Current Price List

This list of charges reflects the standard charges for inpatient and outpatient services provided at Moab Regional Hospital. The hospital’s charges are the same for all patients, but the patient’s financial responsibility for services provided may vary, depending upon payment plans negotiated with individual health insurers as well as reimbursement schedules set forth by public payers such as Medicare and Medicaid. Patients should contact our business office staff for assistance. These charges do not include items or services that may be billed separately for physician services, lab, diagnostic services, etc.

Language indicating that the listed charges do not constitute a contract.

Revenue Code Procedure Code Description Department    Rate
963 00810 COLONOSCOPY-Anesthesia-PHYSICIAN Anesthesia 316.00
964 00810 COLONOSCOPY Anesthesia-CRNA Anesthesia 316.00
982 01996 EPIDERAL MGT DLY Anesthesia 178.00
982 20550 INJ TEND/LIG/TRIG Anesthesia 194.00
982 20552 INJ TRIGGER PT1-2 Anesthesia 205.00
982 20553 INJ 1+ <3 MUSCLES Anesthesia 246.00
981 20605 INJECTION INTERMED JOINT Anesthesia 183.00
982 20610 ARTHOCENT-INJ LG Anesthesia 211.00
982 27096 INJ SAC Anesthesia/STER Anesthesia 617.00
982 27200 CLO TX COCCYGEAL FX Anesthesia 524.00
982 31500 INTUBATE,ENDO ER Anesthesia 471.00
964 31500 CRNA/INTUBATE, ENDO ER Anesthesia 471.00
982 32554 THORA WITH INSTERT OF TUBE INCLU WS Anesthesia 649.00
982 36406 VENIPUNCT UNDER 3 Anesthesia 119.00
982 36410 VENIPINCTURE>3 YR Anesthesia 96.00
981 36410 VENIPUNCTURE +AGE 3, REQ PHYS SKILL Anesthesia 140.00
982 36510 CATH UMBILICAL VN Anesthesia 365.00
370 36556 INVASIVE PRESSURE/CVP Anesthesia 768.00
982 36556 PLACE CENT VENOUS Anesthesia 1,258.00
982 36569 PICC LINE PLACEMENT > 5 Anesthesia 960.00
300 36600 ARTERIAL SUPPLIES Anesthesia 209.00
982 36600 ARTERIAL PUNCTURE Anesthesia 161.00
370 36620 INVASIVE PRESSURE/ARTER Anesthesia 391.00
981 43752 NASO OR ORO GASTRC TUBE PLCMT FLR Anesthesia 225.00
982 43753 GAST INTUB NECESS PHYS SKILL W/LAV IF Anesthesia 90.00
982 62270 PUNCTURE/SPINAL Anesthesia 389.00
964 62270 LUMBAR PUNCTURE Anesthesia 387.00
964 62270 LUMBAR PUNCTURE Anesthesia 509.00
964 62270 CRNA LUMBAR PUNCTURE Anesthesia 389.00
982 62273 INJ EPIDERAL BLOO Anesthesia 982.00
982 62273 INJ EPID,BLD PTCH Anesthesia 982.00
964 62273 INJ, EPIDURAL OF BLOOD OR CLOT PATCH Anesthesia 982.00
964 62322 CRNA/LUMBAR INJ EPIDURAL Anesthesia 752.00
982 62324 EPIDURAL-CERVICAL Anesthesia 1,001.00
982 62326 INJ LUMB/SAC-CATH Anesthesia 865.00
981 64400 INJ. TRIGEMINAL NERVE Anesthesia 572.00
981 64402 INJ FACIAL NERVE Anesthesia 721.00
981 64405 INJ GREATER OCCIPITAL NERVE Anesthesia 823.00
982 64415 INJ BRACHIAL PLEXUAS Anesthesia 871.00
964 64417 INJECTION, AnesthesiaT AGENT; AXILL NERVE CRNA Anesthesia 564.00
982 64420 INJ INTCOSTL NRVE Anesthesia 658.00
982 64421 INJ INTERCOSTAL N Anesthesia 978.00
963 64445 INJECT Anesthesia AGENT SCIAT NERVE SINGLE Anesthesia 553.00
963 64447 INJ Anesthesia AGENT; FEMORAL NERVE, SINGLE Anesthesia 553.00
963 64450 INJECT Anesthesia AGENT OTH PERIPH NERVE/BRANC Anesthesia 428.00
981 64479 INJ TRANSFORAM EPIDURAL CERVICAL Anesthesia 992.00
981 64483 INJ LUMBAR OR SACRAL Anesthesia 1,031.00
963 64484 INJ LUMBAR/SACRAL EA ADD LEVEL Anesthesia 381.00
981 64490 INJ CERVICAL-THORACIC FACET Anesthesia 746.00
981 64491 INJ CERV-THORACIC EACH ADDITIONAL Anesthesia 374.00
982 64493 INJ LUM/SAC-JNTNV Anesthesia 911.00
981 64494 INJ LUMBAR-SACRAL EACH ADDTNL LEV Anesthesia 301.00
982 64495 FACET JOINT INJ THIRD LEVEL Anesthesia 470.00
982 64510 INJ STELLATE GAGL Anesthesia 1,062.00
982 64520 INJ LUMB/THORACIC Anesthesia 1,243.00
982 73040 RADIOLOG EXAM SHOULDER ARTHR Anesthesia 139.00
982 77003 FLOURO GUIDANCE OF NEEDLE CATH Anesthesia 292.00
964 91105 GASTRIC INTUB AND ASP/LAVAGE Anesthesia 277.00
460 93040 EKG BACK PADS Anesthesia 68.00
982 94010 SPIROMETRY Anesthesia 55.00
982 94016 SPIROMETRIC RECORDING Anesthesia 72.00
982 94060 BRONCHOSPAS EVAL Anesthesia 185.00
982 94660 CONT POS AIR PRES Anesthesia 288.00
460 94681 CO2 MONITORING Anesthesia 60.00
460 94760 OXIMETRY CHECK Anesthesia 75.00
963 96372 INTRAMUSCULAR INJECTION Anesthesia 40.00
963 96374 THERAPEUTIC IV PUSH Anesthesia 191.00
982 99144 MOD SEDATION 5 YRS OR OLDER Anesthesia 125.00
963 99145 MOD SED > 5 YRS OLD EAADD 15 MIN Anesthesia 52.00
964 99148 MOD DED: YOUNGER THAN 5 YRS PROFEE Anesthesia 278.00
963 99149 MODERATE SED SERVICES 5 YRS OR > 1ST Anesthesia 106.00
963 99150 ADD 15 MINUTES OF CONSCIOUS SEDATION Anesthesia 55.00
982 99201 OFFICE FOCUSED Anesthesia 114.00
982 99202 KOPELL OFFICE/ OP VISIT Anesthesia 139.00
982 99203 NEW DETAILED Anesthesia 181.00
982 99204 NEW COMPREHENSIVE Anesthesia 257.00
982 99212 EST PROB FOC 10MN Anesthesia 86.00
982 99212 EST PT O.V. 10 MINS Anesthesia 134.00
982 99213 EST EXP PROB 15MN Anesthesia 103.00
982 99214 EST DETAILED Anesthesia 157.00
981 99214 OFFICE VISIT, EST PT, DETAILED Anesthesia 151.00
982 99215 COMPREHENSIVE F/U Anesthesia 319.00
981 99215 EST COMPREHENSIVE Anesthesia 250.00
982 99217 OBSERVATION DISCHARGE CARE Anesthesia 151.00
987 99221 INITIAL IP E&M, LOW Anesthesia 213.00
987 99222 INIT IP CARE MOD COMPLEX Anesthesia 277.00
981 99231 SUBSEQUENT HOSP CARE Anesthesia 114.00
981 99232 SUBSEQUENT HOSP CARE Anesthesia 150.00
981 99233 SUBSEQUENT HOSP CARE Anesthesia 218.00
981 99241 CONSULT-FOCUSED Anesthesia 163.00
982 99242 CONSULTATION LEVEL 2 Anesthesia 217.00
981 99243 CONSULT-DETATILED Anesthesia 264.00
981 99244 CONSULT-MODERATE Anesthesia 343.00
981 99245 CONSULT DETAILED 80 MINUTES Anesthesia 448.00
982 99251 INIT IP CONSULT Anesthesia 201.00
982 99252 NIT IP CONS EST Anesthesia 257.00
982 99253 INIT IP CONS DTLD Anesthesia 317.00
982 99254 IP CONSULT INTERMEDIATE Anesthesia 394.00
982 99255 INIT IP CONSULT-COMPREHENSIVE Anesthesia 495.00
982 99261 IP FOLLOW UP LEVEL I Anesthesia 110.00
981 99262 IP FOLLOW UP LEVEL II Anesthesia 171.00
981 99282 E&M EMERGENCY ROOM, LOW COMP Anesthesia 224.00
981 99284 E&M EMERGENCY ROOM, HIGH COMPL Anesthesia 499.00
981 99291 CRITICAL CARE 30-74 MIN Anesthesia 690.00
981 99292 CRITICAL CARE ADDITIONAL 30 MIN Anesthesia 350.00
982 99360 PHYSICIAN STANDBY SERVICES Anesthesia 207.00
982 99440 NEONATAL RESUSC Anesthesia 676.00
964 99464 ATTEND AT DELIVERY/INITIAL STAB OF NB Anesthesia 166.00
963 99465 NEWBORN RESUSCITATION Anesthesia 521.00
964 99465 CRNA/NEW BORN RESUSCITATION Anesthesia 521.00
370 AnesthesiaTHESIA PER MINUTE Anesthesia 13.00
379 BIS SENSOR XP QUATRO Anesthesia 130.00
370 ARTERIAL MONITORING Anesthesia 153.00
250 LOCAL TRAY Anesthesia 112.00
379 SPINAL BLOCK PROCEDURE Anesthesia 145.00
982 KOPELL READ RESP SCREEN Anesthesia 95.00
370 ADDL 15 MIN AnesthesiaTHESIA Anesthesia 104.00
379 ANTHESIA BREATHING UNIT Anesthesia 100.00
370 LTA 11 EACH Anesthesia 113.00
379 BAIN BREATHING CIRCUIT Anesthesia 88.00
379 VENTULATOR Anesthesia 311.00
963 00740 Anesthesia — ENDOSCOPY PHYSICIAN Anesthesia Professional Fee 300.00
982 92950 Anesthesia CPR Anesthesia Professional Fee 614.00
963 99100 Anesthesia FOR PT OF EXTRM AGE >1YEAR Anesthesia Professional Fee 116.00
963 99140 Anesthesia COMPLICATED BY EMERGENCY COND Anesthesia Professional Fee 88.00
963 Anesthesia PHYS UNITS Anesthesia Professional Fee 78.00
964 Anesthesia CRNA UNITS Anesthesia Professional Fee 78.00
964 Anesthesia -EGD CRNA Anesthesia Professional Fee 300.00
963 Anesthesia PER MINUTE – PROFEE Anesthesia Professional Fee 11.00
964 Anesthesia PER MINUTE – PROFEE Anesthesia Professional Fee 11.00
730 93041 Cardiopulmonary MONITER Cardiopulmonary 459.00
450 93236 Cardiopulmonary MONITOR HOURLY Cardiopulmonary 23.00
739 LIFE PAK Cardiopulmonary 335.00
730 93005 EKG Cardiopulmonary 196.00
482 93017 Cardiopulmonary STRESS TEST Cardiopulmonary 968.00
731 93225 HOLTER, HOOK UP Cardiopulmonary 535.00
731 93226 HOLTER SCAN Cardiopulmonary 556.00
731 93270 EVENT RECORDING HOOKUP Cardiopulmonary 570.00
412 94002 VENTILATOR SET-UP FIRST DAY Cardiopulmonary 2,696.00
412 94003 VENTILATOR; EACH ADDITIONAL DAY Cardiopulmonary 1,038.00
460 94010 PFT W/O BRONC SETUP Cardiopulmonary 227.00
460 94010 INCENTIVE SPIROMETRY INITIAL Cardiopulmonary 158.00
460 94060 PULMON. FNCT. W/BRONCH Cardiopulmonary 423.00
460 94060 SPIROMETRY PRE/POST BRONC Cardiopulmonary 423.00
460 94150 PEAK FLOW TREATMENT Cardiopulmonary 139.00
460 94620 O2 SUMMARY 6 MIN WALK Cardiopulmonary 343.00
412 94640 SVN SUBSEQUENT Cardiopulmonary 175.00
410 94660 CPAP INITATION & MNGMNT (ONCE/VISIT) Cardiopulmonary 822.00
412 94660 SPUTUM INDUCTION Cardiopulmonary 122.00
412 94664 SVN INITIAL Pt teaching Cardiopulmonary 123.00
412 94667 CPT INITIAL TX (once/visit) Cardiopulmonary 310.00
412 94668 CPT SUBSEQUENT Cardiopulmonary 93.00
460 94760 PULSE OX CHECK-EACH Cardiopulmonary 113.00
410 94760 PULSE OXIMETERY CONTINUOUS Cardiopulmonary 269.00
460 94762 SLEEP SATURATION STUDY Cardiopulmonary 332.00
460 RESPIRATOR SCREENING Cardiopulmonary 255.00
460 RESPIRATOR SCREEN WITH XRAY Cardiopulmonary 197.00
460 BIPAP CONTINOUS Cardiopulmonary 584.00
410 COOL MIST CONTINUOUS Cardiopulmonary 52.00
410 HEATED MIST CONTINUOUS Cardiopulmonary 51.00
410 NASAL WASH Cardiopulmonary 42.00
271 OXYGEN PER HOUR <6 lpm Cardiopulmonary 28.00
271 OXYGEN PER HOUR >=6 lpm Cardiopulmonary 28.00
410 USN 24 HRS. ADDITIONAL Cardiopulmonary 66.00
410 CROUP TENT DAILY CHARGE Cardiopulmonary 97.00
412 USN DAILY CHARGE Cardiopulmonary 34.00
412 OXYGEN ANALYZER Cardiopulmonary 44.00
410 OXIMETRY W/EXERCISE Cardiopulmonary 137.00
125 R & B HOSPICE Canyonlands Care Center 604.00
129 R & B RESPITE CARE Canyonlands Care Center 157.00
169 ADULT DAY CARE 4 HRS Canyonlands Care Center 27.00
169 ADULT DAY CARE 8 HRS Canyonlands Care Center 48.00
169 ADULT DAY CARE HOURLY Canyonlands Care Center 6.00
761 29445 APPLICATION RIGID TOTAL CONTACT LEG CAST Central Supplies 446.00
270 32551 HEIMLICH VALVE CHEST DRAIN Central Supplies 320.00
270 32551 PNEUMOTHORAX KIT DISP Central Supplies 467.00
270 36591 COLLECT BLOOD; IMPLANT VENOUS ACCESS DEV Central Supplies 130.00
270 94760 OXIMETRY, PULSE DAY Central Supplies 61.00
278 C1713 SEE 425090200 / ZIMMER K WIRES .063 Central Supplies 46.00
278 C1713 OSTEOSET PELLETS BONE GRAFT Central Supplies 3,150.00
278 C1713 SEE 425132003 Acumed CO-3140 3.5×14 Central Supplies 197.00
278 C1713 SEE 425132004 Acumed CO-3160 3.5×1 Central Supplies 197.00
278 C1713 STRYKER ORTHO 345540 SCREW 4.0X40mm Central Supplies 296.00
278 C1713 ZIMMER 00-8757-000-02 SCREW HOLE PLUG Central Supplies 709.00
278 C1713 SEE 425103044 ZIMMER 00-6250-065-30 SCR Central Supplies 314.00
278 C1713 ACUMED COL-2140 SCREW 2.7X14mm LOCKING Central Supplies 478.00
278 C1713 ACUMED COL-2120 SCREW 2.7X14mm LOCKING Central Supplies 478.00
278 C1713 SEE 425132002 ACUMED CO-3120 SCRE Central Supplies 163.00
278 C1713 ACUMED CO-2712 SCREW 2.7X12mm Central Supplies 466.00
278 C1713 ACUMED COL-3014 SCREW 3.5X14mm LOCKING Central Supplies 486.00
278 C1713 ACUMED COL-3018 SCREW 3.5X18mm LOCKING Central Supplies 478.00
278 C1713 STRYKER 6.5 PEEK ZIP ANCOR Central Supplies 855.00
278 C1713 STRYKER TITANIUM ANCHOR Central Supplies 1,013.03
278 C1713 OR ANKLE FRACTURE Central Supplies 1.00
278 C1713 OR ARM FRACTURE Central Supplies 1.00
278 C1713 OR ELBOW FRACTURE Central Supplies 1.00
278 C1713 OR FOOT FRACTURE Central Supplies 1.00
278 C1713 OR HAND FRACTURE Central Supplies 1.00
278 C1713 OR HIP FRACTURE Central Supplies 1.00
278 C1713 OR KNEE FRACTURE Central Supplies 1.00
278 C1713 OR LEG FRACTURE Central Supplies 1.00
278 C1713 SYNTHES 02.210.124LOCKN SCREW 2.4X24 Central Supplies 875.00
278 C1713 SYNTHES 202.874 SCREW CORTEX 2.7X16 Central Supplies 369.00
278 C1713 SYNTHES 204.840 CORTEX SCREW 3.5X40mm Central Supplies 236.00
278 C1713 SYNTHES 212.121 SCREW 3.5X50 LOCKIN Central Supplies 810.00
278 C1713 ZIMMER 1147-44-40 CANULATE SCREW 4.0X42m Central Supplies 985.00
278 C1713 OR ARTHREX AR-1927PSF-3 TRIPLE 5.5mm Central Supplies 1,215.00
278 C1751 OR POWER PORT 8fr MRI SING LUMEN 1808000 Central Supplies 2,827.00
278 C1751 OR POWER PORT 9.5FR DUO MRI 1829500 Central Supplies 2,592.50
272 C1758 CATHETER, URETHERAL Central Supplies 55.00
272 C1758 CATH SINGLE FOLEY all sizes Central Supplies 50.00
272 C1758 CATH SINGLE FOLEY 14fr Central Supplies 38.00
272 C1758 CATH SINGLE FOLEY 16fr Central Supplies 38.00
272 C1758 CATH SINGLE FOLEY 20fr Central Supplies 40.00
272 C1758 CATH 3-WAY FOLEY 22fr 30ml IRRIGATION Central Supplies 86.00
278 C1765 OR SEPTRAFILM 5X6″ Central Supplies 1,178.00
272 C1769 ACUMED WS-1106ST GUIDE WIRE .045 Central Supplies 97.00
278 C1769 SYNTHES 292.623 GUIDE WIRE NON THR Central Supplies 234.00
272 C1773 OR ROTH NET/RAPTOR GRASPING DEVICE Central Supplies 534.60
272 C1773 OR DISP TALON GRASPER Central Supplies 579.00
278 C1776 OR TOTAL KNEE Central Supplies 1.00
278 C1776 OR TOTAL SHOULDER Central Supplies 1.00
278 C1781 MESH PERMACOL P152840 Central Supplies 32,945.00
278 C1781 OR MESH TECT1510AL POLY LT Central Supplies 628.00
278 C1781 OR MESH TECT1510AR POLY RT Central Supplies 628.00
278 C1781 OR MESH TEM1208GR PROGRIP RT Central Supplies 1,323.00
278 C1781 OR BG MEDICAL TINTRAC15   SURGIMESHXB Central Supplies 4,438.00
278 C1781 OR MESH TEM1208GL PROGRIP LT 47X3″ Central Supplies 1,323.00
278 C1781 OR MESH PCO6VP VENTRAL PATCH Central Supplies 1,549.00
278 C1781 OR MESH PCO8VP VENTRAL PATCH Central Supplies 1,989.00
278 C1781 OR MESH PCO4VP VENTRAL MESH Central Supplies 1,716.00
278 C1781 OR BG MEDICAL TINIRA C-10 SURGIMESH Central Supplies 2,425.00
278 C1781 OR BARD MESH PATCH SM Central Supplies 1,922.00
278 C1781 OR BARD MESH PATCH MED Central Supplies 5,483.00
278 C1781 OR PCO12 POLYESTER 4.8″ MESH Central Supplies 1,970.00
278 C1781 OR PCO1510 POLYESTER 6X4 MESH Central Supplies 1,553.00
278 C1781 OR PCO2015 POLYESTER 8X8 MESH Central Supplies 2,492.00
278 C1781 OR PCO2520 POLYESTER 10X8 MESH Central Supplies 4,014.00
278 C1781 OR TEM1515G PROGRIP 15X15cm MESH Central Supplies 1,542.00
278 C9359 ALLOMATRIX-INJECTABLE PUTTY 5CC Central Supplies 3,027.00
278 C9359 ALLOMATRIX-INJECTABLE PUTTY 1CC Central Supplies 523.00
278 C9359 ALLOMATRIX-MIG INJECTIBLE PUTTY 15CC Central Supplies 4,535.00
278 C9359 ALLOMATRIX-INJECTIBLE PUTTY 10CC Central Supplies 2,329.00
278 C9359 ALLOMATRIX MIG INJECTABLE PUTTY 5cc Central Supplies 3,391.00
278 C9359 ALLOMATRIX- INJECTIBLE PUTTY 3CC Central Supplies 1,485.00
278 C9359 OR ALLOGRAFT Central Supplies 1.00
274 L3908 DME TITAN UNERVERSAL WRIST BRACE Central Supplies 163.00
274 L3980 DME HUMERUS FRACTURE BRACE Central Supplies 183.00
270 Q4006 SUPPLY-LONG ARM FIBERGLASS CAST Central Supplies 336.00
270 Q4008 SUPPLY-LONG ARM FIBERGLASS-CAST PED Central Supplies 269.00
270 Q4010 SUPPLY-SHORT ARM FIBERGLASS CAST-ADULT Central Supplies 195.00
270 Q4012 SUPPLY-SHORT ARM FIBERGLASS-CAST PED Central Supplies 156.00
270 Q4018 SUPPLY-LONG ARM ORTHO-GLASS SPLINT-ADULT Central Supplies 285.00
270 Q4020 SUPPLY-LONG ARM ORTHO-GLASS-SPLINT-PED Central Supplies 228.00
270 Q4022 SUPPLY-SUGAR TONG SPLINT-ADULT Central Supplies 156.00
270 Q4022 SUPPLY-SHORT ARM ORTHO-GLAS-SPLINT-ADULT Central Supplies 187.00
270 Q4024 SUPPLY-SUGAR TONG-SPLINT-PED Central Supplies 125.00
270 Q4024 SUPPLY-SHORT ARM ORTHO-GLASS-SPLINT-PED Central Supplies 149.00
270 Q4030 SUPPLY-LONG LEG FIBERGLASS CAST-ADULT Central Supplies 428.00
270 Q4032 SUPPLY-LONG LEG FIBERGLASS-CAST PED Central Supplies 343.00
270 Q4038 TOTAL CONTACT 3″ TCC2301 Central Supplies 415.00
270 Q4038 TOTAL CONTACT 4″ TCC24001 Central Supplies 435.00
270 Q4038 SUPPLY-SHORT LEG FIBERGLASS CAST-ADULT Central Supplies 329.00
270 Q4040 SUPPLIES, SHRT LEG ORTHO-GLASS PED 0-10 Central Supplies 263.00
270 Q4042 SUPPLY-LONG LEG ORTHO-GLASS SPLINT-ADULT Central Supplies 348.00
270 Q4044 SUPPLY-LONG LEG ORTHO-GLASS-SPLINT PED Central Supplies 279.00
270 Q4046 SUPPLY-SHORT LEG ORTHO-GLAS SPLINT-ADULT Central Supplies 216.00
270 Q4048 SUPPLY-SHORT LEG ORTHO-GLASS-SPLINT-PED Central Supplies 173.00
270 Q4049 SUPPLY-FINGER SPLINT Central Supplies 25.00
272 OR WRIGHT MED DSDS1011 1.1X150MM K-WIRE Central Supplies 218.00
270 DME BOOT EQUALIZER WALKING Central Supplies 151.00
270 ROUTINE SUPPLY CHARGE Central Supplies 42.00
270 CORDGUARD Central Supplies 109.00
270 STAPLER LINEAR TX60B Central Supplies 1,426.68
278 Bone Cement Simplex P 6191-1-010 Central Supplies 605.22
270 SIMPLEX BONE CEMENT Central Supplies 605.22
272 ARTHREX AR-4068-25TL Suture Lasso Left Central Supplies 525.00
278 Acumed CO-3180 3.5x18mm Screw Central Supplies 197.00
278 Achilles Tendon Graft LIVE TISSUE Central Supplies 3,449.00
278 ZIMMER 7818-46 ENDO FEMORAL HEAD 46mm Central Supplies 1,757.00
278 ZIMMER 7818-99 ENDO FEMORAL HEAD ADAPTR Central Supplies 616.00
278 GRAFT JACKET 2X4 MAX FORCE Central Supplies 3,775.00
270 GENZYME 80001 CARTLDGE BX TRANSPORT KIT Central Supplies 2,005.00
278 FEMORAL HEMI CONDYIS RT LATERAL Central Supplies 8,872.00
278 STRYKER ORTHO 702802 TAP 3.5mm Central Supplies 1,085.00
278 STRYKER 700347 DRILL BIT 3.5X125mm Central Supplies 851.00
278 SYNTHES 207.035 SCREW 4.0X35mm CANCELLOU Central Supplies 185.00
278 SYNTHES 207.030 SCREW 4.0X30mm CANCELLOU Central Supplies 160.00
278 ALLODERM 2X4cm REGEN TISSUE MATRIX Central Supplies 1,026.00
278 LIFECELL 1520616 ALLO-DERM 6X16cm THICK Central Supplies 7,891.00
278 LIFEECELL STRATTICE 10X10 Central Supplies 6,729.00
278 LIFECELL 1520108 ALLODERM 6X18 PRE-HYDRA Central Supplies 5,324.00
278 ALLERGAN 133MV-13 TISSUE EXPANDER 13 Central Supplies 4,254.75
278 ALLERGAN BREAST IMPLANT SRM-685 Central Supplies 1,430.00
278 ARTHREX FGRACILIS GRACILIS TENDON Central Supplies 3,278.00
278 SYNTHES 241.401 PLATE 1/3TUB 10H/117mm Central Supplies 1,085.00
278 SYNTHES 058100 DBX MIX 1CC Central Supplies 4,022.00
278 SYNTHES 710.002.99S CHRONOS GRAN 1cc Central Supplies 304.00
270 BONE WAX Central Supplies 77.55
278 STRYKER 5350-4524 HUMERAL HEAD 45mm Central Supplies 7,148.00
278 STRYKER 6188-1-001 SIMPLEX P BONE CEMENT Central Supplies 561.00
270 Colostomy Bag Central Supplies 40.00
270 TUNGSTEN LOOP Central Supplies 80.00
278 SEE 425107710 / STRYKER 5552-E-4821 HU Central Supplies 2,606.00
278 STRYKER ORTHO 6191-1-001 SIMPLEX Central Supplies 405.00
278 STRYKER ORTHO 5552-S-4416 HUMERAL HEAD Central Supplies 5,095.00
270 STAPLER TA 48 3.5mm TA4535S Central Supplies 1,275.00
272 STAPLER TA 60 4.8MM TA6048S Central Supplies 403.96
270 STAPLER ENDO UNIVERSAL 65 DEGREE Central Supplies 1,534.00
270 ENDO LOOPS Central Supplies 316.00
278 ZIMMER 00-8751-012-40 NEUTRAL LINER 40 K Central Supplies 5,392.00
278 ZIMMER 00-8775-040-03 FEMORAL HEAD 40/+3 Central Supplies 7,076.00
272 ZIMMER 8790-007-030 DRILL BIT 3.2X30 Central Supplies 706.00
278 ZIMMER 5001-53-28 MULTIPOLAR BIPOLAR 53/ Central Supplies 1,976.00
278 ZIMMER 5001-54 MULTIPOLAR BIPOLAR CUP Central Supplies 2,464.00
278 ZIMMER 8018-28-03 FEMORAL HEAD 12/14 TAP Central Supplies 2,757.00
278 SEE 425103034 ZIMMER 5972-066-32 PATELLA Central Supplies 1,958.00
278 ZIMMER 00-8751-009-32 CONTINUUM LONGEVIT Central Supplies 4,368.00
278 ZIMMER 00-8757-050-01 CLUSTER-HOLE CONTI Central Supplies 7,735.00
278 ZIMMER 00-8775-032-03 BIOLOX FEM HEAD 32 Central Supplies 6,027.00
278 ZIMMER 5001-044-28 BIPOLAR LINER Central Supplies 1,976.00
278 ZIMMER 5001-046-00 BIPOLAR SHELL 46mm CD Central Supplies 2,464.00
278 ZIMMER 8018-028-03 FEMORAL HEAD 28mm Central Supplies 2,757.00
278 ZIMMER 00-6250-065-15 SCREW 6.5X15 ST Central Supplies 616.00
278 ZIMER 8018-036-05 COCR FEMRAL HEAD 12/14 Central Supplies 3,416.00
278 ZIMMER 00-8751-010-36 CROSSLINK 36X52 Central Supplies 5,392.00
278 ZIMMER 00-8757-052-01 CLUSTER-HOLE SHELL Central Supplies 7,735.00
272 ZIMMER 00-8790-007-02 FLEXDRILL 15m Central Supplies 851.00
278 ACUMED MS-DC28 DRILL 2.8mm Central Supplies 557.00
278 ACUMED 30-0267 SCREW 3.5X35mm Central Supplies 413.00
278 ACUMED PL-PTACK PLATE TACK Central Supplies 315.00
278 ACUMED 30-0258 SCREW 3.5X14mm HEXALOBE Central Supplies 413.00
278 ACUMED 65-0005-S CALLOS INJECT 5cc Central Supplies 2,347.00
278 ACUMED 70-0298 CLAVICLE PLATE 8-H Central Supplies 3,663.00
278 ACUMED COL-3120 SCREW 3.5X12mm LOCK Central Supplies 478.00
278 ACUMED 70-0117 CLAVICLE PLATE 9-H,L Central Supplies 3,422.00
278 ACUMED COL-2100 SCREW 2.7X10mm LOCKING Central Supplies 478.00
278 ACUMED COL-2160 SCREW 2.7X16mm LOCKING Central Supplies 478.00
278 ACUMED CO-2722 SCREW 2.7X22mm Central Supplies 466.00
278 ACUMED 70-0286 CLAVICLE PLATE 8-H Central Supplies 3,422.00
278 ACUMED CO-2716 SCREW 2.7X16mm NL Central Supplies 466.00
278 ACUMED 70-0294 CLAVICLE PLATE 10-H Central Supplies 3,422.00
278 ACUMED 70-0296 CLAVICLE PLATE 6-H, NARRO Central Supplies 3,489.00
278 ACUMED COL-3160 SCREW 3.5X16mm LOCKIN Central Supplies 478.00
278 ACUMED 70-0287 CLAVICLE 8H, RT Central Supplies 3,422.00
278 ACUMED AT2M-1813 DRILL BIT MINI ACUTRAK Central Supplies 1,158.00
278 ACUMED AT2M-L1813 DRILL BIT LONG ACUTRAK Central Supplies 1,288.00
278 ACUMED 70-0118 PLATE 8-H, CLAVICLE Central Supplies 3,489.00
278 ACUMED CO-3080 SCREW 3.5X8mm Central Supplies 478.00
278 ACUMED CO-3220 SCREW 3.5X22mm Central Supplies 478.00
278 ACUMED CA-4260 SCREW 4.0X26mm Central Supplies 538.00
278 ACUMED MS-DC35 DRILL 3.5mm Central Supplies 466.00
278 BIOMET 912082 JUGKNOT 1.0mm 3-0NDLS Central Supplies 1,685.00
278 BIOMET 139247 ENDO II TAPER INSERT STD Central Supplies 644.00
270 BIOMET 51-103150 TPRLC 133 TYPE1 PPS 15 Central Supplies 7,965.00
270 BIOMET 12-139030 ENDO II MOB HEAD SZ53 Central Supplies 976.00
270 PUPIL DILATORS (during cataract procedr) Central Supplies 385.00
450 PROCTOSCOPY Central Supplies 133.00
270 EYE CARE TRAY Central Supplies 46.00
270 COLLES SPLINT Central Supplies 41.00
270 POSION CNTRL CN Central Supplies 87.00
270 NASAL TRAY Central Supplies 55.00
270 WRIST RESTRAINTS Central Supplies 70.00
270 PERITONEAL LAVAGE KIT. Central Supplies 104.00
270 TELEPHON INTERP SVC $2PM Central Supplies 8.00
270 MEPILEX 4X4 SILICONE COATED Central Supplies 41.00
270 BARRIER CREAM CAVILON 2oz Central Supplies 20.00
270 3M “NO STING” BARRIER FILM WIPE 3344 Central Supplies 5.00
272 3M MEDIPORE PAD 3569 Central Supplies 10.00
272 3M MEDIPORE PAD LG 3571 Central Supplies 12.00
272 3M TEGADERM 90003 OVAL Central Supplies 47.00
272 3M TEGADERM 90007 HYDROCOLLOID Central Supplies 72.00
272 3M TEGADERM 90023 HYDROCOLLOID THIN Central Supplies 44.00
272 3M TEGADERM 90024 HYDROCOLLOID Central Supplies 41.00
270 3M TEGADERM 90800 ABSORBANT SMALL OVAL Central Supplies 25.00
270 3M TEGADERM 90801 ABSORBANT 4X5 Central Supplies 40.00
270 3M TEGADERM FOAM DRSG 90619 Central Supplies 53.00
270 DUODERM PASTE Central Supplies 158.00
272 AQUACEL 4X4 DRESSING Central Supplies 81.00
270 3M BARRIER FILM SPRAY “NO STING” Central Supplies 83.00
270 COLLAGEN BIOSTEP 2X2 DRSG Central Supplies 61.00
272 PURACOL PLUS AG 2X2 COLOOAGEN DRESSING Central Supplies 93.00
270 3M WOUND FILLER Central Supplies 36.00
272 DUODERM 4X4 Central Supplies 31.00
270 DUODERM CGF 6X6 Central Supplies 71.00
270 DUODERM SIGNA 5X5 Central Supplies 53.00
270 KALSTAT FORTEX DRSG Central Supplies 60.00
270 LYOFOAM DRESSING Central Supplies 30.00
270 3M TRGADERM 6″X8″ 1628 Central Supplies 18.00
272 MAXORB EXTRA AG+ w/SILVER Central Supplies 54.00
272 MAXORB EXTRA without/SILVER Central Supplies 36.00
272 MEPILEX AG DRESSING 4X4 Central Supplies 88.00
272 MEPILEX BORDER SACRUM 9.2X9.2 Central Supplies 73.00
272 3M TEGADERM 8X12″ 1629 Central Supplies 27.00
270 NU-DERM DRESSING Central Supplies 53.00
270 POLYMEM 5X5 DRESSING Central Supplies 83.00
270 POLYMEM 1X3 DRESSING Central Supplies 18.00
272 SETOPRESS DRESSING 10cm X 3.5cm Central Supplies 63.00
270 STRATA SORB DRESSING Central Supplies 16.00
270 UNNA BOOT Central Supplies 52.00
270 VASELINE GAUZE all sizes Central Supplies 6.00
270 VASELINE GAUZE 1X8 DRESSING Central Supplies 5.00
270 VASELINE GAUZE PACKING STRIP Central Supplies 7.00
270 XEROFORM 1X8 DRESSING Central Supplies 10.00
272 XEROFORM DRESSING all sizes Central Supplies 9.00
270 3M COBAN COMPRESSION SYSTEM Central Supplies 67.00
272 XEROFORM 2X2 DRESSING Central Supplies 6.00
270 XEROFORM 4X4 DRESSING Central Supplies 8.00
250 TUCKS PAD Central Supplies 39.00
257 LIP BALM REMEDY 1oz Central Supplies 20.00
257 REMEDY SKIN REPAIER CREAM 2oz Central Supplies 28.00
272 IODOSORB GEL 10gr Central Supplies 85.00
272 IODOFORM GAUZE 1/4″ Central Supplies 29.00
272 IODOFORM GAUZE 1/2″ Central Supplies 31.00
272 PACKING GAUZE (IODO & PLAIN) all sizes Central Supplies 35.00
272 AQUACEL 2X2 HYDROFIBER WOUND DRESSING Central Supplies 24.00
270 GAMMA PROBE Central Supplies 2,021.00
270 PLAIN PACK STRIP 1/4″ Central Supplies 28.00
270 PLAIN PACKING STRIP 1/2″ Central Supplies 27.00
270 PLAIN PACKING STRIP 1″ Central Supplies 31.00
270 COBAN 3″ Central Supplies 20.00
270 COBAN 4″ & 3″ Central Supplies 24.00
270 STERI STRIP 1/8″ STERILE M1540 Central Supplies 8.00
272 STERI STRIP 1/4″ STERILE M1541 Central Supplies 8.00
272 STERI STRIP 1/2″ STERILE, M1547 Central Supplies 12.00
272 STERI STRIP STERILE, all sizes Central Supplies 24.00
272 TELFA PAD STERILE DRESSING all sizes Central Supplies 5.00
272 TELFA PAD 3X4″ STERILE DRESSING Central Supplies 5.00
272 TELFA PAD 3X6″ STERILE DRESSING Central Supplies 5.00
272 3M TEGADERM 1622,1624, 1626 Central Supplies 5.00
272 3M TEGADERM 2 3/8X2 3/4″ 1624 Central Supplies 5.00
270 3M TEGADERM 4X4″ 1626 Central Supplies 9.00
272 MONTGOMERY STRAP SURGICAL DRSG Central Supplies 27.00
272 ADAPTIC STERILE DRESSING all sizes Central Supplies 7.00
272 ADAPTIC 3X8″ STERILE DRESSING Central Supplies 12.00
272 ADAPTIC 3X16″ STERILE DRESSING Central Supplies 14.00
270 EYE SHIELD ALUMINUM Central Supplies 14.00
272 STERILE 2X2 DRESSING Central Supplies 5.00
272 STERILE 4X4 10/pk Central Supplies 6.00
270 ABD PAD DRESSING Central Supplies 5.00
270 BANDAGE 2″ WRAP ACE Central Supplies 11.00
270 DRAIN SPONGE DISP Central Supplies 5.00
270 EYE PATCH STERILE GAUZE Central Supplies 5.00
270 SUPER SPONGE / FLUFFS KERLIX Central Supplies 69.00
270 STERILE GAUZE PAD 2/pack all sizes Central Supplies 5.00
270 PINK PAD TRENDELENBURG Central Supplies 589.00
272 LAP SPATULA ELECTRODE Central Supplies 343.00
272 KERLIX STERILE GAUZE all sizes Central Supplies 10.00
272 KERLIX 3″ STERILE GAUZE Central Supplies 8.00
272 KERLIX 2″ STERILE GAUZE Central Supplies 9.00
278 OR MESH VERSATEX VTX1515 Central Supplies 753.76
270 MAXORB EXTRA AG ROPE 1″X12″ Central Supplies 78.00
272 CONFORM STERILE DRESSING all sizes Central Supplies 6.00
272 CONFORM 2″ STERILE DRESSING Central Supplies 6.00
272 CONFORM 3″ STERILE DRESSING Central Supplies 5.00
272 CONFORM 4″ STERILE DRESSING Central Supplies 9.00
270 GOLD DUST HYDROPHILIC POLYMER POWDER 3gm Central Supplies 25.00
270 GLOVE COMPRESSION FUL FINGER RIGHT LARGE Central Supplies 128.94
270 GLOVE RADIATION SZ 7.5 Central Supplies 278.00
271 PRONTOSAN WOUND IRRIGATION 350ML Central Supplies 94.00
257 CALMOSEPTINE BARRIER CREAM Central Supplies 52.00
271 PRONTOSAN WOUND GEL Central Supplies 101.00
270 TOTAL CONTACT BOOT XL Central Supplies 587.00
270 TAPE SILICONE MSC1583 Central Supplies 90.00
270 SILVASORB GEL SILVER ANTIMICRO WOUND GEL Central Supplies 124.61
272 OPTIFOAM 3X3 DRESSING W/ SILICONE Central Supplies 32.00
272 OPTIFOAM 4X4 DRESSING W/ SILICONE Central Supplies 48.00
270 PERITONEAL DRAIN KIT ASPIRA Central Supplies 7,567.00
272 SKIN STAPLER ROTATING HEAD Central Supplies 393.44
272 OR SUTURE ENDOSTITCH Central Supplies 154.52
272 OR ENDOSTITCH 10MM SUTURE DEVICE Central Supplies 652.17
270 DME- Central Supplies     –
270 BINDER BREAST ALL SIZES Central Supplies 216.83
272 FORCE FIBER #5 BRADE SUTUER W/ NEEDLE Central Supplies 115.50
270 WATERBIRTH ACCESSORY KIT Central Supplies 599.00
272 FORCE FIBER #2 STRN BLUE 1/2 CIRCLE TAPR Central Supplies 143.50
257 1000cc NS IRRG STERILE SOLUTION Central Supplies 33.00
257 500cc NS IRRG STERILE SOLUTION Central Supplies 33.00
270 SPLASH SHIELD ZEROWET Central Supplies 22.00
272 IRRIG STERILE SOLUTION all sizes Central Supplies 33.00
257 500cc H2O IRRIG STERILE SOLUTION Central Supplies 33.00
250 OR 3000cc NS IRRIGATION SOLUTION Central Supplies 60.00
272 IRRIGATION SYRINGE ASEPTO 50cc Central Supplies 6.00
270 IRRIG TRAY w/2 oz BULB OR PISTON SYR Central Supplies 5.00
270 SPLASH CAP IRRG BLT SHIELD Central Supplies 28.00
257 PEDIALYTE 2oz Central Supplies 12.00
270 IV START KIT Central Supplies 61.00
270 EVACUTAINER BOTTLE 1000cc Central Supplies 64.00
270 4fr TURBO-JECT PICC G03804 SINGLE LUMEN Central Supplies 510.00
272 ANTI REFLUX VALVE Central Supplies 53.00
272 NG TUBE HOLDER NG-50 Central Supplies 13.00
272 NG TUBE 8FR SALEM SUMP Central Supplies 59.30
272 NG TUBE 10fr SALEM SUMP Central Supplies 18.00
272 NG TUBE 14fr SALEM SUMP Central Supplies 19.00
270 NG TUBE 16fr SALEM SUMP Central Supplies 18.00
270 NG TUBE 18fr SALEM SUMP Central Supplies 18.00
272 TUBE ATTACHMENT DEVICE HOLISTER 9785 Central Supplies 55.00
270 FEEDING TUBE 5fr Central Supplies 41.00
270 FEEDING TUBE 8fr Central Supplies 43.00
270 FEEDING TUBE 10fr Central Supplies 10.00
270 FEEDING TUBE DOBBHOFF 8fr Central Supplies 72.00
270 SUCTION FINE TIP Central Supplies 18.00
272 SUCTION TIP YANKER BULBOUS Central Supplies 6.00
270 SUCTION CATH 5fr PEDIATRIC T63C Central Supplies 5.00
270 SUCTION CATH 8fr PEDIATRIC T64C Central Supplies 5.00
270 SUCTION CATH 10fr PEDIATRIC T61C Central Supplies 5.00
272 SUCTION CATH DISP all sizes Central Supplies 5.00
270 OR BLACK HOLE W/TUBING Central Supplies 251.00
272 DELEE SUCTION 10fr Central Supplies 63.00
270 SUCTION TUBING Central Supplies 10.00
270 SUCTION TUBE CONNECT X-MASS TREE Central Supplies 12.00
270 GOMCO SUCTION BOTTLE DISP Central Supplies 86.00
270 SUCTION LINER 1500cc Central Supplies 17.00
270 OR SUCTION LINER 3000cc Central Supplies 22.00
270 SUCTION LINER 2000cc/NURSING DEPT Central Supplies 21.00
270 SUCTION CATH KIT 10fr Central Supplies 8.00
270 SUCTION CATH KIT 12fr Central Supplies 8.00
270 SUCTION CATH KIT 14fr Central Supplies 7.00
270 OR POOLE SUCTION TIP Central Supplies 31.00
270 OR SUCTION TIP YANKER (purple/weeks) Central Supplies 11.00
270 CATH SINGLE FOLEY 8fr Central Supplies 40.00
270 CATH SINGLE FOLEY 10fr Central Supplies 42.00
270 CATH SINGLE FOLEY 12fr Central Supplies 38.00
270 CATH SINGLE FOLEY 18fr Central Supplies 5.00
270 CATH SINGLE FOLEY 22fr Central Supplies 38.00
270 CATH SINGLE FOLEY 24fr Central Supplies 40.00
270 CATH SINGLE FOLEY 26fr 30cc BALLOON Central Supplies 50.00
270 CATHETER ADHESIVE HOLDER Central Supplies 11.00
270 CATH STRAP FOAM W/VELCRO Central Supplies 8.00
272 CATHETER 14fr COUDE TIP Central Supplies 70.00
272 CATHETER COUDE TIP all sizes Central Supplies 70.00
270 CONDOM CATHETER MEDIUM Central Supplies 33.00
270 CLEAN CATCH STERILE CUP Central Supplies 1.00
270 CATH CARE KIT Central Supplies 24.00
270 CATH DRAIN TUBING 5′ Central Supplies 17.00
270 FOLEY CATHETER DRAIN BAG 4000cc Central Supplies 47.00
270 FOLEY CATHETER KIT LATEX FREE Central Supplies 80.00
270 FEMALE CATH KIT Central Supplies 21.00
270 URINE LEG BAG Central Supplies 22.00
270 MALE URINARY POUCH 250ml (HL9811) Central Supplies 84.00
270 ODOR ELIMINATOR SPRAY m9 Central Supplies 26.00
270 PUC PEDIATRIC URINE COLLECTOR Central Supplies 5.00
270 SITZ BATH DISP Central Supplies 71.00
270 ENEMA BUCKET DISP Central Supplies 19.00
270 FLEETS MINERAL OIL Central Supplies 25.00
270 FLEETS ENEMA Central Supplies 53.00
270 PERI-WASH Central Supplies 21.00
270 SPECIMEN CUP STERILE DISP Central Supplies 5.00
270 URETHRAL CATH KIT Central Supplies 18.00
270 URINE METER WITH DRAIN BAG Central Supplies 68.00
270 CALCULI / URINE STRAINER DISP Central Supplies 5.00
270 STOMAHESIVE PROTECTIVE POWDER Central Supplies 44.00
270 STOMA PASTE Central Supplies 58.00
270 STOMA ADHESIVE SPRAY Central Supplies 107.00
270 SIGMOID SPECULUM DISP Central Supplies 48.00
270 OSTOMY 2 1/4″ DRAINABLE POUCH w/FILTER Central Supplies 15.00
270 OSTOMY 1 1/2″ DRAINABLE POUCH Central Supplies 13.00
270 OSTOMY 2 3/4″ CLOSED END POUCH Central Supplies 9.00
270 OSTOMY 2 3/4″ HOLLISTER DRAINABLE POUCH Central Supplies 50.00
272 OSTOMY 416928 POST OP KIT 2 3/4″ Central Supplies 41.00
270 OSTOMY WAFER 2 1/4″ Central Supplies 23.00
270 OSTOMY WAFER 2 3/4″ Central Supplies 21.00
270 OSTOMY POUCH CLAMP Central Supplies 13.00
272 DEBRISOFT PAD Central Supplies 111.00
278 CLEARIFY VISUALIZATION SYSTEM 21-345 Central Supplies 303.00
270 CVC PACK DISP Central Supplies 526.00
272 PLEURAVAC Central Supplies 164.00
270 CHEST TUBE KIT DISP Central Supplies 149.00
270 SUTURE SET DISPOSIBLE Central Supplies 82.00
270 STERILE DRAPE 18X26″ DISP Central Supplies 5.00
270 SUTURE REMOVAL KIT DISP Central Supplies 6.00
270 HEEL PROTECTOR Central Supplies 44.00
270 LUMBAR TRAY DISP all sizes Central Supplies 95.00
270 LUMBAR TRAY PEDIATRIC DISP Central Supplies 82.00
270 THORACENTESIS TRAY 4341B DISP Central Supplies 594.00
270 THORA/PARA TRAY DISP all types Central Supplies 172.00
270 THORA/PARA KIT 8fr TPK1001 DISP Central Supplies 153.00
270 ASPIRA PLEURAL DRAINAGE KIT Central Supplies 5,972.00
270 CAUTERY HIGH TEMP TIP DISP Central Supplies 83.00
270 CAUTERY DISP pen Central Supplies 68.00
272 CHEST TUBE TROCAR CATH all sizes Central Supplies 194.00
270 CHEST TUBE TROCAR CATH 16fr Central Supplies 194.00
270 CHEST TUBE TROCAR CATH 28fr Central Supplies 194.00
270 CHEST TUBE TROCAR CATH 32fr Central Supplies 173.00
272 BARD TRUGUIDE BIOPSY NEEDLE 17G X 3 Central Supplies 109.00
270 V.A.C. VIA 7-DAY SYSTEM COMPLETE Central Supplies 2,208.00
270 V.A.C. CANISTER w/GEL Central Supplies 207.00
270 V.A.C. GRANUFOAM DRESSING LARGE Central Supplies 326.00
270 V.A.C. GRANUFOAM MEDIUM DRESSING Central Supplies 267.00
270 V.A.C. GRANUFOAM SMALL DRESSING Central Supplies 234.00
270 V.A.C. LG WHITE FOAM DRESSING Central Supplies 80.00
270 V.A.C. SMALL WHITE FOAM DRESSING Central Supplies 62.00
270 V.A.C. Y CONNECTOR Central Supplies 21.00
272 SCALPEL DISP PROTECTIVE all sizes Central Supplies 14.00
272 SCALPEL #11 DISP PROTECTIVE Central Supplies 14.00
272 SCALPEL #15 DISP PROTECTIVE Central Supplies 14.00
272 STAPLER DISP all sizes Central Supplies 67.00
270 STAPLER DS-15 DISP Central Supplies 55.00
272 STAPLER DS-5 DISP Central Supplies 46.00
272 OR SKIN STAPLER ETHICN PMW35 DISP Central Supplies 189.00
272 DRAIN PENROSE 1/4″ X 18″ LF Central Supplies 26.00
272 DRAIN PENROSE 1/2″ X 18″ LF Central Supplies 36.00
272 DRAIN PENROSE LF all sizes Central Supplies 45.00
272 3M PREP CLIPPER HEAD DISP Central Supplies 39.00
270 OR BETADINE VAG PREP D50-002 Central Supplies 52.00
270 BIOPSY PUNCH DISP ASSORTED SIZES Central Supplies 48.00
270 OR CHLORAPREP KIT C/TINT 26mm Central Supplies 71.00
272 STERILE BOWL DISP Central Supplies 16.00
270 EPIDURAL KIT DISP Central Supplies 153.00
270 EZ-LAV KIT 28fr Central Supplies 445.00
270 EZ PREP SURGICAL SCRUB CHG 4% Central Supplies 11.00
270 DISP. DEROYAL COLD/HOT THERAPY BLANKETS Central Supplies 111.00
270 GUIAC / HEMOCCULT SLIDE KIT Central Supplies 5.00
270 ICE PACK small SD INITIAL DISP Central Supplies 16.00
270 MASTISOL ADHESIVE Central Supplies 18.00
270 MEDIPORE 2″ TAPE Central Supplies 47.00
270 MEDIPORE TAPE all sizes Central Supplies 5.00
270 OPTIPORE SPONGE Central Supplies 12.00
270 PVP PREP SOLUTION Central Supplies 8.00
272 STAPLE REMOVER DISP Central Supplies 9.00
270 DME ABDUCTION PILLOW HIP MEDIUM Central Supplies 180.00
270 ICE PACK large SD INITIAL DISP Central Supplies 14.00
274 DME ARM ELEVATING PILLOW Central Supplies 191.00
270 STERILE SKIN MARKER NO LABEL Central Supplies 10.00
274 DME CERVICAL COLLAR Central Supplies 84.00
274 DME KNEE IMMOBILER 16″ Central Supplies 116.00
274 DME KNEE IMMOBILIZER 19″ Central Supplies 126.00
274 DME KNEE IMMOBILIZER 22″ Central Supplies 132.00
274 DME KNEE IMMOBILIZER 24″ Central Supplies 144.00
274 DME KNEE T-SCOPE UNIVERSAL Central Supplies 576.00
274 DME KNEE T-SCOPE XLG Central Supplies 586.00
274 DME LEG ELEVATING PILLOW Central Supplies 173.00
274 ULTRASLING (all sizes) DME Central Supplies 264.00
270 STERILE SPECULUM SMALL DISP Central Supplies 26.00
270 STERILE SPECULUM MEDIUM DISP Central Supplies 26.00
272 STERILE SPECULUM DISP all sizes Central Supplies 39.00
270 EAR CURETTES MINI LOOP DISP Central Supplies 13.00
272 EAR CURETTE DISP all sizes Central Supplies 13.00
270 EAR CURETTE CURVED LOOP DISP Central Supplies 13.00
270 POPE EAR WICK 24mm Central Supplies 24.00
270 POPE EAR WICK all sizes Central Supplies 24.00
270 MONOFILAMENT 10g w/PAPER HANDLE Central Supplies 12.00
270 HYPAFIX 2″ X 10yd DRESSING TAPE Central Supplies 58.00
270 HYPAFIX 4″ X2yd DRESSING TAPE Central Supplies 55.00
270 HYPAFIX DRESSING TAPE all sizes Central Supplies 68.00
270 BANDAGE 2″ VELCRO CLOSURE Central Supplies 7.00
270 BANDAGE 3″ VELCRO CLOSURE Central Supplies 10.00
270 BANDAGE 4″ VELCRO CLOSURE Central Supplies 11.00
270 BANDAGE 6″ VELCRO CLOSURE Central Supplies 15.00
270 MEDIHONEY GEL 0.5 Central Supplies 48.00
272 MEDIHONEY CA 2X2 DRESSING Central Supplies 43.00
272 MEDIHONEY HYDROGEL DRSG 2 3/4X2 3/4″ ADH Central Supplies 54.00
270 VENODYNE SCD REG LEG SLEEVE Central Supplies 210.00
270 SCD REGULAR LEG SLEEVE DVT 10 Central Supplies 116.00
270 SCD LARGE SLEEVE DVT 20 Central Supplies 170.00
270 SLIT LAMP Central Supplies 59.00
270 EGG CRATE MATTRESS Central Supplies 85.00
270 KNEE CPM COMPLETE W/PAD KIT COMPLETE Central Supplies 151.00
270 HIP REPLACEMENT KIT w/TOILET RAISER Central Supplies 245.00
270 HIP KIT WITHOUT TOILET RISER Central Supplies 124.00
270 EVERGREEN TLSO Central Supplies 387.00
270 BRACE KNEE CUSTOM FIT Central Supplies 1,959.00
270 TED HOSE SMALL KNEE Central Supplies 22.00
270 TED HOSE MEDIUM KNEE Central Supplies 32.00
270 TED HOSE LARGE KNEE Central Supplies 24.00
270 TED HOSE X-LG KNEE Central Supplies 24.00
270 TED HOSE MED LONG KNEE Central Supplies 79.00
270 TED HOSE LG LONG KNEE Central Supplies 54.00
270 TED HOSE X-LG LONG KNEE Central Supplies 24.00
270 TED HOSE THIGH SMALL Central Supplies 87.00
270 TED HOSE THIGH MEDIUM Central Supplies 88.00
270 TED HOSE THIGH LARGE Central Supplies 79.00
270 TED HOSE THIGH X-LG Central Supplies 53.00
274 TRACTION BOOT Central Supplies 109.00
274 TRACTION FRAME for BED & WEIGHTS BUCKS Central Supplies 87.00
274 TRAPEZE BAR / PATIENT HELPER Central Supplies 94.00
274 DME ARM SLING XLG Central Supplies 43.00
274 DME ARM SLING 2X-SMALL ST JOHN Central Supplies 60.00
274 DME ARM SLING XSMALL ST JOHN Central Supplies 60.00
274 DME ARM SLING SMALL (ST JOHN) Central Supplies 60.00
274 DME ABDOMINAL BINDER 9″ 30-45″ Central Supplies 81.00
274 DME ABDOMINAL BINDER 9″ 46-52″ Central Supplies 81.00
274 DME ABDOMINAL BINDER 12″ 30-45″ Central Supplies 89.00
274 DME ABDOMINAL BINDER 12″ 46-62″ Central Supplies 95.00
274 DME ANKLE BRACE SMALL Central Supplies 97.00
274 DME ANKLE BRACE MEDIUM Central Supplies 97.00
274 DME ANKLE BRACE LARGE Central Supplies 97.00
274 DME ANKLE BRACE X-LG Central Supplies 97.00
274 DME ANKLE GEL-RIGHT 80/20   BRACE ZIMMER Central Supplies 213.00
274 DME ANKLE GEL-LEFT 80/20 BRACE ZIMMER Central Supplies 213.00
270 PODUS BOOT / HEEL PROTECTOR Central Supplies 150.00
274 DME CRUTCHES YOUTH Central Supplies 108.00
274 DME CRUTCHES MEDIUM Central Supplies 108.00
274 DME CRUTCHES LG Central Supplies 108.00
274 DME WALKING BOOT all sizes Central Supplies 328.00
270 OXYGEN MASK ADULT (6850) Central Supplies 20.00
270 OXYGEN MASK CHILD SZ-2 Central Supplies 31.00
270 OXYGEN MASK CHILD SM DYNJAAMASK3 Central Supplies 17.00
270 OXYGEN MASK CHILD LG DYNJAAMASK4 Central Supplies 17.00
270 OXYGEN MASK NEONATAL SZ-0 Central Supplies 31.00
270 OXYGEN MASK CHILD SM SZ-1 Central Supplies 31.00
270 DRAINAGE KIT 500ML PLEURX Central Supplies 438.00
270 PHILIPS M2522A EtCO2 DETECTOR NON-INTUBA Central Supplies 82.00
270 ZOLL PEDI-PADZ DEFIBULATION PAD Central Supplies 294.00
270 ZOLL DEFIB PAD ONESTEP CPR COMPLETE Central Supplies 427.00
270 AED 10 PAD WA – CLINICS MRMC & MRSC Central Supplies 299.00
270 CPRD PADZ AED ZOLL Central Supplies 568.00
270 AMBU BAG all sizes Central Supplies 132.00
270 BITE BLOCKS DISP Central Supplies 20.00
270 CO2 DETECTOR EASY CAP II all sizes Central Supplies 96.00
272 GLIDESCOPE BLADE DISP all sizes Central Supplies 115.00
410 NEONATAL RESUSCITATION Central Supplies 276.00
272 GLIDESCOPE BLADE GVL-2 4-22lb DISP Central Supplies 115.00
272 GLIDESCOPE BLADE GVL-3 22#-ADUL DISP Central Supplies 109.00
272 GLIDESCOPE BLADE GVL-4 >88lb DISP Central Supplies 109.00
270 PEDI-CAP CO2 DETECTOR Central Supplies 96.00
270 AMBU BAG INFANT Central Supplies 172.00
270 AMBU BAG PEDIATRIC Central Supplies 89.00
272 INTRODUCER BOUGIE 15fr COUDE TIP Central Supplies 64.00
270 STYLET 6fr 2.0-4.5mm DISP Central Supplies 41.00
270 STYLET 10fr 4.0-6.0mm DISP Central Supplies 41.00
272 STYLET 14fr DISP Central Supplies 40.00
270 MANOMETER 550ml w/3-WAY STOPCOCK DISP Central Supplies 48.00
270 NERVE BLOCK TRAY DISP Central Supplies 97.00
270 VAGINAL APPLICATOR-MED Central Supplies 52.00
270 PERI BOTTLE Central Supplies 5.00
270 AMBU BAG NEONATE Central Supplies 74.00
270 BILI MASK DISP Central Supplies 15.00
270 BILI BLANKET / VEST DISP Central Supplies 31.00
270 BILI LIGHT w/LIGHT METER CONTINUOUS Central Supplies 405.00
270 OB PACK DISP Central Supplies 99.00
270 UMBILICAL CATHETER TRAY Central Supplies 219.00
270 UMBILICAL CATHETER 2.5fr Central Supplies 198.00
270 UMBILICAL CATHETER 3.5fr Central Supplies 201.00
272 UMBILICAL CATHETER 5fr Central Supplies 174.00
270 PERI COLD PACK DISP Central Supplies 6.00
272 FETAL VACUUM EXTRACTOR KIWI VAC 6000 Central Supplies 197.00
270 SNS STARTER KIT Central Supplies 95.00
270 OXYGEN MASK INFANT W/O INFLAT VALVE Central Supplies 46.00
270 EPISIOTOMY KIT Central Supplies 383.00
272 FETAL SCALP ELECTRODE Central Supplies 121.00
272 IUPC-INTRAUTERINE CATHETER Central Supplies 182.00
270 NITRAZINE PAPER Central Supplies 465.00
270 NIPPLE SHIELD DISP Central Supplies 54.00
270 BREAST SHELL DISP Central Supplies 98.00
270 BREAST PUMP MANUAL DISP Central Supplies 144.00
272 CERVICAL RIPENING BALLOON Central Supplies 260.00
272 BAKRI PP HEMORRHAGE BALLOON Central Supplies 948.00
272 AMNIOHOOK Central Supplies 19.00
270 DERMABOND II Central Supplies 82.00
278 SURGICEL 2X3 (1953) Central Supplies 354.00
272 SUTURE SINGLE PACK Central Supplies 64.00
272 SUTURE SURGICAL TIES Central Supplies 87.00
272 SUTURE CONTROL RELEASE NEEDLE MULTIPACK Central Supplies 188.00
272 SUTURE SET/PACK Central Supplies 65.00
278 OR V-LOC 180 3-0 6″ Central Supplies 170.00
272 OR X-5209 SUTURE ‘COTTONY’ II KHT-3 Central Supplies 159.00
272 OR SUTURE RETREVIER Central Supplies 609.15
272 OR DISP ORTHO NEEDLE 7/16″ CIRCLE Central Supplies 27.00
272 OR DISP ORTHO NEEDLE 9/16 TAPOR POINT Central Supplies 27.00
272 OR RS22 MERSILENE SUTURE 5mm CTX Central Supplies 280.00
272 OR KEITH STRT STERILE NEED 2 1/2″ Central Supplies 53.00
272 OR PLEDGETS PCP50 ETHICON Central Supplies 40.00
272 OR DERMATONE BLADE DISP STERILE Central Supplies 284.00
272 DRESSING SUPER ABSORBENT Central Supplies 51.77
272 OR 11-036 CAST PAD 6″ SPECIALIST Central Supplies 66.00
272 OR SHOULDER CANNULA SET DISPOSABLE Central Supplies 108.00
272 OR 12″ DISP TOURNIQUET CUFF Central Supplies 90.00
272 OR 18″ DISP TOURNIQUET CUFF Central Supplies 141.00
272 OR 24″ DISP TOURNIQUET CUFF Central Supplies 157.00
272 OR 30″ DISP TOURNIQUET CUFF Central Supplies 168.00
272 OR 34″ DISP TOURNIQUET CUFF Central Supplies 181.00
272 OR 42″ DISP TOURNIQUET CUFF Central Supplies 194.00
272 OR PULSE-A-VAC Central Supplies 495.00
272 OR #10 SHIELDED BLADE BC373910 Central Supplies 11.00
272 OR #11 SHIELDED BLADE BC373911 Central Supplies 11.00
272 OR #15 SHIELDED BLADE BC373915 Central Supplies 11.00
272 OR #10 RIB-BACK BLADE BC371150 Central Supplies 5.00
272 OR #11 RIB-BACK BLADE BC371151A Central Supplies 9.00
272 OR #12 RIB-BACK BLADE BC371152A Central Supplies 34.00
272 OR #15 RIB-BACK BLADE BC371153 Central Supplies 5.00
272 OR DISP HOT BIOPSY FORCEP Central Supplies 345.00
272 OR DISP ROTAT SNARE 13mm Central Supplies 362.00
272 OR ENDO DILATING CATH 18-20mm Central Supplies 1,185.00
272 OR ENDO DILATING CATH 15-18mm Central Supplies 1,185.00
272 OR ENDO INFLATION SYR 60ml Central Supplies 325.00
272 OR IMPERVIOUS STOCKIN STERILE DISP Central Supplies 65.00
272 OR ESMARK 6″ STERILE DISP Central Supplies 38.00
272 OR ESMARK 4″ STERILE DISP Central Supplies 28.00
272 NEEDLE COUNTER DISP Central Supplies 8.00
272 OR DISP STERILE MAGNETIC MAT Central Supplies 31.00
272 OR SPOT INK DYE ENDOSCOPIC Central Supplies 178.00
272 OR SPOT INJECTA NEEDLE Central Supplies 175.00
272 OR VESSEL LOOP 30-733 BLUE Central Supplies 16.00
272 OR RED VESSEL LOOP 30-742 Central Supplies 16.00
272 OR MINI LAP CLUTCH GRASPER DISP STERILE Central Supplies 952.00
272 OR MINILAP ALLIGATOR GRASP DISP STERILE Central Supplies 1,218.00
272 OR STERILE TIP INSERTS METZ DISP Central Supplies 181.00
272 OR GEL PREP TRAY Central Supplies 37.00
270 OR MAMMARY PS SUPPORT BRA LG Central Supplies 351.00
272 OR JP-2189 JP 15fr FLUTED Central Supplies 99.00
272 OR 2227J-VAC 10fr ROUND BLAKE 3/4 FLUTE Central Supplies 357.00
272 OR JP RESERVIOR 100cc Central Supplies 54.00
272 OR JP DRAIN 7mm FLAT SU130-1308 Central Supplies 60.00
272 OR JP DRN 10mm FLATE SU130-1309 Central Supplies 60.00
272 OR JP DRN 10fr ROUND SU130-1321 Central Supplies 53.00
272 OR JP DRN 15fr ROUND SU130-1323 Central Supplies 60.00
272 OR JP DRN 19fr rOUND SU130-1325 Central Supplies 60.00
272 OR J-VAC RESERVOIR 450ml Central Supplies 230.00
270 OR MAMMARY PS SUPPORT BRA SMALL Central Supplies 351.00
270 OR MAMMARY PS SUPPORY BRA MEDIUM Central Supplies 351.00
270 OR MAMMARY PR SUPPORT BRA X-LG Central Supplies 351.00
270 BAIR HUGGER FULL DISP Central Supplies 60.00
270 BAIR HUGGER LOWER DISP Central Supplies 58.00
270 BAIR HUGGER UPPER Central Supplies 86.00
270 BAIR HUGGER PEDI DISP Central Supplies 53.00
272 OR UTERINE SUCTION PRIMARY BUNDLE Central Supplies 213.00
272 OR UTERINE CURETTE all sizes Central Supplies 45.00
272 OR URERINE SUCTION SECONDARY BUNDLE Central Supplies 165.00
278 OR FILSHIE CLIP Central Supplies 310.00
621 MAXCORE BIOPSY NEEDLE 14X10cm Central Supplies 570.00
621 MAXCORE BIOPSY NEEDLE 18g Central Supplies 429.00
272 OR LITHOTOMY DRAPE DISP Central Supplies 48.00
270 OR ARM CRADLE POSITIONER Central Supplies 45.00
272 OR DISP CHEST/BREAST DRAPE Central Supplies 84.00
272 OR DISP TOTAL JOINT PACK Central Supplies 269.00
272 OR LEG HOLDER PAD Central Supplies 209.00
272 OR EXTREMITY DISP DRAP Central Supplies 55.00
272 OR IOBAN DISP DRAPE M6650EZ Central Supplies 61.00
272 OR DISP 3/4 SHEET Central Supplies 30.00
272 OR LIGHT HANDLES Central Supplies 37.00
272 MAYO STAND COVER DISP STERILE Central Supplies 28.00
272 OR TABLE COVER DISP STERILE Central Supplies 28.00
272 OR LAP SPONGES DISP STERILE Central Supplies 25.00
272 OR ARTHROSCPIC PACK Central Supplies 288.00
272 OR BASIC PACK DISP STERILE Central Supplies 63.00
272 OR D&C PACK DISP STERILE Central Supplies 159.00
272 OR SHOULDER BEACH CHAIR PACK Central Supplies 338.00
272 OR LAP CHOLE PACK STERILE DISP Central Supplies 232.00
272 OR RATEX 4X4 RADIOPAQUE Central Supplies 7.00
272 OR C-ARM DRAPE DISP STERILE Central Supplies 42.00
272 OR SHOULDER SUPENSION II KIT Central Supplies 94.00
272 OR M1015 DISP STERILE DRAPE Central Supplies 41.00
272 OR M1010 DISP STERILE DRAPE Central Supplies 13.00
272 OR U DRAPE DISP STERILE Central Supplies 28.00
272 OR DISP BEACH CHAIR RESTRAINT Central Supplies 133.00
272 OR DISP ORTHO HAND DRAPE Central Supplies 82.00
272 OR SHOULDER SCOPE DISP DRAPE Central Supplies 121.00
270 OR HEADREST COMFORT FOAM Central Supplies 63.00
272 OR DISP STERILE SLEEVE Central Supplies 11.00
272 OR LAPAROTOMY DRAPE STERILE DISP Central Supplies 65.00
272 OR STERILE UTILITY DRAPE W/STICKY EDGES Central Supplies 19.00
272 OR DISP DISSECTOR CHERRY SPONGE Central Supplies 63.00
272 OR C-SECTION PACK STERILE DISP Central Supplies 279.00
272 OR IOBAN 6617 SHOWER CURTAIN Central Supplies 142.00
272 OR HIP PACK W/POUCH 29439 Central Supplies 119.00
272 OR LAP/PEVIC DRAPE DISP Central Supplies 66.00
272 OR PEDIATRIC DRAPE DISP STERILE Central Supplies 55.00
272 OR BILATERAL EXTREMITY DRAPE MEDLINE Central Supplies 71.00
272 OR LAVH PACK DISP STERILE Central Supplies 147.08
272 OR INSTRUMENT POUCH Central Supplies 79.00
272 OR UNDER BUTTOCKS DRAPE Central Supplies 45.00
272 OR LEGGINS DRAPE Central Supplies 45.00
270 OR DISP STIRRUP STRAP W/RING Central Supplies 71.00
272 OR STERILE ORTHO SPLIT DRAPE DYNJP8301 Central Supplies 63.00
272 OR TOP DRAPE STERILE DYNJP4002 Central Supplies 54.00
272 OR LAVH DRAPE DISP STERILE Central Supplies 88.09
272 OR UTERINE MANIPULATOR DISP STERILE Central Supplies 574.75
272 CAUTERY NEEDLE TIP 0013 Central Supplies 55.00
272 CAUTERY SCRATCH PAD DISP STERILE Central Supplies 5.00
272 CAUTERY TEFLON TIP 0014 Central Supplies 58.00
272 CAUTERY PENCIL Central Supplies 72.00
272 OR P.E.G. TUBE KIT (000330 BARD) Central Supplies 836.00
272 OR COBAN 4″ STERILE Central Supplies 36.00
272 OR COBAN 6″ STERILE Central Supplies 52.00
272 TOWEL PACK STERILE DISP Central Supplies 26.00
272 OR SKIN MARKERS STERILE w/LABELS Central Supplies 19.00
272 OR 11-034 CAST PAD 4″ SPECIALIST Central Supplies 55.00
272 OR 11-032 CAST PAD 2″ SPECIALIST Central Supplies 37.00
272 OR MOBIUS OB RETRACT SM 900-517 PINK Central Supplies 405.00
272 OR MOBIUS OB RETRACTOR LG Central Supplies 1.00
278 OR STAPLER CS40G CONTOUR GREEN Central Supplies 1,791.00
278 OR STAPLE RELOADS CR40G CONTOUR GREEN Central Supplies 1,337.00
278 OR STAPLER CS40B CONTOUR BLUE Central Supplies 1,845.00
278 OR STAPLE RELOADS CR40B CONTOUR Central Supplies 1,224.00
272 OR SMBTTOVL ENDO DISSECT OVAL BALON Central Supplies 1,552.00
272 OR ENDO RELTACK3X10 REL ABSORBATACK Central Supplies 2,009.00
272 OR ENDO ABSTACK30 5mm Central Supplies 1,883.00
278 OR ENDO ROTICULAT GIA 45 STAPLER 030453 Central Supplies 933.00
272 OR ENDO EGIAUSTND UNVERSAL HANDLE 12mm Central Supplies 549.00
272 OR EGIA45AVM ENDO RELOADS GIA 45 Central Supplies 879.00
272 OR ENDO STAPLER GIA6038S Central Supplies 430.00
278 OR GIA6038S ENDO GIA 60 3.8 STAPLER Central Supplies 672.00
278 OR GIA6038L RELOADS GIA 60 3.8 STAPLES Central Supplies 358.00
278 OR GIA6048L RELOADS ENDO STAPLES Central Supplies 375.00
278 OR GIA8038L RELOADS ENDO STAPLES Central Supplies 569.00
278 OR EGIARADMT RELOADS RADIAL MED THK Central Supplies 1,842.00
278 OR TA6035S ENDO STAPLER TA 60 3.5 Central Supplies 409.00
278 OR TA6035L RELOADS STAPLES Central Supplies 291.00
278 OR TA6048L RELOADS STAPLES TA 60 4.8 Central Supplies 291.00
272 OR EGIA60AVM RELOADS ARTICULAT 60mm Central Supplies 1,069.00
278 OR EEA28 STAPLER 28MM Central Supplies 1,370.00
278 OR EEA31 STAPLER 31mm Central Supplies 1,370.00
278 OR EEA33 STAPLER 33mm Central Supplies 1,789.00
272 OR ENDO RELTACK10R 10 RELOAD RELABSORBAT Central Supplies 572.00
272 OR ENDO RELTACK5R 5 RELOADS RELABSORBATA Central Supplies 489.00
278 OR 020242 PURSTRING STAPLER 65 Central Supplies 490.00
272 OR ENDO RELTACK4XDPT ABSORBATACK Central Supplies 2,009.00
272 OR HEM3335 HEMORRHOID STAPLER 3.5 Central Supplies 1,927.00
272 OR HEM3348 HEMORRHOID STAPLER 4.8mm Central Supplies 1,927.00
270 EZ IO STABILIZER Central Supplies 97.00
272 OR HEMOVAC 400cc 10fr DYNJWE402 Central Supplies 61.00
272 OR HEMOVAC 400cc 15fr DYNJWE403 Central Supplies 61.00
272 OR LF4200 LIGASURE IMPACT HANDLE Central Supplies 2,858.00
272 OR LIGASURE LAP 5mm LF1637 Central Supplies 2,008.00
272 OR LF1737 LIGASURE MARYLAND JAW DISP Central Supplies 1,862.00
272 OR LONE STAR COLORECTAL RETRACTOR Central Supplies 574.00
278 OR HEMO-CLIP LG-MED TANTALUM Central Supplies 231.00
272 OR CA500 CLIP APPLIER 5mm Central Supplies 730.00
272 OR CFF03 TROCAR FIXATION 5X100 Central Supplies 127.00
272 OR CFS02 SLEEVE FIXATION 5X100 Central Supplies 64.00
272 OR TROCAR CFF33 11X100 OPTIC Central Supplies 188.00
272 OR CBO40 ENDO SHEARS/SCISSORS 5mm Central Supplies 408.00
272 OR CD003 RETRIVAL BAG 5mm Central Supplies 393.00
272 OR CD001 RETRIEVAL BAG 10mm Central Supplies 393.00
272 OR CFF73 TROCAR 12X100 FIX OPTIC Central Supplies 188.00
272 OR CAO90 CLIP APPLIER 10mm Central Supplies 514.00
272 OR CTF03 TROCAR 5X100 OPTICAL Central Supplies 167.00
272 OR CTF33 TROCAR 11X100mm FIOS Central Supplies 217.00
272 OR CTF73 TROCAR 12X100 FIOS Central Supplies 200.00
272 OR CTS02 SLEEVE THREADED 5X100mm Central Supplies 70.00
272 OR COR47 BLUNT TIP TROCAR 12X100mm Central Supplies 224.00
272 OR CFF01 TROCAR 5X150 FIXATION Central Supplies 127.00
272 OR CFB71 TROCAR 12X150mm Central Supplies 200.00
272 OR C8XX2 GEL PORT Central Supplies 1,754.00
272 OR CNGL2 GEL PORT Central Supplies 2,059.00
272 THUNDER BEAT OLYMPUS Central Supplies 1,701.00
272 OR L-HOOK LAPAROSCOPIC CAUTERY ELECTRODE Central Supplies 343.00
272 OR SMOKE EVACUATOR Central Supplies 163.00
272 OR CONRAY Central Supplies 79.00
272 OR CHOLANGIO CATH Central Supplies 194.00
272 OR LARAROSCOPIC KITTNERS 5mm Central Supplies 78.00
272 OR SMBTTRND SPACEMAKER DISSECT BALON Central Supplies 1,464.00
272 OR APPLIED MED HR004 S/M ALEXIS ORTHO Central Supplies 830.00
272 OR INSUFFLATOR TUBE Central Supplies 103.00
272 OR ANTI FOG Central Supplies 16.00
272 OR TUR TUBING/CYCTO TUBING Central Supplies 26.00
272 OR ENDOCLOSE 173022 Central Supplies 409.00
272 OR VERESS NEEDLE 120mm 172015 Central Supplies 115.00
272 OR SURGIWAND 178091 Central Supplies 288.00
272 OR VERESS NEEDLE PN150 Central Supplies 295.00
278 OR MESH Central Supplies 4,356.47
278 OR MESH VENTRALEX LG BARD Central Supplies 6,048.00
278 OR BARD MESH MED CIRCLE #5950008 Central Supplies 1,404.00
278 OR PCO9 POLYESTER 3.6″ ROUND Central Supplies 1,436.00
278 OR PCO15 POLYESTER MESH 6″ Central Supplies 1,941.00
278 OR TEM1509G PROGRIP 15X9 MESH Central Supplies 1,175.00
278 OR MESH SY12 SYBOTEX COMPOSITE Central Supplies 1,632.00
278 OR MESH SYM9 SYMOBOTEX COMPOSITE Central Supplies 1,580.00
278 OR MESH P100055 PERMACOL 5X5X1 Central Supplies 1,374.00
278 OR MESH SYM15 SYMBOTEX Central Supplies 2,136.00
278 OR MESH SYM1510 SYMBOTEX Central Supplies 1,972.00
278 OR MESH SYMBOTEX SYM2015 Central Supplies 2,379.00
278 OR MESH SYM3420E 34X20 SYMBOTEX Central Supplies 4,401.00
278 OR MESH VTX1510X3 VERSATEX Central Supplies 884.32
272 OR HET BIPOLAR FORCEPS 180-1022 Central Supplies 1,815.00
278 SCREW SOFTSLK 1.5 9X20mm STER Central Supplies 765.45
278 SCREW SOFTSLK 1.5 9X25MM STER Central Supplies 765.45
278 GUIDE WIRE DRILL TIP 2FLT SN 7207221 Central Supplies 302.50
278 CANNU-FLEX 2.0 GUIDE WIRE.078 SN 7205659 Central Supplies 302.50
278 STRYKER 4.0 SHAVER 0385-544-000 Central Supplies 525.56
270 ARTHROSCOPIC BLADE ELECTRODE E1512 BOVIE Central Supplies 112.23
270 MORGAN LENS Central Supplies 135.00
270 MED-SOL ADHESIVE REMOVER Central Supplies 52.00
270 CRICOTHYROTOMY CATH SET DISP Central Supplies 660.00
270 BURN PACK Central Supplies 83.00
270 CUT DOWN TRAY Central Supplies 148.00
270 NASAL SPLINT “LOVE” MALLABLE Central Supplies 161.00
270 NASOSTATE Central Supplies 306.00
270 RHINO ROCKET NASAL PACKING Central Supplies 75.00
270 RAPID RHINO EPISTAXIX DEVICE all sizes Central Supplies 363.00
270 RAPID PAC 5.5cm ANTERIOR NASAL DRESSING Central Supplies 145.00
270 RAPID RHINO 550 UNILATERAL EPISTAXIS Central Supplies 215.00
270 RAPID RHINO 751 UNILAT EPISTAXIS DEVICE Central Supplies 194.00
270 NASAL PAC 752 BILATERAL EPISTAXIS DEVICE Central Supplies 199.00
270 NASAL PAC 750 UNILATERAL EPISTAXIS DEVIC Central Supplies 222.00
270 TRIANGLR BANDAGE DISP Central Supplies 29.00
270 YUEH CENTESIS CATH 5.0fr Central Supplies 77.00
270 BRASLOW PACK ORANGE Central Supplies 548.00
270 BRASLOW PACK RED Central Supplies 548.00
270 BRASLOW PACK all colors Central Supplies 548.00
270 BRASLOW PACK GREEN Central Supplies 548.00
270 BRASLOW PACK WHITE Central Supplies 548.00
270 BRASLOW PACK PURPLE Central Supplies 548.00
270 BRASLOW PACK YELLOW Central Supplies 548.00
270 CASTING TAPE 2″ BLACK Central Supplies 26.00
270 CASTING TAPE 2″ BLUE Central Supplies 26.00
270 CASTING TAPE 2″ GLOW-N-DARK Central Supplies 30.00
270 CASTING TAPE 2″ PINK Central Supplies 26.00
270 CASTING TAPE 2″ GREEN Central Supplies 26.00
270 CASTING TAPE 2″ PURPLE Central Supplies 26.00
270 CASTING TAPE 2″ RED Central Supplies 29.00
270 CASTING TAPE 2″ WHITE Central Supplies 26.00
270 CASTING TAPE 3″ WHITE Central Supplies 36.00
270 CASTING TAPE 3″ PURPLE Central Supplies 29.00
270 CASTING TAPE 3″ BLUE Central Supplies 36.00
270 CASTING TAPE 3″ BLACK Central Supplies 36.00
270 CASTING TAPE 3″ GREEN Central Supplies 33.00
270 CASTING TAPE 3″ RED Central Supplies 29.00
270 CASTING TAPE 3″ PINK Central Supplies 36.00
270 CASTING TAPE 3″ GLOW-N-DARK Central Supplies 38.00
270 CASTING TAPE 4″ WHITE Central Supplies 45.00
270 CASTING TAPE 4″ BLUE Central Supplies 65.00
270 CASTING TAPE 4″ PURPLE Central Supplies 48.00
270 CASTING TAPE 4″ BLACK Central Supplies 48.00
270 CASTING TAPE 4″ GLOW-N-DARK Central Supplies 75.00
270 CASTING TAPE 4″ RED Central Supplies 47.00
270 CASTING TAPE 4″ PINK Central Supplies 65.00
270 CAST PADDING 2″ SPECIALIST Central Supplies 5.00
270 CAST PADDING 3″ SPECIALIST Central Supplies 6.00
270 CAST PADDING 4″ SPECIALIST Central Supplies 8.00
270 CAST PADDING 6″ SPECIALIST Central Supplies 11.00
270 CAST PADDING 2″ PROTOUCH/SYNTHETIC Central Supplies 6.00
270 CAST PADDING 3″ PROTOUCH/SYNTHETIC Central Supplies 8.00
270 CAST PADDING 4″ PROTOUCH/SYNTHETIC Central Supplies 10.00
270 CAST PADDING 6″ PROTOUCH/SYNTHETIC Central Supplies 15.00
270 CAST PADDING 2″ DELTA DRY H2O RESISTANT Central Supplies 63.00
270 CAST PADDING 3″ DELTA DRY H2O RESISTANT Central Supplies 68.00
270 CAST PADDING 4″ DELTA DRY Central Supplies 78.00
270 DISP PELVIC BINDER / STABILIZER Central Supplies 729.00
270 SPINAL TRAY DISP Central Supplies 73.00
270 E-TUBE 2.0 86460 UNCUFFED Central Supplies 19.00
270 E-TUBE 2.5 86461 UNCUFFER Central Supplies 19.00
270 E-TUBE 3.0 86462 UNCUFFED Central Supplies 19.00
270 E-TUBE 3.5 86463 UNCUFFED Central Supplies 19.00
270 E-TUBE 2.0 86221 UNCUFFED Central Supplies 20.00
270 E-TUBE 3.0 86223 UNCUFFED Central Supplies 20.00
270 E-TUBE 5.0 86227 UNCUFFED Central Supplies 20.00
270 E-TUBE CUFFED & UNCUFFED Central Supplies 30.00
270 E-TUBE 4.0 86444 CUFFED Central Supplies 30.00
270 E-TUBE 4.5 86445 CUFFED Central Supplies 30.00
270 E-TUBE 5.0 86446 CUFFED Central Supplies 29.00
270 E-TUBE 6.0 86448 CUFFED Central Supplies 18.00
270 E-TUBE 6.5 86449 CUFFED Central Supplies 29.00
270 E-TUBE 7.0 86450 CUFFED Central Supplies 29.00
270 E-TUBE 7.5 86451 CUFFED Central Supplies 29.00
272 E-TUBE 8.0 86452 CUFFED Central Supplies 29.00
270 E-TUBE 8.5 86453 CUFFED Central Supplies 29.00
270 E-TUBE 9.0 86454 CUFFED Central Supplies 29.00
278 ARTHREX AR-1678-CP INTERNAL BRACE LIGAME Central Supplies 2,160.00
270 NASAL AIRWAY LF all sizes Central Supplies 39.00
270 NASAL AIRWAY 28fr LATEX FREE Central Supplies 37.00
270 NASAL AIRWAY 30fr LATEX FREE Central Supplies 37.00
270 NASAL AIRWAY 32fr LATEX FREE Central Supplies 38.00
270 NASAL AIRWAY 34fr LATEX FREE Central Supplies 38.00
270 NASAL AIRWAY 36fr LATEX FREE Central Supplies 53.00
270 CAPNOGRAPHY MASK Central Supplies 54.00
270 OR DISP SKIN TEMP PROBE SSP400 Central Supplies 23.00
270 STERILE RADIATION GLOVES SIZE 8 Central Supplies 275.00
270 ORAL AIRWAY BERMAN 50mm Central Supplies 5.00
270 ORAL AIRWAY BERMAN 60mm Central Supplies 5.00
270 ORAL AIRWAY BERMAN 70mm Central Supplies 5.00
270 ORAL AIRWAY BERMAN 80mm Central Supplies 15.00
270 ORAL AIRWAY BERMAN 90mm Central Supplies 5.00
270 ORAL AIRWAY BERMAN all sizes Central Supplies 5.00
270 SVN SUPPLIES DISP Central Supplies 17.00
270 PEAK FLOW METER DISP Central Supplies 69.00
270 AERO CHAMBER PEDIATRIC W/SM MASK Central Supplies 93.00
270 OXYHOOD DISP Central Supplies 64.00
270 E-Z PAP SETUP Central Supplies 121.00
270 I-VENT BREATHING CIRCUIT Central Supplies 73.00
270 I-VENT LONG BREATHING CIRCUIT Central Supplies 121.00
270 I-VENT INLET FILTER Central Supplies 16.00
270 HUMIDIFER Central Supplies 51.00
270 IS / INCENTIVE SPIROMETER Central Supplies 41.00
270 MAD MUCOSAL ATOMIZATION DEVICE Central Supplies 53.00
270 TRANSPORT VENT CIRCUIT Central Supplies 127.80
270 NASAL CANNULA 14ft ADULT Central Supplies 12.00
270 NASAL CANNULA 7ft ADULT Central Supplies 7.00
270 NASAL CANNULA 25ft ADULT Central Supplies 20.00
270 NASAL CANNULA CO2 W/MALE LUER CONNECTOR Central Supplies 40.00
270 MASK AREOSOL ADULT (1083) Central Supplies 5.00
270 OXYGEN SETUP Central Supplies 1.00
270 AEROBIKA OSCILLATING POSITIVE EXP PRESUR Central Supplies 300.00
270 MASK NITROUS OXIDE DISP Central Supplies 101.94
270 HEATED MIST SETUP Central Supplies 1.00
270 NEBULIZER ADAPTOR 031-28 Central Supplies 40.00
270 AQUAPAK 440ml w/ADAPTOR 004-00 Central Supplies 33.00
270 BBG NASAL ASPIRATOR Central Supplies 41.00
270 NASAL CANNULA INFANT (1601) Central Supplies 22.00
270 NASAL CANNULA PEDIATRIC 7′ Central Supplies 16.00
270 BiPAP / CPAP CIRCUIT Central Supplies 65.00
270 BiPAP / CPAP MASK NASAL SMALL Central Supplies 83.00
270 BiPAP / CPAP MASK SMALL Central Supplies 173.00
270 BiPAP / CPAP MASK MEDIUM Central Supplies 157.00
270 BiPAP / CPAP MASK LARGE Central Supplies 173.00
270 BiPAP / CPAP FILTER-BACTERIA Central Supplies 33.00
270 BiPAP / CPAP FILTER Central Supplies 106.00
270 OXYGEN HOLDER STICKY NEOTECH Central Supplies 38.00
270 BiPAP / CPAP VALVE WHISPER SWIVEL Central Supplies 154.00
270 OXYMIZER CANNULA Central Supplies 117.00
270 END TIDAL CO2 INTABATION SET ADULT/PEDS Central Supplies 85.00
250 MDI BREATHRITE SPACER Central Supplies 65.00
270 OXYMASK ADULT Central Supplies 46.00
270 SENSOR SPO2 INFANT DISP Central Supplies 105.00
270 SENSOR SPO2 PEDIATRIC DISP Central Supplies 105.00
270 SENSOR SPO2 DISP all sizes Central Supplies 95.00
270 SENSOR MASIMO SPO2 NEO LNOP Central Supplies 86.00
270 VAPOTHERM HUMIDIFICATION FLUID Central Supplies 50.00
270 VAPOTHERM LOW FLOW CIRCUIT Central Supplies 587.00
270 VAPOTHERM HIGH FLOW CIRCUIT Central Supplies 405.00
270 VAPOTHERM ADULT N/C HIGH FLOW Central Supplies 54.00
270 VAPOTHERM INFANT INTERMEDIAT N/C LOWFLOW Central Supplies 51.00
270 VAPOTHERM INFANT N/C LOW FLOW Central Supplies 51.00
270 VAPOTHERM NEONATAL N/C LOW FLOW Central Supplies 60.00
270 VAPOTHERM PEDS/SM ADULT N/C HIGH FLOW Central Supplies 41.00
270 VAPOTHERM PEDIATRIC SMALL N/C LOW FLOW Central Supplies 41.00
270 OXYGEN TUBING 7ft Central Supplies 6.00
270 OXYGEN TUBING 14ft Central Supplies 11.00
270 CORRUGATED TUBING 4-6ft Central Supplies 5.00
270 AQUAPACK W/ADAPTOR 500ml Central Supplies 21.00
270 AEROSOL TEE CONNECTOR Central Supplies 5.00
270 NEBULIZER TEE CONNECTOR Central Supplies 5.00
270 NOSE CLIP Central Supplies 5.00
270 TURBINE KIT w/MOUTH PIECE Central Supplies 19.00
270 PED AERO CHAMBER w/MED MASK Central Supplies 93.00
270 Y-AEROSOL DRAINAGE SYSTEM Central Supplies 13.00
270 PEDIATRIC 3-n-1 MASK Central Supplies 22.00
270 PEDI BI-FLOW NASAL MASK (MOUSE) Central Supplies 23.00
270 THERMOMETER IN LINE Central Supplies 36.00
270 PED AEROSOL MASK (DRAGON) Central Supplies 16.00
270 PED AEROSOL MASK (PENGUIN) Central Supplies 48.00
270 CROUP TENT Central Supplies 62.00
270 SILICONE ADAPTOR 301-9000 Central Supplies 41.00
278 AT2-M18-S 18MM BONE SCREW Central Supplies 1,659.00
272 OR TA9035 STAPLER TA 90 3.5MM Central Supplies 432.00
272 OR TRICRON SUTURE 2.0 SC250 Central Supplies 234.00
278 OR 400150 CANCELLOUS CHIP 30cc Central Supplies 1,784.00
278 OR DBX PUTTY 1cc Central Supplies 1,029.00
278 OR DBX PUTTY 5cc Central Supplies 3,379.40
272 OR REVOLVE FAT GRAFTING RV0001 Central Supplies 2,005.00
278 OR 453015 ALLOGRAFT-SEMI T Central Supplies 5,033.00
278 OR K-WIRE 062″ Central Supplies 30.00
272 OR PIN GUARD .045 WHITE Central Supplies 20.00
272 OR PIN GUARD .062 GREEN Central Supplies 20.00
278 STRATTICE MATRIX MESH 10X22 Central Supplies 9,830.15
272 IOL 40 – SPECIALTY LENS Central Supplies 42.00
272 IOL 100 – SPECIALTY LENS Central Supplies 104.00
272 IOL 140 – SPECIALTY LENS Central Supplies 145.00
272 VISCOELASTIC Central Supplies 104.00
272 BSS+ Central Supplies 99.00
272 PHACO NEEDLES AND SLEEVES Central Supplies 114.00
272 ANTERIOR VIRECTOMY PACK Central Supplies 310.00
272 PUPIL DILATORS Central Supplies 320.00
272 DISPOSABLE BLADES Central Supplies 38.00
272 CAPSULAR TENSION RING Central Supplies 464.00
278 SUTURE 10-0 NYULON CATARACT Central Supplies 444.00
276 VIISOELASTIC SECOND Central Supplies 104.00
276 B&L L161-AO IOLs (FOR A CATARACT PROC) Central Supplies 104.00
272 OR MALYUGIN RINGS PUPIL DILAROR Central Supplies 336.00
270 OR CAMERA w/PIX Central Supplies 853.00
272 MISC INSTRUMENTS STERILE Central Supplies 38.00
272 INSTRUMENT TRAY STERILE Central Supplies 175.00
278 SYNTHES 242.531S ULNA PLATE 2.0 Central Supplies 3,389.00
278 SYNTHES 201.366.97 SCREW 2.0X16 CORTX Central Supplies 286.00
272 SYNTHES 310.507 DRILL BIT 1.5mm Central Supplies 806.00
278 SYNTHES 04.004.540S TIBIAL NAIL CANNU Central Supplies 5,920.00
278 SYNTHES 04.004.000DUAL CORE END CAP Central Supplies 887.00
278 SYNTHES 04.015.540 SCREW 5X50m Central Supplies 1,077.00
278 SYNTHES 02.111.501.10 STOP   PLATE LG Central Supplies 927.00
278 SYNTHES 02.210.084 BUTRES PIN 1.8X14m Central Supplies 733.00
278 SYNTHES 02.210.090 BUTRESS PIN 1.8X20 Central Supplies 733.00
278 SYNTHES 02.107.102 PROX VA PLATE Central Supplies 4,429.00
278 SYNTHES 02.211.028 SCREW LOCKN 2.7X28 Central Supplies 911.00
278 SYNTHES 02.211.026 SCREW KCKN 2.7X26 Central Supplies 911.00
278 SYNTHES 02.211.038 SCREW LOCKN 2.7X38 Central Supplies 770.00
278 SYNTHES 02.211.022 SCREW VA LOCKN 2.7 Central Supplies 851.00
278 SYNTHES 02.211.040 SCREW LOCKN 2.7X40 Central Supplies 770.00
278 SYNTHES 02.211.020 SCREW VA LCKNG Central Supplies 851.00
278 SYNTHES 02.211.024 SCREW VA LCKNG ST Central Supplies 911.00
278 SYNTHES 02.211.030 SCREW VA LCKNG Central Supplies 911.00
278 SYNTHES 02.211.034 SCREW VA LCKNG STW Central Supplies 851.00
278 SYNTHES 02.211.060 SCREW LCKNG STW Central Supplies 770.00
278 SYNTHES 02.117.802 PLATE 2.7/3.5mm Central Supplies 4,639.00
278 SYNTHES 02.107.202 PLATE 2.7/3.5mm Central Supplies 4,221.00
272 SYNTHES 315.35 DRILL BIT 3.5 Central Supplies 531.00
272 SYNTHES 310.25 DRILL BIT 2.5mm Central Supplies 478.00
278 SYNTHES 241.351 PLATE 5;H Central Supplies 911.00
278 SYNTHES 204.814 SCREW 3.5X14 Central Supplies 236.00
278 SYNTHES 204.816 SCREW 3.5X16 Central Supplies 219.00
278 SYNTHES 204.818 SCREW 3.5X18 Central Supplies 236.00
278 SYNTHES 204.824 SCREW 3.5X24 Central Supplies 219.00
278 SYNTHES 206.014 SCREW CANC 4.0X14 Central Supplies 166.00
278 SYNTHES 292.12 K-WIRE 1.25X150mm Central Supplies 478.00
278 SYNTHES 02.226.124 SCREW 3.0X24 HDL Central Supplies 1,948.00
272 SYNTHES 310.221 DRILL BIT 2.0X150 Central Supplies 1,763.00
278 SYNTHES 241.361 PLATE 6HOLE 1/3 TUBF Central Supplies 1,081.00
272 SYNTHES 310.35 DRILL BIT Central Supplies 510.00
278 SYNTHES 206.010 SCREW CANCELLOUS 4.0 Central Supplies 166.00
278 SYNTHES 206.012 SCREW CANCELLOUS 4.0 Central Supplies 166.00
278 SYNTHES 204.812 SCREW CORTEX Central Supplies 236.00
278 SYNTHES 241.618 CALCANEAL PLATE RT MI Central Supplies 2,577.00
278 SYNTHES 292.16 K-WIRE 1.6 TROCAR PT Central Supplies 494.00
272 SYNTHES 310.23 DRILL LONG 2.3 Central Supplies 502.00
278 SYNTHES 02.200.034 SCREW CORTEX 3.5 Central Supplies 212.00
278 SYNTHES 02.200.036 SCREW CORTEX 3.5 Central Supplies 227.00
278 SYNTHES 02.200.038 SCREW CORTEX 3.5 Central Supplies 227.00
278 SYNTHES 02.226.020 SCREW 20m SHT THRD Central Supplies 1,948.00
278 SYNTHES 458.936 SCREW 5.0X36mm Central Supplies 1,004.00
272 SYNTHES 357.399 GUIDE WIRE 3.2X400mm Central Supplies 636.00
272 SYNTHES 357.407 DRILL BIT 3-FLUTED Central Supplies 1,328.00
278 SYNTHES 456.328S FIXATION NAIL 11X235 Central Supplies 6,493.00
278 SYNTHES 456.304 HELICAL BLADE 11.0mm Central Supplies 2,870.00
278 SYNTHES 459.36 TO LOKIN BOLT 36mm Central Supplies 976.00
278 SYNTHES 02.111.530 VA DR PLATE 6-H RT Central Supplies 4,066.00
278 SYNTHES 02.210.120 LOCKN SCREW 2.4X20 Central Supplies 875.00
278 SYNTHES 02.210.122 LOCKN SCREW 2.4X22 Central Supplies 875.00
278 SYNTHES 201.772 SCREW CORTEX 2.4X22 Central Supplies 454.00
278 SYNTHES 202.876SCREW CORTEX 2.7X16 Central Supplies 345.00
272 SYNTHES 310.19 DRILL BIT 1.8X110 Central Supplies 510.00
272 SYNTHES 310.509 DRILL BIT W/TT Central Supplies 980.00
278 SYNTHES 02.111.501.10 PLATE 1.2 REDUC Central Supplies 927.00
272 SYNTHES 310.510 DRILL BIT 1.8 Central Supplies 709.00
272 SYNTHES 323.062 DRILL BIT 0.0 Central Supplies 980.00
278 SYNTHES 02.112.010 CLACICLE PLATE 4-H Central Supplies 3,578.00
278 SYNTHES 204.810 SCREW CORTEX 3.5X10 Central Supplies 219.00
278 SYNTHES 201.764 SCREW CORTEX 2.4X14 Central Supplies 454.00
278 SYNTHES 201.768 SCREW CORTEX 2.4X18 Central Supplies 454.00
278 SYNTHES 202.216 SCREW LOCKIN 2.7X16 Central Supplies 640.00
278 SYNTHES 202.218 SCREW LOCKIN 2.7X18 Central Supplies 761.00
278 SYNTHES 202.222 SCREW LOCKIN 2.7X22 Central Supplies 761.00
278 SYNTHES 458.938 SCREW TI LOCKN 5.0X38 Central Supplies 1,154.00
278 SYNTHES 456.301 TI HELICAL BLADE 11.0 Central Supplies 2,431.00
278 SYNTHES 351.706S REAM ROD 2.5W/BALL T Central Supplies 757.00
278 SYNTHES 04.004.446S TIBIAL TI NAIL CA Central Supplies 5,920.00
272 SYNTHES 03.010.061 DRILL BIT CANN 4.2 Central Supplies 1,563.00
272 SYNTHES 03.010.104 DRILL BIT Central Supplies 1,114.00
278 SYNTHES 04.005.534 SCREW LOCKIN Central Supplies 1,126.00
278 SYNTHES 04.005.544 SCREW LOCKIN Central Supplies 1,126.00
278 SYNTHES 04.005.520 SCREW LOCKIN Central Supplies 948.00
278 SYNTHES 04.005.526 SCREW LOCKIN Central Supplies 948.00
278 SYNTHES 02.211.018 SCREW VA LOCK 2.7X Central Supplies 851.00
278 SYNTHES 02.211.032 SCREW 2.7X32mm VA Central Supplies 851.00
278 SYNTHES 207.045 SCREW 4.0X45 CANNULLE Central Supplies 198.00
278 SYNTHES 219.98 WASHER 7.0mm Central Supplies 227.00
278 SYNTHES 204.845 SCREW 3.5 CORTEX Central Supplies 219.00
278 SYNTHES 204.855 SCREW 3.5 CORTEX Central Supplies 219.00
278 SYNTHES 207.050 SCREW 4.0 CANCELLOUS Central Supplies 198.00
278 SYNTHES 241.371 TUBLAR PLATE 7H Central Supplies 1,029.00
278 SYNTHES 204.820 SCREW CORTEX 3.5X20mm Central Supplies 236.00
278 SYNTHES 02.211.014 SCREW VA LOCKN 2.7 Central Supplies 770.00
278 SYNTHES 204.826 SCREW CORTEX 3.5X26 Central Supplies 236.00
278 SYNTHES 204.828 SCREW CORTEX 3.5X28 Central Supplies 204.00
278 SYNTHES 02.211.048 VA SCREW LOCK 2.7X Central Supplies 770.00
278 SYNTHES 02.107.002 PLATE 2H OLECRANON Central Supplies 3,755.00
278 SYNTHES 241.37 TUBLAR PLATE 1/3 7H Central Supplies 554.00
278 SYNTHES 02.111.630 DIST RADIAL PLATE Central Supplies 4,188.00
278 SYNTHES 02.210.114 SCREW VA LOCK 2.4 Central Supplies 875.00
278 SYNTHES 02.210.086 BTRS PIN LOCK 1.8 Central Supplies 733.00
278 SYNTHES 202.872 SCREW CORTEX 2.7X12 Central Supplies 369.00
278 SYNTHES 204.860 SCREW CORTEX 3.5X60mm Central Supplies 219.00
272 SYNTHES 310.21 DRILL BIT 2.0 Central Supplies 437.00
278 SYNTHES 202.828 SCREW 2.7X28 CORTEX Central Supplies 292.00
278 SYNTHES 202.836 SCREW 2.7X36 CORTEX Central Supplies 283.00
278 SYNTHES 202.845 SCREW 2.7X45 CORTEX Central Supplies 283.00
272 SYNTHES 315.28 DRILL BIT 2.7X125mm Central Supplies 624.00
278 SYNTHES 204.836 SCREW 3.5X36 CORTEX Central Supplies 236.00
278 SYNTHES 202.850 SCREW 2.7X50 CORTEX Central Supplies 254.00
272 SYNTHES 310.20 DRILL BIT 2.0X85mm Central Supplies 514.00
278 SYNTHES 404.818 TI SCREW 3.5X18mm CRT Central Supplies 198.00
278 SYNTHES 404.814 TI SCREW 3.5X14 CORTX Central Supplies 204.00
275 SYNTHES 404.822 TI SCREW 3.5X22 CORTX Central Supplies 198.00
278 SYNTHES 02.112.080 CLAVCLE PLAT 6H R Central Supplies 3,678.00
278 SYNTHES 456.420S FIX NAIL TI CANN 11m Central Supplies 7,238.00
278 SYNTHES 456.306 HELICAL BLADE 11X105 Central Supplies 2,431.00
278 SYNTHES 458.954 SCREW LOCKIN 5.0X54mm Central Supplies 972.00
272 SYNTHES 315.40 DRILL BIT 4.0X195 Central Supplies 903.00
278 SYNTHES 242.465 EX ART DIST RAP PLATE Central Supplies 3,529.00
278 SYNTHES 402.812 TIT2.7X12 CTX SCREW Central Supplies 283.00
278 SYNTHES 402.816 TIT 2.7X16 CTX SCREW Central Supplies 283.00
278 SYNTHES 441.361 6H 1/3 TUBULAR PLATE TI Central Supplies 940.00
278 SYNTHES 02.210.116 VA LK SCREW 2.4X16 Central Supplies 814.00
278 SYNTHES 456.511S TRN 12X235 130 DRGRE Central Supplies 5,499.00
278 SYNTHES 456.307 HELICAL BLADE 11X110 Central Supplies 2,681.00
278 SYNTHES 206.035 CANC SCREW 4.0X35mm Central Supplies 166.00
278 SYNTHES 241.381 LCP TUB PLATE 8H Central Supplies 1,162.00
278 SYNTHES 245.061 LCP PLATE 6H RECONSTR Central Supplies 2,031.00
278 SYNTHES 02.211.016 VA LOCKN SCREW 2.7 Central Supplies 770.00
278 SYNTHES 292.20 K-WIRE 2.0 TROC PT Central Supplies 547.00
278 SYNTHES 204.838 CORTEX SCREW 3.5X38mm Central Supplies 219.00
278 SYNTHES 212.125 SCREW 3.5X65 LOCKIN Central Supplies 701.00
278 SYNTHES 212.123 SCREW 3.5X55 LOCKIN Central Supplies 810.00
278 SYNTHES 212.124 SCREW 3.5X60 LOCKIN Central Supplies 810.00
272 SYNTHES 324.214 DRILL CALIBRA2.8 Central Supplies 1,138.00
278 SYNTHES 02.124.200S LCP PROX TIB PLAT Central Supplies 5,978.00
272 SYNTHES 310.69 CANN DRILL BIT 4.5X233 Central Supplies 1,830.00
278 SYNTHES 456.319S TFN 11X130deg, 120mm Central Supplies 5,499.00
278 SYNTHES 242.458 RT EX ART DIS RAD PLA Central Supplies 3,334.00
278 SYNTHES 402.818 TI SCREW 2.7X18 CORTE Central Supplies 272.00
278 SYNTHES 402.814 TI SCREW 2.7X14 CORTE Central Supplies 283.00
278 SYNTHES 245.101 LCP RECON PLATE 3.5 Central Supplies 2,306.00
278 SYNTHES 202.624 CAN SCREW 3.0X24 ST Central Supplies 1,187.00
278 SYNTHES 202.622 CAN SCREW 3.0X22 ST Central Supplies 1,150.00
278 SYNTHES 206.055 SCREW 4.0X55 CANCE FT Central Supplies 185.00
278 SYNTHES 206.060 SCREW 4.0X60 CANCEL F Central Supplies 198.00
278 SYNTHES 04.005.530 TI SCREW 5.0X40 Central Supplies 1,126.00
278 SYNTHES 04.005.522 TI SCREW 5.0X32 Central Supplies 948.00
278 SYNTHES 04.005.524 TI SCREW 5.0X34 Central Supplies 948.00
278 SYNTHES 710.014.99S CHRON 5CC Central Supplies 2,013.00
278 SYNTHES 02.124.209 L 8H PLATE LOW BEN Central Supplies 5,917.00
278 SYNTHES 204.850 CORTEX SCREW3.5X50 Central Supplies 236.00
278 SYNTHES 212.128 SCREW LOCKN 3.5X80 Central Supplies 676.00
278 SYNTHES 212.130 SCREW LOCKIN 3.5X90 Central Supplies 676.00
278 SYNTHES 212.129 SCREW LOCKIN 3.5X85 Central Supplies 676.00
278 SYNTHES 292.71 K-WIRE Central Supplies 152.00
278 SYNTHES 401.810.96 TI SCREW 2.0X10 Central Supplies 324.00
278 SYNTHES 401.812.96 TI SCREW 2.0X12 Central Supplies 324.00
272 SYNTHES 310.203 DRILL BIT 2.0X75 J-LA Central Supplies 599.00
272 SYNTHES 292.622 GUIDE WIRE 1.1 THREAD Central Supplies 239.00
278 SYNTHES 223.561 LCP 3.5 PLATE 6H 85MM Central Supplies 1,997.00
278 SYNTHES 204.822 SCREW CORTEX 3.5X22 Central Supplies 219.00
278 SYNTHES 223.581 LCP PLATE 8h 3.5X111m Central Supplies 1,641.00
272 SYNTHES 03.010.060 DRILL BIT 3.2 3-FL Central Supplies 1,458.00
272 SYNTHES 03.010.103 DRILL BIT 3.2X145 Central Supplies 944.00
278 SYNTHES TI CAN TIB NAIL 9X300mm Central Supplies 5,920.00
278 SYNTHES 04.005.426 TI LOCKN SCREW 4.0 Central Supplies 980.00
278 SYNTHES 04.005.422 TI LKN SCRW 4.0X32 Central Supplies 1,126.00
278 SYNTHES 04.004.010 TI END CAP for NAI Central Supplies 1,138.00
278 SYNTHES 404.820 3.5X20 CORTEX TI SCREW Central Supplies 204.00
278 SYNTHES 202.870 SCREW 2.7X10 CORTEX SLF- Central Supplies 369.00
278 SYNTHES 02.111.621 DST RAD PLATE 2.4mm 6 Central Supplies 4,615.00
272 SYNTHES 310.530 DRILL BT 2.4X100mm Central Supplies 729.00
278 SYNTHES 02.210.110 SCREW 2.4X10 LOCKIN Central Supplies 875.00
278 SYNTHES 207.040 SCREW 4.0X40 CANCEL PT Central Supplies 198.00
278 SYNTHES 02.124.208S PRO TIB PLAT 8-H RT Central Supplies 7,225.00
278 SYNTHES 212.117 SCREW 305X40 LK ST Central Supplies 701.00
278 SYNTHES 204.830 SCREW CORTX 3.5X30 Central Supplies 236.00
278 SYNTHES 204.834 SCREW CORT 3.5X34 Central Supplies 236.00
278 SYNTHES 226.632 CRV BROAD LCP PLATE 13H Central Supplies 3,175.00
278 SYNTHES 298.801.01S CABLE W/CRIMP 1.7X75 Central Supplies 2,056.00
278 SYNTHES 298.803S THRD CERCL POST PIN 1.7 Central Supplies 1,021.00
278 SYNTHES 02.231.014 VA LOCK SCREW 5.0X14 Central Supplies 1,426.00
278 SYNTHES 02.231.228 VAR ANGLE SCREW 5.0X2 Central Supplies 1,017.00
278 SYNTHES 02.231.236 VAR ANG SCREW 5.0X36 Central Supplies 1,017.00
278 SYNTHES 02.231.238 SCREW VAR ANG 5.0X38 Central Supplies 1,017.00
278 SYNTHES 02.231.240 SCREW VAR ANG 5.0X40 Central Supplies 1,017.00
278 SYNTHES 214.822 CORTEX SCREW 4.5X22 Central Supplies 200.00
278 SYNTHES 214.838 CORTEX SCREW 4.5X38 Central Supplies 215.00
278 SYNTHES 214.840 CORTEX SCREW 4.5X40 Central Supplies 200.00
278 SYNTHES 02.221.512 PERIPROS SCREW 5.0X12 Central Supplies 1,183.00
272 SYNTHES 324.212 PERC DRILL BIT 3.2X300 Central Supplies 1,150.00
272 SYNTHES 324.213 DRILL BIT PERC 4.3X300 Central Supplies 1,045.00
278 SYNTHES 04.003.365S FEM NAIL TI 10X420mm Central Supplies 6,756.00
278 SYNTHES 04.005.560S TI LOCKN SCREW 5.0X7 Central Supplies 1,247.00
278 SYNTHES 02.112.083 3.5mm CLAVICLE PLT Central Supplies 3,892.00
278 SYNTHES 02.226.126 HD COMP SCREW 3.0 Central Supplies 2,009.00
278 SYNTHES 204.832 SCREW 3.5X32 CORTEX ST Central Supplies 236.00
278 SYNTHES 456.318S TI CANN FIX NAIL 11m Central Supplies 5,667.00
272 SYNTHES 456.305 TI HELICAL BLADE 11mm Central Supplies 2,681.00
278 SYNTHES 04.001.352S TI CAN TIB NAIL 9mm Central Supplies 6,100.00
278 SYNTHES 04.005.436 TI SCREW 4.0x46mm Central Supplies 1,049.00
278 SYNTHES 04.005.432 TI SCREW 4.0x42mm Central Supplies 980.00
278 SYNTHES 04.005.448 TI SCREW 4.0x58mm Central Supplies 980.00
278 SYNTHES 01.005.442 TI SCREW 4.0x52mm Central Supplies 980.00
278 SYNTHES 02.111.731 VLR DIST RAD PLT L 7H Central Supplies 4,188.00
278 SYNTHES 02.210.118 VA LOCKN SCREW 2.4X18 Central Supplies 814.00
278 SYNTHES 02.111.721 DSR RAD PLTE 2.4 7H L Central Supplies 4,029.00
278 SYNTHES 808.080 7.0 CAN SCREW 16X80mm Central Supplies 1,539.00
278 SYNTHES 208.090 SCREW 7.0 CAN 16X90mm Central Supplies 1,539.00
272 SYNTHES 292.65 GUIDE WIRE 2.0 THRD Central Supplies 336.00
278 SYNTHES 223.551 LCP PLATE 3.5X72 5H Central Supplies 1,632.00
278 SYNTHES 281.102 DHS PLATE 2H/46mm Central Supplies 2,245.00
278 SYNTHES 214.836 SCREW CORTEX ST 4.5X36mm Central Supplies 215.00
278 SYNTHES 280.900 DHS/DCS LAG SCREW 12.7X Central Supplies 1,904.00
272 SYNTHES 310.31 DRILL BIT 3.2X145mm Central Supplies 593.00
272 SYNTHES 900.723 THRD GUIDE WIRE 2.5X230m Central Supplies 402.00
278 SYNTHES 04.004.346S TI CAN TIBIAL NAIL 9 Central Supplies 6,100.00
278 SYNTHES 04.005.420 TI SCREW LOCKIN 4.0X3 Central Supplies 1,049.00
278 SYNTHES 02.200.024 CORTEX SCREW 3.5X24mm Central Supplies 212.00
278 SYNTHES 02.200.028 CORTEX SCREW 3.5X28mm Central Supplies 227.00
278 SYNTHES 02.200.032 CORTEX SCREW 3.5X32mm Central Supplies 212.00
278 SYNTHES 401.808.96 TI COTX SCREW 2.0X8mm Central Supplies 289.00
278 SYNTHES 401.814.96 TI COTX SCREW 2.0X14m Central Supplies 324.00
278 SYNTHES 449.936 TI-DCP 2.0 6H-PLATE 36mm Central Supplies 1,746.00
272 SYNTHES 310.143 DRILL BIT 1.5mm Central Supplies 458.00
278 SYNTHES 214.550 CANN SCREW PT4.5X50mm Central Supplies 1,179.00
278 SYNTHES 214.540 CANN SCREW 4.5X40mm Central Supplies 600.00
272 SYNTHES 310.65 DRILL BIT 3.2mm Central Supplies 1,830.00
272 SYNTHES 292.72 THRD GUIDE WIRE Central Supplies 281.00
278 SYNTHES 04.005.424 LOCK SCREW W/48 Central Supplies 1,049.00
278 STRYKER 04.004.240S TI CANN TIB NAIL 8mm Central Supplies 6,100.00
278 SYNTHES 02.111.620 VA-LCP 2-CLMN PL 2.4m Central Supplies 4,615.00
272 SYNTHES 02.110.300 K-WIRE 1.8X150mm TRC Central Supplies 454.00
278 SYNTHES 401.818.96 TI CORT SCREW 2.0X18 Central Supplies 289.00
278 SYNTHES 449.931 TI LC-DCP PLAT 2.0X24 4H Central Supplies 1,320.00
278 SYNTHES 211.846 CANLT SCREW 2.4X24mm ST Central Supplies 1,162.00
278 SYNTHES 211.812 CANUTE SCREW 2.4X12mm LT Central Supplies 1,162.00
272 SYNTHES 310.215 CANULTE DRILL BIT 1.7X10 Central Supplies 2,095.00
272 SYNTHES 292.619 GUIDE WIRE 0.8X100mm Central Supplies 927.00
278 SYNTHS 02.226.024 CMP SCREW HDLS 3.0X24 Central Supplies 2,009.00
278 SYNTHES 02.226.026 CMP SCREW 3.0X26 HSLS Central Supplies 2,009.00
272 SYNTHES 02.111.500.10 PLT REDUC WIRE 1.2 Central Supplies 143.00
278 SYNTHES 02.210.112 VA LCK SCREW 2.4X12mm Central Supplies 757.00
278 SYNTHES 201.762 CORTEX SCRW ST 2.4X12mm Central Supplies 469.00
278 SYNTHES 404.812 3.5X12 CORTEX TI SCREW Central Supplies 204.00
278 SYNTHES 406.010 4.0X10 CANCELLOUS TI FT Central Supplies 172.00
278 SYNTHES 407.040 4.0X40 CANCELLOUS TI PT Central Supplies 172.00
278 SYNTHES 407.035 4.0X35 CANCELLOUS TI PT Central Supplies 172.00
278 SYNTHES 04.005.546 5.0X56MM LOCKING SCRW Central Supplies 499.00
278 SYNTHES 04.005.570 Central Supplies 499.00
278 SYTHES 04.003.565S 12MM LAT ENT FEM NAIL Central Supplies 3,080.00
278 SYNTHES 04.003.003 12MM END CAP FEM NAIL Central Supplies 466.00
272 SYNTHES 03.010.061 4.2X330MM DRILL BIT Central Supplies 674.00
272 SYNTHES 03.010.104 4.2X145MM DRILL BIT Central Supplies 480.00
278 SYNTHES 04.003.565S 12MM TI FEMORAL NAIL Central Supplies 6,756.00
278 SYNTHES 04.005.546 5X56MM LOCKING SCREW Central Supplies 980.00
278 SYNTHES 04.005.570 5X80MM LOCKING SCREW Central Supplies 980.00
278 SYNTHES 01.005.540 5X50MM LOCKING SCREW Central Supplies 980.00
278 SYNTHES 04.003.003 12X15MM TI END CAP Central Supplies 915.00
278 SYNTHES 241.623 SHORT LT CALCANEAL PLATE Central Supplies 2,888.00
278 SYNTHES 02.200.030 3.5X30MM CORTEX SCREW Central Supplies 212.00
278 SYNTHES 213.036 3.5X36MM LOCKING SCREW Central Supplies 701.00
278 SYNTHES 213.026 3.5X26MM LOCKING SCREW Central Supplies 701.00
278 SYNTHES 213.034 3.5X34MM LOCKING SCREW Central Supplies 701.00
278 SYNTHES 456.308 11X115 TI HELICAL BLADE Central Supplies 2,681.00
278 SYNTHES 02.117.104 2.7/3.5MM POSTLAT PL Central Supplies 5,277.00
278 SYNTHES 02.117.502 2.7/3.5MM MED DSTL PL Central Supplies 5,115.00
278 SYNTHES 02.211.050 2.7X550MM VA LOCK SCR Central Supplies 851.00
278 SYNTHES 02.211.052 2.7X52MM VA LOCK SCRE Central Supplies 851.00
278 SYNTHES 02.211.056 2.7X56MM VA LOCK SCRE Central Supplies 851.00
278 SYNTHES 02.118.532 2.7X32MM META SCREW Central Supplies 408.00
278 SYNTHES 211.842 2.4X18MM CANN. SCREW Central Supplies 1,247.00
278 SYNTHES 211.844 2.4X20MM CANN. SCREW Central Supplies 1,247.00
278 ZIMMER 00-5980-057-01 TIBIAL PLATE #7 Central Supplies 7,174.00
278 ZIMMER 00-5972-066-35 PATELLA 35mm Central Supplies 3,758.00
278 ZIMMER 00-5962-050-10 CROSSLINK SZ GH Central Supplies 5,563.00
272 ZIMMER 5049-001-00 QUICK VAC MIXING BOWL Central Supplies 411.00
278 ZIMMER 1113-140-01 BONE CEMENT PALACOS Central Supplies 1,836.00
278 ZIMMER 1112-140-01 PALACOS R BONE CEMENT Central Supplies 717.00
278 ZIMMER 7833-014 FRMORAL STEM SZ14 CEM Central Supplies 7,561.00
278 ZIMMER 4510-10 UNIPOL FEM HEAD ADAPT +0m Central Supplies 1,556.00
278 ZIMMER 7859-012 DIST CENTRALIZER 12mm Central Supplies 725.00
278 ZIMMER 4510-00-046 UNIPOLAR FEM HEAD 46m Central Supplies 2,352.00
272 ZIMMER 5049-055 FEM BONE CEMENT PREP KIT Central Supplies 667.00
272 ZIMMER 5049-045-01 3D COMP VAC CEM MIX S Central Supplies 711.00
278 ZIMMER 1147-32-40 SCREW 4.0X32mm Central Supplies 985.00
278 ZIMMER 1147-38-40 SCREW 4.0X38mm Central Supplies 985.00
278 ZIMMER 00-8757-048-01 SHELL 48MM SZ GG Central Supplies 8,328.00
272 ZIMMER 1147-26 DRILL BIT 2.7mm Central Supplies 2,349.00
278 ZIMMER 1147-94 CANNULATED GUIDE PIN SMOO Central Supplies 99.00
278 ZIMMER 7859-013 DISTAL CENTRALIZER 13mm Central Supplies 725.00
278 ZIMMER 4510-10-004 UNIPOLOR FEM HEAD ADA Central Supplies 1,556.00
278 ZIMMER 1147-090-70 CANN SCREW 7.0mm Central Supplies 1,499.00
278 ZIMMER 1147-080-70 CANN SCREW 7.0mm Central Supplies 1,499.00
278 OR ZIMMER 1147-085-70 CANN SCREW 7.0mm Central Supplies 1,426.00
272 OR ZIMMER 1147-030 CANN DRILL BIT 5.0 Central Supplies 2,349.00
272 OR ZIMMER 1147-93 GUIDE PIN 3.2mmX9″ Central Supplies 217.00
278 OR ZIMMER 7834-14 VERS FEM STEM SZ14X135 Central Supplies 7,561.00
278 ZIMMER 7859-09 DISTAL CENTRALIZER 9mm Central Supplies 725.00
278 ZIMMER 4510-00-045UNIPOL FEMORAL HEAD 45 Central Supplies 2,352.00
278 ZIMMER 7351-30-009 DIST HIP STEM CENTRAL Central Supplies 644.00
278 ZIMMER 4510-00-047 UNIPOL FEMHD 47mm Central Supplies 2,352.00
278 ZIMMER 7833-11 FEMORAL STEM SZ-11 Central Supplies 7,561.00
278 ZIMMER 5962-030-12 CROSSLINK SZ-C,D 12mm Central Supplies 7,107.00
278 ZIMMER 5980-037-01 STEM TIBIAL PLATE SZ3 Central Supplies 7,174.00
278 OR ZIMMER 5972-066-32 POLY PATELLA, 32mm Central Supplies 3,758.00
272 ZIMMER 5049-035-01 VACUME CEMENT MIX BOW Central Supplies 639.00
278 ZIMMER 00-5962-051-10 CROSLINK EF,7-10, Central Supplies 5,563.00
272 ZIMMER 2001-00-000 DRILL/PIN SET Central Supplies 484.00
278 ZIMMER 5972-066-38 PATELLA 38mm Central Supplies 3,758.00
278 ZIMMER 00-8757-056-01 CLUS HOLE SHELL 56 Central Supplies 7,735.00
278 ZIMMER 00-6250-065-25 SCREW 6.5X25mm Central Supplies 616.00
278 ZIMMER 00-6250-065-30 SCREW 6.5X30mm Central Supplies 616.00
278 ZIMMER 00-8757-000-01 DOME HOLE PLUG Central Supplies 484.00
278 ZIMMER 00-8851-012-36 CROSS LINK SZ36 Central Supplies 6,637.00
278 ZIMMER 00-8775-036-03 FEMORAL HEAD 36mm Central Supplies 7,896.00
278 ZIMMER 00-5962-032-10 LPSFLEX ART SURF E Central Supplies 5,563.00
272 ZIMMER SKIN GRAFT CARRIER 1:5:1 Central Supplies 140.00
272 ZIMMER 1147-099-01 GUIDE PIN 3.2mm Central Supplies 229.00
278 ZIMMER 1147-105-70 SCREW 7.0X105mm CANNU Central Supplies 1,499.00
278 ZIMMER 1147-110-70 SCREW CANUL 7.0×110 Central Supplies 1,426.00
275 ZIMMER 1147-100-70 SCREW CANULAT 7.0×100 Central Supplies 1,426.00
272 ZIMMER 1147-088-00 GUIDE PIN 3.2X9mm Central Supplies 160.00
278 ZIMMER 00-6250-065-25 6.5X25 BONE SCREW Central Supplies 726.00
278 ZIMMER 00-8851-008-32 NEUT. LINER 32 GG Central Supplies 6,689.00
278 ZIMMER 42-5124-005-10 LT TIB POLY SZ CD Central Supplies 4,775.00
278 ZIMMER 42-5402-000-32 32MM PATELLA POLY Central Supplies 2,434.00
278 ZIMMER 42-5320-067-01 PSN LT TIBIA SZ 8 Central Supplies 5,083.00
272 ZIMMER 00-5901-20-00 TROCAR DRILL PIN Central Supplies 1,213.00
270 DEPUY MITEK 799000 EQUIPMENT RENTAL Central Supplies 1,418.00
272 DEPUY MITEK 232300 ACL DISPOSABLES Central Supplies 1,861.00
278 DEPUY MITEK 210127 RIGIDFIX BTB Central Supplies 1,556.00
278 DEPUY MITEK 231818 MILAGRO ADV 9X23 Central Supplies 1,960.00
278 DEPUY MITEK 231817 MILAGRO ADV 8X23 Central Supplies 1,912.00
272 DEPUY MITEK 232110 ACL GRAFT KNIFE Central Supplies 674.00
272 DEPUY MITEK 700999 RIGIDFIX/MILAGRO Central Supplies 1,013.00
278 OR DEPUY 110050110 BODY SZ14.0 Central Supplies 5,856.00
278 OR DEPUY 110048500 HUMERAL HEAD 48X15 Central Supplies 8,433.00
278 OR DEPUY 110020300 COLLAR SZ48 Central Supplies 2,376.00
278 BIOMET 912040C JUGERKNOT 1.4mm CRVD Central Supplies 1,150.00
278 OR BIOMET 902612 ALLTHREAD TI 5.0mm Central Supplies 1,835.00
278 OR BIOMET 904843P PEEK ALLTHREAK 5.0mm Central Supplies 1,814.00
278 OR BIOMET 902093 BIPASS PLACTIC NITINOL Central Supplies 644.00
278 OR BIOMET 904755 #7 PE ZIPLOOP EXT TOGGL Central Supplies 1,915.00
278 OR BIOMET 906513 TIBIAL FIXATION 9mm TUN Central Supplies 1,949.00
278 OR BIOMET 909846 TOGGLELOC/WASHERLOC DIS Central Supplies 1,635.00
278 OR BIOMET 905942P ATHRD PEEK 5.5 2#2MB Central Supplies 1,770.00
278 OR BIOMET 912030 JGRKNOT SING 1.4mm Central Supplies 1,685.00
278 OR BIOMET 912040 JGRKNT 1.4mm KIT DISP Central Supplies 1,150.00
272 OR BIOMET 9003661 AQUALOC 5X85 CAN SINGL Central Supplies 309.00
272 OR BIOMET 9003601 AQUALOC CAN 7X75 SINGL Central Supplies 309.00
278 OR BIOMET 912057 JGRKNT 2.9mm DISP KIT Central Supplies 1,612.00
278 OR BIOMET 912029 JGRKNT 2.9mm 2#2MB BLUE Central Supplies 1,729.00
272 OR BIOMET 212957012 DRILL BIT 3.2mm Central Supplies 538.00
278 OR BIOMET 112912020 CLAVICLE PIN 3.0mm Central Supplies 4,758.00
278 OR BIOMET 650-1066 TYPE 1 TAPER STND TA Central Supplies 654.00
278 OR BIOMET 650-1056 32 HEAD TYPE 16/18 TA Central Supplies 8,305.00
278 OR MICROPORT EIS4S14R SZ 4 RT 14MM INSER Central Supplies 6,100.00
272 OR BIOMET 829029070 DRILL BIT 2.5mm Central Supplies 620.00
278 OR BIOMET 815037040 CORT SCREW 3.5X40 Central Supplies 387.00
278 OR BIOMET 815037042 CORT SCREW 3.5X42 Central Supplies 387.00
278 OR BIOMET 131218070SCREW CORT LP 3.5mm Central Supplies 448.00
278 OR BIOMET 816140060 SCREW CANC LOCKIN Central Supplies 689.00
278 OR BIOMET 816140050 SCREW CANC LOCK 4.0 Central Supplies 689.00
278 OR BIOMET 816140055 SCREW CANC LOCK 4.0 Central Supplies 689.00
278 OR BIOMET 816135056 SCREW CORT LOCK 3.5 Central Supplies 689.00
278 OR BIOMET 816135080 SCREW CORT LOCK 3.5 Central Supplies 689.00
278 OR BIOMET 816135034 SCREW CORT LOCK 3.5 Central Supplies 814.00
278 OR BIOMET 816135036 SCREW CORT LOCK 3.5 Central Supplies 814.00
272 OR BIOMET 214227070 DRILL BIT 2.7mm Central Supplies 664.00
278 OR BIOMET 144256 STEIN PIN 1.6mmX6″ Central Supplies 266.00
278 OR BIOMET 816235705 PROX TIB PLATE LT 5H Central Supplies 5,216.00
278 OR BIOMET 816335070 SCREW MULTIDIRT 3.5X Central Supplies 1,008.00
278 OR BIOMET 900333 MAXBRAID PE2 WHITE Central Supplies 199.00
278 OR BIOMET 900334 BLUE MAXBRAID Central Supplies 208.00
278 STRYKER ORTHO 5542-P-0052 SP GLENOID Central Supplies 6,861.00
278 STRYKER ORTHO 5552-E-5223 HUMERAL HEAD Central Supplies 5,510.00
278 STRYKER ORTHO 5552-S-5220 HUMERAL HD Central Supplies 5,095.00
278 STRYKER ORTHO 5542-P-0048 GLENOID S-P Central Supplies 7,419.00
278 STRYKER ORT 5552-E5220 RAD HUM HEAD SZ52 Central Supplies 5,587.00
278 STRYKER ORTHO 5542-P-0044 GLENOID SZ44 Central Supplies 5,510.00
278 STRYKER ORTHO 5552-E-4821 RAD HUM HED 48 Central Supplies 5,587.00
278 STRYKER ORTHO 5552S4419 HUMERAL HEAD19MM Central Supplies 5,510.00
278 STRYKER ORTHO 371534 4.0X34 LOCKING SCRE Central Supplies 948.00
278 STRYKER ORTHO 371542 4.0X42 LOCKING SCRE Central Supplies 948.00
278 STRYKER ORTHO 371536 Central Supplies 948.00
278 STRYKER ORTHO 371528 4.0X28 LOCKING SCRE Central Supplies 948.00
278 STRYKER ORTHO 702742 DRILL BIT 3.1 Central Supplies 741.00
278 STRYKER ORTHO 38111090 KWIRE 2.0 Central Supplies 188.00
278 STRYKER ORTHO 437224 PLATE 3 HOLE Central Supplies 4,788.00
278 STRYKER ORTHO 338636 3.5X36 CORTICAL SCR Central Supplies 296.00
278 STRYKER ORTO 345545 4.0X45 CANCELLOUS Central Supplies 296.00
278 STRYKER ORTHO 5542-P-0048 GLENOID Central Supplies 3,383.00
272 STRYKER ORTHO RECIPRO BLADE 0277-096-300 Central Supplies 270.62
272 STRYKER ORTHO RECIPR BLADE 6113-119-090 Central Supplies 386.53
272 STRYKER ENDO PNENMOSURE HEATED TUBESET Central Supplies 410.00
272 STRYKER INST 277-10-230 BURR 3.0 ROUND Central Supplies 454.00
272 STRYKER 0380-542-150 SHAVER BLADE Central Supplies 327.00
272 STRYKER ENDO 0375-545-000 TOMCAT 4.0 REC Central Supplies 327.00
272 STRYKER INST 0606-573-000 CEMNT MIX GUN Central Supplies 761.00
272 STRYKER INST 5400-3-125 BLADE Central Supplies 485.00
272 STRYKER ENDO 375-532-000 RESECTOR 3.5 Central Supplies 327.00
272 STRYKER ENDO 375-940-000 BURR 4.0 ROUND Central Supplies 333.00
272 STRYKER INST 5400-3-114 SAW BLADE Central Supplies 485.00
272 STRYKER ENDO 375-641-000 BUR 2.0 ABRAS Central Supplies 333.00
272 STRYKER INST 277-10-62 BURR 4.0 Central Supplies 389.00
272 STRYKER ENDO 279-350-501 HOOK ABLATOR Central Supplies 761.00
272 STRYKER ENDO 375-951-012 FLUTED BUR 5.5 Central Supplies 333.00
272 STRYKER ENDO 275-542-000 SHAVER 4-0 Central Supplies 477.00
272 STRYKER ARTHRO IRRG TUBING Central Supplies 318.00
272 STRYKER INST 2296-3-155 OSCILLATING BLAD Central Supplies 412.00
272 STRYKER ENDO 375-562-000 RESECTOR 5.5mm Central Supplies 327.00
272 STRYKER ENDO 375-542-000 RESECTOR 4.0 Central Supplies 327.00
272 STRYKER INST 606-563 CEMENT MIXING BOWL Central Supplies 761.00
272 STRYKER INST 2108-150-000 SAGITTAL BLADE Central Supplies 500.00
272 STRYKER INST 5400-3-111 SAW BLADE Central Supplies 485.00
272 STRYKER ENDO 279-351-100 ABLATOR BLADE Central Supplies 608.00
272 OR WRIGHT MED 05-306 K-WIRE 0.9X102MM Central Supplies 242.00
278 OR WRIGHT MED 05-041 IMPLANT SMALL CANNU Central Supplies 4,569.00
272 OR WRIGHT MED DSDS1009 0.9X150MM K-WIRE Central Supplies 218.00
272 OR WRIGHT MED DSDS0022 2.2MM DRILL BIT Central Supplies 1,081.00
278 OR WRIGHT MED D1N30026S 3.0X26MM SCREW Central Supplies 1,195.00
278 OR WRIGHT MED EIS4-S14R RT SZ 4x14mm POL Central Supplies 6,100.00
278 WRIGHT MED EFSR-P6PR Central Supplies 8,540.00
278 WRIGHT MED EFSR-P5PL L FEM SZ 5 Central Supplies 8,540.00
278 WRIGHT MED EFSR-P5PR RT FEMUR SZ 5 Central Supplies 8,540.00
278 OR WRIGHT MED EFSR-P4PR SZ 4 RT FEMUR Central Supplies 8,540.00
278 OR WRIGHT MED EFSR-P4PL FEMUR L SZ4 Central Supplies 8,540.00
278 WRIGHT MED EIS6-S12L POLY SZ6 L 14mm Central Supplies 6,100.00
278 OR WRIGHT MED EFSR-N5PR SZ5 RT FEMUR COM Central Supplies 8,540.00
278 OR WRIGHT MED EIS6-S14R POLY 14mm SZ6 RT Central Supplies 6,100.00
278 OR WRIGHT MED EIS5-S10R POLY 10mm RT SZ5 Central Supplies 6,100.00
278 OR WRIGHT MED PLSS-R010 RENAS STEM SZ10 Central Supplies 7,625.00
278 OR WRIGHT MED EIP6-S10L PS POLY SZ6 L 10 Central Supplies 6,100.00
278 OR WRIGHT MED EFPS-N6PL PS FEMUR SZ6 LEF Central Supplies 8,540.00
278 or wright med plss-r011 renain stem sz11 Central Supplies 7,625.00
278 OR WRIGHT MED 7200-3252 CEAMIC LINER 32m Central Supplies 4,575.00
278 OR WRIGHT MED EIS5-S12L POLY SZ.5, L,12m Central Supplies 6,100.00
278 OR WRIGHT MED 8600-5×05 GRAFT JACKET Central Supplies 8,269.00
278 OR WRIGHT MED 2600-0011 CERAMIC HEAD 32m Central Supplies 6,100.00
278 OR WRIGHT MED PLSS-RO13 STEM SZ13 Central Supplies 7,625.00
278 OR WRIGHT MED 1808-0303 SCREW 3.0cm Central Supplies 5.00
278 OR WRIGHT MED 2600-0009 CERAMIC HEAD 32m Central Supplies 6,100.00
278 OR WRIGHT MED DLXP-GC32 DYNASTY LINE32mm Central Supplies 4,575.00
278 OR WRIGHT MED DSBF-GC50 DYNASTY SHELL 50 Central Supplies 9,150.00
278 OR WRIGHT MED 1808-0304 BONE SCREW 3.5cm Central Supplies 5.00
278 OR WRIGHT MED DSBR-GG58 DYNASTY SHELL 58 Central Supplies 9,150.00
278 OR WRIGHT MED PLSS-R012 STEM SZ 12 RENAI Central Supplies 7,625.00
278 OR WRIGHT MED KPON-TP29 TRI PEG PATEL 29 Central Supplies 810.00
278 OR WRIGHT MED EIS5-S10L LT 10mm POLY SZ5 Central Supplies 6,100.00
278 OR WRIGHT MED ETPK-N5SL LT TIB NASE SZ5 Central Supplies 9,150.00
278 OR WRIGHT MED EIS6-S10L SZ6 LT 10mm POLY Central Supplies 6,100.00
278 OR WRIGHT MED EFSR-N6PL SZ 6 LT FEMUR Central Supplies 8,540.00
278 OR WRIGHT MD 3818-0002 APICAL A HOL PLUG Central Supplies 5.00
278 OR WRIGHT MED DLXP-GG42 DYNASTY LINER 42 Central Supplies 4,575.00
278 OR WRIGHT MED 38CH-4200 BCH FEM HEAD 42m Central Supplies 6,100.00
278 OR WRIGHT MED DSBF-GG60 DYNASTY SHELL 60 Central Supplies 9,150.00
278 OR WRIGHT MED PLSE-R013 FEM STEM SZ13 Central Supplies 7,625.00
278 OR WRIGHT MED 1808-0301 SCREW 2.0cm Central Supplies 5.00
278 OR WRIGHT MED 38NS-3500 LG NECK SLEEVE Central Supplies 5.00
278 OR WRIGHT MED 38CH-4000 BCH HEAD 40mm Central Supplies 6,100.00
278 OR WRIGHT MED DLXP-GF40 DYS LIN 40mm Central Supplies 4,575.00
278 OR WRIGHT MED PLSE-R014 FIX NECK STEM 14 Central Supplies 7,625.00
278 OR WRIGHT MED EIS4-S12L POLY 12m SZ4 LT Central Supplies 6,100.00
278 OR WRIGHT MED ETPK-N4SL TIBIAL BASE SZ4 Central Supplies 9,150.00
278 OR WRIGHT MED EFSR-N4PL EV FEMORAL SZ4 L Central Supplies 8,540.00
278 OR WRIGHT MED EIS6-S12R SZ6 RT 12mm POLY Central Supplies 6,100.00
278 OR WRIGHT MED 1808-0302 SCREW 2.5cm Central Supplies 5.00
278 OR WRIGHT MED PLSE-R011 REN STEM SZ 11 Central Supplies 7,625.00
278 OR WRIGHT MED 2600-0012 CERAMIC HEAD 36m Central Supplies 6,100.00
278 OR WRIGHT MED DLXP-GD36 DYN POLY LIN 36m Central Supplies 4,575.00
278 OR WRIGHT MED DSBF-GD52 DYN SHELL 52mm Central Supplies 9,150.00
278 OR WRIGHT MED KPON-TP38 TRI-PEG POLY 38m Central Supplies 810.00
278 OR WRIGHT MED EIS6-S10R POLY SZ6 RT 10mm Central Supplies 6,100.00
278 OR WRIGHT MED ETPK-N6SR KEL TIB BS 6 RT Central Supplies 9,150.00
278 OR WRIGHT MED EFSR-N6PR EVLT FEM SZ 6 R Central Supplies 8,540.00
278 OR WRIGHT MED EIS5-S12R MP SZ5 RT INSERT Central Supplies 6,100.00
278 OR WRIGHT MED KPON-TP32 PATRLLA 32mm Central Supplies 810.00
278 OR WRIGHT MED RT SZ5 14mm POLY Central Supplies 6,100.00
278 OR WRIGHT M1410-2000 ORTHOSET 2 BONE CEM Central Supplies 1.00
278 OR WRIGHT MED KPON-TP35 TRIPEG PATELLA Central Supplies 810.00
278 OR WRIGHT MED EIS5-S12R RT SZ5 12mm POLY Central Supplies 6,100.00
278 OR WRIGHT MED ETPK-N5SR TIB BASE SZ5 RT Central Supplies 9,150.00
278 OR WRIGHT MED EFSR-N4PR FEMUR SZ4 RT Central Supplies 8,540.00
278 OR WRIGHT MED 496S265 STEM 6.5mm +2 Central Supplies 7,762.00
278 OR WRIGHT MED 496-H26 EVOLVE HEAD 26mm Central Supplies 6,530.00
278 OR ALLERGAN 15-397 BREAST INPLNT STY #15 Central Supplies 2,827.00
278 ALLERGAN 15-234 BREAST IMPLNT STY #15 Central Supplies 2,827.00
278 OR ALLERGAN 133-mv-16 TISSUE EXPANDER 16 Central Supplies 4,255.00
278 OR MEDTRONIC 14142 EAR TUB SHEHY 3.0 Central Supplies 62.00
272 OR MICROAIRE SO625-127-090 OSCILLAT BLAD Central Supplies 327.00
272 OR MICROAIRE SO611-127-090 OSCULAT BLAD Central Supplies 212.00
278 OR RTI ANTERIOR TIBIALIS 453017 Central Supplies 7,930.00
278 OR 453316 POSTERIOR TIBIALIS TENDON Central Supplies 7,930.00
278 OR BG MEDICAL T613-8S SURGIMESH WN Central Supplies 1,013.00
278 OR BG MEDICAL TINTRACK-7 SURGIMESH XB Central Supplies 1,998.00
278 OR EXACTECH 310-02-44 HUMERAL HD 44X21 T Central Supplies 8,449.00
278 OR EXACTECH 300-10-15 REPLC PLATE 1.5mm Central Supplies 5,444.00
278 OR EXACTECH 300-20-02 TORQUE SCREW Central Supplies 1,525.00
278 OR EXACTECH 314-02-03 GLEN PEG CEMENTED Central Supplies 8,052.00
272 OR ARTHREX AR-13995N MUTIF SCORPION NEED Central Supplies 984.00
272 OR ARTHREX AR-6592-08-30 PASPORT CAN 3mm Central Supplies 194.00
278 OR ARTHREX AR-4068-90 LASSO 90` Central Supplies 567.00
278 OR ARTHREX AR-4068-45R LASSO 45RT Central Supplies 911.00
272 OR ARTHREX AR-6562 CRYSTAL CANULA Central Supplies 151.00
272 OR ARTHREX AR-6570 TWIST CANUL 7mm Central Supplies 151.00
272 OR ARTHREX AR-6545 CANNULA 6X9cm Central Supplies 218.00
272 OR ARTHREX AR-1644 BEACH CHAIR KIT Central Supplies 437.00
278 OR ARTHREX AR-7200 FIBERWIRE #2 Central Supplies 112.00
272 OR ARTHREX SP-1399 SN SCORPION NEEDLE Central Supplies 984.00
272 OR ARTHREX AR-1927 PBS DISP. PUNCH Central Supplies 454.00
272 OR ARTHREX AR-8550ST SABRETOOTH 5.5mm Central Supplies 357.00
278 OR ARTHREX AR-1927BF-3 TRIPLAY 5.5mm Central Supplies 1,215.00
278 OR ARTHREX AR-8928BC-CP ACHILLES SPEDBRI Central Supplies 7,582.00
272 OR ARTHREX AR-6592-08-20 PASSPORT CAN 2. Central Supplies 194.00
278 OR ARTHREX AR-1927PSF CORKSCREW 5.5 PEEK Central Supplies 1,154.00
272 OR ARTHREX AR-1934-DS-2 BIO SUTURE TAK Central Supplies 648.00
272 OR ARTHREX AR-4068-25TR LASSO RT SUTURE Central Supplies 567.00
278 OR ARTHREX AR-1934BCF-2 FIB & TRIG WIRE Central Supplies 1,296.00
272 OR ARTHREX AR-1606V STAR SLEEVE Central Supplies 405.00
272 OR ARTHREX AR-1922PBS DISP PUNCH 4.5 Central Supplies 454.00
278 OR ARTHREX AR-1934BCF-24 SUT TAK W/#2 FW Central Supplies 1,766.00
272 OR ARTHREX AR-1934PI SUT TAK INST KIT Central Supplies 1,130.00
278 OR ARTHREX AR-2261 BICEP BUTON 2.6 Central Supplies 1,709.00
272 OR ARTHREX AR-2262 BUTTON INSERTER Central Supplies 810.00
272 OR ARTHREX AR-2263 BICEP BUTTON PIN 3.2 Central Supplies 668.00
278 OR ARTHREX AR-2324BCC SWIVELOCK 4.75 Central Supplies 1,745.00
272 OR ARTHREX AR-6592-08-40 PP CANNULA 4mm Central Supplies 194.00
278 ARTHREX AR-1678-CP INTERNAL LIG REPAIR A Central Supplies 4,249.00
272 ARTHREX AR-8934BCNF-00 SUTURE TAK DX BC Central Supplies 1,883.00
272 ARTHREX AR-8938DSC SUTTAK SM JOINT Central Supplies 842.00
272 ARTHREX AR-1204AF-105 FLIP CUTTER 10.5mm Central Supplies 1,515.00
278 ARTHREX AR-1588RT ACL TIGHTROPE RT Central Supplies 1,628.00
278 ARTHREX AR-1588TB-1 TIGHTROPE ABS 14mm B Central Supplies 996.00
272 ARTHREX AR-1898S DISP KIT TRAN-TIB ACL W Central Supplies 676.00
278 ARTHREX AR-7209 #2 FIBERSTICK Central Supplies 433.00
278 ARTHREX AR-7209T TIGERSTICK, #2 TIGERWIR Central Supplies 433.00
278 ARTHREX AR-7234T TIGERLOOP Central Supplies 312.00
278 ARTHREX AR-7237-7 FIBERTAPE Central Supplies 433.00
278 ARTHREX AR-7246 FIBERWIRE #2 BLUE Central Supplies 200.00
278 ARTHREX AR-1923BC SUT ANCH BIOCOMP Central Supplies 1,745.00
278 ARTHREX AR-1923PK PERC INSERT KIT PL 2.9 Central Supplies 1,276.00
272 ARTHREX AR-6530 CANNULA TWIST IN Central Supplies 218.00
272 ARTHREX AR-6564 CRYSTAL CANN PART THRD Central Supplies 218.00
278 ARTHREX AR-7276 LABRALTAPE W, 1.5mmX36″ Central Supplies 569.00
278 ARTHREX AR-1562BC TEND SCREW BIOCOMP Central Supplies 1,997.00
278 ARTHREX AE-1676DS BIO-TEND SCREW KIT Central Supplies 1,130.00
278 ARTHREX AR-1322BCNF SUTR ANCH 2.4X8.5MM Central Supplies 1,883.00
270 ARTHREX AR-1322DSC DISP INSTR KIT MINI S Central Supplies 1,013.00
270 ARTHREX ANKLE ARTHRO DISTRACTOR STRAP Central Supplies 390.00
278 ARTHREX AR-2325BCC BIO-COMP SWVLK 3.5X14 Central Supplies 1,745.00
272 ARTHREX AR-1644 TRIMANO BEACH CHAIR KIT Central Supplies 437.00
278 ARTHREX AR-2600SBS-4 SPEEDBRG IMP SYS Central Supplies 7,582.00
278 OR ACUMED 70-0301 CLAVICLE PLATE RT 8-H Central Supplies 3,663.00
278 OR ACUMED CO-2714 SCREW 2.7X14mm Central Supplies 484.00
278 OR ACUMED CO-3120 SCREW 3.5X12mm Central Supplies 484.00
278 OR ACUMED CO-3140 SCREW 3.5X14mm Central Supplies 484.00
278 OR ACUMED CO-3160 SCREW 3.5X16mm Central Supplies 484.00
278 OR ACUMED CO-3180 SCREW 3.5X18mm Central Supplies 484.00
278 OR ACUMED CA-4120 SCREW 4.0X12mm Central Supplies 545.00
278 OR ACUMED CA-4140 SCREW 4.0X14mm Central Supplies 545.00
278 OR ACUMED CA-4180 SCREW 4.0X18mm Central Supplies 545.00
272 OR ACUMED MS-DC5020 DRILL BIT 2.0mm Central Supplies 514.00
278 OR ACUMED CA-4160 SCREW 4.0X16mm Central Supplies 545.00
270 WAFER 1 1/2″ (125263) Central Supplies 22.00
621 MAMMOTOME 10G ELITE PROBE Central Supplies 1,013.00
621 MAMMOTOME 13G ELITE PROBE Central Supplies 1,094.00
270 DELETE STERILE GLOVES Central Supplies 37.00
270 Unna Boot Central Supplies 52.05
270 ESOPHAGEAL TEMP PROBE Central Supplies 54.00
270 XP QUANTRO SENSER Central Supplies 281.00
270 SPINAL NEEDLE 7″ Central Supplies 94.00
270 ANTHESIA SUPPLIES Central Supplies 52.00
270 SEE 425… / ORAL AIRWAY Central Supplies 13.00
270 LMA Central Supplies 71.00
270 SYRINGE PUMP W/SUPPLIES Central Supplies 52.00
270 AnesthesiaTHESIA EQUIPMENT Central Supplies 336.00
270 PAIN NEEDLE Central Supplies 47.00
270 EXTRA SPINAL NEEDLE Central Supplies 47.00
270 BRACHIAL PLEXUS INSULATED NEEDLE Central Supplies 71.00
270 TEMPERATURE MONITOR Central Supplies 52.00
270 EXTRA EPIDURAL CATHETER Central Supplies 94.00
270 EXTRA ANTHESIA NEEDLES Central Supplies 12.00
270 LACI LUBE Central Supplies 12.00
270 GEN. AnesthesiaTHESIA SUPPLY Central Supplies 215.00
271 PESSARY DONUT (all sizes) NONRUBBER Central Supplies 218.40
272 C1751 PICC 4fr SINGLE LUMEN G03777 Central Supplies 550.00
270 C1751 PICC 4fr DOUBLE LUMEN Central Supplies 568.00
270 C1751 PICC 5fr DOUBLE LUMEN G03789 Central Supplies 621.00
258 J7030 IV NS 1000cc Central Supplies 45.00
258 J7030 IV NS 100mL BAG Central Supplies 45.00
258 J7040 IV NS 500cc Central Supplies 45.00
258 J7050 IV NS 250cc BAG Central Supplies 45.00
258 J7060 IV D5W 500cc Central Supplies 45.00
258 J7120 IV LR 1000cc Central Supplies 45.00
258 S5010 IV D5 0.45% NS 1000cc Central Supplies 45.00
258 IV D5W 250cc Central Supplies 60.00
270 4.5FR INTRODUCER KIT TEARAWAY Central Supplies 485.00
270 4fr TURBO-JECT POWER-INJECT PICC SINGLE Central Supplies 621.00
270 PICC 5.5fr INTRODUCER KIT PEEL AWAT Central Supplies 485.00
264 BIO-PATCH DISC 4mm Central Supplies 99.00
264 STATLOCK PICC STABLIZING DEVICE Central Supplies 68.00
270 WING GUARD PICC SECURMENT DEVICE Central Supplies 75.00
264 GRIPPER PLUS NEEDLE 19g 1″ Central Supplies 55.00
264 GRIPPER PLUS NEEDLE 20g 1″ Central Supplies 58.00
264 GRIPPER PLUS NEEDLE 22g 3/4″ Central Supplies 58.00
264 GRIPPER PLUS NEEDLE 22g 1 1/4″ Central Supplies 58.00
264 HUBER NEEDLE PORT ACCESS KIT Central Supplies 126.00
272 CENTRAL VENUS CATH MULTI LUMEN 7fr Central Supplies 549.00
264 IV TPN NUTRITIONAL/CHEMO TUBING Central Supplies 92.00
264 IV NITRO TUBING Central Supplies 58.00
264 IV BLOOD TUBING PUMP Central Supplies 86.00
264 IV THERMAL ANGEL BLOOD WARMER Central Supplies 584.00
264 IV PRIMARY PUMP TUBING Central Supplies 51.00
264 IV PRIMARY NON-PUMP TUBING Central Supplies 63.00
264 IV PCA TUBING Central Supplies 94.00
264 IV SECONDARY TUBING Central Supplies 25.00
264 IV EXTENSION 32″ Central Supplies 72.00
264 IV EPIDURAL TUBING SET-UP Central Supplies 67.00
264 FEEDING TUBE PUMP SET W/BAG Central Supplies 66.00
264 IV MICRO EXT SET 7″ Central Supplies 60.00
264 IV MACRO EXT SET 7″ Central Supplies 59.00
264 IV ULTRASITE EXT Central Supplies 60.00
264 IV BLOOD TUBING NON-PUMP 11409-48 Central Supplies 64.00
264 IV FILTERFLOW FILTERED EXT Central Supplies 51.00
264 IV MICRO TUBING 60gtt Central Supplies 76.00
264 IV BURETTE PUMP SET Central Supplies 89.00
264 MASS TRANSFUS BLOOD-FLUID SET Central Supplies 462.00
258 IV D5 .225% NS 1000mL Central Supplies 45.00
258 IV D5LR 1000cc Central Supplies 45.00
258 IV D5 0.45% NS w/20 meq KCL Central Supplies 45.00
258 IV D5NS 1000cc Central Supplies 45.00
258 IV 0.45% NS 1000mL Central Supplies 45.00
258 IV D10 500mL Central Supplies 45.00
258 IV LR 500cc Central Supplies 60.00
264 IV ULTRASITE VALVE / HEPLOCK Central Supplies 36.00
264 IV DUAL CAP Central Supplies 18.00
264 CENTRAL LINE DRSG CHANGE KIT Central Supplies 67.00
270 5 fr TURBO-JECT PICC 2 LUMEN G23916 Central Supplies 621.00
264 GRIPPER PLUS NEEDLE 20g 3/4″ w/Y SITE Central Supplies 58.00
258 IV D5 1/2 NS 500cc Central Supplies 36.00
258 IV NS 50cc BAG Central Supplies 32.00
258 IV NS 50cc ADD VANTAGE BAG Central Supplies 34.00
258 IV NS100cc ADD VANTAGE BAG Central Supplies 34.00
258 IV D5LR 500cc Central Supplies 60.00
264 IV SYR PUMP TUBING DISP STERILE 2C9219 Central Supplies 69.00
264 IV 0.22micron FILTER EXT SET 18″ Central Supplies 77.00
258 IV NS 250ml ADD-VANTAGE Central Supplies 53.00
272 IO NEEDLE 15mm 15g RT 3-39kg Central Supplies 444.00
272 IO NEEDLE 25mm 15g Central Supplies 466.00
272 IO NEEDLE all sizes Central Supplies 426.00
264 BLOOD / FLUID WARMER CARTRIDGE DISP Central Supplies 110.55
278 C1781 OR P151520 PERMACOL 15X20X1.5 Central Supplies 15,180.00
278 C1781 OR P101015 PERMACOL 10X15X1.0 MESH Central Supplies 7,856.00
278 ZIMMER 7850-12-20 FEMORAL STEM Central Supplies 5,242.00
278 STRYKER R5351-4510 HA FRACTURE STEM 10mm Central Supplies 5,591.00
278 ZIMMER 2843 ALLOCLASSIC SL SZ3 12/14 Central Supplies 6,123.00
278 ZIMMER 01.00121.080 ALLOCLAS SLO Central Supplies 6,123.00
278 ZIMMER 2845 ALLOCLASSIC SL SZ5 12/14 Central Supplies 6,123.00
278 ZIMMER 2841 ALLOCLASSIC SL SZ1 12/14 Central Supplies 6,123.00
278 OR 1010002 STRATTICE 10X10cm Central Supplies 4,602.00
278 SYNTHES 03.390.052S EXTERNAL FIXATOR Central Supplies 5,278.00
278 ZIMMER 00-5960-017-52 FEMORAL SZ G RT Central Supplies 6,864.00
278 OR ZIMMER 5764-014-52 LSP FEMORAL SZ D-R Central Supplies 15,580.00
278 ZIMMER 00-5960-016-51 LPS FEM SZF-LT Central Supplies 11,424.00
278 ZIMMER 5960-016-52 LPS FEMORAL SZ-F, RT Central Supplies 6,607.00
278 ZIMMER 01.00121.040 ALLOCLASSIC SL0 SZ 4 Central Supplies 7,115.00
278 ZIMMER 00-5960-015-51 PRCOT FEM SZ E LT Central Supplies 6,607.00
278 ZIMMER 42-5006-064-01 PSN LT FEMUR SZ 8 Central Supplies 3,901.00
278 OR DEPUY 110014100 ST STEM SZ 14 Central Supplies 5,239.00
278 OR BIOMET 51-103120 12X144 FEMORAL STEM Central Supplies 7,965.00
278 OR MICROPORT ETPKN4SR SZ 4 RT KEELED TIB Central Supplies 4,172.00
278 STRYKER ORTHO 5569-P-2012 HUMERAL STEM Central Supplies 8,654.00
278 SYRTKER ORTHO 5569-P-2013 HUMERAL STEM Central Supplies 5,353.00
278 STRYKER ORTHO 5569-P-2014 HUM STEM SZ 14 Central Supplies 5,353.00
278 STRYKER ORTHO 5569-P-2010 HUMERAL STEM Central Supplies 5,098.00
278 OR MICROPORT ETPKN6PR 6+ RT TIBIAL BASE Central Supplies 4,172.00
278 OR WRIGHT MED ETPK-N4SR RT TIB BASE SZ 4 Central Supplies 4,172.00
278 OR WRIGHT MED 3654-0056 LINAGE SHELL 56m Central Supplies 4,057.00
278 OR WRIGHT MED 3651-0052 LINAG SHELL 52mm Central Supplies 4,057.00
278 OR WRIGHT MED ETPK-N6SL SZ6 LT TIB BASE Central Supplies 4,381.00
278 OR WRIGHT MED DSBF-GF56 DYN SHELL 56m Central Supplies 4,381.00
278 OR EXACTECH 300-01-13 HUMAL STM 13mm Central Supplies 5,143.00
982 97802 NUTRITION THER 15 MIN/EA Diabetes 47.00
942 97803 NUTRITION THER RE-ASSES 15 MIN Diabetes 42.00
942 97804 NUTRITION THER GROUP Diabetes 82.00
942 G0108 DIABETIC CONSULT 30 MIN. Diabetes 108.00
450 10030 IMAGE GUIDED FLUID COLLECTION DRAINAGE Emergency Room 1,003.00
450 10060 I&D SIMPLE Emergency Room 399.00
450 10061 I&D ABCESS COM/MX Emergency Room 5,598.00
450 10080 I&D PILONIDAL CYST SIMPL Emergency Room 278.00
450 10081 INCIS DRAINAGE OF PIONIDAL CYST, COMPLCT Emergency Room 1,098.00
450 10120 INCS&REMOVFBSUBQ TISS/SM Emergency Room 433.00
450 10120 REMOVE FB SKIN Emergency Room 136.00
450 10121 INCS&REMOVFBSUB Q/COMPLI Emergency Room 420.00
450 10140 INC/DRAIN HEMA FLUID COL Emergency Room 457.00
450 10160 PUNCT ASPIR ABCESS/HEMA Emergency Room 433.00
450 10180 I&D COMPLEX POSTOP INFEC Emergency Room 886.00
450 11000 DEBR OF EXTENSIVE ECZEMATOUS/INFECT SKIN Emergency Room 248.00
450 11010 DEBRIDEMENT OPEN FX INCL REMOVAL FB Emergency Room 622.00
450 11012 DBRDMT FX&/DISLC SUBQ T/M/F BONE Emergency Room 2,298.00
450 11040 DEBRID; SKIN PART THICK Emergency Room 108.00
450 11041 DEBRID SKIN FULL THCK TE Emergency Room 237.00
450 11042 DEBRIDEMENT;SKIN SUBCU TISSUE Emergency Room 427.00
450 11044 DEBRID SUBQ TIS,MUS,BONE Emergency Room 859.00
450 11100 BIOPSY SIMPLE Emergency Room 219.00
450 11400 EXC, BENIGN LESION T/A/L EXC 0.5 CM < Emergency Room 488.00
450 11401 EXCIS DIAMETER 0.6 TO 1.0 Emergency Room 472.00
450 11403 REM EXC LES BENIGN, TR, ARMS, LG 2.1-3.1 Emergency Room 427.00
450 11719 TRIMMING OF NAIL Emergency Room 90.00
450 11720 DEBID OF NAIL; 1TO 5 TECHNICAL COMP Emergency Room 72.00
450 11730 AVULSIONPLATE PART/COMPL Emergency Room 571.00
450 11740 EVACUATION SUBUNGUAL HEM Emergency Room 550.00
450 11760 REPAIR NAIL BED Emergency Room 1,092.00
450 11765 WEDGE EXC SKIN NAIL FOLD Emergency Room 792.00
450 12001 SIMP SCALP/TRUNK2.5CMLES Emergency Room 322.00
450 12002 SIM REPAIR 2.6 TO 7.5 CM Emergency Room 368.00
450 12004 SIM REPAIR 7.6 TO 12.5 Emergency Room 512.00
450 12005 SIM REPAIR CM 12.6 TO 20 Emergency Room 607.00
450 12006 SIM REPAIR CM 20.1 TO 30 Emergency Room 437.00
450 12007 SIM REPAIR OVER 30. CM Emergency Room 741.00
450 12011 SIM REPAIR FACE/MUC 2.5 Emergency Room 340.00
450 12013 SIM REPAIR 2.6 TO 5.0 Emergency Room 408.00
450 12014 SIM REPAIR CM 5.1 TO 7.5 Emergency Room 689.00
450 12015 SIM REPAIR 7.6 TO 12.5 Emergency Room 843.00
450 12016 SIM REPAIR CM 12.6 TO 20 Emergency Room 1,224.00
450 12017 SIM REPAIR CM 20.1 TO 30 Emergency Room 1,615.00
450 12020 TX SUPERFICIAL WOUND DEHISCIENCE SMP CLO Emergency Room 716.00
450 12021 TX WND DEHISCENCE W/PACK Emergency Room 444.00
450 12031 INT REPAIR SCALP/TRUNK Emergency Room 1,344.00
450 12032 INT REPAIR 2.6 TO 7.5 TE Emergency Room 749.00
450 12034 INT REPAIR CM 7.6 TO 12. Emergency Room 811.00
450 12035 INT REPAIR CM 12.6 TO 20 Emergency Room 1,084.00
450 12036 INT REPAIR CM 20.1 TO 30 Emergency Room 1,101.00
450 12037 INT REPAIR OVER 30.0 CM Emergency Room 920.00
450 12041 INT REPAIR NECK HAND FT Emergency Room 546.00
450 12042 INT REPAIR CM 2.6 TO 7.5 Emergency Room 870.00
450 12044 INT REPAIR CM 7.6 TO 12 Emergency Room 489.00
450 12045 INT REPAIR CM 12.6 TO 20 Emergency Room 635.00
450 12046 INT REPAIR CM 20.1 30.0 Emergency Room 819.00
450 12047 INT REPAIR OVER 30.0 Emergency Room 968.00
450 12051 INT RPR FACE LIPS 2.5 LE Emergency Room 619.00
450 12052 INT REPAIR CM 2.6 TO 5.0 Emergency Room 745.00
450 12053 INT REPAIR CM 5.1 TO 7.5 Emergency Room 784.00
450 12054 INT REPAIR CM 7.6 TO 12 Emergency Room 800.00
450 12055 INT REPAIRCM 12.6 TO 20 Emergency Room 1,377.00
450 12056 INT REPAIR 20.1 TO 30.0 Emergency Room 1,304.00
450 12057 INT REPAIR OVER 30.0 Emergency Room 1,402.00
450 13100 COM REPAIR TRUNK 1.1 TO Emergency Room 343.00
450 13101 COM REPAIR 2.6 TO 7.5 Emergency Room 737.00
450 13102 EA ADD 5CM OR LESS TECH Emergency Room 365.00
450 13120 COM REPAIR SCALP/EX 1.1 Emergency Room 536.00
450 13121 COM RPR SCALP/EX 2.5 TO Emergency Room 995.00
450 13122 EA ADD 5CM OR LESS TECH Emergency Room 329.00
450 13131 COM REPAIR FH/AX/FT 1.1 Emergency Room 760.00
450 13132 COM RPR FRHD/AX/FT 2.6 Emergency Room 1,202.00
450 13133 EA ADD 5CM OR LESS TECH Emergency Room 625.00
450 13150 COM REPAIR LIDS/LIPS 1.0 Emergency Room 710.00
450 13151 COM REPAIR CM 1.1 TO 2.5 Emergency Room 914.00
450 13152 COM REPAIR CM 2.6 TO 7.5 Emergency Room 1,838.00
450 13153 RPR/CMPLX EYELD,NS,ERS,LPS EA ADD 5 CM< Emergency Room 896.00
450 16000 INIT TX 1ST DEGREE BURN Emergency Room 193.00
450 16020 DRSG/DEBRIDENT/SUBQW/OAN Emergency Room 144.00
450 16020 DRSG/DEBRID W/O Anesthesia SM Emergency Room 259.00
450 16025 DSG/DEBRIDINIT/SUBSQTWOA Emergency Room 414.00
450 16030 DRS & / DBRDMT PRTL-THKNS BURNS LARGE Emergency Room 607.00
450 17999 UNLIST PROC SKIN, MM, AND SUB-CU Emergency Room 370.00
450 19000 PUNCTURE ASP OF CYST OF BREAST Emergency Room 696.00
450 20103 WOUND EXPLORATION OF EXTREMITY Emergency Room 2,621.00
450 20520 REMOVAL OF FOREIGHN BODY IN MUSCLE;SIMP Emergency Room 656.00
450 20550 TRIGGER POINT INJECTIONS Emergency Room 227.00
450 20552 TRIGGER PT INJ SING/MULT Emergency Room 273.00
450 20552 INJ SIN/MULT TRIG PTS TE Emergency Room 273.00
450 20553 INJ; SINGLE OR MULT TRIGGER >2 POINTS Emergency Room 327.00
450 20600 ARTHROCEN/ASPIR SM JOINT Emergency Room 174.00
450 20605 ARTHROCENTESIS INTRMD JT Emergency Room 448.00
450 20610 ARTHROCEN/ASPIR LRG JNT Emergency Room 973.00
450 20611 ARTHROCENTESIS, ASP AND/OR INJ TECH Emergency Room 447.00
450 20950 MONITORING OF INTERSTITIAL FLUID PRESSUR Emergency Room 359.00
450 21310 CLO NASAL BONE W/O MANIP Emergency Room 435.00
450 21315 CLO TX OF NASAL FX W/O STABILIZATION Emergency Room 2,539.00
450 21320 CLO TX NASAL BONE FX WITH STABIL Emergency Room 1,974.00
450 21450 CLO TX MANDIBULAR WO MAN Emergency Room 392.00
450 21800 CLO TX RIB FX UNCOMP EA Emergency Room 368.00
450 22305 CLO TX VERTABRAL PROC FX Emergency Room 466.00
450 23500 CLO CLAV W/O MANIP Emergency Room 762.00
450 23505 CLO TX CLAV WITH MANIP Emergency Room 851.00
450 23540 CLO TX AC DISLOCATION WO MANIPULATION Emergency Room 870.00
450 23545 REDUCTION OF AC JOINT W/MANIP Emergency Room 1,010.00
450 23570 CLO TX SCAPULAR FX W/O M Emergency Room 597.00
450 23600 CLO TX PROX HUMERAL F WO Emergency Room 765.00
450 23605 CLO TX OF PROX HUMERAL FX; W MAN W/WO SK Emergency Room 1,958.00
450 23620 CLO TX GR HUM TUBER FX Emergency Room 539.00
450 23625 CLO FX GREATER HUMERAL TUBER/FX W/MANIP Emergency Room 1,440.00
450 23650 CLO TX SHLDR DISLO W/MAN Emergency Room 998.00
450 23655 CLO SHLDR DISLOC W/Anesthesia Emergency Room 1,759.00
450 23665 CLO TX SHOULDER DISL W/FX > HUMERA W/MAN Emergency Room 2,050.00
450 23675 CL TX SHOULDER DISLC.HUMERAL NCK FX Emergency Room 2,432.00
450 24200 RM FB UP ARM/ELBOW SQ Emergency Room 219.00
450 24500 CLO TX HUMERAL FX TECH Emergency Room 590.00
450 24505 CLO TX OF HUMERAL SHAFT FX W/MAN Emergency Room 1,845.00
450 24530 CLO TX SUPRACONDYLAR W/O Emergency Room 1,032.00
450 24535 CLO TX SUPRACONDYLAR/TRANS HUMRAL FX W/ Emergency Room 2,348.00
450 24576 CLO TX HUM/CONDYLAR FX T Emergency Room 612.00
450 24600 CLO ELBOW DISLOC W/O ANE Emergency Room 605.00
450 24605 TX CLO ELBOW DISLOC W/AN Emergency Room 1,759.00
450 24620 CLO TX FX ELBOW W/MANIP Emergency Room 1,308.00
450 24640 CLO TX RAD HEAD SUBLUXA Emergency Room 275.00
450 24650 CLO TX RADIAL HEAD/NECK Emergency Room 693.00
450 24655 CLO TX RAD HEAD FX/W/MAN Emergency Room 828.00
450 24670 CLO TX ULNAR PROX FX WO Emergency Room 656.00
450 25500 CLO TX RAD SHAFT FX W/OM Emergency Room 533.00
450 25505 CLO TX RAD SHAFT FX W/MA Emergency Room 899.00
450 25560 CLO TX RADIAL FX W/O MAN Emergency Room 703.00
450 25565 CLO TX RAD&ULNA SHAFT FX Emergency Room 1,332.00
450 25600 CLO DIST RAD W/O MANIP Emergency Room 789.00
450 25605 CLO DIST RAD W/MANIP Emergency Room 1,207.00
450 25622 CLO CardiopulmonaryAL SCOPHOID W/O Emergency Room 843.00
450 25630 CLO TX CardiopulmonaryAL BONE FX Emergency Room 523.00
450 25635 CLO TX CardiopulmonaryAL FX W/MANIPULATION Emergency Room 1,382.00
450 25650 CLO TX ULNAR SYLOID FX Emergency Room 999.00
450 25660 CLO TX OF RADIOCardiopulmonaryAL W/MANIPULATION Emergency Room 1,274.00
450 25675 CLO TX DIST RADIOULNARFX Emergency Room 923.00
450 25690 TREATMENT OF WRIST DISLOCATION Emergency Room 1,888.00
450 26010 DRAINAGE FINGER ABCESS Emergency Room 504.00
450 26418 REPLACE EXT TENDON FINGER W/O GRAFT Emergency Room 2,509.00
450 26600 CLO METACardiopulmonary W/O MANIP Emergency Room 823.00
450 26605 CLO METACardiopulmonary W/ MANIP Emergency Room 1,229.00
450 26607 FX METACardiopulmonaryAL W MAN. Emergency Room 1,102.00
450 26615 OPEN TX METACardiopulmonaryAL FX Emergency Room 3,140.00
450 26641 CLO TX THUMB DISLOC TECH Emergency Room 1,151.00
450 26645 CLO TX BENNET FX W/M TEC Emergency Room 740.00
450 26670 CLO TX CardiopulmonaryOMETACardiopulmonaryAL DISLOCATION Emergency Room 942.00
450 26675 CLO TX CardiopulmonaryOMETA FX W/MA Emergency Room 609.00
450 26700 CLO TX MCP DIS W/MAN W/O Emergency Room 501.00
450 26705 CLO TX METACardiopulmonaryOPHALANGEAL DISC RQ Anesthesia Emergency Room 1,286.00
450 26715 OPEN TX MTCRPHLNG DISLOC Emergency Room 2,063.00
450 26715 DISLOCATION METACAR.OPEN Emergency Room 886.00
450 26720 CLO TX PHALANG FX WO MAN Emergency Room 564.00
450 26725 CLO TX PHALANGEAL FX W/W Emergency Room 648.00
450 26740 CLO TX ARTICU FX W/O M T Emergency Room 576.00
450 26742 CLO TX OF ARTCLR FX I.E. MCPOR IPJ W/MAN Emergency Room 1,200.00
450 26750 CLO TX DIST PHALANGEALFX Emergency Room 326.00
450 26755 CLO TX DIST PHAL FX W/MA Emergency Room 601.00
450 26765 OPEN TX DIST PHALANG FX Emergency Room 1,036.00
450 26770 CLO TX IP JT DISLOC W/M Emergency Room 527.00
450 26775 CLO TX INTRPHNGL DISL WA Emergency Room 392.00
450 26785 OP TX INTERPHALANGEAL JT Emergency Room 1,008.00
450 26951 AMP F/TH 1/2 JT/P Emergency Room 2,322.00
450 27222 CLO TX ACETABULAR FX W/MANIP TECH COMP Emergency Room 2,607.00
450 27230 CLO TX FEMORAL FX W/O MA Emergency Room 989.00
450 27246 CLO TX GRT TROCHANTER FX Emergency Room 672.00
450 27252 CLO TX HIP DISLCO W/A TE Emergency Room 1,737.00
450 27265 CLO TX POST HIP ARTHROPLTY DSLO W/O Anesthesia Emergency Room 1,957.00
450 27266 CLO TX POST HIP ARTHR TE Emergency Room 1,737.00
450 27372 REM FB DEEP THIGH/KNEE Emergency Room 1,171.00
450 27501 CLO TX SUPRACOND FX TECH Emergency Room 1,585.00
450 27502 CLX TREATMENT OF FEML SHFT FX, W/MANIP Emergency Room 3,772.00
450 27516 CLO TX DIST FEM EPIPH SE Emergency Room 1,107.00
450 27517 CLX REDUCTION OF DISTAL FEMUR DISC Emergency Room 2,546.00
450 27520 CLO TX PATELLAR FX W/O M Emergency Room 822.00
450 27530 CLO TX TIBIAL PROX W/O M Emergency Room 850.00
450 27530 CLO TX TIB FX PROX W/O M Emergency Room 850.00
450 27532 CLO TX TIBIAL FX W/MAN T Emergency Room 1,777.00
450 27538 CLO TX INTERCONDYLAR W/O Emergency Room 879.00
450 27552 CLO TX KNEE DISLO W Anesthesia Emergency Room 1,389.00
450 27560 CLO TX PATEL DISLOC TECH Emergency Room 678.00
450 27562 CLO TX PATELLAR DISLOCATE WITH AnesthesiaTH Emergency Room 1,756.00
450 27570 MANIP KNEE JOINT/GEN ANE Emergency Room 942.00
450 27750 CLO TX TIB FX W/WO FIBFX Emergency Room 809.00
450 27752 CLO TX TIB SHAFT FX W/MA Emergency Room 1,326.00
450 27760 CLO TX MEDMALL FX WO MAN Emergency Room 793.00
450 27762 CLO TX MED MALLEOLUS FX W/MANIPULATION Emergency Room 1,860.00
450 27768 CLOSED TX OF POSTERIOR MALLEOLUS FX/WM Emergency Room 1,718.00
450 27780 CLO TX PRX FIB W/O MANIP Emergency Room 651.00
450 27781 CLO TX PROX FIB FX W/MANIPULATION Emergency Room 1,718.00
450 27786 CLO TX DISTAFIB FX WO Emergency Room 1,060.00
450 27788 CLO TX LAT MALLEOLUS W/M Emergency Room 832.00
450 27808 CLO TX BIMALLEOLAR ANKLE Emergency Room 666.00
450 27810 CLO TX BIMAL ANKLE W/M Emergency Room 1,652.00
450 27816 CLO TX TRIMALL FX W/O MA Emergency Room 737.00
450 27818 CLO TX TRIMALLEOLAR W/MA Emergency Room 1,503.00
450 27824 CLO TX DISTAL TIB WO MAN Emergency Room 970.00
450 27840 CLO TX ANK DISLOC WO ANE Emergency Room 490.00
450 27842 CLO TX ANK DISLOC W/Anesthesia Emergency Room 1,077.00
450 28190 ER FOREIGN BODY REMOVAL, FOOT, SUBQ. Emergency Room 1,536.00
450 28192 REMOVAL OF FOREIGN BODY FOOT; DEEP Emergency Room 1,181.00
450 28400 CLO TX CALCANEAL FX TEC Emergency Room 754.00
450 28405 CLO TX CALCANEAL FRACTURE Emergency Room 1,451.00
450 28430 CLO TX TALUS FX W/O MANI Emergency Room 766.00
450 28435 CLOSED TX TALUS FX, W/MANIPULATION Emergency Room 1,195.00
450 28450 TX TARSAL FX W/O MANIP E Emergency Room 560.00
450 28455 TX OF TARSAL BONE FX WITH MANIPULATION Emergency Room 1,116.00
450 28470 CLO METATARSW/O MAINP EA Emergency Room 569.00
450 28475 CLOSED TX-METATARSAL FX W/MANIP TC Emergency Room 909.00
450 28490 CLO GRT TOE PHALANX W/O Emergency Room 324.00
450 28495 CLTX FX GRT TOE PHLX/PHLG W/MNPJ Emergency Room 1,027.00
450 28510 CLO TX PHALX/PHALNG WO Emergency Room 214.00
450 28515 CLO TX FX PHALANX W/MANI Emergency Room 305.00
450 28545 CLO TX TARSAL DISLO W/AN Emergency Room 543.00
450 28570 CLOSED TX TALOTARSAL JOINT, W/O Anesthesia Emergency Room 565.00
450 28575 CLO TX TALOTARSAL DISLOC Emergency Room 656.00
450 28600 CLOSED TX TARSOMETATARSAL DIS WO AnesthesiaT Emergency Room 624.00
450 28605 CLX TX TARSOMETATARSAL DIS W/Anesthesia Emergency Room 707.00
450 28630 CLO TX MTP JOINT DISLOC; W/O Anesthesia Emergency Room 535.00
450 28635 CLOSED TX MTP JOINT DISLOC;W/AnesthesiaTHESIA Emergency Room 562.00
450 28660 CLO TX INTRPHNGL DISL WO Emergency Room 258.00
450 28660 CLO TX INTRPHNGL DILSOC W/MANIP-W/O Anesthesia Emergency Room 258.00
450 28675 O TX INTERPHAL JNT DISLO Emergency Room 893.00
450 29065 APPLICATION CAST-LONG ARM Emergency Room 423.00
450 29075 APPLICATION CAST; SHORT ARM TC Emergency Room 313.00
450 29105 SPLINT LONG ARM Emergency Room 280.00
450 29125 SPLINT SHORT ARM Emergency Room 270.00
450 29126 SPLINT SHORT ARM;DYNAMIC Emergency Room 224.00
450 29130 SPLINT FINGER; STATIC Emergency Room 126.00
450 29131 SPLINT FINGER; DYNAMIC Emergency Room 147.00
450 29200 STRAPPING THORAX Emergency Room 90.00
450 29220 STRAPPING LOW BACK Emergency Room 126.00
450 29240 STRAPPING SHOULDER Emergency Room 126.00
450 29260 STRAPPING ELBOW OR WRIST Emergency Room 76.00
450 29280 STRAPPING HAND OR FINGER Emergency Room 70.00
450 29325 APPLICATION OF HIP SPICA;BOTH LEGS Emergency Room 1,027.00
450 29345 APPLICATION OF LONG LEG CAST Emergency Room 437.00
450 29405 SHORT LEG FIBERGLASS CAST APPLICATION Emergency Room 3,318.00
450 29505 SPLINT LONG LEG Emergency Room 258.00
450 29515 APPLICATION SPLINT SHORT LEG Emergency Room 279.00
450 29520 STRAPPING HIP Emergency Room 126.00
450 29530 STRAPPING KNEE Emergency Room 97.00
450 29540 STRAPPING ANKL &/OR FOOT Emergency Room 90.00
450 29550 STRAPPING TOES Emergency Room 55.00
450 29580 STRAPPING UNNA BOOT Emergency Room 119.00
450 29590 STRAPPING DENIS-BROWN Emergency Room 126.00
450 29700 REMVL/BIVLVNG; GAUNTLET, BOOT/BODY CAST Emergency Room 120.00
450 29705 REMOVAL/ BIVALVING: FULL ARM OR LEG CAST Emergency Room 168.00
450 30300 REMOVE FB INTRANASAL Emergency Room 142.00
450 30310 REMOVE FB INTRANASAL W/A Emergency Room 707.00
450 30901 CONTRIL NASAL HEMOR/ANT Emergency Room 372.00
450 30903 CONTROL NASAL HEMORRHAGE EXTENSIVE Emergency Room 458.00
450 30905 CNTRL NASAL HEMOR POSTER Emergency Room 555.00
450 30906 CNTRL NASAL HEMRRHG, POSTERIOR; SUBSIQNT Emergency Room 775.00
450 31231 NASL ENDOSCOPY,DAIGNOSTIC,UNI/BIL SEP PR Emergency Room 412.00
450 31238 NASAL/SINUS ENDO, SUR W CONT NASAL HEMOR Emergency Room 1,430.00
450 31500 INTUBATION ENDOTRACHAEL Emergency Room 1,092.00
450 31505 LARYNGOSCOPY,INDIRECT,DIAG(SEP PROC) Emergency Room 314.00
450 31505 LARYNGOSCOPY INDIRECT DX Emergency Room 279.00
450 31525 LARYNGOSCOPY DIRECT, DIAGNOSTIC Emergency Room 879.00
450 31530 LARYNGOSCOPY DIREC W/ FB Emergency Room 1,040.00
450 31575 LARYNGOSCOPY, FLEXIBLE FIBEMPTIC;DIAG Emergency Room 422.00
450 31605 TRACHEOSTOMY, EMERG, CRICOTHYROIDOTOMY Emergency Room 1,620.00
450 32000 THORACENTESIS ASPIR I/S Emergency Room 333.00
450 32002 THORACENTESIS W/TUBE INS Emergency Room 545.00
450 32551 TUBE THORACOSTOMY TECH Emergency Room 1,340.00
450 32554 THORACENTESIS WITH INSERTION OF TUBE Emergency Room 863.00
450 32555 ER/THOR WITH IMAG Emergency Room 1,557.00
450 33010 PERICardiopulmonaryIOCENTESIS; INITIAL Emergency Room 1,039.00
450 33210 INS OR REPLACE OF TEMP TRANSVENOUS ELECT Emergency Room 1,761.00
450 36000 HEPLOCK / ULTRASITE VALVE Emergency Room 132.00
391 36430 BLOOD TRANSFUSION Emergency Room 1,239.00
450 36510 CATHETERIZATION OF UMBILICAL VEIN NB Emergency Room 385.00
450 36556 CENTRAL VENOUS CATH >2 Emergency Room 1,882.00
450 36592 COLL BLOOD CENTRAL OR PERPH CATH VEN NOS Emergency Room 49.00
450 36625 ARTERIAL CATH; CUTDOWN Emergency Room 288.00
450 36680 PLACEMENT OF NEEDLE FOR INTRAOSS INFUS Emergency Room 975.00
450 37195 THROMBOLYSIS, CEREBRAL, BY INTRAV INF Emergency Room 1,689.00
450 38221 BX-BONE MARROW, BIOPSY NEEDLE OR TROCAR Emergency Room 663.00
450 40650 RPR LIP FULL THKNS VERMILION Emergency Room 1,417.00
450 40654 RPR LIP FL THKNS +1/2 VRTCL HGHT Emergency Room 2,660.00
450 40800 DRAIN ABCESS VESTIBULE M Emergency Room 185.00
450 40804 REMOVE FB;MOUTH SIMPLE Emergency Room 322.00
450 40830 CLOSURE OF LAC;VESTIBULE MTH 2.5 CM OR < Emergency Room 458.00
450 40831 CLOSURE OF LAC;VESTIBULE OF MOUTH 2.5CM+ Emergency Room 1,136.00
450 41252 REPAIR OF LAC OVER 2.6CM OF TONGUE Emergency Room 1,516.00
450 41800 I&D OF ABSCESS FROM DENTOALVEOLAR STUC Emergency Room 553.00
450 42700 DRAINAGE OF TONSIL ABCESS Emergency Room 1,248.00
450 42809 REMOVAL FB PHARYNX TECH Emergency Room 328.00
450 43215 ESOPHAGOSCOPY W/REM FB T Emergency Room 1,455.00
450 43752 NASO OR ORO GASTRIC TUBE PLCMT FLUORO Emergency Room 446.00
450 43753 GASTRIC INTUBATION & ASPIRATION INC LVG Emergency Room 239.00
450 43760 CHANGE GASTROSTOMY TUBE Emergency Room 315.00
450 45915 REM FEC/FB IMPC W/Anesthesia Emergency Room 523.00
450 46040 I & D OF ISCHIO/PERIRECTAL ABSCESS Emergency Room 1,362.00
450 46083 INCS THROMBOSED HEMORROI Emergency Room 202.00
450 46320 EXCIS OF THROMBOSED HEMORRHOID;EXTRNL Emergency Room 754.00
450 46600 ANOSCOPY; DX W OR WO COLLECT OF SPECIMEN Emergency Room 151.00
450 49080 PARACENTESIS ABD INI TEC Emergency Room 305.00
450 49081 PARACENT ABD SUBSQ TECH Emergency Room 227.00
450 49082 ABDOMINAL PARACENTESIS W/O IMG GDNC Emergency Room 710.00
450 51010 ASP BLADDER W/INSRT CATH Emergency Room 404.00
450 51610 INJ PROC FOR RTRGR URETHROCYSTOGRAPHY Emergency Room 851.00
450 51700 BLADDER IRR SIMP LAVAGET Emergency Room 336.00
450 51701 INSERTION OF NON INDWELLING BLADDER CATH Emergency Room 369.00
450 51702 INSERTION OF FOLEY CATHETER Emergency Room 445.00
450 51703 CATHETERIZATION COMPLICA Emergency Room 2,645.00
450 54150 CIRCUMCISION CLAMP NB Emergency Room 460.00
450 54450 FORESKIN MANJ W/ LSIS PREP ADS&STRETCH Emergency Room 342.00
450 55100 DRAINAGE OF SCROTAL WALL ABSCESS Emergency Room 2,935.00
450 56405 INCISION & DRAINAGE OF VULVA OR PERINEAL Emergency Room 663.00
450 56420 II & D OF BARTHOLIN’S GLAND ABSCESS Emergency Room 546.00
450 58301 REMOVAL OF INTRAVTERINE DEVICE (IUD) Emergency Room 398.00
450 59812 TX OF INCOMPLETE ABORTION,ANY TRIMESTER Emergency Room 1,461.00
450 62270 SPINAL PUNC LUMBAR DX TE Emergency Room 669.00
450 62273 INJ EPID BLOOD/CLOT PATC Emergency Room 1,249.00
450 64400 INJ, AnesthesiaT AGENT; TRIGEMINAL NERVE Emergency Room 790.00
450 64405 INJ, Anesthesia AGENT; > OCCIPITAL NERVE Emergency Room 725.00
450 64450 INJ Anesthesia AGENT OT PERIPHERAL NRV OR BRNC Emergency Room 535.00
450 65205 REMOVE FB EXTR CONJC SUP Emergency Room 427.00
450 65210 REMOV FB EXTERN EYE CONJ Emergency Room 147.00
450 65220 REMOVE FB EYE Q/O LAMP Emergency Room 399.00
450 65222 REMOVE FB EYE W/LAMP Emergency Room 326.00
450 68420 INC/DRAIN LACRIMAL SAC Emergency Room 449.00
450 69000 DRAINAGE EXTERNAL EAR, ABSCESS. SIMPLE Emergency Room 483.00
450 69200 REM FB EXT AUD CANAL TEC Emergency Room 275.00
450 69200 FB REMOVAL EXT AUD EAR T Emergency Room 275.00
450 69205 REMOVE FB; AUDITORY CANAL W/AnesthesiaTHESIA Emergency Room 1,309.00
450 69209 REM IMPACTED CERUMEN, IRR/LAVAGE Emergency Room 69.00
450 69210 REMOVE IMPACTED CERUMEN Emergency Room 237.00
450 69210 REMOVAL IMPACTED CERUMEN Emergency Room 237.00
450 69300 OTOPLASTY, PROTRUDING EAR, W OR W/O SZ R Emergency Room 3,203.00
310 82948 CHEM BG Emergency Room 37.00
300 82948 CHEM BG Emergency Room 37.00
771 90471 IMMUNIZATION ADMN. IM SUB CU, ONE INJ Emergency Room 103.00
771 90472 EA ADDITIONAL VACCINE ADMINISTERED Emergency Room 33.00
450 91105 GASTRIC INTUBAT&ASPIR/LA Emergency Room 445.00
450 92504 BINOCULAR MICROSCOPY(SEP DIAG PROC) Emergency Room 66.00
450 92511 NASOPHARYNGOSCOPY, W ENDOSCOPE(SEP PROC) Emergency Room 263.00
450 92950 ARREST C/DEFIB Emergency Room 1,310.00
450 92950 CPR Emergency Room 1,310.00
450 92953 TEMPORARY TRANSCUTANEOUS PACING Emergency Room 286.00
450 92960 CardiopulmonaryIOVER/ELEC/ELECTIVE Emergency Room 1,938.00
450 92977 THROMB; DISSOLVE CLOT HEART VESSEL Emergency Room 1,285.00
460 94760 OXIMETRY Emergency Room 107.00
450 96360 INITIAL HOUR HYDRATION Emergency Room 302.00
450 96361 HYDRATION; EA ADD HOUR (AFTER 1ST HOUR) Emergency Room 137.00
450 96365 THERAPEUTIC INITIAL HOUR IV MED Emergency Room 328.00
450 96366 THERAPUETIC IV MED ADD HOUR (AFTER INIT) Emergency Room 164.00
450 96367 THERAPEUTIC IV INFUS; ADD MED-SEQUENTIAL Emergency Room 185.00
450 96368 THERAPEUTIC IV INFUS; SEP SITE-CONCURREN Emergency Room 135.00
450 96372 THERAPEUTIC INJ; IM OR SUBQ EACH Emergency Room 100.00
450 96373 THERAPEUTIC INJ; INTRA-ARTERIAL EACH Emergency Room 69.00
450 96374 THERAPEUTIC IV PUSH; INITIAL DRUG Emergency Room 207.00
450 96375 THERAPEUTIC IV PUSH; EACH ADDITIONAL Emergency Room 135.00
450 96376 EA ADD SEQUEN INTRAVENOUS PUSH Emergency Room 69.00
450 96523 IRRIGATION OF IMPLANTED VENOUS ACCESSS Emergency Room 128.00
450 97597 REMOVAL OF DEVITALIZED TISSUE LESS 20 CM Emergency Room 207.00
450 99024 FOLLOW UP IN GLOBAL PERIOD/ER Emergency Room     –
450 99141 CONCIOUS SEDATION Emergency Room 242.00
450 99143 MOD SEDATION; YOUNGER THAN 5 YRS Emergency Room 214.00
370 99144 MODERATE SEDATION 5 YEARS OR OLDER Emergency Room 407.00
370 99145 MODERATE SEDATION OVER 5;   ADD 15 MIN Emergency Room 82.00
370 99148 MOD SED; YOUNGER THAN 5 YRS Emergency Room 345.00
450 99149 MODERATE SEDATION BY MD NOT DOING PROCED Emergency Room 150.00
370 99150 MOD SEDATE EA ADDITIONAL 15 MIN. Emergency Room 70.00
450 99156 MOD SED OT PHYS/QHP INI 15 MINS 5/> YRS Emergency Room 303.00
450 99157 MOD SED OT PHYS/QHP EA ADD 15 MINS Emergency Room 223.00
450 99175 IPECAC OR SIMILAR ADMIN W/OBSERVATION Emergency Room 112.00
760 99201 FACILITY CHARGE Emergency Room 71.00
450 99218 ER OBSERVATION STRAIGHTFORWARD Emergency Room 246.00
450 99219 ER OBS MODERATE Emergency Room 423.00
450 99220 ER OBSERVATION HIGH COMPLEX Emergency Room 396.00
450 99234 ER OBSERVATION STRAIGHTFORWARD SAMEDAY Emergency Room 269.00
450 99235 ER OBS MODERATE SAME DAY Emergency Room 384.00
450 99236 ER OBS HIGH COMPLEX SAME DAY Emergency Room 458.00
450 99281 ER SERVICE LEVEL 1 Emergency Room 270.00
450 99281 OP NURSING SIMPLE Emergency Room 270.00
450 99282 ER SERVICE LEVEL 2 Emergency Room 406.00
450 99282 OP NURSING MODERATE Emergency Room 173.00
450 99282 OP NURSING COMPLEX Emergency Room 312.00
450 99283 ER SERVICE LEVEL 3 Emergency Room 735.00
450 99284 ER SERVICE LEVEL 4 Emergency Room 1,208.00
450 99285 ER SERVICE LEVEL 5 Emergency Room 2,086.00
450 99291 ER SERVICE CRITICAL CARE 1ST 30-74 Emergency Room 4,011.00
450 99292 ER SERVICE CRITICAL CARE EACH ADD 30 MIN Emergency Room 1,444.00
450 99998 INJECTIONS: SQ, IM, IV Emergency Room 11.00
450 P9612 CATHETERIZATION FOR SPECIMEN COLLECTION Emergency Room 369.00
370 Anesthesia PER MINUTE ER Emergency Room 15.00
270 NO CHARGE Emergency Room     –
450 ER / OR ROOM Emergency Room 173.00
450 CASTING PROCEDURE Emergency Room 267.00
450 SPLINTING PROCEDURE Emergency Room 168.00
450 STRAPPING PROCEDURE Emergency Room 168.00
450 CASTING ADJUSTMENT PROC Emergency Room 105.00
239 INC NURSE CHG 15 MIN UNT Emergency Room 40.00
450 CONSCIOUS SEDATION ER TE Emergency Room 189.00
450 VAGINAL EXAM Emergency Room 230.00
250 ANCEF 500MG IV/IM Emergency Room 42.00
450 FINE NEEDLE ASPIRATION Emergency Room 249.00
450 ECHO/NO CHARGE Emergency Room 3.00
450 EMERGENCY ROOM Emergency Room 4.00
981 10021 FINE NEEDLE ASPIRATION PRO FEE Emergency Room Professional Fee 181.00
981 10030 IMAGE GUIDED FLUID CLLCTN DRNGE PROFEE Emergency Room Professional Fee 743.00
981 10060 I & D SIMPLE Emergency Room Professional Fee 214.00
981 10061 I & D ABCESS COM/MX PROFEE Emergency Room Professional Fee 502.00
981 10080 I&D PILONIDAL CYST SIMPL Emergency Room Professional Fee 201.00
981 10081 INCIS DRAIN OF PILONIDAL CYST, PROFEE Emergency Room Professional Fee 883.03
981 10120 INCS & RMVE FB SUBQ TISS Emergency Room Professional Fee 302.00
981 10121 INCS & REMOVE FB SUB Q Emergency Room Professional Fee 439.00
981 10140 INC/DRAIN HEMA FLUID COL Emergency Room Professional Fee 251.00
981 10160 PUNC ASPIR ABSCS/HEMA/CY Emergency Room Professional Fee 121.00
981 10180 I&D COMPLEX POSTOP INFEC Emergency Room Professional Fee 703.00
981 11000 DEBR OF EXTENSIVE ECZEMATOUS/INFECT SKIN Emergency Room Professional Fee 120.00
981 11010 DEBRIEDEMENT OPEN FX INCL REMOVE FB PF Emergency Room Professional Fee 410.00
981 11012 DBRDMT FX&/DISLC SUBQ T/M/F BONE PROFEE Emergency Room Professional Fee 1,818.00
981 11040 DEBRID SKIN PART THICK Emergency Room Professional Fee 121.00
981 11041 DEBRID SKIN FULL THICK Emergency Room Professional Fee 239.00
981 11042 DEBRIDEMENT;SKIN SUBCU TISSUE PROFEE Emergency Room Professional Fee 206.00
981 11044 DEBRID SUBQ TIS,MUS,BONE Emergency Room Professional Fee 576.00
981 11100 BIOPSY OF SKIN, SUBCU/MM SING LESION Emergency Room Professional Fee 148.00
981 11400 EXC BNGN LES T/A/L EXC 0.5 CM OR<PROFEE Emergency Room Professional Fee 195.00
981 11401 EXCIS DIAMETER 0.6 TO 1.0 Emergency Room Professional Fee 246.00
981 11403 REM EXC LES BEN, TR, ARMS, LG 2.1-3.0 PF Emergency Room Professional Fee 375.00
981 11719 TRIMMING OF NAIL Emergency Room Professional Fee 46.00
981 11720 DEBRID OF NAIL BY ANY METHOD; 1TO 5 PROF Emergency Room Professional Fee 54.00
981 11730 AVULSION PLATE PART/COMP Emergency Room Professional Fee 135.00
981 11740 EVACUATION SUBUNGUAL HEM Emergency Room Professional Fee 108.00
981 11760 REPAIR NAIL BED Emergency Room Professional Fee 574.00
981 11765 WEDGE EXC SKIN NAIL FOLD Emergency Room Professional Fee 317.00
981 12001 SIMPLE LAC REPAIR PROFEE Emergency Room Professional Fee 221.00
981 12002 SIMPLE RPR 2.6-7.5 PROFE Emergency Room Professional Fee 269.00
981 12004 SIMPLE RPR 7.6-12.5 PROF Emergency Room Professional Fee 299.00
981 12005 SIMPLE LAC 12.6-20.0 PF Emergency Room Professional Fee 363.00
981 12006 SIM REPAIR 20.1 TO 30.0 Emergency Room Professional Fee 510.00
981 12007 SIM REPAIR,TRU,SCA,NEC,EXTR>30.0   PROFEE Emergency Room Professional Fee 458.00
981 12011 SIMP FACE/EAR/EYE2.5LESS Emergency Room Professional Fee 269.00
981 12013 SIM REPAIR 2.6 TO 5.0 PF Emergency Room Professional Fee 279.02
981 12014 SIM REPAIR 5.1 TO 7.5 PF Emergency Room Professional Fee 530.00
981 12015 SIM REPAIR 7.6 TO 12.5 P Emergency Room Professional Fee 650.00
981 12016 SIMPLE REPAIR FACE 12.6 TO 20.0 PF Emergency Room Professional Fee 943.00
981 12017 SIM REPAIR 20.1 TO 30CM Emergency Room Professional Fee 1,179.00
981 12020 TX SUPERFICIAL WOUND DEISCENC SMP CLS PF Emergency Room Professional Fee 579.00
981 12021 TX WND DEHISCENCE; W/PAC Emergency Room Professional Fee 449.00
981 12031 INT RPR SCALP/TRUNK 2.5 Emergency Room Professional Fee 269.00
981 12032 INT REPAIR 2.6 TO 7.5 Emergency Room Professional Fee 324.00
981 12034 INT REPAIR 7.6 TO 12.5 Emergency Room Professional Fee 425.00
981 12035 INT REPAIR 12.6 TO 20.0 Emergency Room Professional Fee 460.00
981 12036 INT REPAIR CM 20.1 TO 30 Emergency Room Professional Fee 757.00
981 12041 INT REPAIR NECK HAND 2.5 Emergency Room Professional Fee 302.08
981 12042 INT REPAIR 2.6 TO 7.5 Emergency Room Professional Fee 377.00
981 12044 INT REPAIR 7.6 TO 12.5 Emergency Room Professional Fee 489.06
981 12045 INT REPAIR 12.6 TO 20.0 PROFEE Emergency Room Professional Fee 587.00
981 12051 INT RPR FACE LIPS 2.5 Emergency Room Professional Fee 377.00
981 12052 INT REPAIR 2.6 TO 5.0 Emergency Room Professional Fee 471.00
981 12053 INT REPAIR 5.1 TO 7.5 Emergency Room Professional Fee 620.00
981 12054 INT REPAIR CM 7.6-12 PROFEE Emergency Room Professional Fee 1,064.00
981 12055 INTERMED REPAIR; FACE, 12.6-20 CM PRO FE Emergency Room Professional Fee 1,115.02
981 13100 COM REPAIR TRUNK 1.5-2.5 Emergency Room Professional Fee 340.00
981 13101 COM REPAIR TRUNK 2.6 TO 7.5 Emergency Room Professional Fee 569.00
981 13102 EA ADD 5CM OR LESS PHYSI TRUNK Emergency Room Professional Fee 260.00
981 13120 COM RPR SCALP/EX 1.1-2.5 Emergency Room Professional Fee 536.09
981 13121 COM REPAIR 2.5 TO 7.5 Emergency Room Professional Fee 832.00
981 13122 EA ADD 5CM OR LESS PHYS Emergency Room Professional Fee 334.00
981 13131 COM RPR FH/AX/FT 1.1-2.5 Emergency Room Professional Fee 626.00
981 13132 COM REPAIR FACE, NECK, HANDS 2.6 TO 7.5 Emergency Room Professional Fee 1,213.00
981 13133 EA ADD 5CM OR LESS PHYSI FACE, NECK,HAND Emergency Room Professional Fee 485.00
981 13150 COM REPAIR LIDS/LIPS 1.0 Emergency Room Professional Fee 555.00
981 13151 COM REPAIR 1.1 TO 2.5 Emergency Room Professional Fee 788.00
981 13152 COM REPAIR EYELID,NOSE,LIPS 2.6 TO 7.5 Emergency Room Professional Fee 1,534.06
981 13153 RPR/CMPLX EYELD,NS,ERS,LIP EA ADD 5 CM< Emergency Room Professional Fee 680.00
981 16000 INIT TX 1ST DEGREE BURN Emergency Room Professional Fee 95.10
981 16020 DRSG/DEBRID W/O Anesthesia SM Emergency Room Professional Fee 110.00
981 16025 DSG/DEBRIDINIT/SUBSQTWOA PROFEE Emergency Room Professional Fee 283.00
981 16030 DRS &/DBRDMET PRTL THICKNESS PROFEE Emergency Room Professional Fee 417.00
981 17999 UNLISTED PROC SKIN, MM, AND SUBCU Emergency Room Professional Fee 221.00
981 19000 PUNCTURE ASP OF CYST OF BREAST PROFEE Emergency Room Professional Fee 220.00
981 20103 WOUND EXPLORATION OF EXTREMITY PRO FEE Emergency Room Professional Fee 1,360.00
981 20520 REMOVAL OF FOREIGN BODY MSCL SIMP PROFEE Emergency Room Professional Fee 336.00
981 20550 TRIGGER POINT INJECTIONS Emergency Room Professional Fee 186.01
981 20552 TRIGGER PT INJ SING/MULT Emergency Room Professional Fee 197.00
981 20552 INJ SIN/MULT TRIG PTS PR Emergency Room Professional Fee 197.00
981 20553 INJ; SINGLE OR MULTIPLE TRIGGER POINT PF Emergency Room Professional Fee 216.00
981 20600 ARTHROCEN/ASPIR SM JOINT Emergency Room Professional Fee 174.00
981 20605 ARTHROCENTESIS INTRMD JT Emergency Room Professional Fee 186.01
981 20610 ARTHTOCENTESIS/ASPIR/INJ Emergency Room Professional Fee 206.00
981 20610 ARTHROCEN/ASPIR LRG JNT Emergency Room Professional Fee 206.00
981 20611 ARTHROCENTESIS, ASP AND/OR INJ PROFEE Emergency Room Professional Fee 395.00
981 20950 MONITORING OF INTERSTITIAL PROFEE Emergency Room Professional Fee 288.00
981 21310 CLO NASAL FX W/O MANIPUL Emergency Room Professional Fee 366.00
981 21315 CLO TX OF NASAL FX W/O STABILIZATION PF Emergency Room Professional Fee 1,808.85
981 21320 CLO TX NASAL BONE FX WITH STABIL Emergency Room Professional Fee 947.00
981 21450 CLO TX MANDIBULAR WO PF Emergency Room Professional Fee 393.00
981 21800 TIB FX UNCOMPLICATED Emergency Room Professional Fee 253.00
981 22305 CLO TX VERTABRAL PROC FX Emergency Room Professional Fee 468.00
981 23500 CLAVICLE FX; W/O MANIP Emergency Room Professional Fee 523.00
981 23505 CLO TX CLAV W/ MANIP PF Emergency Room Professional Fee 550.00
981 23540 CLO TX AC DISLOCAT WO MANIPULATION Emergency Room Professional Fee 599.00
981 23545 REDUCTION OF AC JOINT W/MANI/PF Emergency Room Professional Fee 727.00
981 23570 CLO TX SCAPULAR FX W/O M Emergency Room Professional Fee 468.00
981 23600 CLO TX PROX HUMERAL WO M Emergency Room Professional Fee 595.00
981 23605 CLO TX PROX HUMERAL FX W/MANI PRO FEE Emergency Room Professional Fee 1,455.00
981 23620 CLO TX GR HUM TUBER FX Emergency Room Professional Fee 542.00
981 23625 CLO FX > HUMERAL TUBER/FX W/MANIP PROFEE Emergency Room Professional Fee 1,036.00
981 23650 CLO TX SHLDR DISLO W/MAN Emergency Room Professional Fee 574.00
981 23655 SHOULDER DISLOC; W/MAN Emergency Room Professional Fee 781.00
981 23665 CLO TX SHOULDER DISLO FX > HUMERAL W/MAN Emergency Room Professional Fee 1,409.00
981 23675 CL TX SHOULDER DISLC W/MAN PROFEE Emergency Room Professional Fee 1,918.00
981 24200 RM FB UP ARM/ELBOW SQ Emergency Room Professional Fee 220.00
981 24500 CLO TX HUMERAL FX PRO Emergency Room Professional Fee 595.00
981 24505 CLO TX OF HUMERAL SHAFT FX W/MAN PROFEE Emergency Room Professional Fee 1,327.00
981 24535 CLO TX SUPRACONDYLAR/TRAN HUMERAL FX W/M Emergency Room Professional Fee 1,687.00
981 24576 CLO TX HUM/CONDYLAR FX P Emergency Room Professional Fee 618.00
981 24600 CLO ELBOW DISLOC W/O ANE Emergency Room Professional Fee 595.00
981 24605 TX CLO ELBOW DISLOC W/AN Emergency Room Professional Fee 910.00
981 24620 CLO TX; ELBOW W/MANIP PF Emergency Room Professional Fee 1,320.00
981 24640 CLO TX RAD HEAD SUBLUXA Emergency Room Professional Fee 236.00
981 24650 RADIAL HEAD/NECK;W/O MAN Emergency Room Professional Fee 510.00
981 24655 CLO TX RAD HEAD FX/W/MAN Emergency Room Professional Fee 835.00
981 24670 CLO TX UNLAR PROX WO MAN Emergency Room Professional Fee 507.00
981 25500 CLO TX RAD SHAFT FX W/OM Emergency Room Professional Fee 534.00
981 25505 CLO TX RAD SHAFT FX W/MA Emergency Room Professional Fee 903.00
981 25560 CLO TX RADIAL FX W/O MAN Emergency Room Professional Fee 712.00
981 25565 CLO TX RAD & ULNA SHAFT FX PROFEE Emergency Room Professional Fee 1,238.00
981 25600 DISTAL RAD FX; W/O MAN Emergency Room Professional Fee 678.00
981 25605 CLO DIST RADIAL; W/MANIP Emergency Room Professional Fee 943.00
981 25622 CLO CardiopulmonaryAL SCOPHOID WO M Emergency Room Professional Fee 657.00
981 25630 CLO TX CardiopulmonaryAL BONE FX PF Emergency Room Professional Fee 526.00
981 25635 CLO TX CardiopulmonaryAL FX W/MANIPULATION PROFEE Emergency Room Professional Fee 1,086.00
981 25650 ULNAR STYLOID FX Emergency Room Professional Fee 781.00
981 25660 CLO TX OF RADI W/MAN PRO FEE Emergency Room Professional Fee 916.00
981 25675 CLO TX DIST RADIOULNARFX Emergency Room Professional Fee 712.00
981 25690 TREATMENT OF WRIST DISLOCATION W/MANIPUL Emergency Room Professional Fee 1,300.00
981 26010 DRAINAGE OF FINGER ABSCESS PROFEE Emergency Room Professional Fee 121.00
981 26600 METACAR FX, X 1; W/O MAN Emergency Room Professional Fee 410.00
981 26605 CLO METACardiopulmonary W/ MANIP PRO FEE Emergency Room Professional Fee 615.00
981 26615 OPEN TX METACardiopulmonaryAL FX Emergency Room Professional Fee 2,238.00
981 26641 CLO TX THUMB DISLOC PRO Emergency Room Professional Fee 932.00
981 26645 CLO TX BENNET FX W/MANIP Emergency Room Professional Fee 745.09
981 26670 CLO TX CardiopulmonaryOMETACardiopulmonaryAL DIS PRO FEE Emergency Room Professional Fee 650.00
981 26675 CLO TX CardiopulmonaryOMETA FX W/MA Emergency Room Professional Fee 615.00
981 26700 CLO TX MCP DIS W/MAN W/O Emergency Room Professional Fee 366.00
981 26705 CLO TX METACardiopulmonaryOPHALANGEAL PROFEE Emergency Room Professional Fee 886.00
981 26715 OPEN TX MTCRPHALNG DISLO Emergency Room Professional Fee 1,390.00
981 26720 CLO TX PHALANG FX;WO MAN Emergency Room Professional Fee 321.00
981 26725 CLO TX PHALANG FX W/MANI Emergency Room Professional Fee 486.00
981 26740 CLO TX ARTICULAR FX W/OM Emergency Room Professional Fee 419.05
981 26742 CLX TX OF ARTCLR FX I.E. MCPOR W/MAN PRO Emergency Room Professional Fee 668.00
981 26750 CLO TX DIS PHALANGEAL WO Emergency Room Professional Fee 283.00
981 26755 CLO TX DIST PHALA FX W/M Emergency Room Professional Fee 406.00
981 26765 OPEN TX DIST PHALANG FX Emergency Room Professional Fee 1,046.05
981 26770 CLO TX IP JT DISLOC WM Emergency Room Professional Fee 320.00
981 26775 CLO TX INTRPHNGL DISL WA Emergency Room Professional Fee 393.00
981 26785 OP TX INTERPHALANGEAL JT Emergency Room Professional Fee 1,016.00
981 27230 CLO TX FEMORAL FX W/O MA Emergency Room Professional Fee 998.00
981 27246 CL TX GRT TROCHANTER FX Emergency Room Professional Fee 678.00
981 27252 CLO TX HIP DISLOC W/A PR Emergency Room Professional Fee 1,497.00
981 27265 CLTX POST HIP ARTHROPL DSLO W/O Anesthesia PRF Emergency Room Professional Fee 1,092.03
981 27266 CLO TX POST HIP ARTH DIS Emergency Room Professional Fee 1,409.00
981 27501 CLO TX SUPRACOND FX PRO Emergency Room Professional Fee 1,602.00
981 27502 CLXT TRTMNT FEM SHFT FX W/MANI PROFEE Emergency Room Professional Fee 2,599.00
981 27516 CLO DIST FEM EPIPHY SEP Emergency Room Professional Fee 1,116.06
981 27517 CLX REDUCTION OF DISTAL FEMUR DISC PROFE Emergency Room Professional Fee 2,165.00
981 27520 CLO TX PATELLAR FX W/O M Emergency Room Professional Fee 651.04
981 27530 CLO TX TIBIAL PROX W/O M Emergency Room Professional Fee 857.00
981 27530 CLO TX TIB FX PROX W/O M Emergency Room Professional Fee 858.00
981 27532 CLO TX TIBIAL FX W/MANIP Emergency Room Professional Fee 1,342.00
981 27538 CLO TX INTERCONDYLAR W/O Emergency Room Professional Fee 882.00
981 27552 CLO TX KNEE DIS W/ANE PF Emergency Room Professional Fee 936.00
981 27560 CLO TX PATEL DISLOC PRO Emergency Room Professional Fee 569.00
981 27562 CLO TX PATELLAR DISLOCATION WITH AnesthesiaTH Emergency Room Professional Fee 748.00
981 27570 MANIP KNEE JOINT/GEN ANE Emergency Room Professional Fee 636.00
981 27750 CLO TX TIB FX W/WO FIBFX Emergency Room Professional Fee 817.00
981 27752 CLO TX TIB SHAFT FX W/MA Emergency Room Professional Fee 1,338.00
981 27760 CLO MED MALLEOULUS WO MA Emergency Room Professional Fee 607.00
981 27762 CLO TX MED MALLEOLUS FX W/MANIP PRO FEE Emergency Room Professional Fee 1,283.00
981 27768 CLX TX OF POST MALLEOLUS FX W/M PROFEE Emergency Room Professional Fee 1,184.00
981 27780 CLO TX PRX FIB W/O MANIP Emergency Room Professional Fee 595.00
981 27781 CLO TX PROX FIB FX W/MANIPULATION PROFEE Emergency Room Professional Fee 1,184.00
981 27786 DISTAL FIB FX; W/O MANIP Emergency Room Professional Fee 729.00
981 27788 CLO TX LAT MALLEOLUS W/M Emergency Room Professional Fee 841.00
981 27808 CLO TX BIMALLEOLAR FXW/O Emergency Room Professional Fee 710.00
981 27810 CLO TX BIMALL ANKLE W/M Emergency Room Professional Fee 1,264.00
981 27816 CLO TX TRIMALL FX W/O MA Emergency Room Professional Fee 741.00
981 27818 CLO TX TRIMALLEOLAR W/MA Emergency Room Professional Fee 1,517.00
981 27824 CLO TX DISTAL TIBIA Emergency Room Professional Fee 886.00
981 27840 ANKLE DISLOC W/O AnesthesiaTH Emergency Room Professional Fee 489.06
981 27842 CLO TX ANK DISLOC W/Anesthesia Emergency Room Professional Fee 926.00
981 28190 ER FOREIGN BODY REMOVAL, FOOT, SUBQ. PRO Emergency Room Professional Fee 540.00
981 28192 REMOVAL OF FOREIGN BODY,FOOT;DEEP PROFEE Emergency Room Professional Fee 1,158.00
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981 28430 CLO TX TALUS FX W/O MANI Emergency Room Professional Fee 592.00
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981 28470 CLO METATARSAL;WO MAN EA Emergency Room Professional Fee 439.00
981 28475 CLOSED TX-METATARSAL FX W/MANIP PF Emergency Room Professional Fee 864.00
981 28490 CLO GRT TOE PHALANX WO M Emergency Room Professional Fee 360.00
981 28495 CLTX FX GRT TOE PHLX/PHLG W/MANIP PROFEE Emergency Room Professional Fee 485.00
981 28510 CL TX PHALX N GRT TOE;WO Emergency Room Professional Fee 227.00
981 28515 CLO TX FX PHALANX W/MANI Emergency Room Professional Fee 303.05
981 28545 CLO TX TARSAL DISLO W/AN Emergency Room Professional Fee 549.00
981 28570 CLSD TX TALOTARSAL JOINT, W/O ANE PROFE Emergency Room Professional Fee 434.00
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981 28600 ER PF CLOSED TX TARSO MET RED W/O AnesthesiaTH Emergency Room Professional Fee 530.00
981 28605 CLX TX TARSOMETATARSAL DIS W/Anesthesia PF Emergency Room Professional Fee 640.00
981 28630 CLO TX MTP JOINT DISLOC; W/O Anesthesia Emergency Room Professional Fee 370.00
981 28635 CLOSED TX MTP JOINT DISLOC;W/AnesthesiaTHESIA Emergency Room Professional Fee 425.00
981 28660 CLO TX INTRPHNGL DISLO W/MAN-W/O Anesthesia PF Emergency Room Professional Fee 168.00
981 28675 O TX INTERPHAL JNT DISLO Emergency Room Professional Fee 678.00
981 29065 APPLICATION CAST-LONG ARM PROFEE Emergency Room Professional Fee 290.00
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981 29105 APPLICATION SPLINT LONG ARM Emergency Room Professional Fee 148.00
981 29125 APPLICATION SPLINT SHORT ARM Emergency Room Professional Fee 127.00
981 29126 SPLINT SHORT ARM;DYNA PF Emergency Room Professional Fee 168.00
981 29130 SPLINT FINGER;STATIC PF Emergency Room Professional Fee 87.00
981 29131 SPLINT FINGER;DYNAMIC PF Emergency Room Professional Fee 148.00
981 29200 STRAPPING THORAX PRO FEE Emergency Room Professional Fee 87.00
981 29220 STRAPPING LOW BACK PRO F Emergency Room Professional Fee 127.00
981 29240 STRAPPING SHOULDER PF Emergency Room Professional Fee 87.00
981 29260 STRAPPING ELBOW WRIST PF Emergency Room Professional Fee 75.00
981 29280 STRAPPING HAND/FINGER PF Emergency Room Professional Fee 68.00
981 29325 APPLCTN OF HIP SPICA; BOTH LEGS PROFEE Emergency Room Professional Fee 710.00
981 29345 APPLICATION OF LONG LEG CAST Emergency Room Professional Fee 299.00
981 29405 SHORT LEG FIBERGLASS CAST APPLICATION PF Emergency Room Professional Fee 261.00
981 29505 APPLICATION SPLINT LONG LEG Emergency Room Professional Fee 208.00
981 29515 SPLINT SHORT LEG PRO FEE Emergency Room Professional Fee 136.00
981 29515 APPLICA SHORT LEG SPLINT Emergency Room Professional Fee 110.00
981 29520 STRAPPING HIP PF Emergency Room Professional Fee 127.00
981 29530 STRAPPING KNEE PRO FEE Emergency Room Professional Fee 97.00
981 29540 STRAPPING ANKL&/OR FT PF Emergency Room Professional Fee 87.00
981 29550 STRAPPING TOES PRO FEE Emergency Room Professional Fee 54.00
981 29580 STRAPPING UNNA BOOT PF Emergency Room Professional Fee 147.00
981 29590 STRAPPING DENIS-BROWN PF Emergency Room Professional Fee 127.00
981 29700 RMVL/BIVALING; BOOT OR BODY CAST Emergency Room Professional Fee 83.00
981 29705 REM OR BIVAL; FULL ARM/LEG CAST PROFEE Emergency Room Professional Fee 127.00
981 30300 REMOVAL FB INTRANASAL PR Emergency Room Professional Fee 145.00
981 30310 REMOVE FB INTNASAL W/A PF Emergency Room Professional Fee 727.00
981 30901 CTROL NASAL HEM/ANT/SMPL Emergency Room Professional Fee 187.06
981 30903 CONTROL NASAL HEMMORRHAGE EXTENSIVE Emergency Room Professional Fee 353.00
981 30905 CNTRL NASAL HEMOR POSTER Emergency Room Professional Fee 535.04
981 30906 CNTRL NASAL HMRRHG; POSTERIO, SUBQ PROF Emergency Room Professional Fee 556.00
981 31500 INTUBATION ENDOTRACHEAL Emergency Room Professional Fee 390.00
981 31505 LARYNGOSCOPY,INDIRECT DX Emergency Room Professional Fee 283.00
981 31525 LARYNGOSCOPY DIRECT, DIAGNOSTIC PROFEE Emergency Room Professional Fee 695.00
981 31530 LAYRNGOSCOPY DIREC W/ FB Emergency Room Professional Fee 1,050.00
981 32000 THORACENTESIS ASPIR I/S PRO FEE Emergency Room Professional Fee 434.00
981 32002 THORACENTESIS W/TUBEINPF Emergency Room Professional Fee 549.00
981 32551 TUBE THORACOSTOMY PRO Emergency Room Professional Fee 739.00
981 32554 THORACENTESIS WITH INSERTION OF TUBE Emergency Room Professional Fee 620.00
981 32555 THORA WITH IMAG ER PROFEE Emergency Room Professional Fee 712.00
981 33010 PERICardiopulmonaryIOCENTESIS; INITIAL PRO FEE Emergency Room Professional Fee 499.00
981 36510 CATH OF UMBILICAL VN, NB PROFEE Emergency Room Professional Fee 301.00
981 36556 CENTRAL VENOUS CATH>2 PF Emergency Room Professional Fee 403.00
981 36600 ARTERIAL PUNCTURE, WITHDRAWAL OF BLOOD Emergency Room Professional Fee 113.00
981 36680 PLACEMENT OF NEEDLE FOR INTRAOSS INFUS Emergency Room Professional Fee 363.00
981 38221 BX-BONE MARROW, NEEDLE OR TROCAR PROFEE Emergency Room Professional Fee 399.00
981 40650 RPR LIP THKNS VERMILION PRO FEE Emergency Room Professional Fee 1,017.00
981 40654 RPR LIP FL THKNS +1/2 VRTCL HGHT Emergency Room Professional Fee 1,912.00
981 40804 REMOVE FB;MOUTH SIMP PF Emergency Room Professional Fee 321.00
981 40830 CLO OF LAC;VESTIBULE MTH 2.5 CM OR <PROF Emergency Room Professional Fee 329.00
981 40831 CLO OF LAC;VESTIBULE MOUTH 2.5CM+ PROFEE Emergency Room Professional Fee 817.00
981 41252 REPAIR OF LAC OVER 2.6 CM OF TONGUE Emergency Room Professional Fee 1,090.00
981 41800 I&D ABSCESS FROM DENTOALVEOLAR PRO FEE Emergency Room Professional Fee 342.00
981 42700 DRAINAGE OF TONSIL ABSESS PRO FEE Emergency Room Professional Fee 340.00
981 42809 REMOVAL FB PHARYNX PRO Emergency Room Professional Fee 330.00
981 43215 ESOPHAGOSCOPY W/REM FB P Emergency Room Professional Fee 981.00
981 43752 NASO OR ORO GASTRC TUBE PLCMT PRO FEE Emergency Room Professional Fee 215.00
981 43753 GASTRIC INTUBATION $ ASPIRATION PROFEE Emergency Room Professional Fee 87.00
981 43760 CHANGE GASTROSTOMY TUBE Emergency Room Professional Fee 214.00
981 44970 LAPAROSCOPY-APPENDECTOMY Emergency Room Professional Fee 1,833.00
981 45915 REM FEC/FB IMPC W/ Anesthesia Emergency Room Professional Fee 568.00
981 46040 I & D OF ISCHIO/PERIRECTAL ABSCESS Emergency Room Professional Fee 939.00
981 46083 INCS THROMBOSED HEMROID Emergency Room Professional Fee 204.00
981 46320 REMOVAL OF HEMORRHOID CLOT PROFEE Emergency Room Professional Fee 405.00
981 46600 ARONSCOPY; DX W OR WO SPECIMIN PRO FEE Emergency Room Professional Fee 104.00
981 48510 CLO TX SUPRACONDYLAR PF Emergency Room Professional Fee 601.00
981 49080 PARACENTESIS ABDOM INI P Emergency Room Professional Fee 303.05
981 49081 PARACENT ABD; SUBSQ PRO Emergency Room Professional Fee 228.00
981 49082 ABDOMINAL PARACENTESIS W/O IMG GDNC PRFE Emergency Room Professional Fee 488.02
981 49083 PARACENTESIS-IMAGE GUIDED PRO FEE Emergency Room Professional Fee 808.05
981 50243 INJ EPID BLOOD/CLOT PATC Emergency Room Professional Fee 611.00
981 51010 ASP BLADDER W/INSERT CAT Emergency Room Professional Fee 408.00
981 51610 INJ PRC RTRGRD URETHROCYSTOGRAPHY PROFEE Emergency Room Professional Fee 410.00
981 51700 BLADDER IRR SIMP LAVAGEP Emergency Room Professional Fee 87.00
981 51702 INSERTION OF FOLEY CATH PROFEE Emergency Room Professional Fee 319.00
981 54150 CIRCUMCISION CLAMP NB Emergency Room Professional Fee 201.00
981 54450 FORESKN MANJ W/LSS PREP ADS&STRTC PF Emergency Room Professional Fee 233.00
981 55100 DRAINAGE OF SCROTAL WALL ABSC PRO FEE Emergency Room Professional Fee 2,017.00
981 56405 I & D VULVA OR PERINEAL ABSCESS Emergency Room Professional Fee 355.00
981 56420 I & D OF BARTHOLIN’S GLAND ABSCESS Emergency Room Professional Fee 377.00
981 58301 REMOVAL OF INTRVTRNE DEVICE (IUD) PROFEE Emergency Room Professional Fee 275.00
981 59812 TX OF INCOMPLETE AB, ANY TRIMESTR PROFEE Emergency Room Professional Fee 937.00
981 62270 SPINAL PUNC LUMBAR DX PR Emergency Room Professional Fee 375.00
981 64400 INJ, AnesthesiaT AGENT; TRIGEMINAL NERVE PRFEE Emergency Room Professional Fee 543.00
981 64405 INJ, Anesthesia AGENT, > OCCIPITAL NERV Emergency Room Professional Fee 352.00
981 64450 INJ Anesthesia AGENT OT PERIPHERAL NRV OR BRNC Emergency Room Professional Fee 387.00
981 65205 REMOVE FB EXT EYE;CONJUN Emergency Room Professional Fee 162.07
981 65210 REMOVE FB EXT EYE;CONJEM Emergency Room Professional Fee 120.00
981 65220 REMOVE FB EYE; W/O LAMP Emergency Room Professional Fee 133.00
981 65222 REMOVE FB EYE; W/LAMP Emergency Room Professional Fee 149.00
981 68420 INC/DRAIN LACRIMAL SAC Emergency Room Professional Fee 455.00
981 69000 DRAINAGE EXTERNAL EAR PRO FEE Emergency Room Professional Fee 299.00
981 69200 REMOVAL FB EXT AUD CANAL Emergency Room Professional Fee 215.00
981 69205 REMOVE FB; AUDITORY CANAL W/AnesthesiaT PROFEE Emergency Room Professional Fee 902.00
981 69209 REM IMPACTED CERUMEN, IRR/LAVAGE PF Emergency Room Professional Fee 50.00
981 69210 REMOVAL IMPACTED CERUMEN Emergency Room Professional Fee 78.00
981 69210 REMOVE IMPACTED CERUMEN Emergency Room Professional Fee 89.00
981 91105 GASTRIC INTUBAT & ASPIR Emergency Room Professional Fee 276.00
981 92950 CardiopulmonaryIOPULMANARY RESUSCIT Emergency Room Professional Fee 584.00
981 92953 TEMPORARY TRANSCUTANEOUS PACING PROFEE Emergency Room Professional Fee 138.00
981 92960 CardiopulmonaryIOVER/ELEC ELECTIVE Emergency Room Professional Fee 459.00
981 93015 PMS STRESS TEST W/ READ AND INTERP Emergency Room Professional Fee 299.00
981 96372 THERAPEUTIC INJ; IM OR SUBQ EA PROFEE Emergency Room Professional Fee 54.00
981 96376 EA ADD SEQUENTIAL INTRAVENOUS PUSH PF Emergency Room Professional Fee 34.00
981 96523 IRRIGATION OF IMPLATED VENOUS ACCESS PF Emergency Room Professional Fee 78.00
981 97597 REMOVAL OF DVITALIZED TISS LESS 20 CM/PF Emergency Room Professional Fee 95.10
981 98925 OMT ADMIN. BY ER PHYSICIAN Emergency Room Professional Fee 78.00
981 99024 FOLLOW UP IN GLOBAL PERIOD/ER PROFEE Emergency Room Professional Fee     –
981 99143 MOD SEDATION; YOUNGER THAN 5 YRS PROFEE Emergency Room Professional Fee 147.00
981 99144 MODERATE SEDATION 5 YEARS OR OLDER PF Emergency Room Professional Fee 121.00
981 99145 MODERATE SEDATION; OVER 5 YEARS; ADD 15 Emergency Room Professional Fee 53.00
981 99149 MOD SEDATION BY MD NOT DOING PROCEDURE Emergency Room Professional Fee 102.00
981 99156 MOD SED OT PHYSQ/HP INI 15 M 5/> YRS PRF Emergency Room Professional Fee 258.00
981 99157 MOD SED OT PHYS/QHP EA ADD 15 MINS PROF Emergency Room Professional Fee 190.00
981 99175 IPECAC OR SIMILAR ADMIN W/OBSERV PRO FEE Emergency Room Professional Fee 75.00
981 99217 ER OBSERVATION DISCHARGE MANAGEMENT PF Emergency Room Professional Fee 147.00
981 99218 ER OBSERVATION STRAIGHTFORWARD PROFEE Emergency Room Professional Fee 204.00
981 99219 INT OBSERVATION PER DAY Emergency Room Professional Fee 251.00
981 99219 ER OBS MODERATE PROFEE Emergency Room Professional Fee 277.00
981 99220 ER OBSERVATION HIGH COMPLEX PROFEE Emergency Room Professional Fee 317.00
981 99234 ER OBS STRAIGHTFORWARD SAMEDAY PROFEE Emergency Room Professional Fee 226.00
981 99235 ER OBS MODERATE SAME DAY Emergency Room Professional Fee 304.10
981 99236 ER OBS HIGH COMPLEX SAME DAY Emergency Room Professional Fee 384.00
981 99242 Office Consultation Emergency Room Professional Fee 197.00
981 99245 ER CONSULTATION OP PROFEE Emergency Room Professional Fee 432.00
981 99281 ER STRAIGHT FWD PROFEE Emergency Room Professional Fee 115.00
981 99281 FNP/ER LEVEL I Emergency Room Professional Fee 115.00
981 99282 ER LOW COMPLEXITY PRO FEE Emergency Room Professional Fee 249.00
981 99282 FNP/ER LEVEL II Emergency Room Professional Fee 249.00
981 99283 ER MOD COMP FOCUS PROFEE Emergency Room Professional Fee 402.00
981 99283 FNP/ER LEVEL III Emergency Room Professional Fee 402.00
981 99284 ER MOD COMPLEXITY PROFEE Emergency Room Professional Fee 581.02
981 99284 FNP/ER LEVEL IV Emergency Room Professional Fee 581.02
981 99285 ER HIGH COMPLEX PROFEE Emergency Room Professional Fee 810.00
981 99285 FNP/ER LEVEL V Emergency Room Professional Fee 810.00
981 99291 ER CRITICAL CARE 1HR-PF Emergency Room Professional Fee 1,797.00
981 99291 FNP/CC 1ST 30-74 MIN Emergency Room Professional Fee 1,797.00
981 99292 ER CRITICAL ADD 1/2HR PF Emergency Room Professional Fee 590.00
981 99292 FNP/CC EACH ADDL 30 MIN Emergency Room Professional Fee 590.00
981 99386 PHYSICAL EXAM PROFEE Emergency Room Professional Fee 293.00
987 99465 ER PF/DEL RM RESUS PP VENT OR CH COMP Emergency Room Professional Fee 376.00
981 99999 MEDICARE FNP POST OP GLOBAL 10 DAY Emergency Room Professional Fee     –
981 S0630 RMVL OF SUTURES MD NOT MD ORGLY CLOS WD Emergency Room Professional Fee 54.00
300 36415 PHLEBOTOMY-BLOOD DRAW Lab 38.00
300 36600 ARTERIAL PUNCTURE Lab 68.00
300 80048 CHEM 7 Lab 118.00
300 80050 GENERAL HEALTH PANEL Lab 408.00
300 80051 ELECTROLYTE PROFILE Lab 76.00
300 80053 CHEM 12 PROFILE Lab 181.00
300 80055 PRE-NATAL SCREEN Lab 307.00
300 80061 LIPID PROFILE Lab 123.00
300 80069 RENAL FUNCTIONAL PANEL Lab 132.00
300 80074 ACUTE HEPATITIS PANEL Lab 341.00
300 80076 LIVER PROFILE Lab 112.00
300 80100 DRUG SCR QUAL MLT DRUG CLASS EA PX Lab 255.00
300 80101 DRUG SCREEN; SING DRUG CLASS METH Lab 112.00
300 80101 TRICYLIC SCREE Lab 112.00
300 80101 HCV AB RIBA Lab 112.00
300 80101 SINGLE DRUG CLASS METHOD EA DRUG Lab 112.00
300 80101 CANNABINOIDS SERUM Lab 112.00
300 80103 DRUG SCREEN HAIR ANALYSIS Lab 98.00
300 80150 AMIKACIN Lab 160.00
300 80150 DRUG SCREEN QUANTITATIVE AMIKACIN Lab 160.00
300 80152 AMITRIPTYLINE Lab 164.00
300 80154 DRUG SCREEN QUALITATIVE BENZODIAZEPINES Lab 181.00
300 80156 TEGRETAL Lab 157.00
300 80158 CYCLOSPORIN TEST Lab 193.00
300 80159 CLOZAPINE Lab 159.00
300 80160 DESIPRAMINE LEVEL Lab 125.00
300 80162 DIGOXIN Lab 129.00
300 80164 DEPAKANE LEVEL Lab 132.00
300 80166 DOXEPINE LEVEL Lab 120.00
300 80168 ETHOSUXIMIDE Lab 87.00
300 80169 EVEROLIMUS Lab 605.00
300 80170 GENTAMICIN Lab 150.00
300 80173 HALOPERIDOL Lab 219.00
300 80174 IMIPRAMINE LEVEL Lab 125.00
300 80175 LAMOTRIGINE Lab 153.00
300 80177 LEVETIRACETAM Lab 189.00
300 80178 LITHIUM, BLOOD Lab 95.00
300 80182 NORTRIPTYLENE Lab 116.00
300 80183 OXYCARBAZEPINE METABOLITE Lab 178.00
300 80184 PHENOBARBITAL Lab 124.00
300 80185 DILANTIN -PHENYTOIN Lab 145.00
300 80186 PHENYTION, FREE Lab 160.00
300 80188 PRIMIDONE Lab 124.00
300 80188 MYSOLINE Lab 124.00
300 80190 PROCAINAMIDE LEVEL Lab 132.00
300 80195 SIROLIMUS Lab 204.00
300 80197 TACROLIMUS Lab 226.00
300 80198 THEOPHYLINE LEVEL Lab 172.00
300 80200 TOBRAMYCIN Lab 205.00
300 80201 DRUG SCREEN QUALITATIVE TOPIRAMATE Lab 109.00
300 80202 VANCOMYCIN LEVEL Lab 175.00
300 80203 ZONISAMIDE Lab 156.00
300 80299 COUMADIN LEVEL Lab 200.00
300 80299 QUANTITATION OF DRUG NES Lab 973.00
300 80299 DIGITOXIN Lab 200.00
300 80299 DEXTROMETHORPHAN, URINE Lab 200.00
300 80299 QUETIAPINE Lab 200.00
300 80299 ZONISAMIDE Lab 200.00
300 80299 PREGABALIN Lab 200.00
300 80299 KEPPRA Lab 200.00
300 80299 LACOSAMIDE Lab 200.00
300 80299 VORICONAZOLE, SERUM Lab 200.00
300 80299 FLUOXETINE, SERUM Lab 121.00
300 80299 INFLIXIMAB QN W/REFLEX TO Ab, SERUM Lab 577.00
300 80299 ADALIMUMAB QUANT W REFLEX TO ANTI SERUM Lab 681.00
300 80299 ITRACONAZOLE LEVEL Lab 200.00
300 80301 DRUG SCREEN, SERUM Lab 381.00
300 80301 DRUG SCREEN Lab 98.00
300 80301 DRUGS OF ABUSE UMB Lab 748.00
300 80301 DRUGS OF ABUSE SCREEN Lab 381.00
300 80302 MEPERIDINE SCREEN Lab 69.00
300 80302 TRAMADOL SCREEN Lab 69.00
300 80304 DRUG SCREEN ANY NUMBER OF CLASSES Lab 688.00
300 80305 DRUG SCREEN QUAL; MULT DRUG CLASS BY HIG Lab 98.00
300 80307 DRUG ABUSE SURVEY,W/CONFIRM Lab 107.00
300 80307 SALICYLATES Lab 100.00
300 80307 OXYCODONE SCREEN, U Lab 307.00
300 80320 ALCOHOL, ETHYL Lab 124.00
300 80320 ETHANOL, URINE Lab 144.00
300 80321 TEST CONFIRMATION-ETHYL GLUCURONIDE Lab 2.00
300 80321 ALCOHOL BIOMARKERS; 1 OR 2 Lab 159.00
300 80322 ALCOHOL BIOMARKERS; 3 OR MORE Lab 189.00
300 80322 TEST CONFIRMATION-FAEE Lab 2.00
300 80323 NICOTINE & COTININE Lab 178.00
300 80323 TEST CONFIRMATION-COTININE Lab 2.00
300 80324 AMPHETAMINE, SERUM OR PLASMA Lab 137.00
300 80324 TEST CONFIRMATION-AMPHETAMINE Lab 2.00
300 80324 AMPHETAMMES 1 OR 2 Lab 307.00
300 80325 DRUG SCREEN QUANT AMPHETAMINES 3 – 4 Lab 69.00
300 80329 SALICYLATES/DRUGSCREEN ANLGSC NON-OP 1-2 Lab 125.00
300 80329 ASSAY OF ACETAMINOPHEN Lab 125.00
300 80330 SALICYLATES/DRUGSCREEN ANLGSC NON OP-3-5 Lab 143.00
300 80331 SALICYLATES/DRUG SCREEN ANLGSC NON-OP 6+ Lab 164.00
300 80333 ANTIDEPRESSANTS SEROTONERGIC CLASS 3-5 Lab 97.00
300 80335 AMITRIPTYLME & NORTRIPTYIONE Lab 71.00
300 80335 IMIPRAMINE Lab 156.00
300 80337 ANTIDEPRESSANTS TRICYCLIC OT CYCLICLS 6+ Lab 67.00
300 80345 BARBITUATES CONFIRM, URINE Lab 144.00
300 80345 TEST CONFIRMATION-BARBITURATE Lab 2.00
300 80345 DRUG SCREENING BARBITURATES Lab 156.00
300 80346 BENZODIAZEPINES, URINE Lab 144.00
300 80346 TEST CONFIRMATION-BENZODIAZEPINE Lab 144.00
300 80346 DRUG SCREENING BENZODIAZEPINES 1-12 Lab 210.00
300 80348 TEST CONFIRMATION-BURENORPHINE Lab 2.00
300 80348 BUPRENORPHINE/NORBUPRENORPHINE RDM URINE Lab 121.00
300 80349 TEST CONFIRMATION-CANNABINOID Lab 2.00
300 80349 CARBOXY-THC-CONFIRMATION Lab 614.00
300 80349 CARBOXY-TTRHYDRCNNBNL CONFIRM, URINE Lab 144.00
300 80349 DRUG SCREENING CANNABINOIDS NATURAL Lab 614.00
300 80353 DRUG SCREENING COCAINE Lab 614.00
300 80353 TEST CONFIRMATION-COCAINE Lab 2.00
300 80353 COCAINE Lab 614.00
300 80353 COCAINE AND METABOLITE CONF Lab 144.00
300 80356 TEST CONFIRMATION – OPIATE Lab 2.00
300 80356 TEST CONFIRMATION – OXYCODONE Lab 2.00
300 80358 METHADONE CONF, URINE Lab 156.00
300 80358 DRUG SCREENING METHADONE Lab 614.00
300 80358 TEST CONFIRMATION – METHADONE Lab 2.00
300 80359 METHYLENEDIOXY AMPHETAMMES Lab 307.00
300 80359 TEST CONFIRMATION – AMPHETAMINE Lab 2.00
300 80359 DRUG SCREEN AMPHETAMINES 3-4 Lab 307.00
300 80361 OPIATE 1 OR MORE Lab 73.00
300 80361 TEST CONFIRMATION – OPIATE Lab 2.00
300 80362 TEST CONFIRMATION-MEPERIDINE Lab 2.00
300 80365 OXYCODONE W/METABOLITE CONF, URINE Lab 482.00
300 80365 OXYCODONE Lab 73.00
300 80367 TEST CONFIRMATION – PROPOXYPHENE Lab 2.00
300 80369 DRUG SCREENING SKELETAL MSCL RLAXNTS 1-2 Lab 87.00
300 80371 TEST CONFIRMATION-DESIGNER STIMULANTS Lab 2.00
300 80373 TRAMADOL & METABOLITE Lab 166.00
300 80373 TEST CONFIRMATION – TRAMADOL Lab 2.00
300 80375 DRUG/SUBSTNC DEFINTIV QUAL/QUNT NOS 1-3 Lab 469.00
300 80375 CLONIDINE (CATAPRES) Lab 511.00
300 81000 URINALYSIS, COMP Lab 81.00
300 81002 URINALYSIS, DIP ONLY/SP Lab 92.00
300 81002 URINE, SP. GRAV. Lab 92.00
300 81015 URINALYSIS MICRO ONLY Lab 39.00
300 81015 MICROSCOPIC Lab 39.00
300 81050 24 HR URINE MEASUREMENT Lab 32.00
300 81162 BRCA1/BRCA2 GENES FULL GENE ANALYSIS Lab 5,334.00
300 81206 BCR/ABL. p.210. QUANT Lab 1,010.00
310 81206 BCR/ABL1 GENE MAJOR BP Lab 632.00
310 81207 BCR/ABL 1 GENE MINOR BP Lab 632.00
310 81210 BRAF GENE ANALYSIS V600E VARIANT Lab 1,670.00
300 81219 TIER 1 MOLECULA PATH PROCEDURES Lab 1,575.00
300 81220 CFTR GENE ANALYSIS COMMON VARIANTS Lab 410.00
300 81226 CYTO CHROME P450 GENOTYPE Lab 276.00
310 81240 F2 GENE ANALYSIS 20210G >A VARIANT Lab 377.00
319 81241 F5 (COAG FACT V0, HERED. HYPERCOAG GENE Lab 458.00
310 81256 HEREDITARY HEMOCHROMATOSIS DNA MUT ANALY Lab 655.00
300 81257 HGB ELECTROPHORESIS Lab 530.00
300 81259 ALPHA GLOBIN GENE SEQUENCING Lab 1,584.00
300 81261 IG HEAVY CHAIN GENE REARRANGEMENT Lab 2,629.00
300 81264 IGK@GENE REARRANGE DETECT ABNML CLNL Lab 2,629.00
310 81270 JAK-2 Lab 787.00
300 81275 KRAS GENE ANALYSIS VARIANTS CODONS 12-13 Lab 2,543.00
300 81291 MT HFR A 1298C MUTATION ANALYSIS Lab 892.00
310 81291 MTHFR C677T MUTATION ANALYSIS Lab 892.00
300 81291 MT HFR MUTATIONS ANALYSIS Lab 892.00
305 81332 ALPHA-1ANTITRYPSIN QUANT AND MUT ANALYS Lab 454.00
310 81340 T-CELL GENE ARRANGEMENT AMPLICATION Lab 2,629.00
310 81342 T-CELL GENE REARRANGEMENT ANALYSIS Lab 2,629.00
300 81372 HLA-A, B, C CLASS I DNA TYPING Lab 942.00
300 81375 HLA II LOW RESOLUTION HLA-BRB1/34/5 DQB1 Lab 542.00
310 81376 HLA CLASS II TYPING LOW RES ONE LUCUS EA Lab 513.00
300 81382 HLA CLASS II TYPING HIGH RES. ONE LOCUS Lab 513.00
300 81400 DPD MOPATH PROCEDURE LEVEL 1 Lab 215.00
300 81401 HGB ELECTROPHORESIS Lab 530.00
300 81401 HUNTINGTON DISEASE Lab 1,332.00
300 81401 MOLECULAR PATHOLOGY LVL II Lab 1,217.00
300 81402 TIER 2 MOLECULAR PATH PROCEDURE Lab 875.00
300 81403 JAK2 EXON 12 MUTATION DETECTION Lab 1,674.00
310 81403 MOLECULAR PATHOLOGY LVL IV Lab 651.00
310 81403 HGB ELECTROPHORESIS Lab 651.00
310 81404 MEFV GENE, FULL GENE ANALYSIS Lab 2,810.00
300 81404 MOLECULAR PATH PROC LVL 5 Lab 1,535.00
300 81408 FBN1 FULL GENE SEQUENCE Lab 4,725.00
300 81410 MARFAN AND RELATED GENETIC PANEL, B Lab 3,675.00
300 81420 Q NATAL Lab 9,594.00
300 81479 2D6CN PLUS SIX SEQUENCES Lab 13,593.00
300 81479 2D6CN PLUS TWO SEQUENCES Lab 4,532.00
300 81479 2D6CN PLUS FOUR SEQUENCES Lab 9,062.00
300 81479 CYP2D6 COPY NUMBER VARIATION Lab 648.00
300 81479 2D6CN PLUS THREE SEQUENCES Lab 6,797.00
300 81479 2D6CN PLUS ONE SEQUENCING Lab 2,265.00
300 81479 2D6CN PLUS FIVE SEQUENCES Lab 11,327.00
310 81511 FETAL CONGENITAL ABNOR ASSAY FOUR ANAL Lab 103.00
300 82009 ACETONE, BLOOD Lab 52.00
300 82010 ACETONE, BLOOD QUANT. Lab 68.00
300 82010 BETA-HYDROXYBUTYRATE Lab 68.00
300 82017 ACYLCARNITINES;QUANTITATIVE, EACH Lab 194.00
300 82017 ACYLCARNITINES QUANT Lab 130.00
300 82024 ACTH Lab 254.00
300 82030 ADENOSINE, 5-MONOPHOSPHATE, CYCLE Lab 247.00
300 82040 ALBUMIN SERUM Lab 42.00
300 82042 URINE OR OTHER SOURCE, QUANTITATIVE EA. Lab 74.00
300 82042 ALBUMM, BODY FLUID Lab 74.00
300 82043 MICRO ALBUMIN-URINE Lab 114.00
300 82085 ALDOLASE Lab 116.00
300 82088 ALDOSTERONE Lab 311.00
300 82103 ALPHA-1 ANTITRYPSIN Lab 112.00
300 82104 ALPHA1-ANTITRYP PHENOTYP Lab 212.00
300 82105 AFP Lab 178.00
300 82107 AFP-L3 FRACTION & TOTAL AFP Lab 198.00
300 82107 AFP-L3% (PANEL ONLY) Lab 368.00
300 82108 ALUMINUM Lab 368.00
300 82131 AMINO ACID SINGL/QUAN EA Lab 373.00
300 82135 AMINOLEVULINIC ACID, DELTA Lab 165.00
300 82139 AMINO ACIDS, QUANT 6< Lab 653.00
300 82140 AMMONIA, BLOOD Lab 149.00
300 82140 AMMONIUM, K4 HR, U (PANEL ONLY) Lab 36.00
300 82150 AMYLASE Lab 83.00
300 82150 URINE AMYLASE Lab 257.00
300 82150 AMYLASE, BODY FLUID Lab 257.00
300 82157 ANDROSTENEDIONE Lab 219.00
300 82164 ANGIOTENSIN I-ACE Lab 141.00
300 82172 APOLIPOPROTEIN Lab 304.00
300 82172 APOLIPOROTEIN B (PANEL ONLY) Lab 77.00
300 82172 APOLIPOROTEIN EA. (PANEL ONLY) Lab 76.00
300 82175 ARSENIC Lab 156.00
300 82175 ARSENIC – HAIR Lab 258.00
300 82180 ASCORBIC ACID Lab 102.00
300 82205 MEBERAL Lab 91.00
300 82232 BETA 2 MICROGLOBULIN SERUM Lab 196.00
300 82239 BILE ACIDS, TOTAL, SERUM Lab 215.00
300 82247 BILIRUBIN AMNIOTIC FLUD. Lab 97.00
300 82247 BILIRUBIN, TOTAL Lab 97.00
300 82248 BILIRUBIN, DIR Lab 55.00
300 82261 BIOTINDASE, EA SPECIMEN Lab 271.00
300 82270 BLD. OCCLT STOOL Lab 55.00
300 82273 BLD, OCCLT, NOT STOOL Lab 41.00
300 82274 FECAL OCCLT, BLD, CLRCTL, CANCER SCRN Lab 445.00
300 82274 BLD OCC FECAL HGB DTR IA QUAL FECES 1-3 Lab 95.00
300 82300 CADMIUM Lab 216.00
300 82306 CALCIFEDIOL (25-OH VIT D-3) Lab 254.00
300 82307 VITAMIN D LAB TEST Lab 364.00
300 82308 CALCITONIN THYROID Lab 160.00
300 82310 CALCIUM, SERUM Lab 58.00
300 82330 IONIZED CALCIUM Lab 83.00
300 82340 CALCIUM, URINE 24 HR Lab 97.00
300 82340 CALCIUM, U (PANEL ONLY) Lab 32.00
300 82360 CACULI-STONE Lab 171.00
300 82360 KIDNEY STONE ANALYSIS Lab 171.00
300 82360 STONE ANALYST Lab 171.00
300 82365 KIDNEY STONE ANALYSIS Lab 125.00
300 82374 CARBON DIOXIDE Lab 69.00
300 82375 CARBOXY HEMOGLOBIN CO. Lab 194.00
300 82378 CEA Lab 175.00
300 82379 CARNITINE Lab 430.00
300 82380 CAROTENE Lab 73.00
300 82382 CATE CHOLAMINE TOTAL Lab 150.00
300 82384 CATECHOLAMINE FRACT. Lab 271.00
300 82390 CERULOPLASMIN Lab 134.00
300 82390 CEREBRAL SPINAL FLD Lab 134.00
300 82390 CERULOPLASMIN, SERUM Lab 109.00
300 82397 PARATHYROID HORMONE PEPTIDE PTHrP PLASMA Lab 95.00
300 82397 INFLIXIMAB Ab, SERUM Lab 447.00
300 82397 HYPERGLYCOSYLATED HCG Lab 759.00
300 82435 CHLORIDE, SERUM Lab 63.00
300 82436 CHLORIDE, URINE Lab 63.00
300 82436 CHLORIDE, U (PANEL ONLY) Lab 27.00
300 82438 CHLORIDE, CSF Lab 63.00
300 82438 STOOL CHLORIDE Lab 63.00
300 82465 CHOLESTEROL, TOTAL Lab 42.00
300 82465 ASSAY BLD/SERUM CHOLESTEROL Lab 20.00
300 82465 CHOLESTEROL TOTAL (PANEL ONLY) Lab 20.00
300 82480 CHOLINESTER ASE Lab 118.00
300 82480 PCHE Lab 118.00
300 82480 CHOLINESTESTER, SERUM Lab 118.00
300 82482 ACETYLCHOLINESTERASE.RBC Lab 123.00
300 82491 CAFFEINE LEVEL Lab 178.00
300 82491 DOPAMIN URINE Lab 178.00
300 82491 COENZYME Q10 Lab 178.00
300 82495 CHROMIUM Lab 254.00
300 82495 CHROMIUM, SERUM Lab 254.00
300 82507 CITRATE EXCRETION, 24 HR, URINE Lab 172.00
300 82523 COLLAGEN CROSS LINKS Lab 217.00
300 82523 COLLAGEN TYPE I C-TELOPEPTIDE Lab 217.00
300 82525 COPPER, SERUM Lab 198.00
300 82525 24 HOUR URINE COPPER Lab 198.00
300 82530 CORTISOL; FREE Lab 269.00
300 82530 FREE CORTISOL Lab 269.00
300 82530 CORTISOL SALIVA Lab 269.00
300 82530 CORTISOL FREE (PANEL) Lab 35.00
300 82533 CORTISOL, SERUM Lab 117.00
300 82533 CORTISOL,S, LC-MS/MS Lab 195.00
300 82533 CORTISOL, INFERIOR VENA CAVA, SERUM Lab 117.00
300 82542 CLMN CHROM/MASS QUAN/SGL Lab 429.00
300 82542 PORPHYRINS, FRACTION, PLASMA Lab 135.00
300 82542 PROMETHEUS THRPN METABOLITES Lab 985.00
300 82542 COL-CHR/MS NONDRUG QUAL/QUN (PANEL ONLY) Lab 40.00
300 82542 FATTY ACID PROFILE, COMPREHENSIVE Lab 429.00
300 82542 BILE ACIDS FRACTIONATED + TOTAL Lab 594.00
300 82544 FATTY ACID PROFILE, ESSENTIAL Lab 352.00
300 82550 CPK Lab 70.00
300 82552 CPK ISOEMZYMES Lab 147.00
300 82553 CKMB Lab 141.00
300 82565 CREATININE Lab 63.00
300 82565 CREATININE W/ESTMTD GER (CKD-EPI), SERUM Lab 127.00
300 82565 CREATININE W/EGFR Lab 63.00
300 82570 CREATININE, URINE Lab 73.00
300 82570 CREATININE, U (PANEL ONLY) Lab 28.00
300 82575 CREATININE CLEARANCE Lab 132.00
300 82575 CREATININE CLEARANCE 24 HOUR URINE Lab 80.00
300 82595 CRYOGLOBULIN Lab 91.00
300 82600 CYANIDE, BLOOD Lab 234.00
300 82607 VITAMIN B-12 Lab 141.00
300 82610 CYSTATIN C Lab 203.00
300 82615 CYSTINE, URINE Lab 93.00
300 82626 DHEA Lab 324.00
300 82626 DEHYDROEPIANDROSTERONE S Lab 209.00
300 82627 DHEA SULFATE Lab 185.00
300 82627 DEHYDROEPIANDROSTERONE SULFATE DHEA-S Lab 184.00
300 82651 DIHYDROTESTOSTERONE Lab 166.00
300 82652 DIHYDROXYVITAMIN D, 1, 25- Lab 320.00
300 82656 PANCREATIC ELASTASE 1 Lab 387.00
300 82657 METHEMOGLOBINREDUCTASE Lab 461.00
300 82657 TPMT ACTIVITY PROFILE, RBC Lab 1,066.00
300 82664 IEF CONFIRMS Lab 235.00
300 82668 ERYTHROPOIETIN Lab 218.00
300 82670 ESTRADIOL Lab 255.00
300 82671 ESTRONGENS, FRAC-BLOOD Lab 409.00
300 82671 ESTROGENS, FRACT-URINE Lab 409.00
300 82672 ESTROGENS, TOT-BLOOD/URN Lab 178.00
300 82672 ESTROGEN LEVEL Lab 178.00
300 82677 ESTRIOL, PLACENTA Lab 196.00
300 82677 ESTRIOL, FREE Lab 196.00
300 82679 ESTRONE Lab 210.00
300 82705 FAT OR LIPIDS;FECES QUAL Lab 95.00
300 82705 QUAL STOOL FAT Lab 95.00
300 82710 FAT, FECAL TOTAL Lab 160.00
300 82725 OLEIC ACID Lab 70.00
300 82726 VERY LONG CHAIN FAT ACID Lab 398.00
300 82728 FERRITIN Lab 124.00
300 82731 FETAL FIBRONECTIN Lab 561.00
300 82746 FOLATE, SERUM Lab 150.00
300 82746 ASSAY OF FOLIC ACID SERUM (PANEL ONLY) Lab 33.00
300 82747 FOLATE RBC Lab 198.00
300 82784 GAMMAGLOBULIN IG*ADGM EA Lab 107.00
300 82784 Ig E Lab 107.00
300 82784 IMMUNOGLOB. G.A.M. Lab 107.00
300 82784 IGM. BLOOD BY RID Lab 107.00
300 82784 IGG, BLOOD BY RID Lab 107.00
300 82784 IGA Lab 107.00
300 82784 GAMMAGLOBULIN Lab 107.00
300 82785 IGE BLOOD BY RID Lab 55.00
300 82785 IMMUN9O9GLOBULIN E (IgE), S Lab 63.00
300 82787 IGg SUBCLASS 4 Lab 118.00
300 82800 BLOOD PH Lab 62.00
300 82803 ARTERIAL BLOOD GAS Lab 158.00
300 82926 GASTRIC ANALYSIS Lab 150.00
300 82941 GASTRIN Lab 161.00
300 82943 GLUCAGON Lab 173.00
300 82945 GLUCOSE, CSF Lab 210.00
300 82945 GLUCOSE, URINE Lab 210.00
300 82945 GLUCOSE BODY FLUIDS Lab 210.00
300 82947 GLUCOSE, BLOOD Lab 49.00
300 82950 GESTAT. DIABETES Lab 92.00
300 82950 INTREPID GLUCOSE LIPID Lab 92.00
300 82951 GLUCOSE, 1-2HR Lab 142.00
300 82952 GLUCOSE TOL, ADD SPEC Lab 49.00
300 82955 GLUCOSE-6 PHOS DEHYD QUA Lab 125.00
300 82955 G6PD Lab 125.00
300 82962 CHEM BG Lab 40.00
300 82977 GAMMA GT Lab 71.00
300 82978 GLUTATHIONE Lab 104.00
300 83001 FOLLICLE STIM, HORMONE Lab 194.00
300 83002 LUTENIZING HORMONE Lab 214.00
300 83003 GROWTH HORMONE Lab 145.00
300 83010 HAPTOGLOBIN Lab 271.00
300 83010 ASSAY OF HAPTOGLOBIN QUANTITATIVE Lab 122.00
300 83013 H-PYLORI; FOR UREASE ACTIVITY NON RADIOA Lab 359.00
300 83015 HEAVY METALS SCREEN Lab 194.00
300 83018 HEAVY METAL QUANT, EA Lab 288.00
300 83018 COBALT Lab 288.00
300 83018 IODINE Lab 288.00
300 83018 BERYILLIUM Lab 288.00
300 83020 HEMOGLOBIN ELECTROPHOR. Lab 132.00
300 83021 HEMOGLOBIN FRACT & QUANT; CHROMO Lab 276.00
300 83036 GLYCOHEMOGLOBIN Lab 112.00
300 83051 HEMOGLOBLIN; PLASMA Lab 82.00
300 83068 UNSTABLE HEMOGLOBIN Lab 153.00
300 83088 HISTAMINE Lab 254.00
300 83090 HOMOCYSTINE Lab 125.00
300 83150 HVA-HOMOVANILIC ACID Lab 293.00
300 83491 CORTICOSTEROIDS Lab 150.00
300 83491 HYDROXYCORTICOSTEROID Lab 150.00
300 83497 5-HIAA Lab 180.00
300 83498 17-OH PROGESTERONE Lab 246.00
300 83498 PROGESTERONE 17-OH Lab 246.00
300 83516 IMMUNOASSAY FOR OTHER THAN INFECTION Lab 166.00
300 83516 BP 180 Lab 131.00
300 83516 BP 230 Lab 131.00
300 83516 GLIADIN (DEAMIDATED) Ab, Ig A Lab 166.00
300 83516 CENTROMER Ab. IgG Lab 166.00
300 83516 HISTONE AUTO-ANTIBODIES, SERUM Lab 166.00
300 83516 TTG A3 IGG IGA TISSUE TRANS GL UT Lab 166.00
300 83516 F-ACTIN AB, 1gG, S Lab 386.00
300 83516 DESMOGLEIN 1 Lab 81.00
300 83516 DESMOGLEIN 3 Lab 81.00
300 83516 TISSUE TRANSGLT Ab. IgG Lab 166.00
300 83519 IMMUNOASSAY ANALYTE QUAN Lab 446.00
300 83519 NEURONAL V-G K+ CHANNEL AB S EXP ONLY Lab 63.00
300 83519 ACh ECPT MUSCLE BINDING AB EXP ONLY Lab 63.00
300 83519 NTYPE CALCIUM CHANNEL AB EXP ONLY Lab 63.00
300 83519 PQ TYPE CLACIUM CHANNEL AB EXP ONLY Lab 63.00
300 83519 N-TYPE CALCIUM CHANNEL Ab Lab 310.00
300 83519 SCHR GSNGLIONIC NEURONAL AB S EXP ONLY Lab 63.00
300 83519 VGKC-complex Ab IPA, CSF Lab 350.00
300 83519 ACH RECEPTOR MODULATING Lab 184.00
300 83519 MYASTHENIA GRAVIS (MG) EVALUATION Lab 310.00
300 83519 NEURONAL (V-G) K+ CHANNEL Ab. S Lab 310.00
300 83519 ACh RECEPTOR (MUSCLE) BINDING Ab Lab 310.00
300 83519 AChR GANGLIONIC NEURONAL Ab, S Lab 310.00
300 83519 P/Q TYPE CALCIUM CHANNEL AB Lab 310.00
300 83520 IMMUNOASSAY NOS, QUANT Lab 222.00
300 83520 ADALIMUMAB ANTI SERUM Lab 464.00
300 83520 MMP-9 Lab 222.00
300 83520 INHIBM B Lab 222.00
300 83520 MELATONIN Lab 222.00
300 83520 STRIATIONAL STRAITED MUSCLE AB S EXP ONL Lab 63.00
300 83520 RIBOSOME P Ab. IgG Lab 222.00
300 83520 IgM DISIALO GM1b Lab 222.00
300 83520 IgG DISIALO GM1b Lab 222.00
300 83520 THROTROPIN RECEPTOR Ab Lab 147.00
300 83520 IgM ASIALO GM1 Lab 222.00
300 83520 IgG ASIALO GM1 Lab 222.00
300 83520 IgM MONOSIALO GM1 Lab 222.00
300 83520 RNA POLYMERASE III Lab 222.00
300 83520 TRYPTASE SERUM Lab 222.00
300 83520 Ig6 MONOSIALO GM1 Lab 222.00
300 83520 ANTIMULLERIAN HORMONE Lab 222.00
300 83520 GLOM BASEMENT MEMBRANE Ab Lab 222.00
300 83520 IGFBP-3 Lab 222.00
300 83520 GQIB Ab Lab 222.00
300 83520 TRANSFORMING GROWTH FACTOR BETA Lab 368.00
300 83525 INSULIN, SERUM Lab 92.00
300 83527 INSULIN FREE Lab 214.00
300 83540 IRON Lab 69.00
300 83540 ASSAY OF IRON Lab 69.00
300 83550 IRON, BINDING CAPACITY Lab 92.00
300 83550 IRON + TOTAL IRON – BINDING CAPACITY Lab 92.00
300 83586 17 KETOSTEROIDS, TOT Lab 197.00
300 83605 LACTIC ACID Lab 102.00
300 83615 LDH Lab 273.00
300 83615 LACTATE DEHYDROG-BODY LDH Lab 273.00
300 83625 LDH ISOENZYMES Lab 139.00
300 83630 LACTOFERRIN, FECAL; QUALITATIVE Lab 171.00
300 83655 LEAD Lab 191.00
300 83670 LEUCINE AMINO PEPTIDASE Lab 116.00
300 83690 LIPASE Lab 83.00
300 83695 LIPOPROTEIN A Lab 112.00
300 83698 LIPOPROTEIN PLACC2 Lab 164.00
300 83700 Lp(a) CHOLESTEROL (PANEL ONLY) Lab 51.00
300 83701 VAP CHOLESTEROL Lab 213.00
300 83704 LIPOPROTEIN BLD QUAN NUMB SUBCLASSES Lab 70.00
300 83715 LIPOPROTEIN, BLOOD; ELECTROPHORETIC SEPA Lab 132.00
300 83716 LIPOPROTEINS PHNTYP. Lab 125.00
300 83718 HDL Lab 84.00
300 83718 HDL CHOLESTEROL (PANEL ONLY) Lab 37.00
300 83721 LIPOPROTEIN; DIRECT Lab 121.00
300 83735 MAGNESIUM Lab 120.00
300 83735 LACTOSE, URINE; QUALITATIVE Lab 156.00
300 83735 ASSAY OF MAGNESIUM Lab 156.00
300 83735 MAGNESIUM, U (PANEL ONLY) Lab 36.00
300 83785 MANGAnesthesiaE Lab 156.00
300 83785 MANGAnesthesiaE Lab 156.00
300 83789 IODINE, RANDOM URINE Lab 165.00
300 83789 WELLBUTRIN QUANT EACH SPECIMEN Lab 264.00
300 83789 TPMT ACTIVITY Lab 264.00
300 83789 Hb VARIANT BY MASS SPEC Lab 580.00
300 83789 PSILOCYBIN URINE Lab 264.00
300 83789 IODINE, BLOOD Lab 264.00
300 83789 10-HYDROXYCARBAZEPINE Lab 264.00
300 83825 MERCURY, QUANTITATIVE Lab 228.00
300 83835 METANEPHRINES, TOTAL Lab 236.00
300 83835 24 HR. URINE METANEPHRINES Lab 236.00
300 83866 MUCOPOLYSACCHARIDES,ACID Lab 134.00
300 83873 MYELIN BASIC PROTEIN, CSF Lab 269.00
300 83874 MYOGLOBIN Lab 164.00
300 83874 MYOGLOBIN, SERUM Lab 128.00
300 83880 NATRIURETIC PEPTIDE Lab 241.00
300 83880 BNP NATRIURETIC PEPTIDE Lab 241.00
300 83883 NEPHELOMETRY, EACH Lab 293.00
300 83883 ASSAY OF NEPHELOMETRY EA (PANEL ONLY) Lab 92.00
300 83883 DRVVT Lab 293.00
300 83883 C1 ESTERASE (C1ES) INHIBITOR ANTIGEN Lab 101.00
300 83885 NICKEL Lab 180.00
300 83890 MOLECULAR DX;ISOL-EXTRAC Lab 112.00
300 83890 MOLECULAR ISOLAL/EXTRACT Lab 112.00
300 83890 HEMACROMATOSIS DETECTION Lab 112.00
300 83892 MOLECULAR ENZYMATIC DIG Lab 73.00
300 83893 MOLECULARE DIAG DOT/SLOT BLOT Lab 142.00
300 83893 MOLECULAR DX: SET/SLOT BLOT PRODUCTION Lab 142.00
300 83894 MOLECULAR DX;SEPERAT/GEL Lab 102.00
300 83898 MOLECULAR DX;AMPLIFICATI Lab 58.00
300 83900 AMPLIFICATION OF NUCLEIC ACID; FIRST TWO Lab 320.00
300 83901 MOLECULAR DIAGNOSTIC AMP OF NUCLEIC ACID Lab 254.00
300 83901 MOLECULAR DX:AMPLIFIED NUCLEIC ACID Lab 254.00
300 83902 MOLECULAR DX;RVSE TRANSC Lab 125.00
300 83904 MOLECULAR DX; MUTATION ID Lab 292.00
300 83907 MOLEC DX LYSIS Lab 58.00
300 83908 AMPLIFCTN, SIGNAL, EA NUCLEIC ACID SEQ Lab 62.00
300 83908 AMPLFCTN, SIGNAL, EA NUCLEIC ACID SEQUEN Lab 62.00
300 83909 SEPERATE & IDENTIFY BY HIGH RESOLUTION Lab 58.00
300 83912 MOLECULAR DX:INTERPRETATION AND REPORT Lab 136.00
300 83914 MUTATION ID BY ENZY LIG OR PRIME EXT SNG Lab 277.00
300 83914 MUTATION ID BY ENZYMATIC, SINGLE SEQ, EA Lab 277.00
300 83915 NUCLEOTIDASE 5 Lab 325.00
300 83916 OLIGOCLONAL IMMUNOGLOBUL Lab 241.00
300 83916 OLIGOCLONAL IGG Lab 241.00
300 83918 ORGANIC ACID URINE QUANT Lab 512.00
300 83918 ORGANIC ACID, PLASMA Lab 512.00
300 83919 ORGANIC ACIDS; QUALITATIVE EACH SPEC Lab 160.00
300 83921 ORGANIC ACID, SINGLE, QUANITIVE Lab 283.00
300 83921 METHYLMALONIC ACID (MMA) QUANT, PLASMA Lab 103.00
300 83925 OXYDODONE & METABOLITE SERUM Lab 180.00
300 83925 OPIATES SERUM Lab 180.00
300 83925 FENTANYL & NORFENTANYL SERUM Lab 180.00
300 83930 OSMOLALITY SERUM Lab 95.00
300 83935 OSMOLALITY; URINE Lab 102.00
300 83935 OSMOLALITY, U (PANEL ONLY) Lab 36.00
300 83937 OSTEOCALCIN Lab 285.00
300 83945 URINE OXYLATE Lab 107.00
300 83945 OXALATE, U (PANEL ONLY) Lab 65.00
300 83951 ONCOPROTEIN; DES-GAMMA-CARBOXY-PIVKA II Lab 625.00
300 83951 DES-GAMMA-CARBOXY PROTHROMBIN (PANEL) Lab 676.00
300 83970 PARATHYROID HORMONE Lab 313.00
300 83986 ph, URINE (PANEL ONLY) Lab 20.00
300 83986 PH, Body Fluid Lab 134.00
300 83986 pH, BODY FLUID Lab 134.00
300 83992 DRUG SCREENING PHENCYCLIDINE Lab 156.00
300 83992 TEXT CONFIRMATION – PHENCYCLIDINE Lab 2.00
300 83992 PHENCYCLIDINE CONF, URINE Lab 156.00
300 83992 PCP CONFIRMATION Lab 819.00
300 83993 CALPROTECTIN FECAL Lab 801.00
300 84022 PHENOTHIAZINE Lab 241.00
300 84030 PKU Lab 264.00
300 84066 ACID PHOSPHATASE Lab 91.00
300 84075 ALKALINE PHOSPHATASE Lab 49.00
300 84080 ALK PHOS ISOENZYMES Lab 165.00
300 84100 PHOSPHORUS Lab 59.00
300 84105 URINE PHOSPHOUS Lab 57.00
300 84105 PHOSPHORUS, U (PANEL ONLY) Lab 28.00
300 84106 PORPHOBILINOGEN, QUALITY Lab 114.00
300 84110 PORPHOBILINOGEN, URINE; QUANTITAVE Lab 161.00
300 84110 PORPHOBILINOGEN, RANDOM URINE Lab 161.00
300 84112 ANALYSIS OF AMNIOTIC FLUID IN VAG SCRTNS Lab 191.00
300 84120 PORPHYRINS, FRACT. Lab 250.00
300 84120 UROPORPHYRINS, QUANITY Lab 250.00
300 84132 POTASSIUM, SERUM Lab 73.00
300 84133 POTASSIUM, URINE Lab 73.00
300 84133 POTASSIUM, U (PANEL ONLY) Lab 23.00
300 84134 PREALBUMIN Lab 107.00
300 84135 PREGNANDIOL Lab 203.00
300 84138 PREGNANETRIOL Lab 203.00
300 84140 PREGNENOLONE Lab 234.00
300 84143 17 HYDROXYPREGNENOLONE Lab 366.00
300 84144 PROGESTERONE LEVEL Lab 167.00
300 84145 PROCALCITONIN (PCT) Lab 388.00
300 84146 PROLACTIN Lab 176.00
300 84150 2,3-DINOR II BETA-PROSTAGLANDIN f2 ALPHA Lab 276.00
300 84152 PSA; COMPLEXED Lab 216.00
300 84153 PSA; TOTAL Lab 194.00
300 84154 PSA; FREE Lab 194.00
300 84154 FREE PSA Lab 194.00
300 84155 PROTEIN TOTAL SERUM Lab 146.00
300 84155 PRTN XCPT RFRCTMTRY SER PLSM/WHL (PANEL) Lab 277.00
300 84156 PROTEIN, URINE Lab 69.00
300 84156 ELECTROPHORESIS, PROTEIN, 24 HR URINE Lab 69.00
300 84157 CSF PROTEIN Lab 170.00
300 84157 PROTEIN, TOTAL Bf Lab 170.00
300 84163 PAPP-A Lab 68.00
300 84165 BENCE JONES PRO ELECT Lab 181.00
300 84165 BETA LIPOPROTEIN ELECT Lab 181.00
300 84165 PROTEIN ELECTRO. S. Lab 181.00
300 84165 PROTEIN ELECTRO. U. Lab 181.00
300 84165 PRTN ELECT FRACT JQNT J SER (PANEL ONLY) Lab 579.00
300 84166 ELECTROPHORESIS, PROTEIN, BODY FLUID Lab 129.00
300 84166 ELECTROPHORESIS, PROTEIN, 24 HR URINE Lab 68.00
300 84182 PARANEOPLASTIC AUTOAB WB Lab 273.00
300 84182 CRMP-5-IG6 WESTERN BLOT Lab 266.00
300 84182 AMPHIPHYSON WESTERN BLOT Lab 628.00
300 84182 RECOMBX MATA AUTOANTIBODY TEST Lab 1,573.00
300 84202 PROTOPORPHYRIN Lab 93.00
300 84207 VITAMIN B-6 Lab 171.00
300 84210 PYRUVATE Lab 227.00
300 84235 TSH RCPTR ASSAY ENDC OTH/THN STRGN/PRGST Lab 300.00
300 84238 IGE-RAB (RECEPTOR AB) Lab 452.00
300 84238 ACETYCHOLINE RECEPTOR Lab 452.00
300 84238 SOLUABLE TRANSFERRIN RECEPTOR Lab 452.00
300 84244 RENIN Lab 192.00
300 84252 RIBOFLAVIN (VIT B2) Lab 120.00
300 84255 SELENIUM Lab 193.00
300 84260 SEROTONIN Lab 277.00
300 84270 SEX HORMONE BINDING GLOB Lab 185.00
300 84295 SODIUM, SERUM Lab 42.00
300 84300 SODIUM, URINE Lab 68.00
300 84300 SODIUM, U (PANEL ONLY) Lab 26.00
300 84302 STOOL SODIUM Lab 73.00
300 84305 SOMATOMEDIN, IGF-I Lab 228.00
300 84307 SOMATASTATIN Lab 222.00
300 84311 SPECTROPHOTOMETRY ANALYTE Lab 716.00
300 84311 PORPHYRINS, TOTAL PLASMA Lab 153.00
300 84311 STOOL POTASIUM Lab 716.00
300 84311 CHOLESTEROL. BF Lab 716.00
300 84315 SPECIFIC GRAVITY;FLUID Lab 109.00
300 84315 PORPHOBILINOGEN;QUANTITY Lab 109.00
300 84376 SUGARS SINGLE QUALITATIVE, EA SPECIMEN Lab 134.00
300 84392 SULFATE, URINE Lab 49.00
300 84392 SULFATE, U (PANEL ONLY) Lab 25.00
300 84402 TESTOSTERONE, FREE Lab 185.00
300 84402 TESTOSTERONE, FREE Lab 73.00
300 84403 TESTOSTERONE, TOTAL Lab 197.00
300 84403 TESTOSTERONE, TOTAL Lab 74.00
300 84425 VITAMINE B-THIAMINE Lab 249.00
300 84432 THYROGLOBULIN Lab 181.00
300 84432 THYROGLOBULM, TUMOR MARKER Lab 181.00
300 84436 THYROID T-4 Lab 69.00
300 84439 FREE T-4 Lab 116.00
300 84442 THYROXIN BINDING GLOB. Lab 220.00
300 84443 THYROID STIMUL, HORMONE Lab 145.00
300 84443 TSH-SENSITIVE, SERUM Lab 145.00
300 84445 THYROID STIMULATING IMM Lab 546.00
300 84446 TOCOPHEROL ALPHA (VITAMIN E) Lab 178.00
300 84446 ASSAY OF TOCOPHEROL VITMN E (PANEL ONLY) Lab 104.00
300 84450 SGOT Lab 55.00
300 84460 SGPT Lab 55.00
300 84466 TRANSFERRIN Lab 132.00
300 84478 ASSAY OF TRIGLYCERIDES Lab 13.00
300 84478 TRIGLYCERIDES Lab 716.00
300 84478 TRIGLYCERIDES Lab 716.00
300 84478 TRIGLYCERIDES Lab 716.00
300 84478 TRIGLYCERIDES (PANEL ONLY) Lab 26.00
300 84479 T3 Lab 83.00
300 84480 TRIIODOTHYRONINE T3;TOTA Lab 132.00
300 84481 TRIIDOTHYRONINE T3 FREE Lab 234.00
300 84482 T3 REVERSE Lab 97.00
300 84484 TROPONIN Lab 166.00
300 84484 TROPONIN QUANTITATIVE Lab 202.00
300 84488 TRYPSIN, QUALITY Lab 70.00
300 84510 TYROSINE Lab 102.00
300 84515 PAI PLASMINOGEN ACT INHIB AG Lab 98.00
300 84520 BUN Lab 59.00
300 84540 UREA NITROGEN, U (PANEL ONLY) Lab 25.00
300 84550 URIC ACID Lab 59.00
300 84560 URINE URIC ACID Lab 68.00
300 84560 URIC ACID/24HR URINE Lab 68.00
300 84560 URIC ACID, U (PANEL ONLY) Lab 25.00
300 84577 UROBILINOGEN, FECES Lab 82.00
300 84578 UROBILINOGEN, URINE Lab 91.00
300 84585 VMA-VANILLYMANDELIC ACID Lab 156.00
300 84586 VASOACTIVE INTESTINAL PEPTIDE Lab 322.00
300 84588 VASOPRESSIN Lab 270.00
300 84590 VITAMIN A Lab 102.00
300 84590 ASSAY OF VITAMIN A (PANEL ONLY) Lab 85.00
300 84591 NIACIN (B-3) Lab 277.00
300 84597 VITAMIN K Lab 391.00
300 84600 METHANOL Lab 160.00
300 84600 VOLATILES TESTING Lab 160.00
300 84630 ZINC Lab 118.00
300 84681 C-PEPTIDE Lab 189.00
300 84702 GONADOTROPIN Lab 180.00
300 84702 QUANTITATIVE HCG Lab 180.00
300 84702 BETA-HUMAN CHORIONIC GONADOT QUANT, SRM Lab 79.00
300 84703 PREGNANCY TEST Lab 80.00
300 84999 UNLISTED CHEMISTRY PROC Lab 125.00
300 84999 UNLISTED CHEM PROCEDURE (PANEL ONLY) Lab 16.00
300 84999 TESTOSTERONE, BIOAVAILABLE Lab 2.00
300 85002 BLEEDING TIME Lab 132.00
300 85007 DIFFERENTIAL Lab 49.00
300 85008 BLOOD SMEAR EXAM (NOT DIFF COUNT) TECH Lab 27.00
300 85014 HEMATOCRIT Lab 47.00
300 85018 HEMOGLOBIN Lab 47.00
300 85025 CBC W/DIFF Lab 83.00
300 85027 CBC Lab 69.00
300 85041 RED BLOOD COUNT RBCC Lab 42.00
300 85044 RETICULOCYTE COUNT Lab 105.00
300 85045 BLOOD COUNT RETICULOCYTE AUTOMATED Lab 86.00
300 85048 WBC Lab 39.00
300 85049 PLATELET COUNT Lab 50.00
300 85060 BLOOD, SMEAR TO PATH. Lab 79.00
305 85095 BONE MARROW ASPIRATION Lab 269.00
300 85102 BONE MARROW BIOPSY Lab 139.00
300 85170 CLOT RETRACTION Lab 39.00
300 85210 CLOTTING; FACTOR II PROTHROMBIN, SPECIFI Lab 185.00
300 85220 FACTOR V Lab 293.00
300 85230 CLOTTING-FACTOR VII Lab 185.00
300 85240 FACTOR VIII Lab 408.00
300 85240 VON WILLEBRAND PROFILE Lab 408.00
300 85245 RISTOCETIN CO-FACTOR Lab 178.00
300 85246 CLOTTING FACTOR VIII; VW-RISTOCETIN Lab 452.00
300 85246 CLOTTING FACTOR VIII; VW-ANTIGEN Lab 452.00
300 85246 VON WILLEBRAND PROFILE Lab 452.00
300 85247 VON WILLEBRAND FACTOR Lab 216.00
300 85250 FACTOR IX Lab 286.00
300 85260 FACTOR X Lab 270.00
300 85270 FACTOR XI Lab 278.00
300 85280 CLOTTING-FACTOR XII Lab 270.00
300 85300 CLOTTING INHINBITOR-ABTITHROMBIN III ACT Lab 217.00
300 85301 ANTI-THROMBIN III Lab 277.00
300 85301 ANTITHROMBIN ANTIGEN Lab 277.00
300 85302 PROTEIN C AG Lab 204.00
300 85303 FACTOR-PROTIEN C Lab 282.00
300 85305 CLOTTING INHIBITOR, PROTIEN S, TOTAL Lab 277.00
300 85306 FACTOR-PROTIEN S Lab 368.00
300 85307 ACTIVATED PROTEIN C RESISTANCE ASSAY Lab 235.00
300 85335 BETHESDA UNITS Lab 612.00
300 85335 COAG FACTOR VIII INHIB Lab 612.00
300 85362 FIBRIN DGRADJ SPLT PRODX AGG SLIDE SQ Lab 99.00
300 85366 SOLUBLE FIBRIN MCNOMER Lab 142.00
300 85379 FDP Lab 135.00
300 85384 FIBRINOGEN Lab 125.00
300 85385 FIBRINOGEN; ANTIGEN Lab 128.00
300 85390 SPECIAL COAGULATION INTERPRETATION Lab 140.00
300 85397 VON WILLEBRAND PROFILE Lab 554.00
300 85397 VON WILLIBRAND FACTOR ACTIVITY Lab 554.00
300 85415 PLASMINOGEN ACTIVATOR. Ag Lab 504.00
300 85460 KLEIHAUER BETKE Lab 97.00
300 85461 FETAL HGB SCREEN Lab 107.00
300 85520 HEPARIN ASSAY Lab 311.00
300 85540 LEUKOCYTE ALKALINE PHOS Lab 172.00
300 85549 MURAMIDASE Lab 216.00
300 85549 LYSOZYME Lab 216.00
300 85555 OSTMOTIC FRAGILITY, RBC; UNINCUBATED Lab 149.00
300 85557 OSTMOTIC FRAGILITY, RBC; INCUBATED Lab 205.00
300 85597 PLATELET NEUTRALIZATION Lab 223.00
300 85598 STACLOT LA Lab 417.00
300 85610 PROTHROMBIN TIME Lab 51.00
300 85611 PRO TIME; SUB, PLASMA FRACTURE, EACH Lab 70.00
300 85613 LUPUS ANTICOAGULANT Lab 365.00
300 85613 DIL RUSSELLS VIPER VENOM Lab 365.00
300 85613 DRVVT MIX Lab 365.00
300 85613 DRVVT CONFIRMATION Lab 365.00
300 85613 DRVVT MIX Lab 365.00
300 85613 DRVVT MIX Lab 365.00
300 85635 REPTLASE Lab 261.00
300 85651 SED RATE Lab 54.00
300 85660 SICKLE CELL SCREEN Lab 91.00
300 85670 THROMBIN TIME Lab 96.00
300 85730 PTT-PARTIAL THROMBO. Lab 83.00
300 85732 THROMB TIME, PTT; PLASMA OR WHOLE BLOOD Lab 114.00
300 85810 VISCOSITY, SERUM Lab 138.00
300 85999 URINE EOSINOPHIL Lab 87.00
300 86000 FEBRILE AGGLUTINS Lab 116.00
300 86000 FRANCISELLA TULARENSIS Ab, DA Lab 116.00
300 86001 STACHYBOTRYS CHARTANUM Lab 37.00
300 86001 FISH & SHELLFISH PANEL Lab 784.00
300 86003 ALLERGEN SPECIFIC IGE (PER ALLERGEN) Lab 101.00
300 86003 MOUSE EPITHELIUM, IgE Lab 36.00
300 86003 LOBSTER IgE Lab 36.00
300 86003 SUNFLOWER SEED. IgE Lab 36.00
300 86003 ALLERGEN SPECIFIC (PEANUT ALLERGY) Lab 101.00
300 86003 GREY ALDER, IgE Lab 36.00
300 86003 ALTERNARIA TENUIS, IgE Lab 36.00
300 86003 ASPERGILLUS FUMIGATUS, IgE Lab 36.00
300 86003 BERMUDA GRASS, IgE Lab 36.00
300 86003 BOX ELD/MAPLE, S, 1gE Lab 36.00
300 86003 CAT EPITHELIUM, 1gE Lab 36.00
300 86003 MOUNTAIN CEDAR, IgE Lab 36.00
300 86003 CLADOSPORIUM, 1gE Lab 36.00
300 86003 COCKROACH, 1gE Lab 36.00
300 86003 COTTONWOOD, 1gE Lab 36.00
300 86003 HOUSE DUST MITES/D.F.,1gE Lab 36.00
300 86003 DOG DANDER, IgE Lab 36.00
300 86003 HOUSE DUST MITES/DP, IgE Lab 36.00
300 86003 ELM, IgE Lab 36.00
300 86003 MUGWORT, IgE Lab 36.00
300 86003 MULBERRY, IgE Lab 36.00
300 86003 OAK, IgE Lab 36.00
300 86003 OLIVE-TREE, IgE Lab 36.00
300 86003 PENICILLIUM, IgE Lab 36.00
300 86003 ROUGH PIGWEED, IgE Lab 36.00
300 86003 RUSSIAN THISTLE, IgE Lab 36.00
300 86003 RED SORREL, IgE Lab 36.00
300 86003 SHORT RAGWEED, IgE Lab 36.00
300 86003 TIMOTHY GRASS, IgE Lab 36.00
300 86003 ANNATTO SEED (BIXA ORELLANA) IgE Lab 178.00
300 86003 TUNA IgE Lab 36.00
300 86003 SCALLOPS IgE Lab 36.00
300 86003 AVOCADO. IgE Lab 36.00
300 86003 COD FISH IgE Lab 36.00
300 86003 CASHEW NUT. IgE Lab 36.00
300 86003 MILK, IgE Lab 36.00
300 86003 MELONS. IgE Lab 36.00
300 86003 TILAPIA. IgE Lab 178.00
300 86003 CRAB IgE Lab 36.00
300 86003 SESAME SEED. IgE Lab 36.00
300 86003 MUCOR, IgE Lab 36.00
300 86003 EGG WHITE, IgE Lab 36.00
300 86003 EGG YOLK, IgE Lab 36.00
300 86003 PEANUT IgE Lab 36.00
300 86003 SHRIMP IgE Lab 36.00
300 86003 FOOD-NUT PANEL #1 Lab 104.00
300 86003 MOLD PANEL Lab 101.00
300 86003 FOOD-NUT PANEL #2 Lab 104.00
300 86003 EGG WHOLE. IgE Lab 132.00
300 86005 ALLERGEN QUALATIVE MULTI Lab 156.00
300 86021 ANTIBODY ID;LEUKOCYTE AN Lab 298.00
300 86021 ANCA SCREEN Lab 298.00
300 86021 C-ANCA Lab 298.00
300 86021 P-ANCA Lab 298.00
300 86022 HEPARIN INDUCED PLT AB Lab 285.00
300 86022 PLATELET ANTIBODY SCREEN, SERUM Lab 108.00
300 86023 PLATELET AB DIRECT IMMGLBLN ASSAY Lab 189.00
300 86023 CELL-BOUND PLATELET AUTOANTI SCRN, BLOOD Lab 189.00
300 86038 ANTI-NUCLEAR ANTIBODY Lab 154.00
300 86038 AP-ASO Lab 154.00
300 86038 ANA Lab 154.00
300 86038 ANTINUCLEAR ANTIBODIES (ANA) Lab 154.00
300 86038 CONNECTIVE TISSUE DISEASE CASCADE Lab 154.00
300 86038 CENTROMERE AB Lab 154.00
300 86060 ASO TITER Lab 90.00
300 86060 ANTISTREPTOLYSIN O TITER (PANEL ONLY) Lab 22.00
300 86140 C-REACTIVE PROTEIN Lab 109.00
300 86140 CRP Lab 109.00
300 86141 C-REACTIVE PROTEIN, H.S. Lab 124.00
300 86146 BETA 2 GLYCOPROTEIN Lab 254.00
300 86147 CardiopulmonaryIOLIPIN AB; (EACH) Lab 218.00
300 86152 CTC CELL SEARCH Lab 529.00
300 86153 CIRCULATING TUMOR CELLS Lab 266.00
300 86157 COLD AGGLUTININS Lab 87.00
300 86157 COLD AGGLUTININ TITER, SERUM Lab 104.00
300 86160 COMPLEMENT;ANTIGEN, EA Lab 164.00
300 86161 COMPLEMENT;FUNCTIONAL,EA Lab 215.00
300 86162 COMPLEMENT;TOTAL HEMOLYT Lab 225.00
300 86171 COMPLEMENT, SERUM Lab 149.00
300 86200 CYCLIC CITRULLINATED PEPTIDE (CCP); ANTI Lab 172.00
300 86200 CONNECTIVE TISSUE DISEASE CASCADE Lab 172.00
300 86215 DEOXYRIBONUCLEASE ANTIBODY Lab 178.00
300 86215 DEOXYRIBONUCLEASE ANTIBODY (PANEL ONLY) Lab 39.00
300 86225 DEOXYRIBUNUCLEAR ANTIBOD Lab 153.00
300 86226 DEOXYRIBUNUC ANTI SINGLE Lab 189.00
300 86235 EXTRACTABLE NUCLEAR ANTI Lab 134.00
300 86235 PM-SCL AB Lab 134.00
300 86235 Sc1 70 Ab. IgG Lab 134.00
300 86235 Ab TO EXTRACTABLE NUCLEAR Ag EVAL Lab 134.00
300 86235 JO 1 ANTIBODIES, IgG Lab 134.00
300 86235 JO-1 AB Lab 134.00
300 86255 LGI1-IGG CBA Lab 683.00
300 86255 GABA-B-R AB CBA Lab 1,182.00
300 86255 FLUOR NONINFECT AB, EACH Lab 222.00
300 86255 AMPA-R Ab CBA, SERUM Lab 250.00
300 86255 GABA-B-R Ab CBA, CBA, CSF Lab 250.00
300 86255 AMPA-R AB CBA Lab 1,182.00
300 86255 GABA-B-R Ab CBA, SERUM Lab 250.00
300 86255 DS DNA Ab BY CRITHDIA IFA, IgG Lab 531.00
300 86255 RETICULIN igG Lab 222.00
300 86255 ENDOMYSIAL ANTIBODY Lab 222.00
300 86255 ADRENAL ANTIBODY SCREEN Lab 222.00
300 86255 PURKINJE CELL CYTOPLAS AB EXP ONLY Lab 63.00
300 86255 LGI1-IGG CBA, S Lab 250.00
300 86255 NMDA-R Ab CBA, SERUM Lab 250.00
300 86255 PURKINJE CELL CYTO, Ab TYPE 1 Lab 250.00
300 86255 NMDA-R Ab CBA, CSF Lab 250.00
300 86255 FLUORESCENT NON AGT ANTB SCREEN (PANEL) Lab 139.00
300 86255 CRMP 5 IGG S EXP ONLY Lab 63.00
300 86255 ANTINEURONAL AB TYPE 3 EXP ONLY Lab 63.00
300 86255 PURKINJE CELL CYTO AB TYPE 2 EXP ONLY Lab 63.00
300 86255 ANTI-NEURONAL Ab, TYPE 3 Lab 250.00
300 86255 ANTI-NEURONAL NUCLEAR Ab, TYPE 2 Lab 250.00
300 86255 AMPHIPHYSIN Ab, CSF Lab 250.00
300 86255 ANTI-NEURONAL NUCLEAR Ab, TYPE 1 Lab 250.00
300 86255 NMDA-R AB CBA Lab 1,182.00
300 86255 LGI1-IGG CBA, CSF Lab 250.00
300 86255 AMPA-R Ab CBA, CSF Lab 250.00
300 86255 CASPR2-IGG CBA, S Lab 250.00
300 86255 ANTI NEURONAL NUC AB TYPE 1 EXP ONLY Lab 63.00
300 86255 PURKINJE CELL Ab TYPE TR Lab 250.00
300 86255 CASPR2IGG CBA Lab 657.00
300 86255 CRMP-5-IgG, CSF Lab 250.00
300 86255 ANTI-GLIAL NUCLEAR Ab, TYPE 1 Lab 250.00
300 86255 ANTI NEURONAL NUCLEAR AB TYPE 2 EXP ONLY Lab 63.00
300 86255 PURKINJE CELL CYTO AB TYPE 1 EXP ONLY Lab 63.00
300 86255 NMO AQ P4 FACS Lab 431.00
300 86255 AMPHYIPHSIN Ab, S Lab 250.00
300 86255 ANTI-GLIAL NUCLEAR Ab, TYPE 1 Lab 250.00
300 86255 PURKINJE CELL CYTOPLASMIC AB TYPE 2 Lab 250.00
300 86255 PURKINJE CELL CYTOPLASMC Ab TYPE TR Lab 250.00
300 86255 CASPR2-IGG CBA, CSF Lab 250.00
300 86255 AMPHYIPHYSIN AB S EXP ONLY Lab 63.00
300 86255 ANTIGLIAL NUCLEAR AB TYPE 1 EXP ONLY Lab 63.00
300 86256 AMPAR AB IF TITIER ASSAY Lab 237.00
300 86256 ANTIMITOCHONDRIAL Lab 189.00
300 86256 GA BA-B-R ABIFTITERASSAY Lab 237.00
300 86256 FLOUR NONINFECT TITER-EA Lab 531.00
300 86256 NMO/AQP4 FACS TITER Lab 198.00
300 86256 NDMA-R AH IF TITER ASSAY Lab 237.00
300 86300 IMMUNOASSAY TUMOR Lab 201.00
300 86301 IMMUNOASSAY TUMOR ANTIGE Lab 227.00
300 86304 IMMUNOASSAY TUMOR ANTIGE Lab 419.00
300 86305 HUMAN EPIDIDYMIS-PROTEIN 4 (HE4) Lab 419.00
300 86308 HETEROPHILE ANTIBODY Lab 91.00
300 86308 MONO TEST Lab 91.00
300 86316 IMMUNOASSAY TUMOR ANTIGE Lab 246.00
300 86317 IMMUNO INFECTIOUS AGNT ANTIBODY UNSPCFD Lab 138.00
300 86317 TETANUS TOXOID Igb Ab (PANEL ONLY) Lab 118.00
300 86317 DIPTHENA TOXOID Igb Ab (PANEL ONLY) Lab 118.00
300 86317 STREP PNEUM IgG ANTIBODIES 23 SEROTYPES Lab 214.00
300 86318 IMMUNOASSAY INFECT AGENT Lab 70.00
300 86320 IMMUNOELECTROPHOR SERUM Lab 132.00
300 86325 IMMUNOELECTROPHOR CSF Lab 138.00
300 86331 IMMUNODIFFUS GEL QUAL-EA Lab 171.00
300 86332 IMMUNE COMPLEX ASSAY Lab 246.00
300 86334 IMMUNOFIXATION-ELECTROPH Lab 275.00
300 86335 IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS Lab 239.00
300 86335 BETA-2 TRANSFERRIN DETECTION OF SPINAL F Lab 293.00
300 86336 INHIBIN A Lab 246.00
300 86337 INSULIN ANTIBODIES Lab 227.00
300 86340 INTRINSIC FACTOR ANTIBODIES Lab 230.00
300 86341 ISLET CELL ANTIBODY Lab 238.00
300 86341 GAD 65 ANTIBODY ASSAY Lab 173.00
300 86341 GAD65 Ab ASSAY, CSF Lab 450.00
300 86341 GAD65 ANTIBODY ASSAY Lab 415.00
300 86353 LYMPHOCYTE TRANSFORMATIO Lab 389.00
300 86355 B CELLS; TOTAL COUNT Lab 390.00
300 86355 B CELLS TOTAL COUNT Lab 65.00
300 86356 CD20 TOTAL COUNT Lab 599.00
300 86357 NATURAL KILLER CELLS TOTAL COUNT Lab 65.00
300 86359 T CELLS; TOTAL COUNT Lab 244.00
300 86359 T CELLS TOTAL COUNT Lab 65.00
300 86359 CD4 T-CELL COUNT Lab 244.00
300 86360 T CELL ABSOLUTE CD4&CD5 Lab 480.00
300 86360 CD4 T-CELL COUNT Lab 120.00
300 86360 T CELLS ABSLT CD4CD8 CT RTO (PANEL ONLY) Lab 81.00
300 86361 ABSOLUTE CD4 COUNT (LYMPHOCYTE SUB 5) Lab 271.00
300 86376 MICROSOMAL ANTIBODY Lab 196.00
300 86376 THYROID ANTIBODIES Lab 76.00
300 86376 MICROSOMAL ANTIBODIES; LIVER-KIDNEY Lab 196.00
300 86382 NEUTRALIZATION TST POLIOVIRUS Ab, IgG Lab 266.00
300 86382 RABIES TITER RESPONSE Lab 346.00
300 86403 STREPTOZYME WITH REFLEX Lab 107.00
300 86430 RA LATEX FACTOR Lab 254.00
300 86431 RA Lab 52.00
300 86480 QUANTIFERON Lab 335.00
300 86480 QUANTI-FERON-TB GOLD + BLOOD Lab 315.00
300 86510 HISTOPLASMA AGGLUT. Lab 138.00
300 86580 PPD SKIN TEST Lab 91.00
300 86592 RPR Lab 70.00
300 86593 FTA-ABS Lab 93.00
300 86606 ASPERGILLUS PREOP. ID Lab 315.00
300 86606 ASPERGILLUS AB Lab 315.00
300 86609 LISTERIA ANTIBODY SERUM Lab 160.00
300 86611 BARTONELLA AB PANEL IgGtM EXP Lab 43.00
300 86612 BLASTOMYCOSIS TITER Lab 104.00
300 86615 BORDETELLA Lab 205.00
300 86617 ANTIBODY BORRELIA (LYME DZ) CONFIRM TEST Lab 234.00
300 86618 LYME TITRE Lab 181.00
300 86622 BRUCELLOSIS TITER Lab 73.00
300 86628 ANTIBODY CANDIDA Lab 142.00
300 86631 ANTIBODY, CHLAMYDIA Lab 112.00
300 86631 CHLAMYDIA SEROLOGY EXP Lab 69.00
300 86631 CHLAMYDIA SEROLOGY IgG EXP Lab 34.00
300 86632 CHLAMYDIC IGM Lab 179.00
300 86632 CHLAMYDIA SEROLOGY IgM EXP Lab 34.00
300 86632 CHLAMYDIA SEROLOGY EXP Lab 74.00
300 86635 COCCIDIOMYCOSIS ANTI. Lab 132.00
300 86638 Q FERER IgM PHASE I TITER Lab 166.00
300 86638 COXIELLA BURNETII (Q FEVER) Lab 166.00
300 86638 Q FEVER IgG PHASE II TITER Lab 166.00
300 86638 Q FERER IgG PHASE 1 TITER Lab 166.00
300 86638 Q FEVER IgM PHASE II TITER Lab 166.00
300 86644 CMV Lab 222.00
300 86644 CMV NEG BLOOD Lab 222.00
300 86645 ANTIBODY; CYTOMEGALOVIRUS Lab 227.00
300 86648 DIPTHERIA Ab, 1gG Lab 188.00
300 86658 COSAKIE TITER Lab 120.00
300 86663 EB VIRUS AB, EARLY ANTIG Lab 103.00
300 86664 EB VIRUS AB, NUCLR ANTIG Lab 128.00
300 86665 EB VIRUS AB. IGG FLRSCNT Lab 166.00
300 86665 EB VIRUS AB, IGM FLRSCNT Lab 166.00
300 86666 EHRLICHIA CHAFFEENSIS, 1gG Lab 61.00
300 86666 ANAPLASMA PHAGOCYT Ab, IgG Lab 61.00
300 86671 ANTIB FUNGUS NOT ELSEWHERE SPEC (PANEL) Lab 142.00
300 86671 SACCHAROMYCES CER Ab IgG Lab 142.00
300 86671 SACCHAROMYCES CEREVISIAE ANTIBODY, IgA Lab 142.00
300 86677 H. PYLORIE Lab 198.00
300 86682 ECHIMOCOCCOSUS Lab 132.00
300 86689 HTLV/HIV Ab CONFIRMATION Lab 1,083.00
300 86689 HIV-1 Ab CONFIRM BY WESTERN BLOT Lab 244.00
300 86689 HIV-2Ab CONFIRMATION Lab 244.00
300 86694 HERPES SIMPLEX Lab 116.00
300 86694 HSV TYPES 1 AND 2 Ab Lab 38.00
300 86695 ANTIBODY; HERPES SIMP 1 Lab 132.00
300 86695 HSV TYPES 1 AND 2 Ab Lab 38.00
300 86696 ANTIBODY; HERPES SIMP 2 Lab 144.00
300 86696 HSV TYPES 1 AND 2 Ab Lab 38.00
300 86698 ANTIBODY HISTOPLASMA Lab 126.00
300 86701 Lab 132.00
300 86701 ANTIBODY HIV-1 Lab 360.00
300 86701 HIV-1/2 Ab DIFFERENTIATION Lab 360.00
300 86702 HIV-1/2 Ab DIFFERENTIATION Lab 360.00
300 86703 HIV 1 AND HIV 2 Lab 150.00
300 86704 HEPATITIS B CORE ANTIBOD Lab 142.00
300 86705 HEP B CORE ANTI HBCAB IGM ANTI EXP Lab 111.00
300 86705 HEP B CORE ANTIBODY HBCAB IGM ANTIBODY Lab 135.00
300 86706 EMS HEP B, HCV, HIV TESTING Lab 132.00
300 86706 HEPATITIS B SUR AB Lab 132.00
300 86707 HEPATITIS BE ANTIBODY (HBsAb) Lab 180.00
300 86708 HEP “A” ANTIBODY (HAAb) TOTAL Lab 164.00
300 86708 HEP A IgG ANTIBODY SERUM Lab 108.00
300 86709 HEP A AB IGM Lab 132.00
300 86709 HEP ANTI HAAB IGM ANTIBODY EXP Lab 102.00
300 86711 JCV ANTIBODY & INDEX W/REFLEX INHB ASSAY Lab 5,260.00
300 86713 LEGIONAIRES TITER Lab 124.00
300 86720 ANTIBODY; LEPTOSIRA Lab 141.00
300 86720 LEPTOSPIRA, 1 GM, SERUM Lab 377.00
300 86735 MUMPS, IGM Lab 156.00
300 86735 MUMPS, Ab, IgM, S Lab 156.00
300 86738 MYCOPLASMA Lab 149.00
300 86747 PARVO VIRUS Lab 137.00
300 86747 PARVOVIRUS B19 ANTIBODIES IgG/IgM SERUM Lab 137.00
300 86750 ANTIBODY;PLASMODIUM (MALARIA) Lab 198.00
300 86753 TRYPANOSOMA CRUZI AB, TOTAL Lab 196.00
300 86756 RSV Lab 193.00
300 86757 RICKETTSIA Lab 181.00
300 86757 R. TYPHI IgG TITER Lab 181.00
300 86757 RMSF IgM TITER Lab 194.00
300 86757 R. TYPHI IgM TITER Lab 200.00
300 86757 RMSF IgG TITER Lab 174.00
300 86757 RICKETTSIA Ab Lab 118.00
300 86762 RUBELLA TITER Lab 113.00
300 86765 RUBEOLA SCREEN Lab 131.00
300 86774 TETANUS ANTI TOXOID AB Lab 195.00
300 86777 TOXOPLASMOSIS, ANTIBODY Lab 116.00
300 86778 ANTIBODY; TOXOPLASMA, IGM Lab 61.00
300 86780 SYPHILIS IgG Ab W/REFLEX Lab 160.00
300 86780 SYPHILIS Ab, TP-PA Lab 228.00
300 86787 VARICELLA ZOSTER Lab 125.00
300 86787 VARICELLA-ZOSTER Ab IgG Lab 57.00
300 86788 WEST NILE VIRUS IGM Lab 198.00
300 86789 WEST NILE VIRUS Lab 198.00
300 86790 ANTIBODY; VIRUS-NES Lab 292.00
300 86790 HANTAVIRUS Lab 292.00
300 86790 SM NOMBRE VIRUS Igm CONFIRMATION Lab 292.00
300 86790 SM NOMBRE VIRUS IgG CONFIRMATION Lab 292.00
300 86790 DENGUE VIRUS NSI Ag Lab 351.00
300 86790 STRATIFY JCV AB W/ REFLEX Lab 292.00
300 86790 HERPESVIRUS 6 ANTIBODIES IgG IgM Lab 263.00
300 86800 THYROGLOBULIN AB Lab 147.00
300 86800 THYROGLOBULIN ANTIBODY Lab 83.00
300 86803 Lab 132.00
300 86803 HEPATITIS C ANTIBODY Lab 171.00
300 86803 HEP C ANTIBODY EXP Lab 142.00
300 86803 HEP C ANTIBDY SCRN W REFLEX HCV PCR SERU Lab 138.00
300 86804 HEPATITIS/CONFIRMATORY TEST; EF, IMM BLT Lab 339.00
300 86812 HLA-B27 Lab 216.00
300 86850 RBC ANTIBODY SCREEN Lab 107.00
300 86860 ELUTION Lab 142.00
300 86870 ANTIBODY, IDENTIFICATION Lab 470.00
300 86870 AB ID/EA AFTER HRS Lab 470.00
300 86880 COOMBS TEST, DIRECT Lab 113.00
300 86885 COOMBS TEST, INDIRECT Lab 162.00
300 86886 RH ANTIBODY TITER Lab 116.00
300 86900 TYPE Lab 62.00
300 86901 RH Lab 49.00
300 86902 ANTIGEN TESTING OF DONOR BLOOD RGNT SRM Lab 83.00
300 86903 BLOOD TYPING;REAGENT PU Lab 49.00
300 86905 BLOOD TYPING:RBC ANTIGEN Lab 107.00
300 86906 BLOOD TYPING; RH PHENOTYPE Lab 268.00
300 86910 PATERNITY STUDY Lab 501.00
300 86920 CROSS MATCH IMMEDIATE Lab 109.00
300 86921 CROSS-MATCH IMUBATION Lab 93.00
300 86922 BLOOD X-MATCH Lab 164.00
300 86945 IRRADIATION OF BLOOD PRODUCT, EACH UNIT Lab 240.00
300 86970 WARM PANEL Lab 180.00
300 86972 RETICULOCYTE SEPERATION Lab 145.00
300 86976 RBC SERUM PRETX ID DILUTION Lab 122.00
300 86977 RBC ANTBDY ID INCUBATION WITH INHIBITORS Lab 124.00
300 86978 ANTIBODY ABSORBTION Lab 365.00
300 87015 CONCENTRATION FOR INFECT AGENT Lab 193.00
300 87015 MYCOBACTERIA CULTURE, CONC Lab 193.00
300 87040 CULTURE, BLOOD Lab 179.00
300 87045 CULTURE, STOOL Lab 139.00
300 87045 CULTURE, RECTAL Lab 139.00
300 87046 CULTURE; CAMPYLOBACTER Lab 74.00
300 87070 CULTURE, EAR Lab 120.00
300 87070 CULTURE, EYE Lab 120.00
300 87070 CULTURE, G.C. Lab 120.00
300 87070 CULTURE, GALLBLADDER Lab 120.00
300 87070 CULTURE, MISC Lab 120.00
300 87070 CULTURE, NOSE Lab 120.00
300 87070 CULTURE, SPINAL FLD Lab 120.00
300 87070 CULTURE, SPUTUM Lab 120.00
300 87070 CULTURE, THROAT Lab 120.00
300 87070 CULTURE, URETHRAL Lab 120.00
300 87070 VAGINAL CULTURE Lab 120.00
300 87070 CULTURE, WOUND Lab 120.00
300 87070 BACTERIAL CULTURE, AEROBIC Lab 120.00
300 87075 CULTURE, ANAEROBIC Lab 184.00
300 87075 SYNOVIAL FLUID, ANAEROBI Lab 184.00
300 87076 ID MALDI-TOF MASS SPEC ANAEROBE Lab 163.00
300 87077 CULTURE, BACT/BLD;ISOLAT Lab 91.00
300 87077 CULTURE, AEROBIC ISOLATE Lab 91.00
300 87077 RMALD IDENT BY MALDI-TOF MASS SPEC (1) Lab 110.25
300 87081 CLOSTRIDIUM CULTURE Lab 59.00
300 87081 CULTURE, PRESUM/PATHOGEN Lab 59.00
300 87081 Y. PESTIS CULTURE Lab 59.00
300 87081 GROUP B STREP Lab 59.00
300 87081 C.DIFF CULTURE Lab 59.00
300 87086 CULTURE, URINE Lab 93.00
300 87086 CULTURE TESTING Lab 93.00
300 87101 CULTURE, FUNGUS Lab 184.00
300 87102 CULTURE, FUNGI ISOLAT OT Lab 146.00
300 87106 CULTURE, FUNGI DEF ID Lab 142.00
300 87106 YEAST IDENT PANEL D Lab 142.00
300 87106 YEAST IDENT. PANEL B Lab 142.00
300 87106 ID MALDI-TOF MASS SPEC YEAST Lab 142.00
300 87107 FUNGAL IDENT. PANEL B Lab 142.00
300 87107 FUNGAL IDENT. PANEL A Lab 142.00
300 87107 ID MALDI-TOF MASS SPEC FUNGI Lab 142.00
300 87109 MYCOPLASMA CULTURE Lab 172.00
300 87109 MYCOPLASMA COMPREHENSIVE CX Lab 172.00
300 87110 CULTURE, CHLAMYDIA, ANY SOURCE Lab 149.00
300 87116 CULTURE, AFB Lab 181.00
300 87118 Id MALDI – 7OF MASS SPEC AFB Lab 343.00
300 87140 CULTURE, TYPING; IMMUNOFLUOR METHOD, EA Lab 76.00
300 87147 CULTURE;IMMUNOLOGIC METH Lab 66.00
300 87150 MYCOBACTERIA PROBE IDENT SOLID TBMP Lab 431.00
300 87150 MYCOBACTERIA PROBE IDENT, tBPB1 Lab 431.00
300 87150 ID, HISTOPLASMA/BLASTOMYCES PCR Lab 431.00
300 87150 Id. MTB SPECIATION, PCR Lab 431.00
300 87150 IDENT. RAPID PCR COCCIAIVIDES Lab 431.00
300 87153 D2 FUNGAL SEQUENCING ID Lab 479.00
300 87153 ANAEROBE IDENT. BY SEQUENCING ISAN Lab 479.00
300 87153 MYCOBACT. IDENT. BY SEQUENCING Lab 479.00
300 87153 AEROBE IDENT BY SEQUENCING Lab 479.00
300 87163 MICRO, ADD’T ID Lab 18.00
300 87164 DARFIELD EXAM Lab 70.00
300 87168 TICK AND OTHER ARTHROPODS IO Lab 56.00
300 87169 MACROSCOPIC EXAN;PARASIT Lab 57.00
300 87172 PINWORM STUDY Lab 68.00
300 87176 TISSUE PROCESSING Lab 59.00
300 87177 CONCENTRATION Lab 166.00
300 87181 SUSCEPTIBILITY Lab 142.00
300 87185 BETA LACTAMASE Lab 110.00
300 87185 CARBAPENAMASE MODIFIED HODGE TEST Lab 643.00
300 87185 CARBAPENEMASE DETECTION-CARBANP TEST Lab 765.00
300 87186 SENSITIVITY, GRAM NEGATIVE Lab 102.00
300 87186 SENSITIVITY, GRAM POSITIVE Lab 102.00
300 87205 GRAM STAIN, SMEAR, ANY Lab 69.00
300 87205 WBC SMEAR, STOOL Lab 69.00
300 87206 AFB STAIN Lab 83.00
300 87207 MALARIA SMEAR Lab 141.00
300 87207 MALARIA PERCENT PARASITEMIA Lab 166.00
300 87208 PINWORM PREP Lab 42.00
300 87209 SMR PRIM SRC CPLX SPEC STAIN OVAPARASITS Lab 78.00
300 87210 WET MOUNT Lab 59.00
300 87220 KOH PREP Lab 59.00
300 87230 CLOSTRIDIUM DIFFICLE TOXIN “B” SCREEN Lab 280.00
300 87252 VIRUS ISOLATION INCLUDE ID NON-IMMUN MET Lab 395.00
300 87252 CULTURE-VIRAL Lab 395.00
300 87253 VIRAL ISOLATE TISS CULT Lab 147.00
300 87254 VIRUS ISOLATE-CENTRIFUGE Lab 297.00
300 87255 HSV WTIH TYPING Lab 203.00
300 87260 INFECTIOUS AGENT ANTIGEN DETECT BY IMMNO Lab 125.00
300 87265 INFECT AGENT-BORDETELLA Lab 112.00
300 87270 CHLAMYDIA STAIN DFA Lab 166.00
300 87270 CHLAMYDIA Lab 166.00
300 87272 CRYPTOSPORIDIUM Lab 174.00
300 87276 INFLUNEZA A VIRUS Lab 139.00
300 87279 PARAINFLUNZA VIRUS, EA TYPE Lab 128.00
300 87280 RESPIRATORY SYNCYTIAL VIRUS Lab 132.00
300 87299 NOT OTHRWSE SPECIF EA ORGANISM Lab 132.00
300 87301 INFECTIOUS AGENT ANTIGEN DETECT BY ENZYM Lab 66.00
300 87324 INFECT AGENT-CLOSTRIDIUM Lab 189.00
300 87328 GIARDIA AG Lab 139.00
300 87329 GIARDIA Lab 128.00
300 87335 E COLI TOXIN Lab 68.00
300 87338 INFECT AGENT-H. PYLORI/STOOL Lab 254.00
300 87340 HBSAG Lab 110.00
300 87340 HEP B SURFACE ANTIGEN HBaAG EXP Lab 63.00
300 87341 HEP B SURFACE Ag CONFIRMATION Lab 134.00
300 87350 HEPATITIS BE AB OR ANT Lab 180.00
300 87389 HIV-1 & HIV-2 ANTIBODY CONF/DIFF, PLASMA Lab 70.00
300 87389 HIV-1/2 Ag & Ab SCREEN Lab 123.00
300 87420 RSV, DIRECT AG, EIA Lab 132.00
300 87425 ROTAVIRUS Lab 123.00
300 87427 INFECT AGENT-SHINGA LIKE Lab 109.00
300 87449 NOROVIRUS, STOOL Lab 488.00
300 87471 BARTONELLA DNA PCR Lab 182.00
300 87476 BORRELIA BURGDORFERI, AMP PROBE TECH Lab 280.00
300 87481 IADNA CANDIDA SPCS AMP PRB TQ (PAN ONLY) Lab 323.00
300 87490 CHLAMYDIA DNA PROBE Lab 116.00
300 87491 CHLAMYDIA TRACH PROBE TE Lab 166.00
300 87493 C DIFF; MOLECULAR Lab 216.00
300 87496 CYTOMEGALOVIRUS, MOLECULAR DETECTION PCR Lab 427.00
300 87497 INFECTIOUS AGENT DNA CMV QUANT Lab 718.00
300 87498 ENTEROVIRUS, AMPLIFIED PROBE TECHNIQUE Lab 278.00
300 87502 INFECT AGENT DNA/RNA INFLUENZA 1ST 2 TYP Lab 194.00
300 87502 INFLUENAZ TYPE A + B RNA, QUANT RT-PCR Lab 1,097.00
300 87507 GASTROINTESTINAL PATHOGEN PANEL, PCR Lab 1,173.00
300 87517 HEPATITIS B VIRUS, QUANT Lab 389.00
300 87517 HEP B VIRAL; DNA Lab 389.00
300 87521 HEP C, AMPLIFIED PROBE Lab 485.00
300 87522 HEPATITIS C QUANTITIVE Lab 577.00
300 87529 HSV I & II CSF Lab 342.00
300 87529 HERPES SIMP (HSV), MLCLR DETCT, PCR, BLD Lab 172.00
300 87529 HSV PCR Lab 144.00
300 87535 HIV REAL TIME PCR Lab 204.00
300 87536 HIV-1 RNA, PCR Lab 932.00
300 87536 HIV-1 RNA DETECT & QUANTIFICATION PLASMA Lab 360.00
300 87556 M TUBERCULOSIS COMPLEX PCR Lab 1,035.00
300 87581 MYLOPLASMA PNEUMONIAE, MOLECULAR DTC PRC Lab 1,631.00
300 87590 G.C. DNA PROBE Lab 116.00
300 87591 NEISSERIA GONORRHOEAE Lab 164.00
300 87633 RESP. VIRUS PANEL RESPIRATRY PROBE 12-25 Lab 1,976.00
300 87641 MRSA, PCR Lab 218.00
300 87651 INDNA STREPTOCOCCUS GROUP A AMPLIFIED PR Lab 117.00
300 87653 STREP B DNA AMP PROBE Lab 145.00
300 87661 TRICHOMONAS VAGINALIS BY NUCLEIC ACID Lab 546.00
300 87661 TRICHOMONAS VAGINALIS RNA, MALE Lab 81.00
300 87661 IADNA TRICH VAG AMP PROBE (PANEL ONLY) Lab 161.00
300 87798 INFECT AGENT-AMPLIFIED Lab 225.00
300 87798 KPC & NDM PCR Lab 1,769.00
300 87798 TOXOPLASMA GONDII Lab 433.00
300 87798 H1N1 INFLUENZA PCR Lab 433.00
300 87798 WEST NILE PCR.CSF Lab 1,318.00
300 87798 TICK BORNE PANEL, MOLECULAR DETCT, PCR Lab 567.00
300 87798 MALARIA PCR W/PARASITEMIA Lab 404.00
300 87798 PARVORIRUS B19. PCR. PLASMA Lab 433.00
300 87798 BORDETELLA PCR Lab 138.00
300 87798 JC VIRUS, QUANTITATIVE Lab 225.00
300 87798 NOROVIRUS PCR, MOLECULAR   FECES TYPE I Lab 324.00
300 87798 IADNA NOS AMP TQ EA ORGNSM (PANEL ONLY) Lab 484.00
300 87798 VZV, PCR Lab 144.00
300 87798 NOROVIRUS PCR, MOLECLR DET FECES TYPE II Lab 324.00
300 87798 RESPIRATORY VIRUS PANEL Lab 216.00
300 87799 INFECT AGENT DETECT/NUCLEIC ACID NOS Lab 189.00
300 87799 PARROVIRUS DNA; QUANT Lab 189.00
300 87799 VZV DNA QNTF EA ORGNSM Lab 189.00
300 87799 BK VIRUS PCR Lab 189.00
300 87799 EPSTEIN-BARR VIRUS DNA DETECTION & QUANT Lab 320.00
300 87799 EBV PCR QUANT Lab 189.00
300 87800 GC & CHLAMYDIA BY DNA Lab 188.00
300 87801 LYME DX, CSF Lab 293.00
300 87801 BACTERIAL CULTURE; AEROBIC SPECIAL Lab 93.00
300 87801 IADNA MULTI ORGANISMS AMPLIFIED PROBE TQ Lab 117.00
300 87804 INFLUENZA A/B Lab 102.00
300 87880 STREP TEST, DIRECTOGEN Lab 73.00
310 87899 CRYPTOCOCCUS ANTIGEN, URINE Lab 109.31
310 87899 STREPTOCOCCUS PNEUMONIAE, URINE Lab 165.40
310 87899 LEGIONELLA ANTIGEN, URINE Lab 83.50
300 87902 HCV RNA GENOTYPE-HEP C Lab 1,073.00
300 87902 HCV RNA GENOTYPE 3 NS5A DRUG RESIST Lab 2,977.00
310 88104 CYTO PATH, WASH OR BRUSH Lab 116.00
314 88104 CYT FLUIEDS W INTERP Lab 192.00
300 88104 SPUTUM FOR CYTOLOGY Lab 115.00
310 88108 CYTO PATHOLOGY CELL BLOC Lab 131.00
300 88120 UROVYSION FOR BLADDER Lab 264.00
300 88142 CYTOPATH/CERVICAL-VAGINA Lab 118.00
300 88150 CYTOPATHOLOGY, SLIDES, CERV OR VAG;MAN Lab 132.00
300 88160 PAP SMEAR EXTRA GENITAL Lab 139.00
300 88160 CYTOPATH, NON-GYN Lab 139.00
300 88161 URINE CYTOLOGY Lab 107.00
300 88170 FNAB Lab 82.00
300 88172 CYTP DX EVAL FNA 1ST EA SITE Lab 202.00
300 88173 CYTOPATHOLOGY; INTERPRETATION AND REPORT Lab 733.00
300 88180 FLOW CYTOMETY Lab 729.00
300 88184 Lab 844.00
300 88184 FLOW TC MARKER Lab 76.00
300 88184 FLOW CYTMTRY CELL SURF CYTOPLSMC OR NUC Lab 154.00
300 88185 FLOW CYTOMERTY, CELL SURFACE, CYTOPLASMI Lab 844.00
300 88185 FLOW CYTOMETRY, EACH ADDITIONAL MARKER Lab 102.00
300 88185 FLOW TC ADD-ON Lab 48.00
300 88188 FLOW CYTOMETRY; 9 TO 15 MARKERS Lab 509.00
300 88189 FLOW CYTOMERTY, 16 OR MORE MARKERS Lab 330.00
311 88189 CYTOPATHOLOGY PROCEDURES Lab 330.00
300 88230 TISSUE CULT NON NEOPLAST Lab 624.00
300 88233 TISSUE CULTURE; SKIN OR TISSUE BIOPSY Lab 1,087.00
300 88261 CHOMOSOME ANALYS 5 CELL Lab 1,065.00
300 88262 COUNTS 15-20 CELLS 2 KAR Lab 899.00
300 88262 COUNTS 1-14 CELLS 2KARYOTYP BANDING Lab 899.00
300 88262 CHROMOSOME ANALYSIS 15-20 Lab 899.00
300 88271 MOLECULAR CYTOGEN;DNA EA Lab 634.00
300 88273 MOLECULAR CYTO;10-30 CEL Lab 139.00
300 88274 MOLECULAR CYTOGEN Lab 333.00
300 88275 MOLEC CYTG INTERPHASE ISH ANALZ 100-300 Lab 617.00
300 88280 CHROMOSOME ANAL,KARYO EA Lab 263.00
300 88283 CHROMOSOME ANAL,ADD SPEC Lab 208.00
300 88285 CHROMOSOME COUNT ADDITIONAL Lab 65.00
300 88289 CHROMOSOME ANAL,HI RESOL Lab 171.00
300 88291 CYTOGENETICS & MOLECULAR Lab 118.00
300 88291 CHROMOSOMES, CONGENITAL, BLOOD Lab 696.00
310 88300 PATHLOLGY LVL I Lab 87.00
310 88302 PATHOLOGY LVL II Lab 198.00
310 88304 PATHOLOGY PREP LVL III Lab 157.00
310 88305 BONE MARROW INTERPRET Lab 387.00
310 88305 PATHOLOGY PREP LVL IV Lab 109.00
310 88307 PATHOLOGY PREP LVL V Lab 231.00
310 88309 PATHOLOGY PREP LVL VI Lab 305.00
300 88311 DECALCIFICATIION PROCEDU Lab 83.00
310 88312 TRICHROME STAIN Lab 110.00
310 88312 SPECIAL STAINS Lab 205.00
310 88313 BONE MARROW SPECL. STAIN Lab 125.00
310 88313 SPECIAL STAIN, GROUP II Lab 270.00
300 88321 CONSUT & REPT. SLIDE PRE Lab 83.00
310 88329 PATHOLOGY CONSULT CHARGE SURGERY Lab 393.00
300 88331 FROZEN SECTIONS Lab 226.00
310 88332 PATH FZN SECTION-ADD’L TISSUE BLOCK Lab 262.00
310 88334 PATH CYTO EXAM ADDITIONAL SITE Lab 229.00
310 88334 PATH CONS ADD TOUCH PREP Lab 229.00
300 88341 IMHISTOCHEM/CYTCHM EA ADDL ANTI SLIDE Lab 246.00
300 88342 IMMUNOCYTOCHEM; EA ANTIB Lab 58.00
300 88342 IMHISTOCHEM/CYTCHM INIT ANTIBODY STAIN Lab 122.00
300 88342 IMMUNOCY TO CHEM I.E. TISSUE IMMN PRXDS Lab 122.00
300 88346 IMMUNOFLUORESCENCE PER 1ST SINGL ANTS Lab 55.00
300 88349 ELECTRON MICROSCOPY; SCANNING Lab 1,120.00
300 88350 IMMUNOFLUORESCENCE PER SPC ADD SING ANTB Lab 51.00
300 88360 MORPHOMETRIC ANALYSIS, TUMOR IMMUNOHIST Lab 500.00
300 88361 M/PHMTRC ALYS TUMOR IMHCHEM EA ANTI CMPT Lab 605.00
300 88364 IN SITU HYBRID eg FISH PER SPCMN Lab 399.00
300 88365 IN SITU HYBRIDIZATION eg FISH, PER SPCMN Lab 399.00
300 88365 TISSUE SITU HYBRID;I RPT Lab 895.00
300 88368 MORPHOMETRIC ANALYSIS; QUANT OR SEMI MAN Lab 866.00
300 88374 MULTIPLEX PROBE STAIN PROCEDURE Lab 1,071.00
300 88377 EACH MULTIPLEX PROBE STAIN PROCEDURE Lab 962.00
300 88381 MICRODISSECTION, PREP IDENT TRGT MANUAL Lab 928.00
300 89050 CELL COUNT MISC BODY FLD Lab 92.00
300 89050 CSF CELL COUNT Lab 92.00
300 89055 FECAL LEUKOCYTES Lab 125.00
300 89060 CRYSTALS, SYNOVIAL FLD Lab 87.00
300 89060 URIC ACID CRYSTALS Lab 87.00
300 89060 CRYSTALS, BODY FLUID Lab 338.00
750 89100 GASTRO INTESTINAL SVC Lab 570.00
300 89190 EOSINOPHIL COUNT Lab 51.00
300 89310 SEMEN ANALYSIS Lab 517.00
300 89320 SEMEN ANALYSIS Lab 138.00
300 89321 SPERM COUNT Lab 122.00
300 89322 SEMEN ANALYSIS W/ STRICT MORPHOLOGY Lab 222.00
300 89398 UNLSTD REPRODUCTIVE MED LAB PROCEDURE Lab 332.00
300 90384 RHO GAM INJECTION Lab 24.00
731 93226 HOLTER, SCAN, ANALYSIS Lab 556.00
300 99001 HANDLING, CONVEYANCE Lab 49.00
940 99195 THERAPEUTIC PHLEB. Lab 141.00
300 99199 DRUG SCREEN COLLECTION Lab 44.00
300 G0103 PSA; SCREEN Lab 141.00
300 G0103 PSA; SCREENING SPECIAL Lab 47.00
300 G0431 DRUG SCREEN; SINGLE DRUG CLASS METHOD Lab 69.00
300 G0452 MOLECULAR DX;INTERP-RPT Lab 651.00
300 G6053 METHADONE Lab 203.00
636 J2790 Rhogam 300 mcg syrige Lab 432.75
923 P3000 PAP SMEAR Lab 68.00
390 P9016 LEUKO REDUCED PACKED CEL Lab 758.00
390 P9017 PLASMA, FRESH FROZEN Lab 257.00
390 P9019 PLATELETS Lab 132.00
390 P9035 PLATELTS, PHERESIS, LEUKOCYTES REDUCE-EA Lab 2,306.00
390 P9035 PLATELTS, PHERESIS, LEUKOCYTES WITH STAT Lab 2,306.00
390 P9037 PLATELETS, IRRADIATED EACH UNIT Lab 1,401.00
390 P9040 RED BLOOD CELLS, IRRADIATED, EACH UNIT Lab 805.00
390 P9053 PLATELETS, PHERESIS, LEUKOLYTES, CVM NEG Lab 1,489.00
390 P9058 RED BLOOD CELLS; LEUKOCYTES REDUCED CMV- Lab 823.00
300 LAB Lab 3.00
300 HEALTH FAIR LABS CMP, TSH, LIPID Lab 32.00
300 HIV GENO-TYPE Lab 3.00
300 BREATHALIZER TEST Lab 51.00
300 NO CHARGE Lab     –
300 BILL OFFICE LABS Lab 3.00
300 LIPID/GLUCOSE SCREEN Lab 97.00
300 MISC. LAB CHARGE Lab 3.00
300 N-METHYLHISTAMIN, 24 HOUR URINE Lab 429.00
390 BLOOD PROCESSING AND STORAGE Lab 255.00
390 CYROPRECIPETATE Lab 139.00
300 HEALTHFAIR LABS CBC, GLYCO Lab 32.00
300 ECHO/NO CHARGE Lab     –
300 BLUE MUSSEL.IgE Lab 36.00
300 PLASMINOGEN ACTIVITY Lab 166.00
300 VARICELLA-ZOSTER Ab, IgM Lab 57.00
361 20551 INJECTION; SINGLE TENDON / ORIGIN/INSERT Medical Surgical 307.00
761 29581 APP. MULTI LAYER VNS/ WND COMP; BL KNEE Medical Surgical 447.00
761 36569 INSERTION OF PICC WO SUBPORT 5YRS & OLDE Medical Surgical 1,268.00
761 36593 DECLOTTING THROMOLYTIC AGENT IMPLANT DV Medical Surgical 528.00
761 51702 INSERT TEMP INDEWELLING BLADDER CATH TC Medical Surgical 269.00
761 51705 CHANGE CYSTOSTOMY TUBE SIMPLE Medical Surgical 742.00
300 82948 CHEM BG Medical Surgical 37.00
771 90471 IMMUNIZATION ADMINISTRATION Medical Surgical 63.00
771 90472 IMMUNIZATION ADMIN; EA ADDITIONAL VACCIN Medical Surgical 68.00
260 90779 UNLISTED THERAPY PROPH/DX IV INJ Medical Surgical 67.00
260 96360 OP IV THERAPY HYDRATE; 1ST HOUR Medical Surgical 294.00
260 96361 OP IV THERAPY HYDRAT; EA   HOUR UP TO 8 Medical Surgical 109.00
260 96366 IV INFUSION THERAPY/PROPH/DX EA ADD HOUR Medical Surgical 135.00
260 96367 IV THERAPY/PROPH/DX; SEQUENTIAL-1ST HOUR Medical Surgical 178.00
260 96368 IV INFUSION THERAP/ PROPH/ DX-CONCURRENT Medical Surgical 132.00
260 96372 THERAPUTIC/PROPH/DX INJ SUB Q OR IM Medical Surgical 105.00
260 96374 THERAPUTIC/PROPH/DX IV PUSH; SINGLE INJ Medical Surgical 221.00
761 96375 THERAPUTIC/ PROPH/DX INJ;EA SEQENTIL IVP Medical Surgical 138.00
260 96376 THERAPEUTIC IV PUSH; EA. ADD SEQ DRUG Medical Surgical 59.00
331 96400 CHEMO ADMIN SUBCU OR IM W OR W/O AnesthesiaTH Medical Surgical 120.00
331 96401 CHEMO ADMIN; SUB Q -INTER MUSCLE-NO HORM Medical Surgical 258.00
331 96402 CHEMO ADMIN; SUB Q OR IM, HORMONAL Medical Surgical 144.00
331 96409 CHEMO ADMIN; IV PUSH SINGLE OR INITIAL Medical Surgical 317.00
335 96411 CHEMO ADMIN; IV PUSH EA ADD SUBSTAN/DRUG Medical Surgical 417.00
335 96413 CHEMO ADMIN; IV INFUSION UP TO 1 HR Medical Surgical 764.00
335 96415 CHEMO ADMIN; IV INFUSION   EACH ADD HOUR Medical Surgical 157.00
335 96417 CHEMO ADMIN, IV INFUSE; EA SEQUENT INFUS Medical Surgical 228.00
331 96521 REFILLING AND MAINT OF PORTABLE PUMP Medical Surgical 530.00
331 96523 IRRIGAT IMPLANTED VENOUS ACCESS DEVICE Medical Surgical 113.00
761 97597 REMOVAL DEVITAL;TISS, LESS 20 CM Medical Surgical 191.00
761 97598 REM OF DEVIT TISS WND, SELECT >20 SQ CM Medical Surgical 325.00
761 97602 REM OF DEVIT TISS FR WND,DEBRID PER SESS Medical Surgical 172.00
761 97605 NEG PRESSURE WOUND THERAPY; PER SESSION Medical Surgical 120.00
761 97606 NEG PRESS WND THER, SURF AREA 20 SQ.CM Medical Surgical 84.00
760 99201 SHORT STAY ROOM CHARGE Medical Surgical 399.00
291 E0186 HILL-ROM AIR MATTRESS DAILY RENTAL Medical Surgical 158.00
291 E0303 EXCEL CARE THERAPY TZ-AIR DAILY Medical Surgical 632.00
942 G0108 DIABETES INDIV PER HOUR Medical Surgical 147.00
335 Q0084 ONCOLOGY $1.58 PER MIN/$94.8O PER HOUR Medical Surgical 4.00
121 ROOM & BOARD MED/SURG Medical Surgical 1,459.00
410 CPT/PRECUSSION DRNG Medical Surgical 74.00
761 OUTPATIENT TREATMENT ROOM Medical Surgical 113.00
460 OXIMETRY Medical Surgical 111.00
762 ER OBSERVATION PER HOUR Medical Surgical 62.00
762 OBSERVATION WITH MONITORING PER HOUR Medical Surgical 92.00
710 SURG OBS/RECOV PER HOUR Medical Surgical 75.00
655 HOSPICE IP RESPITE CARE Medical Surgical 269.00
656 HOSPICE GENERAL IP Medical Surgical 1,136.00
121 ROOM & BOARD HIGH ACUITY (IMC) Medical Surgical 2,179.00
762 ER OBSERVATION PER HOUR Medical Surgical 62.00
270 HYDROACTIVE CUTIMED SORBACT DRESSING 2X3 Medical Surgical 48.00
270 SCD SLEEVE EXTENDER Medical Surgical 33.00
982 10021 MRC/FINE NEEDLE ASPIRATION Moab Regional Health Center 181.00
982 10022 MRC/FINE NEEDLE ASPIRATION; W/IMAGING GD Moab Regional Health Center 296.00
982 10040 MRC/INCIS & DRAIN;SIM OR SNGL CYST, PSTL Moab Regional Health Center 127.00
982 10060 MRC/INCISION AND DRAINAGE, SIMPLE Moab Regional Health Center 183.00
982 10061 MRC/I & D ABSCESS, COMPLICATED Moab Regional Health Center 372.00
982 10080 MRC/INCISION & DRAINAGE PILONDIAL CYST Moab Regional Health Center 230.00
982 10081 MRC/INCIS DRAIN OF PILONIDAL CYST Moab Regional Health Center 850.00
982 10120 MRC/FB, SUB-Q, SIMPLE Moab Regional Health Center 187.00
982 10121 MRC/INC & REM FB SUBQ TISSUE COMPLX Moab Regional Health Center 474.00
982 10140 MRC/I&D OF HEMATOMA, SEROMA, OR FLUID Moab Regional Health Center 253.00
982 10160 MRC/PUNCTURE ASP OF CYST, HEMATOMA Moab Regional Health Center 169.00
982 10180 MRC/I & D COMPLEX, POST-OP WOUND INFECTI Moab Regional Health Center 666.00
982 11000 MRC/DEBRIDE EXTENSIVE ECZ-INF SKIN -10% Moab Regional Health Center 133.00
982 11004 MRC/DBREMT SKN SUBQ T/M/F NCRO INFCTJ GE Moab Regional Health Center 1,063.00
982 11005 MRC/DBRDMT SKN SUBQ T/M/F NECRO INFCT AB Moab Regional Health Center 1,905.00
987 11008 MRC/REM OF PROS MAT OR MESH ABD WALL Moab Regional Health Center 637.00
982 11010 MRC/DBRDMT, W-REM FM FX&DISLC Moab Regional Health Center 475.00
982 11011 MRC/DBRDMT W/REM FM FX&DISLC SK-SQ & MUS Moab Regional Health Center 983.00
982 11012 MRC/DEBRDMT, REM FM & DISCL SQ T/M/F BON Moab Regional Health Center 1,028.00
982 11040 MRC/DEBRIDEMENT; SKIN, PARTIAL THICK PF Moab Regional Health Center 189.00
982 11041 MRC/DEBRID EXIS; SKIN, 0.6 TO1.0 CM Moab Regional Health Center 206.00
982 11042 MRC/DEBRID EXCIS; SKIN 1.1 TO 2.0 CM Moab Regional Health Center 411.00
982 11043 MRC/DEBRIDE SQ-MUSCLE Moab Regional Health Center 574.00
982 11044 MRC/DEBRID, SKIN-SQ-MUS-BONE Moab Regional Health Center 703.00
982 11046 MRC/DBRDMT MUSCLE/FASCIA EA ADDL 20 SQCM Moab Regional Health Center 137.03
982 11055 MRC/ LESION, PARING, ONE Moab Regional Health Center 51.00
982 11056 MRC/ LESION, PARING, 2-4 Moab Regional Health Center 62.00
982 11100 MRC/BX SKIN LESION Moab Regional Health Center 142.00
982 11101 MRC/ LESION BX, EA ADD. Moab Regional Health Center 137.00
982 11200 MRC/REMOVAL OF SKIN TAGS LESS THAN 15 Moab Regional Health Center 131.00
982 11201 MRC/REMOVAL OF SKIN TAGS EACH ADD. 10 Moab Regional Health Center 110.00
982 11201 MRC/REMOVE SKIN TAG, MULTIPLE PF Moab Regional Health Center 102.06
982 11300 MRC/SHAVING OF EPI OR DRML LES 1.5CM LES Moab Regional Health Center 114.00
982 11301 MRC/SHAVING OF LESION 0.6 TO 1.0 CM Moab Regional Health Center 120.00
982 11302 MRC/SHVG SKIN LES TRNK/ARM/LEG 1.1-2.0CM Moab Regional Health Center 189.00
982 11305 MRC/SHVG EPDML/DRML LES SCLP-GNTLA 0.5CM Moab Regional Health Center 123.00
982 11306 MRC/SHAVING SKN LES 1 S/N/H/F/G 0.6-1.0 Moab Regional Health Center 169.00
982 11307 MRC/SHAVING SKN LES 1 S/N/H/F/G 1.1-2.0 Moab Regional Health Center 199.00
982 11308 MRC/SHAVING SKN LES 1 S/N/H/F/G 2.0 CM Moab Regional Health Center 228.00
982 11310 MRC/SHVNG EPI/DRML LES,FC,ERS,EYEL 0.5CM Moab Regional Health Center 142.00
982 11311 MRC/SHVNG EPI/DRML 1.6 TO 1.0 CM Moab Regional Health Center 165.00
982 11312 MRC/SHVNG EPI/DRML 1.1 TO 2.0 CM Moab Regional Health Center 193.00
982 11313 MRC/SHVNG EPI/DRML OVER 2.0 CM Moab Regional Health Center 244.00
982 11400 MRC/EXCIS, BENIGN LESION 0.5 CM OR LESS Moab Regional Health Center 176.00
982 11401 MRC/EXCIS BEN LES-TRUNK, LIMBS 0.6-1.0 C Moab Regional Health Center 220.00
982 11402 MRC/EXCIS BEN LES, TRUNK,EXTREM 1.1-2.0 Moab Regional Health Center 292.00
982 11403 MRC/EXCIS BEN LES-TRUNK, LIMB   2.1-3.0 C Moab Regional Health Center 375.00
982 11404 MRC/EXC BEN LES TRNK, EXTR 3.1-4.0CM Moab Regional Health Center 584.00
982 11406 MRC/EXCIS BEN LES-TRUNK, LIMBS <4.0 CM Moab Regional Health Center 792.00
982 11420 MRC/EXCIS, BENIGN LESION EXCEPT TAG PF Moab Regional Health Center 218.00
982 11421 MRC/EXCIS BEN LES-SCLP, HND, GEN 0.6-1.0 Moab Regional Health Center 261.00
982 11422 MRC/EXCIS BEN LES-FACE 1.1-2.0 CM Moab Regional Health Center 329.00
982 11423 MRC/EXCS BEN LES-SCLP, HNDS, GEN 2.1-3CM Moab Regional Health Center 627.00
982 11424 MRC/EXCIS, BENIGN LESION EXCEPT TAG PF Moab Regional Health Center 637.00
982 11426 MRC/EXC BEN LES, OVER 4.0 CM Moab Regional Health Center 744.00
982 11440 MRC/EXCIS, OTHER BENIGN LESION PF Moab Regional Health Center 243.00
982 11441 MRC/EXCIS BEN LES-FACE, EARS 0.6-1 CM Moab Regional Health Center 320.00
982 11442 MRC/EXCIS BEN LES- FACE 1.1-2.0 CM Moab Regional Health Center 402.00
982 11443 MRC/EXCISE BENIGN LESION; FACE, EARS, PF Moab Regional Health Center 557.00
982 11444 MRC/EXCIS BEN LES-FACE 3.1-4.0 CM Moab Regional Health Center 697.00
982 11446 MRC/EXCIS BEN LES-FACE <4.0 CM Moab Regional Health Center 995.09
982 11450 MRC/EXCISION OF SKIN AND SUB-Q FOR HIDRA Moab Regional Health Center 760.00
982 11462 EXC HIDRADENITIS INGUINAL SMP/INTRM Moab Regional Health Center 1,034.00
982 11470 MRC/EXC SKIN & SUBCU HIDRA PERIAN SIM OR Moab Regional Health Center 862.46
981 11600 EXC MALG LESION TRNK/ ARM/LEG 0.5 CM/< Moab Regional Health Center 421.00
982 11601 MRC/EXCIS MAL LES-TRUNK, LIMBS .06-1.0 C Moab Regional Health Center 274.05
982 11602 MRC/EXCIS MALG LES TRNK,ARMS,LGS 1.1-2CM Moab Regional Health Center 367.00
982 11603 MRC/EXCIS MAL LES INCL MRGNS 2.1 TO 3.0 Moab Regional Health Center 458.00
982 11604 MRC/EX MAL LES I.E. MAR T,A,L 3.1-4.0CM Moab Regional Health Center 598.00
982 11606 MRC/EXCIS MAL LES, TRUNK, LIMB +4.0 CM Moab Regional Health Center 878.00
982 11621 MRC/EXCIS, MALIGNT LES, SCALP, NECK, HAN Moab Regional Health Center 465.00
982 11622 MRC/EXCIS MAL LES-SCALP, HANDS 1.1-2.0 C Moab Regional Health Center 500.00
982 11623 MRC/EXC MAL LES SCLP-NK-HNDS-FT 2.1-3.0 Moab Regional Health Center 613.00
982 11624 MRC/EXCIS, MALIG LES SCALP, NECK, HAND P Moab Regional Health Center 841.05
982 11626 MRC/EXC MAL LES +4CM   SCLP,NK,HNDS,FT,GN Moab Regional Health Center 968.00
982 11641 MRC/EXC MAL FC,ERS,LIDS,NS,LPS Moab Regional Health Center 397.00
982 11642 MRC/MDCR EXCS MAL LES-FACE, EAR 1.1-2 CM Moab Regional Health Center 568.80
510 11642 MRC/MDCR-EXC MAL LES-FACE,EAR 1.1-2 CM Moab Regional Health Center 63.20
982 11642 MRC/EXC MAL LES-FACE,EAR 1.1-2 CM Moab Regional Health Center 632.00
982 11643 MRC/EXCIS MAL LES-FACE, EARS 2.1-3.0 CM Moab Regional Health Center 820.00
982 11643 MRC(MDCR)X MLG LS,F,ERS,LID,LPS 2.1-3CM Moab Regional Health Center 738.00
510 11643 MRC(MDCR)X MLG LS,FC,LDS,NS,LPS 2.1-3CM Moab Regional Health Center 82.00
982 11644 MRC/EXCIS MAL LES-FACE, EARS 3.1-4 CM Moab Regional Health Center 935.00
982 11646 MRC/EXC MALGNT FACE,EARS,LIDS,NS,LPS 4.0 Moab Regional Health Center 818.00
982 11646 MRC(MDCR)X MLGNT FC, ERS, LDS, NS, LP 4 Moab Regional Health Center 736.20
510 11646 MRC(MDCR)X MAL FC, ERS, LDS, NS, LPS 4. Moab Regional Health Center 81.80
982 11719 MRC/TRIMMING OF NAIL Moab Regional Health Center 44.00
982 11720 MRC/DEBRIDEMENT NAIL ANY MTHD 1 TO 5 Moab Regional Health Center 41.00
982 11720 MRC/(MDCR) DEBRIDE NAIL ANY MTHD 1-5 Moab Regional Health Center 36.90
510 11720 MRC/(MDCR)DERIDE NAIL ANY MTHD 1-5 Moab Regional Health Center 4.10
510 11730 MRC(MDCR) NAIL REM., PARTIAL Moab Regional Health Center 20.00
982 11730 MRC(MDCR) NAIL REM., PARTIAL Moab Regional Health Center 180.00
982 11730 MRC/AVULSION NAIL PLATE, PART OR COMPLET Moab Regional Health Center 200.00
982 11730 MRC/NAIL REM, PARTIAL Moab Regional Health Center 130.00
982 11732 MRC/AVULSION NAIL PLATE EA ADDL Moab Regional Health Center 85.05
982 11740 MRC/MEDCARE)EVACUATION SUBNGUAL HEMATOMA Moab Regional Health Center 60.00
982 11740 MRC/EVACUATION SUBUNGUAL HEMATOMA Moab Regional Health Center 67.00
510 11740 MRC/MDCR)EVACUATION SUBNGUAL HEMATOMA Moab Regional Health Center 6.70
982 11750 MRC(MDCR)NAIL REM., W/MATRIX Moab Regional Health Center 307.80
982 11750 MRC/ NAIL REM., W/MATRIX Moab Regional Health Center 342.00
510 11750 MRC(MDCR)NAIL REM., W/ MATRIX Moab Regional Health Center 34.20
982 11760 MRC/REPAIR NAIL BED Moab Regional Health Center 427.00
982 11765 WEDGE ESC OF SKIN OF NAIL FOLD Moab Regional Health Center 317.00
982 11770 MRC/EXCIS PILONIDAL CYST- SIMPLE Moab Regional Health Center 669.06
982 11771 MRC/EXCIS OF PILONIDAL CYST-EXTENSIVE Moab Regional Health Center 959.00
982 11772 MRC/EXC PILONIDAL CYST COMPLICATED Moab Regional Health Center 1,087.00
510 11900 MRC(MDCR)/INJECT, INTRALESIONAL up to 7 Moab Regional Health Center 8.60
982 11900 MRC(MDCR)INJECT, INTRALESIONAL up to 7 Moab Regional Health Center 77.40
982 11900 MRC/INJECT, INTRALESIONAL up to 7 lesion Moab Regional Health Center 86.00
982 11950 MRC/SUB INJ FILLING MATERIAL Moab Regional Health Center 290.00
982 11976 REMOVE CONTRACEPTIVE CAPSULE Moab Regional Health Center 275.00
982 11981 MRC/INSERT, NONBIODGR DRUG(IMPLANON) Moab Regional Health Center 192.00
982 11982 MRC/REM NON-BIODGRDBL DRUG DEL IMPLANT Moab Regional Health Center 192.00
982 11983 MRC/REMOVE & REINSERT NEXPLANON Moab Regional Health Center 237.00
982 12001 MRC/CLOS-SIMP, 2.5 CM OR LESS Moab Regional Health Center 246.00
982 12001 MRC/(MDCR)CLOS-SIMP,TRNK,NK EX 2.5 – Moab Regional Health Center 221.40
510 12001 MRC/(MDCR)CLOS-SIMP,TRNK,NK EX2.5 – Moab Regional Health Center 24.60
982 12002 MRC/CLOS SIMP,SCLP,NK,TRK,EST 2.6-7.5 CM Moab Regional Health Center 281.00
982 12004 MRC/SIMPLE REPAIR SUPER WOUND PF Moab Regional Health Center 333.00
982 12005 MRC/REPAIR, SIMPLE S-N-T-EXT, 12.6-20CM Moab Regional Health Center 524.00
982 12006 MRC/REPAIR WND 20.1-30CM SC,NK,TRNK, EXT Moab Regional Health Center 463.05
982 12011 MRC/CLOS-SIMP, <2.5 CM, FACE, E,E,N,LIP Moab Regional Health Center 310.00
982 12011 MRC(MDCR)SIMP SPRFCL WNDS FC, EAR, I Moab Regional Health Center 279.00
510 12011 MRC(MDCR)SMP SPFRCL WND FACE, EAR,I Moab Regional Health Center 31.00
982 12013 MRC/CLOS–SIMP 2.6-5.0 CM, F,E,E,N,LIP Moab Regional Health Center 364.00
982 12014 SIM REPAIR 5.1 TO 7.5CM Moab Regional Health Center 402.00
982 12015 SIMP REPAIR 7.6 TO 12.5CM Moab Regional Health Center 420.00
982 12016 SIMP REPAIR 12.6 TO 20CM Moab Regional Health Center 502.00
982 12017 SIM REPAIR 20.1 TO 30CM Moab Regional Health Center 560.00
982 12018 SIM REPAIR 30CM OR GREATER Moab Regional Health Center 580.00
982 12020 TX OF SUPERFICIAL WOUND DEHISCENCE SIMP Moab Regional Health Center 678.65
982 12021 MRC/TX SUPERFIC WOUND DEHISCENCE; PF Moab Regional Health Center 457.00
510 12031 MRC/MDCR REPAIR INTRMDT, SCALP, AXLL 2.5 Moab Regional Health Center 33.00
982 12031 MRC/MDCR REPAIR INTRMDT,SCALP,AXLL 2.5 Moab Regional Health Center 297.00
982 12031 MRC/CLOS-LAYERED, SCLP,AXIL,TRNK,EXT <2. Moab Regional Health Center 330.00
510 12032 MRC/MDCR INTRMD,SCALP, AX, TK, EX 2.6-7. Moab Regional Health Center 54.20
982 12032 MRC/MDCR INTRMD,SCALP, AX, TK, EX 2.6-7. Moab Regional Health Center 487.80
982 12032 MRC/RPR INTRMD,SCALP, AX, TK, EX 2.6-7.5 Moab Regional Health Center 542.00
510 12034 MRC/(MDCR) REPAIR INTERME Moab Regional Health Center 62.50
982 12034 MRC/(MDCR) REPAIR INTERME Moab Regional Health Center 562.50
982 12034 MRC/CLOS-LAYER SCALP,TRNK,EXTR 7.6-12.5 Moab Regional Health Center 625.00
982 12035 MRC/LAYER CLOS OF WOUND PF Moab Regional Health Center 634.10
982 12036 MRC/CLOSURE, LAYERED, 20.1-30.0 CM Moab Regional Health Center 786.00
982 12037 MRC/LAYER CLOS-SCALP, AXIL, TRUNK >30 CM Moab Regional Health Center 834.00
982 12041 MRC/CLOS-LAYER <2.5 CM, NK,HND,FT, EX GE Moab Regional Health Center 385.00
982 12042 MRC/MDCR/CLOS-LAYERS 2.6-7.5 CM Moab Regional Health Center 39.80
982 12042 MRC/MDCR/CLOS-LAYERS 2.6-7.5 CM Moab Regional Health Center 358.20
982 12042 MRC/CLOS-LAYERS N,H,F,GEN 2.6-7.5 CM Moab Regional Health Center 398.00
982 12044 MRC/CLOS-LAYER,7.6-12.5 CM- N,H,F,GEN Moab Regional Health Center 517.00
982 12051 MRC/MDCR CLOS-LAYER, FACE <2.5 Moab Regional Health Center 426.60
510 12051 MRC/MDCR, INTERM WNDS OF FC- LP Moab Regional Health Center 47.40
982 12051 MRC/RPR, INTERM WNDS OF FC- LP Moab Regional Health Center 474.00
510 12052 MRC/(MDCR)CLOS-LAYERS INT,   2.6-5 CM Moab Regional Health Center 46.70
982 12052 MRC/(MDCR)CLOS-LAYERS INT,   2.6-5 CM Moab Regional Health Center 420.30
982 12052 MRC/CLOS-LAYERS, FACE,E,E,N,L   2.6-5 CM Moab Regional Health Center 467.00
982 13100 MRC/REPAIR, COMPLEX, TRUNK; 1.1 CM TO 2. Moab Regional Health Center 310.00
982 13101 MRC/COM REPAIR 2.6 TO 7.5 Moab Regional Health Center 569.00
982 13102 REPAIR COMPLEX TRUNK EA ADD 5CM OR LESS Moab Regional Health Center 255.00
982 13120 MRC/REPAIR COMP SCLP, ARM, LEG 1.1-2.5 C Moab Regional Health Center 542.00
510 13121 MRC/MDCR/Repair com 2.6 to 7.5 Moab Regional Health Center 83.20
982 13121 MRC/MDCR/Repair com 2.6 to 7.5 Moab Regional Health Center 748.80
982 13121 MRC/REPAIR COM SCALP,LEGS,ARM 2.6 TO 7.5 Moab Regional Health Center 832.00
982 13122 MRC/MDCR REPAIR COMPLEX EA ADD ECM PF Moab Regional Health Center 336.60
982 13122 MRC/REP,CMPLX,SCLP,ARM,LEG ADD E 5 CM Moab Regional Health Center 374.00
982 13122 MRC/MDCR REP,CMPLX,SCLP,ARM,LEG ADD E CM Moab Regional Health Center 37.40
982 13131 MRC//CLOS COMP-FACE,GEN,HND,FT   1.1-2.5 Moab Regional Health Center 829.00
982 13132 MRC/REPAIR COMPLEX 2.6-7.5 Moab Regional Health Center 1,260.00
982 13133 MRC/REP-COMP-ADDIT 5 CM-SCALP,ARM,LEG Moab Regional Health Center 500.00
982 13152 MRC/REPAIR COMPLEX; EYELID, NOSE, LIP PF Moab Regional Health Center 1,373.09
982 13160 MRC/REPAIR COMPLEX EYE, NOSE, EAR PF Moab Regional Health Center 1,410.00
982 14000 MRC/ADJACENT TISSUE TRANS, TRUNK; 10 SQ Moab Regional Health Center 1,047.06
982 14020 MRC/ADJ TISS TRANS SCAL ARM, LEGS, DEF 1 Moab Regional Health Center 1,163.00
982 14040 MRC/ADJ TISSUE TRAN FORHEAD,ETC,1->LESS Moab Regional Health Center 1,676.00
982 15734 MRC/MUSC MYOCUTNS/FSCCTNS FLP TRNK Moab Regional Health Center 5,015.00
982 15851 MRC/REM SUTURES UNDER AnesthesiaTHESIA Moab Regional Health Center 123.00
982 16000 MRC/INITIAL TX 1ST DEGREE BURN LOCAL Moab Regional Health Center 100.00
982 16020 MRC/DRSG/DEBRID W/O AnesthesiaT SMALL Moab Regional Health Center 170.00
982 16020 MRC/(MDCR)DEBRID W/O AnesthesiaT SM Moab Regional Health Center 153.00
510 16020 MRC/(MDCR)DEBRID W/O AnesthesiaT SM Moab Regional Health Center 17.00
982 16025 MRC/DRESSINGS AND/OR DEBRID BURNS 5%-10% Moab Regional Health Center 283.00
982 17000 MRC/DESTRUCTION FIRST LESION Moab Regional Health Center 153.00
982 17000 MRC/(MDCR) DETRUCTION 1ST LESION Moab Regional Health Center 137.70
510 17000 MRC/(MDCR) DESTRUCTION 1ST LESION Moab Regional Health Center 15.30
982 17003 MRC/DESTRUCTION OF LESIONS 2-14 (EACH) Moab Regional Health Center 35.00
982 17003 MRC(MDCR)DSTRCT OF LSNS 2-14(EACH) Moab Regional Health Center 31.50
510 17003 MRC(MDCR)DSTRCT OF LSNS 2-14 (EACH) Moab Regional Health Center 3.50
982 17004 MRC/DESTRUCTION BENIGN LESIONS, 15+ Moab Regional Health Center 370.00
982 17004 MRC (MDCR) DSTRC BENIGN LESIONS, 15+ Moab Regional Health Center 333.00
510 17004 MRC(MDCR) DSTRCT BENIGN LESIONS, 15+ Moab Regional Health Center 37.00
982 17106 DESTRUCTION OF HEMATOMA <10 SQ CM Moab Regional Health Center 420.00
982 17110 MRC/DESTRUCTION BENIGN LESIONS UP TO 14 Moab Regional Health Center 128.00
982 17110 MRC/(MDCR)DSTRUCT BNGN LSNS UP TO 14 Moab Regional Health Center 115.20
510 17110 MRC/(MDCR)DSTRUCT BNGN LSNS UP TO 14 Moab Regional Health Center 12.80
510 17250 MRC/(MDCR)CHEM CAUTERIZTN OF GRANULATION Moab Regional Health Center 9.50
982 17250 MRC/(MDCR)CHEM CAUTERIZTN OF GRANULATION Moab Regional Health Center 85.50
982 17250 MRC/CHEM CAUTERIZATION GRANULATION TISSU Moab Regional Health Center 95.00
982 17260 MRC/DSTRCTN MALIGNANT LES T/A/L 0.5 CM/< Moab Regional Health Center 170.00
982 17261 MRC/DES MAL LES TRNK ARM LEG 0.6-1.0 CM Moab Regional Health Center 222.08
982 17262 MRC/DES MAL LES TRNK ARM LEG 1.1-2.0 CM Moab Regional Health Center 280.00
982 17263 MRC/DES MAL LES TRNK ARM LEG 2.1-3.0 CM Moab Regional Health Center 305.00
982 17270 DEST MAKG LES S/N/H/F/G >.05 CM Moab Regional Health Center 296.00
982 17271 MRC/DEST MAL LES .6-1 CM Moab Regional Health Center 249.00
982 17272 DSTRCTN MLGNNT LSN S/N/H/F/G 1.1-2.0CM Moab Regional Health Center 350.00
982 17280 MRC/ DEST, MAL LES; FACE LESS 0.5 CM Moab Regional Health Center 240.03
510 17281 MRC/MDR MAL LES FACE EARS NOSE 0.6-1.0 C Moab Regional Health Center 28.90
982 17281 MRC/DES MAL LES FACE EARS NOSE 0.6-1.0 C Moab Regional Health Center 289.00
982 17281 MRC/MDR MAL LES FACE EARS NOSE 0.6-1.0 C Moab Regional Health Center 260.10
982 17282 DESTRUCTION MALIGNANT LESION 1.1-2.0 CM Moab Regional Health Center 355.00
982 17340 MRC/CRYOTHERAPY SKIN Moab Regional Health Center 122.00
982 17340 MRC/ (MDCR) CRYOTHERAPY SKIN Moab Regional Health Center 109.80
510 17340 MRC/ (MDCR) CRYOPTHERAPY SKIN Moab Regional Health Center 12.20
982 19020 MRC/MASTOTOMY W/DRAINAGE ABSCESS (DEEP) Moab Regional Health Center 794.00
982 19100 MRC/BX, BREAST, NEEDLE CORE Moab Regional Health Center 418.00
982 19101 MRC/BX BREAST, INCISIONAL Moab Regional Health Center 1,040.00
982 19102 MRC/NEEDLE DIRECTED BREAST BX W/IMAGING Moab Regional Health Center 466.00
982 19110 MRC/NIPPLE EXPLOR W/ OR W/O LACTIF DUCT Moab Regional Health Center 1,002.00
982 19120 MRC/EXC-LESION, BREAST Moab Regional Health Center 1,293.00
982 19125 MRC/EXCIS BREAST LS IDENT PLCMT RAD MK S Moab Regional Health Center 1,186.05
982 19126 MRC/BREAST IDENT. PREOP PLCMT RAD.MK,OP Moab Regional Health Center 595.00
982 19300 MRC/MASTECTOMY FOR GYNECOMASTIA Moab Regional Health Center 1,355.00
982 19301 MRC/BREAST LUMPECTOMY(PARTL MASTECTOMY) Moab Regional Health Center 1,594.00
982 19302 MRC/MASECTOMY, PARTIAL; W AXILLARY LYMPH Moab Regional Health Center 2,370.00
982 19303 MRC/MASTECTOMY, SIMPLE, COMPLETE Moab Regional Health Center 1,859.00
982 19304 MRC/MASTECTOMY-SUBCUTANEOUS Moab Regional Health Center 2,670.00
982 19305 MRC/MAST RAD W/PECT MUSCLES AX W/LYMP ND Moab Regional Health Center 3,092.04
982 19307 MRC/MASTECTOMY, MODIFIED RADICAL; INCL A Moab Regional Health Center 3,188.00
982 20000 MRC/INC SOFT TISSUE ABSCESS SUPERFICIAL Moab Regional Health Center 196.00
982 20005 MRC/I&D SOFT TISSUE ABSCESS SUBFASC Moab Regional Health Center 637.00
982 20103 MRC/EXPL PENETRATING WND SPX EXTREMITY Moab Regional Health Center 1,813.00
982 20240 MRC/BX BONE, OPEN, SUPERFICIAL Moab Regional Health Center 572.00
982 20520 MRC/REM FB MUSCLE/TENDON SHEATH SIMPLE Moab Regional Health Center 304.00
982 20525 MRC/REM FB IN MUSCLE OR TNDN SHEATH, DEE Moab Regional Health Center 896.00
982 20526 INJ, THERAPEUTIC, CardiopulmonaryAL TUNNEL Moab Regional Health Center 210.00
982 20550 MRC(MDCR)INJ SNGL TENDN SHTH OR LIGM Moab Regional Health Center 130.50
510 20550 MRC(MDCR)INJ SNGL TENDN SHTH OR LIGM Moab Regional Health Center 14.50
982 20550 MRC/INJ SINGLE TENDON SHEATH OR LIGAMENT Moab Regional Health Center 145.00
982 20551 MRC/INJX SINGLE TENDON ORIGIN/INSERTION Moab Regional Health Center 156.00
982 20552 MRC(MDCR)SNGL/MULTI POINT 1-2 MUSCLE Moab Regional Health Center 159.30
510 20552 MRC(MDCR)SNGL/MULTI POINT 1-2 MUSCLE Moab Regional Health Center 17.70
982 20552 MRC/INJECT(S) SINGLE/MULTIPLE:1-2 MUSCLE Moab Regional Health Center 177.00
982 20553 MRC(MDCR)INJ SGL/MLTI TRGR PNTS3+ Moab Regional Health Center 148.50
982 20553 MRC/TRIGGER POINT INJECTIONS, 3 OR MORE Moab Regional Health Center 165.00
510 20553 MRC(MDCR)INJ SGL/MLTI TRGR PNTS3+ Moab Regional Health Center 16.50
982 20600 MRC/ARTHOCENT SM JT FING/ Moab Regional Health Center 149.00
982 20600 MRC/ (MDCR) ARTHOCENT SM JT FING/ Moab Regional Health Center 134.10
510 20600 MRC/ (MDCR) ARTHOCENT JT FINGER Moab Regional Health Center 14.90
982 20604 ARTHROCNT ASPIR SM. JOINT W/US GUIDANCE Moab Regional Health Center 235.00
982 20605 MRC/ARTHOCENT INT JT WRI/ Moab Regional Health Center 158.00
982 20605 MRC/ (MDCR) ARTHOCENT INT JT WRI/ Moab Regional Health Center 142.20
510 20605 MRC/ (MDCR) ARTHOCENT INT JT WRI/ Moab Regional Health Center 15.80
982 20606 ARTHROCNTSS ASPIR/INJ INTRM JT/BURS W/US Moab Regional Health Center 315.00
982 20610 MRC/ARTHO MAJ JOINT SHLDR, KNEE, HIP Moab Regional Health Center 202.00
982 20610 MRC/ (MDCR) ARTHOCENT MAJOR JOINT Moab Regional Health Center 181.80
510 20610 MRC/ (MDCR) ARTHOCENT MAJOR JOINT Moab Regional Health Center 20.20
982 20611 ARTHRCNTSS, ASP/INJ, MJR JNT W/US PROFEE Moab Regional Health Center 79.00
982 20612 MRC/ASPIRATION GANGLION CYCST Moab Regional Health Center 123.00
982 20612 MRC/MDCR/ASPIR GANGLION CYST Moab Regional Health Center 110.70
510 20612 MRC/MDCR/ASPIR GANGLION CYST Moab Regional Health Center 12.30
982 20650 MRC/INSERT PIN/WIRE W/APPL SKELETAL TRXN Moab Regional Health Center 391.00
982 20670 MRC/REM IMPLANT, SUPERFICIAL Moab Regional Health Center 362.00
982 20680 MRC/REM IMPLANT, DEEP Moab Regional Health Center 1,589.00
982 20690 MRC/APPLICATION EXT FIXATION DEVICE Moab Regional Health Center 1,282.00
982 20692 APPLICATION MULTIPLANE EXTRNL FIX SYSTM Moab Regional Health Center 2,027.00
982 20694 REM EXTRNL FIXATION UNDER AnesthesiaTHESIA Moab Regional Health Center 883.00
982 20827 MRC/REPLANTATION, THUMB COMPLETE AMPUTAT Moab Regional Health Center 398.00
982 20900 MRC/BONE GRAFT, ANY AREA, MINOR Moab Regional Health Center 1,051.45
982 20924 MRC/TENDON GRAFT FROM A DISTANCE Moab Regional Health Center 1,156.59
982 21012 MRC/EXC TUMOR SOFT TISS FC/SCLP SQ 2 CM> Moab Regional Health Center 711.00
982 21181 MRC/RECON; BENIHN TUMOR OR CRANIAL BONE Moab Regional Health Center 2,996.00
982 21299 MRC/CRANIOFACIAL W MAXILLOFACIAL PROCED Moab Regional Health Center 621.00
982 21550 MRC/BX SOFT TISSUE OF NECK OR THORAX Moab Regional Health Center 759.00
982 21552 MRC/EXC NECK LES SC 3CM/> Moab Regional Health Center 1,057.00
982 21554 MRC/EXC TUMOR, SOFT TIS OF NECK SUBF, 5 Moab Regional Health Center 1,740.00
982 21555 MRC/EXC TUMOR, NECK THORAX; SUBCU Moab Regional Health Center 761.00
982 21556 MRC/EXCIS TUMOR; SOFT TISS NECK, DEEP PF Moab Regional Health Center 1,367.00
982 21800 MRC/TREATMENT OF RIB FRACTURE Moab Regional Health Center 303.00
982 21820 MRC/CLO TX STERNAL FX Moab Regional Health Center 542.00
982 21925 MRC/BX SOFT TISSUE, BACK OR FLANK, DEEP Moab Regional Health Center 976.00
982 21930 MRC/EXCIS TUMOR SOFT TISS BACK- FLANK PF Moab Regional Health Center 1,448.00
982 21931 EXCIS TUMOR, BACK/FLANK SQ 3CM/> Moab Regional Health Center 1,562.00
982 21932 EXCISION, TUMOR, SUB FASCIAL, < 5CM Moab Regional Health Center 2,032.00
982 22305 MRC/CLO TX VERTEBRAL PROCESS FX Moab Regional Health Center 529.00
982 22310 MRC/CLO TX VERTEBRAL FX W/O MANIP W-BRAC Moab Regional Health Center 1,048.01
982 22900 MRC/EXCIS, ABD WALL TUMOR, SUBFAS DESMOI Moab Regional Health Center 1,281.00
982 22901 MRC/ EX TUMOR SFT TSS OF ABDMNL WALL 5CM Moab Regional Health Center 1,356.00
982 22902 EXC TUMOR SOFT TISS ABDMNL WLL SUBQ <3CM Moab Regional Health Center 1,036.00
982 22903 EXC TUMOR,SOFT TS ABD WALL SUBQ 3CM/> Moab Regional Health Center 987.00
982 23030 MRC/I&D SHOULDER DEEP ABSCESS/HEMATOMA Moab Regional Health Center 876.00
982 23044 MRC/ARTHOTOMY, ACROMIOCLAVICULAR JT Moab Regional Health Center 1,367.00
982 23065 MRC/BX SOFT TISSUE SHOULDER AREA Moab Regional Health Center 306.00
982 23075 MRC/EXCIS SOFT TISSUE TUMOR; SHOULDER PF Moab Regional Health Center 721.04
982 23101 MRC/ARTHOTOMY;AC JNT OR SC JNT INSLU BX Moab Regional Health Center 2,069.00
982 23107 ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL Moab Regional Health Center 2,304.00
982 23120 MRC/AC RSXN (CLAVICULECTOMY) Moab Regional Health Center 3,004.00
982 23130 MRC/ACROMIOPLASTY OR ACROMIONECTOMY PART Moab Regional Health Center 1,953.00
982 23155 MRC/EXC/CURTG BONE CYST PROX HUM W-GRAFT Moab Regional Health Center 4,019.00
982 23156 MRC/EXC/CURTG B9 BONE CYST PROX HUM W-AL Moab Regional Health Center 2,833.00
982 23350 MRC/INJ PROC FOR SHOULDER Moab Regional Health Center 358.00
982 23350 MRC/MCR-INJECTION, SHOULDER Moab Regional Health Center 322.20
510 23350 MRC/MCR-INJECTION, SHOULDER Moab Regional Health Center 35.80
982 23410 MRC/OPEN REPAIR ROTATOR CUFF, ACUTE Moab Regional Health Center 2,948.00
982 23412 MRC/OPEN REPAIR ROTATOR CUFF, CHRONIC Moab Regional Health Center 3,514.00
982 23420 MRC/RECONSTRUCTION SHOULDER CUFF AVULSIO Moab Regional Health Center 4,828.01
982 23430 MRC/TENODESIS OF LONG TENDON OF BICEPS Moab Regional Health Center 3,744.09
982 23455 MRC/CAPSULORRAHAPHY W-LABRAL REPAIR Moab Regional Health Center 5,782.00
982 23466 MRC/CAPSULORRAHAPHY GLENOHUMERAL JNT Moab Regional Health Center 6,260.00
982 23470 MRC/ARTHROPLASTY GLENOHUMERAL HEMIARTHR Moab Regional Health Center 4,358.00
982 23472 MRC/ARTHROPLASTY GENOHUMERAL TOTAL SHOUL Moab Regional Health Center 5,752.00
982 23485 OSTEO CLVCLE W/WO INT FIXJ W/BN GRF Moab Regional Health Center 4,350.00
982 23500 MRC/CLO TX CLAVICULAR FX W/O MANIP Moab Regional Health Center 523.00
982 23500 MRC/MDCR/CLTX CLAVICULAR FX W/O MANIP Moab Regional Health Center 470.70
510 23500 MRC/MDCR/CLTX CLAVICULAR FX W/O MANIP Moab Regional Health Center 52.30
982 23505 MRC/CLO TX CLAVICULAR FX W-MANIP Moab Regional Health Center 701.00
982 23515 MRC/OP TX CLAVICLE FX Moab Regional Health Center 2,441.00
982 23540 MRC/CLO TX ACROMIOCLAVICULAR DISLOC Moab Regional Health Center 599.00
982 23540 MRC/MDCR/CLTX CLAVICULAR FX W/O MANIP Moab Regional Health Center 539.10
510 23540 MRC/MDCR/CLTX CLAVICULAR DISL W/O MAN Moab Regional Health Center 59.90
982 23550 MRC/OP TX ACROMIOCLAVICULAR DISLC Moab Regional Health Center 3,193.00
982 23552 MRC/OPTX ACROMCLAV DISLC ACT/CRNC W/FSCL Moab Regional Health Center 3,880.00
982 23570 MRC/CLO TX SCAPULAR FX W/O MANIP Moab Regional Health Center 531.00
982 23600 MRC/CLO TX PROX HUM FX W OR W/O MANIP Moab Regional Health Center 680.00
982 23605 MRC/CLO TX PROX HUM FX W-MANIP Moab Regional Health Center 1,333.00
982 23615 MRC/OP TX PROXIMAL HUMERAL FX Moab Regional Health Center 3,281.04
982 23616 MRC/TREAT HUMERUS FX FIX W/PROSTHETIC RE Moab Regional Health Center 5,700.00
982 23620 MRC/LO TX GR HUM TUB FX Moab Regional Health Center 493.00
982 23620 MRC/MDCR/CLTX GRT HUM TUB FX W/O MAN Moab Regional Health Center 443.70
510 23620 MRC/MDCR/CLTX GRTR HUM TUB FX W/O MAN Moab Regional Health Center 49.30
982 23630 OPEN TX > HUMERAL TBRSTY FX, IE INT FIX Moab Regional Health Center 2,852.00
982 23655 MRC/CLO TX SHOULDER DISLOC W-MANIP Moab Regional Health Center 892.00
982 23670 MRC/OP TX SHOULDER DISLOC W/HUMERUS FX Moab Regional Health Center 3,750.00
982 23930 MRC/I&D HEMATOMA/ABSCESS UPP ARM OR ELBO Moab Regional Health Center 841.05
982 23931 MRC/INC & DRAIN UPPER ARM/ELBOW BURSA Moab Regional Health Center 841.05
982 23935 MRC/INC DEEP W/OPENING BONE CORTEX/ELBOW Moab Regional Health Center 1,855.04
982 24006 MRC/ARTHRTMY ELBOW W-CAPSULAR REL Moab Regional Health Center 2,278.00
982 24065 MRC/BX ELBOW OR ABOVE, SOFT TISSUE Moab Regional Health Center 274.00
982 24075 MRC/EXC TUMOR SOFT TISSUE ARM/ELBOW Moab Regional Health Center 711.00
982 24076 MRC/EXC TUMOR SOFT TISS UPR ARM SUBF <5C Moab Regional Health Center 1,300.00
982 24105 MRC/EXC OLECRANON BURSA Moab Regional Health Center 1,136.00
982 24147 MRC/PARTIAL EXCI BONE OLECRANON PROCE Moab Regional Health Center 1,727.00
982 24149 MRC/RAD RESCJ CAPSL TISS, BONE ELBOW Moab Regional Health Center 2,985.00
982 24200 MRC/RMVL FB UP ARM/ELBOW SQ Moab Regional Health Center 275.00
982 24300 MRC/MANIP ELBOW UNDER AnesthesiaTHESIA Moab Regional Health Center 1,037.00
982 24341 MRC/REPAIR-TENDON/MUSCLE UPPER ARM/ELBOW Moab Regional Health Center 2,956.00
982 24342 MRC/REINSERTN RPTD BICEPS/TRICEPS TENDON Moab Regional Health Center 2,701.00
982 24343 MRC/REPAIR LCL ELBOW Moab Regional Health Center 2,571.00
982 24359 MRC/TENO ELBOW LATERAL/MEDIAL DEBRIDE OP Moab Regional Health Center 2,095.00
982 24366 MRC/ARTHROPLASTY, RADIAL HEAD W/IMPLANT Moab Regional Health Center 2,280.00
982 24500 MRC/CLO TX HUM SHAFT FX W/O MANIP Moab Regional Health Center 778.00
982 24500 MRC/MDCR/CLTX HUMRL SHAFT FX W/O MANJ Moab Regional Health Center 700.20
510 24500 MRC/MDCR/CLTX HUMRL SHAFT FX W/O MANJ Moab Regional Health Center 77.80
982 24530 MRC/CLO TX SUPRA TRANS HUM FX W/O MANIP Moab Regional Health Center 785.00
982 24538 MRC/PRQ SKEL FIXJ SPRCNDYLR HUMERAL FX Moab Regional Health Center 2,469.00
982 24545 MRC/OP TX HUMERAL SUPRACONDYLAR FX W/O X Moab Regional Health Center 3,048.00
982 24546 MRC/OP TX HUMERAL SUPRACNDYLR FX W/XTN Moab Regional Health Center 3,814.02
982 24560 MRC/CLO TX HUMERAL EPICOND W/O MANIP Moab Regional Health Center 873.00
510 24560 MRC/MDCR/CLTX HUMERAL HD FX W/O MANIP Moab Regional Health Center 87.30
982 24576 MRC/CLO TX HUM COND FX MED/LAT W/O MANIP Moab Regional Health Center 652.00
982 24576 MRC/MDCR/CLTX HUMERAL CONDLR FX W/O M Moab Regional Health Center 586.80
510 24576 MRC/MDCR/CLTX HUMERAL CONDYLAR   FX Moab Regional Health Center 65.20
982 24576 MRC/MDCR/CLTX HUMERAL HD FX W/O MANIP Moab Regional Health Center 785.70
982 24579 MRC/OP TX HUM CONDYLAR FX Moab Regional Health Center 2,657.00
987 24586 MRC/OPEN PERIART FX AND/OR DISLOC ELBOW Moab Regional Health Center 3,635.00
982 24600 MRC/CLO TX ELBOW DISLOCATION W/O Moab Regional Health Center 611.00
982 24600 MRC/MDCR CLO TX ELBOW DISLOC W/O AnesthesiaTH Moab Regional Health Center 61.10
982 24600 MRC/MDCR/CLTX ELBOW DISL W/O MANIP Moab Regional Health Center 549.90
982 24605 MRC/CLO TX ELBOW DISLOC W-AnesthesiaTHESIA Moab Regional Health Center 915.00
982 24635 MRC/OP TX MONTEGGIA FX DISLC ELBOW Moab Regional Health Center 3,298.05
982 24650 MRC/CLO TX RADIAL HEAD/NECK FX W/O MANIP Moab Regional Health Center 600.00
982 24655 MRC/CLO TX RADIAL HEAD/NECK FX W-MANIP Moab Regional Health Center 877.00
982 24666 MRC/OP TX RADIAL HEAD/NECK FX PROSTHETIC Moab Regional Health Center 2,782.08
982 24670 MRC/CLO TX ULNAR FX PROX W/O MANIP Moab Regional Health Center 600.00
982 24685 MRC/OP TX ULNAR FX W OR W/O MANIP Moab Regional Health Center 2,352.00
982 25000 MRC/INC EXTENSOR TENDON SHEATH WRIST Moab Regional Health Center 1,266.00
982 25020 MRC/DCMPRN FASCT ARM/WRST FLXR/XTNSR Moab Regional Health Center 1,483.00
982 25028 MRC/I&D 4ARM/WRIST DEEP ABSCESS/HEMATOMA Moab Regional Health Center 914.00
982 25040 MRC/ARTHRTMY CRPL JT W DRAINAGE & REM FB Moab Regional Health Center 1,828.00
982 25065 MRC/BX SOFT TISSUE, FOREARM, WRIST Moab Regional Health Center 319.00
982 25066 BIOPSY, SOFT TISSUE OF FOREARM OR WRIST Moab Regional Health Center 1,691.00
982 25075 MRC/EXC TUMOR SOFT TISSUE WRIST SQ <3 CM Moab Regional Health Center 1,197.00
982 25076 EXC TUMOR SOFT TISS FORE/WRIST >3CM Moab Regional Health Center 1,928.00
982 25111 MRC/EXC GANG WRIST DORSAL/VOLAR, PRIM Moab Regional Health Center 1,310.00
982 25118 MRC/SYNOVECTMY EXTNSR TENDON SHTH WRIST Moab Regional Health Center 1,407.00
982 25248 MRC/EXPLORATION-REM FB, DEEP, FOREARM Moab Regional Health Center 1,092.00
982 25260 MRC/REP DNDN/MUSC FLXR F/ARM & WRIST Moab Regional Health Center 1,926.80
982 25270 MRC/REP TNDN/MUSC XTNSR FOREARM/WRIST Moab Regional Health Center 1,483.00
982 25272 MRC/APR TDN/MUSC XTNSR F/ARM/WRST 1 EA Moab Regional Health Center 2,244.00
982 25274 MRC/REP TNDN/MUSC XTNSR FOREARM & WRIST Moab Regional Health Center 2,793.00
982 25295 MRC/TENOLYSIS FLXR/XTNSR TENDON WRIST Moab Regional Health Center 1,815.00
982 25301 TENODESIS AT WRIST; EXT OF FINGER Moab Regional Health Center 2,875.00
982 25400 MRC/REP NON/MALUNION, RAD/ULN W/O GRAFT Moab Regional Health Center 2,567.00
982 25440 MRC/RPR NONUNION SCAPHOID CRPL BNE W/WO Moab Regional Health Center 5,024.00
982 25447 MRC/ARTHRO. INTERPOS. INTERCAR OR CardiopulmonaryOM Moab Regional Health Center 3,440.71
982 25450 MRC/EPIPHYSIODESIS DISTAL RADIUS/ULNA Moab Regional Health Center 1,310.00
982 25500 MRC/CLO TX RADIAL SHAFT FX W/O MANIP Moab Regional Health Center 594.00
982 25505 MRC/CLO TX RADIAL SHAFT FX W-MANIP Moab Regional Health Center 1,009.00
982 25515 MRC/OP TX RAD SHFT FX W OR W/O FIXJ Moab Regional Health Center 2,475.00
982 25525 OPN RDL SHFT FX CLX RAD/ULN JT DISLOCATE Moab Regional Health Center 2,863.00
982 25526 MRC/OP RAD SHFT FX OPEN RAD/ULN JT DISLC Moab Regional Health Center 2,965.00
982 25530 MRC/CLO TX ULNAR SHAFT FX W/O MANIP Moab Regional Health Center 633.00
982 25545 MRC/OP TX ULNAR SHAFT FX W OR W/O AnesthesiaTH Moab Regional Health Center 2,194.00
982 25560 MRC/CLO TX RADIAL & ULNAR SHAFT W/O MANI Moab Regional Health Center 790.02
982 25565 MRC/CLO TX RADIAL & UNLAR FX WITH MANIP Moab Regional Health Center 1,695.00
982 25574 MRC/OPEN TREATMENT OF RADIAL/ULNAR SHAFT Moab Regional Health Center 1,911.00
982 25575 MRC/OP TX RADIAL & ULNAR SHAFT FX W/FIXJ Moab Regional Health Center 3,200.00
982 25600 MRC/CLO TX DISTAL RADIAL FX W/O MANIP Moab Regional Health Center 682.00
982 25600 MRC/MDCR/CLTX DISTAL RAD FX W/O MANIP Moab Regional Health Center 613.80
510 25600 MRC/MDCR/CLTX DISTAL RAD FX W/O MANIP Moab Regional Health Center 68.20
982 25605 MRC/CLO TX DISTAL RADIAL FX W-MANIP Moab Regional Health Center 1,099.04
982 25606 MRC/PERQ SKEL FIXJ OF DISTAL RAD FX Moab Regional Health Center 1,779.00
982 25607 MRC/OP TX DISTAL RADIAL FX Moab Regional Health Center 2,418.00
982 25608 MRC/OP TX DSTL RADL I-ARTIC FX Moab Regional Health Center 2,307.00
982 25609 MRC/OP TX DISTAL RADIUS Moab Regional Health Center 2,008.00
982 25620 MRC/OP TX DISTAL RADIUS FX Moab Regional Health Center 2,133.00
982 25622 MRC/CLO TX CardiopulmonaryAL SCAPHOID FX W/O MANIP Moab Regional Health Center 732.00
510 25622 MRC/MDCR/CLTX CardiopulmonaryAL SCAPHOID W/O MAN Moab Regional Health Center 73.20
982 25622 MRC/MDCR/CLTX CardiopulmonaryAL SCAPHOID W/O MAN Moab Regional Health Center 658.80
982 25624 MRC/CLO TX CardiopulmonaryAL SCAPHOID FX W-MANIP Moab Regional Health Center 948.00
982 25630 MRC/CLO TX CardiopulmonaryAL FX W/O MANIP Moab Regional Health Center 603.00
510 25630 MRC/MDCR/CLTX CardiopulmonaryAL FX W/O MANIP Moab Regional Health Center 60.30
982 25630 MRC/MDCR/CLTX CardiopulmonaryAL FX W/O MANIP Moab Regional Health Center 542.70
982 25635 MRC/CLO TX CardiopulmonaryAL FX W-MANIP Moab Regional Health Center 989.00
982 25650 MRC/CLO TX ULNAR STYLOID FX Moab Regional Health Center 710.00
982 25652 MRC/OP TX ULNAR STYLOID FX Moab Regional Health Center 1,988.00
982 25660 MRC/CLO TX CardiopulmonaryAL DISLOC W-MANIP Moab Regional Health Center 989.00
982 25671 MRC/PRQ SKLTL FIXJ DISTAL RADIOULNAR DIS Moab Regional Health Center 1,439.75
982 25675 MRC/CLO TX DIST RADIOULNAR DISLOC W-MANI Moab Regional Health Center 892.08
982 25690 MRC/CLO TX OF LUNATE DISL W-MANIP Moab Regional Health Center 1,300.00
982 26010 MRC/DRAINAGE OF FINGER ABSCESS, SIM Moab Regional Health Center 260.00
982 26010 MRC/MDCR DRAINAGE FINGER ABSCESS, SIMPLE Moab Regional Health Center 234.00
510 26010 MRC/MDCR-DRAINAGE FINGER ABSCESS-SIMPLE Moab Regional Health Center 26.00
982 26011 MRC/DRAINAGE FINGER ABSCESS, COMPL Moab Regional Health Center 721.00
982 26020 MRC/DRAINAGE TENDON SHEATH DIGIT & PALM Moab Regional Health Center 1,330.00
982 26025 MRC/DRAINAGE OF PALMAR BURSA SINGLE Moab Regional Health Center 1,581.00
982 26055 MRC/TENDON SHEATH INCISION Moab Regional Health Center 1,564.00
982 26070 MRC/ARTHRT, EXPL DRG/ RMVL LOOSE/FB JT Moab Regional Health Center 1,590.00
982 26075 MRC/ARTHOTOMY METACardiopulmonaryOPHALANGEAL Moab Regional Health Center 1,330.00
982 26080 MRC/ARTHOTOMY W/DRAIN OR FM RMVEJTEACH Moab Regional Health Center 1,065.07
982 26110 MRC/BIOPSY FINGER JOINT LINING Moab Regional Health Center 1,131.00
982 26115 MRC/EXC TUM MAL SFT TIS HND/FNG SUBQ<1.5 Moab Regional Health Center 887.00
982 26116 MRC/EXC TUMOR MAL SFT TIS HAND SUBF<1.5C Moab Regional Health Center 1,596.00
982 26160 MRC/EXC LES TDN SHTH/JT CAPSL HAND/FNGR Moab Regional Health Center 1,020.00
982 26210 MRC/EXC/CURET CYST/TUMOR PHALANX Moab Regional Health Center 1,457.00
982 26236 PARTIAL EXCISION DISTAL PHALANX FINGER Moab Regional Health Center 1,740.00
982 26320 REMOVAL OF IMPLANT FROM FINGER OR HAND Moab Regional Health Center 1,430.00
982 26418 REPAIR EXTENSOR TENDON, FINGER WO GR Moab Regional Health Center 1,478.00
982 26426 MRC/REPAIR EXTENSOR TENDON W/LAT BAND Moab Regional Health Center 2,239.00
982 26480 MRC/TR/TRNSPL TDN Cardiopulmonary/MT CRPL HAND W/O Moab Regional Health Center 2,740.22
982 26540 MRC/REP COLL LIG METACardiopulmonary/IP JOINT Moab Regional Health Center 2,747.00
982 26546 REP NON-UNION METCRPL/PHALANX Moab Regional Health Center 2,911.00
982 26600 MRC/CLO TX METACardiopulmonaryAL FX W/O MANIP Moab Regional Health Center 510.00
982 26600 MRC/MDCR/CLTX METACardiopulmonaryAL FX W/O MAN Moab Regional Health Center 459.00
510 26600 MRC/MDCR/CLTX METACardiopulmonaryAL FX W/O MAN Moab Regional Health Center 51.00
982 26605 MRC/CLO TX METACardiopulmonaryAL FX W-MANIP Moab Regional Health Center 763.00
982 26608 MRC/PRQ SKELETAL FIXJ METACardiopulmonaryAL FX Moab Regional Health Center 1,944.00
982 26615 MRC/OPEN TX METACardiopulmonaryAL FX Moab Regional Health Center 2,238.00
982 26641 CLTX CardiopulmonaryO/METCardiopulmonaryAL DISLO THUMB W/MAN Moab Regional Health Center 932.00
982 26670 MRC/CLO TX CardiopulmonaryOMETACardiopulmonaryAL DISLOCATION Moab Regional Health Center 610.00
982 26676 MRC/PRQ SKEL FIXJ CardiopulmonaryO/MTCRPL DISLC THM Moab Regional Health Center 1,201.10
982 26686 MRC/OP TX Cardiopulmonary/MTCRPL DISLOC THUMB Moab Regional Health Center 2,901.00
982 26700 CLO TX MCP DISLOCATION W/MANI W/O AnesthesiaTH Moab Regional Health Center 366.00
510 26720 MRC/MDCR/CLTX PHALANGEAL FX W/O MAN Moab Regional Health Center 34.80
982 26720 MRC/CLO TX PHALANGEAL FX W/O MANIP Moab Regional Health Center 348.00
982 26720 MRC/MDCR/CLTX PHALANGEAL FX W/O MAN Moab Regional Health Center 313.20
982 26725 MRC/CLO TX PHALANGEAL FX W-MANIP Moab Regional Health Center 601.02
982 26727 MRC/PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MI Moab Regional Health Center 1,562.09
982 26735 MRC/OP TX PHALNGEAL SHAFT FX PROX/MIDDLE Moab Regional Health Center 1,841.00
982 26740 MRC/CLO TX ARTICULAR W/O MANIP Moab Regional Health Center 599.00
510 26740 MRC/MDCR/CLTX ARTICULAR FX W/O MANIP Moab Regional Health Center 59.90
982 26740 MRC/MDCR/CLTX ARTICULAR FX W/O MANIP Moab Regional Health Center 539.10
982 26742 MRC/CLO TX ARTICULAR FX W/MANIP Moab Regional Health Center 883.00
510 26742 MRC/MDCR/CLTX ARTICULAR FX W/MANIP Moab Regional Health Center 88.30
982 26742 MRC/MDCR/CLTX ARTICULAR FX W/MANIP Moab Regional Health Center 794.70
982 26746 MRC/OP TX ARTICULAR FX MCP/IP JOINT Moab Regional Health Center 2,545.00
982 26750 MRC/CLO TX DISTAL PHALANGEAL FX W/O MANI Moab Regional Health Center 302.00
982 26750 MRC/MDCR/CLTX DIST PHLNGL FX W/O MAN Moab Regional Health Center 271.80
510 26750 MRC/MDCR/CLTX DIST PHLNGL FX W/O MAN Moab Regional Health Center 30.20
982 26755 MRC/CLO TX DIST PHAL FX W-MANIP (EA) Moab Regional Health Center 559.00
982 26756 MRC/PRQ SKEL FIXJ DISTL PHLNGL FX FINGER Moab Regional Health Center 1,109.00
982 26765 MRC/OP TX DIST PHAL FX Moab Regional Health Center 1,294.00
982 26770 MRC/CLO TX INTERPHAL DISL W-MANIP Moab Regional Health Center 669.00
982 26775 MRC/CLO TX INTRPHLNGL JNT DISLOC W-AnesthesiaT Moab Regional Health Center 767.00
982 26776 MRC/PRQ SKEL FIXJ PHAL JT DISLC W/MANJ Moab Regional Health Center 941.00
982 26785 MRC/OP TX INTERPHALANGEAL JOINT DISLOCAT Moab Regional Health Center 1,556.00
982 26860 MRC/ARTHRODESIS INTERPHALANGEAL JNT W/WO Moab Regional Health Center 1,948.00
982 26951 MRC/AMPUTATION FINGER OR THUMB;ANY JOINT Moab Regional Health Center 1,450.00
982 26952 MRC/AMPUTATION FINGER OR THUMB ANY JOINT Moab Regional Health Center 1,848.00
982 26990 MRC/I&D HEMATOMA-PELVIS OR HIP AREA Moab Regional Health Center 1,330.00
982 27030 MRC/ARTHOSTOMY, HIP, W/DRAINAGE (ef. inf Moab Regional Health Center 3,565.00
982 27047 MRC/EXC, TUMOR, PELVIS & HIP: SUBCU.TISS Moab Regional Health Center 1,131.00
982 27086 REMOVAL OF FOREIGN BODY, PELVIS/HIP SQ Moab Regional Health Center 430.00
982 27087 REMOVAL FOREIGN BODY, PELVIS/HIP DEEP Moab Regional Health Center 1,776.00
982 27093 MRC/ INJ HIP ARTRGRPHY W/O AnesthesiaTHESIA Moab Regional Health Center 577.00
982 27125 MRC/HEMIARTHROPLASTY, HIP, PARTIAL Moab Regional Health Center 8,072.00
982 27130 MRC/ARTHROPLASY, TOTAL HIP Moab Regional Health Center 9,673.02
982 27193 MRC/CLO TX PELVIC RNG FX W/O MANIP Moab Regional Health Center 1,023.00
982 27194 MRC/CLO TX PELV RNG FX DISL W-MANIP & AN Moab Regional Health Center 2,005.00
982 27197 CLX TX PELVIC RIGH FX W/O MANIP Moab Regional Health Center 427.00
982 27220 MRC/CLO TX HIP SOCKET FX W/O AnesthesiaTH Moab Regional Health Center 1,033.00
982 27220 MRC/MDCR/CLTX ACETABULUM HIP W/O MAN Moab Regional Health Center 929.70
510 27220 MRC/MDCR/CLTX ACETABLM HIP W/O MANIP Moab Regional Health Center 103.30
982 27222 MRC/CLO TX ACETABULUM FX W-MANIP Moab Regional Health Center 2,272.00
982 27230 MRC/CLO TX FEM FX PROX END NECK W/O MANI Moab Regional Health Center 909.00
982 27232 MRC/CLO TX FEM FX PRXM END W-MANIP Moab Regional Health Center 2,066.00
982 27235 MRC/PRQ SKEL FIXJ FEMORAL FX PROX END NC Moab Regional Health Center 4,431.00
982 27236 MRC/OP TX FEM FX PROX END NCK W-INT FIXJ Moab Regional Health Center 4,362.00
982 27238 MRC/CLO TX TROCHANTERIC FEM FX W/O MANIP Moab Regional Health Center 1,100.00
982 27240 MRC/CLTX SBTRCHNTRC FEM FX W-MANIP Moab Regional Health Center 2,106.00
982 27240 MRC/MDCR/CLTX FEMRL FX W/MANIP Moab Regional Health Center 1,895.40
510 27240 MRC/MDCR/CLTX FEMRL FX W MANIP Moab Regional Health Center 210.60
982 27244 MRC/TX SUBTRCHNTRIC FEM FX SCREW IMPLNT Moab Regional Health Center 3,585.00
982 27245 MRC/OP TX FEMORAL FX WITH HARDWARE Moab Regional Health Center 4,460.00
982 27246 MRC/CLO TX GRT TROCHANTERIC FX W OR WO M Moab Regional Health Center 748.00
982 27246 MRC/MDCR/CLTX GRT TROCHNTRC FX W-W/O Moab Regional Health Center 673.20
510 27246 MRC/MDCR/CLTX GRT TROCHNTRC FX W-W/O Moab Regional Health Center 74.80
982 27248 OPEN TX > TROCHANTERIC FX Moab Regional Health Center 2,272.00
982 27252 MRC/CLO TX HIP DISLOC W-AnesthesiaTH Moab Regional Health Center 1,474.00
982 27266 MRC/CLO TX POST ARTHRPL HIP DISLOC W-ANE Moab Regional Health Center 1,481.00
982 27269 MRC/OPTX FEMORAL FX, INTERNAL FIXATION Moab Regional Health Center 4,159.00
982 27301 MRC/I&D DEEP ABSCESS, BURSA, HEMATOMA Moab Regional Health Center 978.08
982 27305 MRC/FASCIOTOMY ILIOTIBIAL OPEN Moab Regional Health Center 1,690.00
982 27310 MRC/ARTHOTOMY, KNEE W/DRAINAGE OR REM FB Moab Regional Health Center 3,315.00
982 27331 MRC/ARTHROTOMY KNEE;W BIOPSY REM OF FB Moab Regional Health Center 2,934.00
982 27337 EXC TUMOR SFT TISS THIGH/KNEE SUBQ 3CM/> Moab Regional Health Center 1,121.00
982 27339 MRC/EXC THIGH/KNEE TUM DEP 5CM/> Moab Regional Health Center 5,089.00
982 27340 MRC/EXC PREPATELLAR BURSA Moab Regional Health Center 1,713.00
982 27385 MRC/SUTURE QUADRICEPS/HMSTRNG RUPTURE Moab Regional Health Center 2,381.00
987 27403 ARTHROTOMY W/MENISRUS REPAIR, KNEE Moab Regional Health Center 2,572.00
982 27405 MRC/REPAIR LIGAMENT, KNEE, COLLATERAL Moab Regional Health Center 2,874.00
982 27415 MRC/OSTEOCHONDRAL ALLOGRAFT KNEE OPEN Moab Regional Health Center 6,505.00
982 27418 MRC/ANTERIOR TIBIAL TUBERCLEPLASTY Moab Regional Health Center 3,013.00
982 27420 MRC/RCONSTJ DISLOCATING PATELLA Moab Regional Health Center 2,739.00
982 27422 MRC/RCNST J DISLC PATELLA W/XTNSR RLIGNM Moab Regional Health Center 2,823.00
982 27425 MRC/LAT RETINACULAR RELEASE, OPEN Moab Regional Health Center 1,989.00
987 27447 MRC/TKA KNEE, MED & LAT Moab Regional Health Center 6,597.05
982 27486 MRC/REVISION TKA Moab Regional Health Center 6,600.00
982 27487 MRC/REVJ TKA FEM & TIBIAL COMPONENT Moab Regional Health Center 7,017.00
982 27496 MRC/DECOMPRESSION FASCIOTOMY THIGH/KNEE Moab Regional Health Center 1,414.00
982 27501 MRC/CLO TX SUPRA/TRANS CONDYLAR FEM W/O Moab Regional Health Center 1,676.00
982 27501 MRC/MDCR/CLTX FEMORAL FX W/O MANIP Moab Regional Health Center 167.60
982 27501 MRC/MDCR/CLTX SPRCNDLR FEM FX W/O MAN Moab Regional Health Center 1,508.40
982 27502 MRC/CLO TX FEM SHFT FX W-MANIP W/O TRAX Moab Regional Health Center 2,369.00
982 27506 MRC/OP TX FEM SHAFT FX Moab Regional Health Center 4,904.00
982 27508 MRC/CLO TX DISTL FEM FX MED/LAT W/O MANI Moab Regional Health Center 1,171.00
982 27508 MRC/MDCR/CLTX DISTL FEMRL FX W/O MAN Moab Regional Health Center 1,053.90
510 27508 MRC/MDCR/CLTX DSTL CONDYLR FX W/O MAN Moab Regional Health Center 117.10
982 27513 MRC/OP TX FEM SPRCNDYLR FX W/XTN Moab Regional Health Center 2,316.00
982 27514 MRC/OP TX FEMUR FX DIST MED/LAT CONDYLE Moab Regional Health Center 4,547.00
982 27517 CLX REDUCTION OF DISTAL FEMUR DISC Moab Regional Health Center 2,165.00
982 27520 MRC/CLO TX PATELLAR FX W/O MANIP Moab Regional Health Center 692.00
510 27520 MRC/MDCR/CLTX PATELLAR FX W/O MANIP Moab Regional Health Center 69.20
982 27520 MRC/MDCR/CLTX PATELLAR FX W/O MANIP Moab Regional Health Center 622.80
982 27524 MRC/OP TX PATELLA FX W/SOFT TISSUE REPAI Moab Regional Health Center 2,921.00
982 27530 MRC/CLO TX TIBIAL FX W/O MANIP Moab Regional Health Center 896.00
982 27532 CLTX TIBIAL FX W/WO MANJ W/SKEL TRACJ Moab Regional Health Center 1,342.00
982 27535 MRC/OPEN TREATMENT TIBIAL FX, PROX, FIX Moab Regional Health Center 3,108.00
982 27536 MRC/OP TX TIBIAL FX, PROX BICONDYLAR Moab Regional Health Center 3,604.00
982 27538 MRC/CLO TX TUBEROSITY FX KNEE W-W/O MANI Moab Regional Health Center 1,110.00
982 27540 MRC/OP TX INTERCONDLR SPINE/TUBRST FX KN Moab Regional Health Center 2,921.00
982 27550 MRC/CLO TX KNEE DISLO W/O AnesthesiaTH Moab Regional Health Center 809.00
982 27552 MRC/CLO TX KNEE DISLOC W-AnesthesiaTH Moab Regional Health Center 935.00
982 27560 CLOSED TX PATELLAR DISLOCTN W/O AnesthesiaTH Moab Regional Health Center 569.00
982 27570 MRC/MANIP KNEE UNDER GEN AnesthesiaTH Moab Regional Health Center 578.00
982 27590 MRC/ABOVE THE KNEE AMPUTATION Moab Regional Health Center 3,069.00
982 27596 AMPUTATION THIGH THROUGH FEMUR RE-AMPUTN Moab Regional Health Center 3,096.00
982 27599 MRC/UNLISTED PROCEDURE FEMUR/KNEE Moab Regional Health Center 2,734.00
982 27601 DCMPRN FASCT LEG POST COMP ONLY Moab Regional Health Center 1,443.00
982 27602 MRC/DCMPRN FASCT LEG ANT&LAT&PST CMPRTMT Moab Regional Health Center 1,922.00
982 27603 MRC/ A&D LEG OR ANKLE;DEEP ABSCESS OR HE Moab Regional Health Center 1,048.01
982 27605 INCISION OF ACHILLES TENDON Moab Regional Health Center 669.00
982 27607 MRC/INCISION LEG/ANKLE Moab Regional Health Center 1,909.00
982 27610 MRC/ARTHOTOMY-ANKLE, W/EXPLOR & FB REM Moab Regional Health Center 2,374.00
982 27613 MRC/BX SOFT TISSUE LEG, DEEP Moab Regional Health Center 574.00
982 27620 MRC/ARTHRTMY ANKLE W/WO BX W/WO REM FB Moab Regional Health Center 2,566.00
982 27635 MRC/EX/CURET BONE CYST Moab Regional Health Center 2,573.81
982 27640 MRC/PARTIAL EXCISION BONE TIBIA Moab Regional Health Center 3,184.00
982 27650 MRC/REP PRIM OP/PRQ RUPTRD ACHLLS Moab Regional Health Center 2,638.65
982 27658 MRC/REP FLEXOR TENDON LEG PRIM W/O GRAFT Moab Regional Health Center 1,236.00
982 27675 MRC/REP DISL PERONEAL TNDN W/O FIB OSTEO Moab Regional Health Center 1,236.00
982 27687 MRC/GASTROCNEMIUS RECESSION Moab Regional Health Center 1,428.00
982 27698 MRC/REPAIR OF ANKLE LIGAMENT Moab Regional Health Center 2,986.00
982 27750 MRC/CLO TX TIB FX W/WO FIBFX Moab Regional Health Center 929.00
982 27752 MRC/CLO TX TIBULA FX W-MANIP Moab Regional Health Center 1,528.00
982 27756 MRC/PRQ SKELETAL FIXATION TIBIAL SHAFT F Moab Regional Health Center 2,681.00
982 27758 MRC/OP TX TIBIAL SHAFT FX W/HARDWARE Moab Regional Health Center 3,229.07
982 27759 MRC/TX TIBL SHFT FX BY IMPLT W/WO SCREWS Moab Regional Health Center 3,756.00
982 27760 MRC/CLO TX MED MALL FX W/O MANIP Moab Regional Health Center 692.00
982 27760 MRC/MDCR/CLTX MED MALLEOLUS FX W/O MA Moab Regional Health Center 622.80
510 27760 MRC/MDCR/CLTX MED MALLEOLUS FX W/O MA Moab Regional Health Center 69.20
982 27762 MRC/CLO TX MED MALL FX W-MANIP Moab Regional Health Center 1,231.00
982 27766 MRC/OP TX MEDIAL MAL FX, W OR W/O FIXJ Moab Regional Health Center 2,146.00
982 27767 MRC/CLO TX POSTR MALL FX W/O MANIP Moab Regional Health Center 616.00
982 27769 MRC/OP TX POSTERIOR MALLEOLUS FX Moab Regional Health Center 2,165.00
982 27780 MRC/CLO TX PROX FIB FX W/O MANIP Moab Regional Health Center 637.00
982 27781 MRC/CLO TX FIB FX W MANIP Moab Regional Health Center 1,132.20
982 27784 MRC/OP TX PROXIMAL FIBULA SHAFT FX Moab Regional Health Center 1,991.00
982 27786 MRC/CLO TX DISTAL FIB FX W/O MANIP Moab Regional Health Center 729.00
510 27786 MRC/MDCR/CLTX DISTAL FIB FX W/O MANIP Moab Regional Health Center 72.90
982 27792 MRC/OP TX DISTAL FIBULAR FX Moab Regional Health Center 2,106.00
982 27808 MRC/CLO TX BIMALLEOLAR ANKLE FX W/O MANI Moab Regional Health Center 765.00
982 27808 MRC/MDCR/CLTX BIMALLEOLAR FX W/O MANI Moab Regional Health Center 688.50
510 27808 MRC/MDCR/CLTX BIMALLEOLAR FX W/O MANI Moab Regional Health Center 76.50
982 27810 MRC/CLO TX BIMALLEOLAR FX W MANIP Moab Regional Health Center 1,445.00
982 27814 OPEN TX BIMALLEOLAR ANKLE FX IE INT FIX Moab Regional Health Center 3,000.00
982 27816 MRC/CLO TX TRIMALLEOLAR ANKLE FX W/O MAN Moab Regional Health Center 846.00
982 27818 MRC/CLO TX TRIMALLEOLAR ANKLE FX W-MANIP Moab Regional Health Center 1,651.00
982 27822 MRC/OP TX TRIMALLEOLAR ANKLE FX Moab Regional Health Center 3,441.00
982 27823 MRC/OP TX TRIMALLEOLAR ANKLE FX W/FIXJ Moab Regional Health Center 4,038.00
982 27824 MRC/CLO TX WT BRNG ARTICULAR TIB W/O MAN Moab Regional Health Center 806.00
982 27825 MRC/CLO TX DISTAL TIBIA W-MANIP Moab Regional Health Center 1,651.00
982 27826 MRC/OP TX DISTAL TIBIA Moab Regional Health Center 3,474.00
982 27827 MRC/OP TX FRACTURE DISTL TIBIA Moab Regional Health Center 4,359.00
982 27828 MRC/OP TX FX DISTAL TIBIA & FIBULA Moab Regional Health Center 4,359.00
982 27829 MRC/OP TX DISTAL TIBIOFIBULAR JNT DISRUP Moab Regional Health Center 2,123.00
982 27840 MRC/CLO TX ANKLE DISLOC W/O AnesthesiaTH Moab Regional Health Center 309.00
510 27840 MRC/MDCR/CLTX ANKLE DISLOC W/O AnesthesiaTH Moab Regional Health Center 30.90
982 27840 MRC/MDCR/CLTX ANKLE DISLOC W/O AnesthesiaTH Moab Regional Health Center 278.10
982 27842 MRC/CLO TX ANKLE DISLOC W/Anesthesia Moab Regional Health Center 1,018.00
982 27842 MRC/MDCR/CLTX ANKLE DISLOC W/AnesthesiaTH Moab Regional Health Center 916.20
510 27842 MRC/MDCR/CLTX ANKLE DISLOC W/AnesthesiaTH Moab Regional Health Center 101.80
982 27846 MRC/OP TX ANKLE DISL W/O INTERNAL FIXJ Moab Regional Health Center 2,542.05
982 27848 MRC/OP TX ANKLE DISLOC W/O INTERNAL FIXJ Moab Regional Health Center 2,681.00
982 27870 MRC/ARTHRODESIS, ANKLE, OPEN Moab Regional Health Center 4,835.00
982 27871 MRC/ARTHRODESIS TIBIOFIBULAR JOINT PRX D Moab Regional Health Center 3,368.00
982 27880 MRC/AMPUTATION LEG THR TIBIA & FIBIA Moab Regional Health Center 2,785.00
982 28001 MRC/INC & DRAINAGE BURSA FOOT Moab Regional Health Center 313.00
982 28002 MRC/I&D BELOW FASCIA FOOT 1 BURSAL SPACE Moab Regional Health Center 806.09
982 28003 MRC/I&D BELOW FASCIA FOOT MULT AREAS Moab Regional Health Center 1,216.00
982 28005 MRC/INCISION BONE CORTEX FOOT Moab Regional Health Center 1,215.00
982 28008 MRC/FASCIOTOMY FOOT &/TOE Moab Regional Health Center 1,013.04
982 28020 MRC/ARTHRO INCL EXPLR DRN/REM INTTAR/TAR Moab Regional Health Center 1,006.00
982 28022 MRC/ARTHOTOMY, DRAIN OR REMVL FB, METAT Moab Regional Health Center 1,063.00
982 28024 MRC/ARTHOTOMY OF INTERPHALANGEAL Moab Regional Health Center 937.00
982 28039 MRC/EXC TUMOR SFT TIS OF FT/TOE SUBQ 1.5 Moab Regional Health Center 1,161.00
982 28043 MRC/EXC TUMOR SOFT TISSUE FOOT/TOE SUBQ Moab Regional Health Center 2,043.00
982 28045 MRC/EXC TUMOR SOFT TISSUE FOOT <1.5 cm Moab Regional Health Center 1,141.00
982 28060 MRC/RELEASE OF PLANTAR FASCIA Moab Regional Health Center 1,105.00
982 28080 EXCIS INTERDIGITAL MORTON NEUROMA SINGLE Moab Regional Health Center 1,169.00
982 28090 MRC/EXC LES TEND, TEND SHEATH, OR CAP; F Moab Regional Health Center 994.00
982 28100 MRC/EXC ANKLE/HEEL LESION Moab Regional Health Center 1,442.00
982 28104 MRC/EXC/CURRETAGE OF BEN BONE CYST TARSA Moab Regional Health Center 1,041.00
982 28108 MRC/EXC/CURTG CYST/B9 TUM FOOT PHALANGES Moab Regional Health Center 916.00
982 28118 OSTECTOMY CALCANEUS Moab Regional Health Center 1,466.00
982 28119 MRC/OSTECTOMY, CALC; SPUR, W/WO PLNTR RL Moab Regional Health Center 1,296.00
982 28120 MRC/Partial excision bone; talus or calc Moab Regional Health Center 1,569.00
982 28140 MRC/METATARSECTOMY Moab Regional Health Center 1,372.00
982 28190 MRC/FOREIGN BODY REMOVAL FOOT SUBQ Moab Regional Health Center 540.00
982 28192 MRC/REM FB FOOT, DEEP Moab Regional Health Center 873.00
982 28208 MRC/REPAIR TENDON EXTENSOR, FOOT Moab Regional Health Center 771.00
982 28285 MRC/CORRECTION HAMMER TOE Moab Regional Health Center 1,144.00
982 28290 MRC/BUNIONECTOMY Moab Regional Health Center 1,658.00
982 28296 MRC/CORRJ HALLUX VALGUS W-W/O SESMDC Moab Regional Health Center 2,407.00
982 28312 MRC/OSTEOTOMY OTHER PHALANGES, ANY TOE Moab Regional Health Center 848.00
982 28313 MRC/RCNSTJ ANGULAR DFRM TOE SOFT TISSUE Moab Regional Health Center 782.00
982 28315 MRC/SESAMOIDECTOMY FIRST TOE SPX Moab Regional Health Center 912.00
982 28400 MRC/CLO TX CALCANEAL FX W/O MANIP Moab Regional Health Center 679.00
982 28400 MRC/MDCR/CLTX CALCANEAL FX W/O MANIP Moab Regional Health Center 611.10
510 28400 MRC/MDCR/CLTX CALCANEAL FX W/O MANIP Moab Regional Health Center 67.90
982 28405 MRC/CLO TX CALCANEAL FX W-MANIP Moab Regional Health Center 1,145.00
982 28415 MRC/OP TX CALCANEAL FX Moab Regional Health Center 2,948.00
982 28430 MRC/CLO TX OF TALUS FX W/O MANIP Moab Regional Health Center 688.00
982 28445 MRC/OP TX TALUS FX Moab Regional Health Center 2,711.00
982 28450 MRC/TX TARSAL FX W/O MANJ Moab Regional Health Center 656.00
982 28455 MRC/TX TARSAL FX W/MANJ Moab Regional Health Center 709.00
982 28456 MRC/PRQ SKEL FIXJ TARSL FX W/MANIP Moab Regional Health Center 1,270.08
982 28470 MRC/CLO TX METATARSAL FX W/O MANIP Moab Regional Health Center 510.00
982 28470 MRC/MDCR/CLTX METATARSAL FX W/O MAN Moab Regional Health Center 458.90
510 28470 MRC/MDCR/CLTX METATARSAL FX W/O MAN Moab Regional Health Center 51.10
982 28475 MRC/CLO TX METARTARSAL FX W-MANIP Moab Regional Health Center 760.00
982 28476 MRC/PRQ SKEL FIXJ MET FX W/ MANJ Moab Regional Health Center 1,383.00
982 28485 MRC/OP TX METARSAL FX W-W/O EXT FXJ Moab Regional Health Center 1,797.00
982 28490 MRC//CLO TX FX GREAT TOE, PHALANX WO MAN Moab Regional Health Center 311.00
982 28490 MRC/MDCR/CLTX GREAT TOE FX W/O MANIP Moab Regional Health Center 279.90
510 28490 MRC/MDCR/CLTX GREAT TOE FX W/O MANIP Moab Regional Health Center 31.10
982 28495 MRC/CLO TX GREAT TOE W-MANIP Moab Regional Health Center 521.00
982 28496 MRC/PRQ SKEL FIXJ FX GRT TOE PHLX W/MANJ Moab Regional Health Center 679.00
982 28505 MRC/OP TX FX TOE W OR W/O INT FIXJ Moab Regional Health Center 1,186.00
982 28510 MRC/CL TX PHLX/PHLG OTHER THAN GREAT TOE Moab Regional Health Center 234.00
982 28515 MRC/CLO TX PHLNX FX (NOT GRT TOE) W-MANI Moab Regional Health Center 393.00
982 28525 MRC/OP TX FX PHALANX (NOT GREAT TOE) Moab Regional Health Center 995.00
982 28540 MRC/CLO TX TARSAL DISLOC W/O AnesthesiaTH Moab Regional Health Center 462.00
982 28570 MRC/CLO TX TALOTARSAL JNT DISLOC W/O-ANE Moab Regional Health Center 572.00
982 28575 MRC/CLO TX TALO DISLOC W-AnesthesiaTH Moab Regional Health Center 886.00
982 28605 MRC/CLO TX MEATARSAL JNT DISLOCATE W/ANE Moab Regional Health Center 635.04
982 28606 MRC/PRQ SKEL FIXJ TARS JT DISLOC W/MANJ Moab Regional Health Center 1,028.00
982 28615 MRC/OP TX TARSOMETARSAL JOINT DISLOC Moab Regional Health Center 1,655.00
982 28645 MRC/OPEN REDUCTION OF MCP JOINT FINGER Moab Regional Health Center 1,475.00
982 28660 CLTX INTERPHALANGEAL JNT DISLCT W/O ANE Moab Regional Health Center 168.00
982 28750 MRC/ARTHRODESIS GREAT TOE META JOINT Moab Regional Health Center 2,138.00
982 28810 MRC/AMPUTATION METATARSAL WITH TOE Moab Regional Health Center 1,613.00
982 28820 MRC/AMPUTATION METATARSAL Moab Regional Health Center 1,101.00
982 28825 MRC/AMPUTATION-DISTAL PHALANX Moab Regional Health Center 1,421.00
982 29065 APPLICATION- LONG ARM FIGERGLASS CAST Moab Regional Health Center 240.00
982 29065 MRC/MDCR/APPL FG LONG ARM CAST Moab Regional Health Center 216.00
510 29065 MRC/MDCR/APPL FG LONG ARM CAST Moab Regional Health Center 24.00
510 29075 MRC/(MDCR)SHORT ARM CAST Moab Regional Health Center 18.60
982 29075 MRC/(MDCR)SHORT ARM FIBERGLASS CAST Moab Regional Health Center 167.40
982 29075 APPLICATION-SHORT ARM FIBERGLASS CAST Moab Regional Health Center 186.00
982 29105 APPLICATION- LONG ARM SPLINT Moab Regional Health Center 153.00
982 29105 MRC/MDCR/APPL LONG ARM SPLINT Moab Regional Health Center 137.70
510 29105 MRC/MDCR/APPL LONG ARM SPLINT Moab Regional Health Center 15.30
982 29125 MRC/MDCR/APPL PLSTR SHORT ARM SPLING Moab Regional Health Center 118.80
510 29125 MRC/MDCR/APPL PLSTR SHORT ARM SPLINT Moab Regional Health Center 13.20
982 29125 APPLICATION-SHORT ARM SPLINT Moab Regional Health Center 132.00
982 29130 MRC/APPLICATION OF FINGER SPLINT-STATIC Moab Regional Health Center 84.00
982 29130 MRC/MDCR/APPL FINGER SPLINT Moab Regional Health Center 75.60
510 29130 MRC/MDCR/APPL FINGER SPLINT Moab Regional Health Center 8.40
982 29240 MRC/STRAPPING SHOULDER Moab Regional Health Center 75.00
982 29305 MRC/APPLICATION OF HIP SPICA CASTONE LEG Moab Regional Health Center 581.00
982 29305 MRC/MDCR/APPL HIP SPICA Moab Regional Health Center 522.90
510 29305 MRC/MDCR/APPL HIP SPICA Moab Regional Health Center 58.10
982 29325 APPL HIP SPICA CAST 1 & 1/2/ BOTH LEGS Moab Regional Health Center 750.00
982 29345 APPLICATION LONG LEG CAST Moab Regional Health Center 394.00
510 29345 MRC/MDCR/APPL LONG LEG FBRGLS Moab Regional Health Center 354.60
510 29345 MRC/MDCR/APPL FG LONG LEG CAST Moab Regional Health Center 39.40
982 29365 APPLICATION OF CYLINDER CAST (LONG LEG) Moab Regional Health Center 287.00
982 29405 MRC/MDCR/APPL FG SHORT LEG CAST Moab Regional Health Center 235.80
510 29405 MRC/MDCR/APPL FG SHORT LEG CAST Moab Regional Health Center 26.20
982 29405 APPLICATION-SHORT LEG FIBERGLASS CAST Moab Regional Health Center 262.00
982 29425 MRC/MDCR/APPL WALKING CAST SHORT LEG Moab Regional Health Center 275.40
510 29425 MRC/MDCR/APPL WALKING CAST SHORT LEG Moab Regional Health Center 30.60
982 29425 MRC/APPLICATION WALKING CAST Moab Regional Health Center 306.00
982 29435 MRC/MDCR/APPL PATELLAR TNDN BRNG CAST Moab Regional Health Center 354.60
510 29435 MRC/MDCR/APPL PATELLAR TNDN BRNG CAST Moab Regional Health Center 39.40
982 29435 MRC/APPLICATION PATELLAR TNDN BRNG CAST Moab Regional Health Center 394.00
982 29445 MRC/MDCR/APPL TOTAL CONTACT CAST Moab Regional Health Center 341.10
510 29445 MRC/MDCR/APPL TOTAL CONTACT CAST Moab Regional Health Center 37.90
982 29445 MRC/APPLICATION OF TOTAL CONTACT CAST Moab Regional Health Center 379.00
510 29505 MRC/MDCR/APPL LONG LEG SPLINT Moab Regional Health Center 14.70
982 29505 MRC/MDCR/APPL LONG LEG SPLINT Moab Regional Health Center 132.30
982 29505 APPLICATION LONG LEG SPLINT Moab Regional Health Center 147.00
982 29515 MRC/MDCR/APPL SHORT LEG SPLINT Moab Regional Health Center 127.80
510 29515 MRC/MDCR/APPL SHORT LEG SPLINT Moab Regional Health Center 14.20
982 29515 MRC/APPL SHORT LEG SPLINT CALF-FOOT Moab Regional Health Center 142.00
982 29515 APPLICATION-SHORT LEG SPLINT Moab Regional Health Center 122.00
982 29540 STRAPPING ANKLE &/OR FOOT Moab Regional Health Center 78.00
982 29580 MRC/APPLICATION-UNNA BOOT Moab Regional Health Center 126.00
982 29580 MRC(MDCR)STRAPPING; UNNA BOOT Moab Regional Health Center 113.40
510 29580 MRC(MDCR)STRAPPING; UNNA BOOT Moab Regional Health Center 12.60
982 29705 MRC/REMOVAL/ BIVALVING:FULL ARM, LEG CST Moab Regional Health Center 129.00
982 29740 WEDGING OF CAST Moab Regional Health Center 110.00
982 29805 MRC/ARTHROSCOPY SHOULDER W/WO SYNOVIA Moab Regional Health Center 1,534.00
982 29806 MRC/ARTHROSCOPY SHOULDER CAPSULORRHAPHY Moab Regional Health Center 3,966.00
982 29807 MRC/ARTHROSCOPIC REP SLAP LESION Moab Regional Health Center 4,022.01
982 29819 MRC/ARTH SHOULD SURG W/ REM OF LOOSE B Moab Regional Health Center 2,346.00
982 29820 MRC/ARTHOSCOPY SHOULDER W/PARTIALSYNOV Moab Regional Health Center 3,257.00
982 29821 ARTHROSCOPY, SYNOVECTOMY COMPLETE Moab Regional Health Center 2,797.00
982 29822 MRC/ARTHROSCOPY W DEBRIDEMENT, LIMITED Moab Regional Health Center 3,069.00
982 29823 MRC/ARTHROSCOPY SHLDR W EXTENSIVE DBRDMT Moab Regional Health Center 2,988.09
982 29824 MRC/DISTAL CLAVICULECTOMY Moab Regional Health Center 1,917.00
982 29826 MRC/ARTHROSCOPY SHOULDER W/PART ACROM Moab Regional Health Center 3,167.00
982 29827 MRC/ARTHROSCOPY SHOULDER W/ROTATORCF RE Moab Regional Health Center 3,298.00
982 29828 MRC/ARTHRO SHOULDER SURGICAL BICPS TNDSI Moab Regional Health Center 3,453.03
982 29834 MRC/ARTHROSCOPY, ELBOW, SURG RMVAL Moab Regional Health Center 2,140.00
982 29838 MRC/ARTHRO ELBOW, SURG W/EXTSV DEBRDMT Moab Regional Health Center 2,553.00
982 29856 MRC/ARTHRS AID TIBIAL FX PRX UNCND/BCN Moab Regional Health Center 3,555.09
982 29862 MRC/ARTHROSCOPY, IP, SURGICAL; W/DEBRD Moab Regional Health Center 4,208.09
982 29863 MRC/ARTHROSCOPY HIP SURG W/SYNOVECTOM Moab Regional Health Center 3,740.00
982 29870 MRC/ARTHROSCOPY, KNEE DX W OR W/O SYNVL Moab Regional Health Center 1,324.00
982 29871 MRC/ARTHROS KNEE SUR FOR INFECT LAV DRAI Moab Regional Health Center 1,891.00
982 29873 MRC/ARTHROSCOPY KNEE, SURGICAL, W LAT RL Moab Regional Health Center 2,457.00
982 29874 MRC/ARTHROSCOPY OF KNEE REMOVE LOOSE/FB Moab Regional Health Center 2,734.00
982 29875 MRC/ARTHROSCOPY KNEE;SYNOVECTOMY LTD Moab Regional Health Center 2,698.00
982 29876 MRC/ARTHROSCOPY KNEE, 2 OR MORE COMPARTM Moab Regional Health Center 3,220.00
982 29877 MRC/ARTHROSCOPY DEBRID/SHAVE ARTCLR CRT Moab Regional Health Center 2,879.00
982 29879 MRC/ABRASION ARTHROPLASTY KNEE Moab Regional Health Center 3,310.00
982 29880 MRC/ARTHOSCOPY W/MENISCECTOMY,MEDIAL Moab Regional Health Center 3,957.00
982 29881 MRC/KNEE ARTHROSCOPY W/MENISCTMY (M OR L Moab Regional Health Center 3,274.00
982 29882 MRC/ARTHROSCOPY KNEE W/MED OR LAT MENRPR Moab Regional Health Center 3,544.00
982 29883 MRC/ARTHROSCOPY KNEE W MED & LAT MENISCU Moab Regional Health Center 4,604.07
982 29888 MRC/ARTHRO AID ANTR CRCT LIGMNT AUG Moab Regional Health Center 4,764.00
982 29895 MRC/ARTHRSCPY ANKLE SURG SYNOVCTMY Moab Regional Health Center 2,893.00
982 29914 MRC/ARTHROSCOPY HIP W/FEMOROPLASTY Moab Regional Health Center 3,529.00
982 29916 MRC/ARTHROSCOPY HIP W/LABRL RPR Moab Regional Health Center 3,755.00
982 30000 DRAINAGE ABSCESS/HEMATOMA, NASAL INT APP Moab Regional Health Center 300.00
982 30300 MRC/REMOVAL FB INTRANASAL Moab Regional Health Center 128.00
982 30901 MRC/CTROL NASAL HEM/ANT/SMPL Moab Regional Health Center 169.00
982 30903 CONTROL NASAL HEMMORGE ANTERIOR COMPLEX Moab Regional Health Center 353.00
982 31500 MRC/ENDOTRACHEAL INTUBATION Moab Regional Health Center 407.00
982 31510 MRC/LARYNGOSCOPY W/BX Moab Regional Health Center 774.00
982 31515 MRC/LARYNGOS DIRECT W OR W/O TRACH W ASP Moab Regional Health Center 454.09
982 31575 MRC/LARYNGOSCOPY;FLEXIBLE FIBEROPTIC;DX Moab Regional Health Center 306.00
982 31575 MRC/MCR-LARYNGOSCOPY Moab Regional Health Center 275.40
510 31575 MRC/MCR-LARYNGOSCOPY Moab Regional Health Center 30.60
982 31605 MRC/TRACHEOSTOMY, EMERG PROC, CRICOTHYRO Moab Regional Health Center 1,247.00
982 31622 MRC/BRONCHOSCOPY Moab Regional Health Center 822.00
982 31623 MRC/BRONCHOSCOPY WITH BRUSHING Moab Regional Health Center 841.05
982 32000 MRC/THORACENTESIS Moab Regional Health Center 375.00
982 32000 MRC(MDCR)THORACENTESIS Moab Regional Health Center 337.50
510 32000 MRC(MDCR)THORACENTESIS Moab Regional Health Center 37.50
982 32551 MRC/CHEST TUBE THOROCOSTOMY Moab Regional Health Center 674.00
982 32552 REMOVE LUNG CATHETER Moab Regional Health Center 565.00
982 32554 MRC/THORCNTS, N/C ASP OF PLEURAL W/O IMA Moab Regional Health Center 1,400.00
982 32554 MRC/MCR-THORACENTESIS Moab Regional Health Center 1,260.00
510 32554 MRC/MCR-THORACENTESIS Moab Regional Health Center 140.00
982 32555 MRC/THORCNTS, N/C ASP OF PLEURAL W/ IMAG Moab Regional Health Center 985.00
982 32999 MRC/UNLISTED PROCEDURE LUNGS PLEURA Moab Regional Health Center 6,500.00
982 33010 MRC/PERICardiopulmonaryIOCENTESIS; INITIAL Moab Regional Health Center 453.00
982 35201 MRC/REPAIR BLOOD VESSEL DIRECT NECK Moab Regional Health Center 5,400.00
982 35221 MRC/UNLISTED PROCEDURE VASCULAR SURGERY Moab Regional Health Center 941.00
982 35840 MRC/EXPL PO HEMRRG, THROMB/INFCT J ABD Moab Regional Health Center 1,443.12
982 36010 MRC/INTRO OF CATHETAR, VENA CAVA Moab Regional Health Center 593.00
510 36410 MRC/MCR-VENIPUNCTURE AGE 3+ Moab Regional Health Center 13.30
982 36410 MRC/MCR-VENIPUNCTURE, AGE 3+ Moab Regional Health Center 119.70
982 36410 MRC/VENIPUNCTURE +AGE 3, REQ PHYS SKILL Moab Regional Health Center 133.00
300 36415 MRC/PHLEBOTOMY-BLOOD DRAW Moab Regional Health Center 20.00
300 36416 COLLECTION CAPILLARY BLOOD SPECIMEN Moab Regional Health Center 12.00
982 36471 MRC/SCLEROSING INJ, MULT, SAME LEG Moab Regional Health Center 371.00
982 36510 MRC/CATHETERIZATION OF UMBILICAL VEIN NB Moab Regional Health Center 330.00
982 36556 MRC/PLACEMENT, CATHETAR, SUBCLAVIAN Moab Regional Health Center 1,083.00
982 36558 MRC/INSRT CNTRL VENOUS CATH W/O SQ;5-UP Moab Regional Health Center 1,741.00
982 36561 MRC/INSERT TUNNEL CENTRAL VENOUS DEVICE Moab Regional Health Center 2,669.00
982 36569 MRC/PICC LINE PLACEMENT > 5 Moab Regional Health Center 914.00
982 36571 MRC/INSERT PICC VENOUS DEVISE W/SUBCU;<5 Moab Regional Health Center 3,803.00
982 36576 MRC/RPR CTR VAD W/SUBZ PORT/PMP CTR/PRP Moab Regional Health Center 822.00
982 36589 MRC/REM CENTRAL VENOUS CATH W/O SQ PUMP Moab Regional Health Center 479.00
982 36590 MRC/REM-VENOUS CATH, W/PORT OR PUMP Moab Regional Health Center 904.00
982 36660 INSERTION CATHETER ARTERY Moab Regional Health Center 524.00
982 37609 MRC/BX-TEMPORAL ARTERY Moab Regional Health Center 700.00
982 37718 MRC/SAPHENOUS VEIN STRIPPING Moab Regional Health Center 1,497.00
982 37720 MRC/LIGATION, DIV & STRIP SAPHENOUS VEIN Moab Regional Health Center 1,609.00
982 37722 MRC/LIG DIV STRIP LG > SAPH VEIN FR SPHF Moab Regional Health Center 1,337.00
982 37760 MRC/LIGATION OF PERF VEINS Moab Regional Health Center 2,132.00
982 37766 MRC/PHLEB, VEINS, VARICOSE <20 INCIS Moab Regional Health Center 1,923.00
982 37780 MRC/LIGATION OF PERFORATOR VEINS Moab Regional Health Center 1,037.00
982 38120 MRC/LAPAROSCOPIC SPLENECTOMY Moab Regional Health Center 5,322.00
982 38221 MRC/BX-BONE MARROW, NEEDLE OR TROCAR Moab Regional Health Center 361.00
982 38500 MRC/BX/EXCISION LYMPH NODE Moab Regional Health Center 961.07
982 38510 MRC/BX LYMPH NODE, EXCIS, DEEP Moab Regional Health Center 1,217.00
982 38525 MRC/EXC BX AXILLARY NODE, DEEP Moab Regional Health Center 1,722.00
982 38570 MRC/LAPS SURG RETROPERITONEAL LYMPH Moab Regional Health Center 6,283.00
982 38740 MRC/AXILLARY LYMPHADENECTOMY SUPER PRO F Moab Regional Health Center 2,047.00
982 38792 MRC/INJEC PROC FOR ID OF SENT NODE Moab Regional Health Center 239.09
982 38900 MRC/INTRAOP ID OF SENT LYMPH NODE, ADD O Moab Regional Health Center 720.09
982 40800 MRC/I&D ABCESS VESTIBULE OF MOUTH; SIMPL Moab Regional Health Center 242.00
982 40819 EXCISE LIP OR CHEEK FOLD Moab Regional Health Center 690.00
982 41112 MRC/EXCS LESION OF TONGUE W/C ANTER 2/3 Moab Regional Health Center 671.00
982 42440 MRC/EXC SUBMANDIBULAR SUBMAXILLARY GLAND Moab Regional Health Center 3,196.00
982 42809 MRC/REMOVAL FB PHARYNX Moab Regional Health Center 274.00
982 42815 MRC/EXC BRANCHIAL CLEFT CYST BEN SUB CU Moab Regional Health Center 1,763.00
982 42820 MRC/TONSILLECTOMY&ADNOIDECTOMY; UNDER 12 Moab Regional Health Center 977.00
982 42826 MRC/TONSILLECTOMY <12 Moab Regional Health Center 1,000.00
982 43200 MRC/ESOPHAGOSCOPY Moab Regional Health Center 734.00
982 43202 MRC/ESOPHAGOSCOPY RID OR FLEX W/BX Moab Regional Health Center 684.00
982 43215 MRC/ESOPHAGOSCOPY WITH REMOVE OF FB PF Moab Regional Health Center 892.08
982 43216 MRC/ESOPHOGOSCOPY, REM LESION HOT FORCEP Moab Regional Health Center 1,001.00
982 43220 MRC/ESOPHOGOSCOPY W/BALLOON DILATION Moab Regional Health Center 773.01
982 43235 MRC/EGD–DIAGNOSTIC Moab Regional Health Center 740.00
982 43239 MRC/EGD W/BIOPSY Moab Regional Health Center 852.00
982 43246 MRC/EGD W/PEG TUBE PLACEMENT Moab Regional Health Center 1,462.00
982 43247 MRC/EGD W/ REMOVAL OF FOREIGN BODY Moab Regional Health Center 1,010.00
982 43248 EGD W/DILATION OVER GUIDE WIRE Moab Regional Health Center 825.00
982 43249 MRC/EGD W/BALLOON DILATION Moab Regional Health Center 976.00
982 43250 MRC/EGD W/BX AND FULG OF POLYPS Moab Regional Health Center 1,097.00
982 43251 MRC/EGD- W/REM POLYP SNARE TECH Moab Regional Health Center 1,070.00
982 43255 MRC/EGD W/GASTRIC ULCER CAUT Moab Regional Health Center 1,163.00
982 43257 MRC/EGD WITH THERMAL ENERGY TX Moab Regional Health Center 1,614.06
982 43280 MRC/LAPS SURG ESOPG/GSTR FUNDOPLASTY Moab Regional Health Center 3,635.00
982 43281 MRC/LAPPARAESOPHAG HERN REPAIR Moab Regional Health Center 4,485.00
982 43282 MRC/LAP PARAESOPH HER RPR W/MESH Moab Regional Health Center 5,250.00
982 43456 MRC/BALOON DILATION OF ESOPHAGUS Moab Regional Health Center 706.00
982 43458 MRC/DILATION OF ESOPHAGUS W/BALLOON PF Moab Regional Health Center 893.03
982 43753 MRC/GASTRIC INTUBATION & ASPIRATION Moab Regional Health Center 76.00
982 43753 MRC/MCR-GASTRIC INTUBATION Moab Regional Health Center 68.40
510 43753 MRC/MCR-GASTRIC INTUBATION Moab Regional Health Center 7.60
982 43760 MRC/MDCR-CHANGE OF GASTROSTOMY TUBE Moab Regional Health Center 288.90
510 43760 MRC/MDCR-CHANGE OF GASTROSTOMY TUBE Moab Regional Health Center 32.10
982 43760 MRC/CHANGE OF GASTROSTOMY TUBE Moab Regional Health Center 321.00
982 43840 MRC/REPAIR OF PERFORATED DUODENAL ULCER Moab Regional Health Center 3,154.00
982 44005 MRC/ENTEROLYSIS Moab Regional Health Center 2,805.00
982 44050 MRC/REDUCTION OF VOLVULUS BY LAPAROTOMY Moab Regional Health Center 2,412.00
982 44110 EXC 1/> SM/LG LES OF INTESTINE ENTRTM Moab Regional Health Center 2,480.00
982 44120 MRC/ENTERECTOMY W/RESECTION SM INTESTINE Moab Regional Health Center 3,688.00
987 44121 MRC/EA ADD RESECT AND ANAST Moab Regional Health Center 1,303.00
982 44139 MRC/MOBILIZATION SPLENIC FLEXURE Moab Regional Health Center 262.00
982 44140 MRC/COLECTOMY-PARTIAL Moab Regional Health Center 4,007.00
982 44143 COLECTOMY PRTL W/END COLOSTOMY CLSR DSTL Moab Regional Health Center 4,010.00
982 44144 MRC/COLECTOMY W//COLON RESECTION Moab Regional Health Center 4,518.00
982 44145 MRC/COLECTOMY PRTL W/COLOPROCTOSTOM Moab Regional Health Center 4,900.00
982 44150 MRC/COLCT TOT ABDL W/O PRCTECT W/ILEOSTI Moab Regional Health Center 6,155.00
982 44160 MRC/COLECTOMY, PARTIAL Moab Regional Health Center 4,157.06
982 44180 MRC/LAPAROSCOPY, SURGICAL, ENTEROLYSUS Moab Regional Health Center 2,948.00
982 44200 MRC/LAP FREEING INTESTINAL ADHESIONS Moab Regional Health Center 2,805.00
982 44202 MRC/SIGMOID COLON RESECTION Moab Regional Health Center 3,779.00
982 44204 MRC/LAP SUR COLECTOMY, PARTIAL WITH ANAS Moab Regional Health Center 3,907.00
982 44205 MRC/LAP COLECTOMY, PAR W/ REM OF TERM IL Moab Regional Health Center 4,676.00
982 44207 MRC/LAPAR COLECTOMY W/ ANASTO WITH COLOP Moab Regional Health Center 4,838.00
982 44213 MRC/LAP SURG, MOBIL OF SPLEN FLEX IN CON Moab Regional Health Center 560.00
982 44310 MRC/ILEOSTOMY OR JEJUNOSTOMY, NON-TUBE Moab Regional Health Center 2,420.00
982 44346 MRC/REVI COLOSTOMY W/REP   HERNIA Moab Regional Health Center 2,587.00
982 44361 MRC/SMALL INTESTINAL ENDOSCOPY WITH BX Moab Regional Health Center 909.09
982 44385 MRC/ENDOSCOPY, SMALL INTESTINE Moab Regional Health Center 999.00
982 44388 MRC/COLONOSCOPY THROUGH STOMA-DIAG Moab Regional Health Center 1,131.00
982 44602 MRC/SUTURE SM INTES ULCER, DIV, RUP SING Moab Regional Health Center 2,481.00
982 44604 MRC/SUTURE OF LARGE INTESTINE PRO FEE Moab Regional Health Center 2,481.00
982 44625 MRC/SM BOWEL RESECT W/ANASTOSIS Moab Regional Health Center 2,978.00
982 44626 MRC/COLOSTOMY REVERSAL Moab Regional Health Center 3,231.00
982 44800 EXC MECKEL’S DIVERTICULUM/OMPHALOSMESENT Moab Regional Health Center 2,284.00
982 44950 MRC/APPENDECTOMY Moab Regional Health Center 1,962.00
982 44955 MRC/APPENDECTOMY SECONDARY TO INIT MAJ P Moab Regional Health Center 1,064.00
982 44960 MRC/APPENDECTOMY FOR RUPTURED APPENDIX W Moab Regional Health Center 2,453.00
982 44970 MRC/LAP APPENDECTOMY Moab Regional Health Center 1,962.00
982 45160 MRC/EXC RECTAL TUMOR BY PROCTOTOMY Moab Regional Health Center 3,678.00
982 45170 MRC/EXC RECTAL TUMOR, TRANSANAL APPROACH Moab Regional Health Center 1,635.00
982 45171 MRC/EXC RECT TUM, TRANSANAL NOT INCLUD M Moab Regional Health Center 1,483.00
982 45300 MRC/PROCTOSIGMOIDOSCOPY, DIAGNOSTIC Moab Regional Health Center 255.00
982 45305 MRC/PROCTOSIGMOIDOSCOPY Moab Regional Health Center 276.00
982 45308 MRC/PROCTO W/CAUTERIZATION OF TUMOR Moab Regional Health Center 419.00
982 45309 MRC/PROCTOSIGMOIDOSCOPY, W-POLYPECTOMY-1 Moab Regional Health Center 419.00
982 45315 MRC/PROCTOSIGMOIDOSCOPY W/REM MLT POLYPS Moab Regional Health Center 630.00
982 45330 MRC(MDCR)SIGMOIDOSCOPY FLXBL Moab Regional Health Center 264.60
510 45330 MRC(MDCR)SIGMOIDOSCOPY FLXBL Moab Regional Health Center 29.40
982 45330 MRC/SIGMOIDOSCOPY Moab Regional Health Center 294.00
982 45331 MRC/SIGMOID FLEX W/BIOPSY Moab Regional Health Center 531.00
982 45331 MRC(MDCR)SIGMOID FLX W/ BIOPC Moab Regional Health Center 477.90
510 45331 MRC(MDCR)SIGMOID FLX W/ BIOPC Moab Regional Health Center 53.10
982 45333 MRC/SIGMOIDOSCOPY W/POLYPECTOMY + FLGR Moab Regional Health Center 925.00
982 45334 SIGMOIDOSCOPY FLX CONTROL BLEEDING Moab Regional Health Center 685.00
982 45338 MRC/SIGMOIDOSCOPY FREX; W REMOVE OF TUMO Moab Regional Health Center 1,283.00
982 45339 SIGMOIDOSCOPY & BIOPSY Moab Regional Health Center 982.00
982 45378 MRC/COLONOSCOPY, DIAGNOSTIC Moab Regional Health Center 984.00
982 45380 MRC/COLONOSCOPY W/BIOPSY Moab Regional Health Center 1,082.03
982 45381 MRC/COLONOSCOPY WITH DIRCTD SUBM INJ ANY Moab Regional Health Center 1,121.00
982 45382 MRC/COLONOSCOPY/CONTROL BLEEDING Moab Regional Health Center 1,213.00
982 45383 MRC/COLONOSCOPY W/FULG OF POLYP Moab Regional Health Center 1,510.00
982 45384 MRC/COLONOSCOPY, POLYP REM, CAUT Moab Regional Health Center 1,394.00
982 45385 MRC/COLONOSCOPY, POLYP REM, SNARE Moab Regional Health Center 1,394.00
982 45388 MRC/COLONOSCOPY FLX ABLATION TUMOR POLYP Moab Regional Health Center 1,236.00
982 45397 MRC/LAPS PRCTCTMY CMBND PULL-THRU W/RS Moab Regional Health Center 6,745.00
982 45915 MRC/REM FEC/FB IMPC W/Anesthesia Moab Regional Health Center 543.00
982 45990 MRC/SURG DX EXAM ANORECTAL Moab Regional Health Center 275.00
982 46020 MRC/PLACEMENT OF ANAL SETON Moab Regional Health Center 350.00
982 46030 MRC/REM OF ANAL SETON Moab Regional Health Center 318.00
982 46040 MRC/I&D OF PERIRECTAL ABSCESS Moab Regional Health Center 704.08
982 46050 MRC/INCISION AND DRAINAGE PERIANAL ABSCE Moab Regional Health Center 599.00
982 46060 MRC/I&D ISCHIORCT/INTRA ABSC W/WO SETON Moab Regional Health Center 3,142.00
982 46080 MRC/SPHINCTEROTOMY, ANAL Moab Regional Health Center 1,123.00
982 46083 MRC//INCISION THROM HEMORRHOID, EXTERNAL Moab Regional Health Center 279.00
982 46200 MRC/FISSURECTOMY; W OR WO SPHINCTEROTOMY Moab Regional Health Center 826.00
982 46220 MRC/EXCIS SINGLE EXT PAP. OR TAG; ANUS Moab Regional Health Center 365.00
982 46221 MRC/HEMORRHOIDECTOMY, INTERNAL, BY BAND Moab Regional Health Center 476.00
982 46230 MRC/EXC EXTERNAL HEMORRHOID Moab Regional Health Center 748.00
982 46250 MRC/HEMORRHOIDECTOMY Moab Regional Health Center 1,135.00
982 46255 MRC/HEMORRHOIDECTOMY INT & EXT, SIMPLE Moab Regional Health Center 1,580.04
982 46260 MRC/HEMORRHOIDECTOMY COMPLEX INT & EXT Moab Regional Health Center 1,919.00
982 46270 MRC/FISTULOTOMY Moab Regional Health Center 1,058.00
982 46275 MRC/SURGICAL REMOVAL ANAL FISTULA, INTER Moab Regional Health Center 1,543.00
982 46280 MRC/SURG TX OF ANAL FISTULA;COMPLEX OR M Moab Regional Health Center 1,181.00
982 46320 MRC/EXCIS THROMBOSED HEMORRHOID;EXTRNL Moab Regional Health Center 405.00
982 46600 MRC/ANOSCOPY DX W/WO COLLJ SPEC Moab Regional Health Center 108.00
982 46606 MRC/ANOSCOPY WITH BIOPSY Moab Regional Health Center 286.00
982 46608 MRC/ANOSCOPY WITH REMOVAL OF FB Moab Regional Health Center 398.11
982 46910 MRC/ ELECTRODESICCATION/ DEST ANUS LESIO Moab Regional Health Center 546.00
982 46916 MRC/DESTRUCTION OF LESION, ANUS, CRYO Moab Regional Health Center 490.00
982 46922 MRC/DESTRUCTION OF LESION, ANUS, SIMP EX Moab Regional Health Center 939.00
982 46930 MRC/DESTRUCTION-HEMORRHOIDS INT & EXT Moab Regional Health Center 1,306.00
982 46934 MRC/DESTRUCTION INTERNAL HEMORRHOIDS Moab Regional Health Center 634.00
982 46947 MRC/HEMORRHOIDOPEXY BY STAPLING Moab Regional Health Center 973.00
982 46999 MRC/HEMORRHOIDECTOMY XTR SINGLE COLUMN Moab Regional Health Center 564.00
982 46999 MRC/(MDCR)HEMORRHDECTMY XTR SNGL CLM Moab Regional Health Center 507.60
510 46999 MRC/(MDCR)HEMORRHDECTMY XTR SNGL CLM Moab Regional Health Center 56.40
982 47000 MRC/BX, LIVER, NEEDLE Moab Regional Health Center 627.00
982 47100 MRC/BIOPSY OF LIVER WEDGE Moab Regional Health Center 2,043.00
982 47120 HEPATECTOMY RESCJ PARTIAL LOBECTOMY Moab Regional Health Center 4,586.00
982 47379 MRC/UNLISTED LAPAROSCOPIC PROCEDURE;LIVE Moab Regional Health Center 2,999.00
982 47480 MRC/CHOLECYSTOTOMY Moab Regional Health Center 2,782.10
982 47562 MRC/LAP CHOLECYSTECTOMY Moab Regional Health Center 3,021.00
982 47563 MRC/LAP CHOLE, W/CHOLANGIOGRAPHY Moab Regional Health Center 3,270.00
982 47564 MRC/LAP CHOLE W EXPLOR OF COMMON DUCT PF Moab Regional Health Center 3,601.00
982 47600 MRC/OPEN CHOLECYSTECTOMY Moab Regional Health Center 2,502.00
982 49000 MRC/EXPLORATORY LAPAROTOMY Moab Regional Health Center 2,439.00
982 49020 MRC/DRG PERITONEAL AB/LOCAL PERITONITIS Moab Regional Health Center 3,365.00
982 49060 MRC/DRG RETROPERITONEAL ABSCESS OPEN Moab Regional Health Center 3,740.00
982 49080 MRC/ABDOMINAL PARACENTESIS Moab Regional Health Center 376.00
510 49082 MRC/(MDCR) PARACENTESIS, INITIAL Moab Regional Health Center 37.70
982 49082 MRC/PARACENTESIS, INITIAL Moab Regional Health Center 377.00
982 49082 MRC/(MDCR) PARACENTESIS, INITIAL Moab Regional Health Center 339.30
982 49083 MRC/PARACENTESIS W/IMAGING GUIDANCE Moab Regional Health Center 808.05
982 49250 MRC/UMBILECTOMY Moab Regional Health Center 1,418.00
982 49320 MRC/LAP, DIAGNOSTIC Moab Regional Health Center 1,708.00
982 49321 MRC/LAP W BIOPSY (SINGLE OR MULT) Moab Regional Health Center 1,906.07
982 49322 MRC/LAP W-ASPIRATION CYST Moab Regional Health Center 1,906.07
982 49325 MRC/LAPAROS WITH REVIS OF PREV PLACED IP Moab Regional Health Center 1,301.00
982 49329 MRC/UNLISTED PROCEDURE; LAP/ABDOMEN Moab Regional Health Center 1,450.00
982 49418 MRC/INS INTRAPERITONEAL CATH W/IMG GUIDE Moab Regional Health Center 1,093.00
982 49422 MRC/REMOVAL PERITONEAL CATHETAR Moab Regional Health Center 1,219.05
982 49500 MRC/RPR 1ST INGUN HRNA AGE 6MO-5YRS RDCB Moab Regional Health Center 1,750.00
982 49505 MRC/REPAIR ING HERNIA, 5+ REDUCIBLE Moab Regional Health Center 1,625.00
982 49507 MRC/REPAIR ING HERNIA; 5 +, STRANGULATE Moab Regional Health Center 1,861.00
982 49520 MRC/REPAIR RECURRENT INGUINAL HERNIA Moab Regional Health Center 1,952.00
982 49521 MRC/REPAIR RECURRENT ING HERNIA-INCARC Moab Regional Health Center 2,235.00
982 49525 RPR INGUN HERNIA SLIDING ANY AGE Moab Regional Health Center 1,675.00
982 49550 MRC/REPAIR INIT FEMORAL HERNIA Moab Regional Health Center 1,826.00
982 49555 MRC/REPAIR RECURRENT FEMORAL HERNIA;REDU Moab Regional Health Center 1,735.02
982 49560 MRC/REPAIR VENTRAL HERNIA INIT, REDUCE Moab Regional Health Center 2,266.00
982 49560 MRC/REPAIR HERNIA, VENTRAL, INITIAL, RED Moab Regional Health Center 2,412.00
982 49561 MRC/RPR INIT INCIS OR VENT HERNIA; IN-ST Moab Regional Health Center 2,443.00
982 49565 MRC/REP VENTRAL HERNIA, RECURRENT Moab Regional Health Center 2,799.09
982 49566 MRC/REPAIR VENTRAL HERNIA, INCARCERATED Moab Regional Health Center 3,176.00
982 49568 MRC/MESH OR OTHER PROSTHESIS IMPLANTATIO Moab Regional Health Center 604.00
982 49570 MRC/REPAIR EPIGASTRIC HERNIA Moab Regional Health Center 1,421.00
982 49572 MRC/REPAIR EPIGAS HERNIA; INCRC/STRNGL Moab Regional Health Center 1,513.00
982 49580 REPAIR, OPEN, UMBILICAL HERNIA Moab Regional Health Center 1,119.00
982 49582 REPAIR, OPEN, UMBILICAL HERNIA INCRTD/ST Moab Regional Health Center 1,573.00
982 49585 MRC/REPAIR UMBILICAL HERNIA AGE 5 OR OLD Moab Regional Health Center 1,700.00
982 49587 RPR UMBILICAL HERNIA AGE 5 YRS/>INCARCRT Moab Regional Health Center 1,841.00
982 49650 MRC/LAP INIT ING HERNIA Moab Regional Health Center 1,812.00
982 49651 MRC/LAP REPAIR INGL HERNIA RECURRENT Moab Regional Health Center 2,078.00
982 49652 MRC/LAP UMB HERNIA REPAIR Moab Regional Health Center 3,257.00
982 49652 MRC/LAP ING HERNIA REP (REDUCIBLE) W/MES Moab Regional Health Center 3,257.00
982 49653 MRC/LAP UMB HERNIA REP (STRANG) W/MESH Moab Regional Health Center 4,010.00
982 49654 MRC/LAPAROSCOPY, SURGICAL, REPAIR, INCIS Moab Regional Health Center 3,700.00
982 49655 MRC/LAP HERNIA REP, UMB/VENT, STRANGUL Moab Regional Health Center 4,589.00
982 49657 MRC/LAPAR, SUR, REP RECUR INCIS HERNIA I Moab Regional Health Center 4,211.00
982 49659 MRC/UNLIST LAP PROC, HERNIORRHAPHY, HERN Moab Regional Health Center 1,825.00
982 49905 MRC/OMENTAL FLAP, INTRA-ABDOMINAL Moab Regional Health Center 1,630.00
982 50570 MRC/RENAL ENDOSCOPY Moab Regional Health Center 518.00
982 51040 MRC/CYSTOSTOMY Moab Regional Health Center 4,674.00
982 51045 MRC/CYSTOSTOMY W/CATHETER PLACEMENT Moab Regional Health Center 5,122.00
982 51102 MRC/INSERTION SUPRAPUBIC CATHETAR Moab Regional Health Center 935.00
982 51701 INSERT BLADDER CATHETER Moab Regional Health Center 285.00
982 51702 MRC/INSERT FOLEY CATHETER Moab Regional Health Center 140.00
982 51705 MRC/CHANGE OF CYSTOSTOMY TUBE Moab Regional Health Center 365.00
982 51860 MRC/CYSTORRHAPHY, SUTURE OF BLADDER SIMP Moab Regional Health Center 3,236.00
982 51865 MRC/CYSTORRHAPHY, SUTR OF BLADDER COMPL Moab Regional Health Center 4,160.00
982 52000 MRC/CYSTOURETHROSCOPY Moab Regional Health Center 474.00
982 52281 MRC/CYSTOSCOPY W/DILATION Moab Regional Health Center 791.04
982 52310 CYSTO W/SIMPLE REMOVAL STONE STENT Moab Regional Health Center 700.00
982 52347 MRC/CYSTOURETHROSCOPY W/TRANSURETHRAL Moab Regional Health Center 1,151.01
982 54001 SLITTING OF PREPUCE, DORSAL/LAT XCP NB Moab Regional Health Center 545.00
982 54050 MRC/DESTRCT OF LESN(S) PENIS, SIM;CHEMCL Moab Regional Health Center 213.00
982 54056 MRC/DESTRCTRN OF LES PENIS, SIMP Moab Regional Health Center 450.00
982 54150 MRC/ CIRCUMCISION Moab Regional Health Center 200.00
982 54160 MRC/CIRCUMCISION NEONATE Moab Regional Health Center 475.00
982 54161 MRC/CIRCUMCISION, EXCEPT NEWBORN Moab Regional Health Center 1,416.00
982 54162 MRC/LYSIS PENILE POST-CURCUMCISION ADHS Moab Regional Health Center 505.00
982 54163 MRC/REPAIR INCOMPLETE CIRCUMCISION Moab Regional Health Center 438.00
982 54450 FORESKN MANJ W/LSS PREP ADSSTRETCHING Moab Regional Health Center 233.00
982 54640 MRC/ORCHIOPEXY Moab Regional Health Center 2,292.00
982 54700 MRC/I & D OF EPIDID TEST AND/OR SCROT AB Moab Regional Health Center 500.00
982 54830 MRC/EXCISION OF LOCAL LESION OF EPIDIDYM Moab Regional Health Center 1,596.00
982 55000 MRC/PUNCT. ASPIRATION OF HYDROCELE Moab Regional Health Center 225.00
982 55040 MRC/HYDROCELECTOMY UNILATERAL Moab Regional Health Center 2,575.00
982 55150 RESECTION OF SCROTUM Moab Regional Health Center 1,765.00
982 55250 MRC/VASECTOMY Moab Regional Health Center 800.00
982 55899 UNLISTED PROCEDURE MALE GENITAL Moab Regional Health Center 321.00
982 56405 MRC/ I & D VULVA OR PERINEAL ABSCESS Moab Regional Health Center 321.00
982 56420 MRC/I & D BARTHOLIN’S ABSCESS Moab Regional Health Center 353.00
982 56700 MRC/PARTIAL REMOVAL OF HYMEN Moab Regional Health Center 401.00
982 56740 EXCISION OF BARTHOLIN’S GLAND/CYST Moab Regional Health Center 875.00
982 57061 MRC/DESTRUCTION OF VAGINAL LESION Moab Regional Health Center 378.00
982 57135 EXC OF VAGINAL CYST OR TUMOR Moab Regional Health Center 925.00
982 57160 FITINSJ PESSARY/OTH INTRA VAG SPPT DEVI Moab Regional Health Center 162.00
982 57240 MRC/COLPORRHAPHY, ANTER, W/REP CYSTOCELE Moab Regional Health Center 290.00
982 57250 MRC/POST. COLPORRHAPPY REP OF RECTOCELE Moab Regional Health Center 1,600.00
982 57260 MRC/COMBINED ANTEROPOST COLPORRHAPHY Moab Regional Health Center 2,031.00
982 57268 MRC/REPAIR OF ENTEROCELE, VAG APPROACH Moab Regional Health Center 2,003.00
982 57335 MRC/VAGINOPLASTY Moab Regional Health Center 4,084.00
982 57400 MRC/DILATION OF VAGINA UNDER AnesthesiaTHESIA Moab Regional Health Center 563.00
982 57410 MRC/PELVIC EXAM UNDER AnesthesiaTHESIA Moab Regional Health Center 294.00
982 57420 MRC/COLPOSCOPY OF VAGINA W/CERVIX Moab Regional Health Center 350.00
982 57420 MRC(MDCR)COLPOSCOPY VAG W/CRVX Moab Regional Health Center 315.00
510 57420 MRC(MDCR)COLPOSCOPY VAG W/CRVX Moab Regional Health Center 35.00
982 57421 MRC/COLPOSCOPY OF VAGINA W/CERVIC BIOPSY Moab Regional Health Center 499.00
982 57421 MRC(MDCR)COLPOSCOPY VAG W/CRVX BIOPC Moab Regional Health Center 449.10
510 57421 MRC(MDCR)COLPOSCOPY VAG W/CRVX BIOP Moab Regional Health Center 49.90
982 57452 MRC/COLPOSCOPY OF THE CERVIX I.E. UP/ADJ Moab Regional Health Center 405.00
982 57454 MRC/COLPOSCOPY OF THE CERVIX W/BIOPSY Moab Regional Health Center 575.00
982 57454 MRC(MDCR)COLPOSCOPY CRVX W/ BIOPSY Moab Regional Health Center 517.50
510 57454 MRC(MDCR)COLPOSCOPY CERVX W/ BIOPSY Moab Regional Health Center 57.50
982 57455 MRC/COLPOSCOPY W/BIOPSY(S) OF CERVIX Moab Regional Health Center 250.00
982 57456 COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE Moab Regional Health Center 370.00
982 57460 MRC/BX OF CERVIX W/SCOPE LEEP Moab Regional Health Center 625.00
982 57461 MRC/CONZ OF CERVIX W/SCOPE LEEP Moab Regional Health Center 680.00
982 57500 MRC(MDCR)BX CRVX SGL MLT W/WO FLGRTN Moab Regional Health Center 298.80
510 57500 MRC(MDCR)BX CRVX SGL MLT W/WO FLGRTN Moab Regional Health Center 33.20
982 57500 MRC/BX OF CERVIX SGL OR MLT W &WO FLGRTN Moab Regional Health Center 332.00
982 57511 MRC/CONZ OF CERVIX W/SCOPE LEEP Moab Regional Health Center 390.00
982 57720 MRC/REPAIR UTERINE CERVIX, VAG APPROACH Moab Regional Health Center 1,021.60
982 58100 MRC/ENDOMETRIAL BIOPSY Moab Regional Health Center 298.00
982 58100 MRC/(MDCR) ENDOMETRIAL BIOPSY Moab Regional Health Center 268.20
510 58100 MRC/(MDCR) ENDOMETRAIL BIOPSY Moab Regional Health Center 29.80
982 58110 MRC/EDOMETRIAL BIOPSY W/COLPOSCOPY Moab Regional Health Center 191.00
982 58120 MRC/D&C Moab Regional Health Center 832.00
982 58150 MRC/HYSTERECTOMY, TOTAL, ABDOMINAL Moab Regional Health Center 3,426.00
982 58300 MRC/ INSRT OF INTRAUTERINE DEVICE (IUD) Moab Regional Health Center 382.00
982 58301 MRC/REMOVAL OF INTRAUTERINE DEVICE IUD Moab Regional Health Center 137.00
982 58301 MRC(MDCR)RMVL OF INTRAUTERINE IUD Moab Regional Health Center 123.30
510 58301 MRC(MDCR)RMVL OF INTRAUTERINE IUD Moab Regional Health Center 13.70
982 58353 MRC/ABLATION, ENDOMETRIAL, THERMAL Moab Regional Health Center 1,786.05
982 58545 MRC/LAP MYOMECTOMY 1-4 Moab Regional Health Center 3,155.00
982 58550 MRC/LAVH Moab Regional Health Center 3,330.00
982 58552 MRC/LAVH W/BIL OR UNI SALP OOPH Moab Regional Health Center 3,815.00
982 58558 MRC/HYSTEROSCOPY, WITH BX Moab Regional Health Center 1,786.05
982 58600 MRC/LIG/TRNSXJ FLP TUBE ABDL/VAG AP UNI/ Moab Regional Health Center 2,042.00
982 58605 MRC/LIGATION OF FALLOPIAN TUBE(S) Moab Regional Health Center 1,678.00
987 58611 MRC/TUBAL LIG AT TIME OF C-SECT. Moab Regional Health Center 840.00
982 58615 MRC/OCCLUSION BY DEVICE Moab Regional Health Center 923.00
982 58660 MRC/LAP W-LYSIS OF ADHESIONS Moab Regional Health Center 2,721.00
982 58661 MRC/LAP W OOPHORECTOMY Moab Regional Health Center 2,609.00
982 58662 MRC/LAP FULGURATION/OVARY Moab Regional Health Center 2,982.00
982 58670 MRC/LAP TUBAL Moab Regional Health Center 1,556.00
982 58671 MRC/LAPAROSCOPY, SURGICAL W/ OCCLUSION D Moab Regional Health Center 1,701.00
982 58700 MRC/SALPINGECTOMY Moab Regional Health Center 2,168.00
982 58720 MRC/SALPINGO OOPHORECTOMY Moab Regional Health Center 2,628.00
982 58750 MRC/TUBOTUBAL ANASTATOMOSIS Moab Regional Health Center 4,500.00
982 58925 MRC/OVARIAN CYSTECTOMY Moab Regional Health Center 3,671.00
982 58940 MRC/OOPHORECTOMY Moab Regional Health Center 3,658.00
982 58999 UNLISTED PROCEDURE Moab Regional Health Center 377.00
982 59025 MRC/FETAL NON STRESS TEST Moab Regional Health Center 175.00
982 59151 MRC/LAP TX OF ECTOPIC PREGNANCY W SALPIN Moab Regional Health Center 2,351.00
982 59160 MRC/CURETTAGE-POSTPARTUM Moab Regional Health Center 937.00
987 59200 MRC/INSERT OF CERV DILATOR Moab Regional Health Center 285.00
982 59300 MRC/EPIS OR VAG REP BY OTH THAN ATT PHY Moab Regional Health Center 676.00
987 59400 MRC/ANTEPART, VAG DEL, AND PP CARE Moab Regional Health Center 5,000.00
982 59409 MRC/VAGINAL DELIVERY Moab Regional Health Center 1,920.00
987 59410 MRC/OBSTET CARE DEL & POSTPARTUM Moab Regional Health Center 2,415.00
982 59412 MRC/ EXTERNAL CEPHALIC VERSION Moab Regional Health Center 995.00
982 59425 MRC/ANTEPARTUM CARE ONLY 4-6 VISITS Moab Regional Health Center 700.00
982 59426 MRC/ ANTEPARTUM CARE ONLY 7 + VISITS Moab Regional Health Center 2,000.00
982 59430 MRC/POSTPARTUM CARE ONLY Moab Regional Health Center 280.00
987 59510 MRC/ROUTINE CARE, CESAR SECT, PP CARE Moab Regional Health Center 5,100.00
982 59514 MRC/CESAREAN DELIVERY Moab Regional Health Center 2,507.09
987 59515 MRC/CESAREAN SECT W/PP CARE Moab Regional Health Center 2,464.00
987 59610 MRC/OBST CARE ANTEPA, VAG DEL, PP AFT CS Moab Regional Health Center 3,683.00
987 59612 MRC/VAG DEL/PREV C-SECT DEL ONLY Moab Regional Health Center 1,920.00
982 59812 MRC/TX OF INCOMPLETE AB ANY TRI COMP SUR Moab Regional Health Center 860.00
982 59820 MRC/TX OF MISSED AB COMPL SURG FIRST TRI Moab Regional Health Center 876.02
982 59840 MRC INDCD ABORTION, DILATION & CRTTGE Moab Regional Health Center 710.00
982 59870 MRC/EVACUATE MOLE OF UTERUS Moab Regional Health Center 1,108.00
982 60100 MRC/BX THYROID, PERCUTANEOUS CORE NEEDLE Moab Regional Health Center 368.00
982 60210 MRC/PART THYROID LOBECTOMY, UNI; W OR W/ Moab Regional Health Center 2,472.00
982 60212 MRC/PART THYROIDECTOMY W/ISTHMUSECTOMY Moab Regional Health Center 3,377.00
982 60220 MRC/TOTAL THYROID LOBECTOMY;UNI W OR W/O Moab Regional Health Center 2,544.00
982 60240 MRC/THYROIDECTOMY, TOTAL Moab Regional Health Center 3,574.00
982 61500 MRC/CRANIECTOMY; W EXCIS OF TUMOR OR BON Moab Regional Health Center 6,423.00
982 62230 MRC/RPLCMT/REVJ CSF SHUNT VLV/CATH SHNT Moab Regional Health Center 4,688.00
982 62270 MRC/LUMBAR PUNCTURE Moab Regional Health Center 322.00
982 62270 MRC(MDCR) LUMBAR PUNCTURE Moab Regional Health Center 289.80
510 62270 MRC(MDCR) LUMBAR PUNCTURE Moab Regional Health Center 32.20
982 62273 MRC-INJ EPIDERAL BLOO Moab Regional Health Center 935.00
982 62320 INJ X 1 W/WO CONT Moab Regional Health Center 823.00
963 62322 EPIDURAL-LUMBAR Moab Regional Health Center 716.00
982 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG Moab Regional Health Center 1,072.00
982 63688 MRC/REVISION/REMOVAL IMPLANTED NEUROSTMU Moab Regional Health Center 1,656.00
982 64405 INJ, Anesthesia AGENT, > OCCIPITAL NRV Moab Regional Health Center 352.00
510 64425 MRC/MCR-INJECTION ILIOINGUINAL NERVES Moab Regional Health Center 63.20
982 64425 MRC/MCR-INJECTION ILIOINGUINAL NERVES Moab Regional Health Center 568.80
981 64425 MRC/NERVE BLOCK Moab Regional Health Center 632.00
982 64435 INJ, Anesthesia PARACERVICAL UTERINE NRV Moab Regional Health Center 503.00
963 64445 MRC/INJECT Anesthesia AGENT SCIAT NERVE SINGLE Moab Regional Health Center 526.00
963 64447 MRC/INJ Anesthesia AGENT; FEMORAL NERVE, SINGL Moab Regional Health Center 526.00
982 64447 MRC/MCR-INJECT FEMORAL NERVE, SINGLE Moab Regional Health Center 430.20
510 64447 MRC/MCR-INJECT FEMORAL NERVE, SINGLE Moab Regional Health Center 47.80
982 64455 MRC/INJ TRIGEMINAL NERVE ANY DIV; OCCIPI Moab Regional Health Center 305.00
982 64476 MRC/FACET INJECT-EACH ADDITIONAL LEVEL Moab Regional Health Center 406.00
510 64476 MRC/MCR-FACET INJECT-EACH ADDITIONAL Moab Regional Health Center 40.60
982 64476 MRC/MCR-FACET INJECT-EACH ADDITIONAL Moab Regional Health Center 365.40
982 64495 MRC/FACET JOINT INJ THIRD LEVEL Moab Regional Health Center 447.00
982 64704 MRC/NEUROPLASTY; DIGITAL, NERVE HND/FT Moab Regional Health Center 1,465.00
982 64714 MRC/NEUROPLASTY, MAJOR PERIPH NER ARM LE Moab Regional Health Center 2,838.00
982 64718 MRC/NEUROPLASTY & TRANSPOSITION, ULNAR Moab Regional Health Center 2,830.00
982 64721 MRC/NEUROPLASTY & TRANSPOS MEDIAN NERVE Moab Regional Health Center 2,003.00
982 64772 MRC/TRANSECT OR AVUL SPINAL NERVE, EXTRA Moab Regional Health Center 1,281.00
982 64774 MRC/EXCIS NEUROMA NERVE Moab Regional Health Center 878.00
982 64834 SUTURE 1 NRV HND/FT COMMON SENSORY NERVE Moab Regional Health Center 1,737.00
982 64999 MRC/UNLISTED PROCEDURE NERVOUS SYSTEM Moab Regional Health Center 1,281.00
982 65205 MRC/REMOVE FB EXT EYE;CONJUN Moab Regional Health Center 155.00
982 67700 MRCBLEPHAROTOMY, DRAIN/ABSCESS OF EYELID Moab Regional Health Center 222.08
982 67840 MRC/EXCIS OF LESION OF EYELID W/O CLOS Moab Regional Health Center 412.02
982 69000 DRAINAGE EXTERNAL EAR, ABSCESS OR HEMA;S Moab Regional Health Center 385.00
982 69145 MRC/REMOVE EAR CANAL LESION(S) Moab Regional Health Center 944.00
982 69200 MRC(MDCR) REM FB XTRNL AUDITORY CAN Moab Regional Health Center 119.70
982 69200 MRC/REM FB FR EXT AUD CANALW/O Anesthesia Moab Regional Health Center 133.00
510 69200 MRC (MDCR) REM FB XTRNL AUDITORY CAN Moab Regional Health Center 13.30
982 69209 REMOVAL CERUMEN IRRIGATION/LAVAGE ONLY Moab Regional Health Center 50.00
982 69210 MRC/REMOVAL IMPACTED CERUMEN Moab Regional Health Center 88.00
982 69210 MRC(MDCR)REMOVAL IMPACTED CERUMEN Moab Regional Health Center 79.20
510 69210 MRC(MDCR)REMOVAL IMPACTED CERUMEN Moab Regional Health Center 8.80
982 73040 MRC/RADIOLOG EXAM SHOULDER ARTHR Moab Regional Health Center 132.00
982 76000 MRC/FLUOROSCOPY SPX UP TO 1 HR PHYS/QH Moab Regional Health Center 254.00
982 76001 MRC/FLUOROSCOPY EA ADDTNL HOUR PHYS/QHP Moab Regional Health Center 75.00
982 76801 US PREGNANT UTERUS 14 WK TRNSBL PROFEE Moab Regional Health Center 95.00
402 76801 US US PREGNANT UTERUS 14 WK TRNSBL W/IMG Moab Regional Health Center 375.00
982 76830 MRC/ULTRASOUND, TRANSVAGINAL Moab Regional Health Center 75.00
402 76830 MRC/ULTRASOUND, TRANSVAGINAL Moab Regional Health Center 300.00
982 76857 US PELVIC NONOBSTRC W/DOC LMT F/U PROFEE Moab Regional Health Center 50.00
402 76857 US PELVIC NONOBSTRC W/IMAGE DOC; LMT F/U Moab Regional Health Center 250.00
982 76882 US EXT JOINT/OTH NONVASC READ PROFEE Moab Regional Health Center 80.00
402 76882 US EXT JOINT/OTH NONVASC XTR STRX R-T W Moab Regional Health Center 350.00
402 76942 MRC/US GD NLD PLCMNT TECHNICAL Moab Regional Health Center 120.00
982 76942 MRC/US GD NLD PLCMNT PROFEE Moab Regional Health Center 75.00
982 77071 MRC/MAN APPL STRESS PFRMD BY PHYS JOINT Moab Regional Health Center 71.00
300 80305 DRUG SCREEN QUAL; MULTIDRUG CLSS BY H1G Moab Regional Health Center 93.00
300 81002 MRC/URNLS DIP STICK/TABLET RGNT W/MICRO Moab Regional Health Center 21.00
300 81003 URINALYSIS, AUTOMATED, W/O   MICROSCOPY Moab Regional Health Center 21.00
300 81025 URINE PREGNANCY TEST, BY VISUAL COLOR Moab Regional Health Center 38.00
982 81528 ONCOLOY COLORECTAL SCREENING QUAN 10 DNA Moab Regional Health Center 1,165.00
300 82270 MRC/BLOOD OCCULT, GUAIAC Moab Regional Health Center 21.00
770 82274 BLD OCCLT FCL HGB DTR IA QUAL FECES 1-3 Moab Regional Health Center 90.00
300 82607 CYANOCOBALAMIN VITAMIN B-12 (PANEL ONLY) Moab Regional Health Center 34.00
982 82947 MRC/GLUCOSE TEST Moab Regional Health Center 32.00
982 82947 MRC/(MDCR) GLUCOSE TEST Moab Regional Health Center 28.80
510 82947 MRC/(MDCR) GLUCOSE TEST Moab Regional Health Center 3.20
300 82948 GHEM BG Moab Regional Health Center 37.00
300 82962 MRC/BLOOD GLUCOSE MNTR,OBTND BY FNGR Moab Regional Health Center 19.00
982 82962 MRC(MDCR)BLOOD GLUCOSE MNTR BY FNGR Moab Regional Health Center 17.10
510 82962 MRC(MDCR)BLOOD GLCS MNTR BY FNGR Moab Regional Health Center 1.90
300 85610 PROTHROMBIN TIME Moab Regional Health Center 20.00
300 86580 TUBERSOL Moab Regional Health Center 149.00
510 87164 MRC/MDCR-DK FIELD EXAM W/SPECIMEN Moab Regional Health Center 6.80
982 87164 MRC/MCRD-DK FIELD EXAM Moab Regional Health Center 61.20
982 87164 MRC/EXAM-DK FIELD, W/SPECIMEN COLLECT Moab Regional Health Center 68.00
510 87166 MRC/MCRD-/DARK FIELD EXAM W/O COLLECTION Moab Regional Health Center 6.30
982 87166 MRC/MCRD-/DARK FIELD EXAM W/O COLLECTION Moab Regional Health Center 56.70
982 87166 MRC/DARK FIELD EXAM W/O COLLECTION Moab Regional Health Center 63.00
300 87210 SMR PRIM SRC WET MOUNT NFCT AGT Moab Regional Health Center 39.00
300 87220 KOH PREP Moab Regional Health Center 56.00
300 87804 RAPID FLU SWAB Moab Regional Health Center 34.00
300 87807 RAPID RSV TEST Moab Regional Health Center 28.00
300 87880 STREPTOCOCCUS, GROUP A Moab Regional Health Center 57.00
300 87880 RAPID STREP TEST Moab Regional Health Center 26.00
982 88160 MRC/PAP SMEAR Moab Regional Health Center 67.10
982 88174 MRC/CYTP C/V AUTO THIN LYR PREPJ SCR SYS Moab Regional Health Center 73.00
771 90460 MRC/IMMUNIZATION ADMINISTRATION Moab Regional Health Center 14.52
771 90461 MRC/IMMUNIZATION ADMINISTRATION EA ADD’L Moab Regional Health Center 9.00
771 90471 MRC/INJ VAC OR TOXOID Moab Regional Health Center 33.00
771 90472 MRC/EA ADD IMMUNIZATION ADMINISTRATION Moab Regional Health Center 16.00
771 90472 MRC/PEDIATRIC (MEDICAID) EA ADD Moab Regional Health Center 9.00
771 90472 EA ADDITIONAL VACCINE ADMINISTERED Moab Regional Health Center 33.00
982 90473 MRC/IMADM INTRANSL/ORAL 1 VACCINE Moab Regional Health Center 26.32
771 90474 MRC/IMMUNE ADMIN ORAL/NASAL ADDL Moab Regional Health Center 16.00
982 90702 MRC(MDCR)DPTHERIA & TETNUS TOXIOD Moab Regional Health Center 18.00
510 90702 MRC(MDCR)DIPHERIA & TETNUS TOXOID Moab Regional Health Center 2.00
636 90702 DIPTHERIA & TETNUS TOXOID Moab Regional Health Center 426.75
982 90703 MRC/TETNAS TOXOID Moab Regional Health Center 23.00
982 90703 MRC(MDCR)TETNAS TOXOID Moab Regional Health Center 20.70
982 90782 MRC/INJ, THERAPUTIC/DIAG Moab Regional Health Center 33.00
982 90782 MRC(MDCR) THERAPUTIC/DIAG Moab Regional Health Center 29.70
510 90782 MRC(MDCR) THERAPUTIC/DIAG Moab Regional Health Center 3.30
982 90785 MRC/INTERACTIVE ADD ON CODE Moab Regional Health Center 28.00
982 90791 MRC/MMRCITAL PSYCH DIAG EVAL Moab Regional Health Center 125.00
982 90791 MRC/NEW KID INTERACTIVE PSYCH DIAG EVAL Moab Regional Health Center 223.00
982 90791 MRC/NEWPSYCHIATRIC DIAGNOSTIC EVALUATION Moab Regional Health Center 203.00
982 90792 PSYCHIATRIC DX EVAL W/ MEDICAL SERVICES Moab Regional Health Center 225.00
982 90810 MRC/INDIVIDUAL PSYCHOTHERAPY 20-30 MIN Moab Regional Health Center 124.00
982 90812 MRC/INDIVIDUAL PSYCHOTHERAPY (45-50 MIN) Moab Regional Health Center 134.00
982 90814 MRC/INDIVIDUAL PSYCHOTHERAPY (75-80 MIN) Moab Regional Health Center 188.06
982 90832 MRC/INDIVIDUAL PSYCHOTHERAPY 30 MIN Moab Regional Health Center 122.00
982 90834 MRC/INDIVIDUAL PSYCHOTHERAPY 45 MIN Moab Regional Health Center 125.00
982 90837 MRC/INVIDUAL PSYCHOTHERAPY 60 MIN Moab Regional Health Center 206.01
982 90846 MRC/FAMILY PSYCHOTHERAPY W/O PATIENT Moab Regional Health Center 118.00
982 90847 MRC/FAMILY PSYCHOTHERAPY W/ PATIENT Moab Regional Health Center 147.00
982 90847 MRC/MMRCITAL THERAPY ADDITIONAL SESSIONS Moab Regional Health Center 125.00
982 90853 MRC/GRP PSYCHOTHERAPY I.E. EDUCATION 1UN Moab Regional Health Center 78.00
480 92960 MRC/CardiopulmonaryIOVERS ELEC CONVERS OF ARRHY EXT Moab Regional Health Center 474.00
730 93000 ECG 12 LEAD W/INTERPRETATION Moab Regional Health Center 52.00
730 93005 EKG Moab Regional Health Center 30.00
982 93016 MRC/TREADMILL SUPERVISION Moab Regional Health Center 138.00
982 93016 MRC(MDCR)TREADMILL SUPERVISION Moab Regional Health Center 124.20
510 93016 MRC(MDCR)TREADMILL SUPERVISED Moab Regional Health Center 13.80
982 93018 MRC/TREADMILL INTERP Moab Regional Health Center 138.00
982 93018 MRC(MDCR)TREADMILL INTERP Moab Regional Health Center 124.20
510 93018 MRC(MDCR)TREADMMILL INTERP Moab Regional Health Center 13.80
982 93233 MRC/HOLTER MONITOR INTERP Moab Regional Health Center 231.00
982 93233 MRC/(MDCR) HOLTER MONITOR INTERP Moab Regional Health Center 207.90
510 93233 MRC/ (MDCR) HOLTER MONITOR INTERP Moab Regional Health Center 23.10
982 93272 MRC/EVENT MONITOR INTERP Moab Regional Health Center 207.00
982 93272 MRC/ (MDCR) EVENT MONITOR INTERP Moab Regional Health Center 186.30
510 93272 MRC/ (MDCR) EVENT MONITOR INTERP Moab Regional Health Center 20.70
982 93307 MRC/ECHO-2D Moab Regional Health Center 250.00
982 93307 MRC/(MDCR) ECHO-2D Moab Regional Health Center 225.00
510 93307 MRC/(MDCR)ECHO-2D Moab Regional Health Center 25.00
982 93320 MRC/ECHO-DOPPLER Moab Regional Health Center 187.00
982 93320 MRC/(MDCR) ECHO-DOPPLER Moab Regional Health Center 168.30
510 93320 MRC/(MDCR)ECHO-DOPPLER Moab Regional Health Center 18.70
982 93325 MRC/ECHO-COLOR DOPPLER Moab Regional Health Center 109.00
982 93325 MRC/MDCR) ECHO-COLOR DOPPLER Moab Regional Health Center 98.10
510 93325 MRC/MDCR) ECHO-COLOR DOPPLER Moab Regional Health Center 10.90
480 93770 DERMINATION OF VENOUS PRESSURE Moab Regional Health Center 60.00
982 93970 MRC/READING OF DUPLEX SCAN, VEINS, BILAT Moab Regional Health Center 200.00
460 94010 MRC/PULMONARY FUNCT TEST Moab Regional Health Center 140.00
460 94010 MRC(MDCR)PULMONARY FUNCT TEST Moab Regional Health Center 126.00
510 94010 MRC(MDCR)PULMONARY FUNCT TEST Moab Regional Health Center 14.00
460 94060 BRNCDILAT RSPSE SPMTRY PREPOST-BRNCDILAT Moab Regional Health Center 130.00
982 94150 MRC/VITAL CAPACITY/PEAK FLOW Moab Regional Health Center 56.00
982 94150 MRC(MDCR)VITAL CAPACITY/PEAK FLOW Moab Regional Health Center 50.40
510 94150 MRC(MDCR)VITAL CAPACITY/PEAK FLOW Moab Regional Health Center 5.60
982 94240 MRC/PULM FUNCT TEST-VOLUM Moab Regional Health Center 27.00
982 94240 MRC(MDCR)PULM FUNCT TST-VOLUM Moab Regional Health Center 24.30
510 94240 MRC(MDCR)PULM FCTN TEST-VOLUME Moab Regional Health Center 2.70
460 94375 RESPIRATORY FLOW VOLUME LOOP Moab Regional Health Center 82.00
982 94620 MRC/PULMONARY STRESS TEST;SIM 6-MIN WALK Moab Regional Health Center 270.00
410 94640 MRC/INHALATION TREATMENT FOR AIRWAY OBST Moab Regional Health Center 37.00
410 94640 MRC(MDCR)INHALTN TRMNT, AIRWAY OBST Moab Regional Health Center 37.00
982 94664 MRC(MDCR)DEMO&EVL O PT UTILZ ARSL NEB Moab Regional Health Center 51.30
510 94664 MRC(MDCR)DEMO&EVL O PT UTILZ ARSL NEB Moab Regional Health Center 5.70
982 94664 MRC/DEMO&/ EVAL OF PT UTILIZ AERSL NEB Moab Regional Health Center 57.00
982 94760 MRC/OXIMETRY RESTING Moab Regional Health Center 70.00
982 94760 MRC(MDCR) OXIMETRY RESTING Moab Regional Health Center 63.00
510 94760 MRC(MDCR)OXIMETRY RESTING Moab Regional Health Center 7.00
982 94761 MRC/OXIMETRY EXERCISE Moab Regional Health Center 76.00
982 94761 MRC(MDCR)OXIMETRY EXERCISE Moab Regional Health Center 68.40
510 94761 MRC(MDCR)OXIMETRY EXERCISE Moab Regional Health Center 7.60
982 95115 PROF SVCS ALLG IMMNTX X W/PRV ALLGIC NJX Moab Regional Health Center 23.00
770 95117 MRC/PRO, ALLERGEN IMMUNO NOT INCL EX 2+ Moab Regional Health Center 34.00
982 95903 MRC/NERVE CONDUCTION (EACH NERVE) Moab Regional Health Center 207.00
982 95992 MRC/CANALITH REPOSITIONING PROCEDURE Moab Regional Health Center 287.00
982 96101 MRC/PSYCHOLOGICAL TESTING PER HOUR Moab Regional Health Center 176.00
982 96110 DEVELOPMTL SCREENING W SCORING DOCUMENT Moab Regional Health Center 63.00
982 96116 NEUROBEHAV STATUS EXAM PER HR FTF W INTE Moab Regional Health Center 322.00
982 96125 MRC/COGNITIVE TEST BY HC PRO Moab Regional Health Center 240.00
982 96127 EMOTIONAL/BEHAVIORAL ASSESSMENT Moab Regional Health Center 30.00
982 96150 MRC/INI HLTH & BEHAVIOR ASSMT EA 15 MIN Moab Regional Health Center 48.00
982 96151 MRC/HLTH & BEHAVIOR RE-ASSMT EA 15 MIN Moab Regional Health Center 24.00
982 96152 MRC/HLTH & BEHAVIOR INTRVNTN INDVD 15 MI Moab Regional Health Center 24.00
982 96153 MRC/HLTH & BHVR INRVNTN, GROUP 2 + 15 MI Moab Regional Health Center 34.02
982 96154 MRC/HLTH & BHVR INTRVNTN, FMLY WPT 15MIN Moab Regional Health Center 34.02
260 96360 MRC/IV HYDRATION INITIAL 31MIN TO 1HR Moab Regional Health Center 230.00
260 96361 MRC/HYDRATION, EACH ADDITIONAL HOUR Moab Regional Health Center 54.10
770 96372 MRC/THERAPEUTIC, PROPH, DX INJ IM OR SQ Moab Regional Health Center 36.00
982 96372 MRC(MDCR)THERPTC, PRPH, DX INJ IM/SQ Moab Regional Health Center 32.40
510 96372 MRC(MDCR)THERPTC, PROPH, DXINJ IM/SQ Moab Regional Health Center 3.60
260 96374 MRC/THERAP//PROPH/DX IV PUSH; SINGLE INJ Moab Regional Health Center 172.00
982 97597 MRC/DEBRIDE OPEN WOUND <20 SQ CM Moab Regional Health Center 36.00
982 97598 MRC/REMOVAL DEVITALIZED TISSUE ^20 SQ CM Moab Regional Health Center 107.00
982 97602 MRC/RMVL DEVITAL TISSU FRM WNDS W/O Anesthesia Moab Regional Health Center 74.00
982 97602 MRC(MDCR)RMV DVTAL TISSU FRM WND WO Moab Regional Health Center 66.60
510 97602 MRC(MDCR)RMV DVTL TISSU FR WND W/O Moab Regional Health Center 7.40
982 97605 MRC/WOUND THERAPY, NEG PRESSURE Moab Regional Health Center 69.00
982 98925 MRC/OMT 1-2 BODY REGIONS INVOLVED Moab Regional Health Center 72.00
982 98925 MRC(MDCR)OMT 1-2 BODY RGNS INVLVD Moab Regional Health Center 64.80
510 98925 MRC(MDCR) OMT 1-2 BODY REGIONS INVLV Moab Regional Health Center 7.20
982 98926 MRC/OMT 3-4 REGIONS INVOLVED Moab Regional Health Center 90.00
982 98926 MRC(MDCR)OMT 3-4 RGNS INVLVD Moab Regional Health Center 81.00
510 98926 MRC(MDCR)OMT 3-4 RGNS INVLVD Moab Regional Health Center 9.00
982 98927 MRC/OMT 5-6 BODY REGIONS INVOLVED Moab Regional Health Center 108.00
982 98927 MRC(MDCR)OMT 5-6 BODY RGNS NVLVD Moab Regional Health Center 97.20
510 98927 MRC(MDCR)OMT 5-6 BODY RGNS NVLVD Moab Regional Health Center 10.80
982 98928 MRC/OMT 7-8 BODY REGIONS INVOLVED Moab Regional Health Center 117.00
982 98928 MRC(MDCR)OMT 7-8 BODY RGNS INVLVD Moab Regional Health Center 105.30
510 98928 MRC(MDCR)OMT 7-8 BODY RGNS NVLVD Moab Regional Health Center 11.70
982 98929 MRC/OMT 9-10 BODY REGIONS INVOLVED Moab Regional Health Center 122.00
982 98929 MRC(MDCR)OMT 9-10 BDY RGNS NVLVD Moab Regional Health Center 109.80
510 98929 MRC(MDCR)OMT 9-10 BODY RGNS NVLVD Moab Regional Health Center 12.20
510 98960 MRC(MDCR)EDUCATION & TRAINING 4 SELF Moab Regional Health Center 6.50
982 98960 MRC(MDCR)EDUCATION & TRAINING 4 SELF Moab Regional Health Center 58.50
982 98960 MRC/EDUCATION & TRAINING FOR SELF MNGMNT Moab Regional Health Center 65.00
982 99024 NO CHARGE OB Moab Regional Health Center     –
982 99024 MRC/POST OP NO CHARGE Moab Regional Health Center     –
982 99024 90 DAY GLOBAL Moab Regional Health Center     –
982 99050 MRC/AFTER REG SCHEDULED HOURS 1 Moab Regional Health Center 60.00
982 99058 SVC PRV EMER BSS IN OFFC DISRUPTING SVCS Moab Regional Health Center 85.00
982 99070 MRC/IMMOBILIZER SHOULDER Moab Regional Health Center 53.00
982 99080 MRC/LETTER/REPORT Moab Regional Health Center 84.00
510 99144 MRC/MCR-MODERATE SEDATION (5 YRS & OLDER Moab Regional Health Center 11.90
982 99144 MRC/MCR-MODERATE SEDATION (5 YRS & OLDER Moab Regional Health Center 107.10
982 99144 MRC/MOD SEDATION 5 YRS OR OLDER Moab Regional Health Center 119.00
510 99149 MRC/MCR-MODERATE SEDATION (UNDER 5 YRS) Moab Regional Health Center 10.00
982 99149 MRC/MCR-MODERATE SEDATION (UNDER AGE 5) Moab Regional Health Center 90.00
942 99149 MRC/MCR-MODERATE SEDATION (UNDER AGE 5) Moab Regional Health Center 90.00
963 99149 MRC/MODERATE SED SERVICES 5 YRS OR > 1ST Moab Regional Health Center 100.00
963 99150 MRC/ADD 15 MINUTES OF CONSCIOUS SEDATION Moab Regional Health Center 52.00
982 99150 MRC/MCR-ADDTL 15 MINS CONSCIOUS SEDATION Moab Regional Health Center 46.80
510 99150 MRC/MCR-ADDTL 15 MINS CONSCIOUS SEDATION Moab Regional Health Center 5.20
982 99201 MRC(MDCR)NEW OFFICE LVL 1 Moab Regional Health Center 126.00
982 99201 MRC/ NEW PT VISIT, LEVEL 1 Moab Regional Health Center 140.00
982 99202 MRC/NEW OFFICE LEVEL 2 Moab Regional Health Center 170.00
982 99202 MRC(MDCR)NEW EXP OFFICE LVL 2 Moab Regional Health Center 153.00
982 99203 MRC(MDCR)NEW OFFICE LVL 3 Moab Regional Health Center 202.50
982 99203 MRC/ NEW PT VISIT, LEVEL 3 Moab Regional Health Center 225.00
982 99204 MRC/NEW OFFICE LEVEL 4 Moab Regional Health Center 320.00
982 99204 MRC(MDCR) NEW OFFICE LVL 4 Moab Regional Health Center 288.00
982 99205 MRC/OFFICE VISIT, NEW, HIGH COMPLEXITY Moab Regional Health Center 420.00
982 99205 MRC(MDCR) NEW OFFICE LVL 5 Moab Regional Health Center 378.00
982 99211 MRC/ESTAB OFFICE LEVEL 1 Moab Regional Health Center 75.00
982 99211 MRC/(MDCR) ESTAB OFFICE LVL1 Moab Regional Health Center 67.50
510 99211 MRC/(MDCR) ESTAB OFFICE LVL 1 Moab Regional Health Center 7.50
982 99212 MRC/ESTAB OFFICE LEVEL 2 Moab Regional Health Center 120.00
982 99212 MRC/(MDCR) ESTAB OFFICE LVL 2 Moab Regional Health Center 108.00
510 99212 MRC/(MDCR) ESTAB OFFICE LVL 2 Moab Regional Health Center 12.00
982 99213 MRC/OFFICE VISIT, EST PT, EXPANDED Moab Regional Health Center 140.00
982 99213 MRC/(MDCR) ESTAB OFFICE LVL 3 Moab Regional Health Center 126.00
510 99213 MRC/(MDCR) ESTAB OFFICE LVL 3 Moab Regional Health Center 14.00
982 99214 MRC/ESTAB OFFICE LEVEL 4 Moab Regional Health Center 200.00
982 99214 MRC/(MDCR) ESTAB OFFICE LVL 4 Moab Regional Health Center 180.00
510 99214 MRC/ (MDCR) ESTAB OFFIC LVL 4 Moab Regional Health Center 20.00
982 99214 MRC/EST PT VISIT, LEVEL 4 Moab Regional Health Center 200.00
982 99215 MRC/ESTAB OFFICE LEVEL 5 Moab Regional Health Center 310.00
982 99215 MRC/(MDCR) ESTAB OFFICE LVL 5 Moab Regional Health Center 279.00
510 99215 MRC/(MDCR)ESTAB OFFICE LVL 5 Moab Regional Health Center 31.00
982 99217 MRC/OBS CARE DISCHARGE DAY Moab Regional Health Center 131.00
982 99218 MRC INIT OBS CARE LOW SEVERITY Moab Regional Health Center 167.40
982 99219 MRC/EO OBSSERVATION LEVEL II Moab Regional Health Center 227.00
982 99220 MRC/IP OBSERVASTION LEVEL 3 Moab Regional Health Center 300.00
987 99221 MRC/INITIAL IP E&M, LOW Moab Regional Health Center 202.00
987 99222 MRC/INIT HOSP CARE-LEVEL II Moab Regional Health Center 242.00
987 99223 MRC/INIT HOSP CARE-LEVEL III Moab Regional Health Center 294.00
982 99224 MRC/SUB OBS CARE LOW COMPLEX Moab Regional Health Center 72.00
982 99225 MRC/SUB OBS VISIT MOD COMP Moab Regional Health Center 110.00
987 99231 MRC/SUBSEQUENT HOSP CARE Moab Regional Health Center 108.00
982 99232 MRC/SBSQ HOSPITAL CARE 25 MINS Moab Regional Health Center 129.00
987 99233 MRC/SUBSEQUENT HOSP CARE Moab Regional Health Center 207.00
987 99234 MRC/ADMIT AND D/C SAME DAY-LOW Moab Regional Health Center 240.10
982 99235 MRC/OBS/ADMIT/DC SAME DAY-MOD Moab Regional Health Center 326.93
982 99236 MRC/OBS/IP CARE SAME DAY HIGH COMPLEXITY Moab Regional Health Center 346.00
987 99238 MRC/HOSP DISCHARGE DAY MANAGEMENT Moab Regional Health Center 112.00
987 99239 MRC/HOSP DISCHARGE >30 Moab Regional Health Center 140.00
982 99241 MRC/CONSULT, OP LEVEL 1 Moab Regional Health Center 141.00
982 99242 MRC/OFFIC CONSULT-LOW Moab Regional Health Center 206.00
982 99243 MRC/OFFIC CONSULT-DETAIL Moab Regional Health Center 250.00
982 99244 MRC/OFFIC CONSULT-MODER Moab Regional Health Center 341.00
982 99245 MRC/OFFIC CONSULT-HIGH LVL 5 Moab Regional Health Center 411.00
987 99251 MRC/CONSULT IP LEVEL 1 Moab Regional Health Center 166.00
987 99252 MRC/CONSULT IP LEVEL 2 Moab Regional Health Center 212.00
987 99253 MRC/CONSULT IP LEVEL 3 Moab Regional Health Center 261.00
987 99254 MRC/CONSULT, IP LEVEL 4 Moab Regional Health Center 325.00
987 99255 MRC/CONSULT, IP LEVEL 5 Moab Regional Health Center 408.00
987 99261 MRC/IP CONSULT F/U 1 Moab Regional Health Center 91.00
987 99262 MRC/IP CONSULT F/U 2 Moab Regional Health Center 162.00
987 99263 MRC/IP CONSULT F/U 3 Moab Regional Health Center 203.00
982 99281 MRC/ER VISIT, MINOR PROB Moab Regional Health Center 125.00
981 99282 MRC/E&M EMERGENCY ROOM, LOW COMP Moab Regional Health Center 213.00
982 99283 MRC/ E & M ER ROOM MOD SEVERITY Moab Regional Health Center 364.00
982 99284 MRC/ER VISIT HIGH/URGENT Moab Regional Health Center 529.00
982 99291 MRC/CRITICAL CARE FIRST 30-74 MIN Moab Regional Health Center 1,797.00
982 99292 MRC/CC EACH ADDITIONAL 30 MIN Moab Regional Health Center 303.00
982 99301 MRC/NURSING FACILITY CARE LEVEL 3 Moab Regional Health Center 103.00
982 99301 MRC(MDCR)NRSNG FAC CARE LVL 3 Moab Regional Health Center 92.70
510 99301 MRC(MDCR)NRSNG FAC CARE LVL 3 Moab Regional Health Center 10.30
982 99304 MRC/INI NURSING FACILITY CARE, PER DAY Moab Regional Health Center 108.00
982 99305 MRC/INIT NURSING FAC CARE MOD COMPLEX Moab Regional Health Center 166.00
982 99306 MRC/INIT NURS FAC VISIT HIGH COMPLEX Moab Regional Health Center 190.00
982 99307 MRC/SUB NURSING FAC; STRGT FORWARD Moab Regional Health Center 80.00
982 99308 MRC/SUBSEQ NURSING FAC CARE Moab Regional Health Center 91.00
982 99309 MRC/SBSQ NURSING FACIL VISIT NEW PROB Moab Regional Health Center 117.00
982 99310 MRC/SUB NURSING FAC CARE/HIGH COMPLEX Moab Regional Health Center 215.00
982 99315 MRC/NRSNG FCLTY DSCRG DAY MNGMT 30MIN Moab Regional Health Center 112.00
982 99316 MRC/NURSING FAC VISIT D/C > 30 MIN Moab Regional Health Center 139.00
982 99318 E & M OF PATIENT INVOLVING ANNUAL NFA Moab Regional Health Center 225.00
982 99342 MRC/HOME VISIT NEW PT MOD SEVERITY Moab Regional Health Center 139.00
982 99344 MRC/HOME VISIT LEVEL 4 Moab Regional Health Center 239.00
982 99347 MRC/HOME VISIT EST PT MINOR 15 MIN Moab Regional Health Center 103.00
982 99348 MRC/HOME VISIT E/M 25 MIN Moab Regional Health Center 92.00
982 99349 MRC/HOME VISIT E/M 40 MIN Moab Regional Health Center 140.00
982 99354 MRC/PROLONGED SERVICES 30-74 MIN Moab Regional Health Center 293.00
982 99356 PROLONGED SER I/P REQ UNIT/FLOOR 1ST HR Moab Regional Health Center 449.00
982 99357 PROLONGED SER IP/OBSRV, EACH ADD 30 MIN Moab Regional Health Center 225.00
982 99358 PROLONGED E&M SRVC-INDIRECT CONTACT Moab Regional Health Center 92.00
982 99360 MRC/PHYSICIAN STANDBY 30 MIN Moab Regional Health Center 179.00
982 99363 ANTICOAGULANT MGMT OP INIT 90 DAYS Moab Regional Health Center 210.00
982 99364 ANTICOAGULANT MGMT OP EA SBSQ 90 DAYS Moab Regional Health Center 99.00
510 99374 MRC/MDCR SUPVJ PT HH AGENCY MO 15-29 MNT Moab Regional Health Center 11.40
982 99374 MRC/MDCR SUPVJ PT HH AGENCY MO 15-29 MNT Moab Regional Health Center 102.60
982 99381 MRC/PREVENTATIVE MEDICINE UNDER 1 NEW PT Moab Regional Health Center 148.00
982 99381 MRC(MDCR)PRVNTV MED UNDER 1 NEW Moab Regional Health Center 133.20
510 99381 MRC(MDCR)PRVNTV MED UNDER 1 NEW Moab Regional Health Center 14.80
982 99382 MRC/ INITIAL COMP;PREVENT, NEW PT 1-4 YR Moab Regional Health Center 159.00
510 99382 MRC/ (MDCR) INTL COMP; PRVNT, NP 1-4 Moab Regional Health Center 15.90
982 99382 MRC/ (MDCR) INTL COMP; PRVNT, NP 1-4 Moab Regional Health Center 143.10
982 99383 MRC/ INITIAL COMP;PREVENT,   NEW PT 5-11 Moab Regional Health Center 170.00
982 99383 MRC/ (MDCR) COMP; PRVNT NEW PT 5-11 Moab Regional Health Center 153.00
510 99383 MRC/ (MDCR) COMP; PRVNT NEW PT 5-11 Moab Regional Health Center 17.00
982 99384 MRC/PHYSICAL EXAM 12-17 YRS OLD NEW PT Moab Regional Health Center 182.00
982 99384 MRC(MDCR)PHYS EX 12-17 YRS NEW PT Moab Regional Health Center 163.80
510 99384 MRC(MDCR)PHYS EX 12-17 YRS NEW PT Moab Regional Health Center 18.20
982 99385 MRC/PHYSICAL EXAM 18-39 YRS OLD NEW PT Moab Regional Health Center 246.00
510 99385 MRC(MDCR)PHYS EX 18-39 YRS NEW PT Moab Regional Health Center 24.60
982 99385 MRC(MDCR)PHYS EX 18-39 YRS NEW PT Moab Regional Health Center 221.40
982 99386 MRC/PHYSICAL EX 40-64 YRS OLD NEW PT Moab Regional Health Center 269.00
982 99386 MRC(MDCR) PREV MEDICINE EVAL 40-64 Y Moab Regional Health Center 242.10
510 99386 MRC(MDCR) PREV MEDICINE EVAL 40-64YR Moab Regional Health Center 26.90
982 99387 MRC/PHYSICAL EXAM 65 AND OVER NEW PT Moab Regional Health Center 302.00
982 99387 MRC(MDCR)PHYS EXAM 65 AND OVR NP Moab Regional Health Center 271.80
510 99387 MRC(MDCR)PHYS EX 65 & OVER NP Moab Regional Health Center 30.20
982 99391 MRC(MDCR)PRVNTV MED UNDER 1 ESTB PT Moab Regional Health Center 116.10
510 99391 MRC(MDCR)PRVTNTV MED UNDER 1 ESTB PT Moab Regional Health Center 12.90
982 99391 MRC/PREVENTATIVE MED UNDER 1 EST PT Moab Regional Health Center 129.00
982 99392 MRC/PREVENTATIVE MEDICINE 1-4 ESTAB PT Moab Regional Health Center 129.00
982 99392 MRC(MDCR)PRVNTNV MED 1-4 ESTAB PT Moab Regional Health Center 116.10
510 99392 MRC(MDCR) PRVNTV MED 1-4 ESTAB PT Moab Regional Health Center 12.90
982 99393 MRC/PREVENTATIVE MEDICINE 5-11 ESTB PT Moab Regional Health Center 140.00
982 99393 MRC(MDCR)PRVNTV MED 5-11 ESTB PT Moab Regional Health Center 126.00
510 99393 MRC(MDCR)PRVNTV MED 5-11 ESTB PT Moab Regional Health Center 14.00
982 99394 MRC/PHYSICAL EXAM 12-17 YRS OLD EST PT Moab Regional Health Center 151.00
982 99394 MRC(MDCR)PHYS EX 12-17YRS EST PT Moab Regional Health Center 135.90
510 99394 MRC(MDCR)PHYS EX 12-17 YRS EST PT Moab Regional Health Center 15.10
982 99395 MRC/PHYSICAL EXAM 18-39 YRS OLD EST. Moab Regional Health Center 204.00
982 99395 MRC(MDCR)PHYS EX 18-39 YRS EST Moab Regional Health Center 183.60
510 99395 MRC(MDCR)PHYS EX 18-39 YRS EST Moab Regional Health Center 20.40
982 99396 MRC/PHYSICAL EXAM 40-64 YRS OLD EST. Moab Regional Health Center 223.00
982 99396 MRC(MDCR)PHYSCL EX 40-64YR EST Moab Regional Health Center 200.70
510 99396 MRC(MDCR)PHYSCL EX 40-64YR EST Moab Regional Health Center 22.30
982 99397 MRC/PHYSICAL EXAM 65 AND OVER EST. Moab Regional Health Center 254.00
982 99397 MRC(MDCR)PHYS EX 65 AND OVER EST Moab Regional Health Center 228.60
510 99397 MRC(MDCR)PHYS EX 65 AND OVER EST Moab Regional Health Center 25.40
982 99401 MRC/PREV MEDICINE COUNCIL Moab Regional Health Center 64.00
982 99401 MRC(MDCR)PREV MEDICINE COUNCIL Moab Regional Health Center 57.60
510 99401 MRC(MDCR)PREV MEDICINE COUNCIL Moab Regional Health Center 6.40
982 99402 MRC/PREV MEDICINE-15 MIN Moab Regional Health Center 127.00
982 99402 MRC(MDCR)PREV MEDICINE 15MIN Moab Regional Health Center 114.30
510 99402 MRC(MDCR)PREV MEDICINE 15 MIN Moab Regional Health Center 12.70
982 99403 MRC/PREV MEDICINE-45 MIN Moab Regional Health Center 187.00
982 99403 MRC(MDCR)PREV MEDICINE 45 MIN Moab Regional Health Center 168.30
510 99403 MRC(MDCR)PREV MEDICINE 45 MIN Moab Regional Health Center 18.70
982 99404 MRC/PREV MEDICINE-60 MIN Moab Regional Health Center 248.00
982 99404 MRC(MDCR)PREV MEDICINE 60 MIN Moab Regional Health Center 223.20
510 99404 MRC(MDCR)PREV MEDICINE 60 MIN Moab Regional Health Center 24.80
982 99406 SMOKING TOBACCO USE CESSATION 3-10 MIN Moab Regional Health Center 49.00
982 99406 SMOKING & TABACCO CESS COUNSLNG 3-10 MIN Moab Regional Health Center 20.00
982 99407 SMOKING TOBACCO USE CESS COUNSEL >10 MIN Moab Regional Health Center 97.00
982 99408 ALCOHOL OR SUBSTANCE SCREEN 15-30 MIN Moab Regional Health Center 62.00
982 99409 ALCOHL OR SUBSTANCE SCREEN > 30 MIN Moab Regional Health Center 125.00
982 99411 PREV MED COUNSEL RISK FCTR REDJ GRP 30 M Moab Regional Health Center 30.00
982 99412 PREV MED COUNSEL RISK FCTR REDJ 60 M Moab Regional Health Center 40.00
982 99420 ADMN INTERPJ HLTH RISK ASSMT INSTRMNT Moab Regional Health Center 20.00
982 99441 PHONE E/M BY PHYS 5-10 MIN Moab Regional Health Center 122.00
982 99446 INTRPROFSSNL PHONE/INTRNT BY CNSLT 5-10M Moab Regional Health Center 50.00
982 99447 INTRPROFSSNL PHONE/INTRNT BY CNSLT 11-20 Moab Regional Health Center 75.00
982 99448 INTRPRFSS PHONE/INTERNET CNSLT 21-30M Moab Regional Health Center 110.00
982 99449 INTRPRFSS PHONE/INTERNET CNSLT 31/> Moab Regional Health Center 125.00
982 99450 BASIC LIFE OR DISABILITY EXAM Moab Regional Health Center 280.00
982 99455 MRC/CDL IMPAIRMENT RATING Moab Regional Health Center 127.00
987 99460 MRC/INIT HOSP DAY, NORMAL NB Moab Regional Health Center 181.00
982 99461 MRC/1ST CARE PR DAY NML NB XCPT HOSP Moab Regional Health Center 242.00
987 99462 MRC/SUB HOSP DAY, NORMAL NB Moab Regional Health Center 85.05
987 99463 MRC/ADMIT & D/C SAME DAY NEWBORN Moab Regional Health Center 191.00
987 99464 MRC/ATTEND AT DEL & STAB NB Moab Regional Health Center 144.00
963 99465 MRC/NEWBORN RESUSCITATION Moab Regional Health Center 496.00
987 99468 MRC/CC NB INFANT INITIAL DAY Moab Regional Health Center 2,032.58
987 99477 MRC/INIT HOSP CARE E&M 28 D OR < INVENSI Moab Regional Health Center 1,350.00
987 99479 MRC/SUB INTN CARE LBW INF (1500-2500 GM) Moab Regional Health Center 650.41
987 99480 MRC/SUB INTEN CARE PER DAY E&M OF RECOV Moab Regional Health Center 561.00
982 99490 CHRONIC CARE MGMT, 20 MIN Moab Regional Health Center 75.00
510 99495 MRC (MDCR) TRANSITIONAL CARE MNGMNT MOD Moab Regional Health Center 42.00
982 99495 MRC (MDCR) TRANSITIONAL CARE MNGMNT MOD Moab Regional Health Center 378.00
982 99495 TRANSNL MANAGMT FACE-FACE 14 DAYS DSCHRG Moab Regional Health Center 420.00
510 99496 MRC (MDCR) TRANSNL MAGMT HIGH COMPLXTY Moab Regional Health Center 59.50
982 99496 MRC (MDCR) TRANSNL MAGMT HIGH COMPLXTY Moab Regional Health Center 535.50
982 99496 TRANSNL MAAGMT FACE-FACE 14 DAYS OF DSCH Moab Regional Health Center 595.00
982 99497 ADVANCED CARE PLANNING; 30 MIN Moab Regional Health Center 120.00
982 99498 ADVANCED CARE PLANNING; EA ADD’L 30 MIN Moab Regional Health Center 75.00
982 99499 MRC/OTHER MEDICAL CONSULTATION Moab Regional Health Center 82.76
271 A4266 DIAPHRAM FOR CONTRACEPTIVE USE Moab Regional Health Center 40.00
270 A4614 MRC/PEAK FLOW METER DISP Moab Regional Health Center 59.00
510 G0008 MRC/MRC ADMIN OF INFLUENZA VIRUS VACCINE Moab Regional Health Center 2.50
771 G0008 MRC/ADMIN OF INFLUENZA VIRUS VAC MDCR PT Moab Regional Health Center 25.00
771 G0009 MRC/MDRC ADMINISTRATION OF PNEUMCCCL VAC Moab Regional Health Center 25.00
771 G0010 MRC/ MDCR ADMIN-HEPATITIS B VACCINE Moab Regional Health Center 95.00
982 G0101 MRC/(MDCR)CA SCREEN;PELVIC/BREAST EXM Moab Regional Health Center 150.00
770 G0102 MEDICARE DIGITAL RECTAL Moab Regional Health Center 34.00
510 G0102 MEDICARE DIGITAL RECTAL Moab Regional Health Center 3.40
300 G0103 PSA; SCREENING Moab Regional Health Center 62.00
982 G0105 MRC/COLORECTAL SCRN;HI RISK IND Moab Regional Health Center 984.00
982 G0106 COLON CA SCREEN;BARIUM ENEMA Moab Regional Health Center 375.00
942 G0108 DIABETES MANAGEMENT TRAINING PER INDIVID Moab Regional Health Center 85.00
942 G0109 DIABETES MANAGEMENT TRAINING IND/GROUP Moab Regional Health Center 35.00
982 G0120 COLON CA SCRN;BARIUM ENEMA Moab Regional Health Center 390.00
982 G0121 MRC/COLON CA SCREEN N/HI Moab Regional Health Center 984.00
23 G0181 HOME HEALTH CARE SUPERVISION Moab Regional Health Center 205.00
657 G0182 HOSPICE CARE SUPERVISION (BILLED ONCE A Moab Regional Health Center 185.00
982 G0402 MRC/INIT PE LDT NEW BENEF DUR 1ST 12 MOS Moab Regional Health Center 158.00
982 G0402 MRC(MDCR)INIT LDT NEW BENEF 1-12MO’S Moab Regional Health Center 142.20
510 G0402 MRC(MDCR)INIT LDT NEW BENEF 1-12 MO’S Moab Regional Health Center 15.80
730 G0403 WELCOME TO MEDICARE -EKG Moab Regional Health Center 30.00
982 G0436 MRC/MED,SMKING,TOBACCO,CESS,COUN,3-10MIN Moab Regional Health Center 20.00
982 G0437 MRC/SMOKING & TOBACCO CSSTN INTSV>10 Moab Regional Health Center 32.00
982 G0438 MRC/(MDCR)WELLNESS INITIAL VISIT Moab Regional Health Center 172.80
982 G0438 MRC/WELLNESS INITIAL VISIT Moab Regional Health Center 192.00
982 G0439 MRC/(MDCR)WELLNESS SUBSEQUENT VISIT Moab Regional Health Center 119.70
636 J1040 DEPO-MEDRO INJ MDV 80MG/ML 5ML/V1 EA Moab Regional Health Center 98.86
636 J1071 DEPO-TESTOSTERN INJ 200MG/ML 10ML/V1 Moab Regional Health Center 98.86
636 J1885 KETOROLAC TROMETHAMINE, 60MG Moab Regional Health Center 98.86
250 J7301 SKYLA INTRAUTERINE-SYSTEM Moab Regional Health Center 908.24
270 J7307 CONTRACEPTIVE IMPLANT (IMPLANON) Moab Regional Health Center 950.00
636 J7323 EUFLEXXA 2ML DOSE Moab Regional Health Center 1,400.00
982 Q0091 MRC/OBTAINING SCREEN PAP SMEAR Moab Regional Health Center 75.00
270 Q4006 LONG ARM FIBERGLASS CAST 11+ Moab Regional Health Center 178.00
270 Q4006 LONG ARM FIBERGLASS CAST 10 & UNDER Moab Regional Health Center 150.00
270 Q4010 SHORT ARM FIBERGLASS CAST 11 YRS+ Moab Regional Health Center 92.00
270 Q4012 SHORT ARM FIBERGLASS CAST 10 YRS < Moab Regional Health Center 75.00
270 Q4030 LONG LEG FIBERGLASS CAST 11+ YRS Moab Regional Health Center 329.00
270 Q4032 LONG LEG FIBERGLASS CAST 10 & UNDER Moab Regional Health Center 289.00
270 Q4038 SHORT LEG FIBERGLASS CAST 11+ Moab Regional Health Center 173.00
270 Q4040 SHORT LEG FIBERCLASS CAST 10 YRS & UNDER Moab Regional Health Center 150.00
982 Q5005 MRC/INIT HOSPICE CARE Moab Regional Health Center 106.00
250 S0020 Bupivicaine 0.25% 10mg Moab Regional Health Center 44.00
982 MRC/NO SHOW FEE Moab Regional Health Center 27.00
982 MRC/NO CHARGE Moab Regional Health Center     –
982 MRC/ NO CHARGE OB Moab Regional Health Center     –
982 NO CHARGE Moab Regional Health Center     –
510 MRC/(MDCR)WELLNESS SUBSEQUENT VISIT Moab Regional Health Center 13.30
510 MRC/WELLNESS SUBSEQUENT VISIT Moab Regional Health Center 19.20
982 MRC/ I & D, COMP Moab Regional Health Center 335.00
982 10 GLOBAL PROCEDURE Moab Regional Health Center     –
510 MRC(MDCR)WELLNESS 1ST Moab Regional Health Center 19.20
510 MRC(MDCR) NEW OFFICE LVL 1 Moab Regional Health Center 14.00
510 MRC(MDCR) NEW EXP OFFICE LVL 2 Moab Regional Health Center 17.00
510 MRC(MDCR) NEW OFFICE LVL 3 Moab Regional Health Center 22.50
510 MRC(MDCR) NEW OFFICE LVL 4 Moab Regional Health Center 32.00
510 MRC(MDCR) NEW OFFICE LVL 5 Moab Regional Health Center 42.00
982 SMOKING & TABACCO CESSATION COUNSELING Moab Regional Health Center 49.00
982 11640 EXC MALIGNANT LESION F/E/E/N/L O.5 CM < Moab Regional Health Center 324.00
982 17111 DESTRUCTION BENIGN LESION 15 OR MORE Moab Regional Health Center 269.00
982 44389 MRC/COLONOSCOPY W/BIOPSY, SINGLE OR MULT Moab Regional Health Center 1,404.00
982 44392 MRC/COLONOSCOPY W/REMOVAL BY HOT FORCEPS Moab Regional Health Center 1,644.00
982 67800 EXCISION OF CHALAZION;SINGLE Moab Regional Health Center 297.00
730 93005 EKG Moab Regional Health Center 112.09
459 A6449 RH/ACE WRAP Moab Regional Health Center 3.25
250 J1335 ERTAPENEM 500 MG DOSE Moab Regional Health Center 87.00
250 J7298 MIRENA IUD INTRAUTERINE CONTRACEPTIVE Moab Regional Health Center 802.00
250 J8499 GI COCKTAIL Moab Regional Health Center 20.00
270 Q4049 FINGER SPLINT, STATIC Moab Regional Health Center 13.00
982 10060 INCISION AND DRAINAGE, SIMPLE Moab Regional Health Center 183.00
982 10060 MCR-I&D ABSCESS, SIMPLE Moab Regional Health Center 164.00
510 10060 MCR-I&D ABSCESS, SIMPLE Moab Regional Health Center 19.00
982 10060 MCR-I&D ABSCESS, SIMPLE Moab Regional Health Center 164.00
510 10060 MCR-I&D ABSCESS, SIMPLE Moab Regional Health Center 19.00
982 10081 JV/INCIS DRAIN OF PILONIDAL CYST Moab Regional Health Center 850.00
982 10160 PUNCTURE ASPIRATION OF CYST Moab Regional Health Center 140.40
981 10160 PUNCTURE ASPIRATION OF CYST Moab Regional Health Center 156.00
510 10160 MCR-PUNCTURE ASPIR, ABSCESS/HEMATOMA Moab Regional Health Center 15.60
982 10160 MCR-PUNCTURE ASPIRATION ABSCESS/HEMAT Moab Regional Health Center 140.00
510 10160 MCR-PUNCTURE ASPIR, ABSCESS/HEMATOMA Moab Regional Health Center 16.07
981 20600 ASPIR/INJECT SMALL JOINT Moab Regional Health Center 149.00
982 20605 MCR-ASPIR OR INJECT MEDIUM JOINT Moab Regional Health Center 142.20
510 20605 MCR-ASPIR OR INJECT MEDIUM JOINT Moab Regional Health Center 15.80
982 20605 MCR-ASPIR OR INJECT MEDIUM JOINT Moab Regional Health Center 142.20
510 20605 MCR-ASPIR OR INJECT MEDIUM JOINT Moab Regional Health Center 15.80
510 20610 MCR-ASPIR OR INJECT MAJOR JOINT Moab Regional Health Center 17.80
982 20610 ASPIR OR INJECT, MAJOR JOINT Moab Regional Health Center 201.80
982 20610 MCR-ASPIR OR INJECT, MAJOR JOINT Moab Regional Health Center 184.00
510 20610 MCR-ASPIR OR INJECT MAJOR JOINT Moab Regional Health Center 20.00
982 23350 INJ PROC FOR SHOULDER ARTHROGRAM Moab Regional Health Center 358.00
982 23350 MCR-INJECTION, SHOULDER Moab Regional Health Center 322.20
510 23350 MCR-INJECTION, SHOULDER Moab Regional Health Center 35.80
982 31575 MCR-LARYNGOSCOPY Moab Regional Health Center 275.40
510 31575 MCR-LARYNGOSCOPY Moab Regional Health Center 30.60
982 31575 LARYNGOSCOPY;FLEXIBLE FIBEROPTIC;DX Moab Regional Health Center 306.00
982 31575 MCR-LARYNGOSCOPY Moab Regional Health Center 275.40
510 31575 MCR-LARYNGOSCOPY Moab Regional Health Center 30.60
982 32554 MCR-THORACENTESIS Moab Regional Health Center 505.00
510 32554 MCR-THORACENTESIS Moab Regional Health Center 56.20
982 32554 MCR-THORACENTESIS Moab Regional Health Center 505.80
510 32554 MCR-THORACENTESIS Moab Regional Health Center 56.20
982 36410 MCR-VENIPUNCTURE, AGE 3+ Moab Regional Health Center 108.00
510 36410 MCR-VENIPUNCTURE AGE 3+ Moab Regional Health Center 12.00
982 36410 MCR-VENIPUNCTURE, AGE 3+ Moab Regional Health Center 107.00
510 36410 MCR-VENIPUNCTURE AGE 3+ Moab Regional Health Center 14.00
510 43753 MCR-GASTRIC INTUBATION Moab Regional Health Center 7.60
982 43753 MCR-GASTRIC INTUBATION Moab Regional Health Center 68.40
982 43753 MCR-GASTRIC INTUBATION Moab Regional Health Center 67.00
510 43753 MCR-GASTRIC INTUBATION Moab Regional Health Center 9.00
981 64425 NERVE BLOCK Moab Regional Health Center 632.00
982 64425 MCR-INJECTION ILIOINGUINAL NERVES Moab Regional Health Center 568.80
510 64425 MCR-INJECTION ILIOINGUINAL NERVES Moab Regional Health Center 63.20
982 64425 MCR-INJECTION, ILIOINGUINAL NERVES Moab Regional Health Center 568.80
510 64425 MCR-INJECTION ILIOINGUINAL NERVES Moab Regional Health Center 63.20
982 64447 MCR-INJECT FEMORAL NERVE, SINGLE Moab Regional Health Center 430.20
510 64447 MCR-INJECT FEMORAL NERVE, SINGLE Moab Regional Health Center 47.80
982 64447 MCR-INJECT FEMORAL NERVE, SINGLE Moab Regional Health Center 430.20
510 64447 MCR-INJECT FEMORAL NERVE, SINGLE Moab Regional Health Center 47.80
982 64476 FACET INJECT-EACH ADDITIONAL LEVEL Moab Regional Health Center 406.00
982 64476 MCR-FACET INJECT-EACH ADDITIONAL Moab Regional Health Center 365.40
510 64476 MCR-FACET INJECT-EACH ADDITIONAL Moab Regional Health Center 40.60
982 64476 MCR-FACET INJECT-EACH ADDITIONAL LEVE Moab Regional Health Center 365.40
510 64476 MCR-FACET INJECT-EACH ADDITIONAL Moab Regional Health Center 40.60
982 90785 AR/INTERACTIVE ADD ON CODE Moab Regional Health Center 28.00
982 90791 AR/MARITAL PSYCH DIAG EVAL Moab Regional Health Center 125.00
982 90791 AR/NEWPSYCHIATRIC DIAGNOSTIC EVALUATION Moab Regional Health Center 203.00
982 90791 AR/NEW KID INTERACTIVE PSYCH DIAG EVAL Moab Regional Health Center 223.00
982 90791 ES/PSYCHIATRIC DIAGNOSTIC EVALUATION Moab Regional Health Center 203.00
982 90810 AR/INDIVIDUAL PSYCHOTHERAPY 20-30 MIN Moab Regional Health Center 124.00
982 90812 AR/INDIVIDUAL PSYCHOTHERAPY (45-50 MIN) Moab Regional Health Center 134.00
982 90814 AR/INDIVIDUAL PSYCHOTHERAPY (75-80 MIN) Moab Regional Health Center 188.06
982 90832 AR/INDIVIDUAL PSYCHOTHERAPY 30 MIN Moab Regional Health Center 122.00
982 90834 AR/INDIVIDUAL PSYCHOTHERAPY 45 MIN Moab Regional Health Center 125.00
982 90834 ES/INDIVIDUAL PSYCHOTHERAPY (45 MIN) Moab Regional Health Center 125.00
982 90837 AR/INVIDUAL PSYCHOTHERAPY 60 MIN Moab Regional Health Center 206.01
982 90846 AR/FAMILY PSYCHOTHERAPY W/O PATIENT Moab Regional Health Center 118.00
982 90847 AR/MARITAL THERAPY ADDITIONAL SESSIONS Moab Regional Health Center 125.00
982 90847 AR/FAMILY PSYCHOTHERAPY W/ PATIENT Moab Regional Health Center 147.00
982 90853 AR/GRP PSYCHOTHERAPY I.E. EDUCATION 1UNT Moab Regional Health Center 78.00
982 96101 AR/PSYCHOLOGICAL TESTING PER HOUR Moab Regional Health Center 176.00
982 96101 ES/PSYCHOLOGICAL TESTING PER HOUR Moab Regional Health Center 176.00
982 96150 AR/INI HLTH & BEHAVIOR ASSMT EA 15 MIN Moab Regional Health Center 48.00
982 96151 AR/HLTH & BEHAVIOR RE-ASSMT EA 15 MIN Moab Regional Health Center 24.00
982 96152 AR/HLTH & BEHAVIOR INTRVNTN INDVD 15 MIN Moab Regional Health Center 24.00
982 96153 AR/HLTH & BHVR INRVNTN, GROUP 2 + 15 MIN Moab Regional Health Center 34.02
982 96154 AR/HLTH & BHVR INTRVNTN, FMLY WPT 15MIN Moab Regional Health Center 34.02
982 98925 OMT 1-2 BODY REGIONS INVOLVED Moab Regional Health Center 72.00
982 99144 MCR-MODERATE SEDATION (5 YRS & OLDER) Moab Regional Health Center 97.20
510 99144 MCR-MODERATE SEDATION (5 YRS & OLDER) Moab Regional Health Center 10.80
982 99144 MCR-MODERATE SEDATION (5 YRS & OLDER) Moab Regional Health Center 97.20
510 99144 MCR-MODERATE SEDATION (5 YRS & OLDER) Moab Regional Health Center 10.80
982 99149 MCR-MODERATE SEDATION (UNDER AGE 5) Moab Regional Health Center 81.00
510 99149 MCR-MODERATE SEDATION (UNDER 5 YRS) Moab Regional Health Center 9.00
942 99149 MCR-MODERATE SEDATION (UNDER AGE 5) Moab Regional Health Center 81.00
510 99149 MCR-MODERATE SEDATION (UNDER 5 YRS) Moab Regional Health Center 9.00
982 99150 MCR-ADDTL 15 MINS CONSCIOUS SEDATION Moab Regional Health Center 42.30
510 99150 MCR-ADDTL 15 MINS CONSCIOUS SEDATION Moab Regional Health Center 4.70
982 99201 MCR-NEW PT VISIT, LEVEL 1 Moab Regional Health Center 126.00
510 99201 MCR-NEW PT VISIT, LEVEL 1 Moab Regional Health Center 14.00
982 99201 NEW PT VISIT, LEVEL 1 Moab Regional Health Center 140.00
982 99202 NEW OFFICE LEVEL 2 Moab Regional Health Center 170.00
510 99202 MCR-NEW OFFICE LEVEL 2 Moab Regional Health Center 17.00
982 99202 MCR-NEW PT VISIT, LEVEL 2 Moab Regional Health Center 153.00
982 99203 MCR-NEW PT VISIT, LEVEL 3 Moab Regional Health Center 202.50
982 99203 JV/MCR-OFFICE VISIT-NEW-DETAILED Moab Regional Health Center 134.00
982 99204 MCR-NEW PT VISIT, LEVEL 4 Moab Regional Health Center 288.00
510 99204 MCR-NEW PT VISIT, LEVEL 4 Moab Regional Health Center 32.00
982 99204 NEW PT VISIT, LEVEL 4 Moab Regional Health Center 320.00
982 99205 MCR-NEW PT VISIT, LEVEL 5 Moab Regional Health Center 378.00
510 99205 MCR-NEW PT VISIT, LEVEL 5 Moab Regional Health Center 42.00
982 99205 JV/MCR-OFFICE VISIT-NEW-HIGH COMPLEXITY Moab Regional Health Center 309.02
982 99212 MCR-EST PT O.V. 10 MINS Moab Regional Health Center 108.00
510 99212 MCR-EST PT O.V. 10 MINS Moab Regional Health Center 12.00
982 99213 MCR-EST PT VISIT, LEVEL 3 Moab Regional Health Center 126.00
510 99213 MCR-EST PT VISIT, LEVEL 3 Moab Regional Health Center 14.00
982 99213 EST PT VISIT, LEVEL 3 Moab Regional Health Center 140.00
982 99213 JV/MCR-OFFICE VISIT-EST-EXPANDED Moab Regional Health Center 80.00
982 99214 MCR-EST PT VISIT, LEVEL 4 Moab Regional Health Center 180.00
510 99214 MCR-EST PT VISIT, LEVEL 4 Moab Regional Health Center 20.00
982 99214 EST PT VISIT, LEVEL 4 Moab Regional Health Center 200.00
982 99215 MCR-EST PT VISIT, LEVEL 5 Moab Regional Health Center 279.00
982 99215 EST PT VISIT, LEVEL 5 Moab Regional Health Center 310.00
510 99215 MCR-EST PT VISIT, LEVEL 5 Moab Regional Health Center 31.00
982 99218 MCR-INITIAL OBSERVATION, LOW SEVERITY Moab Regional Health Center 167.00
982 99283 E & M ER ROOM MOD SEVERITY Moab Regional Health Center 254.00
982 99283 MCR-E&M-ER-MODERATE SEVERITY Moab Regional Health Center 228.00
510 99283 MCR-E&M-ER-MODERATE SEVERITY Moab Regional Health Center 27.00
982 99284 MCR-E&M, ER, HIGH SEVERITY Moab Regional Health Center 389.00
510 99284 MCR-E&M, ER, HIGH SEVERITY Moab Regional Health Center 44.00
250 CLONIDINE INJ 100MG/ ML 10 ML VIAL Moab Regional Health Center 70.22
982 NEW PT VISIT, LEVEL 3 Moab Regional Health Center 225.00
471 92587 HEARING SCREEN Nursery 110.00
170 NEWBORN MANAGMENT Nursery 599.00
171 NURSERY ROOM Nursery 732.00
171 NB LONG STAY Nursery 419.00
920 59025 OB TREATMENT/NST Obstetrics 340.00
720 59025 NONSTRESS TEST Obstetrics 325.00
762 59412 EXTERNAL CEPHALIC VERSION, W/WO TCLYSIS Obstetrics 1,045.00
981 59514 KEYS/CESAREAN DELIVERY ONLY Obstetrics 3,491.00
310 82962 CHEM BG Obstetrics 39.00
729 93960 DOPPLER Obstetrics 303.00
260 96360 INITIAL HOUR HYDRATION, 1ST HOUR Obstetrics 297.00
260 96361 HYDRATION, EACH ADDITIONAL HOUR Obstetrics 110.00
260 96365 THERAPEUTIC IV INFUSION, INITIAL HOUR Obstetrics 327.00
260 96366 THERAPEUTIC IV INFUSION; EACH ADD HOUR Obstetrics 138.00
260 96372 THERAPEUTIC SUB-CU OR IM INJECTION Obstetrics 98.00
260 96374 THERAPEUTIC IV PUSH, INITIAL Obstetrics 206.00
260 96375 THERAPEUTIC IV PUSH; EACH ADD. PUSH Obstetrics 133.00
721 99283 LABOR OBSERVATION PER HR Obstetrics 95.00
762 G0378 OO OBSERVATION <1 HOUR Obstetrics 372.00
762 G0378 OO OBSERVATION 1 HOUR – 1HOUR 59 MIN Obstetrics 562.00
762 G0378 OO OBSERVATION 2 HOURS – 2 HOURS 59 MIN Obstetrics 764.00
762 G0378 OO OBSERVATION 3 HOURS – 3 HOURS 59 MIN Obstetrics 963.00
762 G0378 OO OBSERVATION > 4 HOURS Obstetrics 1,162.00
720 EPIDURAL MANAGEMENT SERVICE Obstetrics 415.00
722 DELIVERY SERVICE Obstetrics 1,409.00
721 LABOR MANAGEMENT Obstetrics 374.00
410 INFANT RESUSCITATION Obstetrics 282.00
721 LABOR ROOM-LAST HOUR Obstetrics 198.00
721 LABOR MANAGEMENT ADDITIONAL Obstetrics 464.00
761 16000 BURN CARE INT TX, 1 DEGREE BURN Out Patient Nursing Services 168.00
761 16020 BURN CARE, DRSS, DBRDE, THKNS 1ST/SBSQ Out Patient Nursing Services 258.00
761 16025 BRN CR DRS/DBRDMT, THKNS 1ST/SBSQ MEDIUM Out Patient Nursing Services 409.00
361 29445 APPLIC OF TOTAL CONTACT LEG CAST Out Patient Nursing Services 746.00
761 29580 STRAPPING UNNA BOOT Out Patient Nursing Services 115.00
361 29581 APPLIC MULTI-LAYER COMPRESS. SYSTEM Out Patient Nursing Services 427.00
761 29582 APP MULTI-LAYER COMP SYS LEG & THIGH Out Patient Nursing Services 203.00
391 36430 BLOOD ADMINISTRATION Out Patient Nursing Services 646.00
761 36591 COLL BLOOD FROM VENOUS ACC DEVICE Out Patient Nursing Services 144.00
761 36592 COL OF BLOOD SPEC USING CENT OR PER CATH Out Patient Nursing Services 117.00
761 36593 DECLOTTING THROMOLYTIC Out Patient Nursing Services 543.00
360 51700 BLADDER IRRIGATION Out Patient Nursing Services 233.00
761 51701 INSERTION OF NON INDWELLING BLADDER CATH Out Patient Nursing Services 362.00
761 51702 INSERT FOLEY CATHETER Out Patient Nursing Services 261.00
761 51703 INSJ TEMP NDWLL BLAD CATHETER, COMPLICTD Out Patient Nursing Services 395.00
761 62270 SPINAL PUNCTURE, LUMBAR DIAGNOSTIC Out Patient Nursing Services 679.00
771 90471 IMMUNIZATION ADMIN SUBCU, IM; 1 VACC Out Patient Nursing Services 86.00
260 90779 UNLISTED THERAPY PROPH/DX IN INJ Out Patient Nursing Services 68.00
260 96360 OP IV THERAPY HYDRATE; 1ST HOUR Out Patient Nursing Services 310.00
260 96361 OP IV THERAPY HYDRAT; EA HOUR UP TO 8 Out Patient Nursing Services 200.00
260 96365 IV INFUSION THERAPUTIC/PROPH/DX 1ST HOUR Out Patient Nursing Services 315.00
260 96366 IV INFUSION THERAPY/PROPH/DX EA ADD HOUR Out Patient Nursing Services 149.00
260 96367 IV THERAPY /PROPH/DX; SEQUENTIAL-1ST HR Out Patient Nursing Services 175.00
260 96368 IV INFUSION THERAPY/PROPH/ DX-CONCURRENT Out Patient Nursing Services 234.00
260 96372 THERAPUTIC/PROPH/DX INJ SUB Q OR IM Out Patient Nursing Services 98.00
260 96374 THERAPUTIC/PROPH/DX IV PUSH; SINGLE INJ Out Patient Nursing Services 206.00
260 96375 THERAPUTIC/PROPH/DX INJ; EA SEQ. IVP Out Patient Nursing Services 137.00
260 96376 EA ADD SEQUEN IV PUSH Out Patient Nursing Services 58.00
331 96401 CHEMO ADMIN; SUB Q-INTER MUSCLE- NO HORM Out Patient Nursing Services 264.00
331 96402 CHEMO ADMIN; SUB Q OR IM, HORMONAL Out Patient Nursing Services 248.00
331 96409 CHEMO ADMIN; IV PUSH SINGLE OR INITIAL Out Patient Nursing Services 326.00
331 96411 CHEMO ADMIN; IV PUSH EA ADD SUBSTAN//DRU Out Patient Nursing Services 398.00
335 96413 CHEMO ADMIN; IV INFUSION UP TO 1 HR Out Patient Nursing Services 729.00
335 96415 CHEMO ADMIN; IV INFUSION EACH ADD HOUR Out Patient Nursing Services 213.00
335 96416 INIT OF PROLONGED CHEMO INFUSION Out Patient Nursing Services 600.00
335 96417 CHEMO ADMIN; IV INFUSE; EA SEQUENT INFUS Out Patient Nursing Services 298.00
335 96521 REFILLING MAINTENANCE PORTABLE PUMP Out Patient Nursing Services 492.00
335 96522 REFILL AND MAIN IMPLANT PUMP OR RESIV FO Out Patient Nursing Services 412.00
761 96523 IRRIGAT IMPLANTED VENOUS ACCESS DEVICE Out Patient Nursing Services 123.00
761 97597 SELECT DEBRID < OR = 20 SQ. CM Out Patient Nursing Services 230.00
761 97598 SELECT DEBRID > 20 SQ. CM. Out Patient Nursing Services 213.00
761 97602 REM OF DEVIT TISS FR WND, DEBRID PER SES Out Patient Nursing Services 176.00
761 97605 NEG PRESSURE WOUND THERAPY; PER SESSION Out Patient Nursing Services 161.00
761 97606 NEG PRESS WND THER, SURF AREA 20 SQ. CM Out Patient Nursing Services 276.00
761 99211 OP NURSE VISIT Out Patient Nursing Services 100.00
260 C8957 INTRVENOUS INFSN, INIT PROLGD 8 HRS Out Patient Nursing Services 595.00
260 G0498 INITIATION OF INFUSION PUMP Out Patient Nursing Services 625.00
761 P9612 CATHETERIZATION FOR SPECIMEN COLLECTION Out Patient Nursing Services 362.00
257 CALMOSEPTINE Out Patient Nursing Services 55.00
257 CALMOSEPTINE OINT Out Patient Nursing Services 5.49
360 11730 AVULSION OF NAIL PLATE, PART/COMPLT SIMP Operating Room 277.00
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360 11752 EXC OF NAIL/W AMPUTATION OF TUFT DISTAL Operating Room 614.00
361 20552 INJECT TRIGGER POINT 1-2 MUSCLES Operating Room 485.00
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360 25505 CLX TX OF RADIAL SHAFT FX W/MANIPULATION Operating Room 1,556.00
360 25565 CLO TX RADIAL & ULNAR FX W/MANIPULATION Operating Room 1,664.00
360 25605 CLO DIST RADIAL; W/MANIPULATION Operating Room 1,285.00
360 26755 CLTX DSTL PHLNGL FX FNGR/THUMB W/MANJ EA Operating Room 853.00
360 27570 MANIP OF KNEE UNDER Anesthesia Operating Room 1,435.00
360 27752 CLTX TIBIAL SHFT FX W/MANJ W/WO SKL TRC Operating Room 2,268.00
360 28495 CLX TX OF FX GRT TOE PHLX/PHLG W MANJ Operating Room 541.00
360 38221 BX-BONE MARROW, BIOPSY NEEDLE OR TROCAR Operating Room 2,223.00
360 55250 VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAM Operating Room 1,655.00
361 62273 EPIDURAL BLOOD PATCH Operating Room 1,189.00
360 64483 INJ Anesthesia OR STEROID, LIMB/SACRAL SGL Operating Room 1,775.00
361 64490 INJECT DIAG OR THER PARAVERT FACET JOINT Operating Room 3,173.00
361 64491 INJECT PARAVERT FACET JOINT W/IMAG; 2ND Operating Room 2,377.00
361 64492 FACET JOINT INJECT CER/THO 3RD & ADD LEV Operating Room 780.00
360 64493 INJ DIAG OR THER; PAVAVERT 2ND LEVEL Operating Room 3,192.00
360 64494 INJ; DIAG OR THER; PARAVERT UMB/SAC Operating Room 1,864.00
361 66761 IRIDOTOMY/IRIDECTOMY BY LASER SURGERY Operating Room 1,825.00
360 66821 YAG LASER; 1 OR MORE STAGES Operating Room 2,445.00
360 69205 CLEAR OUTER EAR CANAL W/AnesthesiaTHESIA Operating Room 1,309.00
300 82948 CHEM BG Operating Room 37.00
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372 99145 MODERATE SEDATION EA ADD 15 MIN Operating Room 65.00
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278 C1769 ZIMMER K WIRES .078 Operating Room 42.00
278 C1776 HUMERAL HEAD RT 45mm FROZEN TISSUE Operating Room 2,487.00
360 COLPOSCOPY Operating Room 207.00
270 DME POLAR CARE W/SHOULDER PAD Operating Room 376.00
278 ZIMMER K WIRES .035 Operating Room 42.00
270 DME POLAR CARE 500 W/KNEE PAD Operating Room 346.00
278 CANCELLOUS CHIP 15cc BLT 400145 Operating Room 1,007.00
278 LIFECELL STRATTICE 8X8 Operating Room 2,950.00
250 GELFOAM 100 09-0342-01/HEMOSTATIC SPONGE Operating Room 140.00
369 APPLICATION OF WOUND V.A.C. FREEDOM Operating Room 387.00
278 SYNTHES 456.303 TI HELICAL BLADE 11X90mm Operating Room 1,281.00
278 SEE 425130022 / ARTHREX AR-1934BCF-24 FB Operating Room 989.00
360 COLONOSCOPY SPECIAL Operating Room 1,575.00
360 COLONOSCOPY SPECIAL W/O AnesthesiaTHESIA Operating Room 1,575.00
360 OR SERVICE PER MIN Operating Room 118.00
360 OR SERVICE EGD FIRST 30 MIN.W/SEDATION Operating Room 900.00
360 OR SERVICE EGD EA ADD 15 MIN Operating Room 286.00
360 COLONOSCOPY WITH SEDATION Operating Room 1,575.00
360 OUTPATIENT PROCEDURE Operating Room 825.00
272 see 425002086 / CONRAY Operating Room 74.00
360 EMERGENCY SURGERY Operating Room 3,136.00
278 SEE 425002462 / HEMACLIP MEDIUM Operating Room 49.00
360 TISSUE HARVEST Operating Room 765.00
369 CASTING PROCEDURE Operating Room 737.00
370 CONSCIOUS SEDATION; ORAL, NASAL, RECTAL Operating Room 284.00
278 ZIM 42-5099-025-25 PSN F HX SCREW 2.5X25 Operating Room 570.00
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440 92507 SPEECH THERAPY TREATMENT Physical Therapy 330.00
444 92523 SPEECH EVALUATION SOUND PRODUCTION Physical Therapy 269.00
444 92525 SPEECH SWALLOW EVAL Physical Therapy 165.00
440 92526 SPEECH SWALLOW TX Physical Therapy 424.00
444 92597 SPEECH THER DEVICE EVAL Physical Therapy 165.00
444 92610 SPEECH THERAPY EVALUATIO Physical Therapy 473.00
440 96105 SPEECH APHASIA ASSESSMENT Physical Therapy 165.00
424 97001 PHYSICAL THERAPY EVALUATION Physical Therapy 303.00
424 97002 PHY. THERAPY RE-EVALUATE Physical Therapy 145.00
420 97010 HOT PAKS Physical Therapy 42.00
420 97010 HOT AND COLD PACKS Physical Therapy 87.00
420 97012 MECHANICAL TRACTION Physical Therapy 92.00
420 97014 ELECTRICAL STIMULATION Physical Therapy 92.00
420 97022 WHIRLPOOL Physical Therapy 198.00
420 97022 STERILE WHIRLPOOL Physical Therapy 197.00
420 97032 ELECTRICAL STIM. MANUAL Physical Therapy 142.00
420 97033 IONTOPHORESIS Physical Therapy 220.00
420 97035 ULTRA SOUND Physical Therapy 128.00
430 97110 OT THERAPUTIC EXCERSICES Physical Therapy 87.00
420 97110 THERAPEUTIC EXERCISES Physical Therapy 87.00
420 97112 NEURO MUSCULAR STIM WK Physical Therapy 273.00
420 97116 GAIT TRAINING I Physical Therapy 83.00
420 97124 MASSAGE Physical Therapy 123.00
420 97140 MANUAL THERAPY TECHNIQUE Physical Therapy 73.00
420 97150 THER. EXERCISE GROUP Physical Therapy 142.00
424 97161 PT EVAL; LOW COMPLEXITY Physical Therapy 188.00
424 97162 PT EVAL;MOD COMPLEXITY Physical Therapy 188.00
424 97163 PT EVAL; HIGH COMPLEXITY Physical Therapy 188.00
424 97164 PT RE-EVALUATION ESTBLSHD PLAN OF CARE Physical Therapy 68.00
434 97165 OT EVAL, LOW COMPLEXITY 30 MIN Physical Therapy 184.00
434 97166 OT EVAL MOD COMPLEXITY 45 MIN Physical Therapy 184.00
434 97167 OT EVAL HIGH COMPLEXITY 60 MIN Physical Therapy 184.00
434 97168 OT THERAPY RE-EVAL, EST PLAN OF CARE Physical Therapy 126.00
420 97250 MYFACIAL RELEASE Physical Therapy 142.00
420 97265 JOINT MOBILZATION Physical Therapy 214.00
430 97530 OT FUNCTIONAL ACTIVITIES 1 ON 1 PT CON Physical Therapy 109.00
440 97530 SPEECH THER ACT Physical Therapy 109.00
420 97530 PT FUNCTIONAL ACTIVITIES Physical Therapy 109.00
449 97532 DEVELOPMENT OF COGNITIVE SKILLS EA 15MIN Physical Therapy 46.00
430 97533 SNSRY INTGRTV TECNQ, DIR PT CONTCT EA 15 Physical Therapy 67.00
430 97535 SELF-CARE/HOME MGMT TRAINING EA 15 MIN. Physical Therapy 117.00
430 97537 OT REINTEGRATION TRAINING EA 15 MIN Physical Therapy 136.00
420 97542 WHEELCHAIR MANAGEMENT; EACH 15 MIN Physical Therapy 87.00
420 97703 CHECKOUT FOR ORTHOTIC/PROSTHETIC USE EST Physical Therapy 109.00
430 97760 ORTHOTIC MGMT/TRAIN, UPPER/LOW/TRNK 15 M Physical Therapy 137.00
430 97761 PROSTHTC TRNG, UPPER/LOW EXTREM, EA 15 M Physical Therapy 126.00
430 97762 CHECKOUT ORTHOTIC/PROSTH ESTB PT EA 15 M Physical Therapy 121.00
420 Q0103 ICE TREATMENT P.T. Physical Therapy 42.00
420 PHYSICAL THERAPY Physical Therapy 3.00
420 GAIT TRAINING II Physical Therapy 125.00
420 CardiopulmonaryIAC REHAB Physical Therapy 125.00
420 JOBST STOCKING Physical Therapy 438.00
420 GEL CAST Physical Therapy 197.00
420 MAJOR DRESSING Physical Therapy 103.00
420 MINOR DRESSING Physical Therapy 46.00
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420 DIATHERMY Physical Therapy 79.00
420 L/S SUPPORT AND FITTING Physical Therapy 391.00
420 DOME PASTE ROLL Physical Therapy 157.00
420 NEURO MUSCULAR STML Physical Therapy 125.00
420 STROKE REHAB. Physical Therapy 134.00
420 TENS UNIT Physical Therapy 1,741.00
420 PHONOPHORESIS Physical Therapy 134.00
420 TENS PER WEEK Physical Therapy 172.00
420 W.T. SET UP Physical Therapy 57.00
420 JOINT IM0BILIZER Physical Therapy 139.00
420 W.T. MONITOR Physical Therapy 17.00
420 W.T. OXYGEN Physical Therapy 101.00
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424 WORKMAN COMP OFFICE VIS. Physical Therapy 224.00
424 WORKMANS NEW EVALUATION Physical Therapy 293.00
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420 CONT. PASV. MONTN. Physical Therapy 125.00
420 CONT. MOTION PAD Physical Therapy 172.00
420 AEROSOL CONT CHECK Physical Therapy 36.00
320 10022 US FINE NEEDLE ASPIR W/IMAGE GUIDANCE Radiology 1,017.00
402 10030 IMAGE GUIDED FLUID COLLECT DRNGE BY CATH Radiology 2,337.00
402 19000 PUNCTURE ASPIRATION CYST OF BREAST Radiology 686.00
402 19081 BX BREAST PNC-NEEDLE CORE IMG GDNC Radiology 3,874.00
361 19083 BRST BX W/PLCMNT CLIP PERC 1ST LSN ULSD Radiology 2,870.00
361 19084 BX, BREAST WITH LOC DEVICE PERC, EA ADD Radiology 2,325.00
320 19281 PREOP PLACE NEDLE LOC WIRE Radiology 707.00
401 19281 MAMMOGRAPHY PLACE WIRE Radiology 500.00
320 19281 MAMMO NEEDLE LOCALIZATIO Radiology 500.00
320 19281 PREOP PLACE OF NEEDLE LOC WIRE BREAST Radiology 711.00
320 19285 PERQ DEV BREAST 1ST US IMAG Radiology 1,499.00
320 19295 IMG GID PLMNT MTLC LOC CLIP BST BX/ASPR Radiology 438.00
361 20600 INJECT SMALL JOINT Radiology 306.00
361 20605 ARTHROCENTESIS-JOINT Radiology 263.00
361 20610 INJECT LARGE JOINT Radiology 973.00
400 20611 ARTHROCENTESIS, W/ US GUIDE, W/PRMNT REC Radiology 423.00
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636 90658 MRC/ INFLUENZA VAC <3YR Pharmacy 25.00
636 90660 MRC/ INFLUENZA VAC- INTRANASAL USE Pharmacy 35.00
636 90662 FLUZONE HD 2018/19 Pharmacy 60.00
636 90670 PNEUMOCOCCAL CONJ VACC valent 13 any age Pharmacy 691.00
636 90675 Rabies Vaccine (Rabavert) Pharmacy 1,048.75
636 90680 ROTAVIRUS VACCINE, PENTAVALENT, 3 DOSE Pharmacy 98.86
636 90681 RV1 VACCINE 2 DOSE SCHEDULE LIVE/ORAL Pharmacy 175.00
636 90685 Flu Vaccine(6mo-36mo) 0.25ML (2017-18) Pharmacy 25.00
636 90686 Fluarix 2018/19 Pharmacy 30.00
636 90691 TYPHIM Vi Pharmacy 367.00
636 90696 MRC/DTaP-IPV Pharmacy 193.00
636 90698 DIP/ TET / PERT / IPV / HIB COMBO Pharmacy 176.75
636 90700 MRC/DIPHTHERIA TET, TX & PRTSS UNDER 7 Pharmacy 114.00
250 90702 MRC/DIPTHERIA & TETNUS TOXOID Pharmacy 20.00
636 90703 MRC(MDCR)TETNAS TOXOID Pharmacy 2.30
636 90707 MEASLES, MUMPS AND RUBELLA VIRUS (MMR) Pharmacy 135.50
636 90710 PROQUAD Pharmacy 388.00
636 90713 MRC/POLIOVIRUS VACCINE, INACT (IPV)SQ,IM Pharmacy 122.50
636 90714 MRC/preserv free (Td) 7 yrs IM Pharmacy 125.50
636 90714 MRC/DPTHERIA & TETNUS TOXI (Td) 7 yrs IM Pharmacy 44.50
250 90715 Tet-Diphth-Pertussis Pharmacy 180.75
250 90715 Adacel (Tet/Diph/Pert) Pharmacy 163.50
636 90715 Tdap administered to 7yrs and older Pharmacy 152.50
250 90716 VARICELLA VIRUS VACCINE, LIVE, FOR SUBQ Pharmacy 234.25
250 90723 MRC/DTAP-HEP B-IPV VACCINE Pharmacy 293.25
982 90732 MRC(MDCR)PNEUMOCOCCAL VACC 2YRS OLDE Pharmacy 67.50
510 90732 MRC(MDCR)PNEUMOCOCCAL VACC 2Y OR OLD Pharmacy 7.50
636 90732 MRC/PNEUMOCOCCAL VACC >2 yrs ppv 23 Pharmacy 363.00
636 90733 MENOMUNE VACCINE SUBQ Pharmacy 236.25
636 90734 MENINGOCOCCAL VACC GROUPS A,C,Y,W Pharmacy 433.25
636 90736 ZOSTAVAX VACCINE Pharmacy 408.50
250 90744 Hep B Vaccine Pediatric Pharmacy 188.75
636 90744 HEP B (PED) Pharmacy 98.86
250 90746 Hep B Vaccine Adult Pharmacy 215.75
636 90746 HEP B (ADULT) Pharmacy 109.75
250 90748 HIB-HEPB VACCINE Pharmacy 125.00
636 90750 SHINGRIX VACCINE Pharmacy 269.00
250 A6011 Collagenase Ointment (Santyl) Pharmacy 810.00
636 C9465 DUROLANE inj Pharmacy 4,015.00
250 G9314 Amoxicillin 400mg/5ml Susp. Pharmacy 52.05
636 J0131 Acetaminophen 1000mg vial Pharmacy 154.50
250 J0132 Acetylcysteine 6000mg (IV use) vial Pharmacy 857.00
250 J0133 Acyclovir 500mg vial Pharmacy 115.00
250 J0135 Adalimumab SQ 40mg PFS Pharmacy 9,825.00
250 J0153 Adenosine 6mg/2ml injection Pharmacy 49.84
636 J0171 Epinephrine 1mg PFS Pharmacy 49.84
250 J0171 Epinephrine 1:1000 amp Pharmacy 49.84
250 J0171 Epinephrine 1mg/ml 30ml MDV Pharmacy 243.00
636 J0180 Fabrazyme 35 mg IV Pharmacy 23,485.00
636 J0180 Fabrazyme 5mg vial Pharmacy 3,470.00
636 J0256 Zemaira 1000mg Pharmacy 2,195.00
636 J0256 Aralast 1GM Pharmacy 2,305.00
636 J0282 Amiodarone IV 150mg/3ml Pharmacy 44.00
250 J0282 Amiodarone 150mg vial Pharmacy 49.84
250 J0290 Ampicillin 2Gm vial Pharmacy 115.00
250 J0290 Ampicillin 1Gm vial Pharmacy 95.00
250 J0295 Ampicillin-Sulbactam 1.5Gm vial Pharmacy 95.00
250 J0295 Ampicillin-Sulbactam 3Gm vial Pharmacy 115.00
250 J0330 Succinylcholine 200mg/10ml vial Pharmacy 79.00
250 J0360 Hydralazine 20mg injection Pharmacy 61.75
250 J0456 Azithromycin 500mg IV Pharmacy 49.84
250 J0461 Atropine 1mg/ml 1ml Pharmacy 61.75
250 J0461 Atropine 0.4mg/ml 1ml IV Pharmacy 49.84
250 J0461 Atropine PFS Pharmacy 61.75
636 J0558 PENICILLIAN G BENZATHINE /PENICILLIAN G Pharmacy 120.50
636 J0561 PENICILLIN G BENZATHINE Pharmacy 151.25
636 J0595 Butorphanol 2mg/ml 1ml vial Pharmacy 57.59
250 J0610 Calcium Gluconate 10% 10ml vial Pharmacy 95.00
250 J0630 Calcitonin 400iu injection Pharmacy 8,280.00
636 J0640 Leucovorin 350mg SDV Pharmacy 127.75
250 J0641 Levoleucovorin 50mg vial Pharmacy 411.75
250 J0690 Cefazolin 1Gm vial Pharmacy 95.00
250 J0690 Cefazolin 2gm premix Pharmacy 49.84
250 J0694 Cefoxitin 2Gm vial Pharmacy 115.00
250 J0694 Cefoxitin 1Gm Premix Pharmacy 58.15
250 J0694 Cefoxitin 2Gm Premix Pharmacy 99.00
250 J0696 Ceftriaxone 1Gm vial Pharmacy 49.84
250 J0696 Ceftriaxone 250mg vial Pharmacy 49.84
250 J0696 Ceftriaxone 1Gm Premix Pharmacy 58.15
636 J0696 CEFTRIAXONE 250MG VIAL Pharmacy 98.86
636 J0696 CEFTRIAXONE SODIUM INJ SDV PER 500MG Pharmacy 40.00
636 J0696 CEFTRIAXONE SODIUM INJ SDV 1GM/V1 10/BX Pharmacy 44.00
250 J0697 Cefuroxime 750mg vial Pharmacy 95.00
250 J0697 Cefuroxime 1.5gm vial Pharmacy 95.00
250 J0698 Cefotaxime 1gm vial Pharmacy 44.93
250 J0702 Betamethasone Soluspan 6mg Pharmacy 61.75
250 J0702 Betamethasone Celestone Soluspan 6mg Pharmacy 49.84
636 J0702 Betamethasone Inj (Clinic) Pharmacy 98.86
250 J0712 Ceftaroline 600mg vial Pharmacy 801.50
250 J0735 Clonidine 0.1mg tablets Pharmacy 13.63
250 J0735 Clonidine 0.2mg tablets Pharmacy 15.21
250 J0735 Clonidine TTS-1 Patch Pharmacy 124.00
250 J0735 Clonidine TTS-3 patch Pharmacy 271.00
250 J0735 Clonidine TTS-2 patch Pharmacy 427.50
250 J0743 Imipenem/Cilastin Primaxin 500mg IV vial Pharmacy 115.00
250 J0744 Ciprofloxacin 400mg Premix Pharmacy 113.00
250 J0780 Prochlorperazine 10mg/2ml vial Pharmacy 49.84
250 J0834 Cosyntropin 0.25mg vial Pharmacy 438.75
250 J0840 Crotalidae (Crofab) Antivenin per bottle Pharmacy 12,580.00
250 J0875 Dalbavancin 500mg vial Pharmacy 6,417.00
250 J0878 Daptomycin 500mg vial Pharmacy 2,003.50
636 J0881 Darbepoetin 25mcg PFS Pharmacy 785.00
636 J0881 Darbepoetin 40mcg PFS Pharmacy 1,256.00
636 J0881 Darbepoetin 60mcg PFS Pharmacy 1,884.00
636 J0881 Darbepoetin 100mcg PFS Pharmacy 2,982.00
636 J0881 Darbepoetin 200mcg PFS Pharmacy 5,963.00
636 J0881 Darbepoetin 300mcg PFS Pharmacy 8,806.00
250 J0885 Epogen 10,000 units Pharmacy 682.50
250 J0885 Procrit 40,000 units Pharmacy 4,335.00
250 J0897 Denosumab 120mg vial Pharmacy 8,940.00
250 J0897 Denosumab 60mg vial Pharmacy 4,875.00
636 J1020 DEPO-MEDROL INJ MDV 20MG/ML 5ML/V1 EA Pharmacy 35.00
250 J1030 Depo-Methylprednisolone 40mg Pharmacy 61.75
636 J1030 DEPO-MEDROL 4O MG INJECTION Pharmacy 98.86
250 J1040 Depo-Methylprednisolone 80mg Pharmacy 75.50
636 J1050 MEDROXPROGESTERONE ACTATE 150 MG Pharmacy 92.00
636 J1050 MRC/MEDROXYPROGESTERONE 150MG IM Pharmacy 266.75
250 J1055 Medroxyprogesterone 150mg IM Pharmacy 335.75
250 J1055 MRC/MEDROXYPROGESTERONE 150MG (DEPO) Pharmacy 101.00
250 J1071 Testosterone-Depo 200mg vial Pharmacy 108.00
636 J1071 testosterone 100mg (clinic) Pharmacy 98.86
250 J1100 Dexamethasone 4mg vial Pharmacy 49.84
250 J1100 Dexamethasone 10mg vial Pharmacy 49.84
250 J1110 DHE (Dihydroergotamine) 1mg vial Pharmacy 540.75
250 J1120 Acetazolamide 500mg IV Pharmacy 171.00
250 J1160 Digoxin 500mcg ampule Pharmacy 49.84
250 J1162 Digoxin Immune Fab per bottle Pharmacy 14,016.50
250 J1165 Phenytoin 250mg vial Pharmacy 95.00
250 J1165 Phenytoin 100mg vial Pharmacy 95.00
636 J1170 Hydromorphone 2mg vial Pharmacy 57.59
636 J1170 Hydromorphone MDV 2 mg / 1 ml Pharmacy 49.84
250 J1170 Hydromorphone 1mg/1ml Cardiopulmonaryuject Pharmacy 57.59
250 J1200 Diphenhydramine 50mg vial Pharmacy 49.84
636 J1200 DIPHENHYDRAMINE HCL INJ SDV 50MG 1ML Pharmacy 98.86
250 J1245 Dipyridamole 25mg tab Pharmacy 15.21
250 J1250 Dobutamine/Dextrose 250mg/250ml premix Pharmacy 58.15
250 J1250 Dobutamine 250mg vial Pharmacy 95.00
250 J1265 Dopamine 400mg/250ml premix Pharmacy 59.00
250 J1265 Dopamine 400mg vial Pharmacy 95.00
250 J1327 Eptifibatide 75mg vial Pharmacy 2,442.50
250 J1327 Eptifibatide 20mg vial Pharmacy 794.00
250 J1335 Ertapenem 1Gm vial Pharmacy 593.00
250 J1364 Erythromycin 500mg IV Pharmacy 346.50
250 J1410 Conjugated Estrogen 25mg amp Pharmacy 1,221.75
250 J1442 Filgrastim 300mcg/ml vial Pharmacy 1,422.00
250 J1442 Filgrastim 480mcg/1.6ml vial Pharmacy 2,252.00
250 J1450 Fluconazole 400mg IV bag Pharmacy 58.15
250 J1450 Fluconazole 200mg premix Pharmacy 64.25
250 J1453 Fosaprepitant 150mg vial Pharmacy 1,446.00
250 J1561 IVIG 20gm vial Pharmacy 11,096.97
636 J1569 Gammagard 20 gram Pharmacy 11,068.50
636 J1569 Gammagard 5 gm Pharmacy 2,688.50
636 J1569 Gammagard 30 gm Pharmacy 16,552.50
636 J1569 Gammagard 10 gm Pharmacy 5,517.50
250 J1580 Gentamicin 80mg injection Pharmacy 43.00
250 J1580 Gentamicin 20mg injection Pharmacy 95.00
250 J1610 Glucagon Kit Pharmacy 1,156.00
250 J1630 Haloperidol 5mg injection Pharmacy 49.84
250 J1642 Heparin Flush 500 units Pharmacy 49.84
250 J1644 Heparin 1,000 units vial Pharmacy 49.84
250 J1644 Heparin 5,000 units vial Pharmacy 49.84
250 J1644 Heparin 25,000units/250ml premix Pharmacy 61.75
250 J1650 Enoxaparin 40mg Pharmacy 49.84
250 J1650 Enoxaparin 30mg Pharmacy 49.84
250 J1650 Enoxaparin 80mg Pharmacy 61.75
250 J1650 Enoxaparin 60mg Pharmacy 61.75
250 J1650 Enoxaparin 100mg Pharmacy 61.75
250 J1650 Enoxaparin 120mg Pharmacy 97.57
250 J1670 Tetanus Immune Globulin 250 iu Pharmacy 2,050.00
250 J1720 Hydrocortisone 100mg (Solu-Cortef) Pharmacy 61.75
250 J1726 Hydroxyprogesterone 250mg Pharmacy 3,415.00
250 J1729 HYDROXYPROGESTERONE 250 MG Pharmacy 1,500.00
250 J1740 Ibandronate 3mg/3ml Pharmacy 1,807.75
250 J1742 Ibutilide 1mg injection Pharmacy 49.84
250 J1745 Infliximab 100mg vial Pharmacy 5,224.50
250 J1750 Iron Dextran 100mg vial Pharmacy 109.25
250 J1756 Iron Sucrose 100mg vial Pharmacy 238.00
250 J1800 Propranolol 1mg vial Pharmacy 49.84
250 J1815 Humalog/Novolog Insulin Pharmacy 34.02
250 J1815 Humulin R Insulin Pharmacy 1.00
250 J1815 Humulin N Insulin Pharmacy 1.00
250 J1815 Humulin 70/30 Insulin Pharmacy 1.00
250 J1815 Lantus Insulin Pharmacy 33.08
250 J1815 Detemir Insulin MDV per unit Pharmacy 3.00
250 J1815 Insulin each 1 unit Pharmacy 1.00
250 J1885 Ketorolac 30mg vial Pharmacy 49.84
250 J1885 Ketorolac 60mg vial Pharmacy 49.84
636 J1930 Lanreotide 120 mg Injection Pharmacy 28,885.00
250 J1940 Furosemide 40mg vial Pharmacy 49.84
250 J1940 Furosemide 100mg vial Pharmacy 49.84
250 J1950 Leuprolide Acetate (Eligard) 45mg Pharmacy 9,945.00
250 J1950 Leuprolide Depot (Lupron) 45mg J-Code Pharmacy 34,880.00
250 J1950 Leuprolide Depot 3.75mg kit Pharmacy 5,040.00
250 J1953 Levetiracetam 500mg vial Pharmacy 169.50
250 J1956 Levofloxacin 500mg premix Pharmacy 61.75
250 J1956 Levofloxacin 750mg premix Pharmacy 61.75
250 J1956 Levofloxacin 250mg premix Pharmacy 58.15
250 J2000 Lidocaine Jelly 2% 5ml Pharmacy 52.05
636 J2001 Lidocaine 100mg IMS Prefilled Syr Pharmacy 49.84
250 J2001 Lidocaine 1% w/Epi MPF 30ml Pharmacy 52.05
250 J2001 Lidocaine 1% Pharmacy 52.05
250 J2001 Lidocaine 1% MPF Pharmacy 52.05
250 J2001 Lidocaine 2% Pharmacy 52.05
250 J2001 Lidocaine 2% w/Epi MPF Pharmacy 61.75
250 J2001 Lidocaine/Dextrose Spinal Pharmacy 61.75
250 J2001 Lidocaine 4mg/ml 250ml premix Pharmacy 49.84
250 J2001 Lidocaine 1.5% w/Epi amp Pharmacy 52.05
250 J2001 Lidocaine 2gm premix Pharmacy 49.84
636 J2001 LIDOCAINE HCL INJ NON-RETURNABLE 2% 50ML Pharmacy 98.86
250 J2020 Linezolid 600mg prefilled bag Pharmacy 329.50
250 J2060 Lorazepam 2mg/ml vial Pharmacy 57.59
250 J2150 Mannitol 25% 50ml vial Pharmacy 49.84
250 J2150 Mannitol 20Gm/100mg 500ml premix Pharmacy 92.00
250 J2175 Meperidine 50mg/ml CJ Pharmacy 57.59
250 J2175 Meperidine 100mg/ml CJ Pharmacy 57.59
250 J2175 Meperidine 50mg vial Pharmacy 57.59
250 J2175 Meperidine 100mg vial Pharmacy 57.59
250 J2210 Methylergonovine 0.2mg amp Pharmacy 49.84
250 J2212 Methylnaltrexone 12mg vial Pharmacy 747.75
636 J2250 Midazolam 2mg/2ml vial Pharmacy 57.59
250 J2250 Midazolam 5mg/ml 1ml vial Pharmacy 57.59
250 J2260 Milrinone 10mg injection Pharmacy 61.75
250 J2270 Morphine 4mg PFS Pharmacy 57.59
250 J2270 Morphine 10mg/ml 1ml vial Pharmacy 57.59
250 J2270 Morphine PCA 1mg/ml 30ml Pharmacy 71.17
250 J2270 Morphine 2mg/2ml (Astramorph) Pharmacy 71.17
250 J2270 Morphine 15mg/ml MDV 20ml Pharmacy 33.08
250 J2270 Morphine 2mg PFS Pharmacy 57.59
250 J2300 Nalbuphine 10mg injection Pharmacy 49.84
250 J2300 Nalbuphine 20mg amp Pharmacy 49.84
250 J2310 Naloxone 0.4mg/ml ampules Pharmacy 65.25
250 J2310 Naloxone 2mg PFS Pharmacy 136.00
250 J2315 Naltrexone (Vivitrol) 380mg Pharmacy 5,488.00
250 J2325 Natrecor 1.5mg injection Pharmacy 4,457.00
636 J2350 Ocrelizumab 300mg vial Pharmacy 64,740.00
250 J2353 Octreotide LAR 20mg Pharmacy 12,575.00
250 J2353 Octreotide LAR 30mg Pharmacy 18,605.00
250 J2354 Octreotide 1000mcg/5ml vial Pharmacy 280.00
636 J2358 olanzapine 10mg / 2m vial Pharmacy 142.50
250 J2370 Phenylephrine 10mg vial Pharmacy 61.75
636 J2405 Ondansetron 4mg vial Pharmacy 49.84
636 J2469 Palonosetron 0.25mg vial Pharmacy 2,037.00
250 J2505 Pegfilgrastim 6mg PFS Pharmacy 25,747.50
636 J2505 Neulasta OnPro Pharmacy 41,375.00
250 J2540 Penicillin G 20,000,000 units vial Pharmacy 208.50
250 J2540 Penicillin G 5,000,000 units Pharmacy 115.00
250 J2543 Piperacillin-Tazobactam 3.375 Gram vial Pharmacy 115.00
250 J2543 Piperacillin-Tazobactam 4.5gm vial Pharmacy 115.00
250 J2543 Piperacillin-Tazobactam 2.25gm vial Pharmacy 95.00
250 J2550 Promethazine 50mg injection Pharmacy 49.84
250 J2550 Promethazine 25mg vial Pharmacy 49.84
250 J2550 INJ; PROMETHAZINE UP TO 50MG (PHENERGAN) Pharmacy 98.86
250 J2590 Oxytocin 10 units vial Pharmacy 49.84
250 J2690 Procainamide 1Gm IV 10ml vial Pharmacy 325.00
636 J2704 Propofol 200mg/20ml vial Pharmacy 49.84
250 J2704 Propofol 500mg/50ml vial Pharmacy 61.75
250 J2710 Neostigmine 1:1000 Solution Pharmacy 259.50
250 J2720 Protamine 250mg vial Pharmacy 144.50
250 J2765 Metoclopramide 10mg injection Pharmacy 49.84
250 J2780 Ranitidine 50mg IV Pharmacy 115.00
250 J2780 Ranitidine 50mg Premix Pharmacy 49.84
250 J2795 Ropivacaine 10mg/ml 1% vial Pharmacy 97.57
250 J2795 Ropivacaine 2mg/ml 100ml Pharmacy 167.50
250 J2795 Ropivacaine 5mg/ml 0.5% 30ml vial Pharmacy 49.84
250 J2795 Ropivacaine 2mg/ml 200ml Pharmacy 334.75
250 J2916 Ferric Gluconate Complex 62.5mg IV Pharmacy 123.75
636 J2920 Methylprednisolone 40mg vial Pharmacy 95.00
636 J2930 Methylprednisolone 125mg vial Pharmacy 115.00
636 J2930 Methylprednisolone 500mg vial Pharmacy 155.00
250 J2930 Methylprednisolone 1Gm vial Pharmacy 268.00
636 J2997 Alteplase (Activase) 100mg IV Pharmacy 35,065.00
636 J2997 Cathflo-Alteplase 2mg vial Pharmacy 655.00
636 J3010 Fentanyl 100mcg injection Pharmacy 57.59
636 J3010 Fentanyl 250mcg injection Pharmacy 57.59
250 J3030 Sumatriptan 6mg SQ Vial Pharmacy 583.25
636 J3101 TNKase 50mg Pharmacy 23,355.00
250 J3105 Terbutaline 1mg vial Pharmacy 49.84
250 J3230 Chlorpromazine 25mg/ml injection Pharmacy 103.25
250 J3230 Chlorpromazine 50mg vial Pharmacy 118.25
250 J3260 Tobramycin 80mg vial Pharmacy 95.00
250 J3262 Tocilizumab 200mg Pharmacy 4,389.00
250 J3301 Triamcinolone 40mg injection Pharmacy 61.75
636 J3301 TRIAMCINOLONE 40MG INJECTION Pharmacy 98.86
636 J3357 Stelara 45mg/0.5ml SUB-Q Pharmacy 41,005.00
636 J3358 Stelara 130 mg Pharmacy 6,590.00
636 J3360 Diazepam 10mg injection Pharmacy 112.75
250 J3360 Diazepam 5mg inj Pharmacy 55.00
636 J3360 Diazepam 5 mg / ml MDV Pharmacy 57.59
250 J3370 Vancomycin 500mg vial Pharmacy 95.00
250 J3370 Vancomycin 1Gm vial Pharmacy 115.00
636 J3380 Vedolizumab 300mg vial Pharmacy 23,360.00
250 J3410 Hydroxyzine 100mg vial Pharmacy 145.50
250 J3410 Hydroxyzine 25mg vial Pharmacy 83.25
250 J3411 Thiamine 200mg vial Pharmacy 61.75
250 J3420 Vitamin B-12 1000mcg IM Pharmacy 49.84
636 J3420 VITAMIN B12 INJ 1000MCG/ML 25 X 1ML Pharmacy 49.84
250 J3430 Phytonadione Neonatal 1mg PFS Pharmacy 49.84
250 J3430 Phytonadione Adult 10mg ampule Pharmacy 198.75
636 J3430 PHYTONADIONE ADULT 10MG AMPULE Pharmacy 198.75
250 J3470 Amphadase 150 USP/ml Pharmacy 82.50
250 J3471 Hyaluronidase 200 units Pharmacy 294.25
250 J3475 Magnesium Sulfate 50% 5gm vial Pharmacy 95.00
250 J3475 Magnesium Sulfate 1gm/2ml vial Pharmacy 95.00
250 J3480 Potassium Chloride 40mEq vial Pharmacy 95.00
250 J3480 Potassium Chloride 10mEq/100ml Pharmacy 58.15
250 J3480 Potassium Chloride 20mEq vial Pharmacy 95.00
250 J3486 Ziprasidone 20mg injection Pharmacy 204.50
250 J3489 Zoledronic Acid 4mg injection Pharmacy 1,455.50
250 J3489 Zoledronic Acid 5mg/100ml IV Pharmacy 1,440.75
250 J3490 Amoxicillin 250mg capsules Pharmacy 15.21
636 J3490 Sod Bicarb 4.2% 5mEq Infant Abboject Pharmacy 61.75
636 J3490 Sod Bicarb 8.4% 10mEq Ped. Abboject Pharmacy 61.75
636 J3490 Sod Bicarb 8.4% 50mEq Abboject Pharmacy 49.84
250 J3490 Cephalexin 250mg capsules Pharmacy 15.21
250 J3490 Tetanus Toxoid 0.5ml Pharmacy 165.75
250 J3490 Lidocaine Viscous Pharmacy 1.00
250 J3490 Ketamine 500mg vial Pharmacy 57.59
250 J3490 Methohexital 500mg vial Pharmacy 272.75
250 J3490 Remifentanyl (Ultiva) 1mg vial Pharmacy 267.00
250 J3490 Sufentanil 50mcg ampule Pharmacy 57.59
250 J3490 Actidose (Charcoal) w/ Sorbitol Pharmacy 78.00
250 J3490 Ephedrine 50mg amps Pharmacy 181.25
250 J3490 Doxapram 400mg/20ml vial Pharmacy 173.00
250 J3490 Doxycycline 100mg vial Pharmacy 155.00
250 J3490 Enalaprilat 1.25mg IV Pharmacy 49.84
250 J3490 Etomidate 20mg vial Pharmacy 49.84
250 J3490 Flumazenil 0.5mg/5ml vial Pharmacy 49.84
250 J3490 Folic Acid 5mg IV Pharmacy 95.00
250 J3490 Glycopyrolate 0.2mg injection Pharmacy 61.75
250 J3490 Labetalol 100mg inj. Pharmacy 49.84
250 J3490 Metoprolol 5mg injection Pharmacy 49.84
250 J3490 Nitroprusside 50mg vial Pharmacy 3,947.00
250 J3490 Nitroglycerin 50mg vial Pharmacy 115.00
250 J3490 Physostigmine 2mg ampule Pharmacy 152.75
250 J3490 Vasopressin 20 units vial Pharmacy 698.00
250 J3490 Verapamil 10mg vial Pharmacy 120.00
250 J3490 Nitroglycerin 50mg/250ml premix Pharmacy 43.00
250 J3490 Procalamine for Peripheral TPN Pharmacy 213.77
250 J3490 Isoproterenol 0.2mg/ml 5ml Pharmacy 199.75
250 J3490 Multivitamin Injection Pharmacy 115.00
250 J3490 Diltiazem 25mg/5ml vial Pharmacy 49.84
250 J3490 Diltiazem 50mg/10ml vial Pharmacy 49.84
250 J3490 Tetanus-Diphtheria injection Pharmacy 97.57
250 J3490 PPD (Tubersol) 5 units Pharmacy 49.84
250 J3490 Acidophilus cap Pharmacy 1.05
250 J3490 Sod Bicarb 8.4% 50ml vial Pharmacy 61.75
250 J3490 TPN Clinimix-1000ml Pharmacy 213.77
250 J3490 Acycloivr Ointment 5% Pharmacy 665.00
250 J3490 Labetalol 200mg vial Pharmacy 49.84
250 J3490 Acetaminophen/Caffeine 500/65mg tab Pharmacy 1.05
250 J3490 Sevoflurane per hour Pharmacy 237.00
250 J3490 Rocuronium 50mg vial Pharmacy 49.84
250 J3490 Iron Dextran 50mg vial Pharmacy 77.25
250 J3490 TPN-Clinimix w/ Electrolytes 5/20% Pharmacy 213.77
250 J3490 Labetalol 20mg PFS Pharmacy 49.84
250 J3490 Fat Emulsion (Intralipid) 20% 250ml Pharmacy 213.77
636 J3490 Nafcillin 10 gm Pharmacy 582.75
636 J3490 Sodium Phosphate 45 mM / 15 ml Pharmacy 61.75
250 J3490 Anoro inhaler 62.5-25 mcg Pharmacy 1.00
636 J3490 KCENTRA 1000 unit IV Pharmacy 9,310.00
250 J3490 Etomidate 40mg vial Pharmacy 61.75
250 J3490 MRC/JUVEDERM Pharmacy 98.86
636 J3490 RABIES VACCINE Pharmacy 260.75
636 J7042 Dextrose Pediatric 25% IMS Prefilled Syr Pharmacy 44.00
258 J7042 Dextrose 50% 25Gm PFS Pharmacy 61.75
258 J7042 D5 .22 NS 1000ml bag Pharmacy 45.00
250 J7060 Dextrose 50% 50ml vial Pharmacy 49.84
250 J7296 KYLENA 19.5mg IUD Pharmacy 1,090.76
250 J7298 MIRENA IUD INTRUTERINE CONTRACEPTIVE 5YR Pharmacy 1,090.76
250 J7307 NEXPLANON Pharmacy 1,017.48
636 J7324 MRC/ORTHOVISC 2 ML Pharmacy 599.00
250 J7325 Hylan-20 (Synvisc) vial Pharmacy 1,741.00
250 J7325 MRC/SYNVISC 2 ML INJECTABLE Pharmacy 641.69
250 J7500 Azathioprine 50mg tab Pharmacy 15.21
250 J7506 Prednisone 1mg tabs Pharmacy 15.21
250 J7506 Prednisone 5mg tabs Pharmacy 15.21
250 J7509 Methylprednisolone 4mg tabs Pharmacy 15.21
250 J7509 Methylprednisolone Dosepak 4mg Pharmacy 104.00
250 J7510 Prednisolone 6.7mg/5ml Liquid Pharmacy 3.00
250 J7510 Prednisolone 15mg/5ml Liquid Pharmacy 15.21
250 J7512 Prednisone 2.5mg tabs Pharmacy 15.21
250 J7512 Prednisone 10mg tabs Pharmacy 15.21
636 J7512 Prednisone 20mg tabs Pharmacy 15.21
250 J7512 Prednisone tabs in ER All Strengths Pharmacy 14.00
250 J7604 Acetylcystein 20% 30ml vial Oral Pharmacy 87.50
250 J7605 Arformoterol 15mcg/2ml neb Pharmacy 32.50
250 J7607 Levalbuterol 0.63mg ud Pharmacy 23.50
250 J7607 Levalbuterol 1.25mg ud Pharmacy 0.01
250 J7607 Levalbuterol HFA MDI Pharmacy 301.00
250 J7609 Albuterol HFA 8gm Pharmacy 108.77
250 J7613 Albuterol 0.083% 3ml ud Pharmacy     –
250 J7613 ALBUTEROL, INHALATION SOL, 1 MG (NEB) Pharmacy 10.00
250 J7614 Levalbuterol 0.31mg ud Pharmacy 23.50
250 J7618 Albuterol Solution 20ml Pharmacy 50.00
250 J7620 Ipratropium/Albuterol Inhaler Pharmacy 1,445.00
250 J7620 Albuterol/Ipratropium neb Pharmacy     –
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250 J7626 Budesonide 0.5/2ml Inh. Sol Pharmacy 19.50
250 J7641 Flunisolide Nasal Spray Pharmacy 267.00
250 J7644 Ipratropium Nasal Spray Pharmacy 172.00
250 J7644 MRC/PRATROPLUM BROMIDE, SOL, 1MG (NEB) Pharmacy 45.00
250 J8499 Ibuprofen 400mg tablets Pharmacy 15.21
250 J8499 Ibuprofen 800mg tablets Pharmacy 15.21
250 J8499 Ranitidine 150mg tabs Pharmacy 15.21
636 J8499 CLONIDINE HC1 TABLETS 100/BOTTLE 0.1MG Pharmacy 98.86
250 J8499 Ibuprofen 800 mg (clinic) Pharmacy 98.86
250 J8501 Aprepitant 125mg cap Pharmacy 1,354.75
250 J8540 Dexamethasone 4mg tablets Pharmacy 15.21
250 J8540 Dexamethasone 0.5mg/5ml Oral Liquid Pharmacy 0.25
250 J8540 Dexamethasone 1mg/ml Oral Sol Pharmacy 15.21
636 J8597 ONDANSETRON OD TABS UD 4MG Pharmacy 98.86
250 J8610 Methotrexate 2.5mg tabs Pharmacy 16.75
636 J9000 Doxorubicin 50mg vial Pharmacy 99.75
636 J9034 Bendeka 100mg vial Pharmacy 9,975.00
636 J9035 Bevacizumab (Avastin) 100mg/4ml Pharmacy 3,305.00
636 J9035 Bevacizumab (Avastin) 400mg/16ml Pharmacy 12,540.00
636 J9041 Bortezomid 3.5mg vial Pharmacy 6,600.00
250 J9042 Brentuximab 50mg vial Pharmacy 28,280.00
250 J9045 Carboplatin 450mg vial Pharmacy 900.00
250 J9055 Cetuximab 200mg vial Pharmacy 4,995.00
636 J9070 Cyclophosphamide 2gm vial Pharmacy 6,030.00
636 J9145 DARATUMUMAB 400MG/20ML Pharmacy 8,225.00
636 J9155 Degarelix 80mg vial Pharmacy 2,010.50
250 J9171 Docetaxel 160mg vial Pharmacy 2,340.00
250 J9181 Etoposide 100mg vial Pharmacy 61.75
636 J9190 5-FU 500mg vial Pharmacy 49.84
250 J9201 Gemcitabine 1gm vial Pharmacy 2,202.25
636 J9206 Irinotecan 100mg vial Pharmacy 153.75
250 J9217 Lupron 22.5mg Depot inj Pharmacy 17,440.00
250 J9260 Methotrexate (MTX) 50mg injection Pharmacy 95.00
250 J9260 Methotrexate 250mg vial Pharmacy 165.00
250 J9263 Oxaliplatin 100mg vial Pharmacy 823.25
250 J9264 Nab-Paclitaxel 100mg vial Pharmacy 50.00
636 J9265 *Paclitaxel 30mg J-code Pharmacy 80.00
250 J9267 Paclitaxel 100mg vial Pharmacy 178.25
636 J9271 Keytruda 100mg Pharmacy 18,525.00
250 J9299 Nivolumab 100mg vial Pharmacy 10,420.00
250 J9299 Nivolumab 40mg vial Pharmacy 4,255.00
250 J9303 Panitumumab 400mg vial Pharmacy 18,925.00
250 J9303 Panitumumab 100mg vial Pharmacy 4,988.00
250 J9305 Pemetrexed 100mg vial Pharmacy 2,835.00
250 J9305 Pemetrexed 500mg vial Pharmacy 13,440.00
250 J9306 Pertuzumab 420mg vial Pharmacy 19,390.00
636 J9310 Rituximab 100mg vial Pharmacy 3,720.00
636 J9310 Rituximab 500mg vial Pharmacy 18,000.00
250 J9330 Temsirolimus 25mg vial Pharmacy 7,135.00
250 J9354 Ado-Trastuzumab (Kadcyla) 160mg vial Pharmacy 18,765.00
250 J9355 Trastuzumab 440mg vial Pharmacy 17,685.00
636 J9370 Vincristine 2mg vial Pharmacy 61.75
250 J9390 Vinorelbine 10mg vial Pharmacy 333.75
250 J9390 Vinorelbine 50mg vial Pharmacy 370.50
250 J9395 Fulvestrant 250mg dose Pharmacy 3,935.00
636 Q0138 Feraheme 510mg Pharmacy 3,758.00
250 Q0144 Azithromycin 200mg/5ml Susp. Pharmacy 135.00
250 Q0161 Chlorpromazine 25mg tab Pharmacy 30.25
250 Q0163 Diphenhydramine 25mg capsules Pharmacy 1.05
250 Q0163 Diphenhydramine 12.5mg/5ml Oral Liquid Pharmacy 0.25
250 Q0163 Diphenhydramine 12.5mg/5ml oral liq Pharmacy 0.25
250 Q0164 Prochlorperazine 5mg tabs Pharmacy 15.21
250 Q0169 Promethazine 25mg tabs Pharmacy 15.21
250 Q0177 Hydroxyzine 25mg tablets Pharmacy 15.21
250 Q0180 Dolasetron 100mg tab Pharmacy 382.25
250 Q2009 Fosphenytoin 500mg vial Pharmacy 463.50
250 Q2009 Fosphenytoin 100mg vial Pharmacy 95.00
631 Q2038 MEDICAR/FLUVIRUS VACCINE 3YRS & OLDER Pharmacy 25.00
250 Q9968 Methylene Blue ampules Pharmacy 562.25
250 S0020 Bupivacaine 0.25% 10ml Pharmacy 52.05
250 S0020 Bupivacaine 0.25% mpf 30ml Pharmacy 49.84
250 S0020 Bupivacaine 0.5% mpf 30ml Pharmacy 49.84
250 S0020 Bupivacaine 0.5% w/Epi mpf 30ml Pharmacy 49.84
250 S0020 Bupivacaine Spinal mpf Pharmacy 52.05
250 S0020 Bupivacaine 0.5% mdv Pharmacy 52.05
250 S0020 Bupivacaine w/Epi Inj Pharmacy 61.75
636 S0020 BUPIVACAINE 0.5% MPF 30ML Pharmacy 49.84
250 S0020 BUPIVACAINE 0.25% MPF 30ML Pharmacy 49.84
250 S0028 Famotidine 20mg vial Pharmacy 95.00
250 S0030 Metronidazole 500mg IV Pharmacy 58.15
250 S0032 Nafcillin 1Gm vial Pharmacy 115.00
250 S0032 Nafcillin 2gm vial Pharmacy 155.00
250 S0039 Sulfamethoxazole-Trimethoprim IV Pharmacy 115.00
250 S0040 Timentin 3.1Gm IV Pharmacy 61.75
250 S0073 Aztreonam 1gm vial Pharmacy 119.50
250 S0077 Clindamycin 900mg vial Pharmacy 95.00
250 S0077 Clindamycin 600mg vial Pharmacy 95.00
250 S0077 Clindamycin 300mg vial Pharmacy 95.00
250 S0091 Granisetron 1mg vial Pharmacy 115.00
250 S0106 Bupropion SR 150mg tablets Pharmacy 15.21
250 S0109 Methadone 5mg tabs Pharmacy 19.57
250 S0109 Methadone 10mg tabs Pharmacy 19.57
250 S0119 Ondansetron 4mg tab Pharmacy 87.00
250 S0164 Pantoprazole 40mg IV Pharmacy 95.00
250 S0171 Bumetanide 1mg vial Pharmacy 49.84
250 S0179 Megestrol 40mg/ml Pharmacy 1.50
250 S0179 Megestrol 625mg/5ml Pharmacy 31.50
250 S0191 Misoprostol 100mcg tabs Pharmacy 15.21
250 S0195 Pneumococcal-23 Vaccine Pharmacy 389.25
250 S0197 Prenatal Rx tab Pharmacy 1.05
250 Fluticasone/Salmeterol 100/50 #14 Pharmacy 650.00
250 Fluticasone/Salmeterol 250/50 #14 Pharmacy 650.00
250 Fluticasone/Salmeterol 500/50 #14 Pharmacy 970.00
250 Conjugated Estrogen Vaginal Cream Pharmacy 621.00
636 Fluororuracil 500mg vial Pharmacy 49.84
250 Hydrocod/Ibuprofen 7.5/200mg tab Pharmacy 19.57
250 Apap Suppository in ER All Strengths Pharmacy 3.00
250 Benztropine 1mg tab Pharmacy 15.21
250 Donepezil 10mg tab Pharmacy 71.75
250 Carbachol (Miostat) Intraocular inj. Pharmacy 62.00
250 Oxybutynin XL 5mg tab Pharmacy 16.00
250 Propranolol LA 60mg cap Pharmacy 15.21
250 Peg 3350 (MIRALAX) LAXATIVE Pharmacy 15.21
250 Cataract Pharmacy Kit Pharmacy 398.00
636 Fluphenazine Decanoate 125mg Pharmacy 161.00
250 Lidocaine-Urojet Pharmacy 33.08
250 Verapamil 5mg vial Pharmacy 119.25
250 Tobramycin Ophthalmic Drops Pharmacy 58.00
250 Apap 325mg caplets Pharmacy 1.05
250 Apap ES 500mg caplets Pharmacy 1.05
250 Acyclovir 200mg cap Pharmacy 15.21
250 Albuterol 2mg tablets Pharmacy 24.50
250 Alendronate 70mg tablets Pharmacy 72.50
250 Allopurinol 100mg tablets Pharmacy 15.21
250 Amiodarone 200mg tablets Pharmacy 16.00
250 Amitriptyline 25mg tablets Pharmacy 15.21
250 Amlodipine 2.5mg tablets Pharmacy 15.21
250 Amlodipine 5mg tablets Pharmacy 15.21
250 Amoxicillin 125mg/5ml Susp. Pharmacy 52.05
250 Amoxicillin 200mg/5ml Susp. Pharmacy 52.05
250 Amoxicillin 250mg/5ml Susp. Pharmacy 52.05
250 Amox/Pot.Clav 125mg/5ml Susp. Pharmacy 126.00
250 Amox/Pot.Clav 200mg/5ml Susp. Pharmacy 94.50
250 Amox/Pot.Clav. 400mg/5ml Susp. Pharmacy 52.05
250 Amox/Pot.Clav. 875mg tablets Pharmacy 21.75
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250 Aspirin Chewable 81mg tablets Pharmacy 1.05
250 Aspirin EC 325mg tablets Pharmacy 1.05
250 Aspirin EC 81mg tablets Pharmacy 1.05
250 Muro 128 5% Ophthalmic Ointment Pharmacy 76.00
250 Ciprofloxacin Ophthalmic Solution Pharmacy 123.50
250 Olopatadine (Patanol) Ophthalmic Sol Pharmacy 1,070.00
250 Phenylephrine 2.5% Ophthalmic Solution Pharmacy 52.05
250 Phenylephrine 10% Ophthalmic Solution Pharmacy 71.50
250 Aspirin 325mg tablets Pharmacy 1.05
250 Lidocaine 5% Patch Pharmacy 43.00
250 Miochol-E Intraocular Solution Pharmacy 413.00
250 Sulfacetamide 10% Ophthalmic Solution Pharmacy 230.00
250 Tetracaine 0.5% Ophthalmic Solution Pharmacy 52.05
250 Timolol 0.5% Ophthalmic Solution Pharmacy 52.05
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250 Refresh Plus Lubricant Eye Drops Pharmacy 3.00
250 Calcium Chloride 10% IMS Prefilled Syr Pharmacy 61.75
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250 Atenolol 25mg tabs Pharmacy 15.21
250 Atorvastatin 10mg tablets Pharmacy 18.50
250 Azithromycin 250mg tablets Pharmacy 30.75
250 Baclofen 10mg tablets Pharmacy 15.21
250 Benazepril 5mg tablets Pharmacy 14.63
250 Benzonatate 100mg capsules Pharmacy 15.21
250 Bisacodyl 5mg tablets Pharmacy 1.05
250 Bisoprolol 5mg tablets Pharmacy 14.63
250 Bumetanide 2mg tablets Pharmacy 15.21
250 Bupropion XL 150mg tablets Pharmacy 22.25
250 Buspirone 10mg tablets Pharmacy 15.21
250 Candesartan 4mg tablets Pharmacy 19.25
250 Candesartan 8mg tablets Pharmacy 19.25
250 Candesartan 16mg tablets Pharmacy 18.00
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250 Captopril 25mg tablets Pharmacy 15.21
250 Carbamazepine 200mg tablets Pharmacy 15.21
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250 Carbidopa/Levodopa 25/100mg tablets Pharmacy 15.21
250 Carbidopa/Levodopa 25/250mg tablets Pharmacy 15.21
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250 Carvedilol 6.25mg tablets Pharmacy 15.21
250 Carvedilol 12.5mg tablets Pharmacy 15.21
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250 Cefuroxime 250mg/5ml Susp. Pharmacy 970.00
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250 Celecoxib 200mg capsules Pharmacy 52.75
250 Cephalexin 125mg/5ml Susp. Pharmacy 81.50
250 Cephalexin 250mg/5ml Susp. Pharmacy 114.00
250 Salt Tablets Pharmacy 1.05
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250 Ciprofloxacin 500mg tablets Pharmacy 23.25
250 Citalopram 20mg tablets Pharmacy 15.21
250 Clindamycin 150mg capsules Pharmacy 15.21
250 Clopidogrel 75mg tablets Pharmacy 28.00
250 Clotrimazole 10mg Troche Pharmacy 15.75
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250 Conj. Estrogen 0.625mg tablets Pharmacy 15.21
250 Cyclobenzaprine 5mg tablets Pharmacy 15.21
250 Cyclobenzaprine 10mg tablets Pharmacy 15.21
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250 Divalproex 250mg tablets Pharmacy 15.21
250 Divalproex 500mg tablets Pharmacy 29.00
250 Clarinex 5mg tablets Pharmacy 34.00
250 Dicloxacillin 250mg capsules Pharmacy 15.21
250 Dicyclomine 10mg capsules Pharmacy 15.21
250 Digoxin 0.125mg tablets Pharmacy 15.21
250 Diltiazem 30mg tablets Pharmacy 15.21
250 Diltiazem CD 120mg capsules Pharmacy 15.21
250 Diltiazem CD 180mg capsules Pharmacy 15.21
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250 Doxazosin 2mg tablets Pharmacy 15.21
250 Doxycycline 50mg capsules Pharmacy 15.21
250 Doxycycline 100mg tab Pharmacy 19.00
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250 Enalapril 5mg tablets Pharmacy 15.21
250 Enalapril 10mg tablets Pharmacy 15.21
250 Erythromycin 250mg tablets Pharmacy 15.21
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250 Etodolac 400mg capsules Pharmacy 15.21
250 Ezetimibe/Simvastatin 10/40 tablets Pharmacy 50.00
250 Ferrous Sulfate 325mg tablets Pharmacy 1.05
250 Ferrous Gluconate 324 tablets Pharmacy 1.05
250 Fexofenadine 180mg tablets Pharmacy 15.21
250 Finasteride 5mg tablets Pharmacy 15.50
250 Flecainide 50mg tablets Pharmacy 15.21
250 Fluconazole 100mg tablets Pharmacy 34.00
250 Fluoxetine 10mg tablets Pharmacy 15.21
250 Fluoxetine 20mg capsules Pharmacy 15.21
250 Folic Acid 1mg tablets Pharmacy 15.21
250 Furosemide 20mg tablets Pharmacy 15.21
250 Furosemide 40mg tablets Pharmacy 15.21
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250 Gabapentin 300mg caps Pharmacy 15.21
250 Gabapentin 800mg tablets Pharmacy 15.21
250 Glimepiride 2mg tablets Pharmacy 15.21
250 Glipizide 5mg tablets Pharmacy 15.21
250 Glipizide 10mg tablets Pharmacy 15.21
250 Glipizide XL 5mg tablets Pharmacy 15.21
250 Glipizide XL 10mg tablets Pharmacy 15.21
250 Clarithromycin 250mg tablets Pharmacy 16.07
250 Gemfibrozil 600mg tablets Pharmacy 15.21
250 Rosuvastatin 20mg tablets Pharmacy 27.50
250 Glyburide 5mg tablets Pharmacy 14.63
250 Glutose 15Gm Oral Gel Pharmacy 52.05
250 Guaifenesin 600mg/PSE 60mg   tablets Pharmacy 15.21
250 Guaifenesin 600mg/PSE 120mg tablets Pharmacy 15.21
250 Guaifenesin 600mg tablets Pharmacy 15.21
250 Haloperidol 1mg tablets Pharmacy 15.21
250 Haloperidol 5mg tablets Pharmacy 15.21
250 Hydralazine 25mg tablets Pharmacy 15.21
250 Hydralazine 50mg tablets Pharmacy 15.21
250 Hydrochlorothiazide 25mg tablets Pharmacy 15.21
250 Hydroxychloroquine 200mg tablets Pharmacy 15.21
250 Ibuprofen 600mg tablets Pharmacy 15.21
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250 Imipramine 25mg tablets Pharmacy 15.21
250 Indomethacin 25mg capsules Pharmacy 15.21
250 Irbesartan 150mg tablets Pharmacy 16.25
250 Isosorbide Dinitrate 20mg tablets Pharmacy 15.21
250 Isosorbide Mononitrate 20mg tab Pharmacy 15.21
250 Isosorbide Mononitrate 30mg tab Pharmacy 16.25
250 Ketorolac 10mg tablets Pharmacy 15.21
250 Lamotrigine 200mg tablets Pharmacy 23.75
250 Lamivudine/Zidovudine (Combivir) tablets Pharmacy 59.50
250 Levofloxacin 500mg tablets Pharmacy 68.50
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250 Levothyroxine 75mcg tablets Pharmacy 15.21
250 Levothyroxine 100mcg tablets Pharmacy 15.21
250 Levothyroxine 150mcg tablets Pharmacy 15.21
250 Levothyroxine 175mcg tablets Pharmacy 15.21
250 Levetiracetam 500mg tablets Pharmacy 16.75
250 Lisinopril 2.5mg tablets Pharmacy 15.21
250 Lisinopril 10mg tablets Pharmacy 15.21
250 Loperamide 2mg capsules Pharmacy 15.21
250 Loratadine 10mg tablets Pharmacy 1.05
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250 Losartan 100mg tablets Pharmacy 15.25
250 Meclizine 25mg tablets Pharmacy 15.21
250 Meloxicam 7.5mg tablets Pharmacy 15.50
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250 Mineral Oil Sterile Pharmacy 52.05
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250 Metformin 850mg tabs Pharmacy 15.21
250 Metformin 1000mg tabs Pharmacy 15.21
250 Methocarbamol 500mg tabs Pharmacy 15.21
250 Metoclopramide 10mg tabs Pharmacy 15.21
250 Metolazone 2.5mg tabs Pharmacy 15.21
250 Metolazone 10mg tabs Pharmacy 15.21
250 Metoprolol 25mg tabs Pharmacy 15.21
250 Metoprolol XL 25mg tabs Pharmacy 15.21
250 Metoprolol XL 50mg tabs Pharmacy 15.21
250 Metoprolol 50mg tabs Pharmacy 15.21
250 Metoprolol 100mg tabs Pharmacy 15.21
250 Metronidazole 250mg tabs Pharmacy 15.21
250 Minoxidil 2.5mg tabs Pharmacy 15.21
250 Mirtazapine 15mg tabs Pharmacy 15.21
250 Moexipril 7.5mg tabs Pharmacy 15.21
250 Naproxen 250mg tabs Pharmacy 15.21
250 Nifedipine 10mg caps Pharmacy 15.21
250 Nifedipine ER 30mg tabs Pharmacy 15.21
250 Nitrofurantoin 50mg caps Pharmacy 15.21
250 Nitrofurantoin 100mg (BID) caps Pharmacy 16.75
250 Nitroglycerin 0.4mg tabs Pharmacy 143.50
250 Nortriptyline 25mg caps Pharmacy 15.21
250 Olanzapine 2.5mg tabs Pharmacy 42.00
250 Olanzapine 5mg tabs Pharmacy 48.50
250 Omeprazole 20mg caps Pharmacy 19.25
250 Oxybutynin 5mg tabs Pharmacy 15.21
250 Pantoprazole 40mg tabs Pharmacy 15.21
250 Paroxetine 20mg tabs Pharmacy 15.21
250 Penicillin VK 250mg tabs Pharmacy 15.21
250 Penicillin VK 250mg/5ml Susp Pharmacy 21.25
250 Olanzapine Zydis 10mg SL tabs Pharmacy 89.00
250 Phenazopyridine 100mg tab Pharmacy 15.21
250 Phenytoin Extended 100mg caps Pharmacy 15.21
250 Pioglitazone 15mg tabs Pharmacy 28.25
250 Potassium Chloride 8meq tabs Pharmacy 15.21
250 Potassium Chloride 10meq tabs Pharmacy 15.21
250 Potassium Chloride 20meq tabs Pharmacy 15.21
250 Potassium Chloride 10meq caps Pharmacy 9.00
250 K-Phos Original Pharmacy 15.21
250 Pravastatin 10mg tabs Pharmacy 15.75
250 Neutra-Phos Powder Packets Pharmacy 15.21
250 Prazosin 1mg caps Pharmacy 15.21
250 Propafenone 225mg tabs Pharmacy 15.21
250 Propranolol 10mg tabs Pharmacy 15.21
250 Pseudoephedrine 30mg tabs Pharmacy 1.05
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250 Quetiapine 25mg tabs Pharmacy 18.25
250 Quetiapine 100mg tabs Pharmacy 27.75
250 Ramipril 2.5mg caps Pharmacy 15.21
250 Rifampin 150mg caps Pharmacy 15.75
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250 Risperidone 0.5mg tabs Pharmacy 41.75
250 Risperidone 1mg tabs Pharmacy 20.00
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250 Rosiglitazone 4mg tabs Pharmacy 15.21
250 Selegiline 5mg tabs Pharmacy 15.21
250 Sertraline 25mg tabs Pharmacy 15.21
250 Sertraline 50mg tabs Pharmacy 15.21
250 Sertraline 100mg tabs Pharmacy 15.21
250 Simethicone 80mg tabs Pharmacy 1.05
250 Senna/Docusate tabs Pharmacy 1.00
250 Simvastatin 5mg tabs Pharmacy 15.21
250 Simvastatin 10mg tabs Pharmacy 15.21
250 Simvastatin 20mg tabs Pharmacy 21.25
250 Simvastatin 40mg tabs Pharmacy 21.25
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250 Spironolactone 50mg tabs Pharmacy 15.21
250 Sotalol 80mg tabs Pharmacy 15.21
250 Sulfasalazine 500mg tabs Pharmacy 15.21
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250 Thyroid 60mg tabs Pharmacy 15.21
250 Tizanidine 4mg tabs Pharmacy 15.21
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250 Tramadol 50mg tabs Pharmacy 15.21
250 Trazodone 50mg tabs Pharmacy 15.21
250 Trazodone 150mg tabs Pharmacy 15.21
250 Trihexyphenidyl 2mg tabs Pharmacy 15.21
250 Triamterene/HCTZ 75/50mg tabs Pharmacy 15.21
250 Trimethoprim 100mg tabs Pharmacy 15.21
250 Trimethobenzamide 300mg caps Pharmacy 15.21
250 Valsartan 40mg tabs Pharmacy 29.50
250 Valsartan 160mg tabs Pharmacy 22.25
250 Valacyclovir 500mg tabs Pharmacy 28.50
250 Venlafaxine XR 37.5mg caps Pharmacy 18.75
250 Venlafaxine XR 75mg caps Pharmacy 20.50
250 Verapamil SR 240mg tabs Pharmacy 15.21
250 Warfarin 2.5mg tabs Pharmacy 15.21
250 Warfarin 2mg tabs Pharmacy 15.21
250 Warfarin 3mg tabs Pharmacy 15.21
250 Warfarin 5mg tabs Pharmacy 15.21
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250 Apap 120mg Suppository Pharmacy 1.05
250 Apap 650mg Suppository Pharmacy 1.05
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250 Proctofoam-HC Pharmacy 425.00
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250 Proctosol-HC 2.5% Pharmacy 316.00
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250 Preparation H Suppository Pharmacy 15.21
250 Prochlorperazine 25mg Suppository Pharmacy 46.50
250 Clotrimazole Cream Pharmacy 52.05
250 Cetacaine Spray Pharmacy 52.05
250 Clotrimazole/Betamethasone Cream Pharmacy 322.00
250 Betamethasone Augmented Ointment Pharmacy 664.00
250 Lidocaine/Prilocaine Cream 5gm Pharmacy 52.05
250 HYDROCERIN CREAM Pharmacy 52.05
250 Mupirocin 2% Ointment Pharmacy 162.00
250 Nitroglycerin Ointment Pharmacy 33.59
250 Nicotine 21mg Patch Pharmacy 33.59
250 Nicotine 14mg Patch Pharmacy 33.59
250 Nicotine 7mg Patch Pharmacy 31.00
250 Nitroglycerin 0.1mg Patch Pharmacy 33.59
250 Nystatin Cream Pharmacy 108.77
250 Nystatin (Nystop) Powder Pharmacy 205.00
250 Scopolamine Topical Patch Pharmacy 66.50
250 Silver Nitrate Sticks Pharmacy 15.21
250 SSD 1% Cream 25gm Pharmacy 52.05
250 SSD 1% Cream 85gm Pharmacy 69.00
250 Neomy/Polym/HC Otic Susp. Pharmacy 342.00
250 Fluticasone Nasal Spray Pharmacy 314.00
250 Mometasone-Nasonex Nasal Spray Pharmacy 985.00
250 Ofloxacin Otic Solution ud Pharmacy 16.00
250 Oxymetolazone Nasal Spray Pharmacy 52.05
250 Sodium Chloride Nasal Spray Pharmacy 27.00
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250 Bacitracin Ointment Pharmacy 52.05
250 Erythromycin Ophthalmic Ointment Pharmacy 52.05
250 Eye Wash Solution Pharmacy 52.05
250 Gentamicin Ophthalmic Sol. Pharmacy 80.50
250 Nepafenac (Nevanac) Ophth. Susp. Pharmacy 1,005.00
250 Prednisolone 1% Ophth. Susp. Pharmacy 210.00
250 Timolol 0.5% (Betimol) Ophth. Sol. Pharmacy 126.00
250 Vision Blue Ophth. Sol. Pharmacy 75.00
250 Refresh Plus Ophth. Sol. Pharmacy 3.00
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250 Multivitamin tabs Pharmacy 1.05
250 Calcium w/ Vitamin D tab Pharmacy 1.05
250 Senna 8.6mg tabs Pharmacy 3.00
250 Docusate 100mg caps Pharmacy 1.05
250 Magnesium Oxide 400mg tabs Pharmacy 1.05
250 Vitamin E 400 iu caps Pharmacy 1.05
250 Niacin 500mg caps Pharmacy 2.00
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250 Vitamin B Complex caps Pharmacy 1.05
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250 Magnesium 250mg tabs Pharmacy 15.21
250 Ocuvite tabs Pharmacy 1.05
250 Apap Extra Stength 500mg/15ml Liquid Pharmacy 0.25
250 Belladonna w/PB Elixir Pharmacy 20.25
250 Cetirizine 1mg/ml Liquid Pharmacy 1.05
250 Docusate 50mg/5ml Oral Solution Pharmacy 0.25
250 Glycolax (Miralax) Granules 17gm Pharmacy 14.00
250 Guaifenesen 100mg/5ml Cough Syrup Pharmacy 1.05
250 Guaifenesen DM Cough Syrup Pharmacy 2.11
250 Lactulose 10Gm/15ml Liquid Pharmacy 15.21
250 Ibuprofen 100mg/5ml Oral Susp Pharmacy 1.05
250 Ibuprofen Drops Pharmacy 1.25
250 Lidocaine 4% Solution Pharmacy 64.50
250 Citrate of Magnesia Pharmacy 3.12
250 Maalox Suspension Pharmacy 0.50
250 Milk of Magnesia Pharmacy 0.10
250 Multivitamin Liquid Pharmacy 1.00
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250 Phenytoin 125mg/5ml Suspension Pharmacy 15.21
250 SPS 15Gm/60ml Suspension Pharmacy 42.25
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250 Alprazolam 0.5mg tabs Pharmacy 19.57
250 Alprazolam 1mg tabs Pharmacy 19.57
250 Chlordiazepoxide 10mg caps Pharmacy 19.57
250 Chlordiazepoxide 25mg caps Pharmacy 19.57
250 Clonazepam 0.5mg tabs Pharmacy 19.57
250 Clonazepam 1mg tabs Pharmacy 19.57
253 Apap/Codeine #3 tabs Pharmacy 19.57
250 Apap/Codeine Elixir Pharmacy 4.00
250 Guaifenesin/Codeine Cough Syrup Pharmacy 1.50
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250 Diphenoxylate/Atropine (Lomotil) tabs Pharmacy 19.57
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250 Hydrocod/Apap 7.5/500mg tabs Pharmacy 17.05
250 Hydrocod/Apap 10/325mg tabs Pharmacy 19.57
250 IMN Hydrocod/Apap 10/325mg #6 Pharmacy 53.28
250 Hydrocod/Apap Elixir Pharmacy 4.00
250 Guaifenesin/Hydrocodone Cough Syrup Pharmacy 1.00
250 Ibuprofen/Hydrocod 200/7.5mg tabs Pharmacy 17.01
250 Lorazepam 2mg Oral Liquid Pharmacy 19.57
250 Lorazepam 1mg tabs Pharmacy 19.57
250 Lorazepam 2mg tabs Pharmacy 19.57
250 Phenobarbital 30mg tabs Pharmacy 19.57
250 Pregabalin (Lyrica) 25mg caps Pharmacy 31.41
250 Pregabalin (Lyrica) 75mg caps Pharmacy 31.41
250 Promethazine/Codeine Cough Syrup Pharmacy 5.00
250 Modafinil 100mg tabs Pharmacy 98.00
250 Modafinil 200mg tabs Pharmacy 147.00
250 Temazepam 15mg caps Pharmacy 19.57
250 Temazepam 30mg caps Pharmacy 19.57
250 Zolpidem 5mg tabs Pharmacy 24.96
250 Fentanyl (Actiq) 200mcg Pharmacy 63.00
250 Fentanyl 25mcg Patch Pharmacy 60.00
250 Fentanyl 50mcg Patch Pharmacy 100.50
250 Fentanyl 100mcg Patch Pharmacy 188.50
250 Hydromorphone 2mg tabs Pharmacy 19.57
250 Meperidine 100mg/ml MDV 20ml Pharmacy 53.00
250 Morphine ER 15mg tab Pharmacy 19.57
250 Morphine IR 15mg tabs Pharmacy 19.57
250 Morphine ER 30mg tabs Pharmacy 24.96
250 Morphine 20mg/ml Oral Sol. Pharmacy 17.05
250 Oxycodone IR 5mg tab Pharmacy 19.57
250 Oxycodone ER 10mg tabs Pharmacy 24.96
250 Oxycodone ER 20mg tabs Pharmacy 31.41
250 Oxycodone ER 40mg tabs Pharmacy 16.00
250 Oxycodone/Apap 5/325mg tabs Pharmacy 19.57
250 Oxycodone/Apap 10/325mg tabs Pharmacy 24.96
250 Oxycodone 20mg/ml Oral Sol. Pharmacy 19.57
250 Bupivacaine 0.25% w/Epi mpf 30ml Pharmacy 31.00
250 Lidocaine 2% w/Epi Pharmacy 44.00
250 Lidocaine 1% w/Epi Pharmacy 31.00
250 Cefoxitin 1Gm vial Pharmacy 95.00
250 Ceftazidime 1Gm vial Pharmacy 95.00
250 Ciprofloxacin 400mg vial Pharmacy 53.00
250 Sterile Water for Injection Pharmacy 49.84
250 Sodium Chloride for Injection Pharmacy 49.84
250 Bacteriostatic Water for Injection Pharmacy 44.00
250 Calcium Chloride 10% 10ml vial Pharmacy 95.00
250 Levofloxacin 500mg vial Pharmacy 89.00
250 Levofloxacin 750mg vial Pharmacy 121.00
250 Phentolamine 5mg vial Pharmacy 617.50
250 Vitamin B-1 100mg injection Pharmacy 27.00
250 Avitene Powder 1gm Pharmacy 755.00
250 Lorazepam 0.5mg tabs Pharmacy 19.57
250 Meperidine 50mg tabs Pharmacy 19.57
250 Bisacodyl 10mg Suppositories Pharmacy 0.75
250 Fentanyl 12mcg Patch Pharmacy 80.00
250 Cyproheptadine 4mg tabs Pharmacy 15.21
250 Methylergonovine 0.2mg tab Pharmacy 29.25
250 Vitamin D 50,000 units cap Pharmacy 15.21
250 Promethazine Supp. 12.5mg Pharmacy 63.25
250 Promethazine Supp. 25mg Pharmacy 63.25
250 Pen G Benz/Procaine LA 1,200,000 units Pharmacy 324.00
250 Tisseel 2ml Pharmacy 691.00
250 Rocuronium 10mg dose Pharmacy 44.00
250 Dinoprostone (Prepidil) Gel 0.5mg Pharmacy 2,075.00
250 Carboprost (Hemabate) 250mcg Pharmacy 1,459.00
250 Bacitracin 50,000 units Pharmacy 61.75
250 Dinoprostone (Cervidil) 10mg Supp. Pharmacy 1,195.00
250 Black Widow Antivenin per bottle Pharmacy 114.25
250 Trifluridine 1% Ophth. Sol. Pharmacy 637.00
250 Calcitonin Nasal Spray Pharmacy 432.00
250 Fluorescein/Benoxinate Ophth. Sol. Pharmacy 197.00
250 Octreotide 200mcg Pharmacy 33.08
250 MMR Vaccine Pharmacy 290.50
250 Citalopram 10mg tab Pharmacy 15.21
250 Pen G Benz/Procaine LA 600,000 units Pharmacy 374.00
250 Tolterodine LA 2mg caps Pharmacy 53.25
250 Paroxetine 30mg tabs Pharmacy 15.21
250 Triamcinolone 0.1% Cream Pharmacy 52.05
250 Levothyroxine 88mcg tabs Pharmacy 15.21
250 Nystatin/Triamcinolone Cream Pharmacy 573.00
250 Fleet Enema Pharmacy 52.05
250 Trazodone 100mg tabs Pharmacy 15.21
250 Hydrocod/Homatropine Cough Syrup Pharmacy 19.57
250 Lacrilube Ophth. Oint Pharmacy 52.05
250 Mirtazapine 30mg tabs Pharmacy 12.00
250 Lisinopril 20mg tabs Pharmacy 15.21
250 Diazepam 5mg from MDV Pharmacy 57.59
250 Ropinirole 0.5mg tab Pharmacy 14.00
250 Eszopiclone (Lunesta) 1mg tab Pharmacy 39.00
250 Cataract PreOp Meds Pharmacy 325.00
250 Fluorouracil 1gm vial Pharmacy 275.00
250 Albumin 12.5gm 25% 50ml Pharmacy 236.50
250 Amiloride 5mg tab Pharmacy 15.21
250 Halflytely Bowel Prep Kit Pharmacy 239.00
250 Coenzyme Q-10 100mg Pharmacy 1.05
250 Ramipril 10mg cap Pharmacy 15.21
250 Antipyrine/Benzocaine Otic Pharmacy 52.05
250 Hydralazine 10mg tab Pharmacy 14.00
250 Cetirizine 10mg tab Pharmacy 3.12
250 Charcoal 50gms Pharmacy 91.50
250 Ketoconazole 200mg tab Pharmacy 15.50
250 Olanzapine Zydis 5mg tab Pharmacy 62.00
250 Olanzapine 7.5mg tab Pharmacy 64.00
250 Ondansetron ODT 4mg tab Pharmacy 81.25
250 Verapamil SR 120mg tab Pharmacy 15.21
250 Sucralfate 1gm tab Pharmacy 15.21
250 Clindamycin 75mg/5ml Ped Sol Pharmacy 209.25
250 Vitamin D 1,000 units tab Pharmacy 1.05
250 Warfarin 4mg tab Pharmacy 15.21
250 Losartan 50mg tab Pharmacy 15.21
250 Rosuvastatin 10mg tab Pharmacy 39.50
250 Gabapentin 600mg tab Pharmacy 15.21
250 Fentanyl 75mcg patch Pharmacy 148.00
250 Amitriptyline 10mg tab Pharmacy 15.21
250 Terazosin 1mg cap Pharmacy 15.21
250 Propranolol LA 120mg cap Pharmacy 15.21
250 Levetiracetam 1000mg tab Pharmacy 28.25
250 Levetiracetam 500mg Oral Sol Pharmacy 15.21
250 Oseltamivir 45mg cap Pharmacy 60.25
250 Oseltamivir 75mg cap Pharmacy 65.00
250 Oseltamivir 30mg cap Pharmacy 60.25
250 Ezetimibe-Simvastatin 10/20 tab Pharmacy 50.00
250 Labetalol 100mg tab Pharmacy 15.21
250 Amlodipine 10mg tab Pharmacy 15.21
250 Calcium Carbonate EX 750mg Pharmacy 1.05
250 Betamethasone 0.1% Cream Pharmacy 216.00
250 Lisinopril 5mg tab Pharmacy 15.21
250 Oseltamivir Suspension Pharmacy 651.00
250 Cilostazol 50mg tab Pharmacy 15.21
250 Potassium Chloride 20mEq/15ml Pharmacy 15.21
250 Lisinopril 40mg tab Pharmacy 15.21
250 Sulfamethox/TMP DS tab Pharmacy 15.21
250 Thyroid 90mg tab Pharmacy 15.21
250 Preparation H Ointment Pharmacy 5.25
250 Apap 160mg/5ml Pharmacy 1.05
250 Vancomycin 125mg cap Pharmacy 108.00
250 Ketotifen Ophth Sol Pharmacy 52.05
250 Allopurinol 300mg tab Pharmacy 15.21
250 Linezolid 600mg tab Pharmacy 608.75
250 Betamethasone Dipropionate Cream Pharmacy 388.00
250 Miconazole Cream 2% Pharmacy 52.05
250 Terbinafine Cream Pharmacy 52.05
250 Triamcinolone Lotion Pharmacy 101.00
250 Granulex Spray Pharmacy 77.00
250 Carbachol Intraocular (Miostat) Pharmacy 154.00
250 Moxifloxacin Ophth. Sol. Pharmacy 702.00
250 Bupropion 100mg tab Pharmacy 14.00
250 Ziprasidone 20mg cap Pharmacy 81.00
250 Clonidine 0.3mg tab Pharmacy 14.00
250 Duloxetine 20mg cap Pharmacy 33.25
250 Estradiol 1mg tab Pharmacy 15.21
250 Famotidine 20mg tab Pharmacy 15.21
250 Hydrocortisone 5mg tab Pharmacy 15.21
250 Hydrocortisone 20mg tab Pharmacy 15.21
250 Ibandronate 150mg tab Pharmacy 759.00
250 Minoxidil 10mg tab Pharmacy 10.00
250 Phytonadione 5mg tab Pharmacy 45.75
250 Potassium Chloride 20mEq packets Pharmacy 14.00
250 Probenecid 500mg tab Pharmacy 17.50
250 Tizanidine 2mg tab Pharmacy 15.21
250 Ofloxacin Otic 5ml Pharmacy 274.00
250 Triamterene/HCTZ 37.5-25mg tab Pharmacy 15.21
250 Thrombin 5,000 units Pharmacy 316.00
250 Thrombin 20,000 units Pharmacy 1,160.00
250 Banana Bag Pharmacy 1.00
253 INM Generic Pharmacy 19.00
253 INM Ventolin Inhaler Pharmacy 33.00
250 Cefdinir 250mg/5ml Pharmacy 52.05
250 Budesonide/Formoterol 160/4.5 INHALER Pharmacy 875.00
250 Amphetamine Salts 10mg tab Pharmacy 24.96
250 Aripiprazole 20mg tab Pharmacy 171.00
250 Benazepril 20mg tab Pharmacy 15.21
250 Chromium Picolinate 1000mcg cap Pharmacy 1.00
250 Dakin’s Solution Pharmacy 52.05
250 Dantrolene 20mg vial Pharmacy 365.00
250 Digoxin 0.25mg tab Pharmacy 15.21
250 Ezetimibe/Simvastatin 10/10 tabs Pharmacy 50.00
250 Felodipine 5mg tab Pharmacy 15.21
250 Fenofibrate 145mg cap Pharmacy 22.00
250 Fenofibrate 48mg cap Pharmacy 15.21
250 Fish Oil 1000mg cap Pharmacy 1.05
250 Hydrocod/Apap 7.5/325mg tab Pharmacy 19.57
250 Hydrocortisone 10mg tab Pharmacy 15.21
250 Irbesartan 75mg tab Pharmacy 15.21
250 Ketoconazole Cream Pharmacy 690.00
250 Lovastatin 10mg tab Pharmacy 15.21
250 Menthol/Benzocaine Lozenges Pharmacy 1.05
250 Metoclopramide Syrup 5mg/5ml Pharmacy 0.25
250 Miacalcin Nasal Spray Pharmacy 222.00
250 Midazolam 2mg/ml Oral Solution Pharmacy 24.96
250 Mometasone-Asmanex Nasal Spray Pharmacy 325.00
250 Montelukast 10mg tab Pharmacy 23.75
250 Heparin Flush 10 units/ml Pharmacy 44.00
250 Oxycodone/Apap 7.5/325mg tab Pharmacy 24.96
250 Bismuth Subsalicylate 30ml Pharmacy 1.05
250 Levonorgestrel 1.5mg tab Pharmacy 138.75
250 Prazosin 2mg cap Pharmacy 15.21
250 Pramipexole 0.25mg tab Pharmacy 16.00
250 Famciclovir 500mg tab Pharmacy 99.00
250 Rivastigmine 4.6mg Patch Pharmacy 99.00
250 Ropinirole 2mg tab Pharmacy 15.21
250 Ropinirole 4mg tab Pharmacy 15.21
250 Ropinirole 1mg tab Pharmacy 15.21
250 Saline Nasal Spray Pharmacy 52.05
250 Sitagliptin 100mg tab Pharmacy 61.75
250 Sulfamethox/Trimethoprim Susp. Pharmacy 3.00
250 Terazosin 5mg cap Pharmacy 15.21
250 Tetracaine 2ml Ophth Sol Pharmacy 52.05
250 Thiamine 100mg tab Pharmacy 15.21
250 Ursodiol 300mg cap Pharmacy 29.25
250 Vitamin B-12 500mcg tab Pharmacy 1.05
250 Norepinephrine 4mg/4ml amp Pharmacy 49.84
250 Miconazole Powder 2% Pharmacy 52.05
250 Magnesium 64mg tab Pharmacy 1.05
250 Flaxseed Oil 1200mg cap Pharmacy 1.05
250 Cherry Syrup Pharmacy 0.25
250 LET Topical Solution Pharmacy 2.04
250 Local Anesthesiathetic Pharmacy 44.00
250 Zolpidem 10mg tabs Pharmacy 19.57
250 Sitagliptin 25mg tab Pharmacy 61.75
250 Levofloxacin 250mg tab Pharmacy 60.50
250 Atorvastatin 40mg tab Pharmacy 24.00
250 Vancomycin 250mg cap Pharmacy 195.00
250 Naproxen 375mg tab Pharmacy 15.21
250 Lotrel 5/20 Kit Pharmacy 16.00
250 Docusate 50mg/Senna 8.6mg tab Pharmacy 1.00
250 Vitamin B-6 100mg tab Pharmacy 1.05
250 Quetiapine 200mg tab Pharmacy 54.75
250 Sodium Chloride Neb 7% Pharmacy 16.24
250 Tobramycin/Dex Ophth Susp Pharmacy 229.00
250 Fluorouracil 46-hour BULB Pharmacy 390.00
250 Hydromorphone PCA 1mg/ml 30ml Pharmacy 57.59
250 Chromium Picolinate 200mcg tab Pharmacy 1.05
250 Calcium Citrate 250mg cap Pharmacy 1.05
250 Furosemide 10mg oral solution Pharmacy 15.21
250 Ropinirole 0.25mg tab Pharmacy 15.21
250 Oxycodone IR 15mg tab Pharmacy 19.57
250 Pseudoephedrine ER 120mg calet Pharmacy 1.00
250 Propafenone 150mg tab Pharmacy 15.21
250 Febuxostat 40mg tab Pharmacy 47.25
250 Chloraseptic Spray Pharmacy 4.50
250 Lorazepam 1mg IV/IM dose Pharmacy 53.00
250 Misoprostol 200mcg tab Pharmacy 15.21
250 Thrombin 5,000 units Kit Pharmacy 337.00
250 Moxifloxin 400mg premix Pharmacy 245.00
250 Ibuprofen 200mg tab Pharmacy 1.00
250 Nitroglycerin 0.4mg patch Pharmacy 33.59
250 Moxifloxacin 400mg tab Pharmacy 125.25
250 Mycophenolate 500mg tab Pharmacy 31.25
250 Amox/Clav 500mg tab Pharmacy 17.50
250 Ceftazidime 2gm vial Pharmacy 115.00
250 Carbidopa/Levodopa CR 50/200mg tab Pharmacy 15.21
250 Hyoscyamine 0.125mg tab Pharmacy 15.21
250 Dutasteride 0.5mg cap Pharmacy 30.50
250 Alendronate 35mg tab Pharmacy 72.50
250 Verapamil 40mg tab Pharmacy 15.21
250 Hydromorphone 10mg amp Pharmacy 57.59
250 Pseudoephedrine 60mg tab Pharmacy 15.21
250 Oxycodone IR 30mg tab Pharmacy 24.96
250 Propafenone SR 225mg tab Pharmacy 53.25
250 Cefuroxime 500mg tab Pharmacy 31.50
250 Enema of Choice Pharmacy 52.05
250 Duloxetine 60mg cap Pharmacy 31.00
250 Dopamine 200mg vial Pharmacy 49.84
250 Protamine 50mg vial Pharmacy 41.00
250 Magic Mouthwash Pharmacy 0.50
250 Cisplatin 100mg vial Pharmacy 140.00
250 Enalapril 20mg tabs Pharmacy 15.21
250 Amlodipine/Atorvastatin 10/20mg tab Pharmacy 34.75
250 Polymyxin B 500,000 units Pharmacy 61.75
250 Triamcinolone Dental Paste Pharmacy 578.00
250 Pregabalin (Lyrica) 50mg cap Pharmacy 33.00
250 Hepatitis A Vaccine Adult Pharmacy 277.75
250 Calcium Citrate 950mg tab Pharmacy 1.05
250 Rivaroxaban 10mg tab Pharmacy 60.25
250 Rivaroxaban 20mg tab Pharmacy 31.00
250 Rivaroxaban 15mg tab Pharmacy 31.00
250 Morphine 10mg PFS Pharmacy 57.59
250 HCTZ 12.5mg cap Pharmacy 15.21
250 Ramipril 5mg cap Pharmacy 15.21
250 Sumatriptan 100mg tab Pharmacy 87.75
250 Hydrocod/Apap 5/325mg tab Pharmacy 19.57
250 Latanoprost Ophth. Sol. Pharmacy 346.00
250 Desvenlafaxine 100mg tab Pharmacy 55.25
250 Amantadine 100mg tab Pharmacy 15.21
250 Aripiprazole 10mg tab Pharmacy 122.50
250 Azacitidine 100mg vial Pharmacy 1,796.00
250 Cladribine 10mg vial Pharmacy 1,453.00
250 Morphine Sulfate 10mg/10ml amp Pharmacy 57.59
250 Ivermectin 3mg tab Pharmacy 23.50
250 Permethrin 5% Cream Pharmacy 52.05
250 Nitroglycerin 0.4% PR Ointment Pharmacy 1,093.00
250 Pharmacy Preparation Fee Pharmacy 151.00
250 Bisoprolol/HCTZ 5/6.25mg tab Pharmacy 15.21
250 Bisoprolol/HCTZ 10-6.25mg tab Pharmacy 15.21
250 Gelfoam Size 100 Pharmacy 181.50
250 Docusate 100mg/10ml Pharmacy 1.05
250 Insulin Drip per bag Pharmacy 76.00
250 Esmolol 100mg vial Pharmacy 49.84
250 Telmisartan 80mg tab Pharmacy 22.00
250 Telmisartan 40mg tab Pharmacy 21.00
250 Butalbital, APAP, Caffeine tab Pharmacy 19.57
250 Cipro/Dex Otic Susp. Pharmacy 860.00
250 Ceftriaxone 2gm vial Pharmacy 73.00
250 Thyroid 15mg tab Pharmacy 15.21
250 Topiramate 25mg tab Pharmacy 15.21
250 Estradiol 0.5mg tab Pharmacy 15.21
250 Magnesium Sulfate 10gm vial Pharmacy 95.00
250 Rocuronium 100mg vial Pharmacy 129.50
250 Clarithromycin 500mg tab Pharmacy 20.00
250 Theophylline SR 100mg tab Pharmacy 15.21
250 Nicotine 2mg gum Pharmacy 1.05
250 Lubricant Ophth. Drops Pharmacy 52.05
250 Lubricant Ophth. Ointment Pharmacy 52.05
250 Topotecan 4mg vial Pharmacy 1,000.00
250 Meloxicam 15mg tab Pharmacy 19.25
250 TPN-Advanced Pharmacy Mix 24hrs Pharmacy 300.00
250 Doxorubicin 200mg vial Pharmacy 275.00
250 Ropinirole ER 8mg tab Pharmacy 32.00
250 Ziprasidone 80mg cap Pharmacy 41.00
250 Lithium Carbonate 600mg cap Pharmacy 15.21
250 Risperidone 4mg tab Pharmacy 44.50
250 Lithium Carbonate 300mg cap Pharmacy 15.21
250 Torsemide 100mg tab Pharmacy 15.21
250 Irbesartan/HCTZ 150/12.5mg tab Pharmacy 15.21
250 Detemir Flexpen Pharmacy 295.00
250 Dabigatran 150mg cap Pharmacy 31.50
250 Fluticasone/Salmeterol HFA 115/21mcg Pharmacy 840.00
250 Primidone 250mg tab Pharmacy 15.21
250 Paroxetine CR 37.5mg tab Pharmacy 24.75
250 Melatonin 3mg tab Pharmacy 1.05
250 Liothyronine 25mcg tab Pharmacy 15.21
250 Thyroid 30mg tab Pharmacy 15.21
250 Olanzapine 10mg tab Pharmacy 70.75
250 Niacin SR 250mg cap Pharmacy 1.05
250 Cefepime 1gm vial Pharmacy 95.00
250 Cefepime 2gm vial Pharmacy 115.00
250 Ferrous Sulfate 220mg/5ml Pharmacy 1.05
250 Acyclovir 400mg tab Pharmacy 15.21
250 Minocycline 100mg cap Pharmacy 16.25
250 Nalbupine 5mg dose Pharmacy 49.84
250 Fentanyl 25mcg dose Pharmacy 57.59
253 IMN Hydrocod/Apap 5/325mg #6 Pharmacy 84.87
253 IMN Lorazepam 1mg #6 Pharmacy 53.28
253 IMN Apap/Codeine 300/30mg #6 Pharmacy 24.87
253 IMN ALPRAZolam 0.25mg #6 Pharmacy 53.28
253 IMN Hydrocod/Apap 7.5/325mg #6 Pharmacy 84.87
253 IMN Acyclovir 200mg #5 Pharmacy 15.00
253 IMN Albuterol Inhaler ER To Go Pharmacy 53.28
253 IMN Amoxicillin 500mg #6 Pharmacy 16.00
253 IMN Amoxicillin/Clav. 875mg #3 Pharmacy 24.87
253 IMN Azithromycin 250mg #2 Pharmacy 24.87
253 IMN Benzonatate 100mg #6 Pharmacy 24.87
253 IMN Cefuroxime 250mg #4 Pharmacy 24.87
253 IMN Cephalexin 250mg #10 Pharmacy 24.87
253 IMN Ciprofloxacin 500mg #4 Pharmacy 24.87
253 IMN Clindamycin 150mg #6 Pharmacy 24.87
253 IMN Cyclobenzaprine 10mg #4 Pharmacy 24.87
253 IMN Doxycycline 100mg #6 Pharmacy 24.87
253 IMN Metoprolol 50mg #6 Pharmacy 24.87
253 IMN Levofloxacin 500mg #3 Pharmacy 24.87
253 IMN Metronidazole 500mg #4 Pharmacy 16.00
253 IMN Ondansetron ODT 4mg #4 Pharmacy 24.87
253 IMN Penicillin VK 250mg #6 Pharmacy 16.00
253 IMN Promethazine 25mg #6 Pharmacy 24.87
253 IMN Promethazine Supp 25mg #2 Pharmacy 24.87
253 IMN Prednisone 10mg #10 Pharmacy 24.87
253 IMN Tramadol 50mg #6 Pharmacy 24.87
253 IMN SMX-TMP DS #4 Pharmacy 24.87
253 IMN Oxycodone/Apap 5/325mg #6 Pharmacy 53.28
250 Dextrose Infant PFS Pharmacy 61.75
250 Phenobarbital 65mg vial Pharmacy 115.00
250 Esomeprazole 40mg cap Pharmacy 38.25
250 Ipratropium/Albuterol AnesthesiaTHESIA Pharmacy 43.00
250 Sod Bicarb 650mg tab Pharmacy 1.05
250 Oxytocin 10units/ml 10ml Pharmacy 49.84
250 Atropine 0.4mg/ml 20ml vial Pharmacy 46.25
253 IMN Nitrofurantoin (BID) 100mg #2 Pharmacy 24.87
250 Fexofenadine 60mg tab Pharmacy 15.21
250 Fluticasone-Salmeterol 230/21mcg Pharmacy 1,225.00
250 TPN-Clinimix 5/20% 2000ml Pharmacy 247.20
250 Levothyroxine 200mcg Pharmacy 15.21
250 Phenazopyridine 200mg tab Pharmacy 15.21
250 Phenazopyridine 200mg tab Pharmacy 13.63
250 Bupivacaine Liposome Pharmacy 997.50
250 Tranexamic Acid 1000mg vial Pharmacy 202.00
250 RID Kit Pharmacy 17.00
250 Diphenhydramine plus Zinc Cream Pharmacy 1.05
250 Poractant Alfa 120mg vial Pharmacy 1,700.00
250 Poractant Alfa 240mg vial Pharmacy 3,351.75
250 Sildenafil 50mg tab Pharmacy 271.00
250 Levothyroxine 125mcg tab Pharmacy 15.21
250 Apap/ASA/Caffeine Pharmacy 1.05
250 Raltegravir 400mg tab Pharmacy 103.75
250 Epsom Salts Pharmacy 52.05
250 Fluorescein Strips Pharmacy 52.05
250 Mirabegron ER 25mg tab Pharmacy 51.50
250 Olopatadine Ophthalmic Pharmacy 700.00
250 Loteprednol Ophthalmic Pharmacy 885.00
250 NiCardiopulmonaryipine 25mg vial Pharmacy 97.57
250 Alfentanil 500mcg amp Pharmacy 57.59
250 Zostavax Vaccine Pharmacy 875.50
250 Desflurane per hour Pharmacy 350.00
250 Magnesium Sulfate 4gm bag Pharmacy 49.84
250 Levothyroxine 112mcg tab Pharmacy 15.21
250 Sore No More Pharmacy 27.00
250 Rifaximin 550mg tab Pharmacy 144.75
250 Ferrous Sulfate 15mg Fe/ml Pharmacy 52.05
250 Monsels Solution Pharmacy 52.05
250 Balanced Salt Solution Pharmacy 52.05
250 Levothyroxine 137mcg Pharmacy 15.21
250 Nifedipine/Lidocaine Rectal Ointment Pharmacy 52.05
250 Warfarin 7.5mg tab Pharmacy 17.25
250 Meropenem 1gm vial Pharmacy 120.00
250 Dabigatran 75mg cap Pharmacy 19.50
250 Aripiprazole 2mg Pharmacy 65.50
250 Lamotrigine 150mg Pharmacy 22.75
250 Buprenorphine 5mg Patch Pharmacy 281.50
250 Lorazepam 40mg vial Pharmacy 115.00
250 Sodium Chloride 1gm tab Pharmacy 15.21
250 Clindamycin 300mg #9 Pharmacy 24.87
250 Biafine Top Emulsion 90gm Pharmacy 315.00
250 Biafine Top Emulsion 45gm Pharmacy 245.00
250 Gabapentin 400mg cap Pharmacy 15.21
250 Lacosamide 50mg tab Pharmacy 38.00
250 Loratadine 5mg/Pseudoephedrine 120mg tab Pharmacy 1.05
250 Mercaptopurine 50mg Pharmacy 32.00
250 Omega-3 1gram cap Pharmacy 15.21
250 Pneumococcal-13 Vaccine Pharmacy 763.75
250 Emtricitabine-Tenofovir 200-300mg Pharmacy 225.75
250 Ondansetron Oral Sol. 4mg/5ml Pharmacy 84.00
250 Rizatriptan 10mg tab Pharmacy 149.50
250 Venlafaxine 50mg tab Pharmacy 15.21
250 Sugammadex 500mg vial Pharmacy 49.84
250 Vitamin B-6 100mg vial Pharmacy 62.75
250 Methimazole 5mg Pharmacy 15.21
250 Pancrelipase 24,000 units (Creon) Pharmacy 18.75
250 Buspirone 5mg tab Pharmacy 15.21
250 Nateglinide 120mg Pharmacy 15.21
250 Cefdinir 300mg cap Pharmacy 21.00
250 Sugammadex 200mg vial Pharmacy 49.84
250 Capsaicin Creme Pharmacy 52.05
250 Sildenafil 20 mg tab Pharmacy 71.75
250 Ofloxacin 0.3% ophth drops Pharmacy 150.25
250 Fluoxetine 20mg/5ml solu Pharmacy 33.59
250 Azelastine 0.1% nasal spr Pharmacy 52.05
250 Linaclotide 145 mcg cap Pharmacy 56.00
250 Fosfomycin 3 gm pkt Pharmacy 318.50
250 Tadalafil 2.5 mg tab Pharmacy 50.25
250 AZO Pharmacy 1.05
250 Rivaroxaban 15 mg tab Pharmacy 60.25
250 Diclofenac/Misoprostol 75/200mg Pharmacy 16.25
250 Prochlorperazine 10 mg tab Pharmacy 15.21
250 apixaban 2.5 mg tab Pharmacy 32.75
250 buprenorphine 8 mg tab SL Pharmacy 31.41
250 Ceftriaxone 500 mg vial Pharmacy 49.84
636 Oxytocin LR premix Pharmacy 62.89
250 Diclofenac Topical Gel 1% Pharmacy 183.50
636 Xylocaine 2% 5ml Pharmacy 49.84
636 lidocain 1% 5ml Pharmacy 49.84
250 cilostazol 100mg tab Pharmacy 15.21
636 ceftriaxone 2gm premix Pharmacy 89.00
250 linagliptin 5mg tab Pharmacy 59.25
636 Leucovorin 500mg vial Pharmacy 49.84
636 LITAGLPTIN 5MG TAB Pharmacy 52.00
636 Bupivicaine Spinal 0.75% Pharmacy 49.84
636 Morphine Sulf 5mg/10ml amp Pharmacy 118.50
636 Bupivacaine/epi 0.5% 1:200,000 MDV Pharmacy 1.00
250 Fluconazole 40mg/ml Susp Pharmacy 17.00
250 Fluconazole 10mg/ml Susp Pharmacy 15.21
636 Amiodarone 450/9ml vial Pharmacy 49.84
250 Sodium Chloride 7% Pharmacy 16.24
636 Dobutamine 500mg Premix Pharmacy 49.84
636 ceftriaxone 2gm Pharmacy 49.84
250 fludrocortisone 0.1mg tab Pharmacy 15.21
250 MIDODRINE HCL 2.5 MG Pharmacy 15.21
250 HALOPERIDOL 2 MG / ML ORAL SOLUTION Pharmacy 1.00
250 Olopatadine HCL opth 0.1% Pharmacy 1.00
250 Breo Ellipta 100-25 mcg Pharmacy 566.00
250 Breo Ellipta 200-25 mcg Pharmacy 291.00
250 Arnuity Ellipta 100 mcg Pharmacy 344.00
250 Arnuity Ellipta 200 mcg Pharmacy 459.00
250 SPIRIVA Respimat 2.5mcg Pharmacy 1,540.00
636 INJECTAFER 750mg/15ml injection Pharmacy 4,232.50
250 Potassium ACETATE 40meq Pharmacy 95.00
250 Fluorecein-Proparacaine 0.25-0.5% Opthal Pharmacy 167.00
250 Naltraxone 50mg tab Pharmacy 1.00
250 Morphine Sulfate ER 100mg tab Pharmacy 31.41
250 Floranex Oral Tablets Pharmacy 1.05
636 Tobramycin 1.2gm IV Pharmacy 720.50
250 Sufentanil 100mcg amp Pharmacy 57.59
250 Phenylephrine 1% Nasal Spray Pharmacy 52.05
250 Meperidine in ER 50mg, 100mg Pharmacy 53.00
250 Hetastarch/NS 6% 500ml Pharmacy 86.00
250 Isoflurane per hour Pharmacy 125.00
250 Golytely Solution 4000ml Pharmacy 80.75
250 Glycerin Supp Child Pharmacy 1.05
250 Heparin vials in ER All Strengths Pharmacy 44.00
250 Ibuprofen in ER 400,600,800mg tab Pharmacy 14.00
250 Promethazine Syrup Pharmacy 5.00
250 Promethazine Supp in ER All Strengths Pharmacy 16.00
250 Rifampin 300mg cap Pharmacy 15.21
250 Medroxyprogesterone 2.5mg tab Pharmacy 15.21
250 Pink Bismuth Suspension Pharmacy 3.00
250 SSD Cream 400gm Pharmacy 239.00
250 GI Cocktail Pharmacy 0.25
636 INJECTION, PENCILLN G BENZATHINE 100,000 Pharmacy 13.00
636 GENTAMICIN OPHTHLMC DROP Pharmacy 34.00
636 Bexsero meningicoccal vacine Pharmacy 617.00
636 Trumenba Menigococcal vaccine Pharmacy 512.75
636 MenHibirx Pharmacy 98.86
636 Yellow Fever Vaccine Pharmacy 270.25
636 Hepatitis B [adolescent vaccine](clinic) Pharmacy 117.50
121 ROOM & BOARD SWING BED Swing Bed 729.00
684 TRAUMA TEAM ACTIVATION/LEVEL II Trauma 3,648.00
684 TRAUMA TEAM ACTIVATE/FULL LVL I Trauma 7,283.00
This list of charges reflects the standard charges for inpatient and outpatient services provided at Moab Regional Hospital. The hospital’s charges are the same for all patients, but the patient’s financial responsibility for services provided may vary, depending upon payment plans negotiated with individual health insurers as well as reimbursement schedules set forth by public payers such as Medicare and Medicaid. Patients should contact our business office staff for assistance. These charges do not include items or services that may be billed separately for physician services, lab, diagnostic services, etc.
Language indicating that the listed charges do not constitute a contract