Current Price List | Moab Regional Hospital

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.

Current Price List.xls

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

PLEASE NOTE: ER access is through Main Entrance at front of hospital for next several months, due to construction.