AUDUBON COUNTY MEMORIAL HOSPITAL,
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Charge Code Description,Rate
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INJECT CARPAL TUNNEL,175
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INJECT TENDON/ LIGAMENT,140
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TRIGGER POINT INJECTION 1/2 MUSCL,135
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INJECT TRIGGER POINT 3/>,150
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INJECT JOINT/ BURSA,145
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INJECT JOINT BURSA INT,145
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INJECT JOINT/ BURSA LARGE,155
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ARTHRO INJECTION MAJOR JT/BURSA-BILATERA,315
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SPINAL FLUID TAP DIAGNOSTIC,350
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EPIDURAL PATCH INJECT,400
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INJECT SPINE CERVICAL/ THORACIC,490
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INJECT SPINE LUMBAR/ SACRAL,500
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NERVE BLOCK OCCIPITAL INJ,215
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NERVE BLOCK INTERCOST INJ SNG,235
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NERVE BLOCK INTERCOST INJ MLT,375
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NERVE BLOCK ILIO/HYPGASTRIC INJ,275
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NERVE BLOCK SCIATIC INJ SNG,350
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NERVE BLOCK FEMORAL INJ SNG,340
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NERVE BLOCK OTHER PERIPHERAL,250
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LUMBAR/ SACRAL INJECTION,495
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LUMBAR/ SACRAL JOINT INJECTION EACH LEV,225
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CERVICAL/ THORACIC INJ 1 LEVEL,600
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INJ PARAVERT F JNT C/T 2 LEVEL,250
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INJ PARAVERT F JNT C/T 3 LEVEL,250
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LUMBAR/ SACRAL INJ 1 LEVEL,500
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INJ PARAVERT F JNT L/S 2 LEVEL-SINGLE,200
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INJ PARAVERT F JNT L/S 3 LEVEL,200
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NERVE BLOCK SPENOPALATINE GANGL,275
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NERVE BLOCK LUMBAR/THORACIC,390
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CERVICAL/ THORACIC,900
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LUMBAR/ SACRAL FACET,900
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INJECTION TREATMENT OF NERVE,325
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INJECT SACROILIAC JOINT- BILATERAL,875
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NERVE BLOCK OTHER PERI- BILATERAL,475
LUMBAAR/SACRAL TRANSACTION-BILATERAL,900
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INJ PARAVERT F JNT L/S 1 LEVEL-BILATERAL,975
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INJ PARAVERT F JNT L/S 2 LEVEL-BILATERAL,425
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INJ PARAVERT F JNT L/S 3 LEVEL-BILATERAL,425
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FLOURO GUIDANCE NEEDLE PLACEMENT ADD ON,100
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SACROILIAC JOINT INJECT,450
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PAIN CLINIC NEW PROB FOCUSED,75
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PAIN CLINIC NEW EXP PROBLEM,120
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PAIN CLINIC NEW DETAILED VISIT,185
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OFFICE OUTPATIENT NEW 45 MIN,275
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PAIN CLINIC EST LEVEL 2,70
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PAIN CLINIC EST LEVEL 3,115
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PAIN CLINIC EST LEVEL 4,165
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INITIAL INPATIENT CONSULT,200
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PROBLEM FOCUSED NEW PT,74.32
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EXP PROBLEM FOCUS NEW,141.34
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DETAILED NEW PT,214.43
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COMPREHENSIVE-MOD NEW PT,364.15
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COMPREHENSIVE-HIGH NEW PT,468.41
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"O/P VISIT, EST PT LVL 1",26.72
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OFFICE VISIT LEVEL 2,72.47
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OFFICE VISIT LVL 3,143.64
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DETAILED OFFICE VISIT L4,220.87
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COMPREHENSIVE OFFICE VIST,310.63
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DETAILED HOSP CARE-INITIA,282.5
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COMP MOD INITIAL HOSP CA,383.4
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COMP HIGH INITIAL HOSP CA,564.66
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SUBS OBS CARE LVL 1,111.96
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SUBS OBSER CARE LEVEL 2,204.24
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SUBS OBSER CARE LEVEL 3,293.09
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CARDIOVERSION ELECTRIC EXT,344.48
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"NF CARE, INIT LEVEL 1",257.82
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"NF CARE , INIT LEVEL 2",364.54
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"NF CARE , INIT LEVEL 3",460.43
FACE TO FACE/1ST HOUR,259.78
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FACE TO FACE EA ADD 30 MI,255.13
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EST PT/DISABILITY EXAM,274.01
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NEW PT/DISABLILTY EXAM,269.74
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BONE MARROW ASPIRATE,36.85
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BONE MARROW ASPIRATION,249.25
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BONE MARROW BIOPSY,310.95
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DIAGNOSTIC BONE MARROW ASPIRATIONS/ BIOP,385
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"OFFICE/OP VISIT, NEW LV1",107.18
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"OFFICE/OP VISIT, NEW LV2",203.85
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"OFFICE/OP VISIT, NEW LV3",309.26
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"OFFICE/OP VISIT, NEW LV4",525.21
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"OFFICE/OP VISIT, NEW LV5",675.6
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"OFFICE/OP VISIT, EST LV1",38.53
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"OFFICE /OP VISIT, EST LV2",104.52
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"OFFICE/OP VISIT, EST LV3",207.19
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"OFFICE/OP VISIT, EST LV4",318.57
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"OFFICE/OP VISIT, EST LV5",448.02
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"INPT E/M, INIT. LEVEL 1",407.44
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"INPT E/M, INIT. LEVEL 2",552.98
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"INPT E/M, INIT. LEVEL 3",814.4
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SUBS OBS CARE LVL 1,161.48
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SUBS OBSER CARE LEVEL 2,294.55
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SUBS OBSER CARE LEVEL 3,422.73
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CARPAL TUNNEL TX INJ,198.37
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INJ SGL TENDON SHTH OR LI,145.63
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DRAIN/INJECT SM JNT/BURSA,136.76
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DRAIN/INJ INTERM JNT/BURS,200.21
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ASPIRATE/INJ GANGLION CYS,147.2
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NEUROPLASTY; MEDIAN NERVE,"1,465.57"
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"EXC 1"" WRIST GANGLION","1,104.47"
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TENDON SHEATH INCISION,"1,059.63"
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EXC HAND LES SC < 1.5 CM,"1,146.16"
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EXC TNDN SHTH LES HND/FING,"1,313.97"
POST OP FOLLOWUP VISIT,0
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SHORT ARM CAST,215.56
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APPLY GAUNTLET CAST,171.22
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THUMB SPICA,177.33
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SHORT ARM SPLINT,136.14
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"OFFICE/OP VISIT, NEW LV1",79.45
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"OFFICE/OP VISIT, NEW LV2",151.12
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"OFFICE/OP VISIT, NEW LV3",229.27
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"OFFICE/OP VISIT, NEW LV4",389.35
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"OFFICE/OP VISIT, EST LV1",28.57
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"OFFICE/OP VISIT, EST LV2",77.49
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"OFFICE/OP VISIT, EST LV3",153.59
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"OFFICE/OP VISIT, EST LV4",236.17
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2ND SURG-CYSTOSCOPY,"1,430.00"
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O.R. 1ST 30 MIN,915.28
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2ND SURG-DECOMPRESS FOREARM 1 SPACE,"2,905.50"
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2ND SURG-COLOREC CANCR SCR;COLNSCPY NOT,"1,430.50"
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O.R. EACH ADD 15 MIN,302
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TIS TRNFR F/C/C/M/N/A/G/H/F,"5,691.00"
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INCISION DRAINAGE ABSCESS SIMPLE/SINGLE,"1,844.00"
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INCISION DRAINAGE ABSCESS COMPLEX/MULT,"1,844.00"
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2ND SURG-FRACTURE NASAL INFERIOR TURBINA,"2,167.50"
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COLOREC CANCER SCR;COLONSCPY INDIV HI RI,"2,383.00"
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2ND SURG-REPAIR OF FOOT TENDON,"2,086.50"
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2ND SURG-HEMORRHOIDECTOMY INT RUBBER BAN,950.5
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2ND SURG-EGD DIAGNOSTIC,"1,346.00"
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2ND SURG-PARTIAL EXCISION DISTAL PHALANX,"1,975.00"
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2ND SURG-EGD TRANSORAL BIOPSY SINGLE/MUL,"1,346.00"
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2ND SURG-VASECTOMY UNI/BI SPX W/POSTOP S,"2,776.00"
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2ND SURG-NASAL/SINUS ENDOSCOPY W/ETHMOID,"2,893.00"
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2ND SURG-COMBINED ANTERPOSTERIOR COLPO,"3,359.00"
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2ND SURG-INSERT MESH/ PELVIC FLOOR,"2,096.00"
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2ND SURG -SURG TX ANAL FISTULA SUBQ,"2,665.00"
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2ND SURG-COLPOPEXTY VAG EXTRAPERITONEAL,"3,359.00"
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2ND SURG-SLING OPER STRESS INCONTINENCE,"4,022.50"
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2ND SURG-CYSTO W/SIMPLE REMOVAL STONE ST,"1,430.50"
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2ND SURG-LAPAROSCOPY ASPIRATION,"3,862.00"
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2ND SURG -LAP INSERT TUNNEL IP CATH,"3,862.00"
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2ND SURG-SIGMOIDOSCOPY FLX DX W/COLLJ,950.5
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2ND SURG-SIGNOIDOSCOPY AND BIOPSY,"1,042.00"
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2ND SURG-CYSTO W/INSERT URETERAL STENT,"1,430.50"
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CYSTOURETERO W/ LYTHOTRIPSY,"4,870.00"
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2ND SURG- CYSTO/URETERO W/LITHOTRIPSY,"4,990.00"
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2ND SURG-REMOVAL OF FOREIGN BODY,"2,200.50"
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2ND SURG-DIAGNOSTIC COLONOSCOPY FLEX,"1,430.50"
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2ND SURG-COLONOSCOPY W/BIOPSY SINGLE/MUL,"1,430.50"
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2ND SURG-COLONOSCOPY W/ LESION REMOVAL,"1,662.00"
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2ND SURG-COLSC FLX W/RMVL OF TUMOR POLY,"1,662.00"
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NEPHR INJ VIA INDWELLING,679
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2ND SURG-SUSPENSION OF UTERUS,"2,096.00"
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2ND SURG-VENTILATING TUBE RMVL REQUIRING,"2,320.50"
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2ND-SURG-TYPANOSTOMY GENERAL ANESTH,"2,167.50"
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2ND SURG-EXC FACE-MM B9+MARG 1.1-2 CM,955
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EXC FACE-MM +MARG2.1-3CM,"4,401.00"
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2ND SURG-REPAIR WRIST JOINTS,"5,295.00"
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2ND SURG-DILATION ESOPH UNGUIDED SOUND/B,"1,207.50"
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2ND SURG-RPR 1ST INGUN HRNA AGE 5YRS/> R,"3,536.00"
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2ND SURG-HYSTER BX ENDOMET/POLYPC W /WO,"3,439.00"
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2ND SURG-BIOPSY OF UTERUS LINING,163.5
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2ND SURG-RPR UMBIL HERN REDUC>5 YR,"3,536.00"
LITHOTRIPSY XTRCORP SHOCK WAVE,"11,808.00"
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2ND SURG-DILATE URETHRA STRICTURE,"1,399.00"
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TIS TRNFR E/N/E/L 10 SQ CM/<,"5,691.00"
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INCISE FINGER TENDON SHEATH,"3,950.00"
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2ND-SUTURE 1 NERVE ULNAR MOTOR,"1,700.00"
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2ND SURG-LAPAROSCOPY EXCISE LESIONS,"6,091.50"
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2NS SURG-LAPAROSCOPY TUBAL CAUTERY,"5,317.00"
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REMOVAL IMPLANT DEEP,"3,665.00"
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2ND SURG-IRRIGATION OF BLADDER,308
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2ND SURG-CHANGE OF BLADDER TUBE,602.5
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BILATERAL CARPAL TUNNEL SURGERY,"8,100.00"
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BIOPSY OF MOUTH LESION,"1,591.00"
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2ND SURG- REMOVE EPIDIDYMIS LESION,"2,310.00"
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2ND SURG- WRIST ENDOSCOPY/ SURGERY,"2,715.00"
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2ND SURG-KNEE ARTHROSCOPY/SURGERY,"3,260.50"
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2ND SURG-KNEE ARTHROSCOPY/SURGERY,"3,260.50"
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2ND SURG-ARTHROSC KNEE; W MEN REP-MED&LA,"3,260.50"
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2ND SURG-DILATION OF ANAL SPHINCTER,"2,382.50"
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2ND SURG-EXCISION OF ANAL LESION,"1,647.50"
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2ND SURG-DESTRUCT INTRL HEMORRHOID THERM,"2,382.50"
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2ND SURG-HRHC NTRNL LIG OTHE THAN RUBBR,"2,382.50"
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2ND SURG-LAP APPENDECTOMY,"5,317.00"
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2ND SURG-ARTHROSCOPY OF JOINT,"3,260.50"
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REMOVE MESH FROM ABD WALL,"1,012.00"
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EXC FACE LESION SC <2CM,"3,610.00"
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EXCISION TUMOR SOFT TISS FACE/SCALP 2CM/,"3,610.00"
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DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM,572
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DEBRIDEMENT SUBCUT TISSUE EA ADD 20 SQ C,572
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DEBRIDE ABDOM WALL,"3,691.00"
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BIOPSY SKIN LESION,"1,910.00"
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DRAIN BLADDER INSERT SUPRAPUBIC,"5,848.00"
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REMOVE FOREIGN BODY,"1,535.00"
"COLOREC CANCR SCR, PT NOT HI RISK","2,861.00"
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2ND SURG-EXCISION TR EXT B9+MARG 2.1-3CM,950
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2ND SURG- EXCISION TR EXT B9 1.1-2CM,950
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2ND- EXC B9 LESION MRGN SKN TAG 2.1-3.0,800
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2ND-EXCISION MALIGNANT LES >4.0CM,"1,832.50"
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2ND-REMOVAL OF SKIN TAGS,285
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2ND SURG- INTMD REPAIR S/A/T/EXT 2.6-7.5,360
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2ND SURG- INTMED RPR S/A/T/EXT 2.5CM<,360
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SHAVE SKIN LESION > 2.0CM,572
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2ND-REPAIR COMPLEX TRUNK 2.6-7.5 CM,650
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2ND-REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5,302
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REPAIR COMPLEXT F/C/C/M 2.6.-7.5 CM,603
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2ND SURG- COMPLEX REPAIR E/N/E/L 2.6-7.5,812
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TISSUE TRANSFER TRUNK 10 SQ CM/<,"1,254.00"
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EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2,"1,910.00"
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EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3,"1,910.00"
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EXC TR EXT B9+MARG 3.1-4CM,"1,591.00"
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EXC B9 LESION MRGN XCP SK TG T/A/L>4.0 C,"4,401.00"
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EXCISION H-F-NK-SP B9+MARG 1.1-2,"1,591.00"
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EXCISION B9 LESION MRGN XCP SK TG 2.1-3.,"1,591.00"
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EXC H-F-NK SP B9+MARG>4CM,"1,500.00"
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EXC FACE-MM B9+MARG 0.5 CM/<,"1,910.00"
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2ND SURG-EXC FACE-MM B9+MARG 0.6-1CM,955
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EXC B9LES MEGN XCP SK TG F/E/E/N/L/M 1.1,"1,910.00"
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PARTIAL EXCISION OF LIP,"4,335.00"
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2ND-SPLIT AGRFT F/S/N/H/F/G/M/D 1ST 100,"2,845.00"
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2ND- SKIN SUB GRAFT FACE/ NECK/ HF/G,750
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BIOPSY OF NECK/ CHEST,"1,591.00"
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EXC NECK LES SC 3CM/>,"2,025.00"
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EXCISION NECK LES SC<3 CM,"3,665.00"
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EXC TR-EXT MAL 1.1-2CM,345
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EXCISION MAL LESION TRUNK/ARM 2.1-3.0,"1,591.00"
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EXC MALIGNANT LESION TRUNK/ARM/LEG>4.0 C,"4,401.00"
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EXCISION MALIGNT LESION S/N/H/F/G 1.1-2.,"1,910.00"
EXCISION S/N/H/F/G/ MAL 2.1-3,"1,591.00"
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EXCIS MALGNT LESION S/N/H/F/G>4.0CM,"4,401.00"
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EXC F/E/E/N/L MAL+MRG 0.6-1,"1,910.00"
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EXCISION MALIGNANT LESION F/E/E 1.1-2.0C,"1,591.00"
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EXCISION F/E/E/N/L MAL+MRG 2.1-3,"3,665.00"
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EXC F/E/E/N/L MAL+MRG 3.1-4,"4,401.00"
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EXC F/E/E/N/L/ MAL+MRG >4 CM,"3,665.00"
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CHANGE OF BLADDER TUBE,"1,205.00"
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CHANGE CYSTOSTOMY TUBE COMPLICATED,"1,205.00"
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2ND SURG- REMOVAL OF NAIL PLATE,300
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BIOSPY NAIL UNIT,"1,591.00"
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REMOVE PILONIDAL CYST EXTEN,"4,401.00"
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REMOVAL OF BREAST LESION,"3,646.00"
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EXC BACK LES SC 3 CM/>,"3,665.00"
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EXCISION TUMOR SOFT TISS BACK/ FLANK 5CM,"3,665.00"
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2ND SURG- REMOVE CONTRACEPTIVE CAPSULE,"1,012.00"
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CYSTOSCOPY,"2,861.00"
,
CYSTOSCOPY URETER CATHETER,"2,861.00"
,
INTMD REPAIR S/A/T/EXT 2.5 CM/<,603
,
REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,724
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INTMD RPR S/TR/EXT 7.6-12.5,"1,276.00"
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2ND- REPAIR INTERMED GENT 2.6-7.5,325
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REPAIR INTERMED N/H/H/XTRNL GENT 7.6-12.,724
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REPAIR INTMD F/E/E/N/L/MUC 2.6-5.0CM,724
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2ND SURG-REMOVAL OF FOOT LESION,"3,086.50"
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EXC FACE LESION SC <2CM- 2ND SURG,"1,805.00"
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2ND- EXC B9 LESION 1.1-2.0CM,795
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YAG LASER PROCEDURE,"1,074.00"
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CYSTOSCOPY W/BIOPSY(S),"2,861.00"
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CYSTOSCOPY AND TREATMENT,"2,383.00"
,
CYSTO W/REMOVAL OF LESIONS MINOR,"2,861.00"
,
CYSTO W/REMOVAL OF TUMORS SMALL,"2,861.00"
,
CYSTO W//REMOVAL BLADDER TUMOR,"2,861.00"
,
CYSTO W//REMOVAL TUMOR LARGE,"5,848.00"
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SPINAL PUNCTURE LUMBAR DIAGNOSTIC,"1,152.00"
CYSTOURETHROSCOPY INJ CHEMODENERVATION B,"2,861.00"
,
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CYSTO W/SIMPLE REMOVAL STONE STENT,"2,861.00"
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2ND- LITHOLAPAXY SMP/SM<2.5cm,"4,870.00"
,
2ND SURG-CYSTOSCOPY REMOV URETERAL STONE,"2,924.00"
,
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CYSTOSCOPY STONE REMOVAL,"4,870.00"
,
CYSTO W/INSERT URETERAL STENT,"2,861.00"
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2ND-CYSTOURETERO W/ LITHOTRIPSY,"2,435.00"
,
CYSTO/ URETERO W/ LITHOTRIPSY,"9,981.00"
,
2ND SURG-EXCISON ARM/ ELBOW LES SC 3 CM>,800
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2ND-TNOT ELBOW LAT/MED DEBRIDE OPEN TDN,"3,050.00"
,
EXC FACE-MM B9+MARG .6-1CM,"1,591.00"
,
INCISION EXTENSOR TENDON SHEATH WRIST,"4,839.00"
,
2nd- EAR AND THROAT EXAM,"1,932.00"
,
2ND- CARPECTOMY 1 BONE,"1,645.00"
,
2ND SURG-TRANSPLANT FOREARM TENDON,"4,630.00"
,
EXCISION NECK LESION SC<3 CM,"1,500.00"
,
PROSTATECTOMY (TURP),"8,957.00"
,
LASER VAPORIZATION OF PROSTATE,"8,957.00"
,
2ND SURG- HAND TENDON RECONSTRUCTION,"2,711.00"
,
2ND SURG- EXC THIGH/ KNEE LES SC<3CM,"1,800.00"
,
2ND SURG-INCISION OF FOOT FASCIA,"3,086.50"
,
2ND-OSTECTOMY PRTL 5TH METAR HEAD SPX,"2,450.00"
,
TONSILLECTOMY ADENOIDECTOMY,"4,580.00"
,
2ND-TX OPEM TENDON FLEXOR TOE 1 TENDON,"1,400.00"
,
TONSILLECTOMY ,"4,580.00"
,
2ND- CORRECTION OF HAMMER TOE,"2,570.00"
,
HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT,"7,351.00"
,
REMOVAL OF ADENIODS,"4,580.00"
,
ARTHROSCOPY KNEE LATERAL RELEASE,"6,521.00"
,
BILATERAL CARPAL TUNNEL RELEASE,"9,781.00"
,
ARTHROSCOPY OF JOINT,"6,521.00"
SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/,"4,335.00"
,
MEATOTOMY CUTTING MEATUS SPX EXCPT INFAN,"4,007.00"
,
,
SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTIL,"6,788.00"
,
,
FRACTURE NASAL INFERIOR TURBINATE THERAP,"4,335.00"
,
,
REPAIR COMPLEX TRUNK 1.1-2.5 CM,"1,200.00"
,
CMPLX RPR TRUNK 2.6-7.5CM,"1,314.00"
,
CMPLX RPR TRUNK ADDL 5CM/<,"1,314.00"
,
2ND- REPAIR COMPLEX E/N/E/L 1.1-2.5CM,550
,
COMPLEX REPAIR S/A/L 2.6-7.5 CM,779
,
COMPLEX REPAIR F/C/C/M/N/AX/G/H/F,603
,
2ND SURG-COMPLEX REPAIR F/C/C/M/N,300
,
REPAIR COMPLEX EYELID/NOSE 1.1-2.5CM,"1,062.00"
,
COMPLEX REPAIR E/N/E/L 2.6-7.5 CM,"1,623.00"
,
ESOPHAGOSCOPY RIGID BALLOON,"2,350.00"
,
ESOPHAGOGASTRODUODENOSCOPY TRNASORAL DIA,"2,692.00"
,
,
EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,"2,692.00"
,
EGD PLACE GASROSTOMY TUBE,"2,822.00"
,
EGD REMOVE FOREGN BODY,"2,822.00"
,
EGD REMOVAL TUMOR POLY/OTHER LESION,"1,200.00"
,
EGD CONTROL BLEEDING ANY,"2,350.00"
,
REPAIR ROTATOR CUFF,"11,120.00"
,
OPEN REPAIR OF ROTATOR CUFF CHRONIC,"10,401.00"
,
DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/M,"2,415.00"
,
,
DILATE URETHRA STRICTURE,"2,678.00"
,
TISSUE TRNFR E/N/E/L/10.1-30SQCM,"5,691.00"
,
EXC ARM/ELBOW LES SC 3CM/>,"1,600.00"
,
EXC ARM/ELBOW LES SC<3 CM,"4,401.00"
,
EXCISION OLECTRANON BURSA,"4,839.00"
,
TIS TRNFR S/A/L 10 SQ CM/<,"1,623.00"
,
REMOVAL FOREIGN BODY UPPER ARM/ELBOW,"3,665.00"
LAPAROSCOPE PROC INTESTINE,"12,183.00"
,
2ND- TONSILLECTOMY ,825
,
BILATERAL LAPARSCOPY SURG RPR HERNIA,"12,000.00"
LAPAROSCOPIC APPENDECTOMY,"10,634.00"
,
WOUND PREP TRK/ARM/ LEG,"3,665.00"
,
ID SUBMUOCSAL ABSCESS RECTUM,"3,968.00"
,
REMOVAL OF HYDROCELE,"7,072.00"
,
REMOVE WRIST JOINT LINING- 2ND SURG,"2,420.00"
,
REMOVE WRIST TENDON LESION,"3,289.00"
,
REREMOVE WRIST TENDON LESION,"3,289.00"
,
SPLIT AGRFT F/S/N/H/F GT EA 100CM,"5,691.00"
,
REMOVAL OF WRIST LESION,"6,113.00"
,
SKIN FULL GRAFT TRUNK,"1,623.00"
,
2ND SURG-CYSTOSCOPY URETER CATHETER,"1,430.50"
,
CARPECTOMY 1 BONE,"3,289.00"
,
VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAM,"5,552.00"
,
,
2ND- FTH/GFT FREE W/DIRECT CLOSURE N/E/E,"2,800.00"
,
SKIN SUB GRAFT TRUNK/ARM/LEG,"1,623.00"
,
2ND-TNOT FLXR/XTNSR TEND FOREARM/ WRIST,"2,195.00"
,
SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA,"1,901.00"
,
SIGMOIDOSCOPY AND BIOPSY,"1,736.00"
,
2ND- DILATION OF URETHRA,"1,115.00"
,
DIAGNOSTIC COLONOSCOPY FLEX,"2,861.00"
,
COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,"2,861.00"
,
COLSC FLX W/REMOVAL LESION BY HOT BX FOR,"3,324.00"
,
COLONOSCOPY W/ LESION REMOVAL,"3,324.00"
,
REPAIR WRIST JOINTS,"12,597.00"
,
2ND SURG-REMOVAL OF HYDROCELE,"2,311.00"
,
OPEN TREATMENT RADIAL SHAFT FRACTURE,"8,558.00"
,
2ND SURG-EXC LESION SPERMATIC CORD,"2,776.00"
,
REVISE SPREMATIC CORD VEINS,"4,623.00"
,
REAMER AND DRILL BITS,"1,975.00"
,
PROSTATE NEEDLE BIOPSY ANY APPROACH,"4,137.00"
,
PROSTATE SATURATION SAMPLING,"3,445.00"
,
FUSE HAND BONES WITH GRAFT,"5,423.00"
,
2ND- REMOVAL INTRAUTERINE DEVICE IUD,140
,
ANALYZE NEUROSTIM COMPLEX,158
2ND SURG-DRAINAGE OF SKIN ABSCESS,922
,
RELEASE PALM CONTRACTU;RE,"3,950.00"
,
2ND SURG-INCISION OF ANAL SPHINCTER,"2,382.50"
,
RELEASE PAM CONTRACTURE,"5,423.00"
,
2ND SURG INCISE FINGER TENDON SHEATH,"1,645.00"
,
EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,"3,950.00"
,
2ND SURG-EXCISION SINGLE EXTERNAL PAPILL,950.5
,
HEMMORRHOIDECTOMY INT RUBBER BANK LIGATI,"1,910.00"
,
,
PARTIAL EXCISION DISTAL PHALANX FINGER,"3,950.00"
,
2ND SURG-REMOVE EXT HEM GROUPS 2+,"2,665.00"
,
HEMORRHOIDECTOMY NTRNL XTRNL 1 COL/GR,"4,438.00"
,
HEMORRHOIDECTOMY INT XTRNL 2/> COL/GR,"4,438.00"
,
SURG TX ANAL FISTULA SUBQ,"5,330.00"
,
REMOVAL OF HEMORRHOID CLOT,"3,968.00"
,
REVISE HAND/ FINGER TENDON,"5,423.00"
,
EXCISION HAND/ FINGER TENDON,"5,423.00"
,
GRAFT HAND OR FINGER TENDON,"5,423.00"
,
REPAIR FINGER TENDON,"3,289.00"
,
RELEASE PALM/ FINGER TENDON,"3,289.00"
,
INCISION OF FINGER TENDON,"2,995.00"
,
2ND-NEUROPLASTY/TRANSPOSITION ULNAR NRVE,"1,700.00"
,
,
TRANSPLANT/ GRAFT HAND TENDON,"5,423.00"
,
TRANSPLANT PALM TENDON,"7,134.00"
,
HAND TENDON RECONSTRUCTION,"5,423.00"
,
RCNST TENDON PULLEY EA TND W/TDN/FSCAL G,"5,423.00"
,
,
RECONSTRUCT J COLTRL LIGM,"5,423.00"
,
INSJ TUNNELED CTR VAD W/SUBQ PORT 5 YR/>,"4,863.00"
,
RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRP,"4,401.00"
,
,
ANOSCOPY AND BIOPSY,"1,583.00"
,
VULVECTOMY SIMPLE PARTIAL,"5,595.00"
,
ARTHRODESIS INTERPHALANGEAL JT W/WO INT,"3,289.00"
,
,
DSTRJ LESION ANUS SIMPLE SURG EXCISION,"3,295.00"
,
DESTRUCTION INTERNAL HEMORRHOID THERMAL,"4,765.00"
,
,
TYMPANOSTOMY GEN ANES-BILATERAL,"6,500.00"
,
HRHC NTRNL LIG OTH THAN RBBR BAND 1COL/G,"4,765.00"
,
DESTRUCTION VAGINAL LESIONS SIMPLE,"3,491.00"
,
BIOPSY VAGINAL MUCOSA SIMPLE,"4,192.00"
,
DESTRUCT B9 LESION 1-14,687
,
REPAIR RECTUM VAGINA,"6,718.00"
,
COMBINED ANTERPOSTERIOR COLPORRHAPHY,"6,718.00"
,
EXTENSIVE REPAIR OF VAGINA,"8,045.00"
,
INSJ MESH/PORSTH PELVIC FLOOR DEFECT EA,"4,192.00"
,
COLPOPEXY VAG EXTRAPERITONEAL APPROACH,"6,718.00"
,
,
SLING OPERATION STRESS INCONTINENCE,"6,295.00"
,
EXCESION THIGH/KNEE LESION SC<3CM,"3,665.00"
,
EXC THIGH/KNEE LES SC 3 CM/>,"7,341.00"
,
REMOVAL OF FOREIGN BODY,"4,401.00"
,
COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERV,"1,360.00"
,
CONIZATION OF CERVIX,"3,491.00"
,
LAPAROSCOPY CHOLECTYSTECTOMY,"10,634.00"
,
LAPS CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,"12,183.00"
,
,
FIXATION OF KNEE JOINT,"2,515.00"
,
EXC FOOT/TOE TUM SC 1.5CM/>,"5,141.00"
,
REMOVAL OF FOOT LESION,"6,173.00"
,
REMOVAL OF HEEL SPUR,"6,173.00"
,
PARTIAL EXCISION BONE PHALANX TOE,"5,141.00"
,
REPAIR OF FOOT TENDON,"6,173.00"
,
RPR TENDON FLXR FOOT SEC W/ GRAFT,"8,405.00"
,
VAG HYSTERECTOMY UTERUS 250 GM/<,"8,045.00"
,
VAG HYST 250 GM/< W.RMVL TUBE/OVARY,"8,045.00"
,
VAG HYSTER 250 GM/250GM,"8,045.00"
,
VAG HYST>250 GM RMVL TUBE/OVARY,"8,045.00"
,
CORRECTION OF BUNION,"8,827.00"
,
CORRECT HALLUX VALGUS W/SESMDC W/DIST ME,"7,351.00"
,
,
INCISION OF METATARSAL,"6,173.00"
,
RECONSTRUCT J ANGULAR DFRM SOFT TISS,"5,141.00"
,
TREAT METATARSAL FRACTURE,"8,558.00"
,
BIOPSY LYMPH NODE/ EXCISION CERVICAL NOD,"5,878.00"
,
BIOPSY/ EXC LYMPH NODE OPEN DEEP AX NODE,"4,895.00"
,
LSH W/T/O UT 250 G OR LESS,"10,145.00"
,
LAPS VAG HYSTERECTOMY UTERUS 250 GM/<,"12,183.00"
,
LAPS W/VAG HYSTERECT 250 GM/RMVL TUBE/OV,"12,183.00"
,
,
LAPS W/VAGINAL HYSTER >250 GRAMS,"16,384.00"
,
LAPS VAG HYSTERECT>250 GM RMVL TUBE/OVAR,"16,384.00"
,
,
HYSTER BX ENTOMETRIUM/POLYPC W/WO DC,"6,878.00"
,
HYSTEROSCOPY ENDOMETRIAL ABLATION,"6,878.00"
,
HYSTER BI TUBE OCCLUSION W/PERM IMPLTS,"6,878.00"
,
LAPAROSCOPY LYSIS,"10,634.00"
,
LAPS FULG/EXC OVARY VISCERA/PER SURFACE,"10,145.00"
,
LAPAROSCOPY FULGURATION OVIDUCTS,"10,634.00"
,
REMOVAL OF OVARY/TUBES(S),"8,045.00"
,
FUSION OF BIG TOE JOINT,"10,093.00"
,
REMOVE GROIN LYMPH NODES,"4,895.00"
,
2ND SURG-DRAIN BLADDER INSERT SUPRAPUBIC,"2,924.00"
,
,
REMOVE EXTERNAL EAR PARTIAL,"1,591.00"
,
2ND SURG-PARTIAL REMOVAL COLLAR BONE,"3,670.50"
,
2ND SURG-PARTIAL REPAIR OR REMOVAL OF SH,"3,670.50"
,
2ND SURG- RESECT INFERIOR TURBINATE,"2,167.50"
,
2ND SURG-REMOVE TENDON SHEATH LESION,"1,975.00"
,
CARDIOVERSION ELECTRIC EXT,"1,497.00"
,
MASTECTOMY SIMPLE COMPLETE,"6,842.00"
LAPAROSCOPY ASPIRATION,"7,724.00"
,
VENTILATING TUBE RMVL REQUIRING GNL ANES,"4,641.00"
,
CREATE EARDRUM OPENING,"4,335.00"
,
TYMPANOSTOMY GENERAL ANESTH,"4,335.00"
,
RPR 1ST INGUN HRNA AGE 5YRS/> REDUC OPEN,"6,077.00"
,
REPAIR 1ST INCAL/VNT HERNIA INC,"7,500.00"
,
REPAIR UMBIL HERNIA REDUC < 5 YR,589
,
RPR UMBIL HERN REDUC>5 YR,"7,072.00"
,
RPR UMBILICAL HERNIA 5 YRS/>,"5,889.00"
,
LAP SURG RPR INITIAL INGUINAL HERNIA,"10,634.00"
,
LAPS SURG RPR RECURRENT ING HERNIA,"8,855.00"
,
LAPS REPAIR HERNIA EXCEPT INCAL.INGUN RE,"10,075.00"
,
LAP RPR HRNA XCPT INCAL/INGUN NCRC8/STRA,"9,359.00"
,
LAP REPAIR INCISIONAL HERNIA,"8,855.00"
,
2ND-ARTHROSCOPY SHOULDER SURG SYN PA,"2,715.00"
,
ARTHROSCOPY SHOULDER SURG DEBRIDEMENT EX,"5,431.00"
,
,
2ND-ARTHROSCOPY ELBOW SURG DEBRIDE LTD,"2,700.00"
,
ENDOSCOPIC CARPAL TUNNEL RELEASE,"6,521.00"
,
KNEE ARTHROSCOPY/SURGERY,"6,521.00"
,
KNEE ARTHROSCOPY/SURGERY,"6,521.00"
,
ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W,"6,521.00"
,
,
KNEE ARTHROSCOPY/ SURGERY,"6,521.00"
,
ARTHROSC KNEE; W MEN REP-MED&LAT,"6,521.00"
,
ADDITIONAL LIPOMA REMOVAL,900
,
3RD ADDITIONAL CLOSURES,200
,
3RD SURG- ADDITIONAL LESIONS,400
,
3RD SURG-ADDITIONAL LESIONS,636.66
,
HARDWIRE ROOM,"1,105.00"
,
SKILLED NURSING FACILITY,707
,
HOSPITALITY STAY,273
,
DIRECT ADMIT TO SNF,0
,
FHM NOT IN LABOR,139.13
,
NON-STRESS TST FHM-IP,292.9
NON-STRESS TEST FHM-OP,292.9
,
STRESS TEST FHM,371.01
,
CHEMO-SQ/IM ;NON-HORMONAL,138.2
,
"CHEMO, PUSH TECHNIQUE",138.2
,
OBSERVATION ROOM 1ST HOUR,240
,
CHEMO -INFUSION 0-1 HRS,265.38
,
CHEMO- SQ/IM,138.2
,
OUTPATIENT VISIT,132.88
,
HYPERBARIC TRMT/DAY-LIMB,229.78
,
APPLIANCE FITTING,36.96
,
MED/SURG SEMI-PRIVATE,917
,
HOSPICE ROOM CHARGE,917
,
RESPITE ROOM CHARGE,917
,
CASTING ROOM,282.67
,
MED/SURG PRIVATE,917
,
OBS ROOM EA ADD HOUR,29.44
,
DIRECT ADMINT HOSP OBSERV,0.01
,
CHEMO-INFUSION EA ADD HR,69.1
,
CHEMO-INFUSION OVER 8 HRS,345.45
,
OBSERVATION HYDRATION,39.37
,
CHEMO IV INFUS EACH ADDL,140
,
"IV PUSH, SEQ SAME DRUG",33.43
,
DC ACUTE TO SWB,0
,
IV INFUSION 1ST HOUR IN OBS,63.2
,
IV INFUSION ADD HR IN OBS,40
,
IV INFUSION SEQ+ IN OBS,35.35
,
THER/DIAG CONCURRENT INF,38.25
,
TX/PRO/DX INJ NEW DRUG AD,68.37
,
"IV PUSH, SEQ SAME DRUG IN OBS",16.2
,
CHEMO IV PUSH ADDL DRUG,104.47
,
IRR DRUG DELIVERY DEVICE,59.96
,
IV CONCURRENT INUFISON IN OBS,21.42
,
TX/PRO/DX INJ NEW DRUG AD IN OBS,40.81
,
OBSERVATION BED TYPE,0
,
2ND-COLOREC CANCER SCR HI RISK,450
2ND- COLOREC CANCER SCR NOT HI RISK,440
,
FINE NEEDLE ASPIRATION W/ IMAGING GUID,325
,
INCISION DRAINAGE ABSCESS SIMPLE,280
,
INCISION DRAINAGE ABCESS COMPLICATED/ MU,505
,
,
COLOREC CANCER SCR- PRO FEE,915
,
COLOREC CANCER SCR;NOT HIGH RISK,900
,
PUNCTURE ASPIRATION ABSCESS HEMOTOMA,325
,
2ND- RPR UMBILICAL HERNIA 5 YRS/> INCAR,590
,
DEBRIDEMENT SKN SUBQ T/M/F NECRO INFCTJ,"1,575.00"
,
EXCISION TUMOR SOFT TISS FACE/SCALP 2CM/,"1,200.00"
,
DEB SUBQ TISSUE SQ CM/<,240
,
DEBRIDEMENT SUBCUT TISSUE EA ADD 20 SQ C,100
,
ASPRATION BLADDER INSERT SUPRAPUBIC CATH,515
,
,
2ND-REMOVAL OF SKIN TAGS 4.,740
,
EXCISION B9 LESION MARGIN 2.1-3.0CM,550
,
INTUBATION ENDOTRACHEAL ER PROCEDURE,340
EXC TUMOR SOFT TISSUE NECK/ANT THORAX,"1,100.00"
,
TRACHESOTOMY EMERGENCY PROCEDURE TRANS,515
,
,
EXCISION MALIGNANT LESION TR/ARM LEG>4,"1,000.00"
,
CHANGE CYSTOMSTOMY TUBE SIMPLE,210
,
AVULSION NAIL PLATE PARTIAL/COMPLETE,155
,
REPAIR NAIL BED,475
,
EXCISION TUMOR SOFT TISS BACK/ FLANK 5CM,"1,700.00"
,
SIMPLE LAC REPAIR SCALP/ NECK 2.5CM/<,130.49
,
SIMPLE REPAIR SCALP/NECK 2.6-7.5CM,250
,
REPAIR INTERMEDIATE S/A/T/E 7.6-12.5CM,700
,
REPAIR INTERMEDIATE S/A/T/E/12.6 20CM,700
,
CYSTOURETHROSCOPY WITH BIOPSY,"2,383.00"
,
TUBE THORACOSTOMY INC WATER SEAL,400
,
REPAIR COMPLEX SCAP/ARM/ LEG 2.6-7.5,960
,
REPAIR COMPLEX SCALP/ ARM LEG ADD 5CM,300
,
EGD TRANSORAL DIAGNOSTIC,630
,
EGD BIOPSY SINGLE/ MULTIPLE,961
,
EGD REMOVAL TUMOR POLYP/OTHER LESION,"1,100.00"
,
EXCISION TUMOR SOFT TISS UPPER ARM,"1,100.00"
,
REMOVAL FOREIGN BODY UPPER ARM/ELBOW,"1,250.00"
,
2ND-EGD BIOPSY SINGLE/MULTIPLE,480
,
2ND- EGD REMOVAL LESIONS BIOPSY FORCEPS,500
,
2ND- EGD DIAGNOSTIC BRUSH WASH,375
,
2ND- DILATION ESOPH UNGUIDED SOUND,185
,
COLONOSCOPY STOMA DX INCL COLLJ,650
,
2ND-LAPARO PARTIAL COLECTOMY,"1,900.00"
,
2ND - COLONOSCOPY W/ LESION REMOVAL,640
,
2ND-COLONOSCOPY AND BIOPSY,585
,
2ND-COLONOSCOPY W/ LESION REMOVAL,295
,
2ND-EXCISION SINGLE EXT PAPILLA/TAG,270
,
2ND- LAP RPR INITIAL ING HERNIA,490
,
2ND- LAP RPR HERNIA XCPT INCAL/INGUN STR,"1,100.00"
,
2ND-ANOSCOPY W/ DILATION,650
,
2ND-REMOVAL PERITONEAL FOR BODY,"1,100.00"
2ND-APPENDEC INDICATED PURPOSE OTHER,100
,
2ND-IMPLANT MESH OPEN HERNIA REPAIR,300
,
2ND-RPR UMBILICAL HRNA 5 YRS/>REDUCIBLE,475
,
BILATERAL LAP SURG RPR INITIAL ING HERNI,"1,600.00"
,
LAPROSCOPY APPENDECTOMY,"1,475.00"
,
ID SUBMUCOSAL ABSCESS RECTUM,690
,
REMOVAL OF SPERM DUCT(S),280
,
SIGMOIDOSCOPY FLX DX W/ COLLJ,425
,
COLONSCOPY FLX DX W/COLL SPEC,775
,
COLONOSCOPY AND BIOPSY,"1,200.00"
,
COLONOSCOPY W/LESION REMOVAL,"1,050.00"
,
COLONSCOPY W/ LESION REMOVAL,"1,250.00"
,
VENOGRAPHY VENOUS SINUS/JUGULAR CATH,350
,
INCISION THROMBOSED HEMORRHOID EXT,415
,
HEMORRHOIDECTOMY INT XTNL 2//> COL/GRP,"1,100.00"
,
INSERT TUNNELED CV CATH,"2,620.00"
,
REMOVAL TUN CTR VAD W/SUBQ PORT/PMP,500
,
EXC THIGH/KNEE LES SC 3 CM/>,"1,025.00"
,
LAPROSCOPY SURG CHOLECYSTECTOMY,"1,450.00"
,
LAP SURG CHOLECTYSTECTOMY W/CHOLANG,"1,600.00"
,
BIOPSY SOFT TISSUE LEG/ANKLE SUPERFICIAL,570
,
EXC TUMOR SOFT TISSUE LEG/ANKLE <3CM,"1,025.00"
,
CLOSED TIBIAL SHAFT FX W/O MANIPULATION,800
,
BIOPSY/ EXC LYMPH NODE OPEN DEEP AX NODE,"1,000.00"
,
NEW OFFICE VISIT LEVEL 1,75
,
NEW OFFICE VISIT LEVEL 2,130
,
NEW OFFICE VISIT LEVEL 3,185
,
NEW OFFICE VISIT LEVEL 4,275
,
NEW OFFICE VISIT LEVEL 5,360
,
OFFICE VISIT LEVEL 1,40
,
OFFICE VISIT LEVEL 2,75
,
OFFICE VISIT LEVEL 3,130
,
OFFICE VISIT LEVEL 4,185
,
OFFICE VISIT LEVEL 5,250
,
OBSERVATION CARE DISCH MGMT,158.72
INTIAL OBSERVATION CARE/,175
,
INITIAL OBSERVATION CARE/ DAY,404.54
,
INITIAL IP VISIT LEVEL 1,160
,
INITIAL INPATIENT LEVEL 2,210
,
INITIAL IP LEVEL 3,300
,
SUBSEQUENT OBSERVATION/ 25 MIN,130
,
SUBS HOSPITAL CARE/ DAY15 MIN,80
,
SUBSQ HSOPITAL CARE/ DAY 25 MIN,125
,
SUBSQ HOSPITAL CARE/ DAY 35 MIN,227.92
,
OBSERVATION/ INPATIENT HOSPITAL CARE 40,300.58
,
OBSERVATION/INPATIENT HOSP CARE 50 MIN,373.94
,
HOSPITAL DISCHARGE DAY MGMT 30 MIN/<,158.35
,
HOSPITAL DISCHARGE DAY MGMT >30 MIN,190
,
ER VISIT/ MINOR,100
,
ER VISIT/ LIMITED,125
,
ER VISIT/ MODERATE,150
,
ER VISIT/ HIGH,175
,
INPATIENT CONSULTATION,70
,
MASTECTOMY SIMPLE COMPLETE,"2,300.00"
,
INITIAL NF CARE LEVEL 1,150
,
INITIAL NF LEVEL 2,200
,
INITIAL NF LEVEL 3,250
,
SUBSQ NF CARE/DAY E/M STABLE 10 MIN,96.47
,
SUBSQ NF CARE/DAY MINOR COMPL 15 MIN,149.26
,
SUBSQ NF CARE/ DAY NEW PROB 25 MIN,196.84
,
NF DISCHARGE MGMT 30 MIN,157.99
,
REPAIR 1ST INCAL/VNT HERNIA INC,"2,300.00"
,
REPAIR UMBILICAL HERNIA 5 YRS/>REDUCIBLE,"1,050.00"
,
RPR UMBILICAL HERNIA AGE 5 YRS/> INCAR,"1,180.00"
,
LAPROSCOPY RPR INITIAL INGUINAL HERNIA,985
,
LAP SURG RPR RECURRENT ING HERNIA,"1,350.00"
,
LAPS RPR HERNIA EXCEPT INCAL/ING REDUC,"1,700.00"
,
LAP RPR HERNIA XCPT INCAL/INGUN,"2,130.00"
,
LAP REPAIR INCISIONAL HERNIA,"2,370.00"
,
I&D ABSC; SMPL OR SGL,31.55
I&D ABSC; COMPL OR MULTI,47.46
,
EXPLORATION PENETRATING WOUND SPX EXTREM,775
,
,
REMOVAL OF FOREIGN BODY; SIMPLE,89.28
,
PUNCTURE DRAINAGE OF LESION,63.49
,
REMOVE NASAL FOREIGN BODY,150.77
,
IMMUNIZATION ADMIN,19
,
"IMMUNIZATION ADMIN, EA AD",24
,
INJECT TRIGGER POINTS3/>,36.56
,
"HYDRATION IV INFUSION, IN",106.87
,
"HYDRATE IV INFUSION, ADD",28.82
,
"THER/PROPH/DIAG IV INF, I",129.37
,
"THER/PROPH/DG IV INF, ADD",33.43
,
TX/PROPH/DG ADDL SEQ IV I,57.74
,
THER/DIAG CONCURRENT INF,38.25
,
"THER/PROPH/DIAG INJ, SC/I",55
,
"THER/PROPH/DIAG INJ, IV P",106.01
,
THER/PROPH/DIAG INJ ADD-O,42.13
,
"IV PUSH, SEQ SAME DRUG",33.43
,
ANTERIOR EPISTAXIS CONTRO,72.1
,
"CONTROL OF NOSE BLEED,ANT",263.85
,
CONTROL OF NOSE BLEED,308.16
,
PLACE IN OBSERVATION,35.38
,
BLADDER IRRIGATE LAVAGE/I,69.8
,
INSJ NON-NDWELLG BLADDER CATHETER,49.58
,
INSERT TEMP BLADDER CATH,75.67
,
INSERT BLADDER CATH COMPLEX,91.95
,
CHANGE OF BLADDER TUBE,69.94
,
CHANGE OF CYSTOSTOMY TUBE; COMPLICATED,89.28
,
REMOVAL OF NAIL PLATE SINGLE,89.28
,
EVACUATION SUBUNGUAL HEMATOMA,31.09
,
REPAIR OF NAILBED,143.5
,
DRAINAGE OF GUM LESION,237.91
,
DRAINAGE ABSCESS PALATE UVULA,105.14
,
REPAIR SUPERFICIAL WOUND,82.67
REPAIR SUPERFICIAL WOUND,101.19
,
REPAIR SUPERFICIAL WOUND,122.34
,
REPAIR SUPERFICIAL WOUND,136.89
,
REPAIR SUPERFICIAL WOUND,142.9
,
REPAIR SUPERFICIAL WOUND,99.87
,
REPAIR SUPERFICIAL WOUND,103.82
,
REPAIR SUPERFICIAL WOUND,108.46
,
REPAIR SUPERFICIAL WOUND,123.59
,
REPAIR SUPERFICIAL WOUND,138.39
,
REPAIR SUPERFICIAL WOUND,138.39
,
REPAIR SUPERFICIAL WOUND,138.39
,
REPAIR SUPERFICIAL WOUND,97
,
INT MD RPR S/A/T/EXT 2.6-7.5,191.2
,
INTMD WND REPAIR S/TR/EXT,261.89
,
LAY CLOS FACE LAC 0-2.5CM,158.04
,
ER TO ACUTE CARE,0
,
"TUBE THORA, INCL WATER SE",224.36
,
COMPLEX RPR S/A/L 2.6-7.5 CM,281.68
,
REPAIR COMPLEX,245.35
,
FROM ER TO OBS,0
,
IRRIGATION CORPORA CAVERNOSA PRIAPISM,340
,
INJECT ANES OTHER PERIPHERAL NERVE/BRANC,63.49
,
DRAINAGE OF SCROTUM ABCESS,200
,
REMOVE FOREIGN BODY -EYE,20.6
,
REMOVE FROEIGN BODY -EYE,27.05
,
REMOVE FROEIGN BODY -EYE,26.4
,
REMOVE FROEIGN BODY -EYE,30.27
,
ADMIT TO ACUTE,0
,
DRESSING & DEBRID OF BURN,46.97
,
ID VULVA/PERINEAL ABSCESS,250
,
PICC INSERTON5 YRS OR LES,743.67
,
PICC INSERTON AGE 5 YRS/>,743.67
,
REPAIR CVA CATHETER,245.35
,
TB INTRADERMAL TEST,14.26
,
DRAW BLOOD OFF VENOUS DEVICE,56
TREAT FINGER DISLOCATION,37.68
,
"THROMBOLYSIS, CEREBRAL, B",339.54
,
TREAT KNEECAP DISLOCATION,51.58
,
CLOSED TIBIAL SHAFT FX W/O MANIPULATION,725
,
REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,234.28
,
,
REMOVAL FOREIGN BODY FOOT DEEP,700
,
APPLICATION OF ARM SPLINT,45.06
,
APPLICATION FINGER SPLINT,20.61
,
CLEAR OUTER EAR CANAL,97.21
,
STRAPPING SHOULDER,19.14
,
E.R. VISIT - LEVEL 1,97.19
,
E.R. VISIT - LEVEL 2,150.51
,
E.R. VISIT-LEVEL 3,225
,
E.R. VISIT-LEVEL 4,354
,
E.R. VISIT - LEVEL 5,425
,
CRITICAL CARE-FIRST HOUR,440
,
CRITICAL CARE-ADDL 30 MIN,95
,
APPLICATION SHORT LEG CAST BELOW KNEE,150
,
APPLY SHORT LEG CAST,160
,
APPLICATION LONG LEG SPLINT THIGH ANKLE/,62.69
,
APPLICATION OF LOWER LEG SPLINT,39.26
,
STRAPPING KNEE,14.52
,
STRAPPING ANKLE/FOOT,14.52
,
CPR,216.24
,
DISP KIT DX SWIVELOCK SL 3.5X8.5MM,412.5
,
DX SWIVELOCK SL 3.5X8.5MM W/FORK EYELET,637.5
,
AVIVE SOFT TISSUE MEMBRANCE 3X4 CM,"3,350.00"
,
ARTHREX MICRO SUTURE ANCHOR,656.25
,
SHOULDER SUTURE ANCHOR (ARTHREX),532.5
,
LIGA CLIPS-OPEN BOWEL,85.19
,
ENDOCLIP 5mm,661.2
,
ENDOCLIP 10MM,434.49
,
PERFIX LIGHT PLUG-XL,307.27
,
HERNIA MESH 8X12,862.65
TVT ABBREVO,"2,470.77"
,
EASY CLIP-BICORTICAL FIX DEVICE 10X15X13,"1,700.00"
,
BONE SCREWS CREOSS PIN SELFTAPPING,210
,
SHOULDER SUTURE ANCHOR,850
,
ARTHROFLEX 15X140 1.5MM,"2,325.00"
,
CS MISC IMPLANTABLE,0
,
9.5MM TAPER POST,525
,
15MM DF 2.5X3.5,"2,780.00"
,
2.0 MM GUIDE PIN,115
,
HERNIA PATCH MED CIRCLE 6.4CM,697.5
,
COMPOSIX CIRCLE 2X4,840
,
COMPOSIX MESH 6X8,"1,200.30"
,
COMPOSIX CIRCLE 4.5,851.4
,
COMPOSIX MESH 7X9,"1,325.67"
,
COMPOSIX MESH 8X10,"1,653.75"
,
METALLIC URETERAL STENT RESONANCE,"1,285.81"
,
STENT 6X24-COOK,207.37
,
"COMPR FT SCRW, 2.5 MICRO, 14MM LGTH",505
,
"COMPR FT SCREW, 3.5 MINI 16MM LENGTH",505
,
PENILE IMPLANT ASSEMBLY KIT,795
,
HUNTER TENDON ROD 3MMX24.5CM,"2,200.00"
,
ESSURE,"2,312.50"
,
4FUSION FIXATION DEVICE,"3,896.00"
,
PENILE PROSTHESIS,"10,987.50"
,
INTERSTIM NEURO STIM-STAGE 2,"15,714.00"
,
INTERSTIM STAGE 1 LEAD,"4,268.75"
,
VENTRALEX ST HERNIA PATCH 0380,720
,
PATCH 7.6 ROUND-KUGEL,528.13
,
KUGEL MESH 10.2 ROUND,558.64
,
PATCH 8.0X12-KUGEL,720.18
,
KUGEL MESH 9.5X13,880.2
,
MESH PLUG-SMALL,216.07
,
MESH PLUG-MED,216.07
,
MESH PLUG-LARGE,216.07
,
MESH PLUG X-LRG,274.12
"MINI TIGHTROPE, 1.1 MM",787.5
,
PICC ARROW 6FR 3LUMEN,177.25
,
POWER PORT VAD,777
,
PROSIMA-COMPLETE,"3,012.50"
,
PENILE IMPLANT RESERVIOR,"2,412.50"
,
SOFTMESH 12X12 / 30cm X 30cm,676.5
,
"PROSTOP GUIDE WIRE 0.54""",142.5
,
STENT-BOST SCIEN,346.08
,
PATCH 5.4X7.0-VERTRIO,"1,273.66"
,
PATCH 3.1X4.7-VENTRIO,766.5
,
VENTRIO 11X14 CIRCLE,926.64
,
VENTRIO 11x14-OVAL,"1,206.71"
,
NERVE PROTECTOR 10MMX20MM,"2,900.00"
,
NERVE PROTECTOR 7MM X 40MM,"2,900.00"
,
SOFT TISSUE MEMBRANE 3X4CM,"3,400.00"
,
2.3 M PROFYLE HAND LOCK PLATE ST BAR 4H,800
,
ECHO PS MESH 6X8,"2,300.00"
,
HERNIA MESH 7X9,"2,950.00"
,
MINI SCORPION IMPLANT SYSTEM,"1,495.00"
,
2.4X16MM VAL SCREW,225
,
LOW PROFILE SCREW 2.4X16MM,185
,
2.4X12MM VAL SCREW,225
,
2.4X 18MM VAL SCREW,225
,
LO-PRO LOCK SCREW 3.5 X 12MM,140
,
VOLAR DISTAL RAD PLATE,"1,315.00"
,
LO-PRO SCREW 3.5MM X 13MM,95
,
ADMIN PREVNAR (PNEU 2) VACCINE,21.42
,
CARDIO CLINIC NEW PT,44.01
,
CARDIO CLINIC EST PT,44.01
,
ENT CLINIC VISIT-EST PT,26.96
,
ENT CLINIC VISIT -NEW PT,26.96
,
CIRCUMSION,349.04
,
CLINIC-EST PT,44.01
,
CLINIC-NEW PT,44.01
,
OP VISITING DR-EST PT,55
OP VISITING DR- NEW PT,55
,
ORTHOPEDIC CLINIC-EST,44.01
,
ORTHOPEDIC CLINIC-NEW PT,44.01
,
UROLOGY CLININC-NEW PT,44.01
,
PULMONOLOGY CLINIC-NEW PT,55
,
PULMONOLOGY CLINIC-EST PT,55
,
OB/GYN CLINIC -NEW PT,44.01
,
UROLOGY CLINIC EST PT,44.01
,
OB/GYN CLINIC-EST PT,44.01
,
IV INFUSION 1ST HR-CLINIC,189.56
,
INJECTION,26.41
,
IV INFUSION 1ST HR-THERAP,189.56
,
IV INFUSION ADD HR-THERAP,94.77
,
"IV INFUSION, SEQ+ -THERA",94.77
,
IV INFUSION ADD HR-CLINIC,94.77
,
IV INFUSION SEQ+ - CLINIC,94.77
,
PAIN CONTROL CLINIC-NEW PT,44
,
PAIN CONTROL CLINIC-EST PT,44
,
"INSERTION, DRUG INPLANT",238.53
,
REMOVAL OF DRUG IMPLANT,290.45
,
REMOVE & REINSERT DRUG IMPLANT,526.47
,
"IV PUSH, INITIAL CLINIC",68.37
,
"IV PUSH, INITIAL THERAPEU",68.37
,
"IV PUSH, ADD DRUG-CLINIC",68.37
,
"IV PUSH, ADD DRUG-THERAPU",68.37
,
"INC & REM FB, SQ; SMPL",80.35
,
POST OP CLINC VISIT,0
,
OP VISIT- EST,10
,
OP VISIT- NEW,10
,
PUNCT ASP - ABSC HEMAT CYST,57.14
,
IV HYDRATION 1ST HR-CLINI,189.56
,
IV HYDRATION 1ST HR-THERA,322.44
,
IV HYDRATION ADD HR-CLINI,94.77
,
IV HYDRATION ADD HR-THERA,94.77
,
OUTPATIENT VISIT-CLINIC,132.88
IMMUNIZATION ADMIN,18.78
,
THER INJECTION CARP TUNNEL,140
,
INJ SGL TENDON SHEATH/ LIGAMENT,102
,
INJ TRIGGER POINT 1/2 MUSCL,92
,
"INJECT TRIGGER POINTS, =/",105
,
ARTHROCENTESIS ASPIR/INJ SMALL JT/BURSA,86
,
DRAIN/INJ INTERM JNT/BURSA,91
,
DRAIN/INJ MAJOR JNT/BURSA,112
,
ARTHROCENTESIS ASPRIN/IINJ MAJ JT/BURSA,140
,
ASPIRATE/INJ GANGLION CYST,30.94
,
"IV PUSH, SEQ SAME DRUG",33.43
,
FINE NEEDLE ASPIRATION W/IMAGE,125.57
,
DEBRIDEMENT SKIN SUBQ T/M/F NECRO INFCTJ,"1,500.00"
,
UA DIPSTICK RGNT NON-AUTO W/O MICRO,16.03
,
DEB SUBQ TISSUE 20 SQ CM/<,91.66
,
DRAINAGE OF SKIN ABSCESS; SIMPLE,37.43
,
DRAINAGE OF SKIN ABCESS,41.58
,
"BX-SKIN, SQ/MM; SGL",91.07
,
2ND- EXCISION B9 XCP SK TAG 1.1-2.0CM,150
,
DEBRIDEMENT NAIL ANY METHOD 1-5,50
,
EXCISION NAIL MATRIX PERM REMOVAL,225
,
REMOVAL OF SKIN TAGS 4.0,450
,
EXC H-F-NK-SP B9 0.5/<,290
,
EXCISION H-F-NK-SP B9+MARG 1.1-2,307
,
EXCESION B9 LESION 2.1-3.0CM,385
,
EXC B9 LESION MARGIN XCP SK TG F/E/E/N/L,400
,
DRAIN NECK/CHEST LESION,"1,100.00"
,
EXC TR-EXT MAL 1.1-2CM,345
EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.,445
,
EXCISION MALIGNANT LESION TRUNK/ ARM/,725
,
EXC S//N/H/F/G/MAL +MRG 2.1-3,643.34
,
BLDR IRRIGATION SMPL LAVAGE/INSTLJ,61.91
,
INSERT TEMP BLADDER CATH,67.25
,
CHANGE OF CYSTOSTOMY TUBE,125
,
TREATMENT OF BLADDER LESION,47.02
,
AVULSION NAIL PLATE PARTIAL/COMPLETE,65
,
EXCISION NAIL MATRIX PERM REMOVAL-BILAT,500
,
US URINE CAPACITY MEASURE,31.61
,
INJECTION INTRALESIONAL UP TO 7 LESIONS,75
,
REMOVE CONTRACEPTIVE CAPSULE,80.95
,
SIMPLE REPAIR SCALP/NECK 2.5CM/<,102
,
SIMPLE REPAIR SCALP/NECK 2.6-7.5CM,145
,
DRAIN/ IN JOINT W/O US-BILATERAL,180
,
DRAIN/ INJ JOINT W/O US- BILATERAL,220
,
SPINAL FLUID TAP DIAGNOSTIC,192
,
INJ EPIDURAL BLOOD OR CLO,279
,
ESI-CERVICAL,266
,
ESI-LUMBER,225.58
,
ASPIRATE PLEURA W/O IMAGING,480
,
ARTHOCENTESIS INJ SMALL JT/BURSA-BILATER,160
,
REMOVAL OF URETHRA GLAND,200
,
DILATE URETHR STRICT SOUND; MALE INITIAL,35.94
,
DILAT URETHRAL STRIX DILATOR MALE SBSQ,45.24
,
NERVE BLOCK INJECT OCCIPITAL,154
,
NERVE BLOCK INJECT INTERCOST SNG,166
,
NERVE BLOCK INJECT INTERCOST MLT,224
,
N BLOCK INJ ILIO-ING/HYPOGI,225
,
NERVE BLOCK INJECT SCIATIC SNG,177
,
NERVE BLOCK INJECT FEMORAL SNG,162
,
N BLOCK OTHER PERIPHERAL,111
,
INJECT EPIDURAL LUMBAR/SACRAL,277
,
LUMBAR/ SACRAL INJECTION EACH,110
,
INJ CERVICAL/ THORACIC FACET,261
INJ PARAVERT F JNT C/T 2 LEVEL,145
,
INJ PARAVERT F JNT C/T 3 LEVEL,150
,
FACET INJ JNT L/S 1 LEV,224
,
INJ PARAVERT F JNT L/S 2 LEVEL,200
,
INJ PARAVERT F JNT L/S 3 LEVEL,215
,
NERVE BLOCK SPENOPALATINE GANGL,275
,
NERVE BLOCK LUMBAR/ THORACIC,198
,
CERVICAL/THORACIC,556
,
LUMBAR/ SACRAL FACET,550
,
INJECTION TREATMENT OF NERVE,350
,
PUNCT ASP HYDROCELE TUNIC,53.56
,
EXCISE HYDROCELE; UNILATERAL,596.97
,
EXCISION GANGLION WRIST DORSAL/ VOL PRIM,550
,
IMMUNOTHERAPY 2+ INJECTIONS,17.01
,
CLOSED TX ULNAR SHAFT FRACTURE W/O MANIP,475
,
,
PROSTATE NEEDLE BIOPSY ANY APPROACH,129.17
,
TELEHEALTH FACILITY FEE,44.01
,
ASPIR/INJ THYROID CYST,114.88
,
INCISION THROMBOSED HEMORRHOID EXT,250
,
EXCESION HAND LESION SC<1.5CM,"1,200.00"
,
REMOVAL IMPLANT FROM FINGER/HAND,780
,
THER/DIAG CONCURRENT INF,38.25
,
TX/PRO/DX INJ NEW DRUG AD,68.37
,
IRRIG DRUG DELIVERY DEVIC,192.84
,
PICC INSERTON5 YRS OR LES,743.67
,
PICC INSERTON AGE 5 YRS/>,743.67
,
TB INTRADERMAL TEST,16.81
,
REMOVAL TUNNELED CV CATH,44.01
,
REMOVAL TUN CTR VAD W/SUBQ PORT/PUMP,450
,
DRAW BLOOD OFF VENOUS DEV,39.01
,
COLLECT BLOOD FROM PICC,43.78
,
DECLOT VASCULAR DEVICE,307.69
,
BIOPSY OF VULVA,36.3
,
BIOPSY OF VULVA/ PERINEUM,20
DESTROY VAG LESIONS SIMPLE,25.59
,
INJECT SACROILIAC JOINT,207
,
BIOPSY OF VAGINA,39.81
,
"DESTRUCT B9 LESION, 1-14",67.86
,
CHEMICAL CAUTERY GRANULATION TISSUE,70.82
,
EXAM/BIOPSY VAGINA &/OR CERVIX W/SCOPE,55.36
,
COLPOSCOPY W BIOPSIES,27.2
,
BIOPSY CERVIX SINGLE/MULT EXC OF LESION,190
,
ENDOCERVICAL CURETTAGE/PAP,17.82
,
NEG PRESS WOUND TX ,133.1
,
DRAIN/INJ MAJOR JNT/BURSA,134
REMOVAL OF SUPPORT IMPLAN,427.05
,
ANTERIOR EPISTAXIS CONTRL,166.88
,
"CONTRL NASAL HEMRG,ANT",233.06
,
CONT POSTERIOR NASAL BLEE,294.27
,
"INTUB,ENDOTRACHEAL PROC",327.85
,
BLADDER IRRIGATE LAVAGE/I,133.42
,
INSERT TEMP BLADDER CATH SIMPLE,89.36
,
INSERT BLADDER CAH COMPLEX,310
,
CHANGE OF BLADDER TUBE,155.1
,
CHANGE OF CYSTOSTOMY TUBE; COMPLICATED,236.87
,
REMOVAL OF NAIL PLATE,152.04
,
DRAIN BLOOD FROM UNDER NAIL,95.08
,
REPAIR OF NAILBED,380.63
,
DRAINAGE OF GUM LESION,430.16
,
DRAINAGE ABSCESS PALATE UVULA,305.91
,
SIMPLE LAC REP 0-2.5 CM,130.49
,
SIMPLE LAC REP 2.6-7.5 CM,225
,
SIMPLE LAC 7.6-12.5 CM,215.11
,
SIMPLE LAC 12.6-20.0 CM,290.97
,
SIMPLE LAC 20.1-30.0 CM,353.51
,
SIMPLE LAC 30.1 CM & OVER,438
,
SIMPLE FACE LAC 0-2.5 CM,162.36
,
SIMPLE FACE LAC 2.6-5.0CM,182.72
,
SIMPLE FACE LAC 5.1-7.5CM,231.61
,
SIMPLE FACE LAC 7.6-12.5CM,289.11
,
LAYERED LAC 0-2.5 CM,443.31
,
LAYERED LAC 2.6-7.5CM,565.37
,
"LAY NCK,HND,FT LAC 0-2.5",455.02
,
"LAY NK,HND,FT LAC 2.6-7.5",582.08
,
"LAY NCK,HEAD,FT LAC 20.1& UP",889.63
,
LAY CLOS FACE LAC 0-2.5CM,498.17
,
LAY CLOS FACE LAC 2.6-5.0,583
,
FOREIGN BODY REMOVAL FROM PHARYX,395.57
,
CPR,559.07
,
CARDIOVERSION,364.52
CREP S/A/L; 2.6-7.5CM,779.01
,
COMPLEX REPAIR S/A/L; EA ADD 5 CM/,250.02
,
COMPLEX REPAIR FACE 1.1-2.5CM,836.68
,
TREAT CLAVICLE FRACTURE,631.13
,
ARTERIAL PUNCTURE,46.38
,
TREAT SHOULDER DISLOCATIO,824.82
,
TREAT SHOULDER DISLOCATION W/MAINIP,"1,150.01"
,
NASAL/OROGASTRIC W/TUBE PLMT,119.16
,
CHANGE GASTROSTOMY TUBE,140.64
,
IRRIGATION CORPORA CAVERNOSA PRIAPISM,520
,
INJ ANETH;TRIGEMINAL NERVE,204.6
,
INJ ANESTH; OTHR PERIPHER,135.25
,
TREAT ELBOX DISLOCAITON WO ANES,957.65
,
REDUCTION OF REDIAL SUBLU,271.51
,
DRAINABE OF SCROTUM ABCESS,525
,
EYE PROC-REM FB CONJ LOOS,130.03
,
REMOVE FOREIGN BODY FROM EYE,122.87
,
REMOVE FOREIGN BODY FROM EYE,153.76
,
TREAT FRACTURE RADIUS/ULN,"1,470.46"
,
IV START,50
,
THER/PRHOP/DIAG INJ SC/IM,65
,
VENIPUNCTURE < 3 YRS,57.95
,
VENIPUNCTURE > 3 YRS,27.91
,
TREAT METACARPAL FRACTURE,787.48
,
TREAT METACARPAL FRACTURE,834.9
,
TREAT FINGER FRACTURE EACH,866.71
,
TREAT FINGER FRACTURE EACH W/O MANIP,525.14
,
TREAT FINGER DISLOCATION,730.49
,
CLOSED TX PATELLAR DISLOC,952.89
,
TREAT LOWER LEG FRACTURE,868.64
,
REMOVAL OF FOOT FOREIGN BODY,396.09
,
LONG ARM SPLINT MOLDED,174.18
,
,174.18
,
SHORT ARM SPLINT,114.04
,
,114.04
APPLICATION OF FINGER SPLINT,90
,
CLEAR OUTER EAR CANAL,168.71
,
O/P E/M NEW PT LEVEL 1,78.06
,
O/P E/M NEW PT LEVEL 2,147.22
,
O/P E/M NEW PT LEVEL 3,224.61
,
O/P E/M NEW PT LEVEL 4,381.7
,
O/P E/M NEW PT LEVEL 5,496.24
,
O/P E/M EST PT LEVEL 1,27.34
,
O/P E/M EST PT LEVEL 2,75.02
,
O/P E/M EST PT LEVEL 3,150.11
,
O/P E/M EST PT LEVEL 4,231.73
,
O/P E/M EST PT LEVEL 5,328.28
,
DISCH FROM OBSERVATION,213.86
,
INITIAL OBS/DAY LEVEL 1,295.37
,
INITIAL OBS/DAY LEVEL 2,401.34
,
INITIAL OBS/DAY LEVEL 3,404.54
,
I/P E/M INIT LEVEL 1,298.01
,
I/P E/M INIT LEVEL 2,404.11
,
I/P E/M INIT LEVEL 3,598.68
,
I/P E/M SUBS LEVEL 1,115.47
,
I/P E/M SUBS LEVEL 2,214.14
,
I/P E/M SUBS LEVEL 3,308.15
,
I/P E/M DISCH MGMT,214.91
,
CRITICAL CARE-FIRST HOUR,661.03
,
"NURSING FAC CARE, INIT LO",202.09
,
SNF DISCHARGE MGMT 30 MINUTES,157.99
,
PROLONG SERV-FIRST HOUR,273.62
,
PROLONG SRV EA ADD 30 MIN,264.53
,
"AUDIT/DAST, 15-30 MIN",100.8
,
"AUDIT/DAST, OVER 30 MIN",199.88
,
SHORT LEG CAST,166.08
,
APPLICAT LONG LEG SPLINT,144.94
,
APPLIC SHORT LEG SPLINT,145.06
,
STRAPPING OF KNEE,54.99
,
STRAPPING ANKLE &/OR FOOT,53.17
"CRITICAL CARE, ADD -30MIN",330.43
,
ER PATIENT E/M LEVEL 1,62.27
,
ER PATIENT E/M LEVEL 2,121.91
,
ER PATIENT E/M LEVEL 3,183.41
,
ER PATIENT E/M LEVEL 4,348.61
,
ER PATIENT E/M LEVEL 5,515.22
,
DRAINAGE OF SKIN ABSCESS; SMPL OR SGL,281.79
,
DRAINAGE OF SKIN ABSCESS; COMPL OR MULTI,522.75
,
EXPLORATION PENETRATING WOUND SPX EXTREM,"1,300.00"
,
,
REMOVAL OF FOREIGN BODY SIMPLE,325
,
"PUNCT ASP - ABSC,HEMAT,CY",278.29
,
WOUND CLOSURE UTILIZING TISSUE ADHESIVE,250
,
REMOVE NASAL FOREIGN BODY,362.85
,
TRIGGER POINT INJECTION,135
,
INJECT TRIGGER POINTS 3/>,133.1
,
DRAIN/INJ MAJOR JNT/BURSA,134
,
REMOVAL OF SUPPORT IMPLANT,427.05
,
ANTERIOR EPISTAXIS CONTRO,166.88
,
"CONTRL NASAL HEMRG,ANT",233.06
,
CONT POSTERIOR NASAL BLEE,294.27
,
INSERT EMERGENCY AIRWAY,327.85
,
BLADDER IRRIGATE LAVAGE/I,133.42
,
INSERT TEMP BLADDER CATH SIMPLE,89.36
,
INS BLADDER CATH COMPLEX,251.08
,
CHANGE OF BLADDER TUBE,155.1
,
CHANGE OF CYSTOSTOMY TUBE; COMPLICATED,236.87
,
REMOVAL OF NAIL PLATE SINGLE,152.04
,
2ND- AVULSION NAIL PLAT PARTIAL/COM SIMP,70
,
DRAIN BLOOD FROM UNDER NAIL,95.08
,
REPAIR OF NAILBED,380.63
,
DRAINAGE OF GUM LESION,430.16
,
DRAINAGE ABSCESS PALATE UVULA,305.91
,
SIMPLE LAC REP 0-2.5 CM,130.49
,
SIMPLE LAC REP 2.6-7.5 CM,225
SIMPLE LAC 7.6-12.5 CM,215.11
,
SIMPLE LAC 12.6-20.0 CM,290.97
,
SIMPLE LAC 20.1-30.0 CM,353.51
,
SIMPLE LAC 30.1 CM & OVER,438
,
SIMPLE FACE LAC 0-2.5 CM,162.36
,
SIMPLE FACE LAC 2.6-5.0CM,182.72
,
SIMPLE FACE LAC 5.1-7.5CM,231.61
,
SIMPL FACE LAC 7.6-12.5CM,289.11
,
LAYERED LAC 0-2.5 CM,443.31
,
LAYERED LAC 2.6-7.5CM,565.37
,
"LAY NCK,HND,FT LAC 0-2.5",455.02
,
"LAY NK,HND,FT LAC 2.6-7.5",582.08
,
"LAY NK,HD,FT LAC 20.1&UP",889.63
,
LAY CLOS FACE LAC 0-2.5CM,498.17
,
LAY CLOS FACE LAC 2.6-5.0,583
,
TUBE THORACOSTOMY INCL WATER SEAL,360
,
FOREIGN BODY REMOVAL FROM PHARYX,395.57
,
CPR,559.07
,
CARDIOVERSION,364.52
,
CREP S/A/L; 2.6-7.5CM,779.01
,
COMPLEX REPAIR S/A/L; EA ADD 5 CM/,250.02
,
REPAIR COMPLEX FACE 1.1-2.5CM,836.68
,
TREAT CLAVICLE FRACTURE,631.13
,
ARTERIAL PUNCTURE,46.38
,
TREAT SHOULDER DISLOCATIO,824.82
,
NASAL/OROGASTRIC W/TUBE PLMT,119.16
,
CHANGE GASTROMSTOMY TUBE,140.64
,
INJ. ANESTH;TRIGEMINAL NERVE,204.6
,
INJ ANESTH; OTHR PERIPHER,135.25
,
TREAT ELBOW DISLOCATION WO ANES,957.65
,
TREAT ELBOW DISLOCATION,271.51
,
DRAINAGE OF SCROTUM ABCESS,525
,
REMOVE FOREIGN BODY FROM EYE,130.03
,
REMOVE FOREIGN BODY FROM EYE,122.87
,
REMOVE FOREIGN BODY FROM EYE,153.76
TREAT FRACTUE RADUS/ULNA,"1,470.46"
,
IV START,50
,
DRESS/DEBRID P-THICK BURN S,163.89
,
THER/PROPH/DIAG INJ SC/IM,65
,
VENIPUNCTURE < 3 YRS,57.95
,
ID VULVA/PERINEAL ABSCESS,270
,
VENIPUNCTURE > 3 YRS,27.91
,
REMOVE TUNNELED CV CATH,574.8
,
TREAT METACARPAL FRACTURE,787.48
,
TREAT METACARPAL FRACTURE,834.9
,
TREAT FINGER FRACTURE EACH,866.71
,
TREAT FINGER FRACTURE EACH W/O MANIP,525.14
,
TREAT FINGER DISLOCATION,730.49
,
TREAT KNEECAP DISLOCATION,952.89
,
,952.89
,
REMOVAL OF FOOT FOREIGN BODY,396.09
,
,396.09
,
REMOVAL FOREIGN BODY FOOT DEEP,"1,065.00"
,
LONG ARM SPLINT MOLDED,174.18
,
SHORT ARM SPLINT,114.04
,
APPLICATION OF FINGER SPLINT,90
,
CLEAR OUTER EAR CANAL,168.71
,
O/P E/M NEW PT LEVEL 1,78.06
,
O/P E/M NEW PT LEVEL 2,147.22
,
O/P E/M NEW PT LEVEL 3,224.61
,
O/P E/M NEW PT LEVEL 4,381.7
,
O/P E/M NEW PT LEVEL 5,496.24
,
REMOVE IMPACTED EAR WAX UNI,97.09
,
O/P E/M EEST PT LEVEL 1,27.34
,
O/P E/M EST PT LEVEL 2,75.02
,
O/P E/M EST PT LEVEL 3,150.11
,
O/P E/M EST PT LEVEL 4,231.73
,
O/P E/M EST PT LEVEL 5,328.28
,
DISCH FROM OBSERVATION,213.86
,
INITIAL OBS/DAY LEVEL 1,295.37
INITIAL OBS/DAY LEVEL 2,401.34
,
INITIAL OBS/DAY LEVEL 3,404.54
,
SUBS OBSERVATION CARE,118.47
,
OBSER/HOSP SAME DATE,405.78
,
OBSERV/ HOSP SAME DATE,373.94
,
OBSERV/HOSPITAL SAME DATE,480.47
,
I/P E/M DISCH MGMT,214.91
,
CRITICAL CARE-FIRST HOUR,661.03
,
CRIT CARE-EA ADD 30 MIN,330.43
,
SNF DISCHARGE DAY; 30 MINUTES,214.54
,
APPLICATION SHORT CAST BELOW KNEE,205
,
"AUDIT/DAST, 15-30 MIN",100.8
,
"AUDIT/DAST, OVER 30 MIN",199.88
,
SHORT LEG CAST,166.08
,
APPLICAT LONG LEG SPLINT,144.94
,
APPLIC SHORT LEG SPLINT,145.06
,
STRAPPING OF KNEE,54.99
,
STRAPPING ANKLE &/OR FOOT,53.17
,
PHASE III REHAB 2X PER WK,65.93
,
PHASE III REHAB 3X PER WK,94.22
,
CARDIAC REHAB W ECG MONIT,222.81
,
AEROCHAMBER SPACER,28.95
,
RETROGRADE LIG KNIFE,592.5
,
ANTEGRADE LIG KNIFE,742.5
,
TENEX KIT,"1,147.50"
,
FLOSEAL KIT,308.02
,
BALLOON DILATOR,70
,
DIALATION CATHETER,210.9
,
SUTURE TAPE 1.33MM W/TAILS,70
,
POCKET MASK (FOR ALL),35
,
IVAC MULTI-CHANL PUMP TBG,45.01
,
WARM AND FORM BRACE,80
,
PICCLINE TRAY,105.21
,
ROSIDAL K 8CM X 5M,29.12
,
ROSIDAL K 10CM X 5M,32.75
ROSIDAL K 12CM X 5M,39.12
,
ROSIDAL K 12CM X 10M,58.5
,
K-WIRE W/LENGHT MARKINGS,55
,
TWIST DRILL,235
,
OXYGEN ER/OR,27.6
,
CHROMIC 1 CC01,53.16
,
ANGIO CATH 12G,32.98
,
CHOLANGIO-NASHVILLE,67.5
,
ENDOLOOP LIGATURES,81.72
,
PROSTATE BX NEEDLE GUIDE,41.77
,
QUICK CLIP (ENDO),217.5
,
EGIA HANDLE STANDARD,377.98
,
GIA 12MM SMALL,413.59
,
ENDO GIA 12MM STAPLER,459.55
,
ENDOKITNER 5MM,25.97
,
ENDO CATCH 15MM,349.6
,
ENDO CATCH 10MM GOLD,284.79
,
ENDOCLOSE,100.66
,
SYSTEM POS AIRWAY PRESSURE EZPAP,48.74
,
ACCU PAP MANOMETER,44.72
,
ENDO SUTURE ENDO LOOP,41.74
,
LIGASURE LAP 5MM BLUNT TIP,638.41
,
LINEAR CUTTER 55-OPEN BOWEL,114.19
,
LINEAR RELOAD 55-OPEN BOWEL,98.22
,
LINEAR CUTTER 75-OPEN BOWEL,178.74
,
LINEAR RELOAD 75-OPEN BOWEL,111.19
,
SCISSORS CURVED W/ MONOPOLAR CAUTERY 5mm,109.74
,
,
TROCAR 5MM,145.98
,
TROCAR 5MM LONG,157.75
,
BLADELESS TROCAR 5mm SLEEVE,94.57
,
BLADELESS TROCAR 12mm SLEEVE,125.17
,
TROCAR 12 MM,174.49
,
TROCAR 12MM LONG,194.37
,
TROCAR 15MM,194.54
VARESS INSUFFLATION NEEDLE,85.92
,
INSUFFLATION NDL LONG,69.32
,
NB300 NERVE BLOCK TRAY,44.79
,
NERVE BLOCK TRAY,25.2
,
SPINAL EPIDURAL TRAY,44.1
,
CONTINUOUS EPIDURAL TRAY,60.52
,
SPINAL TRAY W/MARCAINE,29.02
,
RESTORE SILVER DRESSING 4x5,28.87
,
RESTRAINT ARM WITH LOCK,153.9
,
RESTRAINT LEG WITH LOCK,161.44
,
OMEGA3 WOUND 3 X 3.5 cm,551.25
,
OMEGA3 WOUND 3 X 7 cm,"1,102.50"
,
ACAPELLA,86.8
,
AMPLATZ RENAL DILATORS,314.58
,
THORACENTESIS TRAY,25.1
,
SAFE-T-CENTESIS TRAY,105.94
,
ARTHROSCOPY PACK (MANNING),280.57
,
KNEE ARTHRO PACK,155.23
,
ARTHROSCOPY PACK,129.67
,
ARTH SHAVER 3.5 TOMCAT,74
,
ARTH SHAVER 4.0 TOMCAT,74
,
ARTH SHAVER 4.0 AGG PLUS,74
,
ARTH SHAVER 5.5 AGG PLUS,129.78
,
KNEE ARTHRO DRAPE,64.58
,
ENDO GIA 45-2.5MM RELOAD,519.85
,
POWER PICC TRIPLE LUMEN TRAY,406.5
,
BAIR PAWS - FLEX GOWN,36
,
URETERAL SHEATH 16X30,154.42
,
BELLY BAG,44.55
,
FORCEPS HOT BIOPSY,28.05
,
BIPAP MASK SMALL (TRI-ANIM),49.9
,
BIPAP MASK MED (TRI-ANIM),49.9
,
BIPAP MASK LARGE (TRI-ANIM),49.9
,
BIS SENSOR,48.75
,
PROSTATE BX GUN 20CM,64.02
BREAST BX NDL 14GX15CM,53.54
,
BLADDER EVACUATOR,44.8
,
HET BIPOLAR FORCEPS,"2,975.00"
,
BLAKE DRAIN 10FR,115.43
,
BLAKE DRAIN 15FR,32.4
,
BLAKE DRAIN 19FR,114.3
,
BONE MARROW BX TRAY,127.19
,
BONE MARROW BX-JAMSHIDI,31.38
,
18G ILLINOIS BONE MARROW NDLE,31.37
,
15G ILLINOIS BONE MARROW NDLE,44.4
,
STR CHEST TUBE INSERTION TRAY,34.55
,
BUGBEE CAUTERY,122.2
,
C SECTION PACK,72.64
,
CS MISC STERILE BILLABLE,0
,
GELPORT,905.62
,
BREVI-KATH,127.41
,
FOLEY CATH TRAY 16FR,61.36
,
FOLEY CATH TRAY 18FR,28.9
,
E-KATH 12,96
,
3-WAY CATH 24FR COUDE TIP,64
,
TRAY SUPERPUBIC FOLEY,116.68
,
SP CATH-16FR,45.02
,
SP CATH-18FR,45.02
,
SP CATH-20FR,45.02
,
SP CATH-22FR,45.02
,
SP CATH-24FR,45.02
,
FILIFORM 4FR STRAIGHT,25.02
,
FILIFORM 3FR STRAIGHT,30.05
,
FILIFORM 4 FR SPIRAL,29.37
,
FILIFORM 5FR STRAIGHT,30.05
,
FOLLOWERS 16FR,48.97
,
PHIL CATH FOLLOWER 18FR,88.24
,
FOLLOWERS 26FR,48.97
,
FOLLOWERS 10FR,48.97
,
FOLLOWERS 14FR,48.97
SILICONE CATH 24FR 5CC,32
,
SILICONE CATH 24FR 30CC,32
,
SILICONE CATH 22FR 30CC,34.25
,
CATH 3-WAY 24FR,45.44
,
SILICONE CATH 22FR 5CC,32
,
CATH-COUDE 14 FR,38.32
,
HSG CATHETER,60
,
CATH UMBILICAL 3.5 FR,27.2
,
CATH UMBILICAL 5.0 FR,27.2
,
COLORADO CAUTERY TIP,141
,
HANDHELD DISP CAUTERY,26.02
,
PLEURA GUIDE,192.28
,
CHEST TUBE TROCAR 24FR,33.5
,
CHOLANGIO-TAUT,76.3
,
"CHOLANGIOGRAM CATH 18""",47.94
,
"CHOLANG CATH 4.5 FR 18""",60.42
,
ADULT CO2 TUBING,35.45
,
EVAC COBLATOR 2,391.5
,
LG PA STOCKINGS,101.29
,
MED PA STOCKINGS,97.52
,
VAPOTHERM CIRCUITS,130.5
,
ARTHRO CASSETTE TUBING,288.34
,
SINGLE CASSETTE TUBING (BLUE),96.06
,
CT FRONT LOAD SYRINGE,46.35
,
CTR KIT,255.61
,
CUTTING LOOP 26FR,91.88
,
CYSTO PACK,30.85
,
BOTOX BLADDER NEEDLE,141.37
,
BOTOX BLADDER NEEDLE W/ SHEATH,735
,
CYTOLOGY BRUSH DISP,31.97
,
DERMABOND PRINEO,386.65
,
DERMATOME BLADE,55.4
,
DERMABOND-ER,89.7
,
SHILEY TRACH SIZE 7,61.22
,
SHILEY TRACH SIZE 10,57.24
DUETTE 16FR,32.5
,
DUETTE 18FR,32.5
,
GLASSCOCK EAR DRESSING,34.57
,
DURAVENT EAR TUBE 1.27MM,71.66
,
EAR TUBE-RICH.ARMST. DUAL,29.42
,
PAPARELLA EAR TUBE 1.2,56.66
,
PAPARELLA EAR TUBE,47.34
,
ARMSTRONG EAR TUBE,45.18
,
EEA CIRC STAPLER 25MM,"1,222.26"
,
EEA CIRC STAPLER 31MM,"1,483.31"
,
EEA CIRC STAPLER 28MM,"1,483.31"
,
ROLLER BALL ELECTRODE,324.99
,
ENDO TATOO INK,60.8
,
ENDOSTITCH SUTURE 10MM,423.69
,
ENDOSTITCH SUTURE RELOAD,91.03
,
EPIDURAL KIT FLEX TIP,60.76
,
ENTRADA COLONIC OVER TUBE,247.5
,
EPIDURAL TRAY,41.72
,
EPIDURAL ANESTH TRAY,45
,
ENTRADA OVERTUBE 50CM,337.5
,
INTRA OSS NEEDLE SET,187.5
,
INTRA OSS PEDI,204.9
,
INTRA OSS NEEDLE,204.9
,
EXTERNAL NERO STIM,600
,
TRAXTION HEX SNARE,70
,
EXACTO COLD SNARE,50
,
LMA FAST TRACK SZ 3,121.5
,
LMA FAST TRACK SZ 4,121.5
,
LMA FAST TRACK SZ 5,121.5
,
FEED TUBE LP GAST 14FR2.3,135.16
,
CAUTERY CORD DISP,37.5
,
SURGIFOAM 100CM,74.64
,
GLIDESCOPE SZ 1,40.96
,
GLIDESCOPE SZ 2,40.96
,
GLIDESCOPE SZ 3,39.2
SAFETY NEEDLE 25GX2,35.72
,
GLIDESCOPE SZ 4,39.2
,
GLYCINE 3000ML,34.02
,
GASTROSTOMY TUBE KIT,63.2
,
GYNE PACK,25.52
,
ENDO CLIPPER,240
,
JP DRAIN 100ML,163.51
,
SWIFTSET SKIN ADHESIVE,65.18
,
INTERCEED,348.07
,
INTERSTIM & TEST CABLE,180
,
"IOBAN 23""X33""",25.22
,
INSUFFLATION TUBING,43.2
,
TORRENT IRRIGAT TUBING,25
,
"IRRIGATION, EYE",26.76
,
ISOBAND 15CM X 5M,45.37
,
KING LTS-D AIRWAY SIZE 3 (ER),81.08
,
KING LTS-D AIRWAY SIZE 4 (ER),81.08
,
KING LTS-D AIRWAY SIZE 2 (ER),110.05
,
KING LTS-D AIRWAY SIZE 5 (ER),81.08
,
KING LTS-D AIRWAY SIZE 2.5 (ER),110.05
,
LAP CHOLE PACK III,134.34
,
KOPANS 20g 9cm,55.56
,
KOPAN NEEDLE 7cm,53
,
LAPAROTOMY PACK,47.42
,
TPOD PELVIC STABILIZER DEVICE,223.5
,
LAP CHOLE II PACK-ACMH,94.48
,
LAP-PELVIC DRAPE,34.93
,
LAP SCISSORS-DISP,60.66
,
LIGASURE IMPACT,"1,539.58"
,
LEAD INTRODUCER KIT,420
,
LIGASURE 37CM TISSUE FUSION,566.35
,
LEEP ELECTRODES R1007,31.42
,
LEEP ELECTRODE R2010,42.36
,
LINEAR STAP RELOAD 60,89.14
,
LINEAR STAPLER 60MM,82.16
LIGASURE HANDHELD 2.8MM,330.75
,
LOWER EXTREMITY PACK,85.78
,
LITHOTRIPTER PROBES 2FR,254.49
,
LITHOTRIPTER PROBES 9FR,250.5
,
LIGASURE IMPACT 13.5MM,"1,335.69"
,
LUMBAR PUNCT KIT-ADULT,36.65
,
LONG FILTERLINE CO2,25.72
,
PED CO2 TUBING,34.85
,
MAXON 0 - 341LOOP,41.1
,
MAXON 0 - 6319-62,35.97
,
MAXON 1 - 6319-72,34.97
,
MEROCEL NASAL STENT,131.47
,
MITIVAC EXTRACTOR,116.65
,
MORGAN LENSES,45.8
,
CVC KIT 7 FR TRIPLE LUMEN,129.01
,
MYRINGOTOMY KNIFE,45
,
NOZ-STOP KIT,112.5
,
NEUROTHERM EPIDURAL CATH,122.5
,
COIL STONE BASKET-BOS SCI,337.45
,
NS 3000 CC BAG,28.37
,
NASOPORE,382.5
,
CRICOTHYROTOMY CATH SET-ADULT,390
,
NU-TRAKE PED,237.67
,
NU-TRAKE ADULT,288.67
,
LITHOTOMY PACK,41.92
,
CASE SUPPLIES,33.46
,
ORTHO PACK,97.8
,
OXI-SENSOR FOREHEAD,48
,
LITHO UNDERBODY BLANKET,45.55
,
PHILLIPS CATH FOLLOWER 20FR,48.97
,
PHILLIPS CATH FOLLOWER 22FR,48.97
,
EndoVive PEG Kit,136.5
,
DISP. SUCTION IRRIGATOR,124.54
,
LAP SPATULA PISTOL,61.38
,
LMA PAIN PUMP (OR),925.62
POWERLOC 22G KIT,42.5
,
ARROW PICC 6 FR TRIPLE LUMEN,476.59
,
PEG TRAY,118.13
,
PENILE CLAMP-LARGE,67.52
,
PENILE CLAMP-REGULAR,68.4
,
POWERLOC 19G KIT,42.5
,
LAP PLUME FILTER DEVICE,98.82
,
PORTED ELBOW FOR BIPAP,66.88
,
PROBE PLUS II IRRIGATION,77.22
,
PROBE PLUS 5MM HOOK,128.58
,
PROBE PLUS PISTOL HANDLE,245.89
,
PRESSURE BAG 1000CC,47.94
,
PRESSURE BAG 3000CC,97.02
,
POWERLOC 20G KIT,42.5
,
PLEUR-VAC CHEST TUBE,80.5
,
"18"" SINGLE BLADDER",37.25
,
POLYP TRAPS,27.05
,
QUANTUM DILATOR 16MM,163.12
,
QUANTUM INFLATION DEVICE,183.82
,
RAPID RHINO NASAL PACKING,71.2
,
WILSON RETRACTOR,120
,
LONESTAR RETRACTOR,145.53
,
ROTICULAR STAPLER 55MM,866.91
,
RIGID CYSTO BOTOX NEEDLE,77.8
,
ROTH NET-3.0,141
,
QUANTUM DILATOR 14MM,163.12
,
QUANTUM DILATOR 18MM,163.12
,
"24"" SINGLE BLADDER",41.97
,
"34"" SINGLE BLADDER",49.25
,
KALTOSTAT DRESSING,29.25
,
SCLERO NEEDLE-5MMX25G,40.5
,
"18"" DUAL BLADDER",49.26
,
SORBAFIX,735
,
URETERAL ACCESS SHEATH SET 13F/15F,154.42
,
HOT POLYP SNARE 25MM,58
PACK SHOULDER ARTHROSCOPY (MANNING),121.1
,
DR DONS SLING,77
,
SAW BLADE 40X9.5X0.6,50
,
SAW BLADE 25X9.4X0.6,50
,
SAW BLADE 25X5.5X0.6,50
,
SAW BALDE 25X9.4X0.7,50
,
THD SLIDE ONE,747
,
BED CUSHION,97.44
,
STIMU QUIK NEEDLE 21G 150mm,25.17
,
ENDOFORM 2x2,33.62
,
STERILE SHOULDER DRAPE PACK W/POUCH,36.05
,
CLOSESURE SYSTEM-CARTER THOMASOM,169.2
,
ORTHO-LONG/MED BLADE25X9,50.76
,
ORTHO-LONG/MED BLADE31X9,56
,
ORTHO-LONG NARROW BLADE25X5.5,128.76
,
ORTHO-AVG-MED BLADE 25X9MM,137.64
,
ORTHO-LONG NARROW THIN BLADE,40.5
,
SP CATH INTRODUCER,118.08
,
SURGICEL 2x3,116.2
,
FLOOR PAD -YELLOW,28.35
,
TALON GRASPER,214.5
,
THORACIC TROCAR 28FR,39.9
,
THORACENTESIS TRAY,42.87
,
TOUMA T-TYPE EAR TUBE,47.2
,
TRIANGLE HOOK BLADE-STERI,165
,
TROCAR BLADELESS 5MM,157.95
,
TROCAR BLADELESS 12MM,118.52
,
ET TUBE 6.0 UNCUFFED,103.07
,
TUR DRAPE-LINGEMAN,100.43
,
TRU CUTTING KNIFE,119.52
,
TUR TUBING,28.17
,
FOLEY DRAINAGE BAG,30
,
HEYMAN TRAY,214.26
,
URO-JET (XYLOCAINE),19.98
,
UROLOCK II ADAPTER,52.4
HTA HYDRO THERMAL ABALATION,"1,656.25"
,
URETERAL DILATOR SYSTEM,417.15
,
ABALATION CATH,"1,494.19"
,
VR1 VENT CIRCUIT,45.55
,
ORTHO OVAL,42.14
,
ORTHO-EGG BURR,84.02
,
VERSASTEP SLEEVE,114.75
,
ACELL MATRISTEM MICRO MATRIX MM1000,"3,632.50"
,
ACELL MATRISTEM MICRO MATRIX MM0100,541.5
,
ACELL MATRISTEM SURGICAL MATRIX PSMX0710,"2,756.25"
,
,
ACELL MICROMATRIX MM0200,590
,
ACELL MATRIX WSX0505,"1,485.00"
,
ACELL MATRIX WSX0710,"3,330.00"
,
WOUND WASH SALINE 0.9%,15.5
,
LIGASURE- BOWEL RESECTION,"1,092.00"
,
STRATAFIX SYMMETRIC 45cm VIOLET,47.62
,
4-0 FIBER LOOP BLUE,87.5
,
2-0 FIBERWIRE,44
,
ETHIBOND 2-0 CX46D,26.22
,
MICRO COMP DRILL AND 2.00MM BIT,517.5
,
HERNIA TACKER,525
,
"PROSTOP GUIDE WIRE .054""",142.5
,
0.86MM GUIDE WIRE TROCAR TIP,63
,
"0.062"" GUIDE WIRE TROCAR TIP",43
,
".45"" GUIDE WIRE TROCAR",95
,
2.7MM DRILL BIT,215
,
"THREADED G-WIRE .062"" W/TOCAR TIP",44
,
STOPCOCK 3 PORT ANESTHESIA,30.07
,
"12"" SINGLE BLADDER",33.41
,
STRYKER ABLATION WAND,543.09
,
ORTHO-BENT FINE BLADE,69.68
,
ORTHO-LONG WIDE THIN BLADE,53.7
,
ETHIBOND-0 CX45D,25.6
,
OXYGEN PER DAY,89.97
YUEH CENTESIS NEEDLE,36.15
,
GLIDE WIRE BOSTON SCI,149.23
,
RESECTR-BOST SCI,748.5
,
RESECTOR 4.0MM,74
,
HYDROFERA BLUE READY,41.37
,
STONE BASKET 1.9,218.67
,
URO PASS SHEATH,179.74
,
STONE BASKET URO,274.5
,
LUMEN CATH URO,73.36
,
IRRI FLOW,68
,
"ARGYLE TROCAR CATH 24FR X 16""",43.56
,
"ARGYLE TROCAR CATH 28FR X 16""",43.56
,
"ARGYLE TROCAR CATH 32FR X 16""",43.56
,
CASTING SUPPLIES,35
,
THORACENTESIS TRAY,75
,
NON-REIMBURSED SWING BED,273
,
NON-REIMBURSED HOSPICE,273
,
SODIUM CHLORIDE BAG 0.45%,25.9
,
DEXTROSE 10% IN WATER BAG 1000ML,31.1
,
D5W 250ML bag,20.75
,
DEXTROSE 5%/LACT RINGER'S 1000ML,17.35
,
DEXTROSE 5%/LACT RINGER'S 500ML,27.85
,
DEXTROSE 5PCT 0.45PCT SODIUM 1000ML,20.75
,
DEXTROSE 5%/0.225% SOD CH 1000ml,27.85
,
DEXTROSE 5%/0.9% SODIUM C 1000ML,20.75
,
D5W 1000 ML BAG,27.85
,
DEXTROSE 5% IN WATER BAG 100ML,21.2
,
DEXTROSE 5% IN WATER BAG 500ML,24.1
,
DEXTROSE 5% IN WATER BAG 500ML,21.94
,
LACTATED RINGER'S 1000ML,27.85
,
SODIUM CHLORIDE ADD-V BAG 100ML,21.7
,
SODIUM CHLORIDE ADD-V BAG 50ML,21.75
,
D RX SODIUM CHLORIDE INJ 0.9% USP 1000ML,29.1
,
D RX SODIUM CHLORIDE INJ 0.9% 50ML,19.75
,
SODIUM CHLORIDE BAG 0.9% 100CC,20.65
0.9% NS 250ML BAG,27.85
,
SODIUM CHLORIDE BAG 0.9% 500 CC,25.2
,
TPN,278.46
,
STOP SMOKING CLASS,57.88
,
VENT MGMT INPAT INIT DAY,409.16
,
VENT MGMT INPAT SUBQ DAY,294.28
,
INITIAL USN EVAL,71.33
,
USN TREATMENT,75.84
,
NEBULIZER CONT TREATMENT,75.84
,
ACAPELLA TRAINING,105.85
,
ACAPELLA SUBS,122.36
,
OXIMETRY,12.81
,
"OXIMETRY, EXERCISE",20.29
,
TREND OXIMETRY,102.88
,
SUBS NEBULIZER CONT.,75.84
,
SUBS USN TREATMENT,75.84
,
EVALUATE PT USE OF NEBULIZER- INITIAL,96.2
,
SUBS MDI TREATMENT,75.84
,
SUBS INHALATION TREATMENT,75.84
,
NEBULIZER TREATMENT,75.84
,
MDI INITIAL EVAL,96.2
,
MDI TREATMENT,75.84
,
INITIAL IPPB EVAL,96.2
,
IPPB TREATMENT,75.84
,
INIT CHEST PHY THERAPY,105.85
,
SUBS CHEST PHY THERAPY,131.72
,
SUBS IPPB TREATMENT,75.84
,
SPIROMETRY,271.33
,
MVV,171.94
,
PFT-PRE & POST BRONO,441.51
,
PFT BY GAS,297.19
,
CO/MEMBRANE DIFFUSE CAPAC,392.4
,
MIPS/MEPS,194.16
,
OB ROOM CHARGE,640
,
NURSERY,566.55
VALPROIC ACID,141.41
,
FLUOXETINE-PROZAC,142.91
,
CHEM 7 (BASIC METABOLIC),45
,
VET CHEM PROFILE,28.79
,
ELECTROLYTES,73.22
,
"VET CBC, DIFF PL",17.62
,
VET UA,9.57
,
CHEM 12(COMP METABOLIC),52
,
LIVER PROFILE,85.34
,
LIPID PROFILE,139.84
,
RENAL FUNCTION PANEL,90.65
,
ACUTE HEPATITS PANEL,440.17
,
NEONATAL SCREEN,102.04
,
TRIP CHARGE,10
,
URINE NICOTINE,90
,
ROHIPNOL (FLUNITRAZEPAM),758.93
,
"BARBITURATES, SERUM",758.93
,
PATERNITY TEST SWAB,25
,
ALPRAZOLAM,193.03
,
CLOZAPINE,142.91
,
LORAZEPAM (ATIVAN),193.03
,
DALMANE/FLURAZEPAN,206.68
,
CYCLOSPORIN,188.47
,
DESIPRAMINE,164.14
,
DRUG SCREEN QUANTITATIVE OXCARBAZEPINE,30
,
PHENYTOIN; FREE,143.51
,
DRUG SCREEN ANALGENSICS NON-OPOID 1 OR 2,74.14
,
TACROLIMUS,143.19
,
TOPAMAX LEVEL,124.47
,
SOLUBLE TRANSFERRIN RECEPTOR,62
,
RISPERIDONE(RISPERDOL),188.5
,
OLANZAPINE,142.91
,
RITALIN,188.5
,
ZONEGRAN,142.91
,
CHLORPHENIRAMINE,188.47
GABAPENTIN/NEURONTIN,142.91
,
SEROQUEL,142.91
,
TRILEPTOL,142.91
,
CAFFEINE,142.91
,
CLINDAMYCIN,142.91
,
HYDROCODONE,203.17
,
OXYCONTIN,203.1
,
ULTRAM,188.47
,
METHOTREXATE,88.53
,
ASSAY OF OPIATES,204.23
,
SIROLIMUS,142.91
,
DIPHYLLINE (LUFYLLIN),188.47
,
TRAZODONE-DESYREL,88.54
,
VANCOMYCIN TROUGH,141.41
,
VANCOMYCIN PEAK,141.41
,
DRUG SCREEN QUAT AMPHETAMINES 1 OR 2,25
,
DRUG SCREEN AMPHETAMINES 3 OR 4,70
,
LAMOTRIGINE,142.91
,
DRUG SCREEN NON-OPOID 3-5,100
,
DRUG SCREENING METHODONE,41
,
PROSTATE BX'S 1-20 SPC,788
,
MEDICARE DRUG SCREEN 1-7,125
,
TICLID,188.47
,
URINALYSIS-ROUTINE,33.08
,
URINE-DIPSTICK ONLY,23.47
,
24 HR UA MET.NORMET. PANEL,31.3
,
BCR-ABL GENE REARRAGNEMENT,581.75
,
CALRETICULIN MUTATION,185
,
PT 20210 GENE MUTATION,517.39
,
FACTOR V LEIDEN,637.65
,
HEMOCHROMATOSIS GENOTYPE,115
,
JAK2 V617F MUTATION,300.46
,
GROSS MICRO LEVEL III,100
,
MTHFR GENE ANALYSIS,120
,
BONE MARROW NDL BIO,80.77
CYTO OTHER SOURCE,176.51
,
FROZEN SECTION,100.77
,
PML/RARA QUANTITATIVE,"1,100.00"
,
SURGICAL GROSS LEVEL I,86.68
,
GROSS MICRO LEVEL II,75
,
GROSS MICRO LEVEL IV,155
,
HLA II TYPING 1 LOCUS LR,399.47
,
HLA-B5701,987.17
,
ONCO (OVAR) FIVE PROTEINS,"1,040.46"
,
ACETONE-QUAL,47.14
,
ACETONE ASSAY,83.67
,
ACTH,403.17
,
URINARY CYCLICAMP,141.89
,
ALBUMIN,51.7
,
ASSAY OF URINE ALBUMIN,25
,
"MICROALBUMIN, URINE",60.44
,
"ETHANOL, EXCEPT BREATH",112.82
,
ALDOLASE,101.31
,
ALDOSTERONE,425.35
,
ALPHA I ANTITRYPSIN TOTAL,140.21
,
ALPHA I ANTITRYPSIN PHENO,150.91
,
"CYSTINE, URINE",176.09
,
"ALA AMINOLEVULINIC ACID,D",171.8
,
"AMINO ACID, URINE",176.09
,
AMINO ACIDS PLASMA,176.09
,
AMMONIA,152.11
,
AMYLASE,67.7
,
RANDOM URINE TEST-ENZYMAT,67.7
,
ANDROSTENEDIONE,290.92
,
RENIN,229.59
,
ANGIOTENSIN CONV ENZ -ACE,152.35
,
ASSAY OF APOLIPOPROTEIN,75
,
ARSENIC,100
,
ASCORBIC ACID (VITAMIN C),103.16
,
PHENOBARBITAL,119.59
URINE BETA 2 MICROGL,141.89
,
B2 MICROGLOBULIN SERUM,141.89
,
"BILE ACIDS, TOTAL",88.03
,
"BILIRUBIN, TOTAL",52.48
,
"BILIRUBIN, DIRECT",52.48
,
OCCULT BLOOD-EMESIS,33.95
,
CADMIUM,140
,
VIT-D (25 HYDROXY),308.99
,
CALCITONIN,279.46
,
CALCIUM,53.78
,
IONIZED CALCIUM,142.58
,
"CALCIUM, URINE,QUANT",63
,
STONE ANALYSIS,130.78
,
CARBAMAZEPINE,151.93
,
CARBON DIOXIDE (CO2),51.03
,
CARBOXYHEMOGLOBIN,128.65
,
CARNITINE,176.09
,
CAROTENE,96.31
,
"CATECHOLAMINES, TOTAL",263.56
,
ASSAY THREE CATECHOLAMINES,263.56
,
CERULOPLASMIN,112.16
,
DECALCIFICATION,39.53
,
INHIBIN B,140.37
,
CHLOROMYCETIN,132.21
,
CHLORIDE,47.97
,
CHLORIDE-URINE,52.48
,
CHOLESTROL,43.25
,
CHOLINESTERASE-S,82.25
,
RBC CHOLINESTERASE,80.23
,
DOXEPIN,151.5
,
CLONAZEPAM,193.03
,
PSEUDOEPHEDRINE(SUDAFED),142.91
,
SERTRALINE(ZOLOFT),142.91
,
CORDARONE(AMIODORONE),142.91
,
FELBAMATE,142.91
CANNABINOIDS CONFIRMATION,142.91
,
PAXIL,142.91
,
MYCOPHENOLIC ACID,142.88
,
ITRACONAZOLE,142.88
,
KEPPRA,142.91
,
CHROMIUM SERUM,54.45
,
CITRATE,290.21
,
CIPROFLOXACIN-SER,142.91
,
"N-TELOPEPTIDE, URINE",195.11
,
BETA-CTX,195.11
,
COPPER,129.55
,
"CORTISOL, FREE",174.44
,
CORTISOL S OR U,170.2
,
CREATINE,48.4
,
LACOSAMIDE (VIMPAT),188.5
,
LYRICA (PREGABALIN),188.5
,
CPK,68
,
CPK ISOENZYMES (3),139.77
,
CK-MB,55
,
CREATININE,53.51
,
FROZEN SECTION ADDITIONAL,38.41
,
URINE CREATININE,54.02
,
CREAT CLEARANCE,98.63
,
CRYOGLOBULIN,67.53
,
B 12 (VITAMIN),58
,
B-12 BINDING CAPACITY,149.41
,
GROSS/MICRO LEVEL V,550
,
DHEA-S,150
,
FROZEN SECTION WITH STAIN,107.21
,
DIGITOXIN,142.91
,
CONSULT & REPORT ON SLIDE,31.48
,
DIGOXIN,138.6
,
DISOPYRAMIDE (NORPACE),88.54
,
"VIT D,1,25 HYDROXY",401.73
,
"PANCREATIC ELASTASE, FECA",120.42
FROZEN SECTION (CONSULT),50.94
,
"DRUG SCREEN, SGL CLASS",117.35
,
ERYTHROPOIETIN,196.16
,
ESTRADIOL,100
,
ESTROGEN-TOTAL,226.36
,
UNCONJUGATED ESTRIOL,224.33
,
ESTRONE,260.56
,
FECAL FAT-SCREEN,45.05
,
GROSS MICRO LEVEL VI,840
,
FECAL FAT QUANTITATIVE,142.79
,
FERRITIN,142.16
,
FIBRINOGEN QUANT,88.66
,
FOLATE (FOLIC ACID),153.44
,
GENTAMYCIN,171.09
,
GENTAMYCIN PEAK,171.09
,
ASSAY IGA/IGC/IGG/IGM,50
,
IGE,171.89
,
IgG SUBCLASS,36.31
,
IGM,50
,
BLOOD PH,84.49
,
BLOOD GASES ANY COMBINATION,28
,
ARTERIAL BLOOD GAS,205.4
,
OXYGEN SATURATION ONLY,40.1
,
SPEC STAIN-MICROGRAN,265.02
,
GASTRIC ANALYSIS,68.38
,
GASTRIN,184.03
,
"GLUCOSE, BODY FLUID",39.21
,
"GLUCOSE, BLOOD",39.21
,
GLUCOSE CHALLENGE0,49.63
,
GLUCOSE TOLERANCE 3 SPEC,106.77
,
GTT - EACH ADD HOUR,40.94
,
LACTOSE TOLERANCE,106.77
,
G 6-P D SCREEN,72.98
,
SPEC STAIN-TISSUES,109.78
,
GGTP,75.15
FRUCTOSAMINE,149.4
,
FSH,194.04
,
LUTEINIZING HORMONE,193.32
,
HUMAN GROWTH HORMONE,174.01
,
RBC FOLATE,180.79
,
HAPTOGLOBIN,131.34
,
HEAVY MTL SCN-UR,196.58
,
HEMOGLOBIN ELECTRO,54.39
,
FETAL HEMOGLOBIN,86.27
,
HGB A1C (GLYC HGB),50
,
METHEMOGLOBIN,30.64
,
"PLASMA, FREE HEMOGLOBIN",76.29
,
"HEMOSIDERIN, QUANT",34.37
,
HISTAMINE,308.22
,
CELLBLOCK,290.67
,
HVA-UR,202.01
,
17-HYDROXYCORTICOSTERIODS,180.18
,
5-HIAA URINE,72.98
,
17 OH PROGESTERONE,283.49
,
"TISSUE TRANSGLUT, IGG",120.42
,
MITOCHONDRIAL ANTIBODY,120.42
,
PARIETAL CELL ABY,120.42
,
DEXAMETHASONE LEVEL,141.07
,
MELATONIN,141.07
,
ANCA -POSITIVE TITER,120.42
,
ANTICHROMATIN ABY,48
,
ANTI-HISTONE,48
,
GIARDIA ANTIGEN,125.24
,
FETAL LUNG MATURITY,197.47
,
TROPONIN QUANT.,102.74
,
ANTI-GLIADIN ANTIBODIES,120.42
,
BNP,175
,
ANIT-MULLERIAN HORMONE,135.01
,
TRYPTASE,135.01
,
INSULIN-SERUM,119.4
IRON,67.59
,
TIBC,78.67
,
"TISSUE TRANSGLUT, IGA",120.42
,
17-KETOSTERIODS,133.65
,
LACTIC ACID,111.47
,
LDH,63.04
,
LDH ISOENZYMES,133.6
,
FECAL LACTOFERRIN,204.84
,
LEAD,90
,
L/S RATIO,229.4
,
LIBRIUM0URN,193.03
,
LIPASE,71.84
,
LIPOPROTEIN BLD BY NMR,329.19
,
NMR LIPO PROFILE,259.14
,
HDL CHOLESTROL,85.49
,
"LDL, DIRECT",79.8
,
LITHIUM,69.03
,
URINE MAGNESIUM,69.93
,
MAGNESIUM,69.93
,
THIOPURINE METHYL TRANSFE,188.47
,
COBALT SERUM,188.48
,
IODINE LEVEL,188.47
,
MEPROBAMATE,183.97
,
ASSAY OF MERCURY,90
,
METANEPHRINES-URINE,176.85
,
"METANEPHRINE, PLASMA",176.85
,
MYELIN BASIC PROTEIN,179.59
,
MYOGLOBIN - S/U,134.79
,
ASSAY MYELOPEROXIDASE,354.38
,
NORTRIPTYLINE (PAMELOL),141.41
,
NAPA,174.9
,
NAVANE-THIOTHIXENE,142.91
,
FIBROSPECT,60
,
SERUM LIGHT CHAINS,60
,
NICOTINE/COTININE,247.33
5 NUCLEOTIDASE,116.5
,
OLIGOCLONAL BANDS-CSF,75
,
"ORGANIC ACIDS, URINE",171.81
,
METHYLMALONIC ACID,171.86
,
OSMOLALITY,71.15
,
OSMOLALITY-URINE,71.11
,
OXALATE - URINE,134.38
,
PARATHYROID HORMONE,430.8
,
ASSAY PH BODY FLUID NOS,37.34
,
"CALPROTECTIN, STOOL",204.83
,
FLUPHENAZINE (PROLIXIN),162.59
,
MESORIDAZINE,162.59
,
DILANTIN-PHENYTOIN,138.35
,
ACID PHOS - TOTAL,77.1
,
PROSTATIC ACID PHOS,100.84
,
ALKALINE PHOSPHATASE,54.02
,
ALK PHOS ISOENZYME,154.35
,
PHOSPHATIDYLGLYCEROL,172.5
,
PHOSPHOROUS,49.56
,
"PHOSPHORUS, URINE",54.02
,
"PORPHOBILINOGEN, URINE; Q",88.03
,
PORPHYRIN- QUANT FRACTION,153.52
,
PORPHYRIN SCREEN,89.88
,
POTASSIUM,47.97
,
POTASSIUM - URINE,44.91
,
PREGNENOLONE,143.5
,
MYSOLINE (PRIMIDONE),173.16
,
PROCAINAMIDE,174.9
,
PROGESTERONE,95
,
PROCALCITONIN,279.47
,
PROLACTIN,202.3
,
FREE PSA,192
,
"TOTAL PROTEIN,SERUM OR BO",38.27
,
"TOTAL PROTEIN, URINE",38.27
,
TOT PROTEIN-NON URINE/SER,38.27
"PROTEIN ELP, SERUM",112.16
,
"PROTEIN ELP, URINE",186.21
,
PRE-ALBUMIN,152.27
,
CSF PROTIEN,38.27
,
THYROID RELEASE HORM,202.3
,
PROTOPORPHYRIN RBC,149.77
,
VITAMIN B-6,293.17
,
QUINIDINE,152.35
,
TRYPSIN-SR/PL,141.07
,
ESTROGEN RECEPTOR,295.17
,
PROGESTERONE RECEPTOR,295.17
,
ACETYLCHOLINE RECP BINDIN,381.67
,
ACETYLCOCHOLINE RECP BLOC,381.67
,
RENIN DIRECT,229.59
,
SELENIUM,113.56
,
SEROTONIN,323.3
,
SICKLE CELL TEST,57.59
,
SEX HORMONE BINDING GLOBU,226.89
,
SODIUM,50.22
,
SODIUM-URINE,30.07
,
IGF-1,221.83
,
SP GR NOT URINE,26.14
,
URINE SULFATE,49.61
,
FREE TESTOSTERONE,265.73
,
TESTOSTERONE LAB,150
,
THEOPHYLLINE,147.71
,
THIAMINE (VIT B),221.63
,
THYROGLOBULIN,167.64
,
T-4,71.78
,
NEONATAL T4,67.53
,
FREE T4,78.67
,
DIRECT DIALYSIS FT4,78.67
,
THYROXIN BIND. GLOBULI,154.35
,
TSH,75
,
THYROID STIMULATING IMMUN,400
VITAMIN E,148
,
SGOT/AST,53.91
,
SGPT/ALT,55.3
,
TRANSFERRIN,133.26
,
TRIGLYCERIDE,60.08
,
T3 UPTAKE,67.53
,
T-3 RIA,133.06
,
FREE T3,176.85
,
REVERSE T3,164.5
,
BLOOD UREA NITROGEN,41.16
,
URINE BUN,49.62
,
URIC ACID,47.14
,
URIC ACID URINE,49.63
,
VMA-URINE,161.81
,
VIP,62.23
,
VASOPRESSIN (ADH),354.31
,
VISCOSITY,108.95
,
VITAMIN A,121.03
,
VITAMIN K,143.12
,
D-XYLOSE TOLERANCE,123.63
,
"ZINC, SERUM",118.85
,
C-PEPTIDE INSULIN,217.13
,
"B HCG, QUANT",157.1
,
"PREGNANCY,URINE, QUAL",78.36
,
"PREGNANCY, SERUM, QUAL",78.36
,
"HCG, FREE BETACHAIN TEST",157.22
,
TOBRAMYCIN,168.24
,
FECAL REDUCING SUBSTANCE,57.48
,
BLEEDING TIME - IVY/DUKES,47
,
WBC WITH AUTO DIFF,67.53
,
DIFFERENTIAL-MANUAL,35.94
,
HEMATOCRIT,22.26
,
HEMOGLOBIN,22.26
,
CBC W/O DIFF (HEMOGRAM),67.53
,
CBC W/ DIFF,81.14
RED BLOOD CELL COUNT,31.38
,
RETICULOCYTE COUNT,44.91
,
WBC WITH ANC,26.51
,
WHITE BLOOD CELL CNT,26.51
,
SMEAR TO PATHOLOGIST,80.62
,
CLOT RETRACTION,34.9
,
FACTOR V ACTIVITY,141.89
,
FACTOR VIII,141.89
,
FACTOR VIII RELATED AG,239.5
,
VON WILLEBRAND FACTOR,239.5
,
FACTOR 8 VWF MULTIMRC,239.5
,
FACTOR IX ACTIVITY,141.91
,
FACTOR X,142.73
,
FACTOR XII ASSAY,89.38
,
ANTITHROMBIN III,61.13
,
PROTEIN C DEF. PANEL,135.87
,
"PROTEIN C, FUNCTIONAL",135.87
,
"PROTEIN S, FUNCTIONAL",121.03
,
PROTEIN S FREE,159.95
,
APC RESISTANCE PROFILE,159.98
,
FACTOR INHIBITOR TEST,61.13
,
LEE-WHITE COAG,37.8
,
COAG-OTHER,38.85
,
FIBRIN SPLIT PRODUCT,71.84
,
"D-DIMER, QUALITATIVE",74.49
,
"D-DIMER, QUANTITATIVE",84.59
,
ALPHA II ANTIPLASMIN,80.45
,
PLASMINOGEN ACTIVITY,68.05
,
RBC FRAGILITY,92.62
,
LEUKOCYTE ALK PHOS,89.78
,
OSMOTIC FRAGILITY RBC INCUBATED,25
,
PLATELET COUNT -AUTO,46.73
,
PLATELET EST/SMEAR REVIEW,35.94
,
PROTHROMBIN TIME,36.56
,
PT SUBSTITUITON PLASMA,36.56
LUPUS ANTICOAGULANT REFLE,70.93
,
DILUTE RVVT,70.93
,
RUSSEL VIPER VENOM TEST,70.93
,
SEDIMENTATION RATE,37.05
,
PTT,54.39
,
CIRCULATING ANTICOAGULANS,67.54
,
FEBRILE AGGLUTININS,72.83
,
"RAST, INDIVIDUAL ALLERGEN",25
,
NICKEL ALLEGRY TEST,25
,
COLD AGGLUTININS,84.16
,
ANTIBODY IDENTIFICATION PLATELET ANTIBOD,191.68
,
,
IMMUNOGLOBIN ASSAY,85
,
ASO SCREEN,60.28
,
C-REACTIVE PROTEIN,54.02
,
HIGH SENSITIVITY CRP,135.16
,
BETA 2 GLYCOPROTEIN I AB,265.52
,
CEA,198.05
,
"C1 ESTERASE INHABITOR,SER",125.36
,
"COMPLEMENT, TOTAL",212.09
,
C3-COMPLEMENT,125.36
,
C4-COMPLEMENT,125.36
,
HERPES SIMPLEX TYPE I,137.71
,
INFLUENZA A OR B,125.24
,
CMV TITER/CF,175.86
,
CYCLIC CITRULLINATED PEPT,135.16
,
ASO ANTIDNASE B,133.04
,
ANTI-DNA,143.45
,
ANTI DS DNA,143.45
,
ANTI SS DNA,125.84
,
SJOGREN'S ANITBODIES SSA/,48
,
ANTIEXTRATABLE NUCLR ANTI,48
,
ENA PROFILE,48
,
RNP ABY,48
,
SCLERODERMA ABY,48
SMITH ABY,48
,
ANTI-JO-1,48
,
PM/SCL AB,48
,
ALPHA FETO PROTEIN,175.12
,
LYME SEROLOGY,177.79
,
ANCA,125.82
,
MUMPS IGG TITER,137.67
,
ANA,126.19
,
ANTIMITOCHONDRIAL ANITBOD,125.82
,
ANTISMOOTH MUSCLE,125.82
,
ANTI-ENDOMYSIAL ANTIBODY,125.82
,
ANCA - NEGATIVE,125.82
,
ANTI-RETIC,125.82
,
CUTANEOUS IMMUNOFLOR IgG,125.82
,
ANTI CENTROMERE ABY,125.82
,
RUBEOLA SCRN,134.49
,
ROTAVIRUS SCREEN AG,125.24
,
RUBELLA SCREEN,150.23
,
HEP. B SURF AG,100.99
,
HEP B CORE AB,125.82
,
HEPATITIS B CORE IGM,69.93
,
HEPATITIS B SURF AB,112.16
,
HEP. C AB (HCV),148.95
,
HEP BE AG,120.28
,
HEP BE AB,120.73
,
HEP. A ANTIBODY,129.34
,
HEP A AB (IGM),117.53
,
MONONUCLEOSIS TEST,54.02
,
HETEROPHILE TITER (EBV),67.53
,
HIV AB,69.93
,
HIV SCREEN,69.93
,
CHROMOGRANIN A,217.26
,
CA15-3,217.13
,
CA 125,217.13
,
RSV AG,125.24
THYROTROPIN RECEPTOR,40
,
HEPATITIS DELTA ANTIBODY,179.15
,
IMMUNO ELP - SERUM,233.39
,
IMMUNO ELP - URINE,233.39
,
IGG,50
,
HYPERSENS PNEUMO PANEL,125.12
,
HYPE PHEUMO PANEL-ACTINOM,66.59
,
HYPE PNEUMO PANEL-ASPERGI,157.1
,
HYPE PNEUMO PANEL-PROTOZO,61.13
,
IMMUNOFIXATON URINE,306.25
,
INHIBIN A,135.18
,
INSULIN ANTIBODIES,223.5
,
INTRINSIC FACTOR ANTIBODY,153.24
,
ISLET CELL ANITBODY,119.5
,
CLL/LYMPHOMA-1,191.38
,
CLL/LYMPHOMA-2,191.38
,
CA27-29,217.13
,
PSA PROST. SPEC. ANTG,192
,
CA 19-9,217.13
,
SCREENING PSA,192.04
,
SCREENING HEMOCULT,33.95
,
LIVER/KIDNEY MICROSOME T,151.85
,
THYROID PEROXIDASE ABY,151.85
,
"MICROSOMAL ANTIBODY, THYR",151.85
,
LIVER-KIDNEY MICROSOM ABY,151.85
,
PARVO-19 TITER,156.86
,
SPECIMEN COLLECTION,19.99
,
RAST-PERENNIAL PER ALLERG,25
,
RAST-AREA 7 PER ALLERGEN,25
,
RA LATEX (RF),59.25
,
FINE NEEDLE ASPR.,491.2
,
TB TEST CELL IMMUN MEASURE,95
,
RPR (STS),44.52
,
THYROID AUTOANTIBODY,165.99
,
ARTERIAL PUNCTURE,119.11
ASPERGILLUS PRECIPITANS,157.1
,
ROCKY MT SPOTTED FEVER,71.3
,
CAT SCRATCH DISEASE Ab,66.59
,
BLASTOMYCES ANTIBODY,134.69
,
LYME WE IgG,161.65
,
LYME WB IgM,161.65
,
AB; CANDIDA,124.36
,
CHLAMYDIA ANTIBODIES,132.52
,
COCCIDIODES ANITBODY,119.75
,
Q FEVER ABY,36.91
,
CRYPTOCOCCUS ANTIGEN,106.4
,
CMV-IgG,150.23
,
CMV-IgM,175.86
,
ENTEROVIRUS AB,135.95
,
COXACKIE VIRUS Ab,135.95
,
"EBV, EARLY ANITGEN",136.95
,
"EBV, NUCLEAR ANTIGEN",159.74
,
EBV ACUTE PROFILE,80
,
FUNGUS ANTIBODY,84.8
,
"GIARDIA Ab, TOTAL SERUM",153.58
,
"GIARDIA Ab, IgG, SERUM",153.58
,
"GIARDIA Ab, IgM, SERUM",153.58
,
"HELICOBACTER PYLORI,IGG",151.5
,
ACETYLCHOLINE RECEPT,381.67
,
HERPES SIMPLEX TYPE II,71.26
,
HISTOPLASMA ANITBODY,130.41
,
INFLUENZA IGG OR IGM SERU,141.5
,
LEGIONELLA,159.49
,
LEPTOSPIRA ABY,137.67
,
MUMPS IGM,137.67
,
HUMAN PARVOVIRUS B19,156.86
,
ROTAVIRUS ANTIBODY,137.67
,
TOXOPLASMA ANTIBODY,150.23
,
TREPONEMA PALLIDUM ABY,138.33
,
TRICHINELLA ANTIBODY,66.58
VARICELLA ZOSTER AB.,134.49
,
ANTIBODY WEST NILE VIRUS IGM,35
,
ANTIBODY WEST NILE VIRUS,30
,
"HEPATITIS E VIRUS, IGM",134.49
,
ANTIBODY VIRUS NES,134.49
,
THYROGLOBULIN ABY,165.99
,
HEP C RIBA,161.7
,
HLA-B27,200
,
ANTIGEN SCREEN,92.7
,
BLOOD CULTURE,107.72
,
BLOOD CULTURE #2,107.72
,
STOOL CULTURE,98.49
,
YERSINIA CULTURE,98.49
,
MRSA SCREENING CULURE,89.88
,
CULTURE OTHER SOURCE,89.88
,
SPUTUM CULTURE,89.88
,
CLO TEST,75.75
,
ANAEROBIC CULTURE,61.13
,
URINE CULTURE W/CC,84.28
,
"FUNGUS CULTURE, SKIN",80.45
,
"FUNGUS CULTURE,OTHER SOUR",61.13
,
"FUNGUS CULTURE, BLOOD",94.17
,
FUNGUS DEFINITIVE I.D.,107.72
,
MYCOPLASMA0UREA PLASMA,51.5
,
AFB CULTURE,69.68
,
"CULTURE, ADD'L ID",75.75
,
PARASITE EXAM STOOL/SPUTU,92.88
,
"CHLAMYDIA SCREEN, DNA",143.88
,
"GC, GENPROBE, DNA",143.88
,
NITROCEQIN TEST,49.6
,
GRAM POSITIVE SENS,90.26
,
GRAM NEGATIVE SENS,90.26
,
BONE MARROW-SMEAR INTERPR,71.05
,
MICROSPORIDIA,36.91
,
GRAM STAIN,44.54
MICRO EXAM ANY SOURCE,44.52
,
AFB SMEAR,24.54
,
"BORDETELLA PERTUSSIS, IgG",137.68
,
PINWORM EXAM,44.52
,
HANGING DROP-TRICH,44.52
,
INDIA INK PREP.,44.52
,
KOH PREP,44.52
,
"CLOSTRIDUM TOXINS, EIA(C-",125.24
,
HERPES CULTURE,272.09
,
CHLAMYDIA CULTURE,204.43
,
"VIRAL CULTURE, GENERAL",272.09
,
"RETICULIN ANTIBODIES (A,G,M)",125.82
,
BORDETELLA PERTUSSIS SMEA,125.24
,
SMEAR PRIM SRC GRAM/ GIEMSA STAIN,50
,
CYTOMEGALOVIRUS ANTIBODY,124.21
,
HELICOBACTER PYLORI-STOOL,125.24
,
URINE HISTOPLASMOSIS AG,125.22
,
SHIGA-TOXIN,125.22
,
"RAPID STREP SCREEN, EIA",125.24
,
LEGIONELLA ANTIGEN,125.24
,
IADNA BORRELIA BURG AMP PROBE,140
,
CNS DNA/RNA AMP PROBE MUL 12-25,550
,
IADNA CHLAMYDIA PNEU AMPLIFIED PROBE,150
,
C DIFF AMPLIFIED PROBE,60
,
CYTOMEGALOVIRUS NA QUAN,447.11
,
ENDOMYSIAL IGA ANTIBODY,120.42
,
HEPATITIS B VIRUS PCR,447.05
,
HEPATITIS C-GENOTYPE,"2,686.80"
,
HEP C RNA QUANT,447.2
,
HERPES S AMPLIF NA PROBE,366.43
,
HIV 1 RNA PCR,475
,
VIRAL LOAD HIV-1,475
,
MYCOPLASMA PNEUMONIA,158
,
ANIT-CARDIOLIPIN ANITBODY,265.52
,
IADNA RESPIRATORY PROBE 12-25 TARGET,525
BORDETELLA BY PCR,158
,
BK VIRUS QUALITATIVE,158
,
WHIPPLES ANTIBODY-PCR,158
,
NORWALK VIRUS,158
,
BK VIRUS QUANTITATIVE,447.05
,
CAMPYLOBACTER ANTIGEN,120.36
,
DRUG TEST PRSMV CHEM ANALYZER,95
,
DRUG SCREENS GSL CLASS,758.72
,
AUTOPSY/GROSS-MICRO,"1,279.23"
,
"CYTOPATHOLOGY,FLUIDS,SMEA",210.5
,
"CYTOPATHOLOGY,FLUIDS,CONC",218.47
,
NON GYN THIN PREP,405.39
,
HOMOCYSTINE CPT,176.09
,
HYPERSENSITIVE CRP,135.16
,
PAP SMEAR,54.39
,
NEUT-CYTOPLASM ANTBD,125.82
,
CLL/LYMPHOMA 3,249.13
,
CCL/LYMPHOMA 3/1,100
,
"FLOW CYTOMETRY TC, 1ST MA",150
,
FLOW CYTOMETRY EA ADDTL M,100
,
CRYPTOSPORIDIUM-STOOL,125.24
,
"TISSUE CULTURE, LYMPHOCYT",525
,
THIEPURINE METABOLITES,188.47
,
COENZYME Q10A TOTAL,188.47
,
MYCOPLASMA,138.3
,
CHROMOSOME ANALYSIS,750
,
"CYTOGENETICS, 100-300",419.24
,
FISH,716.32
,
CYTOGNETICS INTREP & RPT,45.25
,
E COLI 0157,125.24
,
IMHISTOCHEM/SYTCMH EA ADD ANTIBODY,140
,
IMMUNOCYTOCHEMISTRY,295.17
,
HER-2-NEW,411.62
,
GLIADIN IGG,120.42
,
IGFBP-3,135.01
IMMUNOASSAY ANALYTAL NOS,135.01
,
GLIADIN IGA,120.42
,
M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY,190
,
,
BIOAVAILABLE TESTOSTERONE,265.73
,
PARATHYROID HORMONE-RELAT,141.07
,
GAD-65-ANTIBODY,141.07
,
ANITBODY ID PLATELET IMMUN,47
,
ANTI-GLOMERULAR BM ABY,125.82
,
FLUORESCENT ANTIBODY,125.82
,
STRIATED MUSCLE AB,125.82
,
CYCLOSPORA,24.54
,
WET MOUNT,44.52
,
DETECT AGEN NOS DNA,158
,
CD4 (HELPER SUPPRESSOR PANEL),150
,
"CYTOGENETIC, DNA PROBE",223.62
,
IMMUNOFLUORESCENT STUDY-I,276.63
,
SPECIMEN HANDLING,22.95
,
DOT CUSTODY HANDLING,42.8
,
BREATH ALCOHOL TESTING,42.8
,
CELL COUNT NON-BLOOD,49.34
,
CELL COUNT-CSF/FLUID,57.54
,
WBC STOOL,44.52
,
CRYSTAL ID - JOINT FLD,74.62
,
EOSINOPHIL-NASAL SM,34.9
,
THERAPEUTIC PHLEBOTOMY,50.15
,
"PREPARE & CONSULT, TISSUE",125.91
,
SPERM COUNT,89.88
,
SPERM ANALYSIS,125.82
,
PACKED RED CELLS,407.65
,
PLATELET CONCENTRATE,183.2
,
FRESH FROZEN PLASMA,133.87
,
WASHED RED CELLS,561.81
,
AUTOLOGOUS BLOOD,186.97
,
PLATELETS PHERESIS,"1,095.23"
IRRADIATION OF CELLS,103.65
,
PLATELET CROSSMATCH,463.1
,
RBC ANITOBDY INDENT,103.65
,
DIRECT COOMBS TEST,52.79
,
ANITBODY SCREEN,59.81
,
"CROSSMATCH, COMBS",107.67
,
ABO BLOOD TYPING,59.81
,
DU TYPING,33.97
,
RH BLOOD TYPING,35.79
,
BLOOD TYPIE ANTIGEN DONOR,27.08
,
BLOOD ADMIN FEE 0-2 HOURS,155.85
,
BLOOD ADMIN FEE 2-4 HOURS,207.77
,
BLOOD ADMIN FEE 4-6 HOURS,311.63
,
BLOOD ADMIN FEE 6 HR & UP,415.49
,
ANTIBODY SCREEN RBC,50
,
ANTIBODY ID RBC,87.5
,
ANTIHUMAN GLOBULIN DIRECT EACH,37.5
,
BLOOD TYPING SEROLOGIC,37.5
,
BLOOD TYPE ANTIGEN,87.5
,
BLOOD TYPING ANTIGEN SCREEN,20
,
"CROSSMATCH,IMMEDIATE SPIN",56.1
,
"CORSSMATCH, 37 DEGREES",56.1
,
COMPATIBILITY EACH UNIT,81.25
,
"FRESH FROZEN PLASMA, THAW",33.67
,
POOLING OF PLATELETS,58.07
,
CARDIOVERSION,794.41
,
CARDIAC STRESS TEST,587.97
,
MEDICATION TREADMILL,587.97
,
IPPE EKG,260.26
,
EKG,146.98
,
SUBSEQUENT EKG,146.98
,
SCREENING EKG,146.98
,
RHYTHM STRIP,98.02
,
HOLTER MONITOR RECORDING,294.29
,
HOLTER MONITOR SCANNING,786.09
EEG-AWAKE & DROWSEY,607.77
,
EEG-AWAKE & ASLEEP,607.77
,
SLEEP STUDY- UNATTENDED,360
,
POLYSOMNOGRAPHY,"2,244.85"
,
POLYSOMNOGRAPHY W/CPAP,"2,342.53"
,
EYE FOR FOREIGN BODY,64.52
,
PF MANDIBLE PARTIAL,70.2
,
"MANDIBLE, COMPLETE",94.79
,
SOLITARY PULMONARY NODULE,739
,
"MASTOIDS, COMPLETE",129.09
,
"FACIAL BONES, LTD",75.48
,
"FACIAL BONES, COMPLETE",99.56
,
"NASAL BONES, COMPLETE",64.52
,
XRAY EXAM OF EYE SOCKETS,107.45
,
"SINUSES, LIMITED",67.56
,
"SINUSES, COMPLETE",94.29
,
"SKULL, LIMITED",94.14
,
"SKULL, COMPLETE",128.85
,
TEMP.MANDIB.JTS. COMPLETE,94.14
,
"NECK, SOFT TISSUES",64.52
,
ULTRASOUND EXAM AAA SCREE,222.91
,
CT-BRAIN W/O CONTRAST,323.81
,
"CT BRAIN, W/CONTRAST",432.25
,
"HEAD, W&W/O CONTRAST",485.75
,
"CT ORBIT,SELLA, POST.FOSS",488.57
,
"CT ORBIT, SELLA,POST.FOSS",551.93
,
CT SINUS W/O CONTRAST,436.54
,
CT MAX FACIAL W/O CONTRST,436.54
,
CT MAX FACIAL (SINUS) W,499.21
,
CT MAX FACIAL(SINUS)BOTH,540.86
,
CT NECK TISSUES W/O,489.5
,
CT NECK TISSUE WITH,531.84
,
CT NECK TISSUE BOTH,551.93
,
CT ANGIOGRAPHY HEAD,670.31
,
CT ANGIOGRAPHY NECK,669.95
"MRI-FACE, NECK OR ORBTSWO",513.46
,
"MRI-FACE, NECK OR ORBTS W",621.09
,
"MRI-FACE,NECK,ORBTS W/WO",821.02
,
MRI-ANGIOGRAPHY HEAD W/O,457.14
,
MRA HEAD W/CONTRAST,457.14
,
MRA NECK W/O CONTRAST,457.14
,
MRA-NECK WITH CONTRAST,457.14
,
MRA-NECK W & W/O CONTRAST,689.5
,
MRI-BRAIN,566.39
,
MRI-BRAIN W,685.12
,
MRI-BRAIN W/WO W/ADD SEQU,905.54
,
"RIBS, UNILATERAL(2VIEWS)L",83.75
,
"RIBS, UNILATER(2VIEWS)RT",83.75
,
"CHEST, SINGLE VIEW",67.39
,
"SUBSEQUENT CHEST, SINGLE",69.8
,
"CHEST, TWO VIEWS",83.75
,
"CHEST, 2 VIEWS +LORDO",102.2
,
CHEST SPECIAL VIEWS,69.86
,
"WRIST, PARTIAL LFT",67.26
,
"WRIST, PARTIAL RIGHT",67.26
,
"RIBS, UNI(3 VIEWS)PA LFT",102.2
,
RIBS UNI (3VIEWS)PA RT,102.2
,
"RIBS, BILATERAL, 3 VIEWS",102.2
,
"RIBS, BIL (4VIEWS)INCL PA",119.69
,
STERNUM,73.24
,
STERNOCLAVICULAR JTS,83.75
,
CT CHEST W/O,390.98
,
"CT CHEST, W",477.2
,
CT CHEST BOTH,529.35
,
"CT ANGIOGRAPHY, CHEST",737.24
,
MRI CHEST W/O DYE,554.78
,
MRI-CHEST W/WO CONTRAST,867.18
,
MRA CHEST W OR W/O,697.31
,
VENOUS DUPLEX UNI LEFT,171.57
,
VENOUS DUPLEX UNI RIGHT,171.57
DOP ART.WAVE UPER&LWR,93.53
,
"SPINE, SINGLE VIEW",58.87
,
C SPINE (AP/LAT),88.55
,
C SPINE (4 VIEWS),120.54
,
C SPINE COMPLETE W/EXT &,139.14
,
"THORACIC SPINE,LTD 2 VIEW",86.16
,
"THORACIC SPINE,W/SWIMMER",83.75
,
SPINE-COLOSIS STUDY,113.6
,
"LUMBAR SPINE, LTD",88.55
,
"LUMBAR SPINE, COMP INCLUD",120.54
,
LS SPINE COMP W BENDING,128.82
,
CT SPINE CERV W/O,411.55
,
CERV SPINE W CONTR,461.88
,
CT SPINE THOR W/O,380.52
,
CT SPINE THOR WITH,469.08
,
CT SPINE LUMBAR W/O,380.52
,
CT SPINE LUMBAR WITH,469.08
,
MRI-CERVICAL SPINE,615.45
,
MRI-CERVICAL SPINE W,733.61
,
MRI-DORAL SPINE,615.45
,
MRI-DORSAL SPINE WITH,739.75
,
MRI-LUMBAR SPINE,567.61
,
MRI-LUMBAR W,687.61
,
MRI-CERIVAL SPINE W/WO,987.48
,
MRI-THORACIC SPINE W/WO,987.48
,
MRI-LUMBAR SPINE W/WO,912.24
,
"PELVIS, AP",69.96
,
CT PELVIS W/O CONT,415.39
,
CT PELVIS W/CONT,443.24
,
CT PELVIS BOTH,465.26
,
MRI-PELVIS W/O CONTRAST,559.63
,
MRI-PELVIS W,667.18
,
MRI -PELVIS W & W/O DYE,864.7
,
MRI PELVIS WITHOUT,689.5
,
"PF SACROILIAC JTS, PART",64.52
SACRUM/COCCYX,64.52
,
MRI UPPER JT W/ BOTH,"1,247.18"
,
UPPER JT W/ LEFT,623.58
,
MRI UPPER JT W/ RIGHT,623.58
,
MRI UPPER JOINT LT W & WO,826.08
,
MRI UPPER JOINT RT W &W/O,826.08
,
EPIDUROGRAM+,223.68
,
PF CLAVICLE BILATERAL,123.36
,
"CLAVICLE, LEFT",61.68
,
"CLAVICLE, RIGHT",61.68
,
"SCAPULA, BILATERAL",71.03
,
"SCAPULA, LEFT",69.96
,
"SCAPULA, RIGHT",69.96
,
"SHOULDER, PARTIAL LEFT",56.41
,
"SHOULDER, PARTIAL RIGHT",56.41
,
"SHOULDER, COMPLETE BILATR",73.71
,
"SHOULDER, COMPLETE LEFT",75.15
,
"SHOULDER, COMPLETE RIGHT",75.15
,
SHOULDER ARTHROGRAM,209.42
,
SHOULDER ARTHROGRAM RT,209.42
,
XRAY EXAM OF SHOULDERS,83.12
,
"HUMERUS, LEFT",67.56
,
"HUMERUS, RIGHT",67.56
,
"ELBOW, PARTIAL LEFT",59.59
,
"ELBOW, PARTIAL RIGHT",59.59
,
"ELBOW, COMPLETE BILATERAL",133.11
,
"ELBOW, COMPLETE LEFT",64.52
,
"ELBOW, COMPLETE RIGHT",64.52
,
FOREARM LEFT,62.32
,
FOREARM RIGHT,62.32
,
"WRIST, COMPLETE BILATERAL",135.15
,
"WRIST, COMPLETE LEFT",67.56
,
"WRIST, COMPLETE RIGHT",67.56
,
"HAND, PARTIAL LEFT",62.32
,
"HAND, PARTIAL RIGHT",62.32
"HAND, COMPLETE BILATERAL",130.04
,
"HAND, COMPLETE LEFT",64.52
,
"HAND, COMPLETE RIGHT",64.52
,
FINGER-LEFT THUMB,50.63
,
FINGER-LEFT 2,50.63
,
FINGER-LEFT 3,50.63
,
FINGER-LEFT 4,50.63
,
FINGER-LEFT 5,50.63
,
FINGER-RIGHT THUMB,50.63
,
FINGER-RIGHT 2,50.63
,
FINGER-RIGHT 3,50.63
,
FINGER-RIGHT 4,50.63
,
FINGER-RIGHT 5,50.63
,
CT UPPER EXT LT W/O,388.33
,
"CT UPPER EXTREM, W/O RTVA",388.33
,
MRI UPPER EXTREM W/O,516.07
,
MRI UPPER EXTREM WITH,623.58
,
CT UP EXT BILATERAL W/WO,894.16
,
MRI-UPPER JOINTS LEFT,522.2
,
MRI-UPPER JOINTS RIGHT,522.2
,
MRI- UPPER EXT T- W/ WO CONT BOTH,"1,652.16"
,
MRI-UPPER EXT LT-W/WO CONTR,826.08
,
MRI- UPPER EXT T W/ WO CONT,826.08
,
CT UPPER EXTREM. W RT,443.24
,
"CARDIAC M-MODE, DOPPLER C",512.91
,
M-MODE & REAL TIME,358.54
,
CARDIAC DOPPLER,149.73
,
DOPPLER COLOR FLOW,28.58
,
STRESS ECHO,576.93
,
"HIP, SINGLE VIEW LEFT",69.96
,
"HIP, SINGLE VIEW RIGHT",69.96
,
"HIP, COMPLETE, BILAERAL",103.37
,
"HIP, COMPLETE LEFT",85.83
,
"HIP, COMPLETE RIGHT",85.83
,
AP PELVIS + BOTH HIPS,101.96
KNEE (MIN 3 VIEW) BILATER,150.3
,
KNEE (MIN. 3 VIEWS) LEFT,75.15
,
KNEE (MIN. 3 VIEWS) RIGHT,75.15
,
"HIP, O.R.I.F",112.58
,
KNEE (4 OR MORE VIEW) LFT,88.55
,
KNEE (4 OR MORE VIEW)RT,88.55
,
"PF FEMUR, BILATERAL",134.81
,
"FEMUR, LEFT",67.41
,
"FEMUR, RIGHT",67.41
,
AP STANDING KNEES,72.44
,
KNEE 1 OR 2 VWS BILATERAL,139.91
,
KNEE 1 OR 2 VIEWS LEFT,69.96
,
KNEE 1 OR 2 VIEWS RIGHT,69.96
,
"ANKLE, PARTIAL LEFT",62.32
,
"ANKLE, PARTIAL RIGHT",62.32
,
"ANKLE, COMPLETER BILATERA",36.16
,
"ANKLE, COMPLETE LEFT",64.52
,
"ANKLE, COMPLETE RIGHT",64.52
,
"FOOT, PARTIAL BILATERAL",118.51
,
"FOOT, PARTIAL LEFT",59.25
,
"FOOT, PARTIAL RIGHT",59.25
,
"FOOT, COMPLETE BILATERAL",129.05
,
"FOOT, COMPLETE LEFT",64.52
,
"FOOT, COMPLETE RIGHT",64.52
,
"XRAY OF HEEL, LEFT",62.32
,
"XRAY OF HEEL, RT",62.32
,
TOE-LEFT 1,48.18
,
TOE-LEFT 2,48.18
,
TOE-LEFT 3,48.18
,
TOE-LEFT 5,48.18
,
TOE- RIGHT 1,48.18
,
TOE-RIGHT 2,48.18
,
TOE-RIGHT 3,48.18
,
TOE RT 4TH,48.18
,
TOE- RIGHT 5,48.18
"CT LOWER EXTREM, W/O LT",380.63
,
CT LOWER EXT. W/O RT,380.63
,
MRI-LOWER JOINTS LT-WO CO,519.67
,
MRI-LOWER JOINTS RT-WO CO,519.67
,
MRI-LOWER JNT OR ET W/CON,627.39
,
MRA-LWR EXTREM W/WO CONTR,697.65
,
MRI-LOWER EXT LT WO CONST,513.46
,
MRI-LOWER EXT RT WO CONTR,513.46
,
MRI-LOWER EXT BILAT W CON,"1,263.79"
,
MRI-LOWER EXT LT W CONTRA,631.88
,
MRI-LOWER EXT RT WI CONTR,631.88
,
EXTRACRANIAL DUPLEX,230.41
,
TIBIA/FIBULA BILATERAL,129.04
,
TIBIA/FIBULA LEFT,64.52
,
TIBIA/FIBULA RIGHT,64.52
,
ANKLE/ARM INDEX BILATERAL,94.29
,
LWR. EXT. DUPLEX BILATERA,219.75
,
LTD LWR EXT DUPLEX BILAT,146.71
,
LTD LWR EXT DUPLEX LEFT,149.66
,
LTD LWR EXT DUPLEX RIGHT,149.66
,
UPPER EXT DUPL BILATERAL,175.69
,
LTD UPR EXT DUPLEX LEFT,116.82
,
LTD UPR EXT DUPLEX RIGHT_,116.82
,
VENOUS DUPLEX-BIL STUDY,261.12
,
VASC DUPLEX SCAN OF AB VE,694.65
,
VASCULAR STUDY,465.01
,
DUPLEX OF AORTA,250.4
,
"DUPLEX A, IVC, IL/BPG; UN",166.28
,
LTD VENOUS DUPLEX-UNI STU,171.57
,
LTD VENOUS SUPLEX-UNI STU,171.57
,
"ABDOMEN, SINGLE VIEW",67.39
,
ABDOMEN SUPINE & OBLIQUE,86.58
,
ACUTE ABD SERIES (MAY INC,122.12
,
CT UPPER ABDOMEN W/O,454.28
,
CT UPPER ABDMN WITH,488.26
CT UPPER ABDMN BOTH,535.18
,
CTA ABD/PELVIS,617.34
,
CT ABD & PELVIS W/O CONTR,657.47
,
CT ABDOMEN & PELVIS W/CON,687.61
,
CT ABD & PELVIS 1+ SECTIO,761.41
,
MRI-ADDOMEN W/O CONTRAST,557.23
,
MRI-ABDOMEN W & W/O CONTR,864.7
,
MRA-RENAL ARTERY,689.5
,
"FLOUROSCOPU, ESOPHAG",175.69
,
"FLUORO, SWALLOWING/",203.02
,
"FLUORO, UGI WITHOUT KUB",264.7
,
"FLUORO, UGI W/KUB OR DELA",262.26
,
"FLUOROSCOPY, UGI/SB",348.51
,
"FLURO, DBL CONT UGI",264.7
,
DBL CONT. UGI/SB-FLUO,348.51
,
SMALL BOWEL FOLLOW THRU,178.54
,
"FLOUROSCOPY, BARIUM",264.7
,
"FLOURO,AIR CON BARIUM",378.68
,
XRAY OF BILE DUCT/ PANCREAS,139.14
,
CHOLE ADDITIONAL SET,83.29
,
"UROGRAM, ROUTINE EXAM",186.66
,
"UROGRAM, ROUT +TOMO'S",186.66
,
"UROGRAM, RETROGRADE",139.74
,
CYSTOGRAM +,120.87
,
VOIDING CYSTOGRAM,126.13
,
HYSTEROSALPINGPGRAM,145.45
,
CT ANGIO ABDOMINAL ARTERI,924.29
,
VENOGTAM-EXT UNI-RT,270.51
,
FLUOROGUIDE FOR VEIN DEVI,147.12
,
"FLUOROSCOPY,SEP.PROC.<1HR",64.52
,
FLUOROSCOPE EXAM EXTENSIVE,255.8
,
BONE AGE STUDY,72.75
,
BONE LENGTH STUDY,110.89
,
"X-RAYS, BONE SURVEY, LIMI",172.83
,
"BONE SURVEY, COMPLETE",205.86
BONE DENSITY STUDY,86.35
,
MAMMO UNILATERAL SCREEN,267.97
,
MAMMO SCREEN,267.97
,
"BREAST, SPECIMEN",61.68
,
VENOUS DUPLEX UNI LEFT,171.57
,
CT MULTIPLANNAR/3D RECONS,79.32
,
CT LIMITED OR LOCALIIZED,373.4
,
THYROID TISSUE,213.64
,
"BREAST, BILATERAL",205.86
,
"BREAST, UNILATERAL LEFT",205.86
,
"BREAST, UNILATERAL RIGHT",205.86
,
"UPPER ABD, COMPLETE",307.59
,
ORGAN SPECIFIC ABD,224.24
,
RETROPERIT/AORTA,281.46
,
"RETROPERITONEAL, LTD",224.09
,
OB FIRST TRIMESTER,379.63
,
"US- OB. COMPLETE, >/= 14 WKS",378.31
,
US- OB. LIMITED,245.71
,
US-OB. FOLLOWUP,330.26
,
BIOPHYSICAL PROFILE,413.38
,
TRANS-VAGINAL ULTRASOUND,264.06
,
PELVIS COMPLETE,264.06
,
PELVIS LTD. OR F/U,149.66
,
"TESTICLES, ULTRASOUND",245.53
,
TRANSRECTAL,263.56
,
US EXAM OF EXTREMITY-LT,234.26
,
US EXAM OF EXTREMITY-RT,234.26
,
NEEDLE BIOPSY W/S GUIDED+,256.56
,
"PREOP NEEDLE PLMNT, BRST",214.08
,
"PREOP NDL PLMNT, BRST ADD",214.08
,
NEEDLE LOC(LEASON SPEC)LT,214.08
,
NEEDLE LOC(LEASON SPEC)RT,214.08
,
"DXA BONE DENSITY, VERT FX",50.56
,
MRI -LOWER JTS W/WO BILAT,"1,647.18"
,
MRI-LOWER JOINTS LT W/WO,823.58
MRI-LOWER JTS W/WO CONT,823.58
,
MRI-LOWER EXT BIL-W/WO C,"1,647.18"
,
MRI LOWER EXT LT W/WO CON,823.58
,
MRI-LOWER EXT RT W/WO CON,823.58
,
MRI-LOWER EXT BIL W/WO CO,"1,647.18"
,
CT LOWER EXTREM W/ LEFT,444.33
,
CT LOWER EXT W/ CONTRAST,444.33
,
THYR W/UPTAKE (SINGLE)__,186.66
,
THYR W/UPTAKE (MULTI),189.8
,
TECH. THYROID,144.86
,
THYROID IMAGING ONLY,172.83
,
PARATHYROID IMAGING,310.58
,
LIVER IMAGING WITH FLOW,185
,
LIVER/SPLEEN SCAN W/FLOW,213.79
,
HEPATOBILIARY SYS W/O CCK,328.9
,
HEPATOBIL SYS IMAGE W/CCK,276.97
,
GASTRIC MUCOSA IMAGING,264.7
,
GASTRIC EMPTYING OF STOMA,303.95
,
GI BLEED,375.57
,
MECKELS DIVERT EXAM,259.99
,
BONE IMAGING;LIMITED AREA,237.36
,
"BONE IMAGING, MULT AREAS",313.28
,
BONE IMAGING;WHOLE BODY,326.52
,
BONE IMAGING;3 PHASE,386.27
,
PF BONE IMAG SPECT,390.53
,
THALLIUM STRESS REST,495.81
,
SPECT STRESS/REDIST,609.65
,
RESTING MUGA,371.21
,
MYOCARDIAL PERFUSION STUD,609.65
,
MYOCARD PERFS ST W/EJECTI,609.65
,
LUNG VENTILATION IMAGING,179.26
,
PERFUSION LUNG SCAN,280.1
,
LUNG VENTILAT&PERFUS IMAG,396.5
,
PET/CT BRAIN IMAGING-INIT,563.4
,
PET/CT BRAIN IMAGING-SUBS,563.4
RENAL STATIC IMAGES W FUN,361.22
,
GALLIUM STUDY,299.97
,
PET/CT SKULL-THIGH-SUBS,935.92
,
PET/CT SKULL-THIGH-INIT,935.92
,
PET/CT WHOLE BODY-INITIAL,945.4
,
PET/CT WHOLE BODY-SUBS,945.4
,
EYE FOR FOREIGN BODY,166.69
,
"MANDIBLE, PARTIAL",207.31
,
"MANDIBLE, COMPLETE",223.65
,
"MASTOIDS, > 3 VIEWS",220.93
,
"MASTOIDS, COMPLETE",329.29
,
"FACIAL BONES, LTD",166.91
,
"FACIAL BONES, COMPLETE",243.25
,
"NASAL BONES, COMPLETE",201.98
,
ORBITS,246.4
,
"SINUSES, LIMITED",182.91
,
"SINUSES, COMPLETE",220.93
,
"SKULL, LIMITED",204.7
,
"SKULL, COMPLETE",249.54
,
"TEMP.MADIB.JTS, LTD UNIL",180.31
,
"TEMP.MADIB.JTS, LTS UNIL",180.31
,
TEMP.MANDIB.JTS. COMPLETE,296.97
,
"NECK, SOFT TISSUES",153.2
,
"RIBS, UNILATERAL(2VIEWS)L",176.42
,
"RIBS, UNILATER(2VIEWS)RT",176.42
,
"CHEST, SINGLE VIEW",122.43
,
"SUBSEQUENT CHEST, SINGLE",122.43
,
"SUBSEQUENT CHEST, 2 VIEWS",166.91
,
"CHEST, TWO VIEWS",166.91
,
"CHEST, 2 VIEWS +LORDO",201.85
,
"CHEST, 2 VIEWS + OBLIQ",261.56
,
"CHEST, 2 VIEWS + FLOUR",402.25
,
"WRIST, PARTIAL BILATERAL",371.27
,
"WRIST, PARTIAL LFT",185.63
,
"WRIST, PARTIAL RIGHT",185.63
"RIBS, BILATERAL, PA CXR",429.21
,
"RIBS, UNI(3 VIEWS)PA LFT",214.6
,
RIBS UNI(3VIEWS)P/A RT,214.6
,
"RIBS, BILATERAL, 3 VIEWS",224.11
,
"RIBS, BIL(4 VIEWS)INCL PA",305.32
,
STERNUM,182.8
,
STERNOCLAVICULAR JTS,217.73
,
"SPINE, SINGLE VIEW",131.96
,
C SPINE (AP/LAT),228.97
,
C SPINE (4 VIEWS),307.62
,
C SPINE COMPLETE W/EXT &,407.92
,
"THORACIC SPINE,LTD 2 VIEW",185.95
,
"THORACIC SPINE,W/SWIMMER",220.98
,
"SPINE, THORA JUNCTION",204.7
,
SPINE-SCOLOSIS STUDY,291.39
,
"LUMBAR SPINE, LTD",207.2
,
"LUMBAR SPINE, COMP INCLUD",283.05
,
LS SPINE COMP W BENDING V,396.81
,
SPINE LUMBOSACRAL ONLY BEND 2-3 VIEWS,100
,
"PELVIS, AP",144.62
,
"SACROILIAC JTS, PART",174.86
,
"SACROILIAC JTS, COMP",205.08
,
SACRUM/COCCYX,170.13
,
CERVICAL MYELOGRAM +,757.11
,
THORAIS MYELOGRAM +,702.89
,
LUMBAR MYELOGRAM +,746.19
,
INJECTION FOR MYELOGRAM,"1,015.61"
,
"CLAVICLE, BILATERAL",337.34
,
"CLAVICLE, LEFT",169.4
,
"CLAVICLE, RIGHT",169.4
,
"SCAPULA, BILATERAL",360.63
,
SCAPULA LEFT,180.31
,
"SCAPULA, RIGHT",180.31
,
"SHOULDER, PARTIAL BILATER",268.49
,
"SHOULDER, PARTIAL LEFT",131.96
"SHOULDER, PARTIAL RIGHT",131.96
,
"SHOULDER, COMPLETE BILATR",342.95
,
"SHOULDER, COMPLETE LEFT",172.14
,
"SHOULDER, COMPLETE RIGHT",172.14
,
INJECT FOR SHOULDER X-RAY,412.03
,
SHOULDER ARTHROGRAM BILAT,"1,324.65"
,
SHOULDER ARTHROGRAM+,662.32
,
SHOULDER ARTHROGRAM +,662.32
,
XAY EXAM OF SHOULDERS,237.16
,
"HUMERUS, BILATERAL",338.83
,
"HUMERUS, LEFT",169.32
,
"HUMERUS, RIGHT",169.32
,
"ELBOW, PARTIAL BILATERAL",337.33
,
"ELBOW, PARTIAL LEFT",169.4
,
"ELBOW, PARTIAL RIGHT",169.4
,
"ELBOW, COMPLETE BILATERAL",414.37
,
"ELBOW, COMPLETE LEFT",207.2
,
"ELBOW, COMPLETE RIGHT",207.2
,
"FOREARM, BILATERAL",321.03
,
FOREARM LEFT,160.53
,
FOREARM RIGHT,160.53
,
"WRIST, COMPLETE BILATERAL",468.86
,
"WRIST, COMPLETE LEFT",234.43
,
"WRIST, COMPLETE RIGHT",234.43
,
"HAND, PARTIAL BILATERAL",322.47
,
"HAND, PARTIAL LEFT",161.25
,
"HAND, PARTIAL RIGHT",161.25
,
"HAND, RIGHT & LEFT",387.59
,
"HAND, COMPLETE LEFT",193.83
,
"HAND, COMPLETE RIGHT",193.83
,
FINGER-LEFT THUMB,212.77
,
FINGER-LEFT 2,212.77
,
FINGER-LEFT 3,212.77
,
FINGER-LEFT 4,212.77
,
FINGER-LEFT 5,212.77
FINGER-RIGHT THUMB,212.77
,
FINGER-RIGHT 2,212.77
,
FINGER-RIGHT 3,212.77
,
FINGER-RIGHT 4,212.77
,
FINGER-RIGHT 5,212.77
,
HIP XRAY UNILATERAL 1 VIEW,295.49
,
"HIP, SINGLE VIEW LEFT",147.74
,
"HIP, SINGLE VIEW RIGHT",147.74
,
"HIP, COMPLETE LEFT 2-3 VIEWS",228.97
,
"HIP, COMPLETE RIGHT 2-3 VIEWS",228.97
,
XRAY EXAM HIPS BI 2 VIEWS,130
,
XRAY EXAM HIPS BI 3-4 VIEWS,160
,
XRAY EXAM HIPS BI 5/> VIEWS,185
,
KNEE (MIN 3 VIEW) LEFT AND RIGHT,447.32
,
KNEE (MIN. 3 VIEWS) LEFT,223.65
,
KNEE (MIN. 3 VIEWS) RIGHT,223.65
,
KNEE (4 OR MORE VIEW) LEFT & RIGHT,517.65
,
KNEE (4 OR MORE VIEW) LFT,258.84
,
KNEE (4 OR MORE VIEW)RT,258.84
,
"FEMUR, BILATERAL",316.86
,
"FEMUR, LEFT",158.42
,
"FEMUR, RIGHT",160.53
,
XRAY EXAM OF KNEES,210.03
,
KNEE 1 OR 2 VWS BILATERAL,354.98
,
KNEE 1 OR 2 VIEWS LEFT,177.59
,
KNEE 1 OR 2 VIEWS RIGHT,177.59
,
"LOWER EXTREM., PEDS BILAT",393.06
,
"LOWER EXTREM., PEDS LEFT",196.55
,
"LOWER EXTREM., PEDS RIGHT",196.55
,
"ANKLE, PARTIAL BILATERAL",338.83
,
"ANKLE, PARTIAL LEFT",169.4
,
"ANKLE, PARTIAL RIGHT",169.4
,
"ANKLE, COMPLETE BILATERAL",403.98
,
"ANKLE, COMPLETE LEFT",201.98
,
"ANKLE, COMPLETE RIGHT",201.98
"FOOT, PARTIAL BILATERAL",320.61
,
"FOOT, PARTIAL LEFT",161.25
,
"FOOT, PARTIAL RIGHT",161.25
,
"FOOT, COMPLETE BILATERAL",382.17
,
"FOOT, COMPLETE LEFT",191.08
,
"FOOT, COMPLETE RIGHT",191.08
,
"CALCANEUS, BILATERAL",333.39
,
"CALCANEUS, LEFT",166.59
,
"CALCANEUS, RIGHT",166.69
,
TOE-LEFT 1,191.08
,
TOE-LEFT 2,191.08
,
TOE-LEFT 3,191.08
,
TOE-LEFT 4,191.08
,
TOE-LEFT 5,191.08
,
TOE-RIGHT 1,191.08
,
TOE-RIGHT 2,191.08
,
TOE-RIGHT 3,191.08
,
TOE-RIGHT 4,191.08
,
TOE-RIGHT 5,191.08
,
TIBIA/FIBULA BILATERAL,311.81
,
TIBIA/FIBULA LEFT,154.23
,
TIBIA/FIBULA RIGHT,154.23
,
"UPPER EXT., PEDS BILATERL",327.75
,
"UPPER EXT., PED LEFT",163.88
,
"UPPER EXT., PEDS RIGHT",163.88
,
"ABDOMEN, SINGLE VIEW",128.72
,
,128.72
,
"SUBSEQUENT ABDOMEN, SINGL",128.72
,
ABDOMEN 2 VIEWS,221.67
,
XRAY EXAM SERIES ABDOMEN,265.43
,
"FLOUROSCOPY, ESOPHAGUS",323.59
,
"FLUORO, SWALLOWING/",313.83
,
"FLUORO, UPPER GI WITHOUT KUB",382.24
,
"FLUORO, UPPER GI W/KUB",408.42
,
"FLUOROSCOPY, UGI/SB",635.07
FLURO UPPER GI TRACT,450.05
,
"FLURO,UPPER GI TRACTI W/KUB",517.81
,
DBL CONT.UGI/SB-FLUO,705.38
,
SMALL BOWEL FOLLOW THRU,695.11
,
"FLOUROSCOPY, BARIUM",544.62
,
"FLOURO,AIR CON BARIUM",798.37
,
O.C.G. (GALLBLADDER),440.37
,
"CHOLANGIOGRAM, OPERA,",276.78
,
"UROGRAM, ROUTINE EXAM",720.87
,
"UROGRAM, ROUT +TOMO'S",921.7
,
"UROGRAM, RETROGRADE",906.13
,
CYSTOGRAM +,285.77
,
INJECTION CYCTOGRAM/VCU,360.67
,
XRAY URETHRA/ BLADDER,589.14
,
PELVIMETRY,174.77
,
HYSTEROSALPINGOGRAPHY +,497.81
,
INJECTION FOR HYSTEROSALP,469.08
,
"VENOGRAM, EXT BIALTERAL++",846.95
,
INJ. PROC. VENOGRAM,394.95
,
"VENOGRAM, EXT UNI LEFT",749.36
,
"VENOGRAM, EXT UNI RIGHT",749.36
,
FLUOROGUIDE FOR VEIN DEVICE,465.81
,
"FLUOROSCOPY,SEP.PROC.<1HR",91.5
,
"FLUOROSCOPE EXAM,EXT> 1HR",906.13
,
FLUOROSCOPE - ESI,0
,
NEEDLE LOCALIZATION BY XRAY,200
,
BONE AGE STUDY,112.83
,
BONE LENGTH STUDY,195.55
,
"BONE SURVEY, LIMITED",386.25
,
"BONE SURVEY, COMPLETE",629.11
,
JOINT SURVEY,204.59
,
"TOMOGRAPHY, PER PLANE",659.94
,
CT PROCEDURE,48.99
,
FILM PREP CHARGE-PER FILM,5.64
,
FLURO GUIDANCE NEEDLE PLACE ADD ON,156
INJECT SACROILIAC JOINT,250.41
,
"PERC ABSCESS DRAIN, ABD","6,564.29"
,
ULTRASOUND EXAM AAA SCREE,865.81
,
ASPIRATE PLEURA W/O IMAGE,"1,043.88"
,
ASPIRATE PLEURA W/IMAGING,"1,301.30"
,
"DUPLEX A, IVC, IL/BPG; UN",245.79
,
THYROID TISSUE,320.69
,
US EXAM CHEST,250
,
"US BREAST, BILATERAL",310.39
,
"BREAST, UNILATERAL LEFT",310.39
,
"BREAST, UNILATERAL RIGHT",310.39
,
"US ABDOMEN, COMPLETE",461.68
,
ORGAN SPECIFIC ABD,333.33
,
US ABDOMINAL AORTA SCREENING,865
,
US EXAM ABDOM BACK WALL,421
,
"RETROPERITONEAL, LTD",329.11
,
US RENAL TRANSPLANT W/ DOPPLER,300
,
OB FIRST TRIMESTER,888.86
,
OBSTET. COMPLETE,573.15
,
"OBSTETICAL U/S, MULTIGEST",565.22
,
OBSTET. LIMITED,369.66
,
OBSTET. FOLLOW UP,495.4
,
BIOPHYSICAL PROFILE,613.46
,
TRANS-VAGINAL ULTRASOUND,397.94
,
US PELVIS COMPLETE,390.49
,
PELVIS LTD. OR F/U,218.49
,
"TESTICLES, ULTRASOUND",363.83
,
US TRANSRECTAL,388.63
,
US EXAM OF EXTREMITY-LT,363.33
,
US EXAM OF EXTREMITY-RT,363.33
,
SUBS BREAST CYST ASP LT,234.25
,
SUBS BREAST CYST ASP RT,234.25
,
ABD PARACENTESIS,836.16
,
NEEDLE BIOPSY U/S GUIDED+,333.35
,
NEEDLE BIOPSY PROSTRATE,"1,848.81"
US GUIDANCE AMNIOCENTESIS,222.09
,
NEEDLE BIOPSY BREAST LT,772.92
,
NEEDLE BIOPSY BREAST RT,772.92
,
NEEDLE BIOP OF THYROID LT,905.99
,
NEEDLE BIOP OF THYROID RT,905.99
,
INIT BREAST CYST ASPR. LT,491.56
,
INIT BREST CYCST ASPR. RT,491.56
,
US GUIDE VASCULAR ACCESS,91.27
,
CT-BRAIN W/O CONTRAST,926.89
,
"CT BRAIN, W/CONTRAST","1,211.28"
,
"CT HEAD, W&W/O CONTRAST","1,176.40"
,
"CT ORBIT,SELLA,POST.FOSSA","1,271.14"
,
"CT ORBIT,SELLA,POST.FOSSA","1,899.84"
,
"CT ORBIT, SELLA, POST FOS","2,134.37"
,
CT SINUS W/O CONTRAST,"1,271.14"
,
CT MAX FACIAL W/O CONTRST,"1,271.14"
,
CT MAX FACIAL(SINUS) W,"1,583.04"
,
CT NECK TISSUES W/O,"1,198.79"
,
CT NECK TISSUE WITH,"1,503.18"
,
CT NECK TISSUE BOTH,"1,867.43"
,
CT ANGIOGRAPHY HEAD,"2,486.14"
,
CT ANGIOGRAPHY NECK,"2,486.14"
,
CT CHEST W/O,"1,201.28"
,
"CT CHEST, W","1,510.63"
,
CT CHEST BOTH,"1,879.92"
,
"CT ANGIOGRAPHY, CHEST","2,324.01"
,
CT SPINE CERV W/O,970.8
,
CT SPINE CERV WITH,"1,518.15"
,
"CT CERSPINE, BOTH","1,884.87"
,
CT SPINE THOR W/O,"1,211.28"
,
CT SPINE THOR WITH,"1,525.67"
,
"CT THOR SPINE, BOTH","1,897.36"
,
CT SPINE LUMBAR W/O,"1,206.33"
,
CT SPINE LUMBAR WITH,"1,520.63"
,
"CT LUMBAR SPINE, BOTH","1,887.36"
CT PELVIS W/O CONT,909.38
,
CT PELVIS W/CONT,"1,625.46"
,
CT PELVIS BOTH,"1,852.47"
,
CT UPPER EXTREM W/O BILTL,"2,392.63"
,
"CT UPPER EXTREM, W/O LEFT","1,196.31"
,
"CT UPPER EXTREM, W/O RT","1,196.31"
,
"CT UPPER EXTREM, W/ BILAT","2,991.33"
,
"CT UPPER EXTREM, W LEFT","1,495.66"
,
"CT UPPER EXTREM, W RT","1,495.66"
,
"CT LOWER EXTREM, W/O BILT","2,402.55"
,
"CT LOWER EXTREM, W/O LT","1,201.28"
,
"CT LOWER EXTREM, W/O RT","1,201.28"
,
CT LOWER EXTREM W/ BILAT,"3,046.23"
,
CT LOWER EXTREM W/ LEFT,"1,523.11"
,
CT LOWER EXTREM W/ RIGHT,"1,523.11"
,
CT LOWER EXTREM W&WO BILT,"3,984.36"
,
CT LOWER EXTREM W&WO LEFT,"1,992.18"
,
CT LOWER EXTREM W&WO RGHT,"1,992.18"
,
CT UPPER ABDOMEN W/O,896.97
,
CT UPPER ABDMN WITH,"1,620.41"
,
CT UPPER ABDMN BOTH,"1,889.91"
,
CTA ABD/PELVIS,"2,327.75"
,
CT ABD & PELVIS W/O CONTR,"1,086.53"
,
CT ABDOMEN & PELVIS W/CON,"1,919.85"
,
CT ABD & PELVIS 1+ SECTIO,"2,289.05"
,
CT ANGIO ABDOMINAL ARTERI,"2,483.73"
,
CT GUIDED NEEDLE BIOPSY+,540.16
,
LUNG/MEDIASTINUM BIOPSY,795.45
,
LIVER BIOPSY,797.12
,
BONE BIOPSY-DEEP,839.85
,
BONE BIOSPY-SUPERFICIAL,555.96
,
CT MULTIPLANNAR/3D RECON,370.53
,
CT LIMITED OR LOCALIZED F,724.77
,
FINE NEEDLE ASP. OF DEEP,497.42
,
SINCALIDE INJECTION 5MCG,495.99
THYROID UPTAKE MEASUREMEN,325.06
,
THYROID IMAGING W/BLOOD F,798.73
,
THYROID IMAGING W/BLOOD F,"1,006.09"
,
PARATHYROID IMAGING,"1,214.10"
,
LIVER IMAGING WITH FLOW,822.01
,
LIVER SPECT,919
,
LIVER/SPLEEN,790.04
,
LIVER/SPLEEN SCAN W/FLOW,453.94
,
HEPATOBILIARY SYS W/O CCK,"1,370.96"
,
HEPATOBIL SYS IMAGE W/CCK,"1,667.90"
,
GI TRACT SCAN,"1,014.09"
,
GASTRIC EMPTYING STOMACH,"1,162.90"
,
GI BLEED,"1,395.85"
,
MECKELS DIVERT EXAM,"1,389.45"
,
BONE IMAGING;LIMITED AREA,693.13
,
BONE IMAGING;MULITPLE ARE,882.85
,
BONE IMAGING;WHOLE BODY,975.67
,
BONE IMAG;VASCLR FLO ONLY,724.4
,
BONE IMAGING;3 PHASE,"1,381.46"
,
3 PHASE EXTENDED EXAM,"1,381.46"
,
BONE IMAGING;SPECT,826.85
,
"HT MUSCLE IMAGE SPECT, MU","1,832.00"
,
RESTING MUGA,847.64
,
LUNG VENTILATION IMAGING,749.13
,
PERFUSION LUNG SCAN ONLY,941.2
,
LUNG VENTILAT&PERFUS IMAG,"1,313.36"
,
BRAIN IMAGING SPECT,"1,365.42"
,
RENAL STATIC IMAGES,"1,144.00"
,
RENAL STATIC IMAGES W/VAS,866.82
,
RENAL STATIC IMAGES W FUN,"1,285.00"
,
RENAL STAT FUN W/DRUG,"1,285.00"
,
RENAL STATIC IMAGES;SPECT,"1,180.00"
,
TESTICULAR IMAGING,812.42
,
GALLIUM STUDY,"1,025.27"
,
123-I CAPSULE,369.59
MEBROPHENIN,298.6
,
99MTC-RC-MUGA,639.8
,
TC 99M (THYROID SCAN ONLY,193.13
,
"99M-TC SUL COL (LIVER,SPL",440.33
,
99M-TC MAA,262.65
,
TC MAG 3 (RENAL IMAGING),386.25
,
TECHNESIUM,235.37
,
99M-TC CHOLE TEC (HEPATO,247.2
,
TECHNESIUM W. COLD VL PYP,306.2
,
99M-TC DTPA,386.25
,
KENOVAC,153.7
,
131-I CAPSULE,369.59
,
"ISOTOPES, 99M-TC (BONE)",169.95
,
"TC 99M SULFUR COLLOID, VL",440.33
,
133-XE GS,345.54
,
CARDIO LITE (FOR 4438464),864.57
,
"CARDIO LITE(FOR 8465,8461",602.55
,
CARDIO LITE(PARATHY IMAG),864.57
,
"ISOTOPES, 201-THALLIUM",622.52
,
TC-99M NATCOY (ISOTOPE),208.18
,
TC 99M W/RBC,298.49
,
DIAGNOSTIC DIGITAL BREAST TOMOSYNTHESIS+,50
,
,
MAMMO UNILATERAL SCREEN D,355.68
,
"MAMMO, UNILATERAL DIDGITA",336.44
,
"MAMMO, BILATERAL DIGITAL",428.72
,
MAMMO SCREEN DIGITAL,355.68
,
"BREAST, SPECIMEN",34.59
,
"PREOP NEEDLE PLMNT, BRST",511.87
,
"PREOP NEEDLE PLMNT, BRST",511.87
,
"PREOP NEEDLE PLMNT, BRST",355.3
,
"PREOP NDL PLMNT, BRST ADD",355.3
,
NEEDLE LOC(LEASON SPEC)LT,511.87
,
NEEDLE LOC(LEASON SPEC)RT,511.87
,
BREAST TOMOSYNTHESIS BI,50
DIAGNOSTIC MAMMO UNILATERAL,335
,
DIAGNOSTIC MAMMO BILATERAL,425
,
SCREENING MAMMO BILATERAL,355
,
MRI TEMPOROMANDIBULAR JOINT,785
,
"MRI-FACE,NECK OR ORBTS-WO","3,083.75"
,
MRI-FACE NECK OR ORBTS W,"3,533.35"
,
"MRI-FACE,NECK,ORBTS W/WO","4,274.38"
,
MR-ANGIOGRAPHY HEAD W/O,"3,083.75"
,
MRI ANGIO HEAD W/CONTRAST,"3,654.30"
,
MRI ANGIO NECK W/O CONTRAST,"3,083.75"
,
MRI ANGIO NECK WITH CONTRAST,"3,970.56"
,
MRI ANGIO-NECK W & W/O CONTRAST,"5,006.14"
,
MRI-BRAIN W/O CONTRAST,"3,083.75"
,
MRI-BRAIN W,"3,660.46"
,
MRI-BRAIN W/WO W/ADD SEQU,"4,172.04"
,
MRI-CHEST WO CONTRAST,"3,083.75"
,
MRI-CHEST W,"4,075.97"
,
MRI-CHEST W/WO CONTRAST,"5,006.14"
,
MRI ANGIO CHEST W OR W/O DYE,"3,496.17"
,
MRI-CERVICAL SPINE W/O,"2,820.20"
,
MRI-CERVICAL SPINE W,"3,688.42"
,
MRI-DORSAL SPINE W/O,"2,826.36"
,
MRI-DORSAL SPINE W,"3,161.21"
,
MRI-LUMBAR SPINE W/O,"2,823.29"
,
MRI-LUMBAR W,"3,598.40"
,
MRI-CERIVAL SPINE W/WO,"4,079.06"
,
MRI-THORACIC SPINE W/WO,"3,710.08"
,
MRI-LUMBAR SPINE W/WO,"4,054.29"
,
MRI PELVIS W/O CONTRAST,"3,083.75"
,
MRI-PELVIS W,"3,610.83"
,
MRI PELVIS W & W/O DYE,"4,348.86"
,
MRI ANGIO PELVIS W/O DYE,"3,539.52"
,
MRI UPPER JT W/ BOTH,"6,632.51"
,
MRI UPPER JT W/ LEFT,"3,316.25"
,
MRI UPPER JT W/ RIGHT,"3,316.25"
MRI UPPER JOINT LT W &W/O,"4,048.02"
,
MRI UPPER JOINT RT W &W/O,"4,048.02"
,
MRI UPPER EXTEM W/O,"3,083.75"
,
MRI UPPER EXTEM W,"3,579.82"
,
MRI-UPPER JOINTS BIL W/O,"3,922.47"
,
MRI-UPPER JOINTS LFT W/O,"1,961.24"
,
MRI-UPPER JOINTS RT W/O,"1,961.24"
,
MRI-UPPER EXTREMITY BILAT W/WO,"8,703.88"
,
MRI-UPPER EXT LT-W/WO CONTR,"4,351.95"
,
MRI-UPPER EXT RT-W/WO CONTR,"4,351.95"
,
MRI-LOWER JOINTS BI W/O,"3,922.47"
,
MRI-LOWER JOINTS LT-WO CO,"1,961.24"
,
MRI-LOWER JOINTS RT-WO CO,"1,961.24"
,
MRI ANGIO-LOWER EXTREM W/WO CONTR,"3,558.13"
,
MRI-LOWER EXTREMITY BILAT,"6,167.48"
,
MRI-LOWER EXT LT-WO CONTR,"3,083.75"
,
MRI-LOWER EXT RT-WO CONTR,"3,083.75"
,
MRI-LOWER EXTR W CONTRAST,"7,302.22"
,
MRI-LOWER EXTR W CONTRAST,"3,651.12"
,
MRI-LOWER EXT W CONRAST,"3,651.12"
,
MRI-ABDOMEN WO CONTRAST,"2,844.95"
,
MRI-ABDOMEN W & W/O CONTR,"4,367.47"
,
MRI ANGIO ABDOMEN,"3,536.44"
,
MRI-LOWER JOINTS BI W/WO,"8,089.88"
,
MRI-LOWER JTS W/WO CONTRA,"4,044.93"
,
MRI-LOWER JTS W/WO CONTRA,"4,044.93"
,
MRI-LOWER EXT BIL-W/WO C,"8,778.28"
,
MRI-LOWER EXT LT W/WO CON,"4,389.15"
,
MRI-LOWER EXT RT W/WO CON,"4,389.15"
,
VENOUS DUPLEX-BIL-IN DEPT,"1,129.79"
,
VENOUS DUPLEX UNI LEFT,731.55
,
VENOUS DUPLEX UNI RIGHT,731.55
,
DOP ART.WAVE UPER&LWR,570.21
,
"CARDIAC M-MODE, DOPPLER C","1,219.69"
,
M-MODE & REAL TIME,631.02
"CARDIAC M-MODE, DOPPLER LIMITED",734.18
,
CARDIAC DOPPLER,267.14
,
ECHO DOPLER LIMITED,148.16
,
DOPPLER COLOR FLOW,166.61
,
STRESS ECHO,"1,259.40"
,
CAROTID DUPLEX SCAN; BILAT,"1,129.79"
,
LTD. EXTRACRANIAL,779.17
,
SEG. PRESS. UPR. BILATERA,865.28
,
DOP. ART. WAVE UPR.,570.21
,
SEG. PRESS. LWR. BILATERA,865.28
,
ANKLE/ARM INDEX BILATERAL,570.21
,
LWR. EXT. DUPLEX BILATERA,"1,128.30"
,
LTD LWR EXT DUPLEX BILAT,"1,926.18"
,
LTD LWR EXT DUPLEX LEFT,963.09
,
LTD LWR EXT DUPLEX RIGHT,963.09
,
UPR. EXT. DUPLEX BILATERA,"1,129.79"
,
LTD UPR EXT DUPLEX BILAT,"1,552.91"
,
LTD UPR EXT DUPLEX LEFT,776.46
,
LTD UPR EXT DUPLEX RIGHT,776.46
,
VENOUS DUPLEX-BIL STUDY,"1,129.79"
,
VASC DUPLEX SCAN OF AB VE,"1,128.30"
,
VASCULAR STUDY,921.97
,
DUPLEX OF AORTA,"1,129.79"
,
DUP-SCAN AORTA IVC ILIAC VAS UNI/LMTD,710.37
,
LTD VENOUS DUPLEX-UNI STU,731.55
,
LTD VENOUS DUPLEX-UNI STU,731.55
,
BONE DENSITY STUDY,367.53
,
"DXA BONE DENSITY, VERT FX",181.46
,
F18FDG,369.67
,
PET/CT BRAIN IMAGING-INIT,"6,571.69"
,
PET/CT BRAIN IMAGING-SUBS,"6,571.69"
,
PET/CT SKULL-THIGH-SUBSEQ,"6,571.69"
,
PET/CT SKULL-THIGH-INITIA,"6,571.69"
,
PET/CT WHOLE BODY-INITIAL,"6,571.69"
,
PET/CT WHOLE BODY-SUBSEQ,"6,571.69"
OPIUM TINCTURE 10 MG / ML,18.3
,
MILNACIPRAN TAB 50 MG [N,16.1
,
ROPIVACAINE VIAL 0.5% - 5,63.4
,
CLOBETASOL CREAM 0.05% 30 GM,316.75
,
CONTRST ORAL UGI LOW DENS,25.05
,
CIPROFLOXICIN 250MG TAB,13.35
,
DOXORUBICIN LIPOSOMAL VIA,"1,422.85"
,
FOSPHENYTOIN VIAL 500 MG,65.1
,
CLOPIDOGREL TAB 75MG [*],15.8
,
LEVOFLOXACIN TAB 500MG [*,37.55
,
DIATRIZ- MEGL/ SOD 37% CO,55.75
,
TORSEMIDE TAB 10MG [*],4.8
,
CO Q 10 CAP 100MG,4.4
,
MIRTAZAPINE TAB 15MG [*,5.4
,
RAMIPRIL CAP 2.5MG [*],3.85
,
MINERAL OIL STERILE,9.25
,
MONTELUKAST TAB 10MG [*,13.45
,
NISOLDIPINE ER TAB 20MG,26.7
,
DILTIAZEM CD CAP 240MG,4.95
,
CYSTOGRAFIN 300 ML,63.09
,
IOPAMIDOL VIAL 61% 100ML,206.8
,
SORBITOL 70% 30ML SOLN,9.25
,
"CONTRAST, RUO CYSTO",59.42
,
MAGNESIUM SULF,32.05
,
"INJ, FILGRASTIM G0CSF 1MCG",732.3
,
CICLOPRIOX 0.77% CREAM 15,12
,
CEFPODOXIME ORAL SUSP,12.05
,
HYDROXYZINE TAB 50 MG [NO,4.35
,
DARBEPOETIN SYRINGE 500MC,"8,370.70"
,
HETASTARCH 6% 500ML,63.65
,
MULTIQ 400MG TAB,26.2
,
BENDAMUSTINE 45MG VIAL,"1,402.05"
,
GEMCITABINE VIAL 200MG [,336.6
,
HEMORRHOID OINTMENT TUBE,21.25
,
SODIUM BICARBONATE TAB 6,3.65
INDIGO CARMINE AMP 8MG/ML,33.75
,
TICAGRELOR 90MG,16.25
,
AMIFOSTINE VIAL 500MG [NO,"1,107.10"
,
ROCURONIUM MDV 50 MG/ 5ML,18
,
NYSTATIN SUSPENSION BOTTL,34
,
MITOXANTRONE INJ 2MG/ML 1,63.3
,
MITOMYCIN 40MG VIAL,"2,559.65"
,
BYSTOLIC 10mg,12.95
,
MAGNESIUM SULF 1GM IN 100ML D5W,32.5
,
CEFAZOLIN VIAL 1GM [*],19.45
,
CEFTRIAXONE ADD-V VIAL 1G,48
,
KETOROLAC VIAL/PFS 30MG/M,27.3
,
ENOXAPARIN SYRINGE 40MG/,69.95
,
GLYCERIN SOLN,52.75
,
METHYLPREDNISOLONE VIAL 5,66.45
,
GRANISETRON 1MG VIAL,57.55
,
NITROGLYCERIN BOTTLE 50MG,58.25
,
GANCICLOVIR 500MG VIAL,226.6
,
ATROPINE SYRINGE 1 MG/10,36.5
,
NEFAZODONE 200MG TAB,12.5
,
CLONIDINE PATCH TTS-1,63.2
,
FOSINOPRIL TAB 10MG,5.65
,
NEOM/POLY/HC OPHTH SUSP B,289
,
NEOM/POLY/DEX OPHTH OINT,88.25
,
M-M-R II W/DILUENT SDV [*,120.03
,
DONEPIZIL TAB 10MG [*],39.95
,
VALSARTAN TAB 80MG [*],19.5
,
ROFLUMILAST TAB 500 MCG,22.1
,
NEOM/POLY/DEX OPHTH SUSP,44.75
,
BUPROPRION-SR TAB 150MG,4.85
,
PSEUDOEPHEDRINE CAPLET SR,4.25
,
ISOSORBIDE DINITRATE TAB,5.45
,
FLUDROCORTISONE TAB 0.1 M,6.4
,
METHYLPHENIDATE HCL TAB 5,4.85
,
GABAPENTIN CAP 100MG [*],4.75
GABAPENTIN CAP 300MG [*],5.9
,
ISOSORBIDE DINITRATE TAB,6.05
,
ISOSORBIDE MONONITRATE ER,6.55
,
TRANDOLAPRIL TAB 2MG,5.7
,
EYEVITAMIN TAB,3.7
,
ATRACURIUM VIAL 100MG/10ML,19.95
,
PRAVASTATIN TAB 20MG [NOT,9.4
,
IRBESARTAN TAB 75MG [NOT,9.65
,
METAXALONE TAB 800MG [*],12.3
,
ALENDRONATE TAB 70MG,40.35
,
MISC NONRX DRUG,26.15
,
DOCETAXEL VIAL 20MG/ML,"1,259.80"
,
MIDAZOLAM MDV 10 MG /10ML,8.4
,
NFD,3
,
LIDOCAINE TOPICAL AMP 4%,18.5
,
OFLOXACIN 0.3% OTIC SOLN,142.25
,
NFB,3
,
MISC IV DRUG,0
,
MISC-INCIDENT TO RADIOLOG,0
,
VENLAFAXINE XR CAP 37.5MG,9.65
,
NALOXONE VIAL/PFS 0.4MG/,50.7
,
MUPIROCIN NASAL OINT 2%,46
,
POTASSIUM 10MEQ CAP,5.3
,
CLONAZEPAM TAB 1MG,5.05
,
KETOROLAC LS OPHTH SOLN 0,47.5
,
HEPARIN LOCK PFS 500 UNIT,17.8
,
SOLIFENACIN TAB 5 MG,29.7
,
HEPARIN LOCK PFS 300 UNIT,5.8
,
LEVOTHYROXINE TAB 175 MCG,4.95
,
POTASSIUM 20MEQ- 0.9% SOD,21.3
,
POTASSIUM 20MEQ- D5W-1/2,21.05
,
POTASSIUM 40MEQ- 0.9% SOD,23
,
ETOMIDATE VIAL 20 MG/ 10,28.55
,
SODIUM CHLORIDE ADD-V BAG,23.3
,
OMEGA-3-ACID ETHYL ESTERS,6.25
VANCOMYCIN ADDV VIAL 1GM,61.1
,
REGADENOSON IV PFS 0.4 M,541.3
,
CHLORHEXIDINE 4% ANTISEP,15
,
ZOLPIDEM CR TAB 12.5 MG N,16.85
,
DEXTROSE 5% IN WATER EXCE,20.05
,
MODAFINIL TAB 200 MG,83.4
,
DEXTROSE 5% IN WATER EXCE,20.19
,
IOPAMIDOL VIAL 61% 50 ML,113.85
,
AMLODIPINE TAB 10MG,4.55
,
ZAFIRLUKAST 20MG TAB,7.4
,
ESOMEPRAZOLE CAP 20MG (NO,21.6
,
ADALIMUMAB KIT 40 MG/0.8M,"3,158.25"
,
BUDESONIDE MDI 180 MCG,504.75
,
VECURONIUM VIAL 20MG / 2,54.75
,
DULOXETINE CAP 30 MG,17.4
,
HYLAN ONE SYRINGE 48 MG,"2,785.05"
,
TRIAMCINOLONE ACET 0.1% O,34.25
,
CROMOLYN NASAL AEROSOL SO,9.25
,
SODIUM CHLORIDE MINIBAG PLUS 100ML,27.25
,
ZANAMIVIR 10 DOSE BOX 5,15.5
,
BUDESONIDE-FORMOMDI 80-4.,56.25
,
CYPROHEPTADINE TAB 4 MG [,5.45
,
BUDESONIDE-FORMO MDI 160-,489.5
,
NITROGLYCERIN PATCH 0.1MG,12.5
,
FINASTERIDE TAB 5MG,9.5
,
AZITHROMYCIN ADD-V VIAL 5,37.8
,
PRAVASTATIN TAB 40MG,12.1
,
ZOLPIDEM CR TAB 6.25 MG,16.85
,
DICLOFENAC GEL 1% 100GM,125.75
,
ACETAMINOPHEN IV VIAL 100,103.25
,
CHLORPHEN-HYDROCOD ORAL S,5
,
VARICELLA ZOSTER VACCINE,493.45
,
LEVALBUTEROL AEROSOL MDI,156.5
,
ETONOG-ETHINYL ESTRA V,275.15
,
HYALGAN VIAL 20MG/2ML,297.3
CEFEPIME VIAL 2 GM,37.7
,
METHOCARBAMOL TAB 750 MG,4.6
,
ESTRADIOL TD PAT BIWEEKLY,42
,
ETODOLAC TAB 400MG,6.55
,
BUTAL-ASA-CAFF CAP 50-325,6.6
,
CITALOPRAM TAB 20 MG (*),8.1
,
TESTOSTERONE CYP SDV 200,54.7
,
KETOCONAZOLE SHAMPOO 2% 4,9.5
,
EST ESTROGEN/METHYLTES TA,6.35
,
BEVACIZUMAB VL 100 MG/4ML,"1,737.90"
,
UREA CREAM 40% - 85 GM TU,132.25
,
ALVIMOPAN CAP 12 MG,185.25
,
BUTAL-APAP-CAFF TAB 50-32,6.55
,
ENALAPRILAT VIAL 1.25 MG,23.15
,
CELECOXIB CAP 50 MG [NOT,10.95
,
DICLOFENAC PATCH 1.3% [NO,20.25
,
RIFAMPIN CAP 300MG,5.95
,
SITAGLIPTIN TAB 100 MG,34.45
,
LEVETIRACETAM 500MG VIAL,91.25
,
LEVETIRACETAM TAB 250 MG,8.25
,
ER-ONDANSETRON 4MG ODT,143.8
,
BECLOMETHASONE INHALER 40,290.75
,
BECLOMETHASONE 80MCG INH,386.25
,
TRIAMCIN AQ NASAL INHALE,24
,
CROMOLYN AEROSOL MDI [NO,25.5
,
INFLIXIMAB VIAL 100MG,"2,188.65"
,
PALIPERIDONE 1MG ER SYRINGE,"5,415.15"
,
Paliperidone 156mg ER Syringe,"3,614.05"
,
Paliperidone 117 MG ER SYRINGE,"2,713.30"
,
PHENYLEPHRINE 1% VIAL 10,29.5
,
SUMATRIPTAN STAT DOSE VIA,164.5
,
VITAMIN B-COMPLEX TAB [NO,3
,
VITAMIN B-12 TAB 100 MCG,3.13
,
AZELASTINE NASAL SPRAY 137,9.25
,
VITAMIN B-12 TAB 1000 MCG,4.15
FONDAPARINUX SYRINGE 2.5,131.65
,
ACETAMINOPHEN CR CAPLET 6,3.7
,
PROMETHAZINE SUPP 50MG,67.9
,
FEROCON CAP [NOT STOCKED],4.3
,
HYDROCOD/ACET TAB 10MG/65,5.6
,
MIDODRINE TAB 5MG,7.2
,
ATORVASTATIN TAB 10MG,4.2
,
CARVEDILOL TAB 12.5MG,7.05
,
SITAGLIPTIN-METFORMIN TAB,19
,
GLUCOS/CHOND CAP 500-400,4.1
,
MILNACIPRAN TAB 100 MG [N,16.1
,
AMYL NITRITE INHALANT AMP,10.25
,
CLINDAMYCIN ADD-V VIAL 30,34.25
,
ASPIRIN-ACETAMIN-CAFF TAB,3.7
,
LIDOCAINE LARYNGOTRACHEAL,26
,
DIMENHYDRINATE TAB 50 MG,3.95
,
FISH OIL CAP 1000 MG (*),3.65
,
SODIUM HYPOCHLORITE 0.25%,9.25
,
DARIFENACIN SR TAB 24-HR,30.95
,
SCOPOLAMINE TD PATCH 72HR,47.75
,
BUPROPION XL TAB 150 MG,11.9
,
MESALAMINE TAB DELAYED RE,22.05
,
TORSEMIDE TAB 20 MG,5
,
BUPIVACAINE IN DEX PF SPI,21.15
,
DILTIAZEM VIAL 125MG/25M,41.1
,
ESTRADIOL TAB 2 MG NOT ST,5.2
,
HEPATITIS A VACCINE 1440,157.15
,
PERFLUTREN LIPID MICROSPH,513.3
,
DARBEPOETIN SYRINGE 60MC,"1,014.60"
,
ROSUVASTATIN TAB 20 MG,22.3
,
LEVOTHYROXINE TAB 200 MCG,6.15
,
AZELASTINE NASAL SPRAY 0.,18.5
,
ESTRADIOL TD PATCH BIWEEK,41.75
,
PYRIDOSTIGMINE TAB 60 MG,6.2
,
INSULIN NOVOLOG (ASPART),62.6
INSULIN LANTUS (GLARGINE),45
,
INSULIN NPH PEN 100 UNIT,47.54
,
INSULIN 70/30 PEN 100 UNI,45
,
INSULIN LEVEMIR (DETEMIR),41
,
MENTHOL THROAT LOZENGES B,10.85
,
OXYCODONE ER TAB 30 MG,24.65
,
DENOSUMAB PFS 60 MG/ML,"2,568.00"
,
POTASSIUM 40MEQ- D5W-1/2,21.6
,
FAT EMULSION 20% 250ML,91.35
,
BENDAMUSTINE VIAL 100 MG,"3,922.80"
,
ESMOLOL VIAL 10MG/ML 10ML,39.2
,
GUAIFENESIN/PSEUDOEPHEDRI,4.7
,
ESTROGEN-MEDROXYPROG TAB,17.7
,
DABIGATRA CAP 75 MG [NOT,11.4
,
DABIGATRAN CAP 150 MG [NO,17.95
,
OCTREOTIDE 200 MCG/ML (0.,91.02
,
DALTEPARIN PFS 5000 UNIT/,100.15
,
HYDROCOD/ACET TAB 5MG/325,4.35
,
MAGIC MOUTHWASH,32.8
,
FOSAPREPITANT VIAL 150 MG,708.2
,
VITAMIN D TAB 1000 IU,3.55
,
HYPOCHLOROUS ACID BOTTLE,50.5
,
DENOSUMAB SDV 120 MG/1.7M,"4,800.70"
,
BACITRACIN VIAL IM 50000,35.45
,
CISATRACURIUM IV MDV 2 MG,5
,
TRIPTORELIN PFS 22.5 MG [,"10,551.10"
,
LEVOFLOXACIN TAB 250 MG[*,33.2
,
FEBUXOSTAT TAB 40 MG,26.6
,
RIVAROXABAN TAB 10 MG,33.7
,
PENTOSAN CAPS 100 MG,22.65
,
FENTANYL SDV 0.05MG/ML 10,17.1
,
RIVASTIGMINE PATCH 24HR 4,55.75
,
FENTANYL AMP 250 MCG/ 5ML,20.75
,
DIATRIZOATE URETHRAL,78.1
,
CALCITRIOL CAP 0.25MCG,5.8
HYDROCHLOROTHIAZIDE CAP 1,4.3
,
LEUPROLIDE (6 MONTH) KIT,"18,922.10"
,
FERUMOXYTOL VIAL 510 MG/17 ML,"1,719.05"
,
LEUPROLIDE IM KIT 7.5 MG,"3,163.25"
,
HYDRALAZINE TAB 10MG,3.75
,
ACETAMIN CODEINE UD CUP 1,3.7
,
DICLOFENAC W/ MISOPRTAB 7,21.25
,
LEUPROLIDE ACETATE (3 MON,"9,466.65"
,
OLMESARTAN MEDOXOMIL TAB,18.6
,
FERRIC GLUC CMPLX IN SUCR,85.2
,
"INJ, BUPIVACAINE LIPOSOME",691.9
,
ER-CLINDAMYCIN 150MG CAP #28,43.35
,
DULOXETINE CAP 20 MG,18.9
,
GLIPIZIDE XL TAB 2.5MG,4.25
,
DEXILANT 60MG CAP,21
,
IOPAMIDOL VIAL 41% 200ML,16.85
,
ZOLEDRONIC ACID 1MG,"2,032.45"
,
PREGABALIN CAP 50 MG [*,21.2
,
TELMISARTAN TAB 40 MG,13.55
,
MEMANTINE TAB 5 MG,5.25
,
PAROXETINE 10MG TAB [NOT,8.6
,
CONJUGATED ESTROGEN TAB 0,15.1
,
ROPINIROLE TAB 0.25 MG,4.85
,
ROPINIROLE TAB 1 MG,8.05
,
CARISOPRODOL TAB 350MG,3.95
,
BUDESONIDE MDI 90 MCG,379.25
,
TIOTROPIUM 18 MCG / CAP I,179.25
,
AMMONIUM LAC LOTION TUBE,77.5
,
DILTIAZEM ADD-V VIAL 100M,42.65
,
BETAMETHASONE ACET & SOD,33.75
,
DANTROLENE VIAL 20MG,191.5
,
SODIUM CHLORIDE BAG 3% 5,27.15
,
NOREPINEPHRINE VIAL 4MG/4,60.2
,
PHENTOLAMINE MESYLATE FOR,242.8
,
SODIUM THIOSULFATE VIAL 2,55.4
HYDROXYZINE VIAL 50 MG/ML,49.7
,
TETRACAINE 1% SPINAL PF,97.9
,
LORAZEPAM ORAL CONC 2MG/M,95.45
,
NS FLUSH 10ML SYRINGE,5.35
,
OXYCODONE CONCENTRATE 20,402.75
,
"RABIES VIRUS VACCINE, HDC",744.6
,
RABIES IMMUNE GLOB 150 UN,"3,889.45"
,
FENTANYL PATCH 12 MCG/HR,45.75
,
ALENDRONATE TAB 35MG [NOT,40.4
,
MOMETASONE 220 MCG/INH TW,168.75
,
FLUOXETINE CAP 10MG [NOT,7.85
,
ENOXAPARIN SYRINGE 150 MG,60.1
,
NAFCILLIN ADD-V-VIAL 1 G,48.05
,
TRIFLURIDINE 1% OPHTH SOL,52
,
SERTRALINE TAB 50MG,4.25
,
PIROXICAM CAP 10MG,8.2
,
AZATHIOPRINE TAB 50MG,7.75
,
FLUOCINONIDE GEL 0.05% 15,152
,
FLUTICASONE HFA MDI 44 M,46.25
,
FORMOTEROL MDI 12MCG/CAP-,138.75
,
IMMUNIZATION ADMIN- RABIES,54
,
ACETAZOLAMIDE TAB 250MG,11.05
,
VITAMIN A&D OINT TUBE 45G,13.5
,
ACETAMINOPHEN SUPP 120MG,4.6
,
ACETAMINOPHEN SUPP 325MG,4.7
,
ACETAMINOPHEN SUPP 650MG,4.6
,
ACTIVATED CHARCOAL W/SORB,62.45
,
ACTIVATED CHARCOAL TUBE 2,62.45
,
NIFEDIPINE ER TAB 30MG,5.8
,
ADENOSINE SCAN VIAL 3MG/M,375.95
,
ADENSOINE 1 MG INJECTION,94.35
,
ALBUMIN VIAL 5% (12.5GM/2,166.2
,
SPIRONOLACTONE TAB 25MG,4.35
,
TEMSIROLIMUS VIAL KIT 25,"3,307.95"
,
ALBUTEROL SVN UD VIAL 0,4.95
ER-TOBRAMYCIN OPHTH 5ML S,32.85
,
ER-ERYTHROMYCIN OPH OINT,20
,
ALLOPURINOL TAB 300MG,5.05
,
ALLOPURINOL TAB 100MG,4.4
,
ALFENTANIL AMP 1 MG/ 2 ML,21.05
,
ALPRAZOLAM TAB 0.25MG [*],4.65
,
ALUMINUM HYDROX GEL BO 32,9.05
,
ALPRAZOLAM TAB 0.5MG [*],4.95
,
METAPROTERENOL UD VIAL 0.,5.21
,
ZOLPIDEM TAB 5MG [*],3.7
,
AMINOCAPROIC ACID VIAL 25,30.7
,
AMINOPHYLLINE VIAL 25MG/M,41.1
,
AMITRIPTYLINE TAB 10MG,4.1
,
AMITRIPTYLINE TAB 25MG [*,4.65
,
AMMONIA AROMATIC INHALANT,5.95
,
AMOXICILLIN TAB 875MG,5.1
,
AMOXICILLIN CAP 250MG [*,4
,
AMOXICILLIN/CLAV ORAL SUS,9.95
,
AMOXICILLIN ORAL SUSP 200,17.3
,
AMOXICILLIN ORAL SUSP 400,26.7
,
AMOXICILLIN CAP 500MG,4.4
,
AMPICILLIN VIAL (IV/IM),29.25
,
AMPICILLIN ADD-VIAL (IV),79.05
,
AMPICILLIN ORAL SUSP 250M,59.4
,
AMPICILLIN CAP 500MG,4.6
,
SUCCINYLCHOLINE (10ML MDV,65.45
,
PHYSOSTIGMINE AMP 1MG/ML,96.65
,
NEOM/POLY/HC OTIC SUSPENS,178
,
HYDROCORTISONE SUPP 25MG,42.25
,
ACETAMIN/CODEINE TAB 300M,4.15
,
ACETAMIN/CODEINE UD CUP 1,6.2
,
ACETAMINOPHEN DROPS 80MG/,16.9
,
ACETAMIN/DIPHEN (PM) TAB,3.7
,
ACETAMINOPHEN TAB 500MG [,3.65
,
HYDRALAZINE VIAL 20MG/ML,112.05
SANDOSTATIN LAR DEPOT,"7,148.00"
,
COLLAGENASE 250 U/GM OINT,451.5
,
AQUAPHILIC OINTMENT TUBE,22.5
,
FLUTICASONE NASAL SPRAY 5,162.5
,
ARTIFICIAL TEARS OPHTH SO,16
,
ARTHRITIS CREAM TUBE 35 G,21.5
,
ARIPIPRAZOLE 10MG TAB,67.75
,
ASPIRIN EC TAB 81 MG [*],3.7
,
ASPIRIN CHEW TAB 81 MG [*,3.7
,
LORATADINE/PSEUDOEPHEDRIN,5.3
,
ASPIRIN EC TAB 325MG [*],3.65
,
ASPIRIN TAB 325MG (*),3.6
,
ASPIRIN SUPP 600MG [*],6.25
,
ATENOLOL TAB 25MG,4.85
,
ATENOLOL TAB 50MG [*],5.55
,
ALTEPLASE (TPA) 100MG [NO,"16,385.20"
,
LORAZEPAM VIAL/PFS 2MG/ML,18.65
,
FENTANYL PATCH 25MCG/HR,47.5
,
SULFACETAMIDE 10% OPHTH,119
,
FLUCONAZOLE BAG IN NS 200,16.75
,
NITROGLYCERIN TOPICAL OIN,14
,
ATROPINE VIAL 0.4MG/ML 1M,32.25
,
IPRATROPIUM MDI 17 MCG/AC,785.25
,
IPRATROPIUM BROMIDE UD VI,5.9
,
ATROPINE VIAL 1MG/ML 1ML,41.25
,
ATROPINE SULFATE OPHTH,20
,
AMOXICILLIN/CLAV ORAL SUS,76.95
,
AMOXICILLIN/CLAV TAB 500M,10.35
,
AMOXICILLIN/CLAV TAB 875M,12.6
,
AMOXICILLIN/CLAV 1000MG,10.95
,
ANTIPYRINE/BENZOCAINE OTI,29.5
,
CELECOXIB CAP 100MG,11.85
,
SULFASALAZINE DR TAB 500,4.3
,
TRIAMCINOLONE ACETONIDE I,24
,
VITAMIN B-6 TAB 100 MG,3.6
BACITRACIN 15 GM OINT,16
,
BACTERIOSTATIC WATER FOR,3.6
,
BCG INRAVESICAL VIAL,348.5
,
SULFAMETH/TRIMET 200MG/40,9.45
,
DICYCLOMINE CAP 10MG,4.6
,
METFORMIN TAB 850MG,5.7
,
OXYCODONE ORAL SOLN 5MG/,19.05
,
PRAMIPEXOLE TAB 0.25MG,8.75
,
OXYCODONE ER TAB 10MG [*,11.65
,
OXYCODONE TAB 5MG [*],4.5
,
PEN G BENZ/PEN G PROC C-R,282.45
,
BISACODYL EC TAB 5MG[*],3.7
,
BISACODYL SUPP 10MG [*],4.3
,
BISOPROLOL/HCTZ TAB 2.5M,5.55
,
BISOPROLOL/HCTZ TAB 5MG/,9.6
,
BISOPROLOL/HCTZ TAB 10MG/,9.6
,
PINK BISMUTH LIQUID 262M,9.3
,
BOTULINUM TOXIN VIAL 100,"1,314.70"
,
BISMUTH SUBSALICYLATE CHE,3.75
,
TERBUTALINE INJ 1MG/ML,55.4
,
TERBUTALINE TAB 2.5MG,6.4
,
BRIMONIDINE OPHTH SOL 0.1,345.5
,
BISOPROLOL TABLET 5MG,5.95
,
BUMETANIDE VIAL 1 MG/ 4ML,21.05
,
BUMETANIDE TAB 1MG [*],5.5
,
BUSPIRONE TAB 5MG,4.9
,
VITAMIN C TAB 500MG [*],3.65
,
VITAMIN D TAB 400 IU,4.05
,
VERAPAMIL TAB 80MG (PLA,4.55
,
VERAPAMIL TAB 180MG ER,7.6
,
VERAPAMIL ER TAB 240MG,6.45
,
CALCIUM CHLORIDE SYRINGE,34.95
,
CALCIUM GLUCONATE VIAL 10,24.4
,
CAPTOPRIL TAB 25MG,6.75
,
SUCRALFATE TAB 1GM [*],4.65
SUCRALFATE ORAL SUSP UD C,22.35
,
CARBACHOL OPHTH SOLN 0.01,53
,
CARBAMIDE PEROXIDE EAR WA,17.5
,
CARBIDOPA/LEVODOPA TAB 25,5.2
,
DILTIAZEM VIAL 25 MG/ 5,21.1
,
DILTIAZEM TAB 30MG [*],4.35
,
ofloxacin ophth solution 0.3%,134.75
,
CEFUROXIME TAB 250MG,13.7
,
MULTIVITAMIN LIQUID,9.75
,
MUPIROCIN 2% OINTMENT 22,12.5
,
MENTHOL/BENZOCAINE LOZENG,3.85
,
PHENOL LOZENGE CHERRY,3.55
,
CEPHALEXIN ORAL SUSP 250M,60.75
,
CEPHALEXIN CAP 250MG [NOT,5.05
,
CEPHALEXIN CAP 500MG,5.7
,
CETACAINE SPRAY [NOT STOC,11.75
,
PHENOL THROAT SPRAY,17.25
,
QUINAPRIL TAB 10MG,5.7
,
ACETAMINOPHEN CHEW TAB 80,3.65
,
CHLORAL HYDRATE ORAL SYRU,4.7
,
CHLORDIAZEPOXIDE CAP 10MG,4.65
,
CHLORHEXIDINE ORAL RINSE,27.9
,
CIPROFLOXACIN BAG 400MG/2,22.9
,
CIPROFLOXACIN 0.3% OPH,27.5
,
CILOSTAZOL TAB 100MG [*],6.8
,
MAGNESIUM CITRATE ORAL SO,14.4
,
Mitomycin 20mg vial,"1,290.60"
,
CEFOTAXIME VIAL 1GM,28.2
,
CEFTRIAXONE 1GM BAG,41.6
,
CEFAZOLIN 1GM BAG,29.75
,
CEFTRIAXONE VIAL 1GM [*],43
,
CLINDAMYCIN CAP 150MG [*],4.65
,
CLINDAMYCIN ADD-V VIAL 60,18.65
,
CLINDAMYCIN 150MG/ML 6ML,28.85
,
CLINDAMYCIN IV 900MG/50ML,17.15
CLONIDINE TAB 0.1MG [*],3.95
,
CLOTRIMAZOLE 1% CREAM 30,29
,
CYCLOSPORIN OPH 4ML,375.75
,
COCAINE 4% 4ML,405.15
,
PROBENECID 500MG TAB [NOT,5.6
,
COLCHICINE TAB 0.6MG [*],18.15
,
PROCHLORPERAZINE SUPP 25M,26.15
,
PROCHLORPERAZINE VIAL 10,56.5
,
PROCHLORPERAZINE TAB 5M,4.6
,
HYDROCORTISONE ACETATE TA,7.25
,
AMIODARONE VIAL 450MG / 9,26
,
AMIODARONE TAB 200MG [*],4.6
,
COSYNTROPIN VIAL 0.25 MG,227.33
,
NADOLOL TAB 40MG,16.55
,
NEOM/POLY/BAC/HC OPHTH OI,126.25
,
CIPROFLOX/DEXAMETH OTIC S,481.25
,
WARFARIN TAB 1MG,7.95
,
WARFARIN TAB 2.5MG,8.3
,
WARFARIN TAB 2MG [*],8.15
,
WARFARIN TAB 3MG,8.35
,
WARFARIN TAB 4MG,8.35
,
WARFARIN TAB 5MG [*],8.5
,
CYCLOPENTOLATE OPHTH SOLN,39.25
,
VITAMIN B-12 VIAL 1000MCG,27.25
,
CYCLOBENZAPRINE TAB 10MG,3.65
,
MISOPROSTOL TAB 100MCG,5
,
EYE WASH IRRIGATING SOLN,15.25
,
CYCLOPHOSPHAMIDE LYOPH V,887
,
ETOPOSIDE MDV 100MG/5ML,34.45
,
DOXORUBICIN HCL VIAL 50 M,81.3
,
TOPOTECAN VIAL 4MG/4ML [,"2,169.45"
,
DIVALPROEX ER TAB 500MG,10.4
,
VALPROIC ACID 250MG/5ML S,3.8
,
DIVALPROEX TAB 250MG,6.7
,
VALPROATE VIAL 500 MG/ 5M,31
ESTRADIOL TAB 0.5MG,4.55
,
DEPOMETHYLPRED 40mg,34.35
,
DOXAZOSIN TAB 2MG [*],5.35
,
DEPOMETHYLPRED 80 mg,51.15
,
DEXAMETHASONE TAB 0.5MG,3.9
,
DEXAMETHASONE TAB 4MG,5.7
,
DEXAMETHASONE SDV 4MG/ML,21.25
,
DEXAMETHASONE 10MG/ML SDV,14.35
,
DEXTROSE SYRINGE 50% - 50,34.2
,
GLYBURIDE TAB 2.5MG [NOT,4.35
,
GLYBURIDE TAB 5MG [*],3.95
,
DIAZEPAM SYRINGE 10 MG /,75.6
,
DIAZEPAM MDV 5MG/ML 10 ML,95.3
,
DIAZEPAM TAB 2MG NOT STOC,3.75
,
DIAZEPAM TAB 5MG [*],4.1
,
FLUCONAZOLE TAB 100MG,46.7
,
DILTIAZEM CD CAP 120MG [*,4.3
,
DILTIAZEM CD CAP 180MG [*,4.45
,
PHENYTOIN CAP 100MG [*],4.25
,
PHENYTOIN INFATABS 50MG,5.65
,
DIPHENHYDRAMINE ORAL LIQU,8.2
,
DIPHENHYDRAMINE TAB 25MG,3.6
,
DIPHENHYDRA 2% CREAM,16.25
,
DIPHENOXY/ATROPINE TAB 2.,5.1
,
DIPHENHYDRAMINE VIAL 50M,22.45
,
DARBEPOETIN SYRINGE 300MC,"5,027.05"
,
PROPOFOL VIAL IV 200 M,21.7
,
DARBEPOETIN SYRINGE 200MC,"3,355.20"
,
FEXOFENADINE TAB 60 MG (N,6.25
,
Melatonin 3mg tablet,3.75
,
DIPYRIDAMOLE TAB 50MG,5.2
,
ASPIRIN/DIPYRIDAMOLE CAP,26.2
,
FIBER-LAX TAB 625 MG,3.95
,
INDAPAMIDE 1.25MG TAB,4.22
,
FULVESTRANT 250MG/5ML (2,"1,745.45"
OXYBUTYNIN XL TAB 5MG [,9.45
,
OXYBUTYNIN TAB 5MG [*],4.4
,
DISOPYRAMIDE CAP 100MG,8.65
,
DOBUTAMINE VIAL 250MG/20M,28.5
,
DOCUSATE SODIUM CAP 100MG,3.85
,
DIFLUNISAL TAB 500MG,7.25
,
BELLADONNA ALK/PHENOBARB,5.5
,
DOPAMINE BAG 400 MG D5W 2,42.85
,
DOPAMINE 400 MG/10 ML VIAL,20.6
,
DOXEPIN CAP 25MG[*],5.05
,
DOXEPIN CAP 10MG [*],4.65
,
DOXYCYCLINE TAB 100MG [*],6
,
DOXYCYCLINE MDV 100MG/10M,68.7
,
DONEPEZIL 5MG TAB,17.55
,
LOSARTAN TAB 25MG [*],6.4
,
MORPHINE PF AMP 5 MG/ 10,40.1
,
TRIAMTER/HCTZ CAP 37.5/2,4.35
,
VITAMIN E CAP 200IU,3.1
,
VITAMIN E CAP 400IU [*],3.7
,
MONSEL'S SOLUTION 1 OZ,12.93
,
ERTAPENEM VIAL 1GM,294.45
,
LIDOCAINE/PRILOCAINE CREA,12
,
HEPATITIS-B VACC ADULT SD,134.9
,
EPHEDRINE VIAL 50MG/ML,118.65
,
EPINEPHRINE AMP 1:1000 1M,14.47
,
EPINEPHRINE SYRINGE 1:100,26.35
,
ERYTHROMYCIN DR TAB 250MG,4.75
,
ERYTHROMYCIN OPHTH OINT T,42.75
,
CALCIUM ACETATE CAP 667MG,5.05
,
FENTANYL PATCH 100MCG/HR,150.75
,
FENTANYL PATCH 50MCG/HR,56.5
,
FENTANYL PATCH 75MCG/HR,81.5
,
FERROUS SULF TAB 325MG (5,3.65
,
METRONIDAZOLE TAB 250MG,4.75
,
GLYCERIN SUPP ADULT [*],3.85
FLUTICASONE/SALMETEROL DI,336.75
,
LOSARTAN TAB 50MG,7.6
,
FLUTICASONE/SALMETEROL DI,336.75
,
FLUVASTATIN XL TAB 80MG [,26.75
,
FLUVASTATIN CAP 20MG [NOT,14.55
,
FLUDARABINE VIAL 50MG [NO,677.15
,
FLUORESCEIN SODIUM A.T OP,9.5
,
FLUOROURACIL VIAL 1GM/20M,29.5
,
FLURAZEPAM CAP 15MG,4.85
,
FOLIC ACID TAB 1MG [*],4.15
,
FOLIC ACID MDV 5MG/ML 10,5
,
FOLIC ACID TAB 400MCG,3.6
,
FLUOXETINE CAP 20MG [*],8.05
,
ISOFLURANEFOR INHALATION,9.5
,
CEFTAZIDIME VIAL 1GM,25.6
,
FLURBIPROFEN 0.03% OPTH S,24.75
,
CEFTAZIDIME VIAL 2GM,31.25
,
POLYETHYLENE GLYCOL 17 GM,6.9
,
GENTAMICIN OPHTH OINT 0.,73
,
GENTAMICIN CREAM 0.1% [N,9.5
,
GENTAMICIN OPHTH SOLN 3MG,43.75
,
GEMFIBROZIL TAB 600MG,7.7
,
GENTAMICIN VIAL 80 MG/ 2,18.25
,
CORTROSYN 0.25MG VIAL,241.7
,
GLIMEPIRIDE TAB 2MG,5.1
,
GLUCAGEN VIAL 1MG,382.2
,
GLIPIZIDE TAB 5MG [*],4.3
,
METFORMIN TAB 500MG [*],4.8
,
GLUCOSE GEL 45 TUBE [NOT,3.7
,
GLIPIZIDE XL TAB 5MG [*],4.8
,
GLUCOSE GEL 15 TUBE,10.65
,
GUAIFENESIN/CODEINE SYRUP,4.55
,
GUAIFENESIN CUP 200MG/10M,4.65
,
GUAIFENESIN/CODEINE/PSEUD,3.7
,
GUAIFENESIN/DEXTROMETH CU,4.85
HALOPERIDOL TAB 1MG,4.4
,
HALOPERIDOL VIAL 5MG/ML [,14.1
,
SIMVASTATIN TAB 20MG [*],12.4
,
CARVEDILOL TAB 3.125MG [,7.05
,
CEFPODOXIME TAB 200MG [NO,18.75
,
HEPARIN LOCK FLUSH MDV 10,8
,
SIMVASTATIN TAB 5MG,6.9
,
HEPARIN BAG 25000 UNITS/,34.9
,
"HEPARIN MDV 10,000 UNITS/",32.25
,
EUCERIN (HYDROUCERIN) CRE,17.75
,
HYDRALAZINE TAB 25MG,4
,
HYDROCHLOROTHIAZIDE TAB 2,3.8
,
HYDROCOD/ACET TAB 5MG/50,3.8
,
HYDROCOD/ACET ELIX 7.5MG/,16.1
,
HYDROCHLOROTHIAZIDE 12.5,4.3
,
HYDROCORTISONE CREAM 1% 3,14
,
HYDROCORTISONE CREAM 2.5%,166.25
,
HYDROMORPHONE TAB 2MG [*],4.8
,
HYDROMORPHONE VIAL/AMP 2M,25.85
,
SIMVASTATIN TAB 40MG [*],12.4
,
HYDROXYZINE TAB 10MG,4
,
QUINAPRIL 20MG TAB,5.85
,
HYDROXYZINE TAB 25MG [*],4.25
,
HYDROXYZINE CAP 25MG [*],4.05
,
TERAZOSIN HCL CAP 1MG,6.1
,
TERAZOSIN HCL CAP 5MG,6.1
,
DIBUCAINE 1% OINTMENT TUB,20
,
HYOSCYAMINE SL TAB 0.125M,5.05
,
IMIPRAMINE TAB 25 MG,4.8
,
LOPERAMIDE CAP 2MG [*],5.1
,
LOPERAMIDE ORAL SOLN 1MG/,3.6
,
DROPERIDOL VIAL 5 MG/ 2 M,31.2
,
PROPRANOLOL VIAL 1MG/ML,33.8
,
PROPRANOLOL LA CAP 80MG,7.95
,
INDOMETHACIN CAP 25MG,4.25
IRON DEXTRAN VIAL 100MG/2,68.8
,
FAT EMULSION 10% 500ML [B,16.6
,
IOPAMIDOL VIAL 61% 30 ML,108.1
,
COSOPT OPTH 10ML,394
,
LMD 10% BAG IN 0.9% SOD,75.5
,
POTASSIUM TAB 10 MEQ [*],4.7
,
POTASSIUM TAB 20 MEQ [*],4.75
,
POTASSIUM EFFERV TAB 25 M,4.1
,
INSULIN NOVOLOG (ASPAR,43
,
INSULIN 70/30 MDV - 100 U,31
,
INSULIN NPH MDV 100 UN,31
,
INSULIN REGULAR MDV 100 U,31
,
TRIAMCINOLONE ACET 0.1% I,154.25
,
CLONAZEPAM TAB 0.5MG [*],4.95
,
KETAMINE 200 MG/20 ML,48.5
,
KETOPROFEN CAP 50MG [NOT,5.55
,
KETOCONAZOLE CREAM 2% 15G,64.75
,
LABETALOL MDV 100 MG/ 20,12.4
,
LUBRIFRESH OPH OINT,20.75
,
LACTOBACILLUS CAPSULE,4
,
LACTULOSE SYRUP 10 GM/15,5
,
LANOLIN HYDROUS 28 GM TUB,13
,
DIGOXIN ELIXIR 0.05MG/ML,8.55
,
DIGOXIN IMMUNE FAB VIAL 4,"6,785.05"
,
DIGOXIN TAB 0.125MG [*],6.55
,
DIGOXIN TAB 0.25MG [NOT S,5.5
,
DIGOXIN AMP 0.5 MG/ 2 ML,28.4
,
FUROSEMIDE TAB 20MG (*),3.8
,
FUROSEMIDE VIAL 20MG/2ML,25.4
,
FUROSEMIDE TAB 40MG [*],3.9
,
LEUCOVORIN VIAL 50MG/10M,62
,
FUROSEMIDE VIAL/PFS 40MG/,24.15
,
CHLORDIAZEPOX-CLIDINIUM,12.8
,
LIDOCAINE BAG 0.4% IN D5W,29.1
,
LITHIUM CARBONATE CAP 150,3.85
METOPROLOL TAB 50MG [*],3.75
,
LORAZEPAM TAB 0.5MG [*],4.2
,
BENAZEPRIL TAB 10MG [*],5.2
,
ENOXAPARIN SYRINGE 30MG/,55.35
,
CLOTRIM/BETAMETH CREAM 15,45.5
,
LEUPROLIDE ACETATE FOR IN,"1,302.05"
,
LEVALBUTEROL UD INH SOLN,11.2
,
LEVOFLOXACIN BAG 250MG IN,26.45
,
LEVOFLOXACIN BAG 500MG IN,29.05
,
"PROCRIT 20,000 UNITS/ML","1,122.70"
,
KETOTIFEN EYE DROP,83.75
,
CALCIUM CITRATE + D3,3.9
,
HYDROCOD/IBUP TAB 7.5MG/2,5.6
,
LEVOFLOXACIN 750MG/ 5%,32.6
,
NITROFURANTOIN MACRO CAP,9.85
,
NITROFURANTOIN CAP 50MG,8.5
,
MAGNESIUM SULF VIAL 50% 1,16.55
,
MAGNESIUM OXIDE TAB 400MG,3.7
,
MANNITOL VIAL 25% - 12.5,21.25
,
BUPIVACAINE/ EPI MPF VIAL,19.95
,
BUPIVACAINE MPF VIAL 0.5%,19.85
,
BUPIVACAINE MPF VIAL 0.25,15
,
BUPIVACAINE/ EPI MPF VIAL,19.3
,
CALCITONIN SALMON NASAL S,194.25
,
MECLIZINE TAB 25MG [*],5.05
,
METHYLPREDNISOLONE 4MG TAB,7.4
,
MEGESTROL TAB 40MG,6
,
MEGESTROL ACETATE ORAL SO,8.9
,
THIORIDAZINE 10MG TAB [NO,4.2
,
MENTHOLATUM OINTMENT 1OZ,31
,
MEPERIDINE VIAL 50 MG/ML [,21.25
,
MESALAMINE CAP 500MG,16.65
,
PSYLLIUM SMTH TEXTURE S/F,3.95
,
TENECTEPLASE KIT 50MG,"10,919.60"
,
BENZONATATE CAP 100MG,4.85
METHENAMINE TAB 1GM [NOT,3.95
,
METHOTREXATE TAB 2.5MG,14.75
,
CEFEPIME 1 GM IV BAG,41.85
,
METHYLENE BLUE 1% VIAL 1,378.95
,
METHYLERGONOVINE AMP 0.2,31.95
,
METHOCARBAMOL TAB 500MG,4.25
,
METHOCARBAMOL VIAL 1000 M,225.3
,
METHYLDOPA TAB 250MG,4.2
,
METRONIDAZOLE PREMIX BAG,20.45
,
METOPROLOL TARTRATE VIAL,18.8
,
ENOXAPARIN SYRINGE 60MG/,37.3
,
ENOXAPARIN SYRINGE 80MG/,37.45
,
ENOXAPARIN SYRINGE 120MG/,187.15
,
ENOXAPARIN SYRINGE 100MG/,54.45
,
MILK OF MAGNESIA CUP 30ML,7.75
,
MINERAL OIL (ORAL) 30ML,9.45
,
MOEXIPRIL TAB 7.5MG [NO,6
,
MICONAZOLE NITRATE 2% CRE,21.75
,
FUROSEMIDE ORAL SOLN 10MG,3.85
,
MORPHINE ORAL SOLN BTL 20,9.3
,
MORPHINE SULFATE TABLET 1,6.85
,
MORPHINE SULFATE TAB 15MG,5.15
,
MORPHINE SULFATE VIAL/CAR,20.6
,
IBUPROFEN UD CUP 100MG/5M,5.1
,
IBUPROFEN TAB 200MG [*],3.65
,
IBUPROFEN TAB 400MG [*],4
,
IBUPROFEN TAB 600MG [*],4.15
,
IBUPROFEN TAB 800MG [*],4.25
,
MORPHINE SULFATE VIAL/CAR,20.6
,
MORPHINE SULFATE TABLET 3,9.5
,
ACETYLCYSTINE SOLN 20% (2,18.5
,
MOXIFLOXACIN TAB 400MG [,69.3
,
MULTIVITAMIN TABLET [*],3.65
,
MULTIVITAMIN WITH MINERAL,3.7
,
MULTIVITAMINS (IV) (2 X 5,38.35
CLOTRIMAZOLE TROCHE TAB 1,6.1
,
NYSTATIN/TRIAMCINOLONE CR,210.5
,
"NYSTATIN CREAM 100,000 UN",40.5
,
"NYSTATIN POWDER 100,000 U",58.45
,
SIMETHICONE CHEWABLE TAB,3.7
,
SIMETHICONE 80MG/1.2ML OR,9.25
,
PRIMIDONE 250MG TAB,4.95
,
NAPROXEN 375MG TAB [NOT S,5.5
,
NAPROXEN 500MG TAB,5.7
,
NICARDIPINE PREMIX 20MG/200ML BAG,221.7
,
NALOXONE 0.4MG/ML (IV),21.26
,
NEOM/POLY/BAC OPHTH OINT,111.75
,
NEOSTIGMINE MDV 1:1000 1,15
,
PHENYLEPHRINE OPHTH BOTT,54.5
,
PHENYLEPHRINE 2.5% 3ML OP,22.25
,
INJ. FILGRASTIM G-CSF 1 MCG,"1,159.40"
,
BUPIVACAINE 0.5% 50ML VIAl,5
,
NICOTINE PATCH 14MG (*),7.4
,
NICOTINE PATCH 21MG [*],7.4
,
NIFEDIPINE CAP 10MG,5.7
,
POLYSACCHARIDE IRON COMPL,4
,
NITROGLYCERIN CAP 2.5MG,5.15
,
NITROGLYCERIN CAP 6.5MG,4.95
,
NITROGLYCERIN PATCH 0.2MG,12
,
NITROGLYCERIN PATCH 0.4MG,12.5
,
NITROGLYCERIN PATCH 0.3MG,21.25
,
NITROGLYCERIN SUBLINGUAL,6.2
,
NITROPRUSSIDE VIAL 25MG/M,259.5
,
TAMSULOSIN CAP 0.4MG [*],5.05
,
ORPHENADRINE VIAL 60 MG/,42.45
,
LABETALOL TAB 100MG [*],4.5
,
AMLODIPINE TAB 5MG [*],4.25
,
NAFCILLIN 2 GM VIAL [NOT,67.5
,
NALBUPHINE MDV 10 MG / ML,12.8
,
NULYTELY ORAL SOLN 4 LITE,66.7
NALBUPHINE 10MG/ML 1ML,19.35
,
SALINE NASAL SPRAY [*],16.75
,
OPIUM - BELLADONNA 16A SU,63.75
,
GUAIFENESIN LA TAB 600MG,5.3
,
GUAIFENESIN/DEXTROMETH TA,4.6
,
CALCIUM/ VIT D TAB 600 MG,4.7
,
COMBIGAN 0.2 - 0.5% 5mL,357
,
NORTRIPTYLINE CAP 10MG,4.3
,
PANTOPRAZOLE TAB 40MG [,10.85
,
NORTRIPTYLINE SOLN 10MG/5,3.75
,
NORTRIPTYLINE CAP 25MG,5.1
,
CANDESARTAN TAB 16MG,12.6
,
PACLITAXEL VIAL 300MG/50,295.8
,
Eliquis 5mg,15
,
morphine vial 4mg/mL,15.6
,
TRANYLCYPROMINE TAB 10MG,10
,
PROPAFENONE TAB 150MG,5.2
,
TRASTUZUMAB VIAL 21MG/ML,"8,519.25"
,
LATANOPROST 0.005% OPHTH,36
,
PROPARACAINE OPHTH SOLN,88
,
ALBUTEROL/IPRATROP MDI 14,813.75
,
ALBUTEROL/ IPRATROP NEBUL,7.5
,
PREDNISOLONE ORAL SOLN 5,10.9
,
ZOLEDRONIC ACID VIAL 1MG,"1,732.35"
,
PENICILLIN VK TAB 250MG,3.95
,
PENICILLIN VK 250MG/5ML O,9.15
,
PENICILLIN G POT VIAL 5,43.85
,
PEGFILGRASTIM INJ 6 MG/ 0,"13,470.60"
,
FAMOTIDINE TAB 20MG [*],7.9
,
FAMOTIDINE BAG 20MG/50ML,26.9
,
FELODOPINE TAB 5MG,6.25
,
OXYCODONE/APAP TAB 5MG/,6
,
SULFAMETH/TRIMETHO SS,4.7
,
PHENAZOPYRIDINE TAB 100MG,5.45
,
PROMETHAZINE 6.25MG/5ML O,3.65
PROMETHAZINE SUPP 25MG,35.4
,
PROMETHAZINE TAB 25MG [*],4.5
,
PROMETHAZINE AMP 25MG/M,20.5
,
PROMETH/COD SYRUP 6.25MG,4.25
,
PROMETHAZINE SUPP 12.5MG,35.4
,
PHENOBARBITAL TAB 64.8MG,5.05
,
PHENOBARB 32.4 MG,5.05
,
TRAMADOL/ACETAMIN 37.5MG/,5.45
,
PHENOBARBITAL ELIXIR 4MG/,3.85
,
Ferric Carboxymaltose 750mg/15mL,"1,939.95"
,
PHENYTOIN VIAL 100MG/2 ML,19.25
,
PIPERACILLIN/TAZO 4.5G,44.7
,
PIPERACILLIN/TAZOBACTAM V,34.9
,
PIOGLITAZONE TAB 15MG,16.15
,
PIPERACILLIN/TAZOBACTAM V,42.3
,
PNEUMOCOCCAL 23 VACCINE 0,20.2
,
OXYTOCIN 10U/ML 1ML MDV 1,20.15
,
"POLYMIXIN-B MDV 500,000 U",45.1
,
POTASSIUM CHLORIDE VIAL 2,18.7
,
POTASSIUM CHLORIDE VIAL 4,19.9
,
PREDNISOLONE ACET 1% OPHT,108.75
,
PREDNISONE TAB 1MG,4
,
PREDNISONE TAB 5MG,3.95
,
PREDNISONE TAB 10MG [*],4
,
PREDNISONE TAB 20MG,3.8
,
CONJUGATED ESTROGEN TAB 0,15.1
,
ESTRACE 0.01% VAGINAL CREAM,16.5
,
OMEPRAZOLE CAP 20MG [*],11.05
,
LISINOPRIL TAB 10MG [*],3.8
,
PROCAINAMIDE MDV 500 MG/,30.05
,
LISINOPRIL TAB 5MG,5.1
,
PROCALAMINE BOTTLE 1000ML,72.55
,
EPSOM SALT (TOPICAL) 4 LB,38.53
,
PRAMOXINE FOAM 1%,118
,
PRAMOXINE/HYDROCORT CREAM,30
PROPRANOLOL TAB 20MG,5.6
,
PROTAMINE VIAL 50 MG/ 5ML,43.05
,
PANTOPRAZOLE (IV) VIAL 40,27.3
,
ALBUTEROL MDI 90MCG [*],60.75
,
Opdivo 40mg/4mL,"1,826.90"
,
ALBUTEROL ORAL LIQ 2MG/5M,3.65
,
MEDROXYPROGESTERONE TAB 1,4.4
,
PSEUDOEPHEDRINE SYRUP 30M,3.55
,
PSEUDOEPHEDRINE TAB 30MG,3.09
,
QUINIDINE GLUC ER TAB,6
,
QUINIDINE SULF ER TAB 300,5.4
,
QUINIDINE MDV 80 MG/ML -,7.05
,
QUINIDINE TAB 200MG,3.9
,
RABEPRAZOLE TAB 20MG [NO,41.3
,
RACEPINEPHRINE UD VIAL 2.,12.25
,
METOCLOPRAMIDE TAB 5MG,4.25
,
METOCLOPRAMIDE TAB 10MG,4.05
,
METOCLOPRAMIDE VIAL 10 MG,20.15
,
METOCLOPRAMIDE 5MG/5ML OR,3.65
,
NABUMETONE TAB 500MG,5.85
,
REPAGLINIDE TAB 1MG,10.25
,
RHO D IMMUNE GLOBULIN (HU,184.95
,
DIMETHYL SULFOXIDE-50 VIA,"1,237.25"
,
BENEFIBER POWDER 1.5 GM F,4
,
RISPERIDONE TAB 0.5MG [,11.2
,
RITUXIMAB VIAL 500 MG/ 50,"6,200.85"
,
RIVASTIGMINE CAP 1.5MG,15.9
,
SODIUM CHLORIDE TABLET 1G,3.65
,
ROSIGLITAZONE 4MG TABLET,11.95
,
GLYCOPYRROLATE VIAL 1 MG/,115.5
,
GOSERELIN SYRINGE 10.8MG,"3,931.90"
,
CEFTRIAXONE ADD-V VIAL 2G,55.9
,
CEFTRIAXONE VIAL 2GM [*],17.7
,
FLUMAZENIL MDV 0.5 MG / 5,23.8
,
SODIUM CHLORIDE UD VIAL 0,3.8
SODIUM CHLORIDE SYRINGE 0,4.8
,
SENNA TAB 8.6MG [*],3.65
,
SENNA/DOCUSATE SOD TAB 8,3.7
,
SULFAMETH/TRIMETH (IV) MD,43.6
,
bendamustine 25mg,980.7
,
SODIUM CHLORIDE VIAL 0.9% 10 mL,6.1
,
SALSALATE TAB 750MG,4.95
,
SALMETEROL 50MCG DISKUS,22.75
,
SILVER SULFADIAZINE 1% CR,9.5
,
SILVER NITRATE APPLICATOR,10.25
,
CARBIDOPA/LEVODOPA TAB 25,5
,
CARBIDOPA/LEVODOPA TAB CR,5.2
,
MAG-DELAY TAB 64MG,3.8
,
SULFAMETH/TRIMET DS TAB,4.05
,
SODIUM BICARB SYRINGE 4.2,39.85
,
ROSUVASTATIN TAB 5MG,22.3
,
SODIUM BICARB SYRINGE 8.4,34.35
,
SOD CIT/ CITRIC ACID SOLN,5.45
,
SODIUM POLYSTYRENE SUSP,23.75
,
METHYLPREDNISOLONE VIAL 125 mg,37.45
,
METHYLPREDNISOLONE VIAL 4,29.5
,
METHYLPREDNISOLONE VIAL,139.2
,
SOTALOL TAB 80MG [*],7.7
,
SILVER SULFADIAZINE 1% CR,36
,
calmoseptine ointment,9.25
,
ER-calmoseptine,20
,
BUTORPHANOL VIAL 2MG/ML (,22.05
,
CALCIUM GLUCONATE VIAL 1,18.05
,
FENTANYL SDV /AMP/PFS 100,19.25
,
SULINDAC TAB 150MG,5.3
,
SULINDAC TAB 200MG,6.25
,
SEVOFLURANE/15 MIN,10.75
,
AMANTADINE CAP 100MG [*],9.8
,
LEVOTHYROXINE TAB 100 MCG,4.55
,
LEVOTHYROXINE TAB 50 MCG,4.4
LEVOTHYROXINE TAB 75 MCG,4.5
,
LEVOTHYROXINE TAB 125 MCG,4.7
,
LEVOTHYROXINE TAB 112 MCG,6.05
,
LEVOTHYROXINE TAB 88 MCG,4.5
,
CARBAMAZEPINE CHEW TAB 10,4.7
,
TEMAZEPAM CAP 15MG [*],4.8
,
TETANUS/DIPHTHERIA ADSORB,63.2
,
TETANUS TOXOID ADSORBED [,98.4
,
TETRACAINE HCL 0.5% OPHTH,29
,
THEOPHYLLINE TAB 200MG,4.8
,
THEOPHYLLINE TAB 300MG,4.75
,
THIAMINE TAB 100MG,4.1
,
THIAMINE MDV 100MG/ML [*],18.45
,
CHLORPROMAZINE AMP 25MG/M,65.65
,
CHLORTHALIDONE TAB 25MG [,5.7
,
CHOLESTYRAMINE PACKET 4GM,12.7
,
TICLOPIDINE 250MG TAB [NO,7
,
TIMOLOL MAL 0.5% OPHTH SO,20
,
TOBRAMYCIN/DEXAMETH 0.3%/,474.25
,
TOBRAMYCIN/DEXAMETH 0.3%/,271
,
TOBRAMYCIN MDV 80 MG / 2M,6.7
,
TOLTERODINE LA CAP 2MG,25.2
,
TRIAMCINOLONE VIAL 40MG,29.9
,
TOLTERODINE LA CAP 4MG [N,29.8
,
METOPROLOL SUCCINATE XL T,5.75
,
TIMOLOL MAL 0.5% OPHTH GE,400.25
,
KETOROLAC TAB 10MG,7.4
,
KETOROLAC VIAL 60 MG/ 2 M,25
,
ATRACURIUM MDV 10MG/ML (1,44.6
,
TRAZODONE HCL TAB 50MG,4.3
,
PENTOXIFYLLINE TAB 400MG,6.2
,
TROPICAMIDE 1% OPHTH SOLN,34.25
,
TRIAMCINOLONE ACET 0.1% C,26.25
,
TRIAMTER/HCTZ TAB 75/50M,5.15
,
OCTREOTIDE LAR 20MG DEPOT,"6,747.35"
TUBERSOL MANTOUX MDV [*],28.25
,
WITCH HAZEL PADS,18.75
,
CALCIUM CARB CHEW TAB 500,3.55
,
ACETAMINOPHEN TAB 325MG [,3.6
,
ACETAMINOPHEN ELIXIR UD C,10
,
ARTIFICIAL TEARS PG 5ML,16.5
,
TRAMADOL TAB 50MG [*],4.95
,
AMIODARONE 150MG/3ML VIAL,21
,
AMPICILLIN/SULBAC ADD-V V,30.45
,
AMPICILLIN/SULBACTAM VIAL,33.15
,
ESCITALOPRAM TAB 10MG [*],11.3
,
ESOMEPRAZOLE CAP 40MG [*],19.75
,
BETHANECHOL TAB 25MG,8.35
,
BIMATOPROST 0.01% OPHT,397.75
,
TOBRAMYCIN 0.3% OPHTH SOL,35.25
,
METOPROLOL SUCCINATE XL T,5.55
,
OXCARBAZEPINE TAB 150MG,13.25
,
VANCOMYCIN VIAL 1000 MG [,29.45
,
VANCOMYCIN VIAL 500 MG,23.35
,
ENALAPRIL TAB 5MG [*],6.3
,
EPTIFIBATIDE VIAL 20 MG/,421.5
,
EPTIFIBATIDE VIAL 200 MG/,"3,039.00"
,
VASOPRESSIN MDV 20U/ML,25.75
,
VERAPAMIL VIAL (IV) 2.5MG,52.1
,
MIDAZOLAM VIAL 2 MG/ 2ML,18.5
,
VINORELBINE VIAL 10MG/ML,59.7
,
CHONDROITIN/ HYAL OPHTH S,630
,
QUETIAPINE TAB 25MG [*],11.9
,
VITAMIN K1 SYRINGE 1MG/0.,21.1
,
VITAMIN K1 AMP 10MG/ML [*,115.7
,
DICLOFENAC TAB 50MG,5.2
,
DICLOFENAC 0.1% OPHTH SOL,140.5
,
DICLOFENAC TAB 75MG,6.7
,
TOPIRAMATE 25MG TABLET [N,7.95
,
LANSOPRAZOLE CAP 30MG (*),13.7
LIDOCAINE MDV 1% 10ML [*],17.9
,
LIDOCAINE/EPINEPH MDV 1%,5
,
LIDOCAINE MDV 2 % 10 ML,5
,
LIDOCAINE/EPINEPH MDV 2%,7.4
,
LIDOCAINE MPF VIAL 0.5 %,38.5
,
LIDOCAINE/EPINEPH MDV 0.5,5
,
LIDOCAINE MPF VIAL 1% 5ML,18.85
,
LIDOCAINE MPF VIAL 2% 5M,16.8
,
LIDOCAINE/EPINEPH MPF VIA,21.3
,
LIDOCAINE SYRINGE 2% 100M,23.15
,
LIDOCAINE PATCH 5%,43.25
,
LIDOCAINE URO-JET GEL 2%,23
,
LIDOCAINE VISCOUS CUP 2%,10
,
LIDOCAINE JELLY OPH TUBE,16.25
,
LIDOCAINE JELLY TUBE 2% 5,12
,
ONDANSETRON ODT 4MG,45.1
,
LIDOCAINE JELLY 2% 30ML T,53.75
,
Procrit 40000 units/mL,"2,233.85"
,
RANITIDINE TAB 150MG [*,3.8
,
RANITIDINE ORAL SOLN 15MG,4.85
,
AZTREONAM VIAL [2 GM],161.15
,
ISOVUE-M300,188.08
,
ER-AZITHROMYCIN 250MG PAK,56.65
,
METOLAZONE TABLET 2.5MG [,9.45
,
AZITHROMYCIN VIAL 500MG [,32.55
,
AZITHROMYCIN ORAL SUSP 20,71.8
,
AZITHROMYCIN TAB 250MG [,16.8
,
AZTREONAM VIAL 1 GM,87.7
,
ZINC OXIDE OINTMENT TUBE,14.75
,
ZINC SULF CAP 220MG,3.75
,
ACYCLOVIR CAP 200MG,5.9
,
ACYCLOVIR TAB 800MG,10.15
,
ACYCLOVIR CREAM TUBE 5%,"1,326.75"
,
ACYCLOVIR VIAL 500 MG,70.5
,
SANDOSTATIN 30MG,"11,446.90"
ONDANSETRON PFS/VIAL 4 M,18.55
,
AZITHROMYCIN ORAL SUSP 10,71.8
,
ROSUVASTATIN TAB 10MG [*,19.6
,
OSELTAMIVIR 12MG/ML SUSP,12.7
,
OSELTAMIVIR CAP 75MG,31.35
,
INJECTION I/M - OR,75
,
INJECTION I/M - ER,75
,
INJECTION I/M - CLINIC,75
,
INJECTION IM-OTHER DIAGNO,75
,
INJECTION IM-OTHER THERAP,75
,
CALCIUM/ VIT D TAB 500 MG,3.7
,
METFORMIN XR TAB 500MG [N,6.1
,
LEUPROLIDE DEPOT SYRINGE,"12,618.40"
,
NEOM/POLY/GRAMICIDIN OPHT,54.75
,
HYDROCOD/ACET TAB 10MG/50,4.5
,
OLANZEPINE TAB 2.5MG [*,23.7
,
IRINOTECAN VIAL 100MG/5ML,340.5
,
BUPROPRION-SR / ER TAB 10,6.55
,
BUDESONIDE SVN VIAL 0.5 M,23.6
,
MONTELUKAST CHEWABLE TAB,14.85
,
DORZOLAMIDE OPHTH SOLN 2%,132.5
,
LEVOTHYROXINE TAB 137 MCG,4.7
,
MINOCYCLINE 100MG CAP (NO,6.55
,
ESTRADIOL TDPATCH WEEKLY,71.3
,
LANSOPRAZOLE SOLU-TAB 15M,33.4
,
CETIRIZINE ORAL SYRUP 1 M,4.05
,
FEXOFEN-PSEUDOEPHED 12 HR,5.65
,
FEXOFENADINE TAB 180 MG,7.9
,
MOMETASONE 50 MCG/ACT NAS,41
,
EPOGEN VIAL 10000/ML,567.1
,
LEVOTHYROXINE TAB 25 MCG,4.3
,
CELECOXIB CAP 200 MG,7.9
,
ZOLMITRIPTAN TAB 5 MG,61.8
,
LUTEIN CAP 6MG,3.75
,
PAROXETINE TAB 20MG,8.55
RISEDRONATE SODIUM 35MG T,63.1
,
RIZATRIPTAN 10MG TABLET [,70
,
MUSCLE RUB CREAM 3 OZ TUB,17.5
,
CITALOPRAM TAB 10 MG,8
,
TOPIRAMATE TAB 50 MG,11.5
,
SUMATRIPTAN SUCCINATE TAB,48.75
,
PROPOFOL 1% 50ML VIAL,50.25
,
VALACYCLOVIR HCL 500 MG T,16.5
,
VENLAFAXINE ER CAP 75MG,11.05
,
NIACIN ER CAP 500 MG,14.7
,
AMLODIPINE/BENAZEPRIL CAP,8.65
,
CETIRIZINE TAB 10MG [*] [,8
,
BENAZEPRIL TAB 20MG [NOT,5.25
,
ESCITALOPRAM TAB 20MG,11.65
,
AMLODIPINE/BENAZEPRIL CAP,8.65
,
ATORVASTATIN TAB 20MG (*),5.05
,
CIPROFLOXACIN TAB 500MG [,9.25
,
GEMCITABINE VIAL 1GM [NOT,112.95
,
LOVASTATIN TAB 20MG,5.8
,
WARFARIN TAB 6MG [NOT STO,8.05
,
LEVOTHYROXINE TAB 150 MCG,4.75
,
TERBINAFINE TAB 250 MG,27.05
,
FLUTICASONE HFA MDI 110MC,534.75
,
EZETIMIBE TAB 10MG [*],28.35
,
AMLODIPINE/BENAZEPRIL CAP,8.6
,
ATORVASTATIN TAB 40MG [NO,19.2
,
PRENATAL RX 1 TAB [NOT ST,4.15
,
LORATADINE TAB 10MG [*],4.8
,
MINOCYCLINE 50MG CAP [NOT,6.6
,
SODIUM CHLORIDE 0.9% 50ML MINIBAG PLUS,27.25
,
HYDROCORTISONE VIAL 100 M,25.25
,
INSULIN LISPRO PEN 100 UN,113.9
,
CLARITHROMYCIN TAB 500MG,16.1
,
RIVAXIMIN 550 MG,82.55
,
SIMVASTATIN TAB 80MG [NOT,12.35
METRONIDAZOLE GEL 45 GM T,9
,
PROPRANOLOL LA 120MG CAPS,7
,
PIROXICAM CAP 20MG [NOT S,11.6
,
METHOTREXATE VIAL 50 MG/,20
,
TANNATE SUSP 5MG/4.5MG 5M,4.3
,
PIOGLITAZONE 30 MG TABLET,46.25
,
LETROZOLE TAB 2.5 MG,36.15
,
CIMETIDINE TAB 400MG [NOT,6.15
,
METOPROLOL SUCCINATE XL T,6.55
,
LISINOPRIL TAB 20MG,5.35
,
ATORVASTATIN TAB 80MG [NO,19.2
,
TRAVAPROST 0.004% OPHTH S,376.75
,
FENOFIBRATE 134MG,7.05
,
HALFLYTELY BWL-PREP KIT [,100.81
,
RITUXIMAB VIAL 100 MG/ 10,"1,240.20"
,
INFLUENZA VIRUS VACCINE S,88.6
,
FLUCONAZOLE TAB 150MG,28.75
,
STERILE WATER INJ 10ML,6.4
,
MAG-AL PLUS UD LIQ 30ML [,8.25
,
METHADONE TAB 10 MG [*],4.45
,
LINEZOLID IV PREMIX 600MG,185
,
CARBOPLATIN VIAL 600MG/60,249.8
,
CARBOPLATIN VIAL 50MG/5ML,34.35
,
BORTEZOMIB VIAL 3.5 MG/3.,"2,998.10"
,
MICONAZOLE 100MG VAG SUPP,10.75
,
ER-ACETAMIN/CODEINE ELX 1,23.95
,
ER-AMOXICILLIN 250MG PAK,20
,
ER-AMOXICILLIN 875MG PAK,20
,
ER-AMOXICILLIN 200MG/5ML,20
,
ER-AMOXICILLIN 400MG/5ML,20
,
ER-AMOX/CLAVULANATE 500/1,27.85
,
ER-AMOX/CLAVULANATE 875/1,33.8
,
ER-AMOX/CLAV 400MG/5ML OR,47.75
,
ER-SULFAMETH/TRIMETH DS 8,24.55
,
ER-CEFUROXIME 250MG PAK #,36.4
ER-CIPROFLOXACIN 500MG PA,31.5
,
ER-NEOM/POLY/HCT OTIC SUS,30.15
,
ER-METRONIDAZOLE 250MG PA,20
,
ER-CYCLOBENZAPRINE 10MG P,22.2
,
ER-GENTAMICIN 0.3% OPHTH,28.95
,
ER-GENTAMICIN 0.3% OPHTH,31
,
ER-CEPHALEXIN 500MG PAK #,36.65
,
ER-CEPHALEXIN 250MG/5ML O,61.25
,
ER-LEVOFLOXACIN 500MG PAK,48.55
,
ER-NITROFURANTN MACRO 100,31.2
,
ER-METHYLPREDNISOLONE 4MG,40.05
,
ER-IBUPROFEN 400MG PAK #6,20
,
ER-PREDNISOLONE 5MG/5ML O,108.1
,
ER-PENICILLN VK 250MG PAK,45.7
,
ER-PROMETHAZINE 25MG PAK,20
,
ER-PROMETHAZINE 12.5MG SU,20
,
ER-PROMETHAZINE 25MG SUPP,20
,
ER-PREDNISONE 10MG PAK #1,20
,
ER-ALBUTEROL 2.5MG/3ML IN,20
,
ER-ALBUTEROL 90MCG INHALE,35.7
,
ER-PHENAZOPYRIDINE 100MG,24.35
,
ER-METHOCARBAMOL 500MG PA,26
,
ER-METAXALONE 800MG PAK #,73.4
,
ER-ACETAMINOPHEN/CODEINE,20
,
ER-TRAMADOL 50MG PAK #20,35
,
ER-DOXYCYCLINE 100MG PAK,20
,
ER-HYDROCODONE/APAP 5/325,20
,
ER-HYDROXYZINE PAMOATE 25,20
,
ER-AZITHROMYCIN 200MG/5ML,44.9
,
MONTELUKAST CHEW TAB 4MG,14.85
,
PHENYLHIST DH LIQUID (DIH,9.25
,
EZETIMIBE-SIMVASTATIN TAB,28.1
,
DAPTOMYCIN VIAL 500MG/10ML,978.8
,
ESTRADIOL ACETAT VAG RING,967.5
,
MELOXICAM TAB 7.5 MG,9.1
IMMUNE GLOBULIN IV SOL 5 gm,"1,455.50"
,
METRONIDAZOLE 0.75% CREAM,12.5
,
BUPROPION XL TAB 300 MG [,12.1
,
IMIPENEM-CILASTATIN ADD-V,70.5
,
LORATADINE SYRUP 5MG/5ML,4.75
,
VINCRISTINE VIAL 2MG/2ML,39.6
,
CAPSAICIN 0.025% CREAM 60,27
,
KCL 10MEQ/100 ML,22.75
,
EZETIMIBE-SIMVASTATIN TAB,28.1
,
eliquis 2.5 mg,15
,
IRON SUCROSE VIAL 100MG/5,124.5
,
METOPROLOL SUCCINATE XL,9.7
,
APAP / CODEINE SUSP BOTTL,9.6
,
MIGQUIN CAPSULE [NOT STOC,5.05
,
DULOXETINE CAP 60 MG,17.4
,
FLUOCINONIDE CREAM 0.05%,95.75
,
FERROUS SULFATE CR TAB 4,3.6
,
MELOXICAM TAB 15MG,11.9
,
IBANDRONATE TAB 150MG [NO,415.95
,
PACLITAXEL VIAL 100 MG,110.05
,
CISPLATIN MDV 200MG/200ML,176.35
,
OXALIPLATIN VIAL 100MG/2,"4,955.50"
,
METFORMIN TAB 1000MG,6.25
,
CEFAZOLIN 2GM BAG,36.35
,
FLUNISOLIDE MDI 250 MCG/A,34.25
,
PEMETREXED DISODIUM VIAL,"6,308.15"
,
CHLORZOXAZONE TAB 500MG,5.45
,
PREGABALIN CAP 75 MG,21.2
,
FENOFIBRATE TAB 145 MG,12.8
,
FENOFIBRATE TAB 160MG,7.8
,
OXALIPLATIN VIAL 50MG/10,"2,486.00"
,
LEUCOVORIN VIAL 350MG /,186.55
,
FLUTICASONE/SALMETEROL DI,543.25
,
FOMEPIZOLE VIAL 1 GM/ML,"2,132.05"
,
GLIMEPIRIDE TAB 4MG,9.45
DARBEPOETIN SYRINGE 100MC,"1,683.35"
,
ONDANSETRON ODT 8MG [NOT,70.35
,
DOCETAXEL VIAL 80MG/4ML,"4,298.90"
,
PREGABALIN CAP 25 MG [NOT,19.55
,
NABUMETONE 750MG TABLET [,6.3
,
HYDROXYCHLOROQUINE TAB 20,11.4
,
RAMIPRIL CAP 5MG,3.9
,
CARVEDILOL TAB 6.25MG,7.3
,
TRAMADOL ER 200MG TABLET,18.05
,
TRAMADOL ER 100MG TABLET,11.5
,
ESZOPICLONE TAB 2 MG [NOT,37.4
,
VARENICLINE TAB 1 MG,9.6
,
ALTEPLASE FOR CATHETER V,347.15
,
DARBEPOETIN PFS 40 MCG/0.,680.25
,
CAFFEINE/SOD BENZOATE VIA,39
,
HISTRELIN ACETATE IMPLANT,"8,722.20"
,
SIMVASTATIN TAB 10MG [NOT,8.55
,
BLEOMYCIN VIAL 15 UNITS/5,123.9
,
VINBLASTINE VIAL 1MG/ML [,109.55
,
DACARBAZINE VIAL 200MG/20,42.45
,
OLMESARTAN/HCTZ 40/25 TAB,24.45
,
TETANUS/DIPTHERIA/PERTUSS,106.25
,
VECURONIUM BROMIDE VIAL,35.65
,
TAMOXIFEN TAB 20MG [NOT,10.35
,
OLOPATADINE 0.2% OPHTH SO,161.25
,
IMMUNE GLOBULIN VIAL 10 G,"2,494.80"
,
Prevnar Pnuemococcal vac,412.3
,
ALENDRONATE TAB 70MG + D,72.6
,
DESOXIMETASONE CREAM 0.25,191.25
,
PANCRLIPASE (ZENPEP) CAP,8.2
,
NICOTINE PATCH 7MG/24HR,15.5
,
GRANULEX SPRAY,9.8
,
WOUND WASH SALINE CAN,9.15
,
MOXIFLOXACIN 0.5% OPHTH S,364
,
PALONOSETRON VIAL 0.25MG,995
CEFTRIAXONE ADD-V 2 GM,32.05
,
TORSEMIDE 100MG TABLET,8.75
,
HUMATE P 952,19.35
,
IRBESARTAN TAB 150 MG,9.65
,
MORPHINE SULFATE PCA 30MG,45.25
,
METOPROLOL TAB 25 MG,3.95
,
VITAMIN K1 TAB 5 MG,130.45
,
GADOBENATE MRI 15ML,200.35
,
HEPARIN CARPUJECT 5000 UN,17.7
,
ESTRADIOL VAG TAB 25MCG [,15.7
,
BETAMETHASONE OINT 0.05%,14.5
,
CISPLATIN 50MG/50ML,17.3
,
MAG SULFATE 2GM/50ML,17.15
,
NATEGLINIDE 120 MG,7.25
,
HUMATE-P 1798 IU,19.35
,
INVANZ 1 GM VIAL,294.45
,
EPINEPHRINE 0.3MG AUTO-INJ,456.1
,
EPINEPHRINE 0.15MG AUTO-INJECTOR,456.1
,
sensipar 30 mg tablet,61.6
,
Immune globuline 2.5gm,736
,
Immune Globulin 1 gm,304.3
,
Immune Globulin 20 gm,"4,973.05"
,
Immune Globulin 30 gm,"7,451.30"
,
NPLATE 250 MCG,"3,909.15"
,
SANDOSTATIN LAR DEPOT 30 MG,"13,211.60"
,
NYSTATIN SUSP 5 ML CUP,5.97
,
GEMCITABINE 2GM/52.6ML,"3,172.50"
,
nplate 500 mcg,"7,806.75"
,
PEG BOTTLE 255 GM,3.65
,
DIAZEPAM RECTAL GEL 2.5 MG,516
,
DIAZEPAM RECTAL GEL 10 MG,610.5
,
GAMUNEX-C 40 GM,40.8
,
GAMUNEX-C 2.5GM,40.8
,
DEXAMETHASONE PF 10MG/ML,22.85
,
SYSTANE EYE DROP 0.4%,10.25
gamunex-c 10 gm/100mL,40.8
,
stubbs magic mouthwash,3.85
,
ISOVUE 61% 75mL BOTTLE,16.55
,
XOLAIR 150 MG VIAL,"2,354.40"
,
NEXPLANON 68 MG IMPLANT,"1,934.55"
,
temozolomide 100 mg cap,458.15
,
temozolomide 20 mg cap,107.1
,
temozolomide 5 mg cap,29.55
,
"FLUZONE HIGH DOSE, IM",213.8
,
TRANEXAMIC ACID 1000MG/10ML,25.6
,
STELARA 90 MG SQ INJECTION,"44,473.60"
,
MEROPENEM 1 GM VIAL,40.3
,
SODIUM CHLORIDE 0.9% VIAL 50 ML,5.27
,
ENTACAPONE 200 MG TAB,11.95
,
BACLOFEN 20 MG TAB,5.7
,
LYRICA 200 MG CAP,19.55
,
OSELTAMAVIR 30 MG,18.55
,
RITUXAN HYCELA INJ,"1,225.65"
,
EOVIST 0.25MOL 10 ML,294.84
,
MORPHINE PCA 150MG/30ML,32.94
,
CEFOXITIN 1 GM VIAL,29.5
,
CEFAZOLIN ADD-V VIAL 1 GM,21.85
,
INFLECTRA 100 MG VIAL,"1,776.60"
,
DRONABINOL 2.5MG CAP,13.05
,
PANCRELIPASE 5000/17000/24000 CAP,6.85
,
JEVITY 1.5KCAL/ML 1000 ML BAG,23.56
,
SKYLA 14MCG/24 HR IUD,"1,452.80"
,
SOD CHLORIDE 3% NEB,3.5
,
CINVANTI 130MG INJ,617.47
,
OXYMETAZOLINE NASAL SPRAY 0.05%,19
,
SOD BICARB VIAL 8.4%,18.5
,
ESI ANESTHESIA,940.39
,
SPNIAL FLUID TAP DIAGNOSTIC,350
,
INTRASCALENE NERVE BLOCK,435.51
,
NERVE BLOCK INJ SUPRASCAPULAR,360
INJECTION ANESTHETIC AGENT SCIATIC NERVE,305
,
NERVE BLOCK OTHER PERIPHERAL,250
,
IV START,75
,
PICC LINE INSERTION >5 YRS,743.67
,
INJECT SACROILIAC JOINT,589.16
,
ANESTHESIA FIRST MINUTE,651.03
,
ANESTHESIA ADD'L MINUTES,9.75
,
CONCIOUS SEDATION-30 MIN,282.67
,
CONCIOUS SEDATION-ADD 15M,141.34
,
OT THER EXER-EA 15 MIN,117.13
,
OT ORTHOTIC FIT-EA 15 MIN,138.09
,
OT NUEROMUSCLE RE-ED,122.01
,
OT PARAFFIN BATH,37.2
,
OT WHEELCHAIR MGMT & TRAI,113.43
,
OT LOW COMPLEX EVAL,310
,
OT MODERATE COMPLEX EVAL,440
,
OT HIGH COMPLEX EVAL,570
,
OT REEVALUATION,105
,
THERAPEUTIC ACTIVITY - EA 15 MIN,128.04
,
OT SELF CARE ADL-EA 15 MI,126.93
,
"DEBRIDEMENT, PARTIAL",108.67
,
PARE BENIGN LES; SGL,92.47
,
"DEBRIDE NAIL, 1-5",68.42
,
"DEBRIDE NAIL, 6 OR MORE",115.83
,
Attention current status 0%,0.01
,
Attention current status 1-19%,0.01
,
Attention current status 20-39%,0.01
,
Attention current status 40-59%,0.01
,
Attention current status 60-79%,0.01
,
Attention current status 80-99%,0.01
,
Attention current status 100%,0.01
,
Attention goal status 0%,0.01
,
Attention goal status 1-19%,0.01
,
Attention goal status 20-39%,0.01
,
Attention goal status 40-59%,0.01
Attention goal status 60-79%,0.01
,
Attention goal stataus 80-99%,0.01
,
Attention goal status 100%,0.01
,
Attention @DC 0%,0.01
,
Attention @ DC 1-19%,0.01
,
Attention @ DC 20-39%,0.01
,
Attention @ DC 40-59%,0.01
,
Attention @ DC 60-79%,0.01
,
Attention @ DC 80-99%,0.01
,
Attention @ DC 100%,0.01
,
Memory current status 0%,0.01
,
Memory current status 1-19%,0.01
,
Memory current status 20-39%,0.01
,
Memory current status 40-59%,0.01
,
Memory current status 60-79%,0.01
,
Memory current status 80-99%,0.01
,
Memory current status 100%,0.01
,
Memory goal status 0%,0.01
,
Memory goal status 1-19%,0.01
,
Memory goall status 20-39%,0.01
,
Memory goal status 40-59%,0.01
,
Memory goal status 60-79%,0.01
,
Memory goal status 80-99%,0.01
,
Memory goal status 100%,0.01
,
MECHANICAL TRACTION THERA,59.92
,
ELECTRICAL STIM-UNATTENDE,50.18
,
WHIRLPOOL THERAPY,81.97
,
INFARED THERAPY,21.26
,
OT IONTOPHORESIS-EA 15 MIN,90.66
,
CONTRAST BATH THERAPY,64.2
,
ULTRASOUND THER-EA 15 MIN,46.94
,
Memory @ DC 0%,0
,
Memory @ DC 1-19%,0.01
,
Memory @ DC 20-39%,0.01
,
Memory @ DC 40-59%,0.01
Memory @ DC 60-79%,0.01
,
Memory @ DC 80-99%,0.01
,
Memory @ DC 100%,0.01
,
MANUAL THERAPY-EA 15 MIN,109.45
,
MYOFASCIAL REL-EA 15 MIN,109.45
,
CHEMICAL CAUTERIZATION GR,161.33
,
ORTHOTIC TR/15 MIN,138.09
,
PROSTHETIC TR /15 MIN,120.85
,
COGNITIVE SKILLS DEVELOPMENT,78
,
NEG PRESS WOUND TX<50CM,104.55
,
ORTHOTICS/ PROSTH MGMT/ TRAIN 15 MIN,163.16
,
Mobility current 0%,0.01
,
Mobility current 1-19%,0.01
,
Mobility current 20-39%,0.01
,
Mobility current 40-59%,0.01
,
Mobility current 60-79%,0.01
,
Mobility current 80-99%,0.01
,
Mobility current 100%,0.01
,
Mobility goal 0%,0.01
,
Mobility goal 1-19%,0.01
,
Mobility goal 20-39%,0.01
,
Mobility goal 40-59%,0.01
,
Mobility goal 60-79%,0.01
,
Mobility goal 80-99%,0.01
,
Mobility goal 100%,0.01
,
Mobility @ DC 0%,0.01
,
Mobility @ DC 1-19%,0.01
,
Mobility @ DC 20-39%,0.01
,
Mobility @ DC 40-59%,0.01
,
Mobility @ DC 60-79%,0.01
,
Mobility @ DC 80-99%,0.01
,
Mobility @ DC 100%,0.01
,
UNNA BOOT APPLICATION-LEF,222.32
,
UNNA BOOT APPLICATION-RT,222.32
,
Body pos current 0%,0.01
Body pos current 1-19%,0.01
,
Body pos current 20-39%,0.01
,
Body pos current 40-59%,0.01
,
Body pos current 60-79%,0.01
,
Body pos current 80-99%,0.01
,
Body pos current 100%,0.01
,
Body pos goal status 0%,0.01
,
Body pos goal status 1-19%,0.01
,
Body pos goal status 20-39%,0.01
,
Body pos goal status 40-59%,0.01
,
Body pos goal status 60-79%,0.01
,
Body pos goal status 80-99%,0.01
,
Body pos goal status 100%,0.01
,
Body pos @ DC 0%,0.01
,
Body pos @ DC 1-19%,0.01
,
Body pos @ DC 20-39%,0.01
,
Body pos @ DC 40-59%,0.01
,
Body pos @ DC 60-79%,0.01
,
Body pos @ DC 80-99%,0.01
,
Body pos @ DC 100%,0.01
,
Carrying objects current status 0%,0.01
,
Carrying objects current status 1-19%,0.01
,
Carrying objects current status 20-39%,0.01
,
Carrying objects current status 40-59%,0.01
,
Carrying objects current status 60-79%,0.01
,
Carrying objects current status 80-99%,0.01
,
Carrying objects current status 100%,0.01
,
Carrying objects goal status 0%,0.01
,
Carrying objects goal status 1-19%,0.01
,
Carrying objects goal status 20-39%,0.01
,
Carrying objects goal status 40-59%,0.01
,
Carrying objects goal status 60-79%,0.01
,
Carrrying objects goal status 80-99%,0.01
,
Carrying objects goal status 100%,0.01
,
Carrying objects @ DC 0%,0.01
Carrying objects @ DC 1-19%,0.01
,
Carrying objects @ DC 20-39%,0.01
,
Carrying objects @ DC 40-59%,0.01
,
Carrying objects @ DC 60-79%,0.01
,
Carrying objects @ DC 80-99%,0.01
,
Carrying objects @ DC 100%,0.01
,
Self-care current status 0%,0.01
,
Self-care current status 1-19%,0.01
,
Self-care current status 20-39%,0.01
,
Self-care current status 40-59%,0.01
,
Self-care current status 60-79%,0.01
,
Self-care current status 80-99%,0.01
,
Self-care current status 100%,0.01
,
Self-care goal status 0%,0.01
,
Self-care goal status 1-19%,0.01
,
Self-care goal status 20-39%,0.01
,
Self-care goal status 40-59%,0.01
,
Self-care goal status 60-79%,0.01
,
Self-care goal status 80-99%,0.01
,
Self-care goal status 100%,0.01
,
Self-care @ DC 0%,0.01
,
Self-care @ DC 1-19%,0.01
,
Self-care @ DC 20-39%,0.01
,
Self-care @ DC 40-59%,0.01
,
Self-care @ DC 60-79%,0.01
,
Self-care @ DC 80-99%,0.01
,
Self-care @ DC 100%,0.01
,
Other primary current status 0%,0.01
,
Other primary current status 1-19%,0.01
,
Other primary current status 20-39%,0.01
,
Other primary current status 40-59%,0.01
,
Other primary current status 60-79%,0.01
,
Other primary current status 80-99%,0.01
,
Other primary current status 100%,0.01
,
Other primary goal status 0%,0.01
Other primary goal status 1-19%,0.01
,
Other primary goal status 20-39%,0.01
,
Other primary goal status 40-59%,0.01
,
Other primary goal status 60-79%,0.01
,
Other primary goal status 80-99%,0.01
,
Other primary goal status 100%,0.01
,
"BRIEF VISIT, NEW PT",117.61
,
"LIMITED VISIT, NEW PT",223.69
,
"INTERMED VISIT,NEW PT",339.35
,
"EXTENDED VISIT, NEW PT",576.3
,
WOC EST PT-BRIEF W/PROCED,42.3
,
"BRIEF VISIT, EST PT",114.68
,
"LIMITED VISIT, EST PT",227.35
,
"INTERMEDIATE VISIT, EST P",349.53
,
Other primary @ DC 0%,0.01
,
Other primary @ DC 1-19%,0.01
,
Other primary @ DC 20-39%,0.01
,
Other primary @ DC 40-59%,0.01
,
Other primary @ DC 60-79%,0.01
,
Other primary @ DC 80-99%,0.01
,
Other primary @ DC 100%,0.01
,
Subsequent PT/OT current status 0%,0.01
,
Subsequent PT/OT current status 1-19%,0.01
,
Subsequent PT/OT current status 20-39%,0.01
,
Subsequent PT/OT current status 40-59%,0.01
,
Subsequent PT/OT current status 60-79%,0.01
,
Subsequent PT/OT current status 80-99%,0.01
,
Subsequent PT/OT current status 100%,0.01
,
Subsequent PT/OT goal status 0%,0.01
,
Subsequent PT/OT goal status 1-19%,0.01
,
Subsequent PT/OT goal status 20-39%,0.01
,
Subsequent PT/OT goal status 40-59%,0.01
,
Subsequent PT/OT goal status 60-79%,0.01
,
Subsequent PT/OT goal status 80-99%,0.01
,
Subsequent PT/OTgoal status 100%,0.01
Subsequent PT/OT @ DC 0%,0.01
,
Subsequent PT/OT @ DC 1-19%,0.01
,
Subsequent PT/OT @ DC 20-39%,0.01
,
Subsequent PT/OT @ DC 40-59%,0.01
,
Subsequent PT/OT @ DC 60-79%,0.01
,
Subsequent PT/OT @ DC 80-99%,0.01
,
PT LOW COMPLEXITY EVAL,230
,
PT MODERATE COMPLEX EVAL,312
,
PT HIGH COMPLEX EVAL,390
,
PT REEVALUATION,100
,
MEDCOSOUND,59.38
,
TENS,27.16
,
CANALITH REPOSITIONING PR,132.93
,
HOT/COLD PACKS,38.52
,
MECHANICAL TRACTION THERA,59.92
,
ELECTRICAL STIM THERAPY,69.71
,
ELECTRICAL STIM-UNATTENDE,50.18
,
VASOPNEAUMATIC DEVICE THE,68.63
,
PARAFFIN BATH THERAPY,37.2
,
WHIRLPOOL THERAPY,81.97
,
WHIRLPOOL W/WOUND CARE &,81.97
,
INFARED THERAPY,21.26
,
PT IONTOPHORESIS-EA 15 MIN,114.13
,
CONTRAST BATH THERAPY,64.2
,
ULTRASOUND THER-EA 15 MIN,46.94
,
THERAPEUTIC EX-EA 15 MIN,117.13
,
NEUROMUSCLE REED-EA 15 MI,122.01
,
GAIT TRAINING-EA 15 MIN,104
,
MANUAL THERAPY-EA 15 MIN,109.45
,
MASSAGE THERAPY-EA 15 MIN,95.84
,
MYOFASCIAL REL-EA 15 MIN,109.45
,
ORTHOTIC TR/15 MIN,138.09
,
PROSTHETIC TR /15 MIN,120.85
,
THERAPEUTIC ACTIVITY- EA 15 MIN,128.04
,
SELF CARE MGMT TRAIN-15 M,126.93
PT WHEELCHAIR MGMT & TRAI,113.43
,
ACTIV WOUND CARE/20CM OR<,91.07
,
ACTIVE WOUND CARE>20CM,42.57
,
PHYS PERFORM TEST OR MEAS,122.06
,
ASSESTIVE TECH ASSESS,134.58
,
C/O FOR ORTHOTIC/PROSTH U,163.16
,
Mobility current 0%,0.01
,
Mobility current 1-19%,0.01
,
Mobility current 20-39%,0.01
,
Mobility current 40-59%,0.01
,
Mobility current 60-79%,0.01
,
Mobility current 80-99%,0.01
,
Mobility current 100%,0.01
,
Mobility goal 0%,0.01
,
Mobility goal 1-19%,0.01
,
Mobility goal 20-39%,0.01
,
Mobility goal 40-59%,0.01
,
Mobility goal 60-79%,0.01
,
Mobility goal 80-99%,0.01
,
Mobility goal 100%,0.01
,
Mobility @ DC 0%,0.01
,
Mobility @ DC 1-19%,0.01
,
Mobility @ DC 20-39%,0.01
,
Mobility @ DC 40-59%,0.01
,
Mobility @ DC 60-79%,0.01
,
Mobility @ DC 80-99%,0.01
,
Mobility @ DC 100%,0.01
,
Body pos current 0%,0.01
,
Body pos current 1-19%,0.01
,
Body pos current 20-39%,0.01
,
Body pos current 40-59%,0.01
,
Body pos current 60-79%,0.01
,
Body pos current 80-99%,0.01
,
Body pos current 100%,0.01
,
Body pos goal status 0%,0.01
Body pos goal status 1-19%,0.01
,
Body pos goal status 20-39%,0.01
,
Body pos goal status 40-59%,0.01
,
Body pos goal status 60-79%,0.01
,
Body pos goal status 80-99%,0.01
,
Body pos goal status 100%,0.01
,
Body pos @ DC 0%,0.01
,
Body pos @ DC 1-19%,0.01
,
Body pos @ DC 20-39%,0.01
,
Body pos @ DC 40-59%,0.01
,
Body pos @ DC 60-79%,0.01
,
Body pos @ DC 80-99%,0.01
,
Body pos @ DC 100%,0.01
,
Carrying objects current status 0%,0.01
,
Carrying objects current status 1-19%,0.01
,
Carrying objects current status 20-39%,0.01
,
Carrying objects current status 40-59%,0.01
,
Carrying objects current status 60-79%,0.01
,
Carrying objects current status 80-99%,0.01
,
Carrying objects current status 100%,0.01
,
Carrying objects goal status 0%,0.01
,
Carrying objects goal status 1-19%,0.01
,
Carrying objects goal status 20-39%,0.01
,
Carrying objects goal status 40-59%,0.01
,
Carrying objects goal status 60-79%,0.01
,
Carrrying objects goal status 80-99%,0.01
,
Carrying objects goal status 100%,0.01
,
Carrying objects @ DC 0%,0.01
,
Carrying objects @ DC 1-19%,0.01
,
Carrying objects @ DC 20-39%,0.01
,
Carrying objects @ DC 40-59%,0.01
,
Carrying objects @ DC 60-79%,0.01
,
Carrying objects @ DC 80-99%,0.01
,
Carrying objects @ DC 100%,0.01
,
Self-care current status 0%,0.01
Self-care current status 1-19%,0.01
,
Self-care current status 20-39%,0.01
,
Self-care current status 40-59%,0.01
,
Self-care current status 60-79%,0.01
,
Self-care current status 80-99%,0.01
,
Self-care current status 100%,0.01
,
Self-care goal status 0%,0.01
,
Self-care goal status 1-19%,0.01
,
Self-care goal status 20-39%,0.01
,
Self-care goal status 40-59%,0.01
,
Self-care goal status 60-79%,0.01
,
Self-care goal status 80-99%,0.01
,
Self-care goal status 100%,0.01
,
Self-care @ DC 0%,0.01
,
Self-care @ DC 1-19%,0.01
,
Self-care @ DC 20-39%,0.01
,
Self-care @ DC 40-59%,0.01
,
Self-care @ DC 60-79%,0.01
,
Self-care @ DC 80-99%,0.01
,
Self-care @ DC 100%,0.01
,
Other primary current status 0%,0.01
,
Other primary current status 1-19%,0.01
,
Other primary current status 20-39%,0.01
,
Other primary current status 40-59%,0.01
,
Other primary current status 60-79%,0.01
,
Other primary current status 80-99%,0.01
,
Other primary current status 100%,0.01
,
Other primary goal status 0%,0.01
,
Other primary goal status 1-19%,0.01
,
Other primary goal status 20-39%,0.01
,
Other primary goal status 40-59%,0.01
,
Other primary goal status 60-79%,0.01
,
Other primary goal status 80-99%,0.01
,
Other primary goal status 100%,0.01
,
EVAL NEW OP-20 MIN OR LES,154.56
EVAL NEW OP-30 MIN,231.85
,
EVAL NEW OUTPT 45 MIN,311.61
,
EVAL NEW OUTPT 60 MIN,391.35
,
EVAL ESTAB OUTPT 10 MIN,71.78
,
EVAL ESTAB OP-15 MIN,103.68
,
EVAL ESTAB OUTPT 25 MIN,160.19
,
EVAL ESTAB OUTPT. 40 MIN,246.08
,
EVAL NEW OR EST INPT 30 M,231.85
,
Other primary @ DC 0%,0.01
,
Other primary @ DC 1-19%,0.01
,
Other primary @ DC 20-39%,0.01
,
Other primary @ DC 40-59%,0.01
,
Other primary @ DC 60-79%,0.01
,
Other primary @ DC 80-99%,0.01
,
Other primary @ DC 100%,0.01
,
Subsequent PT/OT current status 0%,0.01
,
Subsequent PT/OT current status 1-19%,0.01
,
Subsequent PT/OT current status 20-39%,0.01
,
Subsequent PT/OT current status 40-59%,0.01
,
Subsequent PT/OT current status 60-79%,0.01
,
Subsequent PT/OT current status 80-99%,0.01
,
Subsequent PT/OT current status 100%,0.01
,
Subsequent PT/OT goal status 0%,0.01
,
Subsequent PT/OT goal status 1-19%,0.01
,
Subsequent PT/OT goal status 20-39%,0.01
,
Subsequent PT/OT goal status 40-59%,0.01
,
Subsequent PT/OT goal status 60-79%,0.01
,
Subsequent PT/OT goal status 80-99%,0.01
,
Subsequent PT/OTgoal status 100%,0.01
,
Subsequent PT/OT @ DC 0%,0.01
,
Subsequent PT/OT @ DC 1-19%,0.01
,
Subsequent PT/OT @ DC 20-39%,0.01
,
Subsequent PT/OT @ DC 40-59%,0.01
,
Subsequent PT/OT @ DC 60-79%,0.01
,
Subsequent PT/OT @ DC 80-99%,0.01
SPEECH THERAPY-EA 15 MIN,72.12
,
SPEECH THERAPY - 30 MIN,144.21
,
SPEECH THERAPY - 45 MIN,216.31
,
SPEECH THERAPY - 1 HR,288.41
,
SPEECH THERAPY-1HR 15 MIN,360.5
,
EVALUATION OF SPEECH FLUENCY,317.93
,
EVALUATION OF SPEECH PRODUCTION,271.95
,
SWALLOWING TREAT-15 MIN,75.23
,
SWALLOWING TREAT -30 MIN,150.51
,
SWALLOWING TREAT-45 MIN,225.75
,
SWALLOWING TREAT- 1 HR,301.01
,
CLINICAL SWALLOW EVAL-15M,194.03
,
CLINICAL SWALLOW EVAL-30,388.04
,
CLINICA SWALLOW EVAL-45,582.06
,
CLINICAL SWALLOW EVAL-60,776.1
,
TRAINING FOR USE OF SGD'S,324.3
,
EX / SPEECH DEVICE RX-1HR,363.72
,
EX/SPEECH DEVICE RX-ADD30,155.64
,
VOICE PROSTHETIC TRAINING,367.49
,
Motor speech @ DC 0%,0.01
,
Motor speech @ DC 1-19%,0.01
,
Motor speech @ DC 20-39%,0.01
,
Motor speech @ DC 40-59%,0.01
,
Motor speech @ DC 60-79%,0.01
,
Motor speech @ DC 80-99%,0.01
,
Motor speech @ DC 100%,0.01
,
Comprehension current status 0%,0.01
,
Comprehension current status 1-19%,0.01
,
Comprehension current status 20-39%,0.01
,
Comprehension current status 40-59%,0.01
,
Comprehension current status 60-79%,0.01
,
Comprehension current status 80-99%,0.01
,
Comprehension current status 100%,0.01
,
Comprehension goal status 0%,0.01
,
Comprehension goal status 1-19%,0.01
Comprehension goal status 20-39%,0.01
,
Comprehension goal status 40-59%,0.01
,
Comprehension goal status 60-79%,0.01
,
Comprehension goal status 80-99%,0.01
,
Comprehension goal status 100%,0.01
,
ASSESSMENT OF APHASIA,307.02
,
Comprehension @ DC 0%,0.01
,
Comprehension @ DC 1-19%,0.01
,
Comprehension @ DC 20-39%,0.01
,
Comprehension @ DC 40-59%,0.01
,
Comprehension @ DC 60-79%,0.01
,
Comprehension @ DC 80-99%,0.01
,
Comprehension @ DC 100%,0.01
,
Expression current status 0%,0.01
,
Expression current status 1-19%,0.01
,
Expression current status 20-39%,0.01
,
Expression current status 40-59%,0.01
,
Expression current status 60-79%,0.01
,
Expression current status 80-99%,0.01
,
Expression current status 100%,0.01
,
Expression goal status 0%,0.01
,
Expression goal status 1-19%,0.01
,
Expression goal status 20-39%,0.01
,
Expression goal status 40-59%,0.01
,
Expression goal status 60-79%,0.01
,
Expression goal status 80-99%,0.01
,
Expression goal status 100%,0.01
,
Expression @ DC 0%,0.01
,
Expression @ DC 1-19%,0.01
,
Expression @ DC 20-39%,0.01
,
Expression @ DC 40-59%,0.01
,
Expression @ DC 60-79%,0.01
,
Expression @ DC 80-99%,0.01
,
Expression @ DC 100%,0.01
,
Attention current status 0%,0.01
Attention current status 1-19%,0.01
,
Attention current status 20-39%,0.01
,
Attention current status 40-59%,0.01
,
Attention current status 60-79%,0.01
,
Attention current status 80-99%,0.01
,
Attention current status 100%,0.01
,
Attention goal status 0%,0.01
,
Attention goal status 1-19%,0.01
,
Attention goal status 20-39%,0.01
,
Attention goal status 40-59%,0.01
,
Attention goal status 60-79%,0.01
,
Attention goal status 80-99%,0.01
,
Attention goal status 100%,0.01
,
Attention @ DC 0%,0.01
,
Attention @ DC 1-19%,0.01
,
Attention @ DC 20-39%,0.01
,
Attention @ DC 40-59%,0.01
,
Attention @ DC 60-79%,0.01
,
Attention @ DC 80-99%,0.01
,
Attention @ DC 100%,0.01
,
Memory current status 0%,0.01
,
Memory current status 1-19%,0.01
,
Memory current status 20-39%,0.01
,
Memory current status 40-59%,0.01
,
Memory current status 60-79%,0.01
,
Memory current status 80-99%,0.01
,
Memory current status 100%,0.01
,
Memory goal status 0%,0.01
,
Memory goal status 1-19%,0.01
,
Memory goal status 20-39%,0.01
,
Memory goal status 40-59%,0.01
,
Memory goal status 60-79%,0.01
,
Memory goal status 80-99%,0.01
,
Memory goal status 100%,0.01
,
Memory @ DC 0%,0.01
Memory @ DC 1-19%,0.01
,
Memory @ DC 20-39%,0.01
,
Memory @ DC 40-59%,0.01
,
Memory @ DC 60-79%,0.01
,
Memory @ DC 80-99%,0.01
,
Memory @ DC 100%,0.01
,
Voice current status 0%,0.01
,
Voice current status 1-19%,0.01
,
Voice current status 20-39%,0.01
,
voice current status 40-59%,0.01
,
Voice current status 60-79%,0.01
,
Voice current status 80-99%,0.01
,
Voice current status 100%,0.01
,
Voice goal status 0%,0.01
,
Voice goal status 1-19%,0.01
,
Voice goal status 20-39%,0.01
,
Voice goal status 40-59%,0.01
,
Voice goal status 60-79%,0.01
,
Voice goal status 80-99%,0.01
,
Voice goal status 100%,0.01
,
Voice @ DC 0%,0.01
,
Voice @ DC 1-19%,0.01
,
Voice @ DC 20-39%,0.01
,
Voice @ DC 40-59%,0.01
,
Voice @ DC 60-79%,0.01
,
Voice @ DC 80-99%,0.01
,
Voice @ DC 100%,0.01
,
Other S/L current status 0%,0.01
,
Other S/L current status 1-19%,0.01
,
Other S/L current status 20-39%,0.01
,
Other S/L current status 40-59%,0.01
,
Other S/L current status 60-79%,0.01
,
Other S/L current status 80-99%,0.01
,
Other S/L current status 100%,0.01
,
Other S/L goal status 0%,0.01
Other S/L goal status 1-19%,0.01
,
Other S/L goal status 20-39%,0.01
,
Other S/L goal status 40-59%,0.01
,
Other S/L goal status 60-79%,0.01
,
Other S/L goal status 80-99%,0.01
,
Other S/L goal status 100%,0.01
,
Other S/L @ DC 0%,0.01
,
Other S/L @ DC 1-19%,0.01
,
Other S/L @ DC 20-39%,0.01
,
Other S/L @ DC 40-59%,0.01
,
Other S/L @ DC 60-79%,0.01
,
Other S/L @ DC 80-99%,0.01
,
Other S/L @ DC 100%,0.01
,
COGNITIVE SKILLS DEVELOPM,78.86
,
Motor speech goal status 0%,0.01
,
Motor speech goal status 1-19%,0.01
,
Motor speech goal status 20-39%,0.01
,
Motor speech goal status 40-59%,0.01
,
Motor speech goal status 60-79%,0.01
,
Motor speech goal status 80-99%,0.01
,
Motor speech goal status 100%,0.01
,
SPEECH SOUND LANG COMPREHEN,552.46
,
BEHAVRAL QUALIT ANALYS VOICE,263.76
,
Swallowing current status 0%,0.01
,
Swallowing current status 1-19%,0.01
,
Swallowing current status 20-39%,0.01
,
Swallowing current status 40-59%,0.01
,
Swallowing current status 60-79%,0.01
,
Swallowing current status 80-99%,0.01
,
Swallowing current status 100%,0.01
,
Swallowing goal status 0%,0.01
,
Swallowing goal status 1-19%,0.01
,
Swallowing goal status 20-39%,0.01
,
Swallowing goal status 40-59%,0.01
,
Swallowing goal status 60-79%,0.01
Swallowing goal status 80-99%,0.01
,
Swallowing goal status 100%,0.01
,
Swallowing @ DC 0%,0.01
,
Swallowing @ DC 1-19%,0.01
,
Swallowing @ DC 20-39%,0.01
,
Swallowing @ DC 40-59%,0.01
,
Swallowing @ DC 60-79%,0.01
,
Swallowing @ DC 80-99%,0.01
,
Swallowing @ DC 100%,0.01
,
Motor speech current status 0%,0.01
,
Motor speech current status 1-19%,0.01
,
Motor speech current status 20-39%,0.01
,
Motor speech current status 40-59%,0.01
,
Motor speech current status 60-79%,0.01
,
Motor speech current status 80-99%,0.01
,
Motor speech current status 100%,0.01
,
DIABETES TEACHING-EA 30MN,34.72
,
DIETARY CONSULT,34.72
,
"MNT,INIT ASSESS-EA 15 MIN",26.78
,
"MNT, REASSES, EA 15 MIN",26.78
,
MNT REASSES 2ND REF-EA 15,57.92
,
WEIGHT LOSS VISIT PER 30 MIN,35.43
,
4 SHORT WEIGH IN VISITS,47.24
,
3 WEIGHT LOSS VISITS,141.72
,
6 WEIGHT LOSS VISITS,236.2
,
BARIATRIC WEIGHT LOSS VISIT,95.61
,
BOOKLETS,5.12
,
SPEECH BOOKLET,8.79
,
TELEPHONE,2.91
,
MEDICARE RHC OFFICE VISIT,0
,
MEDICARE PREVENTATIVE OFFICE VISIT,0
,
ADMIN FLU VIRUS VACCINE,18
,
ADMIN PNEUMONIA VACCINE,52.49
,
ADMIN HEP B VACCINE,52.49
,
FINE NEEDLE ASPIRATION W/O IMAGING,297
ACNE SURGERY MILIA CYSTS,212.1
,
I&D ABSC; SMPLE OR SGL,252.34
,
I&D ABSC; COMP OR MULTIPL,445.15
,
OBTAINING PAP SMEAR,97.55
,
"CA SCRNING, PELV & BRST E",83.72
,
"INC & REM FB, SQ; SMPL",317.08
,
WELCOME MEDICARE VISIT,351.09
,
TOBACCO-USE COUNSEL 3-10,30.94
,
TOBACCO-USE COUNSEL>10MIN,63.89
,
PPPS INITIAL VISIT,373.61
,
PPPS SUSEQ VISIT,249.73
,
ANNUAL DEPRESSION SCREENI,30.27
,
IMADM ANY ROUTE 1ST VAC/T,54.56
,
INADMIN ADD'L VAC <=18 YR,27.04
,
IMMUNIZATION ADM; 1 VACCI,18.78
,
IMMUNIZATION ADM; EA ADDT,26.24
,
IMMUNE ADMIN ORAL/NASAL,18.78
,
INJ SGL TENDON SHTH OR LI,130.29
,
TPI (S) - 1/2 MUSCLE(S),121.33
,
TPI(S) - 3/>MUSCLE(S),137.5
,
DRAIN/INJECT SM JNT/BURSA,104.08
,
DRAIN/INJ INTERM JNT/BURS,109.09
,
DRAIN/INJ MAJOR JNT/BURSA,130.19
,
THER/PROPH/DIAG INJ. SC/I,53.77
,
CONTROL NASAL HEMORRH. AN,205.6
,
CONTROL NASAL HEMORRH. AN,457.68
,
BACK TO SCHOOL PHYSICAL,15
,
URINALYSIS NONAUTO W/O SCOPE,16.03
,
URINE PREG. VISUAL COLOR,18.5
,
DEB SUBQ TISSUE 20 SQ CM/,244.23
,
PARE BENIGN LES; SGL,111.55
,
"TRIM SKIN LESIONS, 2-4",125.83
,
"TRIM SKIN LESIONS, OVER 4",142.01
,
"BX-SKIN, SQ/MM; SGL",220.32
,
REM SKIN TAGS; TO 15,192.6
REMOVE SKIN TAGS ADD-ON,43.02
,
"SHAVE LES, T/A/L; 0.5CM/<",200.31
,
"SHAVE LES, T/A/L; 0.6-1.0",246.38
,
"SHAVE LES, T/A/L; 1.1-2.0",290.3
,
SHAVE LES S/N/F/G;0.5C,204.6
,
"SHAVE LES, S/N/H/F/G DIAM .6-1.0CM",251.73
,
SHAVE LESIONS S/N/H/F/G 1.1-2.0 CM,296.72
,
SHAVE SKIN LESION F/E/E/N/L/M 0.5CM/<,234.59
,
SHAVE SKIN LESION 1.1-2.0 CM,331
,
EXC TR-EXT B9+MARG 0.5 <,269.38
,
"EXC, BEN LES,T/A/L; 0.6-1",316.48
,
"EXC, BEN LES T/A/L; 1.1-2",352.17
,
"EXC, BEN LES, T/A/L;2.1-3",406.6
,
"EXC, BEN LES, T/A/L;3.1-4",462.13
,
"EXC, BLES,S/N/EX,G;0.5CM/",269.32
,
"EXC, BLES, S/N/EX,G;0.6-1",334.08
,
"EXC, BLS,S/N/EX, G;1.1-2.",373.49
,
"EXC, BLES, S/N/EX,G;2.1-3",430.37
,
"EXC, BLES, S/N/EX,G;3.1-4",497.65
,
EXC FACE-MM B9+MARG 0.5<,295.96
,
EXC FACE-MM B9+MARG 0.6-1,357.64
,
EXC FACE-MM B9+MARG 1.1-2,401.41
,
EXC FACE-MM B9+MARG 2.1-3,479.25
,
EXC FACE-MM B9+MARG 3.1-4,602.62
,
CHANGE OF WINDPIPE AIRWAY,85
,
EXC MLES T/A/L;1.1-2.0CM,528.12
,
EXC TREAT EXT MAL+MARB 3.1-4CM,650
,
REMOVAL OF NAIL PLATE,213.43
,
DRAIN BLOOD FROM UNDER TO,105.72
,
EXCISON NAIL PERMANENT REMOVAL,387.31
,
WEDGE EXCISION SKIN NAIL FOLD,358.85
,
SIMPLE LAC REP 0-2.5CM,190.21
,
SIMPLE LAC REP 2.6-7.5 CM,232.17
,
SIMPLE LAC 7.6-A12.5CM,273.85
,
SIMPLE LAC 12..6-20.0CM,346.08
SIMPLE FACE LAC 0-2.5CM,233.07
,
SIMPLE FACE LAC 2.6-5.0CM,244.06
,
SIMPLE FACE LAC 5.1-7.5CM,286.13
,
LAYERED LAC 0-2.5CM,504.59
,
INTMD REPAIR EXT 7.6-12.5,750
,
"OCCULT BLOOD, FECES",14.88
,
TYMPANOGRAM,35.93
,
GLUCOSE BLD BY MONITOR,6.86
,
"DIL URETH STRICT, SOUND;M",181.71
,
HEMOGLOBIN,19.82
,
ALLERGY SINGLE INJECTION,22.51
,
ALLGERY TWO OR MORE INJEC,27.85
,
"REM FB, CONJUNCTIVA; SUPE",123.5
,
"REM FB, EXT EYE; CORNEAL,",127.01
,
I & D OF VULVA OR PERINEAL ABSCESS,236.08
,
ROUTINE VENIPUNCTURE,19.99
,
IRRIG DRUG DELIVERY DEVIC,57.09
,
"SKIN TEST;TB, ID",16.81
,
STREP TEST,35.08
,
REMOVE IMPACTED EAR WAX- BILATERAL,52.5
,
REMOVE IMPACTED EAR WAX- BILATERAL,231
,
DESTRUCT PREMALG LESION,142.24
,
"DESTRUCT PREMLG LES, 2-1",21.42
,
"DESTRUCT B9 LESION, 1-14",235.59
,
"DESTRUCT LESION, 15 OR MO",279.54
,
CLOSED TR MEDIAL MALL FRACTURE W/O MANIP,700
,
,
RAPID FLU TEST,49.07
,
ENDOMETRIAL BX WO CERVICAL DILATION,234.59
,
REMOVAL-FB-FOOT-SUBCUTA,561.1
,
FOLLOW UP VISIT,0
,
LONG ARM SPLINT MOLDED,190.1
,
APPLY SHORT ARM SPLINT,141.88
,
REM FB EXT AUDITORY CANAL,212.88
,
NEW PT OFFICE VISIT LVL 1,82.38
NEW PT OFFICE VISIT LVL 2,142.63
,
NEW PT OFFICE VISIT LVL 3,205.24
,
NEW PT CLINIC VISIT LVL 4,316
,
NEW PT CLINIC VISIT LVL 5,394.56
,
REMOVE IMPACTED EAR WAS UNI,26.33
,
REMOVAL IMPACTED CERUMEN,115.59
,
EST PT CLINIC VISIT LVL 1,39.74
,
EST PT CLINIC VISIT LVL 2,83.07
,
EST PT CLINIC VISIT LVL 3,138.72
,
EST PT CLINIC VISIT LVL 4,206.1
,
EST PT CLINIC VISIT LVL 5,277.44
,
DISCH FROM OBSERVATION,158.72
,
INITIAL OBS/DA LEVEL 1,214.83
,
INITIAL OBS/DAY LEVEL 2,294.95
,
INITIAL OBS/DAY LEVEL 3,404.54
,
INPATIENT E/M INIT LEVEL1,221.44
,
INPT E/M INIT LEVEL 2,300.53
,
INPT E/M INIT LEVEL 3,442.63
,
"SUBS OBSERV, LEVEL 1",87.76
,
"SUBS OBSERV, LEVEL 2",160.09
,
"SUBS OBSERV, LEVEL 3",229.74
,
INPT E/M SUBS LEVEL 1,86.65
,
INPT E/M SUBS LEVEL 2,159.01
,
INPT E/M SUBS LEVEL 3,227.92
,
INPT E/M SUBS LEVEL 4,300.58
,
INPT E/M SUBS LEVEL 5,373.94
,
INPT E/M DISCH MGMT,158.35
,
DISCHARGE MGMT +30 MIN,233.88
,
"NURSING FAC CARE, INIT LO",202.09
,
"NURSING FAC CARE,INIT MED",285.75
,
"NURSING FAC CARE, INIT HI",363.94
,
"NURSING FAC CARE, SUBS LO",96.47
,
"NURSING FAC CARE, SUBSSQ",149.26
,
"NURSING FAC CARE, SUBSEQ",196.84
,
"NURSING FAC CARE, SUBSEQ",292.23
SNF DISCHARGE < 30 MIN,157.99
,
SNF DISCHARGE >30 MIN,227.69
,
"HOME VISIT, EST PATIENT",123.08
,
PROLONGED SERVICE,219.78
,
"PREV MED, NEW PT <1YR",194.42
,
"PREV MED, NEW PT, 1-4 YRS",205.14
,
"PREV MED, NEW PT, 5-11 YR",211.46
,
"PREV MED, NEW PT, 12-17 Y",239.9
,
"PREV MED, NEW PT, 18-39 Y",232.72
,
"PREV MED, NEW PT, 40-64 Y",269.19
,
"PREV MED, NEW PT+65 YRS",292.07
,
"PREV MED, EST PT, < 1YR",174.66
,
"PREV MED, EST PT, 1-4 YRS",186.82
,
"PREV MED, EST PT, 5-11 YR",186.22
,
"PREV MED, EST PT, 12-17 Y",204.7
,
"PREV MED, EST PT, 18-39YR",209.26
,
"PREV MED, EST PT, 40-64 Y",223.24
,
"PREV MED, EST PT, +65YRS",239.9
,
APP OF SHORT LEG CAST,176.94
,
HEALTH RISK ASSESSMENT,26.78
,
NEBULIZER TX,38.86
,
TRANS CARE MGMT 14 DAY DISCH,200
,
TRANSITIONAL CARE MGMT 7 DAY DISCHARGE,275
,
ADVANCE CARE PLAN 30 MINUTES,85
,
ADVANCE CARE PLAN ADDITIONAL 30 MIN,75
,
APPLY LOWER LEG SPLINT,159.66
,
STRAPPING:UNNA BOOT,57.18
,
NURSING HOME/ EMPLOY EXAM,58.92
,
SPORT PHYSICAL-EST PT,15
,
DOT EXAM,123.6
,
SPORTS PHYSICAL-NEW PT,15
,
DAYCARE PHYSICAL,25
,
AFHC MEDICAID/MCO RHC VISIT,0
,
MEDICARE RHC OFFICE VISIT,0
,
MEDICARE PREVENTATIVE VISIT,0
DESTRUCT PREMALIGNANT LESION 15/>,325
,
ADMIN FLU VIRUS VACCINE,18
,
ADMIN PNEUMONIA VACCINE,52.49
,
ADMIN HEP B VACCINE,52.49
,
FNA W/O IMAGE,297
,
ACNE SURGERY MILIA CYSTS,212.1
,
I&D ABSC; SMPLE OR SGL,252.34
,
I&D ABSC; COMP OR MULTIPL,445.15
,
OBTAINING PAP SMEAR,97.55
,
"CA SCRNING, PELV & BRST E",83.72
,
"INC & REM FB, SQ; SMPL",317.08
,
"I&D HEMATOMA, SEROMA, FLUID COLLECTION",340.64
,
WELCOME MEDICARE VISIT,351.09
,
TOBACCO-USE COUNSEL 3-10,30.85
,
PPPS INITIAL VISIT,373.61
,
PPPS SUBSEQ VISIT,249.73
,
ANNUAL DEPRESSION SCREENI,30.27
,
INADMIN 1ST VAC <=18 YRS,54.56
,
INADMIN ADD'L VAC <=18 YR,27.04
,
IMMUNIZATION ADM; 1 VACCI,18.78
,
IMMUNIZATION ADM; EA ADDT,26.24
,
IMMUNE ADMIN ORAL/NASAL,18.78
,
CHRONIC CARE 20 MIN,63
,
INJ SGL TENDON SHTH OR LI,130.29
,
TPI (S) - 1/2 MUSCLE(S),121.33
,
TPI(S) - 3/>MUSCLE(S),137.5
,
DRAIN/INJECT SM JNT/BURSA,104.08
,
DRAIN/INJ INTERM JNT/BURS,109.09
,
DRAIN/INJ MAJOR JNT/BURSA,130.19
,
"THER/PROPH/DIAG INJ, SC/I",53.77
,
CONTROL NASAL HEMORRH. AN,205.6
,
CONTROL NASAL HEMORRH. AN,457.68
,
BACK TO SCHOOL PHYSICAL,15
,
DEBR EXZ/INF SKIN; 10% BS,116.58
,
DEB SUBQ TISSUE 20 SQ CM/,244.23
PARE BENIGN LES; SGL,111.55
,
"TRIM SKIN LESIONS, 2-4",125.83
,
"TRIM SKIN LESIONS, OVER 4",142.01
,
"BX-SKIN, SQ/MM; SGL",220.32
,
"BX-SKIN,SQ/MM; SGL",74.02
,
REM SKIN TAGS; TO 15,192.6
,
REMOVE SKIN TAGS ADD-ON,43.02
,
"SHAVE LES, T/A/L; 0.5CM/<",200.31
,
"SHAVE LES, T/A/L; 0.6-1.0",246.38
,
"SHAVE LES, T/A/L; 1.1-2.0",290.3
,
SHAVE LES T/A/L; > 2.0CM,321.36
,
SHAVE LES S/N/F/G;0.5C,204.6
,
"SHAVE LES,S/N/H/F/G;0.6-1",251.73
,
SHAVE LESIONS 1 S/N/F/G 1.1-2.0 CM,296.72
,
SHAVE SKIN LESION 0.5CM/<,234.59
,
"SHAVE LES,F/E/N/L;0.6-1.0",242.74
,
SHAVE SKIN LESION 1.1-2.0 CM,331
,
EXC TR-EXT B9+MARG 0.5 <,269.38
,
"EXC, BEN LES,T/A/L; 0.6-1",316.48
,
"EXC, BEN LES T/A/L; 1.1-2",352.17
,
"EXC, BEN LES, T/A/L;2.1-3",406.6
,
"EXC, BEN LES, T/A/L;3.1-4",462.13
,
"EXC, BLES,S/N/EX,G;0.5CM/",269.32
,
"EXC, BLES, S/N/EX,G;0.6-1",334.08
,
"EXC, BLS,S/N/EX, G;1.1-2.",373.49
,
"EXC, BLES, S/N/EX,G;2.1-3",430.37
,
"EXC, BLES, S/N/EX,G;3.1-4",497.65
,
EXC FACE-MM B9+MARG 0.5<,295.96
,
EXC FACE-MM B9+MARG 0.6-1,357.64
,
EXC FACE-MM B9+MARG 1.1-2,401.41
,
EXC FACE-MM B9+MARG 2.1-3,479.25
,
EXC FACE-MM B9+MARG 3.1-4,602.62
,
CHANGE OF WINDPIPE AIRWAY,85
,
EXCISION MAL LESION TRUNK/ARM .5CM/<,417.96
,
"EXC MLES,T/A/L;0.6-1.0CM",485.92
EXC MLES T/A/L;1.1-2.0CM,528.12
,
"EXC MLES, T/A/L;2.1-3.0CM",604.74
,
EXC TREAT EXT MAL +MARG 3.1-4CM,650
,
EXCISION MAL LESION S/N/F/G/ 0.5CM/<,412.39
,
"EXC MLES,S/N/EXT/G;0.6-1.",489.38
,
"EXC MLES, S/N/EXT/G;1.1-2",546.85
,
"EXC MLES, S/N/EXT/G;2.1-3",643.34
,
EXC S/N/H/F/G MAL+MRG 3.1-4,725.12
,
"EXC MLES,F/E/E/N/L;0.5CM/",425.98
,
"EXC MLES,F/E/E/N/L;0.6-1.",506.87
,
"EXC MLES,F/E/E/N/L;1.1-2.",579.91
,
INSERT BLADDER CATHETER,117.09
,
INS TEMP BLADDER CATH,150.43
,
INSERT BLADDER CATH COMPLEX,310
,
CHANGE OF CYSTOSTOMY TUBE,199.71
,
TOENAIL REMOVAL,213.43
,
DRAIN BLOOD FROM UNDER TO,105.72
,
REMOVAL OF NAIL BED,387.31
,
WEDGE EXCISION SKIN NAIL FOLD,358.85
,
SIMPLE LAC REP 0-2.5CM,190.21
,
SIMPLE LAC REP 2.6-7.5 CM,232.17
,
SIMPLE LAC 7.6-A12.5CM,273.85
,
SIMPLE LAC 12..6-20.0CM,346.08
,
SIMPLE FACE LAC 0-2.5CM,233.07
,
SIMPLE FACE LAC 2.6-5.0CM,244.06
,
SIMPLE FACE LAC 5.1-7.5CM,286.13
,
LAYERED LAC 0-2.5 CM,504.59
,
INTMD REPAIR EXT 7.6-12.5,750
,
REPAIR INT N/H/F GENT 2.6-7.5CM,617.34
,
OCCULT BLD FECES 1-3 TESTS,14.88
,
SIALOLITHOTOMY; SM UNCOMPLICATED,509.87
,
ASPIRATE PLEURA W/ IMAGING,735
,
TYMPANOGRAM,35.93
,
"DIL URETH STRICT, SOUND;M",181.71
,
DILATE FEMALE URETHRA; INITIAL,145.06
DILATE FEMALE URETHRA; FU,148.7
,
NASAL /OROGASTRIC W/TUBE PLMT,92.19
,
TSH,49.17
,
ALLERGY SINGLE INJECTION,22.51
,
ALLGERY TWO OR MORE INJEC,27.85
,
"REM FB, CONJUNCTIVA; SUPE",123.5
,
"REM FB, EXT EYE; CORNEAL,",127.01
,
INCISE THROMBOSED HEMORRHOID EXT,375.74
,
REMOVAL OF HEMORROID CLOT,391.46
,
IRRIG DRUG DELIVERY DEVIC,57.09
,
STREP TEST,35.08
,
REMOVE IMPACTED EAR WAX- BILATERAL,52.5
,
REMOVE IMPACTED EAR WAX-BILATERAL,231
,
DESTRUCT PREMALG LESION,142.24
,
"DESTRUCT PREMLG LES, 2-1",21.42
,
"DESTRUCT B9 LESION, 1-14",235.59
,
"DESTRUCT LESION, 15 OR MO",279.54
,
DESTR MLES T/A/L; 0.5 CM/,216.47
,
DESTRUCTION MALIGNANT LESION F/E/E/N/L/M,300.01
,
CLOSED TR MEDAL MALL FRACTURE W/O MANIP,700
,
,
ACUPUNCTURE,71.99
,
REMOVE EYELID FOREIGN BODY,580
,
CORONER'S CALL LEV 2,370.08
,
ENDOMETRIAL BX WO CERVICAL DILATION,234.59
,
REMOVAL-FB-FOOT-SUBCUTA,561.1
,
INSERT INTRAUTERINE DEVICE,175
,
OMT AREA 1-2,61.68
,
OMT AREA 3-4,82.16
,
OMT AREA 5-6,120.86
,
FOLLOW UP VISIT,0
,
APPLY LONG ARM CAST,208.84
,
APPLY SHORT ARM CAST,195
,
LONG ARM SPLINT MOLDED,190.1
,
APPLY SHORT ARM SPLINT; S,141.88
REM FB EXT AUDITORY CANAL,212.88
,
NEW PT OFFICE VISIT LVL 1,82.38
,
NEW PT OFFICE VISIT LVL 2,142.63
,
NEW PT OFFICE VISIT LVL 3,205.24
,
NEW PT CLINIC VISIT LVL 4,316
,
NEW PT CLINIC VISIT LVL 5,394.56
,
REMOVE IMPACTED EAR WAX UNI,26.33
,
REMOVAL IMPACTED CERUMEN,115.59
,
EST PT CLINIC VISIT LVL 1,39.74
,
EST PT CLINIC VISIT LVL 2,83.07
,
EST PT CLINIC VISIT LVL 3,138.72
,
EST PT CLINIC VISIT LVL 4,206.1
,
EST PT CLINIC VISIT LVL 5,277.44
,
DISCH FROM OBSERVATION,158.72
,
INITIAL OBS/DA LEVEL 1,214.83
,
INITIAL OBS/DAY LEVEL 2,294.95
,
INITIAL OBS/DAY LEVEL 3,404.54
,
INPATIENT E/M INIT LEVEL1,221.44
,
INPT E/M INIT LEVEL 2,300.53
,
INPT E/M INIT LEVEL 3,442.63
,
"SUBS OBSERV, LEVEL 1",87.76
,
"SUBS OBSERV, LEVEL 2",160.09
,
"SUBS OBSERV, LEVEL 3",229.74
,
INPT E/M SUBS LEVEL 1,86.65
,
INPT E/M SUBS LEVEL 2,159.01
,
INPT E/M SUBS LEVEL 3,227.92
,
INPT E/M SUBS LEVEL 4,300.58
,
INPT E/M SUBS LEVEL 5,373.94
,
OBSERV/HOSP SAME DATE,480.47
,
INPT E/M DISCH MGMT,158.35
,
DISCHARGE MGMT +30 MIN,233.88
,
"NURSING FAC CARE, INIT LO",202.09
,
"NURSING FAC CARE,INIT MED",285.75
,
"NURSING FAC CARE, INIT HI",363.94
,
"NURSING FAC CARE, SUBS LO",96.47
"NURSING FAC CARE, SUBSSQ",149.26
,
"NURSING FAC CARE, SUBSEQ",196.84
,
"NURSING FAC CARE, SUBSEQ",292.23
,
SNF DISCHARGE < 30 MIN,157.99
,
SNF DISCHARGE >30 MIN,227.69
,
"HOME VISIT, EST PATIENT",123.08
,
HOME VISIT EST PATIENT,186.03
,
PROLONGED SERVICE,219.78
,
PROLONGED E/M SVC BEFORE/AFTER DIR PT CA,195
,
"PREV MED, NEW PT < 1YR",194.42
,
"PREV MED, NEW PT, 1-4 YRS",205.14
,
"PREV MED, NEW PT, 5-11 YR",211.46
,
"PREV MED, NEW PT, 12-17 Y",239.9
,
"PREV MED, NEW PT, 18-39 Y",232.72
,
"PREV MED, NEW PT, 40-64 Y",269.19
,
"PREV MED, NEW PT+65 YRS",292.07
,
"PREV MED, EST PT, < 1YR",174.66
,
"PREV MED, EST PT, 1-4 YRS",186.82
,
"PREV MED, EST PT, 5-11 YR",186.22
,
"PREV MED, EST PT, 12-17 Y",204.7
,
"PREV MED, EST PT, 18-39YR",209.26
,
"PREV MED, EST PT, 40-64 Y",223.24
,
"PREV MED, EST PT, +65YRS",239.9
,
APP OF SHORT LEG CAST,176.94
,
HEALTH RISK ASSESSMENT,26.78
,
NEBULIZER TX,39.94
,
TRANS CARE MGMT 14 DAY DISCH,200
,
TRANS CARE MGMT 7 DAY DISCH,275
,
,275
,
ADVANCED CARE PLAN 30 MINUTES,85
,
ADVANCE CARE PLAN ADDITIONAL 30 MIN,75
,
APPLY LOWER LEG SPLINT,159.66
,
STRAPPING:UNNA BOOT,117.61
,
NURSING HOME AGE 40-64,58.92
,
SPORT PHYSICAL-EST PT,15
DOT EXAM,123.6
,
SPORT PHYSICAL-NEW PT,15
,
DAYCARE PHYSICAL,25
,
AFHC MEDICAID RHC VISIT,0
,
"TDAP, ADACEL, IM",60.18
,
"HIB PRP-T, ACTHIB, IM",20
,
ALBUTEROL NON-COMP UNIT 1,2.41
,
NITROSTAT SL TAB 0.4MG,5
,
BETAMETHASONE ACET&SOD PHOSP 3MG,21.42
,
DEXAMETHASONE 4MG/ML VIAL,3.75
,
DIAZEPAM 10MG/2ML SYRINGE,43.16
,
CEFTRIAXONE 1 GM VIAL,33.99
,
"RABIES VIRUS VACCINE, HDC INJ",615
,
DEPO T INJECTION 1MG,0.11
,
DIPHENHYDAMINE 50 MG,17.45
,
DEPO MEDROL 80 MG VIAL,42.3
,
DEPO-MEDROL 40 MG VIAL,29.1
,
"VFC HEP A PEDS, HAVRIX, IM",0
,
VFC HEP B,0
,
"MENINGITIS B, TRUMENBA, IM",181.15
,
"HEP-A VACCINE ADULT, HAVRIX, IM",90.87
,
"PEDIATRIC HEP A VACCINE, HAVRIX, IM",90.87
,
FUROSEMIDE 40 MG VIAL,16.25
,
FLU VAC NO PRSV 3 VAL 6-35 M,25
,
"FLU VACCINE, 3 YRS & >",25
,
"FLU VACCINE HIGH DOSE, FLUZONE HD, IM",82.5
,
FLU VACCINE 3 YRS & > IM,25
,
"PNEUMOCOCCAL VACCINE 13, PREVNAR, IM",315
,
INFLUENZA VIRUS VAC QUAD LIVE INTRANASAL,31.62
,
,
VFC FLU VACCINE 4 VALENT NASAL,0
,
"ROTOVIRUS VACCINE, ROTATEQ, PO",133.9
,
"FLU VAC 6-35M, FLUZONE, IM",25
,
"FLU VACCINE QUAD, FLUZONE/FLULAVAL, IM",25
,
"DTAP-IPV VACCINE 4-6 YRS, KINRIX, IM",73.11
"DTAP VACCINE, DAPTACEL, IM",40
,
"MMR VACCINE, SQ",88.91
,
"POLIOVIRUS IPV, IPOL, SC/IM",50.3
,
"LIVE VARICELLA VACCINE, VARIVAX, SQ",160.5
,
"TD VACCINE, IM",33.55
,
"DTAP-HEPB-IPV, PEDIARIX, IM",130.42
,
"PNEUMOCOCCAL VACCINE 23, PNEUMOVAX, IM",275
,
SQ MPV VACCINE,180.71
,
"MENACWY VACCINE, MENACTRA, IM",125.5
,
HEPB VACC ILL PAT 3 DOSE,202.62
,
"HPV IMMUNIZATION, GARDASIL, IM",259.5
,
"HEP B ADULT, ENGERIX, IM",101.6
,
HYDROXYZINE 25MG,11.42
,
KENALOG 40 MG VIAL,16.7
,
ORPHENADRINE INJ TO 60MG,63.56
,
PHENERGAN 25 MG,8.75
,
PEN BENZATHINE/PROCAINE,188.53
,
METOCLOPRAMIDE 10MG/2ML,22.94
,
ROCEPHIN INJECTION 250ML,28.01
,
SOLU-MEDROL 40 MG VIAL,19.16
,
SOLUMEDROL 125 MG,25.21
,
SILVADENE CREAM,12.52
,
KETOROLAC 30 MG VIAL,6.56
,
KETOROLAC 60MG IM,8.45
,
VITAMIN B-12,11.98
,
ZOFRAN INJ PER 1 MG,10.24
,
SILVER NITRATE APPLICATOR,4.38
,
DEXTROSE 50% SYRINGE,12.65
,
EPINEPHRINE 0.1MG/ML SYRINGE,6.86
,
ATROPINE 1MG/10ML SYRINGE,7.96
,
CALCIUM CHLORIDE 10% SYRINGE,15.74
,
LIDOCAINE 2% SYRINGE,6.76
,
EPINPEHRINE 1MG/ML AMPULE,2.4
,
NALOXONE 0.4MG/ML VIAL,24.28
,
OXYTOCIN 10UNIT/ML VIAL,0.92
AMMONIA INHALANT AMPULE,0.52
,
NIFEDIPINE 10MG TABLET,2
,
METOPROLOL TART 5MG/5ML VIAL,1
,
SODIUM CHLORIDE 1000ML BAG,3.32
,
INDOMETHACIN,1
,
XYLOCAINE 1% VIAL,0
,
XYLOCAINE 1% WITH EPI VIAL,0
,
XYLOCAINE 2% VIAL,0
,
XYLOCAINE 2% WITH EPI VIAL,0
,
MARCAINE 0.25% VIAL,0
,
MARCAINE 0.5% VIAL,0
,
ACTIVATED CHARCOAL 25 GM,29.08
,
ASPIRIN 81 MG CHEWABLE,1.25
,
BENZOIN TINCTURE SWAB,0
,
GENTIAN VIOLET,0
,
EMLA CREAM,0
,
PHENYLEPHRINE 1% NASAL SPRAY,7.84
,
ETHYL CHLORIDE WOUND SPRAY,0
,
MAG-AL SUSPENSION 30 ML,2.75
,
LEVALBUTEROL 1.25MG/0.5ML,3.28
,
IPRATROPIUM/ALBUTEROL SVN,1.25
,
EPINEPHRINE AUTO-INJECTOR ADULT,262.4
,
EPINEPHRINE AUTO-INJECTOR PEDS,262.4
,
GLUCOSE GEL,0
,
TRIPLE ANTIBIOTIC PACK,0
,
ONDANSETRON 4MG/2ML VIAL,2.25
,
TB TEST TUBERSOL,8.75
,
ACETAMIN 160MG/5L UD CUP,2.25
,
CLONIDINE 0.1 MG TAB,2.5
,
CEFTRIAXONE 2 GM VIAL,6.5
,
SOD CHL 10ML FLUSH,2
,
SODIUM BICARB 8.4%,16.5
,
LIDOCAINE 2% VISCOUS ORAL,4.25
,
DONNATAL ELIXIR,14.75
,
OXYMETAZOLINE 0.05% NASAL SRAY AFHC,19
"VFC ROTAVIRUS, ROTARIX, PO",0
,
"VFCHIB, ACTHIB, IM",0
,
"VFC TD, IM",0
,
"VFC HPV, GARDASIL-9, IM",0
,
"VFC FLU VAC QUAD 6-35M, FLUZONE, IM",0
,
"VFC FLU VACCINE QUAD, FLUZONE, IM",0
,
VFC INFLUENZA,0
,
"VFC DTAP, DAPTACEL, IM",0
,
"VFC VARICELLA LIVE, VARIVAX, SQ",0
,
"VFC POLIO, IPOL, SC/IM",0
,
"VFC DTAP-HEPB-IPV, PEDIARIX, IM",0
,
"VFC PNEUMONIA 13 VACCINE, PREVNAR, IM",0
,
"VFC TDAP, ADACEL, IM",0
,
"VFC MMR, SQ",0
,
"VFC MENIGOCOCCOL A, MENACTRA, IM",0
,
VFC H1N1 INJECTABLE,0
,
VFC-H1N1 NASAL,0
,
"VFC-DTAP IPV VACCINE 4-6 YRS, KINRIX, IM",0
,
VFC- MMRV VACCINE SC,0
,
"VFC TDAP, BOOSTRIX, IM",0
,
"VFC HIB, PEDVAXHIB, IM",0
,
"VFC DTAP/IPV/HIB, PENTACEL, IM",0
,
"VFC MMR/VARICELLA, PROQUAD, SQ",0
,
"VFC MENINGITIS B, TRUMENBA, IM",0
,
"VFC ROTOVIRUS, ROTARIX, PO",0
,
"FLU VAC QUAD, FLUZONE, IM, MEDICARE",0
,
"FLU VAC HD, FLUZONE HD, IM, MEDICARE",0
,
"TYPHOID VACCINE, IM, PRIVATE",75
,
"HEPATITIS B VAC, PEDS, IM, PRIVATE",35
,
"VFC HEP B, PEDS,ENGERIX, IM",0
,
"MMRV, PRIVATE, SUBQ",290
,
VFC ADMIN FEE,19.68
,
DERMABOND,25.42
,
SMALL VOLUME NEBULIZER,2.45
,
SILVER SULFADIAZINE CREAM 1% 25 GM TUBE,18.54
DUODERM CGF 4X4 (AFHC,7.87
,
AQUACELL AG RIBBON,24.12
,
UNNA BOOT,18.9
,
EXERCISER VOLUMETRIC VOLDYNE 500,8.23
,
CHRONIC CARE MANAGEMENT,70
,
SPORTS PHYSICAL,15
,
ADMIN FLU VIRUS VACCINE,18
,
ADMIN PNEUMONIA VACCINE,52.49
,
ADMIN HEP B VACCINE,52.49
,
EMC MEDICARE OFFICE VISIT,0
,
EMC MEDICARE PREV EXAM,0
,
FINE NEEDLE ASPIRATION W/O IMAGING GUID,297
,
I&D ABSC; SMPL OR SGL,252.34
,
OBTAINING PAP SMEAR,97.55
,
"CA SCRNING, PELV & BRST E",83.72
,
"INC & REM FB, SQ; SMPL",317.08
,
"INC & REM FB, SQ; COMPL",588.34
,
PUNCT ASP - ABSC HEMAT CY,272.09
,
"REM FB, INTRANASAL; OFFIC",397.99
,
"BLOOD OCCULT TEST,COLOREC",14.88
,
WELCOME MEDICARE VISIT,351.09
,
TOBACCO-USE COUNSEL 3-10,30.94
,
TOBACCO-USE COUNSEL>10 MIN,63.89
,
PPPS INITIAL VISIT,373.61
,
PPPS SUBSEQ VISIT,249.73
,
ANNUAL DEPRESSION SCREENI,30.27
,
INADMIN 1ST VAC <=18 YRS,54.56
,
INADMIN ADD'L VAC <=18 YR,27.04
,
IMMUNIZATION ADM; 1 VACCI,18.78
,
IMMUNIZATION ADM; EA ADDT,26.24
,
IMMUNE ADMIN ORAL/NASAL,18.78
,
INJ SGL TENDON SHTH OR LI,130.29
,
TPI(S) - 1/2 MUSCLE(S,121.33
,
TPI(S) - 3/> MUSCLE(S),137.5
,
DRAIN/INJECT SM JNT/BURSA,104.08
DRAIN/INJ INTERM JNT/BURS,109.09
,
DRAIN/INJ MAJOR JNT/BURSA,130.19
,
ASPIRATE/INJ GANGLION CYS,132.9
,
INTRANASAL LIVE FLU VACCI,34.11
,
"THER/PROPH/DIAG INJ, SC/I",53.77
,
"CONTROL NASAL HEMORRH, AN",220.29
,
"CONTROL NASAL HEMORRH, AN",457.68
,
BACK TO SCHOOL PHYSICAL,15
,
URINALYSIS NONAUTO W/O SCOPE,16.03
,
"URINE PREG, VISUAL COLOR",18.5
,
DEB SUBQ TISSUE 20 SQ CM/,244.23
,
PARE BENIGN LES; SGL,111.55
,
"TRIM SKIN LESIONS, 2 TO 4",125.83
,
"TRIM SKIN LESIONS, OVER 4",142.01
,
"BX-SKIN,SQ/MM; SGL",220.32
,
"BX-SKIN,SQ/MM; SGL",74.02
,
REM SKIN TAGS; TO 15,192.6
,
REMOVE SKIN TAGS ADD-ON,43.02
,
"SHAVE LES,T/A/L; 0.5CM/<",200.31
,
"SHAVE LES,T/A/L; 0.6-1.0C",246.38
,
"SHAVE LES,T/A/L;1.1-2.0CM",290.3
,
"SHAVE LES,T/A/L; > 2.0CM",321.36
,
"SHAVE LES,S/N/H/F/G;0.5CM",204.6
,
"SHAVE LES,S/N/H/F/G;0.6-1",251.73
,
"SHAVE LES,S/N/H/F/G;1.1-2",296.72
,
"SHAVE LES,S/N/H/F/G;> 2.0",324.14
,
"SHAVE LES,F/E/N/L; 0.5CM/",234.59
,
"SHAVE LES,F/E/N/L;0.6-1.0",242.74
,
"SHAVE LES,F/E/N/L; 1.1-2.",331
,
"SHAVE LES,F/E/N/L;>2.0CM",396.45
,
EXC TR-EXT B9+MARG 0.5 <,269.38
,
"EXC, BEN LES,T/A/L; 0.6-1",316.48
,
"EXC, BEN LES,T/A/L; 1.1-2",352.17
,
"EXC, BEN LES,T/A/L; 2.1-3",406.6
,
"EXC, BLES,S/N/EX,G;0.5CM/",269.32
"EXC, BLES,S/N/EX,G;0.6-1.",334.08
,
"EXC, BLES,S/N/EX,G;1.1-2.",373.49
,
"EXC, BLES,S/N/EX,G;2.1-3.",430.37
,
EXC FACE-MM B9+MARG 0.5 <,295.96
,
EXC FACE-MM B9+MARG 0.6-1,357.64
,
EXC FACE-MM B9+MARG 1.1-2,401.41
,
"INTUB, ENDOTRACHEAL PROC",253.79
,
CHANGE OF WINDPIPE AIRWAY,85
,
"EXC MLES,T/A/L;0.5CM/<",417.96
,
"EXC MLES,T/A/L;0.6-1.0CM",485.92
,
"EXC MLES,T/A/L;1.1-2.0CM",528.12
,
"EXC MLES,T/A/L;2.1-3.0CM",604.74
,
EXC TREAT EXT MAL +MARG 3.1-4CM,650
,
"EXC MLES,S/N/EXT/G; 0.5CM",412.39
,
"EXC MLES,S/N/EXT/G;0.6-1.",489.38
,
"EXC MLES,S/N/EXT/G;1.1-2.",546.85
,
"EXC MLES,S/N/EXT/G;2.1-3.",643.34
,
"EXC MLES,F/E/E/N/L;0.5CM/",425.98
,
"EXC MLES,F/E/E/N/L;0.6-1.",506.87
,
"EXC MLES,F/E/E/N/L;1.1-2.",579.91
,
INSERT BLADDER CATHETER,117.09
,
TOENAIL REMOVAL,213.43
,
EXCISION NAIL PERMANENT REMOVAL,387.31
,
WEDGE EXC NAIL FOLD,358.85
,
REMOVAL OF DRUG IMPLANT,290.45
,
REMOVAL W/INSERT NON-BIO DRUG DLVR IMPLA,526.47
,
,
SIMPLE LAC REP 0-2.5CM,190.21
,
SIMPLE LAC REP 2.6-7.5 CM,232.17
,
SIMPLE LAC 7.6-12.5 CM,273.85
,
SIMPLE LAC 12.6-20.0 CM,346.08
,
SIMPLE LAC 20.1-30.0 CM,410.31
,
SIMPLE LAC 30.1 CM & OVER,478.84
,
SIMPLE FACE LAC 0-2.5CM,233.07
,
SIMPLE FACE LAC 2.6-5.0CM,244.06
SIMPLE FACE LAC 5.1-7.5CM,286.13
,
SIMPL FACE LAC 7.6-12.5CM,346.91
,
LAYERED LAC 0-2.5 CM,504.59
,
LAYERED LAC 2.6-7.5CM,645.98
,
INTMD REPAIR EXT 7.6-12.5,750
,
"LAY NCK,HN, FT LAC 0-2.5",505.44
,
"LAY NK,HND,FT LAC 2.6-7.5",617.34
,
"LAY NK,HD,FT LAC 20.1 &UP","1,009.94"
,
LAY CLOS FACE LAC 0-2.5CM,551.68
,
LAY CLOS FACE LAC 2.6-5.0,629.55
,
"OCCULT BLOOD, FECES",14.88
,
TREAT METACARPAL FRACTURE,638.94
,
CPR,659.36
,
CARDIOVERSION,444.67
,
"GLUCOSE, BLD BY MONITOR",6.86
,
"DIL URETH STRICT, SOUND;M",181.71
,
"DILATE URETHR STRICTR, SU",175.53
,
TREAT SHOULDER DISLOCATIO,678.07
,
"CL TX SHLDR DISL, W/MANIP",866.22
,
DILATE FEMALE URETHRA; IN,151.52
,
DILATE FEMALE URETHRA; FU,148.7
,
REDUCTION OF REDIAL SUBLU,297.76
,
HEMOGLOBIN,19.82
,
ALLERGY SINGLE INJECTION,22.51
,
ALLGERY TWO OR MORE INJEC,27.85
,
"REM FB, CONJUNCTIVA; SUPE",123.5
,
"REM FB, EXT EYE; CORNEAL,",127.01
,
REM B CORNL W/SLIP LAMP,144.8
,
NON AUTO ERYTHROCYTE SED,21.64
,
DRESS/DEBRID P-THICK BURN S,174.19
,
DRESSING/DEBRIDEMENT THICK BURN,350
,
QUAL HETEROPHILE AB,15.16
,
"IA INFECTIOUS AGENT, SGL",37.86
,
ROUTINE VENIPUNCTURE,19.99
,
"SKIN TEST;TB, ID",16.81
STREP TEST,35.08
,
REMOVE IMPACTED EAR WAX- BILATERAL,52.5
,
REMOVE IMPACTED EAR WAX- BILATERAL,231
,
DESTRUCT PREMALG LESION,142.24
,
"DESTRUCT PREMALG LES, 2-1",21.42
,
"DESTRUCT B9 LESION, 1-14",235.59
,
"DESTRUCT LESION, 15 OR MO",279.54
,
CHEM CAUT GRANULATION TIS,172.13
,
DESTR MLES T/A/L; 0.5 CM/,202.83
,
DESTR MLES T/A/L; 0.6-1.0,305.93
,
DESTR MLES T/A/L; 2.1-3.0,408.26
,
DESTR MLES F/E/E/N/L/MM;,379.83
,
CLOSED TR MEDIAL MALL FRACTURE W/O MANIP,700
,
,
RAPID FLU TEST,49.07
,
CLOSED FRACTURE REDUCTION,675.45
,
REMOVAL-FB-FOOT-SUBCUTA,561.1
,
SPECIM TRNSF-PHY TO LAB,19.86
,
FOLLOW UP VISIT,0
,
LONG ARM SPLINT MOLDED,190.1
,
SHORT ARM SPLINT,141.88
,
APPLY FINGER SPLINT; STAT,89.93
,
REM FB EXT AUDITORY CANAL,212.88
,
NEW PT OFFICE VISIT LVL 1,82.38
,
NEW PT OFFICE VISIT LVL 2,142.63
,
NEW PT OFFICE VISIT LVL 3,205.24
,
NEW PT CLINIC VISIT LVL 4,316
,
NEW PT CLINIC VISIT LVE 5,394.56
,
REMOVE IMPACTED EAR WAS UNI,26.33
,
REMOVAL IMPACTED CERUMEN,115.59
,
EST PT CLNIC VISIT LVL 1,39.74
,
EST PT CLINIC VISIT LVL 2,83.07
,
EST PT CLINIC VISIT LVL 3,138.72
,
EST PT CLINIC VISIT LVL 4,206.1
,
EST PT CLINIC VISIT LVL 5,277.44
DISCH FROM OBSERVATION,158.72
,
INITIAL OBS/DA LEVEL 1,214.83
,
INITIAL OBS/DAY LEVEL 2,294.95
,
INITIAL OBS/DAY LEVEL 3,404.54
,
INPATIENT E/M INIT LEVEL1,221.44
,
INPT E/M INIT LEVEL 2,300.53
,
INPT E/M INIT LEVEL 3,442.63
,
"SUBS OBSERV, LEVEL 1",87.76
,
"SUBS OBSERV, LEVEL 2",160.09
,
"SUBS OBSERV, LEVEL 3",229.74
,
INPT E/M SUBS LEVEL 1,86.65
,
INPT E/M SUBS LEVEL 2,159.01
,
INPT E/M SUBS LEVEL 3,227.92
,
OBSERV/HOSP SAME DATE,373.94
,
INPT E/M DISCH MGMT,158.35
,
DISCHARGE MGMT +30 MIN,233.88
,
"NURSING FAC CARE, INIT LO",202.09
,
"NURSING FAC CARE,INIT MED",285.75
,
"NURSING FAC CARE, INIT HI",363.94
,
"NURSING FAC CARE, SUBS LO",96.47
,
"NURSING FAC CARE, SUBSSQ",149.26
,
"NURSING FAC CARE, SUBSEQ",196.84
,
"NURSING FAC CARE, SUBSEQ",292.23
,
SNF DISCHARGE < 30 MIN,157.99
,
SNF DISCHARGE >30 MIN,227.69
,
"HOME VISIT, EST PATIENT",123.08
,
PROLONGED SERVICE,219.78
,
PROLONG SERVICE ADD 30 MI,214.54
,
"PREV MED, NEW PT < 1 YR",194.42
,
"PREV MED, NEW PT, 1-4 YRS",205.14
,
"PREV MED, NEW PT, 5-11 YR",211.46
,
"PREV MED, NEW PT, 12-17YR",239.9
,
"PREV MED, NEW PT, 18-39YR",232.72
,
"PREV MED, NEW PT, 40-64YR",269.19
,
"PREV MED, NEW PT + 65 YRS",292.07
"PREV MED, EST PT, > 1 YR",174.66
,
"PREV MED, EST PT, 1-4 YRS",186.82
,
"PREV MED, EST PT, 5-11 YR",186.22
,
"PREV MED, EST PT, 12-17YR",204.7
,
"PREV MED, EST PT, 18-39YR",209.26
,
"PREV MED, EST PT, 40-64YR",223.24
,
"PREV MED, EST PT, +65 YRS",239.9
,
FIREMAN'S PHYSICAL,48.2
,
"AUDIT/DAST, 15-30 MIN",70.16
,
"AUDIT/DAST, OVER 30 MIN",136.21
,
HEALTH RISK ASSESSMENT,26.78
,
SHORT LEG CAST,178.28
,
NEBULIZER TX,38.86
,
TRANS CARE MGMT 14 DAY DISCH,200
,
TRANSITIONAL CARE MGMT 7 DAY DISCHARGE,275
,
ADVANCE CARE PLAN 30 MINUTES,85
,
ADVANCE CARE PLAN ADDITIONAL 30 MIN,75
,
APPLICAT LONG LEG SPLINT,178.36
,
APPLIC SHORT LEG SPLINT,159.66
,
KNEE STRAPPING,63.08
,
STRAPPING ANKLE &/OR FOOT,57.18
,
NURSING HOME/EMPLOY EXAM,58.92
,
SPORT PHYSICAL-EST PT,15
,
DOT EXAM,123.6
,
SPORTS PHYSICAL-NEW PT,15
,
DAYCARE PHYSICAL,25
,
DUAL ELIGIBLE T CHARGE,0.01
,
EMC MEDICAID RHC VISIT,0
,
ADMIN FLU VIRUS VACCINE,18
,
EMC MEDICARE OFFICE VISIT,0
,
EMC MEDICARE PREV VISIT,0
,
FINE NEEDLE ASP W/O IMAGING,297
,
I&D ABSC; SMPLE OR SGL,252.34
,
I&D ABSC; COMP OR MULTIPL,445.15
,
OBTAINING PAP SMEAR,97.55
"CA SCRNING, PELV & BRST E",83.72
,
"INC & REM FB, AQ; SMPL",317.08
,
"INC & REM FB, SQ; COMPL",588.34
,
PUNCT ASP - ABSC HEMAT CY,272.09
,
"REM FB, INTRANASAL; OFFIC",397.99
,
"BLOOD OCCULT TEST, COLORE",14.88
,
WELCOME MEDICARE VISIT,351.09
,
PPPS INITIAL VISIT,373.61
,
PPPS SUBSEQ VISIT,249.73
,
ANNUAL DEPRESSION SCREENI,30.27
,
HEMOGLOBIN,19.82
,
CHRONIC CARE 20 MIN,63
,
INJ SGL TENDON SHTH OR LI,130.29
,
TPI (S) - 1/2 MUSCLE(S),121.33
,
TPI(S) - 3/>MUSCLE(S),137.5
,
DRAIN/INJECT SM JNT/BURSA,104.08
,
DRAIN/INJ INTERM JNT/BURS,109.09
,
DRAIN/INJ MAJOR JNT/BURSA,130.19
,
ASPIRATE/INJ GANGLION CYS,132.9
,
"THER/PROPH/DIAG INJ, SC/I",53.77
,
CONTROL NASAL HEMORRH. AN,205.6
,
CONTROL NASAL HEMORRH. AN,457.68
,
BACK TO SCHOOL PHYSICAL,15
,
DEB SUBQ TISSUE 20 SQ CM/,244.23
,
PARE BENIGN LES; SGL,111.55
,
"TRIM SKIN LESIONS, 2-4",125.83
,
"TRIM SKIN LESIONS, OVER 4",142.01
,
"BX-SKIN, SQ/MM; SGL",220.32
,
REM SKIN TAGS; TO 15,192.6
,
REMOVE SKIN TAGS ADD-ON,43.02
,
"SHAVE LES, T/A/L; 0.5CM/<",200.31
,
"SHAVE LES, T/A/L; 0.6-1.0",246.38
,
"SHAVE LES, T/A/L; 1.1-2.0",290.3
,
"SHAVE LES,T/A/L;> 2.0CM",321.36
,
"SHAVE LES, S/N/H/F/G;0.5C",204.6
"SHAVE LES,S/N/H/F/G;0.6-1",251.73
,
"SHAVE LES, S/N/H/F/G;1.1-",296.72
,
"SHAVE LES, S/N/H/F/G;>2.0",324.14
,
"SHAVE LES, F/E/N/L;0.5CM/",234.59
,
"SHAVE LES,F/E/N/L;0.6-1.0",242.74
,
"SHAVE LES, F/E/N/L 1.1-2.",331
,
"SHAVE LES, F/E/N/L;>2.0CM",396.45
,
EXC TR-EXT B9+MARG 0.5 <,269.38
,
"EXC, BEN LES,T/A/L; 0.6-1",316.48
,
"EXC, BEN LES T/A/L; 1.1-2",352.17
,
"EXC, BEN LES, T/A/L;2.1-3",406.2
,
"EXC, BLES,S/N/EX,G;0.5CM/",269.32
,
"EXC, BLES, S/N/EX,G;0.6-1",334.08
,
"EXC, BLS,S/N/EX, G;1.1-2.",373.49
,
"EXC, BLES, S/N/EX,G;2.1-3",430.37
,
"EXC, BLES, S/N/EX,G;3.1-4",497.65
,
EXC FACE-MM B9+MARG 0.5<,295.96
,
EXC FACE-MM B9+MARG 0.6-1,357.64
,
EXC FACE-MM B9+MARG 1.1-2,401.41
,
"INTUB, ENDOTRACHEAL PROC",253.79
,
CHANGE OF WINDPIPE AIRWAY,85
,
"EXC MLES, T/A/L;0.5CM/<",417.96
,
"EXC MLES,T/A/L;0.6-1.0CM",485.92
,
EXC MLES T/A/L;1.1-2.0CM,528.12
,
"EXC MLES, T/A/L;2.1-3.0CM",604.74
,
EXC TREAT EXT MAL +MARG 3.1-4CM,650
,
"EXC MLES, S/N/EXT/G; 0.5C",412.39
,
"EXC MLES,S/N/EXT/G;0.6-1.",489.38
,
"EXC MLES, S/N/EXT/G;1.1-2",546.85
,
"EXC MLES, S/N/EXT/G;2.1-3",643.34
,
"EXC MLES, F/E/E/N/L;0.5CM",425.98
,
"EXC MLES,F/E/E/N/L;0.6-1.",506.87
,
"EXC MLES, F/E/E/N/L;1.1-2",579.91
,
INSERT BLADDER CATHETER,117.09
,
AVULSION NAIL PLATE PARTIAL/COMPLETE,213.43
DRAIN BLOOD FROM UNDER NAIL,105.72
,
EXCISION NAIL PERMANENT REMOVAL,387.31
,
WEDGE EXC NAIL FOLD,358.85
,
INJECTION INTO SKIN LESIO,121.53
,
SIMPLE LAC REP 0-2.5CM,190.21
,
SIMPLE LAC REP 2.6-7.5 CM,232.17
,
SIMPLE LAC 7.6-A12.5CM,273.85
,
SIMPLE LAC 12..6-20.0CM,346.08
,
SIMPLE LAC 20.1-30.0CM,410.31
,
SIMPLE LAC 30.1 CM & OVER,478.84
,
SIMPLE FACE LAC 0-2.5CM,233.07
,
SIMPLE FACE LAC 2.6-5.0CM,244.06
,
SIMPLE FACE LAC 5.1-7.5CM,286.13
,
SIMPLE FACE LAC 7.6-12.5C,346.91
,
LAYERED LAC 0-2.5CM,504.59
,
LAYERED LAC 2.6-7.5CM,645.98
,
INTMD REPAIR EXT 7.6-12.5,750
,
"LAY NCK,HN,FT LAC 0-2.5",505.44
,
"LAY NK,HND,FT LAC 2.6-7.5",617.34
,
"LAY NK, HD,FT LAC 20.1&UP","1,009.94"
,
LAY CLOS FACE LAC 0-2.5CM,551.68
,
LAY CLOS FACE LAC 2.6-5.0,629.55
,
OCCULT BLD FECES 1-3 TESTS,14.88
,
TREAT METACARPAL FRACTURE,638.94
,
STRAPPING; THORAX,64.9
,
CPR,659.36
,
CARDIOVERSION,444.67
,
"DIL URETH STRICT, SOUND;M",181.71
,
"DILATE URETHR STRICTR, SU",175.53
,
TREAT SHOULDER DISLOCATIO,678.07
,
"CL TX SHLDR DISL, W/MANIP",866.22
,
DILATE FEMALE URETHRA; IN,151.52
,
DILATE FEMALE URETHRA; FU,148.7
,
REDUCTIONA OF REDIAL SUBL,297.76
,
ALLERGY SINGLE INJECTION,22.51
ALLGERY TWO OR MORE INJEC,27.85
,
"REM FB, CONJUNCTIVA; SUPE",123.5
,
"REM FB, EXT EYE; CORNEAL,",127.01
,
REM B CORNL W/SLIP LAMP,144.8
,
DRAIN FINGER ABSC; SIMPLE,562.25
,
REMOVE IMPACTED EAR WAX-BILATERAL,52.5
,
REMOVE IMPACTED EAR WAX-BILATERAL,231
,
DESTRUCT PREMALG LESION,142.24
,
"DESTRUCT PREMLG LES, 2-1",21.42
,
"DESTRUCT B9 LESION, 1-14",235.59
,
"DESTRUCT LESION, 15 OR MO",279.54
,
CHEM CAUT GRANULATION TIS,172.13
,
DESTR MLES T/A/L; 0.5 CM/,202.83
,
DESTR MLES T/A/L; 0.6-1.0,305.93
,
DESTR MLES T/A/L; 1.1-2.0,373.38
,
DESTR MLES T/A/L; 2.1-3.0,408.26
,
DESTR MLES S/N/H/F/G; 0.6 - 1,348.09
,
DESTRUCTION MALIGNANT LESION F/E/E/N/L/M,300.01
,
DESTR MLES F/E/E/N/L/MM;,379.83
,
DESTR MLES F/E/E/N/L/MM;,437.21
,
DESTR MLES F/E/E/N/L/MM;,524.15
,
CLOSED TR MEDIAL MALL FRACTURE W/O MANIP,700
,
,
CLOSED FRACTURE REDUCTION,675.45
,
CORONER'S CALL LEVEL 1,240.7
,
CORONER'S CALL LEV 2,361.05
,
CORONER'S CALL LEEL 3,481.4
,
REMOVAL-FB-FOOT-SBCUTA,561.1
,
INSERTION INTRAUTERINE DEVICE IUD,175
,
REMOVAL INTRAUTERINE DEVICE IUD,215
,
OMT AREA 1-2,61.68
,
OMT AREA 3-4,82.16
,
OMT AREA 5-6,120.86
,
FOLLOW UP VISIT,0
,
LONG AREM SLPINT MOLDED,190.1
SHORT AREM SPLINT,141.88
,
APPLY FINGER SPLINT; STAT,89.93
,
REM FB EXT AUDITORY CANAL,212.88
,
NEW PT OFFICE VISIT LVL 1,82.38
,
NEW PT OFFICE VISIT LVL 2,142.63
,
NEW PT OFFICE VISIT LVL 3,205.24
,
NEW PT CLINIC VISIT LVL 4,316
,
NEW PT CLINIC VISIT LVL 5,394.56
,
REMOVE IMPACTED EAR WAX UNI,26.33
,
REMOVAL IMPACTED CERUMEN,115.59
,
EST PT CLINIC VISIT LVL 1,39.74
,
EST PT CLINIC VISIT LVL 2,83.07
,
EST PT CLINIC VISIT LVL 3,138.72
,
EST PT CLINIC VISIT LVL 4,206.1
,
EST PT CLINIC VISIT LVL 5,277.44
,
DISCH FROM OBSERVATION,158.72
,
INITIAL OBS/DAY LVL 1,214.83
,
INITIAL OBS/DAY LVL 2,294.95
,
INITIAL OBS/DAY LVL 3,404.54
,
INPATIENT E/M INIT LVL 1,221.44
,
INPT E/M INIT LEVEL 2,300.53
,
INPT E/M INIT LEVEL 3,442.63
,
"SUBS OBSERV, LEVEL 1",87.76
,
"SUBS OBSERV, LEVEL 2",160.09
,
"SUBS OBSERV, LEVEL 3",229.74
,
INPT E/M SUBS LEVEL 1,86.65
,
INPT E/M SUBS LVL 2,159.01
,
INPT E/M SUBS LEVEL 3,227.92
,
OBSERV/HOSP SAME DATE,300.58
,
OBSERV/HOSP SAME DATE,373.94
,
OBSERV/HOSP SAME DATE,480.47
,
INPT E/M DISCH MGMT,158.35
,
DISCHARGE MGMT + 30 MIN,233.88
,
STRAPPING; SHOULDER,63.43
,
STRAPPING; ELBOW OR WRIST,63.49
"NURSING FAC CARE, INIT LO",202.09
,
"NURSING FAC CARE,INIT MED",285.75
,
"NURSING FAC CARE, INIT HI",363.94
,
"NURSING FAC CARE, SUBS ME",96.47
,
NURSING FAC CARE SUBSEQ,149.26
,
"NURSING FAC CARE, SUBSEQ",196.84
,
"NURSING FAC CARE, SUBSEQ",292.23
,
SNF DISCHARGE < 30 MIN,157.99
,
SNF DISCHARGE >30 MIN,227.69
,
"HOME VISIT, EST PATIENT",123.08
,
PROLONGED SERVICE,219.78
,
PROLONG SERVICE ADD 30 MI,214.54
,
"PREV MED, NEW PT < 1YR",194.42
,
"PREV MED, NEW PT, 1-4 YRS",205.14
,
"PREV MED, NEW PT, 5-11 YR",211.46
,
"PREV MED, NEW PT, 12-17 Y",239.9
,
"PREV MED, NEW PT, 18-39 Y",232.72
,
"PREV MED, NEW PT, 40-64 Y",269.19
,
"PREV MED, NEW PT+65 YRS",292.07
,
"PREV MED, EST PT, < 1YR",174.66
,
"PREV MED, EST PT, 1-4 YRS",186.82
,
"PREV MED, EST PT, 5-11 YR",186.22
,
"PREV MED, EST PT, 12-17 Y",204.7
,
"PREV MED, EST PT, 18-39YR",209.26
,
"PREV MED, EST PT, 40-64YR",223.24
,
"PREV MED, EST PT, +65YRS",239.9
,
FIREMAN'S PHYSICAL,48.2
,
BEHAV CHNG SMOKING 3-10 M,30.94
,
BEHAV CHNG SMOKING > 10 M,60.25
,
"AUDIT/DAST, 15-30 MIN",70.16
,
"AUDIT/DAST, OVER 30 MIN",136.21
,
HEALTH RISK ASSESSMENT,25.75
,
SHORT LEG CAST,178.28
,
NEBULIZER TX,39.94
,
TRANS CARE MGMT 14 DAY DISCH,200
TRANS CARE MGMT 7 DAY DISCH,275
,
ADVANCE CARE PLAN 30 MINUTES,85
,
ADVANCE CARE PLAN ADDITIONAL 30 MIN,75
,
APPLICAT LONG LEG SPLINT,178.36
,
APPLIC SHORT LEG SPLINT,159.66
,
KNEE STRAPPING,63.08
,
STRAPPING ANKLE &/OR FOOT,57.18
,
NURSING HOME/ EMPLOY EXAM,58.92
,
SPORT PHSICAL-EST PT,15
,
DOT EXAM,123.6
,
SPORTS PHYSICAL-NEW PT,15
,
DAYCARE PHYSICAL,25
,
EMC MEDICAID RHC VISIT,0
,
ADACEL SYRINGE 5 X 0.5ML,60.18
,
"HIB PRP-T, ACTHIB, IM",20
,
ALBUTEROL NON-COMP UNIT 1,2.41
,
NITROGLYCERIN SUBLINGUAL 0.4MG TAB,5
,
CEFTRIAXONE 1 GM VIAL,33.99
,
COMPAZINE INJ UP TO 10 MG,15.05
,
DEPO T INJECTION,0.11
,
DECAVAC VACCINE SYR 10X.0,102.58
,
DIPHENHYDAMINE 50 MG,26.49
,
DEPOMEDRAL 80MG,42.3
,
DEPO-MEDROL 40MG/ML VIAL,29.1
,
DIAZEPAM 10MG/2ML SYRINGE,25.5
,
"VFC HEP A PEDS, HAVRIX, IM",0
,
VFC HEP-B,0
,
"MENINGITIS B, TRUMENBA, IM",181.15
,
EPINEPHRINE AMP1:1000,1.61
,
"ADULT HEP A VACCINE, HAVRIX, IM",90.87
,
"HEP A VACCINE PEDS, HAVRIX, IM",90.87
,
"IM 4 DOSE HIB, PRP-T",47.5
,
FUROSEMIDE 40 MG VIAL,16.25
,
FLU VAC NO PRSV 3 VAL 6-35 M,25
,
"FLU VACCINE, 3 YRS & >",25
"FLU VAC HIGH DOSE, FLUZONE, IM",82.5
,
"PNEUMOCOCCAL VACCINE 13, PREVNAR, IM",315
,
PNEUMOCOCCAL 23 VACCINE,444.35
,
VFC FLU VACCINE 4 VALENT NASAL,0
,
"ROTOVIRUS VACC, ROTATEQ, PO",133.9
,
"FLU VAC QUAD 6-35 M, FLUZONE, IM",25
,
"FLU VACCINE QUAD, FLUZONE/FLULAVAL, IM",25
,
"DTAP AND IPV 4-6 YRS, KINRIX, IM",73.11
,
"DTAP VACCINE,DAPTACEL, IM",40
,
"MMR VACCINE, SQ",88.91
,
"POLIOVIRUS, IPOL, SC/IM",50.3
,
"LIVE VARICELLA VACCINE, VARIVAX, SQ",160.5
,
"TD VACCINE, IM",33.55
,
"DTAP-HEPB-IPV, PEDIARIX, IM",130.42
,
"PNEUMOCOCCAL VACCINE 23, PNEUMOVAX, IM",275
,
SQ MPV VACCINE,180.71
,
"MENACWY VACCINE, MENACTRA, IM",125.5
,
IM 3D PEDI/ADOL HEP-B VAC,32.14
,
"HPV IMMUNIZATION, GARDASIL, IM",259.5
,
"HEP B ADULT, ENGERIX, IM",101.6
,
HYDROXYZINE 25MG,11.42
,
"HEP A VACCINE ADULT, HAVRIX, IM",90.87
,
KENALOG 40 MG VIAL,16.7
,
LIDOCAINE 2% 1.5CC,5
,
NORFLEX 60MG,63.56
,
PHENERGAN 25 MG,8.75
,
PEDIARIX,130.42
,
REGLAN 10ML,22.94
,
ROCEPHIN INJECTION PER 25,28.01
,
SOLUMEDROL 40 MG,19.16
,
SOLUMEDROL 125MG,25.21
,
SILVADENE 50 GM,12.52
,
KETOROLAC 30 MG VIAL,6.56
,
KETOROLAC 60 MG IM,8.45
,
"VANCOMYCIN HCL, 500 MG IN",29.6
VITAMIN B-12,11.98
,
LEVALBUTEROL 0.5 MG,9.2
,
SILVER NITRATE APPLICATOR,4.38
,
DEXTROSE 50% SYRINGE,12.65
,
EPINEPHRINE 0.1MG/ML SYRINGE,6.86
,
ATROPINE 1MG/10ML SYRINGE,7.96
,
CALCIUM CHLORIDE 10% SYRINGE,15.74
,
LIDOCAINE 2% SYRINGE,6.76
,
EPINEPHRINE 1MG/ML AMPULE,2.4
,
NALOXONE 0.4MG/ML VIAL,24.28
,
OXYTOCIN 10UNITS/ML VIAL,0.92
,
AMMONIA INHALANT AMPULE,0.52
,
NIFEDIPINE 10MG TABLET,2
,
METOPROLOL TART 5MG/5ML VIAL,1
,
SODIUM CHLORIDE 1000ML BAG,3.32
,
INDOMETHACIN 25 MG CAPSULE,1
,
DIAZEPAM 10MG/2ML CARPUJECT,43.16
,
XYLOCAINE 1% VIAL,0
,
XYLOCAINE 1% WITH EPI VIAL,0
,
XYLOCAINE 2% VIAL,0
,
XYLOCAINE 2% WITH EPI VIAL,0
,
MARCAINE 0.25% VIAL,0
,
MARCAINE 0.5% VIAL,0
,
ACTIVATED CHARCOAL 25 GM,29.08
,
ASPIRIN 81 MG CHEWABLE,1.25
,
BENZOIN TINCTURE SWAB,0
,
GENTIAN VIOLET,0
,
EMLA CREAM,0
,
PHENYLEPHRINE 1% NASAL SPRAY,7.84
,
ETHYL CHLORIDE WOUND SPRAY,0
,
MAG-AL SUSPENSION 30 ML,2.75
,
LEVALBUTEROL 1.25MG/0.5ML,3.28
,
IPRATROPIUM/ALBUTEROL SVN,1.25
,
EPINEPHRINE AUTO-INJECTOR ADULT,262.4
,
EPINEPHRINE AUTO-INJECTOR PEDS,262.4
GLUCOSE GEL,0
,
TRIPLE ANTIBIOTIC OINT PACK,0
,
ONDANSETRON 4MG/2ML,2.25
,
TB TEST TUBERSOL,8.75
,
SODIUM BICARB 8.4%,16.5
,
OXYMETAZOLINE 0.05% NASAL SPRAY EMC,19
,
"VFC ROTAVIRUS, ROTARIX, PO",0
,
"VFCHIB, ACTHIB, IM",0
,
"VFC TD, TETANUS, IM",0
,
"VFC HPV, GARDASIL-9, IM",0
,
"VFC FLU VAC QUAD 6-35 M, FLUZONE, IM",0
,
"VFC FLU VACCINE QUAD, FLUZONE, IM",0
,
VFC INFLUENZA,0
,
"VFC DTAP, DAPTACEL, IM",0
,
"VFC VARICELLA LIVE, VARIVAX, SQ",0
,
"VFC POLIO, IPOL, SC/IM",0
,
"VFC DTAP-HEPB-IPV, PEDIARIX, IM",0
,
"VFC PNEUMONIA 13 VACCINE, PREVNAR, IM",0
,
"VFC TDAP, ADACEL, IM",0
,
"VFC MMR, SQ",0
,
"VFC MENIGOCOCCOL, MENACTRA, IM",0
,
"VFC- DTAP IPV VACCINE 4-6 YRS, KINRIX IM",0
,
VFC- MMRV VACCINE SC,0
,
"VFC HIB, PEDVAXHIB, IM",0
,
"VFC MENINGITIS B, TRUMENBA, IM",0
,
"FLU VAC HD, FLUZONE HD, IM, MEDICARE",0
,
"FLU VAC QUAD, FLUZONE, IM, MEDICARE",0
,
"VFC ROTOVIRUS, ROTATEQ, PO",0
,
VFC ADMIN FEE,19.68
,
DERMABOND,25.42
,
3-0 663G ETHILON SUTURE,5.77
,
LACERATION TRAY,4.56
,
WOUND WASH SALINE,5.69
,
SMALL VOLUME NEBULIZER,2.45
,
"COBAN 4""",7.13
"KLING 4""-STERILE",2.41
,
MEPILEX BORDER 4X4,9.76
,
UNNA BOOT,18.9
,
,
,
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