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 3.5x14 | Central Supplies | 197.00 |
278 | C1713 | SEE 425132004 Acumed CO-3160 3.5x1 | 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 7.0x110 | Central Supplies | 1,426.00 | |
275 | ZIMMER 1147-100-70 SCREW CANULAT 7.0x100 | 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 8600-5x05 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 |
981 | 28400 | CLO TX CALCANEAL FX PRO | Emergency Room Professional Fee | 492.00 |
981 | 28430 | CLO TX TALUS FX W/O MANI | Emergency Room Professional Fee | 592.00 |
981 | 28435 | CLOSED TREATMENT TALUS FX W/MANIP PROFEE | Emergency Room Professional Fee | 823.00 |
981 | 28450 | TX TARSAL FX W/O MANIP E | Emergency Room Professional Fee | 563.00 |
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 |
981 | 28575 | CLO TX TALOTARSAL DISL W | Emergency Room Professional Fee | 661.00 |
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 |
981 | 29075 | APPLICATION CAST; SHORT ARM PRO FEE | Emergency Room Professional Fee | 206.00 |
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 |
360 | 11732 | AVULSION OF NAIL PLATE EACH ADDITIONAL | Operating Room | 103.00 |
360 | 11750 | EXCISION OF NAIL AND NAIL MATRIX | Operating Room | 426.00 |
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 |
361 | 20610 | ARTHROCENTESIS LARGE JOINT | Operating Room | 973.00 |
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 |
300 | 86999 | UNLISTED TRANSFUSION MEDICINE PROCEDURE | Operating Room | 430.00 |
372 | 99144 | MODERATE SEDATION FIRST 30 MIN | Operating Room | 161.00 |
372 | 99145 | MODERATE SEDATION EA ADD 15 MIN | Operating Room | 65.00 |
379 | 99149 | MODERATE SEDATION INDEPEND OBS FIRST 30 | Operating Room | 165.00 |
379 | 99150 | MODERATE SED INDEPEND OBS EACH ADD 15 MI | Operating Room | 74.00 |
360 | 99998 | INJECTIONS: SQ, IM, IV | Operating Room | 7.00 |
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 | |
430 | 35831 | OT ASSESS R/M | Physical Therapy | 136.00 |
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 | |
420 | TNS SET UP | Physical Therapy | 125.00 | |
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 | |
424 | KINETIC RANGE AND MOTION | Physical Therapy | 134.00 | |
424 | WORKMAN COMP OFFICE VIS. | Physical Therapy | 224.00 | |
424 | WORKMANS NEW EVALUATION | Physical Therapy | 293.00 | |
420 | W.T. EQUIPMENT | Physical Therapy | 128.00 | |
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 |
322 | 23350 | INJECTION PROC FOR SHOULDER ARTHROGRAPHY | Radiology | 619.00 |
322 | 27093 | INJECT PROC FOR HIP ARTHROGRAM | Radiology | 1,050.00 |
360 | 27096 | INJ PRO FOR SI JOINT Anesthesia | Radiology | 1,236.00 |
322 | 27370 | INJ PROC FOR KNEE ARTHROGRAPHY | Radiology | 1,065.00 |
361 | 32405 | BX, LUNG OR MEDIAST PERC NEEDLE | Radiology | 604.00 |
361 | 32421 | THORACENTESIS, INITIAL OR SUB | Radiology | 908.00 |
361 | 32554 | THORACENTESIS W/INSTERT TUBE, INCL WS | Radiology | 1,195.00 |
361 | 32555 | THORACENTESIS, NEED OR CATH ASP W/IMAGIN | Radiology | 1,557.00 |
361 | 36569 | PICC LINE PLACEMENT>5 YRS | Radiology | 1,338.00 |
361 | 47000 | BX OF LIVER, NEEDLE; PERCUTANOUS | Radiology | 3,316.00 |
361 | 48102 | BIOPSY PANCREA PERCUTANEOUS NEEDLE | Radiology | 1,607.00 |
361 | 49082 | PARACENTESIS W/O IMAGING | Radiology | 943.00 |
402 | 49083 | PARACENTESIS WITH IMAGING GUIDANCE | Radiology | 1,722.00 |
361 | 58340 | CATH AND INTRO OF CONT OR SAL INFUS HYST | Radiology | 953.00 |
361 | 62270 | LUMBAR PUNCTURE | Radiology | 660.00 |
360 | 62322 | INJ SNGL W/WO CONTRST, DX/THRPTC SQ EPDL | Radiology | 1,640.00 |
320 | 62323 | NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG | Radiology | 1,578.00 |
361 | 64490 | INJECT DIAG OR THER VERT FAC CER OR THOR | Radiology | 1,160.00 |
361 | 64491 | PARAVERT FAC INJECT 2ND LEVEL CER OR THO | Radiology | 871.00 |
361 | 64493 | INJECT PARAVERT FACET LUMSAC SINGLE LEVE | Radiology | 1,638.00 |
361 | 64494 | INJ DIAG OR THER 2ND LEVEL LUMB | Radiology | 678.00 |
361 | 64495 | FACET JOINT INJ THIRD LEVEL | Radiology | 868.00 |
320 | 70030 | EYE, DETECTION OF FB | Radiology | 377.00 |
320 | 70100 | MANDIBLE XRAY LTD | Radiology | 193.00 |
320 | 70110 | MANDIBLE X RAY | Radiology | 359.00 |
320 | 70130 | MASTOIDS X RAY | Radiology | 239.00 |
320 | 70140 | FACIAL BONES 2 VIEWS | Radiology | 438.00 |
320 | 70150 | FACIAL BONES X RAY | Radiology | 466.00 |
320 | 70160 | NASAL BONES X RAY | Radiology | 370.00 |
320 | 70200 | ORBIT X-RAY | Radiology | 321.00 |
320 | 70210 | PARANASAL SINUS I VIEW | Radiology | 197.00 |
320 | 70220 | PARANASAL SINUS COMPLETE X RAY | Radiology | 506.00 |
320 | 70240 | SELLA TURCIA X-RAY | Radiology | 123.00 |
320 | 70250 | SKULL X RAY 3 VIEWS | Radiology | 390.00 |
320 | 70330 | TMJ | Radiology | 285.00 |
610 | 70336 | MRI-TEMPOROMANDIBULAR JOINT | Radiology | 3,502.00 |
320 | 70360 | NECK SOFT TISSUE X-RAY | Radiology | 324.00 |
351 | 70450 | CT BRAIN W/O | Radiology | 1,385.00 |
351 | 70460 | CT BRAIN W | Radiology | 1,868.00 |
351 | 70470 | CT BRAIN COMB | Radiology | 2,129.00 |
351 | 70480 | CT ORB SEL TEMP WO CONTR | Radiology | 1,272.00 |
351 | 70481 | CT ORB SEL TEMP W | Radiology | 1,745.00 |
351 | 70482 | CT ORB TEMP COMB | Radiology | 2,223.00 |
351 | 70486 | CT SINUS-LIMITED | Radiology | 1,381.00 |
351 | 70486 | CT MAXIL FACIAL WO | Radiology | 1,381.00 |
351 | 70486 | CT SINUS-COMPLETE | Radiology | 1,381.00 |
351 | 70487 | CT MAXIL FACIAL | Radiology | 1,776.00 |
351 | 70487 | CT FACIAL BONE W/ | Radiology | 1,776.00 |
351 | 70488 | CT MAXIL FACIAL COMB | Radiology | 1,908.00 |
351 | 70490 | CT NECK WO | Radiology | 1,453.00 |
351 | 70491 | CT ST NECK W | Radiology | 1,825.00 |
352 | 70492 | CT ST NECK COMB | Radiology | 2,557.00 |
351 | 70496 | CTA HEAD WITH CONTRAST | Radiology | 2,545.00 |
351 | 70498 | CTA NECK W/ CONTRAST | Radiology | 2,540.00 |
610 | 70540 | MRI ORBIT/FACE/NECK W/O CONTRAST | Radiology | 2,590.00 |
610 | 70542 | MRI ORBIT/FACE/NECK WITH CONTRAST | Radiology | 3,419.00 |
610 | 70543 | MRI ORBIT/FACE/NECK COMBO | Radiology | 3,934.00 |
610 | 70544 | MRA-HEAD W/O CONTRAST | Radiology | 2,586.00 |
610 | 70544 | MRV HEAD W/O CONTRAST | Radiology | 2,770.00 |
610 | 70545 | MRA-HEAD WITH CONTRAST | Radiology | 2,879.00 |
610 | 70545 | MRV HEAD WITH CONTRAST | Radiology | 3,449.00 |
610 | 70546 | MRA-HEAD WO CONTRAST FOLLOWED BY W/CONTR | Radiology | 3,584.00 |
610 | 70546 | MRV HEAD W/WO CONTRAST COMBINATION | Radiology | 3,909.00 |
610 | 70547 | MRA-NECK W/O CONTRAST | Radiology | 2,449.00 |
610 | 70548 | MRA - NECK W/CONTRAST MATERIAL | Radiology | 3,089.00 |
610 | 70551 | MRI-BRAIN+STEM W/O CONT | Radiology | 2,722.00 |
610 | 70552 | MRI-BRAIN WITH CONTRAST | Radiology | 3,169.00 |
610 | 70553 | MRI BRAIN COMBO | Radiology | 3,745.00 |
324 | 71045 | CHEST SINGLE VIEW | Radiology | 256.00 |
324 | 71046 | CHEST 2 VIEWS | Radiology | 311.00 |
324 | 71047 | CHEST 3 VIEWS | Radiology | 372.00 |
320 | 71100 | RIB X RAY UNILATERAL | Radiology | 306.00 |
320 | 71101 | RIBS UNILATERAL W/CHEST XRAY | Radiology | 410.00 |
320 | 71110 | RIB X RAY BILATERAL | Radiology | 399.00 |
320 | 71111 | RIBS BILAT W/CHEST XRAY | Radiology | 493.00 |
320 | 71120 | STERNUM X RAY | Radiology | 325.00 |
320 | 71130 | STERNOCLAVICULAR JTS. | Radiology | 285.00 |
352 | 71250 | CT CHEST WO | Radiology | 1,578.00 |
352 | 71260 | CT CHEST W | Radiology | 1,945.00 |
352 | 71270 | CT CHEST COMBO | Radiology | 2,213.00 |
359 | 71275 | CT ANGIOGRAPHY CHEST (NON-CORONARY) W | Radiology | 2,703.00 |
610 | 71550 | MRI CHEST W/O CONTRAST | Radiology | 2,975.00 |
610 | 71551 | MRI CHEST WITH CONTRAST | Radiology | 3,521.00 |
610 | 71552 | MRI CHEST COMBO | Radiology | 4,519.00 |
320 | 72010 | SPINE ENTIRE 2 VIEW | Radiology | 507.00 |
320 | 72020 | SPINE, 1 VIEW | Radiology | 311.00 |
320 | 72020 | SINGLE VIEW SPECIFIC SPINE | Radiology | 311.00 |
320 | 72040 | SPINE-CERVICAL 3V | Radiology | 384.00 |
320 | 72050 | SPINE-CERVICAL 5V | Radiology | 489.00 |
320 | 72052 | SPINE, CERVICAL 7 VIEW | Radiology | 639.00 |
320 | 72070 | SPINE, THORACIC | Radiology | 370.00 |
320 | 72072 | SPINE; THORACIC, 3 VIEWS | Radiology | 324.00 |
320 | 72080 | SPINE T-L JUNCTION | Radiology | 270.00 |
320 | 72080 | THORACOLUMBAR SPINE X-RAY 2 VIEW | Radiology | 301.00 |
320 | 72081 | SCOLIOSIS X RAY | Radiology | 315.00 |
320 | 72100 | SPINE, LUMBAR LIMITED | Radiology | 371.00 |
320 | 72110 | SPINE, LUMBAR COMPLETE | Radiology | 604.00 |
352 | 72125 | CT CERVICAL SP W/O | Radiology | 1,704.00 |
352 | 72126 | CT CERVICAL SF W | Radiology | 1,844.00 |
352 | 72127 | CT CERVICAL SP COMBO | Radiology | 2,119.00 |
352 | 72128 | CT THOR SP W/O | Radiology | 1,570.00 |
352 | 72129 | CT THOR SP/W | Radiology | 2,089.00 |
352 | 72130 | CT THOR SP COMBO | Radiology | 2,119.00 |
352 | 72131 | CT LUMBAR SP W/O | Radiology | 1,642.00 |
352 | 72132 | CT LUMBAR SP W | Radiology | 2,008.00 |
352 | 72133 | CT LUMBAR SP COMBO | Radiology | 2,119.00 |
610 | 72141 | MRI-SPINE/CERVICAL W/O | Radiology | 2,703.00 |
610 | 72142 | MRI-CERVICAL WITH | Radiology | 3,376.00 |
610 | 72146 | MRI-SPINE/THORACIC W/O | Radiology | 2,778.00 |
610 | 72147 | MRI THORACIC WITH CONTRAST | Radiology | 3,306.00 |
610 | 72148 | MRI-SPINE/LUMBAR W/O | Radiology | 2,870.00 |
610 | 72149 | MRI LUMBAR WITH CONTRAST | Radiology | 4,431.00 |
610 | 72156 | MRI CERVICAL COMBO | Radiology | 3,869.00 |
610 | 72157 | MRI-THORACIC COMBO | Radiology | 3,725.00 |
610 | 72158 | MRI-LUMBAR COMBO | Radiology | 3,922.00 |
610 | 72159 | MRA-SPINAL CANAL | Radiology | 2,912.00 |
320 | 72170 | PELVIS 1 VIEW | Radiology | 300.00 |
320 | 72190 | PELVIS 3 VIEW | Radiology | 461.00 |
352 | 72192 | CT PELVIS W/O | Radiology | 1,490.00 |
352 | 72193 | CT PELVIS W | Radiology | 1,928.00 |
352 | 72194 | CT PELVIS COMB | Radiology | 1,983.00 |
610 | 72195 | MRI-PELVIS W/O CONTRAST | Radiology | 2,578.00 |
610 | 72196 | MRI-PELVIS W/CONTRAST | Radiology | 2,838.00 |
614 | 72197 | MRI-PELVIS COMBO | Radiology | 3,839.00 |
320 | 72202 | S I JOINTS X RAY | Radiology | 387.00 |
320 | 72220 | SACRUM AND COCCYX X RAY | Radiology | 346.00 |
320 | 72240 | MYELOGRAM, CERVICAL | Radiology | 1,016.00 |
320 | 72255 | MYELOGRAM, THORACIC | Radiology | 1,016.00 |
320 | 72265 | MYELOGRAM, LUMBAR | Radiology | 1,016.00 |
330 | 72275 | EPIDUROGRAPHY | Radiology | 721.00 |
320 | 73000 | CLAVICLE X RAY | Radiology | 262.00 |
320 | 73010 | SCAPULA X RAY | Radiology | 266.00 |
320 | 73020 | SHOULDER I VIEW | Radiology | 247.00 |
320 | 73030 | SHOULDER X RAY | Radiology | 338.00 |
322 | 73040 | ARTHROGRAM SHOULDER | Radiology | 970.00 |
320 | 73050 | A-C JTD BIL XRAY | Radiology | 423.00 |
320 | 73060 | HUMERUS X RAY | Radiology | 289.00 |
320 | 73070 | ELBOW 2 VIEWS | Radiology | 239.00 |
320 | 73080 | ELBOW COMPLETE | Radiology | 325.00 |
320 | 73090 | FOREARM X RAY | Radiology | 277.00 |
320 | 73092 | INFANT UPPER EXTREMITY | Radiology | 141.00 |
320 | 73100 | WRIST 2 VIEWS | Radiology | 255.00 |
320 | 73110 | WRIST X RAY | Radiology | 320.00 |
322 | 73115 | ARTHROGRAM-WRIST | Radiology | 872.00 |
320 | 73120 | HAND XRAY 2 VIEWS | Radiology | 292.00 |
320 | 73130 | HAND X RAY | Radiology | 332.00 |
320 | 73140 | FINGER X-RAY | Radiology | 264.00 |
352 | 73200 | CT UPPER EXTREM WO | Radiology | 1,425.00 |
352 | 73201 | CT UPPER EXTREM W/CONTRAST | Radiology | 1,914.00 |
352 | 73202 | CT UPPER EXTREMITY COMBO | Radiology | 2,063.00 |
610 | 73218 | MRI-UPPER EXT OTHER THAN JOINT W/O | Radiology | 2,776.00 |
610 | 73219 | MRI-UPPER EXST OTHER THAN JOINT WITH | Radiology | 3,656.00 |
610 | 73220 | MRI-UPPER EXT OTHER THAN JOINT COMBO | Radiology | 4,226.00 |
610 | 73220 | MRA UPPER EXT W OR W/O | Radiology | 4,226.00 |
610 | 73221 | MRI-JOINT UPPER EXTR W/O | Radiology | 2,551.00 |
610 | 73222 | MRI-JOINT UPPER EXT WITH | Radiology | 2,958.00 |
610 | 73223 | MRI-JOINT UPPER EXT COMBO | Radiology | 3,701.00 |
320 | 73501 | HIP 1 VIEW UNILATERAL | Radiology | 225.00 |
320 | 73502 | PELVIS WITH 1 VIEW HIP | Radiology | 167.00 |
320 | 73502 | HIP 2-3 VIEWS, UNILATERAL | Radiology | 167.00 |
320 | 73520 | HIPS BILAT | Radiology | 384.00 |
320 | 73521 | HIP 2-3 VW X-RAY, BILATERAL | Radiology | 245.00 |
320 | 73521 | RADEX HIPS BILAT W/PELVIS 2 VIEWS | Radiology | 162.00 |
320 | 73522 | RADEX HIPS BILAT W/PELVIS 3-4 VIEWS | Radiology | 197.00 |
320 | 73523 | RADEX HIPS BILAT W/PELVIS MIN 5 VIEWS | Radiology | 229.00 |
322 | 73525 | ARTHROGRAM-HIP | Radiology | 1,396.00 |
320 | 73540 | INFANT PELVIS AND HIP | Radiology | 167.00 |
320 | 73551 | RADIOLOGIC EXAMINATION FEMUR 1 VIEW | Radiology | 114.00 |
320 | 73552 | FEMUR | Radiology | 285.00 |
320 | 73552 | RADIOLOGIC EXAM FEMUR MIN. 2 VIEWS | Radiology | 131.00 |
320 | 73560 | KNEE 2 VIEW | Radiology | 291.00 |
320 | 73562 | KNEE THREE VIEWS | Radiology | 326.00 |
320 | 73564 | KNEE 4> VIEWS | Radiology | 343.00 |
320 | 73565 | KNEE STANDING | Radiology | 303.00 |
322 | 73580 | ARTHROGRAM, KNEE | Radiology | 554.00 |
320 | 73590 | TIBIA X RAY | Radiology | 323.00 |
320 | 73592 | INFANT LOWER EXTREMITY | Radiology | 149.00 |
320 | 73600 | ANKLE 2 VIEW X RAY | Radiology | 227.00 |
320 | 73610 | ANKLE X RAY COMPLETE | Radiology | 333.00 |
322 | 73615 | ARTHROGRAM ANKLE | Radiology | 374.00 |
320 | 73620 | FOOT XRAY 2 VIEWS | Radiology | 299.00 |
320 | 73630 | FOOT X RAY | Radiology | 315.00 |
320 | 73650 | CALCANEOUS X RAY | Radiology | 271.00 |
320 | 73660 | TOES X RAY | Radiology | 285.00 |
352 | 73700 | CT LOW EXTREM W/O | Radiology | 1,385.00 |
352 | 73701 | CT LOW EXTREM W | Radiology | 2,279.00 |
352 | 73702 | CT LOW EXTREM COMB | Radiology | 2,019.00 |
610 | 73718 | MRI-LOWER EXT OTHER THAN JOINT W/O | Radiology | 2,489.00 |
610 | 73719 | MRI-LOWER EXT OTHER THAN JOINT WITH | Radiology | 3,731.00 |
610 | 73720 | MRI-LOWER EXT OTHER THAN JOINT COMBO | Radiology | 3,677.00 |
610 | 73721 | MRI-JOINT LOW EXTREM W/O | Radiology | 2,569.00 |
610 | 73722 | MRI-JOINT LOWER EXT WITH | Radiology | 3,006.00 |
610 | 73723 | MRI-JOINT LOWER EXT COMBO | Radiology | 3,537.00 |
610 | 73725 | MRA-LOWER EXT W/ OR W/O | Radiology | 2,137.00 |
320 | 74000 | K.U.B. X RAY | Radiology | 301.00 |
320 | 74018 | KUB RAD EXAM ABD 1 VIEW | Radiology | 307.00 |
320 | 74019 | ABD 2 VIEWS | Radiology | 399.00 |
320 | 74022 | ABDOMEN ACUTE SERIES | Radiology | 453.00 |
352 | 74150 | CT ABDOMEN W/O | Radiology | 1,540.00 |
352 | 74160 | CT ABDOMEN W | Radiology | 2,004.00 |
352 | 74170 | CT ABDOMEN COMBO | Radiology | 2,196.00 |
352 | 74176 | CT ABDMN & PLVS WITHOUT | Radiology | 2,948.00 |
352 | 74177 | CT ABDMN & PLVS WITH | Radiology | 3,835.00 |
352 | 74177 | CT ABDMN & PLVS WITH IV CONTRAST ONLY | Radiology | 3,835.00 |
352 | 74178 | CT ABDM & PLVS COMBO | Radiology | 4,324.00 |
610 | 74181 | MRI ABD W/O CONTRAST | Radiology | 2,630.00 |
610 | 74182 | MRI ABD WITH CONTRAST | Radiology | 3,360.00 |
610 | 74183 | MRI ABD COMBO | Radiology | 3,871.00 |
329 | 74185 | MRA ABD COMBO | Radiology | 3,269.00 |
320 | 74220 | ESOPHOGRAM | Radiology | 575.00 |
320 | 74235 | ESOPH FB REMOVAL | Radiology | 436.00 |
320 | 74240 | BARIUM SWALLOW | Radiology | 660.00 |
320 | 74246 | U.G.I. X RAY | Radiology | 707.00 |
320 | 74249 | U.G.I.X RAY SM. BOWEL | Radiology | 871.00 |
320 | 74250 | SMALL BOWEL X-RAY | Radiology | 774.00 |
320 | 74270 | BARIUM ENEMA SINGLE CONT | Radiology | 761.00 |
320 | 74280 | BARIUM ENEMA AIR CONTRAS | Radiology | 892.00 |
320 | 74283 | BE INTUSSUSCEP | Radiology | 365.00 |
320 | 74290 | OCG | Radiology | 213.00 |
320 | 74290 | OCG WITH KENIVAC INJECTI | Radiology | 387.00 |
320 | 74291 | ODG ADDITIONAL SET | Radiology | 144.00 |
320 | 74300 | CHOLANGIOGRAM X-RAY | Radiology | 737.00 |
320 | 74301 | CHOLANGIOGRAM ADD. SET | Radiology | 101.00 |
320 | 74305 | CHOLANGIOGRAM POST OP | Radiology | 676.00 |
320 | 74320 | CHOLANGIOGRAM PERC | Radiology | 729.00 |
320 | 74340 | INTRO FEEDING TUBE | Radiology | 738.00 |
320 | 74400 | IVP ROUTINE | Radiology | 958.00 |
320 | 74420 | RETROGRADE URETEROGRAM | Radiology | 909.00 |
320 | 74425 | UROGRAPHY ANTEGRADE | Radiology | 959.00 |
320 | 74430 | CYSTOGRAM | Radiology | 1,078.00 |
320 | 74450 | RETROGRADE URETHROGRAM | Radiology | 908.00 |
320 | 74455 | VOIDING CYSTOGRAM | Radiology | 966.00 |
320 | 74475 | NEPHROSTOMY PERCUTANEOUS | Radiology | 2,166.00 |
320 | 74710 | PELVIMETRY | Radiology | 187.00 |
320 | 74740 | HYSTEROSALPINGOGRAM | Radiology | 859.00 |
352 | 75571 | COMPUTED TOMOGRAPHY, HEART W/O CON QUANT | Radiology | 1,249.00 |
359 | 75574 | CTA HRT CORNRY ART/BYPASS GRFTS W/3-D | Radiology | 1,182.00 |
359 | 75635 | CT ANGIOGRAPHY ABD AORTA AND BILATERAL | Radiology | 3,311.00 |
320 | 75820 | VENOGRAM UNILATERAL | Radiology | 470.00 |
320 | 75822 | VENOGRAM BILATERAL | Radiology | 700.00 |
320 | 75989 | ABSCESS DRAINAGE | Radiology | 870.00 |
320 | 76000 | FLUOROSCOPY UP TO 1 HR | Radiology | 939.00 |
320 | 76001 | FLUORO-REMOVAL FOREIGN B | Radiology | 780.00 |
320 | 76010 | FOREIGN BODY CHILD | Radiology | 161.00 |
320 | 76080 | FISTULOGRAM | Radiology | 436.00 |
320 | 76098 | MAMMOGRAPHY SURG. SPEC. | Radiology | 491.00 |
621 | 76140 | CONSULTATION READINGS | Radiology | 65.00 |
350 | 76377 | 3D RENDERING POST PROCESSING SEP WS | Radiology | 892.00 |
320 | 76499 | XTRA VIEW X-RAY | Radiology | 83.00 |
402 | 76506 | ULTRASOUND HEAD | Radiology | 410.00 |
402 | 76536 | ULTRASOUND HEAD & NECK | Radiology | 611.00 |
402 | 76604 | ULTRASOUND CHEST | Radiology | 455.00 |
402 | 76641 | ULTRASOUND BREAST | Radiology | 479.00 |
402 | 76642 | US BREAST, UNI, REAL TIME, DOC LIMITED | Radiology | 356.00 |
402 | 76700 | ULTRASOUND ABD COMPLETE | Radiology | 851.00 |
402 | 76700 | ULTRASOUND GALLBLADDER | Radiology | 851.00 |
402 | 76705 | ULTRASOUND ABD/APPEND LTD. | Radiology | 561.00 |
402 | 76705 | ULTRA SOUND APPENDIX | Radiology | 561.00 |
402 | 76706 | ULTASOUND, ABDMNL AORTA, SCREENING | Radiology | 398.00 |
402 | 76770 | ULTRASOUND RENAL | Radiology | 829.00 |
402 | 76775 | ULTRASOUND AORTA | Radiology | 617.00 |
402 | 76800 | ULTRASOUND SPINAL CANAL & CONTENTS | Radiology | 563.00 |
402 | 76801 | ULTRASOUND OB < 14 WEEKS | Radiology | 555.00 |
402 | 76802 | ULTRASOUND EACH ADD GEST < 14 WEEKS | Radiology | 328.00 |
402 | 76805 | ULTRASOUND OB > 14 WEEKS | Radiology | 668.00 |
400 | 76805 | ULTRASOUND EX OB BY PHYS | Radiology | 668.00 |
402 | 76810 | ULTRASOUND OB >14 WEEKS ADD GEST | Radiology | 453.00 |
402 | 76811 | ULTRASOUND OB COMP FETAL ANATOMY | Radiology | 856.00 |
402 | 76812 | ULTRASOUND EACH ADD GEST FETAL ANATOMY | Radiology | 278.00 |
402 | 76815 | ULTRASOUND OB LTD.CHECK POSITION/AFI | Radiology | 537.00 |
402 | 76816 | ULTRASOUND OB LMT FUFETAL SURVEY | Radiology | 456.00 |
402 | 76817 | ULTRASDOUND TRANS VAG OB | Radiology | 554.00 |
402 | 76818 | ULTRASOUND BIO PROFILE W/NON-STRESS TEST | Radiology | 517.00 |
402 | 76819 | ULTRASOUND BIO PROFILE W/O STRESS | Radiology | 485.00 |
402 | 76830 | ULTRASOUND TRANS VAGINAL NON OB | Radiology | 581.00 |
402 | 76856 | ULTRASOUND PELVIS | Radiology | 598.00 |
402 | 76857 | ULTRASOUND PELVIS LTD. | Radiology | 398.00 |
402 | 76870 | ULTRASOUND SCROTAL | Radiology | 654.00 |
402 | 76872 | ULTRASOUND PROSTATE | Radiology | 525.00 |
402 | 76872 | ULTRASOUND PROSTATE BIOP | Radiology | 370.00 |
402 | 76881 | ULTRASOUND EXTREMITY | Radiology | 582.00 |
402 | 76881 | US, EXT, NON VASC, REAL TIME W/IMG DOC | Radiology | 559.00 |
402 | 76882 | US EXT NON VASC, REALTIME W/IMG LMTD SPF | Radiology | 430.00 |
402 | 76937 | US GUID FOR VAS ACCESS REQ US EVAL OF AC | Radiology | 213.00 |
402 | 76942 | ULTRASOUND NDL BX | Radiology | 641.00 |
402 | 76942 | ULTRASOUND CYST ASPIRATI | Radiology | 641.00 |
402 | 76942 | ULTRASOUND THORAC/PARAC | Radiology | 641.00 |
402 | 76942 | ULTRASOUND NDL BIOP | Radiology | 641.00 |
402 | 76946 | ULTRASOUND AMNIOCENTESIS | Radiology | 785.00 |
402 | 76970 | ULTRASOUND FOLLOW UP | Radiology | 189.00 |
402 | 76970 | ULTRASOUND ECHO LIMITED | Radiology | 141.00 |
402 | 76999 | ULTRASOUND HIPS | Radiology | 247.00 |
400 | 76999 | ULTRASOUND UNLISTED PROCEDURE | Radiology | 391.00 |
320 | 77001 | FLOUROSCOPIC GUIDE FOR CENTRAL VENOUS AC | Radiology | 968.00 |
320 | 77001 | FLOURA GUIDE CENTRAL LINE | Radiology | 968.00 |
320 | 77002 | FLUOROSCOPY; GUIDE OF NEEDLE | Radiology | 480.00 |
320 | 77002 | FLOUROSCOPIC GUIDE OF NEEDLE PLACEMENT | Radiology | 481.00 |
320 | 77003 | FLOURA GUID NEEDLE CATH SPINE | Radiology | 637.00 |
352 | 77012 | CT GUIDED NID BX | Radiology | 1,334.00 |
401 | 77051 | CAD DIAGNOSTIC MAMMOGRAPHY | Radiology | 107.00 |
403 | 77052 | CAD SCREENING MAMMOGRAPHY | Radiology | 144.00 |
320 | 77053 | MAMO DUCTOGRAM | Radiology | 500.00 |
401 | 77056 | MAMMOGRAPHY BILATERAL | Radiology | 391.00 |
403 | 77057 | MAMMOGRAPHY W/IMPLANTS SCREENING | Radiology | 336.00 |
401 | 77065 | MAMMOGRPAHY ADD. VIEWS | Radiology | 347.00 |
401 | 77065 | MAMMOGRAPHY UNILATERAL | Radiology | 300.00 |
401 | 77065 | DX MAMMOGRAPHY I.E. CAD; UNILATERAL | Radiology | 346.00 |
401 | 77066 | MAMMOGRAPHY, BILATERAL | Radiology | 438.00 |
403 | 77067 | SCREENING MAMMOGRAPHY, BILTRL 2-VIEW/CAD | Radiology | 355.00 |
320 | 77072 | BONE AGE X RAY | Radiology | 241.00 |
320 | 77072 | BONE AGE SURVEY | Radiology | 241.00 |
320 | 77074 | METASTATIC BONE SURVEY | Radiology | 519.00 |
320 | 77075 | BONE STUDY COMPLETE ADULT | Radiology | 636.00 |
320 | 77075 | BONE SURVEY | Radiology | 600.00 |
320 | 77076 | INFANT BONE SURVEY | Radiology | 294.00 |
350 | 77078 | CT BONE SCAN | Radiology | 729.00 |
320 | 77080 | DXA BONE DNSTY STUDY 1/> SITES AXIAL SKE | Radiology | 504.00 |
320 | 77081 | HEEL BONE DENSITY | Radiology | 336.00 |
320 | 77085 | DXA BN DNSTY W/ VERTEBRAL FX ASSESSMENT | Radiology | 660.00 |
340 | 78306 | NUC MED BONE SCAN | Radiology | 886.00 |
340 | 78580 | PULMONARY FERFUSION SCAN | Radiology | 856.00 |
340 | 78587 | NUC MED PUL VENT SCAN | Radiology | 721.00 |
402 | 93307 | ULTRASOUND CardiopulmonaryIAC | Radiology | 813.00 |
483 | 93307 | ECHOCardiopulmonaryIOGRAPHY (2D) | Radiology | 982.00 |
483 | 93308 | ECHOCardiopulmonaryIOGRAPHY LIMITED STUDY | Radiology | 615.00 |
480 | 93320 | ECHOCardiopulmonaryIOGRAPHY DOPPLER | Radiology | 655.00 |
480 | 93325 | ECHOCardiopulmonaryIOGR COLOR DOPP | Radiology | 655.00 |
921 | 93880 | ULTRASOUND CAROTID | Radiology | 829.00 |
921 | 93925 | ULTRASOUND ARTERIAL DOP. | Radiology | 539.00 |
402 | 93931 | US ARTERIAL UPPER EXT LTD | Radiology | 499.00 |
921 | 93970 | ULTRASOUND VENOUS-BILAT | Radiology | 847.00 |
921 | 93971 | ULTRASOUND VENOUS-UNILAT | Radiology | 643.00 |
921 | 93971 | ULTRASOUND VENOUS | Radiology | 643.00 |
929 | 93976 | DUPLEX SCAN-LIMITED STUDY | Radiology | 539.00 |
402 | 99050 | ULTRASOUND CALL BACK | Radiology | 184.00 |
255 | A9579 | CONTRAST PROHANCE | Radiology | 212.00 |
636 | Q9967 | CONTRAST ISOVUE 300G399 MG/ML | Radiology | 131.00 |
320 | RADIOLOGY | Radiology | 3.00 | |
403 | RESP SCREEN CHEST 2 VIEWS | Radiology | 73.00 | |
621 | STERILE PROBE COVER NON-LATEX DISP | Radiology | 56.00 | |
621 | FLUID ADMINISTRATION SET | Radiology | 44.00 | |
621 | HSG CATHETER 5fr | Radiology | 84.00 | |
621 | TRUGUIDE 13g 5 1/2" NEEDLE | Radiology | 113.00 | |
279 | AQUASONIC TRANSMISSION MEDIA HIGH VISC | Radiology | 20.00 | |
621 | STERI-DRAPE 15"X15" | Radiology | 21.00 | |
621 | CORMARK 14g NEEDLE BIOPSY | Radiology | 237.00 | |
621 | DUCTOGRAM CANNULA | Radiology | 103.00 | |
621 | DISP TRANSDUCER COVER NON-LATEX | Radiology | 21.00 | |
621 | BARD POWER LOC 20GX0.75" | Radiology | 81.00 | |
621 | 10 FR LOCKING PIGTAIL | Radiology | 192.00 | |
621 | INTRODUCING CATH 30CM | Radiology | 192.00 | |
621 | TRUGUIDE 19G X 13.8CM | Radiology | 79.00 | |
400 | ADD ON FOR DIGITAL R2 READING | Radiology | 27.00 | |
621 | PARA/THORACENTESIS PREP KIT | Radiology | 100.00 | |
270 | PARA/THORACENTESIS KIT | Radiology | 153.00 | |
621 | STERILE CONTRAST KIT | Radiology | 112.00 | |
621 | IVP START KIT | Radiology | 50.00 | |
621 | VCUG KIT | Radiology | 104.00 | |
621 | ULTRASOUND PROBE COVER | Radiology | 59.00 | |
329 | DIAGNOSTIC INJECTION | Radiology | 87.00 | |
320 | GASTROGRAPHIN | Radiology | 69.00 | |
320 | LUNG SCAN | Radiology | 1,651.00 | |
320 | UNIV OF UT X-RAY CHARGES | Radiology | 3.00 | |
320 | UTAH VALLEY X-RAY CHRGS | Radiology | 3.00 | |
320 | PORTABLE X-RAY SERVICE | Radiology | 124.00 | |
621 | HYSTOSALPINGOGRAM TRAY | Radiology | 79.00 | |
621 | PREP KIT (drape, chlorap, 25g3.5" need) | Radiology | 77.00 | |
255 | CONTRAST EOVIST | Radiology | 621.00 | |
621 | ARTHROGRAM TRAY DISP | Radiology | 79.00 | |
621 | X-RAY DUPLICATE PROCESS | Radiology | 15.00 | |
621 | ULTRASOUND PROCEDUR TRAY | Radiology | 87.00 | |
259 | LESION LOCALIZATION NEED | Radiology | 119.00 | |
621 | CYSTOGRAPHIN | Radiology | 62.00 | |
272 | MIDLINE 4FR SINGLE LUMEN | Radiology | 562.00 | |
270 | WING GUARD PICC SECUREMENT DEVICE | Radiology | 65.00 | |
272 | PICC CATH TRAY 5 FR POWER | Radiology | 1,146.00 | |
270 | BIO-PATCH DISC 4 MM | Radiology | 66.00 | |
270 | CVC PACK | Radiology | 193.00 | |
272 | MIDLINE 4FR DUAL LUMEN | Radiology | 671.00 | |
255 | CONTRAST ISOVUE-M | Radiology | 86.00 | |
710 | RECOVERY ROOM | Recovery Room | 257.00 | |
710 | RECOVERY ROOM .75 HR | Recovery Room | 469.00 | |
710 | RECOVERY ROOM 1 HR | Recovery Room | 622.00 | |
710 | RECOVERY ROOM 1.25 HR | Recovery Room | 777.00 | |
710 | RECOVERY ROOM 1.5 HR | Recovery Room | 933.00 | |
710 | RECOVERY ROOM 1.75 HR | Recovery Room | 1,084.00 | |
710 | RECOVERY ROOM 2 HRS | Recovery Room | 1,238.00 | |
710 | RECOVERY ROOM 30 MIN. | Recovery Room | 312.00 | |
250 | MISC. MED | Recovery Room | 3.00 | |
250 | 58300 | Paragard IUD | Pharmacy | 970.20 |
250 | 90371 | Hepatitis B-IG | Pharmacy | 339.75 |
250 | 90375 | Rabies Immune Globulin 1500iu vial | Pharmacy | 14,714.50 |
250 | 90376 | Rabies Immune Globulin 2ml | Pharmacy | 2,974.00 |
636 | 90632 | HEP A VACCINE ADULT IM | Pharmacy | 128.25 |
636 | 90633 | MRC-HEPATITIS A VACCINE PEDS/ADOLESCENT | Pharmacy | 122.25 |
636 | 90636 | HEP A & B | Pharmacy | 275.00 |
636 | 90636 | HEP A & B (Clinic) | Pharmacy | 193.50 |
636 | 90647 | HIB - PEDVAXHIB | Pharmacy | 100.50 |
636 | 90648 | DPT / HIB 4 DOSE | Pharmacy | 98.86 |
636 | 90649 | HPV VACCINE | Pharmacy | 786.25 |
636 | 90651 | Gardasil Vaccine | Pharmacy | 1,317.50 |
636 | 90651 | Gardisil 9 IM Vaccine | Pharmacy | 1,685.50 |
636 | 90651 | GARDASIL 9 | Pharmacy | 310.00 |
636 | 90656 | FLUZONE MDV PB 5ML/VL VIAL | Pharmacy | 30.00 |
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 | - |
250 | J7626 | Budesonide 0.25/2ml amp | Pharmacy | 20.00 |
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 | |
250 | Calcium Carbonate 500mg tablets | Pharmacy | 1.05 | |
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 | |
250 | Tears Natural Ophthalmic Solution | Pharmacy | 1.05 | |
250 | Refresh Plus Lubricant Eye Drops | Pharmacy | 3.00 | |
250 | Calcium Chloride 10% IMS Prefilled Syr | Pharmacy | 61.75 | |
250 | Asa/Dipyridamole 200/25mg capsules | Pharmacy | 39.50 | |
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 | |
250 | Captopril 12.5mg tablets | Pharmacy | 15.21 | |
250 | Captopril 25mg tablets | Pharmacy | 15.21 | |
250 | Carbamazepine 200mg tablets | Pharmacy | 15.21 | |
250 | Carbidopa/Levodopa 10/100mg tablets | Pharmacy | 15.21 | |
250 | Carbidopa/Levodopa 25/100mg tablets | Pharmacy | 15.21 | |
250 | Carbidopa/Levodopa 25/250mg tablets | Pharmacy | 15.21 | |
250 | Carisoprodol 350mg tablets | Pharmacy | 19.57 | |
250 | Carvedilol 3.125mg tablets | Pharmacy | 15.21 | |
250 | Carvedilol 6.25mg tablets | Pharmacy | 15.21 | |
250 | Carvedilol 12.5mg tablets | Pharmacy | 15.21 | |
250 | Cefuroxime 250mg tablets | Pharmacy | 19.50 | |
250 | Cefuroxime 250mg/5ml Susp. | Pharmacy | 970.00 | |
250 | Celecoxib 100mg capsules | Pharmacy | 15.21 | |
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 | |
250 | Cholestyramine 4Gm Powder Packets | Pharmacy | 16.25 | |
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 | |
250 | Colchicine 0.6mg tablets | Pharmacy | 24.25 | |
250 | Conj. Estrogen 0.625mg tablets | Pharmacy | 15.21 | |
250 | Cyclobenzaprine 5mg tablets | Pharmacy | 15.21 | |
250 | Cyclobenzaprine 10mg tablets | Pharmacy | 15.21 | |
250 | Divalproex 125mg tablets | Pharmacy | 14.00 | |
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 | |
250 | Donepezil 5mg tablets | Pharmacy | 30.75 | |
250 | Doxazosin 1mg tablets | Pharmacy | 15.21 | |
250 | Doxazosin 2mg tablets | Pharmacy | 15.21 | |
250 | Doxycycline 50mg capsules | Pharmacy | 15.21 | |
250 | Doxycycline 100mg tab | Pharmacy | 19.00 | |
250 | Duloxetine 30mg capsules | Pharmacy | 36.75 | |
250 | Enalapril 5mg tablets | Pharmacy | 15.21 | |
250 | Enalapril 10mg tablets | Pharmacy | 15.21 | |
250 | Erythromycin 250mg tablets | Pharmacy | 15.21 | |
250 | Escitalopram 10mg tablets | Pharmacy | 19.25 | |
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 | |
250 | Gabapentin 100mg capsules | Pharmacy | 15.21 | |
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 | |
250 | Imipramine 10mg tablets | Pharmacy | 14.00 | |
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 | |
250 | Levothyroxine 50mcg tablets | Pharmacy | 15.21 | |
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 | |
250 | Losartan 25mg tablets | Pharmacy | 15.21 | |
250 | Losartan 100mg tablets | Pharmacy | 15.25 | |
250 | Meclizine 25mg tablets | Pharmacy | 15.21 | |
250 | Meloxicam 7.5mg tablets | Pharmacy | 15.50 | |
250 | Memantine (Namenda) 10mg tablets | Pharmacy | 34.50 | |
250 | Metformin ER 500mg tablets | Pharmacy | 15.21 | |
250 | Mineral Oil Sterile | Pharmacy | 52.05 | |
250 | Metformin 500mg tabs | Pharmacy | 15.21 | |
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 | |
250 | Raloxifene 60mg tabs | Pharmacy | 31.25 | |
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 | |
250 | Risedronate 35mg tabs | Pharmacy | 114.00 | |
250 | Risperidone 0.25mg tabs | Pharmacy | 18.00 | |
250 | Risperidone 0.5mg tabs | Pharmacy | 41.75 | |
250 | Risperidone 1mg tabs | Pharmacy | 20.00 | |
250 | Rosiglitazone 2mg tabs | Pharmacy | 15.50 | |
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 | |
250 | Warfarin 1mg tabs | Pharmacy | 15.21 | |
250 | Solifenacin 5mg tabs | Pharmacy | 50.25 | |
250 | Spironolactone 25mg tabs | Pharmacy | 15.21 | |
250 | Spironolactone 50mg tabs | Pharmacy | 15.21 | |
250 | Sotalol 80mg tabs | Pharmacy | 15.21 | |
250 | Sulfasalazine 500mg tabs | Pharmacy | 15.21 | |
250 | Tamsulosin 0.4mg caps | Pharmacy | 19.00 | |
250 | Terazosin 2mg caps | Pharmacy | 15.21 | |
250 | Terbutaline 5mg tabs | Pharmacy | 27.00 | |
250 | Thyroid 60mg tabs | Pharmacy | 15.21 | |
250 | Tizanidine 4mg tabs | Pharmacy | 15.21 | |
250 | Tolterodine LA 4mg caps | Pharmacy | 53.25 | |
250 | Torsemide 20mg tabs | Pharmacy | 15.21 | |
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 | |
250 | Fluticasone HFA 110mcg 12Gm | Pharmacy | 955.00 | |
250 | Ipratropium ud | Pharmacy | 122.50 | |
250 | Racemic Epinephrine ud | Pharmacy | 0.01 | |
250 | Tiotropium MDI | Pharmacy | 63.50 | |
250 | Apap 120mg Suppository | Pharmacy | 1.05 | |
250 | Apap 650mg Suppository | Pharmacy | 1.05 | |
250 | Glycerin Suppository (Adult) | Pharmacy | 1.05 | |
250 | Proctofoam-HC | Pharmacy | 425.00 | |
250 | Hydrocortisone 1% Cream | Pharmacy | 52.05 | |
250 | Proctosol-HC 2.5% | Pharmacy | 316.00 | |
250 | Hydrocortisone 25mg Suppository | Pharmacy | 79.75 | |
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 | |
250 | Cyclopentolate Ophth. Sol. | Pharmacy | 146.50 | |
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 | |
250 | Tiotropium caps | Pharmacy | 67.25 | |
250 | Metamucil Powder | Pharmacy | 1.05 | |
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 | |
250 | Vitamin C 500mg tabs | Pharmacy | 1.05 | |
250 | Vitamin B Complex caps | Pharmacy | 1.05 | |
250 | Vitamin D 400iu caps | Pharmacy | 15.21 | |
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 | |
250 | Nystatin Suspension | Pharmacy | 15.21 | |
250 | Phenytoin 125mg/5ml Suspension | Pharmacy | 15.21 | |
250 | SPS 15Gm/60ml Suspension | Pharmacy | 42.25 | |
250 | Bicitra Oral Liquid per 15ml | Pharmacy | 1.00 | |
250 | Sucralfate 1Gm Suspension | Pharmacy | 38.25 | |
250 | Simethicone Oral Drops | Pharmacy | 52.05 | |
250 | Alprazolam 0.25mg tabs | Pharmacy | 19.57 | |
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 | |
250 | Diazepam 5mg tabs | Pharmacy | 19.57 | |
250 | Diphenoxylate/Atropine (Lomotil) tabs | Pharmacy | 19.57 | |
250 | Hydrocod/Apap 5/500mg tabs | Pharmacy | 17.05 | |
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 |