $ 8.00
3515810 MULTIVIT/MIN/LUTEIN CAP $ 8.00
3515811 MULTIVIT/MIN/LUTEIN TAB $ 8.00
3515812 MULTIVITAMIN VL 10ML/2 VIALS X1 J3490 $ 58.00
3515813 MULTIVITAMIN TAB $ 8.00
3515814 MUPIROCIN CREAM 2% 15GM $ 321.00
3515815 MUPIROCIN OINT 2% 22GM $ 40.00
3515816 MYCOPHENOLATE CAP 250MG $ 11.00
3515817 MYCOPHENOLAT TB 250MG X2 $ 33.00
3515818 NABUMETONE TAB 500MG $ 9.00
3515819 NAFCILLIN VL 2GM $ 52.00
3515820 NALBUPHINE AMP 10MG/ML $ 30.00
3515821 NALOXONE AMP 0.4MG/ML $ 44.00
3515822 NAPHAZOLN/PHENIR OPH DROP $ 11.00
3515823 NAPROXEN TAB 220MG $ 8.00
3515824 NAPROXEN TAB 275MG $ 7.75
3515825 NAPROXEN TAB 375MG $ 9.00
3515826 NAPROXEN TAB 500MG $ 9.00
3515827 NATEGLINIDE TAB 120MG $ 11.00
3515828 NEFAZODONE TAB 100MG $ 11.00
3515829 NEFAZODONE TAB 50MG $ 8.75
3515830 NEO/BAC/POLY OINT 30GM $ 11.00
3515831 NEO/BAC/POLY OPH OINT $ 102.00
3515832 NEO/POLY/DEX OP DROP 0.1% $ 35.00
3515833 NEO/POLY/DEX OPHTH OINT 0.1% -OR $ 0.00
3515834 NEO/POLY/HC OTIC DROP 1% $ 126.00
3515835 NEOSTIGMINE VL DOSE 0.5MGX2 J2710 $ 16.00
3515836 NESIRITIDE VL 0.1MG X15 $ 771.25
3515837 NICOTINE PAT 14MG/24HR $ 10.00
3515838 NICOTINE PAT 21MG/24HR $ 10.00
3515839 VANCOMYCIN PGBK J3370 500MG X2 $ 73.00
3515840 NICOTINE PAT 7MG/24HR $ 10.00
3515841 NIFEDIPINE ER TAB 30MG $ 9.00
3515842 NISOLDIPINE TAB 20MG $ 32.00
3515843 NITROFUR MCROBID CP 100MG $ 11.00
3515844 NITROGLYCRN ON 2% 1GM PKT $ 10.00
3515845 NITROGLYCERN PAT 0.1MG/HR $ 9.00
3515846 NITROGLYCERN PAT 0.2MG/HR $ 9.00
3515847 NITROGLYCERN PAT 0.4MG/HR $ 9.00
3515848 NITROGLYCERN SPRAY $ 440.00
3515849 NITROGLYCERIN TAB 0.4MG $ 9.00
3515850 NITROGLYCRN PB 50MG/250ML $ 67.00
3515851 SOD NITROPRSS VL 50MG/2ML $ 465.00
3515852 NFD NON-FORMULARY DRUG $ 0.00
3515853 NOREPINEPHRIN AMP 4MG/4ML $ 56.00
3515854 ZZNORGSTRL/ESTRADL 5 TABS $ 21.50
3515855 NORTRIPTYLINE CAP 10MG $ 8.00
3515856 NORTRIPTYLINE CAP 25MG $ 9.00
3515857 NUTRITION DIGESTIVE CAP $ 7.00
3515858 NYSTATIN CREAM 15GM $ 33.00
3515859 NYSTATIN OINT 30GM $ 32.00
3515860 NYSTATIN POWDER 15GM $ 63.00
3515861 NYSTATN SUSP 100MU/ML-473 $ 191.00
3515862 NYSTATIN SUSP 100MU/ML-60 $ 32.00
3515863 NYSTATIN/TRIAMCN CRM 15GM $ 187.00
3515864 OFLOXACIN OPH DROP 0.3% $ 70.00
3515865 OFLOXACIN OTIC DROP 0.3% $ 119.00
3515866 OLANZAPINE TAB 2.5MG $ 21.00
3515867 OLANZAPINE TAB 5MG $ 20.00
3515868 OLOPATADINE OPH DROP 0.2% $ 265.00
3515869 OLOPATADINE OPH DROP 0.1% $ 360.00
3515870 OMEPRAZOLE CAP 20MG $ 9.00
3515871 ONDANSETRON VL 1 MG X4 $ 25.00
3515872 ONDANSETRON ODT 4MG $ 39.00
3515873 ONDANSETRON ODT 4MG X2 $ 63.00
3515874 OPIUM/BELLADON SUPP 30MG $ 53.00
3515875 OSELTAMIVIR CAP 75MG $ 34.00
3515876 OSELTMVR SUSP 6MG/ML 60ML $ 135.50
3515877 OXCARBAZEPINE TAB 300MG $ 10.00
3515878 OXYBUTYNIN ER TAB 10MG $ 11.00
3515879 OXYBUTYNIN ER TAB 15MG $ 11.00
3515880 OXYBUTYNIN TAB 5MG $ 8.00
3515881 OXYCODONE ER TAB 10MG $ 12.00
3515882 OXYCODONE ER TAB 20MG $ 16.00
3515883 OXYCODONE ER TAB 40MG $ 20.00
3515884 OXYCODONE IR TAB 5MG $ 8.00
3515885 OXYCODON/APAP TAB 5-325MG $ 9.00
3515886 OXYCOD/APAP 5-325 6 TAB $ 15.50
3515887 OXYMETAZOLN NAS SPY 0.05% $ 10.00
3515888 OXYTOCIN VL 10U/ML $ 9.00
3515891 PAMIDRONATE VL 30 MG X3 $ 177.50
3515892 PANCURONIUM DOSE 1MG/ML $ 11.00
3515893 PANTOPRAZOLE VL 40MG $ 30.00
3515894 PANTOPRAZOLE TAB 20MG $ 11.00
3515895 PANTOPRAZOLE TAB 40MG $ 12.00
3515896 ONDANSETRON 8MG TAB $ 37.29
3515897 PAROXETINE TAB 10MG $ 10.00
3515898 PAROXETINE TAB 20MG $ 10.00
3515899 PEGFILGRSTM SRN 6MG/0.6ML $ 8,010.00
3515900 PEN G CR SRN 100,000UX12 (J0558) $ 230.00
3515901 PEN G LA SRN 100,000UX12 (J0561) $ 210.00
3515902 PENICILLIN GK 600000X8.4 (J2540) $ 61.00
3515903 PEN V K 250MG/5ML 100ML $ 12.00
3515904 PENICILLIN V K TAB 250MG $ 22.00
3515905 PENICILLIN V K TAB 500MG $ 9.00
3515906 PENTOBARB DOSE 50MG X1 $ 695.00
3515907 PENTOXIFYLLINE TAB 400MG $ 9.00
3515908 PHENAZOPYRIDINE TAB 100MG $ 10.00
3515909 PHENOBARBITAL VL 130MG $ 75.00
3515910 PHENOBARBITAL VL 65MG/ML $ 35.00
3515911 PHENOL THROAT SPRAY $ 10.00
3515912 PHENTOLAMINE VL 5MG $ 255.00
3515913 PHENYLEPHRIN OP DROP 2.5% $ 138.00
3515914 PHENYLEPH DOSE 10MG/ML $ 14.00
3515915 PHENYLEPHRIN NSL SPR 0.5% $ 11.00
3515916 PHENYLEPH VL 10MG/ML X5 $ 63.25
3515917 PHENYTOIN AMP 50MG X5 - $ 45.75
3515918 PHENYTOIN SRN 50MG X2 $ 10.00
3515919 PHENYTOIN ER CAP 100MG $ 8.00
3515920 PHENYTOIN ER CAP 300MG $ 10.00
3515921 PHENYTOIN SUSP 125MG/5ML $ 60.00
3515922 PHYSOSTIGMINE AMP 1MG/ML $ 70.00
3515923 PILOCARPINE OPH DROP 1% $ 0.00
3515924 PILOCARPINE OPH GEL 4% $ 185.00
3515925 PIOGLITAZONE TAB 15MG $ 16.00
3515926 PIOGLITAZONE TAB 30MG $ 20.00
3515927 PIOGLITAZONE TAB 45MG $ 21.00
3515928 PIPRCL/TAZ VL 1.125GM X3 $ 64.00
3515930 PIROXICAM CAP 10MG $ 10.00
3515931 PNEUMOC-23 VAC PNEUMOVAX $ 130.00
3515932 PODOPHYLLUM LQD 25% TOP $ 198.00
3515933 POLIO VAC IPOL $ 60.00
3515934 POLYETHYLEN GLYCOL OP DRP $ 12.00
3515935 POLYETHYLENE GLYCOL PKT $ 9.00
3515936 POLYETHYLEN GLYCOL PWD $ 8.00
3515937 POLY/TRIMETHOP OPH DROP $ 23.00
3515938 D5-1/2NS KCL 20MEQ/1000ML $ 51.00
3515939 POTAS GLUC TAB 99MG $ 8.00
3515940 POTAS PHOS MONO-DIBS PKT $ 7.25
3515941 POTAS BICRB/CIT TAB 25MEQ $ 9.00
3515942 POTAS CL LQD 20MEQ/15ML $ 8.00
3515943 POTAS CL PKT 20MEQ $ 20.00
3515944 POTASSIUM CL VL 2MEQ X10 J3480 $ 46.00
3515945 POTAS CL TAB 10MEQ $ 8.00
3515946 POTAS CL TAB 20MEQ $ 8.00
3515947 POTAS CL PGBK 2MEQ X5 $ 49.00
3515948 POTAS IOD SLN 1GM/ML 30ML $ 38.00
3515949 POVIDON-IODN OPH DROP 5% $ 0.00
3515950 POVIDONE-IODINE OINT 10% $ 11.00
3515951 PRAMIPEXOLE TAB 0.125MG $ 11.00
3515952 PRAMIPEXOLE TAB 0.25MG $ 10.00
3515953 PRAMIPEXOLE TAB 1.5MG $ 15.00
3515954 PRAMOXINE/ZINC OX CREAM $ 15.00
3515955 PRAMOXIN/MENTHOL CREAM $ 14.00
3515956 PRAVASTATIN TAB 20MG $ 11.00
3515957 PREDNISOLONE OPH DROP 1% $ 101.00
3515958 PREDNISOLN LQD 5MG/5ML X6 $ 23.50
3515959 PREDNISONE TAB 1MG X10 $ 8.00
3515960 PREDNISONE TAB 1MG $ 8.00
3515961 PREDNISONE TAB 2.5MG $ 8.00
3515962 PREDNISONE TAB 1MG X20 $ 8.00
3515963 PREDNISONE TAB 5MG X10 $ 9.00
3515964 PREDNISONE TAB 1MG X5 $ 8.00
3515965 PREGABALIN CAP 100MG $ 17.00
3515966 PREGABALIN CAP 150MG $ 15.00
3515967 PREGABALIN CAP 200MG $ 15.00
3515968 PREGABALIN CAP 25MG $ 16.00
3515969 PREGABALIN CAP 50MG $ 17.00
3515970 PREGABALIN CAP 75MG $ 17.00
3515971 PRENATAL/IRON/DSS/FA TAB $ 8.00
3515972 PRIMIDONE TAB 50MG $ 8.00
3515973 PROCAINAMD VL 1000MG/10ML $ 100.00
3515974 PROCHLORPERAZ VL 10MG/2ML (J0780) $ 36.00
3515975 PROCHLORPERZN TAB 5MG X2 $ 8.00
3515976 PROCHLORPERAZINE TAB 5MG $ 8.00
3515977 PROCHLORPERAZIN SUPP 25MG $ 22.00
3515978 PROMETH/COD SRP 10-6.25/5 $ 8.00
3515979 PROMETHAZINE VL 25MG/ML $ 28.00
3515980 PROMETHAZINE SUPP 25MG $ 33.00
3515981 PROMETHAZN SRP 6.25MG/5ML $ 16.00
3515982 PROMETHAZINE TAB 25MG $ 8.00
3515983 PROPAFENONE TAB 150MG $ 9.00
3515984 PROPARACAINE OPHTH 0.5% DROP $ 69.00
3515985 PROPOFOL VL 10MG/ML 20ML $ 33.00
3515986 ZZPROPOXYPHENE HCL CAP 65 $ 7.25
3515987 ZZPROPXNAP/APAP TAB 100-6 $ 7.50
3515988 PROPRANOLOL ER CAP 80MG $ 10.00
3515989 PROPRANOLOL TAB 20MG $ 8.00
3515990 PROPYLTHIOURACIL TAB 50MG $ 8.00
3515991 PROTAMINE VL 10MG/ML X25 $ 47.50
3515992 PSEUD/BROM ELX 15-1MG/5ML $ 19.25
3515993 PSEUDOEPHEDRINE TAB 30MG $ 8.00
3515994 PSEUDOEPHEDRINE TAB 60MG $ 8.00
3515995 PSYLLIUM POWDER PKT $ 8.00
3515996 PSYLLIUM POWDER BULK $ 7.00
3515997 PYRL/APAP/PAMBROM TAB $ 7.00
3515998 ZN PYRITHN SHMP 1% 420ML $ 14.00
3515999 QUETIAPINE TAB 100MG $ 15.00
3516000 QUETIAPINE TAB 200MG $ 31.00
3516001 QUETIAPINE TAB 25MG $ 8.00
3516002 QUETIAPINE TAB 300MG $ 32.00
3516003 QUETIAPINE TAB 50MG $ 15.00
3516004 QUINAPRIL TAB 10MG $ 9.00
3516005 QUININE SULF CAP 324MG $ 16.00
3516006 RABIES IM GLB 150U/ML X10 $ 4,890.00
3516008 RACEPINEPHRINE NEB 2.25% $ 9.00
3516009 RALOXIFENE TAB 60MG $ 16.00
3516010 RAMELTEON TAB 8MG $ 24.00
3516011 RAMIPRIL CAP 10MG $ 10.00
3516012 RAMIPRIL CAP 2.5MG $ 12.00
3516013 RAMIPRIL CAP 5MG $ 9.00
3516014 RANITIDINE VL 25MG/ML X2 $ 41.00
3516015 RANITIDINE DOS 150MG/10ML $ 16.00
3516016 RANITIDINE TAB 150MG $ 9.00
3516017 RANITIDINE TAB 75MG $ 8.00
3516018 RASAGILINE TAB 0.5MG $ 37.00
3516019 RASAGILINE TAB 1MG $ 37.00
3516020 REMIFENTANIL VL 1 MG $ 107.00
3516022 RISEDRONATE TAB 35MG $ 114.00
3516023 RISPERIDONE SOLN 1MG/ML $ 12.00
3516024 RISPERIDONE TAB 0.25MG $ 10.00
3516025 RISPERIDONE TAB 0.5MG $ 11.00
3516026 RISPERIDONE TAB 1MG $ 12.00
3516027 RIVASTIGMINE CAP 3MG $ 11.25
3516028 ROCURONIUM DOSE 10MG/ML $ 31.00
3516029 ROPINIROLE TAB 0.5MG $ 10.00
3516030 ROPINIROLE TAB 1MG $ 8.00
3516031 ROPINIROLE TAB 2MG $ 10.00
3516032 ROPINIROLE TAB 3MG $ 14.00
3516033 ROPIVACAINE VL 1MG X200 $ 8.00
3516034 ROSIGLITAZONE TAB 2MG $ 11.00
3516035 ROSIGLITAZONE TAB 4MG $ 12.00
3516036 ROSIGLITAZONE TAB 8MG $ 17.00
3516037 ROSUVASTATIN TAB 10MG $ 20.00
3516038 ROSUVASTATIN TAB 20MG $ 17.00
3516039 ROTAVIRUS VAC ROTATEQ $ 146.00
3516040 SALMETEROL INHALR 50MCG $ 440.00
3516041 SAW PALMETTO CAP 450MG $ 7.00
3516042 SCOPOLAMINEPAT 1.5MG/72HR $ 51.00
3516043 SECOBARBITAL CAP 100MG $ 62.00
3516044 SELENIUM SULFD SHMP 2.25% $ 233.00
3516045 SENNOSIDES SYRP 8.8MG/5ML $ 8.00
3516046 SENNOSIDES TAB 15MG $ 8.00
3516047 SENNOSIDES TAB 8.6MG $ 8.00
3516048 SENNOSID/DOC TAB 8.6-50MG $ 8.00
3516049 SERTRALINE CONC 20MG/ML $ 113.00
3516050 SERTRALINE TAB 100MG $ 8.00
3516051 SERTRALINE TAB 25MG $ 8.00
3516052 SERTRALINE TAB 50MG $ 8.00
3516053 SEVELAMER TAB 400MG $ 8.25
3516054 SEVOFLURANE LIQUID $ 244.00
3516055 SILDENAFIL TAB 20MG $ 25.75
3516056 SILVER NITRATE STICK $ 8.00
3516057 SILVER SULFADZN CRM 50GM $ 31.00
3516058 SIMETHICONE CHEW 80MG $ 8.00
3516059 SIMVASTATIN TAB 10MG $ 10.00
3516061 SIMVASTATIN TAB 40MG $ 12.00
3516062 SIMVASTATIN TAB 80MG $ 12.00
3516063 SIMVASTATIN TAB 5MG $ 8.00
3516064 SIROLIMUS TAB 1MG $ 20.00
3516065 SITAGLIPTIN TAB 100MG $ 23.00
3516066 SITAGLIPTIN TAB 25MG $ 15.00
3516067 SITAGLIPTIN TAB 50MG $ 31.00
3516068 SOD BICARB SRN 5MEQ/10ML $ 20.00
3516069 SOD BICARB SRN 50MEQ/50ML $ 38.00
3516070 SALINE NASAL SPRAY $ 11.00
3516071 SODIUM CL NEB 0.9% $ 8.00
3516072 SODIUM CL TABS 1GM $ 8.00
3516073 SOD CIT/CIT ACID SLN 30ML $ 10.00
3516075 SOD POLSTYR SSP 15GM/60ML $ 21.00
3516076 EYE WASH OPH SOLN $ 11.00
3516077 SOLIFENACIN TAB 5MG $ 18.00
3516078 SORBITOL SOLN 70% DOSE $ 8.00
3516079 SOTALOL TAB 80MG $ 10.00
3516080 SPIRONOLACTON TAB 12.5 MG $ 8.00
3516081 SPIRONOLACTONE TAB 25MG $ 8.00
3516082 SUCCINYLCHLN DOSE 20MG/ML $ 25.00
3516083 SUCRALFATE SUSP 1GM/10ML $ 250.00
3516084 SUCRALFATE TAB 1GM $ 8.00
3516086 SULFACETAMIDE OP DROP 10% $ 86.00
3516087 SULFACETAMID/SULFUR EMUL $ 59.75
3516088 SULFA/TMP 400-80MG/10ML $ 291.00
3516089 SULFA/TMP TAB 400-80MG $ 8.00
3516090 SULFA/TMP TAB 800-160MG $ 8.00
3516091 SULINDAC TAB 150MG $ 8.00
3516092 SULINDAC TAB 200MG $ 9.00
3516093 SUMATRIPTAN VL 6MG/0.5ML $ 140.00
3516094 TAMOXIFEN TAB 10MG $ 8.00
3516095 TAMSULOSIN CAP 0.4MG $ 12.00
3516097 TEMAZEPAM CAP 15MG $ 8.00
3516098 TENECTEPLASE KIT 1MG X50 $ 7,862.00
3516099 TERAZOSIN CAP 5MG $ 9.00
3516100 TERBINAFINE CREAM 1% $ 22.00
3516101 TERBINAFINE TAB 250MG $ 23.00
3516102 TERBUTALINE VL 1MG/ML $ 37.00
3516103 TERBUTALINE TAB 2.5MG $ 9.00
3516104 TERCONAZOLE CREAM 45GM $ 70.00
3516106 TETANUS/DIP VAC DECAVAC $ 51.00
3516107 TETANUS IMM GLOB HYPTET $ 700.00
3516109 TETRACAINE AMP 10MG/ML $ 14.00
3516110 TETRACYCLINE CAP 250MG $ 16.00
3516111 THEOPHYLLINE ER TAB 100MG $ 8.00
3516112 THEOPHYLLINE ER TAB 300MG $ 8.00
3516114 THYROID TAB 60MG $ 8.00
3516115 TIMOLOL OPH DROP 0.25% $ 24.00
3516116 TIMOLOL OPH DROP 0.5% $ 32.00
3516117 TIOTROPIUM INHALER -5S $ 150.00
3516118 TIOTROPIUM INHALER -30S $ 480.00
3516119 TIZANIDINE TAB 2MG $ 9.00
3516120 TIZANIDINE TAB 4MG $ 9.00
3516121 TOBRAMYCIN OPH OINT 0.3% $ 105.25
3516122 TOBRAMYCIN OPH DROP 0.3% $ 24.00
3516123 TOBRAMYCIN/DEX OPH DROP $ 111.00
3516124 TOBRAMYCIN/DEX OPH OINT $ 311.00
3516125 TOBRAMYCIN/LOTEP OPH DROP $ 311.00
3516126 TOLTERODINE LA CAP 2MG $ 23.00
3516127 TOLTERODINE LA CAP 4MG $ 24.00
3516128 TOLTERODINE TAB 1MG $ 15.00
3516129 TOLTERODINE TAB 2MG $ 15.00
3516130 TOPIRAMATE TAB 100MG $ 24.00
3516131 TOPIRAMATE TAB 50MG $ 14.00
3516132 TORSEMIDE TAB 10MG $ 8.00
3516133 TORSEMIDE TAB 20MG $ 8.00
3516134 TRACE ELEMENTS VL 1ML $ 18.00
3516135 TRAMADOL TAB 50MG $ 8.00
3516137 TRAVOPRST Z OP DRP 0.004% $ 222.00
3516138 TRAZODONE TAB 100MG $ 8.00
3516139 TRAZODONE TAB 150MG $ 9.00
3516140 TRAZODONE TAB 50MG $ 8.00
3516141 TRIAMCINLN CRM 0.1% 15GM $ 14.00
3516142 TRIAMCINLN CRM 0.1% 80GM $ 23.00
3516143 TRIAMCINOLN DOSE 10MG X4 $ 20.00
3516144 TRIAMCINLN OINT 0.1% 15GM $ 14.00
3516145 TRIAMCINLN OINT 0.1% 80GM $ 23.00
3516146 TRIAM/HCTZ CAP 37.5-25MG $ 8.00
3516147 TRIAM/HCTZ TAB 75-50MG $ 8.00
3516148 TRIAZOLAM TAB 0.125MG $ 10.00
3516149 TRIFLURIDINE OPH DROP 1% $ 361.00
3516150 TRIMETHOBENZAM CAP 300MG $ 9.00
3516153 TRIMETHOPRIM TAB 100MG $ 8.00
3516154 TROLAMINE CREAM 10% $ 15.00
3516155 TROPICAMIDE OPH DROP 0.5% $ 20.00
3516156 TROPICAMIDE OPH DROP 1% $ 0.00
3516157 TROSPIUM ER CAP 60MG $ 13.00
3516158 TROSPIUM TAB 20MG $ 10.25
3516159 TUBERCULIN DOSE 5TU/0.1ML $ 34.00
3516160 TYPHOID VAC 25MCG TYPHIM $ 187.00
3516161 URSODIOL CAP 300MG $ 16.00
3516162 VALACYCLOVIR TAB 500MG $ 20.00
3516163 VALGANCICLOVIR TAB 450MG $ 110.00
3516164 VALPROATE SOD VL 100MG/ML $ 66.00
3516165 VALSARTAN TAB 160MG $ 12.00
3516166 VALSARTAN TAB 40MG $ 11.00
3516167 VALSARTAN TAB 80MG $ 17.00
3516168 VANCOMYCIN CAP 125MG $ 60.00
3516169 VANCOMYCIN VL J3370 500MG X2 $ 65.00
3516170 VARENICLINE TAB 0.5MG $ 16.00
3516171 VARENICLINE TAB 1MG $ 14.00
3516172 VARICELLA VAC VARIVAX $ 222.00
3516173 VASOPRESSIN IV 20 UNITS $ 70.00
3516174 VENLAFAXINE TAB 37.5MG $ 9.00
3516175 VENLAFAXINE TAB 75MG $ 10.00
3516176 VENLAFAXINE ER TAB 150MG $ 14.00
3516177 VENLAFAXINE ER TAB 37.5MG $ 14.00
3516178 VENLAFAXINE ER CAP 75MG $ 12.00
3516179 VERAPAMIL SR TAB 180MG $ 8.00
3516180 VERAPAMIL AMP 5MG/2ML $ 45.00
3516181 VERAPAMIL SR TAB 120MG $ 10.00
3516182 VERAPAMIL SR TAB 240MG $ 8.00
3516183 VERAPAMIL TAB 120MG $ 8.00
3516184 RENAL/NEPHRO CAP $ 8.00
3516185 VIT B12/B6/FA TAB $ 8.00
3516186 VIT B12/C/FE/FA CAP $ 8.00
3516187 VITAMIN A CAP 8000UNT $ 8.00
3516188 VIT B COMPLEX CAP $ 8.00
3516189 THIAMN VIT B1 VL 100MG/ML $ 38.00
3516190 THIAMINE VIT B1 TAB 100MG $ 8.00
3516191 CYANOCOBAL B12 1000MCG/ML $ 34.00
3516192 CYANOCOBL B12 TAB 1000MCG $ 8.00
3516193 CYANOCOBAL B12 TAB 100MCG $ 8.00
3516194 CYANOCOBAL B12 TAB 250MCG $ 8.00
3516195 NIACIN VIT B3 TAB 500MG $ 15.00
3516196 PYRIDOXIN VIT B6 TAB 50MG $ 8.00
3516197 ASCORBIC ACID TAB 500MG $ 8.00
3516198 VITAMIN D CAP 50,000U $ 9.00
3516199 VITAMIN D TAB 1000U $ 8.00
3516200 VITAMIN D TAB 400U $ 7.00
3516201 VITAMIN E CAP (400 U) $ 8.00
3516202 PHYTON VIT K AMP 1MG X10 $ 98.00
3516203 PHYTON VIT K NEO AMP 1MG $ 14.00
3516204 PHYTONADION VIT K TAB 5MG $ 116.00
3516205 WARFARIN TAB 1MG $ 8.00
3516206 WARFARIN TAB 2.5MG $ 10.00
3516207 WARFARIN TAB 2MG $ 10.00
3516208 WARFARIN TAB 3MG $ 8.00
3516209 WARFARIN TAB 4MG $ 8.00
3516210 WARFARIN TAB 5MG $ 8.00
3516211 WARFARIN TAB 6MG $ 8.00
3516212 WARFARIN TAB 7.5MG $ 8.00
3516214 ZAFIRLUKAST TAB 20MG $ 10.00
3516215 ZALEPLON CAP 5MG $ 11.00
3516216 ZIDOVUDINE TAB 100MG X3 $ 15.00
3516217 ZINC OXIDE OINT 20% 60GM $ 11.00
3516218 ZINC SULF CAP 220MG $ 8.00
3516220 ZOLEDRONIC ACD PB 1MG X5 $ 1,029.00
3516221 ZOLPIDEM TAB 10MG $ 14.00
3516222 ZOLPIDEM TAB 5MG $ 12.00
3516223 ZONISAMIDE CAP 100MG $ 9.00
3516224 ZONISAMIDE CAP 50MG $ 9.00
3516225 ZOSTER VAC ZOSTAVAX $ 301.00
3516226 PROTEINAS INHIB 10MG X50 $ 307.75
3516227 PROTEINAS INHIB 10MG X100 $ 572.75
3516228 1/2 NS 1000 ML $ 18.00
3516229 NS 250 ML $ 22.00
3516230 NS 1000 ML $ 18.00
3516231 NS 100 ML $ 17.00
3516232 NS 100 ML MB+ $ 14.00
3516233 NS KCL 20 MEQ/1000ML $ 48.00
3516234 NS 500 ML $ 18.00
3516235 NS 50 ML $ 17.00
3516236 D10W 1000 ML $ 18.00
3516237 D5-1/4NS KCL 20MEQ/1000ML $ 49.00
3516238 D5-LR 1000 ML $ 22.00
3516239 D5-1/4 NS 1000 ML $ 18.00
3516240 D5-1/2 NS 1000 ML $ 18.00
3516241 D5-NS 500 ML X2 $ 18.00
3516242 D5W 1000 ML $ 18.00
3516243 D5W 100 ML $ 17.00
3516244 D5W 250 ML GLASS $ 17.00
3516245 D5W 50 ML $ 17.00
3516246 D5W 500 ML $ 18.00
3516247 D10W 250 ML $ 18.00
3516248 GLYCINE IRRIGATION 3L $ 32.00
3516249 SODIUM CL 0.9% IRRIG 3L $ 18.00
3516250 HYPERTON SALINE 3% 500ML $ 48.00
3516251 HYDROCORTISON 100MG/2ML $ 37.00
3516252 ALLOPURINOL TAB 300MG $ 8.00
3516253 BUPIVACN DOSE 0.25% 1ML $ 15.00
3516254 DEXTROSE 25% SYN 10ML $ 36.00
3516255 RHO (D) IMM GLOB RHOGAM $ 202.00
3516256 FENTANYL SDV 100MCG/2ML $ 27.00
3516257 LIDOCAIN SDV 1% 30ML $ 11.00
3516258 LUBIPROSTONE CAP 8MCG $ 15.00
3516259 MINERAL OIL 30 ML $ 8.00
3516260 METHYLPHENIDATE TAB 2.5MG $ 8.00
3516261 NIFEDIPINE CAP 10MG $ 9.00
3516262 RABIES VAC RABAVERT $ 467.00
3516263 SIMVASTATIN TAB 20MG $ 12.00
3516264 SODIUM CL OPH DROP $ 22.00
3516265 SULFA/TMP SUSP 100ML BTL $ 12.00
3516266 ZOLEDRONIC ACD VL 1MG X4 $ 1,135.50
3516267 OPIUM/BELLADON SUPP 60MG $ 59.00
3516268 HYDROMORPHONE TAB 4MG $ 8.00
3516269 METHADONE TAB 10MG $ 8.00
3516270 SODIUM CL FLUSH 5ML $ 8.00
3516271 BENZOCN/MENTHOL SPRAY $ 14.00
3516272 PHARMACY KEY $ 7.00
$ 7.00
3516273 WITCH HAZEL PAD $ 14.00
3516274 SEDATION KIT $ 0.00
3516275 MAGNESIUM KIT $ 0.00
3516277 PT SPECIFIC IV ACCESS $ 7.00
$ 7.00
3516278 OXYBUTYNIN ER TAB 5MG $ 11.00
3516279 LIDOCAN/EPI/TETRA TOP 3ML $ 12.00
3516280 GI COCKTAIL 30ML $ 9.00
3516281 CHLORZOXAZONE TAB 500MG $ 7.75
3516282 DICLOFENAC PATCH 1.3% $ 21.50
3516283 FLUPHENAZINE TAB 5MG $ 7.75
3516284 BENZTROPINE TAB 1MG $ 8.00
3516285 SULFASALAZINE TAB 500MG $ 8.00
3516286 LECITHIN CAP 1200MG $ 7.00
3516287 CYCLOSPORINE MOD CAP 25MG $ 9.00
3516288 FELODIPINE ER TAB 2.5MG $ 8.50
3516289 OCTREOTIDE SRN 1MG X30 $ 4,286.00
3516291 TRASTUZUMAB VL 10MG X44 $ 3,549.25
3516292 RABIES IM GLB 150U/ML X2 $ 1,072.00
3516293 MAGIC MOUTH WASH 240 ML $ 25.00
3516294 CEFDINIR SP 250/5 100ML $ 233.00
3516295 OLMESARTAN 20MG TAB $ 14.00
3516296 CARBAMAZEPINE XR 100MG $ 9.00
3516297 SOD PHOS MON/DIB ENEMA $ 0.00
3516298 ALPRAZOLAM TAB 0.5MG $ 8.00
3516299 METHYLPHENIDATE TAB 5MG $ 8.00
3516300 ESTROG/MEDROX 0.625/2.5MG $ 7.75
3516301 HYDROCOD/IBU TAB 7.5-200M $ 8.00
3516302 FERUMOXYTOL VL 1MG X510 $ 504.75
3516303 OXYCOD/APAP TAB 10-325MG $ 11.00
3516304 TETRIX CREAM KIT $ 253.00
3516305 AMIKACIN INJ VL 100MG X1 $ 51.75
3516306 TESTOSTERONE GEL 1% 5GM $ 35.00
3516307 THALIDOMIDE CAP 100 MG $ 254.75
3516308 THALIDOMIDE CAP 200 MG $ 289.00
3516309 ZIPRASIDONE CAP 20 MG $ 32.00
3516312 TERIPARATIDE INJ 10 MCG X $ 1,080.75
3516313 ESOMEPRAZOLE CAP 20 MG $ 20.00
3516314 COENZYME Q10 CAP 100MG $ 8.00
3516315 MOMETASONE INH 220 MCG $ 311.00
3516316 FORMOTEROL INH 12 MCG $ 187.50
3516317 HYDROXYUREA CAP 500MG $ 8.25
3516318 IMUN GLOB 10% 500MG X20P $ 1,352.50
3516319 TRAND-VERAP CR TB 4-240MG $ 10.25
3516320 INSULIN DETEMIR PEN 5U X60 (J1815) $ 68.00
3516321 INSULIN ASPART PEN 5U X60 (J1815) $ 141.00
3516322 PANCRELIPASE DR 12000UNIT $ 10.00
3516323 AMLODIP/BENAZ CAP 10-20 M $ 18.00
3516324 CARB/LEVO/ENTAC 150 TAB $ 10.75
3516325 BUDES/FORMOT INHAL 160-4. $ 327.00
3516326 MORPHINE VL DOSE 10MG X1 (J2274) $ 17.00
3516327 DEMECLOCYCL TAB 150MG $ 16.25
3516328 BETAMETH DIP CRE 0.05% $ 181.00
3516329 TRIAM/HCTZ TAB 37.5-25 MG $ 8.00
3516330 BRIMONIDINE-TIMOLOL OPH $ 252.00
3516331 PREDNISOLN DOSE 5MG/5ML 30ml Dose $ 8.00
3516332 PHARMACY CONSULT $ 0.00
3516333 BUPIVCN/EPI DOSE 0.25% 1 $ 14.00
3516334 GRANISETRON VL 1MG/ML $ 75.00
3516335 HYDROCOD/APAP TAB 7.5-500 $ 7.25
3516336 HYDROCOD/APAP TAB 7.5-325 $ 8.00
3516337 CODEINE TAB 30MG $ 8.00
3516338 HYDROMORPH VL DOSE 2MG/ML $ 27.00
3516339 FAT EMULSION IV 20% 500ML $ 89.00
3516340 ERYTHROMYCIN BS TAB 250MG $ 15.00
3516341 NEOMYCIN TAB 500 MG $ 9.00
3516342 CAPTOPRIL TAB 25MG $ 9.00
3516343 CARB/LEVO TAB 37.5-150MG $ 8.00
3516344 CITALOPRAM TAB 5MG $ 10.00
3516345 MISOPROSTOL TAB 50 MCG $ 8.00
3516346 MISOPROSTOL TAB 25 MCG $ 8.00
3516347 DORZOLAMIDE OPH DRP 2% $ 71.00
3516348 FERRO S04 ELX 220MG/5ML $ 8.00
3516349 ESTROPIPATE TAB 1.5MG $ 7.50
3516350 PYRIDOSTIG TAB 60MG $ 9.00
3516351 PALIVIZUMAB VL 50 MG $ 3,213.00
3516352 MORPHINE CNC 20MG/ML 30ML $ 51.00
3516353 SODIUM BICARB TAB 325MG $ 8.00
3516354 PANCRELIPASE DR 5000UNIT $ 9.00
3516355 DONEPEZIL ODT 5MG $ 16.00
3516356 PETRO/MINRL/LAN CRM 16OZ. $ 16.00
3516357 PRAMIPEXOLE TAB 0.5 MG $ 11.00
3516358 PALIVIZUMAB VL 100 MG $ 6,066.00
3516359 WARFARIN DOSE MONITOR $ 0.00
3516361 FENOFIBRATE TAB 160MG $ 9.25
3516362 PHENYTOIN VL 50MG X5 $ 9.00
3516363 PHENYTOIN VL 50MG X2 $ 9.00
3516364 CEFUROXIME SP 250/5 50 ML $ 180.00
3516365 METRONIDZL GEL 0.75% 45GM $ 246.00
3516366 NALTREXONE ER IM INJ 1MG $ 1,384.75
3516367 ARIPIPRAZOLE TAB 10MG $ 61.00
3516368 MULTIVIT/MIN EYE CAP $ 8.00
3516369 ESZOPICLONE TAB 1 MG $ 14.50
3516370 1/2 NS KCL 20 MEQ/1000 ML $ 52.00
3516371 DIVALPROEX ER TAB 250MG $ 10.00
3516372 ISOSORBID DINITR TAB 5MG $ 8.00
3516373 LIDOCAINE PATCH REMOVE $ 0.00
3516374 DONEPEZIL ODT 10MG $ 16.00
3516375 VANCO SOLN 50MG/ML 40ML $ 83.75
3516376 OMEGA-3 ESTER CAP 1GM $ 10.00
3516377 DOXEPIN CAP 50MG $ 8.00
3516378 METHYLPHENIDATE TAB 10MG $ 7.50
3516379 D5-1/2NS KCL 10MEQ/1000ML $ 48.00
3516380 DABIGATRAN CAP 75MG $ 15.00
3516382 DOCETAXEL 4ML 1MG X80 $ 1,865.00
3516383 PALONOSETRON VL 25MCG X10 $ 475.50
3516384 SULFA/PREDNS OPH SOLN 5ML $ 32.00
3516385 POT-NA PHOS MONO-DIBS PKT $ 7.25
3516386 LOSARTAN TAB 50MG $ 8.00
3516387 NITROGLYCRN ON 2% 60GM TB $ 9.00
3516388 VORICONAZOLE TAB 50MG $ 18.50
3516389 LR 500ML $ 18.00
3516390 GLUCOSE CHW ORANGE 4GM $ 8.00
3516391 ACIPHEX - MRF/HOME MED $ 0.00
3516392 BENEFIBER 3GM SUBSTITUTE $ 0.00
3516393 GENTAMICIN PBK 80MG/100ML $ 49.00
3516394 NICOTINE PATCH REMOVE $ 0.00
3516395 APAP/CODN SOLN 120ML $ 8.00
3516396 OCTREOTIDE VL 25MCG X4 $ 23.00
3516397 EXENATIDE SYRN 5MCG $ 615.00
3516398 BCG LIVE INTRAVSCL 81MG $ 314.75
3516399 D5-NS KCL 20 MEQ/1000ML $ 48.00
3516400 HYDROCORTSN CRM TOP 2.5% $ 18.00
3516401 LACOSAMIDE TAB 50MG $ 12.00
3516402 FOMEPIZOLE IV 15MG X100 J1451 $ 1,690.00
3516403 CLINDAMYCIN PGBK 600 MG $ 60.00
3516404 ACETAMINPHN ER TAB 650MG $ 0.00
3516405 NITROGLYCERIN TB 0.4MGX25 $ 23.75
3516406 GLYCOPYRROLATE TAB 1MG $ 9.00
3516407 DESVENLAFAXNE SR TB 100MG $ 12.25
3516408 PATIENT TAKES NO MEDS $ 0.00
3516409 AA/DEXT10/LYTE TPN 1000ML $ 166.75
3516410 SUMATRIPTAN TAB 50MG $ 52.00
3516411 ZIDOVUDINE 10MG/ML 240ML $ 62.75
3516412 ZIDOVUDINE VL 10MG/ML X20 $ 76.25
3516413 IMUN GLOB 10% 500MG X20M $ 922.25
3516414 IMUN GLOB 10% 500MG X40M $ 1,823.75
3516415 IMUN GLOB 10% 500MG X2M $ 110.75
3516416 GATIFLOXACN OPH DROP 0.5% $ 118.00
3516417 LINEZOLID PB 200MG X3 $ 263.00
3516418 RIVASTIGMINE PATCH 4.6MG $ 34.00
3516419 TRIAMCINLN OINT 0.5% 15GM $ 9.00
3516420 MINOCYCLINE CAP 100MG $ 9.00
3516421 NEBIVOLOL TAB 5MG $ 11.00
3516422 HALOPERIDOL TAB 5MG $ 8.00
3516423 LIDOCN/PRILOCN CRM 5GM $ 17.00
3516424 KETOROLAC TAB 10MG $ 10.00
3516425 PHENYLEPH VL 10MG/1ML $ 33.00
3516426 IRON POLYSACC CAP 150MG $ 7.25
3516427 FERROUS SO4 ER TAB 160MG $ 8.00
3516428 VITAMIN A & D DOSE 6 GM $ 7.00
3516429 TOBRAMYCIN NEB 80MG/2ML $ 12.00
3516430 TOBRAMYCIN VL 80MG/2ML $ 12.00
3516431 PROBENECID TAB 500MG $ 8.00
3516432 ROFLUMILAST TAB 500MCG $ 18.00
3516433 PYRIDOXIN VIT B6 100MG/ML $ 24.00
3516434 CYCLOSPORINE NONMOD CAP 2 $ 11.00
3516435 TOCILIZUMAB VL 80MG/4ML $ 361.50
3516436 TOCILIZUMAB VL 400MG/20ML $ 1,636.50
3516437 VALPROIC ACD SOLN 250/5ML $ 118.00
3516438 INDAPAMIDE TAB 2.5MG $ 9.00
3516439 ROPINIROLE TAB 0.25MG $ 8.00
3516440 POTAS CL CAP 10MEQ $ 14.00
3516441 AMOX/KCLAV TAB 500-125MG $ 11.00
3516442 ELETRIPTAN TAB 20MG $ 71.00
3516443 LAMOTRIGINE TAB 25MG $ 12.00
3516444 PNEUMOC-13 VAC PREVNAR 13 $ 278.00
3516445 ROTAVIRUS VAC ROTARIX $ 203.00
3516446 INFLUENZA - FLUZONE VACCINE 0.5ML $ 30.00
3516448 HYLAN GF SRN 1MG X 48 $ 1,104.25
3516449 METHOTREXATE DOSE 0.1-5MG $ 12.00
3516450 GENTAMICIN IM 80MG/2ML $ 49.00
3516451 CLINDAMYCIN IM 300MG/2ML $ 25.00
3516452 SOAP SUDS ENEMA $ 0.00
3516453 LACT.ACDPH/BIFIDOBAC. CAP $ 8.00
3516454 PAMIDRONATE VL 30 MG/10ML $ 32.00
3516455 SODIUM CL GEL 20% $ 0.00
3516456 CEFAZOLIN PGBK 500 MG X4 (J0690) $ 54.00
3516457 SUMATRIPTAN TAB 100MG $ 51.00
3516458 PACLITAXL PRT-BND 1MGX100 $ 1,185.00
3516459 CRANBERRY CAP 200MG $ 8.00
3516460 CEFEPIME VL 500MG X4 $ 57.00
3516461 DAPTOMYCIN VL 1MG X500 $ 635.00
3516462 TIGECYCLINE VL 1MG X50 $ 218.00
3516463 ERIBULIN VL 0.1 MG X10 $ 1,071.75
3516464 ETOMIDATE VL 20MG/10ML $ 35.00
3516465 CARBXYMETH OPH DROP 0.5% $ 18.00
3516466 MELATONIN TAB 1-10MG $ 8.00
3516467 BCG LIVE INTRAVSCL 50 MG $ 303.00
3516468 NALBUPHINE DOSE 10MG/ML X1 $ 11.00
3516469 GANCICLOVIR VL 500MG $ 200.00
3516470 ZIPRASIDONE CAP 60MG $ 20.00
3516472 RHO (D) IMM GLOB RHOPHYLA $ 250.00
3516473 HYDROXYPROGESTRN 1MG X250 $ 883.00
3516474 PENTAMIDINE VL 300MG $ 139.00
3516475 AA5%/DEXT15/LYTE 2000ML $ 207.00
3516476 FAT EMULSION IV 20% 250ML $ 65.00
3516477 GLIMEPIRIDE TAB 1MG $ 8.00
3516478 HYDROXYZINE VL 25MG X4 $ 18.00
3516479 BUMETANIDE SDV 1MG/4ML $ 28.00
3516480 COCAINE SOL 4% DOSE $ 287.00
3516481 MORPHINE IR TAB 15 MG $ 8.00
3516482 DOBUTAMINE DRIP 250MG $ 55.00
3516483 FENTANYL PATCH REMOVE $ 0.00
3516484 METOPROLOL TART TB 12.5MG $ 8.00
3516485 CLONAZEPAM ODTAB 0.25 MG $ 8.25
3516486 MINOXIDIL TAB 10MG $ 8.25
3516487 ESTRADIOL TAB 1MG $ 8.00
3516488 SOTALOL TAB 40MG $ 8.00
3516489 CALC/VIT D TAB 600MG-400U $ 8.00
3516490 CEFEPIME VL 500MG X2 $ 53.00
3516491 REGADENOSON SRN 0.1MG X4 $ 345.00
3516492 LEFLUNOMIDE TAB 20MG $ 14.00
3516493 SCOPOLAMINE PATCH REMOVE $ 0.00
3516494 HYDROXYZINE VL 25MG $ 14.00
3516495 MORPHINE CNC 20MG/ML 15ML $ 22.00
3516496 DICLOFENAC PATCH REMOVE $ 0.00
3516497 MIDAZOLAM VL 1MG X10 $ 27.00
3516498 DOXORU LIPO VL 10MG/ML X5 $ 3,710.00
3516499 FEBUXOSTAT TAB 40MG $ 22.00
3516500 MULTIVIT/MIN CHEW TAB $ 8.00
3516501 BIMATOPROST OPH DRP 0.01% $ 239.00
3516502 FESOTERODINE TAB 8MG $ 22.00
3516503 METFORMIN TAB 850MG $ 9.00
3516504 HYDROMORPHONE SRN 1MG/ML $ 29.00
3516505 FLUOCINONID TOP SLN 0.05% $ 116.00
3516506 WARFARIN TAB 0.5MG $ 7.00
3516507 ISOSORBID MONO TAB 15MG $ 8.00
3516508 CAFFEINE TAB 200MG $ 8.00
3516509 LABETALOL SRN 5MG/ML 4ML $ 34.00
3516510 INSTYMEDS KEY $ 7.00
$ 7.00
3516511 MORPHINE ER TAB 60MG $ 14.00
3516512 METOPROLOL SUCC TB 12.5 M $ 8.00
3516513 KETAMINE SRN 50 MG/ML $ 25.00
$ 25.00
3516514 PHENYLEPH SRN 1 MG/10ML $ 25.00
3516515 EPHEDRINE SRN 50MG/5ML $ 30.25
3516516 LIDOCAIN LTA 360 KIT $ 21.00
3516517 LEVONORGESTR TAB 0.75MGX2 $ 62.00
3516518 ETOPOSIDE VL 10MG X10 $ 21.00
3516519 SARGRAMOSTIM VL 50MCG X5 $ 373.00
3516520 HALOPERIDOL DOSE 2MG/ML $ 8.00
3516521 SELENIUM SULFD SHMP 1% $ 12.00
3516522 LOPNVR-RITNVR TB 100-25MG $ 14.00
3516523 ARIPIPRAZOLE TAB 15MG $ 61.00
3516524 AZACITIDINE VL 100MG $ 726.75
3516525 AMPHET /DEXTROAMP TAB 20MG $ 9.00
3516526 AMPHET/DEXTROAMP TAB 5MG $ 7.25
3516527 LUTEIN CAP 6MG $ 8.00
3516528 DERMABOND PEN 6502020 $ 65.00
3516529 TESTOST CYP VL 1MG (J1071) $ 54.00
3516530 SODIUM CL VL 0.9% 20ML $ 0.00
3516531 SODIUM CL VL 0.9% 10ML $ 0.00
3516532 ENOXAPARIN SRN 10MG X15 (J1650) $ 44.00
3516533 RIFAXIMIN TAB 550MG $ 59.00
3516534 LIOTHYRONINE TAB 25MCG $ 9.00
3516535 LIDOCAIN BUFF 1% 5ML $ 26.00
3516536 TRIAMCINOLN 10MG X4 $ 36.00
3516538 LORAZEPAM CARP 2MG X1 (J2060) $ 11.00
3516539 FENTANYL CARP 100MCG/2ML $ 9.00
3516540 FENTANYL CARP (50MCG/ML) $ 10.00
3516541 VALACYCLOVIR TAB 1 GM $ 22.00
3516542 HEPAT B VL 20MCG ADT $ 108.00
3516543 ROPIVACAINE 5MG/ML $ 9.00
3516544 ROPIVACANE 2MG/ML-20 $ 21.00
3516545 DULOXETINE 20MG $ 17.00
3516546 INSULIN DETEMIR PEN 5 UNIT X60(J1815) $ 135.00
3516547 STERILE WATER INJ $ 0.00
3516548 STERILE WATER 20 ML $ 0.00
3516549 STERILE WATER 50 ML $ 2.50
3516550 TRIAMCINOLONE ACE CREAM (0.025%) $ 12.00
3516551 VANCO 600MG J3370 500MG X2 $ 61.00
3516552 VANCO 750MG J3370 500MG X2 $ 61.00
3516553 VANCO 1200 MG J3370 500MG X3 $ 77.00
3516554 VANCO 1250 MG J3370 500MG X3 $ 77.00
3516555 VANCO 1300 MG J3370 500MG X3 $ 55.00
3516556 VANCO 1500 MG J3370 500MG X3 $ 77.00
3516557 VANCO 500MG X1 J3370 $ 50.00
3516558 VANCO 1600 MG J3370 500MG X4 $ 77.00
3516559 VANCO 1700 MG J3370 500MG X4 $ 77.00
3516560 VANCO 1750 MG J3370 500MG X4 $ 77.00
3516561 VANCO 1800 MG J3370 500MG X4 $ 77.00
3516562 VANCO 2000 MG J3370 500MG X4 $ 77.00
3516563 VANCO 2200 MG J3370 500MG X5 $ 93.00
3516564 VANCO 2400 MG J3370 500MG X5 $ 93.00
3516565 MAGNESIUM SULF 1 GM PGBK J3475 500 X2 $ 46.00
3516566 OMEPRAZOLE 40MG $ 10.00
3516567 IBUPROFEN ORAL SUSP DOSE **ED ONLY** $ 0.00
3516568 ACETAMINOPHEN DOSE SUSP **ED ONLY** $ 0.00
3516569 DIPHENHYDRAMINE DOSE SUSP **ED ONLY** $ 0.00
3516570 ADENOSINE IV 1MG X60 J0153 $ 337.00
3516571 ADENOSINE IV 1MG X90 J0153 $ 495.00
3516572 AMINOPHYLLINE IV 250MG X2 J0280 $ 73.00
3516573 AMPICILLIN IV 500MG X2 J0290 $ 51.00
3516574 AMPICILLIN IV 500 X4 J0290 $ 61.00
3516575 AMPICILLIN IV 500MG X1 J0290 $ 53.00
3516576 AMPICILLIN/SULBACTAM 1.5GM X1 J0295 $ 50.00
3516577 AMPCILLIN/SULBACTAM 1.5GM X2 J0295 $ 53.00
3516578 AZITHROMYCIN IV 500MG X1 J0456 $ 53.00
3516579 BUMETANIDE IV 0.5MG X1 S0171 $ 46.00
3516580 CALCIUM GLUC IV 10ML X1 J0610 $ 54.00
3516581 CALCIUM GLUC 10ML X2 J0610 $ 62.00
3516582 CEFAZOLIN IV 500MG X4 J0690 $ 55.00
3516583 CEFEPIME/LIDO IV 500MG X2 J0692 $ 16.00
3516584 CEFEPIME IV 500MG X2 J0692 $ 53.00
3516585 CEFTAZIDIME IV 500MG X1 J0713 $ 50.00
3516586 CEFEPIME IV 500MG X4 J0692 $ 86.00
3516587 CEFTAZIDIME IV 500MG X2 J0713 $ 50.00
3516588 CEFTAZIDIME IV 500MG X4 J0713 $ 56.00
3516589 CEFTRIAXONE/LIDO IV 250MG X4 J0696 $ 9.00
3516590 CEFTRIAXONE IM 250MGX8 J0696 $ 29.00
3516591 CEFTRIAXONE IV 250MG X2 J0696 $ 47.00
3516592 CLINDAMYCIN IV 300MGX4 S0077 $ 53.00
3516593 CLINDAMYCIN IV 300MGX3 S0077 $ 49.00
3516594 CYCLOPHOSPHAMIDE IV 100MGX10 J9070 $ 1,080.00
3516595 DAPTOMYCIN IV 1MGX500 J0878 $ 635.00
3516596 DILTIAZEM IV 125MG $ 57.00
3516597 DEXAMETHASONE IV 1MGX10 J1100 $ 47.00
3516598 DIPHENHYDRAMINE IV 50MGX1 J1200 $ 49.00
3516599 DOBUTAMINE IV 250MGX1 J1250 $ 53.00
3516600 DOCEAXEL IV 1MGX80 J9171 $ 4,655.00
3516601 DOXORUBICIN IV 10MGX5 J9000 $ 3,710.00
3516602 DOXYCYLINE IV 100MG $ 74.00
3516603 ERTAPENEM/LIDO IVP 500MGX2 J1335 $ 144.00
3516604 ERTAPENEM IV 500MGX2 J1335 $ 216.00
3516605 ETOPOSIDE IV 10MGX10 J9181 $ 21.00
3516606 FAMOTIDINE IV 20MGX1 S0028 $ 9.00
3516607 FUROSEMIDE IV DRIP 20MGX5 J1940 $ 51.00
3516608 FUROSEMIDE IV 20MGX5 J1940 $ 48.00
3516609 GENTAMICIN IV 80MGX1 J1580 $ 49.00
3516610 HYDROCORTISONE IV 100MGX1 J1720 $ 57.00
3516611 HYDROCORTISONE IV 100MG 3 x J1720 $ 63.00
3516612 HYDROMORPHONE PCA IV 4MGX10 J1170 $ 31.00
3516613 IMIPENEM/CILASTIN IV 250MGX4 J0743 $ 65.00
3516614 INIPENEM/CILASTIN IV 250MGX2 J0743 $ 85.00
3516615 INFLIXIM IV 10MGX40 J1745 $ 1,515.00
3516616 INFLIXIM IV 10MGX50 J1745 $ 1,515.00
3516617 INSULIN R IV DRIP 5UNITSX20 J1815 $ 8.00
3516618 IRON DEXTRAN IV 50MG X1 (100MG) $ 54.00
3516620 IRON DEXTRAN TEST 25MGX1 J1750 $ 0.00
3516621 IRON SCROSE IV 1MGX100 J1756 $ 105.00
3516622 IRON SUCROSE IV 1MGX150 J1756 $ 195.00
3516623 IRON SUCROSE IV 1MGX200 J1756 $ 195.00
3516624 IRON SUCROSE 1MGX300 J1756 $ 255.00
3516625 MAGNESIUM SULF 500MGX2 J3475 $ 9.00
3516626 MAGNESIUM IV 500MGX4 J3475 $ 11.00
3516627 NEOSTIGMINE MDV DOSE 0.5MG/ML J2710 $ 9.00
3516628 METHYLPRED SUCC IV 125MGX4 J2930 $ 57.00
3516629 MORPHINE IV 10MG X10 J2270 $ 50.50
3516630 MORPHINE PCA 10MG X10 J2270 $ 16.00
3516631 NAFCILLIN IV 2GM S0032 $ 54.00
3516632 NOREPINEPHRINE 4MG/D5W 250ML $ 56.00
3516633 ONDANSETRON IV 1MG X4 J2405 $ 47.00
3516634 OCYTOCIN IV 10U X1 J2590 $ 47.00
3516635 PAMIDRONATE IV 30MG X1 J2430 $ 59.00
3516636 PANTOPRAZOLE 40MG X1 S0164 $ 51.00
3516637 PANTOPRAZOLE 40MG X1 S0164 $ 14.00
3516638 PENICILLIN G IV 2.5MIL.UN X8.4 J2540 $ 52.00
3516639 PENICILLIN G IV 5MIL.U X8.4 J2540 $ 51.50
3516640 PHENYTOIN IV (100-349MG)50MG X1 J1165 $ 8.00
3516641 PHENYTOIN IV (350-699MG) 50MG X1 J1165 $ 8.00
3516642 PHENYTOIN IV(700-1500MG) 50MGX1 J1165 $ 21.00
3516643 PHYTONADIONE IV 1MG X1 J3430 $ 98.00
3516644 RANITIDINE IV 25MG X2 J2780 $ 61.00
3516645 SODIUM BICARB IV 150 MEQ/D5W 1000ML $ 21.00
3516646 TERBUTALINE IV 1MG X20 J3105 $ 37.00
3516647 TIGECYCLINE IV 1MG X50 J3243 $ 218.00
3516648 TOBRAMYCIN IV 80MG X1 J3260 $ 12.00
3516649 VALPROATE NA IV 1000MG/NS 100ML $ 62.00
3516650 VALPROATE NA IV 500MG/ NS 50ML $ 66.00
3516651 NOREPHINEPHRINE 4MG/D5W 1000ML $ 56.00
3516652 NO CHARGE ORDER SET FLLER $ 0.00
3516653 ENOXAPARIN 10MG X12 $ 47.00
3516654 ACYCLOVIR 5MG X 100 $ 68.00
3516655 FERUMOXYTOL 1MG X510 (Q0138) $ 1,503.00
3516656 FERUMOXYTOL IV 1MGX 510 (Q0138) $ 1,503.00
3516657 KETOROLAC CARP 15MG X4 (J1885) $ 11.00
3516658 PHARMACIST CONSULTATION REQUEST $ 0.00
3516659 VISCOUS LIDOCAINE 2% 15ML $ 9.00
3516660 CEFOXITIN IV 1 GM (J0694) $ 53.00
3516661 GENTAMICIN 80MG X2 J1580 $ 11.00
3516662 LEVONORGESTREL TAB 1.5MG X1 $ 62.00
3516663 NALTREXONE 1MG X380 $ 1,930.00
3516664 IRON DEXTRAN 50MG X24 (J1750) $ 363.00
3516665 TRANEXAMIC ACID 1000MG IV (J3490) $ 102.00
3516666 GENTAMICIN 80MG X3 (J1580) $ 57.00
3516667 SODIUM CL SYRN 0.9% 10 ML $ 8.00
3516668 GENTAMICIN IV MOD 80MGX 5 J1580 $ 35.00
3516669 GENTAMICIN IV MOD 80MG X6 J1580 $ 40.00
3516670 CEFAZOLIN IV MOD 500MG X6 IV J0690 $ 50.00
3516671 HYDROCOD/APAP SUSP DOSE 5/325MG-10ML $ 8.00
3516672 PAMIDRONATE IV-MOD 30MG X1 (J2430) $ 32.00
3516673 FOSFOMYCIN TROMETHAMINE PK 3 GM $ 293.00
3516674 THIAMINE/MULTI VITAMIN/NS 1000ML IV MOD $ 56.00
3516675 IMUN GLOB 10% 500MG X80G $ 5,175.00
3516676 RIFAMPIN CAP 300 MG $ 10.00
3516677 ACYCLOVIR 5MG X200 (1000MG) $ 91.00
3516678 IRON DEXTRAN 50MG X2 $ 76.00
3516679 CLINIMIX E 4.25 AMINO/5% DEXTROSE $ 113.00
3516680 CLINIMIX E WITH MULTIVITS $ 113.00
3516681 GENTAMICIN 80MG X2 J1580 $ 8.00
3516682 GENTAMICIN 80MG X2 J1580 $ 53.00
3516683 GENTAMYCIN 80MG X2 J1580 $ 11.00
3516684 VANCOMYCIN ORAL LIQUID 125MG $ 4.00
3516685 PHENYTOIN 50MG X J1165 x 16 (800MG) $ 15.00
3516686 IRON DEXTRAN 50MG (J1750) X24 1155MG $ 450.00
3516687 FOSPHENYTOIN 500MG INJECTION $ 195.00
3516688 DENOSUMAB 1MG (J0897) x 60 $ 1,755.00
3516689 FONDAPARINUX 0.5MG (J1652) X 5 $ 103.00
3516690 PIPRCL/TAZ 1.125GM (J2543) X2 $ 32.00
3516691 LIDOCAINE 1% 2ML VIAL $ 0.00
3516692 INFLUENZA - FLUZONE VACCINE 0.5ML $ 30.00
3516693 ONABOTULINUMTOXINA(BOTOX)1 UNIT X200 $ 1,845.00
3516696 MEROPENEM 1 GM J2185 100MG X10 $ 80.00
3516697 MEGESTROL ACE ORAL SUSP 40MG/ML $ 219.00
3516698 LEVOFLOXACIN 250MG J1956 X1 $ 51.00
3516699 CAPSAICIN CREAM 0.025 $ 15.00
3516700 RISPERDAL CONSTA 0.5MG X50 $ 535.00
3516701 ACETYLCYSTEINE J0132 100MG X 60 $ 310.00
3516702 ACETYLCYSTEINE 12000MG J3490 $ 555.00
3516703 ACETYLCYSTEINE 6000MG J3490 $ 301.00
3516704 ACETYLCYSTEINE 100MG X97.5 J0132 $ 485.00
3516705 GABAPENTIN 600MG COMP SOLN $ 11.00
3516706 RISPERIDONE 2 MG COMP SOLN $ 20.00
3516707 RISPERDAL CONSTA J2794 $ 1,070.00
3516708 1/2 NS 1000 W/SOD BICARB 8.4% 50 MEQ $ 20.00
3516709 FLUCONAZOLE TAB (100MG) $ 17.00
3516710 CIPROFLOXACIN 0.3% OPHTH SOLN $ 73.00
3516711 PANTOPRAZOLE DRIP (80MG) $ 57.00
3516712 BENZOCAINE ORAL ANESTHETIC (20%) $ 31.00
3516713 CEFAZOLIN IV 500MG X1 J0690 $ 47.00
3516714 INSULIN NOVOLOG 5 UNITS X1 J1815 $ 9.00
3516715 MIDAZOLAM COMPOUNND ORAL DOSE $ 9.00
3516716 MICRONIZED COLESTIPOL HCL $ 9.00
3516717 GENTAMICIN IV 80MG x4 J1580 $ 61.00
3516718 ACETYLCYSTEINE 100MGX 72.27 J0132 $ 336.00
3516719 SODIUM CL NEB (3% - 4 ML) $ 8.00
3516720 EPOETIN ALFA 1000 UNIT X20 $ 690.00
3516721 MUSCLE RUB $ 10.00
3516722 DAPTOMYCIN 1 MG X475 (J0878) $ 590.00
3516723 RIVAROXABAN TAB 10MG $ 25.00
3516724 CEFOXITIN IV 1 GM (J0694) (X2) $ 60.00
3516725 FLUCONAZOLE IV 200MG X2 J1450 $ 42.00
3516726 CLINIMIX E W MULTIVITAMINS $ 83.00
3516727 CLINIMIX E W MINERALS $ 83.00
3516728 TROSPIUM ER 60MG CAP $ 15.00
3516729 CLOVE OIL 1ML $ 0.00
3516730 LUGOLS SOLUTION 5% $ 53.00
3516731 TETRACAINE OPHTH DROP 5% $ 0.00
3516732 SIMETHICONE 40MG/0.6ML DROPS $ 8.00
3516733 PRAZOSIN 1 MG CAPSULE $ 8.00
3516734 FLUCONAZOLE IV 200MGX1 J1450 $ 53.00
3516735 CEFTRIAXONE IV TEST DOSE (100 MG) $ 60.00
3516736 GAMUNEX-C 500MG X190 J1561 $ 12,147.00
3516737 METHIMAZOLE 5MG TAB $ 8.00
3516738 MEROPENEM 500mg J2185 100MG X5 $ 80.00
3516739 CHLORHEXIDINE 0.12% SOLUTION $ 20.00
3516740 SLOW-MAG 71.5-119 TABLET $ 8.00
3516741 CEFTRIAXONE 250MG X8 (J0696) $ 49.00
3516742 CEFTRIAXONE IV 250 MG X4 (J0696) $ 47.00
3516743 RITUXIMAB IV 10MG X100 (J9312) $ 13,279.00
3516744 NAPROXEN TAB (250MG) $ 8.00
3516745 SILDENAFIL TAB (20MG) $ 36.00
3516746 KCENTRA 10U X50 J2724 $ 1,670.00
3516747 LANREOTIDE SYR1 MG X120 J1930 $ 7,795.00
3516748 ADVAIR DISKUS 500-50MCG/INH $ 590.00
3516749 PROTAMINE SULFATE J2720 10MG X1 $ 27.00
3516750 MESALAMINE CAP 0.375 GM $ 12.00
3516751 MERCAPTOPURINE TAB 50MG $ 17.00
3516752 BACTERIOSTATIC 0.9% SOLN $ 0.00
3516753 PHOSPHA 250MG TAB $ 8.00
3516754 VANCOMYCIN 500MG IV MOD J3370 $ 53.00
3516755 TEMAZEPAM 7.5 MG CAPSULE $ 16.00
3516756 CLINIMIX E 4.25%/5% 1000 ML $ 80.00
3516757 LACOAMIDE 100 MG TABLET $ 21.00
3516758 LIDOCAINE 5% OINTMENT $ 288.00
3516760 ALBUMIN 25% 20 ML X5 (P9046) $ 148.00
3516761 ALBUMIN 25% 20MLX2 (P0946) $ 151.00
3516762 FILGRASTIM 1MCG X100 J1442 $ 505.00
3516764 FEBXOSTAT 80 MG TABLET $ 22.00
3516765 ORAGEL 20% 11.9 GM $ 14.00
3516766 VANCOMYCIN 500MG X6 J3370 $ 115.00
3516767 RITUXAN 100MG X5 J9310 $ 6,581.00
3516768 CEPASTAT LOZENGE $ 8.00
3516769 OSELTAMIVIR ORAL SUSP 6 MG/ML-60 ML $ 258.00
3516770 VITAMIN K CAPSULE 1000MCG $ 7.00
3516771 OSELTAMIVIR 30MG CAPSULE $ 24.00
3516772 HYDROXOCOBALAMIN 5 GM /NS 200 ML $ 1,190.00
3516773 OCTREOTIDE ACETATE INJ 25 MCGX2 J2354 $ 31.00
3516774 DIGIFAB VIAL 40MGX1 J1162 $ 5,160.00
3516775 METHYLENE BLUE INJ 0.5% $ 299.00
3516776 OCTREOTIDE ACETATE INJ 25MCG X4 J2354 $ 37.00
3516777 OCTREOTIDE ACETATE INJ 25MCG X20 J2354 $ 67.00
3516778 GENTAMICIN SDV 80MG X1 J1580 $ 29.00
3516779 BUMETANIDE 2MG IV-MOD X4 S0171 $ 51.00
3516780 DEFEROXAMINE 500MG X2 IV J0895 $ 68.00
3516781 AMIODARONE IV 150MG X5 J0282 $ 46.00
3516782 AMIODARONE IV-MOD30 MG X30 J0282 $ 50.00
3516783 FOSPHENYTOIN IV 50MG X20 Q2009 $ 314.00
3516784 ACTIVATED CHARCOAL W/O SORB SUSP 25 GM $ 32.00
3516785 EPINEPHRINE IV 0.1 MG X20 J0171 $ 51.00
3516786 EPINEPHRINE IV 0.1 MG X10 J0171 $ 48.00
3516787 DAPTOMYCIN IV1 MG X550 J0878 $ 1,410.00
3516788 LAMIVUDINE 150MG TABLET $ 16.00
3516789 ACETYLCSTEINE IV 100MG X60 JJ0132 $ 310.00
3516790 ACETYLCSTEINE IV 100MG X40 J0132 $ 232.00
3516791 ACETYLCYSTEINE IV 100MG X120 J0132 $ 570.00
3516792 NITROGLYCERIN PATCH REMOVAL $ 0.00
3516793 MORPHINE SULFATE ER 10 MG CAPSULE $ 12.00
3516794 TRIAMCINOLONE 10MG X4 J3301-OR $ 0.00
3516795 DEXAMETHASONE OPHTH DROP 0.1%- OR $ 0.00
3516796 PREDNISOLONE OPHTH 1%- OR $ 0.00
3516797 PROPARACAINE OPHTH 0.5% DROP- OR $ 0.00
3516798 VISION BLUE 0.06% OPHTH SOLN- OR $ 0.00
3516799 MOXIFLOXACIN OPHTH DROP 0.5%- OR $ 0.00
3516800 DICLOFENAC OPHTH SOLN 0.1%- OR $ 0.00
3516801 PHENYLEPHRINE OPHTH SOLN 2.5% $ 0.00
3516802 BACITRACIN OPHTH OINT $ 0.00
3516803 BRILINTA TABLET 90MG $ 15.00
3516804 ZOSYN 1.125 GM X4 J2543 $ 61.00
3516805 POTASSIUM CL VL 2 mEqX5 J3480 $ 46.00
3516806 ZOLENDRONIC ACID 1MG X4 J3489 $ 292.00
3516807 LITHIUM CAPSULE (300 MG) $ 8.00
3516808 THIAMINE IV 100MG X1 J3411 $ 58.00
3516809 PHENYLEPHRINE IV-DRIP 1MLX1 J2370 $ 53.00
3516810 0.9% SODIUM CHLORIDE 250 ML $ 0.00
3516811 0.9% SODIUM CHLORIDE 100 ML $ 0.00
3516812 ONABOUTULINUMTOXINA(BOTOX) 1 UNIT X100 $ 925.00
3516813 CIPRODEX OTIC SUSP 7.5 ML $ 316.00
3516814 GENTAMICIN IV 80MG X6 $ 53.00
3516815 OCTREOTIDE IV 25MCG J2354 25 X10 $ 87.00
3516816 TRANEAMIC ACID 1% J3490 X1 $ 63.00
3516817 DAPTOMYCIN IV 1MG X680 J0878 $ 1,410.00
3516818 TRANEXAMIC ACID ADMIN J3490X1 $ 63.00
3516819 TRANEXAMIC ACID 5% J3490 X 1 $ 63.00
3516820 M.V.I 12 INFVITE INJ 10ML J3490 $ 38.00
3516821 LITHIUM CARBONATE CAPSULE 150MG $ 8.00
3516822 FENOFIBRATE TABLET 160 MG X1 $ 10.00
3516823 KETOROLAC TROMETHAMINE 0.5% OPHTH DROPS $ 49.00
3516824 DEPO LEPRON 3.75MG X3 J1950 $ 5,370.00
3516825 LIOTHYRONINE SODIUM TABLET 5 MCG $ 8.00
3516826 CINACALCET HCL TABLET 1MG X30 J0604 $ 58.00
3516827 RYANODEX BOLUS INJ 250MG $ 3,911.00
3516828 NEO/POLY/BAC/HC OPHTH OINT 3.5GM $ 111.00
3516829 DIAZEPAM DOSE 5MG X1 J3360 $ 23.00
3516830 POTASSIUM CHLORIDE 2 MEQX20 J3480 $ 47.00
3516831 NALOXONE IV DRIP 1MG X4 $ 218.00
3516832 NICOTINE GUM 2MG $ 8.00
3516833 NITHIODOTE KIT J3490 X1 $ 309.00
3516834 SUMATRIPTAN TABLET 25MG $ 53.00
3516835 FERRIC CARBOXYMALTOSE IV 1MGX750 J1439 $ 1,750.00
3516836 PERFLUTREN LIPID MIRCOSPHERE (6.52MG/ML) $ 250.00
3516837 METHOTREXATE SODIUM 50MG/2ML VIAL $ 43.00
3516838 SOD BICARB-CIT AC-SIM PK 4GM $ 27.00
3516839 CETIRIZINE SYRUP DOSE 10 ML $ 11.00
3516840 MYRBETRIQ TABLET X1 $ 9.00
3516841 CALCITONIN SALMON NASAL SPRAY 3.7ML $ 193.00
3516842 APIXABAN TABLET 2.5MG X1 $ 16.00
3516843 VERAPAMIL TABLET 80MG $ 8.00
3516844 DEXAMETHASONE ORAL DOSE 10MG X1 $ 10.00
3516845 ACETYLCYSTEINE IV 100MGX 44 J0132 $ 248.00
3516846 ACETYLCYSTEINE IV 100MG X130 $ 614.00
3516847 TRANEXAMIC ACID 10 ML TOPICAL $ 63.00
3516848 HALOPERIDOL ORAL CONCENTRATE 2MG/ML $ 52.00
3516849 PHENOBARBITAL 100MG TABLET $ 8.00
3516850 ZOLEDRONIC ACID IV MOD 1MGX4 J3489 $ 292.00
3516851 GENTAMICIN IV 80MGX2 J1580 $ 53.00
3516852 DEXAMETHASONE ORAL DOSE 4MGX1 $ 10.00
3516853 DAPTOMYCIN IV 1MGX525 $ 1,410.00
3516854 SIROLIMUS 1 MG (J7520) $ 32.00
3516855 MYCOPHENOLATE MOFETIL 500 MG (J7517) $ 16.00
3516856 LIDOCAINE IV DRIP J2001 10MGX100 $ 52.00
3516857 MOXIFLOXACIN OPHTH INJ 5MG/ML $ 40.00
3519999 pre-effective date drug $ 0.00
906801 Rotari oral Susp (1 ml) x 1 $ 203.00
99999 Clinic No Charge $ 0.00
$ 0.00
$ 0.00
999991 Acetaminophen 120mg Rectal Suppository $ 0.00
9999910 Benzoin Compound Tincture $ 0.00
9999911 Flourescein Sodium 1mg strip $ 0.00
9999912 Benzocain/tetracain/butaben spray $ 0.00
9999914 Clonazepam 0.5mg Tablet $ 0.00
9999915 Diazepam 5mg tablet $ 0.00
9999916 Diphenydramine 25mg capsule $ 0.00
9999917 Ear Wax Removal Drops $ 0.00
9999918 Acarbose 10mg tablet $ 0.00
9999919 Eye irrigation solution $ 0.00
999992 Acetaminophen 325mg Suppository $ 0.00
9999920 Gentamicin Ophthalmic Ointment 0.3% $ 0.00
9999921 Ibuprofen 200mg tablet $ 0.00
9999922 Homatropine 2% ophthalmic drop $ 0.00
9999923 Lidocain 1% MDV $ 0.00
9999924 Lidocain 2% MDV $ 0.00
9999925 Lidocaine 2% Jelly $ 0.00
9999926 Lidocaine 2% Viscous $ 0.00
9999927 Lidocaine 4% cream $ 0.00
9999928 Acetaminophen 160mg/5ml $ 0.00
9999929 Acetaminophen 80mg chew $ 0.00
999993 Activated Charcoal liquid 25GM $ 0.00
9999930 Acetaminophen 500mg tablet $ 0.00
9999931 Meclizine 25mg tablet $ 0.00
9999932 Ferric Subsulfate Solution $ 0.00
9999933 Nitroglycerin 0.4mg sublingual tab $ 0.00
9999934 Podocon 25% Solution $ 0.00
9999935 Prednisolone 1% Ophthalmic Drop $ 0.00
9999936 Prochlorperazine 5mg tablet $ 0.00
9999937 Proparacaine 0.5% opthalmic drops $ 0.00
9999938 Propranolol 20mg tablet $ 0.00
9999939 Diphenhydramine 12.5mg/5ml liquid $ 0.00
9999940 Silver Nitrate Stick $ 0.00
9999941 Silver Sulfadaine 1% Cream $ 0.00
9999942 Sodium Chloride 0.9% Nebulizer Solution $ 0.00
9999943 LUGOLS 5% SOLUTION $ 0.00
9999944 MAG/ALU/SIMETH 200/200/20 - 30ML $ 0.00
9999945 HYDROXYZINE PAMOATE 25MG CAP $ 0.00
9999946 OMEPRAZOLE 20MG CAP $ 0.00
9999948 Tramadol 50mg oral tablet $ 0.00
9999949 Prednisolone 5mg/5ml - 30ml $ 0.00
999995 Calcium Antacid Chew 500mg $ 0.00
9999950 Lorazepam 1mg tablet $ 0.00
9999951 LIDOCAINE OINTMENT DOSE (5%) $ 0.00
9999952 MENTHOL SPRAY 10%-118ML $ 0.00
9999953 LUBIPROSTONE CAPULE 24 MCG $ 0.00
9999954 MAGNESIUM CITRATE SOLN 300ML $ 0.00
9999957 EXCEDRIN 250-250-65 MG $ 0.00
9999958 RACEPINEPHRINE NEB 2.25%- 0.5ML $ 0.00
999996 Auralgan Ear Drop $ 0.00
9999962 TROPICAMIDE OPHTH DROP 0.5% $ 0.00
9999963 PHENYLEPHRINE OPHTH DROP 2.5% $ 0.00
9999964 LIDO/PRILOCAINE CREAM 2.5%- 5 GM $ 0.00
999997 Asprin 81mg chew tab $ 0.00
999998 Asprin 325mg EC $ 0.00
999999 Bacitracin 500U/GM Packet $ 0.00
99999913 Ibuprofen 100mg/5ml Suspension $ 0.00
GENCONV General Conversion $ 0.00
J0561 RX PENICILLIN G LA SRN 100000UX12 $ 17.50
J0690 RX CEFAZOLIN PREMIX (J0690) 500MGX2 IV $ 25.50
J0690 RX1 CEFAZOLIN PREMIX IV (J0690) 500MG X4 $ 13.50
J0696 RX CEFTRIAXONE PREMIX (J0696) IV 250MG X4 $ 14.75
J0696 RX1 CEFTRIAXONE PREMIX (J0696) IV 250MG X8 $ 8.50
J06963 CEFTRIAONE 250MG X4 (J0696) $ 9.00
J06964 CEFTRIAXONE 250MG X8 (J0696) $ 11.00
J1642 RX HEPARIN FLUSH (J1642) 10 UNT X50 $ 0.22
J1644 RX HEPARIN SYRINGE (J1644) 1000 UNIT X5 $ 5.80
J1644 RX1 HEPARIN IV DRIP (J1644) 1000 UNT X25 $ 2.24
J16501 ENOXAPARIN 10MG X4 INJ (J1650) $ 58.00
J16502 ENOXAPARIN 10MG X6 INJ (J1650) $ 74.00
J16503 ENOXAPARIN 10MG X8 INJ (J1650) $ 111.00
J1815 RX INSULIN 5 UNITS INJ (J1815) LEVEMIR PEN $ 2.25
J1815 RX1 INSULIN 5 UNITS INJ (J1815) NOVOLOG $ 2.35
$ 2.35
J1815 RX2 INSULIN 5 UNITS PGBK (J1815) $ 2.00
J1815 RX3 INSULIN 5 UNITS INJ (J1815) LISPRO PEN $ 2.60
J18151 LEVEMIR FLEXPEN 5 UNITS X60 (J1815) $ 0.00
J18152 INSULIN REGULAR DOSE 5 UNIT (J1815) $ 8.00
J1885 RX KETOROLAC SDV (J1885) 15MG X2 $ 13.50
J1885 RX1 KETOROLAC SDV (J1885) 15MG X4 $ 6.75
J18852 KETOROLAC 15MG X2 (J1885) $ 9.00
J18853 KETOROLAC 15MG X4 (J1885) $ 10.00
J1940 RX FUROSEMIDE SDV(J1940) 20MG X2 $ 14.50
J19401 FUROSEMIDE 20 MG X2 IV (J1940) $ 14.50
J1956 RX LEVOFLOXACIN PREMIX (J1956) 250MGX2 $ 29.50
J1956 RX1 LEVOFLOXACIN PREMIX (J1956) 250MGX3 $ 18.00
J22702 MORPHINE 4MG X1 INJ (J2270) $ 28.00
J22703 MORPHINE 10 MG X1 INJ (J2270) $ 28.00
J23002 NALBUPHINE 10MG X1 (J2300) $ 29.00
J2354 RX OCTREOTIDE VL (J2354) 25MCGX2 $ 15.50
J2354 RX1 OCTREOTIDE VL (J2354) 25MCGX20 $ 3.35
J2354 RX2 OCTREOTIDE VL (J2354) 25MCGX4 $ 9.25
J2405 RX ONDANSETRON SDV (J2405) 1MG X4 $ 6.25
J2543 RX PIPERACILLIN/TAZOBAT SDV(J2543)1.125GMX3 $ 22.00
J2543 RX1 PIPERACILLIN/TAZOBAC SDV(J2543)1.125GMX4 $ 15.25
J2597 RX DESMOPRESSION 1MG J2597 $ 500.00
J2765 METOCLOPRAMIDE 10MG X1 J2765 $ 27.00
J3430 RX1 PHYTONADIONE AMP (J3430) 1MG X10 $ 9.80
J3480 RX POTASSIUM CHLORIDE PREMIX(J3480) 2MEQ X5 $ 9.80
J3480 RX1 POTASSIUM CHLORIDE SDV(J3480) 2MEQ X10 $ 4.60
J3480 RX2 POTASSIUM CHLORIDE SDV(J3480) 2MEQX20 $ 2.35
J3490 LEVENORGESTREL IUD (19.5 MG) J3490 $ 1,495.00
J7187 RX HUMATE-P 1 UNIT J7187 $ 1.33
J7187 RX1 HUMATE-P UNIT J7187 $ 1.00
J7296 LEVONORGETREL IUD (19.5MG/24HR) KYLEENA $ 1,430.00
J7326 GEL-ONE INJECTION J7326 X1 $ 1,720.00
J7509 RX METHYPREDNISOLONE 4MG TAB J7509 DOSE PAK $ 2.00
J7512 RX PREDNISONE TABLET (J7512) 1MG X10 $ 0.80
J7512 RX2 PREDNISONE TABLET (J7512) 1MG X20 $ 0.40
J7512 RX3 PREDNISONE TABLET (J7512) 1MG X5 $ 1.60
J7620 IPRATROPIUM/ALBUTEROL (J7620) $ 22.65
J76201 IPRA/ALBU 2.5-0.5MG NEB X1 (J7620) $ 10.00
Q9984 KYLEENA IUD $ 1,430.00
VFC VACCINES FOR CHILDREN $ 20.83
VFC1 Tdap age 7-18 SDV (0.5ML) 90715 $ 20.83
VFC10 INFLUENZA QUAD VACCINE IM (0.25ML) 90685 $ 20.83
VFC11 INFLUENZA QUAD VACCINE IM (0.5ML) 90686 $ 20.83
VFC12 MEASLES/MUMPS/RUBELLA VACCINE MDV 90707 $ 20.83
VFC13 MENINGOCOCCAL VACCINE SDV (4 MCG/0.5 ML $ 20.83
VFC14 PNEUMOC-13 VACCINE VL (0.5 ML) 90670 $ 20.83
VFC15 POLIO VACCINE MDV (0.5 ML/DOSE) 90713 $ 20.83
VFC16 ROTAVIRUS VACCINE ORAL SUSP (1 ML) 90681 $ 20.83
VFC17 VARICELLA VACCINE [CHICKEN POX] VIAL (0. $ 20.83
VFC18 HUMAN PAPIL VIRUS CERVARIX $ 20.83
VFC19 HPV SD (0.5ml) $ 20.83
VFC2 Tdap age 7-18 Syr (0.5ML) 90715 $ 20.83
VFC3 DIP/TET/AP VACCINE SDV (0.5ML) 90700 $ 20.83
VFC4 DIP/TET/AP/POLIO VACCINE SDV (0.5ML) $ 20.83
VFC5 DTAP/HEPB/POLIO PREFILL SYRN VACCINE (0 $ 20.83
VFC6 HAEMOPH B VACCINE (0.5ML) 90647 $ 20.83
VFC7 HEPATITIS A SYRINGE (720U/0.5ML) 90633 $ 20.83
VFC8 HEPATITIS B SDV VACCINE (10MCG/0.5ML) $ 20.83
VFC9 HUMAN PAPILLOMAVIRUSVACCINE SDV (0.5ML) $ 20.83
3700001 PT CONTRACT PRE-EMP EVAL $ 22.00
3700003 PT RE-EVALUATION $ 258.00
3700005 PT CCC SCREEN $ 0.00
3700008 PT EVAL LOW COMPLEXITY $ 257.00
3700009 PT EVAL MOD COMPLEXITY $ 282.00
3700010 PT EVAL HIGH COMPLEXITY $ 306.00
3700011 PT RE-EVALUATION $ 175.00
3700014 PT THER EXERCISE 15 $ 211.00
3700024 PT GAIT TRAINING 15 $ 86.00
3700025 PT THER ACTIVITY 15 $ 224.00
3700026 PT AQUA THERAPY 15 $ 222.00
3700027 PT GAIT TRAINING 15" 59 $ 86.00
3700028 PT THER ACTIVITY 15 59 $ 224.00
3700072 PT ULTRASOUND 15 $ 211.00
3700085 PT IONTOPHORESIS 15 $ 250.00
3700090 PT NEG PRES <50 $ 187.00
3700096 PT MASSAGE $ 194.00
3700097 PT PARAFFIN BATH $ 0.00
3700144 PT MECHANICAL TRACTION $ 224.00
3700145 PT CANALITH REPOSITIONING PROCEDURE/DAY $ 124.00
3700193 PT E-STIM ATTENDED 15 $ 135.00
3700228 PT HOME INSTRUCT 15 $ 224.00
3700252 PT E-STIM MANUAL UNATTENDED $ 292.00
3700253 PT E-STIM UNATTENDED $ 292.00
3700255 PT E-STIM WOUND MANUAL $ 292.00
3700276 PT FIT MEASURE 15 $ 88.00
3700300 PT EQUIPMENT ADJ/REPAIR 15 $ 21.00
3700416 PT DEBRIDE > 20CM ADD GP $ 316.00
3700417 PT DEBRIDE <= 20CM $ 178.00
3700421 PT MANUAL THERAPY 15 $ 220.00
3700422 PT PHONOPHORESIS $ 211.00
3700429 PT NEURO RE-EDUCATION 15 $ 201.00
3700431 PT MANUAL THERAPY 15 59 $ 220.00
3700505 PT HOUR CONSULT SIREN SCHOOL $ 128.00
3700516 PT CONTRACT HEARTS OF GOLD 15" $ 19.00
3700517 PT CON GOOD SAM HC /VISIT PT $ 81.00
3700518 PT CON GOOD SAM HC /VISIT PTA $ 81.00
3700519 PT CONTRACT BIRTH-3 YO $ 124.00
3700520 PT CONTRACT NORTHERN BRIDGES $ 186.00
3700700 PT CROSSBOW EVAL $ 69.00
3705001 LUMBAR/SACRAL ORTHOSIS SUMMIT 631 $ 421.00
3709019 PT MOBILITY CURRENT G8978CH $ 0.00
3709020 PT MOBILITY CURRENT G8978CI $ 0.00
3709021 PT MOBILITY CURRENT G8978CJ $ 0.00
3709022 PT MOBILITY CURRENT G8978CK $ 0.00
3709023 PT MOBILITY CURRENT G8978CL $ 0.00
3709024 PT MOBILITY CURRENT G8978CM $ 0.00
3709025 PT MOBILITY CURRENT G8978CN $ 0.00
3709026 PT MOBILITY GOAL G8979CH $ 0.00
3709027 PT MOBILITY GOAL G8979CI $ 0.00
3709028 PT MOBILITY GOAL G8979CJ $ 0.00
3709029 PT MOBILITY GOAL G8979CK $ 0.00
3709030 PT MOBILITY GOAL G8979CL $ 0.00
3709031 PT MOBILITY GOAL G8979CM $ 0.00
3709032 PT MOBILITY GOAL G8979CN $ 0.00
3709033 PT MOBILITY D/C G8980CH $ 0.00
3709034 PT MOBILITY D/C G8980CI $ 0.00
3709035 PT MOBILITY D/C G8980CJ $ 0.00
3709036 PT MOBILITY D/C G8980CK $ 0.00
3709037 PT MOBILITY D/C G8980CL $ 0.00
3709038 PT MOBILITY D/C G8980CM $ 0.00
3709039 PT MOBILITY D/C G8980CN $ 0.00
3709040 PT BODY POSITION CURRENT G8981CH $ 0.00
3709041 PT BODY POSITION CURRENT G8981CI $ 0.00
3709042 PT BODY POSITION CURRENT G8981CJ $ 0.00
3709043 PT BODY POSITION CURRENT G8981CK $ 0.00
3709044 PT BODY POSITION CURRENT G8981CL $ 0.00
3709045 PT BODY POSITION CURRENT G8981CM $ 0.00
3709046 PT BODY POSITION CURRENT G8981CN $ 0.00
3709047 PT BODY POSITION GOAL G8982CH $ 0.00
3709048 PT BODY POSITION GOAL G8982CI $ 0.00
3709049 PT BODY POSITION GOAL G8982CJ $ 0.00
3709050 PT BODY POSITION GOAL G8982CK $ 0.00
3709051 PT BODY POSITION GOAL G8982CL $ 0.00
3709052 PT BODY POSITION GOAL G8982CM $ 0.00
3709053 PT BODY POSITION GOAL G8982CN $ 0.00
3709054 PT BODY POSITION D/C G8983CH $ 0.00
3709055 PT BODY POSITION D/C G8983CI $ 0.00
3709056 PT BODY POSITION D/C G8983CJ $ 0.00
3709057 PT BODY POSITION D/C G8983CK $ 0.00
3709058 PT BODY POSITION D/C G8983CL $ 0.00
3709059 PT BODY POSITION D/C G8983CM $ 0.00
3709060 PT BODY POSITION D/C G8983CN $ 0.00
3709061 PT CARRYING CURRENT G8984CH $ 0.00
3709062 PT CARRYING CURRENT G8984CI $ 0.00
3709063 PT CARRYING CURRENT G8984CJ $ 0.00
3709064 PT CARRYING CURRENT G8984CK $ 0.00
3709065 PT CARRYING CURRENT G8984CL $ 0.00
3709066 PT CARRYING CURRENT G8984CM $ 0.00
3709067 PT CARRYING CURRENT G8984CN $ 0.00
3709068 PT CARRYING GOAL G8985CH $ 0.00
3709069 PT CARRYING GOAL G8985CI $ 0.00
3709070 PT CARRYING GOAL G8985CJ $ 0.00
3709071 PT CARRYING GOAL G8985CK $ 0.00
3709072 PT CARRYING GOAL G8985CL $ 0.00
3709073 PT CARRYING GOAL G8985CM $ 0.00
3709074 PT CARRYING GOAL G8985CN $ 0.00
3709075 PT CARRYING D/C G8986CH $ 0.00
3709076 PT CARRYING D/C G8986CI $ 0.00
3709077 PT CARRYING D/C G8986CJ $ 0.00
3709078 PT CARRYING D/C G8986CK $ 0.00
3709079 PT CARRYING D/C G8986CL $ 0.00
3709080 PT CARRYING D/C G8986CM $ 0.00
3709081 PT CARRYING D/C G8986CN $ 0.00
3709082 PT SELF CARE CURRENT G8987CH $ 0.00
3709083 PT SELF CARE CURRENT G8987CI $ 0.00
3709084 PT SELF CARE CURRENT G8987CJ $ 0.00
3709085 PT SELF CARE CURRENT G8987CK $ 0.00
3709086 PT SELF CARE CURRENT G8987CL $ 0.00
3709087 PT SELF CARE CURRENT G8987CM $ 0.00
3709088 PT SELF CARE CURRENT G8987CN $ 0.00
3709089 PT SELF CARE GOAL G8988CH $ 0.00
3709090 PT SELF CARE GOAL G8988CI $ 0.00
3709091 PT SELF CARE GOAL G8988CJ $ 0.00
3709092 PT SELF CARE GOAL G8988CK $ 0.00
3709093 PT SELF CARE GOAL G8988CL $ 0.00
3709094 PT SELF CARE GOAL G8988CM $ 0.00
3709095 PT SELF CARE GOAL G8988CN $ 0.00
3709096 PT SELF CARE D/C G8989CH $ 0.00
3709097 PT SELF CARE D/C G8989CI $ 0.00
3709098 PT SELF CARE D/C G8989CJ $ 0.00
3709099 PT SELF CARE D/C G8989CK $ 0.00
3709100 PT SELF CARE D/C G8989CM $ 0.00
3709101 PT SELF CARE D/C G8989CN $ 0.00
3709102 PT OTHER PRIMARY CURRENT G8990CH $ 0.00
3709103 PT OTHER PRIMARY CURRENT G8990CI $ 0.00
3709104 PT OTHER PRIMARY CURRENT G8990CJ $ 0.00
3709105 PT OTHER PRIMARY CURRENT G8990CK $ 0.00
3709106 PT OTHER PRIMARY CURRENT G8990CL $ 0.00
3709107 PT OTHER PRIMARY CURRENT G8990CM $ 0.00
3709108 PT OTHER PRIMARY CURRENT G8990CN $ 0.00
3709109 PT OTHER PRIMARY GOAL G8991CH $ 0.00
3709110 PT OTHER PRIMARY GOAL G8991CI $ 0.00
3709111 PT OTHER PRIMARY GOAL G8991CJ $ 0.00
3709112 PT OTHER PRIMARY GOAL G8991CK $ 0.00
3709113 PT OTHER PRIMARY GOAL G8991CL $ 0.00
3709114 PT OTHER PRIMARY GOAL G8991CM $ 0.00
3709115 PT OTHER PRIMARY GOAL G8991CN $ 0.00
3709116 PT OTHER PRIMARY D/C G8992CH $ 0.00
3709117 PT OTHER PRIMARY D/C G8992CI $ 0.00
3709118 PT OTHER PRIMARY D/C G8992CJ $ 0.00
3709119 PT OTHER PRIMARY D/C G8992CK $ 0.00
3709120 PT OTHER PRIMARY D/C G8992CL $ 0.00
3709121 PT OTHER PRIMARY D/C G8992CM $ 0.00
3709122 PT OTHER PRIMARY D/C G8992CN $ 0.00
3709123 PT OTHER SUBSEQUE CURRENT G8993CH $ 0.00
3709124 PT OTHER SUBSEQUE CURRENT G8993CI $ 0.00
3709125 PT OTHER SUBSEQUE CURRENT G8993CJ $ 0.00
3709126 PT OTHER SUBSEQUE CURRENT G8993CK $ 0.00
3709127 PT OTHER SUBSEQUE CURRENT G8993CL $ 0.00
3709128 PT OTHER SUBSEQUE CURRENT G8993CM $ 0.00
3709129 PT OTHER SUBSEQUE CURRENT G8993CN $ 0.00
3709130 PT OTHER SUBSEQUE GOAL G8994CH $ 0.00
3709131 PT OTHER SUBSEQUE GOAL G8994CI $ 0.00
3709132 PT OTHER SUBSEQUE GOAL G8994CJ $ 0.00
3709133 PT OTHER SUBSEQUE GOAL G8994CK $ 0.00
3709134 PT OTHER SUBSEQUE GOAL G8994CL $ 0.00
3709135 PT OTHER SUBSEQUE GOAL G8994CM $ 0.00
3709136 PT OTHER SUBSEQUE GOAL G8994CN $ 0.00
3709137 PT OTHER SUBSEQUE D/C G8995CH $ 0.00
3709138 PT OTHER SUBSEQUE D/C G8995CI $ 0.00
3709139 PT OTHER SUBSEQUE D/C G8995CJ $ 0.00
3709140 PT OTHER SUBSEQUE D/C G8995CK $ 0.00
3709141 PT OTHER SUBSEQUE D/C G8995CL $ 0.00
3709142 PT OTHER SUBSEQUENT D/C G8995CM $ 0.00
3709143 PT OTHER SUBSEQUENT D/C G8995CN $ 0.00
3709144 PT SELF CARE D/C G8989CL $ 0.00
3709999 MISC $ 0.00
327219 XR DIGITAL BREAST TOMOSYNTHESIS UNILAT $ 121.00
3320001 XR FINGER 2 V RT $ 709.00
3320002 XR FINGER 2 V LT $ 709.00
3320005 XR HAND 2 V RT $ 510.00
3320006 XR HAND 2 V LT $ 510.00
3320011 XR HAND OBLIQUE 3 V RT $ 637.00
3320016 XR FOREARM 2 V RT $ 521.00
3320017 XR FOREARM 2 V LT $ 521.00
3320026 XR WRIST 2 V RT $ 611.00
3320029 XR C-ARM 0-1HR $ 1,123.00
3320030 XR WRIST 3 V RT $ 771.00
3320033 XR HAND 2 V LT $ 510.00
3320035 XR HAND OBLIQUE 3 V LT $ 637.00
3320036 XR ELBOW 2 V RT $ 548.00
3320037 XR ELBOW 2 V LT $ 548.00
3320038 XR ELBOW 2 VIEWS $ 548.00
3320040 XR WRIST 2 V LT $ 611.00
3320041 XR WRIST 3 V LT $ 771.00
3320042 XR ELBOW OBLIQUE 3V RT $ 664.00
3320043 XR ELBOW OBLIQUE 3 V LT $ 664.00
3320045 XR HUMERUS 2 V LT $ 538.00
3320046 XR HUMERUS 2 V RT $ 538.00
3320051 XR SHDR 2 V LT $ 557.00
3320052 XR SHDR 2 V RT $ 557.00
3320056 XR CLAVICLE RT $ 548.00
3320057 XR CLAVICLE LT $ 548.00
3320059 XR SCAPULA COMPLETE LT $ 601.00
3320060 XR SCAPULA COMPLETE RT $ 601.00
3320061 XR STERNUM 2 V LIM $ 574.00
3320062 XR PELVIS/HIPS INF-CHILD $ 899.00
3320064 XR CHEST SINGLE VIEW $ 203.00
3320065 XR CHEST 2 VIEW $ 277.00
3320066 XR STERNUM 2 V $ 574.00
3320067 XR CHEST 3 VIEWS $ 351.00
3320068 XR HYSTEROSALPINGOGRAPHY $ 1,543.00
3320069 XR STERNOCLAVIC MIN 3 V $ 691.00
3320070 XR STRESS ANKLE $ 1,321.00
3320071 XR RIBS 2 V LT $ 315.00
3320072 XR RIBS 2 V RT $ 315.00
3320073 XR UPPER EXTRM INFANT RT $ 646.00
3320074 XR RIBS 4 V W CHEST $ 437.00
3320075 XR UPPER EXTRM INFANT LT $ 646.00
3320076 XR RIBS BILAT $ 385.00
3320077 XR RIBS PA/CHEST TRAUMA $ 351.00
3320078 XR RIBS PA CHEST TRAUMA $ 351.00
3320079 XR WRIST 1 V LT $ 611.00
3320080 XR WRIST 1 V RT $ 611.00
3320081 XR ELBOW 2 V LT $ 548.00
3320083 XR CHEST 4 VIEWS $ 391.00
3320085 XR CLAVICLE LT 76 $ 548.00
3320087 XR CLAVICLE RT 76 $ 548.00
3320091 XR CHEST SINGLE VIEW REPEAT $ 203.00
3320092 XR WRIST 3 V RT $ 771.00
3320093 XR WRIST 3 V LT $ 771.00
3320094 XR CHEST 3 V $ 855.00
3320095 XR CHEST 2 VIEW REPEAT $ 289.00
3320098 XR AC JTS W-WEIGHT $ 782.00
3320099 XR SHDR 1 V RT $ 432.00
3320100 XR SHDR 1 V LT $ 432.00
3320108 XR TOE 2 V LT $ 637.00
3320112 XR FOOT 2 V RT $ 531.00
3320113 XR FOOT 2 V LT $ 531.00
3320114 XR FEMUR 1VIEW LT $ 484.00
3320115 XR FEMUR 1 VIEW RT $ 484.00
3320117 XR FOOT OBLIQUE 3 V LT $ 620.00
3320118 XR FOOT OBLIQUE 3 V RT $ 620.00
3320119 XR TOE 2 V RT $ 637.00
3320122 XR ANKLE 2 V RT $ 548.00
3320123 XR ANKLE 2 V LT $ 548.00
3320127 XR ANKLE 2 V $ 548.00
3320128 XR ANKLE 3 V RT $ 664.00
3320129 XR ANKLE MIN 3 V LT $ 664.00
3320131 XR TIBIA/FIBULA 2 V LT $ 503.00
3320132 XR TIBIA/FIBULA 2 V RT $ 503.00
3320141 XR KNEE 1- 2 V LT $ 574.00
3320142 XR KNEE 1-2 V RT $ 574.00
3320145 XR KNEE 3 V LT $ 735.00
3320146 XR KNEE 3 V RT $ 735.00
3320147 XR KNEE 4 V RT $ 855.00
3320148 XR KNEES AP STANDING $ 691.00
3320149 XR KNEE 4 V LT $ 855.00
3320154 XR FEMUR MIN 2V LT $ 510.00
3320155 XR FEMUR MIN 2V RT $ 510.00
3320156 XR CALCANEUS RT $ 548.00
3320157 XR CALCANEUS LT $ 548.00
3320161 XR CALCANEOUS RT $ 548.00
3320162 XR CALCANEOUS LT $ 548.00
3320163 XR ANKLE 2 V RT $ 548.00
3320164 XR ANKLE 2 V LT $ 548.00
3320169 XR KNEE 1-2 V LT $ 574.00
3320206 XR TOE 2 V RT $ 637.00
3320220 XR HUMERUS 2 V RT $ 538.00
3320221 XR HUMERUS 2 V LT $ 538.00
3320225 XR SHDR 1 V RT $ 432.00
3320227 XR SHDR 1 LT $ 432.00
3320228 XR HUMERUS 2 V LT $ 538.00
3320229 XR STRESS ANKLE $ 1,321.00
3320230 XR SHDR 2 V RT $ 557.00
3320231 XR ELBOW 2 V RT $ 548.00
3320232 XR WRIST 2 V LT $ 611.00
3320233 XR HAND 1 V RT $ 510.00
3320234 XR FOOT 1 V LT $ 531.00
3320235 XR FOOT 1 V RT $ 531.00
3320237 XR TIBIA/FIBULA 1 V LT $ 503.00
3320238 XR TIBIA/FIBULA 1 V RT $ 503.00
3320239 XR HAND 1 V LT $ 510.00
3320241 XR WRIST 2 V RT $ 611.00
3320242 XR ANKLE 2 V RT $ 548.00
3320243 XR TIBIA/FIBULA 2 VIEW LT $ 503.00
3320244 XR SHDR 2 V LT $ 557.00
3320245 XR MASTOIDS 3 V OR LESS $ 709.00
3320246 XR RIBS 2 VIEW RT $ 315.00
3320247 XR HAND OBLIQUE 3 VIEW LT $ 637.00
3320248 XR FOOT OBLIQUE 3 V RT $ 620.00
3320249 XR RIBS 2 VIEW LT $ 315.00
3320250 XR ANKLE 3 V LT $ 664.00
3320251 XR ANKLE 3 V RT $ 664.00
3320252 XR BONE AGE STUDY $ 368.00
3320254 XR SHDR ARTHROGRAPHY $ 2,082.00
3320255 XR LWR EXTREMITY/INFA LT $ 531.00
3320256 XR ARTHROGRAPHY KNEE RT $ 2,693.00
3320257 XR HUMERUS 2 V RT $ 538.00
3320258 XR SHDR ARTHROGRAPHY $ 2,082.00
3320259 XR HAND 2V RT $ 510.00
3320260 XR ARTHROGRAPHY KNEE LT $ 2,693.00
3320261 XR LWR EXTREMITY/ INFA RT $ 531.00
3320262 XR TIBIA/FIBULA 2V RT $ 503.00
3320263 XR TOE 2 V LT $ 637.00
3320264 XR FOREARM 1 VIEW LT $ 521.00
3320265 XR FOREARM 1 VIEW RT $ 521.00
3320266 XR WRIST 1 V LT/RT REPEAT $ 611.00
3320267 XR TIBIA/FIBULA 1 V LT/RT $ 503.00
3320268 XR VIDEO SWALLOW $ 1,717.00
3320301 XR T-SPINE 3 V $ 691.00
3320304 XR FOOT OBLIQUE 3 VIEW LT $ 620.00
3320309 XR NOSE 1+ V $ 664.00
3320313 XR FINGER 2 V LT $ 709.00
3320314 XR CALCANEOUS 1 VIEW RT $ 548.00
3320315 XR KNEE 2 V RT $ 574.00
3320316 XR ELBOW 2 LT $ 548.00
3320317 XR FINGER 2 V RT $ 709.00
3320319 XR FOREARM 2 V RT $ 521.00
3320320 XR FOREARM 2 V LT $ 521.00
3320321 XR LOOPOGRAM (URINARY) LT $ 585.00
3320322 XR HAND OBLIQUE 3 V RT $ 637.00
3320323 XR LOOPOGRAM (URINARY) RT $ 585.00
3320324 XR ELBOW 2 V RT $ 548.00
3321001 XR UPPER GI/AIR $ 2,495.00
3321002 XR UGI/SM BFT/AIR $ 3,887.00
3321003 XR ABD 2 V, CHEST 1V $ 879.00
3321004 XR UGI $ 2,111.00
3321005 XR UGI / SM BFT $ 3,510.00
3321006 XR UGI SMBFT AIR / KUB $ 2,873.00
3321011 XR ESOPHOGRAM $ 1,804.00
3321015 XR BARIUM ENEMA $ 3,250.00
3321025 XR AIR CONT COLON $ 4,525.00
3321031 XR SMALL BOWEL $ 2,244.00
3321048 XR ABDOMEN 1 VIEW $ 404.00
3321049 XR ABDOMEN 2 VIEWS $ 719.00
3321050 XR ABDOMEN 3 OR MORE VIEWS $ 719.00
3321051 XR ABDOMEN 1 VIEW REPEAT $ 404.00
3321052 XR ABDOMEN 2 VIEW REPEAT $ 719.00
3322001 XR IVP $ 2,334.00
3322002 XR UROGRAPHY,RETROGRADE $ 2,334.00
3322008 XR UROGRAPHY LOOPOGRAM $ 585.00
3322016 XR CYSTOGRAPHY MIN 3 VI $ 664.00
3322020 XR VOIDING CYSTO $ 1,797.00
3322026 XR VOIDING CYSTO W-FLUORO $ 1,797.00
3322030 XR THORACENTESIS LT $ 463.00
3322031 XR THORACENTESIS RT $ 463.00
3322032 XR THORACENTESIS W GUIDE $ 596.00
3322033 XR THORACENTESIS W GUIDE $ 596.00
3323001 XR FACIAL BONE MIN 3 V $ 791.00
3323002 XR FACIAL BONE LESS 3 V $ 531.00
3323005 XR NOSE 3 V $ 664.00
3323006 XR NOSE 3 V $ 664.00
3323010 XR MANDIBLES LESS 4 V $ 674.00
3323018 XR SINUSES MIN 3 V $ 701.00
3323020 XR SINUSES LESS 3 V $ 592.00
3323043 XR ORBIT FOREIGN BODY $ 548.00
3323044 XR ORBIT 4 V $ 791.00
3324001 XR C-SPINE 2-3 V $ 637.00
3324002 XR LAT C-SPINE 2 V $ 637.00
3324005 XR C-SPINE 4 V $ 861.00
3324008 XR C-SPINE/FLEX $ 1,159.00
3324009 XR T-SPINE 2 V $ 601.00
3324010 XR LUMBOSACRAL BENDING $ 806.00
3324013 XR L-SPINE 2-3 VIEW $ 646.00
3324014 XR L-SPINE + BENDING $ 1,249.00
3324015 XR THORACOLUMBAR 2 VIEW $ 664.00
3324017 XR L-SPINE 4 V $ 879.00
3324022 XR PELVIS 1-2 V $ 521.00
3324026 XR PELVIS W BIL HIP $ 746.00
3324030 XR PELVIS W LAT HIP $ 746.00
3324032 XR PELVIS 3 V $ 855.00
3324042 XR HIP UNI W PELVIS 1 VIEW LT $ 510.00
3324043 XR HIP UNI W PELVIS 1 VIEW RT $ 510.00
3324044 XR HIP UNI W PELVIS 2-3V LT $ 727.00
3324045 XR HIP UNI W PELVIS 2-3V RT $ 727.00
3324047 XR HIPS BIL W PELVIS 2 VIEW $ 684.00
3324048 XR COCCYX SACRUM $ 538.00
3324049 XR SACRUM/COCCYX $ 538.00
3324050 XR HIP / CONTRAST $ 2,029.00
3324052 XR SI JNT 1-2 V $ 557.00
3324054 XR PELVIS 1-2 V $ 521.00
3324057 XR HIP / CONTRAST $ 2,029.00
3324058 XR L-SPINE 1 VIEW $ 646.00
3324059 XR HIPS BIL W PELVIS 1 VIEW $ 684.00
3324100 XR DORSAL SPINE 4 VIEW $ 879.00
3324108 XR BONE SURVEY INFANT $ 1,886.00
3324109 XR OSSEOUS SURVEY LIMITED $ 1,257.00
3324110 CHOLANGIOGRAM OPERATIVE $ 541.00
3324112 XR ORBIT 2 V $ 674.00
3324113 XR SKULL LESS 4 VIEW $ 664.00
3324120 XR BONE SURVEY COMPLETE $ 2,074.00
3324121 XR ORBIT 1 V $ 791.00
3324122 XR SKULL COMPLETE MIN 4VI $ 800.00
3324505 XR NECK SOFT TISSUE $ 510.00
3324999 XR SPINE 1 V $ 422.00
3326001 XR FLOURO < 1HR $ 1,123.00
3326002 XR FLUORO ESI $ 1,662.00
3326003 FLUORO GUIDANCE/EPIDURAL $ 1,662.00
3326005 FLUORO GUID NEEDLE PLACE $ 1,329.00
3326006 FLUORO GUID NEEDLE PLACE $ 1,329.00
3326007 PARACENTESIS W IMAGING $ 596.00
3327152 COMP DIAG MAMMO ADD ON $ 53.00
3327153 COMP SCRE MAMMO ADD ON $ 53.00
3327211 XR MAMMO DIAG UNI $ 305.00
3327212 XR MAMMO BIL SCREEN TO DIAG $ 318.00
3327213 XR MAMMO DIAG BILATERAL $ 305.00
3327214 XR MAMMO SCREEN TO DIAG BILATERAL $ 318.00
3327215 XR MAMMO SCREENING BILATERAL $ 305.00
3327216 XR MAMMO SCREENING UNI 52 MOD $ 305.00
3327217 XR SCREENI DIGITAL BREAST TOMOSYNTHESIS $ 121.00
3327218 XR DIAG DIGITAL BREAST TOMOSYNTHESIS $ 121.00
3327220 XR DIAG DIGITAL BREAST TOMO BILAT $ 121.00
3327221 XR DIAG DIGITAL BREAST TOMO UNILATERAL $ 121.00
3328475 XR DEXA SCAN $ 602.00
3328662 XR PET CT SKULL BASE TO MID-THIGH $ 3,172.00
3329013 INJ GASTROGRAFIN $ 40.00
3329014 INJ RETROGRADE $ 360.00
3329015 INJ CYSTOGRAM $ 304.00
3329016 INJ VOIDING CYST $ 304.00
3329017 INJ VOIDING CYSTO FLURO $ 304.00
3329021 INJ RENAL SCAN/DRUG $ 506.00
3329022 INJ TC99M SESTAMIBI $ 140.00
3329023 INJ ISOTOPE I-123 $ 177.00
3329024 INJ ISOTOPE THALLIUM $ 436.00
3329026 INJ PROHANCE/GADOLIN 50ML $ 263.00
3329027 INJ MAG 3 TECHNESIUM $ 434.00
3329028 INJ KINEVAC 5 MCG $ 314.00
3329029 INJ ISOVUE 50CC $ 80.00
3329033 INJ RENOGRAFIN 12CC $ 19.00
3329034 INJ CYSTOGRAFIN $ 322.00
3329035 INJ VISAPAQUE 100ML $ 268.00
3329036 INJ HYPAQUE $ 19.00
3329037 INJ OMNIPIAQUE 300 $ 83.00
3329038 INJ TC 99M CHOLETEC 4.8MC $ 95.00
3329039 INJ ISOVUE 370 100cc $ 49.00
3329040 INJ TC99M MEDRONATE 20-30 $ 76.00
3329042 INJ TC99M MAA 10MCI $ 508.00
3329043 INJ TC99M SULFUR COLLOID $ 284.00
3329045 INJ TC99M DTPA AEROSOL $ 508.00
3329046 NM DOSE FDG 45MCI $ 725.00
3329049 INJ CATHETER HYSTEROGRAPH $ 372.00
3329050 INJ TC 99 TECHNETIUM $ 460.00
3329051 INJ SHOULDER XRAY LT $ 231.00
3329052 INJ SHOULDER XRAY RT $ 231.00
3329053 THYROID ISOTOPE I 131 TH $ 58.00
3329054 INJ PROCEDURE HIP LT $ 322.00
3329055 INJ PROCEDURE HIP RT $ 322.00
3329056 INJ LASIX 20MG INJ $ 13.00
3329057 INJ OMNIPAQUE 300 MG $ 518.00
3668101 ST EVALUATION FLUENCY $ 397.00
3668102 ST EVALUATION SOUND $ 323.00
3668103 ST EVALUATION WITH LANGUAGE $ 669.00
3668104 ST SWALLOWING TX 59 $ 259.00
3668105 ST SPEECH THERAPY $ 259.00
3668107 ST SWALLOWING TX $ 259.00
3668109 ST APHASIA EVAL $ 259.00
3668110 ST SWALLOW EVAL $ 460.00
3668112 ST THER EXERCISE 15" $ 172.00
3668113 ST COGNITIVE SKILLS $ 259.00
3668116 ST SPEECH THERAPY 15" 59 $ 259.00
3668117 ST VIDEO SWALLOW STUDY $ 508.00
3668118 ST BEHAVIORAL QUAL ANALYSIS $ 334.00
3669025 ST SWALLOW CURRENT G8996CH $ 0.00
3669026 ST SWALLOW CURRENT G8996CI $ 0.00
3669027 ST SWALLOW CURRENT G8996CJ $ 0.00
3669028 ST SWALLOW CURRENT G8996CK $ 0.00
3669029 ST SWALLOW CURRENT G8996CL $ 0.00
3669030 ST SWALLOW CURRENT G8996CM $ 0.00
3669031 ST SWALLOW CURRENT G8996CN $ 0.00
3669032 ST SWALLOW GOAL G8997CH $ 0.00
3669033 ST SWALLOW GOAL G8997CI $ 0.00
3669034 ST SWALLOW GOAL G8997CJ $ 0.00
3669035 ST SWALLOW GOAL G8997CK $ 0.00
3669036 ST SWALLOW GOAL G8997CL $ 0.00
3669037 ST SWALLOW GOAL G8997CM $ 0.00
3669038 ST SWALLOW GOAL G8997CN $ 0.00
3669039 ST SWALLOW D/C G8998CH $ 0.00
3669040 ST SWALLOW D/C G8998CI $ 0.00
3669041 ST SWALLOW D/C G8998CJ $ 0.00
3669042 ST SWALLOW D/C G8998CK $ 0.00
3669043 ST SWALLOW D/C G8998CL $ 0.00
3669044 ST SWALLOW D/C G8998CM $ 0.00
3669045 ST SWALLOW D/C G8998CN $ 0.00
3669046 ST MOTOR SPEECH CURRENT G8999CH $ 0.00
3669047 ST MOTOR SPEECH CURRENT G8999CI $ 0.00
3669048 ST MOTOR SPEECH CURRENT G8999CJ $ 0.00
3669049 ST MOTOR SPEECH CURRENT G8999CK $ 0.00
3669050 ST MOTOR SPEECH CURRENT G8999CL $ 0.00
3669051 ST MOTOR SPEECH CURRENT G8999CM $ 0.00
3669052 ST MOTOR SPEECH CURRENT G8999CN $ 0.00
3669053 ST MOTOR SPEECH D/C G9158CH $ 0.00
3669054 ST MOTOR SPEECH D/C G9158CI $ 0.00
3669055 ST MOTOR SPEECH D/C G9158CJ $ 0.00
3669056 ST MOTOR SPEECH D/C G9158CK $ 0.00
3669057 ST MOTOR SPEECH D/C G9158CL $ 0.00
3669058 ST MOTOR SPEECH D/C G9158CM $ 0.00
3669059 ST MOTOR SPEECH D/C G9158CN $ 0.00
3669060 ST LANGUAGE COMPRE CURRENT G9159CH $ 0.00
3669061 ST LANGUAGE COMPRE CURRENT G9159CI $ 0.00
3669062 ST LANGUAGE COMPRE CURRENT G9159CJ $ 0.00
3669063 ST LANGUAGE COMPRE CURRENT G9159CK $ 0.00
3669064 ST LANGUAGE COMPRE CURRENT G9159CL $ 0.00
3669065 ST LANGUAGE COMPRE CURRENT G9159CM $ 0.00
3669066 ST LANGUAGE COMPRE CURRENT G9159CN $ 0.00
3669067 ST LANGUAGE COMPRE GOAL G9160CH $ 0.00
3669068 ST LANGUAGE COMPRE GOAL G9160CI $ 0.00
3669069 ST LANGUAGE COMPRE GOAL G9160CJ $ 0.00
3669070 ST LANGUAGE COMPRE GOAL G9160CK $ 0.00
3669071 ST LANGUAGE COMPRE GOAL G9160CL $ 0.00
3669072 ST LANGUAGE COMPRE GOAL G9160CM $ 0.00
3669073 ST LANGUAGE COMPRE GOAL G9160CN $ 0.00
3669074 ST LANGUAGE COMPRE D/C G9161CH $ 0.00
3669075 ST LANGUAGE COMPRE D/C G9161CI $ 0.00
3669076 ST LANGUAGE COMPRE D/C G9161CJ $ 0.00
3669077 ST LANGUAGE COMPRE D/C G9161CK $ 0.00
3669078 ST LANGUAGE COMPRE D/C G9161CL $ 0.00
3669079 ST LANGUAGE COMPRE D/C G9161CM $ 0.00
3669080 ST LANGUAGE COMPRE D/C G9161CN $ 0.00
3669081 ST LANGUAGE EXPRESS CURRENT G9162CH $ 0.00
3669082 ST LANGUAGE EXPRESS CURRENT G9162CI $ 0.00
3669083 ST LANGUAGE EXPRESS CURRENT G9162CJ $ 0.00
3669084 ST LANGUAGE EXPRESS CURRENT G9162CK $ 0.00
3669085 ST LANGUAGE EXPRESS CURRENT G9162CL $ 0.00
3669086 ST LANGUAGE EXPRESS CURRENT G9162CM $ 0.00
3669087 ST LANGUAGE EXPRESS CURRENT G9162CN $ 0.00
3669088 ST LANGUAGE EXPRESS GOAL G9163CH $ 0.00
3669089 ST LANGUAGE EXPRESS GOAL G9163CI $ 0.00
3669090 ST LANGUAGE EXPRESS GOAL G9163CJ $ 0.00
3669091 ST LANGUAGE EXPRESS GOAL G9163CK $ 0.00
3669092 ST LANGUAGE EXPRESS GOAL G9163CL $ 0.00
3669093 ST LANGUAGE EXPRESS GOAL G9163CM $ 0.00
3669094 ST LANGUAGE EXPRESS GOAL G9163CN $ 0.00
3669095 ST LANGUAGE EXPRESS D/C G9164CH $ 0.00
3669096 ST LANGUAGE EXPRESS D/C G9164CI $ 0.00
3669097 ST LANGUAGE EXPRESS D/C G9164CJ $ 0.00
3669098 ST LANGUAGE EXPRESS D/C G9164CK $ 0.00
3669099 ST LANGUAGE EXPRESS D/C G9164CL $ 0.00
3669100 ST LANGUAGE EXPRESS D/C G9164CM $ 0.00
3669101 ST LANGUAGE EXPRESS D/C G9164CN $ 0.00
3669102 ST ATTENTION CURRENT G9165CH $ 0.00
3669103 ST ATTENTION CURRENT G9165CI $ 0.00
3669104 ST ATTENTION CURRENT G9165CJ $ 0.00
3669105 ST ATTENTION CURRENT G9165CK $ 0.00
3669106 ST ATTENTION CURRENT G9165CL $ 0.00
3669107 ST ATTENTION CURRENT G9165CM $ 0.00
3669108 ST ATTENTION CURRENT G9165CN $ 0.00
3669109 ST ATTENTION GOAL G9166CH $ 0.00
3669110 ST ATTENTION GOAL G9166CI $ 0.00
3669111 ST ATTENTION GOAL G9166CJ $ 0.00
3669112 ST ATTENTION GOAL G9166CK $ 0.00
3669113 ST ATTENTION GOAL G9166CL $ 0.00
3669114 ST ATTENTION GOAL G9166CM $ 0.00
3669115 ST ATTENTION GOAL G9166CN $ 0.00
3669116 ST ATTENTION D/C G9167CH $ 0.00
3669117 ST ATTENTION D/C G9167CI $ 0.00
3669118 ST ATTENTION D/C G9167CJ $ 0.00
3669119 ST ATTENTION D/C G9167CK $ 0.00
3669120 ST ATTENTION D/C G9167CL $ 0.00
3669121 ST ATTENTION D/C G9167CM $ 0.00
3669122 ST ATTENTION D/C G9167CN $ 0.00
3669123 ST MEMORY CURRENT G9168CH $ 0.00
3669124 ST MEMORY CURRENT G9168CI $ 0.00
3669125 ST MEMORY CURRENT G9168CJ $ 0.00
3669126 ST MEMORY CURRENT G9168CK $ 0.00
3669127 ST MEMORY CURRENT G9168CL $ 0.00
3669128 ST MEMORY CURRENT G9168CM $ 0.00
3669129 ST MEMORY CURRENT G9168CN $ 0.00
3669130 ST MEMORY GOAL G9169CH $ 0.00
3669131 ST MEMORY GOAL G9169CI $ 0.00
3669132 ST MEMORY GOAL G9169CJ $ 0.00
3669133 ST MEMORY GOAL G9169CK $ 0.00
3669134 ST MEMORY GOAL G9169CL $ 0.00
3669135 ST MEMORY GOAL G9169CM $ 0.00
3669136 ST MEMORY GOAL G9169CN $ 0.00
3669137 ST MEMORY D/C G9170CH $ 0.00
3669138 ST MEMORY D/C G9170CI $ 0.00
3669139 ST MEMORY D/C G9170CJ $ 0.00
3669140 ST MEMORY D/C G9170CK $ 0.00
3669141 ST MEMORY D/C G9170CL $ 0.00
3669142 ST MEMORY D/C G9170CM $ 0.00
3669143 ST MEMORY D/C G9170CN $ 0.00
3669144 ST VOICE CURRENT G9171CH $ 0.00
3669145 ST VOICE CURRENT G9171CI $ 0.00
3669146 ST VOICE CURRENT G9171CJ $ 0.00
3669147 ST VOICE CURRENT G9171CK $ 0.00
3669148 ST VOICE CURRENT G9171CL $ 0.00
3669149 ST VOICE CURRENT G9171CM $ 0.00
3669150 ST VOICE CURRENT G9171CN $ 0.00
3669151 ST VOICE GOAL G9172CH $ 0.00
3669152 ST VOICE GOAL G9172CI $ 0.00
3669153 ST VOICE GOAL G9172CJ $ 0.00
3669154 ST VOICE GOAL G9172CK $ 0.00
3669155 ST VOICE GOAL G9172CL $ 0.00
3669156 ST VOICE GOAL G9172CM $ 0.00
3669157 ST VOICE GOAL G9172CN $ 0.00
3669158 ST VOICE D/C G9173CH $ 0.00
3669159 ST VOICE D/C G9173CI $ 0.00
3669160 ST VOICE D/C G9173CJ $ 0.00
3669161 ST VOICE D/C G9173CK $ 0.00
3669162 ST VOICE D/C G9173CL $ 0.00
3669163 ST VOICE D/C G9173CM $ 0.00
3669164 ST VOICE D/C G9173CN $ 0.00
3669165 ST OTHER LANGUAGE CURRENT G9174CH $ 0.00
3669166 ST OTHER LANGUAGE CURRENT G9174CI $ 0.00
3669167 ST OTHER LANGUAGE CURRENT G9174CJ $ 0.00
3669168 ST OTHER LANGUAGE CURRENT G9174CK $ 0.00
3669169 ST OTHER LANGUAGE CURRENT G9174CL $ 0.00
3669170 ST OTHER LANGUAGE CURRENT G9174CM $ 0.00
3669171 ST OTHER LANGUAGE CURRENT G9174CN $ 0.00
3669172 ST OTHER LANGUAGE GOAL G9175CH $ 0.00
3669173 ST OTHER LANGUAGE GOAL G9175CI $ 0.00
3669174 ST OTHER LANGUAGE GOAL G9175CJ $ 0.00
3669175 ST OTHER LANGUAGE GOAL G9175CK $ 0.00
3669176 ST OTHER LANGUAGE GOAL G9175CL $ 0.00
3669177 ST OTHER LANGUAGE GOAL G9175CM $ 0.00
3669178 ST OTHER LANGUAGE GOAL G9175CN $ 0.00
3669179 ST OTHER LANGUAGE D/C G9176CH $ 0.00
3669180 ST OTHER LANGUAGE D/C G9176CI $ 0.00
3669181 ST OTHER LANGUAGE D/C G9176CJ $ 0.00
3669182 ST OTHER LANGUAGE D/C G9176CK $ 0.00
3669183 ST OTHER LANGUAGE D/C G9176CL $ 0.00
3669184 ST OTHER LANGUAGE D/C G9176CM $ 0.00
3669185 ST OTHER LANGUAGE D/C G9176CN $ 0.00
3669186 ST MOTOR SPEECH GOAL G9186CH $ 0.00
3669187 ST MOTOR SPEECH GOAL G9186CI $ 0.00
3669188 ST MOTOR SPEECH GOAL G9186CJ $ 0.00
3669189 ST MOTOR SPEECH GOAL G9186CK $ 0.00
3669190 ST MOTOR SPEECH GOAL G9186CL $ 0.00
3669191 ST MOTOR SPEECH GOAL G9186CM $ 0.00
3669192 ST MOTOR SPEECH GOAL G9186CN $ 0.00
26123 FASCIECTOMY / PART PALMAR RELEASE $ 2,405.00
3206462 REPAIR SPEGELIAN HERNIA $ 3,085.00
3206651 BONE MARROW ASPIRATION $ 459.00
3207000 CATARACT PHACO LT $ 5,405.00
3207002 INTRACAPSULAR CATARACT EX $ 4,504.00
3207003 YAG LASER RT $ 1,727.00
3207004 YAG LASER LT $ 1,727.00
3207009 YAG LASER BILATERAL $ 2,589.00
3207010 A SCAN RT $ 311.00
3207011 ARTHROSCOPY $ 4,695.00
3207012 FX LAT MALLEOLOUS OPEN REDUC $ 5,066.00
3207013 CATARACT PHACO BILATERAL $ 8,105.00
3207014 D & C $ 1,645.00
3207015 A SCAN LT $ 311.00
3207016 INTRACAPSULAR CATARACT EX $ 4,504.00
3207017 LAP CHOLE $ 5,354.00
3207018 ARTHROSCOPY $ 4,695.00
3207019 GANGLION CYST $ 3,096.00
3207020 A SCAN BILATERAL $ 589.00
3207021 GANGLION CYST $ 2,186.00
3207022 BENIGN LESION 1.0 $ 976.00
3207023 BENIGN LESION 1.0 $ 932.00
3207024 MALIG LESION 1.0 $ 933.00
3207025 CARPAL TUNNEL RELEASE $ 3,109.00
3207026 INGUINAL HERNIA REPAIR $ 3,623.00
3207027 DEPUYTRENS CONTRACTURE RT $ 86.00
3207028 IMPLANTATION OF MESH $ 2,095.00
3207029 EXCISION OF CYST/FINGER $ 2,186.00
3207030 ARTHROSCOPY KNEE $ 5,068.00
3207031 RELEASE TRIGGER FINGER $ 1,958.00
3207032 CARPAL TUNNEL RELEASE $ 3,109.00
3207035 SPERMATOCELE $ 2,587.00
3207036 BUNIONECTOMY $ 4,666.00
3207037 CHOLECYSTECTOMY $ 6,327.00
3207038 ANTEROPOSTERIOR COLPORRAP $ 3,808.00
3207039 VAGINAL HYSTERECTOMY $ 6,750.00
3207042 IRIDOTOMY/IRIDECTOMY $ 3,759.00
3207043 BONE BIOPSY $ 1,258.00
3207044 ARTHROPLASTY / KNEE / PROSTHE $ 6,354.00
3207045 OPEN TX OLECRANON $ 5,941.00
3207046 CLOSED TX PROX HUMERAL MANIP $ 3,651.00
3207047 REPAIR ANKLE LIGAMENT $ 6,024.00
3207048 OPEN TX LATERAL MALLEOLUS $ 5,066.00
3207050 INGUINAL HERNIA $ 4,671.00
3207052 REPAIR ROTATOR CUFF CHRON $ 8,421.00
3207053 ADENOIDECTOMY $ 1,531.00
3207054 TONSILLECTOMY/ADNOIDECTOM $ 2,495.00
3207056 TONSILLECTOMY/ADNOIDECTOM $ 2,603.00
3207057 EXC INTERDIGIT NEUROMA $ 2,885.00
3207058 TRIGGER FINGER RELEASE $ 1,958.00
3207059 DEBRIDEMENT SKIN SUBQ TIS $ 497.00
3207060 ING HERNIA REPAIR $ 4,076.00
3207061 DESTRUC LESION, EXTENSIVE $ 1,533.00
3207062 CATARACT PHACO RT $ 5,405.00
3207063 ARTHROTOMY KNEE / EXPLORATION $ 6,190.00
3207064 SUTURE INFRAPATELL TENDON $ 4,972.00
3207065 D & C/INCOMPLETE MISCAR $ 2,103.00
3207066 MYRINGOTOMY/TUBE PLACE $ 1,223.00
3207067 REMOVAL OF IMPLANT/DEEP $ 2,715.00
3207068 ARTHROSCOPY KNEE $ 5,068.00
3207069 MYRINGOTOMY/TUEB PLACE $ 1,831.00
3207070 MYRINGOTOMY/TUBE PLACE $ 1,223.00
3207071 REMOVAL OF INPLANT/DEEP $ 2,715.00
3207072 D&C SEPTIC MISCAR3 $ 3,295.00
3207073 I&D SUBMUCOSL ABCESS $ 1,106.00
3207074 EXCIS LESION 1.0 CM $ 709.00
3207075 RECONST ROTATOR CUFF $ 8,711.00
3207076 LIGATION OF FALLOPIAN TUB $ 2,741.00
3207077 RELEASE OF TRIGGER FINGER $ 1,958.00
3207078 RELEASE OF TRIGGER FINGER $ 1,958.00
3207079 EXCISION LESION 1.1-2 CM $ 821.00
3207080 TONSILLECTOMY 12+ $ 2,177.00
3207082 VASECTOMY $ 1,898.00
3207083 TONSILLECTOMY/UNDER 12 $ 2,176.00
3207084 GANGLION CYST $ 3,096.00
3207085 RELEASE ULNAR NERVE $ 3,592.00
3207086 OPEN REDUCTION INT / ANKLE $ 5,672.00
3207087 BREAST BIOPSY INCISIONAL $ 1,557.00
3207089 RECONST POST TIBIAL TENDO $ 4,856.00
3207093 TUBAL LIGATION $ 2,886.00
3207096 EXCISION LESION 2.1-3. $ 1,084.00
3207099 HAMMERTOE $ 3,574.00
3207100 HAMMERTOE $ 3,574.00
3207101 HAMMERTOE $ 3,574.00
3207102 HAMMERTOE $ 3,574.00
3207103 HAMMERTOE $ 3,574.00
3207104 HAMMERTOE $ 3,574.00
3207105 GANGLION CYST/RECURRENT $ 3,711.00
3207108 INGUINAL HERNIA/INCAR STR $ 4,854.00
3207110 EXCISION LESION OVER 4CM $ 1,389.00
3207111 INGUINAL HERNIA $ 3,623.00
3207115 DEBRIDE SKIN SUBUT TISSUE $ 497.00
3207124 ADENOIDECTOMY $ 1,531.00
3207125 CYSTOURETHROSCPY/FULGURAT $ 1,943.00
3207126 ARTHOSCOPY $ 5,068.00
3207127 HEMORRHOID,THROMBOSED EXT $ 972.00
3207128 CLOSED/DISTAL RADIAL FX $ 3,813.00
3207129 INCISONAL/VENTRAL HERNIA $ 6,501.00
3207130 EXCISION LESION 1.0CM $ 709.00
3207131 EXCIS LYMPH NODE,DEEP $ 3,612.00
3207132 EXCISION LESION 4CM $ 1,389.00
3207134 TRIGGER FINGER RELEASE $ 1,958.00
3207135 CARPAL TUNNEL RELEASE $ 3,109.00
3207136 EXCISION LESION OVER 4CM $ 1,389.00
3207137 MYRINGOPLASTY $ 2,803.00
3207138 SEPTOPLASTY $ 5,095.00
3207139 ENDOSCOPIC ETHMOIDECTOMY $ 3,385.00
3207143 PELVIC EXAM $ 868.00
3207144 CYSTOURETHOSCOPY/TUMOR LG $ 4,041.00
3207146 ORCHIOPEXY,ING APPROACH $ 3,346.00
3207147 SLING OPERATION/INCONT $ 5,886.00
3207148 CYSTOURETHROSCOPY $ 860.00
3207149 GANGLION CYST $ 2,186.00
3207150 RELEASE TRIGGER FINGER $ 1,958.00
3207157 LAPAROSCOPY/LYSIS ADHESIO $ 4,859.00
3207158 D & C $ 1,645.00
3207159 CIRCUMCISION $ 1,594.00
3207160 HEMORRHOIDECTOMY, INT,EXT $ 2,357.00
3207161 SPHINCTEROTOMY $ 1,275.00
3207166 AUSTIN BUNIONECTOMY $ 5,674.00
3207167 HAMMERTOE $ 3,574.00
3207168 UMBILICAL HERNIA $ 3,194.00
3207172 SUBMUCOUS RESECT TURBIN $ 2,437.00
3207176 GANGLION CYST $ 2,186.00
3207177 INGUINAL HERNIA $ 5,435.00
3207178 I & D PERIRECTAL ABCESS $ 2,508.00
3207179 SPHINCTEROTOMY $ 1,275.00
3207181 INCISIONAL HERNIA REPAIR $ 5,475.00
3207183 AKIN OSTEOTOMY $ 5,163.00
3207184 OSTECTOMY PARTIAL METATAR $ 3,443.00
3207185 EXCISION LESION OVER 4CM $ 1,858.00
3207189 RELEASE OF TRIIGER FINGER $ 1,958.00
3207191 UMBILICAL HERNIA $ 2,177.00
3207202 EXCISION MALIG LESION 4.0 $ 1,619.00
3207205 TX OF TUBAL PREGNANCY $ 5,795.00
3207206 AMPUTATION/TRANSMETATARSA $ 4,994.00
3207207 RECUR/ING HERNIA $ 5,520.00
3207212 INCISIONAL HERNIA/RECURRE $ 5,519.00
3207216 UMBILICAL HERNIA/INCARCER $ 3,650.00
3207217 REMOVAL SKIN TAGS $ 333.00
3207218 HEMORRHOIDECTOMY/INTERNAL $ 2,176.00
3207221 RELEASE TENDON WRIST $ 3,374.00
3207222 GANGLION CYST WRIST $ 3,096.00
3207223 BIOPSY UPPER EYE LID $ 905.00
3207225 UMBILICAL HERNIA $ 3,194.00
3207226 FRENULOTOMY $ 1,296.00
3207228 MYRINGOTOMY/TUBE PLACE $ 1,223.00
3207236 APPENDECTOMY, LAPROSCOPIC $ 4,076.00
3207238 PILONIDAL CYST $ 1,207.00
3207239 INCOMPLETE ABORTION $ 2,103.00
3207240 ARTHROS DEBRIDEMENT/SHAVI $ 4,486.00
3207242 CLOSED/DISTAL RADIAL FX $ 3,813.00
3207243 COLONOSCOPY $ 5,138.00
3207244 EXCISION CYST/FINGER $ 2,186.00
3207245 EXCISON/CYST FINGER $ 2,186.00
3207247 ENTROPIAN REPAIR $ 3,415.00
3207249 NASALPHARYNGOSCOPY $ 377.00
3207252 HAMMERTOE $ 3,574.00
3207254 PILONIDAL CYST/EXTENSIVE $ 3,021.00
3207256 REMOVAL OF IMPLANT DEEP $ 2,715.00
3207260 EXCISION CYST/BREAST $ 2,718.00
3207262 INCISIONAL VENTRAL HERNIA $ 6,501.00
3207263 DEBRIDEMENT SKIN SUBQ TIS $ 497.00
3207266 CLOSED REDUCTION SHOULDER $ 2,802.00
3207267 EXCIS MALIGNANT LESION 2. $ 1,095.00
3207272 NEUROPLASTY ULNAR NERVE $ 3,592.00
3207277 HAMMER TOE $ 3,574.00
3207279 I & D OF ABCESS $ 564.00
3207282 BONE MARROW BIOPSY NEEDLE $ 575.00
3207284 LAPAROSCOPY $ 3,575.00
3207285 EXCIS TUMOR,TISSUE/ELBOW $ 2,139.00
3207286 EXCISION, OLECRANON BURSA $ 2,803.00
3207287 TRANSURETHRAL RESECTION $ 5,417.00
3207288 AUSTIN BUNIONECTOMY $ 5,674.00
3207292 CAPSULOTOMY $ 2,628.00
3207297 EGD $ 2,715.00
3207298 OSTECTOMY FOR SPUR $ 3,650.00
3207304 EXCISION LESION, TENDON $ 3,166.00
3207305 FEMORAL HERNIA/INCARCERA $ 4,468.00
3207310 I & D HEMATOMA,SEROMA,FLU $ 820.00
3207314 REMOVAL OF IMPLANT/DEEP $ 2,715.00
3207316 PALATOPHARYNGOPLASTY $ 4,757.00
3207317 REPAIR OF BLEPHAROPLASTY $ 3,797.00
3207321 EXCISION LESION 4.0 OVER $ 2,093.00
3207323 CLOSED TX DISTAL RADIAL F $ 1,801.00
3207325 INGUINAL HERNIA/INCAR $ 4,854.00
3207327 MICROSURGICAL TECHNIQUE $ 1,732.00
3207332 EXCISION LESION,TENDON $ 3,166.00
3207333 UMBILECTOMY,EXCIS UMBIL $ 4,219.00
3207334 INGUINAL HERNIA $ 4,671.00
3207337 CYSTOURETHROSCOPY/CALIBRA $ 1,206.00
3207340 EXC INTERDIGIT NEUROMA $ 2,885.00
3207341 EXCISION OF LESION 1.1-2 $ 821.00
3207342 ESCISION OF LESION 1.1-2 $ 821.00
3207343 EXCISION OF LESION 3.1-4 $ 1,083.00
3207344 UMBILICAL HERNIA/INCARERA $ 3,650.00
3207345 METACARPAL FX/SKELETON FI $ 4,482.00
3207346 SUBMUCOUS RESECT TURBIN $ 3,657.00
3207347 APPENDECTOMY $ 4,543.00
3207352 EGD/FOREIGN BODY REMOV $ 2,986.00
3207354 TYMPANOSOTMY/LOCAL,TOP $ 1,098.00
3207358 RETINA/COAGULATION $ 4,108.00
3207359 BIOPSY/EXCIS LYMPH NODE $ 1,711.00
3207360 TYMPANOSTOMY/LOCAL OR TOP $ 733.00
3207362 D & C POSTPARTUM $ 1,582.00
3207363 EXCISION TUMOR, DEEP $ 4,236.00
3207365 D & C/ 1ST TRIMESTER $ 2,184.00
3207366 HYSTEROSCOPY/BIOPSY $ 2,177.00
3207374 EXCISION, TUMOR, FOOT $ 2,716.00
3207375 ADENOIDECTOMY $ 1,609.00
3207377 EXCISION NAIL/NAIL MATRIX $ 1,019.00
3207378 UMBILICAL HERNIA/INCARCER $ 3,574.00
3207382 LAP VAG HYS/TUBES/OVARIES $ 6,853.00
3207383 TUBAL LIGATION/POST PARTU $ 2,497.00
3207384 PHOTOCOAGULATION $ 6,043.00
3207385 CESAREAN SECTION $ 7,445.00
3207386 APPENDECTOMY $ 5,600.00
3207388 TEMPORAL ARTERY BIOPSY $ 1,694.00
3207390 AMPUTATION TOE/METARSOPHA $ 2,450.00
3207391 EXCISION OF LESION 1.1-2. $ 1,041.00
3207392 ADENOIDECTOMY/SECONDARY $ 1,664.00
3207393 EXCISION CYST/BREAST $ 2,718.00
3207396 BIOPSY,TISSUE NECK/THORAX $ 1,009.00
3207399 EXC HYPERPLASTIC ALVEOLAR $ 1,692.00
3207405 DISLOC ATHROPLASTY HIP $ 4,796.00
3207406 VENTRAL HERNIA INCAR/RECU $ 6,575.00
3207408 REP RUPTOR ACHILLES TEND $ 6,154.00
3207409 HEMORRHOIDECTOMY EXT/INT $ 3,240.00
3207410 LIGATION VARICOSE VEIN $ 2,095.00
3207411 AUSTIN BUNIONECTOMY $ 5,674.00
3207416 GASTRORRHAPHY $ 7,026.00
3207417 EXPLORATORY LAP $ 5,588.00
3207418 I & D/HEMATOMA $ 2,723.00
3207419 OCCLUSION OF FALLOPIAN TU $ 2,190.00
3207420 ARTHROSCOPY,SHOULDER/DECO $ 6,697.00
3207423 LAPAROSCOPY,SALPIN-OOPHOR $ 4,079.00
3207424 LAPAROSCOPY OVARIAN CYST $ 2,552.00
3207425 TOTAL ABDOMINAL HYSTER $ 7,294.00
3207426 ENTEROLYSIS $ 7,334.00
3207428 EXCISION/CYST/FINGER $ 2,186.00
3207432 ARTHROPLASTY,TOTAL HIP $ 10,790.00
3207433 TUBAL LIGATION/C SECTION $ 624.00
3207437 ARTHROPLASTY,TOTAL HIP $ 10,790.00
3207438 ARTHROPLASTY/METATARSAL $ 3,974.00
3207440 EXCIS MALIG LESION 0.6-1. $ 932.00
3207441 ENDOCERVICAL CURETTAGE $ 643.00
3207442 ENDOMETRIAL BIOPSY $ 696.00
3207444 CYSTOMETROGRAM/SIMPLE $ 2,014.00
3207446 CLAVICULECTOMY/PARTIAL $ 5,344.00
3207450 CYSTOURETHROSCOPY/DIAG $ 2,489.00
3207457 CYSTOSCOPY & URETER CATHE $ 1,019.00
3207458 CYSTOGRAM/SIMPLE $ 2,014.00
3207459 BIOPSY OF PROSTATE $ 709.00
3207460 DIAG LARYNGOSCOPY $ 1,267.00
3207461 PROSTATECTOMY 1ST STAGE $ 5,417.00
3207462 INCISION OF PROSTATE $ 3,471.00
3207463 ING HERNIA/RECURRENT $ 5,520.00
3207464 CYSTOSCOPY & URETER CATH $ 1,019.00
3207467 EXCISION LESION 0.6-1.0CM $ 797.00
3207469 INCISION/REMOVAL FB $ 628.00
3207470 TEMPORAL ARTERY BIOPSY $ 1,694.00
3207472 AMPUTAION METATARSAL $ 4,392.00
3207475 REVISION OF ILEOSTOMY $ 3,739.00
3207480 MALIG LESION -1.0 $ 1,083.00
3207483 MALIG LESION -1.0 $ 1,083.00
3207489 CYSTOURETHROSCOPY/DILATIO $ 1,159.00
3207490 CYSTOURETHROSCOPY,FULG,ME $ 2,285.00
3207491 ENDOSCOPIC INJECTION $ 1,543.00
3207492 ORCHIECTOMY,SIMPLE $ 3,898.00
3207494 EXCISION LESION 1.1- 2CM $ 821.00
3207501 I&D RECTAL ABCESS $ 2,931.00
3207503 ARTHROSCOPY,DEBRIDE/SHAV $ 4,486.00
3207504 ARTHROSCOPY/REMOVAL FB $ 1,275.00
3207505 CYSTOURETHROSCOPY/REM FB $ 1,192.00
3207507 BIOPSY/EXCIS LYMPH NODE $ 1,711.00
3207514 EXCISION LESION 4CM $ 1,389.00
3207516 EXCISION OF LESION 3.1-4C $ 1,266.00
3207517 EXCISON OF LESION 1.1-2CM $ 821.00
3207526 TENOTOMY $ 1,940.00
3207532 ARTHROSCOPY SHOULDER/DECO $ 6,697.00
3207533 EXCISION,TUMOR FOOT DEEP $ 2,470.00
3207534 EXCISON,TUMOR,FOOT,DEEP $ 2,470.00
3207536 AVULSION OF NAIL $ 490.00
3207537 EXCISION OF LESION $ 611.00
3207538 AUSTIN BUNIONECTOMY $ 5,674.00
3207539 EXCISON,TUMOR,FOOT $ 2,716.00
3207541 OPEN TX METATARSAL FX $ 3,294.00
3207545 PROSTATECTOMY/LYMPHADENEC $ 9,176.00
3207546 EXCISION/FULGUR URE POLYP $ 1,366.00
3207550 REPAIR LOWER LEG TENDON $ 3,822.00
3207551 REMOVAL PIN/SIMPLE $ 1,634.00
3207552 REMOVAL TOE LESIONS $ 2,099.00
3207553 REDUCTION MAMMAPLASTY $ 12,870.00
3207554 CHOLECYSTECTOMY/EXP DUCT $ 7,746.00
3207555 CHOLECYSTECTOMY/CHOLANGIO $ 6,130.00
3207557 RECONST POST TIBIAL TENDO $ 4,856.00
3207560 INCISIONAL HERNIA REPAIR $ 5,475.00
3207561 VAGINAL HYSTERECTOMY $ 6,736.00
3207562 REPAIR BLADDER & VAGINA $ 2,844.00
3207563 REMOVAL BLADDER LESION $ 5,185.00
3207564 MYRINGOTOMY/TUBE PLACE $ 1,831.00
3207566 ESCISION TONGUE FOLD $ 1,206.00
3207567 COLOPEXY INTRA PERITONEAL $ 4,103.00
3207568 COLONOSCOPY/BIOPSY $ 4,536.00
3207569 TOTAL KNEE ARTHROPLASTY $ 10,661.00
3207570 REPAIR HALLUX RIGIDUS W/O IMPLANT $ 3,887.00
3207571 FX GREAT TOE TREATMENT $ 1,005.00
3207572 EXCISION OF PENIS LESION $ 953.00
3207574 CYSTOURETHROSCOPY/TUMOR L $ 4,041.00
3207575 EXCISION,LESION 1.0 $ 797.00
3207576 AUSTIN BUNIONECTOMY $ 5,674.00
3207577 CYSTOSCOPY/FULGURATION $ 1,217.00
3207578 BIOPSY OF PROSTATE $ 709.00
3207579 LAPAROSCOPY/BIOPSY $ 2,339.00
3207580 REMOVAL OF SKIN TAG $ 333.00
3207581 CAPSULOTOMY $ 2,628.00
3207582 HAMMERTOE $ 3,574.00
3207583 CAPSULOTOMY/INTERPHAL JT $ 2,940.00
3207584 TENOTOMY $ 1,940.00
3207585 BIOPSY/EXCIS LYMPH NODE $ 1,711.00
3207587 LYSIS PENILE LESION $ 1,412.00
3207588 PARTIAL REMOVAL OF COLON $ 8,695.00
3207589 OSTECTOMY, CALCANEOUS $ 3,083.00
3207590 TUBAL LIGATION/POST PARTU $ 2,497.00
3207591 REMOVAL ABD WALL LESION $ 2,634.00
3207592 EXPLORATION/ABD,FLANK,BAC $ 1,663.00
3207593 LITHOTRIPSY,EXTRACORPOREA $ 5,130.00
3207594 LYMPHADENECTOMY/PELVIC $ 4,713.00
3207595 TENOTOMY/GEN ANESTH $ 2,221.00
3207596 PARTIAL EXCIS CALCANEOUS $ 3,050.00
3207597 EXTRACAPSULAR CATARACT $ 6,495.00
3207598 EXCIS LESION UVULA $ 900.00
3207599 EXCISION NAIL/NAIL MATRIX $ 1,019.00
3207600 CAPSULOTOMY $ 2,628.00
3207601 CAPSULOTOMY $ 2,628.00
3207602 OSTECTOMY,PARTIAL $ 2,917.00
3207603 AMPUTATION LOWER LEG $ 5,649.00
3207604 ARTHROSCOPIC ROTATOR CUFF $ 7,791.00
3207605 TENOTOMY SHOULDER $ 4,513.00
3207606 INSERT PERIPHER CENT VEIN 5YRS> $ 2,295.00
3207607 EXCIS LESION 1.0 CM $ 709.00
3207608 BENIGN LESION 1.0 CM $ 976.00
3207609 ORCHIECTOMY/RADICAL $ 3,647.00
3207610 CYSTOSCOPY/STENT $ 1,106.00
3207611 CYSTOURETHROSCOPY/FULGURA $ 1,943.00
3207612 LAPAROSCOPY/LYSIS ADHESIO $ 4,859.00
3207613 CONIZATION OF CERVIX $ 2,002.00
3207614 ENDOCERVICAL CURRETAGE $ 643.00
3207615 ARTHRODESIS/TOE $ 4,076.00
3207616 SALPINGO-OOPHORECTOMY $ 4,995.00
3207617 BIOPSY/EXCISION LESION $ 424.00
3207618 OPEN REDUCTION INT/ANKLE $ 5,672.00
3207619 REVISION URINARY ANASTOMO $ 3,768.00
3207620 REMOVAL FB DEEP/COMPLICA $ 1,786.00
3207621 ENTERECTOMY/RESEC SM INTE $ 6,972.00
3207622 INSERT CENTRAL VENOUS CAT $ 901.00
3207623 REVISION OF ILEOSTOMY $ 6,154.00
3207624 REMOVAL FB DEEP/COMPLICA $ 1,786.00
3207625 EXCISION NAIL/MATRIX $ 1,019.00
3207626 EXCISION OF NAIL/MATRIX $ 1,019.00
3207627 EXCISION OF NAIL/MATRIX $ 1,019.00
3207628 RETINA/COAGULATION $ 4,108.00
3207629 PROCTECTOMY/COMPLETE $ 11,649.00
3207630 ORCHIECTOMY/RADICAL $ 3,647.00
3207631 LITHOTRIPSY/EXTRACORPOREA $ 4,755.00
3207632 EXCISION HYDROCELE $ 2,354.00
3207633 REMOVAL FB DEEP/COMPLICAT $ 1,786.00
3207634 INCISION TOE TENDON $ 2,448.00
3207635 SALPINGECTOMY $ 5,058.00
3207636 CYSTOSTOMY $ 2,044.00
3207637 REPAIR BLADDER WOUND $ 5,119.00
3207638 CYSTOSCOPY/ STENT $ 1,106.00
3207639 AMPUTATION/ IP JOINT $ 2,051.00
3207640 REMOVAL SHOULDER LESION $ 3,874.00
3207641 EXCISION LESION 1.1-2CM $ 821.00
3207642 IRRIGATION OF BLADDER $ 333.00
3207643 LAPAROSCOPY, TUBAL BLOCK $ 3,618.00
3207644 CONIZATION OF CERVIX $ 2,002.00
3207645 OSTECTOMY FOR SPUR $ 3,650.00
3207646 INCISION / PYLORIC MUSCLE $ 4,492.00
3207647 OPEN REDUCTION ANKLE FX $ 4,614.00
3207648 REPAIR BLADDER AND VAGINA $ 2,844.00
3207649 DISLOC ARTHROPLASTY HIP $ 4,796.00
3207650 REMOVAL PROSTATE REGROWTH $ 2,969.00
3207651 INGUINAL HERNIA/INCARCER $ 4,854.00
3207652 CYSTOSTOMY $ 2,044.00
3207653 CYSTOSCOPY & URTETER CATH $ 1,019.00
3207654 REMOVAL/IMPACTED CERUMEN $ 263.00
3207655 COLONOSCOPY/POLYP/SNARE $ 555.00
3207656 SERVERING/VITREOUS STRAND $ 2,032.00
3207657 INTESTINAL PLICATION $ 6,438.00
3207659 I& D/APPENDICEAL ABSCESS $ 4,370.00
3207660 APPENDECTOMY/ ADD ON $ 4,234.00
3207661 LAPARO/SLING OPERATION $ 5,863.00
3207662 EXCISION LESION 2.1-3. $ 1,084.00
3207663 BIOPSY OVARY $ 969.00
3207664 COLONOSCOPY/COLOSTOMY $ 1,296.00
3207665 LITHOLAPAXY $ 3,505.00
3207666 CYSTOSCOPY/STENT $ 1,106.00
3207667 EXCISION INTESTINE LESION $ 5,032.00
3207668 BUNIONECTOMY/DBL OSTEOTOM $ 4,886.00
3207669 BUNIONECTOMY/DBL OSTEOTOM $ 4,886.00
3207670 OSTEOTOMY OF METATARSAL $ 2,623.00
3207671 DRAINAGE/ HYDROCELE $ 592.00
3207672 INGUINAL HERNIA 6MOS-5YO $ 3,842.00
3207673 FLEX SIGMOID/ POLYPECTOMY $ 743.00
3207674 MARSUPIALIZATION/BARTHOLI $ 1,329.00
3207675 REMOVAL HYDROCELE $ 2,502.00
3207676 VASECTOMY $ 1,898.00
3207677 CYSTOURETHROSCOPY/STONE M $ 1,937.00
3207678 CYSTOSCOPY / STENT $ 1,106.00
3207679 EVACUATE MOLE OF UTERUS $ 3,234.00
3207680 BUNION/ CORRECTION $ 4,666.00
3207681 BONE MARROW/ASPIRATION $ 459.00
3207682 EXCISION OF LESION $ 557.00
3207683 FEMORAL HERNIA REPAIR $ 4,770.00
3207684 RECTOCELE REPAIR $ 4,543.00
3207685 CIRCUMCISION $ 1,594.00
3207686 CYSTOURETHROSCOPY $ 860.00
3207687 CYSTOSCOPY/BIOP/FULGURATI $ 2,858.00
3207688 REVISON LOWER LEG TENDON $ 3,505.00
3207689 UNLISTED PROCEDURE $ 0.00
3207690 ARTHROTOMY ANKLE $ 4,694.00
3207691 TRANSFER SINGLE TENDON $ 6,715.00
3207695 AMPUTATION / IP JOINT $ 2,051.00
3207696 TENOTOMY / TOE $ 1,937.00
3207697 TENOTOMY / TOE $ 1,937.00
3207699 ANTEROPOSTERIOR COLPORRAP $ 3,808.00
3207700 PARTIAL EXCISION TOE $ 3,941.00
3207701 REVISION OF TOE $ 2,624.00
3207702 PARTIAL REMOVAL BONE/FOOT $ 3,665.00
3207703 REMOVAL IMPLANT / DEEP $ 2,715.00
3207704 OSTEOTOMY / METATARSAL $ 2,623.00
3207705 CYSTOURETHROSCOPY/REM FB $ 1,192.00
3207706 EXCISION HYDROCELE $ 2,354.00
3207707 CYSTOSCOPY/ DILATION $ 1,521.00
3207708 ANORECTAL EXAM ANESTHESIA $ 746.00
3207709 BUNIONECTOMY/ DBI OSTEOTO $ 4,886.00
3207710 LAPARO/ SLING OPERATION $ 5,863.00
3207711 EXCISION/TUMOR/FOOT/DEEP $ 2,470.00
3207712 OPEN TX METATARSAL FX $ 3,294.00
3207713 EXC INTERDIGIT NEUROMA $ 2,885.00
3207714 RECONSTRUC EXTERNAL CANAL $ 7,579.00
3207715 COLONOSCOPY/COLOS/LESION $ 1,929.00
3207716 CAPSULOTOMY $ 2,628.00
3207717 METACARPAL FX/SKELETON FI $ 4,482.00
3207718 BREAST BIOPSY $ 1,557.00
3207719 REMOVAL OF OVARYS $ 3,109.00
3207720 BIL-SALP-OOPHOR ABD HYSTE $ 9,471.00
3207721 EXC INTERDIGIT NEUROMA $ 2,885.00
3207722 EXC INTERDIGIT NEUROMA $ 2,885.00
3207723 CAPUSLOTOMY $ 2,628.00
3207724 CYSTOURETHROSCOPY/ STONE $ 1,937.00
3207725 REPAIR BOWEL OPENING $ 6,287.00
3207726 INCISE/GRACFT MIDFOOT BON $ 5,017.00
3207727 EXOSTECTOMY HALLUX $ 2,917.00
3207728 CYSTOSCOPY/ TREATMENT $ 1,408.00
3207729 ARTHODESIS/INTERPHAL JT $ 3,592.00
3207730 INCISE/GRAFT MIDFT BONES $ 5,017.00
3207731 INCISION METATARSAL $ 2,623.00
3207732 ARTHROSCOPY/ LAT RELEASE $ 3,689.00
3207733 ARTHROSCOPY/REMOVAL FB $ 1,275.00
3207734 TIBIA FRACTURE TREATMENT $ 3,905.00
3207735 RECTUM/ BIOPSY $ 1,753.00
3207736 ANORECTAL EXAM $ 746.00
3207737 BUNION/ CORRECTION $ 4,666.00
3207739 BUNION / CORRECTION $ 4,543.00
3207741 EXCISION TUMOR/DEEP KNEE $ 3,993.00
3207742 ARTHROSCOPY/ REMOVAL FB $ 1,275.00
3207743 COLONOSCOPY, SUBMUCOUS IN $ 450.00
3207744 CAUTERIZATION OF CERVIX $ 281.00
3207745 PROCTOSIGMOIDOSCOPY/BIOPSY $ 438.00
3207746 GASTROSTOMY TUBE PLACEMEN $ 1,725.00
3207747 ELBOW DISLOCATION $ 3,158.00
3207748 RELEASE ULNAR NERVE $ 3,592.00
3207749 PERCUT PIN FIXATION FING $ 3,333.00
3207750 VAGINAL SEPTUM $ 422.00
3207751 HYMENECTOMY / PARTIAL $ 1,266.00
3207752 REMOVAL FB EAR $ 841.00
3207753 UNLISTED PRCEDURE FOOT $ 786.00
3207754 RETINAL PHOTO COAG/ LASER $ 2,868.00
3207755 EXCIS BENIGN LESION 0.5CM $ 760.00
3207756 CERVICAL CERCLAGE $ 1,165.00
3207757 TURBINOPLASTY $ 841.00
3207758 OSTECTOMY/ PARTIAL METATA $ 3,443.00
3207759 INCISON OF METATARSAL $ 2,486.00
3207760 AMPUTATION TOE $ 2,450.00
3207761 INCISION OF TOE TENDON $ 1,937.00
3207762 INSICION OF TOE TENDON $ 1,937.00
3207763 TENOTOMY $ 1,940.00
3207765 REMOVAL EPIDIDYMIS $ 2,731.00
3207766 REMOVAL EPIDIDYMIS LESION $ 820.00
3207767 DESTRUCTION PENIS LESION $ 333.00
3207768 REPAIR WOUND OR LESION $ 727.00
3207769 REMOVAL DIGIT NERVE LESIO $ 2,587.00
3207770 DIGIT NERVE ADD-ON $ 1,369.00
3207771 INSERT URETERAL SUPPORT $ 6,416.00
3207772 CYSTOURETHROSCOPY/ FULGUR $ 1,943.00
3207773 PROSTATECTOMY/RADICAL/LYM $ 9,734.00
3207774 TONSILLECTIOMY/ADENOID $ 2,495.00
3207775 I & D OF ABCESS $ 254.00
3207776 TENOTOMY / TOE $ 1,937.00
3207778 HAMMERTOE $ 3,574.00
3207779 TENOTOMY $ 1,937.00
3207780 TENOTOMY $ 1,937.00
3207781 BUNION / CORRECTION $ 4,666.00
3207782 BUNION/ CORRECTION $ 4,543.00
3207783 TENOTOMY $ 1,937.00
3207784 VAGINAL HYSTERECOTMY T/O $ 6,496.00
3207785 MARSUPIALIZATION/BARTHOLN $ 1,329.00
3207786 LAPAROSCOPY $ 3,575.00
3207787 LAPAROSCOPY/EXCISE LESION $ 5,161.00
3207788 BONE MARROW ASPIRATION $ 459.00
3207789 RESECTION TUMOR FOOT $ 4,887.00
3207790 HEMORRHOIDECTOMY EXT/INTE $ 3,240.00
3207791 PHOTOCOAGULATION $ 6,043.00
3207792 EXCISION / TUMOR MPJ $ 2,470.00
3207793 EXCISION / TUMOR MPJ $ 2,470.00
3207794 INCISE BLADDER/ DRAIN URE $ 3,050.00
3207795 CYSTOGRAM / SIMPLE $ 2,014.00
3207796 REMOVAL OF METATARSAL $ 3,419.00
3207797 PARTIAL REMOVAL OF TOE $ 814.00
3207798 FIXATION OF KNEE JOINT $ 1,039.00
3207799 DEBRIDE ABDOMINAL WALL $ 5,509.00
3207800 REMOVAL MESH $ 2,071.00
3207801 INGUINAL HERNIA 6MOS-5YR $ 2,525.00
3207803 HYSTEROSCOPY, ABLATION $ 2,205.00
3207804 HYSTEROSCOPY, BIOPSY $ 2,177.00
3207805 EXCISION OF UVULA $ 1,506.00
3207806 AKIN OSTEOTOMY $ 5,163.00
3207807 REDUCE TESTIS TORSION $ 4,505.00
3207809 EXCISION OF UVULA $ 1,506.00
3207810 LAPAROSCOPY,TUBAL BLOCK $ 3,618.00
3207811 REPAIR DETACHED RETINA / PHOTOCOAG $ 3,786.00
3207812 HAMMERTOE $ 3,574.00
3207813 FUSION / FOOT BONES $ 5,417.00
3207814 REMOVAL FB / DEEP $ 3,177.00
3207815 INCISION OF METATARSALS $ 2,623.00
3207816 COLONOSCOPY $ 1,106.00
3207817 HEMORRHOID TAG REMOVAL $ 1,312.00
3207818 DESTRUCTION ANAL LESION $ 289.00
3207819 ENDOMETRIAL ABLATION/THER $ 1,637.00
3207820 EXCHANGE LENS PROSTHESIS $ 5,993.00
3207821 SEPTOPLASTY $ 5,095.00
3207822 LAPRO-VAG HYST COMPLEX $ 8,205.00
3207823 REMOV LESION BACK/FLANK $ 2,461.00
3207824 EXCISION CYST / BREAST $ 2,718.00
3207825 BREAST BIOPSY INCISIONAL $ 1,557.00
3207826 SUBMUCOUS RESECTION TURBI $ 3,657.00
3207827 ADENOIDECTOMY $ 1,609.00
3207828 MYRINGOTOMY / TUBE PLACE $ 1,223.00
3207829 HEMORRHOIDECTOMY/INTERNAL $ 1,211.00
3207830 REMOVAL IMPLANT / DEEP $ 2,715.00
3207831 BUNIONECTOMY/ DBL OSTEOTO $ 4,886.00
3207832 EXCISION / TUMOR MPJ $ 2,470.00
3207833 CAPSULOTOMY/ INTERPHAL JT $ 2,940.00
3207834 REMOVAL OF VITREOUS $ 2,536.00
3207835 EXPLORATORY LAP $ 5,588.00
3207836 RELEASE TRIGGER FINGER $ 1,958.00
3207837 ENDOSCOPIC INJECTION $ 1,543.00
3207838 REMOVAL OF SPLEEN $ 6,130.00
3207839 CYSTOSCOPY / DILATION $ 1,521.00
3207840 YAG LASER $ 1,727.00
3207841 INCISIONAL HERNIA/RECURRE $ 5,519.00
3207842 EXCISION LESION 1.0 $ 797.00
3207844 HAMMERTOE $ 3,574.00
3207845 CYSTOURETORO W/ LITHOTRIP $ 3,095.00
3207846 REVISION OF BIG TOE $ 2,624.00
3207847 INCISE/GRAFT MIDFOOT BONE $ 5,017.00
3207848 HAMMERTOE $ 3,574.00
3207849 TENOTOMY $ 1,940.00
3207850 UNLISTED PROCEDURE FOOT $ 786.00
3207851 EXCHANGE LENS PROSTHESIS $ 5,993.00
3207852 EXCISION MALIG LESION 4.0 $ 1,619.00
3207853 AMPUTATION METATARSAL $ 4,392.00
3207854 GANGLION CYST/ RECURRENT $ 3,711.00
3207855 PLACE GASTROSTOMY TUBE $ 1,725.00
3207856 EXC INTERDIGIT NEUROMA $ 2,885.00
3207857 FIXATION SHOULDER $ 1,397.00
3207858 BUINION / CORRECTION $ 4,543.00
3207859 TENOTOMY $ 1,940.00
3207860 TENOTOMY $ 1,937.00
3207862 SURG PREP RECIP SITE $ 534.00
3207863 D & C 2ND TRIMESTER $ 2,422.00
3207864 EXCISION OF LESION 1.1-2. $ 1,041.00
3207865 HAMMERTOE $ 3,574.00
3207866 HAMMERTOE $ 3,574.00
3207867 EXCIS. TUMOR,TISSUE/ELBOW $ 2,139.00
3207868 REPAIR ABDOMINAL WALL $ 5,463.00
3207869 YAG LASER $ 1,727.00
3207870 OSTECTOMY / PARTIAL METAT $ 3,443.00
3207871 INCISION METATARSAL $ 2,623.00
3207872 ENDOMETRIAL ABLATION/ THE $ 1,637.00
3207873 LYSIS PENILE CIRCUM LES $ 1,412.00
3207874 RELEASE TRIGGER FINGER $ 1,958.00
3207875 MALIG LESION 1.0 $ 933.00
3207876 I & D OF ABCESS $ 1,131.00
3207877 EXCISION, TUMOR FOOT $ 2,716.00
3207878 UNLISTED PROCEDURE FOOT $ 2,595.00
3207879 ILEOSCOPY $ 459.00
3207880 EXCIS MALIG LESION 3.1-4. $ 1,389.00
3207881 LAYER CLOSURE WOUND $ 397.00
3207882 INCISION OF FOOT FASCIA $ 2,232.00
3207883 DILATE URETHRA STRICTURE $ 468.00
3207884 LITHOTRIPSY/EXTRACORPOREA $ 7,757.00
3207885 EGD/FOREIGN BODY REMOVAL $ 2,986.00
3207886 MASTECTOMY/ MOD RADICAL $ 7,717.00
3207887 KNEE ARTHROSCOPY / DX $ 2,935.00
3207888 PANNICULECTOMY $ 8,141.00
3207889 REMOVAL NASAL FOREIGN BOD $ 1,420.00
3207890 REMOVAL TUNNELED CV CATH $ 1,451.00
3207891 MASTOID CAVITY DEBRIDE $ 928.00
3207892 SKIN PINCH GRAFT $ 2,924.00
3207893 AMPUTATION OF TOE $ 2,450.00
3207894 CYSTOSCOPY/ STENT IMPLANT $ 2,501.00
3207895 CYSTOSCOPY / FULG $ 2,285.00
3207896 REVISE ULNAR NERVE/WRIST $ 1,137.00
3207897 HEMORRHOIDECTOMY/ EXTERNA $ 2,062.00
3207898 INSERT DRUG IMPLANT DEVIC $ 606.00
3207899 CESAREAN SECTION $ 7,445.00
3207900 REMOVAL SWEAT GLAND LES $ 1,489.00
3207901 REMOVAL TAILBONE $ 3,328.00
3207902 EXCISON LESION FACE 1.1-2 $ 1,206.00
3207903 REMOVAL BREAST TISSUE $ 3,744.00
3207904 COLONOSCOPY $ 393.00
3207905 GASTROSTOMY TUBE PLACE $ 4,037.00
3207906 CYSTOSCOPY / TREATMENT $ 1,969.00
3207907 REVISE ULNAR NERVE/ WRIST $ 1,137.00
3207908 REMOVAL ANAL FISTULA $ 2,229.00
3207909 AMPUTATION OF TOE $ 2,450.00
3207910 TREAT TOE DISLOCATION $ 835.00
3207911 EXCISION THROMBOSED VEIN $ 8,368.00
3207912 HYSTEROSCOPY WITH LYSIS $ 2,531.00
3207913 LAPAROSCOPIC PROCEDURE $ 1,906.00
3207914 REMOVAL INTRANASAL LESION $ 2,128.00
3207915 REMOVAL LESION SUBCUT $ 2,409.00
3207916 CHANGE BLADDER TUBE $ 473.00
3207917 EXCISION OF LESION 1.0-2. $ 1,041.00
3207918 REPAIR NASAL STENOSIS $ 6,594.00
3207919 PARTIAL EXCISON PHAL/TOE $ 3,941.00
3207920 BENIGN LESION 1.0 $ 932.00
3207921 EXCIS LESION FACE 3.1-4 $ 1,902.00
3207922 CYSTOURETORO W/ LITHOTRIP $ 804.00
3207923 REPAIR VAGINA/ PERINEUM $ 871.00
3207924 AKIN OSTEOTOMY $ 5,163.00
3207925 CAPSULOTOMY $ 2,628.00
3207926 CYSTOURETHROSCOPY / CALIB $ 1,206.00
3207927 EXC MALIG LESION 0.6-1CM $ 1,151.00
3207928 LAYER CLOSURE OF WOUND $ 1,138.00
3207929 REMOVAL OVARIAN CYST $ 4,556.00
3207930 OMENTECTOMY $ 5,539.00
3207931 POSTERIOR COLPORRHAPHY RE $ 1,009.00
3207932 TREATMENT NOSE FRACTURE $ 3,168.00
3207933 ARTHROSCOPY KNEE, SYNOVEC $ 3,450.00
3207934 ARTHROSCOPY KNEE, SYNOVEC $ 3,450.00
3207935 TREATMENT OF NOSE FRACTUR $ 953.00
3207936 EXCISION LESION 2.1-3.0 $ 976.00
3207937 ARTHROSCOPY, DEBRIDE/SHAV $ 4,486.00
3207938 AMPUTATION TOE $ 2,450.00
3207939 THYROID LOBECTOMY/ TOTAL $ 5,235.00
3207940 TONSILLECTOMY $ 2,177.00
3207941 REPAIR DEFORMITY / TOE $ 1,165.00
3207942 CYSTOSCOPY / TREATMENT $ 1,217.00
3207943 DESTRUCT BENIGN LESION $ 392.00
3207944 ASPIR BLADDER/SUPRAPUB CA $ 1,927.00
3207945 EXCIS MALIG LESION 0.5 $ 721.00
3207947 EXCISION FACE LESION $ 1,501.00
3207948 EXCIS/ FULGUR URETH POLYP $ 1,366.00
3207950 REMOVAL BREAST TISSUE $ 2,495.00
3207951 REMOVAL LESION SUBCUTAN $ 2,409.00
3207952 CHANGE OF BLADDER TUBE $ 473.00
3207953 EGD $ 2,715.00
3207954 REVISION URETHRAL $ 2,892.00
3207955 DESTRUCTION PENIS LESION $ 593.00
3207956 INJECTION OF BLADDER $ 329.00
3207957 FIXATION OF SHOULDER $ 1,397.00
3207958 INJ/ DRAIN JOINT/BURSA $ 351.00
3207959 EXCISION LESION WRIST $ 3,410.00
3207960 INCISION TENDON SHEATH $ 3,374.00
3207961 REPAIR BLADDER NECK $ 4,264.00
3207962 DRAINAGE BLADDER ABCESS $ 957.00
3207963 DRAINAGE URETHRAL ABCESS $ 2,852.00
3207964 OVARIAN CYST RUPTURE $ 2,806.00
3207965 RADICAL RESECT METATARSAL $ 3,576.00
3207966 AMPUTATION TOE $ 2,450.00
3207967 DEBRIDEMENT SKIN SUBQ TIS $ 497.00
3207968 LAPAROSCOPY, SALPING-OOPH $ 4,079.00
3207970 EXCISION / VARICOCELE $ 2,297.00
3207971 BIOPSY / TESTIS $ 1,403.00
3207972 EGD / POLYP / SNARE $ 1,348.00
3207973 DRAIN ABDOMINAL ABSCESS $ 9,334.00
3207974 RADICAL RESECT METATARSAL $ 3,576.00
3207975 EXCISON MALIGNANT LESION $ 1,194.00
3207976 REVISION UPPER EYELID $ 3,264.00
3207977 BENIGN LESION 1.0 $ 932.00
3207978 CYSTOSCOPY/STONE REMOVAL $ 2,454.00
3207979 REPAIR COMPLEX 2.6-7.5CM $ 1,859.00
3207980 REPAIR COMPLEX ADD 5.0CM $ 521.00
3207981 CYSTOSCOPY / TREATMENT $ 1,627.00
3207982 CYSTOSCOPY / TREATMENT $ 1,312.00
3207983 CYSTOSCOPY / BIOPSY $ 927.00
3207984 REMOV/INSERT DRUG IMPLANT $ 1,167.00
3207985 INCIS BLADDER CONTRACTURE $ 2,621.00
3207986 IMPLANT HORMONE PELLETS $ 502.00
3207987 REM INTRAUTERINE DEVICE $ 434.00
3207988 CHEMICAL CAUTERY, TISSUE $ 220.00
3207989 LAPAROSCOPY/SALPING-OOPH $ 4,079.00
3207990 EXCIS MALIG LESION 1.1-2C $ 903.00
3207991 OOPHORECTOMY UNI/BILATER $ 3,109.00
3207992 SHAVING LESION 0.5CM/LESS $ 231.00
3207993 REPAIR BLOOD VESSEL LESIO $ 6,247.00
3207994 EXCISION LESION 2.1-3.CM $ 1,084.00
3207995 COLONOSCOPY $ 3,822.00
3207996 DRAINAGE OVARIAN ABCESS $ 4,285.00
3207997 REMOVAL/ SWEAT GLAND LES $ 1,299.00
3207998 C-SECTION/ATTEMP NOR DELI $ 6,495.00
3207999 SLING OPERATION/ INCONTIN $ 5,886.00
3208000 COLONOSCOPY $ 3,822.00
3208001 COLONOSCOPY $ 3,822.00
3208002 COLONOSCOPY $ 3,822.00
3208003 COLONOSCOPY $ 3,822.00
3208005 COLONOSCOPY/BIOPSY $ 4,536.00
3208006 COLONOSCOPY/BIOPSY $ 4,536.00
3208008 COLONOSCOPY/POLYP/CAUTERY $ 4,643.00
3208009 COLONOSCOPY/POLYP/SNARE $ 4,904.00
3208010 ESOPHAGOSCOPY $ 2,286.00
3208012 ESOPHAGEAL DILAT/FB REMOV $ 3,021.00
3208016 EGD $ 2,715.00
3208017 EGD $ 2,715.00
3208018 EGD $ 2,715.00
3208019 GASTROSCOPY/BIOPSY $ 2,768.00
3208020 UGD/BIOPSY $ 2,768.00
3208021 EGD/CLO TEST/BIOPSY $ 2,768.00
3208022 GASTROSCOPY/BIOPSY $ 2,768.00
3208025 FLEX SIGMOID $ 1,106.00
3208026 CARDIOVERSION $ 935.00
3208027 ESOPHAGEAL DILAT/BIOPSY $ 2,768.00
3208032 COLONOSCOPY $ 3,822.00
3208034 EXCIS BENIGN LESION 0.5CM $ 611.00
3208035 EXCIS BENIGN LESION 0.5CM $ 760.00
3208036 EXCISION LESION 3-1-4 $ 1,083.00
3208037 COLONOSCOPY/POLYP/SNARE $ 4,904.00
3208039 FLEX SIGMOID/BIOPSY $ 1,151.00
3208041 EXCISION OF LESION 1.0 $ 976.00
3208043 HEMORRHOIDECTOMY EXTERNAL $ 2,062.00
3208045 PORTAL CATHETER FLUSH $ 229.00
3208046 FLEX SIGMOID $ 1,106.00
3208048 FLEX SIGMOID/BIOSPY $ 1,151.00
3208049 TYMPANOSTOMY/LOCAL OR TOP $ 733.00
3208051 CYSTOURETHROSCOPY $ 860.00
3208052 SIGMOIDOSCOPY $ 1,106.00
3208053 COLONOSCOPY/BIOPSY $ 468.00
3208054 COLONOSCOPY/POLYP/CAUTERY $ 496.00
3208062 SIGMOID/POLYP $ 1,649.00
3208063 FLEX SIGMOID $ 1,106.00
3208065 SIGMOIDOSCOPY/POLYP REMOV $ 1,534.00
3208068 SUBMUCOUS RESECT TURBINAT $ 2,437.00
3208070 COLONOSCOPY $ 3,822.00
3208071 EGD BIOPSY $ 2,768.00
3208073 COLONOSCOPY $ 3,822.00
3208085 COLONOSCOPY $ 604.00
3208087 HEMORRHOID / FISTULA REM $ 2,229.00
3208088 PLACEMENT SETON $ 1,270.00
3208089 LAP CHOLE $ 5,354.00
3208090 CAST / SHOULDER TO HAND $ 412.00
3208091 CYSTOSCOPY / STENT $ 1,543.00
3208093 INJECTION / JOINT $ 351.00
3208094 INJECTION / JOINT $ 351.00
3208095 INJECTION JOINT $ 254.00
3208096 GASTROSTOMY TUBE PLACEMEN $ 4,037.00
3208098 INJECTION / JOINT $ 261.00
3208100 REOPENING / ABDOMEN $ 5,841.00
3208101 PART REMOV METATARSAL $ 2,031.00
3208102 HYSTEROSCOPY, ABLATION $ 2,205.00
3208103 EXCISION LESION 1.1-2. $ 1,041.00
3208104 CIRCUMCISION / REGIONAL $ 661.00
3208105 CYSTOSCOPY & URETH CATH $ 1,019.00
3208106 REMOVAL SHOULDER LESION $ 3,874.00
3208107 REMOVE CARTILAGE / GRAFT $ 2,961.00
3208108 AUSTIN BUNIONECTOMY $ 5,674.00
3208109 TREAT FX DISTAL RADIAL $ 4,079.00
3208110 PARTIAL REMOVAL COLON $ 9,767.00
3208111 SURGICAL COLONOSCOPY $ 351.00
3208112 INSERT PERITONEAL CATH $ 2,313.00
3208113 INSERT BLADDER CATH/COMPL $ 533.00
3208114 REMOVAL ABD WALL LESION $ 2,634.00
3208115 REMOVAL ABD/OVARIAN CYST $ 4,556.00
3208116 I & D OF ABCESS $ 1,131.00
3208117 REPAIR EYELID DEFECT $ 2,494.00
3208118 TREAT FX DISTAL RADIAL $ 4,079.00
3208119 SUTURE LARGE INTESTINE $ 6,271.00
3208120 LIGATE/STRIP LONG VEIN $ 4,624.00
3208121 REMOVAL ETHMOID SINUS $ 4,856.00
3208122 EXPLORE MAXILLARY SINUS $ 1,927.00
3208123 OPEN TX METACARPAL FX $ 4,289.00
3208124 REMOVAL TUNNELED CV CATH $ 905.00
3208125 EXCISION PENIS LESION (S) $ 953.00
3208126 ENDOSCOPY, MAXILLARY SINU $ 652.00
3208130 OPEN TX METATARSAL FX $ 3,294.00
3208131 DEBRIDE SKIN,MUSC/BONE FX $ 2,590.00
3208132 EXCIS/REP MOUTH LESION $ 1,173.00
3208133 CYSTOSCOPY W / TREATMENT $ 2,172.00
3208134 LAPAROSCOPY/ EXCIS LESION $ 4,079.00
3208135 REPAIR SIMPLE FACIAL 2.6- $ 736.00
3208137 VULVECTOMY / PARTIAL $ 3,305.00
3208138 RELEASE TRIGGER FINGER $ 1,958.00
3208139 LAPAROSCOPY HERNIA REPAIR $ 5,884.00
3208140 UNLISTED PROCEDURE $ 455.00
3208141 REPAIR RECTOCELE $ 4,543.00
3208142 FRACTURE NASAL TURBINATES $ 1,040.00
3208143 CHOLECYSTECTOMY $ 5,354.00
3208144 EXCISION LESION 1.1-2.CM $ 821.00
3208145 EXCISION TUMOR MPJ $ 2,470.00
3208146 LIGATE OVIDUCTS $ 624.00
3208147 LIGATION / STRIP VEIN $ 2,599.00
3208148 EXCISION ANAL LESION $ 764.00
3208149 EXCISION LESION 1.0CM $ 797.00
3208150 REMOVAL KNEE BURSA $ 2,195.00
3208151 EXCISION TUMOR DEEP $ 4,236.00
3208152 DIAG LARYNGOSCOPY $ 1,267.00
3208153 REVISION FALLOPIAN TUBES $ 5,313.00
3208154 I&D HEMATOMA,SEROMA,FLUID $ 820.00
3208155 REMOVAL FOOT FASCIA $ 2,599.00
3208156 PREPUTIAL STRETCHING $ 395.00
3208157 CAPSULOTOMY $ 2,628.00
3208158 CAPSULOTOMY $ 2,628.00
3208159 CAPSULOTOMY $ 2,628.00
3208160 CORRECT/ HALLUX VALGUS $ 2,460.00
3208161 PART REMOV METATARSAL $ 2,031.00
3208162 EXPLORE ABDOMINAL VESSEL $ 4,097.00
3208163 REMOVAL FOREIGN BODY $ 833.00
3208164 INCISION & DRAINAGE ELBOW $ 912.00
3208165 APPLIC BONE FIXATION $ 1,040.00
3208166 COLONOSCOPY/ POLYP/ SNARE $ 4,904.00
3208167 SURGICAL WOUND CLO 2NDARY $ 4,747.00
3208168 SPERMATOCELE $ 2,662.00
3208169 CYSTOSCOPY/ STONE REMOVAL $ 2,454.00
3208170 CYSTOSCOPY/STENT IMPLANT $ 2,501.00
3208171 FIXATION KNEE JOINT $ 1,039.00
3208172 CIRCUMCISON / REGIONAL $ 661.00
3208173 EXTENSIVE REP VAGINA $ 5,471.00
3208174 INSERT MESH / PELVIC $ 1,667.00
3208175 REVISION ETHMOID SINUS $ 778.00
3208176 OSTEOTOMY / METATARSAL $ 2,486.00
3208177 HAMMERTOE $ 3,574.00
3208178 EXPLORE MAXILLARY SINUS $ 1,927.00
3208179 EXCISION LESION OVER 4CM $ 1,389.00
3208180 AMPUTATION TOE $ 2,450.00
3208181 REPAIR ANKLE LIGAMENTS $ 3,520.00
3208182 EXCISION LESION / FACE $ 1,582.00
3208183 EXCISION LESION / FACE $ 1,206.00
3208184 REPAIR HYDROCELE $ 2,481.00
3208185 I&D FOOT $ 1,095.00
3208186 PAR REMOV, FOOT FASCIA $ 2,215.00
3208187 ARTHROSCOPY KNEE,CHONDRO $ 1,524.00
3208188 EGD $ 2,715.00
3208189 COMPLEX DRAINAGE/ WOUND $ 1,033.00
3208190 REMOVAL FOREIGN BODY $ 1,087.00
3208191 EXCISION LESION 3.1-4.0CM $ 1,083.00
3208192 RELEASE PALM CONTRACTURE $ 2,698.00
3208193 GANGLION CYST $ 2,186.00
3208194 LAPAROSCOPY/EXCIS LESION $ 5,161.00
3208195 EXCIS MALIG LESION 3.1-4 $ 1,198.00
3208196 PART REMOV FASCIA FOOT $ 2,215.00
3208197 EXPLORE SM INTESTINE $ 5,582.00
3208198 COLONOSCOPY/POLYP/SNARE $ 4,904.00
3208202 REMOVE FEMUR LESION/BURSA $ 2,634.00
3208203 EXC INTERDIGIT NEUROMA $ 2,885.00
3208204 EXC LESION TENDON $ 2,130.00
3208205 REMOVAL SM INTESTINE $ 6,972.00
3208206 EXCIS TUMOR FOOT $ 2,044.00
3208207 ORCHIDOPEXY $ 2,982.00
3208208 EXCISION, TUMOR TOE $ 2,716.00
3208209 REMOVAL BLADDER STONE $ 2,241.00
3208210 ENDOSCOPY, MAXILLARY SINU $ 652.00
3208211 AMPUTATION TOE $ 2,450.00
3208212 CONIZATION CERVIX $ 1,451.00
3208213 BENIGN LESION 1.0 $ 932.00
3208214 FRACTURE/ FINGER / PIN $ 2,336.00
3208215 CYSTOSCOPY / STONE $ 1,583.00
3208216 CYSTOSCOPY / URETER CATH $ 1,019.00
3208217 REMOV PROSTATE GROWTH $ 2,969.00
3208218 CYSTOSCOPY / STENT $ 1,543.00
3208219 REM GANGLION CYST FINGER $ 2,186.00
3208220 REM INTRAUTERINE DEVICE $ 434.00
3208221 LAP SUPRACERV HYSTERECTOM $ 5,772.00
3208222 PELVIC EXAM / ANES $ 868.00
3208223 HYSTERECTOMY/ SUPRACERV $ 5,351.00
3208266 CYSTOSCOPY STONE REMOVAL $ 2,591.00
3208284 LAPAROSCOPY PROCED UNLIS $ 1,131.00
3208285 CYSTOSTOMY TYBE PLACEMENT $ 628.00
3208286 EXCIS MALIGNANT LESION 2. $ 1,095.00
3208287 DRAINAGE OF OVARIAN CYST $ 2,453.00
3208288 LIGATION HEMORRHOIDS $ 1,186.00
3208289 ARTHRSCOPY, DEBRIDE/SHAV $ 4,486.00
3208290 EXCISE INFERIOR TURBINATE $ 2,693.00
3208291 TONSILLECTOMY/ADNOIDECTOM $ 2,495.00
3208292 ARTHROSCOPY/REMOVAL FB $ 1,275.00
3208293 REPAIR / INTER FAC 2.5 $ 1,138.00
3208294 DILATION URETHRA STRICT $ 587.00
3208295 SWANSON TOTAL IMPLANT $ 2,595.00
3208296 GLAUCOMA FISTULIZATION $ 2,092.00
3208297 REVISION CALF TENDON $ 1,087.00
3208298 REVISION CALF TENDON $ 1,087.00
3208299 INCISION BREAST LESION $ 1,684.00
3208300 ENDOSCOPY URETER $ 1,977.00
3208301 I & D OF ABCESS $ 1,131.00
3208302 ENDOSCOPY,MAXILLARY SINUS $ 1,215.00
3208303 CYSTOSCOPY / TREATMENT $ 530.00
3208304 DRAINAGE FINGER ABSCESS $ 1,044.00
3208305 TENDON SHEATH INJECTION $ 245.00
3208306 INGUINAL HERNIA $ 3,623.00
3208307 REMOVAL SWEAT GLAND LESIO $ 1,489.00
3208308 MYRINGOTOMY $ 1,108.00
3208309 TONSILLECTOMY/ ADNOIDECTO $ 2,603.00
3208310 INFERIOR TUBINOPLASTY $ 1,485.00
3208311 REMOVAL IMPACTED CERUMEN $ 263.00
3208312 TOTAL KNEE ARTHROPLASTY $ 10,661.00
3208313 OPEN TX METATARSAL FX $ 3,294.00
3208314 OPEN TX METATARSAL FX $ 3,294.00
3208315 LAP/ ENTEROLYSIS $ 5,372.00
3208316 COLPOPEXY/ EXTRAPERITONEA $ 1,055.00
3208317 REMOVAL ELBOW LESION $ 2,996.00
3208318 EXCISION, OLECRANON BURSA $ 2,803.00
3208319 COLONOSCOPY / BIOPSY $ 4,536.00
3208320 COLONOSCOPY/POLYP/SNARE $ 4,904.00
3208321 COLONOSCOPY/SUBMUCOUS INJ $ 450.00
3208322 ARTHROSCOPY/ LAT RELEASE $ 3,689.00
3208323 HEMORRHOID/ LIGATION $ 1,254.00
3208324 DEBRIDEMENT TIS/MUSC/BONE $ 1,923.00
3208325 EXCISION LESION 3.1-4 $ 1,083.00
3208326 EXCISION TUMOR FING/HAND $ 2,478.00
3208327 PARTIAL EXCISION PHAL/TOE $ 3,941.00
3208328 LAPARO PROCED UTERUS $ 262.00
3208329 INCISION & DRAINAGE FOOT $ 2,810.00
3208330 OSTEOTOMY / METATARSAL $ 2,623.00
3208331 INSERTION PICC LINE $ 585.00
3208332 REPAIR CIRCUMCISION $ 1,380.00
3208333 EXTRACAPSULAR CATARACT $ 6,495.00
3208334 COLONOSCOPY/ BIOPSY $ 468.00
3208335 REPAIR COMPLEX 2.5-7.5CM $ 2,756.00
3208336 DEBRIDEMENT 20 SQ CM $ 188.00
3208337 OSTEOTOMY / METATARSAL $ 2,623.00
3208338 EXCISION TUMOR FACE $ 2,379.00
3208339 REPAIR TUNNELED CV CATH $ 1,194.00
3208340 BIOPSY TOE JOINT LINING $ 1,466.00
3208341 GASTROSTOMY TUBE REPOSIT $ 650.00
3208342 KNEE ARTHROSCOPY/MENISCUS $ 4,028.00
3208343 SPERMATOCELE $ 2,587.00
3208344 I&D NECK/CHEST LESION $ 1,963.00
3208345 MYOMECTOMY ABD COMPLETE $ 7,203.00
3208346 EXCISION BOWEL POUCH $ 4,614.00
3208347 EXCIS TUMOR BACK >5CM $ 4,605.00
3208348 CORRECT/HALLUX VALGUS $ 2,460.00
3208349 EXCISION LESION 2.1-3. $ 1,084.00
3208350 EXCIS MALIGNANT LESION 2. $ 1,095.00
3208352 ARTHROSCOPY, KNEE CHONDRO $ 4,046.00
3208353 EXCIS PILONIDAL CYST COMP $ 3,363.00
3208354 EXTERNAL HEMORRHOIDS $ 644.00
3208355 CYSTO / URETHRAL STRICTUR $ 1,858.00
3208356 GANGLION CYST $ 3,870.00
3208359 EXCISION MALIGNANT LESION $ 1,194.00
3208360 BIOPSY VULVA / PERINEUM $ 377.00
3208362 COLONOSCOPY $ 3,822.00
3208363 APPLIC BONE FIXATION $ 1,040.00
3208364 COLONOSCOPY $ 3,822.00
3208365 COLONOSCOPY SUBMUC INJ $ 3,822.00
3208366 CYSTOURETHROSCOPY/REM FB $ 1,192.00
3208367 AMPUTATION TOE $ 2,450.00
3208368 COLONOSCOPY SUBMUC INJ $ 3,822.00
3208369 EXCISION VAGINAL CYST $ 1,497.00
3208370 REMOV ANAL FISTULA INTER $ 2,426.00
3208371 BENIGN LEISON 1.0 $ 932.00
3208372 PERITONEAL LAVAGE $ 605.00
3208373 EXCISION LESION 1.0 CM $ 797.00
3208374 EXCISION LESION 4.0 OVER $ 2,093.00
3208375 CYSTO REMOVAL CLOTS $ 1,835.00
3208376 CYSTOMETROGRAM COMPLEX $ 1,353.00
3208377 EAR/THROAT EXAM / ANEST $ 597.00
3208378 REPAIR ELBOW / DEBRIDE $ 3,992.00
3208379 HYSTEROSCOPY/BIOPSY $ 2,177.00
3208380 DEBRIDEMENT/ MUSC FASCIA $ 756.00
3208381 CYSTOURETERO/ LITHOTRIPSY $ 2,712.00
3208382 ANUS PROCEDURE $ 948.00
3208383 SIGMOIDOSCOPY W SUBMUC IN $ 575.00
3208384 BENIGN LESION 1.0 $ 932.00
3208385 EXCISION LESION 0.6-1.0CM $ 935.00
3208386 TREATMENT WRIST FRACTURE $ 2,780.00
3208387 CYSTOSCOPY & URETH CATH $ 1,019.00
3208388 PARTIAL REMOVAL COLON $ 8,695.00
3208389 INDUCED ABORTION D &C $ 1,296.00
3208390 WOUND EXPLORATION $ 2,626.00
3208391 REPAIR COMPLEX 2.6-7.5CM $ 1,859.00
3208392 MARSHALL MARCHETTI COMPLI $ 4,955.00
3208393 METATARSAL FRACTURE $ 2,081.00
3208394 DELIVERY PLACENTA $ 525.00
3208395 EXCISION SKIN TAG/ ANUS $ 670.00
3208396 REMOVAL METATARSAL $ 973.00
3208397 REPAIR FOOT TENDON $ 1,722.00
3208398 DEBRID MUSCLE TISSUE BONE $ 1,923.00
3208399 INJECTION JOINT $ 254.00
3208400 INJECTION JOINT $ 529.00
3208402 CYSTOMETROGRAM W/ VP & UP $ 1,174.00
3208403 REMOVAL ELBOW LESION $ 2,996.00
3208404 TENDON SHEATH INJECTION $ 245.00
3208405 EXCIS WRIST TENDON SHEATH $ 2,134.00
3208406 AUTOGRAFT SKIN SPLIT $ 4,059.00
3208407 REMOVAL CERCLAGE SUTURE $ 769.00
3208408 PARTIAL HYSTERECTOMY $ 5,437.00
3208409 INGUINAL HERNIA INCARCERA $ 7,279.00
3208410 EXCISION LESION 1.0CM $ 709.00
3208411 BENIGN LESION 1.0 $ 932.00
3208412 DESTRUCT BENIGN LESION $ 392.00
3208413 REMOVAL TONGUE JEWELRY $ 191.00
3208414 INJECTION / JOINT $ 351.00
3208415 BIOPSY VAGINA $ 710.00
3208416 PARITAL MASTECTOMY $ 3,581.00
3208417 GANGLION CYST $ 2,186.00
3208418 EXCIS MALIG LESION 3.1-4. $ 1,198.00
3208419 ORCHIOPEXY $ 4,001.00
3208420 ENTROPIAN REP BILATERAL $ 5,122.00
3208421 NASAL ENDOSCOPY $ 436.00
3208422 EXC BENIGN LESION 0.5CM < $ 611.00
3208423 LAPAROSCOPY, SALPIN-OOPHO $ 5,095.00
3208424 REM INT/EXT HEMORRHOID $ 2,326.00
3208425 COLONOSCOPY $ 3,822.00
3208426 EXCIS INTRA-ABDTUMOR $ 6,644.00
3208427 EXCIS MALIG LESION 3.1-4C $ 1,198.00
3208428 REMOVAL FOOT LESION $ 1,940.00
3208430 INJECTION JOINT $ 380.00
3208431 EXCISION GUM LESION $ 1,188.00
3208432 COLONOSCOPY STOMA BIOPSY $ 1,052.00
3208433 EXCISE EXCESS SKIN TISSUE $ 4,131.00
3208434 DRAINAGE SCROTUM ABSCESS $ 941.00
3208435 REMOVAL ETHMOID SINUS $ 2,852.00
3208436 REMOVAL RESIDUAL CERVIX $ 2,322.00
3208437 REMOVAL FOREIGN BODY FOOT $ 1,157.00
3208438 BIOPSY, BONE OPEN $ 1,214.00
3208439 EXCISION BACK TUMOR <5CM $ 3,570.00
3208440 BENIGN LESION 1.0 $ 932.00
3208441 EXCISON LESION 2.1 - 3.0 $ 1,084.00
3208442 TREATMENT TOE FRACTURE $ 2,756.00
3208443 TREATMENT TOE FRACTURE $ 2,220.00
3208444 REM CERVIX /REP VAGINA $ 3,301.00
3208445 CARPAL TUNNEL RELEASE $ 3,109.00
3208446 CARDIOVERSION $ 935.00
3208447 DELIVERY PLACENTA $ 525.00
3208448 EXTERNAL HEMORRHOIDS $ 644.00
3208449 AMPUTATION METATARASL $ 4,392.00
3208450 EXPLORATION FOOT JOINT $ 1,806.00
3208451 EXCISION LESION 1.1-2CM $ 821.00
3208452 FLEX SIGMOID/ BIOPSY $ 1,151.00
3208453 EXC TUMOR SOFT TIS FOOT $ 2,562.00
3208454 ARTHROSCOPY, DEBRIDE/SHAV $ 4,486.00
3208455 HEMORRHOIDECTOMY, INT,EXT $ 2,357.00
3208456 INSERT TUNNELED CV CATH 5YRS> $ 1,945.00
3208457 ARTHROSCOPY KNEE, SYNOVEC $ 3,450.00
3208458 HEMORRHOIDECTOMY/INTERNAL $ 2,176.00
3208459 EXCIS TUMOR FINGER/ HAND $ 2,478.00
3208460 HEMORRHOID,THROMBOSED EXT $ 972.00
3208461 REMOVAL SKIN TAG $ 333.00
3208462 REPAIR SPEGELIAN HERNIA $ 3,085.00
3208463 REPAIR FEMORAL HERNIA $ 3,208.00
3208464 DRAINAGE PELVIC ABSCESS $ 2,392.00
3208467 EXCISION LESION 4.0 OVER $ 2,093.00
3208468 INCISION BONE CORTEX FOOT $ 3,200.00
3208469 AMPUTATION METATARSAL $ 4,392.00
3208470 COLONOSCOPY / BIOPSY $ 4,536.00
3208471 FASCIECTOMY / PALMAR $ 3,241.00
3208472 EXCISION TUMOR SOFT TISSUE $ 2,979.00
3208473 REPAIR COMPLEX EXTR 2.6 - $ 1,859.00
3208474 REPAIR COMPLEX EXTR OVER $ 521.00
3208475 HYSTERECTOMY / DIAGNOSTIC $ 1,039.00
3208476 RELEASE ULNAR NERVE ELBOW $ 1,672.00
3208477 PERCUT PIN FIXATION FINGER $ 3,333.00
3208478 ARTHROTOMY ANKLE $ 3,546.00
3208479 EXCIS TUMOR ANKLE / LEG $ 2,609.00
3208480 CHROMOTUBATION OVIDUCT $ 436.00
3208481 INJECTION / JOINT $ 261.00
3208482 OPEN REDUCTION ANKLE FX $ 4,614.00
3208483 AMPUTATION TOE/ METATARSAL $ 2,450.00
3208484 LIGATION HEMORRHOIDS $ 1,186.00
3208485 AUSITN BUNIONECTOMY $ 5,674.00
3208486 REVISION ETHOMOID SINUS $ 1,869.00
3208487 EXPLORE MAXILLARY SINUS $ 2,410.00
3208488 TREATMENT TOE FRACTURE $ 2,756.00
3208489 REPAIR TENDON / LEG $ 2,007.00
3208490 REPAIR TENDON / LEG $ 2,007.00
3208491 DISLOCATION FINGER / PIN $ 2,422.00
3208492 REPAIR ELBOW / DEBRIDEMENT $ 2,854.00
3208493 EXCISION LESION BACK FLANK 3CM> $ 2,403.00
3208494 REMOVAL SPERM CORD LESION $ 2,319.00
3208495 I & D BARTHOLINS GLAND ABSCESS $ 476.00
3208496 INSERT TUNNELED CV CATH 5YRS> $ 1,834.00
3208497 EXCISION LESION MALIGNANT OVER 4.0CM $ 2,154.00
3208498 REPAIR METATARSAL W OR W/O BONE GRAFT $ 3,172.00
3208499 LAPARO VAGINAL HYSTER W UTERUS>250 $ 7,203.00
3208500 AMPUTATION / IP JOINT $ 2,051.00
3208501 FASCIECTOMY / PALMAR $ 3,241.00
3208502 RELEASE TRIGGER FINGER $ 1,958.00
3208503 THORACENTESIS W/O IMAGING $ 1,701.00
3208504 SUTURE INFRAPATELLAR TENDON $ 4,972.00
3208505 EXCIS BONE CYST,TUMOR, PHALANGE,FOOT $ 1,599.00
3208506 UNLISTED PROCEDURE FOOT / TOES $ 786.00
3208507 OSTECTOMY, PARTIAL $ 2,917.00
3208508 TREAT ECTOPIC PREGNANCY $ 4,017.00
3208509 CATARACT PHACO (2ND) LT $ 5,405.00
3208510 CATARACT PHACO (2ND) RT $ 5,405.00
3208511 YAG LASER (2ND) $ 1,727.00
3208512 YAG LASER (2ND) $ 1,727.00
3208513 INCISIONAL HERNIA / RECURRENT $ 5,519.00
3208514 LARYNGOSCOPY /BIOSPY $ 1,048.00
3208515 REMOVAL NOSE LESION $ 3,398.00
3208516 INJECTION TREATMENT EYE $ 728.00
3208517 PARTIAL REMOVAL TIBIA $ 4,544.00
3208518 REMOVAL KNEE CAP $ 3,549.00
3208519 AMPUTATION / IP JOINT TOE $ 2,051.00
3208520 COLONOSCOPY $ 3,822.00
3208521 REMOVAL KNEE CYST $ 1,303.00
3208522 REVISION ETHOMOID SINUS $ 778.00
3208523 HEMORRHOIDECTOMY INT/ EXT $ 3,240.00
3208524 CYSTOSCOPY CHEMODENERVATION $ 1,270.00
3208525 KNEE ARTHROSCOPY LOOSE BODY REM $ 4,129.00
3208526 REPAIR ELBOW / DEBRIDEMENT $ 2,854.00
3208527 FRACTURE/ FINGER PIN FIXATION $ 2,336.00
3208528 FUSION FOOT BONES $ 4,763.00
3208529 EXCISION TONSIL TAG/S $ 1,507.00
3208530 ARTHRODESIS / TOE $ 4,076.00
3208531 ANUS PROCEDURE $ 948.00
3208532 ARTHROSCOPY KNEE SYNOVEC $ 3,450.00
3208533 EXCISION / CYST / FINGER $ 2,186.00
3208534 ARTHROSCOPY KNEE, DRILLING $ 4,046.00
3208535 SEPTOPLASTY $ 5,095.00
3208536 IMPLANTATION OF MESH $ 2,095.00
3208537 HYSTEROSCOPY / REMOVAL FB $ 2,177.00
3208538 CYSTO REMOVAL CLOTS $ 1,835.00
3208539 REPAIR INTERMED 12.6-20.0 CM $ 1,320.00
3208540 REMOVAL LENS MATERIAL $ 4,086.00
3208541 IRIDOTOMY / IRIDECTOMY BY LASER $ 1,224.00
3208542 INSERT INTRAOCULAR LENS SECONDAR IMPLANT $ 3,972.00
3208543 PARACENTESIS ANTERIOR CHAMBER $ 2,406.00
3208544 REMOVAL FB EAR $ 312.00
3208545 LARYNGOSCOPY / FLEXIBLE DIAG $ 407.00
3208546 RELEASE PALMAR CONTRACTURE $ 2,698.00
3208547 CARPAL TUNNEL RELEASE BILATERAL $ 4,483.00
3208548 INSERT INTRAOCULAR LENS SECONDARY IMPLAN $ 3,972.00
3208549 REMOVAL OF VITREOUS $ 2,536.00
3208550 ARTHRODESIS / TOE $ 4,076.00
3208551 REMOVAL SESAMOID BONE $ 1,747.00
3208552 PARTIAL REMOVAL METATARSAL $ 2,284.00
3208553 DEBRIDEMENT SUBCUT TISSUE $ 497.00
3208554 JOINT INJECTION WITH ULTRASOUND $ 366.00
3208555 JOINT INJECTION WITH ULTRASOUND $ 366.00
3208556 EXCIS TUMOR FOOT $ 2,044.00
3208557 EXC TUMOR SOFT TISSUE FOOT $ 2,562.00
3208558 COLONOSCOPY / BIOPSY $ 4,536.00
3208559 REMOVAL LESION SUBCUT $ 2,409.00
3208560 ARTHROSCOPY KNEE $ 4,695.00
3208561 ENDOSCOPY, MAXILLARY ANTROSTOMY $ 652.00
3208562 EXCISION TUMOR SOFT TISSUE NECK 3CM> $ 2,322.00
3208563 COLONOSCOPY / POLYP / SNARE $ 4,904.00
3208564 COLONOSCOPY , SUBMUCOUS INJ $ 450.00
3208565 COLONOSCOPY / BIOPSY $ 468.00
3208566 INJECTION / JOINT $ 351.00
3208567 INJECTION / JOINT $ 261.00
3208568 LAPAROSCOPY/ EXCIS LESION $ 4,079.00
3208569 CYSTOGRAM / SIMPLE $ 2,014.00
3208570 JOINT INJECTION WITH ULTRASOUND BILAT $ 548.00
3208571 TYMPANIC MEMBRANE REPAIR $ 1,551.00
3208572 LABYRINTHOTOMY $ 667.00
3208573 OPEN TX METACAPAL FX $ 4,289.00
3208574 ABDOMINAL HYSTERECTOMY $ 1,723.00
3208575 REMOV LESION BACK/FLANK $ 890.00
3208576 INGUINAL HERNIA BILAT $ 7,006.00
3208577 CYSTOURETHOSCOPY W LITHO/ STENT $ 2,284.00
3208578 OSTEOTOMY / METATARSAL $ 2,623.00
3208579 EXCISION TUMOR FACE/ SCALP >2CM $ 2,732.00
3208580 EXCISION OLECRANON BURSA $ 2,803.00
3208581 REMOVAL LESION SUBCUT $ 2,409.00
3208582 REPAIR OF ENTEROCELE /VAGINAL APPROACH $ 2,546.00
3208583 EXC TUMOR SOFT TISSUE FOOT $ 2,562.00
3208584 EXCISION LESION 1.1-2.0CM $ 1,041.00
3208585 EGD / FOREIGN BODY REMOVAL $ 2,986.00
3208586 WOUND DEHISCENCE SIMPLE REPAIR $ 1,201.00
3208587 FINE NEEDLE ASPIRATION W/O IMAGING $ 518.00
3208588 REPAIR HALLUX RIGIDUS/ CHEILECTOMY $ 3,887.00
3208589 COLONOSCOPY $ 3,822.00
3208590 DILATE URETHRA STRICTURE $ 370.00
3208591 EXCISION BONE CYST/BENIGN TUMOR FINGER $ 2,218.00
3208592 DILATION URETHRAL STRICTURE $ 482.00
3208593 GANGLION CYST $ 2,186.00
3208594 INJECTION / JOINT $ 261.00
3208595 MANIPULATION / ELBOW W ANESTHESIA $ 2,139.00
3208596 TX TIBIAL FX W MANIP W/WO SKELETAL TRACT $ 2,543.00
3208597 HALLUX RIGIDUS W CHEILECTOMY W IMPLANT $ 2,540.00
3208598 EXC URACHAL CYST/SINUS W W/O UMB HERNIA $ 3,364.00
3208599 CYSTORRHAPHY, SUTURE BLADDER WOUND/INJUR $ 4,694.00
3208600 EXCIS WRIST TENDON SHEATH $ 2,134.00
3208601 BIOPSY LIVER, WEDGE $ 4,316.00
3208602 OSTECTOMY, PARTIAL $ 2,917.00
3208603 TEMPORAL ARTERY BIOPSY BILATERAL $ 2,542.00
3208604 REMOVAL LESION SUBCUT $ 2,409.00
3208605 FASCIECTOMY/ PART PALMAR RELEASE $ 4,304.00
3208606 PROCTOSIGMOIDOSCOPY RIGID DIAGBOSTIC $ 283.00
3208607 EXCISION TUMOR SOFT TISSUE PELVIS / HIP $ 2,403.00
3208608 ORCHIECTOMY SIMPLE $ 1,996.00
3208609 EXCISION TUMOR SOFT TISSUE FINGER HAND $ 2,979.00
3208610 TOTAL KNEE ARTHROPLASTY BILATERAL $ 10,661.00
3208611 DESTRUCT VAGINAL LESIONS SIMPLE $ 470.00
3208612 PARTIAL EXCISION BONE DISTAL PHAL/FINGER $ 3,642.00
3208613 FLEXIBLE CYSTO OFFICE $ 1,527.00
3208614 SIMPLE CYSTOMETROGRAM OFFICE $ 620.00
3208615 HYSTEROSCOPY W REMOVAL LEIOMYOMATA $ 3,992.00
3208616 CLOSED TX NASAL SEPTAL FX W W/O STABIL $ 2,266.00
3208617 FASCIECTOMY, PARTIAL PALMAR RELEASE $ 1,400.00
3328502 US ABDOMEN / SINGLE ORGAN $ 910.00
3328503 US GUIDE NEEDLE PLACE (THERA/PARA/BIOP $ 1,953.00
3328506 US COMPLETE ABDOMEN $ 1,153.00
3328507 US THYROID, NECK, PAROTID $ 1,082.00
3328512 US SEGMENTAL PRESSURE $ 248.00
3328513 US CHEST MEDIASTINUM $ 701.00
3328514 US UNLISTED PROCEDURE $ 1,289.00
3328515 US NON-VASCULAR EXTREMITY (COMPLETE) $ 1,039.00
3328517 US ABDOMINAL DOPPLER (COMPLETE) $ 3,127.00
3328518 US LIMITED OB (HEART MOTION, PLACENTAL $ 673.00
3328521 US OB BPP $ 822.00
3328522 US INTRAVAGINAL (NON OBSTETRICAL) $ 554.00
3328523 US COMPLETE OB 2ND/3RD TRIMESTER (> 14WK $ 820.00
3328524 US COMPLETE OB 2ND/3RD TRIMESTER (>14WKS $ 820.00
3328525 US BILATERAL VENOUS $ 1,766.00
3328526 US OB 1ST TRIMESTER (<14 WKS) $ 897.00
3328527 US OB TWINS 1ST TRIMESTER (USE + 76801) $ 291.00
3328529 US OB TWINS 2ND/3RD TRIMEST (USE +76805) $ 563.00
3328531 US PELVIS $ 1,042.00
3328533 US FOLLOW UP PELVIS / LIMIT BLADDER ONLY $ 846.00
3328535 US AORTA / KIDNEYS ONLY/ TRANSPLANT LIMI $ 920.00
3328536 US THYROID, NECK, PAROTID $ 1,082.00
3328537 US RUQ,SINGLE ORGAN, FU, LIMITED ABD $ 910.00
3328538 US CAROTID $ 1,944.00
3328539 US SCROTUM AND CONTENTS $ 1,061.00
3328540 US DOPPLER COLOR FLOW $ 704.00
3328543 US BREAST, COMPLETE LEFT UNILAT $ 554.00
3328544 US BREAST, COMPLETE RIGHT UNILAT $ 554.00
3328545 US BREAST, COMPLETE BILAT $ 832.00
3328546 US BREAST, LIMITED LEFT UNILAT $ 413.00
3328547 US BREAST, LIMITED RIGHT UNILAT $ 413.00
3328548 US BREAST, LIMITED BILAT $ 620.00
3328551 US LWR/ UPP EXTREMITY VENOUS (UNILAT) $ 1,480.00
3328552 US LWR/ UPP EXTREMITY VENOUS (UNIL) LIMI $ 1,480.00
3328555 US FOLLOW UP OB (GROWTH,AFI,ORGAN RE-EVA $ 874.00
3328556 US IVT OB $ 748.00
3328559 US NON-VASCULAR EXTRMIETY (LIMITED) $ 687.00
3328560 US COMPLETE ABDOMEN LIMITED $ 1,153.00
3328562 US UPPER EXTREMITY ATERIAL DUPLEX BILAT $ 1,502.00
3328563 US LWR EXTREM ARTERIAL DUPLEX BILAT $ 1,868.00
3328565 US KIDNEY / BLADDER $ 1,102.00
3328566 US OB BIO-PHYSICAL PROFILE $ 595.00
3328567 US KIDNEY TRANSPLANT (WITH DUPLEX) $ 1,331.00
3328568 US ABDOMINAL DOPPLER (COMPLETE) MULT TES $ 3,127.00
3328569 US OB BIO-PHYSICAL PROFILE-TWINS(+76819) $ 595.00
3328571 US LWR EXTREMITY ARTERIAL DULEX UNILAT $ 1,214.00
3328572 US KIDNEY TRANSPLANT (WITH DUPLEX) LIMIT $ 1,331.00
3328573 US ABI / SEGMENTAL PRESSURE UNILATERAL $ 433.00
3328574 US ABI / SEGMENTAL PRESSURE UNILAT LIMIT $ 433.00
3328575 US OB TWINS FOLLOW UP (GROWTH ETC) $ 874.00
3328576 US ABDOMINAL DOPPLER (LIMITED) $ 1,727.00
3328577 US AORTA/IVC/ILLIAC DUPLEX/ ABDOMINAL BY $ 1,586.00
3328578 US HEMODIALYSIS ACCESS $ 2,235.00
3328579 US FETAL UMBILICAL ARTERY DOPPLER $ 192.00
3328580 US UPPER EXTREMITY ARTERIAL DUPLEX UNILA $ 1,100.00
3328581 US ABDOMINAL AORTA SCREENING $ 920.00