Chg Code	Description	UB Cd	CPT4 Cd	Price
LABORATORY
5085028	CBC W/DIFFERENTIAL	305	85025	$     112.65
5080937	COMPREH.METABOLIC PANEL	300	80053	$     183.80
5086415	COLLECTION,VENIPUNCTURE	300	36415	$      38.15
5082948	GLUCOSE, DEXTROSTIX	300	82962	$      65.55
5083480	TSH	300	84443	$     146.00
5080061	LIPID PANEL	300	80061	$     146.65
5080936	BASIC METABOLIC PANEL	300	80048	$     147.50
5085732	HEMOGLOBIN A1C	300	83036	$      92.25
5085610	PROTHROMBIN TIME	305	85610	$      81.95
5084439	T4, FREE	300	84439	$     148.80
5083740	MAGNESIUM	300	83735	$      91.30
5087348	CULTURE, UR. W/COLONY CT	306	87088	$     111.80
5081319	COLL, VENIPUNCTURE (FMP)	300	36415	$      38.15
5085015	HEMOGRAM	305	85027	$      92.65
5080803	SENSITIVITY, MIC	306	87186	$     139.85
5081000	URINALYSIS & MICROSCOPY	307	81001	$      78.30
5088199	LVLIV SUR.PATH,GR & MICR	312	88305	$     276.30
5080824	IDENTIFICATION, URINE	306	87077	$     108.05
5081792	C-REACTIVE PROTEIN	300	86140	$     120.70
5081005	URINALYSIS, CHEMICAL ONLY	307	81003	$      51.75
5080211	TROPONIN I	300	84484	$     338.90
5085650	SEDIMENTATION RATE - ESR	305	85652	$      63.40
5080474	COLL.VENIPUNCTURE (CSL)	300	36415	$      38.15
5083928	25-HYDROXYVITAMIN D.TOTAL	300	82306	$     235.40
5080923	PSA	300	84153	$     168.05
5081742	VITAMIN B12	300	82607	$     171.95
5087330	CULTURE, BLOOD	306	87040	$     260.25
5085730	PTT, PARTIAL THROMBO TIME	305	85730	$     103.55
5089997	MISC. LAB/INFO. SYS USE	300		$           -
5083690	LIPASE	300	83690	$     168.75
5081383	COLLECTION, VENIPUNCTURE	300	36415	$      38.15
5085514	COLL, VENIPUNCTURE	300	36415	$      38.15
5081062	GC AMPLIFIED	306	87591	$     200.85
5081061	CHLAMYDIA AMPLIFIED	306	87491	$     200.85
5084555	URIC ACID	300	84550	$      58.50
5083545	IRON	300	83540	$      84.05
5080783	FERRITIN	300	82728	$     120.35
5082007	MICROALBUMIN, RANDOM URIN	300	82043	$     136.75
5083719	T3,FREE	301	84481	$     132.15
5083605	LACTIC ACID	300	83605	$     404.55
5083550	IRON BINDING	300	83550	$     100.25
5085487	25-OH VITAMIN D2&D3	300	82306	$      77.00
5080830	IDENTIFICATION, MANUAL	306	87077	$     108.05
5086100	BLOOD TYPE, RH	302	86901	$      66.95
5080939	RENAL FUNCTION PANEL	300	80069	$     200.25
5086080	BLOOD TYPE, ABO GROUP	302	86900	$      65.45
5082550	CPK	300	82550	$     109.80
5088142	THIN LAYER PAP, IMAGED	923	88175	$     172.65
5086020	ANTIBODY SCREEN	302	86850	$     141.80
5085471	PERTUSSIS,AMPLIFIED PROBE	306	87798	$     118.95
5082565	CREATININE	300	82565	$      70.10
5082622	NT PRO-BRAIN NAT.PEPTIDE	301	83880	$     642.90
5080825	IDENTIFICATION, BACTERIA	306	87077	$     108.05
5081345	COLLECTION, VENIPUNCTURE	300	36415	$      38.15
5085470	RESP.VIRUS 12-25 TARGETS	306	87633	$     674.45
5085472	CHLAM.PNEUM.AMP.PROBE	306	87486	$     118.95
5085473	MYCO.PNEUM.AMP.PROBE	306	87581	$     118.95
5085481	HPV HIGH RISK (THIN PREP)	306	87624	$      74.60
5080911	COMPATIBILITY, IMMED.SPIN	302	86920	$     235.35
5088201	IMMUNOHISTOCHEMISTRY	312	88342	$     212.85
5081733	HEPATITIS C ANTIBODY	302	86803	$     165.80
5081432	COLLECTION, VENIPUNTURE	300	36415	$      38.15
5081480	COLLECTION, VENIPUNCTURE	300	36415	$      38.15
5085700	PSA	300	84153	$     168.05
5088128	CYTOPATH,THIN LAYER PAP S	923	88142	$     118.70
5082891	BLOOD GASES	300	82803	$     270.15
5083717	HIV1/HIV2 ANTIBODIES	301	86703	$     110.80
5087346	CULTURE, THROAT	306	87070	$     143.35
5088220	IHC,EACH ADDITIONAL STAIN	312	88341	$     212.85
5084520	BUN (BLOOD UREA NITROGEN)	300	84520	$      61.40
5081743	FOLATE	300	82746	$     149.70
5080938	HEPATIC FUNCTION PANEL	300	80076	$     136.55
5083160	PREGNANCY TEST, URINE	307	81025	$     112.75
5084757	PARATHYROID HORMONE	301	83970	$     129.95
5081794	HEPATITIS B SURFACE ABS.	300	86706	$     140.80
5081315	HEMOGLOBIN A1C (FMP)	300	83036	$      99.00
5082150	AMYLASE	300	82150	$     130.95
5085569	TESTOSTERONE, TOTAL	300	84403	$      32.80
5085568	TESTOSTERONE, FREE	300	84402	$      32.35
5085613	PROCALCITONIN	300	84145	$      93.50
5084393	D-DIMER, QUANTITATIVE	305	85379	$     143.40
5087351	CULTURE, WOUND (NONSURG)	306	87070	$     143.35
5086001	HEPATITIS B SURF. ANTIGEN	306	87340	$     108.75
5084100	PHOSPHORUS	300	84100	$      69.30
5082251	BILIRUBIN/NEONATAL, TOTAL	300	82247	$      91.75
5084330	GLUCOSE	300	82947	$      63.25
5085506	CBC W/DIFFERENTIAL	305	85025	$      64.65
5081310	PROTIME, FINGERSTICK (FMP	300	85610	$      60.40
5082570	CREATININE, RANDOM URINE	300	82570	$      89.35
5087385	CULTURE, URICULT	300	87084	$      85.55
5082056	ALCOHOL	300	80320	$     152.30
5083455	T4, TOTAL	300	84436	$      97.05
5080257	ELECTROLYTE PANEL	300	80051	$     100.30
5086185	PROCESSING,RBC,LKR,EACH	390	P9016	$     624.55
5081793	RHEUMATOID FACTOR	300	86431	$      83.25
5086405	RPR, QUALITATIVE	302	86592	$      68.70
5082632	ANTINUCLEAR ANTIBODIES	300	86038	$     156.70
5081478	PROTIME,FINGERSTICK(IDA)	300	85610	$      79.50
5082227	PROTEIN, RANDOM URINE	300	84156	$      94.95
5085017	HEMOGLOBIN	305	85018	$      53.35
5085562	GI PATHOGENS 12-25 TARGET	306	87507	$     660.00
5085510	UA, CHEMICAL ONLY	305	81003	$      51.75
5082997	HCG QUANTITATIVE	300	84702	$     201.75
5088193	LVLV SUR.PATH,GR & MICR	312	88307	$     387.45
5087359	CULT.SETUP URN ORG.ID ONL	306	87088	$      91.20
5081317	SEDIMENTATION RATE, (FMP)	300	85652	$      63.40
5082626	T3, TOTAL SERUM	300	84480	$     141.55
5083016	TESTOSTERONE, TOTAL	301	84403	$      54.00
5081746	FOLLICLE STIMULATING HORM	300	83001	$     154.60
5084001	QUANTIFERON-TB GOLD	300	86480	$     297.50
5085532	INFLUENZA ANTIGEN A	306	87400	$     197.05
5085533	INFLUENZA ANTIGEN B	306	87400	$     197.05
5086267	VARICELLA ZOSTER, IGG	302	86787	$     159.85
5080076	ABUSED DRUGS PROFILE I	309	80307	$     541.00
5087389	CULTURE, MRSA SCREEN ONLY	306	87081	$     103.85
5085998	RUBELLA	302	86762	$     121.90
5080940	ACUTE HEPATITIS PANEL	300	80074	$     383.40
5084450	AST (SGOT)	300	84450	$      69.20
5083769	CANDIDA, PROBE	306	87480	$      86.25
5083770	G.VAGINALIS PROBE	306	87510	$      86.25
5083771	T.VAGINALIS PROBE	306	87660	$      86.25
5088239	MUMPS IGG ANTIBODY	302	86735	$     143.05
5087010	GRAM STAIN SMEAR	306	87205	$      95.80
5085509	STREP, GROUP A RAPID	306	87430	$     120.25
5082624	RUBEOLA ANTIBODIES, IGG	302	86765	$     126.40
5084460	ALT (SGPT)	300	84460	$      68.00
5081381	GLYCOHEMOGLOBIN	301	83036	$      99.00
5085235	PROTEIN ELECTROPHORESIS	300	84165	$     105.40
5085020	HEMATOCRIT	305	85014	$      55.95
5087355	CULTURE,STREP SCR.GENITAL	306	87081	$     103.85
5082140	AMMONIA	300	82140	$     177.05
5082785	IgE IMMUNOGLOBULIN	300	82785	$     123.90
5082671	ESTRADIOL	300	82670	$     256.55
5088198	LVLIII SUR.PATH.GR & MICR	312	88304	$     215.40
5080026	VANCOMYCIN TROUGH	300	80202	$     193.40
5081745	PROLACTIN	300	84146	$     163.20
5085234	TOTAL PROTEIN	300	84155	$      36.05
5082531	NEWBORN ADRENAL HYPERPLAS	300	83498	$     110.15
5082094	NEWBORN BIOTINADASE	300	82261	$      57.75
5082530	NEWBORN CYSTIC FIBROSIS	300	83516	$     110.15
5082096	NEWBORN GAL-URIDYLTRANSFE	300	82776	$      57.75
5082095	NEWBORN GALACTOSE	300	82760	$      57.75
5082093	NEWBORN HEMOGLOBINOPATH	300	83020	$     110.15
5082097	NEWBORN MCAD	300	83789	$      72.20
5082092	NEWBORN PHENYLALANINE	300	83789	$      72.20
5085349	NEWBORN SCID	300	81479	$     110.15
5082091	NEWBORN THYROXINE	300	84437	$      57.75
5085551	FLOW CYTOMETRY ADD'L MRKR	300	88185	$     126.30
5081800	CEA (CARCINOEMBRYONIC AG)	301	82378	$     176.55
5085523	COMPLETE METABOLIC PANEL	301	80053	$      92.05
5082977	GAMMA GT	300	82977	$     100.40
5081430	COLLECTION, VENIPUNCTURE	300	36415	$      38.15
5085106	PLATELET COUNT	300	85049	$      79.90
5085501	TRICHOMONAS VAGINALIS	306	87661	$     118.45
5082003	ACETAMINOPHEN	300	80329	$     209.30
5081957	THYROID PEROXIDASE ANTIB.	300	86376	$     138.15
5087391	C.DIFFICILE TOXINS	306	87324	$     148.15
5082673	LEAD, BLOOD	300	83655	$     113.40
5081446	DSL URINALYSIS, CHEMICALS	300	81003	$      69.30
5084242	SALICYLATE	300	80329	$     136.00
5082356	PROFILE 162	300		$     525.25
5081744	CORTISOL	300	82533	$     186.20
5083615	LDH	300	83615	$      75.55
5083525	INSULIN	300	83525	$     102.35
5081747	LUTEINIZING HORMONE	300	83002	$     199.45
5087328	CULTURE, ANAEROBIC	306	87073	$     124.85
5087083	STREP, GROUP A RAPID	306	87430	$     132.35
5087367	CULTURE, STOOL EA ADD'L P	306	87046	$      46.15
5087370	CULTURE, STOOL	306	87045	$     142.65
5081473	UA, CHEMICAL ONLY (IDA)	300	81003	$      69.30
5086191	RBC,LEUKOREDUCED,EACH	390	P9016	$     624.55
5081811	TACROLIMUS	300	80197	$     352.40
5081300	CBC W/DIFFERENTIAL (FMP)	305	85025	$     112.65
5085340	EOSINOPHIL CATIONIC PRTN.	300	83520	$     319.00
5085624	INTERFERON GAMMA	300	83520	$      60.05
5085629	INTERLEUKIN 1 BETA	300	83520	$      60.05
5085627	INTERLEUKIN 10	300	83520	$      60.05
5085623	INTERLEUKIN 12	300	83520	$      60.05
5085628	INTERLEUKIN 13	300	83520	$      60.05
5085634	INTERLEUKIN 17	300	83520	$      60.05
5085633	INTERLEUKIN 2	300	83520	$      60.05
5085622	INTERLEUKIN 2 REC.SOLUBLE	300	83520	$      60.05
5085625	INTERLEUKIN 4	300	83520	$      60.05
5085626	INTERLEUKIN 5	300	83520	$      60.05
5085630	INTERLEUKIN 6	300	83520	$      60.05
5085631	INTERLEUKIN 8	300	83520	$      60.05
5085632	TUMOR NECROSIS FCTR.ALPHA	300	83520	$      60.05
5081778	PROGESTERONE	300	84144	$     157.10
5087394	SHIGA TOXIN 1	306	87427	$      77.55
5087395	SHIGA TOXIN 2	306	87427	$      77.55
5081380	CBC W/DIFFERENTIAL	305	85025	$     112.65
5083069	TISSUE TRANSGLUT.AB.IGA	300	83516	$     178.10
5084140	POTASSIUM	300	84132	$      66.50
5080834	OBSTETRIC PANEL W/HIV	300	80081	$     310.50
5085512	MONOSPOT	301	86308	$     100.25
5082511	CYCL.CITRULL.PEPT.IGG ABS	300	86200	$     194.80
5085414	STREP,GROUP A RAPID (CB)	306	87430	$     120.25
5084544	CD4/CD8 COUNT WITH RATIO	300	86360	$     166.45
5084543	T-CELLS, TOTAL COUNT	300	86359	$     142.15
5084295	SODIUM	300	84295	$      66.50
5087344	CULTURE, RESPIRATORY	306	87070	$     143.35
5086250	COOMBS TEST - DIRECT	302	86880	$     103.10
5081958	THYROGLOBULIN ANTIBODY	300	86800	$     136.85
5087400	INFLUENZA A ANTIGEN	306	87400	$     197.05
5087401	INFLUENZA B ANTIGEN	306	87400	$     197.05
5088140	CYTOPATH SMEAR, NONGYN	311	88112	$     188.50
5081449	INFLUENZA A ANTIGEN	306	87400	$     197.05
5081450	INFLUENZA B ANTIGEN	306	87400	$     197.05
5082687	OCCULT BLOOD	306	82270	$      51.70
5086300	MONOSPOT	302	86308	$     100.25
5081314	UA, CHEMICAL ONLY (FMP)	300	81003	$      51.75
5088200	SPECIAL STAIN, GROUP 2	312	88313	$     188.95
5082783	CELIAC DISEASE REFLEX PNL	300	82784	$     104.45
5087356	CULTURE,STREP SCR.THROAT	306	87081	$     103.85
5086422	SPECIAL ANTIGEN	302	86902	$     151.95
5082661	VALPROIC ACID	300	80164	$     207.10
5080815	T3, REVERSE, SERUM	300	84482	$     149.50
5081445	DSL RAPID STREP	300	87430	$     120.25
5083103	B-TYPE NATRIURETIC PEPTID	300	83880	$     428.35
5082083	HEALTH FAIR PANEL + HGM	300		$      47.95
5082677	TIS TRANSGLUTAMINASE IGA	300	83516	$     293.70
5082729	TISSUE TRANS.IGG ANTIBODY	300	83516	$     133.45
5085674	H.PYLORI C UREA BREATH TE	300	83013	$      79.00
5082996	PREGNANCY TEST, SERUM	300	84703	$     163.90
5080736	RETICULOCYTE COUNT	305	85045	$     106.75
5085805	MAYO T3,FREE	300	84481	$      67.75
5085209	14-3-3 ETA PROTEIN	300	83520	$     330.00
5081015	URINALYSIS, MICRO ONLY	307	81015	$      54.90
5082144	AMPHETAMINES,SCREEN	300	80307	$     108.20
5082667	BENZODIAZEPINES, URINE	300	80307	$     108.20
5082662	COCAINE, SCREEN	300	80307	$     108.20
5084408	MARIJUANA, URINE	300	80307	$     108.20
5082665	OPIATES, SCREEN	300	80307	$     108.20
5084995	PREALBUMIN	301	84134	$     133.30
5087352	CULTURE, WOUND (SURGICAL)	306	87070	$     143.35
5085420	INFLUENZA A ANTIGEN	306	87400	$     197.05
5082800	PH, CORD BLOOD	300	82800	$     126.80
5085421	INFLUENZA B ANTIGEN	306	87400	$     197.05
5087360	CULT.SETUP/BACTRIA ID ONL	306	87077	$      90.70
5083549	C1Q BINDING ASSAY	300	86332	$     388.10
5083548	RAJI CELL ASSAY	300	86332	$     388.10
5085588	ACINETOBACT.NUC.ACID.AMP	306	87150	$      67.40
5085598	CANDIDA ALB.NUC.ACID AMP.	306	87150	$      67.40
5085599	CANDIDA GLAB.NUC.ACID AMP	306	87150	$      67.40
5085600	CANDIDA KRUS.NUC.ACID AMP	306	87150	$      67.40
5085601	CANDIDA PARA.NUC.ACID AMP	306	87150	$      67.40
5085602	CANDIDA TROP.NUC.ACID AMP	306	87150	$      67.40
5085593	E.COLI NUCLEIC ACID AMP.	306	87150	$      67.40
5085592	ENTEROBACTER NUC.ACID.AMP	306	87150	$      67.40
5085582	ENTEROCOCCUS NUC.ACID.AMP	306	87150	$      67.40
5085589	H.INFLUENZAE NUC.ACID.AMP	306	87150	$      67.40
5085594	KLEBSIELLA NUC.ACID.AMP	306	87150	$      67.40
5085595	KLEBSIELLA PNEUM.NUC.ACID	306	87150	$      67.40
5085583	LISTERIA MONOCYT.NUC.ACID	306	87150	$      67.40
5085590	N.MENINGITID.NUC.ACID.AMP	306	87150	$      67.40
5085596	PROTEUS NUCLEIC ACID AMP.	306	87150	$      67.40
5085591	PSEUDOMONAS NUC.ACID.AMP	306	87150	$      67.40
5085597	SERRATIA NUCLEIC ACID.AMP	306	87150	$      67.40
5085584	STAPH.AUREUS NUC.ACID.AMP	306	87150	$      67.40
5085585	STREP.AGALAC.NUC.ACID.AMP	306	87150	$      67.40
5085587	STREP.PNEUMO.NUC.ACID.AMP	306	87150	$      67.40
5085586	STREP.PYOGEN.NUC.ACID.AMP	306	87150	$      67.40
5082010	B-HYDROXYBUTYRATE	300	82010	$     216.60
5081798	CA 125	301	86304	$     196.70
5083652	HIV-1 RNA QUANTIFICATION	300	87536	$     490.05
5085417	UA, CHEMICAL ONLY (CB)	305	81003	$      51.75
5080258	OBSTETRIC PANEL	300	80055	$     219.70
5082249	BILIRUBIN, DIRECT	300	82248	$      66.15
5087332	CULTURE, BODY FLUID	306	87070	$     143.35
5085375	FIBRINOGEN, QUANTITATIVE	305	85384	$     130.20
5083905	TESTOSTERONE, TOTAL,SERUM	300	84403	$     160.85
5084300	SODIUM, RANDOM URINE	300	84300	$      95.65
5084427	CONCENTRATE INFECT.AGENT	300	87177	$      76.65
5084428	SMEAR, PRIMARY SOURCE	300	87209	$     114.15
5081444	DSL PROTIME, FINGERSTICK	305	85610	$      79.50
5083930	OSMOLALITY, SERUM	300	83930	$     225.75
5081382	PROTIME, FINGERSTICK	305	85610	$      79.50
5083411	IMMUNOGLOBULIN A (IGA)	300	82784	$      79.70
5083410	IMMUNOGLOBULIN G (IGG)	300	82784	$      79.70
5083412	IMMUNOGLOBULIN M (IGM)	300	82784	$      79.70
5084465	ANTINUCLEAR ANTIBODIES	300	86038	$      33.00
5084463	COMPLEMENT C3	300	86160	$      30.80
5084464	COMPLEMENT C4	300	86160	$      30.80
5084466	DSDNA AUTOANTIBODIES	300	86225	$      37.70
5082724	HEPATITIS B CORE TOTAL AB	300	86704	$     172.10
5084467	NRNP/SM IGG AUTOANTIBODY	300	86235	$      19.30
5084462	RHEUMATOID FACTOR	300	86431	$      15.55
5084472	RIBOSOMAL P PROTEIN ABS.	300	86376	$      39.90
5084471	SCL-70 IGG AUTOANTIBODIES	300	86235	$      19.30
5084470	SMITH IGG AUTOANTIBODIES	300	86235	$      19.30
5084468	SS-A IGG AUTOANTIBODIES	300	86235	$      19.30
5084469	SS-B IGG AUTOANTIBODIES	300	86235	$      19.30
5084473	THYROID PEROXIDASE ABS.	300	83516	$      31.55
5087211	WET PREP, GENITAL ONLY	306	87210	$      67.40
5081492	INFLUENZA A ANTIGEN	306	87400	$     197.05
5081493	INFLUENZA B ANTIGEN	306	87400	$     197.05
5086329	TRANSFERRIN	300	84466	$     128.55
5081875	H.PYLORI ANTIGEN, STOOL	300	87338	$     276.45
5085453	BASIC METABOLIC PANEL	301	80048	$      67.75
5088197	LVLII SUR.PATH,GR & MICR	312	88302	$     168.20
5087341	CULTURE, GENITAL/COMPLETE	306	87070	$     143.35
5086243	ALPHA FETOPROTEIN,TUMOR	300	82105	$     133.45
5083821	FECAL WBC ANTIGEN	306	83630	$     138.65
5083725	LITHIUM	300	80178	$     127.95
5087327	CULTURE, ABCESS	306	87070	$     143.35
5082804	VENOUS BLOOD GASES	300	82803	$     270.15
5086209	CA 27.29	302	86300	$     200.10
5653324	LAB LT CHRGS ADJUST	98		$           -
5089190	EOSINOPHILS-NASAL SECRETI	310	89190	$      63.25
5085554	FLOW CYTO.INTRP.16+ MRKRS	300	88189	$     343.75
5080540	DIGOXIN LEVEL	300	80162	$     137.30
5082601	HCV RNA QUANTITATION	300	87522	$     538.80
5083256	HSV NON-SPECIFIC	300	86694	$     138.30
5083257	HSV TYPE 1	300	86695	$      72.05
5083258	HSV TYPE 2	300	86696	$      79.95
5084021	VANCOMYCIN, RANDOM	300	80202	$     193.40
5086665	EBV IGM AB, VIR.CAPSID AG	302	86665	$     119.55
5080477	ISTAT BMP	301	80047	$      77.50
5086664	EBV AB TO NUCLEAR AG, IGG	302	86664	$     115.95
5086274	EBV IGG AB VIR.CAPSID AG	302	86665	$     119.55
5086420	FR.FROZEN PLASMA PROCESS.	390	P9017	$     411.10
5082655	DILANTIN, TOTAL	300	80185	$     149.80
5082682	IGA IMMUNOGLOBULIN	300	82784	$     128.60
5081921	IMMUNOGLOBULIN G, SERUM	300	82784	$     104.45
5082310	CALCIUM	300	82310	$      81.40
5088190	SPECIAL STAIN, GROUP 1	312	88312	$     148.25
5088221	IHC,TUMOR,PER SPECIMEN	312	88360	$     266.05
5084632	VITAMIN B6	300	84207	$     169.20
5080913	CROSSMATCH, AHG TECHNIQUE	302	86922	$     563.65
5083935	OSMOLALITY, URINE	300	83935	$     225.75
5081443	DSL PREGNANCY TEST, URINE	300	81025	$     111.95
5085258	THIAMIN (VITAMIN B1),WB	300	84425	$     162.55
5083405	NEUTROPHIL SPECIFIC ABS.	300	86255	$     160.70
5083403	S.CEREVISIAE IGA ANTIBODY	300	86671	$     169.30
5083404	S.CEREVISIAE IGG ANTIBODY	300	86671	$     169.30
5082857	ZINC, SERUM	300	84630	$     125.50
5081912	STONE ANALYSIS	300	82365	$     167.30
5080449	CBC W/DIFFERENTIAL (CSL)	300	85025	$     112.65
5081440	DSL MONOSPOT	300	86308	$     100.25
5089051	CELL CT,W/DIFF, BODY FL.	310	89051	$     161.75
5083609	PSA, FREE	300	84154	$     105.80
5083608	PSA, TOTAL	300	84153	$     136.20
5083098	HEPATITIS A IGM ANTIBODY	301	86709	$     174.80
5081802	HEPATITIS B CORE, IGM ABS	301	86705	$     164.25
5082040	ALBUMIN	300	82040	$      66.25
5085304	LEVETIRACETAM, SERUM	300	80177	$     189.20
5085492	WEST NILE IGG, SERUM	300	86789	$      54.05
5085493	WEST NILE IGM, SERUM	300	86788	$      63.25
5081475	MONOSPOT (IDA)	300	86308	$     100.25
5081479	STREP,GROUP A RAPID (IDA)	300	87430	$     120.25
5082084	HEALTH FAIR + PSA + HGM	300		$      72.85
5084681	C-PEPTIDE, SERUM	300	84681	$     164.55
5088119	FNA, INTERPRET & REPORT	311	88173	$     121.70
5082703	ALPHA-1 ANTITRYPSIN	300	82103	$     192.20
5082652	VITAMIN D 1,25 DIHYDROXY	300	82652	$     475.50
5085507	PROTIME,FINGERSTICK	305	85610	$      60.40
5082330	CALCIUM, IONIZED	300	82330	$     165.35
5081869	GENERAL HEALTH PANEL	300	80050	$     363.45
5081472	CBC W/DIFFERENTIAL (IDA)	305	85025	$     112.65
5088143	THIN LAYER PAP, IMAGED	923	G0145	$     172.65
5085303	LAMOTRIGINE, SERUM	300	80175	$     127.05
5086164	C4 COMPLEMENT	302	86160	$     156.40
5085242	MYCO.TB.COMPLEX PCR	300	87556	$     554.40
5080493	BLOOD GASES, ISTAT	301	82803	$      81.20
5080488	IONIZED CALCIUM, ISTAT	301	82330	$      49.95
5086184	PROCESSING,RBC,LKR,IRR,EA	390	P9040	$     696.65
5083303	CRP, HIGH SENSITIVITY	300	86141	$     172.00
5080489	GLUCOSE, ISTAT	301	82947	$      17.20
5080492	HEMATOCRIT, ISTAT	305	85014	$      10.15
5080487	POTASSIUM, ISTAT	301	84132	$      19.05
5080486	SODIUM, I STAT	301	84295	$      20.15
5085482	HPV GENOTYPE 16&18/45	306	87625	$     137.40
5080827	IDENTIFICATION, YEAST	306	87106	$     124.90
5086182	ANTIBODY IDENTIFICATION	300	86870	$     414.65
5081799	CA 19-9	300	86301	$     174.80
5081393	URINALYSIS, MICROSCOPIC	300	81015	$      49.85
5080082	CSF COUNT & DIFF.	310	89051	$     161.75
5086163	C3 COMPLEMENT	302	86160	$     156.40
5088129	CYTOPATH,THIN LAYER PAP S	923	G0123	$     118.70
5082372	CARBAMAZEPINE (TEGRETOL)	300	80156	$     190.90
5082024	ADRENOCORTICOTROPIC HORMO	300	82024	$     410.05
5083023	KAPPA FREE LIGHT CHAIN	300	83883	$     252.75
5083024	LAMBDA FREE LIGHT CHAIN	300	83883	$     252.75
5082912	MPO ANCA	300	83516	$     170.50
5082911	PR3 ANCA	300	83516	$     170.50
5080251	ADMIN. SUPPORT EA. 15 MIN	990		$        8.05
5085511	HEMOGLOBIN A1C	301	83036	$      99.00
5082226	PROTEIN, CSF	300	84157	$     113.00
5084331	GLUCOSE, CSF	300	82945	$      92.05
5081866	MITOCHONDRIAL M2 IGG ABS	300	83516	$     128.30
5087398	CRYPTOSPORIDIUM ANTIGEN	306	87328	$     112.50
REHABILITATION
5910116	THERAPY EXERCISE @15MIN	420	97110	$     117.90
5920574	SELF CARE/HOME MAN @15MIN	430	97535	$     112.00
5910208	THERAPEUTIC ACTIVITY 15M	420	97530	$     114.90
5910121	GAIT TRAINING @15MIN	420	97116	$     114.50
5937770	DEVEL COG SKILLS @ 15 MIN	440	97532	$     118.40
5920560	THERAPEUTIC ACTIVITY @15M	430	97530	$     114.90
5920573	THERAPY EXERCISE @ 15MIN	430	97110	$     117.90
5931116	INDIVIDUAL TREATMENT	440	92507	$     281.70
5910030	AQUATIC THERAPY @15MIN	420	97113	$     124.05
5960320	MANUAL THERAPY	420	97140	$     120.65
5910310	PT EVAL-LOW COMPLEXITY	420	97161	$     100.00
5910080	MANUAL THERAPY @15MIN	420	97140	$     120.65
5941139	CARDIAC REHAB SBSQ SESSIO	943	93798	$     305.00
5920310	OT EVAL-LOW COMPLEXITY	430	97165	$     150.00
5930097	SWALLOWING/ORAL FUNC TRMT	440	92526	$     289.85
5920080	MANUAL THERAPY @15MIN	430	97140	$     120.65
5960307	THERAPEUTIC EXERCISE	420	97110	$     117.90
5910061	BALANCE TREATMENT @15MIN	420	97112	$     103.00
5910702	MOBILITY-GOAL STATUS	420	G8979	$        0.01
5921560	THERAPEUTIC ACTIVITY @15M	430	97530	$     114.90
5910311	PT EVAL-MOD COMPLEXITY	420	97162	$     160.00
5910701	MOBILITY-CURRENT STATUS	420	G8978	$        0.01
5930096	SWALLOW EVAL-CLINICAL	444	92610	$     335.90
5911208	THERAPEUTIC ACTIVITY @15	420	97530	$     114.90
5910055	UNATTENDED ELEC STIM	420	97014	$      92.75
5931138	ST EVAL LANG COMP & EXPRE	444	92523	$     361.70
5912203	NEUROMUSCULAR RE-ED @15MN	420	97112	$     103.00
5920568	NEUROMUSCULAR RE-ED @15MN	430	97112	$     103.00
5910098	WC ASSESS/FIT/TRAIN @15M	420	97542	$     106.65
5910705	BODY POSITION-GOAL STATUS	420	G8982	$        0.01
5941161	PULM REHAB COPD SBSQ SESS	948	94799	$     212.75
5911116	THERAPY EXERCISE @ 15 MIN	420	97110	$     117.90
5920311	OT EVAL-MOD COMPLEXITY	430	97166	$     200.00
5910704	BODY POSITION-CURR STATUS	420	G8981	$        0.01
5930102	COGNITIVE EVALUATION @ 1	440	96125	$     305.65
5910703	MOBILITY-D/C STATUS	420	G8980	$        0.01
5910312	PT EVAL-HIGH COMPLEXITY	420	97163	$     235.00
5910048	IPCS SVCS	990		$      60.00
5927532	DEVEL COG SKILLS @ 15 MIN	430	97532	$     118.40
5910060	BALANCE ASSESSMENT @15MIN	420	97750	$     108.25
5920065	COMMUNITY WORK INT @15MIN	430	97537	$      78.10
5920211	SELF CARE-GOAL STATUS	430	G8988	$        0.01
5920098	WC ASSESS/FIT/TRAIN @15M	430	97542	$     106.65
5920030	AQUATIC THERAPY @ 15 MIN	430	97113	$     124.05
5911121	GAIT TRAINING @ 15 MIN	420	97116	$     114.50
5920210	SELF CARE-CURR STATUS	430	G8987	$        0.01
5930095	EVAL SWALLOW-MOD BARIUM	444	92611	$     462.90
5920208	CARRY-GOAL STATUS	430	G8985	$        0.01
5960210	PT EVAL-LOW COMPLEXITY	420	97161	$     100.00
5910706	BODY POSITION-D/C STATUS	420	G8983	$        0.01
5930214	SWALLOW-GOAL STATUS	440	G8997	$        0.01
5910717	CARRY-GOAL STATUS	420	G8985	$        0.01
CARDIOLOGY
2710118	DRUG NEB TRT SUBSEQUENT	410	94640	$     164.15
2710141	OXYGEN DAILY	271		$     461.20
3140112	ECG	730	93005	$     337.90
2750001	OFFICE VISIT EST. PATIENT	510	99211	$     110.00
2710119	INCENTIVE SPIROMETER	270		$     123.15
2710016	DRUG NEB TRT - INITIAL	410	94640	$     190.20
3146625	ECHOCARDIOGRAPHY	483	93306	$  2,386.15
5421162	ISOVUE 300 PER ML	636	Q9967	$        2.55
2712711	BIPAP SUBSEQUENT DAY	410	94003	$  2,957.85
3140111	ECG	730	93005	$     337.90
2710111	VOLUME VENT SUBSEQ DAY	410	94003	$  2,957.85
3142000	ECG-ADDITIONAL	730	93005	$     337.90
3141113	ECG-OP CENTER	730	93005	$     337.90
5086599	COLLECTION, ARTERIAL	920	36600	$     110.00
2750111	EKG - HC	730	93005	$     337.90
2711133	BRONCHOSPASM EVALUATION	460	94060	$     681.15
2711136	EXPIRED GAS COLLECTION	460	94250	$     308.65
2711135	FUNCTIONAL RESIDUAL CAP.	460	94727	$     475.05
5420031	PHARMACOLOGIC STRESS	482	93017	$  1,337.90
3140115	HOLTER MONITOR-RWMC	731	93225	$     513.45
3146636	ECHO DOPLR W/CONTRAST	483	C8929	$  2,500.00
2710199	OXIMETRY/EXERCISE	460	94761	$     280.75
2711134	MAXIMUM BREATHING CAP.	460	94200	$     141.25
2750007	PROGRAM DEVICE PACER DUAL	510	93280	$     109.30
3140114	HOLTER SCANNING REPORT	731	93226	$     442.20
2710123	EAR OX W CONT OVERNIGHT M	460	94762	$     618.15
3140102	EEG AWAKE/SLEEP	740	95819	$  1,483.95
3140081	STRESS ECG	482	93017	$  1,337.90
3141001	ECHO COMPLETE W/BUBBLE S	483	93306	$  3,300.00
2710027	ZIO PATCH RECORD>48 HRS	730	0296T	$     250.00
2710028	ZIO PATCH ANALYSIS>48 HRS	730	0297T	$     250.00
2710164	PFT LIMITED	460	94060	$     681.15
220021	2W OBSERVATION PER HR	762	99220	$      63.50
PATIENT CARE
230021	3RD OBSERVATION PER HR	762	99220	$      63.50
230001	ROOM	120		$  1,524.00
300003	REHAB ROOM	128		$  1,610.00
220001	ROOM	120		$  1,524.00
220002	ROOM	120		$  1,524.00
230002	ROOM	120		$  1,524.00
230020	3RD OBSERVATION EA ADD HR	762	99220	$      63.50
730002	ROOM	124		$  1,575.00
222800	2W OBSERVATION-ATD	769	99219	$           -
220020	2W OBSERVATION PER HR	762	99220	$      63.50
232800	3RD OBSERVATION-ADT	760	99219	$           -
720002	ROOM	124		$  2,365.00
BICC
850531	POST OP CHARGES	710		$      11.10
855132	LABOR-HIGH RISK/HOURLY	721		$      89.10
500021	PEDS OBSERVATION PER HR	762	99220	$      66.75
850021	OB OBSERVATION PER HR	762	99220	$      63.50
851000	C-SECTION DELIVERY	722		$  6,670.80
800001	ROOM	120		$  1,524.00
900002	NEWBORN CARE	171		$  1,524.00
500020	PEDS OBSERVATION EA AD HR	762	99220	$      63.50
902000	HEARING SCREEN	470	92588	$     300.00
855131	LABOR-HIGH RISK/1-5 HR	721		$  1,337.35
906009	IMMUN ADM -HEPB-INJ-ONE	771	90471	$     116.20
850433	OB CHECK ANTEPARTUM	514	99212	$     459.80
852000	VAGINAL DELIVERY	722		$  3,235.45
1230001	NEWBORN LEVEL II	172		$  2,275.00
802800	OB OBSERVATION-ADT	760	99219	$           -
EMERGENCY
2310510	IV INF HYDRATION E ADD HR	450	96361	$     147.55
2310055	CATEGORY 5 W/PROCEDURE	450	99285	$  2,028.55
2310516	IV PUSH ADDL SEQUENTIAL	450	96375	$     147.55
2310054	CATEGORY 4 W/PROCEDURE	450	99284	$  1,213.40
1210002	PCU ROOM	206		$  2,800.00
2310001	CATEGORY III (INTERMED)	450	99283	$     844.55
2310502	INJECTION IV PUSH SINGLE	450	96374	$     283.45
2310011	CATEGORY II (LIMITED)	450	99282	$     488.25
2310053	CATEGORY 3 W/PROCEDURE	450	99283	$     844.55
2310554	IV PUSH ADDL SEQUENTIAL	450	96375	$     147.55
2310002	CATEGORY IV (EXTENDED)	450	99284	$  1,213.40
1210007	CICU ROOM	210		$  2,850.00
2310511	IV INF TX/DX INTL TO 1HR	450	96365	$     514.05
2310512	IV INF TX/DX EACH ADDL HR	450	96366	$     147.55
2310553	INJECTION IV PUSH SINGLE	450	96374	$     283.45
1211001	ROOM-ACUTE	120		$  1,524.00
2311149	IVP REPEAT SAME MED	450	96376	$     147.55
2310010	CATEGORY I (BRIEF)	450	99281	$     270.25
2310501	INJECTIONS, SC/IM	450	96372	$     144.75
2310003	CATEGORY V (COMPLEX)	450	99285	$  2,028.55
2310551	IV INF TX/DX INTL TO 1HR	450	96365	$     514.05
2310555	IV PUSH REPEAT SAME MED	450	96376	$      74.45
2310504	IV INF HYDRATION 31-60MIN	450	96360	$     436.35
2310052	CATEGORY 2 W/PROCEDURE	450	99282	$     488.25
1210020	PCU OBSERVATION EA ADD HR	762	99220	$     116.70
2310552	INJECTIONS, SC/IM	450	96372	$     144.75
1212800	CICU OBSERVATION-ADT	760	99220	$           -
2310654	INSERTION FOLEY CATHETER	450	51702	$     140.65
2310056	CATEGORY 6 W/PROCEDURE	450	99291	$  2,904.45
2310505	IMMUNIZATION ADMINISTRAT	450	90471	$     112.75
2310513	IV INF ADD SEQ INF TO 1HR	450	96367	$     147.55
2310514	IV INF TX/DX CONCURR INF	450	96368	$     147.55
2310105	ED/UP TO 2.5 CM-W & L	450	12001	$     480.75
2310106	ED/W/L 2.6CM TO 7.5CM	450	12002	$     493.75
2310500	BLOOD TRANSFUSION	450	36430	$     966.70
2310013	TRAUMA PARTIAL ACTIVATION	682	99285	$  4,577.30
1211600	HEMODIALYSIS-ICU	761	G0257	$  1,790.80
2310164	ED/REPAIR-UP TO 2.5 CM	450	12011	$     476.50
2310550	IV INF HYDRATION 31-60 MI	450	96360	$     436.35
2310139	ED/SPLINT LONG LEG	450	29505	$     333.90
1206008	IMMUN ADM -PNEU-INJ-ON	771	G0009	$     116.20
2310140	ED/SPLINT SHORT LEG	450	29515	$     361.90
2310138	ED/SPLINT SHORT ARM	450	29125	$     328.90
1216008	IMMUN ADM - PNEU-INJ-ONE	771	G0009	$     116.20
1211504	IV INF TX/DX EACH ADDL HR	260	96366	$     147.55
1206007	IMMUN ADM -INFLU-INJ-ON	771	G0008	$     116.20
2310159	ED/LUMBAR PUNCTURE	450	62270	$  1,171.20
2310134	ED/NASAL HEMORAGE-ANTERI	450	30901	$     419.75
2310123	ED/I&D ABSCESS, SIMPLE	450	10060	$     641.50
2310012	TRAUMA FULL ACTIVATION	682	99291	$10,691.75
1216007	IMMUN ADM - INFLU-INJ-ONE	771	G0008	$     116.20
1212827	CICU ADM DIRECT OBS/EVAL	762	99212	$     750.00
1210601	THER/PROPH/DIAG INJ SC/IM	761	96372	$     106.65
5653318	ER LT CHRGS ADJUST	98		$           -
2310019	ED/CENTRAL LINE > 5 YRS	450	36556	$  2,458.95
2310615	ED/CL DIS SHAFT FX WO MAN	450	25600	$     497.70
2310165	ED/2/6 - 5.0 CM-REPAIR	450	12013	$     488.50
2310653	ED/DENTAL BLOCK	450	64400	$     417.40
2310146	ED/STRAP SHOULDER	450	29240	$     345.50
1210021	PCU OBSERVATION PER HR	762	99220	$     116.70
OPERATING ROOM
2112750	OR LEVEL 4	360		$     110.15
2112749	OR LEVEL 3	360		$      82.55
2112752	OR LEVEL 6	360		$     165.35
2112751	OR LEVEL 5	360		$     137.65
2191665	ENDOSCOPY-RECOVERY	710		$        4.10
2182800	PACU OBSERVATION ROOM	710		$           -
2112748	OR LEVEL 2	360		$      55.10
2400509	IV INF TX/DX EACH ADDL HR	761	96366	$     147.55
2400508	IV INF TX/DX INTL TO 1HR	761	96365	$     514.05
IMAGING
5490120	MAMMO SCREEN W CAD BILAT	403	77067	$     385.00
5456401	CT HEAD W/O	350	70450	$  2,158.45
5411010	CHEST PA	324	71010	$     317.15
5456416	CT ABDOMEN & PELVIS W CON	350	74177	$  5,428.05
5431435	SEDATION EA ADD'L 15 MIN	329	99153	$      20.00
5610017	MYOCARD CARDIOLITE	343	A9500	$     275.65
5498287	BONE DENSITY AXIAL	320	77080	$     589.15
5462144	MR-SPINE LUMBAR WITHOUT	612	72148	$  3,683.95
5452125	CT SPINE CERVICAL W/O	350	72125	$  2,602.00
5456419	CT CHEST - P.E.	350	71275	$  3,511.60
5411020	CHEST 2 VIEWS	324	71020	$     371.65
5431434	SEDATION FIRST 15 MIN	329	99152	$     225.00
5456406	CT LUNG W	350	71260	$  2,792.80
5400004	WS US VEINS LOW EXT BILAT	921	93970	$  1,265.00
5456415	CT ABDOMEN & PELVIS W/O C	350	74176	$  4,420.10
5460551	MR-BRAIN ROUTINE-W/O CONT	610	70551	$  3,638.65
5456405	CT LUNG W/O	350	71250	$  2,492.65
5446730	US RENAL	402	76775	$     634.80
5460552	MR-BRAIN WITH & W/O	610	70553	$  4,621.20
5458504	CT KUB/IVU	350	74176	$  4,139.80
5414000	KUB ABD	320	74000	$     355.20
5412100	L SPINE AP & LAT	320	72100	$     480.10
5618991	I-131 TX CAP/MCI	636	A9517	$      29.75
5446710	US GALLBLADDER	402	76705	$     737.40
5412121	L SPINE BENDING VIEWS(4)	320	72120	$     549.70
5462141	MR-SPINE CERV. WITHOUT	612	72141	$  3,462.20
5446941	US GUIDE VASC ACCESS	402	76937	$     695.75
5412040	C-SPINE 2 OR 3 VIEWS	320	72040	$     401.35
5611028	MPI REST/STRESS W PHARMAC	340	78452	$  5,497.85
5452131	CT SPINE LUMBAR W/O	350	72131	$  2,675.60
5446535	US THYROID	402	76536	$     770.55
5490124	MAMMO DIAG W CAD BILAT	401	77066	$     435.00
5456461	CTA HEAD/INTRACRANIAL	350	70496	$  3,032.55
5456462	CTA CAROTID/NECK	350	70498	$  2,938.00
5413500	PELVIS(1) VIEW	320	72170	$     345.45
5446720	US HEPATIC	402	76705	$     737.40
5470016	FDG	343	A9552	$  1,392.60
5465565	MR JOINT, LEFT LOWER W/O	610	73721	$  3,057.85
5465566	MR JOINT, RIGHT LOWER W/O	610	73721	$  3,057.85
5610029	GALLIUM GA 67,PER MCI	636	A9556	$     312.50
5496649	US BREAST, UNILAT RT LMT	402	76642	$     200.00
5431529	WIRE BENTSON CK 035/180	621	C1769	$      46.00
5496648	US BREAST, UNILAT LT LMT	402	76642	$     200.00
5410262	C-SPINE AP/LAT/FLEX/EXT	320	72050	$     509.45
5446850	US PELVIC	402	76856	$     947.25
5413031	SHOULDER-RIGHT-COMPLETE	320	73030	$     424.90
5410237	HIP UNILAT 2-3 VIEWS RT	320	73502	$     310.00
5414022	MULT ABD W/PA CHEST	320	74022	$     644.20
5431007	NDL MICROPUNCTURE 4F COOK	621	C1894	$     275.45
5462143	MR-SPINE THOR ROUTINE W/O	612	72146	$  3,701.90
5456420	CT UROGRAM	350	74178	$  5,868.55
5446700	US ABDOMEN COMPLETE	402	76700	$  1,019.30
5413030	SHOULDER-LEFT-MIN 2 VIEWS	320	73030	$     424.90
5414230	SWALLOW EVAL W VIDEOGRPHY	320	74230	$     699.20
5430494	FLUORO GUIDE CV CATH	320	77001	$  1,031.15
5456404	CT NECK W	350	70491	$  2,693.40
5413561	KNEE R-2 VIEW	320	73560	$     370.15
5431515	ABDOM PARACENTESIS W/IMG	329	49083	$  2,694.80
5418303	CHIBA NEEDLE	621		$      67.00
5465574	MR JOINT, RIGHT UPPER W/O	610	73221	$  2,925.45
5410236	HIP UNILAT 2-3 VIEWS LT	320	73502	$     310.00
5446705	US ABDOMEN UPPER	402	76705	$     737.40
5450488	CT FACIAL BONES W/O	350	70486	$  2,187.55
5414220	ESOPHAGUS	320	74220	$     830.10
5446870	US TESTICULAR	402	76870	$     765.20
5431365	INJECTION, MAJOR JOINT	329	20610	$     672.55
5431527	WIRE AMPLATZ CK 035/80	621	C1769	$      80.00
5413570	KNEE L-4 OR MORE VIEWS	320	73564	$     423.80
5412070	T SPINE/AP & LAT	320	72070	$     405.90
5465573	MR JOINT, LEFT UPPER W/O	610	73221	$  2,925.45
5412110	L SPINE OBL	320	72110	$     654.10
5410231	SCOLIOSIS 2-3 VIEWS	320	72082	$     660.00
5470104	PET/CT SKULL-THIGH SUBSQ	404	78815	$  6,234.00
5413560	KNEE L-2 VIEW	320	73560	$     370.15
5431136	WIRE GL ANGL 035/180	278	C1769	$     345.65
5413571	KNEE R-4 OR MORE VIEWS	320	73564	$     423.80
5413131	HAND R-3 VIEW	320	73130	$     418.20
5411110	RIBS - 3 VIEWS	320	71110	$     522.90
5460556	MRA BRAIN W/O CONTRAST	610	70544	$  3,959.05
5413611	ANKLE R-COMPLETE	320	73610	$     405.30
5610028	TECHNETIUM TC99M DISOFENI	343	A9510	$     518.15
5446830	US TRANSVAGINAL SCAN	402	76830	$     794.00
5431509	US THORACENTESIS	402	32555	$  2,217.35
5431389	EPID. INJ, SINGLE L/S	329	64483	$  2,265.55
5413630	FOOT L-MIN 3 VIEWS	320	73630	$     404.50
5618227	HEPATOBILIARY IMAGE W/ ME	340	78227	$  2,341.50
5440447	US RENAL INCLUDING DOPPLE	402	76775	$     634.80
5443975	DUPLX DOPPLER-ABDOMEN	921	93975	$  1,076.55
5446942	US GUIDED INTERVENTION	402	76942	$     752.70
5450486	CT SINUS COMPLETE	350	70486	$  2,187.55
5431528	WIRE AMPLATZ CK 035/180	621	C1769	$      80.00
5446925	US CAROTID DOPPLER	921	93880	$  1,385.25
5413610	ANKLE L-COMPLETE	320	73610	$     405.30
5412072	T/L JUNCTION MIN 2 VIEWS	320	72080	$     389.85
5490128	MAMMO SDV W CAD UNI LT	401	77065	$     365.00
5456460	CTA CHEST	350	71275	$  3,511.60
5413631	FOOT RT MIN 3 VIEWS	320	73630	$     404.50
5610018	TECHNETIUM TC 99M MEDRNAT	343	A9503	$     319.45
5618751	MPI REST/STRESS MULTIPLE	340	78452	$  5,497.85
5413111	WRIST R-COMPLETE	320	73110	$     420.75
5462158	MR-SPINE-LUMBAR W & W/O	612	72158	$  4,721.25
5413590	TIBIA LEFT	320	73590	$     400.45
5440448	US SUPERFICIAL LUMP	402	76705	$     553.05
5470101	PET/CT INIT SKULL-THIGH	404	78815	$  6,234.00
5431426	FLUORO GUIDE FOR HIP INJE	320	77002	$     987.40
5431070	STARCLOSE	621	C1760	$  1,233.50
5610027	TC-99M SULFR COLLOID,DOSE	343	A9541	$     329.00
5464182	MR-ABD W&W/O CONRTAST	610	74183	$  4,451.05
5490112	BREAST BX US INITIAL	329	19083	$  2,831.25
5462156	MR-SPINE-CERV W & W/O	612	72156	$  4,509.15
5456464	CTA ABDOMEN WO/W CONTRAST	350	74175	$  3,505.90
5413110	WRIST L-COMPLETE	320	73110	$     420.75
5413130	HAND L-3 VIEW	320	73130	$     418.20
5430979	KYPHO CEMENT/MIXER	272	A4649	$     765.25
5430254	MICROPUNCTURE 4F STIFF CK	621	C1894	$     179.75
5440457	US APPENDIX	402	76705	$     737.40
5490129	MAMMO SDV W CAD UNI RT	401	77065	$     365.00
5460564	MRA CAROTID W&W/O CONTRST	610	70549	$  5,819.90
5430852	CATH BERN 4F/100CM	621		$     296.00
5414420	RETROGRADE	320	74420	$     858.70
5490408	NEEDLE - BARD 14 GA CORE	621		$     131.60
5430061	CATH PIG 4F/65CM	621		$      44.60
5413591	TIBIA RIGHT	320	73590	$     400.45
5431061	SHEATH PINNACLE 6F/4CM	621	C1894	$     145.50
5618306	BONE SCAN - TOTAL	340	78306	$  2,045.95
5431192	KYPHO CURETTE SZ 3 WEDGE	272	A4649	$     342.40
5431531	EPIDURAL INJ L/S W FLUORO	329	62323	$  2,075.00
5431537	KYPHO NDL SZ3 DIAMOND	621	A4649	$     675.00
5414020	ABD (2) VIEW	320	74020	$     448.05
5430023	CATH HOCKEY1 4F/65CM	621		$      44.60
5456430	CT ABDOMEN & PELVIS WO/W	350	74178	$  6,871.95
5456417	CT PELVIS W/O	350	72192	$  2,697.90
5431513	US NDLBX LIVER-PCT	329	47000	$  2,306.90
5460537	MR BREAST BILATERAL EXTEN	610	77059	$  3,339.15
5463720	MR LOWER EXT LT W/O CONTR	610	73718	$  2,761.15
5490071	MARKET ULTRACLP 14G VENUS	278	A4648	$     175.00
5431034	SHEATH BRITE 4F/11CM	621	C1894	$     182.60
5446812	US OB 1ST TRI-TRANSAB SNG	402	76801	$     651.05
5410246	FEMUR 2 OR MORE VIEWS RT	320	73552	$     340.00
5431428	FLUORO GUID-SPINAL PROCE	320	77003	$  1,115.30
5413090	FOREARM-LEFT	320	73090	$     387.35
5430472	FLUO-LOCAL FOR NEEDLE BX	320	77002	$     987.40
5461554	MRCP W/O	610	74181	$  3,460.35
5490121	MAMMO SCREEN W CAD EXTEND	403	77067	$     385.00
5490070	MARKER ULTRACLP 14G COIL	278	A4648	$     175.00
5440454	US HERNIA	402	76705	$     717.15
5456459	CTA AORTOILIAC RUNOFF	350	75635	$  3,824.35
5462157	MR-SPINE-THORACIC W & W/O	612	72157	$  4,678.05
5452128	CT SPINE THORACIC W/O	350	72128	$  2,697.90
5430276	KYPHO CEMENT CARTRIDGE	272	A4649	$     219.35
5430279	KYPHO GUN SZ 3	621		$     837.00
5446765	US ABD AORTA	402	76775	$     634.80
5400006	WS US VEINS LOW EXT RT	921	93971	$     930.00
5618264	GASTRIC EMPTYING	340	78264	$  2,187.30
5414250	SMALL BOWEL SERIES	320	74250	$     826.75
5413600	ANKLE L-2 VIEW	320	73600	$     363.10
5431152	WIRE SUPRA CORE 035/300	621	C1769	$     339.50
5431162	MISC SUPPLY OVERRIDE	621		$     995.15
5446536	US THYROID BIOPSY	402	76942	$     752.70
5410245	FEMUR 2 OR MORE VIEWS LT	320	73552	$     340.00
5430485	CVP NON-TUNNEL OVER AGE 5	329	36556	$  2,482.25
5618504	MASK, D FILT & 12' TUBING	270		$      71.60
5413620	FOOT L-2 VIEW	320	73620	$     345.50
5413091	FOREARM-RIGHT	320	73090	$     387.35
5431379	LUMBAR SPINAL PUNCTURE	329	62270	$  1,171.20
5610026	I-123 PER 100 UCI	636	A9516	$     464.20
5618582	PULMONARY VENT & PERFUSIO	340	78582	$  2,814.00
5410250	SKULL 3VIEW	320	70250	$     387.90
5610022	TC 99M PENTATE PER VIAL	636	A9539	$     320.65
5431390	EPID. INJ, BILAT L/S	329	64483	$  3,398.35
5430959	DRAIN CATH MP 10.2F/25	621	C1729	$     246.90
5413080	ELBOW-LEFT-COMPLETE	320	73080	$     428.30
5414240	UPPER GI	320	74240	$     809.05
5413081	ELBOW-RIGHT-COMPLETE	320	73080	$     428.30
5462198	MR-PELVIS W/WO CONTRAST	610	72197	$  5,175.70
5413060	HUMERUS-LEFT	320	73060	$     388.75
5430963	DRAIN CATH MP 8.5F/25	621	C1729	$     246.90
5400005	WS US VEINS LOW EXT LT	921	93971	$     930.00
5413621	FOOT R-2 VIEW	320	73620	$     345.50
5410360	NECK SOFT TISSUE	320	70360	$     374.40
5431546	NDL BX MISSION 18G/16CM	621	A4649	$     117.00
5463724	MR-LOW EXT RT W/O CONTRAS	610	73718	$  2,761.15
5413100	WRIST L-2 VIEW	320	73100	$     362.95
5610019	TC99M ALBUMIN AGGR/DOSE	636	A9540	$     356.70
5413061	HUMERUS-RIGHT	320	73060	$     388.75
5431381	MYEL-INJ. PROCEDURE	329	62284	$  1,556.35
5453701	CT EXT LOWER LT W/O	350	73700	$  2,276.80
5431427	INTRATHECAL INJ FOR CT	320	77003	$  1,115.30
5413601	ANKLE R-2 VIEW	320	73600	$     363.10
5462196	MR-PELVIS W/O CONTRAST	610	72195	$  3,842.90
5451096	CTA ABDOMEN & PELVIS	350	74174	$  6,679.65
5431216	KYPHOPLASTY THORACIC	361	22513	$10,500.00
5413101	WRIST R-2 VIEW	320	73100	$     362.95
5430714	VENOGR.,CAVAL-INFERIOR	320	75825	$  4,553.85
5450493	CT CHEST - HIGH RES	350	71250	$  2,800.50
5618802	TUMOR LOC W/B MULT DAY	340	78804	$  4,230.65
5430875	CATH KMP 4F/40CM	621		$     147.95
5430491	CVP TUNNELLED OVER AGE 5	329	36558	$  4,751.65
5430998	NDL CORE BX 18G/15CM 20T	621		$     271.00
5452132	CT MYELOGRAM LUMBAR	350	72132	$  2,984.35
5490048	PROBE, 10G VAC ASSIST	621		$     619.30
5460554	MRI PITUITARY W&W/O CONTR	611	70553	$  4,621.20
5490123	MAMMO SCREEN W CAD UNI RT	403	77067	$     385.00
5431614	CT BX LUNG OR MEDIASTINUM	329	32405	$  2,197.05
5450480	CT INNER EAR WO CONTRAST	350	70480	$  2,548.70
5412052	C-SPINE 4 OR 5 VIEWS	320	72050	$     602.35
5490061	BREAST BX USVAC INITIAL	329	19083	$  2,831.25
5430985	NDL ACCUSTICK	621	C1894	$     281.75
5457718	CT EXT LOWER RT W/O	350	73700	$  2,276.80
5413070	ELBOW-LEFT-2 VIEW	320	73070	$     363.90
5413071	ELBOW-RIGHT-2 VIEW	320	73070	$     363.90
5416000	FLUO-PHYS ASSIST < 1 HOUR	320	76000	$     701.60
5431700	DIALY SHUNT IMAG W/PTA	329	36902	$  9,275.00
5430609	EPID. INJ, SINGLE C/T	329	64479	$  2,647.30
5446833	US OB TRANSVAGINAL SCAN	402	76817	$     753.50
5430647	AORTOGRAPH-ABDOM-LOW EXT	323	75630	$  3,992.70
5430352	SHEATH PEEL EMBOSAFE 16F	621	C1894	$     151.65
5463722	MR LOW EXT LT W/WO CONTRA	610	73720	$  4,214.95
5490125	MAMMO DIAG W CAD UNI LT	401	77065	$     365.00
5430245	CATH GL C2 4F/65CM	621		$     171.85
5431028	SHEATH ANSEL 6F/45CM	621	C1894	$     348.10
5440444	US EXTREMITY NONVASC LIMI	402	76882	$     590.15
5490122	MAMMO SCREEN 2 CAD UNI LT	403	77067	$     385.00
5490079	NDL BRBX ACHIEVE 14G-11CM	621		$     124.85
5430898	CATH SOS2 4F/80CM	621		$     110.55
5413120	HAND L-2 VIEW	320	73120	$     324.30
5490113	BREAST BX US EA ADDL	329	19084	$  1,287.50
5490407	KOPANS BREAST LOC WIRE	621		$     133.75
5430487	CVP&PORT TUNNEL OVER 5Y	329	36561	$  5,460.55
5431217	KYPHOPLASTY LUMBAR	329	22514	$10,500.00
5460555	MRI IACS W&W/O CONTRAST	611	70553	$  4,621.20
5431059	SHEATH PINNACLE 6F/10CM	621	C1894	$     143.70
5431147	WIRE NIT-VU 018/80	621	C1769	$     284.55
5446814	US OB 2ND/3RD TRI-TRANAB	402	76805	$     793.50
5431626	CT DRAIN ABD/PELV	329	49406	$  3,295.00
5456418	CT PELVIS W	350	72193	$  2,829.80
5431392	EPID. INJ, EA ADD'L L/S	329	64484	$     851.00
5411112	RIBS - 4 VIEWS	320	71111	$     675.30
5431325	NEPHROSTOMY CATH EXCHANGE	329	50435	$  2,350.00
5618195	SENTINEL NODE LOCAL	340	78195	$  2,199.85
5456427	CT ABDOMEN W/O & W IV CON	350	74170	$  3,814.75
5431612	CT GUIDED SI JOINT INJ,RT	329	27096	$  2,520.00
5430940	DILATOR JCD 10.0	621		$      41.60
5430293	KYPHO BALN 10/3	621		$  2,185.20
5461556	MRCP W/O & W	610	74183	$  4,451.05
5413121	HAND R-2 VIEW	320	73120	$     324.30
5437191	VENACAVA FILTER INSERTION	329	37191	$  8,859.40
5610037	TC99M MERTIATIDE PER DOSE	636	A9562	$  2,760.35
5610046	THYROID UPTAKE & IMAGING	340	78014	$  1,525.00
5414246	UGI/AIR CONTRAST	320	74246	$     962.05
5430660	ANGIO,EXTREMITY-UNILATERL	323	75710	$  3,929.50
5431176	SHEATH BRITE 5F/11CM	278	C1894	$     105.95
5440445	US OB LIMITED	402	76815	$     594.05
5456451	CT ORBIT W	350	70481	$  3,034.55
5653325	IMAGING LT CHRGS ADJUST	98		$           -
5490126	MAMMO DIAG W CAD INI RT	401	77065	$     365.00
5430256	KYPHO BALN 15/3	621		$  2,185.20
5457716	CT EXT UPPER RT W/O	350	73200	$  2,088.40
CANCER TREATMENT
5510020	IMRT TREATMENT COMPLEX	333	77386	$  2,297.40
5510110	RAD. TX. DELIVERY COMPLEX	333	77412	$     978.00
5510021	X-RAY GUIDANCE FOR RAD TX	333	77387	$     611.00
5519300	DOSIMETRY CALC. DURING TX	333	77300	$     711.95
5519334	TX DEVICES COMPLEX	333	77334	$  1,441.25
5517500	CONT MEDICAL PHYSICS	333	77336	$     980.50
5511350	PROSTASEED,I125,PER SOURC	278	C2639	$     144.45
5590020	IMRT TREATMENT COMPLEX	333	77386	$  2,297.40
5590110	RAD TX DELIVERY COMPLEX	333	77412	$     978.00
5599300	DOSIMETRY CALC. DURING TX	333	77300	$     711.95
5510007	OUTPATIENT E&M LEVEL 1	510	99211	$     153.70
5517334	TX DEVICES COMPLEX	333	77334	$  1,441.25
5517767	PROSTATE SEEEDING SET	272		$     193.85
5519002	CT THERAPY PLAN W/O CTRST	333	77014	$  1,135.35
PHARMACY
4081672	DAPTOMYCIN 500MG INJ JA	636	J0878	$        2.16
4368408	IOPAMIDOL 370 MG 1ML	636	Q9967	$        2.80
4204015	HUM PROTHROM 1U KCEN JA	636	C9132	$        5.36
4200428	FERRIC CARBOXY 750MG JA	636	J1439	$        3.15
4100186	OXALIPLATIN 100 MG JA	636	J9263	$        4.65
4081836	NATALIZUMAB 300 MG INJ JA	636	J2323	$      48.48
4100122	PEMBROLIZUMAB 100MG/4MLJA	636	J9271	$     108.50
4100192	PERTUZUMAB 420 MG INJ JA	636	J9306	$      26.65
4562292	FOSAPREPITANT 150 MG INJ.	636	J1453	$        4.74
4100065	AZACITIDINE 100MG INJ JA	636	J9025	$      12.70
4100187	PACLITAXEL 300 MG INJ JA	636	J9267	$        0.76
4100095	PACLITAXEL 30 MG INJ JA	636	J9267	$        3.43
4281072	FENTANYL 100 MCG/2ML INJ	636	J3010	$      65.43
4282071	HYDROCODONE/ACET 5/325 MG	250		$        0.75
4100172	DENOSUMAB 120MG INJ JA	636	J0897	$      42.90
4280806	ACETAMINOPHEN 325 MG TAB	250		$        0.80
4411108	*SOD CHLOR 0.9% 1000 ML	258	J7030	$     221.65
4281035	OXYCODONE-APAP 5-325MG TB	250		$        2.60
4121320	ALBUTEROL-IPRATR 3ML UD	250		$      10.80
4561276	DOCUSATE NA-SENNOSIDES TB	250		$        0.80
4100173	DOCETAXEL 80MG/8 ML JA	636	J9171	$      39.23
4281909	ONDANSETRON HCL 4 MG INJ	250		$      65.43
4411498	*LACT RINGERS 1000 ML	258	J7120	$     221.65
4100196	TOCILIZUMAB 80 MG INJ JA	636	J3262	$      12.40
4201204	HEPARIN 5000 U/0.5 INJ	250		$      65.40
4923600	ABATACEPT 250 MG INJ JA	636	J0129	$      98.58
4561256	DOCUSATE SODIUM 100MG CAP	250		$        1.90
4100054	BEVACIZUMAB 400MG/16ML JA	636	J9035	$     181.62
4680416	DEXAMETHASONE 4 MG INJ	636	J1100	$      65.40
4411106	*SOD CHLOR 0.9% 250 ML	258	J7050	$     149.60
4800421	IMM GLOB 40GM PRIVIGEN JA	636	J1459	$     159.98
4569206	VEDOLIZUMAB 300MG JA	636	J3380	$      42.35
4564045	PANTOPRAZOLE 40 MG TAB	250		$        0.78
4411104	*SOD CHLOR 0.9% 100 ML	250		$     149.60
4200412	ENOXAPARIN NA 40 MG INJ	250		$     119.05
4081165	VANCOMYCIN 1 GRAM VIAL	636	J3370	$      65.43
4562220	PALONOSETRON 0.25 MG JA	636	J2469	$     109.81
4564016	FAMOTIDINE 20 MG TAB	250		$        2.80
4100060	OXALIPLATIN 50 MG JA	636	J9263	$        5.01
4800419	IMM GLOB 20G PRIVIGEN JA	636	J1459	$     159.98
4281887	MIDAZOLAM 2 MG/2ML INJ	250		$      78.15
4800414	INFLIXIMAB 100 MG INJ JA	636	J1745	$     283.08
4240901	METOPROLOL TARTRATE 25 MG	250		$        6.05
4280901	IBUPROFEN 600 MG TAB	250		$        0.80
4122003	PROPOFOL 200 MG INJ	636	J2704	$      65.40
4100161	TRASTUZUMAB 150MG JA	636	J9355	$     235.27
4281016	KETOROLAC 30 MG INJ	250		$      65.40
4720008	LIDOCAINE 2% MPF 5 ML INJ	250		$      65.40
4081616	PIPERA/TAZOB3.375G/PB50ML	250		$     243.60
4281228	GABAPENTIN 300 MG CAP	250		$        2.35
4281090	TRAMADOL HCL 50 MG TAB	250		$        1.35
4401257	POTASSIUM CL 20MEQ ER TAB	250		$        1.20
4100107	PACLITAX(ALBUMIN)100MGJA	636	J9264	$      29.65
4202819	FACTOR 8 VWF 500U 1U JA	636	J7187	$        2.99
4200440	SOD FER CPLX 62.5MG IJ JA	250		$      15.42
4201269	ASPIRIN EC 81MG TAB.	250		$        0.55
4202830	FACTOR IX PROF9 1000U 1UJ	636		$        3.17
4280842	ASPIRIN 81 MG TAB	250		$        0.80
4560402	MAGNESIUM OXIDE 400MG TAB	250		$        0.80
4280071	OXYCODONE 5 MG CAP	250		$        0.80
4401219	POTASSIUM CL 10MEQ ER CAP	250		$        0.80
4411103	*SOD CHLOR 0.9% 50 ML	250		$     149.60
4922005	OCRELIZUMAB 300MG/10ML	250		$39,390.00
4881603	CHOLECALCIFEROL 1000 UNIT	250		$        0.85
4560465	FAMOTIDINE 20MG PREMIX PB	636	J3490	$     246.91
4562836	PANTOPRAZOLE 20MG TAB	250		$      10.97
4921200	LEUCOVORIN 200 MG JA	636	J0640	$      12.76
4280023	MORPHINE 4 MG INJ	636	J2270	$      65.40
4100068	BORTEZOMIB 3.5 MG INJ JA	636	J9041	$     113.08
4081374	CEFAZOLIN 1000 MG INJ	250		$     123.70
4240635	ATORVASTATIN 40 MG TAB	250		$        6.05
4929203	MELATONIN 5 MG	250		$        0.78
4401266	POTASS CL 10MEQ/100ML PGB	250		$     246.91
4281227	GABAPENTIN 100 MG CAP	250		$        1.05
4281120	OXYCODONE/ACET 10/325 TAB	250		$        2.55
4100130	FLUOROURACIL 5G/100ML JA	636	J9190	$      12.97
4240863	TAMSULOSIN 0.4 MG CAP 24H	250		$        3.35
4100191	PEMETREXED 500 MG INJ JA	636	J9305	$     156.72
4561227	PSYLLIUM HUSK 0.52 GM CAP	250		$        0.80
4280807	ACETAMINOPHEN 500 MG TAB	250		$        0.80
4920263	ACETYLCYST  6G/30ML JA	636	J0132	$        7.60
4083204	METRONIDAZOLE 500 MG PGBK	636	J3490	$     246.91
4561221	POLYETHYLENE GLY 17G PKT	250		$        3.35
4100087	BEVACIZUMAB 100MG/4ML JA	636	J9035	$     187.02
4560808	LACTOBACILLUS ACID CAP	250		$        0.75
4122023	ROCURONIUM 50MG INJ SOLN	250		$      89.80
4880434	MULTI VIT,TX-FE-CA-MIN TB	250		$        0.80
4200432	FERROUS SULF 325 MG TAB	250		$        0.80
4411107	*SOD CHLOR 0.9% 500 ML	258	J7040	$     221.65
4921201	LEUCOVORIN 350 MG INJ JA	636	J0640	$      24.24
4281727	LORAZEPAM 2 MG INJ	636	J2060	$      65.40
4240809	CLONIDINE HCL 0.1 MG TAB	250		$        0.80
4720033	LIDOCAINE 0.5% 0.3ML SYR	250		$        6.05
4121252	GUAIFENESIN 600 MG ER TAB	250		$        1.50
4201256	FACTOR IX 500U PER 1U JA	636	J7195	$        3.32
4100124	NIVOLUMAB 40MG/4ML INJ	636	J9299	$      62.58
4920319	SUGAMMADEX 200MG/2ML INJ	250		$     230.28
4281525	HYDROMORPHONE 1MG/ML 1ML	636	J1170	$      65.40
4680506	BUDESONIDE 0.5 MG/2ML NEB	250		$      17.25
4561292	SENNOSIDES 8.5 MG TAB	250		$        0.80
4564046	PANTOPRAZOLE 40 MG INJ	636	C9113	$     120.60
4100074	CETUXIMAB 200 MG/100 ML	636	J9055	$     120.53
4401260	CALCIUM ACETATE 667MG CAP	250		$        0.80
4680442	PREDNISONE 20 MG TAB	636	J7512	$        1.51
4121312	LEVALBUTEROL 1.25MG/3ML	250		$        9.85
4100111	DEGARELIX 80 MG JA	636	J9155	$      14.81
4081538	MEROPENEM 1GM PGBK	636	J2185	$      65.43
4281566	HYDROMORPHONE 0.5MG/0.5ML	636	J1170	$      65.43
4800418	IMM GLOB 10G PRIVIGEN JA	636	J1459	$     159.98
4281119	ACET-HYDROCOD 325-10 TAB	250		$        0.80
4280910	FENTANYL 250 MCG/5ML INJ	636	J3010	$     130.86
4240660	MAGNESIUM 2 G PGBK	636	J3475	$     246.91
4240800	METOPROLOL TART 50 MG TAB	250		$        1.05
4081619	CEFAZOLIN 2 G/D2W 50 ML	250		$     397.00
4281794	LORAZEPAM 1 MG TAB	250		$        1.40
4402838	FUROSEMIDE 40 MG TAB	250		$        0.80
4720065	BUPIVACAINE 0.25%30ML INJ	636	J3490	$      65.40
4281889	MIDAZOLAM 10 MG/2ML INJ	636	J2250	$     164.50
4281296	GABAPENTIN 600 MG TAB	250		$        4.50
4121237	ALBUTEROL 2.5MG/3 UD SOLN	250		$        8.40
4081617	PIPERA/TAZOB 4.5G/PB100ML	250		$     256.45
4402840	FUROSEMIDE 40 MG/4ML INJ	250		$      65.40
4040088	DIPHENHYDRAMINE 50 MG INJ	250		$      65.40
4240563	AMLODIPINE 5 MG TAB	250		$        2.60
4880815	FOLIC ACID 1 MG TAB	250		$        0.80
4840820	LIDOCAINE 5% PATCH	250		$        9.37
4720053	LIDOCA BUFF 1% 5 ML SYR	250		$      65.43
4680460	METHYLPRED  40 MG INJ	636	J2920	$      65.40
4401098	LACTULOSE 20 G UD LIQ	250		$        1.20
4280890	HYDROMORPHONE 2 MG INJ	636	J1170	$      65.40
4523618	CLOST BOTULINUM 100U JA	636	J0585	$      14.04
4201214	CLOPIDOGREL 75 MG TAB	250		$        7.35
4402834	FUROSEMIDE 20 MG TAB	250		$        0.80
4120003	MIDODRINE HCL 5 MG TAB	250		$        3.85
4280403	MORPHINE 2 MG INJ	636	J2270	$      65.40
4121214	IPRATROPIUM 0.02% 2.5ML	636	J7644	$        9.95
4240565	AMLODIPINE 10 MG TAB	250		$        2.60
4201284	APIXABAN 5 MG TAB	250		$        5.31
4204011	TENECTEPLASE 50 MG JA	636	J3101	$     260.72
4201236	ENOXAPARIN NA 30 MG INJ	250		$     101.05
4281251	LEVETIRACETAM 500 MG TAB	250		$        3.65
4720007	LIDOCAINE 1% MPF 5 ML INJ	250		$      65.40
4100181	IRINOTECAN 100 MG JA	636	J9206	$      24.10
4281105	FENTANYL 300 MCG/30ML INJ	636	J3010	$     105.10
4100175	ERIBULIN 1 MG INJ JA	636	J9179	$     261.72
4040085	DIPHENHYDRAMINE 25 MG CAP	250		$        0.80
4401225	ORAL ELECTROLYTES TAB	250		$        0.80
4240819	HYDRALAZINE HCL 25 MG TAB	250		$        0.80
4240377	CARVEDILOL 25 MG TAB	250		$        3.10
4412298	1000NS IRRIGATION   PP155	250		$      42.15
4240902	LISINOPRIL 10 MG TAB	250		$        1.45
4120406	BETHANECHOL CL 10 MG TAB	250		$        2.20
4990115	REMOTE ORDER ENTRY	990		$           -
4920245	CHLORHEXIDINE 0.12% 15 ML	250		$        5.80
4401227	POTASSIUM CL 20MEQ UD LIQ	250		$        0.90
4122005	BACLOFEN 10 MG TAB	250		$        1.05
4281252	LEVETIRACETAM 750 MG TAB	250		$        5.15
4990100	CONSULTING - PHARMACIST	990		$      85.00
4400811	SODIUM BICARB 650 MG TAB	250		$        0.80
4282516	PROMETHAZINE 6.25MG IVPB	636	J2550	$     207.55
4280024	QUETIAPINE FUM 25 MG TAB	250		$        3.05
4081498	LEVOFLOXACIN 750 MG PGBK	636	J1956	$     142.51
4680491	DEXAMETHASONE 10MG/ML	250		$      65.40
4280400	PROPOFOL 1000 MG IVSL	636	J2704	$     246.91
4881272	ASCORBIC ACID 500 MG TAB	250		$        0.80
4680461	METHYLPRED 125 MG INJ	636	J2930	$      65.40
4100190	PEMETREXED 100 MG INJ JA	636	J9305	$     162.49
4240912	LISINOPRIL 20 MG TAB	250		$        1.50
4201209	HEPARIN 1000U/ML 10ML INJ	636	J1644	$      65.40
4081411	NEOMYCIN-POLYMYXIN GU 1ML	250		$      84.75
4401821	SEVELAMER CARBINATE 800MG	250		$        2.55
4564024	FAMOTIDINE 20 MG/2 ML INJ	636	J3490	$      65.40
4368407	IOPAMIDOL 370 MG 75 ML	636	Q9967	$     178.17
4180002	ALBUMIN HUMAN 25% 100ML	636	P9047	$     436.32
4240634	ATORVASTATIN 20 MG TAB	250		$        6.05
4281726	LORAZEPAM 0.5 MG TAB	250		$        1.15
4523247	PHENYLEPHRINE 10 MG INJ	636	J2370	$      65.40
4560496	MAGNESIUM CL 64 MG TAB_ER	250		$        0.80
4100100	ETOPOSIDE 100 MG INJ JA	636	J9181	$        9.47
4920002	ALLOPURINOL 100 MG TAB	250		$        0.80
4081185	CEFTRIAXONE 1 G INJ	636	J0696	$     191.20
4204014	ALTEPLASE 100MG/100ML JA	636	J2997	$     207.11
4401223	CALCIUM GLUC 1000MG INJ	636	J0610	$      65.40
4564050	SUCRALFATE 1 G/10 ML UD	250		$        3.30
4480028	GUAIFENESIN 200MG/10ML UD	250		$        0.80
4240817	HYDRALAZINE HCL 50 MG TAB	250		$        0.80
4682100	INSULIN-REGULR 100U/ML3ML	250		$      49.64
4880011	CALCIUM-VIT D 500-200 TAB	250		$        0.80
4281526	ACETAMINOPHE1000MG/100ML	636	J0131	$      90.95
4920350	NICOTINE 21 MG/24 HR PATC	250		$      16.95
4240890	METOPROLOL TART 5MG INJ	636	J3490	$      65.40
4560460	MILK OF MAGNESIA  UD SUSP	250		$        0.80
4564002	SUCRALFATE 1 G TAB	250		$        1.30
4281300	MAGNESIUM SULF 1 G PGBK	636	J3475	$     246.91
4240725	METOPROLOL SUCC 25 MG TAB	250		$        1.40
4280844	ASPIRIN EC 325 MG TAB	250		$        0.80
4280072	ACETAMINOPHEN 325 MG SOLN	250		$        0.80
4482401	ACETYLCYSTEINE 600 MG CAP	250		$        0.78
4683615	LEVOTHYROXINE 50 MCG TAB	250		$        1.19
4402854	BUMETANIDE 1 MG TAB	250		$        0.80
4240376	CARVEDILOL 12.5 MG TAB	250		$        3.10
4922004	GOLIMUMAB 50MG INJ JA	636	J1602	$      77.18
4529200	CARBOXYMETHYCEL 0.5% OPT	250		$        2.95
4280061	MODAFINIL 100 MG TAB	250		$        8.10
4204012	ALTEPLASE 2MG/2ML JA	636	J2997	$     171.51
4280823	METHADONE HCL 5 MG TAB	250		$        0.80
4880819	THIAMINE HCL 100 MG TAB	250		$        0.80
4562008	ONDANSETRON 4 MG ODT	250		$      33.85
4240801	METOPROLOL TART 100MG TAB	250		$        1.35
4682018	METFORMIN HCL 500 MG TAB	250		$        1.15
4240625	PRAVASTATIN 10 MG TAB	250		$        5.20
4682017	METFORMIN HCL 1000 MG TAB	250		$        2.95
4920217	MONTELUKAST 10 MG TAB	250		$        5.25
4560414	CALCIUM CARB 500 MG CHEW	250		$        0.80
4402845	HYDROCHLOROTHIAZIDE 25 MG	250		$        0.80
4683638	LEVOTHYROXINE 75 MCG TAB	250		$        1.20
4040071	CETIRIZINE HCL 10 MG TAB	250		$        3.50
4561204	BISACODYL 5 MG TAB_EC	250		$        0.80
4880845	THIAMINE 200 MG INJ	250		$      65.40
4121627	ARFORMOTEROL 15 MCG/2ML	250		$      14.48
4402841	FUROSEMIDE 20 MG/2ML INJ	250		$      65.40
4564062	PANTOPRAZOL 80MG FOR DRIP	636	C9113	$      65.43
4081490	VANCOMYCIN 125MG/2.5ML UD	250		$        5.25
4040057	LORATADINE 10 MG TAB	250		$        0.80
4682051	HUMALOG PEN 100U/ML	636	J1815	$     118.08
4240633	ATORVASTATIN 10 MG TAB	250		$        4.25
4240944	LOSARTAN 100 MG TAB.	250		$        3.60
4840518	BACITRACIN OINT UD PKT	250		$        0.80
4560415	ALUM-MAG HYDR-SIM DS 30ML	250		$        0.80
4281947	ESCITALOPRAM 10 MG TAB	250		$        3.60
4400821	SOD BICARB 50MEQ VIA	250		$      33.85
4281283	PREGABALIN 75 MG CAP	250		$        2.55
4411113	*SOD CHLOR 0.9% 25 ML	250		$     149.60
4280029	OLANZAPINE 2.5 MG TAB	250		$        9.80
4100002	FLUOROURACIL 500MG JA	636	J9190	$      79.27
4281540	HYDRO/APAP 7.5/325MG15ML	250		$        3.24
4564031	MESALAMINE 400 MG EC TAB	250		$        1.70
4281781	HYDROXYZINE HCL 25 MG TAB	250		$        1.40
4281996	QUETIAPINE 50MG TABLET	250		$        5.70
4100028	CYCLOPHOSPHAMIDE 1G JA	636	J9070	$     145.18
4240643	SIMVASTATIN 40 MG TAB	250		$        7.75
4402864	SPIRONOLACTONE 25 MG TAB	250		$        0.80
4281301	LEVETIRACETAM 500MG INJ``	636	J1953	$     120.65
4081472	CLINDAMYCIN600MG PMX 50ML	636	J3490	$     245.75
4882440	PHYTONADIONE 1 MG INJ	636	J3430	$      65.40
4120403	TIZANIDINE HCL 4 MG TAB	250		$        2.30
4081612	CEFTRIAXONE 1 GM/NS 50 ML	250		$     340.85
4083203	METRONIDAZOLE 500 MG TAB	250		$        1.80
4081471	CIPROFLOXACIN 400MG PGBK	250		$     246.91
4800417	IMM GLOB 5GM PRIVIGEN JA	636	J1459	$     159.98
4683616	LEVOTHYROXINE 100 MCG TAB	250		$        1.23
4281698	SERTRALINE HCL 100 MG TAB	250		$        4.65
4240501	LABETALOL HCL 100 MG TAB	250		$        0.80
4521607	HURRICAINE 1 SPR UD 0.5ML	250		$      12.06
4240903	LISINOPRIL 5 MG TAB	250		$        1.40
4281557	METHADONE 5MG/0.5ML CONC.	250		$        0.89
4411109	*SOD CHLOR 0.9 IRR 3000ML	250		$      97.30
4240693	OMEGA 3 FATTY ACIDS1000MG	250		$        0.80
4240528	AMIODARONE HCL 200 MG TAB	250		$        5.25
4240821	HYDRALAZINE 20 MG/ML INJ	636	J0360	$     208.08
4366807	IOPAMIDOL M 200 41% 10 ML	636	Q9966	$     149.18
4240925	LOSARTAN POT 50 MG TAB	250		$        2.80
4081366	CEPHALEXIN 500 MG CAP	250		$        2.80
4720059	BUPIVACAINE 0.5% 30ML INJ	636	J3490	$     116.30
4081518	MEROPENEM 1 GM INJ.	636	J2185	$     185.00
4122041	SUCCINYCHOLINE 140MG/7 ML	636	J0330	$      65.43
4281697	SERTRALINE HCL 50 MG TAB	250		$        4.65
4201219	HEPARIN 25,000 U PRMX INJ	636	J1644	$     246.91
4520449	ERYTHROMYCIN OP OINT 1G	250		$      12.42
4240642	SIMVASTATIN 20 MG TAB	250		$        7.75
4082411	SULFAMETH-TRIMETH DS TAB	250		$        2.30
4240375	CARVEDILOL 6.25 MG TAB	250		$        3.05
4281297	GABAPENTIN 800 MG TAB	250		$        5.45
4100169	CISPLATIN 100MG INJ JA	636	J9060	$      15.96
4860007	OXYBUTYNIN CL 5 MG TAB	250		$        0.80
4401235	CALCIUM CARBONATE 500 MG	250		$        0.80
4100117	CARBOPLATIN 600MG JA	636	J9045	$      27.82
4680441	PREDNISONE 10 MG TAB	636	J7512	$        0.92
4240540	NIFEDIPINE 30 MG ER TAB	250		$        2.20
4368411	GADOBENATE 529MG/ML 20 ML	636	A9577	$     254.78
4081608	CEFOXITIN 2 G PREMIX IV	250		$     259.50
4282497	ZOLPIDEM TART 5 MG TAB	250		$        4.45
4281218	CLONAZEPAM 0.5 MG TAB	250		$        1.30
4682049	GLARGINE PEN 100U/ML	250	J1815	$      89.47
4401262	*D5-LR+OXYTO 20UNITS 1000	258		$     246.90
4920040	CARBIDOPA-LEVO 25-100 TAB	250		$        1.30
4100177	GEMCITABINE 1000 MG INJJA	636	J9201	$     248.49
4920022	FINASTERIDE 5 MG TAB	250		$        4.85
4121230	EPHEDRINE SULF 50 MG INJ	250		$      83.33
4281688	SERTRALINE HCL 25 MG TAB	250		$        4.65
4281613	TRAZODONE HCL 50 MG TAB	250		$        0.80
4281981	DULOXETINE 60 MG DR CAP	250		$        6.10
4564000	METOCLOPRAMIDE 10MG INJ	636	J2765	$      65.40
4120408	BETHANECHOL CL 25 MG TAB	250		$        2.95
4280777	IBUPROFEN 100MG/5 ML UD	250		$        0.80
4411080	*D5W-NACL 0.9% 1000 ML	258		$     221.65
4281303	LEVETIRACETAM 500/5 SUSP	250		$        4.45
4281773	HALOPERIDOL LAC 5 MG INJ	636	J1630	$      73.35
4081473	CLINDAMYCIN900MG PMX 50ML	636	J3490	$     283.25
4281106	HYDROMORPHONE PCA 6 MG IJ	636	J1170	$     105.10
4081249	AMPICILLIN SOD 1 G INJ	636	J0290	$      65.40
4800801	DIPHTH-PERTUS-TET INJ	636	90715	$     106.34
4280007	CITALOPRAM HBR 20 MG TAB	250		$        4.40
4280893	HYDROMORPHONE 2 MG TAB	250		$        0.80
4680433	DEXAMETHASONE 4 MG TAB	250		$        1.10
4120856	SCOPOLAMINE 1.5 MG PATCH	250		$      20.25
4240705	DILTIAZEM 100MG FOR DRIP	636	J3490	$      65.43
4920003	ALLOPURINOL 300 MG TAB	250		$        1.05
4240924	LOSARTAN POT 25 MG TAB	250		$        2.80
4402876	SPIRONOLACTONE 50 MG TAB	250		$        1.40
4562812	NIZATIDINE 15MG/ML SOLN.	250		$        8.60
4081670	AMPICILLIN-SULB 3 G INJ	250		$      91.20
4201259	HEPARIN 30 U/3 ML INJ	636	J1642	$      19.30
4281229	GABAPENTIN 400 MG CAP	250		$        2.95
4201277	HEPARIN 1000U/NS 1000ML	636	J1644	$     287.10
4281974	DULOXETINE 30 MG CPDR	250		$        5.70
4281897	FLUOXETINE HCL 20 MG CAP	250		$        4.30
4411078	*SOD CHLOR 0.9%-KCL 20 1L	636	J3480	$     246.90
4084000	LINEZOLID 600 MG PGBK JA	250		$      64.64
4680440	PREDNISONE 5 MG TAB	636	J7512	$        0.80
4843607	MENTHOL-ZINC OXIDE OINT	250		$        8.25
4040051	PROMETHAZINE 12.5MG IVPB	636	J2550	$     207.55
4523250	PHENYLEPHRI100MCG/ML 10ML	636	J2370	$      65.43
4281284	PREGABALIN 100 MG CAP	250		$        2.55
4240374	CARVEDILOL 3.125 MG TAB	250		$        3.05
4920352	NICOTINE 14 MG/24 HR PATC	250		$      16.45
4281507	LACOSAMIDE 200 MG TAB	250		$      16.02
4561014	SIMETHICONE 80MG CHEW TAB	250		$        0.80
4240551	DILTIAZEM HCL 60MG CP_12H	250		$        1.20
4100039	RITUXIMAB 500MG JA	636	J9310	$  2,038.97
4240877	METOPROLOL SUCC 50 MG TAB	250		$        1.40
4240797	DOXAZOSIN MESYL 2 MG TAB	250		$        1.45
4202824	TRANEXAMIC-ACID1000MG INJ	250		$     210.75
4882817	B COMPLEX-VITAMINS TAB	250		$        0.90
4081321	DOXYCYCLINE MONOHYD 100MG	250		$        2.39
4683629	LEVOTHYROXINE 150 MCG TAB	250		$        0.80
4561219	DOCUSATE SOD 100MG/10 UD	250		$        0.80
4920261	TACROLIMUS 1 MG CAP	636	J7507	$        6.50
4289221	MEMANTINE HCL 10 MG TAB	250		$        3.65
4240021	AMLODIPINE  2.5 MG TAB	250		$        2.60
4081481	NYSTATIN 500 KU UD SUSP	250		$        2.60
4202826	RIVAROXABAN 10 MG TAB	250		$      13.34
4368405	IOPAMIDOL 370 MG 100 ML	636	Q9967	$     236.96
4281290	DIVALPROEX 500 MG EC TAB	250		$        3.50
4201245	WARFARIN SODIUM 5 MG TAB	250		$        2.31
4240936	LISINOPRIL 40MC TABLET	250		$        2.30
4760042	OXYTOCIN 10 UNITS INJ	636	J2590	$      65.40
4241290	ISOSORBIDE MONO 30MG ER	250		$        2.20
4122048	CYCLOBENZAPRINE 10MG TAB	250		$        1.45
4720056	BUPIVAC-EPI 0.25% 30ML IN	250		$     181.40
4680424	FLUDROCORTISONE 0.1MG TAB	250		$        1.30
4683614	LEVOTHYROXINE 25 MCG TAB	250		$        1.17
4280952	NALBUPHINE 10 MG INJ	636	J2300	$      80.75
4880421	MULTI VIT-PEDI CHEW TAB	250		$        0.80
4240420	DIGOXIN 0.125 MG TAB	250		$        0.80
4720037	LIDOCAINE 1% MPF 30ML INJ	250		$      74.80
4720090	BUPIVACAINE 0.25%10ML INJ	636	J3490	$      65.40
4281217	MAGNESIUM SULF 1G/2ML INJ	250		$      65.40
4081104	AMOXICILLIN-CLAV 875MG TB	250		$        8.20
4281219	CLONAZEPAM 1 MG TAB	250		$        1.40
4081350	GENTAMICIN 80 MG/2ML INJ	636	J1580	$      65.40
4880836	CYANOCOBALAMIN 1000MCG	636	J3420	$        0.80
4281254	HYDROCO/ACETAMI 7.5/325MG	250		$        0.80
4201238	ENOXAPARIN NA 80 MG INJ	636	J1650	$     191.00
4521605	LIDOCAINE 2% VISC 20ML UD	250		$        2.00
4280035	OXYCODONE 20 MG ER TAB	250		$        6.43
4100031	CISPLATIN 50MG INJ JA	250		$      23.15
4280049	LAMOTRIGINE 25 MG TAB	250		$        5.45
4561220	BISACODYL 10 MG SUPP	250		$      10.35
4129200	NICOTINE 4 MG GUM	250		$        0.80
4801216	HEP B VAC 10MCG INJ  PED	636	90744	$     116.20
4201285	SODIUM CITRATE 4% 3ML	250		$      65.43
4562838	LANSOPRAZOLE 30MG SOLTAB	250		$        8.33
4282503	DEXMEDETOMID400MCG/100ML	250		$     384.26
4081622	CEFAZOLIN 1GM/5DW 50 ML	636	J0690	$     273.30
4081497	LEVOFLOXACIN 500 MG PGBK	636	J1956	$     142.51
4683620	LEVOTHYROXINE 125 MCG TAB	250		$        1.32
4240832	HYDROCHLOROTHIAZIDE12.5MG	250		$        0.80
4100129	ATEZOLIZUMAB 1200MG JA	636	C9483	$     174.72
4240641	SIMVASTATIN 10 MG TAB	250		$        4.45
4100083	CARBOPLATIN 450MG INJ JA	636	J9045	$      25.51
4281703	ALPRAZOLAM 0.25 MG TAB	250		$        1.15
4083682	CIPROFLOXACIN 500 MG TAB	250		$        8.25
4081464	CLINDAMYCIN HCL 300MG CAP	250		$        5.95
4281134	FENTANYL 100MCG FOR DRIP	636	J3010	$      65.43
4720010	LIDOCAINE-EPI 2% 20ML INJ	250		$      65.40
4801235	INFLUENZA 0.5 ML FLULAVAL	636	Q2036	$      38.00
4920309	PERFLUTREN (DEFINITY)	636	Q9957	$     346.15
4160007	ALBUMIN HUMAN 25% 50ML IJ	636	P9047	$     218.16
4411111	*SOD CHLOR 0.9% IRR 250ML	250		$      77.35
4121314	ALBUTEROL HFA INHALER	250		$      58.25
4280074	MORPHINE 5MG/ML 1ML	636	J2270	$      65.43
4368409	GADOBENATE 529MG/ML 15ML	636	A9577	$     206.32
4411070	*D5W-NACL 0.45% 1000 ML	258		$     221.65
4366804	IOPAMIDOL 300 61% 50 ML	636	Q9967	$     109.25
4411050	*DEXTROSE 5% 1000 ML SOLN	258	J7070	$     221.65
4120832	BENZTROPINE MESYL 1MG TAB	250		$        0.80
4280027	MIRTAZAPINE 15 MG TAB	250		$        4.40
4081153	AZTREONAM 2 G INJ	636	J3490	$     157.95
4882875	MULTI VIT-MINERALS TAB	250		$        0.80
4480018	BENZONATATE 100 MG CAP	250		$        1.20
4680444	HYDROCORTISONE 100 MG INJ	636	J1720	$      65.40
4411105	*SOD CHLOR 0.9% 150 ML	258		$     149.60
4281299	DIVALPROEX 500 MG 24H TAB	250		$        3.60
4840823	LIDOCAINE 4% 4ML SYRINGE	250		$      31.52
4240700	DILTIAZEM 180 MG CAP_24H	250		$        1.90
4201249	ENOXAPARIN NA 100 MG INJ	636	J1650	$     227.00
4411093	*D5W-LR IV 1000 ML	258		$     221.65
4081842	LEVOFLOXACIN 750 MG TAB	250		$      35.60
4280492	KETAMINE/NS 100MG/10ML	250		$      74.95
4281268	OLANZAPINE 5 MG TAB	250		$      11.70
4281211	PHENYTOIN 100 MG ER CAP	250		$        0.80
4720077	BUPIVACAINE 0.5% 10ML INJ	636	J3490	$      65.40
4100069	FULVESTRANT 250MG/5ML JA	636	J9395	$     466.10
4240022	VERAPAMIL HCL 120MG ER TB	250		$        1.45
4081407	BACIT-NEOM-POLY OINT PKT	250		$        0.78
4201283	APIXABAN 2.5 MG TAB	250		$        5.31
4121307	ROPINIROLE HCL 2 MG TAB	250		$        2.50
4402842	FUROSEMIDE 100MG/10ML INJ	250		$      65.40
4280894	HYDROMORPHONE 4 MG TAB	250		$        1.05
4411088	*D5W-NACL 0.45-KCL 20 1L	258		$     227.60
4522820	BENZO-MENTH-CETHYL LOZ	250		$        0.80
4281709	CHLORDIAZEPOXIDE 25MG CAP	250		$        0.80
4100180	IRINOTECAN 40 MG INJ JA	636	J9206	$      72.36
4683621	LEVOTHYROXINE 88 MCG TAB	250		$        1.22
4083653	NITROFURAN MON MACR 100MG	250		$        3.90
4482400	ACETYLCYST 20% 4ML SOLN	250		$      20.85
4280004	MORPHINE 15 MG TAB 12HR	250		$        1.40
4564001	METOCLOPRAMIDE 10 MG TAB	250		$        0.80
4080006	ACYCLOVIR 400 MG TAB	250		$        3.50
4881606	DOXERCALCIFEROL 4MCG/2ML	636	J1270	$      30.30
4920265	CINACALCET HCL 30 MG TAB	250		$      12.80
4282068	ACETAMIN24OMG/7.5 ML SOLN	250		$        0.75
4121207	EPINEPHRINE HCL 1MG INJ	636	J0171	$      65.40
4882851	MULTIPLE VITAMIN 10ML INJ	250		$      75.55
4281746	DIAZEPAM 5 MG TAB	250		$        0.80
4680467	BETAMETH SUSP 30MG/5 INJ	636	J0702	$     124.20
4280989	IBUPROFEN 400 MG TAB	250		$        0.80
4240649	REGADENOSON 0.4MG/5ML INJ	636	J2785	$     609.40
4561275	SENNOSIDES 8.8 MG UD SYRP	250		$      32.55
4120852	GLYCOPYRROLATE 0.2 MG INJ	636	J3490	$      65.40
4682028	METFORMIN 500MG TAB_24H	250		$        1.40
4289220	MEMANTINE HCL 5 MG TAB	250		$        3.65
4240627	PRAVASTATIN 40 MG TAB	250		$        7.85
4120413	DONEPEZIL HCL 10 MG TAB	250		$        8.40
4081813	CEFUROXIME 500 MG TAB	250		$      18.50
4281948	ESCITALOPRAM 20 MG TAB	250		$        4.10
4201237	ENOXAPARIN NA 60 MG INJ	636	J1650	$     155.20
4240418	DILTIAZEM HCL 30 MG TAB	250		$        0.80
4920090	DEXTROSE 50% 50ML SYRINGE	250		$      65.40
4411081	*DEXTROSE 10% 500 ML SOLN	258		$     221.65
4281704	ALPRAZOLAM 0.5 MG TAB	250		$        1.45
4840525	IODINE TINCTURE 2% 30 ML	250		$        2.89
4121628	FLUTIC/VILANT 100-25 MCG	250		$     137.71
4800451	IMM GLOB OCTAGAM 5GM JA	636	J1568	$     167.77
4560829	LOPERAMIDE HCL 2 MG CAP	250		$        1.15
4281523	FENT-ROPIV 2-0.1% 250 ML	250		$     293.95
4920038	CARBIDOPA-LEVO 10-100 TAB	250		$        1.20
4281050	MORPHINE (PCA) 30 MG INJ	636	J2270	$      93.50
4520005	FLUTICASONE NAS SPRAY	250		$     116.55
4081614	RIFAXIMIN 550 MG TAB	250		$      25.95
4081150	AZTREONAM 1 G INJ	636	J3490	$      96.10
4083670	PHENAZOPYRIDINE 100MG TAB	250		$        0.80
4401812	SOD POLYST SULF 15G SUSP	250		$      14.00
4411040	*DEXTROSE 5% 250 ML SOLN	258	J7060	$     149.60
4280014	DIVALPROEX 125 MG CAP ER	250		$        1.10
4280050	LAMOTRIGINE 100 MG TAB	250		$        5.80
4720016	LIDOCAINE 2% URO 10ML	250		$      35.05
4240440	PROPRANOLOL 10 MG TAB	250		$        0.80
4282460	BUSPIRONE HCL 15 MG TAB	250		$        2.25
4241222	ISOSORBIDE MONO 60MG ER	250		$        1.70
4081289	BACITRACIN 50000 U INJ	250		$      69.40
4120436	RIVASTIGMINE 4.6MG/24HR P	250		$      16.09
4280493	PROPOFOL 500 MG/50 ML	636	J2704	$     219.05
4240532	VERAPAMIL HCL 40 MG TAB	250		$        1.05
4240419	DILTIAZEM HCL 60 MG TAB	250		$        1.15
4950071	SIMPLE SYRUP 1 ML	250		$        0.78
4561604	LI/PR/AM12000/30000/60000	250		$        2.20
4241283	NITROGLYCERIN OINT UD PKT	250		$        6.65
4680490	PREDNISOLONE 15MG/5ML UD	250		$        4.40
4081626	AZITHROMYCIN 500 MG VIAL	636	J0456	$      65.40
4240669	DILTIAZEM 100MG ADDVANTAG	636	J3490	$      65.43
4401301	*SOD CHLO NON-DEHP 250ML	636	J7050	$     221.65
4920123	CHERRY SYRUP 1 ML	250		$        0.78
4240698	DILTIAZEM 120 MG CAP_24H	250		$        2.00
4683622	LEVOTHYROXINE 112 MCG TAB	250		$        1.24
4720014	BUPIVAC-EPI 0.5% 30ML INJ	250		$      77.20
4366812	IOPAMIDOL 300 61% 75 ML	636	Q9967	$     177.12
4121304	ROPINIROLE HCL 0.25MG TAB	250		$        2.50
4680488	DEXAMETH4MG/ML INJ FOR PO	250		$      36.70
4241244	NITROGLYCERIN 0.4 MG SUBL	250		$      28.53
4100023	CYCLOPHOSPHAMIDE 500MG JA	250		$     152.64
4280006	LORAZEPAM 2MG/ML UD CONC	250		$        2.45
4240825	PRAZOSIN HCL 1 MG CAP	250		$        0.80
4682020	GLIPIZIDE 5 MG TAB	250		$        0.80
4240495	LABETALOL HCL 100MG INJ	636	J3490	$     176.05
4281910	PAROXETINE 20 MG TAB	250		$        4.30
4281036	DEXAMETHASONE 2 MG TAB	250		$        1.10
4081529	MICAFUNGIN 100 MG INJ.	636	J2248	$     462.65
4681642	ESTRADIOL 1 MG TAB	250		$        0.80
4480025	GUAIFEN-DM 200-20 MG/10ML	250		$        0.80
4563601	MESALAMINE 1.2 G DR TAB	250		$        9.10
4281705	ALPRAZOLAM 1 MG TAB	250		$        1.80
4080012	HYDROXYCHLOROQ 200 MG TAB	250		$        1.90
4682904	OCTREOTIDE LAR DEP 30MG	636	J2353	$12,705.97
4081495	ERTAPENEM SODIUM 1 G INJ	636	J1335	$     225.92
4680449	METHYLPRED ACET 80 MG INJ	636	J1040	$      82.75
4240002	METOPROLOL SUCC 100MG TAB	250		$        2.05
4240954	NICARDIPINE 20 MG/200 ML	250		$     246.91
4081606	AZITHROMYCIN 500 MG TAB	250		$      24.05
4100082	CARBOPLATIN 150MG INJ JA	636		$      40.97
4880850	CYANOCOBALAMIN 500MCG TAB	250		$        0.80
4281612	TRAZODONE HCL 100 MG TAB	250		$        1.20
4281258	DIVALPROEX 250 MG EC TAB	250		$        2.00
4081692	CEFTRIAXONE 2 GM/NS 50 ML	636	J0696	$     475.90
4281919	VENLAFAXINE 75MG ER CAP	250		$        5.45
4281649	ARIPIPRAZOLE 5 MG TAB	250		$      35.68
4121622	NOREPHINE16MG/NACL 250 ML	250		$     457.70
4280063	PRIMIDONE 50 MG TAB	250		$        0.80